Isebenza ngendlela ehlukile, kodwa iyingozi kakhulu
I-Amiodarone (i-Cordarone, i-Pacerone) iphumelela kakhulu, futhi ngokuqinisekile imishanguzo emangalisayo kakhulu, i-antiarrhythm. Uma udokotela wakho efuna ukuthi uthathe lesi sidakamizwa ngenhloso yokuguqula inhliziyo , udinga ukuqonda idiosyncrasies - nezingozi - ezihlobene nayo.
Izici ezingavamile ze-Amiodarone
I-Amiodarone inezici eziningana ezenza kube okuyingqayizivele phakathi kwezidakamizwa ezithathelwanayo - ngisho naphakathi kwezidakamizwa ngokujwayelekile.
Okokuqala, uma kuthathwa umlomo, i-amiodarone ithatha amasonto ukuze iphumelele ukusebenza kwayo, futhi ngesizathu esingavamile kakhulu. Nakuba izidakamizwa eziningi zijikeleza ngegazi isikhathi esithile kuze kube yilapho zihlanganisiwe noma zixhunyiwe, i-amiodarone igcinwa ezithombeni zomzimba. Imiphumela esebenzayo yokulwa nomuthi ayitholakali kuze kube yilapho izicubu zigcwele ngokwanele nge-amiodarone. Ngakho umuthi kufanele "ulayishwe" ngaphambi kokuba usebenze kahle. Umshini ojwayelekile wokulayisha we-amiodarone wawuzoba ukusebenzisa amanani omlomo amakhulu ngesonto noma amabili, bese uthepha umthamo ngenyanga ezayo noma kunjalo. Akuyona into engavamile ukunikeza abantu abangu-1200 noma 1600 mg ngosuku, bese ekugcineni, ukuzilondoloza okungenani 100 noma 200 mg ngosuku (ngomlomo).
I-Amiodarone nayo ingasetshenziswa ngendlela ephathekayo uma ukwelapha i-arrhythmia kuyiphuthumayo, futhi umphumela wayo uyashesha kakhulu ngale ndlela. Kodwa-ke, ukuguqulwa kokungena komlomo kufanele kwenziwe ngokucophelela, ngoba ukusetshenziswa okungapheli lesi sidakamizwa kusadingeka "silayishwe" isikhathi esithile eside.
Okwesibili, i-amiodarone ishiya umzimba kakhulu, kancane kancane. Akunakulinganiswa nesilinganiso esibonakalayo ngesibindi noma izinso. (I-Amiodarone isetshenziselwa ukuxilongwa kwesibindi ku-desethylamiodarone, ene-antiarrhythmic kanye nemiphumela enobuthi njenge-amiodarone, futhi ehlala emzimbeni isikhathi eside kakhulu.) Ngokuyinhloko, ama-amiodarone namatabolite awo asuswa emzimbeni uma Amaseli a-amiodarone alahlekile - afana namaseli esikhumba, noma amangqamuzana avela emaphethweni omzimba, anikezwa yizigidi ngosuku.
Lokhu, kusobala, kuyinkqubo ende, ende.
Ngakho-ke, uma kunqunywa ukuthi kuyadingeka ukumisa i-amiodarone (ngenxa yemiphumela emibi, isibonelo) lesi sidakamizwa sihlala emzimbeni ngokulinganisa okulinganiselwe isikhathi eside ngemuva kokuthatha umthamo wokugcina. "Ukuphila kwengxenye" ye-amiodarone, ngokungafani nezinye izidakamizwa eziningi, kulinganiswa ngamasonto esikhundleni samahora.
Okwesithathu, ngoba i-amiodarone igcinwa ezinhlobonhlobo eziningi ezihlukene emzimbeni, ingaveza imiphumela emibi echaphazela izitho eziningi ezahlukene. Eminye yemiphumela emibi ingathatha izinyanga noma iminyaka ukuthuthukisa, ngakho noma ubani othatha lesi sidakamizwa kufanele ahlale eqaphele imiphumela emisha emibi.
Okwesine, i-amiodarone isebenza ngezindlela eziningi ezahlukene, ngokungafani nezidakamizwa eziningi. Ihambisana nezigaba ezimbili ezihlukene zezidakamizwa zokulwa (i-Class I no-Class III, ngoba kufaneleka). Isebenza njengesibhakela se- beta futhi njenge- blocker ye-calcium . Ihlanza imithwalo yegazi, futhi ivame ukwenza "ukuvimbela" umphumela wehomoni yegciwane. Yonke le miphumela ifaka isandla ekwenzeni kwayo ukuphatha ama-arrhythmias, futhi mhlawumbe i-akhawunti ye-amiodarone esebenza kahle.
Imiphumela Yecala le-Amiodarone
Imiphumela emibi ye-amiodarone ngokuvamile ithatha amasonto noma izinyanga (noma ngisho neminyaka) ukuthuthukisa, ngakho-ke noma ubani othatha lesi sidakamizwa kumele aqaphele uma nje isidakamizwa sisetshenziswa.
Ngaphezu kwalokho, imiphumela emibi ye-amiodarone ivame ukuba yinto engavamile kakhulu ngezidakamizwa ezithathelwanayo - noma kunoma yisiphi isidakamizwa salolu daba. Ngenxa yalesi sizathu, uma i-amiodarone kuqala ukungena emitholampilo, kuthatha okungaphezu kweminyaka eyishumi kudokotela ukuba babone ukuthi eziningi zezibonakaliso ezingavamile ababezibona zibangelwa i-amiodarone. Kuze kube yilolu suku, odokotela ngokuvamile bayehluleka ukuqapha iziguli zabo zithatha i-amiodarone isikhathi eside, futhi ngokuzikhandla ngokwanele, ukubona ukuthi izidakamizwa ziveza izinkinga.
Nakhu eminye yemiphumela emibi kakhulu engabonakala nge-amiodarone:
- I-Amiodarone ngokuvamile ibangele ukufaka ama-deposit ekwenzeni i-cornea yamehlo, okuvame ukuholela "kumbono we-halo-mbono," lapho ubuka khona izibani ezikhanyayo ebusuku kufana nokubuka inyanga ngobusuku obunzima.
- I-Amiodarone ingabangela ukungcoliswa okukhulu kwesikhumba (futhi mhlawumbe unomphela) ukukhishwa kwebala elihlaza okwesibhakabhaka, ngokuvamile ezindaweni ezindaweni zokukhanya kwelanga.
- I-Amiodarone ivame ukuqinisa isikhumba ekukhanyeni kwelanga, ngakho-ke ukuvezwa okuncane kungabangela ukushisa kwelanga okungalungile.
- I-Amiodarone ingabangela ukuphazamiseka kwe-thyroid, kokubili i- hypothyroidism (i-thyroid ephansi) ne- hyperthyroidism (i-high high.) Lezi zinkinga ze -roid zivame kakhulu nge-amiodarone, futhi kungaba nzima kakhulu ukuthola futhi ukuphatha. Ngenxa yalesi sizathu, iziguli ezithatha lesi sidakamizwa kufanele zibe nemisebenzi yazo ye-thyroid njalo. Funda kabanzi mayelana ne-amiodarone ne-thyroid.
- I-Amiodarone ingabangela ubuthi besibindi, ngakho-ke ama-enzyme enesibindi kudingeka ahlolwe ngezikhathi ezithile.
- I-Amiodarone ingabangela uhlobo olunzima kakhulu lwe- acid reflux disorder .
- I-side effect eyesabeka kakhulu ye-amiodarone ingukudla kwesifo se-lung. Lokhu kungathatha amafomu amaningana. Kungathatha isimo se-acute lung syndrome eyenza iziguli zigula kakhulu, zidinga ukunakekelwa okukhulu, futhi ngokuvamile ziholela ekufeni. Noma, kungabangela ukungahambi kahle, okuncane kancane, okungaqondakali, "ukuqina" kwamapayipi okubili odokotela nesiguli abangakwazi ukuwabheka kuze kube yilapho umonakalo omkhulu, okungenzeka ungenakuphulukiswa wamaphaphu wenziwa. Funda kabanzi mayelana ne-amiodarone toxicity lung.
I-Amiodarone Kufanele Yisetshenziswe Nini?
Ngenxa yobunzima obuyingqayizivele kanye nezingozi zokusebenzisa i-amiodarone, lesi sidakamizwa kufanele sisetshenziswe kuphela kubantu aba-arrhythmias abasongela ukuphila noma abaphazamisa kakhulu empilweni, futhi kuphela uma kungekho ezinye zokwelapha ezizwakalayo. Naphezu kwezinkinga zayo, Nokho, i-amiodarone iphumelela ngempela, futhi isize ukubuyisela izinkulungwane zabantu ngokukhubaza ama-arrhythmias empilweni evamile.
Izwi elivela
Uma isetshenziswe ngendlela efanele, i-amiodarone ingaba yinzuzo enkulu kubantu abane-arrhythmias enhliziyo enamandla. Kodwa ngenxa yobuthi bayo obunobungozi, ukusetshenziswa kwayo kufanele kube nokulinganiselwe. Noma yimuphi udokotela obeka i-amiodarone ubophe isiguli sakhe ingxoxo ngokucophelela ngezinkinga eziningi ezingase zibe khona nezidakamizwa, futhi kufanele zibophe ekubeni umlingani wesikhathi eside wendoda yabo, ukuqapha ngokucophelela imiphumela emibi, njengoba nje le mithi eyingqayizivele isetshenziswa.
> Imithombo:
> Goldschlager N, Epstein AE, Naccarelli GV, et al. Umhlahlandlela owusizo wabahlengikazi abaphatha iziguli nge-Amiodarone: 2007. I-Heart Rhythm 2007; 4: 1250.
> Vassallo P, iTrohman RG. Ukuchaza i-Amiodarone: Ukubukezwa okusekelwe ebufakazini bezinkomba zomtholampilo. I-JAMA 2007; 298: 1312.