I-Verapamil imithi enamandla esetshenziselwa ukwelapha isifo senhliziyo. Ngenxa yokuthi ihlanza imithwalo yegazi yenhliziyo nomzimba womabili, inezinhlelo eziningi zemitholampilo. Kodwa ngaphezu kokusebenzisa okuningi, umthamo wakho we-verapamil udinga ukuhlolwa ngokucophelela ngoba le mithi ibangela ingozi yobuthi futhi ingaba nemiphumela emibi kakhulu. Isibonelo, ukufaka ngengozi kwethebhulethi eyodwa ngumntwana kungabulala.
Indlela Yokusebenza
I-Verapamil i-blocker yomzila we-calcium (umphikisi) owehlisa ukungena kwe-calcium ions ngokusebenzisa iziteshi ze-L-calcium ezisezintweni zezinhliziyo kanye namaseli abushelelezi obukhulu be-vasculature yangaphakathi.
I-Verapamil inemiphumela eminingi ye-physiologic:
- I-Vasodilation kokubili kwe-coronary (inhliziyo) ne-peripheral arteriesoles ne-arterioles
- Ukunciphisa ukuguquka kwenhliziyo
- Umsebenzi we-sinus node ocindezelekile
- Ukuqhutshwa kwe-nodeventrial node conduction
Ngaphezu kwemiphumela engenhla, i-verapamil iphinde iphazamise amandla omzimba wamangqamuzana enhliziyo, okwandisa ukuthembela kwenhliziyo kuma-carbohydrate kunokuba mahhala ama-acid acids. Ngaphezu kwalokho, i-verapamil ivimbela ukukhiqizwa kwe-pancreatic ye-insulini. Lezi zinguquko ezimbili ezinobuthi zibizwa ngokukhethekile lapho kwenzeka ukwethuka lapho umzimba udinga ama-carbohydrate.
I-Metabolism
I-Verapamil ifakwe kahle ngegciwane lesisu futhi isakaza kabanzi emzimbeni wonke (amaphesenti angu-90 amaprotheni ahlanganisiwe).
Ekuhambeni kokuqala kwe-metabolism, i-verapamil idilizwe yisibindi ibe yi-metabolite esebenzayo. Ukuphila kwengxenye kaVerapamil cishe amahora angu-8.
Ukusetshenziswa kwemitholampilo
Ngenxa yemiphumela yaso kokubili kwenhliziyo nomzimba (isitsha segazi), i-verapamil inezinhlobo eziningi zokusetshenziswa. Nazi ezinye zokusetshenziswa kwe-verapamil:
- I-Angina (ezinzile, engazinzile ne-Prinzmetal)
- I-tachycardia ephezulu
- Isimo sikaRaynaud
- Migraine prophylaxis
- I-Cluster ikhanda le-prophylaxis
- I-hypertension engalindelekile noma engabonakaliyo
I-Verapamil yisidakamizwa se-class-IV esingafani. Ngaphambi kokuba odokotela basebenzise i-verapamil ukuphatha ama-arrhythmias, i-propranolol ne-digoxin yayivame ukusetshenziswa.
Imiphumela emibi nokusebenzisana kwezidakamizwa
Nakuba kungavamile ngaphansi kokuqapha okuqaphile kwe-cardiologist, i-verapamil yobuthi iyisikhathazo ngaso sonke isikhathi. Ngaphezu kwemiphumela yaso emibi, i-verapamil nayo ingasebenzisana nezidakamizwa ezihlukahlukene.
Umphumela omubi kaningi kakhulu we-verapamil ukuqotshwa. Kwamanye abantu, i-verapamil ingabangela isizungu, ukukhanya okukhanyayo, ne-hypotension. Uma kwenzeka ngokweqile, i-verapamil iphazamisa isigqi senhliziyo futhi ingaholela ekulahlekelweni kokuphila.
Nazi ezinye zokuxhumana kwezidakamizwa-izidakamizwa ezenziwe yi-verapamil:
- I-Verapamil isebenzisa nge-beta-blockers, i-nitrate kanye ne-diuretics yomshoshaphansi wegazi ingabangela ukucindezeleka kwegazi ukuthi kuwele phansi ngokweqile (hypotension).
- I-Verapamil ingakhuphula umphumela wama-statins, asetshenziselwa ukwelapha i-cholesterol ephakeme, futhi izitho zomzimba zingabangela i-rhabdomyolysis noma ukuphazamiseka kwemisipha okugaya izinso.
- I-Verapamil isetshenzisiwe nge-enzyme ye-cytochrome P450 nokusetshenziswa okuhambisanayo kwemithi kadokotela njenge-amiodarone (enye i-antiarrhythmic) iphazamisa i-P450 eholele ekutheni i-verapamil yobuthi. Ukwengeza, ijusi le-grapefruit liphinde lithinte uhlelo lwe-P450 futhi lungandisa ama-blood concentapal concentrations.
Sicela ugcine engqondweni ukuthi uma isetshenziswe njengeluleka futhi ngendlela ephephile, i-verapamil ingaba nenzuzo enkulu kulabo abayidinga. Ulwazi olukulesi sihloko aluhloswanga ukuthi ulusabe ukusebenzisa i-verapamil uma ululeka. Kodwa-ke, kufanele uqaphele ngokucophelela iseluleko se-cardiologist yakho ngenkathi usebenzisa lokhu, noma enye imithi, imithi.
Uma wena noma othandekayo uthatha i-verapamil, kubalulekile ukuthi uhlolwe ngokucophelela ngokucacisa i-cardiologist yakho. Yenza ama-aphoyintimenti okuhlola ngokujwayelekile ne-cardiologist yakho futhi qinisekisa ukwazisa udokotela wakho nganoma yiziphi izinguquko emgomweni wezokwelapha okubandakanya noma yikuphi ukusetshenziswa kwemithi ye-herbal.
Ngaphezu kwalokho, uma uzizwa noma yimiphi imiphumela emibi engase ibangelwe i-verapamil njengokudangala noma ukulahlekelwa yesikhashana kokuqonda, shayela usizo oluphuthumayo.
Imithombo:
Lynch, T kanye no-Price, A. "Umphumela we-Cytochrome P450 Metabolism ekuphenduleni kwezidakamizwa, ukusebenzisana, nemiphumela emibi" I- American Family Physician. 2007.
I-Mosby's Drug Reference yezobuchwepheshe bezeMpilo, uMqulu wesibili . Elsevier. 2010.
UTomaszewski CA, uBenowitz NL. Isahluko 40. I-Calcium Channel Antagonists. Ku: Olson KR. ama-eds. Ukushisa nokudlulela kwezidakamizwa, 6e . ENew York, NY: McGraw-Hill; 2012.