Liiska daawooyinka antiarrhythmic iyo kala soocidda

Ku dhawaad dhammaan bukaanada la kulmay jidka wadnaha ama mid kale la noocyada kala duwan ee garaaca. Currently, warshadaha ioyo waxay bixisaa noocyo kala duwan oo wakiilada antiarrhythmic. Ay kala soocidda iyo sifooyinka looga hadlay this article.

wadada-gaadhista

Si loo xalliyo garaaca wadnaha ectopic, wakiilada antiarrhythmic loo qoondeeyay. hab ay of tallaabo daroogada sida loogu talagalay ka shaqeeya guryaha myocardial elektarooniga ah ee unugyada,

• Yaraynta xawaaraha iman kara talaabada, oon hoos u tabinta of excitation.
• Hoos u dhaca excitability ee myocardium ah.
• Yaraynta markii madax adkaadeen qaraabada, taasoo keentay in yaraynta of bareeg ah, Toonsaadaan aan caadi ahayn keeni karaan foosha wadnaha.
• Muruqa muddo madax adkaadeen wax ku ool ah, taas oo muhiim ah marka tachycardias iyo baabi'inta karsado kaas oo ka dhici waqti aad u yar ka dib markii hoos u mug leh ka dib.
• Heerka Capacity of excitation in kor homogenization iyo ka hortagtaa arrin ku dib u soo gelida ( «dib u soo gelida").
• Iscelin of qolkii automatism ectopic in xiran yahay la kordhiyo muddada ee depolarization diastolic.
• Baabi'inta kala duwan ee heerka of excitation iyo tilmaamayaasha refractivity.
• Dhimay dareenka wadnaha in dheecaan korontada iyo halista ah ee aamba ventricular.

Qoondaynta oo ah daawooyinka antiarrhythmic

Dhammaan daawooyinka ee kooxdan loo qaybiyay afar fasal. Intaa waxaa dheer, fasalka koowaad waxaa la sii kala qaybiyey saddex Banii-. kala soocidda Tani waxay ku salaysan tahay heerka uu gaarsiisan yahay saameynta daawada on awoodda unugyada wadnaha si ay u fuliyaan ah wax soo saarka iyo tabinta ee signallo koronto. fasalada kala duwan ee daroogada antiarrhythmic leeyihiin wadooyinka ee feydnaanta, sidaa darteed in noocyada kala duwan ee garaaca waxtarkooda noqon doonaa kala duwan.

fasalka ugu horeeya ee ka mid ah blockers channel sodium si dhakhso ah. class IA waxaa ka mid ah daawooyin sida "quinidine" "Dizopiramid", "novokainamid", "Giluritmal". By subclass IB daboolayaa "Piromekain", "tocainide", "Difenin" "Lidocaine", "aprindine", "Trimekain", "Mexiletine." Subclass IC sameynta qalabka sida "Etmozin", "Ritmonorm" ( "Propafenone"), "VFS" "Etatsizin", "Flecainide", "Indekainid", "Bonnekor", "Lorkainid".

fasalka labaad waxay ka kooban tahay beta-blockers ( "metoprolol", "nadolol," "alprenolol," "Kordanum", "Propranolol", "acebutolol", "Pindolol", "Trazikor", "Esmolol").

fasalka saddexaad ka mid ah blockers channel potassium "tosylate bretylium", "Amiodarone", "Sotalol".

fasalka afraad ka mid ah blockers calcium channel gaabis ah (tus, "Verapamil").

Liiska daawooyinka anti-arrhythmic ma waxaa loo soo afjaro. Bixinta kale oo uu leeyahay glycosides wadnaha, chloride potassium, triphosphate sodium, magnesium sulfate.

Daawada Class First

blockers Sodium channel bixinta si degdeg ah waxaa la joojiyay in gacanta of sodium, kaas oo keena dhimaal ee marinka ee Milanello excitation myocardium ah. Iyada oo ay taasi jaray xaaladaha wareegga deg deg qalbiga calaamadaha cudur, iyo arrhythmia sii socoto. Ha ka fikiro si aynu kooxda ka mid ah daroogada antiarrhythmic tirsan fasalka ugu horeysay.

Daawada Class IA

daroogada Antiarrhythmic sida magacaabay at extrasystole (ventricular iyo supraventricular) iyo in la soo celiyo dhaqdhaqaaqa sanka lacala wadne (wadne). Intaa waxaa dheer, waxay ku waxaa loo isticmaalaa si looga hortago weerarrada soo noqnoqday.

"Procainamide" iyo "quinidine" - daroogada antiarrhythmic wax ku ool ah oo la tachycardia. Waxaan kuu sheegi doonaa dheeraad ah oo ku saabsan.

"Quinidine"

daawada waxaa loo isticmaalaa in ay dhacdo paroxysmal tachycardia supraventricular, iyo sidoo kale in paroxysms ee wadne in laxanka sanka. Inta badan, dawada maamulo qaab kiniin.

Sunta daroogada antiarrhythmic dhif dhacaya, laakiin markii la helo "Quinidine" waxyeellooyinka suurtagalka ah sida rabshooyin dheefshiidka (matag, shuban), iyo madax xanuun. Intaas waxaa sii dheer, isticmaalka daroogada waa ay awoodaan in ay keeni hoos u dhac in heerarka dhiig xinjirowga dhiigga, intracardiac gaabis tabinta, yaraynta contractility myocardial. The ugu halista badan dhinaca saamayn - horumarinta tachycardia ventricular, foom u gaar ah, kaas oo sababi kara dhimasho degdeg ah bukaanka. Taasi waa sababta daaweynta "quinidine" Waa in la fuliyo oo keliya gacanta ugu ECG iyo iyada oo ay kormeerayaan dhakhtar takhasus u leh.

Daawada waa u in block intraventricular iyo atrioventricular, sarkhaan glycoside wadnaha, Torombositobiiniya, hypotension, gabsiiya wadnaha, uurka.

"Procainamide"

daroogada waxa uu ku tilmaamo mid ah in loo isticmaalo sida "quinidine". Marar badan waxaa lagu qoray, waayo, ujeedada gargaarka ee wadne paroxysmal. Marka la isku duro xididka "novokainamid" hoos u af badan ee suurtogalka ah ee dhiig-karka sidaas darteed waxaa lagama maarmaan ah inay soo bandhigto xalka ahaa si tartiib ah ugu badnaan.

Ka mid ah waxyeelo kala lallabo, matag, isbeddel ah ee dhiigga, cudurada of habka dareemayaasha jirka oo ah qaab-wareer, madax-xanuun, marmar dhif ah, wareer. Haddii isticmaalka joogta ah daroogada, waxa dhici karta in lupus-sida syndrome (serozity, arthritis, qandho), cudurka microbial in saabka afka, Ulasocto boogaha bogsiinta gaabis iyo boogaha iyo dhiig ciridka. Intaa waxaa dheer, "novokainamid" cadhaysiinina karaa dareen xaasaasi ah, haddii ay taasi ku noqon doonaa calaamadaha ugu horreeya ee dhacdo of tabar-dari muruq in maamulka daroogada.

Codso daawada waa ka mamnuuc marka block atrioventricular, kelyaha iyo wadnaha oo aad u daran failure, hypotension iyo shoog cardiogenic.

class IB

daawooyinka noocan oo kale ah waxay leeyihiin saameyn yar ku Guntin Dalqada wadnaha, xidhiidhka ka atrioventricular iyo Atrium, sidaas ugasii kiiska baarutaan supraventricular. Loo magacaabay by daroogada xogta antiarrhythmic la arrhythmia, tachycardia paroxysmal, ie, waayo, daaweynta ee garaaca ventricular. Waxaa sidoo kale loo isticmaalaa in lagu daaweeyo garaaca, kuwaas oo keena xad dhaafka ah ee glycosides wadnaha.

Liiska daawooyinka antiarrhythmic fasalka this waa arrin ballaaran, laakiin waxay ka dhigan tahay "lidocaine" waxaa inta badan la isticmaalo. Sida caadiga ah, waxaa la maamulo intravenously in kiiska baarutaan ventricular daran in H. t. In Wadnaxanuun myocardial.

"Lidocaine" waa awoodaa inuu carqaladeeyo hawlaha of habka dareemayaasha jirka, kaas oo lagu muujiyey wareer, qallal, dhibaato hadalka iyo aragga xanuunada miyirka. Haddii aan soo bandhigno daroogada ee qaadasho sare, waxaa laga yaabaa in aad yarayso xaddiga garaaca wadnaha, hoos u contractility wadnaha. Sidoo kale, dareen diidmo oo xasaasiyadeed waxaa laga yaabaa in ay sameeyaan anjioedema, urtikaria, pruritus.

"Lidocaine" waa u in block atrioventricular, bukay sanka syndrome. Daawooyinka aan la tilmaamay in kiiska baarutaan supraventricular daran sababtoo ah khatarta kordhaysa oo ah wadne.

class IC

Daawooyinka ka tirsan class this, kordhin tabinta intracardiac, gaar ahaan nidaamka uu-Purkinje ah. Waxay leeyihiin guryaha arrhythmogenic xoog leh, sidaas oo kalena haatan ay la isticmaalo waxaa xadidan.

Liiska daawooyinka antiarrhythmic of class this ayaa sare lagaa siin, laakiin guud ahaan oo keliya loo isticmaalo "Propafenone" ( "Ritmonorm"). Waxaa la tilmaamay waayo garaaca supraventricular iyo ventricular, ee Vol. H. Under SVC syndrome. Tan iyo markii ay jirto halista ah ee saamaynta arrhythmogenic, daawada waa in la isticmaalaa iyada oo ay kormeerayaan dhakhtar.

Waxa intaa dheer in arrhythmia, daroogada this keeni kartaa horumarka ee wadne joogsi iyo sii xumaanaysa ee contractility wadnaha. Ka mid ah kooxda saamaynta noqon kartaa dhadhan macdan muuqaalka Sharaf ah oo afka, lalabo iyo matag. Waxaa la ma laga saaray saamaynta xun sida, sida aragti cawlan, isbeddel ah ee baaritaanka dhiigga, dawakhaad, hurdo la'aan, niyad-jabka.

Beta-blockers

Marka waxay kordhisaa waa ohyahay ee habdhiska u dabacsanaadaan, tusaale ahaan, in ay dhacdo stress, hypertension, xanuunada autonomic, ischemia, in dhiigga, waxaa jira dad badan oo reer catecholamines, oo ay ku jiraan adrenaline. Waxyaabahani waxay u dhaqmaan on receptors beta-adrenergic ee myocardium ah in keenaysaa in xasilooni korontada wadnaha iyo muuqaalka kore ee garaaca.

Beta-blockers hortago kicinta-dhaafka ah ee receptors, Kuna ilaaliyo myocardium ah. Intaa waxaa dheer, waxay hoos u dhigi excitability oo ka mid ah unugyada ee habka tabinta ah, taas oo horseedaysa in ay garaaca qalbigoodu ka raagay.

Daawooyinka of class this waxaa loo isticmaalaa in lagu daaweeyo flutter xogleh iyo wadne-ka hortagga iyo gargaarka baarutaan supraventricular. Intaa waxaa dheer, waxay kaa caawin karaan in ay ka gudbaan tachycardia sanka.

Waxaa loo tixgeliyaa daroogada antiarrhythmic tarin wadne, marka laga reebo kiisaska cudurada ka waxaa keena xad-dhaaf ah oo wareegaya catecholamines.

"Metoprolol" iyo "Inderal" waxaa inta badan loo isticmaalaa daaweynta garaaca. daawooyinka waxay leeyihiin dhibaatooyin soo raaca sida garaaca wadnaha gaabis, yareeyo contractility myocardial, muuqaalka block atrioventricular. Daawooyinka Kuwani waxay keeni kartaa jirka qabow iyo sii xumaanaysa ee socodka dhiigga durugsan. Intaa waxaa dheer, daawooyinka waxyeela habdhiska neerfayaasha, waxayna keentaa hurdo, dawakhaad, murugada, xusuusta dhantaalan. Waxa kale oo ay isbedelaan conductivity ah neerfayaasha iyo murqaha, kaas oo lagu muujiyey by daal iyo tabar.

Beta-blockers waxaa ka mamnuuc ah la isticmaalayo in si lama filaan ah cardiogenic, barar sambabada, sonkorowga ku tiirsan insuliinka, neefta. Sidoo kale sababo taag block atrioventricular oo ahaa darajadii labaad, bradycardia sanka.

blockers potassium channel

Liiska daawooyinka antiarrhythmic in kooxdan waa hab ka xakamaynayay geedi socodka korontada, Kuna xanibeen channels potassium in unugyada wadnaha. The ugu caansan ee fasalka this of daawo - "Amiodarone" ( "Kordaron"). Waxyaabaha kale, ay u dhaqmo on the receptors M-holino- iyo adrenergic.

"Kordaron" waxaa loo isticmaalaa daaweynta iyo ka hortagga ventricular, wadne garaaca iyo supraventricular, rabshooyin garaaca wadnaha ku saabsan asalka ah SVC syndrome. medicament ayaa sidoo kale maamula si looga hortago garaaca ventricular naf-gooyada ah in bukaanka qaba myocardial ba'an. Intaa waxaa dheer, waxaa loo isticmaalaa si loo yareeyo xaddiga garaaca wadnaha ee wadne-joogta.

Haddii aad isticmaasho qalabka muddo dheer waxaa laga yaabaa in interstitial fibrosis sambabada, isbedelka midabka maqaarka (muuqaalka kore ee cado guduudan). Xaaladaha qaarkood, madax xanuun, seexan xanuunada, xusuusta iyo aragga. Reception "Amiodarone" Waxa laga yaabaa in sababta bradycardia sanka, calool, yalaalugo iyo matag.

Ha qoro dawooyinka ee bradycardia hore, QT dheereyn, xad gudub ku ah tabinta intracardiac, cudurka thyroid, hypotension halbowlaha, uurka, neefta.

blockers Calcium channel gaabis ah

Daawooyinkan waxaa lagu qaado qufulka calcium gaabis hadda, oon ku cadaadiyeen Axdigu u ectopic in atria iyo Guntin Dalqada wadnaha automaticity dhimay. Liiska daawooyinka antiarrhythmic in kooxda waxaa ka mid ah "Verapamil," kaas oo loo xilsaaray ka hortagga iyo gargaarka ee tachycardia supraventricular paroxysmal, therapy arrhythmia supraventricular. "Verapamil" waa natiijo la'aan ay dhacdo baarutaan ventricular.

Dhibaatooyinka ay keento waxaa ka mid ah block atrioventricular, bradycardia sanka, hypotension, iyo mararka qaarkood - yaraynta awoodda contractile waxyaalaha qalbiga ku jira ka.

glycosides wadnaha

Qoondaynta oo ah daawooyinka antiarrhythmic ma noqon doono dhamaystiran oo aan xusuusannaa ah lacagtaas. Waxaa ka mid ah daawooyin sida "Tselanid", "Korglikon", "Digitoxin", "Digoxin" iyo kuwo kale. Waxaa loo isticmaalaa in lagu soo celiyo dhaqdhaqaaqa sanka, tachycardia supraventricular, yaraynta heerka ventricular in ay dhacdo wadne. Marka la isticmaalayo glycosides wadnaha leeyihiin si ay ula socdaan xaaladdaada. Calaamadaha sarkhaan digitalis muujiyey by calool xanuun, lalabo iyo matag, madax xanuun, aragga indhaha oo isku darsamay iyo riyo, dhiigbaxa sanka.

Waa mamnuuc in la codsado, kuwaas oo daroogada antiarrhythmic inta lagu guda jiro bradycardia syndrome ERW Go'doominta intracardiac. Iyagu ma loo magacaabay in ay dhacdo tachycardia ventricular paroxysmal.

antiarrhythmics iskujira

Haddii garaaca ectopic in bukaan eegida, isku darka qaar ka mid ah daawooyinka loo isticmaalo. Sidaas darteed, "Quinidine" waxaa loo isticmaali karaa in lala glycosides wadnaha lagu daweeyo arrhythmia joogto ah. Iyada oo beta-blockers "quinidine" waxa lagu meelaynayaa kartaa gargaarka baarutaan ventricular madax adkaadeen in daaweyn kale. Isticmaalka wadajirka ah ee beta-blockers iyo glycosides wadnaha siinayaa saamayn wanaagsan ee ventricular iyo garaaca supraventricular, sidoo kale waxay ka caawisaa si looga hortago soo noq ee tachycardia ectopic iyo tachyarrhythmia.