The daroogada "Amiodarone": analogues, tilmaamaha, dib u eegista

Heart, sida aad ogtahay, jidhkeenna ugu weyn, laakiin waxa ay inta badan ku guuldareysto. Si loo soo celiyo ay ku shaqaynayaan si caadi ah u isticmaalaan noocyo kala duwan oo daroogo. Mid ka mid ah iyaga ka mid ah waa "Amiodarone". Analogs yihiin wax badan ka qaalisan, sida dibadda soo saaray oo aadan had iyo jeer ku ool ah.

Halabuurka The daroogada iyo qaab

The medicament "Amiodarone", kaas oo dib u eegis ku kala duwan ka kooban ee hal kiniin oo ah 200 mg ah ee firfircoon - hydrochloride amiodarone. diyaarinta la sameeyo dheeraad ah sidii xal, halkaas oo 3 ml waa 5% oo qayb firfircoon.

qayb darran ka kooban hal kaniini waa: istaarijka baradho, microcellulose crystalline, lactose, maltodextrin, primelloza, polyvinylpyrrolidone, milmahayn magnesium.

Kiniinnada daboolay glaze midabka cad la yara, Hoos cream khiyaano. Waxay leeyihiin qaab Valium iyo khuseeya iyo Valium. Sidaa darteed, haddii loo baahdo, waxay si fudud loo qaybin karaa laba qaybood loo siman yahay.

lagu iibiyo kartoonada Drug, halkaas oo hal ama laba finan toban kiniin. Daawada waxaa sidoo kale soo saaray in ka dhalooyinka, polymeric oo caag ah, kaas oo ay leeyihiin 30 ama 100 kiniin.

hab ay pharmacological garoomada daroogada

guryaha Antiarrhythmic iyo antianginal waxaa lagu gartaa "Amiodarone" analogues mararka qaarkood isaga bedeli karaa. Its tallaabo anti-arrhythmic ku salaysan yahay hadda hoos u of udhigo potassium marka sakhiray in unugyada xuub - cardiomyocytes. Waxay keentaa hoos u dhac ku Guntin Dalqada wadnaha kuwaas oo foomamka bradycardia ah.

Isticmaalka daroogada "Amiodarone" ka (kiniiniga) kordhin kartaa dhererka farsamo tabinta wadnaha ah madax adkaadeen. Gudhiyay conductivity ee pathways sare ee bukaanka qaba syndrome daran ee Wolff-Parkinson-White syndrome. Taa baddalkeeda, saamaynta daroogada antianginal lagu dhisay on yaraynta isticmaalka oxygen myocardial iyo yaraynta saameynta uu ku jiraa muruqyada halbowlaha. Ka kooban yahay iodine, taas oo ah in isticmaalka taranta badala content ee hormoonka thyroid, taasoo keentay in heerka of raadka ay ku leeyihiin myocardium waa la dhimay.

"Amiodarone" uu saameyn ku wadareed, iyo saamayn fahmayaan ay codsiga dhacdaa kaliya hal todobaad isticmaalka joogtada ah ee daroogada ka dib, iyo ugu badnaan waxaa soo gaadhay ka dib laba-saddex usbuuc.

Inside nuugo oo ku saabsan 40% ka mid ah la cabbo dose ah, Cmax plasma muuqataa 3-7 saacadood ka dib. Saamaynta waa inay awoodaan inay ku adkaystaan dhowr toddobaad. geeddi socodka dheefshiidka dhacaan inta badan ee beerka, halkaas oo element firfircoon waxaa la aasaasay dezetilamiodaron, taas oo metabolite ugu weyn. Kula noqda bile ku qarisay iyo kaadida, T1 / 2 - ka dib markii dose hal ka mid ah daroogada 3,2-20,7 h, la therapy dheer - ka dib 53 ± 24 saacadood.

Daawo "Amiodarone": muujinaya in loo isticmaalo

Qori daroogada ah ka hortagga iyo daaweynta garaaca, kuwaas oo oonad khatar karaan nolol aadanaha, iyo sidoo kale garaaca ventricular, flutter ventricular in dhaqdhaqaaqa deganayn sidoo kale loo isticmaalaa daroogada "Amiodarone."

Tilmaamayaasha ogolaan in la isticmaalo daroogada la:

• flutter wadne-;
• garaaca supraventricular;
• Wolff-Parkinson-White syndrome,
• dhacdo of tachycardia;
• fibrillyatsionnogo intraventricular karno,
• arrhythmia timi sabab u tahay kaafi wadnaha iyo wadnaha;
• Foomamka chronic cudurka wadnaha,
• Wadnaxanuun myocardial.

"Amiodarone": tilmaamaha loo isticmaalo

Kiniiniga waxaa loogu talagalay maamulka afka 15 daqiiqo cuntada ka dib ka dib.

Inta lagu guda jiro ventricular qiyaasta cudurka aamba taliyo dhakhtar, waa 800-1200 mg maalintii. Waa in la kala qaybiyey 3-4 dhaweyntiisa. Daaweyntu waxay kiiskan socdaa qiyaastii 5-10 maalmood si loo xaqiijiyo xaalad deggan ka mid ah bukaanka la kordhin karaa, iyo heerka loo dhigi karaa in 600-800 mg maalintii. daaweyn Tani degdegga ah, taas oo markii danbe soo baxa in ay ka hortag ah, qiyaas hoose ee content daroogada.

Muddada dayactirka daweynta waa 7-14 maalmood, wakhtiga daroogada qaadashada 200-400 mg. mugga daroogada noocan oo kale ah loo xilsaaray si loo xasiliyo xaalada bukaanka muddo poslereabilitatsionny.

Inta badan daawo "Amiodarone" qoray markii bukaanka waa in isbitaalka, iyo farsamo uu xakamayn kartaa dhakhtarka. Taas ayaa ka dhigaysa waxaa suurto gal ah si loo yareeyo saamaynta dhinaca iyo si gaar ah ula qabsadaan dose of daroogada.

Marka angina cudurka medicament laba jeer isticmaalaan maalin at 200 mg. laba todobaad ka dib, qiyaasta waxaa hoos u dhigay hal mar maalintii. The dose dose hal badnaan waa in aanay ka badan 400 mg oo maalin walba ah - 1200 mg.

In magacaabista kuwan daroogada carruurta waa in la dhasha maskaxda ku haysaa in kiniinka saamayn ilmaha waa ka dhakhso badan qof weyn. Sidaa darteed, qiyaasta waxaa lagu saleeyaa miisaanka ilmaha. Sidaas darteed, mid ka mid kiilo ah oo miisaankeedu yahay waa inuu noqdaa 10 mg ah medicament. dose Tani waa in lagu hayaa mudada daweynta tobankii maalmood ama ilaa xaaladda bukaanka ee soo hagaagtay. Halkan, faahfaahinta this si loo yareeyo saamiga of 5 mg halkii miisaanka jidhka kiilo ee ilmaha. dose dayactir ka hortag ah waxa laga soo qaatay oo ku salaysan mid ka mid kiilo of 2.4 mg ah ee daawada "Amiodarone."

Tilmaamayaasha in daawada laguu qoray in ay isticmaalaan xal ku salaysan qayb firfircoon ee hydrochloride amiodarone in garaaca wadnaha ee daran. Xaaladdan oo kale, daroogada la intravenously maamulo, si tartiib ah lagu mudaa jidhka la walax ah. Si arrintan loo sameeyo, 250 ml oo ah 5% xal glucose 1 ama 2 ayaa waxaa si tartiib tartiib ah isku duro dose daroogada of 5 mg halkii miisaanka jidhka kiilo. Wakhtigan, bukaanka waxaa lagula socdaa taasi oo ka ECG iyo akhrinta cabbirka cadaadiska dhiigga.

waxyeellooyin

daawooyin badan oo qoro "Amidaron" ee dalkeenna. Analogs had iyo jeer ma awoodaan in ay isaga bedelo. Laakiin inkastoo saamaynta wanaagsan ee daroogada on jidhka bini'aadamka, ayaa loo aqoonsaday iyo waxyeellooyinka.

Calaamado xun yihiin inta badan ay sabab u tahay badinta daroogada. Tani waxay xadgudub ku ah nidaamka wadnaha iyo, sida bradycardia, Guntin Dalqada wadnaha shaqo failure, block wadnaha, luminta isuduwidda dhaqdhaqaaqa. Sidoo kale qayb ka mid ah habka neefsashada lagu arkay waajihi fibrosis interstitial pulmonary, pneumonia interstitial, Hamm syndrome - Rich, xabad xanuun, cystic pulmonary, tachypnea, dubaaxin bronchopulmonary. failure cagaarshowga ayaa lagu arkay markii la helo "Amidaron" diyaarinta. Kiniiniga marmar dhif ah keeni cagaarshow, hepatitis, cirrhosis mararka qaarkood.

Haddii la raaci waayo qiyaasta waxay keeni kartaa dheelitir weyn ee hormoonnada thyroid, distireoza iyo hypothyroidism, iyo set oo ah kilo oo dheeraad ah. Iska badinta keeni kartaa in carqalad ah qalab ka la daawado, taasoo keenta raasamaal ee subaga wilka iyo in ardayga. Sidoo kale, waxaa jira midabka a fahmayaan of maqaarka, photosensitivity, urtikaria ama erythema. finan yar oo lagu arkay wejigaaga, alopecia, dermatitis. Dhibaatooyinka ay keento sidoo kale saamaysay shaqo taranka ee ragga. Xaaladahan waxaa jira orchitis, kacsi la'aanta, iyo epididymitis. Torombositobiiniya arrin naadir ah, kelyaha, ama vaskulitis anjioedema.

Sababo isticmaalka

"Amiodarone" (feedback ma ahayn had iyo jeer wanaagsan) waxaa loo doortay si adag si gaar ah. Waxaa jira dad in daroogada this ma caawin ama iyagu ma dareentay gebihaanba ma jirto isbedel ku saabsan xaalada caafimaad, kuwa kale waxay bilaabeen inay caburin ka dib markii aad u codsato, dareemay wadno. In erayada ay, Propafenone waa ay awoodaan in ay carqaladeeyaan habka hormoonada jidhka ee hormoonnada kordhiyo. Sidaa darteed, ka hor inta aysan badeecadan daawooyinka waa ma aha oo kaliya si taxadar leh u akhri tilmaamaha, laakiin sidoo kale lacag bixisid si aad u muujinaya, waxyeelo iyo sababo dareenka.

Sayidka, daroogada waa in aan lagu saleyn haddii ay jirto atrioventricular block fasalka 2-3, ee lama filaan ah cardiogenic, tayroodh. Diyaarinta "Amiodarone" looma isticmaalo in ay dareen sare wakiilka firfircoon iyo iodo. Ban yihiin xadgudubyo halis ah ee tabinta wadnaha iyo dhacdooyin of bradycardia la syncope. Ha isticmaalin daawada xilliga uurka iyo nuujinta. Nuujinta, inta lagu jiro mudada daaweynta daawada waa in ay joojiyaan naasnuujinta.

talooyin gaar ah

Waa in si taxadir leh loo kormeero by dhakhtar daaweynta daweynta daroogada "Amiodarone". Tilmaamaha loogu isticmaalo talinaysaa in aad isticmaasho kiniin ka dib markii baadhitaan X-ray beerka, sambabada iyo wadnaha ah. socodka noocan oo kale ah waa in la fuliyaa ee mustaqbalka, haddii bukaanku sii inaad qaadato daawada.

Darnaanta dhacdooyinkan gurracan ee inta badan ku xiran qiyaasta, oo wuxuu isticmaalaa bukaanka. Waa inay ku dadaalaan si ay u isticmaalaan daroogada sida qabsiyada badan ee suurtogalka ah iyo tiro yar. Inta badan sababa la joojiyo garaac aan caadi ahayn "Amiodarone" daroogada.

Tilmaamaha loogu isticmaalo - dib u eegista ay sheegayaan in, in kasta oo ay waxyeelo ka, daroogada this ayaa badbaadiyey in ka badan hal nolol - ayaa sheegay in tallaabada pharmacological daroogada la hayo muddo laba toddobaad oo kale ka dib markii ay la joojiyo.

Kiniiniyada ka kooban iodine, kaas oo ku kordhinaya Heerka raasamaal ee radioiodine ee qanjirka thyroid. Sidaa darteed, bilowga ah ee daaweynta ku-daweynta, inta lagu guda jiro iyo marka uu dhamaado waxaad u baahan tahay in si joogto ah loo baaraa xaddiga hormoonnada thyroid.

Inta lagu guda jiro qabashada daweynta loo baahan yahay si looga fogaado in qorax dheer, waxaa lagama maarmaan ma aha in ay qaataan qorraxda u furan. Daawada waa in loo maamulo si taxadir leh in ay dadka waayeelka ah la suuxinta guud ama inta lagu guda jiro daawaynta oxygen ah. Si taxadir leh waa in ay isticmaalaan Darawaliinta Gaadiidka iyo dadka kuwaas oo xirfad waxa uu la xidhiidhaa fiirsashada gaar ah.

Xaaladaha ah qiyaasta xad dhaafka la kulmi karaan sii xumaanaysa ee waxyeelo, iyo sidoo kale hypotension, arrhythmia. laga yaabaa inuu dhaco bradycardia ama failure of tabinta AV. badin An keeni karta in cillad beerka.

Xaaladdan oo kale, waxaan ku talinaynaa lavage gastric degdeg ah, diiwaanka dhuxusha firfircoonaan, caloosha jilciya biyaha cusbada lagu talinayaa in xal. Haddii irbado bradycardia of atropine, agonister adeegsaday receptors beta-adrenergic, soo saaray laso-.

Xiriirka daawooyin kale

Taxadarka waa in la isticmaalaa daroogada isku mar la daroogo kale, gaar ahaan haddii ay yihiin oo isku mid ah antiarrhythmic. Ma loo baahan yahay in waxa lagu biiriyo soo dhaweynta "erythromycin" ah, "pentamidine" iyo "vincamine." Waxaa jira halis of tachycardia ventricular polymorphic isku dhafan oo "sultopride". Waxaa laguma talinayo in la isu geeyo CCB qaadashada iyo beta-blockers leh "Amphotericin B" iyo daroogada taas oo keeni saamayn caloosha jilcisa, durayo. Iyada oo daryeel u isticmaalaan dawada isku dhafan oo corticosteroids, murugada, "Astemizole", "terfenadine." Awoodaan in ay si weyn kor loogu qaado saamaynta maandooriyayaasha sida "Warfarin", "phenytoin" "takrolimus" ama "Digoxin". Marka lala isticmaalaa "cimetidine" caanuhu geedi-shiid ee jirka.

heerarka nolosha iyo kaydinta

The medicament "Amiodarone", kuwaas oo ficil la faray on tirtirista tachycardia, aamba ventricular, tachyarrhythmia iyo yaraynta flutter wadne, waxaa loola jeedaa in ay diyaar category "B" group. Shelf-nolosha ee daroogada ka yar tahay saddex sano. Kiniiniyada waa in lagu kaydiyaa qabow, oo mugdi ah oo ka fog carruurta.

isticmaalka "Amiodarone" daroogada waa in la si adag gacanta. karinayo si ay u isticmaalaan waxa qoray baxay dhakhtar. Xaaladdan oo kale, is waa in gebi ahaanba laga saaray.

medicament Analogs

Haddii aad si lama filaan ah ma ku haboon daroogada analogs "Amiodarone" waxaa laga heli karaa farmashiyaha kasta. ka mid ah daroogada sida: "Amiodarone Belupo" iyo "Amiodarone Aldaron", "Angoron" iyo "Atlans" kuna bedesho daawo waayeen "Kordaron" ama "Kordinil". La mid ah "Amiodarone" in saamaynta ay jirka insaanka "Medakoron" iyo "Palpitin". Xaaladaha qaarkood, daroogada waxaa lagu bedelaa "Sedakoronom" iyo "Sandoz".

Daawooyinkan waxaa sidoo kale ku jira walax la mid firfircoon ama la mid ah in ay saamayn antiarrhythmic of daawo "Amiodarone". Analogues waxaa inta badan dibadda soo saaray oo ay dhowr jeer ka qaalisan.

Kurtumm

bukaan badan ayaa sheegaya in xasilinta ay xaaladda ka dib markii qaadashada daawada, "Amiodarone". Tilmaamaha loogu isticmaalo - inta badan analogs daroogada lagu doorto oo ku salaysan astaamaha gaarka ah ee u shaqeeyo - ballan qaaday in ay caadi garaaca wadnaha, cadaadiska. Marka dhaweynta go'aysa in yar ka qaataan, guud ahaan dhibaato lahayn, iyo falalka daroogada si wax ku ool ah.

Ka dib markii la isticmaalo daba dheeraaday ee daroogada ee bukaanada qaar u muuqday neefta oo ku qabata, wadno, isku yaacsanaan iyo niyad jabka, isbeddelo ah niyadda oo kordhay hormoonka thyroid, jirro of mareenka caloosha iyo mindhicirka, iyo in qaar ka mid ah xaaladaha, lalabo iyo matag.

Dad aad u badan oo ay u isticmaalaan in daaweyn jiray angina, oo la ogaado in ay tahay ma ka xun dhigooda laga keeno. Ragga qaarkood waxay ka cabsadaan in ay qaataan daawada, sababtoo ah waa iyaga oo ku, inuu awoodo inuu keeni tiro ka mid ah kansarka. Waxaa la rumeysan yahay in daroogada waa in la qaato kaliya ka yar shardi ah in halis ku ah nolosha aadanaha, xaaladaha kale oo dhan, waa in uu raadiyo kale ah. Intaa waxaa dheer, looxa saameyn xun ku shaqo taranka labka ah, kaas oo sidoo kale waa in la tixgeliyo ee ay soo dhaweynta yeelan karaan.

Weli dad badan "Amiodarone" daroogada waxay ahayd talogelin, mahad oo cudurka ayaa u laabteen, laakiin ninkii hadhay. Ma aha xaqiiqada ah in analogues noqon lahaa sida wax ku ool ah. Sidaa darteed, in lagu daaweeyo cudurrada wadnaha, ma ku hari daroogada off, gaar ahaan haddii uu dhakhtarku u soo jeedinaysaa.