Amiodarone

Yayinda yake da tasiri, amma mai guba

Amiodarone (Cordarone, Pacerone) shine mafi mahimmanci, kuma lalle mafi mahimmanci, magunguna antiarrhythmic ya ci gaba. Idan likitanku yana so ku dauki wannan magani don ciwon zuciya na zuciya , kuna buƙatar fahimtar idiosyncrasies - da kuma hadari - hade da shi.

• Karanta game da kwayoyin antiarrhythmic.

Abubuwa masu ban sha'awa na Amiodarone

Amiodarone yana da halaye masu yawa wanda ya sa ya zama mahimmanci tsakanin kwayoyin antiarrhythmic - har ma a cikin kwayoyi a cikin duka.

Na farko, idan aka dauki baki, behadarone yana daukan makonni don cimma matsakaicin tasirinsa, kuma don dalilai marar ban mamaki. Duk da yake mafi yawancin kwayoyi suna zagaye a cikin jini har zuwa wani lokaci har sai sun hadu da su ko kuma sun ɓace, ana adana amiodarone a jikin jikin jikin. Cikakken maganin ƙwayar miyagun ƙwayoyi ba za'a samu ba har sai da takalma ya isa cikakke tare da behadarone. Don haka dole ne a "ƙaddara" ƙwayar miyagun ƙwayar kafin ya zama mai tasiri sosai. Wani tsari na "loading" na behadarone zai yi amfani da dogayen maganganun maganganu na mako daya ko biyu, sa'an nan kuma danna sashi a wata mai zuwa ko haka. Ba sabon abu ba ne don ba mutane 1200 ko 1600 MG kowace rana a farkon, sa'an nan, ƙarshe, don kula da su a kan kadan kamar 100 ko 200 MG a kowace rana (magana).

Amiodarone kuma za'a iya gudanarwa da gangan lokacin da zalunta wani arrhythmia yana da gaggawa, kuma sakamakonsa ya fi sauri ta wannan hanyar. Duk da haka, sauyawa daga intravenous zuwa ga maganin maganin maganin bugun zuciya dole ne a yi a hankali, tun da yake saboda yawancin amfani da miyagun ƙwayoyi dole ne a "ƙaddara" don tsawon lokaci.

Na biyu, behadarone ya bar jiki sosai, sosai sannu a hankali. Ba a cire shi zuwa ga hanta ko hanta ba. (Amiodarone yana cike da hanta zuwa desethylamiodarone, wanda yana da irin wannan antiarrhythmic da cututtuka masu guba kamar yadda behadarone, kuma wanda ya kasance cikin jiki na dogon lokaci.) A mafi yawancin, behadarone da metabolites an cire su daga jiki lokacin sel da ke dauke da sinadarone sun rasa - irin su fatar jiki, ko kwayoyin jikinsu daga gastrointestinal tract, wanda miliyoyin ke zub da su kowace rana.

Wannan, a fili, yana da dogon lokaci, jinkirin aiki.

Saboda haka, idan aka ƙaddara cewa yana da muhimmanci don dakatar da behadarone (saboda sakamakon lalacewa, alal misali) ƙwayar miyagun ƙwayoyi ya zauna a cikin jiki a cikin ma'auni mai kyau don dogon lokaci bayan an dauki kashi na ƙarshe. An auna "rabin rabi" na behadarone, wanda ya bambanta da sauran magungunan, a cikin makonni maimakon sa'o'i.

Na uku, saboda ana adana haladarone a cikin nau'o'in kyakoki daban-daban a cikin jiki, zai iya haifar da sakamako mai lalacewa wanda ya shafi nau'ukan da dama. Wasu daga cikin wadannan halayen na iya daukar watanni ko shekaru don bunkasa, don haka duk wanda ke shan wannan magani ya kamata ya kasance mai hankali don sababbin sakamako masu illa.

Hudu, amiodarone yana aiki ta hanyoyi daban-daban, ba kamar yawancin kwayoyi ba. Ya dace da nau'o'i biyu na kwayoyin antiarrhythmic (Class I da Class III, don abin da ke da daraja). Yana aiki a matsayin beta blocker da kuma a matsayin calcium blocker . Yana rage tasoshin jini, kuma sau da yawa yakan yi "toshe" sakamako na hormone thyroid. Duk wadannan abubuwan da ke taimakawa wajen magance zubar da jini, kuma mai yiwuwa tabbas yana da tasiri na musamman na amiodarone.

Hanyoyin Yanayin Amiodarone

Hanyoyin da ke haifar da behadarone sukan dauki makonni ko watanni (ko ma shekaru) don bunkasa, don haka duk wanda ke shan wannan magani dole ya kasance mai hankali idan dai ana amfani da miyagun ƙwayoyi.

Bugu da ƙari kuma, sakamakon lahani na behadarone yayi kama da sababbin magungunan antiarrhythmic - ko don kowane magani don wannan al'amari. Saboda wadannan dalilai, a lokacin da sindarone ya fara shiga asibiti ya dauki fiye da shekaru goma don likitoci su gane cewa yawancin alamomin da suka gani suna haifar da lahani. Har wa yau, likitoci sukan yi watsi da marasa lafiya da yawa suna daukar nauyin lalata, kuma suna da cikakke, don gane cewa miyagun ƙwayoyi yana haifar da matsaloli.

• Karanta tarihin ban mamaki na behadarone .

Ga wasu daga cikin abubuwan da ke da tasiri wanda zai iya gani tare da behadarone:

• Amiodarone yakan haifar da adiyo don farawa a kan abin da ke gani, wanda yakan kai ga "hangen nesa", inda kallon hasken wuta a dare yana kama da kallon wata a wata maraice.
• Amiodarone zai iya haifar da lalatawar fata (kuma mai yiwuwa) wanda yake da launi na launin shuɗi-launin fata, musamman a yankunan da ke haskaka rana.
• Amiodarone sau da yawa yakan fahimci fatar jiki zuwa hasken rana, don haka har ma da rashin daukan hoto ba zai iya haifar da kunar kunar rana ba.
• Amiodarone na iya haifar da cuta na thyroid, da hypothyroidism (low thyroid) da kuma hyperthyroidism (high thyroid.) Wadannan matsalolin maganin karoid ne na kowa da halaye, kuma zai iya kasancewa da wuya a gane da kuma bi da. A saboda wannan dalili, marasa lafiya suna shan wannan magani ya kamata su kula da maganin thyroid. Kara karantawa game da amiodarone da thyroid.
• Amiodarone zai iya haifar da haɗari hanta, saboda halayen enzymes ya kamata a kula dashi akai-akai.
• Amiodarone zai iya haifar da mummunan yanayin rashin lafiya na acid .
• Sakamakon sakamako mai tsanani na sinadarone shine kwayar cutar huhu. Wannan zai iya ɗauka da yawa. Zai iya ɗaukar nau'in ciwon huhu na huhu wanda ya sa marasa lafiya ke fama da rashin lafiya, yana buƙatar kulawa mai tsanani, kuma yakan haifar da mutuwa. Ko kuwa, zai iya haifar da rashin hankali, da hankali, rashin fahimta, "mai ƙarfi" na huhu wanda duka likita da mai haƙuri zasu iya kaucewa har sai da tsanani, tabbas an lalata lalacewar huhu. Ƙara karin bayani game da cutar mai launi na amiodarone.

Yaya Ya kamata Amiodarone Ya Yi Amfani?

Saboda matsalolin da ke tattare da ƙwayar cuta, wannan magani ya kamata a yi amfani dashi kawai a cikin mutanen da wadanda suke da barazanar rayuwa ko razanar rayuwa, kuma idan ba'a sami hanyoyin magancewa ba. Kodayake ya ɓata, duk da haka, amiodarone hakika yana da tasiri sosai, kuma ya taimakawa mayar da dubban mutane tare da magance arrhythmias zuwa rayuwa ta al'ada.

Kalma Daga

Lokacin da aka yi amfani dashi daidai, behadarone zai iya zama babban amfani ga mutanen da ke dauke da ciwon zuciya mai tsanani. Amma saboda yiwuwar maye gurbinsa, ana amfani da ita ta amfani. Duk wani likita wanda ya rubuta dabi'arrone ya kamata ya yi haƙuri a hankali game da matsaloli masu yawa da zasu iya faruwa tare da miyagun ƙwayoyi, kuma ya kamata ya zama abokin tarayya na masu haƙuri, kula da hankali don sababbin sakamako masu illa, idan dai ana amfani da wannan miyagun ƙwayoyi.

> Sources:

> Goldschlager N, Epstein AE, Naccarelli GV, et al. Jagora mai amfani ga masu likita wadanda ke bi da marasa lafiya tare da Amiodarone: 2007. Zuciya ta 2007; 4: 1250.

> Vassallo P, Trohman RG. Ya bayyana Amiodarone: Ra'ayin da ake nunawa game da Clinical Indications. JAMA 2007; 298: 1312.