Har ila yau, wa'adin ga sauran Dysautonomias, irin su POTS da Vasovagal Syncope
Samun sinadarin da ba daidai ba ne (TST) wani yanayin ne wanda yake da hanzarin zuciya (tachycardia), duka biyu a hutawa da kuma lokacin yin aiki, wanda yakan shafi matasa waɗanda ba su da lafiya sosai. Wadanda ke shan wahala daga IST suna shawo kan matsaloli mai tsanani da kuma nuna rashin haƙuri da gajiya, kuma yanayin zai iya ɓacewa sosai.
Amfanin lafiya na IST, da rashin alheri, yana da kalubale.
Ivabradine wata kasuwar sababbin ƙwayoyi ne da aka sayar da su don maganin angina da zuciya daya. A cikin 'yan shekarun nan ivabradine ya nuna alkawarinsa mai mahimmanci don kula da IST. Rahotanni sun nuna cewa yana iya zama tasiri ga wasu ƙwayar cuta na dysautonomia wadda tachycardia ta kasance wani abu mai ban sha'awa.
Yaya Yayi Ayyukan Ivabradine?
Ivabradine ta kaddamar da tashar tashar tashar tashar tashar tashoshin tashar tashar tashar tashoshi ta tashar tashar tashar tashoshin tashoshi, ta hanyar tashoshin salula wanda zai ba da sodium da potassium su shiga cikin sel I tashar tashar (f "tana nufin" ban sha'awa, "wanda aka kira shi saboda wannan tashar yana nuna bambanta fiye da sauran tashoshi), yana taka muhimmiyar rawa wajen harbe kullin sinus , wanda yake sarrafa yanayin kirki na al'ada. Ta hanyar katange tashar I tashar, ivabradine yana jinkirta ƙwanƙwasawa na fatar sinus, saboda haka yana jinkirta zuciya. Wannan tsari na rage jinkirin sinus yana da mahimmanci daga tsarin da masu amfani da beta da masu amfani da magunguna suke amfani da su , don haka ivabradine yakan haifar da jinkirin zuciya har ma da sauran kwayoyi basuyi haka ba.
An tsara Ivabradine don maganin angina kuma an yarda dashi don amfani a yawancin duniya a shekara ta 2005. An amince da shi a Amurka a watan Afrilu na 2015 don maganin zuciya rashin nasara , amma ba don IST ba.
Ivabradine A cikin IST
Rahotanni kadan - sau da yawa suna kwatanta marasa lafiya ko guda biyu - sun fara bayyana ba da daɗewa ba bayan miyagun ƙwayoyi sun shiga amfani da asibiti, suna nuna cewa ivabradine na iya zama da amfani wajen magance marasa lafiya tare da IST.
Daga bisani, a shekarar 2012, an bayar da rahotanni daga cikin Italiya, wanda aka tsara, wanda aka tsara, wanda ya tabbatar da cewa ivabradine na iya zama tasiri ga wannan yanayin. Tamanin marasa lafiya da aka yi wa Ivabradine sun nuna kusan kashi 75 cikin 100 na alamun bayyanar, kuma kashi 50 cikin 100 na marasa lafiya sun kamu da maganin bayyanar da sauri. Hanyoyi masu rinjaye sun kasance kadan. Idan aka kwatanta da abin da aka saba gani da sauran likitocin da aka yi amfani da su na IST, wannan sakamako ne mai rinjaye.
Wani gwajin da ba a ba da izinin zama ba tare da ivabradine a cikin marasa lafiya 24 tare da IST ya nuna irin wannan sakamako mai kyau. A cikin wannan gwaji, duk da haka, an dakatar da miyagun ƙwayoyi a cikin marasa lafiya 10 bayan shekara guda don ganin abin da zai faru (wasu marasa lafiya sun hana dakatar da shan magani), kuma 8 daga cikin wadannan 10 marasa lafiya sun daina sake dawowa daga IST.
Ivabradine na POTS da Vosovagal Syncope
Ƙungiyar tachycardia ta al'ada (POTS) da kuma syncope vasovagal su ne wasu ɓangarorin biyu na dysautonomia wanda yaduwar tachycardia ke aiki a wani lokaci na taka muhimmiyar rawa wajen samar da alamun bayyanar. Don haka ba abin mamaki bane cewa likitoci za su zabi su gwada ivabradine a cikin waɗannan yanayi.
Akwai ƙananan bayanai game da amfani da ivabradine ga POTS, amma likitoci a duniya sun yi amfani da miyagun ƙwayoyi a cikin mutanen da aka zaɓa tare da wannan yanayin.
Bayanin da yake wanzu, duk da haka, ya nuna cewa, a kalla a cikin wasu mutane, sarrafawa da tachycardia tare da ivabradine na iya rage ko kawar da sauran bayyanar cututtuka da suka shafi POTS. Wani gwaji na asibiti da aka yi amfani da ivabradine ga POTS yanzu ana gudanar a Isra'ila.
Duk da yake syncope na haɗin gwiwar yana haɗuwa da saukowar jini da kuma yawanci (zuciya) a cikin zuciya, an san cewa kafin sanin asarar (wato, lokacin "bayyanar cututtuka" mutane sukan fuskanci wannan yanayin), wani Raunin zuciya mai saurin gaske sau da yawa. A cikin gwajin gwagwarmaya na marasa lafiya 25 tare da syncope wanda ya nuna irin wannan tachycardia kafin ya wuce, fiye da 70% yana da sakamako mai kyau tare da ivabradine - ko dai babbar raguwa ko kawar da bayyanar cututtuka.
Saboda haka, ivabradine na nuna hakikanin alkawari ga dukan dysautonomias wanda sinstarin tachycardia ya zama babban fasali.
Hanyoyi na gefen Ivabradine
Wani sakamako mai ban mamaki da aka ruwaito tare da ivabradine, wanda aka gani a kimanin kashi 15 cikin dari na marasa lafiya, shine yanayin da ake kira "abin mamaki." Wannan abu ne wanda aka kwatanta a matsayin fuskantar "haske" mai mahimmanci a cikin fagen gani, ba tare da wani canji a gani ba . Ana tsammanin zai haifar da katange tashar a cikin kwayoyin cututtuka wanda ke kama da I tashar tasiri a cikin zuciya. Abin farin ciki, wannan sakamako mai sauƙi shine yawanci kuma sau da yawa yakan warware kansa. Wani rahoto na baya-bayan nan ya nuna cewa marasa lafiya a kan wannan miyagun ƙwayoyi na iya samun ƙarin haɗari na fibrillation . Sauran cututtuka marasa rinjaye na yau da kullum sun hada da ciwon kai da damuwa. Yawancin maganin miyagun ƙwayoyi yana da kyau sosai.
Ivabradine a Amurka
Duk da yake an yi amfani da wannan miyagun ƙwayoyi fiye da shekaru goma a Turai, a yawancin Asiya, da Rasha, Australia, da Kanada, an amince da ita a Amurka ne kawai a watan Afrilun 2015. Bugu da ƙari kuma, alamar da aka ba da izini ga ivabradine a Amurka ne don lura da zuciya rashin cin nasara. (Ivabradine ana sayar da shi ta Amgen, a karkashin kamfanin cinikayya Corlentor.)
Idan kana zaune a Amurka kuma kana da IST (ko ɗaya daga cikin dysautonomomy wanda zai iya amsa wannan magani), kuma idan likitan ka yi imanin cewa ivabradine na iya zama da amfani a gare ka, shi ko yanzu ta iya rubuta shi. Duk da haka, tun lokacin da aka kirkiro ivabradine don zuciya rashin nasara a Amurka, likitanku dole ne ya rubuta shi don amfani da "lakabi". A kowane hali, ivabradine yanzu zabin haƙiƙa ko da na Amurkawa da ke da TAS.
> Sources:
> Cappato R., Castelvecchio S., Ricci C., Ƙarƙashin Ciki na Ivabradine a cikin marasa lafiya tare da Sinus ba daidai ba Tachycardia: wani mai yiwuwa, Randomized, Sanya-sarrafawa, Ƙoƙƙwafi biyu, Binciken Ƙaru. J Am Coll Cardiol. 2012; 60: 1323-1329.
> Benezet-Mazuecos J1, Rubio JM, Farré J, et al. Sakamakon lokaci mai tsawo na Ivabradine a cikin Sinus marasa dacewa Tachycardia Marasa lafiya: Daidaita Kwarewa ko marasa lafiya. Pacing Clin Electrophysiol. 2013 Jul; 36 (7): 830-6. Doi: 10.1111 / Pace.12118. Afrilu 2013 Mar 19.
> McDonald C, Frith j, Newton JL. Ƙwarewar Cibiyar Kwarewa ta Ivabradine a Tsarin Ayyukan Cutar Orthostatic Tachycardia. Europace (2011) 13 (3): 427-430. Doi: 10.1093 / europace / euq390.
> Sutton R1, Salukhe TV, Franzen-McManus AC, et al. Ivabradine a Jiyya na Sinus Tachycardia Tsarin Mulki Aiki tare da Syncope.Europace. 2014 Feb, 16 (2): 284-8. Doi: 10.1093 / europace / eut226. Afub 2013 Sat 26.