Amiodarone

Ukusebenza ngokukodwa, kodwa ngokuthe tye

I-Amiodarone (iCordarone, i-Pacerone) iyona ndlela iphumelelayo, kwaye ngokuqinisekileyo iyona nto inqabileyo, izidakamizwa ezichasene nazo. Ukuba ugqirha wakho ufuna ukuba uthathe le nkunkuma kwi- cardiac arrhythmia , kufuneka uqonde idiosyncrasies - kunye neengozi-ezihambelana nayo.

• Funda malunga neziyobisi ezidlulileyo.

Iimpawu ezingavamile ze-Amiodarone

I-Amiodarone ineziganeko ezininzi ezenza ukuba zihluke phakathi kwezidakamizwa ezichaseneyo - kunye nakwezinye iziyobisi ngokubanzi.

Okokuqala, xa kuthathwa ngomlomo, i-amiodarone ithatha iiveki ukufezekisa ukusebenza kwayo, kunye nesizathu esingaqhelekanga. Ngelixa ezininzi iziyobisi zijikeleza kwigazi ngenxa yexesha elithile lide lidibene okanye likhutshwe, i-amiodarone igcinwe kwiisisu zomzimba. Imiphumo epheleleyo ye-antiarrhythm ye-chiza ayiphumeli kude kubekho iifomthi zizaliswe ngokwaneleyo nge-amiodarone. Ngoko le chiza kufuneka "ilayishwe" ngaphambi kokuba isebenze ngokufanelekileyo. I-regimen ye-amiodarone yohlobo "yokulayisha" eqhelekileyo yayiza kusebenzisa amanyathelo omlomo omalunga neveki okanye ezimbini, uze uthethe i-doser kwinyanga ezayo okanye njalo. Akuqhelekanga ukunika abantu abayi-1200 okanye i-1600 mg ngosuku, kwaye ekugqibeleni, ukuba bahlale bengama-100 okanye 200 mg ngosuku (ngomlomo).

I-Amiodarone nayo inokulawulwa kwangaphakathi xa kunyanga i-arrhythmia iphuthumayo, kwaye igalelo layo likhawuleza kakhulu ngale ndlela. Nangona kunjalo, ukutshintshwa ukusuka kwi-intravenous to dosing yomlomo kufuneka kwenziwe ngokucophelela, ekubeni ukusetyenziswa okungapheliyo isilwanyana simele "silayishwe" ixesha elide.

Okwesibini, i-amiodarone ishiya umzimba kakhulu, ngokukhawuleza. Akunakunyulwa kwinqanaba elixabisekileyo ngesibindi okanye iintso. (I-Amiodarone isetyenziselwa isibindi kwi-desethylamiodarone, ene-antiarrhythmic kunye nefuthe eliyingozi njengama-amiodarone, kwaye ihlala nayo emzimbeni ixesha elide.) Ngokona nxalenye, i-amiodarone kunye nemetabolites yayo isuswa emzimbeni xa Amaseli e-amiodarone alahlekile - afana neeseli zesikhumba, okanye iiseli ezisuka kwimizila yesisu, ezichithwa zigidi ngosuku.

Oku, ngokusobala, yinkqubo ende, epholileyo.

Ngaloo ndlela, ukuba kunqunywe ukuba kuyimfuneko ukumisa i-amiodarone (ngenxa yemiphumo emibi, umzekelo) le nkunkuma ihlala emzimbeni ngokulinganisela ixesha elide kakhulu emva kokuba umthamo wokugqibela uthathwa. "Isiqingatha sobomi" se-amiodarone, ngokuchasene nezinye ezininzi iziyobisi, lilinganiswa ngeiveki endaweni yeeyure.

Okwesithathu, ngenxa yokuthi i-amiodarone igcinwa kwiintlobo ezininzi ezihlukeneyo emzimbeni, inokuvelisa iziphumo ezichaphazelekayo ezichaphazela amalungu amaninzi ahlukeneyo. Ezinye zeziphumo zempembelelo zingathabatha inyanga okanye iminyaka ukuphuhlisa, ngoko ke nabani na othabatha le nkunkuma kufuneka ahlale ephaphele imiphumo emitsha.

Okwesine, i-amiodarone isebenza ngeendlela ezininzi ezahlukeneyo, ngokungafani neziyobisi ezininzi. Izahlula kwiindidi ezimbini ezahlukileyo zeziyobisi (iCandelo I kunye neCandelo III, oko kukufanele). Isebenza njenge- bloa blocker kunye ne- calcium blocker . Iyanciphisa imilambo yegazi, kwaye ihlala isenza "ukuvimba" i-hormone ye-thyroid. Zonke ezi ziphumo zenza ukuba zikwazi ukuphatha i-arrhythmias, kwaye mhlawumbi i-akhawunti ye-amiodarone esebenzayo.

Iimpembelelo eziPhakathi ze-Amiodarone

Imiphumo emibi ye-amiodarone isoloko ithatha iiveki okanye iinyanga (okanye neminyaka) ukuphuhlisa, ngoko ke nabani na othabatha le nkunkuma kufuneka baqaphele nje kuphela ukuba isilwanyana sisetyenziswa.

Ukongezelela, iimiphumo zomsindo we-amiodarone zivame ukuba zingavamile kakhulu kwizidakamizwa ezichanekileyo-okanye nasiphi na isilwanyana kuloo mbandela. Ngenxa yezizathu, xa ama-amiodarone eqala ukusetyenziswa kweekliniki kuthatha ngaphezu kweminyaka elishumi ukuba oogqirha baqaphele ukuba ezininzi iimpawu eziqhelekileyo abazibonayo zibangelwa yi-amiodarone. Kulolu suku, oogqirha bonke abavumi ukujongana nezigulane zabo zithatha i-amiodarone ixesha elide, kwaye zikhuthele ngokwaneleyo, ukuqonda ukuba izidakamizwa zivelisa iingxaki.

• Funda umlando ongaqhelekanga we-amiodarone .

Nazi ezinye zeempembelelo ezichaphazelekayo ezingabonwa nge-amiodarone:

• I-Amiodarone ibangela ukuba iifomiti zenzeke kwi-cornea yamehlo, edla ngokukhokelela "kumbono we-halo", apho ikhangele khona izibane ezikhanyayo ebusuku zifana nokujonga inyanga ngobusuku obushushu.
• I-Amiodarone inokubangela ukutshatyalaliswa (kwaye mhlawumbi ngokusisigxina) ukuhlaziywa kweblue eluhlaza okwesibhakabhaka yolusu, ngokubanzi kwiindawo zokukhanya kwelanga.
• U-Amiodarone uvame ukukhumbuza ulusu kwilanga, ukwenzela ukuba ukubonakaliswa okuncinci kungabangela ukushisa kwelanga ngokuthe tye.
• I-Amiodarone ingabangela izifo ze-thyroid, zombini i- hypothyroidism (i-thyroid ephantsi) kunye ne- hyperthyroidism (iphezulu ye-thyroid.) Ezi ngxaki ze-thyroid ziqhelekile kunye ne-amiodarone, kwaye kunokuba nzima ukuqonda nokuphatha. Ngenxa yesi sizathu, izigulane ezithatha le michiza kufuneka zisebenze rhoqo nge-thyroid. Funda kabanzi malunga ne-amiodarone kunye ne-thyroid.
• I-Amiodarone ingabangela ubuthi beesibindi, ngoko- enzyme yesibindi kufuneka ihlolwe ngezikhathi ezithile.
• I-Amiodarone ingabangela uhlobo olubi kakhulu lwe- acid reflux disorder .
• Isiphumo esicatshukisayo kakhulu se-amiodarone isifo sobutyhefu. Oku kunokuthatha iifom ezininzi. Ingathatha ifom ye-pulm syndrome ephazamisayo eyenza izigulane zigula kakhulu, zidinga ukunonyamekela, kwaye zihlala ziphumela ekufeni. Okanye, kunokubangela ukungabonakali, ukugqithisa, ukungabonakali, "ukuqina" kwemiphopho leyo ugqirha kunye nesigulane angakwazi ukuyijonga kude kube nzima, mhlawumbi umonakalo wephunga wamaphaphu. Funda kabanzi malunga ne-amiodarone toxicity.

Xa kufuneka i-Amiodarone ifumaneke?

Ngenxa yobunzima obuyingqayizivele kunye nobungozi bokusebenzisa i-amiodarone, eli chiza kufuneka lisetyenziswe kuphela kubantu abanokuthi abasongela ubomi okanye baphazamise ubomi ubomi, kwaye kuphela xa kungekho zonyango ezifanelekileyo. Nangona kunjalo, ingxaki, i-amiodarone ingumsebenzi oyingqayizivele, kwaye iye yanceda ukubuyisela amawaka amaninzi abantu ngokukhubaza i-arrhythmias kwindawo eqhelekileyo yobomi.

ILizwi

Xa isetyenziswe ngokufanelekileyo, i-amiodarone ingaba yinzuzo enkulu kubantu abaneempawu ezinzima ze-cardiac arrhythmias. Kodwa ngenxa yobunobungozi obuyingozi, ukusetyenziswa kwayo kufuneka kupheliswe. Nawuphi na ugqirha oyalela ukuba i-amiodarone ihlawulwe isigulane ingqalelo ngengxaki ezininzi ezinokuthi zenzeke kunye neziyobisi, kwaye kufuneka zizinikele ekubeni ngumlingane wexesha elide isigulane sayo, ukubeka iliso ngenyameko kwimiphumo emitsha, ngokude nje le nkunkuma ekhethekileyo isetyenziswa.

> Imithombo:

> Goldschlager N, Epstein AE, Naccarelli GV, et al. Isikhokelo esisebenzayo seNtsholongwane abaPhatha izigulane nge-Amiodarone: 2007. I-Heart Rhythm 2007; 4: 1250.

> Vassallo P, iTrohman RG. Ukumisela i-Amiodarone: UkuHlola okusekelwe kwiNkcazo yeeNkcazo zeKlinikhi. JAMA 2007; 298: 1312.