I-block block ye-calcium yilapho iklasi enkulu yezilwanyana ezisetyenziselwa ukunyanga iingxaki ezininzi zeengqondo ezinjenge- angina , uxinzelelo lwengqondo , i -tachycardia engaphezulu , kunye ne- hypertrophic cardiomyopathy .
Sibanzi
I-calcium i-block blockers iyakhusela i-calcium ukungena kwiintliziyo zesisu ezinamahlunu, kwaye zibe kwiiseli ezinamahlombe ezihamba kakuhle ezenza ukuba imithana yegazi ilandele.
Ngokunciphisa i-calcium influx, i-block block ye-calcium yenza ukuba la maseli e-muscle "aphumle." Esi siphumo sokuphumla siphumela ekuphuculweni kwemithambo yegazi, kunye negalelo elincinci lokuqhaqhalwa kweentliziyo zentliziyo.
Ezinye izithinteli zesitishi se-calcium zinciphisa i- node ye-sinus kunye nesantya apho umtshini wombane wezwi uthumela nge- node ye-AV . Ezi ziphumo zenza i-calcium blockers iyanceda ekuphatheni i- arrhythmias .
Yonke imiphumo ye-calcium blockers (i-blood vessel dilation, ukunciphisa intambo ye-muscle contraction, kunye nesantya senhliziyo esicothayo) ukunciphisa inani le-oksijini elifunwa yintliziyo yesisu.
Ukunciphisa inani le-oksijini elisetyenziswe yintliziyo livumela intliziyo ukuba isebenze ixesha elide ngaphandle kokuvelisa i- ischemia , nangona igazi liphuma emithambo ye - coronary ivalwe ngokukodwa ngeplani ye- atherosclerotic . Kwizigulane ezine- angina ezizinzile , i-calcium blockers zivame ukwandisa inani lomzimba ongenziwa ngaphambi kokuba i-angina ivele.
I-block block ye-calcium inokubaluleka ngakumbi kwizigulane ezine- angta ye-Prinzmetal (i-coronary artery spasm) kuba iyakwazi ukukhusela ngokuthe ngqo imida yeeronari.
Iintlobo
Abakhi be-calcium abaninzi abakwiimarike, kwaye akufani konke. Kukho iintlobo ezintathu ze-blockers calcium ezisetyenziswa kakhulu:
1) I-dihydropyradines .
Izidakamizwa i-nifedipine (Procardia, Adalat), i-nicardipine (iKadiene), i-felodipine (i-Plendil), kunye ne-amlodipine (i-Norvasc), ibizwa ngokuba yi-dihydropyridines. Ezi ziyobisi zidala ukukhutshwa okukhulu kwemithambo yegazi kunye nempembelelo encinci kwimisipha yentliziyo kunye nentliziyo yezinga. Ziluncedo kakhulu kunyango lwegazi.
2) I- verapamil. I-Verapamil (iCalan, iCovera, i-Isoptin, i-Verelan) ichaphazela isisu senhliziyo kwaye isebenza ngokuthe ngqo ekunciphiseni izinga lentliziyo, kodwa ayinayo imiphumo emithanjeni yegazi. Akulona luncedo kakhulu kwixinzelelo lwengqondo kodwa luhle kakhulu kwi-angina ne-cardiac arrhythmias.
3) i- Diltiazem. I-Diltiazem (iCardizem, i-Dilacor, i-Tiazac) ineempembelelo ezithobekileyo kwiintliziyo zomzimba kunye nemithambo yegazi. Kuye kube lula ukunyamezela ngakumbi kunabanye abakhi be-calcium
Ukusetyenziswa
Unyango ka-Angina
Zonke iibhloko ze-calcium ziye zasetyenziselwa ukwelapha i-angina. Nangona kunjalo, i-blockers ye-calcium esetyenziswa ngokuqhelekileyo iifom ze-diltiazem kunye ne-verapamil, i-amlodipine, okanye i-felodipine.
I-Nifedipine, ngokukodwa iifom zayo ezimfutshane, kufuneka zikhunjulwe ngokubanzi kwizigulane ezine-angina, kuba i-blood propellation dilution eveliswe yilo mzimba inokunyuka kwi-adrenaline, ekhokelela kwinqanaba lentliziyo ngokukhawuleza, kwaye ngoko ke ukwanda kweemfuno ze-oxygen ( ezinokunyusa amathuba okuphuhlisa i-carchemac ischemia).
Ngokuqhelekileyo, ngelixa i-calcium blockers iyanceda ekunciphiseni i-angina, zithathwa njengento engaphantsi kwe-blocka blockers . Iingcebiso ezikhoyo zilandelayo:
- I-blockers ye-calcium kufuneka ihlolwe kwizigulane ezingenako ukunyamezela i-beta blockers.
- Iibhloko ze-calcium kufuneka zongezwe kwi-beta blockers kwizigulane ezingenakho ukufumana uncedo olufanelekileyo lweempawu ze-beta blockers.
Ezinye izinto eziqhelekileyo
- U xinzelelo. I-dihydropyradine i-calcium blockers iyiluncedo kakhulu ekuphatheni umfutho wexinzelelo, kwaye ihlala isetyenziswa njengonyango lokuqala kumgangatho we-Stage I-blood pressure. Funda ngokukhetha i-"right" drug for hypertension.
- Iziqulatho zengqungquthela. Ama-blockers ase-calcium (ngokukodwa i-verapamil) inqanda ngokukhawuleza umsebenzi we-AV node, kwaye ngoko kaninzi luncedo ekuphatheni ama-arhythmias angaphezulu axhomekeke kwi-AV node ukuze aqhubeke. Ngokukodwa, i- AV nodal reentrant tachycardia (uhlobo oluqhelekileyo lwe-arhymmia) luyakwazi ukulawulwa ngonyango lwe-verapamil.
- Hypertrophic cardiomyopathy. Iibhloko ze-calcium zingasetyenziselwa ukunciphisa "ukuqina" kwe-ventricle ekhohlo kubantu abane-hypertrophic cardiomyopathy, kwaye ngale ndlela kunganciphisa iimpawu.
Imiphumela
Iziphumo eziqhelekileyo zecala le-calcium zithintela i-headache, isiyezi, ukuxubha, neenyawo kunye nokuvuvukala kwe-ankle. I-Verapamil, ngokukodwa, ibuye idale ukumbombozwa.
Ngenxa yokuba i-calcium blockers ithambekele ekunciphiseni amandla okubethelwa kwentliziyo yesisu, kufuneka isetyenziswe ngokuqaphela (ukuba kukho konke) kwizigulane ezinokukhubazeka kwentliziyo .
Ngokuqhelekileyo kulungele ukuthintela i-verapamil kunye ne-diltiazem kubantu abane- Bradycardia ekubeni le miyeza iya kuphucula intliziyo.
> Imithombo:
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> Fihn SD, Gardin JM, Abrams J, et al. I-ACCF / AHA / ACP / AATS / PCNA / SCAI / STS Isikhokelo soLwazi kunye noLawulo lwabaPhantshi abaneSigedic Ischemic Heart Disease: Ingxelo ye-American College of Cardiology Foundation / i-American Heart Association iqela elikhokelayo kwiikholeji zoqeqesho, kunye ne-American College I-Physicians, i-American Association ye-Thoracic Surgery, i-Preventive Cardiovascular Association, i-Society for Cardiovascular Angiography kunye neNongenelo, kunye noMbutho weeNgcali zeTriracic. Ukuhamba ngo-2012; 126: e354.
> Mancia G, Fagard R, Narkiewicz K, et al. 2013 I-ESH / ESC Izikhokelo zolawulo lwe-Arterial Hypertension: i-Task Force yoLawulo lwe-Arterial Hypertension ye-European Society ye-Hypertension (ESH) kunye ne-European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281.