I-Verapamil yinyango enamandla esetyenziselwa ukuphatha isifo senhliziyo. Ngenxa yokuba iyancipha imithwalo yegazi yentliziyo nomzimba zombini, inezicelo ezininzi zeeklinikhi. Kodwa ngaphezu kokusebenzisa ezininzi, i-verapamil yakho kufuneka ihlolwe ngokugqithiseleyo ngenxa yokuba le nyilisi ibangela umngcipheko wentyhefu kwaye ingaba nemiphumo emibi kakhulu. Ngokomzekelo, ukungena ngengozi kwithebhulethi enye ngumntwana kunokubulala.
Indlela yokuSebenza
I-Verapamil i-blocker yesikhombi se-calcium (umchasi) onciphisa ukungena kwe-calcium ions ngokusebenzisa i-L-type calcium channels ezikhoyo kwiiseli zentliziyo kunye neeseli ezihamba kakuhle ze-peripheral vasculature.
I-Verapamil ineempembelelo ezininzi ze-physiologic:
- I-Vasodilation yamaborariary (intliziyo) kunye neetriyeri kunye ne-arterioles
- Ukunciphisa isivumelwano senhliziyo
- Umsebenzi we-sinus ophazamisekile
- Ukuqhutyelwa kweeodrioticism node conduction
Ukongezelela kwimiphumo engentla, i-verapamil iphazamisa amandla omzimba wamaseli enhliziyo, ukwandisa ukuxhomekeka kwentliziyo kwi-carbohydrates kunokuba i-fatty acid acids. Ngaphezu koko, i-verapamil inqanda ukuveliswa kwe-pancreatic ye-insulin. Utshintsho oluthile olunobuthi lubekwe ngokukhethekileyo kwiimeko zokutshatyalaliswa xa umzimba ufuna i-carbohydrate.
Metabolism
I-Verapamil ixutywe kakuhle ngephepha lesisu kunye nokusabalalisa kuwo wonke umzimba (iipesenti ezingama-90 zeprotheni ziboshwe).
Kwi-pass-pass ye-metabolism yokuqala, i-verapamil idilizwe yisibindi ibe yi-metabolite esebenzayo. Ubomi besiqingatha seVerapamil malunga neeyure ezisibhozo.
Ukusetyenziswa kwezonyango
Ngenxa yeziphumo zayo kwintliziyo yesibini kunye nomzimba (isitya segazi), i-verapamil inokusetyenziswa kweentlobo. Nazi ezinye zeetelamil ezisetyenziswayo:
- I-Angina (ezinzile, engaqinisekanga kunye ne-Prinzmetal)
- Tachycardia
- Yinto kaRaynaud
- Migraine prophylaxis
- Intloko yepropylaxis yeCluster
- Ingozi okanye ingcinezelo yengozi
I-Verapamil yiklasi ye-class anti-arrhythm. Ngaphambi kokuba oogqirha basebenzise i-verapamil ukuphatha i-arrhythmias, propranolol kunye ne-digoxin zazihlala zisetyenziswa.
Iziphumo ezimbi kunye nokusebenzisana kwezidakamizwa
Nangona kunqabile phantsi kohlolisiso olusondeleyo lwe-cardiologist, i-verapamil yobunyoyiko isoloko ixhalabisa. Ukongezelela kwimiphumo emibi, i-verapamil inokusebenzisana neentlobo ezahlukeneyo zamachiza.
Isiphumo esona siqhelo sentsholongwane ye-verapamil kukuqhaqha. Kwamanye abantu, i-verapamil inokubangela ukuxakeka, ukuhamba ngokukhanya, kunye ne-hypotension. Kwiimeko zokugqithisa, i-verapamil iyaphazamisa isigqi senhliziyo kwaye ingakhokelela ekulahlekelweni kobomi.
Nazi ezinye zezenzo zokusebenzisa iziyobisi ezinokuthi i-verapamil ibeka:
- I-Verapamil isebenzisa nge-beta-blockers, i-nitrates kunye ne-diuretics yomscinezelo wegazi inokubangela ukuba uxinzelelo lwegazi luwele phantsi kwingozi (hypotension).
- I-Verapamil inokunyusa imiphumo ye-statins, esetyenziselwa ukhathalela i-cholesterol ephezulu, kunye nemimiselo ingabangela i-rhabdomyolysis okanye i-muscle breakdown ehlabayo ngeentso.
- I-Verapamil isetyenziswe nge-enzyme ye-cytochrome P450 kunye nokusetyenziswa ngokugqithisileyo kwemithi yokugonywa njengama-amiodarone (enye i-antiarrhythm) iphazamisa iP450 ekhokelela ekutshatyalaliswa kwesicatshulwa. Ukongezelela, i-juice yamagilebhisi iyathintela inkqubo ye-P450 kwaye inokunyusa izinga legazi le-verapamil.
Nceda ugcine engqondweni ukuba xa usetyenziswe njengengcebiso kwaye ngendlela ekhuselekileyo, i-verapamil inokuba luncedo kakhulu kulabo abayidingayo. Ulwazi olukule nqaku alunakusongela ukuba usebenzise i-verapamil xa ucetyiswa. Nangona kunjalo, kufuneka uqaphele ngokukhawuleza isiluleko sakho se-cardiologist ngelixa usebenzisa le, okanye nayiphi na enye, amayeza.
Ukuba wena okanye othandekayo uthatha i-verapamil, kunyanzelekile ukuba uhlolisiswe ngokunyamekelwa ngu-cardiologist yakho. Yenza ukhetho lokuhlola rhoqo kunye ne-cardiologist kwaye qiniseka ukuxelela ugqirha wakho nayiphi na utshintsho kwimimiselo yonyango kuquka naluphi na ukusetyenziswa kwemithi yamachiza.
Ukongezelela, ukuba uvakalelwa nayiphi na imiphumo emibi engabonakaliswa kwi-verapamil njengokuphazamiseka okanye ukulahleka kwexesha lokukhumbula, nceda uncedo olungxamisekileyo.
Imithombo:
Lynch, T kunye ne-Price, A. "Impembelelo yeCytochrome P450 iMetabolism kwiMpendulo yeMithi, ukuHlangana, kunye nemiphumo emibi" I- American Family Physician. 2007.
I-Mosby ye-Drug Reference ye-Health Professions, Uhlobo lwesiBini . Elsevier. 2010.
UTomaszewski CA, uBenowitz NL. Isahluko 40. I-Calcium Channel Antagonists. Ku: Olson KR. eds. Ukutyhefuza nokugqithiswa kweDrug, 6e . New York, NY: McGraw-Hill; 2012.