Carboanhydrase inhibitors yog cov tshuaj diuretics uas tsis siv los ua diuretics lossis diuretics. Cov lus qhia rau kev teem caij ntawm cov tshuaj no yuav yog glaucoma. Cia peb mus saib cov neeg nyiam tshaj plaws.
Acetazolamide (Acetazolamide)
muaj diuretic zog. Nws nres carbonic anhydrase ntawm lub raum raum tubules, txo cov reabsorption ntawm K, Na thiab dej ions (ua rau ib tug nce nyob rau hauv diuresis), ua rau ib tug txo nyob rau hauv BCC thiab metabolic acidosis. Inhibits carbonic anhydrase ntawm lub cev ciliary thiab ua rau kom txo qis hauv intraocular siab, thiab tseem txo qis kev tso tawm ntawm aqueous lom zem, ua rau muaj kev ua haujlwm antiepileptic hauv hlwb. Nws muaj qhov nqus tau zoo los ntawm txoj hnyuv, hauv cov ntshav Cmax tom qab ob teev. Qhov kev txiav txim tuaj yeem kav ntev txog 12 teev. Txo IOP los ntawm 40-60% thiab txo cov kua dej intraocular.
Kev qhia thiab ntau npaum li cas
Cov lus qhia tseem ceeb: ophthalmohypertension, glaucoma. Rau glaucoma, noj 0.125-0.25 g ntawm qhov ncauj 1-3 zaug ib hnub twg rau 5 hnub, tom qab ntawd nws tsim nyog.so ob hnub.
Cov kev mob tshwm sim: xeev siab, tsis qab los noj mov, raws plab, ua xua, tsis hnov tsw ntawm kov, paresthesia, tinnitus, tsaug zog. Tag nrho cov no tuaj yeem raug provoked los ntawm inhibitors ntawm carbonic anhydrase. Cov tshuaj kuj muaj contraindications. Cov no yog hypersensitivity (xws li sulfonamides), Addison tus kab mob, nyiam acidosis, mob siab thiab raum kab mob, cev xeeb tub, ntshav qab zib mellitus, uremia..
Dorzolamide (dorzolamide)
Inhibits isoenzyme II carbonic anhydrase kev ua haujlwm (pib rov qab hydration cov tshuaj tiv thaiv ntawm carbon dioxide thiab carbonic acid dehydration) ntawm ciliary qhov muag lub cev. Kev tso tawm ntawm cov dej hauv cov hlab ntsha txo qis los ntawm 50%, qhov tsim ntawm bicarbonate ions qeeb, thiab kev thauj mus los ntawm dej thiab sodium yog ib feem txo. Kev tsim cov kua dej intraocular txo qis los ntawm 38%, uas tsis cuam tshuam rau kev ntws tawm.
Nkag mus rau hauv lub qhov muag tsuas yog los ntawm limbus, sclera lossis pob kws. Ib nrab absorbed rau hauv cov hlab ntsha los ntawm cov mucous daim nyias nyias ntawm lub qhov muag (tej zaum qhov tshwm sim ntawm diuretic thiab lwm yam teebmeem ntawm sulfonamides). Tom qab cov tshuaj tau nkag mus rau hauv cov ntshav, nws nkag mus rau hauv erythrocytes sai, uas muaj ntau ntawm carbonic anhydrase II. Dorzolamide yog 33% khi rau plasma proteins. Nws qhia qhov siab tshaj plaws hypotensive nyhuv tom qab instillation tom qab 2 teev thiab khaws cia rau 12 teev. Ntawminstillation mus txog 2 zaug hauv ib hnub txo qis intraocular siab los ntawm 9-21%, thiab thaum instilled 3 zaug ib hnub twg - los ntawm 14-24%. Qhov kev txo qis hauv cov ntshav siab thaum siv cov tshuaj 2% tuaj yeem ncav cuag qhov siab tshaj plaws ntawm 4.5-6.1 millimeters mercury. Kev daws 3% yuav tsis zoo vim tias nws yuav raug ntxuav tawm ntawm cov kab noj hniav sai, vim nws ua rau lacrimation hnyav. Ua ke nrog kev teem sijhawm ntawm timolol, nws muaj cov txiaj ntsig ntxiv los ntawm 13 txog 21%. Carbonic anhydrase inhibitors muaj qhov cuam tshuam me me ntawm cov ntshav siab thiab lub plawv dhia. Diuretics ntawm pab pawg no tsis siv rau lawv lub hom phiaj. Xav paub ntau ntxiv tom qab.
Kev qhia thiab ntau npaum li cas
Cov Lus Qhia: thawj thiab theem nrab qhib-lub kaum sab xis glaucoma, ophthalmohypertension. Cov tshuaj tau qhia 1 poob 2-3 zaug hauv ib hnub. Cov kev mob tshwm sim: paresthesia, poob phaus, kev nyuaj siab, daim tawv nqaij ua pob, aplastic anemia, agranulocytosis, qaug zog, mob taub hau, tshuaj lom epidermal necrolysis, iab hauv qhov ncauj, xeev siab., nce nyob rau hauv lub thickness ntawm cornea, iridocyclitis, blepharitis, keratitis, conjunctivitis, photophobia, qhov muag tsis pom kev, khaus thiab tingling nyob rau hauv lub qhov muag, tsis xis nyob, Stevens-Johnson syndrome, kub hnyiab, lacrimation.
Qhov no carbonic anhydrase inhibitor (qhov muag tee) muaj cov hauv qab no contraindications: hypersensitivity (xws li sulfonamides), thaum yau, mob siab thiab raum kab mob, cev xeeb tub thiab pub niam mis. Tshuaj: qhov muag tee"Trusopt", muaj 20 mg ntawm dorzolamide hydrochloride hauv 1 ml ntawm kev daws. Lub raj mis muaj peev xwm - 5 ml. Tsim nyob rau hauv Netherlands los ntawm Merck Sharp & Dohme.
Carboanhydrase inhibitors: Brinzolamide (brinzolamide)
Qhov tshiab tshaj plaws carbonic anhydrase blocker uas muaj peev xwm, thaum siv tshuaj pleev ib ce, txo qis thiab tswj IOP. Brinzolamide muaj kev xaiv siab rau carbonic anhydrase II thiab lub cev tsim nyog tshaj plaws kom nkag mus rau hauv lub qhov muag zoo. Thaum piv nrog dorzolamide thiab acetozolamide, nws tau pom tias brinzolamide yog cov khoom muaj zog tshaj plaws hauv pawg carbonic anhydrase inhibitor. Muaj pov thawj tias kev siv tshuaj hauv zos lossis hauv cov hlab ntsha ntawm brinzolamide ua rau muaj kev txhim kho hauv ONH. Nws kuj tseem txo qis IOP los ntawm qhov nruab nrab ntawm 20%. Tsis yog txhua tus carbonic anhydrase inhibitors ua haujlwm li no. Cov txheej txheem ntawm kev ua ntawm brinzolamide yog qhov tshwj xeeb.
Kev qhia thiab ntau npaum li cas
Cov lus qhia rau kev siv: ophthalmohypertension, open-angle glaucoma. Siv 2 zaug hauv ib hnub, poob qis.
Cov teebmeem: saj perversion, txawv teb chaws lub cev, qhov muag tsis pom kev tom qab instillation (ib ntus) thiab kub hnyiab. Zoo dua hauv zos zam dua li dorzolamide. Contraindications: hypersensitivity rau cov khoom ntawm cov tshuaj (xws li sulfonamides), thaum yau, cev xeeb tub thiab pub niam mis.
Tshuaj: Azopt qhov muag tee muaj 10 mg ntawm brinzolamide hauv 1 ml ntawm kev ncua. Muaj peev xwmcev 5ml. Tsim nyob rau hauv teb chaws USA los ntawm Alcon.
Yuav ua li cas lwm cov carbonic anhydrase inhibitors muaj?
YProstaglandin derivatives
Latanoprost (latanoprost) yog ib qho kev xaiv prostaglandin receptor agonist. Ua kom cov dej ntws tawm hauv lub cev los ntawm cov choroid ntawm lub qhov muag, uas ua rau kom txo qis hauv cov ntshav siab. Tsis cuam tshuam rau kev tsim cov aqueous lom zem. Tej zaum yuav hloov me nyuam kawm ntawv, tab sis tsuas yog me ntsis. Thaum instilled, nws nkag mus rau hauv daim ntawv ntawm isopropyl ether los ntawm lub cornea thiab yog hydrolyzed nyob rau hauv lub xeev ntawm ib tug biologically active acid, uas yuav txiav txim tau nyob rau hauv thawj 4 teev nyob rau hauv intraocular kua thiab nyob rau hauv plasma thaum thawj teev. 0.16 l / kg - ntim ntawm kev faib tawm. Ob teev tom qab kev sib txuas, qhov siab tshaj plaws ntawm cov khoom nyob rau hauv aqueous lom zem yog mus txog, tom qab uas nws muab faib ua ntej nyob rau hauv lub anterior ntu, uas yog, daim tawv muag thiab conjunctiva, thiab ces nkag mus rau hauv lub posterior ntu (nyob rau hauv ib tug me me npaum li cas). Daim ntawv nquag nyob rau hauv cov ntaub so ntswg ntawm lub qhov muag yog xyaum tsis metabolized, feem ntau biotransformation tshwm sim nyob rau hauv daim siab. Cov metabolites feem ntau yog tawm hauv cov zis. Xav txog qee qhov ntxiv carbonic anhydrase inhibitors.
Unoprostone
Isopropyl unoprostone yog ib qho docosanoid derivative uas txo qis intraocular siab (IOP) los ntawm cov tshuaj tshiab tshiab. Yog tsis hloov lub sij hawm ntawm intraocular kua ntau lawm, nws yooj yim rau nws outflow. Cov kev tshawb fawb pom tau tias piv rau 0.5% txiv neejtimolol, isopropyl unoprostone muaj cov haujlwm zoo sib xws lossis ntau dua hauv kev cuam tshuam rau kev txo qis IOP. Cov tshuaj tsis cuam tshuam rau kev nyob thiab tsis ua rau txo qis hauv cov ntshav hauv cov ntaub so ntswg, miosis lossis mydriasis; Kev ncua ntawm pob corneal regeneration kuj tsis pom. Tom qab siv tshuaj pleev ib ce, tsis hloov isotropil unoprostone tsis tau kuaj pom hauv plasma.
Carboanhydrase inhibitors rau glaucoma yuav tsum tsuas yog kws kho mob tau sau tseg, kev siv tshuaj rau tus kheej tsis tuaj yeem lees txais.
