Txhua yam tshuaj muaj nyob rau hauv ib pawg kws tshuaj. Qhov no txhais tau hais tias qee cov tshuaj muaj tib lub tswv yim ntawm kev ua, kev qhia rau kev siv thiab kev phiv. Ib pawg kws tshuaj loj yog beta-agonists. Cov tshuaj no tau siv dav hauv kev kho mob ntawm cov hlab ntsws thiab cov hlab plawv pathologies.
B-agonists yog dab tsi?
Beta-agonists yog ib pawg tshuaj uas siv los kho ntau yam kab mob. Nyob rau hauv lub cev, lawv khi rau cov receptors tshwj xeeb nyob rau hauv cov nqaij ntshiv ntawm lub bronchi, uterus, plawv, thiab vascular ntaub so ntswg. Qhov kev sib cuam tshuam no ua rau stimulation ntawm beta hlwb. Yog li ntawd, ntau yam txheej txheem physiological tau qhib. Thaum B-agonists khi rau receptors, kev tsim cov tshuaj lom neeg xws li dopamine thiab adrenaline tau txhawb nqa. Lwm lub npe rau cov tshuaj no yog beta-agonists. Lawv cov teebmeem tseem ceeb yog qhov nce hauv lub plawv dhia, nce ntshav siab thiab txhim kho hauv bronchial conduction.
Betaadrenomimetics: kev ua hauv lub cev
Beta-agonists tau muab faib ua B1- thiab B2-agonists. Receptors rau cov tshuaj no yog nyob rau hauv lub cev. Thaum khi rau lawv, beta-agonists ua rau kom muaj ntau yam txheej txheem hauv lub cev. Cov teebmeem hauv qab no ntawm B-agonists yog qhov txawv:
- Kev mob plawv automatism thiab txhim kho kev coj ua.
- Npaj siab lub plawv dhia.
- Accelerating lipolysis. Nrog rau kev siv cov B1-agonists, cov rog dawb tshwm sim hauv cov ntshav, uas yog cov khoom ntawm kev rhuav tshem triglycerides.
- Npaj ntshav siab. Qhov kev txiav txim no yog vim kev txhawb nqa ntawm renin-angiotensin-aldosterone system (RAAS).
Kev khi ntawm adrenomimetics rau B1 receptors ua rau muaj kev hloov pauv hauv lub cev. Lawv nyob hauv lub plawv cov leeg, cov hlab ntsha, cov ntaub so ntswg adipose thiab juxtaglomerular apparatus ntawm lub raum hlwb.
B2-receptors muaj nyob rau hauv lub bronchi, tsev menyuam, cov leeg pob txha, hauv nruab nrab lub paj hlwb. Tsis tas li ntawd, lawv muaj nyob rau hauv lub plawv thiab cov hlab ntsha. Beta-2-agonists ua rau cov teebmeem hauv qab no:
- Txhim kho bronchial conduction. Qhov kev txiav txim no yog los ntawm kev so ntawm cov leeg du.
- Kev nrawm ntawm glycogenolysis hauv cov leeg. Vim li ntawd, cov leeg pob txha sib cog lus sai thiab muaj zog.
- Relaxation ntawm myometrium.
- Kev nrawm ntawm glycogenolysis hauv daim siab hlwb. Qhov no ua rau cov ntshav qab zib nce ntxiv.
- Npaj siab lub plawv dhia.
Cov tshuaj twg yog pawg B-agonists?
Cov kws kho mob feem ntau sau tshuaj beta-agonists. Cov tshuaj uas koom nrog pawg kws tshuaj no tau muab faib ua cov tshuaj ua kom luv luv thiab ua kom ceev ceev. Tsis tas li ntawd, cov tshuaj raug cais tawm uas muaj kev xaiv tsuas yog rau qee yam kabmob. Qee cov tshuaj ua ncaj qha rau ntawm B1 thiab B2 receptors. Cov tshuaj paub zoo tshaj plaws los ntawm pab pawg beta-agonists yog cov tshuaj Salbutamol, Fenoterol, Dopamine. B-agonists yog siv los kho mob ntsws thiab mob plawv. Tsis tas li ntawd, qee qhov ntawm lawv tau siv hauv chav saib xyuas mob hnyav (tshuaj "Dobutamine"). Tsawg dua, cov tshuaj ntawm pab pawg no tau siv hauv kev xyaum gynecological.
Kev faib tawm ntawm beta-agonists: hom tshuaj
Beta-agonists yog pawg kws tshuaj uas suav nrog ntau cov tshuaj. Yog li ntawd, lawv tau muab faib ua ob peb pawg. Kev faib tawm ntawm B-agonists suav nrog:
- Non-selective beta-agonists. Cov pab pawg no suav nrog cov tshuaj "Orciprenaline" thiab "Isoprenaline".
- Xaiv B1-agonists. Lawv siv nyob rau hauv cardiology thiab intensive care units. Cov neeg sawv cev ntawm pab pawg no yog cov tshuaj Dobutamine thiab Dopamine.
- Selective beta-2-agonists. Cov pab pawg no suav nrog cov tshuaj siv rau cov kab mob ntawm lub ntsws. Nyob rau hauv lem, xaiv B2-agonists muab faib ua luv luv-acting tshuaj thiab tshuaj uas muaj ib tug ntevnyhuv. Thawj pab pawg muaj xws li tshuaj "Fenoterol", "Terbutalin", "Salbutamol" thiab "Hexoprenaline". Cov tshuaj ua haujlwm ntev yog cov tshuaj Formoterol, Salmeterol thiab Indacaterol.
Cov lus qhia rau kev siv B-agonists
Cov lus qhia rau kev siv B-agonists nyob ntawm hom tshuaj. Tsis yog xaiv beta-agonists tam sim no siv tsis tau. Yav dhau los, lawv tau siv los kho qee hom arrhythmias, deterioration ntawm cardiac conduction, thiab bronchial hawb pob. Cov kws kho mob tam sim no nyiam sau ntawv xaiv B-agonists. Lawv qhov zoo dua yog tias lawv muaj kev phiv tsawg dua. Tsis tas li ntawd, cov tshuaj xaiv tau yooj yim dua rau kev siv, vim lawv tsuas cuam tshuam rau qee yam kabmob.
Qhia rau kev teem caij ntawm B1-agonists:
- mob plawv tsis ua hauj lwm.
- Kev poob siab ntawm ib qho etiology.
- Collapse.
- Decompensated plawv defects.
- Ntshai - mob hlab ntsha loj heev.
B2-agonists tau muab tshuaj rau bronchial hawb pob, kab mob ntsws ntev. Feem ntau, cov tshuaj no yog siv nyob rau hauv daim ntawv ntawm aerosols. Qee zaum cov tshuaj "Fenoterol" yog siv nyob rau hauv gynecological xyaum ua kom qeeb zog thiab tiv thaiv nchuav menyuam. Nyob rau hauv cov ntaub ntawv no, cov tshuaj yog muab intravenously.
Thaum twg B-agonists contraindicated?
Nws yuav tsum nco ntsoov tias cov tshuaj ntawm pawg beta-agonist muaj ntau yamcontraindications thiab phiv. Qhov no yog qhov tseeb tshwj xeeb rau cov uas tsis yog xaiv B-agonists. Cov kev mob tshwm sim ntawm cov tshuaj no yog kev txhim kho ntawm hyperglycemia, tshee tshee ntawm cov ceg, lub plawv dhia tsis zoo, kev ua kom lub hauv nruab nrab lub paj hlwb, thiab lwm yam. Beta-1-agonists yog cov tshuaj muaj zog, yog li ntawd lawv tsuas yog siv rau hauv cov xwm txheej ceev. Lawv yog contraindicated nyob rau hauv cov neeg mob uas muaj keeb kwm ntawm xws pathologies: ventricular arrhythmia, subaortic stenosis, pheochromocytoma. Tsis tas li ntawd, lawv yuav tsum tsis txhob siv rau lub plawv tamponade.
B2 agonists yog contraindicated nyob rau hauv cov nram no:
- Intolerance rau beta-agonists.
- Kev cev xeeb tub nyuaj los ntshav, placental abruption, hem nchuav menyuam.
- Cov menyuam yaus hnub nyoog qis dua 2 xyoos.
- cov txheej txheem mob hauv myocardium, kev cuam tshuam kev sib dhos.
- Aortic stenosis.
- Hypertension.
- mob plawv tsis ua hauj lwm.
- YThyrotoxicosis.
Tshuaj "Salbutamol": cov lus qhia rau kev siv
Salbutamol yog ib qho luv luv-acting B2 agonist. Nws yog siv rau bronchial obstruction syndrome. Feem ntau siv hauv aerosols, 1-2 koob tshuaj (0.1-0.2 mg). Nws yog qhov zoo dua rau cov menyuam yaus kom nqus tau los ntawm nebulizer. Kuj tseem muaj daim ntawv ntsiav tshuaj ntawm cov tshuaj. Qhov koob tshuaj rau cov neeg laus yog 6-16 mg ib hnub twg.
Salbutamol: tshuaj nqi
Cov tshuaj yog siv los ua monotherapy raumob me me bronchial hawb pob. Yog tias tus neeg mob muaj qhov nruab nrab lossis hnyav theem ntawm tus kab mob, cov tshuaj ntev ntev (ntev beta-agonists) tau siv. Lawv yog cov kev kho mob yooj yim rau bronchial hawb pob. Txhawm rau kom sai sai ntawm kev mob hawb pob, cov tshuaj "Salbutamol" yog siv. Tus nqi ntawm cov tshuaj yog los ntawm 50 mus rau 160 rubles, nyob ntawm seb cov chaw tsim tshuaj paus thiab cov tshuaj muaj nyob rau hauv lub vial.
