Cov tshuaj Cardiotonic yog cov tshuaj uas ua rau kom cov leeg nqaij hauv lub plawv, nws cov contractility thiab siv rau kev kho mob plawv. Cov pab pawg muaj xws li ib tug loj tus naj npawb ntawm cov tshuaj uas muaj ntau yam active tshuaj nyob rau hauv lub composition thiab ib tug txawv mechanism ntawm kev txiav txim. Cardiotonics yog siv los kho mob plawv thiab mob plawv.
Cov tshuaj Cardiotonic: kev faib tawm
Tag nrho cov txiaj ntsig ntawm txhua yam tshuaj hauv pab pawg yog ua raws li kev muaj peev xwm ua kom lub zog ntawm myocardial contractions, ua rau muaj kev nce siab hauv plawv thiab mob stroke. Cardiotonic cov neeg ua haujlwm txo qis diastolic ntim, pulmonary thiab systemic venous siab, thiab ventricular filling siab.
- Mob plawv glycosides - Strofanthin, Korglikon, Digoxin.
- tshuaj Adrenergic - Isadrin, Dobutamine, Dopamine.
- NonadrenergicSynthetic tshuaj - "Amrinon", "Milrinon"
Kev xaiv cov tshuaj siv yog cuam tshuam nrog qhov hnyav ntawm tus neeg mob tus mob thiab daim ntawv ntawm tus kab mob.
Kheev glycosides
Cov pab pawg yog sawv cev los ntawm cov nroj tsuag lossis cov khoom siv hluavtaws. Kev npaj raws li tshuaj ntsuab tau los ntawm foxglove, adonis, caij nplooj ntoos hlav lily ntawm lub hav, oleander, strophanthus, thiab lwm yam.
Lub sijhawm ntawm cov txiaj ntsig kho mob, cov txiaj ntsig ntawm kev sib sau hauv lub cev thiab cov tshuaj neurotoxicity yog nyob ntawm lawv lub peev xwm los tsim cov complexes nrog cov ntshav plasma proteins. Qhov kev sib txuas no muaj zog dua, qhov ua tau zoo ntawm glycoside ntau dua. Cardiotonic cov neeg sawv cev ntawm pab pawg no muaj kev cuam tshuam raws li cov txheej txheem hauv qab no:
- muaj qhov luv ntawm systole nrog nws nce ib txhij;
- lub plawv cov leeg so lub sijhawm ntev;
- lub plawv dhia;
- nce lub peev xwm ntawm cov leeg myocardial kom zoo siab;
- nrog kev siv tshuaj ntau dhau, ventricular arrhythmia tsim.
Digoxin
Cov tshuaj yog tsim los ntawm cov nplooj digitalis. Hais txog glycosides ua haujlwm ntev uas tsis muaj kev phiv loj heev. Nws yog siv rau kev kho mob ntawm lub plawv tsis ua hauj lwm ntev thiab tachysystolic arrhythmia.
Tshuaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj thiab txhaj tshuaj. Cov koob tshuaj yuav tsum raug xaiv kom zoo rau txhua tus neeg mobtus kheej. Nyob rau hauv rooj plaub ntawm kev siv lwm lub plawv glycosides ua ntej Digoxin, cov tshuaj txo qis.
Strophanthin
Yog qhov ua haujlwm luv luv glycoside siv rau qhov tsis txaus ntseeg. "Strophanthin" tsis nyiam nyob rau hauv lub cev. Cov tshuaj no txhim kho kev ua haujlwm ntawm cov hlab ntsha ntawm myocardium thiab ua kom cov ntshav ntim hauv feeb. Nyob rau tib lub sijhawm, muaj qhov txo qhov loj ntawm cov leeg nqaij thiab txo qis hauv nws qhov xav tau oxygen.
Siv intravenously, intramuscularly, nyob rau hauv tej rooj plaub - hais lus. Kev noj ntau ntau tuaj yeem ua rau overdose. Siv nrog lwm cov tshuaj hloov cov txiaj ntsig ntawm glycoside:
- nrog barbiturates cov nyhuv txo;
- nrog "Reserpine", sympathomimetics thiab antidepressants tuaj yeem ua rau kev loj hlob ntawm plawv arrhythmias;
- txais tos nrog tetracyclines, "Levomycetin", "Amiodarone" thiab "Captopril" txhim kho cov nyhuv cardiotonic;
- magnesium sulfate pab txhawb kev txhim kho plawv atrioventricular blockade.
YAdrenergic tshuaj
Non-glycoside cardiotonic tshuaj nrog rau lub sijhawm luv luv. Cov pab pawg no tau siv rau hauv kev mob plawv tsis ua haujlwm los txhawb lub cev tseem ceeb.
"Izadrin" yog ib qho stimulant ntawm adrenoreceptors ntawm cov hlab ntsha, bronchi thiab lub plawv. Cov tshuaj muaj ib tug hypotensive nyhuv, txhim khu lub contractility ntawm lub plawv cov leeg. Nws yog siv nyob rau hauv kev phais plawv nrog ib tug ntse txo nyob rau hauv contractility thaum lub sij hawmphais kev cuam tshuam, nrog rau hauv kev poob siab cardiogenic. Cov kws kho mob cov lus ceeb toom: kev siv tsis raug lossis kev siv tshuaj ntau dhau tuaj yeem ua rau ventricular fibrillation.
"Dobutamine" yog cov qauv tsis-glycoside cardiotonic tus neeg sawv cev uas muaj cov nyhuv stimulating ntawm lub plawv cov leeg, thiab kuj normalizes coronary ntshav txaus. Qhov kev pheej hmoo ntawm kev tsim arrhythmias thaum siv cov tshuaj no tsawg heev, txij li Dobutamine tau xyaum tsis cuam tshuam rau lub plawv automatism.
Teem sijhawm nrog kev xav tau ceev kom ntxiv dag zog rau kev cog lus ntawm myocardium. Tej zaum yuav ua rau muaj kev phiv hauv qee kis:
- nausea;
- mob taub hau;
- mob ntshav siab;
- siab lub plawv dhia;
- mob plab.
"Dopamine" yog catecholamine uas txhawb nqa adrenoreceptors. Cov tshuaj tsub kom ntshav siab, ua kom cov ntshav coronary. Nws yog tshuaj rau mob myocardial insufficiency, poob siab. Siv ceev faj hauv myocardial infarction, cev xeeb tub, thyroid kab mob, arrhythmias.
Non-adrenergic synthetic cardiotonic tshuaj
Cov no yog cov neeg ua haujlwm cardiotonic siv rau hauv cov xwm txheej mob plawv tsis txaus. Cov tshuaj ua rau lub contractility ntawm lub plawv cov leeg, ntxiv dag zog rau nws. Lawv tuaj yeem ua rau muaj kev loj hlob ntawm arrhythmia thiab txo cov ntshav siab, mob raum.
Cov tshuaj Cardiotonic ntawm pab pawg no tsis tuaj yeem siv rau kev mob plawv,as well as cardiomyopathy, cardiac arrhythmia, aortic aneurysm, raum tsis ua hauj lwm, plawv nres, thiab thaum lub sij hawm cev xeeb tub.
txhais tau tias "Amrinon" yog siv tshwj xeeb hauv cov tsev kho mob hnyav, kom tus neeg mob nyob rau hauv kev tswj hwm ntawm cov cuab yeej tshwj xeeb uas qhia txog nws tus mob. Ntxiv nrog rau kev txhim kho lub plawv mob, cov tshuaj ua kom cov hlab ntsha nthuav dav, ua kom cov ntshav khiav thaum lub sij hawm systole, thiab txo qis pulmonary.
Tshuaj raws li kev daws teeb meem. Rau kev txhaj tshuaj, nws yog diluted nkaus xwb nyob rau hauv physiological sodium chloride tov. Tsis txhob sib xyaw nrog lwm cov khoom siv tshuaj. Nrog rau kev taw qhia, kev txo qis hauv siab, nce hauv lub plawv dhia, arrhythmia, pom kev mob taub hau, thiab plab hnyuv muaj peev xwm ua tau.
"Milrinon" yog qhov nquag tshaj li thawj tus neeg sawv cev ntawm pab pawg, thiab raws li kev tshuaj xyuas, nws zoo dua los ntawm cov neeg mob. Kev siv cov tshuaj thaum cev xeeb tub thiab kev loj hlob ntawm myocardial infarction yog contraindicated. Hais txog cov tshuaj ntawm pawg A. Qhov kev xav tau ntawm kev siv tshuaj yog txiav txim los ntawm tus kws kho mob nkaus xwb.
Zoo kawg
Cov tshuaj Cardiotonic tau raug pov thawj zoo ntau tiam dhau los. Kev tshuaj xyuas qhia tau hais tias cov tshuaj hauv pab pawg no pab tiv thaiv lub plawv tsis ua haujlwm. Txawm li cas los xij, noj cov tshuaj no nyob rau hauv daim ntawv ntawm tus kheej noj tshuaj yog nruj me ntsis contraindicated vim kev loj hlob ntawm cov teeb meem tshwm sim,kev phiv los yog overdose. Kev xaiv ntawm cov tshuaj, nrog rau cov koob tshuaj ntawm kev tswj hwm, yog txiav txim los ntawm tus kws kho plawv hauv txhua qhov chaw kho mob ib leeg.
