Ua tsaug rau kev tshawb fawb txog kev lag luam tshuaj, cov txiaj ntsig ntawm cov tshuaj tau kawm tas li, kev tso tawm cov tshuaj niaj hnub muaj txiaj ntsig zoo. Tab sis muaj cov tshuaj broad-spectrum uas tseem tsis tau muaj nyob rau ntau xyoo lawm. Cov no suav nrog alpha blockers.
Lawv feem ntau siv rau hauv kev kho mob ntshav siab, txo cov ntshav siab, nrog rau ntau yam kab mob urological, xws li mob prostatitis thiab benign prostate qog.
Discovery keeb kwm
Qhov kev tshawb pom ntawm alpha-blockers hauv Lavxias kws tshuaj tau tsim xyoo 1976. Txij thaum ntawd los, lawv tau raug suav hais tias muaj txiaj ntsig zoo rau ntshav siab txo cov tshuaj. Tab sis lawv cov kev siv tsis yog ib txwm tsim nyog vim muaj kev phiv ntau dhau. Ib qho ntawm thawj cov tshuaj hauv pawg no yog Prazosin. Tsis tas li ntawd, kev tso tawm ntawm lwm cov alpha-blockers, xws li Doxasosin thiab Terarosin, tau pib. Tag nrho cov ntawm lawv, zoo li Prazosin, yog siv los kho ntshav siab, tab sis txawv ntawmua haujlwm ntev dua.
Tab sis alpha-blockers kuj txawv ntawm qib, qhov chaw thiab lub hom phiaj ua haujlwm. Cov kev npaj yuav nthuav tawm hauv qab no.
Views
Adrenoreceptors muab faib ua ob hom:
- Alpha-1 receptors, uas yog nyob rau ntawm qhov chaw ntawm lub postsynaptic membrane ntawm neuron, yog lub luag hauj lwm rau cov teeb liab tshwm sim thaum siv catecholamines rau lwm cov neurons los yog effector hlwb, nrog rau qee cov vascular hlwb. Qhov tshwm sim ntawm kev ua haujlwm ntawm cov receptors yog vasoconstriction.
- Alpha-2 receptors, uas nyob rau saum npoo ntawm presynaptic daim nyias nyias ntawm cov neuron, tswj kev tsim cov norepinephrine rau hauv cov synaptic cleft los ntawm kev tawm tswv yim tsis zoo, yog li txo qis kev tsim cov norepinephrine hauv cov synaptic cleft.
Kev nqis tes ua ntawm alpha-1 receptor blockade ntawm vascular du nqaij tshem tawm catecholamine-induced vasoconstriction. Nyob rau hauv lem, alpha-2 receptors nyob rau ntawm lub presynaptic daim nyias nyias ntawm lub neuron tsis nyob rau hauv blockade, uas txhais tau hais tias muaj ib tug ncaj ncees ntawm lub tswv yim mechanism uas provokes tso tawm ntawm norepinephrine.
Xaiv 1 (blockers) yog antagonists ntawm postsynaptic receptors. Cov tshuaj no tshem tawm cov kev ua haujlwm receptor vim qhov cuam tshuam ntawm catecholamines hauv kev ncig thiab tso tawm los ntawm cov neurons.
Functions
Ntxiv rau qhov ua rau txo cov ntshav siab, alpha-blockers (tshuajhauv qab no) muaj lwm yam haujlwm. Ethocardial, metabolic, extracardiac kho cov teebmeem. Kev ua haujlwm siab ntawm cov tshuaj hauv pawg no tau raug tshawb fawb pov thawj hauv kev kho mob ntawm kev hloov pauv hauv myocardium, coronary system, thiab cuam tshuam rau cov proteins hauv prostate.
Extracardiac
- Txhim lub raum.
- -ntxuav lub bronchi.
- Txhim kho cov txheej txheem metabolic hauv cov kab mob genitourinary nrog cov qog nqaij hlav benign prostate.
Alpha-blockers muaj txiaj ntsig zoo ntawm kev txo cov qog loj hlob thiab qhov hnyav ntawm impotence.
Nkauj
- Txo cov myocardial hypertrophy.
- Regulate lub plawv dhia.
Siv ceev faj vim muaj qhov tsis zoo hauv lub plawv tsis ua haujlwm thiab angina pectoris.
- Txo txoj kev pheej hmoo ntawm cov quav hniav.
- Txo cov ntshav qab zib (insulin) qib.
Raws li tau hais los saum no, alpha-blockers feem ntau siv los kho cov kab mob prostate hauv cov txiv neej.
Cov txiv neej hnub nyoog tshaj 50 xyoo feem ntau raug cov kab mob zoo li no, thawj qhov chaw ntawm cov kab mob prostatitis thiab prostate adenoma.
Cov kab mob no muaj kev cuam tshuam tsis zoo rau tib neeg txoj kev ua neej feem ntau. Cov teeb meem tsis tu ncua nrog tso zis, tsis xis nyob, nce impotence yog qee yam nyuaj rau tus txiv neej ntawm txhua lub hnub nyoog. Tsis tas li ntawd, cov kab mob saum toj no suav nrogkev loj hlob sai. Feem ntau, kev phais yog qhov tseem ceeb. Cov tshuaj siv los tiv thaiv tus kab mob theem mob.
Rau kev kho mob, a-blockers, 5-alpha reductase inhibitors raug siv.
Txoj kev kho mob ntawm inhibitors
Kev loj hlob ntawm cov leeg nqaij ntawm lub caj pas prostate yog provoked feem ntau los ntawm keeb kwm hormonal. Steroid 5-alpha reductase txhawb kev hloov pauv ntawm cov tshuaj hormone testosterone rau hauv dihydrotestosterone hauv cov kab mob prostate. Lub tom kawg, nyob rau hauv lem, khi rau lub nuclear androgen receptor nyob rau hauv lub prostate thiab provokes lub secretion ntawm paracrine loj hlob yam, uas kuj txav mus rau hauv lub prostate. Alpha-blockers 5-alpha reductase inhibitors tuaj yeem pab hauv qhov xwm txheej no.
ntau dhau ntawm dihydrotestosterone ua rau muaj ntau yam kab mob loj, xws li qog nqaij hlav ntawm prostate, oncological neoplasms, thiab lwm yam kab mob urological ntawm prostate. Ntawm no, 5 alpha reductase inhibitors yog siv los ua kev kho mob. Lawv cov txiaj ntsig kho mob yog los thaiv cov reductase, uas ua rau txo qis ntawm dihydrotestosterone, uas ua rau muaj kev hloov pauv hauv prostate.
Cov tshuaj nrov tshaj plaws hauv pawg no yog Finasteride thiab Dutasteride. Lawv muaj cov txiaj ntsig zoo sib xws, sib txawv ntawm lub sijhawm raug thiab ntau npaum li cas.
5-alpha reductase inhibitor blockers tuaj yeem yuav ntawm lub tsev muag tshuaj nrog daim ntawv xajtus kws kho mob.
Tab sis txawm tias qhov ua tau zoo, cov tshuaj siv nrog ceev faj thiab tsis yog nyob rau hauv txhua rooj plaub vim muaj coob tus ntawm qhov tsis zoo tshwm sim thiab contraindications.
Cov teebmeem tseem ceeb thaum noj
- Muaj peev xwm ntawm hypotension tom qab siv tshuaj los txo cov ntshav siab.
- Ntaus, taub hau, kiv taub hau.
- lub plawv dhia nrawm, ua tsis taus pa.
- mob leeg, qaug zog.
- Sedation.
- dej tuav, o.
- mob plab thiab hnyuv.
- Ua pa nyuaj ntawm qhov ntswg, nqhis dej.
- Ntau zaus ntawm cov poj niam ib nrab ntawm cov pejxeem muaj stimulation ntawm lub zais zis, nquag tso zis.
Alpha-beta blockers yog li yuav tsum tau ceev faj.
Ib qho tshwm sim hnyav tshaj plaws yog postural hypotension, uas tuaj yeem tshwm sim txawm tias ib zaug ntawm cov tshuaj. Nws thawj cov cim tshwm sim tom qab ib nrab teev lossis ib teev tom qab noj cov tshuaj. Qhov no feem ntau siv rau Prazosin. Txhawm rau tiv thaiv cov kev mob tshwm sim no, nws yog ib qho tsim nyog yuav tsum tau sau cov tshuaj ntawm kev noj tshuaj ntau ntxiv thiab nyiam dua thaum hmo ntuj.
Vim cov kev mob tshwm sim saum toj no, alpha-blockers tau muab tshuaj ua ke nrog cov tshuaj diuretics los tiv thaiv cov kua dej thiab cov tshuaj tua kab mob kom txo tau cov tsos mob ntawm qhov mob.
Tshuaj ntawm pab pawg no tau sau tseg raws li kev ywj pheejkev kho, thiab ib txhij nrog lwm cov tshuaj rau kev kho mob ntawm ntau yam kab mob.
Kab mob
Ntau yam kab mob kho nrog alpha-blockers:
- Nyob rau hauv kev sib ntaus tawm tsam kub siab nyob rau hauv txoj kev kho mob, raws li ib tug txhais tau tias kom ua tau ib tug ceev kho nyhuv.
- Kev loj hlob zoo nyob rau hauv lub caj pas prostate.
- YPheochromocytoma.
- Malignant neoplasm hauv prostate.
YContraindications
Thaum twg alpha thiab beta blockers tsis tau tshuaj?
Lub ntsiab contraindications rau noj tshuaj yog:
- ntshav siab;
- dehydration;
- Ydiuretic kho;
- ntau lub plawv tsis xws luag;
- mob plawv tsis ua hauj lwm;
- bronchial hawb pob;
- Lub plawv dhia tsis xwm yeem.
Tsis txhob sau tshuaj ntawm hom no thaum cev xeeb tub thiab lactation, vim tsis muaj cov kev tshawb fawb hauv chaw kuaj pom tseeb ntawm qhov teeb meem no.
Alpha blockers rau adenoma
Cov tshuaj tseem ceeb ntawm pab pawg no siv los kho adenoma:
- Uroxataral.
- Kardura.
- Gitrin.
- "Rapaflo".
- Flomax.
Lub plawv ntawm cov tshuaj no yog alpha-blockers. Daim ntawv mus rau.
Mechanism of action
Lub tshuab ua haujlwm ntawm cov tshuaj no hauv kev tawm tsam adenoma yog yooj yim, lawv txo cov suab nrovcov leeg ntawm prostate thiab zais zis, yog li pab txhawb kom tso zis.
Tshaj cov tshuaj xws li kev kho mob nrog ib tus neeg noj, noj ib zaug lossis ob zaug hauv ib hnub.
Kev muab tshuaj rau cov neeg mob siab heev uas tso zis nyuaj thiab cov tshuaj tsis muaj zog tau ua tsis tiav.
Cov nyhuv kho tseem ceeb pib tshwm sim tom qab ib lub lim tiam ntawm kev noj tshuaj. Tom qab 14-21 hnub, qhov kev kho mob tseem ceeb ntawm tus neeg mob tau tshwm sim.
Cov lus qhia tshwj xeeb
Rau cov txiaj ntsig kho mob siab, alpha-blockers thiab 5-alpha reductase inhibitors raug coj ua khub. Cov ntaub ntawv hais txog kev ua tau zoo ntawm kev siv cov tshuaj ua ke yog tau los ntawm kev tshawb fawb kho mob.
Nws tsis pom zoo kom muab cov tshuaj saum toj no ib txhij nrog cov tshuaj lossis cov khoom noj khoom haus rau impotence. Tej zaum yuav txhim khu kev kho cov nyhuv ntawm blockers, uas yog undesirable. Qhov tshwm sim tuaj yeem yog qhov poob qis hauv cov ntshav siab.
Lwm qhov tsis zoo ntawm kev noj alpha blockers rau kev kho mob ntawm cov kab mob urological tuaj yeem ua rau ejaculation rau hauv lub zais zis. Nws tsis ua rau muaj kev cuam tshuam rau kev noj qab haus huv tag nrho.
Thaum siv tshuaj ntawm pab pawg no los tawm tsam adenoma, nws raug nquahu kom siv lwm yam tshuaj los txo cov ntshav siab. Noj ua ib feem ntawm txoj kev kho mob nyuaj, lawv yuav tsis tshua muaj txiaj ntsig hauv kev kho mob ntshav siab.
Rau cov neeg mob uas tsis muaj ntshav siab, thaum cuam tshuam nrog kev hloov pauv hauv lub qog prostate nrog alpha-blockers, nws raug nquahu kom saib xyuas cov ntshav siab tas li.
Tshuaj Tiv Thaiv
- Tshuaj muaj alpha blockers yuav tsum tau siv raws li koj tus kws kho mob qhia. Tus kws kho mob yuav tsum txiav txim siab npaum li cas, lub sij hawm ntawm kev tswj hwm.
- Kev kho mob nrog kev siv cov tshuaj no yuav tsum tau ua raws li kev saib xyuas ntawm kws kho mob lossis hauv cov phab ntsa ntawm lub tsev kho mob.
- Yog tias muaj kev phiv tshwm sim, tsis txhob noj tshuaj thiab sab laj nrog kws kho mob.
- Tsis txhob hloov qhov koob tshuaj nce siab ntawm koj tus kheej.
- Kev nkag mus rau lwm yam tshuaj tib lub sijhawm raws li alpha-blockers yuav tsum tau pom zoo nrog koj tus kws kho mob.
- Tsis txhob siv alpha-blockers ua kev kho mob kub ntxhov yam tsis tau kws kho mob pom zoo.
- Tsis txhob noj cov tshuaj uas dhau los lossis nrog cov ntim khoom tawg, ua rau lub plhaub tawv ntawm cov ntsiav tshuaj puas.
- Yuav tshuaj los ntawm cov chaw muag tshuaj muaj ntawv tso cai.
- Thaum noj tshuaj ntawm pab pawg saum toj no, ntsuas ntshav siab txhua hnub thiab ua ntej yuav mus pw.
- Kev noj tshuaj rau ntshav siab thaum cev xeeb tub yuav tsum tau pom zoo nrog koj tus kws kho mob.
Nws yog ib qho tseem ceeb kom nkag siab tias kev noj tshuaj ntau dhau ntawm cov tshuaj no tuaj yeem ua rau qhov tshwm sim tsis zoo.
