Lub siab, raws li koj paub, yog peb lub cev tseem ceeb, tab sis feem ntau ua tsis tiav. Txhawm rau rov ua haujlwm zoo li qub, siv ntau yam tshuaj. Ib tug ntawm lawv yog Amiodarone. Analogues yog kim dua, vim lawv tau tsim tawm txawv teb chaws thiab tsis zoo ib yam.
Cov tshuaj thiab tso tawm daim ntawv
Cov tshuaj "Amiodarone", tshuaj xyuas uas txawv heev, muaj nyob rau hauv ib ntsiav tshuaj 200 mg ntawm cov khoom xyaw nquag - amiodarone hydrochloride. Cov tshuaj kuj tau tsim nyob rau hauv daim ntawv ntawm cov tshuaj, qhov twg 3 ml account rau 5% ntawm cov active tshuaj.
Cov khoom pabcuam hauv ib ntsiav tshuaj yog: qos yaj ywm starch, crystalline microcellulose, mis qab zib, m altodextrin, primellose, polyvinylpyrrolidone, magnesium stearate.
Cov ntsiav tshuaj yog coated nrog dawb glaze nrog ib lub teeb, NW nyuam qhuav perceptible cream tint. Lawv muaj lub tiaj-cylindrical zoo li, nrog rau chamfer thiab muaj kev pheej hmoo. Yog li ntawd, yog tias tsim nyog, lawv tuaj yeem muab faib ua ob ntu sib npaug.
Kev muag khoomtshuaj nyob rau hauv cardboard thawv, qhov twg muaj ib los yog ob lub hlwv nrog kaum ntsiav tshuaj. Cov tshuaj kuj muaj nyob rau hauv iav, polymer thiab yas hwj, uas muaj 30 los yog 100 ntsiav tshuaj.
Pharmacological mechanism ntawm tshuaj ua haujlwm
Antiarrhythmic thiab antianginal cov cuab yeej yog tus cwj pwm los ntawm "Amiodarone", analogues hauv qee kis tuaj yeem hloov pauv. Nws cov nyhuv antiarrhythmic yog raws li qhov txo qis hauv cov dej ntws ntawm cov poov tshuaj ions thaum raug rau cov cell membranes - cardiomyocytes. Ua rau txo qis hauv qhov sinus node, uas ua rau bradycardia.
Kev siv cov tshuaj "Amiodarone" (cov ntsiav tshuaj) tso cai rau koj kom nce cov refractory ntu ntawm cov txheej txheem ntawm lub plawv. Nws inhibits conduction raws theem ob txoj hauv kev hauv cov neeg mob hnyav Wolff-Parkinson-White syndrome. Nyob rau hauv lem, cov nyhuv antianginal ntawm cov tshuaj yog raws li ib tug txo nyob rau hauv myocardial oxygen noj thiab txo nyob rau hauv nws cov nyhuv ntawm arterial cov leeg. Nws muaj iodine, uas, thaum noj, hloov cov ntsiab lus ntau ntawm cov thyroid hormones, vim tias cov qib ntawm lawv cov nyhuv ntawm myocardium txo.
"Amiodarone" muaj cov txiaj ntsig zoo, thiab cov txiaj ntsig tau hais los ntawm nws siv tsuas yog tom qab ib lub lim tiam ntawm kev siv cov tshuaj, thiab qhov siab tshaj plaws tau ua tiav tom qab ob mus rau peb lub lis piam.
Kwv yees li 40% ntawm cov tshuaj qaug cawv ntawm cov tshuaj yog nqus sab hauv, Cmax hauv cov ntshav tshwm sim tom qab 3-7 teev. Cov nyhuv tuaj yeem nyob ntev li ob peb lub lis piam. Cov txheej txheem metabolic tshwm sim hauv daim siab, qhov twgLub active caij deethylamiodarone yog tsim, uas yog lub ntsiab metabolite. Tawm nrog cov kua tsib thiab tso zis, T1 / 2 - tom qab ib koob tshuaj 3, 2-20, 7 teev, nrog kev kho mob ntev - tom qab 53 ± 24 hnub.
Tshuaj "Amiodarone": cov lus qhia rau kev siv
Cov tshuaj tau sau tseg rau kev tiv thaiv thiab kev kho mob ntawm arrhythmia, uas tuaj yeem ua rau tib neeg lub neej tuag, nrog rau kev ua haujlwm ntawm ventricular arrhythmias, hauv ventricular flutter nrog tsis ruaj khov, cov tshuaj "Amiodarone" kuj siv.
Cov lus qhia rau kev siv tso cai siv tshuaj thaum:
- atrial flutter;
- supraventricular arrhythmias;
- Hma-Parkinson-White syndrome;
- pom ntawm tachycardia;
- ventricular fibrillation;
- arrhythmia vim lub plawv thiab coronary insufficiency;
- mob plawv mob plawv;
- myocardial infarction.
"Amiodarone": cov lus qhia rau kev siv
Tshuaj yog npaj los ntawm qhov ncauj 15 feeb tom qab noj mov.
Thaum tus kab mob ventricular arrhythmia, koob tshuaj pom zoo los ntawm tus kws kho mob yog 800-1200 mg ib hnub twg. Nws yuav tsum tau muab faib ua 3-4 koob. Cov chav kawm ntawm kev kho mob nyob rau hauv cov ntaub ntawv no kav li ntawm 5-10 hnub thiab tuaj yeem txuas ntxiv kom ntseeg tau tias muaj kev ruaj ntseg ntawm tus neeg mob, thiab tus nqi yuav raug txo mus rau 600-800 mg ib hnub twg. Nws khauskev kho mob, uas tom qab ntawd nce mus rau prophylactic, nrog rau qhov qis dua ntawm cov ntsiab lus ntawm cov tshuaj.
Lub sijhawm kho kho yog 7-14 hnub, lub sijhawm no cov tshuaj tau noj ntawm 200-400 mg. Tus nqi ntawm cov tshuaj no yog muab los ua kom tus neeg mob tus mob nyob hauv lub sijhawm rov qab kho dua.
Ntau zaus, cov tshuaj "Amiodarone" tau sau tseg thaum tus neeg mob nyob hauv tsev kho mob, thiab tus kws kho mob tuaj yeem tswj nws qhov kev noj haus. Qhov no tso cai rau koj txo qis cov kev mob tshwm sim thiab kho tus kheej ntawm cov tshuaj.
Thaum mob angina pectoris, cov tshuaj tau noj ob zaug ib hnub, 200 mg. Tom qab ob lub lis piam, qhov koob tshuaj txo qis rau ib zaug ib hnub. Qhov siab tshaj plaws ib koob tshuaj yuav tsum tsis pub tshaj 400 mg, thiab cov koob tshuaj txhua hnub yuav tsum tsis pub tshaj 1200 mg.
Thaum muab tshuaj zoo li no rau menyuam yaus, yuav tsum nco ntsoov tias cov tshuaj cuam tshuam rau menyuam yaus sai dua li cov neeg laus. Yog li, qhov ntau npaum li cas yog xam raws qhov hnyav ntawm tus menyuam. Yog li, rau ib kilogram ntawm qhov hnyav yuav tsum yog 10 mg ntawm cov tshuaj. Cov koob tshuaj no yuav tsum tau khaws cia rau kaum hnub ntawm lub sijhawm kho lossis kom txog thaum tus neeg mob zoo dua. Nyob rau hauv lub neej yav tom ntej, tus qauv no yog txo mus rau ib feem: 5 mg ib kilogram ntawm tus me nyuam qhov hnyav nyob. Cov koob tshuaj tiv thaiv thiab kev saib xyuas yog noj los ntawm 2.4 mg ntawm Amiodarone ib kilogram ntawm lub cev qhov hnyav.
Cov lus qhia rau cov tshuaj tau sau tseg rau kev siv tshuaj raws li cov khoom xyaw nquag amiodaroneHydrochloride rau mob plawv arrhythmias. Nyob rau hauv cov ntaub ntawv no, cov tshuaj yog muab intravenously, txhaj rau hauv lub cev maj mam nrog ib tug dropper. Ua li no, hauv 250 ml ntawm 5% qabzib tov rau 1 lossis 2 teev, cov tshuaj maj mam txhaj ntawm tus nqi ntawm 5 mg ib kilogram ntawm qhov hnyav. Lub sijhawm no, tus neeg mob tus mob tau saib xyuas siv ECG thiab ntsuas kev nyeem ntshav siab.
Side effects
Ntau tus neeg hauv peb lub tebchaws raug tshuaj Amidaron. Analogs tsis tuaj yeem hloov pauv txhua lub sijhawm. Tab sis, txawm tias muaj txiaj ntsig zoo ntawm cov tshuaj rau tib neeg lub cev, cov kev mob tshwm sim kuj tau txheeb xyuas.
Cov tsos mob tsis zoo tshwm sim feem ntau vim yog siv tshuaj ntau dhau. Cov no yog cov teeb meem hauv kev ua haujlwm ntawm cov hlab plawv, xws li bradycardia, kev ua haujlwm tsis zoo ntawm lub qhov ntswg, lub plawv nres, thiab kev ua haujlwm tsis zoo ntawm kev txav. Tsis tas li ntawd nyob rau hauv ib feem ntawm cov kab mob ua pa, diffuse interstitial pulmonary fibrosis, interstitial pneumonia, Hamman-Rich syndrome, mob hauv siab, pulmonary fibrosis, tachypnea, bronchopulmonary spasms tau pom. Lub siab tsis ua haujlwm tau pom thaum noj tshuaj "Amidarone". Cov ntsiav tshuaj tsis tshua muaj tshwm sim daj daj, kab mob siab, thiab qee zaum cirrhosis ntawm daim siab.
Kev tsis sib haum ntawm cov tshuaj tuaj yeem ua rau muaj qhov tsis txaus ntawm cov thyroid hormones, dysthyroidism, nrog rau hypothyroidism thiab hnyav nce. Kev noj tshuaj ntau dhau tuaj yeem ua rau muaj kev cuam tshuam ntawm cov khoom siv pom, ua rau muaj cov lipids nyob ze ntawm lub cornea hauv cheeb tsam cov tub ntxhais kawm. Kuj muaj ib tug haisdaim tawv nqaij pigmentation, photosensitivity, urticaria los yog erythema. Cov pob me me, alopecia, dermatitis tau pom ntawm lub ntsej muag. Cov kev mob tshwm sim kuj cuam tshuam rau kev ua me nyuam hauv cov txiv neej. Hauv cov xwm txheej no, orchitis, impotence, thiab epididymitis tshwm sim. Tsis tshua muaj, thrombocytopenia, lub raum tsis ua haujlwm, angioedema, lossis vasculitis tau raug tshaj tawm.
Contraindications rau kev siv
"Amiodarone" (kev tshuaj xyuas txog nws tsis yog ib txwm zoo) raug xaiv nruj me ntsis rau tus kheej. Muaj cov neeg uas cov tshuaj no tsis pab lossis lawv tsis pom muaj kev hloov pauv hauv lawv lub xeev kev noj qab haus huv txhua, lwm tus pib choke tom qab siv, xav tias lub plawv dhia ceev. Raws li lawv, nrog rau kev siv ntev, nws tuaj yeem cuam tshuam qhov endocrine system, nce cov tshuaj hormones. Yog li ntawd, ua ntej noj cov tshuaj no, koj yuav tsum tsis tsuas yog ua tib zoo nyeem cov lus qhia, tab sis kuj xyuam xim rau cov lus qhia, kev phiv thiab contraindications.
Yog li, cov tshuaj tsis raug sau tseg yog tias muaj qhov thaiv atrioventricular ntawm 2-3 degrees, nrog rau kev poob siab, thyrotoxicosis. Cov tshuaj "Amiodarone" tsis yog siv nyob rau hauv cov ntaub ntawv ntawm rhiab heev rau nws active tshuaj thiab iodine. Kev txwv tsis pub yog kev ua txhaum loj ntawm kev mob plawv thiab kev tawm tsam ntawm bradycardia nrog syncope. Tsis txhob siv cov tshuaj thaum cev xeeb tub thiab lactation. Thaum lactating, thaum lub sijhawm kho tshuaj, kev pub niam mis yuav tsum raug tso tseg.
Special Recommendations
Kev kho mob nrog Amiodarone yuav tsum tau ua tib zoo saib xyuas los ntawm kws kho mob. Cov lus qhia rauKev siv cov ntsiav tshuaj yog pom zoo kom siv tom qab kuaj X-ray ntawm daim siab, ntsws thiab electrocardiogram. Kev saib xyuas zoo sib xws yuav tsum txuas ntxiv yog tias tus neeg mob tseem noj tshuaj.
Qhov hnyav ntawm cov kev mob tshwm sim feem ntau ncaj qha nyob ntawm cov koob tshuaj uas tus neeg mob noj. Koj yuav tsum sim siv cov tshuaj kom tsawg li ntau tau thiab tsawg kawg nkaus. Feem ntau ua rau lub plawv tsis ua haujlwm kom tshem tawm cov tshuaj "Amiodarone".
Cov lus qhia rau kev siv - tshuaj xyuas hais tias, txawm tias muaj kev phiv los, cov tshuaj no tau cawm ntau tshaj li ib txoj sia - thov tias cov tshuaj siv tshuaj txuas ntxiv mus rau ob lub lis piam tom qab nws tshem tawm.
Cov tshuaj muaj iodine, uas ua rau muaj kev sib txuam ntawm cov tshuaj iodine hauv cov thyroid caj pas. Yog li ntawd, thaum pib ntawm kev kho mob, nyob rau hauv tus txheej txheem thiab thaum kawg, nws yog tsim nyog los mus tas li kuaj cov thyroid hormones.
Thaum lub sijhawm kho, nws yuav tsum tsis txhob raug lub hnub ntev, tsis txhob qhib hnub da dej. Cov tshuaj yuav tsum tau noj nrog ceev faj heev rau cov neeg laus, nyob rau hauv kev siv tshuaj loog lossis thaum lub sijhawm kho cov pa oxygen. Nws yuav tsum tau siv nrog ceev faj los ntawm cov tsav tsheb thiab cov neeg uas nws txoj hauj lwm yog txuam nrog ib tug tshwj xeeb concentration ntawm kev mloog.
Thaum noj tshuaj ntau dhau, tej zaum yuav ua rau muaj kev phom sij ntau ntxiv, nrog rau hypotension, arrhythmia. Bradycardia lossis AV conduction tsis ua haujlwm yuav tshwm sim. Tshaj dhau tuaj yeem ua raulub siab ua haujlwm tsis zoo.
Nyob rau hauv cov ntaub ntawv no, tam sim ntawd gastric lavage yog pom zoo, activated charcoal yog sau, saline laxative daws yog pom zoo. Rau bradycardia, atropine txhaj yog siv, beta-adrenergic agonists yog siv, thiab pacing yog ua.
Kev sib tham nrog lwm yam tshuaj
Nrog ceev faj, cov tshuaj yuav tsum siv ib txhij nrog lwm cov tshuaj, tshwj xeeb tshaj yog tias lawv yog los ntawm tib pab pawg neeg antiarrhythmic. Koj yuav tsum tsis txhob muab nws qhov kev txais tos nrog Erythromycin, Pentamidine thiab Vincamine. Muaj kev pheej hmoo ntawm kev txhim kho polymorphic ventricular tachycardia ua ke nrog Sultopride. Nws tsis pom zoo kom ua ke kom tau txais CCBs thiab beta-blockers nrog Amphotericin B thiab cov tshuaj uas ua rau cov nyhuv laxative, diuretics. Siv cov tshuaj nrog ceev faj ua ke nrog corticosteroids, antidepressants, Astemizol, Terfenadine. Nws tuaj yeem txhim kho cov nyhuv ntawm cov tshuaj xws li: "Warfarin", "Phenytoin", "Cyclosporine" lossis "Digoxin". Thaum siv ib txhij nrog Cimetidine, nws ua rau qeeb cov txheej txheem metabolic hauv lub cev.
Lub neej txee thiab tus nqi cia
Cov tshuaj "Amiodarone", uas nws qhov kev txiav txim yog txhawm rau tshem tawm tachycardia, ventricular fibrillation, tachyarrhythmia thiab txo qis atrial flutter, belongs rau qeb ntawm cov tshuaj ntawm pab pawg "B". Lub txee lub neej ntawm cov tshuaj tsis tshaj peb xyoos. Cov ntsiav tshuaj yuav tsum muab khaws cia rau hauv qhov chaw tsaus, txias kom deb ntawm cov menyuam yaus.
Nws yog ib qho tsim nyog yuav tsum tswj hwm kev siv tshuaj "Amiodarone". daim ntawv qhia rau nwskev siv tsuas yog kws kho mob tau sau tseg. Hauv qhov no, tshuaj noj tus kheej yuav tsum tsis suav nrog tag nrho.
Tshuaj analogues
Yog tias tam sim ntawd cov tshuaj "Amiodarone" tsis haum, cov tshuaj analogues tuaj yeem pom hauv txhua lub tsev muag tshuaj. Ntawm lawv, ib tus tuaj yeem tawm cov tshuaj xws li: "Amiodarone Belupo" thiab "Amiodarone Aldaron", "Angoron" thiab "Atlansil", "Kordaron" lossis "Kordinil" kuj tuaj yeem hloov cov tshuaj no. Zoo ib yam li "Amiodarone" nyob rau hauv lawv cov nyhuv rau tib neeg lub cev "Medakoron" thiab "Palpitin". Qee zaum, cov tshuaj tau hloov los ntawm Sedacoron thiab Sandoz.
Cov tshuaj no muaj tib yam khoom muaj txiaj ntsig lossis zoo sib xws hauv lawv cov tshuaj tiv thaiv rau Amiodarone. Analogues feem ntau tsim tawm txawv teb chaws thiab raug nqi ntau zaus.
Cov lus pov thawj tus neeg mob
Ntau tus neeg mob nco txog kev ruaj khov ntawm lawv tus mob tom qab noj tshuaj "Amiodarone". Cov lus qhia rau kev siv - analogues ntawm cov tshuaj feem ntau xaiv raws li tus neeg yam ntxwv ntawm lub cev - nws cog lus rau normalization ntawm lub plawv dhia thiab siab. Nrog rau kev siv luv luv thiab siv me me, raws li txoj cai, tsis muaj teeb meem, thiab cov tshuaj muaj txiaj ntsig zoo.
Tom qab siv cov tshuaj ntev, qee cov neeg mob ua pa luv, palpitations, nervousness thiab kev nyuaj siab, mus ob peb vas hloov thiab nce cov thyroid hormones, plab hnyuv siab, thiab qee zaum xeev siab thiabntuav.
Ntau tus neeg siv nws hauv kev kho mob ntawm angina pectoris, thiab lawv nco ntsoov tias nws tsis yog phem dua li cov analogues txawv teb chaws. Qee tus txiv neej ntshai noj cov tshuaj, vim nws nyob hauv lawv tias nws tuaj yeem ua rau ntau tus kab mob oncological. Muaj kev xav tias cov tshuaj yuav tsum tau noj tsuas yog nyob rau hauv ib qho kev hem thawj rau tus neeg lub neej, nyob rau hauv tag nrho lwm cov xwm txheej nws yuav tsum nrhiav lwm txoj hauv kev. Tsis tas li ntawd, cov tshuaj tuaj yeem cuam tshuam rau kev ua haujlwm ntawm tus txiv neej, uas yuav tsum tau coj mus rau hauv tus account thaum noj lawv.
Thiab rau ntau tus, cov tshuaj "Amiodarone" tau dhau los ua panacea, ua tsaug rau qhov uas tus kab mob tau rov zoo, thiab tus neeg tseem muaj sia nyob. Tsis yog qhov tseeb tias analogues yuav zoo li zoo. Yog li ntawd, hauv kev kho mob plawv, koj yuav tsum tsis txhob txo cov tshuaj no, tshwj xeeb tshaj yog tias nws tau pom zoo los ntawm kws kho mob.
