Hnub no, ntau tus kws tshaj lij tau sau tshuaj Isoket vasodilator rau cov neeg mob rau lub hom phiaj tiv thaiv lossis, yog tias tsim nyog, txhawm rau tiv thaiv qhov mob angina.
Cov tshuaj no muaj ntau daim ntawv teev npe sib txawv rau kev siv. Nws tau ntse siv hauv kev kho mob plawv pathologies, suav nrog rau kev kho mob ntawm cov mob hnyav.
tshuaj kho mob
Cov tshuaj nquag ntawm cov tshuaj angina no tau tshaj tawm vasodilating thiab vasodilating zog. Isosorbide dinitrate txhawb kev tsim cov nitric oxide nyob rau hauv lub cev thiab txo cov kev xav tau ntawm lub plawv cov leeg rau oxygen thiab lub zog, yog li txo cov load ntawm myocardium. Nws muaj txiaj ntsig zoo txo cov ntshav siab hauv cov hlab ntsws, ua rau cov ntshav ntws mus rau sab xis atrium, txo qhov nro ntawm cov phab ntsa ntawm lub plawv ventricles, txo qis diastolic siab thiab txhim kho systolic muaj nuj nqi hauv lawv. Cov tshuaj tsis cuam tshuam rau lub plawv dhia thiab nthuav cov hlab ntsha hauv hlwb kom zoo. Nws tseem tuaj yeem ua kom cov hlab ntsha hauv dura thiab lub hlwb nws tus kheej, ua rau mob taub hau.
Tus neeg sawv cev cuam tshuam rau kev rov faib cov ntshav coronary hauv thaj chaw uas cov ntshav qis qis. Nrog IHD (kab mob plawv) thiab angina pectoris, vim yog kev ua ntawm cov tshuaj, cov neeg mob muaj lub sijhawm los ua kom lub cev muaj zog ntxiv.
Txau "Izoket" sai sai nqus tag nrho thaj chaw ntawm lub qhov ncauj mucosa, yog li cov nyhuv ntawm nws siv tshwm sim tom qab 30 vib nas this thiab kav ntev txog 120 feeb. Vim nws qhov ceev ntawm qhov kev txiav txim, nws feem ntau yog muab rau cov neeg mob rau kev kho mob ntawm tus mob hnyav.
Ib daim foos
Cov tshuaj yog cov tshuaj ntshiab, tsis muaj xim nrog cov ntxhiab tsw qab. Nws los nyob rau hauv ob hom:
- Txau "Izoket" sublingual thiab dosed. Nrog ib tug nias ntawm lub dispenser, ib koob ntawm nws yog tso tawm nyob rau hauv daim ntawv ntawm me me tee, uas muaj 1.25 mg ntawm cov active ingredient - isosorbide dinitrate, raws li zoo raws li auxiliary ntsiab: ethanol thiab macrogol 400. Cov aerosol tsis muaj freon., yog li ntawd nws belongs rau cov tshuaj uas tsis muaj teeb meem rau ib puag ncig. Ua nyob rau hauv pob tshab fwj ntawm 15 ml, ntim rau hauv ib lub thawv nrog ib tug dispenser thiab cov lus qhia. Lub raj mis iav, tsim rau 300 clicks (duab), tso cai rau koj los saib xyuas cov tshuaj thiab yuav hloov pauv raws sijhawm.
- Kev daws teeb meem nyob rau hauv daim ntawv ntawm cov concentrate rau infusion. 1 ml ntawm cov tshuaj no muaj 1 mg ntawm cov khoom nquag isosorbide dinitrate thiab ntxiv cov tshuaj: sodium chloride, sodium hydroxide, dej. Hauv ib lub ampoule - 10 ml ntawm kev daws rau infusion. Muab tso rau hauvcardboard packs ntawm 10 pieces txhua.
Cov lus qhia rau kev siv
Tshuaj tsuag "Izoket" tau sau los ntawm cov kws tshaj lij rau kev tawm tsam angina ntawm txhua daim ntawv thiab ua kev tiv thaiv kom tsis txhob muaj lawv. Nws kuj raug pom zoo rau cov mob tom qab mob plawv, myocardial infarction nyob rau theem mob hnyav, ua rau muaj kev mob siab rau UTIs thiab kev kho mob rau cov hlab ntsha coronary spasm. Aerosol "Izoket" tau ntse siv los ua tshuaj rau lub plawv tsis ua haujlwm nyob rau sab laug ventricle.
Raws li cov lus qhia, cov tshuaj infusion yog muab rau cov neeg mob uas muaj cov kab mob hauv qab no ntawm cov hlab plawv:
- tsis ruaj khov angina tshwm sim nyob rau hauv lub xeev pre-infarction lossis ua ntej myocardial infarction;
- Yvasospastic angina;
- mob myocardial infarction tshwm sim los ntawm sab laug ventricular tsis ua haujlwm ntawm lub plawv;
- spasm ntawm cov hlab ntsha hauv lub sijhawm phais;
- lub plawv tsis ua hauj lwm;
- mob sab laug ventricular plawv tsis ua hauj lwm;
- pulmonary edema.
Yuav siv aerosol
Cov tshuaj nyob rau hauv daim ntawv ntawm cov tshuaj tsuag yog txau rau hauv tus neeg mob lub qhov ncauj, vim nws nkag mus rau hauv cov hlab ntsha sai. Txhua qhov txhaj tshuaj xyuas kom meej tias ib koob tshuaj nkag mus rau sab hauv. Cov lus qhia rau kev siv qhia ntau yam kev siv tshuaj, nyob ntawm seb cov tsos mob.
Txhawm rau tiv thaiv qhov mob angina, ua ntej qhov kev ntxhov siab ntawm lub cev lossis kev xav uas tuaj yeem dhau losua rau exacerbation, ua tsis taus pa tuav, thiab tus neeg mob tau txais 1 mus rau 3 koob tshuaj nrog lub sijhawm ntawm 30 vib nas this ntawm kev txhaj tshuaj. Kev nce koob tshuaj yam tsis muaj kev saib xyuas ntawm tus kws tshaj lij yog txwv tsis pub.
Thaum xav tias qhov ua rau lub plawv tsis ua haujlwm lossis mob myocardial infarction, tus neeg mob tau txais los ntawm 1 mus rau 3 koob tshuaj raws li kev tswj hwm nruj ntawm ob lub plawv dhia thiab ntshav siab. Yog tias tsis muaj kev txhim kho, ces cov txheej txheem rov ua dua tom qab tsib feeb ntawm kev txiav txim siab ntawm tus kws kho mob. Hauv kaum feeb tom ntej, tus mob yuav tsum ruaj khov. Txwv tsis pub, koj tuaj yeem rov ua qhov kev hloov pauv dua nyob rau hauv kev saib xyuas ntawm tus kws kho mob.
Ua ntej cov txheej txheem kev kho mob rau kev kho mob ntawm cov hlab ntsha (nyob rau hauv cov ntaub ntawv ntawm kev kuaj mob lossis kev kho catheterization), tus neeg mob tau muab 1-2 txhaj tshuaj. Yog tias tsim nyog, cov koob tshuaj tuaj yeem rov ua dua, tab sis raug tswj xyuas cov ntshav ncig tsis tau.
Cov lus pom zoo tshwj xeeb rau kev siv tshuaj tsuag
Yog tias siv aerosol tshiab thawj zaug, lossis ntau dua 24 teev dhau los txij li koob tshuaj kawg, nws raug nquahu kom coj thawj lub siab mus rau hauv huab cua, vim nws yuav tsis muaj qhov xav tau ntau npaum li cas.. Yuav kom tau txais ib koob tshuaj raws li cov lus qhia, lub nebulizer yog nias tsis tu ncua mus rau qhov kawg thiab tom qab ntawd tso tawm. Thaum siv, lub raj mis tshuaj tsuag yuav tsum tau muab khaws cia nrog lub dispenser thiab nyob rau hauv txoj hauj lwm ntsug.
Ceev faj txhob txaws rau qhov muag. Thaum lub sij hawm tag nrho ntawm kev kho mob, kev saib xyuas tas li yog tsim nyog.ntshav siab (BP) thiab ECG. Tus nqi ntawm cov ntshav siab yuav tsum tsis pub tsawg tshaj 100 mm Hg. Art. Kev tshem tawm sai sai ntawm cov tshuaj yog txwv tsis pub los ntawm cov lus qhia, yog li cov koob tshuaj tau raug txo qis zuj zus. Kev haus dej cawv yog contraindicated thaum noj Isoket aerosol.
Kev tshuaj xyuas ntawm cov kws tshaj lij qhia tias kev siv tshuaj ntau npaum li cas, nws nquag teem sijhawm lossis siv cov txheej txheem tuaj yeem ua rau muaj kev ua siab ntev rau tus neeg mob. Qhov no kuj tshwm sim thaum siv lwm yam tshuaj uas muaj nitrates. Hauv cov xwm txheej zoo li no, cov kws kho mob pom zoo kom tshem tawm kev siv tshuaj rau 2-3 hnub, thiab tom qab kev kho mob tsis tu ncua uas siv sijhawm 3-6 lub lis piam, ncua 3-5 hnub, thiab hloov pauv ib ntus nrog lwm cov tshuaj uas muaj txiaj ntsig zoo sib xws.. Feem ntau, tom qab so lossis txiav tawm ntawm kev kho mob, tus neeg mob tau rov qab sai sai. Cov khoom xyaw ntawm cov tshuaj tau tawm hauv daim ntawv ntawm cov metabolites los ntawm ob lub raum yuav luag tag nrho.
Kev noj tshuaj thiab kev siv tshuaj
Raws li cov lus qhia hauv cov lus qhia, cov tshuaj "Izoket" (kev daws teeb meem rau infusion) yog siv intravenously. Cov koob tshuaj yog muab los ntawm tus kws kho mob ib tus zuj zus, suav nrog cov hemodynamic thiab cov tshuaj tsis haum ntawm tus neeg mob. Kev kho mob yuav tsum pib nrog cov koob tshuaj tsawg thiab maj mam nce mus rau qhov xav tau. Qhov koob tshuaj pom zoo los ntawm kev qhia yog 2-7 mg / h, raws li, qhov nruab nrab koob yog li 7.5 mg / h. Yog tias xav tau tshwj xeeb, qhov ntim tuaj yeem nce mus rau 10 mg / h.
Feem ntau, cov neeg muaj lub siabinsufficiency yuav tsum tau ntau dua ntawm cov tshuaj. Kev taw qhia ntawm cov tshuaj yuav tsum muaj nyob rau hauv lub tsev kho mob nyob rau hauv kev saib xyuas ntawm ib tug kws tshwj xeeb thiab siv tsis siv neeg infusion systems. Tag nrho cov txheej txheem yog nrog los ntawm kev saib xyuas cov ntshav ncig tsis tau (ntshav siab thiab lub plawv dhia).
Kev daws rau cov tshuaj txhaj tshuaj yog npaj nyob rau hauv cov xwm txheej tsis muaj menyuam tam sim ua ntej txheej txheem. Cov tshuaj yog khaws cia tsis pub dhau 24 teev. Txoj kev ua noj:
- rau 0.01% concentration (100mcg / mL) - 50mL ntawm 0.1% tshuaj tuaj yeem ua rau 500mL npaj rau kev tswj hwm;
- rau 0.02% concentration (200mcg / mL) - 100mL ntawm 0.1% tshuaj tuaj yeem ua rau 500mL tshuaj npaj rau kev tswj hwm.
Contraindications thiab ceev faj
Cov tshuaj tsis raug sau tseg rau cov neeg mob uas muaj qhov tsis haum rau cov tshuaj nitrate, nrog rau lwm cov ntsiab lus ntawm Isoket aerosol. Kev siv kuj raug txwv yog tias tus neeg mob muaj cov kab mob xws li:
- mob hnyav, uas lub siab systolic poob qis dua 90 mmHg;
- vascular insufficiency nyob rau theem mob, xws li poob siab lossis vascular vau;
- pericarditis thiab pericardial tamponade;
- nrog rau kev poob siab cardiogenic nyob rau hauv rooj plaub uas tsis muaj lwm txoj hauv kev los kho lub siab ntawm sab laug ventricle;
- hypertrophic cardiomyopathy;
- Angle-kaw glaucoma.
Tsis tas li ntawd, cov tshuaj tsis raug muab rau cov neeg muaj hnub nyoog qis dua kaum yim xyoo. Cov lus qhia rau kev siv pom zoo kom siv cov tshuaj nrog ceev faj heev thiab nyob rau hauv kev saib xyuas tas li nyob rau hauv xws li mob:
- myocardial infarction nrog rau daim ntawv mob hnyav ntawm chav kawm thaum muaj qhov txo qis ntawm lub plawv sab laug ventricle;
- nce intracranial siab;
- mitral thiab / lossis aortic stenosis;
- kuaj pom nyob rau hauv tus neeg mob ntawm qhov muaj feem cuam tshuam ntawm orthostatic teeb meem hauv kev tswj cov ntshav ncig;
- raum lossis siab tsis ua haujlwm.
Cov kws tshawb fawb hauv kev txhim kho cov tshuaj tau ua cov kev tshawb fawb tsiaj. Qhov kev sim ntawm cov kev kawm tau pom tias tsis muaj kev puas tsuaj rau tus menyuam hauv plab.
Txawm li cas los xij, thaum cev xeeb tub thiab lactation, kev teem caij ntawm aerosol yog pom zoo tsuas yog nyob rau hauv cov xwm txheej uas cov txiaj ntsig xav tau rau tus poj niam yuav ua rau muaj kev pheej hmoo ntau dua rau tus menyuam hauv plab lossis tus menyuam mos. Kev kho mob hauv cov xwm txheej no yuav tsum tau ua raws li kev saib xyuas nruj ntawm cov kws kho mob tshwj xeeb uas saib xyuas cov ntsuas ntshav ncig (ntshav siab thiab lub plawv dhia), nrog rau cov xwm txheej ntawm tus neeg mob.
Kev sib tham nrog lwm cov tshuaj
Kev siv cov tshuaj vasodilators thiab tshuaj "Izoket" (txhaj tshuaj) raug txwv. Lawv siv nyob rau hauv kev sib xyaw ua ke yuav ua rau muaj kev nce hauv cov nyhuv hypotensive. Tib lub txim entails lub simultaneousnoj Isoket aerosol thiab cov tshuaj xws li: tshuaj tiv thaiv kab mob siab, calcium channel blockers, Quinidine los yog Novocainamide, antipsychotics, phosphodiesterase-5 inhibitors.
Muaj peev xwm nce cov nyhuv antianginal thaum siv nrog tshuaj xws li Amiodarone, Propranolol, Nifedipine, Verapamil, thiab lwm yam calcium qeeb channel blockers.
nce intracranial siab hauv tus neeg mob tuaj yeem tshwm sim thaum kev kho nrog atropine thiab lwm yam m-anticholinergics.
Kev txo qis hauv cov ntshav siab ntau dhau, ua rau muaj kev cuam tshuam ntawm coronary perfusion, tshwm nyob rau hauv kev cuam tshuam ntawm alpha-blockers thiab sympathomimetics.
Kev mob tshwm sim thiab tshuaj xyuas
Cov lus qhia piav qhia ntau yam kev phiv uas tuaj yeem tshwm sim los ntawm cov tshuaj "Izoket" (txhaj tshuaj). Kev tshuaj xyuas ntawm qee tus neeg mob noj cov tshuaj no qhia txog qhov tsos mob taub hau, uas yog hu ua "nitrate" hauv cov tshuaj. Raws li txoj cai, tom qab 2-3 hnub qhov teeb meem ploj ntawm nws tus kheej thiab tsis tas yuav kho. Tsis tshua muaj, cov tshuaj tuaj yeem ua rau cov tsos mob xws li xeev siab, liab ntawm daim tawv nqaij, ntuav thiab qhov ncauj qhuav.
Qee tus neeg mob uas tau txais cov tshuaj thawj zaug yws yws ntawm qhov tsis muaj zog, kiv taub hau, ntshav siab thiab tsis xis nyob. Nws tshwm sim los ntawm kev cuam tshuam me ntsis hauv kev ua haujlwm ntawm cov hlab plawv. Lawv tshwm sim thaum pib siv lossis thaum siv ntau tshaj qhov pom zoo.
Txawm li cas los xij, raws likev tshuaj xyuas, cov neeg mob pom qhov ua tau zoo ntawm cov tshuaj. Thiab thaum noj raws li cov tshuaj ntawm tus kws kho mob tshwj xeeb, cov kev mob tshwm sim tsis tshwm sim ntau zaus. Qhov tshwj xeeb yog mob taub hau hauv thawj hnub ntawm kev siv, uas nrog rau feem ntau, tab sis feem ntau ploj hauv ob peb hnub.
Tshaj qhov ntim siab tshaj
Kev noj ntau dhau ntawm cov tshuaj no tuaj yeem ua rau muaj kev phiv loj heev: syncope, vau, siab intracranial siab, hyperthermia, convulsions, pom kev cuam tshuam, nce tawm hws, methemoglobinemia, bradycardia, tuag tes tuag taw, thiab coma. Yog li ntawd nws yog ib qho tseem ceeb tsis txhob noj nws tus kheej lub plawv, tab sis coj cov tshuaj nruj me ntsis raws li cov lus qhia ntawm tus kws kho mob tshwj xeeb!
Nrog cov tsos mob tau piav qhia, kev tshem tawm cov tshuaj thiab kev kho mob txhawm rau txhawm rau txhim kho tus neeg mob tus mob.
Analogues
Tshuaj "Kardiket" (CHWARZ PHARMA, Lub teb chaws Yelemees) yog ib qho ntawm cov khoom siv sib xyaw (analogues) ntawm cov tshuaj "Izoket" (txhaj tshuaj). Tus nqi ntawm qhov hloov pauv no nyob ntawm qhov concentration ntawm cov khoom xyaw nquag thiab cov ntsiav tshuaj hauv pob.
Piv txwv li, cov tshuaj hauv cov ntsiav tshuaj ntawm 20 mg "Kardiket retard" (20 daim ib pob) raug nqi los ntawm 62 txog 72 rubles, thiab tib cov tshuaj, tsuas yog nrog ib koob ntawm 40 mg ntsiav tshuaj thiab tus nqi ntawm 50. daim, muaj tus nqi 210-220 rubles.
Pab pawg ntawm cov tshuaj "Nitrosorbid", tsim los ntawm ntau lub tuam txhab Lavxias thiab muaj ntau hom kev tso tawm, kuj yog ib qho kev hloov pauv rau cov tshuaj "Izoket". Analogues ntawm pab pawg no muaj cov npe hauv qab no: Nitrosorbide-Rusfar, Nitrosorbide, NitrosorbideN. S., Nitrosorbide-UVI.
Tus nqi
Hauv khw muag tshuaj Lavxias, koj yuav tau them los ntawm 365 txog 470 rubles rau ib koob tshuaj "Izoket" (txhaj tshuaj). Tus nqi yog tsim nyob ntawm qhov chaw ntawm qhov hluav taws xob thiab nws cov xwm txheej. Ntawm cov chaw muag tshuaj, nws tuaj yeem yuav tau ntawm tus nqi qis dua hauv lub tsev muag tshuaj nyob ze lub tsev. Tab sis thaum xaj ntawm Is Taws Nem, koj yuav tau them txog 200 rubles rau kev xa khoom lossis tau txais cov khoom pub dawb ntawm qhov chaw tos txais, uas tsis yog ib qho chaw yooj yim.
Tsis tas li ntawd, hauv txhua lub tsev muag tshuaj koj tuaj yeem yuav ib pob (10 ampoules) ntawm cov tshuaj muaj zog rau infusion "Izoket". Tus nqi rau nws fluctuates ntawm 906-980 rubles.
cov ntaub ntawv dav dav
Cov tshuaj yog tsim los ntawm lub tuam txhab German YUSB Pharma GmbH. Nws lub neej txee yog tsib xyoos. Qhov xwm txheej ntawm kev muag khoom yog qhov pom ntawm tus kws kho mob cov tshuaj. Nrog rau kev siv sijhawm ntev, nws raug nquahu kom kuaj xyuas qhov ua haujlwm ntawm lub atomizer. Ib tug xub kos rau ntawm daim ntawv aerosol nyob hauv qab. Thaum cov kua nce mus txog nws qib, yuav tsum tau yuav cov tshuaj tshiab, vim tias kev siv lub vial uas twb muaj lawm tuaj yeem ua tau tsuas yog nrog nws qhov kev xav me ntsis, uas lub raj nqus dej yog raus rau hauv cov kua.
