Kev kho mob plawv arrhythmias yog ib qho teeb meem kho mob nyuaj uas tseem tsis tau daws tag nrho txawm niaj hnub no. Muaj ntau ntau cov tshuaj antiarrhythmic, tab sis lawv txhua tus muaj ntau yam contraindications thiab phiv, uas tuaj yeem ua rau muaj kev phom sij ntau dua rau tus neeg mob dua li tus kab mob. Muaj tag nrho cov pab pawg ntawm cov tshuaj tsim los kom tsis txhob muaj kev phom sij rau lub neej, tab sis lawv siv rau lub sijhawm ntev tsis pom zoo vim qhov kev nce hauv cov teeb meem tshwm sim los ntawm kev noj tshuaj. Raws li, cov neeg mob xav tau cov tshuaj txhim khu kev qha, zoo, tab sis kuj muaj kev nyab xeeb los yog nws qhov sib npaug.
Kordaron yog ib qho tshuaj tiv thaiv kev mob arrhythmic
Raws li ntau yam kev tshawb fawb, "Kordaron" yog cov tshuaj zoo tshaj plaws ntawm lwm cov tshuaj zoo sib xws, muaj peev xwm ua pov thawj los txo qis kev tuag ntawm cov neeg mob plawv. Nws tau ua tiav siv los kho yuav luag txhua lub plawv arrhythmias. Ntawm cov kws kho mob, nws raug suav hais tias yog tus qauv ntawm chav kawm III tshuaj tiv thaiv arrhythmic. Ntxiv nrog rau cov tshuaj antiarrhythmic, nws muaj cov nyhuv antianginal, raws li nws tau xub tsim los ua tshuaj rau kev kho mob.kab mob plawv.
Nws tsis tau tsuas yog cov yam ntxwv ntawm chav kawm III antiarrhythmics, uas yog, blockade ntawm cov poov tshuaj raws, tab sis kuj muaj cov yam ntxwv ntawm cov tshuaj hauv chav kawm I - blockade ntawm sodium raws, chav kawm IV - thaiv cov calcium channel. Ntawm lwm yam, cov tshuaj muab alpha- thiab beta-adrenergic thaiv, coronary dilating nyhuv.
Cov lus qhia rau kev siv
Cov tshuaj nquag ntawm cov tshuaj yog amiodarone. Lub npe lag luam - "Kordaron". Analogues yog tsim nyob rau hauv lwm lub npe, tab sis muaj tib yam active tshuaj. Amiodarone muaj nyob rau hauv cov tshuaj txhaj thiab cov ntsiav tshuaj.
Cov tshuaj yog siv thaum tsim nyog los nres kev tawm tsam ntawm ventricular thiab supraventricular tachycardia, atrial fibrillation, nrog rau qaug dab peg. Cov ntsiav tshuaj yog siv los tiv thaiv ventricular thiab atrial fibrillation thiab paroxysmal tachycardia.
Txoj Cai Ua Haujlwm
Txo cov txheej txheem ntawm kev thauj mus los hauv cov cell ntawm cov poov tshuaj ions, cov tshuaj txuas ntxiv rau theem peb ntawm kev ua haujlwm ntawm lub plawv cov leeg hlwb. Nyob rau tib lub sijhawm, kev sib kis ntawm hluav taws xob impulse nyob rau hauv cov fibers ntawm lub atrioventricular node kuj suppressed. Vim li no, lub plawv dhia qeeb. Raws li qhov tshwm sim ntawm kev thaiv ib feem ntawm kev cuam tshuam ntawm lub paj hlwb, lub plawv dhia qeeb.
Amiodarone yog metabolized nyob rau hauv daim siab thiab tso tawm feem ntau hauv cov zis. Cov ntsiab lus siab tshaj plaws ntawm cov tshuaj nquag tau pom tom qab 3-7 teev tom qab noj cov ntsiav tshuaj. Kev kho mob tsis tu ncua tsis tshwm simtsawg dua ib lub lim tiam tom qab pib kho.
Analogues ntawm "Kordaron"
Ntau zaus, cov neeg mob rau ntau qhov laj thawj nyiam tsis yog thawj cov tshuaj, tab sis nws cov analogues, generics. Txij li thaum "Kordaron" tsuas yog lub npe lag luam rau amiodarone, cov neeg uas raug kev txom nyem los ntawm arrhythmias feem ntau xav paub seb puas muaj cov tshuaj analogues "Kordaron".
Raws li rau amiodarone, cov lus nug ntawm nws cov analogues yog qhov tseem ceeb, vim tias nws yog ib qho ntawm cov tshuaj plawv nrov tshaj plaws hauv ntiaj teb, uas tau siv dav. Xws li cov tshuaj, raws li tau hais los saum toj no, muaj ntau cov kev mob tshwm sim, feem ntau ua rau kev noj qab haus huv tsis zoo. Yog li ntawd, ob tus kws kho mob thiab tus neeg mob xav xaiv cov tshuaj uas muaj kev ua haujlwm siab tshaj plaws thiab muaj kev pheej hmoo tsawg kawg rau kev noj qab haus huv thiab lub neej. Yog tias koj tab tom nrhiav cov analogues sib npaug rau Kordaron, kev tshuaj xyuas kev kho mob hauv qhov no yuav tsum yog qhov tseem ceeb rau koj, txawm hais tias, tau kawg, kev tshuaj xyuas tus neeg mob kuj tseem ceeb, vim lawv tuaj yeem qhia txog cov kev xav thaum lub sij hawm txais tos thiab hais txog kev ceev ntawm cov neeg mob. kev txhim kho. Nyob rau tib lub sijhawm, kev kho mob nrog "Kordaron" thiab ib qho ntawm nws cov analogues yuav tsum tau nrog kev saib xyuas kev kho mob thiab kev saib xyuas ntawm lub xeev kev noj qab haus huv, suav nrog kev pab ntawm ECG.
Lub luag haujlwm tseem ceeb yog ua los ntawm cov tshuaj muaj pes tsawg leeg. Piv txwv li, iodine, uas yog ib feem ntawm amiodarone, yog contraindicated nyob rau hauv ib tug xov tooj ntawm cov kab mob. Nws kuj tuaj yeem cuam tshuam cov txiaj ntsig ntawm qee qhov kev tshawb fawb. Yog li ntawd, nws tsis yog qhov xav tsis thoob tias ntau tus neeg raug kev txom nyem los ntawm arrhythmia tab tom nrhiav ib qho analogue ntawm Kordaron tsis muaj iodine.zoo li Dronedaron. Tau kawg, koj tuaj yeem hloov cov tshuaj tsuas yog tom qab sab laj nrog kws kho mob. Yog li, ntau tus kws tshaj lij Lavxias tsis pom zoo xaiv Dronedarone yam tsis xav tau, vim nws yog qhov tsis muaj zog ntawm Kordaron analogue. Hauv Tebchaws Europe, txawm li cas los xij, nws yog ib txwm muaj.
Thaum xaiv cov tshuaj lossis analogue, nws yog qhov tsim nyog los sib piv lawv cov muaj pes tsawg leeg. Raws li txoj cai dav dav, analogues thiab generics tsis piv nrog ib leeg - tsuas yog nrog tus thawj. Hais tias, yog tias koj xav tau ib qho analogue ntawm Cordarone nyob rau hauv ampoules, ces benzyl cawv yuav tsum muaj nyob rau hauv cov muaj pes tsawg leeg ntawm cov tshuaj zoo sib xws, xws li nyob rau hauv thawj Cordarone.
Raws li cov kws kho mob, cov tshuaj analogues hauv tebchaws Russia uas tsis qis dua hauv cov khoom rau Kordaron yog sawv cev los ntawm ntau cov tshuaj, suav nrog: Rhythmiodarone, Sedacoron, Amiocordin, Cardiodaron, Ritmorest, "Opacorden", "Amiodarone" los ntawm ntau lub tuam txhab ("Amiodarone-Akri", "Vero-Amiodarone" thiab ntau lwm tus). Tag nrho cov ntawm lawv muaj tib yam active ingredient, tab sis tej zaum yuav txawv excipients. Muaj ntau ntawm lawv yog pheej yig dua li tus thawj. Feem ntau, qhov teeb meem no nyob ntawm tus neeg tsim khoom. Piv txwv li, "Amiodarone", uas yog hu ua tib yam li cov khoom tseem ceeb muaj nyob rau hauv cov tshuaj "Cordarone". Cov analogue yog Lavxias teb sab, thiab nws tus nqi yuav luag peb zaug qis dua, txawm hais tias daim ntawv tso tawm thiab cov lus qhia rau kev teem caij yog tib yam.
Amiodoron yog qhov zoo tshaj plaws analogue hauv Russia. Nws yog xyaum indistinguishable ntawm "Kordaron" ob qho tib si los ntawm lub hauv paus ntsiab lus ntawm kev txiav txim thiab los ntawm txoj kev ntawm daim ntawv thov, nws muaj tib yam.high efficiency nyob rau hauv nres arrhythmia tawm tsam thiab tiv thaiv lawv tshwm sim. Cov neeg mob tshuaj xyuas txog nws feem ntau yog qhov zoo. Ntau tus ntawm lawv tau sau tseg tias Amiodoron ua los ntawm Lavxias teb sab pab sai thiab tsis muaj kev phiv loj heev.
Txoj kev siv tshuaj hauv ampoules
Raws li tau hais los saum toj no, kev txhaj tshuaj yog qhia rau kev daws sai ntawm qhov teeb meem. Hauv lwm qhov xwm txheej, cov ntsiav tshuaj Kordaron tau siv. Analogs ua haujlwm zoo ib yam. Cov kev daws teeb meem yog muab tso rau hauv txoj hlab ntshav los ntawm lub catheter rau 20-120 feeb lossis los ntawm kwj dej tsawg kawg 3 feeb ntawm qhov ntau npaum li 5 mg rau 1 kg ntawm lub cev qhov hnyav.
Txoj kev siv cov ntsiav tshuaj "Kordaron"
Cov tshuaj tau ua ob kauj ruam.
Thawj theem, lossis theem thauj khoom: 600-800 mg ib hnub ib zaug, nce mus rau 10 g.
theem thib ob, lossis theem kev saib xyuas: 100-400 mg ntawm cov tshuaj (lub sijhawm yog txiav txim los ntawm tus kws kho mob). Qhov koob tshuaj ntau tshaj yog 1200 mg ib hnub twg.
Kev noj tshuaj ntau dhau yog qhov txaus ntshai heev. Txhawm rau tiv thaiv nws, tus neeg mob tau qhia kom paub tseeb tias cov lus qhia rau kev siv tau pom zoo kom noj cov tshuaj Kordaron. Analogues, suav nrog cov analogues nrov hauv Russia "Amiadarone", feem ntau muab tib cov tsos mob overdose.
Muaj bradycardia hnyav, txawm tias mus txog lub plawv nres. Yog hais tias nws yog tshwm sim los ntawm ib ntsiav tshuaj daim ntawv, nws yog tsim nyog los ntxuav lub plab thiab noj enterosorbents. Lwm yam kev kho mob kuj tau ua, qhov nyiaj tshuav ntawm electrolyte raug kho. Nruab yog tsim nyogpacemaker.
Cov ntaub ntawv ntawm kev txhaj tshuaj ntau dhau yog ua tsis tiav. Tsis tshua muaj mob ntawm sinus bradycardia, tachycardia, thiab plawv nres tau piav qhia. Kev kho mob zoo ib yam li cov tshuaj uas tau muab tshuaj ntau dhau los ntawm cov tshuaj. Amiodarone thiab nws cov metabolites tsis raug tshem tawm los ntawm hemodialysis.
Side effects
Zoo li txhua yam tshuaj muaj txiaj ntsig nrog kev ua haujlwm muaj zog, "Kordaron", "Amiodarone" thiab lwm yam analogues ua rau muaj kev phiv ntau. Lawv ua rau bradycardia, mus txog rau lub plawv nres, txo cov ntshav siab, muaj kev cuam tshuam tsis zoo rau daim siab, vim hais tias lawv muaj ib tug heev impressive daim ntawv teev cov contraindications.
Ntawm qhov tsis tshua muaj mob hnyav, tab sis txawm li cas los xij cov kev mob tshwm sim tsis zoo, ib tus tuaj yeem hnov mob taub hau thiab kiv taub hau, pleurisy, hnoos, tus neeg mob tuaj yeem yws yws ntawm qhov tsis muaj zog, txo qhov muag pom. Muaj peev xwm ua xua. Cov teeb meem tib yam tuaj yeem tau txais los ntawm kev noj ib qho analogue. Vim li no, Cordarone thiab lwm yam kev npaj amiodarone hauv cov ntsiav tshuaj yog muag hauv khw muag tshuaj nkaus xwb. Kev txhaj tshuaj tsuas yog siv hauv tsev kho mob xwb.
Txawm li cas los xij, yog tias muaj kev ceev faj thaum xaiv cov koob tshuaj ntau tshaj, cov kev mob tshwm sim me me lossis tej zaum yuav tsis tshwm sim. Raws li tau sau tseg hauv kev tshuaj xyuas ntawm Cordarone thiab Amiodarone, cov neeg mob noj cov tshuaj no, cov kev mob tshwm sim feem ntau tsis muaj zog, kev hloov tshuaj ntawm cov tshuaj tau yooj yim tshem tawm.
YContraindications
Vim tias amiodarone yog tshuaj muaj zog zoo nkauj,tsis yog qhov xav tsis thoob, nws tuaj yeem tsis tsuas yog pab txhim kho cov xwm txheej ntawm ntau yam teeb meem plawv, tab sis tib lub sijhawm muaj kev cuam tshuam loj heev rau lwm yam kabmob lossis ua rau cov mob hnyav dua hauv qee cov kab mob sib kis. Txhawm rau kom tsis txhob muaj kev pheej hmoo, kev kho nrog cov tshuaj no tsis pom zoo hauv qee kis.
Muaj ntau yam ntawm cov xwm txheej uas nws txwv tsis pub noj "Kordaron", "Amiodarone" thiab lwm yam analogues hauv cov ntsiav tshuaj. Ua ntej ntawm tag nrho cov, cov no yog ib co pathological mob plawv - sinus bradycardia, mob atrioventricular block, arterial hypotension, prolongation ntawm QT interval ntawm cardiogram. Nws yuav tsum tsis txhob siv yog tias tus neeg mob tsis muaj magnesium thiab potassium hauv lub cev.
Contraindications suav nrog pathologies ntawm cov thyroid caj pas, nrog rau kev xeeb tub thiab kev pub niam mis - yog vim li cas yog iodine, uas muaj cov tshuaj "Kordaron". Ib qho analogue uas tsis muaj nws tsuas yog ua raws li kev pom zoo ntawm tus kws kho mob.
Cov neeg mob hauv lub hnub nyoog laus tau qhia kom noj "Kordaron" thiab "Amiodarone" thiab lwm yam tshuaj nrog ceev faj. Cov neeg mob hnub nyoog qis dua 18 xyoo tsis tau txais cov tshuaj no.
Nws tsis pom zoo kom sau cov tshuaj no rau cov neeg uas muaj mob hawb pob bronchial, ua pa tsis ua haujlwm, thiab mob plawv tsis ua haujlwm. Kev mob hnyav ntawm daim siab thiab ob lub raum kuj yog qhov laj thawj tsis kam kho nrog txoj kev no.
Tsis ntseeg, koj yuav tsum tsis txhob noj tshuaj yog tias muaj ib tus neeg intolerance rau cov tshuaj "Kordaron". Analogues nyob rau hauv Russia thiab lwm lub teb chaws nyob sab Europe muajtib yam muaj pes tsawg leeg, yog li ntawd, nyob rau hauv cov ntaub ntawv no, nws tsis zoo li hais tias nws yuav muaj peev xwm hloov ib qho kev kho nrog lwm tus.
Raws li kev txhaj tshuaj, lawv yuav tsum tsis txhob muab rau cov menyuam yaus hnub nyoog qis dua 3 xyoos, rau cov menyuam yaus hnub nyoog qis dua 3 xyoos, qhov koob tshuaj yuav tsum tsis pub tshaj 5 mg / kg. Tsis txhob muab cov tshuaj sib tov rau hauv tib lub syringe nrog rau lwm cov tshuaj. Feem ntau, contraindications rau kev daws yog zoo li contraindications rau ntsiav tshuaj. Cov no yog sinus bradycardia, mob sinus syndrome thiab hnyav conduction cuam tshuam, nrog rau cov hlab plawv sinoatrial thiab paroxysmal ventricular tachycardia. Tshwj xeeb, cov xwm txheej zoo li no tuaj yeem ua tau thaum noj amiodarone ua ke nrog ntau cov tshuaj.
Nws tuaj yeem sau tshuaj txhaj tshuaj thaum cev xeeb tub nkaus xwb hauv cov xwm txheej tshwj xeeb; thaum lactation, txoj kev kho no tsis suav nrog tag nrho. Nws yog tsis yooj yim sua kom ua tiav kev kho mob siv cov tshuaj Cordarone rau thyroid dysfunctions, tsis haum tshuaj rau iodine los yog amiodarone.
Kev sib tham nrog lwm yam tshuaj
"Kordaron" tuaj yeem ua ke nrog lwm yam tshuaj. Yog li, nws cov nyhuv antianginal yog txhim kho nyob rau hauv ua ke nrog ntev-acting nitrate npaj. Nws tuaj yeem siv ua ke nrog cov tshuaj tiv thaiv coagulants, diuretics, tshuaj cardiotonic, tsis txhob cuam tshuam thiab, raws li, tsis txhob ua kom tsis muaj zog lossis txhim kho cov nyhuv ntawm ib leeg "Kordaron" thiab qee cov tshuaj tiv thaiv kev puas siab puas ntsws, tshuaj tua kab mob, hypnotics thiab sedatives. Yuav luag txhua qhov analog reacts rau cov tshuaj no tib yam.
"Kordaron" tsis tuaj yeem siv ib txhij nrog MAO inhibitors thiab beta-blockers (tsuas yog hauvCov xwm txheej tshwj xeeb).
Ceev faj hauv kev kho Cordarone thiab Amiodarone
Thaum noj cov tshuaj no, yuav tsum tau saib xyuas lub xeev ntawm lub cev ua ntej pib kho, thaum thiab tom qab nws.
ECG raug pom zoo ua ntej thiab thaum lub sijhawm kho cov ntsiav tshuaj. Qhov kev txiav txim ntawm cov tshuaj ua rau muaj kev hloov pauv hauv electrocardiogram, tshwj xeeb, qhov ntev ntawm Q-T thiab Q-Tc. Raws li cov txiaj ntsig ntawm kev kuaj mob, tus kws kho mob tuaj yeem kho qhov ntau npaum li cas thiab txiav txim siab qhov txiaj ntsig ntawm kev kho mob.
Kev kho yog nres yog atrioventricular block II thiab III degree, sinoatrial, bifascicular intraventricular block tsim.
Vim tias ib qho ntawm cov tshuaj yog iodine, kev saib xyuas cov thyroid ua haujlwm yog tsim nyog. Ua ntej kev kho mob, nws yuav tsum tau txiav txim siab theem ntawm cov tshuaj hormones T3, T4 thiab TSH. Thov nco ntsoov tias thaum noj Kordaron, cov txiaj ntsig ntawm kev tshawb fawb radioisotope ntawm cov thyroid caj pas yuav tsis ntseeg tau. Iodine tsis cuam tshuam cov ntaub ntawv qib hormone.
Kuj yog ib qho tseem ceeb yog kev txiav txim siab ntawm cov poov tshuaj hauv cov ntshav ua ntej thiab thaum kho.
Thaum tswj hwm Kordaron intravenously, tsuas yog cov infusions raug pom zoo, tsis yog txhaj koob tshuaj. Txwv tsis pub, nws muaj peev xwm tsim cov kab mob hemodynamic - arterial hypotension, mob plawv tsis txaus. Nws muaj peev xwm muab cov tshuaj nrog ib lub koob txhaj tshuaj tsuas yog thaum muaj xwm txheej ceev tshwj xeeb thiab tsis muaj lwm yam tshwm sim. Hauv qhov no, qhov koob tshuaj yog 5 mg / kg muab ntau tshaj peb feeb,rov ua dua - tsis pub dhau 15 feeb tom qab thawj zaug ntawm cov tshuaj. Cov txheej txheem tsuas yog ua tau nyob rau hauv cardio intensive care units nyob rau hauv ECG tswj. "Kordaron" yog txwv tsis pub muab sib xyaw rau hauv ib lub koob txhaj tshuaj nrog rau lwm yam tshuaj. Yog tias kev kho mob ntev ua ntej, nws yuav tsum tau hloov mus rau infusions. Txhua qhov kev txhaj tshuaj ntawm amiodarone tau muab tso rau hauv tsev kho mob.
Yog tus neeg mob yuav nyob rau hauv ib qho tshuaj loog, tus kws tshuaj loog yuav tsum paub tias tau noj tshuaj.
Yuav kom tsis txhob muaj kev phiv, cov neeg mob yuav tsum ua raws li cov tshuaj uas lawv tus kws kho mob tau sau tseg.
Thaum kho, cov neeg mob yuav tsum zam lub hnub ci thiab, yog tias tsim nyog, siv kev tiv thaiv nws (nrog rau cov tshuaj pleev tshwj xeeb).
Nco ntsoov nrog koj tus kws kho mob yog tias vim qee yam koj npaj yuav tsis noj Cordaron, tab sis nws cov analogue. "Kordaron" thiab cov tshuaj zoo ib yam li nws, zoo li lwm yam tshuaj mob plawv, tuaj yeem ua rau muaj kev phom sij heev yog tias noj tsis tswj tau. Tsuas yog tus kws kho mob tuaj yeem txiav txim siab seb cov tshuaj twg yog qhov zoo tshaj rau koj thiab xaiv ib qho kev nyab xeeb tab sis siv tau zoo.
