Raws li koj paub, nitroglycerin yog qhov tawg ntawm lub zog loj heev. Txawm li cas los xij, hauv cov koob tshuaj me me, nws kuj yog ib qho tshuaj zoo thiab qee zaum tseem tuaj yeem cawm tib neeg txoj sia. Kev txhaj tshuaj nrog tshuaj "Nitroglycerin" tau siv rau ntau tshaj li ib puas xyoo thaum muaj xwm txheej ceev, thaum tus neeg mob lub plawv tsis tuaj yeem tiv nrog nws txoj haujlwm.
keeb kwm me ntsis
Thawj lub peev xwm ntawm nitroglycerin muaj txiaj ntsig zoo rau tib neeg kev noj qab haus huv tau pom los ntawm tus kws kho mob Askiv D. Merrill, thaum saib xyuas cov neeg ua haujlwm koom nrog kev tsim cov khoom tawg. Nws yog tus kws kho mob no tom qab tsim qhov tseeb tias nitroglycerin tuaj yeem siv los ua cov tshuaj tsim los tshem tawm cov hlab plawv.
Lub peev xwm ntawm qhov kev kho mob sai sai nrog angina pectoris tau raug tsim, yog li, tau ua tiav. Qhov tseeb, cov txheej txheem ntawm kev ua ntawm nitroglycerin rau tib neeg lub cev yav tom ntej, hmoov tsis, tsis tau kawm ntev. Cov kev tshawb fawb no tau ua los ntawm cov kws tshawb fawb tsuas yog thaum kawg ntawm lub xyoo pua xeem.
Tam sim no, tshuaj"Nitroglycerin" yog suav hais tias yog ib qho ntawm cov kev siv tau zoo tshaj plaws los pab cov neeg mob uas mob angina tawm tsam sai. Cov nyhuv analgesic ntawm cov tshuaj no yuav luag tam sim.
Composition
Cov tshuaj "Nitroglycerin" tuaj yeem tsim ua ntau hom. Feem ntau, cov neeg mob noj nws hauv cov ntsiav tshuaj. Txawm li cas los xij, feem ntau cov tshuaj no kuj tau muab tso rau hauv kev lag luam hauv daim ntawv ntawm cov kua dej cawv rau kev txhaj tshuaj hauv ampoules ntawm 2-10 ml lossis vials ntawm 50-500 ml.
Daim ntawv qhia rau kev npaj cov tshuaj "Nitroglycerin" yog qhov yooj yim heev. Ib zaug ib zaug, cov tshuaj no tau tsim nyob rau hauv ntau qhov tsawg. Tsuas yog ob peb tus neeg tuaj yeem siv nws rau kev kho mob xwm txheej ceev rau lub plawv nres. Niaj hnub no, cov tshuaj no muaj nyob rau hauv tag nrho cov khw muag tshuaj thiab chaw kho mob. Nws yuav tsis yooj yim los yuav cov tshuaj no yog tias tsim nyog, tsawg kawg hauv cov ntsiav tshuaj.
Cov khoom xyaw tseem ceeb ntawm cov tshuaj no yog, ntawm chav kawm, nitroglycerin nws tus kheej. 1 ml ntawm kev npaj ntawm cov tshuaj no muaj 10 mg. Tsis tas li ntawd, muaj pes tsawg leeg ntawm cov tshuaj "Nitroglycerin" muaj xws li ib tug ntxiv tshuaj xws li ethanol.
Nws cuam tshuam rau tus neeg mob lub cev li cas
Cov nyhuv analgesic ntawm kev siv cawv ntawm "Nitroglycerin" tshwm sim vim qhov txo qis hauv myocardial oxygen xav tau. Qhov no tshwm sim feem ntau vim qhov nthuav dav ntawm cov leeg thiab txo cov ntshav ntws mus rau sab xis atrium. Tsis tas li ntawd, cov tshuaj no tuaj yeem txo qhov siab hauv cov hlab ntsws.
Nyob hauv rooj plaub twg yog muab
tshuaj nitroglycerin tuaj yeem siv yog tias tus neeg mob muaj teeb meem xws li:
- myocardial infarction, suav nrog nrog mob sab laug ventricular tsis ua haujlwm;
- tsis ruaj tsis khov angina;
- pulmonary edema.
Qee zaum, cov tshuaj no tuaj yeem siv rau hauv kev kho mob rov qab los ntawm myocardial infarction.
Side effects
Pab "Nitroglycerin" nrog lub plawv nres thiab angina pectoris zoo heev. Txawm li cas los xij, qhov kev kho no, hmoov tsis, tuaj yeem ua rau muaj kev phiv ntau. Feem ntau, piv txwv li, tom qab txhaj tshuaj ntawm "Nitroglycerin" cov neeg mob pib mob taub hau. Nws tshwm sim vim qhov nthuav ntawm cov hlab ntsha hauv lub hlwb.
mob taub hau hauv cov neeg mob tom qab txhaj tshuaj no qhia tias cov tshuaj tau pib ua haujlwm. Feem ntau, qhov kev mob tshwm sim no tshwm sim hauv cov neeg uas tsis tau siv nitroglycerin hauv ib daim ntawv ua ntej. Feem ntau, qhov tshwm sim tsis zoo no ploj mus nrog lub sijhawm thiab qhov tshwm sim zoo li no tsis pom nyob rau hauv cov neeg mob.
Tsis tas li, thaum siv rau kev kho mob ntawm nitroglycerin, cov neeg mob yuav ntsib:
- hyperemia ntawm daim tawv nqaij;
- tachycardia;
- xav kub;
- xeev siab thiab ntuav;
- arterial hypotension.
Qee zaum cov neeg mob tom qab noj cov tshuaj no pib muaj kev ntxhov siab tsis tsim nyoglos yog lawv txhim kho qee yam kev puas siab puas ntsws. Qee zaum, cov neeg mob kuj tuaj yeem ua xua rau cov khoom ntawm cov tshuaj.
Cov tshuaj puas muaj contraindications
Hmoov tsis zoo, tsis yog txhua tus neeg tuaj yeem siv cov tshuaj nitroglycerin rau kev txhaj tshuaj rau lub plawv, zoo li lwm yam tshuaj. Ua ntej ntawm tag nrho cov, contraindications rau kev siv ntawm cov tshuaj no tej zaum yuav ua xua rau nws cov khoom. Xws li cov tshuaj tiv thaiv yog tshwm sim los ntawm daim tawv nqaij khaus thiab pob khaus. Yog tias cov tsos mob tshwm sim, kev siv tshuaj yuav tsum tau txiav tawm.
Kuj contraindications rau kev siv cov tshuaj no yog:
- collapse;
- shock;
- arterial hypotension;
- hypretrophic obstructive cardiomyopathy;
- mob plawv nres nrog mob hnyav arterial hypotension;
- tshuaj lom pulmonary edema;
- kawm tamponade;
- constrictive pericarditis;
- nce intracranial siab;
- kev mob siab rau hauv glaucoma.
Tsis tas li ntawd, "Nitroglycerin" tsis raug tshuaj rau cov neeg mob uas muaj qhov tsis haum rau nitrates.
Kuv tuaj yeem siv thaum cev xeeb tub
Thaum yug menyuam, noj tshuaj no tau tso cai. Txawm li cas los xij, kev siv cov tshuaj no tsuas yog nyob rau hauv kev saib xyuas ntawm tus kws kho mob uas tuaj koom. Tib txoj caiyuav tsum tau ua raws li thaum siv cov tshuaj thaum lactation.
Kuj, tsuas yog rau kev noj qab haus huv, cov tshuaj no tuaj yeem siv los muab kev kho mob xwm txheej ceev rau cov neeg mob:
- nrog mob qaug dab peg;
- muaj mob siab;
- kub.
Txhua qhov xwm txheej no, qhov tsawg kawg nkaus ntawm cov tshuaj yuav tsum tau siv.
Thaum twg kuv yuav tsum ceev faj
Qee lub sij hawm tus kws kho mob yuav tsum sib npaug cov txiaj ntsig ntawm kev siv cov tshuaj no thiab ua rau muaj kev phom sij los ntawm nws. Qhov no tshwm sim yog tias tus neeg mob muaj, piv txwv li, cov teeb meem xws li:
- constrictive pericarditis;
- mob ntshav qab zib;
- kawm tamponade;
- mob taub hau tsis ntev los no;
- b hlwb hemorrhage;
- mob raum tsis ua haujlwm;
- mob infarction nrog qis sab laug ventricular filling siab;
- kab mob siab;
- Ythyrotoxicosis.
Dab tsi yog qhov tshwm sim ntawm kev noj tshuaj ntau dhau
Cov tshuaj no yuav tsum tau noj nruj me ntsis raws li cov lus qhia. Kev noj tshuaj ntau dhau ntawm cov tshuaj "Nitroglycerin" yuav tsum tsis pub nyob rau hauv txhua rooj plaub. Txwv tsis pub, tus neeg mob yuav tshwm sim:
- tachycardia;
- arterial hypotension;
- mob taub hau;
- xav kub;
- syncope.
Thaum muaj kev noj ntau dhau ntawm cov tshuaj nitroglycerin, cov neeg mob feem ntau muaj qhov nce siab hauv intracranial. Hauv qhov no, tus neeg mob yuav ntsib kev tsis meej pem thiab ntau yam kev mob neuralgic. Kev noj tshuaj ntau dhau ob peb teev ua rau muaj ethanol intoxication.
Vim methemoglobinemia, yog tias siv "Nitroglycerin" tsis raug, tus neeg mob tuaj yeem tsim hypoxia, thiab tom qab ntawd:
- cyanosis;
- coma;
- metabolic acidosis;
- txhawj xeeb;
- vascular collapse.
Kev pab ntau dhau
Arterial hypotension nyob rau hauv cov ntaub ntawv ntawm overdose yuav tsum raug tshem tawm los ntawm kev txo tus nqi lossis txawm tias nres kev tswj hwm ntawm cov tshuaj. Hauv cov xwm txheej hnyav, tus neeg mob yuav tsum tau muab tso rau hauv txoj haujlwm kab rov tav. Yog tias arterial hypotension yog txuam nrog bradycardia, tus neeg mob kuj yuav tau muab tshuaj "Dopamine" thiab "Atropine"..
Methemoglobinemia cov neeg mob yuav tsum txhaj tshuaj methylene xiav tshuaj rau hauv txoj hlab ntshav. Nws cov koob tshuaj yuav tsum sib npaug li 1-2 mg ib kilogram ntawm lub cev qhov hnyav.
Cov lus qhia rau kev siv
Siv cov tshuaj "Nitroglycerin" tsuas yog rau kev txhaj tshuaj rau hauv cov hlab ntsha. Nrog rau txoj kev thov no, cov tshuaj ua haujlwm sai li sai tau. Txhawm rau muab kev pabcuam xwm txheej kub ntxhov rau tus neeg mob yog tias tsim nyog, koj yuav tsum tau siv cov tshuaj "Nitroglycerin" thiab txhaj rau hauv cov hlab ntsha uas siv lub twj tso kua mis infusion lossis tsis siv neeg DLV-1. Dosed suabnoj thiab npaum li cas ntawm cov tshuaj no yuav tsum yog raws li qhov ua tau.
Qee lub sijhawm cov tshuaj no tuaj yeem muab tau los ntawm kev siv lub cev tsis tu ncua uas tsim los hloov cov kua dej. Hauv qhov no, qhov kev xaiv ntawm cov koob tshuaj tiag tiag yog tsim los ntawm kev suav cov tee ib feeb. Ib 0.1% tov ntawm "Nitroglycerin" yog diluted nrog 5% qabzib los yog sodium chloride (9 seem) mus rau ib tug concentration ntawm 0.01%.
Txhua qhov xwm txheej, kev xaiv cov tshuaj "Nitroglycerin" yog ua los ntawm tus kws kho mob uas tuaj koom rau ntawm tus kheej, nyob ntawm:
- ntshav siab;
- ECG;
- venous pressure;
- lub plawv dhia.
Tus nqi pib ntawm kev tswj hwm tus neeg sawv cev no feem ntau yog 0.5-1 mg / h. Qhov siab tshaj plaws hauv qhov no yog 8-10 mg / h. Lub sijhawm ntawm kev tswj hwm yog nyob ntawm tus neeg mob thiab tuaj yeem nyob ntawm ob peb teev mus rau 3 hnub.
Kev sib tham nrog lwm yam tshuaj
Cov nyhuv hypotensive ntawm "Nitroglycerin", uas tus neeg mob muaj ntshav siab, tuaj yeem nce ntxiv nrog kev tswj hwm ib txhij:
- morphine thiab lwm yam vasodilators;
- ACE inhibitors;
- beta-blockers;
- neuroleptics;
- YViagra;
- Ydiuretics;
- tricyclic antidepressants;
- tshuaj tua kab mob;
- ethanol.
Kev siv "Nitroglycerin" ua ke nrog novocainamide lossis quinidine tuaj yeem ua rau muaj kev loj hlob ntawm orthostatic vau hauv tus neeg mob. Txo cov nyhuv ntawm kev siv cov tshuaj no xws li tshuaj "Atropine" thiab cov tshuaj uas muaj M-anticholinergic nyhuv.
Thaum kho nrog nitroglycerin, tus neeg mob yuav tsum tsis txhob haus cawv. Cov tshuaj no yog siv nyob rau hauv daim ntawv ntawm kev daws, tau kawg, feem ntau nyob rau hauv lub tsev kho mob chaw.
Tshuaj analogues
Nrog lub plawv nres, ntau tus neeg tau pab nrog kev siv cov tshuaj nitroglycerin. Hauv Latin, cov tshuaj no hu ua nitroglycerinum. Tab sis tau kawg, yog tias tsim nyog, qee cov tshuaj uas muaj cov nyhuv zoo sib xws tuaj yeem siv rau tib lub hom phiaj.
Koj tuaj yeem hloov nitroglycerin, piv txwv li, nrog tshuaj xws li:
- Nitrocore.
- Dikor Ntev.
- "Nitrogranulong".
- "Nitrosorbite".
txhais tau tias "Nitrocor" thiab "Nitrogranulong" yog cov lus sib piv nrog cov tshuaj no, vim tias lawv muaj tib yam khoom xyaw. Ob txoj kev kho no yog siv rau thaum muaj xwm txheej ceev los daws qhov mob thaum muaj teeb meem plawv.
Cov khoom xyaw nquag ntawm Nitrosorbit yog isosorbite dinitrate. Cov tshuaj no muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj thiab tshuaj. Rau kev qaug dab peg, tsuas yog siv lub thib ob version ntawm cov tshuaj no. "Nitrosorbit" hauv cov ntsiav tshuajua qeeb heev.
txhais tau tias "Dikor Long" tsis yog ib qho analogue ntawm "Nitroglycerin". Nws yog tsuas yog siv rau kev tiv thaiv ntawm qaug dab peg. Ib tug ntawm cov yam ntxwv ntawm cov tshuaj no yog hais tias nws muaj peev xwm unload lub plawv cov leeg. Hmoov tsis zoo, cov tshuaj no ua haujlwm qeeb, thiab yog li siv tsis tau thaum muaj xwm txheej ceev.
tshuaj tshuaj xyuas
Rau feem ntau, cov neeg muaj teeb meem plawv qhuas Nitroglycerin. Nws pab nrog qaug dab peg, txiav txim los ntawm kev txheeb xyuas, zoo heev. Txawm li cas los xij, cov neeg mob feem ntau qhia noj cov tshuaj no tsuas yog thaum nws tsim nyog tiag tiag. Kev mob tshwm sim "Nitroglycerin" ua tau ntau heev.
Txias, piv txwv li, cov tshuaj no tuaj yeem txo qis rau cov kev txwv tseem ceeb. Yog li ntawd, nws yog tsim nyog siv nws, thiab txawm ntau npaum li ntawd nyob rau hauv daim ntawv ntawm ib tug cawv tov intravenously, tsuas yog nrog ib tug muaj zog nres. Tsis muaj teeb meem loj hauv plawv, cov neeg mob feem ntau tseem qhia kom txo qhov mob nrog kev siv tshuaj sib zog, piv txwv li, tib Corvalol.
Storage condition
Ib yam ntawm "Nitroglycerin", ntawm lwm yam, yog tias nws raug puas tsuaj sai heev hauv tshav kub thiab hauv qhov kaj. Khaws cov tshuaj no hauv tsev hauv txhua daim ntawv hauv lub tub yees.
Nyob rau hauv ib lub vial qhib, cov tshuaj no pib poob nws cov khoom sai heev txawm tias nyob hauv qhov chaw txias. Nyob rau hauv xws li ib lub thawv, nws efficiency yuav poob mus rau 30% nyob rau hauv 2 lub hlis.
Lwm cov duabtso
Ntxiv rau cov ntsiav tshuaj thiab cov kua ntshiab rau kev txhaj tshuaj, cov tshuaj no muaj nyob rau hauv daim ntawv ntawm cov tshuaj tsuag lossis roj. "Nitroglycerin" ntawm tag nrho cov hom no, txawm li cas los xij, txiav txim los ntawm kev tshuaj xyuas, pab nrog angina pectoris zoo heev.
Raws li cov tshuaj oily, cov tshuaj no tau muag hauv cov tshuaj ntsiav. Daim ntawv no ntawm nws muag hnub no tuaj yeem pom ntau zaus. Tau kawg, yog tias koj xav tau, koj tuaj yeem noj cov roj ntawm nitroglycerin hauv lub tsev muag tshuaj. Pab nrog teeb meem plawv, daim ntawv no tsis yog ceev npaum li kev txhaj tshuaj cawv. Txawm li cas los xij, kev txiav txim los ntawm kev tshuaj xyuas, nws tuaj yeem suav tias ua tau zoo heev.
Yog tias tus neeg mob hauv lub tsev muag tshuaj txiav txim siab noj cov roj "Nitroglycerin", tau kawg, nws kuj yuav tsum paub siv nws li cas. Hauv qhov no, ib lub tshuaj ntsiav tshuaj muab tso rau hauv qab tus nplaig thaum muaj kev tawm tsam. Cov ntsiav tshuaj ntawm qhov kev kho no yuav tsum tau muab coj los ua tib yam nkaus.
Qee tus neeg kuj xav paub yuav ua li cas thiaj ua tau cov roj nitroglycerin. Daim ntawv qhia rau cov tshuaj no yog qhov yooj yim heev. Cov tshuaj nyob rau hauv daim ntawv no tsis muaj ib tug complex Cheebtsam. Piv txwv li, ib qho ntawm nws cov khoom yog cov roj zaub zoo tib yam. Txawm li cas los xij, rau cov khoom siv thawj zaug hauv tsev, nws tsim nyog yuav, tau kawg, npaj cov tshuaj ntsiav uas muaj cov tshuaj zoo li no. Guaranteed los pab nrog lub plawv nres, ntawm chav kawm, tsuas yog ib qho kev lag luam tshuaj tsim nyob rau hauv ua raws li tag nrho cov yuav tsum tau technologies. Cov kev sim hauv qhov no yuav muajqhov tshwm sim ntau tshaj qhov tu siab.
