Kev cev xeeb tub yog ib yam mob tshwj xeeb ntawm tus poj niam lub cev uas yuav tsum tau ceev faj thiab ua tib zoo xav txog kev noj qab haus huv. Feem ntau, thaum lub sijhawm cev xeeb tub sib txawv, ntau yam tsis zoo tshwm sim, ib qho ntawm cov suab nrov ntawm lub tsev menyuam, uas tuaj yeem ua rau yug ntxov ntxov. Txhawm rau tiv thaiv qhov tshwm sim tsis zoo, ntau cov tshuaj tau sau tseg txhawm rau txhawm rau txhawm rau myometrium. Ntau tus kws kho mob obstetricians tau sau ntawv Ginipral (ntsiav tshuaj) raws li kev kho mob.
Analogues ntawm nws kuj tau siv ntau zaus, vim tias cov tshuaj cuam tshuam rau cov kab mob sib txawv ntawm tus kheej - cov uas pab tau zoo yuav tsis ua rau lwm tus xav tau. Tsis tas li ntawd, cov tshuaj no, txawm tias nws cov txiaj ntsig zoo hauv kev tiv thaiv kev ua haujlwm ua ntej lub sijhawm ua haujlwm, muaj ntau txaus contraindications thiab kev phiv, uas ua rau qee tus neeg mob ntshai thiab tsis kam noj nws. Txawm li cas los xij, xaiv cov tshuaj no lossis txiav txim siab yuav hloov Ginipral li cas yog pom zoo los ntawm tus kws kho mob tshwj xeeb.
Kev piav qhiatshuaj
Cov tshuaj "Ginipral" yog tsim nyob rau hauv daim ntawv ntawm cov dawb biconvex round ntsiav tshuaj uas muaj 500 μg ntawm hexoprenaline sulfate txhua, nyob rau hauv daim ntawv ntawm ib tug tov rau intravenous tshuaj nrog ib koob tshuaj ntawm 5 μg ib 1 ml ntawm kua (10 μg ntawm cov tshuaj nquag rau 1 ampoule). Lawv kuj tsim ib qho kev mloog zoo rau kev npaj cov tshuaj rau infusion (25 mcg ntawm hexoprenaline sulfate hauv ib lub ampoule).
Mechanism of action
Cov tshuaj "Ginipral", qhov kev txiav txim ntawm uas yog vim muaj cov khoom ntawm hexoprenaline sulfate, cais raws li kev xaiv beta2-adrenergic agonist, hais txog cov tshuaj uas txo cov suab nrov thiab kev ua haujlwm ntawm cov leeg ntawm lub tsev menyuam (myometrium), uas yog, nws pab tiv thaiv kev ua haujlwm ntxov ntxov.
Thaum muab tshuaj, tshwj xeeb tshaj yog tso rau hauv cov hlab ntsha, nws sai sai ua rau txo qis ntawm lub tsev menyuam, uas yuav pab txo qhov zaus thiab qhov hnyav ntawm cov leeg nqaij, inhibition ntawm tus kheej los yog provoked los ntawm kev teem caij ntawm oxytocin contractions. Thaum siv thaum lub sij hawm ua hauj lwm, nws yuav pab tau normalize muaj zog heev los yog irregular contractions. Kev txiav tawm ntawm kev ua haujlwm ntxov ntxov ntawm lub tsev menyuam tso cai rau tus poj niam nqa lub cev xeeb tub mus rau lub sijhawm zoo rau qhov pom ntawm tus menyuam.
Ntxiv rau qhov tshwj xeeb, cov tshuaj muaj qee yam cuam tshuam rau lub xeev ntawm lub plawv thiab cov ntshav ntws ntawm leej niam thiab tus menyuam hauv plab, uas yuav tsum tau coj mus rau hauv tus account thaum muab tshuaj.
Kev qhia
Vim tias cov tshuaj no ua rau kom cov leeg nqaij hauv uterine so, txo qhov zaus thiabQhov kev siv ntawm lawv cov contractions, cuam tshuam nrog qhib lub ncauj tsev menyuam, tom qab ntawd kev siv "Ginipral" yog vim qhov tseeb ntawm qhov kev txiav txim no.
Cov tshuaj hauv cov tshuaj tau sau tseg thaum muaj xwm txheej ceev kom nrawm nrawm nrawm:
- thaum mob plab fetal asphyxia tshwm sim thaum yug menyuam;
- ua ntej phau ntawv hloov ntawm tus menyuam los ntawm txoj haujlwm transverse;
- thaum txoj hlua caj dab prolapses;
- nrog kev ua haujlwm nyuaj;
- kom lub tsev me nyuam so ua ntej caesarean;
- hauv kev ua haujlwm ua ntej ua ntej kom qeeb qeeb ua ntej xa tus poj niam cev xeeb tub mus rau tsev kho mob.
Ginipral kuj tseem siv rau hauv cov hlab ntsha:
- muaj kev pheej hmoo ntawm kev mob ntxov ntxov;
- kom so cov leeg ntawm lub tsev menyuam thaum lub sijhawm ua haujlwm ntawm suturing nws lub caj dab txhawm rau tiv thaiv nws qhov kev qhia tsis raws sijhawm;
- rau inhibition ntawm contractions thaum lub hnub nyoog gestational tsis txaus los yog nrog ceev thiab hnyav contractions tiv thaiv keeb kwm ntawm ib tug unprepared caj dab.
Kev siv "Ginipral" hauv cov lus qhia no yuav tsum tau noj tag nrho cov tshuaj, uas tuaj yeem kav ntev li ob peb lub hlis.
Cov tshuaj tau muab tshuaj rau kev pheej hmoo ntawm kev ua haujlwm ua ntej lub sijhawm ua haujlwm, feem ntau yog kev kho mob ntxiv mus.
YContraindications
Kev siv tshuaj yog cuam tshuam nrog ntau cov kev mob tshwm sim loj, yog li ntawd, nws tsuas yog siv raws li kws kho mob tau sau tseg, suav nrog txhua qhov kev txwv, qee zaum tshem tawm cov tshuaj "Ginipral", analogues.uas tej zaum yuav tsim nyog nyob rau hauv ib qho xwm txheej.
Tsis txhob noj tshuaj ntau yam kab mob:
- Ythyrotoxicosis;
- tachyarrhythmias;
- mitral valve tsis xws luag, nrog rau aortic stenosis;
- myocarditis;
- IHD;
- mob ntshav siab;
- kab mob hnyav ntawm lub raum thiab lub siab;
- angle-kaw glaucoma;
- uterine los ntshav ntawm ntau yam etiologies, detachment ntxov ntxov ntawm placenta;
- txhim kho cov kab mob hauv lub cev;
- hauv thawj peb lub hlis twg ntawm cev xeeb tub;
- lactation (pub mis niam);
- hypersensitivity rau cov khoom ntawm cov tshuaj (tshwj xeeb tshaj yog nrog bronchial hawb pob lossis keeb kwm ntawm rhiab heev rau sulfites).
Lub xub ntiag ntawm tag nrho cov npe ntawm contraindications quab yuam nyob rau hauv qee kis los nrhiav kev hloov pauv rau cov tshuaj Ginipral, ib qho analogue uas tuaj yeem nrhiav tau yooj yim, vim nws muaj kev cuam tshuam tshwj xeeb ntawm myometrium, thiab tsis yog. ntawm tag nrho cov nqaij du tag nrho.
daim duab daim ntawv thov
Raws li twb tau hais lawm, noj Ginipral yuav tsum muaj cov lus qhia nruj thiab ua raws li kev noj tshuaj. Kev tswj hwm txoj hlab ntshav yog qhov zoo dua nyob hauv tsev kho mob uas siv cov twj tso kua mis tsis siv neeg los yog cov twj tso kua mis, txij li kev kho tshuaj cuam tshuam nrog nws cov dej ntws qeeb dhau 5-10 feeb.
Thaum muaj xwm txheej ceev, txhawm rau kom tsis txhob muaj kev sib kis sai, cov tshuaj siv tau ntawm ib koob ntawm 10 mcg (ib lub ampoule muaj 2 ml ntawm tus neeg sawv cev), ua raws li. Infusion ntawm cov tshuaj "Ginipral". Lub dropper yog sau nrog kev taw qhia qeeb heev ntawm tus nqi ntawm 0.3 mcg / min. Yog tias qhov kev ua haujlwm uterine txo qis zuj zus lawm, cov tshuaj yuav siv sijhawm ntev dua (0.075 mcg / min).
Yog tias cov txiaj ntsig ntawm kev kho mob zoo li no, kev kho ntxiv tuaj yeem ua tiav siv cov ntsiav tshuaj ntawm koob tshuaj 500 mcg, uas pom zoo kom haus dej txaus, tab sis tsis yog tshuaj yej lossis kas fes, uas tuaj yeem txhim kho qhov tsis zoo ntawm cov tshuaj.. Cov koob tshuaj txhua hnub ntawm cov ntsiav tshuaj yog 4-8 daim thaum noj ib zaug, thawj zaug tom qab 3 teev, tom qab 4-6 teev.
Cov lus qhia tshwj xeeb
Qhov muaj ntau ntawm cov kev mob tshwm sim yuav tsum tau saib xyuas kev noj qab haus huv ntawm tus neeg mob thiab tus menyuam hauv plab, tshwj xeeb, yuav tsum tau saib xyuas kev ua haujlwm ntawm cov hlab plawv. Nws raug nquahu kom ntsuas ECG ua ntej thiab thaum kho.
Yog tias tus neeg mob muaj qhov nkag siab zoo rau cov tshuaj no, nws raug muab tshuaj me me, xaiv nruj me ntsis rau tus kheej, nrog kev saib xyuas tas li ntawm tus kws kho mob.
Yog hais tias muaj cov lus hais tachycardia lossis txo cov ntshav siab, cov tshuaj txo qis. Qhov tshwm sim ntawm cov tsos mob xws li ua tsis taus pa luv, mob hauv cheeb tsam ntawm lub plawv, cov tsos mob ntawm lub plawv ischemia, qhia txog kev tshem tawm tam sim ntawm cov tshuaj no. Txhawm rau txo cov kev mob tshwm sim, Verapamil tau muab tshuaj ntxiv rau cov tshuaj Ginipral, uas yog tsom rau kev ua kom tsis zoo rau cov hlab plawv.
Nrog cov ntshav qab zib nce ntxiv los ntawmsiv cov tshuaj no, koj yuav tsum ua tib zoo saib xyuas cov ntsuas ntawm carbohydrate metabolism hauv cov poj niam uas muaj ntshav qab zib.
Cov tshuaj "Ginipral" pab txo qis diuresis, yog li nws yog ib qho tsim nyog yuav tsum nco ntsoov txhua yam kev hloov pauv uas yuav cuam tshuam nrog cov kua dej hauv lub cev. Qee lub sij hawm kev sib koom ua ke nrog glucocorticosteroids tuaj yeem ua rau mob ntsws ntsws, yog li nws yuav tsum tau saib xyuas lub sijhawm infusion tas li, nrog rau qhov ntim ntawm cov tshuaj txhaj.
Side effects
Thaum siv cov tshuaj uas tuaj yeem cuam tshuam rau tag nrho lub cev hauv txoj hauv kev nyuaj, xws li Ginipral, cov teebmeem tshwm sim tuaj yeem tshwm sim los ntawm txhua lub cev:
- tsis zoo cuam tshuam rau lub hauv nruab nrab thiab lub paj hlwb peripheral yog mob taub hau, kiv taub hau, ntxhov siab, me ntsis tshee ntawm ntiv tes;
- cov txiaj ntsig ntawm cov hlab plawv tuaj yeem ua rau tachycardia, arterial hypotension (feem ntau diastolic) hauv cov poj niam cev xeeb tub, feem ntau tsis tshua muaj kev cuam tshuam ntawm atherosclerosis (ventricular extrasystole) lossis cardialgia tuaj yeem tshwm sim, sai sai tom qab tshem tawm cov tshuaj;
- tsis tshua muaj kab mob ntawm lub plab zom mov tuaj yeem tshwm sim los ntawm xeev siab, ntuav, inhibition ntawm txoj hnyuv motility mus txog qhov ua tiav stagnation ntawm cov zaub mov coma;
- yog tias muaj kev nkag siab zoo rau cov khoom siv ntawm cov tshuaj, kev tsis haum tshuaj yuav tshwm sim hauv daim ntawv ntawm kev ua tsis taus pa, bronchospasm, tsis nco qab, uas tuaj yeem hloov mus rau qhov tsis nco qab, hauv cov neeg mob hawb pob bronchial lossishypersensitivity rau sulfites - mus txog anaphylactic shock.
Ntxiv rau, tawm hws tuaj yeem nce ntxiv, oliguria thiab edema tuaj yeem tshwm sim. Cov menyuam mos liab feem ntau muaj hypoglycemia thiab acidosis.
Ntau tshaj
Thaum muaj xwm txheej kub ntxhov ntawm kev ua haujlwm tsis pub dhau lub sijhawm lossis nyob rau hauv cov ntaub ntawv ntawm cov uterine hypertonicity tsis tu ncua, nws yog ib qho tsim nyog yuav tsum tau muab cov tshuaj no ntau npaum li cas, uas tuaj yeem ua rau ntau tshaj qhov tso cai txhua hnub thiab qhov cuam tshuam tsis zoo.
Cov tsos mob ntawm kev noj tshuaj ntau dhau suav nrog: mob hnyav tachycardia hauv tus poj niam cev xeeb tub (qhov tshwm sim no tsis tshua muaj tshwm sim hauv tus menyuam hauv plab), arrhythmia, tshee ntawm ntiv tes, mob taub hau ntawm ntau qhov chaw, nce tawm hws, ntxhov siab, cardialgia, txo cov ntshav siab. thiab ua tsis taus pa. Qhov tshwm sim ntawm cov tsos mob no yog lub hauv paus rau kev tshem tawm ntawm cov tshuaj "Ginipral", ib qho analogue uas yuav tsis muab cov duab kho mob zoo li no.
Thaum cov tsos mob zoo li no tshwm sim, cov tshuaj antagonist tau muab tshuaj, uas tsis yog xaiv beta-blockers uas tuaj yeem cuam tshuam cov nyhuv ntawm cov tshuaj.
Sib tham nrog lwm yam tshuaj
Kev muaj tus kab mob hauv tus poj niam cev xeeb tub yuav tsum tau noj cov tshuaj uas yuav tsum tau noj tsis tu ncua nrog cov leeg nqaij so, yog li cov lus nug yuav tshwm sim: "Yuav ua li cas hloov Ginipral yog tias tshem tawm cov tshuaj tseem ceeb. ua tsis tau?"
Rau cov tshuaj uas nthuav tawm atypical kev ua thaumKev teem caij sib koom ua ke ntawm kev daws teeb meem lossis cov ntsiav tshuaj "Ginipral", suav nrog:
- beta-blockers uas tuaj yeem ua rau tsis muaj zog lossis ua kom tsis muaj zog ntawm cov tshuaj "Ginipral";
- methylxanthines (nrog rau cov tshuaj "Theophylline"), txhim kho nws cov txiaj ntsig;
- glucocorticosteroids, kev sib xyaw ua ke uas tuaj yeem ua rau txo qis ntawm kev sib xyaw ntawm glycogen hauv daim siab;
- qhov ncauj hypoglycemic tshuaj thaum siv ua ke nrog cov tshuaj no tsis tshua muaj txiaj ntsig hauv lawv txoj kev kho mob;
- Kev sib cuam tshuam ntawm cov tshuaj no nrog cov tshuaj mob plawv thiab cov tshuaj bronchodilator tuaj yeem ua rau muaj kev cuam tshuam ntau ntxiv thiab cov tsos mob ntawm kev noj ntau dhau;
- halothane thiab beta-agonists nce qhov tshwm sim ntawm cov kev mob tshwm sim hauv kev cuam tshuam rau lub plawv thiab lwm yam hauv lub cev;
- ergot alkaloids, MAO inhibitors, tricyclic antidepressants thiab cov neeg ua haujlwm uas muaj calcium thiab vitamin D, nrog rau dihydrotachysterol thiab mineralocorticoids, tsis sib haum nrog Ginipral, qhov kev tshem tawm ntawm qhov no yog qhov tsim nyog.
Txij li cov tshuaj nquag (hexoprenaline sulfate) yog cov nquag nquag, nws tsuas yog diluted nrog isotonic sodium chloride tov thiab 5% dextrose (glucose).
Tshuaj "Ginipral": analogues thiab cov ntsiab lus
Ua los ntawm pab pawg ntawm beta-adrenergic agonists, qhov kev kho no muaj ntau cov tshuaj zoo sib xws hauv kev ua thiab kev qhia:
- "Partusisten" - muaj raws li kev ua kom tsis muaj menyuam rau kev txhaj tshuaj rau hauv cov hlab ntsha thiab hauv cov ntsiav tshuaj, tau muab tshuaj los tiv thaiv kev yug ntxov ntxov hauv tsev kho mob nkaus xwb.
- "Ritodrine" - yog siv feem ntau rau kev mob hawb pob bronchial thiab lwm yam kev cuam tshuam, tab sis kuj tuaj yeem ua kom cov leeg nqaij hauv plab.
- "Fenoterol" - muaj cov txiaj ntsig zoo sib xws, tsuas yog siv hauv kev saib xyuas kev kho mob hauv tsev kho mob.
- "Salbupart" - tau sau tseg rau kev pheej hmoo ntawm kev yug menyuam ntxov, tau muab tshuaj maj mam tso rau hauv 6-12 teev.
Magnesium muaj cov txiaj ntsig zoo sib xws ntawm kev txo cov suab nrov hauv lub tsev menyuam, uas, los ntawm kev thaiv cov calcium channel, ua kom cov myometrium zoo heev, thaum pom cov kev mob tshwm sim tsawg dua.
Lwm cov tshuaj uas tuaj yeem hloov cov tshuaj "Ginipral" yog ib qho analogue ntawm "Indomethacin", ntsig txog prostaglandin inhibitors. Nws tuaj yeem txo cov suab nrov hauv tsev menyuam tau zoo, tab sis thaum siv tom qab cev xeeb tub ntawm 32 lub lis piam, nws ua rau muaj kev cuam tshuam loj heev: nws yuav pab txo qis kev loj hlob ntawm tus menyuam hauv plab cov ntaub so ntswg, thiab tuaj yeem ua rau jaundice thiab enterocolitis..
Qee tus kws kho mob obstetricians sau tshuaj "Nifedipine" kom txo cov suab nrov ntawm lub tsev menyuam. Nws tsis yog ib qho cuab yeej tshwj xeeb uas siv rau hauv gynecology, nws qhov peev xwm feem ntau cuam tshuam txog kev kho mob plawv pathologies, tab sis vim tias cov cuab yeej no pab ua kom cov leeg du, nws kuj tuaj yeem siv los txo cov leeg ntawm lub tsev menyuam. Qhov twgNws yuav tsum raug sau tseg tias cov tshuaj ua rau txo qis ntshav siab, uas tiv thaiv nws cov kev tswj hwm rau cov neeg mob hypotension.
Reviews
Ntau tus poj niam cev xeeb tub nco ntsoov tias kev teem sijhawm ntawm cov tshuaj no ua rau nws tuaj yeem tshem tawm lub suab nrov ntawm lub tsev menyuam, txhawm rau tiv thaiv qhov tshwm sim ntawm kev ua haujlwm ntxov ntxov. Cov niam uas tau txais cov tshuaj "Ginipral" thaum lub sij hawm cev xeeb tub tsis nco txog qhov tshwm sim tsis zoo los ntawm kev siv mus sij hawm ntev hauv cov menyuam mos. Rau ntau tus, kev teem caij ntawm cov khoom no tau pab coj tus menyuam mus rau lub sijhawm muaj kev nyab xeeb rau nws yug, cia tag nrho nws lub cev thiab lub cev los npaj rau lub neej ywj pheej. Qee tus tau ntsib qhov tsis zoo me ntsis hauv daim ntawv ntawm kev tshee ntawm cov ntiv tes, mob taub hau thiab lwm yam, uas ua rau maj mam tshem tawm cov tshuaj, vim nws tsis tuaj yeem tso tseg tam sim ntawd. Kev hloov pauv mus rau ib qho tshuaj tshiab yuav tsum siv qee lub sijhawm, thaum lub sijhawm noj cov tshuaj Ginipral tau ua tib zoo txo qis, thaum qhia cov tshuaj nyiam. Txawm hais tias muaj ntau daim ntawv teev cov contraindications thiab cov kev mob tshwm sim, feem ntau tseem hais lus zoo, tsis nco qab cov txiaj ntsig zoo ntawm cov tshuaj ntawm cov leeg nqaij ntawm lub tsev menyuam, uas yog qhov tseem ceeb tshwj xeeb tshaj yog thaum muaj xwm txheej ceev vim kev xa khoom tsis raws sijhawm.
Yog li, kev siv "Ginipral" tsuas yog ua los ntawm tus kws kho mob uas tuaj koom lossis siv hauv tsev kho mob thaum muaj xwm txheej ceev uas cuam tshuam nrog kev ua haujlwm tsis raws sijhawm. Nyob rau tib lub sijhawm, nws yog ib qho tsim nyog yuav tsum ua tib zoo saib xyuastag nrho cov tshuaj thiab cov koob tshuaj pom zoo kom tsis txhob ua rau muaj kev phiv. Thaum siv cov tshuaj no, koj yuav tsum tau saib xyuas tshwj xeeb rau qhov tsis zoo me ntsis lossis hloov pauv hauv koj tus mob, txhawm rau teb raws sijhawm rau qhov xwm txheej uas tau tshwm sim, yog tias tsim nyog, mus txog qhov tshem tawm ntawm cov tshuaj Ginipral, ib qho analogue ntawm uas tej zaum yuav tsim nyog nyob rau hauv txhua rooj plaub. Txawm hais tias nws yuav tsum tau sau tseg tias qhov ua tau zoo ntawm cov tshuaj no hauv uterine hypertonicity thiab muaj peev xwm ua kom sai sai ntawm myometrial contractions thaum lub sij hawm ua hauj lwm ua ntej.
