Hypertension yog ib yam kab mob nyuaj thiab txaus ntshai ntawm cov hlab plawv, qhia los ntawm kev nce ntshav siab. Tau pom nws cov tsos mob tseem ceeb hauv koj tus kheej, koj yuav tsum ua tib zoo saib xyuas kev kho mob sai li sai tau, vim nws yog qhov ua rau muaj ntau yam teeb meem kev noj qab haus huv, uas tuaj yeem ua rau tuag taus.
Raws li cov lus pom zoo ntawm cov kws tshaj lij feem ntau ntawm cov tshuaj, kev kho mob ntshav siab feem ntau ua tiav los ntawm kev noj cov tshuaj alpha-blockers kom raug - cov tshuaj tshwj xeeb, cov yam ntxwv uas peb yuav tham ntxiv tom qab.
Alpha-blockers txheej txheem cej luam
Cov tshuaj twg yog alpha-blockers? Lawv muaj dab tsi? Xav txog qhov no ntxiv.
Alpha-blockers siv rau kev kub siab yog cov tshuaj uas hu ua xaiv hauv zej zog kho mob. Lawv lub ntsiab feature yog tias lawv cuam tshuampaj hlwb xaus, ua rau ua kom cov ion channels.
Hauv cov lus tso tawm los ntawm cov kws kho mob rau cov tshuaj hauv pab pawg no, nws tau sau tseg tias hauv kev kub siab, alpha-blockers tuaj yeem txo qhov kev pheej hmoo ntawm plawv nres thiab mob stroke. Tsis tas li ntawd, qhov tshwm sim ntawm kev noj qab haus huv thiab raug ntawm cov ntsiav tshuaj no yog tsim cov pa oxygen ntau hauv tib neeg lub cev.
Mechanism of drug action
Xav txog qhov peculiarities ntawm cov txheej txheem ntawm kev ua ntawm cov tshuaj ntawm pawg alpha-blockers, nws yog ib qho tsim nyog yuav tsum xyuam xim rau kev ua haujlwm ntawm cov hlab ntsha impulses thaum lawv nkag mus rau tib neeg lub cev. Yog li, cov teeb liab no, txav los ntawm lub hlwb mus rau qee lub cev ua haujlwm, kov yeej tsis yog cov hlab ntsha xwb, tab sis kuj yog qhov chaw nruab nrab ntawm cov hlwb, uas hauv cov tshuaj hu ua synapses. Txhawm rau kom cov teeb liab kis tau tuaj yeem ua raws li ntxiv, receptors uas cuam tshuam rau tus neeg nruab nrab tuaj yeem ua. Tom qab ntawd, cov tshuaj hormones thiab lwm yam tshuaj pib cuam tshuam rau lub cell membrane.
Nws tsim nyog sau cia tias alpha-adrenergic receptors suav nrog hauv cov ntsiav tshuaj hauv nqe lus nug muaj peev xwm pom tau tsuas yog adrenaline molecules lossis cov khoom zoo sib xws hauv cov khoom sib xyaw rau nws. Raws li qhov no, nws yog ib qho yooj yim los twv tias thaum ib qho alpha-blocker nkag mus rau hauv cov hlab ntsha, tag nrho cov txheej txheem rhiab heev ntawm lub cev yuav ua rau lub cev tsis muaj zog rau adrenaline uas tsim los ntawm lub cev. Yog li ntawd, lub cev nqaij daim tawv pib ua qee cov lus txib uas tau muab los ntawm cov kab ke.kev cai.
Alpha-blockers siv rau kev kub siab muaj nyob rau hauv ntau hom: hmoov rau kev ncua, ntsiav tshuaj, tshuaj ntsiav, pawg rau parenteral tswj, thiab aerosols.
Txoj kev raug mob siab
Nws paub tias cov tshuaj ntawm pab pawg no tau siv, raws li txoj cai, rau kev kho mob ntshav siab. Cov tshuaj no yog vim lub fact tias alpha receptors yuav ua kom siab nyob rau hauv ib tug ib txwm theem, qhov nce ntawm uas yog vim ntau excitation ntawm nqaij fibers. Raws li cov tshuaj kho kom raug thiab siv lawv li niaj zaus, cov teebmeem hauv qab no tau pom:
- tiv thaiv lub cev los ntawm kev cuam tshuam ntawm cov ntshav siab;
- txo qis hauv "phem" cov roj cholesterol, uas feem ntau txhaws cov hlab ntsha mus rau qhov chaw uas cov ntshav tsis ntws los ntawm lawv;
- txo cov ntshav siab mus rau qib tau txais, xis rau tib neeg lub neej.
Nws yog ib qho tsim nyog sau cia tias cov khoom tsim los ntawm kev npaj ntawm pab pawg no tsis cuam tshuam nrog kev saib xyuas kev ua neej zoo los ntawm cov neeg mob ntshav siab, thiab tseem tsis ua mob rau tib neeg lub siab.
Contraindications rau kev siv
Thaum kws kho mob sau tshuaj raws li alpha-blockers rau lawv cov neeg mob, lawv yuav tsum xyuas kom meej tias lawv tsis muaj contraindications rau noj tshuaj nyob rau hauv pawg no. Mus rau kab nopathologies suav nrog:
- muaj teeb meem nrog kev ua haujlwm ntawm lub siab lossis lub raum - cov kabmob uas muaj lub luag haujlwm rau kev ua haujlwm ntawm kev hloov pauv biochemical ntawm cov khoom tseem ceeb ntawm cov tshuaj;
- hypotension;
- valvular stenosis;
- ischemic plawv tsis ua hauj lwm.
Ntxiv rau tag nrho cov saum toj no, cov tshuaj ntawm pab pawg neeg nug tsis tuaj yeem raug sau rau cov neeg uas muaj ib tus neeg intolerance rau yam tsawg ib feem ntawm cov khoom.
Qee tus kws kho mob hais tias qhov teeb meem tseem ceeb ntawm kev noj tshuaj rau ntshav siab los ntawm cov npe ntawm alpha-blockers yog lub hnub nyoog tsis ncaj ncees lawm (txawm tias hluas dhau los lossis, qhov qub, qub).
Lus npe ntawm alpha-blockers rau ntshav siab
Yog tias ib tus neeg muaj ntshav siab, tus kws kho mob tuaj koom, raws li txoj cai, muab cov tshuaj adrenoblockers rau nws. Txog niaj hnub no, cov tshuaj zoo tshaj plaws hauv cheeb tsam no suav nrog:
- "Prazosin";
- "Terazosin";
- "Doxazosin";
- "Fentolamine";
- "Yohimbine";
- "Clonidine";
- "Dopegyt".
Cia peb xav txog qhov cuam tshuam ntawm lawv txhua tus.
Doxazosin
Doxazosin yog ib qho ntawm cov tshuaj alpha-blocker zoo tshaj plaws hauv kev kho mob ntshav siab. Nws lub ntsiab kom zoo dua yog tias sib nrug ntawmCov nyhuv hypertensive, cov khoom tseem ceeb uas tsim cov khoom lag luam muaj cov nyhuv antispasmodic thiab hypolipidemic, vim tias cov hlab ntsha dilate sai sai, thiab cov ntshav khiav zoo dua.
Raws li kev noj tshuaj, yuav tsum xaiv los ntawm kws kho mob nkaus xwb, nyob ntawm qhov mob hnyav.
Kev xyaum qhia tau hais tias qhov blocker no rau kev kub siab tuaj yeem siv tau ob qho tib si ntawm tus neeg mob thiab thaum lub sijhawm ua haujlwm lub cev tsis tu ncua.
Prazosin
Cov alpha-blocker tsim nyog rau kev siab yog Prazosin, uas tuaj yeem yuav ntawm cov khw muag tshuaj Lavxias ntawm tus nqi ntawm 600 rubles ib pob.
Cov txiaj ntsig tseem ceeb ntawm cov tshuaj hauv nqe lus nug yog txhawm rau txo qhov xav tau oxygen hauv cov leeg nqaij, uas yog qhov tseem ceeb tshwj xeeb hauv kev kho mob ntshav siab. Cov kws tshaj lij hauv kev lag luam tshuaj nco ntsoov tias cov khoom tseem ceeb ntawm cov tshuaj "Prazosin" pab txhawb kev nthuav dav ntawm cov hlab ntsha thiab cov hlab ntsha, thaum tsis txhawb kev loj hlob ntawm tachycardia.
Terazosin
Raws li cov kws tshaj lij hauv cov tshuaj, ntawm cov alpha-blockers zoo tshaj plaws rau kev kub siab yog Terazosin, cov tshuaj uas nws cov txiaj ntsig tseem ceeb yog tsom rau kev nthuav dav cov hlab ntsha loj. Cov txheej txheem ntawm kev ua ntawm tus neeg sawv cev hauv nqe lus nug yog txhawm rau thaiv alpha-1-adrenergic receptors, ua rau txo qis ntshav siab.ceev heev.
Tawm tsam keeb kwm yav dhau los ntawm cov txiaj ntsig ntawm cov tshuaj nquag ntawm cov tshuaj "Terazosin", lipid profile normalizes sai heev, thiab cov nyhuv ntawm ACE inhibitors thiab diuretics nce.
Tus nqi nruab nrab ntawm Terazosin hauv Russia yog kwv yees li 270 rubles.
Fentolamine
Alpha-blocker (hloov siab yog ib qho ntawm cov kev qhia rau nws siv) "Fentolamine" Nws muaj cov lus hais, tab sis luv luv arterio- thiab venodilating nyhuv, uas ua rau cov kev kho mob ntawm cov tsos mob uas nrog rau cov chav kawm ntawm hypertensive. Crisis.
Cov kws tshaj lij hauv thaj chaw tshuaj sau tseg tias kev siv tshuaj "Fentolamine" ua rau muaj kev nthuav dav ntawm cov hlab ntsha peripheral, uas tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev tshem tawm ntawm spasms hauv lawv. Raws li txoj cai, raws li qhov tshwm sim, muaj kev txhim kho cov ntshav rau ntawm daim tawv nqaij, cov leeg nqaij ntawm lub cev, thiab cov mucous membranes.
Kev siv cov tshuaj nyob rau hauv nqe lus nug yog categorically contraindicated rau cov neeg uas nws lub cev muaj ib tug ntse hloov nyob rau hauv cov hlab ntsha thiab lub plawv cov leeg.
Cov tshuaj no yog muab rau cov khw muag tshuaj hauv daim ntawv ntawm cov hmoov uas npaj rau kev ncua. Tsis tas li, qee cov tuam ntxhab muab nws ua cov ntsiav tshuaj.
Yohimbine
"Yohimbine" yog cov tshuaj tsim los ntawm cov khoom xyaw ntuj, cov uas muaj alkaloids, uas tau muab rho tawm los ntawmtsob ntoo West African.
Tom qab nkag mus rau tib neeg lub cev, cov tshuaj no pib ua kom cov adrenergic kev ua haujlwm nyob rau hauv cov receptors, uas, raws li qhov tshwm sim, ua rau stimulation ntawm lub paj hlwb thiab txawm tias muaj kev sib deev muaj siab.
Kev noj tshuaj "Yohimbine" yog contraindicated rau cov neeg laus. Ntxiv mus, nws tsis pom zoo rau cov poj niam thiab menyuam yaus.
Tus nqi nruab nrab ntawm cov tshuaj ntsiav hauv cov khw muag tshuaj Lavxias yog kwv yees li 300 rubles.
Clonidine
"Clonidine" yog ib qho ntawm cov tshuaj analogues "Clonidine". Nws cov txiaj ntsig tseem ceeb yog tsom rau qhov tshwm sim ntawm cov teebmeem antihypertensive ntawm tib neeg lub cev, ua rau txo qis tsis yog ntshav siab xwb, tab sis kuj nyob rau hauv qhov muag siab. Nws yuav tsum tau muab sau tseg hais tias qhov kev txiav txim ntawm lub active Cheebtsam ntawm cov tshuaj nyob rau hauv nqe lus nug tseem yog aimed ntawm regulating vascular tone nyob rau hauv lub neurogenic theem.
Nkag mus rau hauv tib neeg lub cev, cov tshuaj nquag ntawm cov tshuaj "Clonidine" tau yooj yim hla cov ntshav-hlwb teeb meem, tom qab ntawd nws pib cuam tshuam nrog cov receptors nyob hauv hypothalamus, vim tias muaj qhov txo qis sai. nyob rau hauv cov ntshav siab thoob plaws hauv tib neeg lub cev.
Tus nqi nruab nrab ntawm ib pob Clonidine hauv cov khw muag tshuaj Lavxias yog kwv yees li 50 rubles, uas yog qhov zoo rau yuav luag txhua tus.
Dopegit
Nov yog cov tshuaj tiam tshiab, cov txiaj ntsig tseem ceeb uas yog tsom txo cov hlab ntshasiab, ua raws li qhov nce hauv cov nyhuv hypotensive.
Cov khoom lag luam nquag txhawb nqa alpha receptors, uas ua rau:
- rau cov tshuaj endogenous hloov dopamine ntawm dopaminergic paj ntaub xaus;
- txo qis hauv kev sib haum xeeb los ntawm kev ua kom muaj zog ntawm central inhibitory presynaptic alpha receptors;
- txo qis hauv qib ntawm renin kev ua haujlwm tam sim no hauv tib neeg plasma;
- inhibiting zus tau tej cov adrenaline thiab noradrenaline, uas yog tiav los ntawm suppressing cov kev ua ntawm lub cim enzyme dopa decarboxylase.
Hauv kev tshuaj xyuas ntawm cov tshuaj alpha-blocker hauv nqe lus nug (nws feem ntau tau sau rau kev kub siab), cov kws kho mob feem ntau nco ntsoov tias qhov kev xav tau ruaj khov tshaj plaws tuaj yeem ua tiav tom qab ob peb hnub txij li pib siv, thiab thawj qhov tshwm sim. tuaj yeem pom tom qab 5-6 teev los ntawm thawj koob.
Cov tshuaj nyob rau hauv nqe lus nug yog nyob rau hauv tus nqi uas tau txais - ib pob ntawm cov ntsiav tshuaj yuav raug nqi 200 rubles.
Muaj kev phiv tshwm sim
Nws tsim nyog sau cia tias vim yog kev noj tshuaj hauv pab pawg no, tus neeg mob yuav muaj kev phiv. Cov no suav nrog:
- txo qis hauv qhov pom kev pom;
- asthenia;
- tachycardia;
- hypotension;
- pom daim tawv nqaij pob;
- cem quav (los yog, hloov, quav quav);
- xerostomia;
- kiv taub hau.
Nws tsim nyog sau cia tias cov tsos mob tau teev tseg tuaj yeem pom thaum noj alpha-blockers ua ke nrog lwm cov tshuaj tsis sib xws. Qee qhov xwm txheej, qhov kev tshwm sim no tshwm sim los ntawm kev haus dej cawv ua ke nrog kev noj tshuaj.
Nws tsim nyog sau cia tias qee cov tsos mob (xws li kiv taub hau lossis ib feem ntawm qhov tsis pom kev) tuaj yeem ua rau muaj xwm txheej, yog li koj yuav tsum tau ceev faj heev thaum lawv tshwm sim.
Txawm li cas los xij, thaum pom ib qho mob uas tsis yog ib txwm muaj, tus neeg mob noj tshuaj ntawm pawg neeg nug yuav tsum hu rau tus kws kho mob tam sim ntawd thiab qhia nws txog qhov teeb meem.
