"Quinidine": yokusetshenziswa, ukwakheka, incazelo kanye nokubuyekeza

Kungani sidinga ithuluzi ezifana "quinidine" ukwenzani? Yokusetshenziswa, intengo, kanye nokubuyekeza ukuqokwa izidakamizwa ethulwa ngezansi. Uyofunda ukuthi izakhiwo kwemithi sici izidakamizwa, kungaba isenzo uhlangothi uhlamvu ukuthi unakho noma yimiphi imikhawulo ukusetshenziswa.

Ukwakheka, ukuma, incazelo

Ngayiphi ifomu weenhlahla ukwenza izidakamizwa "quinidine"? Iziyalezo yokusetshenziswa, enamathiselwe kulokhu izindlela, ukuthi angathengwa ngesimo amaphilisi flat and nxazonke. Sinenkosi nomphumela isikhathi eside futhi ifilimu-camera.

Isithako esemqoka yalolu umuthi quinidine sulfate. Imiyalelo, incazelo umkhiqizo akukuniki yimuphi ulwazi izinto ezengeziwe.

Imithi Pharmaceutical Imikhiqizo

Yiziphi amaphilisi "quinidine"? Yokusetshenziswa, incazelo, ukubuyekezwa babike ukuthi ikhambi for Class IA arrhythmia. Kuyinto lingehla ukuthuthwa ion ngemigudu Na okusheshayo iseli izindonga cardiomyocytes nokwehlisa isivinini umkhawulo depolarization futhi ukwandisa ubude isenzo ezingaba futhi refractory (ngempumelelo) ubude besikhathi.

Reception of a nomuthi attenuates excitability esivimba amanzi, kubamba automaticity kanye AV-conduction e ISIZINDA, besigaxa block legatsha, atrial nezinye izakhiwo. Futhi kubhekwe izindlela has umphumela vagolytic ububonisa umphumela m-anticholinergic, kunciphisa umsebenzi (contractility) we imisipha yenhliziyo nemithambo kubangela ukuncipha komfutho wegazi.

izakhiwo zomuthi

Kuyini ephawulekayo iwukuba umuthi ngokuthi "quinidine"? Yokusetshenziswa siphawula ukuthi kungaba nomphumela omubi inotropic. Lokhu kwenzeka ngenxa deceleration yangaphakathi amandla inqubo yokuguqula mitochondria. Ngokuphathelene izakhiwo antiarrhythmic zomuthi, zihlotshaniswa khona amaqembu amide e isakhiwo molecule ketshezi asebenzayo.

Ngokusho ochwepheshe, edonsa le nomuthi is kakhulu ziyancipha excitation futhi esiphelweni velocity, okuyinto lihlotshaniswa ukuchayeka we asebenzayo izidakamizwa ingxenye ukuze inqubo depolarization.

Abacindezela receptor m-cholinergic, bebheka bonke izidakamizwa kuvusa AV-conduction. Ngezinye ngemithamo zokwelapha liveza izindawo hypotensive elihlobene ne ngincipha ithoni emithanjeni neuropathy nokuvaleka kwemithambo, kanye nomphumela omubi inotropic.

Asinakusho ukuthi lokhu izidakamizwa okwaziyo ukubonisa umphumela kuyacasula wendawo. It Ubuye analgesic futhi antipyretic izakhiwo okuyizinto ezihlobene nomphumela ezicindezelayo ezikuyi-ubuchopho.

Izimfanelo pharmacokinetic ka

Ugxile ukuthi isithako enjalo asebenzayo zomuthi njengoba quinidine sulfate? Yokusetshenziswa yazisa ukuthi yokwamukela umenzeli temlomo ikhuthaza lokuhlushwa eyaqopha egazini emva kwemizuzu 95.

Ukusabela lokhu amaprotheni nomuthi imayelana 77-80%. biotransformation kwalo kwenzeka esibindini. Nokho, abanye nemikhiqizo engimbumbile isinyathelo cardiotonic.

Ingxenye-ukuphila leli thuluzi cishe 7 amahora. It waxoshelwa e nezinso. Ngu acidification umchamo excretion nomuthi inyuka nalapho alkalization yayo - engasenamahloni.

Kusukela lokho ezinqunyiwe?

Yiziphi izinkomba ukusetshenziswa zomuthi has "quinidine"? Iziyalezo yokusetshenziswa uthi injongo izidakamizwa ulungisiswa kuphela kulezi zimo ezilandelayo:

• ngesikhathi atrial tachycardia, AV-tachycardias, extrasystoles ventricular futhi supraventricular, ekuhlaseleni fibrillation atrial futhi flutter;
• ukuvimbela ukuhlaselwa ka tachycardia (supraventricular futhi ventricular), kanye ventricular fibrillation;
• emva cardioversion ukulondoloza itheku isigqi.

Uvala ukusetshenziswa

Yiziphi ngezimo zesiguli liyakwenqabela ukusetshenziswa imithi "quinidine"? Yokusetshenziswa (intengo nemithi ezibalwe ngezansi) imibiko Izimo zomuthi, njenge:

• ukushaqeka cardiogenic;
• AV-block (wesibili noma wesithathu degree);
• purpura thrombocytopenic, okuyinto esavela ngemva kokuthatha zomuthi;
• disorder (esibi kakhulu) conduction intraventricular;
• umqulu block legatsha;
• digitalis ukudakwa, okuyinto kuhambisana conduction kwezinso;
• ukusabela iguliswa zomuthi;
• myasthenia gravis.

Nomuthi "quinidine": yokusetshenziswa

Yamukela ithuluzi kufanele kube ngaphakathi imizuzu 60 ngaphambi noma ngemva kwemizuzu engu-125 ngemva kokudla ne ingilazi egcwele amanzi. Uma ufuna ukunciphisa umphumela ecasulayo zomuthi phezu ulwelwesi lwamafinyila yaleli pheshana wokugaya ukudla, kubalulekile ukuba esikhundleni amanzi ubisi.

izidakamizwa isikhathi eside is hhayi Kunconywa ukuba ukuhlafuna noma wayichoboza.

Umthamo ejwayelekile kubhekwa 200-300 amaphilisi mg kane ngosuku. Uma tachycardia supraventricular (nge paroxysms) leli nani luyanda 400-600 mg njalo ngemva kwamahora 3 ngaphambi impumuzo ephelele paroxysm. Ngo fibrillation atrial, nomuthi ethola 200 mg nsuku chasa 2 (5-8 izikhathi nsuku zonke). Kulokhu-ke umthamo ukulungiswa 200-300 mg kane ngosuku.

Alternative zemithi: 400 mg (uma kuhlasela befika echwebeni, mg 200) njalo ngemva kwemizuzu engu-60 kwaze kwaba ekunqanyulweni ephelele kuhlasela, noma ukuze kuzuzwe umthamo ingqikithi 1 g

In the engekho amathuba okuba nemiphumela engemihle emva komthamo wokuqala e yokwamukela alandelayo inani nomuthi ukuba senyukela mg 600. Ukuthatha izidakamizwa okweqa 4 amagremu ngosuku akuvunyelwe.

Sokuphuzisa izingane

Ngo umthamo imithi enqunyiwe izingane "quinidine Dyuruls"? Yokusetshenziswa, nodokotela bezingane izilinganiso asho ukuthi izilinganiso esezingeni le-ejenti izinsana kuyinto 6 mg / kg izikhathi 5 ngosuku. Prescribers kufanele kube kuphela udokotela abanolwazi, ngokuqinile ngomlomo.

Izenzo-uhlamvu

Yini imiphumela engemihle kungenzeka emva ukusetshenziswa kwezidakamizwa "quinidine Durules"? Yokusetshenziswa, incazelo yaleli izidakamizwa kusikisela ukusabela elandelayo enqabayo:

• asthenia, ekwandiseni isikhawu QRS, myasthenia gravis;
• ethunjini ventricular amabhithi, ukulahlekelwa kukuzwa;
• ukungakuthandi ukudla, fibrillation ventricular, thrombosis lwemithambo, ephansi umfutho wegazi;
• ukuphazamiseka visual, ventricular tachycardia, paroxysmal, tinnitus,
• asystole;
• isicanucanu, itheku bradycardia, isifo sokusha kwesibindi, ubuhlungu besisu, ukudideka;
• gastralgia, ikhanda, ukuhlanza, thrombocytopenia, uhudo, isiyezi, anaemia hemolytic;
• imfiva, lupus-like syndrome, ukuqubuka kwesikhumba.

amacala ukweqisa izidakamizwa

Yiziphi izimpawu ukweqisa izidakamizwa kungabangela imithi "quinidine Dyuruls"? Imiyalelo, amazwana kusukela ochwepheshe ukhulume ukubonakaliswa ezifana tinnitus, ukucindezeleka emsebenzini inhliziyo, iconsi wegazi, isiyezi, flutter atrial, diplopia, quinidine ukushaqeka, ukulahlekelwa kukuzwa.

Ukuqeda uthi okunjalo okwamthinta ebekiwe lavage esiswini, umoya-mpilo umncane, ama-ejenti abanomfutho wegazi ophakeme, sivinini, hemodialysis futhi osephila ngomshini.

izidakamizwa ekuhlanganyeleni

Indlela aphathe izidakamizwa baxhumana izidakamizwa njengoba quinine? Yokusetshenziswa (ukubuyekezwa intengo nomuthi izokwethulwa ekupheleni isihloko) libike ukuthi le nhlanganisela kwandisa ubuthi kokubili.

Futhi, "quinidine" amaphilisi uxhumana imithi ezilandelayo:

• izidakamizwa Antiarrhythmic ukuthuthukisa isinyathelo cardiodepressive.
• Anticholinesterase izidakamizwa nemithi ukuthuthukisa imiphumela kalisodergaszczye "Quinidine".
• izidakamizwa Anticonvulsant ukunciphisa amazinga igazi "Quinidine" futhi ukunciphisa ukusebenza yayo ngenxa ukukhuthazwa umzimba walo.
• Laxatives ukunciphisa ukusebenza kanye lokuhlushwa izidakamizwa egazini kokubuyekezwa.
• Imithi alkalising emchamweni, wandise nengozi yokuba ukusabela anobuthi.
• Izidakamizwa "amiloride" futhi "Amiodarone" ukunciphisa ukusebenza kwe "Quinidine" futhi ube mude qt yayo isikhawu, ngokulandelana.
• Acetylsalicylic acid ubabonisa ukopha, petechiae futhi ikhuthaza opha ngokweqile, izitho zokugaya.
• Ukuthaka imithi "Warfarin" futhi "Verapamil" - sithuthukiswe anticoagulant umphumela izinga lokuqala nelesibili ukuncipha excretion.
• Izidakamizwa "Haloperidol" - kwandisa okuqukethwe kwayo egazini futhi kwandisa ingozi ukusabela ezingezinhle.
• Izidakamizwa "Hydroxyzine" futhi "dextromethorphan" - kwandisa amathuba arrhythmia ezinzima yokwamukela owokuqala yesibili egazini.

ulwazi oluthile

Nge ukuqapha okukhethekile lochazwe imithi Kunconywa inhliziyo ezingamahlalakhona ukwehluleka esiteji 2-3, tachyarrhythmia (ventricular) nge esingaba ukunwebeka qt, itheku node, AV-ukuvinjelwa 1st degree, isifuba somoya, i-hyperthyroidism, hypotension, acute izifo ezithathelwanayo, emphysema , engela-Ukuvalwa ukufiphala hypokalemia, yokwehluleka kwesibindi, thrombocytopenia, wendlala Hyperplasia, ezingamahlalakhona kwezinso ukwehluleka, lactation, ukukhulelwa kanye psoriasis.

Abantu ne myocarditis nezinye izifo esivimba amanzi lapho ithola "Quinidine" ukulawula yezokwelapha avamile liyadingeka. Ngaphambi ukwelashwa, isiguli kumele wenze yokulungiswa izimpawu hypokalemia futhi ukwehluleka zenhliziyo.

Therapy liyadingeka sihlale njalo siqaphele idatha ECG igazi neuropathy hemodynamics.

Okufanayo izindlela, intengo

analogue zemithi ziye kubhekwe okuningi. Ochwepheshe bathi kubo izindlela ezilandelayo: "Kinidin Durules", "Bretilat", "procainamide", "Etatsizin" "Lidocaine", "Amiokordin", "Propanorm", "Amiodarone" "Verapamil", "Propranolol", "Ritmonorm ".

Njengoba for amanani entengo yemithi ezifana "quinidine" futhi "quinidine Durules", abakhileyo ezweni bethu, bayizithunywa engaziwa ngenxa yokuthi le mithi kuthiwa kalisathengiswa eRussia. Noma kunjalo, angathengwa e-Ukraine. Izindleko izidakamizwa ezweni imayelana 540 futhi 670-679 hryvnia, ngokulandelana, okuyinto ilingana ruble 1380 futhi 1760-1780.

Izibuyekezo

Yini abantu bethi mayelana kubhekwe nomuthi kodokotela nabanye ochwepheshe? Ngokusho kwabo, leli thuluzi uzibonakalisa izidakamizwa ngempumelelo kakhulu antiarrhythmic, okuhle, nokuthandekayo, fast ngokwanele ukwelapha izifo ezifana ventricular futhi tachycardia supraventricular. Nokho, kufanele kuphawulwe ukuthi usesho "quinidine" iphilisi Pharmacy Russian akunakwenzeka. Lokhu kungenxa yokuthi lokhu imithi ngaphandle ngesikhathi kutungeletela futhi ayisasetshenziswa ezibhedlela. Odokotela ukuchaza lesi simo yokuthi kukhona ziphephile futhi ziphumelela kangcono kanye nozakwabo ezingabizi emakethe weenhlahla, okuyinto ngenkuthalo lisetshenziswe izimpawu ezifanayo. Kulokhu, izazi zithi quinidine sulfate siyaqhubeka ingasetshenziswa njengendlela ephambili izidakamizwa multicomponent e izidakamizwa eziningi anti-arrhythmic.