Senhliziyo: ukubuyekeza imithi, futhi ukusebenza kwezimpendulo

ejenti Cardiotonic yizidakamizwa ukwandisa umsebenzi umsebenzi we imisipha yenhliziyo, contractile ikhono layo futhi esetshenziswa ekwelashweni ephethwe yisifo senhliziyo. Iqembu kuhlanganisa esibalulekile zezidakamizwa izinto ezahlukene asebenzayo ukwakheka kanye indlela ezahlukene isinyathelo. Cardiotonic esetshenziselwa ukwelapha amafomu oyingozi futhi ezingalapheki ephethwe yisifo senhliziyo.

Senhliziyo: ngezigaba

Umthelela ingqikithi zonke izidakamizwa eqenjini, esekelwe ikhono ukwandisa amandla ukusikwa esivimba amanzi, ngaleyo ndlela kwande inhliziyo okukhipha negazi unhlangothi ivolumu. ejenti Cardiotonic ukunciphisa ivolumu diastolic, yamaphaphu futhi letindzala ingcindezi emithambo yegazi, futhi ingcindezi phakathi ukugcwaliswa we ventricles.

1. glycosides senhliziyo - "Strofantin", "Korglikon", "Digoxin".
2. izidakamizwa Adrenergic - "Izadrin", "Dobutamine", "Dopamine".
3. izidakamizwa Adrenergic zokwenziwa - "Amrinon", "Milrinone".

Ukukhethwa wasebenzisa izidakamizwa elihlobene ne kobukhulu isimo lesiguli kanye nefomu inkambo isifo.

glycosides inhliziyo

Group imelelwa esebenzisa izinhlobo zemifino noma zokwenziwa imvelaphi. Ukwakhiwa ngokusekelwe izinto ethathwe isitshalo digitalis, goritsveta, entwasahlobo umnduze Oeander, strophanthus et al.

Isikhathi isinyathelo zokwelapha, ekuqongeleleni umphumela emzimbeni, futhi neurotoxicity izidakamizwa bathembele ngokuphelele ezintweni ikhono lazo yakha izakhiwo kanye amaprotheni oketshezi olungenambala olusegazini. Kunamandla uxhumano, ezifana enkulu nekusebenta glycoside. Senhliziyo leli qembu babe isenzo esekelwe izindlela ezilandelayo:

• kunciphisa systole kwenzeka kanyekanye inzuzo yayo;
• isikhathi lonke imisipha yenhliziyo is yinde;
• kwehle kwenhliziyo;
• imisipha esivimba amanzi sithuthukiswe ikhono excitation;
• Uma ukweqisa izidakamizwa ethuthuka fibrillation ventricular.

"Digoxin"

Umuthi is umqondo kusuka amaqabunga digitalis. It libhekisela glycosides eside esebenza, ukungayeki eyaba nemiphumela emibi. Isetshenziselwa ukwelashwa eyinkimbinkimbi ezingamahlalakhona inhliziyo ukwehluleka kanye arrhythmia tachysystolic.

Iyatholakala njengoba amaphilisi kanye isixazululo nemijovo. Umthamo kumele kukhethwe ngokucophelela isiguli ngayinye. Endabeni nezinye glycosides senhliziyo bengakafiki "Digoxin" Isikali liyancipha.

"Strofantin"

glycoside senhliziyo mfushane-oyibamba, wasebenzisa uma amafomu okukhulu isifo. "Strofantinom" akuyona eyinqaba buthelela emzimbeni. Ukulungiswa sithuthukisa umsebenzi contractile we myocardium futhi ukwandisa okukhipha inhliziyo. Ngo parallel, kukhona ukuncipha ubukhulu imisipha yenhliziyo nemithambo wehlise umoya-mpilo yayo funa.

Iphathwe ngemithambo yegazi, intramuscularly, kwezinye izimo - ngaphakathi. Ukuphuza esiningi kungaholela ukweqisa izidakamizwa. Ukusetshenziswa kwezinye izidakamizwa ukushintsha ukuphumelela glycoside:

• barbiturates umphumela kuyehla;
• nge "reserpine", sympathomimetics kanye nemithi yokunciphisa ukucindezeleka kungabangela ukuthuthukiswa arrhythmias inhliziyo;
• nedili lomshado nabo tetracyclines, "chloramphenicol", "Amiodarone" futhi "captopril" kuqinisa isinyathelo inhliziyo;
• magnesium sulfate ikhuthaza inhliziyo atrioventricular block.

izidakamizwa adrenergic

Neglikozidnye ejenti cardiotonic kokuba isenzo yesikhashana. Iqembu elisetshenziswa ngokuhamba acute yinhliziyo ukusekela imisebenzi ebalulekile emzimbeni.

"Izadrin" kuyinto ivuselela izitsha adrenergic, bronchi kanye inhliziyo. Umuthi kunomphumela hypotensive, kwandisa ikhono contractile of imisipha yenhliziyo. Asetshenziswa contractility inhliziyo nge ukwehla elibukhali imisebenzi yokusebenza, kanye ukushaqeka cardiogenic. Uphenyo odokotela baxwayisa ngokuthi isicelo engalungile noma imithamo ngokweqile kungabangela fibrillation ventricular zenhliziyo.

"Dobutamine" - cardiotonic neglikozidnye isakhiwo, kumqhubezela ku imisipha yenhliziyo nemithambo yenhliziyo igazi normalizing. Ingozi arrhythmias uma usebenzisa leli thuluzi ngempela ongaphakeme, ngoba "Dobutamine" has cishe akunamthelela automaticity inhliziyo.

Inikezwe ukuthuthukisa contractility we myocardium ngesikhathi okusheshayo kuyadingeka. Kwezinye izimo, kungase kubangele ukuthuthukiswa amathuba okuba nemiphumela engemihle:

• isicanucanu;
• ikhanda;
• nomfutho wegazi ophezulu;
• tachycardia;
• ubuhlungu ngemuva breastbone.

"Dopamine" kuyinto catecholamine inkanuko receptor adrenergic. Umuthi kuphakamisa blood pressure, kwandisa yenhliziyo ukugeleza kwegazi. It kuboniswa ngenxa ukwehluleka oyingozi esivimba amanzi, ukushaqeka. Ukuqapha kumele lisetshenziswe isilethikusebenza, ukukhulelwa, abanale nkinga, arrhythmias.

Adrenergic zokwenziwa cardiotonic

Isetshenziselwa uma acute esingamahlalakhona senhliziyo, izindawo inhliziyo. Izidakamizwa isinyathelo contractility we imisipha yenhliziyo, okwandisa ke. Kungase kubangele ukuthuthukiswa arrhythmias uphinde wehlise blood pressure, iziyaluyalu izinso.

izidakamizwa senhliziyo kuleli qembu ayikwazi ukusetshenziswa zinokukhubazeka inhliziyo, kanye zenhliziyo, inhliziyo isigqi thuthuva, isifo sokuvuvukala kwemithambo yomthambo i-aorta, ukungasebenzi kwezinso, wahlaselwa isifo senhliziyo futhi ngesikhathi abantwana.

Kusho "Amrinon" isetshenziswa kuphela ku-ICU, isiguli wagcinwa ngaphansi kokulawula amadivayisi ezikhethekile, okuwuphawu esimweni saso. Ngaphezu okwandisa kwenhliziyo ukulungiselela yandisa imithambo yegazi, kwandisa igazi ejection ngesikhathi systole kunciphisa ingcindezi yamaphaphu.

It ikhiqizwa njengoba isixazululo. Ukuze emthanjeni kakhulu buhlanjululwe in bokuphila isixazululo sodium chloride. Akufanele exutshwe nezinye izidakamizwa. Ngokwethulwa kungenzeka ukwehla elibukhali ingcindezi, kwenhliziyo, arrhythmia, ikhanda, izinkinga zesisu.

"Milrinone" iyasebenza ezingaphezu kuka ummeleli wokuqala eqenjini, futhi ngokuvumelana Izibuyekezo kangcono ikubekezelele iziguli. Contraindicated ukusetshenziswa imithi ngesikhathi sokukhulelwa kanye nokuthuthukiswa isilethikusebenza. Kuhlanganisa unamasu iqembu A. isidingo izimali kunqunywa kuphela ngudokotela wakho.

isiphetho

Senhliziyo kwafakazela ukusebenza kwe kwezizukulwane ezimbalwa edlule. Izibuyekezo abonisa ukuthi leli qembu izidakamizwa kokusisiza ukuba sibhekane nesimo nge yokumelwa yinhliziyo. Noma kunjalo, ukwamukela lezi imithi ngesimo self-ukwelashwa esokuba contraindicated ngenxa yezinkinga kungenzeka, side effects noma ukweqisa izidakamizwa. Kukhethwa izidakamizwa, kanye wenhliziyo umthamo eyamukelayo inquma ngamunye icala emitholampilo ngabanye.