Sodium nitroprusside: yokusetshenziswa

Kunemithi eminingi ukuthi ube nemiphumela hypotensive. Izidakamizwa ukuthi wehlise blood pressure, ngokuvamile lisetshenziswa ngendlela eyinkimbinkimbi futhi ngezinga elikhulu (izikhathi 1-2 nsuku zonke). iphathwa Ngakho nomfutho wegazi ophezulu. Kwezinye izimo, komkhuba izidakamizwa ukunciphisa umfutho wegazi azisebenzi. Khona-ke ukusebenzisa imithi enamandla efana isixazululo 'sodium nitroprusside. " Lesi sidakamizwa alisetshenziswa ehlelekile futhi ngaphandle isidingo esikhulu. Akusona imithi lokuzikhethela ukwelashwa ezingamahlalakhona senhliziyo nomfutho wegazi ophezulu kanye. Isetshenziselwa kuphela ezimweni eziphuthumayo, lapho umzimba womuntu akasabeli nezinye izidakamizwa ukuthi ukunciphisa blood pressure (isisu, ACE inhibitor). Isixazululo 'sodium nitroprusside "ayikwazi iqondiswa wedwa, ngaphandle kadokotela.

Yini umphumela izidakamizwa has emzimbeni?

Ukulungiselela "Sodium nitroprusside" (ifomula - C ₅ fen ₆ Na ₂ O) libhekisela eqenjini vasodilators neuropathy. Iqukethe ketshezi omnyama umbala obomvu ngesimo zinhlayiya noma powder. Kodwa ekuwulungiseleleni buhlanjululwe ngamanzi futhi lalisetshenziswa ewuketshezi. Ngenxa yokuthi kukhona iqembu nitroso, ukusetshenziswa kwezidakamizwa kubangela vasodilation lichaza ekwakheni ketshezi. Lokhu kwenzeka ngale ndlela: Le ngxube yamakhemikhali lapho udle iguqulwe ibe oxide nitric kanye oyenza enzyme - cyclase guanylate. kumiswa cGMP okuyinto avame ukunqwabelana e semithambo imisipha bushelelezi futhi kubangela ukuphumula yayo lapho ukugqanyiswa. Ngenxa yalokho, nomuthi "Sodium nitroprusside" inikeza imiphumela elandelayo bese arterio venodilatiruyuschy futhi hypotensive. Ngalesi umsebenzi uhlelo semithambo kubangcono ngokushesha. Ngaphezu kwalokho, ikhambi usebenza ngokuvumelana uhlobo glycosides inhliziyo, okuyi-ke kunciphisa esivimba amanzi nomoya-mpilo funa. Lo mphumela ibangelwa pre- kanye afterload ukwehla.

izinkomba nomuthi

Kufanele siqonde ukuthi izidakamizwa isetshenziswa kuphela ezimweni eziphuthumayo izifo ezingathi sína futhi ukumelana umzimba kwamanye amaqembu ukuthaka imithi. Izinkomba ukusetshenziswa zomuthi ibizwa ngokuthi:

1. Ukwehluleka oyingozi inhliziyo. Ikakhulukazi esinazo emqondweni ukuthuthukiswa edema yamaphaphu (somoya inhliziyo). I umuthi ngokushesha iyaluvimba isimo kungekho umphumela isisu.
2. ukuhluleka kwenhliziyo Ezingalapheki, ezinzima. Esigabeni yokugcina ezingamahlalakhona inhliziyo ukwehluleka (2b, 3) musa njalo uphendule ukwelashwa. Ngakho-ke, lapho ukumelana nezinye izidakamizwa futhi isimo emibi isiguli linqume vasodilators neuropathy.
3. Sibi syndrome senhliziyo. Kwezinye izimo, umuthi isetshenziswa isilethikusebenza, ukunciphisa umfutho imithambo yegazi yomuntu inhliziyo, kanye ukugwema ukuthuthukiswa ukushaqeka cardiogenic.
4. Ezingalapheki ku ukwelapha ngokwendabuko nomfutho wegazi ophezulu. Vasodilators ingasetshenziswa pheochromocytoma, usizi paroxysmal, kanye nokuthuthukiswa yezinkinga ezinzima kubangelwe ukwanda okukhulu kwezincwadi komfutho wegazi (stroke, iziyaluyalu psychogenic, isifo senhliziyo).
5. ubuthi Ergot. Lesi simila kuyinto vasospasm abukhali, okuyinto singanciphisa nge nomuthi "sodium nitroprusside." Yokusetshenziswa iphakeji ifaka kufanele kahle kuqondwe odokotela "ambulensi" futhi yokusiza umuntu ukuba aphefumule.

Izimo futhi side effects

Umuthi akufanele lisetshenziswe oluhambisana unhlangothi, kanye ngemva kwalo. It is contraindicated kubantu abaphethwe isifo sezinso futhi i-hypothyroidism. ibuye hhayi lephakanyiselwe abantu lenyuka ingcindezi intracranial. Ukusetshenziswa kwemithi asivunyelwe izingane, abesifazane abakhulelwe kanye nabantu kakhulu eminyakeni yokuguga. Enye contraindication kuyinto nokungababekezeleli ejenti asebenzayo ukuthuthukiswa komzimba.

Phakathi imiphumela emibi evela ukusetshenziswa "sodium nitroprusside" ukulungiselela ukunikeza ukwehla elibukhali komfutho wegazi (kulesi simo, kubalulekile ukuba ayeke ngokushesha abaphathi), kwenhliziyo, isiyezi, isicanucanu noma ukuba buthakathaka jikelele.

ukuphendula Chemical ne-sodium nitroprusside

Ngaphezu kokunikeza umphumela zokwelapha sodium nitroprusside into esetshenziselwa e zamakhemikhali. Uma elixutshwe ketone umzimba (acetone) futhi ibekwe endaweni ane-alikhali, ungabona shintsho olumangalisayo e umbala kwakwakhe. Ukuze kugucuka enjalo usebenzisa 4 amashubhu. Endabeni ngayinye ibekwe wesimo esisodwa kuphela - nitroprusside sodium, acetone, alikhali, acetic acid. Esimweni sokuqala ikhambi okuholela waphenduka elikhanyayo orange-bomvu luhlaza. Ngokulandelayo, lokhu kwakwakhe buhlanjululwe acetic acid. Umbala futhi washintsha, kulokhu ketshezi kuba amnyama bomvu noma nsomi.

Ukulungiselela "Sodium nitroprusside": yokusetshenziswa

Ukuze ufake umuthi, kubalulekile ukuthola ukufinyelela emthanjeni. Ngokushesha ngaphambi kokuba kuqale ukumnika izidakamizwa, kufanele buhlanjululwe in 5% isixazululo glucose. Ngenxa yale njongo, 1 umfuma izidakamizwa e isipetu futhi buhlanjululwe 5 ml ketshezi. Ingxube wafakwa injected singene isitsha ne-5% glucose ukuncibilikisa futhi. Ngemva kwalokho, thatha umthamo oyifunayo. It zokhahlamba kusuka 0.3 kuya kwezingu-8 g ngalinye 1 kg esisindo. Ukumnika wenziwa ngokusebenzisa uhlelo. Kufanele uqale nge umthamo ongaphakeme futhi kancane kancane ukwandisa ngaphansi kokulawulwa izimpawu ezibalulekile (blood pressure, kwenhliziyo, ishayela). Kuyadingeka ukusetha i eyamukelekayo ukumnika izinga elilingana 2.5-3 mg / kg elingu-1. Umthamo kuncike esikhathini izidakamizwa abaphathi. ukumnika isikhathi eside kumelwe ukuqapha ezingeni nomuthi cyanide-aqukethe e "Sodium nitroprusside". Yokusetshenziswa zomuthi kufanele ngokucacile waphawula.

Ukuxhumana nezinye izidakamizwa

Asincomi ukusetshenziswa kwezidakamizwa, nezinye ejenti antihypertensive, njengoba ukuthuthukiswa okungenzeka beshaqekile. Sicela uqaphele ukuthi ukusetshenziswa zokuvimbela inzalo temlomo kunciphisa ukuphumelela izidakamizwa. Lapho kuhlangene nomuthi izidakamizwa "Dobutamine" izibonakaliso esibalulekile isiguli kufanele baqashwe ngokucophelela (ingcindezi mhlawumbe encishisiwe, wedging izitsha wamaphaphu kanye anda ivolumu inhliziyo).