Sodium nitroprusside: tilmaamaha loo isticmaalo

Waxaa jira daawooyin badan oo ay leeyihiin saameynta hypotensive. Daawooyinka yaraado cadaadiska dhiigga, waxaa inta badan loo isticmaalaa in oo adag iyo si ballaadhan (1-2 jeer maalin kasta). Sayidka loola dhaqmo hypertension. Xaaladaha qaarkood, arimahan daawooyin si loo yareeyo cadaadiska dhiigga ma khuseeyaan. Markaas codsan daawooyinka xoog sida xal 'ee nitroprusside sodium. " daroogada Tani looma isticmaalo si nidaamsan oo aan u baahan halis ah. Ma aha daawo ah oo la doortay si loogu daweeyo of hypertension iyo wadnaha chronic. Waxa loo isticmaalaa oo kaliya xaaladaha degdegga ah, markii jirka qofka aanu ka jawaabin daawooyinka kale ee loo yareeyo cadaadiska dhiigga (diuretics, celiyeyaasha ACE). xal A 'ee nitroprusside sodium "aan la keli duri karo, oo aan qoro.

Waa maxay saamaynta daroogada ayaa jidhka?

Diyaarinta "nitroprusside Sodium" (formula - C ₅ biyagaleenka ₆ Na ₂ O) waxaa loola jeedaa koox ka mid ah vasodilators durugsan. Waxaa ku jira walax midabka madow cas ee foomka of kiristaalo ama budo. Laakiin diyaarintiisa qasi jiray biyo iyo sida loo isticmaalo qaab a dareere ah. Sababo la xaqiiqada ah in ay jirto koox nitroso ah, isticmaalka daroogada sababa vasodilation in kooban oo ah walaxda. Tani waxay dhacdaa sida soo socota: xarunta kiimikada Tani markii daama waxaa beddelay xabagta nitric iyo shidaa eulayska - cyclase guanylate. Sidee wanaajiyey formation of cGMP oo waxay noqonaysaa inay ku ururto muruqyada siman vascular iyo sababa ay nasashada. Iyadoo la raacayo, medicament "nitroprusside Sodium" waxay siisaa venodilatiruyuschy arterio iyo hypotensive saamaynta socda iyo. Iyada oo shaqo this nidaamka vascular waxaa ka fiican si deg deg ah ku dhaco. Intaa waxaa dheer, xalka shaqeeya sida ay tahay nooca glycosides wadnaha, i.e. waxay yaraynaysaa baahida oxygen myocardial. saamayn Taana waxaa lagu gaarayaa by hoos u dhac hor iyo afterload.

Tilmaamayaasha medicament

Waa in la qadariyo in daroogada waxaa loo isticmaalaa oo kaliya xaaladaha degdegga ah cudurada halista ah iyo iska caabin ah ee u shaqeeyo in ay jiraan kooxo kale oo medicaments. Tilmaamayaasha ay u isticmaalaan daroogada waxaa loo yaqaan:

1. wadnaha Ba'an. Gaar ahaan waxaan leenahay maanka horumarinta barar sambabada (asthma wadnaha). Daawada si degdeg ah waa ka hortagtaa gobolka this leh saameyn ah kuma laha ee diuretics.
2. wadnaha Chronic, oo daran. Marxaladda ugu danbeysay ee wadnaha chronic (2b, 3) ma mar walba ka jawaabaan daaweynta. Sidaa darteed, markii iska caabin ah si ay daroogo kale iyo xaalad ba'an ee bukaanka qori vasodilators durugsan.
3. Xiisad syndrome wadnaha. Xaaladaha qaarkood, daroogada waxaa loo isticmaalaa in Wadnaxanuun myocardial, si loo yareeyo cadaadiska ku jira marinnada dhiigga ee wadnaha ah, iyo sidoo kale in ay ka fogaadaan horumarinta lama filaan ah cardiogenic.
4. Weydey in daaweyn dhaqanka ee hypertension. Vasodilators waxaa loo isticmaali karaa in pheochromocytoma, dhibaatooyinka paroxysmal, iyo sidoo kale horumarinta dhibaato ba'an oo ay sababeen kor u kac wayn ee cadaadiska dhiigga (stroke, cudurada psychogenic, wadne).
5. sumowga Ergot. Warshad Tani waa vasospasm af badan, taas oo ku buriyaan laga yaabaa via medicament "sodium nitroprusside." Tilmaamaha loogu isticmaalo qobays xirmo waa in si wanaagsan loo fahmo by dhakhaatiirta "ambulance" iyo kicinta.

Sababo iyo waxyeelo

Daawada waa in aan la isticmaali ee stroke dhiigbaxa, iyo sidoo kale waxa ay ka dib. Waxaa waa u waayo qof oo qaba cudurka kelyaha chronic iyo hypothyroidism. waxaa sidoo kale aan lagu talinayaa in dadka cadaadiska intracranial kordhay. Isticmaalka daawada waa xaaraan ee carruurta, haweenka uurka leh iyo dadka ku jira da 'weyn. contraindication kale waa wakiilka xejin firfircoon horumarinta dareen diidmo oo xasaasiyadeed.

Waxaa ka mid ah dhibaatooyinka soo raaca ka isticmaalka "sodium nitroprusside" diyaarinta waa in la siiyo hoos u dhac af ee cadaadiska dhiigga (kiiskan, waxaa lagama maarmaan ah in la joojiyo si degdeg ah maamulka), heerka wadnaha oo kordha, dawakhaad, lalabo iyo tabar guud.

reaction Chemical la nitroprusside sodium

Waxa intaa dheer in la siinayo saamaynta ku daweynta walax sodium nitroprusside loo isticmaalo falgalka kiimikada. Haddii la qaso jirka ketonka (acetone) iyo meeleeyay deegaan xumadoodu, waxaad ka arki kartaa isbedel la yaab leh in midabka ah ee xarunta. Waayo, transformations sida la isticmaalayo 4 tuubooyinka. In kasta oo kaalinta kaliya hal walax - nitroprusside sodium, acetone, alkali, acetic acid. Xaaladda hore xalka keentay jeestay cado orange-cas oo dhalaalaya. Next, xarunta waxaa loo qasi jiray acetic acid. Color mar beddelay, markan dareere uu noqdo gudcur guduudan ama buluug ah.

Diyaarinta "nitroprusside Sodium": tilmaamaha loo isticmaalo

Si aad u galaan daroogada ah, waxaa lagama maarmaan ah in la helo helaan xididka. Isla markiiba ka hor bilowga galiyey daroogada, waa in lagu qasi in 5% xal glucose. Waayo, kanu Ujeedada, 1 waxay fijaankeedii ku daroogada ee silingaha iyo qasi jiray 5 ml oo dareere ah. Isku dar ah taasoo keentay waxaa lagu mudaa weelka la 5% glucose si mar kale ay u milmaan. Ka dib markii in, qaado qiyaasta loo baahan yahay. Waxaa u dhaxeysa 0.3 ilaa 8 g halkii 1 kg ee miisaanka jidhka. faleebo waxaa loo dhigay iyada oo loo marayo nidaamka. Waa in lagu bilaabo qiyaas yar oo si tartiib tartiib ah ha u kordhiyaan gacanta astaamaha aasaasiga ah (cadaadiska dhiigga, garaaca wadnaha, wadnaha). Waxa kale oo lagama maarmaan ah si ay u dejiyaan heerka faleebo la aqbali karo si siman u 2.5-3 mg / kg ee 1 daqiiqo. qiyaasta waxay ku xiran tahay waqtiga maamulka daroogada. faleebo dheer waa in lala socdo heerka medicament cyanide-ka kooban ee "nitroprusside Sodium". Tilmaamaha loogu isticmaalo daroogada waa in si cad arkay.

Dhexgalka daroogooyinka kale

Annagu ma ku talinaynaa isticmaalka daroogada, iyo kuwa kale ee wakiilada antihypertensive, sida horumarinta ee suurtagalka ah ee gobolka a of shock. Fadlan la soco in isticmaalka piller yaraynaysaa waxtarka daawada. Marka lagu daro a daroogada medicament "Dobutamine" calaamadaha muhiimka ah ee bukaanka ah waa in si taxadir leh loo socdo (cadaadis suurto gal dhimay, aaladdda weelal sambabada iyo sidoo kale kor u kacay mugga wadnaha).