The eegtahay "cordarone" ugu fiican Ruush

Daaweynta xanuunada garaaca wadnaha - dhibaato caafimaad oo adag in aan lagu xalin ilaa iyo dhamaadka, xataa maanta. Waxaa jira dad badan daawooyinka anti-arrhythmic, laakiin waxay leeyihiin sababo badan oo waxyeelo, sababta oo ah waxa laga yaabaa in la caddeeyo in ka badan ayaa halis u ah cudurka bukaanka noqon. Waxaa jira kooxo dhan oo lacag loogu tala galay gargaar ee garaaca, ee naf-gooyada ah, laakiin ay u isticmaalaan wakhti dheer laguma talinayo, sababtoo ah korodhka ka dhasha dhibaatooyin qaata daawada. Iyadoo la raacayo, bukaanka u baahan daroogada la isku halayn karo, ku ool ah, laakiin ilaa xad ammaan ah, ama analog ah oo dhanba.

"Kordaron" - daroogo antiarrhythmic wax ku ool ah

Sida laga soo xigtay waxbarashada kala duwan, "Kordaron" waa daawada ugu fiican ee wax soo saarka kale ee la mid ah, waxa uu leeyahay awood la xaqiijiyay in la yareeyo dhimashada ee bukaanka qaba cudurka wadnaha. Waxaa si guul leh loo isticmaalo daaweynta ku dhowaad dhammaan garaaca wadnaha. Ka mid ah dhakhtarrada, ayuu waxaa loo arkaa cabbirka daroogo anti-arrhythmic fasalka III. Waxa intaa dheer in lagu antiarrhythmic, saamayn antianginal waxa ay leedahay, tan iyo markii ugu horeysay ee la aasaasay sida daroogada ah si loogu daweeyo cudurka wadnaha.

Waxay leedahay ma aha oo kaliya caan ku hawlgeli fasalka III antiarrhythmics, Go'doominta i.e. ee channels potassium, laakiin tallaabo, sifo fasalka waxyaabaha aan, - xanibaadda ee channels sodium, fasalka IV - Go'doominta ee channels calcium. Waxyaabaha kale, daroogada siinayaa alpha- iyo beta-adrenoceptor ku furid, saamayn dilator wadnaha.

Tilmaamayaasha

Walaxda firfircoon ee daroogada - amiodarone. Magaca Ganacsiga - "Cordarone." Analogs soo saaray magacyada kale, laakiin ka kooban walax la mid firfircoon. Amiodarone la soo saaray qaab xal la isku duro xididka, iyo kiniiniyada.

Xalka waxaa laga codsadaa in ay dhacdo marka waxaa lagama maarmaan ah in ay joojiyaan weerarrada of ventricular iyo tachycardia supraventricular, wadne, oo ay ku jiraan qalal. Kiniiniga waxaa loo isticmaalaa ka hortagga ventricular iyo garaaca xogleh iyo tachycardia paroxysmal.

Mabda 'hawlgalka

By xakamaynayaan geedi socodka gaadiidka intracellular of udhigo potassium, daroogada dheeraada wajiga saddexaad ee ku iman kara talaabada unugyada muruqa wadnaha. Waxa kale oo lagu cabudhibayo gudbinta garaaca wadnaha korontada ee fiiloyin ah Guntin ah atrioventricular. Taas darteed, wadnaha caanuhu. Sidaas darteed, saamaynta ku furid qayb ka mid ah habdhiska u dabacsanaadaan gaabisaa garaaca wadnaha.

Amiodarone waxaa metabolized beerka iyo raaca inta badan kaadida. content ugu badan oo ah walaxda firfircoon arkay 3-7 saacadood ka dib qofku cuno kiniinka ka dib. Gaaray saameyn ku daweyn u muuqataa ma hore ka badan hal toddobaad ka dib markii bilowga daweynta.

Analogs "cordarone"

Marar badan, bukaanka sababo kala duwan door bidaan in ay daroogada asalka iyo dhigma ay, xabbo. Tan iyo "Kordaron" - kaliya magaca ganacsiga ee amiodarone ah, dhibaato ka soo garaaca inta badan la yaabanahay haddii ay jiraan daawooyin analogues "Cordarone."

Marka la eegayo amiodarone, su'aasha ah ee analogues ay si gaar ah khuseeya, sababtoo ah waa mid ka mid ah daroogada ee ugu caansan dunida ee wadnaha, waxay leedahay codsiga ballaaran. daawooyinkan, sida kor ku xusan, waxay leeyihiin dhibaatooyin soo raaca oo dheeraad ah, oo inta badan sii xumaanaya caafimaadka. Sidaa darteed, ee dhakhtarka iyo bukaanka uu xiiseynayo waa in ay doortaan daroogo la hufnaan ugu badnaan iyo khatarta ugu yar ee nolosha iyo addinka. Haddii aad raadinayso daroogada dhigooda u dhiganta "Kordaron", ee dib u eegista dhakhtarro kiiskan waa in aad haysataa for muhiim ah, in kastoo, dabcan, bukaanka dhab ah sidoo kale waa muhiim, maadaama ay kuu sheegi kara sida ay dareemeen inta lagu guda jiro soo dhaweynta iyo xawaaraha bilawga ah ee horumar. Daaweynta this sida "kordaron" ama wax ka mid ah analogs waa in uu la socdaa kormeer caafimaad iyo la socodka xaaladda caafimaad, oo ay ku jiraan iyadoo loo adeegsanayo ECG ah.

Waxay door muhiim ah oo ka kooban of daroogada. Tusaale ahaan, iodine, qayb ka mid ah amiodarone waa u tiro ka mid ah cudurada. Sidoo kale, waxa ay u xumeeyaan karaa natiijooyinka daraasaadka qaar ka mid ah. Ma aha la yaab leh in badan ku xanuunsado ka arrhythmia raadinaya analoogga "cordarone" aan iodine sida 'dronedarone. " Dabcan, bedelo wax daawo ah oo kaliya ka dib markii uu la tashado dhakhtarkaaga. Sidaas daraaddeed, khubaro badan oo Ruush ha ku talinaynaa in la doorto "Dronedarone" baahneyn, sida ay a analog daciif ah "cordarone". In Europe, si kastaba ha ahaatee, durbadiiba waxaa arrin aad u baahsan.

Marka xulashada daroogo ama analog loo baahan yahay inay is barbar dhigaan ay Halabuurka. Sida caadiga ah, oo u dhigma generic aan marka loo eego midba midka kale - oo keliya asalka ah. Tusaale ahaan, haddii aad u baahan tahay analog ah "cordarone" in ampoules, in qayb ka mid ah xal isku mid ah la isku duro waa in uu ahaadaa khamri benzyl joogo, sida in asalka ah "Cordarone."

Sida dhakhaatiirta ka fiirsan, ma liita sifooyinka daroogada analogues "Kordaron" ee Russia soo bandhigay tiro caddaalad ah oo waaweyn ee wax soo saarka, kuwaas oo ka mid ah: "Ritmiodaron", "Sedakoron", "Amiokordin", "Kardiodaron", "Ritmorest", "Opakorden" "Amiodarone" ka saarayaasha kala duwan ( "Amiodarone akar", "Vero Amiodarone" iyo qaar kale oo badan). Dhammaantood waxay leeyihiin qayb ka mid ah oo firfircoon, laakiin waxaa laga yaabaa excipients kala duwan. Qaar badan oo iyaga ka mid yihiin wax badan ka jaban ka badan asalka ah. Xaaladaha intooda badan, factor taasi ku xiran tahay soo saaraha. Tusaale ahaan, "Amiodarone", oo la odhan jiray la mid ah sida walax aasaasiga ah ee ku jira diyaarinta "Kordaron". analoogga Ruush, oo qiimihiisa waa ku dhawaad saddex jeer hoose, inkastoo qaabka uu u sii daayo, iyo tilmaamo ku ujeeddo oo isku mid.

"Amiodoron" - ka analogues ugu fiican ee Russia. Waxaa gebi ahaanba indistinguishable ka "cordarone" iyo mabda'a ah ficil, iyo habka codsiga uu leeyahay qaab ciyaareed la mid ah sare ee xireen dhacdooyin aamba iyo ka hortagga ah ee ay dhacdo. Kurtumm ku saabsan qaybta ugu wanaagsan. Qaar badan oo iyaga ka mid ah ay sheegayaan in "Amiodoron" wax soo saarka Ruush inay si degdeg ah oo aan pobochki culus ka caawisaa.

Qadarka Qaadashada daroogada ee ampoules

Sida kor ku xusan, xalka la isku duro lagu muujiyay gargaarka deg deg ah ee dhibaatada. codsan kiniin "Kordaron" mararka kale. Analogs shaqeeyaan si la mid ah. xal The muday marinayo tuubo ah 20-120 daqiiqo ama bolusdose ugu yaraan 3 daqiiqo at dose of 5 mg halkii miisaanka jidhka 1 kg.

Keeneysa in kiniin "cordarone"

Daawada waxaa la qaataa kiniin laba marxaladood.

Wejiga kowaad, ama load wajigii: 600-800 mg hal mar maalin kasto, sii kordhaya in 10 g.

Tallaabada labaad, ama wajiga dayactirka: 100-400 daroogada mg (muddada ay go'aamiyeen dhakhtarka). Qiyaasta ugu badan ee 1200 mg maalintii.

badinta daroogada waa khatar ah oo ku filan. Si looga hortago, bukaanka waxaa lagu talinayaa in la ogaado sida saxda ah sida in ay qaataan daawo "Kordaron" diiwaanka. Analogs, oo ay ku jiraan dhigiisa caanka ah ee Russia "Amiadaron", wax badan oo ka siiyaan calaamado la mid ah qiyaasta xad dhaafka ah.

Waxaa jira bradycardia xoog leh, oo xataa ilaa xiray a wadnaha. Haddii la sababa qaab kiniin ah, waxaa lagama maarmaan ah in ay ku dhaq soo baxay caloosha iyo qaadan chelators. Sidoo kale qabtay daaweyn kale ee leh astaamo, dheelitirka elektrolytka waxaa laga beddelo. Haddii loo baahdo, dhigay pacemaker ah.

About macluumaad badinta xididka waa dhamaystirnayn. Ku tilmaamay Xaalado dhif ah bradycardia sanka, tachycardia, wadnaha. Daaweynta la mid tahay in lagu tilmaamay for xad dhaafka sababa kaniiniga. amiodarone kelyaha iyo metabolites ay lama baabbi'in.

waxyeellooyin

Sida wax kasta oo wax ku ool ah tallaabo xoog badan, "Kordaron" "Amiodarone" iyo taxanaha kale ee analogs cadhaysiinina dhacdooyinkan gurracan. Waxay keeni kor bradycardia in la soo xiro wadnaha, cadaadiska dhiigga, waxay leeyihiin saamayn taban ku leh beerka, sidaas leeyihiin liis halkii cajiib ah sababo.

From madax xanuun aad u daran ka yar, laakiin si kastaba ha ahaatee xun dhibaatooyin soo raaca in la ogaadaa karo iyo wareer, pleurisy, qufac, bukaanka waxaa laga yaabaa in ay ka cawdaan daciifnimo, lumista aragga gaara. waxay keeni karaan xasaasiyad. Dhibaatadu waxay la mid ah waxaa laga heli karaa adigoo qaata analog kasta. "Kordaron" iyo kiniiniyada kale daawooyinka amiodarone sabab this, waxaa lagu gadaa farmashiyaasha kaliya by qoro. Xalka la isku duro waxaa loo isticmaalaa oo kaliya in jawi isbitaalka.

Si kastaba ha ahaatee, daryeelka qaaday in xulashada saamaynta dose kooxda ugu badan yihiin wax yar ka muujiyey ama laga yaabaa in aanay muuqan at dhan. Sida ku xusan u eegis lagu sameeyo "kordaron" iyo bukaanka "Amiodarone" qaadato daawooyinkan, pobochka inta badan daciif ah, si fudud ciribtiray by sixitaanka ee dose daroogada.

sababo

Tan iyo amiodarone - daroogada quruxsan awood badan, ma aha la yaab leh in waxa kaliya ee aan ku caawin kara si loo horumariyo gobolka in tiro ka mid ah dhibaatooyinka wadnaha, laakiin waqti isku mid ah saamayn ba'an ku xubnaha kale ama xaaladu kasii darin cudurro saameen qaarkood. Si looga fogaado khatarta, laguma talinayo therapy la daroogada this xaaladaha qaarkood.

Waxaa jira kala duwan oo ka mid ah xaaladaha taas oo waa ka mamnuuc inay aqbalayaan "Kordaron", "Amiodarone" iyo dhigooda kale ee kaniiniga. Ta hore waxa weeye qaar ka mid ah xaalad wadnaha aan caadi ahayn - bradycardia sanka, degree halis ah block atrioventricular, hypotension, dheereyn bareeg QT ku ECG. Ma loo isticmaali karaa haddii bukaanka loo dhigi in content jirka ah ee potassium iyo magnesium ah.

Sababo ka mid ah cudurka thyroid, iyo sidoo kale uurka iyo nuujinta - sababta iodine, taas oo ka kooban daroogada "Cordarone." Analog, ma waxay ka kooban, waa laga qaadi karaa oo kaliya on talo dhakhtar.

Bukaan-socodka ee dadka waayeelka ah waxaa lagula talinayaa in digniin loo qaadan "Kordaron" iyo "Amiodarone" iyo analogs kale. Bukaan-socodka da'doodu ka yar tahay 18 sano, daawooyinka, kuwaas oo aan la magacaabay.

Ha u yeelaan oo macneheedu yahay kuwa ay dhibaatadu ka neefta bronki, neefta, ayaa sheegay in wadnaha. cudur aad u daran beerka iyo kelyaha - sidoo kale sabab inaad diido daaweyn by habkan.

Waxaa sugan, waa in aynaan qaadan daawada haddii ay jirto dulqaad u gaar ah si ay qaybaha daroogada "Cordarone." Analogues ee Russia iyo dalalka kale ee Yurub waxay leeyihiin Halabuurka la mid ah, si ay dhacdo in this si uu u bedelo mid ka mid ah wakiilka kale ee lagama yaabo inay ku guuleystaan.

Iyadoo la tixgelinayo irbado, iyagu ma ay samayn kartaa ilmaha ka yar 3 sano jir, carruurta waaweyn ka badan 3 sano, qiyaasta waa in aanay ka badnaan 5 mg / kg. Ha ku darin daroogada ee silingaha la mid ah daawooyin kale. Guud ahaan, sababo in xal la mid ah sababo ah in kiniiniyada. bradycardia sanka Tani, bukay sanka syndrome iyo cudura tabinta daran, sida block sinoatrial Quluubtooda iyo tachycardia ventricular paroxysmal. Gaar ahaan, ifafaale sida waa u suurtoobaan marka la qaadanayo amiodarone isku dhafan oo dhowr daawooyin kale.

Qori irbado inta aad uurka leedahay ayaa suuragal ah keliya in xaalado gaar ah, marka nuujinta waa hab ka mid ah daaweynta gebi ahaanba waa in laga reebaa. Waa wax aan macquul in ay sameeyaan daaweynta la isticmaalayo "cordarone" xal la xibnaha, dareen diidmo oo xasaasiyadeed in iodine ama amiodarone.

Dhexgalka daroogooyinka kale

"Kordaron" la isku dari karaa daawooyin kale. Sidaas daraaddeed, ay saamayn antianginal waa wanaajiyey isku dhafan oo daroogo amooniyam tallaabo sii dheeraaday. Waxaa loo adeegsan karaa in lala xinjirowga lidka ku ah, diuretics, daroogada cardiotonic, ha la macaamilaan iyo, siday u kala horreeyaan, Ha tabar ama xoojiyaan saamaynta kasta "Kordaron" iyo qaar ka mid ah neuroleptics kale, analgesics, hypnotics iyo dajiyaha. Ku dhawaad sida jawaabaan daawooyinkan analog kasta.

"Kordaron" in aan la isku isticmaali karaa MAO iyo beta-blockers (xaalado gaar ah oo keliya).

Taxadarka lagu daweeyo "kordaron" iyo "Amiodarone"

Inta lagu guda jiro soo dhaweynta ah ee loo adeegsanayo, kuwaas oo u baahan xaalad jirka socodka ka hor daaweynta, inta lagu guda jiro iyo waxa ka dib.

Ka hor iyo inta lagu jiro daaweynta kiniin ECG foomka qabtay waxaa lagula talinayaa. Saamaynta daroogada sababa isbeddelo ah electrocardiogram ah, gaar ahaan, dheereyn bareeg ah T iyo Q-Q-T. Ka dib markii natiijada baaritaanka dhakhtarka qabsato laga yaabaa in qiyaasta iyo si loo ogaado waxtarka daawada.

Daaweynta la joojiyo marka koraya block atrioventricular II iyo III sinoatrialnaya degree, intraventricular laba-dogob.

Tan iyo markii mid ka mid ah qaybaha sida daroogada waa iodine, waxay u baahan tahay la socodka joogtada ah ee hawlaha thyroid. Ka hor inta daaweynta loo baahan yahay si loo ogaado heerka hormoonnada T3, T4 iyo TSH. Fadlan la soco in ku saabsan asalka ah "cordarone" waxbarashada radioisotope thyroid noqon kartaa kalsoonaan karin. On heerarka hormone of iodine uusan saamayn ku lahayn xogta.

Arrin kale oo muhiim ah waa in la go'aamiyo heerka potassium ee serum dhiigga ka hor daaweynta iyo waxa lagu jiro.

Marka ay maamusho "cordarone" talinayaa galiyey xididka oo keliya, oo aan la isku duro sirinj. Haddii kale, laga yaabee horumarinta xanuunada hemodynamic - hypotension halbowlaha, kaafi wadnaha iyo ba'an. Saliingaha si aad isugu durto daroogada kaliya ee xaaladaha degdegga ah aan caadi ahayn ay ka maqan yihiin waxyaabo kale. Xaaladdan oo kale qiyaasta waa 5 mg / kg oo la helay muddo saddex daqiiqo, dib - no si degdeg ah ka badan 15 daqiiqo ka dib markii maamulka ugu horeysay. Nidaamka la fulin karo oo kaliya in waaxda daryeelka wadnaha iyada oo ay kormeerayaan ECG. "Kordaron" in aan la isku dhaf ah oo saliingaha a daawooyin kale. Haddii aad qabto in daaweyn muddada-dheer ayaa loo baahan yahay si ay u galiyey tagaan. Kasta amiodarone xididka fuliyay isbitaalada.

Haddii bukaanka yeelan doonaan suuxinta guud, takhtarka suuxinta waa in lagu talinayaa in aad qaadato dawadan.

Si looga fogaado dhibaatooyin soo raaca, bukaanka waa in la waafajiyaa qiyaasta qoray ladan.

Inta lagu jiro daaweynta, bukaanka waa in ay ka fogaadaan qoraxda oo ay isticmaalaan difaac bay ku qaadeen (oo ay ku jiraan kareemada gaar ah), haddii loo baahdo.

U hubso in aad dhakhtarkaaga kala hadasho, haddii sabab qaar ka mid ah ma doonayo in ay qaataan "Kordaron" iyo dhigiisa. "Kordaron" iyo daawooyin la mid ah isaga oo leh, sida wax daroogo kale wadnaha waxay noqon kartaa mid aad u halis ah haddii dhaweynta caasiyoobay. dhakhtarkaaga kaliya ayaa ah go'aan ka gaari kara oo daawo u noqon lahaa ugu wanaagsan ee dacwaddaada iyo dooran doonaa qiyaasta ammaan ah, laakiin wax ku ool ah.