Mankhwala Anticholinergic: mndandanda. Limagwirira cha zochita za mankhwala anticholinergic

mankhwala Anticholinergic - mankhwala kuti ndigwire ntchito ya mtundu zachilengedwe - acetylcholine - kuti maselo cholinergic. Mu mabuku yachilendo, gulu la mankhwala otchedwa "delirianty" chifukwa mphamvu yochititsa kuona zilubwelubwe.

A pang'ono mabuku a mbiri yakale

Poyamba, mu m'ma 20, mankhwala anticholinergic kanthu ntchito zochizira aakulu obstructive matenda m'mapapo mwanga ndi mphumu, koma m'malo mwa mankhwala zambiri zamakono ndi zotsatira ochepa angathe mbali. Ndi chitukuko cha mankhwala, asayansi anatha kukhala holinoblokatory ngati kuti alibe chomwecho yaikulu mndandanda wa zotsatira zoyipa. Mlingo mitundu asintha, ndi achire mchitidwe matenda m'mapapo mwanga zinayamba anticholinergics ntchito. Limagwirira cha zochita za gulu la mankhwala m'malo zovuta, koma n'zotheka kufotokoza limasonyeza chachikulu.

Kodi holinoblokatory?

The kanthu waukulu wa mankhwala anticholinergic ndi kutsekereza zolandilira cholinergic ndi zosatheka yolimbikitsira iwo mtundu - acetylcholine. Mwachitsanzo, mu bronchi ndi oletsedwa zolandilira ili mu mnofu yosalala.

gulu la mankhwala

Malinga amene zolandilira zimakhudzidwa ndi mankhwala anticholinergic, mndandanda uli m'magulu:

• M-holinoblokatory (atropine, scopolamine, ipratropium bromide).
• H holinoblokatory (pentamine, tubocurarine).

Malinga selectivity a kanthu:

• Central, kapena osakhala kusankha (atropine, pirenzepine, platifillin).
• Zotumphukira kapena kusankha (ipratropium bromide).

M-holinoblokatory

Nthumwi yaikulu ya gulu la mankhwala ndi atropine. Atropine - ndi alkaloid, amene ali ena zomera monga nightshade zakupha, henbane ndi datura. Mbali kutchulidwa wa atropine - antispasmodic. Against maziko a ntchito yake amachepetsa minofu kamvekedwe a m'mimba thirakiti, chikhodzodzo ndi bronchus.

Atropine Kwalamulidwa pakamwa, subcutaneously ndi m'nsinga. nthawi yake kanthu ndi maola 6 ndi ntchito atropine m'malovu nthawi ukuwonjezeka masiku asanu ndi awiri.

Zotsatira pharmacological wa atropine:

• Dilated ana a maso chifukwa wapaulendoyo pa minofu zozungulira wa Iris - ndi Iris minofu kumasuka, motero, mwana dilates. Zotsatira pazipita amapezeka mkati 30-40 Mphindi pambuyo instillation.
• Ziwalo za malawi - disolo lidakali ndi flattened, mankhwala anticholinergic anatsekula diso masomphenya mtunda.
• Kuchuluka kugunda kwa mtima
• Yosangalala minofu yosalala mu bronchi ndi thirakiti m'mimba, chikhodzodzo mkodzo.
• Yafupika mkati katulutsidwe zopangitsa, monga bronchial, m'mimba ndi thukuta.

Ntchito atropine

• Mu pochiza matenda a maso: kuphunzira fundus, ndi tanthauzo la zolakwa refractive.
• Mu cardiology, atropine ntchito bradycardia.
• Mu pulmonology ntchito mankhwala anticholinergic mu mphumu.
• Gastroenterology: chapamimba chilonda ndi mmatumbo chilonda, gastritis giperatsidnom (by kuchepetsa chapamimba asidi katulutsidwe m'mimba zopangitsa). Mankhwala othandiza ngati colic matumbo.
• The anesthetists atropine ntchito ngati premedication patsogolo njira zosiyanasiyana opaleshoni.

Zotsatira zoyipa za atropine.

Yodziwika ndi dryness mkamwa ndi mmero, photophobia, mkhutu pafupi masomphenya, kudzimbidwa, vuto kukodza.

Atropine mwamtheradi contraindicated ntchito khungu chifukwa zotsatira za kuthamanga intraocular. Contraindicated mankhwala anticholinergic kwa incontinence mkodzo, monga kumasuka minofu ya chikhodzodzo. Anticholinergics amafuna kusankha yeniyeni dosing. Mu Mlingo owonjezera akubwera poyizoni chamoyo, amene amakhala ndi galimoto ndi chilakolako chogonana maganizo, mydriasis, hoarseness, amavutika kumeza kukwera kutentha. Odwala kwambiri poizoni anayamba kutaya kuonetsa mu mlengalenga, salinso kuzindikira anthu owazungulira, akuwonetseredwa kuyerekezera zinthu m'maganizo ndi zinyengo. Angathe khunyu kuti apite ku chikomokere, koma chifukwa ziwalo za malo kupuma, munthu amafa mofulumira. tcheru kwambiri Mlingo owonjezera ana - mlingo awo woopsa ndi 6-10 mg.

Scopolamine amapanga ofanana atropine, koma mosiyana lili zotsatira ambiri ochepetsera pa chapakati mantha dongosolo, kumachita monga sedative a. Mundawu ntchito mu ntchito zachipatala - scopolamine ntchito zosiyanasiyana matenda a dongosolo vestibular - chizungulire, mkhutu gait ndi kusamala kupewa chitukuko cha nyanja ndi matenda mpweya.

mankhwala Anticholinergic ali m'gulu la "Aeron," mankhwala amagwiritsidwa ntchito pamaso pa maulendo adziwitse pa ndege ndi sitima. mapiritsi Action kumatenga maola 6. Pali netabletirovannaya mawonekedwe - transdermal achire dongosolo - pulasitala, amene glued pa khutu ndipo zimatulutsa mankhwala pa maola 72. Mankhwalawa anticholinergic - antidepressants Nthawi patsogolo kwambiri kuthandiza mwamsanga kuukitsa mizimu cha odwala amene ali matenda aakulu.

Ipratropium bromide ( "Atrovent") - ndi bronchodilator. Pamene ntchito inhalation pafupifupi osati odzipereka mu magazi ndipo alibe zotsatira zokhudza zonse. Chifukwa anatseka misewu ya maselo cholinergic minofu yosalala bronchi amapanga kuwonjezeka awo. anticholinergics awa alipo ngati njira yothetsera ndi inhaler aerosol, kapena metered ndi mogwira mtima mphumu bronchial ndi COPD. Zotsatira zoyipa za mankhwalawa - kunyansidwa ndi pakamwa youma.

Tiotropium bromide - mankhwala anticholinergic pa katundu ofanana bromide ipratropium. Izo zinabala mu mawonekedwe a ufa inhalation. Chinthu chapadera cha mankhwala ndi kuti Chokhalitsa yaikulu zolandilira cholinergic Choncho, n'kofunika kwambiri kuposa bromide ipratropium. Izo ntchito odwala ndi COPD.

Platifillin - Araneus alkaloid. Mosiyana anticholinergics zina, platifillin amatha dilate Mitsempha. Chifukwa chuma ichi, pali kuchepa pang'ono magazi. mankhwala adzamasulidwa ku njira ndi suppositories thumbo. Ikani ndi spasms m'minofu yosalala ziwalo, chiwindi ndi colic aimpso, mphumu, komanso ululu chifukwa cha kuphipha ndi pachimake chapamimba chilonda ndi mmatumbo chilonda. Mu ophthalmological mchitidwe platifillin ntchito mu mawonekedwe a m'maso kwa ana dilated.

Pirenzepine - preferentially midadada maselo m'mimba yotulutsa histamine. Ndi kuchepetsa histamine kumasulidwa kumachepetsa Kugawilidwa kwanthaka wa acid amathiridwa. Alipidwa achire Mlingo, izi mankhwala ali pafupifupi ziribe mphamvu pa ana ndi kugunda, kotero kwenikweni pirenzepine akutengedwa pakamwa zochizira chilonda muzituluka ndi mmatumbo chilonda.

H holinoblokatory (ganglionic)

Limagwirira kanthu ndi kuti wothandizila anticholinergic wa gulu kutsekereza innervation wachifundo ndi mitsempha parasympathetic pa mfundo kuchepetsa katulutsidwe wa zikuwonjezereka masiku ano ndi noradrenaline, ziletsa malemeredwe ya kupuma ndi vasomotor pakati. Komanso, wamkulu mphamvu ya innervations wachifundo kapena parasympathetic, m'pamenenso kuwonetseredwa lanu kanthu.

Mwachitsanzo, kuchuluka kwa ana wamphamvu parasympathetic innervation makhalidwe - zambiri ana ambiri mwapang'ono. Pankhaniyi, holinoblokatory zidzakhudza mantha dongosolo parasympathetic - chifukwa cha ana ndi dilated. Pafupifupi onse mtsempha mchikakamizo cha mantha dongosolo wachifundo - mankhwala kuthetsa kukopa kwake ndi dilate Mitsempha, chifukwa chimene zoipazi yafupika.

H holinoblokatory adzalandira zotsatira bronchodilatory ndi ntchito kuphipha bronchial, kuchepetsa kamvekedwe ka chikhodzodzo, kotero izi awerenge pa anticholinergics kovuta pokodza. Komanso, mankhwala kuchepetsa mkati zopangitsa katulutsidwe, komanso kusokoneza m'mimba thirakiti motility. Mu yochizira matenda, ntchito zotsatira makamaka hypotensive, amene adzalandira anticholinergics izi. Mndandanda wa mavuto ndi yaikulu:

• Pa mbali pa mundawo m'mimba: pakamwa youma ndi kudzimbidwa.
• Ku dongosolo kupuma: chifuwa, kuyabwa m'dera akhoza nawo.
• Kuchokera CCC: arrhythmia, palpitations chionetsedwe. Zizindikiro zimenezi n'zochepa ndi mosavuta inathetsedwa.
• zotsatira zina kuchepa zithunzi acuity, kukula kwa mawonekedwe pachimake cha khungu, edema.

Contraindications ntchito mankhwala anticholinergic

• Hypersensitivity kuti zotumphukira wa atropine ndi mbali zina za kukonzekera.
• Mimba (makamaka 1 trimester).
• Mkaka wa m'mawere.
• zaka ana (wachibale contraindication).
• Mwamtheradi contraindicated kugwiritsa ntchito mankhwala mu ngodya-kutsekedwa khungu odwala ndi kulephera aimpso m'pofunika mosamala kuwayang'anira boma la magazi ndi mkodzo.