"Finoptinum": yokusetshenziswa, ukwakheka, nozakwabo yangempela

Kusukela isifo senhliziyo semithambo sihlasela abantu abaningi. Ngaphezu kwalokho, njengoba umuntu ekhula, ingozi ezifana isifo uthi luyanda kakhulu. Ukuze kuncishiswe ingozi izinqubo sina emzimbeni, odokotela batusa ukusetshenziswa amathuluzi akhethekile. Phakathi kwabo kukhona ethandwa kakhulu kukhona calcium channel blocker. Ziyakwazi iqembu heterogeneous izidakamizwa. indlela izenzo zaso lihlotshaniswa zabonakala zikwazi ukunqanda Ukungena kwe-calcium ion isuke endaweni extracellular kumaseli nemithambo yegazi inhliziyo. Ukunciphisa lokuhlushwa lezi zinto, lo nomuthi uzabalaza vasodilating senzo.

Umuthi ephumelela kakhulu izakhiwo ezinjalo kuba "finoptinum". Yokusetshenziswa sokuqanjwa, analogs, izinkomba ukusetshenziswa zomuthi futhi imiphumela engemihle bachazwa ngemuva kwalokhu.

Ifomu, ukwakheka

Yini ukuma sici zomuthi "finoptinum"? Imiyalelo isicelo lithi angathengwa njengoba umjovo kanye amaphilisi.

Njengoba isithako lokhu ejenti izenzo verapamil hydrochloride. Futhi ekulungiseleleni zihlanganisa ukuxhumana asizayo ehlukahlukene (kuncike amafomu wokukhishwa).

imiphumela kwemithi

Yiziphi izinto ezinganembile esivela izidakamizwa "finoptinum"? Yokusetshenziswa, ukubuyekezwa uyifune kuyinto blocker-calcium channel (abakhethayo) ekilasini lokuqala. Kuyinto difenilalkilamina esuselwe futhi ubukisa antianginal, antihypertensive futhi isenzo antiarrhythmic.

umphumela Antianginal yalesi izidakamizwa ihlobene ikhono layo kuthinta myocardium futhi hemodynamics neuropathy. Ngamanye amazwi, lo izidakamizwa kunciphisa ithoni kwemithambo. Ngaphezu kwalokho, kunciphisa transformatsiiyu ATP amandla eziqukethwe ubudlelwano ephezulu amandla angaguqulwa abe umsebenzi mechanical kunciphisa contractility esivimba amanzi.

Kufanele wazi futhi ukuthi ukusetshenziswa kwalesi izidakamizwa iyehlisa O2 esivimba amanzi futhi chronotropic negative, inotropic nemiphumela vasodilatory.

izakhiwo zomuthi

Ngenxa Ukwakheka bayo, nomuthi "finoptinum", analogue zazo ezibalwe ngezansi, suppresses le automaticity ka itheku node kunciphisa AV-conduction futhi kwandisa isikhathi refractory.

Ukwandisa izikhathi ukuphumula ventricle diastolic (ngakwesokunxele), lokhu izidakamizwa kunciphisa tonus esivimba amanzi odongeni, isb iyindlela asizayo ekwelapheni obstructive zenhliziyo hypertrophic.

Kufanele kuphawulwe ukuthi imithi kubhekwe ubonisa izindawo anti-arrhythmic nge arrhythmias supraventricular.

I kinetics zomuthi

Ukulungiselela "finoptinum" imfundo elichazwa ngezansi, amuncwa umzimba kusukela ipheshana yesisu (cishe u-90% umthamo). inhlangano yayo nge amaprotheni 90%.

Umuthi is akheka endimeni (kuqala) ngokusebenzisa isibindi. Lokhu yakha esuselwe ezifana norverapamil ukuthi incane umsebenzi hypotensive kuka verapamil unmodified.

Isikhathi isigamu-ukuphila zomuthi ekwamukelweni Isikali ongashadile amahora 3-8. Ngesikhathi ukusetshenziswa Ukweqiwa ngokuphindelela nomuthi, lesi sibalo kuyahlukahluka (amahora 5-12).

Etholakale izidakamizwa ngokusebenzisa amathumbu nezinso.

ubufakazi

Kwezinye izimo, umuthi "finoptinum"? Yokusetshenziswa (amaphilisi kanye isixazululo komjovo babe yokubukisa efanayo) uthi leli thuluzi ingasetshenziswa tachycardia supraventricular (kuhlanganise paroxysmal, syndrome Lown-Ganong-Levine futhi WPW-syndrome), unhlangothi (voltage, ezinzile ngaphandle vasoconstriction, vasospastic ezinzile), itheku tachycardia, flutter atrial, tachyarrhythmia atrial, arrhythmia atrial, crisis abanomfutho wegazi ophakeme (kwezokuphatha ngomjovo), umfutho wegazi ophakeme, umfutho ophakeme wegazi ubalulekile hvs encane kwegazi, hypertrophic zenhliziyo obstructive.

Izimo

Lapho ukuqondisa "finoptinum"? Yokusetshenziswa (imijovo kanye amaphilisi abe Izimo efanayo) ubonisa ukuthi leli thuluzi kungavunyelwe ukusetshenziswa e hypotension ezinzima, sinoatrial bevimbezela futhi itheku ogulayo syndrome (ngaphandle in iziguli umshini wokulawula ukushaya kwenhliziyo), AV-nokuvinjelwa yesithathu neyesibili-degree syndrome Launa -Ganonga-Levin kanye WPW-syndrome lihambisana fibrillation atrial noma flutter atrial (ngaphandle abagulayo bephethwe umshini wokulawula ukushaya kwenhliziyo), ukukhulelwa, hypersensitivity kuya verapamil, ibele.

Izidakamizwa "finoptinum": yokusetshenziswa

Umthamo zomuthi ibalwa udokotela ngamunye.

Adult iziguli ithebhulethi iqondiswa ngomlomo i umthamo kokuqala 40-80 mg kathathu ngosuku. Ukuze umthamo amafomu nge okuqhubekayo ukukhululwa umthamo owodwa kumele lenyuke, futhi imvamisa yokuphathwa - ephansi.

Izingane ezineminyaka engu-6-14, le imithi Kunconywa ukuthatha in inani 80-360 mg ngosuku, futhi kuze iminyaka 6 - at umthamo 40-60 mg ngosuku. Imvamisa nokuphathwa umuthi kane ngosuku.

Uma kudingekile, izidakamizwa okukhulunywa ingasatshenziswa ngemithambo yegazi (kancane). Ngakho kubalulekile ukuqapha ECG, umfutho wegazi kanye kwenhliziyo isiguli.

Alahlwayo isixazululo isilinganiso esithathwa abantu abadala kuyinto 5.10 mg. Uma umphumela zokwelapha engekho, amaminithi ukulungiselela ke ngemva 20 kungenziwa kabusha langena (at umthamo ofanayo).

A umthamo owodwa ifomu nemijovo zomuthi izingane eminyakeni 6-14 ubudala kuyinto 2.5-3.5 mg izingane eminyakeni 1-5 - 2-3 mg, futhi ingane enyakeni owodwa - 0.75-2 mg.

Iziguli isibindi ezinzima umthamo wansuku zonke kumele singeqi mg 120.

Umthamo esiphezulu sokulungiselela ngomlomo ngosuku kuyinto 480 mg.

side effects

Ukulungiselela "finoptinum" kungaba avuse okulandelayo ukusabela uhlangothi:

• kwesisindo bradycardia, agranulocytosis, noma eziya ziba zimbi ukumelwa inhliziyo, hyperprolactinemia, tachycardia, ukulahlekelwa lezivakashi umbono, edema neuropathy;
• ukunciphisa wawubona wegazi, gynecomastia, galactorrhea, samathambo, angina, arrhythmia, edema yamaphaphu, AV-block of the degree lwesithathu, asystole, thrombocytopenia asymptomatic, nciphisa;
• isicanucanu, ukuqina izingalo noma imilenze, Hyperplasia gingival, yokufikelwa, ukukhathala, ukwanda ngesifiso, ukukhathazeka, ukwanda transaminases isibindi;
• ukuqubuka kwesikhumba, isiyezi, ukuqunjelwa noma isifo sohudo, ikhanda, ukucindezeleka, ukupholisa, iziyaluyalu extrapyramidal, ukukhathala, siwasebenzise kwesikhumba, ukozela, exudative erythema multiforme, pruritus.

izidakamizwa ekuhlanganyeleni

Kungenzeka yini ukuba zihlangana kanjani nezinye imithi imithi "finoptinum"? Imiyalelo isicelo uthi inhlanganisela yalezi agents nge izidakamizwa antihypertensive nekhululekile kungenza ngiqiniseke nakakhulu nethonya lazo antihypertensive.

Ngu ekuphathweni emthanjeni of verapamil kubantu abaye babhekana nesimo usanda kuthola umthamo we-beta-blocker, kunobungozi eliphezulu hypotension (lwemithambo) kanye asystole.

Lapho co-iqondiswa "finoptinum" izidakamizwa beta-blocker, imithi yokwelapha ephefumula izinzwa nezidakamizwa antiarrhythmic kwandisa ingozi yokuba inhliziyo ukwehluleka, bradycardia, hypotension ezinzima futhi AV-ukuvinjelwa.

Kanye yokuvuma "Amiodarone" bradycardia iyakhula, nomphumela omubi inotropic, AV-block futhi conduction thuthuva.

Ngenxa verapamil kuvimbela isozyme CYP3A4, ehilelekile umzimba simvastatin, lovastatin futhi atorvastatin kungenzeka ezinye zezindlela nokuxhumana ezibangwa okwandisa lokuhlala statin egazini. amacala rhabdomyolysis babe nako.

izakhiwo antianginal "finoptinum" iyakhula lapho kuhlangene nitrate.

Kanye yokuvuma acetylsalicylic acid luyanda ukopha sikhathi ngenxa okufakiwe isinyathelo antiplatelet.

Ngingakujabulela yini "Dizopiramid" kanye izidakamizwa "finoptinum"? Yokusetshenziswa ibika ukuthi le nhlanganisela kungaholela hypotension ezinzima futhi nciphisa, ikakhulukazi abantu decompensated inhliziyo ukwehluleka noma ukungasebenzi kwezicubu zenhliziyo.

Lapho usebenzisa i-kokubili amaphilisi kanye isixazululo kwandisa lokuhlushwa yayo igazi nge "imipramine", lapho ingozi izinguquko engafuneki ECG. Kufanele kuphawulwe ukuthi verapamil kwandisa bioavailability of "Imipramine", ukunciphisa imvume yayo.

Nge inhlanganisela yemithi nge "carbamazepine" isinyathelo ngcono yokugcina, kanye kwandisa ingozi nemiphumela engemihle evela CNS.

Ngesikhathi esifanayo ukuthatha izidakamizwa nge "clonidine" kukhona izimo ephethwe yisifo senhliziyo kubantu abanomfutho wegazi vele ophakeme.

Lapho ngokuhlanganisa nomuthi nge lithium carbonate kuwukubonakaliswa izidakamizwa ekuhlanganyeleni kukhona ezingalindelekile futhi edidayo. Kukhona amacala neurotoxicity, bradycardia ezinzima, ukuthuthukisa imithelela lithium nokwehlisa lokuhlushwa yayo egazini.

Njengoba "rifampicin" izenzo emuthini "finoptinum"? Manual ithi inhlanganisela eheha enzyme isibindi, usheshisa umzimba verapamil. Lokhu ekugcineni kuholela ukuncipha ngempumelelo emitholampilo ye izidakamizwa ngaphansi ukucatshangelwa.

izincomo ezithile

Okufanele ukwazi ngaphambi kokusebenzisa izidakamizwa "finoptinum" (40 mg)? Umhlahlandlela ibika ukuthi leli thuluzi lisetshenziswa ngokuqapha lapho AV-nokuvinjelwa ngezinga lokuqala, ezinzima stenosis yomthambo i-aorta, bradycardia, isilethikusebenza nokuba khona ngakwesokunxele ventricular ukwehluleka, congestive inhliziyo ukwehluleka bemvelo okungamahlalakhona, hypotension emaphakathi noma oluncane, hepatic noma esingamahlalakhona kwezinso. Futhi ngokucophelela le imithi Kunconywa asebekhulile nentsha.

Ngo-acute akudingeki kwenziwe ngumuntu ukwelashwa nomfutho wegazi ophezulu kanye angina ngu verapamil ne-beta-blocker. Kodwa yini edingekayo ukuze ugweme ekuphathweni emthanjeni lakamuva.

Lapho yokwamukela lokhu kusho isiguli singase ukuthuthukisa zindlela ezingafani ngabanye ezifana ukozela noma isiyezi, okungase kuthinte ikhono lomuntu ukwenza umsebenzi enobungozi.

Nokukhulelwa kanye lactation

Kungakhathaliseki kungenzeka omama abasanda esizayo ezinqunyiwe isidakamizwa "finoptinum"? Yokusetshenziswa ngesikhathi sokukhulelwa has ke ukuthi lokhu kusho nomthelela omubi kwengane esiswini. Iphinde ludlulele ngaphakathi ubisi lwebele. Ngakho-ke, ngaphansi kwalezi zimo isidakamizwa akuvunyelwe contraindicated.

Nomuthi "finoptinum": nozakwabo kanye nezindleko

Intengo kwaleli thuluzi ingase ibe khona ehlukile. Njengomthetho, incike efomini wokukhulula zomuthi, ubuningi bayo noma ububanzi. Isilinganiso izindleko "finoptinum" kuyinto ruble 100-170.

Uma kubhekwa umuthi wena contraindicated, kungaba kuthathelwe indawo yezindlela ezilandelayo: "Verapamil", "Verogalid" "Verapamil-OBL", "Kaveri", "Verapamil Sopharma", "Verapamil-Lect," "Verapamil-Verein" "verapamil-Ratiopharm" "Isoptin", "verapamil-Escom," "Vero verapamil," "verapamil hydrochloride" "Lekoptin".

Izibuyekezo kodokotela abathengi

Ochwepheshe bathi amaphilisi kanye isixazululo "finoptinum" iyindlela ephumelelayo futhi engabizi, okuyinto zenzelwe ukubuyisela blood pressure, futhi sithuthukise nenhlalakahle ezinye izifo izitsha inhliziyo negazi.

Njengoba for the iziguli, iningi lawo ngempela uyaneliseka ngemiphumela ukwelashwa nale ejenti. Amaphilisi noma isixazululo ukumnika emthanjeni kusiza ukuqedwa okusheshayo izimpawu nomfutho wegazi ophezulu kanye nezinye izimpawu zesifo i-ka-uhlelo senhliziyo nemithambo yegazi.

Kufanele futhi wazi ukuthi mayelana izidakamizwa futhi wathola nemibiko engemihle. Bakhuluma ngamacebo inqwaba ohlangothini ukusabela ezenzeka ngokushesha ngemuva izidakamizwa. Futhi, abasebenzisi eziningi akhononde Izimo eziningi.