Izidakamizwa Anticholinergic: uhlu. Lo mshini wezenzo zomuthi anticholinergic

izidakamizwa Anticholinergic - yizidakamizwa ukuvimba isenzo neurotransmitter yemvelo - acetylcholine - ukuze receptor cholinergic. Ezincwadini angaphandle, leli qembu izidakamizwa ngokuthi "delirianty" ngenxa ikhono ukubangela delirium.

Kancane amaqiniso angokomlando

Ngaphambili, phakathi nekhulu lama-20, imithi isinyathelo anticholinergic esetshenziselwa ukwelapha ezingamahlalakhona obstructive isifo samaphaphu kanye somoya, kodwa kwathathelwa indawo izidakamizwa ezengeziwe esine ezimbalwa ezingase zibe nemiphumela engemihle. With ukuthuthukiswa kwemithi, ososayensi bakwazi ukuthuthukisa holinoblokatory yokuthi abanayo okufanayo uhlu omkhulu amathuba okuba nemiphumela engemihle. amafomu Isikali eziye zaguqulwa, futhi empeleni zokwelapha izifo yamaphaphu zabuye isicelo anticholinergics. Lo mshini wezenzo yaleli qembu izidakamizwa esikhundleni eziyinkimbinkimbi, kodwa kungenzeka ukuchaza link main.

Kanjani holinoblokatory?

Isenzo main zomuthi anticholinergic uvimbela receptor cholinergic futhi ukungabi nakwenzeka kwento ezinomthelela kubo neurotransmitter - acetylcholine. Ngokwesibonelo, e-bronchi ivinjiwe receptor elise imisipha abushelelezi.

ngezigaba izidakamizwa

Kuye ngokuthi yiziphi receptor bathonywa izidakamizwa anticholinergic, uhlu is zihlukaniswe ngamaqembu:

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

Kuye selectivity yesenzo:

• Central, noma ze-non-abakhethayo (atropine, pirenzepine, platifillin).
• Neuropathy noma abakhethayo (ipratropium bromide).

M-holinoblokatory

Omele eyinhloko leli qembu izidakamizwa atropine. Atropine - i alkaloid, okuyinto equkethwe kwezinye izitshalo ezifana nightshade ebulalayo, henbane futhi Datura. Isici liphinyiselwe iningi atropine - antispasmodic. Against isizinda wesenzo incipha imisipha linjani wokugaya ukudla pheshana, kwesinye futhi bronchus.

Atropine ezinqunyiwe ngomlomo, phansi kwesikhumba futhi ngemithambo yegazi. ubude bayo isinyathelo mayelana 6 amahora nokusebenzisa atropine amaconsi isikhathi inyuka izinsuku eziyisikhombisa.

imiphumela kwemithi ye atropine:

• abafundi osuke usuvulekile kwamehlo ngenxa umphumela emnandi imisipha isiyingi iris - imisipha iris uphumule, ngokulandelana, umfundi dilates. Umthelela esiphezulu kwenzeka kungakapheli imizuzu 30-40 emva instillation.
• Ukukhubazeka yokuhlala - lens sisalokhu futhi isicaba, izidakamizwa anticholinergic ubukele iso izinto ezikude.
• inhliziyo ukhulise isilinganiso
• Ukuphumula kwemisipha bushelelezi ku bronchi, pheshana emathunjini, esinyeni urinary.
• Encishisiwe yangaphakathi uketshezi nezindlala, ezifana bronchial, wokugaya ukudla izithukuthuku.

Ukusetshenziswa atropine

• Zamehlo: ekutadisheni fundus, incazelo iphutha yezokubona.
• Ngo nezenhliziyo, atropine isetshenziselwa bradycardia.
• Ngo Pulmonology wasebenzisa izidakamizwa anticholinergic somoya.
• Gastroenterology: isilonda esiswini kanye isilonda duodenal, kolwelwesi giperatsidnom (ngokunciphisa esiswini acid uketshezi nezindlala wokugaya ukudla). Umuthi ngempumelelo uma colic emathunjini.
• I anesthetists atropine esetshenziswa njengoba premedication phambi izinqubo ezihlukahlukene kuhlinzwa.

imiphumela emibi atropine.

Libhekene kome umlomo nomphimbo, photophobia, eduze umbono kahle, ukuqunjelwa, ubunzima echama.

Atropine is ngokuphelele contraindicated ukusebenzisa glaucoma ngenxa umphumela waqinisa intraocular. Contraindicated izidakamizwa anticholinergic ngoba incontinence urinary, njengoba imisipha esinyeni. Anticholinergics zidinga Ukukhetha okunembile nokushintsha kokudla nokufakwa. Ngemithamo ngokweqile iza ubuthi umzimba, okuyinto libhekene motor kanye ukuqhanyelwa ngokomzwelo, mydriasis, hoarseness, nobunzima ukugwinya, ongama ku lokushisa. In iziguli kakhulu ubuthi aqala ukulahlekelwa nabuphi emkhathini, isabona kubantu ababezizungezile, ebonakaliswa ukusangana kanye imicabango yokuzakhela. Kwangathi ukuthuthukisa nokuquleka ukuthi bangene equlekile, kodwa ngenxa ukukhubazeka isikhungo zokuphefumula, ukufa kwenzeka ngokushesha. Iningi ebucayi kakhulu ezintweni ezikhipha ngokweqile kwezingane - umthamo wabo ebulalayo 6-10 mg.

Scopolamine ikhipha efana atropine, kodwa ngokungafani kuya inikeza imiphumela ogxile inhibitory ku isimiso sezinzwa esiyinhloko, osebenza njengokuvimbelayo sine. Le mpahla isetshenziswa nomsebenzi wezokwelapha - scopolamine isetshenziswa ezihlukahlukene iziyaluyalu uhlelo vestibular - isiyezi, Gait kahle nokulinganisela, ukuvimbela ukuthuthukiswa ulwandle kanye nomoya ukugula.

izidakamizwa Anticholinergic zifakwe "Aeron," umuthi livame ukusetshenziswa ngaphambi kuhambo oluzayo ezindizeni kanye nemikhumbi. amaphilisi Action kuthathe amahora mayelana 6. Kukhona ifomu netabletirovannaya - transdermal uhlelo zokwelapha - usimende, okuyinto ethe njo ku endlebeni futhi ukukhishwa izidakamizwa ngaphezu kwamahora angu-72. Le mithi anticholinergic - antidepressant, ezimweni eziphambili kakhulu ukusiza ngokushesha ukukhulisa imimoya abagulayo abaphila isifo sokucindezeleka okungamahlalakhona.

Ipratropium bromide ( "Atrovent") - a bronchodilator. Lapho ukusetshenziswa ephefumula cishe ngeke angena igazi ayinayo imiphumela letindzala. Ngenxa nokuvinjelwa receptor cholinergic imisipha abushelelezi bronchi kwenza ukunwetshwa yabo. Lezi anticholinergics etholakalayo njengoba isixazululo i inhaler aerosol, noma alinganisiwe futhi ziyasebenza somoya bronchial kanye COPD. Imiphumela engemihle - isicanucanu nomlomo owomile.

Tiotropium bromide - izidakamizwa anticholinergic ezindaweni efana bromide ipratropium. It ikhiqizwa ngesimo powder for ephefumula. Isici esiphawulekayo lokhu izidakamizwa wukuthi kuba okwengeziwe ithonya elihlala njalo receptor cholinergic, Ngakho-ke, kungcono kunokusebenzisa bromide ipratropium. Isetshenziselwa in iziguli COPD.

Platifillin - Araneus alkaloid. Ngokungafani nezinye anticholinergics, platifillin ukwazi uvuleke imithambo yegazi. Ngenxa yalesi impahla, kukhona ukwehla okuncane wegazi. Umuthi ikhishwe ku isixazululo kanye suppositories rectal. Faka isicelo zibe imisipha abushelelezi izitho zangaphakathi, isibindi colic kwezinso, isifuba somoya, kanye nobuhlungu obubangelwa spasm nge acute isilonda esiswini kanye isilonda duodenal. Ngo ophthalmological umkhuba platifillin elisetshenziswa ngesimo iso lehla abafundi osuke usuvulekile.

Pirenzepine - ngokuncanyelwayo amabhlogo amaseli esiswini ezikhiqiza histamine. Ngokunciphisa histamine ukukhululwa kunciphisa ukwabiwa hydrochloric acid. I evamile ngemithamo zokwelapha, lokhu izidakamizwa has cishe akukho ukusebenza ngomhla ka-abafundi ukushaya kwenhliziyo, ngakho ngokuyisisekelo pirenzepine esithathwayo ngomlomo ukwelapha isilonda esiswini kanye isilonda duodenal.

H holinoblokatory (ganglionic)

Lo mshini wezenzo ukuthi ejenti anticholinergic yaleli qembu ekuvimbeni innervation nozwela futhi izinzwa parasympathetic kuhamba khona izithuthi ukunciphisa uketshezi adrenaline futhi noradrenaline, zivimbela excitation kwemigudu yokuphefumula kanye vasomotor isikhungo. Ngaphezu kwalokho, lo mkhulu ithonya innervations nozwela noma parasympathetic, manifest ngaphezulu ukukhiya senzo.

Ngokwesibonelo, inani abafundi parasympathetic innervation amathonya kunamandla - ngokuvamile abafundi ngokuvamile ayisesemikhulu. Kulokhu, holinoblokatory sizothinta parasympathetic isimiso sezinzwa - ngenxa abafundi kuthiwa osuke usuvulekile. Cishe bonke imithambo yegazi bedle nonozwela isimiso sezinzwa - izidakamizwa ukuqeda usithonye futhi uvuleke imithambo yegazi, ngenxa lapho ingcindezi kuyehla.

H holinoblokatory ifa umphumela bronchodilatory futhi asetshenziselwa spasm bronchial, ukunciphisa ithoni kwesinye, ngakho lezi angabelwa at anticholinergics ukuchama kunzima. Ngaphezu kwalokho, le mithi ukwehlisa yangaphakathi uketshezi nezindlala, kanye ukubambezela yonke emathunjini ipheshana motility. Zokwelapha, wasebenzisa umphumela ngokuyinhloko hypotensive, okuyinto ifa la anticholinergics. Uhlu side effects lisabalele:

• On the ingxenye ipheshana wokugaya ukudla: nomlomo owomile kanye ukuqunjelwa.
• Kusukela umgudu wokuphefumula: ukukhwehlela, ukucasuka bendawo bangase babe nolwazi.
• Kusukela CCC: arrhythmia, palpitations wazwakalisa. Lezi izimpawu ezingajwayelekile kanye kuyaqedwa kalula.
• Okunye imiphumela elimazayo ingase ingasheshi wehlise acuity ezibukwayo, ukuthuthukiswa ifomu okukhulu ukufiphala edema.

Izimo ukusetshenziswa kwezidakamizwa anticholinergic

• Hypersensitivity ukuba amagama ahlobene of atropine nezinye izingxenye ngamalungiselelo.
• Ukukhulelwa (ikakhulukazi 1 yokuthathu).
• Lactation.
• yobudala Wezingane (contraindication isihlobo).
• ukusetshenziswa ngokuphelele contraindicated izidakamizwa e-engeli-Ukuvalwa glaucoma in iziguli ukwehluleka kwezinso kuyadingeka ukuqapha ngokucophelela isimo egazi noma omchamo.