Prokinetics - kuyini? isizukulwane esisha prokinetics: uhlu

Prokinetics - kuyini? Esikhathini amazwe CIS, kungekho ukuvumelana ngalokho imithi afakiwe kuleli qembu, ngakho zonke gastroenterologist yena enquma ukuthi alethe kulolu hlu, futhi yini engasebenzi. Prokinetics - kuyini? Yilokho sizama ukuthola.

Incazelo kanye nencazelo emfushane

Prokinetics - kuyini? This iqembu izidakamizwa ukufukula motility tube wokugaya ukudla futhi kuvimbela amagagasi anastaltic.

izifo emathunjini zivame ukuhambisana Reflux ka chyme kusukela ezindaweni eziphansi tube emathunjini e overlying, ukwephulwa ndima bolus noma yokujama tsi ingxenye emathunjini. Konke lokhu izimpawu ezihlobene ne kahle ukukhuthazwa chyme ngu tube wokugaya ukudla, bese ususa izimpawu kungaba, ezithinta ukusikwa imisipha bushelelezi e abhidliza izindonga zayo. Yilokho prokinetics. umphumela zabo zokwelapha kungenxa uvimba okudluliselwa kulo ion indlela (Dopamine, 5-HT4 receptor, kuhlanganisiwe) noma ithonya phezu umzimba acetylcholine. Ukuphumelelisa umphumela zokwelapha kungenxa esengeziwe acetylcholine emqhokrweni izinhlaka zokuxhumana zobuchopho noma okhulisa imikhiqizo cholinesterase okuyinto sithuthukisa yokubola ach, imikhiqizo ukunciphisa ach kwalapho kuhlangana khona imizwa.

imiphumela Physiologically kusukela izidakamizwa avele ukwandisa inhliziyo ngomphimbo sphincter ithoni, ukuthuthwa kwabantu ngenxa yengozi lokuqukethwe esiswini, lo kusebentisana emkhatsini antrum kanye duodenum, ithele amathumbu peristalsis.

Iqembu lokuqala izidakamizwa

Prokinetics - izidakamizwa ukuthi uvimbele Dopamine D2-receptor, kanjalo inkanuko ukunyakaza kwemisipha nokunikeza Imicu yotshani emathunjini umphumela antiemetic. Le mishanguzo zihlanganisa: "metoclopramide" (abamele isizukulwane sokuqala - "Reglan" futhi "Raglan"), "bromopride", "Domperidone" (second generation), "Dimetpramid", "Itopride".

izidakamizwa Prokinetic, asetshenziswa ukwelapha isifo gastroezofagialnoreflyuksnoy (Gerd), YAZHDPK, dyspepsia, uhlamvu obusebenzayo, ukuvaleka emphinjeni ngemva ukulimala futhi ngenxa ukuvuvukala, nasezinkingeni ezilandela ngemva kokuhlinzwa paresis kokungenela esiswini, ukuphazamiseka outflow ka Bile, ukubuyisa.

Futhi prokinetics - izidakamizwa ukuthi ingasetshenziswa Ukucanuzela kwenhliziyo nokuhlanza okubangelwa ushevu noma ukwephulwa imithetho ukudla, izifo omsakazo amagciwane, kwabakhulelwe senyanga yokuqala, acute esingamahlalakhona senhliziyo, ikhanda ukuhlukumezeka, izinzwa, welashwa ngemisebe nangamakhemikhali. Kuphumelele nokuhlanza imvelaphi vestibular, njengoba akuthinti maphakathi nendlebe kanye oblongata medulla.

Antipsychotics ukusiza nge ukuhlanza

"Sulpiride" futhi "Levosulpirid", kuyinto neuroleptic nge indlela efanayo isinyathelo, futhi ibe nomphumela anti-emetic omuhle, ngakho ingasetshenziswa umkhuba gastroenterological.

"Metoclopramide" (prokinetics): yokusetshenziswa

"Metoclopramide" - a stimulator oqondile kwemisipha bushelelezi futhi zonke izakhiwo ezidingekayo ukuze kuzuzwe imiphumela emtholampilo abalulekile, kodwa ngenxa permeability gematogistologicheskie izithiyo kufanele siyisebenzise ngokuqapha. Okungenzeka komzimba okufana spasm we izicubu ezithile ebusweni, lo uphawu "izinyawo likhale sika", protrusion komqondo ulimi, bulbar neziyaluyalu, imisipha zibe ekrtraokulyarnyh, torticollis spasmodic, ithoni ngokweqile kwemisipha extensor, Parkinson syndrome, somnolence, ubuthakathaka, tinnitus, ukuphathwa ikhanda, ukukhathazeka, nokudideka.

Kwezinye izimo, efiselekayo ukuthatha prokinetiki? Iziyalezo ukusetshenziswa wathi ukusetshenziswa engathandeki ezimeni hypersensitivity kuya izidakamizwa, isimila we- cortex adrenal, isimiso emathunjini, perforation wamathumbu ngibabuyisele ukopha prolaktinozavisimoy izimila, isithuthwane futhi iziyaluyalu extrapyramidal, amasonto 16 esesibelethweni yengane, ngesikhathi lactation, izingane ezingaphansi kweminyaka iminyaka 5. Okumele kuqashelwe kufanele libekwe endaweni imvume esincishisiwe creatinine, kukhuphuke blood pressure, isifuba somoya, abaneminyaka kuze iminyaka 14.

Ukugwinya umuthi isigamu sehora ngaphambi kokudla, esibhebheni at 9:00, 12:00, 15:00 no 18:00. Ubude besikhathi sokwelashwa - amasonto amane kuya kwayisithupha, ngezinye izikhathi kungase kube enwetshiwe sikhatsi lesingaba tinyanga letisitfupha.

Uma ifomu Ukukhululwa - ketshezi, iqondiswa intramuscularly noma ngemithambo yegazi. Kubantu abadala kanye nezingane engaphezu kwengu-14 - 10 mg. Ubuningi ngayinye esisodwa - 20 mg umthamo wansuku - mg 60. Okuqukethwe ampoule kungenziwa buhlanjululwe in nosawoti isotonic noma 5% isixazululo glucose.

"Domperidone": yokusetshenziswa

"Domperidone" ekhetha ngaphezulu Dopamine yokwamukela blocker, ngaphandle ngokungalidli zingene Bbb Kodwa lapho yokwamukela angakhuli imiphumela emibi kuchaziwe ngenhla. Nokho, okwandisa uketshezi of prolactin, ke icuphe gynecomastia, galactorrhea, futhi ukungabi khona menses. Ngaphezu kwalokho, iziguli labika ukuqubuka kwesikhumba, nomlomo owomile, isifo sohudo kanye nekhanda.

Akunconyelwe ukusetshenziswa abantu komzimba nezinto izingxenye imithi, ngopha pheshana emathunjini, isimiso emathunjini, prolactinoma, lactation, ubudala kuze iminyaka 5 ubudala noma nesisindo 20 amakhilogramu. Okumele kuqashelwe ukuthatha ngesikhathi sokukhulelwa, kwezinso kanye / noma esingamahlalakhona hepatic.

Phuza imizuzu amabili ngaphambi kokuba udle ngalinye 10 mg, uma kudingeka, futhi ziphuze ngaphambi kokulala. Umthamo esiphezulu ngelanga - 80 mg. Uma ekhona ekwelapheni antacids, ukunciphisa uketshezi of juice esiswini, kufanele behlukile domperidone ukuphuza, ngidla ukudla.

"Itopride": yokusetshenziswa

"Itopride" ihlanganisa izakhiwo omelene Dopamine yokwamukela kanye blocker ka acetylcholinesterase. Kuthinta ohlelweni hypothalamic-pituitary-adrenal, okwandisa lokuhlala somatostatin futhi ukunciphisa i-hormone adrenocorticotropic. A nomphumela ongemuhle sivezwe njengoba leukopenia, thrombocytopenia, hypersensitivity ukusabela, hyperprolactinemia, isicanucanu, liqhaqhazela, jaundice. Ngesikhathi yokwamukela, kubalulekile ukuqapha isimo igazi neuropathy, futhi ukuqinisekisa ukuthi azikho engemihle.

Akunconyelwe abantu hypersensitivity ohlobo ngokushesha noma imisiwe, emathunjini umlando ukopha, obturating mafutha anciphisa isikhala esingaphakathi emathunjini noma kokucindezelwa sehlangano bezinye izizwe abavela emaqenjini ngaphandle, ngaphansi kweyishumi nesithupha, ukukhulelwa, ibele.

Umuthi esithathwayo ngomlomo ngaphambi ukudla 50 mg kathathu ngosuku.

Abamelene "acetylcholine"

Leli qembu kuhlanganisa:

• "Aceclidine" (M-cholinomimetic);
• "Fiziostigmin" "Galantamine" "Tegaserod" "Prucalopride" (esethola cholinesterase inhibitor)

Le mithi basonta kuphela ingxenye inkampani ka prokinetics ngenxa emibi yawo: nemiphumela exchange of potassium ion, futhi ngenxa yalokho, ayewukela isikhawu qt, okuholela thuthuva isigqi inhliziyo. Inani izidakamizwa sebehoxisiwe ekubeni emakethe kwemithi ngenxa yalesi sizathu.

"Aceclidine": yokusetshenziswa

Prokinetics - kuyini, kanjani futhi nini ukuwasebenzisa? Kunoma yikuphi, qiniseka ukuthi uye kudokotela uyofuna icebiso kanye cwaningo unake imiyalelo ukusetshenziswa.

"Aceclidine" lisetshenziswa ukugwema ukulahleka ithoni ipheshana wokugaya ukudla bese esinyeni emva kokuhlinzwa, kunciphisa ingcindezi intraocular, zingaba ingasetshenziswa zamehlo. Umkhiqizo Ifomu - umjovo, ijovwe phansi kwesikhumba nge 2.1 ml isixazululo 0.2%. Max ngesikhathi - 0.004 g, nge nsuku zonke hhayi ningi than 0.012, imiphumela emibi - ptyalism, ukujuluka, uhudo.

Izimo ukusetshenziswa kukhona CHD, HDL ephakeme, isifuba somoya bronchial, nezinye hyperkinesias parkinsonism, ukukhulelwa, ngopha komgodi ongaphakathi kwamathumbu.

"Fiziostigmin" lisetshenziswa kakhulu practice amehlo, kodwa ngezinye izikhathi ukusebenzisa Gastroenterology at the paresis emathunjini. Umuthi injected ngaphansi kwesikhumba 0.5 - 1 ml isixazululo 0.1%. Inani eliphelele zomuthi ngelanga kumele singeqi 0,001 g

ukungaphathwa kahle imithi kuba ube ukuqina amathe, bronchospasm, spasm emathunjini kwemisipha, izinguquko kwenhliziyo, Ukudlikizela.

Contra-izinkomba: angina, isithuthwane, isifuba somoya, mechanical isimiso emathunjini, peritonitis, sepsis, ukukhulelwa.

"Galantamine": yokusetshenziswa

"Galantamine" ezindabeni ezithile isetshenziswa njengenhlangano omelene ngoba imisipha relaxants esikhathini postoperative nokungawuvivinyi ngokwanele imisipha ithoni wamathumbu futhi avikele ulwelwesi lwesinye. Izimo ukusetshenziswa kukhona hypersensitivity, isithuthwane, isifuba somoya, umfutho wegazi ngenhla 139/99 mmHg, COPD, occlusion mechanical uvule imbobo emathunjini, kwezinso umsebenzi ukungakhuli, iminyaka engu-9. Kunqunyelwe injongo sokukhulelwa ezimweni lapho efanele ibe kuhlu lokuhlukumezeka ezingase zibe zinkulu izinzuzo. Phakathi lactation, angadluliselwa ingane ngokusebenzisa ubisi.

Imiphumela engemihle: nokwehlisa izinga lokushaya kwenhliziyo, TTP, AV ukuvinjelwa, arrythmia, isicanucanu, ukuhlanza, uhudo, dyspepsia, imisipha zibe, incontinence urinary, haematuria, ukuzamazama.

Kungase esizosingathwa phansi kwesikhumba, intramuscularly, ngemithambo yegazi, transdermally, ngomlomo. I umthamo kushintshwe ngamunye, ngokusekelwe umlando lesi sifo, futhi kufanele lilungiswe udokotela ukuba khona. isilinganiso I umthamo wansuku zonke abadala - kusuka 10 kuya 40 mg, lahlukaniswa ezine Ukweqiwa.

Isizukulwane esisha prokinetics

Ngesisekelo namuhla Itopride ukukhiqiza izidakamizwa ezifana "Ganaton", "Itomed", "Pramer". Omunye entsha futhi ephumelela kunazo yilezo prokinetiki isizukulwane esisha ngokuthi "koordinaks" futhi "Prepulsid". Nakuba bangakwazi nemiphumela engemihle enhliziyweni.

Ethandwa kakhulu phakathi gastroenterologists uhlala "Motilium" (esebenzayo isithako - domperidone), elihlanganisa izinga metoclopramide, kodwa akanayo nemiphumela yako emibi.

Yiziphi pprokinetiki ziphumelela kakhulu? Uhlu imikhiqizo manje kuhlanganisa:

1. "Itopride" (isithako esebenzayo) - "Ganaton", "Itomed", "Primer" (igama commercial).
2. "Metoclopramide" - "Raglan" "Reglan".
3. "Cisapride" - "koordinaks", "Prepulsid".
4. "Domperidone" - "Motilium", "Motilak", "Motinorm", "Passazhiks".

Manje sesiyazi ukuthi prokinetic ezinjalo. Zibhaleni phansi njengoba ubona, inkulu kakhulu. Kodwa khumbula, ngaphambi kokusebenzisa noma yimuphi umuthi kufanele bonana nodokotela wakho kuqala! Hlala uphilile!