Amuna ambiri omwe ali ndi matenda a mtima angathe kutenga sildenafil mosamala
Viagra (sildenafil) yasintha njira yothandizira kugonana kwa amuna. Komabe, kugwiritsa ntchito kwake kwakhala koopsa kwa odwala omwe ali ndi matenda ena a mtima. Cholinga cha nkhaniyi ndikubwezeretsa kugwiritsa ntchito sildenafil moyenera mwa amuna omwe ali ndi matenda a mtima.
Zotsatira Zotsatira za Kutenga Sildenafil Ndi Matenda a Mtima
Sildenafil ali ndi zinthu ziwiri zomwe zingakhale zotsatira kwa odwala matenda a mtima.
Poyamba, ikhoza kuchepetsa kuthamanga kwa magazi. Chachiwiri, chimagwirizana ndi nitrates.
Sildenafil ndi vasodilator (ndiko kuti, mankhwala omwe amatsitsa mitsempha ya magazi ), ndipo chifukwa chake, amachepetsanso mphamvu ya magazi ("pamwamba" muyeso ya magazi) ndi pafupifupi 8 mmHg. Odwala ambiri omwe ali ndi matenda a mtima, kuphatikizapo ochuluka omwe akudwala mankhwala osokoneza bongo, izi sizili vuto. Kafukufuku wasonyeza kuti zotsatira za zotsatira zake (kuphatikizapo zotsatira zokhudzana ndi kuthamanga kwa magazi, monga chizungulire ndi kutaya) sizowonjezereka kwa ogwiritsa ntchito sildenafil omwe akugwiritsanso ntchito mankhwala osokoneza bongo.
Komabe, zotsatira za valadilating za sildenafil zimakhala zoopsa pamene zimagwiritsidwa ntchito ndi vasodilating zotsatira za nitrates, mankhwala omwe amagwiritsidwabe ntchito kwambiri kwa odwala matenda a mitsempha. Odwala omwe amatenga nitrates ndi sildenafil amakhala ovuta kwambiri ( kuthamanga kwa magazi ) komanso syncope (kutaya mtima). Odwala omwe amatenga nitrates ku matenda awo a umuna, sayenera kutenga sildenafil.
Komanso, aliyense amene watenga sildenafil m'maola 24 apitayo sayenera kutenga nitrates.
Sildenafil itayamba kufotokozedwa kumapeto kwa zaka za m'ma 1990, mbiri ya matenda a mtima ndi imfa yadzidzidzi atatha kumwa mankhwalawa inapezeka pa nkhani zonsezi. Kafukufuku wotsatira akusonyeza kuti, odwala osatenga nitrates , kugwiritsa ntchito sildenafil kwa odwala omwe ali ndi matenda oopsa a mitsempha sikumayambitsa chiopsezo cha mtima kapena imfa.
Ngakhale kuti zochitikazi zimachitika makamaka kwa odwala omwe ali ndi matenda a mitsempha yamtenda , vuto lawo silikula kuposa odwala omwe amatenga sildenafil.
Zoonadi, sildenafil imawoneka bwino kulekerera mwa amuna omwe ali ndi matenda oopsa a mitsempha, malinga ngati iwo alibe mphamvu ya ischemia (nthawi yomwe mtima wa minofu sukutenga magazi oyenerera, omwe nthawi zambiri amawoneka ndi kupweteka pamtima ) sakutenga nitrates. Komanso, sildenafil sichititsa kuti pakhale mwayi wochita masewera olimbitsa thupi kwa odwala omwe ali ndi matenda osokoneza ubongo.
Pali zinthu zina zomwe zimakhala zochepa kwambiri chifukwa cha kuchepa kwa magazi kotchedwa sildenafil. Odwala omwe ali ndi vuto lalikulu la mtima limodzi ndi mayendedwe ochepa a magazi angakhale oipitsitsa ngati magulu ambiri a hypotension apangidwa. Kuonjezerapo, odwala ena omwe ali ndi hypertrophic cardiomyopathy angakhale chizindikiro ngati mphamvu ya magazi imachepa.
Mfundo Yofunika Kwambiri
American College of Cardiology ndi American Heart Association amavomereza kuti sildenafil ndi yabwino kwa amuna omwe ali ndi matenda okhwima a mitsempha omwe samatenga nitrates koma sayenera kugwiritsidwa ntchito kwa odwala omwe akutenga nitrates. (Nitrates ndi mitundu yonse ya nitroglycerin - mazinthu ang'onoang'ono, transdermal ndi spray mitundu - komanso isosorbide mononitrate, isosorbide dinitrate, pentaerythritol tetranitrate, erythritol tetranitrate, ndi nitrate amyl.)
Tiyenera kukumbukira kuti, ngakhale m'mbuyomu nitrates anali maziko a chithandizo cha matenda a mitsempha, izi siziri choncho. M'nthaŵi ya angioplasty ndi stenting, matenda a mitsempha yamakono amatha kusamalidwa popanda kugwiritsa ntchito nitrates. Odwala omwe akuuzidwa nitrates komanso akufuna kutenga sildenafil ayenera kufunsa madokotala anu za mitundu ina ya mankhwala pa matenda awo a umphawi.
Palinso magulu ena a odwala mtima omwe sildenafil akhoza kukhala owopsa. Izi zimaphatikizapo odwala omwe ali ndi matenda osokoneza ubongo odwala matenda a mitsempha yamtunduwu (kapena, odwala omwe amatha kudwala matenda a mitsempha). Odwalawa, mwachiwonekere, ali ndi vuto lachipatala lomwe liyenera kukhazikika ngati sildenafil ikuganiziridwa.
Akagwiritsidwa ntchito mokwanira, kugwiritsa ntchito sildenafil (komanso njira zina zonse zamakhalidwe, moyo wa tsiku ndi tsiku monga masewero olimbitsa thupi) zingasangalatse.
Odwala ena omwe angakhale ndi vuto la sildenafil ndi omwe ali ndi vuto la mtima limodzi ndi malire otsika magazi , odwala omwe ali ndi hypertrophic cardiomyopathy, ndipo mwina, odwala omwe ali ndi matenda ozunguza bongo.
Ndi zina zotere, sildenafil ingagwiritsidwe ntchito mosamala mwa odwala ambiri omwe ali ndi matenda a mtima.
Zotsatira:
Kostis JB, Jackson G, Rosen R, et al. Kusokonezeka kwa kugonana ndi chiopsezo cha mtima (Komiti yachiwiri ya Princeton Consensus). Am J Cardiol 2005; 96: 313.