Verapamil ndi mankhwala abwino kwambiri ochizira matenda a mtima. Chifukwa amachepetsa mitsempha ya mtima ya thupi ndi thupi lonse, ili ndi ntchito zambiri zamagetsi. Koma kuwonjezera pa kugwiritsa ntchito zambiri, mlingo wanu wa verapamil uyenera kuyang'aniridwa mosamala chifukwa mankhwalawa amawopsa kwambiri ndipo akhoza kukhala ndi mavuto aakulu. Mwachitsanzo, kuyamwa mwangozi kwa piritsi limodzi ndi mwana kungawonongeke.
Njira yogwira ntchito
Verapamil ndi njira ya calcium (antiagonist) yomwe imachepetsa kulowa kwa ma calcium ions kudzera mu L-mtundu wa calcium njira yomwe ili m'maselo a mtima ndi maselo osakanikirana a mlengalenga.
Verapamil ili ndi zotsatira zambiri za thupi:
- Vasodilation ya m'mimba komanso m'mitsempha ya mitsempha ndi arterioles
- Kuchepetsa kugonana kwa mtima
- Kusokonezeka maganizo kwa chithunzithunzi ntchito
- Kuchepetseratu kondomu ya atrioventricular node
Kuwonjezera pa zotsatirazi zapamwamba, verapamil imasokoneza mphamvu ya mphamvu ya maselo a mtima, kuwonjezera mtima kudalira pa chakudya kusiyana ndi kutulutsa mafuta acids. Kuwonjezera pamenepo, verapamil imalepheretsa kupangika kwa insulini. Kusintha kwakukulu kwachiwiri kumeneku kumakhala kotchulidwa makamaka panthawi yomwe thupi limasowa chakudya.
Metabolism
Verapamil imathandizidwa bwino kudzera m'matumbo a m'mimba ndipo imagawanika m'thupi lonse (90 peresenti ya mapuloteni).
Pachiyambi choyambitsa mitsempha, verapamil yathyoledwa ndi chiwindi kupita ku metabolite yogwira ntchito. Hafu ya moyo wa Verapamil ili pafupi maora asanu ndi atatu.
Ntchito zachipatala
Chifukwa cha zotsatira zake pamtima ndi m'thupi (chotengera cha magazi), verapamil ali ndi ntchito zambiri. Nazi zina zomwe amagwiritsira ntchito verapamil:
- Angina (otsika, osakhazikika ndi a Prinzmetal)
- Supraventricular tachcarcardia
- Zochitika za Raynaud
- Migraine prophylaxis
- Cluster mutuache prophylaxis
- Zoipa kapena zosokoneza matenda
Verapamil ndi mankhwala osokoneza bongo. Asanagwiritse ntchito mankhwalawa kuti agwiritse ntchito maselo a arrhythmias, propranolol ndi digoxin nthawi zambiri amagwiritsidwa ntchito.
Zotsatira Zoipa ndi Kuyanjana kwa Mankhwala
Ngakhale kuti sizowoneka pansi pa kuyang'anitsitsa kwa katswiri wa zamoyo, zowopsa kwambiri nthawi zonse zimakhudzidwa. Kuwonjezera pa zotsatira zake zovuta, verapamil ingagwirizanenso ndi mankhwala osiyanasiyana osiyanasiyana.
Zotsatira zovuta kwambiri za katemera ndizo kuvomereza. Kwa anthu ena, verapamil ingayambitse chizungulire, mutu wautali, ndi hypotension. Panthawi yowonjezereka, verapamil imasokoneza chigamulo cha mtima ndipo ikhoza kuwonongera moyo.
Nazi zina zothandizira mankhwala osokoneza bongo omwe amatanthauza:
- Verapamil amagwiritsira ntchito beta-blockers, nitrates ndi diuretics ya magazi amachititsa kuti magazi anu azigwa mosavuta (hypotension).
- Verapamil ikhoza kuonjezera zotsatira za statins, zomwe zimagwiritsidwa ntchito pochizira cholesterol, ndipo statins ikhoza kuyambitsa rhabdomyolysis kapena kupweteka kwa mitsempha yomwe imawomba ndi impso.
- Verapamil imagwiritsidwa ntchito kwambiri ndi mavitamini a cytochrome P450 komanso kugwiritsa ntchito mankhwala oyenera monga amiodarone (mankhwala enaake) amachititsa kuti P450 iwonongeke poizoni. Kuonjezerapo, madzi amtundu wa mpesa amakhudzanso njira ya P450 ndipo amatha kuwonjezereka magazi.
Chonde kumbukirani kuti pamene agwiritsidwa ntchito ngati akulangizidwa komanso mosamala, verapamil ikhoza kukhala yopindulitsa kwa iwo omwe amafunikira. Zomwe zili m'nkhaniyi sizitanthauza kukuopani inu kugwiritsa ntchito verapamil mukalangizidwa. Komabe, muyenera kumvetsera malangizo a katswiri wanu wa mankhwala pamene mukugwiritsa ntchito mankhwalawa, kapena mankhwala ena onse.
Ngati inu kapena wokondedwa wanu mutenga verapamil, nkofunika kuti muziyang'aniritsidwa mosamala ndi momwe mukudziwiratu katswiri wa zamoyo. Pangani zokonzekera kafukufuku wokhazikika ndi katswiri wanu wa cardiologist ndipo onetsetsani kuti mum'dziwitse dokotala za kusintha kulikonse mu mankhwala a mankhwala monga kuphatikizapo mankhwala alionse.
Kuwonjezera pamenepo, ngati mukukumana ndi mavuto omwe angapangidwe ndi zochitika zowonjezereka ngati kutaya kapena kutaya nthawi pang'ono, funsani thandizo lachangu.
Zotsatira:
Lynch, T ndi Price, A. "Zotsatira za Cytochrome P450 Metabolism pa Mayankho a Mankhwala, Kuyanjana, ndi Zotsatira Zoipa" American Family Physician. 2007.
Mosby's Drug Reference kwa Maphunziro a Zaumoyo, Kachiwiri . Elsevier. 2010.
Tomaszewski CA, Benowitz NL. Mutu 40. Njira ya Calcium Antagonists. Mu: Olson KR. eds. Kuchepetsa & Kudyetsa Mankhwala Osokoneza Bongo, 6e . New York, NY: Hill ya McGraw; 2012.