Mankhwala a calcium ndi magulu akuluakulu a mankhwala ogwiritsidwa ntchito pochiza mavuto ambiri a mtima kuphatikizapo angina , matenda oopsa , tachycardia , ndi hypertrophic cardiomyopathy .
Mwachidule
Makina a calcium amachititsa kuti kashiamu lisaloŵe m'mitima ya minofu, ndipo mu maselo osalala omwe amachititsa kuti mitsempha ya magazi ikhale yovuta.
Pochepetsa kuchepa kwa calcium, njira zoteteza calcium zimayambitsa maselo a minofu kuti "asangalale." Zotsatira zotsitsimulazi zimabweretsa kusintha kwa mitsempha ya mitsempha, ndi mphamvu yochepetsedwa ya mitsempha ya mtima.
Zina mwazitsulo za calcium zimachepetsanso nthenda ya sinus komanso mlingo umene makompyuta amamva amatha kupyolera mu vesi la AV . Zotsatirazi zimapangitsa kuti calcium blockers ikhale yogwiritsidwa ntchito pochiza ena a arrhythmias .
Zotsatira zonse za calcium blockers (magazi m'thupi, kuchepetsedwa kwa mitsempha ya mtima, ndi kuchepa mtima kwa mtima) amachepetsa kuchuluka kwa mpweya umene ukufunika ndi minofu ya mtima.
Kuchepetsa kuchuluka kwa mpweya womwe amagwiritsidwa ntchito ndi mtima kumapangitsa mtima kugwira ntchito yaitali popanda kupanga ischemia , ngakhale pamene magazi akuyenda kudzera mu mitsempha yamakono imatsekedwa pang'ono ndi chikhomo cha atherosclerotic . Odwala odwala angina , calcium blockers amawonjezera kuchuluka kwa masewero olimbitsa thupi omwe angayambe angina asanachitike.
Mankhwala a calcium angakhale othandiza makamaka kwa odwala omwe ali ndi angina a Prinzmetal (mitsempha yamakono) chifukwa amatha kulepheretsa kusokoneza mitsempha yamakono.
Mitundu
Ambiri a kashiamu amakhala pamsika, ndipo si onse ofanana. Pali mitundu itatu yomwe amagwiritsidwa ntchito kwambiri ndi calcium blockers:
1) Dihydropyradines .
Mankhwalawa ndi nifedipine (Procardia, Adalat), nicardipine (Cardene), felodipine (Plendil), ndi amlodipine (Norvasc), amatchedwa dihydropyridines. Mankhwalawa amachititsa kuti mitsempha yamagazi iwonjezeke kwambiri komanso zotsatira zake zing'onozing'ono pamitima ndi mtima. Amathandiza kwambiri pochiza matenda oopsa.
2) Vutoli. Verapamil (Calan, Covera, Isoptin, Verelan) imakhudza mitsempha ya mtima ndipo imathandiza kwambiri kuchepetsa kuthamanga kwa mtima, koma zimakhudza kwambiri mitsempha ya magazi. Sizothandiza kwambiri pa matenda oopsa kwambiri koma ndi zabwino kwa angina ndi mtima wa arrhythmias.
3) Diltiazem. Diltiazem (Cardizem, Dilacor, Tiazac) amakhala ndi zotsatira zochepa pa minofu ya mtima ndi mitsempha ya magazi. Zimakhala zolekerera bwino kusiyana ndi zina zambiri za kashiamu
Ntchito
Chithandizo cha Angina
Mankhwala onse a calcium akhala akugwiritsidwa ntchito pochiza angina. Komabe, njira zambiri zomwe amagwiritsidwa ntchito pogwiritsa ntchito calcium ndi mitundu yambiri yogwiritsira ntchito diltiazem ndi verapamil, amlodipine, kapena felodipine.
Nifedipine, makamaka mawonekedwe ake afupipafupi, ayenera kupeŵedwa kwa odwala omwe ali ndi angina, chifukwa chakuti mankhwala omwe amachititsa kuti magazi azikhala ndi mankhwalawa amatha kuwonjezeka mu adrenaline, zomwe zimapangitsa kuti mtima ufike mofulumira, ndipo chifukwa cha kuchuluka kwa mtima wa oxygen ( zomwe zingapangitse mwayi wokhala ndi mtima wa ischemia).
Kawirikawiri, pamene calcium blockers ndi othandizira kuthetsa angina, iwo amawoneka kuti ndi otsika kwa beta blockers . Zotsatira zamakono zili:
- Anthu odwala calcium ayenera kuyesedwa ndi odwala omwe sangathe kulekerera beta blockers.
- Anthu odwala calcium ayenera kuwonjezeredwa kwa odwala omwe ali ndi matenda osokoneza bongo.
Zochita Zina Zofanana
- Kuthamanga kwa magazi. Dihydropyradine calcium blockers ndi ofunika kwambiri pochiza matenda oopsa, ndipo nthawi zambiri amagwiritsidwa ntchito ngati njira yoyamba ya mankhwala a Stage I. Werengani za kusankha "mankhwala" odwala matenda oopsa.
- Mkulu wamakono. Ma calcium blockers (makamaka verapamil) amachepetsa pang'ono ntchito ya kachilombo ka AV, ndipo kawirikawiri ndi ofunika kwambiri pochiza mndandanda wa arrhythmias umene umadalira kachidindo ka AV kuti apitirize. Makamaka, AV nodal reentrant tachycardia (mtundu wambiri wa supraventric arrhythmia) nthawi zambiri imatha kuyendetsedwa ndi chithandizo cha verapamil.
- Hypertrophic cardiomyopathy. Mankhwala a calcium angagwiritsidwe ntchito kuthandiza kuchepetsa "kuuma" kwa zotsalira za ventricle kwa anthu omwe ali ndi hypertrophic cardiomyopathy, ndipo mwa njira iyi akhoza kuchepetsa zizindikiro.
Zotsatira Zotsatira
Zotsatira zoyipa za calcium channel blockers zimaphatikizapo mutu, chizungulire, kuthamanga, ndi phazi ndi kutupa kwa mimba. Verapamil, makamaka, imayambitsanso kudzimbidwa.
Chifukwa chakuti amchere a calcium amachititsa kuchepetsa mphamvu ya kupachika kwa minofu ya mtima, ayenera kugwiritsidwa ntchito mosamala (ngati alipo) odwala omwe ali ndi vuto la mtima .
Ndi bwino kupeŵa verapamil ndi diltiazem mwa anthu omwe ali ndi bradycardia chifukwa mankhwalawa amachepetsanso kuchepa kwa mtima.
> Zotsatira:
> Gersh BJ, Maron BJ, Bonow RO, ndi al. 2011 ACCF / AHA Mndandanda wa Kufufuza ndi Chithandizo cha Hypertrophic Cardiomyopathy: Chidule Chachidule: Lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. Kuyendayenda kwa 2011; 124: 2761.
> Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF / AHA / ACP / AATS / PCNA / SCAI / STS Malangizo othandizira kudziwa ndi kuyang'anira kwa Odwala omwe ali ndi matenda oopsa a Ischemic Heart: Report of the American College of Cardiology Foundation / American Heart Association pazochita zoyendetsera ntchito, ndi American College a Amayi, American Association for Opera Opaleshoni, Opaleshoni Yachikondi Achirendo Association, Society of Cardiovascular Angiography and Interventions, ndi Society of Thoracic Opaleshoni. Kuthamanga kwa 2012; 126: e354.
> Mancia G, Fagard R, Narkiewicz K, ndi al. Mndandanda wa ESH / ESC Wotsogoleredwa ndi Kuthamanga Kwambiri kwa Mthupi: Task Force for Management of Arterial Hypertension ya European Society of Hypertension (ESH) ndi European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281.