Kawirikawiri, pali zifukwa ziwiri zomwe dokotala angakonde kukupatsani pa mankhwala kuti mukhale ndi mtima wambiri . Choyamba, arrhythmia ikhoza kukupangitsani kuti mukhale ndi zizindikiro, monga piratations kapena kumutu , ndipo mankhwala angakhale ofunika kuthetsa zizindikiro. Kapena, chachiwiri, arrhythmia ikhoza kuvulaza kapena kuopseza kuchita zimenezo. Ambiri a arrhythmias sakuchita zinthu ziwiri izi ndipo samafuna chithandizo chomwe chimagwiritsidwa ntchito ndi arrhythmia.
Ngati muli ndi arrhythmia yomwe imadalira chithandizo chamankhwala, pali magulu atatu a mankhwala omwe angakhale othandiza, malingana ndi mtundu wa arrhythmia womwe muli nawo. Gulu loyamba liri ndi mankhwala osokoneza bongo-mankhwala osokoneza bongo omwe amawathandiza kuthetsa ziwalo zosagwirizana ndi mtima. Yachiŵiri imakhala ndi mankhwala omwe amakhudza kachilombo ka AV , kamene kamagwiritsidwa ntchito makamaka kwa tachycardias (SVT). Gulu lachitatu liri ndi mankhwala osiyanasiyana omwe asonyezedwa kuti athetse chiopsezo cha imfa mwadzidzidzi kuchokera kumagido a mtima.
Mankhwala Osokoneza Bongo
Mankhwala osokoneza bongo ndi mankhwala omwe amasintha magetsi a mitsempha ya mtima, ndipo pochita zimenezo, amasintha momwe zizindikiro za magetsi zimafalikira pamtima. Popeza tachycardias (arrhythmias yomwe imachititsa kuti mtima ufike mofulumira) kawirikawiri imagwirizana ndi zosavuta mu chizindikiro cha magetsi, mankhwala omwe amasintha chizindikiro cha magetsi amatha kusintha ma arrhythmias.
Mankhwala oletsa antiarrhymic amagwira bwino ntchito, makamaka pochita zinthu zosiyanasiyana, pochiza mitundu yambiri ya tachycardias.
Mwamwayi, mankhwala osokoneza bongo monga gulu amachititsa kuti poizoni a mtundu umodzi aziwopsa, ndipo zotsatira zake, zingakhale zovuta kutenga. Mankhwala amatsinje aliwonse amadziwika okha, ndipo asanayambe kumwa mankhwalawa, m'pofunika kuti dokotala adziwe bwinobwino zomwe zingatheke ndi mankhwala osankhidwa.
Komabe, pali vuto limodzi loopsya lomwe limakhala lofala pafupifupi mankhwala onse opatsirana pogonana: Nthawi zina mankhwalawa amachititsa kuti chiwerengerochi chikhale choipa m'malo mokhala bwino.
Mbali imeneyi ya mankhwala osokoneza bongo omwe amatchedwa "proarrhythmia" -kuwoneka kuti ndi mankhwala enieni a mankhwala omwe amasintha chizindikiro cha magetsi. Mwachidule, mutasintha kanthu komwe kayendetsedwe ka magetsi kakufalikira pamtima, nkotheka kuti kusinthako kumapangitsa tachycardia kukhala yabwino, kapena kuipira.
Amagwiritsiridwa ntchito mankhwala osokoneza bongo amagwiritsa ntchito amiodarone (Cordarone, Pacerone), sotalol (Betapace), propafenone (Rhythmol), ndi dronedarone (Multaq).
Amiodarone ndi mankhwala ogwiritsira ntchito mankhwala osokoneza bongo komanso amalephera kuyambitsa mankhwala osokoneza bongo kusiyana ndi mankhwala ena. Mwamwayi, mitundu ina ya poizoni yomwe imapezeka ndi amiodarone ikhoza kukhala yonyansa kwambiri, ndipo mankhwalawa ayenera kugwiritsidwa ntchito (monga mankhwala osokoneza bongo) pamene kuli kofunika kwambiri.
Mfundo yaikulu ndi yakuti madotolo ali-ndipo ayenera kukhala osayenerera kupereka mankhwala osokoneza bongo. Mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha ngati arrhythmia ikupereka zizindikiro zazikulu kapena ikuwopsyeza moyo wathanzi.
Mankhwala Osokoneza Bongo a Nodal
Mankhwala otchedwa AV nodal omwe amaletsa mankhwala osokoneza bongo- beta blockers , calcium channel blockers , ndi digoxin-ntchito mwa kuchepetsa mphamvu ya magetsi pamtima pamene ikudutsa muzithunzi za AV pochoka ku atria kupita ku ventricles.
Izi zimapangitsa mankhwala oletsedwa a AV omwe amathandiza kwambiri pochiza SVT. Mitundu ina ya SVT (mwachindunji, AV nodal reentrant tachycardia ndi tachycardias zomwe zimayambitsidwa ndi timapepala), zimafuna kuti kachilombo ka AV kayendetse bwino magetsi, ndipo ngati nthenda ya AV ingapangidwe kuti ipangitse kayendedwe ka magetsi pang'onopang'ono, SVT imangokhala imasiya.
Kwa SVT yomwe imadziwika kuti matenda a atrial fibrillation , mankhwala osokoneza bongo a AV samayimitsa magazi , koma amachepetsa kuthamanga kwa mtima kuti athetse zizindikiro. Ndipotu, kuchepetsa vuto la mtima ndi mankhwala osokoneza bongo a AV ndi njira yabwino kwambiri yogwiritsira ntchito mankhwala opatsirana pogonana .
Mankhwala Ochepetsa Matenda Akumfa Mwadzidzidzi
Mankhwala ochepa amalingalira kuti amachepetsa kufala mwadzidzidzi, mwinamwake pochepetsa chiopsezo cha ventricular tachycardia kapena ventricular fibrillation , arrhythmias yomwe imapangitsa mtima kumangidwa .
Kafukufuku amasonyeza kuti beta blockers mwina amachepetsa chiopsezo cha imfa mwadzidzidzi mwa kulepheretsa zotsatira za adrenaline pamutu wa minofu, motero kuchepetsa mwayi wopanga arrhythmias wakupha. Odwala onse amene apulumuka mtima kapena omwe ali ndi mtima wolephera ayenera kutenga beta.
Chosavuta kufotokozera ndi kuchepetsa imfa yadzidzidzi yomwe inalembedwa ndi odwala omwe amazitenga mafinya , kapena omwe amadya omega-3 fatty acids, koma mankhwalawa akuwoneka othandiza.
> Zotsatira:
> Perekani AO. Mapulogalamu a Ion a Cardiac. Circ Arrythm Electrophysiol 2009; 2: 185.
> Gambit ya Sicilian. Njira Yatsopano Yopangidwira Mankhwala Osokoneza Bongo Akumenyedwa pa Zochita zawo pa Njira za Arrhymmogenic. Task Force of Working Group pa Arrhythmias a European Society of Cardiology. Kuthamangitsidwa 1991; 84: 1831.