Nitrates akhala akuthandizira kwambiri pochiza angina kwa zaka zoposa 100. Masiku ano, nitrates amagwiritsidwa ntchito pothana ndi zizindikiro za angina (monga mawonekedwe a sublingual nitroglycerin kapena nitroglycerin mankhwala opatsirana), ndipo nthawi zonse (mu mapiritsi kapena ngati chikopa) kuti ateteze angina.
Kodi Nitrates Zimagwira Ntchito Bwanji?
Nitrates amagwira ntchito mwa kuchepetsa mitsempha ndi mitsempha, m'mtima komanso kwinakwake m'thupi.
Mitsempha yambiri ya magazi imachepetsa nkhawa pamtima, ndipo amachepetsa kuchuluka kwa mpweya womwe mtima umafuna. Kuchepetsa zofunikira za mtima wa mpweya kumapangitsa mtima kuchita zambiri popanda kupanga ischemia , ngakhale ngati magazi akuyenda kudzera mu mitsempha ya m'mimba imatsekedwa pang'ono ndi matenda a atherosclerosis .
Nitrates imathandizanso kuchepetsa mitsempha yamakono. Popeza kuti mitsempha yamakono yowonjezereka ikadakhululukidwa kale pamene chikwangwani cha atherosclerotic chikulepheretsa kuthamanga kwa magazi, izi zimagwiritsidwa ntchito moperewera kwa anthu omwe ali ndi matenda a mitsempha yamakono . Komabe, mwa anthu okhala ndi Prinzmetal angina - omwe makamaka amayamba chifukwa cha mitsempha yamakina - amchere amathandiza kwambiri.
Kodi Nitrates Zimagwiritsidwa Ntchito Bwanji?
Mankhwalawa (SL) nitroglycerin (nitroglycerin omwe amadziwika mofulumira kuchokera pansi pa lirime) ndi mtundu wakale kwambiri wa mankhwala a nitrate. SL nitroglycerin ndiyo njira yofulumira kwambiri yothetsera vuto la angina lomwe limabweretsedwa ndi zolimbitsa thupi kapena kupanikizika, ndipo kawirikawiri limapereka mpumulo mkati mwa mphindi zochepa.
Komanso, kutenga SL nitroglycerin musanayambe kuchita zinthu zomwe zingayambitse zizindikiro (monga kukwera phiri kapena kuyenda mu chimfine) zingathandize kupewa zigawo za angina. SL nitroglycerin imayamba kutambasula mitsempha ya magazi mkati mwa mphindi ziwiri, ndipo zotsatira zake zimatha mphindi 30.
Nitroglyerin spray, yoperekedwa pakamwa ndi chipangizo cha mlingo, imagwira ntchito mofanana ndi SL nitroglycerin - ndiyo njira yowonjezeramo yokha ya nitroglycerin.
Mankhwala otsika pang'ono (SL kapena zolembera) ayenera kunyamulidwa ndi aliyense amene akuchiritsidwa ndi angina.
Mankhwala otsika nthawi yaitali (mapiritsi kapena zikopa za khungu) amawoneka ngati njira yachiwiri ya mankhwala kwa angina. Iwo amalembedwa ngati beta blockers (mankhwala a mzere woyamba) sangathe kulekerera, kapena sangathe kuthetsa zizindikiro.
Mtundu wambiri wa mapiritsi wa nitrates ndi isosorbide dinitrate (Isordil, Sorbitrate). Ndi mankhwala otulutsa mawu, zotsatira pa mitsempha ya magazi zimayamba mkati mwa mphindi makumi atatu, ndipo zimatenga maola asanu ndi limodzi.
Kutsekemera kwa nitroglycerin mapepala, omwe amapereka nitroglycerin kudzera pakhungu, amapereka nitrate mankhwala othandiza kwa maola eyiti kapena 14.
Khalani Oleza Mtima
Vuto lalikulu ndi kugwiritsidwa ntchito kwa nthawi yaitali-nitrates wakhala chodabwitsa cha "kulekerera." Kulekerera kumatanthawuza kuti ubwino wa mankhwala a nitrate ukhoza kuchepetsedwa pamene nitrates imagwiritsidwa ntchito mozungulira koloko. Kulankhula mwachidule, pamene mitsempha ya magazi nthawi zonse imawonekera ku nitrates, imasiya kuchepa chifukwa cha nitrates, ndipo mphamvu yotsutsa ya mankhwala imatha.
Kulekerera kwachitsulo kungaletsedwe polemba ndondomeko ya mankhwala osaphatikizapo a nitrate kuti athe kupereka nthawi yopanda nitrate tsiku ndi tsiku.
Choncho: oral nitrates kapena nitrate zikopa ziyenera kugwiritsidwa ntchito kwa maola 12 kapena 16 patsiku, ndi ola lachisanu ndi chitatu kapena khumi ndi theka "nthawi yopanda nitrate". Kwa odwala ambiri izi zikutanthauza kuti nitrates amagwiritsidwa ntchito pa nthawi yokhazikika, osati pa nthawi ya tulo. Kwa odwala ena omwe ali ndi angina usiku, komabe nthawi yopanda nitrate ikhoza kukonzedwa panthawi yomwe akukwera.
Zozizwitsa Zina ndi Nitrates
Nitrates sayenera kugwiritsidwa ntchito kwa odwala omwe ali ndi hypertrophic cardiomyopathy (omwe nitrates amachititsa kuti chitetezo choopsya chizikhala mwazi mkati mwa mtima), kapena odwala omwe amatenga Viagra (sildenafil) kapena othandizira ena ofanana ndi erectile dysfunction.
( Kutenga nitrates ndi Viagra palimodzi kungabweretse mavuto ambiri - kuthamanga kwa magazi.)
Asiya amakhala ndi kuchepetsedwa kwa nitrates, ndipo sangapindule kwambiri ndi ntchito yawo.
Zotsatira zofala kwambiri za nitrates ndi kupweteka kwa mutu ndi kuthamanga, ngakhale kuti mutu wa hypotension ukhoza kuchitika. Odwala omwe ali ndi mbiri ya mutu wa mutu wa migraine sangathe kulekerera nitrates.
Zotsatira:
Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF / AHA / ACP / AATS / PCNA / SCS Guide of diagnosis and management of patients with stable ischemic disease disease: summary executive: report of the American College Association of Cardiology Foundation / American Heart Association pa ndondomeko zoyendetsera ntchito, ndi American College of Physicians, American Association for Thoracic Surgery, Association Preventional Nurses Association, Society of Cardiovascular Angiography and Interventions, ndi Society of Thoracic Surgeons. Kuthamanga kwa 2012; 126: 3097.