Mndandanda wa mankhwala antiarrhythmic ndi gulu lawo

Pafupifupi odwala onsewa njira cardiologist kapena wina ndi mitundu yosiyana arrhythmias. Panopa, makampani mankhwala amapereka zosiyanasiyana wothandizila antiarrhythmic. Awo gulu ndi makhalidwe m'nkhani ino nkhani.

njira kukhudzana

Pofuna kuthetsa ectopic arrhythmias mtima, wothandizila antiarrhythmic akutumikira. Limagwirira cha zochita za mankhwala umalimbana ntchito m'mnyewa wamtima electrophysiological katundu maselo:

• Kuchepetsa liwiro angathe kuchitapo kanthu, potero liwiro conduction wa malemeredwe.
• The kuchepa excitability wa myocardium lapansi.
• Kuchepetsa nthawi imene refractory wachibale, chifukwa mu kufupikitsa imeneyi, pamene ndi kugula zapadera zimachititsa mtima chidule.
• Elongation ogwira refractory nthawi, chimene chiri chofunika pamene tachycardias ndi kuchotsa nyemba zimachitika pambuyo yochepa kwambiri pambuyo kuchepetsa akadakwanitsira.
• mlingo mphamvu malemeredwe zimene zimalimbikitsa homogenization ndiponso kupewa chodabwitsa kukonzanso kulowa ( «kukonzanso kulowa").
• Chopinga wa ectopic automatism chipinda chokhudzana ndi kutambasuka kwa nyengo ya depolarization diastolic.
• Kuthetsa kusiyana mlingo wa malemeredwe ndi zizindikiro refractivity.
• Yafupika mtima kudziwa kumaliseche magetsi ndi chiopsezo fibrillation yamitsempha yamagazi.

Gulu la mankhwala antiarrhythmic

mankhwala onse gulu lino magulu anayi. Komanso, kalasi yoyamba lagawidwa zambiri subclasses atatu. Gawo ili zachokera pati mmene mankhwala pa luso la maselo mtima kuti akwanitse kupanga ndi conduction wa chizindikiro magetsi. magulu osiyanasiyana a mankhwala antiarrhythmic ndi maulendo awo kukhudzana, kotero mu osiyanasiyana arrhythmias mogwira mtima wawo udzakhala wosiyana.

Kalasi yoyamba zikuphatikizapo kudya ndi sodium njira blockers. IA kalasi zikuphatikizapo mankhwala monga "quinidine" "Dizopiramid", "novokainamid", "Giluritmal". Ndi IB subclass chimakwirira "Piromekain", "tocainide", "Difenin" "lidocaine wa", "aprindine", "Trimekain", "Mexiletine." Subclass IC kupanga zida monga "Etmozin", "Ritmonorm" ( "Propafenone"), "VFS" "Etatsizin", "Flecainide", "Indekainid", "Bonnekor", "Lorkainid".

The chachiwiri kalasi tichipeza beta-blockers ( "metoprolol", "nadolol," "alprenolol," "Kordanum", "Propranolol", "acebutolol", "Pindolol", "Trazikor", "Esmolol").

M'kalasi yachitatu zikuphatikizapo potaziyamu njira blockers "bretylium tosylate", "Amiodarone", "Sotalol".

Kalasi yachinayi zikuphatikizapo blockers kashiamu njira pang'onopang'ono (mwachitsanzo, "Verapamil").

List of odana arrhythmic mankhwala sikuthetsa kumeneko. Ndalama komanso ndi mtima glycosides, mankhwala enaake potaziyamu, sodium triphosphate, magnesium sulphate.

Mankhwala kalasi yoyamba

Sodium njira blockers yobereka kudya ndi anaima khungu la sodium, zomwe zimabweretsa retardation za ndime ya myocardium malemeredwe timaganiza. Kudzera mwa cropped zinthu kufalitsa mofulumira mu mtima wa chizindikiro pathological, ndi arrhythmia mwawo. Tiyeni tikambirane gulu la mankhwala antiarrhythmic wachokera ku kalasi loyamba.

Mankhwala Maphunziro IA

mankhwala Antiarrhythmic anaikidwa pa extrasystole (yamitsempha yamagazi ndi supraventricular) ndi kubwezeretsa nkusani mungoli vuto la matenda fibrillation (matenda fibrillation). Komanso, iwo ntchito popewa kuukira kobwereza.

"Procainamide" ndi "quinidine" - ogwira antiarrhythmic mankhwala ndi tachycardia. Ife angakuuzeni zambiri za iwo.

"Quinidine"

mankhwala ntchito ngati paroxysmal supraventricular tachycardia, komanso paroxysms wa fibrillation matenda ndi nkusani mungoli. Nthawi zambiri mankhwala kutumikiridwa mu mawonekedwe a mapiritsi.

Poizoni mankhwala antiarrhythmic kawirikawiri zimachitika, koma pamene kulandira "Quinidine" chingachitike mbali monga chisokonezo m'mimba (kusanza, kutsekula m'mimba), ndipo mutu. Komanso, kugwiritsa ntchito mankhwala akhoza kuyambitsa kuchepa madzi a magazi kupatsidwa zinthu za m'mwazi, intracardiac conduction liwiro, kuchepetsa m'mnyewa wamtima contractility. The owopsa mbali zotsatira - chitukuko cha tachycardia yamitsempha yamagazi, mwapadera, zomwe zingachititse imfa yadzidzidzi ya wodwala. N'chifukwa chake chithandizo "quinidine" ayenera kuchitidwa kokha ndi ulamuliro wa ECG ndi kuyang'aniridwa ndi katswiri.

Mankhwalawa ndi contraindicated mu intraventricular ndi atrioventricular chipika, mtima glycoside kuledzera, thrombocytopenia, hypotension, congestive kulephera mtima, mimba.

"Procainamide"

Izi mankhwala ali ndi zizindikiro zofanana ntchito monga "quinidine". Nthawi zambiri izo Kwalamulidwa kwa cholinga mpumulo wa paroxysmal matenda fibrillation. Pamene mtsempha jekeseni "novokainamid" zotheka lakuthwa kuchepetsa magazi choncho m'pofunika kuti atchule njira anali pang'onopang'ono pazipita.

Mwa mavuto kusiyanitsa nseru, kusanza, kusintha mu magazi, matenda ya ubongo mu mawonekedwe a chizungulire, kupweteka kwa mutu, mu nthawi zina, chisokonezeko. Ngati inu ntchito mankhwala mosalekeza, akhoza kukhala lupus ngati syndrome (serozity, nyamakazi, malungo), tizilombo tating'onoting'ono matenda mkamwa, limodzi ndi machiritso pang'onopang'ono mabala ndi zilonda, ndiponso magazi m'kamwa. Komanso, "novokainamid" kungakhale sayanjana, Pankhaniyi adzakhala chizindikiro choyamba cha yatsoka kufooka minofu popereka mankhwala.

Ikani mankhwala ndikoletsedwa pamene atrioventricular chipika, aakulu aimpso ndi mtima kulephera, hypotension ndi cardiogenic mantha.

IB kalasi

mankhwala kwenikweni pa nkusani mfundo, kugwirizana atrioventricular ndi atrium, kotero operewera pa nkhani ya arrhythmias supraventricular. Kuikidwa ndi deta mankhwala antiarrhythmic ndi arrhythmia, paroxysmal tachycardia, ie, zochizira arrhythmias yamitsempha yamagazi. Iwo amagwiritsidwa ntchito pofuna kuchiza arrhythmias, amene amayamba ndi ambiri osokoneza wa glycosides mtima.

Mndandanda wa mankhwala antiarrhythmic mu kalasi ndi yaikulu kwambiri, koma amatanthauza "lidocaine wa" amagwiritsidwa ntchito kwambiri. Childs, ndi kutumikiridwa m'nsinga ngati arrhythmias aakulu yamitsempha yamagazi mu T. H. Mu infarction m'mnyewa wamtima.

"Lidocaine wa" akhoza kusokoneza ntchito kwa wamanjenje dongosolo, amene akuwonekera chizungulire, khunyu, mavuto ndi kulankhula ndi masomphenya matenda a kutsitsimuka. Ngati ife timathandiza mankhwala mu mkulu Mlingo, zavuta wodekha mtima mlingo, utachepa mtima contractility. Komanso, thupi lawo siligwirizana ndi ayenera kupanga angioedema, urticaria, pruritus.

"Lidocaine wa" ali contraindicated mu chipika atrioventricular, odwala nkusani syndrome. Mankhwala si mmene zinachitikira aakulu arrhythmias supraventricular chifukwa pa choopsya fibrillation matenda chinakula.

kalasi IC

Mankhwala yoperekedwa kwa kalasi, kuwonjezera intracardiac conduction, makamaka njira Yake-Purkinje. Iwo amphamvu arrhythmogenic katundu, kotero tsopano awo ntchito yochepa.

List of antiarrhythmic mankhwala izi kalasi zapatsidwa pamwambazi, koma makamaka ntchito kokha "Propafenone" ( "Ritmonorm"). Iwo anasonyeza kuti arrhythmias supraventricular ndi yamitsempha yamagazi, mu syndrome H. Mu SVC Vol.. Popeza pali chiopsezo cha zotsatira arrhythmogenic, mankhwala ayenera kugwiritsidwa ntchito pa dokotala kuyang'aniridwa.

Kuwonjezera arrhythmia, mankhwala akhoza kuyambitsa Kukula kwa matenda a mtima ndi akuchuluka wa contractility mtima. Pakati mbali zotsatira akhoza kukhala wolemekezeka maonekedwe zachitsulo kukoma m'kamwa, kunyansidwa ndi kusanza. Si lilibe zotsatira oipa amenewa, monga kusawona bwino, kusintha atayezetsa, chizungulire, tulo, kuvutika maganizo.

Beta-blockers

Pamene kumawonjezera kamvekedwe ka mantha dongosolo wachifundo Mwachitsanzo, mu nkhani ya nkhawa, matenda oopsa, matenda autonomic, ischemia, mu magazi, pali zambiri makatekolamaini, kuphatikizapo zikuwonjezereka masiku ano. zinthu izi kuchita zolandilira beta-adrenergic wa myocardium yopita ku mtima Kusakhazikika magetsi ndi maonekedwe a arrhythmias.

Beta-blockers kuteteza kukondoweza kwambiri ya maselo ndipo potero kuteteza myocardium. Komanso, kuchepetsa excitability wa maselo a dongosolo conduction, imbaenda ku kugunda kwa mtima wodekha.

Mankhwala izi kalasi ntchito mankhwala a matenda flutter ndi matenda fibrillation kuti kupewa ndi mpumulo wa supraventricular arrhythmias. Komanso, kuthandiza kuthetsa nkusani tachycardia.

Akuti mankhwala osamveka antiarrhythmic kwa fibrillation matenda, kupatulapo nthawi imene kudwala ndi amayamba ndi owonjezera kufalitsidwa makatekolamaini.

"Metoprolol" ndi "Inderal" Nthawi zambiri ntchito zochizira arrhythmias. Mankhwalawa ndi mavuto monga liwiro kugunda kwa mtima, kuchepetsa m'mnyewa wamtima contractility, maonekedwe atrioventricular chipika. mankhwala awa lingachititse m'makona ozizira ndi akuchuluka wa magazi zotumphukira. Komanso, mankhwala bwanji wamanjenje dongosolo, kuchititsa kusinza, chizungulire, maganizo, kukumbukira kuwonongeka. iwonso kusintha madutsidwe wa mitsempha, amene anaonetsa kutopa ndi kufooka.

Beta-blockers akuletsedwa ntchito mu mantha cardiogenic, edema m'mapapo mwanga, insulin amadalira shuga, mphumu. Komanso contraindications protrude atrioventricular chipika cha mlingo wachiwiri, nkusani bradycardia.

blockers potaziyamu njira

Mndandanda wa mankhwala antiarrhythmic mu gulu ili ndi njira retarding njira magetsi ndipo potero kutchinga njira potaziyamu maselo mtima. Wotchuka wa kalasi ya mankhwala - "Amiodarone" ( "Kordaron"). Mwa zina, amachita pa zolandilira M-holino- ndi adrenergic.

"Kordaron" ntchito kwa mankhwala ndi kupewa yamitsempha yamagazi, matenda ndi supraventricular arrhythmias, mtima mungoli chisokonezo pa maziko a SVC syndrome. medicament nazonso kutumikiridwa pofuna kupewa kufa yamitsempha yamagazi arrhythmias odwala ndi m'mnyewa wamtima pachimake. Komanso, ntchito kuchepetsa mlingo mtima pa zonse matenda fibrillation.

Ngati inu ntchito chida kwa nthawi yaitali akhoza kukhala interstitial m'mapapo fibrosis, kusintha kwa khungu (maonekedwe ofiirira hue). Nthawi zina, mutu, kugona matenda, kukumbukira ndi masomphenya. Phwando "Amiodarone" mwina chifukwa cha kutsekeka bradycardia, kudzimbidwa, kunyansidwa ndi kusanza.

Kodi si mankhwala pa koyamba bradycardia, QT prolongation, kuphwanya intracardiac conduction, chithokomiro matenda, wolumikizira hypotension, mimba, mphumu.

Kashiamu njira blockers wosakwiya

Mankhwalawa kunyamula loko pang'onopang'ono kashiamu panopa, potero anapondereza foci ectopic mu atria ndi nkusani mfundo automaticity yafupika. Mndandanda wa mankhwala antiarrhythmic mu gulu ili monga "Verapamil," umene tapatsidwa kapewedwe ndi chithandizo cha paroxysmal supraventricular tachycardia, supraventricular arrhythmia mankhwala. "Verapamil" ndi operewera pa nkhani ya arrhythmias yamitsempha yamagazi.

Zotsatira zake zoyipa monga atrioventricular chipika, nkusani bradycardia, hypotension, ndi zina - kuchepetsa contractile luso la mtima.

glycosides mtima

Gulu la mankhwala antiarrhythmic sizikanakhala kwathunthu popanda kutchulidwa kwa ndalama izi. Zikuphatikizapo mankhwala monga "Tselanid", "Korglikon", "Digitoxin", "Digoxin" ndi ena. Iwo ntchito kubwezeretsa nkusani mungoli, supraventricular tachycardia, kuchepetsa pafupipafupi contractions wa ventricles mu nkhani ya fibrillation matenda. Pamene ntchito glycosides mtima ndi kuwayang'anira chikhalidwe chanu. Zizindikiro za digitalis kuledzera anaonetsa m'mimba ululu, kunyansidwa ndi kusanza, kupweteka kwa mutu, kusawona bwino ndi maloto, magazi kuchokera mphuno.

Iwo analetsedwa kugwiritsa ntchito mankhwala antiarrhythmic pa bradycardia syndrome ERW intracardiac anatseka misewu. Iwo amaikidwa mlandu wa tachycardia paroxysmal yamitsempha yamagazi.

kuphatikiza antiarrhythmics

Ngati kaimbidwe ectopic kuchita matenda, ena kuphatikiza mankhwala ntchito. Motero, "Quinidine" angagwiritsidwe ntchito molumikizana ndi glycosides mtima zochepetsera kulimbikira arrhythmia. Ndi beta-blockers "quinidine" awerenge mpumulo wa arrhythmias yamitsempha yamagazi refractory mankhwala ena. The ntchito ophatikizana a beta-blockers ndi glycosides mtima amapereka umapangitsa mu yamitsempha yamagazi ndi arrhythmias supraventricular, komanso amathandiza kuteteza zisadzachitikenso wa tachycardia ectopic ndi tachyarrhythmia.