"Quinidine": cov lus qhia rau kev siv, muaj pes tsawg leeg, kev piav qhia thiab kev txheeb xyuas

Yog vim li cas peb yuav tsum tau ib lub cuab tam xws li "quinidine"? Cov lus qhia rau kev siv, tus nqi, thiab kev txheeb xyuas cov sij hawm teem tseg ntawm cov tshuaj uas hais no hauv qab no. Koj kuj yuav kawm txog cov khoom pharmacological cov yam ntxwv ntawm cov tshuaj, txawm tias nws yog ib qhov kev txiav txim sab ntawm cov ua cim thiab seb nws muaj tej yam txwv tsis pub rau siv.

Muaj pes tsawg leeg, zoo, hauj lwm

Nyob rau hauv dab tsi daim ntawv kws tuam txhab uas muag ua tshuaj "quinidine"? Cov lus qhia rau siv, txuas mus rau qhov no txhais tau tias, yog hais tias nws muaj peev xwm yuav yuav nyob rau hauv daim ntawv ntawm cov tiaj tus thiab hloov cov ntsiav tshuaj. Lawv muaj ib lub caij nyoog zoo thiab zaj duab xis-coated.

Lub ntsiab muaj cov tshuaj no yog quinidine sulfate. Cov lus qhia, cov khoom hauj lwm tsis muab tej yam ntaub ntawv nyob rau hauv ntxiv tshuaj.

Pharmaceuticals Kws khoom

Yuav ua li cas yog cov tshuaj "quinidine"? Cov lus qhia rau kev siv, hauj lwm, xyuas tau qhia hais tias nws yog ib tug tshuaj rau cov chav kawm ntawv IA arrhythmia. Nws yog tau qeeb tus thauj ntawm ions los ntawm Na raws ceev cell phab ntsa ntawm cardiomyocytes thiab txo cov kev ceev tsis pub tshaj depolarization thiab ua rau kom qhov ntev ntawm qhov kev txiav txim tej zaum thiab refractory (zoo) ntev ntawm lub sij hawm.

Txais tos ntawm ib tug medicament attenuates myocardial excitability, slows automaticity thiab AV-conduction nyob rau hauv cov ntshav, nras ceg thaiv, atrial thiab lwm yam. Tsis tas li ntawd xam tau tias yog txhais tau tias muaj vagolytic nyhuv manifests m-anticholinergic nyhuv, thiaj li muaj cov kev ua si (contractility) ntawm cov kev mob plawv thiab ua rau ib tug txo nyob rau hauv cov ntshav siab.

thaj chaw ntawm cov tshuaj

Yuav ua li cas yog zoo tshaj plaws yog cov tshuaj raws li "quinidine"? Cov lus qhia rau kev siv sau ntawv hais tias nws yuav muaj ib tug tsis zoo inotropic nyhuv. Qhov no tshwm sim raws li ib tug tshwm sim ntawm deceleration hauv cov zog hloov dua siab tshiab txheej txheem nyob rau hauv mitochondria. Nrog kev xav txog cov antiarrhythmic thaj chaw ntawm cov tshuaj, lawv yog txuam nrog lub xub ntiag ntawm amide pawg nyob rau hauv lub molecule qauv ntawm cov active tshuaj.

Raws li cov kws txawj, qhov tsawg ntawm cov no medicament yog significantly txo excitation thiab hais tawm tshaj tawm, uas yog txuam nrog raug ntawm lub active tshuaj tivthaiv rau tus txheej txheem ntawm depolarization.

Suppressing m-cholinergic receptors, suav hais tias cov tshuaj nkoos AV-conduction. Thaum kho koob tshuaj nws exhibits hypotensive zog txuam nrog zuj zus lawm laus peripheral leeg thiab cov hlab ntsha, raws li zoo raws li ib tug tsis zoo inotropic nyhuv.

Peb tsis tau hais tias cov tshuaj no muaj peev xwm mus qhia lub zos khaus nyhuv. Nws kuj muaj analgesic thiab antipyretic zog uas yog txuam nrog ib tug depressing nyhuv rau lub paj hlwb.

Lub pharmacokinetic yam ntxwv ntawm

Absorbed seb xws li ib active ingredient ntawm cov tshuaj raws li quinidine sulfate? Cov lus qhia rau kev siv qhia uas txais tos ntawm ib lub qhov ncauj neeg sawv cev txhawb nws loj tshaj concentration hauv cov ntshav tom qab 95 feeb.

Cov tshuaj tiv thaiv ntawm no nrog cov nqaijrog medicament yog hais txog 77-80%. Nws biotransformation tshwm sim nyob rau hauv lub siab. Txawm li cas los, ib co derivatives tau tsim cardiotonic kev txiav txim.

Lub ib nrab-lub neej ntawm qhov cuab tam yog kwv yees li 7 teev. Nws twb evacuated nyob rau hauv lub ob lub raum. Los ntawm acidification ntawm cov zis feem medicament nce thiab thaum twg nws alkalization - inhibited.

Los ntawm dab tsi yog tshuaj?

Yuav ua li cas yog cov indications rau kev siv ntawm cov tshuaj muaj "quinidine"? Cov lus qhia rau Siv hais tias lub hom phiaj ntawm cov tshuaj yog tsis txhaum xwb nyob rau hauv cov nram no mob:

• ntawm atrial tachycardia, AV-tachycardias, extrasystoles ventricular thiab supraventricular, tawm tsam ntawm atrial fibrillation thiab Flutter;
• los mus tiv thaiv tawm tsam ntawm tachycardia (supraventricular thiab ventricular), thiab ventricular fibrillation;
• tom qab lub cardioversion kom muaj qhov ntswg atherosclerosis.

Bans siv

Yuav ua li cas yog cov kev mob ntawm tus neeg mob txwv tsis pub siv cov tshuaj "quinidine"? Cov lus qhia rau kev siv (tus nqi ntawm cov tshuaj uas muaj npe hauv qab no) ceeb toom ntawm contraindications ntawm cov tshuaj, xws li:

• cardiogenic poob siab;
• AV-thaiv (thib ob los yog peb degree);
• thrombocytopenic purpura, uas tsim tom qab noj cov tshuaj;
• teeb meem (mob loj heev) intraventricular conduction;
• ntshuas ceg thaiv;
• digitalis intoxication, uas yog nrog los ntawm conduction txawv txav;
• ib tug tsis haum cov tshuaj tiv thaiv mus rau yeeb tshuaj;
• myasthenia Heavy kev.

Medicament "quinidine": cov lus qhia rau kev siv

Txais lub cuab tam yuav tsum nyob rau hauv 60 feeb ua ntej los yog tom qab 125 feeb tom qab noj mov nrog ib tug tag nrho khob dej. Yog hais tias koj xav tau kom txo tau cov irritant nyhuv ntawm cov tshuaj nyob rau hauv lub qog ua kua membrane ntawm cov hnyuv, nws yog tsim nyog los hloov cov dej nrog rau mis nyuj.

Heev tshuaj no yog tsis pom zoo kom zom lossis crush.

Tus txheem ntau npaum yog suav tias yog 200-300 mg ntsiav tshuaj plaub zaug ib hnub twg. Yog hais tias supraventricular tachycardia (nrog paroxysms) tus nqi no yog nce rau 400-600 mg txhua txhua 3 teev ua ntej tiav nyem ntawm paroxysm. Nyob rau hauv atrial fibrillation, medicament tau txais 200 mg txhua txhua 2 chasa (5-8 lub sij hawm txhua txhua hnub). Wherein tus txij nkawm koob tshuaj yog 200-300 mg plaub zaug ib hnub twg.

Lwm kiag: 400 mg (yog hais tias tus nres twb tsis docked, 200 mg) txhua txhua 60 feeb kom txog thaum tiav txiav ntawm tus nres, los yog mus cuag ib tug tag nrho ntau npaum ntawm 1 g

Nyob rau hauv lub qhaj ntawv ntawm cov kev phiv tom qab thawj koob nyob rau hauv lub tom ntej txais tos ntawm tus nqi ntawm cov medicament yuav tsum tau nce mus 600 mg. Noj cov tshuaj nyob rau hauv excess ntawm 4 grams tauj ib hnub yog txwv tsis pub.

Dosing rau cov me nyuam

Nyob rau hauv ib koob tshuaj tshuaj rau cov me nyuam "quinidine Dyuruls"? Cov lus qhia rau kev siv, pediatricians kev qhia hais tias ib tug standard ntau npaum ntawm no neeg sawv cev rau cov me nyuam mos yog 6 mg / kg 5 lub sij hawm ib hnub. Prescribers yuav tsum tsuas yog ib tug kws kho mob, nruj me ntsis rau cov lus tim khawv.

Kev nqis tes ua los ntawm-cim

Yuav ua li cas zoo txim tej zaum yuav tshwm sim tom qab siv cov tshuaj "quinidine Durules"? Cov lus qhia rau kev siv, hauj lwm ntawm cov tshuaj no los qhia rau hauv cov nram qab no phiv tshua:

• asthenia, expanding cov QRS luv, myasthenia Heavy kev;
• ectopic ventricular neeg ntaus, tsis hnov lus;
• tsis qab los noj mov, ventricular fibrillation, arterial thrombosis, txo cov ntshav siab;
• nrig txog kev pom teeb, ventricular tachycardia, paroxysmal, tinnitus,
• asystole;
• xeev siab, qhov ntswg bradycardia, kab mob siab, mob plab, tsis meej pem;
• gastralgia, mob taub hau, ntuav, thrombocytopenia, raws plab, kiv taub hau, hemolytic anemia;
• kub taub hau, lupus zoo li syndrome, tawv nqaij sawv pob.

tus neeg mob ntawm overdose

Yuav ua li cas yog cov tsos mob ntawm overdose yuav ua rau cov tshuaj "quinidine Dyuruls"? Cov lus qhia, cov lus los ntawm cov kws txawj tham txog tej ces ua tinnitus, kev nyuaj siab ntawm mob ua hauj lwm, poob nyob rau hauv cov ntshav siab, kiv taub hau, atrial Flutter, diplopia, quinidine poob siab, tsis hnov lus.

Yuav kom tshem tawm tej lub xeev cuam tshuam tshuaj pais plab lavage, oxygen mov, hypertensive agents, lus sib laws liag, hemodialysis thiab lub tshuab ua pa.

tshuaj cov kev sib tshuam

Yuav ua li cas mus kho cov tshuaj ua num ua ke nrog lub tshuaj raws li quinine? Cov lus qhia rau kev siv (tus nqi xyuas ntawm medicament yuav tsum tau nthuav tawm nyob rau thaum xaus ntawm qhov tsab xov xwm) qhia hais tias qhov no ua ke tsub kom lub toxicity ntawm ob leeg.

Tsis tas li ntawd, "quinidine" tshuaj nrog rau cov nram no tshuaj:

• Antiarrhythmic tshuaj txhim khu cardiodepressive kev txiav txim.
• Anticholinesterase tshuaj thiab cov tshuaj txhim khu cov teebmeem kalisodergaszczye "Quinidine".
• Anticonvulsant tshuaj txo ntshav ntawm "Quinidine" thiab txo nws cov hauj lwm zoo vim stimulation ntawm nws cov metabolism.
• Cov tshuaj ntaus cev txo cov hauj lwm zoo thiab concentration ntawm cov tshuaj nyob rau hauv cov ntshav nyob rau hauv kev ntsuam xyuas.
• Cov tshuaj alkalising cov zis, tsub kom kev pheej hmoo ntawm tshuaj lom tshuaj.
• Tshuaj "amiloride" thiab "Amiodarone" txo cov hauj lwm zoo ntawm "Quinidine" thiab lengthen nws luv QT, ntsig txog.
• Acetylsalicylic acid ncua los ntshav, petechiae thiab yeej txhawb los ntshav los ntawm lub digestive kabmob.
• Medicaments "warfarin" thiab "Verapamil" - enhanced anticoagulant nyhuv ntawm tus thawj thiab thib ob txo tus nqi ntawm feem.
• Tshuaj "Haloperidol" - tsub kom nws cov ntsiab lus nyob rau hauv cov ntshav thiab tsub kom kev pheej hmoo ntawm kev phiv tshuaj.
• Tshuaj "Hydroxyzine" thiab "dextromethorphan" - tsub kom qhov yuav mob arrhythmia ntawm lub txais tos ntawm tus thawj thiab tus thib ob nyob rau hauv cov ntshav.

tej ntaub ntawv

Nrog tshwj xeeb ceev faj piav tshuaj pom zoo rau cov mob hauv lub plawv tsis ua hauj lwm theem 2-3, tachyarrhythmia (ventricular) nrog ib tug elongation luv QT, qhov ntswg ntawm, AV-blockade 1 degree, mob hawb pob, hyperthyroidism, hypotension, mob kis tus kab mob, mob hawb pob , lub kaum ntse ntse-kaw glaucoma, hypokalemia, daim siab tsis ua hauj lwm, thrombocytopenia, prostate hyperplasia, mob raum tsis ua hauj lwm, lactation, cev xeeb tub thiab psoriasis.

Cov neeg uas muaj myocarditis thiab lwm yam myocardial kab mob thaum tau txais "Quinidine" tsis tu ncua kho mob tswj yog yuav tsum tau. Ua ntej kev kho mob, tus neeg mob yuav tsum ua ib tug kho lus ntawm cov tsos mob ntawm hypokalemia thiab tsis ua hauj lwm ntawm lub plawv.

Cov kev kho no yuav tsum tau mus tas li saib xyuas qhov kev ECG cov ntaub ntawv ntawm lub peripheral cov ntshav thiab hemodynamics.

Zoo li txhais tau tias, nqe

Drug analogues tau xam tau tias yog ib tug ntau. Kws txawj cwj pwm mus rau lawv cov hauv qab no txhais tau tias: "Kinidin Durules", "Bretilat", "procainamide", "Etatsizin" "lidocaine", "Amiokordin", "Propanorm", "Amiodarone" "Verapamil", "Propranolol", "Ritmonorm ".

Raws li rau tus nqi ntawm tej tshuaj li "quinidine" thiab "quinidine Durules", lub inhabitants ntawm peb lub teb chaws, lawv yog tsis paub hais tias vim lub fact tias cov tshuaj yog tsis muag nyob rau hauv Russia. Txawm li cas los, lawv yuav tsum tau yuav nyob rau hauv Ukraine. Tus nqi ntawm cov tshuaj nyob rau hauv lub teb chaws yog hais txog 540 thiab 670-679 hryvnia, ntsig txog, uas yog sib npaug zos rau 1380 thiab 1760-1780 rubles.

Xyuas

Yuav ua li cas cov neeg hais txog qhov suav hais tias medicament cov kws kho mob thiab lwm cov tub txawg? Raws li lawv, qhov cuab tam qhia tias peb yuav zoo heev antiarrhythmic yeeb tshuaj, uas yog zoo thiab ceev txaus kom kho cov kab mob xws li ventricular thiab supraventricular tachycardia. Txawm li cas los, nws yuav tsum tau muab sau tseg tias nrhiav "quinidine" ntsiav tshuaj nyob rau hauv Lavxias teb sab chaw muag tshuaj yog tsis tau. Qhov no yog vim lub fact tias cov tshuaj no twb cais tawm ntawm dawb kev thiab yog tsis siv nyob rau hauv cov tsev kho mob. Cov kws kho mob piav qhov teeb meem no rau hauv lub fact tias muaj kev ruaj ntseg thiab ntau yam ntxiv zoo li zoo li pheej yig counterparts nyob rau hauv tus kws ua lag luam, uas yog muaj kev koom siv rau tib lub indications. Nyob rau hauv cov ntaub ntawv no, cov kws txawj hais tias quinidine sulfate tseem yuav tsum tau siv raws li ib tug constituent ntawm multicomponent tshuaj nyob rau hauv ntau anti-arrhythmic tshuaj.