Sodium nitroprusside: cov lus qhia rau kev siv

Muaj ntau ntau cov tshuaj uas muaj hypotensive los. Cov tshuaj uas txo cov ntshav siab, feem ntau yog siv nyob rau hauv ib tug complex thiab feem (1-2 lub sij hawm txhua txhua hnub). Yog li kho tawg. Nyob rau hauv tej rooj plaub, npaj cov tshuaj kom txo tau cov ntshav siab tsis thov kev pab. Ces thov muaj zog tshuaj xws li cov tshuaj 'ntawm sodium nitroprusside. " Qhov no tshuaj yog tsis siv systematically thiab tsis muaj ib tug loj yuav tsum tau. Nws tsis yog ib tug tshuaj uas koj xaiv rau kev kho mob ntawm kub siab thiab mob hauv lub plawv tsis ua hauj lwm. Nws yog tsuas yog siv nyob rau hauv tus neeg mob ntawm thaum muaj xwm ceev, thaum ib tug neeg lub cev tsis teb rau lwm yam tshuaj uas txo cov ntshav siab (diuretics, ACE inhibitors). Ib tug tov 'ntawm sodium nitroprusside "tsis tau muab ib leeg, tsis muaj ib tug tshuaj.

Yuav ua li cas nyhuv cov tshuaj muaj nyob rau hauv lub cev?

Kev npaj "Sodium nitroprusside" (formula - C ₅ Fen ₆ Na ₂ O) yog hais txog ib tug pab pawg neeg ntawm peripheral vasodilators. Nws muaj lub substance tsaus liab xim nyob rau hauv daim ntawv ntawm muaju los yog hmoov. Tab sis nws npaj diluted nrog dej thiab siv nyob rau hauv ib cov kua daim ntawv. Vim lub fact tias muaj yog ib tug nitroso pab pawg neeg, kev siv cov tshuaj ua rau vasodilation nyob rau hauv nyob tus yeees ntawm cov tshuaj yeeb dej caw. Qhov no tshwm sim raws li nram no: Qhov no tshuaj compound thaum noj yog hloov dua siab tshiab rau hauv nitric oxide thiab activates lub enzyme - guanylate cyclase. Nyab enhanced tsim ntawm cGMP uas nyhav ntxiv nyob rau hauv vascular tus nqaij thiab ua rau nws so. Raws li, qhov medicament "Sodium nitroprusside" muab lub nram qab no los thiab arterio venodilatiruyuschy thiab hypotensive. Los ntawm no ua hauj lwm ntawm lub vascular system yog tau zoo sai sai. Nyob rau hauv tas li ntawd, cov tshuaj ua hauj lwm raws li lub hom mob glycosides, i.e. nws thiaj li myocardial oxygen thov. Cov nyhuv no yog tiav los ntawm kws tshuaj thiab afterload txo.

indications medicament

Nws yuav tsum tau menyuam tias cov tshuaj yog tsuas yog siv nyob rau hauv thaum muaj xwm ceev mob ntawm loj cov kab mob thiab kuj tau tus kab mob mus rau lwm pab pawg neeg ntawm medicaments. Indications rau kev siv ntawm cov tshuaj no yog hu ua:

1. Mob plawv tsis ua hauj lwm. Nyob rau hauv kev peb muaj nyob rau hauv lub siab txoj kev loj hlob ntawm pulmonary edema (mob hawb pob). Cov tshuaj yog sai tiv thaiv no lub xeev uas tsis muaj cov nyhuv ntawm diuretics.
2. Mob hauv lub plawv tsis ua hauj lwm, mob hnyav. Qhov kawg theem ntawm mob hauv lub plawv tsis ua hauj lwm (2b, 3) tsis yeej ib txwm teb rau kev kho mob. Yog li ntawd, thaum kuj mus rau lwm cov tshuaj thiab cov dire mob ntawm tus neeg mob muab peripheral vasodilators.
3. Mob coronary syndrome. Nyob rau hauv tej rooj plaub, cov tshuaj no yog siv nyob rau hauv myocardial infarction, txo lub siab nyob rau hauv cov hlab ntsha ntawm lub plawv, raws li zoo raws li tsis txhob muaj cov kev loj hlob ntawm cardiogenic poob siab.
4. Intractable tsoos kev kho mob ntawm kub siab. Vasodilators tej zaum yuav siv nyob rau hauv pheochromocytoma, paroxysmal crises, raws li zoo raws li cov kev loj hlob ntawm mob tshwm sim los ntawm ib tug ntse nce nyob rau hauv cov ntshav siab (stroke, psychogenic mob, lub plawv yuav nres).
5. Ergot lom. Qhov no nroj tsuag yog ntse vasospasm, uas tej zaum yuav tsis muaj zog ntawm medicament "sodium nitroprusside." Cov lus qhia rau kev siv nyob rau hauv cov pob inserts yuav tsum zoo to taub los ntawm cov kws kho mob "tsheb thauj neeg mob" thiab resuscitation.

Contraindications thiab kev phiv

Cov tshuaj yuav tsum tsis txhob yuav siv nyob rau hauv hemorrhagic stroke, raws li zoo raws li tom qab nws. Nws yog contraindicated rau cov neeg kev txom nyem los ntawm tus kab mob raum tus kab mob thiab hypothyroidism. nws yog tseem tsis pom zoo rau cov neeg uas muaj zog intracranial siab. Kev siv cov tshuaj yog txwv tsis pub rau cov me nyuam, cev xeeb tub cov poj niam thiab cov neeg nyob rau hauv cov laus hnub nyoog. Lwm contraindication yog saib tsis active neeg sawv cev nrog rau txoj kev loj hlob ntawm kev tsis haum tshuaj loj.

Ntawm cov kev phiv los ntawm kev siv ntawm "sodium nitroprusside" npaj yog muab ib tug ntse txo nyob rau hauv cov ntshav siab (nyob rau hauv cov ntaub ntawv no, nws yog tsim nyog mus lawm tam sim ntawd thawj coj), muaj zog lub plawv dhia, kiv taub hau, xeev siab thiab kev tsis muaj zog.

Tshuaj cov tshuaj tiv thaiv nrog sodium nitroprusside

Nyob rau hauv tas li ntawd mus muab cov kho nyhuv ntawm sodium nitroprusside tshuaj siv nyob rau hauv tshuaj tshua. Yog hais tias nws yog tov nrog rau ib tug ketone lub cev (acetone) thiab muab tso rau hauv ib tug alkaline ib puag ncig, koj yuav saib tau ib tug amazing hloov nyob rau hauv cov xim ntawm lub compound. Rau xws li transformations siv 4 leeg. Nyob rau hauv txhua tso tsuas yog ib yam khoom uas - sodium nitroprusside, acetone, alkali, acetic acid. Nyob rau hauv rooj plaub thawj lub resulting tov muab kaj txiv kab ntxwv-liab Hawj txawm. Tom ntej no, qhov no compound yog diluted nrog acetic acid. Xim dua hloov, lub sij hawm no cov kua yuav tsaus liab los yog liab doog.

Kev npaj "Sodium nitroprusside": cov lus qhia rau kev siv

Yuav kom nkag mus rau ib tug yeeb tshuaj, nws yog tsim nyog los tau tso dej nkag. Tam sim ntawd ua ntej pib ntawm cov tshuaj Txoj kev lis ntshav, nws yuav tsum tau diluted nyob rau hauv 5% zib tov. Rau lub hom phiaj no, 1 vial ntawm cov tshuaj nyob rau hauv ib tug syringe thiab diluted nrog 5 ml ntawm cov kua. Cov uas ua sib tov twb txhaj mus rau hauv lub minyuam lam fwj tshuaj nrog 5% zib yaj dua. Tom qab hais tias, tos tus yam tshuaj. Nws yog hom twg los ntawm 0.3 mus 8 g ib 1 kg ntawm lub cev hnyav. Cov Txoj kev lis ntshav yog tau los ntawm lub system. Nws yuav tsum tau pib nrog ib tug tsawg koob tshuaj thiab maj mam nce nws nyob rau hauv cov kev tswj ntawm tseem ceeb heev tshwm sim (ntshav siab, lub plawv dhia, mem tes). Nws tseem yog tsim nyog los muab ib tug siv tau Txoj kev lis ntshav npaum li cas sib npaug zos rau 2.5-3 mg / kg nyob rau hauv 1 feeb. Cov tshuaj nyob rau hauv lub sij hawm ntawm kev siv yeeb tshuaj koom haum saib xyuas. Heev Txoj kev lis ntshav yuav tsum saib xyuas cov theem ntawm cyanide-muaj medicament nyob rau hauv "Sodium nitroprusside". Cov lus qhia rau kev siv ntawm cov tshuaj yuav tsum tau kom meej meej cai.

Sis nrog lwm yam tshuaj

Peb tsis pom zoo siv cov tshuaj, thiab lwm yam antihypertensive agents, raws li cov tau txoj kev loj hlob ntawm ib lub xeev ntawm kev poob siab. Thov tsum paub hais tias kev siv ntawm qhov ncauj contraceptives thiaj li cov hauj lwm zoo ntawm cov tshuaj. Thaum ua ke nrog ib tug medicament tshuaj "Dobutamine" rau tseem ceeb heev tshwm sim ntawm tus neeg mob yuav tsum tau ua tib zoo saib xyuas (tejzaum nws txo siab, wedging nyob rau hauv lub ntsws hlab ntsha raws li nce mob volume).