Yeyiphi eyona blocker ye-beta yokusilela kwentliziyo?
Ulwazi lweziyobisiIibhloko blocker ze-Beta zivavanywe kakuhle kwaye zinamayeza afanelekileyo. Ababoneleli ngezempilo bebabayalela ukusukela ngeminyaka yee-1970 . Ibhlokhi yeBeta Unemvume ye-FDA yokunyanga yonke into ukusuka kwi-glaucoma ukuya kwi-migraine. Kodwa, zikwasetyenziselwa unyango lweemeko zentliziyo-rhoqo njengonyango lokuqala lodidi lokusilela kwentliziyo.
Zisebenza njani iibhloko ze-beta?
I-Beta blockers isebenza ngokunciphisa imiphumo ye-epinephrine (ekwabizwa ngokuba yi-adrenaline) -ihormone yoxinzelelo. Oku kunciphisa ukubetha kwentliziyo yakho, kunciphisa uxinzelelo lwegazi, kwaye kuvule imithambo yegazi ukuphucula ukuhamba kwegazi. La mayeza anokunyanga uxinzelelo lwegazi (uxinzelelo lwegazi), izingqisho zentliziyo engaqhelekanga (arrhythmia), iintlungu zesifuba, intliziyo ukusilela, migraine, kunye nokuhlaselwa yintliziyo.
Kwizigulana ezinokusilela kwentliziyo, iibhloko ze-beta zihlala zisebenza [ukunciphisa uxinzelelo entliziyweni] ngokunciphisa ukubetha kwentliziyo yesigulana, uyachaza Dawn Shill , Pharm.D., Usokhemesti kwiNkqubo yeMicimbi yezeMpilo yamaGqala eAnchorage, eAlaska.
I-Beta blocker zinceda ekuphuculeni ibhalansi yonikezelo lwe-myocardial kunye neemfuno. Ugqirha Shill uthi, Ngokusisiseko, ngamanye amaxesha ukusilela kwentliziyo kuyischemic. Intsingiselo, kukho ubuthathaka bemisipha entliziyweni ekhokelela ekunciphiseni kwenani legazi elimpompoweyo entliziyweni. Iibhloko blocker zinokunceda ukuphucula ukusebenza kwiindawo ezithile zentliziyo ngokunciphisa inani lokubonelelwa kweoksijini ukuze intliziyo isebenze kwinqanaba elifanelekileyo.
Uphando ikwabonisa ukuba iibhloko ze-beta zinciphisa ukukhutshwa kwe-norepinephrine. Kunye ne-epinephrine, i-norepinephrin ihlala ibopha kwii-receptors kuwo wonke umzimba kwaye iyabandakanyeka kuxinzelelo lwegazi kunye nokubetha kwentliziyo. Ukuthintela ukubopha kwezi neurotransmitters kwii-receptors kunceda ukunciphisa ukubetha kwentliziyo kunye noxinzelelo lwegazi.
Zeziphi iibhlokhi ze-beta ezinokusetyenziselwa ukusilela kwentliziyo?
BI-eta blockers zihlala zinikwa abaguli abafumana isifo sentliziyo ngenjongo yokuthintela uhlaselo lwentliziyo olungenzeki.
Inkqubo ye- Ikholeji yaseMelika yeCardiology icebisa ngokuthe ngqo ezi zilandelayo zibhloka ze-beta, ezivunyiweyo yi-FDA kukusilela kwentliziyo:
- ICoreg (icarvedilol)
- I-Toprol XL (i-metoprolol succinate)
- Zebeta (bisoprolol)
Kubalulekile ukuba uqaphele ukuba kuphela ingxelo ekhutshiweyo ye- iMetoprolol (i-metoprolol succinate) yamkelwe yi-FDA yokusilela kwentliziyo, hayi itartrate yemetoprolol .
Xa usebenzisa ezi blocker ze-beta kunyango lokusilela kwentliziyo, bathintela intliziyo ukuba ingagqithisi kwaye impompe rhoqo, uyachaza UJason Reed , Amachiza D.
Uninzi lweebeta blocker zikwanciphisa ukuba nzima kwempompo zezihlunu zentliziyo, uGqirha Reed uyacacisa. Kodwa ezi blocker ze-beta azenzi loo nto, yiyo loo nto zikwazi ukunyanga esi sifo ngaphandle kokwenza iimpawu zibe mandundu.
Kwi ngokwemiqathango yomahluko phakathi kwe-beta blockers esetyenziselwa ukusilela kwentliziyo, uthi,I-carvedilol ibhloka i-beta-1 beta-2 receptors entliziyweni, kunye ne-alpha-1 receptors kwimithambo yegazi. I-Metoprolol kunye ne-bisoprolol ngokuyintloko ibhloka ii-beta-1 receptors entliziyweni. Nangona ezi blocker ze-beta zinomahluko othile, ziyasebenza ekukhuseleni intliziyo nasekunciphiseni umngcipheko weengxaki kukusilela kwentliziyo.
| Ezona blocker ze-beta zibalaseleyo zokusilela kwentliziyo | |||||
|---|---|---|---|---|---|
| Igama lebrand (Igama eliqhelekileyo) | Ubungakanani | Ukusebenza (ngokuthelekiswa ne-placebo) | Imiphumela | Funda nzulu | Fumana isigqebhezana |
| ICoreg (icarvedilol) | I-3.125 mg kabini imihla ngemihla kwiiveki ezi-2, ilandelwa kukunyuka kwethamo rhoqo kwiiveki ezi-2 de kufikelelwe kwiziphumo ezinqwenelekayo. Ubuninzi be-25 mg kabini yonke imihla kwizigulana ezinobunzima obungaphantsi kwama-85 kg kunye nama-50 mg kabini yonke imihla kwizigulana ezinobunzima obungaphezu kwama-85 kg. | 65% ukuncitshiswa komngcipheko wokufa | Ukuba nesiyezi , ukudinwa, iintloko, ukutyeba, utyatyazo | Funda nzulu | Fumana isigqebhezana |
| I-Toprol XL (i-metoprolol succinate) | I-12.5 ukuya kwi-25 mg kanye yonke imihla kwiiveki ezi-2, emva koko inyuswe rhoqo kwiiveki ezi-2 de kufikelelwe kwiziphumo ezinqwenelekayo. Ubuninzi be-200 mg ngosuku. | 3. 4% ukuncitshiswa komngcipheko wokufa | Ukuba nesiyezi , ukudakumba, ukudinwa, ukuvutha, urhudo | Funda nzulu | Fumana isigqebhezana |
| Zebeta (bisoprolol) | 1.25 mg kanye yonke imihla ngeentsuku ezi-2, emva koko 2.5 mg kanye yonke imihla kwinyanga yokuqala, emva koko yi-5 mg kanye ngemini. Ubuninzi be-10 mg ngosuku. | 3. 4% ukuncitshiswa komngcipheko wokufa | Intloko ebuhlungu , isiyezi, iintlungu ezidibeneyo, urhudo, ukudinwa | Funda nzulu | Fumana isigqebhezana |
Ngawaphi amayeza omiselweyo anokuxhomekeka kubukhali bokungaphumeleli kwentliziyo ohlangabezana nayo. Ugqirha wakho uyakuthathela ingqalelo nakuphi na unyango lwangaphambili olwenzileyo kunye naziphi na iziphumo ebezingalindelekanga oye wazifumana ngaphambili. Umzekelo, i-bisoprolol isebenza kunye nezinye iibhlokhi ze-beta zokungaphumeleli kwentliziyo, kodwa inokubangela ukudinwa okuncinci ngaphezu kwee-beta blocker ezingakhethiyo njenge-carvedilol.
Nini (kwaye njani) i-beta blockers imiselwe
I-block block zeBeta azizomelezi iintliziyo, ziyayeka nje inkqubo yeemvakalelo ukuba ingoyisi kakhulu.Oku kuthintela izihlunu zentliziyo ekusebenzeni kakhulu ziye kwi-hypertrophy ngenxa yoxinzelelo olugqithisileyo, olunokukhokelela kwi-cardiomyopathy, utshilo uGqirha Reed.
Ngelixa iibhlokhi ze-beta zinokunciphisa umonakalo entliziyweni ngokususa uxinzelelo, uGqr Shill ucacisa ukuba ukuba kuthathwe ngokungachanekanga banokuyenza buthathaka intliziyo. Xa zingathathwanga njengoko kumiselwe, zinokukwenza okubi kunokulungileyo.I-Beta blockers inokubangela ukubetha kwentliziyo ngendlela eyingozi ebizwa ngokuba yi-bradycardia enokuthi ikhokelele kuxinzelelo lwegazi.Oku kunokubangela iimpawu ezinje ngesiyezi, isicaphucaphu, ukuphelelwa ngamandla, ukunqongophala koxinzelelo, okanye ukungaboni kakuhle.
Logama nje isigulana sizinzile kwaye i-beta blocker efanelekileyo imiselwe kwidosi elungileyo, iibhloko ze-beta zinokusetyenziswa ngempumelelo ukunyanga ukusilela kwentliziyo. Inkqubo yemfesane yovelwano iyasebenza kwaye ibeka uxinzelelo entliziyweni kwaye yiyo loo nto i-beta blocker izakuqaliswa emva koko iqhubeke, utshilo uGqirha Reed. Emva kokuphuma kwentliziyo ebukhali, uninzi lwezigulana ziya kuqhubeka nonyango lwe-beta blocker. Iibhlokhi zeBeta zibonisiwe ukunciphisa ukusweleka, kwaye kukho ubungqina obomeleleyo obuxhasa ukusetyenziswa kwazo.
Izigulana zinokumiselwa idosi esezantsi ye-beta blocker yokusilela kwentliziyo ukuqala. Bangakwazi ke ukubeka esweni naziphi na iziphumo ebezingalindelekanga phantsi kolawulo lukagqirha kangangeveki okanye ezimbini. Logama nje iyeza linyamezeleka kakuhle, umboneleli wezempilo angalonyusa kancinci ithamo de iimpawu zikhululeke, ngokukaGqirha Reed.
Ngubani ekufuneka hayi sebenzisa ii-beta blocker?
Ngelixa iibhloko ze-beta zinokonga ubomi kwezinye izigulana, ayisiyiyo imeko yomntu wonke.Ukuba isigulana sihlangabezana namava ukusilela kwentliziyo Kunye nezinye iimeko ezi-comorbid ezinje nge-COPD, isifo seswekile okanye isifo se-vascular peripheral, i-beta blockers isenokungabi lolona hlobo lonyango lufanelekileyo. I-Beta blocker kufuneka ithintelwe zizigulana ezinesifuba kunye ne-COPD, utshilo uGqirha Reed. Kananjalo ayingombono olungileyo kwizigulana ezinentliziyo encinci okanye uxinzelelo lwegazi olusezantsi.
Njengawo onke amayeza, i-beta blockers inokuba neziphumo ebezingalindelekanga.
I-postural hypotension yimpembelelo yecala kubantu abaninzi abane-beta blockers, ugqirha Reed uyacacisa. Oku kunokubangela ukuba nesiyezi okanye isiqaqa.
Ezinye iibhlokhi ze-beta zinokubangela iziphumo ebezingalindelekanga ezinje ngoxinzelelo, ukudinwa, kunye nokungasebenzi kakuhle kwe-erectile, ezinokuba ziziphumo ebezingalindelekanga ezimbalwa kwezi ngxaki.
Ke kukho unxibelelwano olunokubakho lweziyobisi ekunokuqwalaselwa. Ezinye zezona ziyobisi zisetyenziswa ngokufuthi ezinxibelelana ne-beta blocker zibandakanya ii-NSAID kunye namayeza okulwa nesilonda, utshilo uGqirha Reed.
Ukongeza kwiiNSAID kunye namayeza okulwa nesilonda, kukho uluhlu olude lwe Unxibelelwano olunokwenzeka ukuba uqaphele. Izigulana kufuneka zithethe noogqirha bazo ngokhuseleko lonyango lwe-beta blocker ukuba zithatha ezi zinto zilandelayo:
- Uxinzelelo lwegazi ukunciphisa iziyobisi
- Olunye unyango lwentliziyo olunjenge-antianginal okanye antiarrhythmic drug
- Iziyobisi zengqondo ezinje ngexinzelelo
- Iintlungu
- Amayeza eStatin
- IWarfarin
- Amayeza eswekile
- Ezinye i-antibiotics ezifana neRifampin
Kwiimeko ezininzi, iibhloko ze-beta lunyango olusebenzayo lokungaphumeleli kwentliziyo, ukunciphisa umngcipheko wokufa kwintliziyo, kunye nokunciphisa umngcipheko wokuhlaselwa sisifo sentliziyo esiphindaphindayo. Thetha nogqirha wakho malunga nayiphi na inkxalabo onokuthi ube nayo, kwaye uqiniseke ukuba uxela naziphi na iziphumo ebezingalindelekanga ohlangabezana nazo ngelixa usebenzisa ibhloko blocker.
