Yini i-beta blocker enhle kakhulu yokwehluleka kwenhliziyo?
Imininingwane YezidakamizwaAma-beta blockers yimithi ehlolwe kahle futhi eguquguqukayo. Abahlinzeki bezempilo bebelokhu bebalaya kusukela ngawo-1970 . Abavimbela i-Beta unemvume ye-FDA yokwelapha yonke into kusuka ku-glaucoma kuya ku-migraines. Kepha, zisetshenziselwa ukwelapha izimo zenhliziyo nemithambo yegazi-imvamisa njengokwelashwa komugqa wokuqala kokuhluleka kwenhliziyo.
Asebenza kanjani ama-beta blocker?
Ama-beta blocker asebenza ngokunciphisa imiphumela ye-epinephrine (eyaziwa nangokuthi i-adrenaline) —i-hormone yokucindezeleka. Lokhu kunciphisa ukushaya kwenhliziyo yakho, kwehlisa umfutho wegazi, futhi kuvule nemithambo yegazi ukwenza ngcono ukugeleza kwegazi. Le mithi ingalapha umfutho wegazi ophakeme (umfutho wegazi ophakeme), isigqi senhliziyo esingajwayelekile (i-arrhythmia), izinhlungu zesifuba, inhliziyo ukwehluleka, i-migraines, nokuhlaselwa yinhliziyo.
Ezigulini ezinokwehluleka kwenhliziyo, ama-beta blockers ngokuvamile asebenza [ukunciphisa ukucindezeleka enhliziyweni] ngokunciphisa ukushaya kwenhliziyo yesiguli, kuchaza I-Dawn Shill , Pharm.D., Usokhemisi weVeteran’s Affairs Healthcare System e-Anchorage, e-Alaska.
Ama-beta blocker asiza ukwenza ngcono ibhalansi yokunikezwa kwe-myocardial kanye nesidingo. UDkt Shill uthi, Ngokuyisisekelo, kwesinye isikhathi ukwehluleka kwenhliziyo kuyischemic. Okusho ukuthi, kunezicubu zemisipha ezibuthakathaka enhliziyweni eziholela ekwehlisweni kwenani legazi elikhishwe enhliziyweni. Ama-beta blockers angasiza ekuthuthukiseni ukusebenza ezindaweni ezithile zenhliziyo ngokunciphisa inani lokutholakala komoya-mpilo odingekayo ukuze inhliziyo isebenze ezingeni elifanele.
Ucwaningo futhi kukhombisa ukuthi ama-beta blockers anciphisa ukukhishwa kwe-norepinephrine. Kanye ne-epinephrine, i-norepinephrine imvamisa ibophezela kuma-receptors emzimbeni wonke futhi ibandakanyeka ekucindezelweni kwegazi nokushaya kwenhliziyo. Ukuvimba ukubopha kwala ma-neurotransmitter kuma-receptors awo kusiza ukunciphisa izinga lokushaya kwenhliziyo nomfutho wegazi.
Yimaphi ama-beta blockers angasetshenziselwa ukwehluleka kwenhliziyo?
BAma-eta blocker avame ukunikezwa iziguli ezihlaselwa yisifo senhliziyo ngenhloso ukuvimbela isifo senhliziyo sesibili ukuthi singenzeki.
I- Ikholeji yaseMelika Yezenhliziyo incoma ngokukhethekile ama-beta blocker alandelayo, avunyelwe yi-FDA okwehluleka kwenhliziyo:
- I-Coreg (carvedilol)
- I-Toprol XL (metoprolol succinate)
- I-Zebeta (bisoprolol)
Kubalulekile ukuthi wazi ukuthi yinguqulo ekhishwe isikhathi eside kuphela ye- i-metoprolol (i-metoprolol succinate) kuvunywa yi-FDA yokwehluleka kwenhliziyo, hhayi i-metoprolol tartrate .
Lapho usebenzisa la ma-beta blocker ekwelashweni kokuhluleka kwenhliziyo, avimbela inhliziyo ukuthi ingagcini ngokweqile futhi ipompe kaningi, kuchaza UJason Reed , Pharm.D.
Iningi lama-beta blocker linciphisa nokuthi kunzima kangakanani amaphampu emisipha yenhliziyo, kuchaza uDkt Reed. Kepha laba bavimba i-beta abakwenzi lokho, yingakho bekwazi ukwelapha lesi sifo ngaphandle kokwenza izimpawu zibe zimbi kakhulu.
Ku- imigomo yokwehluka phakathi kwe-beta blocker esetshenziselwa ukwehluleka kwenhliziyo, uthi,i-carvedilol ivimba i-beta-1 beta-2 receptors enhliziyweni, kanye nama-alpha-1 receptors emithanjeni yegazi. I-Metoprolol ne-bisoprolol ngokuyinhloko zivimba ama-beta-1 receptors enhliziyweni. Yize laba bavimba i-beta benokwehluka okuthile, bayasebenza ekuvikeleni inhliziyo nasekunciphiseni ubungozi bezinkinga ekuhlulekeni kwenhliziyo.
| Ama-beta blocker amahle kakhulu okwehluleka kwenhliziyo | |||||
|---|---|---|---|---|---|
| Igama lomkhiqizo (Igama elejwayelekile) | Isikali | Ukusebenza (kuqhathaniswa ne-placebo) | Okuqhamuka uma udla imishanguzo | Funda kabanzi | Thola isigqebhezana |
| I-Coreg (carvedilol) | I-3.125 mg kabili nsuku zonke amaviki ama-2, ilandelwa ukukhuphuka komthamo njalo emavikini ama-2 kuze kutholakale imiphumela oyifunayo. Isilinganiso esingu-25 mg kabili ngosuku nsuku zonke seziguli ezinesisindo esingaphansi kuka-85 kg kanye no-50 mg kabili nsuku zonke ezigulini ezinesisindo esingaphezu kwama-85 kg. | 65% ukunciphisa ingozi yokufa | Isiyezi , ukukhathala, ukuphathwa ikhanda, ukukhuluphala, isifo sohudo | Funda kabanzi | Thola isigqebhezana |
| I-Toprol XL (metoprolol succinate) | I-12.5 iye kuma-25 mg kanye nsuku zonke amaviki ama-2, bese inyuka njalo emavikini ama-2 kuze kutholakale imiphumela oyifunayo. Isilinganiso esingu-200 mg ngosuku. | 3. 4% ukunciphisa ingozi yokufa | Isiyezi , ukudangala, ukukhathala, ukuqhuma, uhudo | Funda kabanzi | Thola isigqebhezana |
| I-Zebeta (bisoprolol) | 1.25 mg kanye ngosuku izinsuku ezi-2, bese kuba ngu-2.5 mg kanye ngosuku nsuku zonke ngenyanga yokuqala, bese kuba ngu-5 mg kanye ngosuku. Isilinganiso esingu-10 mg ngosuku. | 3. 4% ukunciphisa ingozi yokufa | Ubuhlungu bekhanda , isiyezi, ubuhlungu bamalunga, uhudo, ukukhathala | Funda kabanzi | Thola isigqebhezana |
Imiphi imishanguzo oyinikezwayo engancika ebucayi bokuhluleka kwenhliziyo obhekene nakho. Udokotela wakho uzobuye acabangele noma yikuphi ukwelashwa kwangaphambilini owake wakuzama neminye imiphumela emibi owake wayithola ngaphambili. Isibonelo, i-bisoprolol isebenza kanye namanye ama-beta blockers okwehluleka kwenhliziyo, kepha kungadala ukukhathala okuncane kunama-beta blocker angakhethi njenge-carvedilol.
Kunqunywa nini (futhi kanjani) ama-beta blocker
Ama-beta blockers ayiqinisi inhliziyo, avele amise uhlelo lwezinzwa ukuthi lungalukhulisi ngokweqile.Lokhu kuvimbela imisipha yenhliziyo ekusebenzeni ngokweqile iye kwi-hypertrophy ngenxa yobunzima obedlulele, okungaholela ekushoneni kwenhliziyo, kuchaza uDkt Reed.
Ngenkathi ama-beta blockers enganciphisa ukulimala enhliziyweni ngokususa ubunzima, uDkt Shill uchaza ukuthi uma ethathwa ngokungalungile angayenza buthaka inhliziyo. Uma kungathathwa njengokuyalelwe, bangenza okubi kunokulunga.Ama-beta blockers angadala ukushaya kwenhliziyo okuyingozi okubizwa nge-bradycardia okungaholela ekucindezelekeni kwegazi okuphansi.Lokhu kungadala izimpawu ezifana nesiyezi, isicanucanu, ukuquleka, ukungabibikho kokuhlushwa, noma ukungaboni kahle.
Uma nje isiguli sizinzile futhi i-beta blocker efanele ibekiwe kumthamo ofanele, ama-beta blockers angasetshenziswa ngempumelelo ekwelapheni ukwehluleka kwenhliziyo. Uhlelo lwezinzwa oluzwelayo luyasebenza ngokweqile futhi lubeka inhliziyo enhliziyweni futhi yingakho ama-beta blocker azoqaliswa abese eqhubeka, kusho uDkt Reed. Ngemuva kokuqubuka kokuhluleka kwenhliziyo, iziguli eziningi zizoqhubeka nokwelashwa kwe-beta blocker. Ama-beta blockers akhonjisiwe ukunciphisa ukufa, futhi kunobufakazi obuqinile obusekela ukusetshenziswa kwawo.
Iziguli zingabekwa umthamo ophansi we-beta blocker wokwehluleka kwenhliziyo ukuqala. Bangabe sebebheka noma imiphi imiphumela emibi ngaphansi kokuqondisa kukadokotela isonto elilodwa noma amabili. Uma nje umuthi ubekezelelwa kahle, umhlinzeki wezokunakekelwa kwempilo angakhuphula kancane umthamo kuze kube yilapho izimpawu sezikhululekile, ngokusho kukaDkt.
Ngubani okufanele hhayi sebenzisa i-beta blocker?
Ngenkathi i-beta blockers ingasindisa impilo kwezinye iziguli, lokho akunjalo kuwo wonke umuntu.Uma isiguli sibhekene ukuhluleka kwenhliziyo kanye nezinye izimo ezi-comorbid njenge-COPD, isifo sikashukela noma isifo semithambo yegazi, ama-beta blockers kungenzeka angabi yindlela efanele yokwelashwa. Ama-beta blockers kufanele agwenywe yiziguli ezine-asthma ne-COPD, kusho uDkt Reed. Futhi akuwona umqondo omuhle ezigulini ezinenhliziyo eshaya kancane noma umfutho ophansi wegazi.
Njengayo yonke imithi, ama-beta blockers angaba nemiphumela engemihle.
I-postural hypotension ingumphumela wecala onenkinga kubantu abaningi abane-beta blockers, uDkt Reed uyachaza. Lokhu kungadala isiyezi noma ukuquleka.
Amanye ama-beta blocker nawo angadala imiphumela emibi njengokucindezeleka, ukukhathala, kanye nokungasebenzi kahle kwe-erectile, okungaba eminye yemiphumela emibi kakhulu kule mithi.
Bese kuthi kube nokuhlangana kwezidakamizwa okungahle kubhekwe. Eminye yemithi esetshenziswa kakhulu esebenzisana ne-beta blockers ifaka ama-NSAID nemithi elwa nezilonda, kusho uDkt Reed.
Ngaphezu kwama-NSAID nemithi elwa nezilonda, kukhona uhlu olude lwe- ukuxhumana okungenzeka ukwazi. Iziguli kufanele zikhulume nodokotela bazo ngokuphepha kokwelashwa kwe-beta blocker uma zithatha noma ikuphi kokulandelayo:
- Ukucindezelwa kwegazi kwehlisa izidakamizwa
- Eminye imithi yenhliziyo efana nezidakamizwa ze-antianginal noma antiarrhythmic
- Izidakamizwa ze-Psychotropic njenge-anti-depressants
- Izinzwa zokubulala izinzwa
- Imithi ye-Statin
- I-Warfarin
- Imithi yesifo sikashukela
- Imithi elwa namagciwane efana neRifampin
Ezimweni eziningi, ama-beta blockers ayindlela yokwelapha ephumelelayo yokwehluleka kwenhliziyo, anciphisa ubungozi bokufa ngenxa yokwehluleka kwenhliziyo, nokunciphisa ubungozi bokuhlaselwa yinhliziyo okuphindayo. Khuluma nodokotela wakho nganoma yikuphi ukukhathazeka ongase ube nakho, futhi uqiniseke ukuthi ubika noma yimiphi imiphumela emibi oyitholayo ngenkathi usebenzisa i-beta blocker.
