Procainamide

Chiyambi: Kodi Procainamide ndi chiyani?

Procainamide ndi mankhwala omwe amagwiritsidwa ntchito makamaka pochiza mitundu ina ya kugunda kwa mtima kosakhazikika, komwe kumadziwika kuti arrhythmias. Ndi m'gulu la mankhwala otchedwa antiarrhythmics, omwe amagwira ntchito yobwezeretsa kamvekedwe ka mtima koyenera. Amalimbikitsidwa pazochitika zinazake malinga ndi malangizo a AHA/ACC/HRS ndi ESC, monga tachycardia yokhazikika kapena pamene mankhwala ena alephera, mutayesa zoopsa monga kutalikitsa QT. Procainamide nthawi zambiri imaperekedwa ngati mankhwala ena sagwira ntchito, kapena pamene odwala ali ndi mitundu inayake ya arrhythmias yomwe imafuna kulowererapo.

Ntchito za Procainamide

Procainamide yavomerezedwa kuti igwiritsidwe ntchito m'njira zosiyanasiyana zachipatala, kuphatikizapo:

• Ventricular Arrhythmias: Kawirikawiri amagwiritsidwa ntchito pochiza tachycardia ya ventricular, vuto lomwe mtima umagunda mofulumira kwambiri chifukwa cha zizindikiro zamagetsi zosayenerera.
• Matenda a Atrial Fibrillation: Procainamide ingathandize kubwezeretsa kamvekedwe ka thupi mwa odwala omwe ali ndi vuto la atrial fibrillation, mtundu wofala wa arrhythmia.
• Supraventricular tachycardia: Mankhwalawa ndi othandizanso pochiza tachycardia ya supraventricular, komwe zipinda zapamwamba za mtima zimagunda mofulumira.

Kodi Procainamide Imagwira Ntchito Bwanji?

Procainamide imatseka njira za sodium mumtima, ndikuchepetsa zizindikiro zamagetsi zomwe zimawongolera kugunda kwa mtima. Pochita izi, zimathandiza kukhazikika kwa kamvekedwe ka mtima ndikuletsa kugunda kwake mofulumira kwambiri kapena mosagwirizana. Izi zimathandiza mtima kupopa magazi bwino, zomwe zimapangitsa kuti mtima wonse ugwire bwino ntchito.

Mlingo ndi Utsogoleri

Mlingo wa Procainamide umasiyana malinga ndi matenda, zaka za wodwalayo, momwe impso zake zimagwirira ntchito, komanso momwe amayankhira chithandizo, potsatira malangizo monga a AHA/ACC/HRS.

Akuluakulu:

Mlingo woyambira pakamwa nthawi zambiri umakhala 100 mg mpaka 150 mg maola 6 mpaka 8 aliwonse, womwe umasinthidwa kufika pa mlingo wapamwamba kwambiri wa tsiku ndi tsiku wa magalamu 3. Pa milandu yofulumira, kuperekedwa kwa mtsempha kumayamba ndi mlingo wokweza wa 10-15 mg/kg (mpaka 1 gramu) woperekedwa pang'onopang'ono pa 20-50 mg/mphindi, kutsatiridwa ndi kulowetsedwa kwa 2-6 mg/mphindi ndi ECG ndikuwunika kuchuluka kwa magazi.

Zachipatala:

Mlingo umadalira kulemera, nthawi zambiri 15 mg/kg/tsiku ndi tsiku, kugawidwa pakamwa maola 6-8 aliwonse, kapena kulowetsedwa m'mitsempha pa 10-15 mg/kg (max 1 gram pa 0.5 mg/kg/min) kutsatiridwa ndi kulowetsedwa kwa 30-80 mcg/kg/min. Procainamide imabwera ngati mapiritsi omwa kapena jakisoni wa IV, ndipo IV imasungidwa kuchipatala chomwe chimafuna kuyang'aniridwa mosamala. Nthawi zonse tsatirani malangizo enieni a dokotala wanu.

Zotsatirapo za Procainamide

Monga mankhwala ena onse, Procainamide ingayambitse mavuto ena. Ambiri mwa iwo ndi nseru, kusanza, kutsegula m'mimba, chizungulire, ndi kutopa. Zotsatirapo zoyipa kwambiri zingaphatikizepo kutsekeka kwa mtima, lupus-like syndrome (kupweteka kwa mafupa, kutopa), matenda a magazi monga agranulocytosis (maselo oyera ochepa m'magazi omwe amawonjezera chiopsezo cha matenda), ndi kutalikitsa nthawi ya QT, zomwe zimawonjezera chiopsezo cha rhythm yoopsa yotchedwa torsades de pointes? makamaka ndi metabolite yake ya N-acetylprocainamide m'mavuto a impso. Muyenera kufunafuna thandizo lachipatala mwachangu ngati mukuvutika ndi kupweteka pachifuwa, kupuma movutikira, kukomoka, kapena chizungulire chachikulu.

Kuyanjana kwa Mankhwala

Procainamide imatha kuyanjana ndi mankhwala ena, zomwe zimawonjezera zoopsa kapena kuchepetsa mphamvu yake. Kuyanjana kwakukulu ndi izi:

• Mankhwala ena oletsa kupweteka kwa mtima: Zotsatira zowonjezera zimatha kukulitsa arrhythmias.
• Mankhwala owonjezera nthawi ya QT: (monga mankhwala ena oletsa kuvutika maganizo monga citalopram, maantibayotiki monga ciprofloxacin, antipsychotics): Kuonjezera chiopsezo cha torsades de pointes risk.
• Zoletsa kutulutsa kwa impso: (monga cimetidine, trimethoprim): Kwezani kuchuluka kwa Procainamide.

Chidziwitso: Procainamide siimangosinthidwa ndi ma enzyme a CYP450 koma kudzera mu acetylation; metabolite yake yogwira ntchito ya NAPA imapanga kudzera munjira iyi, ndi kusinthasintha kwa "ma acetylators ofulumira/osachedwa." Dziwitsani dokotala wanu za mankhwala onse, zowonjezera, ndi zitsamba.

Ubwino wa Procainamide

Procainamide ili ndi zabwino zingapo zachipatala:

• Zothandiza pa Arrhythmias Yeniyeni: Ndi yothandiza kwambiri pa matenda a ventricle arrhythmias, ndipo imapereka njira yodalirika pamene mankhwala ena alephera.
• Kuyamba Mwachangu: Ikaperekedwa kudzera m'mitsempha, Procainamide imatha kukhazikika mwachangu mumtima mwa munthu pakakhala vuto lalikulu.
• Mbiri Yakale Yogwiritsidwa Ntchito: Pogwiritsa ntchito mankhwala kwa zaka zambiri, Procainamide yadziwika bwino kuti ndi yotetezeka komanso yogwira ntchito bwino.

Zotsutsana za Procainamide

Anthu ena ayenera kupewa kugwiritsa ntchito Procainamide, kuphatikizapo:

• Odwala omwe ali ndi vuto la mtima wotsekeka pokhapokha ngati ali ndi pacemaker, chifukwa cha chiopsezo cha asystole.
• Amayi oyembekezera, chifukwa zingavulaze mwana wosabadwayo (Gulu C).
• Anthu omwe ali ndi myasthenia gravis, systemic lupus erythematosus, kapena omwe ali ndi hypersensitivity ku mankhwala.

Samalani ndi anthu omwe ali ndi nthawi yayitali ya QT, AV block ya digiri yachiwiri/yachitatu, matenda oopsa a chiwindi/impso, kapena kusalinganika kwa ma electrolyte, chifukwa zimawonjezera chiopsezo cha arrhythmia.

Kusamala ndi machenjezo

Asanayambe kugwiritsa ntchito Procainamide, odwala ayenera kuyesedwa labu kuti awone momwe mtima ndi magazi awo zimagwirira ntchito. Kukumana ndi dokotala nthawi zonse ndikofunikira kuti atsimikizire kuti mankhwalawa akugwira ntchito bwino komanso kusintha mlingo wake ngati pakufunika kutero. Odwala ayeneranso kusamala ndi zochita zomwe zimafuna kukhala maso, chifukwa Procainamide ingayambitse chizungulire.

Ibibazo

• Kodi Procainamide imagwiritsidwa ntchito pa chiyani? Procainamide imagwiritsidwa ntchito pochiza kugunda kwa mtima kosakhazikika, makamaka ventricular tachycardia ndi atrial fibrillation.
• Kodi Procainamide imaperekedwa bwanji? Itha kumwedwa pakamwa ngati piritsi kapena jakisoni kuchipatala.
• Zotsatira zoyipa zomwe zimachitika nthawi zambiri ndi zotani? Zotsatirapo zoyipa zomwe zimachitika nthawi zambiri zimaphatikizapo nseru, chizungulire, komanso kutopa.
• Kodi Procainamide ingagwiritsidwe ntchito limodzi ndi mankhwala ena? Mankhwala ena amatha kusokonezana ndi Procainamide, choncho ndikofunikira kudziwitsa dokotala wanu za mankhwala onse omwe mukumwa.
• Kodi Procainamide ndi yotetezeka panthawi ya mimba? Amayi oyembekezera ayenera kupewa Procainamide pokhapokha ngati dokotala wawapatsa malangizo, chifukwa izi zingayambitse mavuto kwa mwana wosabadwayo.
• Kodi Procainamide imagwira ntchito bwanji? Imagwira ntchito potseka njira za sodium mumtima, zomwe zimathandiza kukhazikika kwa kayendedwe ka mtima.
• Kodi ndingatani ndikaphonya mlingo? Ngati mwaphonya mlingo, imwani mwamsanga mukakumbukira. Ngati ili pafupi ndi mlingo wotsatira, dumphani mlingo womwe mwaphonya ndikupitiriza ndi ndondomeko yanu yanthawi zonse.
• Kodi Procainamide ingayambitse zotsatirapo zoyipa kwambiri? Inde, zotsatirapo zoyipa zimatha kuchitika, kuphatikizapo kutsekeka kwa mtima ndi matenda a magazi. Pitani kuchipatala ngati mukukumana ndi zizindikiro zoopsa.
• Kodi Procainamide imatenga nthawi yayitali bwanji kuti igwire ntchito? Chiyambi cha ntchito chingasiyane; kuperekedwa kudzera m'mitsempha kungapereke zotsatira mwachangu, pomwe njira zoledzeretsa pakamwa zingatenge nthawi yayitali.
• Kodi kuyang'aniridwa pafupipafupi mukamagwiritsa ntchito Procainamide kumafunika? Inde, kuyang'anira nthawi zonse momwe mtima umagwirira ntchito komanso kuchuluka kwa magazi ndikofunikira kuti zitsimikizire kuti mtima ndi wotetezeka komanso wogwira ntchito bwino.

Mayina A Brand

Procainamide imapezeka m'mafakitale osiyanasiyana, kuphatikizapo:

• Pronestyl
• Procanbid

Kutsiliza

Procainamide ndi mankhwala ofunikira kwambiri pochiza mitundu ina ya arrhythmias, omwe amapereka njira zothandiza zothandizira odwala omwe ali ndi vuto la mtima losakhazikika. Kumvetsetsa momwe amagwiritsidwira ntchito, zotsatira zake, komanso momwe amagwirizanirana ndi mankhwala ndikofunikira kwambiri kuti chithandizo chikhale chotetezeka komanso chothandiza. Nthawi zonse funsani dokotala musanayambe kapena kusiya kumwa mankhwala aliwonse.