I-Procainamide - Ukusetyenziswa, Idosi, Iziphumo ebezingalindelekanga nokunye

Intshayelelo: Yintoni iProcainamide?

I-Procainamide liyeza elisetyenziswa kakhulu ukunyanga iintlobo ezithile zentliziyo engaqhelekanga, eyaziwa ngokuba yi-arrhythmias. Likwiqela lamayeza abizwa ngokuba yi-antiarrhythmics, asebenza ukubuyisela isigqi sentliziyo esiqhelekileyo. Liyacetyiswa kwiimeko ezithile ngokwezikhokelo ze-AHA/ACC/HRS kunye ne-ESC, ezifana ne-stable wide-complex tachycardia okanye xa ezinye iindlela zonyango zingaphumeleli, emva kokuvavanya iingozi ezifana ne-QT prolongation. I-Procainamide idla ngokumiselwa xa ezinye iindlela zonyango zingasebenzi, okanye xa izigulane zineentlobo ezithile ze-arrhythmias ezifuna ukungenelela.

Ukusetyenziswa kweProcainamide

I-Procainamide ivunyiwe ukusetyenziswa ngeendlela ezahlukeneyo zonyango, kuquka:

• I-Ventricular Arrhythmias: Isetyenziswa kakhulu ukunyanga i-ventricular tachycardia, imeko apho intliziyo ibetha ngokukhawuleza ngenxa yemiqondiso yombane engafanelekanga.
• I-Atrial Fibrillation: I-Procainamide inokunceda ukubuyisela isigqi esiqhelekileyo kwizigulana ezine-atrial fibrillation, uhlobo oluqhelekileyo lwe-arrhythmia.
• I-Tachycardia ye-Supraventricular: Eli yeza likwasebenza kakuhle ekulawuleni i-supraventricular tachycardia, apho amagumbi aphezulu entliziyo ebetha ngokukhawuleza.

Isebenza njani iProcainamide?

I-Procainamide ivala imijelo yesodium entliziyweni, icothisa imiqondiso yombane elawula ukubetha kwentliziyo. Ngokwenza oku, inceda ekuzinziseni isigqi sentliziyo kwaye iyithintele ekubetheni ngokukhawuleza kakhulu okanye ngokungacwangciswanga. Esi senzo sivumela intliziyo ukuba ipompe igazi ngokufanelekileyo, nto leyo ephucula ukusebenza kwentliziyo iyonke.

Isisombululo kunye noLawulo

Umlinganiselo weProcainamide uyahluka ngokuxhomekeke kwimeko, ubudala besigulana, ukusebenza kwezintso, kunye nendlela esisabela ngayo kunyango, kulandela izikhokelo ezifana nezo zivela kwi-AHA/ACC/HRS.

Abadala:

Umthamo wokuqala ngomlomo udla ngokuba yi-100 mg ukuya kwi-150 mg rhoqo emva kweeyure ezi-6 ukuya kwezi-8, ohlengahlengiswayo ube yidosi ephezulu yemihla ngemihla ye-3 grams. Kwiimeko ezingxamisekileyo, utyando lwe-IV luqala ngedosi yokulayisha ye-10-15 mg/kg (ukuya kuthi ga kwi-1 gram) enikwa kancinci kwi-20-50 mg/min, kulandele utyando lokugcina lwe-2-6 mg/min nge-ECG kunye nokujonga amanqanaba egazi.

Iintsholongwane:

Idosi isekelwe kubunzima, idla ngokuba yi-15 mg/kg/ngosuku yahlulwe ngomlomo rhoqo emva kweeyure ezi-6-8, okanye i-IV loading kwi-10-15 mg/kg (ubuninzi yi-1 gram kwi-0.5 mg/kg/min) ilandelwe yi-30-80 mcg/kg/min infusion. I-Procainamide iza njengeepilisi zomlomo okanye i-IV injections, kwaye i-IV igcinelwe iimeko zesibhedlele ezifuna ukubekwa esweni ngokusondeleyo. Landela imiyalelo ethile kagqirha wakho rhoqo.

Iziphumo ebezingalindelekanga zeProcainamide

Njengazo zonke iziyobisi, iProcainamide inokubangela iziphumo ebezingalindelekanga. Eziqhelekileyo ziquka isicaphucaphu, ukuhlanza, urhudo, isiyezi, kunye nokudinwa. Iziphumo ebezingalindelekanga ezinzulu zinokubandakanya ukuvaleka kwentliziyo, i-lupus-like syndrome (iintlungu zamalungu, ukudinwa), iingxaki zegazi ezifana ne-agranulocytosis (iiseli ezimhlophe zegazi ezisezantsi ezinyusa umngcipheko wosulelo), kunye nokwandiswa kwexesha le-QT, okuphakamisa umngcipheko we-rhythm eyingozi ebizwa ngokuba yi-torsades de pointes? ngakumbi nge-metabolite yayo i-N-acetylprocainamide kwimiba yezintso. Kuya kufuneka ufune uncedo lwezonyango ngokukhawuleza kwiintlungu zesifuba, ukuphefumla okufutshane, ukuquleka, okanye isiyezi esinzima.

Ukusebenzisana kweziyobisi

I-Procainamide inokusebenzisana nezinye iziyobisi, nto leyo ephakamisa umngcipheko weziphumo ebezingalindelekanga okanye inciphise ukusebenza kwayo. Iindlela eziphambili zokunxibelelana ziquka:

• Ezinye ii-antiarrhythmics: Iziphumo ezongezelelweyo zinokubangela ukuba i-arrhythmias ibe mandundu.
• Amayeza okwandisa ixesha le-QT: (umz., amayeza athile okudambisa uxinzelelo afana ne-citalopram, amayeza okubulala iintsholongwane afana ne-ciprofloxacin, amayeza okubulala iingqondo): Ukwandisa umngcipheko we-torsades de pointes risk.
• Izithinteli zokukhupha ulwelo lwezintso: (umz., i-cimetidine, i-trimethoprim): Nyusa amanqanaba eProcainamide.

Qaphela: I-Procainamide ayisetyenziswa kakhulu yi-enzymes ze-CYP450 kodwa isetyenziswa yi-acetylation; i-metabolite yayo esebenzayo ye-NAPA yenzeka ngale ndlela, ngokuguquguquka "kwii-acetylators ezikhawulezayo/ezicothayo." Yazisa ugqirha wakho malunga nawo onke amayeza, izongezo, kunye namayeza.

Iinzuzo zeProcainamide

I-Procainamide ineenzuzo ezininzi zonyango:

• Isebenza kakuhle kwi-Arrhythmias ethile: Isebenza ngakumbi kwi-ventricular arrhythmias, kwaye inika ukhetho oluthembekileyo xa ezinye iindlela zonyango zingaphumeleli.
• Ukuqala kwesenzo esiKhawulezayo: Xa ifakwa ngemithambo yegazi, iProcainamide inokuzinzisa ngokukhawuleza isingqisho sentliziyo kwiimeko eziqatha.
• Imbali ende yokusebenzisa: Ngenxa yokusetyenziswa kwezonyango kangangeminyaka emininzi, iProcainamide ineprofayili yokhuseleko nokusebenza kakuhle.

Izithintelo zeProcainamide

Abantu abathile kufuneka baphephe ukusebenzisa iProcainamide, kuquka:

• Izigulane ezine-heart blocked epheleleyo ngaphandle kokuba zine-pacemaker, ngenxa yomngcipheko we-asystole.
• Abafazi abakhulelweyo, kuba inokwenzakalisa umntwana ongekazalwa (udidi C).
• Abantu abane-myasthenia gravis, i-systemic lupus erythematosus, okanye abane-hypersensitivity kwiyeza.

Lumka kwabo banexesha elide le-QT, i-AV block yenqanaba lesibini/lesithathu, isifo sesibindi/izintso esibi, okanye ukungalingani kwe-electrolyte, njengoko kwandisa umngcipheko we-arrhythmia.

Izilumkiso kunye nezilumkiso

Ngaphambi kokuba uqale iProcainamide, izigulane kufuneka zenze uvavanyo oluthile lwelabhoratri ukuze zijonge ukusebenza kwentliziyo kunye namanqanaba egazi. Ukulandela rhoqo kubalulekile ukuqinisekisa ukuba iyeza lisebenza ngokufanelekileyo kwaye kulungiswe imithamo njengoko kufuneka. Izigulane kufuneka zilumke malunga nokuzibandakanya kwimisebenzi efuna ukuphaphama, njengoko iProcainamide inokubangela isiyezi.

FAQs

• Isetyenziselwa ntoni iProcainamide? I-Procainamide isetyenziselwa ukunyanga ukubetha kwentliziyo okungahambelaniyo, ingakumbi i-ventricular tachycardia kunye ne-atrial fibrillation.
• Isetyenziswa njani iProcainamide? Ingathathwa ngomlomo kwifomu yepilisi okanye inikwe njengenaliti esibhedlele.
• Zeziphi iziphumo ebezingalindelekanga eziqhelekileyo? Iziphumo ebezingalindelekanga eziqhelekileyo ziquka isicaphucaphu, isiyezi, kunye nokudinwa.
• Ngaba iProcainamide ingasetyenziswa kunye namanye amayeza? Amanye amayeza anokusebenzisana neProcainamide, ngoko ke kubalulekile ukwazisa ugqirha wakho ngazo zonke iziyobisi ozisebenzisayo.
• Ngaba iProcainamide ikhuselekile ngexesha lokukhulelwa? Abafazi abakhulelweyo bafanele bayiphephe iProcainamide ngaphandle kokuba imiselwe ngugqirha, kuba inokubangela iingozi kumntwana ongekazalwa.
• Isebenza njani iProcainamide? Isebenza ngokuvala imijelo yesodium entliziyweni, inceda ekuzinziseni isigqi sentliziyo.
• Ndingenza ntoni xa ndiphosa ithamo? Ukuba uphose ithamo, yithathe ngokukhawuleza xa ukhumbula. Ukuba isondele kwidosi elandelayo, tsiba idosi oyiphosileyo kwaye uqhubeke neshedyuli yakho yesiqhelo.
• Ngaba iProcainamide ingabangela iziphumo ebezingalindelekanga ezibi kakhulu? Ewe, iziphumo ebezingalindelekanga ezinzulu zinokubakho, kuquka ukuvalwa kwentliziyo kunye nokuphazamiseka kwegazi. Funa uncedo lwezonyango ukuba ufumana iimpawu eziqatha.
• Ithatha ixesha elingakanani iProcainamide ukusebenza? Ukuqala kokusebenza kunokwahluka; ukunikezelwa ngemithambo yegazi kunokubonelela ngemiphumo ekhawulezileyo, ngelixa iindlela zomlomo zinokuthatha ixesha elide.
• Ngaba kufuneka uhlolwe rhoqo xa usebenzisa iProcainamide? Ewe, ukujonga rhoqo ukusebenza kwentliziyo kunye namanqanaba egazi kubalulekile ukuqinisekisa ukhuseleko kunye nokusebenza kakuhle.

Amagama eBrand

I-Procainamide ifumaneka phantsi kwamagama eempawu ezahlukeneyo, kuquka:

• I-Pronestyl
• I-Procanbid

isiphelo

I-Procainamide liyeza elibalulekileyo lokulawula iintlobo ezithile ze-arrhythmias, libonelela ngeendlela zonyango ezisebenzayo kwizigulana ezineentliziyo ezingaqhelekanga. Ukuqonda ukusetyenziswa kwayo, iziphumo ebezingalindelekanga, kunye nokusebenzisana kwayo kubalulekile kunyango olukhuselekileyo nolusebenzayo. Soloko unxibelelana nomboneleli wezempilo ngaphambi kokuba uqalise okanye uyeke naluphi na unyango.