I-Procainamide

Isingeniso: Kuyini i-Procainamide?

I-Procainamide umuthi osetshenziswa kakhulu ukwelapha izinhlobo ezithile zokushaya kwenhliziyo okungajwayelekile, okwaziwa ngokuthi ama-arrhythmia. Ingokwesigaba semithi ebizwa ngokuthi ama-antiarrhythmics, asebenza ukubuyisela isigqi senhliziyo esijwayelekile. Kunconywa ezimweni ezithile ngokweziqondiso ze-AHA/ACC/HRS kanye ne-ESC, njenge-stachycardia ebanzi ezinzile noma lapho ezinye izindlela zokwelapha zehluleka, ngemuva kokuhlola izingozi ezifana nokwandiswa kwe-QT. I-Procainamide ivame ukunikezwa lapho ezinye izindlela zokwelapha zingasebenzi, noma lapho iziguli zinezinhlobo ezithile ze-arrhythmias ezidinga ukungenelela.

Ukusetshenziswa kwe-Procainamide

I-Procainamide ivunyelwe ukusetshenziswa kwezokwelapha eziningana, okuhlanganisa:

• I-Arrhythmia ye-Ventricular: Ngokuvamile isetshenziselwa ukwelapha i-ventricular tachycardia, isimo lapho inhliziyo ishaya ngokushesha kakhulu ngenxa yezimpawu zikagesi ezingafanele.
• I-Atrial Fibrillation: I-Procainamide ingasiza ekubuyiseleni isigqi esijwayelekile ezigulini ezibhekene ne-atrial fibrillation, uhlobo oluvamile lwe-arrhythmia.
• I-Tachycardia ye-Supraventricular: Lo muthi uyasebenza futhi ekuphatheni i-supraventricular tachycardia, lapho amakamelo aphezulu enhliziyo eshaya khona ngokushesha.

Isebenza Kanjani I-Procainamide?

I-Procainamide ivimba iziteshi ze-sodium enhliziyweni, inciphisa izimpawu zikagesi ezilawula ukushaya kwenhliziyo. Ngokwenza lokhu, kusiza ekuqiniseni isigqi senhliziyo futhi kuyivimbele ekushayeni ngokushesha kakhulu noma ngokungajwayelekile. Lesi senzo sivumela inhliziyo ukuthi ipompe igazi ngempumelelo, ithuthukise ukusebenza kwenhliziyo iyonke.

Isilinganiso nokuphathwa

Umthamo we-Procainamide uyahlukahluka kuye ngesimo, iminyaka yesiguli, ukusebenza kwezinso, kanye nempendulo yokwelashwa, kulandela iziqondiso ezifana nalezo ezivela ku-AHA/ACC/HRS.

Abantu abadala:

Umthamo wokuqala ngomlomo uvame ukuba ngu-100 mg kuya ku-150 mg njalo emahoreni angu-6 kuya kwangu-8, olungiselelwa umthamo omkhulu wansuku zonke wamagremu angu-3. Ezimweni eziphuthumayo, ukuphathwa nge-IV kuqala ngomthamo wokulayisha ongu-10-15 mg/kg (kufika ku-1 gram) onikezwa kancane ku-20-50 mg/min, kulandelwe ukumnika kokugcina okungu-2-6 mg/min nge-ECG kanye nokuqapha izinga legazi.

Izingane:

Isilinganiso sisekelwe esisindweni, ngokuvamile singu-15 mg/kg/ngosuku sihlukaniswe ngomlomo njalo emahoreni angu-6-8, noma umthwalo we-IV ku-10-15 mg/kg (ubuningi be-1 gram ku-0.5 mg/kg/min) kulandelwe ukumiliswa okungu-30-80 mcg/kg/min. I-Procainamide iza njengamaphilisi omlomo noma imijovo ye-IV, kanti i-IV igcinelwe izimo zesibhedlela ezidinga ukubhekwa eduze. Landela njalo imiyalelo ethile kadokotela wakho.

Imiphumela Engemihle ye-Procainamide

Njengayo yonke imithi, i-Procainamide ingabangela imiphumela emibi. Evamile ihlanganisa isicanucanu, ukuhlanza, isifo sohudo, isiyezi, kanye nokukhathala. Imiphumela emibi emibi ingafaka phakathi ukuvimba kwenhliziyo, i-lupus-like syndrome (ubuhlungu bamalunga, ukukhathala), izinkinga zegazi ezifana ne-agranulocytosis (amangqamuzana amhlophe aphansi egazi andisa ingozi yokutheleleka), kanye nokwandiswa kwesikhathi se-QT, okuphakamisa ingozi yesigqi esiyingozi esibizwa ngokuthi i-torsades de pointes? ikakhulukazi nge-metabolite yayo i-N-acetylprocainamide ezinkingeni zezinso. Kufanele ufune usizo lwezokwelapha ngokushesha ngenxa yobuhlungu besifuba, ukuphelelwa umoya, ukuquleka, noma isiyezi esinzima.

Ukusebenzisana kwezidakamizwa

I-Procainamide ingasebenzisana neminye imithi, ikhuphule izingozi zemiphumela emibi noma yehlise ukusebenza kahle. Ukusebenzisana okubalulekile kufaka phakathi:

• Ezinye izidakamizwa ze-antiarrhythmic: Imiphumela eyengeziwe ingase ibe mibi kakhulu kuma-arrhythmia.
• Imithi yokwandisa i-QT: (isib., imithi ethile yokucindezeleka njenge-citalopram, imithi elwa namagciwane njenge-ciprofloxacin, imithi yokwelapha ingqondo): Yandisa ingozi ye-torsades de pointes.
• Izivimbeli zokukhishwa kwezinso: (isib. i-cimetidine, i-trimethoprim): Khuphula amazinga e-Procainamide.

Qaphela: I-Procainamide ayigaywa ngokuyinhloko yi-enzymes ye-CYP450 kodwa nge-acetylation; i-metabolite yayo esebenzayo ye-NAPA yakha ngale ndlela, ngokuguquguquka "kwama-acetylators asheshayo/ahamba kancane." Yazisa udokotela wakho ngayo yonke imithi, izithasiselo, kanye namakhambi.

Izinzuzo ze-Procainamide

I-Procainamide inezinzuzo eziningana zezokwelapha:

• Isebenza kahle kuma-arrhythmias athile: Isebenza kahle kakhulu kuma-arrhythmia e-ventricular, futhi inikeza inketho ethembekile lapho ezinye izindlela zokwelapha zehluleka.
• Ukuqala Kwesenzo Esisheshayo: Uma inikezwa ngemithambo yegazi, i-Procainamide ingasheshisa ukushaya kwenhliziyo ezimweni ezibucayi.
• Umlando omude wokusetshenziswa: Njengoba sekusetshenziswe iminyaka eminingi emtholampilo, i-Procainamide inephrofayili yokuphepha nokusebenza kahle okuqinisekisiwe.

Izimo zokuphikisana ne-Procainamide

Abantu abathile kufanele bagweme ukusebenzisa i-Procainamide, okuhlanganisa:

• Iziguli ezinesifo senhliziyo esivimbekile ngokuphelele ngaphandle kokuba zine-pacemaker, ngenxa yengozi ye-asystole.
• Abesifazane abakhulelwe, njengoba kungase kulimaze ingane esanda kuzalwa (Isigaba C).
• Abantu abane-myasthenia gravis, i-systemic lupus erythematosus, noma ukuzwela kakhulu umuthi.

Qaphela kulabo abanesikhathi eside se-QT, i-AV block yezinga lesibili/lesithathu, isifo esibi sesibindi/izinso, noma ukungalingani kwama-electrolyte, njengoba kwandisa izingozi ze-arrhythmia.

Ukuqapha Nezexwayiso

Ngaphambi kokuqala i-Procainamide, iziguli kufanele zenze izivivinyo ezithile zelebhu ukuze kuqashwe ukusebenza kwenhliziyo kanye namazinga egazi. Ukuqokwa njalo kokulandela kubalulekile ukuqinisekisa ukuthi umuthi usebenza kahle futhi kulungiswe imithamo njengoba kudingeka. Iziguli kufanele futhi ziqaphele ngokuzibandakanya emisebenzini edinga ukuqaphela, njengoba i-Procainamide ingabangela isiyezi.

Imibuzo Evame Ukubuzwa

• I-Procainamide isetshenziselwani? I-Procainamide isetshenziselwa ukwelapha ukushaya kwenhliziyo okungajwayelekile, ikakhulukazi i-ventricular tachycardia kanye ne-atrial fibrillation.
• I-Procainamide inikezwa kanjani? Ingathathwa ngomlomo ngesimo sethebhulethi noma inikezwe njengomjovo esibhedlela.
• Yimiphi imiphumela emibi evamile? Imiphumela emibi evamile ihlanganisa isicanucanu, isiyezi, kanye nokukhathala.
• Ingabe i-Procainamide ingathathwa neminye imithi? Eminye imithi ingasebenzisana ne-Procainamide, ngakho-ke kubalulekile ukwazisa udokotela wakho ngayo yonke imithi oyithathayo.
• Ingabe i-Procainamide iphephile ngesikhathi sokukhulelwa? Abesifazane abakhulelwe kufanele bagweme i-Procainamide ngaphandle kokuthi inikezwe udokotela, ngoba ingabangela izingozi enganeni.
• Isebenza kanjani i-Procainamide? Isebenza ngokuvimba iziteshi ze-sodium enhliziyweni, okusiza ekuqiniseni isigqi senhliziyo.
• Yini okufanele ngiyenze uma ngiphuthelwa umthamo? Uma uphuthelwa umthamo, thatha ngokushesha lapho ukhumbula. Uma kuseduze nomthamo olandelayo, yeqa umthamo futhi uqhubeke neshejuli yakho evamile.
• Ingabe i-Procainamide ingabangela imiphumela emibi kakhulu? Yebo, imiphumela emibi kakhulu ingaba khona, okuhlanganisa ukuvimba kwenhliziyo kanye nokuphazamiseka kwegazi. Funa usizo lwezokwelapha uma uhlangabezana nezimpawu ezinzima.
• Kuthatha isikhathi esingakanani ukusebenza kwe-Procainamide? Ukuqala kokusebenza kungahluka; ukuphathwa ngemithambo yegazi kunganikeza imiphumela esheshayo, kanti izindlela zomlomo zingase zithathe isikhathi eside.
• Ingabe kudingeka ukuqapha njalo uma usebenzisa i-Procainamide? Yebo, ukuqapha njalo ukusebenza kwenhliziyo kanye namazinga egazi kubalulekile ukuqinisekisa ukuphepha nokusebenza kahle.

Amagama Omkhiqizo

I-Procainamide itholakala ngaphansi kwamagama emikhiqizo eminingana, okuhlanganisa:

• I-Pronestyl
• I-Procanbid

Isiphetho

I-Procainamide iwumuthi obalulekile wokuphatha izinhlobo ezithile ze-arrhythmias, inikeza izinketho zokwelapha ezisebenzayo ezigulini ezinezinhliziyo ezingavamile. Ukuqonda ukusetshenziswa kwayo, imiphumela emibi, kanye nokusebenzisana kwayo kubalulekile ekwelashweni okuphephile nokuphumelelayo. Njalo xhumana nomhlinzeki wezempilo ngaphambi kokuqala noma ukuyeka noma yimuphi umuthi.