Anticholinergic drugs: list. Iyo nzira yekuita kwe anticholinergic drug

Anticholinergic zvinodhaka mishonga inorambidza chiito chemurevereri chaiyo - acetylcholine - pane zvinokonzerwa necholinergic. Mune mamwe mabhuku mabhuku ekunze iyi boka remishonga rinoridzirwa se "vanoita basa" nemhaka yekwanisi yekuita delirium.

Nhamba shoma dzezvechokwadi

Pakutanga, pakati pezana ramakumi maviri nemaviri, zvinodhaka zve anticholinergic zvakashandiswa kurapa chirwere chisingaperi chepemmonary uye chechirwere chinonzi bronchial, asi zvakatsiviwa nemishonga yakawanda yemazuva ano ine madhara mashoma. Nekuvandudzika kwemafarmorike, masayendisiti akakwanisa kukudziridza holinoblokatory yakadaro, iyo isina ruzivo rwakakura rwandu rwemigumisiro. Maitiro akave akavandudzwa, uye mukurapa maitiro emishonga yepermonary anticholinergic madawa zvakare akashandiswa. Iyo nzira yekuita kweboka iri remishonga yakanyanya kuoma, asi zvinokwanisika kurondedzera hukama hukuru.

Ko holinoblokatory?

Mhedzisiro yakakosha yemishonga inonzi anticholinergic ndeyekuvhara zvinogamuchirwa zvecholinergic uye hazvigoneki kuvhiringidza nemurevereri - acetylcholine. Semuenzaniso, mu bronchi, mapepa anowanikwa mumisumbu yakanyorovha yakavharwa.

Kurongwa kwemishonga

Zvichienderana nezvipi zvekutora zvinokonzerwa ne anticholinergic zvinodhaka, urongwa hwakakamurirwa mumapoka makuru:

• M-holinoblokatory (atropine, scopolamine, ipratropium bromide).
• N-holinoblokatory (pentamine, tubocurarine).

Zvichienderana nechisarudzo chechiito:

• Central, kana kusina-selective (atropine, pyrensepine, platyphylline).
• Peripheral, kana kusarudza (ipratropium bromide).

M-holinoblokatory

Mumiririri mukuru weboka iri remishonga inokonzerwa neatropine. Atropine inonzi alkaloid inowanikwa mune zvimwe zvirimwa, zvakadai sebelladonna, yakachena uye yakasvibiswa. Imba inonyanya kutaurwa yeatropine is spasmolytic. Mukurwisana nemamiriro ezvakaitwa, mutsara weutema wegumbo, chironda, uye bronchi inoderera.

Atropine inotungamirirwa nemuromo, pasi pemutambo uye mukati. Nguva yezviito zvayo inenge maawa matanhatu, uye kana uchishandisa atropine semadonhwe, nguva inowedzera kwemazuva manomwe.

Pharmacological effects of atropine:

• Kuwedzerwa kwevadzidzi vemeso nekuda kwemagumisiro anokonzera musimba wepachiyero we-iris - mitsipa ye iris inononoka, pamwe chete, mudzidzi anowedzera. Izvozvo zvinowanzoitika 30-40 maminitsi mushure mekudzidzira.
• Kuoma kwemafuro ekugara - lenzi yakatambanudzwa uye yakanyongororwa, mishonga ye anticholinergic inoona ziso kumeso ari kure.
• Kuwedzera mumoyo wekuraira
• Kurasikirwa kwemasese anotsemuka mubronchi, maviri emakumbo, chikwata.
• Kuderedza kuvhara kwemazino emukati, zvakadai sebronchial, digestive uye sweat.

Kushandiswa kweatropine

• Muchifurafi: kuongororwa kwemari, kusarudza kwekudziviswa kweziso.
• Mune chirwere chepfungwa, atropine inoshandiswa kuBradycardia.
• Mu pulmonology, anticholinergics inoshandiswa muhuponi hwechirwere.
• Gastroenterology: ine peptic ulcer yemudumbu uye duodenum, hyperacid gastritis (nokudzikisa kuchengetedzwa kwehydrochloric acid muzvinyorwa zvekudya). Mushonga unobudirira mumukumbo colic.
• Mune anesthesiologists, atropine inoshandiswa sekugadziriswa vasati vasvika pakushandura kwakasiyana-siyana.

Zvikanganiso zveatropine.

Kuwedzerwa mukati momuromo uye marara, photophobia, kukanganisa kwezviso zvakatarisana, kuvhiringidzwa, kunetseka kunyorera kunhu.

Atropine inokonzerwa zvakasiyana-siyana mu glaucoma pamusana pemigumisiro yekuwedzera kwemaitiro emukati. Contraindicated anticholinergic zvinodhaka zvekuvhiringidza urinary, nokuti dzinosunungura mishonga yechipfuva. Cholinolytics inoda kunyatsosarudzwa kwemaji. Kana chirwere chacho chikapfuura, chepfu yehupenyu inowanikwa, iyo inoratidzirwa nemagetsi nemafungiro emumwoyo, kuidzidza kwevadzidzi, inzwi rinotyisa, kuoma mukugedza, pamwe pamwe nefivha. Nehuwandu hwehupfu hwakanyanya, varwere vanotanga kurasikirwa nekutarisana munzvimbo, vanorega kuziva vanhu vakavapoteredza, mazano uye mazano anoratidza. Zvichida kuwedzerwa kwekuvhiringidzika, izvo zvinotamirwa ku coma, uye nekuda kwekuoma kwemuviri wepumusoro, nzvimbo inokurumidza inotanga. Inonyanya kukoshesa kuwandisa kwechirwere vana - murairo wavo unouraya ndewe 6-10 mg.

Scopolamine yakafanana pakugadzirisa kune atropine, asi kusiyana nezvayo, inoshandisa zvinonyanya kuora mwoyo purogiramu yepamusoro yenyika, ichiita sedative. Ndiyo nzvimbo inoshandiswa mumishonga inoshanda - scopolamine inoshandiswa kwezvinetso zvakasiyana-siyana zvezvipfeko zvevastibular - dutu, kusava nemafungiro emararamiro uye kuenzanisa, kudzivirira kusimbiswa kwegungwa uye chirwere chemhepo.

Anticholinergic zvinodhaka zvinosanganiswa mumushonga we "Aeron", iyo inowanzoshandiswa kusati kwauya kunofamba pamapuraneti nemakungwa. Chiito chehwendefa chinotora maawa matanhatu. Iko kune maitiro asina kukodzera - chirongwa chetradermal therapeutic - chigamba chinenge chiri shure kwezeve uye chekita mishonga kwemaawa 72. Izvi zvinodhaka zve anticholinergic - zvinodzvinyirira, muzviitiko zvakanyanyisa kuregererwa zvinobatsira kukurumidza kusimbisa mafungiro omurwere ari muhupenyu husingaperi.

Ipratropium bromide (Atrovent) ihurumende inonzi bronchodilator. Kana yakanyungudutswa, inenge isina kunyanya kuiswa muropa uye haina unhu hwemagetsi. Pamusana pekuvharwa kwezvinyorwa zve cholinergic zvehupfumi hwakanaka hwebronchi, dzinowedzera. Izvi zvinodhaka zve anticholinergic zvinowanikwa nenzira yegadziriro yein inerer kana inerosol ye meter, uye inobatsira muhutachiona hwechirwere uye COPD. Migumisiro inokonzerwa neuseusea uye yakaoma muromo.

Tiotropium bromides inonzi anticholinergic zvinodhaka, zvakafanana muimba ye ipratropium bromide. Yakagadzirwa nenzira yehupfu yehuta. Chimwe chinhu chakasiyana chechirwere ichi ndechekuti inogara kwenguva yakawanda pazvilinergic receptors, saka inoshanda kupfuura ipratropium bromide. Inoshandiswa muCOPD.

Platyphylline ndiyo alkaloid yemuchinjikwa. Kusiyana nemamwe holinoblokatorov, platifillin inokwanisa kuderedza midziyo yeropa. Nemhaka yeimba iyi, pane kuderera kuduku kweropa. Mushonga unobudiswa sechinoshandiswa uye rectal suppositories. Inoshandiswa nemapasimusi mumatumbu asina kutenderera emuviri mukati, chiropa uye renal colic, chirwere chinoputika, uyewo nekurwadziwa kunokonzerwa nekuputika panguva yekuwedzerwa kweputi chechirwere chemudumbu uye duodenum. Muitiro wehupfumi, platyphylline inoshandiswa nenzira yemadonhwe eziso kuti iwedzere vadzidzi.

Pirenzepine - zvikuru inodzima masero emudumbu, kusunungura histamine. Nokuderedza kuvharwa kwe histamine, kusunungurwa kwehydrochloric acid kunopera. Muzviitiko zvinowanzoshandiswa pakurapa, ichi chiremba hachina mhedzisiro kune vadzidzi nekushaya moyo, saka pirenzepin inotorwa inotorwa mukati kuitira kurapa peptic ulcer yemudumbu uye duodenum.

N-holinoblokatory (ganglioblokatory)

Iyo nzira yekuita ndeyekuti anticholinergic zvinodhaka zveboka iri rinodzivirira tsitsi uye parasympathetic innervation pamwero we nerve nodes, kuderedza kusunungurwa kweAdrenaline uye noradrenaline, kunodzivisa kushamwaridzana kweputiro yekupumha uye vasomotor. Uye iyo yakanyanya kukuvadza kwekunzwira tsitsi kana kushaya rusununguko rwekuchengetedza, zvakanyanya kukudzivirira.

Semuenzaniso, ukuru hwevadzidzi hunosimbiswa zvakasimba neparasympathetic innervation - sekutonga, vadzidzi vanowanzopfupika. Muchiitiko ichi holinoblokatory ichakanganisa chirwere chesasympathetic chirwere - semugumisiro, vadzidzi vachawedzera. Anenge mishonga yese yeropa iri pasi pesimba remagadzirirwe emagetsi - madhiragi anobvisa simba rawo uye anoderedza midziyo yeropa, iyo inoderedza kushanda.

N-holinoblokatory ine chinokonzera maronchodilating uye inoshandiswa kuparadzaniswa kwebronchi, kuderedza inzwi rechirwere, saka izvi zvinodhaka zve anticholinergic zvinogona kurongerwa nekunetseka kunyorera. Mukuwedzera, mishonga iyi inoderedza kusvibiswa kwezvinyorwa zvemukati, uye kunonoka kupera kwemaitiro emimba. Mukurapa, iyo hypotensive effect, izvo zvinodhaka izvi zvinorwisa anticholinergic, zvinoshandiswa. Urongwa hwemagumisiro akazara hwakazara:

• Kubva pamakumbo emimba: yakaoma muromo uye kuvimbiswa.
• Pane chikamu chekufema: chifukidziro, zvichida manzwiro ekutsamwa kwemukati.
• Kubva kuCCC: arrhythmias, yakanyorwa palpitation. Zviratidzo izvi hazvishamisi uye zviri nyore kubviswa.
• Mimwe migumisiro: kunogona kuderedza kuonekwa kwakanaka, kukura kwechimiro chakaoma che glaucoma, edema.

Kupindirana kwekushandiswa kwe anticholinergic zvinodhaka

• Hypersensitivity kune zvigadzirwa zveatropine uye zvimwe zvikamu zvezvinodhaka.
• Kubata (kunyanya 1 trimester).
• Lactation.
• Vana vezera remakore (rinopesana nechokuita).
• Kunyatsopesana kushandiswa kwezvinodhaka muvharo-mazinga glaucoma, varwere vane ruzivo rwekushaya kukwana vanofanira kunyatsocherechedza ropa neropa.