Cardiac glycosides. Chii?

Cardiac glycosides akafanana kwemakemikari chivako kuti bile acids, cortisone, mavhitaminzi, mahormone, remafuta akawandisa. Izvi zvinhu zviri dzinongoitika metabolites kuti vanochengetedza chakaipa nokushanda kwenhengo dzemwoyo.

Cardiac glycosides akaumbwa glucone (shuga) uye aglycone. It aglycone ndiko kuona zvinodhaka ari pharmacological basa. Kupinda maitiro nevamwe vanoshingaira zvinhu kunovimbisa unsaturated shanu-membered mhete maumbirwo yavo.

Cardiac glycosides kuti nyama uye nhengo anoparadzirwa vanoiswa. Kunanga zviito zvavo - the myocardium, izvo rinoungana chete 10% of Pfungwa, mamwe 50% ndee muna striated tsandanyama apo kwete kukonzera zvainoita.

Nokuti ya zviito cardiac glycosides akakamurwa:

- refu - digitoxin,

- pakati - digoxin

- pfupi - strofantin, Korglikon.

Cardiac glycosides: mashandiro chiito

In inowanzotorwa neHurumende cardiomyocytes mabhati ka30 kupfuura potassium uye ka20 zvishoma yavaibvisa. Panguva yokuzorora, chokunze penyika muchitokisi Kamudzira iri chokwadi mhosva, uye dzomunyika - pamusoro zvinopesana, akaipa. Pamusoro excitation chikonzero Kamudzira depolarization: yavaibvisa uye calcium yakawanda kupinda sero. Panguva iyi, kuti potassium haangaupfuuri kuburikidza muchitokisi membrane. Kana mangoti vakabva muchitokisi, repolarization kwacho kunotanga. nguva iyi kunoitika chete asati tsandanyama marwadzo. Saka, uwandu calcium Logged anopa rutapudzo masero. Potassium ions vasara muchitokisi, muri mhandu acho.

Cardiac glycosides ngaachimbidzike kutanga repolarization uye zvinopa kunonyanyisa zvibereko potassium cardiomyocytes. Mushure rutapudzo zvinodiwa kuti adzorere pakuenzanisa ions mukati uye kunze muchitokisi (potassium uye yavaibvisa kudzoka goho). Izvi ndizvo novimba simba kuchengeterwa masero, yairevererwa ATP-ase enzayemu. Its vanoshingaira nzvimbo - sulfhydryl boka. Cardiac glycosides adzikatidza kushingaira nzvimbo, achidzikisa basa. izvi zvose zvinotungamirira chokuti yavaibvisa ions kuramba muchitokisi, uye izvi Inowedzera kutanga inotevera depolarization. Kana zviri potassium ions kuchaita kuderera chaizvo, kubatana kwetunhu creatine phosphate yaputswa, iyo inotungamirira zvinoderedza simba marwadzo ose cardiac tsandanyama.

Cardiac glycosides: contraindications

NeMhedziso contraindications kwavo kushandisa Vanoshandisa: atrioventricular nechigumbuso II dhigirii, sinus bradycardia, neutachiona kuti izvi nezvinodhaka, kudhaka pavo.

Nokuti hama contraindications ndedzinotevera: ciliary bradyarrhythmia, AV-nechigumbuso I dhigirii, sinus vanorwara chirwere, nechirwere chemwoyo, sinus bradycardia, BP, mwoyo, hypercalcemia, hypokalemia, renal kana pulmonary insufficiency nhoroondo.

Hazvina kukodzera kushandisa cardiac glycosides pasi zvinotevera ezvinhu: cardiac amyloidosis, diastolic cardiac vhoriyamu zadzisa pamwe kutsemuka insufficiency, thyrotoxicosis, chenjera myocardial infarction, cardiomyopathy, constrictive pericarditis, congestive mwoyo kukundikana apo kuramba yakakwirira cardiac goho, kupererwa neropa uye zvichingodaro.

Zvakananga pachavo contraindications nokuda pasina systolic dysfunction, iro rinotsanangura inefficiency ari cardiac glycosides. Uye, somuenzaniso, panguva Kugadzirwa chakasimba myocardial infarction, kushandiswa kungakonzera pokumuka arrhythmias, zvinopa munhu murombo fungidziro nokuti mberi upenyu murwere.

Before Kushandisa cardiac glycosides vanofanira kubvunzana nyanzvi. Izvi zvichakubatsira kudzivisa kukura zvakakomba yematambudziko.