Inhibitors ye carbonic anhydrase: inogadzirisa maitiro emadonhwe eziso mu glaucoma

Carbonic anhydrase inhibitors inoreva diuretics isingashandiswi se diuretics kana diuretics. Zviratidzo zvekugadzwa kwemishonga iyi zvichave glaucoma. Ngatimbokurukurai nezvinyorwa zvakajeka kwavari.

Acetazolamide (Acetazolamide)

Ane diuretic properties. Iyo inomisa carboanhydrase ye proximal renal tubules, inoderedza kushandiswa kunopisa kweK, Na na-water ions (inokonzera kuwedzera kwe diuresis), zvichiita kuti kuderera kweBcc uye metabolic acidosis. Anodzvinyirira carbonic anhydrase ye ciliary body uye inotungamirira kuderera kwemaitiro epakati, uye kunoderedza kusvinura kwemazino anoreous, kunokonzera kupesana kweanoperesiptic muuropi. Iine huwandu hwakanaka kubva pamakumbo ekudya, muropa reCmax mushure maawa maviri. Chiito chacho chinogona kupera kusvika maawa gumi nemaviri. Pakati pa40-60% inoderedza IOP uye inoderedza kubudiswa kwemukati mahara.

Zviratidzo uye kuwedzerwa

Zviratidzo zvikuru: ophthalmohypertension, glaucoma. Apo glaucoma mukati inotora 0,125-0,25 g katatu pazuva pazuva rimwe nerimwe zuva kwemazuva mashanu, mushure mekunge zuva rimwe remazuva maviri rinodikanwa.

Matambudziko: kusuruvara, kurasikirwa kwechido, chirwere, kurwara, kutadza kubata, paresthesia, tinnitus, kugona. Zvose izvi zvinogona kukonzera inhibitors ye carbonic anhydrase. Kugadzirira kunewo zvinopesana. Uku ndiko kunzwisisika kwakanyanya (sulfonamides kusanganisira), chirwere chaAdisonison, chimiro cheAidosis, chiropa chakanyanya uye chirwere chepfungwa, pamuviri, chirwere cheshuga, uremia.

Zvibvumirano zvekushandisa: pulmonary embolism, emphysema yemapapu (zvichida kusimbisa acidosis).

Kugadzirira: mapiritsi ePoland Polpharma "Diakarb" ye 0.5 g.

Dorzolamide (dorzolamide)

Inhibits isoenzyme II carbonic anhydrase basa (Inoita kuti hydration inopindurwa yemhepo inokonzerwa nekarbon dioxide uye carbonic acid inopera mvura) yeciliary body yemaziso. Kuchengetedzwa kwehutano hwemukati kunopera ne50%, kuumbwa kwebicarbonate ions kunonoka uye kutakura kwemvura uye sodium zvakaderedzwa. Inoderedza kuburitsa kwemukati wehutachiona ne 38%, izvo zvisingabatsiri kubuda. Inopinda muziso reziso kunyanya kuburikidza ne limbus, sclera kana cornea. Kunyorera chikamu muvascular systemic kanzira kubva mucous membrane yeziso (zvichida kubuda kwe diuretic nezvimwe zvinokonzerwa nemafungiro e sulfonamide). Mushure mokunge pfuma yapinda muropa, inopinda nokukurumidzira mumasero matsvuku eropa, ayo ane zvakawanda zve carbonic anhydrase II. Ne 33% dorzolamide inobatanidzwa ne plasma mapuroteni. Inoratidza huwandu hwehuwandu hwe hypotensive mushure mekudzidzira shure kwemaawa maviri uye unoichengeta kwemaawa gumi nemaviri. Kana ikaiswa mairi kusvika pazuva pazuva ne 9-21% inoderedza kushanda kwepisocular, uye kana ichiiswa katatu pazuva - ne14-24%. Kuderedza kudzvinyirira kwemukati mukati mekushandisa kwe 2% yegadzirisani zvakakwana kunogona kuita 4,5-6,1 millimetres e mercury column. Mhinduro ye 3% ichange isisanyatsobudiriri, nokuti ichakurumidza kushambidza kunze kwechiguniti chejunjiti, sezvo inokonzera kuchema kwakanyanya. Mukubatana nekugadzwa kweti timolol kune zvimwe zvakataurwa zvinonzi 13 kusvika ku21%. Izvo zvishoma zvinokonzerwa nehutano hweropa uye kutengesa kwemwoyo zvinodziviswa ne carbonic anhydrase. Diuretics yeboka iri haashandiswi nokuda kwechinangwa chavo chinangwa. Nezve izvi zvakare.

Zviratidzo uye kuwedzerwa

Chiratidzo: chekutanga uye chechipiri yakazaruka-angle glaucoma, ophthalmic hypertension. Chirwere ichi chinoratidzwa 1 inodonha 2-3 nguva pazuva.

Zvimwe zvinokanganisa: paresthesia, kuora kurasikirwa, kuora mwoyo, kuputika kweganda, aplastic anemia, agranulocytosis, kuneta, kushaya musoro, chepfu epidermal necrolysis, kushungurudza mumuromo, kuora mwoyo, kuwedzera korneal thickness, iridocyclitis, blepharitis, keratitis, conjunctivitis, photophobia, Kuchengeta nekudzungaira mumaziso, kunzwa kusagadzikana, Stevens-Johnson syndrome, kupisa, kuchema.

Iyi inhibitor ye carbonic anhydrase (madonhwe emeso) ane zvinotevera zvinopesana: kunyanya kunzwisisika (sulfonamides kusanganisira), utana, chiropa chakakomba uye chirwere chepfungwa, pamuviri nekuyamwisa.

Kugadzirira: madonhwe eziso "Trusopt", iri mune 1 ml ye solution ye 20 mg ye dorzolamide hydrochloride. Iko kukwanisa kwehombodo iyi 5 ml. Yakabudiswa muNetherlands naMerck Sharp & Dohme.

Carbonic anhydrase inhibitors: Brinzolamide (Brinzolamide)

Iyo yakagadziriswa blocker ya carbonic anhydrase, iyo inokwanisa, iyo inoshandiswa munzvimbo ino, kuti inoderedza uye inodzora IOP. Brinzolamide ine high selectivity ye carbonic anhydrase II uye yakakodzera zvakanyanya muviri kuitira kuti ibudirire kupinda mukati meziso. Kana ichienzaniswa ne dorzolamide uye acetosolamide, yakawanikwa kuti brinzolamide ndiyo inonyanya kukosha yeboka re carbonic anhydrase inhibitors. Pane uchapupu hwokuti kushandiswa kwemukati kana kushandiswa kweBrzozolamide kunotungamirira mukuvandudzika muZDN. Uye inoderedza kusvika ne20% IOP. Saka haasi iyo inhibitors ye carbonic anhydrase inoshanda. Iyo nzira yekuita kweBrzozolamide yakasiyana.

Zviratidzo uye maitiro

Zviratidzo zvekushandisa: ophthalmohypertension, open-angle glaucoma. Shandisa 2 kaviri pazuva nedonhwe.

Zvimwe zvikanganiso: kusvibiswa kwemavira, manzwiro emuviri wekunze, shure kwekusimudzira mafungiro ekuona (kwenguva pfupi) uye kupisa kunzwa. Iko kunoshandiswa munzvimbo ino zviri nani kudarika dorzolamide.

Contraindications: kunyanya kunzwisisika kune zvikamu zvemuropa (sulfonamides kusanganisira), utana, pamuviri nekuyamwisa.

Kugadzirira: madonhwe eziso "Azopt", iri mune 1 ml yekumiswa kwe 10 mg yeBrzozolamide. Izvo zvinokonzerwa nehuta ndeye 5 ml. Yakabudiswa muUnited States neAlcon.

Chii chinonzi inhibitors ye carbonic anhydrase?

Derivatives of prostaglandins

Latanoprost (latanoprost) inosarudza agonist ye prostaglandin receptors. Inowedzera kuputika kwemukati wehutachiona kuburikidza nemakumbo emasero ebiso reziso, izvo zvinoita kuti kuderedzwa kwemaitiro emukati. Migumisiro pakugadzirwa kwemvura inenge isina. Unogona kuchinja hukuru hwedzidzi, asi zvishoma. Kana ichiiswa, inopinda nenzira ye isopropyl ether kuburikidza nekromia uye ikoko inodonhedzeswa kune imwe nzvimbo ye biologically activic acid, iyo inogona kutsanangurwa mumaawa mana ekutanga mu intraocular fluid uye mu plasma panguva yekutanga. 0,16 l / kg - ivhu rokuparidzirwa. Maawa maviri mushure mekubatanidza, huwandu hwekutengesa kwechirwere muhutu hwemhepo hunosvika, shure kwahwo hunoparidzirwa kutanga kune imwe nzvimbo yekare, kureva, maziso emajeri uye conjunctiva, uye zvino inopinda chikamu chemashure (mune zvishoma). Iko mafomu anoshingaira mumisumbu yemaziso inenge isingashandisi mishonga, zvikurukuru biotransformation inoitika muchiropa. Kunyanya metabolite yakanyanyiswa mumuguta. Ngatimbokurukurai zvimwe inhibitor ye carbonic anhydrase.

Unoprostone (unoprostone)

Isopropyl unoprostone is dericted derivative iyo inokurumidza kuderedza intraocular pressure (IOP) nerubatsiro rwezvinodiwa zvemishonga. Pasina kuchinja nguva yekusimbiswa kwemukati wehutachiona, inobatsira kubuda kwayo. Zvidzidzo zvakaratidza kuti kana zvichienzaniswa ne 0.5% mazino timolol, isopropyl unoprostone ine basa rakafanana kana rakakwirira pamusoro pechirwere cheIOP chinoderera. Mishonga haibatsiri nzvimbo yekugara uye haina kukonzera kuderera kwekuyerera kweropa mumaziso maziso, miosis kana mydriasis; Kuzononoka kwekugadziriswa kwekorne hakuwanikwi zvakare. Mushure mokushanda kwemashoko, kusanzwisisika kwesotropy ye unoprostone mu plasma haina kuonekwa.

Inhibitor ye carbonic anhydrase mu glaucoma inofanira kuongororwa chete nechiremba, kuzvirapa hakugamuchirwi.