Prokinetics - chii? chizvarwa chitsva prokinetics: pamazita

Prokinetics - chii? Munguva Kishi Munyika, hapana tabvumirana pamusoro chii mishonga zvinosanganisirei boka iri, saka ose gastroenterologist pachake anosarudza kuti vauye pazvinhu izvi, uye chii haadaro. Prokinetics - chii? Ndizvo zvatinofanira kuedza kuwana.

Definition uye tsanangudzo pfupi

Prokinetics - chii? Ichi boka mishonga inotokonya motility pamusoro zvomudumbu chubhu uye chinonditadzisa anastaltic nemafungu.

zvirwere Gastrointestinal kazhinji aine reflux pakati chyme kubva dzapasi intestinal chubhu iri overlying, kutyora ndima bolus kana kurega kunotanga iri ura chidimbu. All zvezviratidzo izvi zvinobatana vasingadzoreki kusimudzirwa chyme kubudikidza zvomudumbu chubhu, ipapo kubvisa zviratidzo zvinogona, kukanganisa marwadzo ari kumeso tsandanyama mu masvingo aro. Ndizvo prokinetics. Dzavo kuchirapa nezvinozoitika nokuda ichivharira pamusoro Ion kuchinjirwa mashandiro (dopamine, 5-HT4 receptors, yaisanganisa) kana kuchinja muviri kuti acetylcholine. Kugona kunotoda nezvinozoitika nokuda yakawanda acetylcholine iri synaptic mumukaha kana amplification kuti cholinesterase zvigadzirwa iyo runogonesa kuti manyowa pamusoro ach, zvinoderedza zvigadzirwa ach tsinga harinzwi.

Physiologically migumisiro kubva zvinodhaka sokuti kuwedzera cardiac esophageal sphincter matauriro, kubvisa mudumbu mukati, kubva Kufambisa pakati antrum uye duodenum, zvibereko ura peristalsis.

Boka rokutanga zvinodhaka

Prokinetics - zvinodhaka kuti vanovhara dopamine D2-receptors, nokudaro anotokonya tsandanyama basa uye kupa gastrointestinal fibers antiemetic kushanda. Mishonga iyi inosanganisira: "metoclopramide" (chizvarwa chokutanga vamiririri - "Reglan" uye "Raglan"), "bromopride", "Domperidone" (chizvarwa chechipiri), "Dimetpramid", "Itopride".

Prokinetic zvinodhaka, kushandiswa pakurapa gastroezofagialnoreflyuksnoy chirwere (Gerd), YAZHDPK, dyspepsia, chadzo hunhu, aienda pamusoro yegurokuro pashure zvinokuvadza uye somugumisiro adhesions, postoperative paresis kupindira mudumbu, kuvhiringidza water drainage pamusoro bile, flatulence.

Uyewo prokinetics - mishonga inogona kushandiswa svoto uye kurutsa zvinokonzerwa muchetura kana kutyora mitemo zvoupfu, zvirwere zvinokonzerwa nemavhairasi kana kwemabhakitiriya etiology, nhumbu rokutanga trimester, chenjera coronary insufficiency, musoro kunotevera, yokutindivadza, nemwaranzi uye mishonga. Basa kuburikidza kurutsa vestibular mavambo, sezvo haina chokuita nepakati nzeve uye medulla oblongata.

Antipsychotics kubatsira kurutsa

"Sulpiride" uye "Levosulpirid", ndiye neuroleptic ane yakafanana mashandiro kuita, ivo vane maonero Anti-emetic mugumisiro, saka anogona kushandiswa mune gastroenterological tsika.

"Metoclopramide" (prokinetics): mirayiridzo kushandiswa

"Metoclopramide" - zvakananga stimulator pakati kumeso tsandanyama uye ane zvakafanira zvose ehupfumi ari kuzadzisa akaora zvinokosha zvabuda, asi nekuda permeability gematogistologicheskie zvipingamupinyi zvinofanira kushandiswa nokungwaririra. Possible nemishonga yakadai spasm ari tsandanyama dzechiso, ari chiratidzo "tsoka rarira kuti", mutinhimira protrusion rurimi, bulbar zvirwere, kurwadza kwacho ekrtraokulyarnyh tsandanyama, spasmodic torticollis, kunyanya mataurire extensor tsandanyama, Parkinson urwere, somnolence, utera, tinnitus, nomusoro, kufunganya, kuvhiringidzika.

Mune zvimwe zviitiko, vanodiwa kutora prokinetiki? Mirayiridzo kushandiswa vakati pamamiriro kushandiswa vanenge hypersensitivity kuti mushonga, bundu iri adrenal cortex, intestinal mhingaidzo, perforation pamusoro bowel nokuvadzidzisa ropa, prolaktinozavisimoy namamota, pfari uye extrapyramidal zvinetso, kusvikira vhiki 16 mwana gestation, panguva lactation, vana pasi 5 makore. Zvokungwarira zvinofanira ushandiswe panguva kwakaderedza Clearance pamusoro creatinine, yakawedzera BP, asima, makore kusvika makore 14.

Achaparadza mushonga yeawa hafu pamberi kudya, pahwendefa pa 9:00, 12:00, 15:00 uye 18:00. Duration kurapwa - zvina kusvika mavhiki matanhatu, dzimwe nguva inogona kuwedzerwa kusvika mwedzi mitanhatu.

Kana kusunungurwa chimiro - mvura, izvozvo chinotarisirwa intramuscularly kana nomutsinga. For vakuru nevana makore 14 - 10 MG. Maximum pa imwe nguva - 20 MG daily dose - 60 MG. Zviri ampoule zvinogona rakasanganiswa mu isotonic sesaline kana 5% shuga mhinduro.

"Domperidone": mirayiridzo kushandiswa

"Domperidone" zvikuru kusarudza dopamine Kanotokonya blocker, kunze kwete zvinopfuura BBB Zvisinei kana mabiko hakusi kutanga marwadzo inorondedzerwa pamusoro. Zvisinei, kuwedzera secretion pamusoro prolactin, izvozvo kunokonzera gynecomastia, galactorrhea, uye kusavapo varikutsika. Uyezve, varwere yakashuma ganda mapundu, muromo yakaoma, manyoka uye nomusoro.

Not pachii kushandiswa nevanhu vane neutachiona kuti zvinoumba mishonga, ropa kubva nemudumbu, intestinal mhingaidzo, prolactinoma, lactation, zera kusvikira makore 5 kana mashekeri kusvika 20 makirogiramu. Matanho kutora panguva pamuviri, renal uye / kana hepatic insufficiency.

Inwai kwemaminitsi makumi maviri usati wadya 10 MG, kana zvichidiwa, uye anogona kunwa ndisati ndarara. The kunonyanyisa dose pazuva - 80 MG. Kana aripo pakurapa antacids, kuderedza secretion pamusoro gastric muto, vanofanira kuva vakaparadzana nokunwa domperidone, achibatanidzwawo kudya zvokudya.

"Itopride": mirayiridzo kushandiswa

"Itopride" anosanganisa ehupfumi ari dopamine Kanotokonya antagonist uye blocker kuti acetylcholinesterase. Zvazvakaita pamusoro hypothalamic-pituitary-adrenal hurongwa, kuwedzera kuwanda somatostatin uye kuderedza adrenocorticotropic kemikari. A kunambwa kunoratidzirwa sezvo leukopenia, thrombocytopenia, hypersensitivity siyana, hyperprolactinemia, kuda kurutsa, tremor, jaundice. Panguva womuchato, zvinokosha kuongorora mamiriro peripheral ropa, uye nechokwadi hapana marwadzo.

Not akakurudzira vanhu vane hypersensitivity pamusoro pakarepo kana ndikanonoka mhando, gastrointestinal ropa kare, obturating ari intestinal lumen kana compression ane muviri vatorwa kunze, pasi pemakore gumi nemaviri, pamuviri, achiyamwa.

The mushonga chinobviswa nomuromo pamberi zvokudya 50 MG katatu pazuva.

Mhandu "Acetylcholine"

boka iri zvinosanganisira:

• "Aceclidine" (M-cholinomimetic);
• "Fiziostigmin" "Galantamine" "Tegaserod" "Prucalopride" (reversible cholinesterase inhibitor)

zvinodhaka izvi ndezvedu yapera boka prokinetics nokuda kwavo nemishonga: migumisiro iri kupanana potassium ions, uye somugumisiro, nezvishoma QT chinguva, iyo inotungamirira vachivavhiringidza pamusoro cardiac mutinhimira. Vanoverengeka zvinodhaka vave vakabviswa pharmacological kumusika nechikonzero ichi.

"Aceclidine": mirayiridzo kushandiswa

Prokinetics - chii, sei uye kana kuzvishandisa? Chero zvazvingava, iva nechokwadi kuti chiremba uye ndinzwe kudzidza mirayiridzo kushandiswa.

"Aceclidine" rinoshandiswa kudzivisa kurasikirwa mataurire zvomudumbu turakiti uye dundira pashure pokuvhiyiwa, kunoderedza intraocular kumanikidzwa, saka anogona kushandiswa ophthalmology. Product Form - jekiseni, jekiseni subcutaneously pamwe 2.1 ml ane 0.2% mhinduro. Max panguva - 0.004 g, pamwe zuva nezuva pasina kupfuura 0.012, kurutivi migumisiro - ptyalism, vangadikitira, uye manyoka.

Contraindications pakushandisa vari CHD, yakakwirira HDL, Árbol asima, uye dzimwe hyperkinesias parkinsonism, pamuviri, ropa kubva abdominal mhango.

"Fiziostigmin" rinoshandiswa kureva muna ophthalmic tsika, asi anogona dzimwe nguva kushandisa gastroenterology panguva yacho intestinal paresis. The chinodhaka jekiseni pasi ganda 0.5 - 1 ml ane 0.1% mhinduro. The kunonyanyisa chitsama mushonga pazuva haafaniri kupfuudza 0,001 d

Marwadzo vari nokusimbaradza salivation, bronchospasm, intestinal spasm tsandanyama, kuchinja mwoyo zvazvingava, nokugwinha.

Contra-zvairatidza: angina, pfari, asima, zvemaziso intestinal mhingaidzo, peritonitis, sepsis, pamuviri.

"Galantamine": mirayiridzo kushandiswa

"Galantamine" mune zvimwe zviitiko rinoshandiswa sechinhu antagonist kuti tsandanyama relaxants ari postoperative munguva pamwe vasanyanye chetsandanyama mataurire bowel uye dundira. Contraindications pakushandisa vari hypersensitivity, pfari, asima, BP pamusoro 139/99 mmHg, COPD, zvokuimba occlusion pamusoro intestinal mutsinga dzinofamba nemukaka, renal basa vanotaura, zera 9 makore. Kungogumira chinangwa pamuviri pacho apo zvinogona pokukuvadza kupfuura zvakanakira. Panguva lactation, zvinogona kutapukira mwana kubudikidza mukaka.

Side Migumisiro: rutapudzo nomwoyo zvazvingava, ttp, AV blockade, arrythmia, kuda kurutsa, kurutsa, manyoka, dyspepsia, kudedera kwetsandanyama, Urinary incontinence, haematuria, tremor.

Zvinogona kupiwa subcutaneously, intramuscularly, nomutsinga, transdermally, nomuromo. The dose iri kugadziridzwa nomumwe, inobva nhoroondo chirwere, uye kunofanira kugadziriswa pachishandiswa kupinda chiremba. Paavhareji daily dose nevakura - kubva 10 kusvika 40 MG, huviri mana mishonga.

Chizvarwa chitsva prokinetics

Pahwaro nhasi Itopride vabereke zvinodhaka akadai "Ganaton", "Itomed", "Pramer". Rimwe Newest uye inonyatsobudirira ndivo avo rudzi prokinetiki chitsva se "koordinaks" uye "Prepulsid". Kunyange vanogona zvokonzera migumisiro mumwoyo.

Chinonyanya akakurumbira pakati gastroenterologists anoramba "Motilium" (active chirungiso - domperidone), iro rinobatanidza kunaka metoclopramide, asi haina zvayo migumisiro yakaipa.

Ndezvipi inonyatsobudirira pprokinetiki? List mishonga ikozvino zvinosanganisira:

1. "Itopride" (active chirungiso) - "Ganaton", "Itomed", "Primer" (yezvokutengeserana zita).
2. "Metoclopramide" - "Raglan" "Reglan".
3. "Cisapride" - "koordinaks", "Prepulsid".
4. "Domperidone" - "Motilium", "Motilak", "Motinorm", "Passazhiks".

zvino tinoziva kuti munhu prokinetic yakadaro. Zvinyore sezvaunoona, zviri guru kwazvo. Asi yeuka, asati kushandisa mushonga upi vanofanira bvunza chiremba wako! Stay utano!