Icyo Urukingo rwa Edrophonium Rumaze: Ibikoreshwa, Urutonde rw'Imiti, Ingaruka Ziterwa n'ibindi

Urukingo rwa Edrophonium ni umuti w'agateganyo ubangamira imikorere ya acetylcholine, umutumwa wa chimique mu mikorere y'imitsi yawe. Ibi bituma habaho iterambere rito ariko rigaragara mu mbaraga z'imitsi n'imikorere yayo. Abaganga bakoresha uyu muti w'urukingo cyane cyane nk'igikoresho cyo gupima kugira ngo bafashe kumenya indwara zimwe na zimwe z'imitsi n'imitsi, cyane cyane myasthenia gravis.

Edrophonium ni iki?

Edrophonium ni umuti ukora mu gihe gito kandi ukaba mu cyiciro cy'imiti yitwa cholinesterase inhibitors. Ikora mu kubuza imikorere ya acetylcholine, ikaba ari ingenzi mu guhuza imitsi yawe n'imitsi. Iyo urwego rwa acetylcholine ruzamutse by'agateganyo, imitsi yawe irashobora kwikurura neza.

Uyu muti uza mu ishusho y'umuti usobanutse, udafite ibara, abaganga bawutanga binyuze mu urukingo mu muyoboro wawe w'amaraso. Bitandukanye n'indi miti myinshi, edrophonium ikora vuba cyane ariko ikamara iminota mike gusa. Iki gihe cyihariye gituma bikoreshwa cyane mu gupima indwara aho gukoreshwa mu kuvura buri gihe.

Muri rusange uzasanga edrophonium mu bitaro cyangwa mu ivuriro, aho abaganga bashobora gukurikirana neza uko ubisangamo. Uyu muti uzwi kandi ku izina ry'ubucuruzi rya Tensilon, nubwo verisiyo rusange ikoreshwa cyane uyu munsi.

Edrophonium ikoreshwa mu iki?

Edrophonium ikoreshwa cyane cyane nk'igikoresho cyo gupima kugira ngo gifashe abaganga kumenya myasthenia gravis, indwara aho umubiri wawe wanga imikorere ihuriweho hagati y'imitsi n'imitsi. Mu gihe cy'igeragezwa, muganga wawe azakwiza edrophonium akareba iterambere ry'agateganyo mu kunanuka kw'imitsi cyangwa amaso amanuka.

Uyu muti ukoreshwa kandi mu gutandukanya hagati ya myasthenic crisis na cholinergic crisis ku barwayi basanzwe barwaye myasthenia gravis. Myasthenic crisis ibaho igihe uburwayi bwawe bujya mu buryo bubi kandi ukeneye imiti myinshi, naho cholinergic crisis ikabaho igihe wahawe imiti myinshi cyane.

Rimwe na rimwe, abaganga bakoresha edrophonium kugira ngo bahindure ingaruka z'imiti imwe n'imwe yoroheje imitsi ikoreshwa mu gihe cyo kubaga. Ibi bifasha kugarura imitsi yawe mu mikorere isanzwe nyuma yo kuvurwa. Ariko, iyi mikoreshereze ntisanzwe nk'uko ikoreshwa mu kumenya indwara.

Mu bihe bidasanzwe, abaganga bashobora gukoresha edrophonium kugira ngo bagerageze izindi ndwara zifata imitsi cyangwa kugira ngo basuzume uko imiti ivura myasthenia gravis ikora. Iyi mikoreshereze yihariye isaba ubuganga bwitondewe kandi buhanitse.

Edrophonium ikora ite?

Edrophonium ikora ibuza enzyme yitwa acetylcholinesterase, isanzwe isenya acetylcholine mu mubiri wawe. Iyo iyi enzyme yabuze, acetylcholine yiyongera ku gihuza imitsi yawe n'imitsi, bigatuma habaho ibimenyetso bikomeye byo gukomera kw'imitsi.

Tekereza acetylcholine nk'urufunguzo rufungura imitsi. Mu ndwara nka myasthenia gravis, nta mafunguzo ahagije akora. Edrophonium ntikora andi mafunguzo, ariko ituma amafunguzo aguma ahari igihe kirekire kugira ngo agire amahirwe menshi yo gukora.

Uyu muti ufashwe nk'ukomeye ku rugero ruciriritse ariko ukora mu gihe gito cyane. Ingaruka zayo zikunze gutangira mu gihe cy'amasegonda 30 kugeza kuri 60 nyuma yo guterwa inshinge kandi zikamaraho iminota 5 kugeza kuri 10 gusa. Iki gihe gito gituma bikwira neza mu kugerageza ariko ntibikwiriye kuvura igihe kirekire.

Gutangira vuba no kumara igihe gito kandi bivuze ko ingaruka zose uzagira zizaba iz'igihe gito. Iyi myitwarire ituma edrophonium itekanye gukoreshwa mu kumenya indwara ugereranije n'imiti ikora igihe kirekire mu cyiciro kimwe.

Nkwiriye gufata gute Edrophonium?

Ntabwo wifata edrophonium wenyine - buri gihe itangwa n'abakora mu buvuzi ahantu hakorerwa ibizamini by'ubuvuzi. Uyu muti uza mu buryo bw'urushinge rushyirwa mu mitsi yawe unyuze mu muyoboro wa IV cyangwa rimwe na rimwe mu mikaya yawe. Muganga wawe azagena urugero nyarwo rwawo bitewe n'uburemere bwawe, imyaka yawe, n'ikizamini gikorerwa.

Mbere yo guhabwa edrophonium, ntugomba kwirinda kurya cyangwa kunywa keretse muganga wawe akubwiye kubikora. Ariko, ugomba kumenyesha ikipe yawe y'ubuvuzi imiti yose urimo gufata, harimo imiti igurishwa idasabye uruhushya rwa muganga n'ibyongerera imbaraga.

Urukinge ubwarwo rufata amasegonda make, ariko uzagenzurwa cyane nyuma y'iminota mike. Ikipe yawe y'ubuvuzi izareba impinduka mu mbaraga z'imikaya yawe, guhumeka, n'imibereho yawe muri rusange muri iki gihe.

Ubusanzwe uzahabwa edrophonium uryamye cyangwa wicaye neza. Uku gushyirwa mu mwanya bifasha kurengera umutekano wawe kandi bigatuma abaganga babasha kureba neza impinduka zose zigaragara mu mikorere y'imikaya yawe.

Nzamara Igihe Kingana Gite Ndafata Edrophonium?

Edrophonium si umuti ufata igihe kirekire. Yagenewe gukoreshwa rimwe mu bizamini byo kumenya indwara, kandi ingaruka zayo zishira mu minota 5 kugeza kuri 10. Ntabwo uzagira urupapuro rwo kujyana mu rugo cyangwa gahunda yo gukurikiza.

Niba uri gukora ibizamini byinshi, muganga wawe ashobora kuguha edrophonium mu bihe bitandukanye, ariko buri gihe cyo gukoresha ni ukumara igihe gito. Uyu muti ntiwiyongera mu mubiri wawe cyangwa ngo usabe kongera cyangwa kugabanya urugero rwawo buhoro buhoro.

Ku barwayi ba myasthenia gravis bakeneye kuvurwa buri gihe, abaganga basanzwe bandika imiti ikora igihe kirekire nka pyridostigmine aho gukoresha inshinge za edrophonium zisubirwamo. Uruhare rwa Edrophonium rukomeza kuba urw'ubumenyi bw'indwara kurusha urw'ubuvuzi.

Ni Iyihe Ngaruka Ziterwa na Edrophonium?

Abantu benshi boroherwa na edrophonium, ariko nk'imiti yose, irashobora gutera ingaruka zidakunda. Inkuru nziza ni uko ingaruka zidakunda zose ushobora kugira zizamarana igihe gito kubera ko umuti ukora igihe gito.

Dore ingaruka zidakunda zisanzwe ushobora kugira, wibuke ko izi zikunda gushira mu minota:

• Urugimbu cyangwa kutumva neza mu nda
• Kongera umusonga
• Kunyeganyega cyane kuruta uko bisanzwe
• Guhinda umushyitsi kw'imitsi cyangwa fasciculations
• Kuribwa mu nda
• Impiswi
• Kongera kunyara
• Kumva urujijo cyangwa umutwe wenda kugenda

Izi ngaruka zibaho kuko edrophonium yongera acetylcholine mu mubiri wawe wose, atari gusa ku mitsi y'imitsi iri gupimwa. Abantu benshi basanga izi ngaruka zoroheje kuko bazi ko zizashira vuba.

Hariho kandi ingaruka zidakunda zikomeye ariko zitabaho cyane zisaba ubufasha bwihuse bw'abaganga. Itsinda ryawe ry'ubuzima rizakurikirana ibi, ariko ni byiza kumenya icyo ari byo:

• Kugorana cyane guhumeka cyangwa guhagarara guhumeka
• Umutima utagenda neza cyangwa kuribwa mu gituza
• Kumva imitsi idakora neza cyane (paradoxical response)
• Kugira ibibazo byo mu mutwe
• Kutagira ubwenge
• Gusubiranamo gukomeye kw'umubiri hamwe no kubyimba cyangwa amabara ku ruhu

Izi ngaruka zikomeye ntizisanzwe, kandi uzaba uri ahantu havurirwa aho kuvurwa byihuse biboneka niba bikenewe. Abaganga bawe bahawe imyitozo yo kumenya no gukemura ibi bibazo vuba.

Ninde utagomba gufata Edrophonium?

Abantu bamwe ntibagomba guhabwa edrophonium kubera kongera ibibazo bikomeye. Muganga wawe azasuzuma amateka yawe y'ubuzima neza mbere yo gufata icyemezo niba uyu muti ari mwiza kuri wewe.

Ntugomba guhabwa edrophonium niba ufite indwara zimwe na zimwe z'umutima, kuko umuti ushobora kugira ingaruka ku mutima wawe n'umuvuduko. Dore indwara zikomeye zituma edrophonium idakwiriye:

• Uburwayi bukomeye bwo mu mutima butuma umutima utera nabi (arrhythmias)
• Umutima umaze iminsi yarwaye cyane cyangwa indwara y'umutima idahagaze neza
• Asima ikomeye cyangwa indwara y'umwuka mubi (COPD)
• Ibibazo byo mu mara cyangwa mu nkari
• Kumenya ko ufite allergie kuri edrophonium cyangwa imiti isa nayo
• Uburwayi bukomeye bw'impyiko
• Uburwayi bukomeye bwo mu gifu

Muganga wawe azitondera gukoresha edrophonium niba utwite cyangwa wonka, nubwo rimwe na rimwe bishobora kuba ngombwa mu gukora isuzuma. Uyu muti ushobora kwambuka placenta kandi ugashobora kugira ingaruka ku mwana wawe.

Niba warigeze kugira ibibazo byo gufatwa n'izindi ndwara, ikipe y'ubuzima izagereranya neza ibyago n'inyungu. Nubwo edrophonium ishobora gutera ibibazo byo gufatwa n'izindi ndwara mu bihe bidasanzwe, amakuru yo gusuzuma itanga ashobora kuba ingenzi mu kwita ku buzima bwawe.

Imyaka yonyine ntigutera kutabona edrophonium, ariko abantu bakuze bashobora kwitaba cyane ingaruka zayo. Muganga wawe azahindura urugero uko bikwiye kandi akugenzure neza mugihe cyo gukora isuzuma.

Amazina y'ubwoko bwa Edrophonium

Edrophonium yabanje gucuruzwa ku izina rya Tensilon na Valeant Pharmaceuticals. Ariko, izina ry'ubwoko ntirigikoreshwa cyane mu bihugu byinshi, harimo n'Amerika.

Uyu munsi, uzasanga edrophonium nk'umuti rusange. Ubwoko rusange bukora kimwe neza nk'ibicuruzwa by'izina ry'ubwoko kandi bukurikiza amategeko y'umutekano n'ubushobozi. Umuganga wawe azavuga gusa "edrophonium" cyangwa "edrophonium chloride."

Mu turere tumwe na tumwe, ushobora gukomeza kubona amagambo yerekeye Tensilon mu nyandiko z'ubuvuzi cyangwa inyandiko za kera, ariko umuti ubona uzaba ari uwo mu bwoko rusange. Guhinduka kuva ku bwoko kugera ku rusange ntiguhindura ubuziranenge cyangwa ubushobozi bwo gukora isuzuma ryawe.

Uburyo bwo gusimbuza Edrophonium

Mugihe edrophonium ikiri ishingiro ryo gukoresha mu bizami byinshi byo kumenya indwara, hari ubundi buryo muganga wawe ashobora gutekereza. Guhitamo biterwa n'icyo barimo gukora iperereza ndetse n'uburwayi bwawe bwihariye.

Mu kumenya indwara ya myasthenia gravis, muganga wawe ashobora gukoresha ubundi buryo aho gukoresha cyangwa bongeraho ibizamini bya edrophonium. Ibizamini by'amaraso bishobora kugaragaza imisemburo yihariye ijyanye na myasthenia gravis, bitanga amakuru yo kumenya indwara hatagombye guterwa urushinge.

Ibyegeranyo by'imikorere y'imitsi n'ibizamini bya electromyography (EMG) nabyo bishobora gufasha kumenya indwara zifitanye isano n'imitsi n'imitsi. Ibi bizamini bipima imikorere y'amashanyarazi mu mitsi yawe n'imitsi, bitanga amakuru arambuye yerekeye uburyo sisitemu yawe y'imitsi ikora neza.

Ku barwayi batabasha guhabwa edrophonium, abaganga bashobora gukoresha ibizamini bya pack ya barafu ku bimenyetso bimwe na bimwe nk'amaso yamanitse. Gushyiraho barafu birashobora gufasha by'agateganyo imikorere y'imitsi muri myasthenia gravis, bitanga ibimenyetso byo kumenya indwara hatagombye imiti.

Mu bindi bihe, muganga wawe ashobora kugusaba gukoresha pyridostigmine yo kunywa, umuti ukora igihe kirekire mu cyiciro kimwe na edrophonium. Niba ibimenyetso byawe bigabanuka cyane n'ubu buvuzi, birashobora gushyigikira icyemezo cyo kumenya indwara ya myasthenia gravis.

Ese Edrophonium iruta Pyridostigmine?

Edrophonium na pyridostigmine bikora ibintu bitandukanye, bityo kubigereranya mu buryo butaziguye ntibisa no kugereranya pome n'amapome. Edrophonium irusha abandi mu gukoreshwa nk'igikoresho cyo kumenya indwara kubera ko ikora vuba kandi igihe gito, mugihe pyridostigmine ikwiriye gukoreshwa mu kuvura buri gihe.

Mu bizamini byo kumenya indwara, imikorere yihuse ya edrophonium ituma irusha pyridostigmine. Urashobora kubona ibisubizo mu munota umwe, kandi niba ugize ingaruka ziterwa n'imiti, zirakira vuba. Pyridostigmine ifata iminota 30 kugeza kuri 60 kugirango ikore kandi ikamara amasaha menshi, bituma bidakwiriye gukoreshwa mu bizamini.

Ariko, mu kuvura myasthenia gravis igihe kirekire, pyridostigmine irakora cyane kurusha edrophonium. Ushobora gufata pyridostigmine unywa mu kanwa inshuro nyinshi ku munsi kugira ngo ugumane ibimenyetso bigenzurwa neza, mu gihe edrophonium yagusaba guhora ufite IV kandi ukaba uri mu bitaro uhakorera igenzura.

Imbaraga z'iyi miti zirasa, ariko igihe imara zikora bituma zikwira mu bihe bitandukanye. Tekereza edrophonium nk'ifoto yihuse yo gupima, mu gihe pyridostigmine itanga inyungu ikomeye yo kuvura.

Muganga wawe azahitamo umuti ukwiriye bitewe niba ukeneye gupimwa cyangwa kuvurwa buri gihe. Abarwayi benshi babanza guhabwa edrophonium kugira ngo bapimwe hanyuma, nibaramuka basanzwe barwaye myasthenia gravis, bahindukirira pyridostigmine kugira ngo babashe kwivuza buri munsi.

Ibikunze Kubazwa Kuri Edrophonium

Ese Edrophonium irakwiriye ku barwayi b'indwara z'umutima?

Edrophonium ishobora kugira ingaruka ku mutima wawe n'umuvuduko wawo, bityo bisaba kubitekerezaho neza niba urwaye indwara y'umutima. Muganga wawe azasuzuma uko umutima wawe umeze kandi ashobora gufata icyemezo cyo gukoresha uburyo bwo gupima buruta ibyago, cyane cyane ko ingaruka z'uyu muti ari nke.

Niba ufite indwara y'umutima idakomeye, ishobora guhoraho, urashobora guhabwa edrophonium ukurikiranwa neza. Ariko, niba ufite ibibazo bikomeye by'umuvuduko w'umutima, watewe n'umutima vuba aha, cyangwa indwara y'umutima idahoraho, muganga wawe ashobora guhitamo uburyo bwo gupima butandukanye.

Itsinda ry'abaganga bazakurikiranira hafi umuvuduko w'umutima wawe igihe cyose ukora igeragezwa niba ufite ikibazo cy'umutima. Bazaba kandi bafite imiti ihari yo guhangana n'ingaruka za edrophonium niba bibaye ngombwa, nubwo ibibazo bikomeye by'umutima bidasanzwe.

Ninkora iki niba mbonye edrophonium nyinshi ku buryo butunguranye?

Kurenza umuti wa edrophonium ni ibintu byihutirwa mu buvuzi, ariko uzahora uhabwa uyu muti ahantu havurirwa aho imiti yihutirwa iboneka. Itsinda ryawe ry’abaganga rizahita rimenya ibimenyetso byo kurenza urugero rw’umuti kandi rihazana neza.

Ibimenyetso byo gufata edrophonium nyinshi birimo ubunebwe bukomeye bw’imitsi, kugorwa no guhumeka, umusonga mwinshi, isesemi ikabije no kuruka, ndetse n’imihindagurikire y’umutima ishobora guteza akaga. Ibi bimenyetso bishobora kwigaragaza vuba ariko biravurwa neza n’ubuvuzi bukwiye.

Abaganga bafite umuti witwa atropine ushobora guhangana n’ingaruka za edrophonium. Uyu muti ukora ubuza imikorere y’umurengera wa acetylcholine itera ibimenyetso byo kurenza urugero rw’umuti. Itsinda ryawe ry’abaganga ryatojwe kubara urugero rukwiye kandi bakarutanga vuba niba bibaye ngombwa.

Inkuru nziza ni uko kurenza urugero rwa edrophonium bidasanzwe kuko abaganga babara urugero neza kandi uwo muti ukora mu gihe gito. Niyo waba wafashe mwinshi, ingaruka zizatangira kugabanuka mu buryo bw’umwimerere mu minota.

Nigira nte niba ikizamini cya edrophonium kitagize icyo gikora?

Ikizamini cya edrophonium kitagize icyo kigaragaza ntibisobanura ko udafite myasthenia gravis cyangwa izindi ndwara zifata imitsi n’imitsi. Rimwe na rimwe ikizamini kigomba gusubirwamo, cyangwa umuganga wawe ashobora gukenera gukoresha uburyo butandukanye bwo gupima kugirango abone igisubizo gisobanutse.

Ibintu bitandukanye bishobora kugira uruhare mu ngaruka z’ibizamini, harimo igihe ibimenyetso byawe byagaragariye, imiti yindi urimo gufata, n’imitsi yihariye iri gupimwa. Umuganga wawe ashobora gutanga igitekerezo cyo gusubiramo ikizamini mu gihe kitandukanye cyangwa igihe ibimenyetso byawe byigaragaje cyane.

Niba ikizamini cya edrophonium gikomeje kutagaragaza neza, umuganga wawe ashobora gutegeka izindi bizamini nk'ibizamini by'amaraso kugirango barebe niba hari imirwano ya myasthenia gravis, kwiga imikorere y'imitsi, cyangwa gukoresha ibikoresho byerekana. Ibi bizamini bishobora gutanga andi makuru kugirango afashe gutanga icyemezo.

Rimwe na rimwe, muganga wawe ashobora kugusaba gukoresha imiti ikora igihe kirekire nka pyridostigmine. Niba ibimenyetso byawe bigabanuka cyane hamwe n'imiti, ibi birashobora gushyigikira icyemezo nubwo ikizamini cya edrophonium cyari kibi.

Nshobora Gusubukura Ibikorwa Bisanzwe Nyuma ya Edrophonium Ryari?

Ubusanzwe ushobora gusubukura ibikorwa bisanzwe ako kanya nyuma yo guhabwa edrophonium, kuko ingaruka zayo zishira mu minota 5 kugeza kuri 10. Ariko, muganga wawe ashobora kugusaba gutegereza akanya gato kugirango wemeze ko wumva umeze neza mbere yo kuva mu kigo cy'ubuvuzi.

Niba wagize ingaruka zose ziterwa n'ikizamini, tegereza kugeza zose zikize mbere yo gutwara imodoka cyangwa gukoresha imashini. Abantu benshi bumva bameze neza mu minota 15 kugeza kuri 20 nyuma yo guhabwa urushinge, ariko umva umubiri wawe kandi ntugahutire niba utumva umeze neza.

Nta mbogamizi z'imirire cyangwa ibikorwa nyuma y'ikizamini cya edrophonium. Urashobora kurya, kunywa, no gufata imiti yawe isanzwe nkuko bisanzwe keretse muganga wawe aguha amabwiriza yihariye.

Niba uri gukora ibindi bizamini cyangwa ibikorwa kuri uwo munsi, menyesha ikipe yawe y'ubuzima ko wakiriye edrophonium. Nubwo bidashoboka ko byabangamira ibindi bizamini, burigihe ni byiza kumenyesha ikipe yawe y'ubuvuzi ku bijyanye n'imiti yose wakiriye.

Nshobora Gufata Imiti Yanjye Isanzwe Nyuma ya Edrophonium?

Yego, muri rusange urashobora gufata imiti yawe isanzwe nyuma yo guhabwa edrophonium. Uyu muti ntugirana imikoranire n'imiti isanzwe, kandi igihe gito ukora bivuze ko ntizaba mu mubiri wawe igihe kirekire cyo gutera imikoranire ikomeza.

Niba umaze gufata imiti ya myasthenia gravis, muganga wawe ashobora kuguha amabwiriza yihariye yerekeye igihe. Rimwe na rimwe, bazagusaba guhagarika iyi miti mbere y'ikizamini kugirango ubone ibisubizo byizewe, hanyuma uyisubizeho nyuma.

Buri gihe menyesha ikipe yawe y'ubuvuzi ku bijyanye n'imiti yose urimo gufata, harimo n'imiti igurishwa itagomba uruhushya rwa muganga ndetse n'ibyongerera imbaraga. Nubwo imikoranire mibi idakunze kubaho na edrophonium, ikipe yawe y'ubuvuzi ikeneye amakuru yuzuye kugira ngo yemeze umutekano wawe.

Niba ufite ibibazo ku bijyanye n'imiti runaka, baze umuganga wawe mbere yo kuva mu kigo cy'ubuvuzi. Bashobora kuguha inama zigendanye n'ubuzima bwawe bwose ndetse n'imiti urimo gufata.