Icyo Norepinephrine ari cyo: Ibyo ikoreshwa, urugero rwo kuyifata, ingaruka zayo, n'ibindi

Norepinephrine ni umuti ukomeye ufasha kuzamura umuvuduko w'amaraso uri hasi cyane mu buryo buteye ubwoba igihe umubiri wawe utabishoboye wenyine. Uyu muti wo kurokora ubuzima ukora ufunganya imitsi y'amaraso kandi ugakomeza imikorere y'umutima wawe, mu by'ukuri ugaha sisitemu yawe ya kardiyovaskulari inkunga ikenewe mu bihe bikomeye. Ubusanzwe uzahura n'uyu muti mu bitaro byita ku barwayi barembye, aho amakipe y'abaganga bawukoresha kugira ngo bahumurize abarwayi bahura no kugabanuka gukabije k'umuvuduko w'amaraso.

Icyo Norepinephrine ari cyo?

Norepinephrine ni verisiyo ya gihanga y'imisemburo kamere umubiri wawe umaze gukora. Imitsi yawe ya adrenal isanzwe ikora uyu muti kugira ngo ifashe kugenzura umuvuduko w'amaraso n'imikorere y'umutima mu bihe by'umunaniro cyangwa ibyago. Iyo itanzwe nk'umuti, yigana izi ngaruka kamere ariko ifite imbaraga nyinshi cyane.

Uyu muti ubarirwa mu cyiciro cy'imiti yitwa vasopressors, bisobanura ko ituma imitsi y'amaraso ifungana kandi ikagabanuka. Tekereza nk'uko guha sisitemu yawe y'imitsi imbaraga zidasanzwe igihe irimo iragerageza gukomeza urujya n'uruza rw'amaraso ruhagije mu ngingo z'ingenzi nk'ubwonko bwawe, umutima wawe, n'impyiko zawe.

Abaganga bita kuri norepinephrine umwe mu miti ikomeye cyane yo kugenzura umuvuduko w'amaraso. Igenewe ibibazo bikomeye aho izindi nshuti zitagize icyo zikora, kandi abarwayi bakeneye inkunga yihuse ya kardiyovaskulari kugira ngo barokoke.

Norepinephrine ikoreshwa mu iki?

Norepinephrine ivura umuvuduko w'amaraso uri hasi cyane uteza ubuzima bwawe cyangwa imikorere y'ingingo zawe akaga. Iyi ndwara, yitwa hypotension, ishobora kubaho igihe umubiri wawe utabasha gukomeza urujya n'uruza rw'amaraso ruhagije wenyine.

Ibihe bisanzwe abaganga bakoresha uyu muti birimo shock ya septic, aho indwara zikomeye zangiza imitsi y'amaraso cyane. Mugihe cya shock ya septic, umuvuduko w'amaraso yawe urashobora kugabanuka cyane ku buryo ibice by'ingenzi by'umubiri bitabona umwuka uhagije wa oxygen n'intungamubiri kugirango bikore neza.

Izindi ndwara zikomeye zishobora gukenera norepinephrine zirimo allergie zikomeye, gutakaza amaraso menshi kubera trauma cyangwa kubagwa, n'ubwoko bumwe bwo kunanirwa k'umutima. Muri buri kibazo, uyu muti ukora nka uburyo bwo kuvura bw'agateganyo, ufasha sisitemu yawe ya cardiovascular mugihe abaganga bakemura ikibazo cyateye.

Abantu bamwe barahabwa norepinephrine mugihe cyo kubagwa umutima bigoye mugihe umutima wabo utabasha gukora neza by'agateganyo. Uyu muti ufasha gukomeza umuvuduko w'amaraso uhamye kugeza umutima ugarutse nyuma yo kubagwa.

Norepinephrine ikora ite?

Norepinephrine ikora mugukora ibice byihariye byo kwakira muri imitsi y'amaraso yawe n'umutsi w'umutima. Iyo ibi bice byakira ikimenyetso cy'uyu muti, bitera impinduka zihuse zizamura umuvuduko w'amaraso yawe kandi zikongera imikorere y'amaraso.

Icya mbere, uyu muti utuma imitsi y'amaraso yawe ifunga cyangwa igakomera. Uku kugabanuka kongera umuvuduko muri sisitemu yawe y'amaraso, bisa no gupfuka igice cy'umuyoboro w'amazi wo mu busitani bikongera umuvuduko w'amazi. Iki gikorwa gifasha gushyira amaraso imbaraga nyinshi mumubiri wawe.

Icya kabiri, norepinephrine ikomeza imitsi y'umutima wawe, ituma buri gutera kw'umutima kugira imbaraga nyinshi. Uku kongera imbaraga zo gutera bifasha kwimura amaraso menshi kuri buri gutera, bikongera imikorere y'amaraso mu ngingo zikeneye oxygen n'intungamubiri.

Uyu muti ufashwe nk'ukomeye cyane kuko utanga ibi bikorwa vuba kandi cyane. Bitandukanye n'imiti yoroheje yo kugabanya umuvuduko w'amaraso ushobora gufata murugo, norepinephrine itera impinduka zihuse kandi zikomeye muri sisitemu yawe ya cardiovascular.

Nkwiriye gufata norepinephrine nte?

Ntushobora gufata norepinephrine unywa cyangwa ngo wiyitwararike mu rugo. Uyu muti uza gusa nk'umuti uterwa mu maraso, abaganga bagomba kuwutera mu maraso yawe binyuze mu muyoboro wihariye wa IV.

Abaganga basanzwe bashyira catheter ya IV mu urugingo runini rw'imitsi, akenshi mu ijosi ryawe, igituza, cyangwa ukuboko kwawe kw'igice cyo hejuru. Uku gushyirwa kwa iyi mirongo yo hagati bituma umuti ugera ku mutima wawe vuba kandi bikemeza ko uvanga neza n'amaraso yawe mbere yo kugera mu tundi duce duto tw'imitsi.

Urutonde rutangira hasi cyane kandi rugenda ruzamuka buhoro buhoro kugeza igihe umuvuduko w'amaraso yawe ugera ku rwego rwiza. Itsinda ryawe ry'abaganga rikora igenzura ry'umuvuduko w'umutima wawe, umuvuduko w'amaraso, n'imikorere y'ingingo buri gihe mugihe cyo guhindura urutonde rw'umuti.

Ntabwo ukeneye guhangayika kubyerekeye imikoranire y'ibiryo cyangwa igihe cyo gufata ibiryo kuko umuti ujya mu maraso yawe. Itsinda ryawe ry'abaganga rikora ibintu byose byo gutanga no gukurikirana mugihe wibanda ku gukira.

Nzagomba kumara igihe kingana iki mfata Norepinephrine?

Igihe cyo kuvura norepinephrine giterwa rwose n'uburwayi bwawe bw'ibanze n'uburyo umubiri wawe witwara vuba ku bundi buvuzi. Abantu benshi barwara bafata uyu muti mu masaha cyangwa iminsi, atari mu byumweru cyangwa amezi.

Itsinda ryawe ry'abaganga rizagenda rigabanya urutonde uko umuvuduko w'amaraso yawe uhagarara kandi ubundi buvuzi bugatangira gukora. Ubu buryo bwo gucanisha bukorwa buhoro kugirango birinde umuvuduko w'amaraso yawe kugabanuka mu buryo butunguranye igihe umuti uhagaze.

Abantu bamwe barwaye indwara zikomeye bashobora gukenera norepinephrine iminsi myinshi mugihe imiti yica mikorobe irwanya indwara y'ibanze. Abandi bakira nyuma yo kubagwa bikomeye bashobora kuyikenera amasaha make gusa kugeza igihe sisitemu yabo y'imitsi n'amaraso ihagaze.

Intego ni ukoresha urutonde ruto ruzana umusaruro mwinshi mugihe gito gishoboka. Igihe umubiri wawe ushobora gukomeza umuvuduko w'amaraso uhagije wenyine, itsinda ryawe ry'abaganga rizahagarika umuti rwose.

Ni Ibihe Bikorwa Bigaragara bya Norepinephrine?

Kimwe n'imiti yose ikomeye, norepinephrine irashobora gutera ibikorwa bigaragara, nubwo ikipe yawe y'abaganga ikugenzura cyane kugirango wirinde kandi ucunge ibibazo byose bivutse.

Ibikorwa bigaragara cyane bifitanye isano n'ingaruka z'umuti wo gufunga imitsi y'amaraso. Urashobora guhura n'umutwe, guhangayika, cyangwa kutagira umutuzo mugihe umubiri wawe wimenyereza umuvuduko w'amaraso wiyongereye. Abantu bamwe barabona ko intoki n'ibirenge byabo bikonja cyangwa bikagira ububabare kuko imigezi y'amaraso muri izo ngingo igabanuka by'agateganyo.

Ibikorwa bigaragara bikomeye ariko bishobora gucungwa birimo:

• Umutima utera nabi cyangwa guhinda umushyitsi
• Urubavu rubabaza cyangwa kutumva neza
• Kugufiwa umwuka
• Isesemi cyangwa kuruka
• Kugorana gusinzira
• Kunyeganyega cyangwa kumva ushushye cyane

Ibikorwa bigaragara bidakunze ariko bikomeye bishobora kubaho niba umuti uvuye muri IV yawe ukajya mu bice byegereyeho. Iyi miterere, yitwa extravasation, irashobora kwangiza uruhu n'ibice byimbitse hafi y'ahaterwa urushinge. Abaforomo bawe bagenzura ahantu IV yawe iherereye kenshi kugirango birinde iki kibazo.

Abantu bamwe bashobora kugira ibibazo by'impyiko niba umuvuduko wabo w'amaraso ukomeje kuba mwinshi igihe kirekire. Ikipe yawe y'abaganga igenzura imikorere y'impyiko zawe binyuze mu igeragezwa ry'amaraso risanzwe kandi igahindura umuti uko bikwiye.

Gahoro cyane, abarwayi bashobora guhura n'uburwayi bukomeye bwo kwanga umuti, nubwo ibi bidakunze. Ibimenyetso birimo kugorana guhumeka, kubyimba, cyangwa ibiheri byose, ikipe y'abaganga ivura ako kanya niba bibaye.

Ninde Utagomba Gufata Norepinephrine?

Norepinephrine muri rusange iratekanye kubantu benshi mugihe ikoreshwa neza mumashami y'ibitaro, ariko ibibazo bimwe na bimwe bisaba kwitonda cyane cyangwa uburyo bwo kuvura butandukanye.

Abantu bafite ibibazo bikomeye by'umuvuduko w'umutima bashobora gukenera imiti itandukanye kuko norepinephrine rimwe na rimwe ishobora gutuma umutima utera nabi. Ikipe yawe y'abaganga izatekereza ibikorwa by'amashanyarazi by'umutima wawe mbere yo gutangira kuvura.

Abarwayi bafite ubwoko runaka bw'indwara z'umutima, cyane cyane izo zifata ibice byihariye by'imitsi y'umutima, ntibashobora kuba abakandida beza. Ingaruka z'umuti ku murimo w'umutima zishobora kongera kwangiza muri ibyo bihe.

Abantu bafite indwara ikomeye y'imitsi y'amaraso yo ku ngingo, aho imitsi y'amaraso yo mu maboko no mu maguru yamaze kugabanuka, bakeneye gukurikiranwa neza. Ingaruka z'umuti zo gufunga imitsi zishobora gutuma amaraso atagera neza muri ibyo bice.

Kugira inda bisaba kwitonderwa byihariye, nubwo abaganga bashobora gukoresha norepinephrine niba ubuzima bwa nyina buri mu kaga. Uyu muti ushobora kwambuka placenta kandi ugashobora kugira ingaruka ku mikorere y'amaraso y'umwana ukiri mu nda.

Abarwayi bafite imitsi ikora cyane ya thyroïde bakeneye guhindura urugero rw'umuti kuko imibiri yabo ishobora kwitaba cyane ingaruka z'umuti. Mu buryo nk'ubwo, abantu bafata imiti imwe na imwe yo kurwanya depression bashobora kugira ibisubizo bikomeye kuri norepinephrine.

Amazina y'ubwoko bwa Norepinephrine

Norepinephrine iboneka mu mazina menshi y'ubwoko, nubwo verisiyo rusange ikora kimwe na formulations zifite amazina y'ubwoko. Izina ry'ubwoko rikoreshwa cyane ni Levophed, ushobora kubona ku byapa by'imiti yawe cyangwa ukumva abaganga babivuga.

Andi mazina y'ubwoko arimo Noradrenaline na formulations zitandukanye rusange ziva mu nganda zitandukanye zikora imiti. Hatitawe ku izina ry'ubwoko, verisiyo zose zirimo ikintu kimwe gikora kandi zikora kimwe mu mubiri wawe.

Farumasi yawe y'ibitaro izabika verisiyo bakunda cyane bitewe n'ikiguzi, uko iboneka, n'ibyo ibigo byifuza. Guhitamo ubwoko ntigira ingaruka ku buryo uvurwa cyangwa umutekano wawe.

Uburyo bwo gusimbuza Norepinephrine

Imiti myinshi ishobora kuvura umuvuduko muke w'amaraso, nubwo buri imwe ikora mu buryo butandukanye kandi ikwiriye ibihe bitandukanye. Itsinda ryawe ry'abaganga rihitamo uburyo bwiza bushingiye ku burwayi bwawe bwihariye n'uburyo umubiri wawe witwara.

Epinephrine isa nk'iyo norepinephrine ariko igira ingaruka zikomeye ku mutima wawe. Abaganga bashobora guhitamo epinephrine ku barwayi bakeneye gushishikariza umutima cyane hamwe no gushyigikira umuvuduko w'amaraso.

Dopamine ni ubundi buryo bushobora kongera umuvuduko w'amaraso mugihe ishyigikira imikorere y'impyiko. Uyu muti ushobora gukundwa ku barwayi bafite ibibazo by'impyiko cyangwa abakeneye gushyigikirwa umuvuduko w'amaraso woroheje.

Vasopressin ikora muburyo butandukanye mugihe igira ingaruka kuburyo impyiko zawe zikoresha amazi n'umunyu. Abandi barwayi bakira uyu muti hamwe na norepinephrine kugirango barusheho kugenzura umuvuduko w'amaraso.

Phenylephrine ikora cyane muguhuza imitsi y'amaraso itagize ingaruka nyinshi kumuvuduko w'umutima. Ubu buryo bushobora gukwira abarwayi bakeneye gushyigikirwa umuvuduko w'amaraso ariko ntibashobore kwihanganira gushishikariza umutima cyane.

Ese Norepinephrine iruta Dopamine?

Norepinephrine na dopamine ni imiti myiza yo kuvura umuvuduko w'amaraso muke, ariko bikora neza mubibazo bitandukanye. Nta numwe uruta undi.

Norepinephrine akenshi ikundwa kuri septic shock kuko ikora neza muguhuza imitsi y'amaraso yoroheje cyane kubera icyorezo. Ifite kandi ingaruka nkeya kumuvuduko w'umutima, bituma iba nziza kubarwayi bafite indwara zimwe na zimwe zumutima.

Dopamine ishobora kuba nziza kubarwayi bafite umutima wanze gukora kuko ishobora gukomeza imitsi yumutima mugihe ishyigikira imikorere y'impyiko. Ariko, birashoboka cyane ko itera umuvuduko w'umutima utajegajega kubarwayi bamwe.

Ubushakashatsi bwa vuba aha bugaragaza ko norepinephrine ishobora kuba nziza muri rusange, ifite ingaruka nkeya kandi ifite ibisubizo byiza kubarwayi barembye cyane. Ariko, itsinda ryawe ry'abaganga rizagena umuti ukwiriye neza imiterere yawe n'amateka yawe y'ubuvuzi.

Ibikunze Kubazwa Kuri Norepinephrine

Ese Norepinephrine irinzwe kubantu bafite indwara zumutima?

Norepinephrine irashobora kuba umutekano ku bantu barwaye indwara z'umutima iyo ikoreshejwe neza kandi bayikurikirana na muganga. Itsinda ry'abaganga bakuvura bazakomeza gukurikirana imikorere y'umutima wawe buri gihe kandi bagahindura urugero rw'umuti bitewe n'uko umutima wawe witwara.

Uyu muti wongera akazi k'umutima wawe, ibyo bishobora kuba impungenge ku bantu bafite imitsi y'umutima yangiritse cyane. Ariko, inyungu zo kugumana umuvuduko w'amaraso uhagije akenshi ziruta izi ngaruka mu bihe bishobora guteza ubuzima akaga.

Itsinda ry'abaganga bakuvura bazakoresha urugero ruto rw'umuti ruzana umusaruro kandi bashobora guhuza norepinephrine n'ubundi buvuzi kugira ngo bagabanye umutwaro ku mutima wawe. Bazahagarika kandi umuti vuba na bwangu igihe ubuzima bwawe buzaba bumaze gusubira mu buryo.

Ninkora iki niba mbonye norepinephrine nyinshi ku buryo butunguranye?

Ntabwo ugomba guhangayika kubera kubona norepinephrine nyinshi ku buryo butunguranye kuko abaganga babihuguriwe bagenzura ibice byose by'ubuvuzi bwawe. Bakoresha ibikoresho bifasha gutanga imiti neza kandi bagakurikirana uko witwara buri gihe.

Niba umuvuduko w'amaraso yawe uziye hejuru cyane, itsinda ry'abaganga bakuvura rizahita rigabanya urugero rw'umuti cyangwa rihagarike by'agateganyo umuti. Bafite uburyo bwo gukora vuba kugira ngo bakureho ingaruka zose zikabije.

Abaforomo n'abaganga bawe bareba ibimenyetso byo kurenza urugero rw'umuti, harimo kubabara umutwe cyane, umuvuduko w'amaraso uri hejuru cyane, cyangwa ibibazo byo gutembera kw'amaraso mu ntoki no mu birenge. Bashobora gukemura ibi bibazo vuba niba bibaye.

Bikunda bite niba umurongo wanjye wa IV utandukanye?

Abakozi bo mu bitaro bashyiraho uburyo bwinshi bwo kwirinda gutandukana kwa IV, kandi itsinda ry'abaganga bakuvura rikomeza gukurikirana umurongo wawe wa IV buri gihe. Niba gutandukana bibaye, ibyuma bizahita bitabaza abakozi.

Umuvuduko w'amaraso yawe ushobora kugabanuka vuba niba umuti uhagaze gutembera, ariko itsinda ry'abaganga bakuvura ryiteguye kongera gutangira IV no gusubiza umuti wawe mu minota mike. Akenshi bafite uburyo bwo kubona IV bwiteguye kubera iyi mpamvu.

Ntugerageze kwisubiranya cyangwa guhindura umurongo wawe wa IV wenyine. Hamagara ubufasha ako kanya niba ubonye ibibazo byose bijyanye n'imikoranire yawe ya IV, kandi ikipe yawe y'abaganga izakemura icyo kibazo mu buryo bwizewe.

Ni ryari nshobora guhagarika gufata Norepinephrine?

Ikipe yawe y'abaganga izahagarika norepinephrine igihe umubiri wawe ushobora kugumana umuvuduko w'amaraso uhagije wenyine. Ibi bikunda kuba igihe uburwayi bwawe bwihishe burushaho gukira hamwe n'izindi nshuti.

Uburyo bwo guhagarika bukorwa buhoro buhoro mu masaha cyangwa iminsi, bitewe n'igihe umaze ufata umuti. Ikipe yawe izagabanya buhoro buhoro urugero rwawo mugihe ikurikirana umuvuduko w'amaraso yawe kugirango yemeze ko uguma uhamye.

Uzamenya ko witeguye guhagarika igihe umuvuduko w'amaraso yawe uguma usanzwe hamwe n'imiti mike kandi ibimenyetso byawe by'ingenzi biguma bihamye. Ikipe yawe y'abaganga ifata iki cyemezo ishingiye ku bintu byinshi, atari umuvuduko w'amaraso gusa.

Ese Norepinephrine ishobora gutera ibibazo by'igihe kirekire?

Abantu benshi barakira neza kuva mu kuvurwa na norepinephrine nta ngaruka z'igihe kirekire. Ingaruka z'umuti ni iz'agateganyo kandi zikora vuba igihe kuvurwa guhagaritswe.

Gahoro cyane, abarwayi bashobora guhura n'imihindukire y'agateganyo mu mikoranire y'intoki n'amano, ariko ibi bikunda gukemuka mu minsi cyangwa mu byumweru. Ikipe yawe y'abaganga ikurikirana ibi bibazo kandi irashobora gutanga imiti yo kunoza imikoranire niba bibaye ngombwa.

Ikintu cy'ingenzi cyane cyo gukira igihe kirekire ni ukuvura uburwayi bwawe bwihishe neza. Norepinephrine ifasha kugumana uhamye mugihe izindi nshuti zikemura icyateye umuvuduko w'amaraso muke.