Esmolol ni iki: Ibikoresho, Urutonde rw'imiti, Ingaruka ziterwa n'ibindi

Esmolol ni umuti w'igihe gito ukoreshwa mu kugabanya imikorere ya beta utangwa binyuze mu muyoboro w'amaraso mu bitaro kugira ngo ugenzure vuba umuvuduko ukabije w'amaraso n'umutima wihuta mu gihe cy'ubuvuzi bwihutirwa. Utekereze nk'igikoresho gihagarika imikorere y'umutima n'imitsi yihuta, abaganga bashobora gufungura no gufunga uko babyifuza. Uyu muti ukora mu minota mike kandi ugashira vuba, bigatuma ugirira akamaro gakomeye iyo amakipe y'ubuvuzi akeneye kugenzura umutima n'umuvuduko w'amaraso by'igihe gito ariko ako kanya.

Esmolol ni iki?

Esmolol ni umuti ugabanya imikorere ya beta ubarizwa mu cyiciro cy'imiti yitwa cardioselective beta-1 adrenergic receptor blockers. Ukora ubugenzuzi bwo guhagarika imikorere y'uturemangingo twihariye two mu mutima wawe twakira adrenaline n'imisemburo isa nayo itera umunaniro. Bitandukanye n'indi miti igabanya imikorere ya beta ushobora gufata buri munsi mu buryo bw'ibinini, esmolol itangwa gusa binyuze mu muyoboro w'amaraso mu bitaro.

Igituma esmolol idasanzwe ni igihe gito cyane ikora. Uyu muti utangira gukora mu minota 1-2 umaze gutangwa kandi ingaruka zawo zigashira mu minota 10-30 nyuma yo guhagarika kuyitera. Ibi bituma abaganga bagira ubugenzuzi bwuzuye ku mutima wawe n'umuvuduko w'amaraso mu bihe bikomeye.

Esmolol ikoreshwa mu iki?

Esmolol ikoreshwa cyane cyane mu kugenzura umuvuduko w'amaraso n'umutima wihuta mu gihe cyo kubagwa, ibikorwa by'ubuvuzi, cyangwa ibibazo by'ubuvuzi bwihutirwa. Abaganga bakoresha uyu muti iyo bakeneye kugenzura umutima n'imitsi by'igihe gito ariko ako kanya bishobora guhindurwa cyangwa guhagarikwa byoroshye.

Ibihe bisanzwe ushobora guhabwamo esmolol birimo mu gihe cyo kubagwa iyo umuvuduko w'amaraso yawe cyangwa umutima wihuta cyane, mu cyumba cy'ubuvuzi bwihutirwa ku bibazo by'umuvuduko ukabije w'amaraso, cyangwa mu cyumba cyita ku barwayi barembye iyo indi miti igabanya umuvuduko w'amaraso itagikora vuba bihagije. Ikoreshwa kandi iyo uva mu burozi kandi imikorere y'umutima n'imitsi yawe ikeneye kuyobozwa buhoro buhoro gusubira mu buryo busanzwe.

Mu buryo butajyenda cyane, esmolol ishobora gukoreshwa mu bibazo bimwe na bimwe by'umutima cyangwa igihe abaganga bakeneye kugenzura uko umutima wawe witwara ku buvuzi bwa beta-blocker mbere yo gutangira kugutera umuti ukora igihe kirekire. Abantu bamwe barayihabwa mu gihe cy'ibikorwa by'ubuvuzi nk'ubwoko bumwe na bumwe bwo kubaga amaso aho kugenzura umuvuduko w'amaraso ari ngombwa.

Esmolol ikora ite?

Esmolol ikora ibyara ibice bya beta-1 mu mikaya y'umutima wawe, bingana n'ibishushanyo bisubiza adrenaline n'izindi hormone z'umuvuduko. Iyo ibyo bice byabujijwe, umutima wawe uratera gahoro kandi n'imbaraga nkeya, ibyo bikagabanya umuvuduko w'amaraso yawe.

Ibi bifatwa nk'umuti ukomeye mu bijyanye n'ingaruka zawo zihuse, ariko nanone biragufi cyane. Umubiri wawe ufite enzymes zidasanzwe mu maraso yawe zisenya vuba esmolol, niyo mpamvu ingaruka zayo zishira vuba iyo IV infusion ihagaze. Iyi myitwarire idasanzwe ituma iba nziza cyane kurusha beta-blockers ikora igihe kirekire mu bihe by'ubutabazi.

Uyu muti ugenda neza kuri beta-1 receptors, bivuze ko cyane cyane ugira ingaruka ku mutima wawe kurusha izindi ngingo nk'ibihaha byawe. Iyi selectivity ituma iba nziza ku bantu bafite ibibazo by'ubuhumekero, nubwo bitari byuzuye nta kaga.

Nkwiriye gufata esmolol nte?

Ntabwo uzifata esmolol wenyine - uyu muti utangwa gusa n'abantu b'inzobere mu by'ubuvuzi banyuze mu murongo wa IV mu bitaro. Itsinda ry'ubuvuzi rizatangira n'urugero rwo gutwara, ari rwo rwinshi rwa mbere, rugakurikirwa n'ubwinjiriro bukomeza bushobora guhindurwa bitewe n'uko umubiri wawe witwara.

Abaforomo bawe n'abaganga bazakugenzura umuvuduko w'umutima wawe, umuvuduko w'amaraso, n'ubuzima bwawe muri rusange buri gihe igihe uri guhabwa esmolol. Bazahindura urugero buri minota mike niba bibaye ngombwa kugira ngo bagere ku kigereranyo gikwiye cy'imimerere yawe yihariye. Ubusanzwe, urugero rwo gutera ruri hagati y'urugero ruto cyane kugeza ku bwinshi, bitewe n'uburyo umubiri wawe witwara n'ibikenewe by'ubuvuzi.

Kubera ko uzaba uri mu bitaro, ntugomba guhangayika ku bijyanye n'imikoranire y'ibiryo cyangwa igihe cyo gufata ibiryo. Itsinda ry'abaganga rikora ibintu byose byo gutanga no kugenzura. Akazi kawe ni ukuruhuka gusa kandi ukareka umuti ukora akazi kawo mugihe abaganga bakurikiranira hafi uko witwara.

Nzamara Igihe Kingana Iki Ndafashe Esmolol?

Esmolol ikoreshwa mu gihe gito cyane, akenshi kiva ku minota mike kugeza ku masaha menshi, bitewe n'imimerere yawe y'ubuvuzi. Abantu benshi barayihabwa mugihe cyo kubagwa, ibikorwa by'ubuvuzi, cyangwa ibihe bikomeye bisaba kugenzura umutima n'imitsi byihuse ariko by'agateganyo.

Igihe biterwa rwose n'ibikenewe byawe by'ubuvuzi n'uburyo umubiri wawe witwara ku buvuzi. Mugihe cyo kubagwa, ushobora kuyihabwa mu gihe cy'igikorwa gusa. Mu bihe by'ubutabazi, itsinda ry'abaganga rishobora kuyikoresha mu masaha make mugihe bagerageza guhagarika imimerere yawe bakakujyana ku miti y'igihe kirekire niba bibaye ngombwa.

Abaganga bawe bazakomeza gusuzuma niba ukikeneye umuti kandi bazawuhagarika vuba na bwangu igihe urwego rwawe rw'umutima n'imitsi ruhagaze. Kubera ko esmolol ivaho vuba cyane, barashobora kuyihagarika byoroshye bakareba uko umubiri wawe witwara mumunota.

Ni Iyihe Ngaruka Ziterwa na Esmolol?

Kimwe n'indi miti yose, esmolol ishobora gutera ingaruka, nubwo abantu benshi bayihanganira neza mugihe gito. Ingaruka zisanzwe zifitanye isano n'igikorwa cyayo cyibanze cyo gutuma umuvuduko w'umutima wawe ugenda gahoro no kugabanya umuvuduko w'amaraso.

Ibi ni bimwe mu bimenyetso bishobora kukugaragaraho, wibuke ko itsinda ryawe ry’abaganga rigukurikiranira hafi kandi rishobora guhindura cyangwa guhagarika umuti niba hari ibibazo bibaye:

• Umuvuduko muke w'amaraso (hypotension), ushobora gutuma wumva uruka cyangwa umutwe wenda kugutwara
• Umutima utinda (bradycardia), nubwo akenshi ari ko bigomba kugenda
• Kumva unaniwe cyangwa ufite intege nke
• Urugimbu cyangwa kubabara mu nda
• Umutwe
• Uruzi
• Kutamenya neza cyangwa kumva umutwe wawe wuzuye ibihuha
• Urubavu cyangwa uburibwe ahantu umuti watewe mu urushinge

Ibi bimenyetso bisanzwe bikunda kuba bike kandi bikavaho vuba iyo umuti uhagaritswe cyangwa urugero rugabanyijwe. Itsinda ryawe ry’ubuvuzi rifite uburambe mu gucunga ibi bimenyetso kandi rizakora impinduka uko bikwiye.

Ibindi bimenyetso bikomeye ariko bidasanzwe bishobora kuba harimo umuvuduko muke w'amaraso, umutima utinda cyane, cyangwa ibibazo by'umutima. Mu buryo budasanzwe, abantu bamwe bashobora guhura n'ingorane zo guhumeka, cyane cyane niba bafite indwara z'umwijima. Kwibasirwa n'ibintu bitera allergie birashoboka ariko ntibisanzwe.

Inkuru nziza ni uko kubera ko esmolol ikora vuba kandi igasohoka mu mubiri wawe vuba, ibimenyetso byinshi biva mu gihe gito cyo guhagarika guterwa. Iki gikorwa cyihuse ni kimwe mu bintu by'ingenzi by'umutekano bituma uyu muti ugirira akamaro mu bitaro.

Ninde utagomba gufata Esmolol?

Esmolol ntikwiriye kuri buri wese, kandi itsinda ryawe ry’abaganga rizasuzuma neza amateka yawe y’ubuvuzi mbere yo gukoresha uyu muti. Umwanzuro wo gukoresha esmolol biterwa no gupima inyungu n'ibishobora kuba byabangamira mu miterere yawe yihariye.

Abantu muri rusange batagomba guhabwa esmolol barimo abafite ibibazo by'umutima runaka nk'ibibazo bikomeye by'umutima, umutima utinda cyane, cyangwa kunanirwa gukora k'umutima bikomeye. Niba ufite indwara yitwa cardiogenic shock, aho umutima wawe udashobora gutera amaraso ahagije kugirango akemure ibyo umubiri wawe ukeneye, esmolol irashobora kubikora nabi.

Asima ikomeye cyangwa ibibazo by’ubuhumekero runaka bishobora gutuma esmolol iba ikwiye kwitonderwa, nubwo ifasha amashyira kurusha izindi beta-blockers zimwe na zimwe. Abantu bafite ubwoko runaka bw’ibibazo by’imitsi y’amaraso cyangwa abafata imiti runaka ishobora gukorana nabi na esmolol bakeneye kwitabwaho by’umwihariko.

Ariko, ibihe by’ubutabazi rimwe na rimwe bisaba ko abaganga bakoresha imiti nubwo hari izo mpungenge, bakongera gukurikiranwa no kwitonda. Itsinda ryawe ry’abaganga rizagena ibi bintu neza kandi rifite gahunda yo gukemura ibibazo byose bishobora kuvuka.

Amazina y’ubwoko bwa Esmolol

Esmolol ikunze kuboneka ku izina ry’ubwoko rya Brevibloc, ryo rikaba ari ryo rimenyekana cyane muri iyi miti. Ushobora kandi kuyibona yitwa gusa "esmolol hydrochloride" mu bitaro.

Abakora imiti batandukanye bashobora gukora ubwoko bwa esmolol, ariko bose bakubiyemo ibintu bikora kimwe kandi bikora kimwe. Ubwinshi n’uburyo bwo gupakira bishobora gutandukana gato hagati y’ubwoko, ariko itsinda ryawe ry’ubuzima rizagena ibisobanuro byose by’ubwoko bw’umuti bakoresha.

Ubwoko bwa Esmolol

Hariho ubundi bwoko bwa esmolol, buri kimwe gifite imiterere itandukanye ituma bikwira mu bihe bitandukanye. Guhitamo biterwa n’uko abaganga bakeneye ko umuti ukora vuba, igihe bifuza ko ibisubizo bimaraho, n’uburwayi bwawe bwihariye.

Izindi miti igabanya umuvuduko w’amaraso ikora mu gihe gito harimo nicardipine cyangwa clevidipine, ikora ku nzira zitandukanye na esmolol. Kugira ngo bigenzurwe igihe kirekire, abaganga bashobora gukoresha metoprolol, propranolol, cyangwa izindi beta-blockers zimara igihe kirekire ariko bifata igihe kinini kugira ngo bitangire gukora.

Labetalol ni indi nyunganizi ikora kuri reseptori za beta na alpha, itanga uburyo bwo kugenzura umuvuduko w'amaraso hakoreshejwe uburyo butandukanye gato. Buri kimwe muri ibi bisubizo gifite inyungu n'ibibi byacyo, kandi itsinda ryawe ry'abaganga rizagena bitewe n'ibyo ukeneye byihariye n'uburwayi ufite.

Esmolol iruta Metoprolol?

Esmolol na metoprolol zombi ni imiti igabanya umuvuduko w'amaraso, ariko zikora ibintu bitandukanye kandi ntizigereranywa mu buryo bwo kuba "byiza" kurusha izindi. Guhitamo hagati yazo biterwa rwose n'uburwayi ufite n'icyo abaganga bawe bagerageza kugeraho.

Inyungu nyamukuru ya Esmolol ni igihe gito cyane ikora, bituma ikwiriye neza mu bihe abaganga bakeneye kugenzura by'igihe gito kandi byoroshye guhindurwa. Ku rundi ruhande, metoprolol imara igihe kirekire kandi ikwiriye neza mu kuvura umuvuduko w'amaraso mwinshi cyangwa indwara z'umutima.

Tekereza esmolol nk'igikoresho cy'ubuhanga gikoreshwa igihe gito, mu gihe metoprolol isa n'ubuvuzi buhoraho bw'igihe kirekire. Mu bihe by'ubutabazi cyangwa mu gihe cyo kubaga, imikorere yihuse ya esmolol irafasha cyane. Mu miyoborere ya buri munsi y'indwara z'umutima, ingaruka za metoprolol zirakora neza.

Itsinda ryawe ry'abaganga rizagena umuti ukwiriye bitewe niba ukeneye kugenzura ako kanya, by'igihe gito cyangwa imiyoborere y'igihe kirekire y'uburwayi bwawe bw'umutima.

Ibikunze Kubazwa Kuri Esmolol

Esmolol irakwiriye ku bantu barwaye diyabete?

Esmolol muri rusange irashobora gukoreshwa neza ku bantu barwaye diyabete, nubwo bisaba gukurikiranwa neza. Bitandukanye n'indi miti igabanya umuvuduko w'amaraso, esmolol ntishobora guhisha ibimenyetso byo hasi y'isukari mu maraso, ariko irashobora kugira ingaruka ku buryo umubiri wawe witwara ku mpinduka z'isukari mu maraso.

Itsinda ryawe ry’abaganga rizakurikirana isukari yo mu maraso yawe neza niba urwaye diyabete kandi uri guhabwa esmolol. Igihe gito cy’imikorere mu by’ukuri gituma kiba cyiza kurusha ibindi byongera umuvuduko w’amaraso bifata igihe kirekire kuko ingaruka zose ku kugenzura isukari yo mu maraso zizakira vuba iyo imiti ihagaritswe.

Nkwiriye gukora iki niba mbonye esmolol nyinshi mu buryo butunganye?

Ntabwo ukeneye guhangayika kubera kubona esmolol nyinshi mu buryo butunganye kuko abaganga babihuguriwe bagenzura uburyo bwose bwo kuyitanga. Uyu muti utangwa binyuze mu miti yitonderwa ya IV hamwe n'ibikoresho bifite umuvuduko wihariye.

Niba byaba bibayeho ko umuntu yafata umuti mwinshi, itsinda ryawe ry’abaganga rihagarika ako kanya imiti kandi rigatanga ubufasha. Kubera ko esmolol iva mu mubiri wawe vuba cyane, ingaruka nyinshi zo gufata umuti mwinshi zizakira mu minota 10-30. Ibitaro bifite imiti n'ibikoresho byiteguye guhangana n'ingorane zose.

Mbigenze nte niba nciweho urugero rwa esmolol?

Gucikanwa n'urugero rwa esmolol ntibigomba guhangayikisha mu buryo busanzwe kuko bitangwa nk'imiti ikomeza mu bitaro. Niba imiti ihagaze kubera impamvu iyo ari yo yose, itsinda ryawe ry’abaganga rizasuzuma uko umeze kandi rikayisubiza niba bikenewe.

Kubera ko esmolol ikora vuba cyane, nta rugero rwo

Muri rusange, esmolol ihagarikwa igihe umuvuduko w'amaraso yawe n'umutima byoroheje, kubagwa kwawe cyangwa igikorwa cyarangiye, cyangwa ikipe yawe y'abaganga yaguhinduriye imiti y'igihe kirekire niba bibaye ngombwa. Icyiza cya esmolol nuko kuyihagarika byoroshye nko kuzimya urushinge rwa IV, kandi ingaruka zayo zigabanuka mu minota mike.

Esmolol yateza ingaruka zirambye?

Esmolol ntigira ingaruka zirambye kubera igihe gito ikora kandi ikoreshwa mu gihe gito. Abantu benshi bakoresha esmolol ntibagira ingaruka zirambye igihe umuti uhagaritswe kandi ukavanywe mu mubiri wabo.

Ingaruka zose ziterwa no gukoresha esmolol muri rusange zizashira mu minota 10-30 nyuma yo guhagarika urushinge. Iyi mikorere yihuse ni kimwe mu bintu by'ingenzi by'umutekano bituma esmolol ifite agaciro mu bitaro. Ikipe yawe y'abaganga izagukurikiranira hafi nyuma yo guhagarika umuti kugirango barebe ko urimo gukira neza.