Mexiletine ni iki: Ibikoresho, Urutonde rw'imiti, Ingaruka zayo n'ibindi

Mexiletine ni umuti wandikirwa na muganga ufasha kugenzura umutima utera nabi mu gufasha imikorere y'amashanyarazi y'umutima wawe. Uyu muti unyobwa mu kanwa ugwa mu cyiciro cy'imiti yitwa antiarrhythmics, ikora nk'abagenzuzi b'amashanyarazi boroheje kugira ngo umutima wawe ukomeze gutera mu buryo buhoraho kandi buzima.

Ushobora kumva uhungabanye wumvise ibyerekeye imiti igenga umutima, ariko mexiletine imaze imyaka myinshi ikoreshwa mu buryo bwizewe mu gufasha abantu kubaho ubuzima burangwa n'umunezero. Tekereza nk'inshuti ishyigikira umutima wawe, ifasha kugumana umuvuduko wayo wa kamere iyo ibintu biba bitameze neza.

Mexiletine ni iki?

Mexiletine ni umuti ubuza sodium kwisuka mu ngingo z'umubiri, ugamije cyane cyane inzira z'amashanyarazi mu mikaya y'umutima wawe. Ni icyo abaganga bita umuti wa Class IB antiarrhythmic, bivuze ko ikora mu kugabanya ibimenyetso by'amashanyarazi bishobora gutuma umutima wawe utera nabi.

Uyu muti uza mu buryo bw'ibikoresho byo kunywa mu kanwa kandi akenshi ufata mu kanwa inshuro ebyiri cyangwa eshatu ku munsi. Muganga wawe azakwandikira mexiletine iyo izindi nshingano zitagize icyo zikora cyangwa iyo ikibazo cyawe cyihariye cy'umutima gishobora gusubizwa neza n'uyu muti wihariye.

Uyu muti umazeho kuva mu myaka ya za 1970 kandi ufite umutekano wemejwe neza iyo ukoreshejwe hakurikijwe ubugenzuzi bw'abaganga. Ufatwa nk'umuti ukomeye wo mu mutima ukeneye gukurikiranwa neza ariko ushobora kugira akamaro kanini ku barwayi bakwiriye.

Mexiletine ikoreshwa mu iki?

Mexiletine ikoreshwa cyane cyane mu kuvura ventricular arrhythmias, ari zo guteragura k'umutima gutangirira mu ngingo zo hasi z'umutima wawe. Izi ngorane z'umuvuduko zishobora kumvikana nk'aho umutima wawe usimbuka, wiruka, cyangwa utera cyane.

Muganga wawe ashobora kugusaba gukoresha mexiletine niba uhora wumva umutima wawe ukubita cyane (PVCs) bigatuma wumva ibimenyetso bibabaje. PVCs ni umutima ukubita wiyongereye bishobora gutuma wumva umutima wawe uvurungana cyangwa ukubita cyane, cyane cyane iyo ugerageza kuruhuka cyangwa gusinzira.

Uyu muti kandi ukoreshwa mu gukumira indwara zikomeye zifitanye isano n'umutima, zirimo ventricular tachycardia, ni ukuvuga igihe umutima wawe ukubita vuba cyane ku buryo buteye akaga. Mu bihe bimwe na bimwe, abaganga bawandikira abarwayi barokotse ubwoko runaka bw'indwara z'umutima kandi bakeneye gukomeza kurindwa ibibazo by'umutima.

Mu buryo butajegajega, mexiletine ishobora gukoreshwa mu buryo butemewe n'amategeko ku ndwara zimwe na zimwe zifitanye isano n'imitsi cyangwa indwara z'imitsi, nubwo ibi bisaba ubufasha bwihariye bw'abaganga. Muganga wawe azatekereza gukoresha uyu muti gusa niba imiti isanzwe itatanze umuti uhagije.

Mexiletine ikora ite?

Mexiletine ikora ibyara inzira za sodium mu ngirangingo z'umutima wawe, ibi bifasha kugabanya ibimenyetso by'amashanyarazi bishobora gutera umutima kutagira umurongo. Bitekereze nk'ugushyiraho ibyuma bigabanya umuvuduko ku mihanda y'amashanyarazi y'umutima wawe kugira ngo wirinde ibimenyetso byihuta cyane.

Iyo ingirangingo z'umutima wawe zahawe ibimenyetso by'amashanyarazi, bisanzwe bifungura inzira zituma sodium itembera, bigatuma umutima ukubita. Mexiletine ifunga igice cy'izi nzira, bigatuma bigorana ko ibimenyetso bidasanzwe by'amashanyarazi bitera umutima kutagira umurongo mugihe bigifasha umutima gusubira mu murongo usanzwe.

Uyu muti ufashwe nk'ukomeye cyane mu miti ikoreshwa ku mutima. Ntabwo ari nk'imiti imwe na rimwe ya Class I antiarrhythmics, ariko irakomeye kurusha beta-blockers yoroheje, ibi bituma ikora neza ku bibazo by'umutima bikomeye bititabira imiti yoroheje.

Umuti ubusanzwe utangira gukora nyuma y'amasaha make uwufashe, ariko ushobora kutumva akamaro kose mu minsi mike cyangwa mu byumweru. Umutima wawe ukeneye igihe cyo kumenyera ingaruka z'umuti, kandi muganga wawe azakurikirana uko witwara neza muri iki gihe.

Nkwiriye Kufata Mexiletine Nte?

Fata mexiletine nk'uko muganga wawe abikwandikiye, akenshi inshuro ebyiri cyangwa eshatu ku munsi hamwe n'ibiryo cyangwa amata. Kuyifata hamwe n'ibiryo bifasha kugabanya ibibazo byo mu nda kandi bishobora no kunoza uburyo umubiri wawe wunguka umuti.

Mimina ibinini byose hamwe n'ikirahure kinini cy'amazi, kandi gerageza gufata imiti yawe mu gihe kimwe buri munsi. Ibi bifasha kugumana urwego rwawo mu maraso yawe, ibi bikaba ari ingenzi kugira ngo umutima ukore neza.

Ushobora gufata mexiletine hamwe n'ibiryo byinshi, ariko wirinde ibiryo byinshi bifite aside cyangwa ibinyobwa mu gihe cyo gufata imiti, kuko bishobora kugira ingaruka ku buryo umubiri wawe ukoresha umuti. Ifunguro risanzwe rikora neza, kandi ntugomba gukurikiza imirire yihariye keretse muganga wawe abigushimye.

Niba ugira ikibazo cyo kwibuka imiti, tekereza gushyiraho alarme kuri terefone cyangwa gukoresha umuteguro w'ibinini. Igihe gihamye gifasha umuti gukora neza cyane, bityo gukora gahunda ikora neza n'igihe cyawe cya buri munsi ni ingenzi cyane.

Ntuzigere uvunagura cyangwa gufungura ibinini, kuko ibi bishobora kugira ingaruka ku buryo umuti usohoka mu mubiri wawe. Niba ugira ikibazo cyo kumira ibinini, ganira na muganga wawe ku bijyanye n'ubundi buryo bwo kubikora cyangwa uburyo bushobora gufasha.

Mbwiriza Kufata Mexiletine Igihe Kingana Gite?

Igihe cyo kuvura na mexiletine gitandukanye cyane bitewe n'uburwayi bwawe bwihariye n'uburyo witwara neza ku muti. Abantu bamwe barayikeneye mu mezi make gusa, mu gihe abandi bashobora kuyifata imyaka cyangwa ndetse igihe kirekire kugira ngo bagumane umutima utunganye.

Muganga wawe akenshi azatangira akoresha iminsi mike kugira ngo arebe uko umutima wawe witwara niba hari ibimenyetso bibangamye ubona. Muri iki gihe, birashoboka ko uzajya ukorwa isuzuma risanzwe kandi wenda no gukurikiranwa kw'umuvuduko w'umutima wawe kugira ngo ukurikirane uko urimo utera imbere.

Ku bantu bafite ibibazo by'umuvuduko w'umutima bihoraho, mexiletine irashobora kuba umuti wo gufata igihe kirekire, kimwe n'uko abantu bamwe bafata imiti igabanya umuvuduko w'amaraso ubuzima bwabo bwose. Intego ni ukubona uburyo bwiza bwo kugenzura ibimenyetso byawe no kugabanya ingaruka zose zishobora kubaho.

Ntuzigere uhagarika gufata mexiletine ako kanya utabanje kuvugana na muganga wawe. Guhagarika ako kanya rimwe na rimwe bishobora gutuma ibibazo by'umuvuduko w'umutima wawe bisubira inyuma bikabije kurusha mbere, ikintu cyitwa rebound arrhythmias.

Muganga wawe azajya asuzuma buri gihe niba ugikenera uwo muti kandi ashobora guhindura urugero rwawo cyangwa agasaba ko wagerageza guhagarika uwo muti igihe umuvuduko w'umutima wawe umaze igihe gihagije utahinduka.

Ni izihe ngaruka ziterwa na Mexiletine?

Kimwe n'imiti myinshi y'umutima, mexiletine irashobora gutera ingaruka, nubwo abantu benshi bayihanganira neza igihe umubiri wabo umaze kuyimenyera. Ingaruka zisanzwe zikunda kuba zoroshye kandi akenshi zigenda zikemuka nyuma y'ibyumweru bike bya mbere by'imiti.

Dore ingaruka ushobora guhura nazo, dutangiriye ku zikunze kubaho kandi akenshi zitari izikomeye:

• Urugimbu cyangwa kuribwa mu gifu, cyane cyane igihe utangiye gufata umuti
• Umuzungero cyangwa kumva ureremba, cyane cyane iyo uhagurutse vuba
• Umuriro cyangwa guhinda umushyitsi gake mu ntoki zawe
• Kunanirwa cyangwa kumva urushye kurusha uko bisanzwe
• Urubavu cyangwa kutagira igifu cyiza
• Ibibazo byo guhuza ibice by'umubiri cyangwa kumva utameze neza
• Ibibazo byo gusinzira cyangwa kurota inzozi zigaragara

Izi ngaruka zisanzwe akenshi zigenda zishira igihe umubiri wawe umaze kumenyera umuti, ariko menyesha muganga wawe niba zikomeje cyangwa zikubangamiye cyane.

Abantu bamwe bahura n’ingaruka ziteye inkeke zisaba ubufasha bwa muganga. Nubwo ibi bitaba kenshi, ni ngombwa kubimenya:

• Ibibazo bishya cyangwa bikomeye by’umuvuduko w’umutima
• Urugero rwo kuribwa cyane cyangwa guta ubwenge
• Urubavu rubabaza cyangwa guhura n’ingorane zo guhumeka
• Isesemi rihoraho cyangwa kuruka
• Umutingito ukabije cyangwa ibibazo byo guhuza ibice by’umubiri
• Imyitwarire ihinduka cyangwa urujijo

Mu buryo butavugwa cyane, mexiletine irashobora gutera ingaruka zikomeye zisaba ubufasha bwihuse bwa muganga. Ibi birimo allergie zikomeye, ibibazo by’umwijima, cyangwa indwara z’amaraso, nubwo ibi bibaho ku bantu batarenze 1% bafata uyu muti.

Vugana na muganga wawe ako kanya niba ugize uruhu ruruka, umuhondo ku ruhu rwawe cyangwa mu maso, gukomeretsa bidasanzwe, cyangwa umuriro uhoraho mugihe ufata mexiletine. Ibi bimenyetso ntibisanzwe ariko bishobora kwerekana igikorwa gikomeye gikeneye ubufasha bwihuse.

Ninde udakwiye gufata Mexiletine?

Mexiletine ntabwo ikwiriye buri wese, kandi muganga wawe azasuzuma neza amateka yawe y’ubuzima mbere yo kuyandika. Indwara zimwe na zimwe z’umutima zituma mexiletine idatekanye cyangwa ishobora kuba iyobye gukoreshwa.

Ntabwo ukwiriye gufata mexiletine niba ufite ubwoko bumwe bw’umutima cyangwa kunanirwa gukomeye k’umutima, kuko uyu muti ushobora gukomeza ibi bibazo. Muganga wawe azakora electrocardiogram (ECG) kugirango arebe imikorere y’amashanyarazi y’umutima wawe mbere yo gutangira kuvurwa.

Abantu bafite ibibazo by’umwijima ntibashobora gufata mexiletine neza, kuko umwijima ukoresha uyu muti. Niba ufite amateka y’indwara y’umwijima cyangwa ufata indi miti igira ingaruka ku mikorere y’umwijima, muganga wawe azagomba kugukurikiranira hafi cyane.

Abagore batwite muri rusange bagomba kwirinda mexiletine keretse inyungu ziruta cyane ibyago, kuko ingaruka zayo ku bana bakiri mu nda ntizisobanukiwe neza. Niba uri konka, mexiletine irashobora kujya mu mata kandi igashobora kugira ingaruka ku mwana wawe.

Bwira muganga wawe imiti yose urimo gufata, harimo imiti itagurishwa ku gasoko n'ibyongerera imbaraga. Mexiletine ishobora gukorana n'indi miti myinshi, cyane cyane indi miti ikoreshwa mu kurinda umutima, imiti imwe ya antibiyotike, na zimwe muri antidepressants.

Niba ufite ibibazo by'impyiko, indwara zo gufatwa n'urugimbu, cyangwa amateka y'indwara zo mu mutwe, muganga wawe azagomba gupima neza inyungu n'ibibazo mbere yo kugushyiriraho mexiletine.

Amazina y'ubwoko bwa Mexiletine

Mexiletine iboneka mu mazina menshi y'ubwoko, aho Mexitil ariyo izwi cyane. Ariko, amavuriro menshi ubu afite ubwoko bwa mexiletine, bufite akamaro kimwe n'ubwoko bw'amazina.

Mexiletine rusange imaze imyaka myinshi iboneka kandi yujuje ubuziranenge bumwe nk'imiti y'amazina. Ubwishingizi bwawe bushobora gukunda ubwoko rusange, kandi akenshi birahendutse cyane nta tandukaniro mu mikorere.

Andi mazina y'ubwoko ushobora kubona harimo Mexitil n'ubwoko butandukanye buturuka mu nganda zitandukanye. Ikintu cy'ingenzi ni ikintu gikora, mexiletine hydrochloride, kimwe na kimwe hatitawe ku bwoko.

Niba uhindura hagati y'abakora mexiletine rusange batandukanye, bimenyeshe muganga wawe, kuko hashobora kubaho itandukaniro rito mu buryo ubwoko butandukanye bwinjizwa n'umubiri wawe.

Uburyo bwa Mexiletine

Niba mexiletine itagukwiriye cyangwa idakoresha neza umutima wawe, indi miti myinshi ishobora kuvura ibibazo bisa. Muganga wawe ashobora gutekereza ku yindi miti irwanya arrhythmia nka flecainide, propafenone, cyangwa amiodarone.

Flecainide ni indi Class I antiarrhythmic ikora kimwe na mexiletine ariko ishobora kwihanganirwa neza n'abantu bamwe. Akenshi ikoreshwa mu bwoko bumwe bw'ibibazo by'umutima kandi ishobora kuba uburyo niba mexiletine itera ingaruka nyinshi.

Ibiyobyabwenge bikoreshwa mu kugabanya umuvuduko w'umutima nka metoprolol cyangwa atenolol ni ibindi bisubizo byoroheje bishobora gukora ku bibazo by'umuvuduko w'umutima butari bukomeye. Iyi miti igabanya umuvuduko w'umutima wawe kandi ishobora kugira akamaro ku bwoko bumwe na bumwe bw'umuvuduko w'umutima utagenda neza idafite ingaruka zikomeye za mexiletine.

Ku bibazo bikomeye by'umuvuduko w'umutima, muganga wawe ashobora gutekereza amiodarone, uyu ukaba ari umuti ukomeye cyane wo kurwanya umuvuduko w'umutima. Ariko, amiodarone ifite ingaruka zayo kandi bisaba gukurikiranwa neza.

Ubuvuzi butakoresha imiti nka catheter ablation cyangwa ibikoresho bishyirwa mu mubiri bishobora kuba ibindi bisubizo ku bantu bamwe, cyane cyane niba imiti itagabanya ibimenyetso byabo neza.

Ese Mexiletine iruta Flecainide?

Niba mexiletine iruta flecainide biterwa rwose n'uburwayi bw'umutima wawe bwihariye n'uko umubiri wawe witwara kuri buri muti. Imiti yombi ikora ku bibazo by'umuvuduko w'umutima, ariko ifite imbaraga zitandukanye n'ingaruka zitandukanye.

Mexiletine akenshi ihitwamo ku bantu bagize ibibazo by'umutima cyangwa bafite ibibazo by'umutima byihariye, kuko muri rusange ni umutekano kurusha flecainide muri ibyo bihe. Ikunda no gukoreshwa iyo abantu bagize ibibazo bikomeye ku yindi miti irwanya umuvuduko w'umutima.

Flecainide ishobora gukundwa ku bantu bafite imitima isanzwe idafite ibibazo by'uburwayi bafite atrial fibrillation cyangwa ubwoko bumwe na bumwe bwa supraventricular tachycardia. Akenshi yihanganirwa neza kandi ishobora gusaba gukoreshwa kenshi kurusha mexiletine.

Muganga wawe azatekereza ibintu nk'ubwoko bwihariye bw'umuvuduko w'umutima wawe, ubuzima bw'umutima wawe muri rusange, izindi ndwara ufite, n'uburyo wabanje kwitwara ku miti y'umutima mugihe uhitamo hagati y'ibi bisubizo.

Rimwe na rimwe abaganga bagerageza umuti umwe mbere hanyuma bagahindukirira undi niba icyo bagerageje mbere kitagize icyo gikora neza cyangwa gitera ingaruka zibabaje. Ubu buryo bwo kugerageza no kwibeshya ni ibisanzwe kandi bisanzwe mu micungire y'umuvuduko w'umutima.

Ibikunze Kubazwa Kuri Mexiletine

Ese Mexiletine ifitiye umutekano abarwayi ba diyabete?

Mexiletine muri rusange ifitiye umutekano abarwayi ba diyabete, ariko bisaba gukurikiranwa neza kuko diyabete ishobora kugira ingaruka ku mutima wawe n'imitsi y'amaraso. Muganga wawe azagomba gusuzuma uko diyabete yawe ifashwe neza niba ufite ibibazo by'umutima bifitanye isano na diyabete.

Uyu muti ntugira ingaruka ku kigero cy'isukari mu maraso, bityo ntuzabangamira imiti yawe ya diyabete cyangwa kugenzura isukari mu maraso. Ariko, niba wumva uruka cyangwa ufite ikibazo mu nda biturutse kuri mexiletine, ibi bishobora kugira ingaruka ku buryo urya ndetse no gucunga isukari mu maraso.

Abantu barwaye diyabete bafite ibibazo by'umutima akenshi bakeneye mexiletine kuko diyabete yongera ibyago byo kurwara arrhythmias. Muganga wawe azakorana nawe kugira ngo yemeze ko ibibazo byombi bicungwa neza.

Nkwiriye gukora iki niba nanyoye mexiletine nyinshi ku buryo butunguranye?

Niba unyweye mexiletine nyinshi ku buryo butunguranye kurusha uko byategetswe, vugana na muganga wawe cyangwa ikigo gishinzwe kugenzura uburozi ako kanya, kabone niyo wumva umeze neza. Kunywa nyinshi bishobora gutera ibibazo bikomeye by'umutima bishobora kutagaragara ako kanya.

Ntugerageze kwivuruguta cyangwa gufata indi miti yo kurwanya uburozi. Ahubwo, shaka ubufasha bw'ubuvuzi ako kanya, cyane cyane niba wumva uribwa, ufite ububabare mu gituza, cyangwa wumva umutima wawe utera nabi.

Zana icupa ry'umuti hamwe nawe mu cyumba cy'abarwayi kugira ngo abaganga babone neza icyo wanyoye n'ingano yacyo. Igihe ni ingenzi iyo umuti w'umutima wanyowe nyinshi, bityo ntugategereze ngo urebe niba ibimenyetso bigaragara.

Kugira ngo wirinde kunywa nyinshi ku buryo butunguranye, tekereza gukoresha umuteguro w'imiti no gushyiraho ibyibutso kuri terefone yawe. Niba ubanana n'abandi, babwire gahunda yawe y'imiti kugira ngo bashobore kugufasha gukurikirana.

Nkwiriye gukora iki niba nsimbukiye urugero rwa mexiletine?

Niba wibagiwe gufata urugero rwa mexiletine, rufate uko wibukije, keretse igihe cyo gufata urugero rukurikira kigeze. Mu gihe nk'icyo, reka urugero wibagiwe urusimbure ukomeze gahunda yawe isanzwe yo gufata imiti.

Ntuzigere ufata urugero rwa kabiri icyarimwe kugira ngo usimbure urugero wibagiwe, kuko ibyo bishobora gutera ibibazo by'umutima biteye akaga. Biruta kwibagirwa urugero rumwe kuruta gushyira ubuzima mu kaga wo gufata imiti myinshi icyarimwe.

Niba ukunda kwibagirwa gufata imiti, ganira na muganga wawe ku bijyanye n'uburyo bwo kugufasha kwibuka. Guhora ufata imiti ni ingenzi kugira ngo mexiletine ikore neza, bityo kubona gahunda igukwiriye ni ingenzi cyane.

Kutafata urugero rimwe na rimwe ntibiba biteye akaga, ariko kutafata imiti buri gihe bishobora gutuma ibibazo by'umutima wawe bisubira kandi bikaba bibi kurushaho uko igihe kigenda.

Ni ryari nshobora kureka gufata Mexiletine?

Ugomba kureka gufata mexiletine gusa uyobowe na muganga wawe, kabone n'iyo wumva umeze neza rwose. Guhagarika imiti ivura umutima mu buryo butunguranye rimwe na rimwe bishobora gutuma umutima wawe utera nabi usubira mu buryo bukomeye kurusha mbere.

Muganga wawe azagabanya urugero rwawe buhoro buhoro mu minsi mike cyangwa mu byumweru kurusha kubihagarika icyarimwe. Ibi bituma umutima wawe ufata igihe cyo kumenyera kandi bigabanya ibyago byo gusubira kwa arrhythmias.

Umwanzuro wo guhagarika mexiletine uterwa n'igihe umaze uyifata, impamvu wayikeneye mbere na mbere, niba ikibazo cy'umutima wawe cyarushijeho gukira. Abantu bamwe bakeneye kuvurwa igihe kirekire, mu gihe abandi bashobora gukora nyuma yo gufata imiti.

Guhura na muganga wawe buri gihe bizafasha kumenya igihe cyiza cyo gutekereza ku guhagarika mexiletine. Muganga wawe ashobora gushaka gukurikirana umutima wawe mu gihe runaka nyuma yo guhagarika kugira ngo arebe ko arrhythmias zawe zitagaruka.

Nshobora kunywa inzoga niba mfata Mexiletine?

Ni byiza kugabanya kunywa inzoga igihe urimo gufata umuti wa mexiletine, kuko inzoga ishobora kongera ingaruka zimwe na zimwe nk'izabura umutwe no kutagira ubushobozi bwo kugenda neza. Mexiletine n'inzoga zombi zishobora kugira ingaruka ku mikorere y'imitsi yawe, bityo kuzifatanya bishobora gutuma wumva utagira umutekano cyangwa uvurunganye.

Inzoga kandi ishobora gutera ibibazo by'umuvuduko w'umutima mu bantu bamwe, ibyo bikaba byarwanya icyo mexiletine igerageza gukora. Niba uhisemo kunywa rimwe na rimwe, bikore mu rugero ruto kandi witondere uko wumva.

Ganira na muganga wawe ku bijyanye n'imigenzo yawe yo kunywa inzoga kugira ngo baguhe inama zishingiye ku miterere yawe. Abantu bamwe bashobora gukenera kwirinda inzoga rwose, mu gihe abandi bashobora kunywa rimwe na rimwe mu buryo butabangamiye ubuzima.

Niba ubonye ko n'inzoga ntoya zigutera isereri cyangwa kutumva neza igihe urimo gufata mexiletine, ni byiza kwirinda inzoga rwose igihe uri kuri uyu muti.