Verapamil (inzira yo mu nshinge) ni iki: Ibikoresho, urugero rwo gukoresha, ingaruka ziterwa n'imiti n'ibindi

Verapamil itangwa binyuze mu nshinge ni umuti w'umutima ukoreshwa mu bihe by'ubutabazi kugira ngo ugenzure vuba imikorere y'umutima idateje akaga. Uyu muti ukora cyane ubuza imiyoboro ya kalisiyumu mu mutima wawe, ugufasha kugabanya umuvuduko w'umutima no gusubiza umutima mu buryo busanzwe iyo izindi nshingwa zitagikora vuba bihagije.

Iyo abaganga batanga verapamil binyuze mu maraso yawe, bashobora kugenzura neza urugero rwinshi wakira no gukurikirana neza uko witwara. Ubu buryo bwo mu nshinge bukora vuba cyane kurusha ibinini, bigatuma ari ngombwa mu bihe by'ubutabazi bw'umutima aho buri munota wose ugira agaciro.

Verapamil (inzira yo mu nshinge) ni iki?

Verapamil yo mu nshinge ni umuti ubuza imiyoboro ya kalisiyumu utangwa mu maraso yawe unyuze mu muyoboro w'amaraso. Ihereranye n'icyiciro cy'imiti ikora ibuza kalisiyumu kwinjira mu ngirangingo z'umutima wawe n'imitsi y'amaraso.

Ubu buryo bwo mu nshinge bugenewe gukoreshwa mu bitaro iyo hakenewe kugenzura umuvuduko w'umutima vuba. Bitandukanye n'ibinini ushobora gufata mu rugo, ubu buryo bwo mu nshinge butuma abaganga bagera ku rwego rwo kuvura mu maraso yawe mu minota mike aho kuba mu masaha menshi.

Uyu muti uza mu iseswa risobanutse kandi ridafite ibara abaganga bategura kandi bagatanga bakoresheje amabwiriza akomeye yo gukoresha neza. Uzahabwa ubu buvuzi gusa ahantu havurirwa aho umuvuduko w'umutima wawe n'umuvuduko w'amaraso bishobora gukurikiranwa buri gihe.

Verapamil (inzira yo mu nshinge) ikoreshwa mu iki?

Verapamil yo mu nshinge ikoreshwa cyane cyane mu kuvura supraventricular tachycardia (SVT), uburwayi aho umutima wawe utera ku buryo buteje akaga kubera ibibazo by'amashanyarazi mu byumba byo hejuru. Uyu muti ushobora kugabanya vuba umuvuduko w'umutima wawe ukagaruka mu buryo bwiza kandi busanzwe.

Abaganga kandi bakoresha verapamil yo mu rwego rwo hejuru (intravenous) mu gihe cyo guhinda umutima kwa atiriya na atiriya flutter iyo ibice byo hejuru by'umutima wawe bikubita mu buryo butari bumwe kandi vuba cyane. Muri ibyo bihe, umuti ufasha kugenzura umuvuduko w'umutima wawe mugihe izindi nshuti zikemura ikibazo cy'umuvuduko w'umutima.

Rimwe na rimwe, amakipe y'abaganga akoresha IV verapamil mugihe cy'ibikorwa bimwe na bimwe by'umutima kugirango bagabanye umuvuduko w'umutima wawe. Ibi bituma abaganga bakora ibizamini byihariye cyangwa imiti isaba umutima utinda kandi ugenzurwa neza.

Mu bihe bidasanzwe by'ubutabazi, abaganga bashobora gukoresha verapamil yo mu rwego rwo hejuru kubera umuvuduko w'amaraso mwinshi udasubiza ibindi byemezo. Ariko, iyi mikoreshereze isaba gukurikiranwa cyane kuko umuti ushobora gutuma umuvuduko w'amaraso umanuka vuba cyane.

Verapamil (inzira yo mu rwego rwo hejuru) ikora ite?

Verapamil ikora ibyara calcium muri muscle y'umutima wawe n'inkuta z'imitsi y'amaraso. Tekereza calcium nk'urufunguzo rusanzwe rufungura imiryango muri selile z'umutima wawe, rukabemerera guhagarara no gukubita.

Iyo verapamil yugara iyi calcium, igabanya ibimenyetso by'amashanyarazi bituma umutima wawe ukubita. Ibi bifasha gusubiza umuvuduko usanzwe iyo umutima wawe ukubita vuba cyane cyangwa mu buryo butari bumwe kubera ibibazo biri mu bice byo hejuru.

Umuti kandi uruhura imitsi yoroshye mu mitsi yawe y'amaraso, bishobora gufasha kugabanya umuvuduko w'amaraso. Ariko, iyo itanzwe mu rwego rwo hejuru, intego yambere ni ugucunga umuvuduko w'umutima aho gucunga umuvuduko w'amaraso.

Nkumuti ukomeye, IV verapamil itanga ingaruka mumunota 1-5 wo gutanga. Ingaruka zikomeye zikunda kubaho mumunota 10-15, niyo mpamvu abaganga bashobora kubona ibisubizo vuba kandi bagahindura imiti uko bikwiye.

Nkwiriye gufata gute Verapamil (inzira yo mu rwego rwo hejuru)?

Ntabwo wowe ubwawe uzifata “verapamil” yinjizwa mu maraso kuko abaganga babihuguriwe bazayikoresha bayinjiza mu urukururuko rwawe. Uyu muti utangwa gahoro gahoro mu minota mike abaganga bakurikirana umuvuduko w'umutima wawe n'umuvuduko w'amaraso.

Mbere yo guhabwa urushinge, abaganga bazashyiraho umurongo wa IV mu kuboko kwawe cyangwa ikiganza. Bazahuza ibikoresho byo gukurikirana umuvuduko w'umutima wawe, umuvuduko w'amaraso, n'urugero rwa oxygen mu gihe cyose cy'ubuvuzi.

Urushinge rwa mbere rukunze gutangwa gahoro gahoro mu minota 2-3, rugakurikirwa no gukaraba amazi y'umunyu kugirango byemeze ko imiti yose yinjira mu maraso yawe. Niba umuvuduko w'umutima wawe utagabanutse nyuma y'iminota 15-30, abaganga bashobora kuguha urundi rushinge.

Mugihe cyo kuyitanga, uzakenera kuryama cyangwa kwicara neza. Itsinda ry'abaganga rizakubaza niba hari ibimenyetso nk'isazi, kubabara mu gituza, cyangwa guhumeka nabi ako kanya.

Kubera ko uyu ari umuti w'ubutabazi bwihutirwa, nta byo kurya byihariye bisabwa mbere. Ariko, niba uzi ubwenge kandi ushobora kuvuga, bwire itsinda ry'abaganga ku bijyanye n'imiti urimo gufata cyangwa indwara ufite.

Nzamara Igihe Kingana Iki Ndafata Verapamil (Inzira yo mu Maraso)?

Verapamil yinjizwa mu maraso akenshi ni ubuvuzi bumwe cyangwa butangwa nk'urushinge rumwe mu masaha make mugihe cy'ubutabazi bwihutirwa. Bitandukanye n'imiti yo kunywa ushobora gufata buri munsi, IV verapamil ikoreshwa mugukontorora umuvuduko w'umutima ako kanya, mugihe gito.

Abantu benshi bahabwa urushinge rwa 1-3 rwa verapamil yinjizwa mu maraso mugihe bari mu bitaro, bitewe n'uko umutima wabo witwara ku buvuzi. Ingaruka za buri rushinge zirashobora kumara amasaha 2-6, biha abaganga umwanya wo gushyira mu bikorwa ubundi buvuzi cyangwa kumenya niba hakenewe izindi dosiye.

Nyuma y’uko umutima wawe utangira gukora neza, muganga wawe ashobora guhindura akoresha imiti yo kunywa cyangwa izindi nshingano zo kuvura igihe kirekire. Guhindura kuva ku miti iterwa mu urugingo rwo mu mubiri (IV) ukajya ku miti yo kunywa bikunze kuba nyuma y’amasaha 24-48 igihe ubuzima bwawe bumeze neza.

Mu bindi bihe, abaganga bashobora gukoresha imiti ya verapamil iterwa mu urugingo rwo mu mubiri (IV) mu gihe cy’amasaha menshi niba ukeneye kugenzura umuvuduko w’umutima. Ubu buryo butuma imiti itangwa neza kandi bigatuma byoroha guhindura urugero rwa yo uko ubuzima bwawe buhinduka.

Ni izihe ngaruka ziterwa na Verapamil (Iterwa mu urugingo rwo mu mubiri)?

Ingaruka zisanzwe ziterwa na verapamil iterwa mu urugingo rwo mu mubiri zifitanye isano n’ingaruka zayo ku mutima wawe n’imitsi y’amaraso. Izi ngaruka zibaho kuko umuti ukora kugira ngo ugabanye umuvuduko w’umutima wawe kandi utume imitsi y’amaraso iruhuka.

Dore ingaruka ushobora guhura na zo, wibuke ko abaganga bazaba bakugenzura cyane kugira ngo bamenye kandi bavure ibibazo byose vuba:

• Umubare muto w’amaraso (hypotension) bitera isereri cyangwa umutwe
• Umuvuduko muto w’umutima (bradycardia) ushobora gutuma wumva unaniwe cyangwa ucogoye
• Isesemi cyangwa kubabara mu nda
• Umutwe cyangwa isereri ryoroheje
• Kwishyushya cyangwa gushyuha mu maso no mu ijosi
• Kuguma mu nda by’igihe gito

Izi ngaruka zisanzwe zikunze kuba nto kandi zikaba iz’igihe gito, akenshi zikagenda zikorohera uko ingaruka z’umuti zigenda zishira mu masaha make akurikira.

Ingaruka zikomeye zishobora kubaho ariko ntizikunze kubaho iyo umuti utanzwe neza mu bitaro. Itsinda ry’abaganga bawe ryatojwe kumenya no kuvura izi ngaruka ako kanya:

• Kugabanuka gukomeye kw’umubare w’amaraso bitera kuruka cyangwa guhagarara kw’umubiri
• Gufunga umutima (igihe ibimenyetso by’amashanyarazi bidashobora gutambuka neza mu mutima wawe)
• Kuzamba kw’umutima mu barwayi bafite ibibazo by’umutima
• Urugero rukomeye rw’uburwayi bw’umubiri butuma ugira ingorane zo guhumeka cyangwa kubyimba
• Kubabara mu gituza cyangwa guhumeka bigoranye

Kubera ko urimo guhabwa uyu muti mu bitaro, abakozi b'ubuvuzi bashobora kumenya vuba no kuvura ibibazo bikomeye bishobora kubaho.

Mu bihe bike, abarwayi bamwe bashobora kugira umuvuduko w'amaraso muke cyangwa umutima utera gake bikaba byasaba imiti yiyongera cyangwa ubufasha. Mu bihe bike cyane, abarwayi bashobora kugira ibibazo by'umwijima cyangwa ibibazo bikomeye by'uburwayi, ariko ibi bibazo ntibisanzwe kandi birashobora gucungwa mu bitaro.

Ninde Utagomba Gufata Verapamil (Uburyo bwo kuyinjiza mu maraso)?

Abantu bamwe ntibagomba guhabwa verapamil inyuzwa mu maraso kuko byatuma indwara zabo zirushaho kuba mbi cyangwa bikavanga n'imiti bari gufata. Itsinda ry'abaganga bazasuzuma amateka yawe y'ubuzima mbere yo kuguha uyu muti.

Ntabwo ugomba guhabwa IV verapamil niba ufite umutima udakora neza cyane, kuko uyu muti ushobora kongera guca intege umutima wawe mu gukora akazi kawo ko gutera amaraso neza. Abantu bafite ubwoko runaka bwo guhagarara k'umutima ntibashobora guhabwa ubu buvuzi.

Dore ibibazo by'ingenzi byatuma utahabwa verapamil inyuzwa mu maraso:

• Umutima udakora neza cyane cyangwa umutima uhagarara
• Guhagarara k'umutima ku gipimo cya kabiri cyangwa icya gatatu hatarimo pacemaker
• Umuvuduko w'amaraso muke cyane (hypotension)
• Kumenya ko ufite allergie kuri verapamil cyangwa imiti isa nayo
• Uburwayi bwa Wolff-Parkinson-White hamwe na atrial fibrillation
• Indwara ikomeye y'umwijima

Muganga wawe azitonda kandi mu kuguha IV verapamil niba ufite umutima udakora neza gato, ibibazo by'impyiko, cyangwa urimo gufata indi miti ishobora kuvangana mu buryo buteje akaga.

Abantu bafata beta-blockers (nka metoprolol cyangwa atenolol) bakeneye kwitabwaho by'umwihariko kuko guhuza iyi miti na IV verapamil bishobora gutera umuvuduko w'umutima muke cyane cyangwa umuvuduko w'amaraso muke. Mu buryo nk'ubwo, abafata digoxin bakeneye gukurikiranwa neza kuko verapamil ishobora kongera urwego rwa digoxin mu maraso yawe.

Abagore batwite muri rusange ntibagomba guhabwa verapamil ya IV keretse inyungu zishoboka zigaragaza neza ko ziruta ibyago, kuko umuti ushobora kwambuka placenta kandi ukagira ingaruka ku mwana ukura.

Amazina ya Verapamil

Verapamil ya intravenous iboneka munsi y'amazina menshi y'ubwoko, nubwo ibitaro byinshi bikoresha verisiyo rusange z'umuti. Izina risanzwe rishobora guhura naryo ni Isoptin, ryakoreshejwe mumyaka myinshi mumiti yihutirwa.

Andi mazina yubwoko arimo Calan na Verelan, nubwo ibi bikunze kuboneka mumitwe yo kunywa aho kuba IV. Ibitaro byinshi bifite verapamil injection rusange, irimo ibikoresho bikora kimwe kandi bikora kimwe na verisiyo yizina ryubwoko.

Ubwoko bwihariye cyangwa verisiyo rusange wakira ntizagira ingaruka kumikorere cyangwa umutekano wumuti. Itsinda ryawe ryubuzima rizakoresha uburyo ubwo aribwo bwose buboneka murwego rwabo, byose bikurikiza ubuziranenge bumwe bukomeye nubuziranenge.

Uburyo bwo gusimbuza Verapamil

Imiti myinshi isimbura irashobora kuvura ibibazo byumutima kimwe na verapamil ya intravenous, nubwo guhitamo neza biterwa nimiterere yawe yihariye namateka yubuvuzi. Muganga wawe azahitamo uburyo bukwiye bushingiye kumiterere yawe.

Adenosine akenshi nicyo gihitamo cya mbere kubwoko bumwe bwumutima wihuta (SVT) kuko ikora vuba kandi ifite igihe gito cyo gukora. Uyu muti urashobora guhagarika umutima udasanzwe mumasegonda ariko ushobora gutera kutumva neza mu gituza cyangwa guhumeka.

Abandi bafunga imiyoboro ya kalisiyumu nka diltiazem (Cardizem) bakora kimwe na verapamil kandi bashobora gukoreshwa niba udashobora kwakira verapamil kubera impamvu runaka. Abafunga beta nka metoprolol cyangwa esmolol nabo barashobora gutinda umutima, nubwo bakora banyuze mumikorere itandukanye.

Ku barwayi bamwe, gukoresha umuriro mu mutima (umuriro wa elegitoriki ucungwa mu mutima) bishobora gukundwa kurusha imiti, cyane cyane niba imiti itagize icyo yizana cyangwa niba ikibazo giteje akaga ako kanya.

Digoxine rimwe na rimwe ikoreshwa mu kugenzura umuvuduko w'umutima igihe kirekire, cyane cyane ku barwayi bafite atrial fibrillation, nubwo akenshi itakoreshwa mu bihe by'ubutabazi nka verapamil ya IV.

Ese Verapamil iruta Diltiazem?

Verapamil na diltiazem ni imiti ifunga imiyoboro ya kalisiyumu ikora kimwe mu kugenzura umuvuduko w'umutima, ariko hariho itandukaniro rituma imwe ikwiriye kurusha indi mu bihe bimwe na bimwe. Nta n'imwe iruta indi rwose.

Verapamil ikunda kugira ingaruka zikomeye ku muvuduko w'umutima kandi ishobora gukora neza ku bwoko bumwe bwa supraventricular tachycardia. Ariko kandi, ifite ingaruka zigaragara ku mikoranire y'imitsi y'umutima, bivuze ko itakwiriye abantu bafite umutima wanze gukora.

Diltiazem akenshi ikundwa ku barwayi bafite umutima wanze gukora byoroheje kuko ntangaruka nyinshi igira ku bushobozi bw'umutima bwo kuvuza, mugihe igifite ubushobozi bwo kugenzura umuvuduko w'umutima. Ikunda kandi guhitwamo ku barwayi bakeneye kugenzura umuvuduko w'umutima no kugenzura umuvuduko w'amaraso.

Gu hitamo hagati y'iyi miti biterwa n'uburwayi bwawe bwihariye, harimo imikorere y'umutima wawe, umuvuduko w'amaraso, indi miti urimo gufata, n'ubwoko bwihariye bw'ikibazo cy'umuvuduko w'umutima urimo guhura nacyo.

Muganga wawe azatekereza kuri ibi byose mugihe afata icyemezo cy'umuti ukwiriye cyane kuri wowe. Iyi miti yombi ikora neza cyane mugihe ikoreshejwe neza.

Ibibazo Bikunze Kubazwa Kuri Verapamil (inzira ya Intravenous)

Q1. Ese Verapamil (inzira ya Intravenous) irakwiriye ku bantu bafite indwara z'umutima?

Verapamil yo mu maraso irashobora kuba nziza ku bantu bafite indwara zimwe na zimwe z'umutima, ariko bisaba isuzuma ryitondewe n'abavuzi bawe. Umutekano biterwa n'ubwoko bwihariye n'uburemere bw'indwara yawe y'umutima.

Ku barwayi bafite indwara y'imitsi y'umutima (imitsi y'umutima yazibye) ariko imikorere y'umutima isanzwe, verapamil yo mu maraso muri rusange iratekanye kandi irashobora gufasha cyane mu kuvura ibibazo by'umuvuduko w'umutima. Ariko, abantu bafite urugero rwo hejuru rwo kunanirwa k'umutima cyangwa imitsi y'umutima yacitse intege (cardiomyopathy) ntibashobora kuba abakandida beza kuko umuti ushobora kongera kugabanya ubushobozi bw'umutima bwo gutera.

Muganga wawe azasuzuma ibizamini byawe bya vuba by'umutima, harimo echocardiograms cyangwa ibisubizo bya catheterization ya cardiac, mbere yo gufata icyemezo niba verapamil yo mu maraso ikwiriye kuri wewe. Bazatekereza kandi ku miti ufata ubu n'ubuzima bwawe muri rusange.

Q2. Nagomba gukora iki niba mbonye verapamil nyinshi ku buryo butunguranye?

Kubera ko verapamil yo mu maraso itangwa gusa n'abavuzi mu bigo by'ubuvuzi, gufata doze nyinshi ku buryo butunguranye ntibibaho cyane. Ariko, niba umuti mwinshi watanzwe, abakozi b'ubuvuzi bahuguwe kumenya no kuvura iyi miterere ako kanya.

Ibimenyetso bya verapamil nyinshi birimo umuvuduko w'amaraso muke cyane, umuvuduko w'umutima utinda cyane, guhumeka bigoye, no gutakaza ubwenge. Niba ibi bimenyetso bibayeho, itsinda ryawe ry'ubuvuzi rizatanga ubufasha bwihuse, bushobora kurimo amazi yo mu maraso, imiti yo kuzamura umuvuduko w'amaraso, ndetse no gushyiraho umuvuduko w'umutima w'agateganyo.

Ibitaro bifite imiti ivura no gukoresha ibikorwa byihutirwa byihariye ku kintu gihagarika imiyoboro ya calcium, harimo gutanga calcium n'izindi ngamba zifasha. Kubera ko umaze gukurikiranwa neza, ibibazo byose byafatwa kandi bigakemurwa vuba.

Q3. Nagomba gukora iki niba nirengagije doze ya verapamil?

Iki kibazo ntikireba verapamil itererwa mu uruhara kuko itangwa nk'umuti umwe cyangwa urukurikirane rw'imiti migufi mu bitaro. Ntabwo uzaba ufite inshingano zo gufata cyangwa kureka imiti y'uyu muti.

Niba wimuriwe kuri verapamil yo kunywa nyuma yo kuva mu bitaro, muganga wawe azaguha amabwiriza arambuye yerekeye gahunda yo gufata imiti n'icyo gukora niba uciweho urugero rwo kunywa umuti.

Ubwoko bwa IV butangwa rwose n'abantu b'inzobere mu by'ubuvuzi nk'igice cyo kuvura byihutirwa, bityo ntakibazo cyo kureka urugero mu buryo busanzwe.

Q4. Ni ryari nshobora kureka gufata Verapamil?

Verapamil iterwa mu uruhara ireka gukora yonyine mu masaha make nyuma yo kuyitanga, bityo ntampamvu yo "kureka" uyu muti. Ingaruka zirashira uko umubiri wawe ukora kandi ugakuraho umuti.

Muganga wawe azemeza niba ukeneye ibindi bice bishingiye ku buryo umutima wawe witwara ku kuvurwa. Iyo umutima wawe uhagaze neza, birashoboka ko bazagushyira ku miti yo kunywa cyangwa izindi nshuti zo gukomeza gucunga.

Niba wandikiwe verapamil yo kunywa nyuma yo kuva mu bitaro, ntuzigere ureka kuyifata ako kanya utabanje kuvugana na muganga wawe, kuko ibi bishobora gutuma ibibazo by'umutima wawe bisubira.

Q5. Nshobora gutwara imodoka nyuma yo guhabwa Verapamil iterwa mu uruhara?

Ntabwo ugomba gutwara imodoka byibuze amasaha 24 nyuma yo guhabwa verapamil iterwa mu uruhara, kuko umuti ushobora gutera isereri, umuvuduko w'amaraso muke, n'izindi ngaruka zishobora kubangamira ubushobozi bwawe bwo gutwara neza.

Kubera ko bishoboka ko uzaba uri mu bitaro iyo uhabwa IV verapamil, gutwara imodoka ntizaba ikibazo cyihuse. Ariko, iyo urekuwe, teganiriza undi muntu kukujyana mu rugo kandi wirinde gutwara kugeza wumva umeze neza rwose kandi muganga wawe akwemereye gukora ibikorwa bisanzwe.

Ibyo umuti ukora ku mitsi y'amaraso n'umuvuduko w'umutima bishobora kumara amasaha menshi, bishobora gutera isereri ryatinze cyangwa intege nke bishobora guteza akaga mu gihe umuntu atwaye imodoka.