Yini i-Diltiazem (Indlela Yokungenisa Ngemithambo): Ukusetshenziswa, Umthamo, Imiphumela Eceleni Nokunye

I-Diltiazem intravenous (IV) ngumuthi wenhliziyo onikezwa ngokuqondile emthanjeni wakho ngeshubhu elincanyana elibizwa ngokuthi umugqa we-IV. Lolu hlobo lwe-diltiazem lusebenza ngokushesha ukwehlisa izinga lokushaya kwenhliziyo yakho futhi lusize ukulawula izinkinga ezithile zesigqi senhliziyo lapho zidinga ukunakekelwa ngokushesha.

Abahlinzeki bezempilo basebenzisa i-IV diltiazem ezindaweni zasemtholampilo lapho udinga ukulawulwa kwezinga lokushaya kwenhliziyo okusheshayo. Ilusizo ikakhulukazi ngesikhathi sezimo eziphuthumayo zezokwelapha noma lapho imithi yomlomo ingasebenzi ngokushesha ngokwanele ngesimo sakho.

Yini i-Diltiazem?

I-Diltiazem ingeyeqembu lemithi ebizwa ngokuthi ama-calcium channel blockers. Le mithi isebenza ngokuvimba i-calcium ukuthi ingangeni emangqamuzaneni athile enhliziyo yakho nasemithanjeni yegazi, okusiza inhliziyo yakho ukuthi ishaye kancane futhi njalo.

Ifomu le-intravenous yinguqulo ewuketshezi yalo muthi oqondiswe ngqo emgudwini wakho wegazi. Lokhu kuyivumela ukuthi iqale ukusebenza ngemizuzu, ngokungafani namaphilisi athatha isikhathi eside ukumuncwa ngohlelo lwakho lokugaya ukudla.

Cabanga ngama-calcium channel blockers njengabalawuli bethrafikhi abanobumnene benhliziyo yakho. Basiza ekuphatheni amasiginali kagesi enza inhliziyo yakho ishaye, baqinisekisa ukuthi ayigijimi ngokushesha lapho kungafanele.

Isetshenziselwani i-Diltiazem?

I-IV diltiazem isetshenziswa ikakhulukazi ukwelapha i-atrial fibrillation ne-atrial flutter - izinhlobo ezimbili zokushaya kwenhliziyo okungajwayelekile, okusheshayo okuqala emagumbini aphezulu enhliziyo yakho. Lapho inhliziyo yakho ishaya ngokushesha kakhulu, ayikwazi ukumpompa igazi ngempumelelo emzimbeni wakho wonke.

Udokotela wakho angase futhi asebenzise lo muthi ukulawula izinga lokushaya kwenhliziyo yakho ngesikhathi senqubo ethile yezokwelapha noma ukuhlinzwa. Ilusizo ikakhulukazi uma unesigameko senhliziyo esidinga ukunakekelwa ngokushesha futhi asikwazi ukulinda imithi yomlomo ukuthi isebenze.

Kwezinye izimo, abahlinzeki bezempilo basebenzisa i-IV diltiazem ye-supraventricular tachycardia (SVT), olunye uhlobo lwesigqi senhliziyo esisheshayo. Lesi simo senza inhliziyo yakho iqale ngokuzumayo ukushaya ngokushesha okukhulu, ngokuvamile ngaphezu kwama-150 beats ngomzuzu.

Isebenza Kanjani I-Diltiazem?

I-Diltiazem ithathwa njengomuthi wenhliziyo olungileyo osebenza ngokuvimba iziteshi ze-calcium emsipheni wenhliziyo yakho nasemathunjini egazi. Lapho i-calcium ingakwazi ukungena kalula kula maseli, inhliziyo yakho ayishwampani ngamandla futhi ishaya kancane.

Lo muthi uqondiswe ngqo endleleni kagesi enhliziyweni yakho ebizwa nge-AV node, esebenza njengonogada phakathi kwamagumbi aphezulu naphansi. Ngokunciphisa amasignali ngale ndlela, i-diltiazem isiza ekuvikeleni inhliziyo yakho ukuthi ingashayi ngokushesha kakhulu.

Ngemizuzu engu-2-5 ngemva kokuthola i-IV diltiazem, ngokuvamile uzoqala ukuzwa izinga lenhliziyo yakho lehla. Umphumela ogcwele uvame ukwenzeka ngemizuzu engu-15, futhi izinzuzo zingahlala amahora angu-1-3 kuye ngokuthi usabela kanjani.

Kufanele Ngiyithathe Kanjani I-Diltiazem?

Ngeke 'uthatha' i-IV diltiazem ngokwakho - ngaso sonke isikhathi inikezwa ochwepheshe bezempilo abaqeqeshiwe esibhedlela noma endaweni yezokwelapha. Lo muthi uza njengoketshezi olucacile olujovwa kancane emgqeni we-IV engalweni yakho noma esandleni sakho.

Umnakekeli wakho noma udokotela uzobheka izinga lenhliziyo yakho nomfutho wegazi ngokusondelene ngenkathi uthola umuthi. Ngokuvamile bazokunika umthamo ngemizuzu engu-2-5 ukuze baqinisekise ukuthi umzimba wakho usabela ngokuphepha ekwelashweni.

Ngaphambi kokuthola i-IV diltiazem, akudingeki ukhathazeke ngemikhawulo yokudla njengoba ungenza ngemithi yomlomo. Kodwa-ke, ithimba lakho lezokwelapha lizobuza nganoma yimiphi eminye imithi oyithathayo ukuze ugweme ukuxhumana okungase kube yingozi.

Kufanele Ngiyithathe Isikhathi Eside Kangakanani I-Diltiazem?

I-diltiazem ye-IV ngokuvamile iyindlela yokwelapha yesikhashana esetshenziswa kuphela ngesikhathi sezimo eziphuthumayo zezokwelapha noma izinqubo. Abantu abaningi bathola umthamo owodwa noma emibili kuphela ukuze balawule izinga lenhliziyo yabo ngesikhathi sesigameko esibukhali.

Uma izinkinga zakho zokushaya kwenhliziyo ziqhubeka, udokotela wakho cishe uzokushintshela ku-diltiazem yomlomo noma elinye imithi yenhliziyo yesikhathi eside uma isimo sakho sesizinzile. Ifomu le-IV linjengokwelashwa okuyibhuloho - lisiza ukulawula ngokushesha izinga lenhliziyo yakho ngenkathi ithimba lakho lezokwelapha lithuthukisa uhlelo lwesikhathi eside.

Umhlinzeki wakho wezempilo uzoqaphela ukuthi uludinga isikhathi esingakanani ukwelashwa ngokusekelwe ekutheni inhliziyo yakho isabela kanjani nokuthi yini ebangela izinkinga zakho zokushaya kwenhliziyo ekuqaleni.

Yiziphi Imiphumela Eceleni ye-Diltiazem?

Abantu abaningi bayakubekezelela kahle i-diltiazem ye-IV, kodwa njengayo yonke imithi, ingabangela imiphumela emibi. Lezo ezivamile kakhulu ongase uzithole zihlobene nokushintsha kwenhliziyo yakho nomfutho wegazi.

Nansi imiphumela emibi ongase uhlangabezane nayo, ukhumbula ukuthi ithimba lakho lezokwelapha lizoyibheka ngokucophelela:

• Umfutho wegazi ophansi (hypotension), okungenza uzizwe unesiyezi noma ukhathele
• Izinga lenhliziyo eliba ngokushesha kakhulu (bradycardia)
• Ukungakhululeki okuncane esifubeni noma ukucindezela
• Ukucasuka noma ukuzizwa unesiyezi
• Ikhanda
• Ukubomvu noma ukufudumala ebusweni nasentanyeni yakho

Le miphumela emibi ejwayelekile ngokuvamile ixazululwa ngokushesha njengoba umzimba wakho uzivumela emithini. Ithimba lakho lezempilo liyazi ukuthi lingayiphatha kanjani uma iba yisicefe.

Nakuba kungavamile, abanye abantu bangase babe nemiphumela emibi engathi sína edinga ukunakekelwa kwezokwelapha ngokushesha:

• Ukuwehla okukhulu kwengcindezi yegazi okubangela ukuquleka
• Izinga lokushaya kwenhliziyo eliba ngeliyingozi ukwehla (ngaphansi kokushaya okungu-50 ngomzuzu)
• Ukuvaleka kwenhliziyo (izinkinga ngezimpawu zikagesi enhliziyweni yakho)
• Ukuphendula okukhulu komzimba okubangela ubunzima bokuphefumula noma ukuvuvukala
• Ukuqina kwezimpawu zokuhluleka kwenhliziyo njengokuphefumula kanzima

Khumbula, uthola lo muthi endaweni yezokwelapha lapho ochwepheshe abaqeqeshiwe bengakwazi ukubhekana ngokushesha nanoma yiziphi izimpawu ezikhathazayo ezingase zivele.

Ubani Ongafanele Athathe I-Diltiazem?

Izimo eziningana zezokwelapha zenza i-IV diltiazem ingaphephile noma idinga izinyathelo zokuphepha ezikhethekile. Udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokunquma ukuthi lo muthi ukufanele yini.

Akufanele uthole i-IV diltiazem uma unesinye salezi zimo:

• Ukuvaleka okukhulu kwenhliziyo (izinkinga ngesistimu kagesi yenhliziyo yakho)
• Izinga lokushaya kwenhliziyo elihamba kancane kakhulu (ngaphansi kokushaya okungu-50 ngomzuzu) ngaphandle kwe-pacemaker
• Ukwehla okukhulu kwengcindezi yegazi
• Ukuhluleka kwenhliziyo okukhulu noma ukushaqeka kwe-cardiogenic
• Ukungezwani okwaziwayo ne-diltiazem noma imithi efanayo

Udokotela wakho uzosebenzisa ukuqapha okwengeziwe uma unehluleka kwenhliziyo, izinkinga zezinso, noma isifo sesibindi, njengoba lezi zimo zingathinta indlela umzimba wakho osebenza ngayo ngomuthi.

Uma ukhulelwe noma uncelisa, umhlinzeki wakho wezempilo uzokala izinzuzo ngokumelene nezingozi ezingaba khona ngaphambi kokusebenzisa i-IV diltiazem. Nakuba kungaziwa ukuthi kubangela ukukhubazeka kokuzalwa, kungena obisini lwebele ngamanani amancane.

Amagama Omkhiqizo we-Diltiazem

Uhlobo lwe-intravenous lwe-diltiazem luvame ukutholakala ngaphansi kwegama lomkhiqizo elithi Cardizem IV. Kodwa-ke, izibhedlela eziningi nezikhungo zezokwelapha zisebenzisa inguqulo ejwayelekile, equkethe isithako esifanayo esisebenzayo futhi esisebenza ngokufanayo.

Ungase futhi uzwe abahlinzeki bezempilo bekhuluma ngayo kalula njengokuthi "IV dilt" noma "diltiazem drip" lapho bexoxa ngemithi yakho. Uhlobo oluthile alibalulekile njengokuqinisekisa ukuthi uthola umthamo ofanele wesimo sakho.

Ezinye izindlela zikaDiltiazem

Eminye imithi eminingi ingasetshenziswa esikhundleni se-IV diltiazem ukulawula ukushaya kwenhliziyo okusheshayo. Udokotela wakho uzokhetha inketho engcono kakhulu ngokusekelwe ohlotsheni lwakho oluthile lwenkinga yokushaya kwenhliziyo kanye nempilo yakho yonke.

Ezinye izindlela ezivamile zihlanganisa i-metoprolol IV, okuyi-beta-blocker nayo enciphisa izinga lokushaya kwenhliziyo kodwa isebenza ngendlela ehlukile. I-Adenosine enye inketho yezinhlobo ezithile zokushaya kwenhliziyo okusheshayo, nakuba isebenza ngokushesha futhi ngesikhashana.

Kwabanye abantu, i-electrical cardioversion (ukushaqeka kagesi okulawulwayo ukuze kusethwe kabusha ukushaya kwenhliziyo) kungase kucatshangelwe esikhundleni semithi. Ithimba lakho lezokwelapha lizochaza ukuthi kungani likhethe i-diltiazem ngaphezu kwezinye izinketho zesimo sakho esithile.

Ingabe i-Diltiazem ingcono kune-Metoprolol?

Kokubili i-diltiazem ne-metoprolol ziyasebenza ekulawuleni ukushaya kwenhliziyo okusheshayo, kodwa zisebenza ngendlela ehlukile futhi zinezinzuzo ezihlukile. I-Diltiazem ivame ukukhethwa nge-atrial fibrillation ngoba ilungele ikakhulukazi ukunciphisa amasiginali phakathi kwamagumbi aphezulu naphansi enhliziyo yakho.

I-Metoprolol ingase ibe yindlela engcono uma unenhliziyo ehlulekayo noma uke wahlaselwa yinhliziyo, njengoba ama-beta-blockers afana ne-metoprolol enezinye izindlela zokuvikela emisipha yenhliziyo. Nokho, i-diltiazem ingase ibe mnene ekuphefumuleni kwakho uma une-asthma encane noma izinkinga zamaphaphu.

Udokotela wakho ucabangela isithombe sakho esiphelele sezokwelapha lapho ekhetha phakathi kwale mithi. Zombili ziphephile futhi ziyasebenza uma zisetshenziswa ngendlela efanele, ngakho themba ukuthi ithimba lakho lezokwelapha likhethe inketho engcono kakhulu yezidingo zakho ezithile.

Imibuzo Evame Ukubuzwa Nge-Diltiazem

Ingabe i-Diltiazem iphephile kubantu abanenhliziyo ehlulekayo?

I-diltiazem ye-IV idinga ukucatshangelwa ngokucophelela kubantu abanenhliziyo ehlulekayo. Ngenkathi ingasetshenziswa ngokuphepha ezimweni eziningi, inethuba lokwenza izimpawu zokuhluleka kwenhliziyo zibe zimbi kakhulu ngoba inganciphisa indlela inhliziyo yakho ekhontraktha ngayo.

Udokotela wakho uzohlola ukusebenza kwenhliziyo yakho nezimpawu zamanje ngaphambi kokunquma ukuthi i-diltiazem ilungile yini. Uma une-heart failure emnene, ezinzile, kungase kuphephe ukuyisebenzisa ngokuqapha okuseduze. Kodwa-ke, uma unezimpawu zokuhluleka kwenhliziyo ezisebenzayo, udokotela wakho angase akhethe umuthi ohlukile.

Kufanele Ngenzeni Uma Ngamukela I-Diltiazem Eningi Ngengozi?

Njengoba i-diltiazem ye-IV inikezwa ochwepheshe bezempilo endaweni yezokwelapha, ukweqisa ngengozi akuvamile kakhulu. Kodwa-ke, uma wamukela okuningi, ungenza ukuthi ube nomfutho wegazi ophansi kakhulu, izinga lenhliziyo elihamba kancane kakhulu, noma isiyezi.

Ithimba lakho lezokwelapha likuqapha eduze ngesikhathi sokwelashwa futhi lingakwazi ukubona ngokushesha nokwelapha noma yiziphi izimpawu zomuthi omningi kakhulu. Bangase bakunikeze uketshezi lwe-IV, imithi yokusekela umfutho wegazi lakho, noma ezinye izindlela zokwelapha zokulwa nemiphumela eminingi.

Kufanele Ngenzeni Uma Ngedlula Umthamo We-Diltiazem?

Lo mbuzo awusebenzi ku-diltiazem ye-IV ngoba inikezwa njengoba kudingeka ezindaweni zezokwelapha kunokuba ngeshejuli ejwayelekile. Abahlinzeki bezempilo banquma ukuthi nini nokuthi bangaki abazokunika ngokuya ngezinga lenhliziyo yakho yamanje nezimpawu.

Uma kamuva unikezwa i-diltiazem yomlomo ukuthi uyithathe ekhaya, udokotela wakho uzokunikeza imiyalelo ethile yokuthi wenzeni uma weqa umthamo wamaphilisi.

Ngingayeka Nini Ukuthatha I-Diltiazem?

Isinqumo sokuyeka i-diltiazem ye-IV sincike ekutheni inhliziyo yakho isabela kanjani ekwelashweni nokuthi yini ebangela izinga lenhliziyo yakho elisheshayo ekuqaleni. Abantu abaningi bathola umthamo owodwa noma emibili kuphela ukuze balawule isigameko esibukhali.

Udkt wakho uzoqapha ukushaya kwenhliziyo yakho futhi angase akuqhubekisele emithini yomlomo uma udinga ukwelashwa okuqhubekayo. Ungalokothi uyeke noma ushintshe imithi yenhliziyo ngokwakho - ngaso sonke isikhathi landela isiqondiso somhlinzeki wakho wezempilo mayelana nokuthi ungasinquma nini futhi kanjani ukwelashwa.

Ngingashayela ngemva kokuthola i-IV Diltiazem?

Akufanele ushayele amahora amaningana ngemva kokuthola i-IV diltiazem, njengoba ingabangela isiyezi, umfutho wegazi ophansi, neminye imiphumela engemihle eyenza ukushayela kungaphephile. Abantu abaningi abathola lo muthi basezibhedlela noma kunjalo.

Uma usukhishwe esibhedlela, buza udkt wakho ukuthi kuphephile nini ukuqhubeka nokushayela. Lokhu ngokuvamile kuncike ekutheni uzizwa kanjani nokuthi ngabe uthatha imithi yenhliziyo eqhubekayo engase ithinte ukuqapha kwakho noma ukuxhumana kwakho.