Yini i-Alprostadil (Indlela ye-Intravenous): Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Alprostadil iyinguqulo eyenziwe ngamachweba yehomoni yemvelo ebizwa ngokuthi i-prostaglandin E1 esiza ukugcina imithambo yegazi ivulekile negazi ligeleza kahle. Uma inikezwa nge-IV, lo muthi usebenza njengomugqa wokuphila wezingane ezisanda kuzalwa ezinokukhubazeka okuthile okungathi sína kwenhliziyo.

Lo muthi onamandla usebenza ngokugcina umthambo wegazi obalulekile obizwa ngokuthi i-ductus arteriosus uvulekile ezinganeni ezisanda kuzalwa. Lo mthambo ngokwemvelo uvaleka ngemva kokuzalwa, kodwa ezinye izingane ziyawudinga ukuthi zihlale zivulekile okwesikhashana ngenkathi odokotela behlela ukuhlinzwa kwenhliziyo okusindisa ukuphila noma ezinye izindlela zokwelapha.

Yini i-Alprostadil?

I-Alprostadil iyikhophi eyenziwe ngumuntu ye-prostaglandin E1, into yemvelo umzimba wakho oyikhiqizayo ukusiza ukulawula ukuhamba kwegazi. Umuthi uza njengesixazululo esicacile, esingenazo izinto ezingcolile esinikezwa abahlinzeki bezempilo ngokuqondile egazini lengane yakho ngomugqa we-IV.

Lo muthi ungowesigaba semithi ebizwa ngokuthi ama-vasodilators, okusho ukuthi usiza ukwandisa imithambo yegazi. Cabanga ngayo njengomsizi omnene ogcina izindlela ezibalulekile zivulekile ukuze igazi ligeleze lapho lidingeka kakhulu.

Isetshenziselwani i-Alprostadil?

I-Alprostadil indlela ye-intravenous isetshenziselwa ngokuqondile ukwelapha izingane ezisanda kuzalwa ezinokukhubazeka kwenhliziyo okuzalwa nakho okuncike ekugcineni i-ductus arteriosus ivulekile. Lokhu kuhlanganisa izimo eziningi ezingathi sína kodwa ezingelapheka ezithinta indlela igazi eligijima ngayo ngenhliziyo namaphaphu engane yakho.

Izimo ezivame kakhulu ezidinga lo muthi zihlanganisa i-hypoplastic left heart syndrome, lapho uhlangothi lwesobunxele lwenhliziyo lungathuthukiswanga kahle, kanye nokushintshwa kwemithambo emikhulu, lapho imithambo emikhulu yegazi ishintshwa khona. Ezinye izimo zihlanganisa i-pulmonary atresia, i-tricuspid atresia, kanye ne-tetralogy of Fallot.

Ngezinye izikhathi odokotela basebenzisa i-alprostadil ezinganeni ezinokuvuvukala okukhulu kwe-aorta, lapho umthambo omkhulu ovela enhliziyweni uncane kakhulu. Ezimweni ezingavamile, ingasetshenziselwa ezinye izinkinga zenhliziyo eziyinkimbinkimbi lapho ukugcinwa kokugeleza kwegazi ngomthambo we-ductus arteriosus kubalulekile ekuphileni.

Isebenza Kanjani I-Alprostadil?

I-Alprostadil isebenza ngokulingisa i-hormone yemvelo evula i-ductus arteriosus ngesikhathi sokukhula kwengane esiswini. Lo mthambo wegazi omncane kodwa obalulekile uxhuma umthambo wamaphaphu ku-aorta, okuvumela igazi ukuthi lidlule emaphashini ngaphambi kokuzalwa.

Ngokuvamile, lo mthambo uvala phakathi kwamahora noma izinsuku ngemva kokuzalwa njengoba amaphaphu engane yakho ethatha imisebenzi ye-oxygen. Nokho, izingane ezinokukhubazeka okuthile kwenhliziyo zidinga lo mthambo ukuthi uhlale uvulekile okwesikhashana ukuze kuqinisekiswe ukuthi igazi ligeleza ngokwanele emaphashini azo noma emzimbeni wazo.

Umuthi ubhekwa njengokwelashwa okuqinile, okubalulekile kulezi zimo ezithile. Ngaphandle kwawo, izingane ezinokukhubazeka kwenhliziyo okuncike ku-ductal zingabhekana nezinkinga ezisongela ukuphila phakathi kwamahora noma izinsuku zokuzalwa.

Kufanele Inikezwe Kanjani I-Alprostadil?

I-Alprostadil kufanele inikezwe kuphela ochwepheshe bezempilo abaqeqeshiwe endaweni yasesibhedlela enezinsiza zokunakekelwa kwenhliziyo ezikhethekile. Umuthi unikezwa nge-IV infusion eqhubekayo, okusho ukuthi ugeleza kancane futhi ngokuqinile emgudwini wegazi lengane yakho.

Ingane yakho izodinga ukuqashwa eduze kuyunithi yokunakekelwa okukhulu kwabantwana (NICU) noma kuyunithi yokunakekelwa okukhulu kwenhliziyo yezingane. Abahlinzeki bezempilo bazobheka izinga lokushaya kwenhliziyo yengane yakho, umfutho wegazi, ukuphefumula, kanye namazinga e-oxygen ngokuqhubekayo ngenkathi bethola lo muthi.

Umthamo ubhalwa ngokucophelela ngokusekelwe esisindweni sengane yakho kanye nesimo esithile. Odokotela bavame ukuqala ngomthamo ophansi kakhulu bese bewulungisa ngokusekelwe endleleni ingane yakho esabela ngayo, ngaso sonke isikhathi besebenzisa inani elincane elisebenzayo.

Kufanele Inikezwe Isikhathi Esingakanani I-Alprostadil?

Isikhathi sokwelashwa nge-alprostadil sihluka kakhulu kuye ngesimo senhliziyo somntwana wakho kanye nohlelo lokwelashwa. Ezinye izingane zingase zidinge izinsuku ezimbalwa nje, kanti ezinye zingase zidinge amasonto amaningana noma izinyanga.

Ezinganeni ezilinde ukuhlinzwa kwenhliziyo, i-alprostadil ivame ukuqhubeka kuze kube yilapho ukulungiswa kokuhlinzwa kuqediwe futhi kuphumelele. Kwezinye izimo, kungase kudingeke njengebhuloho lokufakelwa inhliziyo, okungasho izikhathi zokwelashwa ezinde.

Iqembu lezokwelapha lomntwana wakho lizohlola njalo ukuthi ngabe umuthi usadingeka yini futhi lizokwehlisa kancane kancane umthamo uma kuphephile ukwenza kanjalo. Umgomo uhlala ukusebenzisa isikhathi esifushane esidingekayo ngenkathi kuqinisekiswa ukuthi ingane yakho ihlala izinzile.

Yiziphi Imiphumela Eceleni ye-Alprostadil?

Njengayo yonke imithi enamandla, i-alprostadil ingabangela imiphumela emibi, yize izinzuzo zivame ukwedlula izingozi ezinganeni ezidinga. Ithimba lezokwelapha lizobheka eduze noma yiziphi izinkinga futhi lilungise ukwelashwa njengoba kudingeka.

Imiphumela ejwayelekile eceleni abahlinzeki bezempilo abayiqaphelayo ihlanganisa ubunzima bokuphefumula, izinguquko ekushayeni kwenhliziyo, kanye nokuguquguquka kwengcindezi yegazi. Ingane yakho ingase futhi ibe nomkhuhlane, ukubomvu, noma izinguquko emibaleni yesikhumba sayo.

Nansi imiphumela emibi amaqembu ezokwelapha awaqaphela ngokucophelela kakhulu:

• Izinkinga zokuphefumula noma i-apnea (ukuma okwesikhashana ekuphefumuleni)
• Ukwehla kwengcindezi yegazi noma izinguquko ezingazelelwe zengcindezi yegazi
• Ukushaya kwenhliziyo okungajwayelekile
• Umkhuhlane noma ukungazinzi kwezinga lokushisa
• Ukubomvu noma izinguquko zombala wesikhumba
• Ukuvuvukala ezandleni, ezinyaweni, noma ebusweni
• Ukushaywa yisithuthwane (akuvamile kodwa kubucayi)

Le miphumela ivame ukulawuleka ngaphansi kokuqondiswa okufanele kwezokwelapha futhi ivame ukuthuthuka njengoba umzimba womntwana wakho uzivumela emuthini.

Imiphumela emibi engavamile kodwa ebucayi ihlanganisa ubunzima obukhulu bokuphefumula obudinga umoya-mpilo wemishini, ukwehla okukhulu kwengcindezi yegazi, noma izinkinga zokuphuma kwegazi. Ukusetshenziswa kwesikhathi eside ngezinye izikhathi kubangela izinguquko emathanjeni, kodwa lokhu akuvamile ngokuqapha okucophelelayo okunikezwa ezindaweni zasemitholampilo.

Ubani Ongafanele Athole I-Alprostadil?

Bambalwa kakhulu abantwana abangakwazi ukuthola i-alprostadil uma kudingeka ngokwezokwelapha, njengoba izinzuzo ngokuvamile zidlula izingozi zalabo abanezimo zenhliziyo ezisongela impilo. Kodwa-ke, odokotela bazohlola ngokucophelela isimo ngasinye.

Abantwana abanezifo ezinzima zokuphuma kwegazi noma labo abaye baba nokusabela okukhulu komzimba ku-prostaglandins bangase badinge ezinye izindlela. Ngaphezu kwalokho, abantwana abanezinhlobo ezithile zezinkinga zenhliziyo lapho ukuvula i-ductus arteriosus kungaba yingozi ngeke babe ngabazongenela lokhu kwelashwa.

Izinsana ezingakazalwa noma labo abanezimo zezokwelapha ezinzima badinga ukuqapha okwengeziwe kodwa bangakwazi ukuthola i-alprostadil uma kudingeka. Ithimba lezokwelapha lomntanakho lizohlola zonke izici ukuze linqume indlela yokwelapha ephephe kakhulu.

Amagama Omkhiqizo we-Alprostadil

Isixazululo se-Alprostadil intravenous sitholakala ngaphansi kwegama lomkhiqizo elithi Prostin VR Pediatric, okuyindlela esetshenziswa kakhulu emitholampilo. Lona umuthi ofanayo ngaphandle kwegama lomkhiqizo, olungiselelwe ngqo iziguli zenhliziyo zezingane.

Izinhlobo ezivamile ze-alprostadil nazo ziyatholakala futhi zisebenza ngendlela efanayo. Ukukhetha phakathi kwegama lomkhiqizo nelivamile ngokuvamile kuncike kulokho umtholampilo wakho onakho kanye nezintandokazi zabo zekhemisi.

Ezinye Izindlela ze-Alprostadil

Ezinsaneni ezinokukhubazeka kwenhliziyo okuncike ku-ductal, zikhona ezinye izindlela ezimbalwa kakhulu ze-alprostadil ezinganikeza izinzuzo ezifanayo zokusindisa impilo. Lo muthi ubhekwa njengokwelashwa okuyigolide lokugcina i-ductus arteriosus ivulekile.

Kwezinye izimo, odokotela bangazama eminye imithi ye-prostaglandin efana ne-epoprostenol, kodwa lezi azisetshenziswa kakhulu futhi kungenzeka zingasebenzi kahle. Enye indlela enkulu ngokuvamile ukuhlinzwa kwenhliziyo okuphuthumayo, kodwa izingane eziningi zidinga i-alprostadil ukuzizinzisa ngaphambi kokuba ukuhlinzwa kwenzeke.

Ezinganeni ezingasabeli kahle ku-alprostadil, odokotela bangase bacabange nge-balloon atrial septostomy, inqubo yokuthuthukisa ukuxubana kwegazi enhliziyweni, noma ezinye izindlela zokwelapha i-cardiology ezingenelelayo kuye ngokuthi yisiphi isici senhliziyo esithile.

Ingabe i-Alprostadil Ingcono Kunezinye Imithi Yenhliziyo?

Ezinganeni ezinokukhubazeka kwenhliziyo okuncike ku-ductal, i-alprostadil ayinakushintshwa kunokuthi “ingcono” nje kunezinye izidakamizwa. Isebenzela injongo eyingqayizivele engenziwa ezinye izidakamizwa zenhliziyo.

Ngokungafani nemithi eqinisa imisipha yenhliziyo noma elawula isigqi senhliziyo, i-alprostadil ngokukhethekile igcina umthambo wegazi obalulekile uvulekile. Lokhu kuyenza ihluke kakhulu kwezinye izidakamizwa zenhliziyo ezifana ne-digoxin noma ama-diuretics, asebenzela ezinye izinjongo.

Ukusebenza kahle komuthi kuye kwafakazelwa emashumini eminyaka yokusetshenziswa, ngamazinga empumelelo athuthukise kakhulu imiphumela yezingane ezizalwe zinezinkinga zenhliziyo eziyinkimbinkimbi. Empeleni iguqule izimo ezake zabulala ngaso sonke isikhathi zaba izimo ezingelashwa.

Imibuzo Evame Ukubuzwa Mayelana ne-Alprostadil

Ingabe i-Alprostadil Iphephile Ezinganeni Ezizalwe Ngaphambi Kwesikhathi?

Yebo, i-alprostadil ingasetshenziswa ngokuphepha ezinganeni ezizalwe ngaphambi kwesikhathi uma kudingeka ngokwelashwa, nakuba lezi ziguli ezincane zidinga ukuqapha okucophelelayo. Izingane ezizalwe ngaphambi kwesikhathi zingase zizwele kakhulu imiphumela yomuthi, ngakho odokotela ngokuvamile baqala ngemithamo ephansi futhi baqaphele ngokucophelela noma yiziphi izinkinga.

Iqembu lezokwelapha lizobeka ukunaka okukhethekile ekuphefumuleni, umfutho wegazi, kanye nokulawulwa kwezinga lokushisa ezinganeni ezingakazalwa ezithola i-alprostadil. Ngokunakekelwa okufanele, izingane ezingakazalwa zingazuza kulo muthi osindisa impilo ngendlela efanayo nezingane ezelwe ngesikhathi.

Kufanele ngenzeni uma ingane yami ibonakala sengathi inenani eliningi le-Alprostadil?

Uma uqaphela noma yiziphi izinguquko ezikhathazayo enganeni yakho ngenkathi ithola i-alprostadil, yazisa ngokushesha umhlengikazi noma udokotela wengane yakho. Izimpawu ezingase zikukhathaze zihlanganisa ubunzima bokuphefumula, izinguquko ezinkulu emibaleni yesikhumba, noma uma ingane yakho ibonakala ilala kakhulu noma ingasabeli.

Khumbula ukuthi ingane yakho iqashwe ngokuqhubekayo ochwepheshe abaqeqeshiwe abangashintsha ngokushesha umthamo womuthi uma kudingeka. Ithimba lezokwelapha linesimiso sokubhekana nanoma yiziphi izinkinga ezingase zivele ngenxa yomuthi.

Kwenziwani uma ingane yami iphuthelwa umthamo we-Alprostadil?

I-Alprostadil inikezwa njenge-IV infusion eqhubekayo, ngakho-ke ngokuvamile akukho

Ezinye izingane zingase zikhishwe emuthini i-alprostadil ezinsukwini ezimbalwa ziqala ukuyisebenzisa, kanti ezinye zingase ziyidinge amasonto noma izinyanga. Udokotela wenhliziyo wengane yakho uzoqoka isikhathi esifanele ngokusekelwe ekuhlolweni njalo kokusebenza kwenhliziyo yengane yakho kanye nesimo sayo esiphelele.

Ingabe i-Alprostadil Izothinta Ukukhula Kwengane Yami?

Uma isetshenziswa ngendlela efanele ezimweni zenhliziyo ezisongela impilo, i-alprostadil maningi amathuba okuthi izosiza ukukhula kwengane yakho kunokuyilimaza. Ngokuqinisekisa ukuthi kugeleza igazi elanele nokulethwa komoya-mpilo, lo muthi usekela ukukhula kobuchopho obunempilo kanye nezitho ngalesi sikhathi esibucayi.

Iningi lezingane ezithola i-alprostadil liqhubeka nokukhula ngendlela ejwayelekile, ikakhulukazi ngokulungiswa kwenhliziyo okwenziwa ngumuthi. Noma yimaphi amathuba okuba nemiphumela yesikhathi eside ngokuvamile adlula izinzuzo zokwelapha ezisindisa impilo kanye nokuthuthukiswa kokusebenza kwenhliziyo okukwenzayo.