Yini i-Amiodarone: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Amiodarone iyimithi enamandla yokushaya kwenhliziyo esiza ukulawula ukushaya kwenhliziyo okungajwayelekile okuyingozi. Le mithi isebenza ngokuzinzisa umsebenzi kagesi enhliziyweni yakho, okwenza ishaye njalo futhi ngendlela elindelekile.

Uma udokotela wakho ekunikeze i-amiodarone, cishe ubhekene nesimo senhliziyo esingathi sína esidinga ukuphathwa ngokucophelela. Ngenkathi le mithi ingasebenza kahle kakhulu, idinga ukuqashwa eduze ngoba ithinta izitho eziningi emzimbeni wakho.

Yini i-Amiodarone?

I-Amiodarone ingeyeqembu lemithi ebizwa ngokuthi imithi ye-antiarrhythmic, ikakhulukazi i-Class III antiarrhythmic. Ingenye yemithi enamandla kakhulu etholakalayo yokwelapha izifo zokushaya kwenhliziyo ezisongela impilo.

Le mithi isetshenziswe amashumi eminyaka ukwelapha ama-arrhythmias (ukushaya kwenhliziyo okungajwayelekile) okungaphenduli kahle kwezinye izindlela zokwelapha. Cabanga ngayo njengethuluzi elikhethekile abasebenzi bogesi abangalisebenzisa ngezinkinga eziyinkimbinkimbi zokufaka ucingo - inamandla futhi iyasebenza, kodwa idinga ubuchwepheshe ukuze isetshenziswe ngokuphepha.

I-Amiodarone iza ngesimo samaphilisi omlomo wokwelashwa kwesikhathi eside, nakuba itholakala futhi njengomjovo wezimo eziphuthumayo ezibhedlela. Ifomu lomlomo yilokho abantu abaningi abakuthatha ekhaya ukuze baqhubeke nokuphatha ukushaya kwenhliziyo.

Yini i-Amiodarone Esetshenziselwa Yona?

I-Amiodarone iphatha izinkinga zokushaya kwenhliziyo eziyingozi, ezisongela impilo ezinye izindlela zokwelapha ezingakwazanga ukuzilawula ngempumelelo. Udokotela wakho unikeza le mithi lapho izinzuzo zicacile ukwedlula izingozi.

Izimo eziyinhloko i-amiodarone eziphatha ngazo zihlanganisa i-ventricular tachycardia (ukushaya kwenhliziyo okusheshayo okuyingozi okuvela emagumbini aphansi) kanye ne-ventricular fibrillation (ama-rhythms axakile, asongela impilo). Isetshenziselwa futhi i-atrial fibrillation engaphenduli kwezinye izindlela zokwelapha.

Ngesinye isikhathi odokotela basebenzisa i-amiodarone kwezinye izinkinga ezinzima ze-arrhythmias njenge-atrial flutter noma i-supraventricular tachycardia lapho ukwelashwa kokuqala kungasebenzanga. Lo muthi usiza ukuvimbela ukufa kwenhliziyo okungazelelwe kubantu abanezimo zenhliziyo eziyingozi.

Ezimweni ezingavamile, i-amiodarone ingase inikezwe abantu abanezinkinga ezithile zokushaya kwenhliziyo ezigulayo noma abantu abanenhliziyo ehlulekayo abathola i-arrhythmias eziyingozi. Udokotela wakho wenhliziyo uzohlola ngokucophelela isimo sakho ngaphambi kokuncoma lo muthi.

Isebenza Kanjani I-Amiodarone?

I-Amiodarone isebenza ngokuvimba izindlela eziningi zikagesi emsipheni wenhliziyo yakho, okusiza ukuzinzisa ukushaya kwenhliziyo okungajwayelekile. Ithathwa njengomuthi onamandla kakhulu ngoba ithinta iziteshi eziningana ezahlukene ze-ion ezilawula umsebenzi kagesi wenhliziyo yakho.

Lo muthi welula isikhathi esithathayo ukuthi imisipha yenhliziyo yakho izilungise phakathi kokushaya, okuthintela ukuthi kungabi khona ukushaya okusheshayo okuyingozi. Lokhu kunika inhliziyo yakho isikhathi esiningi sokugcwaliswa ngegazi nokumpompa ngempumelelo.

Ngokungafani nemithi yokushaya kwenhliziyo ebuthakathaka engase ivimbele uhlobo olulodwa kuphela lwendlela kagesi, i-amiodarone ithinta i-sodium, i-potassium, kanye neziteshi ze-calcium. Le ndlela yokusebenzisa izinto eziningi yenza ukuthi isebenze kahle kuma-arrhythmias amabi kodwa futhi yandisa amathuba okuba nemiphumela emibi.

I-Amiodarone futhi inemiphumela ethile emgqeni wakho we-thyroid nakwezinye izitho ngoba iqukethe i-iodine futhi ihlala ezicutshini zomzimba wakho isikhathi eside kakhulu. Yingakho ukuqapha njalo kubaluleke kakhulu uma usebenzisa lo muthi.

Kufanele Ngiyithathe Kanjani I-Amiodarone?

Thatha i-amiodarone ngendlela udokotela wakho ayincomayo, ngokuvamile kanye noma kabili ngosuku ngokudla ukuze unciphise ukuquleka kwesisu. Lo muthi umunca kangcono uma uthathwa ngokudla, ikakhulukazi okune-fat ethile.

Udktela wakho ngokuvamile uzoqala ngomthamo ophezulu "wokulayisha" emasontweni ambalwa okuqala, bese ewunciphisa ube umthamo ophansi wokugcina. Lesi sigaba sokulayisha sisiza umuthi ukuthi wakheke ezicutshini zomzimba wakho lapho udinga ukusebenza khona.

Gwinya amaphilisi wonke ngamanzi agcwele - ungaqobi, uhlafune, noma uwaphule. Zama ukuthatha imithamo yakho ngesikhathi esifanayo nsuku zonke ukuze ugcine amazinga aqhubekayo egazini lakho.

Gwema ama-grapefruit nejusi le-grapefruit ngenkathi uthatha i-amiodarone, ngoba angakhuphula amazinga omuthi emzimbeni wakho. Kufanele futhi ukhawulele ukuchayeka kwelanga futhi ugqoke izingubo ezivikelayo kanye ne-sunscreen uma uphuma ngaphandle, njengoba i-amiodarone yenza isikhumba sakho sizwele kakhulu elangeni.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Amiodarone?

Ubude bokwelashwa nge-amiodarone buhluka kakhulu ngokuya ngesimo senhliziyo yakho esithile nokuthi usabela kahle kangakanani emuthini. Abanye abantu bayayidinga izinyanga, kanti abanye bangase bayidinge iminyaka noma ngisho nokwelashwa kwempilo yonke.

Udktela wakho uzohlola njalo ukuthi usayidinga yini i-amiodarone ngokuqapha isigqi senhliziyo yakho futhi ehlola imiphumela emibi. Bazosebenzisa amathuluzi afana nama-EKG, ukuhlolwa kwegazi, futhi ngezinye izikhathi ama-monitor esigqi senhliziyo ukuze bahlole inqubekela phambili yakho.

Ngenxa yokuthi i-amiodarone ihlala ezicutshini zomzimba wakho isikhathi eside kakhulu, imiphumela yayo ingahlala amasonto noma izinyanga ngisho nangemva kokuyeka ukuyithatha. Lokhu kusho ukuthi udktela wakho uzodinga ukukuqapha eduze ngesikhathi sokuguquka.

Ungalokothi uyeke ukuthatha i-amiodarone ngokuzumayo ngaphandle kokukhuluma nodktela wakho kuqala, ngoba lokhu kungabangela izinguquko eziyingozi zesigqi senhliziyo. Uma udinga ukuyeka umuthi, udktela wakho uzokwenza uhlelo oluqinile lokukuguqula ngokuphepha.

Yiziphi Imiphumela Emibi ye-Amiodarone?

I-Amiodarone ingabangela imiphumela emibi esukela kokuncane kuya kokukhulu, yingakho udktela wakho ezokuqapha eduze ngesikhathi sokwelashwa. Imiphumela eminingi emibi ihlobene nokuthi umuthi uhlala isikhathi esingakanani ezicutshini zomzimba wakho.

Nawa amanye amaphutha avamile ongase uhlangabezane nawo, futhi kubalulekile ukwazi ukuthi abantu abaningi bayasithwala kahle lesi sithako ngaphandle kwala mathuba:

• Ukugula, ukuhlanza, noma ukulahlekelwa isifiso sokudla
• Ukukhathala noma ubuthakathaka
• Isiyezi noma ukukhathala
• Ukuqunjelwa
• Izinkinga zokulala noma amaphupho acacile
• Ukunambitheka kwensimbi emlonyeni wakho
• Ukuzwela kwesikhumba elangeni

Le miphumela emibi ejwayelekile ivame ukuthuthuka njengoba umzimba wakho ujwayela umuthi, kodwa njalo xoxa nganoma yiziphi izinkathazo nodokotela wakho.

Imiphumela emibi engathi sína idinga ukunakekelwa kwezokwelapha ngokushesha, nakuba ingavamile. Udokotela wakho uzobheka lokhu ngokusebenzisa ukuqapha njalo:

• Izinkinga zamaphaphu (ukukhwehlela, ukuphefumula kanzima, ubuhlungu besifuba)
• Izinkinga zesibindi (ukuphuzi kwesikhumba noma amehlo, umchamo omnyama, ukukhathala okukhulu)
• Izinkinga ze-thyroid (ushintsho olukhulu lwesisindo, ukushaya kwenhliziyo okusheshayo, ukujuluka ngokweqile noma ukuzizwa kubanda)
• Ushintsho embonweni (ukubona okungacacile, ukubona ama-halos ezungeze izibani)
• Ukushintsha kombala wesikhumba (umbala oluhlaza okwesibhakabhaka-mpunga, ikakhulukazi ebusweni nasezandleni)
• Izinkinga ezintsha noma eziba zimbi zokushaya kwenhliziyo

Le miphumela emibi engathi sína yingakho ukuhlolwa njalo kanye nokuhlolwa kwegazi kubaluleke kangaka ngenkathi uthatha i-amiodarone.

Imiphumela emibi engavamile kodwa engathi sína ingabandakanya ukulimala okukhulu kwamaphaphu (i-pulmonary fibrosis), ukulimala okukhulu kwesibindi, noma izivunguvungu eziyingozi ze-thyroid. Udokotela wakho uzokuqapha ngama-X-ray esifuba, izivivinyo zomsebenzi wamaphaphu, umsebenzi wegazi, kanye nokuhlolwa kwamehlo ukuze ubambe noma yiziphi izinkinga ekuqaleni.

Ubani Ongafanele Athatha I-Amiodarone?

Abantu abathile akufanele bathathe i-amiodarone ngenxa yengozi eyengeziwe yezinkinga ezingathi sína. Udokotela wakho uzobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokukuyalela lo muthi.

Akufanele uthathe i-amiodarone uma unezinkinga ezithile zesigqi senhliziyo njenge-bradycardia eqinile (isilinganiso senhliziyo esinensayo kakhulu) noma ukuvinjelwa kwenhliziyo ngaphandle kwe-pacemaker. Umuthi ungenza lezi zimo zibe zimbi ngokwenza inhliziyo yakho ihambe kancane.

Abantu abanezifo zesibindi ezinzima, izifo zamaphaphu ezinzima, noma izinkinga ze-thyroid ezingelashwa ngokuvamile akufanele bathathe i-amiodarone. Umuthi ungenza lezi zimo zibe zimbi noma uzenze zibe nzima ukuzilawula.

Uma ukhulelwe noma uncelisa, i-amiodarone ngokuvamile ayinconywa ngoba ingalimaza ingane esakhula noma idlulele obisini. Udokotela wakho uzoxoxa ngezindlela eziphephile uma uhlela ukukhulelwa.

Xhumana nodokotela wakho ngayo yonke imithi oyithathayo, njengoba i-amiodarone isebenzisana nemithi eminingi ehlanganisa i-warfarin, i-digoxin, kanye nama-antibiotics athile. Lokhu kusebenzisana kungaba kubi futhi kudinga ukulungiswa komthamo noma ezinye izindlela zokwelapha.

Amagama Omkhiqizo we-Amiodarone

I-Amiodarone itholakala ngaphansi kwamagama amaningi omkhiqizo, i-Cordarone ne-Pacerone okuyizona ezivamile e-United States. Inguqulo ejwayelekile ebizwa ngokuthi "amiodarone" nayo iyatholakala futhi isebenza ngendlela efanayo.

Ikhemisi lakho lingashintsha phakathi kwezinguqulo ezivamile nezomkhiqizo ngaphandle uma udokotela wakho ekuchaza ngenye indlela. Zonke izinguqulo ezivunyelwe yi-FDA ziqukethe isithako esifanayo esisebenzayo futhi kufanele zisebenze kahle esimweni sakho.

Abanye abantu baqaphela umehluko omncane endleleni abazizwa ngayo phakathi kwezinguqulo ezivamile nezomkhiqizo, nakuba ukusebenza komuthi kuhlala kunjalo. Uma unezinkathazo ngokushintsha phakathi kwezinguqulo, xoxa ngalokhu nodokotela wakho nomkhemisi.

Ezinye izindlela ze-Amiodarone

Eminye imithi eminingi ingelapha izinkinga zesigqi senhliziyo, nakuba ukukhetha kuncike esimweni sakho esithile nomlando wezokwelapha. Udokotela wakho uzocabangela lezi ezinye izindlela ngokusekelwe esimweni sakho.

Eminye imithi elwa nokushaya kwenhliziyo okungajwayelekile ihlanganisa i-flecainide, propafenone, sotalol, kanye ne-dofetilide ngezinhlobo ezithile ze-arrhythmias. Le mithi inezinhlobo ezahlukene zemiphumela engemihle futhi ingase ilungele abanye abantu.

Ukwelashwa okungekona okwemithi njenge-catheter ablation (inqubo ebulala izindawo ezinzima enhliziyweni) noma amadivayisi afakelwayo njengama-pacemakers noma ama-defibrillators angase abe yizinketho kwabanye abantu. Lokhu kwelashwa ngezinye izikhathi kungaqeda isidingo semithi yesikhathi eside.

Ngokukhethekile i-atrial fibrillation, imithi emisha efana ne-dronedarone ingase icatshangelwe, nakuba inganamandla njenge-amiodarone kuma-arrhythmias abucayi. Udokotela wakho wenhliziyo uzosiza ekunqumeni indlela engcono kakhulu yesimo sakho esithile.

Ingabe i-Amiodarone Ingcono Kunezinye Izidakamizwa Zokushaya Kwenhliziyo?

I-Amiodarone ivame ukusebenza kangcono kunezinye izidakamizwa zokushaya kwenhliziyo okungajwayelekile ezibucayi, ezisongela impilo, yingakho odokotela beyikhetha naphezu kwemiphumela yayo engemihle. Ilungele ikakhulukazi ukuvimbela ukufa okungazelelwe kwenhliziyo ezigulini ezinengozi enkulu.

Uma iqhathaniswa neminye imithi elwa ne-arrhythmic, i-amiodarone mancane amathuba okuthi ibangele izinguquko eziyingozi zokushaya kwenhliziyo (ebizwa ngokuthi i-proarrhythmia). Lokhu kuyenza iphephe kubantu abanezifo zenhliziyo ezinkulu noma ukuhluleka kwenhliziyo.

Nokho, i-amiodarone inemiphumela eminingi engemihle engeyona eyenhliziyo kunezinye izidakamizwa zokushaya kwenhliziyo, ethinta amaphaphu, isibindi, i-thyroid, nezinye izitho. Yingakho odokotela ngokuvamile beyigcina ezimweni ezinzima lapho ezinye izindlela zokwelapha zingasebenzi.

Umuthi

Yebo, i-amiodarone ngokuvamile ithathwa njengephephile kubantu abanenhliziyo ebuthakathaka futhi ivame ukuba yindlela ekhethwa kakhulu kulaba bantu. Ngokungafani neminye imithi yokushaya kwenhliziyo, i-amiodarone ayibuthakathisi amandla enhliziyo okumpompa.

Eqinisweni, i-amiodarone ivame ukukhethwa ngokuqondile kubantu abanenhliziyo ebuthakathaka ngoba mancane amathuba okuthi yenze isimo sabo sibe sibi kakhulu ngenkathi isaqeda ngempumelelo izinkinga eziyingozi zokushaya kwenhliziyo. Ucwaningo lukhombisile ukuthi lunganciphisa ingozi yokufa okungazelelwe kwenhliziyo ezigulini ezinokuhluleka kwenhliziyo.

Udkt wakho usazoqhubeka ekuhlola eduze, njengoba iziguli ezinokuhluleka kwenhliziyo zingase zizwe kalula imiphumela emibi ethile ye-amiodarone. Ukuhlolwa njalo kusiza ukuqinisekisa ukuthi umuthi uyaqhubeka ukukuzuzisa ngaphandle kokubangela izinkinga.

Kufanele Ngenzeni Uma Ngiphuzile I-Amiodarone Engaphezu Kwayo Ngengozi?

Uma uphuze i-amiodarone engaphezu kwayo ngengozi, xhumana nodokotela wakho, isikhungo sokulawula ubuthi, noma igumbi eliphuthumayo ngokushesha. Ukweqisa kungabangela izinguquko eziyingozi zokushaya kwenhliziyo, isicanucanu esikhulu, noma ezinye izinkinga ezinkulu.

Ungalindi ukubona ukuthi uzizwa kahle yini - imiphumela yokweqisa i-amiodarone ingase ingaveli ngokushesha kodwa ingaba yingozi. Letha ibhodlela lomuthi nawe ukuze abahlinzeki bezempilo bazi kahle ukuthi yini nokuthi ungakanani okuthathile.

Ngenkathi ulindele usizo lwezokwelapha, ungazami ukuzenza uhlanze ngaphandle uma uqondiswe ngokuqondile ngumhlinzeki wezempilo. Hlala uzolile futhi zama ukukhumbula kahle ukuthi uthathe nini nokuthi ungakanani umuthi owengeziwe.

Kufanele Ngenzeni Uma Ngiphuthelwe Umthamo We-Amiodarone?

Uma uphuthelwe umthamo we-amiodarone, uyithathe ngokushesha lapho ukhumbula, ngaphandle kokuthi sekuseduze isikhathi somthamo wakho olandelayo ohleliwe. Kuleso simo, weqa umthamo ophuthelwe bese uqhubeka nohlelo lwakho olujwayelekile.

Ungalokothi uthathe imithamo emibili ngesikhathi esisodwa ukuze ulungise umthamo ophuthelwe, njengoba lokhu kungabangela imiphumela emibi eyingozi. Ngenxa yokuthi i-amiodarone ihlala ohlelweni lwakho isikhathi eside, ukuphuthelwa umthamo owodwa ngezikhathi ezithile ngeke kubangele izinkinga ngokushesha.

Uma uvame ukukhohlwa imithamo, cabangela ukusetha izikhumbuzi zocingo noma ukusebenzisa umhleli wamaphilisi. Ukuthatha imithi nsuku zonke ngokuqhubekayo kusiza ukugcina amazinga emithi ezinzile futhi kunikeza ukuvikeleka okungcono kakhulu ekuphazamisekeni kwenhliziyo okuyingozi.

Ngingayeka nini ukuthatha i-Amiodarone?

Kufanele uyeke ukuthatha i-amiodarone ngaphansi kokuqondiswa kanye nesiqondiso sikadokotela wakho. Ungalokothi uyeke lo muthi ngokuzumayo, ngoba ukwenza kanjalo kungabangela izinguquko eziyingozi zesigqi senhliziyo ezazivinjwa ngumuthi.

Udokotela wakho uzonquma ukuthi kuphephile nini ukuyeka ngokusekelwe ekuqineni kwesigqi senhliziyo yakho, isimo senhliziyo esingaphansi, kanye nesimo sempilo yakho esiphelele. Bangasebenzisa ukuqapha isigqi senhliziyo noma ezinye izivivinyo ukuze bahlole ukuthi ukuyeka kufanelekile yini.

Uma uyeka i-amiodarone, khumbula ukuthi ihlala emzimbeni wakho amasonto noma izinyanga ngemva kwalokho, ngakho-ke uzodinga ukuqhubeka nokuqapha ngalesi sikhathi sokushintsha. Udokotela wakho angase anqume imithi ehlukile ukuze agcine ukuzinza kwesigqi senhliziyo yakho.

Ngingakwazi yini ukuphuza utshwala ngenkathi ngithatha i-Amiodarone?

Kungcono ukukhawulela ukusetshenziswa kotshwala ngenkathi uthatha i-amiodarone, njengoba zombili lezi zinto zingathinta isibindi nomsebenzi wenhliziyo yakho. Utshwala bungakhuphula nemiphumela emibi ethile ye-amiodarone njengokuquleka nokukhathala.

Uma ukhetha ukuphuza utshwala, kwenze ngokulinganisela futhi uxoxe ngalokhu nodokotela wakho kuqala. Bangakunika iseluleko ngokusekelwe esimweni sakho sempilo esithile nokuthi isibindi sakho sikwazi kangakanani ukusingatha imithi.

Izivivinyo zegazi ezivamile zizoqapha ukusebenza kwesibindi sakho ngenkathi use-amiodarone, futhi ukusetshenziswa kotshwala kungase kubangele lezi zinto noma kwandise ingozi yakho yezinkinga zesibindi. Udokotela wakho angakusiza ukuthi wenze ukukhetha okuphephe kakhulu esimweni sakho.