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

I-Esmolol iyimithi ye-beta-blocker esebenza ngokushesha enikezwa nge-IV ezibhedlela ukuze kulawulwe ngokushesha umfutho wegazi ophezulu kanye nezinga lokushaya kwenhliziyo elisheshayo ngesikhathi sezimo eziphuthumayo zezokwelapha. Cabanga ngayo njengebhethri eliqondile, elisebenza ngokushesha lenhliziyo yakho nemithambo yegazi ongakwazi ukulivula futhi ulivale njengoba kudingeka odokotela. Le mithi isebenza ngemizuzu futhi iyaphela ngokushesha, okwenza ibe wusizo olukhulu lapho amaqembu ezokwelapha edinga ukulawula ngokushesha kodwa okwesikhashana izinga lokushaya kwenhliziyo nomfutho wegazi.

Yini i-Esmolol?

I-Esmolol iyimithi ye-beta-blocker eyisigaba semithi ebizwa ngokuthi ama-cardioselective beta-1 adrenergic receptor blockers. Isebenza ngokuvimba izamukeli ezithile enhliziyweni yakho ezisabela ku-adrenaline nama-hormone okucindezeleka afanayo. Ngokungafani namanye ama-beta-blockers ongawathatha njengamaphilisi ansuku zonke, i-esmolol inikezwa kuphela ngomugqa we-IV ezindaweni zasezibhedlela.

Okuhlukanisa i-esmolol ukuthi isebenza ngokushesha okukhulu. Imithi iqala ukusebenza ngemizuzu engu-1-2 ngemva kokunikezwa futhi imiphumela yayo iyaphela phakathi kwemizuzu engu-10-30 ngemva kokuthi ukumnika kuyeke. Lokhu kunikeza odokotela ukulawula okunembile ngezinga lokushaya kwenhliziyo yakho nomfutho wegazi ezimweni ezibucayi.

Isetshenziselwani i-Esmolol?

I-Esmolol isetshenziswa ikakhulukazi ukuphatha ukwanda okungazelelwe komfutho wegazi kanye nezinga lokushaya kwenhliziyo ngesikhathi sokuhlinzwa, izinqubo zezokwelapha, noma izimo eziphuthumayo zezokwelapha. Odokotela basebenzisa le mithi uma bedinga ukulawula ngokushesha kodwa okwesikhashana inhliziyo nemithambo yegazi okungashintshwa kalula noma kumiswe.

Izimo ezivame kakhulu lapho ungase uthole khona i-esmolol zihlanganisa ngesikhathi sokuhlinzwa lapho umfutho wegazi lakho noma izinga lokushaya kwenhliziyo likhuphuka ngendlela eyingozi, egumbini eliphuthumayo ngezimo eziphuthumayo ze-hypertensive, noma kuyunithi yokunakekelwa okukhulu lapho eminye imithi yomfutho wegazi ingasebenzi ngokushesha okwanele. Isetshenziswa futhi uma uphuma emuthini wokubulala izinzwa futhi inhliziyo yakho nemithambo yegazi idinga ukuholwa ngobumnene ibuyele kokujwayelekile.

Ngokuvamile, i-esmolol ingasetshenziswa ngezinkinga ezithile zesigqi senhliziyo noma lapho odokotela bedinga ukuhlola ukuthi inhliziyo yakho isabela kanjani ekwelashweni nge-beta-blocker ngaphambi kokukuqala emuthini osebenza isikhathi eside. Ezinye iziguli ziyawuthola ngesikhathi sezinqubo zezokwelapha njengezinhlobo ezithile zokuhlinzwa kwamehlo lapho ukulawulwa kwengcindezi yegazi kubalulekile.

Isebenza Kanjani I-Esmolol?

I-Esmolol isebenza ngokuvimba ama-receptor e-beta-1 emsipheni wenhliziyo yakho, afana nokushintsha okusabela ku-adrenaline namanye ama-hormone okucindezeleka. Uma la ma-receptor evinjelwe, inhliziyo yakho ishaya kancane futhi ngamandla amancane, okunciphisa ngokwemvelo ingcindezi yakho yegazi.

Lokhu kuthathwa njengomuthi onamandla ngokulinganisela mayelana nemiphumela yawo esheshayo, kodwa futhi uhlala isikhathi esifushane kakhulu. Umzimba wakho une-enzyme ekhethekile egazini lakho ehlukanisa ngokushesha i-esmolol, yingakho imiphumela yayo inyamalala ngokushesha uma ukumnika nge-IV kuyeka. Lesi sici esiyingqayizivele senza ukuthi siphephe kakhulu kune-beta-blockers esebenza isikhathi eside ezimweni eziphuthumayo.

Lo muthi ukhethekile kuma-receptor e-beta-1, okusho ukuthi ikakhulukazi ithinta inhliziyo yakho kunokuba ezinye izitho njengamaphaphu akho. Lokhu kukhetha kwenza kuphephe kubantu abanezimo ezithile zokuphefumula, nakuba kungaphephile ngokuphelele.

Kufanele Ngiyithathe Kanjani I-Esmolol?

Ngeke uzithathele wena i-esmolol - lo muthi unikezwa kuphela ochwepheshe bezokwelapha abaqeqeshiwe ngomugqa we-IV ezindaweni zasemtholampilo. Ithimba lezokwelapha lizoqala ngomthamo wokulayisha, okuyimali enkulu yokuqala, elandelwe ukumnika okuqhubekayo okungashintshwa ngokuya ngendlela umzimba wakho osabela ngayo.

Abahlengikazi nodokotela bakho bazohlola izinga lokushaya kwenhliziyo yakho, umfutho wegazi, kanye nesimo sakho sonke njalo ngenkathi wamukela i-esmolol. Bazolungisa umthamo njalo ngemizuzu embalwa uma kudingeka ukuze kuzuzwe ibhalansi efanele esimweni sakho esithile. Amazinga ajwayelekile okufakwa ngomthambo asukela emithamini ephansi kakhulu kuya ezingeni eliphezulu, kuye ngokuthi umzimba wakho usabela kanjani nezidingo zakho zezokwelapha.

Njengoba uzobe usesimweni somtholampilo, akudingeki ukhathazeke ngokusebenzisana kokudla noma isikhathi sokudla. Ithimba lezokwelapha liphatha zonke izici zokuphatha nokuqapha. Umsebenzi wakho ukuthula nje futhi uvumele imithi ukuthi yenze umsebenzi wayo ngenkathi ochwepheshe bezempilo beqapha eduze ukuthi usabela kanjani.

Kufanele Ngiyithathe Isikhathi Esingakanani I-Esmolol?

I-Esmolol ivame ukusetshenziswa isikhathi esifushane kakhulu, ngokuvamile kusukela emizuzwini embalwa kuya emahoreni ambalwa, kuye ngesimo sakho sezokwelapha. Iziguli eziningi ziyayithola ngesikhathi sokuhlinzwa, izinqubo zezokwelapha, noma izigameko eziphuthumayo ezidinga ukulawulwa kwenhliziyo nemithambo yegazi okusheshayo kodwa okwesikhashana.

Ubude besikhathi buqondene ngokuphelele nezidingo zakho zezokwelapha nokuthi umzimba wakho usabela kanjani ekwelashweni. Ngesikhathi sokuhlinzwa, ungase uyithole kuphela ngesikhathi senqubo. Ezimweni eziphuthumayo, ithimba lezokwelapha lingayisebenzisa amahora ambalwa ngenkathi lizinzisa isimo sakho futhi likudlulisele emithini yesikhathi eside uma kudingeka.

Odokotela bakho bazohlola ngokuqhubekayo ukuthi usayidinga yini imithi futhi bazoyeka ngokushesha nje lapho uhlelo lwakho lwenhliziyo nemithambo yegazi luzinzile. Ngenxa yokuthi i-esmolol iyaphela ngokushesha, bangayeka kalula ukuyisebenzisa futhi babone ukuthi umzimba wakho usabela kanjani ngemizuzu embalwa.

Yiziphi Imiphumela Eceleni Ye-Esmolol?

Njengayo yonke imithi, i-esmolol ingabangela imiphumela emibi, nakuba abantu abaningi beyibekezelela kahle ngesikhathi sokusetshenziswa kwesikhashana. Imiphumela emibi evame kakhulu ihlobene nesenzo sayo esiyinhloko sokunciphisa izinga lokushaya kwenhliziyo yakho nokwehlisa umfutho wegazi.

Nawa amanye amaphutha ongase uhlangabezane nawo, ukhumbula ukuthi ithimba lakho lezokwelapha likuqapha ngokucophelela futhi lingashintsha noma lime imithi uma kuvela izinkinga:

• Ukwehla kwengcindezi yegazi (i-hypotension), okungenzeka kukwenze uzizwe unesiyezi noma ukhathele
• Ukushaya kwenhliziyo okuhamba kancane (i-bradycardia), nakuba lokhu kuvame ukuba umphumela ohlosiwe
• Ukuzizwa ukhathele noma ubuthakathaka
• Ukucasuka noma isisu esibuhlungu
• Ukukhathazeka kwekhanda
• Isiyezi
• Ukudideka noma ukuzizwa unenkungu engqondweni
• Ubuhlungu noma ukucasuka endaweni ye-IV

Le miphumela evamile ivame ukuba mnene futhi iyanyamalala ngokushesha uma imithi iyekiswa noma umthamo wehlisiwe. Ithimba lakho lezempilo linolwazi ekulawuleni le miphumela futhi lizokwenza izinguquko njengoba kudingeka.

Imiphumela engathi sína kodwa engavamile ingabandakanya ukwehla okukhulu kwengcindezi yegazi, ukushaya kwenhliziyo okuhamba kancane kakhulu, noma izinkinga zesigqi senhliziyo. Ngokungavamile, abanye abantu bangase babe nobunzima bokuphefumula, ikakhulukazi uma benemibandela yamaphaphu ekhona. Ukusabela komzimba kungenzeka kodwa akuvamile.

Izindaba ezinhle ukuthi ngenxa yokuthi i-esmolol isebenza ngokushesha futhi ishiya uhlelo lwakho ngokushesha okukhulu, imiphumela eminingi emibi ixazululwa ngemizuzu embalwa ngemva kokuyeka ukufakwa. Lokhu kubuyela emuva okusheshayo kungenye yezici zokuphepha ezibalulekile ezenza le mithi ibaluleke ezindaweni zasemtholampilo.

Ubani Ongafanele Athole I-Esmolol?

I-Esmolol ayifanele wonke umuntu, futhi ithimba lakho lezokwelapha lizobuyekeza ngokucophelela umlando wakho wezokwelapha ngaphambi kokusebenzisa le mithi. Isinqumo sokusebenzisa i-esmolol sincike ekulinganiseni izinzuzo ngokumelene nezingozi ezingaba khona esimweni sakho esithile.

Abantu ngokuvamile okungafanele bathole i-esmolol bahlanganisa labo abanezinkinga ezithile zesigqi senhliziyo njengokuvaleka kwenhliziyo okukhulu, ukushaya kwenhliziyo okuhamba kancane kakhulu, noma ukuhluleka kwenhliziyo okukhulu. Uma unesimo esibizwa ngokuthi i-cardiogenic shock, lapho inhliziyo yakho ingakwazi ukumpompa igazi elanele ukuze ihlangabezane nezidingo zomzimba wakho, i-esmolol ingakwenza lokhu kube kubi kakhulu.

Isifuba esibi kakhulu noma izinkinga ezithile zokuphefumula nazo zingenza i-esmolol ibe yingozi, nakuba inobungane obuningi emaphashini kunezinye izidakamizwa ze-beta-blockers. Abantu abanezinkinga ezithile zemithambo yegazi noma labo abathatha imithi ethile engase ihlangane ngendlela eyingozi ne-esmolol badinga ukucatshangelwa okukhethekile.

Nokho, izimo eziphuthumayo ngezinye izikhathi zidinga odokotela ukuthi basebenzise imithi naphezu kwalezi zinkinga, ngokubheka okwengeziwe kanye nezinyathelo zokuphepha. Ithimba lakho lezokwelapha lizohlola lezi zici ngokucophelela futhi lizoba namasu okubhekana nanoma yiziphi izinkinga ezingase zivele.

Amagama e-Brand ye-Esmolol

I-Esmolol itholakala ngokuvamile ngaphansi kwegama lomkhiqizo elithi Brevibloc, okuyilona hlobo olwaziwa kakhulu lolu lwazi. Ungase futhi ulubone lubizwa ngokuthi "esmolol hydrochloride" ezindaweni zezibhedlela.

Abakhiqizi abahlukene bangakhiqiza izinguqulo ezivamile ze-esmolol, kodwa zonke ziqukethe isithako esifanayo esisebenzayo futhi zisebenza ngendlela efanayo. Ukugxila nokupakishwa kungase kuhluke kancane phakathi kwemikhiqizo, kodwa ithimba lakho lezempilo lizobhekana nazo zonke izinto zobuchwepheshe mayelana nokuthi yimuphi umkhiqizo othile abawusebenzisayo.

Ezinye izindlela ze-Esmolol

Kukhona ezinye izindlela ze-esmolol, ngasinye esinezici ezihlukene ezenza zifanele izimo ezihlukene. Ukukhetha kuncike ekutheni odokotela badinga ngokushesha kangakanani ukuthi umuthi usebenze, ukuthi bafuna isikhathi esingakanani imiphumela ihlale, kanye nesimo sakho sezokwelapha esithile.

Eminye imithi yokwehlisa umfutho wegazi esebenza ngokushesha ihlanganisa i-nicardipine noma i-clevidipine, esebenza ngezindlela ezihlukene kune-esmolol. Ukuze kulawulwe isikhathi eside, odokotela bangasebenzisa i-metoprolol, i-propranolol, noma ezinye izidakamizwa ze-beta-blockers ezihlala isikhathi eside kodwa zithatha isikhathi esiningi ukuqala ukusebenza.

I-Labetalol enye inketho esebenza kuzo zombili izamukeli ze-beta ne-alpha, inikeza ukulawulwa komfutho wegazi ngendlela ehlukile kancane. Ngayinye yalezi zindlela ezingezinye inezinzuzo zayo kanye nobubi bayo, futhi ithimba lakho lezokwelapha lizokhetha ngokusekelwe ezidingweni zakho ezithile kanye nesimo sakho sezokwelapha.

Ingabe i-Esmolol ingcono kune-Metoprolol?

I-Esmolol ne-metoprolol zombili ziyizithiyo ze-beta, kodwa zisebenzela izinjongo ezihlukene futhi azikwazi ukuqhathaniswa ngokuqondile mayelana nokuthi "zingcono" kunomunye nomunye. Ukukhetha phakathi kwazo kuncike ngokuphelele esimweni sakho sezokwelapha nokuthi odokotela bakho bazama ukukufeza ini.

Inzuzo enkulu ye-Esmolol ubude bayo obufushane kakhulu besenzo, okuyenza ilungele izimo lapho odokotela bedinga khona ukulawula okunembile, kwesikhashana okungahlehliswa kalula. Ngakolunye uhlangothi, i-Metoprolol ihlala isikhathi eside futhi ilungele ukwelashwa okuqhubekayo komfutho wegazi ophezulu noma izimo zenhliziyo.

Cabanga nge-esmolol njengensimbi enembile yokusetshenziswa kwesikhashana, kuyilapho i-metoprolol ifana nokwelashwa okuqhubekayo, kwesikhathi eside. Ezimweni eziphuthumayo noma ngesikhathi sokuhlinzwa, ukuqala okusheshayo kwe-esmolol kanye nokucisha kwenza kungabi nani. Ukuze kulawulwe izimo zenhliziyo nsuku zonke, imiphumela ye-metoprolol ehlala isikhathi eside iyasebenza.

Ithimba lakho lezokwelapha lizokhetha umuthi ofanele ngokusekelwe ekutheni ngabe udinga ukulawulwa okusheshayo, okwesikhashana noma ukuphathwa kwesikhathi eside kwesimo sakho senhliziyo nemithambo yegazi.

Imibuzo Evame Ukubuzwa Mayelana ne-Esmolol

Ingabe i-Esmolol iphephile kubantu abanesifo sikashukela?

I-Esmolol ngokuvamile ingasetshenziswa ngokuphepha kubantu abanesifo sikashukela, nakuba idinga ukuqapha okucophelelayo. Ngokungafani nezinye izithiyo ze-beta, i-esmolol ayinethuba elikhulu lokufihla izimpawu zokuxwayisa zikashukela ophansi, kodwa ingakwazi nokuthinta indlela umzimba wakho osabela ngayo ezingeni likashukela egazini.

Iqembu lakho lezokwelapha lizobheka ushukela wakho wegazi eduze uma unesifo sikashukela futhi uthola i-esmolol. Isikhathi esifushane sokusebenza empeleni senza ukuthi iphephe kune-beta-blockers esebenza isikhathi eside ngoba noma yimiphi imiphumela ekulawuleni ushukela wegazi izoxazululwa ngokushesha uma ukumnika kuyeka.

Kufanele Ngenzeni Uma Ngithola I-Esmolol Eningi Ngengozi?

Akudingeki ukhathazeke ngokuthola i-esmolol eningi ngengozi ngoba ochwepheshe bezokwelapha abaqeqeshiwe balawula yonke inqubo yokuphatha. Umuthi unikezwa ngokumnika kwe-IV okuqashwe ngokucophelela ngemishini yokulinganisa enembile.

Uma kwenzeka ukweqisa, iqembu lakho lezokwelapha lizoyeka ngokushesha ukumnika futhi linikeze ukunakekelwa okusekelayo. Ngenxa yokuthi i-esmolol iphuma ngokushesha emzimbeni wakho, imiphumela eminingi yokweqisa izoxazululwa ngemizuzu engu-10-30. Isibhedlela sinemithi nemishini etholakalayo kalula ukuphatha noma yiziphi izinkinga.

Kwenziwani Uma Umthamo We-Esmolol Uphuthelwa?

Ukuphuthelwa umthamo we-esmolol akuyona into okufanele ukhathazeke ngayo ngomqondo wendabuko ngoba inikezwa njengokumnika okuqhubekayo ezindaweni zesibhedlela. Uma ukumnika kuphazamiseka nganoma yisiphi isizathu, iqembu lakho lezokwelapha lizohlola isimo sakho futhi liqale kabusha uma kudingeka.

Ngenxa yokuthi i-esmolol isebenza ngokushesha, akudingeki ukuthi kube khona umthamo

Ngokuvamile, i-esmolol iyekiswa uma umfutho wegazi wakho nesilinganiso senhliziyo yakho sezizinzile, ukuhlinzwa kwakho noma inqubo isiqediwe, noma ithimba lakho lezokwelapha likushintshele emithini yesikhathi eside uma kudingeka. Ubuhle be-esmolol ukuthi ukuyeka kulula njengokucisha ukumnika kwe-IV, futhi imiphumela yayo iyaphela ngemizuzu embalwa.

Ingabe i-Esmolol ingabangela imiphumela yesikhathi eside?

I-Esmolol ayivamile ukubangela imiphumela yesikhathi eside ngenxa yesikhathi sayo esifushane sokusebenza kanye nesikhathi esifushane sokusetshenziswa. Abantu abaningi abathola i-esmolol abanayo imiphumela ehlala njalo uma imithi iyekisiwe futhi isusiwe ohlelweni lwabo.

Noma yimiphi imiphumela emibi oyitholayo ngenkathi uthola i-esmolol ngokuvamile izoxazululwa ngaphakathi kwemizuzu engu-10-30 yokuyeka ukumnika. Lokhu kubuyela emuva okusheshayo kungenye yezici ezibalulekile zokuphepha ezenza i-esmolol ibaluleke ezindaweni zasemtholampilo. Ithimba lakho lezokwelapha lizokuqapha ngemuva kokuthi imithi iyekisiwe ukuze liqinisekise ukuthi uyalulama kahle.