Wina m'banja mwanu, mwina amayi anu, abambo anu, kapena agogo anu, mwina akumwa mankhwala a matenda a mtima. Pakati pa mankhwala otere, pali mtundu wa mankhwala omwe akhala akugwiritsidwa ntchito kwa nthawi yayitali ndipo amapereka mphamvu yapadera kumtima. Lero tikambirana za gulu la mankhwala otchedwa Cardiac Glycosides. Ngakhale dzinali ndi losokoneza pang'ono, momwe izi zimagwirira ntchito ndi mfundo zomwe tifunika kudziwa ndizofunikira kwambiri.
Mwachidule, kodi ma glycosides a mtima awa ndi chiyani?
Ma glycoside a mtima ndi gulu la mankhwala omwe amathandiza anthu omwe ali ndi matenda ena a mtima. Amabwera ngati mapiritsi, madzi, kapena makapisozi. Madokotala nthawi zambiri amalemba mankhwala awa kuti amwe kamodzi patsiku, nthawi yomweyo tsiku lililonse.
N'zosadabwitsa kuti mtundu uwu wa mankhwala unapezeka koyamba kuchokera ku chomera chotchedwa "Digitalis" kapena "foxglove." Ndicho chifukwa chake mankhwala ena m'gululi amatchedwa dzina la chomera chimenecho.
Kodi mankhwalawa amagwira ntchito bwanji m'thupi?
Pali mfundo zina zasayansi zoti mumvetse izi, koma ndikufotokozerani mosavuta.
Taganizirani maselo omwe ali mu minofu ya mtima wathu ngati mapampu ang'onoang'ono. Mkati mwa maselo amenewa muli zinthu zotchedwa sodium ndi calcium. Kulinganiza kwa izi ndikofunikira kwambiri kuti mtima ugwire bwino ntchito.
1. Kulamulira Sodium: Mukatenga mankhwala a cardiac glycoside, amalamulira pang'ono kutulutsa sodium m'maselo a mtima. Kunena zoona, amaletsa njirayi kwa kanthawi.
2. Kuchuluka kwa calcium: Pamene kuchuluka kwa sodium mkati mwa maselo kukuwonjezeka, kuchuluka kwa calcium mkati mwa maselo kumawonjezeka kokha poyankha.
3. Kulimbitsa kugunda kwa mtima: Pa kugunda kulikonse kwa mtima, calcium yochulukirapo imatulutsidwa. Izi zimapangitsa kuti minofu ya mtima ichepetse mwamphamvu. Izi zikutanthauza kuti kuchuluka kwa magazi omwe amaponyedwa m'thupi pa kugunda kulikonse (komwe timatcha Stroke Volume mu mankhwala) kumawonjezeka.
4. Kugwira ntchito bwino kwa thupi lonse: Kuchuluka kwa magazi omwe amapopedwa kamodzi kokha kukawonjezeka, kuchuluka kwa magazi omwe amapopedwa ndi mtima (kotchedwa cardiac output ) kumawonjezeka. Izi ndi mpumulo waukulu kwa munthu amene ali ndi matenda monga kulephera kwa mtima.
Mwachidule: mankhwalawa amagwira ntchito "powonjezera" mphamvu ya mtima yopompa.
Kuphatikiza apo, mankhwala awa amachita chinthu china chofunikira. Pali malo apadera pomwe zizindikiro zamagetsi zomwe zimalamulira kuyenda kwa kugunda kwa mtima, zotchedwa Atrioventricular (AV) node . Mankhwalawa amatha kuchepetsa liwiro lomwe zizindikirozo zimayendera. Izi zimachepetsa kugunda kwa mtima. Matenda a mtima, monga Atrial FibrillationIzi ndi zothandiza kwambiri kwa anthu omwe ali ndi matenda otere.
Kodi mitundu ya glycosides ya mtima ndi iti, ndipo ndi iti yomwe imagwiritsidwa ntchito kwambiri?
Pali mankhwala angapo omwe ali m'gulu la mankhwalawa.
- Digoxin
- Digitalis
- Digitoxin
Mwa izi, yomwe inu, ine, ndi ena onse mudamvapo, komanso yomwe imagwiritsidwa ntchito kwambiri ku Sri Lanka ndi padziko lonse lapansi, ndi Digoxin . Yang'anani ngati dzinali lili pa mankhwala anu.
Ndani amapatsidwa mankhwala awa? N’chifukwa chiyani si mankhwala oyamba omwe amasankhidwa?
Ma glycosides a mtima nthawi zambiri amaperekedwa pa matenda awiri akuluakulu.
1. Kulephera kwa Mtima: Matenda omwe mtima umalephera kupompa magazi okwanira kupita m'thupi.
2. Kusakhazikika kwa kugunda kwa mtima (Arrhythmias): Makamaka pa milandu yomwe kugunda kwa mtima kumawonjezeka mosalamulirika, monga Atrial Fibrillation.
Koma apa pali mfundo yofunika kwambiri yomwe tonsefe tiyenera kudziwa. Masiku ano, Cardiac Glycosides si mankhwala oyamba operekedwa ndi madokotala. Zaka 20-30 zapitazo, ankagwiritsidwa ntchito kwambiri. Koma tsopano, pali mankhwala atsopano omwe ndi otetezeka, alibe zotsatirapo zoyipa zambiri, ndipo alipo.
Dokotala adzayesa kaye mitundu iyi ya mankhwala:
- Beta-blockers
- Zoletsa za ACE
- Mankhwala ochepetsa madzi m'thupi (Diuretics)
- Ma ARB
Dokotala angagwiritse ntchito Cardiac Glycosides, makamaka Digoxin, ngati gawo lachiwiri kapena lachitatu ngati mankhwala awa alephera kulamulira matendawa kapena ngati wodwalayo ali ndi mavuto ena.
Kodi zimenezi zikutanthauza kuti mankhwalawa si abwino? Ayi, ayi konse. Mankhwalawa ndi mankhwala ofunikira kwambiri, opulumutsa moyo kwa odwala ena. Koma chifukwa chakuti ali ndi zoopsa zina, madokotala amawalemba mosamala kwambiri ndipo okhawo amene akufunikiradi.
Kodi tikudziwanso zoopsa ndi zotsatirapo zake?
Polankhula za mankhwala awa, chinthu chimodzi choyenera kudziwa ndi chiopsezo chake. Pali kusiyana kochepa pakati pa mlingo wochiritsira ndi mlingo woopsa wa mankhwala awa. Izi zikutanthauza kuti ngakhale mutamwa mopitirira muyeso womwe walangizidwa, mutha kukumana ndi zotsatirapo zoyipa.
Ichi ndichifukwa chake dokotala wanu nthawi zonse amafufuza magazi anu (serum digoxin level) kuti aone ngati mlingo wa mankhwala m'thupi lanu uli pamlingo woyenera.
| Mtundu wa zotsatira zoyipa | Zizindikiro zomwe zingachitike |
|---|---|
| Zotsatira zoyipa zofala |
|
| Zizindikiro zazikulu za poizoni wa mankhwala |
Dziwani izi: Ngati muli ndi potaziyamu yochepa, muli pachiwopsezo chachikulu cha zotsatirapo zoyipa kuchokera ku mankhwalawa. Chifukwa chake, dokotala wanu adzayang'ananso kuchuluka kwa potaziyamu m'thupi lanu nthawi zonse.
Kodi muyenera kupita kwa dokotala nthawi yomweyo liti?
Ngati mukumwa mankhwala a cardiac glycoside, makamaka Digoxin, muyenera kulankhulana ndi dokotala nthawi yomweyo ngati mukukumana ndi zizindikiro zotsatirazi. Ngati zizindikirozo zili zazikulu, pitani ku Dipatimenti Yodzidzimutsa (ETU) ya chipatala chapafupi.
| Zizindikiro zoti muzisamala nazo | Zoyenera kuchita? |
|---|---|
| Kuvuta kupuma | Funani upangiri wa dokotala nthawi yomweyo. |
| Kutupa kwa miyendo kapena miyendo | Uzani dokotala. |
| Kupweteka kwambiri m'mimba, nseru, kapena kutsegula m'mimba | Funani upangiri wa dokotala nthawi yomweyo. |
| Chilakolako cha chakudya | Uzani dokotala. |
| Kugunda kwa mtima pang'onopang'ono kapena mofulumira kwambiri, kapena kumva ngati ukudumphadumpha | Funani upangiri wa dokotala nthawi yomweyo. |
Kodi mankhwalawo amatenga nthawi yayitali bwanji kuti agwire ntchito?
Mukayamba kumwa mankhwalawa, zingatenge milungu ingapo, kapena mwezi umodzi kapena iwiri, zizindikiro zanu zisanayambe kuchira. Choncho khalani oleza mtima ndipo pitirizani kumwa mankhwalawo monga momwe dokotala wanu wakuuzani.
Chofunika kwambiri: Musasiye kumwa mankhwalawa popanda kufunsa dokotala wanu, chifukwa choti mukuganiza kuti mukumva bwino. Komanso, musamwe mankhwala opitirira mlingo womwe mwapatsidwa. Nthawi zonse lankhulani ndi dokotala wanu za momwe mankhwalawo akukukhudzirani.
Uthenga Wopita Nawo Kunyumba
- Cardiac glycosides ndi mtundu wa mankhwala omwe akhala akugwiritsidwa ntchito kwa nthawi yayitali kuti awonjezere mphamvu ya mtima yopopa komanso kuwongolera kugunda kwa mtima.
- Ngakhale kuti mankhwalawa sagwiritsidwa ntchito ngati mankhwala oyamba masiku ano, ndi mankhwala ofunikira kwambiri kwa odwala ena.
- Popeza kusiyana pakati pa mlingo wovomerezeka wa mankhwala ndi mlingo womwe umayambitsa zotsatirapo zake ndi kochepa, ndikofunikira kwambiri kumwa mlingo womwe dokotala wakupatsani.
- Ngati mukumva zizindikiro monga nseru, kusintha kwa masomphenya (masomphenya achikasu/obiriwira), kapena kusayenda bwino kwa kayendedwe ka mtima, dziwitsani dokotala wanu nthawi yomweyo.
- Musasiye kumwa mankhwala kapena kusintha mlingo popanda upangiri wa dokotala pazifukwa zilizonse. Ndikofunikira kwambiri kupita kuzipatala ndikuyezetsa magazi nthawi yake.
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