Kodi munayamba mwapitako kwa munthu amene ali mu chipinda chosamalira odwala kwambiri (ICU) m'chipatala? Mukatero, mwina mwazindikira kuti odwala ena nthawi zonse amapatsidwa mankhwala osiyanasiyana kudzera m'machubu amchere. Mwina wina m'banja mwanu wapatsidwa mankhwala a kuthamanga kwa magazi kapena vuto la mtima. Lero, tikambirana za gulu lapadera la mankhwala omwe angagwiritsidwe ntchito pazochitika zotere. Mankhwalawa amatchedwa 'inotropes' m'mawu azachipatala.
Mwachidule, kodi `Inotropes` awa ndi chiyani?
Inotropes ndi mtundu wa mankhwala omwe 'amauza' minofu ya mtima wanu momwe iyenera kulimba kapena kuchedwa. Ganizirani mtima wanu ngati pampu yomwe imapopera madzi kupita kunyumba kwanu. Nthawi zina pampu iyi singathe kupopera madzi okwanira kupita kunyumba kwanu. Nthawi zina, pampu iyi imatha kugwira ntchito mopitirira muyeso, zomwe zimapangitsa kuti kuthamanga kwa magazi kuchuluke komanso kuphulika kwa mapaipi.
Ma inotrope ali ngati switch yomwe imawonjezera kapena kuchepetsa 'mphamvu' ya mota iyi. Pali mitundu iwiri ikuluikulu ya izi.
1. Ma Inotropes Abwino: Izi zimapangitsa mtima kugunda mwamphamvu , monga momwe zimaperekera mphamvu zambiri ku injini yofooka yamadzi.
2. Ma Inotropes Oipa: Izi zimapangitsa mtima kugunda pang'onopang'ono komanso ndi mphamvu zochepa , mofanana ndi kulamulira liwiro la mota yomwe ikugwira ntchito mofulumira kwambiri.
Nchifukwa chiyani `Ma Inotropes Abwino` amafunikira?
Mankhwala oletsa kutupa omwe ali ndi vuto la mtima (inotropes) angathandize pamene mtima wanu uli wofooka ndipo sungathe kupopa magazi okwanira kuti ukwaniritse zosowa za thupi. Mankhwalawa amapangitsa kuti minofu ya mtima igwire mwamphamvu. Izi zimathandiza kuti kuchuluka kwa magazi omwe amapopedwa ndi mtima, kapena kutulutsa kwa mtima, kubwerere mwakale.
Izi zimatsimikizira kuti ziwalo zofunika kwambiri m'thupi lanu, monga ubongo ndi impso, zimalandira magazi ndi mpweya zomwe zimafunikira, zomwe zimawathandiza kupitiriza kugwira ntchito.
Ma ``Positive Inotropes`` amenewa nthawi zambiri amaperekedwa kwa odwala omwe ali m'zipinda zosamalira odwala kwambiri (ICUs) m'zipatala, omwe ali ndi matenda aakulu monga kulephera kwa mtima. Amaperekedwa kudzera mu mtsempha (IV).
Nanga chimachitika ndi chiyani ndi `Negative Inotropes`?
`Negative Inotropes` amachita zosiyana. Amauza minofu ya mtima kuti, "Musagwire ntchito molimbika, gwirani ntchito pang'onopang'ono, ndi mphamvu zochepa."
Izi ndi zothandiza kwa anthu omwe ali ndi matenda monga kuthamanga kwa magazi (`kuthamanga kwa magazi`), kupweteka pachifuwa (`angina`), ndi kugunda kwa mtima kosazolowereka (`arrhythmia`). Mankhwalawa amaletsa mtima kugwira ntchito molimbika kwambiri ndikuletsa zizindikiro zokhudzana ndi izi. Izi nthawi zambiri zimatengedwa ngati mapiritsi ndipo zimatengedwa kwa nthawi yayitali.
Mitundu ingapo ya `Inotropes` yomwe imagwiritsidwa ntchito kwambiri
Madokotala amagwiritsa ntchito mitundu yosiyanasiyana ya `Inotropes` kutengera momwe wodwalayo alili. Nazi zitsanzo zina.
| Ma Inotropes Abwino (omwe amalimbitsa kugunda kwa mtima) | Inotropes Yoipa (yomwe imachepetsa kugunda kwa mtima) |
|---|---|
| Dopamine | Verapamil |
| Dobutamine | Atenolol |
| Epinephrine (Adrenalin®) | Flecainide |
| Norepinephrine (Levophed®) | Clonidine |
| Digoxin (Lanoxin®) | Disopyramide |
Matenda omwe mankhwalawa amagwiritsidwa ntchito
`Positive Inotropes` ndi `Negative Inotropes` ndi mitundu iwiri ya mankhwala omwe amagwiritsidwa ntchito pazifukwa zosiyanasiyana.
Zochitika pamene ma Inotropes Abwino amagwiritsidwa ntchito:
- Kugwedezeka kwa mtima: Matenda omwe amaika moyo pachiswe chifukwa cha kulephera kwa mtima kupopa magazi.
- Kugwedezeka kwa Magazi: Kutsika kwa kuthamanga kwa magazi komwe kumachitika chifukwa cha kukhudzana kwakukulu ndi matenda m'thupi lonse.
- Kulephera kwa Mtima: Kufooka pang'onopang'ono kwa ntchito ya mtima.
- Pambuyo pa opaleshoni yotsegula mtima (`opaleshoni yotsegula mtima`).
- Pambuyo pa kuvulala kwakukulu kapena opaleshoni.
Nthawi yogwiritsira ntchito Negative Inotropes:
- Kuthamanga kwa magazi
- Angina (`Angina`):Kupweteka pachifuwa chifukwa cha magazi osakwanira kufika pamtima.
- Kusagwira bwino ntchito kwa mtima (`Arrhythmia`)
- Hypertrophic Cardiomyopathy: Matenda omwe amayamba chifukwa cha kukhuthala kwa minofu ya mtima.
Kodi zotsatirapo zake zingakhale zotani?
Monga mankhwala ena aliwonse, inotropes imatha kukhala ndi zotsatirapo zake. Izi zimasiyana malinga ndi wodwala aliyense komanso kutengera mtundu wa mankhwala omwe agwiritsidwa ntchito.
| Zotsatirapo za Inotropes Zabwino | Zotsatirapo za Inotropes Yoipa |
|---|---|
| Kusintha kwa kayendedwe ka mtima (`Arrhythmias`) | Chizungulire |
| Kugunda kwa mtima mwachangu (Tachycardia) | Kumva kufooka m'thupi |
| Kuthamanga kwa magazi kotsika kapena kokwera (Hypotension/Hypertension) | Mutu |
| Mutu ndi kusakhazikika | Kudzimbidwa |
| Kuchepa kwa magazi kupita ku minofu ya mtima (`Myocardial ischemia`) | Pakamwa pouma |
| (Chofunika) Kuwonjezeka kwa chiopsezo cha imfa pogwiritsa ntchito mankhwalawa kwa nthawi yayitali. | Kusanza ndi kusanza |
Ndikofunikira kukumbukira kuti ngakhale kuti `Positive Inotropes` ndi mankhwala opulumutsa moyo, ali ndi zoopsa akagwiritsidwa ntchito kwa nthawi yayitali. Ichi ndichifukwa chake madokotala amawagwiritsa ntchitoKwa nthawi yochepa kwambiri yofunikira, mu mlingo wochepa kwambiri.
Kodi muyenera kukaonananso ndi dokotala wanu liti?
Mukapita kunyumba mutalandira `Positive Inotropes` kuchipatala, dziwitsani dokotala wanu nthawi yomweyo ngati zizindikiro zanu zakale zibwerera kapena zikuipiraipira. Komanso, dziwitsani dokotala wanu ngati muli ndi zotsatirapo zoyipa chifukwa cha mankhwala atsopano omwe mudapatsidwa.
Ngati mwakhala mukugwiritsa ntchito mankhwala monga `Negative Inotropes` kwa nthawi yayitali, dziwani izi:
- Ngati simukupeza mpumulo wokwanira kuchokera ku mankhwala omwe mwapatsidwa kapena muli ndi zotsatirapo zoyipa , lankhulani ndi dokotala wanu.
- Musasiye kumwa mankhwala omwe mwapatsidwa pazifukwa zilizonse. Ndikofunikira kumwa mankhwala anu pa mlingo woyenera komanso panthawi yoyenera, ngakhale mutakhala bwino.
- Musamwe mavitamini, mankhwala azitsamba, kapena zowonjezera zina popanda upangiri wa dokotala wanu. Zingagwirizane ndi mankhwala omwe mukumwa panopa. Nthawi zonse kambiranani ndi dokotala wanu za zisankho zanu.
Uthenga Wopita Nawo Kunyumba
- `Inotropes` ndi mankhwala omwe amasintha mphamvu ya kugunda kwa mtima. `Inotropes Yabwino` imalimbitsa kugunda, pomwe `Inotropes Yoipa` imautonthoza.
- ``Positive Inotropes`` nthawi zambiri amagwiritsidwa ntchito m'zipatala zosamalira odwala kwambiri pazochitika zazikulu monga matenda a mtima ndi shock.
- Mankhwala a `Negative Inotropes` nthawi zambiri amaperekedwa ngati mapiritsi oletsa matenda a nthawi yayitali monga kuthamanga kwa magazi ndi kupweteka pachifuwa.
- Musasiye kumwa kapena kusintha mlingo wa mankhwala omwe dokotala wanu wakupatsani nokha.
- Ngati muli ndi nkhawa iliyonse yokhudza mankhwala omwe mukumwa kapena zotsatirapo zake, lankhulani momasuka ndi dokotala wanu.

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