Mumwe munhu mumhuri yako, pamwe amai vako, baba vako, kana vanasekuru vako, angangodaro ari kutora mushonga wechirwere chemwoyo. Pakati pemishonga yakadaro, pane mhando yemishonga yagara ichishandiswa kwenguva yakareba uye inopa simba rakakosha kumoyo. Nhasi tichataura nezveboka remishonga inonzi Cardiac Glycosides. Kunyangwe zita racho richivhiringidza zvishoma, mashandiro aya uye chokwadi chatinofanira kuziva zvakakosha zvikuru.
Zvichitaurwa zviri nyore, chii chinonzi cardiac glycosides idzi?
Mishonga yemwoyo inonzi cardiac glycosides iboka remishonga inobatsira vanhu vane mamwe matambudziko emwoyo. Inogona kuuya muchimiro chemapiritsi, sirapu, kana makapisiri. Vanachiremba vanowanzo nyora mishonga iyi kuti inwe kamwe chete pazuva, panguva imwe chete zuva nezuva.
Zvinoshamisa kuti mhando iyi yemushonga yakatanga kuwanikwa kubva pamuti une maruva unonzi "Digitalis" kana kuti "foxglove." Ndosaka mimwe yemishonga iri muboka iri yakatumidzwa zita remuti iwoyo.
Mushonga uyu unoshanda sei mumuviri?
Pane zvimwe zvinhu zvesainzi zvinonzwisisika, asi ndichakutsanangurira zviri nyore.
Funga nezvemasero ari mutsandanyama dzemwoyo yedu semapombi madiki. Mukati memasero aya mune zvinhu zvinonzi sodium necalcium. Kuenzana kweizvi kwakakosha zvikuru kuti mwoyo urove zvakanaka.
1. Kudzora sodium: Paunotora mushonga we cardiac glycoside, unodzora kuburitswa kwe sodium mumasero emwoyo. Kutaura chokwadi, unomisa maitiro iwayo kwenguva yakati.
2. Kuwedzera kwecalcium: Kana huwandu hwesodium mukati memasero hukawedzera, huwandu hwecalcium mukati memasero hunowedzera otomatiki mukupindura.
3. Kusimbaradza kurova kwemoyo: Nekurova kwemoyo kwega kwega, calcium iyi yakawandisa inoburitswa. Izvi zvinoita kuti tsandanyama dzemwoyo dzibatane nesimba. Izvi zvinoreva kuti huwandu hweropa rinopombwa mumuviri nekurova kwega kwega (kwatinoti Stroke Volume mukurapa) hunowedzera.
4. Kushanda zvakanaka kwese: Kana huwandu hweropa rinopombwa kamwe chete hukawedzera, huwandu hweropa rinopombwa nemoyo (hunonzi cardiac output ) hunowedzera. Izvi zvinozorodza zvikuru munhu ane zvirwere zvakaita sekushaya simba kwemoyo.
Zvichitaurwa zviri nyore: mushonga uyu unoshanda ne "kuwedzera" kugona kwemoyo kupomba.
Pamusoro pezvo, mishonga iyi inoita chimwe chinhu chakakosha. Kune nzvimbo yakakosha apo zviratidzo zvemagetsi zvinodzora kufamba kwemoyo, zvinonzi Atrioventricular (AV) node . Mishonga iyi inogona kuderedza kumhanya kunofamba kwezviratidzo izvozvo. Izvi zvinoderedza kumhanya kwemoyo. Matambudziko emwoyo, akadai seAtrial FibrillationIzvi zvinobatsira zvikuru kuvanhu vane zvirwere zvakadaro.
Ndedzipi mhando dze cardiac glycosides uye ndedzipi dzinonyanya kushandiswa?
Kune mishonga yakati wandei iri muboka iri remishonga.
- Digoxin
- Digitalis
- Digitoxin
Pamishonga iyi, iyo iwe, ini, nevamwe vese takambonzwa nezvayo, uye iyo inonyanya kushandiswa muSri Lanka nepasi rose, iDigoxin . Tarisa uone kana zita iri riri pamishonga yako.
Ndiani anonyorerwa mishonga iyi? Sei isiriyo sarudzo yekutanga?
Maglycoside emwoyo anowanzo kunyorerwa zvirwere zviviri zvikuru.
1. Kukundikana kwemoyo: Chirwere chekuti moyo haugone kupomba ropa rakakwana mumuviri.
2. Kusashanda zvakanaka kwemoyo (Arrhythmias): Kunyanya kana kurova kwemoyo kuchiwedzera zvisingadzoreki, zvakaita seAtrial Fibrillation.
Asi heino pfungwa inokosha yatinofanira kuziva tese. Mazuva ano, Cardiac Glycosides haisiyo nzira yekutanga yekurapa nayo vanachiremba. Makore 20-30 apfuura, yaishandiswa zvakanyanya. Asi ikozvino, kune mishonga mitsva yakachengeteka, ine migumisiro mishoma, uye iripo.
Chiremba achatanga aedza mhando idzi dzemishonga:
- Beta-blockers
- Mishonga inodzivirira ACE
- Mishonga inoderedza mvura mumuviri (diuretics)
- MaARB
Kana mishonga iyi ikatadza kudzora chirwere ichi kana murwere aine mamwe matambudziko, chiremba ndiye achashandisa Cardiac Glycosides, kunyanya Digoxin, sedanho rechipiri kana rechitatu.
Izvi zvinoreva here kuti mushonga uyu hauna kunaka? Kwete, kwete zvachose. Mushonga uyu mushonga unokosha, unoponesa hupenyu hwevamwe varwere. Asi nekuda kwekuti une njodzi, vanachiremba vanoupa nekungwarira kukuru uye kune avo vanouda zvechokwadi chete.
Tinozivawo here njodzi nemigumisiro yadzo?
Kana tichitaura nezvemushonga uyu, chinhu chimwe chete chaunofanira kuziva nezvacho njodzi yacho. Pane musiyano mudiki pakati pemushonga unorapwa nemushonga une chepfu uripo. Izvi zvinoreva kuti kunyangwe ukatora mushonga wakawandisa pane unokurudzirwa, unogona kusangana nemigumisiro yakaipa.
Ndosaka chiremba wako achigara achiongorora ropa rako (serum digoxin level) kuti aone kana huwandu hwemishonga mumuviri wako huri padanho rakakodzera.
| Rudzi rwemhedzisiro yakaipa | Zviratidzo zvinogona kuonekwa |
|---|---|
| Migumisiro yakajairika |
|
| Zviratidzo zvakakomba zvekukuvadzwa nemishonga |
Ndapota cherechedzai: Kana potassium yako iri shoma, uri panjodzi huru yekukanganiswa nemishonga iyi. Saka, chiremba wako achagara achiongorora potassium yako.
Unofanira kuona chiremba nekukasika rini?
Kana uri kutora cardiac glycoside, kunyanya Digoxin, unofanira kuonana nachiremba wako nekukasika kana ukaona chimwe chezviratidzo zvinotevera. Kana zviratidzo zvacho zvakanyanya, enda kuEmergency Department (ETU) yechipatara chiri pedyo.
| Zviratidzo zvekuchenjerera | Chii chekuita? |
|---|---|
| Kuoma kufema | Tsvaga rubatsiro rwechiremba nekukasika. |
| Kuzvimba kwemakumbo kana makumbo | Udza chiremba. |
| Kushungurudzika kwakanyanya mudumbu, kuda kurutsa, kana manyoka | Tsvaga rubatsiro rwechiremba nekukasika. |
| Kuda kudya | Udza chiremba. |
| Kurova kwemoyo kunonoka kana kuti nekukurumidza zvisingawanzoitiki, kana kunzwa kwekusvetuka kurova | Tsvaga rubatsiro rwechiremba nekukasika. |
Zvinotora nguva yakareba sei kuti mushonga ushande?
Mushure mekutanga mushonga uyu, zvinogona kutora mavhiki akati wandei, kana mwedzi mumwe chete kana miviri, zviratidzo zvako zvisati zvatanga kuvandudzika. Saka shivirira uye ramba uchitora mushonga sezvaunoudzwa nachiremba wako.
Chinonyanya kukosha: Usamborega kutora mushonga uyu usina kubvunza chiremba wako, nekuti unofunga kuti uri kunzwa zviri nani. Zvakare, usatore mushonga unopfuura wakatarwa. Gara uchitaura nachiremba wako nezvekuti mushonga wacho uri kukubata sei.
Mharidzo Yekuenda Nayo Kumba
- Mishonga yemwoyo inonzi cardiac glycosides imhando yemishonga yagara ichishandiswa kwenguva yakareba kuwedzera kugona kwemoyo kupomba uye kudzora kurova kwemoyo.
- Kunyange zvazvo mishonga iyi isiri kushandiswa semishonga yekutanga nhasi, mushonga unokosha kune vamwe varwere.
- Sezvo musiyano uripo pakati pemushonga wakanyorwa nemushonga wacho nemushonga unokonzera migumisiro yakaipa uri mudiki, zvakakosha zvikuru kutora mushonga wacho sezvakarairwa nachiremba.
- Kana ukaona zviratidzo zvakaita sekusvotwa, kuchinja kwemaonero (kuona yero/girini), kana kusagadzikana kwemoyo, zivisa chiremba wako nekukasika.
- Usarega kutora mushonga kana kuchinja mwero wemushonga usina kupiwa mazano nachiremba chero chikonzero chipi zvacho. Zvakakosha zvikuru kuenda kukiriniki uye kuongororwa ropa nenguva.
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