"Ginipral": dhigooda. Maxaa bedeli kartaa "ginipral"?

Uurka - state gaar ah ee jirka dumar ah, taas oo u baahan aragti taxadir iyo u digtoon dhinaca caafimaadka. Marar badan, heerar kala duwan oo uur muuqan dabeecadda gobolka sax ah oo kala duwan, mid ka mid ah taas oo sii kordhaya midab ee ilmo-galeenka, ka cadhaysiinina kartaa shaqada risk. Si looga hortago cawaaqib aan loo baahnayn tirada qoray walxaha loogu talagalay nasashada ee myometrium ah. Qaar badan oo ah sida dhalmada ka dhigan tahay qorayaasha "ginipral" (kiniin).

analogues Its waxaa sidoo kale loo isticmaalaa ilaa xad inta badan, sababta oo ah daroogada kala duwan saamayn ku noolaha shakhsi - iyo sidoo kale caawisaa mid laga yaabaa in aan ku siin saamaynta ay ku doonay in dadka kale. Intaa waxaa dheer, daroogada this, inkastoo ay oggolyahay in ka hortaga dhalmada risk sare ayaa tiro ku filan badan oo sababo iyo waxyeelo, taasoo keenta bukaan qaar ka mid ah ka cabsadaan, iyo wax qabad si ay u aqbalaan. Si kastaba ha ahaatee, si ay u joojiyaan doorashada on daroogada ama inay go'aansadaan waxa lagu badalo "ginipral" talinaysaa dhakhtar gaar ah.

Description of diyaarinta

Drug "ginipral" waxaa la soo saaray qaab kiniin wareega biconvex cad, mid kasta oo ka kooban 500 mg hexoprenaline sulfate, foomka of xal maamulka xididka at dose of 5 mg halkii 1 ml ee dareeraha ah (10 mg ah ee firfircoon halkii 1 weel). Sidoo kale soo saari shancosbitaal ah xal loogu talagalay faleebo (25 ug sulfate hexoprenaline ka mid dhalada).

hab of action

Diyaarinta "ginipral" tallaabo waxaa sabab u ah sifooyinka hexoprenaline sulfate, waa in loo gudbiyaa ka xushay beta2-agonister, waxaa loola jeedaa walxaha in la yareeyo dhaqdhaqaaqa midab iyo contractile murqaha ilmo galeenka (myometrium), i.e. ka caawisaa si looga hortago in shaqada dhicis ah.

Marka ay maamusho, gaar ahaan faleebo, si degdeg ah u keena hoos u dhac qarsan ee sii kordhaya ee ilmo-galeenka, taas oo ka caawisaa si loo yareeyo inta jeer iyo xoojinta muruqyada, makaanka, Iscelin of lama filaan ah ama ka xanaajisay by magacaabista oxytocin foosha. Marka loo isticmaalo in mudo ah shaqada ka caawisaa si caadi aad u xoog badan ama aan joogto ahayn foosha. Joojinta hawl contractile makaanka dhicis ah oo u ogolaanaya qof dumar ah uur u sheeg in aan fiicnayn for ah ee kama dambeyska ilmaha.

Waxa intaa dheer in saameynta gaarka ah ee daroogada ayaa qaar ka mid ah saamaynta on gobolka dhaqdhaqaaqa wadnaha iyo socodka dhiigga ee hooyada iyo ilmaha caloosha ku labadaba, taas oo waa in la tixgeliyaa in ballanta.

maragga

Tan iyo medicament ee sababa nasashada ee muruqyada makaanka, yaraynta soo noqnoqoshada iyo xoojinta of foosha, ka hortagga siidaynta afka ilmo-galeenka, isticmaalka "ginipral" sabab goan in ay tallaabo this.

The daroogada la maamulo ee xalka ah ee dhacdo of degdeg ah, waayo degdeg ah xakamaynta of foosha:

• haddii ay dhacdo xilliga dhalmada qabatin uurjiifka intrauterine ba'an;
• ka hor inta wareeg ee ay gacanta ku booska lateral ilmaha;
• qorniin la duubo oo ah xudunta;
• ee foosha iyo dhalmada adag;
• in aad isku dejiso ilmo galeenka ka hor inta caesarean section;
• shaqada dhicis ah, waayo, Iscelin of foosha in uurka ka hor inta isbitaalka diraya.

daroogada xididka "ginipral" waxaa sidoo kale loo isticmaalaa:

• halis ugu foosha shaqada risk;
• in aad isku dejiso murqaha ilmo galeenka lagu jiro khalkhalgelinta ee tolay qoorta iyada si looga hortago in siidaynta iyada dhicis;
• in la xakameeyo foosha ee uurka yar ama kaadida oo soo badata iyo dillaac ku saabsan asalka ah ee afka ilmo-galeenka ah ku ceebownaaye.

The isticmaalka "ginipral" markii sida tilmaamo u baahan karaan soo dhaweynta oo dhan dabcan ka mid ah daroogada taas oo ay u badan tahay in ay ugu danbeysay muddo dhowr bilood ah.

Kiniiniga qoray at halista qaadista dhalashada dhicis ah, inta badan sida in la sii wado daaweynta galiyey.

sababo

Isticmaalka daroogada waxaa la xidhiidha qaar ka mid ah waxyeelo halis ah, sidaa daraadeed waxa ay isticmaalaan oo keliya sida dhakhtar, iyada oo la tixgelinayo oo dhan sababo jira, mararka qaar khaas ah "ginipral" daroogada, kuwaas oo analogs iman yaabaa in xaalad gaar ah.

Ha qaadan daawada for tiro ka mid ah cudurada:

• thyrotoxicosis;
• tachyarrhythmia;
• mada ka daataan mitral ah, iyo stenosis aortic;
• myocarditis;
• cudurka halbowlaha wadnaha,
• hypertension,
• beerka daran iyo cudur kalyaha ah,
• gulukooma xagal-xidho,
• minka dhiig of kala duwan etiology, dhicis ah askartii ka mid ah mandheerta;
• horumarinta cudurka intrauterine;
• in bilaha ugu horreeya ee uurka,
• nuujinta (nuujinta);
• diidmo in daroogada (gaar ahaan neefta bronki ama dareen in sulfites taariikhda).

Joogitaanka liiska ciidamada contra mararka qaarkood si aad u hesho a "ginipral" daroogada bedelka, analoogga ah oo ma fududa in la qaado, sida ay leedahay saamayn gaar ah ku myometrium yahay, halkii muruqyada siman oo dhan guud ahaan.

codsiga nidaamka

Sida hore u soo sheegnay, qalab ah ee "ginipral" waxay u baahan tahay tilmaamo adag oo sax ah ee qiyaasta. Maamulka xididka waa suurad wacan in ay soo saaraan deegaanka isbitaalka la isticmaalayo Electricity si toos ah ama bambooyin galiyey xididka, tan iyo daaweynta daroogada ku lug hakiyo bixinta 5-10 daqiiqadood.

Haddii xaalad degdeg ahi, si ay u si degdeg ah ka joojin xal foosha waxaa loo isticmaalay at dose oo ah 10 micrograms (mid dhalada oo ay ku jiraan 2 ml of sheyga), la "ginipral" raacay by galiyey of daroogada. Faleebo lagu qoray hordhac ah oo aad u gaabis ah heer ah 0.3 g / min. Haddii uu qoraagu si tartiib ah hoos u dhac ah, makaanka dhaqdhaqaaqa, ee xal waxaa maamula muddo wakhti dheer (0.075 g / min).

Haddii saamaynta therapy sii this daaweynta lagu qaban karaa iyadoo la isticmaalayo kiniinka at dose oo ah 500 ug, taas oo ku talinaynaa cabba biyo fara badan, laakiin ma aha kafeega ama shaaha, taas oo kor u dhici karta in ay waxyeello ka soo gaartey ee daroogada. The daily dose waa 4-8 kaniini oo gogo 'halka qaadashada iyaga mid mid iyada ugu horeysay kiniin 3 h, ka dibna - ka dib markii 4-6 saacadood.

ganaaxyada

Joogitaanka of badan oo tiro ka mid ah kooxda saamaynta baahan socodka caafimaadka iyo xaalad ka mid ah bukaanka iyo ilmaha caloosha, gaar ahaan, baahida loo qabo in kormeeraha shaqada wadnaha iyo nidaamka. Waa la jecel yahay in qiyaas ah ECG daaweynta ka hor iyo inta lagu jiro waxaa.

Haddii bukaanka ayaa ah korodhka dareen in sida daroogada, waxaa la maamulo ee qaadasho yar, oo la doortay si adag shakhsi, iyada oo si joogto ah la socodka daaweynta dhakhtarka.

Haddii ay jirto tachycardia a fahmayaan iyo cadaadiska dhiigga hoose, la yareeyo qiyaasta. muujinta calaamadaha sida neefta oo ku qabata, xanuunka ee wadnaha, calaamadaha ischemia wadnaha, waxay ku lug leedahay la joojiyo si degdeg ah daroogada this. Si loo yareeyo ku raaca waxaa maamula in lagu daro "ginipral" daroogada "Verapamil", kaas oo loogu talagalay in lagu tirtiro saamaynta xun ee nidaamka wadnaha.

At heerarka sare ee sonkorta dhiigga, ay keento isticmaalka qalab this, waxaad u baahan tahay in si taxadar leh ula socdaan waxqabadka-shiid carbohydrate ee haweenka qaba cudurka macaanka.

Diyaarinta "ginipral" caawiyaa yareeyo wax soo saarka kaadida, sidaas darteed waxaa lagama maarmaan ah si ay u xusaan dhammaan isbeddellada lala xiriirin karo xadhiga ah ee dareeraha jidhka. Mararka qaarkood co-maamulka la corticosteroids may hogaanka si pulmonary oedema, sidaa darteed waxaa lagama maarmaan ah si ay u fuliyaan si joogto ah la socodka inta lagu guda jiro galiyey muddo, iyo sidoo kale mugga ah mudaa xalka.

waxyeellooyin

Marka la isticmaalayo a daroogada adag oo awood u raadeeyo oo dhan jirka, sida daroogada "ginipral" dhinaca saamaynta qasac dhacaan ka mid ah jirka nidaamka:

• saamayn xun ku ah nidaamka neerfaha dhexe iyo durugsan lagu gartaa madax xanuun, wareer, welwel, gariirka yar ee faraha;
• saamaynta on nidaamka wadnaha iyo waxay keeni kartaa tachycardia uur ah, hypotension (sida caadiga diastolic), inta badan ka yar waxaa laga yaabaa in xadgudub ka dhan ah laxanka (ventricular garaaca dhicis) ama si deg deg ah u gudbin kardialgiya ka dib markii la baabiiyo of daroogada,
• xanuunada dhifka ah ee marinka dheef shiidka muuqdo by lallabo, matag, Iscelin of motility xiidmaha ilaa fadhiidka dhamaystiran oo kooma cuntada;
• haddii uu jiro dareen in ay daroogada waxay keeni kartaa dareen diidmo oo xasaasiyadeed sida neefsashada oo dhib ah, bronchospasm, dhantaalan miyir in ay u badan tahay si ay u tagaan kooma, in bukaanka qaba neefta ama u nuglaan sulfites - ilaa shoog.

Intaa waxaa dheer, waxaa laga yaabaa in ay kor u dhidid, oliguria, iyo bararka dhacaan. Ilmaha dhashay inta badan la fiirsanayo hypoglycemia iyo aysiidh sumaysan.

badinta

In degdeg ah, dhicis dhalashada, ama in ay dhacdo waarta, makaanka hypertonus leeyihiin inay qoraan this daroogada ee waaweyn tiro, waxaa kartaa sababta xad-dhaaf ah oo ka mid ah ugu badnaan ogol yahay maalin kasta dose oo la xiriira xun cawaaqib.

By calaamadaha xad dhaafka ah waxaa ka mid ah: tachycardia calaamadeeyay in uurka (ilmaha caloosha ku sida ugub ah waa mid aad u dhif ah), arrhythmia, gariirka in faraha, madax deegaamaynta kala duwan, dhidid, walaaca, angina been ah, cadaadis dhiig oo hooseeya iyo neefta oo ku qabata. dhacdo ka mid ah calaamadahan waa eed la joojiyo analog daroogada "ginipral" taas oo aan ku siin kara sida sawirka daawayn.

Marka muujinta sida calaamadaha waa qoray walaxda ku Doodeen, taasoo fal sida aan la xushay beta-blockers in qasac si buuxda uga takhalusi lahaayeen hawlgeli oo ka mid ah daroogada.

dhexgalka la waxyaabaha kale ee daweynta

Joogitaanka naagta uurka leh cudur laga yaabaa in u baahan tahay daawo khasab ma aha had iyo jeer la jaan relaxant muruqa, sidaas darteed waxay noqon kartaa su'aasha ah: "? haddii la baabiiyo of daroogada aasaasiga ah suurtogal ma aha" "Waxa bedeli kara" ginipral

Muqaadaraadka soo bandhigista tallaabo atypical la ballan si wadajir ah xal ama kiniin "ginipral" waxaa ka mid ah:

• beta-blockers in wiiqi kara ama xataa takhalusi saameynta ay daroogada "ginipral";
• methylxanthines (lugu daro walaxda "Theophylline"), kobcinta ah waxtarkeeda,
• glucocorticosteroids, saamaynta isku darka kuwaas oo hoos u dhigi karaan xoogga raasamaal ee glycogen beerka;
• afka hypoglycemic wakiilada marka loo isticmaalo in lala this daroogada waa ka yar ku ool ah oo aad ku isticmaali ay ku daweyn saamayn;
• dhexgalka oo ka mid ah daroogada la wadnaha iyo bronchodilators may sii dari ay saamaynta iyo bixitaanka calaamadaha xad dhaafka ah,
• halothane iyo beta adrenostimulyatorov kororka inta jeer ee kooxda saamaynta on wadnaha iyo kale oo xubno ka ah wareegga dhiigga nidaamka;
• wada jir ergot, MAO, murugada tricyclic , iyo wakiilada ka kooban calcium iyo vitamin D, iyo sidoo kale digidrotahisterol iyo mineralocorticoids, gabi ahaanba leheyn daroogada "ginipral" la joojiyo oo ay dhacdo in tani ay tahay lagama maarmaan ah buuxda.

Tan iyo markii ay qayb firfircoon (hexoprenaline sulfate) waa aadka u firfircoon, ka dibna waxaa loo ogol yahay oo kaliya in ay nooc xal isotonic of chloride sodium iyo 5% dextrose (glucose).

Drug "ginipral": micne ah iyo analogues

Waxaa loola jeedaa a group of beta-agonister, qalab uu leeyahay tiro ka mid ah la mid ah tallaabo oo muujinaya dawooyinka:

• "Partusisten" - laga heli karaa sida a oo Nadiif ah xal loogu talagalay xididka maamulka iyo foomka kaniiniyada, tilmaamay ka hortagga of dhicis dhalashada oo kaliya in a isbitaalka.
• "Ritodrine" - inta badan loo isticmaalaa in neefta bronki iyo xaaladaha kale ee obstructive, laakiin waa awoodaan in ay nastaan oo muruqa ilmogaleenka.
• "Fenoterol" - waxay leedahay saameyn la mid ah, loo isticmaalo oo keliya ka yar kormeer caafimaad ee isbitaalka.
• "Salbupart" - waxa lagu qoray markii halista dhalashada dhicis ah la soo bandhigo si tartiib ah intravenously mudo ah 6-12 saacadood.

Sidoo kale hoos tallaabo makaanka midab ayaa ku magnesia wax in ku furid calcium channels, si wax ku ool waxay dejineysaa ku myometrium, bandhigeen badan ka yar dhinaca saamaynta.

daroogada kale oo bedeli kara "ginipral" daroogada - analog ah "indomethacin" xiriira inhibitors ee prostaglandin. Waa inay awoodaan inay si fiican loo yareeyo waa ohyahay camalkooda, makaanka korodhay, laakiin marka la isticmaalo ka dib markii wallaca ah 32 toddobaad sababay tiro aan yareyn oo saamayn halis ah loo kasin: caanuhu uurjiifka koriinkedu unugyada sanbabada keeni kartaa cagaarshow iyo enterocolitis.

Qaar ka mid ah dhalmada qoro si loo yareeyo midab of diyaarinta ilmo-galeenka "Nifedipine". Ma aha qalab gaar ah, kaas oo waxaa loo isticmaalaa in dumarka, ay baaxadda inta badan ku saabsan daaweynta wadnaha heley, laakiin iyada oo loo adeegsanayo waxay dejineysaa muruqyada siman, waxaa loo isticmaali karaa ka saarida kacsanaanta muruq-galeenka. Waxaa in la xuso in daroogada sababa ah hoos u dhac ku cadaadiska dhiigga, taas oo ka horjoogsadaa ay ballan uu bukaanka qaba hypotension.

Reviews

Dumar badan oo uur leh la ogaado in magacaabidda daroogada ogol yahay in meesha laga saaro midab kordhaysa oo ah ilmo-galeenka oo looga hortago dhacdo ee shaqada dhicis ah. Hooyooyinka helay "ginipral" daroogada ee muddada uurka, ma calaamadee wax saameyn xun ku ay aqbalo muddada-dheer ee ka dhasha. ballan badan oo maalkiisa ka caawiyay inay ku wargeliyaan ilmaha si ammaan ah markii uu ku dhashay ee dhammaan xubnaha iyo hababka ay u diyaariyaan nolol madaxbanaan. Qaar ka mid ah soo maray saamayn iftiin negative qaab gariirka ka mid ah farihiisa, madax xanuun, iyo kuwa kale, taasoo keentay in la baabiiyo si tartiib ah daroogada, sida aan la jir- tuuri kartaa. Transition in daroogada cusub waa in ay qaataan waqti qaar ka mid ah, inta lagu guda jiro kaas oo si tartiib ah loo yareeyo qiyaasta kiniiniyada "ginipral" waqti isku mid ah soo bandhigid daawo la door bidaayo. Inkastoo liiska dheer ee sababo iyo waxyeelo, intooda badan ayaa weli si wanaagsan ku hadla, annaga oo ogaaney saamayn nasashada ee daroogada on derbiga muruqa ah ee ilmo-galeenka, taas oo si gaar ah muhiim haddii ay dhacdo xaalad degdeg ah loo gaarsiiyo dhicis ah.

Sidaas darteed, isticmaalka "ginipral" waxaa la soo saaray si gaar ah uu dhakhtarka xaadirka ah ama loo isticmaalo isbitaalka ay dhacdo xaalad degdeg ah oo ku lug leh dhacdo ee shaqada dib u. Xaaladdan oo kale, dhammaan tilmaamaha iyo qaadashada talinayaa waa in si adag loo arkay si aanay u keeni muuqaalka kore ee waxyeellooyin. Marka la isticmaalayo daroogada this waa in si gaar ah u digtoon nabaad ugu yar ama baddalaan xaaladda in, haddii loo baahdo, si wakhtiga dhowreysa in ay ka jawaabaan xaalada ilaa baajiyay analoogga daroogada "ginipral" in laga yaabaa inay noqdaan ku haboon xaalad kasta. In kasta oo ay tahay in la ogaadaa oolnimada sare ee daroogada ee hypertonicity oo ka mid ah ilmo-galeenka oo awood u leh inay si deg deg ah loo xakameeyo hoos u myometrium ee shaqada risk.