Papa Inoa o antiarrhythmic ai 'a me kā lākou Mea Maluna

Ua aneane pau loa nā mea maʻi i ka hoao ana cardiologist ala 'ole i kekahi a me kekahi mauʻano o arrhythmias. Currently, ka mea lāʻau lapaʻau ka hana e kaumaha ana i ka laulāʻano o antiarrhythmic konohiki. Ko lakou Mea Maluna a me nā 'ano kūkākūkā i loko o kēia' atikala.

ala o ka waiū

E hoʻonā i ectopic cardiac arrhythmias, antiarrhythmic konohiki i ia. Keʻano papa hana o ka hana o ia ai 'ua pahuna ma ka hana myocardial electrophysiological waiwai o aeee:

• Hoemi i ka mämä holo o ka hanaʻia, ma laila ka meheu o conduction o excitation.
• Ke emi ma ka excitability o ka myocardium.
• Hoemi i ka manawa o ka hoahanau refractory, kūpono ma ka hua'ōleloʻo o ka wā mawaena o ka halawai momentum hiki i contraction o ka naau.
• Elongation ka hoʻokō refractory i hala, i mea nui ka wā tachycardias, a no ke kāpaeʻana lāʻau ikiʻai wale i hoʻomaka ai ma hope oʻuʻuku manawa ma hope o ka kaʻoi loa ka ho'ēmiʻana.
• Nona iho ana o ka excitation e paipai 'ia ka homogenization, a ua ālai' ka kŰia o ka hou-komo ( «hou-kahi e komo ai").
• Inhibition o ectopic automatism keena i ua pili i ka palena manawa o ka wā o diastolic depolarization.
• Ke kāpaeʻana oko ao ma ka uku o ka excitation a me nā hoailona refractivity.
• Hoemiia cardiac pā lonoaʻili i ka uila hookuuia a me ka pilikia o ka ventricular fibrillation.

Mea Maluna o antiarrhythmic ai '

A pau i nā lāʻau i loko o kēia hui e māheleʻia i loko o eha papa. Eia hou, i ka papa mua ua maheleia hou ia i loko o ekolu subclasses. He Mea Maluna ua ma muli o ka nui o ka lāʻau ole i ka hiki o ka naau keena, e lawe mai i ka? Iecaianoaaiiie a me ka conduction o ka pou no lepa. Kekahi mau papa o antiarrhythmic ai 'i kā lākou? Ooia o ka waiū, no laila, i loko o nāʻano o nā arrhythmias lākou laulā e e okoa.

Ka mua papa ka loaʻa o ka hoʻokēʻai paʻakai Kanal blockers. IA papa nā mea ai 'like "quinidine" "Dizopiramid", "novokainamid", "Giluritmal". By IB subclass uhi "Piromekain", "tocainide", "Difenin" "Lidocaine", "aprindine", "Trimekain", "Mexiletine." Subclass IC ho okumu i na mea paahana, e like me "Etmozin", "Ritmonorm" ( "Propafenone"), "VFS" "Etatsizin", "Flecainide", "Indekainid", "Bonnekor", "Lorkainid".

Ka lua o ka papa ninoieo o Hoʻokolohua-blockers ( "metoprolol", "nadolol," "alprenolol," "Kordanum", "Propranolol", "acebutolol", "Pindolol", "Trazikor", "Esmolol").

Ke kolu o ka papa mai nā 'potasiuma Kanal blockers "bretylium tosylate", "Amiodarone", "Sotalol".

I ka ha o ka papa kikowaena kalipuna Kanal blockers lohi (e laʻa me, "Verapamil").

Papa Inoa o Anati-arrhythmic ai 'aʻole e pau i laila. Ai hoopakele mai no hoi cardiac glycosides, potasiuma koloriside, paʻakai triphosphate, makanekiuma sulufahate.

Ka lapaʻauʻia First Class

Paʻakai Kanal blockers hookeai haawi ua papani iho la i loko o ka halepaahao o ka paʻakai, i kumu retardation o ka hooholo ana o ka myocardium excitation ke kōā. Ma keia paʻapū rula no ka mea kokololio holo i loko o ka naʻau o pathological lepa, a me ka arrhythmia pilikia. E mākou noonoo i ka pae ana o antiarrhythmic ai 'o ia o ka papa mua.

Ka lapaʻauʻia Class IA

Antiarrhythmic ai 'ia i kauoha mai ai ma ka extrasystole (ventricular a me ka supraventricular) a e hoihoi sinus pāpana ma ka hihia o atrial fibrillation (atrial fibrillation). Eia hou kekahi, ka mea i hoʻohana 'e ole recurrent ho'āhewa wale.

"Procainamide" a me ka "quinidine" - ka hoʻokō antiarrhythmic ai 'me tachycardia. E hai aku mākouʻoe hou aku no ia.

"Quinidine"

Kēia ka lapaʻauʻia Ua hoʻohana 'ia ma ka hihia o paroxysmal supraventricular tachycardia, e like me ka paroxysms o atrial fibrillation e sinus pāpana. Loa pinepine, i ka lapaʻauʻia lawelawe i loko o ka palapala o ka papa.

Hoomake mai la i antiarrhythmic ai 'kākaʻikahi ka hana, akā, i ka wa e loaa ana "Quinidine" hikiʻaoʻao' ole e like me digestive haunaele (ka luaʻi, diarrhea), a me nā headaches. Eia kekahi, ua hiki ia i ka emi i loko o ke koko platelet pae, intracardiac conduction ka meheu o, hoemi myocardial contractility ka hoʻohana 'ana i ka lāʻau. Ka noho pilikia loaʻaoʻao hookoia - ka hooulu ana o ka ventricular tachycardia, he kūikawā palapala, a hiki i ulia ka make ana o ka hoʻomanawanui. I mea no ke aha la lapaʻau "quinidine" e halihaliia oia iwaho me wale i ka hooponopono ana o ECG, a ma lalo o ka hooponopono ana o ka hoʻomalu.

Ka lapaau Ua contraindicated ma intraventricular a me ka atrioventricular aeie, cardiac glycoside intoxication, thrombocytopenia, hypotension, congestive naʻau ole, hāpai keiki.

"Procainamide"

Kēia lāʻau i ka ia nāʻikepili no ka hoʻohana like "quinidine". Muli o kona kulana pinepine ka mea, ua hoakaka no ka mea o ke kokua ana o paroxysmal atrial fibrillation. I ka intravenous ka pahu kui "novokainamid" hikiʻoi ka ho'ēmiʻana i loko o ke koko, no laila hoi e pono e hoʻolauna i ke kākoʻo pāʻoihana ua lohi i kā mākou.

Mawaena o kaʻaoʻao waiwai maopopo nausea, ka luaʻi, loli i loko o ke koko, kāna hana o ka'emi'ōnaehana i loko o ka palapala o ka pōniuniu, headache, ma ka pohihihi keia hoopii, hilahila. Inā i ka hoʻohana ana i ka lāʻau a eia i, e hoʻomōhala lupus-e like maʻi pale (serozity, arthritis, kuni), microbial maʻiʻaʻai i ku una ha o ka lua, ai ukali ia e lohi hoola eha a me ulcers, a kahe ana ke koko nui aʻe ana. Eia hou kekahi, "novokainamid" hiki hoʻonāukiuki ka allergic naoh, ma keia hihia, e ia i ka hoailona mua o ka hanana o ke Muscle nawaliwali ma ka lawelawe ana i ka waiʻona.

Pili i ka lapaʻau 'ia kēia wā atrioventricular aeie, loaʻaʻa puʻuwai a me ka naau e hemahema, hypotension a me cardiogenic kŰia.

IB papa

Ia ai 'i iki ia ma luna o ka sinus wahi, atrioventricular pilina a me ka atrium, pela ineffective i loko o ka hihia o supraventricular arrhythmias. I hoonoho ia ma kaʻikepili antiarrhythmic ai 'me arrhythmia, paroxysmal tachycardia,' o ia hoʻi, no ka iapaau ana o ventricular arrhythmias. Ka mea, i kekahi hoʻohana e hana arrhythmias, a i triggered ma ka overdose o cardiac glycosides.

Papa Inoa o antiarrhythmic ai 'i loko o keia papa ka loa nui, akā,' o ia hoʻi "lidocaine" ua hoʻohana 'ia ka hapanui pinepine ana. Nō kāu, ka mea hoi i lawelawe intravenously i loko o hihia o loa ventricular arrhythmias ma 'ole. H. Ma myocardial infarction.

"Lidocaine" Ua hiki i ka loko i ka functioning o ka'emi oihana, a ua hoikeia mai pōniuniu, ke kāʻili 'ana, pilikia me ka olelo a me ka hihio kāna hana o ka ike paka i. Inā mākou e alakaʻi mai i ka lāʻau i loko o nā māhele kiʻekiʻe, e 'ūlōlohi i ka naau ana, ua hoʻemi cardiac contractility. Nō hoʻi, allergic reactions a pau, aolie e hana angioedema, urticaria, pruritus.

"Lidocaine" ua contraindicated ma atrioventricular aeie, maʻi sinus maʻi pale. Ka lapaʻauʻia ua i hōʻike ma ka hihia o ka loa supraventricular arrhythmias no ka mea, o ka mahuahua pilikia o atrial fibrillation.

papa IC

Ai 'o ia i kēia papa, hohola aku intracardiac conduction, pakahi aku la ia i loko o ka His-Purkinje kahua. Ka mea, i ikaika arrhythmogenic waiwai, no laila, e kā lākou hoʻohana mea i kaupalena '.

Papa Inoa o antiarrhythmic ai 'o keia ano, ua haawiia mai luna, akā, ua nui wale hoʻohana "Propafenone" ( "Ritmonorm"). Ua Ua hōʻike no supraventricular a me ka ventricular arrhythmias, ma ka Vol. H. Under SVC maʻi pale. No ka mea, aia no he pilikia o arrhythmogenic loa, pono e hoʻohana i ka lapaʻauʻia ma lalo o kauka hooponopono.

Ma waho aʻeo ia arrhythmia, keia k hiki i Holomua o ka naau a me ka hoʻokō 'ole' worsening o cardiac contractility. Mawaena o kaʻaoʻao waiwai hiki e kūlana kilakila mea hao ho'āʻoʻana i loko o ka waha, nausea a me ka luaʻi. Ua ua i hoʻokoe 'ia hopena maikaʻi' ole, e like me blurred hihio, loli i loko o ke koko hōʻike, pōniuniu, Kanikani'āʻula, kaumaha.

Hoʻokolohua-blockers

Ka wā kūpono i ka leo o ke aloha o ko mākou hopohopo'ōnaehana, no ka mea hoike, ma ka hihia o ka stress, hypertension, autonomic kāna hana, ischemia, i loko o ke koko, he mea nui o catecholamines, me adrenaline. Mau waiwai hana ma Hoʻokolohua-adrenergic receptors o ka myocardium e hiki aku ai i ka cardiac uila instability a me ka helehelena o arrhythmias.

Hoʻokolohua-blockers nuiʻole ka stimulation o receptors a hiki hoomalu iho i ke myocardium. Eia hou, e emi i ka excitability o na keena o ka conduction'ōnaehana, i hiki aku ai i ke kali hoʻi koʻu naʻau kui.

Laau o keia ano i hoʻohana 'ia i loko o ka iapaau ana o atrial koliliʻana a me ka atrial fibrillation no ka Kāohiʻana, a kokua o supraventricular arrhythmias. Eia hou, e kōkua i ka lanakila sinus tachycardia.

Noonoo ineffective antiarrhythmic ai 'no atrial fibrillation, me ke koe o ka hihia ma ka pathology ua kena ae la ma ka oi o ka hoʻolahaʻia catecholamines.

"Metoprolol" a me ka "Inderal" mea pinepine hoʻohana no ka iapaau ana o arrhythmias. Mau ai 'iʻaoʻao' ole e like me ka meheu o ka naau ana, ho'ēmi i myocardial contractility,ʻikea ka mea me atrioventricular aeie. Mau lapaʻauʻia ke kāhea anuʻaoʻao, a worsening ana iʻike ākea koko pele. Eia hou, na ai 'lakou aloha ia na ko mākou hopohopo'ōnaehana, ma o na la drowsiness, pōniuniu, kaumaha, iaiyoe hoʻopilikia. ka mea, hoʻololi 'ana i kekahi i loko o conductivity o na nā aʻalolo a me nāʻiʻo, a ua hoikeia mai ma ka luhi a me ka nawaliwali ka hoomaopopo ana.

Hoʻokolohua-blockers i pāpā mai ka hoʻohana 'ana i loko o cardiogenic kŰia, pulmonary edema, insulina e kaukaʻi mimikō, asthma. No hoi contraindications nei iluna atrioventricular aeie o ka lua o ka degere, sinus bradycardia.

Potasiuma Kanal blockers

Ka papa inoa o ka antiarrhythmic ai 'ma keia pae nō nā mea retarding uila keʻano o ka hanaʻana, a ilaila ka paleʻana potasiuma kaha ma cardiac keena. Ka loa kaulana o keia ano o ka lapaʻauʻia - "Amiodarone" ( "Kordaron"). I waena o nā mea a pau, e hana i ka M-holino- a me ka adrenergic receptors.

"Kordaron" ua hoʻohana 'ia no ka lapaau a me ka Kāohiʻana o ka ventricular, atrial a me supraventricular arrhythmias, naau pāpana haunaele ma ke kāʻei kua o SVC maʻi pale. Ke medicament Ua hoi lawelawe ma ka mea e pale ai i ke ola-na olelo hooweliweli e ventricular arrhythmias i loko o nā mea maʻi me ka huʻi myocardial. Eia hou, ka mea, ua hoʻohana 'ia e ho'ēmi i naau kōmi ma ikaika atrial fibrillation.

Inā 'oe ke hoʻohana i ke koʻi no kekahi manawa loihi e hoʻomōhala interstitial akemāmā fibrosis, loli o ka ili ano (i ka helehelena o ka poni hue). Ma kekahi mau hihia, headaches, hiamoe kāna hana, a me ka hoomanao hihio. ? Eaia "Amiodarone" e ia i ke kumu o ka sinus bradycardia, constipation, nausea a me ka luaʻi.

Mai i koi 'ia ka lapaʻauʻia ma ka loiloi mua bradycardia, QT prolongation, kue o intracardiac conduction, thyroid maʻi, arterial hypotension, hāpai keiki, asthma.

Kalipuna Kanal blockers lohi

Mau ai 'e lawe aku i ka laka kali kalipuna pono, hiki uhi pū i ka ectopic foci ma ka atria a me ka sinus wahi automaticity hoemiia. Ka papa inoa o ka antiarrhythmic ai 'ma keia pae nā "Verapamil," a ua häʻawi mai ai no ka Kāohiʻana, a kokua o paroxysmal supraventricular tachycardia, supraventricular arrhythmia Inc. "Verapamil" Ua ineffective i loko o ka hihia o ka ventricular arrhythmias.

ʻaoʻao waiwai ke loaʻa mai nā atrioventricular aeie, sinus bradycardia, hypotension, a ma kekahi mau hihia a pau - hoemiia ka contractile hiki ana o ka naau.

cardiac glycosides

Mea Maluna o antiarrhythmic ai 'makemake ole e piha me ka hoomanao ana i kēia mau kālā. O ua komo pū ai 'o ia me "Tselanid", "Korglikon", "Digitoxin", "Digoxin" a me kekahi poe e ae. I mai la lakou hoʻohana i ka Hoʻihoʻi' ia mai sinus pāpana, supraventricular tachycardia, ka ho'ēmiʻana o ventricular ana i loko o ka hihia o atrial fibrillation. I ka hoʻohana 'ana i cardiac glycosides ka mea, ua hiki i kanaka hoʻoponopono i kou kulana. Na hoailona o ka digitalis intoxication hoikeia aku ai e abdominal eha, nausea a me ka luaʻi, headaches, blurred hihiʻo, a me ka moe, kahe ana ke koko mai ka ihu.

Ua Ua papaia e pili mau antiarrhythmic ai 'i bradycardia maʻi pale ERW intracardiac blockade. Ua i hookohuia i loko o ka hihia o paroxysmal ventricular tachycardia.

me ka hui pu antiarrhythmics

Inā ectopic rhythms ma lapaʻau hana, i kekahi hui malu pu ana o ka ai 'i hoʻohana. Penei, "Quinidine" hiki ke hoʻohana 'ia ma ka huipūʻana me ka cardiac glycosides no ka hana maikaʻi koʻikoʻi arrhythmia. Me ka Hoʻokolohua-blockers "quinidine" hiki ke hāʻawi no ka kokua o ka ventricular arrhythmias refractory i nā kūlana kanaka. I ka hui 'ana o ka Hoʻokolohua-blockers a me cardiac glycosides haawi i ka maikai ia i loko o ka ventricular a me ka supraventricular arrhythmias, e like me kōkua pale aku i ka recurrence o ectopic tachycardia a me ka tachyarrhythmia.