Beta-blockers tshuaj daim ntawv teev, indications rau kev siv

Tshuaj muaj teeb meem loj kho los yog lug siv los ntawm cov kws tshwj xeeb. Lawv yog siv rau cov kev kho mob ntawm cov kab mob plawv, uas yog cov feem ntau heev nrog lwm pathologies. Cov kab mob no muaj feem ntau yuav ua rau tus tuag ntawm cov neeg mob. Tshuaj uas yuav tsum tau mus kho cov kab mob, yog beta-blockers. Sau cov tub kawm cov tshuaj, muaj raws ntawm 4 seem, thiab lawv kev faib yog hais hauv qab no.

Ib suam ntawm beta-blockers

Cov tshuaj qauv ntawm cov tshuaj chav kawm ntawv uas tsis yog niaj hnub thiab los ntawm cov kev soj ntsuam los yog cov ywj siab. Ntau npaum li cas ib qho tseem ceeb rau faib kev mus rau ib tug kev receptor thiab affinity rau nws. Lub siab dua cov tseem rau lub beta-1 receptors, lub tsawg tshwm sim los ntawm cov tshuaj. Nyob rau hauv no hais txog, daim ntawv teev cov beta-blocker tshuaj hais raws li rationally.

Tus thawj tiam ntawm cov khoom:

• uas tsis yog-xim beta-receptor 1 thiab hom 2, "Propranolol" thiab "Sotalol", "timolol" thiab "oxprenolol", "nadolol," "Penbutamol".

Qhov thib ob tiam:

• xim beta receptor hom 1, "bisoprolol" thiab "Metoprolol", "acebutolol" thiab "Atenolol", "Esmolol."

Peb tiam:

• Selective beta 1 blockers nrog ntxiv pharmacological zog: "Nebivolol" thiab "Betaksalol", "talinolol" thiab "celiprolol".
• Nelektivnye beta-1 thiab beta-2 blockers nrog ntxiv pharmacological zog: "Carvedilol" thiab "carteolol," "Labetalol" thiab "bucindolol".

Cov beta-blockers (saib daim ntawv teev cov tshuaj. Saum toj no) nyob rau hauv txawv lub sij hawm twb lub ntsiab pab pawg neeg ntawm cov tshuaj uas yuav muaj tau siv thiab yog tam sim no siv rau cov kab mob ntawm cov hlab ntsha thiab lub plawv. Muaj ntau ntawm lawv, feem ntau yog cov neeg sawv cev ntawm lub thib ob thiab thib peb tiam, yog siv niaj hnub no. Vim lawv pharmacological los tswj kom tswj lub plawv dhia thiab tuav ectopic atherosclerosis mus rau lub ventricles, los txo lub zaus ntawm angina sib cem ntawm angina.

Ntsiab rau kev faib

Lub earliest tshuaj yog mej zeej ntawm lub thawj tiam, uas yog, uas tsis yog-xim beta-blockers. Ib daim ntawv ntawm cov tshuaj thiab cov kev npaj yog muab saum toj no. Cov tshuaj uas muaj peev xwm ntawm thaiv cov hlab lub receptors ntawm lub 1st thiab 2nd hom, muab ob qho tib si kho teebmeem thiab sab, uas yog qhia bronchospasm. Vim hais tias lawv yog txhob nyob rau hauv cov neeg mob uas COPD, bronchial hawb pob. Qhov tseem ceeb tshaj ntawm cov thawj tiam tshuaj yog "Propranolol", "Sotalol", "timolol".

Ntawm cov neeg sawv cev ntawm lub thib ob tiam ntawm ib daim ntawv teev cov tshuaj beta-blockers, lub mechanism ntawm qhov kev txiav txim uas yog txuam nrog ib tug thawj thaiv cov hlab thawj hom receptors. Lawv tsiag ntawv los ntawm ib tug tsis muaj zog sib ze rau cov receptor hom 2, vim hais tias tsis tshua muaj ua rau bronchospasm nyob rau hauv cov neeg mob uas mob hawb pob thiab COPD. Qhov tseem ceeb tshaj kev npaj ntawm lub 2nd tiam yog "bisoprolol" thiab "Metoprolol", "Atenolol".

Qhov thib peb tiam ntawm beta-blockers

Cov neeg sawv cev ntawm peb tiam - yog qhov tseeb beta blockers. Daim ntawv teev cov tshuaj muaj xws li "Nebivolol", "carvedilol", "Labetalol", "bucindolol", "celiprolol" thiab lwm tus neeg (saib. Saum toj no). Qhov tseem ceeb tshaj los ntawm ib tug soj ntsuam taw tes ntawm view yog cov nram no: "Nebivolol" thiab "Carvedilol". Keeb kwm advantageously sim beta-1 receptors thiab nkoos qhov kev tso tawm ntawm TSIS MUAJ. Qhov no yog tshwm sim los ntawm cov expansion ntawm cov hlab ntsha thiab txo txoj kev pheej hmoo ntawm atherosclerotic plaques.

Nws yog ntseeg hais tias beta-blockers - tshuaj rau tawg thiab kab mob plawv, thaum "Nebivolol" - ib tug generic tshuaj uas yog zoo suited rau ob lub hom phiaj. Txawm li cas los, nws them yog me ntsis ntau tshaj li tus nqi ntawm lwm tus. Zoo li cov nyob rau hauv cov khoom, tiam sis me ntsis kim kim, nws yog tus "Carvedilol". Nws combines lub zog ntawm cov beta-1 thiab alpha-blocker uas pab txo cov zaus thiab quab yuam ntawm lub plawv lus, raws li tau zoo raws li rau kev nthuav cov periphery ntawm cov hlab ntsha.

Cov los tso cai rau koj los tswj mob plawv tsis ua hauj lwm thiab tawg. Thiab nyob rau hauv cov ntaub ntawv ntawm lub plawv tsis ua hauj lwm, "Carvedilol" - cov tshuaj uas koj xaiv, vim hais tias nws tseem yog ib tug antioxidant. Vim hais tias lub cuab tam tsis pub aggravation ntawm atherosclerotic plaques.

Indications tshuaj pab pawg neeg

Tag nrho cov indications rau kev siv ntawm beta-blockers nyob ntawm seb cov kev thaj chaw ntawm cov tshuaj pab pawg neeg. Nyob rau hauv uas tsis yog-xim blockers indications yog nqaim, whereas xim kev ruaj ntseg thiab yuav tau mus thov ntau lug. Nyob rau hauv dav dav, lub indications yog ntau, txawm hais tias lawv raug txwv los ntawm cov impossibility ntawm cov kev siv ntawm cov tshuaj nyob rau hauv ib co neeg mob. Rau uas tsis yog-xim cov tshuaj nram qab no indications:

• myocardial infarction nyob rau hauv tag nrho cov sij hawm, angina, so, tsis ruaj tsis khov angina ;
• Atrial fibrillation normoforma thiab tahiforma;
• qhov ntswg tachyarrhythmia nrog nqa nrog los yog tsis muaj nws ventricles;
• lub plawv tsis ua hauj lwm (mob);
• tawg ;
• hyperthyroidism, hyperthyroidism, los yog tsis muaj ib tug teebmeem ntawm nws;
• pheochromocytoma los ntawm ib tug muaj kev ntxhov ntawm yooj yim txoj kev kho los yog kab mob preoperatively;
• migraine;
• Dissecting aortic aneurysm;
• tshuaj yeeb los yog dej caw ntsoos ntsoos syndrome.

Vim rau kev ruaj ntseg ntawm ntau pawg neeg ntawm cov tshuaj, tshwj xeeb tshaj yog thib ob thiab thib peb tiam, daim ntawv teev cov tshuaj beta-blockers, feem ntau tshwm nyob rau hauv cov ntaub ntawv ntawm cov kev kho mob ntawm lub plawv thiab leeg tshav kab mob. Raws li lub zaus ntawm daim ntawv thov, lawv yog yuav luag identical nrog ACE inhibitors, uas yog siv rau cov kev kho mob ntawm lub plawv tsis ua hauj lwm thiab tawg nrog metabolic syndrome thiab tsis tau nws. Ua ke nrog diuretics, cov ob pab neeg ntawm cov tshuaj peev xwm ua rau lub neej expectancy nyob rau hauv mob mob tsis ua hauj lwm.

Contraindications

Beta-blockers, raws li zoo li lwm yam tshuaj, muaj ib co contraindications. Thiab vim hais tias cov tshuaj ua rau receptors, lawv yog kev tshaj ACE inhibitors. General contraindications:

• mob hawb pob, COPD;
• bradyarrhythmia, muaj mob qhov ntswg syndrome;
• atrioventricular thaiv II degree;
• symptomatic hypotension;
• cev xeeb tub, me nyuam;
• decompensated lub plawv tsis ua hauj lwm - lub plawv tsis ua hauj lwm II B-III.

Tsis tas li ntawd ua raws li ib tug contra tsis haum cov tshuaj tiv thaiv nyob rau hauv cov lus teb rau txais blocker. Yog hais tias cov tshuaj tsis haum tshuaj muaj, cov kev hloov cov tshuaj mus rau lwm daws qhov teeb meem.

Los ntawm cov kev soj ntsuam kev siv ntawm cov tshuaj

Thaum angina tshuaj txo lub zaus ntawm angina tawm tsam thiab lawv lub dag lub zog, txo qhov yuav ua rau mob coronary txheej xwm. Nyob rau hauv CHF kev kho mob nrog beta-blockers nrog ACE inhibitors thiab diuretics ob nce lub neej expectancy. Cov tshuaj yog zoo nyob rau hauv kev tswj tachyarrhythmias thiab oppress heev ectopic yeej nyob rau hauv lub ventricle. Nyob rau hauv tag nrho, cov nyiaj los pab tswj tej tsos mob ntawm kab mob plawv.

Xaus hais txog tus beta-blockers

"Carvedilol" thiab "Nebivolol" - yog qhov zoo tshaj plaws beta-blockers. Daim ntawv teev cov tshuaj uas muaj preferential kev ua ntawm beta-receptors, complements daim ntawv teev cov ntsiab therapeutically tseem ceeb tshuaj. Vim hais tias nyob rau hauv kev soj ntsuam xyaum yuav tsum tau siv los ntawm lub thib peb tiam, namely "Carvedilol" los yog "Nebivolol" los yog feem ntau xim rau cov beta-1 receptor tshuaj, "bisoprolol", "metoprolol". Txawm niaj hnub no, lawv daim ntawv tso cai rau koj los tswj tawg thiab kho lub plawv tus kab mob.