Plawv glycosides. Yuav ua li cas yog nws?

Plawv glycosides zoo xws li nyob rau hauv cov tshuaj qauv rau cov kua tsib acids, cortisone, vitamins, cov tshuaj hormones, cholesterol. Cov tshuaj yog tej yam ntuj tso metabolites uas muaj lub cev tau hauj lwm ntawm lub plawv.

Plawv glycosides yog muaj li ntawm glucone (qab zib) thiab aglycone. Nws aglycone yog lub txiav txim ntawm cov tshuaj nyob rau hauv lub pharmacological kev ua si. Nkag mus rau hauv cov tshuaj tiv thaiv nrog rau lwm cov active tshuaj kom unsaturated tsib-membered nplhaib nyob rau hauv lawv cov qauv.

Plawv glycosides ntawm ntaub so ntswg thiab kabmob uas yuav faib unevenly. Target lawv ua - qhov myocardium, uas accumulates xwb 10% ntawm cov formulation, ib qho ntxiv 50% yog tsau nyob rau hauv lub striated nqaij qhov twg tsis ua kom muaj kev cov nyhuv.

Rau lub caij ntawm kev txiav txim ntawm mob glycosides raug muab faib mus rau hauv:

- ntev - digitoxin,

- nruab nrab - digoxin

- luv luv - strofantin, Korglikon.

Plawv glycosides: mechanism ntawm qhov kev txiav txim

Nyob rau hauv lub qub xeev nyob rau hauv cardiomyocytes muaj 30 lub sij hawm ntau poov tshuaj thiab 20 lub sij hawm tsawg sodium. Thaum so, cov txheej nto ntawm lub cell daim nyias nyias yog zoo them, thiab Internal - nyob rau tsis tooj, yog tsis zoo. Thaum excitation ua membrane depolarization: sodium thiab calcium nkag mus rau ntawm tes. Thaum lub sij hawm tus txheej txheem no, tus poov tshuaj yuav kis tsis tau los ntawm tus xovtooj ntawm membrane. Sai li sai tau raws li lawv tuaj tawm ntawm lub cell, repolarization txheej txheem yuav pib. Qhov no lub sij hawm ntawd tshwm sim ua ntej nqaij contraction. Yog li, tus nqi ntawm cov calcium muab in thiaj li tso txo hlwb. Poov tshuaj ions nyob hauv lub cell, yog antagonists ntawm tus txheej txheem.

Plawv glycosides hasten qhov pib ntawm repolarization thiab muab nyiaj pab ntau tshaj tawm los ntawm poov tshuaj cardiomyocytes. Tom qab txo yog tsim nyog los restore qhov nqi koj tshuav ntawm ions sab hauv thiab sab nraum lub cell (poov tshuaj thiab sodium rov qab tawm los). Qhov no tus txheej txheem yog nyob rau ntawm lub zog cia hlwb, kho hom haum xeeb los ntawm ATP-ASE enzyme. Nws active site - sulfhydryl pab pawg neeg. Plawv glycosides thaiv lub active site, txo cov kev ua. Tag nrho cov no ua rau yus lub fact tias sodium ions nyob twj ywm nyob rau hauv lub cell, thiab qhov no accelerates qhov pib ntawm lub tom ntej no depolarization. Yog hais tias cov ntsiab lus ntawm poov tshuaj ions yuav txo tau ho, lub synthesis ntawm creatine phosphate lawm, uas ua rau yus yuav txo tau nyob rau hauv hlab ntawm contraction ntawm mob mob.

Plawv glycosides: contraindications

Tsis contraindications rau lawv siv yog: atrioventricular thaiv II degree, qhov ntswg bradycardia, kev tsis haum tshuaj rau cov tshuaj no, qaug lawv.

Rau tus txheeb ze contraindications yog cov nram qab no: ciliary bradyarrhythmia, AV-thaiv kuv degree, muaj mob qhov ntswg syndrome, coronary mob plawv, qhov ntswg bradycardia, kub siab, lub plawv, hypercalcemia, hypokalemia, raum los yog pulmonary insufficiency keeb kwm.

Nws yog tsis tsim nyog rau siv mob glycosides raws li nram qab tej yam kev mob: mob amyloidosis, diastolic mob volume overload nrog aortic insufficiency, thyrotoxicosis, mob heart attack myocardial infarction, cardiomyopathy, constrictive pericarditis, txhaws lub plawv tsis ua hauj lwm thaum tswj siab mob tso zis, anemia thiab thiaj li nyob.

Ncaj qha rau lawv tus kheej contraindications vim lub tsis tuaj kawm ntawv ntawm systolic kawg, uas piav txog cov inefficiency ntawm lub mob glycosides. Thiab, piv txwv li, thaum lub sij hawm txoj kev loj hlob ntawm mob myocardial infarction, siv yuav ntxias txoj kev loj hlob ntawm arrhythmias, uas muab ib tug neeg txom nyem raug rau qhov ntxiv lub neej ntawm tus neeg mob.

Ua ntej daim ntawv thov ntawm mob glycosides yuav tsum tham nrog ib tug tshwj xeeb. Qhov no yuav pab tiv thaiv kom txhob loj hlob ntawm loj teeb meem.