Prokinetics - yog dab tsi? ib tug tshiab tiam ntawm prokinetics: daim ntawv teev

Prokinetics - yog dab tsi? Nyob rau hauv lub CIS lub teb chaws, muaj yog tsis muaj kev pom zoo hais txog dab tsi tshuaj no muaj nyob rau hauv pab pawg neeg no, yog li txhua txhua gastroenterologist nws tus kheej txiav txim tias coj nyob rau hauv daim ntawv no, thiab yog dab tsi tsis. Prokinetics - yog dab tsi? Hais tias yog dab tsi peb yuav ua tiag kom paub.

Lus Txhais thiab ib nyuag piav qhia

Prokinetics - yog dab tsi? Qhov no pab pawg neeg ntawm cov tshuaj uas tsim kho lub kom ntawm lub digestive raj thiab tiv thaiv anastaltic tsis.

Hnyuv kab mob yog feem ntau nrog reflux ntawm chyme los ntawm lub qis qhov chaw hauv lub plab hnyuv raj nyob rau hauv overlying, ua txhaum zaj bolus los yog ib tug stagnation nyob rau hauv cov hnyuv ya. Tag nrho cov ntawm cov tsos mob no yog txuam nrog rau lus zoo nce qib chyme los ntawm lub digestive raj, ces tshem tawm cov tsos mob yuav ua tau, rau cov contraction ntawm du leeg nyob rau hauv nws cov phab ntsa. Hais tias yog dab tsi prokinetics. Lawv kho nyhuv yog vim thaiv cov hlab ntawm ion hloov lwm lub tsev mechanism (dopamine, 5-HT4 receptors, neej) los yog cawv rau cov metabolism hauv acetylcholine. Tau raws li kev soj ntsuam cov nyhuv yog vim lub zog npaum li cas ntawm acetylcholine nyob rau hauv lub synaptic cleft los yog lub amplification ntawm cholinesterase khoom uas yuav pab tau lub decomposition ntawm ach, yuav txo tau cov khoom ach paj txoj.

Physiologically los ntawm cov tshuaj yuav tshwm sim los ua kom mob esophageal sphincter laus, khiav tawm ntawm lub plab txheem, lub sib haum ntawm lub antrum thiab lub duodenum, tsim hnyuv peristalsis.

Cov thawj pab pawg neeg ntawm cov tshuaj

Prokinetics - tshuaj uas thaiv dopamine D2-receptors, li no stimulating nqaij ua si thiab muab hnyuv fibers antiemetic nyhuv. Cov tshuaj muaj xws li: "metoclopramide" (thawj tiam neeg sawv cev - "Reglan" thiab "Raglan"), "bromopride", "Domperidone" (thib ob tiam), "Dimetpramid", "Itopride".

Prokinetic tshuaj, siv nyob rau hauv cov kev kho mob ntawm gastroezofagialnoreflyuksnoy kab mob (GERD), YAZHDPK, dyspepsia, tej cim, narrowing ntawm cov hlab pas tom qab raug mob thiab raws li ib tug tshwm sim ntawm adhesions, postoperative paresis pab nyob rau hauv lub plab mog, disturbance ntawm outflow ntawm cov kua tsib, flatulence.

Tsis tas li ntawd prokinetics - tshuaj uas yuav siv tau rau kev xeev siab thiab ntuav tshwm sim los ntawm lom los yog ua txhaum cov cai noj mov, cov kab mob ntawm tus kab mob los yog kab mob etiology, cev xeeb tub nyob rau hauv thawj peb lub hlis, mob coronary insufficiency, lub taub hau raug mob, tshuaj loog, tawg thiab cov kws khomob. Ices los ntawm ntuav vestibular keeb kwm, raws li nws tsis muaj feem xyuam rau hauv nruab nrab lub pob ntseg thiab lub medulla oblongata.

Antipsychotics pab nrog ntuav

"Sulpiride" thiab "Levosulpirid", yog ib tug neuroleptic nrog ib tug zoo xws li cov mechanism ntawm qhov kev txiav txim, lawv kuj muaj ib tug zoo anti-emetic nyhuv, yog li yuav siv tau nyob rau hauv gastroenterological xyaum.

"Metoclopramide" (prokinetics): cov lus qhia rau kev siv

"Metoclopramide" - ib tug ncaj qha stimulator ntawm tus nqaij thiab muaj tag nrho cov tsim nyog cov khoom mus cuag clinically tseem ceeb tau, tab sis vim hais tias ntawm lub permeability gematogistologicheskie tej yuav tsum tau siv nrog ceev faj. Tau phiv xws li spasm ntawm lub ntsej muag nqaij, cov tsos mob ntawm "tus uab lag tus taw", zoo protrusion ntawm tus nplaig, bulbar mob, chua ekrtraokulyarnyh nqaij, spasmodic torticollis, ntev li suab nrov ntawm lub extensor nqaij, Parkinson tus syndrome, somnolence, tsis muaj zog, tinnitus, mob taub hau, ntxhov siab vim, tsis meej pem.

Nyob rau hauv tej rooj plaub, ntshaw kom coj prokinetiki? Cov lus qhia rau kev siv ntawm hais tias undesirable siv nyob rau hauv tus neeg mob meem kev txhawj xeeb mus rau yeeb tshuaj, ib tug mob ntawm lub adrenal cortex, plab hnyuv rhuav txhua, perforation ntawm lub plob tsis so tswj thiab ua rau lawv los ntshav, prolaktinozavisimoy hlav, qaug dab peg thiab extrapyramidal mob, mus txog 16 lub lim piam ntawm tus me nyuam lub hnub, thaum lub sij hawm lactation, cov me nyuam nyob rau hauv 5 xyoos. Ceev faj yuav tsum tau muab rau ib lub txo clearance ntawm creatinine, nce ntshav siab, mob hawb pob, hnub nyoog mus txog rau 14 xyoo.

Nqos cov tshuaj ib nrab ib teev ua ntej ib pluas noj, rau ib ntsiav tshuaj ntawm 9:00, 12:00, 15:00 thiab 18:00. Duration ntawm kev kho mob - plaub mus rau rau lub lim piam, tej zaum nws yuav raug ncua mus txog rau lub hlis.

Yog hais tias qhov kev tso tawm daim ntawv - kua, nws yog xeem intramuscularly los yog intravenously. Rau cov neeg laus thiab cov me nyuam 14 xyoo - 10 mg. Maximum ib ib lub sij hawm - 20 mg hnub koob tshuaj - 60 mg. Tus txheem ntawm lub ampoule yuav diluted nyob rau hauv isotonic saline los yog 5% zib tov.

"Domperidone": cov lus qhia rau kev siv

"Domperidone" yog ntau xim dopamine receptor blocker, dua li tsis txeem tau cov BBB, tiam sis thaum tus txais tos yog tsis tsim sab los piav saum toj no. Txawm li cas los, ua lub tso pa tawm ntawm prolactin, nws ua gynecomastia, galactorrhea, thiab hla ntawm menses. Nyob rau hauv tas li ntawd, cov neeg mob qhia txog ib tug cov tawv nqaij sawv pob, qhov ncauj qhuav, raws plab thiab mob taub hau.

Tsis pom zoo rau kev siv rau cov neeg uas muaj kev tsis haum tshuaj rau Cheebtsam ntawm cov tshuaj, los ntshav los ntawm tus mob huam, plab hnyuv rhuav txhua, prolactinoma, lactation, hnub nyoog txog 5 xyoos ntawm hnub nyoog los yog uas mus txog 20 kilograms. Ceev faj coj thaum lub sij hawm cev xeeb tub, lub raum thiab / los yog hepatic insufficiency.

Haus dej rau nees nkaum feeb ua ntej noj mov rau 10 mg, yog tias xav tau, thiab muaj peev xwm haus dej haus ua ntej yuav mus pw. Qhov siab tshaj plaws tshuaj ib hnub twg - 80 mg. Yog hais tias tam sim no nyob rau hauv cov kev kho mob ntawm antacids, kom txhob muaj cov pa ntawm pais plab kua txiv, lawv yuav tsum tau cais los ntawm lub haus domperidone, sib koom noj mov.

"Itopride": cov lus qhia rau kev siv

"Itopride" combines lub zog ntawm cov dopamine receptor antagonist thiab blocker ntawm acetylcholinesterase. Effect rau lub hypothalamic-pituitary-adrenal system, ua tsi ntsees ntawm somatostatin thiab txo adrenocorticotropic hormone. Ib tug tsis ntxim yog qhia raws li leukopenia, thrombocytopenia, npau taws me ntsis kev tshua, hyperprolactinemia, xeev siab, co, jaundice. Thaum lub sij hawm txais tos, nws yog tsim nyog los saib xyuas hauv lub xeev ntawm lub peripheral cov ntshav, thiab xyuas kom meej muaj tsis muaj kev phiv.

Tsis pom zoo rau cov neeg uas muaj hypersensitivity tam sim ntawd los yog ncua hom, hnyuv los ntshav keeb kwm, obturating lub plab hnyuv lumen los yog compression ntawm ib tug txawv teb chaws lub cev los ntawm tsis muaj, nyob rau hauv lub hnub nyoog ntawm kaum rau xyoo, cev xeeb tub, noj niam mis.

Cov tshuaj no yuav hais ua ntej noj mov rau 50 mg peb zaug ib hnub twg.

Antagonists "acetylcholine"

Qhov no pab pawg neeg no muaj xws li:

• "Aceclidine" (M-cholinomimetic);
• "Fiziostigmin" "Galantamine" "Tegaserod" "Prucalopride" (reversible cholinesterase inhibitor)

Cov tshuaj yuav mus rau tsuas yog cov tuam txhab ntawm prokinetics vim hais tias ntawm lawv cov sab los: teebmeem nyob rau cov kev pauv ntawm poov tshuaj ions, thiab raws li ib tug tshwm sim, lengthening QT luv, uas ua rau yus teeb ntawm mob atherosclerosis. Ib tug xov tooj ntawm yeeb tshuaj tau rho los ntawm cov pharmacological ua lag luam rau no yog vim li cas.

"Aceclidine": cov lus qhia rau kev siv

Prokinetics - dab tsi yog nws, yuav ua li cas thiab thaum twg siv lawv? Nyob rau hauv txhua rooj plaub, nco ntsoov sab laj ib tug kws kho mob thiab attentive txoj kev tshawb no ntawm cov lus qhia rau kev siv.

"Aceclidine" yog siv los tsis txhob poob ntawm suab nrov ntawm cov hnyuv thiab lub zais zis tom qab phais, thiaj li intraocular siab, muaj peev xwm li ntawd yuav tsum siv nyob rau hauv Ophthalmology. Khoom Form - txhaj tshuaj, txhaj subcutaneously nrog 2.1 ml ntawm ib tug 0.2% tshuaj. Max ntawm ib lub sij hawm - 0.004 g, nrog txhua hnub tsis muaj ntau tshaj li 0.012, lub sab los - ptyalism, tawm hws, thiab raws plab.

Contraindications rau kev siv yog CHD, txhawb HDL, bronchial hawb pob, thiab lwm yam hyperkinesias parkinsonism, cev xeeb tub, los ntshav ntawm lub plab kab noj hniav.

"Fiziostigmin" yog siv feem ntau nyob rau hauv ophthalmic xyaum, tab sis tej zaum kuj siv nyob rau hauv Gastroenterology ntawm lub plab hnyuv paresis. Cov tshuaj txhaj cov nyob hauv daim tawv nqaij ntawm 0.5 - 1 ml ntawm ib tug 0.1% tshuaj. Qhov siab tshaj plaws nqi ntawm cov tshuaj ib hnub twg yuav tsum tsis txhob ntau tshaj 0,001 g

Sab los yog ib tug strengthening ntawm salivation, bronchospasm, plab hnyuv spasm ntawm cov nqaij ntshiv, cov kev hloov nyob rau hauv lub plawv dhia, convulsions.

Contra-indications: angina, qaug dab peg, mob hawb pob, neeg kho tshuab cov hnyuv rhuav txhua, peritonitis, sepsis, cev xeeb tub.

"Galantamine": cov lus qhia rau kev siv

"Galantamine" nyob rau hauv particular mob yog siv raws li ib tug antagonist rau nqaij hnaiv nyob rau hauv lub postoperative lub sij hawm nrog ib tug txo nyob rau hauv cov nqaij suab nrov ntawm cov quav thiab zis. Contraindications rau kev siv yog npau taws me ntsis, qaug dab peg, mob hawb pob, ntshav siab saum toj no 139/99 mmHg, COPD, neeg kho tshuab occlusion ntawm lub plab hnyuv duct, raum muaj nuj nqi puas, muaj hnub nyoog 9 xyoos. Luag lub hom phiaj ntawm cev xeeb tub nyob rau hauv tus neeg mob qhov twg lub peev xwm harms outweigh cov kev pab cuam. Thaum lub sij hawm lactation, yuav kis tau mus rau tus me nyuam los ntawm cov mis nyuj.

Sab los: yuav txo tau ntawm lub plawv dhia, TTP, AV blockade, arrythmia, xeev siab, ntuav, raws plab, dyspepsia, nqaij chua, urinary incontinence, haematuria, co.

Nws kuj yuav raug muab subcutaneously, intramuscularly, intravenously, transdermally, hais lus. Cov koob tshuaj yog tom ib lub zuj zus, raws li nyob rau hauv lub keeb kwm ntawm tus kab mob, thiab yuav tsum tau kho los ntawm cov kws kho mob. Qhov nruab nrab txhua hnub koob tshuaj rau cov neeg laus - los ntawm 10 mus rau 40 mg, muab faib mus rau hauv ob mus rau plaub koob.

Ib tug tshiab tiam ntawm prokinetics

Nyob rau lub hauv paus ntawm niaj hnub no Itopride tsim tshuaj xws li "Ganaton", "Itomed", "Pramer". Ib tug ntawm cov newest thiab zoo tshaj plaws yog cov neeg prokinetiki tshiab tiam raws li "koordinaks" thiab "Prepulsid". Txawm tias lawv yuav ua kev phiv loj heev nyob rau hauv lub plawv.

Cov feem nrov ntawm cov gastroenterologists tseem "Motilium" (active ingredient - domperidone), uas combines qhov zoo tshaj ntawm metoclopramide, tab sis tsis muaj nws tsis zoo txim.

Yuav ua li cas yog qhov zoo tshaj pprokinetiki? Daim ntawv teev cov khoom tam sim no muaj xws li:

1. "Itopride" (active ingredient) - "Ganaton", "Itomed", "Primer" (coj mus muag npe).
2. "Metoclopramide" - "Raglan" "Reglan".
3. "Cisapride" - "koordinaks", "Prepulsid".
4. "Domperidone" - "Motilium", "Motilak", "Motinorm", "Passazhiks".

Peb tam sim no paub hais tias xws li ib tug prokinetic. Sau lawv raws li koj pom, nws yog heev loj. Tab sis nco ntsoov, ua ntej yuav siv tej tshuaj yuav tsum tham nrog koj tus kws kho mob! Nyob twj ywm noj qab nyob zoo!