Sodium nitroprusside: imiyalelo yokusebenzisa

Kukho iziyobisi ezininzi ezinempembelelo iqinile. Iziyobisi ukunciphisa uxinzelelo lwegazi, luqhele ukusetyenziswa ngendlela entsonkothileyo yaye ngokubanzi (amaxesha 1-2 yonke imihla). Ngoko ke baphathwe lwegazi. Kwezinye iimeko, ukusoloko amachiza ukunciphisa uxinzelelo lwegazi azisebenzi. Emva koko isicelo amayeza bomelele ezifana sisombululo 'sodium nitroprusside. " Le ichiza ayisetyenziswa ngokucwangcisiweyo yaye ngaphandle isidingo esikhulu. Asinto imithi oyikhethileyo ukunyanga lwegazi kunye nokusilela intliziyo ezigulo ezondeleyo. Oku kusetyenziswa kuphela kwiimeko zonxunguphalo, xa umzimba womntu akaphenduli kwezinye iziyobisi ukunciphisa uxinzelelo lwegazi (womchamo, ACE inhibitors). Isisombululo 'sodium nitroprusside "ayikwazi kulawulwa yedwa, ngaphandle kagqirha.

Xana ichiza ngayo umzimba?

Ukulungiselela "Sodium nitroprusside" (ifomula - C ₅ Fen ₆ Na ₂ O) libhekisela kwiqela vasodilators yoluvo. Uqulathe eyona iziyobisi umbala obomvu mnyama uhlobo ziikristale okanye powder. Kodwa amalungiselelo ayo exutywe ngamanzi kwaye asetyenziswe ngendlela engamanzi. Ngenxa yokuba kukho iqela nitroso, ukusetyenziswa kweziyobisi ibangela vasodilation kwi ekwakhiweni kwezi zinto. Oku kwenzeka ngolu hlobo lulandelayo: Le imichiza compound xa tapeworm iguqulelwa kwi-nitric oxide kwaye iyazingenela enzyme - cyclase guanylate. Esithe ngezo zisenze ukubunjwa cGMP okwakha ukuba yande nemithambo egudileyo kwezihlunu kwaye ibangela nokuphumla yayo. Ngako oko, le medicament "Sodium nitroprusside" inikezela ziphumo zilandelayo arterio venodilatiruyuschy iqinile. Ngesi umsebenzi olujikeleza iba ngcono ngokukhawuleza. Ukongeza, isisombululo isebenza ngokutsho uhlobo glycosides kwentliziyo, ngamanye kunciphisa imfuno ioksijini engabalulekanga. Le isiphumo kuphunyezwa ukuncipha phambi afterload.

Iimpawu medicament

Kufuneka siqonde ukuba ichiza lisetyenziswa kuphela kwiimeko ezingxamisekileyo lwezifo kakhulu kweelana ephilayo namanye amaqela imithi. Iimpawu zokusetyenziswa ichiza ekuthiwa:

1. senhliziyo olunamandla. Ingakumbi esinayo engqondweni uphuhliso nokudumba yemiphunga (asthma intliziyo). Ichiza ngokukhawuleza kuthintela le likarhulumente, akukho ifuthe womchamo.
2. ukusilela intliziyo Chronic, kakhulu. Yinkalo yokugqibela ukusilela kwentliziyo ezingapheliyo (2b, 3) azisoloko ukuphendula unyango. Ngoko ke, xa ukumelana nezinye iziyobisi kunye nemeko ukwenzelwa isigulana amisele vasodilators peripheral.
3. syndrome Acute ivaleke. Kwezinye iimeko, beziyobisi isetyenziswa iposi engabalulekanga, ukunciphisa uxinzelelo kwi imithambo yegazi yentliziyo, kwakunye ukuphepha uphuhliso umothuko cardiogenic.
4. Amalahle kunyango yemveli lwegazi. Vasodilators zingasetyenziswa pheochromocytoma, ubunzima paroxysmal, kwakunye nokuphuhliswa ingxaki enkulu ebangelwa kukunyuka okukhwankqisayo kuxinzelelo lwegazi (stroke, ukuphazamiseka psychogenic, isifo sentliziyo).
5. ubuthi yiergot. Esi sityalo vasospasm elibukhali, nto leyo buthathaka nge medicament "sodium nitroprusside." Imiyalelo ukusetyenziswa ezifakelwa mqulu kufuneka ziqondwe kakuhle ngoogqirha "ambulensi" yokurhaxwa.

Izimo side effects

Ichiza kufuneka ingasetyenziswa xa ukopha stroke, kwakunye emva kwayo. Oku contraindicated kubantu abanengxaki isifo sezintso ezingapheliyo kunye hypothyroidism. ngayo kwakhona akukhuthazwa ukuba abantu noxinzelelo intracranial. Ukusetyenziswa iyeza esalelweyo abantwana, abasetyhini abakhulelweyo kunye nabantu ebudaleni. Enye contraindication yi arhente akaxoleli esebenzayo kunye nophuhliso negazi lakho.

Phakathi ziziphumo ebezingalindelekanga ezivela ekusetyenzisweni yokulungiselela "sodium nitroprusside" kukubonelela ukuhla elibukhali kwi uxinzelelo lwegazi (kulo mzekelo, kuyimfuneko ukuba ayeke ngoko nangoko administration), ukwanda izinga intliziyo, isiyezi, isicaphucaphu kunye ubuthathaka jikelele.

indlela ikhemikhali sodium nitroprusside

Ukongeza ekunikezeleni isiphumo kwezonyango ngeempahla sodium nitroprusside ezisetyenziswa ngayo imichiza. Ukuba kugalelwe umzimba ketone (acetone) kwaye ibekwe kwindawo obrak, ungabona utshintsho emangalisayo umbala ezimbaxa. Kuba utshintshwano ezinjalo usebenzisa zohlobo lwe-4. Xa ngamnye obekwe into enye kuphela - nitroprusside sodium, acetone, kwealkali, acetic acid. Kwimeko yokuqala sisombululo ngenxa wajika-orenji-obomvu umbala eliqaqambileyo. Okulandelayo, le ezimbaxa liyangxengwa nge-acetic acid. kwakhona Umbala zatshintsha, eli xesha ulwelo luba ebomvu okanye emfusa ngebala.

Ukulungiselela "Sodium nitroprusside": imiyalelo yokusebenzisa

Ukufaka ichiza, kuyimfuneko ukuba afumane ufikelelo efakwa. Ngoko nangoko phambi kokuqala nokuhlanganiswa iziyobisi, kufuneka exutywe-5% isisombululo iswekile. Ukulungiselela le njongo, 1 gutyana iziyobisi umntu isirinji exutywe kunye ml 5 ulwelo. Lo mxube yahlaliswa lesitofu igutyana nge-5% iswekile ukunyibilika kwakhona. Emva koko, achole idosi oyifunayo. It zokhahlamba ukusuka 0.3 ukuya 8 g nganye 1 kg ubunzima bomzimba. Nokuhlanganiswa sifakwa kwisixokelelwano. Kufuneka uqale idosi asezantsi ngokuthe ngcembe ndiyandise phantsi kolawulo iimpawu ezibalulekileyo (uxinzelelo lwegazi, izinga intliziyo, ukubetha kwentliziyo). Kuyimfuneko kwakhona ukucwangcisa i elamkelekileyo izinga ukumnika ilingana 2.5-3 mg / kg ngomzuzu 1. Oyidlayo kuxhomekeke kwixesha lolawulo iziyobisi. nokubandakanywa elide kufuneka esweni umgangatho medicament benqanda aqulethe kwi "Sodium nitroprusside". Imiyalelo zokusetyenziswa ichiza kufuneka ziqwalaselwe ngokucacileyo.

Intsebenziswano kunye namanye amachiza

Asazi singacebisi ukusetyenziswa kweziyobisi, kwakunye nezinye izinto umfutho, njengoko uphuhliso nematha kunokwenzeka. Nceda uqaphele ukuba ukusetyenziswa zokucwangcisa zomlomo kunciphisa ukusebenza ichiza. Xa kudityaniswe ichiza "Dobutamine" medicament iimpawu ezibalulekileyo isigulane kufuneka esweni ngononophelo (mhlawumbi kuncitshiswa uxinzelelo, ukuverha kwimikhumbi zemiphunga njengoko kwakunye yobungakanani intliziyo).