"Pipecuronium bromide": mirayiridzo yekushandiswa

Mishonga inozorodza maronda emakumbo anoshandiswa zvakanyanya kwete mukuitisa matanho ekureba uye kwenguva yakareba, asiwo mukutambudzika kwechiitiko nechinangwa chekudzorera kana kubatanidza kushandiswa. "Piperkuroniya bromide" inoreva boka revanhu vanorwisana nehutachiona hwemagetsi uye vane nguva yakareba yekutora kusvika pamaminitsi makumi mashanu nemakumi manomwe, zvichienderana nemamiriro ehupenyu. Ngatimbokurukurai murayiridzo wekushandiswa kwemishonga iyi, pamwe chete nemamiriro ekushandiswa kwayo mune anesthesia practice.

Pharmacological character

Nzira yekuita kwechirwere ichi inosanganiswa nekuvhara kwema-synaptic transmission mu neuromuscular synapse. Nokuda kweizvi, kuitika kwechiito chinogona kuitika pamusana wechipfupa chemisumbu chinowanikwa, uye maererano naizvozvo, musero wesero rinorasikirwa nekwanisi yekubvumirana.

Nekutaridzirwa kwenguva yakareba kumushonga "Piperkuroniya bromide" skeletal muscle relaxes. Tichifunga kuti nicotinic cholinoreceptors haisi chete munzvimbo yekubatana neyeiyo yakagadzirisa mashesi e- somatic nervous system ne muscular cells ye skeletal musculature, asiwo mu ganglia yehutachiona hwehutongi hwekuzvidzivirira, pamwe nekuiswa kwemahombekombe makuru emishonga, iyo inenge isina simba yekuvhara ropa inokonzerwa. Izvi zvinokonzerwa nokuguma kwehutano hwemagetsi hunokonzerwa nehutachiona hwemashupiti emapurusi, izvo zvinoita kuti kuderedzwa kwezvose zvinonzwira tsitsi uye zvinokonzera zvinetso.

Zviratidzo zvekushandiswa

Kugadzirira "Piperkuroniya bromid" inoratidzwa nokuda kwekuzorora kwemafupa emakumbo munguva yekuvhiya. Mishonga iyi inoshanda kuburikidza nehutu hwemutsotsi nokuda kwechinangwa chokuputika kwemhepo.

Contraindications

Sezvo murayiridzo wekugadzirira "Pipercuronium bromide" inoratidza, mushonga wacho unopesana zvachose muhupo hwe hypersensitivity, pamwe chete nekuvapo kwe myasthenia gravis (chirwere chisingawanzi, chinogadziriswa, chinosanganisira kukanganisa kushamwaridzana mu-neuromuscular synapse uye kukura kwehutonda husina simba).

Mushonga wacho unopesana kuti unoshandiswa nevarwere mumatangi ekutanga ekudzivirira. Mune zvikamu zvekare, kushandiswa kwechirwere kunogona kuitika, sezvo inopinda zvisingakoshi kuburikidza nechepental barrier.

Migumisiro Yechiri

Iyo mishonga inokwanisa kukanganisa hutachiona hwehurumende, hunokonzera hyperesthesia.

Kubva kune rumwe rutivi rwehutano hwemwoyo, migumisiro yakaipa inokonzerwa nekudzivirira kutapurirwa mumasikirini echolinergic. Zvinokwanisika kuderedza kushamiswa kwemwoyo, kuderedzwa kweropa, kuderedza ischemic kumamotokari, kushungurudzika kwepfungwa kunobatanidzwa nekuderera kwekupera.

Pakaiswa pachena kumhepo yekufema kunogona kudzvinyirirwa kwebasa rekufema, kuonekwa kweDyspnea kana apnea (kunyanya panguva yekutevedza kwechirwere).

Chirwere ichi chinokanganisa metabolism uye inokwanisa kukonzera kukwira muzinga re potassium muropa, kuwedzera huwandu hwekusika kwekusika uye kukonesa plasma glucose level.

Piperkuroniya bromide - mirayiridzo yekushandiswa

Mushonga unoshandiswa chete pasi pekutarisa kweyanyanzvi. Pamberi pekuiswa kwechirwere ichi, zvakakosha kusimbisa kuvapo kwea anticholinesterase agents ("Neostegmina" kana "Pyridostigmine") kana holinoblokatorov ("Atropina").

Mushure mekunyengedza, kuongororwa kwehurwere kunogara kuchiitwa nguva yose yekuzorora mushure mokunge anesthesia uye musati mutezo wemutsetse utau hwemavara huripo.

Muyero wemishonga inoshandiswa inoitwa maererano nekuongorora kwakakwana kwemurwere uye kuongororwa kwemashoko e laboratory ekuongorora. Kana paine kushayikwa kwebasa rekutsvaira kwetsvo, kushanda kwechiropa kusimba, kuneta, chido chechirwere chinofanira kuderedzwa.

Mhinduro yacho yakagadzirirwa pakarepo kusati kwasvika kugadzirira "Pipecuronium bromide". Chimiro chechirwere chacho chinoputika neupfu lyophilized ine 0.004 g yezvinhu zvinoshanda.

Kune varwere vane simba rakaremara electrolyte reyero kana ropa-base-balance, kuchinjwa kwechirwere kunodiwa zvakare. Kupera kwekutanga kwemaawa ekuisa ropa muropa remvura, supercooling uye kushandiswa kwemwoyo glycosides (panguva yekuenzanisa) kunogona kupedzera nguva yechirwere. Muchiitiko chekuita mushure mekuzorora muboka rakadaro revarwere, zvinokosha kutanga kutanga kuisa mararamiro e electrolyte eropa, ezvo zvinozoita mushure mutsva. Kana varwere vane mwoyo usingakundiki, vachidzivirira kupararira kweropa, nguva yakaderera yekuita kwechirwere ichi inogona kuwedzerwa (nguva iri pakati pehutungamiri uye kutanga kwechiitiko ichiwedzera).

Zvinokwanisika kushandisa chirwere ichi muvana kubva pagore rimwe. Muchiitiko ichi, chinofanira kuyeukwa kuti muviri wevana hauna kunyanya kugadzikana nemigumisiro yemisumbu inononoka, uye nenzira yakafanira, kuti iite zvinodiwa, chiitiko chechirwere chinofanira kuwedzerwa.

Kusunungurwa kwemishonga yemiti

Kupa gadziriro yekugadzirira "Piperkuroniya bromide" kamukira muLatini haikwanise kutarisirwa nachiremba. Chirongwa chekurapa chinogamuchira zvinhu zvakanyanyisa kubva pane chinyorwa A chete pazvinodzingwa uye pamamiriro ehurumende. Mune imwe nyaya yakasiyana, kamukira inogona kunyorwa nemumwe nyanzvi achishandisa "chidimbu" fomu, asi kwete yose mitambo yezvipatara ine kodzero yekutengesa zvinyorwa uye zvine simba zvinhu, kusanganisira misidha yekuzorodza, ku "Pipecuronium bromide".

Mazita ekutengeserana

Mune mishonga yemishonga, mushonga unowanikwa pasi pemazita ekutengeserana akadai saArduan, Vero-pipecuronium, Aperamid, Piperecuronium Bromide. Zita rezvokutengeserana remishonga rinoenderana nemuiti anopa mishonga kumusika wemishonga.

Overdose

Kuwedzerwa kwehuwandu hwemishonga uye kuderedza kushanda kunokwanisika nekuda kwekuiswa kwe anticholinesterase madhiragi. Iyi mishonga inobatsira kuwedzera muyananisi wekugadzirisa acetylcholine, uye nokudaro anokwikwidzana nemisungo inononoka kune nzvimbo dzinosungirirwa panzvimbo yekugamuchira.

Uyewo, maitiro ekurapa pamusana pekudarika kwepamusoro inotarisirwa kuwedzera kuwedzera kweropa, kuchengetedza mabasa anokosha emuviri, kusanganisira kuburikidza nemhepo inowanikwa mumhepo.

Kubatana Kwemishonga

Mushonga wacho haufaniri kusanganiswa nehutano hwakasiyana-siyana, kunze kwe isotonic mhinduro dze sodium chloride uye dextrose. Kubudirira kwemigumisiro yemishonga inononoka pasi, chirwere chinoshanda chekurapa chinowedzera nehutano hwekugadzirisa hutachiona hwemukati muhutano .

Nekubatanidza kushandiswa kwemisumbu inononoka nevanorgetic narcotic, kudzvinyirirwa kwepamuviri yepumusoro nekuvandudzwa kwepnea kunogoneka.

Kushandiswa kwechirwere nemisumbu yekuzorodza kwechirwere chekuchera ropa chinogona kusimbisa uye kuderedza simba rose rekusununguka. Izvi zvinokonzerwa neyero yezvinodhaka, nguva yekutungamirirwa uye mumwe munhu anonzwisisa kumishonga.

Mhedziso

Kuita misi miviri yekuzorodza panguva yekuvhiya kwepurojekiti chikamu chinokosha cheinesthesia yakaoma. Kugadzirira "Piperkuroniya bromide" inoshandiswa zvinobudirira mukurapa nokuda kwezvinangwa izvi.

Inofanira kurangarirwa kuti kushandiswa kwechirwere hakusi kungokonzera kuzvidzora kwemafupa musana anozvipira kuenderera mberi, asiwo kunokonzera kuparara kwemapfupa ekufema. Zvichipa izvi, mishonga inoshandiswa chete mumamiriro ezvinhu ekuvhiya nekudzorera madhipatimendi.