Qalabka Calcium channel waa daroogo badan oo ah daawooyinka loo isticmaalo daaweynta dhibaatooyin wadnaha ah oo ay ku jiraan angina , hypertension , tachycardia supraventricular , iyo hypertrophic cardiomyopathy .
Guudmarka
Bloodyaaliyeyaasha kanaalka Calcium waxay ka hortagaan kalsiyumka iyagoo galaya unugyada muruqyada wadnaha, iyo unugyada murqaha ah oo dheellitiran oo keena xididdada dhiigga si loo xaddido.
Iyadoo la yareeynayo qulqulka calcium, xannibaadayaasha kalsiyum ayaa sababa unugyada muruqyada kuwaas oo "ku nasan." Saamaynta tani waxay ka dhalinaysaa kicinta xididdada dhiigga, iyo xooga hoos u dhaca murqaha muruqa wadnaha.
Qaar ka mid ah blockers channel-ka ayaa sidoo kale hoos u dhigaya noodhka sanka iyo qiyaasta korontada ee maqalka korontada ku dhex maraya AV node . Dhibaatooyinkaasi waxay ka dhigaan xaddiga calcium ee waxtar leh ee lagu daaweynayo xaaladaha qaarkood.
Dhamaan saameynta kalkaaliyeyaasha kalsiyumka (dhiigga xiidmaha, hoos u dhaca muruqyada wadnaha, iyo hoos udhaca wadnaha garaaca) yaree qiyaasta oksijiinta looga baahan yahay muruqa wadnaha.
Yareynta qiyaasta oksijiinta ee loo isticmaalo wadnaha ayaa u ogolaanaya wadnaha inuu ku shaqeeyo waqti dheer iyada oo aan laga helin ischemia , xitaa marka dhiiggu ka yimaado xididdada halbowlaha ah qayb ahaan ka xayiraan lakabka atherosclerotic . Bukaannada qaba angina xasillooni , dadka xannuunsan calcium badanaa waxay kordhiyaan xaddiga jimicsiga ee la samayn karo kahor intaan cudurka angina ku dhaco.
Xasaasiyeyaasha Calcium waxay si gaar ah ugu faa'iideysan karaan bukaanada qaba cudurka angina (Prenzmetal's angina) (oo loo yaqaan 'coronary artery spasm') sababtoo ah waxay si toos ah uga hortegi kartaa isdaba-marinta xididdada wadnaha.
Noocyada
Qaar badan oo ka mid ah xayawaanka calcium ayaa ku jira suuqyada, mana aha dhammaantoodba. Waxaa jira saddex nooc oo kala duwan oo loo isticmaalo kilyaha:
1) dihydropyradines .
Daawooyinka nifedipine (Procardia, Adalat), nicardipine (Cardene), felodipine (Plendil), iyo amlodipine (Norvasc), waxaa lagu magacaabaa dihydropyridines. Daroogooyinkaasi waxay keenaan cufnaan weyn oo ah xididdada dhiigga iyo saameyn aan yareyn oo ku dhaca muruqyada wadnaha iyo garaaca wadnaha. Waxay ka faa'iideystaan daaweynta dhiig-karka.
2) Verapamil. Verapamil (Calan, Covera, Isoptin, Verelan) ayaa saameeya murqaha wadnaha waxayna si gaar ah wax ku ool u tahay hoos u dhigista xaddiga garaaca wadnaha, laakiin saameyn yar ayuu ku leeyahay maraakiibta dhiigga. Maaha wax aad u faa'iido badan oo ku saabsan dhiig-karka, laakiin waa arrin u wanaagsan angina iyo arxan-wadnaha wadnaha.
3) Diltiazem. Diltiazem (Cardizem, Dilacor, Tiazac) ayaa saameyn ku leh muruqyada wadnaha iyo xididdada dhiigga. Waxay u egtahay in loo dulqaadan karo marka loo eego inta badan kalooriyeyaasha kale ee calcium
Isticmaalka
Daaweynta Angina
Dhammaan xannibaadeyaasha calcium ayaa loo isticmaalay daawaynta angina. Si kastaba ha ahaatee, kuwa ugu badan ee loo isticmaalo kalsiyumku waa noocyada dheeriga ah ee diltiazem iyo verapamil, amlodipine, ama felodipine.
Nifedipine, gaar ahaan foomamka gaaban, waa in guud ahaan looga fogaadaa bukaanka qaba angina, tan iyo inta la oofinayo dhiigga dhiigga ee lagu magacaabo daroogadaasi waxay kordhin kartaa adrenaline, taas oo horseedi karta garaaca wadnaha oo aad u deg-deg ah, taas oo keentay kororka shuruudaha oksijiinta wadnaha ( taas oo kordhin karta fursadaha lagu horumarinayo iskubaaxidda wadnaha).
Guud ahaan, halka dadka xaddidan calcium ay faa'iido u leeyihiin in la yareeyo angina, waxaa loo tixgeliyaa inay ka yaryihiin beta blockers . Talooyinka hadda jira waa:
- Calcium-blockers waa in lagu tijaabiyaa bukaanada aan u dulqaadan karin beta-blockers.
- Calcium-blockers waa in lagu daraa beta-blockers ee bukaanada leh calaamado aan ku filneyn calaamadaha beta-xirayaasha.
Isticmaalada kale ee Common
- Dhiirrigelin. Dadka dihydropyradine-ka ee kalsiyum-ka ayaa aad u faa'iido leh si loo daaweeyo dhiig-karka, waxaana badanaa loo adeegsadaa daaweynta xariiqa koowaad ee loogu talagalay Heerka I-da "hypertension". Akhri ku saabsan doorashada daawada saxda ah ee "hypertension".
- Arxan-darrado waaweyn. Calcium Blockers (gaar ahaan Verapamil) ayaa qayb ahaan ka xayiraya shaqada AV node, sidaas darteedna inta badan waa wax aad u faa'iido leh oo lagu daaweynayo arritada qallafsan ee suurtogalka ah ee ku tiirsan AV node si loo sii wado. Gaar ahaan, tarbuun-ku-jimicsiga tarbuunka (qaabka ugu badan ee sufawantricular arrhythmia) ayaa badanaa lagu xakameyn karaa daaweynta verapamil.
- Cudurka 'hypothertrophic cardiomyopathy'. Calcium-blockers waxaa loo isticmaali karaa in lagu caawiyo yareynta "xoojinta" ee xannibanka bidix ee dadka qaba hurgunka wadnaha ee 'hypertrophic cardiomyopathy', taasina waxay yareyn kartaa calaamadaha.
Waxyaabaha kale ee saameynaya
Dhibaatooyinka caadiga ah ee ka yimaada xiniinyaha dhiigga ee calciumka waxaa ka mid ah madax xanuun, madax-wareer, boodid, iyo lugaha iyo bararka canqowga. Verapamil, gaar ahaan, waxay sidoo kale u egtahay inay sababto calool-galinta.
Sababtoo ah xannibaadayaasha calcium waxay u muuqdaan inay yareeyaan xoogga foosha murqaha wadnaha, waa in loo isticmaalaa taxadar (haddii ay dhammaan yihiin) bukaanka qaba wadnaha oo aan shaqeynin .
Badanaa waxa ugu wanaagsan in laga fogaado daawada verapamil iyo diltiazem ee dadka qaba bradycardia sababtoo ah daawooyinkan ayaa sii xoojin doona heerka garaaca wadnaha.
> Ilo:
> Gersh BJ, Maron BJ, Bonow RO, et al. 2011 ACCF / AHA Tilmaamaha Daaweynta iyo Daaweynta Cudurka Kaadi-Galbeedku (Hypertrophic Cardiomyopathy): Soo-koobidda Fulinta: Warbixinta Kuliyada Aasaasiga ah ee American College of Cardiology / Qalabka American Heart Association Association ee Tilmaamaha Tababarka. Wareegga sanadka 2011; 124: 2761.
> Fihn SD, Gardin JM, Abrams J, iyo al. 2012 ACCF / AHA / ACP / AATS / PCNA / SCAI / STS Tilmaamaha loogu talagalay Cilimaadka iyo Maareynta ee Isbitaalada leh Cudurka Wadnaha Is-beddelka ah ee Isku-buufiska leh: Warbixinta Kuliyada Aasaasiga ah ee American College of Cardiology / American Heart Association Association Dhakhaatiirta, Ururka Mareykanka ee Qalitaanka Thoracic, Ururka Kalkaaliyayaasha Wadnaha ee Ka-hortagga Wadnaha, Ururka Bulshada Dhibaatooyinka Wadnaha iyo Is-bahaysiga, iyo Bulshada Qalliinka Thoracic. Wareegga 2012; 126: e354.
> Mancia G, Fagard R, Narkiewicz K, iyo al. 2013 Tilmaamaha ESH / ESC ee Maareynta Dhibaatada Qalodheerta: Hagaajinta Xoogga ee Maareynta Ciladda Ba'an ee Bulshada Yurub ee Dhiirrigelinta (ESH) iyo Bulshada Yurub ee Wadnaha (ESC). J Hypertens 2013; 31: 1281.