Daawada Dronedarone (Multaq) waa daawo ka soo horjeeda antiarrhythmic kaas oo loo sameeyay daaweynta fibrillada atrial . Marka ay raadinayaan daroogo ammaan ah oo wax ku ool ah xaaladdan, shirkadaha dawooyinka ayaa muddo dheer qiyaasaya qashin-khudraddooda: daroogada sida waxtar u leh amiodarone , laakiin aan lahayn sunta gaarka ah. Dronedarone waxaa soo saaray Sanofi (kuwa ka shaqeeya amiodarone) gaar ahaan rajada ah in la abuuro qashinkaas qaaliga ah.
Waxtarka
Maadaama daroogooyinka ka horjeeda antiarrhythmic, drdonaron ay si macquul ah waxtar u tahay daaweynta fibrillada atrial. Nasiib darro, tani maaha mid aad u badan. Dhawr tijaabo caafimaad ayaa muujiyey in drongaronku uu si dhexdhexaad ah u shaqeynayo sidii loo ilaalin lahaa qoyaan caadi ah dadka ku dhacay fibrillada atrial.
Gaar ahaan, drongaronton ayaa lagu muujiyay inay aad uga waxtar badan tahay cirbadda. Weli, 64% bukaannada la daweeyay drongarone waxay qabeen fibrillada dib-u-dhaca ee sannadka ugu horreeya ee daaweynta. Taa bedelkeeda, 75% bukaanjiif oo qaada placebo ayaa ku soo noqnoqonayey fibrillada soo noqnoqda. Horumarkaasi waa mid la mid ah tan la arko daawooyinka kale ee daawada antiarrhythmic - mar kale, ma dhahayo wax aad u badan.
Maxkamadeynta bukaan-eegtada oo la barbardhigay waxtarka tayada dronedarone ee amiodarone, drdonaronone waxay caddaynaysaa in ay ka yartahay daroogada "waalidka". 64% dadka qaba fibrillada atrial-ka ee lagu daaweeyo drdonaronone waxay hal mar soo noqnoqoneysaa xitaa marka la barbardhigo "kaliya" 42% dadka lagu daweeyo amiodarone.
Sidee Wanaagsan Loo Diidayaa Darawaliinta?
Dronedarone waa nooc ka mid ah amiodarone, taas oo ah midka ugu waxtarka badan, laakiin daroogada ugu badan, daroogada antiarrhythmic ayaa weli sameeyay. Si ka duwan sida amiodarone, drdonarone kuma jiraan ciqaabaha iodine. Waxaa la rumeysan yahay in iodine-ka amiodarone uu soo saaro qaar ka mid ah daroogada saameynta sunta ah, gaar ahaan qanjirka thyroid-ka ee la arko daroogada iyo malaha sambabada sunta .
Marka ay soo baxdo, droonontonone ma soo bandhigin noocyada kala duwan ee sunta gaarka ah ee la xidhiidha amiodarone. Si kastaba ha noqotee, sunta kiimikada ayaa laga soo sheegey droonaroonkana, sidoo kale xaaladaha sambabada sunta ayaa sidoo kale la arkay. Dadka qaba dhibaatooyinka beerka ama sambabka ee amiodarone waa in aan la siin droonaroon.
Daraasaduhu waxay soo jeediyeen in dadka qaba wadne-la'aanta , ama ay ka soo baxeen dhinacyada isgoysyada qiyaas ahaan 35% ama ka hooseeya, waxay yeelan karaan halis dheeraad ah oo dhimasho ah marka qaadashada drumbardone. Dronedarone waa in aan loo isticmaalin dadka qaba xaaladdahan.
Dhibaatooyinka kale ee ka yimaada drongaronku waxay u egtahay in uu yahay mid wanaagsan. Calaamadaha ugu caamsan ee la soo sheegay ayaa ah shuban ama lallabo, wadne garaaca wadnaha, iyo firiiric.
Khadadka hoose
Sida dhammaan daroogada daawada loo yaqaan antiarrhythmic, dronedarone waa in loo isticmaalaa taxadar. Isticmaalka isticmaalka waxaa loogu talagalay inuu gacan ka geysto kor u qaadida garaaca wadnaha ee caadiga ah ee bukaanada kuwaas oo qabay ficil-celin atrial ah . Haddii fayruusku uu dib u soo celiyo inta uu qaadanayo drontonkon, daroogada waa in la joojiyaa, iyo istaraatajiyad daaweyn kala duwan.
Daawada ayaa ugu wanaagsan loo isticmaalaa dadka yaryar kuwaas oo leh kali-kali-ficil-celin oo kaliya iyo kuwo kale oo caafimaad qaba.
Akhri wax dheeraad ah oo ku saabsan daaweynta fibrillada atrial .
Ereyga
Sida ay u soo baxday, drdonononon ma aha midda qiiqa. Xaqiiqdii, sheekada daawadani waa sheeko isku mid ah oo la maqlo marar badan daawooyinka antiarrhythmic - farxad bilawga ah, oo ay ku xigto niyad jab kama dambeys ah. Koox ahaan, dawooyinka ka hortaga antiarrhythmic ayaa ah mid dhexdhexaad ah oo waxtar leh, haddana waxay ka mid yihiin daroogooyinka ugu sunta ee daawada. Waa in loo adeegsadaa kaliya marka si taxaddar leh loo tixgeliyo dhammaan noocyada kala duwan, iyo marka faa'idooyinka ka imanaya ay si aad ah uga culus yihiin halis dhab ah.
> Ilo:
> Dorian P. Farshaxanka Daawada Daawada Dronedarone: Waxyaabaha Laga Helo Daaweynta Qalabka Fibbaaridda. J Cardiovasc Pharmacol Ther 2010; 15: 15S.
> Hohnloser SH, Crijns HJGM, van Eickels M, iyo al. Saameynta tayada dronedarone ee ku saabsan dhacdooyinka wadnaha iyo xididdada xuubka. N Engl J Med 2009; 360: 668-678.
> Connolly SJ, Camm AJ, Halperin JL, et al. Dronedarone ku jira khatar sare oo khatar ah oo joogto ah. N Engl J Med 2011; DOI: 10.1056 / NEJMoa1109867.