Prokinetics - ihe ọ bụ? a ọgbọ ọhụrụ nke prokinetics: ndepụta

Prokinetics - ihe ọ bụ? Na CIS mba, ọ dịghị otutu mmadu kwenyere banyere ihe ọgwụ na-gụnyere ke otu a, ya mere, ọ bụla gastroenterologist onwe ya na-ekpebi na-eme ka a na ndepụta, na ihe adịghị. Prokinetics - ihe ọ bụ? Nke ahụ bụ ihe anyị na-agbalị ịchọpụta.

Definition na a nkenke nkọwa

Prokinetics - ihe ọ bụ? Nke a ìgwè nke ọgwụ ọjọọ na-akpali motility nke digestive tube na-egbochi anastaltic ebili mmiri.

Eriri afọ ọrịa na-esokarị site reflux nke chyme si ala akụkụ nke nsia tube na overlying, mebiri Itie bolus ma ọ bụ a ọnọdụ na-achọghị na eriri afọ nke. All ndị a mgbaàmà na-metụtara isi nkwalite chyme site digestive tube, mgbe ahụ, ewepu mgbaàmà nwere ike ịbụ, na-emetụta ndị mkpi nke ezigbo uru mgbidi ya. Nke ahụ bụ ihe prokinetics. Ha ọgwụgwọ mmetụta bụ n'ihi igbochi nke ion nyefe usoro (dopamine, 5-HT4 anabata, jikọrọ) ma ọ bụ mmetụta na metabolism nke acetylcholine. Ọbọ adakarị mmetụta bụ n'ihi na ụba ego nke acetylcholine na synaptic mkpịwa ma ọ bụ ndị amplification nke cholinesterase ngwaahịa nke enhances decomposition nke ach, mbelata ngwaahịa ach akwara endings.

Physiologically mmetụta si ọgwụ ọjọọ apụta ntọt gbasara obi esophageal sphincter ụda, esi kpọpụ mmadụ nile nke afo ọdịnaya, nchikota n'etiti antrum na duodenum, na-arụpụta eriri afọ peristalsis.

The ìgwè mbụ nke ọgwụ ọjọọ

Prokinetics - ọgwụ ọjọọ eme ihe na-egbochi dopamine D2-anabata, si otú na-akpali akpali muscle ọrụ na-enye eriri afọ esiwọrọ antiemetic mmetụta. Ọgwụ ndị a na-agụnye: "metoclopramide" (mbụ ọgbọ nnọchiteanya - "Reglan" na "Raglan"), "bromopride", "Domperidone" (abụọ emana), "Dimetpramid", "Itopride".

Prokinetic ọgwụ ọjọọ, na-eji na ọgwụgwọ nke gastroezofagialnoreflyuksnoy ọrịa (Gerd), YAZHDPK, dyspepsia, ọtọ agwa, ibelata nke na nkọlọ mgbe mmerụ ahụ na dị ka a n'ihi nke adhesions, postoperative paresis aka na afo, nsogbu nke outflow nke bile, flatulence.

Ọzọkwa prokinetics - ọgwụ ọjọọ eme ihe na ike ga-eji maka ọgbụgbọ na vomiting mere site nsí ma ọ bụ mebiri nke iwu nri, ọrịa nke malitere ịrịa ma ọ bụ nje na etiology, afọ ime na mbụ trimester, nnukwu akwara insufficiency, isi trauma, ná Nkụnwụ Ahụ, radieshon na-anara ọgwụ. Adighi ike site vomiting vestibular si malite, dị ka ọ na-adịghị emetụta n'etiti ntị na medulla oblongata.

Antipsychotics aka na vomiting

"Sulpiride" na "Levosulpirid", bụ a neuroleptic na a yiri usoro nke-eme ihe, ha nwere a mma mgbochi emetic N'ezie, otú ike ga-eji na gastroenterological omume.

"Metoclopramide" (prokinetics): ntuziaka maka ojiji

"Metoclopramide" - a kpọmkwem stimulator nke ezigbo muscle na nwere niile dị mkpa Njirimara nweta clinically ịrịba results, ma n'ihi ndị permeability gematogistologicheskie mgbochi a ga-eji na-ekwesịghị. Ekwe Omume mmetụta dị otú ahụ dị ka spasm nke ọdịdị ihu akwara, na mgbaàmà nke "okwukwa ụkwụ", rhythmic protrusion nke ire, bulbar ọrịa, apịajighị apịaji ekrtraokulyarnyh mọzụlụ, spasmodic torticollis, oké ụda nke mgbatị mọzụlụ, Parkinson syndrome, somnolence, adịghị ike, tinnitus, isi ọwụwa, nchegbu, ọgba aghara.

Mgbe ụfọdụ, na-achọsi ike na-prokinetiki? Ntuziaka maka ojiji nke kwuru ekwesighi ojiji na ikpe nke hypersensitivity ọgwụ, a akpụ nke adrenal cortex, nsia mgbochi, perforation nke bowel na-eme ka ha na-agba ọbara, prolaktinozavisimoy etuto ahụ, Akwụkwụ na-adọ na extrapyramidal ọrịa, ruo 16 izu nke nwa gestation, n'oge lactation, ụmụ n'okpuru 5 afọ. Kwesịrị ịkpachara anya maka ọgwụ na a belatara nwechapụ nke creatinine, mụbara ọbara mgbali, ụkwara ume ọkụ, afọ ruo afọ 14.

Ilo ogwu ọkara otu awa tupu a nri, na a mbadamba na 9:00, 12:00, 15:00 na 18:00. Duration ọgwụgwọ - anọ izu isii, mgbe ụfọdụ, o nwere ike gbasaa ruo ọnwa isii.

Ọ bụrụ na ntọhapụ ụdị - mmiri mmiri, ọ na-ndinọ intramuscularly ma ọ bụ intravenously. N'ihi na ndị okenye na ụmụaka ihe karịrị afọ 14 - 10 mg. Oke kwa otu oge - 20 mg kwa ụbọchị dose - 60 mg. Ọdịnaya nke ampoule nwere ike diluted na isotonic saline ma ọ bụ 5% glucose ngwọta.

"Domperidone": ntuziaka maka ojiji

"Domperidone" bụ nhọrọ karị dopamine ihe nnabata blocker, e wezụga na-banye n'ime BBB, Otú ọ dị mgbe n'ikuku bụ adịghị ịzụlite mmetụta kọwara n'elu. Otú ọ dị, na-amụba secretion nke prolactin, ọ na-akpalite gynecomastia, galactorrhea, na enweghị menses. Ke adianade do, ọrịa kọrọ a akpụkpọ ọkụ ọkụ, akọrọ ọnụ, afọ ọsịsa na isi ọwụwa.

Ọ bụghị akwadoro maka ojiji maka ndị mmadụ na nfụkasị Jeremaya ka mmiri nke na ọgwụ, na-agba ọbara si eriri afọ tract, nsia mgbochi, prolactinoma, lactation, afọ ruo 5 afọ ma ọ bụ erikpu ruo 20 kilogram. Anya na-n'oge ime, gbasara akụrụ na / ma ọ bụ hepatic insufficiency.

-Aṅụ maka nkeji iri abụọ tupu ọ bụla nri na 10 mg, ma ọ dị mkpa, na ike na-aṅụ tupu na-aga ụra. The kacha dose kwa ụbọchị - 80 mg. Ọ bụrụ na ugbu a na ọgwụgwọ nke antacids, mbenata secretion nke gastric ihe ọṅụṅụ, ha kwesịrị iche iche si mmanya domperidone, na-ekerịta eri nri.

"Itopride": ntuziaka maka ojiji

"Itopride" agwakọta Njirimara nke dopamine ihe nnabata-eti ọkpọ na blocker nke acetylcholinesterase. Utịp ke hypothalamic-pituitary-adrenal usoro, ịba ụba kasịnụ nke somatostatin ma mbenata adrenocorticotropic hormone. A mmetụta ọjọọ n'ahụ na-kwupụtara dị ka leukopenia, thrombocytopenia, hypersensitivity Jeremaya mere, hyperprolactinemia, ọgbụgbọ, tremor, jaundice. N'oge n'ikuku, ọ dị mkpa inyocha ala nke elu ọbara, ma hụ na e nweghị mmetụta.

Ọ bụghị aro ka ndị na hypersensitivity nke ozugbo ma ọ bụ na-egbu oge ụdị, eriri afọ ọbara ọgbụgba akụkọ ihe mere eme, obturating nsia lumen ma ọ bụ mkpakọ nke a mba ọzọ ahụ si na-enweghị, n'okpuru afọ iri na isi, afọ ime, ara.

Ọgwụ e ji ọnụ na tupu nri maka 50 mg ugboro atọ n'ụbọchị.

Akụ ọkpọ "Acetylcholine"

Nke a na-agụnye:

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

Ndị a ọgwụ ọjọọ eme ihe ndị dịịrị naanị ikpe ụlọ ọrụ nke prokinetics n'ihi na nke ha mmetụta: mmetụta na mgbanwe nke potassium ion, na dị ka a N'ihi ya, amụba QT nkeji, nke na-eduga ná nsogbu nke gbasara obi n'afọ iri na ụma. A ọnụ ọgụgụ nke ọgwụ ọjọọ a anaghachiri si pharmacological ahịa n'ihi nke a.

"Aceclidine": ntuziaka maka ojiji

Prokinetics - ihe ọ bụ, mgbe na otú iji ha? Na nke ọ bụla, jide n'aka na ịkpọ onye dọkịta na enyịn amụ ntuziaka maka ojiji.

"Aceclidine" a na-eji zere ọnwụ nke ụda olu nke digestive tract na eriri afo mgbe ịwa, na-ebelata intraocular nsogbu, nwere ike mere a ga-eji na ophthalmology. Product Ụdị - ogwu ogbugba, agbara subcutaneously na 2.1 ml nke a 0,2% ngwọta. Max na a oge - 0.004 g, na kwa ụbọchị ọ dịghị ihe karịrị 0.012, n'akụkụ mmetụta - ptyalism, sweating, na afọ ọsịsa.

Contraindications ojiji bụ CHD, elu HDL, bronchial ụkwara ume ọkụ, na ihe ndị ọzọ hyperkinesias parkinsonism, afọ ime, na-agba ọbara si abdominal oghere.

"Fiziostigmin" a na-eji isi na ophthalmic omume, ma pụrụ mgbe ụfọdụ iji na Gastroenterology na nsia paresis. The ọgwụ agbara n'okpuru anụahụ nke 0,5 - 1 ml nke a 0,1% ngwọta. Karịa ego nke ọgwụ kwa ụbọchị ekwesịghị gafere 0,001 g

Mmetụta ọjọọ ndị a ike nke salivation, bronchospasm, nsia spasm nke uru ahụ, mgbanwe obi ọnụego, ụfụ.

Contra-egosi: rịaworo, Akwụkwụ na-adọ, ụkwara ume ọkụ, n'ibu nsia mgbochi, peritonitis, sepsis, ime.

"Galantamine": ntuziaka maka ojiji

"Galantamine" n'ọnọdụ ụfọdụ kpọmkwem na-eji dị ka ihe na-eti ọkpọ maka muscle relaxants na postoperative oge na a ọnụ ke Akwara ụda nke bowel na eriri afo. Contraindications ojiji bụ hypersensitivity, àkwụkwụ, ụkwara ume ọkụ, ọbara mgbali n'elu 139/99 mmHg, COPD, n'ibu occlusion nke nsia duct, gbasara akụrụ ọrụ impairment, afọ 9 afọ. Ejedebeghị nzube nke ime n'ebe ndị nwere Harms karịa uru. N'oge lactation, nwere ike ibunye ndị na nwa site na mmiri ara ehi.

Mmetụta: Mbelata obi ọnụego, TTP, AV mgbochi, arrythmia, ọgbụgbọ, vomiting, afọ ọsịsa, dyspepsia, muscle apịajighị apịaji, urinary incontinence, haematuria, tremor.

Ọ nwere ike na-ndinọ subcutaneously, intramuscularly, intravenously, transdermally, ọnụ. The dose na-gbanwee n'otu n'otu, nke dabeere na akụkọ ihe mere eme nke ọrịa, na a ga-gbaziri na ịga dibịa. The nkezi, kwa ụbọchị dose n'ihi na ndị okenye - site 10 ruo 40 mg, kewara abụọ na anọ doses.

A ọgbọ ọhụrụ nke prokinetics

Na ndabere nke taa Itopride emepụta ọgwụ ọjọọ ndị dị ka "Ganaton", "Itomed", "Pramer". Otu n'ime Kacha ọhụrụ na kasị dị irè bụ ndị prokinetiki ọgbọ ọhụrụ dị ka "koordinaks" na "Prepulsid". Ọ bụ ezie na ha nwere ike ime ka oké njọ mmetụta na obi.

Ndị kasị ewu ewu n'etiti gastroenterologists anọgide "Motilium" (n'ọrụ mgwa - domperidone), nke na-agwakọta àgwà nke metoclopramide, ma ọ dịghị nwere esi na ya apụta.

Gịnị bụ ndị kasị dị irè pprokinetiki? List of ngwaahịa ugbu a na-agụnye:

1. "Itopride" (n'ọrụ mgwa) - "Ganaton", "Itomed", "Primer" (azụmahịa aha).
2. "Metoclopramide" - "Raglan" "Reglan".
3. "Cisapride" - "koordinaks", "Prepulsid".
4. "Domperidone" - "Motilium", "Motilak", "Motinorm", "Passazhiks".

Anyị maara ugbu a na ndị dị otú a prokinetic. Depụta ha n'akwụkwọ dị ka ị na-ahụ, ọ bụ nnọọ nnukwu. Ma, cheta na n'ihu iji ọgwụ ọ bụla kwesịrị ịkpọ na dọkịta gị! Nọrọ mma!