Quinidineyog ib hom alkaloid rho tawm los ntawm cov tawv ntoo ntawm tsob ntoo cinchona thiab belongs rau chav kawm Ia anti- tshuaj arrhythmic. Nws muaj cov teebmeem ntawm sodium channel blockade thiab potassium channel prolongation. Nws yog tsuas yog siv los kho atrial thiab ventricular arrhythmias, xws li atrial fibrillation, atrial flutter, thiab ventricular tachycardia. Nws restores sinus atherosclerosis los ntawm kev ua kom lub sijhawm ua haujlwm ntev thiab ua haujlwm tau zoo ntawm lub plawv cov leeg hlwb. Tsis tas li ntawd, quinidine kuj tseem muaj cov tshuaj tiv thaiv -malarial zog, tab sis vim nws cov toxicity siab, nws tau raug hloov los ntawm lwm yam tshuaj.
Nws cov tshuaj siv tshuaj muaj xws li inhibiting sodium ion influx (txo qis conduction ceev) thiab thaiv cov poov tshuaj raws (lengthening repolarization lub sij hawm), thaum tseem qhia txog cov teebmeem anticholinergic thiab alpha receptor blocking ua, uas yuav ua rau kom ntshav siab. Cov kev mob tshwm sim feem ntau suav nrog kev mob plab hnyuv (zaub, xeev siab), cinchonism (tinnitus, mob taub hau), arrhythmias (xws li torsades de pointes ventricular tachycardia), thiab kev tsis haum tshuaj. Vim muaj kev cuam tshuam nrog ntau yam tshuaj (xws li digoxin, warfarin), kev soj ntsuam nruj ntawm cov tshuaj ntshav thiab electrocardiograms yuav tsum tau ua. Vim muaj cov kev mob tshwm sim loj heev, kev siv tshuaj kho mob tau txo qis thiab tsuas yog siv ceev faj hauv cov xwm txheej tshwj xeeb.
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| Tshuaj Formula | C20H24N2O2 |
| Exact Mass | 324.18 |
| Molecular Luj | 324.42 |
| m/z | 324.18 (100.0%), 325.19 (21.6%), 326.19 (2.2%) |
| Elemental Analysis | C, 74.05; H, 7.46; N, 8.63; O, 9.86 |
Anti-Arrhythmic Agent
Quinidinefeem ntau yog siv los ua daim nyias nyias -inhibitory anti- tshuaj arrhythmic. Nws ua ncaj qha rau ntawm daim nyias nyias ntawm myocardial cell, ua kom ntev lub sijhawm myocardial refractory, txo kev ywj pheej, kev coj ua, thiab myocardial contractility.
Nws muaj txiaj ntsig tshwj xeeb tiv thaiv tsis yog -sinus ectopic rhythms. Rau cov kab mob sinus node, nws yuav tsis muaj txiaj ntsig lossis ua kom lub sijhawm ua haujlwm ntev, txo qis kev tshaj tawm, ua kom ntev lub sijhawm refractory zoo, thiab txo qis excitability.
Lub sijhawm ntev ntawm lub sijhawm atrial refractory yog qhov tseem ceeb tshaj qhov ntawm lub ventricle, thaum lub sij hawm atrioventricular junctional refractory yog luv.
Kev tswj hwm qhov ncauj, nws yog qhov tsim nyog rau kev kho mob ntawm atrial contractions ntxov ntxov, atrial fibrillation, paroxysmal supraventricular tachycardia, pre-excitation syndrome nrog supraventricular arrhythmias, ventricular ntxov ntxov ntaus, ventricular tachycardia thiab fibrillation, los yog kev kho mob tom qab hluav taws xob.
Daim ntawv thov kev kho mob
Cov tshuaj antiarrhythmic pharmacological tsuas yog ua kom ntev lub sij hawm refractory ntawm myocardium, txo myocardial kev nyuaj siab, autonomic thiab conductivity, thiab yog siv los kho atrial lossis ventricular tachycardia, thiab thim rov qab atrial flutter thiab atrial fibrillation. thiab tiv thaiv nws rov tshwm sim. Thaum siv nws, vim muaj qhov sib txawv thiab qhov sib txawv ntawm tus kheej, qhov kev siv tshuaj kho mob thiab kev kam rau siab kuj tsis sib haum rau ntau qhov sib txawv. Cov neeg uas muaj hyperthyroidism, mob atrial fibrillation, thiab lub plawv loj muaj peev xwm ua tau siab dua. Ntev -lub sij hawm lub plawv tsis ua hauj lwm, bundle ceg block, thiab coronary heart disease muaj tsawg kam rau ua, thiab tej zaum ib tug ib txwm noj tshuaj yuav ua rau lom. Txawm hais tias nws lom yog cuam tshuam nrog cov koob tshuaj, hauv ib tus neeg mob, ib qho me me tuaj yeem ua rau arrhythmia. Tam sim no ntseeg tau tias nws cov nyhuv inhibitory ntawm kev coj ua tuaj yeem ua rau rov ua kom rov ua haujlwm ntawm cov kab mob myocardium. Txhawm rau txo cov tshuaj lom, cov kev hloov hauv lub plawv dhia, lub suab nrov, ntshav siab thiab electrocardiogram yuav tsum nruj me ntsis saib xyuas thaum noj tshuaj.
Kev Siv & Siv
Qhov ncauj
0.2g txhua lub sijhawm ntawm thawj hnub, ib zaug txhua 2 teev, rau 5 zaug uake. Yog tias nws tsis muaj txiaj ntsig thiab tsis muaj qhov tshwm sim tsis zoo, nce mus rau 0.3g txhua zaus rau hnub thib ob, 0.4g txhua zaus rau hnub peb, ib zaug txhua 2 teev, rau 5 zaug ua ke. Tag nrho cov nyiaj txhua hnub yuav tsum tsis pub tshaj 2g. Tom qab lub plawv dhia zoo li qub, hloov mus rau kev saib xyuas koob tshuaj ntawm 0.2-0.4g ib hnub. Yog tias nws tsis muaj txiaj ntsig lossis muaj kev cuam tshuam tsis zoo tom qab noj nws rau 3-4 hnub, cov tshuaj yuav tsum tau txiav. Cov menyuam yaus yog thawj zaug tau txais koob tshuaj 2mg / kg. Yog tias tsis muaj qhov tshwm sim tsis zoo, kev kho mob yuav pib tom qab 1-2 teev. Thawj hnub, 6mg / kg ib zaug, ib zaug txhua 2 teev, rau 4-5 zaug; yog tias cov nyhuv tsis pom tseeb thiab tsis muaj cov tsos mob ntawm kev lom, thawj koob tshuaj tuaj yeem txuas ntxiv rau hnub ob lossis nce ntxiv 20% ntawm thawj koob tshuaj. Yog tias tsim nyog, thawj koob tshuaj tuaj yeem khaws cia rau hnub thib peb.
Intravenous txhaj los yog intravenous drip
0.25g txhua zaus, diluted rau 50ml nrog 5% qabzib txhaj, thiab maj mam txhaj. Rau cov menyuam yaus, thawj koob tshuaj yog 2 mg / kg, diluted nrog 100 ml ntawm 5% qabzib txhaj tshuaj thiab dripped intravenously. Saib rau 1 teev. Yog tias tsis muaj kev fab tshuaj, ces muab 6 mg / kg ib zaug, ib zaug txhua 3 teev. Tag nrho cov koob tshuaj txhua hnub yuav tsum tsis pub tshaj 30 mg / kg.
Cov tshuaj sib cuam tshuam
Nws muaj cov nyhuv additive thaum siv nrog rau lwm cov tshuaj antiarrhythmic.
Thaum siv ua ke nrog cov tshuaj tiv thaiv coagulants, ob cov tshuaj yuav cuam tshuam rau ib leeg, thiab kev saib xyuas yuav tsum tau them rau kev kho qhov ntau npaum ntawm ob cov tshuaj.
Phenobarbital thiab phenytoin sodium tuaj yeem ua kom cov metabolism ntawm cov khoom no hauv daim siab thiab txo cov ntshav siab.
Thaum siv nrog digoxin, cov ntshav concentration ntawm digoxin tuaj yeem nce ntxiv.
Thaum siv nrog cov tshuaj anticholinergic, qhov ua tau zoo ntawm cov tshuaj anticholinergic tuaj yeem nce ntxiv; Thaum siv nrog cov tshuaj cholinergic, qhov ua tau zoo ntawm cov tshuaj cholinergic tuaj yeem ua rau tsis muaj zog; Thaum siv ua ke nrog neuromuscular blockers, tshwj xeeb tshaj yog tubocurarine thiab succinylcholine, cov nyhuv ua pa nyuaj tuaj yeem txhim kho.
Thaum siv nrog kev npaj cov poov tshuaj, qhov ua tau zoo ntawm cov khoom no tuaj yeem txhim kho, thaum hypokalemia tuaj yeem txo qhov ua tau zoo ntawm cov khoom no.
Thaum siv ua ke nrog beta-blockers, cov nyhuv inhibitory ntawm cov leeg ntawm sinoatrial thiab atrioventricular node tuaj yeem ua rau hnyav dua.
Thaum siv ua ke nrog cov tshuaj antihypertensive, cov nyhuv antihypertensive thiab vasodilation tuaj yeem txhim kho.
Thaum siv ua ke nrog rifampicin, cov ntshav concentration ntawm cov khoom no tuaj yeem txo qis.
Cov zis alkalinizing cov neeg ua haujlwm xws li acetazolamide, antacids lossis bicarbonates tuaj yeem ua kom cov reabsorption los ntawm lub raum tubules, uas ua rau muaj kev nce hauv cov ntshav concentration ntawm cov khoom no, yog li ua rau muaj tshuaj lom.
Quinidineyog ib qho tshuaj antiarrhythmic. Nws cov sulfate feem ntau siv, tab sis hydrochloride thiab gluconate kuj siv. Qhov twg sulfate yog cov hmoov dawb crystalline, tsis muaj ntxhiab tsw, tsis tshua muaj iab, nrog lub melting point ntawm 175-176 degree, yooj yim soluble hauv dej, thiab me ntsis soluble hauv ethanol.
Nws yog alkaloid rho tawm los ntawm cov tawv ntoo ntawm Cinchonaledgeriana (Moens), ib tsob nroj ntawm tsev neeg Rubiaceae. Nws muaj kev cuam tshuam ncaj qha rau ntawm daim nyias nyias ntawm tes, feem ntau yog inhibiting transmembrane txav ntawm sodium ions, thiab muaj kev cuam tshuam ncaj qha rau ntawm tus kheej, kev coj ua, kev chim siab thiab kev cog lus ntawm lub plawv, thiab tseem muaj cov nyhuv anticholinergic ntawm lub plawv. Nws yog qhov tsim nyog rau kev mob plawv thiab kev tiv thaiv ntawm atrial fibrillation, atrial flutter, supraventricular thiab ventricular tachycardia, thiab kev kho thiab tiv thaiv malignant ntxov ntxov.
Nws yog daim ntawv dextrorotatory ntawm quinine. Ob leeg muaj cov tshuaj pharmacological zoo sib xws, tab sis nws muaj 5-10 npaug zog rau lub plawv dua li quinine. Nws khi rau lipoprotein ntawm sodium channel ntawm myocardial cell membrane, nqaim lub rooj vag channel, thiab tiv thaiv kev nkag ntawm Na +, uas ua rau txo qis ntawm depolarization tus nqi ntawm theem 0 thiab qeeb ntawm conduction. Qhov qeeb ntawm depolarization tus nqi ntawm theem 4 txo qis myocardial automaticity thiab inhibits ectopic atherosclerosis cov ntsiab lus. Nws slows downflow ntawm K + nyob rau hauv theem 3, yog li ncua lub sij hawm refractory. Tsis tas li ntawd, nws kuj inhibits myocardial contractility thiab muaj anti-parasympathetic thiab anti-sympathetic teebmeem. Nws thaiv cov receptors, ua rau vasodilation, tshwj xeeb tshaj yog thaum txhaj tshuaj intravenously, uas tuaj yeem ua rau poob qis hauv cov ntshav siab, yog li nws tsis tuaj yeem muab tso rau hauv cov hlab ntsha.
Kev phiv tshuaj
Quinidineyog Class IA antiarrhythmic tshuaj uas ua rau muaj kev cuam tshuam los ntawm inhibiting sodium ion channels hauv myocardial hlwb, ua kom lub sijhawm ua haujlwm ntev thiab lub sijhawm ua haujlwm zoo. Txawm li cas los xij, nws qhov kev kho mob yog nqaim, thiab muaj ntau yam tsis zoo tshwm sim, nrog rau li 30% ntawm cov neeg mob yuav tsum tsis txhob noj tshuaj vim muaj qhov tsis zoo. Cov hauv qab no yog cov lus piav qhia ntxaws txog nws cov kev tsis zoo tshwm sim:
Cardiovascular system phiv tshuaj
Arrhythmia: Quinidine tuaj yeem ua rau lossis ua rau ua ntej - arrhythmias uas twb muaj lawm. Cov hom muaj xws li ventricular premature beats, ventricular tachycardia, ventricular fibrillation, thiab lwm yam. Qhov tshwm sim yog siab dua nyob rau hauv cov neeg mob uas muaj pre- mob plawv (xws li lub plawv tsis ua hauj lwm, myocardial ischemia) los yog ua ke nrog cov tshuaj xws li digoxin. Ntawm qhov kev kho mob ntau, quinidine tuaj yeem ua rau qeeb ntawm cov kab mob intraventricular, ua rau kev nthuav dav ntawm QRS complex; Thaum muaj ntau ntau, nws tuaj yeem ua rau atrioventricular block, sinoatrial block, thiab txawm tias lub plawv nres.
Hypotension:Quinidine tuaj yeem nthuav cov hlab ntsha thiab ua rau cov ntshav siab, tshwj xeeb tshaj yog thaum siv cov tshuaj intravenously lossis ntau npaum li cas. Kev mob ntshav siab hnyav tuaj yeem nrog vasculitis, thiab kev saib xyuas kev hloov ntshav siab yog qhov tsim nyog.
Lub plawv tsis ua hauj lwm:Quinidine tuaj yeem tiv thaiv myocardial contractility thiab ua rau cov tsos mob ntawm lub plawv tsis ua hauj lwm, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob ua ntej - mob plawv.
Gastrointestinal phiv tshuaj
Quinidine muaj qhov cuam tshuam ncaj qha rau ntawm lub plab hnyuv mucosa, thiab cov kev tsis zoo tshwm sim muaj xws li:
xeev siab thiab ntuav
Qhov tshwm sim yog qhov siab, uas tej zaum yuav cuam tshuam nrog kev txhawb nqa ntawm plab hnyuv mucosa lossis hauv nruab nrab paj hlwb teb los ntawm cov tshuaj.
Mob plab thiab raws plab
Quinidine tuaj yeem ua rau mob plab zom mov, ua rau mob plab, raws plab, thiab thaum mob hnyav, mob spasms.
Txo qab los noj mov
Cov tshuaj cuam tshuam rau kev ua haujlwm ntawm plab hnyuv, ua rau txo qis qab los noj mov hauv cov neeg mob.
Lobular kab mob siab thiab esophagitis
Lub sij hawm ntev lossis kev siv ntau dhau ntawm quinidine tuaj yeem ua rau daim siab puas thiab mob plab.
Central paj hlwb tsis zoo tshwm sim
Quinidine tuaj yeem hla cov ntshav- lub hlwb thaiv thiab ua rau cov lus teb hauv nruab nrab paj hlwb, suav nrog hu ua Cinchonism, suav nrog:
Kev tsis hnov lus
Tinnitus thiab hnov tsis hnov lus: Quinidine muaj tshuaj lom rau cov plaub hau sab nrauv ntawm cochlea, thiab kev hnov lus rov qab tsis zoo yog feem ntau nyob rau hauv siab - koob tshuaj lossis ntev - kev kho mob. Kev siv ntev ntev tuaj yeem ua rau tsis hnov lus tsis zoo.
kiv taub hau thiab sib npaug tsis sib haum: Quinidine tsis cuam tshuam rau cov qauv vestibular, tab sis kiv taub hau thiab kev sib npaug tseem tuaj yeem tshwm sim, uas tej zaum yuav cuam tshuam nrog cov tshuaj txuam rau hauv pob ntseg hauv pob ntseg.
Qhov muag tsis pom kev
Qhov muag tsis pom kev, photophobia, diplopia, xim tsis pom kev, cov menyuam kawm ntawv dilated, tsaus me ntsis, thiab hmo ntuj dig muag.
Lwm cov tsos mob ntawm lub paj hlwb
Mob taub hau, liab, palpitations, convulsions, tremors, excitement, coma, ntxhov siab vim, thiab lwm yam. Kev siv quinidine ntev yuav ua rau dementia, thiab cov tsos mob yuav zoo dua tom qab tsis siv tshuaj.
Cov lus nug nquag
Puas yog quinidine yog sodium channel blocker?
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Quinidine txo Vmax los ntawm kev thaiv cov hlab plawv sodium. Hauv kev kho mob ntau, quinidine ua rau me me ntawm tonic block. Thaum depolarization ntawm lub plawv cell membrane, siv -dependent block tsim.
quinidine cuam tshuam rau lub plawv li cas?
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Quinidine yog Class 1a antiarrhythmic. Nws ua haujlwm hauv siab rauqeeb cov hluav taws xob impulses uas ua rau lub plawv cov leeg cog lus thiab tso ntshav. Thaum lub sij hawm arrhythmia, lub plawv nqaij contractions tsis zoo. Ua kom qeeb ntawm cov hluav taws xob impulses tuaj yeem tswj lub plawv dhia thiab nres qhov arrhythmia.
Kuv yuav tsum zam dab tsi thaum noj quinidine?
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Yog li, raws li cov ntaub ntawv tam sim no, cov neeg noj quinidine yuav tsum tsis txhob hauskua txiv kab ntxwvlos yog noj txiv kab ntxwv. Pomegranate kua txiv tau pom tias inhibit tib lub enzyme uas inhibited los ntawm cov kua txiv hmab txiv ntoo. Qib ntawm inhibition yog hais txog tib yam rau txhua yam ntawm cov kua txiv no.
Cim npe nrov: quinidine CAS 56-54-2, lwm tus neeg, manufacturers, hoobkas, lag luam wholesale, yuav, nqe, tej, kev muag khoom