Digoxin

Digoxin

I-Digoxin ibalwa njengenye yemithi yenhliziyo efinyeleleka kakhulu. Uhlu Lwemithi Ebalulekile Yenhlangano Yezempilo Yomhlaba luhlanganisa lomuthi onamandla wenhliziyo, ogqamisa ukubaluleka kwawo ezinhlelweni zokunakekelwa kwempilo emhlabeni wonke.

Odokotela batusa i-digoxin ukwelapha izimo zenhliziyo eziphakathi nendawo ezisiza iziguli ukuthi zilawule ukwehluleka kwenhliziyo kanye ne-atrial fibrillation engapheli. Umuthi usebenza kahle uma iziguli ziwuphuza ngomlomo. Nokho, ukusebenza kwayo kungase kwehle uma uyithatha nokudla okunefayibha ephezulu. 

Lesi sihloko sihlanganisa lokho okufanele ukwazi mayelana namaphilisi e-digitoxin, kusukela ekusebenzeni kwayo kuye emihlahlandlela elungile yokudosa. Ukwazi ukuthi lo muthi usebenza kanjani, uwuphuze nini, nokuthi yiziphi izinyathelo okufanele uzilandele kusiza ukuqinisekisa ukwelashwa okuphephile nokusebenzayo kwezimo zenhliziyo.

Yini i-Digoxin

Isitshalo se-foxglove (Digitalis) sinikeza i-digoxin, umuthi wenhliziyo we-glycoside. Lesi sidakamizwa esimangalisayo sisaqhubeka sidlala indima ebalulekile ekuhlolweni kwenhliziyo yesimanje.

• Lo muthi osebenzayo wenhliziyo uthinta umzimba ngezindlela eziningi:
• Kwenza ukushaya kwenhliziyo ngakunye kube namandla kakhulu ngenkathi yehlisa izinga lokushaya kwenhliziyo
• Ukujikeleza kwegazi kuba ngcono futhi ukuvuvukala ezandleni nasemaqakaleni kuncipha
• Inhliziyo ifinyela ngamandla ngoba ivimba 'ipompo ye-sodium' (i-sodium-potassium ATPase)

Umuthi uza ngezindlela eziningi:

• Amandla amaphilisi ahlukene (62.5 mcg, 125 mcg, 250 mcg)
• Isixazululo somlomo (50 mcg/mL)
• Amafomu omjovo avame ukulawulwa yizibhedlela

Ingxenye yempilo ye-Digoxin ifinyelela cishe emahoreni angama-36 ezigulini ezinomsebenzi wezinso ojwayelekile. Lokhu kufinyelela ezinsukwini ezingu-3.5-5 ezigulini ezine ukwehluleka kwezinso.

I-Digoxin isetshenziswa

Odokotela ngokuvamile banikeza i-digoxin ku:

• Yelapha ukuhluleka kwenhliziyo ngama-diuretics nama-ACE inhibitors
• Lawula izinga lokushaya kwenhliziyo ezimweni ze-atrial fibrillation
• Siza ukuzinzisa ukushaya kwenhliziyo okungajwayelekile (arrhythmias)

Ungawasebenzisa Kanjani Futhi Nini Amathebulethi e-Digoxin

• Thatha ithebhulethi eyodwa ye-digoxin nsuku zonke ngamanzi, okungcono njalo ekuseni ngemva kokudla kwasekuseni. 
• Uma ukuyo, igwinye iphelele futhi ingagayelwanga. 
• Lapho udokotela wakho eqala irejimeni, angase aqale ngomthamo ophezulu, bese ulungisa umthamo wansuku zonke wesondlo we-125 kuya ku-250 micrograms. 

Imiphumela Emibi Yezibhebhe ze-Digoxin

Imiphumela emibi evamile yilezi:

• isiyezi noma ubucwebe
• Ukuzizwa ugula noma oluhlanzayo
• Uhudo
• Ukushintsha kokubona (ukufiphala noma ukubona ama-tints aphuzi/aluhlaza)
• Ukuphuza isikhumba

Ukuqapha

• Ukuhlolwa kwegazi kusiza ukuqapha ukusebenza kwezinso zakho namazinga amaminerali. 
• Yazisa udokotela wakho mayelana nokusebenzisa kwakho i-digoxin ngaphambi kwanoma yikuphi ukuhlinzwa. 
• Phatha umazisi wezokwelapha okhombisa ukuthi uthatha lo muthi.

Indlela Amathebulethi e-Digoxin Asebenza ngayo

I-Digoxin yenza ukufinyela kwenhliziyo kuqine ngokusebenzisa izindlela ezimbili eziyinhloko. Umuthi uvimba iphampu ebizwa nge-Na+/K+ ATPase kumaseli emisipha yenhliziyo, okwandisa amandla enkontileka. Iphinde ivuselele isimiso sezinzwa esine-parasympathetic futhi ibambezele amasignali kagesi nge-AV node yenhliziyo yakho.

Ngingakwazi Ukuthatha I-Digoxin Ngeminye Imithi?

I-Digoxin isebenzisana nemithi eminingi, okuhlanganisa:

• Nemithi Elwa Namagciwane 
• Ama-antifungals
• Imithi yesifo samathambo
• I-diuretics (amaphilisi amanzi)
• Imithi yesigqi senhliziyo noma yomfutho wegazi
• Ukwelashwa kwe-HIV

Ulwazi Lomthamo

• Umthamo olungile we-digoxin udlala indima ebalulekile ekwelapheni izimo zenhliziyo. Udokotela wakho uzobala umthamo odingekayo ngokusekelwe ezicini ezimbalwa.
• Iziguli ezihluleka yinhliziyo kanye ne-atrial fibrillation zidinga imithamo ehlukene ye-digoxin. Odokotela banquma u-0.125 kuya ku-0.25 mg nsuku zonke ezigulini ezihluleka yinhliziyo. 
• Udokotela wakho angase aqale ngo-0.25 kuya ku-0.5 mg bese engeza imithamo engu-0.25 mg njalo emahoreni angu-6 ukuze uthole i-atrial fibrillation. Umthamo ophelele akufanele udlule ku-1.5 mg emahoreni angu-24, futhi imithamo yesondlo isukela ku-0.0625 kuya ku-0.25 mg nsuku zonke.
• Umthamo wakho ofanele uncike esisindweni sakho, ukusebenza kwezinso, kanye neminyaka.
• Ukuhlolwa kwegazi kuyingxenye ebalulekile yokwelashwa kwakho. Udokotela wakho uzohlola amazinga e-digoxin emahoreni angu-6-12 ngemva komthamo ngamunye. Amazinga aphakathi kuka-0.5 no-0.9 ng/mL azonikeza impendulo ephephile.
• Ukugadwa udokotela wakho kubalulekile lapho ushintsha imithamo. Kunegebe elincane kuphela phakathi kwethamo elisebenzayo nelinobuthi.

Isiphetho

I-Digoxin iwumgogodla wokwelashwa kwenhliziyo osekumile isikhathi eside. Lo muthi onamandla usiza iziguli ezingenakubalwa ukuphatha ukuhluleka kwenhliziyo kanye ne-atrial fibrillation nsuku zonke. Umuthi usebenza kahle kakhulu uma unamathela esimisweni esinqunyiwe, ukhombisa ukuhlolwa, futhi uhlale uqaphile izimpawu eziyisixwayiso. Ukuhlolwa kwegazi kusebenza njengenethi yokuphepha egcina umuthi usezingeni elisiza ngaphandle kokudala umonakalo.

I-Digoxin ikhombisa ukuthi amakhambi asuselwa ezitshalweni aguquke kanjani abe umuthi wesimanje onembayo. Ukusetshenziswa okufanele nokuqapha ngokucophelela kwenza i-digoxin ibe indlela enhle yokuthola ukulawula izimo zenhliziyo nokuthuthukisa izinga lempilo.

Imibuzo Evame Ukubuzwa

1. Ingabe i-digoxin isengozini enkulu?

I-Digoxin iza nezingozi ezithile ngenxa yenkomba yayo yokwelapha emincane. Ucwaningo lukhombisa ukuthi iphesenti elincane leziguli ezisebenzisa i-digoxin therapy liba nobuthi. Abantu abanesisindo somzimba esiphansi, ubudala noma izinkinga zezinso bangathola ubuthi ngisho nasezingeni eliphansi.

2. I-digoxin ithatha isikhathi esingakanani ukusebenza?

Izimpawu zakho zokuhluleka kwenhliziyo zingase zithathe amasonto ambalwa kuya ezinyangeni ukubonisa ukuthuthuka. Umuthi usebenza ngokushesha ekulawuleni izinga le-atrial fibrillation, nakuba uzodinga isineke ukuze ubone izinzuzo ezigcwele.

3. Kwenzekani uma ngiphuthelwa umthamo?

Kufanele uphuze umuthi uma ukhumbula kungakapheli amahora ayi-12 wesikhathi sakho esijwayelekile. Yeqa umthamo ogejiwe bese unamathela kolandelayo ohleliwe uma isikhathi esengeziwe sesidlulile. Ukuthatha umthamo ophindwe kabili ukulungisa ophuthelwe kuyingozi.

4. Kwenzekani uma ngiphuza ngokweqile?

Shayela ucingo losizo oluphuthumayo ngokushesha ukuze uthole usizo lwezokwelapha. Qaphela lezi zimpawu ze-overdose:

• I-nausea, ukuhlanza, noma isifo sohudo
• Ukushintsha kokubona (okufiphele noma okuphuzi)
• Ukudideka noma ubuthakathaka
• Ukushaya kwenhliziyo okungajwayelekile noma ukushaya kwenhliziyo

5. Ubani ongakwazi ukuthatha i-digoxin?

Umuthi awuphephile kubantu abanalokhu:

• I-fibrillation ye-ventricular
• Izinkinga zenhliziyo ezinzima njenge i-cardiomyopathy, i-Wolf-Parkinson-White syndrome
• Recent isifo senhliziyo
• Izinkinga ezinkulu zezinso

6. Kufanele ngiyiphuze nini i-digoxin?

Thatha umthamo wakho we-digoxin kanye ngosuku, okungcono ekuseni ngemva kokudla kwasekuseni. Uhlelo lwakho lomthamo kufanele luhlale lungaguquki usuku ngalunye.

7. Zingaki izinsuku zokuphuza i-digoxin?

Iziguli eziningi zidinga i-digoxin njengomuthi wempilo yonke. 

8. Uyimisa nini i-digoxin?

Isiqondiso sikadokotela wakho sibalulekile ngaphambi kokumisa i-digoxin. Ukuyeka ukuqhubeka kungazelelwe kungenza izimpawu zokuhluleka kwenhliziyo zibe zimbi nakakhulu. Udokotela angase atuse ukuyeka imithi uma uba nemiphumela emibi kakhulu noma isimo sakho sishintsha.

9. Ingabe kuphephile ukuphuza i-digoxin nsuku zonke?

I-Digoxin isebenza njengomuthi wempilo yonke ezigulini eziningi. Ukuphepha kwakho kuncike ekuhlolweni kwegazi okuvamile okuhlola ukusebenza kwezinso zakho namazinga amaminerali.

10. Yisiphi isikhathi esingcono kakhulu sokuphuza i-digoxin?

Indlela engcono kakhulu yokuphuza i-digoxin ngemva kokudla kwasekuseni njalo ekuseni. Isheduli engaguquki isiza ekugcineni amazinga egazi azinzile ngempumelelo.

11. Yini okufanele uyigweme uma uthatha i-digoxin?

Hlala kude ne-:

• Ubhanana kanye nezinye esikhundleni sikasawoti (ukwandisa amazinga e-potassium)
• Ugologo omnyama 
• I-St. John's Wort ne-Hawthorn Berry 
• Ukudla okune-fibre ephezulu (thatha i-digoxin ihora eli-1 ngaphambi noma amahora ama-2 ngemva kwalokho.)

12. Ingabe i-digoxin idala ukukhuluphala?

I-Digoxin ingaholela ekwehleni kwesisindo. Iziguli zenhliziyo zingase zingawuboni lo mphumela ngoba isimo sazo ngokuvamile sibangela ukugcinwa koketshezi.

13. Ingabe i-digoxin iyayenyusa i-creatinine?

Umuthi udala imiphumela emibili ehlukene—unciphisa i-creatinine ekuqaleni kodwa ungawukhulisa ngokusetshenziswa isikhathi eside.

14. I-digoxin yenzani enhliziyweni?

Umuthi wenza ukufinyela kwenhliziyo kuqine ngenkathi yehlisa izinga lokushaya kwenhliziyo. Lokhu kwenzeka ngoba i-digoxin ivimba iphampu ye-sodium-potassium kumaseli enhliziyo.

15. Yiziphi izinzuzo zokuthatha i-digoxin?

Iziguli ezinesifo senhliziyo zithola ukulaliswa esibhedlela okumbalwa nge-digoxin. Umuthi uthuthukisa izinga lempilo ngokunciphisa ukukhathala kanye nokuphefumula.