I-Nebivolol

I-Nebivolol

Umfutho wegazi ophezulu kuthinta izigidi emhlabeni wonke, okwenza kube esinye sezimo zezempilo ezivame kakhulu ezidinga ukunakekelwa kwezokwelapha. Odokotela bavame ukunikeza imithi ehlukahlukene yokuphatha lesi simo ngempumelelo, futhi i-nebivolol igqama njengendlela yokwelapha ebalulekile.

Lo mhlahlandlela obanzi uchaza konke iziguli okudingeka zikwazi nge-nebivolol, okuhlanganisa ukusetshenziswa kwayo, umthamo ofanele, imiphumela emibi engase ibe khona, kanye nezinyathelo zokuphepha ezidingekayo. Ukuqonda kangcono lo muthi kusiza iziguli zenze izinqumo ezinolwazi mayelana nohambo lwazo lokwelashwa.

Iyini i-Drug Nebivolol?

I-Nebivolol umuthi onamandla okungokwesizukulwane sesithathu se-beta-blockers, eklanyelwe ukwelapha umfutho wegazi ophakeme. Okwenza lo muthi ukhethekile isenzo sawo esikabili esiyingqayizivele - usebenza kokubili njengesivimbeli se-beta esikhethiwe (esiqondise kuphela ama-β-1 adrenergic receptors) kanye nesiphumuza imithambo yegazi.

Lo muthi ugqama kwamanye ama-beta-blocker ngoba unamandla okubopha aqine kakhulu kuma-beta receptors phakathi kwayo yonke imithi esekilasini lawo. Isebenza ngezindlela ezimbili eziyinhloko:

• Ivimba ama-receptors athile (beta-1) enhliziyweni ukusiza ukulawula umfutho wegazi
• Isiza imithambo yegazi ukuba ikhululeke ngokwandisa ukukhiqizwa kwe-nitric oxide

Iza ngamandla ahlukahlukene: 2.5 mg, 5 mg, 10 mg, kanye namaphilisi angu-20 mg.

Umuthi ufinyelela izinga eliphezulu egazini phakathi kwamahora angu-1.5 kuya kwangu-4 ngemva kokuwuphuza. Icutshungulwa ikakhulukazi yisibindi futhi ishiya umzimba ngomchamo (35%) kanye nendle (44%).

Ukusetshenziswa kweNebivolol

Odokotela banikeza amaphilisi e-nebivolol ngokuyinhloko ekwelapheni umfutho wegazi ophakeme (umfutho wegazi ophezulu). Lo muthi udlala indima ebalulekile ekwehliseni ingozi yokuba bucayi isifo senhliziyo izehlakalo, ikakhulukazi unhlangothi nokuhlaselwa yinhliziyo.

Odokotela banganquma i-nebivolol ngezindlela ezimbili:

• Njengokwelashwa okuzimele komfutho wegazi ophakeme
• Ngokuhlanganiswa neminye imithi yomfutho wegazi efana ne-ACE inhibitors noma i-angiotensin II receptor antagonists

Umuthi ubonisa isithembiso esithile ezimweni ezithile ezithile. I-European Society of Cardiology incoma i-nebivolol njengendlela yokwelapha ehambisana nemithi yomugqa wokuqala yokwehluleka kwenhliziyo. Ukwengeza, isiza ukuphatha i-microvascular angina futhi ikhombisa amandla ekwelapheni ukungasebenzi kahle kwenhliziyo okuhlobene nomdlavuza, nakuba ucwaningo olwengeziwe ludingeka kule ndawo.

Lapho iziguli zithatha i-nebivolol njalo, isiza ukuvikela izitho ezibalulekile emonakalweni obangelwa umfutho wegazi ophakeme isikhathi eside. Lesi sivikelo sidlulela ebuchosheni, enhliziyweni, nasezinso, kusize ukuvimbela izimo ezibucayi ezifana nalezi:

• Stroke
• Ukuhluleka kwenhliziyo
• Ukuhluleka kwezinso
• Ukuhlaselwa yinhliziyo

Indlela yokusebenzisa i-Nebivolol Tablet

Ukuthatha i-nebivolol ngendlela efanele kuqinisekisa ukuthi iziguli zithola inzuzo enkulu emithini yazo. Iziguli zingaphuza ithebhulethi ngokudla noma ngaphandle kokudla, futhi kungcono ukuyigwinya ngamanzi.

Iziguli kufanele ziphuze imithi yazo ngesikhathi esifanayo usuku nosuku ukuze zigcine amazinga egazi angaguquki omuthi. Uma othile egeja umthamo, kufanele awuphuze ngokushesha nje lapho ekhumbula. Kodwa-ke, uma sekusondele isikhathi sethamo elilandelayo, kufanele beqe umthamo futhi baqhubeke neshejuli yabo evamile.

Iziguli akufanele ziyeke ukuthatha i-nebivolol kungazelelwe njengoba lokhu kungase kusenze isimo sazo sibe sibi. Uma bedinga ukumisa imithi, udokotela wabo uzodala uhlelo lokunciphisa umthamo kancane kancane.

Nebivolol Side Effects 

Imiphumela eminingi engemihle imnene futhi ivame ukuba ngcono njengoba umzimba ujwayela umuthi. Imiphumela engemihle evamile iziguli ezingase zibe nayo ihlanganisa:

• bekhanda
• Ukukhathala noma ukukhathala
• isiyezi
• Ukushaya kwenhliziyo okuphansi
• Izinkinga zokugaya ukudla njenge-nausea
• Izandla noma izinyawo ezibandayo
• Kunzima ukulala

Nakuba kuvamile, ezinye iziguli zingase zibe nokusabela okubucayi okudinga ukunakekelwa ngokushesha. Lokhu kubandakanya: 

• Ukushaya kwenhliziyo kuhamba kancane kunokujwayelekile (bradycardia)
• Umfutho wegazi ophansi
• I-peripheral vascular disease
• Ukuphelelwa umoya okungajwayelekile
• Isiyezi esinzima noma ukuquleka
• Ukungezwani okunamandla njengokuqubuka, ukuphefumula kanzima, noma ukuvuvukala kobuso, umlomo, ulimi, noma umphimbo

Ukuqapha

Ukubhekwa: Iziguli ezithatha i-nebivolol zidinga ukuhlolwa njalo kwezokwelapha ukuze kuqinisekiswe ukuthi umuthi usebenza ngendlela efanele. Udokotela wabo uzoqapha umfutho wegazi futhi ahlole imiphumela engadingeki phakathi nalokhu kuvakasha.

Isimo Sezokwelapha: Izimo eziningi zempilo zidinga ukunakwa okukhethekile lapho uthatha i-nebivolol:

• Diabetes (ingase ivale izimpawu zikashukela wegazi ophansi)
• Izinkinga zenhliziyo noma zemithambo yegazi
• Isifo sezinso noma isibindi
• Izinkinga ze-thyroid
• Izinkinga zokuphefumula njengesifuba somoya
• Izinkinga zokujikeleza
• Iziguli ezihlela ukuhlinzwa kufanele zazise udokotela wazo ohlinzayo ngokuthatha i-nebivolol. Umuthi kungase kudingeke ukuthi ulungiswe ngaphambi kwenqubo ukuze kuvinjelwe izinkinga phakathi nokuhlinzwa. 

Ukusetshenziswa Utshwala: Utshwala bungandisa ukozela lapho buhlanganiswe nebivolol. 

Isebenza kanjani i-Nebivolol Tablet

Indlela yokusebenza eyingqayizivele ye-nebivolol iyenza ihluke kweminye imithi yomfutho wegazi. Lo muthi uhlanganisa izenzo ezimbili ezihlukene kuthebhulethi eyodwa, okwenza uphumelele ngokukhethekile ekulawuleni umfutho wegazi.

I-Nebivolol inamandla amakhulu okubopha ama-beta receptors uma kuqhathaniswa neminye imithi ekilasini layo. Isenzo sawo esiyinhloko sibandakanya ukuvimba ama-beta-1 receptors enhliziyweni, esiza:

• Yehlisa izinga lokushaya kwenhliziyo
• Yehlisa amandla okufinyeza kwenhliziyo
• Yehlisa umfutho wegazi
• Lawula ukukhululwa kwamahomoni okucindezeleka

Ngingakwazi Ukuphuza I-Nebivolol Ngeminye Imithi?

Ukusebenzisana Kwezidakamizwa Okubalulekile:

• Ama-block block wesiteshi seCalcium 
• I-Cimetidine
• Imithi yokucindezeleka njenge-fluoxetine ne-paroxetine
• Imithi yenhliziyo, njenge-digoxin, i-verapamil, ne-diltiazem
• Amanye ama-beta-blockers 

Ulwazi Lomthamo

Odokotela batusa umthamo wokuqala we-nebivolol 5 mg kanye ngosuku kubantu abadala abaningi. Odokotela bangalungisa umthamo ngokusekelwe endleleni iziguli ezisabela kahle ngayo ekwelashweni. Lezi zinguquko zivame ukwenzeka ngezikhathi zamaviki ama-2, futhi umthamo ungakhuphuka ube ngu-40 mg nsuku zonke.

Ezinye iziguli zidinga ukucatshangelwa kwe-dosing okukhethekile:

• Abantu abanezinkinga ezinkulu zezinso (Cr clearance ngaphansi kwama-30 mL/min): 2.5 mg nsuku zonke
• Iziguli ezinezinkinga zesibindi ezimaphakathi: 2.5 mg nsuku zonke
• Iziguli asebekhulile: Standard nebivolol 5 mg nsuku zonke

Isiphetho

Ngenxa yendlela eyingqayizivele yokwenza izinto ezimbili, i-nebivolol igqama njengomuthi onamandla wokulawula umfutho wegazi ophakeme. Umuthi usiza iziguli ukulawula umfutho wegazi wazo ngempumelelo, unikeze izinzuzo ezengeziwe ngezakhiwo zawo eziphumuza imithambo yegazi.

Iziguli ezilandela isimiso sazo somthamo esinqunyiwe futhi zixhumana njalo nodokotela bazo zibona imiphumela engcono kakhulu. Ukusebenza kahle komuthi, kuhlanganiswe nephrofayili yawo yomphumela omubi olawulekayo, kuwenza ube yinketho ebalulekile kubantu abaningi abanomfutho wegazi ophakeme.

Impumelelo nge-nebivolol incike ekunakeni ngokucophelela imihlahlandlela yomthamo, ukuqaphela ukusebenzisana okungaba khona, nokuqapha okufanele. Iziguli kufanele zikhumbule ukuthi ukulawula umfutho wegazi kuwukuzibophezela kwesikhathi eside, futhi i-nebivolol isebenza kangcono njengengxenye yohlelo olubanzi lokwelapha oluhlanganisa ukuhlolwa kodokotela okuvamile kanye nokuguqulwa kwendlela yokuphila.

Imibuzo Evame Ukubuzwa

1. Ingabe i-nebivolol iphephile ezinso?

Ucwaningo lubonisa ukuthi i-nebivolol ngokuvamile iphephile ekusebenzeni kwezinso. Ucwaningo lubonisa ukuthi iziguli ezinokukhubazeka okuphakathi kwezinso zabonisa ukubekezelela okuhle emuthini, ngezinga eliphezulu kuphela le-bradycardia (2.3% vs 0.8%) uma kuqhathaniswa nalezo ezinomsebenzi wezinso ojwayelekile.

2. I-nebivolol ithatha isikhathi esingakanani ukusebenza?

Iziguli ngokuvamile ziyayibona imiphumela yokwehlisa umfutho wegazi phakathi namaviki amabili okuqala ukwelashwa. Umuthi ufinyelela ukugcwala kwawo okuphezulu egazini phakathi kwamahora ayi-1.5-4 ngemuva kokuthatha umthamo ngamunye.

3. Kwenzekani uma ngiphuthelwa umthamo we-nebivolol?

Umuntu ngamunye kufanele aphuze umthamo we-nebivolol ophuthelwe ngokushesha nje lapho ekhumbula. Kodwa-ke, uma sekusondele isikhathi somthamo olandelayo ohleliwe we-nebivolol, kufanele beqe ogejiwe futhi baqhubeke neshejuli yabo evamile.

4. Kwenzekani uma ngiphuza ngokweqile?

I-overdose ingabangela izimpawu ezinzima ezihlanganisa:

• Izinga lokushaya kwenhliziyo eliphansi kanye nomfutho wegazi ophansi
• Isiyezi esinzima noma ukuquleka
• Ukuphefumula kanzima
• Ukukhathala okukhulu

5. Ubani ongakwazi ukuthatha i-nebivolol?

I-Nebivolol ayifanele iziguli ezinezimo ezilandelayo:

• Izinkinga ezinkulu zenhliziyo noma izinga lokushaya kwenhliziyo elihamba kancane kakhulu
• Izinkinga ezinkulu zesibindi
• Ukuhluleka kwenhliziyo okungalawuleki
• Ukuphazamiseka okuthile kwesigqi senhliziyo

6. Zingaki izinsuku okufanele ngithathe i-nebivolol?

I-Nebivolol iyindlela yokwelapha yesikhathi eside yomfutho wegazi ophakeme. Iyalawula kodwa ayelaphi umfutho wegazi ophakeme, ngakho iziguli kudingeka ziqhubeke nokuwuthatha njengoba ziyalelwe.

7. Nini ukuyeka i-nebivolol?

Iziguli akufanele neze ziyeke ukuthatha i-nebivolol ngokuzumayo. Udokotela uzodala uhlelo lokunciphisa umthamo kancane kancane emasontweni angu-1-2 uma ukuyeka kuyadingeka.

8. Ingabe i-nebivolol ilungele inhliziyo?

Ucwaningo lubonisa ukuthi i-nebivolol isiza ngempumelelo ukuphatha izimo zenhliziyo. Ithuthukisa ukugeleza kwegazi futhi inciphise umsebenzi wenhliziyo.

9. Kungani uthatha i-nebivolol ebusuku?

Umthamo wakusihlwa we-nebivolol ungase unikeze ukulawula okungcono komfutho wegazi wangaphambi kokuvuka uma kuqhathaniswa nomthamo wasekuseni. Kodwa-ke, umuthi wehlisa ngempumelelo umfutho wegazi kungakhathaliseki ukuthi isikhathi sini.