ivabradine

ivabradine, joe anya logon key beach procorlan brand naam key tahat becha jaataa haye, ack dawa haye, joe ack pacemaker current (aaee "aff") avarodhak haye, jiska upayog hriday seey sambandhit chhaati key dard aur hriday viphalata key lakshanaatmak prabandhan key liye kiya jaataa haye. joe rogi coronary hriday viphalata key liye ivabradine key upayog key liye arhata praapt karate hain, way rogi hain jinake lakshanaatmak hriday viphalata hoti haye, jisamen cumm seey cumm ejection matra aur hriday gati cumm seey cumm 70 bee. pee. aim. hoti haye, aur sthiti koo beeta blockers dwara poori tarah seey prabandhit naheen kiya jaa sakata haye.
ivabradine sinoatrial sanrachana mein nakaratmak chronotropy kii anumati dekar kaary kartaa haye, iss prakaar pacemaker current key vishisht avrodh key madhyam seey hriday darr koo cumm kartaa haye, joe beeta blockers aur calcium channel blockers seey alag ack tantra haye, joe aamtaur parr nirdhaarit cardiac pharmaceuticals key dou antianginal varg hain. ivabradine mein koee spasht aprabhaavi guna naheen hain aur yeh ack cardiotonic agent hoe sakata haye.
chikitsa upayog.
iska upayog samanya sinus lay vaale rogiyon mein deerghakaalik sthir angina pectoris key lakshanaatmak upchaar key liye kiya jaataa haye joe beeta blocker naheen leey sakate hain. iska upayog anuchit sinus tachycardia key upchaar mein bhee kiya jaa rhaa haye. ivabradine ist key saath postoperative cab key rogiyon mein binaa kissy sambaddh dushprabhaav key hr aur lay koo niyantrit karane key liye ack aushadhiya vikalp key roop mein khadaa haye.
chhaati mein dard.
ivabradine beeta blocker atenolol key roop mein prabhaavi haye aur purani sthir angina key prabandhan mein amlodipine key saath tulaniya haye, jaisa kii gair-heenata parikshanon mein kull vyayam avadhi mein sudhaar seey pradarshit hotaa haye, isaliye yeh una logon key liye ack vaikalpik chikitsa hoe sakati haye joe paaramparik upchaaron koo sahan naheen curr sakate hain. joe loga apane angina key liye beeta blockers key saath paryaapt roop seey prabandhit naheen hain, unamen ivabradine jodane seey hriday gati koo aur cumm kiya jaa sakata haye aur kull vyayam avadhi mein sudhaar hoe sakata haye.
dill kii viphalata.
iska upayog hriday viphalata vaale logon mein beeta blockers key saath sanyojan mein kiya jaataa haye, jisamen lvf 35 pratishat seey cumm haye joe akele beeta blockers dwara aparyaapt roop seey niyantrit kiya jaataa haye aur jinaki hriday gati prati minut 70 beats seey adhik hoti haye. joe loga apane hriday kii viphalata key liye beeta blockers key saath paryaapt roop seey prabandhit naheen hain, unamen ivabradine jodane seey hriday kii viphalata key liye aspatal mein bharti honey kaa khatra cumm hoe jaataa haye.
tachycardia.
ivabradine kaa naidaanik upayog cinotrial nodal ootak parr isaki kaarravaai key tantra parr adharit haye jahaan yeh chuninda roop seey mazedaar dhaara ("yadi") koo rokta haye aur isake parinamswarup hriday gati mein kamee aatee haye.
electrophysiology mein ivabradine kaa sabse adhik upayog anuchit sinus tachycardia key upchaar key liye kiya jaataa haye. anuchit sinus tachycardia key liye iska upayog europeeya dawa agency/khaadya aur dawa prashaasan dwara ivabradine key liye anumodit sanket naheen haye.
iska prayog lambe covid key rogiyon mein postural orthostatic tachycardia syndrome key upchaar key liye kiya gayaa haye.
virodhabhas.
ivabradine beemar sinus syndrome mein pratibandhit haye. iska upayog upayog key shaktishali avrodhakon key saath bhee naheen kiya jaanaa chaahiye, jisamen azole antifungal (jaise kii catoconazole), macrolide antibiotic, nephazodone aur antiretroviral davaayen nelfinevir aur ritonavir shamil hain.
verapamil yaa diltiazem key saath ivabradine kaa upayog pratikool haye.
pratikool prabhaav.
kull milakar, ivabradine lene vaale rogiyon key liye 14.5% chamakdaar ghatnaaon kaa anubhav (rogiyon dwara poori tarah seey banaae gaye drishya kshetra mein badhee hui chamak kii samvedana key roop mein varnit). yeh shayed retina mein i "h" aayan chainalon key avrodh key kaaran haye, joe cardiac i "f" key samaan hain. yeye lakshan halke, kshanik aur poori tarah seey prativarti hain. naidaanik adhyayanon mein, sabhi rogiyon mein seey lagbhag 1 pratishat koo inn samvedanaon key kaaran dawa koo bund karna padaa, joe dawa shuru honey key ausatan 40 dinon baad huaa.
ack badey naidaanik pareekshan mein, bradycardia (asamanya roop seey dheemi hriday gati) kramshah 7.5 aur 10 milligram kii khuraak parr ivabradine lene vaale 2 pratishat aur 5 pratishat rogiyon mein huaa (atenolol lene vaalon mein 4.3 pratishat kii tulanaa mein). 2.6-4.8% ney sirdard kii soochana dee. anya samanya pratikool dawa pratikriyaon (rogiyon kii 1-10%) mein pratham-degree aeye. vee. block, ventricular extracistol, chakkar aanaa aur/yaa dhundhali drishti shamil hain.
kaarravaai kaa tantra.
ivabradine aaee "aff" ("aff" "majakia" key liye haye, isaliye kahaa jaataa haye kyonki isaki khoj key samay gyaat anya vartamaan pranaliyon kii tulanaa mein isamen asamanya guna they) aayan dhaara parr kaary kartaa haye, joe cinotrial node mein atyadhik vyakt hotaa haye. i "f" ack mishrit Na +-k + ander kii or dhaara haye joe atidhruveekaran dwara sakriya hoti haye aur swaayatt tantrika tantra dwara sanshodhit hoti haye. yeh sinoatrial (sa) node mein pacemaker gatividhi koo niyantrit karane key liye sabse mahatvapurna ionic dhaaraon mein seey ack haye. ivabradine chuninda roop seey pacemaker aaee "aff" current koo khuraak-nirbhar tareeke seey rokta haye. iss channel koo avaruddh karane seey cardiac pacemaker gatividhi cumm hoe jaati haye, chuninda roop seey hriday gati koo dheema curr detaa haye aur rakt koo myocardium mein pravaahit karane key liye adhik samay detaa haye. aaee "aff" channel koo rokkar, ivabradine hriday gati aur hriday parr kaam key bojh koo cumm curr detaa haye. yeh enzyna key saath-saath hridaya kii viphalata key ilaaj key liye dawa key upayog mein praasangik haye. yeh anya aam taur parr upayog kii jaane vaali darr-cumm karane vaali davaaon key vipareet haye, jaise kii beeta-blocker aur calcium channel blocker, joe naa kewal hriday gati koo cumm karate hain, balki hriday kii sankuchan kshamata koo bhee cumm karate hain. sankshepan kshamata key nuksan key binaa darr mein chayanaatmak kamee koo dekhate hue, ivabradine cumm ejection ansh key saath hridaya viphalata key upchaar key liye prabhaavi saabit hoe sakata haye.
ivabradine aich. see. aine. 4 receptors (potasium/sodium hyperpolarisation-sakriya chakreeya nucleotide-gated channel 4) seey judataa haye, joe y506, f509 aur i510 avasheshon kaa upayog kartaa haye.
naidaanik pareekshan.
coronary dhamani roga.
sunder adhyayan 10917 rogiyon parr yaadrichhik roop seey kiya gayaa haye jinamen sthir coronary dhamani roga aur baaen nilay kii shithilata (ejection ansh <40%) haye. ivabradine ney hriday mrityu key praathamik samagr antim bindu mein mahatvapurna kamee naheen dikhaai, teevra myocardial inforction key liye aspatal mein pravesh, aur naee shuruat yaa bigadati hriday viphalata key liye aspatal mein pravesh. haalaanki, 70 bee. pee. aim. seey adhik kii aadhar rekha hriday darr vaale rogiyon key ack purvanirdhaarit upsamooh mein, ivabradine ney nimnalikhit maadhyamik antim binduon koo kaafee cumm curr diyaah
inn parinamon koo beeta blockers key saath sanyojan chikitsa mein dekhaa gayaa, aur 70 bee. pee. aim. yaa usase adhik hriday darr vaale rogiyon mein coronary dhamani roga key parinamon mein sudhaar karane mein surakshit aur prabhaavi paaya gayaa.
sthir coronary dhamani roga aur 70 beats prati minut seey adhik hriday gati vaale 19102 rogiyon koo maanak chikitsa key alawa ivabradine yaa placebo key hastakshep key liye nirdhaarit kiya gayaa thaa. ivabradine ney rogi samoohon mein maadhyamik parinamon mein mahatvapurna sudhaar naheen kiya, haalaanki hriday gati mein kamee kaa pradarshan kiya. jaba shift adhyayan kii tulanaa mein, hriday mrityu yaa aspatal mein bharti honey mein kamee kaa bhee pradarshan kiya gayaa thaa aur isaliye jaba atirikt chikitsa kaa prashn hoe tou iss parr vichaar kiya jaanaa chaahiye.
purani hriday viphalata.
shift adhyayan mein, ivabradine ney ishtatam chikitsa key sheersh parr placebo kii tulanaa mein bigadate hriday viphalata yaa hriday sambandhi mrityu key liye aspatal mein bharti honey key praathamik samagr antim bindu key jokhim koo 18 pratishat (pee <0.0001) taka cumm curr diyaa. yeye laabh upchaar key 3 maheene baad dekhe gaye they.
badalaav seey yeh bhee pataa chalaa kii hriday viphalata key rogiyon koo ivabradine dene seey hriday viphalata seey mrityu kaa khatra 26 pratishat (pee = 0.014) aur hriday viphalata key liye aspatal mein bharti honey kaa khatra 26 pratishat (pee <0.0001) taka cumm hoe gayaa.
sabhi purvanirdhaarit upsamuhon mein parinamon mein sudhaar dekhaa gayaah yaadrichhikta mein beeta-blockers key saath yaa unake binaa mahila aur purush, 65 varsh seey cumm aur usase adhik ayu key rogi, ischemic yaa gair-ischemic etiology kii hriday viphalata key saath, aine. vaaee. aich. aeye. varg II yaa varg III, IV, madhumeh key saath yaa usake binaa, aur uchch raktchaap key saath yaa usake binaa. 2020 kii cochrane sameeksha mein hriday mrityu darr aur ivabradine key saath deerghakaalik upchaar aur placebo/samanya dekhbhal/hriday viphalata vaale pratibhagiyon mein cumm ejection ansh key saath koee upchaar naheen honey key beach gambhir pratikool ghatnaaon mein koee antar naheen paaya gayaa.
savdhani key liye dhyaan diyaa jaanaa chaahiye. ivabradine, halanki naidaanik roop seey sthir rogiyon mein purani hriday viphalata key liye sanket diyaa gayaa haye, teevra hriday viphalata mein sanket naheen diyaa gayaa haye jahaan badhee hui hriday gati hriday aarakshit kaa pratinidhitva karati haye. ivabradine kaa andhadhundh upayog inn rogiyon koo asthir curr sakata haye.
samaaj aur sanskriti.
sweekriti.
ivabradine koo 2005 mein europeeya dawa agency dwara aur 2015 mein sanyukt raajya america key khaadya aur dawa prashaasan dwara anumodit kiya gayaa thaa.
naam.
iska vipanan sanyukt raajya america mein amgen dwara vyaparik naam corlanor key tahat kiya jaataa haye, aur baaki duniya mein seva pradaata dwara prokoralan (duniya bhar mein), corlan (hangkang, singapur, australia aur kuchh anya deshon mein), corlentor (armenia, spen, itali aur romania mein), lancora (kanada mein) aur coraxon (roose aur serbia mein) key vyaapaar naamon key tahat kiya jaataa haye. ise bhaarat mein ivabrade, ivabid brand naamon key tahat bhee becha jaataa haye. iran mein yeh "bradics" key trademark key tahat becha jaataa haye. ivamac aur bradia. isake vikas key dauran, ivabradine koo aiss-16257 key roop mein jaanaa jaataa thaa.

