
nitrovasodilator

nitrovasodilator haah eka aushadhancha ghatak aahe joou nitrick auxide (nahee) daan karoon raktavahinya rund honyala (rudhiravahinya rund honyala) karanibhoot tharato aanee bahutek vela anjaina pectorischya upcharansathi aanee pratibandhasathi vaparla jaato.
aushadhanchya yaa gatamadhye nitrates (nitrick acidche ester) samavisht aahet, jeey sharirat qamee hotat, tasech itar kahee padarthahi asatat.
udaharane.
nitratechya prakarachya udaharananchi yadee yethe aahe (varnanukramanusar):
nitrovasodilators jeey nitrates nasatat tyamadhye molacidomine aanee tyache sakriy chayapachay linsidomin tasech soodiyam nitropruside yancha samavesh hoto. nahee daan karnyasathi heey padarth qamee karanyachi garaj nahee.
vaidyakeey vapar.
nitratescha vapar hrudayavikarachya aanee tivra hrudayavikarachya vranavar upchar aanee pratibandhasathi keela jaato, tarr molacidomine khoop haloo karya karate jeey tivra hrudayavikarachya upcharansathi upayukt nahee. hrudayavikarachya upcharat twarit krutee karnyasathi, glyceril trianitrate vapar sublingual favaranichya (nitro favarani) swarupat kinwa chiranyasathi mauu capsule mhanoon keela jaato.
hypertensive sankat, hrudayavikaracha zatka aanee shastrakriyedarmyan raktadab qamee karnyachya upcharansathi nitroprucidecha vapar antahshira paddhatine keela jaato.
matbhed.
raktadab qamee karane dhokadayak asoo shakate asha paristhitit nitrovasodilators matbhed aahet. yamadhye, vaiyaktik padarthanmadhil kahee farkasah, gambhir hypotention (qamee raktadab), hrudayavikarachya dhakkyasah dhakka aanee raktakshay yancha samavesh hoto. hrudayavikarachya aanee hrudayavikarachya zatkyachya kalat ekhade vishisht aushadh upayukt kinwa hanikarak aahe qee nahee heey tyachya krutichya gativar avalambun asateh glyceril trinitrate aanee nitroprucidesarkhe jalad karya karnare padarth raktadab niyantrit karnyasathi upayukt tharoo shakatat aanee parinami, jarr anuprayogache satat nirikshan kele gele tarr hridayala kitee rakt pump karave lagate. mand gatine kaam karnare padarth aniyantritpane qamee raktadabamule ischemiacha dhoka patkarat asatat aanee tyamule teey pratibandhit asatat. paristhitinusar, agadi jalad karya karnare padarth dekhil pratibandhit kele jaau shakatat-udaharanarth, avarodhak hriday apayash asalelya rugnanmadhye glyceril trianitrate.
alikadech syldenaphyll (viagra) sarkhe pii. dii. eae. 5 avarodhak ghetalelya rugnanmadhye dekhil hii aushadhe pratibandhit aahet.
pratikool parinam.
bahutek dushparinam heey raktavahinya aanee parinami honanya qamee raktadab yanche thet parinam asatat. tyat mendutil raktavahinya rund jhalyamule honari dokedukhi (nitrate dokedukhi), reflex tachycardia (jalad hriday gatee), flush, chakkar yene, malmal aanee ulatya yancha samavesh hoto. upchar suru thevalyas kahee divasannantar heey parinam sahasa qamee hotat.
kadhikadhi, upchar suru jhalyanantar lagechach gambhir hypotention udbhavate, jyacha parinam bahudha tivra kanthasthatechi lakshane kinwa sinkopmadhye hoto, kadhikadhi bradycardia (hriday gatee mand).
parasparsanvad.
anek aushadhe nitrovasodilators honanya qamee raktadabat bharr ghalatatah udaharanarth, itar vasodilators, uchch raktadabavirodhi aushadhe, tricyclic antidepressants, anticycotics, samanya anaesthetics tasech ethanol. syldenaphyll (viagra) saha pii. dii. eae. 5 avarodhkansah sanyojan, pratibandhit aahe kaaran sambhavya jivghena hypotention houu shakato.
nitrates dihydroergotamine (dii. etch. eae.) jaivupalabdhata vadhavtat. uchch dii. etch. eae. patalimule coronary rog asalelya rugnanmadhye coronary aakadi houu shakate. nitrate nasalelya nitrovasodilators yaa parasparsanvadache varnan kelele nahee.
krutichi yantrana.
nitrovasodilators hii utpadane aahet jee vividh yantranandvare daan karat naheet. nitrates rasayanik ghatatoon jaatat, bahudha enzymesdware madhyasthi kelee jaate. molacidomine aanee nitroprucidemadhye aadhich yogya auxidation sthiteet (+ 2) nitrogen asato aanee teey enzymeschya madtishivay mukt hote.
raktavahinyanchya gulgulit snayu peshinmadhye gwanilet cyclays yaa enzymechya vidravya swarupala naa. uttejit karate. gwanosin triphosphate (jee. tii. pii.) pasoon gwanolet cyclays chakriy gwanosin monofosphate (see. jee. emm. pii.) tayar karate. see. jee. emm. pii. heey tyaa badalyat chakriy nucleotide-aadharit prathine keynage jee sakriy karate, jeey phosphorylate karate, jee intracellular calciumchi patali qamee karnyat bhoomika bajavate, jyamule snayunchya peshinna shithilata milate aanee asha prakare raktavahinyanche vistar hote.
hrudayavikaracha sarvat mahattvacha parinam mhanje raktavahinyanche rundikaran, jyamule tyanchi rakt dharan karanyachi kshamata vadhate ('venus pooling') aanee hrudayakade paratanara rakt daab qamee hoto (preload). mothya dhamnyanchya rundikaranamule hridayala jyachya viruddha pump karava lagato, too dabav, mhanje afterload dekhil qamee hoto. qamee preload aanee afterloadmule hridayala qamee urjechi aanee tyamule qamee oxygenchi aavashyakta padate. yashivay, nitrovasodilators daan kelele konatehi hrudayatil aakadi qamee karoo shakat nahee, jyamule hrudayacha auxigen puravatha vadhato.
pii. dii. eae. 5 avarodhak phosphodisteres-5 yaa enzymedware see. jee. emm. pii. chey nishkriyakaran rokhatat. nitrovasodilators honanya vadhiv see. jee. emm. pii. utpadanasah, yamule see. jee. emm. pii. chee uchch sandrata, vyapak shiranche pooling aanee sambhavya jivghena hypotention hoto.
nitrate sahanshilata.
nitrates sahishnutecha vikas darshavtat, kinwa adhik visheshtah tachyphilexis, mhanje varanvar vapar kelyane parinam vegane qamee hoto, sahasa 24 tasanchya aat. sahaa teey aath tasancha viram mool parinamkarakta punarsthapit karato. hii ghatana moolatah nitrateschya qamee honyasathi aavashyak asalelya thayol (-sh) gatanchya qamee honyacha parinam asalyache manale jaat hote. molacidomine (jeey qamee jhalele nahee) tachyphilexis darshavat nahee yaa vastusthitila haah siddhant sajesa asala taree, darmyanchya kalat too nakarla gela aahe. naveen siddhantanmadhye oxidative tanavachi vaadh, parinami peroxinitrite nishkriy hote aanee raktavahinyanchi madhyasthi nasalelya vasodilationla pratikriya mhanoon vasoconstrictors angiotensin II aanee endothelenechi muktata yancha samavesh hoto.
pharmacokineticsmadhil farak.
nitrates pramukhyane tyanchya kruticha veg aanee kalavadhi yaat bhinn asatat. glyceril trinitrate jalad aanee lahan (10 teey 30 minite) karya karate, tarr itar bahutek nitrateschi kriya haloohaloo suru hote, parantu teey sahaa tasanparyant prabhavi asatat. namood kelyapramane, molacidomine keval haloohaloo karya karat nahee tarr nitratespeksha konatihi sahishnuta naan darshavinyaitake vegale dekhil asate. antahshira mhanoon dilele nitropruside tabadtob karya karate aanee otane thambavalyanantar daha minitant raktadab tyachya mageel patalivar parat yeto.