
ivabradine

procoralan anae brand paerutoe vikrayinche ivabradine, itarulatoe paatu, oka aushadham, idhi pays maker current (ii "eff") inhibitor, idhi gunde sambandhita chaatii noppi mariyu gunde vaiphalyam yokka rogalakshana nirvahana kosam upayoginchabadutundi. coronary haart failure kosam ivabradine vaadakaaniki arhata kaligina rogulu rogalakshana gunde vaiphalyam unna rogulu, takkuva ajection valume mariyu kaneesam 70 bpm hridaya spandana raetu, mariyu beata blockers dwara paristhitini puurtigaa nirvahinchaleni rogulu.
ivabradine cinatrial nirmaanamloo pratikuula chronotropyni anumatinchadam dwara panichestundi, tadwara pays maker current yokka nirdishta nirodham dwara hridaya spandana retunu taggistundi, idhi beata blockers mariyu calcium chaanal blockers kante bhinnamaina yantraangam, saadhaaranamgaa suuchimchabadina rendu antianginal taragatula cardiac pharmaceuticals. ivabradineku spashtamaina inotropic lakshanaalu laevu mariyu idhi cardiotonic agent kaavacchu.
vaidya upayogaalu.
beata blockers teesukoleni saadhaarana sinus rhythm unna rogulalo deerghakaalika sthiramaina anjina pectoris yokka rogalakshana chikitsa kosam dheenini upayogistaaru. idhi anuchitamaina sinus tachycardia chikitsalo off-label gaa kooda upayoginchabadutondi. ivabradine anedi shastrachikitsa anantara cab rogulalo anubandha dushprabhaavaalu lekunda hcr mariyu layanu niyantrinchadaaniki aushadha empikagaa nilustundi.
chaatii noppi.
ivabradine beata blocker attenolol vale prabhaavavantamgaa untundi mariyu deerghakaalika sthiramaina anjina nirvahanalo aamlodipinto polchavachhu, idhi takkuva sthaayi pareekshalalo mottam vyayama vyavadhilo merugudalalu dwara pradarsinchabadindi, anduvalla idhi sampradaaya chikitsalanu sahinchaleni vaariki pratyaamnaaya chikitsagaa untundi. vaari anjina kosam beata blackerlatho taginantagaa nirvahinchaleni vyaktulalo, ivabradine jodinchadam valla hridaya spandana retunu marinta tagginchavachhu mariyu mottam vyayama vyavadhini meruguparustundi.
gunde vaiphalyam.
idhi gunde vaiphalyam unnavaarilo beata blackerlatho kalipi upayoginchabadutundi, elweff 35 saatam kante takkuvagaa beata blackerla dwara matrame niyantrinchabadutundi mariyu dheeni hridaya spandana raetu nimishaaniki 70 beetlanu minchipotundi. vaari gunde vaiphalyam kosam beata blackerlatho taginantagaa nirvahinchaleni vyaktulalo ivabradine jodinchadam valla gunde vaiphalyam kosam aasupatrilo chere pramaadaanni taggistundi.
tachycardia.
ivabradine yokka clinical upayogam sinoatrial nodal kanajaalampai daani charya yokka yantraamgampai anchanaa veyabadindi, ikkada idhi funny karentnu ("iff") empika chesi nirodhistundi mariyu hridaya spandana raetu taggadaaniki daariteestundi.
electrophysiologylo ivabradine yokka atyanta tarachugaa upayoginche anuvartanam anuchitamaina sinus tachycardia chikitsa kosam. anuchita sinus tachycardia kosam daani upayogam european medicines agency/phud und drugg administration-aamodinchabadina ivabradine suuchana kaadu.
sudeergha covid rogulalo bhangimala orthostatic tachycardia syndrome chikitsa kosam dheenini prayogaatmakamgaa upayoginchaaru.
vyatiraeka suuchanalu.
sick sinus syndromelo ivabradine viruddhamgaa untundi. azole anty fungals (ketoconazole vantivi), macrolide antibiatics, nephazodone mariyu antiretroviral mandulu nelfinavir mariyu ritonavirlatho sahaa saip3eah4 yokka saktivantamaina inhibitorsto kooda dheenini upayoginchakudadu.
verapamil ledhaa diltiagentho ivabradine vadakam viruddhamgaa untundi.
pratikuula prabhavalu.
mottammeeda, ivabradine teesukune rogulalo 14.5% prakaasavantamaina drugvishayaanni anubhavistaaru (puurtigaa nirvahinche drushya rangamlo merugaina prakaasam yokka anubhoothulugaa varninchabadina rogulu). idhi bahusha retiinaalooni i "h" ayan chaanella addanki kaaranamgaa kaavacchu, ivi cardiac i "f" thoo chaalaa pooli untaayi. eee lakshanaalu telikapativi, taatkaalikamainavi mariyu puurtigaa tirigi marchagalavu. clinical adhyayanaalalo, eee anubhoothula kaaranamgaa rogulandarilo sumaru 1 saatam mandhi aushadhaanni nilipiveyavalasi vachindi, idhi aushadham praarambhinchina sagatuna 40 rojula tarvaata sambhavinchindi.
oka pedda clinical triallo, broadycardia (asadhaaranamgaa nemmadigaa hridaya spandana raetu) ivabradine teesukune rogulalo 2 saatam mariyu 5 saatam mandhi rogulalo varusaga 7.5 mariyu 10 milligramula motaadulo sambhavinchindi (attenolol teesukune vaarilo 4.3 saatamtoe poliste). 2.6-4.8% talanoppi nivedinchabadindi. itara saadhaarana pratikuula aushadha praticharyalu (rogulalo 1-10%) modati-sthaayi evi block, ventricular extracistoles, maikamu mariyu/ledhaa aspashtamaina drushti.
charya yokka yantraangam.
ivabradine i "f" ("f" anedi "funny" kosam, daani aavishkarana samayamlo telisina itara current vyavasthalatho poliste asaadhaarana lakshanaalanu kaligi unnanduna dheenini pilustaaru) ayan current meeda panichestundi, idhi sinoatrial nodlo ekkuvagaa vyakteekarinchabadutundi. i "f" anedi hyperpolarisation dwara sakriyam cheyabadina mariyu swayampratipatti naadii vyavastha dwara modulate cheyabadina mishrama Na +-k + lopali current. cinatrial (saa) nodlo pays maker karyakalapalanu niyantrinchadaaniki idhi atyanta mukhyamaina ionic pravahalalo okati. ivabradine empika chesina motaadu-aadhaarita paddhatiloo pays maker i "f" karentnu nirodhistundi. eee chaanelnu nirodhinchadam valla cardiac pays maker karyakalapalu taggutaayi, hridaya spandana retunu enchukunna vidhamgaa mandagistundi mariyu myocardianiki raktam pravahinchadaaniki ekkuva samayanni anumatistundi. ii "eff" chaanelnu nirodhinchadam dwara, ivabradine hridaya spandana raetu mariyu hrudayampai panibharanni taggistundi. anjina mariyu raktaprasarana gunde vaiphalyam chikitsaku mandula vaadakamlo idhi sambandhitamgaa untundi. idhi beata-blockers mariyu calcium chaanal blockers vanti saadhaaranamgaa upayoginche itara raetu-tagginche mandulaku viruddhamgaa untundi, ivi hridaya spandana retunu tagginchadame kakunda, hridaya sankocham kooda taggistaayi. sankocham kolpokunda raetu taggadam valla, ivabradine takkuva ajection bhinnamtho raktasrava gunde vaiphalyam chikitsaku prabhaavavantamgaa niroopinchavacchu.
ivabradine, y506, f509 mariyu i510 avasheshaalanu upayoginchi, hcn4 graahakaalato (potassium/sodiyam hyperpolarisation-activated cyclic nucleotide-gated chaanal 4) bandhistundi.
clinical trials.
coronary artary vyaadhi.
eee andamaina adhyayanam 10917 mandiki paiga sthiramaina coronary artary vyaadhi mariyu edama jatarika panicheyakapovadam (ajection fraction <40 saatam) unna rogulanu yaadrucchikamgaa chesindi. ivabradine hridayanaala maranam yokka praadhamika mishrama mugimpu binduvu, teevramaina myocardial inforction kosam aasupatrilo cheradam mariyu kotta prarambham ledhaa gunde vaiphalyam kosam aasupatrilo cheradam vanti vaatilo gananeeyamaina taggudalanu choopinchaledu. ayithe, 70 bpm kante ekkuva baseline hridaya spandana raetu unna rogula mundugaa perkonna upa samuuhamloo, ivabradine eee krindi dviteeya mugimpu binduvulanu gananeeyamgaa tagginchindihi
eee phalitaalu beata blackerlatho kalayika chikitsalo kanipinchaayi, mariyu 70 bpm ledhaa anthakante ekkuva hridaya spandana raetu unna rogulalo coronary artary vyaadhi phalitaalanu meruguparachadamlo surakshitamainavi mariyu prabhaavavantamainavigaa kanugonabaddayi.
sthiramaina coronary artary vyaadhi unna 19102 mandhi rogulu mariyu nimishaaniki 70 beats kante ekkuva unna hridaya spandana raetu unna rogulaku praamaanika chikitsato paatu ivabradine ledhaa placebo jokyaniki ketaayinchaaru. ivabradine roogi samoohaalalo dviteeya phalitaalanu gananeeyamgaa meruguparachaledu, ayithe hridaya spandana raetu taggudalanu pradarsinchindi. shift adhyayanamtho polchinappudu, hridayanaala maranam ledhaa aasupatrilo cheradam taggadam kooda pradarsinchabadindi, anduvalla adanapu chikitsa prashnaarthakamgaa unnappudu pariganinchaali.
deerghakaalika gunde vaiphalyam.
shift adhyayanamlo, ivabradine optimal therapy paina unna placebotho poliste gunde vaiphalyam ledhaa hridayanaala maranaaniki aasupatrilo cherina praadhamika mishrama mugimpu binduvu pramaadaanni 18 saatam (p <0.0001) gananeeyamgaa tagginchindi. chikitsa chesina 3 nelala tarvaata eee prayojanaalu gamaninchabaddaayi.
gunde vaiphalyam unna rogulaku ivabradine ivvadam valla gunde vaiphalyam valla maraninche pramaadaanni 26 saatam (p = 0.014) mariyu gunde vaiphalyam kaaranamgaa aasupatrilo chere pramaadaanni 26 saatam (p <0.0001) gananeeyamgaa tagginchindani kooda maarpu choopinchindi.
anni mundugaa perkonna upa samoohaalalo phalitaalalo merugudalalu gamaninchabaddayi yaadruchchika samayamlo beata-blackerlatho ledhaa lekunda stree mariyu purushulu, 65 samvatsaraala kante takkuva vayassu unna rogulu, ischemic ledhaa naan-ischemic etiology gunde vaiphalyam, naiha class II ledhaa class III, IV, diabetes thoo ledhaa lekunda, mariyu adhika rakthapotutho ledhaa lekunda. 2020 cochrane sameekshalo hridayanaala maranaalu mariyu ivabradine mariyu placebo/saadhaarana samrakshanhatho deerghakaalika chikitsa madhya teevramaina pratikuula sanghatanalalo etuvanti vyatyaasam kanipinchaledu/gunde vaiphalyam unnavaarilo takkuva ajection bhinnamtho chikitsa ledhu.
jagrattagaa undataaniki praadhaanyata ivvali. vaidyaparamgaa sthiramgaa unna rogulalo deerghakaalika gunde vaiphalyaaniki ivabradine suuchimchabadinappatikii, merugaina hridaya spandana raetu cardiac rijarvnu soochinche teevramaina gunde vaiphalyamlo suuchimchabadadu. ivabradine yokka vichakshanaarahita upayogam eee rogulanu asthiraparustundi.
samajam mariyu samskruti.
aamodam.
ivabradine 2005loe european medicines agencyche mariyu 2015loe united states phud und drugg administrationche aamodinchabadindi.
paerlu.
dheenini united stateslo amgen dwara vaanijya paeru carlanar kinda, mariyu prapanchamlooni migilina praantaalalo procoralan (prapanchavyaaptamgaa), coralon (hankong, singapur, australia mariyu konni itara deshaalalo), carlenter (armenia, speyin, italii mariyu romanialo), lancora (kenadaalo) mariyu coraxon (russia mariyu cerbialo) anae vaanijya paerlatoe sarveerlu vikrayistunnaaru. idhi bhaaratadesamlo ivabrad, ivabid anae brand paerlatoe kooda vikrayinchabadutundi. iraanlo idhi "broadics" trademark kinda vikrayinchabadutundi. ivamac mariyu bradia. daani abhivruddhi samayamlo, ivabradine nuu ess-16257 anie pilicheevaaru.

