Sildenafil - zochita, zikuonetsa, contraindications, mavuto

Sildenafil ndi mankhwala omwe amagwiritsidwa ntchito pochiza vuto la erectile. Iwo poyamba analamula odwala m`mapapo mwanga matenda oopsa, koma zotsatira zake pa kugonana anazindikira mwamsanga. Tsopano ndi mankhwala omwe amalimbikitsidwa nthawi zonse kwa amuna omwe akulimbana ndi vuto la kusowa mphamvu. Zomwe muyenera kudziwa za Sildenafil?

1. Kodi Sildenafil ndi chiyani?

Mankhwala akuluakulu othandizira erectile dysfunction ndi phosphodiesterase type 5 inhibitors (PDE-XNUMX). Mankhwala otchuka kwambiri amtunduwu ndi Viagra.

Idayambitsidwa koyamba mu 1998 kumsika waku US ndipo idapezeka pafupifupi kulikonse padziko lapansi. Komabe, ziyenera kukumbukiridwa kuti pali mankhwala ambiri omwe ali ndi njira yofananira. Odziwika kwambiri:

• Sildenafil
• tadalafil,
• Vardenafil.

Kuyamba kwa Sildenafil ndi mitundu yonse ya mankhwala a gulu ili kunali kosasintha. Poyamba, sildenafil analamula odwala m`mapapo mwanga ochepa matenda oopsa. Ake erection yowonjezera mphamvu adazindikira mwachangu ndi odwala, zomwe zidapangitsa kusintha kwazomwe zikuwonetsa kugwiritsa ntchito mankhwalawa.

Isanafike nthawi ya sildenafil, amuna ankagwiritsa ntchito ndipo nthawi zambiri amagwiritsa ntchito ena ambiri, otchedwa anthu, enieni. Ndizomveka kunena kuti mu chikhalidwe chilichonse pali chinthu china chomwe chiyenera kupititsa patsogolo potency. Ndipo inde, anthu akhala akugwiritsa ntchito njira zotsatirazi zochizira matenda a erectile kwazaka zambiri:

• ufa wa nyanga za chipembere ndiwotchuka kwambiri ku China,
• muzikhalidwe zina unali magazi a mileme, machende a nkhandwe ndi nswala, ubongo wa mphaka;
• chowawa, verbena, ginger, adyo, lovage, nutmeg, cloves.

Tiyenera kutsindika kuti zambiri mwazinthuzi zilibe njira yotsimikiziridwa yochitira. Kuchita kwawo kumangodalira chikhulupiriro chamatsenga pakuchita kwawo.

2. Momwe Sildenafil Imagwirira Ntchito

Sildenafil adakhala ndi chilolezo choyamba mu 1996 ndipo adafika pamsika patatha zaka ziwiri. Pakalipano, ndi mankhwala a potency, omwe ali ndi matenda oopsa kwambiri a m'mapapo (III zinchito kalasi) ndi matenda ena a connective minofu.

Mankhwala ali ndi 25-100 milligrams ya sildenafil citrate. Sildenafil ili ndi mawonekedwe ake a piperazine motif ndi guanine analogue, 1H-pyrazolo [4,3-d] pyrimidine. Dongosolo lapakati la phenol limafanana ndi ribose, ndipo zotsalira za sulfone zimafanana ndi gulu la phosphate la nucleotide.

Pawiri iyi m'thupi imalepheretsa makamaka phosphodiesterase mtundu wa 5 (PDE5) - kuyanjana kwa mitundu ina ya enzymeyi ndikotsika kwambiri. PDE5 imadula cGMP, yomwe imayambitsa kupumula minofu yosalala ndikuwonjezera kutuluka kwa magazi ku matupi amphako.

Panthawi yogonana, maselo a mitsempha amayamba kupanga nitric oxide (NO), zomwe zimapangitsa kuti agwiritse ntchito cGMP. Wotsekedwa ndi sildenafil, PDE5 imakulolani "kusunga" erection.

Komabe, mwa amuna ambiri, chifukwa cha neurosis, kupsinjika maganizo, kusalinganika kwa mahomoni kapena kusokonezeka kwa dongosolo lamanjenje lachifundo, kupanga nitric okusayidi ndi maselo a mitsempha kumakhala kofooka kwambiri, zomwe zimabweretsa kufooka komanso kuchepa kwafupipafupi. Kwambiri mofulumira mayamwidwe kumachitika pambuyo kumwa mankhwala pa chopanda kanthu m`mimba. Amatulutsidwa makamaka ndi ndowe (pafupifupi 80%) komanso pang'ono ndi mkodzo.

3. Zizindikiro zogwiritsira ntchito Sildenafil

Khumi mankhwala a potency amalola amuna kukwaniritsa erection okhazikika ndi kugonana. Ubwino wa mankhwalawa ndikuti erection sichitika mutangomwa mapiritsi, koma kukondoweza kwa kugonana kumafunika (mosiyana ndi mankhwala a prostaglandin).

Mankhwala tikulimbikitsidwa kuti amwe maola asanu ndi limodzi asanakonzekere kugonana. Dokotala atawunika kuchuluka kwa kusowa mphamvu ndi kufooka, adokotala amasankha mlingo wa mankhwalawa (25, 50 kapena 100 mg), womwe umakupatsani mwayi kuti mukhale ndi erection kuyambira mphindi 30 mpaka ola limodzi. Mankhwala tikulimbikitsidwa kutengedwa kamodzi patsiku. Kwa anthu omwe ali ndi vuto lalikulu laimpso, kuchepetsa mlingo kumalimbikitsidwa.

4. Contraindications

Mankhwalawa sayenera kumwedwa ndi amuna pamikhalidwe iyi:

• matenda a mtima,
• matenda oopsa oopsa,
• kulephera kwa circulatory (NYHA class III ndi IV),
• ndi matenda a mtima aposachedwa (masabata awiri oyamba),
• obstructive cardiomyopathy
• ndi ventricular arrhythmias (zoyipa, zoyambitsidwa ndi masewera olimbitsa thupi, kupsinjika, malingaliro),
• ndi matenda aakulu a valvular
• kulephera kwakukulu kwa chiwindi ndi impso,
• pambuyo pa sitiroko
• ndi kusintha kosinthika kwa retina (mwachitsanzo, retinitis pigmentosa),
• hypotension,
• ndi hypersensitivity kwa zigawo zikuluzikulu za mankhwala.

Siledenafil Imakhala ndi vasodilatory effect ndipo imatha kukhala yowopsa kwa anthu omwe amamwa mankhwala amtima ndi mitsempha. Kutsutsana kotheratu pakumwa mankhwalawa ndikutenga Nitrate ndi Molsidomine.

Kusiyanasiyana kwa kagayidwe ka mankhwalawa kuyeneranso kuganiziridwa. Imaphwanyidwa m'chiwindi, zomwe zikutanthauza kuti kutuluka kwa mankhwalawa kumachepetsedwa mwa anthu omwe ali ndi chiwindi chowonongeka ndi zaka zoposa 65, ndipo mlingo waukulu ukhoza kukhala woopsa. Mankhwala omwe amadziwika kuti amalumikizana ndi sildenafil ndi awa:

• phatikiza,
• erythromycin,
• ketoconazole,
• rifampicin ndi ena ambiri.

Sildenafil, chifukwa cha njira ya vasodilating, imachepetsa kuthamanga kwa magazi. Mpaka pano, kufa chifukwa chogwiritsa ntchito sildenafil kwachitika mwa anthu omwe amamwa mankhwala amtima monga, mwachitsanzo, nitrate kapena zina. mankhwala ochepetsa kuthamanga kwa magazi.

Mankhwalawa ndi osavomerezeka kuti agwiritsidwe ntchito mu kusowa mphamvu kwa amuna osakwana zaka 18 komanso kuwonongeka kwa thupi la mbolo (monga kupindika, cavernous fibrosis kapena matenda a Peyronie) pambuyo pake. prosthesis ya mbolo ndi mikhalidwe yomwe imawapangitsa kukhala okonda kwambiri (mwachitsanzo, sickle cell anemia, multipleeloma, kapena leukemia). Mankhwala si ntchito ngati mbali ya mankhwala osakaniza zochizira erectile kukanika.

5. Zotsatira zoyipa mutatenga sildenafil

Sildenafil ndi mankhwala omwe amalekerera bwino amuna ambiri. Zimachitika ngakhale zotsatira za sildenafil, Izi zikuphatikizapo:

• mutu ndi chizungulire
• kufiira kwa nkhope
• dyspepsia (zovuta za m'mimba),
• kusawona bwino).

Zotsatira zochepa zomwe zimachitika mukatenga sildenafil ndi:

• kutupa kwa mucosa ya m'mphuno,
• matenda a chikhodzodzo ndi urethra,
• kupweteka kwa minofu ndi mafupa.

Zotsatira za pamwamba za sildenafil zimanenedwa ndi pafupifupi 35 peresenti. Odwala. Maonekedwe azizindikirozi amalumikizidwa ndi kutsekereza PDE mtundu 5, komanso mitundu ina m'zigawo zina. Anthu omwe ali ndi vuto la mtima, kuthamanga kwa magazi, komanso chizolowezi chodwala matenda a mtima amatha kukumana ndi mavuto aakulu, kuphatikizapo myocardial infarction ndi imfa (chifukwa cha kutulutsidwa kwa nitric oxide).

Kugwiritsa ntchito molakwika mankhwalawa ndi amuna athanzi kumatha kubweretsa zovuta zina pakukwaniritsa erection (popanda kumwa mankhwala), kutupa kowawa kwa mbolo, kutupa komanso kuwonongeka kwa matupi amphako.

Kumwa mopitirira muyeso kumatha kusunga erection mpaka maola 6. Chifukwa cha kuthekera kwa kuwonongeka kwa maso ndi chizungulire mutatha kumwa mankhwalawa, muyenera kupewa kuyendetsa galimoto ndikugwira ntchito ndi makina.

6. Zomwe zimayambitsa kusabereka

Kupanda mphamvu (ED) kumatanthauzidwa ngati “kusokonekera kwa kugonana komwe kumawonekera kusowa erection kapena kutulutsa umuna ngakhale mukusangalala komanso kuwoneratu kosangalatsa." Kupanda mphamvu si kusowa kwa erection panthawi yogonana mwachisawawa, zomwe nthawi zambiri zimatsagana ndi nkhawa.

Tikhoza kulankhula za matenda pamene mavuto erection ndipo kutulutsa umuna kumawonekera nthawi zambiri, ngakhale pali kulumikizana komwe kulipo pakati pa okondedwa. Matendawa akhoza kugawidwa ku pulayimale ndi yachiwiri (yochitika pambuyo pa nthawi ya kugonana).

Zomwe zimayambitsa zovuta m'moyo wathunthu wogonana zitha kukhala zamaganizo (psychogenic impotence) ndi organic (somatic).

Gulu loyamba likuphatikizapo: kuopa kugonana, kuopa mimba yapathengo, zovuta, zolakwa, kuchimwa, kupsinjika maganizo, kusokonezeka kwa chitukuko cha psychosexual, introversion (chizoloŵezi chodziganizira nokha). Nthawi zambiri pamikhalidwe yoteroyo, pogona kapena podziseweretsa maliseche, anthu amachita zinthu mwachibadwa.

Zomwe zimayambitsa kusowa mphamvu kwa thupi zimaphatikizapo matenda (shuga mellitus, multiple sclerosis, tetraplegia, ALS, vuto la mtima, matenda oopsa kwambiri, phimosis, flushing, matenda a Peyronie) kapena kusintha kwa zaka (andropause) zomwe zimalepheretsa erections. Zolimbikitsa zina (mowa, amphetamines) ndi mankhwala osokoneza bongo (SSRIs, SNRIs) zingayambitsenso kusowa mphamvu.

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