Sildenafil - chiito, zviratidzo, contraindications, nemigumisiro

Sildenafil mushonga unoshandiswa kurapa erectile dysfunction. Yakatanga kunyorerwa kuvarwere vane pulmonary hypertension, asi mhedzisiro yayo pakuita zvepabonde yakakurumidza kucherechedzwa. Ikozvino wava mushonga unogara uchikurudzirwa kune varume vari kunetseka nedambudziko rekushaya simba. Chii chaunoda kuziva nezveSildenafil?

1. Chii chinonzi Sildenafil?

Mishonga mikuru yekurapa erectile dysfunction ndeye phosphodiesterase type 5 inhibitors (PDE-XNUMX). Mushonga unozivikanwa zvikuru werudzi urwu ndiViagra.

Yakatangwa muna 1998 kumusika weUS uye yave kuwanikwa kunenge kwese kwese pasirese. Zvisinei, inofanira kuyeukwa kuti kune mimwe mishonga yakawanda ine nzira imwechete yekuita. Anonyanya kuzivikanwa:

• Sildenafil
• tadalafil,
• Vardenafil.

Kuiswa kweSildenafil uye huwandu hwese hwemishonga kubva muboka iri hwakanga husina kurongeka. Pakutanga, sildenafil yakarongedzerwa kune varwere vane pulmonary arterial hypertension. Yake erection kuwedzera simba yakakurumidza kuonekwa nevarwere, izvo zvakaita kuti kuchinja kwezviratidzo zvekushandiswa kwechirwere ichi.

Pamberi penguva ye sildenafil, varume vakashandisa uye vanowanzoshandisa vamwe vakawanda, avo vanonzi vanhu, zvakananga. Zvakachengeteka kutaura kuti mutsika dzose kune chimwe chinhu chinofanira kuvandudza potency. Uye hongu, vanhu vanga vachishandisa anotevera marapirwo erectile dysfunction kwemazana emakore:

• hupfu hwenyanga yechipembere hunozivikanwa zvikuru muChina,
• mune dzimwe tsika raive ropa remuremwaremwa, machende egava nemhembwe, uropi hwekatsi,
• gavakava, verbena, ginger, gariki, lovage, nutmeg, cloves.

Inofanira kusimbiswa kuti zvizhinji zvezvinhu izvi hazvina nzira inopupurirwa yekuita. Kubudirira kwavo kunobva pakutenda kwemashiripiti chete muchiito chavo.

2. Sildenafil Inoshanda Sei

Sildenafil yakatanga kupihwa mvumo muna 1996 uye yakarova pamusika makore maviri gare gare. Parizvino, mushonga we potency, une primary pulmonary hypertension (III functional class) uye nezvimwe zvirwere zve connective tissue.

Mishonga ine 25-100 milligrams ye sildenafil citrate. Sildenafil ine muhutano hwayo piperazine motif uye guanine analog, 1H-pyrazolo [4,3-d] pyrimidine. Iyo yepakati phenol system yakarongeka yakaenzana ne ribose, uye sulfone residu inoenderana neboka re phosphate re nucleotide.

Mushonga uyu uri mumuviri unodzivisa kunyanya phosphodiesterase type 5 (PDE5) - kuwirirana kwemamwe marudzi ee enzyme iyi kwakadzikira zvikuru. PDE5 inotsemura cGMP, iyo inokonzeresa kuzorora kwemhasuru uye kuwedzera kuyerera kweropa kumitumbi ine cavernous.

Panguva yekukurudzira pabonde, masero etsinga anotanga kugadzira nitric oxide (NO), iyo inoita kuti zvikwanise kushandisa cGMP. Yakavharwa ne sildenafil, PDE5 inokutendera iwe "kuchengetedza" erection.

Nekudaro, muvarume vazhinji, nekuda kweurosis, kushushikana kwepfungwa, kusaenzana kwehomoni kana kusagadzikana kwetsitsi, kugadzirwa kwenitric oxide nemasero etsinga hakuna kusimba, izvo zvinotungamira kune kushaya simba uye kupfupi erections. Kunyanya kukurumidza kutorwa kunoitika mushure mekutora mushonga mudumbu risina chinhu. Inobudiswa kunyanya netsvina (inenge 80%) uye kusvika pamwero muduku neweti.

3. Zviratidzo zvekushandiswa kweSildenafil

Gumi mushonga we potency inobvumira varume kuwana erection yekusingaperi uye kuita zvepabonde. Kubatsira kwechirwere ichi ndechokuti erection haiitike pakarepo mushure mekutora piritsi, asi kukurudzira zvepabonde kunodiwa (kusiyana nemishonga yeprostaglandin).

Mushonga unokurudzirwa kutorwa imwe kusvika maawa matanhatu vasati varonga kuita zvepabonde. Mushure mekunge chiremba aongorora dhigirii uye chimiro chekushaya simba, chiremba anosarudza chiyero chemushonga (25, 50 kana 100 mg), iyo inokubvumira kuchengetedza erection kubva pamaminitsi makumi matatu kusvika paawa. Mushonga unokurudzirwa kutorwa kamwe chete pazuva. Kune vanhu vane simba renal insufficiency, kuderedza dose kunokurudzirwa.

4. Contraindications

Mushonga uyu haufanirwe kutorwa nevarume pasi pemamiriro anotevera:

• coronary artery chirwere,
• hypertension yakaipa,
• kutadza kweropa (NYHA kirasi III uye IV),
• nechirwere chemoyo chazvino (mavhiki maviri okutanga),
• obstructive cardiomyopathy
• ne ventricular arrhythmias (yakashata, inokonzerwa nekurovedza muviri, kushushikana, manzwiro),
• ane chirwere chakakomba chevhavha
• kukundikana kwakanyanya kwechiropa uye itsvo,
• mushure mekurohwa
• nekuchinja kwekuchinja mu retina (semuenzaniso, retinitis pigmentosa),
• hypotension,
• ne hypersensitivity kune zvikamu zvemushonga.

Siledenafil Iine vasodilating effect uye inogona kuva nengozi kune vanhu vanotora mishonga yemwoyo uye yevascular. Chinhu chinopesana zvachose nekutora mushonga kutora Nitrate neMolsidomine.

Kusiyana kwemetabolism yemushonga uyu kunofanirwawo kuverengerwa. Yakaputsika muchiropa, izvo zvinoreva kuti kubuda kwechirwere ichi kunoderedzwa kune vanhu vane chiropa chakakanganisika uye vanopfuura makore 65, uye mazinga akakwirira anogona kuva nengozi. Zvinodhaka zvinozivikanwa kupindirana nesiledenafil zvinosanganisira:

• tevedzera,
• erythromycin,
• ketoconazole,
• rifampicin nevamwe vakawanda.

Sildenafil, nekuda kwevasodilating mechanism, inoderedza ropa. Kusvika iye zvino, kufa nekuda kwekushandiswa kwe sildenafil kwakaitika kune vanhu vanotora mishonga yemwoyo yakadai, semuenzaniso, nitrate kana zvimwe. mishonga yekudzikisa BP.

Mushonga uyu haukurudzirwe kuti ushandiswe mukushaya simba muvarume vari pasi pemakore gumi nemasere uye mukuremara kweanatomical yenhengo (sekukotama, cavernous fibrosis kana chirwere chePeyronie) mushure. penile prosthesis uye nemamiriro ezvinhu anovaparira priapism (semuenzaniso, sickle cell anemia, multiple myeloma, kana leukemia). Mushonga haushandiswe sechikamu chemusanganiswa kurapa kurapwa kwe erectile dysfunction.

5. Matambudziko mushure mekutora sildenafil

Sildenafil mushonga unobvumirwa zvakanaka nevarume vakawanda. Zvinoitika zvakadaro migumisiro ye sildenafilIzvi zvinosanganisira:

• musoro uye dzungu
• kutsvuka kwechiso
• dyspepsia (kushungurudzika kwemudumbu);
• kusaona).

Zvishoma zvakajairika mhedzisiro yekutora sildenafil ndeiyi:

• kuzvimba kwenasal mucosa,
• utachiona hwedundira uye urethra,
• kurwadziwa kwemhasuru nemajoini.

Izvo zviri pamusoro pemigumisiro ye sildenafil inonzi inenge 35 muzana. Varwere. Kuonekwa kwezviratidzo izvi kunobatanidzwa nekuvhara PDE mhando 5, pamwe nemamwe marudzi mune dzimwe nhengo. Vanhu vane rhythms yemoyo isina kujairika, high blood pressure, uye tsika yekuva nekurwadziwa kwemoyo vanogona kusangana nezvinetso zvakakomba, kusanganisira myocardial infarction uye kufa (nekuda kwekusunungurwa kwenitric oxide).

Kushandiswa zvisina kunaka kwemushonga nevarume vane hutano kunogona kukonzera mamwe matambudziko mukuwana erection (pasina kutora mushonga), kuzvimba kunorwadza kwepeni, kuzvimba uye kuparadzwa kwecorpora cavernosa.

Kunyanya kushandiswa kunogona kuchengetedza erection kusvika kumaawa matanhatu. Nekuda kwekugona kukanganisa kwekuona uye dzungu mushure mekutora mushonga, iwe unofanirwa kurega kutyaira mota uye kushanda nemagadzirirwo.

6. Zvikonzero zvekushaya simba

Kushaya simba (ED) kunotsanangurwa se“kusashanda zvakanaka kwepabonde kunoratidza kushaya erection kana kubudisa ejaculate pasinei nekunakidzwa uye kugutsikana kwepamberi." Kushaya simba hakusi kusavapo kwe erection panguva yekusangana pabonde, izvo zvinowanzoperekedzwa nekushushikana.

Tinogona kutaura nezvehurwere kana matambudziko ekumira uye ejaculation inooneka kakawanda, zvisinei nehukama huripo pakati pevadyidzani. Chirwere ichi chinogona kukamurwa kuva chekutanga uye chechipiri (chinoitika mushure menguva yehutano hwepabonde).

Mhedzisiro yematambudziko muhupenyu hwakazara hwepabonde inogona kuve yepfungwa (psychogenic impotence) uye organic (somatic) zvinhu.

Boka rekutanga rinosanganisira: kutya kusangana, kutya kwepamuviri pasingadiwi, kuoma, mhosva, kutadza, kushungurudzika, psychosexual development disorders, introversion (maitiro ekutarisa iwe pachako). Kazhinji mumamiriro ezvinhu akadaro, pakuvata kana kuti bonhora, zvinowanzoitika.

Zvikonzero zvemuviri zvekushaya simba zvinosanganisira zvirwere (chirwere cheshuga mellitus, multiple sclerosis, tetraplegia, ALS, kukanganisa kwemwoyo, hypertension yakaoma, phimosis, flushing, chirwere chePeyronie) kana kuchinja kwezera (andropause) kunodzivirira kumira. Zvimwe zvinokurudzira (doro, amphetamines) uye zvinodhaka (SSRIs, SNRIs) zvinogona kukonzera kushaya simba.

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