Na Cocer Peptides 
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INGINGO ZOSE N'AMAKURU Y’IBICURUZWA BITANZWE KURI URU RUBUGA BISANZWE KUBONA AMAKURU N'INTEGO Z'UBUREZI.
Ibicuruzwa byatanzwe kururu rubuga bigenewe gusa mubushakashatsi bwa vitro. Mu bushakashatsi bwa vitro (Ikilatini: * mu kirahure *, bisobanura mu bikoresho by'ibirahure) bikorwa hanze y'umubiri w'umuntu. Ibicuruzwa ntabwo ari imiti, ntabwo byemejwe n’ikigo cy’Amerika gishinzwe ibiryo n’ibiyobyabwenge (FDA), kandi ntigomba gukoreshwa mu gukumira, kuvura, cyangwa gukiza indwara iyo ari yo yose y’ubuvuzi, indwara, cyangwa indwara. Birabujijwe rwose n'amategeko kwinjiza ibyo bicuruzwa mumubiri wabantu cyangwa inyamaswa muburyo ubwo aribwo bwose.
1. Incamake
Tadalafil, nka fosiforiesterase-5 (PDE-5) inhibitor ikora, itanga inzira nshya zo kuvura imiterere itandukanye no kunoza imikorere yumubiri.
Igishushanyo 1 Bisobanura impinduka ziva kumurongo, hamwe 95% intera yicyizere (CIs), muminota 6 yo kugenda muminota 6 mugihe cyicyumweru cya 16 mumatsinda ya tadalafil na placebo.
2. Ingaruka ku Kuzenguruka kw'amaraso
Uburyo bwa Vasodilation: Mu mubiri w'umuntu, aside nitide (OYA) - cyclic guanosine monophosphate (cGMP) - PDE5 yerekana inzira igira uruhare runini mugutunganya imitsi yoroshye y'amaraso. Iyo selile ya endoteliyale irekuye OYA iyo ikangutse, OYA ikora guanylate cyclase, iteza imbere guanosine triphosphate (GTP) kuri cGMP. Nkintumwa ya kabiri idasanzwe, cGMP ikora protein kinase G (PKG), biganisha kuri vasodilasiyo yimitsi yoroshye yimitsi, kongera diameter yimitsi, no kongera amaraso. Uburyo bwibikorwa bya Tadalafil nuguhagarika ibikorwa bya PDE5, kugabanya kwangirika kwa cGMP, bityo bikagumana urugero rwinshi rwa cGMP mungirangingo kandi bikomeza ingaruka za vasodilatori kugirango amaraso atembera neza.
Ingaruka ku buriri butandukanye bw'imitsi
Kuzenguruka kw'ibihaha: Mu kuzenguruka kw'ibihaha, Tadalafil ikoreshwa cyane mu kuvura hypertension ya arterial (PAH). Mu barwayi ba PAH, kwiyongera kw'imitsi iva mu mitsi itera kwiyongera k'umurimo ukabije w'amashanyarazi, ari nako bigira ingaruka ku mikorere y'umutima no gutembera kw'amaraso. Tadalafil yagura imiyoboro yimpyiko, igabanya kurwanya imitsi yimitsi ihumeka, igabanya umuvuduko ukabije wumuvuduko wamashanyarazi, igahindura imitekerereze yimitsi ihindagurika, ikongera umusaruro wumutima, bityo bigatuma abarwayi bihanganira imyitozo nubuzima bwiza. Abarwayi ba PAH bahabwa mg 40 za Tadalafil rimwe buri munsi bagize iterambere ryinshi mubushobozi bwimyitozo ngororamubiri no gutinda kwivuza.
Kuzenguruka kwa sisitemu: Mu kuzenguruka kwa sisitemu, Tadalafil nayo igira ingaruka nziza mumitsi. Yaguka imitsi ya periferique, igabanya imiyoboro y'amaraso ya periferique, kandi igateza imbere amaraso. Ku barwayi bafite indwara zifata imitsi ya periferique, nka claudication rimwe na rimwe, Tadalafil irashobora kongera amaraso mu mitsi yo hepfo, kugabanya ibimenyetso bya ischemia mugihe cy'imyitozo ngororamubiri, no kunoza intera yo kugenda no gukora siporo. Tadalafil irashobora kandi kunoza imiyoboro y'amaraso ya koronariyeri kandi ikanashobora kongera imitsi ya myocardial kubarwayi barwaye indwara zifata imitsi, nubwo hakenewe ubundi bushakashatsi kugirango hemezwe izo ngaruka.
Microcirculation: Microcirculation ni urubuga rukomeye rwo guhanahana ibintu hagati yinyama zabantu namaraso. Tadalafil itezimbere imiyoboro ya microcirculaire, ikongera umubare wa capillaries ifunguye, kandi ikongerera amaraso ya tissue hamwe no gutanga ogisijeni. Mu bushakashatsi bumwe na bumwe, byagaragaye ko nyuma yo kuvura Tadalafil, umuvuduko w’amaraso wa microcirculatory umuvuduko w’uruhu n’imitsi byihuta, byorohereza itangwa ryintungamubiri zoroshye ndetse no kuvanaho imyanda ya metabolike, bityo bigafasha gukomeza imirimo isanzwe yumubiri yimitsi.
3. Porogaramu mugutezimbere imikorere yumubiri
Kongera imbaraga zo kwihangana
Abarwayi bafite indwara z'umutima bavukanye: Ku barwayi bafite indwara z'umutima bavukanye, cyane cyane abafite imikorere imwe ya ventricle babazwe na Fontan, kwihanganira imyitozo nyuma yo kubagwa akenshi bigabanuka. Tadalafil, ibinyujije mu ngaruka zayo za vasodilatory, igabanya imitsi iva mu mitsi no kurwanya imitsi itunganijwe neza, igateza imbere umutima, kandi ikongera umutima, bityo igatanga imitsi hamwe na ogisijeni nintungamubiri nyinshi mu gihe cyo gukora siporo. Mu barwayi 16 babazwe na Fontan, nyuma yo kuvurwa kwa Tadalafil (mu ikubitiro 10mg rimwe ku munsi, hanyuma 10mg buri masaha 12 nyuma y'ibyumweru 2, amezi 6 yose), impuzandengo y'urugendo rw'iminota 6 yiyongereye kuva kuri 418.75m igera kuri 439.06m, kandi gufata ogisijeni ntarengwa (VO2 max) byiyongereye kuva kuri 0.84 L / min kugeza ku 1.07 L / min.
Abaturage bafite ubuzima bwiza: Tadalafil irashobora kandi kugira ingaruka nziza mukwihangana kwimyitozo kubantu bafite ubuzima bwiza. Nubwo ubushakashatsi bunini ku baturage bafite ubuzima bwiza ari buke, ubushakashatsi bumwe na bumwe bwerekana ko Tadalafil ishobora guteza imbere umuvuduko w'amaraso mu gihe cy'imyitozo ngororamubiri, bigatuma imitsi ishobora kubona ogisijene ihagije mu gihe cy'imyitozo ngororamubiri, gutinda gutangira umunaniro, ndetse bikaba byanongera imbaraga mu mikino ngororamubiri. Muri siporo imwe yo kwihangana, abakinnyi bavuze ko bahumekeye neza kandi bahumeka imyitozo nyuma yo gukoresha Tadalafil; icyakora, ubushakashatsi bukomeye bwa siyansi burakenewe kugirango hemezwe ibyavuye.
Kunoza imikorere yimitsi: Imikorere isanzwe yimitsi iterwa no gutanga amaraso ahagije hamwe na ogisijeni. Mugutezimbere kwamaraso, Tadalafil irashobora gutanga imitsi hamwe na ogisijeni nintungamubiri nyinshi, bigatera imbaraga metabolism. Irashobora kandi kugira ingaruka nziza kubikorwa byo kugabanuka kwimitsi no kuruhuka muguhuza inzira zerekana ibimenyetso. Mu bushakashatsi bw’inyamaswa, inyamaswa zivuwe na Tadalafil zagaragaje imbaraga zimitsi no kwihangana. Ku barwayi barwaye imitsi cyangwa imitsi iterwa no kuruhuka igihe kirekire, Tadalafil irashobora guteza imbere umuvuduko wamaraso waho, igateza imbere gusana imitsi no kuvugurura, kandi ikongera imikorere yimitsi.
Kunoza imikorere yumubiri ya buri munsi: Ku barwayi bafite imikorere mibi (ED), Tadalafil ntabwo itezimbere imikorere yumugabo gusa ahubwo igira n'ingaruka nziza kumikorere rusange yumubiri nubuzima bwiza. Abarwayi ba ED bakunze guhura nibibazo byimitekerereze bitewe nubuzima bwabo, ibyo bikagira ingaruka kubushake bwabo mubikorwa bya buri munsi no mumikorere yumubiri. Tadalafil ituma amaraso atembera neza muri penile corpus cavernosum, agarura imikorere yumugabo, mugihe kandi byongera abarwayi icyizere, bigatuma bashobora kurushaho gukora mubuzima bwa buri munsi. Byongeye kandi, ku barwayi bafite hyperplasia nziza ya prostatique (BPH) hamwe n’ibimenyetso byo mu nkari zo hasi (LUTS), Tadalafil irashobora kunoza imikorere yinkari mu koroshya imitsi yoroshye ya prostate no mu ruhago rw’uruhago, kugabanya ibibazo by’umubiri biterwa n’ingorane z’inkari, bityo bikazamura imikorere y’abarwayi ya buri munsi ndetse n’ubuzima bwiza.
4. Incamake
Tadalafil yerekana ingaruka zikomeye mugutezimbere amaraso no gukora kumubiri. Haba mu kuvura indwara z'umutima-dameri nka hypertension armonial arterial hypertension n'indwara y'amaraso ya periferique, cyangwa mukongera imbaraga zo kwihanganira imyitozo ngororamubiri, kunoza imikorere yimitsi, no kongera imikorere yumubiri ya buri munsi kubarwayi bafite indwara z'umutima bavukanye, bigira uruhare runini.
Inkomoko
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