Sildenafil - isenzo, izinkomba, contraindications, side effects

I-Sildenafil iyisidakamizwa esisetshenziselwa ukwelapha ukungasebenzi kahle kwe-erectile. Ekuqaleni yayinqunyelwe iziguli ezine-hypertension yamaphaphu, kodwa umphumela wayo ebulilini wabonakala ngokushesha. Manje sekuyisidakamizwa esinconywa njalo kwabesilisa abanenkinga yokungabi namandla. Yini okudingeka ukwazi ngeSildenafil?

1. Iyini i-Sildenafil?

Imithi eyinhloko yokwelapha ukungasebenzi kahle kwe-erectile i-phosphodiesterase type 5 inhibitors (PDE-XNUMX). Isidakamizwa esidume kakhulu salolu hlobo yi-Viagra.

Yasungulwa ngo-1998 emakethe yase-US futhi kusukela ngaleso sikhathi ibitholakala cishe yonke indawo emhlabeni. Kodwa-ke, kufanele kukhunjulwe ukuthi kunezidakamizwa eziningi ezengeziwe ezinomshini ofanayo wokusebenza. Okudume kakhulu:

• I-Sildenafil
• i-tadalafil,
• I-Vardenafil.

Ukwethulwa kweSildenafil nalo lonke uhla lwezidakamizwa kuleli qembu kwakungahleliwe. Ekuqaleni, i-sildenafil yayinqunyelwe iziguli ezine-pulmonary arterial hypertension. Okwakhe umphumela wokuthuthukisa ukuqhanyelwa yasheshe yabonwa iziguli, okwaholela ekushintsheni kwezinkomba zokusetshenziswa kwalesi sidakamizwa.

Ngaphambi kwenkathi ye-sildenafil, amadoda ayesebenzisa futhi avame ukusebenzisa amanye amaningi, okuthiwa adumile, aqondile. Kuphephile ukusho ukuthi kuwo wonke amasiko kukhona into ethile okufanele ithuthukise amandla. Futhi yebo, abantu bebelokhu besebenzisa izindlela zokwelapha ezilandelayo zokungasebenzi kahle kwe-erectile amakhulu eminyaka:

• Impushana yophondo lukabhejane idume kakhulu eChina,
• kwamanye amasiko kwakuyigazi lelulwane, amasende empungushe nenyamazane, ubuchopho bekati,
• umhlonyane, i-verbena, i-ginger, i-garlic, i-lovage, i-nutmeg, i-clove.

Kufanele kugcizelelwe ukuthi iningi lalezi zinto azinayo indlela efakazelwe yokusebenza. Ukusebenza kwabo kusekelwe kuphela okholweni lwemilingo esenzweni sabo.

2. Isebenza kanjani i-Sildenafil

I-Sildenafil yaqala ukugunyazwa ngo-1996 futhi yafika emakethe eminyakeni emibili kamuva. Njengamanje, kungumuthi wamandla, one-primary pulmonary hypertension (III isigaba sokusebenza) kanye nezifo ezithile zezicubu ezixhumeneyo.

Imithi iqukethe i-25-100 milligrams ye-sildenafil citrate. I-Sildenafil iqukethe esakhiweni sayo i-piperazine motif kanye ne-guanine analog, i-1H-pyrazolo[4,3-d]pyrimidine. Isistimu ye-phenol emaphakathi ilingana ngokwesakhiwo ne-ribose, futhi izinsalela ze-sulfone zihambisana neqembu le-phosphate le-nucleotide.

Le nhlanganisela emzimbeni ivimbela ikakhulukazi uhlobo lwe-phosphodiesterase 5 (PDE5) - ukuhlobana kwezinye izinhlobo zale enzyme kuphansi kakhulu. I-PDE5 ihlukanisa i-cGMP, enesibopho sokuphumuza imisipha ebushelelezi kanye nokwandisa ukugeleza kwegazi emizimbeni enemigede.

Ngesikhathi sokuvuselela ucansi, amangqamuzana ezinzwa aqala ukukhiqiza i-nitric oxide (NO), okwenza kube nokwenzeka ukusebenzisa i-cGMP. Ivinjwe i-sildenafil, i-PDE5 ikuvumela ukuthi "ugcine" ukuma.

Kodwa-ke, emadodeni amaningi, ngenxa ye-neurosis, ukucindezeleka kwengqondo, ukungalingani kwe-hormonal noma ukuphazamiseka kwesimiso sezinzwa esizwelayo, ukukhiqizwa kwe-nitric oxide ngamangqamuzana ezinzwa kubuthakathaka kakhulu, okuholela ekumiseni okubuthakathaka nokufushane kakhulu. Ukumuncwa okushesha kakhulu kwenzeka ngemva kokuthatha umuthi esiswini esingenalutho. Ikhishwa ikakhulukazi ngendle (cishe 80%) futhi kancane ngomchamo.

3. Izinkomba zokusetshenziswa kweSildenafil

Ishumi umuthi wamandla ivumela amadoda ukuthi afinyelele ukuqhanyelwa unomphela futhi enze ucansi. Inzuzo yalo muthi yiqiniso lokuthi ukumiswa akwenzeki ngokushesha ngemva kokuthatha iphilisi, kodwa ukukhuthazwa ngokocansi kuyadingeka (ngokungafani nezidakamizwa ze-prostaglandin).

Umuthi utuswa ukuthi uthathwe ihora elilodwa kuya kwayisithupha ngaphambi kokuya ocansini okuhleliwe. Ngemva kokuba udokotela ehlola izinga kanye nemvelo yokungabi namandla, udokotela ukhetha umthamo womuthi (25, 50 noma 100 mg), okuvumela ukuthi ugcine ukumiswa kusuka kumaminithi angu-30 kuya ehora. Umuthi unconywa ukuthi uthathwe kanye ngosuku. Kubantu abanokwehluleka okukhulu kwezinso, kunconywa ukunciphisa umthamo.

4. Contraindications

Lo muthi akufanele uthathwe amadoda ngaphansi kwezimo ezilandelayo:

• isifo se-coronary artery,
• i-hypertension eyingozi,
• ukwehluleka kokujikeleza kwegazi (isigaba se-NYHA III ne-IV),
• ngokuhlaselwa yinhliziyo kwakamuva (emasontweni amabili okuqala),
• i-obstructive cardiomyopathy
• nge-ventricular arrhythmias (okubi, okubangelwa ukuzivocavoca, ukucindezeleka, imizwelo),
• ngesifo esibi kakhulu se-valvular
• ukwehluleka okukhulu kwesibindi nezinso,
• ngemva kokushaywa unhlangothi
• ngezinguquko eziwohlokayo ku-retina (ngokwesibonelo, i-retinitis pigmentosa),
• i-hypotension,
• nge-hypersensitivity ezingxenyeni zomuthi.

I-Siledenafil Inomphumela we-vasodilatory futhi ingaba yingozi kubantu abasebenzisa izidakamizwa zenhliziyo nemithambo yegazi. Ukuphikisana okuphelele ekuphuzeni umuthi ukuthatha i-Nitrate ne-Molsidomine.

Umehluko kumetabolism yalesi sidakamizwa kufanele futhi ucatshangelwe. Iphulwa esibindini, okusho ukuthi ukuphuma kwalesi sidakamizwa kuyancipha kubantu abanezibindi ezilimele nabangaphezu kweminyaka engama-65 ubudala, futhi imithamo ephakeme ingaba yingozi. Izidakamizwa ezaziwa ukuthi zisebenzisana ne-siledenafil zifaka:

• fanisa,
• i-erythromycin,
• i-ketoconazole,
• i-rifampicin nabanye abaningi.

I-Sildenafil, ngenxa yendlela ye-vasodilating, yehlisa ukucindezelwa kwegazi. Kuze kube manje, ukufa ngenxa yokusetshenziswa kwe-sildenafil kuye kwenzeka kubantu abasebenzisa izidakamizwa zenhliziyo ezifana, isibonelo, i-nitrate noma ezinye. izidakamizwa zokwehlisa umfutho wegazi.

Lesi sidakamizwa asinconywa ukuthi sisetshenziswe ekusweleni amandla emadodeni angaphansi kweminyaka engu-18 ubudala kanye nokukhubazeka kwe-anatomical yepipi (njengokugoba, i-cavernous fibrosis noma isifo sikaPeyronie) ngemva kwalokho. i-penile prosthesis kanye nezimo ezibabeka phambili ekubeni ne-priapism (isb, i-sickle cell anemia, i-multiple myeloma, noma i-leukemia). Umuthi awusetshenziswa njengengxenye yokwelapha okuhlangene ekwelapheni ukungasebenzi kahle kwe-erectile.

5. Imiphumela emibi ngemva kokuthatha i-sildenafil

I-Sildenafil iyisidakamizwa esibekezelelwa kahle amadoda amaningi. Kuyenzeka nokho imiphumela emibi ye-sildenafilLokhu kufaka phakathi:

• ikhanda kanye nesiyezi
• ukubomvu kobuso
• i-dyspepsia (ukuphazamiseka kwesisu),
• ukungaboni kahle).

Imiphumela emibi engajwayelekile yokuthatha i-siledenafil yile:

• ukuvuvukala kwe-mucosa yamakhala,
• izifo zesinye kanye ne-urethra,
• ubuhlungu bemisipha namalunga.

Imiphumela emibi engenhla ye-sildenafil ibikwa cishe ngamaphesenti angu-35. Iziguli. Ukubonakala kwalezi zimpawu kuhlotshaniswa nokuvimbela uhlobo lwe-PDE 5, kanye nezinye izinhlobo ezithweni ezithile. Abantu abanezigqi zenhliziyo ezingavamile, umfutho wegazi ophakeme, kanye nokuthambekela kokuhlaselwa yinhliziyo bangaba nezinkinga ezinkulu, okuhlanganisa i-myocardial infarction nokufa (ngenxa yokukhululwa kwe-nitric oxide).

Ukusetshenziswa kabi kwesidakamizwa ngamadoda anempilo kungabangela ubunzima obengeziwe ekufezeni i-erection (ngaphandle kokuthatha umuthi), ukuvuvukala okubuhlungu kwepipi, ukuvuvukala nokubhujiswa kwe-corpora cavernosa.

Ukusetshenziswa ngokweqile kungagcina i-erection ifika emahoreni ayi-6. Ngenxa yokuthi kungenzeka ukuthi ungaboni kahle kanye nesiyezi ngemuva kokuthatha umuthi, kufanele uyeke ukushayela izimoto nokusebenza ngezinqubo.

6. Izimbangela zokungabi namandla

Ukungabi namandla (ED) kuchazwa “njengokungasebenzi kahle kocansi okubonakala ukuntuleka kokuqhanyelwa noma i-ejaculate naphezu kwenjabulo kanye ne-foreplay eyanelisayo." Ukungabi namandla akukhona ukungabi khona kwe-erection ngesikhathi sokuya ocansini okungavamile, okuvame ukuhambisana nokucindezeleka.

Singakhuluma ngokugula nini izinkinga zokuqhanyelwa futhi ukuqhanyelwa kuvela izikhathi eziningi, ngaphandle kokuxhumana okukhona phakathi kozakwethu. Lesi sifo singahlukaniswa sibe esiyinhloko nesesibili (esenzeka ngemva kwesikhathi socansi oluvamile).

Imbangela yobunzima empilweni egcwele yocansi ingaba yizici zengqondo (ukungabi namandla kwengqondo) kanye nezici ze-organic (somatic).

Iqembu lokuqala lihlanganisa: ukwesaba ucansi, ukwesaba ukukhulelwa okungafunwa, izinkimbinkimbi, icala, ukona, ukucindezeleka, ukuphazamiseka kokuthuthukiswa kwengqondo, i-introversion (ukuthambekela kokugxila kuwe). Ngokuvamile ezimweni ezinjalo, ngesikhathi sokulala noma ukushaya indlwabu, ukusabela kuvamile.

Izimbangela ezingokomzimba zokuntula amandla zihlanganisa izifo (isifo sikashukela, i-multiple sclerosis, i-tetraplegia, i-ALS, ukukhubazeka kwenhliziyo, umfutho wegazi ophakeme, i-phimosis, umkhuhlane, isifo sikaPeyronie) noma izinguquko ezihlobene neminyaka (andropause) ezivimbela ukuqhanyelwa. Ezinye izikhuthazi (utshwala, ama-amphetamine) nezidakamizwa (SSRIs, SNRIs) nazo zingadala ukungabi namandla.

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