French anticoagulant Fraxiparin: kedu ihe ọ bụ na gịnị kpatara eji ede ya?

Ngwọta a ga-eji gbaa ya ọgwụ bụ nke na-acha ọbara ọbara ma ọ bụ nke na-acha odo odo, na-enweghị odo ma ọ bụ edo edo dị mfe.

Ndị e mere: calcium hydroxide ma ọ bụ dilute hydrochloric acid ka pH 5-7.5 ruo pH 5.0-7.5, mmiri d / na ruo 0.6 ml.

0.6 ml - sirinji otu (2) - blisters (5) - ngwugwu nke kaadiboodu.

r d / ogwu. 9500 IU anti-Xa / 1 ml: 0.8 ml sirinji 10 pcs.
Reg. Mba: 4110/99/05/06 nke 04/28/2006 - Kagbuo

Ngwọta a ga-eji gbaa ya ọgwụ bụ nke na-acha ọbara ọbara ma ọ bụ nke na-acha odo odo, na-enweghị odo ma ọ bụ edo edo dị mfe.

Ndị e mere: calcium hydroxide ma ọ bụ dilute hydrochloric acid ka pH 5-7.5 ruo pH 5.0-7.5, mmiri d / na ruo 0.8 ml.

0.8 ml - sirinji otu (2) - blisters (5) - ngwugwu nke kaadiboodu.

Omume ọgwụ

Calcium nadroparin bụ heparin dị obere mkpụmkpụ (NMH) nke enwetara site na heparin. Ọ bụ glycosaminoglycan nke nwere ntakịrị molecula 4300 daltons.

O gosiputara ikike di elu nke ijikọ protein protein Platini na antithrombin III (ATIII). Njikọ a na - eduga n'ịgba mgbochi nke ihe Xa, nke a bụ n'ihi oke ike antithrombotic nwere nadroparin. Ihe eji eme ihe di na Calcium nadroparin bu ihe ndi mmadu nwere ike imegide anti-Xa dika ihe na anti-IIa factor ma obu anti antromrombotic.

Otherzọ ndị ọzọ na-enye ọrụ antithrombotic nke nadroparin gụnyere mkpali nke anụ ahụ na - egbochi ụzọ (TFPI), ịgbalite fibrinolysis site na ntọhapụ nke anụ ahụ plasminogen anụ ahụ na mkpụrụ ndụ endothelial, na ịgbanwe ihe ndị dị na rheological nke ọbara (ibelata viscosity ọbara na ịba ụba nke platelet na granulocyte).

Nadroparin bụ heparin dị ala dị ala nke na-ekewapụta ọgwụ antithrombotic na anticoagulant, nke ọrụ heparin dị elu, na-egosipụta ọrụ dị elu megide isi Xa, ma e jiri ya tụnyere ọrụ megide nke IIa. Ọ nwere ma ọgwụ antithrombotic dị nso ma dị ogologo oge. Ihe dị n'etiti ụdị ọrụ ndị a maka calroparin calcaridi dị na nha 2.5-4.

N'iji ya na heparin na-adịghị arụ ọrụ, nadroparin nwere obere mmetụta na platelet na nchịkọta yana nwechaghị ọkwa na hemostasis.

N'ime usoro onyonyo prophylactic, nadroparin anaghị ebute mbelata nke akụkụ thrombin akụkụ arụmọrụ (APTT).

N'ime usoro ọgwụgwọ n'oge arụ ọrụ kachasị, mmụba na APTT ruo uru 1.4 dị elu karịa ọkọlọtọ ahụ ga-ekwe omume. Ogologo oge dị otú a na-egosipụta nsị antithrombotic mmetụta nke calcium nadroparin.

Mlọ ọgwụ

A na-ekpebi ihe ndị dị na Pharmacokinetic na ntọala nke mgbanwe na ọrụ ihe mgbochi ọgwụ nke plasma.

Mgbe sc nchịkwa, absorption fọrọ nke nta ka 100%. C max na plasma ruru n'etiti awa atọ na ise.

Mgbe ị na-eji calcium nadroparin na usoro 1 nke ntụtụ / ụbọchị, C max ruru n'etiti 4 na 6 awa mgbe nchịkwa gasịrị.

Ọ bụ metabolized n'ime imeju site na nkụda mmụọ na depolymerization.

Mgbe sc nchịkwa nke T 1/2 nke ihe na-akpata anti bụ Xa bụ awa 3-4. Mgbe ị na-eji heparins molecule dị ala, ihe omume nke IIa na-apụ n'anya na plasma ngwa ngwa karịa ihe na-akpata anti-Xa. A na - egosipụta ihe omume Anti-Xa n’ime awa iri na asatọ gachara ị afterụ ọgwụ ahụ.

Site na ya bụ akụrụ na-agbanwe ya n'ụdị na-agbanweghi agbanwe ma ọ bụ n'ụdị metabolites dị iche na ihe na-agbanweghi agbanwe.

Pharmacokinetics n'ihe gbasara ọrịa

N'ime ndị ọrịa agadi, n'ihi nrụrụ anụ arụ nke ọrụ akụrụ, mkpochasị na-akwụsịlata. Mgbe ị na-a theụ ọgwụ maka prophylaxis na ụdị ndị ọrịa a, ọ dịghị mkpa ịgbanwe usoro ọgwụgwọ usoro iji nwee nsogbu mmerụ ahụ dị nro.

Tupu ịmalite ọgwụgwọ maka ọrịa LMWH (heparin dị ala), ọrụ nwatakịrị nwere ndị agadi karịrị afọ 75 kwesịrị ịnwale usoro iji Cockcroft usoro.

N'ime ndị ọrịa nwere nnukwu akụrụ ezughi oke na nchịkwa s / c nke nadroparin, T 1/2 na-agbatịkwu ruo awa 6, ya mere nadroparin na-egbochi ọgwụ maka ndị ọrịa dị otú ahụ. Mgbe ị na-eji nadroparin na usoro onyonyo profilactic na ngalaba ndị ọrịa, ekwesịrị ịbelata dose ahụ site na 25%.

N'ime ndị ọrịa nwere oke akwara ezughị oke (CC karịa 30 ml / min), n'ọnọdụ ụfọdụ, ọ bụ ihe amamihe dị na ya ijikwa ọkwa nke ihe omume anti-Xa na ọbara iji wepu ohere nke ịdoụbiga mmanya ókè. Nchikota nadroparin nwere ike ime na udi ndi oria a, yabụ, na ndị ọrịa dị otú ahụ, a ga-ebelata ọgwụ nadroparin site na 25% na ọgwụgwọ nke thromboembolism, angina na-enweghị ntụkwasị obi na infịction na myocardial na-enweghị usoro ọgbụgba Q. Na ụdị a nke ndị ọrịa na-enweta nadroparin maka igbochi nsogbu nke thromboembolic, ọdịnaya ahụ nadroparin adịghị agafere nke ahụ na ndị ọrịa nwere ọrụ mkpo nkịtị, na-asesụ usoro ọgwụgwọ nke nadroparin. Ya mere, iwetulata onodu nadroparin ewere dika ihe mgbochi na udi otu ndi oria a achoghi ya.

N’oge akwara ọbara, iwebata nnukwu ihe dị ala dị na heparin dị ala n’ime usoro akwara nke usoro akwara (iji gbochie ọbara ụkọ n’ọnụ) anaghị ebute mgbanwe na ọgwụ ọgwụ, belụsọ n’ihe banyere ịdoụbiga mmanya ókè, mgbe ọgwụ ga-abanye na sistemụ sistem nwere ike ibute mmụba n’ihe omume mgbochi-Xa, jikọtara ya na njedebe ọgbụgba azụ.

Ihe ngosi maka ojiji

• igbochi thrombosis n'oge ịwa ahụ na ọgwụ orthopedic,
• igbochi coagulation ọbara na sistemụ mmekpa ahụ ọzọ
• igbochi nsogbu nke thromboembolic n'ime ndị ọrịa nwere nnukwu thrombosis (na nnukwu akụkụ iku ume na / ma ọ bụ nkụda obi na ọnọdụ ọnọdụ ICU),
• thromboembolism ọgwụgwọ,
• ọgwụgwọ angina na-ejighi ike na ọrịa myokia na-enweghị nkwarụ ọgbụgba Qlo na ECG.

Usoro usoro onunu ogwu

A na-ahụ maka ọgwụ ahụ s / c (belụsọ maka iji ya na usoro ịba ama. Ezubere ụdị usoro ọgwụgwọ a maka ndị okenye. Emeghị ọgwụ a na mmanụ. 1 ml nke Fraxiparin bụ ihe ruru 9500 ME nke ọrụ ihe mgbochi nke calcium nadroparin.

Mgbochi Thromboembolism na gerywa Ahụ

Ndụmọdụ ndị a metụtara usoro ịwa ahụ a na-arụ n'okpuru usoro izizi.

Ugboro eji ogwu a bu ntụtụ 1 / ụbọchị.

A na-ekpebi ọgwụ ahụ site n'ọtụtụ ihe ize ndụ nke thromboembolism n'otu ọnọdụ nyocha ma dabere na ahụ ahụ onye ọrịa na ụdị ọrụ ya.

Site na nsogbu nke thrombogenic na-agafeghị oke, yana na ndị ọrịa na-enweghị oke ụba nke thromboembolism, a na-enweta mgbochi dị mma nke ọrịa thromboembolic site na ịnye ọgwụ ahụ na oke 2850 ME / ụbọchị (0.3 ml). A na-etinye ọgwụ mbu ahụ ruo awa 2 tupu a waa ya ahụ, mgbe ahụ a na-enye nadroparin 1 otu / ụbọchị. A na-aga n'ihu ọgwụgwọ ọ dịkarịa ala ụbọchị 7 yana oge ihe ize ndụ nke thrombosis ruo mgbe a gafere onye ọrịa na ọnọdụ outpatient.

Site na oke ọghọm thrombogenic (ịwa ahụ n'apata ụkwụ na ikpere), dose Fraxiparin dabere na ahụ ahụ onye ọrịa. A na-enye ọgwụ ahụ na nha 38 Mg / kg tupu ịwa ahụ, i.e. 12 awa tupu usoro ahụ, mgbe ịwa ahụ gasịrị, i.e. bido n’awa iri na abụọ gachara ngwụcha usoro a, emesịa otu oge / ụbọchị ruo ụbọchị 3 ka ọrụ ahụ gachara. Ọzọkwa, na-amalite site na ụbọchị 4 mgbe a wasịrị ahụ, 1 oge / ụbọchị na dose 57 ME / kg n'oge ohere nke thrombosis tupu ebufee onye ọrịa na ọnọdụ outpatient. Obere oge pere mpe bụ ụbọchị iri.

A na-egosipụta usoro nke Fraxiparin dabere na ahụ ahụ na tebụl.

Mgbe ị na-edepụta ọgwụ ahụ nye ndị ọrịa na-abụghị ịwa ahụ nke nwere nnukwu arịa ọrịa thrombosis, na-abụkarị na nlekọta nlekọta ike (yana ọdịda okuku ume na / ma ọ bụ ọrịa akụkụ iku ume na / ma ọ bụ obi na-adịghị ala ala), dose nke nadroparin dabere na ahụ onye ọrịa ma edepụtara ya na tebụl dị n'okpuru. A na-achịkwa ọgwụ 1 oge / ụbọchị. A na-eji Nadroparin n'oge niile nke ihe ize ndụ nke thrombosis.

N'ọnọdụ ebe ọghọm nke thromboembolism metụtara ụdị ọrụ (ọkachasị na arụ ọrụ oncological) yana / ma ọ bụ njirimara nke onye ọrịa (ọkachasị na akụkọ banyere ọrịa thromboembolic) yiri ka ọ ga-abawanye, ọnụọgụ 2850 ME (0.3 ml) zuru ezu, mana ekwesịrị ịhazi ọgwụ ahụ. n’otu n’otu.

Oge ọgwụgwọ. Ọgwụgwọ na Fraxiparin yana usoro usoro ịgbatị agbatị nke mpaghara ala ka aga-aga n'ihu ruo mgbe ebigharịchara ọrụ moto onye ọrịa ahụ. Na usoro ịwa ahụ, ogologo oge eji Fraxiparin dị ihe dị ka ụbọchị iri mgbe enweghị otu ọrịa thromboembolism nke venous metụtara na njiri mara onye ọrịa ahụ. Ọ bụrụ na ihe ọghọm nke nsogbu thromboembolic dị mgbe oge ọgwụgwọ a tụrụ aro gafere, ekwesịrị ịgagide ọgwụ prophylactic, ọkachasị na ọgwụ anticoagulants.

Agbanyeghị, ebumnuche ọgwụgwọ nke ọgwụgwọ ogologo oge nwere obere heparins pere mpe ma ọ bụ ndị na-emegide vitamin ekwenyebeghị.

Mgbochi ọbara coagulation na sistemụ ọbara ọgbụgba na extracorporeal

Ekwesịrị iji ọgwụ Fraxiparin mee intravascularly n'ime akwara ozi nke akwara dialysis.

N'ime ndị ọrịa na-anata nnọkọ hemodialysis ugboro ugboro, a na-enweta mgbochi nke coagulation na looc extrapocpoporeal ọcha site na iwebata ọgwụ mbụ nke 65 IU / kg n'ime usoro akwara nke akwara mkpọnwụ mmalite nke nnọkọ ahụ.

Ogwu a, nke a na-eji dị ka otu ọgwụ mgbochi intravascular bolus, bụ naanị ihe dị mma maka nnọkọ akwara na-akarịghị awa 4. Nke na-esote, enwere ike ịtọ dose ahụ dabere na nzaghachi onye ọrịa ahụ, nke dị iche.

Usoro nke ọgwụ a dabere na ịdị arọ ahụ ka a na-egosipụta na tebụl.

Ọ bụrụ na ọ dị mkpa, enwere ike ịgbanwe dose ahụ dabere na ọnọdụ ụlọ ọrụ akọwapụtara yana yana ọnọdụ teknụzụ nke usoro akwara. N'ime ndị ọrịa nwere nnukwu ọbara ọgbụgba, enwere ike ịme usoro ọgwụgwọ akụrụngwa site na ibelata dose nke ọgwụ ahụ ugboro abụọ.

Ọgwụgwọ Deep Vein Thrombosis (DVT)

Ekwesịrị igosi nkwenye ọ bụla nke thrombosis miri emi n’inyocha ule kwesịrị ekwesị.

Ugboro eji ọgwụ ahụ bụ 2 injections / ụbọchị yana obere ihe dị ka awa 12.

Otu ọgwụ Fraxiparin bụ 85 ME / n'arọ.

Ekpebighi uzo ozo banyere Fraxiparin dabere na aru aru na ndi oria nwere aru kariri 100 kilogram ma obu erughi 40 n'arọ. N'ime ndị ọrịa nwere nnukwu ahụ karịrị 100 n'arọ, enwere ike belata ịdị irè nke LMWH. N'aka nke ọzọ, n'ime ndị ọrịa na-erughị kilogram 40, ohere nke ọbara ọgbụgba nwere ike ịba ụba. N'ụdị ndị a, a chọrọ nleba anya puru iche.

A na-egosiputa doses ndị a tụrụ aro na tebụl.

Oge ọgwụgwọ. Ekwesịrị iji ọgwụ anticoagulants dochie ọgwụgwọ nke LMWH ngwa ngwa, belụsọ na nke ikpeazụ a na - egbochi contragrafana. Ogologo oge ọgwụgwọ maka LMWH ekwesịghị gafere ụbọchị iri, gụnyere oge ntughari na ndị na-emegide vitamin K, ewezuga okwu ndị ahụ mgbe ọ siri ike ịkwụsi ike MHO. Ya mere, ekwesịrị ịmalite ọgwụgwọ anetọgulants site na ngwa ngwa o kwere omume.

Ọgwụ nke enweghi nsogbu angina pectoris / myocardial infarction na enweghị nje Q na-efe efe na ECG

A na-achịkwa Fraxiparin na subcutaneously na 86 ME / kg 2 ugboro / ụbọchị (na nkeji nke awa 12) yana ọgwụ acetylsalicylic acid (a na-atụ aro iji ọgwụ ọnụ nke 75-325 mg mgbe ntakịrị opekempe nke 160 mg).

A na-ahazi ọgwụ mbụ nke 86 ME / n'arọ iv na bolus - mgbe ahụ na otu s / c. Oge akwadoro ọgwụgwọ ga-abụ ụbọchị 6 ruo mgbe ọrịa ahụ kwụsịrị.

A na-egosipụta usoro nke Fraxiparin dabere na ahụ ahụ na tebụl.

Maka mgbochi nke thrombosis na ndị ọrịa nwere obere gbasara akụrụ na-ada ada (CC ≥ 30 ml / min na mbelata dose) Achọghị n'ime ndị ọrịa nwere nnukwu akụrụ gbasara (CC, ekwesịrị ịbelata dose ahụ site na 25%.

Na ọgwụgwọ nke thromboembolism, angina na-ejighi ike na infarction myocardial na-enweghị usoro nje na-efe efe na ndị ọrịa nwere nnukwu akwara na-akwụghị ụgwọ ma na-agafeghị oke, a ga-belata dose ahụ site na 25%. Nadroparin na contraindicated na ndị ọrịa nwere nnukwu gbasara akụrụ odida.

Iwu nke ochichi ogwu

Ọ ka mma ịbanye na ọkwa onye ọrịa ahụ n'ọkpụkpụ apịtị nke ma ọ bụ n'apata ụkwụ, ma ọ bụ aka nri na aka ekpe. Ahapụrụ gị ka ọ banye na apata ụkwụ.

Iji zere ọnwụ nke ọgwụ mgbe ị na-eji sirinji, ekwesighi iwepu ntụfu ikuku tupu ntụtụ.

Ekwesịrị itinye agịga ahụ n'otu oge, ọ bụghịkwa n'akụkụ ya, n'ime anụ ahụ akpọchiri akpọchi, nke a na-ejide n'etiti isi mkpịsị aka na isi aka ruo mgbe njedebe nke ngwọta. Etekwala ebe a na-anya ntụtụ gị. Ezubere sirinji ndị a kapịrị ọnụ ka ahọpụta dose dabere na ahụ aru onye ọrịa.

Mgbe nchịkwa nke ọgwụ ahụ, ekwesịrị iji usoro nchebe agịga maka sirinji:

• na-ejide sirinji ejiri ya n'aka otu site na ikpe nchebe, were aka nke ọzọ na -ejide ihe jidere aka ịhapụ mkpọ ma kpochie mkpuchi iji kpuchie agịga ahụ ruo mgbe ọ pịa. A na-echekwa agịga eji eme ihe.

Nsonaazụ

Mmeghachi omume mpaghara:

• Ọtụtụ mgbe - ịkpụbe obere hematoma subcutaneous na ntụtụ,
• N'ụfọdụ, a na-ahụta ọdịdị nke akwara dị okirikiri nke na-apụtaghị na heparin encapsulation, nke na-apụ mgbe ụbọchị ole na ole gasịrị.
• Akpukpo aru nke aru kari aru kari aru (nke purpura buru uzo ma obu ihe nlere ma obu ahuhu nke puru iche, nke nwere ike ma obu juputara ya site na mgbaàmà ndi ozo).
• n'ọnọdụ ndị a, a ga-akwụsị ọgwụgwọ ozugbo).

Site na coagulation ọbara:

• mgbe ị na-eji ọgwụ ahụ na oke doses, ọbara ọgbụgba nke mpaghara dịgasị iche iche ga-ekwe omume (na ndị ọrịa nwere ihe ndị ọzọ dị ize ndụ)

Site na sistemụ hemopoietic:

• mgbe ejiri ya na usoro dị elu, thrombocytopenia dị nro (ụdị nke I), nke na-apụ n'anya n'oge ọgwụgwọ ọzọ,
• dịkarịsịrị ala - eosinophilia (atụgharịghachi mgbe ịkwụsị ọgwụ gachara),
• N'ụfọdụ, thrombocytopenia na - alụso ọrịa ọgụ (ụdị II), jikọtara ya na akwara ozi ma ọ bụ thromboembolism venous.

Ndị ọzọ:

• nwa oge na abawanye nwa oge na ọrụ nke enzymes imeju (ALT, AST),
• o siri ike - mmeghachi omume nfụkasị ahụ, hyperkalemia (na ọrịa ndị a na - eme eme),
• n'ọnọdụ ụfọdụ - mmeghachi omume anaphylactic, priapism.

Ihe ngbanwe

• ihe ịrịba ama nke ọbara ọgbụgba ma ọ bụ ohere dị ukwuu nke ọbara ọgbụgba metụtara ya na hemostasis, ma e wezụga DIC, ọ bụghị heparin kpatara.
• mmebi nke anụ ahụ nwere oke agba ọbara (dịka ọmụmaatụ, ọnya afọ ma ọ bụ ọnya afọ),
• mmerụ ahụ ma ọ bụ usoro ịwa ahụ na etiti akwara ozi,
• oria endocarditis,
• ọbara ọgbụgba n'ime intracranial,
• ọdịda akụrụngwa siri ike (Ejiri CC kpachara anya na thrombocytopenia (akụkọ ihe mere eme)).

Ime na lactation

Ekwesighi iji nadroparin n'oge ime ime. Ajụjụ nke dọkịta nwere ike ikpebi ma enwere ike ị dee ọgwụ a naanị mgbe nyochachara nke ọma etu ọghọm dị na uru ọgwụgwọ ọ dị.

Na nyocha nnwale, etolitela teratogenic ma ọ bụ fetotoxic nke nadroparin. Ihe omuma banyere uzo banyere nadroparin site na ihe mgbochi nke buru buru ibu n’etiti ndi mmadu.

Enwere ugbua data ezughi oke maka inye nadroparin na mmiri ara. N'akụkụ a, akwadoghị iji nadroparin n'oge a na-enye nwa ara (inye nwa ara).

Jiri maka ọrụ ezighi ezi na-arụ ọrụ

Ọgwụgwọ:

• site na obere ọbara ọgbụgba, dịka iwu, ọ zuru ezu igbu oge iwebata usoro nke ọgwụ ọzọ. Ekwesịrị inyocha nọmba Platelet na ihe mgbochi ọbara ndị ọzọ.

N'ụfọdụ, ejiri protamine sulfate gosipụta, ebe ekwesịrị iburu n'uche na arụmọrụ ya dị ntakịrị karịa na oke heparin na-adịghị arụ ọrụ. Ekwesịrị iji nlezianya nyochaa uru / ihe ize ndụ nke sọlfọ protamine n'ihi nsonaazụ ya (ọkachasị ihe mgbaze anaphylactic). Ọ bụrụ na emere mkpebi iji protinine sulfate, mgbe ahụ ekwesịrị iji nwayọ were nwayọọ nwayọọ mee ya. Ọgwụ ya dị irè dabere na usoro nchịkwa heparin (nke protamine sulfate na otu ọgwụ antiheparin 100 na-eji eme ihe iji gbochie 100 ME anti-XA factor factor LMWH), oge gafere mgbe nchịkwa heparin (yana enwere ike ịbelata ọgwụ mgbochi). Ka osi di, o gaghi ekwe omume iwepu ihe omume nke ogha-ogha. Ọzọkwa, uru nke NMH absorption na-ekpebi ọdịdị nwa oge nke mmetụta na - egbochi protamine sulfate; n'akụkụ a, ọ nwere ike ịdị mkpa iji kewaa ọgwụ ya n'ọtụtụ injections (2-4) n'ehihie.

Mkparịta ụka ọgwụ ọjọọ

Ihe ọghọm nke ịbawanye hyperkalemia na-abawanye site na iji Fraxiparin na ndị ọrịa na-anata salts potassium, spure diuretics, ACE inhibitors, angiotensin II antagonist, NSAIDs, heparins (obere molikula dị ala ma ọ bụ na-enweghị ihe mgbochi), cyclosporine na tacrolimus, trimethoprim.

Fraxiparin nwere ike mee ka mmetụta nke ọgwụ na-emetụta hemostasis, dị ka acetylsalicylic acid na NSAIDs ndị ọzọ, vitamin K antagonists, fibrinolytics na dextran, nke na-eduga n'ịgba ume na mmetụta ahụ.

Ndị na - egbochi Platelet nchịkọta (ewezuga acetylsalicylic acid dị ka ọgwụ ọgwụ analgesic na antipyretic, i.e. na ọnụọgụ karịa 500 mg, NSAIDs):

• abciximab, acetylsalicylic acid dị ka ihe nnọchianya antiplatelet (ya bụ, na nke 50-300 mg) maka ngosipụta obi na akwara, beraprost, clopidogrel, eptifibatide, iloprost, ticlopidine, ọtụtụfiban nwere ike ibute ọbara ọgbụgba.

Fraxiparin: gini bu gini?

Fraxiparin bụ ọgwụ na-ebelata ọbara ịmịkọrọ ọbara ma na-ebelata ohere nke thrombosis vaskụla.

Ihe mejupụtara ọgwụ a bụ ngwongwo a na-enweta anụ ahụ n'ime anụ ehi.

Ọgwụ a na - akwalite ịcha ọbara ma na - eme ka njupụta platelet dị na - enweghị mmerụ ọrụ ha.

Ndị na-ahụ maka ọgwụ

Ọ na-eduzi anticoagulants na-eme ihe (heparins) nke obere ihe dị omimi.

Nke a bụ ndepụta nke ọgwụ na-emetụta sistemụ hemostasis, nke bụ maka ọbara coagulation.

Na mgbakwunye, ha na-ezube igbochi ịmepụta ọgbụgba ọbara na-eso akpata ọnya anụ ahụ atherosclerotic.

Heparins dị ala nke dịkarịsịrị ala bụ ihe kachasị ọhụrụ ma nwee ọtụtụ uru: nnabata ngwa ngwa, ime ihe dị ogologo, mmetụta na-abawanye. N'ihi ya, a na-ebelata ọgwụ ogwu iji nweta nsonaazụ kacha mma ọ nwere ike belata.

Xizọ Fraxiparin nwere bụ na mgbakwunye na arụmọrụ ya kachasị, ọ na-enwe mmetụta mgbochi mkpali, na-ebelata cholesterol ọbara ma na-eme ka ijegharị n'ọbara.

Mwepu nke ọgwụ ahụ fọrọ nke nta ka ọ gwụchaa (karịa 85%). Nke kachasị dị irè n'ime awa 4-5 yana iji ọgwụgwọ, ọ gafeghị ụbọchị iri.

Ihe edere na Fraxiparin: ihe ngosi

A na-eji Fraxiparin mee ihe na ahụike maka ọgwụgwọ na mgbochi nke ọrịa ndị na-esonụ:

• thromboembolism - nnukwu mgbochi nke arịa ọbara site na thrombus,
• Ọrịa thromboembolic n'oge ịwa ahụ na ọgwụgwọ orthopedic na ndị ọrịa nọ n'ihe ize ndụ,
• n'oge usoro akwara ọbara (ime ka ọbara dị ọbara n'ime akwara na-adịghị ala ala),
• na angịdị na enweghi nsogbu,
• mgbe ị na-ebu nwa n’afọ mgbe usoro IVF gasịrị.
• n'oge ịwa ahụ ọ bụla na ndị ọrịa na-arịa oke ọbara.

Fraxiparin bụ ihe nwere ike. Enweghị ike iji ya n'ọnọdụ ọ bụla na-enweghị nkwenye nke ọkachamara.

Kedu ihe kpatara eji etinye Fraxiparin maka IVF?

Usoro igba oke obara puru ime na nwoke ma nwanyi. Agbanyeghị, maka ha abụọ, nke a abụghị ihe a na-ahụkarị.

N'ime ụmụ nwanyị, a na-achọpụta usoro a ọtụtụ oge, n'ihi na site n'ọdịdị ha, ọbara ha na-etinyekarị nke ukwuu iji gbochie nsọ nsọ.

N'oge afọ ime, a na-amanye sistemụ mgbasa ozi niile ka o kwekọọ na ọnọdụ dị ugbu a: olu nke na-ekesa ọbara, n'ihi ya, netwọkụ ọbara niile na-abawanye. N’ime afọ ime, iribiga oke ọbara nwere ike bụrụ ezigbo nsogbu, na-emetụta oke ọdịmma nwanyị.

Na mgbakwunye, ozugbo usoro ọmụmụ ahụ, ọbara ahụ na-etinye uche dị ka o kwere mee iji zere ọbara ọgbụgba buru ibu, nke nwere ike itinye ndụ ndị nne n'ihe ize ndụ Otú ọ dị, edeghị Fraxiparin n'oge a na-echekwa ebumpụta ụwa, ebe ọ bụ na anụ ahụ ji nwayọ na-eme onwe ya n'oge usoro ịhazigharị.

Site na usoro nke IVF, nwanyị nwere oge siri ike karịa ime ya dị ime.

Site na mmetụta nke ọgwụ ịbawanye n’ime ọria, ọ na - agbagwo n’ọbara. N'ihi ya, enwere ihe ọghọm nke mmachi ọbara, nke nwere ike imerụ ndụ nne na nwa ahụ. Iji gbochie nke a, a na-enye ọgwụ anticoagulants.

N'oge ịtụrụ ime na IVF, a na-enye Fraxiparin iwu:

• Ọbara na-eme gị,
• igbochi imechi arịa ọbara site na nhazi nke thrombotic,
• Maka ezigbo nhazi nke Plasenta, nke na - ebute ebu n’arụ n’arụ nne n’ime nwa ebu n’afọ,
• maka ndozi kwesịrị ekwesị na ntinye nke ẹmbrayo.

N'oge mmegharị nke nwa a tụụrụ ime site na iji usoro IVF, ọgwụ anticoagulants na-aghọ ihe dị mkpa, na ojiji nke ọgwụ ahụ nwere ike ịga n'ihu n'oge oge ịmụ nwa na nwa oge mgbe amuchara nwa.

Ntuziaka maka iji Fraxiparin

Ọgwụ a na-ezo aka na anticoagulants na-eme ihe kpọmkwem, i.e. ọ na - emetụta ihe mejupụtara ọbara dị n'ọbara, ọ bụghị na usoro ndị na - emebi ọgba aghara nke enzymes. Dabere na ntuziaka maka ojiji, ihe na-arụ ọrụ nke usoro ntụtụ ahụ bụ heparin dị ala na-egbu ala (glycosaminoglycan acidic nwere sọlfọ acid). A na-eji Heparin mee ihe na ahụike iji gbochie ịba ụba ọbara (dịka ọmụmaatụ, n'oge ọrụ) na thrombosis.

Ngwakọta na ụdị ntọhapụ

Fraxiparin dị na sirinji nwere ọnya doro anya na obere ego nke kwụsịtụrụ. Mpempe hypodermic dị mkpụmkpụ ma dị gịrị iji belata ihe mgbu mgbe ị na-akụ. E gosipụtara usoro nke ọgwụ na ụdị ntọhapụ na tebụl:

Calcium Nadroparin (IU Anti-Ha)

Mmiri wayo (a na-akpọ calcium hydroxide) ma ọ bụ ntụpọ hydrochloric acid

Mmiri ara ehi maka ogwu ogbugba (ml)

Na ego achọrọ

1 blisters 1 ma ọ bụ 5 na ngwugwu kaadiboodu nke nwere sirinji 0.3 ml nke nwere ike diski

Na ego achọrọ

1 blisters blisters 1 na ngwugwu kaadiboodu nwere ihe dị n'ime mmiri 0 0 ml nke a pụrụ ịtụfu

Na ego achọrọ

1 blisters 1 ma ọ bụ 5 na ngwugwu katoonu nwere sirinji ihe dị milimita abụọ 0.6

Na ego achọrọ

1 blisters 1 ma ọ bụ 5 na mkpọ katoonu nwere sirinji nke 0 0.8 ml nke nwere ike ịfe

Na ego achọrọ

1 blisters 1 ma ọ bụ 5 na igbe kaadi nwere ihe dị n'ime sirinji 2 nke 1 ml ọ bụla

Pharmacodynamics na pharmacokinetics

A na-ahụta ọrụ anticoagulant nke heparin site na ịgbalite nke protein protein nke plasma (protein protein) antithrombin 3. Isi ihe Fraskiparin bụ coagulant kpọmkwem na nsonaazụ ya bụ ibelata ọrụ nke thrombin n'ime ọbara (mwepu nke ihe Xa). Mmetụta antithrombotic nke calcium nadroparin bụ n'ihi ngbanwe nke ntụgharị nke thromboplastin anụ ahụ, ngwangwa nke mgbasa nke mkpụkọ ọbara (n'ihi ntọhapụ nke plasminogen anụ ahụ) na mgbanwe nke ihe ndị rheological nke platelet.

Tụnyere heparin na-adịghị arụ ọrụ, heparin dị ala nwere obere mmetụta na obere hemostasis na na prophylactic doses adịghị eduga na mbelata nke ukwuu na ọkara akụkụ nke thromboplastin. A na-enweta ntinye uche kachasị n'ihe na plasma ọbara mgbe njikwa ọgwụ subcutaneous nke ọgwụ ahụ mechara awa 4-5, mgbe ọ gbasasịrị ịgba ọgwụ - mgbe nkeji iri gachara. Metabolism na - aputa site na depolymerization na nkụda mmụọ site na mkpụrụ ndụ imeju.

Etu esi abanye Fraxiparin

A na-edozi ọgwụ ahụ na subcutaneously site na ntụtụ n'ime anụ ahụ nke afọ ma ọ bụ azụ nke afọ. Uzo esi ewebata ogba a bụ etinye aka n’ogiri n’etiti mkpịsị aka ya, ebe a na-ewebata akuku ya n’akụkụ elu. Enwere ike dochie injections nke Fraxiparin n'ime afọ site na injections n'ime apata ụkwụ. Iji gbochie ihe ize ndụ nke thromboembolism n'oge ịwa ahụ, a na-enye heparin awa iri na abụọ tupu etinye aka ahụ na awa iri na abụọ mgbe nke ahụ gasịrị, a na-edenye ọgwụ mgbochi irighiri ihe ngwọta. Usoro usoro usoro ọgwụgwọ dabere na ọnọdụ onye ọrịa na oke ahụ ya:

Usoro nchịkwa, ml

Ọgwụgwọ angina na-ejighi n'aka

A na-achịkwa usoro izizi ọbara ruo oge ọbara, nke na - esote - awa 12 ọ bụla, subcutaneously, usoro ọgwụgwọ ahụ bụ ụbọchị iri

A na-a drugụ ọgwụ ahụ ugboro abụọ kwa ụbọchị ruo mgbe a ga-enwetara ọgwụ mgbochi rheological chọrọ

Profalaxis ọbara n'ọbara n'oge ịba ọcha n'anya

A na-enye Fraxiparin otu ugboro intraven tupu emume ịrịa ọrịa, nwere nnukwu ọbara ọgbụgba, a ga-belata dose ahụ

Ntụziaka pụrụ iche

Mgbe ị na-eji ọgwụ ọgwụ ndị so n'ọbara heparins nwere obere moleculely, ekwesịrị iburu n'uche na enweghi ike ijikọta Fraxiparin yana ọgwụ ndị ọzọ. Ebumnuche ogwu a abụghị maka ọgwụ mgbochi intramuscular. N'oge usoro ọgwụgwọ, ọ dị mkpa iji nyochaa ọnụ ọgụgụ platelet iji gbochie ohere nke thrombocytopenia. Maka ndị ọrịa agadi, tupu itinye ọgwụ anticoagulant ahụ, a na-atụ aro ka ọ gaa nyocha nyocha iji chọpụta arụ ọrụ akụrụ.

N’oge ime ime

Nsonaazụ nke ihe nyocha nke nadroparin na anumanu gosiputara enweghi terratogenic na nsonaazụ fetotoxic, mana data dịnụ agaghị emetụta ya na ụmụ mmadụ, ya mere, injections heparin n'oge ịtụrụ ime bụ ihe mgbochi. N’oge ị na-a ,ụ ara, a ga-ahapụ iji ọgwụ ahụ eme ihe n’ihi ntakịrị data maka ike nke ihe dị n’ọrụ ịbanye na mmiri ara.

Site na njikọta ọgwụ ọgwụ vitro, a na-enye onye ọrịa ọgwụ mgbochi nke homonụ. N'ihi eziokwu ahụ na homonụ nwere ike ịkpalite coagulation ọbara na-arịwanye elu ma na-eme ka ihe ọmụmụ ya dịkwuo mma, dọkịta na-edepụta usoro anticoagulant tupu ịtụrụ ime iji gbochie thrombosis ma kwalite itinye embrayo.

Na nwata

A naghị eji ndị na-arịa Heparin eme ihe na usoro ọgwụgwọ ụmụaka, yabụ, afọ nke ndị ọrịa na-erubeghị afọ 18 bụ contraindication maka iji anticoagulant. Enwebeghị nnyocha ọmụmụ a na-achịkwa maka ojiji nke ọgwụ ahụ na ụmụaka, mana enwere ahụmịhe na-adakarị na nchịkwa ọgbụgba ọgwụ nke ụmụaka ahụ, nke sitere na mkpa ngwa ngwa maka usoro ahụ. Nsonaazụ enwetara dị ka nsonaazụ nke omume ndị a enweghị ike iji ya.

Mmanya na Fraxiparin ndakọrịta

Ethanol dị n’ime ihe ọholicụholicụ ndị na-aba n’anya na-eso eme ka e kee mkpụkọ ọbara ma na-eme ka mmetụta nke thromboembolic pụta, n’ihi eziokwu ahụ na ngwaahịa ndị na-emebi emebi na-eme ka idobe akwara na abụba dịrị n’ahụ́ arịa ọbara. Ojiji nke anticoagulant na mmanya na-egbu egbu na-eduga na mbibi nke mmetụta bara uru nke ọgwụ ahụ na iwusi mmetụta ndị dị na ya ike.

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