I-Atrogrel yezidakamizwa: imiyalelo yokusetshenziswa

I-Atrogrel isidakamizwa esinomphumela we-antiplatelet. Isetshenziselwa ukwelapha nokuvimbela ukushaya kwenhliziyo okuyisisekelo, okuhlala kwenzeka, lapho kunesifo esikhona ezigulini. Umuthi usiza ukuqeda i-atherosclerosis ye-vascular ngenxa yezakhi ze-clopidogrel ekuvimbeleni ukuhlanganiswa kweplatelet. Kubalulekile ukucabanga ukuthi ngesikhathi sokwelashwa, isikhathi sokumisa ukopha siyanda.

Igama Lezwe elingafanele

Clopidogrel

I-Atrogrel isetshenziselwa ukwelapha nokuvimbela ukushaya kwenhliziyo okuyisisekelo, ukuhlasela kwenhliziyo nokushaya njalo.

I-ATX

B01AC04

Khipha amafomu nokwakheka

Umuthi wenziwa ngefomu lethebhulethi. Iyunithi yalesi sidakamizwa ihlanganiswa ngefilimu, ipendiwe emhlophe. Ithebhulethi eyi-1 iqukethe ama-75 mg wekhompiyutha esebenzayo - i-clopidogrel bisulfate. Izinto ezengeziwe zifaka:

• i-microcrystalline cellulose;
• uwoyela we-hydrogenated castor;
• ushukela wobisi;
• crodarmellose sodium.

Igobolondo langaphandle liqukethe i-carmine, i-hypromellose, ushukela we-lactose, i-titanium dioxide, i-triacetin.

Umuthi wenziwa ngefomu lethebhulethi. Ithebhulethi eyi-1 iqukethe ama-75 mg wekhompiyutha esebenzayo - i-clopidogrel bisulfate.

Isenzo se-Pharmacological

Umuthi uvimbela ukubopha kwe-adenosine diphosphate kumaseli ahambisanayo ngaphezulu kwesitho seplatelethi, ngenxa yalokho ukusebenza kwalamapuleti egazi kuncishisiwe. Njengomphumela wesenzo se-clopidogrel, ukuhlanganiswa kweplatelet kanye nokunamathela kuncishisiwe, kubangelwa ngokwemvelo noma kucasulwe ithonya leminye imithi. Umphumela wokwelapha uqoshwa ezifundweni zaselebhu 2 amahora ngemuva kokuphathwa komlomo umuthi.

Ngomthamo wesibili, umphumela wesidakamizwa uyathuthukiswa futhi uvuseleleke kuphela ngemuva kwezinsuku ezingama-3-7 zokwelashwa kwezidakamizwa. Ngaphezu kwalokho, ukuvimbela okujwayelekile kokuhlanganiswa kweplatelet kufinyelela ku-45-60%. Umphumela wokwelapha uqhubeka isonto lonke, emva kwalokho ukuhlanganiswa kwamapuleti egazi nomsebenzi we-serum kubuyela kumanani abo okuqala. Lokhu kungenxa yokuvuselelwa kwamangqamuzana egazi (impilo ye-platelet izinsuku ezingama-7).

I-Pharmacokinetics

Lapho ithathwa ngomlomo, i-clopidogrel idonswa ngokushesha emathunjini amancane. Uma ingena egazini, isakhi samakhemikhali sifinyelela amazinga aso aphezulu we-plasma emahoreni ama-2 ngemuva kokulawulwa futhi ngu-0,025 μg / L I-Clopidogrel ibhekana nezinguquko ku-hepatocytes ngokwenziwa kwemikhiqizo ye-metabolic engenawo umsebenzi wezidakamizwa (85% wokuhlushwa kwe-plasma yokuqala).

Ukuqoqwa kwento esebenzayo kubantu asebekhulile kuphakeme kunokwejwayelekile.

Ngemuva kokuphathwa ngomlomo, u-50% womthamo othathwe ukhishwa ngohlelo lokuchama, u-46% ushiya isidumbu ngamathumbu kungakapheli amahora angama-120 ngemuva kokuphathwa ngomlomo. Isigamu sempilo amahora angama-8.

Ukuqoqwa kwento esebenzayo kubantu asebekhulile kuphakeme kunokwejwayelekile. Ngaso leso sikhathi, izinkomba zokuhlanganiswa kweplatelet kanye nesikhathi sokuphuma kwegazi azithinteki.

Yini esiza?

Umuthi usetshenziswa njengezinyathelo zokuvimbela ekwelapheni i-atherothrombosis ezigulini ezindala futhi uqede lezi zimo ezilandelayo:

• izifo zemithambo yethambo ngesikhathi sokuthuthukiswa kwenqubo ye-pathological ngenxa ye-atherothrombosis emaphethelweni aphansi;
• i-acute coronary syndrome emelana nokuhlaselwa yisifo senhliziyo ngokungabikho kwe-Q wave ku-electrocardiogram (ECG) noma lapho kukhona i-angina engazinzile;
• ukuvimbela infarction yesibili ye-myocardial kanye nokusheshisa ukuvuselelwa kwemisipha yenhliziyo (umuthi awusetshenziswa kungakapheli izinsuku ezingama-35 emva kokuvela kwe-pathology);
• ukuvimbela ukufa kwe-coronary kungazelelwe;
• i-acute myocardial infarction lapho iphakamisa ingxenye ye-ST ku-ECG ekwelashweni okulondoloziwe nge-acetylsalicylic acid;
• unhlangothi lwe-ischemic ekuqaleni kwezokwelapha ngemuva kwezinsuku eziyi-7 (kungakapheli izinyanga eziyi-6) ukusuka ekwakhekeni kwe-pathology.

Umuthi usetshenziswa njengezinyathelo zokuvimbela ekwelapheni i-atherothrombosis ezigulini ezindala.

Futhi, umuthi usetshenziselwa ukuvimbela ukugoqwa kwe-myocardial yesibili.

I-Atrogrel ibekelwe iziguli ukuvimbela ukufa kwe-coronary okungazelelwe.

Isibonakaliso sokusetshenziswa kwalesi sidakamizwa yi-ischemic stroke ekuqaleni kwezokwelapha ngemuva kwezinsuku eziyi-7 (azikho izinyanga ezingekho kwezi-6) kusukela ekukhuleni kwe-pathology.

Umuthi usetshenziselwa ukuvikela ukuvela kwesimo se-atherothrombotic kanye ne-blockage (embolism) ye-lumen yomkhumbi yi-thrombus ngesikhathi se-atrial fibrillation. Kulesi simo, kunconywa ukusebenzisa ukwelashwa okuhlanganisa i-acetylsalicylic acid ene-clopidogrel.

Contraindication

Umuthi awunqunyelwe phambi kwalezi zinto ezilandelayo zobungozi:

• ukwanda kokucasuka kwezicubu ezintweni ezihlelekile ze-Atrogrel;
• inqubo ye-pathological enzima esibindini, ukungasebenzi komzimba;
• izilonda zokuguguleka kwesisu kanye ne-duodenum esigabeni esibuhlungu;
• i-intracranial hemorrhage, ukopha;
• i-ulcerative colitis.

Umuthi awunconywa ukuba uphathwe ngesikhathi sokuncelisa kanye nabesifazane abakhulelwe.

Ngokunakekela

Ukuqapha kuyelulekwa ezigulini ezisengozini enkulu yokopha ngenxa yomunyu wethambo, ukungenelela kokuhlinzwa, kanye nokungalingani ekulinganisweni kwe-acid emzimbeni. Ukwemukelwa kwe-Atrogrel kuyinto engathandeki ezigulini ezinokungasebenzi kahle kwesibindi, ngoba kunengozi yokuthuthukisa i-hemorrhagic diathesis.

Umuthi awubekelwe inqubo eqinile yesibindi.

I-Atrogrel ayisetshenziselwa izilonda zokulimala kwesisu kanye ne-duodenum esigabeni esibuhlungu.

Umuthi awunconywa ukuba uphathwe ngesikhathi sokuncelisa kanye nabesifazane abakhulelwe.

Ukuqwashiswa kuyelulekwa ezigulini ezisengozini enkulu yokopha.

Ungayithatha kanjani i-Atrogrel?

Umuthi wenzelwe ukuphathwa ngomlomo, kungakhathalelwa ukuthathwa kokudla. Umthamo ojwayelekile wansuku zonke ngu-75 mg kanye. Iziguli ezinomonakalo obukhulu emithanjeni ye-coronary, i-angina engazinzile kanye ne-myocardial infarction kunconywa ukuthatha umuthi ongu-300 mg ngosuku lokuqala - amaphilisi ama-4. Imithamo elandelayo iyejwayelekile.

Isikhathi sesifundo sinqunywa udokotela ohambela yedwa, ngokuya ngesithombe somtholampilo senqubo ye-pathological. Ukwelapha okuhlanganisa neminye imithi kuchazwe ngokushesha okukhulu. Isikhathi sokwelashwa esiphezulu singamaviki ama-4.

Ngoshukela

Umuthi awunawo umphumela onoshevu ekusebenzeni kwamaseli we-pancreatic beta futhi awuthinti ukugcwala kwe-glucose ku-serum yegazi. Isifo sikashukela asidingi ukushintsha uhlobo lokwelashwa.

Imiphumela emibi ye-Atrogrel

Ukuphendula okungalungile okuvela ezinhlotsheni nasezinhlotsheni kukhula ezimweni eziningi uma isiguli sinokuphazamiseka kokusebenza kokuphazamiseka kwezitho noma lapho amaphilisi ephuzwa ngokungafanele.

Umuthi wenzelwe ukuphathwa ngomlomo, kungakhathalelwa ukuthathwa kokudla.

Iziguli ezinomonakalo obukhulu emithanjeni ye-coronary, i-angina engazinzile kanye ne-myocardial infarction kunconywa ukuthatha umuthi ongu-300 mg ngosuku lokuqala - amaphilisi ama-4.

Isifo sikashukela asikho isidingo sokushintsha irekhodi lokwelashwa nomuthi.

Engxenyeni yesitho sombono

Umuthi awuthinti ukusebenza kokubonakalayo.

Kusuka ezicutshini zemisipha

Imiphumela emibi ohlelweni lwe-musculoskeletal ibonakala ngendlela yobuhlungu emisipha nasekuhlanganeni.

Amapheshana wesisu

Mhlawumbe ukubonakala kobuhlungu besisu, uhudo okuhlala isikhathi eside nohudo. Ezimweni ezikhethekile, kukhona ukuqunjelwa, isilonda sesisu kanye nesilonda esidonsayo.

Izitho zeHematopoietic

Inani lezakhi ezakhiwe egazini liyancipha, ukukhiqizwa kwama-leukocytes kanye ne-eosinophilic granulocytes kuyaphazamiseka. Isikhathi sokumisa ukopha siyanda. I-Thrombocytopenic purpura, i-anemia, i-thrombocytopenia ne-agranulocytosis ingaqala ngomonakalo ohlelweni lwe-hematopoietic.

Iziguli ziphawula ukukhula kokuphuma kwegazi ngemuva kwenyanga yokwelapha izidakamizwa.

Isistimu yezinzwa ephakathi

Ngomthelela onobuthi wesidakamizwa ohlelweni lwezinzwa, ikhanda, isiyezi nokulahleka kokuzwela kokuthuthuka kukhula. Ezimweni ezingavamile, ukulahleka kokulawulwa okungokomzwelo, ukubona okucatshangwayo, ukudideka nokulahlekelwa ukwazi, izinhlamvu zokunambitheka ezikhathazekile kungenzeka.

Imiphumela emibi ye-Atrogrel ohlelweni lwe-musculoskeletal ibonakala ngendlela yobuhlungu emisipha nasekuhlanganeni.

Njengomphumela oseceleni wesidakamizwa, i-dyspepia kungenzeka.

Ngokusetshenziswa isikhathi eside kwalo muthi, ukuphefumula kanye nomphimbo obuhlungu kungakhula.

Kusuka ohlelweni lokuphefumula

Ngokusetshenziswa isikhathi eside kwalo muthi, ukuphefumula kanye nomphimbo obuhlungu kungakhula.

Engxenyeni yesikhumba

Isikhumba ukuqhuma, ubomvu, ukulunywa.

Kusuka ohlelweni lwezitho zofuzo

Ezimweni ezihlukile, i-glomerulonephritis kanye nokwanda kokuxineka kwegazi le-serum kwegazi kungenzeka.

Kusuka ohlelweni lwezinhliziyo

Ngomthelela onobuthi wesidakamizwa ohlelweni lokujikeleza kwegazi, kuvela i-tachycardia, ukuphazamiseka kwemithambo yegazi kanye nobuhlungu esifubeni.

Ngomthelela onobuthi wesidakamizwa ohlelweni lokujikeleza kwegazi, kuvela i-tachycardia.

Ngokuthuthukiswa kwemiphumela emibi emgodini wesisu, ukwehla kwesifiso sokudla kungenzeka.

Iningi leziguli linama-urticaria, ama-rashes.

Ngasohlangothini lwe-metabolism

Umuthi awunamphumela oqondile kumetabolism, kepha ngokuthuthuka kwemiphumela emapheshana emathunjini, ukwehla kwesifiso sokudla kungenzeka.

Allergies

Ezigulini ezimiselwe ukuthuthukiswa kokuphendula kwe-anaphylactoid, ezimweni ezingavamile kunengozi yokuthola ukushaqeka kwe-anaphylactic, i-edema kaQuincke, umkhuhlane wezidakamizwa. Iningi leziguli linemichilo, imichilo, ukulunywa isikhumba.

Ukuhambisana notshwala

Ngesikhathi sokulashwa kwezidakamizwa, akunconywa ukuphuza utshwala. I-ethyl alcohol idonsa kanzima isimo sezinzwa eziphakathi nendawo nezinhliziyo, ikhulisa amathuba emiphumela emgodini wokugaya ukudla futhi yandise nesikhathi sokuphuma kwegazi. I-Ethanol ingadala ukuqina kwezindonga zesisu.

Imiyalo ekhethekile

Ngemisebenzi ehleliwe, kufanele uyeke ukuthatha amaphilisi ezinsukwini ezingama-5-7 ngaphambi kokuqala kokuhlinzwa. Isiguli kufanele sazise udokotela ohlinzayo kanye ne-anesthetist ngokusetshenziswa kwe-Atrogrel.

Ngesikhathi sokulashwa kwezidakamizwa, akunconywa ukuphuza utshwala.

Ngemisebenzi ehleliwe, kufanele uyeke ukuthatha amaphilisi ezinsukwini ezingama-5-7 ngaphambi kokuqala kokuhlinzwa.

Umuthi awunconyelwe ukuthi usetshenziswe ezigulini ezingaphansi kweminyaka engu-18.

Uma ukuphuma kwegazi kungazelelwe kwenzeka (i-hematuria, ukulimala kwegamu, i-menorrhagia), kuyadingeka ukuthi uhlolwe ukuze ubekhona kwezinguquko ze-hepatitis. Ucwaningo luzosiza ekuboneni ukugxila kanye nokusebenza kwamapuleti, isikhathi sokuopha.

Sebenzisa ebudaleni

Ukwelashwa kwezidakamizwa kubantu abangaphezu kweminyaka engu-75 ubudala kuqala ngaphandle kokuyalela umthamo wokulayisha. Akukho zinguquko ezengeziwe kuhlobo lomthamo ezidingekayo.

Isabelo sezingane

Ngenxa yokuntuleka kwezifundo ezanele zomtholampilo ngemiphumela ye-clopidogrel ekukhuleni nasekuthuthukisweni komzimba ebuntwaneni nasebusheni, umuthi awunconyelwe iziguli ezingaphansi kweminyaka engu-18.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Umuthi uphulwe ukuze usetshenziswe ngabesifazane abakhulelwe, ngoba i-clopidogrel ingaphazamisa ukubekwa kwezitho nezitho ngesikhathi sokukhula kombungu noma ikhulise amathuba wokopha ngesikhathi sokubeletha, okudala isimo esibucayi empilweni kamama.

Umuthi udotshwa emgodini wezilwane ezincelisayo futhi ukhishwe ubisi lwebele, ngakho-ke, ngesikhathi sokwelashwa nge-Atrogrel, kunconywa ukuthi uyeke ukuncelisa ibele.

Ukulungiswa komthamo owengeziwe womonakalo wezinso akudingekile.

Isicelo sokusebenza kokulimala kwezinso

Ukulungiswa komthamo owengeziwe womonakalo wezinso akudingekile.

Sebenzisa umsebenzi wesibindi okhubazekile

Uma isibindi singasebenzi kahle, kuyadingeka ukubonisana nodokotela wakho ngesidingo somuthi.

Ukweqisa kwe-Atrogrel

Ngokusebenzisa kabi izidakamizwa, ukuvela kokusabela okungekuhle emgudwini wokugaya ukudla (izilonda eziwohloka ulcerative, izinhlungu esifundeni se-epigastric, uhudo kanye nokuhlanza, ukuphuma kwesibindi emgodini wethambo lomgudu wesisu) nesikhathi sokuphuma kwegazi isikhathi eside kungenzeka. Ngomthamo owodwa womthamo omkhulu, ohlukunyeziwe kufanele abize i-ambulensi. Ezimweni zokuma, ukufakelwa igazi kwenziwa ngokushesha ukubuyisela isimo segazi segazi.

Uma isiguli singenise inani elikhulu lamathebhulethi emahoreni angama-4 okugcina, khona-ke isiguli sidinga ukukuhlanza, hlamba i-patity yesisu bese sinika into yokumunca ukunciphisa ukumuncwa kwe-clopidogrel.

Uma umuthi uhlukunyezwa, kungavela imizwa emibi emgudwini wokugaya ukudla, njengokuhlanza.

Ngomthamo owodwa womthamo omkhulu, ohlukunyeziwe kufanele abize i-ambulensi.

Ezimweni zokuma, ukufakelwa igazi kwenziwa ngokushesha ukubuyisela isimo segazi segazi.

Ukuqina kwama-hemorrhages ezithweni eziyize kuyathuthukiswa yisenzo seWarfarin.

Ukuxhumana nezinye izidakamizwa

Ngokusebenzisa ngasikhathi sinye i-Arthrogrel nezinye izidakamizwa, lokhu kusebenzisana kwezidakamizwa okulandelayo kuyabonakala:

1. Ngenkathi uthatha izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala, kukhona ukwanda kwamathuba okuphuma kwegazi emgodini wesisu. Ukuqina kwama-hemorrhages ezithweni eziyize kuyathuthukiswa yisenzo seWarfarin.
2. Ukwanda kwe-plasma kwe-phenytoin ne-tolbutamide kuyanda. Kulokhu, ukusabela okungekuhle okuvela emzimbeni akubukeki.
3. I-Heparin ne-acetylsalicylates ayithinti umphumela wokwelapha we-Atrogrel.

Akukho ukusabela kwamakhemikhali kuhlangene ne-beta-adrenergic receptor blockers, ama-diuretics, izidakamizwa ze-antiepileptic ne-hypoglycemic.

Umthelela ekhonweni lokulawula izindlela

Umuthi awephuli motility kanye nesimo sokusebenza semisipha yamathambo. Ngakho-ke, ngesikhathi sokulashwa, ukushayela, ukulawula izindlela eziyinkimbinkimbi neminye imisebenzi edinga ijubane lesiguli lokuphendula nokusebenza kwengqondo kuvunyelwe.

Ama-Analog

Izikhala ze-Atrogrel zifaka le mithi elandelayo, ngesithako esisebenzayo esifanayo kanye nomphumela we-pharmacological:

• ISylt;
• Clopacin;
• Clopidogrel;
• Acecor Cardio;
• I-Agrelide;
• I-Cormagnyl;
• I-Ecorin;
• I-Cardiomagnyl.

Uma ungekho umphumela wokwelapha lapho uthatha i-Atrogrel, kubalulekile ukubonisana nodokotela wakho mayelana nokubuyiselwa komuthi. Ukushintshela komunye umuthi uwedwa akunconywa.

Imibandela yekhefu lekhemisi

Umuthi uthengiswa ngomuthi onikezwe wona.

Ngingakwazi ukuthenga ngaphandle kadokotela?

Umuthi unciphisa ukuqina kwegazi futhi wenyusa nengozi yokuphuma kwegazi, okuyingozi empilweni ezimweni ezibucayi. Ngokuphepha kweziguli, ukuthengiswa kwamahhala kwesidakamizwa kukhawulelwe.

Intengo

Izindleko ezijwayelekile zesidakamizwa se-antiplatelet kumakhemisi ziyahlukahluka kusuka kuma-ruble angama-344 kuya kwangama-661.

Izimo zokugcina zomuthi

Kunconywa ukugcina umuthi endaweni evikelwe umswakama kanye nelanga, emazingeni okushisa afinyelela ku + 25 ° C.

Isikhathi sokuphelelwa yisikhathi

Iminyaka emi-2

I-analogue edumile yezidakamizwa yiCardiomagnyl.

Uma kunesidingo, umuthi ungathathelwa indawo ngeZilt.

Ukwakheka okufanayo yi-clopidogrel.

Umkhiqizi

Isikhungo Sezempilo Nesayensi Yezempilo i-JSC "Borshchagovsky Chemical and Pharmaceutical Plant", e-Ukraine.

Ukubuyekezwa

U-Oleg Hvorostnikov, oneminyaka engama-52 ubudala, u-Ivanovo.

Ngokunconywa ngudokotela, waqala ukuthatha i-1 i-tablet engu-75 mg ebusuku maqondana nokuxilongwa kwe-atherosclerosis yamaphethelo aphansi. Umuthi usizile, ubulukhuni baqala ukuzizwa bebancane. Kepha ngosuku lwe-5 lokwelashwa kwadingeka ngishayele i-ambulensi. Ukuqala kwamakhala emgodini wesisu kwaqala. Angincomi abantu abathambekele ekwakheni i-gastritis kanye nezilonda. Mina, lokhu bekuyiphutha.

UVictor Drozdov, oneminyaka engama-45, uLipetsk.

Umngani okwathi ngemuva kokuhlaselwa unhlangothi, wakhubazeka, wanikezwa ithebhulethi elilodwa le-Atrogrel amasonto ama-2. Ngemuva kokushaywa unhlangothi, i-ischemia yaqala, ngakho ingalo yangakwesokudla ayizange izwakale. Ekupheleni kwesonto lokuqala lokwelashwa, ukudonsa kwaqala emilenzeni. Umuthi unikeze umphumela. Odokotela bathi lo muthi uvimbele imithambo yegazi futhi wenyusa ukugeleza kwegazi endaweni ye-ischemic. Ngishiya umbono omuhle.