Ungayisebenzisa kanjani i-Zilt yezidakamizwa?

I-Zilt isidakamizwa se-antiplatelet esisebenzayo esinciphisa ukuhlanganiswa kweplatelet. Ochwepheshe bayayinikeza iziguli ukuze zivikeleke i-thrombosis, unhlangothi kanye nokuhlaselwa yisifo senhliziyo.

Igama

Igama lesiLatini nguZyllt. Isidakamizwa se-INN: i-clopidogrel.

I-Zilt isidakamizwa se-antiplatelet esisebenzayo esinciphisa ukuhlanganiswa kweplatelet.

I-ATX

B01AC04.

Khipha amafomu nokwakheka

Umuthi ukhiqizwa ezibhebheni ze-75 mg zento esebenzayo (clopidogrel hydrosulfate). Ezinye izinto zifaka:

• I-MCC;
• propylene glycol;
• i-talc;
• udayi wensimbi;
• izinhlobonhlobo zesitashi;
• titanium dioxide;
• macrogol-6000;
• ifomu le-anactrous le-lactose;
• uwoyela we-hydrogenated castor;
• hypromellose.

Umuthi ukhiqizwa ezibhebheni ze-75 mg zento esebenzayo (clopidogrel hydrosulfate).

Amaphilisi athengiswa ngamaphakethe ama-14, 28, 30, 56, 84 kanye nama-90 ama-PC.

Isenzo se-Pharmacological

Umuthi ungoweqembu le-clopidogrel Prodrug. Kukhetha ukuvimbela ukubopha kwe-ADP kuma-platelet receptors kanye nokunye ukusebenza kwe-GPIIb / IIIa tata (glycoprotein), okucasulayo ukuvimbela kokuhlanganiswa kweplatelet.

Le nqubo iyaqhubeka amaviki ayi-1-1.5. I-metabolite esebenzayo ivela ngenxa yokuqalwa kwe-CYP450 isoenzymes. Kodwa-ke, akuzona zonke iziguli ezinokuphendula okwanele, ngoba amanye ama-isoenzymes ane-polymorphism, aguqulwa ngaphansi kwethonya lezinye izidakamizwa, noma abe nezinga elihlukile lokuvinjwa kwe-ADP.

Umuthi ukhombisa ukusebenza kahle ekuvimbeleni imiphumela ye-atherothrombotic ezigulini ezinomonakalo wemithambo yegazi yemisuka ehlukahlukene, ikakhulukazi ku-pathology ye-peripheral, coronary and cerebral artery.

Umuthi ukhombisa ukusebenza kahle ekuvikeleni imiphumela ye-atherothrombotic ezigulini ezinokulimazeka kwemithambo yegazi yemvelaphi ehlukahlukene.

I-Pharmacokinetics

Umuthi udonswa ngokushesha ngemuva kokuphathwa ngomlomo. Ukuphakanyiswa okukhulu kwe-plasma kwesithako esisebenzayo kutholakala imizuzu engama-40-45 ngemuva kokuthatha umthamo we-75 mg.

Izakhi zomuthi ngaphakathi kwesibindi zithathelwa phezulu. Isigamu sempilo singamahora ayi-6. I-46% yezidakamizwa ikhishwa ngamathumbu, enye izinso.

Izinkomba zokusetshenziswa

Umuthi usetshenziselwa ukuvikela izinkinga ze-atherothrombotic ezigulini ezindala ezitholakele zinama-pathologies anje:

• infarction myocardial;
• ischemic stroke;
• isifo senhliziyo;
• isifo se-arlial arterial isifo (i-peripheral);
• ifomu le-aconor syndrome (elikhuphukayo engxenyeni ye-ST futhi ngaphandle kwalo).

Umuthi lo uyasetjenziswa ezigulini zobudala obudala obudala obutholakala ukuthi une-myocardial infarction.

Umuthi lo uyasetshenziswa ezigulini zobudala zabantu abadala ezitholakala zinesifo senhliziyo.

Umuthi lo uyasetshenziswa ezigulini zobudala zabantu abadala ezitholakala zinenkinga yokushaywa unhlangothi.

Ngaphezu kwalokho, umuthi usetshenziselwa ukuvikela izinkinga ze-thromboembolic kanye ne-atherothrombotic ye-atrial fibrillation, stroke.

Contraindication

• hypersensitivity kuzithako zomuthi;
• ukukhulelwa nokuqunjelwa;
• ukopha (umqubuko);
• i-pathology enzima ne-hepatic hepatitis;
• iminyaka engaphansi kweminyaka eyi-18;
• I-GGM syndrome, ukungabekezelelani kwe-lactose, ukuntuleka kwe-lactase.

I-Zilt i-contraindicated kwabesifazane abakhulelwe.

I-Zilt i-contraindicated kubantu abane-hypersensitivity kuzithako zomuthi.

I-Zilt i-contraindified kubantu abangaphansi kweminyaka engu-18 ubudala.

Ngokunakekela

• izinkinga zesibindi ezilinganiselwe nezinobumnene;
• umsebenzi wezinso ongonakalisiwe;
• izimo lapho kunengozi enkulu yokopha;
• ukuhlanganiswa ne-Heparin, Warfarin ne-glycoprotein agents
• ukungabekezelelani kwamanye ama-thienopyridines (Prazogrel, Ticlopidine, njll.).

Ngokuqapha, umuthi uthathwa ngokuhlanganiswa nama-glycoprotein inhibiting agents.

I-Lozap Plus icutshaniswe nokulimazeka okukhulu kwezinso.

Ngokuqapha, umuthi uthathwa njengezinkinga zesibindi ezilinganiselwe nezincane.

Ungayithatha kanjani iZilt?

Umuthi kufanele udakwe 1 isikhathi ngosuku. Ukudla akuwuphazamisi umsebenzi kanye nokumunyisa umuthi.

Nge-ischemia, infyoction ye-myocardial kanye ne-occlusive arterial vascular sifo, umthamo omaphakathi ngu-75 mg (iphilisi elilodwa) kanye ngosuku.

Ezigulini ezine-fibrillation ye-atrial, umuthi ubekwe kumthamo we-75 mg. Umthamo omkhulu wansuku zonke ngu-300 mg. Kulokhu, i-acetylsalicylic acid kwesinye isikhathi isetshenziswa ngokungeziwe.

Uma weqa ukusetshenziswa komuthi olandelayo womuthi, ungawuthatha kungakapheli amahora ayi-12. Ngemuva kwalokhu, irejimeni yokwelashwa akufanele yephulwe. Musa ukuphinda kabili umthamo.

Umuthi kufanele udakwe 1 isikhathi ngosuku.

Ukuthatha umuthi wesifo sikashukela

Uma unesifo sikashukela, kufanele uthintane njalo nochwepheshe wezokwelapha ngaphambi kokuthatha umuthi.

Kuthatha isikhathi esingakanani?

Isikhathi sokulashwa kwezidakamizwa akufanele singeqi unyaka.

Imiphumela emibi

Umuthi ungadala ukusabela okungafuneki. Uma lokhu kuvela, kufanele uthintane nodokotela wakho ngokushesha.

Amapheshana wesisu

• Ubuhlungu esiswini;
• isifo sohudo nokuqunjelwa;
• izihlakala;
• i-pancreatitis
• ukopha ezingxenyeni ze-gastrointestinal (i-retroperitoneal hemorrhage);
• isicanucanu
• ukuhlanza
• dyspepsia.

Imiphumela emibi evela emgodini wesisu isisu sohudo.

Imiphumela emibi evela emgodini wesisu ukuhlanza.

Imiphumela emibi evela emapheshana esiswini: ukukhuphula i-pancreatitis engamahlalakhona.

Izitho zeHematopoietic

• i-leukopenia;
• i-anemia
• i-agranulocytosis;
• i-granulocytopenia;
• i-thrombocytopenia;
• neutropenia (ezimweni ezingavamile).

Isistimu yezinzwa ephakathi

• ikhanda
• umkhuhlane
• ukwazi okungaphelele;
• ukucashunwa kwemisindo nokubukwayo;
• Isiyezi
• ukuthuthumela.

Imiphumela emibi evela ohlelweni lwezinzwa oluphakathi: isiyezi.

Imiphumela emibi evela ohlelweni oluphambili lwezinzwa: ukwazi okufiphalisiwe.

Imiphumela emibi evela ohlelweni lwezinzwa oluphakathi ibuhlungu bekhanda.

Kusuka ohlelweni lomchamo

• glomerulonephritis (ezimweni ezingavamile kakhulu);
• i-hematuria;
• umsebenzi wezinso ongonakalisiwe;
• ukukhula kwe-plasma creatinine okuhlushwa.

Kusuka ohlelweni lokuphefumula

• igazi eliphuma ekhaleni;
• secretion of mucus negazi kusuka emgudwini wokuphefumula;
• ifomu lokuhlangana kwezinduna;
• spasms bronchial.

Imiphumela emibi ingaba uhlobo lwe-pneumonia.

Imiphumela emibi evela ohlelweni lokuphefumula ingahle ibe yizixongo ze-bronchial.

Imiphumela emibi evela ohlelweni lokuphefumula igazi elivela ekhaleni.

Engxenyeni yesitho sombono

• ukuncipha kokuqonda kokuqonda;
• ukukhuphuka kwengcindezi ye-intraocular;
• umbono ophindwe kabili.

Engxenyeni yesibindi ne-biliary

• ukukhuphula ukwehluleka kanye nokunye ukungasebenzi kahle kwesibindi;
• ihepatitis.

Kusuka ezicutshini zemisipha

• i-hemorrhage yemisipha;
• i-hemarthrosis;
• i-myalgia;
• i-arthralgia;
• isifo samathambo.

Imiphumela emibi evela ezicutshini zesisipha nokuqina: isifo samathambo.

Imiphumela emibi evela ezicutshini zesisipha nokuqina: i-arthralgia.

Imiphumela emibi evela kwezicubu zomzimba kanye nezicubu ezihlangene: ukuqina kwemisipha.

Ngaphezu kwalokho, ukusabela kwe-anaphylactoid kungenzeka lapho uthatha amaphilisi.

Imiyalo ekhethekile

Iziguli ezenze izinqubo ezingahlaseli kanye nokuhlinzwa zidinga ukubhekwa ngokucophelela lapho ziphuza umuthi ukugwema izinkinga ngenxa yokopha okungazelelwe.

Umuthi wandisa isikhathi sokuphuma kwegazi. Ngakho-ke, kunqunywa ngokuqapha ezigulini ezinobungozi obukhulu besimo esinjalo.

Ngaphambi kokuhlinzwa okuhleliwe, lapho isenzo se-antiplatelet singadingeki, umuthi kufanele uyekwe okungenani ezinsukwini ezingama-5-6 ngaphambi kokuhlinzwa. Lokhu kufaka izinqubo zamazinyo.

Ukuhambisana notshwala

Inhlanganisela yomuthi notshwala ingavusa ukuphazamiseka kwesilinganiso senhliziyo, ukuthuthukiswa kwe-tachycardia ne-bradycardia. Ngakho-ke, ngokwelashwa kwezidakamizwa, ukuhlangana okunjalo kufanele kugwenywe.

Inhlanganisela yomuthi notshwala ingavusa ukuphazamiseka kwesilinganiso senhliziyo, ukuthuthukiswa kwe-tachycardia ne-bradycardia.

Umthelela ekhonweni lokulawula izindlela

Umuthi awunawo nomthelela ekhonweni lokushayela imoto nemisebenzi edinga ukusabela nokunakwa okusheshayo.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Ngesikhathi sokukhulelwa, umuthi unqunyelwe kuphela ezimweni lapho inzuzo elindelekile izodlula ubungozi obungahle bube khona.

Lapho uthatha futhi uphuza umuthi, ukuncelisa kufanele kulahlwe.

Ukuqokwa kukaZilt ezinganeni

Umuthi awuhloselwe ukwelashwa kweziguli ezincane.

Sebenzisa ebudaleni

Ezigulini esezikhulile, umthamo awulungiswa. Kodwa-ke, kufanele balahle umthamo wokulayisha.

Ezigulini esezikhulile, umthamo awulungiswa.

Ukweqisa

Ngomthamo omkhulu kakhulu, umuthi ungaholela ekwandeni kwesikhathi sokuphuma kwegazi nezinkinga ze-hemorrhagic. Ukwenza isimo sibe sesimweni ngokwejwayelekile Umuthi awunawo umuthi wokudambisa izidakamizwa.

Ukuxhumana nezinye izidakamizwa

Kuyinto engathandeki ukuhlanganisa umuthi nama-anticoagulants omlomo ngenxa yengozi yokwanda kwegazi lokuqina kwegazi.

Kusho ukuthi kuvimbela imisebenzi yephampu yeproton ibe nomthelela omncane ku-isoenzyme CYP2C19 - iLansoprazole nePantoprazole. Zingahlanganiswa nomuthi okukhulunywa ngawo.

Ingxenye esebenzayo yesidakamizwa ayithinti izakhiwo ze-pharmacokinetic ze-warfarin. Kepha inhlanganisela enjalo ikhulisa ubungozi bokuphuma kwegazi ngenxa yokuwohloka kokuqina kwegazi.

Lapho umuthi uhlanganiswa ne-Theophylline ne-Digoxin, ama-pharmacokinetics awo awashintshi.

Kunconywa ukugwema ukusetshenziswa kanyekanye ne-omeprazole.

Kuyinto engathandeki ukuhlanganisa umuthi nama-anticoagulants omlomo ngenxa yengozi yokwanda kwegazi lokuqina kwegazi.

Ama-Analog

• I-Aterocardium;
• I-Areplex;
• I-Agrel;
• Brilinta;
• I-Deplatt;
• I-Avix;
• I-Diloxolum;
• I-Jendogrel;
• Clopact;
• I-Klopigrel.

Imibandela yekhefu lekhemisi

Ngingakwazi ukuthenga ngaphandle kadokotela?

Umuthi awutholakali ngaphandle kwemithi kadokotela.

Intengo Ebunjiwe

Izindleko zomuthi ziqala kusuka kuma-ruble ayi-120 amathebulethi ayi-14 ama-75 mg ento esebenzayo ebhokisini lekhadibhodi.

Umuthi awutholakali ngaphandle kwemithi kadokotela.

Izimo zokugcina zomuthi

Kungcono ukugcina umuthi ngamazinga okushisa angadluli ku + 20 ° C, endaweni epholile neyomile lapho ukukhanya kwelanga kungatholi khona.

Isikhathi sokuphelelwa yisikhathi

Izinyanga ezingama-24.

Ukubuyekezwa kwe-Sylt

Odokotela

U-Igor Kvashnin (owelaphi), oneminyaka engama-40, uBarnaul.

Umenzeli osebenzayo futhi onamandla ovela eqenjini lama-antiplatelet agents. Into esebenzayo ekwakhekeni kwayo iyakwazi ukwehlisa ijubane i-AT. Sebenzisa la maphilisi kuphela ngenxa yezizathu zokwelashwa futhi ngokuya ngemiyalo kadokotela. Uma lokhu kunganakwa, umuntu angahlangabezana nokuphendula okungathandeki kakhulu nezinkinga.

Iziguli

U-Anton Wigman, oneminyaka engama-45, eMoscow.

Kwaphela iminyaka eminingi ehlushwa i-angina pectoris. Cishe iminyaka emi-3 edlule ngibe nozwelo. Ngemuva kwenqubo, ngithatha i-1 i-tablet yalesi sidakamizwa nsuku zonke. Muva nje ephumelele ukuhlolwa, udokotela akazange aveze noma yikuphi ukwephulwa, kunalokho, waphawula ukuthuthuka kwesimo esejwayelekile. Impilo yakhe ibuye yathuthuka, futhi nokuhlasela kwe-angina akusabonakali.

UVladimir Dubov, oneminyaka engama-47, uLipetsk.

Kwangimangaza kakhulu ubuchwepheshe bochwepheshe emtholampilo wethu owasheshe wahlola isimo sami sangaphambi kokushaywa unhlangothi futhi wasindisa impilo yami. Kwakudingeka ngiye kodokotela cishe izinyanga eziyi-12. Udokotela wezinhliziyo uxwayise ngengozi engaba khona yokusebenzisa inqwaba yezidakamizwa futhi wancoma ukusebenzisa lo muthi ngoba ubonwa kahle ngumzimba futhi akuvamile ukuthi ucasule ukusabela okubi. Manje imithambo yami nemithambo yegazi kujwayelekile.