I-FRAXIPARIN: IMIPHUMELA EMIBI, UKUHAMBISANA KOTSHWALA, UKUPHIKISANA

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Izinkinga zokuqina kwegazi, izinkinga ze-thromboembolic ziyizifo ezimbi kakhulu ezidinga ukwelashwa ngokushesha.

Kaningi ezimweni ezinjalo, odokotela banquma isidakamizwa i-Fraxiparin. Imiphumela emibi kanye ne-contraindication yokusetshenziswa kwayo kuyatholakala, futhi kubalulekile ukwazi ngayo.

Lezi zingqinamba, kanye nemininingwane yokusetshenziswa komuthi, umphumela wawo kanye nokubuyekezwa kuzoxoxwa ngokuhamba kwesikhathi.

Isenzo se-Pharmacological

I-Fraxiparin iqukethe i-heparin ephansi yesisindo, ukudalwa kwayo kwenziwa ngaphansi kwenqubo yokuqothulwa komhlaba. Isici esisetshenziswayo somuthi kuthiwa senziwa umsebenzi maqondana ne-coagulation factor Xa, kanye nomsebenzi obuthakathaka we-factor Pa.

Umsebenzi we-Anti-Xa umenyezelwa kakhulu kunomphumela womenzeli wesikhathi sokusebenza kweplatototic eyingxenye. Lokhu kukhombisa umsebenzi we-antithrombotic.

Umuthi Fraxiparin

Lesi sidakamizwa sinemiphumela yokulwa nokuvuvukala ne-immunosuppress. Ngaphezu kwalokho, isenzo somenzeli singabonakala ngokushesha okukhulu, futhi sihlala isikhathi eside ngokwanele. Kungakapheli amahora angama-3-4, umuthi udakwe ngokuphelele. Igcotshwa kanye nomchamo ngokusebenzisa izinso.

Ngaphambi kokuqala ukusetshenziswa, kuyadingeka ukuhlola ukusebenza kwesibindi nezinso, izinga lokuqina kwegazi, kanye nokuqukethwe kwe-cholesterol.

Izinkomba zokusetshenziswa

Ukusetshenziswa kwe-Fraxiparin ngezihloko ezilandelayo:

ukwelashwa kwe-myocardial infarction;
ukuvimbela izinkinga ze-thromboembolic, ngokwesibonelo, ngemuva kokuhlinzwa, noma ngaphandle kokuhlinzwa;
i-coagulation prophylaxis ngesikhathi se-hemodialysis;
ukwelashwa kwezinkinga ze-thromboembolic;
ukwelashwa kwe-angina pectoris engazinzi.

Kukhululwa ifomu, ukwakheka

Ukukhishwa kweFraxiparin kusesimweni sesisombululo somjovo, obekwe kwisirinji. Isirinji yona ngokwayo itholakala ku-blister, egcwele izingcezu ezi-2 noma eziyi-10 ebhokisini lekhadibhodi.

Ukwakheka kufaka into esebenzayo ebizwa nge-calcium adroparin 5700-9500 IU. Izici ezisizayo lapha yile: i-calcium hydroxide, amanzi ahlanziwe, ne-chloric acid.

Imiphumela emibi

Njengemithi eminingi, i-Fraxiparin kwesinye isikhathi ibangela imiphumela emibi:

i-thrombocytopenia;
ukungahambi kahle komzimba (okuvame kusuka esiswini sokukhipha i-Fraxiparin), kufaka phakathi i-edema ka-Quincke;
ukopha kwezindawo ezahlukahlukene;
isikhumba i-necrosis;
ubuqiniso;
i-eosinophilia ngemuva kokuhoxiswa kwezidakamizwa;
hyperkalemia eguqukayo;
ukwakheka kwe-hematoma encane endaweni yomjovo, kwesinye isikhathi kuqhuma izicucu ezinkulu ezivela eFraxiparin (isithombe ngezansi);
ukwanda kokuqukethwe kwama-enzyme e-hepatic.

Izithelo ezivela Fraxiparin

Ezinye iziguli ezisebenzisa i-Fraxiparin zaphawula umuzwa onamandla wokushiswa ngemuva komjovo.

Contraindication

I-Contraindication Fraxiparin inoku okulandelayo:

i-thrombocytopenia;
iminyaka efinyelela eminyakeni eyi-18;
izilonda ze-organic zezitho ezithambekele kokopha;
i-intracranial hemorrhage;
ukuzwela kuzakhi ezingeqile kokujwayelekile;
ukuhlinzwa noma ukulimala kwamehlo, ubuchopho kanye nentambo yomgogodla;
ukopha noma ingozi enkulu yokuvela kwayo kwephula i-hemostasis;
ukwehluleka okunzima kwe-renal ngenxa yokufakelwa kwe-myocardial, angina engazinzile, ukwelashwa kwe-thromboembolism.

Ngengozi eyandayo yokopha, iFraxiparin kufanele ithathwe ngokuqapha. Izimo zimi ngalendlela elandelayo:

ukwehluleka kwesibindi;
ukuphazamiseka kokujikeleza kwe-retina ne-choroid;
ukwelashwa okuhlala isikhathi eside kunokunconywa;
isisindo somzimba kuze kufike ku-40 kg;
isikhathi ngemuva kokuhlinzwa emehlweni, umgogodla, ubuchopho;
umfutho ophakeme we-arterial hypertension;
ukungahambisani nemibandela yokwelashwa;
izilonda ze-peptic;
ukuthatha imishanguzo ngasikhathi sinye okungaba nomthelela ekhipheni ukopha.

Ukungena kwe-nadroparin nge-placenta akufundiswanga ngokuphelele, ngakho-ke, ngesikhathi sokukhulelwa, futhi akunconywa ukusebenzisa umuthi. Lokhu kuyasebenza nasekunceliseni ibele.

Imiyalo yokusebenzisa

I-Fraxiparin ingeniswa esiswini ngezicubu ezingaphansi. Isibaya sesikhumba kumele sigcinwe ngaso sonke isikhathi ngenkathi ikhambi liphathwa.

Isiguli kufanele siqambe amanga. Kubalulekile ukuthi inaliti iphelele, futhi hhayi ekhoneni.

Ekuhlinzweni okujwayelekile kokuvinjwa kwezinkinga ze-thromboembolic, ikhambi liphathwa ngevolumu engu-0.3 ml kanye ngosuku. Umuthi uthathwa okungenani isonto kuze kufike isikhathi sobungozi.

Umthamo wokuqala ukhishwa ngaphambi kokuhlinzwa emahoreni angama-2-4. Endabeni yokuhlinzwa kwamathambo, umuthi uphathwa amahora angu-12 ngaphambi kokuhlinzwa namahora ayi-12 ngemuva kokuqedwa kwawo. Ngaphezu kwalokho, umuthi uthathwa okungenani izinsuku eziyi-10 kuze kuphele isikhathi sobungozi.

Umthamo wokuvimbela unqunywe ngokususelwa kumzimba wesiguli:

40-55 kg - kanye ngosuku ngo-0,5 ml;
60-70 kg - kanye ngosuku ngo-0,6 ml;
70-80 kg - kabili ngosuku, 0,7 ml lilinye;
85-100 kg - kabili ngosuku nge-0.8 ml.

Ukwelashwa kwezinkinga ze-thromboembolic, umuthi uphathwa ngezikhathi ezithile ezingamahora ayi-12 kabili ngosuku izinsuku eziyishumi.

Ekwelapheni kwezinkinga ze-thromboembolic, isisindo somuntu sidlala indima ekunqumeni umthamo:

kuze kufike ku-50 kg - 0,4 mg;
50-59 kg - 0.5 mg;
60-69 kg - 0,6 mg;
70-79 kg - 0,7 mg;
80-89 kg - 0,8 mg;
90-99 kg - 0,9 mg.

Ekunqandweni kokuhlangana kwegazi, umthamo kufanele unqunywe ngokuhlukile ngokuya ngezimo zobuchwepheshe zedalysis. Imvamisa, lapho ukuvinjezelwa kuvinjelwe, indawo yokukhosela umthamo wokuqala wabantu ongama-0,3 kg, u-0.4 mg kuya kuma-60 kg, u-0.6 mg ngaphezulu kuka-70 kg.

Ukwelashwa kwe-myocardial infarction kanye ne-angina engazinzile kunconywa kuhlanganiswe ne-Aspirin izinsuku eziyi-6. Kuqala, umuthi ufakwa kwi-catheter ye-venous. Umthamo osetshenzisiwe yi-86 ME anti-Xa / kg. Okulandelayo, isixazululo sikhishwa ngokubandlululwa kabili ngosuku ngosuku umthamo ofanayo.

Ukweqisa

Uma kwenzeka kweqa isidakamizwa esinjalo, kuphuma ukonakala kobunzima obuhlukahlukene. Uma zingabalulekanga, khona-ke ungakhathazeki. Kulesi simo, udinga ukunciphisa umthamo, noma ukwandisa isikhathi phakathi kwemijovo. Uma ukopha kubalulekile, khona-ke udinga ukuthatha i-protamine sulfate, engu-0.6 mg yayo ekwazi ukudonsa amandla we-0,1 mg weFraxiparin.

Ukusebenzelana kwezidakamizwa

Ukuthatha i-franksiparin ngasikhathi sinye ngemithi ethile kungaholela ku-hyperkalemia.

Lokhu kufaka phakathi: usawoti we-potassium, i-ACE inhibitors, ama-heparins, ama-NSAID, ama-diuretics e-potassium-sparing, i-Trimethoprim, i-angiotensin II receptor blockers, iTacrolimus, uCyclosporin.

Izidakamizwa ezithinta i-heestasis (i-anticoagulants engaqondile, i-acetylsalicylic acid, i-NSAIDs, i-fibrinolytics, i-dextran), kanye nokusetshenziswa kwalomenzeli, zithuthukisa umphumela womunye nomunye.

Ingozi yokuqhamuka kwegazi inyuka uma i-Abciximab, Beraprost, Iloprost, Eptifibatide, iTirofiban, iTiclopedin nayo ithathwa. I-acetylsalicylic acid nayo ingasiza kulokhu, kepha kuphela kumithamo ye-antiplatelet, okungukuthi yi-50-300 mg.

I-Fraxiparin kufanele ichazwe ngokucophelela lapho iziguli zithola ama-dextrans, anticoagulants, kanye ne-corticosteroids e-systemic. Endabeni yokuthatha i-anticoagulants engaqondile kanye nalesi sidakamizwa, ukusetshenziswa kwayo kuyaqhubeka kuze kube yilapho inkomba ye-INR ivamile.

Ukuhambisana kwe-Fraxiparin notshwala akunangqinamba. Umuthi usetshenziselwa ukuvikela izinkinga ze-thromboembolic, futhi utshwala, kunalokho, bandisa ubungozi babo.

Ukubuyekezwa

Njengazo zonke izidakamizwa eziningi, kunokubuyekezwa okungqubuzanayo ngeFraxiparin. Kukhona labo abasizile, futhi ubhekwa njengosebenza, kepha iziguli ezithatha umuthi njengezingenalusizo ngokuphelele azikhishwa.

Ukubuyekezwa okungalungile kuza ngokusekelwe ekubeni khona kwenani elikhulu lemiphumela emibi, imibimbi. Ngaso leso sikhathi, ngaphandle kwezexwayiso zokuthatha lesi sidakamizwa kwabesifazane abakhulelwe, akunamphumela empilweni nasentuthukweni yengane etholakele.

Amavidiyo ahlobene

Ungayifaka kanjani i-Fraxiparin:

Ngakho-ke, i-Fraxiparin ivame ukubekelwa izinkinga zezinkinga zegazi, isidingo sokwelashwa noma ukuvimbelwa kwezinkinga ze-thromboembolic. Into esemqoka ukunamathela ezinconyweni zikachwepheshe onganquma ukufaneleka kokusetshenziswa kwayo kanye nomthamo odingekayo. Ngaphandle kwalokho, ngaphezu kokuntuleka komphumela, kunalokho, umphumela ongemuhle kungenzeka uhambisana ne-overdose, ukuthuthukiswa kokopha, ne-hyperkalemia.

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