Okuphansi isisindo yamangqamuzana heparins: izidakamizwa, izinkomba ukusetshenziswa

Ukwelashwa of thrombosis futhi thromboembolic izenzakalo akuyona ngaphandle anticoagulants, okuhlanganisa ongaphakeme yamangqamuzana isisindo heparins. Lezi izinto lichaza ekwakheni imithi ukushintsha igazi ekunqandeni, kanjalo ekubuyiseleni patency.

Izinhlobonhlobo anticoagulants oqondile

Uma ucabangela indlela emphumeleni compounds antithrombotic kungase kuqashelwe ukuthi zingabantu isinyathelo nenkhulumombiko. Ezisetshenziswa kakhulu iqembu lokuqala izinto.

Anticoagulants ithonya ngqo ku isakhiwo zihlukaniswe ongaphakeme yamangqamuzana isisindo heparins futhi unfractionated. Zingabonisa oqondile thrombin inhibitor, kuba njani, isibonelo, hirudin.

Okuphansi yamangqamuzana isisindo heparins Isici

ehlukile ngokuthi compounds zabo fractionated isisindo yamangqamuzana kabani isilinganiso zokhahlamba kusuka 4000 kuya 6000 daltons. imisebenzi yabo zihlobene okusithiyayo ongaqondile kumiswa nomsebenzi we thrombin enzyme. Leyo heparin umphumela enalo igazi coagulation isici Xa. Umphumela kuyinto anticoagulant nomphumela antithrombotic.

Okuphansi yamangqamuzana isisindo heparins etholakala izinto unfractionated behlukene wezingulube epithelium emathunjini, ngesikhathi inqubo depolymerization zamakhemikhali noma enzymatic. Ngenxa yalokho okunjena polysaccharide chain is mfushane eyodwa kwezintathu zobude yayo yasekuqaleni, esiza ukunciphisa i-molecule ye anticoagulant.

Kunezinhlobo ezehlukene ongaphakeme yamangqamuzana isisindo heparins, futhi lokhu ngezigaba kusekelwe izindlela yokuthola compounds usawoti-aqukethe.

Ukukhishwa

ukwakhiwa zabo ziyisiliva izixazululo komjovo kwezokuphatha ongama noma emthanjeni. Zivame phama ampules noma imijovo zalutho.

Okuphansi yamangqamuzana isisindo heparins kungukuthi kukhiqizwa amaphilisi.

imithi Intramuscularly alisetshenziswa.

Incazelo "Gemapaksan" izidakamizwa

Libhekisela izidakamizwa ngemiphumela ngqo anticoagulant. Isithako esebenzayo ngesimo enoxaparin sodium usawoti, okuyinto kubhekwa a esuselwe heparin. Lokhu ukuguqulwa ihlinzeka adsorption okusezingeni eliphezulu lapho zaphathwa phansi kwesikhumba futhi ngabanye ukuzwela ongaphakeme.

It ikhiqizwa yinkampani Italian "Italfarmako SpA" njengoba isixazululo kucace, kungekho nto enemibala emihle noma ukukhanya-ephuzi umjovo zahlanganiswa ngo imijovo ye 0.2, 0.4 noma 0.6 ml.

enoxaparin sodium Isikali kangakanani 2000 IU kuya ku-20 mg; 4000 IU ukuba 40 mg kanye 6000 mg 60 IU. Isithako asebenzayo siphela emanzini umjovo izidakamizwa.
Enoxaparin sodium ububonisa ngezilinganiso 100 IU ngayinye 1 mg ephezulu umphumela inhibitory igazi coagulation isici Xa futhi ongaphakeme umthelela antithrombin umthamo 28 IU ngayinye 1 mg.

Ukusetshenziswa zokwelapha izidakamizwa lokuhlala yezifo ezihlukahlukene aliholeli ukwanda isikhathi ukopha.

Prophylactic sodium enoksaparinovaya Isikali akukushintshi isebenze ngokwengxenye thromboplastin isikhathi, akwephuli a clumping platelet futhi inqubo yabo uxhumano amangqamuzana fibrinogen.

Okuphansi isisindo yamangqamuzana heparins e umuthi lokuhlushwa ngaphezulu (6000 IU e 0.6 ml) asetshenziswa:

• I-therapy ye-thrombosis e ngemithambo ekujuleni kolwandle;
• yakha angina engazinzile esivimba amanzi emangalisa infarcted isimo imisipha lihambisana acetylsalicylic acid;
• nokuvimbela coagulation kwandisa isikhathi inqubo hemodialysis.

Isingeniso ongama nokushintsha kokudla nokufakwa isixazululo 2000 futhi 4000 IU of 0.2 futhi 0.4 ml, ngokulandelana, isetshenziswa ukuvimbela thrombosis futhi emithambo yegazi isimo thromboembolic uhlelo:

• ngesikhathi wamathambo imisebenzi kuhlinzwa uhlamvu;
• embhedeni iziguli nesifo esingamahlalakhona kwemigudu yokuphefumula noma ukumelwa inhliziyo uhlelo iyunithi 3 kanye nohlobo 4;
• izifo sibi ezithathelwanayo noma rheumatism, lapho kukhona ingozi ngoba amahlule;
• ezigulini esezikhulile;
• nge yamafutha amaningi sebethule;
• lapho yokwelapha i-hormone.

Umuthi isetshenziswa phansi kwesikhumba odongeni besisu, e posterior yayo futhi zone anterolateral.

Imithi is contraindicated thrombocytopenia, ukopha, iziyaluyalu ekunqandeni, isifo esidalwa yizilonda emathunjini sibe we ulwelwesi lwamafinyila we isisu duodenum, subacute endocarditis webhaktheriya, isifo sikashukela, isifo sikashukela, sensitivity high nokukhulelwa.

"Gemapaksan" Medicine: Intengo

Izindleko umjovo equkethe 2000 IU isipetu e 0.2 ml we izingcezu eziyisithupha ruble 955.

Ukuze umthamo ngaphezulu izidakamizwa "Gemapaksan 'amanani amabanga ruble 1500 iphakheji imijovo eziyisithupha.

Incazelo "Clexane" izidakamizwa

Libhekisela indlela efanayo ngesisekelo enoxaparin sodium. Ikhishwa inkampani French "Sanofi Aventis" njengoba i solution komjovo ecacile okungaba kungekho nto enemibala emihle noma nge kancane aphuzi tint.

Kube Isikali "Clexane" ukulungiswa 10000, 8000, 6000, 4000 no-2000 IU of enoxaparin sodium ukuze 1.0; 0.8; 0.6; 0.4; 0.2 ml izidakamizwa liquid, ngokulandelana. Isithako asebenzayo ikhambi 1 mg 1,000 IU.

Okuphansi yamangqamuzana isisindo heparins ekhiqizwa in ingilazi imijovo, okungase iphakethe 2 noma izingcezu 10.

Izidakamizwa "Clexane" ku thrombotic lokuvimbela igciwane lesandulela ngculaza kanye iziyaluyalu thromboembolic lihambe ngemithambo ngesikhathi kokungenela kuhlinzwa ezihlobene amathambo, futhi hemodialysis.

Isixazululo saphathwa phansi kwesikhumba at ukuqedwa emithambo yegazi uthi thrombotic e iphaphu ezijulile futhi zibe umthambo.

Izidakamizwa uswidi angina imvelo engazinzile esivimba amanzi imisipha emangalisa kanye esivimba amanzi ngokuhlanganyela amaphilisi "aspirin".

"Clexane" Medicine: Intengo

Izindleko umjovo equkethe 2000 IU 0.2 ml isipetu ngamunye ruble angu-175.

Omunye iyunithi umthamo 4,000 IU nge 0.4 ml RUB 280 kungadingeka akhokhe ngoba 6,000 IU ngayinye 0.6 ml - 440 ruble 8000 IU ngayinye 0.8 ml - 495 ruble.

Lapho belungela ukuya khona "Clexane" Inani le-unit izicucu 10 ngamunye nge umthamo 20 mg, 40 mg kanye 80 mg kuyinto 1685, 2750, ama-ruble angu-4000.

Incazelo "Fragmin" izidakamizwa

Uphiko asebenzayo zomuthi kuyinto esuselwe heparin izidakamizwa emelelwa dalteparin sodium. It is etholwe depolymerization by isenzo of oxide acid , kulandele uhlanzekile usebenzisa ion exchange chromatography. Dalteparinovaya sodium usawoti yakhiwa polysaccharide amaketanga ngaphansi sulphation, nge isisindo isilinganiso yamangqamuzana daltons ayizinkulungwane eziyisihlanu.

Nezinsizasenzo aphume ashone umjovo wamanzi futhi sodium chloride usawoti. Belgian nomuthi "Fragmin" manual uchaza njengoba isixazululo umjovo ongama kanye nokuphathwa emthanjeni ewuketshezi esobala tint kungekho nto enemibala emihle noma aphuzi.

ukukhululwa yayo monodose ingilazi imijovo ye 2500 IU ngayinye 0.2 ml; 5000 IU ngayinye 0.2 ml; 7500 IU ngayinye 0.3 ml; 10,000 IU e 1.0 ml; 12.500 IU e 0.5 ml; 15,000 IU ngayinye 0.6 ml; 18,000 IU ngalinye 0.72 ml.

Izidakamizwa "Fragmin" manual uncoma ukusebenzisa isilinganiso yokuvimbela kokulawulwa igazi ekunqandeni indlela e hemodialysis futhi haemofiltration nemisebenti lehlose ekwelapheni nokwehluleka ukusebenza kwezinso, ukuvimbela ukwakheka amahlule ekuhlinzeni.

I nomuthi iqondiswa ukuqeda izilonda thromboembolic iziguli esembhedeni ngenxa yokugula.

Isixazululo uswidi angina, engazinzile futhi infarct esivimba amanzi isimo emangalisa kwemisipha, lingaze thromboembolism emithambo yegazi.

Incazelo izidakamizwa "Anfibra"

ongaphakeme yamangqamuzana isisindo heparins wayo ubizwa inkampani Russian OJSC "Veropharm". Kukhona isixazululo ukusula umjovo, okungase tint kungekho nto enemibala emihle noma aphuzi.

Ezicashile izindlela sodium enoxaparin usawoti, okungase kube equkethwe 2000 IU e 0.2 ml; 4000 IU ngayinye 0.4 ml; 6000 IU ngayinye 0.6 ml; 8000 IU ngayinye 0.8 ml; 10,000 IU e 1.0 ml. Amanzi distilled isetshenziswa njengoba kuphela.

It prepacked e ampules noma imijovo ye 1ml, okuyizinto 2, 5, no-10 izingcezu Agcwele amaphakethe amakhadibhodi.

Izidakamizwa "Anfibra" imfundo Kunconywa nokuvinjelwa isimo thromboembolic kwebhizinisi lapho uqhuba zokukhwabanisa kanye hemodialysis ekwelapheni kumiswa ihlule izitsha ezijulile-amanga.

Isixazululo ekwelapheni uhlobo engazinzile angina futhi inhliziyo isimo imisipha infarct lapho kungekho izinyo Q phezu electrocardiogram.

Incazelo "Fraksiparin"

Ngu ongaphakeme isisindo yamangqamuzana heparins zingezikaJehova calcium nadroparin, okuyinto etholakala phakathi kwenqubo depolymerization. molecule zako ziyizindlela glycosaminoglycans, isilinganiso isisindo yamangqamuzana okuyinto ilingana 4.300 Daltons.

Ukulungiselela "Fraksiparin" (imijovo ongama) e ngezithako zawo calcium hydroxide nosawoti nadroparin, okuyinto ziyoncibilika emanzini nemijovo.

Isikali isithako esisebenzayo kuyinto 2850 ME e 0.3 ml; 3800 ME 0.4 ml; 5700 ME 0.6 ml, 0.8 ME 7600 ml, 9500 ME e 1 ml.

Ukulungiswa uketshezi esobala noma kancane opalescent, okuyinto has umbala ukukhanya yellow noma kungenambala ngokuphelele.

Nadroparinovaya usawoti amaprotheni ezinhle sibopha ukuthi antithrombin III, elibangela okusithiyayo esasizosheshisa of isici Xa. Ingqikithi oyenza inhibitor ukuhlinzeka ukuguqulwa kwezicubu isici, kwehlisa umfutho viscosity futhi ngakhula platelet ulwelwesi permeability namaseli granulocytic. Ngakho-ke okwenziwa umphumela antithrombotic zomuthi.

Imijovo "Fraksiparin" okunqunyiwe ukuvimbela isimo thromboembolic kwebhizinisi lapho uqhuba zokukhwabanisa wamathambo waqina futhi hemodialysis. Umuthi iqondiswa iziguli ukuba ingozi eliphezulu legazi ihlule ekwakhekeni, acute esingamahlalakhona zokuphefumula nesifo senhliziyo, engazinzile angina pectoris, esivimba amanzi emangalisa imisipha esivimba amanzi ingenawo Q-wave.

Ukusetshenziswa anticoagulants e ingane esindayo

Okuphansi isisindo yamangqamuzana heparins ekukhulelweni babelwa iziguli ukopha iziyaluyalu hhayi kwakheka esinomhlapho amahlule eziholela isisu, ukuze preeklampsicheskomu-high blood pressure, ikhasi kwakubusa ingane nge ukopha esindayo, imisiwe ukukhula umbungu kwesibeletho, okubangela ongaphakeme isisindo ingane.

anticoagulants okunjalo kuyabekwa kuwo abesifazane kule sikhundla nge sengcupheni yokukhiqiza ihlule kwetinhlavu ngemithambo ejulile, isibonelo wemikhawulo aphansi, kanye wamaphaphu Umthambo occlusion.

yokwelapha LMWH kuyinqubo ubuhlungu, lapho isiguli abakhulelwe ingena izidakamizwa nsuku zonke ngaphansi kwesikhumba esiswini.

Nokho, ngesikhathi olwenziwa emitholampilo zazitholakala Imiphumela yokuhlolwa okuyinto ukufakazela ukuthi ukusetshenziswa anticoagulants enjalo ngokuvamile ungakuvumeli ukuba nethonya elihle. Futhi wathola ukuthi ongaphakeme isisindo yamangqamuzana heparins yokwelapha kungalimaza umzimba kamama elihlobene ne ukopha kakhudlwana futhi kwehle ukukhululeka ubuhlungu emshikashikeni.

Lezi ucwaningo luye lwabonisa ukuthi ukuqedwa ukwelashwa anticoagulant ungagcina nabesifazane abaningi bakwamanye ezingadingekile izimpawu ubuhlungu ngenkathi enza ingane.

Imiyalo ukusetshenziswa amalungiselelo esekelwe ongaphakeme yamangqamuzana yokwelapha isisindo heparin is contraindicated ekukhulelweni.