Daawada xinjirowga tallaabo toos ah iyo si aan toos ahayn. Daawada xinjirowga aan tooska ahayn: liiska daawooyinka, hab ay of action, kala soocidda. Daawada xinjirowga dadban badinta

Iyada oo shaqaynaya saxda ah ee nidaamka xinjirowga dhiigga iyo antisvertyvayuschey caadi ah dheelitirka gudaha ee jirka. socodka dhiigga iyada oo weelasha ma laha caqabadaha iyo caqabadaha, iyo formation thrombus heerka saxda ah. Marka dheelitirka loo jeediyo shaqaynaya nidaamyada ay guushu ku hawshooda ee xinjirowga dhiigga, waxaa jira xaalado keeni kara formation-dhaafka ah ee xinjiro. Daawada xinjirowga aan tooska ahayn - mid ka mid ah kooxaha daroogada loo isticmaalo dib u soo kabashada ee xanuunada gudaha.

Waa maxay daawada xinjirowga lidka?

Xinjirowga yeedhay lacag, taas oo saamayn anticoagulant oo shidaa Barxo ee dhiigga. Tani waxay u ogolaaneysaa in aad si loo soo celiyo sifooyinka rheological iyo in la yareeyo thrombosis.

Means waxaa laga heli karaa qaab kiniin ah, sida saliidda, jel iyo diyaarinta duro. Waxaa loo xilsaaray ma aha oo kaliya oo lagu daaweeyo cudurka, laakiin sidoo kale si looga hortago formation sii kordhaya ee xinjiro dhiig.

Inta badan xubnaha kooxdan oo ah daawooyinka aan la aasaasay thrombus, iyo dhaqdhaqaaqa xinjirowga. Geedi socodka ah ee gaadhista arrimaha plasma, iyo wax soo saarka ee thrombin, taas oo yaraysa xinjiro dhiig.

Daroogooyinka waxaa loo kala qaybiyaa laba kooxood sida ay hawlahooda:

• Daawada xinjirowga toos ah;
• Daawada xinjirowga aan toos ahayn.

tallaabo toos ah daroogada heparin ku salaysan

Kooxdaan lacagaha uu saameyn toos ah ku cofactors plasma oo la xakameeyo thrombin ah. Wakiilka ugu muhiimsan waa heparin. Iyadoo ku saleysan, waxaa jira tiro ka mid ah daroogada simaha la mid ah iyo shibbane magaca:

• "Ardeparin".
• "Nadroparin."
• "Klivarin".
• "Longiparin".
• "Sandoparin".

Heparin ama taagayo xidho antithrombin-III taas oo horseedaysa isbeddel ku meesha uu u taagoo ay,. Tani waxay kor u dadajiyaa xidhiidhka ka mid cofactor ah thrombin, ka dibna si daawaca habka xinjirowga.

Features of "heparin" codsiga

walxaha Action loogu talagalay ka hortagga koritaanka iyo faafinta ee xinjir dhiig. Heparin taagoo si ay u sameeyaan adag la antithrombin, taas oo inhibitor ah arrimo xinjirowga. maalkiisu waa silsilad glycosaminoglycan. daroogada waxaa lagu duraa subcutant iyo bilaabaa ay talaabo dhowr saacadood ka dib.

Haddii loo baahdo, tallaabo degdeg ah "heparin" galiyey maamula intravenously si loo dardar-qabadka iyo in la kordhiyo bioavailability. Doorashada qiyaasta daawada waxay ku xiran tahay gobolka, taas oo qofka bukaanka ah waxa uu ku yaalaa. Waxaa intaa dheer, xisaabta lagu darsadaa joogitaanka cudurada saameen, maamulka isku midka ah kooxaha kale ee medicaments, baahida loo qabo hab qalliin weelal.

oligopeptides

Daawooyinka oo si toos ah u dhaqmaan on xarunta hawlgelinta thrombin, waxaa loo arkaa inhibitors xoog gaarka ah ee nidaamka thrombosis. Walaxda firfircoon ee daroogada on iyaga u gaar ah ku xidhmaan arrimaha xinjirowga, beddelo ay conformation.

Tani waxay daawada "inogatran", "Hirudin", "Efegatran", "Tromstop" iyo kuwa kale. Loo isticmaalo si looga hortago wadne of angina, cudurka qaradhku, ka hortagga ah ee thromboembolism, reocclusion inta lagu guda jiro qalliinka.

Daawada xinjirowga aan tooska ahayn (liiska)

daawada xinjirowga lidka ugu horeysay ayaa loo qarnigii XX ee Maraykanka, markii lagu helay cudur cusub oo lo ', oo iska xanaajin dhiigbax culus. Marka Jidka ayaa elucidated xaalad cudur, waxa ay caddeeyeen in xayawaanka qaba caaryada dhaqmo dhir, oo ku yaalla masruufaan. Laga soo bilaabo wax this cayriin waxaa ku dhexsameeysmo by antiplatelet daroogada marka hore ficilka aan toos ahayn - "Dicoumarol".

Si aad u taariikhda, liiska hantida in ay yihiin analogs ka badan boqol iyo alaabta. All of daawooyinkan - xinjirowga lidka ku ah ee afka laga qaato. hab ay of action ah koox ka mid ah daroogada ku saleysan Iscelin tallaabada of vitamin K.

Waxaa taaaso arrimood oo ay ku xiran tahay vitamin this. Daawada xinjirowga aan toos ahayn la xakameeyo dardargelinta borotiinada xinjirowga iyo cofactors vitaminozavisimyh. Isticmaalka caasiyoobay daawooyinkaan waxaa ka mamnuuc ah, sida waxaa kordha halista dhibaatooyinka dhiig.

Waxaa jira laba kooxood oo ugu waaweyn, kuwaas oo loo kala qaybiyey dhammaan daawada xinjirowga lidka ku dadban. Qoondaynta oo ah lacag ku salaysan yahay walxaha firfircoon ka mid ah diyaarinta. kala saaro:

• taagayo coumarin;
• qalabka indandiona ku salaysan.

diyaarinta indandiona

Ka dib markii fulinta tiro badan oo ah waxbarashada, saynisyahano ogaaday in waxyaabaha ku salaysan walax this firfircoon waa in aan la isticmaali ee therapy. daawooyinka The lahaa tiro badan oo waxyeelo cadaanyo. Saamayntii saameynta on nidaamka protivosvertyvaniya sidoo kale ma tusin natiijo joogto ah.

Kooxdaan waxaa ka mid ah daroogada daroogada, "phenindione", "Difenindion", "Anisindion". Waxaa la go'aansaday in la joojiyo doorashada koowaad ee kooxda labaad ee wakiilada antiplatelet iyo taagayo indandiona hadda oo kaliya loo isticmaalo "Fenilin".

daroogada waxay leedahay qiimo jaban ah, waxa lagu heli karaa qaab kiniin ah. Sharci ah muddo 10 saacadood, oo ay tahay mid aad u muhiim ah si ay u ilaaliyaan mudada doonayo ee therapy. Saamaynta waa la gaari oo kaliya ka dib 24 saacadood laga bilaabo wakhtiga marka ugu horeeysa. Codsiga dhacdaa by yahay ee la socodka xaaladda bukaanka via dhiigga oo xuduudaheedu shaybaarka (xinjirowga, imtixaanka guud ahaan, Kiimikada noole).

Nidaamku wuxuu of the 'fenilina ":

1. Maalintii ugu horraysay - 1 kiniin 4 jeer.
2. maalintii labaad - 1 kiniin ah 3 jeer.
3. Inta kale ee daaweynta - 1 kiniin ah maalin kasta.

Daawada waa in la qaato daawooyin in la yareeyo heerka glucose ee jirka.

taagayo coumarin

Coumarin - walax taas oo ah in dhirta iyo laga been abuurtay synthetically shaybaarka. First, ka dib markii ay ka saarida, qalab loo isticmaali jiray sunta ah ee gacanta ku jiirka. Kaliya dhererka waqtiga bilaabay inuu codsan daroogada si uu ula thrombosis xad-dhaaf ah ka qabtaan.

Daawada xinjirowga lidka ku ah tallaabo aan toos ahayn - diyaarinta ku salaysan coumarin - wakiil habka soo socda Daawada:

• "Warfarin" (analogues ay - "Marevan" "Sodium Warfarin", "Varfareks").
• "Atsenokumarola" (analoogga - "Sinkumar").
• "Neodikumarina" (analoogga - "Etilbiskumatsetat").

"Warfarin": Tilmaamo codsiga

Daawada xinjirowga lidka ku ah tallaabo aan toos ahayn (liiska waxaa laga heli karaa maqaalka) waxaa inta badan wakiil "Warfarin". Taas macnaheedu waxa weeye tableted, macmalay by 2,5, 3 ama 5 mg. Saamaynta on shaqeeyo aadanaha yeesho 1.5-3 maalmood ka dib markii maamulka koowaad ee kiniin ah ka dib. saamaynta ugu badan dhammaadka toddobaadka ugu horreeya.

Ka dib markii qaadashada daroogada ku soo koobin rheological dhiigga ku soo laabtay si caadi ah 5 maalmood laga bilaabo taariikhda la joojiyo ka dib markii "ee warfarin." Means 2 jeer maalintii, isticmaalay mid ka mid ah iyo waqti isku mid ah. Oo maalintii 5aad ee therapy baadhayno-beegyada uu dhiig si loo ogaado ka Bulshda iyo oggolyahay.

koorsada daawada waxaa loo doortay takhasus kiis kasta oo gaar ah. dalalka cudur gaar ah (tus, wadne) u baahan yihiin codsi joogto ah. Iyadoo horumarinta PE (pulmonary lungemboli) Wakiilka antiplatelet lagu qorin wax ka yar lix bilood ah ama nolosha.

Marka baahida loo qabo in qalliin "Warfarin" si aad u joojiso 5 maalmood ka hor qalliinka. Tani waxay u ogolaaneysaa indices dhiigga ku noqdaan caadi. Iyada oo baahi sare oo sii isticmaalka daaweynta xinjirowga, qalab la bedelay heparin unfractionated. Qiyaasta soo dhaafay waxaa kala maamulayay 4 saacadood ka hor-gelinta.

Ka dib markii qaliin ilaa 4 chasa dib looguma soo heparin unfractionated. Qaadashada wakiilada antiplatelet aan toos ahayn loo soo celin karaa laba maalmood, ka dib markii la socodka gobolka dhiigga iyadoo la kaashanayo sheybaar.

In kiisaska waxaa loo isticmaalaa daawada xinjirowga lidka?

xinjirowga Direct iyo si aan toos ahayn loo isticmaalo ka hortagga thromboembolism, thrombosis ba'an nidaamka arooriyaha ay dhacdo of a filtarka wadnaha bedalay farsamo iyo wadne.

The cudurada ugu waaweyn ee horumarka ah oo loo qoondeeyay xinjirowga lidka ku ah si toos ah iyo tallaabo aan toos ahayn, waxay leeyihiin horyaalka ka dib markii kooxo:

1. Thrombosis nidaamka halbowlaha ah:
   • Wadnaxanuun myocardial;
   • lungemboli;
   • stroke oo leh calaamado of ischemia;
   • dhaawac argagaxa leh in ay xididdada ka dhanka ah atherosclerosis.
2. Faafiyay xinjirowga intravascular :
   • nixin dalalka;
   • dhaawac argagaxa leh,
   • horumarinta sepsis.
3. thrombosis Ba'an ee xididka by:
   • xinjiro dhiig ee asalka ah ee xididdada qaradhku;
   • thrombosing plexus arooriyaha hemorrhoidal,
   • xinjir in cava ku vena liita.

sababo ugu weyn

Daawada xinjirowga aan tooska ahayn - daawooyinka waa ka mamnuuc in joogitaanka deficiency lactose, nuugeynin glucose iyo galactose. Waxaa jira tiro ka mid ah daroogada waqti isku mid ah in aad uma isticmaali karo daawada xinjirowga lidka afka. List of daroogada oo ka kooban daawooyin magnyl anti-bararka, "aspirin", "Dipyridamole", "clopidogrel", "penicillin", "Chloramphenicol", "cimetidine".

Xaaladaha looma isticmaali karo daawada xinjirowga lidka toos ah iyo tallaabo aan tooska ahayn:

• cudurada kolit of mareenka caloosha iyo mindhicirka,
• aneurysm vascular,
• cudurka beerka,
• dhiigbax ba'an;
• Torombositobiiniya;
• renal failure;
• Waxaan Bilood oo bishii la soo dhaafay ee uurka,
• heerarka sare ee kariyaatiniin.

Dhibaatooyinka ay keento wakiilada antiplatelet

Mid kasta oo ka daroogada ee kooxdan oo ah wakiilada leedahay dhibaato la mid ah. Waxay isu mariyo iyada oo is ama dose munaasib ahayn ama xad gudub ku saabsan isticmaalka talooyinka.

Dhibaatooyinka ay keento waxaa ka mid ah horumarinta dhiig, calaamadaha dyspeptic sida matag, lallabo iyo shuban. Waxaa jira xanuun caloosha xoog leh, finan maqaarka xasaasiyad nooca finan ama canbaar. Waxaa laga yaabaa in la horumariyo galleeyda, timaha, cuncun maqaarka.

Ka hor inta aadan bilaabin daawaynta, bukaanka waa inay ku aflaxaan taxane ah oo baadhitaano si loo ogaado in ay u isticmaalaan daroogada kuwan. Bukaanku samatabbixiyaa count a complete dhiig, Kiimikada noole, urinalysis, kaadida on Nechiporenko, xinjirowga. Waxaa sidoo kale lagu talinayaa in la sameeyo baaritaan ultrasound of kelyaha ah, oo dhex mari saxarada si ay dhiig u weedhu.

Daawada xinjirowga dadban badinta

Dhaafka ah ee kooxdan oo ah daroogada waa kuwo dhif ah. Tani waxay dhici kartaa haddii ilmo yar oo hooy u noqon doontaa daroogada oo isku day for dhadhan. Sida caadiga ah, fiirsashada oo ah walaxda waa yar yahay, sidaas oo kale ayaa kiniin hal dose ma ayan ka cabsan jirin. In case of isticmaalka gaarka ah ama ula kac ahayn ee qaadasho weyn oo ah walaxda horumarin karaan coagulopathy iyo dhiig.

rugta badinta ma laha calaamado gaar ah, sidaas darteed u maleynayaa in waxa dhacay cabo xaddi badan oo daroogada ah, waa ay adag tahay. Symptomatology daliilka la mid ah oo cudurro kala cayncayn ah iyo dalalka bahal ah ee u shaqeeyo. Bukaanku waxaa uu:

• burbur iftiin on maqaarka,
• dhiigga kaadida ama saxarada;
• dhiig, makaanka,
• hematoma qoorta;
• hemorrhage intracranial.

Horaantii, stroke hore, bukaanka dadka waayeelka ah, dhiig-bax iyo mindhicirka iyo taariikh hiimotokiriit hooseeyo - arrimo la xiriira in uu yarayn karaa nuglaato ee fiirsashada marinka ee daawooyinka.

badinta therapy Antiplatelet

1. Nadiifiyo ama dhalaal iyada oo caloosha dhowr saacadood ka dib markii maamulka daroogada wuxuu leeyahay macnaha lahayn.
2. bukaanka la siiyo dhuxusha firfircoonaan for nuugista xiidmaha.
3. "Cholestyramine" gudaha maamula in ay dhacdo "warfarin" badinta ama analogues ay.
4. Bukaanka ayaa la dhigayaa in xaaladaha antitravmaticheskie, si looga fogaado in soo bixitaanka of hematomas cusub iyo hemorrhages.
5. Dhiig la'aan la taaban karo ama lagu shubo plasma qaadeen sameeyay xubno ka, mararka qaarkood dhiig oo dhan. Ool ah in isticmaalka unugyada dhiigga cas buuxiyey, Cryoprecipitate, adag prothrombin.
6. waxyaabaha loo magacaabay "Phytomenadione" ku salaysan vitamin K.
7. Haddii loo baahdo, ku meeleeyo ma therapy antiplatelet, daroogada "Phytomenadione" koorsada daaweynta magacaabay, halkii ay sida gargaarka koowaad.

Haddii xaaladda bukaanka si caadi ah ku soo laabtay, laakiin waxaa lagama maarmaan ah in ay sii wadaan si ay u isticmaalaan daawada xinjirowga lidka afka, waxaa lagama maarmaan ah in ay "Warfarin" ku meel gaar ah bedelo daroogada heparin taxane.

gunaanad

Isticmaalka daroogada antiplatelet caadi karo ma aha oo kaliya heerarka rheological dhiig, laakiin sidoo kale si loo hagaajiyo xaaladda guud ee bukaan-socodka iyo ka hortagga horumarinta cudurro halis ah.

dareenka taxadir isticmaalka daawada xinjirowga, doorashada ee qiyaasta iyo la socodka xaalada bukaanka ka caawin kartaa in la yareeyo halista jahawareerka iyo guul. Professionals isticmaala kooxdan oo ah daroogada ee ay dhaqanka, waxaa lagama maarmaan ah si loo horumariyo aqoonta iyo in ay si adag u hoggaansamaan talooyinka caafimaadka ee caalamiga ah.