Anticoagulants mwachindunji kapena kudzera m'njira zina kanthu. Sitipereka anticoagulants: mndandanda wa mankhwala, limagwirira kanthu, gulu. Ambiri osokoneza anticoagulants tikupanga

Ndi uziyenda bwino kachitidwe coagulation ndi magazi antisvertyvayuschey normalization wa bwino a mkati mwa thupi. magazi kudzera ziwiya alibe zopinga ndi zopinga, ndipo thrombus lomenyera mlingo zolondola. Pamene bwino akawinduka ntchito kwa kachitidwe mokomera kutsegula ya coagulation magazi, pali zinthu zimene zingachititse kuti mapangidwe kwambiri a kuundana. Sitipereka anticoagulants - limodzi mwa magulu a mankhwala ntchito ayambe matenda mkati.

Kodi anticoagulants?

Anticoagulant otchedwa ndalama, zimene zotsatira anticoagulant ndi imayendetsa ndi dilution wa magazi. Zimenezi zimathandiza kuti abwezeretse makhalidwe rheological ndi kuchepetsa thrombosis.

Chimatha alembedwe piritsi, monga mafuta, angakhale angelo ndi kukonzekera jekeseni. Akutumikira osati zochepetsera matenda, komanso kuteteza chodziwa mapangidwe magazi kuundana.

anthu ambiri gulu la mankhwala sumangoyambika thrombus, ndi ntchito clotting. The ndondomeko kukhudzana ndi zinthu plasma, ndi kupanga thrombin, amene kubweza magazi kuundana.

Mankhwala m'magulu awiri malinga ndi ntchito zawo:

• anticoagulants mwachindunji;
• mosadziwika anticoagulants.

mwachindunji mankhwala heparin ofotokoza

Gulu la ndalama kumakhudza mwachindunji pa cofactors plasma zomwe ziletsa thrombin. Nthumwi chachikulu ndi heparin. Pa mfundo imeneyi pali mankhwala akuchita zofanana ndi consonant ndi dzina la:

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

Heparin kapena ofanana nawo kumumanga kuti antithrombin-III, imbaenda kusintha malo mamolekyulu ake. Izi kufulumizitsa kugwirizana kwa cofactor kwa thrombin, ndiyeno inactivate ndondomeko clotting.

Features ya ntchito "heparin"

Action zinthu umalimbana yopewera kukula ndi kufalikira kwa magazi aumirira. Heparin mamolekyulu kupanga zovuta ndi antithrombin, chomwe ndi woletsa zinthu coagulation. thunthu ndi unyolo glycosaminoglycan. Mankhwala jekeseni subcutaneously ndipo akuyamba ntchito zake patapita maola angapo.

Ngati ndi kotheka, mwamsanga "Heparin" kulowetsedwa kutumikiridwa m'nsinga kuti imathandizira ntchito ndi kuonjezera bioavailability. Kusankha mankhwala mlingo zimadalira boma imene wodwala ndi ili. Komanso n'komwe pamaso pa matenda concomitant, utsogoleli yomweyi magulu ena a medicaments, kufunika popanga munthu opaleshoni pa zotengera.

oligopeptides

Mankhwala kuti zinthu mwachindunji pa malo a thrombin kutsegula, amaonedwa amphamvu zoletsa enieni a dongosolo thrombosis. The yogwira pophika mankhwala paokha kugwirizana kwa zinthu clotting, kusintha conformation awo.

Izi mankhwala "inogatran", "Hirudin", "Efegatran", "Tromstop" ndi ena. Ntchito popewa matenda a mtima wa angina, matenda varicose, chifukwa kupewa thromboembolism, reocclusion pa angioplasty.

anticoagulants mosadziwika (mndandanda)

The anticoagulant woyamba wakhala analandira mu XX atumwi mu United States, pamene anatulukira matenda atsopano a ng'ombe, n'zothandiza magazi lolemera. Pamene chifukwa wakhala elucidated chikhalidwe pathological, izo zinatsimikizira kuti nyama ndi kachilombo nkhungu amachita clover ili chakudya. Kuyambira nkhaniyi yaiwisi anali apanga ndi mankhwala oyamba antiplatelet mozungulira kanthu - "Dicoumarol".

Pakali pano, mndandanda wa katundu amene analogs wa zinthu zoposa zana. Zonse mankhwala - anticoagulants m'kamwa. Limagwirira cha zochita za gulu la mankhwala zochokera chopinga anachita vitamini K.

Pali clotting zinthu zimene zimadalira vitamini imeneyi. anticoagulants sitipereka ziletsa kutsegula mapulotini coagulation ndi cofactors vitaminozavisimyh. The ntchito mosadziletsa mankhwala ndikoletsedwa, monga zikuchulukirachulukira chiopsezo cha matenda oyamba magazi.

Pali magulu awiri aakulu, amene anagawa anticoagulants onse yozungulira. Gulu la ndalama zachokera yogwira m'gulu lokonzekera. kusiyanitsa:

• coumarin opangidwa kuchokera;
• ofotokoza zipangizo indandiona.

kukonzekera indandiona

Pambuyo pogwira ambiri maphunziro, asayansi apeza kuti mankhwala zochokera mankhwala yogwira sayenera kugwiritsidwa ntchito mu mankhwala. formulations anali ambiri a mavuto monga thupi lawo siligwirizana. Mphamvu amene amadza pa dongosolo protivosvertyvaniya komanso sankafuna zotsatira zogwirizana.

Gulu la mankhwala zikuphatikizapo mankhwala, "phenindione", "Difenindion", "Anisindion". Anaganiza kuti asiye kusankha chachikulu gulu lachiwiri la wothandizira antiplatelet ndi ena ofanana indandiona panopa ankangomva "Fenilin".

Mankhwala ali ndi mtengo wotsika, ndi alembedwe piritsi. Chomveka maola 10, ndipo ndikofunika kukhala nthawi Napempha kwa mankhwala. Zotsatira zimatheka maola pokhapokha 24 kuchokera nthawi mlingo woyamba. Ntchito kumachitika mwa kuyan'anila mmene wodwalayo kudzera m'magazi a magawo zasayansi (coagulation, mayesero ambiri, sayansi).

Chiwembu cha 'fenilina ":

1. Tsiku loyamba - piritsi 1 maulendo 4.
2. Tsiku lachiwiri - 1 matabuleti 3.
3. Ena a chithandizo - piritsi 1 patsiku.

Mankhwala ayenera kumwedwa ndi mankhwala kuchepetsa mlingo wa shuga m'thupi.

opangidwa kuchokera coumarin

Coumarin - mankhwala omwe ali zomera akhoza kupangidwa synthetically zasayansi. Choyamba, pambuyo kuchotsa ake, chida ntchito ngati poizoni ulamuliro rodent. Only ndime ya nthawi kuyamba kugwiritsa ntchito mankhwala kuthana ndi thrombosis kwambiri.

Anticoagulants kanthu mozungulira - kukonzekera zochokera coumarin - ankaimira mwa njira zotsatirazi mankhwala:

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

"Warfarin": ntchito mbali

Anticoagulants kanthu mosadziwika (mndandanda lilipo m'nkhani) nthawi zambiri umaimiridwa ndi "Warfarin". Izi zikutanthauza tableted, chopangidwa ndi 2,5, 3 kapena 5 mg. Zotsatira pa chamoyo munthu umayambira atapita masiku 1.5-3 pambuyo utsogoleli loyamba la piritsi. Zolemba malire tingati ndi kumapeto kwa sabata loyamba.

Pambuyo kutenga mankhwala magawo rheological magazi zinayambanso kuyenda bwino pambuyo masiku 5 kuyambira tsiku Kulipira "wa warfarin." Njira ntchito nthawi 2 tsiku, pa wina ndi nthawi yomweyo. Pa tsiku 5 cha mankhwala ndi zina kuti afufuze magawo magazi kudziwa kuthekera ndi lapamwamba.

The njira ya mankhwala amasankhidwa katswiri pa nkhani iliyonse payokha. Zina matenda limati (mwachitsanzo, matenda fibrillation) amafuna ntchito mosalekeza. Ndi chitukuko cha Pe (m'mapapo mwanga embolism) wothandizila antiplatelet si tapatsidwa miyezi yosakwana sikisi kapena moyo.

Pamene kufunika alowererepo opaleshoni "Warfarin" kuletsa masiku 5 isanafike opaleshoni. Izi adzalola akalozera magazi kubwerera mwakale. Ndi kufunika mkulu ntchito anapitiriza mankhwala anticoagulant, chida m'malo unfractionated heparin. Mlingo lomaliza kutumikiridwa maola 4 isanafike alowererepo.

Pambuyo ntchito kupyolera 4 chasa reintroduced unfractionated heparin. Kulandira wothandizila mozungulira antiplatelet amabwezeretsedwa mu masiku awiri, pambuyo kuyan'anila boma la magazi ndi thandizo la mayesero zasayansi.

Imene milandu ntchito anticoagulants?

Direct ndi mosadziwika anticoagulant ntchito kupewa thromboembolism, pachimake thrombosis a dongosolo venous likhoza mwamwambo mavavu apulasitiki mtima ndi matenda fibrillation.

The matenda chachikulu chitukuko chimene amapatsidwa anticoagulants mwachindunji ndi kanthu mozungulira, ndi gulu zotsatirazi m'magulu:

1. Thrombosis a dongosolo wolumikizira:
   • m'mnyewa wamtima infarction;
   • embolism m'mapapo mwanga;
   • sitiroko ndi zizindikiro za ischemia;
   • zoopsa choipa kwa mitsempha ndi atherosclerosis.
2. Mwiniwakeyo intravascular coagulation :
   • kudabwitsa limati;
   • zoopsa choipa;
   • chitukuko cha sepsis.
3. Pachimake thrombosis ya mitsempha ndi:
   • magazi kuundana ku maziko a mitsempha varicose;
   • thrombosing hemorrhoidal venous plexus;
   • aumirira ku wosakoma vena cava.

contraindications chachikulu

Sitipereka anticoagulants - mankhwala amene koletsedwa pamaso pa akusowa lactose, malabsorption shuga ndi galactose. Pali mankhwala pa nthawi yomweyo kuti simungathe ntchito anticoagulants m'kamwa. Mndandanda wa mankhwala ongokhala mankhwala nonsteroidal odana ndi yotupa, "ndi aspirin", "Dipyridamole", "clopidogrel", "Penicillin", "Chloramphenicol", "cimetidine".

Zinthu zomwe sangathe ntchito anticoagulants mwachindunji ndi kanthu mozungulira:

• matenda anam'peza pa mundawo m'mimba;
• mtima aneurysm;
• chiwindi matenda;
• pachimake magazi;
• thrombocytopenia;
• aimpso kulephera;
• Ine trimester ndi mwezi watha mimba;
• mpweya wambiri wa creatinine.

Zotsatira zoyipa za wothandizila antiplatelet

Aliyense wa mankhwala gulu la wothandizira ali amagawanika mbali. Iwo zimapezeka kupyolera okha kapena mlingo zosayenera kapena kulakwila pa ntchito malangizo.

Zotsatira zoyipa monga chitukuko cha magazi, zizindikiro dyspeptic ngati kusanza ndi kutsekula m'mimba. Pali amphamvu ululu m'mimba, matupi awo sagwirizana zotupa pa khungu ndi mtundu wa ming'oma kapena chikanga. Angathe necrosis, tsitsi imfa, khungu kuyabwa.

Asanayambe chithandizo, wodwala ayenera pochitika mndandanda wa mayesero kuona ngati ntchito mankhwala. Wodwala akukamba wathunthu magazi, sayansi, urinalysis, mkodzo pa Nechiporenko, coagulation. Izo analimbikitsanso kuti ultrasound Kupenda impso ndi pochitika chopondapo magazi zamatsenga.

Ambiri osokoneza anticoagulants tikupanga

Overdoses wa gulu la mankhwala n'zochepa kwambiri. Izi zingachitike ngati mwana wamng'ono adzakhala nyumba ya mankhwala ndi kuyesera iyo pofuna kukoma. Childs, anthu ambiri mankhwala ndi otsika, choncho miyala mlingo umodzi sanali adawopa. Mu nkhani ya ntchito yapadera kapena mwangozi wa Mlingo waukulu wa mankhwala akhoza kukhala coagulopathy ndi magazi.

chipatala ambiri osokoneza alibe zizindikiro zenizeni, kotero ndikuganiza zimene zinachitika kumwa yambiri ya mankhwala, n'zovuta. Symptomatology mawonetseredwe ofanana ndi matenda osiyanasiyana ndipo limati pathological wa chamoyo. Wodwalayo:

• mikwingwirima kuwala pa khungu;
• magazi mu mkodzo kapena ndowe;
• magazi uterine;
• hematoma pakhosi;
• intracranial kukha magazi.

Poyambirira, yapita sitiroko, odwala achikulire, magazi m'mimba ndi mbiri ya otsika hematocrit - zinthu zogwirizana kuti akhoza kuchepetsa chiwopsezo cha pakhomo ndende ya mankhwala.

Antiplatelet mankhwala ambiri osokoneza

1. Kutsukidwa kapena yasintha kudzera m'mimba maola angapo pambuyo utsogoleli wa mankhwala chiribe tanthauzo.
2. Wodwala wapatsidwa adamulowetsa makala mayamwidwe matumbo.
3. "Cholestyramine" mkati kutumikiridwa mu nkhani ya "warfarin" ambiri osokoneza kapena analogues ake.
4. Wodwala aikidwa mu zinthu antitravmaticheskie, kupewa zikamera wa hematomas latsopano ndi magazi.
5. Imfa yokulirapo magazi kapena magazi anagwira plasma anapanga zinthu, nthawi zina magazi athunthu. Imayenera mu ntchito ya maselo odzaza ofiira, cryoprecipitate, prothrombin zovuta.
6. Yoikika "Phytomenadione" zinthu zochokera vitamini K.
7. Ngati ndi kotheka, perekani palibe antiplatelet mankhwala mankhwala "Phytomenadione" yoikidwiratu njira ya chithandizo, osati monga chothandiza choyamba.

Ngati alili zinayambanso kuyenda bwino, koma m'pofunika kupitiriza ntchito anticoagulants m'kamwa, m'pofunika "Warfarin" mongoyembekezera m'malo mankhwala heparin zino.

Pomaliza

Kugwiritsa ntchito mankhwala antiplatelet silingakhoze kokha matenda magazi rheological mfundo komanso kusintha ambiri wodwala ndi kulepheretsa chitukuko cha matenda aakulu.

Mosamala chidwi ntchito anticoagulants, kusankha mlingo ndi kuyan'anila alili akhoza kuthandiza kuchepetsa chiopsezo cha matenda oyamba ndi kupambana. Ogwira ntchito gulu la mankhwala zawo, m'pofunika kudziwa ndi kutsatira mosamalitsa ndi malangizo umoyo padziko lonse.