Anticoagulants kpọmkwem ihe. Anọ anticoagulants: ndepụta nke ọgwụ ọjọọ, usoro nke ihe, nhazi ọkwa. Ovadozu anọ anticoagulants

Na kwesịrị ekwesị ịrụ ọrụ nke coagulation na ọbara usoro antisvertyvayuschey normalisation nke esịtidem itule nke ahu. ọbara site na arịa na-adịghị nwere ihe mgbochi na ụlọ, na thrombus n'usoro na ziri ezi larịị. Mgbe itule na-nsogbu n'obi ịrụ ọrụ nke usoro na ihu ọma nke ebighị nke ọbara coagulation, e nwere ọnọdụ ndị nwere ike ime ka oké guzobere egbochi mkpụkọ. Anọ anticoagulants - onye nke ìgwè dị iche iche nke ọgwụ ọjọọ eme ihe maka mgbake nke esịtidem ọrịa.

Gịnị bụ anticoagulants?

Anticoagulant akpọ ego, nke nwere anticoagulant mmetụta na activates dilution nke ọbara. Nke a-enye gị ohere iji weghachi rheological e ji mara na belata thrombosis.

N'aka dị mbadamba ụdị, dị ka ointments, gels na ọgwụ preparations. Ha na-ekenye bụghị naanị maka ịgwọ ọrịa, ma iji gbochie ubara guzobere egbochi mkpụkọ nke ọbara.

Kasị otu a ndị ọgwụ ọjọọ eme ihe na-adịghị kpụrụ thrombus, na clotting ọrụ. The usoro nke ikpughe na plasma ihe, na mmepụta nke thrombin, nke slows ala egbochi mkpụkọ nke ọbara.

Ọgwụ ọjọọ na-kewara abụọ iche iche dị ka ha na-eme:

• kpọmkwem anticoagulants;
• anọ anticoagulants.

ime ihe n'onwe nke heparin dabeere ọgwụ

Otu a nke ego na-emetụta na plasma cofactors nke inhibit thrombin. Isi nnọchiteanya bụ heparin. Dabere na nke a na e nwere ọtụtụ ọgwụ ọjọọ na-eme yiri na mgbochiume na aha:

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

Heparin ma ọ bụ nkwekọrịta kee ka antithrombin-III, nke na-eduga a mgbanwe ọnọdụ nke ya ụmụ irighiri. Nke a gbapụrụ ọsọ elu njikọ nke a cofactor maka thrombin, na mgbe ahụ ka inactivate na clotting usoro.

Atụmatụ nke ngwa "heparin"

Action bekee iji na-egbochi uto na mgbasa nke a ọbara clot. Heparin ụmụ irighiri na-etolite a mgbagwoju na antithrombin, nke bụ inhibitor nke coagulation ihe. Umi bụ a glycosaminoglycan yinye. The ọgwụ na-agbara subcutaneously na-amalite ya edinam mgbe a di na nwunye nke awa.

Ọ bụrụ na ọ dị mkpa, ngwa ngwa ihe "Heparin" infusion ndinọ intravenously iji mee ngwangwa arụmọrụ ma na-amụba bioavailability. Oke nke ọgwụ onunu ogwu na-adabere na ala na nke onye ọrịa na-emi odude. Ọzọkwa, sonye na akaụntụ ọnụnọ nke concomitant ọrịa, yiri ochichi nke ọzọ dị iche iche nke ọgwụgwọ, mkpa maka usoro ịwa ahụ na arịa.

oligopeptides

Ọgwụ na-eme ihe na na center nke thrombin ebighị, na-atụle ike kpọmkwem inhibitors nke thrombosis usoro. The n'ọrụ mgwa nke ọgwụ na ha onwe ha jikọọ na clotting ihe, na-agbanwe ha conformation.

Nke a na ọgwụ "inogatran", "Hirudin", "Efegatran", "Tromstop" na ndị ọzọ. Mee iji gbochie obi ọgụ nke rịaworo, varicose ọrịa, maka mgbochi nke thromboembolism, reocclusion n'oge angioplasty.

Anọ anticoagulants (ndepụta)

The mbụ anticoagulant e natara na XX narị afọ na United States, mgbe ọ chọpụtara a ọhụrụ ọrịa nke ehi-ha, nākpasu arọ ọbara ọgbụgba. Mgbe ihe kpatara e elucidated enweghị nchịkwa ọnọdụ, ọ gosipụtara na ụmụ anụmanụ na-oria na ebu eme klova, emi odude ke ndepụta. Site na nke a akụrụngwa e synthesized site mbụ ọgwụ antiplatelet anọ edinam - "Dicoumarol".

Iji ụbọchị, ndepụta nke akụ na-analogs nke ihe karịrị otu narị ihe. All ndị a ọgwụ ọjọọ eme ihe - onu anticoagulants. The usoro nke ihe nke a otu ọgwụ dabeere na mgbochi nke ihe nke vitamin K.

E clotting ihe na-adabere na nke a vitamin. Anọ anticoagulants inhibit ebighị nke coagulation edozi na cofactors vitaminozavisimyh. The na-achịkwaghị achịkwa ojiji nke ọgwụ ndị a na-aju, dị ka na-amụba ihe ize ndụ nke na-agba ọbara nsogbu.

E nwere isi ihe abụọ dị iche iche, nke na-ekewa niile anọ anticoagulants. Nhazi ọkwa nke ego dabeere na-arụ ọrụ bekee gụnyere ke nkwadebe. ịmata ihe dị iche:

• coumarin nkwekọrịta;
• dabeere ngwaọrụ indandiona.

preparations indandiona

Mgbe arụ a ọnụ ọgụgụ buru ibu nke ọmụmụ, ndị ọkà mmụta sayensị chọpụtara na ngwaahịa dabeere na a nọ n'ọrụ umi ghara ga-eji na ọgwụ. The formulations nwere a ịrịba ama ọtụtụ ndị mmetụta dị ka nfụkasị Jeremaya mere. Irè nke mmetụta na protivosvertyvaniya usoro nwekwara egosighị na-agbanwe agbanwe na-arụpụta.

Otu a ọgwụ ọjọọ eme ihe na-agụnye ọgwụ ọjọọ, "phenindione", "Difenindion", "Anisindion". Ọ na-e kpebiri ịkwụsị isi oke maka ìgwè nke abụọ nke antiplatelet elekọta mmadụ na nke nkwekọrịta indandiona ugbu a na-eji "Fenilin".

The ọgwụ nwere a ala na-eri, na ọ bụ dị mbadamba ụdị. Irè n'ihi na 10 awa, na ọ dị ezigbo mkpa ịnọgide na-enwe chọrọ oge nke ọgwụ. Mmetụta a na-enweta naanị mgbe awa 24 site n'oge mbụ dose. Ngwa emee site nlekota ọnọdụ onye ọrịa site n'ọbara nke ime nnyocha parameters (coagulation, n'ozuzu ule, n'ihi mmiri ọgwụ).

Atụmatụ nke 'fenilina ":

1. Ụbọchị mbụ - 1 mbadamba 4 ugboro.
2. Ụbọchị nke abụọ - 1 mbadamba 3 ugboro.
3. The ike nke ọgwụgwọ - 1 mbadamba kwa ụbọchị.

Ọgwụ kwesịrị iwere na ọgwụ na ibelata glucose ke idem.

coumarin nkwekọrịta

Coumarin - a umi nke bụ na osisi na ike-emepụta synthetically na laabu. Akpa, mgbe ya mwepụ, na ngwá ọrụ e ji mee ka a nsi maka òké akara. Naanị Itie oge malitere itinye ọgwụ obibi oké thrombosis.

Anticoagulants nke anọ edinam - preparations dabere na coumarin - anọchi anya ndị na-esonụ n'aka ọgwụ:

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

"Warfarin": ngwa atụmatụ

Anticoagulants nke anọ edinam (ndepụta dị na isiokwu) esiwak na-anọchite anya "Warfarin". Nke a pụtara tableted, arụpụtara site 2,5, 3 ma ọ bụ 5 mg. Mmetụta mmadụ na-amalite mgbe 1.5-3 ụbọchị mgbe mbụ ochichi nke mbadamba. Oke mmetụta site na njedebe nke izu mbụ.

Mgbe na-ewere ọgwụ na-rheological kwa ọbara laghachi nkịtị mgbe 5 ụbọchị site na ụbọchị nke kagbuo "nke warfarin." Ji 2 ugboro n'ụbọchị, na otu oge. On 5th ụbọchị nke ọgwụ na-achọpụta na ọbara kwa ikpebi feasibility na nrụpụta ọrụ.

The ọgwụgwọ a họọrọ ọkachamara na nke ọ bụla n'otu n'otu. Ụfọdụ ọrịa na-ekwu, (e.g., atrial fibrillation) achọ na-aga n'ihu na ngwa. Na mmepe nke Pee (akpa ume embolism) antiplatelet gị n'ụlọnga na-adịghị kenyere maka ihe na-erughị ọnwa isii ma ọ bụ ndụ.

Mgbe ọ dị mkpa ka a waa aka "Warfarin" iji kagbuo 5 ụbọchị tupu ịwa ahụ. Nke a ga-ekwe ka ọbara indices laghachi nkịtị. Na a elu mkpa iso ojiji nke anticoagulant ọgwụ, na ngwá ọrụ na-anọchi unfractionated heparin. The ikpeazụ dose e ndinọ 4 awa tupu aka.

Mgbe ọrụ site 4 chasa reintroduced unfractionated heparin. Ịnata anọ antiplatelet mmadụ nwere ike laghachi na ụbọchị abụọ, mgbe nlekota ala nke ọbara na-enyemaka nke laabu ule.

Na nke ikpe na-eji anticoagulants?

Direct na anọ anticoagulant eji maka mgbochi nke thromboembolism, nnukwu thrombosis nke venous usoro ihe omume nke a n'ibu prosthetic obi valves na atrial fibrillation.

The isi ọrịa na mmepe nke na-kenyere anticoagulants kpọmkwem ihe, nwere ndị na-esonụ nkewa n'ime iche iche:

1. Thrombosis nke ọbara usoro:
   • myocardial infarction;
   • akpa ume embolism;
   • ọrịa strok na mgbaàmà nke ischemia;
   • traumatic ọjọọ akwara megide atherosclerosis.
2. Akwadebe intravascular coagulation :
   • ujo na-ekwu;
   • traumatic mmerụ;
   • mmepe nke sepsis.
3. Nnukwu thrombosis nke veins site na:
   • ọbara-egbochi mkpụkọ na ndabere nke varicose veins;
   • thrombosing hemorrhoidal venous plexus;
   • clot na usụhọde vena cava.

isi contraindications

Anọ anticoagulants - ọgwụ ọjọọ eme ihe na-nditịm ajuru aju n'iru lactose erughi, malabsorption nke glucose na galactose. E nwere ọnụ ọgụgụ nke ọgwụ ọjọọ n'otu oge na i nwere ike iji ọnụ na anticoagulants. List of ọgwụ ọjọọ esịnede ndị so ná ndị mgbochi mkpali ọgwụ ọjọọ, "aspirin", "Dipyridamole", "clopidogrel", "penisilini", "Chloramphenicol", "Cimetidine".

Ọnọdụ ndị na-apụghị-eji anticoagulants kpọmkwem edinam:

• ọnyá ọrịa nke eriri afọ tract;
• vaskụla aneurysm;
• ọrịa imeju;
• nnukwu ọbara ọgbụgba;
• thrombocytopenia;
• gbasara akụrụ odida;
• M trimester na ikpeazụ nke ọnwa nke dị ime;
• elu-etoju nke creatinine.

Mmetụta nke antiplatelet mmadụ

Onye ọ bụla nke ọgwụ ọjọọ na otu a nke mmadụ nwere yiri mmetụta. Ha na-egosipụta onwe ha site onwe ma ọ bụ na-ezighị ezi dose ma ọ bụ mebiri na ojiji nke na-atụ aro.

Mmetụta gụnyere mmepe nke agba ọbara, dyspeptic mgbaàmà dị ka vomiting, ọgbụgbọ na afọ ọsịsa. Na e nwere ike abdominal mgbu, anabata akpụkpọ ọkụ ọkụ na ụdị nke aṅụ ma ọ bụ eczema. Ka ịzụlite necrosis, ntutu isi ọnwụ, anụ itching.

Tupu ịmalite ọgwụgwọ, onye ọrịa ga-agabiga a usoro nke ule iji chọpụta ma na-eji ndị a ọgwụ ọjọọ. Onye ọrịa na-anapụta a zuru ọbara ọnụ, n'ihi mmiri ọgwụ, urinalysis, mmamịrị na Nechiporenko, coagulation. Ọ na-atụ aro ka onye ultrasound nyochaa akụrụ ma na-agafe stool maka mgbaasị ọbara.

Ovadozu anọ anticoagulants

Overdoses nke otu a ọgwụ ọjọọ eme ihe na-adị nnọọ obere. Nke a nwere ike ime ma ọ bụrụ na a obere nwa ga n'ụlọ ọgwụ na-agbalị ya maka uto. A, ịta nke umi bụ ala, otú ahụ otu dose mbadamba mere adịghị atụ egwu. Bụrụ na nke pụrụ iche ma ọ bụ elezighị ojiji nke nnukwu doses nke umi pụrụ ịzụlite a coagulopathy na ọbara ọgbụgba.

ovadozu ọgwụ nwere dịghị kpọmkwem mgbaàmà, otú maa ihe mere na-aṅụ nnukwu ichekwa nke ọgwụ, ọ bụ ike. Symptomatology yiri ngosipụta na ọrịa dị iche iche na-enweghị nchịkwa na-ekwu, nke organism. Onye ọrịa nwere:

• ìhè bruises na akpụkpọ;
• ọbara mmamịrị ma ọ bụ na nsị;
• eriri akpa nwa ọbara ọgbụgba;
• hematoma na olu;
• intracranial hemorrhage.

Tupu mgbe ahụ, aga ọrịa strok, agadi ọrịa, eriri afọ ọbara ọgbụgba na a akụkọ ihe mere eme nke ala hematocrit - metụtara ihe ndị pụrụ ibelata susceptibility nke fọrọ ịta nke ọgwụ ọjọọ.

Antiplatelet ọgwụ ovadozu

1. Kpochara ma ọ bụ gbarụrụ site afo ọtụtụ awa mgbe ochichi nke ọgwụ ọjọọ nwere dịghị pụtara.
2. Onye ọrịa e nyere ọrụ unyi maka nsia absorption.
3. "Cholestyramine" n'ime ndinọ na ikpe nke "warfarin" ovadozu ma ọ bụ ya analogues.
4. Onye ọrịa na-enịm ke antitravmaticheskie ọnọdụ, izere ntoputa nke ọhụrụ hematomas na hemorrhages.
5. Na ọkpụrụkpụ ọbara na ọnwụ ma ọ bụ mmịnye plasma kpụrụ ọcha, mgbe ụfọdụ, ọbara n'ozuzu. Oru oma na ojiji nke juru n'ọnụ mkpụrụ ndụ ọbara uhie, cryoprecipitate, prothrombin mgbagwoju.
6. Kara Aka "Phytomenadione" ngwaahịa dabeere na vitamin K.
7. Ọ bụrụ na ọ dị mkpa, na-ekenye dịghị antiplatelet ọgwụ, ọgwụ "Phytomenadione" họpụtara ọgwụgwọ, kama dị ka a mbụ enyemaka.

Ọ bụrụ na ọrịa na-arịa laghachi nkịtị, kama ọ dị mkpa iji nọgide na-eji onu anticoagulants, ọ dị mkpa iji "Warfarin" nwa oge dochie ọgwụ ọjọọ heparin usoro.

ọgwụgwụ

The ojiji nke antiplatelet ọgwụ ọjọọ nwere ike ọ bụghị naanị normalize ọbara rheological ụkpụrụ, kamakwa iji melite izugbe ọnọdụ nke onye ọrịa na-egbochi mmepe nke oké njọ nke ọrịa.

Nlekuru anya na ojiji nke anticoagulants, oke nke usoro onunu ogwu na nlekota ọrịa na-arịa pụrụ inye aka belata ihe ize ndụ nke nsogbu na-aga nke ọma. Ọkachamara ndị na-eji otu a ọgwụ ọjọọ eme ihe ha na-eme, dị mkpa ka mma ihe ọmụma ma na-enupughi isi na iwu mba ahụ ike na-atụ aro.