Kev kho mob thrombosis thiab thromboembolism tsis ua tiav yam tsis muaj cov tshuaj tiv thaiv coagulants, uas suav nrog qhov hnyav molecular heparins. Cov tshuaj no nyob rau hauv muaj pes tsawg leeg ntawm cov tshuaj hloov ntshav txhaws, yog li rov kho vascular patency.
Ntau yam ntawm cov tshuaj tiv thaiv ncaj qha
Muab cov txheej txheem ntawm kev txiav txim ntawm cov tshuaj tiv thaiv kab mob, nws tuaj yeem raug sau tseg tias lawv tuaj yeem ua ncaj qha thiab tsis ncaj. Thawj pab pawg neeg feem ntau yog siv.
Anticoagulants ntawm kev cuam tshuam ncaj qha tau muab faib ua qhov hnyav molecular thiab unfractionated heparins raws li lawv cov qauv. Lawv kuj tuaj yeem yog cov inhibitors ncaj qha ntawm thrombin, xws li hirudin.
yam ntxwv ntawm qis molecular hnyav heparins
Lawv yog lwm yam hu ua fractionated compounds, uas qhov nruab nrab molecular hnyav li ntawm 4000 txog 6000 d altons. Lawv cov haujlwm yog txuam nrog kev kho kom haum xeeb inhibition ntawm kev tsim thiab kev ua haujlwm ntawm thrombin enzyme. Heparin muaj cov txiaj ntsig zoo li no rau cov ntshav txhaws ntshav Xa. Qhov tshwm sim yog cov nyhuv anticoagulant thiab antithrombotic.
Tsawg molecular hnyav heparins yog tau los ntawm unfractionated tshuaj cais tawm ntawm plab hnyuv epithelium ntawm ib tug npua, thaum lub sij hawm ib tug tshuaj los yog enzymatic depolymerization txheej txheem. Raws li qhov tshwm sim ntawm cov tshuaj tiv thaiv no, cov saw hlau polysaccharide luv luv los ntawm ib feem peb ntawm nws qhov ntev ntev, uas yuav pab txo qis cov tshuaj tiv thaiv coagulant.
Muaj ntau qhov hnyav molecular hnyav heparins, kev faib tawm uas yog raws li txoj hauv kev kom tau txais cov ntsev uas muaj cov tshuaj sib xyaw.
Ib daim ntawv
Kev npaj raws li lawv yog cov tshuaj txhaj rau subcutaneous lossis txhaj tshuaj. Lawv feem ntau tau ntim rau hauv ampoules lossis syringes rau kev siv ib zaug.
Tsawg molecular hnyav heparins tsis tsim nyob rau hauv cov ntsiav tshuaj.
tshuaj intramuscular tsis siv.
Kev piav qhia ntawm cov tshuaj "Gemapaxan"
Hais rau cov tshuaj tiv thaiv kab mob ncaj qha. Cov khoom xyaw nquag yog enoxaparin nyob rau hauv daim ntawv ntawm sodium ntsev, uas yog suav hais tias yog ib tug derivative ntawm heparin. Qhov kev hloov kho no muab cov adsorption siab thaum tswj hwm subcutaneously thiab qis tus neeg rhiab heev.
Tsim los ntawm Italian tuam txhab Italfarmaco S.p. A. nyob rau hauv daim ntawv ntawm ib tug ntshiab, tsis muaj xim los yog lub teeb daj tov rau kev txhaj tshuaj, ntim rau hauv syringes ntawm 0, 2, 0, 4 los yog 0.6 ml.
Cov koob tshuaj ntawm enoxaparin sodium yog 2000 IU hauv 20 mg; 4000 IU hauv 40 mg thiab 6000 IU hauv 60 mg. Cov khoom xyaw nquag ntawm cov tshuaj yog yaj hauv cov dej txhaj tshuaj. Sodium enoxaparin nthuav tawm ntau npaum li 100 IU ib 1 mg.ib qho inhibitory nyhuv ntawm cov ntshav coagulation yam Xa thiab cov nyhuv qis ntawm antithrombin ntawm ib koob ntawm 28 IU ib 1 mg.
Kev siv cov tshuaj kho mob siab rau ntau yam kab mob tsis ua rau muaj kev nce ntshav hauv lub sijhawm poob.
Prophylactic sodium enoxaparin ntau npaum tsis hloov qee lub sijhawm ua haujlwm thromboplastin, tsis cuam tshuam cov platelet aggregation thiab cov txheej txheem ntawm lawv cov kev sib txuas nrog fibrinogen molecules.
Tsawg molecular hnyav heparins hauv cov tshuaj ntau dua (6000 IU hauv 0.6 ml) yog siv:
- rau kev kho mob ntawm cov hlab ntsha sib sib zog nqus;
- nrog angina pectoris cov ntaub ntawv tsis ruaj khov thiab mob ntawm cov leeg myocardial ua ke nrog acetylsalicylic acid;
- rau kev tiv thaiv ntawm kev nce coagulation thaum lub sijhawm ua haujlwm hemodialysis.
Kev tswj hwm cov tshuaj subcutaneous nrog ntau npaum li 2000 thiab 4000 IU ib 0.2 thiab 0.4 ml, raws li, yog siv los tiv thaiv thrombosis thiab thromboembolic mob ntawm cov hlab ntsha:
- thaum phais orthopedic;
- txaj cov neeg mob uas tsis txaus ntawm lub tshuab ua pa ntev lossis lub plawv mob hom 3 thiab 4;
- mob kis mob los yog kab mob rheumatic thaum muaj kev pheej hmoo rau ntshav txhaws;
- cov neeg mob laus;
- muaj roj ntau dhau;
- nrog kev kho tshuaj hormone.
Cov tshuaj no yog siv subcutaneously nyob rau hauv lub plab phab ntsa, nyob rau hauv nws postero- thiab anterolateral cheeb tsam.
Cov tshuaj yog contraindicated nyob rau hauv thrombocytopenia, los ntshav, coagulation disorders, peptic rwj ntawm lub plab hnyuv mucosa thiab duodenal rwj, subacute kab mob endocarditis, ntshav qab zib mellitus, hypersensitivity thiab cev xeeb tub.
Hempaxan tshuaj: nqe
Tus nqi ntawm kev txhaj tshuaj muaj 2000 IU ib 0.2 ml hauv ib lub koob txhaj rau rau daim yog 955 rubles.
Rau qhov ntau dua ntawm Hemapaksan, tus nqi hloov pauv li ntawm 1,500 rubles rau ib pob ntawm rau syringes.
Kev piav qhia ntawm cov tshuaj "Clexane"
Hais txog cov khoom zoo sib xws raws li enoxaparin sodium. Nws yog tsim los ntawm Fabkis lub tuam txhab Sanofi Aventis raws li kev txhaj tshuaj ntshiab, uas tuaj yeem tsis muaj xim lossis nrog cov xim daj me ntsis.
Muaj ntau npaum li cas ntawm cov tshuaj "Clexane" ntawm 10000, 8000, 6000, 4000 thiab 2000 IU ntawm enoxaparin sodium hauv 1, 0; 0.8; 0,6; 0.4; 0.2 ml ntawm cov kua tshuaj, feem. Cov ntsiab lus ntawm cov khoom xyaw nquag hauv 1 mg ntawm cov tshuaj yog 1000 IU.
Tsawg molecular hnyav heparins yog tsim nyob rau hauv iav syringes, uas yuav ua tau 2 los yog 10 daim nyob rau hauv ib pob.
Cov tshuaj "Clexane" yog siv los tiv thaiv thrombotic thiab thromboembolic mob nyob rau hauv cov hlab ntsha thaum lub sij hawm kev phais cuam tshuam nrog orthopedics thiab hemodialysis.
Cov tshuaj yog muab tshuaj subcutaneously tshem tawm cov mob thrombotic nyob rau hauv cov hlab ntsha sib sib zog nqus thiab hauv cov hlab ntsha ntawm lub ntsws.
Cov tshuaj kho mob angina pectorisTus cwj pwm tsis ruaj khov thiab cov leeg mob myocardial infarction ua ke nrog cov tshuaj Aspirin.
Clexane tshuaj: nqe
Tus nqi ntawm kev txhaj tshuaj muaj 2000 IU ib 0.2 ml rau ib lub syringe yog 175 rubles.
Rau ib chav tsev uas muaj 4000 IU rau 0.4 ml koj yuav tau them 280 rubles, rau 6000 IU rau 0.6 ml - 440 rubles, rau 8000 IU rau 0.8 ml - 495 rubles.
Rau tshuaj "Clexane" tus nqi rau ib pob ntawm 10 daim nrog ib koob ntawm 20 mg, 40 mg thiab 80 mg yog 1685, 2750, 4000 rubles.
Kev piav qhia ntawm cov tshuaj "Fragmin"
Cov khoom xyaw nquag ntawm cov tshuaj no yog cov tshuaj heparin-derived uas sawv cev los ntawm sodium d alteparin. Nws yog tau los ntawm depolymerization nyob rau hauv qhov kev txiav txim ntawm nitrous acid, ua raws li purification siv ion pauv chromatography. Sodium d alteparin ntsev suav nrog sulphated polysaccharide chains nrog qhov nruab nrab molecular hnyav ntawm tsib txhiab d altons.
Cov khoom siv pabcuam yog dej rau kev txhaj tshuaj thiab sodium chloride ntsev. Cov tshuaj Belgian "Fragmin" tau piav qhia los ntawm kev qhia raws li kev daws teeb meem rau kev txhaj tshuaj subcutaneous thiab tso dej hauv cov kua dej pob tshab, tsis muaj xim lossis nrog cov xim daj.
Nws yog tsim nyob rau hauv ib koob tshuaj iav syringes ntawm 2500 IU hauv 0.2 ml; 5000 IU hauv 0.2 ml; 7500 IU hauv 0.3 ml; 10,000 IU hauv 1.0 ml; 12500 IU hauv 0.5 ml; 15,000 IU hauv 0.6 ml; 18000 IU hauv 0.72 ml.
Cov tshuaj "Fragmin" cov lus qhia pom zoo siv nws los ua kev tiv thaiv los tswj cov txheej txheemntshav txhaws hauv hemodialysis thiab hemofiltration ntsuas tsom rau kev kho mob raum tsis ua haujlwm, txhawm rau tiv thaiv kev tsim cov hlab ntsha hauv kev phais.
Cov tshuaj yog siv los tshem tawm cov kab mob thromboembolic ntawm cov neeg mob bedridden.
Cov tshuaj yog siv los kho cov tsis ruaj khov angina pectoris thiab myocardial leeg infarction, cov tsos mob venous thromboembolism.
Kev piav qhia ntawm cov tshuaj "Anfibra"
Nws raug cais raws li qhov hnyav molecular heparin ntawm Lavxias lub tuam txhab JSC "Veropharm". Muaj raws li kev daws teeb meem rau kev txhaj tshuaj, uas tej zaum yuav tsis muaj xim lossis daj.
Cov khoom lag luam yog raws li sodium ntsev ntawm enoxaparin, uas tuaj yeem muaj 2000 IU hauv 0.2 ml; 4000 IU hauv 0.4 ml; 6000 IU hauv 0.6 ml; 8000 IU hauv 0.8 ml; 10,000 IU hauv 1.0 ml. Cov dej distilled yog siv los ua cov kuab tshuaj.
Packed hauv ampoules lossis syringes ntawm 1 ml, uas tau ntim rau hauv cov thawv ntim ntawm 2, 5 thiab 10 daim.
Kev qhia pom zoo siv cov tshuaj Anfibra los tiv thaiv kev txhim kho ntawm lub xeev thromboembolic thaum lub sijhawm phais thiab hemodialysis, hauv kev kho cov hlab ntsha hauv cov hlab ntsha sib sib zog nqus.
Cov tshuaj yog siv los kho cov mob tsis ruaj khov angina pectoris thiab infarction ntawm cov leeg plawv, uas tsis muaj Q yoj ntawm electrocardiogram.
Kev piav qhia ntawm Fraxiparine
Calcium nadroparin belongs rau qhov hnyav molecular heparins, uas tau txais thaum lub sijhawm depolymerization. Nws cov molecules yog glycosaminoglycans,nws qhov nruab nrab molecular hnyav yog 4300 d altons.
Fraksiparin (subcutaneous txhaj) muaj calcium hydroxide thiab nadroparin ntsev, uas yog yaj hauv cov dej txhaj tshuaj.
Cov tshuaj ntawm cov khoom xyaw nquag yog 2850 IU hauv 0.3 ml; 3800 ME hauv 0.4 ml; 5700 IU hauv 0.6 ml, 7600 IU hauv 0.8 ml, 9500 IU hauv 1 ml.
Cov tshuaj yog cov kua ntshiab lossis me ntsis opalescent uas muaj lub teeb daj daj lossis tsis muaj xim kiag li.
Nadroparin ntsev khi zoo rau antithrombin protein III, uas ua rau nrawm inhibition ntawm yam Xa. Cov tshuaj activates tus inhibitor uas ua kom muaj kev hloov pauv ntawm cov ntaub so ntswg, txo cov ntshav viscosity thiab ua rau cov membrane permeability ntawm platelet thiab granulocytes. Qhov no yog li cas cov nyhuv antithrombotic ntawm cov tshuaj tau ua.
Fraxiparine txhaj tshuaj yog sau los tiv thaiv cov mob thromboembolic thaum lub sij hawm phais orthopedic thiab hemodialysis. Cov tshuaj no yog siv rau cov neeg mob uas muaj kev pheej hmoo ntawm cov ntshav txhaws, mob ua pa nyuaj thiab plawv tsis ua hauj lwm, tsis ruaj khov angina, myocardial infarction tsis muaj Q-wave.
Kev siv tshuaj tiv thaiv kab mob hauv menyuam yaus
Tsawg molecular hnyav heparins thaum cev xeeb tub yog muab rau cov neeg mob ntshav txhaws kom tsis txhob muaj cov placental thrombus, uas yuav ua rau rho menyuam, mus rau lub xeev pre-eclamptic nrog ntshav siab.siab, detachment ntawm tus me nyuam qhov chaw nrog hnyav los ntshav, qeeb txoj kev loj hlob ntawm fetus nyob rau hauv lub tsev me nyuam, uas yuav ua rau cov me nyuam mos yuag.
Cov tshuaj tiv thaiv coagulants no tau muab rau cov poj niam nyob rau hauv txoj hauj lwm uas muaj peev xwm ua rau cov hlab ntsha hauv cov hlab ntsha sib sib zog nqus, piv txwv li, hauv qis qis, nrog rau cov hlab ntsha ntawm lub ntsws.
Kev kho mob uas tsis muaj qhov hnyav molecular heparins yog cov txheej txheem mob uas tus neeg mob cev xeeb tub txhua hnub txhaj tshuaj hauv qab ntawm daim tawv nqaij ntawm lub plab.
Txawm li cas los xij, nyob rau hauv cov kev sim tshuaj ntsuam xyuas randomized, cov txiaj ntsig tau txais uas ua pov thawj tias feem ntau siv cov tshuaj tiv thaiv kab mob no tsis ua rau muaj txiaj ntsig zoo. Nws kuj tseem pom tau tias kev kho mob heparin qis qis tuaj yeem ua mob rau leej niam lub cev, cuam tshuam nrog kev nce ntshav thiab txo qis hauv kev mob hnyav.
Cov ntaub ntawv tshawb fawb tau pom tias kev tso tseg kev kho mob anticoagulant tuaj yeem cawm ntau tus poj niam los ntawm qhov mob tsis tsim nyog thaum cev xeeb tub.
Hauv cov lus qhia rau kev siv tshuaj raws li qhov hnyav molecular heparin, kev kho thaum cev xeeb tub yog contraindicated.
