Tshuaj rau cov ntshav nyias yam tsis muaj "Aspirin": cov npe tshuaj zoo

2024 Tus sau: Curtis Blomfield | [email protected]. Kawg hloov kho: 2023-12-16 21:10

Nyob zoo ib tsoom niam txiv kwv tij neej tsas sawv daws lo koom kev lom zem thiab ua tsaug ntau. Tsis tas li ntawd, tus naj npawb ntawm cov tshuaj uas ua haujlwm tau zoo tam sim no tau nce ntxiv. Nws tsis pom zoo kom xaiv lawv tus kheej, tsuas yog kws kho mob yuav tsum xaiv lawv.

Tab sis txhua tus yuav tsum paub tias cov ntshav thinners yam tsis muaj "Aspirin" siv hauv tshuaj.

Vim li cas ntshav nyias

Nrog rau hnub nyoog, ntau tus neeg muaj mob los ntshav. Cov txheej txheem ntawm cov txheej txheem no txawv, qee qhov tsis nkag siab.

Kuv yuav ua dab tsi los txo cov ntshav? Strokes, nrog rau thrombosis thiab thromboembolism, yog pathologies uas tshwm sim vim qhov tseeb tias cov ntshav txhaws txhaws lub lumen ntawm cov hlab ntsha thiab nres cov ntshav ntws hauv qee thaj tsam ntawm peb lub cev.

Cov teeb meem vascular no txaus ntshai heev, lawv yeej tsis mus yam tsis muaj kab: tsis muaj sijhawmkev kho mob yuav tuag los yog xiam oob qhab.

Raws li kev tshuaj xyuas, cov ntshav thinners yam tsis muaj "Aspirin" yog thawj qhov chaw hauv kev tiv thaiv kom tsis txhob muaj thrombosis, thiab yog li ntawd, lawv tiv thaiv kev tuag los ntawm cov kab mob plawv.

Ntxiv rau kev tiv thaiv, lawv kuj tau siv los kho cov kab mob uas twb tsim lawm.

Tshuaj kom txo qis ntshav kom zoo

Cov tsos mob ntawm cov hlab ntsha yog qhib los ntawm ntau yam kab mob hauv cov ntshav. Muaj:

1. Pib platelet hemostasis. Platelets lo nrog ib leeg thiab cov phab ntsa vascular, yog li txhaws lub lumen ntawm lub nkoj me me.
2. Secondary, coagulation hemostasis. Muaj kev ua kom cov ntshav plasma coagulation yam thiab tsim cov fibrin thrombus.

Raws li, cov tshuaj txo cov ntshav uas tsis muaj "Aspirin" faib:

1. Ntawm cov tshuaj tiv thaiv kab mob (tiv thaiv cov adhesion ntawm platelets, qeeb vascular thiab platelet hemostasis).
2. Anticoagulants (thaiv plasma coagulation yam thiab tiv thaiv fibrin clot tsim).

Cov tshuaj tiv thaiv kab mob

Kev kho tshuaj tua kab mob yog qhia nyob rau hauv cov xwm txheej hauv qab no:

1. Thaum cov leeg ntawm lub plawv puas, provoked los ntawm qhov tsis txaus lossis kev tso ntshav mus rau myocardium.
2. Nrog ischemia ntawm lub plawv, uas tshwm sim nrog qhov tshwm sim ntawm ischemic necrosis ntawm cov leeg nqaij.
3. Rau cov neeg mob uas muaj kev cuam tshuam kev sib dhos.
4. Kev tiv thaiv ntshav txhaws hauv cov neeg uas tau mob stroke.
5. Tom qab kev phais mob ntawm lub plawv thiab cov hlab ntsha.
6. Cov neeg mob uas muaj kab mob peripheral arterial.

Antiaggregants tsis muaj "Aspirin"

Cov tshuaj tiv thaiv tsis zoo los ntawm cov tshuaj muaj "Aspirin" yuam cov kws tshaj lij nrhiav lwm txoj hauv kev, cov ntshav tsis muaj teeb meem ntau dua nrog cov txiaj ntsig zoo sib xws.

Tom qab ntawd, ntau yam tshuaj uas tsis muaj acetylsalicylic acid, uas muaj cov nyhuv antithrombotic, tam sim no tau siv rau hauv kev kho mob.

Tab sis nws yuav tsum nco ntsoov tias cov tshuaj muaj kev nyab xeeb kiag li ntawm pab pawg no tsis muaj nyob, txhua tus ntawm lawv muaj qee yam kev txwv, thiab lawv kuj raug tshuaj los ntawm kws kho mob nkaus xwb. Qee cov tshuaj antiplatelet niaj hnub no txawm raug muab tshuaj los ua ib qho ntxiv rau acetylsalicylic acid.

Daim ntawv teev cov ntshav tsis muaj "Aspirin":

1. "Dipyridamole" ("Curantil").
2. "Ticlodipine" ("Ticlid").
3. "Clopidogrel" ("Plavix").
4. "Ticagrelor" ("Brilint").
5. "Prasugrel" ("Effient").
6. YCilostazol (Pletax).
7. "Pentoxifylline" ("Trental").

Cov tshuaj tiv thaiv kab mob ntxiv rau cov ntshav thinning yam tsis muaj "Aspirin" yuav yogtham ntau yam ntxiv.

Y"Dipyridamole"

Cov tshuaj suav hais tias yog phosphodiesterase inhibitor raws li cov txiaj ntsig ntawm cov teebmeem, thiab tseem muaj vasodilating thiab antiplatelet nyhuv. Nws qhov kev txiav txim me ntsis qis dua li ntawm "Aspirin", tab sis nws muaj kev ncaj ncees tag nrho nyob rau hauv cov ntaub ntawv ntawm ib tus neeg intolerance rau tom kawg.

Ntxiv rau, "Dipyridamole" yog tib cov tshuaj tiv thaiv kab mob uas tau pom zoo siv rau cov poj niam cev xeeb tub thiab lactating. Cov tshuaj yog noj ntawm 75 milligrams plaub zaug ib hnub twg, yog tias tsim nyog, cov koob tshuaj txhua hnub yog nce mus rau 450 mg.

Tshuaj "Dipyridamole" hauv daim ntawv ntsiav tshuaj. Cov tshuaj nrog lub npe lag luam "Kurantil" yuav raug nqi ntau dua - los ntawm 650 txog 800 rubles.

Ticlodipine

Cov tshuaj no inhibits platelet aggregation, txo cov ntshav viscosity thiab ncua sij hawm los ntshav. Cov tshuaj tau muab tshuaj ntawm 250 milligrams ob zaug ib hnub. Cov tshuaj pharmacological ntawm cov ntshav thinner yam tsis muaj "Aspirin" tau ua tiav rau hnub plaub ntawm kev kho.

Cov tshuaj tiv thaiv tsis zoo:

• xiav;
• thrombocytopenia (ib yam kab mob tshwm sim los ntawm kev txo qis hauv platelets hauv qab ib txwm muaj, nrog rau cov ntshav ntau ntxiv thiab teeb meem nrog kev tso ntshav tawm);
• leukopenia (txo qis ntawm cov qe ntshav dawb hauv cov ntshav);
• mob plab;
• mob plab.

Tus nqi ntawm cov tshuaj yog 1600 rubles.

Y"Clopidogrel"

Cov tshuaj zoo ib yam hauv spectrum rau "Tiklodipin", tab sis zoo dua thiab muaj kev nyab xeeb dua li nws. Nws yuav tsum tau noj ntawm 75 milligrams ib hnub ib zaug, tsis hais zaub mov. Tus nqi ntawm cov tshuaj uas tsis muaj tshuaj Aspirin txawv ntawm 300 txog 900 rubles.

Tshuaj "Clopidogrel" raws li hauv qab no:

1. Rau tus mob coronary mob, 300 milligrams ib zaug.
2. Rau lub hom phiaj prophylactic los tiv thaiv stent thrombosis tom qab stenting. Siv ua ke nrog acetylsalicylic acid tshwj tsis yog txwv.
3. kab mob ischemic plawv, uas tshwm sim nrog cov tsos mob ntawm ischemic necrosis ntawm myocardium.
4. Ischemic stroke (kev puas tsuaj microcirculation ntawm lub hlwb nrog kev puas tsuaj rau lub hlwb cov ntaub so ntswg, cuam tshuam ntawm nws lub luag haujlwm vim yog qhov nyuaj lossis tsis ua haujlwm ntawm cov ntshav ntws mus rau ib chav haujlwm tshwj xeeb).
5. Kev cuam tshuam ntawm cov hlab ntsha peripheral (vascular insufficiency uas tshwm sim thaum lub patency los yog blockage ntawm cov hlab ntsha yog impaired, vim hais tias kev thauj cov ntshav mus rau ib tug tshwj xeeb lub cev raug cuam tshuam, uas ua rau muaj teeb meem nyob rau hauv nws cov hauj lwm).

Ticagrelor

Innovative tshuaj, spectrum ntawm kev ua zoo ib yam li "Clopidogrel". Ua nyob rau hauv cov ntsiav tshuaj daim ntawv ntawm 60 thiab 90 milligrams, siv ob zaug ib hnub twg. Ntawm qhov tsis zoo tshwm sim, ntxiv rau los ntshav, ua pa luv yuav tsum tau sau tseg. Tus nqi ntawm cov tshuaj yog 4500 rubles.

tshuaj ntxiv

Prasugrel yog ib yam tshuaj tshiab uas tau siv rau hauv cov neeg mob uas muaj mob plawv uas tab tom yuav mob stenting. Cov tshuaj tua kab mob ntshav no tsis muaj tshuaj Aspirin muaj txiaj ntsig zoo dua li Clopidogrel, tab sis tib lub sijhawm, cov tshuaj tsis zoo tshwm sim thaum nws siv ntau zaus. Nws tsis pom zoo siv rau cov neeg mob uas tau mob stroke. Tus nqi ntawm cov tshuaj yog kwv yees li 4,000 rubles.

"Pletax" muaj cov nyhuv antiplatelet thiab vasodilating. Zoo dilates cov hlab ntsha ntawm ob txhais ceg. Nws yog siv, raws li txoj cai, rau obliterating lesions ntawm cov hlab ntsha. Cov koob tshuaj - 100 milligrams ob zaug ib hnub. Tus nqi ntawm cov tshuaj yog 2000 rubles.

"Trental" muab cov tshuaj tiv thaiv kab mob thiab vasodilating teebmeem. Txo cov ntshav viscosity, pab txhim kho cov ntshav ncig. Siv raws li kev daws teeb meem rau kev txhaj tshuaj hauv cov hlab ntsha, thiab cov ntsiav tshuaj. Tus nqi ntawm cov tshuaj txawv ntawm 200 txog 1500 rubles.

Anticoagulants

Cov no yog cov tshuaj uas inhibit qhov kev ua ntawm plasma coagulation yam. Lawv tau siv nyob rau hauv cov xwm txheej uas cov tshuaj antiplatelet ib leeg yog qhov tseem ceeb, rau kev kho mob ntawm cov teeb meem thromboembolic, nrog rau cov laj thawj prophylactic, thaum muaj qhov tshwm sim ntawm cov teeb meem siab heev..

Cov tshuaj rau ntshav nyias cov tshuaj tsis muaj "Aspirin":

1. Ib qhov txhaws hauv cov hlab ntsha pulmonary, uas feem ntau tshwm sim hauv cov hlab ntsha loj hauv ob txhais ceg lossis lub plab mog.
2. Ib kab mob uas cov leeg tsimntshav txhaws uas cuam tshuam rau cov ntshav ntws.
3. mob plawv mob plawv.
4. Ischemic stroke (kev puas tsuaj cerebral microcirculation nrog kev puas tsuaj rau lub hlwb cov ntaub so ntswg, cuam tshuam ntawm nws lub luag haujlwm los ntawm kev nyuaj lossis kev txiav cov ntshav ntws mus rau ib chav haujlwm tshwj xeeb).
5. Atrial fibrillation hauv cov neeg mob plawv ischemia.
6. Tau muaj mob stroke nrog atrial fibrillation.
7. Prosthetic heart li qub.
8. Atrial thrombus (ib txheej txheem ntuj tsim ua kom cov ntshav txhaws hauv cov hlab ntsha lossis kab noj hniav ntawm lub plawv).
9. Stent stenosis (narrowing ntawm cov hlab ntsha).

Muaj pab pawg ntawm cov tshuaj no:

1. Direct anticoagulants uas inactivate thrombin hauv cov ntshav. Cov no yog "Heparin" thiab nws cov kev hloov kho ntau yam, nrog rau "Hirudin".
2. Indirect anticoagulants thaiv kev tsim cov ntshav coagulation yam hauv lub siab ("Warfarin", "Phenylin", "Neocoumarin", "Sincumar").
3. Tshiab qhov ncauj tshuaj tiv thaiv kab mob.

Direct anticoagulants

Unfractionated heparin yog ib qho tshuaj tiv thaiv kab mob uas muaj nyob hauv ntau lub cev nqaij daim tawv. Hauv cov ntshav, nws inhibits thrombin, yog li txo lub peev xwm los tsim cov ntshav txhaws.

"Heparin" yog siv los ntawm parenterally hauv siab - txhawm rau tshem tawm cov mob myocardial infarction, thrombosis ntawm cov hlab ntsha ntawm cov extremities, pulmonary embolism, hauv me me - raws li kev tiv thaiv kev tiv thaiv los tiv thaiv thromboembolism. Cov tshuaj yog sau nrogKev saib xyuas tshwj xeeb nyob rau hauv kev tswj cov ntshav txhaws hauv lub chaw kho mob nkaus xwb.

Heparin ointments thiab gels rau siv hauv zos kuj raug tsim tawm (heparin ointment, Lyoton, Venitan, Venolife). Lawv raug pom zoo rau cov leeg varicose, nrog rau hemorrhoids.

Tsawg molecular hnyav heparins feem ntau yog txhaj subcutaneously ob zaug ib hnub. Tso tawm hauv cov koob txhaj tshuaj pov tseg. Feem ntau, cov tshuaj hauv qab no tau sau tseg:

1. "D alteparin" ("Fragmin") - 2500 microunits / 0.2 milliliters - tag nrho ntawm kaum koob txhaj tshuaj hauv ib pob. Tus nqi ntawm cov tshuaj txawv ntawm 1700 txog 2800 rubles.
2. "Nadroparin" ("Fraksiparin") - tsim nyob rau hauv ntau qhov sib txawv, tus nqi ntawm cov tshuaj nyob ntawm 2000 txog 4000 rubles.
3. "Enoxoparin" ("Clexane") - koob tshuaj ntawm 2000 txog 8000 units, tus nqi sib txawv ntawm 700 txog 3000 rubles.
4. "Bemiparin" ("Cibor") - muaj nyob rau hauv cov koob txhaj tshuaj ntawm 3500 microunits, kaum daim, 3900 rubles.

Raws li txoj cai, qis molecular hnyav heparins yog siv prophylactically los tiv thaiv thrombosis hauv cov neeg mob tom qab kev phais. Tsis tas li ntawd, lawv tuaj yeem siv tau rau cov poj niam cev xeeb tub nrog lub xeev autoimmune hypercoagulable provoked los ntawm antiphospholipid antibodies.

"Sulodexide" yog ib qho tshuaj tiv thaiv kab mob,uas muaj ob glycosaminoglycans tsim los ntawm txoj hnyuv mucosa ntawm tus npua. Lub spectrum ntawm kev ua zoo li qis molecular hnyav heparins. Nws yog siv, raws li txoj cai, los tiv thaiv microthrombosis hauv cov neeg mob ntshav qab zib. Qhov kom zoo dua ntawm cov tshuaj yog nws zoo tolerability, nrog rau kev siv tsis tau tsuas yog nyob rau hauv kev txhaj tshuaj, tab sis nyob rau hauv capsules rau qhov ncauj siv. Tus nqi ntawm 10 ampoules yog 2000 rubles, tus nqi ntawm capsules yog 2700 rubles.

"Warfarin" yog yuav luag tib cov tshuaj tiv thaiv coagulant uas tau sau tseg rau kev siv ntev. Nws tseem suav hais tias yog tus qauv tiv thaiv uas txhua yam tshuaj niaj hnub nrog cov txiaj ntsig zoo sib piv. Hauv daim siab, nws thaiv cov metabolism ntawm vitamin K thiab yog li tiv thaiv kev tsim ntawm ntau yam plasma coagulation yam. Tom qab ntawd, cov ntshav poob nws lub peev xwm los tsim cov ntshav txhaws.

Nrog rau kev siv txuas ntxiv, Warfarin txo qhov tshwm sim ntawm cov hlab ntsha ntawm 64 feem pua. Tab sis cov tshuaj no tsis zoo tag nrho, nws tsis yooj yim rau kev siv ntau zaus.

Main cons:

1. Qhov xav tau rau kev soj ntsuam hauv chav kuaj tsis tu ncua thiab hloov kho qhov ntau npaum li cas.
2. Txoj kev ua raws li kev noj haus.
3. Incompatible with most drug.
4. Ntsuag los ntshav.

Warfarin tseem yog cov tshuaj tiv thaiv kab mob ntau tshaj plaws, feem ntau vim nws tus nqi pheej yig. Qhov ntau npaum li cas ntawm cov tshuaj yog xaiv nyob rau hauv kev tswj ntawm ib tug kuaj ntshav kuaj, tej zaum qhov kev xaiv ntawm qhov zoo tshaj plaws concentration ntawm cov tshuaj yuav siv sij hawm ob peb lub hlis.hli.

Cov tshuaj yog tsim nyob rau hauv ntsiav tshuaj daim ntawv ntawm 2.5 milligrams. Tus nqi ntawm cov tshuaj txawv ntawm 70 mus rau 200 rubles, nyob ntawm tus neeg tsim khoom.

Cov tshuaj tiv thaiv qhov ncauj tshiab yog cov tshuaj tiam tshiab tshaj plaws uas tau qhia rau hauv kev kho mob tsis ntev dhau los, tab sis tau txais sai sai los ntawm cov kws kho mob thiab cov neeg mob.

Txhua cov tshuaj tiv thaiv qhov ncauj tshiab tuaj yeem muab faib ua ob pawg:

1. Direct thrombin inhibitors ("Dabigatran").
2. Direct factor Xa inhibitors (Rivaroxaban, Apixaban, Endoxaban).

Lawv cov txiaj ntsig tuaj yeem piv nrog "Warfarin", tab sis nws yooj yim dua los ua haujlwm nrog lawv rau ob tus kws kho mob thiab tus neeg mob. Lub ntsiab kom zoo dua yog tias lawv tsis tas yuav muaj kev tswj xyuas hauv chav kuaj. Lub ntsiab tsis zoo yog lawv cov nqi siab.

"Dabigatran" inhibits thrombin, yog li tiv thaiv kev hloov pauv ntawm fibrinogen rau fibrin. Zoo absorbed los ntawm lub plab zom mov. Nws cov cawv kuj yog piv rau Warfarin. Kev phiv tshuaj tsis tshua muaj, thiab kev siv yooj yim dua.

Dabigatran yog tsim nyob rau hauv capsules ntawm 75, 110 thiab 150 milligrams, siv ob zaug ib hnub twg, qhov noj txhua hnub yog xaiv los ntawm tus kws kho mob nyob ntawm lub hom phiaj ntawm kev teem caij. Nws yog txwv tsis pub siv cov kev kho mob los ntshav, nrog rau qhov tsis ntev los no hemorrhagic stroke, mob raum tsis ua haujlwm, cev xeeb tub. Kev tswj hauv chav kuaj feem ntau tsis tas yuav tsum tau ua.

Tus nqi ntawm cov tshuaj yog 1900 rubles.

"Rivaroxaban", "Apixaban", "Edoxaban" inhibit ob qho tib si dawb thiab thrombus-uas cuam tshuam yam Xa. Lub npe lag luam:

1. Rivaroxaban - Xarelto.
2. "Apixaban" - "Eliquis".
3. "Endoxaban" - "Lixiana".

Cov lus qhia rau kev siv yog tib yam li "Warfarin". Tag nrho peb cov tshuaj tau sai sai ntawm lub plab zom mov.

Qhov txawv yog qhov tseeb tias koj yuav tsum siv cov ntsiav tshuaj Xarelto nrog zaub mov, tus so - tsis hais txog kev noj zaub mov. Eliquis - ob zaug ib hnub, tus so - ib zaug.

tshuaj kho ntshav ntshav tsis muaj "Aspirin"

Tshuaj muaj ntau yam kev txwv, yog li koj yuav tsum saib lwm yam tshuaj ntuj (tshuaj ntsuab, txiv hmab txiv ntoo, txiv hmab txiv ntoo) thiab lwm yam pog cov zaub mov txawv:

1. Ntsuab uas pab txo cov ntshav - dawb willow tawv, tshuaj qab zib clover, Caucasian Dioscorea cag, hazel bark thiab nplooj, nees chestnut, lungwort, ginkgo biloba nplooj.
2. Vim yog cov khoom siv tshuaj ntawm sodium bicarbonate (baking soda), cov neeg mob tuaj yeem tshem tawm ntawm lub plab hyperacidity thiab cov ntshav tuab.
3. Cranberries muaj ntau cov vitamins. Cov ntsiab lus ntxiv ntawm ascorbic acid muaj txiaj ntsig zoo rau ntawm phab ntsa ntawm cov hlab ntsha, ua rau nws muaj zog, uas txo cov ntshav txhaws.