Thaum tus neeg hlub tau mob, koj xav ua txhua yam los pab nws. Nrog rau kev nrhiav ib qho txuj ci tseem ceeb uas yuav kho tau nws tam sim ntawd. Hmoov tsis zoo, cov tshuaj no tseem tsis tau tsim, thiab ib qho yuav tsum muaj cov ntsiab lus nrog cov khoom siv dav dav ntawm cov tshuaj uas tau tsim los rau niaj hnub no. Muaj ntau yam tshuaj yog, raws li nws tau, ntawm qhov verge, thaum lawv cov txiaj ntsig zoo tuaj yeem tig mus rau hauv kev phom sij hauv ntiaj teb. Cov tshuaj no kuj muaj xws li pharmacological pab pawg neeg ntawm anticoagulants, uas, tiv thaiv kev tsim ntawm cov ntshav txhaws, nyob rau hauv ib co taw tes pab rau qhov tshwm sim ntawm spontaneous los ntshav, uas, nyob ntawm seb lub zos, yuav ua rau tuag taus. Xws li cov tshuaj "Pradaksa" thiab "Warfarin", cov kev mob tshwm sim los ntawm kev siv uas tuaj yeem tshwm sim raws li kev mob hemorrhagic.
Pradaxa pawg kws tshuaj
Cov tshuaj no yog cov pab pawg ntawm cov tshuaj tiv thaiv kab mob. Nws cov khoom xyaw nquag, dabigatran etexilate, yog qhov hnyav molecular tsawg, pharmacologically inactive precursor ntawm dabigatran, kev sib tw, thim rov qab ncaj qha thrombin inhibitor.manifesting nws lub zog feem ntau nyob rau hauv cov ntshav plasma. Inhibition ntawm thrombin kev ua si tiv thaiv cov txheej txheem ntawm thrombus tsim. Ntxiv rau qhov cuam tshuam ncaj qha rau cov ntshav coagulation, cov tshuaj nquag ntawm Pradaxa cov tshuaj, cov kev tshuaj xyuas ntawm cov kws kho mob ntawm qhov kev txiav txim uas qhia tias nws yog cov tshuaj niaj hnub thiab siv tau zoo, cuam tshuam rau fibrin clots thiab platelet aggregation.
Cov lus qhia rau kev siv
Cov tshuaj kws tshuaj no, uas cuam tshuam rau lub cev hauv txoj kev hnyav tshaj plaws, yuav tsum tau ua tib zoo tuav thiab ua raws li qhov ntau npaum li cas. Tsuas yog tus kws kho mob thiaj li sau tau cov tshuaj no. Qhov no anticoagulant yog siv los tiv thaiv qhov tshwm sim ntawm venous thromboembolism nyob rau hauv cov neeg mob uas muaj keeb kwm ntawm ib qho kev phais orthopedic, nrog rau kev tiv thaiv kev loj hlob ntawm mob stroke, systemic thromboembolism, thiab txo tus nqi ntawm cov hlab plawv tuag nyob rau hauv cov neeg uas muaj atrial fibrillation. Cov neeg mob uas muaj kev paub dhau los ntawm kev siv Pradaxa tawm feem ntau cov kev tshuaj xyuas zoo, txij li nws qhov kev teem caij muaj feem cuam tshuam tsawg dua piv rau cov tshuaj qub qub.
Contraindications rau kev siv
Raws li tau hais lawm, cov tshuaj los ntawm pab pawg no muaj kev cuam tshuam loj rau lub cev, yog li lawv tau muab tshuaj rau cov lus qhia nruj heev.
Pradax ntsiav tshuaj tsis siv rau:
- hypersensitivity rau cov khoom xws li dabigatran, abigatranetexilate los yog rau cov koom haum pab koom nrog hauv cov khoom xyaw;
- lub raum tsis ua haujlwm hnyav (CC tsawg dua 30 ml / min);
- mob hnyav los ntshav, hemorrhagic diathesis, spontaneous lossis pharmacologically induced hemostasis disorder;
- lub cev puas tsuaj vim los ntshav tseem ceeb, suav nrog hemorrhagic stroke hauv 6 lub hlis ua ntej kho;
- ib txhij teem sijhawm ntawm "Ketoconazole" rau kev siv;
- Lub siab ua haujlwm tsis zoo lossis kab mob cuam tshuam rau kev ciaj sia;
- tus neeg mob hnub nyoog qis dua 18 xyoo (vim tsis muaj ntaub ntawv los ntawm kev tshawb fawb soj ntsuam).
Txawm hais tias muaj cov npe tseem ceeb ntawm kev txwv tsis pub siv rau Pradaxa, cov kws kho mob tshuaj xyuas tseem pom tias nws muaj kev nyab xeeb dua li qee qhov ntawm nws cov analogues.
Txoj kev thov thiab ntau npaum li cas
Cov tshuaj no, tsim los ntawm Boehringer Ingelheim hauv Austria thiab Lub Tebchaws Yelemees, muaj nyob rau hauv cov tshuaj ntsiav uas muaj 75 mg, 110 mg thiab 150 mg ntawm cov khoom xyaw nquag. Capsules tau noj ntawm qhov ncauj yam tsis tau qhib, tsis hais noj mov. Kev txais tos ntau - txog li 2 zaug hauv ib hnub.
Rau kev tiv thaiv ntawm venous thromboembolism nyob rau hauv cov neeg uas tau txais kev phais orthopedic, Pradaxa 110 mg yog tshuaj ib zaug, ob lub tshuaj ntsiav txhua. Cov neeg mob tom qab lub hauv caug arthroplasty tau qhia kom pib noj tshuaj tsis pub dhau 4 teev tom qab qhov kawg ntawm kev ua haujlwm. Lub sijhawm kho yog 10 hnub. Ntawmhip arthroplasty, cov tshuaj yuav tsum tau txuas ntxiv mus txog 28-35 hnub.
Rau kev tiv thaiv ntawm ischemic stroke nyob rau hauv cov neeg mob uas tsis yog-valvular atrial fibrillation, ib koob ntawm 150 mg 2 zaug ib hnub twg ntawm Pradaxa yog sau, tshuaj xyuas ntawm kev siv uas qhia ib tug zoo feem pua ntawm kev tiv thaiv kab mob.
Anticoagulants, tiv thaiv kev tsim cov ntshav txhaws, ua rau txo qis hauv cov ntshav txhaws, uas ua rau muaj kev cuam tshuam dav dav ntawm qhov tsis zoo. Los ntawm cov lymphatic thiab circulatory systems, thrombocytopenia thiab anemia yuav tshwm sim. Kev cuam tshuam hauv lub cev tiv thaiv kab mob tuaj yeem tshwm sim raws li qhov tshwm sim tsis txaus ntseeg (urticaria, khaus, ua pob, bronchospasm). Kev nce vascular permeability tuaj yeem ua rau hematomas, los ntshav ntawm ntau qhov chaw, suav nrog intracranial, qhov ntswg, plab hnyuv, thiab lwm yam. Nyob rau ib feem ntawm lub plab zom mov, qhov mob, dyspepsia, ntuav, dysphagia, gastroesophagitis, daim siab ua haujlwm tsis zoo thiab lwm yam kev txawv txav hauv plab hnyuv yuav tshwm sim. Ntawm daim tawv nqaij, kev tshwm sim ntawm daim tawv nqaij hemorrhagic syndrome tuaj yeem pom, thiab kev puas tsuaj rau cov kab mob sib txuas thiab cov pob txha tuaj yeem tshwm sim raws li hemarthrosis.
Pradax tshuaj. Analogues. Nqe
Raws li tau hais los saum toj no, cov tshuaj no yog cov pab pawg ntawm cov tshuaj tiv thaiv coagulants, yog li cov tshuaj ntawm tib pab pawg tuaj yeem hloov pauv. Thaum xaiv cov tshuaj tsim nyog, koj yuav tsum paub meej tias koj tsis tuaj yeem raug coj los ntawm cov txheej txheem xws li: "qhov nopheej yig dua" los yog "nws pab ib tug neeg nyob ze heev." Anticoagulants yog cov tshuaj hnyav heev uas cuam tshuam rau tag nrho lub cev, yog li ntawd, tsuas yog tus kws kho mob tuaj yeem sau tau ob qho tshuaj thiab analogue ntawm Pradaxa.
Tsis muaj kev hloov pauv rau cov tshuaj no raws li cov qauv ntawm cov tshuaj nquag. Raws li pab pawg kws tshuaj, cov tshuaj "Warfarin", "Marcumar", "Fenilin" thiab "Xarelto" yuav tsim nyog.
Tus nqi ntawm cov tshuaj no yog siab heev. Yog li, ib pob uas muaj 60 tsiav tshuaj raug nqi txog 3 txhiab rubles, 30 tsiav tshuaj yuav raug nqi txog 2 txhiab rubles. Tus nqi ntawm cov tshuaj me ntsis nyob ntawm cov ntsiab lus ntawm cov tshuaj nquag. Rau Pradaxa 110 lossis Pradaxa 150, tus nqi yuav txawv me ntsis.
tshuaj "Warfarin"
Cov tshuaj no yog qhov qub tshaj plaws ntawm cov tshuaj tiv thaiv kab mob saum toj no. Kev siv yuav tsum tau ua tib zoo ua raws li kev noj tshuaj thiab kev saib xyuas ntawm cov ntshav hauv lub xeev, vim tias qhov ntau npaum li cas yog qhov txaus ntshai heev - cov tshuaj "Warfarin" dhau los ua tshuaj lom. Nws yog siv rau kev kho mob thiab tiv thaiv thrombosis thiab embolism ntawm cov hlab ntsha. Xws li tau muab tshuaj rau mob venous thrombosis, pulmonary embolism, transient ischemic attacks thiab strokes, nrog rau kev tiv thaiv theem nrab ntawm myocardial infarction thiab cuam tshuam cov teeb meem thromboembolic. Cov tshuaj kuj tseem siv los tiv thaiv cov teeb meem thromboembolic hauv cov neeg mob uas muaj atrial fibrillation, kab mob plawv lossis nrog lub plawv li qub, nrog rau lub sijhawm tom qab phais tom qab kev cuam tshuam orthopedic,kom txo tau cov ntshav txhaws.
cov ntsiav tshuaj Warfarin tsis yog siv rau hauv cov ntaub ntawv ntawm qhov tsis txaus ntseeg rau cov khoom xyaw ntawm cov tshuaj, thaum mob los ntshav, cev xeeb tub (tshwj xeeb tshaj yog thaum thawj peb lub hlis twg thiab hauv 4 lub lis piam dhau los), vim nws muaj cov nyhuv teratogenic ntawm fetus, mob raum mob hnyav thiab siab, mob DIC, tsis muaj C thiab S proteins, thrombocytopenia. Nws kuj tseem tsis raug sau tseg rau cov neeg mob uas xav tias yuav los ntshav (xws li cov kab mob hemorrhagic), kev txom nyem los ntawm cov hlab ntsha varicose leeg, arterial aneurysms, gastric lossis duodenal ulcers, kab mob endocarditis, malignant hypertension. Tsis txhob siv rau hauv cov neeg mob uas tau tsim muaj hemorrhagic stroke lossis intracranial hemorrhage, nrog rau qhov txhab mob hnyav (xws li kev phais), ua ntej lumbar puncture.
Anticoagulants, tiv thaiv cov ntshav txhaws ntau dhau, qee zaum tuaj yeem ua rau lub cev tsis zoo, ua rau los ntshav ntau ntxiv. Cov tshuaj "Warfarin" kuj muaj xws li cov nyhuv. Cov kev mob tshwm sim raug txo feem ntau yog los ntshav ntawm ntau yam hauv zos. Tsis tas li ntawd, kev zom zaub mov tuaj yeem tshwm sim.
Kev noj zaub mov thaum noj Warfarin
Qhov ua tau zoo ntawm cov khoom no yog nyob ntawm cov ntsiab lus ntawm cov vitamin K. Nws nkag mus rau hauv lub cev nrog qee cov zaub mov, tshwj xeeb tshaj yog nplooj ntsuab. Tab sis koj tsis tas yuav ua kom nce lossis txo qhov feem ntawm cov zaub no hauv kev noj haus. Pib txais toscov tshuaj, koj yuav tsum tsis txhob hloov pauv cov ntawv qhia zaub mov ib txwm lossis noj cov vitamins lossis tshuaj ntxiv yam tsis pom zoo nrog koj tus kws kho mob. Thaum cov koob tshuaj tau raug xaiv thiab tau txiav txim siab, qhov nce ntxiv ntawm kev noj cov zaub mov uas muaj vitamin K tuaj yeem txo nws cov txiaj ntsig thiab ua rau muaj kev nce ntxiv ntawm cov thrombosis. Qhov loj tshaj ntawm cov vitamin no muaj nyob rau hauv tshuaj yej ntsuab, spinach, parsley, zaub qhwv ntawm ntau yam, lettuce. Kev taw qhia sai sai ntawm cov khoom no rau hauv kev noj zaub mov tuaj yeem ua rau tsis muaj zog ntawm cov nyhuv ntawm cov tshuaj, thiab kev noj cov txiv hmab txiv ntoo los yog kua txiv cranberry, ntawm qhov tsis sib xws, tuaj yeem ua rau muaj txiaj ntsig zoo. Kev haus dej cawv yog qhov tsis txaus ntseeg kiag li. Ntawd yog, kev noj haus thaum noj "Warfarin" yog qhov yuav tsum tau ua ua ntej rau kev kho kom zoo thiab nyab xeeb.
Niaj hnub nimno analogues ntawm cov tshuaj "Warfarin"
Tam sim no, ntau cov tshuaj tau raug tsim tawm uas tuaj yeem hloov cov tshuaj no, tab sis muaj cov kev mob tshwm sim tsawg dua, suav nrog cov uas tsis tas yuav tsum tau saib xyuas tas li ntawm INR (tus cim qhia txog ntshav txhaws). Hloov pauv rau cov tshuaj Warfarin, kev siv uas yog vim qhov xav tau los txo qhov kev pheej hmoo ntawm thrombosis hauv lub sijhawm tom qab phais, suav nrog cov tshuaj Warfarex, Marevan, nrog rau Pradaxa thiab Xarelto, uas muaj cov txheej txheem zoo sib xws ntawm kev ua thiab kev qhia rau siv.
Cov tshuaj "Varfarex" hauv daim ntawv ntawm cov ntsiav tshuaj, uas muaj warfarin sodium clarate ua cov khoom xyaw nquag. Nws yog siv rau hauv cov kab mob xws li pulmonary thromboembolism, tob vein thrombosis, plawv nres, nrog rau kev phais rauProsthetic Heart li qub.
"Marevan" muaj tib yam tshuaj nquag, tshuaj rau cov kab mob hauv qab no: thrombosis, plawv nres (nrog rau kev tiv thaiv cov teeb meem tom qab lub plawv nres), valve hloov thiab lwm yam kab mob hauv lub plawv, mob stroke thiab ischemic attacks (xws li rau lawv tiv thaiv).
Cov nyiaj saum toj no, sib txawv tsuas yog nyob rau hauv qhov muaj pes tsawg leeg ntawm excipients, nthuav tawm tag nrho cov yam ntxwv ntawm lub hauv paus, thiab tseem xav tau kev ceev faj zoo sib xws thiab kev tswj hwm ntawm INR.
Pradaksa yog ib qho tshuaj tiv thaiv coagulant uas yog ib qho ncaj qha inhibitor ntawm thrombin, khi uas tiv thaiv kev tsim cov ntshav txhaws. Nws tau raug sau tseg rau kev kho mob thiab kev tiv thaiv ntawm thrombosis ntawm extremities, rau kev tiv thaiv ntawm strokes, systemic thromboembolism thiab txo cov kev pheej hmoo ntawm cov teeb meem nyob rau hauv atrial fibrillation.
Xarelto (rivaroxaban) yog siv los ua prophylactic rau thromboembolism tom qab muaj kev cuam tshuam orthopedic ntawm sab qis.
Drug "Xarelto". Nyob ntawm kev teem caij
Cov ntsiav tshuaj zaj duab xis no muaj micronized rivaroxaban ua cov khoom xyaw nquag, uas ua raws li cov tshuaj tiv thaiv ncaj qha. Nws yog ib qho ncaj qha inhibitor ntawm factor Xa (cov ntshav txhaws, uas yog ib qho activator ntawm prothrombin), pab txhawb kev tsim cov thrombin tshiab molecules, tab sis tsis cuam tshuam rau cov uas twb muaj lawm hauv cov hlab ntsha. Muab tshuaj rau kev tiv thaivkev loj hlob ntawm venous thromboembolism nyob rau hauv cov neeg mob nyob rau hauv lub postoperative lub sij hawm tom qab nws kim heev kev pab cuam orthopedic.
Koj tsis tuaj yeem siv cov tshuaj "Xarelto" - ib qho analogue ntawm "Pradaksa" - nrog hypersensitivity rau rivaroxaban thiab lwm yam khoom ntawm cov ntsiav tshuaj, kev kho mob tseem ceeb los ntshav (piv txwv li, intracranial lossis gastrointestinal), kab mob siab, nrog rau los ntawm coagulopathy, uas ua rau muaj kev pheej hmoo ntawm hemorrhages txaus ntshai. Tsis txhob sau cov tshuaj no thaum cev xeeb tub thiab pub niam mis, nrog rau cov menyuam yaus hnub nyoog qis dua 18 xyoo. Kev siv cov tshuaj los ntawm cov neeg mob uas mob raum tsis txaus lossis muaj kev tsis haum xeeb rau galactose lossis lactose tsis pom zoo. Nrog ceev faj, cov ntsiav tshuaj Xarelto tau muab rau cov neeg mob uas muaj kev pheej hmoo los ntshav ntawm ib qho etiology: nrog los ntshav los yog tau txais los ntshav, nrog rau cov hlab ntsha loj heev, nrog exacerbation ntawm ulcerative txhab ntawm lub plab thiab duodenum, nrog rau cov ntaub ntawv tsis ntev los no ntawm intracranial los yog intracerebral. hemorrhage, nrog rau tej pathologies ntawm cov hlab ntsha ntawm lub paj hlwb los yog tus txha caj qaum, nrog ib tug tsis ntev los no ua hauj lwm ntawm tus txha caj qaum, hlwb los yog ob lub qhov muag. Nws tsis pom zoo kom siv cov tshuaj rau cov tib neeg uas siv cov tshuaj tiv thaiv kab mob hauv cov kab mob azole (piv txwv li, cov tshuaj "Ketoconazole") lossis tau txais cov tshuaj tiv thaiv kab mob HIV, vim tias cov tshuaj no nce cov ntsiab lus ntawm rivaroxaban (cov khoom xyaw nquag ntawm cov ntsiav tshuaj.) hauv cov ntshav plasma, uas ua rau muaj kev pheej hmoo los ntshav.
Xarelto tshuaj. Dosage and side effects
Cov ntsiav tshuaj tau noj hauv qhov ncauj, tsis hais noj zaub mov, ib hnub ib zaug (10 mg koob). Raws li kev tiv thaiv ntawm venous thromboembolism tom qab kev phais mob hnyav ntawm lub duav sib koom, kev kho mob txuas ntxiv rau 5 lub lis piam, ntawm lub hauv caug sib koom - txog li 2 lub lis piam.
Cov tshuaj "Xarelto" yog ib qho analogue ntawm "Pradaksa", yog li qhov tshwm sim tsis zoo tom qab noj lawv zoo ib yam. Qhov kev pheej hmoo ntawm overt los yog zais los ntshav los ntawm cov ntaub so ntswg thiab cov kab mob hauv lub cev tuaj yeem nce ntxiv, ua rau muaj ntshav qab zib posthemorrhagic. Cov teeb meem no tuaj yeem tshwm sim tsis muaj zog, kiv taub hau, pallor, mob taub hau, thiab ua tsis taus pa.
Koj nyiam tshuaj twg: Warfarin, Pradaxa lossis Xarelto?
Koj yuav tsum nkag siab meej tias cov tshuaj tiv thaiv kab mob tsis tuaj yeem raug xaiv los ntawm nws tus kheej, cov tshuaj tsim nyog, nws cov koob tshuaj thiab kev tswj hwm tau muab tshwj xeeb los ntawm kws kho mob. Thiab cov lus pom zoo no yuav tsum ua raws li nruj me ntsis. Cov ntaub ntawv muab yog rau cov ntaub ntawv xov xwm nkaus xwb thiab tsis tuaj yeem yog phau ntawv qhia ua haujlwm.
Raws li qhov txiaj ntsig tseem ceeb ntawm cov tshuaj Pradaxa thiab Xarelto, lub sijhawm zoo li no tau sau tseg tias lawv siv tsis tas yuav muaj kev tswj hwm INR thiab ua rau muaj kev phiv ntau dua. Tab sis lawv tsuas tuaj yeem raug tshuaj rau cov kab mob uas tsis yog-valvular. Cov kab mob Rheumatic valve lossis hloov nrog cov khoom siv li qub suav nrog kev siv Warfarin nkaus xwb.
Qhov zoo ntawm Xarelto tshaj lwm tusyog tias nws tsuas yog noj ib zaug ib hnub, thiab, raws li qee qhov kev tshawb fawb, nws tsis ua mob rau lub plab zom mov ntau heev. Tab sis qhov ntau ntawm cov lus qhia rau nws siv yog nqaim heev, thiab qhov kev kho mob no yog tsim nyog rau cov neeg mob tom qab ua haujlwm loj ntawm cov extremities los tiv thaiv kev loj hlob ntawm thromboembolism. Tsis tas li ntawd, qhov analogue ntawm Pradaxa yog categorically tsis haum rau cov poj niam thaum cev xeeb tub (txhua lub sijhawm) thiab lactation, vim hais tias cov tshuaj nquag nkag mus rau hauv cov placenta, muaj kev cuam tshuam tsis zoo rau tus menyuam hauv plab, thiab tseem ua rau lub tsev menyuam los ntshav, thiab raug tso tawm hauv leej niam. mis nyuj, yog li nws lub sijhawm teem tseg tsuas yog ua tau nrog kev tshem tawm tag nrho ntawm kev pub niam mis.
Raws li twb tau hais lawm, cov tshuaj "Warfarin" muaj ntau qhov dav, suav nrog, nws tsuas yog cov tshuaj uas tau sau tseg rau qhov mob ntawm lub plawv li qub ntawm ib qho etiology (rheumatic lossis hloov khoom cuav), hauv qhov no nws muaj. tsis muaj analogues. Nws kuj tuaj yeem siv tau thaum cev xeeb tub (tsuas yog qhov xav tau muaj zog heev), tshwj tsis yog rau thawj peb lub hlis twg (vim tias nws muaj cov nyhuv teratogenic) thiab plaub lub lis piam dhau los ua ntej yug me nyuam (tej zaum yuav ua rau los ntshav spontaneous). Tus nqi ntawm cov tshuaj kuj tseem zoo li ntxim nyiam, uas yuav haum rau ob peb puas rubles, thaum tus nqi ntawm cov ntsiav tshuaj Xarelto lossis Pradax capsules yog kaum npaug siab dua. Qhov tsis zoo ntawm "Warfarin" yog ntau dua ntawm cov kev mob tshwm sim thiab xav tau kev saib xyuas cov ntshav tas li.
Cov tshuaj "Pradaksa" muaj ntau yam ntawmcov lus qhia rau kev siv, tsis tas yuav tsum tau saib xyuas cov ntshav suav, tsawg dua yuav ua rau muaj qhov tsis zoo. Nws tsis pom zoo siv thaum cev xeeb tub thiab lactation, txawm hais tias nws tsis yog ib qho contraindication, raws li kev tshawb fawb txog nws cov teebmeem hauv pawg no tsis tau ua. Kev sim ntawm tsiaj txhu tsis tau qhia qhov tsis zoo.
Yog li, piv cov analogues ntawm cov tshuaj "Pradaksa", peb tuaj yeem xaus tias thaum xaiv ib qho ntawm lawv, koj yuav tsum tau coj mus rau hauv tus lej tseem ceeb ntawm cov txheej txheem. Txhua yam tshuaj muaj lawv tus yam ntxwv hauv daim ntawv thov, thiab txhua qhov tshwj xeeb yuav tsum tau txiav txim siab sib cais. Yog li ntawd, tsuas yog ib tus kws kho mob tuaj yeem sau tshuaj kho kom txaus thiab nyab xeeb (kev siv Warfarin, Xarelto lossis Pradaxa).
