Anticoagulants isinyathelo nenkhulumombiko. anticoagulants ongaqondile: uhlu izidakamizwa, lo mshini wezenzo, ngezigaba. anticoagulants Overdose engaqondile

Nge ekusebenzeni kahle coagulation negazi izinhlelo antisvertyvayuschey ukuzinza esele zomzimba zangaphakathi. ukugeleza kwegazi ngokusebenzisa izitsha akanayo izithiyo mani, futhi thrombus kumiswa ezingeni elifanele. Lapho kulinganisela kuyaphazamiseka ukusebenza izinhlelo esivuna ukusebenza igazi coagulation, zikhona izimo ezingase zisenze kumiswa ngokweqile amahlule. anticoagulants ongaqondile - elinye lamaqembu izidakamizwa ezisetshenziselwa nokuvulwa iziyaluyalu yangaphakathi.

Yiziphi anticoagulants?

Anticoagulant ngokuthi izimali, ezithinta ukusebenza anticoagulant kanye oyenza lo dilution yegazi. Lokhu kukuvumela ukubuyisela izici rheological futhi ukunciphisa thrombosis.

Kusho ayatholakala ifomu ithebhulethi, njengoba yokugcoba, si futhi umjovo amalungiselelo. Abelwe hhayi kuphela ekwelapheni isifo, kodwa futhi ukuvimbela ukwakheka lelitfutfukile amahlule.

Iningi lamalungu aleli qembu elithi izidakamizwa abumane thrombus, nomsebenzi ekunqandeni. Inqubo ukuchayeka plasma izici, nokukhiqizwa kwezincwadi thrombin, okuyinto kubambezela amahlule.

Izidakamizwa zihlukaniswe amaqembu amabili ngokuvumelana imisebenzi yabo:

• anticoagulants ngqo;
• anticoagulants engesobala.

isinyathelo esiqondile izidakamizwa heparin ezisekelwe

Leli qembu kwezimali liyithinta ngokuqondile phezu cofactors plasma okuyinto zivimbela thrombin. Omele main kuyinto heparin. Kulesi sisekelo kukhona izinhlobo eziningi zezidakamizwa wenza okufanayo futhi ungwaqa enegama:

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

Heparin noma izithako abophezele antithrombin-III, okuholela ushintsho indawo molecule ayo. Lokhu isheshisa uxhumano cofactor ngoba thrombin, bese okunqanda inqubo ekunqandeni.

Izici isicelo "heparin"

Isenzo izinto ukuze kuvinjelwe lesi Ngokukhula nokusakazeka kwezindaba ihlule legazi. Heparin athomu isakhiwo nge antithrombin, esiwumfanekiso inhibitor ka ezijiyisa igazi. Ingqikithi kuyinto uchungechunge glycosaminoglycan. Umuthi is injected phansi kwesikhumba futhi iqala ukusebenza kwawo ngemva kwamahora ambalwa.

Uma kudingeka, isinyathelo esisheshayo "Heparin" ukumnika iqondiswa ngemithambo yegazi nokusheshisa ukusebenza ukwandisa bioavailability. Kukhethwa imithi umthamo incike esimweni lapho isiguli itholakala. Ngaphezu kwalokho, kunakwe khona izifo concomitant, abaphathi parallel kwamanye amaqembu ukuthaka imithi, isidingo nezinqubo kuhlinzwa ezikebheni.

oligopeptides

Imithi ukuthi isinyathelo ngqo phakathi nendawo thrombin kusebenze, ezibhekwa inhibitor eqinile ezithile thrombosis uhlelo. Isithako asebenzayo zomuthi bebodwa ukuxhuma kwi-izakhi ezijiyisayo, ukushintsha conformation yabo.

Lo muthi "inogatran", "Hirudin", "Efegatran", "Tromstop" nabanye. Zokunqanda ukuhlaselwa inhliziyo angina, isifo varicose, nokuvimbela thromboembolism, reocclusion ngesikhathi angioplasty.

anticoagulants ongaqondile (uhlu)

I anticoagulant lokuqala itholiwe ekhulwini XX e-United States, lapho kutholakala isifo esisha izinkomo, ingqondo ukopha esindayo. Lapho imbangela iye cacisa isimo sokugembula, kwaba ukuthi izilwane utheleleke nge isikhunta izenzo clover, ise-feed. Kule impahla eluhlaza ukuthi kuhlelwe umqondo wokuqala izidakamizwa antiplatelet isinyathelo ngokungaqondile - "Dicoumarol".

Kuze kube manje, uhlu izimpahla ukuthi kukhona analogs lwezinto ezingaphezu kwekhulu. Konke lokhu izidakamizwa - anticoagulants ngomlomo. Lo mshini wezenzo leqembu izidakamizwa esekelwe okusithiyayo isenzo vitamin K.

Kube ekunqandeni izici encike saleli vithamini. anticoagulants ongaqondile zivimbela ukusebenza amaprotheni coagulation futhi cofactors vitaminozavisimyh. Ukusetshenziswa engalawuliwe le mithi kungavunyelwe, njengoba okwandisa ingozi yezinkinga ukopha.

Kunamaqembu amabili ayinhloko, okuyinto zihlukaniswe zonke anticoagulants engesobala. Ukwahlukanisa izimali kusekelwe izinto asebenzayo kufakwe nokulungiselela. ukuhlukanisa:

• coumarin nemikhiqizo;
• ngokusekelwe amathuluzi indandiona.

amalungiselelo indandiona

Ngemva enifeza inani elikhulu izifundo, ososayensi bathola ukuthi imikhiqizo esekelwe yalolu ketshezi asebenzayo akufanele isetshenziswe therapy. I ukwakhiwa kwadingeka nabaningi side effects njengoba komzimba. Ukuphumelela umthelela protivosvertyvaniya uhlelo futhi akazange abonise imiphumela kuyavumelana.

Leli qembu izidakamizwa kuhlanganisa izidakamizwa, "phenindione", "Difenindion", "Anisindion". Kwanqunywa ukuba ayeke ukukhetha esiyinhloko kuneqembu labasebenzi antiplatelet yesibili futhi nemikhiqizo indandiona okwamanje isetshenziswa kuphela "Fenilin".

Umuthi has a eziphansi, itholakala ifomu tablet. Lungile amahora 10, futhi kubaluleke kakhulu ukuba silondoloze isikhathi oyifunayo yokwelapha. Umthelela kufinyelelwa amahora kuphela emva-24 kusuka ngesikhathi komthamo wokuqala. Isicelo kwenzeka esebenzisa ukuqapha isimo isiguli nge igazi nemingcele laboratory (coagulation, ukuhlolwa jikelele, oyisazi samakhemikhali ezinto eziphilayo).

Isikimu we 'fenilina ":

1. Ngosuku lokuqala - 1 ithebhulethi izikhathi 4.
2. Eyesibili usuku - 1 ithebhulethi izikhathi 3.
3. Ezinye izindaba zika-ukwelashwa - 1 ithebhulethi ngosuku.

Imithi kufanele kuthathwe imithi ukuthi ukunciphisa ezingeni glucose emzimbeni.

coumarin nemikhiqizo

Coumarin - into okuyinto ezitshalweni zingaba synthetically egunjini lokucwaninga esibhedlela. Okokuqala, emva kususwe, ithuluzi yayisetshenziswa njengesikhungo ushevu ukulawula igundane. Kuphela kwesikhathi waqala ukusebenzisa izidakamizwa ukubhekana thrombosis ngokweqile.

Anticoagulants yesenzo ngokungaqondile - amalungiselelo esekelwe coumarin - omelelwa izindlela ezilandelayo imithi:

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

"Warfarin": izici zohlelo lokusebenza

Anticoagulants yesenzo engaqondile (uhlu itholakala isihloko) uvame abamelelwa "Warfarin". Lokhu kusho tableted, oluqanjwe 2,5, 3 noma 5 mg. Ithonya Lako umzimba womuntu eba emva kwezinsuku 1.5-3 emva ekuphathweni lokuqala tablet. umphumela Maximum ekupheleni ngesonto lokuqala.

Ngemva ngokuthatha izidakamizwa nemingcele rheological wegazi wabuyela esimweni esivamile emva kwezinsuku 5 kusukela osukwini lokukhansela "ka warfarin." Kusho esetshenziswa izikhathi 2 ngosuku, ngesinye futhi ngesikhathi esifanayo. Ngosuku lonyaka wesi-5 yokwelapha kuthiwa kokuhlola igazi imingcele ukunquma zibheke nokusebenza ngempumelelo.

Inkambo yokwelashwa ikhethwa onguchwepheshe uma ngayinye. Ezithile isifo uthi (isib fibrillation atrial) zidinga isicelo okuqhubekayo. With ukuthuthukiswa PE (pulmonary embolism) antiplatelet ejenti akuyona esiwabelwe ezingaphansi kwezinyanga eziyisithupha noma ukuphila.

Lapho isidingo kokungenela kuhlinzwa "Warfarin" ukukhansela izinsuku 5 ngaphambi kokuba uhlinzwe. Lokhu kuzovumela indices igazi ukubuyela esimweni esivamile. Benesidingo okusezingeni eliphezulu ukusetshenziswa okuqhubekayo ukwelashwa anticoagulant, ithuluzi esikhundleni heparin unfractionated. Umthamo wokugcina saphathwa 4 amahora ngaphambi kokungenela.

Ngemva kokuhlinzwa ngokusebenzisa 4 chasa udla heparin unfractionated. Ukuthola engaqondile ejenti antiplatelet lungabuyiselwa ezinsukwini ezimbili, ngemva ukuqapha isimo igazi ngosizo ukuhlolwa laboratory.

Kukuyiphi amacala isetshenziswa anticoagulants?

anticoagulant nenkhulumombiko esetshenziselwa nokuvimbela thromboembolism, thrombosis acute kohlelo emithambo yegazi uma kwenzeka i-mechanical wokufakelwa inhliziyo valve futhi fibrillation atrial.

Izifo esemqoka ekuthuthukisweni zazo anticoagulants babelwe eqondile isinyathelo ngokungaqondile, ube division elandelayo ngemacembu:

1. Thrombosis kohlelo lwemithambo:
   • isilethikusebenza;
   • embolism yamaphaphu;
   • unhlangothi zikhala ischemia;
   • ukulimala kuhlasimulise ukuze imithambo ngokumelene isifo sokuqina kwemithambo yegazi.
2. Eqonda coagulation intravascular :
   • ukwethusa uthi;
   • ukulimala kuhlasimulise;
   • ukuthuthukiswa sepsis.
3. thrombosis okukhulu ngemithambo ngu:
   • amahlule isizinda varicose emithanjeni;
   • thrombosing hemorrhoidal plexus emithambo yegazi;
   • ihlule e bakhiphe elezinga eliphansi vena cava.

Izimo main

anticoagulants ongaqondile - izidakamizwa ukuthi avinjelwa ngokuqinile ebukhoneni ukuntula lactose, malabsorption of glucose ne-galactose. Kukhona izinhlobo eziningi zezidakamizwa ngesikhathi esifanayo ukuthi yini angasebenzisa anticoagulants ngomlomo. Uhlu izidakamizwa ehlanganisa izidakamizwa nonsteroidal eqeda ukuvuvukala, "aspirin", "Dipyridamole", "clopidogrel", "penicillin", "Chloramphenicol", "Cimetidine".

Imibandela ezingeke anticoagulants esetshenziswa ngqo futhi isenzo engaqondile:

• izifo emathunjini yokusetshenziswa pheshana emathunjini;
• useshonile semithambo;
• isifo sesibindi;
• ukopha acute;
• thrombocytopenia;
• ukwehluleka kwezinso;
• Mina senyanga nenyanga okugcina enkathi yokukhulelwa;
• amazinga aphezulu creatinine.

Imiphumela engemihle ejenti antiplatelet

Ngamunye izidakamizwa kuleli qembu ejenti has ezifanayo engemihle. Bona azibonakali ngokuzilimaza noma umthamo okungafanele noma ukwephulwa ekusetshenzisweni izincomo.

Imiphumela engemihle zihlanganisa ukuthuthukiswa ukopha, izimpawu dyspeptic njengoba ukuhlanza, isicanucanu noma ikhishwe yisisu. Kukhona ubuhlungu eqinile besisu, iguliswa ukuqubuka kwesikhumba ngohlobo isifuba noma eczema. Kwangathi ukuthuthukisa necrosis, nezinwele, isikhumba ukulunywa.

Ngaphambi kokuqala ukwelashwa, isiguli ngizodabula kokuxilongwa ukunquma ukuthi yokusebenzisa le mithi. Isiguli sinikeza ephelele kakhulu segazi, oyisazi samakhemikhali ezinto eziphilayo, urinalysis, umchamo ku Nechiporenko, coagulation. It is ibuye Kunconywa sokulihlolisisa ultrasound nezinso ukudlula sezinyawo igazi nokulumba.

anticoagulants Overdose engaqondile

Nokwenza lokhu iqembu izidakamizwa abasakwazi ezingavamile. Lokhu kungenzeka uma ingane encane Izoba yisikhungo izidakamizwa futhi kuzame ukunambitheka. Ngokuvamile, lokuhlushwa ketshezi kuyinto ongaphakeme, ngakho izibhebhe olulodwa umthamo akazange wayemesaba. Uma ukusetshenziswa ekhethekile noma ongahlosile amazinga okukhishwa esikhulu ketshezi ingakha coagulopathy ukopha.

umtholampilo ukweqisa izidakamizwa asinazo izimpawu ezithile, ngakho ukuqagela kwenzekeni ukuphuza esiningi izidakamizwa, kunzima. Symptomatology ukubonakaliswa okufanayo yizifo nezinhlupheko ezihlukahlukene, uthi sokugembula umzimba. Isiguli sinelungelo:

• nemihuzuko ukukhanya phezu kwesikhumba;
• igazi e umchamo noma indle;
• lesizalo ukopha;
• hematoma entanyeni;
• ukopha intracranial.

Ngaphambili, unhlangothi odlule, iziguli esezikhulile, ukopha emathunjini bese umlando ongaphakeme hematocrit - ezihlobene izici ezingaba ukunciphisa ezifweni we lokuhlushwa embundwini izidakamizwa.

Antiplatelet yokwelapha ukweqisa izidakamizwa

1. Kukhanseliwe noma ezibomvana ngokusebenzisa esiswini amahora ambalwa ngemva kokuphathwa izidakamizwa ayinakho incazelo.
2. Isiguli sinikezwa namalahle ocushiwe for ukumuncwa emathunjini.
3. "Cholestyramine" ngaphakathi iqondiswa esimweni "warfarin" ukweqisa izidakamizwa noma analogue yayo.
4. Isiguli ibekwe ezimweni antitravmaticheskie, ukugwema ukuvela hematomas entsha nokopha.
5. Nge eningi igazi ukulahleka noma ngokumpontshelwa plasma eyenziwa kwakheka izakhi, ngezinye izikhathi lonke igazi. Ngokuyikho e ukusetshenziswa igcwele abomvu egazi, cryoprecipitate, prothrombin eziyinkimbinkimbi.
6. Esimisiwe 'Phytomenadione "imikhiqizo esekelwe Vitamin K.
7. Uma kudingekile, nika alikho ikhambi antiplatelet, lesi sidakamizwa "Phytomenadione" abamiselwe imithi oyinikiwe, kunokuba njengendlela usizo lokuqala.

Uma isimo lesiguli wabuyela esimweni esivamile, kodwa kubalulekile ukuba uqhubeke ukusebenzisa anticoagulants temlomo, kubalulekile ukuba "Warfarin" esikhundleni izidakamizwa heparin uchungechunge okwesikhashana.

isiphetho

Ukusetshenziswa kwezidakamizwa antiplatelet abakwazi kuphela kujwayeleke igazi amazinga rheological, kodwa futhi ukuthuthukisa isimo jikelele isiguli futhi kuvimbele ukuthuthukiswa izifo ezingathi sína kwababhemayo.

qikelela ukuthi ukusetshenziswa anticoagulants, kukhethwa umthamo kanye nokuqapha isimo lesiguli kungasiza ukunciphisa ingozi yezinkinga nempumelelo. Professionals abasebenzisa leli qembu izidakamizwa e umkhuba wabo, kuyadingeka ukuthuthukisa ulwazi futhi ukulandela ngokucophelela izincomo ezempilo emhlabeni jikelele.