"Atsekardol": indications rau siv, cov lus qhia, xyuas, analogs

Ntawm cov txhais tau tias ntawm antiplatelet txoj kev kho, uas yog siv rau kev tiv thaiv ntawm mob plawv txheej xwm, tau ntev lawm ib tug tseem ceeb qhov teeb meem acetylsalicylic acid (ASA). Tsim nyob rau hauv 1887, nws yog ntau tshaj li 125 xyoo lawm tau nquag siv nyob rau hauv kev kho mob xyaum raws li ib tug antiplatelet neeg saib xyuas thiab antipyretic. Thiab raws li lub active tshuaj yam khoom uas yog muaj nyob rau hauv lub "Atsekardol" npaj, indications uas maj txhab raws li txoj kev tshawb no pathogenic mechanisms ntawm tus kab mob.

System yam ntxwv medicament

Lub active tshuaj npaj raws li cov kev faib koom txhais tau tias rau kev tiv thaiv aggregation. Nyob rau hauv no series ntawm ACK yog lub feem ntau npaum cov tshuaj muaj pes tsawg leeg uas muaj peev xwm kiag li tsis yooj yim sua kom muab tau platelet aggregation tag nrho pas dej ua ke. Kws yees yeeb tshuaj "Atsekardol", indications rau siv, thiab nws analogs ntau npaum daim ntawv nyob rau hauv cov nqe lus ntawm pharmacodynamics, qhia cov nram qab no:

• nws nquag muaj - ASA mediating antithrombotic ntxim rau cov atherosclerosis ntawm cov hlab ntsha tom qab;

• optimally dosed tshuaj rau kev tiv thaiv ntawm tus kab mob plawv;

• nws ntau npaum daim ntawv minimizes cov nyhuv gastrotoxicity ASA;

• Kev npaj yog lub feem ntau pheej yig nrog sib tw cov khoom uas muaj zoo tib yam efficiency.

Cov nyhuv ntawm kev tiv thaiv thrombosis ASA piav blockade tsim ntawm prostanoids. Vim hais tias inhibition ntawm COX-1 - platelet Cyclooxygenase-1 - ntxhov pib thrombus tsim tau - lub aggregation ntawm cov ntshav platelets. Inhibition tshwm sim tsim ntawm thromboxane A2, pib tus txheej txheem ntawm txuas ntawm platelets mus rau lub puas feem ntawm cov hlab phab ntsa.

Cim asterisk tso thiab characterization gastrotoxicity

Target indications rau "Atsekardola" muaj xws li kev tiv thaiv ntawm thrombus tsim. Txawm li cas los, cov ASA, lub active khoom sib ua zaub mov ntawm cov tshuaj, muaj yog ib undesirable nyhuv yog txuam nrog nonselective cyclooxygenase. Tsis tas li ntawd cuam tshuam tov ntawm epithelial hlwb ntawm lub pais plab ib ntsuj av. Yog nyob rau hauv tus ntawm txhoj puab heev acidic plab ib puag ncig, lawv muaj ntau puas, uas ua rau txoj kev loj hlob ntawm mob mob gastral. Qee zaus (hais txog 3.5% ntawm tag nrho cov neeg mob) nws provokes los ntshav nyob rau hauv lub digestive ib ntsuj av.

Rau formulation, uas siv "Atsekardol" indications rau kev siv ntau lug vim hais tias ntawm lub ntau dua kev ruaj ntseg. Nws yaj thiab yog absorbed yog nyob rau hauv lub 12-duodenum, cov sawv cev enteric kardioformu ASA. Nws kev sib cuag nrog lub hlwb ntawm lub plab yog zoo tshem tawm, li no inhibited nws sab nyhuv gastrotoxicity. Local ua nyhuv "Atsekardola" yog nyoog, vim hais tias cov tshuaj yog nyob rau hauv daim ntawv ntawm cov enteric twb xam tau tias yog raws li ib tug xim inhibitor ntawm COX-1. Thaum COX-2 inhibition kuj yuav siv sij hawm qhov chaw nyob rau hauv cov hnyuv, uas yog tsis muaj teeb meem loj tsis taus.

Ib qho tseem ceeb nyhuv uas cov tshuaj daim ntawv "Atsekardola" yog ib tug ncaj lub zos yuav txo tau gastrotoxicity. Vim muaj cov antacid nyob rau hauv daim ntawv ntawm magnesium hydroxide probability pais plab puas tsawg txawm ntau dua. Thiab nyob rau lub sij hawm ntawd nyob rau hauv lub pharmacological ua lag luam ntawm Lavxias teb sab Federation "Atsekardol" nws yog ib tug ntawm peb cov nyiaj nrog cov khoom. Tshuav feem ntau pheej yig cov zoo sib xws, nws yog hom phiaj haum rau mus tas li siv.

Qhov chaw "Atsekardola" nyob rau hauv txoj kev kho antithrombotic

ASA rau lub prophylaxis ntawm thrombotic phenomena yog thov raws li nyob rau hauv lub plurality ntawm kev tshawb fawb. Lawv tau paub tseeb hais tias nws cov hauj lwm zoo nyob rau hauv txo tus neeg mob lub neej no los ntawm cov hlab plawv tus kab mob. Nyob rau hauv kev:

• THOV 16% txo lub neej no cov neeg mob thaum muaj kev kub mob plawv neeg:

• 25% txo rau hauv cov xwm txheej ntawm ischemic stroke;

• 25% thiaj li muaj cov kev pheej hmoo ntawm thromboembolism, pulmonary leeg thiab nws tej ceg;

• ib tug 29% txo rau hauv cov ntxim yuav zoo siv ntawm kev tsim symptomatic venous thromboembolism me me plab mog los yog extremities;

• 33% txo rau hauv cov xwm txheej ntawm myocardial infarction.

Cov teebmeem thiab muab tag nrho cov tshuaj "Atsekardol" indications uas me ntsis wider tshaj zheludochnorastvorimoy ASA. Thiab tam sim no lub hwj chim ntawm tus antithrombotic kev txiav txim ntawm tshiab antiplatelet tshuaj yog soj ntsuam xwb nyob rau hauv kev sib piv nrog nws. Raws li, "Atsekardol" raws li ib tug ntau ruaj ntseg, yuav tsum nyob ib qho chaw central nyob rau hauv lub prophylactic kev kho mob ntawm cov neeg mob raws li cov zaj lus tim khawv.

Contingent cov neeg mob uas indications rau kev siv

Nyob rau hauv kev npaj "Atsekardol" indications rau siv, nqe, cov hauj lwm zoo thiab txaus ntshai ntawm kev siv optimally balanced. Qhov no tso cai rau koj nqa mus siv rau ASA nyob rau hauv lub tshuaj daim ntawv ntawm ib tug ntau yam ntawm cov neeg mob nrog occlusive muaj tej yam. Thiab cov tshem tawm ntawm feem ntau ntawm cov kev phiv los ntawm cov tshuaj ua nyob rau hauv cov nram no mob:

• (ACS) mob coronary syndromes nrog nce, kev nyuaj siab los yog lawm ST luv rau lub ECG;

• mob cerebral mob (cerebral) kev (ADCC);

• nraum (lub hlwb) ischemic nres (tia);

• migrated nyob rau hauv cov kab mob los mus tiv thaiv recurrent mob;

• nrog ruaj angina pectoris rau kev tiv thaiv ntawm ACS;

• nrog paroxysm los yog tas mus li hauv daim ntawv ntawm atrial fibrillation;

• venous varicose veins.

Pathogenetic substantiation ntawm daim ntawv thov "Atsekardola"

Cov indications rau "Atsekardola" vim soj ntsuam cov nyhuv ntawm cov tshuaj. Nws yog zoo siv raws li ib tug txhais tau tias ntawm kev tiv thaiv arterial thrombosis ntawm qhov chaw ntawm lub ciam thiab concentric atherosclerotic plaques. Nyob rau hauv cov chaw no vim narrowing ntawm arterial ntshav ndlwg cuam tshuam tsim tau ib cov vortex ntshav txaus. Neeg kho tshuab siab rau lub thinned feem ntawm lub endothelium ua rau nws tearing. Ntshav coagulation system pom tau tias no av raws li ib tug ua txhaum ntawm vascular ntseeg, uas yuav tsum tau cov neeg kho tshuab kaw platelets tsim tau ib los khov rau ntawd.

Lub Symptoms ntawm platelets yog, thawj zaug rau theem ntawm thrombus tsim, nyob rau tiav uas yuav tsum tsim lub moj khaum rau lub neej yav tom ntej ntawm cov ntshav los khov rau ntawd. Ces, nws loj tsub kom vim qhov kev ncua ntawm cov ntshav. Tag nrho cov kawm tiav dab hemostasis ua rau muaj mob loj (ntau tshaj 75 cheeb tsam%) narrowing ntawm cov hlab lumen. Feem ntau nws txawm npog cov ntshav khiav tsis zoo hauv lub artery, thiab qhov chaw uas muaj yav tas los noj rau ntawm nws lub kev ischemia. Qhov no txoj kev ntaub ntawv lub hauv paus ntawm ACS thiab mob stroke, yog li kev tiv thaiv ntawm cov phenomena yog tsis tshua muaj ib qho tseem ceeb nyob rau hauv thiaj li yuav txo ib tug neeg lub neej no los ntawm atherosclerotic lub plawv thiab brachiocephalic cov hlab ntsha.

Pharmacodynamics antithrombotic kev txiav txim "Atsekardola"

Txuas mus rau lub tshuaj "Atsekardol" phau ntawv qhia (piav qhia ntawm cov khoom) tsis muaj kev cuam tshuam nws pharmacodynamic los, thiab qhia txog nws nyob rau hauv cov nqe lus ntawm kev nyeem ntawv thiab kev txais tos nta. Txawm li cas los, nws tsis piav qhia txog ib qho kev nyhuv ntawm ASA, li no depriving tus neeg mob ntawm ib qho tseem ceeb cov lus qhia txog lub mechanism ntawm qhov kev txiav txim. Nws tshwm sim los algorithms yog raws li nram no:

• inhibition ntawm COX-1 thiab cessation ntawm synthesis ntawm prostanoids;

• tsim irreversible blockade ntawm platelet thromboxane A2;

• rhuav txhua platelet Symptoms mus rau lub tsis xws luag ntawm lub endothelium;

• inhibition ntawm platelet adhesion dab;

• cov impossibility ntawm txoj kev ib tug thrombus occluding lub arterial lumen.

"Atsekardol" nyob rau hauv mob tej yam kev mob

Tsis tas li ntawd txuas mus rau yeeb tshuaj "Atsekardol" cov lus qhia rau kev siv (Txoj kev piav qhia) tsis muab cov lus qhia rau tus neeg mob txog tau ntawm nws siv thaum lub sij hawm ntawm kev tsim mob mob ntawm cov ntshav ncig nyob rau hauv lub plawv los yog lub hlwb. Nyob rau hauv kev, nrog rau cov kev loj hlob ntawm tus soj ntsuam syndrome cov yam ntxwv ntawm myocardial los yog cerebral infarction, thiab tej zaum yuav tsum muaj ntaub ntawv ASA.

Ntsiav tshuaj yuav tsum zom cov tshuaj (ntawm ib koob tshuaj 150-300 mg) thiab tsis nqos. Yog hais tias tus neeg mob cov tshuaj nyob rau hauv ib koob tshuaj 50 mg, lub sij hawm ntawm ib tug mob mob yuav tsum tau ob leeg 3-6 zom cov ntsiav tshuaj thaum lub ntau npaum ntawm 100 mg, ntsiav tshuaj 2-3 thaum 300 mg, lub 1 ntsiav tshuaj. Nws yog ib qho xwm txheej ceev cuab tam, los ntawm cov uas muaj nuj nqis txo yuav ua rau muaj mob loj heev vascular thrombosis.

Contraindications rau kev siv ntawm "Atsekardola"

Nyob rau hauv kev npaj "Atsekardol" (ntsiav tshuaj) cov lus qhia rau kev siv, tiag tiag cov tub txawg thiab kws tshawb fawb cov ntaub ntawv paub meej tias qhov nqi koj tshuav ntawm txaus ntshai thiab cov kev pab ntawm daim ntawv thov. Txawm li cas los, contraindications vim comorbidities yuav tsum xam tias yog thaum peb noj lub tshuaj thiab tham ib tug tshwj xeeb. Contraindications raug muab faib mus rau hauv qhov (tsis) thiab lub sij hawm. Tsis yog:

• tshuaj intolerance rau ASA, bronchoconstriction;

• intracranial hematoma qhov chaw txawv;

• hemorrhagic vasculitis ;

• Nws yog txwv tsis pub siv nyob rau hauv cov tub ntxhais hluas thiab cov me nyuam vim txoj kev pheej hmoo ntawm Reye syndrome ;

• Nws yog txwv tsis pub mus txais cov poj niam thaum lub sij hawm lactation, nyob rau hauv kuv thiab III peb lub hlis uas cev xeeb tub.

Tsis tas li ntawd dog dig tag txais tos lub sij hawm thiab txheeb ze contraindications:

• hepatocellular thiab lub raum tsis ua hauj lwm;

• lub xub ntiag ntawm tu ncua los ntshav, thaum ntxov postoperative lub sij hawm (ib ntus contraindication);

• tawg thaum lub sij hawm ntawm ntsoog, uncontrolled tawg;

• rwj 12 duodenal rwj los yog pais plab exacerbation (lub sij hawm txwv).

Ntau los "Atsekardola"

Nyob rau hauv tas li ntawd mus txheem thiab zoo kawm los tshwm sim los ntawm inhibition ntawm COX muaj ACK tshwm sim thiab lwm cov kev txiav txim. Nws twb tau tshwm sim nyob rau hauv ib tug series ntawm statistical cov kev tshawb fawb nyob rau hauv cancer thiab geriatric chaw zov me nyuam nyob rau hauv Teb Chaws Asmeskas. Nyob rau hauv lub chav kawm ntawm lawv muaj pov thawj zoo nyhuv ntawm ASA rau kev tiv thaiv ntawm cov kab mob phem - colorectal cancer txawv localizations.

Tam sim no peb ua pov thawj cov kev mechanism ntawm tus tiv thaiv kev txiav txim ntawm cov tshuaj. Raws li feem ntau soj ntsuam ntawm thiab clinicians pom zoo rau cov predominance ntawm lub inhibitory nyhuv ntawm COX-2 nyob rau hauv lub qis hnyuv. Inhibiting lub synthesis ntawm prostaglandin E2, ACK pub artificially tswj kev puas tsuaj thiab tu tub tu kiv ntawm lub hlwb. Los ntawm txoj kev, qhov no xyov cellular txheej txheem yog central rau cov kev loj hlob ntawm ib tug nqaij hlav.

Xaus nyob rau hauv lub hauv paus ntawm cov pov thawj tseeb muaj raws li nram no: cov tshuaj "Atsekardol" kev qhia ntawv, daim ntawv thov, tiag tiag cov tub txawg uas paub meej tias nws kuas cov nyhuv, kuj yuav siv tau raws li ib tug prophylactic kev tiv thaiv ntawm lub qog dab nyob rau hauv lub qis feem ntawm tus mob huam. Tsis pub dhau 5-12 xyoo tau txais txo txoj kev pheej hmoo ntawm mob cancer tuag, uas yog lawm yuav tsub kom lub lifespan. Cuaj kaum ACK yuav siv tsis tau rau cov kev kho mob ntawm twb tsim colorectal adenoma los yog carcinoma hnyuv.

Analogs npaj thiab cawm

Khoom yam ntxwv "Atsekardol": daim ntawv thov, cov neeg siv, analogs, indications rau antithrombotic kev kho mob koj muaj peev xwm siv nws los kho ntau yam ntawm cov neeg mob. Txawm li cas los, nyob rau hauv ib tug series ntawm antiplatelet agents, nws tsis yog tsuas txhais tau tias. Nyob rau hauv Russia muaj txog 20 generic ACK, ib feem ntawm uas yog nyob rau hauv daim ntawv zheludochnorastvorimoy. Lawv concede cov kev ruaj ntseg spectrum "Atsekardolu".

Enteric ntaub ntawv ntawm cov ASA ( "Cardiomagnyl", "Polokard") tso tawm rau lub pharmacological ua lag luam, ho muaj dua tus nqi. Rau kev npaj "Atsekardol" nqi hlis kho mob yog 25 rubles. Kiag tib yam nrog counterparts nyob rau hauv tib ntau yam ntawm kev ruaj ntseg yog ob-feem-peb ntau. Txawv teb chaws cov tshuaj zoo rau nws di- los yog tsib lub sij hawm siab tshaj tus nqi ntawm kev kho mob ntawm cov nyiaj txiag rau cov tsis muaj khees kev pab rau tus neeg mob uas tau txais cov "Atsekardol". Cov lus qhia rau kev siv, kev kho mob, xyuas, cov nqe lus ntawm analogs ntawm cov tshuaj no kuj zoo tib yam.

Cov lus xaus txog cov kev pab cuam thiab kev txaus ntshai ntawm analogues "Atsekardola"

Tseem lub feem ntau pheej yig, cov tshuaj "Atsekardol" siab raws li cov kev cai ntawm clinicians. Qhov uas nws siv yog balanced nrog rau kev siv cov tswv yim xws li antiplatelet agents. Nws zoo tsis pub recurrent thrombosis ntawm lub plawv thiab cov hlab ntsha ntawm lub paj hlwb, yog siv nyob rau hauv atrial fibrillation, yog siv rau varicose veins. Thiab piv nrog rau regional kom zoo dua analogs "Atsekardola" yog affordability.

Qhov tseeb ho tsub kom qhov tseeb ntawm lub "Atsekardol" khoom: tus nqi ntawm cov tshuaj yog ntau tshaj 20 rubles. Qhov no yog considerably tsawg tshaj li tus nqi ntawm lwm yam antiplatelet agents. Ntxiv mus, ntawm cov tshuaj ASA ua nyob rau hauv lub feem ntau muaj kev ruaj ntseg enteric daim ntawv no, uas yog raws li uas tsis muaj kuas "Atsekardol". Lawm, nws yog najnpawb uas cov kev kho mob ntawm cov kab mob hais los saum no, thiab lawv tiv thaiv. Ib tug xov tooj ntawm daim ntawv thov chaw yuav maj mam nce.