Noj qab haus huv, Npaj
"Plagril": cov lus qhia rau kev siv, tiag tiag cov kws kho mob. Drug analogues "Plagril"
Cov kab mob ntawm cov hlab plawv system yog nyob rau hauv niaj hnub tshuaj tej zaum nyob rau hauv thawj qhov chaw. Lub neej no tus nqi los ntawm cov kab mob yog siab tshaj plaws. Muaj teeb meem nyob rau hauv cov cheeb tsam no uas yuav muaj dab ib tug neeg los ntawm lub caij yug. Txawm li cas los, muaj cov neeg nyob rau hauv uas ib tug neeg tus kheej txoj kev loj hlob theem loj "pab". Ib tug xws li tus kab mob - atherosclerosis. Yog hais tias qhov teeb meem no muaj feem xyuam rau mas cov hlab ntsha saj zawg zog thiab elastic nqaij hom. Lub essence ntawm tus kab mob nyob rau hauv hais tias, vim kev ua txhaum uas muaj protein ntau thiab lipid metabolism noog nyob rau hauv cov hlab ntsha ntawm cholesterol deposits thiab tej yam cov pej xeem ntawm lipoproteins. Yog li tsim atherosclerotic plaques. Thaum lub sij hawm, lub connective cov ntaub so ntswg ntawm ntsha nyob rau hauv cov plaques nthuav, uas ua rau ib tug narrowing ntawm lub lumen ntawm leeg kom txog thaum lub occlusion.
Nyob rau hauv thiaj li yuav pab tau cov neeg mob, cov neeg tshawb fawb tau tsim ib daim ntawv teev cov tshuaj uas yuav qeeb los yog kiag li suppress lub aggregation txheej txheem (tebchaw, tsevneeg) ntawm platelets. Tshuaj nrog xws li muaj peev xwm yog hu ua antiplatelet (antithrombotics). Ib tug xws li tshuaj yog "Plagril".
Qauv thiab pes tsawg leeg
Lub mechanism ntawm yeeb tshuaj
Cov tshuaj yog ib lub inhibitor (inhibit - inhibit, suppress tej txheej txheem) aggregation (compound) platelets. Nws muaj koronarorasshiryayuschee kev txiav txim. Txheej txheem deceleration platelet aggregation (hais txog 40%) muaj peev xwm yuav pom tom qab 2 xuab moos tom qab haus ntawm cov tshuaj nyob rau hauv ib tug ntau npaum ntawm 400 mg. Nyob rau hauv thiaj li yuav ua tau nyiaj pab ntau tshaj efficiency (60% inhibition ntawm aggregation) los ntawm cov ntsiav tshuaj "Plagril", cov lus qhia rau kev siv raws li qhov yuav tsum tau rau txoj kev kho rau 4-7 hnub. Tag nrho cov koob tshuaj ib hnub twg yuav tsum tau los ntawm 50 mus rau 100 mg. Nyob rau hauv cov ntaub ntawv no, antiplatelet nyhuv yuav kav rau lub neej tag nrho lub voj voog ntawm platelets (7 mus rau 10 hnub). Tsis pub dhau 5 hnub tom qab tshuaj ntsoos ntsoos tus nqi ntawm platelet aggregation, thiab los ntshav lub sij hawm rov qab mus rau thawj lub ua tau zoo.
Tas "Plagril" raum thiab hnyuv (50% thiab 46% feem). deducing sij hawm - 120 lub sij hawm tom qab thawj coj.
Lub ntsiab tau txais kev pab ntawm "Plagrila"
Tshwj xeeb cov pab pawg neeg ntawm lub plawv cov neeg mob uas muaj qhia ua ntaub ntawv thov cov tshuaj "Plagril". Cov lus qhia yuav tsum tau siv sij hawm ib tug yeeb tshuaj rau cov neeg kev txom nyem los ntawm atherosclerosis. Tshuaj yog zoo li ib tug tiv thaiv kev ntsuas los txo cov kev pheej hmoo ntawm cov teeb meem txuam nrog rau thrombosis nyob rau hauv cov neeg uas tau muaj ib tug myocardial infarction los yog ischemic stroke. Nws kuj muaj tseeb rau cov neeg mob kev txom nyem los ntawm cov occlusion (lub deterioration ntawm permeability) peripheral hlab ntsha.
Nyob rau hauv tandem nrog acetylsalicylic acid (aspirin) tej zaum yuav siv "Plagrila" nyob rau hauv thiaj li yuav tiv thaiv kom txhob thrombotic teeb meem nyob rau hauv cov neeg uas raug kev txom nyem los ntawm mob coronary syndrome. Qhov no yuav muaj xws li cov neeg uas muaj angina (tsis ruaj tsis khov daim ntawv), nrog rau heart attack myocardial infarction tsis yoj tsim Q. Koj siv tau cov tshuaj nyob rau hauv cov neeg mob uas underwent stenting. Lub essence ntawm lub lag luam - installation nyob rau hauv lub cov ntsha stent (nyias zoo-meshed hlau raj), uas yog tom qab inflated tshwj xeeb zais pa, li no ua lub permeability ntawm cov hlab thiab kev txhim kho cov ntshav txaus rau lub plawv.
Ntau npaum: daim ntawv thov hom
Tshuaj "Plagril" cov neeg mob yuav tsum noj ntawm ncauj, tsis hais txog ntawm cov khoom noj. Nyob rau hauv cov neeg mob niaj myocardial infarction, ischemic stroke los yog tsim mob txog cov patency ntawm cov hlab ntsha deterioration, lub koob tshuaj ntawm 75 mg coj ib hnub ib zaug. Lub sij hawm ntawm kev kho mob kho tom qab Q-yoj myocardial infarction yuav kav mus txog 35 hnub. Nyob rau hauv ischemic stroke, nyob ntawm seb qhov heev ntawm tus mob, kev kho tej zaum yuav yog los ntawm 7 hnub rau rau lub hlis.
Thaum tus cwj nrag nyob rau hauv ib tug tsis ruaj tsis khov daim ntawv no, thiab myocardial infarction tsis muaj tus tsim ntawm Q-yoj yog feem ntau ib tug standard regimen ntawm cov ntsiav tshuaj no yog raws li nram no: ua ntej, ib tug-lub sij hawm loading koob tshuaj ntawm 300 mg, ua raws li los ntawm 75 mg ib hnub twg nrog rau cov tshuaj aspirin (75 rau 325 mg ib hnub twg). Vim hais tias qhov tsawg ntawm cov tshuaj aspirin tsub kom qhov uas yuav los ntshav, lub siab tshaj plaws ib koob tshuaj yuav tsum tsis txhob ntau tshaj 100 mg. Tshuaj kho mob - txog li 1 xyoo.
txais tos "Plagril" antiplatelet txoj kev kho no kuj qhia rau cov mob myocardial infarction. Muab tshuaj rau noj rau ntawm ib koob tshuaj 75 mg, nyob rau hauv ib hnub. Nws yog pom zoo kom pib kho mob nrog rau cov thawj cov chaw thau khoom koob tshuaj nyob rau hauv ua ke nrog nrog acetylsalicylic acid. Tej zaum nyob rau hauv thaum uas tig mus kev thrombolytics (los yog tej zaum yuav tsis coj).
Yog hais tias cov neeg mob tau hla 75 xyoo ntawm lub hnub nyoog txwv, "Plagril" (zoo li clopidogrel kuj yog siv tau thiab) yog tsa tsis muaj ib tug thawj zaug loading koob tshuaj. Tom qab cov tsos ntawm cov ua ke kev kho mob ntawm cov tsos mob yuav tsum tau pib li thaum ntxov li sai tau. Hoob no yuav tsum kav tsawg kawg yog 4 lub lis piam.
Tau tshwm sim los ntawm
Thaum lub sij hawm hauv chav kawm ntawm kev kho mob nrog cov kev npaj "Plagril" phau ntawv qhia qhia hais tias ib tug ntau yam ntawm tej kev phiv los ntawm ntau yam systems thiab kabmob.
ntshav system yuav feem ntau teb mus rau lub tsos ntawm txoj hnyuv los ntshav. Tsawg nquag yuav tsim hemorrhagic stroke, ntshav los ntawm lub qhov ntswg thiab, nyob rau hauv Feem ntau, qhov kev nce rau hauv los ntshav lub sij hawm. Nyob rau hauv tsawg tus neeg mob, tej zaum yuav tshwm sim hematomas, hematuria.
Ntau yam qhia los ntawm cov hemopoietic system. Cov no muaj xws eosinophilia, neutropenia, thrombocytopenia. Ho yuav tsis tsim granulocytopenia, yooj yim los yog aplastic anemia.
Nyob rau hauv ib feem ntawm lub hauv paus thiab peripheral lub paj hlwb tej zaum yuav mob taub hau, kiv taub hau, paresthesia, kiv tauv hau (tsis tshuav nyiaj li cas, nrog los ntawm ib tug txiav txim zoo ntawm kev sib hloov ntawm cov khoom nyob ib ncig ntawm lub cev, los yog vice versa - lub cev ntawm kev sib hloov), hallucinations, tsis meej pem. Heev tsawg, tab sis tus neeg mob kev phiv xwm txheej tshwm sim nrog cov hlab plawv system, nyob rau hauv cov nqe lus ntawm tsis muaj ntshav siab, vasculitis txoj kev loj hlob. Bronchospasm thiab interstitial pneumonitis - qhov no tej zaum yuav ua tau ib tug tshuaj tiv thaiv ntawm lub pa system yuav tau txais cov tshuaj no.
Feem ntau cov feem ntau nyob rau hauv cov tshuaj "Plagril" (xyuas ntawm cov kws kho mob thiab cov neeg mob paub meej tias qhov no fact) reacts digestive system. Cov tshuaj tiv thaiv ntawm lub cev yog manifested nyob rau hauv txoj kev loj hlob ntawm kev zawv plab, dyspepsia, mob plab. Tsawg ntau tau tshua xws li xeev siab, ntuav, quav tawv, mob gastritis thiab pais plab thiab duodenal ulcers, flatulence. Tsis tshua muaj tab sis tau tshwm sim ntawm cov kab mob xws li mob plab, pancreatitis, stomatitis, kab mob siab, kho saj, kev loj hlob ntawm mob siab ua hauj lwm.
Osteo-npag system yuav tshaj tawm nws tus kheej kev mob caj dab, myalgia. Txawm hais tias nws tshwm sim tsis tshua. Glomerulonephritis tej zaum yuav raug los ntawm cov tshuaj tiv thaiv ntawm lub urinary system. Dermatologists hais tias ib tug ua tau qhov tsim nyog tau muaj ib tug "Plagrila" yog khaus, bullous pob, erythematous pob, Lichen planus, eczema. Tej zaum qhov kev loj hlob ntawm kev tsis haum tshuaj nyob rau hauv daim ntawv ntawm cov angioedema, anaphylaxis, ntshiab kev mob kev nkeeg. Ntawm cov tshwm sim muaj tau muab sau tseg ua npaws, kom ntshiab creatinine.
Txoj kev siv "Plagrila": dab tsi mus nrhiav
Yog hais tias rau ib qho teeb meem no yog undesirable antiplatelet cawv, los yog yuav tsum rau kev phais, koj yuav tsum rho cov kev kho mob nrog "Plagril". Cov lus qhia rau kev siv kom ua tau li ntawd tsawg kawg yog 7 hnub ua ntej rau kev phais. Tom qab lub abolition ntawm cov tshuaj kom tsis txhob mam li nco dheev pib los ntshav yuav tsum tau ntau lub sij hawm. Cov neeg mob yuav tsum tau ceeb toom txog nws thiab qhia mus qhia rau tus kws kho mob txog txhua yam txawv los ntshav. Nyob rau hauv cov kev txaus siab ntawm tus neeg mob mus qhia rau tus kws kho mob txog cov kev kho mob ntawm "Plagrilom" nyob rau hauv cov neeg mob, yog tias yuav tsum tau kev phais, los yog tus neeg mob yog muab rau tej cov tshuaj tshiab.
Nyob rau hauv lub chav kawm ntawm kev kho mob kho yog ib qho tseem ceeb kom nyob rau hauv kev tswj ntawm lub system tsis muaj homeostasis (platelet suav, kev ntsuam xyuas ntawm kev haumxeeb ua si, APTT). Lub haumxeeb ua si ntawm lub siab thiab yuav tsum tsis tu ncua saib xyuas thiab soj ntsuam raws li yam mob loj heev deviations nyob rau hauv nws cov hauj lwm yuav ua rau kom txoj kev pheej hmoo ntawm hemorrhagic diathesis.
Medicaments, uas nws lub ntsiab active khoom sib ua zaub mov yog clopidogrel ( "Plagril" analogs), yog tsis pom zoo rau cov neeg uas tau raug kev txom nyem ib tug mob myocardial infarction, yam tsawg kawg thaum lub sij hawm thawj ob peb lub lis piam tom qab pib. Kev kho mob cov tub txawg tsis tau hais kom "Plagrilom" txoj kev kho yog hais tias tus neeg mob muaj tsis ruaj tsis khov angina, nrog ischemic stroke nyob rau hauv coronary bypass phais.
Nrog ib qhov nqi ntawm kev ceev faj yuav tsum tau siv sij hawm ib tug yeeb tshuaj rau cov neeg muaj kev tsis taus nyob rau hauv lub hauj lwm ntawm ob lub raum.
Yuav kom counter-txais tos "Plagrila"?
"Plagril" (ntsiav tshuaj) qhia txwv tsis pub cov neeg mob uas npau taws me ntsis los yog intolerance rau tus neeg tseem ceeb thiab tej koom haum Cheebtsam ntawm lub medicament. Tsis txhob noj cov tshuaj no thaum twg cov kab mob predisposing rau los ntshav (pais plab thiab duodenal ulcers, hyperfibrinolysis, mob ntsws cancer, tuberculosis, etc.). Ib tug muaj zog paus rau cov uas tsis yog-siv "Plagrila" yog mob hepatic tsis ua hauj lwm, hemorrhagic syndrome. Nyob rau hauv tas li ntawd mus rau saum toj, yog txhob noj tshuaj rau cev xeeb tub cov poj niam thiab niam. Tsis muab cov tshuaj rau cov me nyuam nyob rau hauv 18 lub xyoos ntawm hnub nyoog.
npaj analogues
Nyob rau hauv lub chaw ua tshuaj ua lag luam niaj hnub no, ib tug pab pawg neeg ntawm cov tshuaj antiplatelet agents ( "Plagril" txhais nws cov ntsiab lus ntawm lub ntsiab active Cheebtsam) muaj txaus lug. Ntau tshaj 3 lub teb tshuaj - antiplatelet agents muaj tib lub active ingredient (clopidogrel) thiab nyob rau tib lub npaum (75 mg). Sib nrug los ntawm Lavxias teb sab manufacturers tsim antiplatelet Indian kws tuam txhab uas muag, qhauj Hungary, Ua Ixayees, Malta, Fabkis.
"Dr. Reddies Laboratories" "Plagril" nws tus kheej ua ib tug Indian lub tuam txhab. Los ntawm analogy, peb yuav muaj xws li cov Fabkis "Plavix" German "Clopidogrel Ratiopharm," Hungarian "Clopidogrel-Richter," Israeli "Clopidogrel Teva," Maltese "Liporel" Makadaunias "Listab 75". "Zilt" yuav cais los ntawm cov nto moo tshaj plaws thiab dav nyob rau hauv kev thov Lavxias teb sab nrog.
"Zilt" - Lavxias teb sab "Plagril"
Lub ntsiab active tshuaj ntawm cov kev npaj "Zilt" ( "Plagril" nyob rau hauv hais tias nws yog tag nrho raws li) yog clopidogrel. Tshuaj belongs rau cov pab pawg neeg ntawm cov neeg ua hauj antiplatelet. Cov thawj zaug koob tshuaj (rau "Zilt" - 400 mg) tom qab 2 xuab moos tom qab thawj coj slows platelet aggregation. Ib yam li "Plagril", "Zilt", yog muab hais txog kev txais 50-100 mg ib hnub twg yuav muab lub siab tshaj plaws kho nyhuv tom qab 4-7 hnub.
Medicament metabolized nyob rau hauv lub siab. Lub pes tsawg leeg ntawm cov ntshav ntawm active metabolites yog kuaj. Kwv yees li 50% "Zilta" tas los ntawm ob lub raum, lub tshuav 46% tsis pub dhau 5 hnub tom qab txais yuav rho los ntawm cov hnyuv.
Indications rau kev siv ntawm tus "Zilta" yog tib yam li nyob rau hauv "Plagrila": kev tiv thaiv ntawm thrombus tsim nyob rau hauv cov neeg mob niaj myocardial infarction, ischemic stroke los yog kev txom nyem los ntawm kev ntshawv siab leeg patency.
neeg lub tswv yim
Zoo li tej yeeb tshuaj, cov "Plagrila" muaj ob zoo kev ntsuam xyuas ntawm cov neeg, ob leeg zoo thiab tsis zoo xyuas. Muaj cov neeg mob nyob rau hauv uas cov tshuaj tau raug taw rau cov kev kho mob ntawm angina thiab qhia nws tus kheej ib tug heev zoo tshuaj. Nrog nws cov kev siv ntawm cov kev tawm tsam coj qhov chaw los yog nyob rau tag nrho cov, los yog lawv tau los ua considerably tsawg. Ua ke nrog cov neeg muas zaub nyob rau hauv qhov kev luj xyuas ntawm cov tshuaj "Plagril" teb los ntawm cov kws kho mob.
Txawm li cas los, koj yuav tau ntsib thiab pom txog tej kev phiv los ntawm kev siv cov tshuaj. Ib txhia neeg sau txog cov tsos ntawm doog, lwm leej lwm tus kom meej meej manifested anemia. Lawv cov neeg mob thiab lub sijhawm uas nws mob mob taub hau, thiab qhia sib txawv heev mob nyob rau hauv lub digestive system. Tsis tshua muaj, tiam sis yuav tsum hnov nyob rau advanced nyob rau hauv tus txheej txheem ntawm tau txais "Plagrila" pais plab rwj los yog duodenal rwj.
Nyob rau hauv kev, nws yuav tsum tau hais tias cov tshuaj "Plagril cov lus qhia rau kev siv yog positioned raws li ib tug loj heev txaus tshuaj yog tsis tau tshaj rau tag nrho cov tshuaj. Muaj ib tug ncaj uas nws kim heev daim ntawv teev cov contraindications, yuav ua tau ib tug ntau ntawm cov kev phiv los ntawm ib tug ntau yam ntawm lub thiab kabmob. Tsis ceev faj siv yuav hnia txaus tsis zoo (thiab tej zaum kuj irreversible) txim rau lub noj qab haus huv ntawm tus neeg mob.
Qhov xaus ntawm tag nrho cov saum toj no yog nws tus kheej-tsheev. "Plagril" rau cov kev kho mob kawg yuav tsum raug taw los ntawm lub mus kawm tus kws kho mob. Thiab qhov zoo tshaj plaws kev xaiv ntawm kev kho mob nrog cov tshuaj no - nyob rau hauv ib tug lub tsev kho mob thiab nyob rau hauv lub saib xyuas ntawm uas cov kws txawj. Tsuas yog nyob rau hauv cov ntaub ntawv no peb yuav cia siab rau ib tug zoo ntxim ntawm cov tshuaj muaj tsawg heev uas yuav muaj tshwm sim.
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