"Clopidogrel": analogue, ukusetshenziswa, manual, intengo

Kwezinye izimo, odokotela umuthi "Clopidogrel"? Yokusetshenziswa, analogs, ifomu ukukhululwa, ukubunjwa, side effects kanye izinkomba ukusetshenziswa lomutsi izokwethulwa ngokuningiliziwe kulesi sihloko. Ngaphezu kwalokho, uyofunda ukubaluleka izidakamizwa kanye neziguli umbono othile ngayo.

Khipha ifomu kanye nokwakheka

ungakwazi ukuthenga izidakamizwa "Clopidogrel" ngayiphi indlela? Umhlahlandlela ibika ukuthi izidakamizwa ikhishwe ngendlela amaphilisi, okuyinto camera nge enamathela ifilimu. Kokunye ibhamuza iqukethe izingcezu 14, ebhange - 14 noma 28, e isixha amakhadibhodi - 1 noma 2 amapuleti bathathe imithi yabo. The main isithako esebenzayo clopidogrel ngefomu hydrogen sulphate. Izingxenye asizayo eziqukethwe ekwakhiweni izidakamizwa ahlanganisa lactose anhydrous, magnesium stearate, isitashi pregelatinized, hydrogenated uwoyela ocolisekileyo, polyethylene glycol 6000 futhi microcrystalline cellulose. Film enamathela, okuyinto camera ithebhulethi ehlanganisa ama-titanium dioxide, hypromellose, aluminium lacquer (okusekelwe udayi Ponceau 4 R), kanye polyethylene glycol 400 futhi 6000 lwenteke nomuthi 'Clopidogrel' (intengo uyoboniswa ngezansi) nge uchungechunge drugstores, kodwa khona kadokotela.

izici kwemithi

Ngo ukwelashwa izidakamizwa, encishisiwe platelet wokuhlanganisa esibangelwa nezinye agonists. Ukulingisa imithi "Clopidogrel" (yokusetshenziswa, intengo, ukubuyekezwa, futhi eziningi neminye imininingwane ewusizo ayatholakala nge-inthanethi kumawebhusayithi abaningi bezokwelapha kanye okwethulwa kulesi iphepha) amahora amabili, esiphezulu ukusebenza kahle akhawunti izinsuku 4-7 ngaphansi kombandela yokwemukela 50-100 mG ngosuku. umphumela Antiplatelet ihlala phakathi nezinsuku ezingu-7 kuya kwezingu-10 kulo lonke isikhathi zokuphila platelet.

Pharmacokinetics

Ngemva kokuphathwa ngomlomo izidakamizwa "Clopidogrel" (75 mg - umthamo ejwayelekile) ngokushesha ugxile kusukela ipheshana emathunjini, ne okuhlushwa engxenyeni liquid igazi luyanda kancane, kodwa ngemva kwamahora angu-2 bese sifinyelela ezingeni okungase kunqunywe (0.025 g / L).

It is kabanzi akheka yi isibindi. I metabolite esiyinhloko esuselwe angasebenzi we carboxylic acid (cishe 85% kokuqala impahla afundwa kakhulu plasma). Isilinganiso lokuhlushwa esiphezulu emva Ukulisebenzisa ngokuphindaphindiwe "clopidogrel" 3 mg / l, ke kungabonakala nasemkhakheni ihora elilodwa emva ukungenisa.

izidakamizwa okusebenzayo kanye metabolite itjhuguluko engekhe yalungiseka nakanjani plasma amaprotheni. Ukuxhumana uhlala ezinganeliseki.

Ngemva kokuphathwa ngemlomo ngaloko lokusandza kwenteka 14C-esibhalwe ukuthi "clopidogrel" cishe ingxenye umthamo livela ukuchama, cishe ngo-46% - indle phezu amahora 120. T1 / 2 we metabolite main - 8 amahora.

Gcwalisa isikhala metabolite kaningi iziguli sifikile engu-75 ubudala, lokhu akushintshi platelet wokuhlanganisa nesikhathi ukopha.

I-plasma yegazi e ezinzima izinso lokuhlushwa metabolite ivela 5 kuya ku-15 ml / imiz, kanti uma isilinganiso isifo kobukhulu kuba 30-60. Naphezu kweqiniso lokuthi umphumela inhibitory in iziguli adenosine diphosphate - eyenga platelet wokuhlanganisa lancipha, lenyuka ukopha isikhathi, kanye amavolontiya aphilile.

ubufakazi

Ingabe uyazi, okuyiwona izinjongo udokotela ekunike umuthi iziguli ngokuthi "Clopidogrel"? Analogs, futhi wamisa nomuthi nokuvimbela yezinkinga thrombotic ka -stroke ischemic, isilethikusebenza kanye neuropathy lwemithambo isifo occlusive. ukwelashwa Ngesikhathi acetylsalicylic acid "clopidogrel" njengoba kuboniswe kweyoku-zokuvimbela izinkinga thrombotic, okuyinto ibe imbangela sibi syndrome senhliziyo.

Izimo

'Clopidogrel' (intengo Pharmacy esifundeni eMoscow imayelana 510 ruble) ukusebenzisa esiphikisayo:

• hypersensitivity;
• ukopha acute;
• syndrome haemorrhagic ;
• ukungakhuli ezinzima hepatic;
• Kuthululwa zokugula intracranial futhi ungalokothi uphuze ekuthuthukiseni ukopha (wamaphaphu isimila, exacerbation of peptic isilonda, hyperfibrinolysis, isifo sofuba);
• ukuntula lactose (ngoba umthamo amafomu equkethe ubisi noshukela), lezinceku galactose ukungabekezelelani, malabsorption syndrome zikashukela-galactose.

"Clopidogrel": ukusetshenziswa kanye umthamo

Izibhebhe ngokulandela imiyalelo, zingafundwa kungakhathaliseki ukudla. Ngokuba nokuvimbela izenzakalo thrombotic in iziguli unhlangothi ischemic noma isilethikusebenza, odokotela linqume nsuku zonke "Clopidogrel" 75 mg. Ngo isifo oyingozi, okuyinto kubangelwa intuthuko ebalulekile necrosis ischemic we imisipha yenhliziyo, ukwelashwa kufanele iqalwe kusukela ezinsukwini zokuqala. yokwelapha nokusetshenziswa "Clopidogrel" - akukho izinsuku ezingaphezu kwezingu-35. Iziguli unhlangothi ischemic kungathatha lokhu imithi izinyanga eziyisithupha. Lapho yezinkinga thrombotic ezivukayo kwezinhlansi ACS ngaphandle oqeda ST ingxenye, impatho isiqalisile nokuthola ukulayisha alahlwayo umthamo (300 mg), futhi laphinde akuthathi ngaphezulu koyedwa ithebhulethi ngosuku. ngempumelelo enkulu siyenzeka emva kwezinyanga ezintathu. Isikhathi yokwelapha nge 'Clopidogrel' (analogs kanye imithi ejwayelekile abekwe ngezansi) kumele singeqi onyakeni owodwa. Against isizinda sibi syndrome senhliziyo nge ST ingxenye kokuphakama evame ukunikezwa 75 mg zomuthi nsukuzonke nge kokuqala ukusebenzisa kwesikhathi esisodwa kwama-izilinganiso ukulayisha lihambisana ejenti thrombolytic futhi acetylsalicylic acid. Uma avele izimpawu, udinga ukuya ukwelashwa. Iziguli engaphezu kwengu-75 yokwelashwa kunikezwa ngaphandle umthamo ukulayisha.

ukweqisa izidakamizwa

On ethola izidakamizwa ngemithamo esingeqile Kunconywa, lokho kufakazelwa ukukhuphuka ngo ukopha isikhathi kanye nezinkinga okwalandela. Ezimweni ezinjalo, uzodinga ukwelashwa okufanele. Esimeni lapho udinga ukulungiswa okusheshayo isikhathi eside ukopha sikhathi, udinga ukumpompela TM. Lingekho ikhambi ethize.

Ukusebenzisana neminye imithi

reception ngesikhathi esisodwa "clopidogrel 'okwakuhambisana nemiphumela warfarin e ukwanda izinga ukopha, yingakho le nhlanganisela engathandeki kakhulu. It kwandisa amathuba ukopha futhi ekwelapheni umuthi lihambisana izidakamizwa nonsteroidal eqeda ukuvuvukala, aspirin, glycoprotein inhibitor futhi heparin.

side effects

Ukwelashwa nomuthi 'Clopidogrel' (umsebenzisi, intengo, indlela yokuphathwa umthamo zichazwe ngokuningiliziwe kule material) kungaholela nemiphumela engathandeki:

• Igazi coagulation uhlelo: enyangeni yokuqala yokwelapha ngokuvamile kuphakama ukopha, hematomas avele; okungenani - ukopha conjunctive; Ezimweni letimele - ukopha intracranial.
• uhlelo hematopoietic: ezimweni ezingajwayelekile - thrombotic purpura thrombocytopenic, granulocytopenia, ukuntuleka kwegazi emzimbeni, kuhlanganise pancytopenia, futhi anaemia aplastic.
• isimiso sezinzwa: ngezinye izikhathi avele ikhanda, paresthesia, isiyezi; ezingavamile - inzululwane; Ezimweni letimele - ukudideka kwengqondo futhi babone izinto ezingekho.
• imithambo yegazi nemithambo ye inhliziyo, ngokuvamile akhiwa hematoma; Ngezinye izikhathi kufanele ezinzima ukopha, vasculitis, kwehlisa blood pressure.
• uhlelo zokuphefumula: epistaxis, bronchospasm, ukopha yamaphaphu, pneumonitis interstitial, hemoptysis.
• ipheshana wokugaya ukudla: uhudo, dyspepsia, ubuhlungu besisu, ngopha ipheshana wokugaya ukudla, kolwelwesi kanye isilonda esiswini, ukuhlanza, ukuqumba, isicanucanu, ukuqunjelwa, ukopha retroperitoneal, nesifo, pancreatitis, stomatitis, yokwehluleka kwesibindi acute, isifo sokusha kwesibindi, kukhuphuke enzyme isibindi.
• uhlelo zemisipha: arthralgia, myalgia, Arthritis.
• Skin: bullous ukuqubuka (Stevens-Johnson syndrome ne anobuthi epidermal necrolysis, erythema multiforme), eczema, ukuqubuka erythematous, futhi ulele planus.
• System urinary: hematuria, hypercreatininemia, glomerulonephritis.
• komzimba: edema angioneurotic, ukugula serum, urticaria, pseudoallergy ukuphendula.

Lapho ukwelashwa nale imfiva izidakamizwa kuyaqabukela waphawula, okungasekelwe beqonda ngenxa ethola nomuthi, futhi njengoba uphawu umkhuhlane.

Izixwayiso

Medicine "Clopidogrel" ngokucophelela okukhulu uma nithatha awokuthi ukopha ngenxa ukungenelela kuhlinzwa, iziyaluyalu hemostatic. Uma ukuhlinzwa lapho zidingeka, futhi antiplatelet nomphumela engathandeki kakhulu kusukela nokuphathwa izidakamizwa kumelwe zilahlwe sonto ngaphambi kwesikhathi esimisiwe bokuhlinzwa. imithi ukunakekelwa ngokukhethekile engabelwe okunzima umsebenzi sesibindi, okungase kubangele oluhambisana diathesis. Uma izimpawu ukopha kakhulu, kudingeka sitadishe uhlelo hemostatic. Ngaphezu kwalokho, isidingo njalo ukusebenza umsebenzi obusebenzayo kwesibindi. Isexwayiso "Clopidogrel 'lisetshenziswa heparin, ama-NSAID, warfarin. Lapho siqhuba izifundo zokuhlola abuthole umphumela umdlavuza futhi genotoxic zomuthi, ngaphezu, ungabeki umthelela ukulawulwa kwezimoto umthamo.

"Clopidogrel": analogs kanye imithi ejwayelekile

Synonyms (analogs) izidakamizwa - umuthi kokuba isenzo esifanayo noma kokuba ukwakheka efanayo. Imiphi imithi Ungashintshanisa imithi "Clopidogrel"? Analogs ukulungiselela we ketshezi esebenzayo okulandelayo: "Kardutol", "Detromb", "Agregal", "Trombeks", "Klopilet" "Trocken", "Plavix", "Plagril", "Plogrel", "Targetek", "Egitromb" "Clopidogrel Teva,".

izidakamizwa ngamunye sinezici ezahlukene, ngakho ukusetshenziswa kuvunyelwe kuphela emva kokubonisana udokotela wakho.

Imibono ephathelene imithi

Okushiwo ngabantu mayelana nokulungiselela ezifana "Clopidogrel"? Izibuyekezo ekubulaleni iziguli ezigulela kwadingeka ithuba ukuze uthumele izifo ezinzima kanye nokungenelela kuhlinzwa akhayo kakhulu. Iziguli ukubika okusezingeni eliphezulu isinyathelo efanele nomuthi, it is nokho ayenzelwanga reception ukuze zokuzelapha. Analogue izidakamizwa ukusiza iziguli ukhethe best ngabafuna ratio intengo nekhwalithi, kodwa injongo kanye nokuphumelela ukulawula kufanele esiphathiswe uchwepheshe abanolwazi.