Antiplatelet vamiririri: mazita zvinodhaka. Anticoagulants uye antiplatelet nevasori, unhu hwavo

Kuwedzera ropa kunowanzokonzera thrombosis, iyo inotungamirira kuupenyu zvikuru nemigumisiro, kusanganisira rufu. Pharmacology mberi kubvumira kuponesa upenyu varwere zvinetso zvakadaro nokuda yokuzvigadzirisa kurapa sezvo kugamuchira zvinodhaka antiplatelet.

Ndezvipi anticoagulants?

Rheological ehupfumi ropa pakati nepakati coagulation uye anticoagulation enyika. Kuramba takatsiga ichi sechipo dzinongoitika anticoagulant chinhano antithrombin III uye heparin, iyo inoshanda yakananga antithrombotic basa, ndiko, kutadzisa paumbwe ropa clot. The mashandiro chiito weava inobatanidzwa chokuumba zvakaoma pamwe antithrombin III, zvichiguma nokuumbwa chinoshingaira antithrombin. Iyewo ndiye basa Maisungirwa kuti thrombin, zvichiita basa - rinobatsira kuti chinovhiringidza pamusoro thrombus inotungamirwa. Zvisinei, Antithrombin III pachachowo ane anticoagulant ehupfumi kubudikidza inactivating thrombin, maitiro anoenderera zvishoma nezvishoma.

Mano heparin kuitira inactivation pamusoro thrombin kunoenderana uwandu antithrombin III muropa. Raida dose kuchinja kunodiwa inobva kuongorora. Kazhinji zvinoda kugadzwa zvinodhaka maviri kamwechete - heparin uye antithrombin III, panguva iyoyo chipimo chemushonga vanosarudzwa mumwe nomumwe nomumwe munhu.

Unosungira kuti antithrombin - kwete chete mashandiro heparin. Uyezve, iye anokwanisa kuputsa fibrin pasina kutora chikamu plasmin, anonzi non-enzymatic lysis. Uku kuita paumbwe yeimwe siyana pakugadzira vanoshingaira zvinhu, kusanganisira peptides uye mahormone. Pakati pezvimwe zvinhu kusiyanisa kudzvinyirira vanoverengeka makemikari zvinobatanidzwa kushoma (kunoderedza kusimba kwayo), uyewo activation kuti lipoprotein lipase uye kuvandudza ropa riyerere mumwoyo midziyo.

Ndeipi antiplatelet vamiririri?

Kugadzirira anticoagulants uye antiplatelet yomuchipatara vari zvinobudirira inoshandiswa mukurapa. Zita iri akagamuchira mari, izvo tunodzivisa chokuedza (aggregation) masero eropa - masero matsvuku eropa uye maplatelet. The mashandiro chiito izvi zvinhu zvakasiyana, izvo akabvumira mapoka akawanda. Antiplatelet vamiririri, zvakadzama mazita zvinodhaka izvo dzinoiswa sezvinotevera.

1. Karusiyamu mhandu ( "Verapamil").
2. Enzayemu FIs, izvo zvinosanganisira zvinhu anovhiringidza cyclooxygenase (acetylsalicylic acid, "naproxen", "Indomethacin") uye adenylate cyclase uye phosphodiesterase ( "Ticlopidine", "Pentoxifylline").
3. Mishonga inotokonya paumbwe prostacyclin ( "pirazolinov").
4. Prostanoids ( "Prostacyclin" uye ayo analogues ose chakaita zvokugadzirwa mavambo).
5. Zvinodhaka kuti vamise okuyerera zvinhu zviri maplatelet ( "Pyracetam").

umboo

Antiplatelet zvinodhaka - zvinodhaka mazita anozivikanwa nevakawanda nokuda kwazvo kushanda. The chikuru basa boka iri - kubva thrombosis prophylaxis. Antiplatelet zvinodhaka - zvinodhaka kuti zvinobudirira kushandisa nenzira dzinoverengeka zvemwoyo pathologies, uyewo pashure pokuvhiyiwa (prosthetic mwoyo mavharuvhu).

Antiplatelet vamiririri: mazita zvinodhaka izvo yaiwanzoshandiswa okurapa

Zvinodhaka kuti muri boka iri, zvikuru zvakawanda, uye vose vane peculiarities dzavo. Kusarudza mushonga kunobva kunotoda nyaya. Uye, chokwadi, dzokuzvirapa mumamiriro ezvinhu hakuna kunaka.

"Asipurini"

In murau pakati hemostasis eicosanoids unobatanidzwa izvo zviri oxidation ose arachidonic acid. Pakati chinonyanya kukosha thromboxane A2, uye ayo chikuru nerevane - kuona platelet aggregation. Kuitwa asipurini inoendeswa chinovhiringidza ane enzayemu, inonzi cyclooxygenase. Somugumisiro kwetunhu iri woutsinye tomboksana A2, saka hwakaipa thrombus inotungamirwa pezvakaitwa. Kuvhiringidzwa kunowedzera apo kuzodzosera kutora mushonga nokuda kuwanda. Nokuti chinovhiringidza kuti cyclooxygenase zvaida daily yaunodya zvakakwana. The optimum chipimo chemushonga kunoderedza mukana wokuti nemishonga, "asipurini" kunyange kuramba kushandiswa. Dose panova nezvisingabvumwi, sezvo pane mukana ropa yematambudziko.

"Ticlopidine"

The zvinodhaka kwakavakirwa ichivharira zvimwe receptors kuti vane basa ropa. Kazhinji, kana iwe kubatanidza kwavari pane kuchinja ADP platelet aggregation kwakamutsa uye shaped, uye "Ticlopidine" kuchititadzisa izvi. A chepfungwa antiplatelet mumiririri ari mukuru bioavailability, izvo zvinoitwa kumhanya kubvisa. Pashure hwekubvisa kushanda ari kuchengetwa kunyange kwemazuva 3-5. The drawback ndiyo vakawandisa nemishonga, kusanganisira zvakajairika kuda kurutsa, manyoka, kupererwa neropa uye agranulocytosis.

"Clopidogrel"

Antiplatelet yomuchipatara maererano mhando chiito hwakafanana "ticlopidine", asi ayo anobatsirwei vade yakaderera toxicity. Uyezve, mukana nemishonga kana kutora zvinodhaka uku dererei zvikuru. Parizvino vanachiremba kupa kupfuura "clopidogrel" nokuda kusavapo yematambudziko akadai agranulocytosis uye thrombocytopenia.

"Eptifibatide"

The mushonga anopa aggregation kuburikidza rakavhara glycoprotein, riri munzvimbo platelet membrane. Basa nokuti intravenous bolus, kazhinji zviri angina uye angioplasty kuderedza mukana wokuti myocardial infarction.

"Dipyridamole"

The chikuru mugumisiro mushonga - zvaanoda vasodilatation, kureva kuwedzera midziyo ropa, asi akaratidza antiplatelet kushanda ari kuchengetwa kana kubatanidzwa nemamwe zvinodhaka. "Dipyridamole" vakagadzwa ne "asipurini", kana paine mukuru mukana ropa. Zvinogonekawo chokubatanidza ne "warfarin", kuti zvinobudirira rinoshandisirwa mushure prosthetic mwoyo vharuvhu kuderedza mukana wokuti embolisms. In monotherapy nezvinozoitika zvishoma raidudzwa.

zvinodhaka Antiplatelet - zvinodhaka (zvawanyora: "Elikvis", "clopidogrel" uye vamwe), iri zvinowanzoshandiswa uchidzidzira.

Contraindications

Kudomwa antiplatelet kurapa zvinoda kungwarira kare, izvo zvinosanganisira mashoko comorbidity. In paine chirwere ari contraindication pakugamuchira mishonga iri boka iri, nokururamiswa kurapwa urongwa. Muzviitiko zvakadaro, munhu pakusarudza munhu zvinodhaka uye dzavo dosages, uye kurapwa rinoitwa pasi kuzviomesera zvokurapa achitarisirwa. Hapana nyaya anofanira yakazvimirira kugadzwa antiplatelet vamiririri, nokuti migumisiro yacho inogona kuva nengozi.

The mazita contraindications:

• Kurwara;
• Hemorrhagic diathesis;
• nengozi ropa;
• chakakomba chiropa uye itsvo insufficiency;
• munhoroondo arrhythmia;
• BP, yakanyanya;
• obstructive zvirwere kufema hurongwa;
• Children zera (nokuti zvinhu zvikuru).

Mukuwedzera, vakawanda antiplatelet nevasori (pamazita zvigadzirwa kudzokororwa munyaya ino) vari contraindicated panguva yepamuviri uye lactation. Panguva iyi, inofanira vaifarira mishonga kuti vakachengeteka nokuti mwana uye nokuda mai.

Antiplatelet yomuchipatara. Zvinodhaka: mazita pamuviri

Kana mukaputsa fetus kuparadzirwa mukana pamuviri. Fani iyi inonzi fetoplacental insufficiency. Kana mukaputsa chokuendesa okisijeni kusvikira ropa mudumbu kusimukira zvikuru hypoxia, izvo vanotyisidzira haangogoni zvakasiyana kwayo kukura, asi rufu. Kana diagnosing munhu zvokurwara kunoda nokukurumidza kurapwa randinogara kuwedzera ropa aibuda, achidzikisa ropa viscosity. Nokuti ichi uye akagadzwa antiplatelet nevasori Zvisinei, ziva kuti havasi vose zvinodhaka muboka iri vakachengeteka panguva yepamuviri. Possible kushandisa chete vamwe mari.

"Kurantil"

The mushonga kwakakurumbira chaizvo nokuti kuti ayo mazita contraindications hapana nepamuviri uye achiyamwa. Active chirungiso "chime" - kare akatsanangura dipyridamole, iyo dilates midziyo ropa uye kuchititadzisa thrombus inotungamirwa. It kunonatsiridza ropa aibuda myocardial, achivimbisa hurukuro runodiwa okisijeni. Nenzira iyi, K "Urantia" rinogona kushandiswa pamberi zvemwoyo chirwere vakadzi vane pamuviri. Zvisinei, mukuru chiratidzo nokuda nhumbu zviri placentofetal kukundikana. Nokuvandudza rheological zvivako ropa uye vasodilatation, ekudzivirira clogging nhumbi placenta, saka mudumbu hakuiti kutambura hypoxia. Chimwe mukana zvinodhaka anganzi immunomodulating kushanda. The mushonga kunomutsa kugadzirwa interferon, nokudaro kuderedza ngozi nemavhairasi nezvirwere mai. Kunyange zvazvo "Kurantil" uye kunogona kushandiswa panguva pamuviri uye lactation, asi tinofanira chete taurira izvozvo kana akaratidza. Nepo kutora mushonga unofanira kuderedza kudyiwa yetii uye kofi pavanenge kudukupiswa kugona kwaro. Antiplatelet zvinodhaka - zvinodhaka (zvakarongwa pamusoro apa) kuti hakufaniri pamwe mvura yakadaro. Kunyange zvazvo pamuviri haina akavayambira kuti vaite chero nzira.

Antiplatelet vamiririri, mazita zvinodhaka zvinosanganisira hwakawanda mazita, anoshandiswa zvinobudirira pakurapa zvirwere kumwoyo. Zvisinei, kuziva zvinoita yematambudziko chokuita yadzikira ropa viscosity uye pakugwamba chinovhiringidza. zvinodhaka Antiplatelet - mishonga inogona kushandiswa chete pasi kutarisira kupinda chiremba, achaita kunhonga anodiwa chipimo chemushonga uye yawapiwa.