"Clopidogrel": analogues, kushandiswa, manual, mutengo

Mune mamwe mamiriro ezvinhu, vanachiremba mishonga "Clopidogrel"? Mirayiridzo yokushandisa, analogs, kusunungurwa chimiro, akafanana, nemishonga uye zvairatidza kuti kushandisa mushonga uyu zvichakurukurwa zvakadzama munyaya iyi. Uyezve, uchadzidza kukosha zvinodhaka uye varwere maonero nezvazvo.

Release chimiro uye sezvamunoita

unogona kutenga zvinodhaka "Clopidogrel" In ipi? Guide inoshuma kuti mushonga ukasunungurwa muchimiro pamahwendefa, izvo zvinenge zvakazara firimu unhani. Mune imwe mhoni rine zvidimbu 14, mubhangi - 14 kana 28, ari makadhibhokisi svinga - 1 kana 2 pamahwendefa pamwe nemishonga. The chikuru achishingaira chinoita ndiyo clopidogrel mu rehydrogen sulphate fomu. The ebetsero zvinoriumba zviri zvinodhaka Pfungwa zvinosanganisira anhydrous lactose, magnesium stearate, pregelatinized starch, hydrogenated mafuta Castor, polyethylene glycol 6000 uye microcrystalline cellulose. Film bemhapemha, izvo zvemapuranga piritsi zvinosanganisira titanium dioxide, hypromellose, aruminiyamu lacquer (inobva dhayi Ponceau 4 R), uye polyethylene glycol 400 uye 6000 chinozoiswa medicament 'Clopidogrel' (mutengo kucharatidzwa pazasi) Via ngetani drugstores, asi chete pamberi Hupenyu.

pharmacological unhu

In kurapika, akaderedza platelet aggregation vakafurira nedzimwe agonists. Vachiita mushonga "Clopidogrel" (mirayiridzo kushandiswa, mutengo, ongororo, uye mujenya nezvimwe mashoko anobatsira anowanikwa ari zhinji wezvokurapa Websites uye akapa pepa rino) kwemaawa maviri, kunonyanyisa kushanda nyaya kwemazuva 4-7 pasi mamiriro rubvumo 50-100 MG pazuva. Antiplatelet zvazviri rinovapo pakati 7 kusvika 10 mazuva yose ya platelet upenyu.

Pharmacokinetics

Pashure zvokuudzwa kwokubatsira mushonga "Clopidogrel" (75 MG - mureza dose) yava kunyura kubva nemudumbu, pamwe wevasungwa iri mvura mugove ropa ichiwedzerwa zvishoma, asi pashure 2 maawa uye anosvika pamwero iyo inogona tsunga (0.025 g / L).

Zvinonzi nezvo rinoita kuti chiropa. The chikuru metabolite iri akaneta rinobva ane carboxylic asidhi (vanenge 85% kutanga zvinhu achiparadzira mu plasma). Paavhareji kunonyanyisa pfungwa pashure akadzokorora kushandiswa "clopidogrel" ndiyo 3 MG / L, unogona kuonekwa awa rimwe pashure ingestion.

Active fuma uye metabolite irreversibly vakasungwa mapuroteni eplasma. Kukurukurirana anoramba usingagoni kuguta.

Pashure zvokuudzwa kwokubatsira 14C-akanzi "clopidogrel" inenge hafu dose iri weti, vanenge 46% - the faeces pamusoro maawa 120. T1 / 2 huru metabolite - 8 maawa.

Saturation metabolite varwere kakawanda pashure richisvika nemakore 75, ichi haachinji platelet aggregation uye nekudeura ropa nguva.

The plasma kwazvo itsvo wevasungwa pamusoro metabolite kubva 5 kusvika 15. / Maminitsi, asi kana avhareji chirwere kwokuomerwa ndiyo 30-60. Pasinei nokuti inhibitory kushanda muna varwere adenosine diphosphate - vakafurira platelet aggregation akanga aderedzwa, chakatowedzera ropa nguva, uyewo nevazvipiri utano.

umboo

Uri kuziva, nokuti iro zvinangwa chiremba waakaudzwa mumwe mushonga varwere se "Clopidogrel"? Analogs, uye akagadza mumwe medicament nokuda kudzivirira thrombotic yematambudziko ose ischemic sitiroko, myocardial infarction uye peripheral arterial occlusive chirwere. Mawa kurapwa pamwe acetylsalicylic asidhi uye "clopidogrel" sezvinoratidzwa pana kudzivirira thrombotic yematambudziko, iyo yava kukonzera chakasimba coronary syndrome.

Contraindications

'Clopidogrel' (mutengo Pharmacies Moscow nharaunda anenge 510 rubles) kushandisa pakaunda ne:

• hypersensitivity;
• chenjera ropa;
• haemorrhagic urwere ;
• zvakakomba hepatic vanotaura;
• Kuyerera intracranial zvokurwara uye predisposing kukudziri- ropa (zvemapapu bundu, exacerbation pamusoro peptic urikanwi, hyperfibrinolysis, tiibhii);
• lactose kushaikwa (nokuti chipimo chemushonga siyana ane shuga mukaka), nhaka galactose kusashivirira, malabsorption chirwere shuga-galactose.

"Clopidogrel": kushandiswa uye chipimo chemushonga

Mahwendefa maererano nemirayiridzo, anogona kutorwa zvisinei kudya. Nokuti kudzivirira thrombotic zviitiko varwere ischemic sitiroko kana myocardial infarction, vanachiremba akarayira ose zuva "Clopidogrel" 75 MG. In chenjera chirwere, izvo zviri kukonzerwa kukura zvatichiri ischemic necrosis mwoyo tsandanyama, kurapwa inofanira vakatanga kubva pamazuva okutanga. kurapa nokushandiswa kwe "Clopidogrel" - hapana mazuva anopfuura 35. Varwere ischemic sitiroko anogona kutora mushonga uyu kwemwedzi mitanhatu. Kana thrombotic matambudziko anomuka pakati ACS pasina nokusimudza ST chidimbu, kurapwa ndiye anosarudza pamwe kugamuchira kuraswa vachizvitakudza dose (300 MG), uye mberi asingarambi kutora piritsi anopfuura rimwe chete pazuva. Kunonyanyisa kunyatsoshanda ari kuchengetwa pashure pemwedzi mitatu. Ya yokurapa ne 'Clopidogrel' (analogs uye generics zvinoitirwa pazasi) hazvifaniri pfuura rimwe gore. Tikafunga chakasimba coronary chirwere pamwe ST chidimbu kukwirira kazhinji ushandiswe 75 MG zvinodhaka zuva nezuva pamwe kwokutanga imwe-nguva kushandisa vachizvitakudza chipimo chemushonga akabatana thrombolytic yomuchipatara uye acetylsalicylic acid. Kamwe zviratidzo kuonekwa, unofanira kuenda wemishonga mishonga. Varwere makore 75 kurapa anopiwa pasina vachizvitakudza dose.

ovhadhozi

On kugamuchira mushonga mu mishonga varumbidzwa kwazvo, runoratidzwa kuwedzera ropa nguva kwaizotevera matambudziko. Mumamiriro ezvinhu akadaro, unofanira zvakakodzera kurapwa. Kana kana uchida kukurumidza nokururamiswa kubuda ropa kwenguva refu nguva, unofanira kuisira TM. Hapana chaizvo mushonga.

Aiita zvimwe zvinodhaka

Mawa negashiro "clopidogrel" pamwe warfarin kunoguma nokuwedzera ropa zvazvingava, ndokusaka mubatanidzwa uyu zvikuru kunaka. It anowedzera mukana ropa uye ari kurapwa mumwe mushonga akabatana nonsteroidal Anti-anogumbura zvinodhaka, aspirin, glycoprotein FIs uye heparin.

nemishonga

Treatment medicament 'Clopidogrel' (mushandisi, mutengo, nzira chourongwa uye chipimo chemushonga vanorondedzerwa zvizere mashoko aya) kungaita kuti varwadziwe:

• Blood coagulation hurongwa: panguva yokutanga mwedzi yokurapa kazhinji simuka ropa, hematomas kuratidzika; Kanenge - conjunctive ropa; Mumwewo kacho - intracranial kubuda ropa.
• hematopoietic maitiro: mu zvisingawanzoitiki zviitiko - thrombotic thrombocytopenic purpura, granulocytopenia, kupererwa neropa, kusanganisira pancytopenia, uye aplastic kupererwa neropa.
• Tsinga: neapo kuzviratidza nemusoro, paresthesia, dzungu; rova - vertigo; Mumwewo kacho - kuvhiringidzika mupfungwa uye fungidziro.
• tsinga uye mwoyo, kazhinji ndivo akaumba hematoma; dzimwe nguva tine zvakakomba ropa, vasculitis, vaburusira BP.
• Respiratoria hurongwa: epistaxis, bronchospasm, pulmonary ropa, interstitial pneumonitis, hemoptysis.
• Zvomudumbu turakiti: manyoka, dyspepsia, abdominal kurwadziwa, ropa kubva zvomudumbu turakiti, gastritis uye gastric urikanwi, kurutsa, flatulence, kuda kurutsa, kupatira, retroperitoneal ropa, colitis, pfungwa nomuviri zvemwana asati, stomatitis, rikwanise chiropa kukundikana, hepatitis, wakawedzera chiropa makemikari.
• Zvetsandanyama nemapfupa hurongwa: arthralgia, myalgia, chearthritis.
• Skin: bullous rashes (Stevens-Johnson chirwere uye chepfu epidermal necrolysis, erythema multiforme), eczema, erythematous mapundu, uye lichen planus.
• Urinary System: hematuria, hypercreatininemia, glomerulonephritis.
• Neutachiona: angioneurotic edema, serum kurwara, urticaria, pseudoallergy zvakaitwa.

Kana kurapa iri zvinodhaka fivha haawanzopiwi wakacherechedza, usina kunzwisisa somugumisiro kugashira medicament, uye sezvo chiratidzo zvinowanzoitwa chando.

Zvokungwarira

Medicine "Clopidogrel" nokungwarira kunyanyisa kana achitora yakakwirira ndingangokuvara ropa semubairo zvomusejari kupindira, hemostatic zvirwere. Kana vavhiyiwa kunodiwa, uye antiplatelet nezvinozoitika zvikuru chisingadiwi kubva kwokubatsira mushonga anofanira kuraswa kuti vhiki isati yakatarwa wokuvhiya. Kunyanya hanya mushonga nachiremba kwazvo kutyorwa chiropa basa, izvo zvinogona kukonzera Hemorrhagic diathesis. Kana zviratidzo kunyanya ropa vanofanira kudzidza hemostatic hurongwa. Uyezve, vanofanira kuramba kuongorora mabasa ari kushanda basa chiropa. Kungwarira "Clopidogrel" rinoshandiswa heparin, NSAIDs, warfarin. Pakuitisa zvidzidzo zvokuongorora kuwana carcinogenic uye genotoxic mugumisiro zvinodhaka, mukuwedzera, usaisa matambudziko pamusoro motokari utariri chinzvimbo.

"Clopidogrel": analogs uye generics

Anoreva zvakafanana (analogs) zvinodhaka - mushonga muchiva chiito kana muchiva sezvamunoita. Chii mishonga anogona kutsiva mushonga "Clopidogrel"? Analogs gadziriro yezviri fuma zvinotevera: "Kardutol", "Detromb", "Agregal", "Trombeks", "Klopilet" "Trocken", "Plavix", "Plagril", "Plogrel", "Targetek", "Egitromb" "Clopidogrel din email,".

Mumwe mushonga ane unhu hwakasiyana, saka kushandiswa anobvumirwa chete pashure zano nachiremba wako.

Opinions pamusoro mushonga

Chii vanhu vanoti gadziriro akadai "Clopidogrel"? Reviews wevarwere vaiva nomukana uchatamisa kwazvo zvirwere uye zvomusejari kupindira zviri chaizvo zvakanaka. Varwere dzinoshuma yakakwirira vakarongeka kuitwa medicament, zviri chisava arongera womuchato kuti dzokuzvirapa. Analogues zvinodhaka kubatsira varwere kusarudza zvakanakisisa chingaitwa vari reshiyo mutengo uye unhu, asi chinangwa uye kubudirira kuzvidzora anofanira akaronzesa ane ruzivo nyanzvi.