Atrogrel ndi mankhwala omwe ali ndi antiplatelet. Amagwiritsidwa ntchito pochiza komanso kupewa matenda oyamba, obwera pafupipafupi, kugunda kwa mtima pamaso pa odwala. Mankhwalawa amathandizira kuthetsa mtima wamatenda a mtima chifukwa cha mphamvu ya clopidogrel poletsa kuphatikizira kwa maselo ambiri. Ndikofunikira kudziwa kuti mukamalandira chithandizo, nthawi yoletsa magazi imawonjezeka.
Dzinalo Losayenerana
Clopidogrel
Atrogrel amagwiritsidwa ntchito pochiza komanso kupewa chachikulu, kubwerezanso kwa mtima komanso sitiroko.
ATX
B01AC04
Kutulutsa mafomu ndi kapangidwe kake
Mankhwala amapangidwa piritsi. Chigawo cha mankhwalawa ndi utoto-wamafuta, wopakidwa zoyera. Piritsi 1 ili ndi 75 mg yogwira - clopidogrel bisulfate. Zowonjezera zina zikuphatikiza:
- ma cellcose a microcrystalline;
- hydrogenated castor mafuta;
- shuga mkaka;
- croscarmellose sodium.
Chipolopolo chakunja chimakhala ndi carmine, hypromellose, shuga ya lactose, titanium dioxide, triacetin.
Mankhwala amapangidwa piritsi. Piritsi 1 ili ndi 75 mg yogwira - clopidogrel bisulfate.
Zotsatira za pharmacological
Mankhwalawa amalepheretsa kumangiriza kwa adenosine diphosphate ku zolumikizira zolingana padziko lapansi, zomwe zimapangitsa kuti ma cellelo azigwira. Zotsatira zamachitidwe a clopidogrel, kuphatikiza kwa maselo ambiri ndi zomatira zimatsitsidwa, zimayambika mwachilengedwe kapena zimayambitsa chidwi cha mankhwala ena. The achire zotsatira olembedwa labotale 2 mawola pambuyo pakamwa mankhwala.
Ndi mlingo wachiwiri, mphamvu ya mankhwalawa imapangidwira komanso imakhazikika pokhapokha pakadutsa masiku 3-7 a mankhwala. Komanso, choletsa chophatikizira cha kuphatikizika kwa maplateleti chimafika pa 45-60%. The achire zotsatira zimapitirira kwa sabata, pambuyo pake kuphatikiza kwamagazi ndi ntchito za seramu kubwerera pazomwe amayambira. Izi zimachitika chifukwa cha kukonzanso kwa maselo amwazi (moyo wa m'mapulogalamu ndi masiku 7).
Pharmacokinetics
Mukamwa pakamwa, clopidogrel imatengedwa mwachangu m'matumbo ang'onoang'ono. Ngati ilowa m'magazi, mankhwala ophatikizira amafikira kuchuluka kwa plasma patatha maola 2 kuchokera pakukonzekera ndipo ndi 0,025 μg / L Clopidogrel imasinthidwa mu hepatocytes ndi mapangidwe a metabolic omwe alibe ntchito ya mankhwala (85% ya plasma ya ndende yoyamba).
Kuchuluka kwa zinthu zogwiritsidwa ntchito mwa okalamba ndiwokwera kuposa momwe zimakhalira.
Pambuyo pakamwa, 50% ya mankhwalawo amatengedwa kudzera mu kwamikodzo, 46% imachoka m'thupi ndi ndowe mkati mwa maola 120 pambuyo pamlomo. Hafu ya moyo ndi maola 8.
Kuchuluka kwa zinthu zogwiritsidwa ntchito mwa okalamba ndiwokwera kuposa momwe zimakhalira. Nthawi yomweyo, zizindikiro za kuphatikiza kwa mapulateleti ndi nthawi yotuluka magazi sizikhudzidwa.
Kodi chimathandiza ndi chiyani?
Mankhwala amagwiritsidwa ntchito ngati njira yochizira matenda a atherothrombosis mwa odwala akuluakulu ndikuchotsa zotsatirazi:
- matenda a zotumphukira mitsempha pa chitukuko cha matenda a mtima chifukwa atherothrombosis m'munsi malekezero;
- pachimake coronary syndrome motsutsana ndi vuto la mtima osakhalapo ndi mafunde a Q pa electrocardiogram (ECG) kapena pamaso pa angina osakhazikika;
- kupewa yachiwiri myocardial infarction ndi kufulumizitsa kukonzanso kwa mtima minofu (mankhwalawa ntchito osapitirira 35 patatha masiku zachitika matenda);
- kupewa kufa mwadzidzidzi kwa coronary;
- pachimake myocardial infarction mukweza gawo ST pa ECG ndiwofatsa mankhwala ndi acetylsalicylic acid;
- ischemic stroke pa chiyambi cha mankhwala pambuyo masiku 7 (pasanathe miyezi 6) kuchokera pakupanga matenda.
Mankhwalawa amagwiritsidwa ntchito popewa kupezeka kwa chikhalidwe cha atherothrombotic ndi blockage (embolism) ya lumen ya chotengera ndi thrombus panthawi ya atrum fiber Pankhaniyi, tikulimbikitsidwa kugwiritsa ntchito kuphatikiza kwa acetylsalicylic acid ndi clopidogrel.
Contraindication
Mankhwala sinafike pamaso pa zinthu zotsatirazi:
- kuchuluka kwa tiziwalo timene timapanga zinthu tambiri ta Atrogrel;
- kwambiri matenda a chiwindi, chiwindi ntchito;
- zilonda zam'mimba zotupa ndi duodenum mu pachimake siteji;
- intracranial hemorrhage, magazi;
- zilonda zam'mimba.
Mankhwalawa osavomerezeka kuti amwe panthawi yoyamwitsa ndi amayi apakati.
Ndi chisamaliro
Chenjezo limaperekedwa kwa odwala omwe ali pachiwopsezo chachikulu chokhetsa magazi chifukwa cha kuvulala kwamakina, njira zopangira opaleshoni, komanso kusakhazikika bwino kosakwanira kwa asidi m'thupi. Kuvomerezedwa kwa Atrogrel ndikosayenera kwa odwala omwe ali ndi vuto lolakwika la chiwindi, chifukwa pali chiopsezo chokhala ndi hemorrhagic diathesis.
Kodi kutenga Atrogrel?
Mankhwalawa adapangira pakumwa pakamwa, ngakhale kudya zakudya. Muyezo tsiku lililonse ndi 75 mg kamodzi. Odwala omwe ali ndi vuto lalikulu la mitsempha ya coronary, osakhazikika a angina ndi myocardial infarction amalimbikitsidwa kuti atenge 300 mg ya mankhwala tsiku loyamba - mapiritsi 4. Mlingo wotsatira ndi muyezo.
Kutalika kwa maphunzirowa kumatsimikiziridwa ndi dokotala aliyense payekhapayekha, kutengera chithunzithunzi cha matenda. Kuphatikiza mankhwala ndi mankhwala ena kumayikidwa posachedwa. Nthawi yayitali yodwala ndi milungu 4.
Ndi matenda ashuga
Mankhwalawa alibe poizoni pazochita za maselo a pancreatic beta ndipo samakhudza kuchuluka kwa shuga m'magazi a magazi. Anthu odwala matenda ashuga sayenera kusintha njira yochizira.
Zotsatira zoyipa za Atrogrel
Zotsatira zoyipa kuchokera ku ziwalo ndi machitidwe zimakhazikika nthawi zambiri ngati wodwalayo ali ndi vuto loti ziwalo zina zigwirira ntchito kapena mapiritsi atengedwa molakwika.
Pa mbali ya gawo la masomphenyawo
Mankhwala sasokoneza mawonekedwe owoneka.
Kuchokera minofu ndi mafupa
Zotsatira zoyipa mu musculoskeletal system zimawonekera mu mawonekedwe a ululu mu minofu ndi mafupa.
Matumbo
Mwina kuoneka ngati kupweteka m'mimba, kutsegula m'mimba kwa nthawi yayitali ndi matenda osokonekera. Mwapadera, mumakhala kudzimbidwa, zilonda zam'mimba ndi zilonda zam'mimba.
Hematopoietic ziwalo
Kuchuluka kwa zinthu zomwe zimapangidwa m'magazi kumachepa, kupanga ma leukocytes ndi eosinophilic granulocytes kusokonezeka. Nthawi yosiya magazi ikutuluka. Supombocytopenic purpura, kuchepa magazi, thrombocytopenia ndi agranulocytosis angayambe ndi kuwonongeka kwa hematopoietic dongosolo.
Odwala amati kukula kwa magazi pambuyo pa mwezi umodzi wamankhwala.
Pakati mantha dongosolo
Ndi poizoni wamavuto a mankhwalawo mu ubongo, mutu, chizungulire komanso kuwonongeka kwa chidwi. Nthawi zina, kuwonongeka kwa malingaliro, kuyerekezera zinthu, kusokonezeka ndi kusazindikira, kukomoka kwa zipatso zotheka ndikotheka.
Kuchokera ku kupuma
Ndi kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, kupuma movutikira komanso zilonda zapakhosi kumatha.
Pa khungu
Zotupa pakhungu, redness, ndi kuyabwa.
Kuchokera ku genitourinary system
Mwapadera, glomerulonephritis ndi kuwonjezeka kwa seramu yamagetsi ya syntinine.
Kuchokera pamtima
Ndi poizoni wa mankhwalawa pamagazi, tachycardia imawoneka, kusokoneza kwamitsempha yama coronary komanso kupweteka pachifuwa.
Kuchokera kumbali ya kagayidwe
Mankhwalawa alibe mphamvu pa kagayidwe kachakudya, koma ndikupanga zotsatira zoyipa m'matumbo am'mimba, kuchepa kwa chilakolako chokwanira kumatha.
Matupi omaliza
Odwala omwe akuyembekezeka kukhazikika kwa anaphylactoid zimachitika, nthawi zina pamakhala chiopsezo chokhala ndi anaphylactic, edema ya Quincke, mankhwala osokoneza bongo. Odwala ambiri amakhala ndi ming'oma, totupa, komanso kuyabwa pakhungu.
Kuyenderana ndi mowa
Munthawi yamankhwala osokoneza bongo, sikulimbikitsidwa kumwa zakumwa zoledzeretsa. Mowa wa Ethyl umakulitsa mkhalidwe wamkati wamanjenje ndi mtima, kuwonjezereka kwa zovuta m'magawo am'mimba ndikuwonjezera nthawi yotuluka magazi. Mowa ungayambitse zilonda zam'mimba.
Malangizo apadera
Ndi ntchito yomwe mwakonzekera, muyenera kusiya kumwa mapiritsiwo masiku 5-7 musanayambe opareshoni. Wodwalayo ayenera kudziwitsa dokotala wa opaleshoni ndi opaleshoni yokhudza kugwiritsa ntchito Atrogrel.
Ngati magazi atatuluka mwadzidzidzi (hematuria, kuwonongeka kwa chingamu, menorrhagia), ndikofunikira kuti mupite kukayezetsa kupezeka kwa kusintha kwa ma hepatasis. Phunziroli lithandizira kudziwa kuchuluka kwa mapulatini, nthawi ya magazi.
Gwiritsani ntchito mu ukalamba
Kugwiritsa ntchito mankhwala osokoneza bongo kwa anthu azaka zopitilira 75 kumayambira osapereka mankhwala. Palibe zosintha zina zowonjezera pamalingo zomwe zimafunikira.
Kupatsa ana
Chifukwa cha kuchepa kwa maphunziro a chipatala okwanira pazokhudza clopidogrel pakukula ndi kukula kwa thupi muubwana ndi unyamata, mankhwalawa sawavomerezeka kwa odwala omwe ali ndi zaka 18.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwalawa amalembedwa kuti agwiritsidwe ntchito ndi amayi apakati, chifukwa clopidogrel imatha kusokoneza kuyika kwa ziwalo ndi machitidwe pakukonzekera kwa embryonic kapena kuonjezera mwayi wokhetsa magazi nthawi yakubala, zomwe zimapangitsa mkhalidwe wovuta m'miyoyo ya mayi.
Mankhwalawa adakonzedwera m'matumbo a mammary ndikuthira mkaka wa m'mawere, chifukwa chake, pamankhwala a Atrogrel, tikulimbikitsidwa kuti muchepetse kuyamwa.
Kusintha kwa mlingo wowonjezera pakuwonongeka kwa impso sikofunikira.
The ntchito aimpso kuwonongeka
Kusintha kwa mlingo wowonjezera pakuwonongeka kwa impso sikofunikira.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Ngati chiwindi sichikugwira ntchito moyenera, ndikofunikira kufunsa dokotala wanu pakufunika kwa mankhwala.
Mankhwala osokoneza bongo a Atrogrel
Ndi kugwiritsa ntchito mankhwala osokoneza bongo, kukulitsa zovuta zomwe zimachitika m'matumbo am'mimba (zotupa zam'mimba zam'mimba, kupweteka kwa epigastric dera, kutsekula m'mimba ndi kusanza, kukha mwazi m'mitsempha yam'mimba mwa thirakiti la m'mimba) ndikutuluka kwa nthawi yayitali. Ndi gawo limodzi la mlingo waukulu, wolakwiridwayo ayenera kuyimba ambulansi. M'malo osasunthika, kuikidwa magazi kumathandizira kubwezeretsa mwachangu ziwopsezo zamagazi.
Ngati wodwala walowetsa mapiritsi ambiri mkati mwa maola 4 apitawa, ndiye kuti wodwalayo ayenera kusanza, kutsuka m'mimba ndikupereka chinthu chothandizira kuti muchepetse kuyamwa kwa clopidogrel.
Kuchita ndi mankhwala ena
Pogwiritsa ntchito nthawi yomweyo Arthrogrel ndi mankhwala ena, izi ndizogwirizana ndi mankhwalawa:
- Ngakhale mukumwa mankhwala osagwiritsa ntchito mankhwala a anti-yotupa, pali kuwonjezeka kwa kutuluka kwa magazi m'mimba. Kulimba kwa zotupa m'matumbo mwake kumatheka chifukwa cha ntchito ya Warfarin.
- Kuchuluka kwa plasma ya phenytoin ndi tolbutamide kumawonjezeka. Pankhaniyi, zosintha zoyipa za thupi sizimawonedwa.
- Heparin ndi acetylsalicylates sizikhudza kuchiritsa kwa Atrogrel.
Palibe kutengera kwa mankhwala kophatikizana ndi beta-adrenergic receptor blockers, diuretics, antiepileptic ndi hypoglycemic.
Zokhudza mphamvu pakuwongolera njira
Mankhwalawa saphwanya kuyenda ndi magwiridwe antchito a minofu ya mafupa. Chifukwa chake, munthawi yoperekera chithandizo, kuyendetsa, kuwongolera njira zovuta ndi zochitika zina zomwe zimafuna kuthamanga kwa wodwalayo pakuchitika ndi psychomotor ndikuloledwa.
Analogi
M'malo a Atrogrel mulinso mankhwala otsatirawa, omwe ali ndi yogwira pophika monga mankhwala ndi ma pharmacological:
- Sylt;
- Clopacin;
- Clopidogrel;
- Acecor Cardio;
- Agrelide;
- Cormagnyl;
- Ecorin;
- Cardiomagnyl.
Popeza mankhwalawa palibe pamene mukumwa Atrogrel, ndikofunikira kuti mufunsane ndi dokotala za kusintha kwa mankhwalawa. Kusinthira ku mankhwala ena nokha osavomerezeka.
Kupita kwina mankhwala
Mankhwala amagulitsidwa ndi mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Mankhwalawa amachepetsa kukhathamira kwa magazi ndikuwonjezera mwayi wokhetsa magazi, omwe ndi oopsa moyo nthawi zovuta. Kwa wodwala chitetezo, kugulitsa kwaulere mankhwalawa kumakhala kochepa.
Mtengo
Mtengo wapakati wa mankhwala a antiplatelet muma pharmacies umasiyana 344 mpaka 661 rubles.
Zosungidwa zamankhwala
Ndikulimbikitsidwa kusunga mankhwalawo pamalo otetezedwa ku chinyezi ndi kuwala kwa dzuwa, kutentha mpaka + 25 ° C.
Tsiku lotha ntchito
Zaka 2
Wopanga
JSC Sayansi ndi Chipatala Center "Borshchagovsky Chemical and Pharmaceutical Plant", Ukraine.
Ndemanga
Oleg Hvorostnikov, wa zaka 52, Ivanovo.
Potsatira dokotala, adayamba kumwa piritsi limodzi la 75 mg usiku wokhudzana ndi matenda a atherosulinosis a m'munsi. Mankhwalawa adathandizira, zovuta zake adayamba kumva kuperewera. Koma patsiku la 5 la chithandizo ndimayenera kuyimba ambulansi. Kutupa kwamkati mwa m'mimba kunayamba. Sindikulimbikitsa kuti anthu azolowere kukhala ndi gastritis ndi zilonda zam'mimba. Kwa ine, izi zinali zolakwika.
Victor Drozdov, wazaka 45, Lipetsk.
Mnzake yemwe, atadwala matenda opha ziwalo, atadwala, adamulembera piritsi limodzi la Atrogrel kwa masabata awiri. Pambuyo pa sitiroko, ischemia idayamba, choncho mkono wamanja sunamveke. Pamapeto pa sabata loyamba la chithandizo, kulumikizana kunayambika mu manja. Mankhwalawa adapereka chotsatira. Madotolo adati mankhwalawo amachepetsa mitsempha yamagazi ndikuwonjezera magazi m'magazi a ischemic. Ndikusiyirani ndemanga yabwino.
