Lopirel ndi gawo limodzi mwa gulu la antiplatelet agents. Mothandizidwa ndi mankhwalawa, kukula kwa zikhalidwe zamatumbo zomwe zimayamba chifukwa cha kuphatikiza mapulateleti, kuphatikiza kwawo ndi makhoma amitsempha yamagazi kumaletsedwa.
Dzinalo Losayenerana
Clopidogrel.
Lopirel ndi gawo limodzi mwa gulu la antiplatelet agents.
ATX
B01AC04.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapezeka m'mapiritsi omwe ali ndi 1 yogwira (clopidogrel hydrosulfate) ndi maipi omwe alibe mphamvu ya antiplatelet. Ndende ya phula loyambirira ndi 97.87 mg. Ndalamayi ikufanana ndi 75 mg ya clopidogrel. Mapiritsiwo ali ndi chipolopolo chapadera, chifukwa chomwe mankhwalawo amayamba kusintha. Pankhaniyi, chinthu chogwira ntchito chimamasulidwa pang'onopang'ono, kuyamwa kumachitika m'matumbo. Zinthu zazing'ono:
- crospovidone;
- lactose;
- ma cellcose a microcrystalline;
- glyceryl dibehenate;
- Opadry II 85 G34669 pinki;
- talcum ufa.
Phukusili lili ndi mapiritsi 14, 28 kapena 100.
Mankhwalawa amapezeka m'mapiritsi omwe ali ndi 1 mankhwala othandizira.
Zotsatira za pharmacological
Ntchito yayikulu ya mankhwalawo ndi antiplatelet, zomwe zikutanthauza kuthekera kwa mankhwalawa kuti asokoneze mapangidwe a maselo am magazi: ma cell. Chikhalidwe chawo cha kukwatirana ndi endothelium yamitsempha yamagazi chimachepa. Chifukwa cha izi, zinthu zabwinobwino zimapangidwa kuti magazi asasunthidwe. Chiwopsezo chochepetsera lumen cha mitsempha yodutsa chimachepetsedwa, chomwe chimathandiza kupewa kukula kwa matenda oopsa.
Kuphatikiza apo, kuchepa kwa kukana kwamasamba kumadziwika. Kuphatikiza pa kuchepetsa ntchito ya kuphatikiza kupatsidwa zinthu za m'magazi, mankhwalawa amagwiranso ntchito ina - amachepetsa kukangana kwa mbali ya erythrocyte. Zotsatira zake, zinthu zomwe zimapangidwazo zimasokonezeka mwachangu, zomwe zimapangitsa kuti magazi azithamanga.
Ndi mankhwala a Lopirel, zimakhala zotheka osati kungoletsa mapangidwe amwazi, komanso kuwononga omwe alipo.
Ndi mankhwala a Lopirel, zimakhala zotheka osati kungoletsa mapangidwe amwazi, komanso kuwononga omwe alipo. Chifukwa cha kuthekera, mankhwalawa amadziwitsidwa mu nthawi ya postoperative, chifukwa cha matenda omwe amayenda limodzi kapena chifukwa cha kupangika kwa magazi. Pharmacodynamics imakhazikika pa kuthekera kumangiriza adenosine diphosphate kwa mapulateleti othandizira. Zotsatira zake, kuphatikiza kwa maselo amwazi pakati pawo kumasokonezeka.
Chifukwa cha njirayi, ADP imataya mwayi wopititsa patsogolo mpaka kumapeto kwa mapulatulo, omwe ndi masiku 7-10. Komabe, Lopirel ali ndi vuto. Imakhala ndi mphamvu zochepa pochita zinthu zina. Izi ndichifukwa choti kumasulidwa kwa metabolite yogwira kumachitika mothandizidwa ndi isoenzymes ya P450 cytochrome system, ena mwa omwe amapanikizika ndi mankhwala ena. Zotsatira zake, kuyipa kosakwanira kwa Lopirel kumawonedwa.
Mankhwala amagwira ntchito mu mtima.
Mankhwala amagwira ntchito mu mtima minyewa kugwirizana ndi yafupika chilolezo, kuphwanya patency. Pankhaniyi, munthu sayenera kuyembekezera kuchira kwathunthu, clopidogrel imathandizira kupewa zovuta zomwe, motsutsana ndi maziko a matenda omwe atchulidwa, ndikuwopseza moyo. Zotsatira zabwino kwambiri zimatha kugwiritsidwa ntchito limodzi ndi Lopirel ndi ma antiplatelet othandizira ena.
Pharmacokinetics
Mankhwalawa amayamba kugwira ntchito mwachangu paulamuliro - pambuyo pa maola 2 pali kuchepa kwamphamvu kwa kuphatikizana kwa maplatelet. Kukula kwake kwa mankhwalawo, kumakhala kusinthaku mwachangu. Zizindikiro zopweteka za matendawa zikachotsedwa, mankhwalawa amachepa. Zotsatira zake, mutatha kukonza Mlingo wa Lopirel kwa masiku 4-7, chiwopsezo chachikulu cha mankhwalawa chimafikiridwa. Zomwe zimapezeka zimasungidwa nthawi yayitali yamagazi (masiku a 5-7).
Kuthana kwa clopidogrel kumathamanga, pomwe kumangiriza mapuloteni a plasma ndiokwera kwambiri (98%). Kutembenuka kwa chinthuchi kumachitika m'chiwindi. Imadziwika mu njira ziwiri: kudzera pamagawo ndikumaperekedwa kwa carboxylic acid (sikuwonetsa ntchito); ndi gawo la cytochrome P450. Njira yomangirizira ku ma cell a platinamu imachitika mothandizidwa ndi metabolites.
Tiyenera kudziwa kuti kumwa mankhwalawa muyezo waukulu (300 mg kamodzi) kumabweretsa chiwopsezo chachikulu. Mtengo wa chizindikirochi ndiwokwera nthawi 2 kuposa kuchuluka kwa anthu ozunzidwa nthawi zonse pamene mankhwalawa akukonzedwa kwa masiku anayi.
Kupukusa zinthu zomwe zimapangidwa ndi mankhwalawa kumachitika kudzera mu impso.
Kutupa kwa zinthu zomwe zimapangidwa ndi mankhwalawa kumachitika kudzera mu impso ndi matumbo (m'magawo ofanana). Izi zimachitika pang'onopang'ono. Kuchotsa kwathunthu kwa zinthu zogwira ntchito kumachitika kawiri patsiku la 5 mutatha kumwa kwa Lopirel komaliza.
Zizindikiro zogwiritsidwa ntchito
Wothandizirayo akuwongolera zotere:
- matenda osiyanasiyana amitsempha yama mtima ndi mtima: myocardial infarction (bola kuti nthawi yayitali ya matendawa isadutse masiku 35), ischemic stroke idavutika miyezi 6 isanayambike chithandizo, zina zokhudzana ndi zotumphukira zamitsempha yamagazi;
- coronary syndrome yokhala ndi mawonekedwe owoneka, osakwera komanso kukwera kwa ST, acetylsalicylic acid (ASA) imayikidwa nthawi yomweyo ndi clopidogrel.
Contraindication
Mankhwalawa sagwiritsidwa ntchito ngati zotsatirazi zam'magazi zatsimikizika:
- kusintha kwamtundu uliwonse wa Lopirel:
- magazi otupa pachimake (chotupa cha m'mimba, kuchepa kwa zilonda zam'mimba);
- cholowa cholandirira lactose ndi zingapo zomwe zimayenderana ndi izi: kuperewera kwa lactase, shuga-galactose malabsorption.
Ndi chisamaliro
Ngati opaleshoni yakonzedwa, mankhwalawa sanatchulidwe chifukwa choika magazi. Zochitika zina zamatenda zomwe zimaphatikizidwa ndi gulu la zotsutsana:
- matenda omwe amatha kutulutsa magazi kwambiri, mwachitsanzo, ndi kuwonongeka kwa ziwalo zam'maso kapena m'mimba;
- mbiri ya ziwengo kwa thienopyridines.
Momwe mungatenge Lopirel
Nthawi zambiri, 0,075 g ndi zotchulidwa kamodzi patsiku. Malangizo ogwiritsira ntchito mankhwalawa nthawi zina:
- coronary syndrome yotsatana ndi kukwera kwa ST: pa 0,075 g patsiku kuchokera tsiku lachiwiri, mlingo woyamba ndi 0,3 g kamodzi, nthawi yayitali ya chithandizo sichitali milungu 4, chithandizo chamankhwala chachitali sichinakhazikitsidwe;
- coronary syndrome yopanda zizindikiro za kukwera kwa ST: mawonekedwe ake ndi ofanana, koma kutalika kwa maphunzirowa kumatha kukhala kutalika (mpaka miyezi 12);
- Fibrillation yoyeserera: 0,075 g patsiku.
Munthawi zonsezi, kugwiritsa ntchito ASA ndikofunikira. Komabe, pali malire: osapitirira 0,1 mg patsiku.
Kumwa mankhwala a shuga
Ndizovomerezeka kugwiritsa ntchito mankhwala ochizira matendawa, koma tiyenera kusamala chifukwa cha lactose yake. Kuphatikiza apo, motsutsana ndi maziko a matenda ashuga, chiopsezo chokhala ndi stroke, myocardial infarction imakulanso. Mankhwala othandizira antiplatelet ndi gawo lofunikira pakuchiza matendawa, mlingo wokhawo womwe umatsimikiziridwa payekhapayekha, poganizira momwe thupi liliri.
Chovomerezeka kugwiritsa ntchito mankhwalawa matenda a shuga, koma muyenera kusamala mukamamwa mankhwalawo.
Zotsatira zoyipa za Lopirel
Mwa zovuta za mankhwalawa pali ambiri omwe amachitika mosavomerezeka. Kuphatikiza apo, amatha kupanga mbali zosiyanasiyana za thupi.
Matumbo
Kudzimbidwa, kupweteka pamimba, kusintha kwa chopondapo kumawonetsedwa nthawi zambiri, mseru ungachitike. Pafupipafupi, kukula kwa kukokoloka m'mimba kumadziwika, kutulutsa kwanyumba kumakhala kovuta, kapangidwe ka mpweya kumakulirakulira. Nthawi zina chilonda chimapezeka, kusanza kumachitika. Ngakhale chocheperako kwambiri ndi colitis ndi pancreatitis.
Hematopoietic ziwalo
Zomwe zili m'mapulateleti ndi granulocytes zimachepa. Leukopenia, thrombocytopenia.
Pakati mantha dongosolo
Chizungulire, kupweteka mutu, kusokonezeka kwa kukoma, kutayika kwake kwathunthu. Kuwona. Kusokonezeka kwa chikumbumtima kumadziwika.
Kuchokera kwamikodzo
Glomerulonephritis.
Kuchokera ku ziwalo zamagetsi
Diso, mphuno.
Kuchokera ku chitetezo chamthupi
Matenda a Serum, anaphylactoid zimachitika.
Kuchokera ku genitourinary system
Kuphwanya mkodzo wa mkodzo.
Kuchokera pamtima
Sinthani mukupanikizika, vasculitis.
Dongosolo la Endocrine
Sapezeka.
Pa mbali ya chiwindi ndi biliary thirakiti
Hepatitis, kuchuluka kwa hepatic transaminases.
Matupi omaliza
Hemorrhagic diathesis, pruritus, purpura, erythema, kutupa.
Lopirel ikhoza kuyambitsa kusintha kwa kukakamiza.
Zokhudza mphamvu pakuwongolera njira
Palibe zoletsa pamene mukuyendetsa galimoto. Izi ndichifukwa choti mankhwalawa samathandizira kuti ntchito ya ziwalo zamasomphenya, kumva, CVS ndi mantha am'mimba.
Malangizo apadera
Amadziwika kuti mwa amayi kuletsa kwa kuphatikizana kwa maplateleti sikumatchulidwa kwenikweni.
Ngati matenda a ischemic atagwa, kuphwanya m'mimba ndi kuwonjezeka kwa ST sikunadutse masiku 7, chithandizo sichiyenera kuyamba.
Kutulutsa magazi kukachitika, kuyezetsa magazi kumayikidwa, ndikuwunikanso chiwindi kumachitidwanso.
Mankhwalawa amasiya kumwa sabata 1 asanachite opareshoni.
Mankhwalawa amasiya kumwa sabata 1 asanachite opareshoni.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Osati kutumizidwa azimayi mu milandu iyi. Clopidogrel imadutsa mkaka, chifukwa chake, kuyamwa kumayimitsidwa kwa nthawi yayitali.
Kulemba Lopirel kwa ana
Mankhwalawa sagwiritsidwa ntchito, chifukwa palibe kafukufuku wachitetezo wokhudzana ndi clopidogrel pamthupi la ana omwe adachitika.
Gwiritsani ntchito mu ukalamba
Kusintha kwa Mlingo sikofunikira, chifukwa odwala omwe ali mgululi amalola kulandira chithandizo bwino. Zadziwika kuti ziwonetsero zamagulu ambiri ndizofanana ndi achinyamata. Komabe, kusamala kuyenera kuchitidwa chifukwa cha ngozi yakuchepa kwa kukakamizidwa, komwe kumachitika chifukwa cha kusintha kwa mamvekedwe amwazi, kukwera kwa lumen m'mitsempha yamagazi, komanso kuchepa pakukana kwawo.
The ntchito aimpso kuwonongeka
Mankhwala amavomerezedwa kuti agwiritsidwe ntchito mofatsa pang'ono. Zizindikiro zowopsa ndizo chifukwa chosiya kuyamwa.
Mankhwala amavomerezedwa kuti agwiritsidwe ntchito mofatsa pang'ono.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Ndizololedwa kupereka mankhwalawo mukufunsidwa, koma muyenera kusamala powona zomwe akuwonetsa.
Mankhwala osokoneza bongo a Lopirel
Kuopsa kwa magazi kumachuluka. Komabe, kuwonjezeka kwa nthawi yamagazi kumadziwikanso. Pofuna kuthana ndi vuto la bongo, tengani njira zoyenera. Ngati mukufuna kuthetsa magaziwo mwachangu, kuikidwa magazi m'thupi kumachitika.
Kuchita ndi mankhwala ena
Kuwonjezeka kwa kuthamanga kwa magazi kumadziwika chifukwa cha ASA. Zomwezi zimawonedwa mukamagwiritsa ntchito warfarin.
Sizikudziwika ngati ndi kotetezeka kugwiritsa ntchito Heparin nthawi yomweyo ndi Lopirel, koma pali chidziwitso chotsimikizira kuti Heparin sichikhudza mphamvu ya antiplatelet ya mankhwala omwe akufunsidwa.
Kutenga Naproxen ndiye chifukwa chake chiopsezo chakutuluka magazi chikuwonjezeka kwambiri.
Kutenga Naproxen ndiye chifukwa chake chiopsezo chakutuluka magazi chikuwonjezeka kwambiri. Komanso, kufalikira kwa mawonetseredwe a chizindikiro ichi ndi kugaya kwam'mimba.
Othandizira okhala ndi estrogen, Phenobarbital, Cimetidine amaphatikizidwa bwino ndi mankhwala omwe amafunsidwa.
Kukumana kwa mankhwala monga Tolbutamide, Phenytoin kumakulanso.
Kuyenderana ndi mowa
Ndi zoletsedwa kugwiritsa ntchito mankhwala omwe ali ndi antiplatelet zotsatira komanso nthawi yomweyo kumwa zakumwa zoledzeretsa. Mowa umalimbikitsa vasoconstriction, womwe motsutsana ndi maziko a kuchepa kwa magazi m'magazi ndi kufalikira kwa magazi kungayambitse zovuta zazikulu.
Analogi
M'malo mwa Lopirel, amagwiritsa ntchito njira izi:
- Clopidogrel;
- Cardiomagnyl;
- Plavix;
- Sylt.
Mwa awa, otsika mtengo ndi Cardiomagnyl, clopidogrel.
Kupita kwina mankhwala
Mankhwala amagulitsidwa ndi mankhwala.
Mtengo wa Lopirel
Mtengo kuchokera ku 650 mpaka 1300 rubles.
Zosungidwa zamankhwala
Kutentha kovomerezeka m'chipindacho sikokwanira kuposa + 30 ° ะก. Kufikira kwa ana kwa mankhwalawa kuyenera kutsekedwa.
Tsiku lotha ntchito
Kutalika kwa nthawi yogwiritsira ntchito - zaka zitatu kuyambira tsiku lomwe watulutsa.
Wopanga
Gulu la Actavis, Iceland.
Ndemanga za Lopirel
Valentina, wazaka 45, Voronezh
Chifukwa cha kuchuluka kwa magazi m'magazi, ndili ndi chiopsezo chambiri chotupa. Pazifukwa izi, ndakhala ndikumwa mankhwalawa kwa miyezi isanu ndi umodzi. Pakadali pano, kuwerengetsa konse kwa magazi ndi kwachibadwa.
Anna, wazaka 39, Penza
Ndakhala ndikumwa mankhwalawa kwa zaka 4, zinthu zakhala bwino, ndikayerekezera ndi momwe ndimamvera ndikadayamba kulandira chithandizo. Ngakhale mavuto okhala ndi kukakamiza, kapena kusamva - palibe chizindikiro cha kutsekeka kwa mtima. Ndangoima ndikupanga mtengo. Mankhwala tsopano akhala okwera mtengo.
