Contraindication, zotsatira zoyipa ndi malingaliro ofunikira pakugwiritsa ntchito Fraxiparin

Mavuto ndi kuwundana kwa magazi, zovuta za thromboembolic ndi matenda oopsa omwe amafunikira chithandizo cham'tsogolo.

Nthawi zambiri muzochitika izi, madokotala amatiuza mankhwala a Fraxiparin. Zotsatira zoyipa ndi zotsutsana ndikugwiritsa ntchito zimapezeka, ndipo ndikofunikira kudziwa za iwo.

Izi, komanso chidziwitso pakugwiritsa ntchito mankhwalawa, momwe zimachitikira ndikuwunikiranso tidzakambirana pambuyo pake.

Zotsatira za pharmacological

Fraxiparin imakhala ndi heparin yotsika maselo, mapangidwe ake omwe adachitika mu depolymerization. Gawo lodziwika bwino la mankhwalawa limatchulidwa kuti likuchitika pokhudzana ndi kusokonekera kwa chinthu Xa, komanso ntchito zopanda mphamvu za Pa.

Ntchito za Anti-Xa ndizodziwika bwino kuposa momwe amathandizira pakuyambitsa mbali ya mphindikati ya chakudya. Izi zikuwonetsa ntchito ya antithrombotic.

Mankhwalawa ali ndi zotsutsa-kutupa komanso immunosuppressive. Kuphatikiza apo, zochita za wothandizira zitha kuzindikiridwa mwachangu kwambiri, ndipo zimatenga nthawi yayitali. Mkati maola 3-4 Amawachotsa pamodzi ndi mkodzo kudzera mu impso.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito mitundu ya Fraxiparin pazinthu zotsatirazi:

• mankhwalawa myocardial infarction;
• kupewa zovuta za thromboembolic, mwachitsanzo, pambuyo pakuchita opaleshoni, kapena popanda kuchitidwa opareshoni;
• coagulation prophylaxis pa hemodialysis;
• mankhwalawa thromboembolic zovuta;
• Chithandizo cha matenda osakhazikika angina pectoris.

Kutulutsa mawonekedwe, zikuchokera

Kutulutsidwa kwa Fraxiparin kuli ngati njira yothetsera jakisoni, woyika syringe. Syringe imo imakhala pachimake, chomwe chimakhala ndi zidutswa ziwiri kapena 10 m'bokosi lamatoni.

Kuphatikizikako kumaphatikizapo chinthu chomwe chimatchedwa calcium adroparin 5700-9500 IU. Zothandiza pano ndi izi: calcium hydroxide, madzi oyeretsedwa, ndi chloric acid.

Zotsatira zoyipa

Monga mankhwala ambiri, Fraxiparin nthawi zina amayambitsa mavuto:

• thrombocytopenia;
• thupi lawo siligwirizana (nthawi zambiri limachokera m'mimba yakuuma kwa Fraxiparin), kuphatikiza edema ya Quincke;
• magazi a malo osiyanasiyana;
• khungu necrosis;
• zenizeni;
• eosinophilia atasiya mankhwala;
• Hyperkalemia yosinthika;
• kupangidwa kwa hematoma yaying'ono pamalo opangira jakisoni, nthawi zina mikwingwirima yayikulu yochokera ku Fraxiparin imawonekeranso (chithunzi pansipa);
• kuchuluka kwa hepatic michere.

Odwala ena omwe amagwiritsa ntchito Fraxiparin adazindikira kuwonongeka kwakukulu pambuyo pakubayidwa.

Contraindication

Fraxiparin ili ndi zotsatirazi:

• thrombocytopenia;
• zaka mpaka 18;
• organic zotupa ndi ziwalo magazi;
• intracranial hemorrhage;
• kukhudzika kwa zigawo zopitilira muyeso;
• opaleshoni kapena kuvulala kwa maso, ubongo ndi msana;
• magazi kapena kuwopsa kwake komwe kumachitika ndikuphwanya hemostasis;
• kwambiri kulephera chifukwa a myocardial infarction, osakhazikika angina, chithandizo cha thromboembolism.

Pokhala ndi chiwopsezo chowonjezeka cha magazi, Fraxiparin iyenera kumwedwa mosamala. Izi ndi monga:

• kulephera kwa chiwindi;
• zovuta zamagazi mu retina ndi choroid;
• chithandizo cha nthawi yayitali kuposa momwe analimbikitsira;
• kulemera kwa thupi mpaka 40 kg;
• nthawi pambuyo ntchito pa maso, msana, ubongo;
• kwambiri matenda oopsa;
• osagwirizana ndi zochitika zamankhwala;
• zilonda zam'mimba;
• kumwa mankhwala nthawi yomweyo zomwe zimathandizire kutaya magazi.

Malangizo ogwiritsira ntchito

Fraxiparin imalowetsedwa pamimba m'matumbo a subcutaneous. Khola la pakhungu liyenera kusungidwa nthawi yonseyi pomwe yankho likuperekedwa.

Wodwala ayenera kunama. Ndikofunikira kuti singano ikhale yokhazikika, osati pakona.

Opaleshoni yayikulu pakuletsa zovuta za thromboembolic, yankho limayendetsedwa ndi kuchuluka kwa 0,3 ml kamodzi patsiku. Mankhwalawa amatengedwa kwa sabata limodzi mpaka nthawi yangozi itadutsa.

Mlingo woyamba umaperekedwa musanachitike opaleshoni mu maola 2-4. Pankhani ya opaleshoni ya mafupa, mankhwalawa amaperekedwa maola 12 asanachitike ntchito ndi maola 12 atamaliza. Kupitilira apo, mankhwalawa amatengedwa kwa masiku osachepera 10 mpaka kutha kwa nthawi yangozi.

Mlingo wopewa umadalira malinga ndi kulemera kwa thupi la wodwala:

• 40-55 kg - kamodzi patsiku kwa 0,5 ml;
• 60-70 kg - kamodzi patsiku kwa 0,6 ml;
• 70-80 kg - kawiri pa tsiku, 0,7 ml iliyonse;
• 85-100 kg - kawiri pa tsiku kwa 0,8 ml.

Zochizira zotupa za thromboembolic, mankhwalawa amaperekedwa pafupipafupi kwa maola 12 kawiri pa tsiku kwa masiku 10.

Mankhwalawa thromboembolic zovuta, kulemera kwa munthu kumathandiza kuti mudziwe mtundu:

• mpaka 50 makilogalamu - 0,4 mg;
• 50-59 kg - 0,5 mg;
• 60-69 makilogalamu - 0,6 mg;
• 70-79 kg - 0,7 mg;
• 80-89 makilogalamu - 0,8 mg;
• 90-99 makilogalamu - 0,9 mg.

Popewa kugundana kwa magazi, mlingo uyenera kutumikiridwa aliyense payekha kutengera luso la dialysis. Mwachilengedwe, pamene kuphatikizika kukuletsedwa, malo okhala ndi gawo loyamba la 0,3 mg kwa anthu mpaka 50 kg, 0,4 mg mpaka 60 kg, 0,6 mg kuposa 70 kg.

Mankhwala a myocardial infarction ndi angina osakhazikika amalimbikitsidwa pamodzi ndi Aspirin kwa masiku 6. Poyamba, mankhwalawa amapaka jakisoni wambiri. Mlingo womwe umagwiritsidwa ntchito ndi 86 ME anti-Xa / kg. Kenako, yankho limaperekedwa kawiri tsiku lililonse muyezo womwewo.

Bongo

Ngati mankhwala osokoneza bongo otere, magazi amtundu wosiyanasiyana akuwonekera. Ngati ndi ochepa, ndiye musadandaule. Panthawi imeneyi, muyenera kuchepetsa mlingo, kapena kuwonjezera nthawi pakati pa jakisoni. Ngati magazi ndi ofunikira, ndiye kuti muyenera kutenga protamine sulfate, 0,6 mg wa omwe amatha kupangitsa kuti 0.1 mg ya Fraxiparin ikhale.

Kuyanjana kwa mankhwala osokoneza bongo

Kutenga franksiparin nthawi imodzi ndi mankhwala ena kumatha kubweretsa Hyperkalemia.

Izi zikuphatikiza: mchere wa potaziyamu, zoletsa za ACE, heparins, NSAIDs, potaziyamu - zothetsera m'mimba, Trimethoprim, angiotensin II receptor blockers, Tacrolimus, Cyclosporin.

Mankhwala omwe amakhudza hemostasis (indico anticoagulants, acetylsalicylic acid, NSAIDs, fibrinolytics, dextran), limodzi ndi wogwiritsa ntchito wothandizirazi, zimathandizira zotsatira zake.

Kuopsa kwa magazi kumawonjezeka ngati Abciximab, Beraprost, Iloprost, Eptifibatide, Tirofiban, Ticlopedin nawonso atengedwa. Acetylsalicylic acid imathandizanso pamenepa, koma mu mankhwala a antiplatelet, omwe ndi 50-300 mg.

Fraxiparin iyenera kuthandizidwa mosamala kwambiri odwala akamalandira ma dextrans, anticoagulants, ndi systemic corticosteroids. Ngati mukumwa mankhwala osokoneza bongo limodzi ndi mankhwalawa, kugwiritsidwa ntchito kwake kumapitilizidwa mpaka chizindikiro cha INR chikasintha.

Ndemanga

Monga ndi mankhwala ena ambiri, pali ndemanga zotsutsana za Fraxiparin. Pali omwe adawathandiza, ndipo amawawoneka wothandiza, koma odwala omwe amawona kuti mankhwalawo ndi osathandiza kwenikweni samachotsedwa ntchito.

Ndemanga zoyipa zimabwera chifukwa cha kuchuluka kwa zoyipa, zotsutsana. Nthawi yomweyo, ngakhale anali atachenjezedwa kuti atenge mankhwalawa kwa amayi apakati, sizinakhudze thanzi ndi chitukuko cha mwana.

Makanema okhudzana nawo

Momwe mungabayitsire Fraxiparin:

Chifukwa chake, Fraxiparin nthawi zambiri imalembedwa chifukwa cha zovuta za magazi, kufunikira kwa chithandizo kapena kupewa zovuta za thromboembolic. Chachikulu ndikutsatira malingaliro a katswiri yemwe angadziwe kuyenera kwa kugwiritsa ntchito kwake komanso mlingo woyenera. Kupanda kutero, kuwonjezera pa kusowa kwa mphamvu, m'malo mwake, zotsatira zoyipa zimatha kuphatikizidwa ndi bongo, kukula kwa magazi, ndi hyperkalemia.