Zilt yog ib qho tshuaj tiv thaiv tshuaj antiplatelet uas ua rau qeeb qeeb ntawm platelet sib sau ua ke. Cov kws kho mob tshwj xeeb muab nws rau cov neeg mob kom tiv thaiv thrombosis, mob hlab ntsha tawg thiab plawv nres.
Npe
Lub npe Latin yog Zyllt. INN tshuaj: clopidogrel.
Zilt yog ib qho tshuaj tiv thaiv tshuaj antiplatelet uas ua rau qeeb qeeb ntawm platelet sib sau ua ke.
ATX
B01AC04.
Tso cov ntawv thiab cov nyob ua ke
Cov tshuaj yog tsim hauv cov ntsiav tshuaj ntawm 75 mg ntawm cov tshuaj nquag (clopidogrel hydrosulfate). Lwm yam tshuaj muaj xws li:
- MCC;
- propylene glycol;
- talc;
- hlau zas;
- pregelatinized ntau yam ntawm hmoov txhuv nplej siab;
- titanium dioxide;
- macrogol-6000;
- anhydrous daim ntawv ntawm lactose;
- cov roj castor hydrogenated;
- hypromellose.
Cov tshuaj yog tsim hauv cov ntsiav tshuaj ntawm 75 mg ntawm cov tshuaj nquag (clopidogrel hydrosulfate).
Ntsiav tshuaj yog muag hauv pob ntawm 14, 28, 30, 56, 84 thiab 90 pcs.
Pharmacological kev txiav txim
Cov tshuaj yog zwm rau pawg ntawm clopidogrel prodrugs. Nws xaiv inhibits qhov khi ntawm ADP rau platelet receptors thiab txuas ntxiv ntawm GPIIb / IIIa complex (glycoprotein), uas ua rau cov inhibition ntawm platelet aggregation.
Tus txheej txheem no txuas ntxiv rau 1-1.5 lub lis piam. Cov nquag metabolite tshwm sim los ntawm kev ua kom muaj CYP450 isoenzymes. Txawm li cas los xij, tsis yog txhua tus neeg mob muaj cov tshuaj tiv thaiv txaus, vim tias qee qhov isoenzymes muaj polymorphism, hloov hauv qab ntawm lwm cov tshuaj, lossis muaj kev sib txawv ntawm kev tiv thaiv ntawm ADP.
Cov tshuaj yeeb yam qhia txog kev ua tau zoo ntawm kev tiv thaiv atherothrombotic kev rau txim rau cov neeg mob uas muaj kev puas tsuaj rau cov hlab ntsha ntawm ntau lub hauv paus, tshwj xeeb tshaj yog nyob rau hauv pathology ntawm peripheral, mob hlab ntshav siab thiab hlab ntsha hauv hlab ntsha.
Cov tshuaj yeeb yaj kiab qhia ua tau zoo ntawm kev tiv thaiv atherothrombotic kev rau txim rau cov neeg mob uas muaj kev puas tsuaj rau cov hlab ntshav ntawm ntau yam hauv paus.
Cov Tshuaj Pharmacokinetics
Cov tshuaj yog nqus sai sai tom qab kev tswj hwm qhov ncauj. Qhov siab tshaj plaws ntshav plasma ntawm cov khoom xyaw nquag yog tiav 40-45 feeb tom qab noj ib koob ntawm 75 mg.
Lub Cheebtsam ntawm cov tshuaj hauv daim siab yog metabolized. Ib nrab-lub neej nyob yog li 6 teev. 46% ntawm cov tshuaj tau tawm los ntawm txoj hnyuv, so ntawm lub raum.
Kev ntsuas rau siv
Cov tshuaj yog siv los tiv thaiv atherothrombotic cov teeb meem nyob rau hauv cov neeg laus cov neeg mob uas tau soj ntsuam nrog cov pathologies:
- myocardial infarction;
- ischemic mob stroke;
- kev mob plawv hauv lub plawv;
- kab mob occlusive arterial (peripheral);
- mob sai ntawm cov mob vwm (nrog kev nce hauv ntu hauv ST thiab tsis muaj nws).
Ntxiv rau, cov tshuaj yog siv los tiv thaiv thromboembolic thiab atherothrombotic cov teeb meem ntawm atrial fibrillation, mob stroke.
Cov Yuav Tsum Muaj
- muaj lub cev tsis haum rau cov tshuaj;
- cev xeeb tub thiab lactation;
- los ntshav (mob);
- kab mob siab thiab mob hnyav;
- hnub nyoog qis dua 18 xyoo;
- GGM syndrome, lactose tsis haum, tsis muaj lactase.
Nrog saib xyuas
- teeb meem hauv nruab nrab thiab mob siab;
- lub raum tsis ua haujlwm;
- cov mob uas ua rau muaj feem los ntshav;
- ua ke nrog Heparin, Warfarin thiab glycoprotein inhibiting cov neeg sawv cev;
- intolerance mus rau lwm cov thienopyridines (Prazogrel, Ticlopidine, thiab lwm yam).
Yuav noj Zilt li cas?
Cov tshuaj yuav tsum quag cawv 1 zaug nyob rau ib hnub. Cov zaub mov tsis cuam tshuam rau kev ua thiab kev nqus ntawm cov tshuaj.
Nrog ischemia, myocardial infarction thiab occlusive arterial vascular kab mob, qhov nruab nrab koob yog 75 mg (1 ntsiav tshuaj) ib hnub.
Rau cov neeg mob uas muaj atrial fibrillation, cov tshuaj yog kws kho hauv qhov ntau npaum ntawm 75 mg. Qhov nyiaj pab ntau tshaj txhua hnub yog 300 mg. Hauv qhov no, acetylsalicylic acid qee zaum ntxiv siv.
Yog tias koj hla kev siv txoj kev siv tshuaj ntxiv rau tom ntej, koj tuaj yeem siv nyob hauv 12 teev. Tom qab qhov no, cov tshuaj kho yuav tsum tsis ua txhaum. Tsis txhob txhaj ob koob.
Cov tshuaj yuav tsum quag cawv 1 zaug nyob rau ib hnub.
Noj cov tshuaj rau ntshav qab zib
Yog tias koj muaj ntshav qab zib, koj yuav tsum sab laj nrog tus kws kho mob ua ntej noj cov tshuaj.
Yuav ntev npaum li cas?
Lub sijhawm tiv thaiv kev siv tshuaj yuav tsum tsis pub ntau tshaj 1 xyoos.
Sab sij huam
Cov tshuaj tuaj yeem ua rau tsis muaj qhov tsis haum. Yog tias muaj cov no tshwm sim, koj yuav tsum hu rau koj tus kws kho mob tam sim ntawd.
Kev kho mob txoj hnyuv
- mob hauv plab;
- raws plab thiab quav tawv;
- plaub sua;
- pancreatitis
- los ntshav hauv txoj hnyuv ntu (retroperitoneal hemorrhage);
- xeev siab
- ntuav
- dyspepsia.
Hematopoietic plab hnyuv siab raum
- leukopenia;
- anemia
- agranulocytosis;
- granulocytopenia;
- thrombocytopenia;
- neutropenia (hauv qee yam tsis tshua muaj).
Nruab nrab hauv lub paj hlwb
- mob taub hau
- npaws
- qhov muag plooj;
- auditory thiab pom kev pom;
- Kiv taub hau
- tshee hnyo.
Los ntawm cov kab mob zis
- glomerulonephritis (hauv cov neeg tsis tshua muaj neeg pom);
- hematuria;
- lub raum tsis ua haujlwm;
- nce plasma creatinine ntau ntxiv.
Los ntawm lub tshuab ua pa
- ntshav tawm los ntawm lub qhov ntswg;
- kev zais ntawm cov hnoos qeev thiab cov ntshav los ntawm txoj hlab pa;
- interstitial daim ntawv ntawm mob ntsws;
- bronchial spasms.
Ntawm ib feem ntawm cov khoom hauv nruab nrog kev pom
- tsis tshua meej qhov pom;
- nce siab intraocular;
- ob lub zeem muag.
Ntawm ib sab ntawm daim siab thiab cov hnyuv
- exacerbation ntawm tsis ua hauj lwm thiab lwm daim siab tsis ua haujlwm;
- kab mob siab.
Los ntawm cov leeg nqaij thiab pob txha sib txuas
- mob leeg ntshav ntswg;
- hemarthrosis;
- myalgia;
- arthralgia;
- mob caj dab.
Ntxiv rau, anaphylactoid tshua yuav tshwm sim thaum noj cov ntsiav tshuaj.
Cov lus qhia tshwj xeeb
Cov neeg mob uas tau ntsib cov txheej txheem thiab kev ua haujlwm yuav tsum tau ua tib zoo saib xyuas thaum noj cov tshuaj kom tsis txhob muaj teeb meem vim los ntshav sai.
Cov tshuaj ncua sijhawm ntev ntawm qhov los ntshav. Yog li, nws tau kho nrog ceev faj rau cov neeg mob uas muaj kev pheej hmoo siab ntawm cov mob no.
Ua ntej kev ua haujlwm npaj, thaum ua haujlwm tiv thaiv tshuaj tiv thaiv kab mob tsis tas yuav tsum, cov tshuaj yuav tsum tau tsum tsis pub dhau tsawg kawg 5-6 hnub ua ntej kev phais mob. Qhov no suav nrog cov txheej txheem kho hniav.
Cawv tau zoo
Kev sib xyaw ntawm cov tshuaj nrog cawv tuaj yeem ua rau lub plawv tsis zoo, kev tsim tachycardia thiab bradycardia. Yog li ntawd, nrog kev kho mob siv yeeb tshuaj, kev sib txuam zoo li no yuav tsum zam.
Kev sib xyaw ntawm cov tshuaj nrog cawv tuaj yeem ua rau lub plawv tsis zoo, kev tsim tachycardia thiab bradycardia.
Cuam tshuam rau lub peev xwm los tswj cov tshuab
Cov tshuaj tsis muaj qhov cuam tshuam rau lub peev xwm tsav lub tsheb thiab kev ua ub no uas yuav tsum muaj kev cuam tshuam sai sai thiab saib xyuas.
Siv thaum cev xeeb tub thiab lactation
Thaum lub sijhawm cev tes taw, cov tshuaj tau hais tawm tsuas yog hauv qhov xwm txheej uas xav tias yuav muaj txiaj ntsig tshaj qhov kev pheej hmoo.
Thaum lactating thiab kev noj tshuaj, kev pub niam mis yuav tsum muab pov tseg.
Zilt lub sijhawm teem rau menyuam yaus
Cov tshuaj tsis yog npaj rau kev kho mob ntawm tus neeg mob me.
Siv rau lub sijhawm qub
Rau cov neeg mob laus, cov koob tshuaj tsis hloov kho. Txawm li cas los xij, lawv yuav tsum muab cov khoom thauj pov tseg.
Rau cov neeg mob laus, cov koob tshuaj tsis hloov kho.
Noj ntau dhau
Hauv kev noj tshuaj ntau dhau, cov tshuaj yeeb yaj kiab tuaj yeem ua rau lub sijhawm ntev ntawm lub sijhawm los ntshav thiab hemorrhagic muaj teeb meem. Txhawm rau qhov xwm txheej ntawm tus neeg raug mob, ntshav hloov ntshav yog kho tau. Cov tshuaj tsis muaj cov tshuaj tua kab mob.
Kev cuam tshuam nrog lwm yam tshuaj
Nws yog qhov tsis tsim nyog los ua ke ua ke noj tshuaj nrog tshuaj tiv thaiv qhov ncauj vim tias qhov kev pheej hmoo ntawm kev nce ntxiv ntawm kev siv los ntshav.
Txhais tau tias ua kom qhov ua haujlwm ntawm lub twj tso kua mis proton muaj qhov cuam tshuam tsawg tshaj plaws ntawm isoenzyme CYP2C19 - Lansoprazole thiab Pantoprazole. Lawv tuaj yeem ua ke nrog cov tshuaj hauv cov lus nug.
Cov tshuaj tiv thaiv tsis ua mob rau cov tshuaj no tsis cuam tshuam rau lub zog ntawm cov tshuaj warfarin. Tab sis xws li kev sib txuam ua ke nce qhov kev pheej hmoo ntawm los ntshav vim tias txuas ntxiv ntawm cov ntshav coagulation.
Thaum cov tshuaj ua ke nrog Theophylline thiab Digoxin, lawv cov tshuaj pharmacokinetics tsis hloov.
Nws raug nquahu kom tsis txhob siv ib txhij nrog omeprazole.
Nws yog qhov tsis tsim nyog los ua ke ua ke noj tshuaj nrog tshuaj tiv thaiv qhov ncauj vim tias qhov kev pheej hmoo ntawm kev nce ntxiv ntawm cov ntshav khov.
Analogs
- Aterocardium;
- Thaj chaw;
- Ua Cuam;
- Brilinta;
- Deplatt;
- Avxwv;
- Diloxolum;
- Jendogrel;
- Clopact;
- Klopigrel.
Cov ntsiab lus ntawm lub tsev muag tshuaj tawm
Kuv puas yuav tau yam tsis muaj daim ntawv yuav tshuaj?
Yuav muab tsis tau hom tshuaj yam tsis muaj ntawv kho mob.
Zauv Nqe
Tus nqi ntawm cov tshuaj pib los ntawm 120 rubles rau 14 ntsiav tshuaj ntawm 75 mg ntawm cov tshuaj nquag nyob rau hauv cov thawv ntawv thawv.
Yuav muab tsis tau hom tshuaj yam tsis muaj ntawv kho mob.
Cia rau cov neeg mob rau cov tshuaj
Nws raug nquahu kom khaws cov tshuaj ntawm qhov kub ntawm tsis ntau tshaj + 20 ° C, nyob rau qhov chaw txias thiab qhuav qhov chaw hnub ci tsis tau.
Hnub tas sij hawm
24 Hlis.
Kev tshuaj xyuas rau Sylt
Cov kws kho mob
Igor Kvashnin (tus kws kho mob), hnub nyoog 40 xyoo, Barnaul.
Tus neeg sawv cev ua tau zoo thiab muaj hwj chim los ntawm pawg ntawm cov neeg ua haujlwm antiplatelet. Cov tshuaj nquag hauv nws cov muaj pes tsawg leeg muaj peev xwm ua kom qeeb hauv AT. Siv cov tshuaj no tsuas yog siv rau kev kho mob thiab raws li cov lus qhia ntawm kws kho mob. Yog tias qhov no tsis saib xyuas zoo, ces ib qho kuj yuav ntsib qhov tsis haum thiab tsis haum.
Cov neeg mob
Anton Wigman, 45 xyoo, Moscow.
Tau ntau xyoo raug kev txom nyem los ntawm angina pectoris. Txog li 3 lub xyoos dhau los Kuv tau raug mob stenting. Tom qab cov txheej txheem, Kuv noj 1 ntsiav tshuaj ntawm cov tshuaj no txhua hnub. Tsis ntev los no nws dhau qhov kev xeem, tus kws kho mob tsis tau qhia txog ib qho kev ua txhaum cai, ntawm qhov tsis sib xws, tau sau tseg tias muaj kev txhim kho hauv tus mob. Nws txoj kev noj qab haus huv kuj zoo tuaj, thiab kev tawm tsam angina kuj tsis tshwm sim ntxiv lawm.
Vladimir Dubov, 47 xyoo, Lipetsk.
Kuv xav tsis thoob los ntawm cov kws tshaj lij ntawm cov kws tshaj lij hauv peb lub tsev kho mob uas tau kuaj pom kuv tus mob ua ntej thiab mob stroke thiab cawm kuv txoj sia. Kuv yuav tsum mus cuag kws kho mob li 12 lub hlis. Tus kws kho plawv tau ceeb toom rau kuv txog cov kev pheej hmoo txaus ntawm kev siv tshuaj ntau thiab pom zoo siv cov tshuaj no vim tias nws pom zoo los ntawm lub cev thiab tsis tshua ua rau muaj kev phiv tshuaj. Tam sim no kuv cov hlab ntsha thiab cov hlab ntsha tau li qub.
