FRAXIPARIN: PHIV, DEJ CAWV SIB TXUAM, CONTRAINDICATIONS

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Teeb meem nrog ntshav coagulation, cov teeb meem thromboembolic yog cov mob hnyav heev uas yuav tsum tau kho tam sim ntawd.

Ntau zaus hauv cov xwm txheej zoo li no, cov kws kho mob tau muab tshuaj rau Fraxiparin. Cov kev mob tshwm sim thiab contraindications rau nws siv yog pom, thiab nws yog ib qho tseem ceeb kom paub txog lawv.

Cov teeb meem no, nrog rau cov ntaub ntawv hais txog kev siv tshuaj yeeb, nws cov txiaj ntsig thiab kev tshuaj xyuas yuav tham txog tom qab.

Pharmacological kev txiav txim

Fraxiparin muaj cov roj tsis tshua hnyav molecular heparin, kev tsim cov khoom uas tau coj los ua cov txheej txheem depolymerization. Ib qho yam ntxwv ntawm kev siv yeeb tshuaj yog tshaj tawm kev ua haujlwm nrog kev sib txuam nrog coagulation factor Xa, nrog rau cov haujlwm tsis muaj zog ntawm qhov tseem ceeb Pa.

Anti-Xa cov haujlwm yog tshaj tawm ntau dua li cov nyhuv ntawm tus neeg sawv cev ntawm qhib ua ntu ib nrab thrombotic phaj sijhawm. Qhov no qhia tau tias kev ua antithrombotic.

Cov tshuaj Fraxiparin

Cov tshuaj no muaj anti-inflammatory thiab immunosuppressive zoo. Ntxiv mus, kev ua ntawm tus neeg sawv cev tuaj yeem pom sai sai, thiab nws siv sijhawm ntev txaus. Hauv 3-4 teev, cov tshuaj kom nqus tau. Nws yog tawm nrog nrog zis los ntawm ob lub raum.

Ua ntej pib siv, nws yog ib qho tsim nyog yuav tsum kuaj xyuas lub luag haujlwm ntawm lub siab thiab lub raum, theem ntawm cov ntshav coagulability, ntxiv rau cov ntsiab lus ntawm cov roj.

Kev ntsuas rau siv

Siv cov Fraxiparin siv nyob rau kis no:

kev kho mob ntawm myocardial infarction;
kev tiv thaiv ntawm cov teeb meem thromboembolic, piv txwv li, tom qab phais, lossis tsis phais;
coagulation prophylaxis thaum mob hemodialysis;
kev kho mob ntawm cov teeb meem thromboembolic;
kev kho mob tsis ruaj khov angina pectoris.

Tso tawm daim ntawv, muaj pes tsawg leeg

Kev tso tawm ntawm Fraxiparin yog nyob rau hauv qhov kev daws teeb meem rau kev txhaj tshuaj, muab tso rau hauv cov koob txhaj tshuaj. Cov koob txhaj tshuaj nws tus kheej yog nyob rau hauv cov hlwv, uas tau ntim rau hauv 2 lossis 10 daim hauv ib daim ntawv thawv.

Cov nkauj muaj xws li cov tshuaj nquag hu ua calcium adroparin 5700-9500 IU. Cov khoom siv pabcuam hauv qab no yog: calcium hydroxide, dej lim, thiab chloric acid.

Sab sij huam

Zoo li feem ntau cov tshuaj, Fraxiparin qee zaum ua rau muaj kev phiv:

thrombocytopenia;
kev tsis haum tshuaj (feem ntau los ntawm Fraxiparin khaus plab), suav nrog Quincke's edema;
los ntshav ntawm ntau qhov chaw;
daim tawv nqaij necrosis;
txoj kev muaj tiag;
eosinophilia tom qab rho yeeb tshuaj;
thim rov qab hyperkalemia;
qhov tsim muaj cov ntshav me nyob ntawm qhov chaw txhaj tshuaj, qee zaum doog ntshav loj los ntawm Fraxiparin kuj tshwm (duab hauv qab);
nce ntxiv hauv cov ntsiab lus ntawm hepatic enzymes.

Bruises los ntawm Fraxiparin

Qee tus neeg mob uas tau siv Fraxiparin pom tias qhov kev hnov mob hnyav tom qab kev txhaj tshuaj.

Cov Yuav Tsum Muaj

Cov Lus Pom Tsis Zoo Fraxiparin muaj cov hauv qab no:

thrombocytopenia;
hnub nyoog txog 18 xyoo;
organic qhov txhab ntawm cov plab hnyuv siab raum nrog txoj kev nyiam los ntshav;
intracranial hemorrhage;
rhiab nkag mus rau cov cheebtsam hauv qhov dhau ntawm qhov qauv;
phais mob lossis raug mob rau lub qhov muag, lub hlwb thiab tus txha caj qaum;
los ntshav los yog qhov kev pheej hmoo siab ntawm nws tshwm sim hauv kev ua txhaum ntawm hemostasis;
mob raum tsis zoo uas tau tshwm sim los ntawm myocardial infarction, tsis khov tsis khov, kev kho mob ntawm thromboembolism.

Nrog kev pheej hmoo siab los ntshav, Fraxiparin yuav tsum ua nrog ceev faj. Cov xwm txheej muaj raws li nram no:

daim siab ua haujlwm;
circulatory mob hauv retina thiab choroid;
lub caij nyoog kho ntev dua li kev pom zoo;
lub cev hnyav txog 40 kg;
lub sijhawm tom qab ua haujlwm ntawm lub qhov muag, txha caj qaum, paj hlwb;
mob ntshav liab hnyav heev;
tsis ua raws li kev kho mob;
mob plab peptic;
noj tshuaj tib lub sijhawm uas tuaj yeem ua rau los ntshav.

Kev nkag mus ntawm nadroparin los ntawm cov hno tseem tsis tau kawm txaus, yog li ntawd, thaum cev xeeb tub, nws kuj tsis pom zoo kom siv cov tshuaj. Qhov no kuj siv rau kev pub niam mis.

Cov lus qhia rau kev siv

Fraxiparin tau nkag mus rau hauv plab plab hauv cov nqaij mos. Daim tawv nqaij yuav tsum tswj xyuas txhua lub sijhawm thaum kev daws teeb meem tau muab tshuaj.

Tus neeg mob yuav tsum tau dag. Nws yog ib qho tseem ceeb tias rab koob yog txiav tawm, thiab tsis nyob ntawm kaum sab xis.

Hauv kev phais dav dav rau kev tiv thaiv cov teeb meem thromboembolic, cov tshuaj yog muab rau hauv lub ntim ntawm 0.3 ml ib zaug ib hnub. Cov tshuaj no yuav siv tsawg kawg yog ib lub lim tiam kom txog thaum lub caij nyoog txaus ntshai dhau.

Thawj koob tshuaj yog muab ua ntej kev phais mob hauv 2-4 teev. Xws li kev phais orthopedic, cov tshuaj raug muab 12 teev ua ntej kev ua haujlwm thiab 12 teev tom qab nws ua tiav. Ntxiv mus, cov tshuaj raug coj mus rau tsawg kawg 10 hnub txog rau thaum xaus ntawm lub sijhawm pheej hmoo.

Cov koob tshuaj rau kev tiv thaiv yog tsim raws tus neeg mob lub cev qhov hnyav:

40-55 kg - ib hnub ib zaug rau 0.5 ml;
60-70 kg - ib zaug ib hnub rau 0.6 ml;
70-80 kg - ob zaug ib hnub, 0.7 ml txhua;
85-100 kg - ob zaug ib hnub rau 0.8 ml.

Txog kev kho cov teeb meem thromboembolic, cov tshuaj no tau muab sij hawm ncua sij hawm ntawm 12 teev ob zaug ib hnub twg rau 10 hnub.

Hauv kev kho mob ntawm cov teeb meem thromboembolic, qhov hnyav ntawm ib tug neeg ua lub luag haujlwm ntawm kev txiav txim qhov koob tshuaj:

txog li 50 kg - 0.4 mg;
50-59 kg - 0.5 mg;
60-69 kg - 0.6 mg;
70-79 kg - 0.7 mg;
80-89 kg - 0.8 mg;
90-99 kg - 0.9 mg.

Hauv kev tiv thaiv ntawm cov ntshav coagulation, cov koob tshuaj yuav tsum tau sau tseg ib tus zuj zus raws li cov zwj ceeb ntawm kev lim ntshav. Feem ntau, thaum coagulation tiv thaiv, vaj tse yog qhov pib ntawm 0.3 mg rau cov neeg txog 50 kg, 0.4 mg rau 60 kg, 0.6 mg dua 70 kg.

Kev kho mob ntawm myocardial infarction thiab tsis khov kho angina tau pom zoo kom sib xyaw nrog cov tshuaj aspirin rau 6 hnub. Thaum pib, cov tshuaj raug txhaj rau hauv cov hlab ntshav tawm (venous catheter). Cov koob tshuaj siv yog 86 ME anti-Xa / kg. Tom ntej no, txoj kev daws teeb meem tau muab tshuaj subcutaneously ob zaug hauv ib hnub nyob rau tib lub tshuaj.

Noj ntau dhau

Nyob rau hauv cov ntaub ntawv ntawm overdose ntawm xws li yeeb tshuaj, los ntshav ntawm ntau yam mob tshwm. Yog tias lawv tsis pom zoo, yog li tsis txhob txhawj xeeb. Hauv qhov xwm txheej no, koj yuav tsum tau txo qhov ntau npaum li cas, lossis nce ntxiv lub sijhawm ntawm kev txhaj tshuaj. Yog tias qhov los ntshav tseem ceeb, tom qab ntawd koj yuav tsum noj tshuaj protamine sulfate, 0.6 mg ntawm qhov muaj peev xwm tiv thaiv 0.1 mg ntawm Fraxiparin.

Yeeb tshuaj sib cuam tshuam

Noj franksiparin ib txhij nrog qee cov tshuaj tuaj yeem ua rau hyperkalemia.

Cov no suav nrog: cov ntsev qab ntsev, ACE inhibitors, heparins, NSAIDs, potassium-sparing diuretics, Trimethoprim, angiotensin II receptor blockers, Tacrolimus, Cyclosporin.

Cov tshuaj uas cuam tshuam rau hemostasis (tsis ncaj anticoagulants, acetylsalicylic acid, NSAIDs, fibrinolytics, dextran), ua ke nrog kev siv ntawm tus neeg sawv cev no, txhim kho cov txiaj ntsig ntawm ib leeg.

Txoj kev pheej hmoo ntawm los ntshav ntau ntxiv yog tias Abciximab, Beraprost, Iloprost, Eptifibatide, Tirofiban, Ticlopedin kuj tau noj. Acetylsalicylic acid kuj tseem tuaj yeem pab txhawb rau qhov no, tab sis tsuas yog hauv cov tshuaj antiplatelet, uas yog 50-300 mg.

Fraxiparin yuav tsum ua kom zoo zoo thaum cov neeg mob tau txais dextrans, tsis tso tshuaj tua tsis tau, thiab tshuaj tua corticosteroids zoo ib yam. Kev noj tshuaj tiv thaiv tsis tau tus kheej ua ke nrog cov tshuaj no, nws txoj kev siv txuas ntxiv mus txog thaum INR qhov ntsuas tsis ua haujlwm.

Fraxiparin thiab cawv kev sib txuam yog qhov tsis zoo. Cov tshuaj yog siv los tiv thaiv cov teeb meem thromboembolic, thiab haus dej cawv, ntawm qhov tsis sib xws, ua rau muaj kev pheej hmoo.

Xyuas

Raws li nrog ntau lwm yam tshuaj, muaj qhov tsis sib haum tshuaj xyuas txog Fraxiparin. Muaj cov neeg uas nws tau pab, thiab nws raug txiav txim siab ua haujlwm zoo, tab sis cov neeg mob uas xav tias cov tshuaj yuav tsum tau siv tsis muaj tseeb tsis suav nrog.

Cov kev xav tsis zoo muaj los ntawm qhov muaj ntau ntawm cov kev mob tshwm sim, contraindications. Tib lub sijhawm, txawm tias muaj lus ceeb toom hauv kev siv tshuaj rau cov poj niam cev xeeb tub, tsis muaj kev cuam tshuam rau kev noj qab haus huv thiab kev loj hlob ntawm tus menyuam tau pom.