"Atsekardol": ezibonisa ukusetyenziswa, imiyalelo, ukubuyekeza, analogs

Phakathi kwiindlela unyango antiplatelet, okusetyenziselwa nokuthintela iziganeko zosulele sentliziyo, iye yaba ngumba ophambili acetylsalicylic acid (ASA) elide. Kuhlelwe ngo-1887, oko kukuthi iminyaka engaphezu kwama-125 ibisoloko isetyenziswa yezonyango njengearhente antiplatelet kunye antipyretic. Kwaye njengoko engekho mthethweni esebenzayo iqukiwe ekulungiseleleni "Atsekardol", ezibonisa ngokuthe ngcembe kwandiswa njengoko isifundo iindlela yayintsholongwane eyosulela sifo.

System medicament uphawu

Amalungiselelo into esebenzayo ngokutsho yokuhlela inxulumene nendlela ekuthinteleni udibaniso. Kolu ngcelele eyo na imichiza ukubunjwa isebenzayo ekwaziyo bangakwazi ukunika yonke zegazi udibaniso pool. iziyobisi ukuqikelela "Atsekardol", kubonakala ukuba ukusetyenziswa, kwaye analogs yayo uhlobo umthamo ngokubhekiselele pharmacodynamics, lwabonisa oku kulandelayo:

• isithako yayo esebenzayo - ASA ekufumaneni iziphumo antithrombotic kwi yamafutha imvelaphi kwemithambo;

• ngeyona ndlela inenzuzo enkulu imvukelo kweziyobisi kuthintelo nesifo sentliziyo;

• uhlobo wayo oyidlayo kunciphisa i-ASA isiphumo gastrotoxicity;

• Alungiselelwe ezingabizi kakhulu phakathi bekhuphisana iimveliso kunye ngendlela efanayo.

Ifuthe ekuthinteleni thrombosis ASA wachaza kwafa ukubunjwa prostanoids. Ngenxa inhibition of Cox-1 - Cyclooxygenase-1 zegazi - kuphazanyiswa ukuqalisa thrombus ukubunjwa factor - ukuba udibaniso lwe zegazi. Inhibition kwenzeka ekumisweni thromboxane A2, uqala inkqubo kuthinjwe zegazi kwinxalenye ezonakeleyo eludongeni inqanawa.

Izizathu kunye kwabalinganiswa gastrotoxicity

ezibonisa ekujoliswe for "Atsekardola" ziquka kuthintelo thrombus Ukwakheka. Nangona kunjalo, i-ASA, eyona nto ebonakalayo ichiza, kukho isiphumo ezingathandekiyo ezinxulumene cyclooxygenase nonselective. Kwakhona yaphazamiseka iphelele iiseli epithelial nesiqephu esiswini. Ukuba phantsi kweempembelelo banqande bume isisu asidi, ukuba baninzi yonakele, nto leyo ebangela ukuba uphuhliso bezifo komtshiso gastral. Amaxesha (malunga 3.5% yazo zonke iimeko) oko Uxhokonxwa ukopha lokugaya.

Kuba ekuqulunqeni, esebenzisa "Atsekardol" ezibonisa ukuba ukusetyenziswa ngakumbi ngokubanzi ngenxa ukhuseleko enkulu. It iyachithakala kwaye kuphela kwi-duodenum 12, elimele ama kardioformu-ASA. contact kwakhe kwiiseli esiswini cishe nya, ngaloo elinganeno isiphumo ecaleni layo gastrotoxicity. ukusebenza Local ekonakaleni "Atsekardola" uyacutheka, ngokuba ichiza ngokohlobo ama sele ingqalelo njenge inhibitor uyakhetha of Cox-1. Nangona Cox-2 inhibition kwakhona lwenzeka kwi emathunjini, nto leyo ayiboniswanga Ukuphazamiseka ebalulekileyo.

Isiphumo ebalulekileyo ifomu idosi "Atsekardola" yakule gastrotoxicity ngqo ukwehla. Ngenxa yobukho esesiwini ngohlobo wemagniziyam hayidroksayidi amathuba umonakalo esiswini kunciphisa ephakamileyo. Yaye mzuzu kwimarike amayeza we-Russian Federation "Atsekardol" yenye imali ezintathu kwezi zakhiwo. Nguyena ezingabizi kakhulu phakathi efanayo, oko udalelwe ukusetyenziswa ngokusisigxina.

Indawo "Atsekardola" in kunyango antithrombotic

ASA ngokuba prophylaxis of ngezenzeko thrombotic lisetyenziswa isekelwe phezu ezininzi zophononongo. Baye kuqinisekiswa impumelelo yayo ekunciphiseni lokusweleka nomonde ukuba isifo sentliziyo. Ngokukodwa:

• BUZA-16% kunciphise ukufa phakathi nezigulane iqela phezulu nengozi yokuba nesifo senhliziyo:

• 25% unciphiso isehlo stroke kobuchopho;

• 25% lunciphisa ubungozi thromboembolism, pulmonary amasebe awo;

• 29% kunciphisa amathuba thrombosis kwangumqondiso lwemithambo of isinqe amancinci okanye iziphelo;

• 33% unciphiso isehlo iposi engabalulekanga.

Ezi ziphumo kwaye inika iziboniso iziyobisi ngokupheleleyo "Atsekardol" apho kancinane banzi ASA zheludochnorastvorimoy. Kwaye ngoku amandla yezenzo antithrombotic kwamachiza amatsha antiplatelet kuhlolwa kuphela xa kuthelekiswa nayo. Ngokufanelekileyo, "Atsekardol" njengoko ekhuselekileyo ngakumbi, kufuneka kungene indawo esembindini unyango umbala zezigulane ngokutsho yesingqino.

izigulane anokwenzeka kunye ezibonisa zokusetyenziswa

Xa Elungiselela "Atsekardol" ezibonisa ukusetyenziswa, ixabiso, ukusebenza kunye imingcipheko ngokusebenzisa ngeyona ndlela inenzuzo enkulu elungeleleneyo. Oku kukuvumela ukuba uthathe ASA kwifomu idosi ke uluhlu olubanzi kwizigulane kunye imiba occlusive lomngcipheko. Kunye nokuphelisa ezininzi iziphumo ebezingalindelekanga oonobangela kweziyobisi kwezi meko zilandelayo:

• (ACS) syndromes zosulele semithambo kunye ukuphakama kwayo, ukudakumba okanye ukusiwa ST lokuphumla kwi ECG;

• ukuphazamiseka ebuchotsheni etsolo (ebuchotsheni) ukujikeleza (ADCC);

• ezidlulayo (ubuchopho) kobuchopho (TIA);

• bafudukela phantsi kwezi zifo ukuze kuthintelwe amatyala yomhla nezolo;

• kunye ezinzileyo sifuba angina yokuthintela ACS;

• nge paroxysm okanye uhlobo isigxina fibrillation atrial;

• mithambo lwemithambo varicose.

substantiation Pathogenetic isicelo "Atsekardola"

Ezi ezibonisa for "Atsekardola" ngenxa isiphumo bezonyango beziyobisi. It isetyenziswa ngokufanelekileyo njengendlela ekuthinteleni emithanjeni thrombosis kwindawo womda kunye umonakalo concentric atherosclerotic. Kule ndawo ngenxa licuthe yokumpompoza kwegazi esimbaxa iphazamisekile ukwenza owayenethombo legazi umsinga. uxinzelelo Mechanical phezu izabelo thinned le endothelium kukhokelela ukukrazula yayo. inkqubo Blood coagulation ingqalelo eli lizwe libe kophulwa ingqibelelo semithambo, efuna platelets wokuvala ngoomatshini ukuze ibe lihlwili.

Le kuthinjwe zegazi kukuthi, isigaba sokuqala thrombus Ukwakheka, ekugqibeni okufanele isikhokelo malunga nekamva ihlwili legazi. Emva koko, ubukhulu balo kwandisa ngenxa yokulibaziseka iiseli zegazi. ukugqitywa ngokupheleleyo iinkqubo kukhokelela hemostasis esiqatha (ngaphezu kwe-75%) licuthe le sayo isitya. Lidla nokuba iquka igazi ukugeleza kwemithambo, kunye neendawo loo madini ebekade wondla kumava akhe ischemia. Le nkqubo ngenxa ACS nobetho, ngoko nokuthintelwa la kubaluleke kakhulu ukwenzela ukuba isifo ngamnye ukusuka atherosclerotic entliziyweni kunye brachiocephalic imithambo.

Pharmacodynamics isenzo antithrombotic "Atsekardola"

Okuqhotyoshelwe ichiza "Atsekardol" yemiyalezo (inkcazo imveliso) ayibonisi iziphumo zayo pharmacodynamic, kwaye iyichaza ngokubhekiselele kwiimpawu zokufunda kunye yolwamkelo. Nangona kunjalo, oko akuthethi ukuchaza isiphumo ethile ASA, ngokwenjenjalo ukubandezana ogulayo ulwazi olubalulekileyo malunga indlela yokusebenza. ubuchule yayo ezilandelanayo zezi zilandelayo:

• inhibition of Cox-1 kunye ukumisa Yindibanisela prostanoids;

• ukuvelisa ukuvimba lakho zegazi thromboxane A2;

• umqobo zegazi uncamathiselo kwi iziphene le endothelium;

• inhibition kweenkqubo adhesion zegazi;

• nakwenzeka wokusungula thrombus occluding le mithambo umfutho.

"Atsekardol" kwiimeko oyingozi

Kukwaqhotyoshelwe imiyalelo "Atsekardol" iziyobisi zokusetyenziswa (isishwankathelo inkcazelo) ayiboneleli ngolwazi kwisigulana malunga namathuba ukusetyenziswa kwayo ngexesha wokuhlaselwa ukuphazamiseka nokoyika kwegazi ezintliziyweni okanye ingqondo. Ngokukodwa, kunye nophuhliso lwezonyango syndrome uphawu iposi engabalulekanga okanye palsy, kwaye isicelo ASA.

Iipilisi kufuneka ukuhlafuna ichiza (kwi ithamo ka 150-300 mg) kwaye hayi ukuba imginye. Ukuba isigulane beziyobisi umthamo we-50 mg, mzuzu kukho imeko etsolo kufuna zombini amacwecwe hlafuna 3-6 xa umthamo 100 mg, amacwecwe 2-3 xa 300 mg, 1 tablet. Kuyinto sisixhobo likaxakeka, apho kakhulu zanciphisa amathuba thrombosis kakhulu nemithambo.

Izimo ekusebenziseni "Atsekardola"

Xa Elungiselela "Atsekardol" (tablets) imiyalelo ukusetyenziswa, iingcali zokwenene kunye neenkcukacha zophando amayeza ukuqinisekisa intsalela lweengozi kunye neenzuzo kwesicelo. Noko ke, Izimo ngenxa comorbidities kufuna ingqalelo xa ezithatha ichiza aze adibane specialist. Izimo zahlulwe rhoqo (ingundoqo) kunye nexesha. Kuphelele zezi:

• nobandlululo kweziyobisi ASA, bronchoconstriction;

• hematoma intracranial kwiindawo ezahlukeneyo;

• sophele vasculitis ;

• Akuvunyelwe ukuyisebenzisa abafikisayo abantwana ngenxa esichengeni Reye engqondweni ;

• Akuvunyelwe ukwamkela abasetyhini ngexesha zisanyisa, ku mna III senyanga lokukhulelwa.

Kwakhona ukuyaphi ixesha ulwamkelo kunye Izimo isihlobo:

• hepatocellular kunye ukusilela kwezintso;

• ubukho ukopha oluqhubekayo, ixesha ekuqaleni postoperative (contraindication okwexeshana);

• hypertension ngexesha lobunzima, hypertension olungalawulwayo;

• isilonda 12 isilonda duodenal okanye exacerbation esiswini (umda ixesha).

imiphumela Multiple "Atsekardola"

Ukongeza yeziphumo standard yaye bafunda kakuhle okubangelwa inhibition of Cox babe eyo ukho yaye enye intshukumo. Wayehlatyelwe kuthotho izifundo manani kwi umhlaza kunye nakumaziko zamaxhego kwi-US. Ekuhambeni kwaba isiphumo yabo emihle ASA nokuthintela izifo amabi - umhlaza colorectal kwendawo ezahlukeneyo.

Ngoku sibonisa indlela ethile yezenzo zikhusela ichiza. Ngokutsho kwabaphandi ezininzi baseklinikhi ayavuma ngakumbi ubukho bezinto isiphumo inhibitory ka Cox-2 emathunjini asezantsi. Ziyibuyisela umva le Yindibanisela prostaglandin E2, eyo ikuvumela eyenziweyo ukulawula ukutshatyalaliswa nokukotshwa eziseleni. Hi ndlela leyi, le nkqubo ethile cellular kubalulekile kuphuhliso ithumba.

Isiphelo ngenxa leefekthi nezingqinekayo zimi ngolu hlobo lulandelayo: amayeza "Atsekardol" umyalelo, isicelo, iingcali yokwenene leyo ukuqinisekisa ukusebenza kwayo elungeleleneyo, nazo zingasetyenziswa njenge umbala kuthintelo iinkqubo ithumba kwi ngokwezahlulo asezantsi phecana zesisu. Phakathi 5-12 iminyaka Andamkeli kuyayinciphisa ingozi ngumhlaza ukufa, nto leyo eyandisa ngokwemvelo sempilo. Noko ke eyo ayikwazi zingasetyenziswa ukunyanga adenoma colorectal sele ziphuhlisiwe okanye carcinoma emathunjini.

Analogs ukulungiswa kunye nezinye

iimpawu Product "Atsekardol": isicelo, umsebenzisi, analogs, kubonakala ukuba unyango antithrombotic onokusebenzisa ukuphatha uluhlu olubanzi kwizigulane. Nangona kunjalo, kuthotho arhente antiplatelet, nguye kuphela kwendlela. In Russia kukho malunga 20 eyo generic, inxalenye yayo eveliswe kwifomu zheludochnorastvorimoy. Bevuma ukuba spectrum yokhuseleko "Atsekardolu".

iintlobo ama of ASA ( "Cardiomagnyl", "Polokard") ibonisiwe kwimarike amayeza, ixabiso aphezulu kakhulu. Lokulungiselela "Atsekardol" unyango nyanga ixabiso le engange-25. Completely twatse ne kunoogxa kumqolo ofanayo zokhuseleko esithathwini-ngakumbi. machiza abavela kwamanye amazwe zizonke indo- okanye ngaphezulu izihlandlo ezihlanu ngaphezu iindleko zonyango lwe-mali ngaphandle kwesizathu yingenelo kwisigulana ekufumaneni i "Atsekardol". Imiyalelo yokusebenzisa, unyango, ncomo, iingxelo ezivela analogs kweli chiza nazo twatse.

Izigqibo malunga iinzuzo kunye iingozi analogue "Atsekardola"

Wahlala ke ezingabizi kakhulu, ichiza "Atsekardol" liyahambisana ngokupheleleyo iimfuno oonoklinikhi. Umngcipheko ukusetyenziswa kwayo ukulungelelana nokusetyenziswa izicelo ezisebenzayo ezifana arhente antiplatelet. Oku kwenza ukuba thrombosis nezolo iimpahla intliziyo negazi ingqondo, isetyenziswa fibrillation atrial, sisetyenziselwa mithambo varicose. Kwaye xa kuthelekiswa ne analogs inzuzo yommandla "Atsekardola" i nokufikeleleka.

Le nto kakhulu kwandisa ukufaneleka "Atsekardol" imveliso: ixabiso ichiza engange ngaphezu kwama-20. Oku ngaphantsi kakhulu iindleko kwezinye izinto antiplatelet. Ngaphezu koko, phakathi iziyobisi ASA eziveliswa kule ndlela ikhuselekileyo ama, ezizezi sezantsi elungeleleneyo "Atsekardol". Ngokuqhelekileyo, oko wesuka ukuba unyango lwe ezi zifo zikhankanywe apha ngasentla, kunye nokuthintela kwabo. A Inani kwiindawo yesicelo ziza kwanda.