"Plagril": imiyalelo yokusetyenziswa, iigqabagululo zegqirha. Iziganeko zesilwanyana "Plagril"

Izifo ze-cardiovascular system zisezinyango zanamhlanje malunga nendawo yokuqala. Inani lokufa kwezi zifo liphezulu. Kukho iingxaki kule ndawo ezinokumnceda umntu ukususela ngexesha lokuzalwa. Nangona kunjalo, kukho nabo abaphuhliso lwabo umntu onesandla sakhe kuletha "inxaxheba" enkulu. Esinye isifo sifana ne-atherosclerosis. Ngaloo ngxaki, imirhoxo ye-elastic and muscular-elastic type ixhala kakhulu. Ingundoqo yesifo kukuba ngenxa yokuphulwa kweprotheni kunye ne-lipid metabolism, idiphostolol kunye neepoproteinzi ezithile zihlangene kwimida. Ngaloo ndlela, i-atherosclerotic plaques yenziwe. Ngokuhamba kwexesha, izicubu ezidibeneyo zeendonga zeempahla kule mihlaba zikhula, ezikhokelela ekunciphiseni kwe-lumen yomthamo ukuya kwi-occlusion.

Ukuze kuncede izigulane ezinjalo, izazinzulu ziye zaphuhlisa uluhlu olupheleleyo lwezonyango ezinokunciphisa okanye ukuphelisa ngokupheleleyo inkqubo yokuhlanganiswa (ukujoyina, i-gluing) yamaplatelet. Iimeko ezinjalo zibizwa ngokuba yi-antigregregants (i-antithrombotic agents). Esinye sezi zizobisi "Plagril".

Ukubunjwa kunye nefomu yokukhululwa

Isilwanyana sifumaneka kwiipilisi, ezigutyungelwe igobolondo yefayili yepinki. Iiblulethi zijikelezileyo, i-biconvex. Ngalunye icala lucwecwe "C 127". Into ehamba phambili yeziyobisi i-clopidogrel. Ngokuqinisekileyo, isilwanyana "Plagril" i-INN (igama elingamazwe angaphandle) lilingana negama eliyinhloko - clopidogrel. Umthamo womxholo kwithebhulethi enye ngu-75 mg. Ukongeza kwinqanaba eliphambili, ukwenziwa kweyeza kubandakanya izinto ezincedisayo: i- microcrystalline cellulose, i- mannitol, i-croscarmellose sodium, i-colloidal i-dioxide ye-coloniid, i-magnesium stearate. Abavelisi bakhiqiza izidakamizwa kwi-blisters ngamaqhekeza angama-10.

Indlela yokusetyenziswa kweziyobisi

Isilwanyana sisisithibethi esithile (vimbela - vimbela, vimbela nayiphina inkqubo) udidi (uxhumano) lweeplatelet. Unomsebenzi osasazekayo. Inkqubo yokunciphisa i- platelet aggregation (malunga nama-40%) ibonakala emva kweeyure ezingama-2 emva kokungeniswa kweziyobisi kumyinge we-400 mg. Ukuze ufikeleleke kakuhle (60% ukuvimbela ukuhluthwa) ukusuka kwimiphumo yamacwecwe e-"Plagril", imiyalelo yokusetyenziswa ibonisa imfuno yonyango iintsuku ezingama-4-7. Umthamo wonke weentsuku kufuneka ube ngowama-50 ukuya ku-100 mg. Kule meko, umphumo we-antiplatelet uza kuqhubeka kuwo wonke umjikelezo wobomi weeplatelet (iintsuku ezi-7 ukuya kwe-10). Kwiintsuku ezingama-5 emva kokuyeka ukusetyenziswa kweziyobisi, isantya se-platelet aggregation kunye nexesha lokulipha liya kubuya kwiimpawu zabo zokuqala.

Ikhutshwe emzimbeni "Plagril" ngamazinyo kunye namathumbu (50% kunye no-46% ngokulandelanayo). Ixesha lokuphelisa liiyure ezingama-120 emva kokulawulwa.

Abathengi abakhulu be "Plagril"

Kukho amaqela akhethekileyo e-patient-cores, aboniswa ukusebenzisa izilwanyana "Plagril". Imiyalelo ichaza ukuthatha isibisi kubantu abaphethwe yi-arteriosclerosis yemithwalo yegazi. Amachiza asebenzayo ngenjongo yokukhusela ukunciphisa ubunzima beengxaki ezinxulumene ne-thrombosis kubantu ababenomdlavuza we-myocardial okanye u-stroke. Kwakhona kubalulekile kwizigulane ezinobunzima be-occlusion (ukukhubazeka okungapheliyo) kweetriyeri zomhlaba.

Nge-acetylsalicylic acid (aspirin), kuya kwenzeka ukusebenzisa "i-Plagril" ukwenzela ukukhusela iingxaki zengxubevange kulabo abahluphekayo kwi-coronary syndrome. Oku kubandakanya abantu abane-angina (ifomu engaqinisekanga), kunye ne-myocardial infarction ngaphandle kokwakhiwa kwezinyo Q. Unokusebenzisa izilwanyana kwizigulana eziye zatshisa. Ingundoqo yesenzo kukufakela i-stent kwisitya esichaphazelekayo (ityhumbulu, ityhidi-metal besh tube), ekugqibeleni ihlonyelwe ibhaluni ekhethekileyo, ngaloo ndlela yandisa ukwenziwa komkhumbi kunye nokuphucula igazi le ntliziyo.

Imilinganiselo yolawulo

Izigulana zingathabatha iyeza "Plagril" ngaphakathi, kungakhathaliseki ukuba kutya. Kwizigulane ezithatha i- myocardial infarction, i- ischemic stroke, okanye ngubani ofumene ukuxilongwa kwe-patter's patency, umthamo we-75 mg uthathwa kanye ngosuku. Ixesha leyonyango emva kwe-Q-yokwenza i-myocardial infarction ingapheli kwiintsuku ezingama-35. Kwizigulane ezine-stroke zesischemic, ngokuxhomekeke kwimeko enzima, inkqubo yokonyango ingaba kwiintsuku ezi-7 ukuya kwiinyanga ezintandathu.

Nge-angina kwindlela engaqinisekanga kunye ne-myocardial infarction ngaphandle kokubunjwa kwe-Q-wave, i-regimen eqhelekileyo ibonakala ilandelayo: i-dose yokulayisha enye ye-300 mg, ngoko-75 mg ngosuku ngokufana nokuthatha aspirin (75 ukuya ku-325 mg ngosuku). Ekubeni umngcipheko wokuphuma kwegazi ukhula ngokuthatha i-aspirin, umthamo owodwa ungasayi kuba ngaphezu kwe-100 mg. Inkqubo yokwelapha unyango ifike kunyaka o-1.

Xa imeko ye-myocardial infarction, i-antigregregant "Plagril" ibonisiwe. Iibhilethi zichaza ukuthatha umyinge we-75 mg, enye ngosuku. Kucetyiswa ukuba uqalise unyango kunye nomlinganiselo wokuqala wokulayisha ngokudibanisa ne-acetylsalicylic acid. Kungenzeka ngokufana nokuthatha i-thrombolytics (okanye awukwazi ukuyithatha).

Ukuba izigulane ziye zawela umda weminyaka engama-75 ubudala, i-Plagril (efana ne-clopidogrel ingathathwa kwakhona) inikwe ngaphandle kwesaziso sokuqala. Emva kokuqala kweempawu zesi sifo, unyango oluhlangeneyo kufuneka luqaliswe ngokukhawuleza. Ikhosi kufuneka igcine ubuncinane iiveki ezi-4.

Iziphumo ezichaphazelekayo

Xa inkqubo yokonyango ilawulwa kunye nokulungiswa "kwe-Plagril", umyalelo wesicelo uzisa kwisiqalo sokuba iziphumo ezichaphazelekayo zinokwenzeka kwiindawo ezahlukeneyo kunye nezitho.

I-system coagulation system inokuphinda iphendule ngokubonakala kwintsholongwane yamanzi. Okungaqhelekanga kukuphuhliswa kwemivimbo ephazamisayo, i-nosebleeds kwaye, ngokubanzi, ukwanda kwithuba lokuphuma kwegazi. Kwiimeko ezinqabileyo, i-hematomas kunye ne-hematuria zinokuvela.

Kukho imbonakalo eyahlukileyo kwi-system ye hematopoiesis. Oku kuquka i-eosinophilia, i-neutropenia, i-thrombocytopenia. I-Granulocytopenia, i-anemia elula okanye ye-anemia ayiphuculwa kakhulu.

Isistim se-central ne-peripheral se-headquarters singaba nekhanda, utywala, i-paresthesia, i-vertigo (ukulahlekelwa kwe-balance, ihamba kunye nomvakalelo wokujikeleza kwezinto ezijikeleze umzimba okanye ngokuphambene-ukujikeleza komzimba), ukuguquka, ukudideka. Ngokuqhelekileyo, kodwa kukho iziganeko ezingabonakaliyo kwinkqubo ye-cardiovascular system, ebonakaliswa ekunciphiseni uxinzelelo lwegazi, ukuphuhliswa kwe-vasculitis. Iibronchospasms kunye ne-pneumonitis ye-interstitial - oku kungayimpendulo yenkqubo yokuphefumula ukuthatha isiza.

Ngokuqhelekileyo, imithi "ye-Plagril" (ukuphononongwa koogqirha kunye nezigulane ziqinisekisa le nyaniso) iyayiphendula kwinkqubo yokutya. Ukuphendula komzimba kubonakala ekuphuhliseni urhudo, i-dyspepsia, intlungu yesisu. Okungaqhelekanga iimpendulo ngendlela yesicathuko, ukuhlanza, ukuzitywa, ukunyanzeliswa kwe-gastritis kunye nesisu nesilonda, izilonda. Ngokuqhelekileyo, kodwa kunokwenzeka ukubonakala kwezifo ezinjenge-colitis, pancreatitis, stomatitis, i-hepatitis, utshintsho kwintetho, ukuphuhliswa kwesantya esibi.

Inkqubo ye-musculoskelet iyakwazi ukuzibonakalisa nge-arthritis, i-myalgia. Nangona oku akukwenzeka rhoqo. I-Glomerulonephritis inokubangelwa ukusabela kwenkqubo yokucoca. Odokotela-dermatologists bathi isiphumo esinokwenzeka sokusebenzisa "i-Plagril" ukubetha, ukuqhaqhaqhaqhaqhaqha, ukugqithisa, ukugqithisa i-erythematous, i-lichen flat, eczema. Kunokwenzeka ukuphuhliswa kweempembelelo ezinobungozi ngendlela ye-angioedema, i-anaphylaxis, isifo se-serum. Kwimiba echaphazelekayo, kukho ukunyuka kokushisa komzimba, umxholo ophezulu we-serum creatinine.

Ukusetyenziswa kwe "Plagril": yintoni eyokujonga

Ukuba imeko ethile ayiyinto engathandekiyo yefuthe le-antiplatelet, okanye ukuba ingenelelo yokucoca iphakanyisiwe, ngoko unyango kunye no-Plagril kufuneka luyeke. Umyalelo wokusetyenziswa ucebisa ukwenza okungenani iintsuku ezi-7 ngaphambi kokusebenza. Emva kokurhoxiswa kwesilwanyana sokumisa ngokukhawuleza kokuphuma kwegazi, kuya kuthatha ixesha elide. Izigulane kufuneka zixeliswe ngale nto kwaye zicebise ukuba zixelele ugqirha oya kwi-bleeding ngayinye engavamile. Inomdla wesigulane ukuxelela ugqirha malunga nokunyangwa "nge-Plagril" kwimeko apho kukho nongenelelo olwenziweyo olufunekayo, okanye unyango olumiselwe isigulane.

Kwinkqubo yokwelapha unyango kubalulekile ukugcina iiparameters kwinkqubo ye-homeostasis (inani lamaplatelets, iimvavanyo zomsebenzi wazo, APTTV) ekulawuleni. Umsebenzi osebenzayo wesibindi kufuneka kwakhona uhlolisiswe rhoqo kwaye uhlalutye, kuba ukungaqhelekanga kowomsebenzi walo kunokunyusa umngcipheko wesifo se-diathesis.

Amachiza anesifo se-clopidogrel ("Plagril", analogs) njengokuba isithako esisebenzayo asikhuthazelwanga kubantu ababenomdla wokutshatyalaliswa komzimba we-myocardial ubuncinane kwiiveki zokuqala emva kokuqala kwesi sifo. Abasebenzi bezonyango abacebisi unyango lwe-Plagril ukuba isigulane sine-angina engaqinisekiyo, isifo se-ischemic, i- coronary artery bypass graft.

Ngomlinganiselo othile wokulumkisa, misela ukuba uthathe isibisi kubantu abanokungaqhelekanga ekusebenzeni kweentso.

Ubani "indlela ye-Plagril" engqinelana ngayo?

"I-Plagril" (amacwecwe) imyalelo evimbela ukuthatha izigulane nge-hypersensitivity okanye ukunyamezela ngabanye kwiinkalo eziphambili kunye nabancedisi beyeza. Awukwazi ukuthabatha isilwanyana nasiphi na isifo esibangele ukuphuhliswa kwegazi ( izilonda zesisu kunye ne- duodenal ulcers, hyperfibrinolysis, izifo zamaphaphu, isifo sofuba, njl.). Isizathu esihle sokwenqaba ukusebenzisa i- "Plagril" sihluleka kakhulu kwesibindi, isifo segazi. Ukongeza kuzo zonke ezi ngasentla, amayeza aphikisana nabasetyhini abakhulelweyo kunye nomama onesiko. Akuvumelekanga ukunikezela ngemithi yokwelapha kwabantwana abangaphantsi kweminyaka eyi-18 ubudala.

Analogs

Kwimakethe yezobisi zanamhlanje, iqela lama-antiplatelet agents ("Plagril", ezichaseneyo zalo mxholo wesithako esisebenzayo) senziwa ngokubanzi. Izidakamizwa ezingaphezulu kwe-3 zinezixhobo eziphambili ze-antiplatelet zinomzimba osebenzayo (clopidogrel) kunye nomyinge ofanayo (75 mg). Ukongeza kubenzi baseRashiya, ama-anti-aggregators akhiqizwa yiinkampani zamayeza aseNdiya, amabhizinisi aseHungary, amaSirayeli, iMalta, eFransi.

"Plagril" ngokwayo iveliswa yinkampani yaseNdiya "uDkt. Reddis Laboratoris". Izifaniso ziquka isiFrentshi Plavix, isiJalimane iClopidogrel Ratiofarm, isiHungary Clopidogrel-Richter, i-Israel Clopidogrel-iTeva, iLimalore iLiporel, iMakedonian Listaf 75. Eyona ndawo eyaziwa kakhulu kwaye ifunwa ngokubanzi kwizidakamizwa zaseRashiya ingaziwa "i-Zilt".

"Zilt" - isiRussia "Plagril"

Isisombululo esisisiseko sonyango "I-Zilt" ("Plagril" kule nto ihambelana ngokupheleleyo) i-clopidogrel. Isilwanyana singeqela le-antiplatelet agents. I-dose yokuqala (i-"Zilt" - 400 mg) emva kweeyure ezingama-2 emva kokungcola kunciphisa ukuhlanganiswa kweeplatelet. Kanye kunye ne "Plagril", "Zilt", ngokuxhomekeke ekuthathe i-50-100 mg ngosuku, isiphumo esiphezulu sonyango siya kunika emva kweentsuku ezingama-4-7.

I-Metabolized medicine esibindi. Akukho metabolites esebenzayo itholakala egazini . Phantse i-50% ye "Zilt" idityaniswe yizintso, i-46% esele zingadlulanga iintsuku ezi-5 emva kokumiselwa iya kuhoxiswa emathunjini.

Izibonakaliso zokusetyenziswa kwi "Zilt" zifana ne "Plagril": ukuthintela i-thrombosis kwizigulane ezithe zatshutshiswa i-myocardial infroction, i-ischemic stroke okanye ixinzeleleke ekuphatheni komzimba.

Umbono womthengi

Njengawuphi na isicatshulwa, "Plagril" iye yavavanya ukuvavanya kwabathengi, kunye nempendulo engalunganga. Kukho izigulana apho izidakamizwa eziye zamiselwa unyango lwe-angina kwaye zibonakaliswe ukuba ziyingozi kakhulu. Ngokusetyenziswa kwakhe kokuhlaselwa kwagqitywa konke, okanye bahamba kakhulu. Ubumbano kunye nabathengi ekuvavanyeni izilwanyana "Plagril" uphando oogqirha.

Nangona kunjalo, umntu unokufumana iingxelo malunga neziganeko ezimbi ezibangelwa ukusetyenziswa kweziyobisi. Ezinye izigulane zabhalwa malunga nokubonakala kweempawu ze-hematomas, ezinye zibonisa i-anemia ecacileyo. Kwakukho izigulane kunye nokuhlaselwa kweentloko ezinzima, kunye nezikhokelo ezahlukeneyo zesifo kwi-digestive system. Ngokuqhelekileyo, kodwa unokuva malunga nesilonda esiswini okanye isilonda se-duodenal sakhula ngexesha lolawulo lwe "Plagril".

Ngokuqhelekileyo, kuyafaneleka ukuthetha ukuba isilwanyana "umyalelo we-Plagril" wokusetyenziswa sisetyenziswe njengesilwanyana esilungeleyo esingahambelani nawo onke amayeza. Unoluhlu olubanzi lwezinto ezingqinelanayo, lunokubangela ezininzi iziphumo ezichaphazelekayo kwiinkqubo ezahlukeneyo kunye namalungu. Isicelo esingalawulekiyo singakhuthaza ngokungafanelekanga (kwaye ngamanye amaxesha kungenakwenzeka) kwimpilo yesigulane.

Isigqibo esivela ngasentla siyabonakala. "I-Plagril" yenkqubo yokonyango kufuneka iqeshwe ngudokotela oya kwiindawo. Kwaye ukhetho olunona lukhulu kunonyango olu siza esibhedlele kwaye phantsi kweliso lweengcali ezikhokelayo. Kule meko kunokwenzeka ukuba nethemba lokuba nomthelela omuhle wokuthatha le nkunkuma ngengozi encinci yokuphuhlisa imiphumo.