Anticoagulants kai tsaye da kuma kai tsaye ba mataki. Kai tsaye ba anticoagulants: jerin kwayoyi, ginshikai na mataki, rarrabuwa. Yawan abin sama kai tsaye ba anticoagulants

Tare da dace aiki na coagulation da jini tsarin antisvertyvayuschey daidaita da ciki balance na jiki. jini ya kwarara ta hanyar tasoshin ba shi da shinge da kuma saka, kuma thrombus samuwar a daidai matakin. Lokacin da sikẽli da aka gaji da damuwa da aiki na tsarin a cikin ni'imar kunnawa da jini coagulation, akwai yanayin da zai iya kai ga wuce kima samuwar clots. Kai tsaye ba anticoagulants - daya daga cikin kungiyoyin da kwayoyi amfani ga dawo da ciki cuta.

Menene anticoagulants?

Anticoagulant kira kudi, wanda da anticoagulant sakamako da kuma activates da dilution na jini. Wannan ba ka damar mayar da rheological halaye da kuma rage thrombosis.

Yana nufin suna samuwa a kwamfutar hannu tsari, kamar yadda man shafawa, mala'iku kuma allura shirye-shirye. Suna sanya ba kawai ga zalunta cuta, amma kuma su hana karin samuwar jini clots.

Mai membobin wannan kungiya da kwayoyi ba su kafa thrombus, kuma clotting aiki. A tsari na daukan hotuna zuwa jini dalilai, da kuma samar da thrombin, wanda slows saukar jini clots.

Kwayoyi ya kasu kashi biyu kungiyoyin bisa ga ayyukan:

• kai tsaye anticoagulants.
• kai tsaye ba anticoagulants.

kai tsaye mataki na heparin-tushen kwayoyi

Wannan rukuni na kudi yana da wani kai tsaye sakamako a kan jini cofactors wanda hana thrombin. Babban wakilin ne heparin. A wannan hasashe akwai da dama da kwayoyi mukaddashin kama da baƙi da sunan:

• "Ardeparin".
• "Nadroparin."
• "Klivarin".
• "Longiparin".
• "Sandoparin".

Heparin ko Kalam kisa to antithrombin-III, wadda take kaiwa zuwa wani canji a cikin wuri na ta kwayoyin. Wannan gudãnar up dangane da wani cofactor for thrombin, sa'an nan zuwa inactivate da clotting tsari.

Features na aikace-aikace "heparin"

Action abubuwa da nufin hana ci gaban da kuma yaduwar wani jini gudan jini. Heparin kwayoyin ta samar da hadaddun da antithrombin, wanda shi ne wani mai hanawa na coagulation dalilai. The abu ne mai glycosaminoglycan sarkar. Da miyagun ƙwayoyi ne allura subcutaneously kuma ta fara faduwa mataki bayan kamar wata hours.

Idan dole, sauri mataki "Heparin" jiko gudanar intravenously don hanzarta yi da kuma kara bioavailability. A zabi na magani sashi dogara da jihar da mãsu haƙuri ne located. Haka kuma, a dauki la'akari da kasancewar concomitant cututtuka, a layi daya gwamnati na sauran kungiyoyin na medicaments, da bukatar m hanyoyin kan tasoshin.

oligopeptides

Magunguna da cewa aiki kai tsaye a tsakiyar thrombin kunnawa, suna dauke da karfi musamman hanawa na thrombosis tsarin. The aiki sashi daga cikin miyagun ƙwayoyi a kan nasu haɗi zuwa clotting dalilai, canza su conformation.

Wannan magani "inogatran", "Hirudin", "Efegatran", "Tromstop" da sauransu. Amfani da su hana zuciya harin na angina, varicose cuta, don rigakafin thromboembolism, reocclusion a lokacin angioplasty.

Kai tsaye ba anticoagulants (jerin)

A farko anticoagulant an samu a cikin XX karni a Amurka, lokacin da aka gano wani sabon cutar da shanu, ya sa nauyi zub da jini. Lokacin da hanyar da aka daki-daki pathological yanayin, shi ya tabbatar da cewa a cikin dabbobi kamu da mold abubuwa Clover, dake a cikin abinci. Daga wannan albarkatun kasa da aka hada ta farko miyagun ƙwayoyi antiplatelet kaikaitaccen mataki - "Dicoumarol".

Don kwanan wata, jerin dukiya da cewa suna analogs na fiye da ɗaya da ɗari abubuwa. Duk wadannan kwayoyi - baka anticoagulants. Ginshikai na mataki na wani rukuni na kwayoyi bisa hanawa daga cikin mataki na bitamin K.

Akwai clotting dalilai da suka dogara a kan wannan bitamin. Kai tsaye ba anticoagulants hana kunnawa da coagulation sunadaran da cofactors vitaminozavisimyh. A uncontrolled yin amfani da wadannan kwayoyi da aka haramta, kamar yadda aka kara hadarin zub da jini da rikitarwa.

Akwai biyu main kungiyoyin, wanda aka raba duk tsaye ba anticoagulants. Nau'in kudi dogara ne a kan aiki abubuwa kunshe a cikin shirye-shiryen. rarrabe:

• coumarin Kalam.
• tushen kayan aikin indandiona.

shirye-shirye indandiona

Bayan dauke da fitar da wani babban yawan karatu, masana kimiyya ya gano cewa, da kayayyakin bisa wannan aiki abu kamata ba a yi amfani a far. A formulations da wani gagarumin yawan illa kamar rashin lafiyan halayen. A tasiri na da tasiri a kan protivosvertyvaniya tsarin kuma bai nuna m results.

Wannan rukuni na kwayoyi ya hada da miyagun kwayoyi, "phenindione", "Difenindion", "Anisindion". Aka yanke shawarar dakatar da farko da zabi ga na biyu rukuni na antiplatelet jamiái da kuma na Kalam indandiona a halin yanzu kawai amfani da "Fenilin".

Da miyagun ƙwayoyi yana da wani low cost, shi ne samuwa a kwamfutar hannu tsari. Inganci don 10 hours, kuma yana da muhimmanci sosai don kula da da ake so tsawon lokaci na far. A sakamakon aka samu kawai bayan 24 hours daga lokacin na farko kashi. Aikace-aikace na faruwa ta wajen saka idanu da yanayin haƙuri via jinin awon sigogi (coagulation, janar gwaje-gwaje, Biochemistry).

A makirci na 'fenilina ":

1. A ranar farko - 1 kwamfutar hannu sau 4.
2. A rana ta biyu - 1 kwamfutar hannu sau 3.
3. Sauran magani - 1 kwamfutar hannu per day.

Magani ya kamata a dauka tare da magunguna da cewa rage matakin na glucose a cikin jiki.

coumarin Kalam

Coumarin - wani abu wanda yake a cikin shuke-shuke da kuma za a iya samar synthetically a cikin dakin gwaje-gwaje. Da farko, bayan ta kau, da kayan aiki da aka yi amfani da matsayin mai guba ga rodent iko. Kawai da nassi daga lokaci ya fara amfani da miyagun ƙwayoyi a magance wuce kima thrombosis.

Anticoagulants na kai tsaye ba mataki - shirye-shirye dangane da coumarin - wakilta da wadannan wajen magani:

• "Warfarin" (ta analogues - "Marevan" "sodium Warfarin", "Varfareks").
• "Atsenokumarola" (analogue - "Sinkumar").
• "Neodikumarina" (analogue - "Etilbiskumatsetat").

"Warfarin": aikace-aikace siffofin

Anticoagulants na kai tsaye ba mataki (cikin jerin ne samuwa a cikin labarin) ne mafi sau da yawa wakilta "Warfarin". Wannan yana nufin tableted, kerarre da 2,5, 3 ko 5 MG. Sakamako a kan mutum kwayoyin tasowa bayan 1.5-3 kwanaki bayan da farko gwamnati na kwamfutar hannu. Matsakaicin sakamako da karshen makon farko.

Bayan shan miyagun ƙwayoyi da rheological sigogi na jini koma zuwa al'ada bayan 5 days daga ranar sakewa "na warfarin." Yana nufin amfani da sau 2 a rana, a waje daya kuma a lokaci guda. A 5th ranar far ake dubawa jini sigogi domin sanin yiwuwa da kuma inganci.

A hanya na lura da aka zaba gwani a kowane hali daidaiku. Wasu cuta jihohin (msl, atrial fibrillation) ya bukatar ci gaba da aikace-aikace. Tare da ci gaban PE (na huhu embolism) antiplatelet wakili ba sananne ga kasa da watanni shida, ko ga rayuwa.

Lokacin da bukatar m baki "Warfarin" to soke 5 kwanaki kafin tiyata. Wannan zai ba da damar da jini fihirisa komawa zuwa al'ada. Tare da wani babban bukatar ci gaba da yin amfani da anticoagulant far, da kayan aiki ne a maye gurbin unfractionated heparin. A karshe kashi da aka gudanar 4 hours kafin shiga tsakani.

Bayan aiki ta hanyar 4 chasa reintroduced unfractionated heparin. Karbar tsaye ba antiplatelet jamiái za a iya koma cikin kwana biyu, bayan sa idanu jihar na jini da taimakon dakin gwaje-gwaje gwaje-gwaje.

A wadda lokuta da ake amfani da anticoagulants?

Direct da kuma kai tsaye ba anticoagulant amfani don rigakafin thromboembolism, m thrombosis na venous tsarin a taron na wani inji} afar roba zuciya bawuloli da atrial fibrillation.

Babban cututtuka a gaban wanda aka sanya anticoagulants kai tsaye da kuma kai tsaye ba mataki, da wadannan rabo a cikin kungiyoyin:

1. Thrombosis na jijiya tsarin:
   • tsokar zuciya infarction.
   • na huhu embolism.
   • bugun jini tare da bayyanar cututtuka na ischemia.
   • traumatic rauni ga jijiyoyi da atherosclerosis.
2. Watsa intravascular coagulation :
   • buga jihohi.
   • traumatic rauni.
   • da ci gaban sepsis.
3. M thrombosis na jijiyoyinmu by:
   • jini clots a bango na varicose veins.
   • thrombosing hemorrhoidal venous plexus.
   • gudan jini a baya vena cava.

babban contraindications

Kai tsaye ba anticoagulants - kwayoyi da aka tsananin haramta a gaban lactose rashi, malabsorption na glucose da kuma galactose. Akwai da dama da kwayoyi a lokaci guda cewa ba za ka iya amfani da baka anticoagulants. List of kwayoyi ya kunshi nonsteroidal anti-mai kumburi da kwayoyi, "asfirin", "Dipyridamole", "clopidogrel", "penicillin", "Chloramphenicol", "Cimetidine".

Yanayin da ba za a iya amfani da anticoagulants kai tsaye da kuma kai tsaye ba mataki:

• ulcerative cututtuka na gastrointestinal fili.
• jijiyoyin bugun gini aneurysm.
• cutar hanta.
• m zub da jini;
• thrombocytopenia.
• koda gazawar.
• Na trimester da kuma watan jiya na ciki.
• high matakan da creatinine.

Side effects na antiplatelet jamiái

Kowace daga cikin kwayoyi a cikin wannan rukuni na jamiái yana da irin wannan illa. Sun bayyana kansu ta hanyar kai ko rashin kashi ko take hakkin a yin amfani da shawarwari.

Side effects hada da ci gaban da na jini, dyspeptic cututtuka kamar amai, tashin zuciya da kuma gudawa. Akwai alaka mai karfi ciwon mara, rashin lafiyan fata rash a kan irin amya ko eczema. Iya ci gaba necrosis, gashi hasara, fata itching.

Kafin fara jiyya, da mãsu haƙuri dole wuce jerin gwaje-gwaje domin sanin ko yin amfani da wadannan kwayoyi. A haƙuri kai cikakken jini count, Biochemistry, urinalysis, fitsari a kan Nechiporenko, coagulation. Haka kuma an bada shawarar yin wani duban dan tayi jarrabawa da kodan da kuma wuce stool for occult jini.

Yawan abin sama kai tsaye ba anticoagulants

Overdoses na wannan kungiya da kwayoyi ne quite rare. Wannan zai iya faruwa idan wani karamin yaro zai gida da miyagun ƙwayoyi da kuma kokarin da shi ga dandano. Yawanci, da maida hankali abu ne low, don haka da guda kashi Allunan bai ji tsõron. A hali na musamman ko laifi sabõda yãsasshiya amfani da manyan allurai daga cikin abu zai iya ci gaba da wani coagulopathy da kuma zub da jini.

yawan abin sama asibitin ba shi da wani takamaiman bayyanar cututtuka, don haka tsammani abin da ya faru da shan yawa daga cikin miyagun ƙwayoyi, shi ne wuya. Symptomatology kama manifestations da cututtuka daban-daban da kuma pathological jihohin da kwayoyin. A haƙuri yana da:

• haske bruises a kan fata.
• jini a fitsari ko tumbi.
• igiyar ciki na jini.
• hematoma a cikin wuyansa.
• intracranial hemorrhage.

Tun da farko, baya bugun jini, tsofaffi da marasa lafiya, gastrointestinal zub da jini da kuma wani tarihi na low hematocrit - alaka abubuwan da za su iya rage laulayi na bakin kofa taro na kwayoyi.

Antiplatelet far yawan abin sama

1. Goge ko flushed ta cikin ciki sa'o'i da dama bayan gwamnati da kwayoyi ba shi da wani ma'ana.
2. A haƙuri ne da aka kunna gawayi domin hanji sha.
3. "Cholestyramine" ciki gudanar a yanayin saukan "warfarin" yawan abin sama ko ta analogues.
4. A haƙuri aka sanya a cikin antitravmaticheskie yanayi, don kauce wa fitowan da sabon hematomas da hemorrhages.
5. Tare da gwaji jini asara ko transfusions dauki jini kafa abubuwa, wani lokacin dukan jini. Ingantaccen a cikin yin amfani da cushe ja da maikacin jini, cryoprecipitate, prothrombin hadaddun.
6. Nada "Phytomenadione" kayayyakin bisa bitamin K.
7. Idan ya cancanta, sanya wani antiplatelet far, da miyagun ƙwayoyi "Phytomenadione" nada hanya na lura, maimakon a matsayin taimakon farko.

Idan haƙuri da yanayin koma al'ada, amma wajibi ne a ci gaba da yin amfani da baka anticoagulants, shi wajibi ne don "Warfarin" dan lokaci maye gurbin kwayoyi heparin jerin.

ƙarshe

A amfani da antiplatelet kwayoyi ba zai iya kawai normalize jini rheological matsayin, amma kuma ya inganta general yanayin haƙuri da kuma hana ci gaban tsanani cututtuka.

Hankali da hankali ga yin amfani da anticoagulants, zabi na sashi da kuma sa idanu haƙuri da yanayin iya taimaka rage hadarin da rikitarwa da kuma nasara. Ma'aikata da suka yi amfani da wannan kungiyar da kwayoyi a cikin su yi, shi ne zama dole don inganta ilmi da da matužar bin duniya kiwon lafiya shawarwari.