Antiplatelet agents: daim ntawv teev cov tshuaj. Anticoagulants thiab antiplatelet agents, lawv cov yam ntxwv

Kom los ntshav feem ntau ua rau thrombosis, uas ua rau yus mus rau mob hnyav txim, xws li kev tuag. Pharmacology kho cia tseg lub neej ntawm cov neeg mob nrog xws li mob vim txij nkawm txoj kev kho raws li tau txais antiplatelet tshuaj.

Yuav ua li cas yog anticoagulants?

Rheological thaj chaw ntawm cov ntshav los ntaus ib tug nqi koj tshuav ntawm coagulation thiab anticoagulation systems. Nyob rau hauv kev tswj no tshuav nyiaj li cas raws li ib tug natural anticoagulant koom antithrombin III thiab heparin, uas ua hauj lwm ncaj antithrombotic muaj nuj nqi, uas yog, tiv thaiv kom txhob tsim ntawm ib tug ntshav los khov rau ntawd. Lub mechanism ntawm qhov kev txiav txim ntawm lub yav tas yog txuam mus ua ib lub complex nrog antithrombin III, uas ua nyob rau hauv lub tsim ntawm ib tug active antithrombin. Nws, nyob rau hauv lem, yog lub luag hauj lwm rau cov thwj toob rau thrombin, ua rau nws tsaug zog - nws muaj txhawb rau inhibition ntawm thrombus tsim. Antithrombin III nws tus kheej kuj muaj anticoagulant zog los ntawm inactivating thrombin, txawm li cas los, cov tshuaj tiv thaiv hais heev maj mam.

Lub peev xwm ntawm heparin los xyuas kom meej inactivation ntawm thrombin nyob rau tus nqi ntawm cov antithrombin III nyob rau hauv cov ntshav. Yuav tsum tau txhaj koob tshuaj hloov yog yuav tsum tau raws li nyob rau hauv tus tsom xam. Feem ntau yuav tsum tau lub sij hawm ntawm ob lub tshuaj ib zaug - heparin thiab antithrombin III, nyob rau tib lub npaum raug xaiv ib lub zuj zus rau txhua tus neeg.

Ruaj rau antithrombin - tsis tsuas yog muaj nuj nqi ntawm heparin. Nyob rau hauv tas li ntawd, nws muaj peev xwm mus ua txhaum down fibrin tsis muaj kev koom tes los ntawm plasmin, yog hu ua tsis yog-enzymatic lysis. Qhov no cov tshuaj tiv thaiv yog tus tsim ntawm lub tebchaw nrog ib tug ntau yam ntawm biologically active tshuaj, xws li peptides thiab cov tshuaj hormones. Cov lwm nta paub qhov txawv cov hluav ntawm ib tug xov tooj ntawm enzymes muab kev koom tes nyob rau hauv lub inflammatory txheej txheem (thiaj li nws siv), raws li zoo raws li qhov ua kom ntawm lipoprotein lipase thiab txhim kho cov ntshav khiav tsis zoo hauv lub plawv hlab ntsha.

Yuav ua li cas yog lub antiplatelet agents?

Npaj anticoagulants thiab antiplatelet ua hauj lawm yog zoo siv nyob rau hauv cov tshuaj. Qhov no lub npe tau txais cov nyiaj, uas inhibit qhov kev tsevneeg (aggregation) ntawm cov ntshav - ntshav liab thiab qe ua ntshav khov. Lub mechanism ntawm qhov kev txiav txim ntawm cov tshuaj sib txawv, uas tso cai rau ob peb pab pawg. Antiplatelet agents, uas nws kim heev daim ntawv teev cov tshuaj uas yog dej num raws li nram qab no.

1. Calcium antagonists ( "Verapamil").
2. Enzyme inhibitors, uas muaj xws li tshuaj uas suppress cyclooxygenase (acetylsalicylic acid, "naproxen", "Indomethacin") thiab cov adenylate cyclase thiab phosphodiesterase ( "Ticlopidine", "Pentoxifylline").
3. Cov tshuaj uas tsim kho lub tsim ntawm prostacyclin ( "pirazolinov").
4. Prostanoids ( "Prostacyclin" thiab nws cov analogues ntawm cov khoom cua keeb kwm).
5. Cov tshuaj uas suppress cov kws tshuaj muaj nyob rau hauv platelets ( "Pyracetam").

zaj lus tim khawv

Antiplatelet tshuaj - tshuaj uas nws npe yog lub npe hu rau ntau vim lub dav daim ntawv thov. Lub ntsiab muaj nuj nqi ntawm no pab pawg neeg - ntawm thrombosis prophylaxis. Antiplatelet tshuaj - tshuaj uas zoo thov nyob rau hauv ib tug xov tooj ntawm cov hlab plawv tus pathologies, raws li zoo raws li tom qab phais (prosthetic plawv).

Antiplatelet agents: daim ntawv teev cov tshuaj uas nquag siv nyob rau hauv kev kho mob xyaum

Cov tshuaj uas yuav mus rau pab pawg neeg no, ib tug heev heev, thiab tag nrho lawv muaj lawv tus kheej peculiarities. Xaiv ntawm ib tug yeeb tshuaj nyob rau hauv lub soj ntsuam cov ntaub ntawv. Thiab, ntawm chav kawm, nws tus kheej-tshuaj nyob rau hauv qhov teeb meem no yog tsis tsim nyog.

"Aspirin"

Nyob rau hauv cov kev cai ntawm hemostasis eicosanoids yog muab kev koom tes uas yog ib yam khoom ntawm lub oxidation ntawm arachidonic acid. Ntawm cov tseem ceeb tshaj plaws ntawm thromboxane A2, thiab nws cov ntsiab muaj nuj nqi - kom ntseeg tau platelet aggregation. Qhov kev txiav txim ntawm tshuaj aspirin yog raws kev coj kom inhibition ntawm ib qho enzyme, hu ua cyclooxygenase. Raws li ib tug tshwm sim ntawm no synthesis yog suppressed tomboksana A2, yog li ntawd inhibited thrombus tsim dab. Cov nyhuv tsub kom thaum rov noj cov tshuaj vim txuam nrog. Rau ib tug tag nrho inhibition ntawm cyclooxygenase yuav tsum tau txhua hnub kom tsawg. Lub zoo npaum thiaj li yuav ua rau muaj kev phiv, "aspirin" txawm nrog tas mus li siv. Koob escalation yog tsis tsim nyog, txij thaum muaj kev pheej hmoo ntawm los ntshav teeb meem.

"Ticlopidine"

Cov tshuaj no yog raws li nyob rau hauv thaiv cov hlab tej receptors uas yog lub luag hauj lwm rau cov ntshav txhaws. Feem ntau, thaum twg koj txuas mus rau lawv muaj ib tug kev hloov ntawm ADP platelet aggregation tsa thiab zoo li tus, thiab "Ticlopidine" cheeb txheej txheem no. Ib tug feature ntawm lub antiplatelet neeg uas sawv cev ib tug siab bioavailability, uas yog tiav los ntawm kev kub ceev suction. Tom qab cancelling cov nyhuv yog cai txawm rau 3-5 hnub. Lub drawback yog lub loj tus naj npawb ntawm kev phiv, xws li ntau xeev siab, raws plab, anemia thiab agranulocytosis.

"Clopidogrel"

Antiplatelet cov neeg ua hauj raws li lub hom ntawm kev txiav txim yog zoo li tus "ticlopidine", tab sis nws zoo dua yog qhov kuj tsis tshua muaj toxicity. Nyob rau hauv tas li ntawd, txoj kev pheej hmoo ntawm kev phiv thaum noj cov tshuaj no yog npaum li cas qis. Tam sim no lub tshwj xeeb muab nyiam mus rau "clopidogrel" vim lub tsis tuaj kawm ntawv ntawm cov teeb meem xws li agranulocytosis thiab thrombocytopenia.

"Eptifibatide"

Cov tshuaj muab aggregation los thaiv cov hlab lub glycoprotein, uas yog nyob rau hauv lub platelet membrane. Yam uas luag muab tso dej raws leeg bolus, feem ntau yog nyob rau hauv angina thiab angioplasty los txo qhov yuav ua rau myocardial infarction.

"Dipyridamole"

Lub ntsiab nyhuv ntawm cov tshuaj - nyob vasodilatation, piv txwv li cov expansion ntawm cov hlab ntsha, tab sis qhia antiplatelet cov nyhuv yog cai thaum ua ke nrog lwm yam tshuaj. "Dipyridamole" tsa nrog "aspirin", yog hais tias muaj yog ib tug yuav muaj ntshav txhaws. Nws yog tseem tau mus ua ke nrog lub "warfarin", uas yog zoo thov tom qab lub prosthetic lub plawv valve los txo qhov yuav ua rau embolisms. Nyob rau hauv monotherapy nyhuv yog tsawg pronounced.

Antiplatelet tshuaj - tshuaj (hauv daim ntawv teev: "Elikvis", "clopidogrel" thiab lwm tus neeg), yog dav siv nyob rau hauv xyaum.

Contraindications

Sij hawm ntawm antiplatelet kho yuav tsum tau ceev faj keeb kwm, uas muaj cov ntaub ntawv nyob rau hauv comorbidity. Nyob rau hauv lub xub ntiag ntawm ib tug kab mob uas yog ib tug contraindication tau txais cov tshuaj nyob rau hauv pab pawg neeg no, ib tug kho lus ntawm cov kev kho mob txoj kev npaj. Nyob rau hauv xws li mob, ib tug xaiv ntawm ib tug neeg siv tshuaj yeeb thiab lawv noj tshuaj npaum cas, thiab kev kho mob yog nqa tawm nyob rau hauv nruj kho mob saib xyuas. Nyob rau hauv tsis muaj cov ntaub ntawv yuav tsum muaj ib qho kev teem caij ntawm antiplatelet agents, vim hais tias lub txim yuav ua tau disastrous.

Daim ntawv teev cov contraindications:

• phiv tshuaj;
• hemorrhagic diathesis;
• qhov uas yuav los ntshav;
• mob loj heev siab thiab raum insufficiency;
• keeb kwm ntawm arrhythmia;
• tawg, mob;
• obstructive cov kab mob ntawm lub pa system;
• Cov me nyuam uas muaj hnub nyoog (rau feem ntau cov khoom).

Nyob rau hauv tas li ntawd, muaj ntau yam ntawm antiplatelet agents (hauv daim ntawv ntawm cov khoom rov los xyuas dua nyob rau hauv no tsab xov xwm) yog txhob thaum lub sij hawm cev xeeb tub thiab lactation. Thaum lub sij hawm no lub sij hawm, yuav tsum tau nyiam cov tshuaj uas muaj kev ruaj ntseg rau tus me nyuam thiab rau cov niam.

Antiplatelet agents. Tshuaj: ib daim ntawv teev cov uas cev xeeb tub

Yog hais tias koj ua txhaum lub me nyuam hauv plab kev kev pheej hmoo ntawm rho me nyuam tawm. Qhov no tshwm sim yog hu ua fetoplacental insufficiency. Yog hais tias koj ua txhaum qhov tus me nyuam ntawm oxygen mus rau cov ntshav ntawm lub fetus tsim mob loj heev hypoxia, uas hawv ua phem tsis tau tsuas yog cov variations nyob rau hauv nws txoj kev loj hlob, tab sis kuj tuag. Thaum diagnosing ib tug pathology yuav tsum tau ua sai li sai kho mob, uas muaj nyob rau hauv kev txhim kho cov ntshav txaus, txo cov ntshav viscosity. No thiab tsa antiplatelet agents, txawm li cas los, yuav tsum paub hais tias tsis yog tag nrho cov tshuaj nyob rau hauv pab pawg neeg no muaj kev ruaj ntseg thaum lub sij hawm cev xeeb tub. Tau siv tsuas yog ib ntawm cov nyiaj.

"Kurantil"

Cov tshuaj yog heev nrov vim lub fact tias nyob rau hauv nws cov daim ntawv teev cov contraindications tsis muaj cev xeeb tub thiab pub niam mis. Active muaj "chimes" - yav tas los piav dipyridamole, uas ceev cov hlab ntsha thiab cheeb thrombus tsim. Nws pab txoj kev myocardial ntshav txaus, kom ntseeg tau qhov tus me nyuam ntawm qhov yuav tsum tau npaum li cas ntawm cov pa. Nyob rau hauv no txoj kev, K "Urantia" yuav siv tau nyob rau hauv lub xub ntiag ntawm cov hlab plawv tus kab mob nyob rau hauv cev xeeb tub cov poj niam. Txawm li cas los, lub ntsiab hais rau cev xeeb tub nws yog placentofetal tsis ua hauj lwm. Los ntawm kev txhim kho rheological thaj chaw ntawm cov ntshav thiab vasodilatation, kev tiv thaiv clogging hlab ntsha ntawm lub tsho me nyuam, ces tus me nyuam hauv plab tsis raug kev txom nyem los ntawm hypoxia. Ib tug ntxiv zoo dua ntawm cov tshuaj yuav tsum tau muab hu ua immunomodulating nyhuv. Cov tshuaj nkoos zus tau tej cov interferon, li no kom txhob muaj txoj kev pheej hmoo ntawm tus kab mob cov kab mob nyob rau hauv lub niam. Txawm hais tias "Kurantil" thiab nws yuav siv tau thaum lub sij hawm cev xeeb tub thiab lactation, tab sis yuav tsum tau tsuas muab yog hais tias tau hais tseg. Thaum noj cov tshuaj yuav tsum tau kom tsis txhob noj nqos tau cov tshuaj yej thiab kas fes raws li lawv txo nws cov hauj lwm zoo. Antiplatelet tshuaj - tshuaj (daim ntawv teev saum toj no) uas yuav tsum tsis txhob ua ke nrog xws li ib tug haus dej. Txawm tias cev xeeb tub tsis yog qhia kom lawv muab kev koom tes nyob rau hauv txhua txoj kev.

Antiplatelet agents, ib daim ntawv teev cov tshuaj uas muaj xws li dozens ntawm cov npe, yog siv zoo nyob rau hauv cov kev kho mob ntawm cov kab mob ntawm cov hlab plawv system. Txawm li cas los, yuav tsum paub txog cov tau teeb meem txuam nrog rau poob ntshav viscosity thiab txhaws inhibition. Antiplatelet tshuaj - tshuaj uas muaj peev xwm tsuas yog siv nyob rau hauv lub saib xyuas ntawm tus kws kho mob, nws yuav tsum khaws cov tsim nyog ntau npaum thiab cov hoob kawm ntawm kev kho mob.