"Clopidogrel": analogues, siv, phau ntawv, nqi

Nyob rau hauv tej lub sijhawm, cov kws kho mob muab tshuaj "Clopidogrel"? Cov lus qhia rau kev siv, analogs, tso tawm daim ntawv no, muaj pes tsawg leeg, mob tshwm sim thiab indications rau cov kev siv cov tshuaj no yuav tsum tau nthuav tawm nyob rau hauv kom meej nyob rau hauv no tsab xov xwm. Nyob rau hauv tas li ntawd, koj yuav kawm txog cov nqi ntawm cov tshuaj thiab cov neeg mob lub tswv yim hais txog nws.

Tso daim ntawv thiab muaj pes tsawg leeg

koj muaj peev xwm yuav cov tshuaj "Clopidogrel" Nyob rau hauv dab tsi daim ntawv no? Phau Ntawv Qhia hais tias cov tshuaj yog tso tawm nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, uas yog coated nrog ib tug zaj duab xis txheej. Nyob rau hauv ib hlwv muaj 14 daim, nyob rau hauv lub bank - 14 los yog 28, nyob rau hauv ib tug duab los qhia nras - 1 los yog 2 daim hlau uas tshuaj. Lub ntsiab active ingredient yog clopidogrel nyob rau hauv hydrogen sulphate daim ntawv. Lub koom haum pab Cheebtsam muaj nyob rau hauv cov tshuaj formulation xws li anhydrous lactose, magnesium stearate, pregelatinized starch, hydrogenated castor roj, polyethylene glycol 6000 thiab microcrystalline cellulose. Zaj duab xis txheej, uas coated ntsiav tshuaj muaj titanium dioxide, hypromellose, txhuas lacquer (raws li nyob rau hauv cov xim Ponceau 4 R), thiab polyethylene glycol 400 thiab 6000 los siv medicament 'Clopidogrel' (tus nqi yuav tsum tau qhia rau hauv qab no) ntawm ib cov saw ntawm drugstores, tiam sis tsuas yog nyob rau hauv lub xub ntiag ntawm tshuaj.

pharmacological yam ntxwv

Nyob rau hauv cov tshuaj kho mob, txo platelet aggregation ntxias los ntawm lwm yam agonists. Ua noj tshuaj "Clopidogrel" (cov lus qhia rau kev siv, nqe, xyuas, thiab ntau ntau lwm yam tseem ceeb cov lus qhia no muaj nyob rau ntau cov kev kho mob websites thiab nyob rau hauv daim ntawv no) rau ob teev, nyiaj pab ntau tshaj efficiency nyiaj rau 4-7 hnub nyob rau hauv lub zwj ceeb ntawm kev txais neeg kawm 50-100 mg ib hnub twg. Antiplatelet nyhuv kav ntawm 7 mus rau 10 hnub thoob plaws qhov ntev ntawm platelet lub neej.

tshuaj

Tom qab qhov ncauj thawj coj ntawm cov tshuaj "Clopidogrel" (75 mg - txheem koob tshuaj) yog sai absorbed los ntawm tus mob huam, nrog rau cov concentration hauv cov kua feem ntawm cov ntshav yog nce me ntsis, tab sis tom qab 2 xuab moos thiab nce mus txog rau qib uas yuav tsum tau txiav txim (0.025 g / L).

Nws yog feem metabolized los ntawm lub siab. Qhov loj metabolite yog tsaug zog derivative ntawm ib tug carboxylic acid (kwv yees li 85% pib cov ntaub ntawv uas circulating nyob rau hauv cov ntshav). Qhov nruab nrab nyiaj pab ntau tshaj concentration tom qab rov siv "clopidogrel" yog 3 mg / l, nws yuav tsum tau cai ib teev tom qab haus.

Active tshuaj thiab metabolite irreversibly ua txhua yam rau ntshav proteins. Kev sib txuas lus tseem insatiable.

Tom qab qhov ncauj thawj coj ntawm 14C-sau tias "clopidogrel" yuav luag ib nrab ntawm cov koob tshuaj zoo nkaus li nyob rau hauv tso zis, hais txog 46% - lub faeces tshaj 120 teev. T1 / 2 ntawm lub ntsiab metabolite - 8 teev.

Saturation metabolite ntau lub sij hawm ntau cov neeg mob tom qab kho kom sawvdaws xeeb 75 xyoo ntawm lub hnub nyoog, qhov no tsis hloov platelet aggregation thiab los ntshav lub sij hawm.

Cov ntshav ntshav nyob rau hauv mob loj heev raum concentration ntawm lub metabolite yog los ntawm 5 mus rau 15 ml / min, whereas thaum lub nruab nrab tus kab mob heev ntawm nws yog 30-60. Txawm tias muaj tseeb hais tias cov inhibitory nyhuv nyob rau hauv cov neeg mob uas adenosine diphosphate - ntxias platelet aggregation twb txo, nws tau nce los ntshav lub sij hawm, raws li tau zoo raws li nyob rau hauv kev noj qab nyob tuaj pab dawb.

zaj lus tim khawv

Yog koj paub, rau cov uas lub hom phiaj tus kws kho mob tshuaj tshuaj rau cov neeg mob raws li "Clopidogrel"? Analogs, thiab nws tau tsa ib tug medicament rau kev tiv thaiv ntawm thrombotic teeb meem ntawm ischemic stroke, heart attack myocardial infarction thiab peripheral arterial occlusive kab mob. Tib mus kho mob nrog acetylsalicylic acid thiab "clopidogrel" raws li qhia nyob kev tiv thaiv ntawm thrombotic teeb meem, uas ua ib tug ua ntawm mob coronary syndrome.

Contraindications

'Clopidogrel' (tus nqi nyob rau hauv khw muag tshuaj Moscow thaj av ntawd yog hais txog 510 rubles) mus thov counter nrog:

• npau taws me ntsis;
• mob ntshav;
• haemorrhagic syndrome ;
• mob loj heev hepatic puas;
• outpouring intracranial pathology thiab predisposing rau txoj kev loj hlob ntawm los ntshav (mob ntsws mob, exacerbation ntawm peptic rwj, hyperfibrinolysis, tuberculosis);
• lactose tsis muaj peev xwm (rau ntau npaum ntaub ntawv uas muaj mis nyuj qab zib), raws roj ntsha galactose intolerance, malabsorption syndrome glucose-galactose.

"Clopidogrel": cov kev siv thiab ntau npaum

Cov ntsiav tshuaj raws li cov lus qhia, yuav tsum noj tsis hais noj mov. Rau kev tiv thaiv ntawm thrombotic txheej xwm nyob rau hauv cov neeg mob uas ischemic stroke los yog heart attack myocardial infarction, cov kws kho mob muab tshuaj rau txhua txhua hnub "Clopidogrel" 75 mg. Nyob rau hauv mob tus kab mob, uas yog tshwm sim los ntawm txoj kev loj hlob ntawm focal necrosis ischemic ntawm cov kev mob plawv, kev kho mob yuav tsum tau pib los ntawm cov thawj hnub. txoj kev kho nrog rau cov kev siv ntawm "Clopidogrel" - tsis muaj ntau tshaj li 35 hnub. Cov neeg mob uas ischemic stroke yuav tau noj cov tshuaj rau rau lub hlis. Thaum lub thrombotic teeb meem uas tshwm sim taus amid ACS tsis lifting lub ST ya, kev kho mob yog pib nrog tau txais pov tseg loading koob tshuaj (300 mg), thiab ntxiv tsis tau ntau tshaj li ib ntsiav tshuaj ib hnub twg. Maximum efficiency yog cai tom qab peb lub hlis. Lub caij ntawm txoj kev kho nrog 'Clopidogrel' (analogs thiab Generics hais hauv qab no) yuav tsum tsis pub tshaj ib xyoos. Tawm tsam tom qab ntawm mob coronary syndrome nrog ST ya nce feem ntau tus kws kho 75 mg ntawm cov tshuaj nyob rau txhua hnub nrog ib tug thawj zaug ib-lub sij hawm siv ib tug loading ntau npaum nyob rau hauv ua ke nrog nrog thrombolytic neeg thiab acetylsalicylic acid. Thaum cov tsos mob tshwm sim, koj yuav tsum tau mus ua ke nrog txoj kev kho. Cov neeg mob tshaj 75 xyoo ntawm kev kho mob yog muab tsis muaj ib tug loading koob tshuaj.

overdose

Nyob rau tau txais cov tshuaj nyob rau hauv koob tshuaj tshaj pom zoo, rawsli los ntawm cov kev nce rau hauv los ntshav lub sij hawm thiab tom ntej teeb meem. Nyob rau hauv tej lub sijhawm, koj yuav tsum tau tsim nyog kho mob. Nyob rau hauv lub rooj plaub thaum koj xav tau ib tug ceev kho ntawm heev los ntshav lub sij hawm, koj xav tau ib tug ntshav ntawm TM. Muaj yog tsis muaj ib yam tshuaj.

Sib tshuam nrog lwm yam tshuaj

Tib mus txais tos ntawm "clopidogrel" nrog warfarin tau nyob rau hauv ib qho kev nce rau hauv los ntshav tus nqi, uas yog vim li cas no thaum lawv tseem yog heev undesirable. Nws tsub kom lub sij hawm ntawm los ntshav thiab nyob rau hauv cov kev kho mob ntawm ib tug yeeb tshuaj nyob rau hauv ua ke nrog nrog nonsteroidal anti-inflammatory siv tshuaj, cov tshuaj aspirin, glycoprotein inhibitors thiab heparin.

phiv

Kev kho mob medicament 'Clopidogrel' (cov neeg siv, tus nqi, cov qauv ntawm cov thawj coj thiab ntau npaum yog piav nyob rau hauv kom meej nyob rau hauv no cov ntaub ntawv uas) yuav ua tau kom undesirable txim:

• Ntshav coagulation system: thaum lub sij hawm rau thawj lub hli ntawm txoj kev kho feem ntau tshwm sim hemorrhage, hematomas tshwm sim; tsawg kawg yog - conjunctive hemorrhage; raug rho tawm tus neeg mob - intracranial los ntshav.
• hematopoietic system: nyob rau hauv uas tsis tshua muaj mob - thrombotic thrombocytopenic purpura, granulocytopenia, anemia, xws li pancytopenia, thiab aplastic anemia.
• Lub paj hlwb: puav yuav tshwm sim mob taub hau, paresthesia, kiv taub hau; tsawg - Kiv tauv hau; raug rho tawm tus neeg mob - puas siab puas ntsws tsis meej pem thiab hallucinations.
• Cov hlab ntsha thiab lub plawv, feem ntau yog tsim nyob rau hematoma; tej zaum muaj mob loj heev hemorrhage, vasculitis, nws txo qis ntshav siab.
• Ua pa system: epistaxis, bronchospasm, pulmonary hemorrhage, interstitial pneumonitis, hemoptysis.
• Hnyuv: raws plab, dyspepsia, mob plab, los ntshav los ntawm cov hnyuv, gastritis thiab pais plab rwj, ntuav, flatulence, xeev siab, cem quav, retroperitoneal los ntshav, mob plab, pancreatitis, stomatitis, mob siab tsis ua hauj lwm, kab mob siab, muaj zog siab enzymes.
• Licas: arthralgia, myalgia, mob caj dab.
• Ntawm daim tawv nqaij: bullous ua pob ua xyua (Stevens-Johnson syndrome thiab lom epidermal necrolysis, erythema multiforme), eczema, erythematous pob, thiab Lichen planus.
• Mob txeeb System: hematuria, hypercreatininemia, glomerulonephritis.
• Cov kev tsis haum: angioneurotic edema, ntshiab kev mob kev nkeeg, urticaria, pseudoallergy cov tshuaj tiv thaiv.

Thaum txoj kev kho nrog cov tshuaj no ua npaws yog tsis tshua cai, uas yog tsis ntaus nqi raws li ib tug tshwm sim uas tau txais cov medicament, thiab raws li ib tug cov tsos mob ntawm tus mob khaub thuas.

ceev faj

Tshuaj "Clopidogrel" nrog huab ceev faj thaum noj siab yuav los ntshav raws li ib tug tshwm sim ntawm kev phais tiv thaiv, hemostatic ntshawv siab. Yog hais tias kev phais uas yuav tsum tau, thiab antiplatelet nyhuv yog heev undesirable los ntawm lub koom haum saib xyuas ntawm cov tshuaj yuav tsum tau muab pov tseg rau hauv lub lim tiam ua ntej lub sij hawm teem ntawm kev phais. Kev kho mob tshuaj kws kho rau mob loj heev kev ua txhaum ntawm lub siab muaj nuj nqi, uas muaj peev xwm ua rau hemorrhagic diathesis. Yog hais tias tej yam tshwm sim ntawm ntau los ntshav yuav tsum mus kawm lub hemostatic system. Nyob rau hauv tas li ntawd, qhov yuav tsum tau rau lossi saib xyuas kev kawm ntawm lub haumxeeb ua si ntawm lub siab. Ceev faj "Clopidogrel" yog siv nrog heparin, narcotics yuav muab, warfarin. Thaum kev sim kev tshawb fawb pom tsis muaj carcinogenic thiab genotoxic nyhuv ntawm cov tshuaj, nyob rau hauv tas li ntawd, tsis txhob muab tej yam nyob rau hauv tsheb tswj lub peev xwm.

"Clopidogrel": analogs thiab Generics

Txhais (analogs) tshuaj - ib tug tshuaj muaj tib lub txiav txim los yog muaj tib lub muaj pes tsawg leeg. Yuav ua li cas cov tshuaj yuav hloov tau cov tshuaj "Clopidogrel"? Analogs kev npaj ntawm lub active tshuaj nram qab no: "Kardutol", "Detromb", "Agregal", "Trombeks", "Klopilet" "Trocken", "Plavix", "Plagril", "Plogrel", "Targetek", "Egitromb" "Clopidogrel Teva,".

Txhua cov tshuaj muaj ntau yam ntxwv, ces tus siv yog tso cai tsuas yog tom qab kev sib tham nrog koj tus kws kho mob.

Tswvyim txog cov tshuaj

Yuav ua li cas cov neeg no hais txog tej kev npaj raws li "Clopidogrel"? Xyuas ntawm cov neeg mob uas muaj lub sij hawm mus rau cov hloov mob heev thiab phais tiv thaiv yog cov tsis tshua zoo. Cov neeg mob qhia siab npaum kev txiav txim ntawm medicament, nws yog cuaj kaum tsis npaj rau kev txais tos nyob rau hauv kev txiav txim rau nws tus kheej-tshuaj. Analogues ntawm cov tshuaj los pab tus neeg mob xaiv qhov zoo tshaj plaws kev xaiv rau lawv nyob rau hauv lub ratio ntawm tus nqi thiab zoo, tab sis lub hom phiaj thiab cov hauj lwm zoo ntawm cov kev tswj yuav tsum tau muab rau ib tug tej tus kws khomob tshwjxeeb.