Ama-antigregregants: uluhlu lwezilwanyana. Ama-Anticoagulants kunye nama-antiplatelet agents, iimpawu zabo

Ukwanda kwe-coagulation kubangelwa ukuba i-thrombosis, ekhokelela kwimiphumo emibi, kuquka nokufa. Impumelelo kwi-pharmacology yenza ukuba kube lula ukugcina ubomi kubagulane abanalo le-pathology ngenxa yonyango lwezonyango ngendlela yezidakamizwa ze-antiplatelet.

Ziziphi i-anticoagulants?

Iipropati ze-Rheological zegazi zibonelelwa ngokulinganayo phakathi kwe-coagulation kunye neenkqubo ze-anticoagulant. Ekulondolozweni kwesi silanki, ndiyithatha i-antithrombin III kunye ne-heparin njenge-anticoagulants yemvelo, eyenza umsebenzi othe ngqo wokuthintela, okuthintela ukubunjwa kwe-thrombus. Inkqubo yesenzo saloo mva inxulumene nokubunjwa kwe-antithrombin III, okubangele ukubunjwa kwe-antithrombin esebenzayo. Kananjalo yena unembopheleleko yokubopha i-thrombin, okwenza ingasebenzi-oku kuncedisa ekuthintekeni kokubunjwa kwe-thrombus. I-Antithrombin III ngokwayo inempahla ye-anticoagulant, inactivating thrombin, nangona le mpendulo ithatha ngokukhawuleza.

Ikhono le-heparin ukuqinisekisa ukuba ukungenakwenziwa kwe-thrombin ngqo kuxhomekeke kwisixa se-antithrombin III egazini. Ulungelelwaniso lwe dose olufunekayo olusekelwe kuhlalutyo. Ngokuqhelekileyo, ukuqeshwa kwamachiza amabini ngexesha elilodwa - i-heparin kunye ne-antithrombin III, kunye nemilinganiselo ekhethiweyo ngamnye kumntu ngamnye.

Ukubophezela kwi-antithrombin akuyona yodwa umsebenzi we-heparin. Ukongeza, iyakwazi ukudibanisa i-fibrin ngaphandle kokubandakanyeka kwe-plasmin, ebizwa ngokuba yi-non-enzymatic lysis. Le mpendulo ihambelana nokubunjwa kwamacandelo kunye nezinto ezahlukeneyo eziphilayo, phakathi kwazo iip peptides kunye nama-hormone. Phakathi kweminye imisebenzi, ukunqandwa kweenzyme, ukubandakanyeka kwinkqubo yokuvutha (ukunciphisa ubukhulu bayo), kunye nokusebenza kweepoprotein lipase kunye nokuphucula ukuhamba kwegazi kwiinqanawa zentliziyo.

Ziyiphi i-antigregregants?

Ukulungiselela ama-antiticoagulants kunye nama-antigregregants asetyenziswa ngokufanelekileyo kwiyeza. Eli gama linikezelwa kwii-agent ezithintela i-gluing (aggregation) yeeseli zegazi - iiplatelet kunye ne-erythrocytes. Indlela yokusebenza kwezi zinto zihluke, okwenza kube lula ukubona amaqela amaninzi. Ama-Antigregregants, uluhlu lwabalungiselelo olubanzi, lubalwa njengolu hlobo lulandelayo.

1. Abaphikisi beCalcium (iVerapamil).
2. Enzyme inhibitors, ezibandakanya izinto ezivimbela i-cyclooxygenase (i-acetylsalicylic acid, i-Naproxen, i-Indomethacin), kunye ne-adenylate cyclase kunye ne-phosphodiesterase (i-Ticlopidine, i-Pentoxifylline).
3. Iziyobisi ezikhuthaza ukubunjwa kwe-prostacyclin ("Pyrazolin").
4. Iprostanoids ("i-Prostacyclin" kunye nezifana zayo zendalo).
5. Iziyobisi ezithintela ukukhutshwa kwezinto eziseplatelet ("iPiracetam").

Iinkcazo

I-Antiagreganty - iziyobisi, amagama abo ayaziwa ngabantu abaninzi ngokusetyenziswa jikelele. Umsebenzi oyintloko wale qela kukukhusela i-thrombosis. Ama-Antigregregants asebenzisa iziyobisi ezisetyenziswa ngokufanelekileyo kwinani leentsholongwane ze-cardiovascular disease, kunye nasemva kokusebenza kwezicwangciso (ii-valve heart valves).

Ama-antigregregants: uluhlu lwezilwanyana eziqhelekileyo zisetyenziselwa ukusetyenziswa kwonyango

Kukho ezininzi iziyobisi eziseli qela, kwaye zonke zazo zizodwa. Ukukhethwa kwamachiza kuxhomekeke kwimeko yeklinikhi. Kwaye, ngokwemvelo, ukuzinyango kule meko akufanelekanga.

"Aspirin"

Kwimimiselo ye-hemostasis, i-eicosanoids ithatha inxaxheba, eyimveliso ye-oxidation ye-arachidonic acid. Phakathi kwabo, i-thromboxane A2 ibaluleke kakhulu, kwaye umsebenzi wayo oyintloko kukubonelelwa kwe- platelet aggregation. Isenzo se-aspirin sijoliswe kwi-inhibition ye-enzyme, ebizwa ngokuba yi-cyclooxygenase. Ngenxa yoko, ukuhlanganiswa kwe-thymboxane A2 kugxothwa, ngoko ke, iinkqubo ze-thrombogenesis ziyacinywa. Isiphumo sanda ngokulawulwa ngokuphindaphindiweyo kweziyobisi ngenxa yokunyusa. Ukukhusela ngokupheleleyo i-cyclooxygenase, kufuneka kuthathwe i-daily quake. Ixabiso elifanelekileyo liyanciphisa amathuba okuba nemiphumo emibi "I-Aspirin", kunye nokusetyenziswa rhoqo. Ukunyuka kwamanqanaba akukwamkelekanga, kuba kukho umngcipheko weengxaki ezinjengegazi.

"Ticlopidine"

Impembelelo yeziyobisi isekelwe ekuthintekeni kweemvume ezithile ezijongene nokubunjwa kwe-thrombus. Ngokuqhelekileyo, xa i-ADP ibophelela kubo, ifomu yeplatelet iyatshintsha kwaye i-aggregation ivuselelwe, kwaye "iTiclopidine" inqanda le nkqubo. Isixhobo sale antiaggregant siphezulu sokufumaneka kobomi, okufezekiswa kwinqanaba eliphezulu lokutywala. Emva kokurhoxiswa, umphumo ugcinwa ezinye iintsuku ezingama-3-5. Ukungalungi yinkalo enkulu yemiphumo emibi, phakathi kweyiphi i-nausea, isifo sohudo, i-thrombocytopenia kunye ne-agranulocytosis.

"Clopidogrel"

I-Antiaggregant ngohlobo lwezenzo lifana ne "Ticlopidine", kodwa inzuzo yalo iyancitshiswa kakhulu. Ukongeza, umngcipheko weempembelelo xa uthabatha eli liyeza liphantsi. Okwangoku, iingcali zikhetha "iKlopidogrel" ngenxa yokungabikho kweengxaki ezinjenge-agranulocytosis kunye ne-thrombocytopenia.

"Eptifibatide"

Isilwanyana siyaphazamisa ulwahlulo ngokukhusela i-glycoprotein, ekhoyo kwisibilini seplatelet. Kufuneka ukuba ulawulo lwe-intravenous fluid, ngokuqhelekileyo lube ne-angina kunye ne-angioplasty ukunciphisa amathuba okuba i-myocardial infarction.

"I-Dipyridamole"

Isiphumo esisisiseko sonyango yi-vasodiation, oko kukuthi, i-vasodilatation, nangona kunjalo, xa idibaniswe nezinye iziyobisi, i-effect anti-proplatelet isichazwe. "I-Dipiridamol" imiselwe kunye kunye ne "Aspirin" ukuba kukho umngcipheko omkhulu wokubunjwa kwe-thrombus. Kwakhona kunokwenzeka ukudibanisa neWarfarin, esebenzise ngokufanelekileyo emva kweeprovatic heart valve ukunciphisa amathuba okubamba. Nge-monotherapy, umphumo awunakuchazwa.

Antiagreganty - iziyobisi (uluhlu: "uEliksvis", "Clopidogrel" kunye nabanye), esetyenziswa ngokubanzi kwisenzo.

Ukungqinelana

Ukutyunjwa kwamagosa e-antiplatelet kufuna ukuqokelela ngokucophelela kwe-anamnesis, equka ulwazi malunga neengxaki ze-pathologies. Ngaphambi kwesi sifo okanye eso sifo, okuchasene nokuthatha amachiza ale qela, ukulungiswa kwesicwangciso sonyango kuyimfuneko. Kwiimeko ezinjalo, kukhethwa kwamanye amayeza kunye namayeza abo, kwaye unyango luqhutywa phantsi kolawulo oluqinileyo lugqirha. Akukho na imeko evunyelwe ukuzimela ngokuzimeleyo ama-antiplatelet agents, kuba imiphumo ingaba yingozi.

Uluhlu lweenkcazo:

• Ukuguqulwa kwamanzi;
• I-diathesis yeHemorrhagic;
• Ingozi yokuphuma kwegazi;
• Ubumbele obukhulu kunye nokungaphumeleli kwezintso;
• I-arrhythmia kwi-anamnesis;
• Uxinzelelo olunzulu lwegazi;
• Izifo ezithintekayo zenkqubo yokuphefumula;
• Ubudala bezingane (ezininzi zeziyobisi).

Ukongezelela, amaninzi amanxusa e-antiplatelet (uluhlu lwezilwanyana ezicatshangelwe kule nqaku) aphikisana nokukhulelwa kunye nokuhlaselwa. Ngeli thuba, ukhetho lufanele lunikezelwe kumayeza aya kukhuseleka kumntwana nomama.

Antigregregants. Ukulungiselela: uludwe lokukhulelwa

Ukuba kukho ukuphulwa kwegazi kwi-fetus, kukho umngcipheko wokukhipha isisu. Le nto yayibizwa ngokuba yi- fetoplacental insufficiency. Ukuba ukuhanjiswa kwe-oksijini egazini kuphazamisekile, umntwana ukhula nge-hypoxia enamandla, engasongeli nje ukungaqhelekanga ekuphuhlisweni kwayo, kodwa nokufa. Xa ufumanisa ukuba unyango olunjalo, unyango olukhawulezayo lufunekayo, okuphucula ukuhamba kwegazi, ukunciphisa i-viscosity yegazi. Ukwenza oku, ama-antiplatelet agents anqunyelwe, kodwa kufuneka kukhunjulwe ukuba akuzona zonke iziyobisi zeli qela zikhuselekile ngexesha lokukhulelwa. Kuyamkeleka ukusebenzisa kuphela izixhobo ezithile.

"Kurantil"

Isilwanyana sithandwa kakhulu ngenxa yokuba kuluhlu lweenkcazo zalo akukho ukukhulelwa nokuncelisa. Into esebenzayo "i-Kurantila" yi-dipyridamole echazwe ngaphambili, idibanisa imithana yegazi, kwaye iphinda ikhuphe ukubunjwa kwe-thrombus. Isilwanyana siphucula ukunikezelwa kwegazi kwisisu senhliziyo, ukuqinisekisa ukuhanjiswa kwexabiso elifunekayo le-oksijini. Ngenxa yoko, i-K "Urantil" ingasetyenziselwa phambi kwentsholongwane ye-cardiovascular in a woman pregnant. Nangona kunjalo, isibonakaliso esiphezulu sokumisela kwabafazi abasetyhini kukungakwazi ukuhamba. Ngenxa yokuphuculwa kweempawu ze-rheological zegazi kunye ne-vasodilation, ukuthintela ukukhutshwa kwemithambo yegazi ye-placenta kuyenziwa, ngoko umntwana akahluphekanga nge-hypoxia. Inzuzo eyongeziweyo yeziyobisi ingabizwa ngokuba yimpomomodulating effect. Isilwanyana sishukumisa ukuveliswa kwe-interferon, oku kubangela umngcipheko omncinci wokuvelisa izifo zentsholongwane kumama. Nangona "i-Kurantil" kwaye ingasetyenziselwa ekukhulelweni nasekuhlaleni, kunjalo, kuyimfuneko kuphela ukuyibeka ukuba kukho ubungqina. Xa uthatha isibisi kufuneka unciphise ukusetyenziswa kweti kunye nekhofi, njengoko ukunciphisa ukusebenza kwayo. I-Antiagreganty - iziyobisi (uluhlu olungentla), olungenakuhlanganiswa neziphuzo ezinjalo. Nangona ngexesha lokukhulelwa abacebisi ukuba bathathwe naliphi na imeko.

Ama-Antigregregants, uluhlu lwezilwanyana ezinobuninzi bamagama, zisetyenziselwa ukunyanga izifo zesimo senhliziyo. Nangona kunjalo, umntu kufuneka akhumbule malunga neengxaki ezinokwenzeka ezinxulumene nokunciphisa i-viscosity yegazi kunye nokuxothwa kwe-clotting. I-Antiagreganty - iziyobisi ezingasetyenziswa kuphela phantsi kweliso loogqirha, uya kukhetha i-dosage efunekayo kunye nekhosi yeyeza.