Fraxiparin - nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana, ka mea, nā hōʻike, nā puka o ka hoʻokuʻu i nā ʻaoʻao, nā hopena ʻaoʻao, nā analogues a me nā kumukūʻai

ʻO ka anticoagulant pololei he haʻahaʻa kaumaha heparin.
Keʻano lāʻau: FRAXIPARINE
ʻO ka mea ikaika o ka lāʻau lapaʻau: kalekaʻi nadroparin
Manaʻo ATX: B01AB06
KFG: Direct-hana anticoagulant - heparin kiʻekiʻe heparin
Ka helu kākau: P No. 015872/01
Lā hoʻopaʻa inoa: 07/28/06
Mea ʻai reg. acc.: GLAXO WELLCOME KAKOU

Hoʻokuʻu i ka palapala Fraksiparin, kālai lāʻau lāʻau a me ka hoʻonohonoho.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

1 pūwāwa
kalekaʻi nadroparin
2850 IU Anti-Ha

Nā mea hoʻihoʻi: ka hāleʻa calmona hāneanea a hoʻoheheʻe ʻia i ka wai hoʻoneʻe hydrochloric i ka pH 5.0-7.5, wai wai / a - a hiki i 0.3 ml.

ʻO 0.3 ml - kahe mau puʻuwai kū hoʻokahi (2) - blisters (1) - nā kīʻaha o ke kāleka.
ʻO 0.3 ml - ka waiū hoʻokahi-mau kekona (2) - blisters (5) - nā pā o ka pahu paʻi.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

1 pūwāwa
kalekaʻi nadroparin
3800 IU Anti-Ha

Nā mea hoʻihoʻi: ka hāleʻa calmona hāneanea a hoʻoheheʻe ʻia i ka wai wai hydrochloric i ka pH 5.0-7.5, wai wai / a - a hiki i 0.4 ml.

0.4 ml - ʻonanahi mau kūmole kū hoʻokahi (2) - blisters (1) - nā kīʻaha o ke kāleka.
0.4 ml - ʻonanahi mau kūmole kū hoʻokahi (2) - blisters (5) - nā pā o ka papalepa.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

1 pūwāwa
kalekaʻi nadroparin
5700 IU Anti-Ha

Nā mea hoʻihoʻi: ka hāleʻa calmona hāneanea a hoʻoheheʻe ʻia i ka wai wai hydrochloric i ka pH 5.0-7.5, wai wai / a - a hiki i 0.6 ml.

ʻO 0.6 ml - kaheʻe hoʻokahi-dosis (2) - blisters (1) - nā pā o ka papalepa.
ʻO 0.6 ml - kaheʻe hoʻokahi-dosis (2) - blisters (5) - nā pā kīkaha o ke kāleka.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

1 pūwāwa
kalekaʻi nadroparin
7600 IU Anti-Ha

Nā mea hoʻihoʻi: ka hāleʻa calmona hāneanea a hoʻoheheʻe ʻia i ka wai wai hydrochloric i ka pH 5.0-7.5, wai wai / a - a hiki i 0.8 ml.

0.8 ml - kani-kūwaho kūwaho (2) - blisters (1) - nā pā o ka pahu.
ʻO 0.8 ml - kahe mau ʻāpana o ke kū hoʻokahi (2) - blisters (5) - nā pahu kīpē.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

1 pūwāwa
kalekaʻi nadroparin
9500 IU Anti-Ha

Nā mea hoʻihoʻi: ka hāleʻa calmona hāneanea a hoʻoheheʻe ʻia i ka wai wai hydrochloric e pH 5.0-7.5, wai wai / a - a hiki i 1 ml.

1 ml - kani kūwaho kū hoʻokahi (2) - blisters (1) - nā kīpē o ka palaka.
1 ml - kani kūwaho kū hoʻokahi (2) - nā wili (5) - nā pālaha o ke kāleka.

Kahi ʻia ka wehewehe ʻana o ka lāʻau lapaʻau ma luna o nā kuhikuhi i pili i ka hoʻohana.

Lapaʻa lāʻau lapaʻau Fraxiparin

ʻO ka calciumium nadroparin he haʻahaʻa haʻahaʻa haʻahaʻa heparin (NMH) i loaʻa e ka depolymerization mai ka heparin maʻamau, he glycosaminoglycan me ke kau palena molelole 4300 daltons.

Hōʻike i kahi hiki nui ke hiki i ka protein plasma me ka antithrombin III (AT III). Hoʻopuka kēia hāmeʻa i ka wikiwiki o ka hoʻololi ʻana o ke kumu Xa, aia ma muli o ke kūlana kiʻekiʻe antithrombotic kiʻekiʻe o ka nadroparin.

ʻO nā hana ʻē aʻe e hāʻawi ana i ka hopena antithrombotic o ka nadroparin me ka hoʻihoʻi ʻana i ka hoʻoweliweli ʻōiwi kiko (TFPI), hoʻōla o ka fibrinolysis ma ka hoʻokuʻu ʻana i kahi kiko o ka plasminogen aine mai nā cell endothelial, a me ka hoʻololi ʻia o ka waiwai rheological o ke koko (hoʻohaʻahaʻa i ka hoʻokahe ʻia o ke koko a me ka hoʻonui ʻana i ka permeability o platelet a me nā granulocyte membranes).

Hōʻike ʻia ka calciumium nadroparin e ka mea koʻikoʻi anti-Xa kumumanao kahi hoʻohālikelike ʻia i ka hanana anti-IIa a i ʻole ka hana antithrombotic a ua loaʻa koke ka hana antithrombotic hana.

Hoʻohālikelike me ka heparin unfractionated, ua loaʻa ka nadroparin i ka hopena pākahi ma ka platelet function a me ka hōʻuluʻulu ʻana, a me kahi hopena i emi ʻole i ka hemostasis mua.

Ma nā hopena prophylactic, ʻaʻole i hoʻonele ka nadroparin i kahi hōʻemi i ʻōlelo ʻia i loko o APTT.

Me ka papa o ka mālama ʻia i ka wā o ka hana nui, hiki i ke hoʻonuiʻana i ka APTT i kahi kumukūʻai 1.4 mau manawa ma mua o ka maʻamau. Hōʻike kēia mau lōʻihi i ka hopena antithrombotic residual o ka calcium nadroparin.

ʻO ka Pharmacokinetics o ka lāʻau.

Hoʻoholo ʻia nā waiwai Pharmacokinetic ma ke kumu o nā loli i ka hana anti-Xa factor plasma.

Ma hope o ka hoʻokō ʻana o Cutanx i ka plasma koko i ka hoʻokō ʻia ma hope o 3-5 mau hola, ua aihue ʻo Nadroparin kokoke loa (kokoke i ka 88%). Me ka / i ka hoʻomaka ʻana o ka hana anti-XA loa i hoʻokō ʻia ma kahi o 10 mau minuke, ʻo T1 / 2 mau hola 2

Hoʻomili ʻia ka mea nui i ka ate ma ka desulfation a me ka depolymerization.

Ma hope o ka hoʻomalu ʻana ʻo SC iā T1 / 2 ma kahi o nā hola 3.5. Akā, hoʻomau ka hana anti-Xa ma ka liʻiliʻi he 18 mau hola ma hope o ka loaʻa ʻana o ka nadroparin ma kahi ʻano o 1900 anti-XA ME.

ʻO ke ʻano o ka lāʻau Fraxiparin

ʻ solutionlelo i nā hopena ʻōpina 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.6 ml, blister 2, pahu (pahu) 1,
ʻ solutionlelo i nā ʻōpina kūmole 9500 IU (anti-XA) / ml, hoʻoiho ʻoki manu 1 ml, blister 2, pahu (pahu) 5,
ʻ solutionlelo ihi mai nā kānaka kūlehu 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.8 ml, blister 2, pahu (pahu) 5,
ʻ solutionlelo i nā hopena ʻōpina 9500 IU (anti-XA) / ml, hoʻoiho ʻoki pū ana 0.8 ml, blister 2, pahu (pahu) 1,
ʻ solutionlelo ihi mai nā kānaka kūlehu 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.6 ml, blister 2, pahu (pahu) 5,
ʻ solutionlelo ihi mai nā kānaka kūlehu 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.3 ml, blister 2, pahu (pahu) 1,
ʻ solutionlelo ihi mai nā kānaka kūlehu 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.3 ml, blister 2, pahu (pahu) 5,
ʻutanlelo i nā ʻōpoki kikoho a 3800 IU, hoʻoiho ʻoki i ka 0.4 ml, blister 2, pahu (pahu) 1,
ʻ solutionlelo i nā ʻōpina kūmole 9500 IU (anti-XA) / ml, hoʻoiho ʻoki manu 1 ml, blister 2, pahu (pahu) 1,
ʻutanlelo ʻōpiha i kū mai ai 3800 IU, hoʻoiho i ka ʻili ʻili 0.4 ml, blister 2, pahu (pahu) 5,
ʻ solutionlelo i nā hopena ʻōpulika 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.4 ml, blister 2, pahu (pahu) 1,
ʻ solutionlelo i nā hopena ʻōpulika 9500 IU (anti-XA) / ml, hoʻoiho ʻoki ana 0.4 ml, blister 2, pahu (pahu) 5,

Hōʻike
Kōkahi 1 syringe
kalepona nadroparin ME anti-Ha 2850
nā mea hoʻihoʻi: nā hāleʻa calcium hydroxide - q.s. (a hoʻoheheʻe ʻia ka wai wai hydrochloric) i ka pH 5.0–7.5, wai no ka hoʻonāukiuki - q.s. a i 0.3 ml
i kahi pahu kili 2 mau ʻeke he 0.3 ml hiki, i loko o kahi pahu pahu 1 a i ʻole 5 mau palaka.

Kōkahi 1 syringe
nadroparin kalima me ME anti-Ha 3800
nā mea hoʻihoʻi: nā hāleʻa calcium hydroxide - q.s. (a hoʻoheheʻe ʻia ka wai wai hydrochloric) i ka pH 5.0–7.5, wai no ka hoʻonāukiuki - q.s. a i 0.4 ml
i loko o kahi pahu he 2 mau māka i hiki ke hoʻokuʻu ʻia he 0.4 ml i kēlā me kēia, ma kahi pahu pahu kahi 1 a 5 mau walo paha.

Kōkahi 1 syringe
kalepona nadroparin, ME anti-Ha 5700
nā mea hoʻihoʻi: nā hāleʻa calcium hydroxide - q.s. (a hoʻoheheʻe ʻia ka wai wai hydrochloric) i ka pH 5.0–7.5, wai no ka hoʻonāukiuki - q.s. a i 0.6 ml

Kōkahi 1 syringe
kalepona nadroparin, ME anti-XA 7600
nā mea hoʻihoʻi: nā hāleʻa calcium hydroxide - q.s. (a hoʻoheheʻe ʻia ka wai wai hydrochloric) i ka pH 5.0–7.5, wai no ka hoʻonāukiuki - q.s. a i luna o 0.8 ml
i kahi blister, 2 mau ʻoki ʻoki i ka 0.6 ml i kēlā me kēia, i kahi pahu kāleka 1 a i ʻole 5 mau palaha paha.

Kōkahi 1 syringe
kalepona nadroparin, ME anti-Ha 9500
nā mea hoʻihoʻi: nā hāleʻa calcium hydroxide - q.s. (a hoʻoheheʻe ʻia ka wai wai hydrochloric) i ka pH 5.0–7.5, wai no ka hoʻonāukiuki - q.s. a hiki i 1 ml
i kahi blister, 2 mau ʻoki i loaʻa i ka 1 ml i kēlā me kēia, i kahi pahu kāleka 1 a i ʻole 5 mau blisters.

ʻO nā lāʻau lapaʻau o ka lāʻau Fraxiparin

ʻO Calcium nadroparin he kumu kiʻekiʻe anti-Xa i hoʻohālikelike ʻia i ka hanana anti-IIa a i ʻole ka hana antithrombotic. Loaʻa ka ʻike ma waena o nā hana ʻelua no ka nadroparin ma waena o 2.5-4.

I nā paukū prophylactic, ʻaʻole kahi kuhi a ka rotroparin i ka hōʻaha poʻokela i ka manawa partial thrombin hoʻoneʻe (APTT).

Me kahi papa o ka mālamaʻana i ka wā o ka hana nui, hiki i ka APTT ke hoʻonui i kahi kumukūʻai 1.4 mau manawa ma mua o ka maʻamau.ʻO ke ʻano lōʻihi o ia mea e hōʻike ana i ke koena antithrombotic hopena o ka calcium nadroparin.

Hoʻohana ʻia ka lāʻau Fraxiparin i ka wā hāpai

ʻAʻole i hōʻike ʻia nā hoʻokolohua holoholona me ka teratogenic hopena o ka calcium nadroparin, akā naʻe, i ka mea hoʻokani mua o ka hapai ʻana, ʻoi aku ka maikaʻi o ka haʻalele ʻana i ka hoʻokele ʻana o Fraxiparin i ka hopena pale a i ke ʻano o kahi papa hana.

I ka wā ʻo II a me III e hoʻomaʻamaʻa ʻia, hiki ke hoʻohana ʻia Fraxiparin e like me nā ʻōlelo a ke kauka no ka pale ʻana i ka thrombosis venous (i ka wā e hoʻohālikelike ana i nā pōmaikaʻi o ka makuahine me ka loaʻa ʻana o ka pūpū). ʻAʻole hoʻohana ʻia ka hana papa ʻōlelo i kēia wā.

Inā aia kekahi nīnau e pili ana i ka hoʻohana ʻana o ka maʻi āpau o ka maʻi maʻi, ua hōʻike ʻia, ʻoiai hiki i ke kāpae i ke ʻano he prophylactic me ka heparin ma kahi o 12 mau hola ma mua o ka hana maʻi.

Mai ka lilo ʻana o ka lāʻau i loko o ka pēpē gastrointestinal i loko o nā pēpē, ʻoiai, ʻaʻole hiki ʻole ke mālama ʻia me ka Fraxiparin o nā hānai hānai.

ʻO nā hoʻohālikelike i ka hoʻohana o ka lāʻau Fraxiparin

ʻO ka hypersensitivity (e pili ana i ka thrombocytopenia) i Fraxiparin a i ʻole LMWH a i / a heparin paha i loko o ka anamnesis, nā hōʻailona hōʻailona o ke koko a i ʻole ka hoʻonui ʻana i ka ʻaihue e pili ana i ka hemostasis impaired, me ka hoʻokaʻawale ʻana iā DIC, ʻaʻole i kumu ʻia e ka heparin, ʻokoʻa nā kino o ka kino me ka makemake e hoʻoheheʻe ʻia. (no ka laʻana, ka ʻōpala maʻi o ka ʻōpū a i ʻole duodenum), nā hōʻeha a me nā hōʻuluʻulu hou ʻana ma ka ʻōnaehana saraf waena, endocarditis septic.

ʻO nā hopena ʻaoʻao o ka lāʻau Fraxiparin

ʻO ka hopena maʻamau ka mea i hana i kahi hematoma subcutaneous i ka pūnaewele injection. I kekahi mau hihia, aia ka hiʻohiʻona no nā nodules dense ʻaʻole i manaʻo i ka heparin encapsulation, kahi e nalo aku nei ma hope o kekahi mau lā.

Hiki i nā inikua nui o Fraxiparin ke hoʻonāukiuki i nā kahe o nā wahi like ʻole a me ka thrombocytopenia mālie (type I), e nalo i ka wā o ka hana hou. Malia paha he hoʻonui liʻiliʻi iki i ka pae o nā enzymes ati (ALT, AST).

ʻO nā ʻili ʻili a me nā maʻi kūlohelohe ka līlū. Ua hōʻike ʻia he mau hihia o ka hopena anaphylactic a me thrombocytopenia (type II), i hui pū ʻia me ka arterial a me / or venous thrombosis a i ka thromboembolism.

ʻO ka hoʻomoe a me ke kāohi o ka lāʻau Fraxiparin

E komo i loko o ka ʻōpū subcutaneous o ka ʻōpū, i loko o ka mānoanoa o ka ʻili o ka ʻili (ʻoi ka pono ka pili i ka paʻu). Mālama ka ʻōwili i ka manawa o ka hoʻokele. Kāohi i ka thromboembolism ma nā hoʻomaʻamaʻa maʻamau: 0.3 ml 1 manawa i kēlā me kēia lā. Lawelawe ʻia ka 0.3 ml mau hola 2 ma mua o ka hoʻomaʻamaʻa ʻana. ʻO ka papa ala o ka mālamaʻana ma kahi o 7 mau lā. No nā kumu therapeutic: hoʻolako ʻia i 2 manawa i hoʻokahi lā no 10 mau lā ma kahi hapa o 225 U / kg (100 IU / kg), e pili ana i: 45-55 kg - 0.4-0.5 ml, 55-70 kg - 0.5-0.6 ml, 70 -80 kg - 0.6-0.7 ml, 80-100 kg - 0.8 ml, ʻoi aku ma mua o 100 kg - 0.9 ml. I loko o nā hoʻokūkū orthopedic, koho ʻia ke ʻano ma muli o ke kaumaha o ke kino. Hoʻohana ʻia ia i hoʻokahi lā i kēlā me kēia lā, ma kēia mau ʻai iho: me ke koʻikoʻi o ke kino ma lalo o 50 kg: 0.2 ml i loko o ka wā preoperative a i loko o 3 mau lā ma hope o ka hana ʻana, ʻo 0.3 ml i loko o ka wā postoperative (hoʻomaka i 4 lā). Me ka paona kino o 51 a 70 kg: i ka wā preoperative a i loko o 3 mau lā ma hope o ka hōʻoki ʻana - 0.3 ml, ma ka wā postoperative (hoʻomaka mai 4 lā) - 0.4 ml. Me ka paona kino o 71 a 95 kg: i ka wā preoperative a i loko o 3 mau lā ma hope o ka hōʻoki ʻana - 0.4 ml, ma ka wā postoperative (hoʻomaka mai 4 lā) - 0.6 ml. Ma hope o ka venography, e mālama ʻia i kēlā me kēia mau hola 12 no 10 mau lā, e hilinaʻi ʻia ka pāpaona ma ke kaumaha o ke kino: me ka lehulehu o 45 kg - 0.4 ml, 55 kg - 0.5 ml, 70 kg - 0.6 ml, 80 kg - 0.7 ml, 90 kg - 0.8 ml, 100 kg a mei aku - 0.9 ml. Ma ka hoʻomaʻamaʻa ʻana o ka angina unstable a me myocardial infarction me ka hawewe Q, ka pahu o 0.6 ml (5700 IU antiXa) i hoʻokahi manawa i ka lā.

ʻO ke overdose me Fraxiparin

Hoʻopilikia kūlohelohe inā s / i ka hoʻolauna ʻana i nā dosis nui o nā heparins palupalu haʻahaʻa i hiki ai i ke koko.

I ka hihia laʻana - ʻoiai he dosis nui - no ka heparin koʻikoʻi haʻahaʻa haʻahaʻa (ʻoiai ʻaʻole i ʻike ʻia), nā hopena koʻikoʻi e kali ʻole ʻia, hāʻawi ʻia i nā haʻahaʻa haʻahaʻa haʻahaʻa o ka lāʻau.

Hoʻolālā: no ka hoʻohaʻahaʻa haʻahaʻa - lohi i kahi mahele hou aʻe.

I kekahi o nā pilikia, hiki ke hōʻike ʻia ka hoʻohana ʻana o ka protamine sulfate, me ka noʻonoʻo ʻana i kēia: a ua hoʻohaʻahaʻa ʻia ka ʻoihana pono ʻole ma mua o ka mea i hōʻike ʻia me ka overdose o ka heparin unfractionated, ʻae i ka hopena o ka hopena me ka hopena o ka protamine sulfate e nānā pono ʻia ai ma muli o nā hopena ʻulaʻi (ʻoiai me ka weliweli anaphylactic. )

Inā hoʻoholo ia e pili i ia ʻano hana, lawe ʻia ka neutralization e ka lūlū ʻana i ka hoʻomalu ʻana o ka protamine sulfate.

ʻO ka hopena o ka hopena o ka protamine sulfate e hilinaʻi nei: ʻo ka heparin i hoʻolele ʻia e ka heparin (100 mau ʻāpana antiheparin o ka protamine sulfate hiki ke hoʻohana e hoʻonaninani i ka hana o 100 IU anti-XA factor hana o LMWH), i hala ka manawa ma hope o ka hoʻokele ʻana o ka heparin, me kahi laʻa o ka hoʻēmi i ka hopena o antidote.

Eia naʻe, hiki ʻole ke hoʻokaʻawale loa i ka hana anti-Xa.

Eia kekahi, ʻo ka kinetics o ka hoʻopili haʻahaʻa ʻana i ka haʻalulu haʻahaʻa heparin hiki ke hāʻawi i kēia neʻe kūlohelohe i kahi ʻano pōkole a koi i nā ʻāpana o ka huina helu o ka protamine sulfate no kekahi mau inikina (2–4) i hoʻoili ʻia i kēlā me kēia lā.

Hoʻopili i nā lāʻau Fraxiparin me nā lāʻau lapaʻau'ē aʻe

Hoʻokumu ka hoʻomohala ʻana i ka hyperkalemia ma ka manawa like o kekahi mau pilikia. ʻO nā maʻi lapaʻau Hyperkalemia: paʻakai pālala, potassium diaring-potassium, ka inhibitor ACE, angiotensin II receptor blockers, NSAIDs, heparins (haʻahaʻa haʻahaʻa kumuika a ʻaʻole i hoʻolimalima), cyclosporin a me tacrolimus, trimethoprim. Hoʻopilikia ka pilikia o ka hyperkalemia me ka hui pū o nā kālā i luna me Fraxiparin.

ʻO ka hoʻohana pū ʻana o Fraxiparin me nā lāʻau lapaʻau e pili pono ana i ka hemostasis, e like me ka acetylsalicylic acid, nā NSAIDs, nā vitamina K antagonist, fibrinolytics a me ka dextran, alakaʻi i ka hoʻohui like ʻana o ka hopena.

Eia kekahi, pono e noʻonoʻo pono i ka poʻe platelet aggregation inhibitors (koe wale nō i ka acetylsalicylic acid me nā analgesic a me nā kinipōpō antipyretic, i.e. ma ke ʻano o ka hou o 500 mg): NSAIDs, abciximab, acetylsalicylic acid ma antiplatelet doses (50-300 mg) i ka wai (50-300 mg) i ka wai indikasi o ka cardiological a me ka neurological, beraprost, clopidogrel, eptifibatid, iloprost, ticlopidine, tirofiban e hoʻonui i ka hopena o ke kahe.

ʻO nā ʻōlelo koʻikoʻi no ka lawe ʻana iā Fraxiparin

ʻOiai ka mea i ʻike ʻia i ka hoʻokaʻina ʻana o nā meaʻokoʻa o ka haʻahaʻa heparins haʻahaʻa haʻahaʻa, ua hōʻike ʻia i loko o nā hui honua o ka hana anti-Xa factor, ʻae ʻia ko lākou mākaukau i ka hana kumu anti-Xa. Ke hoʻololi nei i ka hoʻoponopono dosage o kekahi NMH me kekahi ʻē aʻe he hōʻino a hoʻokele ʻole ʻia, no ka mea ua hoʻāʻo ʻia kēlā me kēia regimen me nā hōʻike lāʻau lapaʻau kūikawā. No laila, pono ka mālama kūikawā a me ka mālama pono i nā ʻōlelo kikoʻī no ka hoʻohana ʻana i kēlā me kēia lāʻau lapaʻau pono.

Pilikia ke koko. Pono e mālama ʻia nā ʻoihana therapeutic (dosage a me ka lōʻihi o ka mālama ʻana). I ka hihia ʻē aʻe, hiki mai paha ke kahe koko, ʻoi aku hoʻi i nā mea maʻi me ka make (ka poʻe ʻelemakule, nā mea maʻi e hōʻeha nei i ka hiki ʻole o ka renal, a pēlā aku).

Ua ʻike ʻia ke koko o ka maʻi: ma nā mea maʻi maʻi, ʻo ka pili me ka nāwaliwali o ka hana ʻana i ka hana me ka makahiki, me ka hiki ʻole o ka pilikia, i nā mea maʻi ke kaupaʻa ʻia ma mua o 40 kg, inā i ka wā o ka mālama ʻana iʻoi aku ka nui o nā mea i kau ʻia (10 mau lā), i ka hihia me ka nānā ʻole ʻana i nā kūlana mālama i ʻōlelo ʻia ʻia ( ma ka pae aku ka lōʻihi a me ka kau ʻana ma luna o ke kaupaona ʻana no ke kino lāʻau no ka hoʻohana ʻana), i ka wā e hui pū ai me nā lāʻau e hoʻonui ai i ka nui o ke kahe.

I kēlā me kēia hihia, pono ke kuleana kūikawā i nā maʻi maʻi a me nā poʻe maʻi e hōʻeha nei i ka hiki ʻole o ka renal, a me ka manawa o ka hoʻohana ʻana i ka lāʻau lapaʻau ma mua o 10 lā. I kekahi mau hihia, he mea kūpono paha e ana i ka hana ʻoi aku ka anti-Xa e ʻike i ka hōʻiliʻili o ka lāʻau.

ʻO ka hopena o ka trombocytopenia heparin-induced (HIT).Inā loaʻa ka mea maʻi i ka mālama ʻana no ka LMWH (ma ke kuhi a i ʻole nā ​​prophylactic dosis) ka hopena: ka nui o ka maikaʻi o ka thrombosis e mālama ʻia ai ka mea maʻi, phlebitis, embolism pulmonary, ʻeha haʻahaʻa ischemia haʻahaʻa, myocardial infarction a i ʻole hahau, ʻike ʻia lākou ka hōʻike ʻana o ka trombocytopenia heparin-induced, a helu koke i ka helu platelet.

Hoʻohana i nā keiki. Ma muli o ka nele o nā hōʻike, ʻaʻole ʻae ʻia ka hoʻohana ʻana o LMWH i nā keiki.

Hola a kaʻili. Ma mua o ka hoʻomaka ʻana i ka mālama ʻana no LMWH, pono ia e nānā i nā hana renal, ʻoi aku hoʻi i nā mea maʻi ʻelemakule ma mua o 75 mau makahiki. Hoʻāliʻi ka clearance cleance e like me ka formula Cockcroft a hoʻokumu ʻia i ke kaumaha kino maoli o ka mea maʻi: i nā kāne, Cl creatinine = (140 mau makahiki) × ke kaumaha o ke kino / (0.814 × serum creatinine), e hōʻike ana i nā makahiki i nā makahiki, ke kaumaha o ke kino i ka kg, a me ka kumu serum ma μmol / l (inā hōʻike ʻia ka creatinine ma mg / ml, hoʻonui ʻia ma 8.8).

I nā wahine, hoʻohui ʻia kēia ʻano e ka hoʻonui ʻana i ka hopena ma 0.85

ʻO ka hoʻomaopopo ʻana o ka hikiʻole o ka renal koʻikoʻi (Cl creatinine e pili ana i 30 ml / min) he contraindication i ka hoʻohana ʻana o LMWH i ke ʻano papa (ʻike ʻia "Contraindications").

Helu helu platelet

Ma muli o ka pilikia o ka hoʻomohala ʻana i ke GIT, pono ka mana o ka platelet, me ka ʻole o ka hōʻailona no ka hoʻohana ʻana a me ka ʻono i ʻōlelo ʻia. Hana ʻia ka helu platelet ma mua o ka hoʻomaka ʻana o ka mālama ʻana a i ʻole ma mua o ka lā o ka lā mua ma hope o ka hoʻomaka ʻana o ka hoʻōla, a laila 2 mau manawa i kahi hebedoma no ka holoʻokoʻa o ka mālama ʻana.

Pono e hōʻike ʻia kahi hoʻokolohua GIT inā helu helu platelet

Mea papa waiwai: nadroparin calcium

1 ml 9500 anti-Xa nadroparin calcium

1 syringe paʻa mua (0.3 ml) loaʻa i ka 2850 anti-Xa nadroparin calcium

1 syringe paʻa mua (0.4 ml) he 3800 anti-Xa nadroparin calcium

Nā mea hoihoi: kaʻaila kalaiwa hydroxide (a i ʻole wai dilule hydrochloric), wai no ka hōʻoki ʻia.

ʻO nā waiwai Pharmacological

ʻO Nadroparin kahi haʻahaʻa heparin hoʻoneʻe liʻiliʻi i hoʻomohala ʻia e ka depolymerization o ka heparin maʻamau. ʻO kahi glycosaminoglycan me ka nui molelika mololi o 4300 daltons. Hōʻike ʻo Nadroparin i kahi kiʻekiʻe kiʻekiʻe o ka nakinaki ʻana i nā protein plasma me III antithrombin. ʻO kēlā pili pili i alakaʻi i ka wikiwiki o ka hoʻololi ʻana o ke kumu Xa, ʻo ia ka mea nui o ka hana antithrombotic kiʻekiʻe o ka nadroparin. ʻO nā hana ʻē aʻe o ka hana antithrombotic o ka nadroparin ka hoʻowalewale ʻana i ka kiko factor pathway inhibitor, hoʻolaʻa ʻana o nā fibrinolysis ma ka hoʻokuʻu ʻana i ka kiko o ka plasminogen kikoo mai nā cell endothelial, hoʻololi i nā ʻāpana hemorheological (hoʻēmi i ka kahe koko a hoʻonui i ke kahe o ka platelet a me ka membulocy granulocyte). He kiʻekiʻe nā Nadroparin ma waena o ka hana anti-Xa a me ka hana anti-IIa. Loaʻa ia i kahi hopena antithrombotic koke a lōʻihi. Hoʻohālikelike me ka heparin unfractionated, ua loaʻa ka nadroparin i kahi hopena liʻiliʻi i ka platelet function a me ka hōʻuluʻulu ʻana a heʻuʻuku loa ka hopena ma ka hemostasis mua.

Hoʻoholo ʻia nā waiwai ʻo pharmacokinetic ma ke ana ʻana i ka hana anti-Xa factor o ka plasma koko.

Ma hope o ka hoʻokele subutanutan, kahi kiʻekiʻe ma ka hana anti-Xa (C max) ka hoʻokō ʻia ma hope o 3-5 mau hola (T max). Kokoke pau ka Bioavailability (e pili ana i ka 88%).

Ma hope o ka hoʻokele ʻana, ua loaʻa ka hopena anti-Xa (C max) ka hopena ma lalo o ka 10 mau minuke me ka hapalua ola -ʻo 2:00.

Ma hope o ka hoʻolālā subutaneus, ʻo ka hoʻopau ʻana o ka hapalua-ola he aneane 3.5 mau hola. Eia nō naʻe, hoʻomau ka hana anti-XA ma ka liʻiliʻi loa he 18 mau hola ma hope o ka loaʻa ʻana o ka nadroparin ma ke ʻano o 1900 anti-XA ME.

Nā hui ahonui kūikawā

ʻO nā maʻi maʻi

Mai ka hele ʻana o ka hana kino o nā pūpū me ka wā'ōmaʻomaʻo, pau ka make ʻana i ka lāʻau. ʻO ka hiki ke hoʻomohala i ka hana ʻole i kēia pūʻulu o nā mea maʻi e kaupaona ʻia a ʻo ke ʻano o ka lāʻau lapaʻau e hoʻoponopono pono ʻia.

Wahi a nā haʻawina loiloi e pili ana i ka parakiʻi o ka pharmacokinetic o ka nadroparin, i ka wā i lawelawe ʻia ai i nā mea maʻi me nā ʻāpana like ʻole o koʻi hoino ʻole ʻia, kahi hōʻike i hōʻike ʻia ma waena o ka holoi ʻana o ka nadroparin a me ka hē o ka hana. I nā mea maʻi me ka hiki ʻole o ka renal moderate (ʻo ka cleinine clearance 36-43 ml / min), kahi pae ʻokoʻa ma lalo o ka kukuhi kukuna / wā (AUC) a me ka hapalua ola i hoʻonui ʻia i ka 52% a me 39%, kēlā me kēia, i hoʻohālikelike ʻia me nā mea hana manuahi olakino. I kēia mau mea maʻi, ua hōʻemi ka awelika plasma hoʻoliʻiliʻi a nadroparin i ka 63% o ke kumu. Ua nānā ʻia ke ʻano ʻōpiopio like ʻole. I nā mea maʻi me ka maikaʻi o ka renal maikaʻi ʻole (ka hana ʻana o creinine o 10-20 ml / min), ʻo AUC a me ka hoʻopauʻana i ka hapalua-ola e hoʻonui i ka 95% a me ka 112%, ko kēlā me kēia, i hoʻohālikelike ʻia me nā mea hana olakino. ʻO ka hoʻomaʻemaʻe i nā mea maʻi me nā pilikia hana ʻole i hōʻemi ʻia i 50% hoʻohālikelike ʻia me nā mea maʻi me ka hana maʻamau maʻamau. I nā mea maʻi me ka maikaʻi o ka renal maikaʻi ʻole (ʻo ka clearanine clearance 3-6 ml / min) ka mea ma ka hemodialysis, ʻo ia ka nui o AUC a me ka hoʻopau ʻana i ka hapalua ola-nui i hoʻonui ʻia i ka 62% a me 65%, kēlā me kēia, i hoʻohālikelike ʻia me nā mea hana olakino. ʻO ka hoʻomaʻemaʻe i nā mea maʻi me ka maikaʻi o ka renal i hōʻino ʻia e ka hemodialysis i hōʻemi ʻia i ka 67% i nā mea maʻi me ka hana o ka maʻi maʻamau.

ʻO ka paleʻana i nā hoʻopiʻi thromboembolic ma ka nui a i ka lāʻau orthopedic ākea i nā mea maʻi me ka hopena kiʻekiʻe o nā hoʻopiʻi thromboembolic.

Ke hoʻomaʻemaʻe nei i ka thrombosis vein hohonu.

ʻO ka paleʻana i ka hoʻomohala koko i ka wā hemodialysis.

Ke mālama nei i ka pectoris angina pectoris a me ka myocardial infarction ʻole me ka pathological Q neʻe ma kahi ECG i hui pū me ka acetylsalicylic acid.

Hoʻopili me nā lāʻau lapaʻau a me nā ʻano ʻē aʻe ʻē aʻe

Pono e hoʻohana ʻia ka Nadroparin me ka makaʻala i nā mea maʻi e lawe ana i nā anticoagulants waha, nā glucocorticosteroids systemic, a me dextrans. Inā makemake ʻia nā anticoagulants waha no ka mālama ʻana i nā mea maʻi e lawe ana i ka nadroparin, pono e hoʻonui ʻia ka mālama ʻana me ka nadroparin e hoʻomau i ka pae ma ka pae kūpono o ka rula normalisation (INR).

Nā hiʻohiʻona noi

I ka mea he hopena o ka heparin thrombocytopenia, pono e nānā ʻia ka helu platelet i ka holo ʻana o ka mālama holoʻokoʻa.

Ua hōʻike ʻia nā hihia o ka thrombocytopenia i kekahi manawa, ua hōʻeha ʻia, ka mea i hui pū ʻia e ka trombosis arterial a vena, he mea koʻikoʻi loa ia e noʻonoʻo ai i nā kūlana e pili ana: me ka thrombocytopenia, me kahi emi nui o ka helu platelet (mai ka 30% a 50% i hoʻohālikelike ʻia me ka pae mua) ka hana o ka thrombosis, no ia mea i kau ʻia ai ka mālama ʻana, me ka nānā ʻana o ka thrombosis i ka wā mālama, me ka maʻi o nā mea e hoʻonālikelike ʻia ai ka intravascular coagulation. Inā hele kēia mau hanana, pono e hoʻōla ʻia ka lāʻau heparin.

ʻO nā hopena ma luna aʻe he immuno-allergic ma ke ʻano, a inā e hoʻopili ʻia ka mālama ʻana no ka manawa mua, e kū ana ma waena o ka lā 5 a me ka lā 21 o ka mālama ʻana, akā hiki ke nui ma mua inā he moʻolelo ʻo ka maʻi heparin thrombocytopenia.

ʻO ka maʻi me ka thrombocytopenia i kū i ka wā o ka mālama ʻana me ka heparin (ma o ka maʻamau a me ke kaumaha moliki haʻahaʻa) i ka mōʻaukala o ka mālama me ka heparin, ʻaʻole pono e kuhikuhi ʻia inā pono. I kēia hihia, pono ka nānā ʻana i nā mea lapaʻau a me ka hoʻoholo ʻana o ka helu platelet i kēlā me kēia lā. Ma ka hihia o ka thrombocytopenia, pono e hoʻokaʻawale koke ke ʻano heparin.

Ma ka hihia o ka thrombocytopenia i ka wā e mālama ai me ka heparin (ʻelua paona a me ke kaumaha mololi haʻahaʻa), pono e noʻonoʻo pono ai i ke kau ʻana i nā lāʻau antithrombotic o kekahi papa ʻē aʻe. Inā loaʻa ʻole ia lāʻau lapaʻau, hiki iā ʻoe ke kahakaha i kekahi lāʻau lapaʻau hou ma ka pūʻulu o nā heparins haʻalulu haʻahaʻa, inā pono ka hoʻohana ʻana o ka heparin.I kēia hihia, pono e nānā pono ʻia ka helu platelet i ka liʻiliʻi o ka manawa 1 i kēlā me kēia lā a pono e hoʻokuʻu ʻia ka hoʻomaʻamaʻa inā hiki i ka wā ke hoʻomau ka thrombocytopenia mua ma hope o ke kahuli ʻana i ka lāʻau.

Kekahi hōʻike hōʻike vitro platelet i hoʻokō waiwai ʻia o ka waiwai o ka heparin thrombocytopenia.

ʻO nā kūlana i ke ala o ka hopena o ke koko e hoʻonui

Pono e hoʻohana ʻia ka Nadroparin me ka makaʻala i nā kūlana i hoʻopili ʻia me ka nui o ka neʻe ʻana o ke kahe, e like me

• pūpū hema
• hipertension hypertension kiʻekiʻe,
• ʻeha ka ʻōpū a i ʻole ulia duodenal a i ʻole nā ​​lelo manuahi hoʻi e hiki ai i ke koko,
• ʻO nā maʻi ʻeha o ka pākaukau,
• ka manawa ma hope o nā hana ma ka lolo a me nā piʻi, ma nā maka.

Ua ʻike ʻia ua lawe ʻia ka nadroparin e nā keiki, a me ke ala i ka piʻi ʻana o ka ʻike o ka nadroparin i nā maʻi me nā maʻi papalū. I nā maʻi me ka pilikia ʻole, ua hoʻonui ʻia ka pilikia o ke koko, a e mālama ʻia lākou me ka mālama aka.

Pono ke kau i ka manaʻo e pili ana i ka hiki ʻana o ka hōʻemi i ka nui o nā maʻi i nā maʻi me ka cleinine cleance mai 30 a 50 ml / min pono i ka loiloi ma ka loiloi e nā kauka o nā mea kūlohelohe o kēlā me kēia maʻi e pili ana i ka hopena o ke koko i hoʻohālikelike ʻia me ka hopena o ka thromboembolism.

Hiki i ka Heparin ke pani i ka huna ʻia o ka adrenal o ka ald testosterone a kumu i ka hyperkalemia, ʻoi aku hoʻi i nā poʻe maʻi me ka kiʻekiʻe o ka pākela plasma kiʻekiʻe a i ʻole ka hopena o ia hoʻonui ʻana o ka plasma koko i nā mea maʻi me ka maʻi mellitus, nā mea maʻi me ka maʻi renal failed, metabolic acidosis a nā mea maʻi e lawe nei i nā lāʻau lapaʻau. hiki ke kumu i ka hyperkalemia (e.g., ACE inhibitors, non-steroidal anti-inflammatory drug).

Hōʻemi ka piʻi ʻana o ka hyperkalemia me ka hoʻonui ʻana i ka lōʻihi o ka mālama ʻana, akā ʻano hōʻano pinepine ka hyperkalemia. I ka poʻe maʻi me nā pilikia pilikia, pono e nānā ʻia nā pae o ka potassium potassium.

Spest / epidural anesthesia, spinal lumbar puncture a me nā lāʻau lapaʻau e pili ana

Hōʻalo ka hōʻeha o nā hematomas spinal / epidural me ka hoʻohana ʻana i kahi catheter epidural a i ʻole ka hoʻohana ʻana o nā lāʻau lapaʻau ʻē aʻe e pili ana i ka hemostasis, e like me nā huahana anti-inflammatory anti-inflammatory, nā platelet aggregation inhibitors, a i ʻole nā ​​anticoagulants. Hoʻonui ka puʻe me ka traumatic a i ʻole ka hoʻomau a ulia paha, no laila, ʻo ka hoʻoholo ma ka hoʻohana pū ʻana o ka blockade neuroaxial a me nā anticoagulants e hana ma hope o ka loiloi ʻana i ka pōmaikaʻi / hopena pili i kēlā me kēia hihia pilikino.

• i nā mea maʻi e hoʻomaʻamaʻa ʻia me nā mea hana anticoagulant, pono e noʻonoʻo pono nā pono o ka hoʻohana ʻana i ka palaka neuroaxial me ka hiki,
• i nā mea maʻi e hoʻomākaukau ana no ka ae ʻana i ka maʻi hōʻiliʻili me ka neʻe ʻana o ka neuroaxial blockade, pono pono ka maikaʻi o ka hoʻohana ʻana i ka anticoagulants me ka makaʻala.

Ke hana nei i ka punthure lumbar, spinal a epidural anesthesia, pono ke mālama ʻia ka wā ma ka hola 12:00 inā e hoʻohana ana i ka nadroparin i nā pale pale a me 24 mau hola i ka wā e hoʻohana ai ʻo nadroparin i nā hopena therapeutic ma waena o ka inikua o ka nadroparin a me ka hoʻopuka a wehe paha i kahi cat spato / epidural catheter a he lāʻau pono. No ka poʻe maʻi me ka pani ʻole ʻana, hiki i kēia manawa ke hoʻonui ʻia.

Pono e nānā pono nā mea maʻi i mea e ʻike ai i nā hōʻailona o ka maʻi neʻokeʻo. Inā hele lākou, pono kupono kūpono nā lawelawe.

ʻO Salicylates, nā lāʻau lapaʻau anti-inflammatory o ka lāʻau a me nā inhibitors ke hoʻohui platelet

No ka pale aku a mālama ʻana paha i nā hoʻopiʻi thromboembolic venous a no ka pale ʻana i ka ʻaila koko i ka wā o ka hemodialysis, ka hoʻohana ʻana o ka acetylsalicylic acid, nā salicylates ʻē aʻe, nā lāʻau lapaʻau anti-inflammatory a me ke ʻano o ka platelet aggregation, ʻaʻole i ʻōlelo ʻia, no ka mea e hiki ke hoʻonui i ka hōʻeha. Inā ʻaʻole hiki ke pale ʻia ka hoʻohana ʻana o ia ʻano hui, e mālama ʻia ka nānā ʻana i nā lāʻau lapaʻau.

I ka wā o nā hoʻokolohua lapaʻau no ka mālama ʻana i ka pectoris angina pectoris a me ka myocardial infarction me ka loaʻa ʻole o ka path Q Q, ʻo ECG nadroparin i hui pū me ka acetylsalicylic acid ma kahi o kahi wai o 325 mg / lā.

ʻAʻole hōʻike ʻia nā hihia nui o nā ʻili nekiola. ʻO mua kēia o ka hiʻohiʻona ʻana o nā ʻenehana purpura a i ʻole infiltrated erythematous element me ka ʻole ʻole o nā hōʻailona maʻamau. I ia kūlana, pono e hoʻōki koke ʻia ka mālama ʻana.

Allergy latex

ʻO ka pāpale pale ma ka pūliki o kahi syringe i hoʻopiha ʻia i loko o ka huehue mai ka latex kūlohelohe, hiki ke hana i ka maʻi kūlohelohe i nā poʻe pili i ka latex.

Hoʻohana i ka wā hāpai a lactation

ʻAʻohe kauka haʻawina ma ka hopena o heparin ma ka ulu momona. ʻAʻole i hōʻike ʻia nā haʻawina holoholona i ka hopena teratogenic a fetotoxic o ka heparin. Eia nō naʻe, ua pau ka ʻike o ka lāʻau lapaʻau e pili ana i ka wehe ʻana o ka inokele o nadroparin i nā wahine hāpai. No laila, ʻaʻole i kuhikuhi ʻia ka hoʻohana ʻana o ka heparin i ka wā hapai, inā ʻaʻole ʻoi aku ka pōmaikaʻi o ke olakino.

Hoʻolaha ʻia ka ʻikepili ma ka excretion o nadroparin i ka waiū umauma, no laila ʻaʻole kuhikuhi ʻia ka hoʻohana ʻana o ke nadroparin i ka wā o ka hoʻoulu ʻana.

ʻAuhea e hiki ai ke hoʻohana i ka huahana?

ʻOiai ka ʻōlelo noʻonoʻo mai kekahi mau kauka e palekana ana ka fraxiparin i ka wā hāpai, ʻaʻole pono ʻoe e hoʻohana inā ʻaʻole pono maoli. Kuhi pinepine ka loea i ka lāʻau lapaʻau i ka mea maʻi inā ua ʻoi aʻe ka hoʻoweliweli i ka ola o ka makuahine ma mua o ka hiki i ka pūpū.

Therapy i ka wā gestation

Ua hōʻike ʻia ka lāʻau lapaʻau e like me ka prophylaxis a me ka mālama ʻana i nā pathologies e hoʻonāukiuki i ka piʻi ʻana o ke koko. Hoʻoholo kū hoʻokahi ke kauka i ka lōʻihi o ka lāʻau lapaʻau. ʻO ka lōʻihi o ke papa ma ke ʻano o ka hōʻeha o ka ʻeha.

I kekahi manawa ke makemake ʻia nā makuahine e neʻe i ka lāʻau lapaʻau i ka wā holoʻokoʻa o ka hapai ʻana. He hāmeʻa kekahi o ka mea hana, ʻaʻole ia e hilinaʻi ʻia inā pili ʻia a i ʻole e hoʻolālā ana a hāpai i ka hapai ʻana:

• paa ka lāʻau i ka protein plasma, ke pale i nā mea pili koko,
• hoʻemi i ka nānāʻike koko
• pale i nā ʻōwili koko i ke kāwili pū ʻana.

Aia nō ka hoʻokū ʻia e hoʻopaʻapaʻa ʻia e pili ana i ka nui o ka fraxiparin i ka wā hāpai a hiki i ka pōpilikia no ka mea maʻi a me ka makuahine makemake. Manaʻo kekahi poʻe loea ʻaʻole hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka ʻōpio, a he nui nā makahiki o ka noi ʻana i hōʻoia i kēia.

Ke manaʻoʻiʻo nei kekahi e hiki i ka lāʻau lapaʻau ke hōʻeha i ka huhū o loko, kahi pilikia nui loa no ke olakino o ka wahine a me kāna pēpē. Eia kekahi, hōʻike nā ʻōkuhi i hana ʻole i nā mea ʻepekema i hana i kekahi mau noiʻi e pili ana i ka hopena o ka lāʻau ma ka fetus, no laila ʻaʻole hiki ke hoʻopaʻapaʻa.

I ka wā hapai, ke kauka nei ke kauka i nā inikini fraxiparin i loko o nā kūlana koʻikoʻi, inā nui ka nui o ka coagulation koko. Hiki i kēia kūlana ke:

• limahana hana
• makehewa
• wili kala hele.

ʻO ka maʻamau, kuhikuhi nā kauka i ka lāʻau lapaʻau wale nō i loko o ka lua o ke kolamu o ka mea i hōʻiliʻili ʻia. Aia kekahi mau kumu no kēia.

Ulu ka plasenta me ka ūka no nā mahina ʻeiwa. Hoʻokumu ia i kahi ʻoihana o nā kapillaries a me nā kīʻaha koko e hoʻolako i ka pēpē i kaʻai. Inā ua hoʻomehala ka wahine i ke koko, hoʻomaka ʻo ia e pohō i nā capillaries.A ke hopena, loaʻa ka trombosis, pololi pololi o ka pūpū. ʻAʻole hiki ke pili i kēia i ka hoʻomohala ʻana a me ka maikaʻi.

I ka wā o ka trimester hope loa, hiki i ka ʻōpū i kona nui loa, no laila ke kau nei i ke kaomi ikaika ma luna o nā uaua o ke pelvis, i mea e hōʻeha ai i ke kahe koko i loko o nā wāwae. Hoʻomaka ke koko ma nā koʻo o lalo, no laila e ʻike ʻia nā koko koko. ʻO ka hopena ka embolism pulmonary. Hoʻoweliweli kēia i ka make o ka wahine a me kāna pēpē.

Kuhi ʻia i ka wā e hoʻolālā a alakaʻi ʻia ai ka wahine hāpai

Akā i kekahi mea, i ka wā hāpai, ʻo ka lālapa tranexam, fraxiparin a me nā mea lapaʻau hou aku e kuhikuhi ʻia e nā kauka wale nō ma hope o ka kūkā ʻana o kekahi kanaka. I kekahi manawa ho'ōla e ola i ka ola o ka wahine a me kāna wahine hānau. No laila, ʻaʻole hiki ke hoʻopaʻapaʻa ʻia ua pāpā paʻa ʻia ka lāʻau lapaʻau. E hoʻoholo ʻia nā mea a pau ma kahi pilikino pilikino.

Nā hopena ʻaoʻao a me nā contraindications

I ka wā hapai, pono ʻoe e heluhelu pono i nā kauoha no ka hoʻohana ʻana i ka lāʻau fraxiparin. E like me kekahi lola, kūpono lāʻau lapaʻau, fraxiparin has contraindications and side effects. No laila, ma mua o ka hoʻohana ʻana i ka huahana, pono e noʻonoʻo pono i ka pilikia a noʻonoʻo pono i nā hopena kūpono e kū mai ana mai ka mālama ʻana. Pāpā ʻia ka lāʻau lapaʻau i nā hihia aʻe.

1. ʻAʻole ʻae ka mea maʻi i ka mea i ʻike ʻia i ka nano kaha, ka mea i loaʻa i ka lāʻau lapaʻau.
2. Loaʻa ka Coagulopathy, ʻo ia ka hemahema o ka ʻaʻā koko.
3. ʻAʻohe hopena mai ka maʻi maʻi me nā lāʻau antiplatelet: Aspecard, Cardiomagnyl, Aspirin Cardio.
4. Endocarditis hopuna o ka maʻi.
5. ʻO ka hōʻeha cerebrovascular hemorrhagic.
6. ʻO ka hoʻomohala ʻana o ka thrombocytopenia ma hope o ka hoʻohana ʻana i ka calcium nitrroparin ma mua.

Ma hope o ka mālama ʻana, hoʻomohala ʻia nā hopena ʻano, akā, me ka hoʻoponopono ʻana e nā loiloi a ke kauka, ʻike pinepine ʻole. E pili ana ia i nā hopena maikaʻi ʻole.

1. Anaphylactic pīhoihoi.
2. ʻO ka edema ʻo Quincke.
3. ʻĀlioiaʻi.
4. Allergy i ke ʻano o ka heching a i ʻole ai.

Pono ka lāʻau e hoʻokaʻawale me nā wīwī i nā wahine i loaʻa i nā pilikia i ka ʻeha gastrointestinal, ke koko kiʻekiʻe, ke koko a me nā puʻuwai. Hoʻomaopopo i kahi hoʻoweliweli overdose e hoʻolilo i ke kahe. Hiki ke hoʻonui aʻe i ke kiʻekiʻe o nā enzyme o ka ate (AST, ALT).

Nā hōʻailona no ka hoʻohana ʻana

Hoʻohana nui ʻia ma Fraxiparin i loko o nā pilikia penei:

• ka mālama ʻia ʻana o ka maʻi infocococial,
• ka pale ʻana o nā hoʻopiʻi thromboembolic, no ka laʻana, ma hope o ka hoʻomaʻamaʻa ʻole a me ka ʻole ʻoi ʻana,
• prophylaxis coagulation i ka wā o ka hemodialysis,
• ka mālama ʻana i nā hoʻopiʻi thromboembolic,
• ka mālama ʻana o ka pectoris angststable.

Nā ʻōkuhi no ka hoʻohana

Hoʻokomo ʻia ka Fraxiparin i loko o ka ʻōpū i ka kiko subutanutan. Pono ka mālama ʻia o ka paʻu i nā manawa a pau e lawelawe ʻia ana ka hoʻonā.

Pono ka hoʻomanawanui. He mea nui ia e pili pono ana ka nira, ʻaʻole ma ke kihi.

Ma ka ʻoihana nui no ka pale ʻana i nā hoʻopiʻi thromboembolic, e mālama ʻia ana ka hoʻonā i loko o kahi waihona o 0.3 ml i hoʻokahi lā i ka lā. Lawe ʻia ka lāʻau no ka liʻiliʻi ma kahi hebedoma a hiki i ka wā i waiho ʻia ai ka hopena o ka pilikia.

Hoʻoponopono ʻia ka lāʻau mua ma mua o nā hana ma 2-4 mau hola. Ma ka hihia o orthopedic surgery, mālama ʻia ka lāʻau i nā hola he 12 ma mua o ka hana a me 12 mau hola ma hope o kona hōʻea ʻana. ʻOi aku, lawe ʻia ka lāʻau lapaʻau ma nā liʻiliʻi he 10 a hiki i ka hopena o ka manawa pilikia.

Hoʻomaopopo ʻia ka dosage no ka pale ʻana ma muli o ke kaumaha o ke kino o ka mea maʻi

• 40-55 kg - hoʻokahi manawa no ka 0.5 ml,
• 60-70 kg - hoʻokahi manawa no 0.6 ml,
• 70-80 kg - ʻelua mau manawa i ka lā, 0.7 ml kēlā me kēia.
• 85-100 kg - ʻelua mau manawa i kahi lā no 0.8 ml.

No ka mālamaʻana i nā hoʻopiʻi thromboembolic, mālama ʻia ka lāʻau lapaʻau ma waena o 12 mau hola ʻelua i kēlā me kēia lā no 10 lā.

I ka mālamaʻana i nā hoʻopiʻi thromboembolic, ʻo ka paona o ke kanaka e hana i ka hana e hoʻoholo ai i ka ʻōpū:

• a i ka 50 kg - 0.4 mg,
• 50-59 kg - 0,5 mg,
• 60-69 kg - 0.6 mg
• 70-79 kg - 0.7 mg
• 80-89 kg - 0.8 mg
• 90-99 kg - 0,9 mg.

I ka pale ʻana o ka ʻaila koko, pono e hoʻokaʻawale ʻia ke ʻano ma luna o nā ʻano loea o ka dialysis. ʻO ka maʻamau, ʻo ka wā e pale ʻia ai ka coagulation, ʻo ka wahi e hōʻemi ai i ka laʻi mua loa o 0.3 mg no ka poʻe a hiki i ka 50 kg, 0.4 mg a 60 kg, 0.6 mg ma mua o 70 kg.

Hoʻolālā ʻia ka mālama ʻia o ka infarction myocardial a me ka angina paʻa i ka hui pū ʻana me Aspirin no 6 lā. I ka mua, ua hoʻopaʻa ʻia ka lāʻau i loko o ka catheter venous. Hoʻohana ʻia ka maʻi dosis o 86 ME anti-Xa / kg no kēia. ʻOi aʻe, mālama ʻia ka hoʻonā ʻālepana i ke aniani ʻelua a i ka lā hoʻokahi.

Hoʻohui nūhou

ʻO ka lawe ʻana i nā franksiparin i ka manawa like me kekahi mau lāʻau lapaʻau hiki ke alakaʻi i hyperkalemia.

Hoʻopili kēia i nā: paʻakai potasi, nā ACE inhibitors, heparins, NSAIDs, diuretics potassium-sparing, Trimethoprim, angiotensin II receptor blockers, Tacrolimus, Cyclosporin.

ʻO nā lāʻau hōʻeha e pili ana i ka hemostasis (kūlue i ka anticoagulants, acetylsalicylic acid, nā NSAIDs, fibrinolytics, dextran), me ka hoʻohana ʻana o kēia ʻāpana, hoʻonui i ka hopena o kēlā me kēia.

Hiki ke piʻi aʻe ka hopena o ke kaila inā he Abciximab, Beraprost, Iloprost, Eptifibatide, Tirofiban, Ticlopedin e lawe pū ʻia. Hiki i ka acetylsalicylic acid ke hana i kēia, akā aia wale nō i nā inikena antiplatelet, ʻo ia ka 50-300 mg.

Pono ka hoʻokaʻawale ʻana o Fraxiparin i ka wā e loaʻa ai ka poʻe maʻi i ka dextrans, nā ku ole anticoagulants, a me nā corticosteroids systemic. I ka lawe ʻana o nā anticoagulants kūlike me kēia lāʻau lapaʻau, hoʻomau ʻia kona hoʻohana a hiki i ke ʻano o ka hōʻike INR.

Hoʻokomo maikaʻi ka hopena o ka Fraxiparin a me ka waiʻona. Hoʻohana ʻia ka lāʻau lapaʻau e pale i nā hoʻopiʻi thromboembolic, a me nā mea inu wai, ma ke kū'ē, e hoʻonui ai i ko lākou pilikia.

Hōʻike Indra Fipxiparin syringe ampoule

ʻO ka pale ʻana i nā hoʻopiʻi thromboembolic i ka wā o ka hōʻemi a me ka hoʻohaʻahaʻa orthopedic i nā mea maʻi me ka hopena nui o ka thrombosis (ma ke kino hanu a me / a i ʻole nā ​​pilikia o ka naʻau ma lalo o nā ʻano o ka ICU, ka pectoris angina pectoris, kaʻi myocardial me ka ʻole o ka neʻe Q pathological a ECG).
- Ke hoʻomaʻamaʻa ʻana i ka thromboembolism.
- Ke pale aku nei i ka coagulation koko i ka wā hemodialysis.

Contraications Fraxiparin syringe ampoule

ʻO Thrombocytopenia me kahi mōʻaukala nadroparin.
- ʻO nā hōʻailona o ke kahe a he piʻi nui paha o ke koko e pili ana me ka hemostasis impaired (me ka ʻokoʻa ʻole o DIC, ʻaʻole i kumu ʻia e heparin).
- Nā maʻi maʻi me ke ʻano o ke koko (no ka laʻana, he ʻōpū o ka ʻōpū maʻi a i ʻole ulī duodenal).
- ʻeha hōʻeha a i ʻole kaʻawale ʻana i ka pale ma ka lolo a me nā kaula spinal a i ʻole nā ​​maka.
- Hoʻomahule - Intracranial.
- He endocarditis septic.
- ʻO kahi hōʻole renal maikaʻi loa (CC ma mua o 30 ml / min) i nā mea maʻi e loaʻa Fraxiparin no ka mālamaʻana i ka thromboembolism, ka uka paʻa ʻole a me ka infarction myocardial me ka ʻole o ka nalu Q.
- nā keiki a me nā ʻōpio (a hiki i ka 18 makahiki).
- Kūpono o nā kinipōpō a i ʻole nā ​​mea ʻē aʻe o ka lāʻau lapaʻau.
Me ka mālama aka, pono e kau ʻia ʻo Fraxiparin i nā kūlana e pili ana i ka nui o ka pilikia o ke kahe: me ka hiki ʻole o ka puʻuwai, me ka pale ʻana o ka maʻi, a me ka maha o ka hypertension koʻikoʻi, me ka mōʻaukala o nā maʻi peptic a me nā maʻi ʻē aʻe me ka nui o ka ulu ʻana o ke kahe, me ka pilikia kaʻe ma ka choroid a me ka retina. ma ka manawa postoperative ma hope o nā hana ma ka lolo a me ka manamana lima a i ʻole nā ​​maka, i nā mea maʻi e kaupaʻa ana ma mua o 40 kg, me kahi lōʻihi o ka lapaʻau e ʻoi aku i ka ʻōlelo Dowa (10 lā) i loko o ka hihia o ka ole-kaʻaeʻana me ka paipai lapaʻau kūlana (pakahi aku la ia hoonui i ka lōʻihi like 'ole a me ka mahele lāʻau no ka papa o ka i), ka wā hui me ka ai' e hoomahuahua i ka pilikia o ke kahe ana ke koko.

ʻO kahi wī a me ka lactation Fraxiparin syringe ampoule

I kēia manawa, aia wale nō ka 'ikepili e pili ana i ke komo ʻana o ka nadroparin ma o ka mea paʻa placental i loko o nā kānaka.No laila, ʻaʻole i kuhikuhi ʻia ka hoʻohana ʻana o Fraxiparin i ka wā hapai, inā ʻaʻole pono ka pōmaikaʻi hiki i ka makuahine ke ʻoi aku i ka hopena o ka wahine maʻi. I kēia manawa, palena wale nō nā ʻikepili ma ka alakiʻi ʻana o ka nadroparin me ka waiū umauma. Ma kēia e nānā ʻia ai, ʻaʻole hoʻohana ʻia ka hoʻohana ʻana o ka nadroparin i ka wā lactation (breastfeeding). I nā hoʻokolohua holoholona hoʻomaʻamaʻa, ʻaʻohe i ka hopena teratogenic o ka calcium nadroparin i loaʻa.

ʻO ka lohi a me ka hoʻokele o nā fraxiparin syringe ampoule

Kahi / i ka hoʻolilo ʻana i ka lāʻau lapaʻau e mālama maikaʻi ʻia i ke kūlana kiʻekiʻe o ka mea maʻi, i ka s / c kiko o ka anterolateral a i ʻole posterolateral luna o ka ʻōpū, i ʻole ka laulima ma ka ʻaoʻao hema a hema. Hāʻawi ʻia e komo i ka ʻōpū. I mea e pale ai i ka nalowale ʻana o ka lāʻau ke hoʻohana ʻana i nā syringes, ʻaʻole pono e haʻalele i nā leʻe o ka lewa ma mua o ka huakaʻi.
E hoʻokomo pono ʻia ka pono me ka wili ʻana, a ʻaʻole ma ke kihi, i loko o ka paila i hoʻopili ʻia ma waena o ka manamana lima a me ka mua. Pono ka mālama i ka wā o ka mālama o ka lāʻau. Mai ʻūleʻa i ka pūnaewele inake ma hope o ke ahulau.
No ka paleʻana i ka thromboembolism ma ka hoʻomaʻamaʻa maʻamau o ka olelo paipai o Fraxiparin he 0.3 ml (2850 anti-Xa ME) s / c. Hoʻohana ʻia ka lāʻau lapaʻau i nā hola 2-4 ma mua o ka hoʻomaʻamaʻa ʻana, a laila - 1 manawa / lā. Hoʻomau ʻia ka mālama ʻana no ka liʻiliʻi o 7 mau lā a i loko o ka manawa holoʻokoʻa o ka mahuahua o ka thrombosis, a hiki i ka mea maʻi ke neʻe aku i kahi pae maʻi maʻi.
No ka pale ʻana i ka thromboembolism i ka wā o nā hana orthopedic Hāʻawi ʻia ka Fraxiparin sc ma kahi kiko i hoʻoholo ʻia ma muli o ke kaumaha o ke kanaka maʻi ma ka awelika ʻo 38 anti-XA IU / kg, hiki ke hoʻonui ʻia i 50% ma ka lā 4 o ka wā ʻoihana. Ua kuhikuhi ʻia ka paʻu ma mua he 12 mau hola ma mua o ka hoʻomaʻamaʻa ʻana, ka lua o ka wai - 12 mau hola ma hope o ka pau o ka hana. Eia kekahi, hoʻomau ka hoʻohana ʻana iā Fraxiparin i ka manawa 1 i ka lā no ka manawa holoʻokoʻa o ka nui o ka nui o ka hiki ʻana i ka thrombosis a hiki i ka mea maʻi ke neʻe aku i kahi pae maʻi outpatient. ʻO ka palena iki o ka mālamaʻana he 10 mau lā.
ʻO nā mea maʻi i ke kīpē nui o ka thrombosis (me ka angina hiki ʻole, ka infarction myocardial me ke kū ʻole Q.) Kuhi ʻia ka Fraxiparin sc 2 mau manawa / lā (i kēlā me kēia mau hola 12). ʻO ka lōʻihi ka mea mālama i ka 6 mau lā. Ma nā noiʻi haukapila, nā mea maʻi me ka angina pectoris / myocardial infarction ʻole me Q wave Fraxiparin i kuhikuhi pū ʻia me ka acetylsalicylic acid ma kahi o 325 mg / lā. E mālama ʻia ka ʻōlelo mua ma ke ʻano he hoʻokahi intravenous bolus injection, ua mālama ʻia nā pona ma hope o sc. Kau ka paena ma muli o ke kaupaona ʻana o ke kino ma ka wikiwiki o 86 anti-XA IU / kg.
I ka loaʻa ʻana o ka thromboembolism, wahaʻalani anticoagulants (i ka ʻole o nā contraindications) e kuhikuhi koke i ka manawa. ʻAʻole paʻa ka Therapy me Fraxiparin a hiki i ka loaʻa ʻana o nā waiwai kumu o ka hōʻailona manawa prothrombin. Noi ʻia ka lāʻau lapaʻau s / c 2 mau manawa / lā (i kēlā me kēia mau hola 12), ʻo ka manawa maʻamau o ka papa he 10 lā. Hoʻokomo ka dosis i ka paona kino o ka mea maʻi i ka helu o 86 anti-XA ME / kg koʻikoʻi kino.
ʻO ka paleʻana i ka hoʻomohala koko i ke kaila o ka extracorporeal i ka wā o ka hemodialysis: pono ka hoʻonohonoho o Fraxiparin i hoʻokahi no kēlā me kēia maʻi, e noʻonoʻo ana i nā ʻano loea o ka dialysis. Hoʻomaka ka Fraxiparin i hoʻokahi manawa i ka laina o ka pehu dialysis ma ka hoʻomaka ʻana o kēlā me kēia. No nā mea maʻi me ka piʻi ʻole o ka kahe, ke hoʻonohonoho ʻia nā neʻe mua i kau ʻia ma luna o ke kaumaha o ke kino, akā lawa nō kahi hālāwai dialysis 4-hola.
I ka poʻe maʻi i ka ulu nui o ke kahe Hiki iā ʻoe ke hoʻohana i ka hapalua o ke ʻano i ʻōlelo ʻia i ka lāʻau. Inā he lōʻihi ka lōʻihi o ka dialysis ma mua o 4 mau hola, e mālama ʻia nā pupu liʻiliʻi no Fraxiparin. I ka wā o nā manawa dialysis ma hope, e pono ke koho o ka pauka ma muli o nā hopena i nānā ʻia.Pono ka nānā ʻana o ka mea maʻi i ka wā o ka hana dialysis ma muli o hiki i ke kahe koko a i ʻole nā ​​hōʻailona o ka thrombosis i loko o ka papa dialysis.
I nā maʻi maʻi maʻi ʻAʻole koi ʻia ka hoʻoponopono ʻana (me ka ʻole o nā mea maʻi me ka hana renal impaired). Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me Fraxiparin, ʻoi ʻia ia e nānā i nā māka hana hana lela.
I ka poʻe maʻi me ka leʻalolo a me ke kaulike ʻole o ka renal (clearance clearance ≥ 30 ml / min a ma mua o 60 ml / min): no ka pale ʻana i ka thrombosis, ʻaʻole pono ka hoʻemi ʻana o ka hōʻemi, ma nā mea maʻi me ka ʻōpū o ka renal koʻikoʻi (ʻo ka hana ʻana i hana ʻia ma lalo o 30 ml / min), pono ke hoʻemi ʻia ka nui ma ka 25%.
I ka poʻe maʻi me ka hōʻeha ʻole i ke aʻa: no ka mālamaʻana i ka thromboembolism a i ʻole no ka pale ʻana i ka thromboembolism i nā maʻi me ka hōʻeha o ka thrombosis (me ka angina paʻa ʻole a me ka myocardial infarction me ka neʻe o ka Q), e hoʻemi ʻia ka nui o ka hopena ma ka 25%, ua hoʻohele ʻia ka lāʻau lapaʻau i nā mea maʻi me ka maikaʻi ʻole o ka renal.

Nā ʻōlelo kikoʻī kūikawā Fraxiparin syringe ampoule

Pono e mālama pono i nā ʻōlelo kikoʻī no nā hoʻohana ʻana no kēlā me kēia lāʻau no ka papa o ka heparins weight low low, e like me hiki ke hoʻohana ʻia i nā pūʻulu dosage (nā ʻāpana a i ʻole mg). Ma muli o ia mea, ʻaʻole i ʻae ʻia ke ʻano o Fraxiparin me LMWH me ka mālama lōʻihi. Pono hoʻi e kiaʻi pono i kahi o nā lāʻau e hoʻohana ai - Fraxiparin a i Fraxiparin Forte, no ka mea pili kēia i ka regimen dosage. Hoʻokumu ʻia nā syringes puka i koho ai i ke ʻano ma ka kaumaha o ke kino o ka mea maʻi.
ʻAʻole noʻonoʻo ʻia ka Fraxiparin no ka hoʻokele intramuscular. No ka mea he hiki i ka thrombocytopenia (he heparin-indone thrombocytopenia) i ka wā e hoʻohana ai i nā heparins, pono ia e nānā i nā helu platelet i loko o ka papa o ka mālama ʻana me Fraxiparin. Ua hōʻike ʻia nā hihia o ka maʻi thrombocytopenia i kekahi manawa, e hiki ke pili me ka thrombosis arterial a venous paha, he mea nui e noʻonoʻo ai i nā hihia i hala iho nei: me ka thrombocytopenia, me ka hoʻohaʻahaʻa nui ʻana i ka helu platelet (ma o 30-50% i hoʻohālikelike ʻia me nā kumu maʻamau), me ka dinamika hewa mai ka thrombosis, kahi e mālama ai ka mea maʻi, me DIC. I kēia mau hihia, pono e hoʻokaʻa ʻia ka mālama ʻana me Fraxiparin. ʻO ka thrombocytopenia he immuno-allergic ma ke ʻano a kū pinepine ma waena o ka lā 5 a me 21 o ka lā o ka maʻi, akā e hiki ke hele ma mua inā he mea nā moʻolelo o ka thrombocytopenia heparin-induced.
I mua o ka trombocytopenia heparin-induced i ka anamnesis (e kūʻē ana i ke ʻano o ka hoʻohana ʻana o ka heparins i hoʻonaʻauao manula a i ʻole), hiki ke kuhikuhi ʻia ʻo Fraxiparin inā pono. Eia nō naʻe, i kēia kūlana, ʻike ʻia nā mākaʻi koʻikoʻi ma, ma ka liʻiliʻi, hōʻike ʻia nā helu platelet i kēlā me kēia lā. Inā hele mai ka thrombocytopenia, hiki ke hoʻokuʻu koke ʻia ka hoʻohana ʻana o Fraxiparin. Inā kū mai ka thrombocytopenia kū'ē i ka hope o nā heparins (ʻoi paha ka nui o ka moleloli haʻahaʻa), a laila pono ke noʻonoʻo pono i ka hana ʻana i nā anticoagulants o nā hui ʻē aʻe. Inā loaʻa ʻole nā ​​lāʻau ʻē aʻe, hiki i ka hoʻohana ke hoʻohana i kekahi mea heparin. I kēia hihia, pono ʻoe e nānā i kēlā me kēia lā ka nui o nā platelets i ke koko. Inā mālama ʻia nā hōʻailona o ka thrombocytopenia mua ma hope o ka hoʻōla ʻana o ka lāʻau, pono e hoʻokaʻawale ʻia ke ʻano ma ka hiki.
Pono e hoʻomanaʻo ʻia o ka mana o ka pākeke platelet i hoʻokumu ʻia i loko o nā hōʻike vitro i palena iki ʻia i ka hopena o ka maʻi heparin-induced thrombocytopenia. I nā poʻe maʻi maʻi, ma mua o ka hoʻomaka ʻana i ka maʻi me Fraxiparin, pono ia e loiloi i ka hana renal.Hiki i nā Heparins ke hōʻeha i ka hana huna ʻana o ka ald testosterone, hiki iā lākou ke alakaʻi i ka hyperkalemia, ʻoi aku hoʻi i nā mea maʻi me nā papa o ka paʻakai i ke koko a i ʻole nā ​​mea maʻi e pilikia ai ka hoʻomohala ʻana i ka hyperkalemia (me ka maʻi mellitus maʻi maʻamau, kūleʻa hiki ʻole ka hopena, ka metabolic acidosis a me ka hoʻohana pū ʻana i nā lāʻau lapaʻau e hiki ai ke hoʻonāuki i ka hyperkalemia i ka wā holomua). I ka nui o nā mea maʻi me ka piʻi nui o ka ulu ʻana i ka hyperkalemia, pono nā kia o ka potassium ma ke koko.
Hoʻopilikia ka hōʻeha o nā hematomas spinal / epidural i nā kānaka me nā catheters epidural i hoʻopili a i ʻole me ka hoʻohana pū ʻana me nā lāʻau ʻē aʻe e pili ana i ka hemostasis (NSAIDs, nā antiplatelet agents, nā anticoagulants). Hiki ke hoʻonui ʻia ka hopena me ka traumatic a i ʻole ka hōʻeha a me nā lāʻau spinal. ʻO ka nīnau pono o ka hoʻohana pū ʻana o ka blockade neuroaxial a me anticoagulants e hoʻoholo pono ʻia, ma hope o ka loiloi ʻana i ka pae e pili ana i ka hopena. I nā mea maʻi e loaʻa hou ana i nā anticoagulants, pono ka pono no ka spinal a i ʻole epidestia anesthesia. I ka poʻe maʻi e hoʻolālā ʻia ai nā hana koho e hoʻohana i ka anesthesia spinal a i ʻole epidural, pono ke koi ʻia no ka hoʻopuka ʻana o nā anticoagulants. Inā hāʻawi ʻia ka mea maʻi i kahi punanui lumbar a i ʻole a spinal a epidest anesthesia, pono kahi manawa kūpono e pono ai e mālama ʻia ma waena o ka lawelawe ʻana o Fraxiparin a me ka hoʻokele a wehe paha i ka spinal / epidural catheter a he lāʻauʻe. Pono e nānā pono ai i ka mea maʻi e hiki ai ke hoʻomaopopo i nā hōʻailona a me nā hōʻailona o nā maʻi neʻokeʻo. Inā ʻike ʻia nā kipi i ka kūlana neurological o ka mea maʻi, koi pono ke koi ʻia e pono ai ka lāʻau lapaʻau.
I loko o ka prophylaxis a i ʻole ka mālama ʻana i ka thromboembolism venous, a me ka ke pale ʻana i ka coagulation koko i loko o ka ʻōnaehana extracorporeal i ka wā o ka hemodialysis, mālama pū me ka ʻoihana Fraxiparin me nā lāʻau like ʻole e like me ka acetylsalicylic acid, nā salicylates ʻē aʻe, nā NSAID a me nā ʻāpana antiplatelet. e hoʻonui i ka nui o ke koko.
Pono e hoʻohana ʻia ka Fraxiparin me ka makaʻala i nā mea maʻi e loaʻa ana i nā anticoagulants waha, corticosteroids no ka hoʻohana pono i ka systemic, a me dextran. Ke koho ʻana i nā anticoagulants waha i nā maʻi e loaʻa Fraxiparin, pono e hoʻomau ʻia kona hoʻohana a hiki i ka hōʻailona manawa prothrombin paʻa i ka waiwai i makemake ʻia.

Kaihou o Fraxiparin Syringe Ampoule

Nā Hoʻomaka ka hōʻailona nui o kahi overdose ke koko, pono ia e nānā i ka nui o nā platelets a me nā mea ʻē aʻe o ke ʻōnaehana coagulation koko.
Lāʻau: ʻAʻole koi ke kaila liʻiliʻi me ka lāʻau lapaʻau kūikawā (ʻoi aku ka lawa o ka hōʻemi ʻana i ka nui o ka hōʻawa ʻana a i hoʻoluhi i ka hoʻokō ʻia). Ua hoʻohālikelike ka protamine sulfate ma ka hopena antiicoagulant o ka heparin, eia naʻe, i kekahi mau mea, hiki ke hoʻihoʻi hou i ka hana a anti-Xa. Pono ke hoʻohana ʻana o ka protamine sulfate i nā hihia koʻikoʻi wale nō. Pono e hoʻomanaʻo ʻia he 0.6 ml o ka protamine sulfate e hoʻohālikelike i ka 950 anti-Xa ME nadroparin. Hoʻomoe ʻia ka nui o ka protamine sulfate e nānā i ka manawa i hala ma hope o ka hoʻokele ʻana o ka heparin, me kahi hoʻohaʻahaʻa i ka hopena o ka antiidote.

Ke waiho nei ke kūlana Fraxiparin syringe ampoule

Pono e mālama i ka lāʻau ma waho o ka hiki ʻana o nā keiki, kahi mamao loa i nā mea hoʻomohala wela i kahi mahana ʻaʻole i oi aku ka 30 ° C, mai hoʻokaʻawale.

Fraxiparin Syringe Ampoule kahi koho maikaʻi. ʻO nā huahana a pau ma ka pūnaewele FARM-M pharmacy, komo pū me Fraxiparin syringe ampoule, hala i ka mana o nā huahana ma o kā mākou mea hoʻolako. Hiki iā ʻoe ke kūʻai i ka Fraxiparin syringe ampoule ma kā mākou pūnaewele ma ke kaomi ʻana i ka pona "Buy". E hauʻoli mākou e hāʻawi iā ʻoe ma Fraxiparin syringe ampoule i kekahi wahi i loko o ka wahi

ʻĀlelo aʻo

Pehea e hoʻokomo ai i ka lāʻau lapaʻau

Ma mua o ke kauka ʻana i kahi kauka i nā inikinui fraxiparin i loko o ka ʻōpū i ka wā hāpai, pono ʻo ia e kuhikuhi i ka mea maʻi i ka hoʻokaʻina koko e hoʻoholo ai i ka pauku aʻoaʻo coagulation. Hoʻolālā ʻia ka nui o ka lāʻau i ke kanaka pilikino wale nō ma hope o nā hoʻokolohua e hōʻike i ka pono no ka mālama ʻana. Hoʻopau ka lōʻihi a me ka pāpaʻi ma ke kaumaha o ke kino a me ka kiʻekiʻe o ka maʻi.

He mea nui loa ia e ʻike pehea e hoʻokomo ai i ka fraxiparin i ka wā hāpai. Hana ʻia ia no ka subcutaneous a me ka hoʻokō kūloko, loaʻa i ka palapala paʻa ma kahi syringe. Hāʻawi ʻia nā lua ʻelua: 0.3 ml a me 0.6 ml.

I ka wā hāpai, ʻoi aku ka maikaʻi o ke nānā ʻana i kahi wikiō e pehea e pololei ai ke kuhikuhi iā fraxiparin iā ia iho, akā e hoʻokō i kēia mea i nā loea. Pono e hoʻopili ʻia nā ʻōlelo pākahi i hoʻokahi lā. Akā ʻaʻoleʻike ka poʻe āpau i ka hele i ke haukapila i kēlā me kēia lā, no laila ke makemake nei kekahi mau mea maʻi e hana pilikino i kahi kaʻina ma ka home.

1. Pono pono e lawe i ka syringe no laila ke alakaʻi ʻia ʻana ua palaki a piʻi i luna, a laila nūlū maikaʻi i nā ea āpau.
2. E ana i nā manamana lima ʻelua mai kavel a i ʻole (ʻaʻohe koko koko).
3. Hoʻopili i ka ili me kahi hopena disinfectant.
4. Lawe i ka ʻili i nā ʻōlima kūpaʻa.
5. Hoʻokomo i ka manamana i ka ʻili i ke kihi o 90 degere.
6. E hoʻolōʻihi i ka lāʻau lapaʻau.
7. E ʻohi i ke kuʻi a kaomi ʻana i ka huluhulu huluhulu i ka pūnaewele injection.

Ma hope o ke kūpono, hiki i kahi ʻāpana liʻiliʻi. ʻAʻohe kumu kumu hoihoi, mahalo maoli kēia hanana. Inā ʻike ʻoe i ke ʻano o nā hopena o nā ʻaoʻao, pono e hoʻokaʻawale i ka mālama ʻana a nīnau aku i kahi loea. I ka wā hapai, ʻo ia ka mea e aʻo iā ʻoe ma ka kikoʻī e pili ana i ka nānā pono ʻana o ka fraxiparin.

ʻO ke kauka wale nō ke kākau

Nā huahana o kēia lāʻau

Aia kekahi mau kikowaena o ka fraxiparin kaulana. Akā i ka wā hāpai, pono ʻoe e kamaʻilio mau i ke kauka, ʻaʻole hoʻi i kuhikuhi iā lākou iho. Aia nā lāʻau lapaʻau i loko o kahi hui o ka laikini like me nā mea like a me nā māka o ka hana o ka hana:

• Zibor 2500 a i ʻole 3500 (ʻōkino subutan).
• Flagmin (intravenous a subutaneus injection),
• Piyavit (kapo),
• Clexane (ʻōkuhi subkutan)
• Heparin sodium (intravenous and subcutaneous administration),
• Heparin-Ferein (ka hoʻopuka intravenous a me ka subcutaneous),
• Heparin Sandoz (subcutaneous injection),
• Heparin (kūloko kūloko a me ka subcutaneous),
• Heparin (ʻōpala amphora),
• Hemapaxan (ʻōkuhi subuhi)
• ʻO Vesel Douay F (ka hopena no ka hoʻokō intravenous a me ka subcutaneous, capsules),
• 3 Antithromin 3 kanaka lyophilisate (infusion),
• Angioflux (intravenous a me intramuscular injection),
• Antioflux (nā kākō).

ʻOiai ke ʻano o nā hana like o ka fraxiparin, ka clexane, a heparin paha, pono wale ke kauka e hoʻoholo i ka mea maikaʻi loa no ke kaikamahine i ka wā hāpai. Hoʻoweliweli wale ka lāʻau lapaʻau pilikino me ka hiʻona o ka olakino a me ka hoʻomohala ʻana i ka hopena maikaʻiʻole.

Ua lawe ʻo ia i ka fraxiparin i ka wā mua o kona wā hāpai. He lāʻau lāʻau koʻikoʻi loa ia, akā ʻaʻohe mea e pono ai: i ka ʻeono wikiō e nui ana kahi ʻano koko nui e pono ai iaʻu e hele ai i kahi moe. Nui loa koʻu makaʻu, no ka mea, ʻo ke ʻano maʻi ʻoi ʻole e hakakā i loko o ka ʻōpū. Ua hōʻike i ka loiloi genetic kahi predisposition i ke koko, pono e hana ʻia. Hoʻokomo kahi mahina i hoʻokahi lā.

Lawe ʻoi i ka fraksiparin i ka wā e hāpai ai i ka hapai lua. Ma mua o kēlā mea, ʻelua mau kekelē, no laila hoʻomaka wau i ka hoʻoluhi ʻana i ka lāʻau ma hope koke o ka ʻāʻā ʻana. Kūkā ka nui o ke kahe, ʻaʻole hiki ke hoʻopaʻa ʻia, no laila ua nalowale ke keiki. Ua ʻōlelo ke kauka he mea hoʻopiʻi kēia lāʻau lapaʻau, no ka mea hiki ke hōʻake ʻia ma hope o 7 wiki.

Lawe wau i ka fraxiparin i ka wā i māhala ʻia ai i ka wā hāpai a loaʻa i kaʻu thrombophlebia hoʻoilina. ʻAʻole i ʻoluʻolu ke kumu, akā ma mua o ʻelua mau kolohe, a ua hōʻike ka D-dimer i kahi hopena maikaʻi ʻole i 8 mau pule. Pono wau e hoʻoiho i 0.3 i kēlā me kēia lā no ka piha o 9 mau mahina. Ua kāpae ke kauka i ka lā ma mua o ka hānau ʻana, i kona hele ʻana e hoʻopakele.ʻAʻole hala ke koko i ka wā hānau, ua hānau maikaʻi kaʻu keiki. Ma hope o kekahi mau 2 hou ua hoʻomau ʻo ia e hoʻomālamalama.

ʻAʻohe wā hāpai, ma ke ʻano he kānāwai, hoʻopau piha me ka hoʻohana ʻole ʻana i nā lāʻau. Puhi pinepine nā makuahine hūnā e pili ana i kēia, ʻoiai inā he koʻikoʻi ke kauka i nā lāʻau lapaʻau koʻikoʻi, nā ʻōlelo kikoʻī e wehewehe pololei ai: "ʻAʻole hiki iā ʻoe ke hoʻohana i ka wā hāpai." ʻO kekahi lāʻau lapaʻau ʻo Fraxiparin. I kēia manawa, ʻaʻole i ʻike nā ʻepekema i ka ʻike e pili ana i ka hopena o ka mea ikaika o kēia lāʻau lapaʻau ma ka ʻōpio, no laila ma mua o ke kuhikuhi ʻana iā Fraxiparin i ka makuahine e kali ana, pono no ke kauka ke loaʻa ka pōmaikaʻi o ia mea e ʻoi aku i ka pōʻino hiki i ke keiki.

ʻO Fraxiparin, he lāʻau haʻahaʻa haʻahaʻa heparin koʻikoʻi, he hopena kūpono i ka hemostasis o ke kino kanaka - hoʻohaʻahaʻa ia. ʻO Hemostasis ka waiwai o ka hoʻopaʻa koko. Ua hāʻawi ka ʻola kūlohelohe i nā poʻe me kēia polokalamu palekana e loaʻa iā lākou kahi manawa e ola ai i loko o nā kūlana weliweli loa a me ka hiki ʻole mai. No kahi wahine hāpai, nui nā mea hōʻike hemostasis: ʻo ka liʻiliʻi o ke kaulike ka hopena koʻikoʻi ma ke ola o ka wahine hāpai. ʻO ia ke kumu, kiaʻi pinepine nei i ka hakahaka o ka hemostasis i ke kino wahine, ke kuhikuhi iā Fraxiparin ma ka hiki koke ke hoʻihoʻi iā lākou i nā maʻamau.

ʻO kāu e ʻike pono ai e pili ana iā Fraxiparin

ʻO ka lāʻau lapaʻau i ke ʻano o kahi hopena no ka hoʻokō subutaneus i loaʻa i kahi syringe dispable. Eia kekahi ʻano o ka lāʻau lapaʻau, e like me nā papa, ʻaʻohe. Nui nā hewa nui o ka lāʻau lapaʻau: Fraxiparin 0.3 ml, 0.4 ml, 0.6 ml, 0.8 ml, 1 ml, a me Fraxiparin Forte.

ʻO ke ʻano ikaika o ka lāʻau nā kala calcium nadroparin. Hoʻopili koke kēia mea i nā protein i loko o ke koko koko, e pale i ka hōʻemi ʻana o nā kīnā koko. Eia kekahi, hoʻowalewale ʻo Fraxiparin i ke koko, ke kāohi i kona waiwai coagulation, ʻaʻole ia e ʻae i ka pehu ʻana o nā platelets i ka plasma koko.

Hoʻohana ʻia ka hoʻohana ʻana o Fraxiparin ma waena o nā makuahine e kali mai nei - i ka wā i lilo ai ke koʻikoʻi a hoʻoweliweli i ka wahine hāpai me ka hoʻopiʻi ʻole ʻana ma ke ʻano o ka hānau mua, kolohe a i ʻole ka male fetal. Aia i kēlā me nā hopena weliweli i hoʻonui ʻia ke koikoi i ke koko inā hiki ke hoʻoponopono ʻia kēia ʻano pathological i ka wā. Hāpai ʻia kekahi mau wahine hāpai e hana ʻia me Fraxiparin no nā mahina ʻeiwa e kali nei o ka pēpē. He mea koʻikoʻi kēia inā i hala i kēlā mau maʻi nā keiki ma muli o kahi maʻi coagulation pathological.

Hiki iā ʻoe ke kūʻai iā Fraxiparin i loko o kahi lāʻau lapaʻau ma o ka nānā ʻana. ʻO 3 mau makahiki kahi e noho ai ke ola o ka noho lāʻau. Pono e mālama i nā ʻili i kahi e hiki ʻole ai nā keiki ke hele, ma kahi wela ʻē aʻe o 30 0 C.

Pono ka Hemostasiologists aia i nā kūlana o ka makemake koʻikoʻi, hiki i ka hoʻohana lōʻihi ʻana i ka ʻōlelo Fraxiparin ʻaʻole i hoʻopilikia i ka wahine hāpai, ʻo ka hōʻole ʻana i ka lāʻau lapaʻau no ka liʻiliʻi hoʻokahi lā e hiki ke hopena i ka make fetal. No laila no ke aha i loko o nā kauoha no ka lāʻau lapaʻau e pale i nā wahine hāpai i ka hoʻohana ʻole ʻana? ʻO ka nīnau e pili ana i ka palekana o kēia lāʻau lapaʻau no ka makuahine e kali ana ua wehe ʻia i kēia lā.

Keʻike nei nā kauka i ke kākoʻo ʻana iā Fraxiparin, he kīnā ʻole ka lāʻau lapaʻau hou loa i ka māmā a me kāna pēpē. Ke kānalua nei kekahi ʻē aʻe, ʻoiai ua aʻo ʻia nā hopena e pili ana i nā hopena teratogenic o Fraxiparin ma kahi wahine hāpai. ʻO ia mau mea, akā, i ka hoʻomaka mua ʻana o ke kūlana "hoihoi", ʻaʻole i kuhikuhi ʻia kēia lāʻau lapaʻau. ʻO ka mālama ʻana a me ke kōkua ʻana me kāna kōkua ʻana e hoʻomaka ʻia mai ka hōʻea ʻana o ka lua a me ke kolu, ʻo ka loaʻa ʻole o ka makuahine i ka wā e hiki mai ana.

Inā familiarize ʻoe iā ʻoe iho me ke kikoʻī o ka hapai i ka kikoʻī, a laila nīnau i nā nīnau e pili ana i ka pili o Fraxiparin i kēia manawa kū ʻole.I loko o 9 mau mahina o ka hānau ʻana i kahi pēpē, hana ʻia ka plasenta a ulu mau, ka mea e pale ai iā ia. ʻIke nui ʻia kēlā me kēia lā i loko o kēia ua wai a me nā mea koko a me nā capillaries e hānai i ka wahine hāpai. Inā, no kekahi mau kumu, e hoʻonui nui ka hemostasis, hana ʻia nā māla koko ma ka pleka, no ia mea, e loaʻa ai ka pololi o ka pololi o ke keiki.

I ka wā hope o ka hapai ʻana, hina ka ʻōpū a ikaika loa i ka pelvis liʻiliʻi, ka ʻū ʻana i nā wahī i kēia wahi. A ʻo kahi kumu, ka puka nui o ke koko mai nā veins o nā lalo haʻahaʻa loa i ulu nui, he mea pono ia no ka hoʻokumu ʻana i nā kīnā koko. Hoʻopilikia kēia kūlana i ka wahine hāpai me ka hoʻopiʻi koʻikoʻi nui i kapa ʻia ʻo ka embolism pulmonary. Hiki ke hoʻonāukiuki i ka make o ka wahine a me kāna keiki.

Ke hōʻuluʻulu nei, ʻike mākou ʻo Fraxiparin, me kāna mau nuances āpau, i hōʻike ʻia e nā kuhikuhi no ka lāʻau lapaʻau, ke hoʻohana mau nei ia i ka wā hapai, akā naʻe, hiki ke nānā pono ʻia kona hoʻohana ʻana e ke kauka ma kēlā me kēia hihia.

A pono kahi wahine hāpai iā Fraxiparin

ʻO Fraxiparin i ka wā hāpai ʻia ua kuhikuhi ʻia i kekahi mau hihia:

• no ka pale ʻana i ka hoʻonui ʻia ʻana o ke koko, e hiki ai ke hana i ka hoʻokumu ʻana o nā mākaʻi koko,
• no ka pale ʻana i nā koko koko i ka wā o ka hoʻomaʻemaʻe,
• ma ke kaʻina hana o ka mālama ʻana i ka myocardial infarction a me ka angina unstable.
• i ka wā o ka mālamaʻana i ka thromboembolism,
• i mea e pale ai i ka hoʻomohala ʻana o nā pilikia o ka thromboembolism.

Fraxiparin i ka wā hāpai. Nā hiʻohiʻona a me nā hopena ʻaoʻao

Ke aʻo aku nei ʻo Fraxiparin i ka lāʻau lapaʻau he mau contraindications a me nā hopena ʻaoʻao. ʻAʻole kuhikuhi ʻia ka lāʻau lapaʻau no nā maʻi me nā ʻano e hiki mai ana:

• kiʻekiʻe loa ka ʻikeaʻana i ka mea ola o Fraxiparin,
• coagulopathy - maikaʻi coagulability koko ma ke alo o ke koko,
• nele i nā hopena lapaʻau maikaʻi me nā lāʻau antiaggregant: Aspirin Cardio, Cardiomagnyl, Aspecard,
• hopohopo e hoʻonāukiuki i ka ʻāpana valvular o ka naʻau (endocarditis),
• ka hiʻohiʻona o ka thrombocytopenia ma hope o ka hoʻohanaʻana i ka calcium nadroparin i ka wā i hala,
• maʻi maʻi cerebrovascular.

Ma waena o nā hopena hopena paha ma hope o ka hoʻohana ʻana iā Fraxiparin, ʻike mākou:

• lapau a me ka ʻeha ma ka wahi i ʻōlelo ʻia,
• urticaria
• ʻO ka makeʻe o Quincke,
• pīhoihoi anaphylactic - i nā ʻokoʻa kūʻokoʻa.

A eia kahi papa inoa o nā mea i mua o ka Fraxiparin i kuhikuhi ʻia i ka hapai me ka akahele nui:

• akeo a me nā uhao o ka hana,
• nā maʻi hūʻai ma nā maka makamae,
• koko koko kiʻekiʻe
• nā māka pinepine o ka ʻeha gastrointestinal ma mua o ka wā hapai.

ʻOi aku ka nui o ka lāʻau lapaʻau e hoʻonui nui i ka hopena o ke kahe koko.

ʻO ka hoʻohana ʻana o Fraxiparin i ka wā hāpai

Hoʻohana ʻia ka mālama ʻana i ka makuahine e hiki mai me kēia lāʻau lapaʻau ma hope wale nō o kona hoʻoilo ʻia ʻana no ke ʻano o ka hoʻohālikelike koko. Hoʻohana ʻē aʻe ka Fraxiparin ma lalo o ka mākaʻikaʻi ʻana o ke kauka i hele mai. ʻO ka maʻi nui a me ke kūpaʻa o ka mālama ʻana no kēlā me kēia maʻi hāpai i kēlā me kēia.

ʻO ka lāʻau lapaʻau i ke ʻano o kahi kūhao maikaʻi, kīwaha ʻole e uhi ʻia i loko o kahi syringe disile me kahi nū ʻōpala no ka ʻike sīkia ʻenehana. ʻŌlelo i nā ʻōlelo no ka hoʻohana ʻana iā Fraxiparin, ua hana ʻia nā injections o ka lāmela i loko o ka ʻōpū, i loko o ka wahi ma luna o ka navel. Hōʻike ka hana hōʻike i ka mālama ʻana i ka maʻi injinato ma nā hapa he nui e maʻalahi ʻia e nā wahine hāpai. ʻO nā wale wale nō ma muli o ka lilo ʻana o Fraxiparin e hoʻomohala ai ka nausea a me ka malaise laulā. Inā he lōʻihi lōʻihi ka mālama ʻana o ka mea maʻi, hiki iā ia ke hana i nā injections o ka lāʻau lapaʻau ponoʻī iho.

Pehea e hoʻopaʻa ai iā Fraxiparin ma loko o ka ʻōpū

ʻOiaʻiʻo, he mea paʻakikī loa ia no ka wahine hāpai e noʻonoʻo pehea e hoʻokō ai ʻo ia i ke kuleana a me nā mea, he aha ka mea e hūnā ai, kahi hana weliweli - he hōʻeuʻeu nā subcutaneous.Akā inā ʻaʻohe mea ʻē aʻe e hana i kēia, ʻaʻole hiki ke haʻalele ʻia ka mālama ʻana, ʻoiaʻiʻo hoʻi, hiki iā ʻoe ke hoʻomalu i kēia ʻano akamai, ʻoiai ka mea ʻole ka paʻakikī i nā inikini subcutaneous.

Ma kēia e hana mākou i kēlā me kēia e ka wehewehe e pehea e hoʻoili ai iā Fraxiparin:

1. Lawe i ka syringe a kau i luna (me ka ʻōlelo nike), a laila, hoʻomoʻi mālie a lūlū i ka piston, hoʻomoʻi i ka lewa mai ka syringe. ʻO kahi hōʻailona e kāpae ai, e hōʻike aku ai i ke kihi o ka pono o kahi puʻupuʻu liʻiliʻi.
2. E hoʻomoe me kou kua ma ke papa ʻāina. ʻO kāu wahi e "hana" ʻo ia ka wahi a puni ka pusaka ma kahi mamao o 1 - 2 cm. Disinfect the site of a injection future and a solution solution alkohol.
3. E kālaki i ka ʻili i nā manamana lima ʻelua o ka lima hoʻokahi, a hoʻokomo i ka pono ma laila ma kahi kihi ʻākau (pono ka lole pono ma kahi kūlana e pili ana i ka pā).
4. E kaomi iki i ka plunger a huki pono i ka lāʻau lapaʻau ma lalo o ka ʻili, a laila e hoʻoneʻe i ka pono a hoʻomaʻemaʻe ʻia i ka pūnaewele inikua.

Ma hope e hiki koke ai ke loli ʻana i ka lace i ka wahi ʻomaʻoma - he ʻano maʻamau kēia e hopohopo ʻole ai i ka mea i manaʻo ʻia.

Fraxiparin: analogues o ka lāʻau

Ke hāʻawi nei ka ʻoihana hoʻolaʻa kūloko a me nā ʻāina ʻē i ka nui o nā mea hoʻohui o Fraxiparin. Aia nā poʻe āpau i hoʻokahi ʻāpana hui, a he ʻano ʻano like like o ke kino. ʻO nā mea kaulana loa:

• Zibor 2500 a me Zibor 3500 (ʻōlelo i ka ʻona hoʻokolokolo kūkanʻo),
• Clexane (inikua no ka mālama ʻokoʻa subutaneus),
• Heparin a me ka heparin sodium (nā ʻōlelo inikua no ka ʻōpū subcutaneous a intravenous),
• Flagmin (nā ʻōlelo inikua no ka hoʻokele kūpaʻa a me ka ʻoihana intravenous).

ʻOiaʻiʻo, ʻo nā wahine i kahi hoʻoikaika e hiki i ka lalo o ke kumu kumu e nīnau i nā kauka i ka nui o nā nīnau. No ka ʻike, ʻo wai lā ka lāʻau e palekana aku ana a ʻoi aku ka maikaʻi - Fraxiparin a i ʻole Clexane? Manaʻo mākou iā ʻoe i kēlā mea pili i ke kuleana pili i ka hoʻoholo ʻana o kahi loea. ʻO ka ʻoiaʻiʻo ʻo Fraksiparin lāua ʻo Kleksan (e like me Zibor, Flagmin, etc.), he mau analogues, he mau hōʻailona like ʻole no ka hana a me ka hana ma ke kumu kūlike. A no ke ʻano ʻole o nā haʻawina i hana ʻia e hoʻoholo ai i nā pōmaikaʻi o kekahi lāʻau lapaʻau ma mua o kekahi, ʻo ka mea kūpono loa e hiki ai i kahi makuahine e hiki mai ana ke hilinaʻi nei i kāna kauka. Ka loea ʻo ka mea hoʻokūkū mākaukau, i ke nānā i ke kiʻi o ka lāʻau lapaʻau o ka maʻi a me ke ʻano maʻamau o ka wahine hāpai, e kuhikuhi i ka ʻano kūpono e pili ana i kona ʻike ponoʻī.

Ma nā hoʻolaha o kahi pūnaewele ʻoihana pūnaewele, hiki iā ʻoe ke ʻike i nā loiloi he nui e pili ana iā Fraxiparin. ʻO kaʻoiaʻiʻo, ʻoi aku kekahi o nā mea iʻoi aku ka maikaʻi ma mua o ka hōʻoluʻolu. He aha nā kumu o kēlā mau koho? E hopohopo kekahi mau wahine e pili ana i nā hematomas e kū mai nei i ka pūnaewele injection o ka lāʻau. Eia naʻe, he hopena o kēia hanana ke ʻano o ka loiloi hewa, ʻaʻole ia. I kēia hihia, pono ʻoe e noi i ke kauka e hoʻākāka hou aku a pehea e hoʻoponopono ai i ka lāʻau lapaʻau i loko o ka syringe. I ke aʻo ʻana i ka hāʻawi ʻana i ka ʻōlelo Fraxiparin i loko o ka ʻōpū o ka ʻōpū, ʻaʻole ʻoe e hālāwai me ka hopena maikaʻi ʻole ma ke ʻano o nā mea kīwaha a me nā mea lahilahi.

ʻOi aku ka hopohopo o nā makuahine ʻē aʻe e pili ana i nā pilikia kālā, no ka mea, ʻaʻole ʻolua kekahi ʻano. No laila, ʻo ka uku o Fraxiparin 0.3 mau pae mai 300 mau rubles. no 1 syringe a hiki i 2600 - 3000 rubles. no ka pauka 1 i loko o nā pūlapa he 10. Eia naʻe, ʻo nā wahine i loaʻa i ka hala mau ʻana o ka lawaiʻa a ʻike pono ʻia ka hauʻoli o ka makuahine he mea kīnā ʻole ʻia a mākaukau lākou e uku i kekahi kālā no ka manawa kūpono e hoʻomanawanui i ka pēpē ola. Eia nō naʻe, ma ka nui o nā hihia, ka mea i hoʻololi ʻia i ka inane 3-5 wale nō hiki ke hoʻopau ʻia me Fraxiparin. Eia kekahi, hiki iā ʻoe ke noi mau i kāu kauka e koho i kahi ʻano kūpono o kēia lāʻau lapaʻau.

ʻO ke koena o ka lāʻau lapaʻau, e like me nā wahine hāpai, ua hoʻomanawanui maikaʻi. Ma hope o ke kōkō, ua manaʻo nui nā makuahine hānai he ʻano liʻiliʻi a ʻeha paha. Eia naʻe, hiki ke maʻalahi ka hopena i nā hopena liʻiliʻi inā i nā manawa āpau āu e noʻonoʻo ai ke ola nei ke ola a me ke olakino o nā poli i ka lōʻihi lōʻihi.

Pehea e hana pololei ai i kahi inikua subcutaneous. Wikiō

ʻO ka pale ʻana i ka trombosis i ka wā o ka hōʻiliʻili o ke koko, ka hakakā ʻana o ke koko i ka ʻōnaehana hoʻōla o ka extracorporeal i ka wā o ka hemodialysis a i ʻole hemofiltration, hoʻopiʻi thromboembolic i nā maʻi me ka hopena o ka thrombosis (ma ka hanu kūlohelohe a / a i ʻole hōʻeha o ka naʻau ma ka hui mālama mālama kino).

Ka hoʻomaʻemaʻe ʻana i ka thromboembolism, kaomi mau kaika a me ka myocardial infarction me ka nalu Q.

E hoʻokuʻu i ke ʻano, ka hoʻonohonoho ʻana a me ka pōpoki

Nā mea hoʻihoʻi: ka hāleʻa kalima wai (hydroxide solution) a i ʻole hoʻoheʻe ʻana i ka wai wai hydrochloric (a hiki i ka pH 5.0-7.5), d / i ka wai (a hiki i ka 0.4 ml).

ʻO 0.4 ml - kahe mau ʻānahi hoʻokahi (2) - nā blisters (1) - nā kīʻaha o ke kāleka; 0.4 ml - hoʻokahi mau ʻāpana o nā syringes (2) - blisters (5) - nā pā o ka papahola.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

Nā mea hoihoi: ka hopena o ka calcium hydroxide a i hoʻoheheʻeʻana i ka wai wai hydrochloric (a hiki i ka pH 5.0-7.5), d / i ka wai (a hiki i ka 0.6 ml).

ʻO 0.6 ml - kahe mau ʻānahi hoʻokahi (2) - nā blisters (1) - nā pā o ka papalaka; 0.6 ml - nā wai kuʻuna hoʻokahi (2) - blisters (5) - nā pā kīpē o ka pepa.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

Nā mea hoihoi: ka hopena o ka calcium hydroxide a i hoʻoheheʻe ʻia i kahi wai wai hydrochloric (a hiki i ka pH 5.0-7.5), d / i ka wai (a hiki i ka 0.8 ml).

ʻO 0.8 ml - kahe mau ʻāpana kū hoʻokahi (2) - blisters (1) - nā pā o ke kāleka; 0.8 ml - hoʻokahi mau ʻāpana o nā syringes (2) - blisters (5) - nā pā kīpē o ka pepa.

ʻO ke kūleʻa no ka hoʻokele sc me ke aniani, he opalescent, ʻokoʻa ʻole a ʻulaʻula paha i ka kala.

Nā mea hoihoi: ka hāleʻa kalepa ʻeleʻele ai a i ʻole hoʻoheʻe ʻana i ka wai wai hydrochloric (a hiki i ka pH 5.0-7.5), ka wai / i ka wai (a hiki i ka 1 ml).

1 ml - mau pūlani kū hoʻokahi (2) - blisters (1) - nā kīpē o ke kāleka. 1 ml - ʻonaneka a me nā ʻōwili (2) - blisters (5) - pākeke o ke kāleka.

FRAXIPARINE: ʻOSʻANA

Kahi / i ka hoʻolilo ʻana i ka lāʻau lapaʻau e mālama maikaʻi ʻia i ke kūlana kiʻekiʻe o ka mea maʻi, i ka s / c kiko o ka anterolateral a i ʻole posterolateral luna o ka ʻōpū, i ʻole ka laulima ma ka ʻaoʻao hema a hema. Hāʻawi ʻia e komo i ka ʻōpū.

I mea e pale ai i ka nalowale ʻana o ka lāʻau ke hoʻohana ʻana i nā syringes, ʻaʻole pono e haʻalele i nā leʻe o ka lewa ma mua o ka huakaʻi.

E hoʻokomo pono ʻia ka pono me ka wili ʻana, a ʻaʻole ma ke kihi, i loko o ka paila i hoʻopili ʻia ma waena o ka manamana lima a me ka mua. Pono ka mālama i ka wā o ka mālama o ka lāʻau. Mai ʻūleʻa i ka pūnaewele inake ma hope o ke ahulau.

No ka pale ʻana i ka thromboembolism ma ka hana hoʻomaʻamaʻa maʻamau, ʻo ke ʻano o Fraxiparin i ʻōlelo ʻia ʻia ʻo 0.3 ml (2850 anti-Xa ME) s / c. Hoʻohana ʻia ka lāʻau lapaʻau i nā hola 2-4 ma mua o ka hoʻomaʻamaʻa ʻana, a laila - 1 manawa / lā. Hoʻomau ʻia ka mālama ʻana no ka liʻiliʻi o 7 mau lā a i loko o ka manawa holoʻokoʻa o ka mahuahua o ka thrombosis, a hiki i ka mea maʻi ke neʻe aku i kahi pae maʻi maʻi.

No ka pale ʻana i ka thromboembolism i ka wā o nā hana orthopedic, ʻo Fraxiparin e mālama ʻia i ka subcutaneously ma kahi paona i kau ʻia ma ke ʻano o ke kino o ka mea maʻi ma ka pae o 38 anti-XA IU / kg, hiki ke hoʻonui ʻia i 50% ma ka lā postoperativeʻo 4. Ua kuhikuhi ʻia ka paʻu ma mua he 12 mau hola ma mua o ka hoʻomaʻamaʻa ʻana, ka lua o ka wai - 12 mau hola ma hope o ka pau o ka hana. Eia kekahi, hoʻomau ka hoʻohana ʻana iā Fraxiparin i ka manawa 1 i ka lā no ka manawa holoʻokoʻa o ka nui o ka nui o ka hiki ʻana i ka thrombosis a hiki i ka mea maʻi ke neʻe aku i kahi pae maʻi outpatient. ʻO ka palena iki o ka mālamaʻana he 10 mau lā.

ʻO ka poʻe maʻi me ka pilikia nui o ka thrombosis (maʻamau i loko o ka ʻina mālama mālama / ʻina mālama mālama / loina i ka hanu ʻana ʻole / a i ʻole a i ʻole a me ka maʻi ʻana o ka ʻeha a me / a i ʻole hōʻeha o ka naʻau /) Ua kau ʻia ʻo Fraxiparin s / c 1 manawa / lā ma kahi laina i kau ʻia ma luna o ke kaumaha o ke kino. ka mea maʻi. Hoʻohana ka Fraxiparin i ka manawa holoʻokoʻa o ka hopena o ka thrombosis.

I ka mālamaʻana i ka pectoris angina pectoris a me myocardial infarction me ka niho Q, ʻō ʻia ʻo Fraxiparin sc 2 mau manawa / lā (i kēlā me kēia mau hola 12). ʻO ka lōʻihi ka mea mālama i ka 6 mau lā.Ma nā noiʻi haukapila, nā mea maʻi me ka angina pectoris / myocardial infarction ʻole me Q wave Fraxiparin i kuhikuhi pū ʻia me ka acetylsalicylic acid ma kahi o 325 mg / lā.

E mālama ʻia ka ʻōlelo mua ma ke ʻano he hoʻokahi intravenous bolus injection, ua mālama ʻia nā pona ma hope o sc. Kau ka paena ma muli o ke kaupaona ʻana o ke kino ma ka wikiwiki o 86 anti-XA IU / kg.

I ka loaʻa ʻana o ka thromboembolism, wahaʻalani anticoagulants (i ka ʻole o nā contraindications) e kuhikuhi koke i ka manawa. ʻAʻole paʻa ka Therapy me Fraxiparin a hiki i ka loaʻa ʻana o nā waiwai kumu o ka hōʻailona manawa prothrombin. Noi ʻia ka lāʻau lapaʻau s / c 2 mau manawa / lā (i kēlā me kēia mau hola 12), ʻo ka manawa maʻamau o ka papa he 10 lā. Hoʻokomo ka dosis i ka paona kino o ka mea maʻi i ka helu o 86 anti-XA ME / kg koʻikoʻi kino.

ʻO ka paleʻana i ka hoʻomohala koko ma ka hoʻihoʻi extracorporeal i ka wā o hemodialysis

Pono ka ʻōnaehana o Fraxiparin e hoʻokaʻawale i kēlā me kēia maʻi, e noʻonoʻo ana i nā kūlana ʻenehana o ka dialysis.

Hoʻomaka ka Fraxiparin i hoʻokahi manawa i ka laina o ka pehu dialysis ma ka hoʻomaka ʻana o kēlā me kēia. No nā mea maʻi me ka piʻi ʻole o ka kahe, ke hoʻonohonoho ʻia nā neʻe mua i kau ʻia ma luna o ke kaumaha o ke kino, akā lawa nō kahi hālāwai dialysis 4-hola.

I nā maʻi me ka piʻi nui o ka huhū, hiki iā ʻoe ke hoʻohana i ka hapalua o ke ʻano o ka lāʻau i manaʻo ʻia.

Inā he lōʻihi ka lōʻihi o ka dialysis ma mua o 4 mau hola, e mālama ʻia nā pupu liʻiliʻi no Fraxiparin.

I ka wā o nā manawa dialysis ma hope, e pono ke koho o ka pauka ma muli o nā hopena i nānā ʻia.

Pono ka nānā ʻana o ka mea maʻi i ka wā o ka hana dialysis ma muli o hiki i ke kahe koko a i ʻole nā ​​hōʻailona o ka thrombosis i loko o ka papa dialysis.

I nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika (me ka ʻokoʻa o nā mea maʻi me ka hana pūpū o ka maʻi). Ma mua o ka hoʻomaka ʻana i ka mālama ʻana me Fraxiparin, ʻoi ʻia ia e nānā i nā māka hana hana lela.

I nā maʻi me ka hōʻemi a i ʻole kaulike ʻole renal (CC ≥ 30 ml / min a

Kauka kino (kg)
Hoʻomoe ka hopena o Fraxiparin he 12 mau hola ma mua o 12 mau hola ma hope o ka hana ʻana, a laila 1 manawa / lā a hiki i ka lā 3 ma hope o ka hōʻeha.
E hoʻolōʻihi ʻia ka hopena o Fraxiparin 1 mau manawa / lā, e hoʻomaka ana mai ka lā 4 aʻe ma hope o ka hoʻomaʻamaʻa ʻana
Kālā (ml)
Anti-Ha (ME)
Kālā (ml)
Anti-Ha (ME)
0.2
1900
0.3
2850
50-69
0.3
2850
0.4
3800
>70
0.4
3800
0.6
5700
Kauka kino (kg)
ʻO ka maʻa o Fraxiparin me ka hoʻomakaʻana o ka manawa 1 / lā
Ka nui o Fraxiparin (ml)
Anti-Ha (ME)
≤ 70
0.4
3800
> 70
0.6
5700
Kauka kino (kg)
Initial dosis no iv ka hoʻokō ʻana
Nā hala no ka maʻi (sc 12) i kēlā me kēia manawa.
Anti-Ha (ME)
0.4 ml
0.4 ml
3800
50-59
0,5 ml
0,5 ml
4750
60-69
0.6 ml
0.6 ml
5700
70-79
0.7 ml
0.7 ml
6650
80-89
0.8 ml
0.8 ml
7600
90-99
0.9 ml
0.9 ml
8550
≥ 100
1.0 ml
1.0 ml
9500
Kauka kino (kg)
Ka hana i ka wā e lawelawe ʻia 2 manawa / lā, lōʻihi 10 mau lā
Kālā (ml)
Anti-Ha (ME)
0.4
3800
50-59
0.5
4750
60-69
0.6
5700
70-79
0.7
6650
80-89
0.8
7600
≥ 90
0.9
8550
Kauka kino (kg)
Arterial line injection o ka peke dialysis ma ka hoʻomaka ʻana o ka hālāwai dialysis
Kālā (ml)
Anti-Ha (ME)
0.3
2850
50-69
0.4
3800
≥ 70
0.6
5700

ʻŌpū a me ka lactation

I kēia manawa, aia wale nō ka 'ikepili e pili ana i ke komo ʻana o ka nadroparin ma o ka mea paʻa placental i loko o nā kānaka. No laila, ʻaʻole i kuhikuhi ʻia ka hoʻohana ʻana o Fraxiparin i ka wā hapai, inā ʻaʻole pono ka pōmaikaʻi hiki i ka makuahine ke ʻoi aku i ka hopena o ka wahine maʻi.

I kēia manawa, palena wale nō nā ʻikepili ma ka alakiʻi ʻana o ka nadroparin me ka waiū umauma. Ma kēia e nānā ʻia ai, ʻaʻole hoʻohana ʻia ka hoʻohana ʻana o ka nadroparin i ka wā lactation (breastfeeding).

I nā hoʻokolohua holoholona hoʻomaʻamaʻa, ʻaʻohe i ka hopena teratogenic o ka calcium nadroparin i loaʻa.

FRAXIPARINE: KOMO MEAʻO KĀNOLELO

Hōʻike ʻia nā hopena kūpono ʻole e pili ana i ka ʻike pinepine ʻana:> pinepine pinepine (> 1/10), pinepine (> 1/100, 1/1000, 1/10 000,

Mai ke ʻano piʻipiʻi koko: pinepine - nā kahe o nā ʻano kaiāulu ʻana, ʻoi aku ka nui o nā mea maʻi me nā pilikia ʻē aʻe.

Mai ka ʻōnaehana hemopoietic: līpeke - thrombocytopenia, ʻehā loa - eosinophilia, hoʻihoʻi ma hope o ka hoʻokuʻu ʻana o ka lāʻau.

Mai ka papa hana o ka hanu: pinepine - hoʻonui i ka hana o ka transaminases hepatic (maʻa mau nā mea maʻamau i loko o ke ʻano).

Nā ʻano maʻi alekohi: ʻaʻohe liʻiliʻi - ka edema o Quincke, ʻano pili kino.

Nā kūmole kūloko: pinepine pinepine - ka hoʻokumu ʻana o kahi hematoma subcutaneous liʻiliʻi ma ka wahi i ʻōlelo ʻia, ma kekahi mau manawa aia ke ʻano o nā nodules kikowaena (ʻaʻole ʻia ke ʻano heparin) e nalowale ma hope o kekahi mau lā, ākea loa - ili ʻili o ka ili, ka mea maʻamau ma ka wahi i ʻōlelo ʻia. ʻO ka hana ʻana o ka necrosis e hana mua ʻia e purpura a i ʻole kahi erythematous kahi infiltrated a hōʻeha paha, i ʻole a i ʻole pū ʻia e nā hōʻailona maʻamau (i kēlā mau hanana, mālama ʻia me ka Fraxiparin pono e hoʻokaʻawale koke).

ʻO kekahi: ʻehā loa - priapism, hiki i ka hyperkalemia hoihoi (pili i ka hiki o nā heparins e hoʻomau i ka huna o ka ald testosterone, a ma ka mea maʻi ma ka hopena).

Nā kuleana a me nā kūlana e waiho ai

Papa inoa B. Pono e mālama i ka lāʻau ma waho o ka hiki ʻana o nā keiki, kahi mamao loa i nā mea hoʻomohala wela i kahi mahana ʻaʻole iʻoi aku ka 30 ° C, mai hoʻokaʻawale. ʻO 3 mau makahiki kahi ola.

• ka pale ʻana o nā hoʻopiʻi thromboembolic (i ka wā o ka hōʻemi a me ka hoʻoliʻiliʻi orthopedic, i loko o nā mea maʻi me ka hopena nui o ka thrombosis i loko o ka hanu a me / a me ka hāʻule ʻole o ka naʻau ma lalo o nā kūlana o ka ICU).
• hana lapaʻau thromboembolism,
• ka pale ʻana o ka ʻaila koko i ka wā o hemodialysis,
• ka mālama ʻana i ka angina paʻa ʻole a me ka myocardial infarction me ka make ʻole Q.

Ke noi no ka hana renal impaired

I nā maʻi me ka hōʻemi a i ʻole kaulike ʻole renal (CC ≥ 30 ml / min a

I ka poʻe maʻi me ka pēpē i ke kaulike a ka hopena o ka renal, no ka mālama ʻana i ka thromboembolism a i ʻole no ka pale ʻana i ka thromboembolism i nā poʻe maʻi me ka ʻeha o ka thrombosis (me nā kuʻuna paʻa ʻole a me ka myocardial infarction me ka pā o Q).

Pharmacokinetics i nā maʻi lapaʻau kūikawā kūikawā ʻo Fraxiparin syringe ampoule

I ka poʻe maʻi nā maʻi, ma muli o ka hōʻemi kino o ka hana o ka renal function, kahi i hoʻopau ʻia ai ka nadroparin i iho i lalo. Ke hoʻohana nei i ka lāʻau lapaʻau no ka prophylaxis i kēia māhele o nā mea maʻi, ʻaʻohe mea pono e hoʻololi i ka regimen dosing i ke hihia o ka hōʻemi kino o ka maʻi.

Ma nā haʻawina loiloi ma ka pharmacokinetics o nadroparin me ka hoʻomalu iv iv i nā mea maʻi me ka hiki ʻole o nā hana like ʻole o ka ʻano paʻakikī, ua hoʻokū ʻia kahi pilina ma waena o ka puka ʻana o ka nadroparin a me ka wehe ʻana o ka creatinine. Ke hoʻohālikelike nei i nā waiwai i loaʻa me ia o nā mea hana olakino olakino, ua ʻike ʻia he nui ka AUC a me ka T1 / 2 i ka 52-87%, a i ka cleinine clearance i ka 47-64% o nā waiwai maʻamau. Ua nānā pū ʻia ka noiʻi ʻana i nā ʻokoʻa ʻē aʻe.

I nā mea maʻi me ka maʻi renal koʻikoʻi, koʻikoʻi ʻo T1 / 2, ua hoʻonui nui ʻia ka nadroparin a hiki i ka 6 mau hola ma luna o ka hoʻokele SC. Ua hōʻike ʻia nā hopena o ka hōʻike ʻana i ka hōʻemi ʻana o ka nadroparin i ʻike ʻia i nā mea maʻi me ka hōʻemi aʻa ʻole ʻole (hōʻemi i ka hana ma hope o 30 ml / min a i ʻole ka liʻiliʻi. 60 ml / min). ʻO ka hopena, pono e hoʻemi ʻia ka nui o ka Fraxiparin e 25% i nā mea maʻi e loaʻa iā Fraxiparin no ka mālama ʻana i ka thromboembolism, ka hoʻomau ʻole i ka angina pectoris / myocardial infarction me ka pā o Q. ʻO nā mea maʻi me ka piha o ka renal nui loa no ka mālama ʻana i kēia mau kūlana, ua hoʻohālikelike ʻia ʻo Fraxiparin.

I nā mea maʻi me ka hina ʻole a me ke kaulike ʻole, i ka wā e hoʻohana ai iā Fraxiparin i mea e pale ai i ka thromboembolism, ʻaʻole i ʻoi aku ka hōʻuluʻulu ʻana o ka nadroparin i kēlā me nā mea maʻi me ka hana maʻamau maʻamau, e lawe ai i ka Fraxiparin ma nā dosis therapeutic. Ke hoʻohana ʻana iā Fraxiparin i mea e pale ai i ka hoʻemi ʻana i kēia mahele o nā mea maʻi ʻaʻole pono. I nā mea maʻi me ka maikaʻi o ka renal ka loaʻa ʻana o ka prophylactic fraxiparin, pono ke hōʻemi ʻia ʻana o 25%.

Hoʻololi ʻia ka haʻahaʻa kaumaha heparin i loko o ka laina o ka laina o ka dialysis loop i nā nui kiʻekiʻe e pale ai i ke koko i loko o ke kīʻaha dialysis.ʻAʻole loli iki nā ʻōkole pharmacokinetic, me ka ʻole o ka overdose, i ka wā i hiki ai ke kaʻi o ka lāʻau i loko o ka ʻōnaehana kūlana i hiki ke hoʻonui i ka hana kumu anti-Xa, ma muli o ke kaʻina hope o ka maikaʻi ʻole o ka renal.

Lapaʻau Kauka

ʻO ka calciumium nadroparin he haʻahaʻa haʻahaʻa haʻahaʻa heparin (NMH) i loaʻa e ka depolymerization mai ka heparin maʻamau, he glycosaminoglycan me ke kau palena molelole 4300 daltons.

Hōʻike i kahi hiki nui ke hiki i ka protein plasma me ka antithrombin III (AT III). Hoʻopuka kēia hāmeʻa i ka wikiwiki o ka hoʻololi ʻana o ke kumu Xa, aia ma muli o ke kūlana kiʻekiʻe antithrombotic kiʻekiʻe o ka nadroparin.

ʻO nā hana ʻē aʻe e hāʻawi ana i ka hopena antithrombotic o ka nadroparin me ka hoʻihoʻi ʻana i ka hoʻoweliweli ʻōiwi kiko (TFPI), hoʻōla o ka fibrinolysis ma ka hoʻokuʻu ʻana i kahi kiko o ka plasminogen aine mai nā cell endothelial, a me ka hoʻololi ʻia o ka waiwai rheological o ke koko (hoʻohaʻahaʻa i ka hoʻokahe ʻia o ke koko a me ka hoʻonui ʻana i ka permeability o platelet a me nā granulocyte membranes).

Hōʻike ʻia ka calciumium nadroparin e ka mea koʻikoʻi anti-Xa kumumanao kahi hoʻohālikelike ʻia i ka hanana anti-IIa a i ʻole ka hana antithrombotic a ua loaʻa koke ka hana antithrombotic hana.

Hoʻohālikelike me ka heparin unfractionated, ua loaʻa ka nadroparin i ka hopena pākahi ma ka platelet function a me ka hōʻuluʻulu ʻana, a me kahi hopena i emi ʻole i ka hemostasis mua.

Ma nā hopena prophylactic, ʻaʻole i hoʻonele ka nadroparin i kahi hōʻemi i ʻōlelo ʻia i loko o APTT.

Me ka papa o ka mālama ʻia i ka wā o ka hana nui, hiki i ke hoʻonuiʻana i ka APTT i kahi kumukūʻai 1.4 mau manawa ma mua o ka maʻamau. Hōʻike kēia mau lōʻihi i ka hopena antithrombotic residual o ka calcium nadroparin.

Loaʻa ka hopena

• Hōʻike ʻia nā hopena kūpono ʻole e pili ana i ka maʻamau o ka hiki ʻana mai

Kekahi pinepine (ʻoi aku ma mua o 1/10), pinepine (ʻoi aku ma mua o 1/100, emi ʻole i ka 1/10), i kekahi manawa (ʻoi aku ʻoi aku i ka 1/1000, emi ʻole ma lalo o 1/100), ʻokoʻa (ʻoi aku ma mua o 1/10 000, emi iho me ka 1/1000) ʻokoʻa (ma lalo o 1/10 000).

• Mai ka pūnaehana hoʻoiho koko
  • Kekahi pinepine - koko o nā localizations like, pinepine i nā mea maʻi me nā pilikia ʻē aʻe.

• Mai ka ʻōnaehana hematopoietic
  • Kekaha, thrombocytopenia.
  • Kēia loa - eosinophilia, hoʻihoʻi ma hope o ka hoʻokuʻu ʻana o ka lāʻau.

• Mai ka pūnaehana hana ʻana
  • Hōʻike pinepine - hoʻonui i ka hana o ka transaminases hepatic (maʻa mau nā loli maʻamau).

• Allergic hopena pili
  • Kuhi loa ʻole - ka pālahalaha o Quincke, ʻano ʻili o ka ʻili.

• Nā kūloko kūloko
  • ʻO ka pinepine - ka hoʻokumu ʻana o ka hematoma subcutaneous liʻiliʻi ma ka wahi i ʻōlelo ʻia ai, i kekahi mau manawa aia ke ʻano o nā nodules kikino (ʻaʻole ia e pili ana i ka heparin encapsulation), kahi e nalowale nei ma hope o kekahi mau lā.
  • Kēia loa, paʻakikī ka mikrosis, ka mea maʻamau ma ka wahi o ka injection. ʻO ka Necrosis ke alakaʻi mua ʻia e ka purpura a i ʻole kahi erythematous infiltrated a hōʻeha paha, a i ʻole a hele pū ʻole ʻia e nā maʻi maʻamau (i kēlā mau hanana, pono e hoʻōla me ka maʻi ʻo Fraxiparin).

ʻO Fraxiparin Syringe Ampoule kekahi

Kuhi loaʻole - priapism, hoʻihoʻi ʻia ka hyperkalemia (pili i ka hiki o nā heparins e hoʻomau i ka hilo ʻana o aldosterone, ʻoi aku hoʻi i nā mea maʻi ma ka hopena).

Fraxiparin Syringe Ampoule kahi koho maikaʻi. ʻO nā huahana a pau ma ka pūnaewele FARM-M pharmacy, komo pū me Fraxiparin syringe ampoule, hala i ka mana o nā huahana ma o kā mākou mea hoʻolako. Hiki iā ʻoe ke kūʻai i ka Fraxiparin syringe ampoule ma kā mākou pūnaewele ma ke kaomi ʻana i ka pona "Buy". E hauʻoli mākou e hāʻawi iā ʻoe ma Fraxiparin syringe ampoule i kekahi wahi i loko o ka wahi

Nā helu helu inoa

kūleʻa no ka hoʻokō ʻana o 9500 IU anti-Xa / 1 ml: syringes 1 ml 2 a i ʻole 10 pcs. Hoʻopuka P N015872 / 01 (2018-06-09 - 0000-00-00) no ka hoʻokō ʻana i ka 9500 IU anti-Xa / 1 ml: syringes 0.6 ml 2 a i ʻole 10 mau pā. Hoʻopuka P N015872 / 01 (2018-06-09 - 0000-00-00) no ka hoʻokō ʻana i ka 9500 IU anti-Xa / 1 ml: syringes 0.8 ml 2 a i ʻole 10 mau pā. ʻO ka waihona ʻo P N015872 / 01 (2018-06-09 - 0000-00-00) no ka hoʻokō ʻana i ka 9500 IU anti-Xa / 1 ml: syringes 0.3 ml 2 a i ʻole 10 mau pā. Hoʻopuka P N015872 / 01 (2018-06-09 - 0000-00-00) no ka hoʻokō ʻana i ka 9500 IU anti-Xa / 1 ml: syringes 0.4 ml 2 a i ʻole 10 mau pā.P N015872 / 01 (2018-06-09 - 0000-00-00)

ʻO nā pilikia me ka hoʻopukapuka koko, nā maʻi hoʻopiʻi thromboembolic he maʻi koʻikoʻi nā maʻi nui e pono ai ka mālama koke.

I ka manawa pinepine o nā hihia, kuhikuhi nā kauka i ka lāʻau Fraxiparin. Loaʻa nā hopena ʻaoʻao a me nā contraindications no kāna hoʻohana, a he mea nui e ʻike e pili ana iā lākou.

ʻO kēia mau pilikia, aʻo ka ʻike e pili ana i ka hoʻohana ʻana i ka lāʻau, kona hopena a me nā loiloi e kūkākūkā ma hope aʻe.

ʻO Fraxiparin ka haʻahaʻa heparin haʻalulu haʻahaʻa, ʻo ka hana i lawe ʻia i loko o ke kaʻina o ka depolymerization. ʻO kahi hiʻohiʻona hiʻohiʻona o ka lāʻau lapaʻau e haʻi i ka hana me ka mahalo i ko coagulation factor Xa, me ka hana haʻahaʻa o nā kumu Pa.

ʻOi aku ka maikaʻi o ka hana anti-Xa ma mua o ka hopena o ka aihue ma ka manawa partial thrombotic plate time. Hōʻike kēia i ka hana antithrombotic.

ʻO kēia lāʻau lapaʻa he hopena anti-inflammatory a me ka immunosuppressive hopena. Eia kekahi, hiki ke ʻike wikiwiki ʻia ka hana a ka luna mea, a hiki lōʻihi loa ia. I loko o nā hola 3-4, e hoʻopili maikaʻi ʻia ka lāʻau lapaʻau. Hoʻopili ʻia ia me ka urine ma o nā keiki.

Ma mua o ka hoʻohana mua ʻana, pono e nānā i ka hana o nā aʻi a me nā pōpoki, ka pae o ka coagulation koko, me ka ʻike kolamu.

FRAXIPARINE - hoʻokuʻu i ke ʻano, ka hoʻopili a me ka hoʻopili

Nā hopena no ka hoʻokele sc

Hoʻolaha ka paila hydroxide hoʻoheheʻe a hoʻohemo ʻana i ka wai wai hydrochloric (a hiki i ka pH 5.0-7.5), wai wai / i (a hiki i ka 0.3 ml).

ʻO 0.3 ml - kahe mau puʻuwai kū hoʻokahi (2) - blisters (1) - nā kīʻaha o ke kāleka.
ʻO 0.3 ml - ka waiū hoʻokahi-mau kekona (2) - blisters (5) - nā pā o ka pahu paʻi.

Nā hopena no ka hoʻokele sc ʻala, hāpili, ʻokoʻa a ʻulaʻula ʻole.

ʻO ka hoʻonāʻana o ka hydrium hydroxide a hoʻoheheʻe ʻia i ka wai wai hydrochloric (a hiki i ka pH 5.0-7.5), wai / ka wai (a hiki i ka 0.4 ml).

0.4 ml - ʻonanahi mau kūmole kū hoʻokahi (2) - blisters (1) - nā kīʻaha o ke kāleka.
0.4 ml - ʻonanahi mau kūmole kū hoʻokahi (2) - blisters (5) - nā pā o ka papalepa.

Nā hopena no ka hoʻokele sc ʻala, hāpili, ʻokoʻa a ʻulaʻula ʻole.

Hoʻolaha ka paila hydroxide hoʻoheheʻe a hoʻohemo ʻana i ka wai wai hydrochloric (a hiki i ka pH 5.0-7.5), ka wai / me ka wai (a hiki i ka 0.6 ml).

ʻO 0.6 ml - kaheʻe hoʻokahi-dosis (2) - blisters (1) - nā pā o ka papalepa.
ʻO 0.6 ml - kaheʻe hoʻokahi-dosis (2) - blisters (5) - nā pā kīkaha o ke kāleka.

Nā hopena no ka hoʻokele sc ʻala, hāpili, ʻokoʻa a ʻulaʻula ʻole.

Hoʻolaha ka paila hydroxide hoʻoheheʻe a hoʻohemo ʻana i ka wai hamo (a hiki i ka pH 5.0-7.5), wai d / u (a hiki i ka 0.8 ml).

0.8 ml - kani-kūwaho kūwaho (2) - blisters (1) - nā pā o ka pahu.
ʻO 0.8 ml - kahe mau ʻāpana o ke kū hoʻokahi (2) - blisters (5) - nā pahu kīpē.

Nā hopena no ka hoʻokele sc ʻala, hāpelika, ʻiliʻili a ʻulaʻula paha.

Hoʻolaha ka paila hydroxide hoʻoheheʻe a hoʻohemo ʻana i ka wai hamo (a hiki i ka pH 5.0-7.5), wai ka wai / i (a i ka 1 ml).

1 ml - kani kūwaho kū hoʻokahi (2) - blisters (1) - nā kīpē o ka palaka.
1 ml - kani kūwaho kū hoʻokahi (2) - nā wili (5) - nā pālaha o ke kāleka.