ʻO ka lāʻau Fraxiparin: hoʻokuʻu i nā pepa a me ke kumukūʻai

ʻO ka wehewehe e pili ana i 29.12.2014

Palapala Latin: Hoʻoikaika
ʻĀkau ATX: B01AB06
Mea waiwai: Kalumate Nadroparin (Kaleponi Nadroparin)
Mea Hana: KAHOA MAKAUKA GLAXO (Farani)

1 syringe o ka lāʻau Fraxiparin he 9500, 7600, 5700, 3800 a i ʻole 2850 IU anti-Xa kalsieka nadroparin.

Nā kumuhana hou: hoʻohuihui hanehana a i ʻole ka hopenakalomo ka ʻauhau hauwai.

Pharmacodynamics a me ka pharmacokinetics

Lapaʻau lāʻau

ʻO ka kaupaona haʻahaʻaheparinhoʻohālikelike ʻia e ka poʻe depolymerization mai ka heparin maʻamau glycosaminoglycan me ka paona molekole kiʻekiʻe o 4300 daltons.

Loaʻa iā ia nā tropism kiʻekiʻe no ka protein koko antithrombin 3, kahi e alakaʻi ai i ka kaohi ʻana o ke kumu Xa - ʻo ia ka mea nui ma muli o ka haʻi antithrombotic hopena nadroparin.

Hoʻoulu: nā hāmeʻa hoʻololi hoʻololi blocker, fibrinolysis ma ka hoʻokuʻu ʻana i ka kiko stimulant plasminogenmai nā kiko endothelial, kahi hoʻololi i nā ʻāpana o ka rheological o ke koko (ka hoʻohaʻahaʻa i ka nui o ke koko a me ka hoʻonui ʻana i ka hāhā o nā membranes o nā cellelet cell me nā cellulocyte cells).

Kūlike ʻia i heparin unpractionated he nawaliwali loa i ka hana o ke platelet, ma ka hoʻohui ʻana a ma ka hemostasis mua.

I ka wā o ka mea lapaʻau o ka mālama ʻana me ka hana nui loa, kahi APTT elongation o 1,4 manawa hiki ke kūpono. I nā dosages prophylactic, ʻaʻole ia e kumu i ka emi nui o ka APTT.

Lapaʻau lāʻau

Ma hope o ka loaʻa ʻana o ka subcutaneous, ka hana kiʻekiʻe loa anti-Xa, ʻo ia hoʻi, ʻo ka piʻi ʻana o ka nui o ke koko ma hope o nā hola 4-5, aneane piha loa (a hiki i 88%). Me ka inikini intravenous, ʻo ka hana kiʻekiʻe anti-Xa kiʻekiʻe loa ma hope o 10 mau minuke. Hoʻomaka ka hapa hoʻopau hapalua o ke ola he 2 mau hola. Eia nō naʻe, ʻike ʻia nā waiwai anti-Xa ma ka liʻiliʻi loa 18 mau hola.
Hoʻopili i ka puʻuwai lawaiʻa a depolymerization.

Nā hōʻailona no ka hoʻohana ʻana

Ke nānā ʻananā hoʻopiʻi thromboembolic(ma hope o nā hana orthopedic a me nā ʻoihana hoʻoili, ma ka poʻe me ka huhū o ka thrombosis, ʻeha ʻana ka naʻau a i ʻole pauna aho hanuʻano ʻano).

Nā Hoʻohui

Kūpono a i nā loli e pili ana i ka ulu ʻana hemostasis.
ʻO Thrombocytopenia ke pau ana nadroparini nā lā ma mua.
Hoʻopilikia ka hui me kahi pilikia o ka kahe.
He 18 makahiki.
He kaumaha pilikia kūlohelohe.
Hoʻopuka intracranial.
ʻO nā hōʻeha a i ʻole nā hana ma ka spinal cord a i ʻole ka palu a i ʻole nā makamae.
Sharp hopohopo endocarditis.
Hypersensitivity i nā māhele o ka lāʻau lapaʻau.

E hoʻohana me ka akahele: maʻiila a i ʻole pilikia hāpau, hypertensionkaumaha, me ʻeha nā ʻōpū maʻi peptici nā lā i hala a i ʻole nā maʻi ʻē aʻe me ka piʻi nui ʻana o ke kahe, ke hoʻololi ʻana i ke kahe koko i loko o ka choroid ocular a me ka retina, ma hope o ka hōʻea ʻana, i nā mea maʻi e kaupaʻa ana a hiki i 40 kg, inā ua lōʻihi loa ka lōʻihi o ka mālama ʻana i ka lā 10, kuʻi ʻole i ka hoʻoponopono ʻia ʻana o ka lāʻau lapaʻau ʻia, i hui pū ʻia me nā mea ʻē aʻe anticoagulants.

Nā hopena hopena

Nā hopena mai ka ʻōnaehana coagulation: kahe koko o nā ʻano kaiāulu ʻokoʻa.
Nā hopena mai ka hematopoietic ʻōnaehana: thrombocytopenia, eosinophilia.
Nā hopena Hepatobiliary: hoʻonui i ke kiʻekiʻenā ate Enzy.
Nā hopena mai ke ʻano pale mai: hypersensitivity hopena.
Nā kūloko kūloko: ke hoʻokumu ʻana o kahi subcutaneous liʻiliʻi hematomas ma ka wahi inikini, ka hiʻohiʻona o nā ʻano hana paʻa e nalowale ana ma hope o kekahi mau lā, nā ʻōpū ʻili i ka wahi o ka hoʻokele. I kēia mau hihia, pono e hoʻoneʻe ʻia ka lāʻau me Fraxiparin.
Nā manaʻo ʻē aʻe: hyperkalemia, priapism.

Ke keu

Hoʻomaʻomaʻo: ʻaʻole pono ke koko wailua e hoʻolōʻihi i ka maʻi (e hoʻohaʻahaʻa i ka palena a hoʻolohi paha i ka maʻi ma hope). Palekana Sulfate kūlike ʻole anticoagulant hana heparin. ^ E Ha yM. Pono kāna hoʻohana ʻana i nā hihia koʻikoʻi. Pono ʻoe e ʻike he 0.6 ml protamine sulfate neutralizing ma kahi o 950 anti-Ha ME nadroparin.

Hoʻohui

Mea paʻakikī o ka hanana hyperkalemiahoʻonui inā hui pū mePaakai potassium, ACE inhibitors, potassium-sparing diuretics, angiotensin receptor blockers, heparins, non-steroidal anti-inflammatory drug, tacrolimus, cyclosporine, trimethoprim.

Hoʻohana pū me ka acetylsalicylic acid, kūlohelohe anticoagulants, NSAIDs, fibrinolytics a i ʻole dextran hoʻoikaika ʻoi i ka hopena o nā lāʻau.

E hoʻokuʻu i ke ʻano a me ka ʻano

Loaʻa ka Fraxiparin i ke ʻano o ka hopena no ka hoʻokele subcutaneous (sc): kahi wai hoʻokaʻawale a ʻāwili paha, ʻaʻole ʻāpana a ʻulaʻula paha (ma ke ʻano o 0.3 ml, 0.4 ml, 0.6 ml, 0.8 ml a i ʻole 1 ml i loko o ke aniani kuʻi manuahi, 2 mau syringes i loko o kahi kāwele, i loko o kahi pūpū kāleka o 1 a i 5 paha blisters).

1 ml o ka hoʻonā i loaʻa:

mea waiwai: kalepona nadroparin - 9500 ME (ʻāpana kālā) anti-Xa,
nā mea kōkua: nā kūmole kalaiwa (nā wai wai hoʻomalu waʻa wai), ka wai no ka injection.

Ma 1 syringe, kāla ʻia ka ʻike o ka calcium me ka nadroparin a pili i kēia helu.

volume 0.3 ml - 2850 ME anti-Xa,
polona 0.4 ml - 3800 ME anti-Xa,
volume 0.6 ml - 5700 ME anti-Xa,
volume 0.8 ml - 7600 ME anti-Xa,
1 ml ka nui - 9500 ME anti-Xa.

Lapaʻau lāʻau

ʻO ka hoʻoholoʻana i nā waiwai pharmacokinetic ma muli o nā loli i ka hana anti-Xa factor plasma.

Ma hope o ka hoʻomalu sc, a hiki i ka 88% nadroparin i ka huli ʻana, ka nui o ka hana anti-Xa (C_max) ua hiki i ka 3-5 hola. Me ka me / i ka hoʻokomo ʻana o C_max aia ma loko o kahi liʻiliʻi o ka 1/6 o ka hola.

Hoʻomauʻālua ʻia ia i ka ate i kahi nui aʻe e ka depolymerization a me ka desulfation.

T_{1/2 (}hapalua hapalua-ola) me ka hoʻomalu iv - e pili ana i 2 mau hola, me s / c - kahi o ka hola 3.5. Eia kekahi, hana anti-Xa ma hope o ka hoʻomalu sc ma ka maʻa o ka 1900 ME anti-Xa e hoʻomau nei no ka liʻiliʻi o 18 mau hola.

I ka poʻe maʻi maʻi makua, hana ʻia ka hoʻoponopono ʻia e like me ka pilikia o ka physiological e pili ana i ka makahiki.

I ka hoʻohālikelike ʻia ʻana o Fraxiparin no ka mālama ʻana i ka angina hiki ʻole, hoʻokuʻu ʻia ka myocardial me ka ʻole o ka lele Q a i ʻole thromboembolism i loko o nā mea maʻi me ka hiki ʻole o ke aʻa āpau me ka hōʻemi a me ka cleince creatinine (CC) mai 30 ml / min a i 60 ml / min, pono ke hōʻemi ʻia ka lāʻau ma ka 25%. I nā maʻi me ka pilikia ʻole o ka pilikia, ua contraindicated ke koho.

No ka pale ʻana i ka thromboembolism i nā maʻi me ka hōʻemi aono ʻole paha i hōʻemi ʻia, ʻaʻole pono ka hoʻēmi ʻana o ka nadroparin me ka hōʻemi loa ʻana i ka hopena, pono ke hōʻemi ʻia ka nui o 25%.

ʻO ka hoʻokomoʻana i nā haʻahaʻa kiʻekiʻe o ka papa heparin haʻahaʻa haʻahaʻa i ka laina o ka arterial o ka peke dialysis e pale ai i ka hōʻili ʻana i ke koko i loko o ka māka dialysis. Ma ka hihia o ka overdose, ʻo ka hoʻokomo ʻana o Fraxiparin i ka hoʻopuni i ka hoʻonohonoho ʻana i hiki ai ke hoʻonui i ka hana anti-Xa e pili ana i ka hana hope loa o ka maikaʻi ʻole o ka renal.

Nā ʻōlelo kikoʻī

Mai lana i ka lāʻau lapaʻau intramuscularly!

I ka wā o ka mālamaʻana me Fraxiparin, ʻo kona loli ʻana me nā lāʻau ʻē aʻe e pili ana i ka papa o ka lowpar low weight heparin. ʻO kēiaʻaʻa paha he hikiʻole i ke kipi o ka regimen dos i kuhikuhi ʻia ma muli o ka hoʻohana ʻana o nā pūʻulu dosage ʻokoʻa i ka lāʻau lapaʻau.

ʻAe nā syringes i kēnā ʻia e koho pololei i ka ʻano hoʻokahi, me ka noʻonoʻo ʻana i ke kaumaha o ke kino o ka mea maʻi.

ʻO nā hōʻailona o ka nekrosis ma ka wahi o ka hoʻokele hoʻomalu ka mea maʻamau ia o ka purpura, kahi erythematous hōʻeha a i kahi infiltrated wahi (me nā hōʻailona maʻamau). Inā kū lākou, e ho'ōki me ka hoʻohana ʻana iā Fraxiparin.

Hoʻonui ka Heparins i ka hopena o ka thrombocytopenia, no laila e pono ke mālama ʻia e ka mālama ʻana me ka mālama pono ʻana o ka helu platelet. Pono e mālama nui ʻia, a inā i ʻike ʻia mai nā ʻano, hiki ke hoʻokaʻawale ʻia ka mālama ʻana: thrombocytopenia, kahi hoʻokaʻawale i hōʻailona ʻia (30-50% o ka waiwai mua) o ka helu platelet, ka dinamika hewa o ka thrombosis e mālama ʻia ana, a hoʻomohala ʻia ka thrombosis i ka wā o ka mālama ʻana i ka lāʻau. , hoʻolaha i ka maʻi coagulation intravascular.

Inā pono, hiki iā ia ke kuhikuhi iā Fraxiparin i nā mea maʻi me ka mōʻaukala o ka he thrinocytopenia heparin-induced i loaʻa i ka wā o ka hoʻohana ʻana i kahi heparins o ke kaumaha a me nā mea laanewa. I kēia hihia, hōʻike ʻia kahi helu platelet i kēlā me kēia lā. Inā hele mai ka thrombocytopenia, kāpae koke ʻoe i ka hoʻohana ʻana i ka lāʻau lapaʻau a noʻonoʻo i ka koho ʻana o nā anticoagulants o nā hui ʻē aʻe.

ʻO ka koho ʻana iā Fraxiparin pono e noʻonoʻo i ka hopena o ka loiloi o ka hana kumu.

E kūʻē i ka hope o ka hoʻohana ʻana o ka heparin i nā mea maʻi me ka nui o ka paʻakai o ka paʻakai i loko o ke koko a i ʻole ka loaʻa ʻana o ka hoʻonui ʻana o ka pāhana o ka pāhana i loko o ke koko, e piʻi aʻe ka hopena o ka hyperkalemia. Ma kēia mea, me ke ʻano lōʻihi o ka lāʻau a me ka mālama ʻana i nā poʻe maʻi me ka hiki ʻole o ka pilikia kōpiko, ka maʻi diabetes mellitus, ka metabolic acidosis a me nā mea e loaʻa ana i ka concomitant therapy me ka angiotensin e hoʻohuli ana i ka enzyme inhibitors (ACE), nā lāʻau lapaʻau anti-inflammatory o ka steroid (NSAIDs) a me nā lāʻau ʻē aʻe e kōkua ana i ka hoʻomohala ʻana i ka hyperkalemia, pono pono e mālama pono. kāʻei i ke kiʻekiʻe o ka paʻakai ma ke koko.

ʻO ka hoʻoholo ma ka hiki ʻana o ka hoʻohui pū ʻana i nā anticoagulants me ka poloka neuroaxial i hana pilikino ʻia e pili ana i kahi loiloi o ka ratio o ka loaʻa o ka pōmaikaʻi a me ka loaʻa ʻana o kēia hoʻohui.

Ke lawe nei i ka pōpio a me ka laʻi aestestia a lumbar puncture, ka wā ma waena o ka lawelawe ʻana i ka lāʻau a me ka hoʻopuka a wehe paha i ka huʻu pulima a i ʻole catheter e pono ai. Ke hoʻohana nei iā Fraxiparin no ka pale ʻana i ka thromboembolism, aia ma ka liʻiliʻi o 12 mau hola, no ke kumu o ka mālama - 24 hola. I nā renal hikiʻole, hoʻonui ʻia ka huakaʻi.

Me ka hana pūnāwai paʻa ʻole

No ka mālamaʻana i ka thromboembolism, ka kaila paʻa ʻole a me ka myocardial infarction ʻole me ka neʻe ʻana o ka Q, ka mālama ʻia o ka hoʻonāula ʻana o ka calcium nitrroparin i loko o nā maʻi me nā pilikia ʻole o ka maʻi (CC ma mua o 30 ml / min). Me kahi CC o 30-60 ml / min, ua hōʻemi ʻia ka nui o 25%.

Ke hoʻohana nei iā Fraxiparin no ka pale ʻana i ka thrombosis i nā maʻi me ka hōʻeha o ka renal, ʻaʻole koi ʻia kahi hōʻemi me ka CC o 30-60 ml / min, me kahi CC ma lalo o 30 ml / min - e hoʻemi ʻia e 25%.

Hoʻohui nūhou

Me ka hoʻohana ʻana o Fraxiparin:

heprins a hoʻoneʻe haʻahaʻa kaumaha heparins, potassium di-sparing diuretics, potassium salt, angiotensin II receptor blockers, cyclosporin, tacrolimus, trimethoprim, ACE inhibitors, NSAIDs: hoʻonui i ka hopena o ka hyperkalemia,
nā lālani e hoʻopili ai i ka hemostasis (kūpaʻa anticoagulants, dextran, fibrinolytics, acetylsalicylic acid, NSAIDs): e hoʻoulu ai i ka hoʻonui like pū.
acetylsalicylic acid (ma ke ʻano o 50-300 mg no ka hōʻike ʻana o ka cardiological a i ʻole neurological), abciximab, clopidogrel, beraprost, iloprost, eptifibatide, tirofiban, ticlopidine: loaʻa iā lākou kahi hopena ma ka hoʻonui nui o ka hoʻokahe koko;
anticoagulants kūleʻa, dextrans, glucocorticosteroids systemic: pono e hoʻohana me ka akahele. Ma hope o ka hoʻomoe ʻana i nā anticoagulants kūhelu ʻole, e hoʻomau ʻia ka hoʻohana ʻana o Fraxiparin a hiki i ka loaʻa ʻana o ka MHO (International Normalized Ratio).

The analogs of Fraxiparin are: Fraxiparin Forte, Atenativ, Fragmin, Wessel Douay F, Kleksan, Heparin, Heparin-Darnitsa, Heparin-Biolek, Heparin-Indar, Heparin-Farmeks, Heparin-Novofarm, Novoparin, Tsibor, Enoks.

ʻO nā waiwai Pharmacological

Nā hana hana i ka hana
ʻO ka calciumium nadroparin he haʻahaʻa haʻahaʻa haʻahaʻa heparin (LMWH) i loaʻa e ka depolymerization mai ka heparin maʻamau. He glycosaminoglycan me ka nui molekole pāpaona ma kahi o 4300 daltons.
Hōʻike ʻo Nadroparin i kahi hiki nui e nakinaki i ka protein plasma me ka antithrombin III (AT III). ʻO kēia paʻa ke alakaʻi i ka wikiwiki o ka hoʻololi ʻana o ke kumu Xa. ma muli o ke kiʻekiʻe kiʻekiʻe o ka antithrombotic hiki o nadroparin. ʻO nā hana ʻē aʻe e hāʻawi ana i ka hopena antithrombotic o ka nadroparin. hoʻohui i ka hoʻowalewale o kahi ʻōnaehana hoʻololi ʻana i ka moho (TFPI), hoʻōla o ka fibrinogenesis ma ka hoʻokuʻu ʻana i kahi kiko o ka plasminogen a kikoo mai nā cell endothelial, a me ka hoʻololi ʻana i ka rheology i ke koko (ka hōʻemi i ka viscosity koko a hoʻonui i ka mana o platelet a me nā granulocyte membranes).

Lapaʻau lāʻau
Hōʻike ʻia ʻo Nadroparin e ka hana kiʻekiʻe aʻe i ke kumu XA, hoʻohālikelike ʻia me ka hana e kūʻē i ke kumu IIa. Loaʻa ia i ka hana Antithrombotic hana koke a lōʻihi.
Hoʻohālikelike i ka heparin unfractionated, ua loaʻa ka nadroparin i ka hapa iki i ka hana platelet a ma ka hōʻiliʻili ʻana a he liʻiliʻi ka hopena i ka hemostasis mua.
I nā dosis prophylactic, ʻaʻole ia e hoʻoneʻe i ka emi ʻana o ka manawa o ka manawa part 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.

Lapaʻau lāʻau
Hoʻoholo ʻia nā waiwai Pharmacokinetic ma ke kumu o nā loli i ka hana anti-Xa factor plasma.
Hoʻopau
Ma hope o ka lawelawe ʻākanana, loa o nā hana anti-Xa (C_max) loaʻa ma hope o 35 mau hola (T_max).
Bioavailability
Ma hope o ka hoʻokele subutaneus, ua komo loa ka nadroparin (ma kahi o 88%).
Me ka hoʻokele intravenous, ua hoʻokō ʻia ka hana anti-Xa kiʻekiʻe ma lalo o 10 mau minuke, hapalua-ola (T_½ ) kahi paha 2 hola.
Hāpai
ʻO ka Metabolism ka mea nui i ka ate (desulfation, depolymerization).
Leʻaleʻa
ʻO ka hapalua o ka ola ma hope o ka noho ʻana o ka subutaneus ʻehā mau hola 3. Eia naʻe, ke hoʻomau nei 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.

Nā hui pilikia

ʻO nā maʻi maʻi
I ka nui o nā maʻi maʻi, ma muli o ka hiki ʻana o ka hoʻohaʻahaʻa i ka hana ʻana, e hoʻopau pono ana ka nadroparin. ʻO ka hiki ʻole o ka lawelawe kīpē i kēia pūʻulu o nā mea maʻi e pono ke loiloi a me ka hoʻoponopono hoʻoponopono kūpono.

ʻO ka maʻi me ka hana renal impaired
Ma nā haʻawina loiloi ma ka pharmacokinetics o nadroparin i ka wā i hoʻopili ʻia ai ka maʻi i ka poʻe maʻi me ka wehe ʻole ʻana o nā ʻano paʻakikī, ua hoʻokū ʻia kahi pilina ma waena o ka puka ʻana o ka nadroparin a me ka palu o ka hana. Ke hoʻohālikelike nei i nā waiwai i loaʻa me kēlā mau mea hana olakino, ua ʻike ʻia ka nui o ka AUC a me ka hapalua ola i 52-87%, a ka cleinine clearance i 47-64% o nā waiwai maʻamau. Ua nānā pū ʻia ka noiʻi ʻana i nā ʻokoʻa ʻē aʻe. I ka poʻe maʻi me ka hikiʻole o ka renal maikaʻi loa, ua hoʻonui ka hapalua o ke ola me ka administrrop subcutaneous i 6 mau hola.Hōʻike nā hualoaʻa ma ka hōʻemi ʻana i nā nadroparin iki i loko o nā mea maʻi me ka hōʻola ʻole a me ka haʻalulu ʻole (ʻoi aku ka ʻoi aku ka nui ma mua o ke ʻano o Som / min a ma lalo o 60 ml / min), no laila, ʻo ka hopena o Fraxiparin e hoʻemi ʻia e 25% i kēlā mau mea maʻi e loaʻa iā Fraxiparin no ka mālamaʻana i ka thromboembolism, ka kaila pectoris / myocardial infarction o ka make ʻole Q. Fraxiparin ua contraindicated i ka poʻe maʻi me ka hiki ʻana o ka pilikia papalapa, i mea e mālama ai i kēia mau kūlana.
I ka poʻe maʻi me ka hina ʻole a me ke kaulike ʻole, ka hoʻohana ʻana o Fraxiparin no ka pale ʻana 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 ana i nā dosis therapeutic o Fraxiparin. No laila, ʻaʻole i pono ka hoʻemi ʻana i ka maʻi o Fraxiparin i lawe ʻia no nā kumu prophylactic i kēia māhele o nā mea maʻi ʻaʻole pono. I ka poʻe maʻi me ka hoʻomaʻamaʻa ʻole o ka renal ka loaʻa ʻana o ka prophylactic fraxiparin, kahi hōʻemi hoʻoneʻe o 25% pono e hoʻohālikelike ʻia me nā palapala i kuhikuhi ʻia i nā mea maʻi me ka cleince creatinine maʻamau.
Hemodialysis
Hoʻomohala ʻia ka heparin koʻikoʻi molekula ma ke kaona o ka hika o ka dialysis i nā koina nui loa e pale ai i ke kō me ke koko i loko o ka pōʻai. ʻAʻole loli iki nā ʻōkole pharmacokinetic, me ka ʻole o ka hihia o ka overdose, i ka manawa i hiki ke komo ʻia ka lāʻau i loko o ka ʻōnaehana hoʻonohonoho i ka hoʻonui i ka hana kumu anti-Xa e pili ana i ka hopena hope loa o ka maikaʻi ʻole.

ʻLoe a me ke kākele

ʻO ka lāʻau Fraxiparin ka mea i hoʻākāka no ka hoʻokele subcutaneous. ʻO ka hopena o ka lāʻau a me ka lōʻihi o ka papa o ka mālama ʻana i hoʻoholo ʻia e ke kauka, ma muli o nā hōʻike a me nā ʻano o ke kino o ka mea maʻi.

I ka manawa pinepine, ua koho ʻia ka ʻili o ka anterolateral o ka ʻōpū a i ʻole ʻūhā no ka maʻi maʻi. Hoʻopaʻa ʻia ka ʻili i loko o kahi kuʻekuʻe ma waena o ka manamana lima a me ka manamana lima a ua hoʻokomo ʻia nā pulia i pili i ka ʻili.

No ka pale ʻana i ka hoʻomohala ʻana o ka thromboembolism ma hope o ka hoʻomaʻemaʻe ʻana, ʻo 0.3 ml o Fraxiparin e lawelawe ʻia i nā hola 2 ma mua o ka hoʻomaʻamaʻa ʻana, a laila no kekahi mau lā i hoʻokahi lā, a ma kahi o 7 mau lā.

Hoʻohana i ka wā hāpai a me ka lactation

ʻAʻole kōkua ʻia ka hoʻohana ʻana i ka lāʻau Fraxiparin i ka wā hāpai ʻana, no ka mea ua palena ʻia ka ʻike lāʻau. I ka hoʻomaka ʻana o nā holoholona holoholona, ʻaʻole i hoʻokumu ʻia ka hopena teratogenic a i ʻole embryotoxic o ka lāʻau ma ka ʻōpio, eia naʻe, ʻaʻole i kuhikuhi ʻia ka lāʻau lapaʻau no nā wahine e hāpai ana i kahi keiki. Inā pono, loiloi ke kauka i ka hoʻohalike o nā pōmaikaʻi o nā pono a me nā pilikia no ka makuahine a me ka maʻa.

I ka wā o ka umauma, ʻaʻole i kuhikuhi ʻia ka lāʻau Fraxiparin i ka makuahine, ʻoiai ʻaʻole i ʻike ʻia e pili ana i ka hiki o ka lāʻau lapaʻau e hoʻopau i ka umauma wai. Inā pono e lawelawe i nā ʻōlelo ʻauʻau o Fraxiparin i kahi makuahine hānai, pono e hoʻopili ʻia ka lactation a hoʻoneʻe ʻia ke keiki i nā mea kanu kolona me kahi hui waiū hoʻopono.

Nā hopena hopena

Ma ke kānāwai, ke hoʻomanawanui maikaʻi ʻia ka lāʻau e nā maʻi, akā i kekahi mau manawa, hiki ke hoʻomohala ʻia ka hoʻomohala pili.

mai ka ʻōnaehana hana koko o ke koko - kahe koko ʻana o nā ʻano kūʻokoʻa,
mai nā ʻenehana hemopoietic - ke emi ʻana o ka helu o nā platelets a me ka eosinophilia, e hoʻomaka koke ana i kā lākou iho ma hope o ka pau ʻana o ka ʻaiā,
mai ka hiʻi - urticaria, holo o ke koko a i ka maka, ʻāhai ka wela i ke poʻo, ka angioedema, dermatitis,
hoʻonui i nā ate, hoʻonui i nā hana hepatic transaminases,
nā kūloko kūloko - ka hū ʻana o nā hematomas subcutaneous i ka wahi i werohia, ka hiʻohiʻona o nā ʻeha hōʻeha ma lalo o ka ʻili, ʻulaʻula a ke ʻula e puni ana i ka wahi o ka maʻi maʻi, nā ʻōpū o ka ʻōpala i ka wahi o ka injection.

Inā hele nā hopena ʻaoʻao, pono e nīnau koke i ke kauka no ka ʻōlelo aʻo.

Waihona a me nā kūlana waiho

Hoʻokuʻu ʻia ka lāʻau Fraxiparin mai nā lāʻau lapaʻau ma o ka lāʻau lapaʻau. Mālama i nā syringes me ka lāʻau lapaʻau ʻaʻole i hiki aku i nā keiki, kahi mamao loa i nā kumu kumu o ka wela a me ka māmā. Ua hōʻike ʻia ka ola o ka noho o ka lāʻau lapaʻau ma luna o ka pōpō a ʻo 2 mau makahiki mai ka lā i hana ai.

Mai hoʻohana i ka hopena o ka hoʻokele inā ua hoʻemi ʻia ka kū pololei o ka pākaukau.

Nā kahina pectoris kahe a me ka myocardial infarction me ka make ʻole Q

Hoʻohana ʻia ka Fraxiparin i kēlā me kēia mau hola 12. ʻO ka lōʻihi o ka hoʻohana ʻana, ma ke ʻano he kānāwai, 6 mau lā. I ka wā hōʻeha o nā lāʻau lapaʻau, ua kuhikuhi ʻia ka lāʻau lapaʻau me ka hui pū me ka acetylsalicylic acid (325 mg i kēlā me kēia lā).

Pono e hāʻawi ʻia ka ʻōmole mua ma ke ʻano he tokone bolra hoʻokahi, ukali ʻia e s / c.

Hoʻoholo ʻia ka lāʻau lāʻau e ka paona - 86 anti-XA IU / kg.

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

Hoʻoholo kū hoʻokahi ka makeke o Fraxiparin, i ka ʻike ʻana i nā kūlana loea o ka dialysis.

I ka hoʻomakaʻana o kēlā me kēia kau, ke hoʻolauna ʻia ʻo Fraxiparin i hoʻokahi manawa i loko o ka laina ʻula o ka peke dialysis. No nā mea maʻi me ka piʻi ʻole o ka kahe, hele ke kau ʻia nā ʻōmaka mua ma muli o ke kaupaona, akā ua lawa no ka hālāwai ʻehā mau hola.