"Atsekardol": zvairatidza kuti kushandiswa, mirayiridzo, wongororo, analogs

Pakati zvokurarama antiplatelet kurapa, izvo inoshandiswa kudzivisa chakasimba zvemwoyo zviitiko, vagara nyaya huru acetylsalicylic asidhi (Asa). Synthesized muna 1887, ndiwo makore anopfuura 125 ave achishingaira kushandiswa okurapa ive antiplatelet mumiririri uye antipyretic. Uye sezvo yezviri zvinodhaka fuma rwuripowo "Atsekardol" gadziriro, zvairatidza iyo zvishoma nezvishoma kuwedzerwa sezvo kudzidza pathogenic zvigadziriswe zvirwere.

System mamirire medicament

The rinoita fuma gadziriro maererano kupatsanura chokuita nzira yokudzivisa aggregation. Munyaya dzino ACK ndiyo vakarongeka makemikari anoumba inokwanisa zvachose kusingabviri kupa platelet aggregation yose dziva. Kupima zvinodhaka "Atsekardol", zvairatidza kuti kushandiswa, uye analogs ayo chipimo chemushonga chimiro tichitarisa pharmacodynamics, yakaratidza zvinotevera:

• chacho vanoshingaira chirungiso - Asa muyananisi antithrombotic zvazvinoita atherosclerosis pamusoro arteries kumashure;

• optimally dosed mushonga nokuda kudzivirira zvemwoyo chirwere;

• ayo chipimo chemushonga chimiro waanodzikisira mugumisiro gastrotoxicity Asa;

• Kugadzirira ndicho risingadhuri pakati kukwikwidzana zvinhu pamwe fanana kunyatsoshanda.

The mugumisiro kudzivisa thrombosis Asa akatsanangura blockade inotungamirwa prostanoids. Nekuti chinovhiringidza pamusoro Cox-1 - Platelet Cyclooxygenase-1 - vachanetseka kumharuro thrombus inotungamirwa chinokonzera - the aggregation ropa maplatelet. Chinovhiringidza kunoitika nezvekugadzirwa thromboxane A2, inotanga chirongwa kuda kuti maplatelet kuti mugove dzaparadzwa ari mudziyo rusvingo.

Pfungwa uye characterization gastrotoxicity

Target zvairatidza kuti "Atsekardola" anosanganisira kudzivirira thrombus inotungamirwa. Zvisinei, Asa, zvinoshingaira wemafuta zvinodhaka, pane kunaka kushanda chokuita nonselective cyclooxygenase. Also anetseka reconstitution pakati epithelial mumasero gastric turakiti. Kuva pasi pokudzora hasha acidic nomudumbu ezvinhu, vari zvakawanda kukuvaradzwa, izvo zvinoita kuti pave chirwere kuzvimba gastral. Apo neapo (anenge 3,5% vose nyaya) nayo chinokurwadzai ropa iri zvomudumbu turakiti.

Nokuti Pfungwa, iyo inoshandisa "Atsekardol" zvairatidza kuti kushandiswa munzvimbo dzakawanda nemhaka kuchengeteka zvikuru. It urwa uye wefodya chete muna 12-duodenum, anomirira enteric kardioformu Asa. kuonana kwake mumasero mudumbu iri zvachose zvachose, nokudaro hwakaipa ayo divi kushanda gastrotoxicity. Local zvikuvadze "Atsekardola" iri kushoma, nokuti mushonga riri muchimiro enteric kare vaiona ari inhibitor zvokusarudza kuti Cox-1. Nepo Cox-2 chinovhiringidza anoshayisa nzvimbo ura, izvo hakuratidzwi chinokosha vanotaura.

Chimwe chinhu chinokosha chaizvoizvo ari chipimo chemushonga vanoumba "Atsekardola" ndizvo zvakananga omunharaunda rutapudzo gastrotoxicity. Nokuda pamberi antacid muchimiro magnesium hydroxide mukana gastric kukuvadzwa kunoderedza yakatokura. Uye panguva iyoyo pasi pharmacological pamusika yeRussian Federation "Atsekardol" zviri mumwe mari vatatu ehupfumi izvi. Kuramba kupfuura kutengeka pakati zvakafanana, zviri Zvakanakisa wakanyatsokodzera kushandiswa zvachose.

Place "Atsekardola" iri antithrombotic kurapa

Asa nokuti prophylaxis pamusoro thrombotic mananara rinoshandisirwa kwakavakirwa muzvizhinji kunotoda kurapwa zvidzidzo. Vakaita yakasimbisa kushanda kwayo mukuderedza murwere hunofa kubva zvemwoyo chirwere. In zvikuru:

• KUMBIRA 16% shoma kufa pavarwere panguva mukuru boka pangozi zvemwoyo:

• 25% zvinoderedza kuitika ischemic sitiroko;

• 25% kunoderedza ngozi thromboembolism, pulmonary tsinga uye awo;

• 29% kunoderedza mukana wokuti symptomatic venous thrombosis kuti chiuno duku kana migumo;

• 33% zvinoderedza kuitika myocardial infarction.

Migumisiro izvi uye anogovera dzizere zvinodhaka "Atsekardol" zvairatidza kuti icho zvishoma kupfuura zheludochnorastvorimoy Asa. Zvino simba antithrombotic chiito mishonga mitsva antiplatelet iri kuongororwa chete kana vachienzaniswa naye. Saizvozvowo, "Atsekardol" sezvo yakachengeteka zvikuru, chinofanira kutora nzvimbo nechepakati iri prophylactic mabatiro wevarwere maererano neuchapupu.

Varwere Contingent vane zvairatidza kuti kushandiswa

Mukugadzirira "Atsekardol" zvairatidza kuti kushandiswa, mutengo, kushanda uye ngozi kushandisa optimally nepakati. Izvi zvinobvumira kuti kutora ramakumi chipimo chemushonga muchimiro zvakawanda varwere zvinokonzera occlusive pangozi. Uye kubviswa dzakawanda kurutivi zvinokonzerwa zvinodhaka zvinokonzera zvinotevera nyaya:

• (ACS) chakasimba coronary syndromes pamwe kwaro, mwoyo kana sanganisika ST penguva pamusoro ECG;

• chenjera chepfungwa zvirwere (chepfungwa) kuparadzirwa (ADCC);

• zvinopfuura (uropi) ischemic kurwisa (Tia);

• akatamira pasi zvirwere izvi kudzivirira idzokororo nyaya;

• pamwe yakadzikama angina pectoris kuti kudzivirira ACS;

• pamwe paroxysm kana zvachose mhando atrial fibrillation;

• venous varicose mutsinga.

Pathogenetic substantiation kuti chikumbiro "Atsekardola"

zvairatidza izvi nokuti "Atsekardola" nokuda kurapwa mugumisiro chezvinodhaka. Zvinonzi zvinobudirira kushandiswa senzira yokudzivirirwa arterial thrombosis panguva nzvimbo muganhu uye concentric atherosclerotic plaques. Munzvimbo idzi nokuda aienda ropa kuyerera arterial riri kwakakanganiswa chokuumba vortex ropa riyerere. Zvokuimba kumanikidzwa pamusoro thinned zvikamu endothelium kunotungamirira yaro iri kubvambura. Blood coagulation hurongwa anoona nyika ino sezvo kutyorwa vascular kuvimbika, chinoda zvokuimba okupedzisa maplatelet vaite clot.

The kuda kuti maplatelet ndiko, Paunotanga thrombus inotungamirwa, pamusoro kupedziswa izvo zvinofanira kuumba yemibvunzo yemberi ropa clot. Zvadaro, saizi yayo kunowedzera nokuda kunonoka nemasero ropa. Full kupera kurongedza hemostasis zvinoisa zvikuru (anopfuura 75 nzvimbo%) aienda pamusoro mudziyo lumen. Kazhinji kunyange anofukidza ropa riyerere iri tsinga, uye munzvimbo dzakanga kare zvokudya pamusoro wake ruzivo ischemia. Izvi ndizvo hwaro ACS uye sitiroko, saka kudzivirira izvi mananara kunokosha zvikuru kuti kuderedza mumwe kufa kubva atherosclerotic mwoyo uye brachiocephalic arteries.

Pharmacodynamics antithrombotic chiito "Atsekardola"

Vasiyana mushonga "Atsekardol" mirayiridzo Chinyorwa (tsanangudzo chigadzirwa) hazviratidzi yayo pharmacodynamic nemigumisiro, uye anorondedzera nayo panyaya kuverenga uye mutambo mamiriro. Zvisinei, izvozvo haritsananguri chairo mugumisiro Asa, nokudaro nokunyima murwere mashoko anokosha pamusoro mashandiro nezvaaiita. sequential algorithms Its ndeinotevera:

• chinovhiringidza pamusoro Cox-1 uye kumira kwetunhu prostanoids;

• zvibereko kusingarapiki blockade kuti platelet thromboxane A2;

• chipingamupinyi platelet aida kuremara ari endothelium;

• chinovhiringidza pamusoro platelet adhesion pezvakaitwa;

• hazvibviri wezvamatongerwe thrombus occluding ari arterial lumen.

"Atsekardol" iri rikwanise ezvinhu

Also vasiyana mushonga "Atsekardol" mirayiridzo kushandiswa (pfupiso Rondedzero) haripi mashoko murwere nezvomukana kushandiswa kwayo panguva nekukudziridza chakasimba kusagadzikana kweropa mumwoyo kana uropi. Kunyanya, pamwe kukura kunotoda chirwere hunhu myocardial kana chepfungwa infarction, uye anogona kuiswa Asa.

Mahwendefa vanofanira dzinodzeya mushonga (panguva dose ine 150-300 MG) uye kwete kumedza. Kana murwere zvinodhaka ari dose 50 MG, panguva imwe rikwanise ezvinhu kunoda vaviri 3-6 chew Mahwendefa apo chipimo chemushonga 100 MG, mahwendefa 2-3 apo 300 MG, 1 piritsi. Hazvina njodzi mudziyo, naro zvikuru kwakaderedza mukana wokuti zvikuru vascular thrombosis.

Contraindications pakushandisa "Atsekardola"

Mukugadzirira "Atsekardol" (Mahwendefa) mirayiridzo kushandiswa, chaizvo nyanzvi uye mishonga tsvakurudzo Data kuzosimbisa pakuenzanisa ngozi uye zvakanakira kushandisa. Zvisinei, contraindications nokuda comorbidities zvinoda kufungwa kana kutora zvinodhaka uye kunobvunza nyanzvi. Contraindications vari rakakamurwa rusingaperi (Mhedziso) uye nguva. Dzinofanira vari:

• mushonga kusashivirira kuna Asa, bronchoconstriction;

• intracranial hematoma siyana dzomuNorth;

• Hemorrhagic vasculitis ;

• Zvinonzi rambidzwa kuzoshandisa kuyaruka uye vana nokuda ngozi Reye kuti urwere ;

• Zvinonzi rambidzwa kubvuma vakadzi panguva lactation, muna I uye III trimester akazvitakura.

Uyewo zvishoma zvishoma kugamuchirwa nguva uye hama contraindications:

• hepatocellular uye renal kukundikana;

• kuvapo kunopfuurira ropa, mangwanani postoperative nguva (pfupi contraindication);

• neBP panguva dzenhamo, kudzora neBP;

• urikanwi 12 duodenal urikanwi kana gastric exacerbation (nguva muganhu).

Multiple migumisiro "Atsekardola"

Mukuwedzera mureza uye zvakanaka vakadzidza matambudziko anokonzerwa chinovhiringidza pamusoro Cox vane ACK ariko uye mumwe chiito. Wakazvizivisa akatevedzana Statistical zvidzidzo zviri kenza uye geriatric nzvimbo iri US. Nokufamba kwavo kwakaratidza kuti Mugumisiro Asa kuti kudzivirira nyanyisa zvirwere - colorectal kenza zvakasiyana localizations.

Zvino isu kuratidza unyanzvi mashandiro ari runodzivirira zviito zvinodhaka. Maererano nevaongorori vakawanda uye vanachiremba vanobvumirana pamusoro predominance ari inhibitory mugumisiro Cox-2 rezasi ura. Zvichivhiringidza kubatana kwetunhu prostaglandin E2, ACK ambotirega artificially waidzora kuparadza uye kubereka nemasero. Zviya, ichi kunyanya cellular muitiro ndiyo musimboti chitange bundu.

Mhedziso pahwaro nekusimba zvinhu ndeinotevera: mushonga "Atsekardol" mirayiridzo, chikumbiro, nenyanzvi chaiwo izvo zvinoratidza epakati nepakati mugumisiro, anogonawo kushandiswa senzvimbo prophylactic nokuda kudzivirira bundu pezvakaitwa vari zvikamu nemudumbu ezasi. Mukati 5-12 Makore dzi- kwakaderedza pangozi kenza rufu, izvo sezvingatarisirwa inowedzera lifespan. Asi ACK haagoni kushandiswa pakurapa kare dzakabudirira colorectal adenoma kana carcinoma ura.

Analogs kugadzirira uye inotsiva

Product unhu "Atsekardol": chikumbiro, mushandisi, analogs, zvairatidza kuti antithrombotic kurapwa unogona kurishandisa kubata-siyana varwere. Zvisinei, mune akatevedzana antiplatelet vamiririri, haasi chete nzira. MuRussia mune anenge 20 Generic ACK, chikamu iyo anogadzirwa fomu zheludochnorastvorimoy. Ivo bvumidza kuchengeteka chakarondedzera "Atsekardolu".

Enteric siyana Asa ( "Cardiomagnyl", "Polokard") akaratidza pamusoro pharmacological pamusika, yekudyidzana yepamusoro mutengo. Nokuti gadziriro "Atsekardol" mutengo mwedzi kurapwa 25 rubles. Chose kufanana ne dzomuzana imwe chete-siyana kuchengeteka vari vaviri pavatatu zvakawanda. zvinodhaka Foreign chose va- kana dzakakwirira kashanu pane mari pakurapa bhajeti kuti hapana pachena kubatsira murwere mekugamuchira "Atsekardol". Mirayiridzo yokushandisa, kurapwa, ongororo, mashoko kubva analogs zvinodhaka ichi zvakare zvakafanana.

Mhedziso nezvokubatsirwa uye ngozi analogues "Atsekardola"

Akaramba kupfuura kutengeka, mushonga "Atsekardol" zvizere sezvarayirwa zvinodiwa vanachiremba. Ngozi kushandiswa zvarinotaura zvine nokushandiswa dzinoshanda mafomu akadai antiplatelet nevamiririri. It zvinobudirira chinonditadzisa idzokororo thrombosis mwoyo uye ropa nemidziyo uropi, inoshandiswa atrial fibrillation, rinoshandiswa kuti varicose mutsinga. Uye kuenzaniswa remunharaunda zvinobatsira analogs "Atsekardola" ndiyo affordability.

Izvi zvinooneka kunowedzera kushanda kwemashoko "Atsekardol" chigadzirwa: mutengo zvinodhaka kunopfuura 20 rubles. Izvi zvinooneka isingasviki mari nezvimwe antiplatelet nevamiririri. Uyezve, pakati zvinodhaka Asa anogadzirwa kupfuura yakachengeteka enteric chimiro, kureva yakaderera mwero "Atsekardol". Sezvingatarisirwa, zvinoita Zvinosarudzwa kuti kurapwa zvirwere ataurwa pamusoro apa, uye ekudzivirira dzavo. Vanoverengeka chikumbiro nzvimbo zvishoma nezvishoma wedzera.