"Pradaksa" - analogues. "Warfarin", "Ksarelto": xyuas, nqi

Cov antithrombotic cov neeg ua hauj siv los tshem tawm ib tug thromboembolism nyob rau hauv cov leeg tom qab phais, ntau npaum qhia tau hais tias kev npaj "Pradaksa". Nws analogues muaj nrug indications rau kev siv thiab nyob rau hauv cov qauv muaj ntau active cov khoom xyaw. Anticoagulants yog muaj nyob rau hauv cov khoom noj daim ntawv uas txawv noj tshuaj npaum cas.

Hauj lwm "Pradaksa" tshuaj

Chaw tsim tshuaj paus antithrombotic thiab anticoagulant tshuaj "Pradaksa" yog lub tuam txhab "Boehringer Ingelheim Pharma GmbH & Co. KG. KG ". Qhov txhais tau tias nyob rau hauv ib qho nyuaj tsiav tshuaj, uas muaj hauv me me daj pellets. Lub active tshuaj dabigatran etexilate xam tau tias yog tsaug zog daim ntawv no, tus naj npawb ntawm cov uas txiav txim seb tus ntau npaum cov tshuaj. Tej zaum nws yuav 75 mg, 110 mg thiab 150 mg.

Yuav ua li cas cov tshuaj "Pradaksa" yog siv

Lub hom phiaj tseem ceeb ntawm tsiav tshuaj yog kev cob cog rua nrog cov kev tiv thaiv ntawm venous thromboembolism tom qab phais departments nyob rau hauv lub licas.

Yuav ua li cas lub cuab tam "Pradaksa"

Nws yog txuam nrog cov hluav ntawm thrombin ua si mechanism ntawm qhov kev txiav txim ntawm cov tshuaj "Pradaksa". Analogs muaj me ntsis txawv zog. Ua ib tug me me molecule, dabigatran etexilate twb tsis muaj pharmacological kev txiav txim.

Tsuas nkag mus hauv tib neeg lub cev, cov tshuaj yeeb dej caw yog phua tom qab hydrolysis rau cov dawb dabigatran yog active reversible ncaj kev sib tw inhibitor ntawm thrombin enzyme. Lub luag hauj lwm ntawm thrombin yog losis tswvyim dabtsi rau fibrin, thrombin, txo cell aggregation ntawm platelet tshwm sim los ntawm thrombin kev ua si.

cov cuab yeej

Muaj tshuaj "Pradaksa" counterparts. Tab sis nyob rau hauv nws muaj pes tsawg leeg, lawv tsis muaj dabigatran etexilate, nws yog hloov nrog rau lwm cov anticoagulant agents. Yog li, lub active khoom sib ua zaub mov zoo xws li cov txhais tau tias "warfarin" yog warfarin, nyob rau hauv lub medicament "Ksarelto" muaj rivaroxaban. Txhais npaj "Pradaksa" muaj cai "Marcumar" thiab "Fenilin" muaj xws li phenprocoumon thiab phenindione feem.

Hauj lwm "warfarin" tshuaj

Peb twb teev, uas muaj cov tshuaj "Pradaksa" counterparts. Cia peb tam sim no xav txog nyob rau hauv ntau yam ib tug ntawm lawv.

Lub medicament "warfarin" yog ua nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj nrog ib tug ntau npaum ntawm active ingredient, 2.5 mg. Cov chaw tsim tshuaj paus ntawm cov tshuaj yog tus Lavxias teb sab lub tuam txhab "Kanonfarma ntau lawm."

Nws muaj lwm yam ntau npaum (1 mg, 2 mg, 3 mg thiab 5 mg) txawv teb chaws raws li cov tshuaj warfarin. Tus duab, xim thiab loj ntawm lub ntsiav tshuaj yog txawv ntawm ob sab ntawm applied koob tshuaj nyob rau hauv mg.

Vim li cas cov tshuaj no yog siv

Txais tos "warfarin" yog tau:

• thrombosis ntawm lub venous system los yog predisposition;
• rau lub prophylactic kev kho mob ntawm thrombosis thiab thromboembolism;
• nyob rau hauv mob venous thrombosis thaum lub sij hawm thiab embolism nyob rau hauv lub ntsws cov ntaub so ntswg;
• ntawm postoperative thrombosis;
• mob myocardial lub plawv mob;
• thaum lub sij hawm kev phais thiab thrombolytic txoj kev kho ntawm thrombosis;
• nrog nraum ischemic tawm tsam;
• rau heev kev kho mob ntawm recurrent venous thrombosis;
• thaum lub sij hawm ib tug prosthetic valve nyob rau hauv lub plawv.

Yuav ua li cas tus neeg saib xyuas

Cov ntsiab ntawm qhov teeb meem "warfarin" txo cov ntshav txhaws yam inhibit zus tau tej cov (X, IX, VII, II), vitamin K-dependent ntshav thiab ua coagulation. Hepatic Anticoagulant cov nqaijrog C thiab S yog tsim rau ib tus twg lesser nyob rau hauv tus ntawm cov tshuaj. Tag nrho cov no thiaj li muaj cov tsim ntawm cov ntshav txhaws uas ua rau cov tsim ntawm cov ntshav txhaws.

Yuav kom tshem tawm venous thrombosis kws kho mob muab tshuaj rau kev kho mob nrog indirect anticoagulants. Qhov no tsis rov tsim thrombosis, uas yuav ua rau mob.

Muab xam los ntawm cov koob tshuaj warfarin txawv cov nqi INR

Sij hawm "warfarin" tshuaj sai tau tom qab ncauj lus kom ntxaws xeem, thaum lub sij hawm uas qhia txog tag nrho cov contraindications. Qhov tsom xam rau ntxiv kev kho mob xaiv tau cov kev kawm npaum li cas ntawm medicament "warfarin". Cov koob tshuaj ib hnub twg yuav tsum tsis pub tshaj 5 mg ntawm lub ntsiab active tshuaj. Nrog txaus kho nyhuv ntawm cov kev kho mob nqa tawm kho. Nws yog pom zoo kom sau tus tau txais koob tshuaj, INR ntau ntau thiab cov teebmeem uas tshwm sim taus rau tus tsom xam ntawm txoj kev kho.

Nyob rau hauv lub INR (thoob ntiaj teb normalized piv) hais standard rau kev txiav txim cov kev ua ntawm txhaws ntshav ntsiab. ntshav txhaws yam feem xyuam rau txoj tus nqi ntawm qhov ntsuas. Nws yog ib qho tseem ceeb los mus saib xyuas lub INR thaum tau txais "warfarin" rationing uas yog inversely xwm yeem mus rau cov ntshav txhaws. Yog li, thaum muaj kev kub normalized piv slows txhaws thiab tsub kom hypocoagulation.

Thaum sib txawv xeev yuav tsum tau saib xyuas nyob rau hauv tej yam INR.

1. Rau ib tug noj qab kab, nws cai yog hais txog 1.0 (los yog lo lus zoo lus me ntsis - los ntawm 0.85 mus 1.25).
2. Mob atrial fibrillation thaum tau txais "warfarin" pellets yuav tsum tau nrog los ntawm ib tug normalized piv ntawm 2.0 rau 3.0 units.
3. Neeg kho tshuab valve prosthesis yus muaj los ntawm ib tug INR ntawm 2.0 mus 3.0, ib tug txhua yam prosthetic mitral valve los ntawm 2.5 mus rau 3.5.
4. Nyob rau hauv cov kev kho mob ntawm thromboembolism nyob rau hauv lub pulmonary leeg thiab ib co plawv tsis xws luag xav tau ib theem index ntawm 2.0 rau 3.0.
5. Yuav kom tiv thaiv thrombosis nyob rau hauv lub sib sib zog nqus leeg tom qab kev phais thiab kev kho mob ntawm venous thrombosis, ua raws li qhov tseem ceeb ntawm 2.0-3.0.

Cov tshuaj "warfarin" yuav tsum tau nqa tawm nrog ceev faj xyuas ntawm INR Performance index thiab nruj kho mob saib xyuas, yuav tsum tau mus kho ntau npaum. Stabilization normalized piv thiab xaiv ntawm qhov yuav tsum tau npaum li cas medicament yog nqa tawm rau txog ib lub lim tiam, thiab ces txhua txhua 4 lub lis piam no tus nqi yog soj ntsuam.

Los ntawm cov nyhuv ntawm daim ntawv thov ntawm "warfarin" ntawm cov tshuaj, yuav ua li cas coj tshaj rau ntxuav cia thiab seb ua ke nrog ntawm cov zaub mov, koj yuav tsum paub. Ntsiav tshuaj haus dej haus ob zaug ib hnub twg, tsis combining nrog noj nqos tau cov khoom noj khoom haus. Lawv ntxuav cia nrog dej thiab noj nyob rau tib lub sij hawm. Nyob rau hauv tas li ntawd, tus me nyuam ntawm analyses rau lub INR yuav tsum nyob rau hauv lub tib lub sij hawm thiab nyob rau hauv lub ruaj khov laboratory. Thaum es txhaj koob tshuaj uas yuav tsum tau nqa tawm tom ntej no feem ntawm lub txais tos lub sij hawm.

Thaum cov nqi tsawg tshaj li 2.0 INR yog suav tias yog cov ntshav tuab, cov tshuaj yog tsis zoo, yog li ntawd, nws yog tsim nyog los siv ib tug ntau dua ntau npaum "warfarin".

Nyob rau hauv cov nqe lus ntawm ntau tshaj 3.0 INR nws yog suav tias yog kua ntshav, los ntshav yuav tshwm sim, yog li ntawd nws yog tsim nyog los thov tsawg kawg siab ntau npaum ntawm cov tshuaj.

Tus nqi ntawm ib yam tshuaj "warfarin"

Nyob rau hauv kev sib piv nrog rau cov German tshuaj "Pradaksa" nws Lavxias teb sab sib npaug ntawm "warfarin", tus nqi ntawm uas yog los ntawm 80 rubles ib pob, nws yog ntau npaum li cas pheej yig dua thiab ntau mus siv cuag.

Hauj lwm "Ksarelto" tshuaj

Thaum medicament "Pradaksa" analogs yuav nrog anticoagulant zog, muaj direct cawv. tshuaj "Ksarelto" yog hais txog rau lawv. Nws ua nws nyob rau hauv daim ntawv ntawm round zaj duab xis loj ntsiav tshuaj nyob rau hauv lub tuam txhab German "Bayer".

Muaj pes tsawg leeg muaj rivaroxaban nyob rau hauv micronized daim ntawv. Ntsiav tshuaj "Ksarelto" yog nyob rau hauv cov nram no noj tshuaj npaum cas: 2.5 mg, 10 mg, 15 mg thiab 20 mg.

mechanism ntawm qhov kev txiav txim

Rivaroxaban xa mus rau raws li heev xim ncaj tshaj Xa inhibitors uas muaj siab bioavailability cai tom qab qhov ncauj thawj coj.

Lub coagulation cascade yog tsim los ntawm qhov ua kom ntawm qhov zoo tshaj X, uas, vim nrog thiab lwm coagulation pathway yog hloov dua siab tshiab rau hauv qhov zoo tshaj Xa. Qhov no feem yog muab kev koom tes nyob rau hauv lub tsim ntawm lub prothrombinase compound los ntawm qhov kev txiav txim ntawm uas tus prothrombin yog hloov dua siab tshiab rau thrombin. Cov dab tsim tau ib fibrin los khov rau ntawd, thiab activates platelets. Muaj yog ib tug "tawg" nyob rau hauv uas vim muaj ib tug zoo tshaj Xa molecule yog tsim rau ib txhiab ntawm cov ntshav.

Siv xim inhibitors uas kom tsis txhob ua hauj lwm activator tshwm sim tsis txhob "thrombin tawg". Action rivaroxaban raws kev coj kom hloov cov kev tshwm sim ntawm kev los yog kev kuaj ntsuam los ntawm kwv yees ib lub xeev ntawm lub coagulation system. Qhov zoo tshaj yuav Xa kev ua si txawv nyob ntawm seb lub inhibitor koob, uas ua hauj lwm pab raws li cov tshuaj "Ksarelto" (15 mg ntawm cov ntsiav tshuaj los yog lwm yam ntau npaum nws).

Qhov ntawd yog kho nrog cov tshuaj no

Cov phau ntawv qhia txog kev siv ntawm ib tug medicament rau kev tiv thaiv ntawm txoj kev tuag tom qab kab mob plawv txuam nrog myocardial lub plawv mob thiab mob coronary syndrome. Tshuaj "Ksarelto" zoo cim kev tau rau lub zoo ua ke nrog txoj kev kho nyob rau hauv nrog cov tshuaj aspirin los yog tshuaj aspirin thiab thienopyridine.

Yuav ua li cas coj txawv koob tshuaj ntawm cov tshuaj

Cov tshuaj no yog npaj rau hauv kev siv. Ntsiav tshuaj tag nrho cov koob tshuaj noj nrog zaub mov.

Nyob rau hauv thiaj li yuav tshem tawm mob coronary syndrome yuav tsum tau mus noj ib ntsiav tshuaj ntawm 2.5 mg ib hnub ob zaug. Ua ke nrog cov kev npaj "Ksarelto" (kev qhia cov hauj lwm zoo ntawm kev siv xws li ib tug ua ke ntawd) yuav muab acetylsalicylic acid nyob rau hauv ib tug txhua txhua hnub koob tshuaj los ntawm 75 mus 100 mg, thiab ua ke nrog cov tshuaj aspirin thiab clopidogrel nyob rau hauv ib tug npaum li ntawm 75 mg ib hnub twg. Qhov no txoj kev kho yuav tsum tau tas li kho mob saib xyuas rau observance ntawm tshuav nyiaj li cas, uas yog pab txhawb mus rau ib sab yuav ua ischemic los yog teeb meem los ntshav. Noj cov tshuaj ntev thiab yuav siv sij hawm txog ib lub xyoo, nyob rau hauv ib co neeg mob mus txog ob lub xyoos.

Cov ntsiav tshuaj nyob rau hauv ntau npaum ntawm 10 mg rivaroxaban coj ib lub sij hawm ib hnub twg. Tus thawj haus tom qab 6-9 teev ntawm daim teb phais nrog zoo hemostasis. Lub caij ntawm kev kho mob yog txiav txim nyob rau hauv xws li ib tug muaj nuj nqis ntawm cov tshuaj rau txhua tus neeg mob ib lub zuj zus, nyob ntawm seb cov kev pheej hmoo ntawm venous thromboembolism, complexity thiab hom ntawm cov lag luam.

Thaum lub sij hawm cov tshuaj thawj coj "Ksarelto" hip hloov (10 mg ntsiav tshuaj) kav mus txog rau 5 lub lis piam, thaum lub sij hawm lub hauv caug arthroplasty nws yog coj 14 hnub.

Yog hais tias tus neeg mob twb tsis nco qab mus haus dej haus ib koob tshuaj rivaroxaban, nws yuav tsum tau sai li sai tau noj, thiab hnub tom qab mus ntxiv cov kev kho mob, 1 ntsiav tshuaj.

Ntau dua noj tshuaj npaum cas ntawm 15 mg los sis 20 mg kuj txhob muab rau ib qho kev npliag plab.

Nyob rau hauv thiaj li yuav tiv thaiv kom txhob rau lub xeev ntawm ib tug mob stroke thiab mauj embolism cim uas tsis-valvular atrial fibrillation ntuj atrial lub plawv siv ib ntsiav tshuaj txhaj koob tshuaj ntawm 20 mg ib zaug ib hnub twg.

Nyob rau hauv lub raum tsis ua hauj lwm, thaum tus nqi ntawm creatinine tshem tawm ib nrab-lub neej ntawm tsawg tshaj li 30 ml rau 1 feeb, siv ib koob tshuaj 15 mg 1 lub sij hawm ib hnub.

Lub caij ntawm kev kho mob nyob rau hauv lub xub ntiag ntawm kev hem thawj ntawm Stroke thiab thromboembolism xeev systematic.

Qhov siab tshaj plaws tolerable hnub ntau npaum yuav tsum tsis txhob yuav ntau tshaj 20 mg rivaroxaban.

Thrombosis, sib sib zog nqus cov hlab ntsha rau, rau kev tiv thaiv ntawm kev rov muaj dua ntawm tus kab mob thiab thromboembolic rau lub pulmonary leeg, siv ib tug thawj zaug koob tshuaj ntawm 15 mg ib hnub ob zaug thaum lub sij hawm thawj peb lub lis piam. Tom qab koj tsiv mus ntsiav tshuaj ntawm 20 mg rivaroxaban ib zaug ib hnub twg rau ib tug ntev-lub sij hawm kev kho mob thiab kev tiv thaiv ntawm re-thrombosis thiab recurrent pulmonary embolism.

Nws tsis yog ib txwm tau mus cov neeg mob yuav nqos tag nrho cov ntsiav tshuaj, tshwj xeeb tshaj yog ib tug loj loj, ces nws yog tau tso cai rau kev sib tsoo thiab nws nrog cov dej ntshiab los yog ib tug kua zaub mov ua ntej noj. Tam sim ntawd tom qab noj cov tshuaj tus neeg mob yuav tsum tau noj.

Nws yog tseem tau mus ua kom paub cov crushed tshuaj los ntawm gavage, txoj hauj lwm uas nyob rau hauv lub digestive system yog hauj lwm ua ke nyob rau hauv ua ntej nrog koj tus kws kho mob. Cov ntsiab lus uas ua crushed ntsiav tshuaj nyob rau hauv no txoj kev muaj nyob rau hauv nws cov tshuaj nrog ib tug me me npaum li cas ntawm cov dej thiab tom ntej mus saib xyuas. Tom qab uas yog lawm ua tus sau nrog ib tug me ntsis dej kom tshem tawm cov tshuaj residues los ntawm cov kev sojntsuam. Tom qab noj tshuaj tsim nyog los nqa tawm lub enteral noj kom tsawg.

Tus nqi ntawm cov tshuaj "Ksarelto"

Qhov cuab yeej no siv rau mas cov tshuaj uas muaj nqi. Piv txwv li, cov tshuaj "Ksarelto" nqi ntawm qhov tsawg tshaj plaws koob yuav nyob rau hauv 56 pellets ntawm txog 950 rubles. Nws yog ntau ntau kim tshaj nws cov Lavxias teb sab analogue - tshuaj "warfarin". Nyob rau hauv cov tshuaj "Ksarelto" nqi nce nyob rau qhov kev nce rau hauv ntau npaum. Yog li, tus nqi 14 ntsiav tshuaj ntawm 15 mg rivaroxaban yuav txog 850 rubles, thaum lub sij hawm packing (28 daim ntawm cov ntsiav tshuaj) nrog lub siab tshaj plaws tshuaj (20 mg thawj xib fwb active ingredient) yuav them 1450 rubles.