"Atsekardol": zikuonetsa ntchito, malangizo, ndemanga, analogs

Mwa njira ya mankhwala antiplatelet, amene ntchito kupewa zochitika pachimake mtima kalekale tingafunse acetylsalicylic asidi (ASA). Apanga mu 1887, zaka zoposa 125 lakhala likugwiritsidwa ntchito mwakhama zochiritsira m'mwamba antiplatelet ndi antipyretic. Ndipo ngati mankhwala mankhwala yogwira zili m'gulu la "Atsekardol" lokonzekera, zikuonetsa zomwe pang'onopang'ono anawonjezera monga kuphunzira njira tizilombo matenda.

System khalidwe medicament

The yogwira thunthu kukonzekera monga gulu ikugwilizirana ndi njira popewa loitanirana. Zino wa ACK ndi kothandiza kwambiri mipweya angathe zosatheka kwathunthu kupereka kupatsidwa zinthu za m'mwazi loitanirana lonse dziwe. Kuyerekeza mankhwala "Atsekardol", zikuonetsa ntchito, ndipo analogs ake mlingo mawonekedwe mwa mawu a pharmacodynamics, anawulula zotsatirazi:

• yogwira pophika ake - ASA mediating zotsatira antithrombotic pa atherosclerosis a mitsempha maziko;

• optimally dosed mankhwala chifukwa kupewa matenda a mtima;

• mlingo mawonekedwe ake minimizes zotsatira gastrotoxicity ASA;

• Kukonzekera kwambiri angakwanitse mwa kupikisana mankhwala dzuwa zofanana.

Zotsatira kuteteza thrombosis ASA anafotokoza anatseka misewu mapangidwe prostanoids. Chifukwa chopinga a Cox-1 - kupatsidwa zinthu za m'mwazi Cyclooxygenase-1 - kusokonezedwa kuyambitsa thrombus mapangidwe chinthu - ndi loitanirana cha othandiza magazi kuundana magazi. Chopinga amapezeka mapangidwe thromboxane A2, nkuyamba ndondomeko za ubwenzi wa othandiza magazi kuundana kuti gawo kuonongeka kwa mpanda chotengera.

Chowaloleza ndi mapangidwe gastrotoxicity

Chandamale zikuonetsa kuti "Atsekardola" monga kupewa thrombus mapangidwe. Komabe, ASA, ndi yogwira pophika mankhwala, pali zotsatira osafunika kugwirizana ndi cyclooxygenase nonselective. Komanso kusokonezedwa reconstitution maselo zaminyewa pa mundawo muzituluka. Kukhala pansi pa chikoka cha aukali malo acidic m'mimba, iwo zambiri kuonongeka, zomwe zimabweretsa chitukuko cha matenda kutupa gastral. Nthawi zina (za 3.5% milandu onse) kuti amakwiya magazi kapepala kakuti m'mimba.

Pakuti chiphunzitso, zomwe amagwiritsa "Atsekardol" zikuonetsa ntchito zambiri ndipo anthu ambiri chifukwa cha chitetezo wamkulu. Amasungunula ndipo odzipereka okha 12 duodenum, woimira enteric kardioformu ASA. kukhudzana ake ndi maselo a m'mimba ndi pafupifupi inathetsedwa, potero imathetsa mbali zotsatira zake gastrotoxicity. Local sichikupindulitsani zotsatira "Atsekardola" ndi sanamvere, chifukwa mankhwala ndi mu mawonekedwe a enteric takambiranazi, ngati woletsa kusankha Cox-1. Ngakhale Cox-2 chopinga komanso chikuchitika mu intestine, amene sitingachisonyeze kuwonongeka kwambiri.

Zimakhudzanso zofunika za mlingo mawonekedwe "Atsekardola" ndi mwachindunji m'dera kuchepetsa gastrotoxicity. Chifukwa kukhalapo kwa mankhwala ochotsa asidi mu mawonekedwe a mankhwala enaake a hydroxide Mwina kuwonongeka chapamimba amachepetsa ngakhale apamwamba. Ndipo panthawi pa msika pharmacological la Chitaganya cha Russia "Atsekardol" ali mmodzi wa ndalama zitatu ndi katundu izi. Otsalira kwambiri angakwanitse mwa zofanana, izo oyenereradi ntchito mpaka kalekale.

Place "Atsekardola" mu mankhwala antithrombotic

ASA kwa prophylaxis zodabwitsa thrombotic umagwiritsidwa zochokera kuchuluka kwa maphunziro matenda. Iwo anatsimikizira nchito zake kuchepetsa imfa wodwala matenda a mtima. Makamaka:

• FUNSANI 16% yafupika imfa pakati pa anthu odwala pa mkulu mtima gulu chiopsezo:

• kuchepetsa 25% mu zochitika za sitiroko ischemic;

• 25% amachepetsa chiopsezo thromboembolism, mtsempha wamagazi m'mapapo mwanga ndipo nthambi zake;

• 29% amachepetsa imabwera symptomatic venous thrombosis a mafupa a chiuno yaing'ono kapena malekezero;

• kuchepetsa 33% mu zochitika za infarction m'mnyewa wamtima.

Izi zotsatira ndipo amapereka zonse mankhwala "Atsekardol" zikuonetsa kuti zomwe pang'ono onse kuposa ASA zheludochnorastvorimoy. Ndipo tsopano mphamvu ya kanthu antithrombotic mankhwala atsopano antiplatelet ndi imawunikidwa yekha poyerekeza ndi iye. Motero, "Atsekardol" monga otetezeka, ayenera zimakhala pakati penipeni pa matenda prophylactic odwala malinga ndi umboni.

odwala chimadalira ndi zizindikiro ntchito

Pokonzekera "Atsekardol" zikuonetsa ntchito, mtengo, moyenerera ndiponso mavuto pogwiritsa ntchito optimally moyenera. Zimenezi zimathandiza kuti kutenga ASA mu mlingo mawonekedwe osiyanasiyana waukulu odwala ndi zinthu occlusive chiopsezo. Ndi kuwonongedwa ambiri mavuto a zimayambitsa mankhwala milandu zotsatirazi:

• (ACS) pachimake inatsekeratu syndromes ndi kukwezedwa, maganizo kapena labwinobwino cha ku Switzerland imeneyi pa ECG;

• matenda pachimake oziziritsa (oziziritsa) kufalitsidwa (ADCC);

• chosakhalitsa (ubongo) ischemic kuukira (TIA);

• asamuka pansi matenda amenewa kuteteza milandu kobwereza;

• ndi khola angina pectoris kwa kupewa ACS;

• ndi paroxysm kapena mawonekedwe mpaka kalekale fibrillation matenda;

• venous varicose mitsempha.

Pathogenetic substantiation ntchito "Atsekardola"

Izi zikuonetsa kuti "Atsekardola" chifukwa zotsatira matenda a mankhwala. Iwo bwino ntchito ngati njira yopewera thrombosis wolumikizira pa malo malire ndi concentric mipukutuyi atherosclerotic. Kumalo amenewa chifukwa kuchepetsa akulowera wolumikizira magazi akusokoneza kupanga otaya mmene kanyamaka magazi. Mawotchi kuthamanga pa mbali thinned wa endothelium amatsogolera kukolowola ake. dongosolo magazi coagulation amazindikira dziko lino monga kuphwanya umphumphu mtima, chimene chimafuna makina kutseka othandiza magazi kuundana kupanga aumirira.

Ubwenzi wa maselo othandiza magazi kuundana ndi, gawo koyamba thrombus mapangidwe, pa akamaliza amene ayenera kupanga chimango tsogolo la nthinthi magazi. Kenako, kukula kwake kumawonjezera chifukwa akuchedwa maselo magazi. Full akamaliza njira hemostasis kumam'phunzitsa munthu aakulu (kuposa 75 m'dera%) kuchepetsa wa lumen chotengera. Nthawi zambiri ngakhale chimakwirira magazi mu mtsempha wamagazi, ndi malo omwe kale kudyetsedwa zinachitikira ischemia ake. ndondomeko maziko a ACS ndi opuwalitsa ziwalo, choncho kupewa zinthu zimenezi n'kofunika kwambiri kuti kuchepetsa imfa za munthu ku mtima ndi brachiocephalic mitsempha atherosclerotic.

Pharmacodynamics antithrombotic kanthu "Atsekardola"

Mayina mankhwala "Atsekardol" malangizo Buku (ofotokoza za mankhwala) susonyeza zotsatira zake pharmacodynamic, ndipo limafotokoza mawu a kuwerenga ndi phwando mbali. Komabe, sakufotokoza zotsatira zenizeni za ASA, potero kuwamana moleza mtima zinthu zofunika zokhudza limagwirira ntchito mwakhama. ma aligorivimu ake yotsatana ali motere:

• chopinga a Cox-1 ndi kutha kwa kaphatikizidwe prostanoids;

• kubala sizingasinthe anatseka misewu ya kupatsidwa zinthu za m'mwazi thromboxane A2;

• chopinga kupatsidwa zinthu za m'mwazi ubwenzi ndi zilema wa endothelium ya;

• chopinga njira kupatsidwa zinthu za m'mwazi guluu wolimba;

• ndikosatheka n'kupanga thrombus occluding ndi wolumikizira lumen.

"Atsekardol" zinthu pachimake

Komanso Ufumuyo mankhwala "Atsekardol" malangizo ntchito (mwachidule kulongosola) sasamalira zambiri kwa wodwalayo zokhuza kuthekera ntchito pa nthawi ya kudwala matenda pachimake cha magazi mu mtima kapena ubongo. Makamaka, ndi chitukuko cha matenda syndrome khalidwe la m'mnyewa wamtima kapena oziziritsa infarction, ndipo angagwiritsidwe ntchito ASA.

Mapiritsi ayenera kutafuna mankhwala (pa mlingo wa 150-300 mg) osati kumeza. Ngati wodwalayo ndi mankhwala mlingo wa 50 mg, nthawi chikhalidwe pachimake amafuna onse 3-6 mapiritsi kutafuna pamene mlingo wa 100 mg, miyala 2-3 pamene 300 mg, ndi piritsi 1. Ndi chida mwadzidzidzi, imene yafupika imabwera thrombosis aakulu mtima.

Contraindications ntchito "Atsekardola"

Pokonzekera "Atsekardol" (mapiritsi) malangizo ntchito, akatswiri weniweni ndi deta mankhwala kafukufuku atsimikizire bwino kuopsa ndi ubwino wa ntchito. Komabe, contraindications chifukwa comorbidities Pamafunika ankaona pamene mukumwa mankhwala ndi kukaonana ndi katswiri. Contraindications anawagawa zonse (mtheradi) ndi nthawi. Chenicheni:

• tsankho mankhwala kuti ASA, bronchoconstriction;

• intracranial hematoma malo osiyana;

• hemorrhagic vasculitis ;

• Ndi zoletsedwa ntchito achinyamata ndi ana chifukwa ngozi ya matenda Reye ndi ;

• Ndi zoletsedwa kuvomereza akazi pa mkaka wa m'mawere, mu Ine ndi III trimester mimba.

Komanso penapake okha phwando nthawi ndi contraindications wachibale:

• hepatocellular ndi kulephera aimpso;

• kukhalapo kwa magazi ankatero oyambirira postoperative nthawi (zosakhalitsa contraindication);

• oopsa pa nthawi ya mavuto, kusalankhula oopsa;

• chilonda 12 mmatumbo chilonda kapena chapamimba exacerbation (nthawi malire).

Zotsatira angapo "Atsekardola"

Kuwonjezera zotsatira muyezo komanso kuphunzira chifukwa cha chopinga a Cox ndi ACK alipo ndi zochita wina. Zinawululidwa mu mndandanda wa maphunziro zowerengera khansa ndi malo geriatric mu US. M'kupita kwa anasonyeza mmene zabwino ASA chifukwa kupewa matenda oopsa - colorectal khansa osiyana localizations.

Tsopano timasonyeza limagwirira enieni kanthu poteteza mankhwala. Ofufuza kwambiri ndi clinicians kugwirizana pa predominance cha mphamvu ochepetsera a Cox-2 intestine m'munsi. Inhibiting kaphatikizidwe wa prostaglandin E2, ACK amalola chongopeka zonse m'chiwonongeko ndi kubalana maselo. Mwa njira, ichi ndondomeko makamaka ma ndiye pakatikati pa chitukuko cha chotupa.

Kutsiliza pa maziko a mfundo kutsimikiziridwa ndi awa: mankhwala "Atsekardol" malangizo, ntchito, akatswiri weniweni umene kutsimikizira zotsatira zake moyenera, akhoza kugwiritsidwa ntchito ngati prophylactic kwa kupewa njira chotupa mu magawo m'munsi pa mundawo m'mimba. Mkati 5-12 zaka kulandira yafupika chiopsezo imfa khansa yomwe mwachibadwa kumawonjezera utali wamoyo. Komabe ACK sangathe ntchito zochizira kale colorectal adenoma kapena carcinoma intestine.

Analogs kukonzekera ndi njira zina

makhalidwe mankhwala "Atsekardol": ntchito, wosuta, analogs, zikuonetsa mankhwala antithrombotic mukhoza ntchito pofuna kuchiza osiyanasiyana odwala. Komabe, pa nkhani wothandizila antiplatelet, iye si njira yokha. Mu Russia pali pafupifupi 20 generic ACK, limene mbali opangidwa mu mawonekedwe zheludochnorastvorimoy. Iwo concede ndi sipekitiramu chitetezo "Atsekardolu".

mitundu Enteric wa ASA ( "Cardiomagnyl", "Polokard") anasonyeza pa msika pharmacological, mtengo apamwamba kwambiri. Kukonzekera "Atsekardol" mtengo mwezi mankhwala 25 rubles. Kwathunthu zofanana ndi Akhristu mu uthunthu wofanana wa chitetezo ndi kulandilidwa ndi mphambu ziwili kwambiri. mankhwala achilendo palimodzi di- kapena kasanu kuposa mtengo wa chithandizo cha bajeti sichithandiza zikuoneka kuti wodwalayo polandira "Atsekardol". Malangizo ntchito, mankhwala, ndemanga, mfundo zochokera analogs za mankhwala komanso zofanana.

Mawuwo za ubwino ndi mavuto a analogues "Atsekardola"

Anakhalabe kwambiri angakwanitse, mankhwala "Atsekardol" complies kwathunthu ndi zofunikira za clinicians. Chiopsezo ntchito yake ndi moyenera ndi ntchito ofunsira othandiza monga nthumwi antiplatelet. Mogwira chindiletsa thrombosis kobwereza mtima ndi magazi zotengera za ubongo, ntchito fibrillation matenda, ntchito kwa mitsempha varicose. Ndipo poyerekeza ndi analogs dera ntchito "Atsekardola" ndi chodya.

Zimenezi kwambiri kumawonjezera kufunika kwa "Atsekardol" mankhwala: mtengo wa mankhwala ndi zoposa 20 rubles. Ichi ndithu zosakwana mtengo wa atumiki antiplatelet. Komanso, mwa mankhwala ASA opangidwa mu otetezedwa kwambiri mawonekedwe enteric, ndicho monga otsika moyenera "Atsekardol". Mwachibadwa, adalipo kuti zochizira matenda tatchulazi, ndi kupewa awo. madera angapo ntchito pang'onopang'ono kuonjezera.