Mankhwala a Wessel Duet F

Matenda a mtima masiku ano amapanga imodzi mwa matenda owopsa kwambiri. Gulu lawo langozi likukula chaka chilichonse, kuphatikiza achichepere ndi achinyamata ambiri. Ichi ndichifukwa chake mankhwala omwe amagwiritsidwa ntchito kukonza zinthu zoopsa zomwe zimakhudzana ndi zovuta zamitsempha yamagazi ayenera kukhala amtundu wapamwamba kwambiri komanso ogwira ntchito. Kupatula apo, thanzi, komanso nthawi zina moyo wa wodwala, zimadalira kwathunthu izi. Ambiri amaona kuti ndizomveka kumwa mankhwala a Wessel Douay F. Malangizo ogwiritsira ntchito, ndemanga, analogi ndi mawonekedwe a mankhwalawa ndizomwe zidzachitike pankhaniyi. Kuganizira za mfundo zoterezi kumathandizadi kusankha bwino.

Kufotokozera kwa mankhwala "Wessel Duet F": malangizo, ntchito, kugwiritsa ntchito

Chofunikira chachikulu cha mankhwala chomwe chikufunsidwa chinali mankhwala a sulodexide. Zowonjezera zomwe zimawonetsetsa kuti mankhwalawa agwira bwino ndi silicon dioxide, sodium lauryl sarcosinate ndi triglycerides.

Mankhwalawa angathe kugulidwa m'mitundu iwiri yokha: makapisozi ndi jakisoni. Makapisozi a Gelatin ndi ofiira. Chotengera chilichonse chokhala ndi matuza awiri, chilichonse chimakhala ndi makapu makumi awiri ndi asanu. Njira yothetsera jakisoni imakhala yotuwa ndipo imapezeka m'mililita iwiri.

Akatswiri amapereka kuyesa kosagwirizana ndi chida cha Wessel Douay F. Ndemanga ya madotolo omwe akupezekapo akuwonetsa kuwoneka kozizwitsa kwa mankhwalawa polimbana ndi macroangiopathy ndi thrombosis. Komanso, mankhwalawa omwe amawaganizira adalandira ndemanga zabwino pamankhwala azovuta zamatenda omwe ali ndi odwala omwe ali ndi matenda a shuga.

Amayi oyembekezera omwe amapereka mankhwala omwe amafunsidwawo ayenera kukhala ndi chidziwitso chonse pa mankhwala a Wessel chifukwa F. Ndemanga za kugwiritsidwa ntchito kwa mankhwalawa panthawi yakubala kwa mwana kumawonetsa chitetezo cha mankhwalawa kwa mayi komanso mwana. Zotsatira zoyipa zimatha kuchitika pokhapokha ngati mankhwalawo sagwiritsidwa ntchito molingana ndi chiwembu chokhazikitsidwa ndi katswiri waluso.

Mfundo za mankhwalawa

Mankhwala omwe amafunsidwa ali ndi zotsatirazi mthupi la munthu: anticoagulant, antithrombotic, angioprotective, profibrinolytic. Komabe, nthawi zambiri, mankhwalawa amagwiritsidwa ntchito ngati anticoagulant mwachindunji.

Mphamvu ya anticoagulant yamankhwala imadziwonekera yokha mkati mwa kupangika kwa magazi.

Mphamvu ya angioprotective, yomwe imaperekedwanso ndi mankhwalawo, imachitika chifukwa cha kubwezeretsa kofunikira kwa magetsi a kachulukidwe (kokhala ndi chizindikiro)

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amagwiritsidwa ntchito pazochitika zotsatirazi: vuto la kuchepa kwa magazi m'mimba, thrombosis, matenda a thrombotic thrombocytopenia, microangiopathy, matenda am'magazi, matenda am'mimba, antiphospholipid syndrome, mikhalidwe yomwe imayambitsa matenda a shuga mellitus (cardiopathy, encephalopathy, ndi shuga).

Zomwe zimagwiritsidwa ntchito komanso kuchuluka kwa mankhwala

Kumayambiriro kwa mankhwalawa (nthawi zambiri masabata awiri kapena atatu a mankhwalawa), mankhwalawa amaperekedwa ndi kholo. Itha kukhala jakisoni wamkati ndi wamitsempha.

Njira yothandizira jakisoni yakonzedwa motere. Ndikofunikira kupukusira mamililita awiri a mankhwalawa mumililita mazana awiri a mchere.

Maphunzirowa atatha ndi chithandizo cha jakisoni atha, chingakhale chanzeru kupitiliza chithandizo ndi mapiritsi a Wessel Douay F kwa mwezi umodzi. Malangizo ogwiritsira ntchito, kuwunikira kwa mapiritsiwa kumalimbikitsidwa kuti azimwedwa kawiri pa tsiku, kamodzi. Ndikofunika kuchita izi pakati pa chakudya.

Chaka chilichonse, ndikofunikira kubwereza zamankhwala ndi Wessel Douay F kawiri. Malangizo ogwiritsira ntchito, kuwunika kwa mankhwalawa kumawonetsa kuti nthawi zina, chifukwa cha mawonekedwe ena amthupi, kupezeka kwa matenda ena oyanjana, njira iyi yogwiritsira ntchito mankhwalawa imatha kusintha. Dokotala wokha ndi amene angachite izi.

Contraindication

Sikuti aliyense angathe kugwiritsa ntchito Wessel Duet F mopanda mantha. Malangizo ogwiritsira ntchito, kuwunika kwa mankhwalawa kumapereka chithunzi chonse chokhudzana ndi contraindication pakugwiritsa ntchito mankhwalawa. Amakhala osagwirizana ndimagazi, mtima wokonda kusinthasintha, komanso kusalolera kapena kusakanikirana kwa zinthu zomwe zimagwira popanga mankhwala.

Zotsatira zoyipa za mankhwalawa

Monga mankhwala ena aliwonse, ili ndi zovuta zake komanso Wessel Dou F. Malangizo ogwiritsira ntchito amalimbikitsa kulabadira zotsatirazi zomwe zimachitika mthupi.

Chifukwa chake, nthawi zina pamakhala zotupa pakhungu ndi zovuta zina zamthupi. Pakhungu lomwe mankhwala adalowetsedwera, kumverera koopsa kapena hematoma. Nthawi zina odwala amayamba kuda nkhawa ndi mseru komanso kusanza, komanso kupweteka kwa epigastric kosiyanasiyana.

Kuti tidziwe momwe mankhwalawa angakhudzire wodwala wina, poganizira momwe thupi lake limakhalira, ndibwino kuti muphunzire ndemanga za "Wessel Dou F". Malangizo ogwiritsidwira ntchito amaperekanso chidziwitso pazochitika za mankhwalawo, zomwe zimakupatsani mwayi wolongosola kuthekera kwa kusokonezeka kwa thupi lanu.

Madokotala amawunika za Wessel duet F

Kugwiritsa ntchito kwambiri ischemia. Itha kugwiritsidwa ntchito pa matenda ashuga. Panalibe zovuta za hemorrhagic pazaka 7 zogwiritsidwa ntchito.

Kutsika mtengo pang'ono kwa odwala ambiri. Wopanga sasamala kwenikweni za kukonzanso layisensi, chifukwa chomwe mankhwalawo sanali kupezeka m'mafakitisi kwa nthawi yayitali.

Njira yothanira yolimbana ndi ischemia yodwala odwala atherosulinosis ndi matenda ashuga, makamaka ndi kuphatikiza kwa matendawa.

Nthawi zambiri ndimalemba mankhwala anga mankhwala osokoneza bongo. Imakhala ndi chothandiza mankhwalawa matenda osokoneza bongo obwera chifukwa cha kuwonongeka kwa magazi, kupangika pakulankhula, kuwonetsa kwa venous kusakwanira. Ndikupangira makamaka ndi zotupa zomwe zimatha m'mitsempha yam'munsi.

Mankhwala kusankha pa matenda a mtima matenda osiyanasiyana etiologies ndi genesis n`zotheka onse intramuscularly ndi kukhetsa ndi pakamwa.

Si ma pharmacist onse omwe ali nawo.

Njira yabwino kwambiri yothandizira, momwe mungagwiritsire ntchito mankhwalawa pambuyo pake imakupatsani mwayi wochita maphunzirowa kamodzi miyezi isanu ndi umodzi yopanda zovuta zamitsempha yamagazi, zomwe ndizofunikira, chifukwa mtengo wa mankhwalawa

Kwambiri odwala odwala m'munsi miyendo ischemia ndi matenda ashuga angiopathy. Imodzi mwa mankhwala ochepa omwe angafotokozedwe kwa mtima wamatenda omwe ali ndi matenda a shuga.

Mtengo wokwera wa mankhwalawo. Zotsatira zoyipa chifukwa cha anticoagulant katundu wa mankhwala.

Mankhwala abwino omwe amagwiritsidwa ntchito mu mawonekedwe a drip ndi piritsi mwa odwala omwe ali ndi matenda ochepa a ischemia, mawonekedwe osokoneza a kuwonongeka kwa kama wothandizira motsutsana ndi matenda osokoneza bongo.

Ndikupangira mankhwala a Wessel Dou F kwa odwala kuti magazi aziyenda bwino, makamaka ndi matenda a shuga komanso matenda amitsempha yam'munsi. Mankhwala ndi a gulu la heparin sulfates, pomwe sayambitsa kuphwanya kwamwambo magazi, ndi othandizika pa matenda a matenda ashuga oyenda ndi matenda ashuga osakhazikika.

Ndiokwera mtengo kwambiri (1800-2000), kupatsidwa ogula (nzika zapamwamba).

Ndi osavomerezeka kugwiritsa ntchito mankhwalawa odwala omwe ali ndi proliferative retinopathy (osagwiritsa ntchito odwala omwe ali ndi vuto la retinal hemorrhage). Mukufuna kuonana ndi oculist kuti muone momwe ndalama ziliri.

Mankhwala abwino kwambiri othandizira odwala matenda ambiri a mtima. Zabwino pa matenda ashuga apansi. Mwambiri, imodzi mwama mankhwala ochepa omwe amatha kutumikiridwa ndi matenda a shuga.

Nthawi zambiri, odwala amadandaula za kukwera mtengo kwa njira yonse ya mankhwala.

Mafomu otulutsidwa.

Mankhwala adziwonetsa okha kuchokera pandime yanga. Mulingo wake ndi wokwanira: onse mu ochepa matenda a m'mimba (matenda osokoneza bongo, matenda ashuga), komanso venous insuffence (post-thrombotic matenda ndi varicose mitsempha yam'munsi yokhala ndi zovuta za trophic pakhungu).

Nthawi zina limodzi ndi zovuta za hemorrhagic, kuwongolera kwa coagulogram kumafunika.

Kubwezeretsa kapangidwe ka endothelium ya kama wogona, sikumangokhudza zochitika za antithrombogenic, kumatha kukhudza kwambiri chitetezo chamthupi. Pofuna kuchepetsa kukhuthala kwa magazi, kusintha ma microcirculation kumagwiritsidwa ntchito mwa amayi apakati mu II-III trimester (mwachitsanzo, ndi gestosis).

Mwa odwala ena, zimawonjezera kwambiri mtunda wa kudalirana kwapang'onopang'ono.

kusowa kwa umboni wokwanira wogwiritsa ntchito mankhwalawa ndi ulcerogenic (pali zoopsa zokulitsa chilonda cha m'mimba ndi zilonda zam'mimba)

Ndimagwiritsa ntchito limodzi ndi lipoic acid kukonzekera (zipatso, thioctacid) mwa odwala matenda a shuga.

Zowonetsa zosiyanasiyana, zowonjezera zabwino pakama pamimba. Imakulitsa mtunda woyenda komanso wopanda ululu, umachepetsa milingo ya fibrinogen ndi triglycerides. Mbiri yabwino kwambiri yololera, palibe vuto limodzi lomwelo lomwe lidatchulidwa. Komanso kutsimikizika chitetezo cha mankhwalawa pogwiritsa ntchito nthawi yayitali. Kuphatikizidwa ndi chitsogozo cha dziko pakuwongolera odwala omwe ali ndi matenda am'munsi miyendo.

Mtengo wa mankhwalawa siabwino.

Analimbikitsa Inde mankhwala ndi mankhwalawa.

Chimodzi mwazida zochepa, kugwiritsa ntchito komwe kumatheka mwa odwala omwe ali ndi matenda ashuga, chifukwa zimayambitsa zovuta zochepa za hemorrhagic m'gulu lino la odwala. Kuphatikiza apo, mankhwalawa amagwira ntchito mwa odwala atherosulinosis, mitsempha ya varicose, thromboangiitis obliterans.

Kuperewera kwa fanizo. Chaposachedwa pomwepo chidawoneka analogue, chomwe sichinafotokozedwe m'mafesi athu.

Ndemanga za Wessel duet F

Adayamba kuthandizidwa ndi mankhwalawa pomwe impso zimayamba kulephera, creatinines adapita pamlingo, urea anali wokwera. Analandira chithandizo chamankhwala miyezi isanu ndi umodzi iliyonse. Pambuyo pa chithandizo, zidakhala zosavuta, mayesowo adayamba kuyenda bwino, kumverera kwa miyendo kudadzuka, kupweteka kwa mutu kudachepera. Aliyense amene ali ndi matenda osachiritsika amathandiza kwambiri, magazi a mkaka, magazi amayamba kuzungulira kulikonse komwe akufunika, osati pokhapokha ngati angathe. Pali ma ampoules ndi mapiritsi, osagwirizana.

Anatenga Wessel Douay F pa nthawi yomwe akukonzekera kukhala pakati komanso panthawi yophunzira malinga ndi zoopsa chifukwa cha chiwopsezo chachikulu cha thrombophilia. Mankhwalawa ndi anticoagulant, mwakulankhula kwina, amachepetsa magazi ndikuwatchinjiriza ndi thrombosis. Mlingo anali osiyanasiyana piritsi 1 mpaka 6 patsiku, kutengera mayeso apamwezi. Monga machitidwe awonetsera, mankhwalawa ndi othandiza. Ilibe fanizo. Zoyipa za mankhwalawa zimaphatikizapo mtengo wake wokwera.

"Wessel Dou F" adasankhidwa ndi hematologist pambuyo pakupambana bwino kwambiri pochita komanso kuyesera kuchepetsa coagulogram, makamaka d-dimer, pakubala koyambirira. Akatswiri azachipatala amathandizira mosiyanasiyana, wina amalipira chidwi, wina osati kwenikweni. Ndinaganiza zosewera bwino komanso kulandira upangiri kuchokera kwa katswiri waluso kwambiri. Poyamba, jakisoni wa Fraxiparin adayesedwa. Ndikuganiza chifukwa choyambirira trimester ili mu zoletsa zovomerezeka. Koma pa jakisoni, d-dimer imayamba kugwa pang'onopang'ono, ndipo nthawi zina nthawi zambiri imakhala "m'malo". Zonse zidatha mwezi ndi theka. Tidaganiza zoyesa mankhwalawa ndipo, pah pah, coagulogram idayamba kukonza. Komabe, kuwerengera kwamankhwala awiri onsewo, komwe cholinga chake ndi kukwaniritsa cholinga chimodzi, kungakhale ndi zotsatira. Osotsika mtengo, koma ngati moyo wa munthu wachichepere umadalira iye, ndalama, sichoncho chisoni.

Ndinatenga Wessel Douai F pa nthawi yoyembekezera. Sabata 20, wowerengeka adawonetsa kuti mwana akusowa oxygen ndipo adotolo adandiwuza ine mankhwalawa. Ndinkamwa maphunzirowa kwa milungu itatu, ndinadutsa mayeso a d-dimer, ndikuwonjezera doppler ndipo kusanthula kunawonetsa kuti zonse zabwerera mwanzeru. Chokhacho ndikuti mtengo sotsika mtengo kwa mankhwalawa, koma ogwira ntchito.

Kufotokozera kwapfupi

Mankhwala achizungu ochokera ku Italy omwe amakonda kwambiri dzina loti "Wessel duet F" ndi zinthu zachilengedwe zomwe zimachokera ku mucous membrane wamatumbo a nkhumba. Uku ndikusakaniza kwachilengedwe kwa mucopolysaccharides, 80% yomwe ndi kachigawo kama heparin, ndipo 20% yotsalayo ndi dermatan sulfate. Mphamvu ya mankhwalawa ya mankhwalawa (ndi dzina lakunja losakhala ladziko lapansi limamveka ngati sulodexin) imakhala yokhudzana ndi magazi ndi mitsempha yamagazi ndipo imayamba ndikumangirira mwachidule profibrinolytic (kuthekera kwa kuwononga fibrin, womwe ndi maziko a magazi), antithrombotic (zonse zili zomveka apa), angioprotective (kutsitsa kutsika kwa makoma mitsempha yamagazi) ndi anticoagulant (zoletsa magazi kuundana). Gawo lokhala ngati heparin lokhala ngati liwiro limadyetsa "kukhudzika" kwa antithrombin III, ndipo kachigawo kamene kamakhala ndi mgwirizano wa cofactor heparin II, yomwe "imatulutsa" chinthu chofunikira kwambiri mu dongosolo la kuphatikiza magazi - thrombin. Mwachidule, iyi ndi njira ya zochita za anticoagulant za Wessel dué F. Mphamvu yake ya antithrombotic imayamba chifukwa cha kukhazikitsidwa kwa mapangidwe ndi kumasulidwa kwa prostacyclin (PGI2), kuchepa kwa kuchuluka kwa fibrinogen m'magazi, kuletsa kwa activated X factor, etc. The profibrinolytic zotsatira za Wessel duet F chifukwa kuwonjezeka kwa magazi am'magazi a plasminogen - kutsogolera kwa minofu ya plasmin activator, komanso kuchepa kwamtundu womwewo pamlingo wake wa inhibitor.

The angioprotective zotsatira za mankhwala tichipeza kukonzanso morphological ndi magwiridwe antchito endothelial mtima maselo, matenda a milandu zoipa pores a basal mtima nembanemba.Kuphatikiza apo, pali kusintha kwa kayendedwe ka magazi chifukwa chakuchepa kwa zomwe zimachitika m'matumbo a triglycerides (mankhwalawa amathandizira enzyme lipoprotein lipase, yomwe imaphwanya ma triglycerides omwe amapanga cholesterol "yoyipa"). Chifukwa chokomera bedi lamitsempha, mankhwalawa amapezeka m'matenda osiyanasiyana amitsempha yamagazi a matenda amtundu uliwonse, mavuto a magazi, kuphatikiza chifukwa cha matenda ashuga.

Wessel duet F imapezeka m'mitundu iwiri: makapisozi ndi yankho la jakisoni. Njira yothetsera vutoli imayendetsedwa onse mu intramuscularly komanso kudzera mu mtsempha (kumapeto, pamodzi ndi 150-200 ml ya saline). Kumayambiriro kwa mankhwalawa, mankhwalawa 1 amagwiritsidwa ntchito tsiku lililonse kwa masiku 15- 20, ndiye kuti kusintha kwa kamwa kumachitika ndi pafupipafupi masiku 2 pa tsiku, kapisozi imodzi pakati pakudya kwa masiku 30 mpaka 40. Njira yonse ya chithandizo iyenera kubwerezedwa kawiri pachaka. Dokotala wothandizapo angathe, mwakuwona kwake, asinthe mtundu wa mankhwalawo.

Kutulutsa Fomu

Makapisozi ndi yankho.

Makapisozi ofiira, a galatinous, ofiira owuma mkati amakhala ndi kuyimitsidwa koyera (imvi yowonjezera ya kirimu wa pinki ndiyotheka).

Phukusi la makatoni pamakhala matuza awiri (makapu 25 aliwonse).

Yankho lomveka bwino ndi chikasu chachikasu kapena chopepuka cha 2 ml ampoules.

Mu paketi ambiri makatoni 1 kapena 2 amtundu (ma ampoules asanu aliyense).

Zotsatira za pharmacological

Direct anticoagulant.Chosakaniza chophatikizika ndi gawo lachilengedwe la Sulodexide, yopatulidwa ndikuchokera ku mucous membrane wamatumbo ang'onoang'ono a nkhumba.

Gawo lothandizali limapangidwa ndi glycosaminoglycans: dermatan sulfate ndi kachigawo kama heparin.

Mankhwala ali ndi zotsatirazi:

• angioprotective
• anticoagulant
• profibrinolytic,
• antithrombotic.

Mphamvu ya anticoagulant kuwonetsedwa chifukwa cha kuphatikizana kwa heparin mu cofactor-2, mothandizidwa ndi kuphatikizika kwa thrombus.

Zotsatira za antithrombotic imawonjezera kubisalira ndi kaphatikizidwe ka prostacyclin, kutsutsana ndi gawo la X, kuchepa kwa fibrinogen m'magazi.

Mphamvu ya Profibrinolytic kukwaniritsidwa mwa kuchepetsa mulingo wa minofu ya plasminogen activator inhibitor ndikuwonjezera chisonyezo cha woyambitsa m'magazi.

Angioprotective zotsatira Amagwirizananso ndi kubwezeretsanso kwa kachulukidwe kake ka magetsi osokoneza bongo a pores. Kuphatikiza apo, zotsatira zake zimatsimikiziridwa ndikubwezeretsanso umphumphu wa maselo endothelial maselo (magwiridwe antchito komanso mawonekedwe).

Wessel Douai F amachepetsa mulingo triglycerideskukonza magawo a magazi. Chosakaniza chophatikizacho chimatha kugwedeza lipoprotease (enzyme yapadera ya lipolytic) yomwe ma hydrolyzes triglycerides omwe ali m'gulu la "zoyipa" cholesterol.

At matenda ashuga nephropathy yogwira Sulodexide amachepetsa kupanga kwa masanjidwe amkatikati mwa kuletsa kuchuluka kwa maseloum mesumum, amachepetsa makulidwe apansi apansi.

Pharmacodynamics ndi pharmacokinetics

Mankhwala amaphatikizidwa mu aimpso ndi chiwindi. Zomwe zimagwiritsidwa ntchito sizikuwonongeka, mosiyana ndi mitundu yamagetsi otsika heparin ndi heparin wosakhudzidwa.

Kusindikiza kumalepheretsa ntchito ya antithrombotic ndipo imathandizira kwambiri njira yochotsera thupi.

Gawo lolimbikira limadziwitsidwa mu lumen yamatumbo ang'ono. 90% ya yogwira chinthu imalowetsedwa ndi mtima endothelium. Maola 4 atalandila, Sulodexide imachotsedwa kudzera mu impso.

Vesel Douai, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

M'masiku oyamba 15 mpaka 15, mankhwalawa amaperekedwa kwa kholo. Jakisoni wamkati ndi mu mnofu amaloledwa. Intravenous makonzedwe akhoza kukhala kukapanda kuleka kapena bolus.

Chiwembu: 2 ml (600 LU - 1 ml) zamkati mwa ampoule zimasungunuka mu saline yachilengedwe yokhala ndi 200 ml. Akamaliza jakisoni wa jekeseni, amasinthana ndi kumwa mankhwalawo kwa masiku 30 mpaka 40. Kawiri pa tsiku, 1 kapisozi. Nthawi yomwe akukonda ili pakati pa chakudya.

Ndikulimbikitsidwa kutenga maphunziro a 2 pachaka. Malangizo a Vesel Dou F ali ndi chidziwitso cha kusintha kwa njira yomwe ili pamwambapa poganizira machitidwe a munthu, kulekerera, ndi matenda ena oyanjana.

Malangizo apadera

Kuchiza pamafunika kuwongolera kuzisonyezo zonse za kusanthula magazi magazi (antithrombin-2, APTT, nthawi ya kusokonekera, nthawi yakukha magazi).

Mankhwala amatha kuonjezera APTT poyerekeza ndi nthawi yoyamba ndi theka. Mankhwalawa samakhudza kuyendetsa galimoto.

Wessel Douai F pa nthawi yoyembekezera (mkaka wa m'mawere)

Mankhwala sangathe kutumikiridwa mu trimester yoyamba ya kutenga pakati. Mabuku azachipatala amafotokoza zabwino zomwe adakumana nazo. sulodexide azimayi oyembekezera omwe ali ndi mtundu wa matenda a shuga I amandulutsira mu 2 ndi 3 trimesters kuteteza matenda a mtima komanso nthawi yolembetsa mochedwa toxicosis pa mimba.

Mankhwalawa amatha kugwiritsidwa ntchito mu 2nd ndi 3 trimesters moyang'aniridwa ndi adotolo komanso mwachilolezo chaopetera-gynecologist, opaleshoni ya mtima.

Chitetezo cha Wessel Douai F cha kuyamwa sapezeka m'mabuku oyenera.

Wessel Douay F Ndemanga

Ndemanga za madotolo zimatsimikizira kukwera kwakukulu kwa mankhwalawa pochiza matenda a thrombosis ndi macroangiopathy. Mankhwala adziwonetsa okha muzochizira zamitsempha yama mtima kwa odwala omwe ali ndi matenda ashuga.

Ndemanga pa Wessel Duet F pa nthawi yapakati: sizimayambitsa zovuta, ngati zimagwiritsidwa ntchito mogwirizana ndi dongosolo la mankhwalawa.

Wessel Douai F - malangizo ogwiritsira ntchito

Cholinga chachikulu cha mankhwalawa ndi kupewetsa magazi m'mbale, zomwe zimalepheretsa mapangidwe a magazi. Komabe, ngati anticoagulants osalunjika apereka mphamvu yokhalitsa pogwiritsa ntchito vitamini K, mwachindunji, omwe akuphatikiza Wessel Duet, amachita heparin motero amagwira ntchito nthawi yomweyo, koma osakhalitsa. Mphindi yodziwika yankho la mapiritsi a Wessel Douai ndi mapiritsi: makonzedwe ake amakhala ndi sodeode, chomwe ndi zinthu zachilengedwe, zomwe ndi kuchuluka kwa matumbo a glycosaminoglycans omwe amapezeka m'matumbo ang'onoang'ono a nkhumba (membrane wake wa mucous).

Mitu ya mankhwalawa

Nthawi zina wodwala sangathe kugwiritsa ntchito mankhwala pazifukwa zosiyanasiyana. Chimodzi mwa izo ndi mtengo wake wokwera. Monga lamulo, ma analogi ake ali ndi mtengo wotsika kwambiri, womwe umawalola kugula mwaulere ndikupitiliza chithandizo. Zikatero, mankhwalawa amagwiritsidwa ntchito omwe amafanana ndi Wessel Douay F. Awa ndi Sulodexide ndi Angioflux.

Kupanga ndi mawonekedwe a kumasulidwa

The yogwira pophika mankhwala Wessel Douai ndi sulodexide, ndende zimatengera mtundu wa kumasulidwa. Mankhwala amapatsa ogula njira ziwiri zokha za Wessel Douai: makapisozi (omwe odwala ndi madokotala amatcha mapiritsi) ndi yankho lomwe limagwiritsidwa ntchito jakisoni (jakisoni wa mu mnofu) kapena makonzedwe amkati. Njira yothetsera vutoli imapezeka mu ampoules, iliyonse yokhala ndi voliyumu ya 2 ml, madzi amakhala omveka bwino, amtambo wachikasu. Phukusili limatha kukhala ndi ma ampoules 5 kapena 10. Iliyonse mwa iyo ili ndi magawo 600 a lipoprotein lipase a sodeodeide.

Kamangidwe ka yankho la Wessel Duet ndi motere:

mpaka 2 ml

Makapisozi amakhalanso ndi chipolopolo cha gelatin, mawonekedwe a oval ndi mtundu wofiira. Zomwe zili m'mabotolo ndi kuyimitsidwa koyera, komwe kumatha kukhala ndi pinki. Phukusi lamankhwala limakhala ndi makapu 25. Iliyonse imangokhala ndi 250 lipoprotein lipase ya sodeode, ndipo mawonekedwe athunthu amawoneka motere:

Colloidal silicon dioxide

Dioo ya red iron

Mankhwala

Mankhwalawa Wessel Duet F ali ndi mankhwala othana ndi chiwopsezo, chifukwa cha mankhwala omwe amapanga: sulodexide ndi gawo laling'ono la heparin ndi 20% yokha ya dermatan sulfate. Chifukwa cha izi, kuyanjana kwa heparin cofactor 2 kumawonedwa, komwe kumalepheretsa kutseguka kwa thrombin. Kuphatikiza apo, akatswiri amalimbikitsa mfundo zingapo:

• Kuchepa kwa kuchuluka kwa fibrinogen ndikuwonjezereka kwa kuphatikizika kwa prostacyclin kumayambitsa kupangira kwa antithrombotic kanthu.
• Sulodexide imawonjezera ndende ya plasminogen activator yothandizira ndipo nthawi yomweyo imatsitsa mulingo wa inhibitor yake, yomwe imakulitsa ma prostaglandins ndikuwona mphamvu ya Wessel Duet.
• Pankhani ya matenda ashuga nephropathy, mesangium cell prolifate, yomwe imachepetsa makulidwe am'mimba.
• Chifukwa cha kuchepa kwa ma triglycerides, magawo a magazi a magazi amapangika modabwitsa.
• Limagwirira angioprotective kanthu kubwezeretsa umphumphu wa mtima maselo endothelial maselo.

Mlingo ndi makonzedwe

Njira yapamwamba yogwirira ntchito limodzi ndi anticoagulants a mtundu uwu ndi motere: choyamba, wodwalayo amapatsidwa mankhwala osokoneza bongo (osakhalitsa - osakhazikika). Ndondomeko zimachitika kwa masabata awiri, kenako wodwalayo amamuika pakumwa mapiritsi, omwe amakhala mwezi 1-1.5. Kenako amapuma ndipo, ngati kuli kotheka, abwereza mankhwalawa chaka chilichonse patadutsa miyezi isanu ndi umodzi. Komabe, chiwembu choterechi chimagwira ntchito monga mtima wamitsempha, komanso kupewa matenda a thrombosis ndi matenda ena amitsempha amachitika m'njira yolimbikitsira.

Makapisozi a Wessel Douai F

Kuwongolera pakamwa kumachitika nthawi zonse kumachitika ola limodzi asanadye kapena 1.5-2 maola pambuyo pake, kotero kuti m'mimba mumakhala zopanda kanthu. Ndi bwino kumwa makapisozi 2 kawiri pa tsiku, mukalandira chithandizo, komanso kamodzi patsiku - ngati munthu akutenga nawo mbali kupewa matenda a mtima. Muyenera kumwa mapiritsi pa ndandanda: nthawi yomweyo. Kutalika kwa maphunzirowa kumasiyanasiyana malinga ndi cholinga cha mankhwalawa, koma sangathe kupitilira masiku 40. Mlingo muzochitika zonse - 1 kapisozi pa mlingo.

Yankho la jakisoni

Kwa jakisoni, ma ampoules amagwiritsidwa ntchito mwa mawonekedwe awo oyera, jekeseni wamitsempha. Ngati Wessel Douai angagwiritsidwe ntchito ngati dontho lokha, zomwe zili m'mapikisidwezo ziyenera kusakanizika ndi mchere (2 ml pa 150-200 ml). Ndondomeko ikuchitika kamodzi patsiku, kuthamanga kwa mtsempha wamitseko kuyenera kudziwitsidwa ndi dokotala. Mlingo wa amayi omwe ali ndi mochedwa toxicosis ndi nthawi yayitali ya mankhwala amatsimikizidwanso ndi katswiri.

Zochita Zamankhwala

Malangizo aboma sakusonyeza kusamvana pakati pa Wessel Duet ndi mankhwala ena, komabe, akatswiri samalangiza kugwiritsa ntchito anticoagulants onse osachita mwachindunji komanso mwachindunji, kapena kugwiritsa ntchito antiplatelet agents limodzi ndi sulodexide. Kuphatikiza kwa mankhwalawa kumatha kuonjezera ngozi zakugwa, makamaka mwa anthu omwe ali ndi chidwi chokwanira ndi thupi.

Wessel Douai F ndi mowa

Chifukwa cha kuchuluka kwa mankhwalawa pakukhudzana ndi magazi, madokotala amalangiza momwe angathere kupewa kumwa mankhwala omwe ali ndi zakumwa panthawi yamankhwala. Ma anticoagulants amapereka zotsatira zosayembekezereka akaphatikizidwa ndi mowa, chifukwa zimawonjezera zotsatira zawo. Malangizidwe aboma pazomwe zingachitike samanena chilichonse, choncho nkhaniyi iyenera kuthandizidwa ndi adotolo.

Zotsatira zoyipa ndi mankhwala osokoneza bongo

Ndi pakamwa pakamwa, zomwe zimachitika m'matumbo am'mimba sizimachotsedwa: odwala mu kuwunika amadandaula mseru, kupweteka m'mimba, kusanza kosowa. Pambuyo jakisoni kapena ma dontho, zotupa pakhungu ndizotheka, ndipo kwa anthu omwe ali ndi vuto lalikulu, makonzedwe amtumbo amatha kumva kuwawa, kupweteka, ndi hematomas. Mankhwala osokoneza bongo amadziwika ndi magazi kwambiri, omwe amathandizidwa ndi kuchoka kwa mankhwala kapena kulowetsedwa kwa protamine sulfate (30 mg).

Pharmacology

Wothandizira anticoagulant, heparinoid. Ili ndi antiaggregant, antithrombotic, angioprotective, hypolipidemic ndi fibrinolytic zotsatira. Zomwe zimagwiritsidwa ntchito ndizopeza kuchokera ku mucous membrane wamatumbo ang'onoang'ono a nyama, omwe ali osakanikirana mwachilengedwe cha kachigawo kakang'ono ngati heparin (80%) ndi dermatan sulfate (20%). Imapumira activation X, imathandizira kaphatikizidwe ndi katulutsidwe ka prostacyclin (prostaglandin PgI2), ndikuchepetsa ndende ya plasma fibrinogen. Amawonjezera kuchuluka kwa minofu ya profibrinolysin activator (plasminogen) m'magazi ndikuchepetsa kuchuluka kwa zoletsa zake m'magazi.

Limagwirira angioprotective kanthu limagwirizana ndi kubwezeretsa kapangidwe ndi magwiridwe mtima maselo endothelial maselo, komanso zachilendo mphamvu osagwirizana magetsi pores wa zotumphukira chapansi. Amasinthasintha magwiridwe ena a magazi mwa kuchepetsa TG komanso kuchepetsa magazi.

Kugwiritsa ntchito bwino kwa matenda ashuga nephropathy amatsimikiza ndikuchepa kwa makulidwe apansi apansi ndi kuchepa kwa kupanga matrix pochepetsa kuchuluka kwa maseloum mesangium. Iv ikaperekedwa muyezo waukulu, mphamvu yake imawonekera chifukwa cha chopinga cha heparin cofactor II.

Dongosolo la kuyanjana "Wessel Duet F" ndi mankhwala ena

Motere, mankhwalawa amafunsidwa ngati otetezeka, chifukwa palibe kuyanjana kwakukulu ndi mankhwala ena komwe kunapezeka.

Komabe, ndikofunikira kukumbukira kuti osagwirizana ndi omwe mankhwalawo angagwiritsidwe ntchito ndi mankhwala monga anticoagulants ndi antiplatelet agents.

Kugwiritsa ntchito mankhwalawa panthawi yapakati

Panthawi yobala mwana, thupi la mkazi limayamba kutengeka ndi zinthu zachilengedwe komanso mankhwala omwe mayi wofanana naye amakakamizidwa kuchiza. Mankhwala ena omwe amagwira ntchito amatha kuvulaza mwana wosabadwayo. Ichi ndichifukwa chake musanagule ndikugwiritsa ntchito malangizo "Wessel Ngenxa F", kuwunika kuyenera kuphunziridwa mosamala kuti musapeze zotsatira zoyipa.

Mankhwala omwe amafunsidwa sangaperekedwe kwa mkazi nthawi yoyamba ya pakati. Komabe, kuchokera ku trimester yachiwiri, mankhwalawa atha kutumizidwa ndi mayi wapakati moyang'aniridwa ndi omwe amapita kuchipatala, komanso dokotala wazachipatala yemwe amachititsa izi.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa, chifukwa deta yolondola pakatetezedwe kake ilipo.

Ndi motere kuti kugwiritsa ntchito mankhwala a Wessel chifukwa F kumalimbikitsidwa kwa amayi omwe ali ndiudindo. Ndemanga pa nthawi yomwe muli ndi pakati komanso munthawi yomweyo ndimalandira mankhwala omwe tafotokozawa takambirana pamwambapa.

Dongosolo lagulitsidwe ndi zofunika kuti zizisungidwa

Mankhwala omwe akufunsidwa angagulitsidwe ndi mankhwala pokhapokha ngati wogula ali ndi mankhwala olembedwa ndi adokotala.

Kukonzekera "Wessel Dou F" kukusonyeza kuti mugwiritse ntchito malangizo ogwiritsira ntchito malo amdima ndi kutentha kofunikira (kutentha sikuyenera kupitirira madigiri seshasi 30).

Kukhala ndi thanzi la mtima kungateteze matenda ambiri ndikuwonetsa moyo wautali. Zachidziwikire, kudya moyenera komanso njira yabwino yothandizirana kumatha kugwira ntchito ngati matenda a mtima komanso kusintha kamvekedwe ka minyewa, komabe, ngati vutoli lilipo kale, muyenera kusankha mankhwalawa kuti muthane ndi mavuto.Monga momwe mukuchitira pafupipafupi ndi kuwunikira makamaka kuwonetsa, mankhwala odalirika ngati amenewo ndi mankhwala omwe atchulidwa m'nkhaniyi. Magulu osiyanasiyana a mankhwalawa amapereka kutseguka kwa kayendedwe ka magazi ndi kuwongolera mavuto ena angapo omwe afotokozedwa pamwambapa. Kugwiritsa ntchito mankhwalawa kufunsidwa, poganizira pulogalamu yomwe madokotala amapita, yomwe imaganizira mawonekedwe onse a wodwalayo, kuphatikizapo kupezeka kwa matenda opatsirana, imatsimikizira kukula kwa mkhalidwe wabwino wodwalayo.

Osanyalanyaza thanzi lanu kapena kusunga pa iwo, kugwiritsa ntchito zotsika mtengo, komanso nthawi yomweyo, mankhwala otsika mtengo. Kupatula apo, moyo ndiye chinthu chamtengo wapatali kwambiri chomwe munthu amakhala nacho. Simungamuchitire zachipongwe. Khalani athanzi nthawi zonse!

Migwirizano yogulitsa ndikusunga

Wessel Douai amatha kumasulidwa ku pharmacy ngati wodwala atalandira mankhwala kuchokera kwa dokotala. Kutalika kwakusungidwa pansi pa magawo onse (malo amdima, kutentha pansi pa madigiri 30) kukhoza kukhala zaka 5 kuyambira tsiku lamankhwala. Malo otseguka a Wessel Duet ayenera kugwiritsidwa ntchito nthawi yomweyo - kusungidwa kwa yankho lomwe lakumana ndi mpweya sikuloledwa.

Pali zolowa m'malo ochepa a Wessel Douai - Angioflux okha ndi omwe amagwiritsa ntchito sulodexide mofananamo, zomwe sizimasiyana pamtengo wotsika (2200-2400 rubles pakompyuta ya makapisozi). Ngati tilingalira mndandanda wanthawi zonse wa ma antiicoagulants ochokera ku ma cell ochepa heparin, omwe pali ndemanga zabwino za madokotala, ndiye titha kutchula:

Mtengo Wessel Douai F

M'mafakitala aku Moscow, mankhwalawa amapezeka m'mitundu yonse iwiri, mtengo uliwonse umayambira 1800-2400 p. Kwa makapisozi 50, wogula ayenera kulipira 2400-2800 p., Ampoules azikhala otsika mtengo, koma amafunikira zambiri: ma PC 10. mankhwala ogulitsa 1800-1900 p. Kukwera kwathunthu kwamitengo ya Wessel Duet kungadalitsidwe patebulo:

Pharmacokinetics

Mafuta a sulodexide amapezeka m'matumbo ang'onoang'ono. Pambuyo m`kamwa makonzedwe olembedwa mankhwala, pachimake ndende yogwira ntchito m'magazi amadziwikiratu pambuyo 2 mawola, ndipo wachiwiri pachimake ndende pambuyo 4-6 maola, pambuyo pake sulodexide sanadziwikenso plasma. Mphamvu ya chinthucho yogwira ntchito imabwezeretseka patatha pafupifupi maola 12, kenako nkukhazikika chimodzimodzi mpaka maola 48. Pafupipafupi wa sulodexide m'madzi a m'magazi amatsimikiza pambuyo pa maola 12 pambuyo pakukonzekera, zomwe, mwina, zimachitika chifukwa chamasulidwa pang'onopang'ono kuchokera ku ziwalo za mayamwidwe, kuphatikizapo mtima wam'mimba.

Ndi mtsempha wa intravenous kapena intramuscular, sulodexide imalowetsedwa mwachangu, ndipo kuchuluka kwa mayamwidwe kumatsimikiziridwa ndi kuthamanga kwa magazi mu malo a jakisoni. Zomwe zili m'madzi a plasma omwe ali ndi vuto limodzi la intaneti la Wessel Duet F pa 50 mg pambuyo pa 15, 30 ndi 60 maminiti anali 3.86 ± 0.37 mg / l, 1.87 ± 0.39 mg / l ndi 0,98. ± 0,09 mg / l, motero.

Thupi limagawidwa mu vasot endumheli wam'mimba, ndipo zomwe zili mkati ndizochulukirapo ka 20-30 kuposa zomwe zimachitika ndi minofu ina.

Sulodexide imapukusidwa mu chiwindi ndikuchotsa makamaka mkodzo. Kafukufuku wogwiritsa ntchito mankhwala a radiolabeled adatsimikiza kuti 55.23% ya yogwira ntchito idatulidwa kudzera mu impso m'masiku anayi oyamba.

Malangizo ogwiritsira ntchito Wessel Douai F: njira ndi mlingo

Wessel Douay F amatha kutumikiridwa mu intramuscularly kapena kudzera m'mitsempha (pambuyo pa kuchepetsedwa mu saline yamoyo mu voliyumu ya 150-200 ml) komanso kumwa mkamwa (pakati pa chakudya).

Kumayambiriro kwa mankhwalawa kwa masiku 15-20, mankhwalawa amathandizidwa ndi intramuscularly, 1 ampoule tsiku lililonse, kenako masiku 30 mpaka 40, kumwa mapiritsi 2 kawiri pa tsiku.

Maphunzirowa ayenera kubwerezedwa kawiri pachaka. Kutengera ndikuwonetsa komanso momwe amathandizira, adokotala amatha kusintha mtundu wa mankhwalawa.

Mimba komanso kuyamwa

Pali malipoti a zokumana nazo zabwino pa mankhwalawa komanso kupewa kwa mtima wamankhwala ndi mankhwalawa odwala omwe ali ndi matenda amtundu wa II mu II ndi ma trimesters a II, komanso pankhani ya toxosis ya amayi apakati.

Palibe chidziwitso chogwiritsidwa ntchito ndi Wessel Douay F panthawi yachulukitsidwe.

Makonda a Wessel Douai F

Ndemanga za Wessel Douay F, omwe asiyidwa ndi akatswiri, amawonetsa kuti amagwira ntchito kwambiri macroangiopathies ndi ma thromboses. Kugwiritsa ntchito mankhwalawa kumapereka zotsatira zabwino pa matenda a mtima wamankhwala kwa odwala omwe ali ndi matenda osokoneza bongo. Mothandizidwa ndi Wessel Douay F pa nthawi yapakati, zovuta zoyipa ndizosowa kwambiri ngati zimagwiritsidwa ntchito molingana ndi malingaliro a dokotala.