Lithethefatsi tsa antiplatelet - P2Y12 inhibitors

Liplatelete ke lisele tse nyane maling a hau tseo 'mele oa hau o li sebelisang ho theha mahloele le ho emisa ho tsoa mali. Haeba u na le liplatelete tse ngata haholo kapa liplatelete tsa hau li khomaretse haholo, ho na le monyetla oa hore u ka hlama. Ho koala hoo ho ka etsahala kahare ho methapo ea hau mme ho lebise tlhaselong ea pelo kapa setorong.

Lithethefatsi tsa li-antiplatelet li sebetsa ho etsa hore liplatelete tsa hau li se ke tsa khomarela ka tsela eo li thusa ho thibela maqeba a mali ho theha methapo ea hau.

• Aspirin ke setlhare sa antiplatelet se ka sebelisoang.
• Li-block block tsa P2Y12 ke sehlopha se seng sa lithethefatsi tsa antiplatelet. Sehlopha sena sa lithethefatsi se kenyelletsa: clopidogrel, ticlopidine, ticagrelor, prasugrel le cangrelor.

Lithethefatsi tsa antiplatelet li ka sebelisoa ho:

• Thibela lefu la pelo kapa stroke ho ba nang le PAD.
• Clopidogrel (Plavix, generic) e ka sebelisoa sebakeng sa aspirin bakeng sa batho ba fokotsang methapo ea mali kapa ba kentsoeng stent.
• Ka linako tse ling lithethefatsi tse peli tsa antiplatelet (e 'ngoe ea tsona hangata e le aspirin) li fuoa batho ba nang le angina e sa tsitsang, lefu le matla la lefu la pelo (angina e sa tsitsang kapa matšoao a pele a lefu la pelo), kapa ba fumaneng stent nakong ea PCI.
• Bakeng sa thibelo ea mantlha le ea bobeli ea lefu la pelo, aspirin ea letsatsi le letsatsi hangata ke khetho ea pele bakeng sa kalafo ea antiplatelet. Clopidogrel e laeloa ho fapana le aspirin bakeng sa batho ba alejiki ea aspirin kapa ba sitoang ho mamella aspirin.
• Aspirin le moriana oa bobeli oa li-antiplatelet hangata li khothaletsoa ho batho ba nang le angioplasty ka ntle kapa ntle le stenting.
• Thibela kapa u phekole lefu la pelo.
• Thibela litlhaselo tsa setorouku kapa tsa nakoana (li-TIA ke matšoao a qalang a temoso ea seterouku. Li boetse li bitsoa "stroke-mini.")
• Thibela maqeba hore a se ke a theha kahare ho kenya methapo ea hau ho a bula.
• Matšoao a bohloko a lefu la pelo.
• Kamora ho etsa opereishene e kenang e sebelisang motho kapa maiketsetso a entsoeng ka methapo e ka tlasa lengole.

Mofani oa hao oa tlhokomelo ea bophelo o tla khetha hore na ke efe ea lithethefatsi tse loketseng bothata ba hau. Ka linako tse ling, o ka kopuoa ho noa aspirin ea lethal dose hammoho le e 'ngoe ea lithethefatsi tsena.

Litla-morao tsa moriana ona li ka kenyelletsa:

• Letšollo
• Ho hlohlona
• Ho nyekeloa
• Ho phatloha ha letlalo
• Bohloko ba mala

Pele o qala ho noa meriana ena, bolella mofani oa hau haeba:

• U na le mathata a ho tsoa mali kapa liso tsa ka maleng.
• U imme, rera ho ima, kapa u anyesa.

Ho na le litla-morao tse ling tse ngata tse ka bang teng, ho latela hore na u laetsoe sethethefatsi sefe. Ka mohlala:

• Ticlopidine e ka lebisa ho palo e tlase haholo ea lisele tse tšoeu tsa mali kapa lefu la 'mele le senyang liplatelete.
• Ticagrelor e ka baka likarolo tsa phefumoloho e khuts'oane.

Meriana ena e nkoa e le pilisi. Mofani oa hau a ka fetola lethal dose nako le nako.

Nka meriana ena ka lijo le metsi a mangata ho fokotsa litla-morao. U kanna ua hloka ho emisa ho sebelisa clopidogrel pele u etsoa opereishene kapa mosebetsi oa meno. Se ke oa emisa feela ho noa meriana ea hau u sa bua le mofani oa hau pele.

Bua le mofani oa hau pele u noa efe kapa efe ea lithethefatsi tsena:

• Heparin le tse ling tse fokotsang mali, tse kang warfarin (Coumadin)
• Moriana oa bohloko kapa ramatiki (joalo ka diclofenac, etodolac, ibuprofen, indomethacin, Advil, Aleve, Daypro, Dolobid, Feldene, Indocin, Motrin, Orudis, Relafen, kapa Voltaren)
• Phenytoin (Dilantin), tamoxifen (Nolvadex, Soltamox), tolbutamide (Orinase), kapa torsemide (Demadex)

Se ke oa nka lithethefatsi tse ling tse ka bang le aspirin kapa ibuprofen ho tsona pele u bua le mofani oa hau. Bala mangolo ka meriana ea sefuba le ea ntaramane. Botsa hore na ke meriana e fe e sireletsehileng eo u ka e nkang bakeng la mahlaba le bohloko, sefuba kapa ntaramane.

Haeba u na le mofuta oa ts'ebetso o reriloeng, ho ka 'na ha hlokahala hore u emise lithethefatsi tsena matsatsi a 5 ho isa ho a 7 pele ho letsoho. Leha ho le joalo, lula u botsa mofani oa hau pele hore na ho bolokehile ho emisa.

Bolella mofani oa hau haeba u imme kapa u rerile ho ima, kapa ho anyesa kapa ho rera ho anyesa. Basali ba mekhahlelo ea morao-rao ea bokhachane ha baa lokela ho nka clopidogrel. Clopidogrel e ka fetisetsoa ho masea ka lebese la matsoele.

Bua le mofani oa hau haeba u na le lefu la sebete kapa la liphio.

Haeba u hloloheloa tekanyetso:

• E nke kapele kamoo ho ka khonehang, ntle le haeba e le nako ea tekanyetso ea hau e latelang.
• Haeba e le nako ea tekanyetso ea hau e latelang, nka chelete ea hau e tloaelehileng.
• Se ke oa noa lipilisi tse eketsehileng bakeng sa tefo eo u e hlolohetsoeng, ntle le haeba ngaka eu joetse.

Boloka lithethefatsi tsena le meriana e meng kaofela sebakeng se phodileng se ommeng. Li boloke moo bana ba sitoang ho fihla ho tsona.

Letsetsa haeba o na le litla-morao tsena 'me ha li tlohe:

• Matšoao afe kapa afe a ho tsoa mali ka mokhoa o sa tloaelehang, joalo ka mali ka morong kapa litulo, ho tsoa mali ka nosebong, ho tsoa mali ho sa tloaelehang, ho tsoa mali haholo ka lebaka la ho khaola, litulo tse ntšo tsa ho leta, ho khohlela mali, ho tsoa mali a boima ho feta tloaelo ea ho ea khoeling kapa ho tsoa mali ka bosaling ho sa lebelloang, mahlatsa a shebahalang joalo ka mabaka a kofi
• Botsoa
• Ho thata ho koenya
• Ho tiea sefubeng kapa sefubeng bohloko
• Ho ruruha sefahlehong kapa matsohong a hau
• Ho hlohlona, ​​hives kapa ho hlohlona sefahlehong kapa matsohong a hau
• Ho hema kapa ho hema ka thata
• Bohloko bo bohloko ba mpa
• Ho phatloha ha letlalo

Li-thinner tsa mali - clopidogrel; Phekolo ea li-antiplatelet - clopidogrel; Thienopyridine

• Letlapa le hahang ka methapo

Abraham NS, Hlatky MA, Antman EM, le al. Tokomane ea tumellano ea ACCF / ACG / AHA 2010 mabapi le ts'ebeliso e lumellanang ea proton pump inhibitors le thienopyridines: ntlafatso e shebaneng le tokomane ea tumellano ea litsebi tsa ACCF / ACG / AHA 2008 mabapi le ho fokotsa likotsi tsa masapo tsa kalafo ea antiplatelet le ts'ebeliso ea NSAID: American College of Cardiology Foundation Task Force mabapi le Litsebi tsa Consensus ea Litsebi. J Ke Coll Cardiol. 2010; 56 (24): 2051-2066. PMID: 21126648 pubmed.ncbi.nlm.nih.gov/21126648/.

Fihn SD, Blankenship JC, Alexander KP, le al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS e shebile ntlafatso ea tataiso ea tlhahlobo le taolo ea bakuli ba nang le lefu la pelo le tsitsitseng: tlaleho ea American College of Cardiology / American Heart Association Task Force on Practice Guidelines, le Mokhatlo oa Amerika oa Phekolo ea Thoracic, Mokhatlo oa Baoki ba Thibelang Maikutlo, Mokhatlo oa Maikutlo a Madi a Pelo le Litšebetso, le Mokhatlo oa Lingaka tsa Ngaka tsa Thoracic. Tsamaiso. 2014; 130: 1749-1767. PMID: 25070666 e fetotsoe.ncbi.nlm.nih.gov/25070666/.

Khauta ea LB. Thibelo le taolo ea leqeba la ischemic. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 65.

Ka January CT, Wann LS, Alpert JS, et al. Tataiso ea 2014 AHA / ACC / HRS bakeng sa taolo ea bakuli ba nang le mafura a atrial: tlaleho ea American College of Cardiology / American Heart Association Task Force mabapi le Litataiso tsa Tloaelo le Mokhatlo oa Heart Rhythm Society. J Ke Coll Cardiol. 2014; 64 (21): e1-e76. PMID: 24685669 e fetotsoe.ncbi.nlm.nih.gov/24685669/.

Mauri L, Bhatt DL. Ho kenella hoa methapo ea pelo. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 62.

Meschia JF, Bushnell C, Boden-Albala B, le al. Litaelo tsa thibelo ea mantlha ea stroke: polelo bakeng sa litsebi tsa tlhokomelo ea bophelo bo botle ho tsoa ho American Heart Association / American Stroke Association. Leqeba. 2014; 45 (12): 3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

Morrow DA, ea Lemos JA. Boloetse ba pelo bo tsitsitseng ba ischemic. Ka: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Lefu la pelo la Braunwald: Buka ea bongaka ea meriana ea pelo. 11th ed. Philadelphia, PA: Elsevier; 2019: khaolo ea 61.

Matla WJ, Rabinstein AA, Ackerson T, et al. Litaelo tsa taolo ea pele ea bakuli ba nang le leqeba le matla la ischemic: Tlhatlhobo ea 2019 ho Litaelo tsa 2018 bakeng sa taolo ea pele ea bakuli ba nang le leqeba le bohloko la ischemic: tataiso bakeng sa litsebi tsa tlhokomelo ea bophelo bo botle ba American Heart Association / American Stroke Association. Leqeba. 2019; 50 (12): e344-e418. PMID: 31662037 e fetotsoe.ncbi.nlm.nih.gov/31662037/.

• Angina
• Sebaka sa Angioplasty le stent - mothapo oa carotid
• Angioplasty le stent placement - methapo ea kutlo pheriferale
• Ho buuoa ka sekhahla sa aortic - ho hlasela hanyane ka hanyane
• Ho buuoa ka sekhahla sa aortic - ho bulehile
• Mekhoa ea ho tlosoa ha pelo
• Ho buuoa ka methapo ea Carotid - ho bulehile
• Lefu le sa foleng la pulmonary (COPD)
• Coronary lefu la pelo
• Ho buuoa ke pelo
• Ho buuoa ka pelo - ho hlasela hanyane
• Ho hloleha ha pelo
• Pelo ea pelo
• Likhahla tse phahameng tsa k'holeseterole ea mali
• Khatello ea mali e phahameng - batho ba baholo
• Cardioverter-defibrillator e ka kenngoang
• Ho buuoa ka Mitral valve - e hlaselang hanyane
• Ho buuoa ka Mitral valve - ho bulehile
• Mothapo o potang leoto - leoto
• Pheriferale mothapo lefu - maoto

• Angina - ho tsoa
• Angioplasty le stent - pelo - lero
• Ho beoa ha Angioplasty le stent - mothapo oa carotid - ho tsoa
• Ho beoa ha angioplasty le stent - methapo ea methapo - ho tsoa
• Aspirin le lefu la pelo
• Atrial fibrillation - ho tsoa
• Ho ba mafolofolo ha o na le lefu la pelo
• Catheterization ea pelo - ho tsoa
• Ho buuoa ka methapo ea Carotid - ho tsoa
• Ho laola khatello ea mali e phahameng
• Lefu la tsoekere - ho thibela lefu la pelo le stroke
• Lefu la pelo - ho tsoa
• Ho buuoa ka pelo - ho tsoa
• Ho buuoa ka pelo - ho hlaseloa hanyane ka hanyane - ho tsoa
• Ho hloleha ha pelo - ho tsoa
• Ho buuoa ka valve ea pelo - ho tsoa
• Pheriferale mothapo feta - leoto - tjhajoloha
• Stroke - ho tsoa

• Ho fokotsa mali