Iziyobisi Antiplatelet - P2Y12 inhibitors

Iiplatelets ziiseli ezincinci egazini lakho ezisetyenziswa ngumzimba wakho ukwenza amahlwili kunye nokuyeka ukopha. Ukuba uneeplatelets ezininzi okanye iiplatelets zakho zinamathele kakhulu, kunokwenzeka ukuba wenze amahlwili. Oku kuguquka kunokubakho ngaphakathi kwimithambo yakho kwaye kukhokelele ekuhlaselweni sisifo sentliziyo okanye ukubetha.

Amachiza e-antiplatelet asebenza ukwenza ukuba iiplatelet zakho zingabinamathelisi kwaye ke oko kunceda ekuthinteleni amahlwili egazi angene kwimithambo yakho.

• I-Aspirin sisiyobisi esinokusetyenziswa.
• I-P2Y12 receptor blockers lelinye iqela leziyobisi ezichasene neplatelet. Eli qela leziyobisi libandakanya: clopidogrel, ticlopidine, ticagrelor, prasugrel, kunye necangrelor.

Amachiza e-antiplatelet angasetyenziselwa:

• Thintela ukubetha kwentliziyo okanye ukubetha kwabo banePAD.
• I-Clopidogrel (I-Plavix, i-generic) inokusetyenziswa endaweni ye-aspirin kubantu abancitshisiweyo kwimithambo ye-coronary okanye abaye bafakelwa i-stent.
• Ngamanye amaxesha iziyobisi ezi-2 antiplatelet (enye yazo iphantse ibeyi-aspirin) imiselwe abantu abane-angina engazinzanga, i-acon coronary syndrome (i-angina engazinzanga okanye iimpawu zokuqala zesifo sentliziyo), okanye abo bafumana i-stent ngexesha le-PCI.
• Kuthintelo lwezifo zentliziyo eziziiprayimari kunye nezesekondari, i-aspirin yemihla ngemihla lukhetho lokuqala lonyango lwe-antiplatelet. I-Clopidogrel imiselwe endaweni ye-aspirin kubantu abane-aspirin ye-aleji okanye abangakwaziyo ukuyinyamezela i-aspirin.
• I-Aspirin kunye neyeza lesibini le-antiplatelet zihlala zicetyiswa kubantu abafumana i-angioplasty kunye okanye ngaphandle kokunuka.
• Khusela okanye unyange isifo sentliziyo.
• Thintela ukubetha okanye ukuhlaselwa yischemic okwethutyana (ii-TIAs ziimpawu zesilumkiso zakwangoko zokubetha).
• Thintela amahlwili ekubunzeni ngaphakathi ngaphakathi afake ngaphakathi kwimithambo yakho yokuvula.
• Isifo se-coronary syndrome.
• Emva kokudlula kotyando olwenziwe ngumntu okanye olwenziwe ngomthambo olwenziwe kwimithambo engezantsi kwedolo.

Umboneleli wakho wezempilo uya kukhetha ukuba leliphi kula machiza afanelekileyo kwingxaki yakho. Ngamanye amaxesha, unokucelwa ukuba uthathe i-aspirin yedosi esezantsi kunye nala machiza.

Iziphumo zeliyeza zinokubandakanya:

• Urhudo
• Ukurhawuzelela
• Isicaphucaphu
• Ukudumba kolusu
• Intlungu yesisu

Ngaphambi kokuba uqale ukuthatha la mayeza, xelela umboneleli wakho ukuba:

• Unengxaki zokopha okanye izilonda zesisu.
• Ukhulelwe, cwangcisa ukukhulelwa, okanye uncelise.

Zininzi ezinye iziphumo ebezingalindelekanga ezinokubakho, kuxhomekeke kweliphi ichiza omiselweyo. Umzekelo:

• I-Ticlopidine inokukhokelela kwinani eliphantsi kakhulu leeseli ezimhlophe zegazi okanye isifo se-immune esitshabalalisa iiplatelets.
• I-Ticagrelor inokubangela iziqendu zokuphefumla okufutshane.

Eli yeza lithathwa njengepilisi. Umboneleli wakho unokutshintsha idosi yakho amaxesha ngamaxesha.

Thatha eli yeza ngokutya kunye namanzi amaninzi ukunciphisa iziphumo ebezingalindelekanga. Kuya kufuneka uyeke ukuthatha i-clopidogrel ngaphambi kokuba wenze utyando okanye umsebenzi wamazinyo. Sukuyeka nje ukuthatha amayeza akho ungakhange uqale uthethe nomboneleli wakho.

Thetha nomboneleli wakho ngaphambi kokuba uthathe naliphi na kula machiza:

• I-Heparin kunye namanye amacwecwe egazi, njenge-warfarin (Coumadin)
• Intlungu okanye amayeza e-arthritis (njenge-diclofenac, etodolac, ibuprofen, indomethacin, Advil, Aleve, Daypro, Dolobid, Feldene, Indocin, Motrin, Orudis, Relafen, okanye Voltaren)
• IPhenytoin (Dilantin), tamoxifen (Nolvadex, Soltamox), tolbutamide (Orinase), okanye torsemide (Demadex)

Musa ukuthatha ezinye iziyobisi ezinokuba ne-aspirin okanye ibuprofen kuzo ngaphambi kokuba uthethe nomboneleli wakho. Funda iilebhile kumayeza okubanda nawomkhuhlane. Buza ukuba ngawaphi amanye amayeza akhuselekileyo ukuze uwathathe njengamahlaba, iintlungu, okanye umkhuhlane.

Ukuba unalo naluphi na uhlobo lwenkqubo ecwangcisiweyo, kuya kufuneka uyeke la machiza kwiintsuku ezi-5 ukuya kwezi-7 phambi kwesandla. Nangona kunjalo, soloko ujonga umboneleli wakho kuqala malunga nokuba kukhuselekile na ukuyeka.

Xelela umboneleli wakho ukuba ukhulelwe okanye ucwangcisa ukukhulelwa, okanye ukuncancisa okanye ukucwangcisa ukuncancisa. Abasetyhini kumanqanaba okugqibela okukhulelwa akufuneki bathathe i-clopidogrel. IClopidogrel inokudluliselwa kwiintsana ngobisi lwebele.

Thetha nomboneleli wakho ukuba unesibindi okanye isifo sezintso.

Ukuba uphosa idosi:

• Yithathe ngokukhawuleza okukhulu, ngaphandle kokuba ilixesha ledosi yakho elandelayo.
• Ukuba lixesha ledosi yakho elandelayo, thabatha isixa sakho esiqhelekileyo.
• Musa ukuthatha iipilisi ezingaphezulu ukwenza idosi oyiphosileyo, ngaphandle kokuba ugqirha wakho ukuxelele.

Gcina la machiza kunye nawo onke amanye amayeza kwindawo epholileyo neyomileyo. Zigcine apho abantwana bengenakufikelela kuzo.

Tsalela umnxeba ukuba unazo naziphi na iziphumo ebezingalindelekanga kwaye azihambi:

• Nayiphi na imiqondiso yokopha okungaqhelekanga, njengegazi kumchamo okanye ilindle, ukuphuma kweempumlo, nakuphi na ukugruzuka okungaqhelekanga, ukopha okunzima ukusikeka, ilindle elimnyama, ukukhohlela igazi, ukusinda ukopha okungaphaya kokuya exesheni okanye ukopha okungalindelekanga kwilungu lobufazi, ukugabha okujongeka njengendawo yekofu
• Ukuba nesiyezi
• Kunzima ukugwinya
• Ukuqina kwisifuba sakho okanye iintlungu zesifuba
• Ukudumba ebusweni okanye ezandleni zakho
• Ukurhawuzelela, imihlathi, okanye ukubetha ebusweni okanye ezandleni zakho
• Ukubetha okanye ubunzima bokuphefumla
• Intlungu ebuhlungu esiswini
• Ukudumba kolusu

Abacoci begazi - iclopidogrel; Unyango lwe-antiplatelet - clopidogrel; Iintsholongwane

• Ukwakhiwa kweplaque kwimithambo

UAbraham NS, Hlatky MA, Antman EM, et al. I-ACCF / ACG / AHA uxwebhu lokuvumelana ngoochwephesha malunga nokusetyenziswa okuhambisanayo kweproton pump inhibitors kunye ne-thienopyridines: uhlaziyo olujolise kwi-ACCF / ACG / AHA uxwebhu lwesivumelwano sokunciphisa umngcipheko wamathumbu kunyango lwe-antiplatelet kunye nokusetyenziswa kwe-NSAID: ingxelo yengxelo Ikholeji yaseMelika yeCardiology Foundation Task Force kumaXwebhu okuVumelana ngeNgcali. J NdinguColl Cardiol. Ngo-2010; 56 (24): 2051-2066. IINKCUKACHA: 21126648 pubmed.ncbi.nlm.nih.gov/21126648/.

UFihn SD, uBlankenship JC, uAlexander KP, et al. Ngo-2014 i-ACC / AHA / AATS / i-PCNA / i-SCAI / i-STS igxile ekuhlaziyweni kwesikhokelo sokuchongwa kunye nolawulo lwezigulana ezinesifo sentliziyo esisigxina: ingxelo yeAmerican College of Cardiology / American Heart Association Task Force kwiZikhokelo zokuSebenza, kunye Umbutho waseMelika woNyango lwe-Thoracic, uMbutho wabahlengikazi abaThintelayo be-Cardiovascular, uMbutho we-Cardiovascular Angiography kunye nongenelelo, kunye noMbutho woNyango lweTroacic. Ukujikeleza. Ngo-2014; 130: 1749-1767. IINKCUKACHA: 25070666 pubmed.ncbi.nlm.nih.gov/25070666/.

IGoldstein LB. Uthintelo kunye nolawulo lwe-ischemic stroke. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 65.

NgoJanuwari CT, uWann LS, uAlpert JS, et al. Isikhokelo se-AHA / ACC / HRS sika-2014 kulawulo lwezigulana ezine-atrial fibrillation: ingxelo ye-American College of Cardiology / American Heart Association Task Force kwiZikhokelo zokuziqhelanisa kunye ne-Heart Rhythm Society. J NdinguColl Cardiol. Ngo-2014; 64 (21): e1-e76. IINKCUKACHA: 24685669 pubmed.ncbi.nlm.nih.gov/24685669/.

UMauri L, uBhatt DL. Ungenelelo ngoncedo lwe-coronary. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 62.

UMeschia JF, uBushnell C, uBoden-Albala B, et al. Izikhokelo zothintelo lokuqala lwe-stroke: ingxelo yabasebenzi bezempilo kwi-American Heart Association / American Association. Ukubetha. Ngo-2014; 45 (12): 3754-3832. IINKCUKACHA: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

UMorrow DA, de Lemos JA. Isifo sentliziyo esomeleleyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 61.

Amandla WJ, Rabinstein AA, Ackerson T, et al. Izikhokelo zolawulo lwakwangoko lwezigulana ezinesifo esibukhali eschemic: Ukuhlaziywa kwe-2019 kwizikhokelo ze-2018 zolawulo lwakwangoko lwezigulana ezinesifo esibuhlungu seschemic: isikhokelo sabaqeqeshi bezempilo kwiAmerican Heart Association / American Stroke Association. Ukubetha. 2019; 50 (12): e344-e418. IINKCUKACHA: 31662037 pubmed.ncbi.nlm.nih.gov/31662037/.

• UAngina
• I-angioplasty kunye nokubekwa kwindawo entle-umthambo wecarotid
• I-angioplasty kunye nokubekwa ngokufanelekileyo - imithambo yendlela
• Utyando lwevalvu yeAortic -ungena kancinci
• Utyando lwe-aortic valve-luvulekile
• Iinkqubo zokupheliswa kwentliziyo
• Utyando lweCarotid-luvulekile
• Isifo esinganyangekiyo semiphunga (COPD)
• Isifo sentliziyo
• Utyando lwentliziyo ngokudlula
• Utyando lwentliziyo olugqithisileyo- olungenayo intsholongwane
• Ukumelwa yintliziyo
• Intliziyo yomenzi wentliziyo
• Amanqanaba aphezulu e-cholesterol egazini
• Uxinzelelo lwegazi oluphezulu - abantu abadala
• Isixhobo se-Cardioverter-defibrillator esinokufakwa
• Utyando lweMitral valve -yincinci
• Utyando lweMitral valve-luvulekile
• Umda we-peripheral artery-umlenze
• Izifo zemithambo yegazi - imilenze

• Angina - ukubhobhoza
• I-Angioplasty kunye ne-stent-heart-discharge
• I-Angioplasty kunye nokubekwa kwindawo entle-umthambo we-carotid-ukukhutshwa
• I-angioplasty kunye nokubekwa ngokuqinileyo-imithambo yendlela-yokukhutshwa
• I-Aspirin kunye nesifo sentliziyo
• I-Atrial fibrillation - ukukhutshwa
• Ukusebenza xa unesifo senhliziyo
• Ukucinywa kwentliziyo - ukukhutshwa
• Utyando lweCarotid-ukukhutshwa
• Ukulawula uxinzelelo lwegazi oluphezulu
• Isifo seswekile -ukuthintela ukubetha kwentliziyo kunye nokubetha
• Ukuhlaselwa yintliziyo - ukukhutshwa
• Utyando lokudlula kwentliziyo-ukukhutshwa
• Utyando lokudlula kwentliziyo-ukukhutshwa kancinci okungafunekiyo
• Ukungaphumeleli kwentliziyo - ukukhutshwa
• Utyando lwevalvu yentliziyo - ukukhutshwa
• Umda we-peripheral artery-umlenze-ukukhutshwa
• Stroke - ukubhobhoza

• Ukucoca igazi