BivarudunMwachitsanzo jakisoni

250mg / Vacur mphamvu

Chiwonetsero:Bivarudunakuwonetsedwa kuti agwiritsidwire ntchito ngati anticoagulant odwala omwe amapezeka pachaberoraneonary kulowererapo (PCI).

Kugwiritsa ntchito mankhwala: Imagwiritsidwa ntchito jakisoni wamkati ndi kugwa kwamkati.

Zisonyezo ndi kugwiritsa ntchito

1.1 Percutanerone Translum Eronal Angiooplasty (PTCA)

Bivaruudin ya jakisoni akuwonetsedwa kuti agwiritsidwe ntchito ngati anticoagulant odwala osakhazikika angina omwe amapezeka panjira pecuninal Angluasty (PTCA).

1.2 Precunary Coronal kulowererapo (PCI)

Bivalirudin ya jakisoni ndi kugwiritsa ntchito kwa glycoprotein iib / iiia inrobitor (GPI) monga alembedwe mu

Sinthani-2 kuyesedwa kumawonetsedwa kuti mugwiritse ntchito ngati anticoagulant odwala omwe akukumana ndi vuto la Coronary (PCI).

Bivaruudin ya jakisoni akuwonetsedwa kwa odwala, kapena pachiwopsezo cha, heparin adayika thrombocytopenia (kugunda) kapena heparin adayika thrombony syndrome (hipts) zotupa.

1.3 US e ndi aspirin

Bivaruudin ya jakisoni mu zisonyezo izi zikugwiritsidwa ntchito kuti agwiritsidwe ntchito ndi aspirin ndipo waphunziridwa kwa odwala omwe amalandila aspirin.

1.4 Kugwiritsa Ntchito Kugwiritsa Ntchito

Kutetezedwa ndi kugwira ntchito kwa jamuruudin chifukwa cha jakisoni sikunakhazikitsidwe mwa odwala omwe ali ndi matenda a pachimake a Coronary Syndromes omwe sakuyang'anitsitsa PTCA kapena PCA.

2 Mlingo ndi makonzedwe

2.1 Yemwe analimbikitsa

Bivaruudin ya jekeseni ndi ya mtsempha wa magazi.

Bivaruudin ya jakisoni amapangidwira kuti agwiritsidwe ntchito ndi aspirin (300 mpaka 325 mg tsiku lililonse) ndipo waphunziridwa kwa odwala omwe amalandila aspirin.

Kwa odwala omwe alibe kugunda / Hitts

Mlingo woyenera wa Bivaruudin wa jakisoni ndi mtsempha wa magazi (IV) Bolus mlingo wa 0,75 mg / kg / h pofika nthawi ya PCI / PTCA. Miyezi isanu pambuyo pa bolus mlingo waperekedwa, nthawi yotseguka (Act) iyenera kuchitidwa ndi bolus yowonjezera ya 0,3 mg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg / kg

GPI Administration iyenera kulingaliridwa pamwambowu kuti zikhalidwe zilizonse zomwe zatchulidwa m'mbuyomu-2 matanthauzidwe oweruzira milandu alipo.

Kwa odwala omwe amenya / hitts

Mlingo woyenera wa Bivaruudin wa jakisoni wodwala / Hitts omwe amapezeka PCI ndi IV Bolus wa 0,75 mg / kg. Izi zikuyenera kutsatiridwa ndi kulowetsedwa kosalekeza pamlingo wa 1.75 mg / kg / h kwa nthawi ya njirayi.

Njira yopitilira chithandizo

Bivaruudin kulowetsedwa jekesenion utha kupitiriza kutsatira njira 4 positi polemba kwa dokotala wothandizira.

Odwala omwe ali ndi gawo la st gawo lotupa (stemi) kupitiliza kwa bivarudin ku jakisoni wolowetsedwa mu chiopsezo cha 175 mg / ptca kwa maola 4

After four hours, an additional IV infusion of bivalirudin for injection may be initiated at a rate of 0.2 mg/kg/h (low-rate infusion), for up to 20 hours, if needed.

2.2 dosing mu impso kuwonongeka

Palibe kuchepetsedwa mu mlingo wa Bolus ndikofunikira kuti aimpso asokonezedwe. The kulowetsedwa mlingo wa jamuruudin jekesekani angafunike kuchepetsedwa, ndipo anticoagulant akhale okhazikika mwa odwala omwe ali ndi vuto laimpso. Odwala omwe ali ndi vuto la impso kuwonongeka (30 mpaka 59 ml / min) ayenera kulandira kulowetsedwa kwa 1.75 mg / kg / h. Ngati chilolezo cha creatinine sichitha 30 ml / min, kuchepetsa kwa kulowetsedwa kwa 1 mg / kg / h kuyenera kuganiziridwa. Ngati wodwala ali pa hemodialysis, kuchuluka kwa kulowetsedwa kuyenera kuchepetsedwa mpaka 0.25 mg / kg / h.

Malangizo 2.3 a makonzedwe

Bivaruudin yopanga jakisoni amapangidwira jaloluous jalus komanso kulowetsedwa kosalekeza ndi kulowetsedwa kobwerezabwereza. Pa 250 mg vial, onjezani 5 ml ya madzi osabala a jakisoni, USP. Pang'ono pang'onopang'ono mpaka zinthu zonse zisungunuke. Kenako, kusiya ndikutaya 5 ml kuchokera ku thumba la 50 ml yokhala ndi 5% dextrose m'madzi kapena 0,9% sodium chloride ya jakisoni. Kenako onjezerani zomwe zili mu thumba la kulowetsedwa lomwe lili ndi 5% dextrose m'madzi kapena 0,9% sodium chloride kuti mulole jakisoni wa jakisoni wa 5 mg / ml mu 50 ml; 5 Mbale mu 250 ml). Mlingo wothandizidwa ndikusinthidwa molingana ndi kulemera kwa wodwalayo (onani tebulo 1).

Ngati kulowetsedwa kotsika kumagwiritsidwa ntchito pambuyo kulowetsedwa koyambirira, thumba lotsika kwambiri liyenera kukonzedwa. Pofuna kukonzekera kutsika kotsika kumeneku, gwiritsani ntchito vial ya 250 mg ndi 5 ml ya madzi osabala a jakisoni, USP. Pang'ono pang'onopang'ono mpaka zinthu zonse zisungunuke. Kenako, kusiya ndi kutaya 5 ml kuchokera thumba la 100 ml yokhala ndi 5% dextrose m'madzi kapena 0,9% sodium chloride ya jakisoni. Kenako onjezerani zomwe zili mu thumba la kulowetsedwa lomwe lili ndi 5% dextrose m'madzi kapena 0,9% sodium chloride yopangira jakisoni kuti mupereke ndende yomaliza ya 0,5 ml / ml. Kulowetsa kuperekedwa kuyenera kusankhidwa kuchokera kumanja kumanja kwa pagome 1.