IbhayisikileNgomjovo

I-250mg / i-vial amandla

Isibonakaliso:Ibhayisikilekukhonjiswa ukusetshenziswa njenge-anticoagulant ezigulini ezibhekene nokungenelela kwe-coronary (PCI).

Isicelo somtholampilo: Isebenzisa umjovo we-intraveaveous we-intravenous kanye drip ye-intravenous.

Izinkomba nokusetshenziswa

1.1 I-Precutaneour Translal Cornary Avioplasty (PTCA)

I-Bilivaribudin ye-imveloture ikhonjiswa ukuthi isetshenziswe njenge-anticouagulant ezigulini ezinama-angina angazinzile angenzelwa u-angconary angioplasty (PTCA).

1.2 Ukungenelela kwe-CORONARY CORONARY (PCI)

I-BiliviRudin yokujova ngokusetshenziswa kwesikhashana kwe-glycoprotein iib / IIII NESIBICICTO (GPI) njengoba kubhalwe ku

I-Person-2 Icala likhonjiswa ukuthi lisetshenziswe njenge-anticouagulant ezigulini ezibhekene nokungenelela kwe-coronary (PCI).

IBiviliRudin yokujova ikhonjiswa iziguli ezine, noma engcupheni, i-heparin inqoba i-thrombocytopenia (hit) noma i-heriphon inyuse i-thrombocytopenia ne-thrombosis syndrome (ama-hitts) abhekene ne-PCI.

1.3 US e nge-aspirin

I-BiliviRudin yokujova kulezi zinkomba ihloselwe ukusetshenziswa nge-aspirin futhi ifundelwe kuphela ezigulini ezithola i-aspirin eqondile.

1.4 Umkhawulo Wokusebenzisa

Ukuphepha kanye nokusebenza kahle kwe-BilivaliRudin for umjovo akusungulwa ezigulini ezinama-syndromes acite coronary angenayo i-PTCA noma i-PCI.

2 umthamo nokuphatha

2.1 umthamo onconyiwe

IBiviliRudin yokujova yezokulawulwa kwe-intravenous kuphela.

IBiviliRudin yokujova yenzelwe ukusetshenziswa nge-aspirin (300 kuye ku-325 mg nsuku zonke) futhi ifundwe kuphela ezigulini ezithola i-aspirin eqondile.

Ezigulini ezingenazo Hit / Hitts

Umthamo onconyiwe we-bivilibudin for umjovo (iv) umthamo we-intravenous (iv) umthamo we-angavuli we-0.75 mg / kg, ulandelwa ngokushesha ngokufakwa kwe-1.75 mg / kg / h isikhathi senqubo ye-PCI / KTCA. Amaminithi amahlanu ngemuva kokuthi umthamo we-bolus uphathwe, kufanele kwenziwe isikhathi (isenzo) noma isenzo esingeziwe se-0.3 mg / kg kufanele sinikezwe uma kudingeka.

Ukuphathwa kwe-GPI kufanele kubhekwe emcimbini wokuthi noma yimiphi imibandela ebhalwe entweni ethile-2 Clinical Trial ikhona.

Ezigulini ezishaywe / ama-hit

Umthamo onconyiwe we-bivilibudin we-imjovo ezigulini ezinama-hit / hitts abhekene ne-PCI yi-IV bolus ka-0.75 mg / kg. Lokhu kufanele kulandelwe ukumnika okuqhubekayo ngesilinganiso se-1.75 mg / kg / h isikhathi senqubo.

Inqubo eqhubekayo yezokwelashwa

I-BiliviRudin yokufakwa umjovo ingaqhutshelwa kulandela inqubo ye-PCI / PTCA kuze kube yilapho kufika kumahora afinyelela kwayi-4 inqubo yokubhala ngokubona kodokotela ophathayo.

Ezigulini ezine-St Segment Elevation infaction Myocardial infarntaction (Stemi) Ukuqhubeka kwe-Bilivaribudin ukufakwa komjovo ngesilinganiso se-1.75 mg / kg / h ukulandela i-PCI / PTCA kuze kube yilapho inqubo efika emahoreni ayi-4 kufanele kubhekwe njengengozi ye-thrombosis eqinile.

Ngemuva kwamahora amane, ukufakwa okungeziwe kwe-IV kwe-bivilibudin for umjovo kungaqalwa ngesilinganiso se-0.2 mg / kg / h (ukumiliselwa okuphansi), kube amahora angama-20, uma kudingeka.

2.2 I-DOSIng ekulimazelweni kwe-renal

Akukho ukuncishiswa komthamo we-bolus odingekayo nganoma yisiphi isihlobo sokulimazeka kwe-renal. Umthamo wokumfaka we-bivilirudin womjovo angadinga ukuncishiswa, futhi isimo se-anticoagulant sibhekwe ezigulini ezinokulimazeka kwe-renal. Iziguli ezinokukhubazeka kwe-renal ezilinganiselayo (30 kuya ku-59 ml / min) kufanele zithole ukumiliselwa kwe-1.75 mg / kg / h. Uma imvume ye-creatinine ingaphansi kwama-30 ml / min, ukuncishiswa kwezinga lokumnika ku-1 mg / kg / h kufanele kubhekwe. Uma isiguli sikwi-hemodialysis, izinga lokumnika kufanele lincishiswe libe ngu-0.25 mg / kg / h.

2.3 Imiyalo yokuphatha

IBiviliRudin ye-Ivalibudin yenzelwe ukujova kwe-intravenous bolus kanye nokufakwa okuqhubekayo ngemuva kokwakhiwa kabusha kanye ne-dilution. Kumuntu ngamunye we-250 mg we-vial, engeza u-5 ml wamanzi oyinyumba womjovo, i-USP. Swirl ngobumnene kuze kube yilapho yonke impahla ichithiwe. Okulandelayo, khipha bese ulahla ama-5 ml kusuka ku-500 ml infusion bag equkethe ama-5% dextrose emanzini noma ngo-0.9% sodium chloride ngomjovo. Bese wengeza okuqukethwe yi-vial evuselelwe kabusha esikhwameni sokumnika esiqukethe ama-5% dextrose emanzini noma ngo-0.9% sodium chloride ukuze ukhiqize ukugxila kokugcina okungu-5 mg / ml (isib. Ama-vials ama-5 ku-250 ml). Umthamo ozophathwa ulungiswa ngokuya ngesisindo sesiguli (bheka Ithebula 1).

Uma ukufakwa kwezinga eliphansi kusetshenziswa ngemuva kokufakwa kokuqala, kufanele kulungiswe isikhwama sokuhlushwa esiphansi. Ukuze ulungiselele lokhu kugxila okuphansi, uphinde uphinde uphinde uphinde uphinde ukhiphe i-250 mg vias nge-5 ml yamanzi ayinyumba emjovo, i-USP. Swirl ngobumnene kuze kube yilapho yonke impahla ichithiwe. Okulandelayo, khipha bese ulahla ama-5 ml kusuka ku-500 ml infusion bag equkethe ama-5% dextrose emanzini noma ngo-0.9% sodium chloride ngomjovo. Bese wengeza okuqukethwe yi-vial esenziwe kabusha esikhwameni sokumnika esiqukethe ama-5% dextrose emanzini noma ngo-0.9% sodium chloride ukuze uveze ukugxila kokugcina kwe-0.5 mg / ml. Izinga lokumnika okufanele liphathwe kufanele likhethwe kwikholomu yesokudla kuThebula 1.