Izidakamizwa ze-antiplatelet - P2Y12 inhibitors

Ama-platelet amangqamuzana amancane egazini lakho asetshenziswa umzimba wakho ukwakha amahlule futhi ayeke ukopha. Uma unama-platelet amaningi kakhulu noma ama-platelets akho anamathela kakhulu, kungenzeka ukuthi wakhe amahlule. Lokhu kuhlangana kungenzeka ngaphakathi kwemithambo yakho futhi kuholele ekuhlaselweni yinhliziyo noma kohlangothi.

Izidakamizwa ze-antiplatelet zisebenza ukwenza amaplatelet akho anganamatheli futhi ngaleyo ndlela asize ukuvimbela amahlule egazi ukuthi akhe emithanjeni yakho.

• I-Aspirin ngumuthi olwa nama-antiplatelet ongasetshenziswa.
• Ama-block blocker we-P2Y12 elinye iqembu lemithi elwa namagciwane. Leli qembu lezidakamizwa lifaka phakathi: i-clopidogrel, i-ticlopidine, i-ticagrelor, i-prasugrel, ne-cangrelor.

Izidakamizwa ze-antiplatelet zingasetshenziselwa:

• Vimbela isifo senhliziyo noma isifo sohlangothi kulabo abane-PAD.
• I-Clopidogrel (i-Plavix, i-generic) ingasetshenziswa esikhundleni se-aspirin kubantu abanciphisa imithambo yegazi noma abafake i-stent.
• Kwesinye isikhathi izidakamizwa ezimbili zama-antiplatelet (enye yazo cishe i-aspirin njalo) inikezwa abantu abane-angina engazinzile, i-acute coronary syndrome (i-angina engazinzile noma izimpawu zokuqala zesifo senhliziyo), noma labo abathole i-stent ngesikhathi se-PCI.
• Ngokuvinjelwa kwezifo zenhliziyo okuyisisekelo nokuvikela, i-aspirin yansuku zonke ngokuvamile iyindlela yokuqala yokwelashwa kwama-antiplatelet. I-Clopidogrel ibekiwe esikhundleni se-aspirin kubantu abane-aspirin yokungezwani komzimba noma abangakwazi ukubekezelela i-aspirin.
• I-Aspirin kanye nomuthi wesibili we-antiplatelet kuvame ukunconywa kubantu abenza i-angioplasty nge noma ngaphandle kokunuka.
• Vimbela noma welaphe isifo senhliziyo.
• Vimbela ukushaywa unhlangothi noma ukuhlaselwa yischemic okwedlulayo (ama-TIAs yizimpawu zokuqala zokuxwayiswa kohlangothi. Zibizwa nangokuthi "imivimbo emincane.")
• Vimbela amahlule ekwenzeni amafinyila angaphakathi afakwa ngaphakathi kwemithambo yakho yokuwavula.
• I-acute coronary syndrome.
• Ngemuva kokudlula ngokuhlinzwa okwenziwe ngokuxhunyelelwa okusebenzisa okwenziwe ngabantu noma okokufakelwa okwenziwe emithanjeni engezansi kwedolo.

Umhlinzeki wakho wokunakekelwa kwezempilo uzokhetha ukuthi iyiphi yale mithi elungele inkinga yakho. Ngezinye izikhathi, ungacelwa ukuthi uthathe i-aspirin yedosi ephansi kanye nomunye wale mithi.

Imiphumela emibi yalo muthi ingafaka:

• Uhudo
• Ukulunywa
• Isicanucanu
• Ukuqhuma kwesikhumba
• Ubuhlungu besisu

Ngaphambi kokuba uqale ukuthatha le mithi, tshela umhlinzeki wakho uma:

• Unezinkinga zokopha noma izilonda zesisu.
• Ukhulelwe, uhlela ukukhulelwa, noma uncelisa.

Kuneminye imiphumela emibi engaba khona, kuya ngokuthi unikezwe muphi umuthi. Ngokwesibonelo:

• I-Ticlopidine ingaholela enanini eliphansi kakhulu lamaseli amhlophe egazi noma isifo sokuzivikela komzimba esonakalisa amaplatelets.
• I-Ticagrelor ingadala iziqephu zokuphefumula okuncane.

Lo muthi uthathwa njengephilisi. Umhlinzeki wakho angashintsha umthamo wakho ngezikhathi ezithile.

Thatha lo muthi ngokudla namanzi amaningi ukunciphisa imiphumela emibi. Ungadinga ukuyeka ukuthatha i-clopidogrel ngaphambi kokuhlinzwa noma umsebenzi wamazinyo. Ungayeki nje ukuthatha umuthi wakho ngaphandle kokukhuluma kuqala nomhlinzeki wakho.

Khuluma nomhlinzeki wakho ngaphambi kokuthatha noma imuphi wale mithi:

• I-Heparin namanye ama-thinner wegazi, njenge-warfarin (Coumadin)
• Umuthi wezinhlungu noma we-arthritis (njenge-diclofenac, etodolac, ibuprofen, indomethacin, Advil, Aleve, Daypro, Dolobid, Feldene, Indocin, Motrin, Orudis, Relafen, noma Voltaren)
• I-Phenytoin (Dilantin), i-tamoxifen (i-Nolvadex, i-Soltamox), i-tolbutamide (i-Orinase), noma i-torsemide (i-Demadex)

Ungathathi ezinye izidakamizwa ezingaba ne-aspirin noma ibuprofen kuzo ngaphambi kokukhuluma nomhlinzeki wakho. Funda amalebula emithini ebandayo nemikhuhlane. Buza ukuthi yimiphi eminye imithi ephephile ongayithatha uma uzwa izinhlungu, imikhuhlane noma umkhuhlane.

Uma unanoma yiluphi uhlobo lwenqubo oluhleliwe, kungadingeka ukuthi umise le mithi izinsuku ezi-5 kuya kwezi-7 ngaphambi kokunikezwa. Kodwa-ke, hlola njalo nomhlinzeki wakho kuqala mayelana nokuthi kuphephile yini ukuma.

Tshela umhlinzeki wakho uma ukhulelwe noma uhlela ukukhulelwa, noma ukuncelisa noma uhlela ukuncelisa. Abesifazane abasezigabeni zakamuva zokukhulelwa akufanele bathathe i-clopidogrel. IClopidogrel ingadluliselwa ezinganeni ngobisi lwebele.

Khuluma nomhlinzeki wakho uma unesifo sesibindi noma sezinso.

Uma uphuthelwa umthamo:

• Yithathe ngokushesha okukhulu, ngaphandle uma kuyisikhathi sedosi yakho elandelayo.
• Uma sekuyisikhathi somthamo wakho olandelayo, thatha inani lakho elijwayelekile.
• Ungathathi amaphilisi angeziwe ukwenzela umthamo owuphuthelwe, ngaphandle kwalapho udokotela wakho ekutshela ukuthi ukwenze.

Gcina le mithi nayo yonke eminye imithi endaweni epholile, eyomile. Zigcine lapho izingane zingakwazi ukufinyelela kuzo.

Shayela uma uneminye yale miphumela emibi futhi ingapheli:

• Noma yiziphi izimpawu zokopha okungajwayelekile, njengegazi emchameni noma esitokisini, ukuphuma kwamakhala, noma yikuphi ukulimaza okungajwayelekile, ukopha kakhulu ekusikeni, izitulo ezimnyama zokubamba, ukukhwehlela igazi, ukuphuma kwegazi okunzima kunokujwayelekile noma ukopha okungalindelekile kwesitho sangasese sowesifazane, ukuhlanza okubukeka njengezizathu zekhofi
• Isiyezi
• Kunzima ukugwinya
• Ukuqina esifubeni noma esifubeni
• Ukuvuvukala ebusweni noma ezandleni zakho
• Ukulunywa, isifuba, noma ukuncinza ebusweni noma ezandleni zakho
• Ukuphefumula noma ukuphefumula kanzima
• Ubuhlungu besisu obubi kakhulu
• Ukuqhuma kwesikhumba

Abanciphisi begazi - i-clopidogrel; Ukwelashwa kwe-antiplatelet - clopidogrel; I-Thienopyridines

• I-plaque buildup emithanjeni

U-Abraham NS, Hlatky MA, u-Antman EM, et al. Idokhumenti yokuvumelana kochwepheshe be-ACCF / ACG / AHA 2010 ngokusetshenziswa okuhambisanayo kwe-proton pump inhibitors kanye ne-thienopyridines: ukubuyekezwa okugxile kwedokhumenti yokuvumelana kochwepheshe be-ACCF / ACG / AHA ka-2008 ekwehliseni ubungozi bamathumbu be-antiplatelet therapy kanye nokusetshenziswa kwe-NSAID: umbiko we I-American College of Cardiology Foundation Task Force kuma-Expert Consensus Documents. UJ Am Coll Cardiol. 2010; 56 (24): 2051-2066. I-PMID: 21126648 pubmed.ncbi.nlm.nih.gov/21126648/.

UFihn SD, uBlankenship JC, u-Alexander KP, et al. Isibuyekezo esigxile ku-2014 ACC / AHA / AATS / PCNA / SCAI / STS somhlahlandlela wokuxilongwa nokuphathwa kweziguli ezinesifo senhliziyo esisimeme: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice, kanye ne I-American Association for Thoracic Surgery, I-Preventive Cardiovascular Nurses Association, i-Society for Cardiovascular Angiography kanye nokungenelela, kanye ne-Society of Thoracic Odgeons. Ukujikeleza. 2014; 130: 1749-1767. I-PMID: 25070666 pubmed.ncbi.nlm.nih.gov/25070666/.

IGoldstein LB. Ukuvimbela nokuphathwa kwesifo se-ischemic. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 65.

UJanuwari CT, Wann LS, Alpert JS, et al. Umhlahlandlela we-2014 AHA / ACC / HRS wokuphathwa kweziguli ezine-fibrillation ye-atrial: umbiko we-American College of Cardiology / American Heart Association Task Force on Guidelines Practice kanye ne-Heart Rhythm Society. UJ Am Coll Cardiol. 2014; 64 (21): e1-e76. I-PMID: 24685669 pubmed.ncbi.nlm.nih.gov/24685669/.

UMauri L, uBhatt DL. Ukungenelela kwe-coronary okwenzeka ngamandla. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 62.

UMeschia JF, uBushnell C, uBoden-Albala B, et al. Imihlahlandlela yokuvimbela okuyinhloko ukushaywa unhlangothi: isitatimende sabasebenzi bezempilo abavela e-American Heart Association / American Stroke Association. Unhlangothi. 2014; 45 (12): 3754-3832. I-PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

UMorrow DA, de Lemos JA. Isifo senhliziyo esisimeme. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 61.

Amandla WJ, Rabinstein AA, Ackerson T, et al. Imihlahlandlela yokuphathwa kokuqala kweziguli ezine-acute ischemic stroke: 2019 update to the 2018 Guidelines for the early management of patients with acute ischemic stroke: umhlahlandlela wabasebenzi bezempilo abavela e-American Heart Association / American Stroke Association. Unhlangothi. 2019; 50 (12): e344-e418. I-PMID: 31662037 pubmed.ncbi.nlm.nih.gov/31662037/.

• Angina
• Ukubekwa kwe-Angioplasty nokuqina - umthambo we-carotid
• Ukubekwa kwe-angioplasty kanye ne-stent - imithambo yegazi
• Ukuhlinzwa kwe-aortic valve - kungangenisi kakhulu
• Ukuhlinzwa kwe-aortic valve - kuvulekile
• Izinqubo zokukhipha inhliziyo
• Ukuhlinzwa komthambo weCarotid - kuvulekile
• Isifo esingapheliyo se-pulmonary disease (COPD)
• Isifo senhliziyo
• Ukuhlinzwa kokudlula kwenhliziyo
• Ukuhlinzwa kokudlula kwenhliziyo - kukuhlasela kancane
• Ukwehluleka kwenhliziyo
• Umenzi wenhliziyo
• Amazinga aphezulu e-cholesterol egazini
• Umfutho wegazi ophezulu - abantu abadala
• I-cardioverter-defibrillator engafakelwa
• Ukuhlinzwa kwe-Mitral valve - kungena kancane
• Ukuhlinzwa kwe-Mitral valve - kuvulekile
• Ukudlula emthanjeni wokudlula - umlenze
• Isifo semithambo eseceleni - imilenze

• I-Angina - ukukhishwa
• Ukukhishwa kwe-angioplasty ne-stent - inhliziyo
• Ukubekwa kwe-Angioplasty kanye ne-stent - umthambo we-carotid - ukukhishwa
• Ukubekwa kwe-angioplasty nokuma okuqinile - imithambo yegazi - ukukhipha
• I-Aspirin nesifo senhliziyo
• I-Atrial fibrillation - ukukhishwa
• Ukusebenza lapho unesifo senhliziyo
• I-catheterization yenhliziyo - ukukhishwa
• Ukuhlinzwa komthambo weCarotid - ukukhipha
• Ukulawula umfutho wegazi ophakeme
• Isifo sikashukela - ukuvimbela isifo senhliziyo nesifo sohlangothi
• Isifo senhliziyo - ukukhipha
• Ukuhlinzwa kokudlula kwenhliziyo - ukukhipha
• Ukuhlinzwa kokudlula kwenhliziyo - ukukhipha okungatheni okweqile
• Ukuhluleka kwenhliziyo - ukukhipha
• Ukuhlinzwa kwe-valve yenhliziyo - ukukhipha
• Ukudlula emthanjeni wokudlula - umlenze - ukukhishwa
• Ukushaywa unhlangothi - ukukhishwa

• Ukuncipha Kwegazi