Bivalirudin no ka pahu kui

250mg / hue Oiaio

PAaIEN: Bivalirudin ua hōʻike no ka hoʻohana me he anticoagulant i loko o nā mea maʻi undergoing percutaneous coronary 'uao (PCI).

Lapaʻau noi: He usedfor intravenous ka pahu kui a me ka intravenous drip.

Nāʻikepili AND'Āpana

1.1 Percutaneous Transluminal Coronary Angioplasty (PTCA)

Bivalirudin no ka pahu kui ua hōʻike no ka hoʻohana me he anticoagulant i loko o nā mea maʻi i lolelua ka angina undergoing percutaneous transluminal coronary angioplasty (PTCA).

1,2 Percutaneous Coronary 'uao (PCI)

Bivalirudin no ka pahu kui me ka Kūikawā, hoʻomaka ihola 'ana o glycoprotein IIb / IIIa inhibitor (GPI) e like me ka helu ana ma ka

Puku-2 e hookolokolo ua hōʻike no ka hoʻohana me he anticoagulant i loko o nā mea maʻi undergoing percutaneous coronary 'uao (PCI).

Bivalirudin no ka pahu kui ua hōʻike no nā mea maʻi i, a ma ka pilikia o, heparinʻonou thrombocytopenia (pa a ke ku) a heparinʻonou thrombocytopenia a me ka thrombosis maʻi pale (HITTS) undergoing PCI.

1,3 Us E me Aspirin

Bivalirudin no ka pahu kui i loko o kēia mau nāʻikepili ua manao ia no ka hoʻohana me ka aspirin a me ka ua, ua aʻo wale i loko o nā mea maʻi loaa concomitant aspirin.

1.4 i kaupalena 'o E ho ohana i

Ke ola a me ka laulā o ka bivalirudin no ka pahu kui i ole, ua hoʻokumu 'ia i loko o nā mea maʻi me ka huʻi coronary syndromes i mea ole undergoing PTCA paha PCI.

2 laʻau heluna AND hooponopono

2.1 paipai mahele lāʻau

Bivalirudin no ka pahu kui mea no intravenous hooponopono wale.

Bivalirudin no ka pahu kui ua manao ia no ka hoʻohana me ka aspirin (300 a hiki i 325 mg kela la i keia) a ua, ua aʻo wale i loko o nā mea maʻi loaa concomitant aspirin.

No ka hoʻomanawanui iki mai ka poe mai ole i HIT / HITTS

Ke paipai mahele lāʻau o ka bivalirudin no ka pahu kui mea he intravenous (IV) bolus mahele lāʻau o 0,75 mg / kg, hahai koke ma ka infusion o 1,75 mg / kg / h no ka lōʻihi like 'ole o ka PCI / PTCA ina hana. Five min ma hope o ka bolus mahele lāʻau i ua lawelawe iho la no, ka ho'ā 'clotting manawa (KANAWAI) E hanaʻia nō ia, a pono e haawiia ka hou bolus o 0,3 mg / kg inā pono.

GPI aaieieno? E e noʻonoʻo i loko o ka hanana i kekahi o nā kūlana helu ma ka puku-2 lapaʻau hookolokolo hōʻikeʻano mea i loaʻa.

No ka hoʻomanawanui iki mai ka poe i HIT / HITTS

Ke paipai mahele lāʻau o ka bivalirudin no ka pahu kui i loko o nā mea maʻi me ka pa a ke ku / HITTS undergoing PCI mea he IV bolus o 0,75 mg / kg. Kēia E e ukali ma kekahi ana infusion i ka uku o ka 1,75 mg / kg / h no ka lōʻihi like 'ole o ke kaʻina hana.

No ka mākau alu lapaʻau moʻomanaʻo ke kaʻina hana no

Bivalirudin no ka pahu kui infusion i ke hoomau kēia PCI / PTCA no i ka 4 hola Mail hana ma ka manao ana o ka hana maikaʻi kauka.

Ma nā mea maʻi me ka ST Hoʻohana elevation myocardial infarction (STEMI) mau nō lā hoʻi o ka bivalirudin no ka pahu kui infusion i ka uku o ka 1,75 mg / kg / h kēia PCI / PTCA no i ka 4 hola kia-hana e manaoia e mitigate pilikia o ka stent thrombosis.

Ma hope o eha hora, he hou IV infusion o bivalirudin no ka pahu kui i ke kaulana nō i ka uku o ka 0.2 mg / kg / h (haʻahaʻa-kōmi infusion), no ka mea, i ka 20 hola, ina pono.

2.2 Dosing iʻaʻa puʻuwai hoʻopilikia

No ka ho'ēmiʻana i loko o ka bolus mahele lāʻau ua pono ai no kekahi degere o kaʻaʻa puʻuwai hoʻopilikia. Ke infusion mahele lāʻau o ka bivalirudin no ka pahu kui i Pono ia e hoemi, a me ka anticoagulant kūlana ua hoʻonānā i loko o nā mea maʻi me kaʻaʻa puʻuwai hoʻopilikia. Nā mea maʻi me ka lōpūʻaʻa puʻuwai hoʻopilikia (30 a hiki i 59 ML / min) e loaa ka infusion o 1,75 mg / kg / h. Inā ka creatinineʻae mea emi o 30 ML / min, ka ho'ēmiʻana o ka infusion ana i 1 mg / kg / h E e noʻonoʻo. Inā he hoomanawanui mea ma hemodialysis, e e hoemiia ka infusion ana i 0,25 mg / kg / h.

2.3 Ke Kumu no ka noho kia'āina '

Bivalirudin no ka pahu kui ua manao ia no ka intravenous bolus ka pahu kui a me ke ana infusion ma hope o reconstitution a me ka dilution. I kela a me keia 250 mg hue, hoʻokomo 5 ML o Sterile Wai no ka pahu kui, USP. Mālie swirl a pau nā ka mea hoʻoheheʻe. Next, hoihoi a i kāpaeʻia 5 ML, mai ka 50 ML infusion eke i loaʻa ka 5% Dextrose i loko o ka wai a 0,9% paʻakai koloriside no ka pahu kui. A laila, hui kahi o ka reconstituted hue i ka infusionʻeke i loaʻa ka 5% Dextrose i loko o ka wai a 0,9% paʻakai koloriside no ka pahu kui e hua mai i ka lehulehu hope o 5 mg / ML (e like, 1 hue i loko o 50 ML; 2 hue i loko o 100 ML; 5 hue i loko o 250 ML). Ka mahele lāʻau e e lawelaweia'ku ua like e like me ka hoʻomanawanui i ka kaumaha (e nānā Papa 1).

Inā ka haʻahaʻa kōmi infusion ua hoʻohana 'ia ma hope o ka puka mua infusion, he haʻahaʻa lehulehuʻeke e hoomakaukau e. I mea e hoomakaukau keia malalo lehulehu, reconstitute i ka 250 mg hue me 5 ML o Sterile Wai no ka pahu kui, USP. Mālie swirl a pau nā ka mea hoʻoheheʻe. Next, hoihoi a i kāpaeʻia 5 ML, mai ka 500 ML infusion eke i loaʻa ka 5% Dextrose i loko o ka wai a 0,9% paʻakai koloriside no ka pahu kui. A laila, hui kahi o ka reconstituted hue i ka infusionʻeke i loaʻa ka 5% Dextrose i loko o ka wai a 0,9% paʻakai koloriside no ka pahu kui e hua mai i ka lehulehu hope loa o 0.5 mg / ML. Ke infusion uku ia e lawelawe ai e wae i ke kolamu'ākau-lima, mai ka Papa 1.