Bivalirudin hoki werohanga

250mg / kaha oko

: Tohu Bivalirudin te tohua hoki te whakamahi hei anticoagulant i roto i tūroro pangia wawaotanga coronary percutaneous (PCI).

tono Haumanu: ko reira usedfor i werohia rō-uaua, me te maturuturu rō-uaua.

Tuhinga me te whakamahi

1.1 Percutaneous Transluminal Coronary Angioplasty (PTCA)

Bivalirudin hoki Werohanga te tohua hoki te whakamahi hei anticoagulant i roto i te tūroro ki te angina iu pangia percutaneous angioplasty coronary transluminal (PTCA).

1.2 Percutaneous Intervention Coronary (PCI)

Bivalirudin hoki Werohanga ki te whakamahi takitaro o glycoprotein IIb / IIIA inhibitor (GPI) rite i tabulahia i roto i te

tohua WHAKAHŌU-2 tamataraa te mo te whakamahi hei anticoagulant i roto i tūroro pangia wawaotanga coronary percutaneous (PCI).

Kei te tohua Bivalirudin mō Werohanga mō ngā tūroro ki, ranei i mōrea o, heparin piri ana thrombocytopenia (Patua) heparin piri thrombocytopenia me Thrombosis syndrome ranei (HITTS) pangia PCI.

1.3 Us e ki ahipirini

Bivalirudin hoki Werohanga i roto i enei tohu e te tikanga mo te whakamahi ki te ahipirini me kua ako anake i roto i te tūroro te fariiraa i ahipirini te rere.

1.4 TE WHAKAWHĀITITANGA o Whakamahia

Kua kore i whakapumautia te haumaru me te whai huatanga o te bivalirudin mō te werohanga i roto i te tūroro ki te syndromes coronary whakapeka kahore e nei pangia PTCA PCI ranei.

2 inenga AND Tuhinga

2.1 Taunakitia Horopeta

Bivalirudin hoki Werohanga he hoki whakahaere rō-uaua anake.

tikanga Bivalirudin hoki Werohanga te mo te whakamahi i te ahipirini (300 ki te 325 mg ia rā) me kua ako anake i roto i te tūroro te fariiraa i ahipirini te rere.

Hoki tūroro e kore e kua HIT nei / HITTS

Ko te horopeta tūtohutia o bivalirudin mō te werohia he rō-uaua (IV) bolus horopeta o 0.75 mg / kg, aru tonu i te whaowhia o 1.75 mg / kg / h mo te roanga o te PCI / PTCA tukanga. kua E rima min i muri i te horopeta bolus kua whakahaerea, kia he wa upoo- whakahohe (ACT) kia whakamana a kia te bolus atu o 0.3 mg / kg kia hoatu ki te hiahiatia.

kia whakaaro GPI whakahaere i roto i te kaupapa i te mea reira tetahi o nga tikanga i tabulahia i roto i te WHAKAHŌU-2 whakamārama whakamātautau haumanu.

No te tūroro e kua HIT / HITTS

Ko te horopeta tūtohutia o bivalirudin mō te werohanga i roto i te tūroro ki te Patua / HITTS pangia PCI ko te bolus IV o 0.75 mg / kg. kia aru tenei e te whaowhia tonu i te tere o te 1.75 mg / kg / h mo te roanga o te tukanga.

Hoki haere tonu tukanga maimoatanga pou

kia tonu Bivalirudin mō te werohanga whaowhia e whai ake nei PCI / PTCA hoki whakairi tukanga ake ki te 4 hāora i te ngarahu pai o te rata te rongoā.

I roto i te tūroro ki ST wāhanga poipoi infarction myocardial (STEMI) tonu o te bivalirudin mō te werohanga whaowhia i te tere o te 1.75 mg / kg / h e whai ake nei PCI / PTCA hoki ki runga ki te 4 haora kia whakaaro pou-tukanga ki te faaiti i tūpono o stent Thrombosis.

I muri i wha haora, kia tīmataria te atu whaowhia IV o bivalirudin mō te werohanga i te tere o te 0.2 mg / kg / h (iti-auau e whaowhia), hoki ki runga ki te 20 haora, ki te hiahiatia.

2.2 Dosing i Waimaerotanga Renal

hiahiatia No whakaiti i roto i te horopeta bolus te hoki tetahi tohu o te waimaerotanga tākihi. kia Me te horopeta e whaowhia o bivalirudin mō te werohanga ki te kia heke, me te mana anticoagulant aroturukitia i roto i tūroro ki waimaerotanga tākihi. kia riro Tūroro ki te waimaerotanga tākihi āhua (30 ki te 59 mL / min) he whaowhia o 1.75 mg / kg / h. Ki te ko te waere creatinine iti iho i te 30 mL / min, whakaiti o te auau whaowhia ki te 1 mg / kg / kia whakaaro h. Ki te ko te manawanui i runga i tātari toto, kia heke te auau e whaowhia ki te 0,25 mg / kg / h.

2.3 Tohutohu mō te Whakahaere

tikanga Bivalirudin hoki Werohanga te mo te rō-uaua werohanga bolus me whaowhia tonu i muri i faati'a faahou me te waimehatanga. Ki ia pounamu 250 mg, tāpiri 5 mL o horomata Water mo Werohanga, USP. Ata E whakakopikopikoa rewa noa te rauemi katoa. Next, whakahoki iho me te tūraki 5 mL i te putea 50 mL whaowhia kei roto 5% tēhuka i Water ranei 0.9% pūhaumāota Konutai mō Werohanga. Na ka tāpiri i te tirotiro o te oko houtia ki te putea e whaowhia kei roto 5% terehuka i Water 0.9% pūhaumāota Konutai ranei mo ki te Werohanga tukua te kukū whakamutunga o 5 mg / mL (hei tauira, 1 oko i 50 mL: 2 oko i 100 mL; 5 oko i roto i 250 mL). whakaritea te horopeta ki kia whakahaerea te rite ki te taimaha o te manawanui (kite Ripanga 1).

Ki te whakamahia te whaowhia iti-auau te i muri i te whaowhia tuatahi, kia rite te putea kukū raro. I roto i te tikanga ki te faaineine i tenei kukū raro, hanga anö i te oko 250 mg ki 5 mL o horomata Water mo Werohanga, USP. Ata E whakakopikopikoa rewa noa te rauemi katoa. Next, whakahoki iho me te tūraki 5 mL i te putea 500 mL whaowhia kei roto 5% tēhuka i Water 0.9% pūhaumāota Konutai ranei mo te Werohanga. Na ka tāpiri i te tirotiro o te oko houtia ki te putea e whaowhia kei roto 5% tēhuka i Water 0.9% pūhaumāota Konutai ranei mo ki te Werohanga tukua te kukū whakamutunga o 0.5 mg / mL. kia te auau e whaowhia ki kia whakahaerea kia tīpakohia i te tīwae matau-ringa i roto i te Ripanga 1.