Bivalirudin nokuti jekiseni

250mg / chinu Strength

Indication: Bivalirudin is indicated for use as an anticoagulant in patients undergoing percutaneous coronary intervention (PCI).

Clinical kushanda: Hazvina usedfor intravenous jekiseni uye intravenous donhwe.

Zvairatidza uye pakushandisa

1.1 Percutaneous Transluminal Coronary Angioplasty (PTCA)

Bivalirudin nokuti jekiseni kunoratidzwa kushandiswa somunhu anticoagulant pavarwere vane kusagadzikana angina kuwana percutaneous transluminal coronary angioplasty (PTCA).

1.2 Percutaneous Coronary Kupindira (PCI)

Bivalirudin nokuti jekiseni rine dikidiki kushandiswa glycoprotein IIb / IIIa inhibitor (GPI) vakaverengwa ari

Tsiva-2 kutongwa kunoratidzwa kushandiswa somunhu anticoagulant pavarwere kuwana percutaneous coronary kupindira (PCI).

Bivalirudin nokuti jekiseni kunoratidzwa nokuda varwere, kana pangozi, heparin vakafurira thrombocytopenia (HIT) kana heparin anonyengetedzwa thrombocytopenia uye thrombosis syndrome (HITTS) achirapwa PCI.

1.3 Us E pamwe asipurini

Bivalirudin nokuti jekiseni iri zvinoratidza izvi zvichiitirwa kushandiswa ne asipurini uye rave akadzidza chete varwere kugamuchira concomitant asipurini.

1.4 Limitation of Use

The kuchengeteka uye Kushanda bivalirudin kuti jekiseni vasina vanosimbiswa varwere chakasimba coronary syndromes vasiri achirapwa PTCA kana PCI.

2 chipimo chemushonga AND Administration

2.1 Recommended Dose

Bivalirudin nokuti jekiseni ndechokuti intravenous yaitonga chete.

Bivalirudin nokuti jekiseni rinotarisirwa kushandiswa ne asipurini (300 kusvika 325 MG daily) uye rave akadzidza chete varwere kugamuchira concomitant asipurini.

Varwere vasina rova ​​/ HITTS

Zvavakabvumirana dose kuti bivalirudin kuti jekiseni chinhu intravenous (IV) bolus dose pakati 0.75 MG / makirogiramu, vakatevera pakarepo nomukuru aizomupa 1.75 MG / makirogiramu / h kuti nguva yose PCI / PTCA nzira. Five Maminitsi mushure bolus dose kwave raitongwa, imwe nguva pakugwamba kusashanda (ITA) inofanira kuitwa uye wokuwedzera bolus kuti 0.3 MG / makirogiramu vanofanira kupiwa kana zvichidiwa.

GPI Kutarisirwa vanofanira munyaya chiitiko kuti chero mamiriro ezvinhu akanyorwa kutsiva-2 kunotoda kutongwa Rondedzero aripo.

Varwere vanenge rova ​​/ HITTS

Zvavakabvumirana dose kuti bivalirudin kuti jekiseni pavarwere vane HIT / HITTS achirapwa PCI ane IV bolus pamusoro 0.75 MG / makirogiramu. Izvi zvinofanira kuteverwa chinoramba aizomupa pamwero wenyika 1.75 MG / makirogiramu / h kwenguva ya nzira.

Nokuti kuramba kurapwa romukova nzira

Bivalirudin nokuti jekiseni aizomupa anogona vakaramba kutevera PCI / PTCA kusvika 4 maawa kuposita nzira panguva kungwara ari kurapa chiremba.

In varwere ST chidimbu kukwirira myocardial infarction (STEMI) kuenderera bivalirudin kuti jekiseni aizomupa pamwero wenyika 1.75 MG / makirogiramu / h inotevera PCI / PTCA kusvika 4 maawa post-nzira inofanira kuonekwa kuderedza ngozi stent thrombosis.

Mushure maawa mana, chimwezve IV aizomupa bivalirudin kuti jekiseni inogona anosarudza pamwero wenyika 0.2 MG / makirogiramu / h (yakaderera-zvazvingava aizomupa), kwemaawa anosvika 20, kana zvichidiwa.

2.2 Dosing mu Renal vanotaura

No rutapudzo ari bolus dose runodikanwa chero mwero renal vanotaura. The aizomupa dose kuti bivalirudin kuti jekiseni ingada kuderedzwa, uye anticoagulant mamiriro kuongororwa pavarwere vane renal vanotaura. Varwere mwero renal vanotaura (30 kusvika 59 ML / Nha) vanofanira kugamuchira chinhu aizomupa 1.75 MG / makirogiramu / h. Kana creatinine Clearance idukusa 30 ML / Maminitsi, zvinoderedza pamusoro aizomupa mwero 1 MG / makirogiramu / h zvinofanira kufungwa. Kana murwere iri hemodialysis, kuti aizomupa mwero anofanira airarama 0.25 MG / makirogiramu / h.

2.3 Mirayiridzo Administration

Bivalirudin nokuti jekiseni inhoroondo ya intravenous bolus jekiseni uye kuramba aizomupa pashure reconstitution uye dilution. Mumwe 250 MG chinu, wedzera 5 ml chena Water kuti jekiseni, USP. Zvinyoronyoro Swirl kusvikira zvose zvinhu yakanyauka. Next, dzinobvisa uye kurasa 5 ML kubva 50 ML aizomupa Saga rine 5% Dextrose muna Water kana 0,9% Sodium Chloride kuti jekiseni. Zvadaro kuwedzera zviri patsva chinu kuti aizomupa Saga rine 5% Dextrose muna Water kana 0,9% Sodium Chloride kuti jekiseni kubvumirana kwokupedzisira wevasungwa 5 MG / ML (semuenzaniso, 1 chinu muna 50 ML; 2 ndiro muna 100 ml; 5 ndiro muna 250 ML). The dose chinofanira kutarisirwa ari kugadziridzwa maererano murwere uremu (ona Table 1).

Kana low-mwero aizomupa rinoshandiswa pachapera aizomupa, wevasungwa bhegi yakaderera vanofanira kugadzirira. Kuti tigadzirire ichi yakaderera wevasungwa, reconstitute 250 MG chinu pamwe 5 ml chena Water kuti jekiseni, USP. Zvinyoronyoro Swirl kusvikira zvose zvinhu yakanyauka. Next, dzinobvisa uye kurasa 5 ML kubva 500 ML aizomupa Saga rine 5% Dextrose muna Water kana 0,9% Sodium Chloride kuti jekiseni. Zvadaro kuwedzera zviri patsva chinu kuti aizomupa Saga rine 5% Dextrose muna Water kana 0,9% Sodium chloride kuti jekiseni kubvumirana kwokupedzisira Kuwanda 0.5 MG / ML. The aizomupa zvazvingava chinofanira kutarisirwa anofanira kusarudzwa kubva kurudyi Mbiru mu Table 1.