Antiplatelet tshuaj - P2Y12 inhibitors

Platelets yog cov keeb me nyob hauv koj cov ntshav uas koj lub cev siv txhaws ua ntshav txhaws thiab ntshav los tsis tu. Yog tias koj muaj ntau cov qe ntshav lossis koj cov platelets txuas ua ke ntau dhau, koj muaj feem ntau yuav ua clog. Qhov txhaws no tuaj yeem ua rau sab hauv koj cov hlab ntsha thiab ua rau lub plawv nres lossis mob hlab ntsha tawg.

Cov tshuaj tiv thaiv kev ua haujlwm ua haujlwm ua kom koj cov ntshav tsis khov thiab yuav pab tiv thaiv cov ntshav txhaws ntawm cov hlab ntsha.

• Tshuaj aspirin yog tshuaj antiplatelet uas tej zaum yuav siv.
• P2Y12 receptor blockers yog lwm pawg ntawm cov tshuaj tiv thaiv mob antiplatelet. Pawg tshuaj no suav nrog: clopidogrel, ticlopidine, ticagrelor, prasugrel, thiab cangrelor.

Siv cov tshuaj tiv thaiv kab mob hauv lub cev:

• Tiv thaiv kev mob plawv lossis mob stroke rau cov neeg uas muaj PAD.
• Clopidogrel (Plavix, feem ntau) siv tau rau cov tshuaj aspirin rau cov neeg uas muaj hlab ntshav tawm ntawm cov ntshav me me lossis cov uas muaj hlab ntsha tsis muaj ntxig.
• Qee zaum 2 tshuaj tiv thaiv mob antiplatelet (ib qho uas yuav luag ib txwm tshuaj aspirin) yog tshuaj rau cov neeg uas tsis muaj ntshav siab tsis zoo, mob hlwb tsis nco qab (mob hlwb tsis zoo lossis lub cim thaum ntxov ntawm lub plawv), lossis cov uas tau txais stent thaum PCI.
• Txog kev tiv thaiv kab mob plawv thiab kev tiv thaiv kab mob thib ob, cov tshuaj aspirin txhua hnub yog qhov kev xaiv thib ib rau kev kho mob antiplatelet. Clopidogrel yog tus kws kho mob es tsis txhob noj cov tshuaj aspirin rau cov neeg uas muaj kev tsis haum tshuaj aspirin lossis tus neeg tsis tuaj yeem tiv thaiv aspirin.
• Cov tshuaj aspirin thiab tshuaj tiv thaiv tshuaj antiplatelet thib ob feem ntau tau pom zoo rau cov neeg uas tab tom mob angioplasty nrog lossis tsis stenting.
• Tiv thaiv lossis kho mob plawv.
• Tiv thaiv kom txhob mob stroke lossis trans ischemic tawm tsam (TIAs yog cov kev qhia ntxov ntawm tus mob stroke. Lawv tseem hu ua "mini-strokes.")
• Tiv thaiv cov ntshav txhaws ntawm kev ua cov hlab ntsha hauv sab hauv koj cov hlab ntsha kom qhib lawv.
• Mob plawv mob.
• Tom qab bypass graft phais uas siv txiv neej ua los yog ua pob txha caj dab ua rau cov hlab ntsha hauv qab ntawm lub hauv caug.

Koj tus kws kho mob yuav xaiv qhov tshuaj twg zoo tshaj rau koj qhov teeb meem. Qee lub sij hawm, koj yuav tau hais kom noj cov tshuaj aspirin tsawg nrog rau ib qho ntawm cov tshuaj no.

Cov kev mob tshwm sim los ntawm cov tshuaj no tuaj yeem suav nrog:

• Zawv plab
• Khaus
• Xeev siab
• Cov tawv nqaij ua pob
• Plab mob

Ua ntej koj pib noj cov tshuaj no, qhia koj tus kws kho mob yog tias:

• Koj muaj teeb meem los ntshav lossis mob plab.
• Koj xeeb menyuam, npaj yuav cev xeeb tub, lossis pub mis niam.

Muaj ib tug xov tooj ntawm lwm cov kev mob tshwm sim, nyob ntawm seb cov tshuaj uas koj tau muab tshuaj rau. Piv txwv li:

• Ticlopidine tuaj yeem ua rau cov qe ntshav dawb qis qis los yog cov tiv thaiv kab mob hauv lub cev uas tua cov ntshav plasmaets.
• Ticagrelor tuaj yeem ua rau lub sijhawm ntu kev ua tsis taus pa.

Cov tshuaj no coj los siv hauv cov tshuaj. Koj tus kws khomob yuav pauv hloov koj cov tshuaj ntau zaug.

Noj cov tshuaj no nrog zaub mov thiab dej kom ntau los txo cov kev phiv. Koj yuav tsum tsum tsis txhob noj clopidogrel ua ntej koj phais lossis kho hniav. Tsis txhob cia li tsum tsis txhob noj koj cov tshuaj yam tsis tau tham ua ntej nrog koj tus kws kho mob.

Tham nrog koj tus kws kho mob ua ntej siv cov tshuaj no:

• Heparin thiab lwm cov ntshav ua kom ntshav nyias, xws li warfarin (Coumadin)
• Tshuaj mob los yog mob caj dab (xws li diclofenac, etodolac, ibuprofen, indomethacin, Advil, Aleve, Daypro, Dolobid, Feldene, Indocin, Motrin, Orudis, Relafen, lossis Voltaren)
• Phenytoin (Dilantin), tamoxifen (Nolvadex, Soltamox), tolbutamide (Orinase), lossis torsemide (Demadex)

Tsis txhob noj lwm yam tshuaj uas tej zaum muaj cov tshuaj aspirin lossis ibuprofen hauv lawv ua ntej tham nrog koj tus kws kho mob. Nyeem cov npe ntawm cov tshuaj txias thiab mob khaub thuas. Nug seb puas muaj lwm yam tshuaj zoo rau koj noj tshuaj rau mob ib ce thiab mob khaub thuas, mob khaub thuas, lossis mob npaws.

Yog tias koj muaj ib hom kev teem sijhawm, koj yuav tsum tso tseg cov tshuaj no 5 txog 7 hnub ua ntej siv tes. Txawm li cas los xij, ib txwm nrog koj tus kws kho mob ua ntej txog seb nws puas nres.

Qhia koj tus kws kho mob yog tias koj cev xeeb tub los yog npaj yuav cev xeeb tub, los yog pub mis niam lossis npaj kom pub mis. Cov poj niam nyob rau theem tom qab ntawm cev xeeb tub yuav tsum tsis txhob noj clopidogrel. Clopidogrel tuaj yeem sib kis tau rau cov menyuam mos los ntawm niam mis.

Tham nrog koj tus kws kho mob yog tias koj muaj mob rau daim siab los sis lub raum.

Yog tias koj plam koob tshuaj:

• Noj kom sai li sai tau, tshwj tsis yog tias txog sijhawm koj cov tshuaj ntxiv.
• Yog tias nws txog sijhawm rau koj li tshuaj noj tom ntej, noj koj li qub.
• Tsis txhob noj tshuaj ntxiv los tsim ib qho tshuaj uas koj tsis nco qab, tshwj tsis yog koj tus kws kho mob hais kom.

Muab cov tshuaj no thiab lwm yam tshuaj khaws cia rau qhov chaw txias thiab qhuav. Cia lawv nyob qhov chaw uas menyuam yaus ncav tsis cuag.

Hu yog tias koj muaj tej kev mob tshwm sim thiab lawv tsis ploj:

• Txhua qhov cim ntawm kev los ntshav txawv, xws li tso ntshav tawm hauv cov zis lossis tso quav, tawm pob qhov ntswg, muaj qhov doog ib ce, ntshav ntau los ntawm kev txiav, tso quav dub tawv, hnoos tawm ntshav, hnyav dua li kev coj khaub ncaws los ntshav lossis qhov quav tsis txaus, qhov ntuav uas zoo li thaj chaw kas fes.
• Kiv taub hau
• Nyuaj nqos nyuaj
• Zawm ntawm koj lub hauv siab lossis mob hauv siab
• O o koj lub ntsej muag lossis ob txhais tes
• Khaus, khaus, lossis tingling hauv koj lub ntsej muag lossis txhais tes
• Hawb pob lossis ua pa nyuaj
• Mob plab heev
• Cov tawv nqaij ua pob

Ntshav cov ntshav - clopidogrel; Antiplatelet txoj kev kho - clopidogrel; Thienopyridines

• Cov quav hniav buildup hauv cov hlab ntsha

Abraham NS, Hlatky MA, Antman EM, li al. ACCF / ACG / AHA 2010 tus kws tshaj lij kev pom zoo cov lus pom zoo txog kev siv cov twj tso kua mis tiv thaiv kab mob thiab thienopyridines: kev hloov kho tshiab ntawm ACCF / ACG / AHA 2008 tus kws tshaj lij kev pom zoo txog kev txo cov plab hnyuv phom sij ntawm kev siv tshuaj tiv thaiv kab mob thiab NSAID siv: tsab ntawv tshaj qhia American College of Cardiology Foundation Task Force ntawm Cov Ntawv Teev Tseg Kws Muaj Peev Xwm. J Am Coll CardiolCov. Xyoo 2010; 56 (24): 2051-2066. PMID: 21126648 pubmed.ncbi.nlm.nih.gov/21126648/.

Fihn SD, Blankenship JC, Alexander KP, li al. 2014 ACC / AHA / AATS / PCNA / SCAI / STS tau hloov kho cov lus qhia rau kev kuaj mob thiab kev tswj hwm cov neeg mob uas muaj lub plawv mob ischemic ruaj khov: ib tsab ntawv tshaj tawm ntawm Asmeskas College ntawm Cardiology / American Heart Association Task Force ntawm Kev Coj Qhia, thiab Cov Koom Haum Asmeskas rau Thoracic Kev Kho Mob, Kev Tiv Thaiv Kab Mob Hauv Lub Hlwb, Cov Koom Haum Rau Kev Mob Hlwb Plawv thiab Cov Kev Tiv Thaiv, thiab Lub Koom Haum ntawm Thoracic Cov Neeg phais. Kev ncigCov. Xyoo 2014; 130: 1749-1767. PMID: 25070666 pubmed.ncbi.nlm.nih.gov/25070666/.

Kubstein LB. Kev tiv thaiv thiab tswj hwm ntawm ischemic stroke. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 65.

Lub Ib Hlis CT, Wann LS, Alpert JS, li al. 2014 AHA / ACC / HRS cov lus qhia rau kev tswj hwm cov neeg mob atrial fibrillation: ib daim ntawv tshaj tawm ntawm American College of Cardiology / American Heart Association Task Force ntawm Kev Coj Qhia thiab Lub Zej Zog Lub Plawv. J Am Coll CardiolCov. Xyoo 2014; 64 (21): e1-e76. PMID: 24685669 pubmed.ncbi.nlm.nih.gov/24685669/.

Mauri L, Bhatt DL. Kev tuaj yeem tiv thaiv txoj hlab ntshav sib txuam. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 62.

Meschia JF, Bushnell C, Boden-Albala B, li al. Cov lus qhia rau kev tiv thaiv kev tiv thaiv mob stroke thawj: ib nqe lus rau cov kws kho mob los ntawm American Heart Association / American Stroke Association. Mob strokeCov. Xyoo 2014; 45 (12): 3754-3832. PMID: 25355838 pubmed.ncbi.nlm.nih.gov/25355838/.

MAY DA, de Lemos JA. Lub plawv ruaj khov ischemic. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 61.

Powers WJ, Rabinstein AA, Ackerson T, li al. Cov lus qhia rau kev tswj hwm thaum ntxov ntawm cov neeg mob uas muaj ischemic stroke: 2019 hloov tshiab rau 2018 Cov Lus Qhia rau kev tswj hwm thaum ntxov ntawm cov neeg mob mob ischemic stroke: cov lus qhia rau cov kws kho mob los ntawm American Heart Association / American Stroke Association. Mob strokeCov. 2019; 50 (12): e344-e418. PMID: 31662037 pubmed.ncbi.nlm.nih.gov/31662037/.

• Angina
• Angioplasty thiab stent tso kawm - carotid leeg
• Angioplasty thiab stent muab tso rau - cov hlab ntsha peripheral
• Aortic valve phais - qhov tsis muaj ntxeem tau
• Aortic valve phais - qhib
• Cov txheej txheem txo qis plhu
• Carotid leeg txoj hlab ntshav phais - qhib
• Mob Hlwb Mob Hlwb Ntev (COPD)
• Coronary mob plawv
• Kev phais plawv bypass
• Kev phais mob hauv lub plawv bypass - tsawg tus tus
• Lub plawv tsis ua hauj lwm
• Lub plawv ua zog
• Cov ntshav siab hauv cov qib siab
• Ntshav siab - cov neeg laus
• Implantable cardioverter-defibrillator
• Mitral valve phais - tsawg minimally tus
• Mitral valve phais - qhib
• Peripheral artery bypass - txhais ceg
• Mob peripheral leeg - txhais ceg

• Angina - tawm hauv
• Angioplasty thiab stent - lub siab - tso tawm
• Angioplasty thiab stent tso kawm - carotid leeg - tso tawm
• Angioplasty thiab stent muab tso rau - cov hlab ntsha peripheral - tawm
• Cov tshuaj aspirin thiab kab mob plawv
• Atrial fibrillation - paug tawm
• Nquag nquag siv thaum koj muaj kab mob plawv
• Mob catheterization - paug
• Carotid leeg txoj kev phais - kev tshem tawm
• Tswj koj cov ntshav siab
• Mob ntshav qab zib - tiv thaiv lub plawv nres thiab mob hlab ntsha tawg
• Plawv nres - tso tawm
• Kev phais plawv bypass - kev tso tawm
• Kev phais plawv bypass - tsawg minasally tus - tawm
• Lub plawv tsis ua haujlwm - tso tawm
• Kev phais lub plawv valve - kev tso tawm
• Peripheral artery bypass - txhais ceg - paug
• Mob Stroke - tawm

• Ib Nplooj Siab Tsis Qhuav Ntshav