ILovenox vs. heparin: Umehluko, ukufana, nokuthi yikuphi okungcono kuwe
Izidakamizwa Vs. UmnganiUkubuka konke kwezidakamizwa nokwehluka okuyinhloko | Izimo zilashwa | Ukusebenza | Ukutholakala komshuwalense nokuqhathaniswa kwezindleko | Okuqhamuka uma udla imishanguzo | Ukusebenzisana kwezidakamizwa | Izexwayiso | Imibuzo evame ukubuzwa
Ungahle unikezwe iLovenox (enoxaparin) noma i-heparin ukwelapha noma ukuvimbela i-clot yegazi. ILovenox ne-heparin zombili izidakamizwa ezijojwayo eziyingxenye yeqembu elikhulu lemithi ebizwa ngama-anticoagulants. Njengama-anticoagulants, noma ama-blood thinner, i-Lovenox ne-heparin isiza ekwelapheni nasekuvimbeleni i-vein thrombosis (DVT) ejulile kanye ne-pulmonary embolism (PE).
Kokubili uLovenox no-heparin banendlela efanayo yokusebenza. Zisebenza ngokubophezela kumangqamuzana amancane amaprotheni abizwa ngokuthi i-antithrombin nokuvimba izenzo ze-thrombin, factor Xa, namanye ama-enzyme abandakanyeka ekunqandeni igazi. Yize iLovenox ihlukaniswa njenge-low molecular weight heparin (LMWH), ayifani ne-heparin ejwayelekile.
Uyini umehluko omkhulu phakathi kukaLovenox no-heparin?
ILovenox yigama lomkhiqizo le-enoxaparin. I-LMWH eyenziwe yiSanofi-Aventis. ILovenox ijojowe ngomgogodla (ngaphansi kwesikhumba), futhi itholakala ngokugxila okubili: i-100 mg / ml ne-150 mg / ml.
Amasirinji agcwaliswe ngaphambili weLovenox angena ngamandla ahlukahlukene futhi ayatholakala ngo-300 mg / 3 ml.
ILovenox ine-half-life of around 4.5 kuya ku-7 amahora ngemuva kokuphathwa, futhi imiphumela yaso ye-anticoagulant ihlala amahora afinyelela kwangu-12. Ngenxa yomphumela wayo omude wesigamu sempilo nemiphumela ebikezelwayo, iLovenox ayidingi ukuqashelwa okunzulu noma ukugadwa ukuyisebenzisa.
I-Heparin, eyaziwa nangokuthi i-heparin ejwayelekile noma i-heparin engahluziwe (UFH), ingumjovo ojwayelekile. IHeparin nayo ihamba ngamagama emikhiqizo efana neHep-Lock.
I-Heparin ivame ukuphathwa ngemithambo yegazi (ngokusebenzisa umthambo) noma ngaphansi kwesikhumba (ngaphansi kwesikhumba). Itholakala kumthamo womthamo owodwa kanye namafomu emithamo eminingi ngamandla ahlukahlukene angafaka amayunithi ayi-1 000 e-USP / ml, amayunithi ayi-5,000 e-USP / ml, kanye nama-unit angu-10,000 e-USP / ml.
Uma kuqhathaniswa neLovenox, i-heparin ine-half-life emfushane yamahora angu-0,5 kuya kwangu-2. I-Heparin idinga ukunikezwa kaningi kune-Lovenox, futhi imvamisa iphathwa esimweni sesibhedlela. Imiphumela ye-heparin ye-anticoagulant idinga ukubhekwa ngoba imiphumela yayo ayinakulindeleka kakhulu kune-heparin yesisindo esiphansi samangqamuzana.
| Umehluko omkhulu phakathi kweLovenox ne-heparin | ||
|---|---|---|
| I-Lovenox | I-Heparin | |
| Isigaba sezidakamizwa | I-Anticoagulant | I-Anticoagulant |
| Isimo somkhiqizo / ejwayelekile | Uhlobo lomkhiqizo nohlobo olujwayelekile luyatholakala | Uhlobo lomkhiqizo nohlobo olujwayelekile luyatholakala |
| Ngubani igama elijwayelekile? | Enoxaparin | IHeparin yigama elijwayelekile leHeparin Sodium ADD-Vantage |
| Izidakamizwa zingena ngaziphi izinhlobo? | Isixazululo somjovo | Isixazululo somjovo |
| Uyini umthamo ojwayelekile? | 40 mg ngaphansi kwesikhumba kanye ngosuku. Isilinganiso singahluka ngokuya ngesimo esiphathwayo. | Amayunithi angama-5000 agqitshwa ngaphansi kwamahora ayisishiyagalombili kuya kwayi-12. Isilinganiso singahluka ngokuya ngesimo esiphathwayo. |
| Yelashwa isikhathi esingakanani? | Izinsuku eziyi-7, ngaphezulu noma ngaphansi kuya ngesimo esiphethwe | Izinsuku eziyi-7, ngaphezulu noma ngaphansi kuya ngesimo esiphethwe |
| Ubani ovame ukusebenzisa umuthi? | Abantu abadala, izingane, nezinsana | Abantu abadala, izingane, nezinsana |
Ufuna intengo engcono kuLovenox?
Bhalisela izexwayiso zamanani entengo yeLovenox bese uthola ukuthi intengo ishintsha nini!
Thola izexwayiso zentengo
Izimo eziphathwe nguLovenox ne-heparin
Kokubili iLovenox ne-heparin kuvunyelwe e-U.S. Ekwelashweni kwe- i-venous thromboembolism (VTE) , isimo esifaka phakathi i-vein thrombosis ejulile kanye ne-embolism ye-pulmonary. Amahlule egazi angahle akheke emilenzeni noma ezingalweni (deep vein thrombosis / DVT) futhi angahambela emaphashini lapho efakwa khona emithanjeni yegazi (embolism pulmonary embolism / PE).
ILovenox ne-heparin nazo zisetshenziselwa ukuvimbela amahlule egazi, ikakhulukazi ngemuva kokuhlinzwa njengokuhlinzwa kwedolo noma ukuhlinzwa kwe-hip esikhundleni. Ukuphumula embhedeni ngemuva kokuhlinzwa kungenye yezinto eziyingozi enkulu kumahlule egazi. Ezinye izinto eziyingozi kumahlule egazi zihlanganisa umlando womndeni wokuphazamiseka kwegazi, ukukhulelwa, ukukhuluphala, ukubhema nomdlavuza.
IHeparin nayo ivunyelwe ukuvimbela nokwelapha amahlule egazi angavela i-fibrillation ye-atrial . Ngakolunye uhlangothi, iLovenox ivunyelwe ukwelapha nokuvimbela izinkinga kubantu abathola izinhlobo ezithile zobuhlungu besifuba (i-angina engazinzile) nokuhlaselwa yinhliziyo (i-non-Q-wave myocardial infarction).
| Isimo | I-Lovenox | I-Heparin |
| Ukwelashwa nokuvinjelwa kwe-venous thromboembolism | Yebo | Yebo |
| Ukwelashwa nokuvimbela amahlule egazi ngemuva kokuhlinzwa | Yebo | Yebo |
| Ukuvimbela nokwelashwa kwezinkinga ezivela ku-fibrillation ye-atrial | Ngaphandle kwelebula | Yebo |
| Ukuvimbela izinkinga ezivela ku-angina engazinzile nasekuhlaselweni kwenhliziyo | Yebo | Ngaphandle kwelebula |
Ingabe iLovenox noma i-heparin isebenza kangcono?
ILovenox ne-heparin zombili ziyasebenza ekwelapheni nasekuvimbeleni amahlule egazi. Basebenza ngezindlela ezifanayo ukuvumela igazi ukuba ligeleze ngokukhululeka. Ukuthanda isidakamizwa esisodwa ngaphezu komunye kuya ngezindleko, imiphumela emibi, nokuphathwa.
Uma kuqhathaniswa ne-heparin, uLovenox unempilo ende ende. Okusho ukuthi, ihlala isikhathi eside futhi ingaphathwa kanye ngosuku. Umthamo ungabikezelwa kakhulu ngeLovenox, yize iziguli ezinesisindo somzimba esiphakeme zidinga ukufakwa kokuphindwe kaningi, njengomjovo owodwa amahlandla amabili nsuku zonke.
Ekuhlaziyweni kwe-meta kusuka ku- Ijenali yeThrombosis neHaemostasis , i-enoxaparin ne-heparin engakhiswanga yaqhathaniswa nokuvimbela amahlule egazi ezigulini ezisesibhedlela. Izilingo ezine zomtholampilo zifakiwe ekuhlaziyweni kwe-meta futhi kwahlolwa inani leziguli ezingama-3,600. Imiphumela ithole ukuthi, uma kuqhathaniswa ne-heparin, i-enoxaparin yehlise kakhulu amahlule egazi ngaphandle kokukhulisa ubungozi bokopha okukhulu.
I-caatat eyodwa yokusebenzisa i-Lovenox ukuthi umthamo wayo udinga ukuguqulwa ezigulini ezinokwehluleka kwezinso. Ngaphandle kwalokho, kunengozi eyengeziwe yokopha. Ekusebenzeni komtholampilo, i-heparin engakhiphiwe iyathandwa kubantu abanokukhubazeka kwezinso.
Udokotela wakho uzokunikeza i-anticoagulant engcono kakhulu yesimo sakho. I-anticoagulant esebenza kahle kakhulu izonqunywa ngokuya ngomlando wakho jikelele wezokwelapha.
Ukuqhathaniswa kanye nezindleko zokuqhathaniswa kweLovenox vs. heparin
Iningi le-Medicare nezinhlelo zomshuwalense zizohlanganisa uLovenox. Kodwa-ke, umshwalense kungenzeka ukuthi uhlanganise i-generic Lovenox, futhi kungenzeka bangakhokhi izindleko ezigcwele. Intengo emaphakathi yokuthengisa yeLovenox icishe ibe $ 380. Uma uthenga imijovo yeLovenox ukuze uyisebenzise ekhaya ekhemisi, ungasebenzisa ikhadi leLovenox SingleCare ukonga imali. Esikhundleni sokukhokha inani eligcwele leLovenox, ungakhokha ngaphansi kwama- $ 75 ngamasirinji ayi-10 ajwayelekile akhethiwe.
I-Heparin ivame ukumbozwa yi-Medicare nezinhlelo zomshuwalense. Kubuye kube kubiza kancane kuneLovenox. Noma kunjalo, intengo ejwayelekile yokuthengisa ye-heparin ingu- $ 120, kuya ngobungako nangomthamo. Ngekhuphoni le-SingleCare, ungalithola ngaphansi kwama- $ 50 emakhemisi abambe iqhaza.
| I-Lovenox | I-Heparin | |
| Ngokuvamile embozwe umshwalense? | Yebo | Yebo |
| Imbozwe ngokwejwayelekile yi-Medicare Part D? | Yebo | Yebo |
| Umthamo ojwayelekile | 40 mg ngaphansi kwesikhumba kanye ngosuku (ubuningi be-10) | Amayunithi angama-5000 agxila ngaphansi kwamahora ayisishiyagalombili kuya kwayi-12 (ubuningi be-10) |
| I-Medicare copay ejwayelekile | $ 5– $ 58 | $ 1– $ 3 |
| Izindleko ze-SingleCare | $ 71 + | $ 45 + |
Thola ikhadi lesaphulelo sekhemisi
Imiphumela emibi ejwayelekile yeLovenox vs. heparin
Umphumela ovame kakhulu weLovenox ne-heparin ukusabela kwendawo yokujova. Ngemuva kokufaka imijovo yeLovenox noma i-heparin, ungahle uzwe ubuhlungu, ukungaphatheki kahle, ukucasuka noma ukuvuvukala ezungeze indawo yomjovo. Kodwa-ke, le miphumela emibi ivame ukuba mnene futhi ihambe yodwa.
Njengoba iLovenox ne-heparin kuvimbela amahlule egazi, kungadala imiphumela emibi yokopha. Ngenkathi usebenzisa iLovenox noma i-heparin, ungahlangabezana nokulimala kaningi. Ama-anticoagulants nawo angadala ukopha kakhulu. Izimpawu zokopha okukhulu zifaka ukulimaza okunzima negazi esitokisini noma emchameni. Funa usizo lwezokwelapha uma uhlangabezana nezimpawu zokopha kakhulu.
Bona ishadi elingezansi ngeminye imiphumela emibi ejwayelekile.
| I-Lovenox | I-Heparin | |||
| Umphumela oseceleni | Kusebenza? | Imvamisa | Kusebenza? | Imvamisa |
| Ubuhlungu, ukucasuka, ukuvuvukala ezungeze indawo yokujova | Yebo | * | Yebo | * |
| Ukopha | Yebo | * | Yebo | * |
| Ama-enzyme wesibindi aphakeme | Yebo | * | Yebo | * |
| Isicanucanu | Yebo | * | Akunjalo | - |
| Uhudo | Yebo | * | Akunjalo | - |
* akubikiwe
Ukuvama akususelwa kudatha evela esivivinyweni sekhanda kuya ekhanda. Lokhu kungenzeka kungabi uhlu oluphelele lwemiphumela emibi engenzeka. Sicela ubheke udokotela wakho noma umhlinzeki wezokunakekelwa kwempilo ukuze ufunde kabanzi.
Umthombo: DailyMed ( I-Lovenox ), IDailyMed ( I-Heparin )
Ukusebenzisana kwezidakamizwa kweLovenox vs. heparin
ILovenox ne-heparin inokusebenzisana kwezidakamizwa okufanayo. Ama-Platelet inhibitors, noma ama-antiplatelet agents, yizigaba ezahlukahlukene zemithi ezingasiza futhi ukuvimbela amahlule egazi. Ukuhlanganisa ama-antiplatelets afana ne-clopidogrel, i-ticagrelor, noma i-prasugrel ne-Lovenox noma i-heparin kungandisa ingozi yokuphuma kwegazi.
Izidakamizwa ezingezona ukuvuvukala (ama-NSAID) angathinta i- ukusebenza kwama-platelets . Ingozi yokopha ingakhuphuka lapho uthatha ama-NSAID kanye neLovenox noma i-heparin. Tshela udokotela wakho uma uthatha ama-NSAID ngaphambi kokuqala ukwelashwa kuLovenox noma i-heparin.
| Izidakamizwa | Isigaba sezidakamizwa | I-Lovenox | I-Heparin |
| I-Aspirin Ibuprofen Indomethacin UCelecoxib | Izidakamizwa ezingezona ukuvuvukala (ama-NSAID) | Yebo | Yebo |
| I-Clopidogrel I-Ticagrelor Prasugrel I-Dipyridamole | Ama-antiplatelet agents | Yebo | Yebo |
Thintana nochwepheshe wezokunakekelwa kwempilo mayelana nokunye ukuxhumana kwezidakamizwa okungenzeka
Izexwayiso zikaLovenox ne-heparin
Ama-anticoagulants afana neLovenox ne-heparin angakhuphula ingozi yokopha kakhulu, noma ukopha. Ukopha kungaba nzima futhi kuvame ukukhonjiswa yizimpawu ezifana negazi emchameni noma esitulweni. Ingozi yokuphuma kwegazi nayo ingaphakama kubantu abanomlando wokuphazamiseka kokopha.
IHeparin ingadala i-heparin eyenziwe i-thrombocytopenia (HIT) , isimo esibi esibonakala ngenani eliphansi leplatelet. Ngenkathi abantu ngokuvamile bengazitholi izimpawu ezicacile ze-HIT, kuyinkinga esongela impilo engadala ukopha kakhulu noma ukufa. Uma kuqhathaniswa neLovenox, i-heparin inengozi enkulu ye-HIT. Ukusetshenziswa kweHeparin kuvame ukubhekwa kakhulu ngenxa yalesi sizathu.
ILovenox inobungozi obandayo be-spinal epidural hematoma, noma iqoqo legazi elizungeze umgogodla. I-spinal epidural hematoma ingaholela ezinkingeni noma ekukhubazekeni. Ingozi iyakhuliswa uma ngabe uke wabamba isikhathi esidlule noma esivela kaninginingi somgogodla noma we-epidural; uthatha ama-NSAID, ama-platelet inhibitors, nama-anticoagulants; noma une-catheter ye-epidural ehlala ngaphakathi.
Xhumana nomhlinzeki wakho wezokunakekelwa kwempilo ukuthola ezinye izinyathelo ezihlobene neLovenox ne-heparin.
Imibuzo ebuzwa njalo ngeLovenox vs. heparin
Yini iLovenox?
ILovenox iyi-anticoagulant ejojozayo, noma inciphise igazi. Kubuye kubhekwe njenge-heparin yesisindo esiphansi. ILovenox iyatholakala ngokugxila kuka-100 mg / ml no-150 mg / ml. Imvamisa iphathwa kanye noma kabili nsuku zonke njengomjovo ongaphansi. Igama elijwayelekile likaLovenox lithi enoxaparin.
Yini i-heparin?
IHeparin yaziwa nangokuthi okujwayelekile noma i-heparin engaxutshiwe . Itholakala ezinhlotsheni ezijwayelekile noma zegama lomkhiqizo. I-heparin ilawulwa njengomjovo we-intravenous noma wesikhumba. Imvamisa inikezwa lapho kubekwa khona isibhedlela, yize ezinye izinhlobo ze-heparin zingaphathwa ekhaya.
Ngabe i-Lovenox ne-heparin ziyefana?
ILovenox ne-heparin akufani. ILovenox isisindo esiphansi samangqamuzana i-heparin (LMWH), esihlukile kwi-heparin ejwayelekile noma engaxutshiwe (UFH). Yize uLovenox no-heparin bobabili bengama-anticoagulants, banokuhluka ekwakhiweni nasekusetshenzisweni okuvunyelwe yi-FDA.
Ngabe i-Lovenox noma i-heparin ingcono?
ILovenox ne-heparin zombili ziyasebenza ekwelapheni nasekuvimbeleni izimo zokuvala igazi njenge-vein thrombosis (DVT) ejulile kanye ne-pulmonary embolism (PE). ILovenox inamapharamitha wokuqapha nokuqapha angaqageleka kalula futhi ngenxa yalokho, ikhethwa kakhulu ukusetshenziswa kwasekhaya. Isikhathi eside sempilo kaLovenox sisho ukuthi singancishiswa kanye nsuku zonke.
Uma kuqhathaniswa neLovenox, i-heparin idinga ukwenziwa idosi kaningi nangamanani aphezulu ngenxa yempilo yayo emfushane. I-Heparin ibiza kancane kuneLovenox, futhi imvamisa iphathwa endaweni yokubeka isibhedlela lapho ukuqapha imiphumela emibi kulula khona.
Ngingayisebenzisa yini i-Lovenox noma i-heparin ngenkathi ngikhulelwe?
ILovenox noma i-heparin ngokuvamile iphephile futhi iyasebenza ekwelapheni ukuphazamiseka kwe-thromboembolic ngesikhathi sokukhulelwa . Kokubili ama-anticoagulants awaweli i-placenta. Kodwa-ke, ama-heparin wesisindo esiphansi (ama-LMWHs), njengoLovenox, ancanyelwa ukwelapha amahlule egazini kwabesifazane abakhulelwe.
Ngingasebenzisa i-Lovenox noma i-heparin ngotshwala?
Abahlinzeki bezempilo batusa ukunciphisa noma ukugwema utshwala ngenkathi usebenzisa i-Lovenox noma i-heparin. Utshwala ingasebenza njenge-thinner yegazi , okungaholela engcupheni eyengeziwe yokopha lapho utshwala buhlanganiswa nomuthi olwa negciwane.
Yini engasetshenziswa esikhundleni se-heparin?
Ama-heparin wesisindo esiphansi (ama-LMWHs) avame ukusetshenziswa esikhundleni se-heparin. ILovenox (enoxaparin), iFragmin (dalteparin), ne-Innohep (tinzaparin) yizibonelo zama-LMWHs angasetshenziswa ukwelapha noma ukuvimbela amahlule egazi. I-Arixtra (fondaparinux) ingelinye i-antithrombotic agent, ehlukile kwi-LMWH ne-UFH, engavimbela i-factor Xa futhi yelaphe amahlule egazi.
Ama-anticoagulants womlomo aqondile (ama-DOAC), afika efomini lamaphilisi, nawo asetshenziswa kabanzi esikhundleni se-heparin. Izibonelo zama-DOAC zifaka phakathi iXarelto (rivaroxaban powder), Pradaxa (dabigatran), ne-Eliquis (apixaban).
Isetshenziselwani iLovenox?
ILovenox (enoxaparin) isetshenziselwa i-anticoagulation ne-thromboprophylaxis. Kungasiza ukwelapha noma ukuvimbela amahlule egazi angavela emithanjeni yegazi. ILovenox ingasiza ekwelapheni amahlule egazi akha emilenzeni noma ezingalweni (deep vein thrombosis) noma amahlule afakwa emaphashini (embolism pulmonary embolism). ILovenox ibuye isetshenziselwe ukuvimbela izinkinga ezivela ku-angina engazinzile kanye nezinhlobo ezithile zokuhlaselwa yinhliziyo.
Ingabe uLovenox umuthi onengozi enkulu?
ILovenox iyingozi kakhulu, noma umuthi wokuxwayisa kakhulu. Yize imvamisa kuyimithi ephephile, iLovenox ingadala ukulimala okukhulu nezinkinga uma isetshenziswe ngokungafanele. Uma iLovenox inikezwa ngomthamo ophakeme kakhulu, kunengozi eyengeziwe yokopha nemiphumela emibi. ILovenox kufanele isetshenziswe kuphela ngemithi kadokotela kanye nokuholwa okufanele kusuka kumhlinzeki wezokunakekelwa kwempilo.
