Tinzaparin sodium

Chemical name

Sodium salt depolimerizovannogo unchanged from the bowel mucosa of pigs received by geparinaza allocated from Flavobacterium heparinum

Characteristics

Low heparin derived from the standard method of heparin enzyme depolymerization. Molecular weight 1000-14000 D, the maximum peak molecular weight of about 4500 D.

Of drugs

The drugs-antikoagulyatine. Provides direct antikoagulyazionoe effect. Associated with antitrombinom III, and encouraged the opening of the jet center, which leads to inactivation Ha-factora blood clotting. As a result of the lower, as compared to nefrackzionirovannam geparinom, the length of chain sugar residue, to a lesser extent associated with trombinom (the predominantly Anti-ha-factor activity does not increase ACTV. A clinical effectiveness in the treatment of acute coronary syndromes (unstable stenocardia and myocardial infarction without zubza Q) as well as for the treatment and prevention of trombozov deep vein thromboembolism and pulmonary branches �ртерии.Биодоступност ь the p / for a 90% period poluabsorbtion-200 mines, Anti-ha-factor maximum activity is four to six hours and the activity of plasma and radiation is a linear relationship. T_1/2 about 80 minutes. Write mainly with urine in an unmodified form. In patients with chronic renal failure may increase concentration in Krovi.v experiments on animals have been found negative of a fetus. Internationally mnogocentrovom study (Barkagan Z.S., Sanson B.J., Lensing A.W.A., Prins H. et al. , 1998), based on the analysis of 486 reports of the use of low-molecular geparinov (incl. tinzaparina) during pregnancy concluded that the safety of their application to the foetus and the mother. With the doses Anti-ha 30-40 IU / kg in the second trimester of pregnancy is detected infiltration through the placenta. The ability to infiltrate the breast milk is not installed.

Indications

Fever deep vein, prevention postoperatingo ankle deep vein, incl. after orthopaedic interventions and giperkoagulyatsii in ekstrakorporalna circulation in the kidney.

Restrictions on the use of

The potential risk of hemorrhage (bleeding, and severe thrombocytopenia), of the kidney or liver.

Pregnancy and lactation

The caution (not enough clinical experience).

Contraindications

Hypersensitivity, the propensity to bleeding, uncontrolled severe arterial hypertension, acute cerebrovascular violations endocardit Baghdad.

Side-Effects

Haemorrhagic complications.

Patient interaction

Antagonists vitamin C, increased acid protivosvertawati effect.

Overdosing

Symptoms : Krovotechenia.lechenie : a 1% solution Protamine sulphate in / with drip (1 mg Protamine sulfate activity neutralizes 100 Anti-ha tinzaparina IU).

Precautions

Before therapy to determine the number of platelets, to make sure that there are no pathology on the part of blood clotting in the study of fibrinoguena indicators ACTV, protrombina and availability in history gemorragi episodes. Attention should be paid to the attendant diseases, during which may worsen кровотечением.Контро��ь for the therapy (not mandatory) can be carried out to determine Anti-ha-factor activity.

Dosing and Administration

Treatment ankle deep vein : c / to Anti-ha 175 IU / kg every Sutki.prophylactika trombozov in patients with a moderate risk (general surgery) : 3500 IU Anti-ha s / to two hours in advance of the operation and posleoperazionny period Anti-ha 3500 IU once a day 7-10 Dnei.prophylactika trombozov in patients with high-risk : 50 Anti-ha IU / kg m / to two hours in advance of the operation, then once a day to restore motion activity Ballogo.gemodializ period of up to 6700 : the introduction of bolusnoe Anti-ha 2,000 IU in hypertension line or / in at the beginning �емодиализа.Гемодиали з more lengthy 6700 : bolusnoe a 2500 IU Anti-ha hypertension in line or / in at the beginning of dialysis, and then drip in the dose of 750 IU Anti-ha / h. During hemodialysis bolusnuu dose may have to be gradually raise or lower to 250 IU Anti-ha until a therapeutic effect.

Literature

1. Barkagan Z.S., Sanson B.J., Lensing A.W.A., Prins H. et al. The low geparinov of pregnancy (International mnogocentrowoe study) / / Mountain. pharmacology and therapy-1998-N 7 - C. 4-8.2. Panchenko E. The application geparinov low molecular mass кардиологии//Сердечна я lack .- 2000 .- T. 1-N 4 .- C. 144-147.3. R. Racine Differentiation of the low-molecular-weight heparins / / Pharmacotherapy .- 2001 .- V. 21-N-6 P. 62-70.

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