недостаточности, у пациентов пожилого возраста (старше 60 лет, особенно
женщины).
Не рекомендуется в/м введение гепарина из-за возможности развития гематомы,
а также в/м введение других препаратов на фоне лечения гепарином.
С осторожностью применяют наружно при кровотечениях и состояниях повышенной
кровоточивости, тромбоцитопении.
Во время лечения гепарином необходим контроль показателей свертывания крови.
Для разведения гепарина используют только физиологический раствор.
При развитии тяжелой тромбоцитопении (снижение количества тромбоцитов в 2
раза от первоначального числа или ниже 100 000/мкл) необходимо срочно
прекратить применение гепарина.
Риск кровотечения может быть сведен до минимума при тщательной оценке
противопоказаний, регулярном лабораторном контроле свертывания крови и
адекватном дозировании
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
Начните сравнивать цены и заказывать лекарства прямо в приложении
Наведите камеру на QR-код, чтобы скачать
Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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Дефицит антитромбина"}},{"type":"paragraph","data":{"text":"III в плазме или в месте тромбоза может снизить антитромботический эффект"}},{"type":"paragraph","data":{"text":"гепарина."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Профилактика и терапия: тромбоз глубоких вен, тромбоэмболия легочной"}},{"type":"paragraph","data":{"text":"артерии (в том числе при заболеваниях периферических вен), тромбоз коронарных"}},{"type":"paragraph","data":{"text":"артерий, тромбофлебиты, нестабильная стенокардия, острый инфаркт миокарда,"}},{"type":"paragraph","data":{"text":"мерцательная аритмия (в том числе сопровождающаяся эмболией), ДВС-синдром,"}},{"type":"paragraph","data":{"text":"профилактика и терапия микротромбообразования и нарушения микроциркуляции,"}},{"type":"paragraph","data":{"text":"тромбоз почечных вен, гемолитико-уремический синдром, митральный порок"}},{"type":"paragraph","data":{"text":"сердца (профилактика тромбообразования), бактериальный эндокардит,"}},{"type":"paragraph","data":{"text":"гломерулонефрит, волчаночный нефрит."}},{"type":"paragraph","data":{"text":"Профилактика свертывания крови во время операций с использованием"}},{"type":"paragraph","data":{"text":"экстракорпоральных методов кровообращения, при проведении гемодиализа,"}},{"type":"paragraph","data":{"text":"гемосорбции, перитонеального диализа, цитафереза, форсированного диуреза,"}},{"type":"paragraph","data":{"text":"при промывании венозных катетеров."}},{"type":"paragraph","data":{"text":"Приготовление образцов несвертывающейся крови для лабораторных целей и"}},{"type":"paragraph","data":{"text":"переливания крови."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Кровотечения, заболевания, сопровождающиеся нарушением процессов"}},{"type":"paragraph","data":{"text":"свертывания крови, подозрение на внутричерепное кровоизлияние, аневризма"}},{"type":"paragraph","data":{"text":"сосудов головного мозга, геморрагический инсульт, расслаивающая аневризма"}},{"type":"paragraph","data":{"text":"аорты, антифосфолипидный синдром, злокачественная артериальная гипертензия,"}},{"type":"paragraph","data":{"text":"подострый бактериальный эндокардит, эрозивно-язвенные поражения ЖКТ,"}},{"type":"paragraph","data":{"text":"тяжелые поражения паренхимы печени, цирроз печени с варикозным расширением"}},{"type":"paragraph","data":{"text":"вен пищевода, злокачественные новообразования в печени, шоковые состояния,"}},{"type":"paragraph","data":{"text":"недавно проведенные хирургические вмешательства на глазах, мозге,"}},{"type":"paragraph","data":{"text":"предстательной железе, печени и желчных путях, состояние после пункции"}},{"type":"paragraph","data":{"text":"спинного мозга, менструация, угрожающий выкидыш, роды (в том числе недавние),"}},{"type":"paragraph","data":{"text":"повышенная чувствительность к гепарину."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Способ применения и режим дозирования конкретного препарата зависят от его"}},{"type":"paragraph","data":{"text":"формы выпуска и других факторов. Оптимальный режим дозирования определяет"}},{"type":"paragraph","data":{"text":"врач. Следует строго соблюдать соответствие используемой лекарственной"}},{"type":"paragraph","data":{"text":"формы конкретного препарата показаниям к применению и режиму дозирования."}},{"type":"paragraph","data":{"text":"Индивидуальный, в зависимости от применяемой лекарственной формы,"}},{"type":"paragraph","data":{"text":"показаний, клинической ситуации и возраста пациента."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны свертывающей системы крови: возможны кровотечения ЖКТ и мочевых путей, кровотечение в месте введения,"}},{"type":"paragraph","data":{"text":"в областях, подвергающихся давлению, из операционных ран, а также"}},{"type":"paragraph","data":{"text":"кровоизлияния в других органах, гематурия, тромбоцитопения."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: тошнота, снижение аппетита, рвота, диарея, повышение активности печеночных"}},{"type":"paragraph","data":{"text":"трансаминаз."}},{"type":"paragraph","data":{"text":"Аллергические реакции: гиперемия кожи, лекарственная лихорадка, крапивница, ринит, кожный зуд и"}},{"type":"paragraph","data":{"text":"ощущение жара в подошвах, бронхоспазм, коллапс, анафилактический шок."}},{"type":"paragraph","data":{"text":"Со стороны свертывающей системы крови: тромбоцитопения (может быть тяжелой вплоть до летального исхода) с"}},{"type":"paragraph","data":{"text":"последующим развитием некроза кожи, артериального тромбоза,"}},{"type":"paragraph","data":{"text":"сопровождающегося развитием гангрены, инфаркта миокарда, инсульта."}},{"type":"paragraph","data":{"text":"Со стороны костно-мышечной системы: при длительном применении - остеопороз, спонтанные переломы, кальцификация"}},{"type":"paragraph","data":{"text":"мягких тканей."}},{"type":"paragraph","data":{"text":"Местные реакции: раздражение, боль, гиперемия, гематома и изъязвления в месте введения."}},{"type":"paragraph","data":{"text":"Прочие: преходящая алопеция, гипоальдостеронизм."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Противосвертывающее действие гепарина усиливается при одновременном"}},{"type":"paragraph","data":{"text":"применении антикоагулянтов, антиагрегантов и НПВС."}},{"type":"paragraph","data":{"text":"Алкалоиды спорыньи, тироксин, тетрациклин, антигистаминные средства, а"}},{"type":"paragraph","data":{"text":"также никотин уменьшают действие гепарина."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"C осторожностью применять у пациентов, страдающих поливалентной аллергией"}},{"type":"paragraph","data":{"text":"(в том числе при бронхиальной астме), при артериальной гипертензии,"}},{"type":"paragraph","data":{"text":"стоматологических манипуляциях, сахарном диабете, эндокардите, перикардите,"}},{"type":"paragraph","data":{"text":"при наличии внутриматочного контрацептива, при активном туберкулезе,"}},{"type":"paragraph","data":{"text":"лучевой терапии, печеночной недостаточности, хронической почечной"}},{"type":"paragraph","data":{"text":"недостаточности, у пациентов пожилого возраста (старше 60 лет, особенно"}},{"type":"paragraph","data":{"text":"женщины)."}},{"type":"paragraph","data":{"text":"Не рекомендуется в/м введение гепарина из-за возможности развития гематомы,"}},{"type":"paragraph","data":{"text":"а также в/м введение других препаратов на фоне лечения гепарином."}},{"type":"paragraph","data":{"text":"С осторожностью применяют наружно при кровотечениях и состояниях повышенной"}},{"type":"paragraph","data":{"text":"кровоточивости, тромбоцитопении."}},{"type":"paragraph","data":{"text":"Во время лечения гепарином необходим контроль показателей свертывания крови."}},{"type":"paragraph","data":{"text":"Для разведения гепарина используют только физиологический раствор."}},{"type":"paragraph","data":{"text":"При развитии тяжелой тромбоцитопении (снижение количества тромбоцитов в 2"}},{"type":"paragraph","data":{"text":"раза от первоначального числа или ниже 100 000/мкл) необходимо срочно"}},{"type":"paragraph","data":{"text":"прекратить применение гепарина."}},{"type":"paragraph","data":{"text":"Риск кровотечения может быть сведен до минимума при тщательной оценке"}},{"type":"paragraph","data":{"text":"противопоказаний, регулярном лабораторном контроле свертывания крови и"}},{"type":"paragraph","data":{"text":"адекватном дозировании"}}]}],"source":null},"description_toggle":false,"short_description":"Антикоагулянт прямого действия, относится к группе среднемолекулярных гепаринов. В плазме крови активирует антитромбин III, ускоряя его противосвертывающее действие. Нарушает переход протромбина в тромбин, угнетает активность тромбина и активированного фактора X, в некоторой степени уменьшает агрегацию тромбоцитов. Для нефракционированного стандартного гепарина соотношение антиагрегантной активности (антифактора Xa) и антикоагулянтной активности (АЧТВ) составляет 1:1. Увеличивает почечный кровоток; повышает сопротивление сосудов мозга, уменьшает активность мозговой гиалуронидазы, активирует липопротеинлипазу и обладает гиполипидемическим действием. Снижает активность сурфактанта в легких, подавляет чрезмерный синтез альдостерона в коре надпочечников, связывает адреналин, модулирует реакцию яичников на гормональные стимулы, усиливает активность паратгормона. В результате взаимодействия с ферментами может увеличивать активность тирозингидроксилазы мозга, пепсиногена, ДНК-полимеразы и снижать активность миозиновой АТФазы, пируваткиназы, РНК-полимеразы, пепсина. Имеются данные о наличии у гепарина иммунодепрессивной активности. У больных с ИБС (в комбинации с ацетилсалициловой кислотой) снижает риск развития острых тромбозов коронарных артерий, инфаркта миокарда и внезапной смерти. Уменьшает частоту повторных инфарктов и летальность больных, перенесших инфаркт миокарда. В высоких дозах эффективен при тромбоэмболиях легочной артерии и венозном тромбозе, в малых - для профилактики венозных тромбоэмболий, в том числе после хирургических операций. При в/в введении свертывание крови замедляется почти сразу, при в/м - через 15-30 мин, при п/к - через 20-60 мин, после ингаляции максимум эффекта - через сутки; продолжительность антикоагулянтного действия соответственно - 4-5, 6, 8 ч и 1-2 нед., терапевтический эффект - предотвращение тромбообразования - сохраняется значительно дольше. 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