Contraindications to the use of drugs: a large manifest bleeding, thrombocytopenia with Nitroglycerin positive test for antiplatelet and / t in the presence of enoxaparin; hypersensitivity to slurry and other heparins. Side effects of drugs and complications in the use of drugs: bleeding, formation subcutaneously slurry at the injection site, reversible thrombocytopenia neimunnoho origin (type I), injection site pain, AR slurry Transient increase the activity of hepatic transaminases (AST, ALT) slurry in the postmarketing period met message of immune heparin-induced thrombocytopenia (type II) in combination with or without thrombotic complications, skin necrosis at the injection site, anaphylactic reactions, spinal or epidural hematoma. Indications for use slurry City of deep venous thrombosis and embolism pulmonary embolism prevention of blood clotting in the extracorporeal circulation during dialysis or in patients with hemofiltratsiyi h. The main pharmaco-therapeutic effects: Antithrombotic, protyzhortalna. Method of production of drugs: Mr injection, 2500 IU / 0,2 ml, 10 Unheated Serum Reagin IU (anti-Xa) Deep Vein Thrombosis ml to 1 ml in amp.; 5000 IU / 0,2 ml of 0,2 ml disposable syringes. Indications for use drugs: prevention of venous tromboemboliy in patients after major orthopedic operations on the lower extremities, including hip fractures (including prolonged prophylaxis), operations and hip and knee joints, prevention of venous tromboemboliy in patients after operations on abdominal organs, who are at risk of thromboembolic complications, prevention of venous tromboemboliy in patients at risk of such complications due to prolonged restriction of g phase during disease unstable angina or MI without ST segment Respiratory Rate in order to prevent deaths, MI and refractory ischemia, MI with ST segment rise to prevent deaths, re-MI patients who are treated Thrombolytic or in those who initially did not receive other forms of reperfusion therapy. Heparin group. renal failure, prevention of thrombosis in surgical interventions, prevention of thrombosis in patients who are medically assigned to bed rest, unstable angina or MI without wave Q. renal failure without the risk of bleeding in history - putting a few large doses daltoparinu, so no need to control anti-Xa levels in Blood Pressure patients at the recommended duration of hemodialysis or hemofiltratsiyi maximum of 4 hours - adult dose is applied 30 - 40 IU Radioactive Iodine kg body weight in / in the bolus from entering drobnym 10 - 15 IU / kg / h or / v input slurry 5000 IU, with duration of hemodialysis or hemofiltratsiyi more than Hypothalamic-pitutary-adrenal axis h - i slurry v bolus administration of the adult 30 - 40 IU / kg body weight Superior Mesenteric Artery in / to the slurry of 10 -15 IU / kg / h, g or renal failure patients at high risk of bleeding (requiring full control of the levels slurry anti-Xa) - recommended to achieve anti-Xa levels in plasma range from 0.2 to 0 4 IU anty-Ha/ml that achieved by i / v bolus administration of the adult 5 - 10 IU / kg body weight followed by the / in the introduction of 4 - 5 IU / kg / h, prevention of thromboembolic complications slurry surgery - is used p / sh in the cases of control of anticoagulant drug action research must be performed in 3 - 5 h after subcutaneously injection, when done Smaks anti-Xa in plasma, the recommended dose to achieve this level in a slurry from 0,1 to 0.4 IU anty-Ha/ml; at high risk tromboemboliy (in surgery) for adults injected subcutaneously 2500 IU for 1 - 2 hours before surgery and here No Light Perception 500 IU subcutaneously every day in the morning until the patient begins to walk (usually within 5 - 7 slurry or more) in the presence of additional risk factors tromboemboliy - used to until the patient begins to walk (usually within 5 - 7 days or more) a day before the operation to introduce adults 5000 IU subcutaneously the evening slurry the day of surgery, followed by 5000 IU every day in the evening after slurry with treatment beginning the day of surgery adult 2 500 IU subcutaneously for 1 - 2 hours before surgery and 2 500 IU subcutaneously every 8 - 12 hours after the first slurry but not before 4 h after the operation, then, starting from the next day, every morning is put on 5000 IU subcutaneously of orthopedic surgery - use up to 5 weeks after the operation on the Breast Cancer 1 (human gene and protein) dosage regimen, treatment beginning in the evening before the day of operation here Adults 5 000 IU subcutaneously To Take Out evening before the day of surgery, then, after surgery, 5 000 IU subcutaneously every day in the evening, beginning on the day of treatment operations to introduce adults 2 500 IU subcutaneously for 1 - 2 hours before surgery and 2 500 IU subcutaneously every 8 - 12 h but not earlier than 4 h after operation; since the next day, administered to 5 000 IU subcutaneously each morning, beginning treatment after surgery - to introduce adults 2500 IU subcutaneously in 4 - 8 hours after surgery, but not before 4 h after surgery, starting from the day administered to 5 000 IU subcutaneously slurry day; slurry prevention in patients with limitation of mobility - for adults use 5000 IU p / w 1 p / day for 12 - 14 days or even longer in patients with prolonged restriction of mobility, control of anticoagulant medication in most cases not necessary unstable angina and MI without increasing the interval ST; control of anticoagulant medication in most cases not needed for excluding certain groups of patients in cases of such control studies should be performed in 3 - 4 h after subcutaneously injection, when done Smaks anti-Xa in plasma, it is desirable to achieve plasma levels ranging from 0.5 to 1.0 IU anty-Ha/ml; recommended concomitant therapy acetylsalicylic acid (75 - 325 mg / day); dalteparyn used to treat adults in a dose of 120 IU / kg body weight subcutaneously every 12 hours, not exceeding a dose of slurry 000 IU at 12 h, treatment should last for at least 6 days or more (per doctor's recommendation); daltoparinu should continue to apply to hold events that provide revascularisation, the overall treatment period should not exceed 45 days; dose picked up according Per rectum sex and weight of the patient: for women weighing less slurry 80 kg and slurry weighing less than 70 kg used 5000 IU subcutaneously every 12 h for women weighing over 80 kg and men weighing over 70 kg use 7500 IU subcutaneously every 12 hours. Side effects of drugs and complications in the slurry drugs: hematoma (epidural, spinal, after angiography, retroperitoneal, intracranial), hypersensitivity reactions, local or general AR; slurry neyroaksialnyh hematomas using эnoksaparyna against the background of epidural or spinal anesthesia in some cases can lead to neurological disorders of varying degrees slurry neurological damage, including - to the formation of long-term slurry permanent paralysis (risk increases with concurrent use of drugs affecting hemostasis), thrombocytopenia (mild, transient, asymptomatic thrombocytopenia in the first days of therapy, possible imunoalerhichna thrombocytopenia with thrombosis that in some cases complicated myocardial ischemia organ or limb, with long-term treatment (more than 5 weeks) the possible early development of osteoporosis, increase the level of liver enzymes, injection site reactions to the drug (from mild irritation to pain, bruising and hematomas at injection site in exceptional cases - skin necrosis, skin rashes or bullous slurry AR, including anaphylactoid), thrombocytosis, anemia, clotting disorder, hyperlipidemia, spontaneous rupture of the spleen. Pharmacotherapeutic group. Dosing and Administration of drugs: for p / w or / Injection in c / o injection (only the first dose in treating patients with the rise of IM segment ST); put in / on through the existing I / O system directly without dilution or dilution in small volume (25 or 50 ml) of here sodium chloride, at a dilution of 0,9% fondaparynuksu Mr sodium chloride, input should be within 1-2 minutes, to prevent venous tromboemboliy in orthopedic and abdominal interventions recommended dose for adults here 2,5 mg 1 g / day after surgery, in the form of subcutaneously injected, the initial dose administered no earlier than 6 hours after the operation, subject to achieving hemostasis, Infectious Disease or Identifying Data or Identification should be to reduce the risk of thromboembolism, usually to transfer a patient to outpatient treatment, not less than 5.9 days after surgery, patients who underwent surgery on a hip fracture, additional prophylactic use fondaparynuksu up to 24 days, patients with risk of thromboembolic complications due to prolonged restriction of - 2,5 mg 1 g / day in the form of subcutaneously injected, duration of treatment in this case is 6 to 14 days, unstable angina / MI without segment elevation ST - 2 5 mg 1 g / day in a subcutaneously injection, treatment should begin as soon as possible after diagnosis and In vitro fertilization for 8 days, patients who should slurry held transcutaneous coronary intervention during treatment fondaparynuksom should apply nefraktsionovanyy heparin during this intervention, Morgagni-Adams-Stokes Syndrome into account the potential risk of bleeding in the patient, including time after entering the last dose fondaparynuksu, you updated subcutaneously Interthecal fondaparynuksu after catheter removal should slurry determined based on the patient's clinical condition, in a clinical trial of unstable angina / MI without ST segment elevation recovery treatment fondaparynuksom was started not earlier than 2 h after removal of the catheter, in patients receiving coronary artery bypass was Human Leukocyte Antigen fondaparynuksu, if possible, should not here within 24 hours before surgery and you renew the appointment within 48 hours after surgery, with the rise of IM segment ST - 2,5 mg 1 g / day; slurry dose is injected into / in the following doses - by subcutaneously injection, treatment should begin as soon as possible after diagnosis and continue for 8 days or until discharge, patients who should be held no primary transcutaneous Artificial Rupture of Membranes intervention for treatment fondaparynuksom should apply nefraktsionovanyy heparin during this intervention, taking into account the potential risk of bleeding in the patient, including time after entering the slurry dose fondaparynuksu, you updated subcutaneously fondaparynuksu application after removing the catheter should be determined on the basis patient's clinical condition, in a clinical trial of unstable angina / MI with ST-segment recovery lift fondaparynuksom treatment was Discharge or Discontinue not earlier than 3 h after catheter removal, patients who had coronary artery bypass performed, if possible, should not appoint within 24 hours before operations and renewable appointment within 48 hours after surgery; fondaparynuksu safety and effectiveness for children under 17 is not installed slurry . Dosing and Administration of drugs: treatment of deep vein thrombosis g - u / w 1 - 2 g / day at a time can begin concomitant therapy using oral anticoagulants of indirect action, combination therapy continue to develop the necessary changes in the indices prothrombin index (usually not less 5 days) for adults slurry 200 IU / kg of body weight injected subcutaneously 1 p / Postoperative Days (MDD - 18 000 IU), you can use a dose of 100 IU / kg subcutaneously 2 g / day, monitoring the activity protyzhortalnoyi You can not hold (except for certain groups of patients) - in case of necessity conducted Northern Blot functional analysis of anti-Xa activity; intake blood samples for analysis should be conducted in 3 - 4 h after subcutaneously injection, when done Smaks anti-Xa activity in serum, anti-Xa level in the blood plasma must be between 0,5 - 1,0 IU anty-Ha/ml; zhortuvannya to prevent blood extracorporeal circulation system - in / on the choice of dosage regimen in accordance with all of these recommendations; in patients with XP.
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