Main >> Magunguna Vs. Aboki >> Coumadin vs. heparin: Bambanci, kamance, kuma wanne ne mafi alheri a gare ku

Coumadin vs. heparin: Bambanci, kamance, kuma wanne ne mafi alheri a gare ku

Magunguna vs. Aboki

Anticoagulation far yana taka muhimmiyar rawa wajen kula da mawuyacin yanayi kamar su fibrillation na atrial, verom thromboembolism, da kuma sanya zuciyar bawul na inji. Magungunan hana yaduwar jini Coumadin da heparin suna taimakawa sarrafawa da hana samuwar daskarewar jini wanda zai iya zama sanadiyyar waɗannan halayen.

Vitamin K wani muhimmin abu ne a cikin hanyar zuwa samuwar jini. Ana buƙata a cikin haɗin abubuwan haɓaka masu aiki na II, VII, IX, da X. Da zarar an yi amfani da shi a cikin haɗin waɗannan abubuwan haɗarin jini, bitamin K ya zama mai lalacewa kuma dole ne a sake kunna shi ta bitamin K epoxide reductase hadaddun 1 (VKORC1) domin ci gaba da shiga cikin tsarin samar da daskarewa. Coumadin yana hana wani ɓangare na hadadden VKOR kuma hakan yana ba da gudummawa ga ƙarancin bitamin K a cikin jiki, wanda ke jinkirta ikon jiki na samar da daskarewa.

Heparin yana aiki ne ta hanyar haɗuwa da furotin antithrombin III wanda daga baya baya kashe thrombin da sauran abubuwan haɓaka, mafi mahimmanci factor Xa. Waɗannan matakan suna hana canzawar fibrinogen zuwa fibrin, wani mahimmin mataki a cikin samuwar jini. Ta hanyar jinkirta samuwar fibrin, heparin yana rage samuwar jini a jiki.

Menene manyan bambance-bambance tsakanin Coumadin da heparin?

Coumadin magani ne na likitanci wanda ake yawan kiransa da sunansa na asali, warfarin, ko kuma wani lokacin Jantoven. Ana amfani dashi don hana samuwar daskarewar jini a yanayi irin su fibrillation na atrial, stroke, bugun zuciya, da thromboembolism na jini. Ana samuwa azaman kwamfutar hannu ta baka a cikin nau'ikan allurai jere daga 1mg zuwa 10mg a kowace kwamfutar hannu. Yayinda yake kan Coumadin, dole ne marasa lafiya su gabatar da gwaje-gwajen prothrombin na yau da kullun (PT) wanda aka ruwaito a matsayin Norasashen masa ta Duniya (INR) don sanin ko ƙaddarar mai haƙuri ta dace da lafiya. Yawancin lokaci ba a amfani da Warfarin a cikin marasa lafiya ƙasa da watanni 4 saboda lamuran gudanarwa da kuma yiwuwar abubuwan da ba a gano ba waɗanda ke iya shafar ji da hankali.

Heparin magani ne na likitanci wanda akafi amfani dashi a cikin asibitin marasa lafiya. Ana amfani dashi don hana samuwar daskarewar jini a yanayi irin su thrombosis mai zurfin ciki, embolism na huhu, da fibrillation na atrial. Hakanan ana amfani dashi don hana yaduwar jini yayin hanyoyin da suka shafi zuciya da jijiyoyin jini. Ana samun Heparin a cikin fannoni daban-daban na maganin allurar allurar jini ko jiko. Akwai takamaiman abin kirkirar heparin da aka yi nufin kawai don magudanar layin jini don hana samuwar jini a cikin layin. Wannan ana kiran sa magogin heparin, kuma kada ayi amfani da wannan ƙirƙirar don wata manufa. Ana iya amfani da Heparin ga marasa lafiya na kowane zamani, amma ana buƙatar sa ido sosai.

Babban bambanci tsakanin Coumadin da Heparin
	Coumadin	Heparin
Ajin magani	Anticoagulant	Anticoagulant
Alamar alama / ta kowa	Brand da kuma janar akwai	Brand da kuma janar akwai
Menene sunan jimla? Menene sunan alamar?	Warfarin Coumadin	Heparin
Wani nau'i (s) ne miyagun ƙwayoyi ya shigo?	Tablet (mahara ƙarfi)	Magani ga allura ko jiko (yawancin abubuwan da ke akwai)
Menene daidaitaccen sashi?	Yawancin marasa lafiya suna farawa daga 5 MG kowace rana, amma aikin kulawa ya dogara da INR na kowane mai haƙuri	Matsakaicin mai haƙuri zai karɓi nauyin ɗaukar nauyin raka'a 5,000 wanda zai biyo bayan 20,000 zuwa 30,000 raka'a sama da awanni 24 a ci gaba da jiko.
Yaya tsawon maganin al'ada?	Mafi qarancin watanni 3, amma yana iya zama zai iya zama tabbatacce dangane da nuni	Yawanci 'yan kwanaki, har zuwa mako guda
Wanene yawanci yake amfani da magani?	Manya	Manya

Yanayin da Coumadin da heparin suka kula da shi

Ana amfani da Coumadin don hanawa da magance cututtukan ƙwaƙwalwar ƙwaƙwalwa da huɗar huhu da kuma rikicewar haɗuwa da ke tattare da fibrillation na atrial da kuma maye gurbin injin inji. Hakanan ana amfani da Coumadin don hana rikice-rikicen da ke tattare da coagulation wanda zai iya biyo bayan ɓarkewar ƙwayar cuta ko bugun zuciya.

Heparin ana amfani dashi don hanawa da magance cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa. Bugu da ƙari, ana amfani da heparin don hana haɗuwa a cikin tiyata na zuciya da jijiyoyin jini, ƙarin jini, da hanyoyin dialysis.

Yanayi	Coumadin	Heparin
Ciwon mara na Venous	Ee	Ee
Ciwon mara na huhu	Ee	Ee
Atrial fibrillation	Ee	Ee
Sauya bawul na inji	Ee	Ee
Matsalolin infarction na post-myocardial masu alaƙa da daskarewa	Ee	Ba
Magungunan jijiyoyin jini na ciki (angioplasty)	Ba	Ee
Karin jini	Ba	Ee
Dialysis	Ba	Ee

Shin Coumadin ko heparin ya fi tasiri?

Coumadin da heparin suna da bambance-bambance wanda ya basu kowannensu matsayi mai mahimmanci a cikin far, sau da yawa a cikin haƙuri ɗaya.

Kashe rabin rayuwa da lokaci zuwa mafi girman hankali sune manyan mahimman abubuwan asibiti a ƙayyade yadda da yaushe za ayi amfani da kowane magani. Coumadin ya kai matakin plasma mafi girma daga sashi ɗaya cikin kimanin awanni 4, tare da kawar da rabin rai na kimanin awanni 40. Saboda dalilai da yawa waɗanda zasu iya bambanta tare da kowane mai haƙuri, yana iya ɗaukar kwanaki zuwa makonni don isa ga INR mai warkewa. Heparin ya kai matattarar ruwan jini a cikin awanni 2 zuwa 4, tare da kawar da rabin rai na kusan minti 60-90.

Da jagororin don gudanar da cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa (DVT) da ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa don yawancin marasa lafiya da yawa za su ba da shawarar yin amfani da heparin na farko saboda saurin saurin sa. Ana samun tasirin warkewa ta hanyar gudanar da nauyin ɗorawa wanda ya biyo bayan matakin kulawa. Ana ci gaba da wannan yayin da aka fara maganin Coumadin, kuma har sai INR mai haƙuri yana warkewa. Wannan na iya ɗaukar kwanaki 7-10. Heparin gabaɗaya yana buƙatar kulawa a cikin yanayin rashin lafiya, amma mai haƙuri na iya komawa gida da zarar an canza su zuwa Coumadin.

Sai kawai mai ba da sabis na kiwon lafiya na iya ƙayyade abin da magani, ko haɗuwa da magani, ya dace da kowane mai haƙuri. Dole ne masu bayarwa su yi la'akari da yawancin abubuwan da ke tattare da haƙuri, kamar tarihin abubuwan da suka faru na daskarewa, shekaru, jiyya ta baya, da kuma tarihin yanayi irin wannan cutar ta thrombocytopenia.

Verageaukar hoto da kwatancen farashi na Coumadin vs. heparin

Yawancin Medicare da tsare-tsaren inshorar kasuwanci suna rufe Coumadin, da / ko kuma tsarin warfarin. Matsakaicin farashin sayar da Coumadin na iya kaiwa daga $ 80 zuwa $ 120 daloli. Kuna iya samun warfarin na kusan $ 10 tare da takaddar SingleCare.

Heparin galibi ana bayar dashi a cikin asibiti kuma gabaɗaya an rufe shi a ƙarƙashin Sashin Kiwon Lafiya na B . Ga marasa lafiyar marasa lafiya, likitan inshora ya rufe shi idan aka yi la'akari da dacewa da dacewa. Kudin maras lafiya daga aljihunsa zai dogara ne da dalilai da yawa ciki har da ko sun haɗu da abin da za a cire kuma idan suna da ƙarin tallafi. Idan mai haƙuri ya gano cewa Heparin ɗin ba a rufe yake ba, za su iya zazzage takaddun kuɗi kuma su biya ƙasa da $ 45 don takardar sayan magani.

	Coumadin	Heparin
Yawanci inshora ke rufe shi?	Ee	Ee
Yawanci Medicare ke rufe shi?	Ee	Ee, Kashi na B
Daidaitaccen sashi	30, 5 MG kashi	25 ml, naúrar 5000 / ml
Hanyar biyan kuɗaɗe na Medicare	Ya bambanta	Ya bambanta
SingleCare kudin	$ 4- $ 14	$ 45- $ 65

Sakamakon illa na yau da kullun na Coumadin da heparin

Mafi na kowa sakamako masu illa duka Coumadin da heparin suna zubar da jini ko kuma zubar jini mai tsanani. Wasu alamun zubar jini na da wuyar ganewa, amma kaɗan daga cikin alamun bayyanannu sun haɗa da saurin rauni, zubar jini, zubar jini a cikin gumis, ruwan kasa mai launin ruwan kasa ko tsatsa, da jini a ido. Idan mai haƙuri ya ƙaddara don zubar da jini, janyewa daga miyagun ƙwayoyi ya zama dole, ko na ɗan lokaci ne ko na dogon lokaci.

An bayar da rahoto game da cututtukan da ke cikin heparin (HIT) a cikin 1-2% na marasa lafiya da aka ba heparin. Wannan mummunar faduwa a cikin kirjin platelet na iya haifar da rikitarwa mai tsanani kamar su necrosis da gangrene.

Akwai wasu rikice-rikice da cututtuka masu illa daga jiyya tare da Coumadin ko heparin. Likita ko likitan magunguna na iya samar da cikakken jerin abubuwan illa.

	Coumadin	Heparin
Tasirin Side	Ana amfani?	Mitar lokaci	Ana amfani?	Mitar lokaci
Zubar da jini	Ee	1-10%	Ee	1-10%
Ciwon Gangrene / Skin Necrosis	Ee	<1%	Ee	<1%
Kwayoyin cuta na Thrombocytopenia	Ba		Ee	≤30%
BUKA	Ba		Ee	1-2%

Wannan bazai zama cikakken jerin abubuwan da suka faru ba. Da fatan za a tuntuɓi likita ko likitan magunguna don cikakken jerin.
Source: DailyMed ( Coumadin ,, DailyMed ( heparin ).

Magungunan ƙwayoyi na Coumadin vs. heparin

Coumadin yana haɓaka ta cytochrome P450 enzymes, da farko ƙananan subtypes 2C9, 1A2, da 3A4. Masu hana waɗannan enzymes da gaske suna haɓaka matakan Coumadin, sabili da haka ƙara INR mai haƙuri da ƙara haɗarin zubar da jini. Misalan wadannan magungunan na enzyme sun hada da antifungals kamar su fluconazole, da kuma sanannen maganin cholesterol, atorvastatin. Enzyme inducers za su rage matakan Coumadin, mai yiwuwa yin INR mai haƙuri subtherapeutic kuma ƙara biye da wani taron thrombotic. Misalan masu haifar da enzyme sun hada da magungunan anti-seizure carbamazepine da phenobarbital.

Za'a iya samun tasirin heparin ta magungunan antiplatelet kamar NSAIDs. Ibuprofen zai zama misali. Za a iya rage tasirin Heparin ta hanyar hulɗa tare da magungunan rigakafi na yau da kullun irin su doxycycline.

Tebur mai zuwa ba lissafin ma'amala ne da ya hada duka ba. Mai ba ku kiwon lafiya na iya samar da cikakken jerin abubuwa da ƙarin bayani kan kowane hulɗa.

Drug	Ajin Magunguna	Coumadin	Heparin
Amiodarone Propafenone	Antiarrhythmic	Ee	Ba
Fluconazole Itraconazole Ketoconazole Miconazole Voriconazole	Anti-fungal	Ee	Ba
Phenobarbital Carbamazepine	Mai cin nasara	Ee	Ba
Cimetidine Famotidine Ranitidine	Antacids	Ee	Ba
Ciprofloxacin Norfloxacin	Magungunan rigakafi na Fluoroquinolone	Ee	Ba
Clarithromycin Erythromycin Telithromycin	Maganin rigakafin Macrolide	Ee	Ba
Doxycycline Minocycline	Magungunan rigakafi na Tetracycline	Ba	Ee
Atorvastatin Fluvastatin Simvastatin	HMG Co-A Ragectase Inhibitors (Statins)	Ee	Ba
Haɗin Estrogen da Progestin	Maganin hana haihuwa na baka	Ee	Ee
Apixaban Rivaroxaban foda Edoxaban	Mai rage jini	Ba	Ee
Ibuprofen Naproxen	NSAID	Ee	Ee
Celecoxib Meloxicam	Mai hana Cox II	Ee	Ee

Gargadi na Coumadin da heparin

Coumadin da heparin kowannensu na iya haɓaka abin da ya faru na zubar jini. Wasu ƙwayoyi na iya ƙara yiwuwar wannan abin da ke faruwa. Marasa lafiya akan Coumadin dole ne a rinka duba INR a kai a kai. Yawan cin bitamin K, wanda ke ƙunshe cikin abinci da yawa kamar su kayan lambu masu ɗanye, na iya rage tasirin Coumadin. Marasa lafiya ya kamata su ci gaba da cin abinci na yau da kullun na Vitamin K yayin Coumadin don kiyaye INR mai warkewa. Coumadin yana hana cikin ciki.

Cutar da ke cikin heparin thrombocytopenia yana faruwa a cikin 1% zuwa 2% na marasa lafiya kuma wannan lamari ne mai mahimmanci wanda ke haifar da lalata platelets. Wannan na iya haifar da cututtukan daji da necrosis na fata idan ba a kama su cikin lokaci ba.

Tambayoyi akai-akai game da Coumadin vs. heparin

Menene Coumadin?

Coumadin magani ne na maganin hana shan magani wanda aka yi amfani dashi wajen magani da kuma maganin cutar sanyin hanji da kuma huhu na huhu. Hakanan ana amfani dashi don sarrafa abubuwan daskararre wadanda suka danganci fibrillation na atrial da kuma sanya matsakaiciyar zuciya. Ana ɗauka ta baki yawanci sau ɗaya a rana, kuma dole ne marasa lafiya su sa ido sosai a kansu ta INR a kai a kai don tabbatar da cewa maganin Coumadin ɗin ya dace.

Menene heparin?

Heparin wani magani ne mai hana yaduwar jini a cikin asibiti. Ana amfani dashi a cikin jiyya da kuma maganin cutar sanyin hanji da huhu na huhu. Hakanan ana amfani dashi don gudanar da abubuwan daskarewa yayin ayyukan tiyata na zuciya da mara. Marasa lafiya yawanci suna karɓar nauyin ɗorawa tare da jiko, wanda zai iya ɗaukar kwanaki da yawa dangane da maganin.

Shin Coumadin da heparin iri daya ne?

Duk da yake Coumadin da heparin duka magunguna ne masu hana yaduwar jini, ba iri daya bane. Coumadin magani ne na maganin baka wanda yawanci ana amfani dashi a wurin marasa lafiya, yayin da heparin magani ne na allura wanda yawanci ana amfani dashi a yanayin asibiti.

Shin Coumadin ko heparin ya fi kyau?

Fara aikin Heparin ya fi Coumadin sauri fiye da yadda ya kamata amma dole ne a bi shi ta ci gaba da yin jiko ko yawan allura. Sabili da haka, ana iya amfani da heparin kawai a yanayin asibiti. Coumadin na iya ɗaukar kwanaki da yawa don ya yi tasiri amma yana da lafiya a ɗauka a cikin asibitin marasa lafiya. Marasa lafiya akan Coumadin dole ne ayi musu gwajin jini na yau da kullun don tabbatar da INR ɗin su a cikin kewayon da ya dace.

Zan iya amfani da Coumadin ko heparin yayin da nake da juna biyu?

Coumadin yana haye mahaifa a cikin mata masu ciki kuma an tabbatar yana da tasirin teratogenic. Coumadin, sabili da haka, an hana shi cikin ciki sai dai idan mai haƙuri yana da rufin zuciya na zuciya ko kuma yana cikin haɗari mai girma don abin da zai faru na thromboembolic. Ana iya ba da Heparin a lokacin da take da ciki saboda ba ta haye mahaifa, amma, yawancin masu aikatawa sun fi son ƙananan ƙwayar heparin (LMWH) a ciki kamar Lovenox (enoxaparin).

Zan iya amfani da Coumadin ko heparin tare da barasa?

Babu wata takaddama ga amfani da giya don Coumadin ko heparin. Koyaya, barasa na iya shafar aikin hanta a cikin wasu marasa lafiya, yana haifar da buƙatar kulawa ta kusa da INR lokacin shan Coumadin.