antitrombotice

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Author:
t014_b
ID:
220364
Filename:
antitrombotice
Updated:
2013-05-20 09:52:05
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antitrombotice
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antitrombotice
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  1. indicatii alteplaza(3)
    • infarct 15mg IVD apoi 0,75(30 min) apoi 0,5(60min)
    • EP 10mg(1-2 min), 90 mg (2 ore)
    • AVC isch sub 3 ore
  2. doze tenecteplaza si steptokinaza in infarct
    • 10U (2 bolus de 30 min)
    • 1,5 M U/45 min
  3. doza hemisuccinat cu alteplaza
    100mg bolus, 50 mg /6ore
  4. LMWH - indicatii + metod de adm

    1 preventie
    3 curativ
    Preventia bolii trombembolice venoase

    Risc moderat : sc, o injectie cu 4 h inainte si apoi una pe zi

    Risc crescut : 12h inainte, apoi una pe zi



    Trat curativ : TVP, Embolia pulm necomplicata, SCA fara supradeniv



    (ca fondaparinux)
  5. Fondaparinux : indicatii (34)
    • preventia bolii tromembolice venoase
    • trat curativ al TVP si emboliei pulm necomplicate
    • SCA fara supradenivelare

    (ca LMWH)
  6. indicatii heparina nefractioanata(2)
    preventia bolii tromboembolice venoase

    risc moderat : 5000UI 2h inainte apoi la 8 ore

    risc crescut la 8h ptr aPTT (TCA) de 1,5

    Curativ : SCA cu/fara supradeniv

    AVC isc de origine embolica cardiaca

    FiA, Proteza valvulara mecanica, Embolie pulm, Embolie arteriala
  7. risc crescut de boala tromboembolica venoasa (2)
    chir ortop

    chir onco
  8. risc moderat de boala tromboembolica venoasa(2)
    repaus la pat ptr patologie medicala (avc, infacrt)

    interv chir ulterioare
  9. CI heparina absolute (5)
    alerg la heparina

    hemoragii in curs/recente, in special cerebromeningeale(sub 2 sapt) sau  viscerale (sub 10 zile)

    chir neuro oftalmo sau traumatism cranian grav (sub 3 sapt)

    anomalii a hemostazei

    injecti i.m. sau intra articulare
  10. CI relative la heparina (7)
    • chir recenta
    • HTA severa
    • ulcer GD evolutiv
    • asociere cu AINS, aspirina, clopidogrel
    • endocardita infect (exceptand daca are proteza valvulara sau FiA)
    • pericardita
    • disectie de aorta
  11. teste heparina nefractioanata
    aPTT intre 2-3

    heparinemie intre 0,4 - 0,6

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