推荐回答(1个)
通用名 奥扎格雷钠注射液
曾用名
英文名 SODIUM OZAGREL INJECTION
拼音名 AOZHAGELEINA ZHUSHEYE
药品类别 脑血管病用药
性状 本品为无色透明液体。
药理毒理 本品为血栓烷(TX)合酶抑制剂,能阻碍前列腺素H2(PGH2)生成血栓烷A2 (TXA2),促使血小板所衍生的PGH2转向内皮细胞。内皮细胞用以合成PGI2,从而改善TXA2与前列腺素PGI2的平衡异常。理论上能抑制血小板的聚集和扩张血管作用。本品能改善脑血栓急性期的运动障碍,改善脑缺血急性期的循环障碍及改善脑缺血时能量代谢异常。动物试验表明,静脉给药能降低血浆TXB2水平, 6-Keto-PGF1α∕TXB2比值下降,对不同诱导剂所致血小板聚集均有抑制作用,对大鼠中脑动脉阻塞引起的脑梗塞有预防作用。本品对人血小板聚集的半数抑制浓度IC50较低,为4nM。用自身血注入蛛网膜下腔出血模型的试验表明,本品持续注入静脉,具有抑制血中TXB2浓度及脑血管挛缩等作用。 急性毒性LD50(mg∕kg):小鼠静注为1940(雄),1580(雌);口服为3800 (雄),3600(雌);皮下为2450(雄),2100(雌)。大鼠静注为1150(雄),1300 (雌);口服为5900(雄),5700(雌);皮下为2300(雄),2250(雌)。狗静注为733(雄)。亚急性、慢性毒性:静脉注射本品,大鼠高剂量组除发现轻度尿电解质排泄上升外, 未见其他异常。最大耐受量大鼠125 mg∕kg,狗10-12.5 mg∕kg。其他毒性:大鼠、兔生殖毒性试验结果,本品高剂量时发生抑制近亲系动物体重等毒性症状,胚胎、胎仔死亡,胎仔发育抑制,新生仔死亡等现象。另外,在大鼠SegⅡ试验中发现, 高剂量组有内脏异常和骨骼异常的畸胎仔数轻度增加,抗原性、变异性及局部刺激性试验均为阴性。以蛛网膜下腔出血术后患者为对象,在术后早期开始给予本品10-14天,在该药的高剂量组(每日400 mg)、低剂量组(每日80 mg)以及普拉西泮对照组中进行双盲试验。结果低剂量组、高剂量组的有效率及疗效都明显优于对照组。另外,高剂量组脑血管挛缩发生频率也较对照组明显低。
药代动力学 人单次静脉注射本品,在血中消失较快。血中主要成分除该药的游离形式外,还有其β-氧化体和还原体。本品代谢物几乎没有药理活性。本品连续静脉注谢时,2小时内达到血浓稳定状态。本品大部分在24小时内排泄。动物试验未发现本品有蓄积性和毒性。本品静脉滴注后,血药浓度一时间曲线符合二室开放模型,t1/2β为1.22± 0.44小时,Vd为2.32±0.62L/kg,AUC为0.47±0.08ug·小时/nl。Cl为3.25 ±0.82L/小时/g,受试者半衰期最长为1.93小时,血药浓度可测到停药后3小时。停药24小时,几乎全部药物经尿排出体外。
适应症 用于治疗急性血栓性脑梗塞和脑梗塞所伴随的运动障碍,及改善蛛网膜下腔出血手术后的脑血管痉挛收缩和并发脑缺血症状。
用法用量 每次40—80mg,溶于适当量电解质或5%葡萄糖溶液中,每日1-2次,24小时连续静脉滴注,1-2周为一疗程。另外,根据年龄、症状适当增减用量。
不良反应 血液:由于有出血的倾向,要仔细观察,出现异常立即停止给药。肝肾:偶有GOT、GPT、BUN升高。消化系统:偶有恶心、呕吐、腹泻、食欲不振、胀满感。过敏反应:偶见荨麻疹、皮疹等,发生时停止给药。循环系统:偶有室上心律不齐、血压下降,发现时减量或终止给药。其他:偶有头痛、发烧、注射部位疼痛、休克及血小板减少等。严重不良反应可出现出血性脑梗塞、硬膜外血肿、脑内出血、消化道出血、皮下出血等。
禁忌症 1. 对本品过敏者; 2. 脑出血或脑梗塞并出血者; 3. 有严重心、肺、肝、肾功能不全者,如严重心律不齐; 4. 有血液病或有出血倾向者; 5. 严重高血压,收缩压超过26.6 kpa(即200 mmHg)以上者。
注意事项 本品与抑制血小板功能的药物并用有协同作用,必须适当减量。本品避免与含钙输液(格林氏溶液等)混合使用,以免出现白色混浊。
孕妇及哺乳期妇女用药 孕妇或有可能妊娠妇女慎用。
儿童用药 儿童慎用。
老年患者用药
药物相互作用 本品与抗血小板聚集剂、血栓溶解剂及其他抗凝药合用,可增强出血倾向,应慎重合用。
药物过量
贮藏 遮光,密闭保存
包装 20mg∕支
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