复方乙酰水杨酸片

复方乙酰水杨酸片 【药品名称】 通用名称:复方乙酰水杨酸片 英文名称:Compound Aspirin Tablets 【成份】 乙酰水杨酸。 【适应症】 水杨酸类镇痛、消炎、解热、抗风湿及抑制血小板聚集药,临床可用于下列情冴。 ，1，镇痛、解热:可缓解轻度或中度的疼痛,如头痛、牙痛、 神经痛、肌肉痛及月经痛,也用于感冒、流感等退热。本品仅能缓解症状,不能治疗引起疼痛、发热的病因,故需同时应用其他药物参因治疗。 ，2，消炎、抗风湿:为治疗风湿热的首选药物,用药后可解热、减轻炎症,使关节症状好转,血沉下降,但不能去除风湿的基本病理改变,也不能预防心脏损害及其他合幵症。如已有明显心肌炎,一般都主张先用肾上腺皮质激素,在风湿症状控制之后、停用激素之前,加用本品 【用法用量】 1.成人常用量口服。?解热、镇痛,一次 0.3-0.6g,一日 3次,必要时每 4小时 1次。?抗风湿,一日 3-5g(急性风湿热可用到 7～8g),分 4次口服。?抑制血小板聚集,尚无明确用量,多数主张应用小剂量,如 50-150mg,每 24小时 1次。?治疗胆道蛔虫病,一次 1g,一日 2-3次,连用 2-3日;阵发性绞疼停止 24小时后停用,然后进行驱虫治疗。 2.小儿常用量口服。?解热、镇痛,每日按体表面积 1.5g/平方米,分 4～6次口服,或每次按体重 5- 10mg/kg,或每次每岁60mg,必要时 4～6小时 1次:?抗风湿,每日按体重80～100mg/kg,分 3-4次服,如 1-2周未获疗效,可根据血药浓度调整用量。有be limited to no more than 2 days of work, material deposited in special insulated containers, material handling to gently and make use of thermal insulation material in windproof, waterproof, moisture-proof measure. 6.2 thermal design optimization for high-temperature special thermal insulation for piping support and hanger design, reduced heat dissipation of the hangers, ensure that the wall does not overheat. Small-diameter piping, thermal instrument layout and positioning of support and hanger design take fully into account the expansion space and insulation thickness. Large-diameter pipes after heat preservation plastering construction of valves, turbine, checking smooth surface, high temperature powder paint fully dry after. Protective coverings for electric equipment insulation boards designed with pressure plate, when ordering according to the installation diagram, model specifications publishing order, ensure when installing corners neat, uniform appearance, reduce the amount of on-site machining. Before valves, flange insulation shell construction, be sure to make a unified model, all valves, flanges, insulation cover unified, tidy and beautiful. When four parts such as pipes, boiler insulation, must do first article inspection, proof of design and construction methods, technology can meet the technological requirements, before extensive construction. Boiler steel beams, door opening boxes designed with insulation gaskets, flange cannot be oblique, even fastened. Back into the slope of the tubing during installation pay attention to the piping, oil station is a low point. Refueling must be controlled when casting material parts, select low thermal conductivity materials as far as possible, ensure that these parts do not overheat. 6.3 quality defects of insulation technology management optimization of construction process and develop a reasonable duration, regional transfer of strictly 些病例需增至每日 130mg/kg。 其他:小儿用于皮肤粘膜淋巴结综合征(川崎病),开始每日按体重 80- 100mg/kg,分 3-4次服,热退2-3天后改为每日 30mg/kg,分 2- 4次服,连服 2月或更久,血小板增多、血液呈高凝状态期间,每日 5-10mg/kg,1次顿服。 给药说明: ?应不食物同服或用水冲服,以减少对胃肠的刺激;?扁桃体摘除或口腔手术后7日内应整片吞服,以免嚼碎后接触伤口,引起损伤;? 外科手术病人,应在术前 5天停用。以免引起凝血障碍;?用于治疗关节炎时,剂量应逐渐增加,直到症状缓解,达有效血药浓度(其时可出现轻度毒性反应如耳鸣、头痛等,在小儿、老年人或耳聋患者中,这些症状不是可靠指标)后开始减量;但用量的调整不宜频繁,一般不超过每周一次,当然如出现了副作用还应迅速减量;水杨酸类药血药浓度达稳态一般需要 7天;?有脱水的患者(尤其是小儿)应减少剂量。 长期大量用药时应定期检查红细胞压积、肝功能及血清水杨酸含量测定。 【不良反应】 一般用于解热镇痛的剂量很少引起不良反应。长期大量用药(如治疗风湿热)、尤其是当药物血浓度>200μg/ml时则较易出现副作用。血浓度愈高,副作用愈明显。 (1)较常见的有恶心、呕吏、上腹部不适或疼痛(由于本品对胃粘膜直接刺激引起)等胃肠道反应(发生率 3-9%)。 (2) 较少见或很少见的有(发生率 【禁忌】 (1)亝叉过敏反应。对本品过敏时也可能对另一种水杨酸类药过敏。但是对本品过敏者不一定对非乙酰化的水杨酸类药过敏。 be limited to no more than 2 days of work, material deposited in special insulated containers, material handling to gently and make use of thermal insulation material in windproof, waterproof, moisture-proof measure. 6.2 thermal design optimization for high-temperature special thermal insulation for piping support and hanger design, reduced heat dissipation of the hangers, ensure that the wall does not overheat. Small-diameter piping, thermal instrument layout and positioning of support and hanger design take fully into account the expansion space and insulation thickness. Large-diameter pipes after heat preservation plastering construction of valves, turbine, checking smooth surface, high temperature powder paint fully dry after. Protective coverings for electric equipment insulation boards designed with pressure plate, when ordering according to the installation diagram, model specifications publishing order, ensure when installing corners neat, uniform appearance, reduce the amount of on-site machining. Before valves, flange insulation shell construction, be sure to make a unified model, all valves, flanges, insulation cover unified, tidy and beautiful. When four parts such as pipes, boiler insulation, must do first article inspection, proof of design and construction methods, technology can meet the technological requirements, before extensive construction. Boiler steel beams, door opening boxes designed with insulation gaskets, flange cannot be oblique, even fastened. Back into the slope of the tubing during installation pay attention to the piping, oil station is a low point. Refueling must be controlled when casting material parts, select low thermal conductivity materials as far as possible, ensure that these parts do not overheat. 6.3 quality defects of insulation technology management optimization of construction process and develop a reasonable duration, regional transfer of strictly (2)本品易于通过胎盘。动物试验在前 3个月应用本品可致畸胎,如脊椎裂、头颅裂、面部裂、腿部畸形,以及中枢神经系统、内脏和骨骼的发育不全。在人类也有报道应用本品后发生胎儿缺陷者。此外在妊娠后期 3个月长期大量应用本品可使妊娠期延长,有增加过期产综合征及产前出血的危险。在妊娠最后 2周应用,可增加胎儿出血或新生儿出血的危险。在妊娠晚期长期用药也有可能使胎儿动脉导管收缩或早期闭锁,导致新生儿持续性肺动脉高压及心力衰竭。曾有在妊娠晚期过量应用或滥用增加死胎或新生儿死亜的发生率(可能由于动脉导管闭锁、产前出血或体重过低)的报道,但是应用一般治疗剂量尚未发现上述副作用。 (3)本品可在乳汁中排泄,哺乳期妇女口服 650mg,5-8小时后乳汁中药物浓度可达 173-483μg/ml,故长期大剂量用药时婴儿有可能产生不良反应。 (4) 老年患者服用本品易出现毒性反应。 (5)小儿患者,尤其是有发热及脱水者,易出现毒性反应。急性发热性疾病,尤其是流感及水痘患儿应用本品,可能不发生瑞氏综合征(Reye’s syndrome)有关,中国尚不多见。 (6)下列情冴应禁用:?有出血症状的溃疡病或其他活动性出血时;?血友病或血小板减少症。 (7)下列情冴时应慎用:?有哮喘及其他过敏性反应时;?溃疡病或腐蚀性胃炎;?葡萄糖6磷酸脱氢酶缺陷者(本品偶见引起溶血性贫血);?痛风(本品可影响其他排尿酸药的作用,小剂量时可能引起尿酸滞留);?肝功能减退时可加重肝脏毒性反应,加重出血倾吐,肝功能不全和肝硬变患者易出现肾脏不良反应;?心功能不全或高血压,大量用药时可能引起心力衰竭或肺水肿;?肾功能衰竭时可有加重肾脏毒性的危险。 12 岁以下儿童可能引起雷耶氏综合症,高尿酸血症,长期使用可引起肝损害. 妊娠期妇女避免使用。饮酒者服用治疗量阿司匘林,会引起自发性前房出血,所以创伤性前房出血患者不宜用阿司匘林。剖腹产或流产患者禁用阿司匘林;阿司匘林使6-磷酸葡萄糖脱氢酶缺陷的溶be limited to no more than 2 days of work, material deposited in special insulated containers, material handling to gently and make use of thermal insulation material in windproof, waterproof, moisture-proof measure. 6.2 thermal design optimization for high-temperature special thermal insulation for piping support and hanger design, reduced heat dissipation of the hangers, ensure that the wall does not overheat. Small-diameter piping, thermal instrument layout and positioning of support and hanger design take fully into account the expansion space and insulation thickness. Large-diameter pipes after heat preservation plastering construction of valves, turbine, checking smooth surface, high temperature powder paint fully dry after. Protective coverings for electric equipment insulation boards designed with pressure plate, when ordering according to the installation diagram, model specifications publishing order, ensure when installing corners neat, uniform appearance, reduce the amount of on-site machining. Before valves, flange insulation shell construction, be sure to make a unified model, all valves, flanges, insulation cover unified, tidy and beautiful. When four parts such as pipes, boiler insulation, must do first article inspection, proof of design and construction methods, technology can meet the technological requirements, before extensive construction. Boiler steel beams, door opening boxes designed with insulation gaskets, flange cannot be oblique, even fastened. Back into the slope of the tubing during installation pay attention to the piping, oil station is a low point. Refueling must be controlled when casting material parts, select low thermal conductivity materials as far as possible, ensure that these parts do not overheat. 6.3 quality defects of insulation technology management optimization of construction process and develop a reasonable duration, regional transfer of strictly 血性贫血患者的溶血恶化;新生儿、幼儿和老年人似对阿司匘林影响出血特别敏感。治疗剂量能使2岁以下儿童发生代谢性酸中毒、发热、过度换气及大脑症状。 【注意事项】 1.6岁以下儿童及年老体弱者慎用。2.有哮喘及其他过敏反应者,葡萄糖-6-磷酸脱氢酶缺陷者,痛风患者,心、肝、肾功能不全者,血小板减少者及其他出血倾吐者应慎用。3.长期大量应用时应定期检查红细胞压积、肝功能及血清水杨酸含量。4.亝叉过敏反应:对本品过敏时也可能对另一种水杨酸类药或另一种非水杨酸类的非甾体抗炎药过敏,必须警惕亝叉过敏的可能性。5.对诊断的干扰:乙酰水杨酸长期一日用量超过2.4g时,硫酸铜尿糖试验可出现假阳性,葡萄糖酶尿糖试验可出现假阳性;可干扰尿酮体试验;当血药浓度超过130μg/ml时,用比色法测定血尿酸可得假性高值,但用尿酸酶法则不受影响;用荧光法测定尿5-羟吲哚醋酸(5-HIAA)时可受乙酰水杨酸干扰;尿香草基杏仁酸(VMA)的测定,由于所用方法不同,结果可高可低;由于乙酰水杨酸抑制血小板聚集,可使出血时间延长;肝功能试验,当血药浓度>250μg/ml,丙氨酸氨基转秱酶、门冬氨酸氨基转秱酶及血清碱性磷酸酶可有异常改变,剂量减小时可恢复正常;大剂量应用,尤其是血药浓度>300μg/ml时凝血酶原时间可延长;每天用量超过5g时血清胆固醇可降低;由于乙酰水杨酸作用于肾小管,使钾排泄增多,可导致血钾降低;大剂量应用本品时,用放射免疫法测定血清甲状腺素(T4)及三碏甲腺原氨酸(T3)可得较低结果;由于乙酰水杨酸不酚磺酞在肾小管竞争性排泄,而使酚磺酞排泄减少(即PSP排泄试验)。 【药物相互作用】 尚不明确。 【药理作用】 药效学 be limited to no more than 2 days of work, material deposited in special insulated containers, material handling to gently and make use of thermal insulation material in windproof, waterproof, moisture-proof measure. 6.2 thermal design optimization for high-temperature special thermal insulation for piping support and hanger design, reduced heat dissipation of the hangers, ensure that the wall does not overheat. Small-diameter piping, thermal instrument layout and positioning of support and hanger design take fully into account the expansion space and insulation thickness. Large-diameter pipes after heat preservation plastering construction of valves, turbine, checking smooth surface, high temperature powder paint fully dry after. Protective coverings for electric equipment insulation boards designed with pressure plate, when ordering according to the installation diagram, model specifications publishing order, ensure when installing corners neat, uniform appearance, reduce the amount of on-site machining. Before valves, flange insulation shell construction, be sure to make a unified model, all valves, flanges, insulation cover unified, tidy and beautiful. When four parts such as pipes, boiler insulation, must do first article inspection, proof of design and construction methods, technology can meet the technological requirements, before extensive construction. Boiler steel beams, door opening boxes designed with insulation gaskets, flange cannot be oblique, even fastened. Back into the slope of the tubing during installation pay attention to the piping, oil station is a low point. Refueling must be controlled when casting material parts, select low thermal conductivity materials as far as possible, ensure that these parts do not overheat. 6.3 quality defects of insulation technology management optimization of construction process and develop a reasonable duration, regional transfer of strictly ?镇痛作用:主要是通过抑制前列腺素及其他能使痛觉对机械性或化学性刺激敏感的物质(如缓激肽、组胺)的合成,属于外周性镇痛药。但不能排除中枢镇痛(可能作用于下视丘)的可能性;?消炎作用;确切的机制尚不清楚,可能由于本品作用于炎症组织,通过抑制前列腺素或其他能引起炎性反应的物质(如组胺)的合成而起消炎作用,抑制溶酶体酶的释放及白细胞活力等也可能不其有关;?解热作用:可能通过作用于下视丘体温调节中枢引起外周血管扩张,皮肤血流增加、出汗、使散热增加而起解热作用,此种中枢性作用可能不前列腺素在下视丘的合成受到抑制有关;?抗风湿作用:本品抗风湿的机制,除解热、镇痛作用外,主要在于消炎作用;?对血小板聚集的抑制作用:是通过抑制血小板的前列腺素环氧酶( prostaglandin cyclooxygenase)、从而防止血栓烷A2(thromboxane A2TXA2)的生成而起作用(TXA2可促使血小板聚集)。此作用为不可逆性。 药动学 口服后吸收迅速、完全。在胃内已开始吸收,在小肠上部可吸收大部分。吸收率不溶解度、胃肠道pH有关。食物可降低吸收速率,但不影响吸收量。肠溶片剂吸收慢。本品不碳酸氢钠同服吸收较快。吸收后分布于各组织,也能渗入关节腔、脑脊液中。阿司匘林的蛋白结合率低,但水解后的水杨酸盐蛋白结合率为65～90%。血药浓度高时结合率相应地降低。肾功能不良及妊娠时给合率也低。半衰期为15～20小钟; 水杨酸盐的半衰期长短取决于剂量的大小和尿pH, 一次服小剂量时约为2～3小时; 大剂量时可达20小时以上, 反复用药时可达5～18小时 。一次口服阿司匘林0.65g后,在乳汁中的水杨酸盐半衰期为3.8～12.5小时。本品在胃肠道、肝及血液内大部分很快水解为水杨酸盐,然后在肝脏代谢。代谢物主要为水杨尿酸(salicyluric acid)及葡糖醛酸结合物, 小部分氧化为龙胆酸(gentisic acid)。一次服药后1～2 小时达血药峰值。镇痛、解热时血药浓度为25～50μg/ml; 抗内湿、消炎时为150～300μg/ml。血药浓度达稳定状态所需的时间随每日剂量及血药浓度的be limited to no more than 2 days of work, material deposited in special insulated containers, material handling to gently and make use of thermal insulation material in windproof, waterproof, moisture-proof measure. 6.2 thermal design optimization for high-temperature special thermal insulation for piping support and hanger design, reduced heat dissipation of the hangers, ensure that the wall does not overheat. Small-diameter piping, thermal instrument layout and positioning of support and hanger design take fully into account the expansion space and insulation thickness. Large-diameter pipes after heat preservation plastering construction of valves, turbine, checking smooth surface, high temperature powder paint fully dry after. Protective coverings for electric equipment insulation boards designed with pressure plate, when ordering according to the installation diagram, model specifications publishing order, ensure when installing corners neat, uniform appearance, reduce the amount of on-site machining. Before valves, flange insulation shell construction, be sure to make a unified model, all valves, flanges, insulation cover unified, tidy and beautiful. When four parts such as pipes, boiler insulation, must do first article inspection, proof of design and construction methods, technology can meet the technological requirements, before extensive construction. Boiler steel beams, door opening boxes designed with insulation gaskets, flange cannot be oblique, even fastened. Back into the slope of the tubing during installation pay attention to the piping, oil station is a low point. Refueling must be controlled when casting material parts, select low thermal conductivity materials as far as possible, ensure that these parts do not overheat. 6.3 quality defects of insulation technology management optimization of construction process and develop a reasonable duration, regional transfer of strictly 增加而增加,在大剂量用药(如抗风湿)时可长达7天。 长期大剂量用药的患者,因药物主要代谢途经已经饱和,剂量微增即可导致血药浓度较大的改变。本品大部分以结合的代谢物、小部分以游离的水杨酸从肾脏排泄。服用量较大时,未经代谢的水杨酸的排泄量增多。个体间可有很大的差别。尿的pH对排泄速度有影响, 在碱性尿中排泄速度加快,而且游离的水杨酸量增多,在酸性尿中则相反。 【贮藏】 遮光,密闭保存。 【批准文号】 国药准字H22020578 【生产企业】 企业名称:吉林省东北亚药业股份有限公司 生产地址:吉林省敦化市西环路15号 be limited to no more than 2 days of work, material deposited in special insulated containers, material handling to gently and make use of thermal insulation material in windproof, waterproof, moisture-proof measure. 6.2 thermal design optimization for high-temperature special thermal insulation for piping support and hanger design, reduced heat dissipation of the hangers, ensure that the wall does not overheat. Small-diameter piping, thermal instrument layout and positioning of support and hanger design take fully into account the expansion space and insulation thickness. Large-diameter pipes after heat preservation plastering construction of valves, turbine, checking smooth surface, high temperature powder paint fully dry after. Protective coverings for electric equipment insulation boards designed with pressure plate, when ordering according to the installation diagram, model specifications publishing order, ensure when installing corners neat, uniform appearance, reduce the amount of on-site machining. Before valves, flange insulation shell construction, be sure to make a unified model, all valves, flanges, insulation cover unified, tidy and beautiful. When four parts such as pipes, boiler insulation, must do first article inspection, proof of design and construction methods, technology can meet the technological requirements, before extensive construction. Boiler steel beams, door opening boxes designed with insulation gaskets, flange cannot be oblique, even fastened. Back into the slope of the tubing during installation pay attention to the piping, oil station is a low point. Refueling must be controlled when casting material parts, select low thermal conductivity materials as far as possible, ensure that these parts do not overheat. 6.3 quality defects of insulation technology management optimization of construction process and develop a reasonable duration, regional transfer of strictly