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商品訊息功能
商品訊息描述
Laxatone艾斯克化毛膏 麥芽口味X1 +鮪魚口味X1
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有效幫助愛貓排出毛球，避免毛球阻塞消化道
預防犬貓便秘、減輕生殖及排泄器官手術後腹壓
補充鐵質，促進造血
添加必需脂肪酸，讓寵物擁有絲緞般光滑亮麗的皮毛
每星期2-3次、每次0.5-1茶匙
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麥芽口味
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鮪魚口味
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商品訊息特點
- ◎有效幫助愛貓排出毛球，避免毛球阻塞消化道
- ◎預防犬貓便秘、減輕生殖及排泄器官手術後腹壓
- ◎補充鐵質，促進造血
添加必需脂肪酸，讓寵物擁有絲緞般光滑亮麗的皮毛
↓↓↓限量特惠的優惠按鈕↓↓↓
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體驗
不論心臟或心血管疾病，或是部分慢性疾病患者，為降低產生血栓、血塊的機率，常常必須服用口服抗凝血劑或阿斯匹靈，但阿斯匹靈屬抗血小板類藥物，效果不如抗凝血劑，因此口服抗凝血劑成為不可或缺的存在。然而，有利必有弊，口服抗凝血劑雖控制了凝血作用，使產生血栓的機率下降，相對地卻帶來「出血」的風險。
二○一三年十二月十八日的清晨，前民進黨立委蔡同榮突然倒臥在地，由於腦出血面積過大，送醫後經過二十五天的治療仍然回天乏術。醫師表示，蔡同榮因長期服用抗凝血劑，腦出血後，手術期間很可能血流不止，死亡率大增。也因為這起新聞，讓口服抗凝血劑的風險開始廣為人知。
易產生血栓血塊 用藥對象分長短期 口服抗凝血劑用藥對象分為長期與短期兩種，最擔心出血風險的往往是長期服用的患者，國泰醫院心臟內科醫師黃奭毓表示，需要長期服用抗凝血劑最常見的就是心律不整，即心房纖維顫動（Artrial fibrillation）的患者。其他如腦血管疾病，也必須長期服用，以防中風。
統計顯示，全國罹患心房纖維顫動的患者約有二十三萬人，台灣地區五十五歲以上的腦中風人數則約兩萬六千～四萬人。
心房纖維顫動患者的心房無法正常、有效地收縮，在快速地顫動之下，使得血液無法正常移動，易產生血栓，一旦血栓流出心臟，就可能導致中風。為了降低形成血栓的機率，患者必須長期服用抗凝血劑。但「沒吃藥缺血性中風，吃藥後出血性中風」進退兩難的局面，令醫病雙方困擾不已，因此必須小心翼翼地監測用藥狀況。
此外，更換金屬心臟瓣膜的患者也是必須長期服用傳統型抗凝血劑的對象之一。「因為是金屬瓣膜放在體內，難免會產生排斥或血液循環較差的情況，長期服用可以避免血栓、血塊的形成。」黃奭毓表示，除了上述兩種狀況需長期服用之外，有些是因長期疾病造成凝血系統異常，或有抵抗力問題的風濕性疾病患者，如類紅斑性狼瘡症候群，另外則是因體質或癌症，易產生反覆性血栓血塊的病人，都屬於必須長期用藥的族群。
至於短期服用的患者，以靜脈栓塞或動脈栓塞患者為主，通常動脈栓塞機會較小，多以短期針劑治療來控制病情，也因為只是短暫地服用，出血風險相對較小。
抗凝血劑有風險 新型口服用藥問世 口服抗凝血劑正如其名，是阻擋凝血作用的藥物，因此最害怕的就是出血風險，其中「顱內出血」最令人畏懼，因為它影響的不只是生命，若患者因顱內出血導致失能，更是家庭的一大經濟負擔。
隨著醫學進步，三種新型抗凝血劑相繼問世，第四種新藥（Edoxaban）更在今（二○一六）年九月一日在台灣通過健保給付，新藥帶來最振奮人心的消息是──顱內出血的比例低於以往使用的傳統型抗凝血劑。這無疑是長期用藥者的一大福音，然而，是不是所有人都適用新型抗凝血劑？而新型抗凝血劑真的只有利、沒有弊嗎？
目前台灣需要服用抗凝血劑的患者，服用傳統型口服抗凝血劑Wafarin約五～六成，在用藥控制得好的國家用藥比例則約七～八成，因此，台灣在傳統型用藥上的狀況可以說是中規中矩。
Wafarin中文又稱作華法令或可邁丁，上市長達六十年，因此藥物的適應症多於新藥，服用人口也多。而新型抗凝血劑則是近幾年才在台灣陸續推出，共有四種，分別為：Dabigatran、Rivaroxaban、Apixaban、Edoxaban，新、舊兩種口服藥在藥理上不同，適應症、用藥對象與風險也相異。
亞東醫院藥學部藥師楊欣瑜表示，就藥理而言，傳統抗凝血劑主要是拮抗維他命K的還原作用，因為人類的肝臟合成凝血因子後，凝血因子要能發揮作用就需要維他命K的幫助，因此傳統型抗凝血劑可以說是「間接」影響凝血作用。「新藥最大的不同，在於它是直接作用在特定凝血因子上，『直接』地影響凝血作用，」楊欣瑜解釋，也因為新藥「直接」的特性，使得藥物起效時間較傳統型來得快，而新藥本身的代謝速度也較快。
另外，傳統型抗凝血劑在服用後，必須定時回醫院抽血追蹤患者的INR（國際標準凝血時間比值），也容易與其他藥物或食物產生交互作用，只要食物中富含維他命K，就可能影響到藥效，因此醫師會提醒服用的患者平日須避開的食物與藥物，如深綠色蔬菜、抗生素或普拿疼等；而新型抗凝血劑雖然目前沒有特定抽血指標可追蹤療效濃度，但是較不易與其他藥物、食物交互影響。
新藥比較好嗎？ 無解毒劑、難監測 然而，新型口服抗凝血劑也並非零缺點，其中風險猶存。「目前並非所有新型抗凝血劑都有解毒劑，也無法透過抽血觀察患者對藥物的反應，這是新藥帶來的風險，」楊欣瑜解釋，傳統型抗凝血劑只要以維他命K1作為解毒劑就可以反轉其抗凝血作用，但是想要控制新型抗凝血劑的效果，國外目前僅針對其中一種新藥（Dabigatran）做出解毒劑（idarucizumab），然而台灣目前尚未正式通過可用藥資格，普遍狀況而言好康無法使用，只有少部分患者必須用藥的例外狀況，需以國外專案進口自費的方式申請才得以取得。
此外，也並非所有的患者都適用新型抗凝血劑，「新型抗凝血劑主要有三者不能使用，分別是腎臟功能太差、更換金屬瓣膜與二尖瓣膜狹窄的患者。」黃奭毓解釋，在用藥前，會先檢查腎功能不佳患者的Ccr（肌酸酐廓清率），若腎功能太差的患者就不宜使用新藥。此外，楊欣瑜也表示，美國曾有研究指出，置換金屬心臟瓣膜的患者，服用新藥後可能會增加栓塞或出血的風險，懷孕、腸胃狀況不佳或腸胃曾經出血的患者，也都不建議服用。
目前新藥的適應症以心律不整與靜脈栓塞為主，部分則可用於膝蓋關節置換與肺栓塞患者。
服用抗凝血劑後 出血風險避無可避 這四種新藥上市之後，許多媒體均強調新型抗凝血劑出血風險較低，但是，楊欣瑜提醒，「只要是抗凝血劑，出血的風險就一定存在，站在藥師立場，並不強調哪一種藥的出血風險比較低，」確實有研究指出新型抗凝血劑可以降低重大出血的機率，但是新藥或許也會造成其他副作用如腸胃道出血的風險，尤其抗凝血劑併用其他會產生交互作用的藥物，風險也都會隨之而來。
事實上，服用抗凝血劑的患者本來就必須在日常生活中多注意，除了定期接受醫師檢查，有特殊狀況須如實反應，此外，平時因為小病去看醫生時，最好主動和醫師說明服用抗凝血劑的狀況。進行重大手術時，醫師也會在術前先針對手術大小以及患者的抗凝血劑服用狀況?量應在術前幾天停止服用。對服用抗凝血劑的患者而言，就醫及手術事前的溝通工作不可少！
此外，需要服用抗凝血劑的患者在飲食上必須節制，血糖、血壓和糖尿病等症狀要時時監測，如果控制得當，也能減少出血的風險。「若血糖控制不好，就很有可能造成血管病變、鈣化，造成出血風險，」黃奭毓說，總而言之，作息正常、睡眠充足、適量補充水分與運動都是患者可努力的方向，維護好基本的身體機能，自然可以降低出血的機率。
下面附上一則新聞讓大家了解時事
國聯冠軍賽第2戰，道奇隊靠著王牌Clayton Kershaw，7局僅被敲2安的超完美表現，以及Adrian Gonzalez在2局的關鍵陽春彈，幫助球隊在客場扳回一城，避免落入0：2落後，回到洛杉磯的窘境。
今天2局上道奇隊就靠著Adrian Gonzalez，從小熊先發Kyle Hendricks手中轟出陽春彈，取得1：0的領先。率先在第2戰打下分數，對昨天遭轟滿貫砲輸球的道奇來說，是一個好的開始。而事後也證明，這1分對這場比賽來說，非常非常巨大。
而隊友火力上的幫忙，看似也對Clayton Kershaw個人的信心有所提升，他今天上半場前5又2/3局都還是處於完全比賽的狀態 ，讓對方打者14上14下，完全對他的球路一籌莫展，直到Javier Baez在5局下兩出局時，才敲出首支安打。總計他今天主投7局，只被敲2支安打，送出1個保送，沒有失掉分數，幫助球隊一路保持領先。
8局下，道奇一如既往地提前推出終結者Kenley Jansen上場關門，他上來讓對手6上6下，賞給對方4K，幫助球隊穩穩守下勝利，最後道奇就是以1：0獲得最後的勝利。
小熊這場比賽送給對方7次三振，雖然最後沒有造成傷害，但或許也顯示了投手群的控球不若前幾場來的穩定，下一場比賽若想取勝，勢必得做出調整。
★更多相關新聞
Baez好會玩球 故意假動作製造雙殺好神！
道奇隊的傳奇「老爹」 拉索達住院觀戰
7局魔王米勒 季後賽2好球後僅被敲1安
快被遺忘的蒙特羅 用代打滿貫彈留名
Lindor鞋子大有玄機 開轟真的剛好啦！
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- 大力推薦 Reviving the dead
Chicago won more than 100 games without Kyle Schwarber, one of the Cub's elite young superstars. Schwarber hit five postseason home runs last year, but tore his ACL just two games into this season.?
Now, there's talk he might be back.?
Since coming off the disabled list on Saturday, Schwarber has been getting back into playing shape in the Arizona Fall League (AFL). Depending on his performance in an AFL game Monday night, the Cubs could activate him for a designated hitter role in the World Series on Tuesday.?
There's sure to be rust, but if Schwarber performs anything like the player he was in 2015, he could be a difference-maker.?
For Cleveland, it's looking like starting pitcher Danny Salazar will return as well.
The All-Star right-hander, who struck out more than 10 batters per nine innings during the regular season, has been sidelined with a forearm strain since Sept. 9. It's unclear whether or not Salazar will start, considering the long layover, but he would bring stability to a starting rotation that desperately needs it.?
Both teams aren't taking any chances. They want their best lineups on the field.
Image: Maddie Meyer/Getty ImagesThis World Series figures to be epic, not only because of the historical context, but because of how each team's strengths counter the other's. Chicago's bats are scary, but Cleveland's pitching is hot. The Indians' bullpen is ferocious, but the Cubs know how to score late.?
Regardless, one of these long-suffering franchises will see relief soon. A historic championship drought will be quenched with a champagne shower.?
The loser? Well, they're already used to losing, and can wait just a little longer.?">
If you don't like baseball, watch baseball, or know what baseball is, know this — the 2016 World Series is different.?
When the Cleveland Indians host the Chicago Cubs in a best-of-seven series
．．． 較多If you don't like baseball, watch baseball, or know what baseball is, know this — the 2016 World Series is different.?
When the Cleveland Indians host the Chicago Cubs in a best-of-seven series beginning Tuesday night, we won't just witness another run-of-the-mill Fall Classic. This year's matchup is steeped in history, characterized by decades of suffering, and features two teams who know a whole lot about losing.?
By the end of this World Series, one city will hoist the championship trophy for the first time in a very, very, long time.?
SEE ALSO: The dark side of a feel-good World Series
The Cubs haven't won a World Series since 1908, the longest championship drought in North American professional sports. They haven't even been to a World Series since 1945.?
Chicago's franchise is supposedly cursed, and the years of bad luck and losing seasons prove it.?
But a revamped front office and minor-league farm system have turned the Cubs from lovable losers to a national powerhouse. They showed up at Spring Training with the best odds of winning the World Series and led baseball with 103 wins during the regular season. ?
It's easy to root for this year's Cubs, until you remember who's in the other corner.
Image: Jamie Squire/Getty Images
The Indians haven't won a World Series since 1948, the second longest championship drought in baseball. Cleveland stumbled through the 1970s and '80s, failing to make the postseason every season in a 24-year span. Its last World Series appearances — both losses, of course — came in 1995 and 1997.?
The history of this World Series is huge, and each team's drought will be hyped constantly. But there's more to this matchup.
So, if you're just tuning in, here are our five biggest storylines to watch during the 112th World Series.?
1. Battle of the bullpens
The Cubs and Indians have one very specific thing in common —?in July, they both picked up two of the best relief pitchers in baseball, courtesy of the New York Yankees. The Indians, who traded for Andrew Miller, and the Cubs, who traded for Aroldis Chapman, understood the value of a shut-down bullpen in the postseason, and made sure to stock up on elite relievers.?
Andrew Miller has been unbeatable.
Image: Elsa/Getty Images
The results have been undeniable.?
Miller struck out 21 batters in 11.2 scoreless postseason innings for the Indians, earning MVP honors in the American League Championship Series. He's at the helm of a monster bullpen with a 1.67 ERA in the playoffs.?
Cleveland's strategy this postseason is simple —?get an early lead and let the bullpen save it.?
Though the Cubs' bullpen might not have the flashiest postseason numbers this year — a 3.53 ERA and a couple blown saves — it still features Chapman, who fires 100-mph fastballs right by hitters on a regular basis.?
Image: mlb
Keep an eye on the bullpen. This series could hinge on the guys emerging from it.?
2. The fountain of youth
You can bet Fox announcers will constantly tout the young talent of both World Series teams, particularly Chicago.?
The average age of the Cubs infield — featuring All-Star Addison Russell, NLCS co-MVP Javier Baez, 2015 Rookie of the Year Kris Bryant and MVP candidate Anthony Rizzo — is 24 years old.?
Russell and Baez are only 22 and 23, respectively. They epitomize the Cubs' philosophy of developing young superstars and complimenting them with big-budget free agent signings.?
Clearly, that model has worked.?
Javier Baez was the Cubs' co-MVP of the NLCS.
Image: mlb
The Indians have shallower pockets, and couldn't afford to take the powerhouse approach. Instead, Cleveland relies on contributions from more frugal pick-ups like Rajai Davis and Mike Napoli.?
They still boast a solid young core that features All-Star shortstop Francisco Lindor (22), José Ramirez (24) and rookie Tyler Naquin (25). Rookie starting pitcher Ryan Merritt (24) made only one major league start before helping the Indians clinch a World Series berth last week.?
For a World Series soaked in historical context, this Fall Classic belongs to the kids.?
3. It starts with starting pitching
With all eyes on the bullpen, starting pitching could be the Cubs' not-so -secret weapon.?
Chicago boasts a deep starting rotation that led the majors with a 2.96 ERA during the regular season. Between Jon Lester — who's posted a 0.86 ERA in three postseason games — Jake Arrieta and Kyle Hendricks, the Cubs are set.?
The Indians had a brilliant starting rotation of their own at one point this season, but lost two of their talented arms to injury. There are murmurs of one of them returning, but more on that later.
Aside from Game 1 starter and former Cy Young Award winner Corey Kluber, the Indians have relied on good — but not elite — starting pitchers who turn in gutsy performances.?
Corey Kluber won 18 games in 2016.
Image: Maddie Meyer/Getty Images
Josh Tomlin is largely untested. Trevor Bauer bled himself off the mound last week. Ryan Merritt has two major league starts to his name.
Still, the Indians starting rotation has an impressive 1.86 ERA this postseason.
But don't let the numbers fool you. Chicago has an edge here.?
4. Comeback kids
This World Series will feature elite relief pitching, the best of the best. Games will surely come down to the late innings.
But here's something to chew on.?
This postseason, the Cubs have scored 17 runs in the seventh inning or later, the best of any team. They've thrived on comeback wins, and never seem to go down quietly.
Image: Jamie Squire/Getty Images
How many have the Indians scored in the seventh or later?
Zero.?
Cleveland appears incapable of putting runs on the board with their backs against the wall. Their game plan, as mentioned, is to get an early lead and turn things over to the bullpen.
That might not work against a team like the Cubs.?
Chicago's bullpen is beatable, but it's still formidable in the late innings, a time when the Indians' bats seem to be incredibly weak.?
5. Reviving the dead
Chicago won more than 100 games without Kyle Schwarber, one of the Cub's elite young superstars. Schwarber hit five postseason home runs last year, but tore his ACL just two games into this season.?
Now, there's talk he might be back.?
Since coming off the disabled list on Saturday, Schwarber has been getting back into playing shape in the Arizona Fall League (AFL). Depending on his performance in an AFL game Monday night, the Cubs could activate him for a designated hitter role in the World Series on Tuesday.?
There's sure to be rust, but if Schwarber performs anything like the player he was in 2015, he could be a difference-maker.?
For Cleveland, it's looking like starting pitcher Danny Salazar will return as well.
The All-Star right-hander, who struck out more than 10 batters per nine innings during the regular season, has been sidelined with a forearm strain since Sept. 9. It's unclear whether or not Salazar will start, considering the long layover, but he would bring stability to a starting rotation that desperately needs it.?
Both teams aren't taking any chances. They want their best lineups on the field.
Image: Maddie Meyer/Getty Images
This World Series figures to be epic, not only because of the historical context, but because of how each team's strengths counter the other's. Chicago's bats are scary, but Cleveland's pitching is hot. The Indians' bullpen is ferocious, but the Cubs know how to score late.?
Regardless, one of these long-suffering franchises will see relief soon. A historic championship drought will be quenched with a champagne shower.?
The loser? Well, they're already used to losing, and can wait just a little longer.?
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2016年10月25日週二 台北標準時間上午6時37分
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