"Epoetin alfa": mirayiridzo yekushandiswa, kuongorora uye zvakafanana

Uncharacteristic level ye hemoglobin concentration ndiyo imwe yezviratidzo zveanemia. Ichokwadi, hachiri kuongororwa, asi chiratidzo chete chinoshumira sekadhi rekushanyira rezvirwere zvakawanda. Kufambira mberi kwehutano hwakadaro kunogona kuratidza chiremera chikuru cheropa.

I erythropoiesis stimulant, inozivikanwa nedzimwe nyika isiri yepamutemo zita rokuti "Epoetin alfa", inoshandiswa se reagent inobatsira zvikuru, iyo inyanzvi yemishonga inoshandiswa pakurapa nekudzivirira kwehutachiona hwehutano hwakasiyana-siyana. Sarudzo yakasarudzwa yakarongeka kwete chete inobatsira kugadzikana kwechikamu chemuumbi weropa, asiwo zvakanaka inobata basa remuviri wemwoyo.

Kubudiswa kusununguka uye makemikari

Chigadzirwa chemishonga chinoendeswa kumafarisi nenzira ye:

• Mishonga inoshandiswa isina kuchena nemushonga unotarirwa mberi (iyo yakagadzirisa inopa kumwe kuchengetedzwa kwesinete);
• Solution in vials.

Basa rebatsiro rekubatsira rinopiwa kune:

• Injection water;
• Chloride uye sodium dihydrate-hydrogenphosphate;
• Polysorbate-80.

Basa rezvinyorwa zvechirwere muzviputi zvinogona kunge zvakasiyana. Kazhinji kazhinji inenge chikwi chimwe chete kana zviviri zvuru zvemaundi emarudzi ose 0.5 kilo yemvura. Zvisinei, mamwe maitiro e reagent ariwo akatengesa, kusanganisira "Epoetin alfa" maundi 10 000/1 ml.

Mechanism of action pharmacological action

Izvo zvipenyu uye maune immunological zvigadzirwa zvekugadzira zvakagadzikana zvakafanana neyerythropoietin yemhuka. Nokudaro, mushonga uyu unonyatsopedza zviratidzo zvekushaya ropa uye unogadzirisa kuumbwa kweropa sechimiro che glycoprotein. Ndinofanira kutaura kuti "Epoetin alfa" inonyanya kufunga nezvekuwedzera hematocrit uye nekusimudzira hemoglobin level. "Basa rayo remwoyo", pamwe chete nehuwandu hwezvimwe zvikamu zvekuvandudza kuteura ropa mukati memaviri, hazvirevi kududzwa.

Half-life time:

• Nejojo inopisa-maawa mana;
• Apo rinotungamirirwa pasi pekunze - anenge zuva.

Iyo yakawanda yakakosha ye reagent mu plasma inofanira kutarisirwa mushure memaawa 12-18.

Pharmacokinetic nuances

Munguva yekutsvakurudza kwakawanikwa kuti mishonga yakatsanangurwa inoita kuti kuumbwa kwezvirwere mu "latent" mode, uye kukosha kwaro mune zvemapurisa mune zvinoitika zvepafu marrow fibrosis iri pedyo ne zero. Puroteni chikamu chechirwere "Epoetin alfa" ine 165 amino acids (58% yehuwandu huwandu hunorema), uye izvi zvinoratidzika muhupamhi uye hunoenderana nemigumisiro yezvikamu zvekuparadzanisa / kusiyaniswa kwemasero emagetsi.

Nhamba dzakawanda dzekutengesa (pasi pemamiriro ekusavapo kwechirwere chechirwere) haitungamiri pakuunganidza zvinhu zvinoshanda; Vana vari pasi pemakore gumi nemaviri vanogona kupedzera nguva T1 / 2 kusvika ku6 maawa.

Zviratidzo zvekushandiswa

"Epoetin alfa" inokurudzirwa kuti ishandiswe kana:

• Anemia inoonekwa sechirwere chehematopoietic chinosangana nechirwere chinokonzerwa nehutachiona (pane zvipembenene zvisingagoneki);
• Murwere ane ruzivo rwekugara kwehemo- kana kuti peritoneal dialysis ;
• Pane mubvunzo wekuita chirwere chakakwana chokuvhiya nekushandiswa kwekuwedzerwa ropa kwechiropa;
• Murwere ane HIV uye anotambira zidovudine-based therapy;
• Kubudirira kunobudirira kunodiwa.

Optimal dosing regimen

Pamusoro pezvinodhaka "Epoetin alfa" nzira yekusarudzwa kwomunhu mumwe wezuva nezuva inoshanda. Zvisinei, mazano anowanzogadzirisa anogadziriswa pane zvigadziriswa uye maitiro:

• Pakutanga chirongwa chekugadzirisa: makumi mashanu maitiro (ED) kilogram yehutatu hwehuviri, asi kwete majekiseni matatu / infusions pavhiki;
• Mukushaikwa kwekuchinja kunooneka: 75 mauniti / kg panguva imwe chete, asi kwete kupfuura mwedzi mushure mokutanga kurapwa;
• Mumamiriro ezvinhu akasiyana-siyana: 100-200 U / kg, kunyatsoteerera purogiramu yakaratidzwa yejojo (danho rekuwedzera - 25 maundi / mwedzi);
• Maintenance therapy: iyo inonzi yakagadzirirwa kuverenga humatocrit yepamusoro mukati me 30-35 vol. %.

Sezvakaratidzwa zvinoratidzira, nokuda kwe "chimiro" chinowanzosara che 30-100 U / kg, icho chinowanzotorwa mushure mekuguma kwenzira ye dialysis, inowanzotorwa. Iyo nguva yakakwana yeA IV inopera imwechete kusvika kumaminitsi maviri; Neyo nzira isina kumira yekutengeswa kwezvinhu zvinoshanda zvinotungamirirwa nemitemo yakafanana.

Kuenzanisa kwemigumisiro yakaipa

Pane mamiriro ezvinhu ehupenyu hwehupenyu hwehupenyu kusvika pakuvapo kwezvikamu zvechirwere "Epoetin alfa" murayiridzo wekushandisa unozivisa zvinotevera:

• Zvinokwanisika kufungidzira zviratidzo zvinokonzerwa nemavhuvira ane chirwere - chirwere chakakomba, kuora mwoyo, kushaya simba, fivha, kurwadziwa kwakanyanya mumasangano / misumbu;
• Kubvumirwa kusabvumiranwa mubasa remwoyo nemitsetse yeropa - kuwedzera kwakanyanya kwehutano hweropa, hutachiona hwehutano hwakanyanya;
• Iwe haugoni kufuratira dambudziko re thrombocytosis (chirwere ichi, kunyange chichiita kuti chave chisinganzwisisiki kazhinji, asi chakazara nezvinetso zvakakomba);
• Iyo reagent inokwanisa kukonzera urinary system nekuchinja yakawandisa ye potassium uye phosphate mumuviri (iyo yero ye creatinine mu plasma yeropa haina kubviswa).

Paganda, kutsamwa kunokonzerwa nokuiswa kwechirwere "Epoetin alfa" dzimwe nguva zvinoonekwawo. Iyo murayiridzo, kunyanya, inotaura nezvemashes, eczema, angioedema. Uye izvi zvinonakidza: nejovo dzemuviri, chiyero chekutaura chiripamusoro-soro: kune chiuru chemazana mashoma, anenge 4 episodes (ne IV infusions - chete 1.6).

Hapana ruzivo rwakavimbika maererano nehutachiona hwemusununguko hunogona kukonzerwa neiyo chinhu (kungoita simba rakambotaurwa kare remishonga inoita kuti kuumbwa kwezvirwere zvinokodzera kutarisirwa).

Contraindications yakasimbiswa nemuti

Kutonga nemashoko anowanikwa mumutungamiri wepamutemo, "Epoetin alfa" (akafanana sa "Binocritus" uye "Eralfon", munyaya iyi vari pedyo nepamunogona kune yakasikwa) haafaniri kushandiswa kana:

• Kusachengetedzwa kwehutano kwehutachiona kwakaonekwa;
• Murwere ane hypersensitive kune zvigadzirwa;
• Preliminary analysis yakaratidza kuvepo kwechirwere chekutambudza kweropalines;
• Murwere ane chirwere chemwoyo (ichi ndicho chakaitika kare);
• Pane chikonzero chekutenda kuti kupararira kwakakwana muuropi kwave kwakanganiswa.

Mune mamwe mazwi, kutanga kwerapi kunofanira kutungamirirwa neongororo yekurapa.

Special instructions

"Epoetin alfa" (zita rebhizimisi rekugadzirisa kwakarongeka kunogona kunge kwakasiyana - somuenzaniso, zvakafanana zvingaitwa sechimwe chinotsiva: "Aeprin", "Raphoetin-SP", "Epocombe", "Eprex", nezvimwewo) Kuwedzera kuchenjerera kune vanhu vane chirwere che periodic / chronic chronic peripheral musculature. Murairo uyu unonyanya kukosha kana mune an anamnesis episodes yekushungurudzika kwezvinoitika zvatove zvakanyorwa semhinduro yemuviri kusvika pakuwana mamwe mishonga.

Hazvizoiti kudzivirira kutarisa uye gout. Accents munzvimbo yekutanga inofanira kuiswa munyaya dzine chokuita neropa reropa uye kuitika kwemusoro wepamusoro (antihypertensive drugs - chimwe chezvingasarudzwa zvekodzero yekururamisa mhando). Zvisinei, zvakakoshawo kuti uongorore mamiriro echokwadi esimbi iron (kunyange tisati tagara majekiseni). Apo mufambiro wezviyero zvakakwana hauratidzirwe muzviratidzo zvekushandiswa kweropa, kugamuchirwa kwezvinorondedzerwa zvemishonga yemagetsi kunomiswa.

Inofanira kuyeukwa kukundikana kwechirwere, incology uye kutapukirwa kweHIV zvinosanganiswa muurwere rwezvirwere, panguva iyo, maererano nehutano hwekuwedzera hematocrit concentration, pane chimiro chinopera muzinga re ferritin mu plasma yeropa. Kuenzanisa kusawirirana kunoshandiswa kunzvimbo yekurapa iyo inosanganisira Fe-ine reagents.

Samples ye hemoglobin inofanira kutorwa 1 nguva mazuva manomwe. Uyezve, mumwedzi miviri yokutanga, kugara uchicherechedza platelet count kunodiwa. Uye kwemazuva 5-10 kusati kwapindira kupindira, kadhi yakanyatsofungidzirwa yemurwere inopindwa nezvinhu zvine antithrombotic.

Muiti wacho haaiti kuti zvikamu zvechirwere zvinokwanisa kuchinja mamwe marudzi emaronda, saka, kutarisa kwemuurwere hakufaniri kumira kunyange mushure mekushanda kwebasa rekurapa.

Chii chaunofanira kuita kana ukanyanya kudarika?

"Epoetin alfa" (synonyms-zvinodhaka, zvichiitika, zvinoita nenzira imwecheteyo) apo kudarika kwemaitiro kunoita maererano nemaitiro ekugadzirisa akaiswa mumakemikari ekugadzirisa zvakare erythropoietin, kureva kuti, inokonzera polycythemia uye kuchinja kwehutano hwehematocrit. Pamusana pekusavapo kwemazana ekare antidotes, hapachina matanho anokosha ekudzivisa kushandiswa kwezvinhu - imwe chete mishonga inongorambidzwa.

Kuisa ropa ropafadzo kunoshandiswa mumamiriro ezvinhu anotsvaga, apo chiratidzo che transcendental hemoglobin chinoratidza ngozi chaiyo muupenyu.

Kuwirirana nemishonga

Kana uine hutano hwakawanda hwakaoma, hunonyanya kukosha kuti uone mazano e "maitiro ehutachiona" ezvekare "Epoetin alfa" (fomu yakasunungurwa, sezvataurwa pamusoro apa, inogona kunge yakasiyana, asi iyo nzira yehupenyu hwemagariro haisi kuchinja kubva apa).

Nokudaro, kunyanya, kuenzaniswa kwehutano nemishonga yeropa kunobatsira hutano hunoita simba. Asi tinofanira kuyeuka kuti kubudiswa kweimwe sarudzo kune umwe hakugamuchirwi. Mishonga "kubatana" ne cyclosporine yakazara nekuderera kwemazana ekupedzisira (iyo yakakwana yehuwandu yezviyero inotsanangurwa nenzira yekuedza).

Ongororo nemashoko

Kuongororwa kwemaonero akaratidzirwa kunoratidza kuti mibvunzo yakawanda kwazvo inomuka kana ichiuya kune zvingasarudzwa zvekugadzirisa dambudziko rimwechete. Semuenzaniso, vashoma varwere vanotungamirirwa nekusiyana kwezvinhu zvakadai se "Epoetin alfa" uye "Epoetin beta".

Ndeupi mutsauko - zviri nyore kunzwisisa kana iwe uchiteerera kune zvataurwa navanachiremba. Ichokwadi ndechokuti maitiro ekugadzira eerythropoietin anomiririrwa nemaketani maviri, ayo maviri ayo ane zvaanoda pane ropa. Vagadziri vemishonga imwechete, nekuda kwekusiyana kwe teknolojia, vanogadzira kana chidimbu chechi alpha kana beta.

Kana iri mhinduro pamusoro pemishonga pachayo, vazhinji veavo vaifanira kuzviedza ivo pachavo, vanopupura kuti mushonga wacho unoshanda chaizvo, uye mune dzimwe nguva zviitiko zvakare hazvikwanisiki kune mamwe mapoka evarwere.