"Epoetin alfa": imfundo manual, ukubuyekezwa kanye analogue

ezingeni Uncharacteristic ka lokuhlushwa i-hemoglobin - omunye izimpawu igazi. Empeleni, lokhu akukona sifo, kodwa uphawu kuphela okungukuthi lwentando izifo eziningi. Inqubekela phambili isifo ezinjalo zingase zibonise ukuthi lesion ayinhloko esimiso igazi.

I stimulator ka erythropoiesis, eyaziwa ngaphansi ngamazwe igama non-nokuphathelene ngokuthi "Epoetin alfa" yokusetshenziswa njengendlela ukusebenza high ukubeka reagent izakhiwo kwemithi iya ukwelashwa kanye nokuvimbela anemias of etiologies ezahlukene. Isikali kahle akhethwa awugcini nje ngokusisiza usimamise igazi isakhiwo ingxenye, kodwa futhi kuba nomphumela omuhle ku imisipha yenhliziyo.

Khipha ifomu amakhemikhali ukwakheka

Umkhiqizo okwelapha itholakala Pharmacy ngesimo:

• oyinyumba isipetu alahlwayo nge umthamo esethiwe (design sihlinzekela ezengeziwe izinaliti Ukuvikelwa);
• isixazululo in vials.

Indima isithako asizayo unikezwa:

• amanzi komjovo;
• chloride dihydrate kanye sodium hydrogenphosphate;
• polysorbate-80.

Umsebenzi begazi ketshezi egabheni kungaba ezahlukene. Ezimweni eziningi, ayinkulungwane noma anamabini amawaka Units International ngayinye 0.5 ml ketshezi. Nokho, kukhona ukuthengisa nezinye izinhlobo reagent, kuhlanganise "epoetin alfa" 10,000 PC. / 1 ml.

Lo mshini wezenzo kwemithi

izakhiwo Biological and immunological komkhiqizo kwemiqondo efana ncamashí erythropoietin zemvelo. Ngakho-ke, imithi kakhulu ngempumelelo suppresses izimpawu kwegazi, futhi aqondise igazi njengendlela glycoprotein ejwayelekile. Mangisho ukuthi "epoetin alfa" ngokuyinhloko okuhloswe ngaso okwandisa hematocrit kanye namazinga e-hemoglobin ukuzinza. 'Inhliziyo yakhe umsebenzi, "kanye nokuthambekela yezingxenye ukuthuthukisa ukugeleza kwegazi ezicutshini lingaphansi evelele.

isikhathi sokuphumula:

• ngomjovo emthanjeni - amahora amane
• lapho injected phansi kwesikhumba nge - cishe usuku.

Ubuningi wokugcina reactant plasma kumelwe zilindelwe ngemuva kwamahora 12-18.

umehluko wemisindo nemiqondo yamagama pharmacokinetic

Ucwaningo luye lwabonisa ukuthi izidakamizwa echazwe eheha kumiswa masosha omzimba "ithule" Imodi, kanye nekubaluleka kwalo kwemithi ezinqutsheni umnkantsha cystic iseduze zero. I amaprotheni ingxenyenamba nomuthi "Epoetin alfa" siqukethe mayelana 165 amino acid (58% we isisindo yamangqamuzana Imininingwane), futhi lokhu kubonakala ngezinga nekhwalithi yezingxenye ukuthonya division / kwamangqamuzana ka sikakhokho amaseli.

Okuphindaphindayo ekuphathweni emthanjeni (ngokungabi bikho pathologies kwezinso) aliholeli ekuqongeleleni ketshezi esebenzayo; izingane ezingaphansi kweminyaka engu-engu-12 kungenzeka prolongation ka T1 / 2 nezikhathi amahora angu-6.

izinkomba ngoba

"Epoetin alfa" Kunconywa ukuba isetshenziswe uma:

• anaemia okwatholakala ukuphazamiseka umsebenzi hematopoietic, okuhambisana umdlavuza (zenzeke ukuba izimila okungezona myeloid);
• isiguli uzizwa isidingo hemodialysis ejwayelekile noma isebenzisa umshini wezinso peritoneal ;
• umbuzo yokufeza ukuhlinzwa eziyinkimbinkimbi ne kokumpontshelwa igazi allogeneic;
• isiguli HIV yokwelapha ngesisekelo zidovudine;
• Amaphuzu kudinga zokuvimbela.

Kwemisebenzi yoMnyango nokushintsha kokudla nokufakwa lwemithi

Ukuze ukulungiselela "Epoetin alfa", ifomula yokukhethwa ngazinye umthamo wansuku zonke. Nokho, izincomo jikelele nomkhiqizi kukhawulwe imigomo enjalo futhi amazinga:

• ekuqaleni ukulungiswa isigaba amahlanu isinyathelo amayunithi (IU) ngamunye isisindo amakhilogramu umzimba, kodwa abangeqile kwabathathu imijovo / infusions ngeliviki;
• ngokungabi bikho shift ebonakalayo: amayunithi 75 / kg ngesikhathi isikhawu efanayo, kodwa akukho ngenyanga ngaphambili kweyodwa ngemva Ukuqalwa ukwelashwa;
• e isimo esihlukile: 100-200 U / kg, ngokuqinile ukunamathela wathi isheduli umjovo (isinyathelo ukwanda - amayunithi 25 / ngenyanga);
• ukwelashwa yesondlo: umthamo iqondiswa ngesilinganiso okwakusendlini ububanzi hematocrit ka 30-35 vol. %.

Njengoba umkhuba ubonisa, ngokuba "ejwayelekile" kaningi ithathwa izinga elilodwa 30-100 IU / kg, ngokuvamile ukushayela ekupheleni isebenzisa umshini wezinso. Ubude kahle i / v ukumnika - oyedwa imizuzu emibili; ezosetshenziswa ukulethwa ongama zezinto asebenzayo ulandele imithetho efanayo.

Ukwahlukanisa kungenzeka nemiphumela emibi

On ukuphendula zimo atypical umzimba ukuba khona yezingxenye izidakamizwa "Epoetin alfa" imfundo manual ibika lokhu okulandelayo:

• kungenzeka ukubona ngehlo lengqondo i izimpawu ezithile ukuze Umkhuhlane amagciwane - isiyezi ezinzima, ukucindezeleka, ubuthakathaka, imfiva, ezinzima ubuhlungu bamalunga / imisipha;
• bavunyelwe ukungalingani inhliziyo negazi imithambo - waba ukwanda okukhulu kwezincwadi blood pressure, umfutho ophakeme wegazi abulalayo;
• umuntu akakwazi indiva ingozi thrombocytosis (sifo, yize-ke kuba nethonya kukalutshwana kakhulu, kodwa igcwele eziyingozi);
• reagent ohlelweni urinary uyakwazi ukuthonya ngokushintsha inani potassium ne-phosphate emzimbeni (amazinga creatinine hhayi axoshwe anda plasma).

On the isikhumba futhi ukucasuka ngezinye izikhathi obonakalayo kwabangela ngokwethula "Epoetin alfa" ukulungiselela. Imiyalelo, ngokukhethekile, ukhuluma ukuqubuka, eczema, angioedema. Futhi yini ezithakazelisayo: lapho ongama umjovo iphesenti kobukhulu iphezulu kakhulu: ngokwesilinganiso ayinkulungwane izimo, ama-4 iziqephu (nge ku / e infusions - 1.6 kuphela).

On izinguquko mzimba engakwenza wathi into, kungekho ukwaziswa okunokwethenjelwa (Kungokuphawulekayo ngaphandle ukuthi ikhono kushiwo ngaphambili zomuthi ntombazane kumiswa amasosha omzimba).

Ngokwe-Izimo nomkhiqizi

Ngokolwazi enikeziwe in the Umhlahlandlela esemthethweni, "Epoetin alfa" (analogs ezifana "Binokrit" futhi "Eralfon" kulesi sici eduze original) akufanele isetshenziswe uma:

• kwatholakala ukuthi nginesifo nomfutho wegazi ophezulu engalawuliwe;
• isiguli sibe hypersensitivity kuya izithako;
• ukuhlaziywa olwandulelayo yabonisa ezibucayi pathologies igazi imigqa;
• isiguli yisifo senhliziyo (sikhuluma esidlulileko);
• kukhona isizathu sokukholwa ukuthi ukuphazamiseka evamile igazi flow ebuchosheni.

Ngamanye amazwi, ukuqala imishanguzo kumelwe kwandulelwe lapho ngihlolwa.

Izixwayiso

"-Alpha Epoetin" (tradename ikhipha ekwakhiweni ezifanayo zingahluka - isibonelo, indawo tingafundziswa analogs "Aeprin", "Repoetin-SP", "Epokomb", "Eprex", njll ...) Kufanele kusetshenziswe ne ngokuqapha anda ngokumelene kubantu abaphethwe yansukuzonke iziyaluyalu / ezingamahlalakhona kwemisipha neuropathy. Lo mthetho kuyiqiniso ngokukhethekile uma umlando njengempendulo yomzimba edonsa izidakamizwa ezithile kakade iqoshwe iziqephu ukusabela convulsive.

Akukona liphazamisane siqaphile futhi sifo. Ukuphimisela okokuqala udinga ukubeka ezindabeni eziphathelene blood pressure kanye okuvela bekhanda (antihypertensives - omunye izilungiso Yiqiniso yezokwelapha elandelayo). Nokho, kubalulekile ngokulinganayo ukuze bahlole futhi isimo kweqiniso yensimbi izitolo (ngaphambi imijovo njalo). Lapho efeza imisebenzi yokuzithandela ezanele is hhayi kubonakala ngokuya blood pressure, inqubo echazwe umkhiqizo kwemithi imisiwe.

Kumele sikhumbule ukuthi izinso ukwehluleka, umdlavuza kanye ne-HIV ohlwini izifo ngokuhamba okuyinto, sinombono emakamu hematocrit, kukhona ukwehla izici ferritin amazinga e-plasma. Ukuze nokunciphisa ukungalingani noma aphendukele ekuthengiseni yokwelapha esikhundleni ezihilela reactants Fe-aqukethe.

Amasampula for elithwala umoya-mpilo kungcono ukuthatha isikhathi esingu-1 njalo ezinsukwini ezingu-7. Futhi ngesikhathi kwethulwa izinyanga ezimbili liyadingeka zokuqapha njalo ka platelet count. Futhi 5-10 izinsuku ngaphambi kokuba uhlinzwe, isiguli iqondiswa imithi ikhadi izinto kokuba izakhiwo antithrombotic.

Umenzi alikwenqabeli ukuphuza ukuthi izingxenye zomuthi kungathinta izinhlobo ezithile nezimila, ngakho okwashiwo isiguli akufanele wayeka ngisho ekupheleni esebenzayo ukwelashwa isigaba.

Okufanele ukwenze uma ukweqisa izidakamizwa?

"-Alpha Epoetin" (omqondofana-izidakamizwa, ngenhlanhla kwenta ngendlela efanayo) kanye ukweqisa izidakamizwa athathe ubuchule ifakwe ku-formula amakhemikhali isakhi sokuzakhela erythropoietin isb kuphakamisa polycythemia hematocrit ezingeni futhi oscillations. Ngenxa yokuntuleka sinqobe zakudala, abanye izinyathelo esikhethekile ukungaqaliswa izithako akuyona eyenziwa - nje kukhanselwe omunye imithi aphoyintimenti.

ngokukhipha igazi Ngenhloso esebenzayo ezimeni eziphuthumayo, uma i phezu-umkhawulo inkomba-hemoglobin kubonisa buyingozi khulu ekuphileni.

Ukusebenzelana Imithi

Ekuqhubeni multi-esiteji yokwelapha eziyinkimbinkimbi kubaluleke kakhulu ukuba baqonde izimiso "zokuziphatha kwemithi" "Epoetin alfa" reagent (ifomu ukukhululwa, njengoba kuchaziwe ngenhla, kungaba ezahlukene, kodwa indlela okunjena kwamakhemikhali ayishintshi).

Ngakho, ngokukhethekile, zifana kuya isingeniso kwemikhiqizo yegazi kuba nomphumela omuhle ekuthuthukiseni Dynamics. Kodwa kufanele sikhumbule ukuthi lo dilution ka isixazululo lomunye kuyinto inadmissible. Umuthi "sobunye 'cyclosporin kubabangele ngincipha lokuhlushwa yokugcina (elikhulu isilinganiso volumetric we ngemithamo kunqunywa empirically).

Amazwana

Ukuhlaziywa kwe-ukubukwa libonisa ukuthi yisibalo esikhulu sabasebenzi esingakaze imibuzo ephakamayo uma kuziwa okukhona ukuxazulula leyo nkinga. Ngokwesibonelo, bambalwa kakhulu iziguli ababeyizazi umehluko ezenzekayo phakathi imikhiqizo efana kwemithi, njengokuthi "epoetin alfa" futhi "epoetin beta."

Uyini umehluko - kulula ukukuqonda, uma thina sinake okwashiwo odokotela. Iqiniso lokuthi imodeli isakhi erythropoietin zemvelo imelelwa ngamaketanga amabili, kanye nomphumela ofiselekayo uhlelo igazi kokubili. Abakhiqizi umuthi ofanayo, ngenxa umehluko kwezobuchwepheshe, noma synthesize-alpha-isinqamu noma i-beta.

Ngokuqondene nokukhulumela ngohlelo ukulungiselela ngokwayo, abaningi labo okwakuye kwadingeka kuzame ngokwakho, bonisa okusho ukuthi siyasebenza ngempela, futhi kwezinye izimo akhethekile nhlobo esisemqoka nezigaba ezithile iziguli.