Umuthi 'Kortef ": yokusetshenziswa, izimpawu, contraindications, umthamo, ukubuyekezwa

Glucocorticosteroids (GCS) abizwa ngokuthi izidakamizwa zokwenziwa, okuyizinto analogue hormone endogenous ezivezwa cortex adrenal. GCS has emzimbeni womuntu ezihlukahlukene imiphumela: anti-inflammatory futhi desensitizing, immunosuppressive, anti-esinobuthi antishock.

Namuhla emakethe zemithi Russia uhlu olubanzi kwemithi enjalo. Omunye wabo "Kortef". Yokusetshenziswa incoma balithathe ngenombolo izifo.

Sakhiwo Ukwakheka

I nomuthi senzelwe abaphathi ngomlomo. Uphiko esebenzayo eyinhloko "Kortef" ukulungiselela (imiyalelo iqukathe lolu ulwazi) yilo hydrocortisone - hormone ekhiqizwa yi-nezindlala adrenal. Ukuze ukusetshenziswa eluhlelweni kanye lendawo asetshenziswa ezindaweni zokwelapha hydrocortisone zemvelo noma esters yayo.

Ngo Imithi "Kortef" le hormone kuqukethwe inani 10 mg. Njengoba eyengeziwe aphume ashone izinto ezifana calcium stearate, corn isitashi, sucrose, i-lactose, uwoyela amaminerali, futhi sorbic acid.

Ifomu main lapho kuphakanyiswa ukuthi Kortef abathengi ' "- amaphilisi. Yokusetshenziswa, real lezamaphilo abahlinzeki kanye neziguli ithi high nekusebenta izidakamizwa. Izibhebhe ukuma isiyingi nge umugqa phezu futhi embossed kuso esinelebuli «CORTEF10» ezipakishiwe ku izitsha eziyisikhombisa ingilazi mnyama (ngamunye igcwele izingcezu 100). Thenga imithi kuphela kadokotela kadokotela.

pharmacodynamics

Njengoba kushiwo ekuqaleni kwalesi sihloko, izidakamizwa has a uhlu olude imiphumela emzimbeni womuntu: anti-inflammatory futhi antishock, desensitizing anti-iguliswa, anti-anobuthi, immunosuppressive futhi antimetabolite. Incazelo zomuthi (imfundo manual) liqukethe ulwazi mayelana nenqwaba izinqubo lapho izidakamizwa kuthinta. It kuvimbela ukukhululwa kwe balamuli ukuvuvukala futhi kakhulu kubamba ukukhululwa kwe cytokines (interferon, interleukin) kusukela macrophage nama-lymphocyte.

Futhi, "Kortef" ekhuthaza isitoreji glycogen esibindini, kwandisa umthamo glucose eziqukethwe igazi, uketshezi kubambezela futhi excreted Na + futhi K + iyakhula. Nge oqondile ukuzibandakanya we nomuthi liyancipha ukukhiqizwa histamine (umlamuli, t. E. uMlamuleli edingekayo ngokushesha uhlobo iguliswa ukusabela).

Ngaphezu kwalokho, ukulungiswa Kortef "yokusetshenziswa njengoba kusho indlela kunciphisa inani lingene yeselula (cell izakhi ngegazi kanye lymph) nasesikhathini obuqand ukuvuvukala foci locomotor umsebenzi leukocyte lymphocyte kusiza ukunciphisa permeability capillary. Umuthi kuvimbela zamagama futhi kwandisa izinga amaprotheni ukuphuka.

"Kortef" kuthinta pituitary futhi suppresses ukukhiqizwa kwe corticotropin (ACTH), ngaphandle kwalokho, kungaba ayeke ngokuphelele ekusebenzeni cortex adrenal.

Medicine "Kortef": imfundo, isicelo

ochwepheshe lezivakashi bathi phambi kwethu imithi isetshenziswa emikhakheni ehlukahlukene imithi. Isetshenziselwa ukususa esigulini phakathi anobuthi, kuyashaqisa, ukusha, cardiogenic, ukushaqeka tekusebenta ezimweni lapho standard yokwelapha antishock zilethe yi. Ake sicabangele la maphuzu ngokuningiliziwe.

imikhakha Ngakho, indlela iziguli okunqunyiwe "Kortef"?

Yokusetshenziswa, imithi incazelo kulethwa abathengi ulwazi mayelana nokwenzeka elisetshenziswa Endocrinology. Lapha, i-izidakamizwa kungaba ngempumelelo izifo ezifana esingamahlalakhona we adrenal cortex ukusebenza, thyroiditis (subacute ifomu), Hyperplasia adrenal (imvelo kokuzalwa), hypercalcemia, eyabonakala ku ngemuva komdlavuza.

Ngaphezu kwalokho, e-Rheumatology "Kortef" omuhle kuzibonakalisa ekwelapheni bursitis, samathambo (sifo, i-rheumatoid psoriatic), ankylosing spondylitis, tenosynovitis nonspecific. Good imiphumela siyithola, iziguli ethatha "Kortef" e omzimba izicubu erythematosus, acute rheumatism senhliziyo, polymyositis, epicondylitis.

Kukhona izinkomba ukusetshenziswa "Kortefa" futhi emkhakheni nezesikhumba. Lapha umuthi ngempumelelo ekwelapheni pemphigus, mycosis fungoides, herpetiformis, futhi dermatitis exfoliative. Futhi, ezinqunyiwe psoriasis ezinzima, dermatitis seborrheic, erythema multiforme ukugeleza esindayo.

Allergists ukunquma "Kortef" nge serum ukugula, iguliswa rhinitis imvelaphi, nge atypical kanye contact dermatitis, isifuba somoya bronchial kanye hypersensitivity ngabanye izidakamizwa.

Ochwepheshe-bamehlo njengoba umkhuba wokusebenzisa ukuqoka "Kortefa" ngenombolo izifo. I nomuthi liphumelele izilonda corneal conjunctivitis Lokudabuka nomzimba, nge keratitis futhi iritis, iridocyclitis lapho, neuritis, uevite, njll emkhakheni of Oncology GCS "Kortef" ebekiwe wegazi, e Neurology - .. sclerosis amaningi.

Kukuphi lapho esetshenziswa "Kortef"? Yokusetshenziswa liqukethe ulwazi ukuthi angaqoka iziguli zayo Pulmonology (sarcoidosis lingaze, fulminant isifo sofuba yamaphaphu, nenshisekelo pneumonia) kanye Haematology (thrombocytopenia yesibili, anaemia aplastic noma hemolytic, erythroblastopenia).

Izicelo kanye nokushintsha kokudla nokufakwa

I nomuthi "Kortef" senzelwe abaphathi ngomlomo. Nokho, i-esithela lyophilizate yesixazululo "Solu-Kortef" imfundo manual liyala iqondiswa intramuscularly, ngemithambo yegazi (bolus noma ukumnika) kanye isikhwama periarticular.

Njengoba kwezokuphatha temlomo, umthamo kokuqala zingahluka kusuka mg 20 ku-240 ngosuku kuye ngokuthi isifo ukuhlolelwa lesi sifo futhi kobukhulu isimo lesiguli. Umthamo elilungile esimweni ngasinye kukhethwa ukwehlisa ekuqaleni yokutholwa kuya kulencane ezonikeza umphumela oyifunayo.

Ezimweni oyingozi futhi isidingo sokwelashwa esiphuthumayo Kunconywa emthanjeni imithi ukuphathwa "Solu-Kortef". Yokusetshenziswa uchaza icebo ezilandelayo standard. Isixazululo lokuqala 100 mg (umthamo kokuqala) iqondiswa phezu kwesigamu somzuzu. Umqulu esilandelayo izidakamizwa mg 500 kufanele sinikezwe kungakapheli imizuzu 10. Ngaphezu kwalokho, njalo ngemva kwamahora 2-6, nezinqubo kufanele liphindwe, ngaphandle ukukhohlwa ukuba ngokuqhubekayo nokuqapha isimo lesiguli.

Kumelwe sikhumbule ukuthi ebulilini, "Sol-Kortef" isetshenziswa kuphela inkathi yokululama esiguli, kodwa izinsuku ezingaphezu kwezingu-3.

V / m "Kortef" yaphathwa volume of 125-250 mg / usuku. Positive imiphumela izidakamizwa wabonakaliswa ngemuva kwamahora 6-25 emva inqubo kanye ingathatha izinsuku ezingu-eziningana noma amasonto.

Uma kudingeka, "Kortef" imijovo babe naphakathi-articular noma periarticular esikhwameni. Umthamo eliphumelelayo emalungeni ezinkulu (ehlombe, amadolo, hip) kuyinto 25-50 mg, kodwa izimo oyingozi futhi ingafinyelela mg 100. Ukuze amalunga omzimba amancane (izindololwane, izihlakala phalanges) luyoba olwanele umjovo ivolumu 10-20 mg, wenza 1 isikhathi. Phinda inqubo Kunconywa njalo emavikini 1-3 (ngezinye izikhathi kudingeka futhi kaningi - zonke izinsuku 3-5).

Ngokuvamile, ngokuphathelene yokwelapha izidakamizwa "Kortef" nokushintsha kokudla nokufakwa nokuPhatha bangase bakhethe kuphela udokotela ukuba khona. Kungazelelwe umutsi akuyona kufiseleka, awokuthi kokushelela. Ukugcwaliswa ukwelashwa kwenzeka elokhu enciphisa umthamo.

Izimo ukusetshenziswa "Kortefa"

Kukhona uhlu izifo kanye nezimo umzimba, lapho akuvumelekile ukuthatha olucutshungulwayo ngumuthi. Lokhu izifo yisinanakazana futhi esithathelanayo imvelaphi viral, ukukhunta webhaktheriya (adluliselwe esikhathini esidlule yamuva, ukuthatha indawo ngaleso sikhathi).

Umncele ke uma isiguli sekutholakele ukuthi sine- sengqondo esigabeni oyingozi, isifo sikashukela decompensated noma abantu behlupheka hypothyroidism, i-hyperthyroidism, umfutho wegazi ophakeme, peptic isilonda emathunjini bese izilonda dermatological, isilonda peptic noma ube uhlobo ezithathelwanayo.

Kukhona uhlu Izimo for umjovo intraarticular "Solu-Kortef" izidakamizwa. Musa akunikeze imithi, futhi eziningi izinkinga esimiso senhliziyo nemithambo yegazi, kuhlanganise umlando kwakamuva kwe isilethikusebenza.

Ukuze kutholakale isilinganiso esisodwa, ngisho "kubalulekile" isidingo contraindication sohlelo hypersensitivity ngakunye izingxenye izidakamizwa.

imiphumela engathandeki

Kusukela izizathu eziningana incike imvamisa nokukhanya yemiphumela emibi, uhlu equkethe zemithi "Kortef" imfundo manual. Izinkomba, umthamo, ubude course enqunyiwe yi ukuya kudokotela kufanele kuqashelwe nakanjani. Ezinye ukubaluleka nalo exhunywe ukugcinwa le isigqi lomzimba yendawo (iyehla iyenyuka ukushuba izinqubo ezihlukahlukene zezinto eziphilayo elihlobene ne ushintsho imini nobusuku).

I endocrine uhlelo ekuphenduleni eyamukelayo "Kortefa" okungukuthi ukwazi kusabela ukwehla kuvelana glucose ne ukuthuthukiswa sikashukela steroid imvelo, ukusebenza adrenal ukucindezelwa. Kukhona amathuba othuthukayo Cushing Syndrome, main izimpawu zazo inhlendla okwenyanga uhlobo ebusweni, ukukhuluphala pituitary uhlobo ukwanda amazinga wegazi, myasthenia gravis, ahlukahlukene iziyaluyalu we menstrual cycle kwabesifazane.

Ukusabela yokusetshenziswa pheshana emathunjini kungaba izimpawu ezifana isicanucanu nokuhlanza, pancreatitis, futhi ulceration ahlukahlukene steroid ka ipheshana wokugaya ukudla, ukopha kwegazi, nokusetshenziswa perforation ka (GI) izindonga zakhe, esophagitis erosive.

Kusukela eceleni senhliziyo ukusabela ezingezinhle ukuba "Kortef" (umsebenzisi kuqinisekisa lokhu kwaziswa) kukhona arrhythmia, bradycardia, thrombosis, ukwanda wegazi izinkomba. Ngokumelene okwenza i infarction oyingozi futhi subacute esivimba amanzi "Kortef" kungabangela ukusabalala necrosis, okusithiyayo kwetinhlavu isibanda izicubu, okungaholela ukudabuka of imisipha yenhliziyo.

Ngokuvamile ebaphatha kabi ukusetshenziswa "Kortefa" ngandlela-thile kungaba ezihlukahlukene kwezitho izinhlelo zomzimba womuntu. Okungenzeka ukubonakaliswa we sezinzwa uhlelo futhi kungokoqobo izitho, ukuphazamiseka umzimba kanye zemisipha uhlelo. Zingase ukubonisa ezihlukahlukene komzimba nezinto. Ulwazi oluphelele kakhulu kuqukethwe nomuthi ukusetshenziswa "Kortef" imiyalelo.

Nokukhulelwa kanye lactation

Esikhathini esiyiminyaka esesibelethweni futhi ingane ibele ngokuqinile unqabela nomuthi "Kortef" imfundo manual. Incazelo (ebukhoneni ezinye izinhlobo imithi Gcoba i-Benzyl utshwala liyazikhulumela), umuthi liqukethe ulwazi mayelana akwenzayo kungase kubathinte kanjani ukusetshenziswa 'Kortefa "ezinkathini ezifana ukwehluleka umsebenzi adrenal, isimo Ukuphelelwa, ukufa.

Izingane, omama ngesikhathi sokukhulelwa baye baphoqeleka ukuba athathe hydrocortisone, kufanele kwenziwe ngaphansi kokuqondisa eduze kwabasebenzi bezokwelapha ne sinombono kusenesikhathi izimpawu esingamahlalakhona adrenal.

Lokho kufanele sinake?

Aphatha ngayo ukusetshenziswa kwezidakamizwa "Kortef" Umsebenzisi Isicelo Kunconywa ukudla nokukhawulela kusawoti. Ngaphezu kwalokho, umzimba kumele zithole amaprotheni eyanele. Futhi ngalesi sikhathi akuvumelekile ubambe noma yiluphi uhlobo ngokugoma. Kuyadingeka ukuba ukuziphatha okuqhubekayo zokuqapha wegazi imingcele, lokuhlushwa glucose egazini layo ekunqandeni. Kubalulekile futhi ukuqapha umchamo okukhipha nesisindo isiguli.

Uma kukhona ezicindezelayo izimo, Abantu ababhekene nokwelapha Yiqiniso nge "Kortefa" isidingo ukwanda umthamo corticosteroids. iziguli Ngokuphathelene abaphethwe isifo sofuba, ukuthi kukhona esigabeni asebenzayo kumelwe athathe "Kortef" kuphela parallel yokwelapha okuhambisanayo ziqondiswe ekwelapheni lesi sifo ecashile. Ngo sofuba okwenzeka ifomu esicashile, noma inqubo goba tuberculin ihlola abasebenzi bezokwelapha kufanele eduze ukuqapha isimo lesiguli futhi zibeka chemoprophylaxis ezifanele uma kudingekile.

Uma ukuqokwa izidakamizwa kwabangela intuthuko yesibili esingamahlalakhona adrenal, kungenzeka kute simo sibuyele kulesetayelekile ngu elokhu enciphisa umthamo. Ngemva ukwelashwa usuphothuliwe, ngisho izinyanga ezimbalwa kungabonwa lolu hlobo ukuhluleka. nezimo ezicindezelayo eziye zenzeka kule nkathi ziyinkomba ngoba resumption of the GCS uya khona.

Ngokuqondene elula herpes izifo esweni, i- "Kortef" (umsebenzisi, isicelo, ochwepheshe zangempela ngani esihlokweni), kanye nanoma yimiphi eminye corticosteroids kumele kusetshenziswe ngokuqapha okukhulu, njengoba kungenzeka ukuthuthukiswa perforation corneal.

Abasebenzi bezempilo kufanele bazazi yokuthi ngesikhathi le ndlela yokwelapha "Kortefom" ezinye izifo ezithathelwanayo kungaba asymptomatic, ngefomu esicashile, futhi ube ntshashintshe of kobukhulu. Njengoba kwanda esenikwe corticosteroids esetshenziswa kwandisa amathuba asathuthuka izifo esicashile. E. Ngaphansi kwethonya 'Kortefa "snizhet ukumelana ukutheleleka, kunciphisa ikhono okwasekhaya umthombo ukutheleleka.

Labo ababelwe ngemithamo immunosuppressive "Kortefa" noma yimuphi omunye corticosteroids yanconywa hhayi mbeni nabantu upokisi noma isimungumungwana. Uma oxhumana enjalo akazange athathe indawo, udinga ukuba uxhumane nodokotela babo ekwelapheni ngokushesha.

SCS kungaba imbangela yezifo zengqondo, noma ukuqinisa ukubonakaliswa ingqondo ekhona, kukhuphuke ukuntengantenga ngokomzwelo.

Kukhona ulwazi kwezinye iziguli isizinda "Kortefa" (noma ezinye corticosteroids) ithuthukiswe Sarcoma Kaposi sika. Nokho, ngemuva kokuhoxiswa nomuthi waphawula ukuthethelelwa emtholampilo.

Ngenxa yokuthi yezinkinga ngemuva kokuthatha izidakamizwa encike ngqo kwi isikhathi umthamo isilinganiso, isinqumo ukuqala izifundo ukwelashwa, ubude bayo kanye imithamo ovumelekile udokotela ithatha lapho ehlolisisa izinzuzo nezinsolo isiguli futhi izingozi ezingaba khona izidakamizwa.

Ukuxhumana nezinye izidakamizwa

Ngakho, saxoxa yini ehilelekile 'Kortef ". Yokusetshenziswa, izinkomba kanye contraindications side effects zomuthi Uphinde abhekwe. It uhlala ukuze wazi ukuthi labo onekhono ekumisweni izidakamizwa iziguli kufanele uqaphele ukuthi hydrocortisone is wasithukuthelela ezihlukahlukene izinto, futhi lezi zakhi kungadala umonakalo omkhulu emzimbeni.

Okokuqala, hydrocortisone pharmaceutically engahambelani neminye imithi futhi umzamo uxhumano bangase bafinyelele insolubles. Okwesibili, it kwandisa ubuthi glycosides inhliziyo, ngenxa yalokho zingase ukuthuthukisa hypokalemia, bese kukhona ingozi nesanda arrhythmia.

Nge iqhaza ngqo "Kortefa" (ngokukhethekile, ingxenye yayo esemqoka) kwandisa izinga excretion of acetylsalicylic acid (ASA), kanye nokuqukethwe level yayo kule liyancipha igazi.

Ukusetshenziswa hydrocortisone ku isizinda bukhoma igciwane yokugoma engabangela ukusebenza amagciwane kanye nokuthuthukiswa izifo.

Paracetamol esihambisana "Kortefom" kungenzeka hepatotoxic. Ngezinye ekuphathweni okwesikhathi eside kwandisa lokuhlushwa i-folic acid emzimbeni. Ngezinye imithamo ephezulu hydrocortisone kunciphisa ukusebenza kwe somatropin (ozokusebenzisa).

Ngaphezu kwalokho, isithako esebenzayo eyinhloko kunciphisa ukusebenza imithi hypoglycemic kodwa kwandisa umphumela anticoagulant ka coumarin nemikhiqizo. "Kortef" suppresses imiphumela vitamin D ku inqubo ukumuncwa Ca ₂ + e mafutha anciphisa isikhala esingaphakathi emathunjini. Ngaphansi kwethonya hydrocortisone kwandisa ubuthi cyclosporine futhi ketoconazole.

Ephambi kwezinduna izinto ezifana ephedrine, theophylline, rifampicin, barbiturates yimuphi umphumela oqabulayo GCS umphumela liyancipha. Induna kanye nokuthuthukiswa hirsutism (ukukhula ngokweqile esibulalayo - eqinile amnyama - izinwele besifazane iphethini besilisa) obulandela reception kanye nezinye izidakamizwa hydrocortisone steroid hormone (Ama-anabolic steroid, estrogens inzalo temlomo).

Umbono we amakhasimende mayelana izidakamizwa "Kortef"

"Kortef" izidakamizwa kuyinkimbinkimbi ukuba abanalo impendulo engeyinhle. Nakuba omuhle kaningi. Incazelo nemithi "Kortef" (ukubuyekezwa impilo abasebenzi ukuqinisekisa leli qiniso) ikuvumela ukuba uqonde indlela ezibanzi yayo ububanzi, ngakho uhlu okungukuthi eside futhi esibi izenzakalo. Ukwahlulela ngokubukeka ukubuyekezwa iziguli ngokwabo, umuntu ekhulula ngokushesha esuka ukuhlupheka, okuholela ngcono izinga lempilo, kodwa othile eye yabangela okuningi emibonweni engemihle, futhi imizwa iziguli ayinazo umphumela.

Lesi sidakamizwa kubi noma kuhle - umbuzo yayincane kakhulu ukuba ithuluzi ezifana "Kortef". Into esemqoka lapha - ukuncika isipiliyoni kanye namakhono of udokotela ukuba khona futhi ukuhambisana nayo yonke izincomo zayo.