Momwe mungagwiritsire ntchito mankhwala a Lucentis?

Chogwira ntchito ranibizumab Kodi chidutswa cha anti-humanised anti-endothelial grow factor A, chomwe chimafotokozedwa ndi kuphatikizika kofanananso kotchedwa Escherichia coli.

Kuphatikiza apo, kuyankhulana kosankhidwa kunadziwika.ranibizumaba ndi isoforms ya mtima kukula endothelial factor, VEGF-A ndi ena, kuletsa kuyanjana kwawo ndi ma receptors omwe ali pamwamba pa maselo a endothelial. Izi zimathandizira kupondereza onse neovascularization ndi kuchuluka kwa mtima. Kugwiritsa ntchito mankhwalawa sikungolepheretsa kukula kwa mitsempha yatsopano ya magazi, komanso kuimitsa kukula kwa mawonekedwe a exudative-hemorrhagic a AMD - kuchepa kwa zaka za macular, komanso macular edema mwa odwala matenda ashuga ndi msempha wa retinal.

Zotsatira zake zoyambitsa ntchito yogwira Thupi la Vitreous, kuphatikiza kwake kumadalira mwachindunji pa mlingo womwe walandiridwa. Malinga ndi kusanthula kwa pharmacokinetic ndi chidziwitso chakuchotsa kwa ranibizumab pazomwe zimapangidwira magazi a m'magaziMitreous theka-moyo pafupifupi 9 masiku.

Kukhazikitsidwa kwa pamwezi kwa ranibizumab mkati mwa vitreous kumathandiza kukwaniritsa ndende yambiri ya plasma yokwanira kuchitira nthawi yayitali.

Zisonyezero zogwiritsa ntchito Lucentis

Zizindikiro zazikulu pakugwiritsa ntchito kwa Lucentis:

mawonekedwe amvula amtundu wa AMD mwa odwala akuluakulu,
kuchepa kwamawonedwezomwe zingayambitse matenda ashuga macular edema kapena msempha wa retinalmu mawonekedwe a monotherapy, komanso zovuta kuchipatala.
amachepetsa maonedwe owoneka omwe adayambitsa choroidal neovascularizationchifukwa cha matenda myopia.

Contraindication

Mankhwala ali osavomerezeka makonzedwe ndi:

chidwi chapamwamba pa ranibizumab kapena zinthu zina,
kutsimikizika kapena kukayikira kwamatenda am'maso, njira zachitukuko cha periocular,
mkaka wa m'mimba, pakati,
kutupa kwamitsempha,
osakwana zaka 18, popeza momwe mankhwalawa amathandizira gulu ili la odwala silinaphunzire.

Zotsatira zoyipa

Pochiza Lucentis, zotsatira zosafunikira za zovuta zosiyanasiyana zimatha kuchitika.

Zoyipa zazikulu zikuphatikiza: endophthalmitis, regmato native retachation ndi mphiraoyambitsidwa ndi iatrogenic trauma, kutupa kwamitsempha, kuwonjezeka kwakukulu kwa kuthinana kwa intraocular ndi zina zambiri.

Kuphatikiza apo, kukulitsa kupatuka pakugwira ntchito zamanjenje, zam'mimba, kupuma ndi zina sizikhudzidwa. Zosokoneza zomwe zingatheke mu ntchito ya kupangika kwa magazi, ziwalo zamasomphenya, dongosolo la masculoskeletal ndi zinthu zina.

Chifukwa chake, mukalandira chithandizo, mutha kumvako: kuchepa magazi, nkhawa, kupweteka mutu, nseru, chifuwa ndi mitundu yosiyanasiyana thupi lawo siligwirizana.

Ngati wodwala ali ndi vuto lililonse mwa izi kapena kupanga mtundu wina wamavuto, muyenera kudziwitsa dokotala nthawi yomweyo.

Malangizo a Lucentis (Njira ndi Mlingo)

Malinga ndi malangizo a mankhwalawa, amangogwiritsidwa ntchito pokhapokha jakisoni wolowa m'thupi la vitreous.

Mwakutero, botolo limodzi limapangidwa kuti lipange jekeseni imodzi. Tisaiwale kuti kuwongolera kwina kwa Lucentis kutha kuchitika ndi ophthalmologist wodziwa zambiri. Ndikofunikira kuti pakhale pakati pakabayidwe ka jakisoni wa mankhwala osachepera mwezi.

Lucentis amapaka jekeseni wa 0,05 ml kamodzi pamwezi. Mu gawo limodzi, mankhwalawa amaperekedwa m'diso limodzi. Mankhwalawa, kukhudzika kwa mwezi uliwonse kuyenera kuwonedwa.

Mulimonsemo, pafupipafupi chithandizo ndi mankhwala pachaka chimatsimikiziridwa ndi dokotala, poganizira kuphwanyidwa ndi mawonekedwe a thupi la wodwalayo.

Bongo

Pankhani ya bongo, kuwonjezeka kwakukulu ndikotheka. kupanikizika kwamitsemphamaonekedwe a ululu ndi kusasangalala mkati mwa diso.

Pankhaniyi, chithandizo chikuchitika kuchipatala, monga kuwunika pafupipafupi kukakamira kwa odwala ndi mawonekedwe a wodwala ndikofunikira.

Malangizo apadera

Chololedwa kuperekera mankhwalawo kokha ndi ophthalmologist wodziwa jakisoni wa intravitreal. Ndondomeko amachitika pansi aseptic zinthu. Pakatha sabata limodzi, wodwalayo amafunika kuwunika kwambiri momwe matendawa angathere. Ngati wodwala akuwona kusintha kulikonse kosayenera, ndiye kuti muyenera kufunsa dokotala.

Mankhwala Lutsentis sikuti kutumizidwa mwachangu pamaso onse, popeza n`zotheka kuwonjezera zokhudza zonse zotsatira za mankhwala ndi chitukuko cha mavuto.

Pa chithandizo, kuwonongeka kwakanthawi kowonekera sikumayikidwa pambali, komwe kumakhudza kuthekera koyendetsa magalimoto ndikugwira ntchito ndi njira zosiyanasiyana. Chifukwa chake, tikulimbikitsidwa kuti zinthu ngati izi zitha kukhala kwakanthawi mpaka kuwonongeka kwakanthawi kochepa kuthe.

Ndemanga za Lucentis

Nthawi zambiri, kuwunika kwa Lucentis kukugwirizana ndi njirayi. Pafupifupi gulu lililonse la ophthalmological lili ndi mauthenga ochokera kwa ogwiritsa ntchito omwe amafunikira chithandizo, koma akuwopa kupita njirayi.

Komabe, odwala omwe alandila kale chithandizo cha Lucentis akuti kukonzekera jakisoni ndikofunika kwambiri. Ndondomeko yokhayi ilibe zowawa. Nthawi yomweyo, akuyesera kuthandizira ndikutsimikizira anthu omwe akungoyembekezera chithandizo.

Mwa zina zosasangalatsa, kusasangalala kwina mkati mwa diso kufotokozedwa, komwe kumatha kupitilira kwakanthawi.

Ponena za momwe mankhwalawa amathandizira, odwala ambiri amafotokoza kusintha kwakukulu m'masomphenyawo, ndikuwonjezera zovuta ndi kulondola kwa mizereyo. Kwa anthu ena, zotulukapo zapamwambazi zinali mwina zosayembekezeka.

Malinga ndi akatswiri, njirayi imapangidwa nthawi zonse ndikuphunzira. Inde, sikuti nthawi zonse mankhwalawa amagwira ntchito bwino. Milandu yokhudzana ndi zovuta zamankhwala zimadziwikanso, koma kwa odwala ambiri mankhwalawo amathandizanso kukonza masomphenyawo ndikubwezeretsa moyo wabwino.

Kuphatikiza pa kuwopa njira yovuta ngati iyi, anthu amayimitsidwa ndi mtengo wokwera wa mankhwalawo. Chifukwa chake, mutha kupeza malipoti kuti odwala ali okonzekera kulandira chithandizo chotere, koma alibe ndalama pa izi.

Kupanga ndi mawonekedwe a kumasulidwa

Ndi njira yowonekera kapena yowoneka bwino pang'onopang'ono yoperekera mankhwala "Lucentis" (ndemanga za odwala zimatsimikizira izi).

Chofunikira chachikulu cha mankhwalawa ndi ranibizumab. Zomwe zili mu botolo 1 la mankhwalawa ndi 2.3 mg. Kuphatikiza apo, zigawo zothandizira izi ndi gawo la Lucentis:

α-trehalose dihydrate,
polysorbate,
L-histidine hydrochloride monohydrate,
madzi.

Phukusi limodzi la carton limodzi ndi mankhwalawa limaphatikizapo:

0,23 ml ya galasi loyera ndi mankhwala,
singano yofiyira
syringe wosalala ndi singano.

Mankhwala amaperekedwa m'mafakisoni pokhapokha ngati mwalandira mankhwala.

Gawani matenda angapo am'maso "Lucentis". Kuunika kwa odwala kumakhala kopatsa chidwi, pogwira ntchito - mankhwalawa amathandiza munthu, ndipo wina sawona momwe zimakhalira. Komabe, "Lutsentis" amalembedwera matenda otsatirawa:

chonyowa (zamitsempha) mawonekedwe okhudzana ndi zaka
Kuchepa kwa kuwona kwakapangidwe chifukwa cha chitukuko cha matenda a shuga a macula - amagwiritsidwa ntchito kamodzi kapena kuphatikizidwa ndi laser coagulation,
Kuchepa kwa mawonekedwe chifukwa cha edema ya macular yoyambitsidwa ndi ma cell a retinal vein
Kuchepa kwa kuwona chifukwa cha choroidal neovascularization yoyambitsidwa ndi pathological myopia.

M'malo mwake chithandizo chimasokonekera

Palinso zochitika zina pomwe chithandizo chimayenera kusokonezedwa mwachangu ndikusayesanso kuyambiranso:

Kusintha kwa ma intraocular anzawo mpaka 30 mm kapena kupitilira. Art.,
kutsika kwa zithunzi zowoneka bwino ndi zilembo 30 kapena kupitilira apo poyerekeza ndi muyeso wotsiriza,
kupuma retinal
zotupa zam'mimba zomwe zimakhudza fossa yapakati, kapena zomwe zimakhudza oposa 50% a malowa.
kuchita opaleshoni yamitsempha.

Pokhapokha ma jakisoni m'thupi la vitreous omwe amagwiritsidwa ntchito "Lucentis". Ndemanga za odwala zimawonetsa kuti njirayo imakhala yopweteka.

Popeza njira yochizira imaphatikizira jakisoni angapo, ziyenera kukumbukiridwa kuti nthawi yayitali ya mwezi umodzi uyenera kuchitika pakati pawo. Mlingo wovomerezeka wa Lucentis wa jakisoni imodzi ndi 0,5 mg. Pakati pa zamankhwala, kuyang'anira pafupipafupi maonedwe akuyenera kuchitika.

Popereka mankhwala kwa odwala azaka zopitilira 65, kusintha kwapadera kwa mankhwala sikofunikira.

"Lucentis": malangizo ogwiritsira ntchito

Kuunikiranso za mankhwalawo pawokha komanso ntchito ya madokotala zikuwonetsa kuti wodwalayo ayenera kutsatira kukonzekera kwa makinawo kuti apewe kunyalanyaza.

Chifukwa chake, asanayambire mankhwalawa, muyenera kuonetsetsa kuti yankho likukumana ndi zofunikira - mtundu, kusasinthika, kusowa kwa matope. Ngati musintha mthunzi kapena kukhalapo kwa tinthu tating'onoting'ono, "Lucentis" saloledwa kugwiritsa ntchito.

Mankhwalawa amayenera kuperekedwa pa zinthu zosavomerezeka: manja a omwe akuthandizira azaumoyo amayenera kugwiridwa bwino, magolovesi sayenera kukhala osabala, ndikupukuta, chowonjezera pamaso ndi zida zina zonse zomwe zidzagwiritsidwe ntchito ziyeneranso kukhala zopanda ntchito.

Nthawi yomweyo jakisoni isanachitike, khungu lozungulira diso ndi chikope limatetezedwa. Kenako opaleshoni imachitidwa ndipo antimicrobials amathiridwa. Kumbukirani kuti ma antimicrobials amayenera kukhazikitsidwa katatu patsiku lisanachitike komanso pambuyo pa njirayi kwa masiku atatu.

Pokhapo kutsatira malamulowa ndi pomwe “Lucentis” amathandizika. Ndemanga za omwe adapitilapo zikuwonetsa kuti pali zochitika zina pomwe dokotala wavulala mankhwala ndi odwala awiri omwe ali ndi singano yomweyo. Izi ndizosavomerezeka ndipo zimatha kudwala matenda osiyanasiyana ndi matenda ngati Edzi.

Mankhwalawo pawokha amaphatikizidwa ndi thupi lamphamvu, ndikuwongolera kunsonga ya singano kuloza pakatikati pa khungu. Jekeseni wotsatira uyenera kuchitika mu theka la sclera lomwe silinakhutire ndi jakisoni woyamba.

Popeza kupanikizika kwa ma intraocular kumatha kuwonjezeka patatha ola limodzi njirayi itatha, iyenera kuyang'aniridwa ndipo kuphatikiza kwa mutu wamitsempha ya maso kuyang'aniridwa. Ngati ndi kotheka, chithandizo chikhala chofunikira kuti muchepetse kupanikizika.

Mwa njira imodzi, amaloledwa kupereka mankhwalawa m'maso amodzi okha.

Kuchita ndi mankhwala ena

Sizikudziwika momwe mankhwalawa "Lucentis" amakhudzirana ndi mankhwala ena. Ndemanga za odwala (ambiri a iwo) zimatilola kuganiza kuti madokotala samapereka mankhwala ena aliwonse ndi Lucentis kupatula anesthetics ndi anti-virus.

Izi ndichifukwa choti palibe maphunziro omwe adachitika pokhudzana ndi kuphatikiza kwa Lucentis ndi mankhwala ena. Chifukwa chake, mankhwalawa saloledwa kugwiritsa ntchito njira zina kapena mankhwala.

Pa mimba ndi mkaka wa m`mawere

Jekeseni wa Lucentis waperekedwa kwa azimayi oyembekezera komanso oyembekezera (ndemanga zimatsimikiziranso izi). Izi ndichifukwa choti mankhwalawa amawerengedwa ngati mankhwala a teratogenic ndi embryotoxic, ndiye kuti, amayambitsa chisokonezo pakukula kwa mwana wosabadwayo.

Koma azimayi a zaka zobala, nthawi pakati pa kutha kwa chithandizo ndi kutenga pakati ayenera kukhala osachepera miyezi itatu - panthawiyi, ranibizumab kwathunthu wachotsedwa. Mpaka pano, muyenera kugwiritsa ntchito njira zodalirika zakulera.

Malo osungira

"Lucentis" iyenera kusungidwa kutentha kwa madigiri 2 mpaka 8 Celsius, koma sayenera kuzizira. Sungani malondawo pamalo amdima komanso owuma kumene kulibe ana. Alumali moyo wa mankhwalawa ndi zaka 3 kuyambira tsiku lopangira. Sizoletsedwa kugwiritsa ntchito "Lucentis" yomwe idatha.

"Lutsentis": ndemanga za madokotala

"Lutsentis" nthawi zambiri imalimbikitsidwa ndikuyikidwa ndi madokotala, chifukwa imawerengedwa ngati mankhwala othandiza. Komabe, wodwala nthawi zonse sangakwanitse kulipira nambala yofunikira ya majekeseni: Lucentis ndi njira yotsika mtengo. Muzochitika izi, madokotala amati asinthane ndi analogue yotsika mtengo, Avastin. Komabe, omalizirawa sanafufuzidwe mokwanira, chifukwa chake malingaliro oyamba a madokotala amakhalabe oyesedwa ndi kuyesedwa a Lucentis. Ophthalmologists adziwa kalekale chida ichi, amadziwa zomwe zingachitike, ndipo amazindikira kugwira ntchito kwake.

Ndemanga za Odwala

Tsopano tiyeni tikambirane zomwe odwala omwe akuganiza pa mankhwalawo "Lucentis". Ndemanga zikuwonetsa kuti mankhwalawa samakhala ndi zotsatira zomwe amayembekezera. Komabe, ambiri mwa odwala omwe anamaliza maphunzirowa akuti masomphenyawa asintha kwambiri kapena asiya kutsika. Nthawi yomweyo, zovuta za alumali monga kupweteka komanso kupezeka kwa matenda zimadziwika, koma maantibayotiki amatha kuthana ndi izi. Kuphatikiza apo, odwala ambiri ali ndi chidaliro kuti zotsatira zosasangalatsa zotere ndizofunika.

Komabe, pali zochitika zina pomwe mankhwalawa sanathe. Zowona kuti "Lutsentis" zimathandiza osati pazochitika 100%, madokotala omwe amatero. Ngakhale mtengo wofunikira kwambiri, malinga ndi odwala, ndi mtengo wake wa zinthu. Sikuti aliyense angathe kugula jakisoni wathunthu.

Zina mwazabwino, kuwonjezera pakukonzekera, zimatchedwa kugwiritsa ntchito "Lucentis" mopanda kupweteka (ndemanga zikugwirizana pa nkhaniyi). Zomwe zimangowonongekazo ndizovuta pambuyo poyambira kuperekera mankhwala. Komabe, ndizolekerera, ndipo jakisoni pawokha samamveka. Pambuyo pakuchotsa kwa opaleshoni, kupweteka pang'ono kumadziwika.

Komabe, "Lutsentis" imawona chida chothandiza, pambuyo poti odwala azindikira masinthidwe.

Njira yamachitidwe

Ranibizumab ndi kachidutswa kakang'ono ka ma antibodies amtundu wa antihodies kuti achulukitse kukula A. Amapangidwa pogwiritsa ntchito mtundu wa Escherichia coli.

Lucentis ali ndi antiangiogenic chifukwa chomangira ku endothelial vascular grow factor. Izi zimalepheretsa kulumikizana kwakumapeto ndi ma receptors pamwamba pa endothelium ndipo kumalepheretsa kuchuluka kwa mtima ndi kusokonekera kwa mitsempha.

Chifukwa chakuti retinal neoangiogeneis amachepetsa, mankhwalawa amalepheretsa kusintha kwamatenda mu mawonekedwe a exudative-hemorrhagic okalamba azaka zokhudzana ndi macular degeneration ndi edema ya macula motsutsana ndi maziko a matenda osokoneza bongo a mellitus ndi retinal vein thrombosis.

Mlingo ndi makonzedwe

Lucentis amagwiritsidwa ntchito pokonzekera ma intraocular, ndiko kuti, intravitreal (mwachindunji mu thupi la vitreous). Mlingo wovomerezeka wa jakisoni ndi 0.5 mg, kapena 0,55 ml. Kukhazikikaku nthawi zambiri kumachitika nthawi 1 pamwezi. Poterepa, kuphatikiza kwapadera pamwezi ndikofunikira kuwongolera maonedwe acuity.

Mankhwalawa azaka zokhudzana ndi macular osokoneza bongo, jakisoni wa mwezi uliwonse amaperekedwa mpaka kukhazikika kwa zowona pamlingo wapamwamba. Imadziwika ndi Optometry kwa miyezi itatu motsutsana ndi maziko a kukhazikitsidwa kwa Lucentis.

Ngati maonedwe acuity adatsikanso ndi mizere 1 kapena kuposerapo, ndiye kuti, kuposa zilembo 5, ndiye kuti chithandizo chamankhwala chimayambiranso. Nthawi yomweyo, kukhalapo kwa zaka zokhudzana ndi kuwonongeka kwa macular komwe kwapezeka pakaunikira ndikofunikira. Chithandizo chimapitilizidwa mpaka mawonekedwe atakhazikika.

Ngati kuchepa kwamawonedwe kumayambitsidwa ndi matenda a shuga a macula, ndiye kuti chithandizo cha Lucentis chimapitilira mpaka zotsatira zokhazikika za miyezi itatu. Kuchiza kuyenera kuyambiranso ndi kuchepa kwa kuwona kwa chidwi chifukwa cha matenda ashuga a macular edema. Chithandizocho chimaletsedwanso ngati zotsatira zokhazikika za opaletiki zimapezeka.

Cholinga cha mankhwalawa Lucentis akhoza kuphatikizidwa pogwiritsa ntchito laser kapena kugwiritsidwa ntchito pambuyo pake (odwala omwe ali ndi matenda ashuga a macular edema). Ngati izi zikuchitika patsiku limodzi, ndiye kuti nthawi yopangira intraocular ya mankhwala ndi laser coagulation iyenera kupitirira theka la ola.

Kwa odwala omwe ali ndi retin vein occlusion ndi kuchepa kwa masomphenyawo, mankhwalawa amaperekedwa kamodzi pamwezi ndikupitilizidwa mpaka opaleshoni yokhazikika kwa miyezi itatu. Pambuyo pa izi, kuyezetsa kuchipatala pamwezi ndikofunikira, ndikuchepa kwamawonedwe owonekera, chithandizo chimayambiranso. Chithandizo cha odwala omwe ali ndi retin vein occlusion amatha kuphatikizidwa ndi laser coagulation, kapena kugwiritsidwa ntchito pambuyo pake. Tiyenera kukumbukira kuti jakisoni wa intraocular sayenera kuchitika pasanathe theka la ola atatsiriza gawo la laser coagulation.

Nthawi yomweyo jekeseni isanakwane, yankho lake liyenera kuphunziridwa (sediment, color). Njira yothetsera vutoli siyingagwiritsidwe ntchito ngati mawonekedwe awoneka ngati ma insoluble particles kapena mtundu.
Mukamachita manambala, malamulo a aseptic ndi antiseptic amayenera kuyang'aniridwa mosamala, kuphatikiza ndi manja molondola, gwiritsani ntchito magolovesi oyala okha, zopukutira ndi matope, komanso zida zothandizira paracentesis.

Nthawi yomweyo musanayambe kugwiritsa ntchito mankhwalawa, muyenera kupewetsa khungu khungu ndi maso. Kenako chiritsani conjunctiva ndi mankhwala osokoneza bongo komanso anti-anti-virus. Njira ya mankhwala opha maantibayotiki iyenera kukhala masiku 6 (masiku atatu asanafike ndi masiku atatu atabayidwa jakisoni wambiri).

Njira yodziwitsa Lucentis ndikuti nsonga ya singano iyenera kupezeka mthupi la vitreous pa 3.5-4 mamilimita kumbuyo kwa limbus. Poterepa, meridian iyenera kupewedwa ndipo singano iyenera kulozedwa pakatikati pa maso. Kuchuluka kwa yankho lolowa ndi 0,05 ml. Jakisoni wotsatira wa mankhwalawa uyenera kuchitika mu theka lina la sclera ya diso.

Chifukwa chakuti matenda oopsa a intraocular amatha kuchitika patangotha ola limodzi pambuyo poti jekeseni wa Lucentis, ndikofunikira kuyendetsa kuthinana m'maso ndi kupangika kwa mutu wamitsempha ya maso. Ngati ndi kotheka, chithandizo chikuyenera kuperekedwa. Kupanikizika kwa ma intraocular pambuyo pa kugwiritsa ntchito Lucentis kumathanso kukula.

Mu gawo limodzi, mankhwalawa amatha kuperekedwa m'maso amodzi okha. Kusintha kwa Mlingo sikofunikira kwa odwala azaka zopitilira 64.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri komanso zoopsa zomwe zimagwirizanitsidwa ndi intraocular ya mankhwala ndi monga:

• endophthalmitis,
• iatrogenic zoopsa zowopsa,
• regmato native retachation.

Kusintha kwina kwakukuru kwa ziwonetsero zamagetsi zomwe zimachitika pomwe Lucentis adayikidwa kuphatikiza kuwonjezeka kwa kukakamiza kwa intraocular ndi njira ya intraocular yotupa.

Izi ndi zotsatira zomwe zimawonedwa mwa odwala ndi kupezeka kwa mankhwala a Lucentis (0,5 mg). Makulidwe awo sanadutse 2% ya milandu poyerekeza ndi gulu loyang'anira (placebo kapena Photodynamic therapy).
Pafupipafupi amayesedwa molingana ndi chiwembu chokhazikika (nthawi zambiri - 10%, nthawi zambiri 1-10%, kawirikawiri 0.1-1%, kawirikawiri 0.01-0.1%).
Njira zopatsirana: nasopharyngitis inali yofala, chimfine komanso matenda a genitourinary system amapangidwa nthawi zambiri.

Kuchokera ku hemopoiesis, kuchepa kwa magazi nthawi zambiri kumachitika.

Pakati pa zovuta m'maganizo, odwala nthawi zambiri amakhala ndi nkhawa.

Kugonjetsedwa kwa dongosolo lamanjenje kwapakati kumachitika nthawi zambiri ndi mutu, komanso pafupipafupi - kumenyedwa.
Chiwonetsero cha masisitiricho chinakhudzidwa ndi milandu yambiri:

• Nthawi zambiri intraocular kutupa, kuphwanya, kutulutsa ndi kutukusira kwa thupi lamatupi, kuwoneka kosokoneza, kupweteka kwam'mimba komanso kuwonekera kwam'mimba, kupweteka komanso kumva thupi lachilendo m'maso, kutsitsimuka kwawo ndi kuyabwa, kuwonjezeka kwa kuthamanga kwa mitsempha, kuchepa kwa khungu, kapena mosemphana ndi khungu. ,
• Nthawi zambiri pamakhala kusintha kwina kwa retina, kupindika kwake ndi misozi, kupasuka ndi kupindika kwa epithelium pigment, zotupa ndi zotupa mu dera la vitreous, kuchepa kwa kuwona kwamphamvu, kusintha kwa kutupa (iritis, uveitis, iridocyclitis), kugwetsa mphindikati, kuphatikiza zilonda zam'mimba, zilonda zam'mimba zam'mimba, zotupa zam'mimba, mawonekedwe akhungu, kutuluka kwa magazi, kuphatikizapo malo a jekeseni, cell opalescence, Photopsy, conjunctivitis, makamaka chifuwa eskoy chikhalidwe, photophobia, conjunctival redness, kumaliseche diso, wachifundo ndi kutupa zikope za,
• Kuwonongeka kwathunthu kwa kuwona (khungu), endophthalmitis, edema, striae, ma cornea, kupweteka ndi kukwiya pamalo a jekeseni, Hypopion, hyphema, adhesions a iris, zomveka zachilendo m'maso am'maso, kupweteka kwa eyelids.

Zotsatira zoyipa za kupuma zimawonetsedwa kawirikawiri ndi chifuwa, komanso kugaya chakudya - ndi mseru.

Mawonekedwe a mziwopsezo nthawi zambiri amapezeka pakhungu (erythema ndi pruritus, zidzolo ndi urticaria).

Machitidwe a minofufupa nthawi zambiri amayankha makonzedwe a Lucentis ndi arthralgia.

Ngati, poganiza za kugwiritsa ntchito mankhwalawa, chilichonse chotsatira zoyipa chikuyamba kupita patsogolo, kapena zikhalidwe zomwe sizinafotokozedwe zikuwoneka, muyenera kudziwitsa dokotala.

Mtengo wa mankhwala a Lucentis

Mtengo wa mankhwalawo m'mafakisi ku Moscow ndi Russia ndikuchokera ku ruble 52,000. (10 mg / ml 0.23 ml vial). Izi sizikuphatikiza mtengo wa makonzedwe amkati. Wodwala angagule mankhwalawo pawokha pa mankhwala, kapena angagwiritse ntchito mankhwalawa omwe amapezeka kuzipatala zamaso (zomwe zingakhale zopindulitsa kwambiri, chifukwa botolo limodzi lingagwiritsidwe ntchito pakudwala kwa odwala angapo.)

Mtengo wa makonzedwe amkati a Lucentis (popanda mtengo wa mankhwalawo) ku Moscow Eye Clinic ndi ma ruble 19,000. Mankhwalawo pawokha amalipiridwa mosiyana (ma ruble 50,000) Mutha kufotokoza bwino kufunika kwa zomwe zaperekedwa mu gawo la "Mitengo"

Avastin (Avastin, bevacizumab) - amagwiritsidwa ntchito momu ndi mndandanda wa Lucentis pothandiza matenda omwewo.

Nthawi yomweyo, Avastin ali ndi mtengo wotsika, womwe ungakhale chimodzi mwazinthu zomwe zikugwirizana nawo. Lucentis idapangidwa kuti izigwiritsidwa ntchito mu ophthalmology, Avastin imagwiritsidwanso ntchito pa oncology.

Kanema wa kukhazikitsidwa kwapadera kwa Lucentis:

Kutembenukira ku "Moscow Eye Clinic", mutha kuyesedwa pazida zamakono kwambiri zowunikira, ndipo malinga ndi zotsatira zake - pezani malingaliro anu kuchokera kwa akatswiri otsogolera pakuthandizira matenda omwe adadziwika.

Chipatalachi chimagwira ntchito masiku asanu ndi awiri pa sabata, masiku asanu ndi awiri pa sabata, kuyambira 9 koloko mpaka 9 koloko. Pangani nthawi ndi kufunsa akatswiri mafunso anu onse pafoni 8 (495) 505-70-10 ndi 8 (495) 505-70-15 kapena pa intaneti, pogwiritsa ntchito mawonekedwe oyenera pamalowo.

Lembani mafomu ndikupeza kuchotsera kwa 15% pazomwe zikuwunikira!

Kutulutsa mawonekedwe ndi kapangidwe kake

Lucentis amawonetsedwa ngati njira yothetsera kasamalidwe ka mkati. Utoto wamadzimadzi ndi wowoneka bwino kapena wopanda mitambo. Botolo imodzi ili ndi chofunikira chachikulu - ranibizumab, 2.3 mg. Wopanga - Switzerland.

Komanso, zikuchokera mankhwala othandizira ophatikizidwa: polysorbate, madzi, α-trehalose dihydrate, L-histidine monohydrate hydrochloride.

Makatoni amodzi okhala ndi mankhwalawa ali ndi:

singano yofiyira,
vial ya mankhwala okhala ndi 0,23 ml,
syringe wosalala ndi singano,
ntchito malangizo lucentis.

Mankhwala operekedwa ndi akatswiri azamankhwala mosamalitsa pa mankhwala.

Contraindication

Monga mankhwala ena aliwonse, lucentis sangathe kugwiritsidwa ntchito ndi odwala onse. Nthawi zina, mankhwalawa amakhala otsutsana:

odwala ndi intraocular kutupa,
anthu omwe ali ndi matenda opatsirana a maso,
osakwana zaka 18,
pakati ndi azimayi nthawi yobereka,
ndi hypersensitivity kumodzi kapena zingapo zosakaniza za mankhwala.

Mosamala komanso moyang'aniridwa mosamala. omwe amapatsidwa magulu otsatirawa a odwala:

ndi hypersensitivity,
ngati pachitika ngozi ya stroko.
odwala omwe ali ndi DME komanso matenda amiseche,
Ngati wodwalayo akutenga kale mankhwala ogwirizana ndi endothelial mtima kukula.

Pali nthawi zina pomwe dokotala amakakamizidwa kusokoneza chithandizo ndi Lucentis, popanda mwayi kuti ndiyambenso:

kusintha kwa zamankhwala mumtsempha wa intraocular,
kupuma retinal
kutsika kwamphamvu kwa maonedwe owoneka bwino poyerekeza ndi zizindikiro zaposachedwa,
Kuthandizira kwamkati
hemorrhage yocheperako yomwe imakhudza zoposa 50% ya malo athunthu kapena amakhudza fossa yapakati.

Malangizo

Ophthalmologists amagwiritsa ntchito lucentis pokhapokha pobayira jekiseni m'thupi la vitreous. Ndondomeko yokhayi ilibe zowawa. Njira yothetsera botolo imodzi imapangidwira jakisoni imodzi yokha ya intravitreal.

Ndondomeko ziyenera Dokotala a maso okha, kunyumba, kunyenga kotero kumatha kubweretsa kulumala.

Popeza chithandizo chimaphatikizapo jakisoni angapo, ziyenera kukumbukiridwa kuti pakati pawo payenera kukhala gawo limodzi la mwezi umodzi osachepera. Munthawi yonse ya chithandizo, adokotala amayang'anitsitsa wodwalayo ndipo amayeserera kupenyerera kwake. Kusintha kwa mankhwalawa sikuyenera kokha kwa odwala azaka zopitilira 65.

Njira yoyambira

Popewa kunyalanyaza kwa dokotala, wodwalayo ayenera kuyang'anira ukhondo wa jakisoni.

Asanayambe kudukiza, wodwalayo ayenera kuonetsetsa kuti yankho lake ndilabwino, mtundu wake ndi kusasinthasintha ndikulondola, ndipo palibe kuwongolera. Lucentis amaletsedwa kugwiritsa ntchito ngati madziwo apeza kachikasu kapena kakuda, timabowo tomwe timapanga.

Jakisoni ayenera kuchitidwa m'mayendedwe oyera, osati manja okha a dotolo ndi wothandizira amayenera kukhala osabala, komanso chowonjezera chowonjezera, komanso zida zilizonse.

Pamaso jakisoni, dokotala amayendetsa kupezeka kwa khungu la eyelid ndi dera lonse kuzungulira maso. Pambuyo pa kukhazikitsa kwa opaleshoni, katswiri wothira kukonzekera amayambitsa mankhwala othana ndi kutupa komanso antimicrobial. Wodwala ayenera kukumbukira kufunika kokhazikitsa mankhwala owonjezera antimicrobial mkati mwa masiku atatu zisanachitike, ndipo patatha masiku awiri atatu atatha.

Pokhapokha pakuwona malamulowa titha kudalira zabwino za Lucentis. Njira yothetsera vutoli iyenera kulowetsedwa m'thupi la vitreous, ndipo nsonga ya singano iyenera kukhala kuloza kumbali yakumaso. Mankhwala enanso amafunika kulowetsedwa m'chigawo china cha sclera.

Kupanikizika kwa ma intraocular kuyenera kulamulidwa ponseponse pobera, chifukwa kumatha kufika povuta. Ndiponso adotolo amakakamizidwa kuwongolera kuphatikiza kwa mawonekedwe a disc. Ngati pakufunika thandizo, gulu liyenera kukhala lokonzeka kuchepetsa kukakamizidwa mwachangu. Munjira imodzi, mankhwalawa amatha kuperekedwa m'maso amodzi okha.

Milandu yambiri

Pa mayesero azachipatala, milandu ya bongo ndi momwe thupi limawakhudzira limawonedwa. Zizindikiro zofala: kuchuluka kwawoko, kupweteka kwambiri m'maso.

Wodwalayo akazindikira zofanana ndi izi, ayenera kuuza wodwalayo, amene athetse matendawo msanga.

Mimba komanso kuyamwa

Lucentis amapangika makamaka kwa amayi omwe ali ndi maudindo, komanso amayi oyamwitsa.

Izi ndichifukwa choti malonda amapezeka m'gulu la mankhwala a embryotoxic ndi teratogenic. Mwanjira ina lucentis amachititsa kusokonekera kwa fetal.

Kwa azimayi a msinkhu wobereka, nthawi yayitali pakati pa kutenga pakati ndi kumaliza mankhwala ayenera kukhala osachepera miyezi itatu. Amakhulupirira kuti nthawi imeneyi zinthu zimachotsedwa kwathunthu m'thupi. Pakadali pano, muyenera kugwiritsa ntchito njira zodalirika zakulera.

Zotsatira zoyipa

Zotsatira zoyipa za jakisoni ndizosowa kwambiri, chifukwa akatswiri sawopa kupereka lucentis.

Malangizo ogwiritsira ntchito amafotokozera zingapo zomwe zingachitike poyipa Pambuyo pa mankhwala: retinal detachment, endophthalmitis, amphala, intraocular kutupa, kuchuluka intraocular anzawo.

Zowopsa zochepa zomwe zimagwiritsa ntchito jakisoni wa intraocular zimaphatikizapo:

kupweteka kwa maso
cholowa champhamvu,
kutupa kwamphamvu,
matenda am'mimba
blepharitis
kuphatikiza hemorrhage,
kuyipa kwamaso
matenda amaso owuma
misozi,
uveitis
irit
choyipa cha Iris
kuchepa kowoneka bwino,
khungu la maso
matenda a retina.

Zotsatira zoyipa zosagwirizanitsidwa ndi ziwalo zamasomphenya ndi izi:

chimfine
nasopharyngitis,
kuchepa magazi
nkhawa
mutu
nseru
kutsokomola
mikwingwirima
arthralgia,
zotupa ndi kuyabwa
kulephera kudziwa.

Zotsatira zonse zoyipa izi chosowa kwambiri, 2% yokha ya odwala. Chizindikiro chodziwika bwino ndi kupweteka kofatsa komanso kufiyira, komabe, ndipo zimadutsa mwachangu.

Mitu ya mankhwalawa

Zoyimira jakisoni zimaperekedwa ndi makampani angapo azamankhwala.

Chifukwa chake Avastin waku Roche adagwiritsidwa ntchito kwambiri pambuyo pa lucentis. Awa ndimankhwala wozikidwa pa bevacizumab, omwe samagwiritsidwa ntchito kokha mu ophthalmology, komanso othandizira matenda angapo a oncological.

Kusiyana kwakukulu pakati pa mankhwalawa ndi mtengo. Ngati lucentis imawononga ndalama zokwana ma ruble 50,000 phukusi lililonse, Avastin adzagula ruble 20-30,000.

Nthawi zambiri, madokotala amagwiritsa ntchito opareshoni ya intraocular Dexamethasone ndi Vizudin Ozurdexntchito neovascularization.

Pakumwa mankhwala a lucentis, wodwalayo amatha kukumana ndi zowoneka zomwe zimakhudza kuyendetsa bwino galimoto komanso kugwira ntchito ndi zovuta. Ngati zizindikiro za malaise zikuwoneka, sikulimbikitsidwa kuyendetsa. Zizindikiro zikatha, mutha kupitilizabe kukhala ndi moyo wabwino.

Madokotala osalangiza kuyendetsa galimoto atangobayira jekeseni, ngakhale mutapezeka kuti palibe zotupa. Zotsatira zoyipa zimatha kumveka pakatha ola limodzi kapena awiri jekeseni, kapena atangomaliza kumwa mankhwala opweteka.

Ndemanga za madotolo ndi odwala

Popeza lucentis imawonedwa ngati mankhwala othandiza, nthawi zambiri imayikidwa ndi ophthalmologists. Chifukwa cha mtengo wokwera wa mankhwalawo, si aliyense amene angakwanitse kugula mankhwala ngati amenewo.

Zikatero, adotolo amatumiza Avastin, yemwe amakhala wotsika mtengo kwambiri ma 2. Mankhwala ali ndi opanda - akadali osafufuzidwa bwino. Tsopano mankhwalawa amagwiritsidwa ntchito kwambiri m'makliniki a khansa, avastin mu ophthalmology sagwiritsidwa ntchito kwenikweni.

Ndemanga za odwala zimawonetsa kuti lucentis nthawi zambiri samakhala ndi zotsatira zomwe amayembekezera. Komabe, ambiri mwa odwala omwe adachita maphunziro awo lankhulani za mankhwalawo molimba mtima, popeza masomphenya, omwe izi zisanawonongeke mwachangu, adayamba kukonza, kapena kukhalabe yemweyo, kusiya kuwonongeka. Zotsatira zoyipa, odwala amawona kuthekera kwa matenda, kupweteka ndi kusungunuka. Mankhwala owonjezera, maantibayotiki, amalimbana mwachangu ndi zofooka izi. Komanso, odwala akutsimikiza kuti ngakhale zovuta zina zomwe zimadza chifukwa chotsatira zoyipa ndizofunikira chifukwa zomwe zimadza.

Pakati pa mankhwala a intraocular njira yoyendetsera, lucentis mwina ndiye kutsogolera. Malinga ndi kuchuluka, ndinayenera kupanga majakisoni atatu, omwe ali pafupifupi ma ruble 200,000. Nditaperekedwa m'malo mwa lucentis ndi mankhwala otsika mtengo, ndinakana, chifukwa ngakhale mtengo umakhala wokwera mtengo, thanzi limadalirabe. Pambuyo pa miyezi itatu, ndidayamba kuwona bwino kwambiri. Palibe zoyipa zomwe zimawonedwa, maso akungoyang'ana pang'ono.

Mankhwala Lucentis adandiuza dokotala wachipatala chathu chazachipatala yemwe amandipeza ndi matenda am'mimba a serous chorioretinopathy. Ngakhale mtengo wa mankhwalawo si kanthu poyerekeza ndi mawu omwe dotolo akuti "mwezi wina wopanda mankhwalawa ndipo mudzasiyidwa wopanda diso". Ndilongosola momwe matendawa akuwonekera: malo akuda bii amawoneka ndipo pang'onopang'ono amafalikira pamaso pake, chithunzicho chimatseka pang'ono, diso limasiya kuwona. Mankhwalawa amafunika 55,000 pa ampoule umodzi, ndipo pali majakisoni atatu otere.

Mchitidwewu pawokha ulibe chopweteka, koma chosasangalatsa ngati kokha chifukwa singano ikuwoneka pamaso pa diso, yomwe yatsala pang'ono kulowa gawo lofunika kwambiri. Jakisoni amaperekedwa pansi pa opaleshoni yakumaloko mu opareshoni, koma akadali ocheperako koma opareshoni. Masiku awiri zisanachitike komanso masiku awiri pambuyo pa njirayi, madontho a anti-kutupa adayikidwa.

Mankhwala ndi othandizadi, ngakhale kuti ndi okwera mtengo. Ngati tsiku lina ndidzafunika kuyesanso kuyesa uku osaganiziranso za mtengo, ndidzagula lucentis.

Pharmacokinetics

C_max (kuchuluka kwa plasma ndende) ya ranibizumab nthawi 1 mwezi pamwezi kayendetsedwe ka thupi lolimba ndi kukonzanso mawonekedwe a AMD anali otsika komanso osakwanira kulepheretsa kwachilengedwenso ntchito za VEGF-A ndi 50%, C_max pamene adalowetsedwa mu vitreous muyezo wa 0,05 mpaka 1 mg anali wofanana ndi mlingo womwe umagwiritsidwa ntchito.

Pafupifupi theka moyo wa chinthu (0,5 mg) kuchokera ku vitreous, malinga ndi zotsatira za kusanthula kwa pharmacokinetic ndikuganizira zomwe zatuluka mu madzi am'magazi, pafupifupi masiku 9.

Kuchulukitsidwa kwa ranibizumab m'madzi am'magazi pakaphatikizidwa kamodzi pamwezi m'thupi la vitreous kumakhala ndi mtengo wokwanira tsiku 1 mutabayidwa jekeseni ndipo lili pamtunda kuchokera pa 0.79 mpaka 2.9 ng pa 1 ml. Kuchuluka kochepa mu plasma kumasiyana kuchokera pa 0.07 mpaka 0.49 ng pa 1 ml. Mu seramu yamagazi, kugundika kwa chinthu kumakhala kotalika pafupifupi 90,000 kuposa komwe kuli mu vitreous.

Malangizo ogwiritsira ntchito Lucentis: njira ndi mlingo

Njira yothetsera vutoli (0,05 ml), kudzera mu jekeseni wamkati, imalowetsedwa m'thupi lamtundu wa 3.54 mm kumbuyo kwa miyendo, ndikuwongolera singano pakatikati pa eyebulo ndikupewera Meridi yopingasa. Jekeseni wotsatira amachitika mu theka lina la sclera. Popeza mkati mwa 1 h pambuyo pa jekeseni wa yankho kuchulukitsa kwakanthawi kwakanthawi kake ndikotheka, ndikofunikira kuthana ndi kukakamiza kwazinthu zamkati, kupindika kwa mutu wamitsempha ndikugwiritsa ntchito mankhwala oyenera (ngati kuli kofunikira). Pali malipoti akuwonjezeka kwa kukakamiza kwa intraocular pambuyo pa kukhazikitsidwa kwa Lucentis.

Botolo imodzi yokhala ndi mankhwalawa cholinga chake ndi jakisoni imodzi yokha. Mu gawo limodzi, yankho limayendetsedwa ndi diso limodzi lokha.

Jakisoni imachitika pansi pa aseptic, kuphatikiza chithandizo cha manja a ogwira ntchito kuchipatala, kugwiritsa ntchito ma napkins, magolovesi osabala, chowonjezera eyelid kapena analogue, ndi zida za paracentesis (ngati pakufunika).

Pamaso jakisoni, amakhala ndi mawonekedwe oyipa a khungu la eyelids ndi malo ozungulira maso, conjunctival anesthesia and wide-spectrum antimicrobialapy (amadziika mu conjunctival sac katatu pa tsiku kwa masiku atatu asanafike komanso atagwiritsa ntchito Lucentis.

Kukhazikitsidwa kwa mankhwalawa kuyenera kuchitika kokha ndi ophthalmologist wodziwa kupanga jekeseni wa intravitreal.

Ndikofunika kuti muzisamala kwakanthawi 1 mwezi (osachepera) pakati pakukhazikitsa awiri Mlingo wa mankhwala.

Mlingo womwe analimbikitsidwa ndi 0.05 ml (0.000 5 g) wa Lucentis kamodzi pamwezi.

Asanakhazikitsidwe ndalama zimayang'anira mtundu wake ndi mtundu wa kuvunda. Posintha mtundu ndikuwoneka ngati tinthu tating'onoting'ono, Lucentis sangathe kugwiritsidwa ntchito.

Wet AMD

Kukhazikitsidwa kwa Lucentis kumapitilizidwa mpaka kukhazikika kopambana kwamawonekedwe akwaniritsidwa. Amatsimikiziridwa pakapita katatu kolandila pamwezi munthawi yogwiritsira ntchito mankhwalawa.

Kuwona acuity pamankhwala ndimayang'aniridwa kumayang'aniridwa pamwezi. Mankhwalawa amayambiridwanso ndikuchepa kwa maonekedwe a acuity ndi 1 kapena kuposa mizere yolumikizidwa ndi AMD, yomwe imatsimikiziridwa ndikuwunikira ndikupitiliza mpaka ma visual acuity okhazikika amapezekanso maulendo atatu otsatizana pamwezi.

Kupewera kwa maonedwe ophatikizidwa ndi DME

Kukhazikitsidwa kwa mankhwalawa kumachitika pamwezi ndipo kumapitilira mpaka ma visual acuity akhazikika pakapita katatu mosagwirizana munthawi ya mankhwala.

Odwala omwe ali ndi matenda osokoneza bongo a macular edema, Lucentis angagwiritsidwe ntchito ndi laser coagulation, kuphatikiza odwala omwe amagwiritsidwa ntchito kale ndi laser coagulation. Ngati njira zonse ziwiri za mankhwalawa zimaperekedwa kwa tsiku limodzi, mankhwalawa amaperekedwa pambuyo pa theka la ola pambuyo povunduka kwa laser.

Kuchepa kwa mawonekedwe owonekera chifukwa cha macular edema chifukwa cha chotupa cham'mimba (chapakati chamitsempha cham'mimba ndi nthambi zake)

Lucentis amaperekedwa pamwezi, chithandizo chimapitilizidwa mpaka pazowoneka bwino zowoneka bwino, zotsimikizika mwa kuyendera katatu kwa pamwezi munthawi yamankhwala.

Mankhwala, Lucentis pamwezi amachita zowoneka bwino.

Ngati kuwunika kwa mwezi kumawonetsa kuchepa kwa maonedwe am'mimba chifukwa cha kuchuluka kwa mitsempha ya m'mimba, yankho limayambiranso ngati jakisoni wa mwezi uliwonse, ndikupitilizabe kufikira maonedwe olimbitsa atasuntha katatu maulendo angapo otsatizana.

Mankhwalawa amatha kugwiritsidwa ntchito limodzi ndi laser coagulation. Ngati njira zonse ziwiri za mankhwalawa zimaperekedwa mkati mwa tsiku limodzi, Lucentis amatumizidwa pambuyo pa theka la ola (osachepera) pambuyo pakupanga kwa laser. Mankhwalawa amatha kugwiritsidwa ntchito mwa odwala omwe amagwiritsidwa ntchito kale ndi laser coagulation.

Kuchepa kwamaso owoneka chifukwa cha CVD chifukwa cha myopia yatsika

Mankhwalawa amayamba ndi jakisoni imodzi yamankhwala. Ngati panthawi yoyang'anira momwe wodwalayo alili (kuphatikiza mayeso a zamankhwala, fluorescence angiography ndi kuyanjana kwamalingaliro), chithandizo chimayambiranso.

M'chaka choyamba cha chithandizo, odwala ambiri amafuna jakisoni 1 kapena 2 yankho. Komabe, kwa odwala ena, kugwiritsa ntchito kwambiri Lucentis kungafunike. Zikatero, m'miyezi iwiri yoyambirira, zinthu zimayang'aniridwa pamwezi, kenako, miyezi itatu iliyonse (osachepera) mchaka choyamba chamankhwala.

Komanso, pafupipafupi pakuwongolera payekhapayekha kumatsimikiziridwa ndi adokotala.