Latren Pentoxifylline

Latren ndi mankhwala omwe amasintha ma microcirculation komanso zigawo zamagazi. Zomwe zimapangidwira kukonzekera kwa Latren ndi pentoxifylline, yomwe imatchula za zotumphukira za vasodilators za gulu la purine. Latren amachotsa kuphipha kwa minofu yosalala yamitsempha yamagazi, bronchi ndi ziwalo zina zamkati. Mankhwala tikulephera phosphodiesterase, bwino masinthidwe a magazi ndi ma microcirculation, amathandizira kuonjezera zomwe zili cyclic 3,5-AMP m'maselo osalala a minyewa. Mukamagwiritsa ntchito Latren, pali kuwonjezeka kwa zomwe zili mu ATP m'maselo ofiira am'mwazi komanso kuwonjezereka kwa mphamvu yama cell. Latren imathandizira kupumula kosalala kwamitsempha yamagazi, imachepetsa kukana kwamitsempha yamagazi (popanda kusintha kwakukulu pamitima yamtima), komanso kuwonjezera miniti ndi magazi a systolic.

Latren imakhala ndi antianginal effect, yomwe imatheka mwa kupumula minofu yosalala ya mitsempha ya coronary.
Mankhwala amathandizira kukhathamiritsa kwa mpweya m'magazi, kukulitsa ziwiya zam'mapapu, kutsitsa minofu ya kupuma (diaphragm ndi minofu yolumikizana), kumathandizira kutsika kwa magazi kozungulira (kuzungulira) ndikuwonjezera kuchuluka kwa magazi akuyenda ziwalo ndi ziwalo.
Latren imakhala ndi phindu pa ntchito ya bioelectric yamkati wamanjenje ndipo imathandizira kukulitsa zomwe zili mu ATP m'maselo aubongo.
Kuchita pa zimagwira nembanemba wama cell ofiira am'magazi, Latren imawonjezera kuchepa kwake. Zimayambitsa kusagwirizana kwamatumbo komanso kuchepetsa magazi.

Chifukwa cha kuchuluka kwa magazi mothandizana, kufalikira kwa magazi m'magawo a ischemic kumakhala bwino.
Ndi claudication yapakatikati (zotupa zokhudzana ndi zotumphukira), pentoxifylline imatalikitsa mtunda woyenda, imachotsa minyewa yamadzulo ya minofu ya ng'ombe ndikuletsa kuwoneka kwa ululu pakupuma.
Mankhwalawa amakonzedwa pafupifupi kwathunthu, ndikupanga ma metabolites a 5, kuphatikiza omwe amagwira mankhwala. Pentoxifylline imapukusidwa makamaka ndi impso mu mawonekedwe a metabolites. Hafu ya moyo wa pentoxifylline ndi ma metabolites ake ndi pafupifupi maola 0,5-1,5. Kukhalapo kwa vuto laimpso kapena kwa chiwindi kungayambitse kuchuluka kwa moyo.

Zizindikiro zogwiritsidwa ntchito

Mankhwala Latren analamula kuti zotumphukira kufalikira, matenda ashuga, kupatsirana claudication, matenda ndi a Raynaud's syndrome, kuthetsa endarteritis.
Mankhwala Latren amagwiritsidwanso ntchito pophwanya minofu ya trophic.
Mankhwala akhoza zotchulidwa mu zovuta mankhwala a varicose mitsempha, pambuyo-thrombotic syndrome, gangrene, frostbite ndi trophic zilonda.

Latren imalembedwa kwa odwala omwe ali ndi vuto la ubongo, ischemic stroke, dyscirculatory encephalopathy, komanso matenda amitsempha yama cell omwe amaphatikizidwa ndi mutu, chizungulire, kugona komanso kukumbukira.
Kuphatikiza apo, Latren imagwiritsidwa ntchito pochiza matenda obwera chifukwa cha choroid ndi retina, komanso kusintha kosasinthika ndikusokonekera kwapang'onopang'ono chifukwa cha mtima wamkati wamkati.

Njira yogwiritsira ntchito

Mankhwala Latren anafuna kuti mtsempha wake akonzedwe. Mlingo wokhazikitsidwa ndi dokotala payekhapayekha ndipo amawerengedwa poganizira kuchuluka kwa thupi la wodwalayo, kuopsa kwa zovuta zamagazi, matenda okhudzana ndi kulolerana ndi mankhwala.

Kwa akulu ndi ana opitilira zaka 12, ma regimens otsatirawa amalimbikitsidwa kuti apange intravenous management:
Zomwe zili mu vial ya 200 ml (100 mg ya pentoxifylline) zimathandizira kudzera motsika kwa mphindi 90-180.
Ndi kulekerera kwabwino, ndizotheka kuwonjezera kuchuluka kwa jet intravenous makonzedwe a 200-300 mg (omwe akufanana ndi 400-500 ml ya yankho).
Kutalika kwa nthawi ya maphunzirowa, monga lamulo, ndi masiku 5-7 ndipo zimatengera mphamvu ya matendawa. M'tsogolomu, wodwalayo amatha kusamutsidwira kumapangidwe a pentoxifylline.
Mlingo wambiri watsiku ndi tsiku ndi 300 mg.

Amaloledwa kugwiritsa ntchito mankhwalawa pochiza ana osaposa zaka 12 ndi akhanda. Zikatero, mlingo umawerengeredwa kutengera kulemera kwa thupi. Kwa ana ochepera zaka 12, monga lamulo, Latren amamuika muyezo umodzi wa 5 mg (10 ml Latren solution) pa 1 makilogalamu a thupi.

Zotsatira zoyipa

Mukamagwiritsa ntchito Latren mwa odwala, kukulitsa zovuta zosafunikira chifukwa cha pentoxifylline ndikotheka:
Kuchokera kwamanjenje: kugona kusokonezeka, kupweteka mutu, chizungulire, nkhawa zopanda pake, kukokana. Nthawi zina, chitukuko cha matenda a aseptic meningitis adadziwika.
Kumbali ya hematopoietic dongosolo, mtima ndi mtsempha wamagazi: hyperemia ya khungu la nkhope ndi chapamwamba thupi, edema, angina pectoris, arrhythmia, tachycardia, Cardialgia, ochepa hypotension, leukopenia, thrombocytopenia, pancytopenia.

Kuchokera kwa hepatobiliary dongosolo ndi kugaya chakudya mundawo: matumbo atonyamula, mseru, kusanza, anorexia, cholestatic hepatitis, kuchuluka kwa cholecystitis, kuchuluka kwa michere ya chiwindi.
Ena: hematomas, magazi amkati, amachepetsa maonedwe, kuwonjezeka kwa misomali.
Thupi lawo siligwirizana: Hyperemia a khungu, kuyabwa, urticaria, anaphylactic mantha, angioedema.

Contraindication

Latren sinafotokozeredwe kwa odwala omwe ali ndi hypersensitivity pazinthu zilizonse za mankhwala, komanso xanthine.
Latren sayenera kugwiritsidwa ntchito pochiza odwala omwe ali ndi vuto lalikulu la infarction, porphyria, hemorrhage, hemorrhagic stroke, mitundu yoopsa ya matenda am'mimba kapena coronary atherossteosis.
Latren sagwiritsidwa ntchito pochiza odwala omwe ali ndi arrhasmia, osasinthika ochepa hypotension, aimpso kapena kwa hepatic, komanso odwala ndi magazi ambiri.

Chenjezo liyenera kuchitika popereka Latren kwa odwala omwe ali ndi matenda osokoneza bongo, kulephera kwa mtima, zilonda zam'mimba kapena duodenum, komanso odwala okalamba.
Chenjezo liyenera kuchitika popereka Latren kwa odwala omwe akuchitidwa opaleshoni (kuyang'anira hemoglobin ndi hematocrit ndikofunikira nthawi zonse).

Kuyanjana kwa mankhwala osokoneza bongo

Kusuta kumachepetsa kuthandizira kwa pentoxifylline.
Mankhwala Latren ophatikizidwa amatha kupititsa patsogolo zotsatira za anticoagulants mwachindunji komanso osamveka komanso othandizira othandizira. Kugwiritsa ntchito mankhwalawa kumaphatikizidwa pokhapokha kuwunikira njira zopangira magazi.
Latren ntchito munthawi yomweyo kumapangitsa machitidwe a cephalosporin mankhwala.
Pentoxifylline, ikagwiritsidwa ntchito palimodzi, imapititsa patsogolo zotsatira za valproic acid, antihypertensive mankhwala, othandizira pakamwa ndi insulin.

The kuchuluka kwa pentoxifylline mu madzi am`magazi kumawonjezera pamodzi ndi ntchito cimetidine.
Kuphatikiza pamodzi kwa mankhwala a Latren ndi mankhwala ena a xanthine omwe angapangitse kuti chiwonjezere cha mantha.

Bongo

Mukamagwiritsa ntchito mankhwala osokoneza bongo a pentoxifylline odwala, chizungulire, kufooka, kukomoka, matenda ena, kugona, kapena kugona. Kuphatikiza apo, komanso kuwonjezeka kwa muyezo wa Latren, odwala adazindikira kukula kwa tachycardia, hyperthermia, kusiya kuzindikira, areflexia, kutaya magazi m'mimba, ndi kukomoka.

Palibe mankhwala enieni. Ngati mankhwala osokoneza bongo, onani mankhwala omwe cholinga chake ndicho kuthetseratu zizindikiro za kuledzera ndi pentoxifylline.
Mankhwala osokoneza bongo ayenera kuchitika kuchipatala moyang'aniridwa ndi ogwira ntchito zachipatala.

Mlingo

Kulowetsedwa Solution 0,5 mg / ml

1 ml ya mankhwala ali

ntchito yogwira - pentoxifylline 0,5 mg,

othandizirachinthu: sodium chloride, potaziyamu mankhwala enaake, calcium chloride, sodium lactate, madzi a jekeseni.

Wopanda mawonekedwe kapena wachikasu pang'ono.

Mankhwala

Pharmacokinetics

Main pharmacologically yogwira metabolite 1- (5-hydroxyhexyl) -3,7-dimethylxanthine (metabolite I) imatsimikizika mu plasma mu ndende yopitilira 2 nthawi yazinthu zosasinthika ndipo ili m'malo obwezeretsanso kufanana kwamomwemonso. Pankhaniyi, pentoxifylline ndi metabolite yake iyenera kuonedwa ngati yogwira ntchito yonse. Hafu ya moyo wa pentoxifylline ndi maola 1.6.

Pentoxifylline imapukusidwa kwathunthu; zoposa 90% zimachotsedwa mu impso mu mawonekedwe a unculugated, soluble polar metabolites. Osakwana 4% ya mankhwalawa omwe amaperekedwa amawachotsa ndowe. Odwala omwe ali ndi vuto la aimpso, kuwonongeka kwa metabolites kumachepetsedwa. Odwala omwe ali ndi vuto la chiwindi, kuwonjezeka kwa theka la moyo wa pentoxifylline kunadziwika.

Mankhwala

Pentoxifylline ndi mtundu wa methylxanthine. Limagwirira a pentoxifylline limalumikizana ndi chopinga wa phosphodiesterase ndi kudzikundikira 3,5-AMP maselo yosalala minofu maselo, magazi, komanso ena zimakhala. Pentoxifylline imalepheretsa kuphatikizika kwa mapulosi ndi maselo ofiira, kumawonjezera kusinthasintha kwake, kumachepetsa kuchuluka kwa fibrinogen m'madzi a m'magazi ndikuwonjezera fibrinolysis, yomwe imachepetsa mamasukidwe akayendedwe amwazi ndikuwongolera mphamvu zake zamatsenga. Kuphatikiza apo, pentoxifylline imakhala yofooka ya myotropic vasodilator, imachepetsa pang'ono paziphuphu zonse za mtima ndipo imakhala ndi zotsatiraropropic. Chifukwa chogwiritsa ntchito pentoxifylline, ma microcirculation komanso kupatsirana kwa oksijeni ku minofu imayenda bwino, koposa zonse mu miyendo, chapakati mantha, komanso moyenera impso. Mankhwalawa amachepetsa ziwiya zamagetsi.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala akupezeka mu mitundu yotsatira:

• Njira yothetsera kuphatikizira kwamitsempha yama cell ndi ma intramuscular: madzi owoneka bwino, opanda khungu kapena amtundu (2 ml kapena 4 ml mu ampoules, mu cell ya PVC (polyvinyl chloride) filimu ya 1, 2 kapena 5 ampoules, 1 cell phukusi pa katoni).
• Mapiritsi okhala ndi tinthu: chipolopolo chachikaso (zidutswa 10 chimodzi m'matumba a chithuza, paketi imodzi mu bokosi la makatoni).

Mu 1 ml yankho lili:

• Zogwira pophika: ondansetron hydrochloride dihydrate (malinga ndi ondansetron) - 2 mg,
• Zothandiza: hydrochloric acid, sodium chloride, madzi a jakisoni.

Piritsi 1 yokhala ndi:

• Zogwira pophika: ondansetron hydrochloride dihydrate (malinga ndi ondansetron) - 4 mg,
• Zothandiza: Aerosil (colloidal silicon dioxide), microcrystalline cellulose, magnesium stearate, starch mbatata,
• Phula: hydroxypropyl cellulose (hyprolose), tropeolin O, polysorbate (pakati-80), mafuta a castor.

Mimba

Palibe chokwanira pakugwiritsa ntchito mankhwalawa amayi apakati.
Chifukwa chake sankhani Latren pa mimba osavomerezeka.
Pentoxifylline yaying'ono imadutsa mkaka wa m'mawere. Ngati mankhwala ndi Latren adalembedwa, kuyamwitsa kuyenera kuyimitsidwa.

Kuchita ndi mankhwala ena

Latren imatha kupititsa patsogolo zotsatira za mankhwala omwe amakhudza magazi omwe amapanga magazi mosagwirizana (mwachindunji komanso mwachindunji anticoagulants, thrombolytics). Imawonjezera mphamvu ya maantibayotiki cephalosporins (cefamandol, cefoperazone, cefotetan) powongolera malowedwe a ma antibayotiki mu minofu powonjezera kuyenda kwamitsempha yamagazi. Imawonjezera ntchito ya valproic acid. Amawonjezera mphamvu ya antihypertensive mankhwala, insulin ndi mankhwala amkamwa a hypoglycemic. Cimetidine amachulukitsa kuchuluka kwa Latren m'madzi am'magazi, zomwe zimapangitsa kuti akhale ndi mavuto ambiri.
Kugwiritsa ntchito mankhwalawa limodzi ndi mankhwala ena a xanthine kungayambitse kuwonjezeka kwamanjenje.

Zochita zamankhwala osokoneza bongo

Zotsatira zochepetsera shuga wamagazi zomwe zimayambira ku insulin kapena othandizira matenda amkamwa zimatha. Chifukwa chake, odwala omwe amalandila mankhwala a shuga ayenera kuyang'aniridwa bwino.

Munthawi yotsatsa, milandu yokhudza kuchuluka kwa anticoagulant idanenedwa kwa odwala omwe amathandizidwa nthawi yomweyo ndi pentoxifylline ndi anti-vitamini K. Mlingo wa pentoxifylline utasankhidwa kapena kusintha, ndikulimbikitsidwa kuwunika ntchito ya anticoagulant m'gululi. Pentoxifylline imatha kupititsa patsogolo hypotensive zotsatira za mankhwala a antihypertensive ndi mankhwala ena omwe angayambitse kuchepa kwa magazi. Kugwiritsa ntchito pamodzi kwa pentoxifylline ndi theophylline mwa odwala ena kumatha kuonjezera kuchuluka kwa theophylline m'magazi. Chifukwa chake, ndikotheka kuwonjezera pafupipafupi ndikuwonjezera mawonetsedwe azovuta za theophylline.

Kusagwirizana.Mankhwala sayenera kusakanikirana ndi mankhwala ena omwe ali mumtsuko womwewo.

Malangizo apadera

Pazizindikiro zoyambirira za anaphylactic / anaphylactoid, mankhwalawa ayenera kusiyidwa pomwepo ndi kufunsa dokotala. Pankhani yogwiritsa ntchito mankhwalawa, odwala omwe ali ndi vuto la mtima wosakhazikika ayenera kufikira gawo lakulipirira magazi.

Odwala omwe ali ndi matenda a shuga komanso kulandira chithandizo cha mankhwala a insulin kapena mankhwala opatsirana pakamwa, mukamagwiritsa ntchito Mlingo wambiri wa mankhwalawa, ndizotheka kuwonjezera mphamvu ya mankhwalawa pamagazi a magazi (onani gawo "Drug Interaction"). Muzochitika izi, mlingo wa insulin kapena mankhwala othandizira odwala matenda ashuga ayenera kuchepetsedwa, ndipo wodwalayo ayenera kuyang'aniridwa mosamala. Odwala omwe ali ndi zokhudza zonse lupus erythematosus (SLE) kapena ndi matenda ena othandizira minofu amatha kutsegula pentoxifylline pokhapokha atafufuza bwino za zoopsa zomwe zingachitike komanso phindu. Popeza kuti pali chiopsezo chokhala ndi magazi m'thupi a aplastic pakagwiritsidwa ntchito ndi pentoxifylline, kuwunika pafupipafupi kuchuluka kwa magazi ndikofunikira.

Odwala omwe amalephera kupweteka kwa aimpso (creatinine chilolezo chochepera 30 ml / min) kapena kukanika kwambiri kwa chiwindi, chimbudzi cha pentoxifylline chitha kuchepetsedwa. Kuwunika koyenera ndikofunikira.

Makamaka kuwunikira ndikofunikira:

- odwala kwambiri mtima arrhythmias,

- odwala ndi myocardial infarction,

- odwala ndi ochepa hypotension,

Odwala omwe ali ndi vuto lalikulu la ubongo ndi ziwiya zamatumbo, makamaka zokhudzana ndi matenda oopsa komanso mtima. Odwala awa, akamwa mankhwalawa, kuukira kwa angina pectoris, arrhythmias ndi ochepa matenda oopsa,

- odwala aimpso kulephera (kuvomerezeka kwa creatinine pansipa 30 ml / min),

- odwala omwe ali ndi vuto lalikulu la chiwindi,

- odwala omwe ali ndi vuto lotaya magazi ambiri, chifukwa, mwachithandizo ndi anticoagulants kapena vuto la magazi. Pankhani yokhudza magazi - onani gawo la "Contraindication",

- odwala omwe kuchepa kwa kuthamanga kwa magazi kumakhala pachiwopsezo chachikulu (mwachitsanzo, odwala omwe ali ndi vuto lalikulu la mtima kapena mtima wam'mimba womwe umapereka magazi ku ubongo),

- odwala omwe nthawi yomweyo amalandila chithandizo cha pentoxifylline ndi ma antivitamini K (onani gawo "Drug Interaction"),

- odwala omwe nthawi yomweyo amalandila chithandizo cha pentoxifylline ndi antidiabetesic agents (onani gawo "Drug Interaction").

Gwiritsani ntchito pa nthawi yoyembekezera kapena mkaka wa m'mawere. Pa mimba ndi mkaka wa m`mawere, kugwiritsa ntchito mankhwalawa contraindicated.

Ana. Palibe zokuchitikirani ndi kugwiritsa ntchito mankhwalawa kwa ana.

Zomwe zimachitika chifukwa cha mankhwalawa amatha kuyendetsa galimoto kapena njira zina zowopsa

Popeza mankhwalawa amagwiritsidwa ntchito kuchipatala, palibe deta pazotsatira zake.