Desmopressin - malangizo ntchito

Kufotokozera kogwirizana ndi 30.07.2015

• Dzina lachi Latin: Desmopressinum
• Code ya ATX: H01BA02
• Machitidwe C₄₆H₆₄N₁₄O₁₂S₂
• Code la CAS: 16679-58-6

Mphamvu zamankhwala

Desmopressin ndi analogue opanga vasopressin antidiuretic timadzi, yomwe imapangidwa nthawi zambiri ndi lobe yakumbuyo zodabwisa. Katunduyo anapezedwa ndi chitukuko cha molekyulu. vasopressin:1-cysteine ​​deamination ndi zina 8-l-argininekupezeka mu molekyulu yoyambayo 8-D-arginine.

Chipangizocho chimakhala chosatulutsa bwino minofu ya bedi lamitsempha komanso ziwalo zamkati, koma odana ndi duretic kwenikweni analankhula mwamphamvu kwambiri.

Pharmacodynamics ndi pharmacokinetics

Thupi limayambitsa Vasopressin V2 Receptorszomwe zimapezeka mu minofu ya epithelial opukusika ndi Kukwera malupu a Henle, izi zimabweretsa kuwonjezeka kwa njira yobwezeretsanso madzi m'mitsempha yamagazi, yolimbikitsa 8 zopangika.

The antiduretic mphamvu ya mankhwalawa zimatheka ndi subcutaneous, mtsempha wa magazi, intramuscular, kuphunzitsa mankhwala pamphuno.

Hafu ya moyo wa mahomoni opanga = mphindi 75. Komabe, kuchuluka kwa zinthu moyenera kumatha kupezeka m'thupi mkati mwa maola 8 mpaka 20, atatha kutsata. Zizindikiro zatsimikiziridwa polyuria kusowa pambuyo 2-3 nthawi kugwiritsa ntchito. Intravenous makonzedwe ndi othandiza kwambiri kuposa intranasal makonzedwe.

Odwala hemophilia ndi von Willebrandt matenda atatha jakisoni imodzi ya 0,4 μg ya mankhwala pa 1 kg ya kulemera kwake, 8 zopangikaamachulukitsa katatu. Zotsatira za mankhwalawa zimayamba kuwonekera pambuyo pa theka la ola ndikufika pazofunikira zake mkati mwa theka ndi theka - maola awiri.

Komanso, mukamagwiritsa ntchito mankhwalawa, kuwonjezereka kwachilengedwe kwa plasma kumawonedwa plasminogenkoma nthawi yomweyo mulingo fibrinolysis amakhalabe yemweyo.

Thupi limapukusidwa mu zimakhala za chiwindi. Cleavage zimachitika mlatho wosasangalatsa kuphatikiza enzyme transhydrogenases. Mankhwala omwe ali ndi mkodzo amachotsedwa osasinthika kapena mawonekedwe a metabolites osagwira. Desmopressin ali ndi poizoni wotsika, ayi teratogenic kapena katundu wa mutagenic.

Kutulutsa Fomu

Mankhwalawa amapangidwa m'mitundu ingapo. Musanasankhe mawonekedwe, muyenera kufunsa dokotala kuti mupeze yoyenera yothandizira matenda.

Njira yothetsera jakisoni imayendetsedwa kudzera mu mnofu, kudzera m'mitsempha, mosavuta.

Mankhwala amapezeka mu mawonekedwe a mapiritsi oyera, ozungulira. Mbali ina pali mawu oti "D1" kapena "D2". Pa mzere wachiwiri wogawa. Kuphatikiza pazogwira, desmopressin, kaphatikizidwe kamaphatikizidwe ndi magnesium stearate, wowuma wa mbatata, povidone-K30, lactose monohydrate.

Mankhwala amapezeka mu mawonekedwe a mapiritsi oyera, ozungulira.

Madontho a Nasal ndi madzi osapaka utoto. Omwe amathandizira ndi chlorobutanol, sodium chloride, madzi, hydrochloric acid. Mlingo wa 0.1 mg pa 1 ml.

Ndiwisi yabwino. Yokhala ndi botolo lapadera ndi dispenser. Omwe amathandizira ndi potaziyamu sorbate, madzi, hydrochloric acid, sodium chloride.

Pharmacokinetics

Hafu ya moyo wa mahomoni opanga ndi mphindi 75. Koma munthawi yomweyo, mankhwalawa amatha kuzindikirika mkati mwa thupi kwa maola 8 mpaka 20 atatha kugwiritsa ntchito. Zinawululidwa kuti zizindikiro za polyuria zimatha pambuyo pakugwiritsa ntchito mankhwala 2-3. Pankhaniyi, jakisoni wamkati ndiwothandiza kwambiri kuposa makonzedwe a intranasal.

Mu anthu omwe ali ndi matenda a von Willebrand, komanso hemophilia yemwe ali ndi vuto limodzi la 0,4 μg / kg, kuchuluka kwa katatu kwa zomwe 8 zimapangitsa kuti magazi aziwonekera. Mankhwalawa amayamba kugwira ntchito pambuyo pa mphindi 30 kuyambira pomwe agwiritsidwe ntchito ndikufika pazowonjezera pambuyo pa maola 1.5-2.

Nthawi yomweyo, kugwiritsa ntchito mankhwalawa kumabweretsa kuwonjezeka kwanyengo yamakhalidwe a plasminogen, ngakhale zizindikiro za fibrinolysis zimakhala chimodzimodzi.

Mankhwala amapita kagayidwe mkati mwa chiwindi. Mlatho wosavomerezeka umamangidwa ndi michere ya transhydrogenase.

Kutupa kwa zinthu zosasinthika kapena zinthu zosagwira mu metabolic zimachitika ndi mkodzo.

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Contraindication

• polydipsia a psychogenic kapena kobadwa nako,
• kukhalapo kwa anuria,
• plasma hypoosmolality,
• kuchuluka kwa madzi mkati mwa thupi,
• kukhalapo kwa kulephera kwa mtima ndi kufunika kwa mankhwala okodzetsa,
• thupi lawo siligwirizana.

Ndi zoletsedwa kupaka mankhwalawa kudzera mwa odwala a Willebrand-Dian a subtype 2b, komanso kuphatikiza ndi angina osakhazikika

Mlingo ndi makonzedwe

Mapiritsi ayenera kumwedwa pakamwa, pambuyo maola ochepa atatha kudya (ndi kugwiritsa ntchito nthawi yomweyo, kufooketsa kuperewera kwa mankhwalawa, komwe kungapangitse kuchepa kwa mphamvu yake). Kutumiza makulidwe ndi nthawi yayitali ya mankhwala amasankhidwa ndi adokotala.

Anthu omwe ali ndi matenda a shuga amayamba kumwa mankhwalawa katatu pa tsiku. Pambuyo pa izi, ndikofunikira kusankha payekhapayekha gawo, poganizira momwe mapiritsiwo alili, komanso kuleza mtima kwawo ndi wodwalayo. Pafupifupi, mlingo wake ndi 0,0-0.2 mg, amatengedwa katatu patsiku.

Kukula kwakanthawi kovomerezeka kwakumwa kwamankhwala tsiku ndi 1,2 mg.

Ndi kusakhazikika kwa usiku waukulu, nthawi zambiri amamwa mankhwala a 0 mg mg usiku. Ngati vutoli silokwanira, gawo limachulukitsidwa mpaka 0,4 mg. Popereka chithandizo, muyenera kuchepetsa kuchuluka kwa madzimadzi mu theka lachiwiri la tsiku. Pafupifupi, kupitiliza mankhwala kumatenga masiku 90. Poganizira chithunzi chachipatala, dokotala amatha kutalikitsa maphunzirowa (nthawi zambiri, asanatalikitse mankhwalawo, mankhwalawo amachotsedwa kwa masiku 7, kenako, poganizira zomwe adalandira kuchipatala atachotsa mankhwala, amasankha ngati wodwalayo akuyenera kupitiliza maphunzirowo).

Akuluakulu, omwe amakhala ndi polyuria yamtundu wausiku, nthawi zambiri amafunika kumwa 0,5 mg wa mankhwalawa usiku. Pokhapokha ngati pakuchitika zochizira, ndizotheka kuchulukitsa kawiri - mpaka 0,5 mg. Moyang'aniridwa ndi dokotala, mlingo wa mankhwalawa ukhoza kupitilirabe ngati pakufunika kutero. Pakakhala kuti palibe kusintha kwa mankhwalawa pakatha mwezi umodzi wa ntchito, mankhwalawo ayenera kusiyidwa.

Utsi wa intranasal umagwiritsidwa ntchito m'magawo 10-40 mcg / tsiku, omwe amagawidwa m'njira zingapo zosiyanasiyana. Ana osachepera miyezi itatu ndi kupitirira 12 zaka ayenera kusintha tsiku lililonse mlingo, womwe uli mulingo wa 5-30 micrograms.

Mlingo wa Desmopressin wa iv, s / c, komanso jekeseni wa m ndi 1-4 mcg / tsiku (kwa akuluakulu). Ana amaloledwa kulowetsa ma microphoni a 0,4-2 patsiku.

Ngati palibe zotsatira pambuyo pa sabata la 1 la chithandizo, ndikofunikira kusintha tsiku lililonse. Kusankha mitundu yoyenera ya mankhwala nthawi zina zimatenga nthawi yambiri - mkati mwa milungu ingapo.

50 makilogalamu ndi von Willebrand matenda kapena Mild Hemophilia A. | Maganizo a Magazi "target =" _ blank "rel =" noopener noreferrer "> 41 ,,,,,,,

Bongo

Kupha poizoni ndi mankhwala nthawi zambiri kumayambitsa kusungunuka kwa madzimadzi komanso kukula kwa zizindikiro za hyponatremia.

Zikatero, amafunika kupereka njira yovomerezeka ya isotonic kapena hypertonic solution ya sodium chloride, komanso kupatsa wodwala diuretic (furosemide).

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Kuchita ndi mankhwala ena

Kuphatikizidwa ndi dopamine, makamaka pamankhwala okwanira, amatha kupangitsa mphamvu ya Pressor.

Indomethacin imakhudza kuchuluka kwa mankhwala omwe amachokera ndi Desmopressin.

Kuphatikiza kwa mankhwalawa ndi lithiamu carbonate kumabweretsa kuchepa kwa mphamvu zake zotsutsana.

Chisamaliro chiyenera kutengedwa kuphatikiza mankhwalawa ndi mankhwala omwe amawonjezera zovuta za kutulutsidwa kwa timadzi tating'onoting'ono: monga carbamazepine ndi chlorpromazine, phenylephrine yokhala ndi tricyclics, ndi epinephrine. Kuphatikizika kotereku kumatha kuyambitsa mphamvu ya vasopressor ya mankhwala.

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Ntchito kwa ana

Kukula kwa tsiku ndi tsiku kwa ana ochepera zaka 12 kuyenera kusinthidwa.

Mu makanda mpaka zaka 1, kuledzera ndi chinthu kungayambitse kukulitsa - chifukwa cha kukwiya kwa mankhwalawa pa NS.

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Zofanizira za chinthucho ndizopangira Vazomirin, Minirin ndi Emosint ndi Presinex, komanso kuwonjezera Adiuretin, Desmopressin acetate, Nourem ndi Nativa, Apo-Desmopressin ndi Adiuretin SD.

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Desmopressin amalandila ndemanga zabwino mankhwalawa amathandizira ana, ngakhale zimadziwika kuti zotsatira za kugwiritsidwa ntchito kwake sizimachitika mwachangu, koma patatha milungu ingapo. Nthawi yomweyo, ndemanga zimati mankhwalawa amalekeredwa bwino.

Palinso ndemanga yokhudza kugwiritsa ntchito bwino kwa mankhwala omwe ali ndi matenda osokoneza bongo - osagwiritsa ntchito shuga - kugwiritsa ntchito kwake kumawongolera mkhalidwe wa wodwalayo, kuchepetsa zizindikiro za matenda.

Njira yamachitidwe

Zomwe zimagwiritsidwa ntchito ndi molekyulu yosinthika ya vasopressin ya mahomoni. Mankhwala akalowa m'thupi, ma receptor apadera amayamba, chifukwa chomwe njira yobwezeretsedwera madzi imatheka. Kuphatikizika kwa magazi kumakhala bwino.

Odwala omwe ali ndi hemophilia, mankhwalawa amonjezera kuwonjezeka kwa 8 katatu. Pali kuchuluka kwa plasminogen mu plasma yamagazi.

Intravenous management imakupatsani mwayi woti mukwaniritse zotsatira zake.

Mankhwala amasintha magazi.

Ndi chisamaliro

Ngati kuphwanya kuchuluka kwamadzi-electrolyte, fibrosis ya chikhodzodzo, matenda amkati mwa mtima kapena impso, chiopsezo cha kukakamizidwa kwa intracranial, kusamala kuyenera kuchitika pakumwa. Chitsulo chobera chimawonedwa ngati choposa zaka 65.

Mlingo ndi dongosolo regimen zimadalira matenda, mikhalidwe ya wodwala. Ayenera kusankhidwa limodzi ndi adokotala. Muyenera kudziwa bwino malangizo ogwiritsa ntchito.

Mlingo woyambirira wa madontho amphuno, kutsitsi kumasiyana 10 mpaka 40 mcg patsiku. Iyenera kutengedwa kangapo. Ana osakwana zaka 12 adzafunika kusintha. Kwa iwo, mlingo wa ma 5 mpaka 30 makilogalamu amasankhidwa masana.

Pogwiritsa ntchito jakisoni wa akulu, mulingo wambiri umachokera pa 1 mpaka 4 ma kilogalamu pa kilogalamu iliyonse yakulemera kwa thupi. Muubwana, ma microgram a 0,4-2 akuyenera kuperekedwa.

Ngati chithandizo sichibweretsa zomwe zikuyembekezeka mkati mwa sabata, mlingo wake uyenera kusintha.

Ngati chithandizo sichibweretsa zomwe zikuyembekezeka mkati mwa sabata, mlingo wake uyenera kusintha.

Zotsatira zoyipa

Chizungulire, kupweteka mutu, kusokonezeka ndizotheka. Nthawi zambiri, odwala amadwala. Kulemera kwa thupi kumatha kuchuluka, rhinitis ikhoza kuchitika. Odwala ena, nembanemba ya mphuno imatupa. Kusoka, mseru, komanso kupweteka m'mimba ndizotheka.

Kuthamanga kwa magazi kumatha kuchuluka kapena kuchepa. Nthawi zina oliguria, kutentha kwa moto, thupi limagwidwa. Hyponatremia ikhoza kuchitika. Mukamagwiritsa ntchito jakisoni, ululu utha kuzindikirika pamalo operekera jakisoni.

Ngati mankhwalawa amagwiritsidwa ntchito pochiza ana osaposa miyezi 12, khunyu ndikotheka.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsidwa ntchito kwa Desmopressin kumawonetsedwa pakuwunika komanso kuchiza matenda apakati pa matenda a shuga.

Kuphatikiza apo, masanjidwe osiyana a mitundu:

• mapiritsi: ana a zaka zopitilira 5 - maphunzitsidwe a usiku wausiku, akulu - Zizindikiro zamankhwala osokoneza bongo a nocturnal polyuria,
• Mlingo wa metred -mphuno ndi madontho amphuno: kuyesa kwa kuperewera kwa impso,
• madontho amphuno: pachimake polyuria ya genesis yapakati, yomwe imayambitsidwa ndi matenda kapena kulowererapo kwa opaleshoni yamkati, kupweteka kwachisoni.

Kuyenderana ndi mowa

Kumwa mowa panthawi yamankhwala sikulimbikitsidwa, chifukwa kumapangitsa kuti mankhwalawa akhale othandiza.

Mankhwalawa ali ndi ma syonyms ambiri. Analogs ndi mapiritsi Minirin, Nativa, Adiuretin, Spayneks zikumapeto, Vasomirin. Desmopressin Acetate imagwiritsidwanso ntchito. Palinso ma kapisozi ena, mapiritsi ndi mayankho omwe ali ndi katundu wa antidiuretic. Mwina ntchito mankhwala wowerengeka.

Minirin ndi analogue ya Desmopressin.

Mlingo ndi makonzedwe

Mapiritsi amatengedwa pakamwa, patapita nthawi atatha kudya.

• pakati matenda a shuga a insipidus: mlingo woyambirira ndi 0,5 mg katatu patsiku kwa ana ndi akulu. Kenako, mlingo umasankhidwa poganizira zaumoyo wazachipatala, umatha kuyambira 0,2 mg mpaka 1.2 mg patsiku,
• chachikulu nocturnal enursis: woyamba mankhwalawa ndi 0,2 mg nthawi yogona, pakakhala popanda achire zotsatira zake, akhoza kuchuluka mpaka 0,4 mg. Ndikofunikira kuchepetsa kumwa kwamadzimadzi madzulo. Maphunzirowa amatenga masiku 90. Pambuyo pakupuma kwamasiku 7, mapiritsi amatha kuyambiranso kutengera umboni wakuchipatala,
• nocturnal polyuria mwa akulu: mlingo woyambirira ndi 0.1 mg nthawi yogona, osagwirizana ndi zotsatira zake, umachulukitsidwa masiku onse a 0,1 mg mpaka 0,5 mg mpaka mlingo utakwaniritsidwa womwe umapereka chokwanira.

Pokhapokha ngati pakhale chithandizo choyenera pambuyo poti mwalandira masiku 30, mankhwalawo ayenera kusiyidwa.

Mlingo wammphuno

Utsiwo umagwiritsidwa ntchito ndi makina a intranasal, kudina kamodzi pa chipangizo chofanana ndi 0,01 mg wa mankhwalawa.

Pochiza ana, njirayi iyenera kuchitika moyang'aniridwa ndi akulu.

Mulingo woyenera kwambiri umatsimikiziridwa ndi kusankha kwa munthu.

• matenda apakati a shuga a insipidus: akuluakulu - 0.01-0.04 mg, ana - 0.01-0.02 mg patsiku. Ndondomeko ikuchitika kamodzi kapena kugawa muyeso wa mankhwala atatu jekeseni,
• mayeso amisala ya impso: achikulire - 0,04 mg, ana a zaka zopitilira 1 - 0.01-0.02 mg, ana osakwana zaka 1 - 0,01 mg. Pambuyo makonzedwe, wodwalayo ayenera kuchotsa chikhodzodzo, patatha maola 8 otsatira, mawotchi awiri amkati amatengedwa kuti akaphunzire mankhwalawa. Kuchuluka konse kwamadzi akumwa ndi wodwala poyesedwa (ola limodzi musanayambe kuphunzira komanso maola 8 otsatira) sayenera kupitirira 500 ml. Ngati mndandanda wa osmolality pansi pa 800 mOsm / kg mwa akulu ndi 600 mOsm / kg mwa ana wapezeka, kuyesedwako kumachitika. Potsimikizira kuphwanya kwamphamvu ya impso, kumafunikanso mayeso ena.

Nasal akutsikira

Madontho amagwiritsidwa ntchito mwamphamvu, mwakuwunikira njira ya m'mphuno kulocha mphuno ya mphuno ndikukhomekera pang'ono kumbuyo kwa mutu ndikulowera mbali.

Kuwonetsedwa kwa achire zotsatira kumachitika mkati mphindi 30 pambuyo kukhazikitsidwa kwa mankhwala.

• matenda a shuga insipidus a chiyambi chapakati: akuluakulu - 0,01-0.04 mg (2-8 madontho), ana - 0,005-0.02 mg (madontho a 1-4) patsiku. Mankhwalawa amaperekedwa kamodzi, kapena mlingo wa tsiku ndi tsiku umagawidwa jakisoni awiri. Dotoloyo amakuuzani mlingo ndi nthawi pakati pa oyendetsa payekhapayekha, potengera momwe chidwi cha wodwalayo chimvera,
• pachimake mawonekedwe a chapakati pa polyuria: 0,01 mg aliyense. Zakudya za diuresis ndi madzimadzi zimayenera kuyesedwa pakadutsa ola limodzi mpaka kukwaniritsa kwathunthu. Pakadutsa maola 3-5, yang'anani zamasamba am'madzi ndi mkodzo, kuchuluka kwa sodium m'magazi,
• kuphunzira zakuthwa kwa impso: akulu - 0,015 mg, ana okulirapo 1 chaka - 0.01-0.015 mg. Pambuyo kuphatikiza mankhwala, chikhodzodzo chodzimitsa ndichofunika. Kenako zitsanzo za mkodzo zimasonkhanitsidwa kuti mudziwe osmolarity, njirayi imabwerezedwanso kanayi ndi gawo limodzi la ola limodzi. Ngati ludzu likachitika, saloledwa kutenga zosaposa 200 ml zamadzimadzi nthawi yonseyo (ola limodzi musanayambe kuphunzira komanso mkati mwa maola 8 otsatira) phunzirolo.

Malangizo apadera

Desmopressin sayenera kugwiritsidwa ntchito mwa odwala omwe ali ndi concomitant pathologies kapena kumwa mankhwala omwe angayambitse kusungunuka kwa madzi m'thupi komanso zovuta zamagetsi.

Odwala omwe amakhala ndi enctis ya nthawi yayitali ya ola limodzi asanadutse ndi maola 8 mutatha kugwiritsa ntchito mankhwalawa ayenera kuchepetsa kumwa kwamadzi - izi zimachepetsa chiopsezo cha mavuto.

Kugwiritsidwa ntchito kwa Desmopressin pochizira ma enctis am'mawa mwa ana ndi odwala achinyamata kumayambitsa matenda a edema.

Odwala omwe ali ndi polyuria kuchokera ku 2.8 mpaka 3 malita ndi otsika ochepa a plasma sodium ali pachiwopsezo chachikulu cha mavuto.

Mosamala kwambiri, tikulimbikitsidwa kugwiritsa ntchito mankhwalawa kwa odwala omwe ali ndi zaka zopitilira 65 chifukwa cha chiwopsezo chachikulu cha kusungidwa kwa madzimadzi, chitukuko cha hyponatremia ndi zina zosakomera. Wodwala amayenera kuperekedwa ndi kayendetsedwe ka boma ndi nthawi zonse (chisanachitike chithandizo, pambuyo pa masiku atatu othandizira komanso panthawi iliyonse ya kuchuluka) kutsimikiza kwa kuchuluka kwa sodium ndende ya plasma.

Ngati pali matenda, kutentha kwa pakhungu kapena gastroenteritis, kugwiritsa ntchito mankhwalawa kuyenera kutha.

Pofuna kupewa hyponatremia, kawirikawiri maphunziro amathandizidwa kudziwa kuchuluka kwa sodium mu plasma yamagazi, makamaka pophatikiza mapiritsi ndi ma tridclic antidepressants, kusankha serotonin inhibitors, chlorpromazine, carbamazepine, mankhwala ena omwe amachititsa kuti pakhale kuperewera kwa mahomoni a antidiuretic, komanso kuphatikiza mankhwala osapatsa-anti-antiidal NSAIDs).

Kuzindikira ndi kuchiza kwamikodzo kwamkodzo, kuchepa kwamitsempha ndi / kapena kukomoka, matenda a kwamikodzo, chikhodzodzo, kapena zotupa za mu Prostate, matenda a shuga, polydipsia, ndi uchidakwa ziyenera kuchitika musanagwiritse ntchito Desmopressin.

Mwa ana osakwana zaka 1, kuyezetsa chidwi cha impso kuyenera kuchitika kuchipatala chokha.

Pambuyo pakuyesa kuzindikiritsa, wodwalayo amaloledwa kulandira madzimadzi mu voliyumu yomwe imapereka ludzu la ludzu.

Mlingo wa mankhwalawa sungagwiritsidwe ntchito kwa ana ngati mlingo wofunikira wa chithandizo uli pansipa 0,01 mg.

Kafukufuku wokhudza kutsekeka kwa impso ndi madontho mu ana osakwana chaka chimodzi amayenera kuchitika mwapadera, popeza pakadali pano mphamvu ya impso imachepa. Ndondomeko iyenera kuchitidwa ndi dotolo wa ana. Kwambiri mlingo mu makanda kungayambitse kuyamwa kwamanjenje, yomwe imayendera limodzi ndi kukula kwa khunyu. Pakutola mkodzo, kupatula kwathunthu kwamadzi akumwa kumafunika.

Popeza ndi rhinitis yayikulu, mayamwidwe amadzimadzi amadzaza, tikulimbikitsidwa kugwiritsa ntchito mankhwalawa mkati.

Ndi matenda a shuga a insipidus apakati, kuphatikiza kwa desmopressin kumawonjezera mwayi wokhala ndi hyponatremia.

Kuyanjana kwa mankhwala osokoneza bongo

Pogwiritsa ntchito nthawi yomweyo ya Desmopressin:

• indomethacin ingayambitse kuwonjezeka kwa desmopressin popanda kuwonjezera nthawi yake,
• tetracycline, glibutide, norepinephrine, kukonzekera kwa ma lithiamu kumachepetsa mphamvu ya mankhwala antidiuretic.
• othandizira oonjezera anzawo amathandizira kusintha kwake,
• kusankha serotonin zoletsa, tricyclic antidepressants, carbamazepine, chlorpromazine angayambitse matenda osakwanira katulutsidwe wa antidiuretic timadzi, kuchuluka antidiuretic wa desmopressin, kuchuluka chiopsezo madzi ndi chitukuko cha hyponatremia,
• NSAIDs imawonjezera chiopsezo cha madzi osungika m'thupi, kupezeka kwa hyponatremia,
• dimethicone amachepetsa mayamwidwe a mankhwala,
• loperamide ndi mankhwala ena omwe amachepetsa peristalsis amatha kuonjezera kuchuluka kwa plmma ya desmopressin nthawi 3 ndikuwonjezera kwambiri chiopsezo cha madzi osungidwa ndi hyponatremia.

Ma Analogs a Desmopressin ndi awa: mapiritsi - Minirin, Nativa, Nourem, kutsitsi - Apo-Desmopressin, Presineks, Minirin, Vasomirin.

Kuchita

Kugwiritsa ntchito mosiyanasiyana, makamaka pamiyeso yayikulu, ndi dopamine zimatha kukometsa mphamvu.

Indomethacin zimakhudzanso kukula kwa chiwonetsero cha Desmopressin m'thupi.

Mukumwa mankhwala ndi lithiamu carbonate, zotsatira zake zotsutsana zimafooka.

Mosamala, chinthucho chiyenera kuphatikizidwa ndi mankhwala omwe amachititsa kuti amasulidwe. ma antidiuretic mahomoni: chlorpromazine, carbamazepine, tridclic antidepressants, phenylephrine, epinephrine. Kuphatikiza uku kungapangitse kuwonjezeka kwa vasopressor zochita za Desmopressin.

Zotsatira za pharmacological

Desmopressin ndi chithunzi cha masoka achilengedwe a arginine-vasopressin okhala ndi tanthauzo lodziwika bwino.

Poyerekeza ndi vasopressin, imakhala ndi mphamvu yocheperako pamitsempha yamagazi ndi ziwalo zamkati, zomwe zimachitika chifukwa cha kusintha kwamapangidwe a molekyulu ya desmopressin poyerekeza ndi molekyule yachilengedwe ya vasopressin - deamination ya 1-cysteine ​​ndi kusintha kwa 8-L-arginine ndi D-arginine.

Kuchulukitsa kupezeka kwa epithelium kwa zigawo za distal yama tubules yamadzi ndikuwonjezera kubwezeretsanso. Kugwiritsidwa ntchito kwa Desmopressin pakatikati pa matenda a shuga makamaka kumapangitsa kutsika kwamkodzo kukuchuluka komanso kuwonjezeka kwamtundu umodzi kwamkodzo komanso kuchepa kwa madzi am'magazi. Izi zimabweretsa kuchepa kwa pafupipafupi kukodza komanso kuchepa kwa masana polyuria.

Mulingo wofunikira wa antidiuretic umachitika mukamamwa pakapita maola 4 mpaka 7.7.

Bedwetting

• Funsani wamisala funso
• Gulani mankhwala
• Onani mabungwe

Mafomu a mankhwala

Wopanga amapanga mankhwalawo m'njira zingapo zamankhwala, zomwe:

1. Madontho a Nasal, omwe ali amadzimadzi omveka bwino, opanda khungu. Mmatumba a mabotolo ogwetsera, omwe ali ndi 5 ml ya mankhwalawa.
2. Phula la nasal "Desmopressin". Ndiwowoneka bwino wopanda khungu. Atakulungidwa m'mabotolo opangidwa ndi galasi lakuda ndipo ali ndi chida chapadera chothira mafuta. Bokosi lirilonse limakhala ndi Mlingo 50.
3. Mapiritsi Ndi zoyera pamtundu, kumbali imodzi ndizowopsa. Atanyamula mu polyethylene muli 28, 30, 90 zidutswa, kapena chithuza mapaketi a 10, 30 zidutswa.

Malangizo ogwiritsira ntchito mayendedwe a "Desmopressin" sakusonyezedwa. Tikambirana pansipa.

Chosakaniza chogwiritsidwa ntchito pamapiritsi ndi kupopera kwammphuno ndi desmopressin acetate, m'madontho - desmopressin. Popanga mapiritsi, zida zothandizira monga magnesium stearate, wowuma wa mbatata, povidone-K30, lactose monohydrate amagwiritsidwa ntchito.

Zothandiza pazitsulozi ndi: madzi oyeretsedwa, hydrochloric acid, sodium chloride, potaziyamu sorbate.

Zomwe zimagwiritsidwa ntchito popanga madontho zimagwiritsidwa ntchito: madzi oyeretsedwa, hydrochloric acid, sodium chloride, chlorobutanol.

Mavuto a mapiritsi a Desmopressin ndi kutsitsi sikutivuta kupeza, koma adotolo ayenera kuchita izi.

Zotsatira zoyipa zogwiritsa ntchito mankhwalawa

Potengera momwe amagwiritsidwira ntchito madontho, utsi ndi mapiritsi a Desmopressin, wodwalayo atha kusintha zinthu zosiyanasiyana molakwika, mogwirizana ndi momwe tikulimbikitsidwa kutsatira mosamalitsa Mlingo womwe dokotala watchulidwa. Nthawi zambiri, ndi mankhwala a mankhwala amawonekera:

• Ululu pamalowo jekeseni.
• Kuwonongeka kwa kusamalidwa.
• Thupi lawo siligwirizana.
• Mafunde.
• Mawonekedwe a khungu lawo pakhungu.
• Algodismenorea.
• Mimba yamkati.
• Kubweza
• Kupweteka kwam'mimba.
• Kuchepetsa mseru
• Kutupa chifukwa cha maziko osungira madzi m'thupi.
• Hyponatremia.
• Oliguria.
• Kuchulukitsa kapena kuchepa kwa kuthamanga kwa magazi ngati mankhwalawa amaperekedwa mofulumira.
• Kutupa kwa mucous nembanemba.
• Hypoosmolality.
• Rhinitis.
• Kulemera.
• Kutaya chikumbumtima.
• Chisokonezo.
• Chizungulire.
• Mutu.
• Coma

Pakachitika zovuta zina, ndikofunikira kudziwitsa dokotala. Izi zimatsimikiziridwa ndi malangizo ogwiritsa ntchito. Analogs a Desmopressin ali ndi zotsatirapo zoyipa.

Kugwiritsa ntchito mankhwalawa: momwe mungachitire bwino

Njira zochizira ndi mtundu wa wodwala aliyense zimayenderana ndi dokotala.

Pogwiritsa ntchito mitundu ya intranasal ya mankhwalawa, makonzedwe a 40 mgk a mankhwala patsiku amasonyezedwa. Mlingo womwe akuwonetsedwa uyenera kugawidwa panjira zingapo. Pochiza ana, kusintha kwa mankhwalawa kumafunikira, popeza mpaka 3 μg patsiku nthawi zambiri amagwiritsidwa ntchito.

Ngati mankhwala a mankhwala kutumikiridwa intramuscularly, mtsempha wa magazi, subcutaneally, ndiye kuti odwala ayenera kugwiritsa ntchito mpaka 4 μg patsiku, ana - mpaka 2 μg.

Pokhapokha ngati mukuthandizira mankhwalawa sabata iliyonse mukamagwiritsa ntchito mankhwalawa, muyenera kufunsa dokotala kuti musinthe. Nthawi zambiri zimatenga mpaka milungu ingapo kuti musankhe njira yoyenera yolandirira.

Zosungidwa zamankhwala

Sungani mankhwalawo pamalo osavomerezeka ndi ana, kutentha komwe sikupitirira 30 digiri.

Pewani mankhwalawo patali ndi ana.

Mimba komanso kuyamwa

Maphunziro okwanira komanso osamalitsa okhazikika a chitetezo cha desmopressin pa nthawi yoyembekezera komanso mkaka wa m`mawere sanachitike. Ngati ndi kotheka, kugwiritsa ntchito desmopressin m'gulu lino la odwala kuyenera kuganizira zabwino zomwe zingachitike pochiritsa amayi komanso chiopsezo cha mwana wosabadwayo kapena mwana.

Kukonzekera kokhala ndi DESMOPRESSIN (DESMOPRESSIN)

• APO-DESMOPRESSINE (msuzi wa daladala). 10 mcg / 1 mlingo: fl. 2.5 ml (25 Mlingo) kapena 5 ml (50 Mlingo) • EMOSINT (EMOSINT) yankho d / jakisoni. 4 μg / 0,5 ml: amp. Ma ma PC 10. • tsamba la MINIRIN® (MINIRIN). sublingual 120 mcg: ma 10, 30 kapena 100 ma PC. • tabu ya MINIRIN® (MINIRIN). 200 mcg: ma ma PC 30. • tabu ya MINIRIN® (MINIRIN).

100 mcg: ma PC 30. • Njira ya jakisoni (EMOSINT) ya jakisoni. 40 mcg / 1 ml: amp. Ma ma PC 10. • DESMOPRESSIN (DESMOPRESSIN) kutsanulira kwamphuno komwe kumatulutsa 10 mcg / 1 mlingo: vial. Mlingo 50 ndi dosing. • Pulogalamu ya MINIRIN ® (MINIRIN) yopopera. 10 mcg / 1 mlingo: fl. 2,5 ml (25 Mlingo) kapena 5 ml (50 Mlingo) • tabu ya MINIRIN® (MINIRIN).

magawo 240 mcg: 10, 30 kapena 100 ma unit • PRESINEX (kutsitsi la nasal dosing). 10 mcg / 1 mlingo: fl. Mlingo 60 • EMOSINT (EMOSINT) yankho d / jakisoni. 20 mcg / 1 ml: amp. Ma PC 10. • DESMOPRESSIN (DESMOPRESSIN) mphuno imatsika 100 μg / 1 ml: vial. 5 ml

• tsamba la MINIRIN® (MINIRIN).

sublingual 60 mcg: 10, 30, kapena 100 ma PC.