Minirin® (Minirin)

Mitundu ya Minirin:

• Mapiritsi a 100 mcg: oyera, ozungulira, ma convex, olembedwa "0.1" mbali imodzi ndi scuff mbali inayo (ma PC 30. Mu botolo la pulasitiki, pabokosi lamatabwa, 1 botolo),
• Mapiritsi a 200 mcg: oyera, ozungulira, otukusira, olembedwa "0.2" mbali imodzi ndi scuff mbali inayo (ma 30 ma PC. Mu botolo la pulasitiki, pabokosi la makatoni, 1 botolo),
• Mapiritsi am'munsi 60 mcg: yoyera, yozungulira, yolembedwa mbali imodzi ngati dontho limodzi (ma PC 10. Mu chithuza, mu mtolo wa makatoni a 1, 3 kapena 10 matuza),
• Mapiritsi okhala ndi mphamvu 120 mcg: yoyera, yozungulira, yolembedwa mbali imodzi ngati madontho awiri (ma PC 10. Mu chithuza, mu mtolo wa makatoni 1, 3 kapena 10 matuza),
• Mapiritsi am'munsi, 240 mcg: yoyera, yozungulira, yolembedwera mbali imodzi ngati madontho atatu (ma PC 10. Pakutupa, pamatabwa a 1, 3 kapena 10 matuza),
• Mlingo wowerengeka wa ntchito yammphuno (2,5 kapena 5 ml iliyonse mu botolo lagalasi lakuda lodzaza ndi chikwangwani cha pamphuno, pakatoni kamtundu umodzi umodzi).

The yogwira ndi desmopressin acetate, zomwe zimatengera mtundu wa kumasulidwa:

• Mapiritsi: mu chidutswa chimodzi - 100 kapena 200 μg (motero 89 kapena 178 ofg wa desmopressin),
• Mapiritsi am'munsi: mu chidutswa chimodzi - 67, 135 kapena 270 mcg (60, 120 kapena 240 mcg wa desmopressin, motero),
• Spray: mu 1 ml (10 Mlingo) - 100 mcg.

• Mapiritsi: magnesium stearate, povidone, wowuma wa mbatata, lactose,
• Mapiritsi ang'onoang'ono: citric acid, mannitol, gelatin,
• Spray: benzalkonium chloride, sodium hydrogen phosphate dihydrate, sodium chloride, citric acid (monohydrate), madzi oyeretsedwa.

Zizindikiro zogwiritsidwa ntchito

• Matenda a shuga
• Nocturia (nocturnal polyuria) mwa akulu monga dalili zozizwitsa,
• Ana a zaka zosaposa zisanu ndi chimodzi.

Komanso, kutsitsi kumalimbikitsidwa kuti mugwiritse ntchito pochizira polydipsia ndi polyuria pakanthawi kogwira ntchito, komanso ngati chida chofufuzira kukhazikitsa chidwi cha impso.

Contraindication

• Kulephera kwa mtima ndi zinthu zina zomwe zimafunikira kuyang'anira okodzetsa,
• Polydipsia wodziwika bwino kapena wa psychogenic (wokhala ndi mkodzo 40 ml / kg / tsiku),
• Hyponatremia,
• Zizindikiro zosakwanira kupanga ma antidiuretic mahomoni (ADH),
• Kulephera kwapakati komanso kwakanthawi kwa impso (kuvomerezedwa kwa creatinine

Mlingo ndi makonzedwe

Mapiritsi amatengedwa pakamwa nthawi yayitali atatha kudya, chifukwa kudya kungachedwetse kuyamwa kwa mankhwalawa ndikuchepetsa mphamvu yake.

Mapiritsi ang'onoang'ono amagwiritsidwa ntchito mozungulira (kufikika pansi pa lilime), osatsukidwa ndi madzi!

Mlingo pakati pa mitundu iwiri ya minirin a Minirin ndi awa: mapiritsi ochepa a 60 ndi 120 μg amafanana ndi mapiritsi a 100 ndi 200 μg. Mulingo woyenera wa mankhwalawa uyenera kusankhidwa payekha.

Mlingo woyenera wamapiritsi ang'onoang'ono:

• Matenda a shuga apakati. Mlingo woyambirira ndi 60 mcg katatu patsiku, mtsogolomo umasinthidwa kutengera mphamvu ya mankhwalawa. Mlingo watsiku ndi tsiku umatha kusiyana ndi 120 mpaka 720 mcg, muyeso wabwino wokwanira wa odwala ambiri ndi 60-120 mcg katatu pa tsiku,
• Pulogalamu yoyamba yamadzulo. Mlingo woyambirira ndi 120 mcg, wotengedwa kamodzi patsiku usiku, osathandizira mankhwala, kuwonjezeka kwa mlingo mpaka 240 mcg ndikololedwa, madzulo wodwala amalangizidwa kuchepetsa kumwa kwamadzi. Pambuyo pa miyezi itatu yamankhwala omwe akupitiliza kulandira chithandizo, chisankho chofuna kupitiliza kumwa mankhwalawa chimapangidwa pamaziko azachipatala omwe amadziwika masiku 7 atachokapo,
• Nocturnal polyuria mwa akulu. Mlingo woyambirira ndi 60 mcg usiku, osapeza zotsatira mkati mwa sabata limodzi, mlingo umakulitsidwa mpaka 120 mcg, ndipo, ngati kuli kotheka, ku 240 mcg (ndi kuchuluka kwa sabata sabata iliyonse). M'pofunika kuganizira kuopseza madzimadzi kusunga m'thupi. Ngati pakadatha masabata anayi, pomwe mankhwalawa adachitika, sizotheka kukwaniritsa zomwe zimayembekezereka, kugwiritsa ntchito mankhwalawa sikungathandize.

Utsi wa Minirin umagwiritsidwa ntchito intranasally, kuchuluka kwa madontho kumayendetsedwa ndi kupepuka kwa dontho, lomwe ndi gawo la lotsekera botolo. Popereka mankhwalawa, wodwalayo ayenera kukhala "atakhala" kapena "kugona", mutu wake nkuwugwetsera kumbuyo. Akuluakulu amalimbikitsidwa tsiku lililonse 1040 mcg (1-4 akutsikira mu Mlingo wa 2-4), kwa ana 3 mpaka zaka 12 - 5-30 mcg. Zochizira zam'mimba zosokoneza usiku, mankhwalawa amaperekedwa pogona nthawi yoyamba ya 20 mcg, ngati mankhwalawa sangathe, kuwonjezeka kwa mlingo mpaka 40 mcg ndikovomerezeka, pambuyo pa miyezi itatu yamankhwala, kupuma kwa sabata kumachitika kuti muwunike zotsatira zake.

Zotsatira zoyipa

Mukamagwiritsa ntchito Minirin, zotsatira zoyipa zimayamba nthawi zambiri ngati chithandizo chikuchitika popanda kutsekeka kwamadzi, komwe kumakhudza maonekedwe a hyponatremia komanso / kapena madzi osungira. Izi zitha kukhala zopanda pake kapena kutsagana ndi izi:

• Mchitidwe wamsempha: chizungulire, kupweteka mutu, m'malo ovuta - kukokana,
• Matumbo a pakudya: nseru, pakamwa kowuma, kusanza,
• Zina: kuchuluka kulemera, zotumphukira edema.

Zowonjezera za kutsitsi:

• Machitidwe a kupumira: kutupa kwa mucosa wammphuno, rhinitis,
• Matenda a mtima: kuchuluka kwa kuthamanga kwa magazi (mukamagwiritsa ntchito Mlingo waukulu),
• Gawo lamasomphenya: conjunctivitis, vuto lacacation.

Pankhani ya bongo, kuchuluka kwa minirin kumawonjezeka, chiwopsezo cha hyponatremia ndi kusungidwa kwamadzi kumawonjezeka. Mwanjira imeneyi, muyenera kusiya kugwiritsa ntchito mankhwalawa, kusiya malamulo oletsa kukhathamiritsa madzi ndikuyendera katswiri. Ngati ndi kotheka, ndikotheka kupaka njira ya hypertonic kapena isotonic sodium chloride, komanso kuikidwiratu kwa furosemide (ndikukula kwa khunyu komanso kutaya chikumbumtima).

Malangizo apadera

Ndi chachikulu usiku, kuvomerezedwa kwa madzi osokoneza bongo osachepera ola limodzi musanadye maola 8 mutatha kumwa mankhwalawo. Kupanda kutero, chiopsezo chokhala ndi zotsatira zosafunidwa chimakulitsidwa.

Pa mankhwala, ndikofunikira kuwunika mosamala mkhalidwe wa okalamba, ana ndi achinyamata, odwala omwe akuwopseza kuchuluka kwazovuta zamkati kapena ndi madzi osokonekera komanso / kapena malire a elekitirodi.

Minirin akaperekedwa kwa odwala okalamba, isanayambike maphunzirowa, patadutsa masiku atatu atangoyamba kugwiritsa ntchito komanso pakulimbikitsa kwa mlingo uliwonse, ndikofunikira kuwunika momwe wodwalayo alili, komanso kudziwa kuchuluka kwa sodium m'madzi a m'magazi.

Pankhani ya kulowetsedwa kwa mankhwalawa kwa mankhwalawa, kupezeka kwa rhinitis ndi kutupa kwa mphuno kumatha kuyambitsa kulowetsedwa kwa desmopressin, chifukwa chomwe makonzedwe apakamwa amalimbikitsidwa.

Mukamagwiritsa ntchito Minirin ngati chida chofufuzira, sikulimbikitsidwa kuchita kukakamizidwa (mwina pakamwa kapena mwa kholo), wodwalayo ayenera kumwa madzi ambiri momwe amafunikira kuti athetse ludzu.

Kugwiritsa ntchito mankhwalawa pophunzira za mphamvu ya impso mwa ana osaposa chaka chimodzi amafunikira kuchitika mchipatala okha.

Ndi matenda omwe alipo kale a shuga ndi polydipsia, maonekedwe a dysuria ndi / kapena nocturia, pachimake kwamkodzo, matenda amkodzo, zotupa zomwe zimayikiridwa ndi chithokomiro cha Prostate kapena chikhodzodzo, kuwunika ndi kuthandizira matendawa ndi machitidwe kuyenera kuchitika asanayambe chithandizo ndi Minirin.

M`pofunika kuletsa kumwa mankhwalawa ngati muli ndi malungo, gastroenteritis, matenda amtundu panthawi ya mankhwalawa.

Kuyanjana kwa mankhwala

Kumbukirani kuti akaphatikizidwa ndi Minirin:

• Indomethacin - imawonjezera mphamvu ya mankhwala,
• Tetracycline, glibutide, norepinephrine, lifiyamu - kuchepetsa ntchito yotsutsana,
• Kusankha ma serotonin zoletsa, ma tridclic antidepressants, carbamazepine, chlorpromazine - kungayambitse chiwonetsero chotsutsana ndipo kungakulitse chiopsezo cha kusungunuka kwa madzi ndi hyponatremia,
• Mankhwala omwe amaletsa kutupa - amalimbikitsa chiopsezo cha mavuto,
• Dimethicone - imathandizira kuchepetsa kuyamwa kwa desmopressin.

Minirin ikaphatikizidwa ndi loperamide, kuwonjezeka kwaposachedwa kwa kuchuluka kwa desmopressin mu plasma kumatha kuchitika, zomwe zimakweza kwambiri chiopsezo cha kusungidwa kwa madzimadzi ndi kupezeka kwa hyponatremia. Pali mwayi kuti mankhwala ena omwe amachepetsa peristalsis angayambenso kuchita chimodzimodzi. Pankhani yogwiritsidwa ntchito nthawi imodzi ndi mankhwala omwe ali pamwambawa, kuwunika pafupipafupi kuchuluka kwa sodium mu plasma ya magazi kumafunika.

Gulu la Nosological (ICD-10)

Pharmacological zimatha mankhwala Minirin

Mapiritsi a Minirin ali ndi desmopressin - analogue yopanga ya mahomoni achilengedwe a kumbuyo kwa pituitary gland - arginine-vasopressin (mahomoni antidiuretic). Desmopressin idalandiridwa chifukwa cha kusintha kwamapangidwe a molekyulu ya vasopressin: kusintha kwa 1-cysteine ​​ndi kusintha kwa 8-L-arginine ndi 8-D-arginine.
Poyerekeza ndi vasopressin, desmopressin imasokoneza msempha wosalala wamitsempha yamagazi ndi ntchito yodziwika bwino yotsutsana. Chifukwa cha kusinthika kwakapangidwe, Minirin imayambitsa masopicin V2 okha omwe amapezeka mu epithelium ya tubules okokomeza komanso gawo lalikulu la mitengo ya Henle yomwe ikukwera, zomwe zimapangitsa kukulitsa kwa ma pores m'maselo a nephron epithelial ndipo kumabweretsa kuwonjezeredwa kwamadzi kulowa m'magazi. Mutatha kumwa mankhwalawa, zotsatira za antidiuretic zimachitika mkati mwa mphindi 15. Kupanga kwa 0,5-0.2 mg wa desmopressin kumathandizira odwala ambiri mpaka maola 8 - 12. Kugwiritsa ntchito kwa Minirin mu odwala omwe azindikira kuti ali ndi matenda a shuga omwe amapezeka pachiwindi chapakati kumapangitsa kutsika kwamkodzo wamkodzo komanso kuwonjezeka kwawoscolarity. Zotsatira zake, pafupipafupi amachepetsa ndipo kuuma kwa nocturia kumachepa.
Teratogenic kapena mutagenic zotsatira za desmopressin sizinadziwikebe.
Desmopressin imayamba kupezeka m'magazi mphindi 15-30 pambuyo pa kuperekedwa. Kwambiri kuchuluka kwa madzi am`magazi amafikira pambuyo maola 2. Hafu ya moyo wa desmopressin m'madzi am'magazi ndi maola 1.53.5.

Kugwiritsa ntchito mankhwala Minirin

Gwiritsani ntchito mankhwalawa pokhapokha ngati mwalangizidwa ndi dokotala. Mulingo woyenera wa mankhwalawa amasankhidwa payekha.
Matenda a shuga. Mlingo woyambirira wa akulu ndi ana opitilira zaka 5 ndi 0,5 mg wa desmopressin katatu patsiku. Mlingo wina umasankhidwa kutengera zomwe wodwalayo akuchita. Kutengera ndi zotsatira zaumoyo wazachipatala, mlingo wa tsiku ndi tsiku umasiyana kuchokera ku 0,2 mpaka 1.2 mg wa desmopressin. Kwa odwala ambiri, ndizabwino kwambiri kutenga 0,0-0.2 mg wa desmopressin katatu patsiku.
Pulogalamu yoyamba yamadzulo. Mlingo woyamba wa akulu ndi ana opitilira zaka 5 ndi kumwa 0 mg wa desmopressin usiku umodzi. Pankhani ya kusakwanira kwenikweni, mlingo umatha kuwonjezeka mpaka 0,4 mg. Njira ya mankhwala ndi miyezi itatu. Funso lofuna kupitiliza chithandizo chamankhwala liyenera kuganiziridwa pambuyo pakupuma kwa sabata mutamwa Minirin. Pa mankhwala, muyenera kuchepetsa kumwa kwamadzimadzi usiku ndikatha kumwa mankhwalawa.
Nocturia (nocturnal polyuria). Mlingo woyambirira woperekedwa kwa akulu ndi ana opitilira zaka 5 ndi 0,5 usiku. Pankhani ya kusakwanira kwa koyamba kwa mankhwalawa kwa sabata limodzi, mlingo umakulitsidwa pang'onopang'ono sabata lililonse mpaka 0,2 mg ndipo pambuyo pake ndi 0,4 mg. Muyenera kudziwa kusungidwa kwa madzimadzi mthupi. Odwala azaka zapakati pa 65 ndi kupitirira, mulingo wa sodium m'magazi uyenera kuyang'aniridwa musanalandire chithandizo, mutatha 3 Mlingo wa mankhwalawa ndikuwonjezera mlingo.
Pakakhala zizindikiro za madzi akusungidwa ndi / kapena hyponatremia (mutu, nseru, kusanza, kulemera, muzoopsa - kukokana), mankhwalawa amayenera kuyimitsidwa nthawi yomweyo mpaka wodwalayo atachira. Mukayambiranso chithandizo, munthu ayenera kuyang'anitsitsa kuchepetsedwa kwamadzi ndi wodwala.

Zochita zamankhwala Minirin

Indomethacin imatha kupititsa patsogolo zotsatira za Minirin popanda kuwonjezera nthawi yake kuchitapo kanthu. Zinthu zomwe zimayambitsa kuchuluka kwa antidiuretic mahomoni (vasopressin), mitundu yina ya ma antidepressants (chlorpromazine ndi carbamazepine) imatha kupititsa patsogolo mphamvu ya antidiuretic ya Minirin ndikuwonjezera mwayi wokhala ndi madzi ochuluka mthupi.

Mankhwala osokoneza bongo a Minirin, zizindikiro ndi chithandizo

Ndi bongo wambiri, chiopsezo cha hyponatremia ndi madzimadzi posungira mthupi zimachuluka. Ngakhale chithandizo cha hyponatremia chiyenera kukhala chokhazikika, pali malingaliro ambiri:

• ngati asymptomatic hyponatremia, chithandizo cha Minirin sichiyenera kusokonezedwa ndipo wodwalayo ayenera kukhala ochepa pakumwa madzi,
• vuto la chifukwa cha hyponatremia, njira yokhazikika ya iso- kapena hypertonic sodium chloride solution iyenera kuchitidwa,
• woopsa, kusungunuka kwa madzi m'thupi, kuwonetseredwa ndi kupweteka komanso / kapena kusazindikira, kuyenera kuphatikizidwa ndi zovuta (chizindikiro) cha furosemide.

Kufotokozera kwamankhwala

Zotsatira zazikulu za mankhwalawa ndi antidiuretic.

Zochita zina zofunika za mankhwalawa ndi monga:

1. Kutha kukopa njira ya magazi. Mankhwalawa amayambitsa VIII chifukwa cha njirayi. Izi ndizofunikira kwa anthu omwe ali ndi matenda a hemophilia kapena von Willebrand,
2. Woyambitsa plasma amadzuka
3. Mosiyana ndi mankhwala ena onse, imagwira ntchito mofatsa minofu yosalala. Kufatsa kofananako kumachitika ku ziwalo zonse,

The antidiuretic zotsatira pambuyo kumwa mankhwalawa mawonekedwe ammphuno madontho kapena mapiritsi amapezeka ola limodzi. Antihemorrhagic zotsatira zidzachitika pambuyo makonzedwe mkati 15-30 mphindi. Mulingo wothandiza kwambiri wa antidiuretic umachitika pambuyo pa maola 1-5 pambuyo pa mapiritsi amkati kapena maola 4-7 mutatha mapiritsi.

Mchitidwewo upitiliza kugwiritsa ntchito madontho kwa maola 8-20. Ngati mankhwalawa atengedwa ngati mapiritsi, ndiye kuti muyezo wa 0-0-0.2 mg umapereka maola 8, ndi 0,4 mg - ntchito kwa maola khumi ndi awiri.

Zizindikiro zazikulu zogwiritsidwa ntchito

Choyamba, mankhwalawa amalembedwa kuti apezeke ngati ali ndi matenda a shuga a pakati (mtundu wachiwiri wa matenda ashuga). Minirin amathandizanso ngati pachitika kuvulala kwa genesis wapakati, matenda ena aubongo. Mankhwalawa amamulembera ngati postoperative pakugwira ntchito ya pituitary gland ndi malo oyandikana nawo.

Minirin nthawi zambiri amatchulidwa kuti azindikire poyambira kukodza kwamkodzo, komanso kudziwa mphamvu ya impso kukhazikika. Ndikofunikanso kuwonjezera hemophilia A ndi matenda a von Willebrand (kupatula mtundu IIb) pamndandanda.

Zinthu zogwiritsira ntchito ndi contraindication

Kupezeka kwa hypersensitivity kwa yogwira thunthu ndiye kuphwanya kwakukulu. Tiyeneranso kukumbukiranso za polydipsia yachilendo kapena psychogenic. Mankhwalawa sayenera kumwa akumwa mankhwala a diuretic.Anthu omwe ali ndi chidwi chokhazikitsidwa ndi thrombosis amafunikiranso kusiya Minirin.

Angina osakhazikika komanso kukhalapo kwa matenda a Wil Willebrand mtundu IIb amathanso kuwonjezeredwa pamndandandawu. Pali magawo osiyanasiyana ogwiritsira ntchito madontho - ichi ndi chifuwa cha msana ndi mphuno yotupa, kupezeka kwa matenda am'mimba kapenanso kupindika kwa mucosa. M'pofunikanso kuwonjezera kusokonezeka kwa chikumbumtima komanso zinthu zina zofunika kuchita pambuyo pake.

Izi ndizofunikira! Minirin iyenera kumwedwa makamaka kwa anthu omwe ali ndi vuto la impso, chikhodzodzo. Komanso osavomerezeka kwa ana ochepera chaka chimodzi kapena achikulire. Makamaka osamala ayenera kukhala oyembekezera kapena anthu omwe ali pachiwopsezo chowonjezeka kwambiri mukulumikizidwa kwa intracranial. Komanso, mosamala, mankhwalawa amayenera kugwiritsidwa ntchito ndi anthu odwala matenda ashuga ndikuphwanya mulingo wamadzi-electrolyte.

Zotsatira zoyipa:

• Mawonekedwe owawa kwambiri m'mutu,
• Kumverera kotheratu kwa nseru
• Mphuno zam'mimba, komanso mphuno chifukwa cha kuthamanga kwa magazi,
• Compachatory tachycardia,
• Mapaundi owonjezera, omwe amaphatikizidwa ndi kutupa kwathunthu kwa thupi,
• Dry eye syndrome, conjunctivitis imatha,
• Hyperemia wa pakhungu,
• Mawonetsedwe osiyanasiyana amzoipa,

Mankhwala osokoneza bongo amachititsa kuti aledzeretse madzi, zomwe zimapangitsa kukomoka. Kuwonetsedwa kwa mitundu yosiyanasiyana yamitsempha ndi malingaliro ndizotheka. Monga chithandizo, ndibwino kugwiritsa ntchito kuchotsera kwa mankhwalawa.

Pakakhala vuto la bongo, ndikofunikira kupatsa thupi chakudya chowonjezereka, zingafunike kuyambitsa pang'onopang'ono njira zamchere zowonjezera.

Momwe mungatenge Minirin?

Mlingo wamba wa munthu wamkulu umatsika kangapo patsiku. Kuchuluka kwa mankhwalawa kuyenera kukhala kosiyanasiyana mwa 10-40 mcg tsiku limodzi. Ngati ana ali ndi miyezi isanu ndi itatu kufika zaka 12 (mankhwalawa amatha kugwiritsidwa ntchito, koma mosamala kwambiri), ndiye kuti mankhwalawa ayenera kukhala 20 mcg nthawi yogona (yoyenera kuguwa).

Njira ya mankhwalawa imayenera kukhala kwa sabata limodzi, kenako ndikubwereza pambuyo pa miyezi itatu.

Kukonzekera kwamasamba ndikofunikira kwambiri kuti mugone kapena mukhale pansi. Pankhaniyi, ndikofunikira kuponyera mutu wanu kuti mankhwalawo afikire pomwepo. Njira yosavuta yotulutsira imakulolani kuti musinthe kuchuluka kwa madontho. Pofuna kudziwa mphamvu ya impso, mankhwalawa amaperekedwa kwa ana a 10 mcg.

Mulingo waukulu sayenera kupitirira 50 mcg. Mlingo wocheperako kwa munthu wamkulu ndi 20 mcg. Mutapereka mankhwalawa, muyenera kupita kuchimbudzi pang'ono kuti mukachotsetse chikhodzodzo kwakanthawi, osayamwa zakumwa (osachepera maola anayi, koma ndi bwino kuyamba kumwa pambuyo pa maola asanu ndi atatu mutatha kumwa mankhwalawo).

Kufotokozera za mtundu wa kipimo

Mapiritsi ang'onoang'ono, 60 mcg: mozungulira, zoyera, zokhala ndi dontho limodzi mbali imodzi.

Mapiritsi ang'onoang'ono, 120 mcg: mozungulira, yoyera, yokhala ndi madontho awiri mbali imodzi.

Mapiritsi ang'onoang'ono, 240 mcg: mozungulira, yoyera, yokhala ndi madontho atatu mbali imodzi.

Mankhwala

Desmopressin ndi ma analogue a arginine-vasopressin, mahomoni a pituitary mwa anthu. Kusiyana kuli pakupanga kwa cysteine ​​ndi kusintha kwa L-arginine ndi D-arginine. Izi zimabweretsa kukulira kwakukulu kwakanthawi kochedwa ndi kusakhalapo kwathunthu kwa vasoconstrictor.

Desmopressin imawonjezera kupezeka kwa epithelium ya distal confoluted tubules ndikuwonjezera kubwezeretsanso madzi, zomwe zimapangitsa kuchepa kwamkodzo kwamkodzo, kuwonjezeka kwa osmolarity kwamkodzo ndi kutsika kwamodzimodzi mu osmolarity ya plasma ya magazi, kuchepa kwa pafupipafupi kwamitsempha yamitsempha ndi usiku.

Pharmacokinetics

The bioavailability wa desmopressin munthawi yaying'ono pa Mlingo wa 200, 400 ndi 800 μg ndi pafupifupi 0,25%.

C_max plasma desmopressin imatheka mkati mwa 0,5-2 patatha kumwa mankhwalawo ndipo mwachindunji mogwirizana ndi mlingo womwe mwalandira: mutatha 200, 400 ndi 800 μg C_max zinali 14, 30 ndi 65 pg / ml, motsatana.

Desmopressin samadutsa BBB. Desmopressin imachotsedwanso ndi impso, T_1/2 Maola 2.8

Zisonyezero za mankhwala Minirin ®

matenda a shuga

ana azaka zopitilira 6,

nocturia mwa achikulire ogwirizana ndi nocturnal polyuria (kuchuluka kukodza mwa akulu, kupitilira mphamvu ya chikhodzodzo ndikupangitsa kufunika kodzuka usiku koposa kamodzi kutulutsa chikhodzodzo) - monga chizindikiro chothandizira ..

Mimba komanso kuyamwa

Zambiri zokhudzana ndi kugwiritsa ntchito desmopressin mwa amayi apakati omwe ali ndi matenda a shuga insipidus (n = 53) amawonetsa kuti desmopressin siyikukhudza mozungulira njira ya pakati kapena thanzi la mayi wapakati, mwana wosabadwa, kapena wakhanda. Kafukufuku wazinyama sanawululire zowopsa kapena machitidwe owonongeka pakubala, kutaya kwa fetal kapena intrauterine, kubereka mwana kapena chitukuko cha pambuyo pake.

Amayi oyembekezera ayenera kusankhidwa Minirin ® pokhapokha atawunikira mozama maubwino ndi zoopsa zake. Mankhwalawa amalembedwa pokhapokha ngati mayiyo akuyembekezeredwa kuti athandize mayi kuti atulutse chiwopsezo kwa khanda. Gwiritsani ntchito mankhwalawa amayi apakati mosamala, tikulimbikitsidwa kuchita pafupipafupi kuyang'anira magazi.

Kafukufuku wokhudza mkaka wa m'mawere wa azimayi omwe adalandira desmopressin pa mlingo wa 300 mcg mosonyeza kuti kuchuluka kwa desmopressin komwe kumalowa mthupi la mwana ndikochepa kwambiri ndipo sikungakhudze mayikidwe ake.

Mlingo ndi makonzedwe

Pang'onopang'ono (pansi pa lilime), kuti ugwirizanenso. Osamamwa piritsi ndi madzi! Mlingo woyenera wa Minirin ® amasankhidwa payekha.

Mlingo pakati pa mitundu iwiri yapakamwa ya mankhwalawa ndi awa:

Mapiritsi

Mapale Olimba 0,1 mg60 mcg 0,2 mg120 mcg 0,4 mg240 mcg

Mankhwala a Minirin ® ayenera kumwedwa pakudya pambuyo pake kuyamwa kumachepetsa kuyamwa kwa mankhwalawa komanso kugwira ntchito kwake.

Shuga insipidus wa chapakati. Mankhwala oyamba a Minirin ® ndi 60 mcg katatu pa tsiku. Pambuyo pake, mlingo umasinthidwa malinga ndi kuyambika kwa achire. Mlingo wovomerezeka watsiku ndi tsiku uli mumitundu yosiyanasiyana ya 120-720 mcg. Mulingo woyenera kwambiri wokonza ndi 60-120 mcg katatu pa tsiku subling (pansi pa lilime).

Pulogalamu yoyamba yamadzulo. Mlingo woyambira wabwino ndi 120 mcg usiku. Popanda kuchitapo kanthu, mlingowo ukhoza kuchulukitsidwa kukhala 240 mcg. Pa chithandizo, ndikofunikira kuchepetsa kumwa kwamadzimadzi madzulo. Njira yovomerezeka yopitilira chithandizo ndi miyezi itatu. Chisankho chofuna kupitiliza chithandizo chimapangidwa chifukwa cha manambala azachipatala omwe amawonedwa atatha kumwa sabata 1.

Nocturia. Mlingo woyambitsidwa ndi 60 mcg usiku sublingally (pansi pa lilime). Ngati palibe vuto sabata 1, mlingo umakulitsidwa ku 120 μg ndipo kenako 240 μg ndi kuchuluka kwa mankhwalawa pafupipafupi osapitilira 1 nthawi sabata limodzi.

Ngati pambuyo 4 milungu chithandizo ndi kusintha mlingo wokwanira matenda sizinachitike, osavomerezeka kupitiriza kumwa mankhwala.

Wopanga

Catalent Yu.K. Swindon Zidis Ltd., UK.

Bungwe lazamalamulo lomwe dzina lake lalembetsa likuperekedwa: Ffer AG, Switzerland.

Zodandaula za ogula ziyenera kutumizidwa ku adilesi: LLC Fering Pharmaceuticals. 115054, Moscow, Kosmodamianskaya nab., 52, p. 4.

Foni: (495) 287-03-43, fakisi: (495) 287-03-42.

Pankhani yodzanyamula ku Pharmstandard-UfaVITA OJSC, zonena za ogula ziyenera kutumizidwa kwa: Pharmstandard-UfaVITA OJSC. 450077, Russia, Ufa, ul. Khudaiberdina, 28.

Tele./fax: (347) 272-92-85.

Katemera, kapangidwe, mawonekedwe

Mankhwala "Minirin", mtengo womwe umasonyezedwa pansipa, umapezeka m'mitundu iwiri:

• kutsitsi wa ntchito zamkati,
• mapiritsi oyera ndi a biconvex (pakamwa ndi kutsekemera).

Zonsezi, ndi njira zina zikuyimira antidiuretic, analog ya vasopressin. Chithandizo chogwira mankhwalawa ndi desmopressin acetate (desmopressin). Mapiritsiwo amagulitsidwa mumtsuko wa pulasitiki ndi mapaketi am'm cell, ndi kutsina kwammphuno - m'chidebe chogulitsa.

Mitengo mumaofesi a mankhwala ku Moscow

Zomwe zimaperekedwa pamitengo yamankhwala si kupatsa kapena kugulitsa zinthu.
Chidziwitsochi cholinga chake ndi kuyerekezera mitengo yamafesi apamtunda yomwe ikuyenda molingana ndi Article 55 ya Federal Law "On the Circulation of Medicines" ya 12.04.2010 N 61-ФЗ.

Zotsatira za pharmacological

Chithandizo chogwira ntchito cha mankhwala ndi mawonekedwe ake okhala ngati mahomoni achilengedwe ngati arginine-vasopressin. Desmopressin imapezeka ndikusintha kapangidwe ka mamolekyu a vasopressin ndikusintha ma 8-L-arginine ndi 8-D-arginine.

Poyerekeza ndi vasopressin, mphamvu ya mankhwalawa (kuphatikiza ndi luso la antidiuretic) imabweretsa zotsatira zosatchulika pamisempha yosalala yamitsempha yamagazi ndi mitsempha yamagazi. Izi zimapangitsa kuti pakhale zosafunikira zoyipa za spastic chilengedwe.

The pharmacological zotsatira za mankhwala ndi chifukwa chake. Mankhwalawa amatha kuwonjezera kukhalitsa kwa epithelium ya infalated distal tubules yamadzi ndikuwonjezera kubwezeretsanso.

Kugwiritsa ntchito mankhwala a shuga insipidus kumabweretsa kuchepa kwa osmolality a plasma wamagazi ndi kuchuluka kwa mkodzo wothandizidwa, komanso kuwonjezeka munthawi yomweyo kumveka kwamkodzo. Zotsatira zotere zimayambitsa kuchepa kwa pafupipafupi pokodza komanso usiku.

Kulandila kwa 0-0-0.2 mg wa desmopressin amatha kupereka mphamvu yotsutsana ndi maola 9-12.

Zizindikiro za Pharmacokinetic

Kodi ndingamwe mankhwala "Minirin" ndi chakudya? Akatswiri akuti kuphatikiza kotere ndikosayenera. Izi ndichifukwa choti kumayamwa nthawi yomweyo chakudya kumachepetsa kwambiri kuchuluka kwa mankhwalawo pakukonza chakudya (pafupifupi 40%). Kuchuluka kwa mankhwalawa kwa plasma kumachitika pambuyo pa maola awiri. The bioavailability wa desmopressin amasiyana pakati 0.08-0.16%. Mwanjira iyi, chinthu chogwira ntchito sichilowa BBB.

Kuchoka kwa mankhwalawa kumachitika ndi mkodzo (pambuyo pafupifupi maola 2-3).

Mankhwala "Minirin": malangizo ogwiritsira ntchito

Mankhwala ayenera kumwedwa pokhapokha mutatha kudya. Izi ndichifukwa choti chakudya chimatha kuthana ndi mayendedwe achilengedwe komanso kugwira ntchito kwake bwino.

Ndiye kodi mankhwalawa a Minirin amayenera kumwa motani? Mlingo wa chida ichi amasankhidwa ndi dokotala payekhapayekha.

Pamaso penipidus wamkulu wa shuga, mlingo woyenera wa akulu ndi ana ndi 100 mcg katatu patsiku. M'tsogolomu, kuchuluka kwa mankhwalawa kumasinthidwa malinga ndi momwe wodwalayo amayankhira chithandizo. Monga lamulo, mlingo wa tsiku ndi tsiku umasiyana pakati pa 0,5-1.2 mg. Komabe, kwa anthu ambiri, mulingo woyenera wokonza ndi 100-200 mcg katatu patsiku.

Kodi ma ensais akuyenera kuthandizidwa bwanji? Minirin wokhala ndi matendawa amapatsidwa kuchuluka kwa 200 mcg (kutengedwa usiku). Ngati palibe zoyenera, ndiye kuti muyezowo ungathe kuwiriridwa kawiri. Pochotsa kupatuka uku, kuwunika mosamalitsa pakutsatira kuletsa kumwa kwamadzulo ndizofunikira. Njira yopitilira mankhwala ndi masiku 90. Lingaliro la chithandizo chachitali lalitali limapangidwa ndi adokotala okhawo pazidziwitso zamankhwala zomwe zimawonedwa pambuyo posiya mankhwala mkati mwa sabata 1.

Kodi muyenera kumwa bwanji mankhwala a Minirin usiku wa polyuria? Malangizo ogwiritsira ntchito akuti kwa akulu omwe ali ndi vuto lotere, mlingo woyenera ndi 100 mcg (wotengedwa usiku). Ngati kufunika komwe kulibe masiku 7, ndiye kuti mankhwalawa amawiriridwa kawiri, kenako - ndikuwonjezeredwa katatu (pafupipafupi osapitirira kamodzi pa sabata). Pochiza matenda omwe atchulidwa kale, munthu ayenera kukumbukira kuopsa kosungira madzi mthupi.

Ngati mankhwala atatha milungu 4, komanso kusintha kwa mlingo, matendawo samayang'aniridwa, ndiye kuti mankhwalawa sayenera kupitilizidwa.

Zizindikiro zochuluka

Mankhwala osokoneza bongo omwe akufunsidwa amatsogolera kuchuluka kwa nthawi yomwe mankhwalawo achita, komanso chiwopsezo chowonjezereka cha hyponatremia ndi madzi osungidwa m'thupi (kuphatikizapo kutaya chikumbumtima, kugwidwa, ndi zina zambiri).

Monga chithandizo cha hyponatremia, mankhwalawa amasiya, zoletsa zomwe zimamwa madzi zimathetsedwa, kulowetsedwa kwa hypertonic kapena isotonic sodium chloride solution kumachitika.

Zotsatira zoyipa

Mankhwala "Minirin" kwa mwana ndi wamkulu ayenera kuyikidwa malinga ndi zomwe akuwonetsa. Zotsatira zoyipa kwambiri zimawonedwa nthawi zambiri pamene mankhwalawa amachitika popanda kuchepetsa kudya kwamadzi, chifukwa chomwe chikuchedwa, komanso hyponatremia. Zochita zoterezi zimatha kukhala zosasangalatsa kapena kuwoneka ngati mutu, chizungulire, kukokana, mseru, kusanza, mkamwa wowuma, zotumphukira edema, komanso kunenepa kwambiri.

Kuyamwa ndi nthawi ya mimba

Zotsatira zakugwiritsa ntchito mankhwalawa "Minirin" mwa amayi omwe ali ndi matenda a shuga insipidus zimawonetsa kusakhalapo kwa zotsatira zoyipa panjira ya kubereka, komanso thanzi la mayi yemwe ali ndi pakati, mwana wosabadwa ndi mwana wakhanda.

Dziwani kuti kuchuluka kwa desmopressin, komwe kumalowa mthupi la mwana limodzi ndi mkaka wa m'mawere wa amayi, ndikochepa kwambiri kuposa zomwe zingakhudze diuresis.

Mitu ya mankhwalawa

Pali zithunzi zambiri za chida chomwe chikufunsidwa. Monga lamulo, amaperekedwa ngati mankhwalawa sioyenera kwa wodwala pazifukwa zina. Pakati pa mankhwala ochepetsa kwambiri komanso okwera mtengo a analog, kukonzekera kwapabizinesi kotsatira kungadziwike: Adiuretin, Emosynt, Adiuretin SD, Presineks, Apo-Desmopressin, Nativa, Vasomirin, Desmopressin Acetate, Desmopressin.

Ndemanga za madotolo ndi odwala

Odwala omwe amamwa kapena akamamwa mankhwalawo amasiya malingaliro osiyanasiyana za izi. Ambiri aiwo ali ndi chiyembekezo. Ndi yoyenera makonzedwe, mankhwala omwe atchulidwa amathandizadi kugona kwa ana usiku, komanso usiku. Mankhwalawa amalimbananso ndi matenda a shuga apakati.

Komabe, odwala ambiri amati mankhwalawo omwe amatchulidwa nthawi zambiri amayambitsa zotsatira zoyipa. Zina mwazodziwika ndi izi: kupweteka mutu, chizungulire, kukokana, mseru, kusanza, kamwa yowuma, zotumphukira edema, ndi kunenepa kwambiri. Powona zoterezi, madokotala amalimbikitsa kusiya kumwa mankhwalawo.

Tiyeneranso kudziwa kuti kuchuluka kwa malingaliro osalimbikitsa okhudza mankhwalawa "Minirin" kumalumikizidwa ndi mtengo wake. Odwala amati mtengo wamapiritsi mu 1600-1700 ma ruble aku Russia ukupitilira muyeso. Komabe, akatswiri akuti mtengo womwe unawonetsedwa wa mankhwalawo ulibe chifukwa. Awa ndi mankhwala ochokera kunja omwe amalimbana ndi ntchitoyo.

Ngati mulibe ndalama kuti mugule, mankhwalawo amatha kusintha ndi analogues otsika mtengo. Komabe, musanawatenge, muyenera kufunsa dokotala, chifukwa atha kukhala osiyana siyana, zotsutsana ndi njira zogwiritsira ntchito.