Ib yam tsis zoo ntawm hemoglobin concentration yog ib qho ntawm cov cim qhia ntawm ntshav liab. Qhov tseeb, qhov no tseem tsis tau kuaj pom, tab sis tsuas yog cov tsos mob uas ua rau muaj ntau yam kab mob. Kev nce qib ntawm cov kab mob pathology no tuaj yeem qhia tau tias yog thawj qhov mob ntawm cov ntshav.
Erythropoiesis stimulator, paub nyob rau hauv lub ntiaj teb no tsis yog-tus tswv lub npe raws li "Epoetin alfa", yog positioned los ntawm cov lus qhia rau kev siv raws li ib tug zoo reagent, lub pharmacological zog uas yog aimed ntawm kev kho mob thiab kev tiv thaiv ntawm anemia. ntau yam etiologies. Ib qho tshuaj uas tau xaiv zoo tsis yog tsuas yog pab txhim kho cov qauv ntawm cov ntshav, tab sis kuj muaj txiaj ntsig zoo rau kev ua haujlwm ntawm lub plawv cov leeg.
khoom daim ntawv thiab tshuaj muaj pes tsawg leeg
Cov khoom siv tshuaj yog muab rau cov khw muag tshuaj hauv daim ntawv:
- sterile, pov tseg pre-set koob txhaj tshuaj (tsim nrog ntxiv koob tiv thaiv);
- daws teeb meem hauv vials.
Lub luag haujlwm ntawm cov khoom pabcuam yog muab rau:
- xov dej;
- chloride thiab sodium hydrogen phosphate dihydrate;
- polysorbate-80.
Kev ua haujlwm lom neeg ntawm cov tshuaj hauv vials yuav txawv. Feem ntau, qhov no yog ib txhiab lossis ob txhiab thoob ntiaj teb units rau txhua 0.5 ml ntawm cov kua. Txawm li cas los xij, muaj lwm hom reagent muag, suav nrog "Epoetin alfa" 10,000 units / 1 ml.
Mechanism of pharmacological action
Cov khoom lom thiab tiv thaiv kab mob ntawm cov tshuaj synthesized yog kiag li zoo tib yam rau ntuj erythropoietin. Yog li, cov tshuaj no zoo heev inhibits cov tsos mob ntawm anemia thiab kho cov ntshav muaj pes tsawg leeg raws li ib tug raug glycoprotein. Kuv yuav tsum hais tias "Epoetin alfa" feem ntau yog tsom rau kev nce hematocrit thiab normalizing hemoglobin qib. Nws "kev ua haujlwm plawv", nrog rau qhov nyiam ntawm cov khoom siv los txhim kho cov ntshav ntws hauv cov ntaub so ntswg, tsis tshua muaj suab.
Ib nrab neej:
- nrog kev txhaj tshuaj - plaub teev;
- nrog kev txhaj tshuaj subcutaneous - txog ib hnub.
Qhov siab tshaj plaws plasma concentration ntawm reagent yuav tsum cia siab tom qab 12-18 teev.
Pharmacokinetic nuances
Hauv chav kawm ntawm kev tshawb fawb, nws tau pom tias cov tshuaj tau piav qhia ua rau muaj cov tshuaj tiv thaiv kab mob hauv hom "latent", thiab nws cov tshuaj tseem ceeb hauv cov txheej txheem ntawm cov pob txha pob txha fibrosis zero. Cov protein feem ntawm cov tshuaj "Epoetin alfa" muaj li ntawm 165 amino acids (58% ntawm tag nrho cov molecular hnyav), thiab qhov no pom nws.kev xav hauv cov degree thiab qhov zoo ntawm kev cuam tshuam ntawm cov khoom ntawm kev faib / sib txawv ntawm cov hlwb progenitor.
Kev rov ua kom cov hlab ntsha rov qab (thaum tsis muaj lub raum pathologies) tsis ua rau tsub zuj zuj ntawm cov tshuaj nquag; Hauv cov menyuam yaus hnub nyoog qis dua 12 xyoos, qhov ntev ntawm T1 / 2 lub sijhawm mus rau 6 teev yog qhov zoo.
Cov lus qhia rau cov tshuaj
Epoetin alfa raug pom zoo siv yog:
- mob ntshav qab zib tau kuaj pom tias yog ib qho teeb meem ntawm hematopoietic muaj nuj nqi uas nrog mob qog noj ntshav (muaj cov qog tsis yog myeloid);
- tus neeg mob xav tau hemo- lossis peritoneal dialysis;
- muaj lus nug txog kev ua haujlwm phais mob uas siv cov ntshav allogeneic;
- tus neeg mob HIV tau txais kev kho mob zidovudine;
- tiv thaiv kom muaj txiaj ntsig.
Kev noj tshuaj zoo tshaj plaws
Rau cov tshuaj "Epoetin alfa" cov mis rau ib tus neeg xaiv ntawm cov koob tshuaj txhua hnub yog siv tau. Txawm li cas los xij, cov lus pom zoo dav dav ntawm cov chaw tsim khoom raug txo qis rau cov kev cai thiab cov qauv hauv qab no:
- thaum pib ntawm theem kho: tsib caug qhov ua haujlwm (AU) ib kilogram ntawm lub cev hnyav, tab sis tsis pub ntau tshaj peb txhaj tshuaj / infusions ib lub lis piam;
- thaum tsis pom qhov hloov pauv: 75 U / kg ntawm tib lub sijhawm, tab sis tsis ntxov tshaj li ib hlis tom qab pib kho;
- hauv qhov xwm txheej tshwj xeeb: 100-200 U / kg, nruj me ntsis ua raws li lub sijhawm teev tsegtxhaj tshuaj (qib nce ntxiv - 25 units / hli);
- kev kho mob kho: koob tshuaj tau sau tseg kom cov hematocrit nyob rau hauv thaj tsam ntawm 30-35 vol. %
Raws li kev xyaum qhia, "tus qauv" feem ntau yog coj los ua ib qho kev cai ntawm 30-100 U / kg, uas feem ntau yog coj mus rau qhov kawg ntawm kev lim ntshav. Lub sijhawm zoo ntawm kev txhaj tshuaj IV yog ib mus rau ob feeb; Nrog rau cov txheej txheem subcutaneous rau kev xa cov tshuaj nquag, tib txoj cai tau ua raws.
Kev faib tawm ntawm qhov yuav tshwm sim
Hais txog qhov xwm txheej ntawm qhov tsis zoo ntawm lub cev rau qhov muaj cov tshuaj "Epoetin alfa", cov lus qhia rau kev siv qhia cov hauv qab no:
- Kev pom cov tsos mob tshwm sim hauv tus kab mob khaub thuas yog ua tau - kiv taub hau, kev nyuaj siab, tsis muaj zog, kub taub hau, mob pob qij txha / mob leeg;
- tso cai tsis txaus ntseeg hauv kev ua haujlwm ntawm lub plawv thiab cov hlab ntshav - nce siab hauv cov ntshav siab, mob ntshav siab;
- tsis tuaj yeem tsis quav ntsej txog kev pheej hmoo ntawm thrombocytosis (tus kab mob no, txawm hais tias nws ua rau nws tus kheej tsis tshua muaj, yog fraught nrog cov teeb meem loj);
- Cov tshuaj reagent tuaj yeem cuam tshuam rau cov zis los ntawm kev hloov pauv cov poov tshuaj thiab phosphates hauv lub cev (nce qib ntawm cov ntshav creatinine tsis suav nrog).
Ntawm daim tawv nqaij, qee zaum khaus kuj tseem pom tau, provoked los ntawm kev qhia txog cov tshuaj "Epoetin alfa". Cov lus qhia, tshwj xeeb, hais txog pob khaus, eczema, angioedema. Thiab dab tsi yog qhov nthuav: nrog kev txhaj tshuaj subcutaneous, feem pua ntawm qhov hnyav yog ntau dua: ib txhiabQhov nruab nrab cov xwm txheej suav txog li 4 ntu (nrog IV infusions - tsuas yog 1, 6).
Tsis muaj cov ntaub ntawv txhim khu kev qha txog kev tiv thaiv kev hloov pauv uas yuav tshwm sim los ntawm cov tshuaj no (tsuas yog lub peev xwm ntawm cov tshuaj tau hais dhau los txhawm rau txhawb kev tsim cov tshuaj tiv thaiv tsim nyog tau txais kev saib xyuas).
Contraindications tshaj tawm los ntawm cov chaw tsim khoom
Kev txiav txim siab los ntawm cov ntaub ntawv muab hauv phau ntawv tshaj tawm, "Epoetin alfa" (analogues xws li "Binocrit" thiab "Eralfon" hauv qhov no yog ze li qhov ua tau rau tus thawj) yuav tsum tsis txhob siv yog:
- kuaj pom tias tsis tswj tau ntshav siab;
- tus neeg mob yog qhov tsis txaus siab rau cov khoom xyaw;
- kev tshuaj xyuas ua ntej pom tias muaj cov kab mob tseem ceeb ntawm cov kab ntshav;
- tus neeg mob mob plawv (peb tham txog yav dhau los);
- muaj laj thawj ntseeg tias cov ntshav ncig hauv cheeb tsam hauv lub hlwb raug cuam tshuam.
Ib yam lus, kev pib kho yuav tsum ua ntej ntawm kev kuaj mob.
Cov lus qhia tshwj xeeb
"Epoetin alfa" (lub npe lag luam ntawm cov tshuaj zoo ib yam yuav txawv - piv txwv li, nws cov analogues tuaj yeem muab hloov pauv: "Aeprin", "Repoetin-SP", "Epocomb", "Eprex ", thiab lwm yam..) yuav tsum tau siv nrog ceev faj heev rau cov neeg uas raug kev txom nyem los ntawm kev sib tshuam / mob peripheral leeg mob. Txoj cai no yog ib qho tseem ceeb tshwj xeeb tshaj yog tias cov ntu twb tau sau tseg hauv anamnesis raws li cov lus teb ntawm lub cev rau kev noj cov tshuaj.convulsive tshua.
Ceev faj thiab gout yuav tsis mob. Thawj qhov yuav tsum tau muab tso rau hauv cov teeb meem ntsig txog ntshav siab thiab qhov tshwm sim ntawm kev mob taub hau (cov tshuaj tiv thaiv hypertensive yog ib qho ntawm cov kev xaiv rau kev hloov kho cov tshuaj). Txawm li cas los xij, nws yog ib qho tseem ceeb sib npaug los ntsuas qhov tseeb ntawm cov hlau depot (txawm tias ua ntej kev txhaj tshuaj tsis tu ncua). Thaum qhov kev siv ntawm cov kev ntsuas txaus tsis cuam tshuam rau hauv cov ntsuas ntshav siab, kev txais tos ntawm cov khoom lag luam tshuaj tau raug tso tseg.
Peb yuav tsum nco ntsoov tias lub raum tsis ua haujlwm, oncology thiab kab mob HIV tau suav nrog hauv cov npe ntawm cov kab mob, thaum lub sijhawm ntawd, tiv thaiv keeb kwm yav dhau los ntawm kev nce hauv hematocrit concentration, muaj cov yam ntxwv txo qis hauv qib ferritin hauv cov ntshav. ntshav ntshav. Txhawm rau ua kom qhov tsis sib xws, lawv tau hloov kho nrog kev koom tes ntawm Fe-muaj reagents.
Nws raug nquahu kom coj mus kuaj hemoglobin 1 zaug txhua 7 hnub. Tsis tas li ntawd, thaum pib ob lub hlis, yuav tsum tau saib xyuas cov naj npawb ntawm cov platelets. Thiab 5-10 hnub ua ntej kev phais, cov tshuaj uas muaj cov tshuaj tiv thaiv thrombotic raug txhaj rau hauv tus neeg mob cov ntaub ntawv kho mob.
Cov chaw tsim khoom tsis suav nrog tias cov khoom siv ntawm cov tshuaj tuaj yeem cuam tshuam rau qee hom qog nqaij hlav, yog li kev saib xyuas tus neeg mob yuav tsum tsis txhob nres txawm tias tom qab qhov kawg ntawm kev kho mob.
Yuav ua li cas thaum noj tshuaj ntau dhau?
"Epoetin alfa" (synonyms-drugs, los ntawm txoj kev, coj tus cwj pwm zoo ib yam) nrog rau kev ua ntau dhauRaws li cov algorithms embedded nyob rau hauv cov tshuaj formula ntawm recombinant erythropoietin, uas yog, nws provokes polycythemia thiab hematocrit fluctuations. Vim tsis muaj cov tshuaj tiv thaiv classic, tsis muaj kev ntsuas tshwj xeeb los ua kom tsis muaj cov khoom xyaw - cov tshuaj tom ntej no tsuas yog tso tseg.
Kev mob siab phlebotomy muaj feem xyuam rau thaum muaj xwm txheej ceev, thaum qib hemoglobin ntau dhau ua rau muaj kev hem thawj rau lub neej.
Kev sib tham nrog tshuaj
Thaum ua ntau theem kev kho mob, nws yog ib qho tseem ceeb heev kom nkag siab txog cov hauv paus ntsiab lus ntawm "kev coj cwj pwm" ntawm Epoetin alfa reagent (daim ntawv tso tawm, raws li tau hais los saum no, yuav txawv, tab sis cov txheej txheem ntawm biochemical. cov tshuaj tiv thaiv tsis hloov ntawm qhov no).
Yog li, tshwj xeeb, kev tswj hwm tib lub sijhawm ntawm cov khoom siv ntshav muaj txiaj ntsig zoo rau kev noj qab haus huv. Tab sis peb yuav tsum nco ntsoov tias kev sib tov ntawm ib qho kev daws teeb meem nrog lwm qhov yog qhov tsis tsim nyog. Medicinal "union" nrog cyclosporine yog fraught nrog ib tug txo nyob rau hauv lub concentration ntawm lub tom kawg (qhov pom zoo ntim piv ntawm koob tshuaj yog txiav txim empirically).
Kev tshuaj xyuas thiab cov lus pom
Kev tshuaj xyuas cov kev xav tau nthuav tawm qhia tias cov lus nug loj tshaj plaws tshwm sim thaum nws los txog rau kev xaiv los daws qhov teeb meem tib yam. Piv txwv li, ob peb tus neeg mob paub txog qhov sib txawv uas tshwm sim ntawm cov khoom siv tshuaj xws li Epoetin alfa thiab Epoetin beta.
Qhov txawv yog dab tsi - nws yooj yim to taub yog tias koj ua tib zoo mloog cov lus ntawm cov kws kho mob. Qhov tseeb yog tias tus qauv qauv ntawm ntuj erythropoietin yog sawv cev los ntawm ob txoj hlua, thiab ob qho tib si muaj qhov xav tau ntawm cov ntshav. Cov neeg tsim tshuaj, vim qhov sib txawv ntawm cov thev naus laus zis, ua ke ntawm alpha fragment lossis beta.
Raws li kev tshuaj xyuas txog cov tshuaj nws tus kheej, ntau ntawm cov neeg uas yuav tsum tau sim ntawm lawv tus kheej ua tim khawv tias qhov kev kho tau zoo heev, thiab qee qhov tshwj xeeb, qhov tseem ceeb ntawm qee yam ntawm cov neeg mob.
