"Epoetin alfa": umyalelo manual, imihlolo analogue

inqanaba Uncharacteristic ingqalelo mpilo - enye iimpawu kwegazi. Enyanisweni, oku sifo, kodwa uphawu kuphela okuluphawu izifo ezininzi. Inkqubela sifo inokuba sikombisa sisilonda esidumbileyoesingaphakathi ephambili kwinkqubo yegazi.

Le stimulator of erythropoiesis, eyaziwa phantsi ngamazwe igama non-ezizizo njengoko imiyalelo "Epoetin alfa" ukuze zisetyenziswe njengendawo yokusebenza eliphezulu endaweni reagent iipropati amayeza esilithundezela unyango kunye nothintelo anemias of etiologies ezahlukeneyo. oyidlayo Kakuhle okhethiweyo kunceda nje ekulinganiseni isakhiwo candelo, kodwa ibe nempembelelo entle imisipha intliziyo.

ifomu Release nemichiza nokwakheka

Le mveliso amayeza ifumaneka nakwiikhemisti ngohlobo lwe:

• ngesirinji wawuqalekisa ezilahlwayo kunye idosi acwangciswe (uyilo ubonelela iinaliti ukhuseleko olongezelelweyo);
• solution yentsha.

Indima le nto ezixhasayo kunikwa:

• amanzi injectable;
• chloride dihydrate kunye sodium hydrogenphosphate;
• polysorbate-80.

Umsebenzi eziphilayo ukwimo ebhotileni kunokuba ezahlukeneyo. Kwiimeko ezininzi, a iiYunithi amawaka okanye amabini amawaka International nganye 0.5 ml ulwelo. Nangona kunjalo, kukho kwakhona ukuthengisa ezinye iintlobo reagent, kuquka iiPC "epoetin alfa" 10,000. / 1 ml.

Indlela of action imithi

ngokobugcisa kunye ngumzimba imveliso kuhlelwe efanayo erythropoietin zendalo. Ngoko ke, iyeza ngempumelelo kakhulu ayisayicinezeli i iimpawu kwegazi, yaye uyasiqeqesha igazi nje glycoprotein eqhelekileyo. I kufuneka athi "alfa epoetin" lwajoliswa ekwandiseni hematocrit kunye namanqanaba athwala ukuzinza. "Umsebenzi intliziyo," lakhe kwakunye nendlela macandelo ukuze kuphuculwe ukuhamba kwegazi ukuya ancedisana lingaphantsi kubi.

kwesiqingatha sokuqala:

• ngenaliti efakwa - iiyure ezine
• xa zifakwa kwesikhumba nge - malunga ngemini.

Le xi liphezulu a reactant kwi plasma ukuba kulindeleke emva kweeyure 12-18.

bokuqonda pharmacokinetic

Uphononongo lubonise ukuba ichiza echazwe ukhuthaza ukuyilwa antibodies ikwimo "aleleyo", kunye nokubaluleka kwayo amayeza kwiinkqubo lomongo wethambo abanesigulo lisondele ku zero. I protein iqhekeza medicament "Epoetin alfa" iqulathe asidi malunga 165 acid (58% yabo ubunzima iyonke molecule), kwaye oku kubonakala kumlinganiselo kunye nomgangatho macandelo nefuthe ulwahlulo / umahluko kweeseli ukhokho.

Ukuphinda ulawulo efakwa (kungekho ezimbi sezintso) oko kungakhokelela nokwanda ukwimo esebenzayo; abantwana abangaphantsi kweminyaka eli-12 kungenzeka isongezo lamathuba T1 / 2 ukuya kwiiyure ezi-6.

Ubungqina obubonakalayo buxela ukuba

"Alfa Epoetin" kuyacetyiswa ukuba kusetyenziswe ukuba:

• anaemia kwafunyaniswa njenge ukuphazamiseka komsebenzi hematopoietic, okuhambisana umhlaza (kwenzeka ukuba yamathumba non-myeloid);
• isigulane uva imfuneko ihaemodialysis rhoqo okanye dialysis peritoneal ;
• Lo ngumbuzo yokuphumeza utyando nezintsonkothileyo ukusetyenziswa ukutofelwa igazi allogeneic;
• isigulane osuleleke ngayo ngugawulayo nokufumana unyango ngokusekelwe zidovudine;
• Amanqaku ifuna zokuthintela.

Eyiyo abakwisigaba nomthamo

Lokulungiselela "Epoetin alfa", ifomula ukulungiselela ukhetho ngamnye idosi yemihla ngemihla. Noko ke, iingcebiso jikelele umenzi kuphela mithetho nemigangatho:

• e ukulungiswa ekuqaleni iiyunithi amanyathelo kwisigaba amahlanu (IU) ubunzima bomzimba kilogram nganye, kodwa akukho iinaliti / infusions ngaphezu ezintathu ngeveki;
• xa engekho shift ebonakalayo: iiyunithi 75 / kg kwi lekhefu enye, kodwa akukho nyanga ngaphambi kwe enye emva kokuqaliswa zonyango;
• kule meko ezizodwa: 100-200 U / kg, ukubambelela ngokungqongqo athi ishedyuli isitofu (ukunyuka inyathelo - iiyunithi 25 / ngenyanga);
• therapy yesondlo: zedosi elawulwa ngokomlinganiselo esibe kuluhlu hematocrit ka 30-35 vol. %.

Njengoko practice ibonisa, kuba umlinganiselo ukuthathwa "umgangatho" ongowohlobo 30-100 IU / kg, nto leyo edla ukuqhuba ekupheleni dialysis. Ubude ngokupheleleyo i / V ukumnika - nye ukuya imizuzu emibini; inkqubo ukunikezelwa ongama kwezi zinto esebenzayo kwangale miqathango.

Ucalulo yemiphumela emibi kunokwenzeka

On abasabela nemiboniso omzimba Nedlac ukuze ubukho macandelo zeziyobisi "Epoetin alfa" yemiyalezo ingxelo oku kulandelayo:

• ukuba nomfanekiso iimpawu ezithile ukuze iintsholongwane umkhuhlane - nesiyezi kakhulu, ukudakumba, ubuthathaka, ifiva, iintlungu ngokudibeneyo eziqatha / imisipha;
• ukuba ukungalingani intliziyo igazi imithambo - esibukhali ukunyuka koxinzelelo lwegazi, hypertension amabi;
• umntu ngoyaba ingozi thrombocytosis (esi sifo, nangona onesiphumo kunqabile kakhulu, kodwa izaliswe iingxaki ezinkulu);
• reagent inkqubo wokuchama unako ukuphembelela ngokuguqula isixa potassium kunye phosphate emzimbeni (amanqanaba creatinine umgxothwa ukwanda plasma yegazi).

On isikhumba nayo ukukruquka maxa wambi buqapheleke kuxhokonxwa ukuqaliswa yokulungiselela "Epoetin alfa". Imiyalelo, ingakumbi, uthetha irhashalala, nangokhwekhwe, angioedema. Kwaye yintoni umdla: xa ongama-ziphene ipesenti obubungqongo liphezulu kakhulu: kwi-avareji iwaka amatyala, ezenza malunga nesi-4 ngeziqendu (nge / e infusions - 1.6 kuphela).

Phezu utshintsho omzimba eyayiza kubangela uthe into, akukho ulwazi oluthembekileyo (Kuyaphawuleka ngaphandle ukuba amandla okhankanywe ngaphambili beziyobisi aqhubela ukuyilwa omzimba).

Ngokutsho Izimo kumenzi

Ngokusekelwe kule nkcazelo enikwe kwi sikhokelo esemthethweni, "Epoetin alfa" (analogs ezifana "Binokrit" yaye "Eralfon" ngokuphathelele oku likufutshane neloqobo) kufuneka ingasetyenziswa xa:

• unesifo wegazi eyenzeke;
• isigulane nakho hypersensitivity ukuba izithako;
• Uhlalutyo lokuqala wabonisa imigca ezibalulekileyo igazi ezimbi;
• isigulane wahlaselwa yintliziyo (sithetha nje kwixa elidlulileyo);
• kukho isizathu sokukholelwa ukuba ukuphazamiseka kwegazi abaqhelekileyo kwi ebuchotsheni.

Ngamanye amazwi, ukuqala unyango kufuneka lwandulelwe axilongwe.

oyi

"Alpha Epoetin" (tradename ngokokwakheka kuqulunqo efana inokuba nomahluko - umzekelo, abe lilalela ezinokufundiswa analogs "Aeprin", "Repoetin-SP", "Epokomb", "Eprex", njl ...), kufuneka isetyenziswe ukwanda isilumkisa abantu abaneengxaki nezolo / ezingapheliyo kwemisipha yoluvo. Lo mthetho kuyinyaniso ingakumbi xa kukho imbali njengempendulo umzimba ukuya ukutya iziyobisi ezithile sele babhala iziqephu basabele convulsive.

It akuyiphazamisi lomlindi kunye sifo. Nokuphimisela kufuneka kuqala ukubeka kwimibandela enxulumene uxinzelelo lwegazi kunye kukuvela yintloko (antihypertensives - enye izilungiso ikhosi yonyango ezilandelayo). Nangona kunjalo, kubalulekile ngokulinganayo ukuvavanya kunye nemeko lokwenyaniso engoovimba yentsimbi (phambi iinaliti njalo). Xa kusenziwa imisebenzi eyaneleyo kungaboniswanga ngokwemiqathango uxinzelelo lwegazi, ubuchule echazwe imveliso amayeza uvinjwa.

Simele sikhumbule ukuba kidney ukungaphumeleli, umhlaza kunye HIV kuluhlu kwezifo kwikhosi leyo, malunga nemvelaphi xi hematocrit apho, ukuhla iimpawu kwi kumanqanaba ferritin kwi plasma yegazi. Ukuze ukunciphisa ukungalingani okwetyeli kuthomalaliso endaweni ebandakanya reactants Fe-equlethe.

Iisampuli kwalo ke kucetyiswa ukuba kuthathwe 1 ixesha zonke iintsuku ezisi-7. Kwakhona ngexesha kusungulwa leenyanga ezimbini kufuneka esweni rhoqo zegazi count. Ke kaloku iintsuku 5-10 phambi utyando, isigulane ilawulwa izinto ikhadi amayeza ukuba iipropati antithrombotic.

Umenzi akayi kulawula ukuba amacandelo ichiza inokuchaphazela iintlobo ezithile yamathumba, ngoko kusakhelwa isigulane kufuneka ukumiswa nkqu ekupheleni kwesigaba unyango olusebenzayo.

Kufuneka wenze ntoni xa kwimeko libanda?

"Alpha Epoetin" (ntonye-iziyobisi, ngokuzenzekelayo, kwenza ngendlela efanayo) kunye libanda, usebenzela ubuchule ifakwe kwifomula eekhemikhali amayeza erythropoietin ngamanye kudale kwinqanaba hematocrit polycythemia kunye oscillations. Ngenxa yokunqongophala antidotes odidi, amanye amanyathelo ezizodwa ukhupha ulwenziwo singàphunyezwa izithako - irhoxisiwe nje elinye iyeza idinga.

igazi ngabom esebenzayo kwiimeko zonxunguphalo, xa phezu-umda Isalathisi mpilo ibonisa isoyikiso sokwenene ebomini.

Nokusebenzisana Medicines

Ekuqhubeni multi-nqanaba unyango complex kubaluleke kakhulu ukuqonda imigaqo "ukuziphatha amayeza" "Epoetin alfa" reagent (ifom release, njengoko kuchaziwe apha ngasentla, unokuba ezahlukeneyo, kodwa indlela le yokusabela zengqo- akatshintshi).

Ngaloo ndlela, ingakumbi, kufana ukusungulwa iimveliso igazi nempembelelo entle ekuphuculeni amandla. Kodwa simele sikhumbule ukuba ukuxutywa kwesisombululo ye enye azamkeleki. Ichiza "umanyene" cyclosporin izaliswe kunye nokunciphisa ingqalelo le yokugqibela (umlinganiselo kangangoko womthamo we ngokwemithamo uzimisele empirically).

izimvo

Uhlalutyo iimbono ibonisa ukuba nani likhulu imibuzo xa kuziwa kwi iinketho ezikhoyo zokusombulula ingxaki efanayo. Ngokomzekelo, bambalwa izigulana owayesazi umahluko ezenzekayo phakathi iimveliso amayeza, njengabo "epoetin alfa" yaye "epoetin beta."

Yintoni umahluko - eqondeka kakuhle, ukuba sinikela ingqalelo izimvo oogqirha. Inyaniso ukuba umfuziselo noshowo erythropoietin yendalo zimelwe ngemixokelelwane emibini, kunye nezo ziphumo zinqwenelekayo kwinkqubo yegazi baye zombini. Abavelisi amayeza efanayo, ngenxa umahluko kwezobugcisa, okanye nokulungelelanisa Alpha-Isiqwenga okanye beta.

Njengoko ngokuba izimvo ekulungiseleleni ngokwayo, abaninzi kwabo ukuzama kuwe, ibonisa ukuba ithetha kuyaphumelela kakhulu, kwaye kwezinye iimeko ezizodwa yaye onke neemfanelo iindidi ezithile izigulane.