Octreotide ndi analogue yopanga mankhwala Somatostatin, ili ndi mankhwala ofanana, koma ili ndi nthawi yayitali. Mankhwalawa amathandizira kupondereza kuchuluka kwa mahomoni opanga kukula, ma insulin, serotonin, gastrin, glucagon, thyrotropin.
Poyerekeza ndi zachilengedwe somatostatin, mankhwala opangira amachepetsa kubisalira kwa kukula kwa mahomoni mwamphamvu kwambiri kuposa insulin ya mahomoni. Ndi acromegaly, kupweteka kwambiri m'mutu, kutupa m'matumbo ofewa, hyperhidrosis, kupweteka kwapawiri, paresthesia kumachepa. Kukula kwa chotupa mu pituitary adenomas yayikulu kumacheperanso.
Octreotide imathandizanso kupititsa patsogolo matendawa atachitidwa opaleshoni, chemotherapy, kuphatikizira kwa mitsempha ya chiwindi. Ngati pali zotupa zama carcinoid, mankhwalawa amachepetsa kuchuluka kwa serotonin m'magazi, amathetsa m'mimba komanso kuthamanga kwa magazi pankhope.
Zochita zamankhwala
Pamaso pa chotupa cha pancreatic chifukwa cha matumbo a vasoactive, kutsegula m'mimba kwambiri kumachepa ndipo, chifukwa chake, wodwalayo amakhala bwino. Nthawi zina, michere yama mankhwala amachepetsa kapena kuyimitsa chotupa chopita patsogolo, kuchepetsa kukula kwake ndikuchepetsa kuchuluka kwa peptides mu plasma.
Mankhwalawa sakukhudza kuchuluka kwa shuga m'magazi pamaso pa matenda a shuga, chifukwa chake, wodwalayo ayenera kumwa mankhwala ochepetsa shuga. Octreotide imathandizanso kutsegula m'mimba, pomwe nthawi imodzimodziyo imapangitsa kuti munthu akhale wowonda.
Pozindikira matenda a Zollinger-Ellison, mankhwalawa amatha kuchepetsa kuchuluka kwa hydrochloric acid m'mimba, kuchepetsa gastrin m'magazi, ndikuchepetsa m'mimba komanso kuthamanga kwa magazi. Chithandizo chitha kuchitika palokha komanso mophatikizana ndi mankhwala ena omwe adokotala amafufuza.
- Ngati pali insulinoma, mankhwalawa amachepetsa kwambiri insulini yogwira ntchito m'magazi, koma njira yothandizira achire imakhala yochepa ndipo imatha osaposa maola awiri. Munthawi yogwira ntchito, mwa anthu omwe ali ndi chotupa chogwira ntchito, Octreotide imabwezeretsa ndikuwonetsa ma glycemic indices.
- Pamaso pa chotupa chosowa kwambiri chomwe chimayamba chifukwa cha kukula kwa mahomoni, zizindikiro zotchulidwa za acromegaly zimachepetsedwa ndikumapondereza kupanga kwa mahomoni. Mtsogolomo, chithandizo chimayambitsa pituitary hypertrophy.
- Mukapezeka ndi immunodeficiency syndrome, mankhwalawo amatha kupindika bwino kapena pang'onopang'ono, omwe mankhwalawo amachititsa kuti mankhwalawo asamavutike kwambiri.
- Ngati mukufuna kuchita opaleshoni, Octreotide imatengedwa isanachitike komanso itatha opareshoni. Izi zimachepetsa chiopsezo cha zovuta za postoperative mu mawonekedwe a pancreatic fistula, abscess, pancreatitis pachimake.
Komanso, kugwiritsa ntchito mankhwalawa kumatsimikiziridwa pamaso pa cirrhosis. Kuvulala kumalepheretsa magazi kutuluka m'mitsempha ya varicose ndi esophagus, komanso kumathandizanso wodwalayo kuti azikhala wodwala. Mankhwalawa amachitika limodzi ndi njira zazikulu zamankhwala.
Mwambiri, mankhwalawa ali ndi malingaliro abwino kuchokera kwa madokotala ndi odwala.
Kugwiritsa ntchito mankhwala osokoneza bongo
Mankhwala ataperekedwa ndi dokotala kuti apatsidwe mosakwiya kapena m'mitsempha, mankhwalawo amayamba kuyamwa nthawi yomweyo. Pazipita ndende yogwira pophika wamagazi imawonedwa theka la ola pambuyo pakupereka mankhwala.
Ngati yankho la mankhwalawa lidaperekedwa mosavomerezeka, Octreotide amachotsedwa m'thupi ola limodzi ndi theka atatha kubayidwa. Ndi jekeseni wamkati, chimbudzi chimachitika m'magawo awiri, pambuyo pa mphindi 10 ndi 90. Kuphatikizira kwakukulu kumatulutsidwa m'matumbo, ndipo gawo lachitatu la thunthu kudzera mu impso.
Mwayi wokwanira wamankhwala amtundu wa thupi ndi 160 ml pamphindi. Nthawi yomweyo, mwa anthu okalamba, magazi amatsuka pang'onopang'ono chifukwa cha kuchuluka kwa moyo. Ndi matenda aimpso aakulu kulephera, chilolezo chimacheperanso kawiri.
Mankhwala othandizira amagwiritsidwa ntchito:
- Acromegaly kuwongolera mawonetseredwe akuluakulu a matendawa ndikuchepetsa kukula kwa mahomoni pamene opaleshoni yamankhwala othandizira ndi radiation alibe zotsatira;
- Pachimake kapamba komanso ngati prophylaxis atachitidwa opaleshoni pamimba;
- Kutulutsa magazi makamaka ngati zilonda zam'mimba ndi duodenum;
- The kukhalapo kwa carcinoid zotupa molumikizana ndi carcinoid syndrome;
- Ma tumor a kapamba omwe amapanga ma peptides oyipa a m'matumbo;
- Zollinger-Ellison matenda osakanikirana ndi mankhwala oyambira;
- Kuzindikiridwa ndi glucagon, insulin, somatoliberin.
Ndikofunika kumvetsetsa kuti mankhwalawa sagwiritsidwa ntchito ndi mankhwalawa omwe amachotsa zotupa, kotero amatha kugwiritsidwa ntchito ngati kuwonjezera pa regimen yayikulu yamankhwala. Octreotide amatha kuletsa kutaya magazi ndi mitsempha ya varicose yam'mimba ndi esophagus mwa anthu omwe ali ndi matenda a cirrhosis.
Mankhwalawa sungagwiritsidwe ntchito pochiza ana ndi achinyamata ochepera zaka 18. Komanso, contraindication imaphatikizapo hypersensitivity pazigawo za mankhwala. Chisamaliro chapadera chikuyenera kuchitika ngati munthu ali ndi matenda a shuga komanso matenda a gallstone. Musanagwiritse ntchito mankhwalawa, amayi oyembekezera komanso oyamwa ayenera kufunsa dokotala.
Malangizo ogwiritsira ntchito mankhwalawa
Octreotide ndi njira yowoneka bwino, yopanda utoto ya jakisoni wamkati ndi wamkati. Mankhwala amagulitsidwa m'makatoni okhala ndi Mlingo wa 50, 100, 300 ndi 600 mcg
ml, kutengera kuchuluka kwa ma ampoules komanso zomwe zili mu 1 ml.
Zosagwira ntchito ndi madzi a jakisoni ndi sodium chloride. Mutha kugula yankho muchipatala chilichonse mukamapereka mankhwala a dokotala.
Ndi jekeseni wamkati, ma ampoule amayenera kuyang'aniridwa kuti yankho lisakhale ndi zosayera. Madziwo ayenera kuwotenthetsedwa kuti akhale kutentha. Tsegulani ma ampoule nthawi yomweyo jakisoni, yankho lomwe latsala litatayidwa. Kubayira kuyenera kuchitika m'malo osiyanasiyana a thupi kuti asayambitse mkwiyo pakhungu.
- Ngati mtsempha wa intravenous akugwiritsa ntchito dontho, ndiye kuti madzi amawumitsidwa ndi 0,9% sodium kolorayidi nthawi yomweyo isanachitike. Mchere wokonzeka umaloledwa kuti usungidwe mufiriji masana muzikhala kutentha kwa madigiri 2-8.
- Ngati pali pancreatitis pachimake, Mlingo wa 100 μg umathandizidwa katatu patsiku kwa masiku asanu. Kupatula, mlingo wa tsiku ndi tsiku ungathe kuwonjezeka mpaka 1200 mcg.
- Pambuyo pakuchita opaleshoni pa kapamba, chithandizo cha subcutaneous cha 100-200 mcg chimagwiritsidwa ntchito. Mlingo woyamba umaperekedwa maola awiri asanachitidwe opaleshoni, ndiye kuti pambuyo pa ntchito, jakisoni amapangidwa katatu patsiku kwa sabata.
- Pofuna kuletsa magazi kulowa zilonda zam'mimba, kulowetsedwa kumachitika. Kupitilira masiku asanu, wodwalayo amapatsidwa 25-50 mcg pa ola limodzi. Momwemonso, mankhwalawa amachitika chifukwa cha magazi kuchokera ku mitsempha ya varicose yam'mimba ndi kummero.
Ndi acromegaly, mlingo woyambirira ndi 50-100 μg, yankho limaperekedwa maola onse asanu ndi atatu kapena khumi ndi awiri. Ngati mulibe zotsatira zabwino, mankhwalawa amakwera 300 mcg. Kutalika kwa tsiku limodzi kumaloledwa kugwiritsa ntchito zosaposa 1500 mcg wa mankhwalawa.
Ngati pambuyo pa miyezi itatu mlingo wa mahomoni okula sanachepe, mankhwalawo amachotsedwa ndikuwabweza ndi ofanana nawo.
Zotsatira zoyipa
Mankhwalawa ali ndi zovuta zina. Nthawi zambiri, mukalandira chithandizo, odwala amatha kuona zizindikiro zam'mimba kapena kudzimbidwa, nseru, kutuphuka, komanso kupweteka m'mimba.
Mtundu wa chopondapo ukusintha, ndipo ndowe zamafuta ochulukirapo zimamasulidwa, m'mimba mumawoneka odzaza komanso olemera. Chosimbacho chimakhala chofewa, pamakhala kusanza, kupukusa chakudya kumasokonekera, kulemera kumachepera.
Komanso, dokotala amatha kudziwa za cholelithiasis, cholecystitis, hyperbilirubinemia. Colloidal solid of bile imalephera, chifukwa omwe ma miccrystals a cholesterol amapangidwa. Kuphatikizira kumatha kuwulula bradycardia, ndipo nthawi zina - tachycardia.
- Mwa zina zoyipa, hyperglycemia ndi hypoglycemia zimatha kusiyanitsidwa, chithokomiro cha chithokomiro chimasokonekera, kusintha kwa kulolera kwa glucose.
- Munthu akhoza kudwala chifukwa cha kupuma movutikira, kupweteka mutu, chizungulire cha nthawi.
- Kuthamanga ndi kuyabwa pakhungu, ming'oma imayamba, ndipo nthawi zina tsitsi limagwa. M'dera la jakisoni, ululu ukhoza kumva.
Ndi hypersensitivity yowonjezereka, anaphylactic angayambire. Kuphatikiza anthu ena ali ndi arrhasmia. Koma zizindikiro zoterezi zimawerengedwa kuti sizimadziwika, chifukwa chiyanjano cha zinthu zotere sichinadziwikebe.
Octreotide imathandizira kuchepetsa kuyamwa kwa mankhwala a cyclosporine, kuonjezera bioavailability wa bromocriptine, kuchepetsedwa kuyamwa kwa cimetidine, kuchepetsa kagayidwe kamankhwala omwe amachititsa ma enzymes a cytochrome P450.
Ngati mukumwa mankhwala a insulin panthawi yomweyo, muthandizire ndi mankhwala a hypoglycemic, glucagon, calcium blockers, beta-blockers ndi okodzetsa, mlingo uyenera kusinthidwa.
Popewa zovuta, munthawi yamankhwala, ndikofunikira kuwunika mwadongosolo kuchuluka kwa shuga m'magazi, makamaka pakakhala magazi chifukwa cha mitsempha ya varicose ya kum'mero kwa chiwindi.
Zizindikiro zoterezi zimapangitsa kuti chiwopsezo chiziwonjezereka.
Zolemba za Octreotide
Pali mankhwala ambiri omwe ali ndi vuto lofanana ndi thupi. Izi zikuphatikizapo mankhwala Sermorelin, Sandostatin, Octrid, Genfastat, Diferelin. Jenereta Octreotide Depot ndi Octreotide Long amakhalanso ndi chinthu chofananira.
Mtengo wake umatengera wopanga, kuchuluka kwake ndi kuchuluka kwa zochulukirapo, mufamuyo mtengo wamankhwala otere umasiyana ndi ma ruble 600 mpaka 3500.
Njira yothetsera vutoli ikhoza kukhala pamalo owuma, kutali ndi ana komanso dzuwa lowongolera. Mkhalidwe womwe umasungidwa mankhwalawa ndi madigiri 8-25. Moyo wa alumali sukupitilira zaka zisanu, pambuyo pake yankho lake liyenera kutayidwa, ngakhale silinatsegulidwe.
Momwe mungachiritsire khansa ya kapamba akufotokozedwa mu kanema munkhaniyi.
