"Cyclosporin": umarnin don amfani. "Cyclosporin A": wa'azi da shi. Ido saukad da cyclosporine

A yanayi, akwai abubuwa iya suppressing da salon salula da kuma humoral barã'aa cikin dabba jiki za'ayi da T-lymphocytes. Yana yiwuwa a samu nasarar gudanar da wani sashin jiki transplants kuma mu bi cututtuka dangantawa da sosai rigakafi da tsarin. Wata irin wannan cyclosporin ne na halitta mahadi.

description

Opening na abu alaka da nazari na fungal damuwa Tolypocladium inflatum da Cylindrocarpon lucidum. Hada da ilimin aiki jamiái kamar cyclosporin A da C nuna immunological aiki da lymphocytic jini Kwayoyin. Wannan yanayin na farko gano a 1972 da masana kimiyya daga "Sandoz" na Swiss Lab. An gano cewa, da sinadaran tsarin na cyclosporine ne tsaka tsaki lipophilic cyclic endecapeptide da alama takamaiman immunosuppressive mataki.

Yana dogara ne a kan kwayoyi da zabe mataki a kan T-lymphocytes kashe salula da kuma humoral rigakafi. Cyclosporin jini damuarn samar da lymphokines, wanda rage lymphocyte aiki, amma ba shi da wani sakamako a kan aiwatar da hematopoiesis da aikin phagocytes, na nuna cewa zabe mataki na fili a cikin jiki.

sashi siffofin

Yana yana zuwa da za a haɗe a cikin kit da magani dauke da cyclosporin, umurci manual. Daga cikin wadansu abubuwa, shi ya hada bayani a kan a saki nau'i na da miyagun ƙwayoyi. Shirye-shirye na wannan abu samar a cikin hanyar:

• m capsules tare da wani sashi na 25, 50 da kuma 100 milligrams.
• giya baka bayani da 100 milligrams na cyclosporin da ml na bayani.
• mai baka bayani da 100 milligrams na cyclosporin da ml na bayani.
• mayar da hankali ga yi wani bayani domin jiko gwamnati da 50 da kuma 650 milligrams na cyclosporin da milliliter.
• ido saukad da 500 micrograms da milliliter na cyclosporine.

Dangane da yin amfani da sashi form zai zama daban-daban: for ciki gwamnati, domin allura, domin Topical aikace-aikace.

An yi imani da cewa kudi na sha na aiki bangaren, da jari lokaci na cincirindo a jini na kwantena da kuma bayani ga ciki liyafar suna dauke m.

Drug "Tacrolimus": takwarorinsu

A pharmaceutical kasuwar akwai da dama da kwayoyi samar a cikin wannan pharmaceutical tsari, da kuma samar da ma cikin irin wannan tasirin. The aiki sashi a gare su shi ne cyclosporine. Umurnai na yin amfani da ma'ana immunodepressorov la'akari interchangeably kwayoyi zuwa kashe rigakafi halayen.

Daga cikin magunguna encapsulated a wani m gelatin harsashi da ruwa mafita shi ne asalin miyagun ƙwayoyi "Sandimmun Neoral" samar da Swiss Pharmaceutical kamfanin "Novartis". A wasu kwayoyi dauke sake bugawa a cikin hoton halitta da farko abun da ke ciki tare da wani abu cyclosporin. Analogues kamar kwayoyi "Cyclosporin hexane", "Ekoral", "Tsiklopren" "Cyclosporin A", samar a cikin nau'i na capsules ko wani bayani ga ciki ko karbar injections.

Su babban manufar - rage kin amincewa a dasawa da kayan ciki, ko bargo. Bi da su kamar yadda autoimmune cututtuka, kamar yadda evidenced da a haɗe zuwa da miyagun ƙwayoyi "Tacrolimus" umarnin don amfani. Analogs da irin wannan halaye, da kuma alamomi don amfani.

Ginshikai na mataki "Cyclosporin A" miyagun ƙwayoyi

A zuciya na duk mataki na immunosuppressive kwayoyi ne a zabe sakamako a kan T-lymphocytes. Babu togiya da miyagun ƙwayoyi "Cyclosporin A". Guide, daki-daki maida hankali ne akan babban sunadaran pharmacodynamic effects na aiki bangaren, da ta ɗaure su da tsoka mai amsa sigina tsarin a cikin sel. Rage-rage samar da interleukins da interferon rage magana da rabe ga Il-2.

Medicament "Cyclosporin A" rage samar da antibodies directed a kansa Kwayoyin kuma tsokoki, wanda suka la'akari da dan hanya, kuma ya halaka. Wannan yanayin ba ka damar rage immunological cuta da kuma rage aiki na autoimmune cututtuka.

Great yadda ya dace "Cyclosporin A" a game da allograft. Dalilin kin amincewa da transplanted tsokoki da kuma gabobin ne kunnawa da rigakafi T Kwayoyin generated. Su rayayye fara da za a samar a karkashin sakamakon dasawa antigens da shafi dasa Kwayoyin, abu zuwa ga mutuwa.

Action immunodepressora take kaiwa zuwa tarewa mahada T-Kwayoyin da hanawa da T-lymphocytes bayyana a cikin rigakafi halayen. Saboda haka, tasiri na da miyagun ƙwayoyi "Cyclosporin A" (mai amfani da ya nuna wannan) ya auku ne kawai bayan da danniya na dashi antigens. By lalata dangantaka antigen antibody hana necrosis na transplanted gabobin Kwayoyin.

Me nema

Alamomi ga Amfani "Tacrolimus" umarnin don amfani da miyagun ƙwayoyi ne zuwa kashi biyu Categories.

Na farko shi ne dasawa ko dasawa da bayarwa da nama da kuma gabobin. A magani amfani da su hana kin amincewa da sashin jiki ko nama podsazhennogo. Yawanci, da grafts amfani da fata, zuciya, bargo, huhu, hanta, koda, pancreas. Zai yiwu amfani da miyagun ƙwayoyi domin kawar da kin amincewa lokacin da wasu immunosuppressive jamiái. Sinfi na biyu shi ne wani autoimmune cuta a cikin mai tsanani form. Har ila yau, wakili wajabta ga low yadda ya dace da sauran kwayoyi.

A abin da cututtuka mu bi da miyagun ƙwayoyi "Tacrolimus"? don amfani a alamomi ciki har da wa'azi allocates m siffofin atopic dermatitis da neurodermatitis, manifestations na psoriasis, rheumatoid amosanin gabbai, da kuma cewa rinjayar da kananan gidajen abinci ne inflamed. Zai yiwu amfani a uveitis a tsakiyar da kuma raya sassa na ido lokacin da inflamed choroid kuma akan tantanin ido, da kuma nephrotic ciwo da kuma hormone-gormonoustoychivoy yanayi.

m dokoki

Drug magani bada shawarar kawai a karkashin likita dubawa a wani asibiti. Yawanci amfani da ciki aikace-aikace ko igiyar jini drip, ko da yake son ne da aka ba su sami baka bayani ko capsules.

Tableware, amfani ga shirya wani bayani ga igiyar jini allura dole ne a yi ta da gilashin, maimakon na polyvinyl chloride don kauce dauki tare da Castor man.

Domin dilution na tattara amfani da wani physiological 0.9 bisa dari bayani daga sodium chloride , ko kashi 5 cikin dari glucose bayani. Dilution da aka aikata a cikin rabbai daga 1:20 zuwa 1: 100, dangane da wannan manufa. Gabatar da miyagun ƙwayoyi sannu a hankali daga biyu zuwa shida hours.

Kafin transplanting gabobin ko kyallen takarda gabatar a gabãnin cyclosporin bayani ga kamar hudu zuwa goma hours. Don hana rashin lafiyan bayyananen a layi daya nada antiallergic magani da kuma sauran immunosuppressants. Bayan makonni biyu da igiyar jini gwamnati da miyagun ƙwayoyi da baka aikace-aikace. A kullum kashi wajabta ta your likita, dauka sau biyu a sa'a goma sha biyu.

Capsules sha dukan ba tare da bude ambulan, wanke saukar da ruwa. Da miyagun ƙwayoyi a cikin ruwa nau'i kafin amfani diluted a cikin ruwan sha a gilashin beaker. The manual bayyana a cikin daki-daki, yadda za a fitad da kaya da kunshin da kuma yadda za a gwada wani bayani kammala karatunsa sirinji na gilashi kwalban, domin yadda ya kamata zabi da hakkin adadin magani. Bayan da shan bayani ganga aka rinsed da ruwa da kuma sha ruwa, da cewa babu wani asarar kashi.

Concomitant amfani ne contraindicated kwayoyi da kuma garehul ruwan 'ya'yan itace, wanda rage sakamako daga cikin miyagun ƙwayoyi, kuma a lokacin jiyya haramta ta alurar riga kafi tare da live attenuated da Sera daga rubella, cutar shan inna, cutar kyanda, mumps.

sashi

Lokacin da transplanted adult m farawa da kullum kashi na 10-14 milligrams da kilogram na jiki nauyi. Bayan bakwai zuwa goma sha hudu da kwana magani ne auna ta maida hankali cyclosporine a cikin jini. An rinjayi da kudi na sha da kuma hira a cikin jiki. Wannan nuna alama ne da muhimmanci a saka idanu, a domin su hana illa da kuma kauce wa mummunan interactions da sauran kwayoyi. Bayan nan, da kullum kashi na magani an rage wa 3.6 milligrams da kilogram na jiki nauyi, shi ne zuwa kashi biyu amfani. Warkewa jini abun ciki na cyclosporin haka dabam daga 110 zuwa 410 nanograms da milliliter.

Bayan dasawa na kodan samun medicament a kashi na kasa da uku zuwa hudu milligrams da kilogram na jiki nauyi zai iya sa kin amincewa.

Bargo dasawa bukatar yin amfani da wani hade da cyclosporine da methotrexate. A kwanakin kafin dashi haƙuri ne gudanar kullum intravenously na daga 2.5 zuwa 5 milligrams da kilogram jiki nauyi abubuwa.

Bayan da miƙa mulki ga lura da capsules fara da kullum kashi na 12.5 milligrams da kilogram na jiki nauyi, wadda aka dauka a matsayin sau biyu. Hanyoyin kwantar da hankali da irin wannan yawa daga cikin miyagun ƙwayoyi yana daga uku zuwa watanni shida. A hankali da bukatar rage sashi har ƙarshe na lura lokaci.

Don kawar da wani m yanayin amfani na farko kullum kashi na magani daga 12.5 zuwa 15 milligrams da kilogram na jiki nauyi (dauki ra'ayoyin biyu). Hamsin kwanaki ciyar sashi akan rage kashi biyar bisa dari na mako, da kuma bayan watanni biyar na shan miyagun ƙwayoyi gama. ƙarin magani "Cyclosporin" medicament kwashe a hali na maimaita dauki. Umarnin don amfani, comments dauke da bayani game da rayuwa da transplanted gabobin (zuciya, hanta). Bisa kididdigar da, shekara guda ta kai tamanin cikin dari.

Jiyya na autoimmune cututtuka na bukatar na musamman m zuwa zabi na allurai domin kowane cuta.

By samun "Cyclosporin" shirye-shiryen koyar da manual bada shawarar jiyya na tsanani uveitis. Dole ne mu fara da kullum kashi na 5-10 milligrams da kilogram na jiki nauyi da kuma tsaya ga shi don rage kumburi da kuma daidaita gani aiki. A hanya na lura shi ne uku zuwa goma sha shida watanni. A tsanani raunuka na hade tare da prednisolone a kashi na 200 zuwa 600 micrograms da kilogram na haƙuri nauyi.

A tsanani psoriasis kullum kashi ne 2.5 milligram da kilogram na jiki nauyi, liyafar da aka yi a cikin biyu fuskanci. A sashi ne ya karu da 1 milligram da kilogram na jiki nauyi, amma ba fiye da 5 milligrams da kilogram, idan bayan kwana talatin bayan qaddamarwa na far, babu wani ci. Kudin shiga soke bayan makonni shida idan lura shi ne m.

Nephrotic ciwo tare da al'ada na koda aiki a manya daukarsu amfani da sashi daga cikin miyagun ƙwayoyi zuwa 6 milligrams da kilogram jiki nauyi a yara - har zuwa 5 milligrams da kilogram na jiki nauyi. Idan koda aiki ne sosai, sashi - ba fiye da 2.5 milligrams da kilogram na jiki nauyi.

A lokacin jiyya da cyclosporin ciki ana kula a cikin jini jini. Domin warkewa inganci na bukatar ta maida hankali a cikin jini a cikin wani adadin 60-160 nanograms da milliliter.

A lokacin farko da watanni uku dole ne iko da creatinine matakin a jini magani, kamar karuwa a wannan nuna alama iya sigina na farkon na kin amincewa da wani transplanted sashin jiki ko koda cuta. Domin mutanen da suke da kodan suna aiki yadda ya kamata, da bincike ne da za'ayi sau daya a kowace kwana goma sha huɗu, idan akwai hakki, creatinine index aka auna kowane kwana bakwai. Lokacin da taro na nuna alama fiye da 200 micromoles da lita ga manya da kuma fiye da 140 micromoles da lita yara kwashe yarjejeniyoyin da miyagun ƙwayoyi.

Saboda da zai yiwu mai guba sakamakon da miyagun ƙwayoyi ne da za'ayi lokaci-lokaci monitoring daga cikin abun ciki na bilirubin, urea, amylase, magnesium da potassium ions a jini, hanta enzymes aka ƙaddara.

Rheumatoid amosanin gabbai ne mai tsanani nau'i a lokacin farko shida makonni bi da shirye-shiryen "Cyclosporin" a wani kashi na 2.5 milligrams da kilogram na jiki nauyi, bi da magani tare da kullum kashi kada wuce 4 milligrams da kilogram na jiki nauyi. Lokacin da matalauta tolerability na medicament ne mai yiwuwa a rage adadin da m tasiri kashi. Zai yiwu mai hade da "Ciclosporin" miyagun ƙwayoyi da kananan adadin corticosteroids ko nonsteroidal anti-kumburi kwayoyi.

M siffofin atopic dermatitis da aka bi da kullum gwamnatin miyagun ƙwayoyi a cikin kashi na 2.5 milligrams da kilogram na jiki nauyi. Idan akwai wani sakamako bayan kwana goma sha huɗu wajabta iyakar kullum kashi - 5 milligrams da kilogram na jiki nauyi. Idan akwai kyautata a jihar, shi ne shawarar a hankali a hankali rage a cikin kashi na magani.

Kamar yadda amfani cyclosporine ido? ido saukad

Immunosuppressive jamiái da aka yi amfani da ophthalmology domin lura da bushe ido. Domin wadannan dalilai, cyclosporine. Ido saukad da abinda ke ciki (0.05 bisa dari) an kasuwanci a karkashin tradename "Restasis".

Wannan wakili nasa ne da kungiyar magunguna amfani kare cornea da humidification. Samar shiri a cikin guda kashi na 0.4 milligram vials daga cikin abun ciki a cikin daya milliliter na bayani da 500 MG na aiki sashi.

Abin da magunguna nuna cyclosporine? Ido saukad da nuna anti-mai kumburi, immunomodulatory sakamako, hana samar da lachrymal mugunya a lokacin bushe keratoconjunctivitis.

Yadda za a yi amfani da miyagun ƙwayoyi "Restasis"

Gida amfani wajen "Restasis" dauke da cyclosporin. Anfani Guide bada shawarar eyedrops farko girgiza vial kafin su sami wani yi kama opaque fari emulsion. Kawai sai za ka iya fara domin qarfafa saukad da cikin da conjunctival jakar kwai na haƙuri da ido. Wannan hanya ne da za'ayi sau biyu a rana, da zarar kowane sa'a goma sha biyu. A da ake ji da miyagun ƙwayoyi kamata ku shãfe gefen ido mucosa vial su hana ingress kamuwa da cuta a cikin bayani. Yana da muhimmanci a tuna cewa kana bukatar ka yi amfani da magani nan da nan bayan bude vial, sauran bayani ne ba amfani, shi da ake amfani.

Babu magani "Restasis" miyagun ƙwayoyi a lokacin da saka lambar sadarwa ruwan tabarau. Suna cire kafin amfani da bayani, kuma za a iya reinserted bayan kawai minti goma sha biyar.

A amfani da cyclosporine ga dabbobi

A halin yanzu, wannan immunosuppressive wakili da ake amfani da ma domin lura da autoimmune cututtuka a karnuka da sauran dabbobi.

Da farko kawai ga mutane ta amfani da cyclosporine. "Sandimmune" - mai bayani dauke da ba fili, a lokacin da amfani da daban-daban marasa lafiya ya sa wani daban-daban taro na aiki sashi a cikin jini.

more zamani nau'i an halitta sa'an nan - ultramicronized cyclosporine ( "Neoral"). Ana sa da samuwar wani microemulsion a lokacin da hulda da ruwa. Wannan ya kai ga wani ci gaba a cikin sha da kuma bioavailability da miyagun ƙwayoyi a matsayin adawa da man fetur bayani wanda bai dace da dabbobi.

Mai ƙãga halittar dabbobi nau'i na da miyagun ƙwayoyi ne dauke da wani kamfanin "Novartis". Lasisi miyagun ƙwayoyi da aka saki a 2003 da ake kira "atopic", shi ne aka yi nufi ga jiyya na atopic dermatitis a dabbobi. Har sai wannan lokacin, informally immunosuppressants amfani ga dashi koda bala'in domin taimako na bayyanar cututtuka na kumburi tafiyar matakai.

Alamun atopic dermatitis yawanci bayyana a cikin matasa da karnuka da maguna tsakanin zamanai na watanni shida zuwa shekaru uku. Yana da wani kullum cutar halin da maimaita dakwai, komowan cutar. Yana bukatar da za a bi lifelong shiri dauke da cyclosporine. Umarnin don amfani da dabbobi "atopic" na nufin maki da yiwuwar amfani da shi lokaci mai tsawo ya kamata da kuma amince.

Tare da lokaci daya abinci ci da magani ga canje-canje a sha, shi ne shawarar ya dauki kayan aiki a sa'o'i biyu bayan ko kafin abinci.

Daga cikin niyya ba sakamakon amfani da miyagun ƙwayoyi ne ya fi kowa cuta a cikin narkewa kamar tsarin, amma aka nuna su a wani sauƙi hanya. Sauran illa akwai ãyõyi na hypertrichosis, gingival hyperplasia da hyperplastic dermatitis. By rage sashi daga cikin miyagun ƙwayoyi ne su sauka a hankali bacewar.

Karbar cyclosporin rage girma da bunkasar staphylococcal cututtuka da kuma pathogens malassezioznogo dermatitis, a warkewa kashi ba sa koda gazawar, hauhawar jini, samuwar neoplasms. Duk wadannan hujjoji nuna low hadarin da rikitarwa a lokacin dogon lokacin da magani daga atopic dermatitis a karnuka.