"Cyclosporin": malangizo ntchito. "Cyclosporin A": malangizo. M'maso ndi cyclosporine

Mu chikhalidwe, pali zinthu angathe kupondereza ndi chitetezo chokwanira ma ndi humoral mu thupi nyama ikuchitika ndi T-lymphocytes. N'zotheka mopambana limba kupatsa ndi kuchiza matenda kugwirizana ndi chitetezo chakhungu. Mmodzi cyclosporin amenewa ndi mankhwala achilengedwe.

mafotokozedwe

Kutsegula kwa thunthu zokhudzana ndi maphunziro a mafangasi ta Tolypocladium inflatum ndi Cylindrocarpon lucidum. Apanga a wothandizila biologically yogwira monga cyclosporin A ndi C kuonetsa ntchito immunological ndi maselo lymphocytic magazi. Mbali imeneyi woyamba anatulukira mu 1972 asayansi ku "Sandoz" wa labu Swiss. Iwo wapezeka kuti kapangidwe ka cyclosporine mankhwala ndi ndale lipophilic ozungulira endecapeptide ndi amalembedwa yeniyeni kanthu immunosuppressive.

Bukuli lili ndi mankhwala ndi kanthu kusankha pa T-lymphocytes kubisa chitetezo chokwanira pa ma ndi humoral. magazi Cyclosporin kumabwezera mmbuyo ntchito yopanga lymphokines, omwe amachepetsa ntchito lymphocyte, koma alibe mphamvu pa ndondomeko hematopoiesis ndi ntchito phagocytes, kusonyeza kuti kanthu kusankha pawiri mu thupi.

mitundu mlingo

Izo ziyenera Ufumuyo mu zida ndi mankhwala okhala cyclosporin, malangizo Buku. Mwazina, kumaphatikizapo zambiri pa kumasulidwa mtundu wa mankhwala. Kukonzekera wa mankhwala opangidwa mu mawonekedwe:

• makapisozi zofewa ndi mlingo wa 25, 50 ndi 100 mamiligalamu;
• mowa m'kamwa njira ndi mamiligalamu 100 a cyclosporin pa ml ya njira;
• mafuta m'kamwa njira ndi mamiligalamu 100 a cyclosporin pa ml ya njira;
• simuvutika kupanga njira kwa makonzedwe kulowetsedwa ndi 50 650 mamiligalamu wa cyclosporin pa milliliter;
• m'maso ndi micrograms 500 pa milliliter wa cyclosporine.

Malinga ntchito mawonekedwe mlingo adzakhala osiyana; pakuti makonzedwe mkati, kwa jekeseni: pa ntchito apakhungu.

Akukhulupirira kuti mlingo wa mayamwidwe wa chigawo yogwira, kudzikundikira nthawi ya ndende apamwamba mu magazi a kapisozi ndi njira yothetsera phwando mkati amaonedwa ofanana.

Mankhwala "Tacrolimus": Anzawo

Mu msika mankhwala pali mankhwala opangidwa mofanana mawonekedwe mankhwala, ndi kupereka zayamba zotsatira chomwecho. The yogwira pophika nawo cyclosporine. Malangizo ntchito ofanana matanthauzo immunodepressorov kuganizira akhoza mankhwala kupondereza zochita m'thupi.

Mwa mankhwala encapsulated mu khoko lofewa gelatin ndi njira madzi ndi mankhwala pachiyambi "Sandimmun Neoral" opangidwa ndi kampani Swiss mankhwala "Novartis". The mankhwala zina zomwe chinaonekeranso mwa chifaniziro analengedwa ndi zikuchokera woyamba ndi cyclosporin mankhwala. Analogues monga mankhwala "Cyclosporin hexane", "Ekoral", "Tsiklopren" "Cyclosporin A", opangidwa mu mawonekedwe a makapisozi kapena njira yothetsera jakisoni mkati kapena kulandira.

cholinga chawo chachikulu - kuchepetsa Kunyansidwa kupatsidwa zina za ziwalo kapena mafupa. Kuwachitira matenda autoimmune, umboni ndi Ufumuyo mankhwala "Tacrolimus" malangizo ntchito. Analogs ndi makhalidwe ofanana ndi zikuonetsa ntchito.

Limagwirira kanthu "Cyclosporin A" mankhwala

Pa mtima wa kanthu onse mankhwala immunosuppressive ndi zotsatira kusankha pa T-lymphocytes. Nazonso ndi mankhwala "Cyclosporin A". Guide mwatsatanetsatane chimakwirira njira yaikulu zotsatira pharmacodynamic wa chigawo zambiri, ndipo zimenezi chimamanga kwa formations lilime m'kati mwa maselo. Amachepetsa yopanga interleukins ndi interferon amachepetsa mawu a zolandilira kwa IL-2.

Medicament "Cyclosporin A" amachepetsa kupanga chitetezo amalandira maselo yake ndipo zimakhala, amene iwo amaona mlendo ndi kuwononga. Mbali imeneyi zimathandiza inu kuchepetsa matenda immunological ndi kuchepetsa ntchito ya matenda autoimmune.

Great Mwachangu "Cyclosporin A" mu ulemu wa allograft lapansi. Chifukwa kukana zimakhala kuziika ndi ziwalo ndi kutsegula kwa m'thupi maselo T kwaiye. Iwo mwachangu kuyamba kupangidwa pansi zotsatira za antigens kupatsidwa zina kusintha maselo kumezanitsa, kutsogolera ku imfa.

Action immunodepressora kumabweretsa kutsekereza kugwirizana T-maselo chopinga wa T-lymphocytes yanthanda pa zochita m'thupi. Choncho, mphamvu ya mankhwala "Cyclosporin A" (wosuta limauza) limapezeka pokhapo yimitsira wa kumuika antigens. Ndi kuononga ubale Antigen oteteza kupewedwa necrosis a kuziika maselo ziwalo.

N'chifukwa chiyani tiyenera kutsatira

Zikuonetsa Ntchito "Tacrolimus" malangizo ntchito mankhwala ali m'magulu awiri.

Choyamba ndi kupatsidwa zina kapena kupatsidwa zina minofu mwiniwake ndi ziwalo. mankhwala A ntchito popewa kukana podsazhennogo chiwalo kapena minofu. Childs, grafts ntchito khungu, mtima, mafupa, mapapo, chiwindi, impso, kapamba. Mwina ntchito mankhwala kuthetsa kukana pamene atumiki immunosuppressive. Gulu lachiwiri ndi matenda autoimmune mu mawonekedwe kwambiri. Komanso wothandizila Kwalamulidwa kwa dzuwa otsika mankhwala ena.

Kodi matenda timachitira mankhwala "Tacrolimus"? ntchito zizindikiro kuphatikizapo malangizo allocates mitundu wokonda atopic dermatitis ndi neurodermatitis, maonekedwe a psoriasis, nyamakazi, ndi zokhudza mfundo zazing'ono chofuna. Tigwiritse ntchito mu uveitis m'mbali pakati ndi kumbuyo kwa diso pamene chofuna choroid ndi diso, ndi matenda nephrotic ndi timadzi-gormonoustoychivoy chikhalidwe.

malamulo chikuonetseratu

mankhwala tikulimbikitsidwa kokha moyang'aniridwa ndi achipatala m'chipatala. Childs ntchito ntchito mkati kapena mtsempha kukapanda kuleka, ngakhale zokonda zapatsidwa kulandira yankho m'kamwa kapena makapisozi.

Tableware, ntchito pokonza njira jekeseni mtsempha iyenela yopangidwa ndi galasi, mmalo mwa polyvinyl mankhwala enaake kupewa anachita ndi Kasitolo mafuta.

Pakuti dilution wa maganizo ndi ntchito zokhudza thupi peresenti 0,9 njira ya sodium kolorayidi kapena 5 peresenti shuga njira. Dilution ndi m'Matchalitchi kufanana kwa 1:20 1: 100, malingana ndi cholinga. Atchule mankhwala pang'onopang'ono maola awiri sikisi.

Pamaso Thirani ziwalo kapena zimakhala anayambitsa zapatsogolo cyclosporin njira kwa maola pafupifupi zinayi kapena khumi. Pofuna kupewa mawonetseredwe awo sagwirizana mu kufanana yoikidwiratu chithandizo antiallergic ndi immunosuppressants ena. Patatha milungu iwiri ya utsogoleli mtsempha wa mankhwala ndi ntchito m'kamwa. Mlingo tsiku zotchulidwa dokotala anu, anatengedwa kawiri maola khumi ndi ziwiri.

Makapisozi kumwa lonse popanda kutsegula envelopu, ndasambitsa pansi ndi madzi. Mankhwala mu madzi mawonekedwe pamaso ntchito kuchepetsedwa mu madzi akumwa mu beaker galasi. Buku anafotokoza mwatsatanetsatane mmene kungomasula phukusi ndi momwe oyimba njira maphunziro syringe botolo galasi, kuti bwino kusankha kuchuluka kwa mankhwala. Pambuyo kumwa njira chidebe anali chizitsukidwa ndi kumwa madzi, kuti palibe imfa ya mlingo.

ntchito Concomitant ndi contraindicated mankhwala ndi manyumwa madzi, omwe amachepetsa zotsatira za mankhwala, komanso pa mankhwala oletsedwa ndi katemera ndi moyo attenuated ndi Sera ku chikuku, poliyo, chikuku, mumps.

mlingo

Pamene kuziika wamkulu chikuonetseratu akuyamba ndi mlingo tsiku la mamiligalamu 10-14 pa kilogalamu ya kulemera kwa thupi. Patapita masiku asanu ndi khumi ndi zinayi wa chithandizocho anayeza ndi anthu ambiri cyclosporine m'magazi. Iwo zimakhudza mlingo wa mayamwidwe ndi kutembenuka mu thupi. chizindikiro zimenezi n'kofunika kuti aziona pofuna kupewa mavuto ndi kupewa ankachita zoipa ndi mankhwala ena. Kenako, mlingo tsiku la mankhwala yafupika mamiligalamu 3.6 pa kilogalamu ya kulemera kwa thupi, kuti lagawidwa ntchito ziwiri. Achire plasma zili cyclosporin Choncho zimasiyanasiyana nanograms 110 mpaka 410 pa milliliter.

Pambuyo kupatsidwa zina za impso kulandira medicament mu mlingo wa mamiligalamu osachepera atatu kapena anayi pa kilogalamu ya kulemera kwa thupi zingachititse kukanidwa.

Mafupa kupatsidwa zina amafuna kugwiritsa ntchito osakaniza cyclosporine ndi methotrexate. A masiku angapo pamaso pa kumuika wodwala kutumikiridwa tsiku m'nsinga wa ku mamiligalamu 2.5 5 pa kilogalamu thupi zinthu.

Pambuyo pa kusintha kwa mankhwala a kapisozi kuyamba ndi mlingo tsiku la mamiligalamu 12,5 pa kilogalamu ya kulemera kwa thupi, yomwe analandidwa kawiri. Zochiritsira zamtunduwu kuchuluka kwa mankhwala kumatenga miyezi itatu kapena isanu ndi umodzi. Pang'ono ndi kufunika kuchepetsa mlingo mpaka kumalizidwa kwa nyengo mankhwala.

Kuthetsa mkhalidwe pachimake ntchito mlingo woyamba tsiku la mankhwala kwa mamiligalamu 12,5 15 pa kilogalamu ya kulemera kwa thupi (kutenga njira ziwiri). masiku makumi asanu amathera kuchepetsa mlingo wa peresenti asanu mlungu, ndi miyezi isanu kutenga mankhwala mapeto. zina mankhwala "Cyclosporin" medicament nazo nkhani ya anachita mobwerezabwereza. Malangizo ntchito, ndemanga ali ndi mfundo za kupulumuka ziwalo kuziika (mtima, chiwindi). Malinga ndi kafukufuku, chaka chimodzi akatero peresenti makumi asanu ndi atatu.

Chithandizo cha matenda autoimmune amafuna njira yapadera kwa kusankha Mlingo uliwonse matenda.

Polandira "Cyclosporin" kukonzekera malangizo Buku akuonetsa chithandizo cha uveitis kwambiri. Tiyenera kuyamba ndi mlingo tsiku la mamiligalamu 5-10 pa kilogalamu ya kulemera kwa thupi ndipo chitani zomwezo kuchepetsa kutupa ndi normalization wa ntchito zithunzi. The njira ya mankhwala miyezi itatu sikisitini. Mu zotupa choopsa cha kuphatikiza ndi prednisolone pa mlingo wa micrograms 200 600 pa kilogalamu ya kulemera kwa wodwalayo.

Mu psoriasis aakulu mlingo tsiku ndi 2.5 milligram pa kilogalamu ya kulemera kwa thupi, phwando imagwiridwa mu njira ziwiri. Mlingo ndi chinawonjezeka ndi 1 milligram pa kilogalamu ya kulemera kwa thupi, koma palibe mamiligalamu oposa 5 pa kilogalamu, masiku ngati pambuyo makumi atatu pambuyo mwambo wa mankhwala palibe kusintha. Chikuonetseratu kuletsa pambuyo masabata asanu ngati mankhwala operewera.

Nephrotic syndrome ndi ntchito yachibadwa aimpso akuluakulu akukuchitirani ntchito mlingo wa mankhwala kuti mamiligalamu 6 pa kilogalamu thupi ana - mpaka mamiligalamu 5 pa kilogalamu ya kulemera kwa thupi. Ngati ntchito aimpso ndi bwino mlingo - zosaposa 2.5 mamiligalamu pa kilogalamu ya kulemera kwa thupi.

Pa mankhwala ndi okhutira cyclosporin wotiyang'anira mu madzi a m'magazi. Pakuti achire efficacy amafuna ndende zake magazi mu kuchuluka kwa nanograms 60-160 pa milliliter.

M'miyezi itatu yoyambirira ayenera kukhala ndi ulamuliro pa mlingo creatinine ku seramu magazi, monga kuwonjezeka chizindikiro ichi chikhoza kukusonyeza kumukana ndi kuziika chiwalo kapena impso matenda. Kwa anthu amene ali ndi impso ntchito bwino, kuwunika ikuchitika kamodzi pa masiku khumi, ngati pali kuyan'anila, creatinine index chimaonekera masiku seveni aliwonse. Pamene ambiri chizindikiro kuposa micromoles 200 pa lita akuluakulu ndi micromoles oposa 140 pa lita ana anagwira chiyembekezo chakuti mankhwala.

Chifukwa nkotheka zotsatira poizoni mankhwala ikuchitika nthawi kuwunika zili bilirubin, urea, amylase, magnesium ndi potaziyamu ayoni mu magazi, chiwindi michere anatsimikiza.

Nyamakazi ndi aakulu mawonekedwe pankhondo yoyamba masabata asanu ankachitira kukonzekera "Cyclosporin" pa mlingo wa mamiligalamu 2.5 pa kilogalamu ya kulemera kwa thupi, kenako mankhwala ndi mlingo tsiku sayenera upambana mamiligalamu 4 pa kilogalamu ya kulemera kwa thupi. Pamene tolerability osauka medicament ndi zotheka kuchepetsa kuchuluka kwake kwa osachepera mlingo ogwira. Mwina osakaniza "Ciclosporin" mankhwala ndi pang'ono corticosteroids kapena nonsteroidal odana ndi yotupa mankhwala.

mitundu choopsa cha atopic dermatitis amaliona ndi tsiku makonzedwe mankhwala mlingo wa mamiligalamu 2.5 pa kilogalamu ya kulemera kwa thupi. Ngati palibe zotsatira pambuyo pa masiku khumi ndi zinayi zotchulidwa pazipita mlingo tsiku - 5 mamiligalamu pa kilogalamu ya kulemera kwa thupi. Ngati pali kusintha boma, Ndi bwino kuchepetsa pang'onopang'ono mlingo wa mankhwala.

Monga ntchito cyclosporine diso? madontho diso

wothandizila Immunosuppressive akhala akugwiritsidwa ntchito pochiza matenda a maso zochizira msozi. Pakuti zolinga zimenezi, cyclosporine. M'maso nkhani zake (peresenti 0.05) ali akugulitsa pansi pa tradename "Restasis".

wothandizila ili gulu la mankhwala ntchito kuteteza diso ndi humidification. Yopangidwa kukonzekera mu mlingo umodzi wa 0.4 milligram vayozi wa zili mu milliliter imodzi yothetsera 500 mg wa yogwira pophika.

Kodi asatayike limasonyeza cyclosporine? Diso madontho kubala odana ndi yotupa, immunomodulatory tingati ziletsa yopanga lachrymal katulutsidwe pa keratoconjunctivitis youma.

Kodi kugwiritsa ntchito mankhwala "Restasis"

Kwanuko ntchito njira "Restasis" munali cyclosporin. Kagwiritsidwe Guide akuonetsa eyedrops woyamba sansani vial kupeza homogeneous opaque woyera emulsion. Only ndiye inu mukhoza kuyamba kuphunzitsa madontho mu za sac conjunctival wa diso wodwalayo. Ndondomeko ikuchitika kawiri pa tsiku, mawola khumi ndi ziwiri. Kugwiritsa ntchito mankhwala sayenera mphepete mwa diso mucosa vial kuteteza ingress kachilombo mu njira. Nkofunika kukumbukira kuti muyenera kugwiritsa ntchito mankhwala mwamsanga pambuyo kutsegula vial, yankho otsala si ntchito, ndi ntchito.

Palibe mankhwala "Restasis" mankhwala pamene kuvala magalasi kukhudzana. Iwo kuchotsedwa isanafike ntchito njira, ndipo akhoza reinserted pambuyo maminiti khumi ndi asanu okha.

Ntchito cyclosporine nyama

Pakali pano, wothandizila izi immunosuppressive ntchito komanso zochizira matenda autoimmune agalu ndi nyama zina.

Poyamba kuti anthu pogwiritsa ntchito cyclosporine. "Sandimmune" - mafuta njira munali pawiri pano, pamene ntchito ndi odwala osiyana anachititsa ndende zosiyanasiyana yogwira pophika mu madzi a.

zambiri zamakono mtundu analengedwa ndiye - ultramicronized cyclosporine ( "Neoral"). Amachititsa mapangidwe microemulsion m'nthawi mogwirizana ndi madzi. Zimenezi zinachititsa kuti kusintha mayamwidwe ndi bioavailability wa mankhwala zotsutsana ndi njira mafuta omwe si oyenera nyama.

Mlengi wa mtundu Chowona Zanyama mankhwala imatengedwa kampani "Novartis". Namwino mankhwala anamasulidwa mu 2003 wotchedwa "atopic", chinali cholinga zochizira atopic dermatitis nyama. Mpaka nthawi imeneyo, mwamwayi immunosuppressants ntchito amphaka kumuika impso ndi agalu kuti mpumulo wa zizindikiro za njira yotupa.

Zizindikiro za atopic dermatitis zimakhala agalu wamng'ono ndi amphaka a zaka zapakati pa miyezi isanu ndi umodzi zaka zitatu. Ndi matenda aakulu yodziwika ndi musabise kobwereza. Lifunika ankachitira kukonzekera kwa moyo wonse munali cyclosporine. Malangizo ntchito nyamazo "atopic" amatanthauza mfundo kuthekera ntchito nthawi yaitali komanso wotetezeka.

Ndi munthawi yomweyo kudya chakudya ndi mankhwala kusintha mayamwidwe, Ndi bwino kutenga chida mu maora awiri kapena musanadye.

Mwa zotsatira posakonzekera ntchito mankhwala ndi matenda ambiri mu dongosolo m'mimba, koma iwo amaoneka mwa njila yosavuta. zotsatira zina mbali ndi zizindikiro za hypertrichosis, gingival hyperplasia ndi hyperplastic dermatitis. Ndi kuchepetsa mlingo wa mankhwala ndi mofulumira awo pang'onopang'ono.

Kulandira cyclosporin amachepetsa kukula ndi chitukuko cha matenda staphylococcal ndi tizilombo toyambitsa matenda malassezioznogo dermatitis, mu mlingo achire sayambitsa impso kulephera, matenda oopsa, mapangidwe neoplasms. mfundo zonsezi zikusonyeza ngozi yochepa ya mavuto pa nthawi yaitali mankhwala a dermatitis atopic agalu.