U ka sebelisa Sandostatin joang bakeng sa pancreatitis?

Tlhaloso e amanang le 05.08.2015

• Lebitso la Latin: Sandostatin
• Khoutu ea ATX: H01CB02
• Lintho tse sebetsang: Octreotide
• Moetsi: Novartis Pharma (Switzerland)

1 ml ea tharollo bakeng sa tsamaiso ea iv le s / c e na le 50, 100 kapa 500 μg ea ntho e sebetsang octreotide.

Vial e le 'ngoe ea li-microspheres bakeng sa ho hlophisoa ha ho emisoa bakeng sa tsamaiso ea i / m Sandostatin Lar e na le 10 mg ea karolo e sebetsang ka foromo octreotide acetate.

Tekanyetso le tsamaiso

Sandostatin e laeloa bakuli kamora ho buuoa ka pancreatic ka ho eketsoa ke pancreatitis. Moriana o fokotsa bohloko ba pelo, hobane ho fokotseha ha sebopeho sa enzyme ho emisa ts'ebetso ea ts'ebetso ea ho senyeha hoa litho tsa setho.

Ka mokhoa o sa foleng oa pancreatitis, Sandostatin e nolofalletsa maemo a bakuli, e thusa ho fokotsa palo ea ho ts'oaroa. Sandostatin ka ampoules e fuoa bakuli ka mokhoa o sa tsitsang, ka methapo, kahare ka ho kenella makhetlo a 3 ka letsatsi. Li-Dropper li etsoa pakeng tsa lijo le pele u robala. Ho hlahisoa ha Sandostatin ho etsoa hora e le 'ngoe pele ho ts'ebetso le matsatsing a 7 ka mor'a eona. Litekanyetso li beoa ke ngaka e tsamaeang ka bonngoe, ho latela mofuta oa lefu lena. Moriana o qala ho sebetsa metsotso e 5 kamora ho qala ts'ebetso.

Litlamorao

Ka kalafo ea Sandrostatin, litla-morao li ka hlaha. Ho tloha ka mpeng ea ka mpeng, ho nyekeloa ke pelo, ho hlatsa, ho sithabela ha setuloana, ho ruruha, cholecystitis, ho hlaha ha majoe ka har'a pampitšana ea biliary, keketseho ea litaba tsa bilirubin le li-enzymes tsa sebete maling, le ho hlonama mpeng. Ho ka ba le mathata a pelo, methapo le endocrine:

• hypothyroidism (ho hloka mosebetsi oa qoqotho),
• mathata a metabolic a glucose 'meleng,
• bradycardia (lebelo la pelo le liehang),
• pelo lippitations,
• hlooho e bohloko.

Ka ho se mamellane likarolo tsa Sandostatin, ho ka ba le lintho tse ngata tse ka kulang.

Ho sebelisana le lithethefatsi tse ling

Ka tlhokomeliso, Sandostatin e lokela ho sebelisoa hammoho le li-beta-blockers le lithethefatsi tsa diuretic. Ha e kopantsoe le cyclosporine, phello ea morao e ea fokotseha. Sandostatin e nang le insulin e laetsoe ka hloko. Tabeng ena, ho hlokahala ho laola sethala sa tsoekere maling. Sandostatin e fokotsa ho kenngoa ha cimetidine. Ho ikamahanya le joala ha hoa lumelloa. Setlhare ha se na phello ea ho khanna koloi.

Sebopeho le mofuta oa tokollo

Ntho e sebetsang ea lithethefatsi ke octreotide, e leng analogue ea maiketsetso ea hormone somatostatin. Setlhare se tsoa ka tsela ea tharollo ea ente (ampoules) kapa lyophilisate, eo tharollo e lokiselitsoeng ho eona.

Ampoule e le 'ngoe e nang le bophahamo ba 1 ml e na le tekanyetso ea 0,05-0.1 mg ea ntho e sebetsang. Ntle le tharollo e felileng, moriana o hlahisoa ka mokhoa oa phofo, o tlotsoang pele o sebelisoa ka har'a khatello e hlokahalang.

Sokolla foromo le sebopeho

Mofuta oa litekanyetso tsa Sandostatin e lokolloang ke tharollo bakeng sa tsamaiso ea methapo le e sa sebetseng: ho hloka mebala, ho pepeneneng (ka ampoules ea 1 ml, ka karete ea karete ea likarete tse 5 kapa tse 10).

Sebopeho sa 1 ml ea tharollo:

• ntho e sebetsang: octreotide (e le peptide ea mahala) - 50, 100 kapa 500 μg,
• likarolo tse ling: sodium bicarbonate, lactic acid, mannitol, carbon dioxide, metsi a ho entoa.

Mofumahali

Ntho e sebetsang ea Sandostatin ke octreotide - octapeptide, analogue ea matla a tlhaho somatostatin, e nang le litlamorao tse tšoanang tsa litheko, empa ketso ea nako e telele haholo.

Octreotide e hatella secretion ea kholo ea kholo (GH), e eketsehang le ho hlaha ka lebaka la insulin hypoglycemia, ts'ebetso ea 'mele, le ho pepesehela arginine. Sandostatin e boetse e thibela secretion ea insulin, serotonin, gastrin le glucagon, e eketsehang ea methapo ea kelello kapa ka lebaka la phepelo ea lijo. E hatella secretion ea glucagon le insulin e susumetsoang ke arginine, hammoho le secretion ea thyrotropin e bakoang ke thyroliberin.

Ho fapana le somatostatin, octreotide e hatella secretion ea GR ka tekanyo e kholo ho feta secretion ea insulin. Setlhare ha se lebise ho hypersecretion e latelang ea lihormone (mohlala, lihormone tsa kholo ho bakuli ba nang le acromegaly). Ka acromegaly, Sandostatin e fokotsa maemo a plasma a GH le kholo ea insulin-factor factor (IGF-1). Ho bakuli ba 90%, ho na le ho fokotseha ha khatello ea GH ka bonyane 50%, ha boemo ba GH ka tlase ho 5 ng / ml bo ka fihlelisoa ho hoo e ka bang 50% ea linyeoe. Ho bakuli ba bangata ba nang le acromegaly, lithethefatsi li fokotsa ho ruruha ha lisele tse bonolo, ho teba ha hlooho ea hlooho le hyperhidrosis, paresthesia le bohloko bo kopaneng. Ka li-adenoma tse kholo tsa pituitary, Sandostatin e ka fokotsa boholo ba tumor.

Octreotide e ka ntlafatsa tsela ea lefu lena ha le sa sebetse hantle kalafo (hepatic artery embolism, opereishene, chemotherapy, ho kenyelletsa le 5-fluorouracil le streptozotocin) ea tumello ea sephiri ea "endocrine" ea "gastrointestinal" le "pancreas". Kahoo, ka marang a nang le carcinoid, Sandostatin e fokotsa botebo ba lets'ollo le maikutlo a ho sutumetsa sefahleho, hangata a tsamaeang le ho fokotseha hoa khatello ea plasma ea serotonin le excretion ea 5-hydroxyindoleacetic acid morong. Ka li-tumor tsa VIP tse nang le hyperproduction ea vasoactive intestinal peptide (VIP), lithethefatsi maemong a mangata li fokotsa letšollo le matla la sephiri, ka lebaka leo, li ntlafatsa boleng ba bophelo ba mokuli haholo. Ka nako e ts'oanang, ho ferekana ho kopaneng ho tekanyetso ea electrolyte (mohlala, hypokalemia) hoa fokotsoa, ​​e leng se etsang hore ho hlakoloe tšebetso ea botsamaisi le ea entriki ea li-electrolyte le metsi. Ho bakuli ba bang, Sandostatin e lieha esita le ho emisa tsoelo-pele ea hlahala, e fokotsa boholo ba eona, le boholo ba metastases ea sebete. Ntlafatso ea tleliniki, joalo ka molao, e tsamaisana le ho fokotseha kapa ho tloaeleha ha khatello ea plasma ea VIP.

Ka glucagonomas, octreotide e fokotsa migrans ea erythema. Ho tsoekere ea lefu la tsoekere, lithethefatsi ha li ame ho teba ha hyperglycemia, ka hona tlhoko ea li-hypoglycemic agents kapa insulin hangata e lula e sa fetohe. Ka lebaka la phokotso ea lets'ollo, ho ka ba le keketseho ea boima ba 'mele. Mme leha ho fokotseha hoa khatello ea "plasma" ea glucagon tlasa ts'usumetso ea Sandostatin e le ha nakoana sebopeho, ntlafatso maemong a bongaka e tsitsitse nakong eohle ea ho sebelisa moriana.

Ho gastrinomas / Zollinger-Ellison syndrome, ts'ebeliso ea octreotide e le setheoana se le seng kapa hammoho le histamine H blockers₂-receptors kapa proton pump inhibitors li ka lebisa ho fokotseha ha hypersecretion ea hydrochloric acid ka mpeng, ho fokotseha hoa khatello ea gastrin ka plasma ea mali le ho teba ha mahlaseli a chesang le lets'ollo.

Ho bakuli ba nang le insulinomas, Sandostatin e thusa ho fokotsa boemo ba insulin e maling maling (phello ena e ka ba ea nakoana, ho fihlela lihora tse 2). Ha ho na le lihlahala tse sebetsang, moriana o ka khutlisetsa le ho boloka standardoglycemia nakong ea ts'ebetso. Ka li-tumor tse sa sebetseng le tse mpe, taolo ea glycemic e ka ntlafala ntle le ho fokotseha hoa nako e telele ka nako e telele molemong oa insulin maling.

Ho bakuli ba nang le hlahala tse sa tloaelehang tse hlahisang li-hormone tsa kholo ea ho hola (somatoliberinomas), Sandostatin e fokotsa botebo ba matšoao a acomegaly, hobane e thibela sephiri sa kholo ea ho hola ea hormone le ho hola hoa hormone ka boyona. Nakong e tlang, ho fokotseha ha pituitary hypertrophy le hona hoa khoneha.

Ha ho tsoa mali ho tsoa methapong ea varicose ea esophagus le mala ho bakuli ba nang le lefu la cirrhosis, ho kenyelletsoa ha octreotide kalafong e itseng (mohlala, ho sclerotherapy) ho ka emisa ho tsoa mali hantle le ho thibela ho phetoa hape, ho fokotsa palo ea tšelo le ho ntlafatsa pholoho ea matsatsi a 5. Ho lumeloa hore mochine oa tšebetso oa Sandostatin o bakoa ke ho fokotseha ha phallo ea mali a setho ka lebaka la khatello ea lihormone tse tsoekere tse kang glucagon le VIP.

Ho bakuli ba bontšitsoeng bakeng sa ts'ebetso ea pancreatic, Sandostatin, e sebelisoang nakong ea ha le ka mor'a ho buuoa, e fokotsa ts'oaetso ea mathata a tloaelehileng a postoperative (mohlala, postoperative acute pancreatitis, pancreatic fistula, sepsis, abscesses).

Ka lets'ollo le hanoang ho bakuli ba nang le Acquired Immunodeficiency Syndrome (AIDS), Sandostatin ka botlalo kapa ka tsela e sa lekanyetsoang setulo maemong a ka bang 30% ha lets'ollo le sitoa ho laoloa ka kalafo e nepahetseng ea antidiarrheal le / kapa antimicrobial.

Mofumahali

Kamora tsamaiso ea subcutaneous, octreotide e potlaka ebile e kenella ka botlalo. Palo e phahameng ea plasma e fihla metsotso e ka bang 30.

Ka liprotheine tsa plasma li tlama ho 65%. Puisano le lisele tsa mali ha e na taba. Boholo ba phepelo - 0,27 l / kg. Tlhahiso e felletseng ke 160 ml / min.

Kamora ho ente ea subcutaneous, halofo ea bophelo (T_½) - Metsotso e 100 Ho tlosoa hoa lithethefatsi kamora hore tsamaiso ea methapo e kenngoe ka mekhahlelo e 'meli, T_½ ke 10 le 90 min, ka ho latellana. Palo e kholo ea lithethefatsi e hlobolisoa mantle, hoo e ka bang 32% - ka moroto o sa fetohe.

Matšoao a ho sebelisoa

• acromegaly: ha e na katleho e lekaneng ea radiation / kalafo ea kalafo e le ho laola lipontšo tse ka sehloohong tsa lefu lena le maemo a tlase a GR (hormone ea kholo) le IGF-1 (insulin-like ukukhula factor) ho plasma, haeba mokuli a hana ts'ebetso kapa haeba ho na le litlolo bakeng sa ts'ebetsong ea eona, haufinyane Phekolo mahareng a lithuto tsa radiation ho fihlela nako eo phello ea eona e ntlafalitsoeng ka botlalo,
• ho pata li-tumellano tsa "endocrine tumors" ea mokokotlo (gastrointestinal) le manyeme (bakeng sa taolo ea matšoao): Li-VIP, glucagonomas, tumor ea carcinoid e hlahang le lefu la carcinoid, insulinomas (bakeng sa kalafo ea tlhokomelo le taolo ea hypoglycemia nakong ea ts'ebetso) , e khetholloang ke hyperproduction of releasing factor GR), gastrinomas / Zollinger - Ellison syndrome (hangata e le hammoho le tšebeliso ea li-blockamine H blockers₂li-receptors le proton pump inhibitors). Re lokela ho hopola hore Sandostatin ha se setlhare sa antitumor, mme ts'ebeliso ea eona ha e lebise kalafong ea bakuli bona.
• letšollo le hanyetsang ho bakuli ba AIDS (ho laola matšoao),
• mathata a ka mor'a ho buuoa ka pancreatic (bakeng sa thibelo),
• ho tsoa mali ho tsoa methapong ea varicose ea ka mpeng le esophagus le cirrhosis ea sebete (hammoho le mehato e itseng ea kalafo (mohlala, endoscopic sclerotherapy) ho emisa ho tsoa mali le ho thibela ho oela hape.

Contraindication

Phoso e felletseng ea kalafo ke ho ba teng ha hypersensitivity ho likarolo tsa moriana.

Ho latela litaelo, Sandostatin e lokela ho sebelisoa ka hloko maemong a latelang:

• cholelithiasis,
• lefu la tsoekere
• boimana
• nako ea ho anyesa.

Pholiso ea thepa

Theko: Ho tloha ho 1750 ho isa ho 1875 li-ruble.

Lithethefatsi li na le phello ea antithyroid 'meleng, ha tlhahiso ea lihormone tse kang TSH le STH e fokotseha, e tlatsetsang pontsong ea phello ea antispasmodic. Sandostatin e na le phello e ikhethang moetlong oa tšilo ea lijo - e fokotsa tšusumetso le tlhahiso ea lero la gastric. Tlas'a tšusumetso ea sethethefatsi sena, thibelo ea secretion e eketsehileng ea serototin le kholo ea kholo (tlhahiso ea eona e etsoang ka kotloloho ke tsamaiso ea endocrine), hammoho le li-peptide, lia bonoa.

Moriana o ama mofuta oa lihormone tsa kholo haeba ho e-na le insulin hypoglycemia, e thibela secretion ea glucogan, gastrin, li-peptide tse ling, hammoho le insulin. Octreotide e emisa ts'ebetso ea tlhahiso ea thyrotropin tlas'a tšusumetso ea thyroliberin. Kamora ho tsamaisoa ha tharollo tlasa letlalo, hypersecretion ea lihormone ha e tlalehiloe.

Bathong ba nang le lefu la ho ferekana, setlama sena ha se fokotsa feela letšoao la li-hormone tsa kholo, empa le somatomedin A maling. Phekolo ea kalafo e etselitsoeng e ka fetofisa boemo ba lihormone tsa kholo ho 50% ea bakuli.

Ho bakuli ba nang le hlahala ea "carcinoid tumor", matšoao a boloi a fokotsehile haholo, sethethefatsi se laola boemo ba serotonin, pampitšana ea gastrointestinal, mme "ho chesa" ho tlosoa.

Ho li-pathologies tse khetholloang ka mokhoa o mongata oa secretion ea "peptide" ea vasoactive, ho nka octreiotide haholo ho ntlafatsa bophelo bo botle, mme ho leka-lekana ha electrolyte ho khutlela ho tloaelehileng ka kalafo. Ho bohlokoa ho hlokomela hore maemong a 'maloa ho ata ha lefu lena hoa emisa, palo ea neoplasm e fokotseha, menyetla ea ho hasanya metastases ho sebete e fokotseha.

Batho ba nang le lets'ollo ba sa khaotseng ba hlokomela ho fokotseha ho hoholo hoa lona khahlano le nalane ea kalafo ka octreotide. Ka lebaka la sena, hoa khoneha ho nolofatsa boima ba 'mele, ho fokotsa sekhahla sa tsoekere' meleng. Sandostatin hangata e khothalletsoa ho sebelisoa hammoho le li-blockers tsa H2 receptor, hammoho le li-inhibitors tsa proton, tseo ka tsona li nang le phello e ntle ho teba ha matšoao a fapaneng le boemo ba gastrin (ho fokotseha hoa bonahala).

Tlas'a tšusumetso ea lithethefatsi, ho fokotseha ha tekanyo ea insulin e sa sebetseng ho tlalehiloe ho batho ba fumanoeng ba na le insulinoma (phello e ntle e bonoa nakong ea lihora tse peli). Batho ba nang le neoplasm e sebetsanang ba hlokomela ho bolokoa hoa standardoglycemia kamora ho buuoa.

Ka tlhahiso e feteletseng ea hormone ea ho hola e lokollang, ho fokotseha ho teba ha matšoao a acromegaly. Matla ana a fumaneha ka ho thibela tlhahiso ea lihormone tsa kholo, hammoho le ntlha ea eona ea tokollo. Kamora nako, bophahamo ba mofets'e oa "hypertrophied pituitary" "oa fokotseha.

Ka kalafo ea Sandostatin, lethargy e felisoa, hlooho e neng e bonoa pele e nyamela, matšoao a hyperhidrosis, bohloko masapong le manonyeletsong hammoho le neuropathy ea peripheral.

Litla-morao le ho sebelisa overdose haholo

Nakong ea kalafo, nts'etsopele ea bohloko ba ka mpeng, litlhaselo tsa ho nyekeloa, lets'ollo, lefutso, ho eketseha hoa boemo ba li-enzyme tse nang le microsomal, steatorrhea, alopecia ha ho ahloloe kantle ho thupelo e mpe ea hepatitis, hyperbilirubinemia, keketseho ea index ea GGT e ka rekota.

Kamora kalafo ea nako e telele, mamello ea tsoekere e ka fokotseha, mathata a pancreatitis, hypoglycemia, nts'etsopele ea cholelithiasis, lipontšo tsa mafu le ho hlaha ha hyperglycemia e phehellang ho khonahala.

Ho ka etsahala hore maikutlo a tukang, pontšo ea bohloko ba lehae, a ruruhe setsing sa ente.

• Ho opeloa ke mala
• Ho hlaha ha "maqhubu"
• Likotsi tsa ho nyekeloa ke pelo
• Ho fokotseha ha sekhahla sa pelo
• Abdominal spastic syndrome.

Pontšo ea kalafo ea matšoao.

F-Synthesis, Russia

Theko ho tloha ho 616 ho isa ho 23800 rub.

Octreotide ke lithethefatsi tse tšoanang le Sandostatin, e nang le phello e kang somatostatin 'meleng. E bontšoa bakeng sa kalafo le thibelo ea li-pathologies tse fapaneng tsa endocrine. E hlahisoa ka mokhoa oa tharollo ea ente.

Melemo:

• E ka laeloa bakeng sa pancreatitis e etsahalang kamora ho buuoa
• E thibela nts'etsopele ea seoperis ea postoperative
• Ho khaola lets'ollo la Reflex ho AIDS.

Chelete:

• Hyperbilirubinemia e ka hlaha nakong ea phekolo
• E ke ke ea kopantsoe le joala.
• E fanoe ke lengolo la ngaka.

Tlhahisoleseling ea lithethefatsi

Sandostatin ke analog ea maiketsetso ea somatostatin ea motho. Ka har'a 'mele oa motho, hormone ena ea protheine e hlahisoa libakeng tse peli: hypothalamus le lihlekehlekeng tsa endocrine tsa manyeme. Ntho ena e sebetsang ea bioloji e na le phello e sitisang ho hlahisoa ha li-hormone tse 'maloa ka nako e le' ngoe: thyrotropin le kholo ea kholo, hape e fokotsa secretion ea insulin, cholecystokinin, gastrin, glucagon.

Ntho ea mantlha ea lithethefatsi Sandostatin ke octreotide, analogue ena ea maiketsetso e bontšoa ke ketso e telele ho feta somatostatin ea tlhaho.

Sandostatin e etsoa ka mokhoa oa tharollo ea ente kapa lyophilisate bakeng sa ho e lokisa. Ampoule e le 'ngoe e nang le bophahamo ba 1 ml e kanna ea ba le tekanyetso ea 0,05 mg kapa 0,5 mg ea ntho e sebetsang.

Lethathamo la matšoao a sebelisoang

Ho latela litaelo tsa moriana, tšebeliso ea Sandostatin e laoloa ke moetsi maemong a latelang:

1. Acromegaly.
2. Li tumor tse hlahisang li-hormone tsa "endocrine" tsa "manyeme" le "gastrointestinal" (Zollinger-Ellison syndrome, li-tumor tsa carcinoid moo ho nang le lefu la carcinoid, VIPoma, insulinoma, jj.
3. Ho tsoa mali ho tsoa methapong ea varicose ea esophagus (e le karolo ea kalafo e felletseng).
4. Thibelo ea mathata a teng ho bakuli ba kenang lipakeng tsa pancreatic.

Hlokomela! Sandostatin ha e na thepa ea lithethefatsi tsa antitumor mme e ka se sebelisoe e le monotherapy bakeng sa li-pathologies tsa oncological.

Ho sebelisana le meriana e meng

Kaha Sandostatin e na le ts'ebetso e hlophisehileng 'meleng oa mokuli, tšebeliso ea eona e ka hloka phetoho ea lithethefatsi tsa meriana e meng eo mokuli a ntseng a e fumana.

Ka lebaka la bokhoni ba li-hormone ba ho ama sekhahla sa pelo le molumo oa pelo, khalemelo ea li-antiarrhythmics (beta blockers) le li-antihypertensive agents (li-calcium channel blockers, diuretics, jj.) Hangata ho hlokahala.

Ts'ebeliso ea bromocriptine ha e bapisoa le Sandostatin e lebisa ntlafatsong ea bioavailability ea ergot alkaloid ena. Empa mabapi le sethethefatsi se seng sa ergot, phello e fapana ka ho felletseng: ho kopana ha Cyclosporin le Sandostatin ho baka ho fokotseha ho kenyelletsoa ha cytostatic.

Ho boetse ho na le tlhoko ea tokiso ea litekanyetso tsa lithethefatsi tse fokotsang tsoekere ea mali, mme haeba mokuli a fumana insulin e ka kenang, ho tla hlokahala hore a fuoe lipalo tsa hae hape.

Sandostatin e baka ho putlama ha cimetidine mme e fokotsa index ea lithethefatsi tse hlahisoang ke sisteme ea cytochrome.

Pancreatitis le kalafo ea eona

Pancreatitis (ho ruruha ha manyeme) e hlaha ka lebaka la khaello ea phepo e nepahetseng, ho noa joala haholo le kofi e ngata, ts'ebeliso ea lithethefatsi tse ling, mafu a tsamaiso ea methapo le mathata a mang a mangata. Naoloji ena e na le mefuta e 'meli ea ho teba ho fapaneng: ho hlobaetsang le ho sa foleng, kalafo eo e fapaneng haholo.

Ntho ea bohlokoa ea pancreatitis ke timetso ea makhopho ke lintho tsa tlhaho tseo le tsona li li hlahisang. Ka tloaelo, nts'etsopele ea mathata a joalo e amahanngoa le ho thibela ho tsoa ha maro a pancreatic ka methapo ho kena ka mpeng e nyane, e lebisang ho bokelleng ha li-enzyme kahare ho li-lobules tse li hlahisang, ts'ebetso ea peleho ea liprotheine le ho ipolaea ha li-tishu.

Sandostatin e na le phello e sithabetsang ts'ebetsong ea lekunutu ea manyeme, ka hona, lingaka tse buoang hangata li e laela ho bakuli ba matla ba ileng ba etsoa opereishene ea pancreatitis e matla.

Sena se o lumella ho fokotsa mats'oao a bohloko, hobane ho fokotseha ha tlhahiso ea li-enzyme tsa ho sefa ho re thusa ho fokotsa haholo ts'ebetso ea ts'enyeho ea litho tsa setho se amehang.

Tabeng ea pancreatitis e hlobaetsang, bophahamo ba tšenyo e kholo haholo, bakuli ba joalo ba hloka ho kenngoa sepetlele ka potlako sepetleleng sa bongaka se sebetsanang le kalafo e matla, e bolokang maikutlo, 'me hangata e etsoa kalafo. Haeba lefu la lefu le fokola hanyane, ka linako tsa ho phahama le ho bonts'a matšoao, ho ka etsahala hore re bue ka pancreatitis e sa foleng. E ka hola ka lilemo le mashome a lilemo, kaha ts'oaetso ea ts'oaetso e ama libaka tse nyane tsa manyeme. Ka nako e ts'oanang, ho pancreatitis e sa foleng, ho felisoa ha li-pancreatic tises ho khoneha le ntle le ho pepeseha ha lefu lena.

Leha taba ea hore ts'ebeliso ea Sandostatin bakeng sa pancreatitis e sa foleng e sa hlalosoe matšoao a ts'ebeliso, ka linako tse ling e laeloa bakuli nakong ea ho eketseha ho matla. Mokhoa o joalo oa kalafo o lumella mokuli ho ikutloa a imolohile hanghang, empa ha e le hantle ha e ame khafetsa le ho atoloha ha nako e tlang. Leha ho le joalo, lingaka tse ngata ha li rate ho sebelisa Sandostatin kalafong ea bakuli ba sa foleng, hobane e hloka khetho e nepahetseng ea litekanyetso ebile e na le litlatsetso tse 'maloa le litlamorao tse sa thabiseng.

Bongaka

Sandostatin ke lithethefatsi tse fanoang ke lingaka 'me li lokela ho betoa leihlo. Pele o qala thupelo ea bongaka, ho kgothaletsoa ho etsa tlhahlobo ea mali, hammoho le tlhahlobo ea ultrasound ea mokokotlo oa mpa le manyeme. Nakong e tlang, liteko tsena li tla hloka ho phetoa ho lekola phello ea Sandostatin 'meleng.

Sandostatin e tsamaisoa ka mokhoa o sa ts'oaneng, ka methapo kapa ka mokhoa o kenang kahare makhetlo a 3 ka letsatsi, e lumelloa ho hlapolla lithethefatsi ka metsi bakeng sa ente, empa ho se joalo ka tharollo ea glucose. Kenyelletso e lokela ho laeloa lipakeng tsa lijo, le pele u robala, ka tsela eo, e fokotsa menyetla ea ho ba le litlamorao.

Tekanyo ea lithethefatsi e khethoa ka mokhoa o fapaneng, ho latela lefu le boima ba eona.

Nako ea kalafo le Sandostatin e itšetlehile ka nosology mme e ka ba matsatsi a 5 ho isa ho a supileng ho isa likhoeling tse 'maloa. Kahoo ho thibela mathata a ho bakuli ba nang le pancreatitis e hlobaetsang e sebetsanang le manyeme, Sandostatin e fuoa bonyane hora pele ho ts'ebetso le matsatsing a supileng kamora hore e sebetse.

Video e bua ka mochini oa tšebetso oa Sandostatin:

Litaelo tse khethehileng

Phokotseho ha e hlahe hangata kalafong ea bakuli ba nang le gastroentero-pancreatic endocrine neoplasms.

Ka li-neoplasms tse khethiloeng tsa lefutso, ho hlahlojoa ha bakuli ka hloko ho hlokahala bakeng sa ho bona hore na hlahala ea tumor le ho fokotseha ka nako e kae masimo a pono.

Ho bakuli ba fumanoeng insulinomas keketseho e tšoaeang ho teba le ho teba ha nako hypoglycemia. Ka kenyelletso ea Sandostatin ka nako lipakeng tsa lijo, le ka nako ea ho robala, hoa khoneha ho fokotsa botebo ba litla-morao tse tsoang pampiring ea tšilo ea lijo.

Ka kalafo ea nako e telele ea acromegaly, ho hlahlojoa ha maemo ho hlokahala lefu la senya bakeng sa tlhahlobo ea mafu a gallstone ka nako. Ha ho khothalletsoe ho fana ka liente ka linako tse khutšoane libakeng tse le ngoe.

Sandostatin ha ho anyesa le ho ima ho emeloa ho latela matšoao a hlakileng.

Ka tsamaiso e khafetsa ea litekanyetso tse nyane, ho fokotseha ho matla ha tsoekere ho ka qojoa. Nakong ea kalafo, ho hlahlojoa tsoekere ea mali kamehla hoa hlokahala.

Sandostatin LAR e ke ke ea tsamaisoa ka matla, e tsamaisoa ka mokhoa o tebileng (haholo-holo gluteus maximus). Tabeng ea ho kenella ka sejelong sa mali, ho khutlisoa ka nale le sebaka sa ente hoa hlokahala.

Moriana efe e phekolang liso tsa ka mpeng

Sehlopha se seng sa lithethefatsi se tummeng ka nako e telele ke li-antacid. Lithethefatsi tsena li kenyelletsa li-alkalizing tse sebelisang acid e feteletseng ea ka mpeng. Sena se kenyelletsa sodium bicarbonate, kapa sopho ea ho baka. Monyetla oa lithethefatsi ke ho se leka-lekane hanghang ha acid, hampe ke ho hlohlona ha liphetoho tsa alkaline 'meleng ka lebaka la ho monya soda ho sa sebetseng.

Calcium carbonate ke lithethefatsi tse matla ho feta moriana o hlalositsoeng kaholimo, empa o na le matla a tšoanang. Ho sebelisa litlhare tse nang le tšebeliso ea nako e telele ho baka ho ruruha le secretion ea bobeli.

Lithethefatsi tsa antacid bakeng sa liso tsa ka mpeng li boetse li kenyelletsa magnesium oxide, tropilati ea magnesium, aluminium hydroxide. Lintho tsena li na le phello ea ho monya le ho koala. Lintho tsa alkalizing li fumaneha ka har'a meriana e kang Vicalin, Bellgin, Bekarbon, Vikair, Almagel, Fosfalugel, Maaloks.

Matla a antacid ke ho fokotsa ho otla ha pelo le bohloko, tse hlahisoang ka lebaka la ho fokotseha hoa acidity ea litaba tsa ka mpeng. Matla a lithethefatsi tsena a ipapisitse le bokhoni ba tsona ba ho qalella ho nka metsotso e 20 ho isa ho e 60. Moriana o nooa hofihlella ka makhetlo a 6 ka letsatsi pele ho lijo le bosiu. Ho hlakola matšoao a lefu la sethoathoa, li-antacid ka bofefo li kenya letsoho ho foliseng liso mme ha li ame sesosa sa lefu lena.

Lithunya tsa sephiri tsa mpa

Moriana o khahlanong le liso tsa ka mpeng tsa sehlopha sena o na le ntho e bitsoang cimetidine. E thibela nerve Reflex le lihokelo tsa lihormone tse etsang hore ho be le hydrochloric acid. Ho ipapisitsoe le cimetidine, Ranitidine, Nizotidine, Famotidine le li-analogues tse ling tse ngata li hlahisoa.

Tlas'a tšusumetso ea lithethefatsi tsena, ho etsoa ha pepsin le hydrochloric acid ho hatelloa ka mokhoa o tšepahalang, 'me bohloko le mala a ka mpeng a felisoa. Ketso e qala hang kamora ho sebelisa litlhare, bohloko bo nyamela kamora matsatsi a 5, ho hlatsa le ho opeloa ke pelo - kamora beke. Ulcers e qala ho fola nakong ea libeke tse 4-6, e potlakileng haholo ho feta ha u sebelisa meriana e meng. Litlamorao li nyane.

Li-secretion blockers tsa pharmacological group

Lithethefatsi tsena tsa ulcer ea ka mpeng li na le phello e sa tsotelleng. Ntle le ho thibela secretion, li ama lits'ebetso le litho tse ling. Meriana e thusa ho phekola ulcers. Motsoako oa tlhaho oa litlama ke monokotšoai oa belladonna, o nang le atropine. Ntho ena ha e fokotse feela tlhahiso ea hydrochloric acid, empa e boetse e fokotsa mosebetsi oa motor ka mpeng. Tlhahiso ea Belladonna ke karolo ea litokisetso tse kang Bellalgin, Bellastesin, Bekarbon.

Ntho ea platifillin, hammoho le metacin, e arotsoeng makhasi a lehloa, ha e na matla. Ba theola khatello ea ka mpeng mme ba theola secretion ea eona ka bonolo.

Gastrocepin kapa pirenzepine e thusa ho thibela ho khutlisoa hape le pholiso ea liso tsa ka. Ntho ena e ea sebetsa, hobane nako e telele e fokotsa secretion ea acid, ha e na phello mosebetsing oa gastric.

Ho thehoa ha acid liseleng tsa sephiri ho sitisoa ke pheko e ncha ea li-ulcers tsa ka mpeng - Omeprazole. E baka phello e tšoarellang, e sebelisetsoa pheko ea tlhokomelo. Litlhare tse ncha tsa lihormone "Sandostatin", "Octreotide", hammoho le "Diakarb" di kenya letsoho ho fokotseha ha sephiri.

Alsa ea ka mpeng: kalafo ka lithethefatsi tse cytoprotective

Sehlopha sena se kenyelletsa meriana e sirelletsang lisele tsa gastric mucosa. Li sebetsa hantle haholo bakeng sa liso tsa ka mpeng, ha thepa e sireletsang ea membrane ea mucous e fokotsoa haholo. Ho na le palo e kholo ea mefuta ea cytoprotectoral. Tse ling tsa tsona li thusa haholo ho hlahisa mofuta o mong o thusang oa ho itšireletsa mafung. Tsena ke meriana e thehiloeng motsoeng oa licorice (granules ea Flacarbin, li-extracts, sesebelisoa sa licorice, matlapa a Likvirshpon) le li-rhizomes tsa (Vikalin le Vikair litokisetso). Ba bang ba eketsa thepa ea ho itšireletsa mafung. Ena ke decoction e tsoang metso ea elecampane (matlapa a Alantoin), lero la hop e tala.

Ka liso tse ncha tse tebileng, ho tsoa mali ka tšohanyetso, ho bonts'oa meriana ea liso tsa ka mpeng - lingaka tse etsang lifilimi (meriana "Ulkogant", "Carafate", "Keal").

Litokisetso tsa Bismuth

Meriana ea liso tsa ka mpeng e thehiloeng nthong ena e na le phello e kopaneng. Ba koahela bofokoli ba mucosa, bo etsa tšitiso e sireletsang. Ntle le moo, li thibela ketso ea acid ka mpeng, e bolaea likokoana-hloko tse bakang ulcers (Helicobacter pylori). Setlhare se sebetsang ka ho fetisisa ke De-nol.

Ts'ebetsong ea bongaka, ho na le liphihlelo tse hlokang khatello ea mesebetsi e meng ea 'mele: secretion ea li-enzyme, lihormone. Sena se hlokahala bakeng sa bophelo bo felletseng kapa nakong ea ts'ebetso ea ho buoa bakeng sa ho hlaphoheloa ho tloaelehileng nakong ea ts'ebetso ea ts'ebetso. Maemo a joalo a kliniki a kenyelletsa acromegaly, mofets'e, sebopeho tsamaisong ea endocrine, monyetla oa mekhoa ea kalafo ea kalafo (kalafo ea radiation, ts'ebetso ea ts'ebetso ea bongaka).

Litaelo tsa ho sebelisa Octreotide

Setlhare sena se bua ka li-syntalogue kapa li-hormone tsa tlhaho tsa 'mele oa motho. Ntho e sebetsang e nka sebaka sa somatostatin, e na le phello e tšoanang ea meriana, empa e na le phello e telele. Octreotide ea lithethefatsi e thibela tlhahiso ea li-hormone tsa kholo, insulin, serotonin, glucagon, gastrin, e hlahisoang ka mokhoa o feteletseng ka lebaka la pathology kapa kamora ho ja.

Tekanyetso le tsamaiso

Setlhare ke moetsi ea sebetsang ho hatella tlhahiso ea lihormone, ka hona, phetoho e ikemetseng ea litekanyetso kapa lengolo la ngaka ntle le likeletso tsa ngaka ha ea lumelloa. Tšebeliso e mpe ea lithethefatsi e lebisa ho nts'etsopele ea lefu le ka tlase, kapa ho thehoeng ha tse ncha ka lebaka la litekanyo tse sa lekaneng tsa lihormone. Tekanyo le sebopeho sa ente e laetsoe feela ho nahanela tlhahlobo le boemo ba mokuli ea itseng. Mefuta ea Depot le e telele e tsamaisoa feela ka intramuscularly.

Melemo ea mohlala ea maloetse a fapaneng ke e latelang:

• octreotide bakeng sa pancreatitis (a hlobaetsang) - 100 mcg makhetlo a 3 ka letsatsi bakeng sa matsatsi a 5 ka tsela e sa sebetseng (s / c) (ho khonahala ho eketsa tekanyo ho 1200 mcg / ka letsatsi ka ente e le mothapo (iv),
• ho emisa ho tsoa mali ka mpeng - 25-50 mcg / hora iv bakeng sa matsatsi a 5,
• ho emisa venous (varicose) ho tsoa mali ho esophagus - 25-50 mcg / hora iv bakeng sa matsatsi a 5,
• prophylactic lethal dose nakong ea ts'ebetso - 100-200 mcg s / c lihora tse 1-2 pele ho buuoa, makhetlo a 100-200 s / c makhetlo a 3 / ka letsatsi - kamora ho buuoa matsatsi a 5-7,
• ligome tsa ligomegaly kapa gastroenteropancreotic - 50-100 li-mcg 1-2 liente ka letsatsi.

Ho sebelisana le lithethefatsi

Setlhare se fokotsa ho kenngoa ha cimetidine hape se fokotsa ho monya cyclosporine. Tumellanong le diuretics, beta-blockers, insulin, litlhare tsa hypoglycemic tsa molomo, li-blockers tsa "liteishene" tsa "calcium" tse butle, ho hlokahala hore ho fetoloe tekanyetso. The bioavailability ea bromocriptine e ntse e eketseha. Moriana o tsamaeang le metabolism ea li-enzymes tsa sistimi ea cytochrome P450 e behiloe tlasa taolo e tiileng ea setsebi.

Bongata

Nakong ea phekolo, overdose e ka bonoa moo matšoao a bonahatsoang: ho nyekeloa, ho ruruha ha sefahleho, ho ikutloa eka ha ho na letho ka mpeng, ho fokotseha ha sekhahla sa pelo, ho opeloa ke pelo. Haeba e 'ngoe ea lipontšo tsena e etsahala, emisa kalafo mme u ee ngakeng.

Maemo a polokelo

Boloka sethala ka sehatsetsing ka mocheso oa + 2 ... + 8ºC.Se ke oa theola moriana. Arohane le khanya ea letsatsi.

Letsatsi la ho felloa ke nako

Nako ea polokelo - lilemo tse 3.

Sebopeho le mofuta oa tokollo

Ntho e sebetsang ke okreotide. Foromo ea tokollo ke li-ampoules tse nang le tharollo bakeng sa tsamaiso e poteletseng le e kenang le li-microspheres bakeng sa tlhahiso ea ho emisoa bakeng sa tsamaiso intramuscularly.

Bokhachane le pelehi

Nakong ea kemolo le kanyeso, sethethefatsi ha se laeloe.

Sebelisa bongoaneng

Ha ho na tlhahisoleseling mabapi le tšebeliso ea lithethefatsi bakeng sa bana.

Lipehelo tsa Maemo a Phomolo ea meriana

Lifekthering, lithethefatsi li rekisoa ka taelo ea ngaka.

Tlas'a leqeba la ka mpeng ho utloisisoa sebopeho sa sekoli se shebileng leboteng la setho. Ho feta moo, ts'ebetso e mpe e ama haholo-holo lera la mucous. Pele u khetha moriana oa ulc tsa ka mpeng, o hloka ho tseba hanyane ka lefu lena.

Mefuta e fapaneng ea ulcers

Ho latela botebo ba lesapo, ulcts ha e sebetse hantle, e ama feela membrane ea mucous, mme e tebile, e hapa likarolo tsa mpa tsa mpa le mesifa. Ka ho ripitloa ha marako a setho, a re mabapi le ho etsoa ka mokhabiso. Tabeng ena, lintho tse ka mpeng li tšeloa ka mpeng ea mpa. Ka nako e telele ea bokuli, baahisani ba ka khomarela leboteng la setho se hlahisitsoeng ho tsoa kantle, mme litlamorao tsa liso li ka fetela ho bona. Boemong bo tšoanang, re bua ka liso tsa kenella.

Moriana efe e phekolang liso tsa ka mpeng

Sehlopha se seng sa lithethefatsi se tummeng ka nako e telele ke li-antacid. Lithethefatsi tsena li kenyelletsa li-alkalizing tse sebelisang acid e feteletseng ea ka mpeng. Sena se kenyelletsa sodium bicarbonate, kapa sopho ea ho baka. Monyetla oa lithethefatsi ke ho se leka-lekane hanghang ha acid, hampe ke ho hlohlona ha liphetoho tsa alkaline 'meleng ka lebaka la ho monya soda ho sa sebetseng.

Calcium carbonate ke lithethefatsi tse matla ho feta moriana o hlalositsoeng kaholimo, empa o na le matla a tšoanang. Ho sebelisa litlhare tse nang le tšebeliso ea nako e telele ho baka ho ruruha le secretion ea bobeli.

Lithethefatsi tsa antacid bakeng sa liso tsa ka mpeng li boetse li kenyelletsa magnesium oxide, tropilati ea magnesium, aluminium hydroxide. Lintho tsena li na le phello ea ho monya le ho koala. Lintho tsa alkalizing li fumaneha ka har'a meriana e kang Vicalin, Bellgin, Bekarbon, Vikair, Almagel, Fosfalugel, Maaloks.

Matla a antacid ke ho fokotsa ho otla ha pelo le bohloko, tse hlahisoang ka lebaka la ho fokotseha hoa acidity ea litaba tsa ka mpeng. Matla a lithethefatsi tsena a ipapisitse le bokhoni ba tsona ba ho qalella ho nka metsotso e 20 ho isa ho e 60. Moriana o nooa hofihlella ka makhetlo a 6 ka letsatsi pele ho lijo le bosiu. Ho hlakola matšoao a lefu la sethoathoa, li-antacid ka bofefo li kenya letsoho ho foliseng liso mme ha li ame sesosa sa lefu lena.

Lithunya tsa sephiri tsa mpa

Moriana o khahlanong le liso tsa ka mpeng tsa sehlopha sena o na le ntho e bitsoang cimetidine. E thibela nerve Reflex le lihokelo tsa lihormone tse etsang hore ho be le hydrochloric acid. Ho ipapisitsoe le cimetidine, Ranitidine, Nizotidine, Famotidine le li-analogues tse ling tse ngata li hlahisoa.

Tlas'a tšusumetso ea lithethefatsi tsena, ho etsoa ha pepsin le hydrochloric acid ho hatelloa ka mokhoa o tšepahalang, 'me bohloko le mala a ka mpeng a felisoa. Ketso e qala hang kamora ho sebelisa litlhare, bohloko bo nyamela kamora matsatsi a 5, ho hlatsa le ho opeloa ke pelo - kamora beke. Ulcers e qala ho fola nakong ea libeke tse 4-6, e potlakileng haholo ho feta ha u sebelisa meriana e meng. Litlamorao li nyane.

Li-secretion blockers tsa pharmacological group

Lithethefatsi tsena tsa ulcer ea ka mpeng li na le phello e sa tsotelleng. Ntle le ho thibela secretion, li ama lits'ebetso le litho tse ling. Meriana e thusa ho phekola ulcers. Motsoako oa tlhaho oa litlama ke monokotšoai oa belladonna, o nang le atropine. Ntho ena ha e fokotse feela tlhahiso ea hydrochloric acid, empa e boetse e fokotsa mosebetsi oa motor ka mpeng. Tlhahiso ea Belladonna ke karolo ea litokisetso tse kang Bellalgin, Bellastesin, Bekarbon.

Ntho ea platifillin, hammoho le metacin, e arotsoeng makhasi a lehloa, ha e na matla. Ba theola khatello ea ka mpeng mme ba theola secretion ea eona ka bonolo.

Gastrocepin kapa pirenzepine e thusa ho thibela ho khutlisoa hape le pholiso ea liso tsa ka. Ntho ena e ea sebetsa, hobane nako e telele e fokotsa secretion ea acid, ha e na phello mosebetsing oa gastric.

Ho thehoa ha acid liseleng tsa sephiri ho sitisoa ke pheko e ncha ea li-ulcers tsa ka mpeng - Omeprazole. E baka phello e tšoarellang, e sebelisetsoa pheko ea tlhokomelo. Litlhare tse ncha tsa lihormone "Sandostatin", "Octreotide", hammoho le "Diakarb" di kenya letsoho ho fokotseha ha sephiri.

Alsa ea ka mpeng: kalafo ka lithethefatsi tse cytoprotective

Sehlopha sena se kenyelletsa meriana e sirelletsang lisele tsa gastric mucosa. Li sebetsa hantle haholo bakeng sa liso tsa ka mpeng, ha thepa e sireletsang ea membrane ea mucous e fokotsoa haholo. Ho na le palo e kholo ea mefuta ea cytoprotectoral. Tse ling tsa tsona li thusa haholo ho hlahisa mofuta o mong o thusang oa ho itšireletsa mafung. Tsena ke meriana e thehiloeng motsoeng oa licorice (granules ea Flacarbin, li-extracts, sesebelisoa sa licorice, matlapa a Likvirshpon) le li-rhizomes tsa (Vikalin le Vikair litokisetso). Ba bang ba eketsa thepa ea ho itšireletsa mafung. Ena ke decoction e tsoang metso ea elecampane (matlapa a Alantoin), lero la hop e tala.

Ka liso tse ncha tse tebileng, ho tsoa mali ka tšohanyetso, ho bonts'oa meriana ea liso tsa ka mpeng - lingaka tse etsang lifilimi (meriana "Ulkogant", "Carafate", "Keal").

Litokisetso tsa Bismuth

Meriana ea liso tsa ka mpeng e thehiloeng nthong ena e na le phello e kopaneng. Ba koahela bofokoli ba mucosa, bo etsa tšitiso e sireletsang. Ntle le moo, li thibela ketso ea acid ka mpeng, e bolaea likokoana-hloko tse bakang ulcers (Helicobacter pylori). Setlhare se sebetsang ka ho fetisisa ke De-nol.

Ts'ebetsong ea bongaka, ho na le liphihlelo tse hlokang khatello ea mesebetsi e meng ea 'mele: secretion ea li-enzyme, lihormone. Sena se hlokahala bakeng sa bophelo bo felletseng kapa nakong ea ts'ebetso ea ho buoa bakeng sa ho hlaphoheloa ho tloaelehileng nakong ea ts'ebetso ea ts'ebetso. Maemo a joalo a kliniki a kenyelletsa acromegaly, mofets'e, sebopeho tsamaisong ea endocrine, monyetla oa mekhoa ea kalafo ea kalafo (kalafo ea radiation, ts'ebetso ea ts'ebetso ea bongaka).

Litaelo tsa ho sebelisa Octreotide

Setlhare sena se bua ka li-syntalogue kapa li-hormone tsa tlhaho tsa 'mele oa motho. Ntho e sebetsang e nka sebaka sa somatostatin, e na le phello e tšoanang ea meriana, empa e na le phello e telele. Octreotide ea lithethefatsi e thibela tlhahiso ea li-hormone tsa kholo, insulin, serotonin, glucagon, gastrin, e hlahisoang ka mokhoa o feteletseng ka lebaka la pathology kapa kamora ho ja.

Sebopeho le mofuta oa tokollo

Octreotide e fumaneha feela ka tharollo bakeng sa tsamaiso ea methapo le methapo. Bophahamo ba ampoules ke 1 le 5 ml. Litekanyetso li fapana ka tekanyo ea ntho e sebetsang ka 1 ml ea tharollo: 50, 100, 300, 600 mcg. Mokelikeli ha o na 'mala ebile ha o na monko. Setlhare sena se fanoa ka mabokoseng a lebokoseng a lebokoseng. Octreotide-Depot le Octreotide-Long ke phofo ea lyophilized bakeng sa infusion (ka mefuta e meng, e hatelletsoeng letlapeng) e phethehile ka solvent, ho emisoa hape, syringe e ikhethang le nale ea ente ea intramuscular.

Ho sebelisa litlhare tse litokisetso

Metsi bakeng sa ente

Octreotide-Depot e na le pololymer ea dl-lactic le glycolic acid, polysorbate-80, metsi a ente, D-mannitol, letsoai la sodium ea carboxymethyl cellulose. Bakeng sa lithethefatsi Octreotide-Long, carmellose sodium, D-mannitol e sebelisoa. Phapang lipakeng tsa mefuta e meraro ea lithethefatsi ke:

• ka lebelo la ho
• nako ea ho fumana khatello ea maikutlo ea ntho e sebetsang kahare ho mmele,
• tataiso ea tšusumetso.

Pharmacodynamics le pharmacokinetics

Setlhare se etselitsoe ho hatella secretion ea lihormone tse hlahisoang ka bongata ke mmele oa mokuli ka lebaka la li-pathologies le kamora ho ja. Sena se sebetsa ho glucagon, insulin, gastrin, serotonin, insulin. Octreotide e fokotsa tlhahiso ea lihormone tsa kholo tse bakoang ke ho ikoetlisa ka ho feteletseng, arginine, kapa insulin hypoglycemia. Secretion ea Thyrotropin le eona ea hatelloa.

Setlhare sena se sebelisetsoa ho fokotsa kotsi ea ts'ebetso ea postoperative kamora ts'ebetso ea ho buoa ka manyeme (pancreatic fistula, pancreatitis e bohloko ka mor'a ho buuoa, sepsis, abscesses). Octreotide e sebelisoa, hammoho le lithethefatsi tse ling, ho emisa ho tsoa mali hantle le ho khutla hape ha eona ka methapo ea varicose ea mpeng le tšibollo ea mali ho bakuli ba nang le lefu la cirrhosis.

Ka tsamaiso ea subcutaneous, moriana o kenella kapele kamoo ho ka khonehang: mohopolo o phahameng oa ntho e sebetsang o fihlella ka mor'a metsotso e 30. Ntho ena e latela liprotheine tsa plasma ea mali ka 65%. Setlhare se tlotsoa 'meleng ka mor'a metsotso e 100 ka tsamaiso e poteletseng. Ka ente ea methapo, ho tsoa ha octreotide 'meleng ho etsoa ka mekhahlelo e' meli: kamora metsotso e 10 le 90. Boholo ba ntho bo epolloa ka mala, 32% e tlosoa ke liphio li sa fetoloe.

Matšoao a sebelisang Octreotide

Moriana o etselitsoe ho hatella secretion ea lihormone ka lenane le akaretsang la mafu. Ho ekelletsa moo, moriana o sebelisetsoa ho thibela mathata a kahare ho litho tsa ka mpeng. Sesebelisoa se amoheloa hore se sebelisoe hammoho le mefuta e khethehileng ea kalafo (mohlala, endoscopic sclerotherapy). Litataiso tse kholo tsa ts'ebeliso ea Octreotide:

• pancreatitis e hlobaetsang
• emisa ho tsoa mali ka peptic ulcer ea duodenum le mpa,
• thibelo le ho emisoa ha methapo ea varicose e nang le cirrhosis ea sebete,
• kalafo le thibelo ea mathata a ka mpeng ka mor'a ho buuoa,
• acromegaly, ka ho se sebetse hantle ha dopamine agonists, ho sitoa ho etsa ts'ebetso ea ho buoa, kalafo ea radiation,
• hlahala ea ka mpeng ea "gastroenteropancreatic system",
• glucagonoma
• gastrinoma
• Reflexory (immune) lets'ollo ho bakuli ba AIDS.

Tekanyetso le tsamaiso

Setlhare ke moetsi ea sebetsang ho hatella tlhahiso ea lihormone, ka hona, phetoho e ikemetseng ea litekanyetso kapa lengolo la ngaka ntle le likeletso tsa ngaka ha ea lumelloa. Tšebeliso e mpe ea lithethefatsi e lebisa ho nts'etsopele ea lefu le ka tlase, kapa ho thehoeng ha tse ncha ka lebaka la litekanyo tse sa lekaneng tsa lihormone. Tekanyo le sebopeho sa ente e laetsoe feela ho nahanela tlhahlobo le boemo ba mokuli ea itseng. Mefuta ea Depot le e telele e tsamaisoa feela ka intramuscularly.

Melemo ea mohlala ea maloetse a fapaneng ke e latelang:

• octreotide bakeng sa pancreatitis (a hlobaetsang) - 100 mcg makhetlo a 3 ka letsatsi bakeng sa matsatsi a 5 ka tsela e sa sebetseng (s / c) (ho khonahala ho eketsa tekanyo ho 1200 mcg / ka letsatsi ka ente e le mothapo (iv),
• ho emisa ho tsoa mali ka mpeng - 25-50 mcg / hora iv bakeng sa matsatsi a 5,
• ho emisa venous (varicose) ho tsoa mali ho esophagus - 25-50 mcg / hora iv bakeng sa matsatsi a 5,
• prophylactic lethal dose nakong ea ts'ebetso - 100-200 mcg s / c lihora tse 1-2 pele ho buuoa, makhetlo a 100-200 s / c makhetlo a 3 / ka letsatsi - kamora ho buuoa matsatsi a 5-7,
• ligome tsa ligomegaly kapa gastroenteropancreotic - 50-100 li-mcg 1-2 liente ka letsatsi.

Ho sebelisana le lithethefatsi

Setlhare se fokotsa ho kenngoa ha cimetidine hape se fokotsa ho monya cyclosporine. Tumellanong le diuretics, beta-blockers, insulin, litlhare tsa hypoglycemic tsa molomo, li-blockers tsa "liteishene" tsa "calcium" tse butle, ho hlokahala hore ho fetoloe tekanyetso. The bioavailability ea bromocriptine e ntse e eketseha. Moriana o tsamaeang le metabolism ea li-enzymes tsa sistimi ea cytochrome P450 e behiloe tlasa taolo e tiileng ea setsebi.

Litlamorao

Tšebeliso ea nako e telele ea lithethefatsi e halefisa sebopeho sa majoe ka gallbladder. Ntle le karabelo ea mmele le alopecia ha u sebelisa lithethefatsi, mefuta e fapaneng ea maikutlo e fapaneng e ka hlaha. Ponahalo ea bona ka kotloloho e latela botee ba lefu lena, boemo bo akaretsang ba mokuli le tšebelisano ea lithethefatsi. Tlhokomelo e tlameha ho isoa lijong ka lebaka la liphetoho tse bang teng ka har'a insulin le li-hormone tse ling. Litlamorao tse ka bang teng:

• anorexia
• ho nyekeloa ke pelo, ho hlatsa, ho thunya, ho ruruha, lets'ollo, ho nyekeloa ke bohloko, lehlaba le bohloko,
• ho thijoa ke mala
• hepatitis e hlobaetsang ntle le cholestasis,
• arrhythmia,
• bradycardia
• hyperbilirubinemia,
• hyperglycemia
• mamello ea tsoekere e sa sebetseng hantle,
• nts'etsopele ea hypoglycemia e phehellang,
• ho hlohlona, ​​ho chesa, bofubelu, ho ruruha ha letlalo kapa mesifa sebakeng sa ente.

Bongata

Tšebeliso ea lithethefatsi Octreotide ka bongata bo baka ho fokotseha ha sekhahla sa sekhahla sa pelo, maikutlo a potlakileng a mali hloohong le sefahlehong. Ka thoko, overdose e ka iponahatsa e le khahlano le ts'ebetso ea ts'ebetso ea mpa: ho nyekeloa ke pelo, lets'ollo, maikutlo a mpa e se nang letho (tlala ea tšohanyetso), bohloko ba spastic. Boemo bo phekoloa ka mokhoa o hlakileng, ha bo hloke ho felisoa ha kalafo (ntle le maemong a bohloko).

Li-analog tsa Octreotide

Lithethefatsi tsa ka tlung li laeloa hore li mamellane ho moemeli oa motheo kapa ho se khonehe ha lona. Li-Analogs li fumaneha hape ho lengolo la ngaka, ka hona, ka ts'ebeliso ea bona e ikemetseng ho fapana le Octreotide ha e khonehe. Ho lokela ho hopoloa hore phetoho nakong ea kalafo e etsoa feela ke setsebi motheong oa karabelo ea motho ka mong ea mokuli ho kalafo. Litšoantšo tse ka sehloohong tsa Octreotide:

• Sandostatin - analogue ea phofo bakeng sa ho etsa litharollo tsa ente ea iv le SC, ntho e sebetsang ke octreotide, phello e teng 'meleng e tšoana,
• Somatostatin - lithethefatsi tse thehiloeng holim'a ntho e hloekileng e thibelang tlhahiso ea li-hormone tsa kholo, inhibitor ea serotonin, li-peptide tse ling.
• Diferelin, analogue ea subcutaneous tsamaiso e thehiloeng ho triptorelin acetate, e sebelisoa kalafo ea ho hloka thari ea basali, IVF ho hatella lihormone le lintho tse ling ha ho khonehe ho sebelisa octreotide,
• Sermorelin lithethefatsi - e sebelisoang ho hlahloba bokhoni ba ho nchafala le tšebetso ea lihormone tsa kholo (ho hlahloba khaello ea kholo ea kholo ea bana ho bana ba makala).

Ka lebaka la litlhahiso tsa tokiso, sethethefatsi se theko e boima (li-analogues ha se fapana haholo ka theko ebile li na le litlhaloso tsa bona tsa tšebeliso). Litšenyehelo tse tloaelehileng mefuteng ea meriana ea litlama tsa meriana ke li-ruble tse 1300. Litsenyehelo li fapana ho latela mofuta oa lithethefatsi, khatello ea tsona, naha ea tlhahiso. Likarolong, ka linako tse ling sehlahisoa se bitsa theko e boima ho feta 15-30% ka lebaka la tlhoko ea sona e tlase. Karolelano ea litheko ho la Moscow le sebakeng sa motse-moholo: