Desmopressin - nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana

ʻO ka wehewehe e pili ana i 30.07.2015

• Palapala Latin: Desmopressinum
• ʻĀkau ATX: H01BA02
• ʻ formulalelo hoʻokolohua: C₄₆H₆₄N₁₄O₁₂S₂
• CAS Code: 16679-58-6

Nā waiwai kūlohelohe

ʻO ka Desmopressin kahi hoʻohālikelike synthetic vasopressin antidiuretic hormone, aia ka mea i hana ʻia e nā limu hua uila huakai walionary. ^ E Ha yM. Loaʻa ia mau mea e ke ʻano o ka hoʻopololei. wīwaha:1-cysteine ​​deamination a me nā mea hou 8-l-argininei kēia manawa i ka molekele mua ma 8-D-arginine.

ʻO ka hāmeʻa he hopena liʻiliʻi ia i ka nui o nā ʻiʻo o ka moe vascular a me nā kino o loko, akā ʻo ia anti-duretic hopena Ua hōʻike ikaika.

Pharmacodynamics a me ka pharmacokinetics

Hoʻōla ka mea hana Nā Kūleʻa Vasopressin V2aia kēlā ma ka ʻāpana epithelial nā kime hoʻohui a i E piʻi i nā papa o Henle, ke alakaʻi nei kēia i kahi hoʻonui i ke kaʻina o ka reabsorption o ka wai i loko o nā kīʻaha koko, e hoʻoulu ai 8 nā mea hoʻoiho.

Loaʻa ka hopena antiduretic o ka lāʻau me ka subutanutan, intravenous a me ka intramuscular hoʻokele, me ka instillation nā lāʻau lapaʻau i ka ihu.

ʻO ka hapalua o ka ola o ka hormone synthetic = 75 mau minuke. Eia naʻe, ʻike ikaika loa ʻia ka waiwai i loko o ke kino i loko o 8-20 mau hola, ma hope o ka hoʻokele ʻana. Ua hōʻike ʻia nā hōʻailona male polyuria nalowale ma hope o 2-3 mau manawa i ka hoʻohana ʻana i ka huahana. ʻOi aku ka maikaʻi o ka hoʻokele intravenous ma mua o ka hoʻokele intranasal.

I nā maʻi me hemofilia a me nā maʻi von Willebrandt ma hope o ke kaha o ka hōʻemi he 0.4 gg o ka lāʻau i ka 1 kg o ke kaupaona ʻana, 8 ʻaʻano kāpilihoʻonui i 3-4 mau manawa. Hoʻomaka ka hopena o ka lāʻau lapaʻau ma hope o ka hapalua hola a hōʻea i kona waiwai nui ma loko o ka hapalua a me kahi hapalua - 2 mau hola.

Eia kekahi, ke hoʻohana nei i ka lāʻau lapaʻau, ʻike pinepine kahi wikiwiki i ka neʻe ʻana o ka plasma plasminogenakā i ka manawa like i ka pae palu ka like mau.

Hoʻomili ʻia ka waiwai i loko o nā lau o ka puhi. Loaʻa nā hoʻomaʻemaʻe kaila paʻa e pili ana i ka ʻaihue transradrogenases. ^ E Ha yM. Hoʻololi ʻia ka lāʻau lapaʻau me ka urine i ʻole a i ʻole ke ʻano o ka metabolites ʻole. ʻO ka Desmopressin he haʻahaʻa haʻahaʻa, ʻaʻole teratogenic a i ʻole nā huahana mutagenic.

E hoʻokuʻu i ke ʻano

Hoʻohui ʻia ka lāʻau i nā mana nui. Ma mua o ke koho ʻana i kahi mana, pono ʻoe e kamaʻilio i kāu kauka e ʻike i ke kūpono no ka mālama ʻana i ka maʻi.

Hoʻopau ke ʻano no ka inikua intramuscularly, intravenously, subcutaneously.

Loaʻa ka lāʻau lapaʻau i ke ʻano o nā keʻokeʻo a puni, nā ʻāpana pōpoki. Ma kekahi ʻaoʻao ka ʻatikala ʻo "D1" a i ʻole "D2". Ma ka lua o ka manamana hakakā. Ma ka hoʻohui i ka mea hana, desmopressin, ʻo ka pūmeni ka mea e loaʻa ai ka magnesium stearate, starch potato, povidone-K30, lactose monohydrate.

Loaʻa ka lāʻau lapaʻau i ke ʻano o nā keʻokeʻo a puni, nā ʻāpana pōpoki.

ʻO nā waila o ka ihu kahi wai kala. ʻO nā mea kū'ē he chlorobutanol, sodium chloride, wai, hydrochloric acid. Ka helu 0.1 mg i ka 1 ml.

He wai eleele. Aia i loko o kahi hue kūikawā me kahi dispenser. ʻO nā mea hoihoi he potassium sorbate, wai, hydrochloric acid, sodium klorida.

Lapaʻau lāʻau

ʻO ka hapalua hapalua o nā hāmeʻe piliila he 75 mau minuke. Akā i ka manawa like, hiki ke nānā ʻia ka lāʻau lapaʻau ma nā waiwai nui i loko o ke kino no ka 8-20 mau hola ma hope o ka hoʻohana. Ua hōʻike ʻia ua pau nā hōʻailona o ka polyuria ma hope o ka hoʻohana ʻana o 2-3 i nā lāʻau lapaʻau. I kēia hihia, ʻoi aku ka maikaʻi o nā inikini intravenous ma mua o ka hoʻokele intranasal.

I ka poʻe me nā maʻi ʻo W Waebrand, a me ka hemophilia pū me kahi hoʻomalu hoʻokahi o 0.4 gg / kg o ka mea, ua hoʻonui ʻia nā manawa he 3-4 ka mea nui o ka coagulation koko. Hoʻomaka ka lāʻau lapaʻau e hana ma hope o 30 mau minuke mai ka manawa o kona hoʻohana a hōʻea i nā helu kiʻekiʻe ma hope o nā hola 1.5-2.

I ka manawa like, ʻo ka hoʻohana ʻana i ka lāʻau e alakaʻi i ka wikiwiki o ka neʻe ʻana o nā kumu plasma o ka plasminogen, ʻoiai ke mau nei nā hōʻailona fibrinolysis.

Hoʻomaʻamaʻa ka lāʻau lapaʻau i ka metabolism i loko o ke ake o ke ake. Hoʻopili ʻia ke alahaka disulfide e ka enzyme transhydrogenase.

Ka hana o nā loli a i ʻole nā ​​loli i ka huahana metabolic i hana ʻia me ka urine.

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Nā Hoʻohui

• polydipsia o kahi psychotic a congenital ʻano,
• ka hiki ana o anuria,
• plasma hypoosmolality,
• ka waiho ʻana o ka wai i loko o ke kino,
• ka hele ʻana o ka puʻuwai pu me ka pono o ka lāʻau diuretic,
• pane kūlohelohe i ka lāʻau lapaʻau.

Lā ʻia ʻo ia ka lawelawe ʻana i ka lāʻau intravenously me von Willebrand-Dian maʻi o subtype 2b, a me ke ʻano pū me ka angina paʻa ʻole.

ʻLoe a me ke kākele

Pono e kiʻi ʻia nā papa ʻōlelo, ma hope o kekahi mau hola ma hope o ka ʻai ʻana (me kā lākou hoʻohana like ʻana, nā nāwaliwali o ka inu ʻana o nā lāʻau lapaʻau, e alakaʻi ai i ka emi ʻana o kona pono). Koho ʻia ka nui a me ka lōʻihi o ka lāʻau e koho ʻia e ke kauka.

ʻO ka poʻe me ka maʻi mellitus type mua e pono e lawe i ka 0.1 mg o ka waiwai 1-3 mau lā i ka lā. Ma hope o kēia, pono e koho pilikino i kahi mahele, i ka ʻike ʻana i ka hopena i hoʻopiʻi ʻia e nā papa, a me ko lākou ʻae ʻia e ka mea maʻi. I ka awelika, ʻo ka dosage ka 0.1-0.2 mg, lawe ʻia i nā manawa 1-3 i ka lā.

ʻO ka nui o ka palena ʻokoʻa ma ke ʻano o nā lāʻau lapaʻau i kēlā me kēia lā he 1.2 mg.

Me ka hemahema ʻole o ka pō, ua ʻike pinepine lākou i ka 0.2 mg o ka mea i loko o ka pō. Inā lawa ʻole ka hopena, e pāpālua ʻia ka māhele i 0.4 mg. Ke alakaʻi nei i ka mālama ʻana, pono ʻoe e kāpī i nā kōʻai wai i loko o ka hapalua o ka lā. ʻO ka awelika, hoʻomau ka lāʻau e 90 mau lā. I ka noʻonoʻo ʻana i ke kiʻi no ka lāʻau lapaʻau, hiki i ke kauka ke hoʻolōʻihi i ka papa (ʻoi aku, ma mua o ka hoʻolōʻihi ʻana i ka mālama ʻana, hoʻopau ʻia ka lāʻau lapaʻau no 7 lā, a laila, e noʻonoʻo ana i ka ʻike pili lāʻau ma hope o ka haʻalele ʻana i ka lāʻau lapaʻau, hoʻoholo lākou inā pono ke hoʻomau ka mea maʻi i ka papa).

ʻO nā pākeke, me nā poli o ka lā pōkā, pono pinepine lākou e lawe i ka 0.1 mg o ka lāʻau lapaʻau ma ka pō. I ka hiki ʻole o kahi hopena therapeutic, hiki ke hoʻolōʻihi i ka nui - i ka 0.2 mg. Ma lalo o ka mākaʻi o ke kauka, hiki ke hoʻonui ka nui o ka nui inā pono. I ka haʻalele ʻana o nā hōʻailona o ka holomua ma hope o ka 1 o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono e hoʻokuʻu ʻia ka lāʻau.

Hoʻohana ʻia ka ʻāpana intranasal i nā mahele o 10-40 mcg / lā, kahi i hāʻawi ʻia i nā ʻāpana ʻē aʻe. ʻO nā keiki i hala ma ka liʻiliʻi he 3 mau mahina a ʻoi aku ka nui o 12 mau makahiki e pono e hoʻoponopono i kēlā me kēia lā, aia ma ka 5-30 micrograms.

Nā Dosis o ka Desmopressin no iv, s / c, a me nā mea / m inikū he 1-4 mcg / lā (no nā pākeke). Hiki iā nā keiki ke komo i ka 0.4-2 micrograms o ka lāʻau i kēlā me kēia lā.

Inā ʻaʻohe hopena ma hope o ka hebedoma mua o ka mālama ʻana, pono ia e hoʻoponopono i kēlā me kēia lā. Ke koho ʻana i nā hoʻoponopono lapaʻau kūpono kūpono i kekahi manawa ke makemake nui nei - i loko o kekahi mau pule.

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Ke keu

ʻO ka pōʻino me ka lāʻau lapaʻau e hoʻokau pinepine i ka hoʻomauʻana o ka wai a me ka hoʻomohala ʻana i nā hōʻailona o ka hyponatremia.

I kēia mau hihia, pono ia e hoʻokō i ka hoʻonā intravenously iso-a i ʻole ka hypertonic o ka sodium chloride, me ke koho ʻana i ka mea maʻi e lawe i kahi diuretic (furosemide).

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ʻO ka pilina me nā lāʻau lapaʻau ʻē aʻe

ʻO ka hui pū me ka dopamine, ʻoi aʻe i nā kiʻekiʻe kiʻekiʻe, hiki ke hoʻokaʻawale i ka hopena pressor.

Hoʻokomo ka Indomethacin i ka nui o ka hopena o ka lāʻau lapaʻau i hoʻopuka ʻia e Desmopressin.

ʻO ka hui pūʻana o ka lāʻau me ka lithium carbonate e alakaʻi i kahi hōʻemi i kāna mau kūlana antidiuretic.

Pono e mālama i ka mālama ʻana e hoʻohui i ka lāʻau lapaʻau me nā lāʻau lapaʻau e hoʻonui ai i ka paʻakikī o ka hoʻokuʻu ʻana o ka hormone antidiuretic: e like me ka caramazepine me ka chlorpromazine, phenylephrine me ka tricyclics, a me ka epinephrine. ʻO kēlā hui hui hiki ke kumu i ka potentiation o ka hopena vasopressor i nā lāʻau.

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Ke noi no nā keiki

ʻO ka nui o ka lawelawe ʻana i nā lā no nā keiki i emi iho ma mua o 12 mau makahiki e pono ke hoʻoponopono ʻia.

I nā pēpē a hiki i ka makahiki 1 mau makahiki aku, lilo i ka hoʻohuihui me kahi mea hiki ke alakaʻi i ka hoʻouluʻana o kahi pōpilikia - pili i ka hopena o ka hōʻeha ʻana i ka lāʻau lapaʻau ma NS.

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ʻO nā mea hoʻohālike o ka pahuhopu ka mākaukau ʻo Vazomirin, Minirin a me Emosint me Presinex, a me ka manawa Adiuretin, Desmopressin acetate, Nourem me Nativa, Apo-Desmopressin a me Adiuretin SD.

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Loaʻa iā Desmopressin nā loiloi kūpono ma ka mālama ʻana i ka enuresis nocturnal i nā keiki, ʻoiai ʻo ka mea i ʻike ʻia ʻaʻole e ulu koke ka hopena o kona hoʻohana ʻia, akā ma hope o kekahi mau pule. Ma ka manawa like, ua ʻōlelo nā ʻōlelo e hoʻomanawanui maikaʻi loa ka lāʻau.

Aia kekahi mau loiloi e pili ana i ka hana kūpono o ka lāʻau lapaʻau ma ka maʻi ōkelē ʻole o ke kūpaʻa gula - ʻo kona hoʻohana e hoʻomaikaʻi i ke ʻano o ka mea maʻi, hōʻoluʻolu i nā hōʻailona o ka maʻi.

Nā hana hana i ka hana

ʻO ka mea kanu ka mea neoneo i hoʻololi ʻia ma kahi o ka vasopressin hormone. Ke komo ka lāʻau i ke kino, hoʻōla ʻia nā mea kūikawā kūikawā, ma muli o ka hana e hoʻonui ai ke kaʻina o ka reabsorption wai. E hoʻomaikaʻi ke kōkō koko.

I ka poʻe maʻi me ka hemophilia, hoʻonui ka lāʻau i ka coagulation factor 8 e 3-4 mau manawa. Aia ka hoʻonuiʻana o ka nui o ka plasminogen i loko o ke koko koko.

Ke hoʻokae nei ka luna hoʻolālā i hiki iā ʻoe ke hoʻokō wikiwiki i ka hopena.

Hoʻonui ka lāʻau i ka coagulation koko.

Me ka mālama pono

I ka hihia o ka hōʻino ʻana o ka hoʻāla wai-electrolyte, fibrosis o ka pālaʻi, nā maʻi o nā ʻōnaehana o ke ʻano o ka cardiovascular a i ʻole aʻeha paha, e hoʻonui ʻia ka nui o ka hoʻoulu ʻia ʻana o ka intracranial, pono e hoʻomaʻamaʻa ʻia ka wā o ka mālama ʻana. Manaʻo kekahi mau contraindication pili ʻia ma luna o 65 mau makahiki.

Hoʻokomo nā dosis a me ka dosage ma muli o ka maʻi, nā ʻano pilikino o ka mea maʻi. Pono lākou e koho pū me ke kauka. Pono ʻoe e hoʻomaʻamaʻa iā ʻoe iho i nā ʻōlelo aʻoaʻo no ka hoʻohana.

ʻO ka ʻōmole mua no ka hāʻule o ka ihu, hoʻohālikelike ia ka papa mai 10 a 40 mcg i kēlā me kēia lā. Pono e lilo i mau manawa. Pono nā keiki ma lalo o 12 mau makahiki e pono ke hoʻoponopono. No lākou, kahi koho o 5 a 30 mau micrograms i koho ʻia i ka lā.

Me ka hoʻopuka o nā inikini no nā pākeke, ka make ʻana o ka nui mai 1 a 4 mau micrograms i hoʻokahi kilogram o ke kino o ke kino. I ke wā ʻōpiopio, pono ʻia ʻo 0.4-2 micrograms.

Inā ʻaʻole e lawe mai ka lāʻau lapaʻau i ka hopena i manaʻo ʻia i loko o hoʻokahi pule, e hoʻoponopono ʻia ka dosage.

Inā ʻaʻole e lawe mai ka lāʻau lapaʻau i ka hopena i manaʻo ʻia i loko o hoʻokahi pule, e hoʻoponopono ʻia ka dosage.

Nā hopena hopena

ʻO ka ʻeha, ka poʻo, ke kue ka hiki. ʻO nā mea maʻamau, hāʻule nā ​​poʻe maʻi i kahi coma. Māhuahua paha ke kaumaha o ke kino, hiki paha i ka rhinitis. I kekahi mau mea maʻi, nā momona o ka ihu o ka ihu. Hoʻomau, ʻeha, a me ka ʻeha ʻōpū e hiki.

Hiki ke piʻi a emi paha ke koko. I kekahi manawa oliguria, uila wikiwiki, hele mai nā hopena pālola. Hiki i ke hyponatremia. Ke hoʻohana nei i nā injections, hiki ke nānā ʻia ka ʻeha ma ka wahi i hoʻopaʻa ʻia.

Inā hoʻohana ʻia ka lāʻau lapaʻau e mālama i nā keiki ma lalo o ke 12 mau makahiki o ka noho ʻana, hiki i nā make.

Nā hōʻailona no ka hoʻohana ʻana

Hoʻomaopopo ʻia ka hoʻohana ʻana o Desmopressin no ka hoʻomohala ʻana a me ka mālama ʻana i ka maʻi maʻi maʻi indipidus waena.

Eia kekahi, hoʻokaʻawale i nā hōʻailona hōʻike no nā ʻano uku:

• nā papa: nā keiki ma mua o 5 mau makahiki - mua nocturnal enuresis, makua, makua - hōʻailona maʻi nocturnal polyuria,
• Metered-dosis nasal spray a me nā ihu: ua hōʻike ʻia ka hōʻike ʻana no ka hiki ke paʻa ʻana i nā pūpū,
• nā ihu ihu: polyuria huehue o nā genesis waena, i hoʻoulu ʻia e kahi maʻi a hōʻoki hōʻemi paha i ka ʻōnaehana o ka nerve, trauma.

Hoʻolaha ka waipuna

ʻAʻole hoʻolako ʻia ka inu ʻawaʻawa i ka wā maʻi, no ka mea he maikaʻi ʻole ka lāʻau lapaʻau.

ʻO ka lāʻau lapaʻau ka nui o nā mea like. ʻO nā ʻōmomi nā papa ʻaina Minirin, Nativa, Adiuretin, presayneks sprays, Vasomirin. Hoʻohana pū ʻia ʻo Desmopressin Acetate. Aia kekahi mau capsules, nā papa a me nā hopena me nā waiwai antidiuretic. Malia paha e hoʻohana i ka pono o nā kūpeʻe.

ʻO Minirin kahi analogue o Desmopressin.

ʻLoe a me ke kākele

Lawe ʻia nā papa papaʻaina, i kekahi manawa ma hope o kahi pāʻina.

• center insipidus waena: ʻo ka helu mua he 0.1 mg 1-3 mau manawa i ka lā no nā keiki a me nā pākeke. ʻO ka manawa, ua koho ʻia ka ʻona ma ke ʻano he pane kūʻokoʻa o kēlā me kēia, hiki iā ia ke piʻi mai 0.2 mg a 1.2 mg i kēlā me kēia lā.
• ʻO ka hoʻōla mua a nocturnal: ʻo ka palena mua he 0.2 mg i ka wā hiamoe, me ka ʻole o ka hopena therapeutic kūpono, hiki ke hoʻonui i ka 0.4 mg. Pono e hoʻōla i ka hoʻoulu wai ʻana i ke ahiahi. Hele ka papa ʻaina 90 mau lā. Ma hope o ka hoʻomaha ʻana o ka lā 7 lā, hiki ke hoʻomau ʻia nā paila ma luna o nā hōʻike no ke olakino.
• polyuria nocturnal i nā pākeke: ke kumu mua loa he 0.1 mg i ka wā hiamoe, me ka ʻole o ka hopena e pono ai, e hoʻonui ʻia ana ia i kēlā me kēia 0.1 mau lā ma 0.1 mg a hiki i kahi hopena e loaʻa ai nā hopena kūpono loa.

Ma ka hana ʻole o kahi pane lapaʻau kūpono kūpono ma hope o nā lā 30 o ka mālama ʻana, pono e hoʻoneʻe ʻia ka lāʻau lapaʻau.

Hoʻokomo ʻia ka pūpū nasal

Hoʻopili ʻia ke kaomi i ka hoʻokele intranasal, hoʻokahi kaomi ma ka ʻaoʻao me ke kala ʻoiai he 0.01 mg o ka lāʻau.

I ka wā e mālama ai i nā keiki, pono ke kaʻina ʻia o ke kaʻina ma lalo o ka mālama ʻana o nā pākeke.

Hoʻoholo ʻia ka hopena ʻoi loa e ke koho ponoʻī.

• insipidus waena pokona: nā pākeke - 0.01-0.04 mg, nā keiki - 0,01-0.02 mg i kēlā me kēia lā. Hoʻoholo ʻia ke kaʻina hana i hoʻokahi manawa a hoʻokaʻawale paha i ka lāʻau i kuhikuhi ʻia i nā inikua 2-3.
• ʻai kauaka hoʻāʻo: ka pākeke - 0,04 mg, nā keiki ma mua o hoʻokahi makahiki - 0.01-0.02 mg, nā keiki ma lalo o ka makahiki 1 o ka makahiki - 0.01 mg. Ma hope o ka hoʻokele ʻana, pono e hoʻokaʻawale ka mea maʻi i ka lālani, ma nā hola 8 aʻe i hala aʻe, lawe ʻia nā lawelawe he 2 o ka urine e aʻo ai i kona osmolality. ʻO ka nui o ka nui o ka wai i inu ʻia e ka mea maʻi i ka wā o ka hōʻike (1 mau hola ma mua o ke aʻo ʻana a ma nā hola 8 aʻe) ʻaʻole pono e hānai i ka 500 ml. Inā loaʻa kahi mākaʻina osmolality ma lalo o 800 mau mOsm / kg i nā pākeke a me 600 mOsm / kg i nā keiki ka ʻike, ʻike ʻia ka hōʻike. I ka hōʻoia ʻana i ka hala o ka hiki ʻana o ka paʻa ʻana o nā keiki, e koi ʻia nā ʻike hou.

Holo ʻaʻa

Hoʻopili ʻia nā mea hōʻiliʻili, ma o ka hoʻoilo ʻana i ka puka ihu i ka septal nasal me kahi kīʻaha liʻiliʻi o ke poʻo i hope a me kona komo ʻana i ka ʻaoʻao.

ʻO ka hōʻike ʻana o ka hopena therapeutic e loaʻa i loko o 30 mau minuke ma hope o ke kanu ʻana i ka lāʻau.

• maʻi maʻi maʻi indipidus o ke kumu waena: nā pākeke - 0.01-0.04 mg (2-8 mauʻai), nā keiki - 0,005-0.02 mg (1-4 mauʻu) i kēlā me kēia lā. Hoʻohana ʻia ka lāʻau ma hoʻokahi, a i ʻole ʻāpana i kēlā me kēia lā i loko o ka 2-3 inikini. Kūkulu ke kauka i ka maʻi a me ka kikowaena ma waena o nā ʻoihana hoʻokahi, me ka mālama ʻana i ka naʻau o ka mea maʻi i ka lāʻau lapaʻau,
• hoʻonāukiuki ma waena o nā polyuria kikowaena: 0,01 mg i kēlā Pono ka loiloi o ka diuresis a me nā kao ʻana i ka manawa like a hiki i ka loaʻa ʻana o kahi kaulike holoʻokoʻa. I loko o 3-5 mau hola, e nānā i ka osmolarity o ka plasma a me ka urine, ke kikoo o ka sodium i loko o ke koko,
• ka noiʻi ʻana o ka hiki ke paʻa o nā pūpū: nā pākeke - 0.015 mg, nā keiki i ʻoi aku ma mua o ka makahiki 1 - 0.01-0.015 mg. Ma hope o ka instillation o ka lāʻau, pono ke oki ʻana. A laila e hōʻiliʻili ʻia nā tauira o ka urine e hoʻoholo ai i ka osmolarity, e haʻi hou ʻia ke kaʻina hana he 4 mau manawa me kahi manawa o 1 hola. Inā make ka makewai, ua ʻae ʻia ka lawe wai ʻole o ka 200 ml wai no ka manawa holoʻokoʻa (1 hola ma mua o ka hoʻopaʻa ʻana a i loko o 8 mau hola) o ka hoʻopaʻa ʻia.

Nā ʻōlelo kikoʻī

ʻAʻole pono e hoʻohana ʻia ka Desmopressin i nā maʻi me nā pathologies concomitant a i ʻole e lawe ana i nā lāʻau lapaʻau e hiki ai i ka hoʻomoʻomaʻi i nā wai ma loko o ke kino a me nā pilikia electrolyte.

ʻO nā mea maʻi me ka nocturnal enuresis mua i hoʻokahi hola i mua a i loko o 8 mau hola ma hope o ka hoʻohana ʻana i ka lāʻau, e hōʻemi i ka inu o ka wai - e hōʻemi kēia i nā hopena o nā hopena.

ʻO ka hoʻohana ʻana o Desmopressin no ka mālama ʻana i ka enuresis nocturnal i nā keiki a me nā poʻe ʻōpio ke hōʻeha i ka hoʻomohala ʻana i ka edema cerebral.

ʻO nā maʻi me ka polyuria mai 2.8 a 3 lita a me nā haʻahaʻa sodium plasma liʻiliʻi haʻahaʻa e mālama pono ana i nā hopena ʻaoʻao.

Me ka nui o ka makaʻala, ʻoi aku ia e hoʻohana i ka lāʻau lapaʻau i nā mea maʻi ma mua o 65 mau makahiki no ka nui o ka nui o ka hiki ʻana o nā wai ʻauana, ka hoʻomohala ʻana o ka hyponatremia a me nā hopena ʻē aʻe. Pono e hāʻawi ʻia ka mea maʻi me ka mālama o ka moku a me ka maʻamau (ma mua o ka mālama ʻana, ma hope o nā lā ʻekolu o ka lāʻau a me nā hoʻonui ʻana i kēlā me kēia nui) ka hoʻoholo ʻana i ka pae o ka nui o ka sodium i loko o ke koko koko.

Inā aia ka maʻi, nā maʻi ʻōnaehana a i ʻole gastroenteritis, pono e hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau.

I mea e pale ai i ka hyponatremia, ua hōʻike ʻia nā haʻawina pinepine e hoʻoholo i ke ʻano o ka sodium i ka plasma koko, ʻoi aku ka hoʻohui ʻana i nā papa me nā antidepresants tricyclic, chlorpromazine, carbamazepine, nā lāʻau lapaʻau ʻē aʻe e hana ai i ka maʻi o ka huna ʻole o ka lāʻau antidiuretic, a me ka hoʻohui pū ʻana me nā lāʻau anti-inflammatory non-steroid. NSAID).

Ka hana ʻana a me ka mālama ʻana o ka maʻi laʻa o ka urinary, nocturia a / a i ʻole disuria, ka pā ʻana i ka maʻi urinary, bladder a i ʻole ka prostate tumor, decompensated diabetes mellitus, polydipsia, a me ka mea inu waihue e pono e lawe ʻia ma mua o ka hoʻohana ʻana o Desmopressin.

I nā keiki ma lalo o ka makahiki 1 o ka makahiki, kahi hoʻokolokolo e hoʻoholo i ka hiki ʻana o ke ake o nā palu e lawe ʻia i loko o kahi haukapila.

Ma hope o ka hoʻokō ʻana i nā hoʻokolohua diagnostic, ʻae ʻia ka mea maʻi e loaʻa i ke kahe i loko o kahi e hoʻolako ai i ka make wai.

ʻAʻole hiki ke kuhikuhi ʻia ka hoʻōla waiwawa i nā keiki inā makemake ʻia ka lāʻau lapaʻau ma lalo o 0.01 mg.

Kahi ʻia kahi haʻawina o ka hiki ʻana i nā pū me nā hina i nā keiki ma lalo o 1 mau makahiki he nui e hana ʻia i loko o nā hihia kūikawā, ʻoiai i kēia manawa ua hoʻemi ʻia ka hiki ʻana o ka pūpū. Pono e kaʻina ke kaʻina hana e ka neurologist pediatric. ʻO kahi hopena kiʻekiʻe loa i ka pēpē hiki ke hoʻonāukiuki i ka wahī o ka wahī, i hui pū ʻia e ka hoʻomohala ʻana i ka make. I ka wā o ka ʻohi ʻana i ka urine, koi pono ke kāpae ʻia o ka hoʻohana ʻana i ka wai.

No ka mea, me ka nui o ka rhinitis, ua hoʻopiʻi ʻia ka nui o nā kō, ua kauoha ʻia e hoʻohana i ka lāʻau i loko.

Me ka insipidus maʻi o ka punawai pokela, e hoʻonui ka paʻahana intranasal o desmopressin i ka uluʻana o ka ulu ʻana i ka hyponatremia koʻikoʻi.

Hoʻohui nūhou

Me ka hoʻohana ʻana o Desmopressin:

• hiki i ka maʻi maʻi indomethacin ke hoʻonui i ka hana i ka desmopressin me ka hoʻonui ʻole i ka lōʻihi,
• tetracycline, glibutide, norepinephrine, hoʻomākaukau o ka lithium me ka hoʻēmi ʻana i ka hopena antidiuretic o ka lāʻau,
• Hoʻonui nā loea hypertensive i kā lākou hopena,
• inhibitor serotonin selective, tricyclic antidepressants, carbamazepine, chlorpromazine hiki iā ia ke hana i ka maʻi o ka huna ʻole ʻana o ka hormone antidiuretic, hoʻonui i ka hopena antidiuretic o ka desmopressin, i hoʻonui nui ʻia i ka hoʻopulima o ka waipuna a me ka hoʻomohala ʻana i ka hyponatremia.
• Hoʻonui ka NSAID i ka hopena o ka noho ʻana o ka wai ma loko o ke kino, ka hopena o ka hyponatremia,
• hoʻemi ka dimethicone i ka hoʻopili ʻana o ka lāʻau,
• loperamide a me nā lāʻau lapaʻau e hoʻolōʻihi i ka peristalsis hiki ke hoʻonui i nā pae plasma o desmopressin e 3 mau manawa a hoʻonui i ka nui o ka noho ʻana o ka wai a me ka hyponatremia.

ʻO nā ʻalogpana o Desmopressin nā papa: nā papahele - Minirin, Nativa, Nourem, hoʻolaʻa - Apo-Desmopressin, Presineks, Minirin, Vasomirin.

Hoʻohui

Hoʻohana piha, ʻoi aku hoʻi i nā nui nui, me dopamine hiki ke hoʻoikaika i ka hopena pressor.

Nā Indomethacin e pili paha i ka ikaika o ka wehe ʻana o Desmopressin i ke kino.

ʻOiai e lawe ana i ka lāʻau lapaʻau me litium karbonat, ua hoʻonā nā hopena antidiuretic.

Me ka mālama aka, pono e hoʻohui pū ʻia ke ʻano me nā lāʻau lapaʻau e hoʻonui ana i ka hoʻokuʻu. hormone antidiuretic: chlorpromazine, carbamazepine, antidepressants tricyclic, phenylephrine, epinephrine. ^ E Ha yM. Hiki i kēia hoʻohui ke alakaʻi i kahi hoʻonui o nā hana vasopressor o Desmopressin.

Ka hana lāʻau lapaʻau

ʻO ka Desmopressin kahi analogue o ka arginine-vasopressin kūlohelohe maoli me kahi hopena antidiuretic i haʻi.

Hoʻohālikelike ʻia me nā vasopressin, he hopena iki ia i ka māiʻe ʻana o nā kahe maemae o nā kīʻaha koko a me nā ʻōpū o loko, ʻo ia ke kumu o nā loli i ke kaola o ka molekala desmopressin hoʻohālikelike i ka kūlohelohe vasopressin kūlohelohe - deamination o 1-cysteine ​​a me nā hoʻololi o 8-L-arginine me D-arginine.

Hoʻonui nā kikoo o ka epithelium o nā māhele mamao o nā tubule convoluted no ka wai a hoʻonui i kona reabsorption. ʻO ka hoʻohana ʻana o Desmopressin i loko o ka maʻi diabetes maʻi intipidus e alakaʻi i ka emi ʻana i ka nui o ka urine i hoʻopā ʻia a me ka hoʻonui pinepine ʻana i ka osmolality o ka urine a me kahi hoʻohaʻahaʻa iho i ka osmolality o ke kaila koko. Ke alakaʻi nei kēia i kahi emi o ka urination a me kahi laʻa o ka polyuria nocturnal.

ʻO ka hopena antidiuretic loa ka hopena i ka wā e lawe ai i ka waha - ma hope o nā hola 4-7. Ka hopena antidiuretic i ka wā e lawe ʻia ai i ka waha ma kahi o 0.1-0.2 mg - a hiki i 8 mau hola, ma kahi ohe 0.4 mg - a hiki i 12 mau hola.

Kūpono ʻaoʻao

• E nīnau i ka nīnau ʻana i ka neurologist
• Buy lāʻau
• E nānā i nā hui

Nā ʻano lāʻau lapaʻau

Hoʻopuka ka mea hana i ka lāʻau lapaʻau i kekahi mau lāʻau lapaʻau, i waena o lākou:

1. ʻO nā puna o ka ihu, ʻo ia ka wai lehelehe keʻokeʻo. Hoʻopili ʻia i loko o nā pahu pīpī, kēlā me kēia me ka 5 ml o ka lāʻau lapaʻau.
2. Hoʻopili ke Nasal "Desmopressin". ʻO kahi wai holoi wai ʻole me ka waihoʻoluʻu. Hoʻopili ʻia i loko o nā hue i hana ʻia i ke aniani keʻokeʻo a paʻa ʻia i kahi lako kūikawā no ka hōʻoki. E paʻa ka paona i 50 mau keneka.
3. Nā Palaki Ke keʻokeʻo nei lākou i ka waihoʻoluʻu, ma kahi ʻaoʻao kahi pōpilikia. Hoʻopili ʻia i loko o nā waihona polyethylene o 28, 30, 90 mau ʻāpana, a i loko o nā pā hepū o 10, 30 ʻāpana.

ʻAʻole i kuhikuhi ʻia nā ʻōkuhi no ka hoʻohana ʻia no nā analogie "Desmopressin". E noʻonoʻo mākou iā lākou ma lalo nei.

ʻO ka papa hana i nā papa a me ka ihu o ka ihu ka desmopressin acetate, i loko o ka hāʻule - desmopressin. I ka hana ʻana i nā papa, hoʻohana ʻia nā mea kōkua like e like me ka magnesium stearate, starch potato, povidone-K30, lactose monxidate.

ʻO nā mea kōkua i ka pīpī i: nā wai maʻemaʻe, ka wai hydrochloric, sodium chloride, potassium sorbate.

E like me nā mea hou i ka hana ʻana o nā pūpaka e hoʻohana ʻia: ka wai maʻemaʻe, ka wai hydrochloric, sosa sodiumide, chlorobutanol.

ʻO nā mea inoa o nā papa Desmopressin a me nā mea paʻakikī ʻaʻole ia he mea paʻakikī ke koho, akā pono e hana ke kauka hele hele i kēia.

ʻO nā hopena maikaʻiʻole o ka hoʻohana ponoʻana i ka lāʻau

E kūʻē i ka hope o ke hoʻohana ʻana o ka puna, ka ʻuʻoki a me nā papa Desmopressin, hiki i ka mea maʻi ke hoʻomohala i nā ʻano manaʻo ʻino ʻole, e pili pū ana me ia e hoʻolako ʻia i nā pilala i kuhikuhi ʻia e ke kauka. Hōʻike pinepine ʻia me nā lāʻau lapaʻau:

• He ʻeha ma ka ʻena pūnaewele.
• Haki i ka lacrimation.
• Alluncic conjunctivitis.
• ʻO nā ʻalā.
• ʻO nā hōʻike e pili ana i ka ʻili.
• Algodismenorea.
• Colic Intestinal.
• Lohea
• ʻEha ka ʻōpū.
• Kahula
• Ke kuʻi nei ma ke kua o ka paʻa o ka wai i loko o ke kino.
• Hyponatremia.
• Oliguria.
• Hoʻonui a hoʻohemo paha i ke kahe koko inā ke hoʻokele wikiwiki ʻia ka lāʻau.
• Ka kuʻi ʻana o nā mea ʻohu i ka mucous waha.
• ʻO ka Hypoosmolality.
• Rhinitis.
• ʻO ka loaʻa kālā.
• Ka nui o ka ʻike.
• Ke kue.
• ʻʻAla.
• Nā Aliʻi.
• Coma

Inā he hanana ʻino e kū ʻia, pono ia e hōʻike i kāu kauka. Hoʻomaopopo ʻia kēia ma nā ʻōkuhi no ka hoʻohana. Nā likeʻala o Desmopressin i nā hopena like like.

Ke hoʻohana nei i ka lāʻau lapaʻau: pehea e hana pololei ai

ʻO ka hoʻoponopono lāʻau a me ka hoʻoponopono ʻia no ka mea maʻi no kēlā me kēia maʻi e hoʻoholo ʻia e ke kauka.

Ke hoʻohana ʻia nei nā ʻano intranasal o ka lāʻau lapaʻau, hōʻike ʻia ke kaʻina o a hiki i ka 40 mgk o ka lāʻau lapaʻau i kēlā me kēia lā. Pono e mahele ʻia ke ʻano lāʻau i hōʻike ʻia i kekahi mau noi. I ka mālamaʻana i nā keiki, pono kahi hoʻoponopono ʻana no ka laʻana, mai ka 3 μg i kēlā me kēia lā e hoʻohana pinepine ʻia.

Inā ke kauoha ʻia ka lawelawe ʻana o ka lāʻau i ka intramuscularly, intravenously, subcutaneously, a laila pono nā mea maʻi i hoʻohana i ka 4 μg i kēlā me kēia lā, nā keiki - a hiki i 2 μg.

Ke hala ʻole o kahi hopena therapeutic i loko o ka hebedoma hoʻohana ʻana o ka lāʻau lapaʻau, pono ʻoe e ʻimi i ke kauka i mea e hoʻoponopono ai i ka ʻolō. Lawe pinepine ia i mau hebedoma e koho i ka regimen lapaʻau kūpono.

Ke waiho nei i nā kūlana no ka lāʻau lapaʻau

E mālama i ka lāʻau lapaʻau i kahi wahi hiki ʻole i nā keiki, ka mahana ma loko o kahi o 30 mau kiʻekiʻe.

E hoʻomau i ka lāʻau lapaʻau i ka hiki ʻole o nā keiki.

ʻŌpū a me ka lactation

ʻO ka lawa ʻana a me ke aʻo ʻia ʻana i nā haʻawina no ka palekana o ka desmopressin i ka wā hāpai a me ka lactation ʻaʻole i alakaʻi ʻia. Inā pono e hoʻohana i ka desmopressin i kēia māhele o nā mea maʻi, ʻo nā pōmaikaʻi i manaʻi ʻia o ka lāʻau no ka makuahine a me ka mea hiki paha i ke kuʻi ʻana a i ʻole ke keiki e kaupaona ʻia.

Hoʻomihala hoʻokō ʻia DESMOPRESSIN (DESMOPRESSIN)

• APO-DESMOPRESSINE (hiki i ka ihu kolo manuʻa). 10 mcg / 1 dosis: fl. 2.5 ml (25 inakene) a i ʻole 5 ml (50 inakene) • nā hopena EMOSINT (EMOSINT) d / injection. 4 μg / 0,5 ml: amp. 10 nā pcs. • ka pahu MINIRIN® (MINIRIN). sublingual 120 mcg: 10, 30 a i ʻole 100 pcs. • nā kauʻu MINIRIN® (MINIRIN). 200 mcg: 30 nā pcs. • ka pahu MINIRIN® (MINIRIN).

100 mcg: 30 pcs. • ʻĀina EMOSINT (EMOSINT) no ka maʻi maʻi. 40 mcg / 1 ml: amp. 10 nā pcs. • DESMOPRESSIN (DESMOPRESSIN) nasal spray dosed ka 10 mcg / 1 kaʻe: vial. 50 dosis me nā pihi. • ʻIRlani MINIRIN® (MINIRIN) ʻōpiopio dona. 10 mcg / 1 dosis: fl. 2,5 ml (25 inakene) a i ʻole 5 ml (50 inakene) • nā kauʻu MINIRIN® (MINIRIN).

sublingual 240 mcg: 10, 30 a i ʻole 100 mau pūʻulu • PRESINEX (ihal dosing spray). 10 mcg / 1 dosis: fl. 60 kekona • nā ʻōhua EMOSINT (EMOSINT) d / inikua. 20 mcg / 1 ml: amp. 10 nā pcs. • DESMOPRESSIN (waʻolo o ka ihu) 100 mcg / 1 ml: vial. 5 ml

• mau lāʻau MINIRIN® (MINIRIN).

sublingual 60 mcg: 10, 30, a i ʻole 100 pcs.