Minirin® (Minirin)

Dosage cov ntaub ntawv ntawm Minirin:

• 100 mcg ntsiav tshuaj: dawb, oval, convex, nrog cov ntawv sau "0.1" ntawm ib sab thiab scuff ntawm lwm yam (30 pcs. Hauv lub raj mis yas, hauv daim ntawv thawv ntawv, 1 lub raj mis),
• 200 mcg ntsiav tshuaj: dawb, puag ncig, convex, nrog cov ntawv sau "0.2" ntawm ib sab thiab scuff ntawm lwm yam (30 pcs. Hauv lub raj mis yas, hauv daim ntawv thawv ntawv, 1 lub raj mis),
• Sublingual ntsiav tshuaj 60 mcg: dawb, puag ncig, daim ntawv lo rau ntawm ib sab li ib tee (10 pcs. Hauv cov hlwv, hauv pob duab los qhia 1, 3 lossis 10 hlwv),
• Sublingual ntsiav tshuaj 120 mcg: dawb, puag ncig, daim ntawv lo rau ntawm ib sab li ob tee (10 pcs. Hauv cov hlwv, hauv ib pob duab los qhia ntawm 1, 3 lossis 10 hlwv),
• Sublingual ntsiav tshuaj, 240 mcg: dawb, puag ncig, daim ntawv lo rau ntawm ib sab hauv daim ntawv ntawm peb tee (10 pcs. Hauv ib lub hlwv, hauv daim duab los ntawm pob ntawv ntawm 1, 3 lossis 10 hlwv),
• Muab cov tshuaj tsuag rau qhov ntswg siv (2,5 lossis 5 ml txhua qhov hauv lub khob iav tsaus kom tiav nrog tus neeg thov tshuaj rau qhov ntswg, hauv daim ntawv ntim los ntawm daim ntawv 1 teeb).

Cov tshuaj yeeb tshuaj yog desmopressin acetate, cov ntsiab lus nyob ntawm daim ntawv tso tawm:

• Ntsiav tshuaj: hauv 1 daim - 100 lossis 200 μg (feem 89 lossis 178 μg ntawm desmopressin),
• Sublingual ntsiav tshuaj: hauv 1 daim - 67, 135 lossis 270 mcg (60, 120 lossis 240 mcg ntawm desmopressin, ntsig txog),
• Txau: hauv 1 ml (10 koob) - 100 mcg.

• Ntsiav tshuaj: magnesium stearate, povidone, qos hmoov txhuv nplej siab, lactose,
• Sublingual ntsiav tshuaj: citric acid, mannitol, gelatin,
• Txau: benzalkonium chloride, sodium hydrogen phosphate dihydrate, sodium chloride, citric acid (monohydrate), dej lim.

Kev ntsuas rau siv

• Ntshav qab zib insipidus ntawm hauv paus chiv keeb,
• Nocturia (nocturnal polyuria) rau cov neeg laus raws li kev kho mob,
• Primary nocturnal enuresis rau cov menyuam yaus hnub nyoog qis dua 6 xyoo.

Tsis tas li, cov tshuaj txau raug pom zoo rau kev siv rau kev kho mob ib ntus polydipsia thiab polyuria tom qab kev ua haujlwm hauv lub caj pas pituitary, thiab ua cov cuab yeej kuaj mob los tsim cov peev xwm hauv lub raum.

Cov Yuav Tsum Tau Ua

• Lub plawv tsis ua hauj lwm thiab lwm yam mob uas yuav tsum tau tswj hwm ntawm diuretics,
• Cov paub lossis puas hlwb polydipsia (nrog ib tug zis ntawm 40 ml / kg / hnub),
• Ntshav Qab Zib,
• Kev mob tsis txaus ntawm cov tshuaj tiv thaiv antidiuretic (ADH),
• Mob raum tsis txaus thiab mob raum (creatinine ntshiab

Tsuas tshuaj thiab tswj hwm

Cov ntsiav tshuaj tau noj ntawm qhov ncauj qee lub sijhawm tom qab noj mov, vim hais tias kev noj mov tuaj yeem txo qhov nqus ntawm qhov tshuaj thiab txo nws cov nyhuv.

Sublingual ntsiav tshuaj siv sublingually (nqus tau nyob hauv tus nplaig), tsis ntxuav nrog kua!

Qhov ntau npaum cas ntawm cov tshuaj ntawm ob lub qhov ncauj ntawm Minirin yog raws li nram no: sublingual ntsiav tshuaj ntawm 60 thiab 120 correspondg sib piv rau cov ntsiav tshuaj ntawm 100 thiab 200 μg. Qhov zoo ntawm koob tshuaj yuav tsum tau xaiv ib tus zuj zus.

Pom zoo kom noj tshuaj rau cov ntsiav tshuaj sublingual:

• Nruab nrab hauv ntshav qab zib insipidus. Qhov hno thawj zaug yog 60 mcg 3 zaug hauv ib hnub, yav tom ntej nws raug kho nyob ntawm qhov siv ntawm cov tshuaj. Qhov koob tshuaj txhua hnub tuaj yeem sib txawv los ntawm 120 rau 720 mcg, qhov koob tshuaj zoo tshaj plaws rau cov neeg mob feem ntau yog 60-120 mcg 3 zaug hauv ib hnub,
• Thawj nocturnal enuresis. Thawj koob tshuaj yog 120 mcg, noj ib hnub ib hmos thaum hmo ntuj, nrog kev kho mob tsis muaj txiaj ntsig, qhov koob tshuaj nce siab txog li 240 mcg yog qhov kev tso cai, thaum yav tsaus ntuj tus neeg mob tau qhia kom txwv cov kua dej tsawg. Tom qab 3 lub hlis ntawm cov kev kho mob tsis tu ncua, kev txiav txim siab mus txuas ntxiv noj cov tshuaj yog ua raws cov ntaub ntawv soj ntsuam khaws tseg rau 7 hnub tom qab nws tshem tawm,
• Nocturnal polyuria rau cov neeg laus. Qhov tshuaj thawj zaug yog 60 mcg thaum hmo ntuj, thaum tsis muaj qhov xav tau nyob rau hauv 1 lub lis piam, qhov koob tshuaj tau nce mus rau 120 mcg, thiab tom qab ntawd, yog tias tsim nyog, rau 240 mcg (nrog rau qhov kev xav tau ntau ntxiv hauv lub lis piam). Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv qhov kev hem thawj ntawm kev tuav dej hauv lub cev. Yog hais tias tom qab 4 lub lis piam, thaum lub sij hawm qhov tshuaj txhaj tshuaj tau ua tiav, nws tsis tuaj yeem ua tiav qhov kev cia siab hauv cov chaw kho mob, kev siv tshuaj ntxiv yog impractical.

Minirin tshuaj tsuag yog siv sab hauv, tus naj npawb ntawm cov tee yog tswj hwm los ntawm lub teeb siab ntawm cov kua dej, uas yog ib feem ntawm kev kaw lub raj mis. Thaum tswj hwm cov tshuaj, tus neeg mob yuav tsum nyob hauv "zaum" lossis "dag" txoj haujlwm, nrog nws lub taub hau pov rov qab. Cov neeg laus raug pom zoo kom noj ib hnub 10-40 mcg (1-4 tee hauv 2-4 koob), rau cov menyuam muaj 3 hlis txog 12 xyoos - 5-30 mcg. Rau kev kho mob ntawm cov thawj cov kab mob nocturnal enuresis, cov tshuaj tau muab rau lub sijhawm pw thaum pib ntawm 20 mcg, yog tias cov tshuaj tsis muaj txiaj ntsig, qhov koob tshuaj nce txog 40 mcg yog tau tso cai, tom qab 3 lub hlis ntawm kev kho, ib lub lim tiam so tawm los soj ntsuam cov txiaj ntsig kho.

Sab sij huam

Thaum siv Minirin, qhov tshwm sim tsis zoo tshwm sim feem ntau tshwm sim hauv cov xwm txheej no thaum kev kho mob nqa tawm yam tsis muaj kev txwv cov kua dej, uas nkag mus rau qhov pom ntawm hyponatremia thiab / lossis kua dej cia. Cov mob no tuaj yeem yog asymptomatic lossis nrog nrog cov xwm txheej hauv qab no:

• Tej leeg hauv lub cev tsis muaj zog: kiv taub hau, mob taub hau, mob hnyav - tu cev,
• Lub plab zom mov: xeev siab, qhuav lub qhov ncauj, ntuav,
• Lwm yam: ua kom yuag, lub cev tawv nqaij.

Txuas ntxiv rau tshuaj tsuag:

• Cov kab mob ntsws: o ntawm lub qhov ntswg mob ntsws, hnoos qeev,
• Kev mob plawv: nce ntshav siab (thaum siv ntshav siab),
• Lub cev ntawm lub zeem muag: pom mob pob txha, mob lacrimation mob.

Yog tias muaj kev haus ntau dhau, lub sijhawm ntawm Minirin nce, qhov kev pheej hmoo ntawm hyponatremia thiab kua dej nce ntxiv. Hauv cov xwm txheej no, koj yuav tsum tsum tsis txhob siv cov tshuaj, tso tseg cov kev txwv ntawm kev haus dej thiab sab laj nrog tus kws tshaj lij. Yog tias tsim nyog, nws muaj peev xwm ua kom infuse hypertonic lossis isotonic sodium chloride tov, nrog rau kev teem caij furosemide (nrog kev txhim kho ntawm qaug dab peg thiab tsis nco qab).

Cov lus qhia tshwj xeeb

Nrog kev pib nocturnal enuresis, yuav tsum tau txwv tsis pub cov kua dej mus rau qhov tsawg kawg nkaus 1 teev ua ntej thiab tsis pub dhau 8 teev tom qab noj cov tshuaj yuav tsum ua. Txwv tsis pub, txoj kev pheej hmoo ntawm kev tsim cov tsis xav tau nce ntxiv.

Thaum kho, nws yog qhov yuav tsum tau ua tib zoo saib xyuas cov xwm txheej ntawm cov neeg laus, menyuam yaus thiab tub ntxhais hluas, cov neeg mob uas muaj kev hem thawj ntawm lub siab mob ntxiv lossis nrog cov dej tsis zoo thiab / lossis hluav taws xob sib npaug.

Thaum Minirin raug xaj rau cov neeg mob laus, ua ntej pib kev kawm, 3 hnub tom qab thawj daim ntawv thov thiab ntawm txhua qhov kev nce ntxiv, nws yog qhov yuav tsum tau soj ntsuam tus neeg mob, nrog rau kev txiav txim siab lub siab ntawm sodium hauv ntshav plasma.

Kev siv tshuaj intranasal ntawm cov tshuaj, muaj cov mob rhinitis heev thiab o ntawm lub qhov ntswg mob tuaj yeem ua rau lub cev tsis muaj zog ntawm desmopressin, vim tias qhov kev tswj hwm qhov ncauj pom zoo nyob rau hauv cov xwm txheej zoo li no.

Thaum siv Minirin ua cov cuab yeej siv tshuaj, nws tsis pom zoo kom nqa tawm cov dej yuam (tsis hais ntawm ncauj lossis niam txiv), tus neeg mob yuav tsum haus dej ntau li qhov tsim nyog kom nqhis dej nqhis dej.

Kev siv cov tshuaj nyob rau hauv kev kawm ntawm kev paub txog lub peev xwm ntawm lub raum hauv cov menyuam yaus hnub nyoog qis dua 1 xyoos yuav tsum tau nqa tawm tshwj xeeb hauv tsev kho mob.

Nrog cov kab mob ua kom tsis muaj ntshav qab zib mellitus thiab polydipsia, nrog cov tsos mob ntawm dysuria thiab / lossis nocturia, mob tso zis ceev, mob txeeb zig, xav tias yuav mob qog ntshav ntawm lub qog ua haujlwm lossis lub zais zis, kev kuaj mob thiab kev kho mob ntawm cov kab mob no thiab yam yuav tsum tau nqa tawm ua ntej pib kev kho mob nrog Minirin.

Nws yuav tsum tsis kam noj cov tshuaj yog tias muaj mob ua npaws, mob ncauj plab, muaj kab mob rau hauv lub sijhawm kho.

Yeeb tshuaj sib cuam tshuam

Nco ntsoov tias thaum ua ke nrog Minirin:

• Indomethacin - txhim kho kev ua tau zoo ntawm cov tshuaj,
• Tetracycline, glibutide, norepinephrine, lithium - txo cov tshuaj tiv thaiv kab mob,
• Xaiv cov serotonin inhibitors, tricyclic cov tshuaj tiv thaiv kab mob, carbamazepine, chlorpromazine - tuaj yeem ua rau cov nyhuv antidiuretic ntxiv thiab yuav ua rau muaj kev pheej hmoo ntawm cov kua dej tawm thiab cov mob hyponatremia,
• Nonsteroidal anti-inflammatory tshuaj - ua rau muaj kev pheej hmoo ntawm kev phiv,
• Dimethicone - pab txo qis kev nqus ntawm desmopressin.

Thaum Minirin koom ua ke nrog loperamide, qhov peb zaug yuav tsum nce siab ntawm desmopressin hauv plasma tuaj yeem pom, uas ua rau muaj kev pheej hmoo ntawm cov kua dej tawm thiab qhov tshwm sim ntawm hyponatremia. Muaj qhov ntxim nyiam tias lwm cov tshuaj qeeb qeeb peristalsis tuaj yeem ua rau muaj kev tsis sib xws. Hauv kev siv nrawm nrog rau cov tshuaj saum toj no, yuav tsum saib xyuas qib ntawm sodium hauv cov ntshav ntshav yog yuav tsum muaj.

Nosological kev faib tawm (ICD-10)

Pharmacological thaj chaw ntawm cov tshuaj Minirin

Minirin ntsiav tshuaj muaj desmopressin - ib qho hluavtaws sib piv ntawm lub cev loj ntawm cov posterior pituitary caj pas - arginine-vasopressin (antidiuretic hormone). Desmopressin tau txais los ntawm kev hloov pauv hauv tus qauv ntawm vasopressin molecule: deamination ntawm 1-cysteine ​​thiab hloov ntawm 8-L-arginine nrog 8-D-arginine.
Piv nrog vasopressin, desmopressin muaj qhov tsis pom kev zoo ntawm cov leeg nqaij ntawm cov hlab ntshav nrog ntau qhov kev tawm tsam antidiuretic. Vim cov kev hloov pauv piav qhia, Minirin ua kom tsuas yog vasopressin V2 receptors nyob rau hauv epithelium ntawm cov tub ntxhais hluas txoj kev ua pa thiab ib qho dav ntawm qhov nce ntu Henle loops, uas ua rau muaj qhov nce ntawm pores hauv nephron epithelial hlwb thiab ua rau kom muaj kev cuam tshuam cov dej rov qab rau hauv cov ntshav. Tom qab noj cov tshuaj, cov tshuaj tua kab mob tshwm sim hauv 15 feeb. Kev tswj hwm ntawm 0.1-0.2 mg ntawm desmopressin muab ib qho tshuaj tiv thaiv kab mob rau hauv cov neeg mob feem ntau txog li 8 hours12 teev. Kev siv Minirin hauv cov neeg mob nrog kev kuaj mob ntshav qab zib insipidus ntawm cov hauv paus chiv keeb ua rau txo qis cov zis tso zis tawm thiab ua rau muaj kev cuam tshuam ntau ntxiv hauv nws cov osmolarity. Raws li qhov tshwm sim, lub zaus txo qis thiab qhov mob ntawm nocturia txo qis.
Teratogenic lossis mutagenic cov teebmeem ntawm desmopressin tseem tsis tau txheeb xyuas.
Desmopressin pib raug kuaj pom hauv cov ntshav 15-30 feeb tom qab kev tswj hwm. Qhov siab tshaj plaws hauv cov ntshav ntshav tau mus txog tom qab 2 teev Lub sijhawm ib nrab ntawm lub neej ntawm desmopressin hauv ntshav plasma yog 1.5-3.5 teev. Cov tshuaj tawm hauv cov zis tawm hauv cov zis tsis hloov, ib feem tom qab enzymatic cleavage.

Kev siv cov tshuaj Minirin

Siv cov tshuaj tsuas yog qhia koj tus kws kho mob. Cov qib siab ntawm cov tshuaj yog xaiv ntawm tus kheej.
Mob ntshav qab zib insipidusCov. Thawj koob tshuaj rau cov neeg laus thiab menyuam yaus hnub nyoog dhau 5 xyoos yog 0.1 mg ntawm desmopressin 3 zaug hauv ib hnub. Koob tshuaj ntxiv yog xaiv raws li kev hloov pauv ntawm tus neeg mob. Raws li cov txiaj ntsig kev soj ntsuam, qhov kev noj tshuaj txhua hnub nws txawv ntawm 0.2 txog 1.2 mg ntawm desmopressin. Rau feem ntau ntawm cov neeg mob, nws yog qhov zoo dua rau noj 0.1-0.2 mg ntawm desmopressin 3 zaug hauv ib hnub.
Thawj nocturnal enuresisCov. Thawj koob tshuaj rau cov neeg laus thiab menyuam yaus hnub nyoog dhau 5 xyoos yog noj 0.1 mg ntawm desmopressin thaum hmo ntuj. Thaum tsis muaj txiaj ntsig tsis txaus, qhov kev cia siab yuav nce ntxiv rau 0.4 mg. Lub chav kawm ntawm kev kho mob yog 3 lub hlis. Cov lus nug ntawm qhov yuav tsum tau txais kev kho mob txuas ntxiv yuav tsum txiav txim siab tom qab ib lim tiam so thaum noj Minirin. Thaum kho, koj yuav tsum txwv tsis pub haus dej thaum hmo ntuj thiab tom qab noj cov tshuaj.
Hmo ntuj (nocturnal polyuria). Thawj koob tshuaj pom zoo rau cov neeg laus thiab cov menyuam yaus hnub nyoog dhau 5 xyoos yog 0.1 mg thaum tsaus ntuj. Thaum tsis muaj txiaj ntsig ntawm kev pib siv rau 1 lub lim tiam, qhov kev noj tshuaj yog maj mam nce txhua lub asthiv mus rau 0.2 mg thiab tom qab ntawd rau 0.4 mg. Koj yuav tsum paub txog kev tuav dej hauv lub cev. Hauv cov neeg mob 65 xyoo thiab laus dua, qib ntawm sodium hauv cov ntshav yuav tsum tau saib xyuas ua ntej kev kho mob, tom qab 3 koob tshuaj thiab tom qab nce qhov koob tshuaj.
Thaum muaj cov tsos mob ntawm kev tso kua dej tawm thiab / lossis hyponatremia (mob taub hau, xeev siab, ntuav, nce ntxiv, hauv qhov mob hnyav - cramps), kev kho mob yuav tsum nres tam sim ntawd kom txog thaum tus neeg mob zoo tu qab tso. Thaum rov pib kho mob, ib qho yuav tsum nruj dua ntxiv saib xyuas qhov kev txwv ntawm cov kua dej ntau ntau los ntawm tus neeg mob.

Kev sib cuam tshuam yeeb tshuaj Minirin

Indomethacin tuaj yeem txhim kho cov nyhuv ntawm Minirin yam tsis muaj nce ntev ntawm kev ua. Cov tshuaj yeeb dej caw uas ua rau muaj kev nce ntxiv ntawm cov tshuaj antidiuretic (vasopressin), qee yam tshuaj tiv thaiv kab mob (chlorpromazine thiab carbamazepine) tuaj yeem txhim kho antidiuretic nyhuv ntawm Minirin thiab ua rau muaj kev pheej hmoo ntawm kev tuav dej hauv lub cev.

Ntau tshaj ntawm cov tshuaj Minirin, cov tsos mob thiab kev kho mob

Nrog ib qho kev tshaj tawm, qhov kev pheej hmoo ntawm hyponatremia thiab kua dej hauv lub cev nce ntxiv. Txawm hais tias kev kho mob ntawm hyponatremia yuav tsum yog tus neeg, muaj cov lus qhia dav dav:

• Thaum asymptomatic hyponatremia, kev kho mob Minirin yuav tsum tsis txhob cuam tshuam thiab tus neeg mob yuav tsum tau txwv tsis pub noj kua,
• Thaum muaj cov tsos mob tshwm sim los ntawm hyponatremia, kev tswj hwm cov iso- lossis hypertonic sodium chloride daws yuav tsum tau ua,
• nyob rau hauv cov teeb meem loj, tso kua dej rov qab rau hauv lub cev, ua kom pom los ntawm kev chua leeg thiab / lossis tsis nco qab, yuav tsum muaj nyob hauv qhov kho mob (mob) kev kho ntawm furosemide.

Pharmacological kev piav qhia ntawm cov tshuaj

Lub ntsiab zoo ntawm cov tshuaj no yog antidiuretic.

Lwm qhov tseem ceeb ntawm cov tshuaj muaj xws li:

1. Lub peev xwm los cuam tshuam rau cov txheej txheem ntawm cov ntshav coagulation. Cov tshuaj ua kom lub hauv paus ntxiv VIII ntawm txoj kev no. Qhov no tseem ceeb rau cov neeg muaj tus mob hemophilia lossis voos Willebrand,
2. Lub tshuab ntaus ntshav nce
3. Tsis zoo li lwm yam tshuaj, nws ua ntau dua maj mam ua rau cov leeg du. Tib txoj kev cuam tshuam me me tshwm sim rau txhua yam kabmob,

Qhov tshuaj tiv thaiv kab mob nyhuv tom qab noj cov tshuaj nyob rau hauv daim ntawv ntawm qhov ntswg dauv lossis ntsiav tshuaj tshwm sim hauv ib teev. Antihemorrhagic nyhuv yuav tshwm sim tom qab tswj hwm hauv 15-30 feeb. Qhov siab tshaj plaws antidiuretic nyhuv yuav tshwm sim tsuas yog 1-5 teev tom qab tswj hwm hauv qhov ntswg lossis 4-7 teev tom qab noj cov ntsiav tshuaj.

Qhov kev ua yuav muaj txuas ntxiv thaum siv cov tee rau 8-20 teev. Yog tias cov tshuaj tshwm sim hauv daim ntawv ntawm cov ntsiav tshuaj, tom qab ntawd qhov ntau npaum ntawm 0.1-0.2 mg yuav muab yim-teev, thiab 0.4 mg - cov nyhuv rau kaum ob teev.

Lub cim tseem ceeb rau kev siv

Ua ntej tshaj plaws, cov tshuaj tau raug muab tshuaj rau kev kuaj mob, thiab tom qab ntawd rau kev kho mob ntshav qab zib ntawm hauv paus chiv keeb (hom mob ntshav qab zib thib ob). Minirin kuj tseem pab yog tias muaj kev raug mob ntawm lub hauv paus txha caj qaum, lwm cov kab mob hlwb. Cov tshuaj yog tshuaj tom qab txiav thaum ua haujlwm lub caj pas pituitary thiab thaj chaw ib sab nws.

Minirin feem ntau tau sau tseg rau cov tsos mob thawj zaug ntawm kev tso zis tsis ua hauj lwm, kuj txiav txim siab lub peev xwm ntawm lub raum kom mloog zoo. Nws kuj tseem tsim nyog ntxiv rau cov kab mob hemophilia A thiab von Willebrand (tshwj tsis yog hom IIb) rau daim ntawv.

Cov yam ntxwv ntawm kev siv thiab contraindications

Lub xub ntiag ntawm hypersensitivity rau lub active khoom yog lub ntsiab contraindication. Nws kuj tseem yuav tsum tau sau tseg kev mob paj hlwb los yog mob hlwb. Cov tshuaj yuav tsum tsis txhob noj thaum tab tom kho tus mob diuretic.Cov neeg uas mob siab rau tsim ntawm thrombosis kuj yuav tsum tso tseg Minirin.

Tsis txaus ntseeg angina thiab muaj cov kab mob von Willebrand hom IIb tuaj yeem txuas ntxiv rau cov npe no. Muaj cov yam ntxwv sib cais ntawm kev siv cov tee - qhov no yog ua xua thiab ua xua txhaws ntswg, muaj cov mob kis mob rau sab hauv lub ntsws lossis o ntawm lub qhov ntswg mob. Nws kuj tsim nyog ntxiv kom poob ntawm kev nco qab thiab mob hnyav tom qab kev mob.

Qhov no tseem ceeb heev! Minirin yuav tsum tau ua tshwj xeeb tshaj yog rau cov neeg muaj lub raum tsis ua haujlwm, zais zis ntawm cov leeg. Tsis tas li tsis pom zoo rau cov menyuam yaus hnub nyoog qis dua ib xyoos lossis laus dua. Tshwj xeeb yuav tsum tau ceev faj yuav tsum yog cev xeeb tub los yog cov neeg uas muaj kev pheej hmoo ntawm kev mob siab ntxiv rau hauv intracranial siab. Tsis tas li, nrog ceev faj, cov tshuaj no yuav tsum tau siv los ntawm cov ntshav qab zib nrog kev ua txhaum ntawm cov dej-electrolyte tshuav nyiaj li cas.

Cov tshuaj phiv:

• Qhov khaus ntawm qhov mob hauv lub taub hau,
• Lub siab yeej tsis xaus qhov zoo siab ntawm xeev siab
• Los ntswg, thiab cov ntswg zoo li vim muaj ntshav nce siab,
• Nyiaj tachycardia,
• Cov phaus ntxiv, uas nrog los ntawm dav dav ntawm lub cev,
• Qhov muag qhuav ua mob rau pob txha, yuav muaj tshwm sim,
• Hyperemia ntawm daim tawv nqaij,
• Txawv qhov sib txawv ntawm kev ua xua,

Kev siv ntau dhau ntawm cov tshuaj ua rau dej intoxication, uas ua rau kev nriaj. Qhov kev ua kom paub ntau yam mob ntawm lub paj hlwb thiab lub siab yog tau. Raws li kev kho mob, nws yog qhov zoo uas yuav tsum tau siv tshem ntawm cov tshuaj.

Thaum noj ntau dhau, nws yog qhov yuav tsum tau muab lub cev kom haus ntxiv cov kua dej, nws yuav tsum maj mam ua kom paub cov ntsev sib xyaw.

Yuav noj Minirin li cas?

Qhov tshuaj nruab nrab rau cov neeg laus yog li ib mus rau plaub ncos ob peb zaug hauv ib hnub. Qhov ntau npaum li cas ntawm cov tshuaj yuav tsum nyob hauv thaj tsam ntawm 10-40 mcg hauv ib hnub. Yog tias cov menyuam yaus muaj hnub nyoog 3 hlis txog 12 xyoos (cov tshuaj siv tau, tab sis nrog kev ceev faj ntxiv), tom qab ntawd cov tshuaj yuav tsum yog 20 mcg thaum mus pw (tso cai rau lub txaj pw).

Lub chav kawm ntawm kev kho mob yuav tsum kav rau ib lub lim tiam, thiab tom qab ntawd rov ua dua tom qab peb lub hlis.

Qhov ntswg npaj yog qhov yooj yim tshaj los dag thaum tsawg. Hauv qhov no, nws yog qhov yuav tsum tau pov koj lub taub hau kom cov tshuaj tau raws nraim ntawm qhov chaw tswj hwm. Daim foos yooj yim tso tawm tso cai rau koj yooj yim kho cov naj npawb ntawm cov tee. Txhawm rau txiav txim siab lub peev xwm concentration ntawm ob lub raum, cov tshuaj yog tawm rau cov menyuam ntawm 10 mcg.

Qhov siab tshaj plaws yuav tsum tsis pub tshaj 50 mcg. Qhov koob tshuaj tsawg kawg nkaus rau cov neeg laus yog 20 mcg. Tom qab siv cov tshuaj, koj yuav tsum mus rau hauv chav dej ib pliag kom khoob lub zais zis rau qee lub sijhawm, sim tsis txhob haus dej (tsawg kawg plaub teev, tab sis nws zoo dua yog pib haus dej tom qab yim teev tom qab noj tshuaj).

Kev piav qhia ntawm daim ntawv tshuaj

Sublingual ntsiav tshuaj, 60 mcg: puag ncig, dawb, cim nrog ib tee ntawm ib sab.

Sublingual ntsiav tshuaj, 120 mcg: puag ncig, dawb, cim nrog ob tee ntawm ib sab.

Sublingual ntsiav tshuaj, 240 mcg: puag ncig, dawb, cim nrog peb tee ntawm ib sab.

Cov Tshuaj Hauv Tshuaj

Desmopressin yog cov qauv ua pov thawj ntawm cov tshuaj arginine-vasopressin, cov pituitary hormone hauv tib neeg. Qhov sib txawv yog nyob rau hauv deamination ntawm cysteine ​​thiab hloov ntawm L-arginine nrog D-arginine. Qhov no ua rau muaj qhov tseem ceeb txuas ntxiv rau lub sijhawm ua haujlwm thiab tag ua tsis tiav ntawm kev siv vasoconstrictor.

Desmopressin tsub kom qhov permeability ntawm epithelium ntawm lub distal convoluted tubules thiab nce lub reabsorption ntawm cov dej, uas ua rau txo qis cov zis ntawm cov zis tawm, qhov nce ntawm osmolarity ntawm cov zis nrog ib txhij txo nyob rau hauv osmolarity ntawm cov ntshav ntshav, txo qis ntawm qhov nquag ntawm tso zis thiab txo qis rau hauv nocturia (hmo ntuj polyur).

Cov Tshuaj Pharmacokinetics

Lub bioavailability ntawm desmopressin nyob rau hauv daim ntawv sublingual ntawm koob tshuaj 200, 400 thiab 800 μg yog li 0.25%.

C_max plasma desmopressin tau tiav nyob rau hauv 0.5-2 teev tom qab noj cov tshuaj thiab yog ncaj qha rau cov koob tshuaj: tom qab noj 200, 400 thiab 800 μg C_max ntau npaum li cas rau 14, 30 thiab 65 pg / ml, feem.

Desmopressin tsis hla BBB. Desmopressin ua haujlwm tawm los ntawm ob lub raum, T_1/2 2.8 teev

Kev taw qhia ntawm cov tshuaj Minirin ®

ntshav qab zib insipidus ntawm hauv paus chiv keeb,

thawj nocturnal enuresis rau cov menyuam yaus tshaj 6 xyoo,

nocturia hauv cov neeg laus, cuam tshuam nrog kev mob ntsws nocturnal polyuria (nce tso zis rau cov neeg laus, ntau dua qhov muaj peev xwm ntawm lub zais zis thiab ua rau kom muaj kev xav tau thaum hmo ntuj ntau dua ib zaug los nchuav cov zais zis) - raws li kev kho mob ntsig txog ..

Cev xeeb tub thiab lactation

Cov ntaub ntawv tsawg tsawg ntawm kev siv desmopressin rau cov poj niam cev xeeb tub uas muaj ntshav qab zib insipidus (n = 53) qhia tias desmopressin tsis cuam tshuam dab tsi rau kev xeeb tub lossis kev noj qab haus huv ntawm tus poj niam cev xeeb tub, menyuam hauv plab, lossis menyuam mos. Cov kev tshawb fawb tsiaj tseem tsis tau qhia tawm cov kev phom sij los cuam tshuam hauv chav cev xeeb tub, yug menyuam hauv plab lossis yug menyuam, yug menyuam lossis yug menyuam tom qab.

Cov poj niam cev xeeb tub yuav tsum tau txhaj tshuaj Minirin ® tsuas yog tom qab kev soj ntsuam zoo ntawm cov txiaj ntsig thiab kev pheej hmoo. Cov tshuaj yog kws kho tsuas yog thaum cov kev cia siab pab rau leej niam outweighs qhov kev pheej hmoo rau tus me nyuam hauv plab. Siv cov tshuaj hauv cov poj niam cev xeeb tub nrog kev ceev faj, nws raug nquahu kom ua tib zoo soj ntsuam ntshav siab.

Kev tshawb txog cov kua mis ntawm cov poj niam uas tau txais desmopressin ntawm koob tshuaj 300 mcg intranasally tau qhia tias qhov ntau npaum ntawm desmopressin uas tuaj yeem nkag mus rau tus menyuam lub cev tau me dua thiab tsis tuaj yeem cuam tshuam nws cov diuresis.

Tsuas tshuaj thiab tswj hwm

Sublingually (hauv qab tus nplaig), rau resorption. Tsis txhob haus tshuaj nrog kua! Cov koob tshuaj zoo ntawm Minirin ® raug xaiv ntawm tus kheej.

Qhov ntau npaum cas ntawm cov tshuaj ntawm ob lub qhov ncauj yog raws li nram no:

Ntsiav tshuaj

Sublingual ntsiav tshuaj 0.1 mg60 mcg 0.2 mg120 mcg 0.4 mg240 mcg

Cov tshuaj Minirin ® yuav tsum noj qee lub sijhawm tom qab noj mov tas, kev noj haus yuav txo qhov nqus ntawm cov tshuaj thiab nws cov hauj lwm zoo.

Mob ntshav qab zib insipidus ntawm lub hauv paus hauv paus. Qhov pom zoo kom pib koob Minirin ® yog 60 mcg 3 zaug hauv ib hnub. Tom qab, cov koob tshuaj tau hloov pauv nyob ntawm qhov pib ntawm kev kho tshuaj. Cov tshuaj pom zoo txhua hnub nyob hauv thaj tsam ntawm 120-720 mcg. Cov koob tshuaj txij nkawm zoo tshaj plaws yog 60-120 mcg 3 zaug hauv ib hnub sublingually (hauv qab tus nplaig).

Thawj nocturnal enuresis. Qhov pom zoo kom pib siv yog 120 mcg thaum tsaus ntuj. Thaum tsis muaj cov nyhuv, qhov koob tshuaj yuav tau nce mus txog 240 mcg. Thaum kho, nws yog qhov yuav tsum tau txwv kom tsis txhob muaj kua dej thaum yav tsaus ntuj. Qhov kev pom zoo ntawm kev kho mob txuas ntxiv yog 3 hlis. Qhov kev txiav txim siab txuas ntxiv kev kho mob yog txiav txim siab los ntawm cov ntaub ntawv soj ntsuam uas yuav pom tom qab tsis siv tshuaj rau 1 lub lis piam.

Hmo Nocturia. Qhov pom zoo kom pib koob tshuaj yog 60 mcg thaum tsaus ntuj sublingually (hauv qab tus nplaig). Yog tias tsis muaj tshwm sim rau 1 lub lis piam, qhov koob tshuaj tau nce mus rau 120 μg thiab tom qab ntawd mus rau 240 μg nrog qhov nce ntxiv ntawm cov koob tshuaj uas muaj ntau zaus tsis tshaj 1 zaug hauv ib as thiv.

Yog tias tom qab 4 lub lis piam ntawm kev kho mob thiab tshuaj kho kom haum ib qho txiaj ntsig hauv qhov chaw kho mob tsis pom, nws tsis pom zoo kom noj cov tshuaj ntxiv.

Chaw tsim tshuaj paus

Tus txhav Yu.K. Swindon Zidis Ltd., UK.

Cov koom haum muaj cai hauv nws lub npe cov ntawv pov thawj tau muab: Ferring AG, Switzerland.

Kev thov cov neeg tau txais kev pabcuam yuav tsum xa mus rau qhov chaw nyob: LLC Ferring Pharmaceuticals. 115054, Moscow, Kosmodamianskaya nab., 52, p. 4.

Xovtooj: (495) 287-03-43, fax: (495) 287-03-42.

Kev ntim ntawm Chaw Muag Khoom ntawm Pharmstandard-UfaVITA OJSC, cov neeg siv khoom lag luam yuav tsum xa mus rau: Pharmstandard-UfaVITA OJSC. 450077, Russia, Ufa, ul. Khudaiberdina, 28.

Tel./fax: (347) 272-92-85.

Ntim, muaj pes tsawg leeg, duab

Cov tshuaj "Minirin", tus nqi uas tau qhia hauv qab no, muaj nyob hauv ob hom sib txawv:

• txau rau kev siv intranasal,
• cov ntsiav tshuaj dawb thiab biconvex (rau kev tswj hwm qhov ncauj thiab resorption).

Ob qho ntawd, thiab lwm yam txhais tau sawv cev rau antidiuretic, ib qho sib piv ntawm vasopressin. Cov tshuaj ua haujlwm nquag ntawm cov tshuaj no yog desmopressin acetate (desmopressin). Cov ntsiav tshuaj mus muag hauv lub thawv yas thiab cov ntawv ntim ntawm tes, thiab cov tshuaj txau qhov ntswg - hauv ib lub taub ntim nrog cov tshuaj ntim khoom.

Cov nqi hauv cov khw muag tshuaj hauv Moscow

Cov ntaub ntawv muab ntawm cov nqi tshuaj tsis yog qhov qhia rau muag lossis yuav khoom.
Cov ntaub ntawv yog npaj tsuas yog los sib piv cov nqi hauv cov chaw muag tshuaj hauv kev ua haujlwm raws li Nqe Lus 55 ntawm Tsoomfwv Txoj Cai "ntawm Kev Tswj Xyuas Tshuaj" hnub tim 12.04.2010 N 61-ФЗ.

Pharmacological kev txiav txim

Cov tshuaj nquag ua haujlwm ntawm cov tshuaj yog cov qauv tshuaj tiv thaiv ntawm xws li lub cev ntuj tsim raws li arginine-vasopressin. Desmopressin tau los ntawm kev hloov cov qauv ntawm vasopressin lwg me me thiab hloov 8-L-arginine nrog 8-D-arginine.

Piv nrog vasopressin, cov nyhuv ntawm cov tshuaj no (ua ke nrog muaj peev xwm ua kom muaj cov tshuaj tiv thaiv kab mob) ua rau cov ncauj lus tsis tshua zoo rau cov leeg nqaij ntawm cov plab hnyuv siab raum thiab cov hlab ntshav. Qhov no ua rau qhov tsis muaj qhov tsis xav tau qhov tshwm sim ntawm qhov chaw ua kom haum.

Cov nyhuv pharmacological ntawm cov tshuaj yog vim nws muaj pes tsawg leeg. Cov tshuaj muaj peev xwm nce lub permeability ntawm epithelium ntawm lub convoluted distal tubules rau dej thiab nce nws cov dej ntau dua reabsorption.

Kev siv cov tshuaj rau ntshav qab zib insipidus ua rau txo qis osmolality ntawm cov ntshav ntshav thiab cov ntim ntawm cov zis tawm, nrog rau tib lub sijhawm nce ntshav osmolality ntawm cov zis. Xws li cov nyhuv ua rau txo qis ntau zaus ntawm tso tawm thiab nocturnal polyuria.

Txais tos ntawm 0.1-0.2 mg ntawm desmopressin muaj peev xwm muab cov nyhuv antidiuretic rau 9-12 teev.

Pharmacokinetic ntsuas

Kuv puas tuaj yeem noj tshuaj "Minirin" nrog zaub mov? Cov kws tshaj lij hais tias kev sib xyaw ua ke yog qhov tsis xav tau. Qhov no yog vim qhov tseeb tias kev noj mov ib txhij ntawm cov zaub mov ua rau txo qis ntau ntau ntawm kev nqus ntawm cov tshuaj los ntawm cov hnyuv (ua li 40%). Qhov siab tshaj plaws ntawm cov tshuaj hauv ntshav tau mus txog tom qab ob teev. Lub bioavailability ntawm desmopressin sib txawv ntawm 0.08-0.16%. Hauv qhov no, cov tshuaj nquag tsis txuam nrog BBB.

Kev tshem ntawm cov tshuaj yog nqa nrog zis (tom qab li 2-3 teev).

Cov tshuaj "Minirin": cov lus qhia rau kev siv

Cov tshuaj yuav tsum tau noj tsuas yog tom qab noj mov. Qhov no yog vim qhov tseeb tias cov khoom noj tau yooj yim cuam tshuam rau kev nqus ntawm cov khoom thiab nws cov hauj lwm zoo.

Ntau npaum li cas ntawm cov tshuaj Minirin yuav tsum tau noj? Qhov ntau npaum ntawm cov cuab yeej no yog xaiv los ntawm tus kws kho mob ib leeg zuj zus.

Hauv qhov pom ntawm kab mob ntshav qab zib insipidus, koob tshuaj pom zoo rau cov neeg laus thiab menyuam yaus yog 100 mcg peb zaug ib hnub. Yav tom ntej, cov tshuaj tau hloov pauv nyob ntawm tus neeg mob cov lus teb rau kev kho mob. Raws li txoj cai, koob tshuaj txhua hnub nws txawv ntawm 0.2-1.2 mg. Txawm li cas los xij, rau feem ntau ntawm cov neeg, cov tshuaj kho kom zoo tshaj yog 100-200 mcg peb zaug hauv ib hnub.

Yuav kho tus mob li cas? Minirin nrog cov kabmob no tau sau tseg hauv 200 mcg (noj thaum hmo ntuj). Yog tias tsis muaj cov txiaj ntsig uas tsim nyog, ces lub koob tshuaj yuav muaj ob npaug. Hauv kev kho qhov sib txawv no, yuav tsum ua tib zoo saib xyuas kom ua raws li cov kev txwv tsis pub muaj dej ntau nyob rau yav tsaus ntuj. Lub chav kawm ntawm kev kho mob tsis tu ncua yog 90 hnub. Qhov kev txiav txim siab txog kev kho mob ntev dua tsuas yog txiav txim los ntawm tus kws kho mob raws kev soj ntsuam cov ntaub ntawv uas tau pom tom qab tshem yeeb tshuaj tsis pub dhau 1 lub lim tiam.

Koj yuav tsum noj cov tshuaj Minirin li cas thaum hmo ntuj polyuria? Cov lus qhia rau kev siv hais tias rau cov neeg laus uas muaj qhov mob no, txoj kev pom zoo kom noj yog 100 mcg (noj thaum hmo ntuj). Yog tias cov nyhuv xav tau tsis tuaj yeem tau li 7 hnub, tom qab ntawd cov tshuaj muaj ob npaug, thiab tom qab ntawd - thiab plaub npaug (nrog rau ntau zaus tsis ntau tshaj ib zaug ib lim tiam). Thaum kho cov kab mob hais los saum no, ib tug yuav tsum nco ntsoov qhov txaus ntshai ntawm kev tuav dej hauv lub cev.

Yog tias tom qab 4 lub lis piam ntawm kev kho, nrog rau kev kho kom haum tshuaj, cov txiaj ntsig kev kho mob tsis pom, ces cov tshuaj yuav tsum tsis txuas ntxiv.

Tshaj tsos mob

Kev noj tshuaj ntau dhau ntawm cov lus nug yuav ua rau lub sijhawm ntau ntxiv ntawm cov tshuaj, nrog rau kev pheej hmoo ntawm hyponatremia thiab tuav dej hauv lub cev (suav nrog poob ntawm kev nco qab, qaug dab peg, thiab lwm yam).

Raws li kev kho mob rau hyponatremia, cov tshuaj raug tso tseg, cov kev txwv ntawm kev nqus dej yog tso tseg, kev tshaj tawm ntawm hypertonic lossis isotonic sodium chloride tov yog nqa tawm.

Sab sij huam

Cov tshuaj "Minirin" rau menyuam yaus thiab tus neeg laus yuav tsum raug kho tsuas yog ua raws li kev qhia. Cov kev mob tshwm sim feem ntau tau pom nyob rau hauv cov teeb meem no thaum txoj kev kho tshuaj yog nqa tawm yam tsis muaj kev txwv cov dej haus, vim qhov ntawd tau ncua, ntxiv rau qhov mob hyponatremia. Cov kev ua no tuaj yeem ua asymptomatic lossis yuav ua rau mob taub hau, kiv taub hau, mob plab, xeev siab, ntuav, lub qhov ncauj qhuav, mob pob txha, thiab ua rau lub cev hnyav.

Lactation thiab lub sijhawm ntawm cev xeeb tub

Cov txiaj ntsig ntawm kev noj tshuaj "Minirin" rau cov poj niam mob ntshav qab zib insipidus qhia txog qhov tsis muaj kev phiv los ntawm lub cev xeeb tub, nrog rau kev nyob zoo ntawm tus poj niam hauv kev mob plab, lub cev xeeb tub thiab cov menyuam mos.

Nws yuav tsum raug sau tseg tias qhov nyiaj ntawm desmopressin, uas nkag rau hauv tus menyuam lub cev nrog rau leej niam cov kua mis, yog qhov tsawg dua qhov yuav cuam tshuam nrog diuresis.

Analogues ntawm cov tshuaj

Muaj ntau ntau cov qauv ntawm cov khoom siv hauv cov lus nug. Raws li txoj cai, lawv tau sau tseg yog tias cov tshuaj no tsis haum rau tus neeg mob rau ib qho laj thawj lossis lwm qhov. Ntawm qhov zoo tshaj plaws thiab pheej yig cov tshuaj analog, cov khw muag tshuaj hauv qab no tuaj yeem sau tseg: Adiuretin, Emosynt, Adiuretin SD, Presineks, Apo-Desmopressin, Nativa, Vasomirin, Desmopressin Acetate, Ntshaw-chim.

Kev tshuaj xyuas ntawm cov kws kho mob thiab cov neeg mob

Cov neeg mob uas noj lossis ib zaug noj cov tshuaj hauv cov lus nug tawm hauv kev tshuaj xyuas ntau yam txog nws. Feem ntau ntawm lawv muaj qhov zoo. Nrog rau kev tswj hwm kom zoo, cov tshuaj hais raug zoo heev nocturnal enuresis rau menyuam yaus, zoo li nocturnal polyuria rau cov neeg laus. Kuj, cov tshuaj siv tau zoo rau kev sib deev hauv nruab nrab insipidus.

Txawm li cas los xij, ntau tus neeg mob thov tias cov tshuaj uas tau hais feem ntau ua rau muaj kev tsis haum lub siab. Ntawm cov nquag muaj xws li hauv qab no: mob taub hau, kiv taub hau, cramps, xeev siab, ntuav, qhov ncauj qhuav, peripheral edema, thiab ua rau lub cev muaj ceeb thawj. Thaum saib qhov xwm txheej zoo li no, cov kws kho mob pom zoo kom tsis txhob noj tshuaj.

Nws tseem yuav tsum tau sau tseg tias ntau ntau ntawm kev tshuaj xyuas tsis zoo txog cov tshuaj "Minirin" cuam tshuam nrog nws tus nqi. Cov neeg mob thov tias tus nqi ntawm cov ntsiav tshuaj hauv 1600-1700 rubles Lavxias yog overpriced. Txawm li cas los xij, cov kws tshaj lij hais tias cov nuj nqi ntawm cov tshuaj yog heev txaus. Nov yog cov tshuaj yeeb tshuaj txawv teb uas tuaj yeem lav nrog txoj haujlwm.

Yog tias koj tsis muaj nyiaj yuav nws, cov tshuaj tuaj yeem hloov nrog cov tshuaj zoo dua. Txawm li cas los xij, ua ntej coj lawv, koj yuav tsum tau sab laj nrog koj tus kws kho mob, vim tias lawv yuav muaj qhov txawv txav tsis haum, tsis pom zoo thiab cov hau kev siv.