Octreotide yog ib qho hluavtaws sib piv ntawm cov tshuaj Somatostatin, nws muaj cov yam ntxwv zoo sib xws, tab sis muaj lub sijhawm ntev dua ntawm kev ua. Cov tshuaj pab rau txo cov kab mob pathologically ntau ntxiv ntawm kev loj hlob hormone, insulin, serotonin, gastrin, glucagon, thyrotropin.
Muab piv rau lub ntuj tsim tshuaj somatostatin, ib qho tshuaj tua hluavtaws ua rau lub ntsej muag tsis pub dhau kev loj hlob hormone ntau dua li cov tshuaj insulin. Nrog acromegaly, mob taub hau heev, o ntawm cov nqaij mos, hyperhidrosis, mob pob qij txha, kab mob paresthesia yog txo qis. Qhov loj me ntawm cov qog ua nyob rau hauv loj pituitary adenomas kuj txo.
Octreotide kuj tseem txhim kho cov chav kawm ntawm tus kabmob tom qab kev phais mob, kev kho mob rau tshuaj, embolization ntawm hepatic hlab ntsha. Yog tias muaj cov qog carcinoid, cov tshuaj txo cov concentration ntawm serotonin hauv cov ntshav, tshem tawm mob raws plab thiab maj ntshav ntawm lub ntsej muag.
Tshuaj ua
Nyob rau ntawm qhov muaj mob qog nqaij hlav hlav tawm los ntawm vasoactive plab hnyuv peptides, muaj cov kab mob tsis pub lwm tus neeg mob hnyav kom tsawg zuj zus thiab, vim li ntawd, qhov xwm txheej dav dav ntawm tus neeg mob txhim kho. Qee qhov xwm txheej, cov tshuaj enzymes qeeb los sis nres qhov ua mob qog, txo nws qhov loj me thiab txo cov tshuaj peptides hauv cov ntshav.
Cov tshuaj tsis cuam tshuam rau theem ntawm cov piam thaj hauv cov ntshav thaum muaj ntshav qab zib mellitus, yog li, tus neeg mob yuav tsum ntxiv noj tshuaj muaj suab thaj. Octreotide ua rau muaj mob raws plab, thaum tib lub sijhawm ua rau nws qhov hnyav ntxiv.
Nrog kev kuaj mob ntawm Zollinger-Ellison syndrome, cov tshuaj muaj peev xwm txo qis cov hydrochloric acid hauv plab, txo qis ntawm gastrin nyob rau hauv cov ntshav, thiab daws cov mob raws plab thiab maj ntshav. Kev kho mob tuaj yeem nqa tawm ntawm ob leeg thiab ntawm kev sib xyaw nrog lwm cov tshuaj uas kws kho mob tau sau tseg.
- Yog tias muaj cov tshuaj insulinoma, qhov tshuaj txig txo cov tshuaj insulin ntau dua hauv cov ntshav, tab sis cov tshuaj kho tau luv luv thiab kav ntev tsis tshaj li ob teev. Hauv lub sijhawm preoperative, hauv cov neeg muaj lub qog ua haujlwm, Octreotide rov qab kho thiab tswj hwm glycemic.
- Nyob rau ntawm qhov muaj cov qog uas tsis tshua muaj tshwm sim los ntawm kev loj hlob cov tshuaj hormones, cov cim qhia tau ntawm acromegaly yog txo los ntawm kev txwv kev tsim cov tshuaj hormone. Nyob rau hauv lub neej yav tom ntej, kev kho mob ua rau muaj kev cuam tshuam pituitary hypertrophy.
- Thaum kuaj pom tias tau txhaj tshuaj tiv thaiv kab mob, cov tshuaj puv nkaus los yog qee qhov ib txwm ua rau cov quav, uas cov tshuaj tiv thaiv kab mob los yog tshuaj tua kab mob ib txwm tsis daws.
- Yog tias koj npaj siab yuav ua haujlwm rau txiav, mob Octreotide yog coj ua ntej thiab tom qab phais mob. Qhov no txo txoj kev pheej hmoo ntawm kev mob postoperative nyob rau hauv daim ntawv ntawm pancreatic fistula, mob qog nqaij hlav, mob txhawm rau mob rau leeg.
Tsis tas li ntawd, qhov kev ua haujlwm siab ntawm cov tshuaj tau raug pov thawj nyob rau hauv muaj cov kab mob siab. Kev txhaj tshuaj nrawm nrawm los ntshav tawm ntawm txoj hlab ntshav sib kis thiab txoj hlab pas, thiab tseem ua tsis tau xwm txheej ntawm tus neeg mob. Kev Kho Mob yog coj los ua ke nrog txoj hauv kev tseem ceeb ntawm kev kho.
Feem ntau, cov tshuaj muaj cov tshuaj xyuas zoo heev los ntawm kws kho mob thiab cov neeg mob.
Kev siv yeeb tshuaj
Tom qab cov koob tshuaj uas kws kho mob tau muab tshuaj subcutaneously lossis txhaj tshuaj, cov tshuaj pib yuav nqus sai sai. Qhov siab tshaj plaws ntawm cov tshuaj nquag nyob hauv cov ntshav ntshav tau pom ib nrab ib teev tom qab kev coj ntawm cov tshuaj.
Yog tias cov tshuaj tau muab tshuaj rau subcutaneously, Octreotide yog tawm ntawm lub cev ib thiab ib nrab xuaj moos tom qab txhaj tshuaj. Nrog kev txhaj tshuaj rau hauv lub cev, kev nthuav tawm tshwm sim hauv ob theem, tom qab 10 thiab 90 feeb. Lub ntsiab tseem ceeb yog tso tawm los ntawm txoj hnyuv, thiab feem peb ntawm cov khoom los ntawm lub raum.
Tag nrho tus nqi ntawm kev tshem tawm cov tshuaj los ntawm cov nqaij hauv lub cev yog 160 ml ib feeb. Nyob rau tib lub sijhawm, hauv cov neeg laus dua, cov ntshav ntxuav ntau dua vim tias nce ib nrab ntawm lub neej. Nrog rau kev kuaj mob ua rau mob raum tsis zoo, kev ua kom pom tseeb kuj dhau mus ob zaug qis dua.
Cov tshuaj nquag siv rau:
- Acromegaly los tswj cov cim tseem ceeb ntawm tus kabmob thiab txo qis theem ntawm kev loj hlob hormone thaum kev phais mob thiab kev kho hluav taws xob tsis muaj yam xav ua;
- Mob caj dab thiab yuav ua kom hno tom qab kev phais mob plab hnyuv;
- Kev los ntshav nyob rau hauv cov ntaub ntawv ntawm peptic rwj ntawm lub plab thiab duodenum;
- Qhov muaj cov qog nqaij hlav ua ke nrog cov carcinoid syndrome;
- Cov qog ntawm tus txiav ua vasoactive plab hnyuv peptides;
- Zollinger-Ellison syndrome ua ke nrog cov tshuaj hauv paus;
- Kev kuaj pom los ntawm glucagon, insulin, somatoliberin.
Nws yog ib qho tseem ceeb kom nkag siab tias qhov tshuaj tsis siv rau cov tshuaj uas tshem tawm cov qog, yog li nws tsuas yog siv los ua ib qho kev ntxiv rau kev kho mob tseem ceeb. Octreotide muaj peev xwm tiv thaiv kev los ntshav nrog ntau txoj hlab nqaij ntawm lub plab thiab txoj hlab pas rau cov neeg muaj tus mob no.
Cov tshuaj tsis tuaj yeem siv rau hauv kev kho mob ntawm menyuam yaus thiab tub ntxhais hluas hnub nyoog qis dua 18 xyoo. Tsis tas li, contraindications suav nrog hypersensitivity rau lub Cheebtsam ntawm cov tshuaj. Kev saib xyuas tshwj xeeb yuav tsum tau saib xyuas yog tias ib tus neeg muaj kab mob ntshav qab zib mellitus thiab mob gallstone. Ua ntej siv cov tshuaj, cov poj niam cev xeeb tub thiab lactating yuav tsum sab laj lawv tus kws kho mob.
Cov lus qhia rau kev siv tshuaj
Octreotide yog cov ntshiab, tsis muaj kob uas tov rau txoj kev txhaj tshuaj rau sab hauv thiab subcutaneous. Cov tshuaj raug muag hauv cov thawv muaj qhov ntau ntawm 50, 100, 300 thiab 600 mcg
ml, nyob ntawm seb muaj pes tsawg tus ampoules thiab cov ntsiab lus ntawm yam muaj sia hauv 1 ml.
Cov tshuaj tiv thaiv tsis muaj zog yog dej rau kev txhaj tshuaj thiab sodium chloride. Koj tuaj yeem yuav cov tshuaj hauv txhua lub tsev muag tshuaj thaum muab cov kws kho mob sau rau.
Nrog kev txhaj tshuaj subcutaneous, cov ampoule yuav tsum raug kuaj xyuas kom cov tshuaj tsis muaj impurities. Cov kua yuav tsum tau sov rau chav sov. Qhib cov ampoule tam sim ntawd ua ntej kev txhaj tshuaj, cov tshuaj ntxiv yog muab pov tseg. Kev txhaj tshuaj yuav tsum tau ua nyob rau ntau qhov chaw ntawm lub cev thiaj li tsis ua rau ua kev ntxhov siab ntawm daim tawv nqaij.
- Rau kev tswj hwm kev siv tus xa me me, ampoule yog diluted nrog 0.9% sodium chloride ua ntej txheej txheem. Cov dej qab ntsev raug tso cai muab cia rau hauv tub yees thaum nruab hnub nyob rau qhov kub thiab txias ntawm 2-8 degrees.
- Yog tias muaj tus mob voos nyom, ib koob tshuaj ntawm 100 μg yog muab tshuaj subcutaneously peb zaug hauv ib hnub rau tsib hnub. Raws li qhov kev zam, cov kev muab tshuaj rau niaj hnub tuaj yeem nce txog 1200 mcg.
- Tom qab kev phais mob ntawm tus txiav, txiav kab mob los ntawm 100-200 mcg yog siv. Thawj qhov muab tshuaj yog ob teev ua ntej kev phais mob, tom qab ntawd tom qab lub sijhawm txiav txim siab, ib qho kev txhaj tshuaj yog ua peb zaug ib hnub rau ib lim tiam.
- Txhawm rau kom tsis txhob ulcerative los ntshav, kev kho mob Txoj Kev lis ntshav yog nqa tawm ntawm txoj leeg. Tshaj li tsib hnub, tus neeg mob tau siv 25-50 mcg ib teev twg. Zoo sib xws, kev kho mob yog nqa tawm rau los ntshav los ntawm varicose leeg ntawm lub plab thiab txoj hlab pas.
Nrog acromegaly, qhov tshuaj thawj zaug yog 50-100 μg, cov tshuaj yog muab rau txhua yim lossis kaum ob teev. Yog tias tsis muaj cov txiaj ntsig zoo, qhov tshuaj tau nce mus rau 300 mcg. Qhov siab tshaj plaws ntawm ib hnub raug tso cai siv tsis pub ntau tshaj 1500 mcg ntawm cov tshuaj.
Yog tias tom qab peb lub hlis theem ntawm kev loj hlob hormone tsis tau txo, cov tshuaj tau thim tawm thiab hloov nrog ib tus zoo ib yam.
Sab sij huam
Cov tshuaj muaj qee yam tshwm sim. Feem ntau, thaum kho, cov neeg mob yuav pom tsos mob raws li kev zawv plab lossis cem quav, xeev siab, tsam plab thiab mob hauv plab.
Cov xim ntawm cov quav pauv, nrog quav muaj rog ntau dua tso tawm, lub plab zoo li puv thiab qhov hnyav. Cov quav ua cov mos mos, muaj khaus ntawm ntuav, cov txheej txheem zom plab tau cuam tshuam, qhov hnyav poob zuj zus.
Tsis tas li, tus kws kho mob tuaj yeem kuaj mob cholelithiasis, cholecystitis, hyperbilirubinemia. Colloidal ruaj ntseg ntawm bile yog qhov tsis muaj zog, vim tias cov microcrystals ntawm cov roj (cholesterol) tau tsim los. Xws li yuav tuaj yeem qhia txog bradycardia, thiab qee kis - tachycardia.
- Ntawm cov kev mob tshwm sim, hyperglycemia thiab hypoglycemia tuaj yeem paub qhov txawv txav, cov thyroid caj pas cuam tshuam, qabzib kam rau ua pauv.
- Tus neeg yuav raug kev ua tsis taus pa siav, mob taub hau, raws sij hawm kiv taub hau.
- Cov pob khaus thiab khaus tshwm rau ntawm daim tawv nqaij, khaus khaus thiab, qee zaum plaub hau ntog. Hauv thaj chaw txhaj tshuaj, qhov mob yuav hnov zoo.
Nrog rau kev ua haujlwm siab sai, kev tiv thaiv anaphylactic kuj yuav tshwm sim. Xws li qee tus neeg muaj arrhythmia. Tab sis cov tsos mob li tau suav hais tias yog raug rho tawm, txij li ib qho kev sib raug zoo ntawm cov xwm txheej zoo li no tseem tsis tau txheeb xyuas.
Octreotide pab txhawm rau txo qhov nqus ntawm cov tshuaj Cyclosporine, ua kom lub cev ntau dua ntawm bromocriptine, qeeb kev nqus ntawm cimetidine, txo cov metabolism hauv cov tshuaj uas ua rau lub cytochrome P450 enzymes.
Yog tias koj ib txhij nqa tawm cov tshuaj insulin, kho nrog tshuaj ntawm qhov ncauj hypoglycemic, glucagon, calcium channel blockers, beta-blockers thiab diuretics, noj tshuaj yuav tsum tau kho.
Txhawm rau zam kom tsis txhob muaj teeb meem, thaum lub sij hawm ntawm txoj kev kho, nws yog ib qho tsim nyog los soj ntsuam xyuas cov qib ntawm cov piam thaj hauv cov ntshav, tshwj xeeb tshaj yog nyob rau ntawm kev los ntshav vim muaj kev hloov ntshav ntawm txoj hlab pas thiab txoj hlab ntsws.
Cov tsos mob zoo li no yuav ua rau muaj kev pheej hmoo ntxiv cov piam thaj ntxiv.
Cov Lus Qhia Txog Octreotide
Muaj ntau yam tshuaj uas ua rau lub cev zoo sib xws. Cov no suav nrog cov tshuaj Sermorelin, Sandostatin, Octrid, Genfastat, Diferelin. Generics Octreotide Depot thiab Octreotide Ntev kuj tseem muaj cov tshuaj zoo sib xws.
Tus nqi nyob ntawm qhov chaw tsim khoom, ntim thiab cov lej ntawm ampoules hauv pob, hauv khw muag tshuaj tus nqi ntawm cov tshuaj zoo li txawv ntawm 600 txog 3500 rubles.
Txoj kev daws teeb meem yuav nyob hauv qhov chaw qhuav, kom deb ntawm cov menyuam yaus thiab ncaj qha tshav ntuj. Tus mob rau khaws cov tshuaj yog 8-25 degrees. Txee lub neej tsis yog ntau tshaj tsib xyoos, tom qab ntawd cov tshuaj yuav tsum tau muab pov tseg, txawm tias nws tsis tau qhib.
Yuav kho cov mob qog nqaij hlav kom ntshav zoo li cas piav nyob hauv daim video hauv kab lus no.
