UMinirin umuthi onomphumela ophambene we-diuretics (diuretics). Lo muthi usetshenziswa kabanzi ekwelapheni abantu abanesifo sikashukela i-insipidus ne-polyuria. Umuthi i-analogue ye-vasopressin (ihomoni ye-hypothalamus).
Igama Lezwe elingafanele
Igama lomhlaba jikelele lesi sidakamizwa ngesiLatin lithi Desmopressin.
UMinirin umuthi onomphumela ophambene we-diuretics (diuretics).
I-ATX
Ikhodi kaMinin ye-ATX (ukuhlukaniswa kwamakhemikhali nokwelashwa) yi-H01BA02.
Khipha amafomu nokwakheka
Izidakamizwa ezenziwa nge-Desmopressin zisetshenziswa ngendlela yamathebulethi okuphatha ngomlomo kanye nesifutho sokusebenzisa i-topical (intranasal). Isikhathi sobhaliso sokufafaza siphelelwe yisikhathi. Amathebulethi eMinirin anezici ezilandelayo:
- i-convex;
- ukwakheka okusaqanda noma okujikelezayo (kuncike kumthamo);
- ngokubhala nengozi;
- umbala omhlophe;
- aqukethe i-100 noma i-200 μg ye-desmopressin, ehambelana ne-0,5 ne-0,2 mg yesidakamizwa.
Ukwakheka kwamathebhulethi kufaka phakathi amakhompiyutha ahlukahlukene asizayo afana nesitashi.
Ukwenziwa kwamathebhulethi kufaka phakathi izinhlanganisela ezihlukene ezisizayo (i-magnesium stearate, isitashi, ushukela wobisi ne-povidone). Amacwecwe agcwele emabhodleleni epulasitiki angama-30 ama-pcs. kanye namabhokisi amakhadibhodi.
Isifutho esuselwa ku-Desmopressin siqukethe into esebenzayo, amanzi, i-sodium chloride nezinye izinto. I-1 ml yesifutho iqukethe umuthi ongu-0.1 μg.
Isenzo se-Pharmacological
Umuthi unomphumela olandelayo:
- Kuthuthukisa ukubuyiselwa kwamanzi kabusha (ukubuyiselwa emuva) kwamanzi engxenyeni eseceleni yama-tubules wezinso aqinisekisiwe, okunomthelela ekugcineni ukugcwala kwamanzi.
- Kwenyusa ukuvama kwemikhumbi emincane kwizicubu zezinso.
- Yehlisa ukukhuphuka (ukuphuma komchamo).
- Kwandisa i-osmolarity (ukuqoqwa kwazo zonke izinto ezincibilikile) zomchamo.
- Yehlisa i-osmolarity yegazi.
- Ikhuthaza ukukhiqizwa kwe-von Willebrand factor (i-glycoprotein edingekayo ukugcina isimo segazi segazi futhi kuvinjelwe ukulahleka kwayo).
- Kancane uthinta imisipha ebushelelezi yezitho zangaphakathi nemithambo yegazi.
- Isiza ukunciphisa i-polyuria ne-nocturia.
- Icindezela ukukhiqizwa kwe-adrenal gland hormone ye-ACTH kubantu abanesifo sikaCushing.
Impahla ebalulekile yomuthi ukuthi ayikhulisi umfutho wegazi.
Impahla ebalulekile yomuthi ukuthi ayikhulisi umfutho wegazi. Lokhu kubalulekile ekwehlulekeni kwenhliziyo. Lapho uthatha amaphilisi, umphumela omuhle kakhulu ubonwa ngemuva kwamahora angama-4-7. Umphumela wokwelapha uthatha amahora angama-4-8, kuya ngomthamo womuthi.
I-Pharmacokinetics
Umuthi ubonakala nge-bioavailability ephansi lapho uthathwa ngendlela yamathebulethi angaphansi. Ukudla kuqinisa ukumuncwa kwe-desmopressin. Iqoqo eliphakeme kakhulu lomuthi osegazini laziwa ngemuva kwamahora ama-2 ngemuva kokuthatha amaphilisi. Umuthi awungeni ohlelweni oluphambili lwezinzwa (ubuchopho) futhi udonswa kancane uma kuqhathaniswa ne-vasopressin. Umuthi udotshwa ikakhulu yizinso ngomchamo. Ukuqedwa kwesigamu sempilo kwenza amahora angama-2-3.
Izinkomba zokusetshenziswa
Umuthi ubekelwe i-pathologies elandelayo:
- Isifo sikashukela esimaphakathi. Lesi sifo sibonisa ngokuncipha kokuhlanganiswa kwehomoni ye-antidiuretic ngokumelene nesizinda sokulimala kohlelo lwe-hypothalamic-pituitary.
- I-Envesis (ukuwohloka komchamo) ezinganeni ngemuva kweminyaka engu-5.
- I-Nocturia kubantu abadala.
- IPolydipsia (ukuphuza amanzi amaningi phakathi komile kakhulu) ngemuva kokuhlinzwa.
Ngenxa yomphumela wayo we-antidiuretic, i-desmopressin ingasetshenziswa hhayi ngezinjongo zokwelashwa kuphela, kepha futhi ngezinhloso zokuxilonga ukuthola umsebenzi wezinso futhi uthole i-insipidus yesifo sikashukela.
Contraindication
Ukuxhumana kokusetshenziswa kwe-desmopressin acetate yile:
- hypersensitivity;
- ukomela imvelaphi ye-psychogenic;
- i-polgenips (eyinhloko) i-polydipsia;
- i-syndrome yokwephulwa kokukhiqizwa kwe-hormone ye-antidiuretic;
- ukwehluleka kwenhliziyo;
- ukwehla kwe-osmolarity ye-plasma yegazi;
- ukwehluleka kwezinso;
- ukugcwala koketshezi kwezicubu;
- uhlobo olungazinzile lwe-angina pectoris;
- isifo sikaWillebrand;
- izimo ezidinga ukusetshenziswa kwezidakamizwa ezi-diuretic.
Ukwehluleka kwezinso, umuthi kufanele usetshenziswe ngokuqapha.
Ngokunakekela
Ukwelashwa kweMinirin kwenziwa ngokuqapha ku:
- ukwehluleka kwezinso;
- ukushintshwa kwezicubu ezisebenzayo ze-bladder nge-scarring;
- ukungalingani kwe-electrolyte;
- ingozi enkulu ye-intracranial hypertension;
- ethwele isibeletho.
Izinyathelo zokuqapha ziyadingeka ekwelashweni kwezingane ezingaphansi konyaka owodwa nabantu abanesizungu. Lapho welapha asebekhulile, kubalulekile ukulawula okuqukethwe kwe-sodium esegazini.
Izinyathelo zokuqapha ziyadingeka ekwelashweni kwezingane ezingaphansi konyaka owodwa nabantu abanesizungu.
Ungamthatha kanjani uMinirin
Umthamo ukhethiwe ngokulandelana uthatha iminyaka yobudala ye-akhawunti, izinkomba kanye ne-concomitant pathology. Ngokuhluleka kokuhamba kancane kwe-urine (imini nobusuku), umuthi kufanele uqale udakwe i-200 mcg ngesikhathi sokulala. Ezimweni ezinzima futhi ngenkathi igcina izikhalazo, umthamo uphakama ufike kuma-400 mcg.
Ngesikhathi sokulashwa, udinga ukunciphisa ukunciphisa ukugeleza kwamanzi ntambama.
Ukwelashwa kungahlala izinyanga ezintathu. Izibhebhe ze-Desmopressin kufanele zithathwe ngemuva kokudla. Kwesinye isikhathi umuthi ubekwa kumthamo ka-60 no-120 mcg.
Ukwelashwa kwe-nocturnal polyuria
Nge-nocturnal polyuria, umthamo wansuku zonke ekuqaleni kwezokwelapha ngu-100 mcg. Uma isiguli singazizwa singcono ngemuva kwesonto kusukela kuqale ukwelashwa, umthamo uyakhuphuka ube ngu-200 mcg.
Uma ungekho umphumela inyanga, ukwelashwa noMinirin kuyamiswa.
Ukwelashwa kwesifo sikashukela
Ku-mellitus yesifo sikashukela, umthamo ngu-100-200 mcg / ngosuku. Nge-insipidus yesifo sikashukela esimaphakathi, umuthi uthathwa izikhathi ezingama-1-3 ngosuku, ama-100 mcg. Uma kunesidingo, lungisa umthamo. Umthamo wansuku zonke ngu-0,5-1.2 mg. Ukuze ulondoloze umuthi ofunekayo womuthi osegazini, udinga ukuthatha ama-200 e-Minirin.
Imiphumela emibi kaMinirin
Imiphumela engathandeki ivame ukuhlotshaniswa nokuphuza okungafanele ngesikhathi sokwelashwa, ukwehla kwe-sodium esegazini (hyponatremia), ukugcinwa kwamanzi emzimbeni, kanye nokungahambisani nomthamo kanye nerejimenti kaMinirin.
Ubuhlungu bekhanda ngezinye izikhathi bungenzeka lapho kuthathwa iMinirin.
Isistimu yezinzwa ephakathi
Lapho uthatha iMinirin, ukuphazamiseka kwemizwa okulandelayo kungenzeka:
- Isiyezi
- iminyakazo
- ikhanda.
Amapheshana wesisu
Engxenyeni yesistimu yokugaya ukudla, imiphumela engathandeki yesidakamizwa iyenzeka, njengomlomo owomile, isicanucanu, ubuhlungu besisu nokugabha.
Allergies
Ukuphendula okwenziwa yilesi sifo kulo muthi akutholakali. Umuthi ubekezelelwa kahle.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti amandla okulawula ubuchwepheshe.
Umuthi awuthinti amandla okulawula ubuchwepheshe.
Imiyalo ekhethekile
Lapho uthatha uMinirin, kufanele uhambisane nemiyalo elandelayo:
- ungaphuzi uketshezi oluningi ihora eli-1 ngaphambi kwamahora ama-8 ngemuva kokuthatha amaphilisi;
- yenza ukuhlolwa kwegazi ukuthola ukwakheka kwe-ionic;
- welapha zonke izifo nezimo ze-pathological ngaphambi kokwelashwa, okuhambisana nokoma, ukuphazamiseka kwengqondo kanye nokuqubuka komchamo obunzima;
- sanitize ukugxila kokutheleleka kwezifo zomgudu womchamo obunzima futhi ongamahlalakhona;
- khansela umuthi uma kwenzeka ukusabela okuhlelekile ngendlela yomkhuhlane kanye ne-gastroenteritis (ukuvuvukala esiswini namathumbu amancane).
Ukuqokwa kukaMinirin ezinganeni
Amaphilisi we-Sublingual (sucking) anganikwa izingane.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi ubekelwa ngokuqapha kunabahlengikazi nakwabesifazane abakhulelwe. Ezifundweni, kwakungekho mphumela omubi we-desmopressin kwi-fetus.
Umuthi ubekelwa ngokuqapha kunabahlengikazi nakwabesifazane abakhulelwe.
Sebenzisa ebudaleni
Imiyalo yokusebenzisa iMinirin ikhombisa ukuthi iziguli ezingaphezulu kweminyaka engama-65 zivame ukuthuthukisa i-hyponatremia. Banciphise i-plodium sodium.
Isicelo sokusebenza kokulimala kwezinso
Ngokuthola imvume kwe-creatinine ngaphansi kwama-50 ml / min, umuthi uvunyelwe.
Sebenzisa umsebenzi wesibindi okhubazekile
Mhlawumbe ukusetshenziswa kweMinirin kwezifo zesibindi.
I-Overdose kaMinirin
Ukweqisa izidakamizwa kubonakaliswa izimpawu zokuthi ukubambezeleka komamanzi womzimba (ukwehluleka, i-edematous syndrome, ukungazi kahle) nemiphumela emibi ekhuphukayo. Usizo lubandakanya ukumisa ukwelashwa. Uma kunesidingo, kwethulwa izixazululo ze-electrolyte. Nge-edema, kuchazwe i-diuretic (Furosemide).
I-drug overdose ibonakaliswa yizimpawu zokuthi ukubambezeleka kwetshezi lomzimba (ukuqaqanjelwa, i-edematous syndrome, ukungazi kahle).
Ukuxhumana nezinye izidakamizwa
Ukusetshenziswa kanyekanye kweMinirin nemithi elandelayo akunconyiwe:
- ILoperamide;
- Ama-NSAIDs (Indomethacin);
- izidakamizwa ezihamba kancane emathunjini;
- dimethicone;
- ama-anticepressants ama-tricyclic;
- i-chlorpromazine;
- i-carbamazepine;
- i-serotonin reuptake inhibitors.
Umphumela weMinirin ufoxa lapho umuthi uhlanganiswa nama-tetracyclines, amalungiselelo we-lithium, i-norepinephrine ne-glibutide. I-Desmopressin ithuthukisa umphumela we-hypertensive wezidakamizwa ezithile.
Ukuhambisana notshwala
Ukusetshenziswa kotshwala ngesikhathi somuthi no-Minirin akulungile.
Ukusetshenziswa kotshwala ngesikhathi somuthi no-Minirin akulungile.
Ama-Analog
Le mithi elandelayo ihlobene nezimpawu zikaMinirin:
- Desmopressin.
- Nativa.
- I-Antiqua Rapid.
- Nourem.
- I-Presinex (iyatholakala ngesimo sokufafaza ngamakhala).
- UVasomirin.
Isidakamizwa iMinirina Melt asithengiswa.
Imibandela yekhefu lekhemisi
Umuthi umuthi.
Intengo kaMinirin
Umuthi osokhemisi ubiza kusuka kuma-ruble ayi-1300.
Izimo zokugcina zomuthi
Zigcinwa emazingeni okushisa angaphansi kuka-25 ° C endaweni eyomile engenakufinyeleleka ezinganeni.
Ukusetshenziswa kanyekanye kweMinirin ngeLoperamide akunconyiwe.
Isikhathi sokuphelelwa yisikhathi
Amacwecwe afanele iminyaka emi-2 kusukela ngosuku akhiqizwa ngalo.
Umkhiqizi
Umuthi kanye nama-analogues akhiqizwa eRussia (Nativa), eJalimane, eSwitzerland, e-Italy (Presinex), e-Iceland, eNorway, eGeorgia naseCanada.
Ukubuyekezwa mayelana neMinirin
UGalina, oneminyaka engu-35 ubudala, eMoscow: "Indodana yami eneminyaka eyisishiyagalolunye i-enursis. Udokotela unikeze umuthi osuselwa kudesopopin. Ngemuva kokudla iphilisi lokuqala, indodana yayeka ukuchama embhedeni."
UZlata, oneminyaka engama-38, uKirov: "Indodana yethu nendodakazi yentombazane yami yayinesifo esifanayo - behlika embhedeni. Bahlolwa futhi belashwa ndawonye. Udokotela wangiyala ukuthi ngisebenzise uMinirin. Indodakazi yomngane wami ayizange isebenzise umuthi, kepha sasinenkambo eyodwa yokwelashwa. Manje indodana yakhe Musa ukungalali embhedeni bese uphila impilo enempilo. "
