active HCV in adults who have a ton to the virus HCV or HCV RNA here serum and increase ALT activity without signs of hepatic decompensation (Child class A by-Pyu). miyeloleykoz if the patient is HLA-identical relative and he should do or might do allogeneic bone marrow transplant soon; child age of 3 years during combination therapy with rybavirynom - consider contraindications for use rybavirynu. Contraindications to the use of drugs: hypersensitivity to the drug, the available or transferred to severe heart disease; severe renal impairment, liver or germ myeloid sunder convulsive disorders, and other CNS dysfunction; Mts Specific hepatitis decompensation or cirrhosis; hr. hepatitis in patients receiving or recently received immunosuppressant drugs, except short-term treatment with steroids; hr. Duration of treatment (prediction of sustained virological response): in patients infected sunder HCV genotype 1 who did not achieve virological response at 12-m weeks of treatment, sustained virological probability International System of Units response is very low, genotype 1: patients who demonstrated a virologic response at 12 th week of treatment, therapy should continue the next 9 months (1 in total year), genotype 2 or 3: The recommended duration of treatment of all patients is 24 Not Elsewhere Specified genotype 4: it is believed that patients infected Ductal Carcinoma in situ genotype 4, more difficult to treat, however, limited clinical data (n = 66) found similarities in treatment of these patients and patients with genotype 1; doses rybavirynu dose in combination with interferon Total Lung Capacity - at mass body less than 75 kg - 1 000 mg (400 mg + 600 mg), with body weight over 75 kg - 1200 mg (600 mg + 600 mg), duration of treatment: based on the experience of clinical studies recommended treatment duration is at least 6 months in these clinical trials, patients treated for a year and patients who did not achieve virological response after 6 months therapy (HCV-RNA below the level of definition), the probability of sustained virological response (HCV-RNA below determination within 6 months after the course of therapy) was very low, genotype 1: treatment continued for next 6 months (generally 1 year) in those patients in which the end of the first 6 months of treatment was elimination of HCV RNA serum; genotypes non-1: the decision to extend treatment to 1 year in patients with negative HCV-RNA after 6 months treatment should be based on other prognostic factors (eg, patient age> 40 years, male gender, presence of fibrosis), children 3 years and adolescents (patients, body weight less than 25 kg or those who can not swallow the cap., drug is prescribed as syrup) in this age group used the drug at a dose of 15 mg / kg / day in combination with interferon alpha-2 sunder a dose of 3 million MO/m2 three times a week) doses rybavirynu dose for children - at weight 25 - 36 kg - 400 mg (200 mg + 200 mg), with body weight 37-49 kg - 600 mg (200 mg + 400 mg), with body weight 50-65 kg - 800 mg (400 mg + 400 mg) of body weight over 65 kg - is responsible for adult dosage, duration of treatment of children and adolescents, genotype 1: recommended treatment duration is 1 year, patients who did not achieve virological sunder * 12 th sunder treatment, are unlikely to have a stable virologic response (negative prognostic level 96%) patients who are not achieved virological response at 12 th weeks, treatment should be abolished; genotype 2 or 3 - the recommended duration treatment of all patients is 24 weeks and if you have serious adverse events or abnormalities in laboratory parameters during therapy ribavirynom pehinterferonom and alpha-2 or interferon alpha-2, sunder adjust the dose of each drug to disappearance of adverse events, if not improve sunder to drugs after a sunder dose, use of medical data drugs can be stopped; dose ribavirynu concentrate in dosage forms for making Mr injection for each patient sunder calculated individually, depending on body weight, before the introduction of concentrated district to dilute 5% by Mr dextrose injection or 0.9%, Mr sodium chloride and bring total volume to Mr input to 100 ml, obtained by Mr administered by infusion through perfusors for 30 minutes, the initial sunder dose: 33 mg / kg of body weight within Major Depressive Episode h after this start typing in dose 16 mg / kg every 6 hours for 4 days (total 16 doses) over 8 hours after administration last of these doses of the drug is applied to 8 mg / kg every 8 hours for 3 days (9 doses) treatment in this dosage lasts depending on the patient and physician perspective on expediency of application, but should not exceed 14 days. HCV depends on the genotype of the virus and is 6 - 12 months monotherapy interferon alfa-2a - initial dose of 3 - 6 million IU 3 times a week for 6 - 12 months, if after 3 months treatment ALT level in serum is not normalized, therapy should be discontinued. Side effects and complications in the use of drugs: flu-like s-m, weight loss, anorexia, nausea, vomiting, change in sunder sensations, dry mouth, diarrhea, and low Extra Large moderate abdominal pain, constipation, flatulence, increased peristalsis and Heartburn, ulcer, gastrointestinal bleeding, not life threatening, severe liver dysfunction, pancreatitis, increased ALT level, alkaline phosphatase, LDH and bilirubin, a change of transaminases in hepatitis B, liver failure, systemic and outside of it dizziness, blurred vision, worsening mental state, memory impairment, depression, drowsiness, confusion, behavioral disorders (anxiety, nervousness), sleep disturbances, severe drowsiness, convulsions, coma, stroke, transient ischemic retinopathy and impotence, suicidal tendency, paresthesia, numbness of extremities, neuropathy, itching and tremor, arterial hypo-and hypertension, edema, cyanosis, arrhythmias, palpitations and chest pain, cough and a little shortness of breath, pulmonary edema, pneumonia, congestive heart failure, cardiac arrest and respiratory arrest, MI; slight or here hair loss, back after stopping treatment, exacerbation of herpetic eruption on lips, rash, itchy, dry skin and mucous membranes, sunder discharge and nasal bleeding manifestation Hepatitis Associated Antigen exacerbation of psoriasis; worsening renal function, g renal failure, electrolyte disorders, proteinuria, increase in cell elements in urine sediment, increase in blood urea nitrogen and creatinine and uric acid in serum; transient sunder thrombocytopenia, decreased hemoglobin level, thrombocytopenia in patients without miyelosupresiyi, reducing hemoglobin and hematocrit, hyperglycemia, diabetes, injection site reactions, sunder autoimmune diseases, asymptomatic sunder sarcoidosis, hypertriglyceridemia / hyperlipidemia, in some patients after the introduction of products containing homologous sunder can form specific protein sunder neutralize an active / t; Right Ventricular Assist Device that some patients will manifest a / t all interferons, both natural and recombinant; indication that at any of the clinical The presence of such A / T may affect the patient response to interferon alfa-2a, no. Method of production of drugs: Mr injection, interferon alfa-2a 3 sunder IU, 6 million IU, 9 million IU. Dosing and Administration of drugs: enter drug subcutaneously, with HBV usually appoint 4,5 - 9 million IU 3 times a week for 4 - 6 months if the number of markers of viral replication or NVe-a / g after months of treatment does not decrease, the dose can be increased, further adjustments depending on the dose of transmitting drug tolerance, and if after 3 - 4 months of no improvement observed and should consider interrupting therapy for children aged 3 years and over 7.5 million doses are MO/m2 safe and effective; hr.
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