Choriogonadotropin Alfa
Jeneng merek: Ovidrel
Kelas obat:
Agen Antineoplastik
Panganggone Choriogonadotropin Alfa
Infertilitas Wanita
Digunakake bebarengan karo agen infertilitas liyane (contone, agonis hormon pelepas gonadotropin, FSH) kanggo induksi pematangan folikel pungkasan lan luteinisasi awal ing wanita ovulasi, ora subur sajrone teknologi reproduksi sing dibantu (ART). ) program.
Gunakake ing pasien kanthi obstruksi tuba mung yen melu program ART.
Choriogonadotropin alfa (r-hCG) padha karo hCG sing asale saka urin babagan jumlah oosit sing pulih, dibuahi. oosit utawa embrio, lan lair urip.
Digunakake bebarengan karo agen perangsang folikel kanggo ngindhuksi ovulasi ing wanita anovulasi, ora subur sing anovulasi fungsional lan ora amarga gagal ovarium primer.
Choriogonadotropin alfa (r-hCG) padha karo hCG sing diturunake urin babagan tingkat ovulasi.
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Carane nggunakake Choriogonadotropin Alfa
Umum
Administrasi
Administrasi Sub-Q
Administrasi kanthi injeksi sub-Q, umume menyang abdomen nggunakake jarum suntik sing wis disedhiyakake kanthi komersial; bisa ditindakake kanthi mandiri dening pasien.
Dosis
Dewasa
Infertilitas Wanita ART Sub-Q250 mcg, diwenehi 1 dina sawise dosis pungkasan agen stimulasi folikel. (Deleng Umum ing Dosis lan Administrasi.)
Sub-Q Induksi Ovulasi250 mcg, diwenehi 1 dina sawise dosis pungkasan agen stimulasi folikel. (Deleng Umum ing Dosis lan Administrasi.)
Yen stimulasi ovulasi ora kasil, atur dosis agen stimulasi folikel sing diwenehake ing siklus sabanjure adhedhasar respon wanita ing siklus sadurunge.
Batesan Resep
Dewasa
Sub-Q Infertilitas WanitaDosis tunggal maksimal 500-mcg sing diteliti ing uji klinis.
Pènget
Contraindications
Pènget/PanandhapPènget
Pembesaran Ovarium
Risiko pembesaran ovarium sing entheng nganti sedheng sing ora rumit; bisa uga diiringi distensi abdomen lan / utawa nyeri, nanging umume mundur tanpa perawatan sajrone 2-3 minggu. Ngawasi kanthi ati-ati respon ovarium dianjurake.
Yen ovarium nggedhekake ora normal sajrone stimulasi ovarium sing dikontrol, nahan choriogonadotropin alfa sajrone terapi saiki kanggo nyuda resiko OHSS. (Deleng Sindrom Hiperstimulasi Ovarium ing Cautions.)
Sindrom Hiperstimulasi OvariumRisiko OHSS sing bisa abot, ditondoi kanthi paningkatan permeabilitas vaskular sing nyata sing bisa nyebabake akumulasi cairan kanthi cepet ing rongga peritoneal, thorax, lan potensial, perikardium.
Mungkin maju kanthi cepet (sajrone 24 jam nganti pirang-pirang dina). Manifestasi awal kalebu nyeri bangkekan sing abot, mual, muntah, lan bobot awak. Gejala liyane kalebu nyeri weteng / distensi, diare, pembesaran ovarium sing abot, dyspnea, lan oliguria. Hipovolemia, hemokonsentrasi, ketidakseimbangan elektrolit, asites, hemoperitoneum, efusi pleura, hidrothorax, gangguan paru akut, lan tromboemboli bisa kedadeyan.
Kelainan tes fungsi ati transien, sing bisa uga diiringi owah-owahan morfologis (kaya sing dideteksi dening biopsi ati), dilaporake.
Kedadeyan paling kerep sawise rampung terapi gonadotropin, tekan keruwetan maksimal sawise 7-10 dina; biasane rampung kanthi spontan kanthi wiwitan menstruasi. Monitor pasien ≥2 minggu sawise administrasi hCG. OHSS bisa uga luwih abot lan protracted yen ngandhut.
Yen OHSS parah berkembang, mandhegake terapi, rawat pasien ing rumah sakit, lan konsultasi karo dokter sing berpengalaman ing manajemen OHSS utawa ketidakseimbangan cairan lan elektrolit.
Multiple LairKaping pirang-pirang ovulasi sing nyebabake pirang-pirang gestasi dilaporake ing 30,9 utawa 13,3% wanita sajrone program ART utawa induksi ovulasi.
ThromboembolismPotensi kanggo arterial thromboembolism ana.
Fetal/Neonatal Morbidity and MortalitasBisa nyebabake cilaka janin; ora kalebu meteng sadurunge miwiti perawatan.
Panaliten kewan nuduhake efek sing ora becik tumrap asil meteng lan/utawa tenaga kerja. (Deleng Contraindications ing Cautions.)
Pancegahan Umum
Evaluasi lan Pemantauan Pasien sing NyukupiAdministrasi mung ing sangisore pengawasan dokter sing nduweni kualifikasi sing ngalami gangguan kesuburan lan interpretasi indeks ovulasi.
Ngawasi perkembangan folikel (contone, nggunakake transvaginal). ultrasonik, konsentrasi estradiol serum) kanggo ngenali kanthi bener pematangan folikel, nemtokake wektu administrasi choriogonadotropin alfa, ndeteksi pembesaran ovarium, lan nyilikake risiko OHSS lan pirang-pirang gestation.
Entuk konfirmasi klinis ovulasi saka indeks produksi progesteron langsung lan ora langsung, kalebu kenaikan suhu awak basal, paningkatan konsentrasi progesteron serum, lan menstruasi sawise owah-owahan ing suhu awak basal. Bukti sonografi ovulasi kalebu temuan cairan ing cul-de-sac, stigmata ovarium, folikel ambruk, lan endometrium sekretori.
Populasi Spesifik
KandhutanKategori X. (Deleng Morbiditas lan Mortalitas Janin/Neonatal lan uga Kontraindikasi miturut Ati-ati.)
LaktasiOra dingerteni manawa choriogonadotropin alfa disebarake menyang susu. Ati-ati.
Panggunaan PediatrikKaslametan lan khasiat durung ditetepake.
Panggunaan GeriatrikKeslametan lan khasiat durung ditetepake.
Gangguan HepatikKaamanan lan khasiat durung ditetepake.
p> Gagal GinjalKeamanan lan khasiat ora ditetepake.
Efek Umum sing Sabar
ART: Reaksi ing situs injeksi (yaiku nyeri, bruising), nyeri weteng, mual, muntah, nyeri pasca operasi.
Induksi ovulasi: Situs injeksi reaksi (yaiku, nyeri, inflamasi, bruising, reaksi situs injeksi liyane), kista ovarium, hiperstimulasi ovarium, nyeri abdomen.
Apa obatan liyane bakal mengaruhi Choriogonadotropin Alfa
Ora ana studi interaksi obat resmi nganti saiki.
Tes Laboratorium
Tes
Interaksi
Komentar
Radioimmunoassays kanggo gonadotropin
Kamungkinan reaksi silang karo radioimmunoassays kanggo gonadotropin, utamane LH
Laboratorium individu kudu netepake tingkat reaktivitas silang karo uji gonadotropin
Nalika njaluk penentuan konsentrasi gonadotropin, ngandhani laboratorium terapi choriogonadotropin alfa
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