Cromolyn (Systemic, Oral Inhalation)
Kelas obat: Agen Antineoplastik
Panganggone Cromolyn (Systemic, Oral Inhalation)
Asma
Nyegah gejala asma bronkial.
Wis digunakake minangka alternatif kanggo kortikosteroid inhalasi dosis rendah ing pasien kanthi asma persisten entheng, nanging kurang efektif lan umume ora disenengi minangka terapi awal.
Ora efektif kanggo ngobati serangan asma akut, utamane status asma. (Deleng Bronkospasme Akut ing Pèngetan/Pancegahan.)
Nyegah Bronkospasme
Nyegah bronkospasme sing disebabake olahraga utawa sing disebabake dening paparan faktor precipitating liyane (contone, hawa garing sing adhem, alergen, sulfur dioksida, toluene diisosianat, polutan lingkungan). Kurang efektif tinimbang agonis β2-adrenergik sing dihirup kanthi lisan kanggo nyegah bronkospasme sing disebabake olahraga.
Mastositosis Sistemik
Pengobatan gejala mastositosis sistemik (ditunjuk minangka obat yatim piatu dening US FDA kanggo panggunaan iki). Mbenakake diare, nyeri weteng, pruritus, whealing, flushing, disfungsi kognitif, sirah, mual, muntah, lan urtikaria. Khasiat katon padha karo chlorpheniramine maleate plus cimetidine kanggo nyuda pratandha lan gejala mastositosis.
Alergi Pangan
Wis digunakake kanggo manajemen profilaksis alergi pangan† [off-label].
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Carane nggunakake Cromolyn (Systemic, Oral Inhalation)
Umum
Asma
Administrasi
Administrasi oral utawa liwat inhalasi lisan. Aja nyuntikake konsentrasi oral utawa digunakake kanggo terapi inhalasi lisan.
Administrasi kanthi interval biasa.
Oral Administration
Oral ConcentrateDilute sakdurunge administrasi; kosongake isi ampul menyang segelas banyu lan aduk.
Administrasi minangka solusi sing diencerke; Pasien kudu ngombe kabeh solusi sing diasilake.
Aja nyampur solusi karo jus woh, susu, utawa panganan.
Atur 30 menit sadurunge mangan lan sadurunge turu.
Oral Inhalation
Oral Inhalation AerosolPrime aerosol inhaler (preparasi aerosol kanggo oral inhalasi ora kasedhiya kanggo komersial ing AS ) sadurunge digunakake pisanan lan sawise periode nonuse kanthi mencet sapisan (ie. , actuating) ing ndhuwur kaleng logam.
Kaleng kudu ing suhu kamar sadurunge digunakake; goyangake sadurunge aktuasi.
Pasien kudu ambegan alon-alon lan rampung lan nyelehake cangkeme inhaler ing tutuk kanthi lambe ditutup. Ngiringake inhaler munggah lan sirah mundur banjur ambegan jero liwat tutuk nalika ngaktifake inhaler. Copot inhaler saka tutuk, tahan ambegan sawetara detik, banjur ambegan alon-alon. Baleni maneh yen perlu inhalasi kaping pindho.
Aja nyemprotake menyang mripat.
Resiki inhaler kanthi nyopot tabung saka inhaler lan ngresiki cangkeme plastik nganggo banyu anget.
Buang tabung sawise nomer aktuasi sing dilabeli.
Nyegah bronkospasme: Atur 10–15 menit nanging ≤60 menit sadurunge ngleksanani sing diantisipasi utawa paparan faktor precipitating liyane.
Solusi kanggo NebulisasiAtur solusi inhalasi oral kanthi nebulisasi nggunakake power- nebulizer sing dioperasikake kanthi tingkat aliran sing nyukupi lan topeng rai sing cocog. Aja nggunakake nebulizer sing dioperasikake tangan.
Administrasi kanthi nebulisasi kanggo bocah cilik sing angel nggunakake inhaler aerosol oral (ora kasedhiya kanggo komersial ing AS).
Keamanan lan stabilitas lisan solusi inhalasi nalika dicampur karo obatan liyane ing nebulizer ora diadegaké.
Nyegah saka bronkospasme: Atur 10-15 menit sadurunge ngleksanani diantisipasi utawa paparan faktor precipitating liyane.
Dosis
Kasedhiya minangka sodium cromolyn; dosis ditulis ing syarat-syarat uyah.
Kajaba nyatakake, dosis natrium cromolyn liwat inhalasi aerosol (preparasi aerosol kanggo inhalasi lisan ora kasedhiya maneh ing AS) dituduhake minangka jumlah sing dikirim saka cangkeme inhaler saben semprotan meter. Inhaler aerosol lisan ngirim kira-kira 1 mg saka katup lan 800 mcg saben semprotan meter saka corong. Ing 8.1- utawa 14.2-g canister ngirim paling 112 utawa 200 meter sprays, mungguh.
Pasien Pediatrik
Mastositosis Sistemik OralNeonatus lan bayi cukup umur <2 taun† [off-label]: Kaping pisanan, 20 mg / kg saben dina ing 4 dosis dibagi. (Deleng Panganggone Pediatrik ing Ati-ati.)
Bocah 2-12 taun: Kaping pisanan, 100 mg 4 kali dina.
Bocah ≥13 taun: Kaping pisanan, 200 mg 4 kali dina.
Dosis bisa ditambah sawise 2-3 minggu, miturut respon klinis.
Turunake dosis nganti tingkat efektif minimal nalika respon sing cukup.
Alergi Pangan† [ off-label] OralBocah umur 2-14 taun: Kaping pisanan, 100 mg 4 kali dina 15-20 menit sadurunge mangan wis digunakake. Yen kontrol gejala sing nyenengake ora bisa digayuh sajrone 2-3 minggu, dosis bisa tikel kaping pindho nanging ora ngluwihi 40 mg/kg saben dina.
Turunake dosis nganti tingkat efektif minimal yen wis entuk respon sing cukup.
Bocah-bocah umur 2-14 taun sing mbutuhake terapi sok-sok (contone, nalika nyingkiri panganan alergen ora bisa dijamin): 100 mg udakara 15 menit sadurunge mangan dianjurake. Dosis optimal kudu individual.
Asma Oral InhalationAerosol inhalation (ora ana komersial maneh ing AS ) ing bocah ≥5 taun: 1,6 mg (2 inhalasi) 4 kali dina. Dosis sing luwih murah bisa uga efektif, utamane ing pasien sing luwih enom. Sawise stabilisasi, nyuda frekuensi administrasi kanthi bertahap saka 4 dadi 3 banjur 3 nganti 2 kaping (2 inhalasi saben dosis) saben dina.
Solusi inhalasi kanggo nebulisasi ing bocah-bocah ≥2 taun: 20 mg 4 kali dina kanthi interval biasa. Sawise stabilisasi, kanthi bertahap nyuda frekuensi administrasi saka 4 nganti 3 kaping saben dina.
Yen kontrol saya suda ing dosis suda (<4 dosis saben dina), kanthi utawa tanpa agen bebarengan ing dosis suda, bisa uga kudu ditindakake. nambah dosis sodium cromolyn lan miwiti maneh utawa nambah dosis agen bebarengan.
Nyegah Bronkospasme Oral InhalasiAerosol inhalasi (ora kasedhiya maneh ing AS ) ing bocah-bocah ≥5 taun: 1,6 mg (2 inhalasi) 10-15 menit nanging ≤60 menit sadurunge diantisipasi olahraga utawa paparan faktor precipitating.
Solusi inhalasi kanggo nebulisasi ing bocah-bocah ≥2 taun: 20 mg 10-15 menit sadurunge ngleksanani diantisipasi utawa paparan faktor precipitating.
Dewasa
Mastositosis Sistemik OralKaping pisanan, 200 mg 4 kali dina. Dosis bisa ditambah sawise 2-3 minggu, miturut respon klinis. Kurangi dosis nganti tingkat efektif minimal nalika respon sing nyukupi diraih.
Alergi Pangan† [off-label] OralKaping pisanan, 200 mg 4 kali dina diwenehi 15-20 menit sadurunge mangan. Yen gejala ora bisa dikontrol sajrone 2-3 minggu, dosis bisa tikel kaping pindho.
Turunake dosis nganti tingkat efektif minimal nalika entuk respon sing cukup.
Wong diwasa mbutuhake terapi sok-sok (contone. , nalika nyingkiri panganan alergen ora bisa dijamin): 200 mg udakara 15 menit sadurunge mangan dianjurake. Dosis optimal kudu individual.
Asma Oral InhalationAerosol inhalation (ora ana komersial maneh ing AS): 1,6 mg (2 inhalasi) 4 kali dina. Sawise stabilisasi, nyuda frekuensi administrasi kanthi bertahap saka 4 nganti 3 banjur 3 nganti 2 kaping saben dina.
Solusi inhalasi kanggo nebulisasi: 20 mg 4 kali dina. Sawise stabilisasi, nyuda frekuensi administrasi saka 4 nganti 3 kaping saben dina.
Nyegah Bronkospasme Inhalasi OralAerosol inhalasi (ora kasedhiya kanggo komersial maneh ing AS): 1,6 mg (2 inhalasi) 10-15 menit nanging ≤60 menit sadurunge diantisipasi olahraga utawa paparan faktor precipitating.
Solusi inhalasi kanggo nebulisasi: 20 mg 10-15 menit sadurunge ngleksanani diantisipasi utawa paparan faktor precipitating.
Batesan Resep
Pasien Pediatrik
Mastositosis Sistemik OralBayi <6 sasi† [off-label]: Maksimal 20 mg/kg saben dina.
Bocah ≥2 taun: Maksimal 40 mg/kg saben dina.
Asma Oral InhalasiBocah ≥5 taun: Maksimal 1,6 mg 4 kali dina liwat aerosol dosis meter (ora ana komersial maneh kasedhiya ing AS ).
Dewasa
Asma Oral InhalasiMaksimum 1,6 mg 4 kali dina liwat aerosol dosis meter (ora kasedhiya kanggo komersial maneh ing AS).
Populasi Khusus
Gangguan Hepatik
Mastositosis SistemikNgurangi dosis oral.
Asma/BronkospasmeNgurangi inhalasi aerosol (ora kasedhiya kanggo komersial maneh ing AS ) dosis.
Gangguan Ginjal
Mastositosis SistemikNgurangi dosis oral.
Asma/BronkospasmeNgurangi inhalasi aerosol (ora ana ing AS) dosis.
Geriatri Pasien
Konsentrasi oral: Miwiti dosis ing ujung ngisor kisaran dosis. (Deleng Panggunaan Geriatrik ing Caution.)
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Bronkospasme akut
Cromolyn dudu bronkodilator lan nduweni tumindak sing alon; aerosol dosis meter (ora kasedhiya maneh ing AS) utawa solusi kanggo inhalasi lisan ora bisa digunakake kanggo ngilangi bronkospasme akut, utamane status asma.
Bronkospasme, arang banget, lan/utawa watuk kacarita sawise inhalasi lisan. Cromolyn bisa uga kudu diendhegake sanajan diwenehi bronkodilator.
Terapi Kortikosteroid KoncomitantIng pasien asma sing gumantung karo kortikosteroid sing nampa sodium cromolyn sajrone sawetara minggu, coba ngurangi dosis kortikosteroid kanthi bertahap sanajan ana gejala peningkatan. asma ora diamati. Ngawasi pasien kanthi ati-ati sajrone nyuda dosis kasebut kanggo nyegah eksaserbasi asma.
Ngawasi pasien kanthi rapet nalika mungkasi terapi cromolyn ing pasien sing dosis terapi kortikosteroid wis suda. Exacerbations saka asma mbutuhake terapi langsung lan nambah dosis kortikosteroid.
Pneumonia EosinofilikMungkasi yen radhang paru-paru eosinofilik utawa infiltrasi paru karo eosinofilia kedadeyan.
CAD utawa Aritmia JantungInhalasi aerosol dosis meter (ora kasedhiya kanggo komersial maneh ing AS ) ngandhut propelan fluorokarbon; ora dianjurake kanggo nggunakake ing pasien CAD utawa riwayat aritmia jantung.
Reaksi Sensitivitas
Reaksi anafilaksis sing abot kacarita.
Populasi Tertentu
KandhutanKategori B.
LaktasiOra dingerteni manawa cromolyn disebar ing susu. Gunakake kanthi ati-ati; nimbang keuntungan potensial kanggo ibu marang risiko potensial kanggo bayi nalika nimbang therapy.
Pediatric GunakakeGunakake kanthi ati-ati ing patients pediatric. Coba keuntungan tinimbang risiko terapi jangka panjang.
Keamanan lan khasiat natrium cromolyn sing diwenehake minangka konsentrat oral, aerosol inhalasi oral (ora kasedhiya kanggo komersial maneh ing AS), utawa solusi inhalasi lisan sing durung ditetepake kanggo bocah-bocah < 2, <5, utawa <2 taun, mungguh.
Pengobatan mastositosis sistemik ing neonatus lengkap lan bayi <2 taun dianjurake mung yen penyakit abot lan incapacitating lan yen entuk manfaat sing jelas. luwih gedhe tinimbang risiko.
Panggunaan GeriatrikKonsentrasi lisan: Pengalaman sing ora cukup ing pasien ≥65 taun kanggo nemtokake manawa pasien geriatrik nanggapi beda karo wong diwasa sing luwih enom. Pilih dosis kanthi ati-ati amarga nyuda fungsi ati, ginjel, lan/utawa jantung sing gegandhengan karo umur lan potensial kanggo penyakit bebarengan lan terapi obat.
Inhalasi aerosol (ora kasedhiya kanggo komersial maneh ing AS): Pengalaman ora cukup ing pasien ≥65 taun kanggo nemtokake manawa respon pasien geriatrik beda karo wong diwasa sing luwih enom.
Efek Umum sing Sabar
Konsentrasi lisan: Sakit sirah, diare.
Inhalasi aerosol (ora kasedhiya kanggo komersial maneh ing AS): Iritasi utawa garing ing tenggorokan, rasa ora enak, watuk, wheezing, mual.
Solusi kanggo inhalasi lisan: Irung macet, watuk, wahing, wheezing, mual.
Disclaimer
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