Fluticasone (Systemic, Oral Inhalation)
Kelas obat: Agen Antineoplastik
Panganggone Fluticasone (Systemic, Oral Inhalation)
Asma
Fluticasone digunakake kanggo nyegah bronkospasme ing pasien kanthi asma.
Ing pasien sing gumantung karo kortikosteroid, fluticasone bisa ngidini nyuda substansial ing dosis pangopènan saben dina kortikosteroid sistemik lan mungkasi dosis pangopènan kortikosteroid kanthi bertahap.
Fluticasone/salmeterol kombinasi tetep mung digunakake ing pasien asma ora nanggapi kanthi cukup kanggo terapi pengontrol asma jangka panjang (contone, kortikosteroid inhalasi) utawa sing keruwetan penyakit kasebut kanthi jelas njamin wiwitan perawatan karo kortikosteroid inhalasi lan agonis β2-adrenergik long-acting.
Sawise kontrol asma bisa digayuh lan tetep, evaluasi pasien kanthi interval reguler lan mundurake terapi (umpamane, mungkasi fluticasone / salmeterol), yen bisa tanpa kontrol asma, lan njaga pasien ing terapi pengontrol asma jangka panjang. (contone, kortikosteroid inhalasi).
Aja nggunakake fluticasone/salmeterol ing pasien asma sing dikontrol kanthi cukup ing dosis rendah utawa medium kortikosteroid sing dihirup.
COPD
Kombinasi tetep karo salmeterol minangka bubuk inhalasi lisan (Advair Diskus) digunakake kanggo perawatan pangopènan obstruksi aliran udara ing pasien COPD, kalebu bronkitis kronis lan / utawa emfisema; uga digunakake kanggo nyuda exacerbations COPD ing pasien kanthi riwayat eksaserbasi.
Fluticasone/salmeterol ora dituduhake kanggo ngilangi bronkospasme akut.
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Carane nggunakake Fluticasone (Systemic, Oral Inhalation)
Umum
Asma
Konversi menyang Terapi Inhalasi Oral ing Pasien sing Nampa Kortikosteroid Sistemik
Administrasi
Administrasi kanthi inhalasi lisan.
Oral Inhalation
Administrasi fluticasone piyambak utawa ing kombinasi tetep karo salmeterol (Advair HFA) minangka suspensi microcrystalline dening inhalasi lisan nggunakake inhaler aerosol lisan karo hydrofluoroalkane (HFA; non-chlorofluorocarbon) propelan.
Atur bubuk inhalasi kanthi kombinasi tetep karo salmeterol kanthi nggunakake inhaler lisan khusus (Advair Diskus) sing ngirim obat kasebut saka lepuh sing dibungkus foil.
Sakwisé perawatan, mbilas tutuk kanthi banyu tanpa ngulu.
Inhalation PowderAdministrasi fluticasone ing kombinasi tetep karo salmeterol nggunakake inhaler lisan khusus (Advair Diskus). Gunakake kaping pindho saben dina (esuk lan sore), kira-kira 12 jam.
Tahan piranti Diskus ing tangan siji, lebokake jempol tangan liyane ing jempol, banjur pencet jempol nganti cangkeme katon lan pas ing posisine.
Pencet tuas adoh saka awak nganti keprungu klik; pengungkit pierces blister foil lan nerbitaké tamba powdered menyang port metu. Aja ngiringake utawa nutup piranti Diskus, muter karo tuas, utawa maju tuas luwih saka sapisan ing titik iki. Penghitung dosis bakal maju saben pengungkit ditekan.
Ambegan alon-alon lan rampung lan lebokake cangkeme inhaler kanthi apik ing tutuk kanthi lambe ditutup. Sawise inhalasi dosis liwat tutuk, tahan ambegan kanggo 10 detik, lan exhale alon.
Aja ambegan menyang piranti Diskus. Aja nggunakake dosis ekstra saka piranti Diskus yen pasien ora ngrasakake utawa ngrasakake obat kasebut.
Mbilas tutuk sawise inhalasi fluticasone/salmeterol. Geser thumbgrip menyang awak kanggo nutup piranti Diskus lan ngreset piranti kanggo dosis sabanjure. Aja wisuh inhaler utawa copot.
Aja nggunakake fluticasone/salmeterol kanthi piranti spacer.
Aerosol InhalasiGoyang kanthi apik (5 detik) sakdurunge nggunakake wiwitan. Aktifake inhaler aerosol fluticasone 4 kaping sadurunge nggunakake wiwitan. Tes semprotan inhaler aerosol sing ngandhut fluticasone ing kombinasi tetep karo salmeterol (Advair HFA) 4 kaping menyang udhara (adoh saka pasuryan) sadurunge nggunakake dhisikan, lan goyangake nganti 5 detik sadurunge saben semprotan.
Aktifake inhaler fluticasone sapisan sadurunge digunakake yen ora digunakake luwih saka 1 minggu utawa yen inhaler mudhun. Yen inhaler aerosol Advair HFA ora digunakake luwih saka 4 minggu utawa yen inhaler dicelupake, coba inhaler semprotan kaping pindho menyang udhara (adoh saka pasuryan) lan goyangake nganti 5 detik sadurunge saben semprotan.
Ambegan alon-alon lan rampung lan lebokake cangkeme inhaler kanthi apik ing tutuk kanthi lambe ditutup. Ambegan alon-alon lan jero liwat tutuk nalika ngaktifake inhaler. Tahan ambegan nganti 10 detik, copot cangkem, lan ambegan alon-alon.
Turunake 30 detik antarane inhalasi sakteruse saka inhaler aerosol.
Sakwise perawatan, mbilas tutuk sak tenane.
Resiki inhaler fluticasone paling sethithik sepisan seminggu sawise dosis sore kanthi nyopot tutup mouthpiece saka inhaler lan ngumbah cangkeme nganggo katun sing wis dibasahi; ngidini aktuator garing ing wayah wengi.
Resiki inhaler aerosol Advair HFA kanthi ngusap bukaan ing ngendi obat nyemprot metu saka tabung logam lan cangkem kanthi swab katun sing garing lan tisu sing dibasahi, paling ora sepisan seminggu. sawise dosis sore; ngidini actuator kanggo online-garing sewengi.
Nalika counter dosis ing inhaler aerosol kanggo fluticasone piyambak utawa ing kombinasi tetep karo salmeterol (Advair HFA) maca "020", nyaranake pasien hubungi apotek kanggo ngisi ulang utawa takon dokter kanggo nemtokake perlu kanggo isi ulang. Buang inhaler aerosol nalika counter dosis maca "000". Aja ngganti utawa mbusak counter dosis saka tabung.
Dosis
Kajaba nyatakake liyane, dosis fluticasone propionate sing diwenehake minangka aerosol liwat inhaler dosis meter dituduhake minangka jumlah sing dikirim saka aktuator inhaler saben semprotan meter.
Aerosol inhalasi oral Fluticasone propionate ngirimake 50, 125, utawa 250 mcg saka katup, lan 44, 110, utawa 220 mcg, saka aktuator saben semprotan meter. Kaleng 10,6- utawa 12-g ngirim semprotan 120 meter.
Dosis fluticasone propionate lan salmeterol ing bubuk inhalasi lisan kombinasi tetep (Advair Diskus) dituduhake minangka dosis nominal (label) sing ana ing saben foil. - blister sing dibungkus. Jumlah bubuk obat sing dikirim menyang paru-paru gumantung saka faktor kayata aliran inspirasi pasien.
Saben aktuasi inhaler aerosol oral Advair HFA ngirimake 50, 125, utawa 250 mcg fluticasone propionate lan 25 mcg saka salmeterol saka katup. Dosages Advair HFA sing ditulis ing syarat-syarat tamba dikirim saka mouthpiece; saben aktuasi inhaler ngirim 45, 115, utawa 230 mcg fluticasone propionate lan 21 mcg salmeterol saka mouthpiece. g canister, mungguh.
Pasien Pediatrik
Asma Fluticasone Inhalation Oral AerosolBocah 4-11 taun: Dosis wiwitan lan maksimal yaiku 88 mcg kaping pindho saben dina.
Bocah ≥12 taun umur sadurunge nampa bronkodilator piyambak: Kaping pisanan, 88 mcg kaping pindho saben dina. Yen kontrol asma ora cukup sawise 2 minggu terapi ing dosis awal, kekuatan sing luwih dhuwur bisa nyedhiyakake kontrol asma tambahan. Yen perlu, dosis bisa ditambah nganti maksimal 440 mcg kaping pindho saben dina. Coba dosis awal> 88 mcg kaping pindho saben dina ing bocah-bocah kanthi kontrol asma sing ora cukup.
Bocah ≥12 taun sadurunge nampa kortikosteroid inhalasi: Kaping pisanan, 88-220 mcg kaping pindho saben dina. Yen perlu, dosis bisa ditambah nganti maksimal 440 mcg kaping pindho saben dina. Coba dosis awal> 88 mcg kaping pindho saben dina ing wong sing nampa kortikosteroid inhalasi ing pungkasan dosis sing luwih dhuwur.
Bocah ≥12 taun sadurunge nampa kortikosteroid oral: Kaping pisanan, 440 mcg kaping pindho saben dina; dosis maksimum yaiku 880 mcg kaping pindho saben dina.
Fluticasone/Salmeterol Kombinasi Tetap Oral Inhalasi AerosolBocah ≥12 taun: 90, 230, utawa 460 mcg fluticasone propionate lan 42 mcg salmeterol (2 inhalasi) kaping pindho saben dina, diwenehi kira-kira 12 jam saben dina (esuk lan sore); dosis awal sing disaranake adhedhasar terapi asma pasien saiki.
Yen kontrol asma ora cukup sawise 2 minggu terapi ing dosis awal, ngganti kekuatan saiki kombinasi tetep kanthi kekuatan sing luwih dhuwur (kekuwatan sing luwih dhuwur ngemot dosis sing luwih dhuwur saka fluticasone mung) bisa nyedhiyakake kontrol asma tambahan.
Bubuk Inhalasi OralBocah umur 4-11 taun: 100 mcg fluticasone propionate lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina, diwenehi kira-kira 12 saben jam (esuk lan sore).
Bocah ≥12 taun: 100, 250, utawa 500 mcg fluticasone propionate lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina, diwenehi kira-kira 12 jam ( esuk lan sore); dosis awal sing disaranake adhedhasar keruwetan asma pasien.
Yen kontrol asma ora cukup sawise 2 minggu terapi ing dosis awal, ngganti kekuatan saiki kanthi kekuatan sing luwih dhuwur (kekuwatan sing luwih dhuwur mung ngemot dosis fluticasone sing luwih dhuwur. ) bisa nyedhiyakake kontrol asma tambahan.
Dewasa
Asma Fluticasone Inhalasi Oral AerosolSadurungé nampa bronkodilator piyambak: Kaping pisanan, 88 mcg kaping pindho saben dina. Yen perlu, dosis bisa ditambah nganti maksimal 440 mcg kaping pindho saben dina. Coba dosis awal> 88 mcg kaping pindho saben dina ing wong diwasa kanthi kontrol asma sing ora nyukupi.
Sadurungé nampa kortikosteroid inhalasi: Kaping pisanan, 88-220 mcg kaping pindho saben dina. Yen perlu, dosis bisa ditambah nganti maksimal 440 mcg kaping pindho saben dina. Coba dosis awal> 88 mcg kaping pindho saben dina ing wong sing nampa kortikosteroid inhalasi ing dosis sing luwih dhuwur.
Sadurungé nampa kortikosteroid oral: Dosis awal lan maksimal yaiku 880 mcg kaping pindho saben dina.
Yen kontrol asma ora cukup sawise 2 minggu terapi ing dosis awal, kekuatan sing luwih dhuwur bisa nyedhiyakake. kontrol asma tambahan.
Fluticasone/Salmeterol Kombinasi Tetap Oral Inhalasi Aerosol90, 230, utawa 460 mcg fluticasone propionate lan 42 mcg salmeterol (2 inhalasi) kaping pindho saben dina, diwenehi kira-kira 12 jam saben dina (esuk lan sore). ); dosis awal sing disaranake adhedhasar terapi asma pasien saiki.
Yen kontrol asma ora nyukupi sawise 2 minggu terapi ing dosis awal, ngganti kekuatan saiki kanthi kekuatan sing luwih dhuwur (kekuwatan sing luwih dhuwur mung ngemot dosis fluticasone sing luwih dhuwur) bisa nyedhiyakake kontrol asma tambahan.
Bubuk Inhalasi Oral100, 250, utawa 500 mcg fluticasone propionate lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina, diwenehi kira-kira 12 jam (esuk lan sore); dosis awal sing disaranake adhedhasar keruwetan asma pasien.
Yen kontrol asma ora cukup sawise 2 minggu terapi ing dosis awal, ngganti kekuatan saiki kanthi kekuatan sing luwih dhuwur (kekuwatan sing luwih dhuwur mung ngemot dosis fluticasone sing luwih dhuwur. ) bisa nyedhiyakake kontrol asma tambahan.
COPD Fluticasone/Salmeterol Kombinasi Tetap Bubuk Inhalasi Oral250 mcg fluticasone propionate lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina, diwenehi kira-kira saben 12 jam (esuk lan sore) .
Watesan Resep
Pasien Anak
Asma Fluticasone Inhalasi Oral AerosolBocah 4–11 taun: Maksimal 88 mcg kaping pindho saben dina.
Bocah ≥12 taun sadurunge nampa bronkodilator piyambak utawa kortikosteroid inhalasi: Maksimum 440 mcg kaping pindho saben dina.
Bocah ≥12 taun sadurunge nampa kortikosteroid oral: Maksimum 880 mcg kaping pindho saben dina.
Fluticasone/Salmeterol Kombinasi Tetap Oral Inhalasi AerosolBocah ≥12 taun: Maksimal 460 mcg flutikason propionat lan 42 mcg salmeterol (2 inhalasi) kaping pindho saben dina.
Bubuk Inhalasi OralBocah 4–11 taun: Maksimal 100 mcg fluticasone propionate lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina.
Bocah ≥12 taun: Maksimum 500 mcg fluticasone propionate lan 50 mcg salmeterol (1 inhalasi ) kaping pindho saben dina.
Wong diwasa
Asma Fluticasone Inhalasi Oral AerosolSadurungé nampa bronkodilator tunggal utawa kortikosteroid inhalasi: Maksimum 440 mcg kaping pindho saben dina.
Sadurungé nampa kortikosteroid oral: Maksimum 880 mcg kaping pindho saben dina.
Fluticasone/SalmeterolMaksimum 500 mcg flutikason propionat lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina.
COPD Fluticasone/Salmeterol Kombinasi Tetap Bubuk Inhalasi OralMaksimum 250 mcg flutikason propionat lan 50 mcg salmeterol (1 inhalasi) kaping pindho saben dina. Panganggone dosis sing luwih dhuwur tinimbang sing disaranake ora ningkatake fungsi paru-paru.
Populasi Khusus
Informasi ing ngisor iki alamat dosis fluticasone propionate ing populasi khusus. Nalika fluticasone propionate digunakake ing kombinasi tetep karo salmeterol, syarat dosis kanggo salmeterol kudu dianggep.
Pasien Geriatrik
Aerosol inhalasi: Pilih dosis kanthi ati-ati, nuduhake frekuensi sing luwih gedhe saka fungsi ati sing mudhun, anane kahanan sing ana bebarengan, utawa terapi obat liyane.
Fluticasone/salmeterol: Pangaturan dosis ora dianjurake mung amarga umur.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Panganggone Kombinasi Tetep
Yen digunakake ing kombinasi tetep karo salmeterol, nimbang ati-ati, pancegahan, kontraindikasi, lan interaksi sing ana gandhengane karo saben obat.
Kedadeyan sing gegandhengan karo Asma SeriusAgonis β2-adrenergik sing tumindak dawa, kayata salmeterol, komponen Advair, nambah risiko pati sing gegandhengan karo asma nalika digunakake minangka monoterapi. Data saka uji klinis nuduhake yen monoterapi karo agonis β2-adrenergik sing dawa tumindak uga nambah risiko rawat inap sing gegandhengan karo asma ing bocah lan remaja.
Gunakake kombinasi tetep saka fluticasone lan salmeterol mung ing pasien asma sing durung nanggapi kanthi cukup kanggo terapi pengontrol asma jangka panjang (umpamane, kortikosteroid inhalasi) utawa sing keruwetan penyakit kasebut kanthi jelas njamin wiwitan perawatan karo loro obat kasebut. kortikosteroid inhalasi lan agonis β2-adrenergik long-acting. (Deleng Asma ing Panggunaan.)
Adhedhasar review saka 4 uji klinis (3 ing wong diwasa lan remaja lan 1 ing bocah-bocah), FDA nyimpulake ora ana peningkatan risiko klinis sing penting kanggo kedadeyan asma sing serius (yaiku. , rawat inap sing gegandhengan karo asma, intubasi, pati) sing digandhengake karo nggunakake terapi bebarengan karo agonis β2-adrenergic long-acting lan kortikosteroid inhalasi dibandhingake karo nggunakake kortikosteroid inhalasi mung kanggo perawatan asma. Panaliten kasebut uga nuduhake yen terapi kombinasi tetep karo agonis β2-adrenergik sing dawa tumindak lan kortikosteroid sing dihirup luwih efektif kanggo nyuda kedadeyan eksaserbasi asma dibandhingake karo nggunakake kortikosteroid sing dihirup wae.
Exacerbations Akut Asma utawa COPDAja miwiti terapi kanthi kombinasi tetep fluticasone lan salmeterol ing pasien kanthi asma sing saya elek utawa sayat akut utawa gejala COPD akut.
Gagal nanggapi. kanggo dosis fluticasone sing sadurunge efektif ing kombinasi tetep karo salmeterol bisa nunjukake asma utawa COPD sing saya tambah akeh sing mbutuhake evaluasi maneh.
Aja miwiti flutikason ing kombinasi tetep karo terapi salmeterol ing pasien kanthi gejala asma akut (contone, ora responsif kanggo obat-obatan biasa, nambah kabutuhan β-agonis short-acting sing dihirup, gejala tambah akeh, kunjungan kamar darurat anyar, kerusakan dadakan utawa progresif ing fungsi paru-paru).
Yen kontrol gejala sing ora nyukupi tetep karo suplemen tambahan. Terapi bronkodilator agonis β2 utawa fungsi paru-paru (contone, PEF) suda banget, evaluasi maneh terapi asma kanthi cepet. Dosis ekstra/tambah salmeterol utawa β2-agonis inhalasi long-acting liyane (contone, formoterol) ora kudu digunakake ing kahanan kaya ngono. Evaluasi ulang kasebut bisa uga kalebu nambah kekuatan kombinasi tetep (kekuwatan sing luwih dhuwur mung ngemot dosis fluticasone sing luwih dhuwur), nambah kortikosteroid inhalasi tambahan, utawa miwiti kortikosteroid sistemik. Aja nambah frekuensi administrasi kombinasi tetep.
Penarikan Terapi Kortikosteroid SistemikKamungkinan eksaserbasi asma utawa insufisiensi adrenal sing ngancam nyawa ing pasien sing diowahi saka kortikosteroid sistemik menyang flutikason sing dihirup oral.
Mbusak terapi kortikosteroid sistemik kanthi bertahap lan monitor pratandha obyektif saka insufisiensi adrenal (contone, lemes, lemes, kekirangan, mual, muntah, hipotensi) nalika mundur saka terapi sistemik. Uga kanthi ati-ati ngawasi fungsi paru-paru (FEV1 utawa PEF esuk), panggunaan agonis β2-adrenergik tambahan, lan gejala asma. Patients sing wis maintained ing ≥20 mg saka prednisone (utawa padha karo) saben dina bisa paling rentan kanggo efek salabetipun, utamané sak bagean pungkasan saka transfer.
Gejala mundur kortikosteroid (contone, nyeri sendi, nyeri otot, lemes, lemes, depresi) bisa kedadeyan.
Pantau kanthi ati-ati kanggo kekurangan adrenal akut nalika kena trauma, operasi, utawa infeksi (utamane gastroenteritis) utawa kahanan liyane sing ana gandhengane karo mundhut elektrolit akut.
Pantau kanthi ati-ati kanggo eosinofilia, ruam vaskulitis, gejala paru-paru sing saya tambah, komplikasi jantung, lan/utawa neuropati sing cocog karo sindrom Churg-Strauss.
Pantau kanthi teliti kanggo mbukak tutup kondisi sing sadurunge dikontrol dening terapi kortikosteroid sistemik (contone, rhinitis, konjungtivitis, eksim, atritis, kondisi eosinofilik).
Aja nggunakake kombinasi tetep flutikason lan salmeterol minangka aerosol inhalasi oral (Advair HFA) kanggo nransfer pasien saka terapi kortikosteroid sistemik.
Patients ImmunosuppressedTambah kerentanan kanggo infeksi ing pasien sing njupuk obat imunosupresan dibandhingake karo wong sing sehat. Infèksi tartamtu (contone, cacar air, campak) bisa nyebabake asil sing luwih serius utawa malah fatal ing pasien kasebut, utamane ing bocah-bocah.
Ngati-ati supaya ora kena paparan ing pasien sing rentan. Yen paparan cacar air utawa campak dumadi ing pasien sing rentan, pertimbangake kanggo menehi varicella zoster immune globulin (VZIG) utawa pooled immune globulin (IG). Coba perawatan karo agen antivirus yen cacar ayam berkembang.
Efek PernafasanBronkospasme lan/utawa wheezing bisa kedadeyan.
Yen ana bronkospasme, nambani langsung (contone, karo agonis β-adrenergik short-acting), lan mungkasi perawatan karo fluticasone.
Reaksi Sensitivitas
Reaksi hipersensitivitas langsung (contone, urtikaria, angioedema, ruam, bronkospasme, anafilaksis).
Reaksi anafilaksis dilapurake ing pasien alergi protein susu sing abot sawise inhalasi oral produk bubuk sing ngandhut laktosa (contone, Advair Diskus). (Deleng Contraindications ing Cautions.)
Pancegahan Umum
Efek OkularGlaukoma, tekanan intraokular sing tambah, lan katarak jarang dilapurake. Coba priksa mata biasa.
Efek Kortikosteroid SistemikAdministrasi dosis flutikason sing dihirup luwih dhuwur tinimbang sing disaranake bisa nyebabake manifestasi hiperkortisisme lan penekanan fungsi HPA. Yen owah-owahan kasebut kedadeyan, ngurangi dosis fluticasone alon-alon, konsisten karo prosedur sing ditampa kanggo ngurangi dosis kortikosteroid lan ngatur gejala asma.
Ngati-ati banget kanggo ngawasi pasien sawise operasi utawa sajrone wektu stres kanggo bukti adrenal ora nyukupi. nanggepi.
Efek MuskuloskeletalPanganggone jangka panjang bisa nyebabake metabolisme balung normal, sing nyebabake ilang kepadatan mineral tulang (BMD).
Panganggone flutikason ing kombinasi tetep karo salmeterol bisa nyebabake. risiko tambahan ing pasien kanthi faktor risiko utama kanggo nyuda BMD, kayata nggunakake rokok, umur tuwa, gaya urip sing ora aktif, nutrisi sing kurang, riwayat osteoporosis ing kulawarga, utawa nggunakake obat-obatan kronis sing bisa nyuda massa balung (contone, antikonvulsan, kortikosteroid) .
Amarga pasien karo COPD asring duwe macem-macem faktor risiko kanggo nyuda BMD, priksa BMD sadurunge miwiti terapi lan kanthi periodik sesampunipun. Coba gunakake agen kanggo nambani utawa nyegah osteoporosis yen pangurangan sing cukup ing BMD katon lan nggunakake fluticasone lan salmeterol ing kombinasi tetep dianggep penting kanggo perawatan COPD.
InfèksiInfeksi candidal lokal saka pharynx kacarita . Yen infèksi ana, perawatan lokal utawa sistemik sing cocog lan / utawa mandheg terapi bisa uga dibutuhake.
Gunakake kanthi ati-ati banget, yen kabeh, ing pasien kanthi infeksi Mycobacterium tuberculosis klinis utawa tanpa gejala ing saluran pernapasan; infèksi jamur, bakteri, utawa parasit sing ora diobati; utawa herpes simplex okular utawa infèksi virus sistemik sing ora diobati.
Tetep waspada kanggo kemungkinan pangembangan radhang paru-paru ing pasien COPD sing nampa fluticasone kanthi kombinasi tetep karo salmeterol (Advair Diskus) bubuk inhalasi oral, amarga gejala klinis pneumonia lan eksaserbasi COPD kerep tumpang tindih.
Infeksi saluran napas ngisor, (umpamane, radhang paru-paru) dilaporake ing pasien COPD sing nampa kortikosteroid sing dihirup, kalebu fluticasone piyambak utawa ing kombinasi tetep karo salmeterol (Advair Diskus) bubuk inhalasi oral.
Efek LiyaneEfek obat jangka panjang, sistemik, lan lokal sing ora dingerteni ing manungsa, utamane proses perkembangan utawa imunologi ing tutuk, pharynx, trakea, lan paru-paru.
Populasi Spesifik
KandhutanKategori C.
LaktasiDistribusi menyang susu ing tikus; ora dingerteni manawa disebarake menyang susu manungsa.
Data uga ora kasedhiya babagan efek fluticasone ing bocah sing disusui utawa ing produksi susu.
Ngati-ati ing wanita sing nyusoni.
Pikirake keuntungan saka susu. -Pakanan bebarengan karo kabutuhan klinis wong wadon kanggo tamba lan potensial efek salabetipun ing anak-disusun saka fluticasone utawa kondisi ibu ndasari.
Pediatric GunakakeAman lan khasiat saka fluticasone oral inhalation aerosol utawa oral inhalation bubuk liwat Diskus ngemot fluticasone ing kombinasi tetep karo salmeterol ora ditetepake ing bocah-bocah <4 taun.
Aman lan khasiat aerosol inhalasi lisan sing ngemot fluticasone ing kombinasi tetep karo salmeterol (Advair HFA) ora ditetepake ing bocah-bocah <12 taun. Profil efek salabetipun Flovent HFA ing pasien pediatrik (umur 4-11 taun) umume padha karo sing diamati ing remaja lan wong diwasa.
Kanthi nggunakake jangka panjang, tingkat pertumbuhan sing alon ing bocah lan remaja; Ngawasi kanthi rutin (umpamane, liwat stadiometri) wutah lan perkembangan bocah-bocah sing nampa terapi kortikosteroid sing dawa. Timbang keuntungan saka terapi kortikosteroid versus kemungkinan dipatèni wutah lan risiko sing ana gandhengane karo terapi alternatif. Gunakake dosis paling murah sing efektif ngontrol asma.
Panggunaan GeriatrikOra ana bedane signifikan ing safety lan khasiat relatif kanggo wong diwasa enom, nanging tambah sensitivitas ora bisa ditolak lewat.
Pengalaman sing ora cukup karo fluticasone ing kombinasi tetep karo bubuk inhalasi oral salmeterol ing pasien ≥65 taun karo asma kanggo nemtokake manawa pasien geriatrik nanggapi beda karo pasien sing luwih enom.
Peningkatan insiden serius. efek salabetipun kacarita ing patients ≥65 taun karo COPD nampa fluticasone ing kombinasi tetep karo bubuk inhalasi lisan salmeterol dibandhingake karo wong diwasa enom; Nanging, distribusi saka efek salabetipun padha ing loro kelompok. (Deleng Pasien Geriatrik miturut Dosis lan Administrasi.)
Gangguan HepatikKonsentrasi plasma bisa uga tambah. Ngawasi pasien kanthi rapet.
Efek Umum sing Sabar
Aerosol inhalasi oral Fluticasone: Infeksi saluran napas ndhuwur, peradangan saluran napas ndhuwur, sinusitis, infeksi sinus, dysphonia, iritasi tenggorokan, kandidiasis, batuk, bronkitis, sirah.
Apa obatan liyane bakal mengaruhi Fluticasone (Systemic, Oral Inhalation)
Informasi ing ngisor iki alamat potensial interaksi karo fluticasone. Nalika digunakake ing kombinasi tetep karo salmeterol, nimbang interaksi sing digandhengake karo salmeterol. Ora ana studi interaksi obat resmi sing ditindakake nganti saiki karo kombinasi tetep.
Dimetabolisme dening isoenzim CYP3A4.
Obat sing Ngaruhi Enzim Mikrosomal Hepatik
Inhibitor kuat CYP3A4: interaksi farmakokinetik potensial (tambah konsentrasi plasma flutikason propionat).
Obat Spesifik
Obat
Interaksi
Komentar
Eritromisin
Ora ana efek ing farmakokinetik flutikason
Ketoconazole
Peningkatan konsentrasi flutikason ing plasma nyebabake nyuda AUC kortisol plasma
Gunakake bebarengan kanthi ati-ati
Ritonavir
Nambah konsentrasi fluticasone plasma lan AUC, nyebabake efek kortikosteroid sistemik (contone, sindrom Cushing, suppression adrenal)
Panggunaan bebarengan ora dianjurake kajaba keuntungan potensial luwih gedhe tinimbang risiko efek samping kortikosteroid sistemik
Disclaimer
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