Pilocarpine Hydrochloride
Jeneng merek: Salagen
Kelas obat:
Agen Antineoplastik
Panganggone Pilocarpine Hydrochloride
Mulut Garing sing diakibatake dening radiasi
Pengobatan gejala cangkeme garing sing disebabake dening radiasi (xerostomia) ing pasien kanker sirah lan gulu.
Mulut Garing Sekunder kanggo Sindrom Sjögren
Pengobatan gejala tutuk garing ing pasien karo sindrom Sjögren.
Ana sawetara studi komparatif babagan pilocarpine lan cevimeline (agonis muskarinik sing padha). Senajan loro obat bisa nambah aliran salivary lan nambah gejala saka tutuk garing, efek salabetipun bisa beda-beda adhedhasar beda ing selektivitas lan afinitas kanggo reseptor muscarinic. (Deleng Tindakan.)
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Carane nggunakake Pilocarpine Hydrochloride
Administrasi
Administrasi Lisan
Atur kanthi lisan 3-4 kaping saben dina.
Dosis
Kasedhiya minangka pilocarpine hydrochloride; dosis ditulis ing syarat-syarat uyah.
Dewasa
Mulut Kering sing disebabake dening radiasi OralKaping pisanan, 5 mg 3 kali dina; titrasi dosis adhedhasar respon terapeutik lan toleransi.
Rentang dosis biasané yaiku 15-30 mg saben dina diwènèhaké ing dosis sing dibagi (ora ngluwihi 10 mg saben dosis).
Efek sing ora becik yaiku dosis. gegandhengan; nggunakake dosis sing paling efektif lan ditoleransi kanggo terapi pangopènan.
Paling ora 12 minggu terapi terus-terusan bisa uga dibutuhake kanggo entuk manfaat terapeutik.
Mulut Kering Sekunder kanggo Sindrom Sjögren OralDosis sing disaranake yaiku 5 mg 4 kali dina. Kanggo nyilikake kedadeyan kringet, sawetara dokter nyaranake miwiti terapi kanthi dosis sing sithik (umpamane, 2 mg sapisan utawa kaping pindho saben dina), banjur nambah kanthi bertahap nganti 5 mg 3 utawa 4 kali dina.
Ing studi klinis, efek terapeutik diamati sajrone 6 minggu perawatan.
Watesan Resep
Dewasa
Mulut Kering sing disebabake dening radiasi OralAja ngluwihi 10 mg saben dosis.
Populasi Khusus
Gangguan Hepatik
Gagal hepatik ringan: Ora ana pangaturan dosis sing dibutuhake.
Gangguan ati moderat: Ngurangi dosis awal dadi 5 mg kaping pindho saben dina tanpa preduli saka indikasi; nyetel dosis sakteruse adhedhasar respon lan tolerability. (Deleng Cacat Hepatik ing Ati-ati.)
Gangguan hepatik sing abot: Gunakake ora dianjurake.
Gangguan Ginjal
Produsen ora menehi rekomendasi dosis khusus.
Pasien Geriatrik
Produsen ora menehi rekomendasi dosis khusus.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Efek Kardiovaskular
Risiko owah-owahan konduksi jantung lan/utawa detak jantung. Pasien karo penyakit kardiovaskular sing penting sacara klinis bisa uga ora bisa ngimbangi owah-owahan transien ing hemodinamik utawa irama jantung sing disebabake dening pilocarpine.
Gunakake kanthi ati-ati lan ing pengawasan medis sing cedhak ing pasien sing duwe riwayat penyakit kardiovaskular (contone, angina). pectoris, MI).
Efek OkularSesanti burem dilapurake kanthi formulasi ophthalmic. Bisa nyebabake persepsi jero lan nyuda ketajaman visual, utamane ing wayah wengi lan ing pasien kanthi owah-owahan lensa tengah; bisa ngrusak kemampuan kanggo nyopir ing wayah wengi utawa nindakake aktivitas mbebayani ing cahya sing suda. (Deleng Saran kanggo Pasien.)
Efek PulmonalBisa nambah resistensi saluran napas, nada otot polos bronkial, lan sekresi bronkial. Gunakake kanthi ati-ati lan ing pengawasan medis sing cedhak kanggo pasien asma sing dikontrol, bronkitis kronis, utawa COPD.
Pancegahan Umum
Efek ParasimpatomimetikKamungkinan efek parasimpatomimetik sing berlebihan (contone, sirah, gangguan visual, lakrimasi, kringet, gangguan ambegan, kejang GI, mual, muntah, diare, blok AV, takikardia, bradikardia. hipotensi, hipertensi, kejut, kebingungan mental, aritmia jantung, tremor).
Kringet minangka efek samping sing paling umum. Kringet sing berlebihan bisa nyebabake dehidrasi. (Deleng Saran kanggo Pasien.)
Efek EmpeduGunakake kanthi ati-ati ing pasien sing dikenal utawa dicurigai cholelithiasis utawa penyakit saluran empedu.
Kontraksi kandung empedu utawa otot polos empedu bisa nyebabake komplikasi (contone. , cholecystitis, cholangitis, obstruksi bilier) ing pasien karo cholelithiasis.
Efek GinjalBisa nambah nada otot polos ureter, lan sacara teoritis nyebabake kolik ginjal utawa refluks ureter ing pasien nephrolithiasis.
Efek CNSDosis-related efek CNS kacarita; ati-ati ing pasien sing duwe gangguan kognitif utawa kejiwaan.
Populasi Tertentu
KandhutanOra ana studi sing nyukupi lan dikontrol kanthi apik ing wanita ngandhut; fetotoksisitas lan kelainan perkembangan sing dilapurake ing studi kewan.
Gunakake nalika ngandhut mung yen manfaat potensial mbenerake potensial resiko kanggo janin.
LaktasiOra dingerteni manawa pilocarpine disebarake menyang susu manungsa; mungkasi nyusoni utawa obat kasebut.
Panggunaan PediatrikKeslametan lan khasiat ora ditetepake ing bocah-bocah.
Panggunaan GeriatrikIng pasien ≥65 taun karo kanker sirah lan gulu, efek saleh umume padha karo sing diamati ing wong diwasa sing luwih enom.
Ing pasien ≥65 taun karo sindrom Sjögren , tambah insidensi frekuensi urin, diare, lan pusing sing dilapurake dibandhingake karo pasien sing luwih enom.
Gangguan HepatikClearance mudhun ing pasien sing duwe gangguan hepatik. (Deleng Populasi Khusus ing Farmakokinetik.) Pengurangan dosis dibutuhake ing pasien kanthi gangguan hepatik moderat. (Deleng Gangguan Hepatik ing Dosis lan Administrasi.)
Gagal GinjalFarmakokinetik ora owah sacara substansial ing pasien kanthi gangguan ginjel (rata-rata Clcr 25.4 mL/menit; kisaran 9.8–40.8 mL/menit).
Efek Umum sing Sabar
Mulut garing sing disebabake dening radiasi: Kringet, mual, rhinitis, diare, hawa adhem, flushing, frekuensi urin, pusing, asthenia, sirah, dyspepsia, lacrimation, edema. p>
Mulut garing sekunder saka sindrom Sjögren: kringet, frekuensi urin, mual, flushing, rhinitis, diare, sirah, sindrom flu, dyspepsia, pusing.
Apa obatan liyane bakal mengaruhi Pilocarpine Hydrochloride
Obat Spesifik
Obat
Interaksi
Komentar
Agen antimuskarinik (contone, atropin, ipratropium)
Potensi antagonisme efek antimuskarinik
Agen pamblokiran β-adrenergik
Kamungkinan gangguan konduksi jantung
Ati-ati yen digunakake bebarengan
Agen parasympathomimetic
Kamungkinan efek aditif
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