Plasminogen, Human-tmvh
Jeneng merek: Ryplazim
Kelas obat:
Agen Antineoplastik
Panganggone Plasminogen, Human-tmvh
Plasminogen, manungsa-tmvh nduweni kegunaan ing ngisor iki:
Plasminogen, manungsa-tmvh dituduhake kanggo perawatan pasien kanthi kekurangan plasminogen tipe 1 (hypoplasminogenemia). Plasminogen, human-tmvh wis ditunjuk minangka obat yatim piatu dening FDA kanggo digunakake ing perawatan kondisi iki.
Efikasi plasminogen, human-tmvh wis dievaluasi ing uji klinis label terbuka ing 15 pasien ( 9 wong diwasa lan 6 pasien pediatrik 4-16 taun) kanthi kekurangan plasminogen tipe 1. Kabeh pasien nampa plasminogen, manungsa-tmvh 6,6 mg / kg IV saben 2-4 dina suwene 48 minggu kanggo nambah aktivitas plasminogen liwat ing paling ora 10% ing ndhuwur garis dasar lan kanggo nambani manifestasi klinis penyakit kasebut. Kabeh pasien kanthi lesi ing awal entuk paling sethithik 50% perbaikan ing jumlah / ukuran lesi. Ing pungkasan sinau 48 minggu, 25 saka 32 lesi eksternal (78%) lan 9 saka 12 ditaksir lesi internal (75%) wis ditanggulangi; ora ana lesi ambalan utawa anyar sing diamati utawa diidentifikasi ing studi pencitraan liwat minggu 48.
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Carane nggunakake Plasminogen, Human-tmvh
Umum
Plasminogen, human-tmvh kasedhiya ing vial 50-mL dosis siji sing ngemot 68,8 mg plasminogen minangka bubuk lyophilized kanggo rekonstitusi karo 12,5 mL banyu steril kanggo injeksi. Sawise rekonstitusi, saben vial bakal ngemot 5,5 mg/mL plasminogen.
Dosis
Penting panyedhiya label pabrikan kudu takon luwih lengkap. informasi rinci babagan dosis lan administrasi obat iki. Ringkesan dosis:
Kanggo nggunakake IV mung sawise rekonstitusi.
Plasminogen, bubuk lyophilized manungsa-tmvh kudu direkonstitusi kaya sing diarahake dening pabrikan kanggo nyedhiyakake solusi 5,5-mg / mL. Solusi kasebut kudu disiapake sajrone 3 jam administrasi. Dosis plasminogen sing disiapake, manungsa-tmvh kudu ditindakake alon-alon sajrone 10-30 menit (yaiku, kira-kira 1 ml saben 12 detik) menyang vena perifer nggunakake jarum suntik administrasi ukuran sing cocog sing disambungake liwat saringan disk jarum suntik menyang set infus kupu-kupu.
Pasien Pediatrik
Dosis lan AdministrasiDosis plasminogen sing disaranake, manungsa-tmvh kanggo perawatan kekurangan plasminogen tipe 1 ing pasien pediatrik yaiku 6,6 mg / kg sing diwenehake IV saben 2-4 dina. Frekuensi administrasi adhedhasar tingkat aktivitas plasminogen lan status klinis lesi. Labeling pabrikan kudu dikonsultasi kanggo informasi rinci babagan interpretasi tingkat aktivitas plasminogen lan nemtokake frekuensi dosis.
Dewasa
Dosis lan AdministrasiDosis plasminogen sing disaranake, manungsa-tmvh kanggo perawatan saka kekurangan plasminogen tipe 1 ing wong diwasa yaiku 6,6 mg / kg diterbitake IV saben 2-4 dina. Frekuensi administrasi adhedhasar tingkat aktivitas plasminogen lan status klinis lesi. Labeling pabrikan kudu takon kanggo informasi rinci babagan interpretasi tingkat aktivitas plasminogen lan nemtokake frekuensi dosis.
Pènget
Kontraindikasi
Plasminogen, manungsa-tmvh dikontraindikasi ing pasien kanthi hipersensitivitas sing dikenal kanggo plasminogen utawa komponen plasminogen liyane, manungsa-tmvh.
Pènget/PanandhapPerdarahan
Pasien kanthi kekurangan plasminogen tipe 1 bisa ngalami getihen amarga lesi aktif sing gegandhengan karo penyakit mukosa sajrone terapi plasminogen, manungsa-tmvh. Gumantung ing situs lesi, iki bisa diwujudake minangka pendarahan gastrointestinal (GI), hemoptisis, epistaksis, pendarahan vagina, utawa hematuria.
Plasminogen, manungsa-tmvh bisa nambah pendarahan aktif sing ora ana hubungane karo lesi penyakit. Siji pasien kanthi riwayat pendarahan GI sing anyar amarga ulkus lambung ngalami pendarahan GI rong dina sawise nampa dosis kaping pindho plasminogen, manungsa-tmvh. Pasien nampa plasminogen, manungsa-tmvh liwat program nggunakake welas asih lan dosis 6,6 mg / kg saben 2 dina. Endoskopi nuduhake pirang-pirang ulkus kanthi siji ulkus pendarahan aktif ing cedhak pilorus. Amarga mekanisme tumindak plasminogen ing fibrinolisis, bisa uga plasminogen, manungsa-tmvh nduweni peran kanggo nambah utawa nambah pendarahan aktif. Plasminogen, manungsa-tmvh durung diteliti ing pasien kanthi risiko tambah getihen amarga penyakit utawa ciloko.
Sadurunge miwiti perawatan karo plasminogen, human-tmvh, konfirmasi penyembuhan lesi utawa tatu sing dicurigai minangka sumber saka acara getihen anyar. Plasminogen, human-tmvh bisa nambah utawa nambah pendarahan ing pasien sing ngalami diatesis getihen utawa ing pasien sing njupuk antikoagulan lan / utawa obat antiplatelet lan agen liyane sing bisa ngganggu koagulasi normal. Ngawasi pasien sajrone lan 4 jam sawise infus nalika menehi plasminogen, human-tmvh kanggo pasien sing ngalami diatesis getihen lan pasien sing njupuk antikoagulan, obat antiplatelet, utawa agen liyane sing bisa ngganggu koagulasi normal. Yen pasien ngalami pendarahan sing ora bisa dikendhaleni (ditetepake minangka getihen GI utawa getihen saka situs liyane sing tetep luwih saka 30 menit), golek perawatan darurat lan langsung mandhegake plasminogen, human-tmvh.
Tissue Sloughing
Tissue sloughing ing situs mukosa bisa kedadeyan sawise wiwitan perawatan karo plasminogen, human-tmvh minangka tingkat aktivitas plasminogen dibalekake menyang tingkat fisiologis lan fibrinolysis dumadi. Lesi ing sistem ambegan, GI, lan genitourinary bisa dadi slough sawise perawatan sing nyebabake pendarahan utawa obstruksi organ. Pasien karo lesi trakeobronkial bisa ngalami obstruksi saluran napas utawa hemoptisis. Ngawasi kanthi rapet pasien sing nandhang penyakit saluran napas sing dikonfirmasi utawa dicurigai minangka diwujudake kanthi batuk, wheezing, sesak ambegan, utawa owah-owahan ing wicara (dysfonia). Miwiti perawatan karo plasminogen, manungsa-tmvh ing setelan klinis sing cocok karo personel sing dilatih ing manajemen saluran napas lan peralatan dhukungan ambegan sing kasedhiya. Ngawasi pasien sing beresiko ing setelan kasebut paling sethithik 4 jam sawise dosis pertama plasminogen, human-tmvh.
Pasien sing ngalami GI lan lesi genitourinary bisa ngalami sloughing jaringan sing nyebabake nyeri, getihen, utawa ngliwati jaringan saka sistem organ sing kena pengaruh. Pasien kudu nglaporake nyeri weteng, panggul, utawa panggul sing terus-terusan menyang dokter.
Transmisi Agen Infèksius
Amarga plasminogen, manungsa-tmvh asalé saka plasma manungsa, mula ana risiko nularaké agen infèksius. Adhedhasar pamriksan donor sing efektif lan proses manufaktur produk, plasminogen, manungsa-tmvh nggawa risiko remot kanggo transmisi penyakit virus lan varian penyakit Creutzfeldt-Jakob (vCJD). Ana risiko teoritis kanggo panularan penyakit Creutzfeldt-Jakob (CJD), nanging, yen risiko kasebut pancen ana, risiko panularan uga dianggep sithik banget. Sampeyan uga bisa uga ana agen infèksi sing ora dingerteni ing plasminogen, manungsa-tmvh. Resiko panularan agen infèksi wis dikurangi kanthi nliti donor plasma kanggo paparan sadurunge virus tartamtu, nguji anané infeksi virus tartamtu, lan kalebu langkah-langkah inaktivasi / penghapusan virus ing proses manufaktur kanggo plasminogen, human-tmvh. p>
Lapokake infeksi apa wae sing dianggep bisa ditularake dening plasminogen, human-tmvh menyang Prometic ing 800-735-4086 lan [email protected], utawa FDA ing 800-FDA-1088 utawa [Web].
Reaksi Hipersensitivitas
Reaksi hipersensitivitas, kalebu anafilaksis, bisa kedadeyan karo plasminogen, manungsa-tmvh. Yen reaksi hipersensitivitas, mateni plasminogen, human-tmvh langsung lan nambani miturut praktik medis standar.
Antibodi Neutralisasi
Pembentukan antibodi netralisasi (inhibitor) kanggo plasminogen sawise administrasi plasminogen, manungsa-tmvh durung dilaporake nganti saiki. Ngawasi pasien kanggo ilange khasiat klinis kaya sing diwujudake kanthi pangembangan lesi anyar utawa ambalan nalika plasminogen, terapi manungsa-tmvh, lan entuk tingkat palung aktivitas plasminogen kanggo ngonfirmasi yen tingkat aktivitas plasminogen sing nyukupi wis diraih lan dijaga. p>
Abnormalitas Laboratorium
Pasien sing nampa plasminogen, manungsa-tmvh bisa uga duwe tingkat D-dimer ing getih. Tingkat Intepret D-dimer kanthi ati-ati ing pasien sing disaring kanggo thromboembolism vena (VTE), amarga tingkat munggah pangkat bisa digandhengake karo aktivitas fisiologis plasminogen, human-tmvh (fibrinolisis lesi ligneous) lan ora nuduhake VTE. Coba tes liyane kanggo nampilake VTE ing pasien sing nampa plasminogen, human-tmvh, amarga tingkat D-dimer ora bisa diinterpretasikake.
Populasi Spesifik
KandhutanRingkesan Resiko: Ora ana uji klinis babagan plasminogen, panggunaan manungsa-tmvh ing wanita ngandhut. Ora ana studi keracunan reproduksi lan perkembangan kewan sing ditindakake kanthi plasminogen, human-tmvh kanggo netepake apa bisa nyebabake cilaka janin nalika diwenehake marang wanita ngandhut. Ing Amerika Serikat, risiko latar mburi cacat lair utama kira-kira 3%, lan keguguran dumadi nganti 20% saka meteng sing diakoni sacara klinis.
LaktasiPlasminogen endogen disebarake menyang susu manungsa; Nanging, ora ana informasi sing kasedhiya babagan anané plasminogen, manungsa-tmvh ing susu manungsa, efek ing bayi sing disusui, utawa efek ing produksi susu. Mupangat pangembangan lan kesehatan saka nyusoni kudu dianggep bebarengan karo kabutuhan klinis ibu kanggo plasminogen, human-tmvh lan efek samping sing bisa nyebabake bayi sing disusui saka plasminogen, human-tmvh utawa saka kondisi ibu sing ndasari. p> Panggunaan Pediatrik
Aman lan khasiat plasminogen, manungsa-tmvh wis ditetepake ing pasien pediatrik. Panganggone plasminogen, manungsa-tmvh didhukung dening rong uji klinis lan kanthi akses sing ditambahi lan program panggunaan welas asih sing kalebu 18 pasien pediatrik umur 11 sasi nganti 17 taun.
Panggunaan GeriatrikAman lan khasiat plasminogen , manungsa-tmvh durung ditetepake ing pasien geriatrik. Pasinaon klinis plasminogen, manungsa-tmvh kanggo indikasi iki ora kalebu pasien umur 65 taun lan luwih lawas. Umumé, pamilihing dosis kanggo pasien tuwa kudu ati-ati, biasane diwiwiti ing pungkasan dosis sing paling sithik, nggambarake frekuensi sing luwih gedhe saka fungsi ati, ginjel, utawa jantung sing mudhun, lan penyakit bebarengan utawa terapi obat liyane.
Efek Samsaya Awon
Reaksi salabetipun ingkang paling asring (insiden ≥10%) reaksi salabetipun ing uji klinis inggih punika nyeri abdomen, kembung, mual, lemes, nyeri ekstremitas, pendarahan, konstipasi, tutuk garing, sirah. , pusing, artralgia, lan nyeri punggung.
Apa obatan liyane bakal mengaruhi Plasminogen, Human-tmvh
Obat Spesifik
Iku penting panyedhiya label pabrikan dikonsultasi kanggo informasi sing luwih rinci babagan interaksi karo obat iki, kalebu kemungkinan pangaturan dosis. Sorotan interaksi:
Deleng label produk kanggo informasi interaksi obat.
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