Protein C Concentrate
Jeneng merek: Ceprotin
Kelas obat:
Agen Antineoplastik , Agen Antineoplastik
Panganggone Protein C Concentrate
Defisiensi Protein C Bawaan
Terapi panggantos ing pasien sing kekurangan protein C kongenital sing abot kanggo nyegah lan ngobati trombosis vena lan purpura fulminans (ditunjuk minangka obat yatim piatu dening FDA kanggo panggunaan iki).
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Carane nggunakake Protein C Concentrate
Umum
Administrasi
IV Administrasi
Administrasi dening injeksi IV.
Miwiti terapi ing sangisore pengawasan saka dokter sing berpengalaman ing terapi penggantian kanthi faktor koagulasi/inhibitor lan ing ngendi pemantauan aktivitas protein C bisa ditindakake.
Protein C (manungsa) bisa diwenehake dhewe yen dokter nemtokake manawa pasien lan/utawa pengasuh kompeten kanggo menehi obat kanthi aman sawise latihan sing cocog.
RekonstitusiSadurungé rekonstitusi, wêdakakêna lyophilized lan diluent sing disedhiyakake pabrikan dadi anget nganti suhu kamar.
Reconstitute bubuk lyophilized karo pengencer sing diwenehake dening pabrikan. Gunakake teknik aseptik sing ketat amarga obat kasebut ora ana pengawet.
Rekonstitusi jumlah bokor sing cocog adhedhasar dosis sing dituduhake. Vial ngemot kira-kira 500 utawa 1000 IU protein C (manungsa); Potensi nyata diwenehi label ing saben vial.
Reconstitute bokor siji-sijine bubuk lyophilized kanthi nambahake 5 utawa 10 ml banyu steril kanggo injeksi menyang vial sing ngemot kira-kira 500 utawa 1000 unit protein C (manungsa). , nggunakake jarum transfer sing diwenehake dening pabrikan; solusi sing diasilake ngemot kira-kira 100 unit protein C (manungsa) saben mL. Puteran vial alon-alon nganti wêdakakêna larut rampung.
Copot solusi sing dikonstitusi saka vial nganggo jarum saringan sing disedhiyakake pabrikan. Sadurunge administrasi, ganti jarum panyaring nganggo jarum sing cocog utawa set infus nganggo adaptor bersayap. Jarum saringan sing disedhiyakake pabrikan dimaksudake kanggo nyaring isi vial siji.
Administrasi ing suhu kamar sajrone 3 jam rekonstitusi.
Tarif AdministrasiPasien sing bobote <10 kg: Suntik ing tingkat maksimal 0,2 mL/kg saben menit.
Pasien sing bobote ≥10 kg: Nyuntikake kanthi kecepatan maksimal 2 mL/menit.
Dosis
Potensi protein C (manungsa) ditemtokake kanthi uji kromogenik lan dituduhake ing unit internasional (IU, unit) sing diuji marang aktivitas standar referensi WHO.
Sawijining unit kira-kira padha karo protein C aktivitas (minangka diukur dening assay amidolytic) ana ing 1 ml plasma. Jumlah unit protein C dituduhake ing label saben vial.
Pasien Anak
Defisiensi Protein C Bawaan Perawatan Episode Akut Trombosis Vena lan Purpura Fulminans IVKaping pisanan, 100 –120 unit/kg, disusul 60–80 unit/kg saben 6 jam kanggo 3 dosis lan dosis pangopènan sakteruse 45–60 unit/kg saben 6 utawa 12 jam.
Setel dosis miturut sing diukur aktivitas protein plasma C; wiwitane njaga aktivitas protein C plasma puncak ing 100% normal. Sawise resolusi kedadeyan akut, njaga aktivitas protein C plasma ing tingkat ndhuwur 25% saka normal sajrone perawatan.
Ing pasien sing miwiti terapi antikoagulan oral, terusake terapi penggantian protein C nganti antikoagulasi sing nyukupi. (Deleng Obat Spesifik ing Interaksi.)
Profilaksis Kedadean Trombotik IVProfilaksis jangka pendek: Kaping pisanan, 100–120 unit/kg, disusul 60–80 unit/kg saben 6 jam kanggo 3 dosis lan a dosis pangopènan sakteruse 45–60 unit/kg saben 6 utawa 12 jam.
Profilaksis jangka panjang (dosis pangopènan): 45–60 unit/kg saben 12 jam; nyetel dosis kanggo njaga aktivitas protein C plasma liwat 25% saka normal. Peningkatan aktivitas protein C plasma puncak bisa uga cocog sajrone periode risiko trombotik tambah (contone, infeksi, trauma, operasi).
Setel dosis miturut aktivitas protein C plasma sing diukur; wiwitane njaga aktivitas protein C plasma puncak ing 100% normal. Sawise resolusi kedadeyan akut, njaga aktivitas protein C plasma ing tingkat ndhuwur 25% saka normal sajrone perawatan.
Ing pasien sing miwiti terapi antikoagulan oral, terusake terapi penggantian protein C nganti antikoagulasi sing cukup. digayuh. (Deleng Obat Spesifik ing Interaksi.)
Dewasa
Perawatan Kekurangan Protein C Bawaan Episode Akut Trombosis Vena lan Purpura Fulminans IVKaping pisanan, 100–120 unit/kg, disusul 60 –80 unit/kg saben 6 jam kanggo 3 dosis lan dosis pangopènan sakteruse 45–60 unit/kg saben 6 utawa 12 jam.
Setel dosis miturut aktivitas protein C plasma sing diukur; wiwitane njaga aktivitas protein C plasma puncak ing 100% normal. Sawise resolusi kedadeyan akut, njaga aktivitas protein C plasma ing tingkat ndhuwur 25% saka normal sajrone perawatan.
Ing pasien sing miwiti terapi antikoagulan oral, terusake terapi penggantian protein C nganti antikoagulasi sing cukup. digayuh. (Deleng Obat Spesifik ing Interaksi.)
Profilaksis Kedadean Trombotik IVProfilaksis jangka pendek: Kaping pisanan, 100–120 unit/kg, disusul 60–80 unit/kg saben 6 jam kanggo 3 dosis lan a dosis pangopènan sakteruse 45–60 unit/kg saben 6 utawa 12 jam.
Profilaksis jangka panjang (dosis pangopènan): 45–60 unit/kg saben 12 jam; nyetel dosis kanggo njaga aktivitas protein C plasma liwat 25% saka normal. Peningkatan aktivitas protein C plasma puncak bisa uga cocog sajrone wektu risiko trombotik mundhak (contone, infeksi, trauma, operasi).
Setel dosis miturut aktivitas protein C plasma sing diukur; wiwitane njaga aktivitas protein C plasma puncak ing 100% normal. Sawise resolusi kedadeyan akut, njaga aktivitas protein C plasma ing tingkat ndhuwur 25% saka normal sajrone perawatan.
Ing pasien sing miwiti terapi antikoagulan oral, terusake terapi penggantian protein C nganti antikoagulasi sing cukup. digayuh. (Deleng Obat Spesifik ing Interaksi.)
Batesan Resep
Pasien Anak
Defisiensi Protein C Bawaan IVPasien sing bobote <10 kg: Nyuntikake kanthi tingkat maksimal 0,2 mL/kg saben menit.
Pasien sing bobote ≥10 kg: Injeksi kanthi kecepatan maksimal 2 mL/menit.
Dewasa
Defisiensi Protein C Bawaan IVInjeksi kanthi tingkat maksimal 2 mL/menit.
Populasi Khusus
Ora ana rekomendasi dosis populasi khusus ing wektu iki.
Pènget
Kontraindikasi
Pènget/PanandhapReaksi Sensitivitas
Reaksi Hipersensitivitas
Reaksi hipersensitivitas sing mungkin, kalebu anafilaksis. Yen reaksi hipersensitivitas kedadeyan, langsung mandheg lan tindakake terapi sing cocog kaya sing dituduhake.
Reaksi alergi sing bisa ditindakake kanggo nglacak jumlah protein murine (tikus) lan/utawa heparin.
Pembentukan AntibodiNyandhet antibodi marang protein C (manungsa) ora diamati ing studi klinis; nanging, potensi ngembangake antibodi ora bisa diilangi.
Risiko Agen Transmisi ing Preparasi sing Diturunake Plasma
Potensi kendaraan kanggo transmisi virus manungsa (yaiku, HIV, hepatitis A [HAV], hepatitis B [HBV], hepatitis C [HCV], parvovirus B19) lan agen infèksius liyane.
Skrining donor sing luwih apik, prosedur inaktivasi virus (contone, pelarut/deterjen, perawatan panas), lan/utawa prosedur kromatografi immunoaffinity wis suda nanging ora bisa ngilangi risiko transmisi patogen kanthi lengkap. preparat protein C (manungsa) sing asale saka plasma. Sawetara virus (umpamane, parvovirus manungsa B19, HAV) angel dibusak utawa ora aktif.
Infeksi parvovirus manungsa B19 paling serius ing wanita ngandhut (infeksi janin) utawa pasien immunocompromised.
Coba vaksinasi (nglawan infeksi HAV lan HBV) kanggo pasien sing rutin utawa bola-bali nampa protein C (manungsa).
Kemungkinan teoritis nularake agen penyebab penyakit Creutzfeldt-Jakob (CJD).
Lapokake sing dicurigai infeksi menyang pabrikan ing 866-888-2472.
Pendarahan
Pendarahan parah dilapurake; bisa uga digandhengake karo panggunaan antikoagulan bebarengan. (Deleng Obat Spesifik ing Interaksi.)
Trombositopenia sing diakibatake heparin
Kemungkinan trombositopenia sing disebabake heparin (HIT) amarga jumlah heparin sing ana ing preparat protein C (manungsa).
Yen ana HIT, langsung nemtokake count platelet lan nimbang penghentian protein C (manungsa).
Kandungan Sodium
Jumlah sodium ing dosis maksimum saben dina saka protein C (manungsa) ngluwihi 200 mg.
Populasi Spesifik
KandhutanKategori C.
LaktasiOra dingerteni manawa protein C (manungsa) disebarake menyang susu ing manungsa.
Panggunaan PediatrikKeamanan lan khasiat ditetepake ing bocah-bocah umur ≥2 dina.
Farmakokinetik ora ditetepake ing pasien pediatrik. Nanging, paparan sistemik bisa dikurangi ing bocah cilik banget dibandhingake karo wong sing luwih tuwa; nimbang kasunyatan iki nalika milih regimen dosis kanggo anak. (Deleng Pasien Anak ing Dosis lan Administrasi lan deleng Populasi Khusus ing Farmakokinetik.)
Panggunaan GeriatrikPengalaman ing pasien umur ≥65 taun ora cukup kanggo nemtokake manawa respon kasebut beda karo wong diwasa sing luwih enom.
Hepatik KerusakanKeamanan lan khasiat ora ditetepake ing pasien sing duwe gangguan hepatik.
Gagal GinjalKeamanan lan khasiat ora ditetepake ing pasien sing duwe gangguan ginjel.
Ngawasi kanthi teliti kanggo kakehan sodium. (Deleng Konten Sodium ing Ati-ati.)
Efek Sabar sing Umum
Reaksi hipersensitivitas (contone, gatal, ruam), pusing.
Apa obatan liyane bakal mengaruhi Protein C Concentrate
Ora ana studi interaksi obat resmi nganti saiki.
Obat Spesifik
Obat
Interaksi
Komentar
Antikoagulan, oral
Resiko kahanan hypercoagulable transien (sadurunge efek antikoagulan sing dikarepake bisa ditindakake) kanthi wiwitan terapi bebarengan amarga protein C (manungsa) duwe umur paruh sing luwih cendhek tinimbang akeh protein sing gumantung karo vitamin K (yaiku faktor II, IX, lan X). ndadékaké supresi aktivitas protein C (manungsa) luwih cepet tinimbang faktor prokoagulan
Tambah risiko nekrosis kulit sing diakibatake warfarin ing pasien kanthi kekurangan protein C kongenital sing abot
Mungkin. tambah risiko pendarahan
Nalika ngalih menyang antikoagulan oral, terusake terapi pengganti protein C (manungsa) nganti antikoagulasi sing nyukupi diraih
Miwiti antikoagulan oral kanthi dosis sing sithik, banjur penyesuaian dosis tambahan. ; dosis loading antikoagulan standar ora dianjurake
Trombolytik (contone, alteplase, reteplase, tenecteplase)
Risiko pendarahan
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