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首页 泮立苏(Panlisu)

泮立苏(Panlisu).doc

泮立苏(Panlisu)

苏君韵
2018-02-03 0人阅读 举报 0 0 0 暂无简介

简介:本文档为《泮立苏(Panlisu)doc》,可适用于社会民生领域

泮立苏(Panlisu)泮立苏(Panlisu)PantoprazolesodiumnameofdrugPantoprazolesodiumEnglishgenericname:PantoprazoleSodiumOthername:Fushitan,Innocent,PanMeilu,PanLisu,Taimeinike,pantoloc,Enteric,EntericCoated,security,Panmeiluclinicalapplication,mainlyusedforpepticulcers(gastriculcer,duodenalulcer,anastomoticulcer,etc)andtheirbleeding,includingnonsteroidalantiinflammatorydrugscausedbyacutegastricmucosaldamageandstressulcerbleedingforrefluxesophagitis,alsoforgeneralanesthesiaormajorsurgeryandcomacomapatients,topreventacidrefluxcombinedwithaspirationpneumoniaforgastrin,incombinationwithotherantimicrobialagentssuchasclarithromycin,amoxicillinandmetronidazole,eradicationofHelicobacterpylori(Hp)infection,reduceduodenalulcerandgastriculcerrecurrencepharmacologypharmacodynamics,thedrugispantoprazolesodiumsalt,theactionisthesameaspantoprazolePantoprazoleisthethirdgenerationofprotonpumpinhibitor,selectivelyactontheparietalcellsofthegastricmucosa,inhibitionofcellwallinH,KATPenzymeactivity,thecellwallwithintheHcannotbetransportedintothestomach,therebyinhibitinggastricacidsecretionPantoprazoleisweaklyalkaline,inweakacidicenvironmentwasmorestablethansimilardrugs,afterbeingactivatedonlywithaprotonpumpontheactivationsitetwobindingsites(omeprazole,lansoprazoleandshowedmoreactivationandindependentbindingsites),reflectingthehighlyselectivecombinedwithprotonpumpatthemolecularlevelAtthesametime,itcanalsoreducethesecretionofgastricjuiceandinhibitpepsinsecretionandactivityInaddition,thisdruginhibitsthegrowthofHpandcaneradicateHpcompletelywithantibacterialagentsBecausethedrughaslowaffinityforcytochromePenzymesandhasaphaseIImetabolicpathway,otherdrugsthatpassthroughtheenzymesysteminteractlesswiththisdrugPantoprazoleissimilartoomeprazole,buttheanalgesiceffectisbetterthanomeprazoleTheeffectofintravenousdriptherapyonpepticulcerandacutegastricmucosallesion,compoundulcer(analgesiaandhemostasis)isremarkable,andthetotaleffectiverateisaboutAtthesametime,pantoprazolecancurepepticulcerswithnormalorhighdosesofHreceptorantagonistsDatashowthatcasesofranitidineinthetreatmentofinvalidulcers,pantoprazoletreatmentforweeks,thehealingratewas,andcontinuetomaintaintreatmentafterhealing,ofpatientswithstablecondition,norecurrencepharmacokinetics,thebioavailabilityofthisdrugisrelativelyhighandrelativelystable,andthebioavailabilityaftersingleormultipledosesismaintainedatabout,anditisnotaffectedbyfoodorotherantacidThepeakvalueofserumconcentration(Cmax)mgLreachedhoursafteroraladministrationofmgentericcoatedtabletsThefirstpasseffectintheliverwaslowAfteroraladministrationorintravenousadministrationofmg,theareaundercurve(AUC)andCmaxincreasedproportionallywithincreasingdoseItsapparentvolumewasLkg,andthebindingrateofplasmaproteinwasDrugsintheliverbycytochromePmetabolism,andanotherphaseIImetabolicpathway,themainmetaboliteofpantoprazolesulfate,whichismostlyexcretedbythekidneys,afew(<)thesecretionofbileexcreted,theeliminationhalflifeforhoursmattersneedingattentioncontraindications()allergictothedrug()lactatingwomen()womeninthefirstmonthsofpregnancybecarefulwithhepaticorrenaldysfunction,theeffectofdrugsonchildren,thereisnoexperienceinchildmedicationtheeffectofdrugsonpregnancyhasnotbeenobservedinanimalexperimentsTheriskofpregnancyforthisdrugintheUnitedStatesisBgradeFDA,theeffectofdrugsonlactation,inanimalexperiments,asmallamountofdrugssecretedintothemilkLactatingwomenshouldnotbeusedbeforeandaftertheuseofdrugsandshouldbecheckedormonitoredforpatientswithsevereliverdysfunction(liverfailure),duringthemedicationshouldberegularlymonitoredchangesinliverenzymesadverseeffectsThismedicinehaslessadversereactionIsufferfromdizziness,insomnia,lethargy,nausea,diarrhea,constipation,skinrashesandmusclepainsEdema,feverandtransientvisualdisturbancesareseeninsomecases(blurredvision)Arrhythmia,aminotransferase,renalfunctionandgranulocytedecreasecanbeobservedinlargedosesadversereactionsabroadreferenceAcasereportofeosinophiliainthebloodsystem,thenervoussystemcansufferfromheadacheandvertigo,rarelethargyorinsomnia,andtherearealsocasesofdepressiontheendocrinesystemisreportedtohavehyperglycemia,thedigestivesystemcancausediarrhea,andoccasionallyliverenzymes(suchasserumalanineaminotransferase)increasedOtherreportshaveshownthatlongtermuseofdrugscancauseproliferationofintestinalchromaffincellsFiveAcasereportofhematuriaandimpotenceduringthetreatmentofgenitourinarysystemAnteriorischemicopticneuropathycanoccurineyeswiththeuseofthismedicineCasereportsofvisualdisturbances(suchasblurredvision)skinrashanditching,butalsoafterthetreatmentofhairloss,exfoliativedermatitis,photosensitivitydermatitis,andthendevelopedintodiscoidlupuserythematosuscasereportsInaddition,therehavebeenreportsofvascularedema,erythemamultiformeandtoxicepidermolysisbullosaduringtreatmentothercasesofallergicreactions,fever,edema,andothercasesofmultipleorganfailuredruginteractionDrugdruginteractions,thismedicinecanreducethegastrointestinalabsorptionofitraconazole,ketoconazoleandsoon,andreduceitsefficacy,theactiveingredientofthisdrugismetabolicallysolubleintheliverthroughcytochromePenzymes,soanyotherdrugthathasbeenpassedthroughtheenzymesystemisnotassociatedwiththepossibilityofinteractionwithitButthedetectionofthesedrugs(suchasCMasiBing,caffeine,diclofenac,diazepam,digoxin,ethanol,glibenclamide,MeiTOROM,nifedipine,phenprocoumon,phenytoin,theophylline,HuaFalinandoralcontraceptives),butnointeractionswereobservedwithobviousclinicalsignificancebetweenthedrugandtheir,thedrugalsohasnointeractionwiththebasicantacidusedsimultaneouslyDrugfoodinteractionFoodcandelaytheabsorptionofthedrugforhoursorlonger,butCmaxandAUChavenotchangedsignificantlydirectionsforAdministrationgastricandesophagealmalignanciesshouldbeexcludedbeforetheuseofthedrugsoastoavoiddelayeddiagnosisduetosymptomaticreliefdonotchewthismedicinewhenitisentericcoated,thismedicinecanonlybedissolvedordilutedwithSodiumChlorideInjectionorspecialsolvent,andcannotbedissolvedordilutedwithothersolventsordrugsAfterdissolvinganddiluting,themedicinemustbeusedupinhoursusageanddosageAdultRoutinedoseOraladministrationgeneralusage:mgperday,timesaday,preferablybeforebreakfastTheduodenalulcerisusuallytreatedforweekswithpepticulcerandrefluxesophagitisforweekspatientswithHpinfectionneedtobetreatedwithcombinationdrugsThefollowingoptionsareavailable:()pantoprazole(mgperday,timesdaily)amoxicillin(gperday,timesdaily)clarithromycin(mgperday,timesdaily)()pantoprazole(mgperday,timesaday)metronidazole(mgperday,timesdaily)clarithromycin(mgperday,timesdaily)()pantoprazole(mgperday,timesdaily)amoxicillin(gperday,timesaday)metronidazole(mgperday,timesaday)CombinationtherapyusuallylastsfordaysThereafter,ifsymptomspersist,itisnecessarytocontinuetakingthemedicinetoensurecompletehealingoftheulcer,withadailydoseofmgIntravenousinfusionofmgeachtime,timesadayBeforeuse,dissolvewithmLspecialsolvent,andthendissolvetheliquidintomL,SodiumChlorideInjection,dilutedandgiveninminutesRenalfailuretimedoseThedoseshouldnotexceedmgperdayHepaticinsufficiencydoseInpatientswithseverehepaticfailure,thedosageshouldbereducedtomgeveryotherdayElderlydoseThedoseshouldnotexceedmgperdayHowever,inthecombinationtherapytoeradicateHpinfection,elderlypatientscanalsouseconventionaldosesatweeksoftreatment,thatis,mgperday,timesadayusage,dosage,referenceAdultTheconventionaldosewasdeterminedbyitsactiveingredientpantoprazoleOraladministrationofentericcoatedtabletsshouldbetakenbeforebreakfastoratbreakfastgastroesophagealrefluxdisease(GERD):therecommendeddoseismgperday,timesadayforamaximumofweekspepticulcers:theusualdosageismgperdayforsevereordrugresistantpatients,thedosemaybeincreasedtomgperdayThesymptomswererelievedwithinweeksandhealedwithinweeksThecourseshouldnotexceedweekswithHpinfection:MetaanalysisofthestudiesshowedthatwhenthetripletherapywasusedtoeradicateHpinfection,thedaycourseoftreatmentwasmoreeffectivethanthedaycourse,butthelongerthecourseoftreatment,thehigherthefrequencyofadversereactionsIntravenousdripgastroesophagealrefluxdisease(GERD):theintravenousinfusionwithafilterwasadministeredintravenously,eachtimemg,timesaday,fordaysgastrin:therecommendeddoseismgpertime,timeseveryhoursThedailytotalshouldnotexceedmg,thecourseoftreatmentshouldnotexceeddaysRenalfailuretimedosePatientswithrenalinsufficiencydonotneedtobecutdown,butshouldnotexceedthemaximumdailydoseofmgAlthoughthehalflifeofthemajormetaboliteofthedrugwasprolongedtohours,TherewillbenoaccumulationofdrugsinthebodyHepaticinsufficiencydoseMildtomoderateliverdiseaserequiresnoadjustmentofdosageNeedfurtherevaluationforpatientswithmoresevereliverdiseaseusingpantoprazolesodium,canconsideralternatedaydosingcomparedwithdailymedication,althoughthecontrolofgastricacidsecretionisless,butdecreasetheriskofdrugaccumulationElderlydoseThemaximumdailydoseofolderpatientsshouldnotexceedmgDialysisdoseHemodialysispatientsdonotneedtobecutdown,butshouldnotexceedthemaximumdailydoseofmgpreparationsandspecificationsPantoprazoleSodiumEntericcoatedTabletsmgStoragemethod:airtight,cool,dryplacetopreservePantoprazoleSodiumEntericcoatedCapsulesmgStoragemethod:airtight,cool,dryplacetopreservePantoprazoleSodiumforInjectionmgStoragemethod:sealedandprotectedfromlight

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