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当前位置:药品说明书与价格首页 >> 激素类 >> 新药推荐 >> 醋酸替可克肽注射剂Synacthen(TETRACOSACTIDE,Tetracosactrin)

醋酸替可克肽注射剂Synacthen(TETRACOSACTIDE,Tetracosactrin)

2011-10-04 17:23:46  作者:新特药房  来源:中国新特药网天津分站  浏览次数:459  文字大小:【】【】【
简介: 【中文品名】替可克肽 长效促皮质素【药效类别】促皮质素类合成多肽【通用药名】TETRACOSACTIDE【别  名】Cosyntropin, Tetracosactrin【化学名称】 α1-24-Corticotropin【CA登记号】[16960-16-0 ...

【中文品名】替可克肽  长效促皮质素
【药效类别】促皮质素类合成多肽
【通用药名】TETRACOSACTIDE
【别  名】Cosyntropin, Tetracosactrin
【化学名称】 α1-24-Corticotropin
【CA登记号】[16960-16-0]
【结 构 式】
【分 子 式】CHNOPS·

英商品名: Synacthen* depot
中文藥名: 注射劑
健保碼: 無健保給付 
學名: Tetracosactide hexaacetate 1mg/1mL Amp
用途: 腎上腺皮質激素 
外觀特徵: 
注意事項: 本藥只能肌肉注射,絕不可靜脈注射。
儲存方式: 冰箱保存

替可克肽 [tetracosactide]
适应症
参见用法用量。
适应症/成人常用量
静脉/肌肉注射 肾上腺皮质机能不全诊断普通制剂:250 mcg。在注射前即刻和注射后30分钟准时取血测量血浆皮质醇浓度。醋酸盐缓释剂:1 mg,肌注。在注射前即刻和注射后30分钟、1、2、3、4和5小时准时取血测定血浆皮质醇浓度。肌肉注射 皮质类固醇激素治疗;类风湿性关节炎和骨关节炎辅助治疗 1 mg/天。急性期:1 mg,12小时一次。维持剂量:1 mg,2-3天一次。反应良好的患者:0.5 mg,2-3天一次或 1 mg/周。
肾上腺皮质功能低下诊断试验
成人: 普通制剂:250 mcg,肌注/静注。在注射前即刻和注射后30分钟准时取血测量血浆皮质醇浓度。如果肾上腺皮质功能正常,注射后血浆皮质醇浓度升高应≥200 nmol/L(70 mcg/L)。醋酸替可克肽控释剂(如果注射普通制剂后未能明确诊断):1 mg,肌注。分别在注射前即刻和注射后30分钟、1、2、3、4和5小时准时取血测定血浆皮质醇浓度。如果注射后血浆皮质醇浓度在1小时升高2倍,并持续平稳增加,说明肾上腺皮质功能正常。预期1小时水平:600-1,250 nmol/L,5小时时缓慢增加至1000-1800 nmol/L。
儿童: 250 mcg/1.73 m2体表面积,静注。
禁忌
未控制的急性感染, 活动期或静止期结核,变态反应疾病史如哮喘,妊娠和哺乳期妇女 (治疗用途)禁用。用药期间不要接种活疫苗。
注意事项
下列情况慎用:心力衰竭, 近期心梗, 青光眼, 甲状腺机能低下, 肝衰竭, 肾损害, 高血压, 癫痫, 偏头痛, 骨质疏松症, 精神病/严重情绪异常,消化性溃疡, 非特异性溃疡性结肠炎,憩室炎,糖尿病,易发生血栓栓塞的患者,重症肌无力,存在发生水痘/严重带状疱疹危险的患者。长期用药时,监测儿童生长发育,进行心脏超声检查。突然停药会引发垂体功能低下的症状。
不良反应
钠水潴留, 钾丢失增加。过敏反应如呼吸困难、荨麻疹。
严重不良反应: 全身过敏反应。
药物相互作用
增加降糖药和抗高血压药的需求量。与排钾利尿剂、两性霉素B或支气管扩张剂如黄嘌呤类或β2-激动剂合用,发生低钾血症的风险增加。影响抗凝剂的作用。拮抗治疗重症肌无力的抗毒蕈碱药的作用。巴比妥酸盐、卡马西平、苯妥英、扑米酮或利福平会导致本药作用降低。口服避孕药或利托那韦会导致本药血浓度增加。与非甾体类抗炎药合用,增加胃肠道出血和溃疡的发生率。
替可克肽: 增强下列药物的毒性:卡介苗

程度分级:       

严重 - 这些药物之间的相互作用有生命危险或可能导致永久性残疾。这些药物通常不能合用,需要给予医学干预。

文献证据分级:
有充分研究资料证实 - 尽管无关于药物相互作用的临床对照研究,但数个病例报道已经证实了它们之间的相互作用,并获得其它证据的有力支持。

可能的作用机制:
全身大剂量使用皮质激素的患者会发生免疫抑制,对这样的患者使用减毒活疫苗有引起严重的、全身性感染的风险。促肾上腺皮质激素与减毒活疫苗的相互作用与皮质激素类似。同样,也需要在停止促肾上腺皮质激素治疗至少3个月后才能接种减毒活疫苗。

处理措施:
1. 两药间转换需要间隔一段时间(参考医学文献)。
2. 禁止合用。

替可克肽 属于一种 垂体促肾上腺皮质激素
合成的类固醇激素,可替代内源性促肾上腺皮质激素。
       
C级: 动物研究证明药物对胎儿有危害性(致畸或胚胎死亡等),或尚无设对照的妊娠妇女研究,或尚未对妊娠妇女及动物进行研究。本类药物只有在权衡对孕妇的益处大于对胎儿的危害之后,方可使用。
       
贮藏/有效期

肠道外给药: 2-8°C贮存。避光。
药理作用

替可克肽是合成的多肽,能诱导肾上腺增生,刺激肾上腺皮质激素,尤其是氢化可的松(皮质醇)和某些盐皮质激素如皮质酮的分泌,也能刺激雄激素的分泌,但作用较弱。对醛固酮的分泌几无影响。
分布: 快速从血浆清除,大部分分布于肾上腺和肾脏。
代谢: 被血清肽链内切酶代谢为无活性的寡肽,然后被氨基肽酶代谢为自由氨基酸。
排泄: 通过尿液排泄。终末半衰期:3小时。
MIMS药物分类

肾上腺皮质激素 (Corticosteroid Hormones)

【原产地英文商品名】:CORTROSYN 0.25MG/VIAL 10VIALS/BOX
【原产地英文药品名】:COSYNTROPIN
【原产地英文化合物名称】:α1-24-Corticotropin
【中文参考商品译名】:CORTROSYN 0.25毫克/瓶 10瓶/盒
【中文参考药品译名】:替可克肽
【生产厂家中文参考译名】:美药星制药
【生产厂家英文名】:AMPHASTAR

GENERIC NAME: COSYNTROPIN - INJECTION (koe-sin-TROW-pin)

BRAND NAME(S): Cortrosyn

USES: Cosyntropin is a man-made portion of a certain natural substance made by the body (ACTH). It is used to diagnose adrenal gland problems (e.g., Addison's disease, insufficiency due to corticosteroid use, pituitary tumor).

HOW TO USE: This medication is given by injection into a vein or muscle by a health care professional. Health care professionals must follow all the manufacturer's instructions for properly mixing and giving this drug. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. When this drug is given into a vein, it may be injected quickly (2 minutes) or mixed into a solution and given slowly (6 hours) as directed by your doctor.To test for your disease, your health care professional will usually do a blood test before giving this drug and then 30 minutes after your dose. Depending on the type of test your doctor is performing, he or she may require blood or urine samples at different times to measure your response to the test. Consult your doctor for details.

SIDE EFFECTS: Minor irritation at the injection site (e.g., redness, swelling) may occur. If any of these effects persist or worsen, tell your doctor.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before using cosyntropin, tell your doctor or pharmacist if you are allergic to it; or to corticotropin; or if you have any other allergies.Before using this medication, tell your doctor or pharmacist your medical history.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: cortisone, estrogen, hydrocortisone, spironolactone, "water pills" (e.g., furosemide, hydrochlorothiazide).This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Blood/urine tests will be done to monitor your response. Consult your doctor for more details.

MISSED DOSE: Not applicable.

STORAGE: Store at room temperature between 59-86 degrees F (15-30 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.After mixing, this product should be used immediately. Discard any unused portion of the vial.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

责任编辑:admin


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