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#46
06.12.2005, 23:41
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Öèòàòà:
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#47
07.12.2005, 00:17
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Ä-ð Îëåã çàáàíåí íà íåäåëþ çà ãðóáîñòü, íåêîððåêòíîñòü ïî îòíîøåíèþ ê êîëëåãàì è áîëüíûì, à òàêæå ïî ñîâîêóïíîñòè http://forums.rusmedserv.com/showthread.php?t=17260. Âàñ ïðåäóïðåæäàëè è íå ðàç, ä-ð.Îëåã.
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#48
07.12.2005, 08:31
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Öèòàòà:
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#50
07.12.2005, 09:36
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Öèòàòà:
 Íàñêîëüêî ÿ ïîìíþ, Îëåã ôîðìàëüíî áûë ïðàâ. |
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#52
07.12.2005, 13:00
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Öèòàòà:
Óâåðåí,÷òî ìíîãèå åå óæå èçó÷èëè,íî ïðèâåäó öèòàòû è ññûëêó. Ïðèìåíåíèå àíòèãèñòàìèííûõ ïðåïàðàòîâ Êëþ÷åâûå ïîëîæåíèÿ • Âûáîð àíòèãèñòàìèííîãî ïðåïàðàòà çàâèñèò â ïåðâóþ î÷åðåäü îò ñóáúåêòèâíûõ îùóùåíèé áîëüíîãî (áûñòðîòà íàñòóïëåíèÿ ïðîòèâîçóäíîãî ýôôåêòà, óëó÷øåíèå ñíà). •  ñëó÷àÿõ ñîõðàíåíèÿ êîæíîãî çóäà, äàæå â ïåðèîä ðåìèññèè, âîçìîæíî ñî÷åòàíèå ïðåïàðàòîâ 1-ãî ïîêîëåíèÿ, êîòîðûå ëó÷øå íàçíà÷àòü íà íî÷ü, ñ ïðåïàðàòàìè 2-ãî è 3-ãî ïîêîëåíèé, íàçíà÷àåìûìè â äíåâíîå âðåìÿ. • Ïðè ñî÷åòàíèè ÀòÄ ñ ðåñïèðàòîðíûìè ïðîÿâëåíèÿìè àòîïèè ïðèìåíåíèå àíòèãèñòàìèííûõ ïðåïàðàòîâ òåì áîëåå îïðàâäàíî, ïîñêîëüêó ïîìèìî ïðîòèâîçóäíîãî ýôôåêòà îíè óãíåòàþùå äåéñòâóþò è íà ñèìïòîìû òàêèõ çàáîëåâàíèé, êàê ñåçîííûé è êðóãëîãîäè÷íûé àëëåðãè÷åñêèé ðèíèò è ðèíîêîíúþíêòèâèò. •  ïåäèàòðè÷åñêîé ïðàêòèêå ðàçðåøåíû ê èñïîëüçîâàíèþ ñëåäóþùèå àíòèãèñòàìèííûå ïðåïåðàòû: õëîðîïèðàìèí, êëåìàñòèí, ìåáãèäðîëèí, öèïðîãåïòàäèí, äèìåòèíäåí, õèôåíàäèí, ëîðàòàäèí, öåòèðèçèí, ôåêñîôåíàäèí, êåòîòèôåí. Âîçðàñòíûå îãðàíè÷åíèÿ è ëåêàðñòâåííûå ôîðìû, ïðèìåíÿåìûå ó äåòåé, óêàçàíû â äåéñòâóþùåé èíñòðóêöèè ïî ïðèìåíåíèþ (òàáë. 1). • Ïðè äëèòåëüíîì èñïîëüçîâàíèè Í1-àíòàãîíèñòîâ 1-ãî ïîêîëåíèÿ íåîáõîäèìî ïîìíèòü îá èõ îòðèöàòåëüíîì ñâîéñòâå – ðàçâèòèè ñíèæåíèÿ èõ òåðàïåâòè÷åñêîé ýôôåêòèâíîñòè (òàõèôèëàêñèÿ), à ïîýòîìó èõ ñëåäóåò ìåíÿòü êàæäûå 10–14 äíåé. • Ïðèìåíåíèå àíòèãèñòàìèííûõ ïðåïàðàòîâ â êà÷åñòâå ïðîòèâîçóäíûõ ñðåäñòâ ïðè ÀòÄ ÿâëÿåòñÿ ïàòîãåíåòè÷åñêè îïðàâäàííûì, ýôôåêòèâíûì è îáîñíîâàííûì êàê ó äåòåé, òàê è ó âçðîñëûõ. Òðàäèöèîííî â êà÷åñòâå ñðåäñòâ, óìåíüøàþùèõ çóä ïðè ýòîì çàáîëåâàíèè, èñïîëüçóþò àíòèãèñòàìèííûå ïðåïàðàòû.  ïîñëåäíèå ãîäû ýôôåêòèâíîñòü Í1-àíòàãîíèñòîâ ïðè àòîïè÷åñêîì äåðìàòèòîì ïîäâåðãàåòñÿ ñîìíåíèþ â ñâÿçè ñ íåäîñòàòêîì äàííûõ, îòâå÷àþùèõ òðåáîâàíèÿì äîêàçàòåëüíîé ìåäèöèíû. Îäíàêî ïðèìåíåíèå ýòèõ ïðåïàðàòîâ â òåðàïèè àòîïè÷åñêîãî äåðìàòèòà êëèíè÷åñêè îïðàâäàíî, âî-ïåðâûõ, ìíîãîëåòíèì îïûòîì èõ óñïåøíîãî èñïîëüçîâàíèÿ è, âî-âòîðûõ, îòñóòñòâèåì àëüòåðíàòèâíûõ ñðåäñòâ. Êðîìå òîãî, íàëè÷èå ó ìíîãèõ áîëüíûõ àòîïè÷åñêèì äåðìàòèòîì ðåñïèðàòîðíûõ ïðîÿâëåíèé àòîïèè, òàêèõ êàê ïîëëèíîç, êðóãëîãîäè÷íûé àëëåðãè÷åñêèé ðèíèò, òàêæå ÿâëÿåòñÿ áåññïîðíûì ïîêàçàíèåì ê èõ èñïîëüçîâàíèþ. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Êîíå÷íî,ññûëêè íà çàðóáåæíûå ïóáëèêàöèè íåïëîõî,íî âðà÷àì,æèâóùèì â Ðîññèè íàäî îðèåíòèðîâàòüñÿ íà îòå÷åñòâåííûå ïóáëèêàöèè,ñòàíäàðòû è ðåêîìåíäàöèè. |
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#54
07.12.2005, 13:32
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Öèòàòà:
- À íèêòî è íå ñïîðèë, ÷òî àíòèãèñòàìèííûå ïðèìåíÿþòñÿ â ëå÷åíèè àòîïè÷åñêîãî äåðìàòèòà â êà÷åñòâå ñåäàòèâíûõ. -Âòîðîé ïóíêò íå òðåáóåò êîìåíòàðèåâ. -Ïî òðåòüåìó ïóíêòó - ìû ýòî óæå ñëûøàëè íà ôåëüäøåð.ðó, ÷òî íàøè "áóðæóèíñêèå" äåòè "óñòðîåíû" ïî äðóãîìó, íå òàê, êàê ðîññèéñêèå.  ß-òî âñåãäà ñ÷èòàëà, ÷òî îðèåíòèðîâàòüñÿ íàäî íà ñàìûå ïîñëåäíèå äîñòèæåíèÿ ìåäèöèíû, êîãäà ëå÷èøü áîëüíûõ. Îøèáëàñü, âèäíî..."Èçâèíÿéòå, ìû ñàìè íå ìåñòíûå..." |
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#55
07.12.2005, 13:36
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Öèòàòà:
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#56
07.12.2005, 13:41
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Öèòàòà:
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#57
07.12.2005, 13:56
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Öèòàòà:
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#58
07.12.2005, 14:04
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Öèòàòà:
Öèòàòà:
Íå áûëî ëè èçìåíåíèé â êîíñåíñóñå âñâÿçè ñ FDA alert? Öèòàòà:
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#59
07.12.2005, 15:18
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Öèòàòà:
Ìîæíî îçíàêîìèòüñÿ ñ îñíîâíûìè ïîëîæåíèÿìè? Please!!! |
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#60
07.12.2005, 15:35
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FDA ALERT [03/2005]:
The FDA has issued a public health advisory to inform healthcare professionals and patients about a potential cancer risk from use of Elidel (pimecrolimus). This concern is based on information from animal studies, case reports in a small number of patients, and knowledge of how drugs in this class work. It may take human studies of ten years or longer to determine if use of Elidel is linked to cancer. In the meantime, this risk is uncertain, and FDA advises Elidel should be used only as labeled, for patients after other prescription treatments have failed to work or cannot be tolerated. This information reflects FDA’s preliminary analysis of data concerning this drug. FDA is considering, but has not reached a final conclusion about, this information. FDA intends to update this sheet when additional information or analyses become available. -------------------------------------------------------------------------------- To report any unexpected adverse or serious events associated with the use of Elidel, please contact the FDA MedWatch program at 1-800-FDA-1088 or [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Recommendations Physicians with patients using Elidel, or who are considering prescribing the drug, should consider the following: Use Elidel only as second-line agent for short-term and intermittent treatment of atopic dermatitis, a form of eczema, in patients unresponsive to, or intolerant of other treatments. Avoid use of Elidel in children younger than 2 years of age. The effect of Elidel on the developing immune system in infants and children is not known. In clinical studies, infants and children younger than 2 years old treated with Elidel had a higher rate of upper respiratory infections than those treated with placebo cream. Use Elidel only for short periods of time, not continuously. The long term safety of Elidel is unknown. Children and adults with a weakened or compromised immune system should not use Elidel. Use the minimum amount of Elidel needed to control the patient’s symptoms. In animals, increasing the dose resulted in higher rates of cancer. Data Summary Although pimecrolimus is not genotoxic and does not interact directly with DNA, it may have a potential to impair local immunosurveillance. Repeat dose studies conducted with topical application of pimecrolimus in mice demonstrated a dose and treatment dependent development of lymphoma. Carcinogenicity studies conducted with oral administration of pimecrolimus in mice demonstrated a dose dependent development of lymphoma and benign thymoma. Carcinogenicity studies conducted with topical administration of pimecrolimus in rats demonstrated development of follicular cell adenoma of the thyroid. Data from a recently conducted oral nine-month monkey study showed a dose-related increase in virus-associated lymphoma following administration of pimecrolimus. As of December 2004, the FDA had received 10 cases of postmarketing reports linking Elidel with cancer-related adverse events. Four cases occurred in children, 3 of these in children less than 6 years of age. The other 6 cases occurred in adults. Of the 10 postmarketing cases reporting cancer, 6 described cutaneous tumors, 1 described a lymph node/cutaneous tumor related event, and the locations of 3 others were unreported. Four cases described lymphomas; 5 cases described a variety of tumors, including basal cell carcinoma and squamous cell carcinoma; and 1 case described granulomatous lymphadenitis. The median time until diagnosis after initiation of treatment with Elidel was 90 days, with a range between 1 week and 300 days. Two cases also reported a lymphadenopathy. Two cases were confounded, 1 with the presence of nodules prior to the diagnosis of basal cell carcinoma; and another with a pre-existing condition associated with an increased risk for malignant transformation. Elidel is sometimes absorbed through the skin, though usually at very low amounts. Occasionally, children who have been treated with Elidel have had measurable blood levels of the drug. The potential for systemic immunosuppression is unknown and the role of Elidel in the development of the cancer-related events in the individual postmarketing cases is also uncertain. FDA Patient Information Sheet [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
Ëèíåéíûé âèä
