Category: Medical/Disease gt; gt; Internal Medicine
Problem description:
My child has suffered from renal syndrome for one year and has relapsed three times. He is currently taking cyclosporine. I have been taking A for three days. On the fourth day, I suddenly developed cramps in the early morning, my face was blue, my lips were purple, and I was foaming at the mouth. My blood pressure was as high as 155 and 125. What is going on? What should I do? Urgent, urgent!!!! Thank you!!!!
Analysis:
Cyclosporine A
Added time: 2005-12-20 09:45:01
English name Cyclosporin
Category of urinary system drugs
Alias ??cyclosporin A; cyclosporin; cyclosporin A; Cyspin; Sandimin, cyclosporine, New Sandamine, cyclosporin A
Foreign names are Ciclosporin A, CsA, Cs-A, CY-A, Sandimmune, Ciclosporin, Cyspin.
Indications are mainly used for liver, It can be used together with adrenocortical hormones to prevent rejection of kidney and heart transplants, and can also be used to treat some immune diseases.
Dosage and usage
Oral administration: The dose depends on the patient’s condition. Generally, the first dose before organ transplantation is 14 to 17.5 mg per kilogram of body weight per day, and 4 to 12 mg before surgery. Take orally once an hour, maintain this dose until 1 to 2 weeks after surgery, and then reduce it by 5% every week according to creatinine and Sandimin blood concentration until the maintenance dose is 5 to 10 mg per kilogram of body weight per day. At the same time, auxiliary hormone therapy was given. Oral liquids must be diluted with milk, chocolate or orange juice with the attached straw before taking, and the temperature is preferably 25°C. After opening the protective cover, use a straw to suck out the required amount of liquid from the container (must be accurate), then put it into a glass filled with milk, chocolate or orange juice (plastic cups cannot be used), dilute and stir the liquid, Drink immediately and rinse the glass with milk before drinking to ensure accurate dosage. Before returning the used straw, be sure to dry it with a clean dry towel. Do not wash it with water or other solutions to avoid causing turbidity of the Sandi Ming solution. The intravenous injection method is only used for patients who cannot take oral medications. The first intravenous injection dose should be 4 to 12 hours before transplantation, 5 to 6 mg per kilogram of body weight per day (equivalent to 1/3 of the oral dose). This dose can last until surgery. Then, until you can take Sandimin orally. Before use, it should be diluted with 5% glucose or isotonic saline to a concentration of 1:20 to 1:100, and dripped slowly within 2 to 6 hours.
Notes
1. Nephrotoxicity: glomerular thrombosis, renal tubular obstruction, proteinuria, cast urine. 2. Hepatotoxicity: hypoalbuminemia, hyperbilirubinemia, and elevated serum aminotransferases. 3. Nervous system: motor spinal syndrome, cerebellar-like syndrome and mental disorder, tremor, abnormal sensation, etc. 4. Gastrointestinal tract: anorexia, nausea, vomiting. 5. Although there are no contraindications for bone marrow transplantation, there are adverse reactions. 6. Have high blood pressure and hirsutism. After intravenous administration, allergic reactions such as redness of the chest and face, difficulty breathing, wheezing, and heart palpitations may occasionally occur. Once it occurs, the drug should be stopped immediately, and in severe cases, intravenous epinephrine and oxygen should be given for rescue. 7. Not suitable for use by children under 1 year old.
Storage and validity period
Specifications Oral liquid: 100mg × 50ml per ml Pills: 25mg, 100mg.
Intravenous drip: 50mg per ml, 5ml × 10 tubes.
Treatment of nephrotic syndrome
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1 Diet: Generally, there is no need to limit food. Protein should be increased in an appropriate amount, but for those with azotemia It should be limited; sodium salt should be limited for children with edema and hypertension, and the amount of water intake should be limited when edema is severe.
2 If infection exists, antibiotics (such as penicillin) that do not damage the kidneys should be given.
3. Diuresis: Oral hydrochlorothiazide or spironolactone, furosemide can be used if necessary.
4 Plasma and blood protein transfusion can increase serum protein and reduce edema.
5 Hormone therapy: Oral prednisone is often taken to diuretic, reduce swelling, and reduce urinary protein. Divide the daily dose into 3 to 4 times. After 4 weeks of continuous use, if the urinary protein disappears within 7 to 10 days, If the results are negative for 3 consecutive times (i.e. there is no protein in the urine test), then the whole day's dosage should be taken once every other day in the morning for another 4 weeks, and then the dosage should be reduced every 2 to 4 weeks until the drug is stopped, with a total course of 4 One 6 months.
If the urinary protein does not disappear in the first 4 weeks of treatment, the course of treatment needs to be extended. It cannot be changed to once every other day. The original dose should still be continued for 4 weeks. If the urinary protein persists for 3 consecutive weeks within 8 weeks, If the drug is negative every time (within 7 to 10 days), it can be taken once every other morning for another 4 weeks, and then the dose can be reduced every 2 to 4 weeks until the drug is stopped, and the total treatment course is extended to 9 to 12 months.
6 When hormones are ineffective or toxic side effects occur, immunosuppressant treatment (such as cyclophosphamide, chlorambucil or nitrogen mustard, etc.) can be used.
7 Traditional Chinese medicine treatment: For spleen deficiency type, use Wuling Powder (codonopsis root, atractylodes, dried tangerine peel, polygonum polygonum, polyporus polyporus, Alisma, corn silk, Magnolia officinalis, Chen gourd, Zhizhi licorice). For spleen and kidney yang deficiency, use Shipi Yin combined with Fangji Huangshi Decoction (Aconite, dried ginger, Poria, Atractylodes, Fangji, yam, Morinda meat, Cistanche deserticola, Xianlingpi).