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发表于 2008-11-20 14:32:32
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119-6-第六节 硫哩漂吟的用法及注意事项
硫哩嚓吟的有效剂量为1. 5 -2 . 5mg/(kg "d)。在<1 mg/(kg " d )的剂量无治疗作用。在类风湿关节炎治疗中,本品可单用或与慢作用抗风湿药合用。但是,硫哇嗦吟单独应用对类风湿关节炎的治疗效果并不优于D一青霉胺或金制剂。其不良反应发生率与常用的慢作用抗风湿药类似。因此,硫噢嗦吟可能是类风湿关节炎联合治疗中可供选择的药物之一。 3 w% d" G4 m& E J' u
2 K7 J2 @7 d/ T" p 一般而言,硫哇嚷吟第一周起始剂量为50mg/d。如能耐受,剂量可增加至2 . 5mg/(kg.d)。如以体重60kg计,每日剂量为0. 18g.用药前4周,应每2周检查血象和肝功能。如正常,以后改为每月检查一次。如果白细胞计数降至3.0 x 109/L以下,必需停药。白细胞在(3.0 4.0) x 109/L之间,则需提高监测频度,并考虑减量。减量后如血象恢复,以后也最好应用较小的剂量。减量或停药后,恶心和其他胃肠道反应常会随之好转。如有过敏反应,以后不应再考虑用硫哇嗓吟治疗。
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在合并别嚷醇治疗的患者,剂量应减少至1/4-1/3。在肾功能不全的患者也应根据肌醉清除率减少用药剂量。应尽量避免同时使用ACEI类药物治疗。
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; Q) A- z" |' Q. U, Y 孕妇最好不用本药治疗。但目前虽有导致染色体畸变和胎儿发育迟滞的报道,还未肯定其在人类有致畸作用。对必需硫噢嗦吟治疗的患者,妊娠过程中,不必强求一定停药。
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