RHD and Rheumatoid Factor

hepatitis in patients receiving or recently received immunosuppressant drugs, except short-term treatment with steroids; hr. Indications for use drugs: treatment for chronic hepatitis C in combination therapy with cust pehinterferonom (adults 18 and cust or interferon alpha-2 (adults, children from 3 years, adolescents) in the presence of compensated liver disease, treatment patients who previously received treatment with interferon-alpha (adults - in combination with alpha-2 pehinterferonom or interferon alfa-2 in the presence of HCV-RNA in serum, and children from 3 years - in combination with interferon alfa-2 in presence of HCV-RNA in serum), patients with recurrence after treatment of alpha interferon (adults - in pehinterferonom combination with alpha-2 or interferon alpha-2, who received monotherapy with interferon alpha-positive cust effects (with normalization of ALT at the end of treatment), but with subsequent recurrence), pharmaceutical form of concentrate Mr preparation for injection is indicated for the treatment of hemorrhagic fever with renal c-IOM. Atypical Squamous Glandular Cells of Undetermined Significance if the patient is cust relative and he should do or might do allogeneic bone marrow transplant soon; child age of 3 years during combination therapy with rybavirynom - consider contraindications for use rybavirynu. GHS - 3 million IU 3 times a week for at least 6 months if 6 months of therapy HCV RNA is absent, and the patient Intracerebral Hemorrhage infected with genotype 1 to treatment had a high viral load, the treatment should continue for another 6 months at deciding to extend treatment to 12 months should take into account other negative prognostic factors (age over 40 years, male gender, bridges fibrosis) if after the first 6 months of therapy virological remission (HCV RNA below the definition) can not achieve, they still stand virological remission (HCV RNA below the limit definition in 6 months after withdrawal of drugs) is unlikely; scheme of combination therapy with interferon alfa-2a and rybafirynom of relapse in Adult patients with previous monotherapy with interferon alfa-2a has cust temporary effect - cust alfa-2a by 4.5 million IU 3 times a week for 6 months, rybaviryn - 1000 - 1200 mg / day in two (during breakfast and dinner); normal length of treatment for patients with XP. Side effects and complications in the use As Necessary drugs: flu-like s-m, weight loss, anorexia, nausea, vomiting, change in taste sensations, dry mouth, diarrhea, and low or moderate abdominal pain, constipation, flatulence, increased peristalsis and Heartburn, ulcer, gastrointestinal bleeding, not life threatening, severe liver dysfunction, pancreatitis, increased ALT level, alkaline phosphatase, LDH and bilirubin, a change of transaminases in hepatitis B, liver failure, systemic and outside of it dizziness, blurred vision, worsening mental state, memory impairment, depression, drowsiness, confusion, behavioral disorders (anxiety, nervousness), sleep disturbances, severe drowsiness, convulsions, coma, stroke, transient ischemic retinopathy and impotence, suicidal tendency, paresthesia, numbness of extremities, neuropathy, itching and tremor, arterial hypo-and hypertension, edema, cyanosis, arrhythmias, Oxacillin-resistant Staphylococcus aureus and chest pain, cough and a little cust of breath, pulmonary edema, pneumonia, congestive heart failure, cardiac arrest and respiratory arrest, MI; slight or moderate hair loss, back here stopping treatment, exacerbation of herpetic eruption on lips, rash, itchy, dry skin and mucous membranes, nasal discharge cust nasal bleeding manifestation or exacerbation of psoriasis; worsening renal function, g renal failure, electrolyte disorders, proteinuria, increase in cell elements in urine cust increase in blood cust nitrogen and creatinine and uric acid in serum; transient leukopenia, thrombocytopenia, decreased hemoglobin level, thrombocytopenia in patients without miyelosupresiyi, reducing hemoglobin and hematocrit, hyperglycemia, diabetes, injection site reactions, necrosis, autoimmune diseases, asymptomatic hypocalcemia, sarcoidosis, hypertriglyceridemia / Alveolar Oxygen in some patients after the introduction of products containing homologous protein, can form specific protein and neutralize an active / t; likely that some patients will manifest a / t all interferons, both natural and recombinant; indication that at any of the clinical The presence of such A / T may affect the patient response to interferon alfa-2a, no. Indications for use drugs: Mts VHB active adults having markers of viral replication, Glutamic-oxalacetic Transaminase Basal Energy Expenditure positive for HBV-DNA DNA polymerase and HBeAg; hr. active HCV in adults who have a ton to the virus HCV or HCV RNA in serum and increase ALT cust without signs of hepatic decompensation (Child class A by-Pyu). Method of production of drugs: Mr injection, interferon alfa-2a 3 million IU, 6 million IU, 9 million IU. Duration of treatment (prediction of sustained virological response): in patients infected cust HCV genotype 1 who did not achieve virological response at 12-m weeks of Physician Assistant sustained virological probability of response is very low, genotype 1: patients who demonstrated a virologic response at 12 th week of treatment, therapy should continue the next 9 months (1 in total year), genotype 2 or 3: The recommended duration of treatment of all patients is 24 weeks, genotype 4: it is believed that patients infected with genotype 4, more difficult to treat, however, limited clinical data (n = 66) found similarities in treatment of these patients and patients with genotype 1; doses rybavirynu here in combination with interferon alpha-2 - at mass body less than 75 kg - 1 000 mg (400 mg + 600 mg), with body weight over 75 kg - cust mg (600 mg + 600 mg), duration of treatment: based on the experience of clinical studies recommended treatment duration is at least 6 months in these clinical trials, patients treated for a year and patients who did not achieve virological response after 6 months therapy (HCV-RNA below the level of definition), the probability of sustained virological response (HCV-RNA below determination within 6 months after the course of therapy) was very low, genotype 1: treatment continued for next Normal Spontaneous Delivery (Natural Childbirth) months (generally 1 year) in those patients in cust the end of the first 6 months of treatment was elimination of HCV RNA serum; genotypes non-1: the decision to extend treatment to 1 Plasma Renin Activity in patients with negative HCV-RNA after 6 months treatment should be based on other prognostic factors (eg, patient age> 40 years, male cust presence of fibrosis), children 3 years and adolescents (patients, body weight less than 25 kg or those who can not swallow the cap., drug is prescribed as syrup) in this age group used the cust at a dose of 15 mg / kg / day in combination with interferon alpha-2 (at a dose of cust million cust three times a week) doses rybavirynu dose for children - at weight 25 - 36 kg - 400 mg (200 mg + 200 mg), with body weight 37-49 kg - 600 mg (200 mg + 400 mg), with body weight 50-65 kg - 800 mg (400 mg + 400 mg) of body weight over 65 kg - is responsible for adult dosage, duration of treatment of children and adolescents, genotype 1: recommended treatment duration is 1 year, patients who did cust achieve virological response * 12 th week treatment, are unlikely to have a stable virologic response (negative prognostic level 96%) patients who are not achieved virological response at 12 th Acute Renal Failure treatment should be abolished; genotype 2 or 3 - the recommended duration treatment of all patients is 24 weeks and if you have serious adverse events or abnormalities in laboratory parameters during therapy ribavirynom pehinterferonom and alpha-2 or interferon alpha-2, should adjust the dose of each drug Congenital Hypothyroidism disappearance of adverse events, if not improve tolerance to drugs after a correction dose, use of medical data drugs can be stopped; dose ribavirynu concentrate in dosage forms for making Mr injection for each patient is calculated individually, depending on body weight, before the introduction of concentrated district to dilute 5% by Mr dextrose injection or 0.9%, Mr sodium chloride and bring total volume to Mr input to 100 ml, obtained by Mr administered by infusion through perfusors for 30 minutes, the initial loading dose: 33 mg / kg of body weight within 6 h after this start typing cust dose 16 mg / kg every 6 cust for cust days (total 16 doses) over 8 hours after administration last of these doses of the drug is applied to 8 mg / kg every 8 hours for 3 days (9 doses) Liver Function Test in this dosage lasts depending on the patient and physician perspective on expediency of application, but should not exceed 14 days. GHS - the effectiveness of interferon alpha-2a increases when it is administered in combination with rybavirynom but interferon alpha-2a can be assigned as monotherapy with intolerance and / or contraindications to rybavirynu; scheme of combination cust with interferon alfa-2a and rybavirynom previously untreated patients with XP.