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Actemra is a pharmaceutical product that is manufactured in the form of a concentrated solution. The drug can be administered directly or mixed with an infusion solution with 20mg/ml. Below are information and notes for drug users.1. Indications and contraindications when using Actemra
In 1ml of Actemra concentrated solution contains 20mg tocilizumab. The amount of this substance analyzed in one syringe reached 162mg. For ease of use for many purposes, the drug is suitable for both mixing in solution for infusion or subcutaneous injection. If the patient is having problems with rheumatoid arthritis and the condition is still mild, it can be reduced after the first use. Some patients with moderate rheumatoid arthritis who have undergone treatment may also improve against the risk of rheumatoid arthritis or tumor necrosis after using the drug.The most common patients taking this drug will be in adulthood. Arthritis syndrome in adolescence may appear polyarthritis due to environmental influences or the ability to receive drugs when conducting previous treatment. If the patient is more than 2 years old, it may be difficult to respond to NSAIDs and systemic corticosteroids. Currently, the new guidelines are contraindicated in patients with hypersensitivity to the drug's components or in the presence of a severe inflammatory infection that does not improve.
2. Appropriate dosage for the patient
Dosage will be considered as the drug is administered by infusion or by subcutaneous injection. You should note that the current condition is rheumatoid arthritis or idiopathic juvenile arthritis. For rheumatoid arthritis, intravenous infusion can be administered at a dose based on body weight. One hour intravenous infusion with a dose calculated as 8mg per kg of body weight for one month of infusion. The side with a weight of over 100kg should note that a single use does not exceed 800mg. If administered subcutaneously, a dose of 162 mg per week may be used.The transition from infusion to solution for injection should be done at the next attempt. Adolescents presenting with polyarticular idiopathic arthritis will receive intravenous fluids at a dose of 10 mg/kg for patients under 30 kg. Over 30kg, the amount of drug used will be 8mg/kg and this amount is used for 1 month. When determining systemic juvenile idiopathic arthritis, patients under 30 kg will increase the dose by 12 mg/kg and above 30 kg will remain unchanged. However, this dosing system is prescribed for 2 weeks.
The dose of Actemra can be changed and adjusted depending on the progression or abnormality in the patient. Some clinical symptoms may prompt the physician to make a decision to discontinue the drug. If a child develops idiopathic-onset polyarthritis or a teenager has systemic idiopathic arthritis, a detailed medical evaluation is required to identify clinical or laboratory abnormalities before making a decision. Actemra injection or infusion.
3. Usage and some notes when using Actemra
When used with the same infusion solution, Actemra will be diluted in 0.9% NaCl solution. For subcutaneous injection, the doctor will choose the abdomen, or thighs or arms. But do not inject into the skin with moles, scars, bruises, damage caused by other effects, ... Before injecting the medicine tube will not be shaken. Injectable drugs have a faster effect due to intravenous absorption, but at the same time, the pharmacology will also affect the patient's condition after taking the drug.Patients with a history of previous infections should report to their doctor for assistance. Especially patients who have had problems such as ulcerative colitis, been treated for suspected tuberculosis, hepatitis caused by viruses, hereditary liver diseases, etc. When taking drugs, you should consult your doctor. If concurrent vaccination is required, consider adjusting the discontinuation of injections. Avoiding concomitant administration may inactivate necessary effects.
When a TB test is negative, there is a risk of false results. Some also have absolute neutrophils below 2 x 109/L or platelets less than 0.5 x 109/L,... The neutrophil counts are quite complicated, so they will affect the decision to use. medication you need to consider carefully. Pregnant women without indications should not use the drug. For those raising small children, the doctor will consider the effects as well as the benefits for the child to decide to use the drug for the mother.
4. Side effects
Pharmacological drugs can inadvertently cause interactions that appear dangerous side effects to the patient's health. Typically, patients are at risk of developing upper respiratory tract infections and elevated blood cholesterol levels are common. Some were found to be cellulitis, pneumonia, mouth ulcers, gastritis, rashes, .... In addition to the symptoms that need to be checked for indicators such as white blood cells and platelets, you will face signs. pain, weight gain, shortness of breath or cough after the injection. These points should be noted for early detection and at the same time proactively checking health to help control any internal problems.When you are using prescribed drugs, you must not arbitrarily increase or decrease the dose for personal purposes. Even the dose of Actemra should be maintained exactly as directed by your doctor. Patients who arbitrarily use it without specific instructions or requests from a doctor will affect the drug reaction or reduce the body's recovery function at the time of starting to use that drug.
5. Using actemra in Covid 19 patients
According to doctors, rheumatoid arthritis can appear in both children and adults. Currently, the drug supply may be affected due to the increased demand due to the pandemic. Therefore, the treatment process is becoming difficult when the shortage of drugs affects the ability to recover when not providing enough doses for patients. With rheumatoid arthritis, immune cells play a role in protecting the body from invading bacteria. Some bacteria will be controlled by the synovial membrane from the joint, so it is called an autoimmune disease.When this disease attacks the joints, it activates the synovial membrane and protective organs. Inflammation in the ankles or fingers,... is a common characteristic. When the patient's condition is complicated and cannot be treated with conventional drugs, the doctor chooses to use Actemra. At this time, the drug will treat rheumatoid arthritis thanks to its ability to resist interleukin-6. After absorption, the body will correct the error of sending false signals about inflammation and reduce the spread of various types of inflammation affecting the joints.
In patients with Covid 19, the disease stage will appear a cytokine storm. This signal creates a signal for the body to mobilize immune cells to repair the area that is inflamed or damaged by a virus attack. The inflammatory response will be controlled by the drug Actemra and prevent damage to the healthy tissue cells. Many studies have shown the inflammatory potential of SARS COV 2 and its ability to fight inflammation when used correctly.
Using Actemra 200mg / 10ml or Actemra 400mg / 20ml will depend on the inflammatory problem in each patient. You should follow your doctor's instructions to protect your health. It also prevents the spread of rheumatoid arthritis.
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