"Akromegalie \nZpo\u010D\u00E1tku ka\u017Ed\u00FDch 8 nebo 12 hodin 0,05-0,1 mg subkut\u00E1nn\u011B. D\u00E1vkov\u00E1n\u00ED by m\u011Blo b\u00FDt upraveno na z\u00E1klad\u011B m\u011Bs\u00ED\u010Dn\u011B stanovovan\u00FDch hladin GH a IGF-1 (c\u00EDlem je: GH\u00A0<\u00A02,5\u00A0ng/ml; IGF 1 v norm\u00E1ln\u00EDm rozmez\u00ED), v\u00A0z\u00E1vislosti na klinick\u00FDch p\u0159\u00EDznac\u00EDch a na toleranci. U v\u011Bt\u0161iny nemocn\u00FDch je optim\u00E1ln\u00ED d\u00E1vka 0,3 mg. Maxim\u00E1ln\u00ED denn\u00ED d\u00E1vka 1,5 mg by nem\u011Bla b\u00FDt p\u0159ekro\u010Dena. U pacient\u016F na st\u00E1l\u00E9 d\u00E1vce Sandostatinu se hodnocen\u00ED GH prov\u00E1d\u00ED ka\u017Ed\u00FDch 6\u00A0m\u011Bs\u00EDc\u016F. \nNedos\u00E1hne-li se za 3 m\u011Bs\u00EDce od zah\u00E1jen\u00ED l\u00E9\u010Dby Sandostatinem v\u00FDznamn\u00E9ho sn\u00ED\u017Een\u00ED hladin r\u016Fstov\u00E9ho hormonu ani zlep\u0161en\u00ED klinick\u00FDch p\u0159\u00EDznak\u016F, m\u011Bla by b\u00FDt l\u00E9\u010Dba p\u0159eru\u0161ena. \nGastro-entero-pankreatick\u00E9 endokrinn\u00ED n\u00E1dory \nZahajovac\u00ED l\u00E9\u010Dba 0,05 mg jednou nebo dvakr\u00E1t denn\u011B formou subkut\u00E1nn\u00ED injekce. Podle klinick\u00E9 odpov\u011Bdi, \u00FA\u010Dinku na hladiny hormon\u016F vylu\u010Dovan\u00FDch n\u00E1dorem (v p\u0159\u00EDpad\u011B karcinoid\u016F na vylu\u010Dov\u00E1n\u00ED 5-hydroxyindoloctov\u00E9 kyseliny mo\u010D\u00ED) a podle sn\u00E1\u0161enlivosti se m\u016F\u017Ee d\u00E1vka postupn\u011B zvy\u0161ovat na 0,1 a\u017E 0,2 mg 3x denn\u011B. Ve v\u00FDjime\u010Dn\u00FDch p\u0159\u00EDpadech m\u016F\u017Ee b\u00FDt nutn\u00E1 vy\u0161\u0161\u00ED d\u00E1vka. Udr\u017Eovac\u00ED d\u00E1vka mus\u00ED b\u00FDt stanovena individu\u00E1ln\u011B. \nPokud nen\u00ED u karcinoidn\u00EDch n\u00E1dor\u016F dosa\u017Eeno b\u011Bhem 1 t\u00FDdne l\u00E9\u010Dby Sandostatinem, p\u0159i maxim\u00E1ln\u00ED tolerovan\u00E9 d\u00E1vce, terapeutick\u00E9ho \u00FA\u010Dinku, m\u011Bla by b\u00FDt l\u00E9\u010Dba p\u0159eru\u0161ena. \nRefraktern\u00ED pr\u016Fjmy souvisej\u00EDc\u00ED s AIDS\nOptim\u00E1ln\u00ED po\u010D\u00E1te\u010Dn\u00ED d\u00E1vka je podle \u00FAdaj\u016F 0,1 mg 3x denn\u011B subkut\u00E1nn\u011B. Pokud nedojde k \u00FAprav\u011B pr\u016Fjmu po 1 t\u00FDdnu l\u00E9\u010Dby, d\u00E1vka by m\u011Bla b\u00FDt upravena individu\u00E1ln\u011B a\u017E na 0,25\u00A0mg 3x denn\u011B. D\u00E1vka by m\u011Bla b\u00FDt stanovena podle stolice a sn\u00E1\u0161enlivosti. Pokud nen\u00ED b\u011Bhem 1 t\u00FDdne l\u00E9\u010Dby Sandostatinem p\u0159i d\u00E1vce 0,25 mg 3x denn\u011B dosa\u017Eeno zlep\u0161en\u00ED, l\u00E9\u010Dba by m\u011Bla b\u00FDt p\u0159eru\u0161ena. \nKomplikace po chirurgick\u00E9 intervenci na pankreatu\nL\u00E9\u010Dba se zahajuje v den operace nejm\u00E9n\u011B 1 hodinu p\u0159ed laparatomi\u00ED a pod\u00E1v\u00E1 se 0,1 mg 3x denn\u011B subkut\u00E1nn\u011B po dobu n\u00E1sleduj\u00EDc\u00EDch 7 dn\u00ED. \nKrv\u00E1cen\u00ED z gastroezofage\u00E1ln\u00EDch varix\u016F \nPod\u00E1v\u00E1 se 25 mikrogram\u016F/hodinu po dobu 5 dn\u016F v kontinu\u00E1ln\u00ED i.v. infuzi. Sandostatin lze \u0159edit ve fyziologick\u00E9m roztoku. U pacient\u016F s\u00A0jatern\u00ED cirh\u00F3zou a s krv\u00E1cen\u00EDm z j\u00EDcnov\u00FDch varix\u016F byl Sandostatin dob\u0159e tolerov\u00E1n a\u017E do d\u00E1vky 50 mikrogram\u016F/hodinu po dobu 5 dn\u016F v kontinu\u00E1ln\u00ED i.v. infuzi. \nU\u017Eit\u00ED u star\u0161\u00EDch lid\u00ED\nU star\u0161\u00EDch pacient\u016F l\u00E9\u010Den\u00FDch Sandostatinem nebyly pozorov\u00E1ny zm\u011Bny sn\u00E1\u0161enlivosti ani nutnost \u00FApravy d\u00E1vkov\u00E1n\u00ED.\nU\u017Eit\u00ED u d\u011Bt\u00ED\nZku\u0161enosti s pod\u00E1v\u00E1n\u00EDm Sandostatinu u d\u011Bt\u00ED jsou omezen\u00E9.\nU\u017Eit\u00ED u pacient\u016F se zhor\u0161enou jatern\u00ED funkc\u00ED\nU pacient\u016F s cirh\u00F3zou jater m\u016F\u017Ee b\u00FDt biologick\u00FD polo\u010Das l\u00E9\u010Div\u00E9ho p\u0159\u00EDpravku zv\u00FD\u0161en, z tohoto d\u016Fvodu m\u016F\u017Ee b\u00FDt nutn\u00E1 \u00FAprava d\u00E1vkov\u00E1n\u00ED.\nU\u017Eit\u00ED u pacient\u016F se zhor\u0161enou ren\u00E1ln\u00ED funkc\u00ED\nZhor\u0161en\u00E1 funkce ledvin neovliv\u0148uje celkovou expozici (AUC) s.c. pod\u00E1van\u00E9ho oktreotidu, proto nen\u00ED nutn\u00E1 \u00FAprava d\u00E1vkov\u00E1n\u00ED.\n"@cs . . . . . "004.002" . . . "4.2\tD\u00E1vkov\u00E1n\u00ED a zp\u016Fsob pod\u00E1n\u00ED "@cs . . . . . . . . . . .