注射去纤维钠需要注意什么？

(Defitelio) is a sodium salt of single-stranded polydeoxyribonucleic acid that has anti-thrombotic, anti-inflammatory and fibrinolytic properties. In recent years, multiple collaborative groups in Europe and the United States have reported that defibrinated sodium (5-60 mg/kg/d) was used to treat patients with severe VOD and multiple organ failure after HSCT. The complete remission rates were 55% and 36% respectively. 43% and 35% of patients survived +100 days, and there were no obvious toxic or side effects. Therefore, the drug is considered to be one of the safe and effective therapeutic drugs.

If you want to obtain obvious therapeutic effects from it, you need to use the medicine correctly. So, what should patients pay attention to when injecting defibrotide sodium (defibrotide)?

Defibrotide sodium can be administered via intravenous injection or oral administration. Intravenous administration can quickly reach the maximum blood concentration Cmax, and oral administration can reach Cmax 30 minutes later. In view of factors such as hydrolytic inactivation of digestive tract nucleases, intestinal absorption efficiency of defibrinated sodium, and liver first-pass effect, the oral bioavailability is only 58-71%. The half-life of defibrinated sodium for injection is about 10-30 minutes, while the elimination of defibrinated sodium for oral administration takes several hours and is mainly excreted through urine and feces. The advantage of oral administration is that defibrinated sodium can exert its effect slowly and continuously.

The recommended dose of defitelio for adult and pediatric patients is 6.25 mg/kg given every 6 hours as a 2-hour intravenous infusion. The dose should be based on the patient's baseline weight, which is defined as the patient's weight before the HSCT preparation protocol. Give Defitelio for a minimum of 21 days. If signs and symptoms of hepatic VOD have not resolved after 21 days, continue treatment with Defitelio until resolution of VOD or up to a maximum of 60 days.

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