Introduction to Crohn's disease

Introduction Crohn's disease is also known as "limited enteritis", "segmental enteritis", "chronic full-thickness of the intestinal wall" and so on. Its characteristics are unclear, more common in young people, manifested as granulomatous inflammatory lesions, combined with fibrosis and ulcers. It can invade any part of the gastrointestinal tract, including the mouth and anus. The lesions are segmental or jumping, and can invade the outside of the intestines, especially the skin. The clinical manifestations vary according to the location, extent and extent of the lesion, which can be manifested as abdominal pain, diarrhea, abdominal mass, fistula formation and intestinal obstruction, accompanied by fever and anemia. The course of the disease is slow and easy to relapse. Causes (1) The cause of the disease has not been determined so far. Recent studies have tended to suggest that the disease may be the result of a combination of genetic susceptibility and a variety of exogenous factors. 1. Genetic susceptibility (1) Genetic factors: A large number of data indicate that Crohn's disease is related to genetic factors. The study found that the coincidence rate of Crohn's disease among twins with single egg development was significantly higher, at 67%, while the twins of twins had a coincidence ratio of only 8%. At the same time, it was found that patients with Crohn's disease showed inconsistency with their spouses and did not differ from the general population. The above indicates that the disease has family aggregation. It has also been reported that the Jewish family has a high incidence of the disease in the Jewish family compared with non-Jewish people and finds mainly those of the Ash Kenazi race. The survey of Askenazi people scattered around the world has a higher incidence of Crohn's disease than those of non-Askens children living in the same area. Perhaps the Askenaz Jews represent humans. People with genetic susceptibility. It has also been reported that patients with Crohn's disease are more associated with HLA-DR4 type serum antigens. How genetic factors affect the occurrence of this disease is unclear. Some people think that genetics determine the body's immune response. The genetic factors of patients with inflammatory bowel disease determine that they have an excessive immune response to some antigenic substances in the intestinal lumen. (2) Changes in susceptibility: At present, most scholars believe that the occurrence of Crohn's disease may be related to the abnormal immune response of the body to various antigens stimulated in the intestine. A growing body of evidence suggests increased T cell activation in the lamina propria of Crohn's disease, including increased expression of surface markers for T cell activation, increased production of T cell cytokines, and increased cytotoxic T cell function. This increase in T cell activation leads to aggregation of effector cells such as neutrophils. Subsequent synthesis of destructive substances (such as proteases and reactive oxygen metabolites) results in intestinal damage in Crohn's disease. The triggering mechanism of T cell activation is unclear. In the past, there was some conviction that it was caused by chronic mycobacterial infection, but there is no reliable evidence. It is currently believed that it may not be singular and is more likely to be activated by a number of widely occurring triggering substances. The fundamental defect of Crohn's disease leads to the permanent activation of T cells, a defect that is currently being explored. It may be a foreign antigen, increased antigen delivery (increased intestinal permeability), and a genetically predisposed mucosal immune disorder. The result of a complex interaction. Current research indicates that the view that this disease was once considered an autoimmune disorder is inaccurate. In fact, there is no credible evidence that there is an immune response directly associated with any autoantigen that can cause the inflammatory process observed in Crohn's disease. 2. Exogenous factors (1) Infectious factors: In early years, the pathological manifestations of Crohn's disease were similar to those of non-calcified tuberculosis. It was suspected that the disease was caused by Mycobacterium tuberculosis, but the pathogen was not isolated by various methods. In the late 1970s and early 1980s, there were reports of mycobacteria of Kansasii or mycobacteria similar to Mycobacterium tuberculosis in the intestinal segment and mesenteric lymph nodes excised from Crohn's disease. Studies have found that these mycobacteria inoculated in the peritoneal cavity of mice can cause granuloma in the liver and spleen and develop acid-fast bacilli. These acid-fast bacilli are then administered orally to the dairy sheep, and non-caseal granuloma can occur at the end of the ileum of the sheep after several months. It is believed that mycobacteria may be the cause of Crohn's disease. However, some authors have observed that these mycobacteria are also present in some non-inflammatory bowel diseases or normal human intestinal tissues, and it has been reported that Streptococcus faecalis can cause local granuloma in the intestinal wall of rabbits, so these branches are not certain. Bacilli is the exact cause of the disease. It has also been suspected that the cause of Crohn's disease is a virus. In 1970, Mitchell and Rees inoculated mesenteric lymph nodes and tissue homogenates from patients with Crohn's disease through a 220 nm filter screen and inoculated on the toes of rats. After 6-24 months, epithelioid cell granuloma and giant cell granuloma occurred on the toes of rats. In the same way, granuloma can occur in the ileum of rabbits. Immunosuppressive drugs have no effect on the pathogenesis, suggesting that there may be an infectious microorganism that may be a virus. However, the results of this experiment have not been repeated. It is also believed that Crohn's disease is associated with viral infections such as measles and influenza. However, the true virus particles have not been isolated from the intestinal tissue of Crohn's disease patients, so the cause of this disease cannot be confirmed as a virus. (2) Environmental factors: The incidence of urban residents is higher than that of rural people. This difference also exists in Sweden, where rural health care is high, which may be related to social and economic status. Some studies have shown that oral contraceptives increase the risk of inflammatory bowel disease. But other studies have failed to confirm. Numerous studies have shown that smokers are at increased risk of Crohn's disease. And smoking can increase the likelihood of recurrence of Crohn's disease. The mechanism is still unclear. Some potential environmental factors can trigger the development of Crohn's disease. The increase in edible refined sugar has been identified as a disadvantage. An ordinary period of birth can also be used as a stimulating factor to cause some pregnant women to develop Crohn's disease after childbirth. (B) the pathogenesis 1. Distribution of lesions The disease can be affected from any part of the gastrointestinal tract from the mouth to the anus, the lesions are leaping or segmental distribution. Simultaneous involvement of the small intestine and colon is the most common, accounting for 40% to 60%; limited to 30% to 40% of the small intestine, mainly in the terminal ileum; lesions occurring in the anus or rectum alone are rare, accounting for 3%, mostly with the small intestine and Colonic lesions are present in combination; colons are less common, accounting for 5% to 20%. The stomach or duodenum, esophagus, and oral lesions account for about 10% or less. 2. The early pathological changes of the general pathology are small ulcers of the mouth ulcers, ranging in size. The smallest is the tip of the needle, accompanied by bleeding; the larger one is clearly shallow and the bottom is white. If a small lesion is missed during surgical resection, it can recur from there. Typical ulcers are longitudinal or limp, discontinuous, and vary in size. Cobblestone-like changes are present in approximately 1/4 of the cases. Thickening of the intestinal wall and intestinal stenosis are more common. About 95% of surgical cases have stenosis. Some Crohn's disease can be seen with multiple inflammatory polyps. 3. Microscopically, the lesions under the microscope are found in the intestinal mucosa, submucosa and serosal layer, mainly the submucosa. Common lymphocyte aggregation can have a germinal center. The location of lymphocyte aggregation is closely related to blood vessels and dilated lymphatic vessels. Lymphocyte aggregation of the serosa layer can form a rosette-like pattern. Plasma cells, multinucleated cells, and eosinophils can also be seen. A mucosal layer can be seen in the sac abscess. Non-case granuloma is one of the important features of this disease. It consists of epithelioid cells and giant cells. There is no cheese necrosis in the center, which is uncommon. It is only found in about 50% of cases. It should be noted that granulomas can also be found in Yersinia infection or Chlamydia infection, which can be identified by an experienced pathologist. Glassy and adenoid inclusions are seen in 5% of cases, as seen in sarcoidosis and tuberculosis. Granuloma is often very atypical and has a distinct boundary formed by lymphocytes. It can be seen in the whole layer of the intestinal wall, but the submucosa and serosal layer are most likely to appear. In addition to the intestinal wall, granulomas can also be found in local lymph nodes. The fissure ulcer of the intestinal wall extends deep into the muscularis propria. Transmural penetration is the basis for the formation of internal fistulas and cutaneous fistulas and abscesses. The fracture under the naked eye is linear and may have branches, surrounded by edema and island-like mucosa. In the cross section, the fissure branches appear as intramural abscesses. Due to edema and lymphatic vessel expansion and an increase in the number of collagen fibers, the submucosa is widened and the intestinal wall is thickened. Symptoms Clinical manifestations of Crohn's disease are insidious onset, often asymptomatic in the early stages, or mild in symptoms and easily overlooked. From symptomatic to confirmed diagnosis, it usually averages 1 to 3 years. The course of the disease is often chronic and recurrent. More common in young people, women are slightly more than men. 1. Common symptoms (1) Systemic manifestations: weight loss, increasing weight loss is the most common symptom. About one-third of patients have low or moderate fever, without chills. At this time, there are often active lesions or complications. (2) Abdominal pain: the most common symptom, intermittent attack. Lighter only has bowel and abdominal discomfort, and severe cases can be severe colic. Eating foods containing more cellulose often causes episodes of abdominal pain. Colonic lesions often have diarrhea and abdominal pain, and abdominal pain can be relieved after defecation or deflation. Sudden abdominal pain can occur at the end of the ileum due to lesions, which is caused by lesions in the visceral or peritoneal nerve endings. When the lesion invades the stomach and duodenum, abdominal pain is similar to peptic ulcer, and often accompanied by pyloric and duodenal obstruction. When the lesion invades the ileocecal area. Pain often occurs in the umbilical cord and is later confined to the lower right abdomen. Some cases have no obvious symptoms and sudden abdominal pain. Similar to acute appendicitis or intestinal perforation, it is the first symptom of this disease. Therefore, it is often misdiagnosed as acute appendicitis or intestinal perforation. Crohn's disease is only found when open. The lesion invades the jejunum and can be manifested as upper abdominal pain. When it develops into a granulomatous abscess and extensive mesenteric damage, it is often misdiagnosed as a bone or kidney lesion with back pain. (3) Defecation changes: Most patients have diarrhea, mostly intermittent seizures, and the number of stools is related to the extent of the lesion. 2 to 3 times a day to 10 times, or even dozens of times. For soft stools or loose stools, no pus or mucus. A wide range of diffuse small bowel lesions can have watery stools or fat stools. The onset of diarrhea is often associated with eating foods rich in cellulose. Emotional or nervous can also induce diarrhea, but unlike mental diarrhea, nighttime can be awakened by a sense of defecation. Patients with distal colon involvement may have symptoms such as urgency, urgency, or constipation, and difficulty in defecation. (4) Nausea and vomiting: When the lesion invades the stomach and the duodenum, jejunum, ileum, or forms part of intestinal obstruction caused by intestinal stenosis, symptoms such as nausea, vomiting, and abdominal pain occur. (5) Nutritional deficiency: A wide range of intestinal lesions can cause a decrease in the absorption area, dysbacteriosis, resulting in diarrhea, anorexia, and reduced food intake, resulting in varying degrees of malnutrition. The extent of malnutrition is closely related to the extent and location of the lesion. It is characterized by anemia, hypoproteinemia, vitamin deficiency, electrolyte imbalance and so on. Due to calcium deficiency, osteoporosis is seen and the trunk is painful. Young and pre-pubertal patients may experience growth retardation due to malnutrition and delayed maturity. It can be improved after surgery. (6) Relationship with pregnancy in women: Pregnancy can make the condition worse or worse. If the disease occurs during pregnancy, it will pose a threat to the fetus and mother, prone to stillbirth, miscarriage, premature delivery, fetal malformation. (7) Extra-gastrointestinal manifestations: This disease may be associated with multiple arthritis. When the lesion is relieved or surgically removed, the joint symptoms disappear. The skin may have urticaria, erythema multiforme, nodular erythema, and the like. In addition, conjunctivitis, iridocyclitis, corneal ulcer, keratitis can occur. Fatty liver, amyloidosis, cirrhosis, primary sclerosing cholangitis, etc. can also occur. (8) Anal and rectal lesions: abscess around the anus or around the rectum. Sinus and fistula are the more common manifestations of Crohn's disease. Crohn et al reported that the incidence of fistula was 14.2%, and it was reported that the incidence rate was 81%. Infections around the rectum and anus can develop into rectal abscesses, rectal vaginal fistulas. Extensive ulcers and granulomatous lesions can be found around the anus and on the buttocks. Individual patients with anal fistula are the first sign of the disease. (9) Common signs: The parts of the lesions are different, and their signs are also different. The mass can be touched at the site of the lesion, and there is local tenderness. The lower right abdominal mass is more common, the shape is sausage-like, the boundary is unclear, and it is relatively fixed. Intestinal obstruction often has bloating, and the intestinal type and the dilated bowel can be seen. Ulcers, sinus or fistulas can be seen around the anus. In some cases, clubbing, liver palm, and nodular erythema (mostly occurring in front of the sputum). Occasionally hepatosplenomegaly. 2. Classification of disease activity Due to the large difference in the condition of the disease, the disease activity index is currently graded internationally using the disease activity index. The following two methods for calculating the scores are commonly used: (1) The activity index of Crohn's disease is counted according to the eight variables of the disease proposed by Best and Singbton of the Crohn disease collaboration group in the United States (Crohn's

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Related drugs

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  • Crohn's disease , Hereditary angioedema

    Hydrocortisone

    【Product name】Cortef, SOLU-CORTEF

    [English common name]Hydrocortisone

    [Chinese common name]Hydrocortisone

    [English name]Alacort, Signef

    [Chinese other name]Azole

    [indications]
    Hydrocortisone injection: This product is used for adrenal insufficiency and hypopituitarism, and is also used for allergic and inflammatory diseases to rescue critically toxic infections.
    Hydrocortisone acetate tablets: mainly used for the treatment of adrenal insufficiency replacement therapy and congenital adrenal hyperplasia.
    Hydrocortisone acetate cream: for allergic, non-infectious skin diseases and some proliferative skin disorders such as dermatitis, eczema, neurodermatitis, seborrheic dermatitis and pruritus.
    Hydrocortisone acetate eye ointment: for allergic conjunctivitis.
    Hydrocortisone acetate eye drops: This product is used for iridocyclitis, keratitis, iritis, conjunctivitis and the like.

    【Dosage】
    Hydrocortisone injection:
    1. Intramuscular injection: 20 ~ 40mg a day, intravenous infusion of 100mg once a day.
    2. Add 25 times of sodium chloride injection or 5% glucose injection 500ml before intravenous drip, and add vitamin C 0.5 ~ 1g.
    Hydrocortisone acetate tablets:
    1. Oral: 20-30mg a day, 2/3 in the morning, 1/3 after lunch, in the case of stress, the amount should be increased, can be increased to 80mg a day, in divided doses.
    2. The therapeutic dose of children is 20-25mg/M2 per day, taken in 3 times.
    Hydrocortisone acetate cream: topical. Apply a proper amount to the affected area and gently rub for a while. 2-4 times a day.
    Hydrocortisone acetate eye ointment: applied to the eyelids 3 times a day.
    Hydrocortisone acetate eye drops: eye drops, 3 to 4 times a day, shake well before use.

    [Storage]
    Hydrocortisone injection: shading, sealed storage.
    Hydrocortisone acetate tablets: shading, sealed and preserved.
    Hydrocortisone acetate cream: sealed, cool and dry place.
    Hydrocortisone acetate eye ointment: sealed, kept in a cool dry place.
    Hydrocortisone acetate eye drops: sealed.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease , Optic neuromyelitis

    Methylprednisolone

    【Product name】Medrol

    [English common name]Methylprednisolone

    [Chinese common name]Methylprednisolone

    [English name]Methylprednisolone, A-Methapred, Adlone-40, Adlone-80

    [Chinese other name]A strong dragon, 6a-methylprednisolone, methylprednisolone, methylprednisolone

    [Indications] Mainly used for indications of allergic and autoimmune inflammatory diseases.

    【Dosage】
    1. According to the treatment needs of different diseases, the initial dose of methylprednisolone tablets can be adjusted between 4mg and 48mg of methylprednisolone per day.
    (1) Patients with mild symptoms usually receive a lower dose; some patients may require a higher initial dose.
    (2) Diseases that are clinically required to be treated with higher doses include multiple sclerosis (200 mg/day), cerebral edema (200-1000 mg/day), and organ transplantation (up to 7 mg/kg/day).
    (3) If there is no satisfactory clinical effect after sufficient treatment for a period of time, the methylprednisolone tablet should be discontinued and other suitable treatment methods should be used.
    (4) If it is necessary to stop the drug after long-term treatment, it is recommended to reduce the amount by volume, and not to withdraw the drug suddenly.

    [Storage] sealed, stored at 15 ° C -25 ° C.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease , Uveitis

    Adalimumab

    【Product name】Humira

    [English common name]Adalimumab

    [Chinese common name]Adalimumab

    [English name]

    [Chinese other name]

    [Indications] This product is suitable forRheumatoid Arthritis:
    1. This product is combined with methotrexate for the treatment of adult patients with moderate to severe active rheumatoid arthritis who have changed their disease resistance to rheumatoid drugs (DMARDs), including methotrexate.
    2. This product can be used in combination with methotrexate to slow the progression of joint damage in patients (X-ray display) and improve physical function.

    [Usage and Dosage] The treatment of this product should be carried out under the supervision of a specialist with experience in the diagnosis and treatment of rheumatoid arthritis. For those patients who are considered appropriate by the treating physician and who can be followed up when necessary, they can be administered by themselves after receiving the correct injection technique training.
    1. Discontinuation of dosing, available data indicates that re-use of the product after 70 days or more intervals will achieve the same level of clinical response and safety as before discontinuation of dosing. For adults, for adults with rheumatoid arthritis, a recommended dose of 40 mg adalimumab is administered subcutaneously every 2 weeks. Methotrexate should continue to be used during the treatment of this product.

    [Storage] Sealed.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    Monoclonal antibodies

    【Product name】IILARIS, ADCETRIS, Muromonab

    [English common name]Monoclonal antibody

    [Chinese common name]Monoclonal antibodies

    [English name]

    [Chinese other name]

    [indications]
    Iodine [131I] tumor cell nuclear human mouse chimeric monoclonal antibody injection: for the late stage of radiotherapy and chemotherapy can not control or relapseLung cancerRadioimmunotherapy.
    Recombinant anti-CD25 humanized monoclonal antibody injection: This product is suitable for preventing the occurrence of acute rejection after renal transplantation, and can be combined with an immunosuppressive regimen containing a calmodulin inhibitor and corticosteroids.

    【Dosage】
    Iodine [131I] tumor cell nuclear human mouse chimeric monoclonal antibody injection:
    1. Medication method:
    (1) Systemic administration: This product can be directly bolused, or intravenously established with saline to make a bolus or instillation.
    (2) Topical administration: The drug is injected into the tumor by pulmonary puncture under imaging guidance (CT, fluoroscopy or DSA).
    2. Dosage: Two times per course of treatment, with an interval of 2-4 weeks. The specific dosage is:
    (1) Systemic intravenous injection: The dose is 29.6 MBq (0.8 mCi)/kg.
    (2) Topical administration: Each dose was 18.5-37.0 MBq (0.5-1 mCi)/cm3 of tumor, and the maximum dose was 1850 MBq (50 mCi).
    Recombinant anti-CD25 humanized monoclonal antibody injection: the recommended dose is 1mg/kg, diluted to 50mL of 0.9% sodium chloride injection before use, and then intravenously infused, 15 minutes after the end. The first dose should be administered within 24 hours prior to transplantation, and then administered once every 14 days, twice for a course of treatment. This product can not be directly injected, but should be diluted with 50% of 0.9% sodium chloride injection before intravenous administration. Do not violently oscillate when mixing the solution and gently flip it to prevent foaming. Since this product does not contain any preservatives or bacteriostatic agents, it must be carefully stored to ensure the solution is sterile. This product is a colorless liquid contained in a disposable bottle. Any unused parts after opening should be discarded. Do not dilute and infuse with other drugs in the same solution.

    [Storage]
    Iodine [131I] tumor cell nuclear human mouse chimeric monoclonal antibody injection: sealed, shading, and stored in a dry place.
    Recombinant anti-CD25 humanized monoclonal antibody injection: stored and transported at 2-8 ° C in the dark. Do not freeze or shake vigorously. After dilution, the drug solution can be stored at 2-8 ° C for 24 hours and at room temperature for 4 hours.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    Metronidazole

    【Product name】Rozex, Nidazea, Metronidazol, Flagyl, Metronidazole, PYLERA

    [English common name]Metronidazole

    [Chinese common name]Metronidazole

    [English name]2-Methyl-5-nitroimidazole-1-ethanol, 2-(2-methyl-4-nitro-1H-imidazol-1-yl)ethanol

    [Chinese other name]2-methyl-5-nitroimidazole-1-ethanol, 2-(2-methyl-4-nitro-1h-imidazol-1-yl)ethanol

    [indications]
    Compound bismuth potassium citrate metronidazole capsule: for gastric, duodenal ulcer, superficial gastritis, atrophic gastritis and chronic gastritis.
    Metronidazole suppository: This product is used to treat vaginal trichomoniasis.
    Metronidazole injection: This product is mainly used for the treatment of anaerobic infection.
    Artificial bezoar metronidazole capsule: This product is mainly used for acute wisdom tooth pericoronitis, local alveolar abscess, pulpitis, periapical periodontitis and so on.
    Metronidazole chlorhexidine lotion: This product is a compound preparation, containing 1.2 mg of chlorhexidine gluconate and 0.2 mg of metronidazole per ml.

    【Dosage】
    Compound bismuth potassium citrate metronidazole capsule: oral. 1 to 2 capsules each time, once a day.
    Metronidazole suppository: 0.5g once a vaginal administration, once a night 0.5g, for 7 to 10 days, should also take metronidazole tablets, 0.2g each time, four times a day, and even served for seven days.
    Metronidazole injection: intravenous drip.
    1. Commonly used amount of adults: anaerobic infection, intravenous administration for the first time according to body weight of 15mg/kg (70g for adults), maintenance dose of 7.5mg/kg by weight, intravenous infusion every 6-8 hours.
    2. Commonly used in children: The injection dose of anaerobic infection is the same as that of adults.
    Artificial bezoar metronidazole capsule: oral. 2 capsules at a time, 3 times a day.
    Metronidazole chlorhexidine lotion: vaginal rinse. 50 ml once, 2 times a day, 7-10 days for a course of treatment.

    [Storage]
    Compound bismuth potassium citrate metronidazole capsule: sealed, placed in a cool place.
    Metronidazole suppository: shading, sealed, stored in a cool place below 30 °C.
    Metronidazole injection: shading, sealed storage.
    Artificial bezoar metronidazole capsule: shading, confined preservation.
    Metronidazole chlorhexidine lotion: placed in a cool dry place.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    BCG

    【Product name】IMMUCYST, Immunobladder, TICE BCG

    [English common name]Bacillus Calmette-Guerin vaccine

    [Chinese common name]BCG

    [English name]

    [Chinese other name]

    [Indications] This product (BCG immunotherapeutic agent) is suitable for intravesical use and treatment of primary recurrent carcinoma in situ (CIS) of the bladder to reduce the frequency of tumor recurrence. It is indicated for the treatment of carcinoma in situ with or without papillary tumors. However, it is not suitable for the treatment of papilloma that occurs alone. This product is also used as a remedy for the bladder to respond to other in situ carcinoma (CIS) treatments. Treatment and prevention of primary or recurrent carcinoma in situ or superficial papilloma after transurethral resection (TA and T1).

    [Usage and Dosage] Intravesical treatment and prevention of bladder carcinoma in situ (CIS) should be started 7 to 14 days after biopsy or transurethral resection. In a single dose of 3 vials, this product (BCG immunotherapeutic agent) was administered by intravesical injection once a week for 6 weeks (induction therapy). Each dose (3 bottles of prepared vials) was diluted with 50 ml of bacteria and diluted with preservative-free saline to a total of 53 ml. The urethral catheter is inserted into the bladder under aseptic conditions, guiding the contents of the bladder, and then slowly injecting 50 ml of the suspension of the product by gravity, and then taking out the catheter. During the first hour after perfusion, the patient should be placed in the prone, lying down and lying on the left and right sides for 15 minutes. The patient can then stand but maintain the suspension for 60 minutes for a total of 2 hours. It should be taught to urinate if needed for less time. . At the end of the 2 hours, all patients urinate in a sitting position for safety reasons. Patients should be taught to maintain adequate water. The true number of perfusions required to achieve the optimal response is still unknown. Most responding patients are achieved with 6 to 12 perfusions.

    [Storage] The medicine should be placed in a refrigerator of 2 to 8 degrees Celsius (not frozen); if it deteriorates or expires, it can no longer be used.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    Tacros

    【Product name】Putti, Envarsus, MODIGRAF, PROGRAF, Tacrolimus, ASTAGRAF

    [English common name]Tacrolimus

    [Chinese common name]Tacros

    [English name]Big ring piperon, Taikelima

    [Chinese other name]Macrocyclic melam, texley horse

    [indications]
    Tacrolimus Sustained Release Capsule: Prevents graft rejection after liver or kidney transplantation.
    Tacrolimus injection:
    1. Prevention of graft rejection after liver or kidney transplantation.
    2. Treatment of graft rejection after liver or kidney transplantation using other immunosuppressive drugs.
    Tacrolimus ointment: This product is suitable for patients with moderate to severe atopic dermatitis who are not suitable for traditional treatment due to potential risks, or who have not responded to traditional therapies or cannot tolerate traditional therapy, as short-term or intermittent long-term treatment. .
    Tacrolimus capsule: Prevents graft rejection after liver or kidney transplantation.

    【Dosage】
    Tacrolimus Sustained Release Capsules:
    1. Recommended starting dose for oral administration of Prograf in adults after surgery:
    (1) For patients with liver transplantation, the initial oral dose should be 0.1-0.2 mg/kg per day by weight, taken orally twice, and started 6 hours after surgery.
    (2) For kidney transplant patients, the initial oral dose should be 0.15-0.3 mg/kg per day by weight, divided into two orally, and the drug should be started within 24 hours after surgery.
    2. Rejection that is ineffective against traditional immunosuppressive therapy:
    (1) For patients with rejection and traditional immunosuppressive therapy, patients should start treatment with Prograf. The recommended starting dose is the same as the level of first immunosuppressive agent.
    Tacrolimus injection: The following recommended doses for oral and intravenous administration are only general indicators. The actual dose of the drug should be adjusted according to the needs of individual patients. The recommended dose is only the initial dose, so the treatment should be The clinical judgment was supplemented with monitoring of the concentration of tacrolimus in the blood to adjust the dose.
    1. Oral administration: The daily dose is administered in two divided doses. It is best to take capsules on an empty stomach or at least 1 hour before eating or 2-3 hours after eating to achieve maximum absorption. Oral capsules are usually administered continuously to inhibit transplant rejection and have no limitations during treatment.
    2. Intravenous administration:
    (1) The concentrate for infusion must be diluted with 5% glucose or physiological saline in polyethylene or glass bottles.
    Tacrolimus ointment:
    1. Adult 0.03% and 0.1% tacrolimus ointment Apply a thin layer of this product on the affected area, gently rub it, and cover it completely, twice a day, until the atopic dermatitis symptoms and signs disappear one week. Encapsulation therapy may promote systemic absorption and its safety has not been evaluated. This product should not be used for external application of package dressings.
    2. Children 0.03% tacrolimus ointment Apply a thin layer of this product on the affected area, gently rub it, and cover it completely, twice a day, until a week after the disappearance of atopic dermatitis symptoms and signs. Encapsulation therapy may promote systemic absorption and its safety has not been evaluated. This product should not be used for external application of package dressings.
    Tacrolimus capsule:
    1. Recommended starting dose for oral administration of Prograf in adults after surgery:
    (1) For patients with liver transplantation, the initial oral dose should be 0.1-0.2 mg/kg per day by weight, taken orally twice, and started 6 hours after surgery.
    (2) For kidney transplant patients, the initial oral dose should be 0.15-0.3 mg/kg per day by weight, divided into two orally, and the drug should be started within 24 hours after surgery.
    2. Rejection that is ineffective against traditional immunosuppressive therapy:
    (1) For patients with rejection and traditional immunosuppressive therapy, patients should start treatment with Prograf. The recommended starting dose is the same as the level of first immunosuppressive agent.
    (2) The patient is converted from cyclosporine to prograf, and the first dose interval of Prograf is no more than 24 hours.

    [Storage]
    Tacrolimus Sustained Release Capsules: sealed, stored in a cool, dry place.
    Tacrolimus injection: shading, sealed and preserved.
    Tacros ointment: sealed.
    Tacrolimus capsule: sealed, placed in a cool place.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    6-巯嘌呤 (6MP)

    【Product name】MERCAPTOPURINE, PURINETHOL

    [English common name]Mercaptopurine

    [Chinese common name]6-琉嘌呤 (6MP)

    [English name]Purinethol

    [Chinese other name]

    [indications]Suitable forChorionic epithelial carcinoma,Malignant moleAcute lymphoblastic leukemia and acute non-lymphocytic leukemia, chronic granulocytic leukemia.

    【Dosage】Oral administration:
    1 Chorionic epithelial cancer: commonly used in adults, daily 6mg ~ 6.5mg / kg, divided into two oral, 10 days for a course of treatment, intermittent treatment for 3 to 4 weeks.
    2 leukemia: start, daily 2.5mg / kg or 80 ~ 100mg / m, once a day or in divided doses, generally 2 to 4 weeks after treatment can be markedly effective, such as 4 weeks after medication, no clinical improvement and The number of white blood cells is decreased, and it can be considered to be added to 5 mg/kg per day under careful observation; maintenance, 1.5 mg to 2.5 mg/kg or 50 mg to 100 mg/m per day, once a day or in divided doses.

    [Storage] shading, sealed and stored.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    5-aminosalicylic acid

    【Product name】CANASA

    [English common name]5-Aminosalicylic acid

    [Chinese common name]5-aminosalicylic acid

    [English name]5-ASA; 5-Amino salicylic acidl, Mesalazine

    [Chinese other name]5-amino-2-hydroxybenzoic acid, mesalazine

    [Indications] For the treatment of ulcerative colitis, Crohn's disease; suppositories for the treatment of ulcerative proctitis, can also be combined with mesalazine tablets.

    [Usage and Dosage] Oral: Adult, ulcerative colitis (acute attack): 4 times a day, 1g each time; maintenance treatment, 3 times a day, 0.5g each time.
    Crohn's disease: 4 times a day, 1g each time. For children over 2 years old, take 20-30mg per kilogram of body weight per day, in divided doses.
    Suppository: Adult, 1-2 times a day, 1 suppository each time. Children over the age of two, follow the doctor's advice.

    [Storage] The tablets should be stored at room temperature (15-25 °C) and should not be taken after the expiration date. Suppositories should be stored at room temperature (15-25 °C) in the original package and should not be used after the expiration date.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease

    Sulfasalazine

    [product name] Crescent

    [English common name]Salazosulfapyridine

    [Chinese common name]Sulfasalazine

    [English name]Salicylazosulfapyridine

    [Chinese other name]Sulfa azopyridine, 5-[p-(2-pyridylaminesulfonyl)benzene]azosalicylic acid

    [Indications] This flat applies to:
    1. Ulcerative colitis: treatment of mild to moderate ulcerative colitis; can be used as an adjuvant therapy in severe ulcerative colitis. It can also be used for maintenance treatment in the remission period of ulcerative colitis.
    2. Crohn's disease: for the treatment of active Crohn's disease, especially those with colitis.
    3. Rheumatoid arthritis: Rheumatoid arthritis and juvenile rheumatoid arthritis (multi-articular) with no significant effect on salicylic acid or other non-steroidal anti-inflammatory drugs.

    [Usage and Dosage] Oral: 2 to 3 g per day for adults, divided into 3 to 4 times, gradually increased to 4 to 6 g per day, and reduced daily by 1.5 g after the improvement, until the symptoms disappear. Can also be used for enema, 2g per day, suspended in 20 ~ 50ml of isotonic saline for retention enema; white and powder can also be added to increase the viscosity of the drug solution.

    [Storage] shading, confined storage.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease , Behcet disease

    Infliximab

    【Product name】REMICADE, Remicade

    [English common name]Infliximab

    [Chinese common name]Infliximab

    [English name]

    [Chinese other name]

    [indications]
    Rheumatoid Arthritis
    This product is a disease-control anti-rheumatic drug. For patients with moderate to severe active rheumatoid arthritis, this product can be used in combination with methotrexate:
    · Reduce symptoms and signs;
    · Improve physical function and prevent disability in patients.
    Crohn's disease
    For patients with moderate to severe active Crohn's disease who are not well received by traditional treatment, this product can be used for:
    · Reduce symptoms and signs;
    · Achieve and maintain clinical efficacy;
    · Promote mucosal healing;
    · Improve the quality of life;
    · Reduce the amount of corticosteroids or stop using corticosteroids.
    Tracheal Crohn's disease
    For patients with fistile Crohn's disease, this product can be used for:
    Reduce the number of intestinal-cutaneous fistulas and rectal-vaginal fistulas to promote and maintain fistula healing;
    · Reduce symptoms and signs;
    · Improve the quality of life.
    Ankylosing spondylitis
    For patients with active ankylosing spondylitis, this product can be used for:
    · Alleviate symptoms and signs, including increasing the range of activity;
    · Improve physical function;
    · Improve the quality of life.
    psoriasis
    For patients with psoriasis, this product can be used for:
    Adult patients with chronic severe plaque psoriasis who require systemic treatment and are ineffective, contraindicated or tolerant to other systems such as cyclosporine, methotrexate or photochemotherapy. This product is intended for use only in patients who are treated under close supervision by a physician and regularly followed up by a physician.

    【Dosage】
    Usage: intravenous infusion.
    Rheumatoid Arthritis
    The product was administered 3 mg/kg for the first time, and then the same dose was administered once every 8 weeks after the second week and the sixth week after the first administration and thereafter. This product should be combined with methotrexate. For patients with poor efficacy, consider adjusting the dose to 10 mg/kg and/or adjusting the medication interval to 4 weeks.
    Moderate and severe active Crohn's disease, fistula Crohn's disease
    The product was administered 5 mg/kg for the first time, and then the same dose was administered once every 8 weeks after the second week and the sixth week after the first administration and thereafter. For patients with poor efficacy, consider adjusting the dose to 10 mg/kg.
    Ankylosing spondylitis
    The product was administered 5 mg/kg for the first time, and then the same dose was administered once every 6 weeks after the second week and the sixth week after the first administration and thereafter.
    User guides
    Sterility should be performed.
    1. Calculate the dosage and determine the number of bottles used in this product: This product contains 100mg of infliximab per bottle, and calculate the total amount of the solution to be prepared.
    2. Dissolve each bottle of medicine with 10 ml of sterile water for injection using a syringe equipped with a 21 gauge (0.8 mm) or smaller needle: remove the flip of the vial, wipe the top of the vial with a medical alcohol swab, and insert the syringe needle into the vial Cover, inject sterile water for injection. If the vacuum in the vial has been destroyed, the bottle cannot be used. Gently rotate the vial to dissolve the powder. Avoid shaking for a long time or with force. Do not oscillate. Foam may appear during the dissolution of the drug. After 5 minutes of storage, the solution should be colorless or light yellow, and the milk is white. Since infliximab is a protein, there may be some translucent particles in the solution. If opaque particles, discoloration or other substances appear in the solution, they cannot be used any more.
    3. Dilute the sterile aqueous solution of this product to 250 ml with 0.9% sodium chloride injection: withdraw the same amount of liquid from the 250 ml 0.9% sodium chloride injection bottle or bag as the sterile injectable aqueous solution of this product. The sterile aqueous solution for injection of this product is completely injected into the infusion bottle or bag and gently mixed.
    4. The infusion time should not be less than 2 hours: the infusion set should be equipped with a built-in, sterile, pyrogen-free, low protein binding filter (pore size ≤ 1.2 μm). Unused infusions should not be stored for further use.
    5. The physical and biochemical compatibility studies of this product in combination with other drugs have not been carried out, and this product should not be infused simultaneously with other drugs.
    Products administered parenterally should be visually inspected for the presence of particulate matter or discoloration prior to administration. If opaque particles, discoloration, or other foreign matter are found, the drug may not be used.
    Plaque psoriasis
    The product was administered 5 mg/kg for the first time, and then the same dose was administered once every 8 weeks after the second week and the sixth week after the first administration and thereafter. If the patient does not respond after week 14 (ie, after 4 doses), the product should not be treated.
    Psoriasis patients re-administered
    Patients with psoriasis have limited experience with a single administration after 20 weeks, suggesting a reduction in the effectiveness of the product compared to the initial induction therapy and an increase in mild to moderate infusion response.
    After relapse of the disease, limited experience with repeated induction therapy showed an increase in infusion response (including severe reactions) compared to 8-week maintenance therapy.
    If treatment interruption is maintained, it is not recommended to initiate induction therapy again and should be re-administered according to maintenance therapy.

    [Storage]Store at 2-8 °C in the dark.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease , Behcet disease

    Azathioprine

    【Product name】Yimulan, IMURAN

    [English common name]Azathioprine

    [Chinese common name]Azathioprine

    [English name]Azathioprine

    [Chinese other name]Milan

    [indications]
    1.Acute and chronic leukemia,CorrectChronic myeloid leukemiaThe short-term effect is better, the effect is fast, but the remission period is short;
    2. Acquired hemolytic anemia, idiopathic thrombocytopenic purpura, systemic lupus erythematosus;
    3. ChronicRheumatoid arthritis, chronic active hepatitis (hepatitis associated with autoimmunity), primary biliary cirrhosis;
    4. Hyperthyroidism,Myasthenia gravis;
    5. Others: chronic non-specific ulcerative colitis, segmental enteritis, multiple radiculitis, lupus nephritis, proliferative nephritis, Wegener's granulomatosis, etc.

    【Dosage】
    1. Oral daily 1.5mg ~ 4mg / kg, once a day or divided into oral.
    2. Allogeneic transplantation, daily 2mg ~ 5mg / kg, once a day or divided into oral.
    3. Leukemia, daily 1mg ~ 3mg / kg, once a day or divided into oral.

    [Storage] shading, sealed and stored.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

  • Crohn's disease , Psoriatic arthritis (PsA)

    Utec monoclonal antibody

    【Product name】Stelara

    [English common name]Ustekinumab

    [Chinese common name]Utec monoclonal antibody

    [English name]

    [Chinese other name]

    [Indications] Stelara is a drug used to treat the following diseases:
    Moderate to severe plaque psoriasis (a disease that causes red, scaly plaque in the skin). It is used in adults and children over the age of 12, and its condition is unresponsive or cannot be treated with other systemic (systemic) psoriasis, such as cyclosporine, methotrexate or PUVA (psoralen UV A). PUVA is a treatment in which a patient receives a drug containing a compound called "psoralen" prior to exposure to ultraviolet light.
    Activity in adultsPsoriatic arthritis(Inflammation of the joints associated with psoriasis), when the condition is not adequately responsive to other treatments, is called anti-rheumatic drugs (DMARDs) that improve the disease. Stelara can be used alone or in combination with methotrexate (DMARD); moderate to severe activity in adultsCrohn's disease(a disease that causes intestinal inflammation), whose condition is poorly responsive to other Crohn's disease treatments or is unacceptable for such treatment.

    [Usage and Dosage] Adults aged 18 years and older started treatment with a loading dose of 320 mg delivered to two 2 ml, subcutaneously 160 mg on the same day at two different locations. Continue to use a weekly injection of 160 mg as a single, 2 ml, subcutaneously administered dose. Don't give ARCALYST more often than once a week. Pediatric patients are 12 to 17 years old: the starting dose for treatment is 4.4 mg/kg, up to 320 mg, delivered with one or two subcutaneous injections, with a maximum single injection volume of 2 mL. Continue to administer a weekly injection of 2.2 mg/kg, up to 160 mg, as a single subcutaneous injection, up to 2 ml. If the initial dose given is two injections, they should be on the same day at two different locations. Don't give ARCALYST more often than once a week.

    [Storage] Store in the refrigerator (2 ° C – 8 ° C). Do not freeze. Keep the vial in an outer carton to prevent light from shining.

    [Tips] Some of the information on this site comes from the Internet and is only used internally by pharmacists or medical staff. It is not a substitute for doctors to diagnose face to face. Please consult a professional pharmacist for specific medications. Please refer to the actual product manual or the actual product for the product content.

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