{"id":57495,"date":"2024-02-27T17:47:19","date_gmt":"2024-02-27T17:47:19","guid":{"rendered":"https:\/\/medsname.com\/hcqs\/"},"modified":"2026-04-30T10:24:26","modified_gmt":"2026-04-30T10:24:26","slug":"hcqs","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/hcqs\/","title":{"rendered":"HCQS"},"content":{"rendered":"

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Rychl\u00e1 odpov\u011b\u010f<\/h3>\n

HCQS<\/strong> obsahuje hydroxychlorochin sulf\u00e1t<\/strong> 200 mg a 400 mg (Cipla). Pou\u017e\u00edv\u00e1 se k l\u00e9\u010db\u011b a prevenci mal\u00e1rie citliv\u00e9 na chloroquine<\/strong>, a je prvn\u00edm l\u00e9kem ze skupiny aminochinolon\u016f pro revmatoidn\u00ed artritidu<\/strong>, syst\u00e9mov\u00fd lupus erythematodes<\/strong>, diskoidn\u00ed lupus<\/strong>, a Sj\u00f6gren\u016fv syndrom<\/strong>. D\u00e1vkov\u00e1n\u00ed: 400 mg\/den pro autoimunitn\u00ed onemocn\u011bn\u00ed (dlouhodob\u00e1 udr\u017eovac\u00ed d\u00e1vka \u2264 5 mg\/kg\/den skute\u010dn\u00e9 t\u011blesn\u00e9 hmotnosti); po\u010d\u00e1te\u010dn\u00ed d\u00e1vka 800 mg, pot\u00e9 400 mg v 6., 24. a 48. hodin\u011b pro akutn\u00ed nekomplikovanou mal\u00e1rii citlivou na chlorochin. Povinn\u00e9 vstupn\u00ed a n\u00e1sledn\u00e9 ka\u017edoro\u010dn\u00ed o\u010dn\u00ed vy\u0161et\u0159en\u00ed<\/strong> po 5 letech kontinu\u00e1ln\u00edho u\u017e\u00edv\u00e1n\u00ed k detekci retinopatie. Modern\u00ed endemick\u00e9 oblasti (subsaharsk\u00e1 Afrika, Indie, jihov\u00fdchodn\u00ed Asie, Amazonie) maj\u00ed roz\u0161\u00ed\u0159enou rezistenci na chlorochin \u2014 hydroxychlorochin NEN\u00cd vhodnou profylax\u00ed pro tyto destinace. U\u017e\u00edvejte s j\u00eddlem ke sn\u00ed\u017een\u00ed gastrointestin\u00e1ln\u00edch pot\u00ed\u017e\u00ed.<\/p>\n<\/div>\n

\ud83c\udfed V\u00fdrobce certifikovan\u00fd WHO-GMP<\/strong>  \u00b7  \ud83d\udce6 Diskr\u00e9tn\u00ed balen\u00ed<\/strong>  \u00b7  \ud83c\udf0d Doprava do cel\u00e9ho sv\u011bta<\/strong>  \u00b7  \u2b50 1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a><\/strong><\/div>\n

\ud83d\udee1\ufe0f Ka\u017ed\u00e1 objedn\u00e1vka je kryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, za\u0161leme zdarma n\u00e1hradn\u00ed z\u00e1silku prost\u0159ednictv\u00edm kur\u00fdrn\u00ed slu\u017eby EMS nebo ITPS.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

HCQS je dod\u00e1v\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP a expedov\u00e1n po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm balen\u00ed. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a> a podporov\u00e1na na\u0161\u00ed 1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>. . Celosv\u011btov\u00e1 doprava bez p\u0159edpisov\u00e9 dokumentace.<\/p>\n

O p\u0159\u00edpravku HCQS<\/h2>\n

HCQS je hydroxychlorochin sulf\u00e1t v tablet\u00e1ch s r\u016fznou silou \u00fa\u010dinku, vyr\u00e1b\u011bn\u00fd spole\u010dnost\u00ed Cipla za podm\u00ednek certifikovan\u00fdch WHO-GMP. Hydroxychlorochin je antimalarikum ze skupiny 4-aminochinolon\u016f, kter\u00e9 z\u00e1rove\u0148 slou\u017e\u00ed jako z\u00e1kladn\u00ed konven\u010dn\u00ed syntetick\u00fd chorobu modifikuj\u00edc\u00ed antirevmatikum (csDMARD)<\/strong> pro m\u00edrnou a\u017e st\u0159edn\u011b z\u00e1va\u017enou revmatoidn\u00ed artritidu a onemocn\u011bn\u00ed pojivov\u00e9 tk\u00e1n\u011b, s nejni\u017e\u0161\u00edm profilem toxicity ze v\u0161ech DMARD p\u0159i spr\u00e1vn\u00e9m d\u00e1vkov\u00e1n\u00ed.<\/p>\n

Jak hydroxychlorochin funguje<\/h2>\n

Hydroxychlorochin se hromad\u00ed v kysel\u00fdch lyzosomech bun\u011bk. P\u0159i malarick\u00e9 parazity<\/strong> naru\u0161uje tr\u00e1ven\u00ed hemoglobinu v potravn\u00ed vakuole, co\u017e umo\u017e\u0148uje hromad\u011bn\u00ed toxick\u00e9ho voln\u00e9ho hemu a n\u00e1sledn\u00e9 usmrcen\u00ed parazita. autoimunitn\u00ed onemocn\u011bn\u00ed<\/strong> lyzosomotropn\u00ed efekt zvy\u0161uje pH lyzozom\u016f, co\u017e naru\u0161uje zpracov\u00e1n\u00ed antigen\u016f dendritick\u00fdmi bu\u0148kami, potla\u010duje signalizaci Toll-like receptor\u016f (zejm\u00e9na TLR-7 a TLR-9, kter\u00e9 rozpozn\u00e1vaj\u00ed vlastn\u00ed nukleov\u00e9 kyseliny) a sni\u017euje produkci interferonu-\u03b1. Tento dvoj\u00ed mechanismus vysv\u011btluje, pro\u010d jedin\u00fd l\u00e9k l\u00e9\u010d\u00ed dv\u011b nesouvisej\u00edc\u00ed onemocn\u011bn\u00ed.<\/p>\n

Polo\u010das rozpadu je ~ 40 dn\u00ed (ust\u00e1len\u00fd stav za 4\u20136 t\u00fddn\u016f). \u00da\u010dinek na autoimunitn\u00ed onemocn\u011bn\u00ed se rozv\u00edj\u00ed za 8\u201312 t\u00fddn\u016f a d\u00e1le se prohlubuje po dobu 6 m\u011bs\u00edc\u016f \u2014 d\u016fle\u017eit\u00e1 je trp\u011blivost a adherence.<\/p>\n

Indikace a d\u00e1vkov\u00e1n\u00ed<\/h2>\n
\n\n\n\n\n\n\n\n\n\n\n
Indikace<\/th>\nD\u00e1vka<\/th>\nD\u00e9lka l\u00e9\u010dby \/ pozn\u00e1mky<\/th>\n<\/tr>\n<\/thead>\n
Revmatoidn\u00ed artritida (m\u00edrn\u00e1 a\u017e st\u0159edn\u011b z\u00e1va\u017en\u00e1)<\/td>\n200\u2013400 mg\/den v 1\u20132 d\u00e1vk\u00e1ch (max. 5 mg\/kg\/den skute\u010dn\u00e9 t\u011blesn\u00e9 hmotnosti)<\/td>\nN\u00e1stup \u00fa\u010dinku za 8\u201312 t\u00fddn\u016f. Dlouhodob\u00e1 udr\u017eovac\u00ed l\u00e9\u010dba. \u010casto kombinov\u00e1no s methotrex\u00e1tem nebo sulfasalazinem.<\/td>\n<\/tr>\n
Syst\u00e9mov\u00fd lupus erythematodes (SLE)<\/td>\n200\u2013400 mg\/den, max. 5 mg\/kg\/den<\/td>\nZ\u00e1kladn\u00ed terapie pro t\u00e9m\u011b\u0159 v\u0161echny pacienty se SLE dle EULAR \u2014 sni\u017euje vzplanut\u00ed, po\u0161kozen\u00ed org\u00e1n\u016f, tromb\u00f3zu a zlep\u0161uje p\u0159e\u017eit\u00ed.<\/td>\n<\/tr>\n
Discoid \/ cutaneous lupus<\/td>\n200\u2013400 mg\/den<\/td>\nPrvn\u00ed volba syst\u00e9mov\u00e9 l\u00e9\u010dby u lupusu postihuj\u00edc\u00edho pouze k\u016f\u017ei. Viditeln\u00e9 zlep\u0161en\u00ed m\u016f\u017ee trvat 8\u201312 t\u00fddn\u016f.<\/td>\n<\/tr>\n
Sj\u00f6gren\u016fv syndrom<\/td>\n200\u2013400 mg\/den<\/td>\nM\u00edrn\u011b prok\u00e1zan\u00e9 zlep\u0161en\u00ed \u00fanavy a artralgie; minim\u00e1ln\u00ed \u00fa\u010dinek na suchost.<\/td>\n<\/tr>\n
Akutn\u00ed nekomplikovan\u00e1 chlorochin-citliv\u00e1 P. falciparum \/ P. vivax \/ P. ovale \/ P. malariae<\/td>\n800 mg \u00favodn\u00ed d\u00e1vka \u2192 400 mg po 6 h \u2192 400 mg po 24 h \u2192 400 mg po 48 h (celkem 2 g za 48 h)<\/td>\nL\u00e9\u010debn\u00fd re\u017eim pouze pro oblasti citliv\u00e9 na chlorochin. K radik\u00e1ln\u00edmu vyl\u00e9\u010den\u00ed vivax\/ovale p\u0159idejte primachin.<\/td>\n<\/tr>\n
Profylaxe chlorochin-citliv\u00e9 mal\u00e1rie<\/td>\n400 mg jednou t\u00fddn\u011b<\/td>\nZa\u010dn\u011bte 1\u20132 t\u00fddny p\u0159ed cestou, pokra\u010dujte t\u00fddn\u011b b\u011bhem expozice, pokra\u010dujte 4 t\u00fddny po n\u00e1vratu. Omezen\u00e1 modern\u00ed vyu\u017eitelnost \u2014 v\u011bt\u0161ina destinac\u00ed je rezistentn\u00edch.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n
Varov\u00e1n\u00ed p\u0159ed retin\u00e1ln\u00ed toxicitou (\u010derven\u00fd r\u00e1me\u010dek).<\/strong> Hydroxychlorochin se kumuluje v pigmentov\u00e9m epitelu s\u00edtnice. Riziko nevratn\u00e9 makulopatie s obrazem b\u00fd\u010d\u00edho oka<\/strong> v\u00fdrazn\u011b stoup\u00e1 po 5 letech kontinu\u00e1ln\u00edho u\u017e\u00edv\u00e1n\u00ed, zejm\u00e9na p\u0159i d\u00e1vk\u00e1ch > 5 mg\/kg\/den skute\u010dn\u00e9 t\u011blesn\u00e9 hmotnosti, p\u0159i ren\u00e1ln\u00ed insuficienci, p\u0159i sou\u010dasn\u00e9m u\u017e\u00edv\u00e1n\u00ed tamoxifenu nebo u pacient\u016f s p\u0159edchoz\u00edm onemocn\u011bn\u00edm s\u00edtnice. Doporu\u010den\u00ed Americk\u00e9 akademie oftalmologie \/ Kr\u00e1lovsk\u00e9 koleje oftalmolog\u016f: vstupn\u00ed vy\u0161et\u0159en\u00ed o\u010dn\u00edho pozad\u00ed na za\u010d\u00e1tku dlouhodob\u00e9 terapie + ka\u017edoro\u010dn\u00ed screening od 5. roku<\/strong> pomoc\u00ed spektr\u00e1ln\u00ed dom\u00e9ny OCT, automatizovan\u00e9ho zorn\u00e9ho pole 10-2 (b\u00edl\u00fd testovac\u00ed objekt) a autofluorescence o\u010dn\u00edho pozad\u00ed. D\u0159\u00edv\u011bj\u0161\u00ed screening p\u0159i d\u00e1vce > 5 mg\/kg\/den, ren\u00e1ln\u00edm CrCl < 60 ml\/min nebo sou\u010dasn\u00e9m u\u017e\u00edv\u00e1n\u00ed tamoxifenu. L\u00e9k vysa\u010fte p\u0159i prvn\u00edm n\u00e1znaku p\u0159edtoxicity \u2014 ji\u017e vznikl\u00e9 po\u0161kozen\u00ed se nevr\u00e1t\u00ed.<\/div>\n
Pozn\u00e1mka k G6PD.<\/strong> Hydroxychlorochin m\u00e1 mnohem men\u0161\u00ed sign\u00e1l G6PD-hemol\u00fdzy ne\u017e primachin, ale u t\u011b\u017ek\u00e9ho deficitu G6PD existuj\u00ed kazuistiky. Pokud nen\u00ed stav G6PD zn\u00e1m, monitorujte hemol\u00fdzu (tmav\u00e1 mo\u010d, bledost, \u00fanava) v prvn\u00edch t\u00fddnech vysokod\u00e1vkov\u00e9 terapie.<\/div>\n

Pl\u00e1n monitorov\u00e1n\u00ed<\/h2>\n
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\u010casov\u00fd bod<\/th>\nVy\u0161et\u0159en\u00ed<\/th>\nD\u016fvod<\/th>\n<\/tr>\n<\/thead>\n
V\u00fdchoz\u00ed hodnota<\/td>\nO\u010dn\u00ed vy\u0161et\u0159en\u00ed (fundus + OCT + zorn\u00e9 pole), FBC, U&E, jatern\u00ed testy, gluk\u00f3za, hmotnost<\/td>\nStanoven\u00ed v\u00fdchoz\u00edho stavu s\u00edtnice + v\u00fdpo\u010det d\u00e1vky podle aktu\u00e1ln\u00ed hmotnosti + screening kontraindikac\u00ed.<\/td>\n<\/tr>\n
M\u011bs\u00edce 1\u20136<\/td>\nHodnocen\u00ed p\u0159\u00edznak\u016f p\u0159i ka\u017ed\u00e9m klinick\u00e9m kontaktu<\/td>\nGI tolerance, bolest hlavy, n\u00e1lada, ko\u017en\u00ed vyr\u00e1\u017eka, svalov\u00e1 slabost.<\/td>\n<\/tr>\n
Rok 1, pot\u00e9 ka\u017edoro\u010dn\u011b<\/td>\nFBC + jatern\u00ed testy<\/td>\nVz\u00e1cn\u00e9 cytopenie a vz\u00e1cn\u00e9 hepatotoxick\u00e9 \u00fa\u010dinky.<\/td>\n<\/tr>\n
Rok 5, pot\u00e9 ka\u017edoro\u010dn\u011b<\/td>\nKomplexn\u00ed o\u010dn\u00ed screening (OCT + 10-2 zorn\u00e9 pole + autofluorescence fundu)<\/td>\nDetekce \u010dasn\u00e9 retinopatie p\u0159ed nevratn\u00fdm po\u0161kozen\u00edm.<\/td>\n<\/tr>\n
Na z\u00e1klad\u011b p\u0159\u00edznak\u016f<\/td>\nCK + EMG p\u0159i proxim\u00e1ln\u00ed slabosti; vy\u0161et\u0159en\u00ed nervov\u00e9ho veden\u00ed p\u0159i neuropatick\u00fdch p\u0159\u00edznac\u00edch<\/td>\nVz\u00e1cn\u011b myopatie\/neuromyopatie p\u0159i dlouhodob\u00e9m u\u017e\u00edv\u00e1n\u00ed.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n