Mankhwala Finlepsin: malangizo ntchito

Malinga ndi malangizo omwe aperekedwa ku Finlepsin, zomwe zikuwonetsedwa:

khunyu (kuphatikizapo kusakhalapo, zoopsa, khunyu),
idiopathic trigeminal neuralgia,
wamba ndi atypical trigeminal neuralgia yoyambitsidwa ndi sclerosis yambiri,
idiopathic neuralgia ya glossopharyngeal nerve,
pachimake manic (mu mawonekedwe a monotherapy kapena mankhwala osakaniza),
mavuto okhudzana ndi gawo
kuletsa mowa,
matenda a shuga
polydipsia ndi polyuria yoyambira ya neurohormonal.

Malangizo Finlepsin

Malangizo a Finlepsin amafotokozera njira zotsutsana motere:

Hypersensitivity kwa carbamazepine,
kuphwanya mafupa hematopoiesis,
pachimake porphyria,
Kugwiritsa ntchito zoletsa za MAO,
AV blockade.

Finlepsin iyenera kugwiritsidwa ntchito mosamala pakuwonongeka kwa mtima, ADH hypersecretion syndrome, hypopituitarism, adrenal cortex kusakwanira, hypothyroidism, uchidakwa wogwira ntchito, ukalamba, kulephera kwa chiwindi, kuchuluka kwazovuta za intraocular.

Zotsatira zoyipa za finlepsin

Zotsatira zoyipa izi zimanenedwa pomwe Finlepsin amagwiritsidwa ntchito:

kumbali ya National Assembly: chizungulire, kupweteka mutu, kusokonezeka kwa malingaliro, chikumbumtima, kuyerekezera zinthu zina, zolimbitsa thupi, kupanikizana,
Kuchokera m'mimba: kusanza, nseru, kuchuluka kwa mankhwalawa,
kuchokera ku CCC: kuchuluka kapena kuchepa kwa kuthamanga kwa magazi, kuchepa kwa mtima, kuphwanya kwa kapangidwe ka AV,
kuchokera ku hematopoietic dongosolo: kuchepa kwa chiwerengero cha ma neutrophils, maselo oyera am'magazi, mapanelo
Kuchokera impso: oliguria, hematuria, nephritis, edema, kulephera kwa impso,
Kuchokera kupuma:
kuchokera ku dongosolo la endocrine: kuwonjezeka kwa milingo ya prolactin, yothandizidwa ndi galactorrhea, gynecomastia, kusintha kwa kuchuluka kwa mahomoni a chithokomiro.
ena: matupi awo sagwirizana, kuphatikizapo matenda a Stevens-Johnson.

Zotsatira zoyipa zambiri zimayambitsa malingaliro a Finlepsin kuchokera kwa odwala. Pofuna kupewa kuwoneka kapena kuchepetsa kuwonda, mutha kugwiritsa ntchito Finlepsin mogwirizana ndi malangizo omwe ali ndi mlingo wokwanira komanso moyang'aniridwa ndi achipatala.

Njira ya ntchito, Mlingo wa finlepsin

Finlepsin ndi yogwiritsa ntchito pakamwa. Mlingo woyambira wa akulu ndi 0,2-0.3 g patsiku. Pang'onopang'ono, Mlingo umakwera mpaka 1.2 g. Mlingo wambiri watsiku ndi tsiku ndi 1.6 g. Mlingo wa tsiku ndi tsiku umapangidwira mitundu itatu kapena inayi, yayitali - pakadutsa kamodzi kapena kawiri.

Mlingo wa Finlepsin wa ana ndi 20 mg / kg. Mpaka wazaka 6, mapiritsi a Finlepsin sagwiritsidwa ntchito.

Kugwirizana kwa Finlepsin ndi mankhwala ena

Kugwiritsa ntchito nthawi yomweyo kwa Finlepsin ndi ma MA inhibitors sikuvomerezeka. Ma anticonvulsants ena amatha kuchepetsa anticonvulsant zotsatira za Finlepsin. Ndi munthawi yomweyo makonzedwe a mankhwalawa ndi valproic acid, n`zotheka kukhala ndi vuto la chikumbumtima. Finlepsin imawonjezera kuwopsa kwa kukonzekera kwa lifiyamu. Pogwiritsa ntchito munthawi yomweyo macrolides, calcium blockers, isoniazid, cimetidine ndi Finlepsin, kuchuluka kwa plasma kwamapeto kumawonjezeka. Finlepsin amachepetsa ntchito za anticoagulants ndi njira zakulera.

Bongo

Ndi mankhwala osokoneza bongo a Finlepsin, kuphwanya chikumbumtima, kupsinjika kwa kupuma ndi mtima, kutsekeka kwa magazi, komanso kuwonongeka kwa impso ndikotheka. Chithandizo chosadziwika: chapamimba cha m'mimba, kugwiritsa ntchito mankhwala othandizira ndi ma enterosorbents. Chifukwa cha kuthekera kwakukulu kwa mankhwalawa kumangiriza mapuloteni a plasma, peritoneal dialysis ndi kukakamizidwa diuresis wokhala ndi bongo wa Finlepsin sikugwira ntchito. Hemosorption pamankhwala amalaala amachitika. Mwa ana aang'ono, kuthandizira wina magazi ndi kotheka.

Chifukwa cha kuchuluka kwa mankhwalawa, kuthekera kwa kupereka mankhwala munthawi zosiyanasiyana, kuwunika kwa Finlepsin ndi kwabwino. Mankhwala ali ogwira antiepileptic kwenikweni, analgesic zotsatira za neuralgia.

Malangizo apadera

Musanagwiritse ntchito mankhwalawa, ndikofunikira kuphunzira malangizo a Finlepsin mwatsatanetsatane.

Mukamasankha mulingo woyenera, ndibwino kudziwa kuchuluka kwa plasma ya carbamazepine. Kuchoka kwadzidzidzi kwa mankhwalawa kumatha kudzetsa khunyu. Kuwunika kwa hepatic tramsaminases ndikofunikira popereka Finlepsin. Malinga ndi zikuwonetsa mosamalitsa, Finlepsin ikhoza kugwiritsidwa ntchito ndi odwala omwe ali ndi kukhudzika kwamkati mwa intraocular, koma chizindikiro ichi chikuyenera kuyang'aniridwa.

Kutulutsa mawonekedwe ndi kapangidwe kake

Finlepsin imapezeka m'mapiritsi: ozungulira, wokhala ndi bevel, yoyera, yodziwika mbali imodzi ndipo ali ndi chiwopsezo chowoneka ngati chotchinga - mbali inayo (ma PC 10. M'matumba, pamakatoni oikidwa 3, 4 kapena 5 matuza).

Mapangidwe piritsi limodzi:

yogwira mankhwala: carbamazepine - 200 mg,
othandizira: gelatin, magnesium stearate, microcrystalline cellulose, croscarmellose sodium.

Mankhwala

Finlepsin ndi antiepileptic mankhwala. Ilinso ndi antipsychotic, antidiuretic ndi antidepressant. Odwala neuralgia, limawonetsa analgesic kwenikweni.

Kupanga kwa kachitidwe ka carbamazepine kumachitika chifukwa cha kutsekeka kwa njira zamagetsi zomwe zimadalira mphamvu yamagetsi, zomwe zimathandizira kukhazikika kwa ma membrane am'mitsempha yamaukosi, zimayambitsa zoletsa zamitsempha yama cell amitsempha ndikuchepetsa kuperekera kwamkati mwa ma synapses. Kuchita kwa carbamazepine kumalepheretsa kupangidwanso kwa mphamvu mu maselo otayika a neuronal, kumachepetsa kumasulidwa kwa glutamate (chosangalatsa cha neurotransmitter amino acid), kumawonjezera kulanda kwa khunyu yapakati ndipo, chifukwa chake, kumachepetsa chiopsezo cha kugwidwa. Mphamvu ya anticonvulsant ya Finlepsin imakhalanso chifukwa cha kusinthasintha kwa njira zamagetsi zamagetsi zamagetsi a 2 2 ndikuwonjezereka kwa K + conductor.

Carbamazepine ndiwothandiza kugwidwa kosavuta ndi kosavuta kwa khunyu (kapena popanda kuphatikiza kwachiwiri), ndimakokedwe a matenda a tonic komanso matenda osiyanasiyana. Mankhwala nthawi zambiri amakhala osagwira kapena sagwira ntchito pang'onopang'ono kukomoka (kusowa, kukomoka kwa myoclonic, petit mal).

Odwala omwe ali ndi khunyu (makamaka paubwana ndi unyamata), mankhwalawa amakhudza bwino zizindikiro za kupsinjika ndi nkhawa, komanso amachepetsa kukwiya komanso kuchita ukali.

Mphamvu ya Finlepsin pa psychomotor magwiridwe antchito ndikuzindikira kumadalira mlingo.

Mphamvu ya anticonvulsant ya mankhwalawa imayamba maola angapo mpaka masiku angapo, ndipo nthawi zina mpaka mwezi umodzi.

Odwala omwe ali ndi trigeminal neuralgia, Finlepsin, monga lamulo, amateteza kupezeka kwa matenda opweteka. Kuchepetsa kwa ululu wamankhwala kumawonedwa mosiyanasiyana kuyambira maola 8 mpaka 72 atatha kumwa mankhwalawo.

Ndi kusiya kwa mowa, carbamazepine imawonjezera kuchepa kwa chiyembekezo chotsimikizika, komanso kumachepetsa kuuma kwa zizindikiro zamatenda monga kugwedezeka, kuwonjezeka kwa mkwiyo ndi chiwopsezo champhamvu.

Mphamvu ya antipsychotic ya mankhwalawa imayamba pambuyo pa masiku 7-10, omwe amatha kuphatikizidwa ndi zoletsa za norepinephrine ndi dopamine.

Pharmacokinetics

Carbamazepine pang'onopang'ono koma odzipereka kwathunthu. Kudya pafupifupi sikukhudza kuchuluka ndi kuthamanga kwa mayamwidwe. Pazitali ya plasma ndende imafika maola 12 mutamwa kamodzi. Kufanana kwa plasma mozungulira kumachitika pambuyo pa masabata 1-2, kutengera umunthu wa kagayidwe, komanso mlingo wa mankhwalawo, mkhalidwe wa wodwalayo komanso nthawi yayitali.

Mu ana, carbamazepine amamangiriza mapuloteni a plasma ndi 55-59%, mwa akulu - mwa 70-80%. Kuchuluka kwawogawa mankhwalawa ndi 0.8-1.9 l / kg. Carbamazepine amawoloka chotchinga ndipo amachotseredwa mkaka wa m'mawere (kuchuluka kwake mkaka wa mayi woyamwitsa ndi 25-60% ya kuchuluka kwa carbamazepine mu plasma).

Kagayidwe ka mankhwala kumachitika mu chiwindi, makamaka panjira ya epoxy. Zotsatira zake, metabolites yotsatirayi imapangidwa: yogwira metabolite - carbamazepine-10,11-epoxide, metabolite wosagwira - amalumikizana ndi glucuronic acid. Zotsatira zamachitidwe a metabolic, mapangidwe a metabolite osagwira, 9-hydroxymethyl-10-carbamoylacridane, ndizotheka. Mkulu wa metabolite yogwira ndi 30% ya ndende ya carbamazepine.

Mutamwa kamodzi muyezo wa mankhwalawo, theka-moyo ndi maola 25-65, mutatha kugwiritsa ntchito mobwerezabwereza - maola 12- 24 (kutengera nthawi yayitali ya mankhwala). Odwala omwe amaphatikizanso anticonvulsants ena (mwachitsanzo, phenobarbital kapena phenytoin), theka la moyo limatsitsidwa mpaka maola 9-10.

Patatha kamodzi muyezo wa Finlepsin, pafupifupi 28% ya mankhwalawo amatengedwa mu ndowe ndi 72% mkodzo.

Ana, chifukwa cha kuthamanga kwa carbamazepine, kugwiritsa ntchito mankhwalawa kwa mankhwala okwanira kilogalamu iliyonse ya thupi kungafunike.

Zambiri pazakusintha kwa pharmacokinetics a Finlepsin mwa odwala okalamba siziperekedwa.

Mlingo ndi makonzedwe

Finlepsin amatengedwa pakamwa ndi madzi okwanira kapena madzi ena. Mapiritsi ayenera kumwedwa ndi chakudya kapena mukatha kudya.

Ndi khunyu, ndikofunika kupaka mankhwala momwe mungapangire monotherapy. Mukalumikizana ndi Finlepsin ku mankhwala othandizira antiepileptic, kusamala ndi pang'onopang'ono kuyenera kuchitika, ngati kuli kotheka, kusintha momwe mankhwalawa amagwiritsidwira ntchito.

Mukadumpha mlingo wotsatira, muyenera kumwa piritsi lomwe mwasowa mukangokumbukira izi. Simungathe kutenga kawiri mlingo wa carbamazepine.

Zochizira khunyu, muyeso woyamba wa Finlepsin kwa akulu ndi achinyamata opitirira zaka 15 ndi 200-400 mg patsiku. Pambuyo pake, mlingo umakulitsidwa pang'onopang'ono mpaka mulingo woyenera wabwino kwambiri. Pafupifupi kukonzanso kwa mankhwalawa amachokera 800 mpaka 1200 mg wa tsiku patsiku la 1-3. Mlingo waukulu wa akuluakulu ndi 1600-2000 mg patsiku.

Kwa ana omwe ali ndi khunyu, mankhwalawa amapatsidwa mankhwala otsatirawa:

ana a zaka 1 mpaka 5: 100-200 mg patsiku kumayambiriro kwa mankhwalawa, pang'onopang'ono, mankhwalawa amawonjezeka ndi 100 mg patsiku mpaka njira yothandizidwa itakwaniritsidwa, mlingo wowonjezera ndi 200-400 mg patsiku muyezo zingapo.
ana azaka zapakati pa 6 mpaka 10: 200 mg patsiku, mtsogolomo, pang'onopang'ono, mankhwalawa amawonjezeka ndi 100 mg patsiku mpaka njira yothandizidwa itakwaniritsidwa, mankhwala okonza ndi 400-600 mg patsiku mu 2-3
ana ndi achinyamata azaka za 11-15 zaka: 100-300 mg wa patsiku, ndikuwonjezereka pang'onopang'ono kwa mlingo ndi 100 mg patsiku mpaka zotsatira zomwe mukufuna, njira yokonza ndi 600-1000 mg patsiku mu Mlingo wa 2-3.

Ngati mwana sangathe kumeza piritsi la Finlepsin lonse, amatha kuphwanya, kutafuna kapena kugwedezeka m'madzi ndikumwa njira yothetsera.

Kutalika kwa mankhwalawa kwa khunyu kumatengera zomwe akuwonetsa komanso zomwe wodwalayo amayankha. Dokotala amasankha kutalika kwa mankhwalawa kapena kusiya kwa Finlepsin payekhapayekha kwa wodwala aliyense. Funso loti muchepetse mulingo kapena kusiya kumwa mankhwalawo limaganiziridwa pambuyo pa chithandizo cha zaka 2-3, pomwe kulanda kulibe.

Mlingo wa Finlepsin umachepetsedwa pang'onopang'ono zaka 1-2, kuyang'anira electroencephalogram nthawi zonse. Ndi kuchepa kwa tsiku ndi tsiku mu ana, ndikofunikira kuti muganizire kuchuluka kwakuthana ndi kulemera kwa thupi.

Ndi idiopathic glossopharyngeal neuralgia ndi trigeminal neuralgia, mlingo woyambirira wa mankhwalawa ndi 200-400 mg patsiku. M'tsogolomu, iwonjezedwa mpaka 400-800 mg mu Mlingo wa 1-2. Chithandizo chimapitilizidwa mpaka ululuwo utazimiririka. Mwa odwala ena, n`zotheka kugwiritsa ntchito carbamazepine muyezo wotsikirapo wokonza - 200 mg kawiri pa tsiku.

Okalamba odwala ndi omwe ali ndi hypersensitivity kwa Finlepsin, mankhwalawa adapangidwira muyeso yoyamba, womwe ndi 200 mg patsiku 2 waukulu.

Chithandizo cha kumwa mochizira matenda amachitika kuchipatala. Mankhwala ndi mankhwala pafupifupi tsiku lililonse la 600 mg mu 3 oga magawo. Muzovuta kwambiri, mlingo wa carbamazepine ukuwonjezeka mpaka 1200 mg tsiku lililonse 3 waukulu. Ngati ndi kotheka, mankhwalawa angagwiritsidwe ntchito nthawi yomweyo ndi mankhwala ena mankhwalawa akumwa mowa. Chithandizo chimayimitsidwa pang'onopang'ono kwa masiku 7-10. Munthawi yonse ya chithandizo, wodwalayo ayenera kuyang'aniridwa mosamala chifukwa cha zovuta zomwe zingachitike chifukwa cha mantha.

Ululu womwe umachitika chifukwa cha matenda ashuga a m'mimba, Finlepsin ndi mankhwala pafupifupi tsiku lililonse a 600 mg mu katatu. Mwapadera, mankhwalawa amawonjezera mpaka 1200 mg wa tsiku lililonse 3 mgulu.

Zochizira komanso kupewa psychosis, carbamazepine amadziwitsidwa tsiku lililonse 200-400 mg ndi kuchuluka kwa mankhwala, ngati n`koyenera, kwa 800 mg tsiku lililonse 2 mg.

Ndi kupweteka kwa khunyu kokhudzana ndi ma sclerosis ambiri, Finlepsin ndi mankhwala a 400-800 mg mu 2 mg.

Zotsatira zoyipa

Zotsatira zoyipa za mankhwala kuchokera ku chapakati mantha dongosolo mwina chifukwa cha wachibale bongo wa carbamazepine kapena kusinthasintha kwakukulu mu ndende ya mankhwala mu magazi.

Mukamalandira mankhwala a Finlepsin, mavuto obwera chifukwa cha machitidwe ndi ziwalo zotsatirazi zingachitike:

kupukusa m'mimba: kukamwa kambiri, kusanza, nseru, kuchuluka kwa zam'mimba zotupa zam'mimba, nthawi zina kudzimbidwa kapena kutsekula m'mimba, kupweteka pamimba, kuchuluka kwa michere ya chiwindi, kawirikawiri stomatitis, gingivitis, glossitis, parenchymal ndi cholestatic hepatitis, granulomatous hepatitis, jaundice, kapamba, kulephera kwa chiwindi,
mtima dongosolo: kawirikawiri - kuchuluka kapena kuchepa kwa kuthamanga kwa magazi, kukula kapena kukulira kwa mtima kulephera, bradycardia, kuchulukitsa kwa matenda a mtima, thromboembolic syndrome, kusokonezeka kwa intracardiac conduction, block atrioventricular, limodzi ndi kukomoka, thrombophlebitis, kugwa,
Pakati mantha dongosolo: pafupipafupi - kupweteka mutu, kugona, chizungulire, kupuma kwa malo okhala, ataxia, kufooka wamba, nthawi zina - nystagmus, kusowa kwadzidzidzi kungoyambira, kawirikawiri - kutaya chidwi, kusokonezeka kwa mawu, nkhawa, kufooka kwa minyewa, kukhumudwa kwa psychomotor paresis, makutu kapena zowonera, kusokonezeka kwa oculomotor.
ziwalo zam'malingaliro: kawirikawiri - conjunctivitis, kugundika kwa mandala, kusokonezeka kwa kukoma, kuwonongeka kwa kumva, kuwonjezeka kwa magazi,
Genitourinary dongosolo: kawirikawiri - kwamikodzo posungira, kukodza pafupipafupi, kusokonekera kwa impso, ma nephritis apakati, kuchepa kwa potency, kulephera kwa impso,
minofu: Mafupa a minofu ndi mafupa,
kagayidwe ndi endocrine dongosolo: Nthawi zambiri - kuchuluka kwa thupi, edema, hyponatremia, madzi osungika, osowa - kuwonjezeka kwa kuchuluka kwa chithokomiro cholimbitsa ndi prolactin, kuchepa kwa ndende ya L-thyroxin, calcium ndi phosphorous metabolism m'mafupa, hypertriglyceridemia, hypercholesterolemia, hypercholesterolemia kukula kwa zamitsempha
hematopoietic dongosolo: Nthawi zambiri - eosinophilia, thrombocytopenia, leukopenia, kawirikawiri - agranulocytosis, leukocytosis, reticulocytosis, hemolytic, megaloblastic ndi aplastic anemia, lymphadenopathy, splenomegaly, kuperewera kwa asidi wa folic acid, erythrocyte aramid
thupi lawo siligwirizana: pafupipafupi - zotupa tulo, nthawi zina - organic ambiri anachedwa mtundu wa hypersensitivity zimachitikira, anaphylactoid zimachitika, matupi awo sagwirizana, chiberekero cha Quincke, aseptic meningitis, chibayo cha eosinophilic, kawirikawiri - kuyabwa pakhungu, kufooka kwa mafupa a khungu
zina zimachitika: ziphuphu zakumaso, kuchepa kwa tsitsi, kufinya, thukuta kwambiri, kuphwanya khungu.

Mimba komanso kuyamwa

Ndikofunika kuti azimayi azaka zobadwa ndi mwana apereke mankhwala a Finlepsin m'njira yothandizirana kwambiri komanso mwanjira yotsika kwambiri, popeza pafupipafupi zovuta zina zatsopano zokhala ndi ana omwe amayi awo analandila antiepileptic mankhwala ndi apamwamba kuposa mwa ana omwe amayi awo amalandila carbamazepine okha.

Amayi oyembekezera, makamaka pa trimester yoyamba, mankhwalawa amayikidwa mosamala, poganizira zabwino zomwe zingachitike komanso zovuta zomwe zingachitike. Finlepsin imatha kukulitsa vuto la kukula kwa intrauterine mu akhanda omwe amayi awo ali ndi khunyu.

Mankhwala othandizira antiepileptic amalimbikitsa kuchepa kwa folic acid, omwe nthawi zambiri amawonedwa mwa amayi apakati, kotero pokonzekera kutenga pakati komanso ngati zikuchitika, prophylactic management of folic acid tikulimbikitsidwa. Pofuna kupewa matenda a hemorrhagic mu makanda, amayi kumapeto kwa pakati komanso akhanda amalimbikitsidwa kuti apereke vitamini K₁.

Finlepsin imadutsa mkaka wa m'mawere, kotero ndimankhwala omwe akupitiliza nthawi yoyamwitsa, mapindu omwe akuyembekezeredwa kwa mayi ndi chiwopsezo chotheka kwa mwana ayenera kuyesedwa.

Kuyanjana kwa mankhwala osokoneza bongo

The kuchuluka kwa carbamazepine m'magazi kumawonjezereka ndi munthawi yomweyo kugwiritsa ntchito Finlepsin ndi zinthu zotsatirazi ndi kukonzekera (kukonza mlingo wa carbamazepine kapena kuwunika kwake kuchuluka kwa plasma ndikofunikira): felodipine, viloxazine, fluvoxamine, acetazolamide, desipramine, verapamil, dextropropide mwa achikulire okha komanso muyezo waukulu), diltiazem, azoles, macrolides, loratadine, isoniazid, HIV protease zoletsa, terfenadine, propoxyphene, madzi a mphesa.

Anthu ambiri carbamazepine magazi amachepetsa pamene ntchito Finlepsinum ndi zinthu zotsatirazi mankhwala: phenytoin, metsuksimid, theophylline, cisplatin, phenobarbital primidone, rifampicin, doxorubicin, fensuksimid mulole - asidi valproic, clonazepam, oxcarbazepine, valpromid, kukonzekera za Hypericum perforatum.

Carbamazepine kungachepetse woipa plasma mankhwala zotsatirazi: clonazepam, ethosuximide, asidi valproic, dexamethasone, prednisolone, tetracycline, methadone, theophylline, lamotrigine, tricyclic antidepressants, clobazam, digoxin, primidone, alprazolam, cyclosporine, haloperidol, anticoagulants m'kamwa, topiramate, felbamate, clozapine , HIV protease inhibitors, kukonzekera kwapakamwa komwe kumakhala ndi progesterone ndi / kapena estrogens, calcium blockers, tiagabine, levothyroxine, olazapine, risperidone, ciprasidone, oxcarbazepi n, praziquantel, tramadol, itraconazole, midazolam.

Ndi kuphatikiza kwa Finlepsin ndi kukonzekera kwa lifiyamu, ndikotheka kupititsa patsogolo zotsatira za mankhwalawa onse, ndimatumbo - zimatha kufooketsa zovuta zochizira za carbamazepine, ndi paracetamol - chiwopsezo cha zovuta za paracetamol pa chiwindi chimawonjezeka ndipo mphamvu yake imachepa, ndi ma diuretics, hyponatremia Mowa, ndi isoniazid - mphamvu ya hepatotoxic ya isoniazid imalimbikitsidwa, popewa kupumula kwa minofu - tanthauzo limafooka. relaxants minofu, ndi mankhwala myelotoxic - carbamazepine kumatheka haematotoxicity.

Mphamvu ya anticonvulsant ya Finlepsin imatsika ndikugwiritsa ntchito munthawi yomweyo ndi pimozide, haloperidol, clozapine, phenothiazine, molindone, maprotiline, thioxanthenes ndi ma tridclicants atatu.

Carbamazepine imathandizira kagayidwe kazakudya zakuberekera kwa mahomoni, ma anticoagulants, ma anesthetics, praziquantel ndi folic acid, komanso zimathandizanso kubisa kwa mahomoni a chithokomiro.

Zofanizira za Finlepsin ndi: Zeptol, Carbamazepine, Carbamazepine-Akrikhin, Carbamazepin-Ferein, Carbamazepine retard-Akrikhin, Tegretol TsR, Tegretol, Finlepsin retard.

Ndemanga za Finlepsin

Odwala omwe akhala akumwa mankhwalawo kwa zaka zingapo, komanso abale awo, amasiya ndemanga zabwino za Finlepsin, popeza chithandizo cha khunyu chimatha chifukwa cha chithandizo. Nthawi yomweyo, odwala ena amawona zovuta za mankhwalawa pazinthu zanzeru. Makamaka, adazindikira kuphwanya kwa kayendedwe ka anthu komanso mawonekedwe a mphwayi.

Finlepsin adapezeka kuti ndiwothandiza pothana ndi mavuto a mantha, koma kusakhazikika kwa gait kumapitilira kwa odwala ena.

Zotsatira za pharmacological

Mankhwala othandizira antiepileptic (dibenzazepine derivative), omwe ali ndi antidepressant, antipsychotic ndi antidiuretic kwenikweni, ali ndi mphamvu ya analgesic kwa odwala a neuralgia.

Limagwirira ntchito limalumikizidwa ndi blockade yamagetsi yamagetsi-gated sodium, komwe kumayambitsa kukhazikika kwa membrane wa overexcited neurons, kuletsa mawonekedwe a serial kutulutsa kwa neurons ndi kuchepa kwa synaptic impulse impuction. Imalepheretsa kupangidwanso kwa Na + -kudalira kothandizirana mu ma neurons a depolarized. Kuchepetsa kumasulidwa kwa neurotransmitter amino acid - glutamate, kumawonjezera kugunda kwapakati pa dongosolo lamanjenje lamkati, motero, kumachepetsa chiopsezo chodwala khunyu. Imawonjezera kuyendetsa kwa K +, modulates vol-gated Ca 2+ njira, zomwe zimathandizanso pakuyambitsa kwa anticonvulsant ya mankhwala.

Kugwira zolimba mozungulira (zochepa komanso zovuta), kutsagana kapena kutsagana ndi kutsata kwachiwiri, kwa kugwidwa mwamtundu wa tonic-clonic, komanso kuphatikiza kwa mitundu iyi ya kukomoka (nthawi zambiri sikugwira ntchito pakukoka kwazing'ono - petit mal, kulibe komanso kugwidwa myoclonic). Odwala omwe ali ndi khunyu (makamaka ana ndi achinyamata) amakhala ndi zotsatira zabwino pazizindikiro za nkhawa komanso kukhumudwa, komanso kuchepa kwa kusakwiya komanso kukwiya. Zokhudzana ndi kuzindikira kwa ntchito ndi psychomotor magwiridwe ake amadalira mlingo. Kukhazikika kwa anticonvulsant zotsatira kumasiyana kwa maola angapo mpaka masiku angapo (nthawi zina mpaka mwezi umodzi chifukwa chogwiritsa ntchito kagayidwe kachakudya).

Ndi ofunika ndi sekondale yotupa neuralgia, carbamazepine nthawi zambiri imalepheretsa kuyambika kwa kupweteka. Kupumula kwamphamvu mu trigeminal neuralgia kumadziwika pambuyo pa maola 8-72.

Pankhani yakumwa mowa, kumawonjezera kugunda kovutikira, komwe kumakhala kofupikitsidwa pamenepa, ndikuchepetsa zovuta zakuchipatala kuwonekera kwa matenda (kuchuluka kosangalatsa, kugwedezeka, kusokonezeka kwa gait).

Machitidwe a antipsychotic (antimaniacal) amakula pambuyo pa masiku 7-10, mwina chifukwa cha kuletsa kwa kagayidwe ka dopamine ndi norepinephrine.

Kutalika kwa nthawi yayitali kumathandizira kuti magazi azisungika kwambiri m'magazi mukamamwa 1-2 pa tsiku.

Mimba komanso kuyamwa

Pomwe zingatheke, Finlepsin ® retard imalembedwera azimayi amisinkhu yobala ngati monotherapy, muyezo wogwira, monga pafupipafupi kusinthika kwa kubereka kwa akhanda kuchokera kwa amayi omwe anatenga mankhwala othandizira antiepileptic ndiwokwera kuposa ndi monotherapy.

Mimba ikachitika, ndikofunikira kuyerekeza phindu lomwe mungayembekezere la chithandizo chamankhwala ndi zovuta zomwe zingatheke, makamaka munthawi yoyamba kubereka. Amadziwika kuti ana a amayi omwe ali ndi vuto la khunyu amakhala okonzekera kutukuka kwa intrauterine, kuphatikizapo kusokonekera. Fardard ya Finlepsin ® imatha kuwonjezera chiwopsezo cha zovuta izi. Pali malipoti akutali a milandu yamatenda obadwa nawo komanso kusokonezeka, kuphatikizapo kusatseka kwa ziphuphu zakumaso (spina bifida).

Mankhwala othandizira antiepileptic amalimbikitsa kuchepa kwa folic acid, omwe nthawi zambiri amawonedwa panthawi yomwe ali ndi pakati, omwe amatha kukulitsa vuto la kubadwa kwa ana, chifukwa chake kutenga folic acid kumalimbikitsidwa asanakonzekere pakati komanso panthawi yomwe ali ndi pakati. Pofuna kupewa zovuta za hemorrhagic mwa ana akhanda, ndikulimbikitsidwa kuti amayi omwe ali m'milungu yotsiriza ya mimba, komanso akhanda, apatsidwe vitamini K.

Carbamazepine imadutsa mkaka wa m'mawere, motero maubwino komanso zosafunikira zoyamwitsa ziyenera kufananizidwa ndi chithandizo chanthawi zonse. Ndi kupitiriza kuyamwitsa pamene mukumwa mankhwalawa, muyenera kukhazikitsa kuwunika kwa mwanayo kuti athe kuyambika mosiyanasiyana (mwachitsanzo, kugona kwambiri, khungu lawo siligwirizana).

Mlingo ndi makonzedwe

MkatiMukamadya kapena mukatha kudya ndi madzi ambiri. Kuti mugwiritse ntchito mosavuta, piritsi (komanso theka kapena kotala) likhoza kusungunuka m'madzi kapena madzi, chifukwa Katundu wa ntchito yotulutsidwa kwa nthawi yayitali atatha kuyimitsa piritsi mumadziyo amasungidwa. Mlingo wambiri womwe umagwiritsidwa ntchito ndi 400-1200 mg / tsiku, womwe umagawidwa mu Mlingo wa 1-2 patsiku.

Pazipita mlingo tsiku lililonse sayenera kupitirira 1600 mg.

Ngati zingatheke, Finlepsin ® retard iyenera kutumizidwa ngati monotherapy. Chithandizo chimayamba ndikugwiritsa ntchito mlingo wocheperako tsiku lililonse, womwe umayamba kuwonjezeka pang'onopang'ono mpaka utakwaniritsidwa. Kuphatikizidwa kwa Finlepsin ® kubwezeretsanso kwa antiepileptic therapy kuyenera kuchitika pang'onopang'ono, pomwe Mlingo wa mankhwala ogwiritsidwa ntchito sasintha kapena, ngati pakufunika, ndikulondola. Ngati wodwalayo wayiwala kumwa mlingo wotsatira wa mankhwalawa munthawi yake, mlingo womwe watayika uyenera kumwedwa nthawi yomweyo mukazindikira izi, ndipo simungathe kumwa mankhwalawo pawiri.

Akuluakulu Mlingo woyambirira ndi 200-400 mg / tsiku, ndiye kuti mwambowu umakulitsidwa pang'onopang'ono mpaka zotsatira zabwino zithe. Mankhwala okonza ndi 800-1200 mg / tsiku, omwe amagawidwa mu Mlingo wa 1-2 patsiku.

Ana. Mlingo woyambirira wa ana kuyambira zaka 6 mpaka 15 ndi 200 mg / tsiku, ndiye kuti mlingo umakulitsidwa pang'onopang'ono ndi 100 mg / tsiku mpaka zotsatira zabwino. Mlingo wothandizira ana a zaka 6 mpaka 10 ndi 400-600 mg / tsiku (mu 2 waukulu), kwa ana azaka 11-15 - 600-1000 mg / tsiku (mu 2 waukulu).

Kutalika kwa nthawi ya ntchito kumatengera zomwe wodwala akalandira ndi chithandizo. Lingaliro la kusamutsa wodwalayo ku Finlepsin ® retard, nthawi yayitali yogwiritsidwa ntchito kwake komanso kuthetsa mankhwalawa kumatengedwa ndi dokotala. Kutheka kuchepetsa kuchuluka kwa mankhwalawa kapena kusiya kumwa mankhwala kumaganiziridwa patatha zaka zitatu kusakhalapo kwathunthu pakugwidwa.

Mankhwalawa amayimitsidwa, pang'onopang'ono kuchepetsa mlingo wa mankhwalawa kwa zaka 1-2, motsogozedwa ndi EEG. Mu ana, ndi kuchepa kwa mlingo wa tsiku ndi tsiku wa mankhwalawa, kuwonjezeka kwa thupi ndi msinkhu kuyenera kukumbukiridwa.

Trigeminal neuralgia, idiopathic glossopharyngeal neuralgia

Mlingo woyambirira ndi 200-400 mg / tsiku, omwe amagawidwa pawiri. Mlingo woyambirira umakulitsidwa mpaka ululuwo utazimiririka, pafupifupi mpaka 400-800 mg / tsiku. Pambuyo pake, mu gawo lina la odwala, chithandizo chitha kupitilizidwa ndi mlingo wochepetsetsa wa 400 mg.

Finlepsin ® retard imalembedwa mwa okalamba odwala ndi odwala omwe amazindikira Karabamazepine muyezo woyamba wa 200 mg kamodzi patsiku.

Ululu wa matenda ashuga a m'mimba

Wapakati tsiku lililonse 200 mg m'mawa ndi 400 mg madzulo. Mwapadera, Finlepsin ® retard imatha kutumikiridwa muyezo wa 600 mg 2 kawiri pa tsiku.

Chithandizo cha kumwa mchipatala

Pakati pa tsiku, pafupifupi 600 mg (200 mg m'mawa ndi 400 mg madzulo). Woopsa milandu, m'masiku oyamba, mlingo utha kuwonjezeka mpaka 1200 mg / tsiku, omwe amagawidwa pawiri.

Ngati ndi kotheka, Finlepsin ® retard ikhoza kuphatikizidwa ndi zinthu zina zomwe zimagwiritsidwa ntchito pochotsa zakumwa zoledzeretsa, kuwonjezera pa sedative-hypnotics.

Pa mankhwala, ndikofunikira kuwunika pafupipafupi zomwe zili m'magazi a carbamazepine.

Pokhudzana ndi kukhazikika kwa zoyipa kuchokera ku chapakati komanso zam'magazi azinthu, odwala amayang'aniridwa mosamala kuchipatala.

Epileptiform kugunda angapo sclerosis

Pafupifupi tsiku lililonse 200-500 mg 2 kawiri pa tsiku.

Chithandizo ndi kupewa psychosis

Mlingo woyambira ndi kukonza nthawi zambiri amakhala ofanana - 200-400 mg / tsiku. Ngati ndi kotheka, mlingo utha kuwonjezeka mpaka 400 mg 2 kawiri pa tsiku.

Kuchita ndi mankhwala ena

The munthawi yomweyo makonzedwe a carbamazepine ndi CYP3A4 zoletsa angapangitse kuwonjezeka ake kuchuluka kwa magazi am'magazi ndipo zimayambitsa zovuta. Kugwiritsa ntchito kwa CYP3A4 inducers kungayambitse kuchuluka kwa kagayidwe ka carbamazepine, kuchepa kwa kuchuluka kwa carbamazepine m'magazi am'magazi komanso kuchepa kwa njira yochiritsira, m'malo mwake, kuletsa kwawo kungachepetse kuchuluka kwa biotransfform ya carbamazepine ndikuwonjezera kuchuluka kwake.

The kuchuluka kwa carbamazepine mu plasma ukuwonjezeka ndi verapamil, diltiazem, felodipine, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, cimetidine, acetazolamide, danazole, desipramine, nicotinamide (mu akulu, kokha ecinythitis, diaccinthitis. (itraconazole, ketoconazole, fluconazole), terfenadine, loratadine, isoniazid, propoxyphene, madzi a mphesa, ma virus a proteinase inhibitors ogwiritsidwa ntchito pochiza matenda a HIV (mwachitsanzo ritonavir) - kusintha kwa mankhwalawa kumafunikira ndikuwunikira kuchuluka kwa plasma ya carbamazepine.

Felbamate amachepetsa kuchuluka kwa carbamazepine mu plasma ndikuwonjezera kuchuluka kwa carbamazepine-10,11-epoxide, pamene kuchepa kwamtundu womwewo mu seramu ya felbamate ndikotheka.

Mafuta a carbamazepine amachepetsedwa ndi phenobarbital, phenytoin, primidone, metsuximide, fensuximide, theophylline, rifampicin, cisplatin, doxorubicin, mwina clonazepam, valpromide, valproic acid, oxcarbazepine ndi mbewu zomwe zimakhala ndi St. (Hypericum perforatum). Pali kuthekera kosamutsidwa kwa carbamazepine ndi valproic acid ndi primidone kuchokera kumayanjano ndi mapuloteni a plasma ndikuwonjezereka kwa kuchuluka kwa pharmacologically yogwira metabolite (carbamazepine-10,11-epoxide). Ndi kuphatikiza kwa Finlepsin ndi valproic acid kuphatikizika, pazochitika zina, chikomokere ndi chisokonezo zimatha kuchitika. Isotretinoin amasintha bioavailability ndi / kapena chilolezo cha carbamazepine ndi carbamazepine-10,11-epoxide (kuwunika kuchuluka kwa carbamazepine mu plasma ndikofunikira).

Carbamazepine imachepetsa plasma ndende (ingachepetse ngakhale kusintha kwathunthu zotsatira) ndipo imafuna kusintha kwa mankhwalawa: - clobazam, clonazepam, digoxin, ethosuximide, primidone, valproic acid, alprazolam, corticosteroids (prednisolone, dexamethasone), cyclosporin, cyclospin haloperidol, methadone, kukonzekera kwa pakamwa komwe kumakhala ndi estrogens ndi / kapena progesterone (kusankha njira zina zakulera ndikofunikira), theophylline, anticoagulants pamlomo (warfarin, fenprocoumone, dicumar la), lamotrigine, topiramate, tridclic antidepressants (imipramine, amitriptyline, nortriptyline, clomipramine), clozapine, felbamate, tiagabine, oxcarbazepine, protease zoletsa zomwe zimagwiritsidwa ntchito pochiza matenda a HIV (indinavir, rquonaid, saquineid, squididid felodipine), itraconazole, levothyroxine, midazolam, olanzapine, praziquantel, risperidone, tramadol, ziprasidone.

Pali mwayi wowonjezera kapena kuchepetsa phenytoin mu plasma wamagazi motsutsana ndi maziko a carbamazepine ndikukulitsa mulingo wa mefenytoin. Pogwiritsa ntchito munthawi yomweyo carbamazepine ndi lithiamu kukonzekera, zotsatira za neurotoxic pazinthu zonse zomwe zimagwira zimatha kupitilizidwa.

Tetracyclines ikhoza kukhala yodziwika bwino yokhudza carbamazepine. Akaphatikizidwa ndi paracetamol, chiwopsezo cha chiwopsezo chake pachiwindi chimawonjezeka komanso kuthandizira kwamankhwala amachepetsa (imathandizira kagayidwe ka paracetamol).

The munthawi yomweyo makonzedwe a carbamazepine ndi phenothiazine, pimozide, thioxanthenes, mindindone, haloperidol, maprotiline, clozapine ndi tricyclic antidepressants kumabweretsa kukulira kwa choletsa zotsatira zapakati zamanjenje komanso kufooketsa mphamvu ya anticonvulsant of carbamazepine.

Mao inhibitors amachulukitsa mwayi wokhala ndi vuto la hyperpyretic, kusokonekera kwa magazi, kugwidwa, ndi zotsatira zakupha (asanaikidwe kwa carbamazepine, maohibulogalamu a MAO ayenera kuchotsedwa osachepera sabata 2 kapena, ngati vutoli limalola, ngakhale kwa nthawi yayitali).

Kugwiritsa munthawi yomweyo ndi diuretics (hydrochlorothiazide, furosemide) kungayambitse hyponatremia, limodzi ndi mawonetsedwe azachipatala.

Imapatsirana zotsatira za kusapondaponda kwa minofu yopuma (pancuronium). Pankhani yogwiritsa ntchito kuphatikiza uku, mwina pangafunikire kuwonjezera kuchuluka kwa opuma minofu, pomwe kuwunika wodwalayo kuli kofunikira chifukwa chitha kupumula msanga kwa opuma pang'onopang'ono.

Carbamazepine amachepetsa kulolera kwa ethanol.

Mankhwala a Myelotoxic amakulitsa kuchuluka kwa mankhwalawo.

Imathandizira kagayidwe ka anticoagulants osadziwika, njira za kulera, ma folic acid, praziquantel, ndipo zimathandizira kuthetseratu mahomoni a chithokomiro.

Imathandizira kagayidwe ka mankhwala a anesthesia (enflurane, halotane, fluorotan) ndikuwonjezera chiopsezo cha hepatotoxic zotsatira, kumathandizira mapangidwe a nephrotoxic metabolites a methoxyflurane. Imawonjezera hepatotoxic mphamvu ya isoniazid.

Zolemba zogwiritsira ntchito

Monotherapy ya khunyu imayamba ndi kukhazikitsidwa kwa mankhwala ochepa oyamba, pang'onopang'ono amawonjezera mpaka njira yothandizidwa itakwaniritsidwa.

Posankha mulingo woyenera, ndikofunikira kudziwa kuchuluka kwa carbamazepine m'madzi a m'magazi, makamaka ndi kuphatikiza mankhwala. Nthawi zina, mulingo woyenera kwambiri umatha kupatuka pa kachulukidwe koyamba komanso kosamalira, mwachitsanzo, pokhudzana ndi kuphatikizidwa kwa microsomal chiwindi kapena chifukwa chogwiritsa ntchito mankhwala osakanikirana.

Carbamazepine sayenera kuphatikizidwa ndi mankhwala a sedative-hypnotic. Ngati ndi kotheka, Finlepsin ® retard ikhoza kuphatikizidwa ndi zinthu zina zomwe zimagwiritsidwa ntchito pochotsa mowa. Pa mankhwala, ndikofunikira kuwunika pafupipafupi zomwe zili m'magazi a carbamazepine. Pokhudzana ndi chitukuko cha zoyipa kuchokera pakatikati ndi autonomic mantha dongosolo, odwala amayang'aniridwa mosamala pachipatala. Mukasamutsa wodwala ku carbamazepine, mlingo wa mankhwala omwe adagwiritsidwa ntchito kale antiepileptic uyenera kuchepetsedwa pang'onopang'ono mpaka kuthe. Kutha kwadzidzidzi kwa carbamazepine kungayambitse kugwidwa. Ngati kuli koyenera kusokoneza mwadzidzidzi chithandizo, wodwalayo ayenera kusinthidwa kupita ku mankhwala ena antiepileptic motsogozedwa ndi mankhwala omwe akusonyezedwa milandu yotere (mwachitsanzo, diazepam yoyendetsedwa iv kapena rectally, kapena phenytoin inj inj.

Pali milandu ingapo ya kusanza, kutsekula m'mimba ndi / kapena kuchepa kwa chakudya, kupsinjika ndi / kapena kupsinjika kwa ana akhanda omwe amayi awo adatenga carbamazepine nthawi yomweyo monga anticonvulsants ena (mwina zoterezi ndi mawonetseredwe a matenda achire). Musanalembe carbamazepine komanso munthawi ya chithandizo, kafukufuku wokhudzana ndi chiwindi ndi chofunikira, makamaka kwa odwala omwe ali ndi mbiri ya matenda a chiwindi, komanso odwala okalamba. Pankhani yakuwonjezeka kwa vuto la chiwindi lomwe likupezeka kale kapena ngati matenda a chiwindi akugwira, mankhwalawo ayenera kusiyidwa. Musanayambe chithandizo, ndikofunikira kuti muphunzire chithunzi cha magazi (kuphatikizapo kuwerengera kupatsidwa magazi, ma reticulocytes), mulingo wa chitsulo mu seramu yamagazi, kuyesa kwamkodzo pafupipafupi, kuchuluka kwa urea m'magazi, electroencephalogram, kutsimikiza kwa kuchuluka kwa ma electrolyte mu seramu yamagazi (komanso nthawi yamankhwala, chifukwa chitukuko cha hyponatremia). Pambuyo pake, zizindikirozi ziyenera kuyang'aniridwa m'mwezi woyamba wamankhwala sabata iliyonse, kenako mwezi uliwonse.

Nthawi zambiri, kuchepa kwapang'onopang'ono kapena kupitirirabe kwa kuchuluka kwa maselo am'magazi sikutanthauza kuyambika kwa aplasic anemia kapena agranulocytosis. Komabe, musanayambe chithandizo, komanso nthawi ndi nthawi munkachitika chithandizo, kuyezetsa magazi kwa kachipatala kuyenera kuchitidwa, kuphatikizapo kuwerengetsa kuchuluka kwa ma cell ndi mwina reticulocytes, komanso kudziwa mulingo wachitsulo mu seramu yamagazi. Asymptomatic leukopenia yopanda patsogolo sikufunikira kuchoka, komabe, chithandizo chikuyenera kutha ngati leukopenia kapena leukopenia wapita patsogolo, limodzi ndi zizindikiro za matenda opatsirana.

Carbamazepine iyenera kuchotsedwa yomweyo ngati mawonekedwe a hypersensitivity kapena zizindikiro zikuwoneka, zomwe zikusonyeza kuti chitukuko cha matenda a Stevens-Johnson kapena Lyell's. Kutulutsa kofatsa (kosiyana ndi maculopapular exanthema) nthawi zambiri kumatha patapita masiku angapo kapena milungu ingapo ndikupitilira chithandizo chanthawi yocheperako kapena wodwalayo atachepetsa. (Wodwalayo ayenera kuyang'aniridwa ndi adokotala panthawiyi).

Kuthekera kwa kutseguka kwa ma psychoses komwe kumachitika posachedwapa kuyenera kukumbukiridwa, ndipo odwala okalamba, mwayi wokhala ndi kusokonezeka kapena psychomotor mukubwadamuka.

Nthawi zina, kulandira mankhwala ochepetsa mphamvu ya antiepileptic kumachitika limodzi ndi kupezeka kwa kuyesayesa / kudzipha. Izi zinatsimikizidwanso ndi meta-kusanthula kwa mayesero osankhidwa mwamankhwala pogwiritsa ntchito mankhwala othandizira antiepileptic. Popeza momwe zimayambira kupezeka kwa kuyesa kudzipha pogwiritsa ntchito mankhwala antiepileptic sizikudziwika, kupezeka kwawo sikungaletsedwe mu chithandizo cha odwala omwe ali ndi Finlepsin ® retard. Odwala (ndi antchito) akuyenera kuchenjezedwa za kufunika kowunikira komwe kukuchitika kwa malingaliro ofuna kudzipha / kapena kudzipha ndipo, ngati pali zizindikiro, pitani kuchipatala msanga.

Pakhoza kukhala chofooka chachimuna ndi / kapena vuto la spermatogenesis, komabe, ubale wamavutikidwe awa ndi carbamazepine sunakhazikitsidwe. Kuwonongeka kwa magazi mkati mwa njira imodzi ndi njira imodzi yogwiritsira ntchito njira zakulera zamkamwa ndizotheka. Carbamazepine ikhoza kusokoneza kudalirika kwa njira zakulera zam'mlomo, chifukwa chake amayi omwe ali ndi zaka zobereka ayenera kugwiritsa ntchito njira zina zodzitetezera pakati pa chithandizo cha mimba. Carbamazepine iyenera kugwiritsidwa ntchito moyang'aniridwa ndi achipatala.

Ndikofunikira kudziwitsa odwala za zizindikiro zoyambirira za kawopsedwe, komanso zizindikiro kuchokera pakhungu ndi chiwindi. Wodwalayo amadziwitsidwa za kufunsa kukafunsira kwa dotolo msanga ngati pakumva kupweteka, kutentha kwapakhosi, zotupa, zilonda zamkamwa, kuwoneka kosavulaza kwam'mimba, hemorrhage mu mawonekedwe a petechiae kapena purpura.

Musanayambe chithandizo, kumayesedwa kuti mupeze matenda a maso, kuphatikiza kuunika kwa fundus ndi muyeso wa mapiritsi a intraocular. Potumiza mankhwala kwa odwala omwe ali ndi kukhudzika kwa intraocular, kuyang'anira chizindikirocho kumafunikira.

Odwala omwe ali ndi vuto lalikulu la mtima, kuwonongeka kwa chiwindi ndi impso, komanso okalamba amapatsidwa mankhwala ochepa. Ngakhale ubale wapakati pa mlingo wa carbamazepine, kugwiritsidwa ntchito kwake mwamphamvu ndi chithandizo chamankhwala ndizochepa kwambiri, komabe, kutsimikiza kwokhazikika kwa kuchuluka kwa carbamazepine kungakhale kothandiza muzochitika zotsatirazi: ndi kuwonjezeka kwambiri kwa pafupipafupi pakuwukira, kuti muwone ngati wodwalayo akumwa mankhwalawo moyenera. pa mimba, mankhwala a ana kapena achinyamata, ndi akuganiza malabsorption a mankhwala, akuwoneka kukula kwa poizoni zimachitika ngati wodwala ultiple mankhwala.

Mukamalandira mankhwala a Finlepsin ® retard, tikulimbikitsidwa kuti musamwe mowa.

Kufotokozera mtundu wa mankhwala, zikuchokera

Mapiritsi a Finlepsin ali ndi mawonekedwe ozungulira, mawonekedwe a convex mbali imodzi, chamfer choti chingathe kuthyoledwa pakati, komanso mtundu woyera. Chofunikira chachikulu pa mankhwalawa ndi carbamazepine, zomwe zili piritsi limodzi ndi 200 mg. Komanso, momwe zimapangidwira zimaphatikizanso zinthu zina zowonjezera, monga:

Magnesium wakuba.
Gelatin
Microcrystalline mapadi.
Croscarmellose sodium.

Mapiritsi a Finlepsin amawaika mu chithuza chamtundu wa zidutswa 10. Phukusi la katoni lili ndi matuza 5 (mapiritsi 50), komanso malangizo ogwiritsira ntchito mankhwalawa.

Kugwiritsa ntchito moyenera

Mapiritsi a Finlepsin amapangidwira kukonzekera kwa pakamwa (pakamwa pakamwa) pakudya kapena pambuyo chakudya. Sichitafuna ndipo imatsukidwa ndi madzi okwanira. Njira yotsogolera mankhwala ndi mlingo zimadalira zomwe wodwala akuwonetsa:

Khunyu - tikulimbikitsidwa kugwiritsa ntchito mankhwalawa ngati monotherapy. Zotheka kuti ma anticonvulsants a magulu ena azachipatala adagwiritsidwa ntchito kale kapena akugwiritsidwa ntchito panthawi yopanga mapiritsi a Finlepsin, mlingo umayamba ndi kuchuluka kochepa. Ngati mungadumphe mlingo, muyenera kuutenga mwachangu, pomwe simungathe kubwereza muyeso. Kwa akulu, Mlingo woyambirira ndi 200-400 mg (mapiritsi a 1-2), ndiye umachulukitsidwa pang'onopang'ono kuti akwaniritse zomwe mukufuna. Mlingo wokonza ndi 800-1200 mg wa patsiku, wogawidwa mu 2-3 Mlingo. Mlingo wambiri watsiku ndi tsiku sayenera kupitirira 1.6-2 g Kwa ana, mlingo umadalira zaka. Kwa ana azaka zapakati pa 1-5 - 100-200 mg ndi kuwonjezeka pang'onopang'ono kwa 100 mg tsiku lililonse mpaka njira yothira bwino yomwe ikwaniritsidwa, nthawi zambiri mpaka 400 mg, zaka 6-12 - mlingo woyambirira ndi 200 mg patsiku ndikuwonjezeka pang'onopang'ono mpaka 400- 600 mg, zaka 12-15 - 200-400 mg ndi kuchuluka pang'onopang'ono mpaka 600-1200 mg.
Trigeminal neuralgia - mlingo woyambirira ndi 200-400 mg, pang'onopang'ono umachulukitsidwa mpaka 400-800 mg. Nthawi zina, 400 mg ndi yokwanira kuchepetsa kupweteka.
Kuthana ndi mowa, mankhwalawa omwe amachitika mchipatala - mlingo woyambirira ndi 600 mg patsiku, womwe umagawidwa pazigawo zitatu. Ngati ndi kotheka, ikhoza kuwonjezeka mpaka 1200 mg patsiku. Kumwa mankhwalawa kumayima pang'onopang'ono. Kugwiritsa ntchito pamodzi mankhwala ena mankhwalawa pochotsa zizindikiro zochoka kumaloledwa.
Ululu wamankhwala mu diabetesic neuropathy - pafupifupi tsiku lililonse ndi 600 mg, mwapadera zimakwera mpaka 1200 mg patsiku.
Epileptiform kupukusika, komwe kumayambitsidwa ndi sclerosis yambiri - 400-800 mg kamodzi patsiku.
Kupewa komanso kuchiza matenda a psychosis - koyamba ndi kusintha kwa mankhwalawa ndi 200-400 mg patsiku, ngati kuli kotheka, amatha kuchuluka mpaka 800 mg patsiku.

Kutalika kwa nthawi ya mankhwala ndi mapiritsi a Finlepsin amatsimikiziridwa payekha ndi dokotala.

Mawonekedwe akugwiritsidwa ntchito

Asanapereke mapiritsi a Finlepsin, dokotala amawerenga mosamala malangizo a mankhwalawo ndikuwonetsa mbali zingapo za momwe amagwiritsidwira ntchito moyenera:

Monotherapy ndi mankhwala imayamba ndi mlingo woyambirira, womwe umayamba pang'ono ndi pang'ono kufikira pakubwera wodwala.
Ndi kusankha kwa wina muyezo Mlingo, tikulimbikitsidwa kuti zasayansi yotsimikiza ya ndende ya carbamazepine m'magazi.
Ngakhale mukumwa mapiritsi a Finlepsin, kuoneka kwa chizolowezi chodzipha mwa wodwala sikumachotsedwa, zomwe zimafunikira kuti dokotala awonetsetse.
Sikulimbikitsidwa kuphatikiza mankhwalawa ndi mapiritsi ogona ndi zositsa, kupatula kugwiritsa ntchito kwawo mankhwalawa pakuchiza zizindikiro zakumwa zoledzeretsa.
Popereka mankhwala a Finlepsin pomwe mukugwiritsa ntchito anticonvulsants ena, mlingo wawo uyenera kuchepetsedwa pang'onopang'ono.
Potengera maziko a mankhwala, nthawi zina labot yowunika ya ntchito ya impso, chiwindi, ndi zotumphukira magazi ikuyenera kuchitika.
Musanalembe mapiritsi a Finlepsin, tikulimbikitsidwa kuti tichite kafukufuku wa ma laboratory pofufuza magazi (zamankhwala amuzolengedwa, kusanthula kwamankhwala), mkodzo. Kenako kusanthula koteroko kumachitika mobwerezabwereza.
Ndikofunikira kuwongolera kuchuluka kwa maselo pazigawo zilizonse zamagazi pamiyeso yautali wa mankhwala.
Odwala okalamba, atayamba kumwa mapiritsi a Finlepsin, chiopsezo chowonekera cha psychent (latent) psychosis chimawonjezeka.
Kuphwanya kwachuma kwa bambo wokhala ndi osabereka kwakanthawi chifukwa chogwiritsa ntchito mankhwalawa sikumayikidwa padera, mwa akazi - mawonekedwe akuwukha magazi kwapakati.
Kumayambiriro kwa maphunziro a mankhwalawa ndi mankhwalawa, komanso nthawi ndi nthawi yake, kuphunzira kochitidwa kwa gawo la masomphenya kuyenera kuchitika.
Mukamagwiritsa ntchito mapiritsi a Finlepsin, mowa sukulimbikitsidwa.
Kugwiritsa ntchito mankhwalawa kwa amayi apakati ndikotheka pambuyo pokhazikitsidwa ndi dokotala pazifukwa zovuta zamankhwala.
Gawo lomwe limagwiritsa ntchito mankhwalawa limatha kuyanjana ndi mankhwala a magulu ena a pharmacological, omwe amayenera kukumbukiridwa ndi dokotala asanaikidwe.
Popeza mankhwalawa akukhudza mwachindunji magwiridwe antchito amanjenje, ndiye, motsutsana ndi momwe amagwiritsidwira ntchito, ndizosatheka kuchita zochitika zowopsa, kuphatikiza kufunikira kwa kuthamanga kwa zochitika zama psychomotor ndi chidwi.

Mapiritsi a Finlepsin muma pharmacies amapezeka pamankhwala. Popewa kukula kwamavuto ndi zotsatira zoyipa zaumoyo, sizikulimbikitsidwa kuti muzigwiritsa ntchito palokha.