Konvalis: malangizo, ndemanga, analogi ndi mitengo

Yogwira pophika mankhwalayo ali ofanana mu gamma-aminobutyric acidndiye neurotransmitter. Thupi limangirizaalpha-2-δ-kugonjera kwa calcium njirandikuletsa kuyenda kwa calcium kudzera mwa iwo. Ndi njira izi zomwe zimapereka kufalitsa kwa vuto lakumanjaku lomwe limayesa kupweteka.

Komanso, chidachi chimathandizanso kudalira glutamatekufa kwa mitsempha, kumawonjezera kaphatikizidwe GABAamachepetsa kumasulidwa ma neurotransmittersgulu la monoamine.

Pazowoneka bwino mkati magazi a m'magazi mankhwalawa samakhudza ena Ma GABA receptors, benzodiazepine, kususuka ndi ma receptor ena. Thupi silimalumikizana ndi mayendedwe a sodium.

Mukachulukitsa mulingo wa mankhwalawa, kuphatikiza kwachuma chake, mosiyana, kudzachepa. Zolemba malire plasma ndende magazi amapezeka patatha maola awiri ndi atatu atayikidwa. Bioavailability pafupifupi 60%. Kudya, ngakhale nditakhala ndi mafuta ambiri, sikukhudza magawo a mankhwala.

Kuchotsa hafu ya moyo ndi pafupifupi maola 6. Zomwe zimagwira sizikhala ndi mphamvu yomanga m'mapuloteni a plasma.

Mankhwala sadziunjikira m'thupi, sayambitsa kuyambitsa kwa chiwindi michere. Kuchoka m'thupi kudzera mu impso ndi mkodzo. Komabe, mu okalamba odwala, anthu odwala matenda a chiwindi, chilolezo cha gabapentin kuchepetsedwa pang'ono.

Odwala omwe ali ndi vuto laimpso, makamaka omwe amapita nthawi ndi nthawi hemodialysis, Mlingo watsiku ndi tsiku uyenera kusinthidwa.

Zizindikiro zogwiritsidwa ntchito

• at khunyu Akuluakulu ndi ana azaka 12 zakubadwa ngati mbali ya chithandizo chokwanira kapena chida chodziimira pawokha,
• zochizira kupweteka kwa m'mimba,
• at khunyu ndi generalization.

Contraindication

Makapisozi sangagwiritsidwe ntchito:

• ana ochepera zaka 12
• at pachimake kapamba,
• anthu osalolera lactose, kuchepa kwa lactase ndi shuga galactose malabsorption,
• pa kupezeka chifuwa pazinthu za mankhwala.

Odwala omwe kulephera kwa aimpsochisamaliro chikuyenera kumwedwa mukamamwa mankhwalawo.

Zotsatira zoyipa

Mukamagwiritsa ntchito mankhwala kuchitira kupweteka kwa m'mimba zitha kuchitika:

Ngati mankhwala ndi mankhwala pang'ono penakenako zotsatirazi mavuto:

• leukopenia, chinangwa,
• kulimba kuthamanga kwa magazi, Vasodilationnjira yotupa mkamwa (matenda a mano ndi mano),
• ziphuphuzotupa ndi kuyabwa pakhungu,
• gingivitis, kudzimbidwa, kutsegula m'mimbakukwezedwa kulakalaka ndi kudzimbidwanseru chisangalalokupweteka mkati dera la epigastric,
• kupweteka kumbuyo, kutupa kwamisempha, arthralgiamafupa olimba
• chizunguliremavuto ndi tendon Reflex, nkhawa, kukhumudwakukhumudwa, nystagmusmavuto,
• mphunokutsokomola chibayo,
• chitukuko cha matenda gawo,
• Hyperkinesis, paresthesia, amnesiachisokonezo ndikuchepa kwa kayendedwe ka kayendedwe, dysarthria, kusowa tulo, kunjenjemera,
• kukana libido ndi kusabala,
• kusawona bwino, diplopiakutopa, kutupa kwa nkhope ndi zotumphukira, asthenia.

Zotsatira zoyipa monga ataxia, chizungulire, nystagmus ndi kugona, zimatengera mlingo womwe umamwa.

Ndi kusiyiratu kumwa kwa mapiritsiwo, zizindikiro za kusiya matenda zingachitike: nseru, kupweteka m'malo osiyanasiyana, thukuta, nkhawa, kugona tulo.

Malangizo ogwiritsira ntchito Convalis (njira ndi Mlingo)

Mankhwalawa amatengedwa pakamwa popanda kutafuna kapena kugawa piritsi, mosasamala chakudya.

Malangizo ogwiritsira ntchito Convalis ngati mankhwala a khunyu

Mlingo woyambirira ndi 300 mg patsiku. Kenako, tsiku ndi tsiku mlingo umakulitsidwa 900 mg, umagawidwa pafupipafupi. Pambuyo pake, ngati ndi kotheka komanso potsatira lingaliro la adokotala, kuchuluka kwa mankhwalawa patsiku kungafikire 1200 mg.

Max Qty gabapentinyomwe imatha kudya tsiku lonse ndi 3600 mg (maola 8 aliwonse). The pakati pakati Mlingo salinso kuposa 12 maola.

Neuropathic ululu mankhwala

Patsiku loyamba, 300 mg ya mankhwalawa amatengedwa, wachiwiri - 600 mg mu magawo awiri ogawanika, lachitatu - 300 mg, katatu patsiku. Kupitilira apo, mlingo wa tsiku ndi tsiku utha kuwonjezeredwa mpaka 3600 mg.

Ndi matenda a impso:

• Ngati creatinine chilolezo kuyambira 50 mpaka 79 ml patsiku, ndiye kuti mutha kumwa 600-1800 mg wa mankhwala patsiku,
• ngati KK kuyambira 30 mpaka 49 ml / mphindi - mpaka 900 mg pa tsiku,
• ngati chilolezocho chili mpaka 30 ml / mphindi - 600 mg,
• ndi chilolezo chochepera 15 ml pamphindi, mlingo wa 300 mg patsiku uyenera kutsatiridwa.

Odwala hemodialysis, pambuyo pa maola 4 aliwonse, mankhwala owonjezera 300 mg ayenera kumwa.

M'masiku pamene dialysis osati ikuchitika, kuchuluka tsiku ndi tsiku ndizosatheka.

Bongo

Ngati mugwiritsa ntchito mwanzeru chida ichi chikuwoneka chizungulire, kutsegula m'mimba, diplopia, dysarthria ndi kugona.

Monga achire pofuna kuthana ndi vuto losafunikira, phokoso lamatumbo limayikidwa mu maola oyamba pambuyo pa kumwa mopitirira muyeso ammayankhomasymptomatic mankhwala. Zothandiza kwenikweni hemodialysis.

Kuchita

Cimetidine kumawonjezera nthawi yochotsa gabapentin kunja kwa thupi.

Kulandila nthawi imodzi ndi kulera kwamlomookhala ethinyl estradiolkapena norethisterone sizimayambitsa kulumikizana kwawo kwa mankhwala.

Kuphatikiza kwa mankhwala ndi morphinengati morphine anatengedwa mphindi 120 m'mbuyomugabapentinkumabweretsa pakukulitsa Auc ndalama ndi 50% ndikuwonjezera ululu.

Mukumwa mankhwalawo ndi ma anticonvulsants ena (Phenobarbital, Valproic Acid, Carbamazepine, Phenytoin) palibe kuyanjana pakati pa mankhwalawa kumachitika.

Maantacid okhala omwe zotayidwakapena magnesiumkuchepetsa bioavailability wa mankhwala. Tengani ndalamazi limodzi ndi maola awiri.

Kuphatikiza kwa mankhwala omwe amakhala ndi ethanol, zotsatira zoyipa zimakula.

Kulandila ndi Naproxen kumabweretsa kukulira kwa mayamwidwe nthawi ya Convalis.

Malangizo apadera

Nthawi zina atayamba kumwa mankhwalawa anthu omwe akudwala matenda ashugaMungafunike kusintha kwa muyezo othandizira a hypoglycemic.

Mukamasanthula mkodzo wogwiritsa ntchito mapulotenipepala lonyutsa Zotsatira zitha kupotozedwa. Ndikulimbikitsidwa kupanga mawunikidwe pogwiritsa ntchito njira ina iliyonse.

Sikulimbikitsidwa kuyendetsa kapena kuchita zinthu zomwe zimafunikira chidwi chachikulu ngati mukutenga Convalis.

Ngati pa mankhwala ndi mankhwala kuzindikira pachimake kapamba, chithandizo chiyenera kusokonezedwa.

Kuletsa kapena kusinthanitsa ndi mapiritsi kuyenera kuchitika pang'onopang'ono, mkati mwa masiku 7 chifukwa cha chiwopsezo cha kugwidwa.

Ndikulimbikitsanso kuwunikira momwe wodwalayo alili. Pa mankhwala, chiwopsezo chotukuka kukhumudwazochitika malingaliro ofuna kudzipha ndi machitidwe.

Zolemba za Convalis

Ma fanizo odziwika bwino a mankhwala: Algerica, Gerolamic, Lamiktal, Normeg, Lamitrile, Latrigil, Topiramin, Levetiracetam, Levitsit, Nyimbo, Epimil, Topilex, Neogabin, Topamax, Topilepsin, Epileptal, Epiramat, Epitrizhin, Wimpat, Keppra, Lamitor, Lamitor.

Gabagamma, Gabantin, Grimodin, Neuralgin, Tebantin, Gabalept, Gabapentin, Gabalept, Meditan, Newropentin.

Ndemanga za Convalis

Amayankha bwino mankhwalawo, makamaka mankhwalawo khunyu. Zovuta zomwe zimachitika kawirikawiri ndimavuto la mutu, nseru, ndi zovuta m'mimba. Komanso dandaulirani za zomwe zinachitika achire syndromendi kuthetseratu kwakumwa kwa mapiritsi.

Ndemanga za Konvalis pamaforamu:

• “... Mankhwala abwino kwambiri, komabe, amayenera kumwa kwa nthawi yayitali ndikutsatira njira yodalirika yochiritsira”,
• “... Ndili ndi matenda a hernia a intervertebral disc, pa Konvalis Ndimamva bwino, ndimatha kuyenda kwambiri, ndinali wolimbikira. Koma maphunzirowo atatha, zopweteketsazo zinabweza”,
• “... Zowawa za Neuropathic zimakhalabe chimodzimodzi. Zowona, pambuyo pa maola 2x 3 mutatenga, ndizotheka kugona kwa maola atatu”.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mtundu wa mankhwalawa ndi makapisozi achikasu, zomwe zili ndi mawonekedwe a ufa wamakristali oyera kapena amtundu wachikasu (makapisozi 10 pacake, 3 kapena 5 mapaketi a katoni).

Zomwe zimagwiritsidwa ntchito ndi gabapentin, 300 mg mu 1 kapisozi.

Zowonjezera: pregelatinized chimanga wowuma, lactose monohydrate, magnesium stearate, talc.

Kuphatikizidwa kwa kapisozi yolimba ya gelatin: utoto wachikasu wachikasu, gelatin, titanium dioxide.

Mlingo ndi makonzedwe

Mankhwala amatengedwa pakamwa, ngakhale kudya zakudya, kumeza athunthu, osafuna kutafuna ndi kumwa ndi madzi.

Popanga monotherapy ndikugwiritsa ntchito Convalis ngati njira yothandizira matenda a khunyu pang'ono mwa akulu ndi ana opitirira zaka 12, tikulimbikitsidwa kuti ayambe ndi mlingo wa 300 mg ndikuwonjezera pang'onopang'ono mpaka 900 mg:

• Tsiku loyamba - 300 mg 1 nthawi,
• Tsiku lachiwiri - 300 mg 2 times,
• Tsiku lachitatu - 300 mg katatu.

M'tsogolomu, tsiku lililonse mlingo ungakhale wachulukirachulukira. Pafupipafupi, amatha kukhala 900-1200 mg, muyezo waukulu tsiku lililonse ndi 3600 mg, wogawika pakulidwe Mlingo umodzi wofanana ndi maola 8. Kutalika kwakukulu pakati Mlingo sayenera kupitirira maola 12 (pofuna kupewa kuyambiranso).

Pochiza ululu wa neuropathic akuluakulu, Convalis amalembedwa tsiku loyamba pa mlingo wa 300 mg, patsiku lachiwiri - 600 mg (300 mg 2 nthawi), patsiku lachitatu - 900 mg (300 mg katatu). Ngati mukumva kupweteka kwambiri, mankhwalawa amatha kutumikiridwa patsiku loyamba katatu mu 300 mg. Kutengera mphamvu ya mankhwalawa, mlingo umatha kuwonjezeka pang'onopang'ono, koma osapitilira 3600 mg / tsiku.

Mlingo wotsatira watsiku ndi tsiku umaperekedwa kwa odwala omwe ali ndi vuto la Impso, kutengera chilolezo cha creatinine (QC):

• KK 50-79 ml / mphindi - 600-1800 mg,
• KK 30-49 ml / mphindi - 300-900 mg,
• KK 15-29 ml / mphindi - 300-600 mg,
• CC zosakwana 15 ml / mphindi - 300 mg (tsiku lililonse kapena tsiku lililonse).

Mlingo woyambirira wa 300 mg umalimbikitsidwa kwa odwala pa hemodialysis, ndiwowonjezereka wa 300 mg pambuyo pa hemodialysis imatengedwa pambuyo pa gawo lililonse la hemodialysis wokhala ndi maola 4. M'masiku amenewo pamene dialysis sinachitike, mankhwalawa sanaikidwe.

Zotsatira zoyipa

Zotsatira zotsatirazi zimatha kuchitika pa neuropathic ululu mankhwala:

• Central mantha system (CNS): amnesia, chisokonezo, ataxia, kusowa bwino kwa tulo, kugona, chizungulire, kukhumudwa, kugwedezeka, kuganiza kwamkati,
• Matumbo: Kutupa kwa m'mimba, kutsegula m'mimba, kudzimbidwa, kusanza, kugona, kusanza, pakamwa kowuma, kupweteka pamimba,
• Dongosolo lothandizira: pharyngitis, dyspnea,
• Zamoyo zam'mimba: amblyopia,
• Mawu: zotupa pakhungu,
• Zina: matenda ngati chimfine, matenda opatsirana, asthenic syndrome, mutu, zotumphukira edema, kupweteka kwa kutukuka kosiyanasiyana, kuwonda.

Konvalis akathandizidwa ndi kukomedwa pang'ono, zotsatirazi zingaoneke:

• Mitsempha yamagazi: leukopenia, purpura (nthawi zambiri zimachitika mu mikwingwirima yomwe imachitika pakachitika zoopsa),
• Matenda a mtima: kuchepa kapena kuwonjezeka kwa kuthamanga kwa magazi (BP), zizindikiro za vasodilation,
• Mchitidwe wamsempha: paresthesia, kukwezedwa, kufooka kapena kusowa kwa tendon Reflex, kusokonezeka kwa kayendedwe ka kayendedwe, nkhawa, ataxia, amnesia, chidani, chisokonezo, dysarthria, kupsinjika, kuthedwa nzeru, kugona, kunjenjemera, kugona, kugona, Hyperkinesis
• Matumbo ochita kuperewera: dyspepsia, pakamwa pouma, pakhungu, kusefukira, kusanza, kudzimbidwa, gingivitis, anorexia, kupweteka kwam'mimba, kuchuluka kwa chidwi, matenda a mano.
• Matenda a minofu ndi mafupa: myalgia, kupweteka kwa msana, arthralgia, mafupa osokonekera a mafupa,
• Machitidwe opatsirana: rhinitis, pharyngitis, chifuwa, chibayo,
• Njira zamkodzo ndi kubereka: kwamikodzo thirakiti, kusabala,
• Khungu: kuyabwa pakhungu, ziphuphu, zotupa, zotupa pakhungu,
• Ziwalo zomvera: amblyopia, kuwonongeka kwa mawonekedwe, diplopia,
• Zina: kutopa, kupweteka mutu, kutentha thupi, edema ya nkhope, asthenic syndrome, kachilombo ka virus, kunenepa kwambiri, edema yopuma.

Poyerekeza kulekerera kwa Convalis pa Mlingo wa 300 ndi 3600 mg / tsiku, mlingo wodalira pazinthu monga kugona, ataxia, chizungulire, nystagmus ndi paresthesia.

Polemba ntchito pambuyo pa kulembetsa ntchito, panali zochitika za kufa mwadzidzidzi, osafotokozeredwa kosagwirizana ndi chithandizo cha gabapentin.

Pa mankhwala ndi mankhwala, zotsatirazi zosatheka zimachitika: pachimake aimpso kulephera, thupi lawo siligwirizana, gynecomastia, kuchuluka kwa mammary gland voliyumu, zovuta zamagalimoto (dystonia, dyskinesia, myoclonus), kuyerekezera zinthu zina, kusokonekera kwa mankhwalawa, kusokonekera kwa mankhwalawa, zovuta pokodza, tinnitus.

Pambuyo pakutha kwa chithandizo, zomwe zimachitika kawirikawiri monga: nseru, kusowa tulo, kupweteka kosiyanasiyana, nkhawa, thukuta.

Ngati mungakhale ndi chimodzi mwazizindikiro zomwe zili pamwambapa kapena zotsatirapo zina zilizonse, muyenera kufunsa dokotala.

Ndi bongo wa Convalis, kutsegula m'mimba, kusokonezeka kwa mawu, kuzama, chizungulire, dysarthria, kugona. Pa kuyesa mbewa ndi makoswe, muyeso wowopsa wa gabapentin, womwe umatenga pakamwa, unali mlingo wa 8000 mg / kg. Zizindikiro za kawopsedwe wazakudya zomwe zimatchulidwa mu nyama zinafotokozedwa mu ataxia, kupuma movutikira, ptosis, hypoactivity kapena kusasitsa.

Mankhwala osokoneza bongo ndi chizindikiro, hemodialysis imatha kuperekedwa kwa odwala omwe amalephera kwambiri aimpso.

Kupanga ndi mawonekedwe a kumasulidwa

Gulu la zipatala ndi mankhwala: anticonvulsant mankhwala.

Wogwira popanga gabapentin ndiwofanana mu kapangidwe ka neurotransmitter GABA, koma amasiyana ndi momwe amagwirira ntchito, alibe malo a GABAergic, ndipo sasokoneza kagayidwe ndi katemera ka GABA. Thupi limakhala ndi anticonvulsant ogwira ndipo limawonetsa katundu wosayimilira, ndikuwonjezera mphamvu ya thupi.

Mankhwalawa amapezeka mu mawonekedwe a makapu a gelatin achikasu. Mkati mwake muli ufa (woyera). Zomwe zimapangidwira ndikupezeka ndi gabapentin mu mlingo wa 300 mg.

Chifukwa chiyani Convalis adatumizidwa?

Monga akunenera malangizo a Convalis, mankhwalawa amagwiritsidwa ntchito ngati mankhwala:

• ndi khunyu kwa akulu ndi ana azaka 12 zakubadwa ngati mbali ya chithandizo chokwanira kapena ngati chida chodziimira pawokha,
• zochizira neuropathic ululu,
• ndi khunyu khunyu ndi generalization.

Zotsatira za pharmacological

The yogwira thunthu wa Convalis ali anticonvulsant. Kuphatikiza apo, Konvalis, malinga ndi malangizo, ali ndi zotsatira zake, zomwe zimalumikizidwa ndi kuwonjezereka kwa mphamvu yogwira ntchito ya thupi. Mankhwalawa ali ndi zolimbitsa mphamvu za analgesic ngati pali ma polyneuropathies, ndipo phindu lake pamankhwala ena omwe ali ndi machitidwe ofanana ndi chitetezo.

Mimba komanso kuyamwa

Palibe zosakwanira pakugwiritsa ntchito gabapentin mwa amayi apakati.Mankhwalawa sayenera kugwiritsidwa ntchito panthawi yomwe ali ndi pakati ngati phindu lomwe lingakhalepo kwa mayi silikupita pachiwopsezo cha fetus.

Mankhwalawa amapita mkaka wa m'mawere, zomwe zimakhudza ana nthawi yoyamwitsa sizikudziwika, chifukwa chake, panthawi yoyamwitsa, mankhwalawa amayenera kugwiritsidwa ntchito pokhapokha ngati phindu lomwe lingakhalepo chifukwa cha mayi kumwa mankhwalawo limaposa chiwopsezo cha mwana.

Maumbidwe (i.e., yogwira)) ma analogu a Convalis ndi Gabagamma, Gapentek, Gabapentin, Catena, Lepsitin, Neurontin, Tebantin, Egipentin, Eplirintin.

Mtengo wapakati wa CONVALIS m'mafakisi (Moscow) ndi ma ruble 450.

Kuyanjana kwa mankhwala osokoneza bongo

Convalis akaphatikizidwa ndi mankhwala ena, zotsatirazi zimatha kuchitika (AUC - kuchuluka kwa zinthu m'magazi am'magazi, C_max - pazipita kuchuluka kwa zinthu m'magazi):

• Maantacid okhala ndi aluminiyamu kapena magnesium: kuchepa kwa bioavailability wa gabapentin (nthawi yochepera maola 2 pakati pamiyeso iyenera kuwonedwa),
• Morphine (mutamwa morphine 2 maola musanatenge Convalis): kuwonjezeka kwa AUC kwa gabapentin ndi 44% (poyerekeza ndi monotherapy ndi gabapentin),
• Cimetidine: kuchepa pang'ono kwa impso excretion wa gabapentin,
• Ethanol ndi mankhwala osokoneza bongo omwe amagwiritsa ntchito:
• Naproxen: kuchuluka kwa gabapentin,
• Hydrocodone: AUC yowonjezera ya gabapentin ndikuchepetsa AUC ndi C_max hydrocodone.

Convalis analogues ndi: Algerica, Gerolamic, Lamictal, Normeg, Lamitril, Latrigil, Topiramin, levetiracetam, Levitsit, Lyric, Epimil, Topilex, Neogabin, Topamax, Topilepsin, Epileptal, Epiramat, Epitrigin, Wimpatin, Lampatin, Lampatin, Lampatin Gabagamma, Gabantin, Grimodin, Neuralgin, Tebantin, Gabalept, Gabapentin, Gabalept, Meditan, Newropentin, Neurontin, Catena.

Kupanga pa 1 kapisozi:

ntchito: gabapentin - 300.0 mg,
zokopa: lactose monohydrate - 66.0 mg, pregelatinized wowuma chimanga - 30.0 mg, talc - 3.0 mg, magnesium stearate - 1.0 mg.
Kuchuluka kwa zomwe zili mu kapisozi ndi 400.0 mg.
Kupanga kwa chipolopolo
Makapisozi a gelatin olimba 0: - 96.0 mg.
Nyumba ndi chivundikiro: titanium dioxide (E 171) - 2.0000%, chitsulo cha utoto wachitsulo (E 172) - 0,6286%, gelatin - mpaka 100%.
Kulemera konse kwa kapisozi ndi zomwe zili 494.0 mg.

Gulu la Pharmacotherapeutic: antiepileptic mankhwala.

Nambala ya ATX: N03AX12.

Mankhwala

Mankhwala
Kapangidwe ka mankhwala a gabapentin ndi ofanana ndi kapangidwe ka GABA neurotransmitter (gamma-aminobutyric acid), koma kapangidwe kake kazinthu ndizosiyana ndi zina zomwe zimagwira ndi GABA synapses, monga valproates, barbiturates, benzodiazepines, GABA transaminase inhibitors, GABA reuptake inhibitors, and GABA reabu. GABA mankhwala osokoneza bongo. M'maphunziro mu vitro Ndi radioisotope gabapentin, malo atsopano opangira mapuloteni amapezeka mu ubongo wama rat, kuphatikiza neocortex ndi hippocampus, yomwe ikhoza kukhala yokhudzana ndi anticonvulsant ndi analgesic ntchito ya gabapentin ndi zotumphukira zake. Zinapezeka kuti malo omangira a gabapentin ndi gawo la α-2-δ (alpha-2-delta) la njira zamagetsi zamagetsi zamagetsi.
Pazochitika zazikuluzikulu zokhudzana ndi matenda, gabapentin samamangiriza kwa ma receptor ena othandizira omwe amapezeka mu ubongo, kuphatikiza GABA_AGABA_Mu, benzodiazepine, glutamate, glycine ndi N-methyl-D-aspartate receptors.
Gabapentin mikhalidwe mu vitro sichilumikizana ndi njira zama sodium, zomwe zimasiyanitsa ndi phenytoin ndi carbamazepine. M'mayeso angapo oyesa mu vitro Kugwiritsa ntchito kwa gabapentin kunapangitsa kutsika pang'ono kwa mayankho a gl -amyl agonist N-methyl-D-aspartate (NMDA), koma pokhapokha pamsasa wopitilira 100 μmol / L, womwe sungathe kupezeka mu vivo. M'mikhalidwe mu vitro kugwiritsa ntchito gabapentin kumabweretsa kuchepa pang'ono pakumasulidwa kwa monoamine neurotransmitters.
Magulu enieni a zochita za gabapentin sakudziwika.

Pharmacokinetics
Zogulitsa
Pambuyo pakukonzekera pakamwa, pazotheka kuchuluka kwa gabapentin m'madzi a m'magazi kumatheka mkati mwa maola awiri ndi atatu. The bioavailability wa gabapentin amayamba kuchepa ndi kuwonjezeka mlingo. Mtheradi wa bioavailability mutatenga makapisozi 300 mg ndi pafupifupi 60%. Zakudya, kuphatikiza zomwe zili ndi mafuta ambiri, sizikhala ndi vuto lililonse pakamerokentin.
Ma pharmacokinetics a gabapentin sasintha ndikusinthasintha kwa mankhwalawa.
Kugawa
Gabapentin samanga mapuloteni a plasma, ndipo voliyumu yake yogawa ndi malita 57.7. Odwala omwe ali ndi khunyu, kuchuluka kwa gabapentin mu cerebrospinal fluid (CSF) pafupifupi 20% ya osachepera plasma ndende. Gabapentin amachotseredwa mkaka wa m'mawere.
Biotransformation
Palibe deta pa kagayidwe ka gabapentin mthupi la munthu. Gabapentin samalimbikitsa kuyambitsa ma oxidases osayimira a chiwindi omwe ali ndi vuto la metabolism ya mankhwala.
Kuswana
Gabapentin amachotseredwa mosasinthika kokha chifukwa cha impso. Hafu ya moyo wa gabapentin ndiwodziyimira palokha pa mlingo womwe umatengedwa ndi maola 5 mpaka 7.
Mu okalamba ndi odwala omwe ali ndi vuto laimpso, kupatsirana kwa plapma kumachepetsedwa. Kuchotsa kosalekeza, chilolezo cha plasma ndi chilolezo cha impso cha gabapentin ndizogwirizana mwachindunji kupangira chilolezo.
Gabapentin amachotsedwa m'madzi a m'magazi panthawi ya hemodialysis. Odwala omwe ali ndi vuto la impso kapena omwe ali ndi hemodialysis amalangizidwa kuti asinthe mlingo wa mankhwalawa (onani gawo "Mlingo ndi Administration").
Linearity / nonlinearity of pharmacokinetics parameter
The bioavailability wa gabapentin amachepetsa ndi kuchuluka kwa kuchuluka, komwe kumakhala kosagwirizana ndi magawo a pharmacokinetic, omwe amaphatikizapo chizindikiro cha bioavailability (F), mwachitsanzo, Ae%, CL / F, Vd / F. Elimination pharmacokinetics (magawo kuphatikiza F, monga CLr ndi T_1/2) ikufotokozedwa bwino ndi mtundu wazithunzi. Kutalika kwa plasma kwa galapentin kuli kolosera kutengera data ya kinetics ndi mlingo umodzi.

Gwiritsani ntchito pa nthawi yoyembekezera komanso nthawi yoyamwitsa

Chiwopsezo chachikulu chifukwa cha khunyu komanso antiepileptic mankhwala
Chiwopsezo chokhala ndi ana okhala ndi vuto lobadwa nalo mwa amayi omwe amathandizidwa ndi anticonvulsants kwa khunyu limachulukitsa katatu. Nthawi zambiri pamakhala kutsekeka kwa milomo yapamwamba komanso mkamwa, kuwonongeka kwa mtima ndi vuto la neural chubu. Komanso, kutenga maanticonvulsants angapo atha kuphatikizidwa ndi chiopsezo chachikulu chakupunduka kuposa momwe mungapangire monotherapy. Chifukwa chake, ngati kuli kotheka, imodzi mwamankhwala ogwiritsa ntchito iyenera kugwiritsidwa ntchito. Amayi azaka zoyambira kubereka, komanso azimayi onse omwe angakhale ndi pakati, ayenera kufunsa akatswiri. Ngati mayi akukonzekera kutenga pakati, kufunika kopitiliza mankhwala anticonvulsant kuyenera kuwonetsedwanso. Nthawi yomweyo, anticonvulsants sayenera kuthetsedwa mwachangu, chifukwa izi zimatha kuyambitsa kuyambanso ndi zovuta zoyipa kwa mayi ndi mwana. Nthawi zina, mwa ana omwe amayi awo amadwala khunyu, kuchedwa kukukula kumawonedwa. Komabe, ndizosatheka kudziwa ngati kuchepa kwakuthupi kumalumikizidwa ndi majini kapena zochitika zina, matenda a amayi, kapena mankhwala anticonvulsant.

Chiwopsezo cha Gabapentin
Palibe zambiri pakugwiritsa ntchito mankhwalawa amayi apakati. Poyeserera nyama, kuwopsa kwa mankhwala kwa mwana wosabadwayo kunawonetsedwa. Ponena za zoopsa zomwe zingachitike, anthu alibe deta. Chifukwa chake, gabapentin iyenera kugwiritsidwa ntchito pokhapokha ngati phindu lomwe lingapezeke kwa mayi likuwonetsa kuwopsa kwa mwana wosabadwayo.
M'milandu yomwe yanenedwa, ndizosatheka kunena motsimikiza ngati kugwiritsa ntchito gabapentin pa nthawi ya pakati kumayendera limodzi ndi chiopsezo chowonjezeka, poyamba, chifukwa cha kupezeka kwa khunyu, ndipo chachiwiri, chifukwa chogwiritsa ntchito anticonvulsants ena .
Kuyamwitsa
Gabapentin amuchotseredwa mkaka wa m'mawere, momwe zimayambira kukhanda sakudziwika, chifukwa chake, panthawi yoyamwitsa Convalis ® iyenera kuyikidwa pokhapokha ngati phindu kwa mayi likuwonetsa kuwopsa kwa khanda.
Kafukufuku wazinyama sanawonepo zovuta za gabapentin pa chonde.

Mlingo ndi makonzedwe

Convalis ® imalembedwa pakamwa mosasamala kanthu za kudya. Ngati kuli kofunikira kuchepetsa mlingo, kuletsa mankhwalawo kapena kusinthanitsa ndi wothandizira wina, izi ziyenera kuchitidwa pang'onopang'ono kwa sabata limodzi.
Kupweteka kwamitsempha m'mimba mwa akulu
Mlingo woyambirira ndi 900 mg / tsiku mu Mlingo utatu wogawanika, ngati kuli kotheka, kutengera mphamvu, mlingo umakulitsidwa pang'onopang'ono mpaka kufika pa 3600 mg / tsiku. Kuchiza kumayamba pang'onopang'ono ndi mlingo wa 900 mg / tsiku (300 mg katatu patsiku) kapena mutha kukulitsa mlingo pang'onopang'ono mpaka 900 mg patsiku kwa masiku atatu oyambilira malinga ndi dongosolo lotsatira:
Tsiku loyamba: 300 mg ya mankhwala 1 nthawi patsiku,
Tsiku lachiwiri: 300 mg ya mankhwala 2 pa tsiku,
Tsiku la 3: 300 mg ya mankhwala katatu patsiku.
Kukakamira pang'ono
Ndi khunyu, chithandizo cha nthawi yayitali chimafunikira. Mlingo wa mankhwalawa umatsimikiziridwa ndi adotolo kutengera kutengera kwake kumathandizira komanso kuugwira mtima kwa mankhwalawo.
Akulu ndi ana a zaka zopitilira 12: ogwira mlingo - kuchokera 900 mpaka 3600 mg / tsiku. Mankhwalawa amatha kuyamba ndi 300 mg katatu patsiku patsiku loyamba kapena pang'onopang'ono mpaka 900 mg molingana ndi chiwembu chomwe chatchulidwa pamwambapa (onani gawo la "kupweteka kwa Neuropathic mu akulu") Pambuyo pake, mlingowo umatha kuwonjezeka mpaka kufika pa 3600 mg / tsiku (logawidwa mu 3 Mlingo wofanana). Kulekerera kwabwino kwa mankhwala muyezo mpaka 4800 mg / tsiku kunadziwika. Pazitali pakati pakati Mlingo ndi katatu Mlingo wa mankhwala sayenera upambana maola 12 kuti tipewe kuyambiranso.
Odwala ambiri
Odwala omwe ali ndi vuto lalikulu, mwachitsanzo, ngati kuchepa kwa thupi, kufalikira kwa ziwalo, ndi zina, mlingo uyenera kuchulukitsidwa pang'onopang'ono, pogwiritsa ntchito Mlingo wotsika kapena popanga nthawi yayitali musanakulitse mlingo.
Gwiritsani ntchito odwala okalamba (opitilira zaka 65)
Chifukwa cha kuchepa kwa ntchito ya impso, okalamba angafunikire kusintha kwa mlingo (kuti mumve zambiri, onani Gome 1). Kugona, zotumphukira edema ndi asthenia mwa odwala okalamba zimatha kuchitika pafupipafupi.
Mlingo wosankhidwa chifukwa cha kulephera kwa impso
Kwa odwala omwe ali ndi vuto la aimpso, kutsitsa kwa gabapentin kumalimbikitsidwa malinga ndi tebulo 1:

A - Mlingo wa tsiku ndi tsiku uyenera kufotokozedwa katatu.
B - khazikitsani 300 mg tsiku lililonse,
B - odwala omwe ali ndi chilolezo cha creatinine ®. Kuti mudziwe mapuloteni mumkodzo, tikulimbikitsidwa kugwiritsa ntchito njira ina yapadera yodumphira mpweya ndi sulfosalicylic acid.
Zotsatira za CNS
Pa chithandizo cha gabapentin, pakhala pali chizungulire komanso kugona, zomwe zimawonjezera mwayi wovulala mwangozi (ngati waponyedwa). Mu nthawi yolembetsa pambuyo polembetsa, milandu ya chisokonezo, kufooka kwa chikumbumtima ndi ntchito yamisala idanenedwanso. Chifukwa chake, odwala ayenera kulangizidwa kuti asamale mpaka athe kudziwa zovuta zomwe zingachitike chifukwa cha mankhwalawa.
Pogwiritsa ntchito munthawi yomweyo ma opioid analgesics, kuwonjezereka kwa kuchuluka kwa gabapentin m'madzi a m'magazi kungadziwike. Pankhaniyi, wodwala amafunika kuwunikira mosamala kuti apange zizindikiro za kukhumudwa kwapakati pa mitsempha, monga kugona, kugona, ndi kupuma. Mlingo wa gabapentin kapena opioid analgesics uyenera kuchepetsedwa.
Mothandizidwa ndi ma antacid
Gabapentin akulimbikitsidwa kuti atengedwe pafupifupi maola 2 mutatha kumwa maid.

Zokhudza mphamvu pakutha kuyendetsa magalimoto ndi zida

Ngakhale mukumwa mankhwalawa, odwala saloledwa kuyendetsa magalimoto kapena kugwiritsa ntchito zida zowopsa mpaka pomwe zotsatirapo zoyipa za mankhwalawa zikuchitika.
Gabapentin amakhudza dongosolo lamkati lamanjenje ndipo amatha kuyambitsa chizungulire, kugona, kusokonezeka, kusokonezeka kwa chikumbumtima, kapena zizindikiro zina zamagetsi amkati. Ngakhale kuwuma pang'ono kapena pang'ono, izi sizovuta kukhala zowopsa kwa odwala omwe akuyendetsa magalimoto kapena zina. Izi ndizotheka kwambiri kumayambiriro kwa chithandizo kapena mutatha kuchuluka kwa gabapentin.