Tegretol cr malangizo ntchito, contraindication, mavuto, ndemanga

Mlingo wa kutulutsidwa:

• madzi: oyera, a viscous, ali ndi kununkhira kwa caramel (m'mabotolo amdima amdima a 100 ml, botolo 1 yamtundu wa makatoni odzaza ndi supuni ya kipimo),
• mapiritsi: oyera, oyera, okhala ndi mawonekedwe, 200 mg aliyense - wozungulira, wolemba mbali imodzi - CG, mbali inayo - G / K, ali pachiwopsezo mbali imodzi, 400 mg - woboola pakati, wolemba mbali imodzi - LR / LR , mbali inayo - CG / CG, mbali zonse za ngoziyo (ma PC 10. m'matumba, matuza atatu kapena asanu mubokosi lamakhadi).

Bokosi la makatoni lilinso ndi malangizo ogwiritsira ntchito Tegretol.

Muli madzi 5 ml:

• yogwira mankhwala: carbamazepine - 100 mg,
• othandizira: macrogol stearate - 100 mg, kuwala kwa caramel - 50 mg, hydroxyethyl cellulose (hyetellose) - 500 mg, sodium saccharase - 40 mg, madzi sorbitol - 25 000 mg, propylene glycol - 2,5 mg, Avicel RC 581 (microcrystalline cellulose + sodium carmellose) - 1000 mg, methyl paraben (methyl parahydroxybenzoate) - 120 mg, sorbic acid - 100 mg, propyl paraben (propyl parahydroxybenzoate) - 30 mg, madzi oyeretsedwa mokwanira.

Piritsi 1:

• yogwira mankhwala: carbamazepine - 200 kapena 400 mg,
• othandizira (200/400 mg): magnesium stearate - 3/6 mg, sodium carmellose - 10/20 mg, cellcrystalline cellulose - 65/130 mg, colloidal silicon dioxide - 2/4 mg.

Kutulutsa mawonekedwe Tegretol tsr, ma CD ndikuphatikizira ndi mankhwala.

Mapiritsi otsekemera otetezedwa, okhala ndi utoto wa lalanje, ali owondera, biconvex pang'ono, wokhala ndi notch mbali iliyonse, olembedwa "HC" mbali inayo, ndi "CG" mbali inayo.

1 tabu
carbamazepine
200 mg

Omwe amathandizira: microcrystalline cellulose, sodium carmellose, polyacrylate dispersion 30% (Eudragit E 30 D), ethyl cellulose madzi obalalitsidwa, talc, colloidal silicon dioxide anhydrous, magnesium stearate.

Mapangidwe a chipolopolo: hypromellose, talc, titanium dioxide, mafuta a castor (macrogol glycerylincinoleate), iron oxide ofiira, iron oxide chikasu.

Ma PC 10 - matuza (5) - mapaketi a makatoni.

Mapiritsi otsekemera otulutsa tchire, lalanje-lalanje, owunda, pang'ono ndi biconvex, wokhala ndi notch mbali iliyonse, olembedwa "ENE / ENE" mbali inayo, "CG / CG" mbali inayo.

1 tabu
carbamazepine
400 mg

Omwe amathandizira: microcrystalline cellulose, sodium carmellose, polyacrylate dispersion 30% (Eudragit E 30 D), ethyl cellulose madzi obalalitsidwa, talc, colloidal silicon dioxide anhydrous, magnesium stearate.

Mapangidwe a chipolopolo: hypromellose, talc, titanium dioxide, mafuta a castor (macrogol glycerylincinoleate), iron oxide ofiira, iron oxide chikasu.

Ma PC 10 - matuza (3) - mapaketi a makatoni.

Kufotokozera kwa ZOTHANDIZA ZABWINO.
Zonse zomwe zaperekedwa zimangoperekedwa kuti mudziwe bwino za mankhwalawo, muyenera kufunsa dokotala zokhudzana ndikugwiritsa ntchito.

Pharmacological kanthu tegretol cr

Mankhwala othandizira antiepileptic ochokera ku tricyclic iminostilbene. Amakhulupirira kuti zotsatira za anticonvulsant zimagwirizanitsidwa ndi kuchepa kwa mphamvu ya ma neurons kuti asunge kwambiri zochitika zomwe zingachitike mobwerezabwereza poyambitsa masodium njira. Kuphatikiza apo, kuletsa kwa ma neurotransmitter kumasulidwa ndi kutsekereza njira za preynaptic sodium komanso kukula kwa zinthu zina zomwe zimachepetsa kufalitsa kwa synaptic, zikuwoneka kuti ndizofunikira.

Imakhala ndi antimaniacal, antipsychotic zotsatira, komanso analgesic zotsatira zopweteka za neurogenic. Ma GABA receptors, omwe amatha kuphatikizidwa ndi njira za calcium, akhoza kutengapo gawo machitidwe, komanso zotsatira za carbamazepine pama neurotransmitter modulator system nawonso zikuwoneka kuti ndizofunikira.

Mphamvu yotsutsa ya carbamazepine imatha kuphatikizidwa ndi hypothalamic zotsatira za osmoreceptors, zomwe zimayendetsedwa kudzera mchinsinsi cha ADH, komanso chifukwa cha kuthana ndi vuto la aimpso.

Pharmacokinetics wa mankhwala.

Pambuyo pakumwa pakamwa, carbamazepine imangokhala yodzaza kwathunthu kuchokera kumimba. Kumangiriza kwa mapuloteni a plasma ndi 75%. Imagwira ma enzymes a chiwindi ndipo imathandizira kagayidwe kake.

T1 / 2 ndi maora 12-16. 70% amamuchotsa mkodzo (mwanjira ya metabolites) ndi 30% - yokhala ndi ndowe.

Zisonyezero zogwiritsidwa ntchito:

Matenda a khunyu: akuluakulu, osakanikirana, osakanikirana (kuphatikiza zazikulu ndi zozama) khunyu. Kupweteka kwamatenda makamaka kwa chiyambi cha neurogenic, kuphatikiza kofunikira mu triuralmural neuralgia, trigeminal neuralgia mu sclerosis yofunikira, glossopharyngeal neuralgia. Kupewa kuukira ndi vuto lochotsa mowa. Magwiridwe othandizira komanso osokoneza bongo (monga njira yoletsera). Matenda a diabetes a neuropathy. Matenda a shuga a insipidus apakatikati, polyuria ndi polydipsia ya chikhalidwe cha neurohormonal.

Mlingo ndi njira ya mankhwala.

Ikani payekha. Mukamamwa pakamwa kwa akulu ndi achinyamata azaka 15 ndi akulu, mlingo woyambayo ndi 100-400 mg. Ngati ndi kotheka, ndi kuganizira matenda, mlingo ukuwonjezeka osapitirira 200 mg / tsiku limodzi pakapita sabata 1. Pafupipafupi oyang'anira ndi nthawi 1-4 / tsiku. Mankhwala okonza nthawi zambiri amakhala ali ndi 600 mg00 mg / tsiku zingapo. Kutalika kwa chithandizo kumatengera zikuwonetsa, kuthandizira kwake, momwe wodwalayo amayankhira chithandizo.

Mwa ana osakwana zaka 6, 10-20 mg / kg / tsiku amagwiritsidwa ntchito mu Mlingo wogaŵikana wachiwiri, ngati kuli koyenera komanso chifukwa chololera, muyezo mumawonjezeranso osaposa 100 mg / tsiku limodzi pakadutsa sabata 1 -350 mg / tsiku ndipo sizidutsa 400 mg / tsiku. Ana a zaka zapakati pa 6 mpaka 12 - 100 mg 2 / tsiku tsiku loyamba, ndiye kuti mlingo umakulitsidwa ndi 100 mg / tsiku ndi nthawi 1 sabata. mpaka mulingo woyenera kwambiri, mlingo wokonzanso nthawi zambiri ndi 400-800 mg / tsiku.

Mlingo waukulu: mukamamwa pakamwa, akulu ndi achinyamata a zaka 15 ndi okalamba - 1,2 g / tsiku, ana - 1 g / tsiku.

Zotsatira zoyipa za tegretol tsr:

Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: Nthawi zambiri - chizungulire, ataxia, kugona, kuthekera kupweteka kwa mutu, diplopia, chisokonezo pogona, osowa - kusuntha mwadzidzidzi, nystagmus, zina - oculomotor zosokoneza, dysarthria, zotumphukira neuritis, paresthesia, kufooka kwa minofu, zizindikiro paresis, kuyerekezera zinthu m`maganizo, kukhumudwa, kutopa, kuchita ukali, kusokonezeka kwa chikumbumtima, kuchuluka kwa psychosis, kukoma kuwonongeka, conjunctivitis, tinnitus, hyperacusis.

Kuchokera pamimba: kukhumudwa, kuchuluka kwa GGT, kuchuluka kwa zamchere phosphatase, kusanza, pakamwa kowuma, kawirikawiri - kuchuluka kwa transaminases, jaundice, hepatitis ya cholestatic, kutsekula m'mimba, kuperewera, nthawi zina - kuchepa kwa chakudya, kupweteka pamimba, glossitis, stomatitis.

Kuchokera pamtima dongosolo: kawirikawiri - kusokonezeka kwa myocardial, nthawi zina - bradycardia, arrhythmias, AV blockade ndi syncope, kugwa, kulephera kwa mtima, mawonekedwe a kupindika kwa coronary, thrombophlebitis, thromboembolism.

Kuchokera pa hemopoietic dongosolo: leukopenia, eosinophilia, thrombocytopenia, osowa - leukocytosis, nthawi zina - agranulocytosis, aplasic anemia, erythrocytic aplasia, megaloblastic anemia, reticulocytosis, hemolytic anemia, granulomatous hepatitis.

Kuchokera kumbali ya kagayidwe: hyponatremia, kusungika kwamadzimadzi, kutupa, kuchepa thupi, kuchepa kwa plasma osmolality, nthawi zina - kuperewera kwapakati pa porphyria, kuperewera kwa asidi wa folic acid, kusokonezeka kwa calcium calcium, kuchuluka kwa cholesterol ndi triglycerides.

Kuchokera ku endocrine system: gynecomastia kapena galactorrhea, kawirikawiri - kusowa kwa chithokomiro.

Kuchokera kwamikodzo dongosolo: kawirikawiri - kusokonezeka kwa impso, zamkati nephritis ndi aimpso kulephera.

Kuchokera pakapumidwe: munthawi zina - dyspnea, chibayo kapena chibayo.

Thupi lawo siligwirizana: zotupa pakhungu, kuyabwa, kawirikawiri - lymphadenopathy, malungo, hepatosplenomegaly, arthralgia.

Gwiritsani ntchito pa nthawi yoyembekezera

Ngati ndi kotheka, gwiritsani ntchito panthawi yomwe muli ndi pakati (makamaka pa trimester yoyamba) komanso mkaka wa m`mawere ayenera kuganizira bwino za chithandizo chomwe mayi akuyembekezera komanso chiwopsezo kwa mwana wosabadwayo kapena mwana. Pankhaniyi, carbamazepine tikulimbikitsidwa kuti azigwiritsidwa ntchito ngati monotherapy mu Mlingo wothandiza kwambiri.

Amayi amisinkhu yobala mwana panthawi yochizira ndi carbamazepine akulimbikitsidwa kugwiritsa ntchito njira zolerera za mahomoni.

Malangizo apadera ogwiritsira ntchito Tegretol tsr.

Carbamazepine sagwiritsidwa ntchito kukomoka kapena kuwononga khunyu pang'ono, kugwidwa ndi myoclonic kapena atonic epileptic. Sipamayenera kugwiritsidwa ntchito pochepetsa ululu wamba, monga prophylactic panthawi yayitali yotulutsidwa kwa trigeminal neuralgia.

Amagwiritsidwa ntchito mosamala ngati matenda obwera chifukwa cha mtima wamitsempha, matenda a chiwindi ndi / kapena ntchito ya impso, matenda a shuga, kuchuluka kwa kukakamira, ndi mbiri ya kusintha kwa hematological kugwiritsa ntchito mankhwala ena, hyponatremia, kusungika kwamikodzo, komanso chidwi chachikulu cha antidepressants atatu. , ndi zomwe zikuwonetsa mbiri ya kusokonezeka kwa chithandizo cha carbamazepine, komanso ana ndi odwala okalamba.

Chithandizo chikuyenera kuchitika moyang'aniridwa ndi dokotala. Ndi chithandizo chotenga nthawi yayitali, ndikofunikira kuwongolera chithunzi cha magazi, momwe chiwindi chimagwirira ntchito komanso impso, kuchuluka kwa ma electrolyte m'magazi amwazi, komanso kuyezetsa maso. Pafupipafupi kutsimikiza kwa kuchuluka kwa carbamazepine m'madzi a m'magazi tikulimbikitsidwa kuwunika momwe ntchito ikugwirira ntchito komanso chitetezo.

Osachepera milungu iwiri musanayambe mankhwala a carbamazepine, ndikofunikira kusiya mankhwala ndi mao inhibitors.

Munthawi ya chithandizo musalole kumwa mowa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Pa chithandizo, munthu ayenera kupewa kuchita zinthu zomwe zingakhale zovulaza zomwe zimafunikira chidwi chochulukirapo, komanso kuthamanga kwa zochitika zama psychomotor.

Kuchita tegretol tsr ndi mankhwala ena.

Ndi munthawi yomweyo kugwiritsa ntchito zoletsa za isoenzyme CYP3A4, kuchuluka kwa carbamazepine m'madzi amwazi.

Ndi munthawi yomweyo kugwiritsa ntchito zopangira za CYP3A4 isoenzyme dongosolo, kuthamanga kwa kagayidwe kake ka carbamazepine, kuchepa kwake kozizira m'magazi am'magazi, ndi kuchepa kwamankhwala othandizira ndizotheka.

Ndi munthawi yomweyo kugwiritsa ntchito carbamazepine kumapangitsa kagayidwe ka anticoagulants, folic acid.

Pogwiritsa ntchito munthawi yomweyo ndi valproic acid, kuchepa kwa kuchuluka kwa carbamazepine ndi kuchepa kwakukulu kwa ndende ya valproic acid m'madzi a m'magazi kumatha. Nthawi yomweyo, kugwiritsidwa ntchito kwa carbamazepine metabolite, carbamazepine epoxide, kumawonjezera (mwina chifukwa cha kuletsa kwake kusintha kwake kwa carbamazepine-10,11-trans-diol), yomwe imakhalanso ndi ntchito yotsutsana, kotero zotsatira za kuyanjanaku zimatha kuyendetsedwa, koma mawonekedwe osokoneza nthawi zambiri amapezeka - masomphenya osokoneza, chizungulire, kusanza, kufooka, nystagmus. Pogwiritsa ntchito munthawi yomweyo valproic acid ndi carbamazepine, kukula kwa hepatotoxic kungatheke (mwachiwonekere, chifukwa cha kupangika kwa metabolite yachiwiri ya valproic acid, yomwe imakhala ndi hepatotoxic athari).

Pogwiritsa ntchito munthawi yomweyo, valpromide imachepetsa kagayidwe kake ka chiwindi cha carbamazepine ndi metabolite carbamazepine-epoxide chifukwa chopewera kwa enzyme epoxide hydrolase. Metabolite yotchulidwa imakhala ndi zochita za anticonvulsant, koma pakuwonjezereka kwa ndende ya plasma imatha kukhala ndi poizoni.

Pogwiritsa ntchito munthawi yomweyo ndi verapamil, diltiazem, isoniazid, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, mwina ndi cimetidine, acetazolamide, danazole, desipramine, nicotinamide (mu akulu, kokha muyezo waukulu), erythromycin, trolesamole (kuphatikizapo ndi itraconazole, ketoconazole, fluconazole), terfenadine, loratadine, kuchuluka kwa carbamazepine mu madzi amwazi kumatha kukhala pachiwopsezo cha mavuto (chizungulire, kugona, ataxi ine, diplopia).

Pogwiritsa ntchito munthawi yomweyo ndi hexamidine, mphamvu ya anticonvulsant ya carbamazepine imafooka, ndi hydrochlorothiazide, furosemide - ndizotheka kuchepetsa zofunikira za m'magazi, ndi njira yolerera ya mahomoni - ndizotheka kufooketsa mphamvu ya njira zakulera komanso kukula kwa magazi a acyclic.

Pogwiritsa ntchito nthawi yomweyo ndi mahomoni a chithokomiro, ndizotheka kuwonjezera kuthetseratu kwa mahomoni a chithokomiro, omwe ali ndi clonazepam, ndizotheka kuwonjezera chidziwitso cha clonazepam ndikuchepetsa chilolezo cha carbamazepine, ndikukonzekera kwa lifiyamu, kupititsa patsogolo mphamvu ya neurotoxic.

Pogwiritsa ntchito munthawi yomweyo primidone, kuchepa kwa kuchuluka kwa carbamazepine m'madzi a m'magazi kungatheke. Pali malipoti kuti primidone imatha kuwonjezera kuchuluka kwa plasma yogwira metabolac - makamaka carbamazepine-10,11-epoxide.

Pogwiritsa ntchito munthawi yomweyo ndi ritonavir, mavuto a carbamazepine atha kupitilizidwa, ndi sertraline, kuchepa kwa kuchuluka kwa sertraline ndikotheka, ndi theophylline, rifampicin, cisplatin, doxorubicin, kuchepa kwa kuchuluka kwa carbamazepine m'magazi a plasma, ndi tetracycline.

Pogwiritsa ntchito munthawi yomweyo ndi felbamate, kuchepa kwa kuchuluka kwa carbamazepine m'madzi a m'magazi kungatheke, koma kuwonjezeka kwa kuchuluka kwa metabolite ya carbamazepine-epoxide, pomwe kuchepa kwa ndende mu plasma ya felbamate ndikotheka.

Ndi munthawi yomweyo kugwiritsa ntchito phenytoin, phenobarbital, kuchuluka kwa carbamazepine m'madzi amwazi kumachepa. Kuchepetsa mphamvu za zochita za anticonvulsant ndikotheka, ndipo nthawi zina, kulimbitsa kwake.

Mankhwala

Tegretol ndi antiepileptic ndipo ndi buku la dibenzodiazepine. Kuphatikiza pa antiepileptic zotsatira, mankhwalawa amakhalanso ndi psychotropic ndi neurotropic.

Monga antiepileptic wothandizila kugwiritsa ntchito carbamazepine imathandiza pochotsa kugwirira mwachidwi / kosavuta / khunyu komwe kumachitika ndi / popanda kudziwitsidwa kwachiwiri, kugunda khunyu wa tonic-clonic komanso kuphatikizira kwa mitundu ina ya kukomoka.

Panthawi ya mayesero azachipatala, zidapezeka kuti ndi Tegretol monotherapy odwala omwe ali ndi khunyu (makamaka ngati amagwiritsidwa ntchito pochita zochiritsa ana), psychotropic zotsatira za carbamazepine zimadziwika, zomwe, makamaka, zimadziwonetsera zokhazokha pazizindikiro za kukhumudwa ndi nkhawa, komanso kuchepa kwaukali komanso kusakwiya. . Malinga ndi kafukufuku wambiri, zotsatira za Tegretol pazizindikiro zama psychomotor ndi chidziwitso chazidziwitso zimatsimikiziridwa ndi mlingo ndipo amakayikira kapena kutsutsa. Maphunziro ena afotokoza zotsatira zabwino za carbamazepine pa chidwi, kukumbukira ndi luso la kuphunzira.

Tegretol monga wothandizira neurotropic imagwira ntchito zingapo matenda amitsempha.Makamaka, zimathandiza kupewetsa kupweteka kwa idiopathic / sekondale yotchedwa negegia. Kuphatikiza apo, kugwiritsa ntchito carbamazepine ndizoyenera kuti athe kuchepetsa ululu wa neurogenic m'malo osiyanasiyana, kuphatikiza kuwuma kwa msana, kuvulala kwa postresthesia ndi postherpetic neuralgia. Odwala omwe amachotsa mowa, carbamazepine imathandizira kukulira kosavuta kutsimikiza (munthawi imeneyi imafupikitsidwa) komanso kuchepa kwa zovuta zakuchipatala komwe kumawonetsa matendawa (munthawi ya kusekerera, kunjenjemera, matenda a gait). Chifukwa cha chithandizo cha Tegretol, odwala matenda a shuga a insipidus apakati oyambira amachepetsa kutulutsa mkodzo komanso ludzu.

Monga psychotropic othandizira, kugwiritsa ntchito Tegretol kumagwira odwala omwe ali ndi vuto lothandizidwa, monga mankhwalawa pachimake manic, pakukonzekera matenda a bipolar affective (manic-depression) (monga monotherapy kapena kuphatikiza ndi kukonzekera kwa lithiamu, antidepressants kapena antipsychotic), mankhwalawa schizoaffective ndi manic psychoses (komwe amagwiritsidwa ntchito nthawi imodzi ndi antipsychotic), epute polymorphic schizophrenia (epocode cycling haraka).

Limagwirira ntchito Tegretol zachokera blockade wamagetsi-gated sodium njira, chifukwa chomwe kukhazikika kwa nembanemba wa overexcited neurons kumachitika, zoletsa kupanga chosalekeza kutulutsa kwa neurons ndi kuchepa kwa synaptic conduction.

Mphamvu ya anticonvulsant ya carbamazepine imakhala makamaka chifukwa cha kukhazikika kwa zimitsempha za m'mimba komanso kuchepa kwa kumasulidwa kwa glutamate, kuchepa kwa ntchito ya neurotransmitter amino acid glutamate, popeza glutamate ndiye mkhalapakati wamkulu, palibe deta pa gawo la aspartate.

Tegretol imawonjezera kufinya kwa gawo lamkati lamanjenje, mwakutero kuchepetsa mwayi wa khunyu. Kuwonjezeka kwa maphatikizidwe a potaziyamu, komanso kusinthasintha kwa njira zama calcium, zomwe zimayendetsedwa ndi mawonekedwe apamwamba a membrane, zimatha kuyambitsa mphamvu ya anticonvulsant ya mankhwala. Carbamazepine amachotsa kusintha kwa umunthu wa khunyu ndipo, monga chotulukapo, kumawonjezera kuyanjana kwa odwala ndikuthandizira kukonzanso kwawo.

Tegretol ikhoza kutumikiridwa ngati chithandizo chachikulu chothandizira kapena kugwiritsidwa ntchito limodzi ndi mankhwala ena okhala ndi anticonvulsant kanthu.

Contraindication

Hypersensitivity a mankhwalawo - carbamazepine kapena mankhwala ofanana ndi mankhwala (mwachitsanzo, ma tridclic antidepressants) kapena mankhwala ena aliwonse, mafupa a hematopoiesis (anemia, leukopenia), pachimake "porphyria" (kuphatikizapo mbiri), AV blockade, munthawi yomweyo makonzedwe a MAO zoletsa.

Mosamala. Kuwonongeka kwa mtima kwa mtima, dilution hyponatremia (ADH hypersecretion syndrome, hypopituitarism, hypothyroidism, adrenal insuffence), uchidakwa wopitilira muyeso (kupsinjika kwa CNS kumakulitsidwa, kagayidwe ka carbamazepine kakulidwe), kufooka kwa mafupa kumalumikizidwa, ndipo kulephera kwa chiwindi kumalumikizidwa ndi kuchepa kwa magazi, ndipo , Prostatic hyperplasia, kuchuluka kwa ma intraocular.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, osasamala chakudyacho ndi madzi pang'ono.

Mapiritsi a retard (piritsi lonse kapena theka) ayenera kumezedwa lonse, osafuna kutafuna, ndimadzi ochepa, kawiri pa tsiku. Mwa odwala ena, mukamagwiritsa ntchito mapiritsi obwezeretsa, zingafunikire kuwonjezera kuchuluka kwa mankhwalawa.

Khunyu Ngati zingatheke, carbamazepine iyenera kutumizidwa ngati monotherapy. Chithandizo chimayamba ndikugwiritsa ntchito mlingo wocheperako tsiku lililonse, womwe umayamba kuwonjezeka pang'onopang'ono mpaka utakwaniritsidwa.

Kuphatikizana ndi carbamazepine ku mankhwala othandizira antiepileptic kuyenera kuchitika pang'onopang'ono, pamene Mlingo wa mankhwala ogwiritsidwa ntchito sasintha kapena, ngati pakufunika kusintha, sinthani.

Kwa akuluakulu, mlingo woyambirira ndi 100-200 mg wa mankhwala 1-2 kawiri pa tsiku. Kenako mlingo umakulitsidwa pang'onopang'ono mpaka mulingo woyenera wowonjezera (nthawi zambiri umagwiritsidwa ntchito kwa 400 mg katatu patsiku, kuchuluka kwa 1.6-2 g / tsiku).

Ana kuyambira zaka 4 - muyezo woyambirira wa 20-60 mg / tsiku, pang'onopang'ono akuwonjezeka ndi 20-60 mg tsiku lililonse. Mwa ana okulirapo zaka 4 - mu koyamba mlingo wa 100 mg / tsiku, mlingo umakulitsidwa pang'onopang'ono, sabata iliyonse ndi 100 mg. Kuthandiza Mlingo: 10-20 mg / kg patsiku (Mlingo wambiri): kwa zaka 4-5 - 200-400 mg (mu Mlingo wa 1-2), zaka 6-10 - 400-600 mg (mu 2-3 ), kwa zaka 11-15 - 600-1000 mg (mu 2-3 waukulu).

Ndi trigeminal neuralgia, 200-400 mg / tsiku limayikidwa tsiku loyamba, pang'onopang'ono limawonjezeka osapitilira 200 mg / tsiku mpaka ululu utatha (pafupifupi 400-800 mg / tsiku), kenako ndikuchepetsa. Pankhani ya kupweteka kwa chiyambi cha neurogenic, mlingo woyambayo ndi 100 mg 2 kawiri patsiku patsiku loyamba, ndiye kuti mlingo umakulitsidwa osaposa 200 mg / tsiku, ngati kuli kofunikira, kuwonjezera ndi 100 mg maola 12 aliwonse mpaka ululu utachira. Njira yokonza ndi 200-1200 mg / tsiku angapo Mlingo.

Mankhwalawa okalamba ndi odwala omwe ali ndi hypersensitivity, mlingo woyambirira ndi 100 mg 2 kawiri pa tsiku.

Alcohol achire syndrome: pafupifupi mlingo wa 200 mg katatu patsiku, m'malo ovuta kwambiri, m'masiku ochepa, mlingo umatha kuchuluka mpaka 400 mg katatu pa tsiku. Kumayambiriro kwa chithandizo chazovuta zochizira, tikulimbikitsidwa kupereka mankhwala osakanikirana ndi mankhwala a sedative-hypnotic (clidweazole, chlordiazepoxide).

Shuga insipidus: avareji ya mankhwala akuluakulu ndi 200 mg katatu patsiku. Mwa ana, mlingo uyenera kuchepetsedwa malinga ndi zaka komanso kulemera kwa thupi kwa mwana.

Matenda a shuga odwala matenda ashuga, limodzi ndi mavuto: pafupifupi 200 mg 2 mg kawiri pa tsiku.

Popewa kubwereranso pamankhwala oyanjana ndi osokoneza bongo - 600 mg / tsiku mu 3-4 Mlingo.

M'mavuto owopsa okhudzana ndi zovuta komanso zosokoneza (bipolar), Mlingo wa tsiku ndi tsiku ndi 400-1600 mg. Wapakati tsiku ndi tsiku ndi 400-600 mg (mu 2-3 waukulu). Mu woopsa manic boma, mlingo wa mankhwalawa ukuwonjezeka mwachangu, ndi kukonza mankhwalawa othandizira matenda - pang'onopang'ono (kusintha kulekerera).

Zotsatira zoyipa

Mukamayesa kuchuluka kwa zomwe zimachitika mosiyanasiyana, makondedwe otsatirawa adagwiritsidwa ntchito: nthawi zambiri - 10% ndipo nthawi zambiri, nthawi zambiri 1-10%, nthawi zina 0,1-1%, kawirikawiri 0.01-0.1%, kawirikawiri 0.01%.

Mlingo wothandizidwa ndi Mlingo umasowa patangopita masiku ochepa, zonse munthawi yomweyo ndipo pambuyo pochepetsedwa kwakanthawi mlingo wa mankhwala. Kukula kwa zoyipa zimachitika ku chapakati mantha dongosolo mwina chifukwa cha kuchuluka kwa mankhwala kapena kusinthasintha kwa ndende ya yogwira plasma. Zikatero, tikulimbikitsidwa kuwunikira kuchuluka kwa mankhwala omwe ali m'magazi.

Kuchokera kumbali ya chapakati mantha dongosolo: nthawi zambiri - chizungulire, ataxia, kugona, asthenia, nthawi zambiri - kupweteka mutu, paresis malo okhalamo, nthawi zina - zachilendo mwadzidzidzi kayendedwe (mwachitsanzo, kugwedezeka "kugwedezeka" kugwedezeka - asterixis, dystonia, tics), nystagmus, kawirikawiri - orofacial dyskinesia , kusokonezeka kwa oculomotor, kusokonezeka kwa malankhulidwe (mwachitsanzo dysarthria), kusokonezeka kwa choreoathetoid, zotumphukira neuritis, paresthesias, myasthenia gravis ndi zizindikiro za paresis. Udindo wa carbamazepine ngati mankhwala omwe amachititsa kapena amathandizira kuti pakhale vuto loyipa la antipsychotic syndrome, makamaka akapatsidwa mankhwala limodzi ndi antipsychotic, sadziwika bwinobwino.

Kuchokera pagawo lamalingaliro: kawirikawiri - kuyerekezera zinthu m'maganizo (zowoneka kapena zowerengera), kukhumudwa, kuchepa kwamphwayi, kuda nkhawa, kuchita zamtopola, kukwiya, kusokoneza, sizowopsa - kuyambitsa psychosis.

Thupi lawo siligwirizana ndi zigawo zikuluzikulu za mankhwalawa: kawirikawiri urticaria, nthawi zina erythroderma, kusowa kwa lupus ngati khungu, kuyabwa kwambiri pakhungu, kawirikawiri kawirikawiri exudative erythema multiforme (kuphatikiza Stevens-Johnson syndrome), poizoni wa epidermal necrolysis (Lyell syndrome), photosensitivity.

Pafupipafupi, matupi ambiri amachedwa-mtundu wa hypersensitivity zimachitika ndi kutentha, zotupa za pakhungu, vasculitis (kuphatikizapo erythema nodosum monga mawonekedwe a khungu vasculitis), lymphadenopathy, zizindikiro zofanana ndi zamitsempha, arthralgia, leukopenia, eosinophilia, chiwindi chimagwira ndi chiwindi ndi hepatosplenomegaly. wopezeka mumitundu yosiyanasiyana). Ziwalo zina (mwachitsanzo, mapapu, impso, kapamba, myocardium, colon) zingathenso kuchita nawo. Osowa kwambiri - aseptic meningitis ndi myoclonus ndi zotumphukira eosinophilia, anaphylactoid anachita, angioedema, chifuwa chachikulu cha pneumonitis kapena eosinophilic chibayo. Ngati zotupa zakumwambazi zikuchitika, kugwiritsa ntchito mankhwalawa kuyenera kusiyiratu.

Hematopoietic ziwalo: pafupipafupi - leukopenia, nthawi zambiri - thrombocytopenia, eosinophilia, kawirikawiri - leukocytosis, lymphadenopathy, kuperewera kwa asidi folic, kawirikawiri - agranulocytosis, aplasic anemia, zowona za erythrocytic aplasia, mealumblastic anemia, puteorrume kuchepa magazi

Kuchokera pamimba yogaya chakudya: pafupipafupi - nseru, kusanza, kawirikawiri - mkamwa wowuma, nthawi zina - kutsegula m'mimba kapena kudzimbidwa, kupweteka kwam'mimba, kawirikawiri - glossitis, stomatitis, kapamba.

Kumbali ya chiwindi: pafupipafupi - kuwonjezeka kwa ntchito ya GGT (chifukwa cha kukhazikitsidwa kwa puloteni iyi m'chiwindi), yomwe nthawi zambiri ilibe kanthu, nthawi zambiri - kuwonjezeka kwa ntchito ya mankhwala a phosphatase ya alkaline, nthawi zina - kuwonjezeka kwa zochitika za "chiwindi" transaminases, kawirikawiri - hepatitis ya hematocellular kapena hepatocellular mtundu wosakanikirana, jaundice, osowa kwambiri - granulomatous hepatitis, kulephera kwa chiwindi.

Kuchokera ku CCC: kawirikawiri - kusokonezeka kwa mtima wa mtima, kuchepa kapena kuwonjezeka kwa magazi, kawirikawiri - bradycardia, arrhythmias, AV block ndi kukomoka, kugwa, kuchuluka kapena kukulitsa kwa mtima kulephera, kufalikira kwa matenda a mtima (kuphatikiza kapena kuwonjezeka kwa matenda a angina), thrombophlebitis, thromboembolic syndrome.

Kuchokera ku endocrine dongosolo ndi kagayidwe: nthawi zambiri - edema, kuchepa kwamadzi, kulemera, hyponatremia (kuchepa kwa osmolarity chifukwa cha zotsatira zofanana ndi ADH, zomwe nthawi zina zimabweretsa kuchepa kwa magazi, kuphatikizidwa ndi ulesi, kusanza, kupweteka mutu, kusokonezeka ndi zovuta zamitsempha), kawirikawiri - hyperprolactinemia (ikhoza kukhala limodzi ndi galactorrhea ndi gynecomastia), kuchepa kwa ndende ya L-thyroxine (kwaulere T4, T4, T3) komanso kuchuluka kwa TSH (nthawi zambiri sikuyenda limodzi) mawonetseredwe azachipatala), kagayidwe kakang'ono ka calcium-phosphorous mu minofu yamafupa (amachepetsa plasma Ca2 + ndi 25-OH-colecalciferol): osteomalacia, hypercholesterolemia (kuphatikizapo HDL cholesterol) ndi hypertriglyceridemia.

Kuchokera ku genitourinary system: kawirikawiri - interstitial nephritis, kulephera kwa impso, kusokonezeka kwa impso (mwachitsanzo, albuminuria, hematuria, oliguria, kuchuluka kwa urea / azotemia), kuchuluka kukodza, kusungika kwamikodzo, kuchepa potency.

Kuchokera ku minculoskeletal system: kawirikawiri - arthralgia, myalgia kapena kukokana.

Kuchokera ku ziwalo zam'maganizo: kawirikawiri - kusokonezeka kwa kulawa, kuyendetsa ma mandala, conjunctivitis, kumva kuwonongeka, kuphatikizapo tinnitus, hyperacusis, hypoacusia, kusintha kwamtundu wa mawu.

Zina: zovuta za pakhungu la khungu, purpura, ziphuphu, kuchuluka thukuta, alopecia. Nthawi zambiri vuto la hirsutism lafotokozedwapo, koma chiyanjano cha izi ndi carbamazepine sichikudziwika. Zizindikiro: Nthawi zambiri zimawonetsa kusokonekera kwa dongosolo lamkati lamanjenje, CVS, ndi kupuma.

Kuchokera kumbali ya dongosolo lamkati lamanjenje ndi ziwalo zamatsenga - kuponderezedwa kwamitsempha yamagazi, kukhumudwitsa, kugona, kukhumudwa, kuyerekezera zinthu, kukomoka, chikomokere, kuwoneka kosokonekera ("chifunga" pamaso pa maso), dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (poyamba), hyporeflexia (poyamba), hyporeflexia ), zopweteka, zovuta zama psychomotor, myoclonus, hypothermia, mydriasis).

Kuchokera ku CCC: tachycardia, kutsitsa magazi, nthawi zina kumawonjezera kuthamanga kwa magazi, kusokonezeka kwa kulowetsedwa kwa intraventricular ndi kukulira kwa QRS zovuta, kumangidwa kwa mtima.

Pa mbali ya kupuma dongosolo: kupuma kupsinjika, pulmonary edema.

Kuchokera pamimba: kugaya ndi mseru komanso kusanza, kuthamangitsa chakudya m'mimba, kunachepetsa mphamvu ya matumbo.

Kuchokera kwamikodzo dongosolo: kwamikodzo posungira, oliguria kapena anuria, madzi osungira, hyponatremia dilution.

Zizindikiro zasayansi: leukocytosis kapena leukopenia, hyponatremia, metabolic acidosis, hyperglycemia ndi glucosuria, kuwonjezeka kwa gawo la minofu ya KFK.

Chithandizo: palibe mankhwala enaake. Chithandizo chimatengera wodwala, kuchipatala, kutsimikiza kwa kuchuluka kwa carbamazepine mu madzi a m'magazi (kutsimikizira poizoni ndi mankhwalawa komanso kuyesa kuchuluka kwa kuchuluka), kutsekeka kwa m'mimba, kuyika kwa makala oyamwa (kutulutsidwa mochedwa kwa chapamimba kungayambitse kuchepetsedwa kwa masiku awiri ndi atatu ndikuyambiranso) mawonekedwe a kuledzera panthawi yobwezeretsa).

Kukakamizidwa diuresis, hemodialysis, ndi peritoneal dialysis sikuthandiza (dialysis imasonyezedwa ndikuphatikiza kwa poizoni wamphamvu ndi kulephera kwa aimpso). Ana aang'ono angafunike kuthiridwa magazi. Zizindikiro zothandizira mu chipinda chosamalira bwino, kuyang'anira ntchito zamtima, kutentha kwa thupi, mawonekedwe a impso, impso ndi chikhodzodzo, kukonza masoka a electrolyte. Ndi kuchepa kwa kuthamanga kwa magazi: malo okhala ndi mutu wachepetsedwa, m'malo mwa plasma, osakwanira - iv dopamine kapena dobutamine, ndikusokonekera kwa mtima - chithandizo chimasankhidwa payekha, ndi kupweteka - kuyambitsa kwa benzodiazepines (mwachitsanzo diazepam), mosamala (chifukwa cha kuchuluka kwa kukhumudwa kupuma) kukhazikitsidwa kwa ma anticonvulsants ena (mwachitsanzo, phenobarbital). Ndi chitukuko cha dilution hyponatremia (madzi kuledzera) - kuletsa magazi kuyamwa ndi kulowetsedwa pang'onopang'ono ndi 0.9% NaCl yankho (ingathandize kupewa kukula kwa matenda a edema). Hemosorption pa kaboni sorbents tikulimbikitsidwa.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapezeka mu mawonekedwe a mapiritsi okhala ndi mafupa. Mapiritsiwo ali ndi mawonekedwe a biconvex.

Mapiritsi a 200 mg amapezeka m'matakatoni a 50 zidutswa. Mkati mwathumba la matuza 5 azinthu 10.

Mapiritsi a 400 mg amapezeka m'matumba a zidutswa 30. Mkati mwa paketi 3 matuza a zidutswa 10.

Malangizo apadera

Monotherapy ya khunyu imayamba ndi kukhazikitsidwa kwa Mlingo wocheperako, womwewo umawonjezera iwo kuti akwaniritse zofunikira zochizira.

M'pofunika kudziwa kuchuluka kwa plasma kuti musankhe mlingo woyenera, makamaka ndi kuphatikiza mankhwala.

Mukasamutsa wodwala ku carbamazepine, mlingo wa mankhwala omwe amadziwika kale antiepileptic uyenera kuchepetsedwa pang'onopang'ono mpaka utachotsedwa kwathunthu.

Kuthana kwadzidzidzi kwa mankhwalawa kumayambitsa kukomoka. Ngati kuli koyenera kusokoneza mwadzidzidzi chithandizo, wodwalayo ayenera kusinthidwa kupita ku mankhwala ena antiepileptic pachiwonetsero cha kukonzekera chomwe chikusonyezedwa muzochitika zotere (mwachitsanzo, diazepam kutumikiridwa kudzera mkati kapena rectally, kapena phenytoin yoyendetsedwa iv).

Pali milandu ingapo yosanza, kutsekula m'mimba ndi / kapena kuchepa kwa chakudya, kukhudzika ndi / kapena kupsinjika kwa ana akhanda omwe amayi awo amakhala ndi carbamazepine mogwirizana ndi anticonvulsants ena (izi zimatha kukhala mawonetseredwe a "kuchoka" kwa akhanda).

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 mupange kafukufuku wamagazi (kuphatikiza kupatsidwa zinthu za m'magazi, kuchuluka kwa maselo), seramu Fe ndende, urinalysis, magazi urea, EEG, kutsimikiza kwa serum electrolyte ndende (komanso nthawi yamankhwala, chifukwa chitukuko cha hyponatremia). Pambuyo pake, zizindikirozi ziyenera kuyang'aniridwa m'mwezi woyamba wamankhwala sabata iliyonse, kenako mwezi uliwonse.

Carbamazepine iyenera kuchotsedwa nthawi yomweyo ngati thupi lawo siligwirizana kapena ngati zikuwoneka kuti akuganiza kuti akupanga matenda a Stevens-Johnson kapena a Lyell. Kutulutsa kofatsa (kosiyanitsa macular kapena maculopapular exanthema) nthawi zambiri kumatha patatha masiku angapo kapena milungu ingapo ndikupitilira chithandizo kapena pakumachepetsa mlingo (wodwalayo ayenera kuyang'aniridwa ndi adokotala panthawiyi).

Carbamazepine amakhala ndi anticholinergic ofooka, akaperekedwa kwa odwala omwe ali ndi vuto la intraocular, kuwunika kwake nthawi zonse ndikofunikira.

Kuthekera kwa kutseguka kwa ma psychoses komwe kumachitika posachedwapa kuyenera kukumbukiridwa, ndipo odwala okalamba, mwayi wokhala ndi chisokonezo kapena kukondwerera.

Mpaka pano, pakhala pali malipoti osiyana abwinobwino a chonde cha abambo ndi / kapena spermatogenesis (ubale wa zovuta izi ndi carbamazepine sunakhazikitsidwe).

Pali malipoti a kutuluka magazi kwa azimayi pakati pa nthawi ya kusamba kwa msambo panthawi yomwe njira zakulera zimagwiritsidwa ntchito nthawi yomweyo. Carbamazepine ikhoza kusokoneza kudalirika kwa mankhwala oletsa kubereka pamlomo, chifukwa chake, amayi omwe ali ndi zaka zobereka ayenera kugwiritsa ntchito njira zina zodzitetezera pakati pa nthawi ya chithandizo.

Carbamazepine iyenera kugwiritsidwa ntchito moyang'aniridwa ndi achipatala.

Ndikofunikira kudziwitsa odwala za zizindikiro zoyambirira za poizoni mu zovuta za hematologic, komanso zizindikiro kuchokera pakhungu ndi chiwindi. Wodwalayo amadziwitsidwa zakufunika kofunsira dokotala nthawi yomweyo pakagwiritsidwa ntchito kosafunikira monga malungo, zilonda zapakhosi, zotupa, zotupa zamkamwa, chifukwa chovulaza, zotupa m'mimba mwa mawonekedwe a petechiae kapena purpura.

Nthawi zambiri, kuchepa kwapang'onopang'ono kapena kupitirirabe kwa kuchuluka kwa maselo am'magazi sikutanthauza kuyambika kwa aplasic anemia kapena agranulocytosis. Komabe, asanayambe chithandizo, komanso nthawi ndi nthawi yamankhwala, kuyezetsa magazi kwa kachipatala kuyenera kuchitidwa, kuphatikizapo kuwerengera kwamapulogalamu am'magazi komanso ma reticulocytes, komanso kudziwa kuchuluka kwa Fe 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.

Musanayambe chithandizo, ndikofunikira kuti mupange mayeso a ophthalmological, kuphatikiza kuyesa kwa fundus ndi nyali yoyenda ndi muyeso wa kukakamiza kwa intraocular ngati kuli kotheka. Potumiza mankhwala kwa odwala omwe ali ndi kukhudzika kwa intraocular, kuyang'anira chizindikirocho kumafunikira.

Ndikulimbikitsidwa kuti musiye kugwiritsa ntchito ethanol.

Mankhwala osakhazikika mawonekedwe amatha kumwa kamodzi, usiku. Kufunika kochulukitsa mlingo mukasinthira mapiritsi ndikosowa kwambiri.

Ngakhale ubale wapakati pa mlingo wa mankhwalawa, kugwiritsidwa ntchito kwake komanso kupatsa mphamvu kwakanthawi kochepa kwambiri, komabe, kutsimikiza kwa nthawi yayitali kwa carbamazepine kungakhale kothandiza pazinthu zotsatirazi: kuwonjezeka kwambiri kwa pafupipafupi pakuwukira, kuti muwone ngati wodwalayo akumwa mankhwalawo moyenera. pa mimba, mankhwalawa ana kapena achinyamata, ndi akuganiza malabsorption a mankhwala, ndi akuganiza chitukuko cha poizoni zimachitika ngati wodwala akutenga mankhwala angapo.

Mwa amayi omwe ali ndi zaka zobereka, carbamazepine iyenera kugwiritsidwa ntchito ngati chithandizo chamankhwala nthawi zonse (pogwiritsa ntchito mlingo wocheperako) - pafupipafupi malingaliro obadwa nawo mwa makanda obadwa kwa amayi omwe adalandira chithandizo cha antiepileptic ndi apamwamba kuposa omwe adalandira lirilonse ngati mankhwalawa.

Mimba ikachitika (posankha kukhazikitsidwa kwa carbamazepine panthawi yapakati), ndikofunikira kuyerekeza bwino phindu lomwe lingachitike pakubwera kwa mankhwala ndi zovuta zake, makamaka m'miyezi itatu yoyambirira ya pakati. Amadziwika kuti ana obadwa kwa amayi omwe ali ndi khunyu amakhala okonzekera kutukuka kwa intrauterine, kuphatikizapo kusokonekera. Carbamazepine, monga mankhwala ena onse antiepileptic, amatha kukulitsa chiwopsezo cha zovuta izi. Pali malipoti apadera a matenda obadwa nawo komanso kusokonezeka, kuphatikizapo kusatsekedwa kwa ziphuphu zakumaso (spina bifida). Odwala ayenera kupatsidwa chidziwitso chakuchulukitsa chiopsezo cha kusokonezeka ndi kuthekera kozindikira matenda oyembekezera.

Mankhwala othandizira antiepileptic amalimbikitsa kuchepa kwa folic acid, omwe nthawi zambiri amawonedwa pakakhala pakati, omwe amatha kukulitsa vuto la kubadwa kwa ana (asanachitike komanso nthawi yomwe ali ndi pakati, kupatsidwa folic acid kumathandizidwa). Pofuna kupewa kuwonjezeka kwa ana obadwa kumene, ndikulimbikitsidwa kuti amayi omwe ali m'milungu yotsiriza ya mimba, komanso akhanda, apatsidwe vitamini K1.

Carbamazepine akudutsa mkaka wa m'mawere; maubwino ndi zotsatira zoyipa za kuyamwitsa ziyenera kufananizidwa ndi chithandizo chanthawi zonse. Amayi omwe amamwa carbamazepine amatha kuyamwitsa ana awo, malinga ngati mwana amawunikidwa kuti apange zovuta zoyipa (mwachitsanzo, kugona kwambiri, thupi lawo siligwirizana.

Munthawi ya chithandizo, chisamaliro chikuyenera kuchitika poyendetsa magalimoto ndi kuchita zina zomwe zingakhale zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Kupanga ndi mawonekedwe a kumasulidwa

mu chithuza 10 ma PC., mumapaketi okhala ndi makatoni 5 (200 mg aliyense) kapena matuza atatu (400 mg aliyense).

Mlingo ndi makonzedwe

Mkati mukamadya kapena mukatha kudya, kapena pakati pa chakudya, ndimadzi pang'ono.

Mapiritsi otetezedwa (piritsi lonse kapena theka, ngati lilozedwa ndi dokotala) ayenera kumwedwa popanda kutafuna.

Mankhwala angagwiritsidwe ntchito onse mu mawonekedwe a monotherapy, komanso monga gawo la mankhwala.

Popeza mankhwala othandizira amasulidwa pamapiritsi a nthawi yayitali pang'onopang'ono, amapatsidwa mankhwala 2 kawiri pa tsiku.

Popeza kuti mankhwala a Tegretol ® CR amaperekedwa kawiri pa tsiku, njira yolandirira bwino kwambiri imatsimikiziridwa ndi adokotala potengera zomwe akuvomerezazo.

Kusamutsa wodwala kuti atenge Tegretol ® ngati mapiritsi wamba kupita ku Tegretol ® CR, mapiritsi otulutsidwa kwa nthawi yayitali

Zochitika zamankhwala zikuwonetsa kuti mwa odwala ena, akamagwiritsa ntchito mapiritsi atulutsidwa nthawi yayitali, pangafunikire kuwonjezera kuchuluka kwa mankhwalawo.

Poganizira momwe mankhwalawa amagwiritsidwira ntchito ndi mankhwala a antiepileptic, odwala okalamba ayenera kusankhidwa mosamala.

Ngati ndi kotheka, mankhwalawa ayenera kuikidwa ngati monotherapy.

Mankhwalawa nthawi zambiri amakhala osagwira chifukwa chogwirira ntchito (petit mal, abscess) komanso myoclonic.

Chithandizo chimayamba ndikugwiritsa ntchito mlingo wocheperako tsiku lililonse, womwe umayamba kuwonjezeka pang'onopang'ono mpaka utakwaniritsidwa.

Kusankha mulingo woyenera wa mankhwalawa, tikulimbikitsidwa kuti chikhazikitso cha omwe agwira ntchito m'madzi a m'magazi azitsimikizika.

Tegretol ® CR ikawonjezeredwa ku mankhwala ena antiepileptic omwe amamwa, mlingo wa Tegretol ® CR umakulitsidwa pang'onopang'ono. Ngati ndi kotheka, gwiritsani ntchito mankhwalawa moyenerera.

Kwa akulu, muyeso woyamba wa carbamazepine ndi 100-200 mg 1 kapena 2 kawiri pa tsiku. Kenako amawonjezedwa pang'onopang'ono kuti akwaniritse bwino kwambiri mankhwala othandizira, nthawi zambiri amakwaniritsidwa pa mlingo wa 400 mg katatu patsiku. Odwala ena angafunike kuchuluka kwa tsiku ndi tsiku mpaka 1600 kapena 2000 mg.

Mankhwala a Tegretol ® CR, mapiritsi olimbitsa otsekemera ayenera kugwiritsidwa ntchito mwa ana azaka 4 kapena kupitirira. Mwa ana osakwana zaka 3, mankhwalawa Tegretol ® amagwiritsidwa ntchito mwanjira yamadzi chifukwa chovuta kugwiritsa ntchito mitundu yolimba ya m'badwo uno. Mwa ana opitirira zaka 4, mankhwalawa amatha kuyambitsidwa ndi kugwiritsidwa ntchito kwa 100 mg / tsiku, mlingo umakulitsidwa pang'onopang'ono, ndi 100 mg pa sabata.

Mlingo wokonza kwa ana okhazikika pamlingo wa 1020 mg / kg / tsiku (muyezo zingapo).

Kwa ana a zaka 4-5, mlingo wa tsiku lililonse ndi 200-400 mg, zaka 6-10 - 400-600 mg, wazaka 11-15 - 600-1000 mg.

Trigeminal neuralgia

Mlingo woyambirira ndi 200-400 mg / tsiku. Imachulukana pang'onopang'ono mpaka ululu utazimiririka (kawirikawiri - 200 mg 3-4 pa tsiku). Kenako, mankhwalawo amayamba kuchepetsedwa pang'ono pang'ono. Mlingo woyambira wopatsa odwala ndi 100 mg kawiri pa tsiku.

Mowa kusiya matenda

Mlingo wamba ndi 200 mg katatu patsiku. Woopsa milandu, mlingo akhoza kuchuluka mu masiku angapo oyamba (mwachitsanzo, 400 mg katatu patsiku). Kuwonetsedwa kwambiri kwa kusiya kumwa, mankhwalawa amayamba ndi kugwiritsa ntchito mankhwalawa limodzi ndi mankhwala omwe ali ndi mphamvu yosintha komanso mwachitsanzo (clanzoazole, chlordiazepoxide). Pambuyo kuthetsa gawo la pachimake, chithandizo ndi mankhwalawa chitha kupitilizidwa ngati monotherapy.

Polyuria ndi polydipsia ya chikhalidwe cha neurohormonal mu matenda a shuga insipidus apachigawo chapakati

Mlingo wamba wa akulu ndi 200 mg katatu patsiku. Mwa ana, mlingo uyenera kuchepetsedwa malinga ndi zaka komanso kulemera kwa thupi kwa mwana.

Ululu matenda am'mbuyomu neuropathy

Mlingo wamba ndi 200 mg 2-4 kawiri pa tsiku.

Pachimake manic zinthu ndi thandizo mankhwala othandizira (kupuma) mavuto

Mlingo watsiku ndi tsiku ndi 400-1600 mg. Wapakati tsiku ndi tsiku ndi 400-600 mg (mu 2-3 waukulu). Munthawi yodwala, mankhwalawa amayenera kuchuluka msanga. Ndi mankhwala othandizira okhudzana ndi kupuma, kuti muonetsetse kuti mukulumikizana bwino, kuchuluka kulikonse kwa mankhwalawa kuyenera kukhala kochepa, mlingo wa tsiku ndi tsiku uyenera kuchuluka pang'onopang'ono.

Malangizo ogwiritsira ntchito Tegretol (Njira ndi Mlingo)

Malangizo ogwiritsira ntchito Tegretol amakulolani kumwa mapiritsi panthawi kapena mukatha kudya nthawi yomweyo ndi madzi pang'ono. At khunyungati kuli kotheka, mankhwalawa amayenera kumwedwa ngati monotherapy.

Chithandizo cha mankhwalawa chimayamba ndikugwiritsa ntchito mlingo waung'ono wa tsiku ndi tsiku, womwe umakulitsidwa pang'ono ndi pang'ono. Kusankha mulingo woyenera, ndikulimbikitsidwa kuti zomwe zili mu magazi zitsimikizike.

Mankhwala akaphatikizidwa ku mankhwala omwe asankhidwa kale, izi ziyenera kuchitika pang'onopang'ono, ndipo Mlingo wa mankhwala ogwiritsidwa ntchito nthawi zambiri sasintha kapena kulondola.

Mlingo woyambirira wa akuluakulu ndi 100-200 mg 1-2 kawiri pa tsiku. Ndiye kuti mankhwalawa amawonjezedwa pang'onopang'ono mpaka zotsatira zabwino zowonjezera zimachitika, monga lamulo zimakwaniritsidwa ndi 400 mg patsiku. Odwala ena angafunike kumwa ma gramu 1.6 kapena 2 a mankhwala patsiku.

Ana azaka 4 ndi ochepera ayenera kuyamba kulandira mankhwalawa 20-60 mg wa mankhwala patsiku ndikuwonjezera mlingo wa 20-60 mg tsiku limodzi.

Mwa ana opitirira zaka 4, mankhwalawa amaloledwa kuyamba ndi 100 mg patsiku, mlingo umakulitsidwa pang'onopang'ono, ndi 100 mg kamodzi pa sabata.

Malingo othandizira a ana ndi 10-20 mg / kg patsiku.

Pa mankhwala trigeminal neuralgia mlingo woyambirira ndi 200-400 mg patsiku. Imachulukitsa pang'onopang'ono mpaka kupwetekako kumatsitsidwa (200 mg mpaka 4 pa tsiku), kenako ndikutsika pang'ono. Mlingo woyambira wokalamba ndi 100 mg kawiri mu ulesi.

At kusiya mowa muyezo mlingo 200 mg katatu patsiku. M'madera ovuta kwambiri, m'masiku ochepa, mankhwalawa akhoza kuchuluka. Kuwonetsedwa kwambiri kwa kusiya mowa, mankhwalawa amayamba ndi kuphatikiza kwa tegretol ndi mankhwala osokoneza bongo opatsa chidwi. Pambuyo poletsa gawo laphokoso, Tegretol monotherapy ikhoza kuchitidwa.

At matenda ashugapafupifupi odwala wamkulu ndi 200 mg ya mankhwala mpaka katatu pa tsiku. Mwa ana, mlingo uyenera kuchepetsedwa malinga ndi zaka komanso kulemera kwa mwana.

Mankhwalawa matenda ashuga a m'mimba ndi kupweteka, mankhwalawa amapezeka 200 mg mpaka kanayi pa tsiku.

At manic limati pachimake mtundu ndi mankhwala kukonza matenda a kupuma, Mlingo watsiku lililonse ndi 400-1600 mg. Mlingo watsiku ndi tsiku ndi 400-600 mg.

Bongo

Zizindikiro za bongo: kukwiya, kupsinjika kwa mitsempha, kugona,kusanja, kuyerekezera,masomphenya osalala chikomokere, dysarthriamawu achipongwe ataxia, nystagmus, dyskinesia, hyporeflexia, hyperreflexia, hypothermia, kupweteka, myoclonus, zovuta zama psychomotor mydriasis,pulmonary edemakupuma tachycardia, matenda oopsa, ochepa hypotension, mtima kumangidwa, kukomoka, kusanza, kuchepa kwamatumbo, oliguria, posungira kwamkodzo, madzi osungira, anuria, hyponatremia, hyperglycemia, metabolic acidosis,kuchuluka kwawonjezeka creatinine phosphokinase.

Chithandizo cha bongo: kuchipatala, kutsimikiza mtima carbamazepinem'magazi kuti muwone kukula kwa bongo. Kuchotsa zomwe zili m'mimba, kugwiritsa ntchito enterosorben, symptomatic chithandizo, kuyang'anira mtima, kukonza ma electrolyte zosokoneza. Zapadera mankhwala kulibe.

Tegretol, malangizo ogwiritsira ntchito: njira ndi mlingo

Tegretol amatengedwa pakamwa. Mapiritsi amasambitsidwa pansi ndi madzi ochepa. Mankhwalawa atha kumwa mosasamala chakudya.

Mwina kugwiritsidwa ntchito kwa Tegretol monga monotherapy kapena kuphatikiza mankhwala ena.

Ndikofunika kumwa madzi (5 ml - supuni 1 woyesedwa - 100 mg) ngati kumeza kumakhala kovuta kapena ngati pakufunika kusankha mosamala mlingo. Mukamagwiritsa ntchito mankhwalawa, mumakhala chofunikira kwambiri poyerekeza ndi momwe mankhwalawa amapangira Tegretol.Pofuna kupewa kukulana ndi zovuta zoyipa, tikulimbikitsidwa kuti muyambe kulandira chithandizo chokhala ndi Mlingo wochepa, pambuyo pake umachulukana pang'ono. Musanagwiritse ntchito, gwiritsani botolo ndi madzi.

Ngati wodwala watengedwa kuchokera pakumwa mapiritsi a mitundu ya mankhwala, mlingo wa tsiku ndi tsiku sunasinthidwe, komabe, tikulimbikitsidwa kuti muchepetse kukula kwa mlingo umodzi ndikukulitsa kuchuluka kwa Tegretol.

Ndikofunikira kusankha mankhwalawa kwa odwala okalamba omwe ali ndi chisamaliro chapadera.

Ngati ndi kotheka, tegretol iyenera kumwedwa ngati monotherapy.

Kumayambiriro kwa maphunzirowa, kumwa mankhwala ochepa tsiku lililonse, komwe kumakulitsidwa pang'onopang'ono.

Kuti musankhe mulingo woyenera kwambiri, tikulimbikitsidwa kudziwa kuchuluka kwa plasma yogwira ntchito m'magazi (nthawi zambiri 0.004-0.012 mg / ml).

Mlingo woyambirira wa Tegretol kwa akulu ndi ana a zaka 16 ndi 100-200 mg 1-2 kawiri pa tsiku, avareji yolondola kwambiri ndi 2-3 pa tsiku kwa 400 mg. Nthawi zina muyenera kuwonjezera tsiku lililonse 1600-2000 mg.

Trigeminal neuralgia

Mlingo woyambira tsiku lililonse wa Tegretol ndi 200-400 mg, kwa odwala okalamba - 200 mg (100 mg 2 kawiri pa tsiku). Iwo amawonjezereka pang'onopang'ono mpaka ululu utazimiririka, pafupifupi kawiri pa tsiku patsiku, 200 mg aliyense. Mlingo wovomerezeka tsiku lililonse ndi 1200 mg. Kenako lembani mulingo woyenera wokonza Tegretol.

Ngati kupweteka kumachoka, chithandizo chimathetsedwa pang'onopang'ono mpaka vuto lotsatira litayamba.

Mowa kusiya matenda

Wapakati tsiku lililonse la Tegretol ndi katatu pa tsiku, 200 mg aliyense. Muzovuta kwambiri, masiku angapo oyambirira amawonjezereka (mwachitsanzo, mpaka katatu patsiku, 400 mg aliyense).

Mwinanso kuphatikiza kugwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi mphamvu zoyambitsa komanso zosokoneza (mwachitsanzo, ndi chlordiazepoxide, clidweazole). Pambuyo pachimake gawo atatsimikiza, mankhwala a Tegretol amapitilizidwa ngati monotherapy.

Kusiya mankhwala

Kutha kwakanthawi kwa kutenga Tegretol kungayambitse kukulitsa khunyu, kotero chithandizo chikuyenera kuchotsedwa pang'onopang'ono kwa miyezi 6 kapena kupitilira.

Ngati ndi kotheka, lemekezani chithandizo kwa odwala omwe ali ndi khunyu, kusintha kwa mankhwala ena omwe ali ndi antiepileptic kanthu kuyenera kuchitika mothandizidwa ndi mankhwalawa.

Kugwiritsa ntchito tegretol mwa ana

Chizindikiro chachikulu chogwiritsa ntchito Tegretol mwa ana ndi khunyu.

Ayenera kuyamba Mlingo watsiku ndi tsiku:

• mpaka zaka 4: kuchokera 20 mpaka 60 mg, tsiku lililonse mlingo umatha kuchuluka ndi 20-60 mg,
• kuyambira zaka 4: 100 mg, ndiye kuti mlingo utha kuwonjezeka ndi 100 mg pa sabata.

Mlingo wokonza umayikidwa muyezo wa 10-20 mg / kg patsiku, womwe umagawika ma Mlingo angapo:

• mpaka chaka chimodzi: 100-200 mg (Mlingo wa madzi atatu),
• Zaka 1-5: 200-400 mg (Mlingo wa madzi mu 2 Mlingo),
• Zaka 6 - 10: 400-600 mg (Mlingo 2 wa madzi mu 2 waukulu),
• 11-16 zaka: 600-1000 mg (2-3 Mlingo wa madzi mu 3 mg; mukamagwiritsa ntchito 1000 mg, muyenera kuwonjezera kuchuluka kwa madzi ndi 5 ml),
• kuyambira zaka 15: kuyambira 800 mpaka 1200 (m'malo osowa kwambiri) mg.

Mulingo wambiri watsiku lililonse wa Tegretol:

• mpaka zaka 6: 35 mg / kg,
• Zaka 6-15: 1000 mg,
• kuyambira zaka 15: 1200 mg.

Popeza, pokhudzana ndi kutenga Tegretol pazowonetsera zina, ana alibe kuchuluka kofunikira chidziwitso chokwanira, ndikulimbikitsidwa kuti mankhwalawa azigwiritsidwa ntchito molingana ndi kulemera ndi msinkhu wa mwana, osapitirira malire omwe atchulidwa pamwambapa.