Kokarnit jakisoni: malangizo

Mankhwala Kokarnit amachokera ku mavitamini ndi ma coenzymes, mwa omwe ma metabolic ntchito mu minofu ndi maselo a thupi amakhala bwino. Mankhwalawa ali ndi zotsatira monga neurometabolic ndi analgesic, komanso amathandizanso pa zachilengedwe zomwe zimakonda zachilengedwe. Kodi mankhwala a Kokarnit ndi ziti, komanso momwe amagwiritsidwira ntchito, tikambirana pankhaniyi.

Pharmacological zochita za mankhwala

Mankhwala Kokarnit amawonetsedwa mu mawonekedwe a zovuta za metabolic zinthu ndi mavitamini a magulu osiyanasiyana. Kapangidwe kamankhwala Kokarnit kali ndi zinthu monga nicotinamide, komwe ndi mavitamini ovuta kwambiri omwe mawonekedwe ake ali pafupi kwambiri ndi nikotini acid. Kudzera mu chinthu ichi, zinthu zotsatirazi zimawonekera:

• Kukhazikitsa kwa redox kumagwira ntchito mu maselo aumunthu ndi zimakhala.
• Iwo likukonza kusintha kwa nayitrogeni kagayidwe.
• Mlingo wa atherogenic lipoproteins womwe uli m'magazi umachepetsedwa.
• Otsutsa-sayanjana zotsatira.

Cocarboxylase wopezeka mu mankhwala a Kokarnit ndi coenzyme wochokera ku gulu la ma enzymes ophatikizidwa m'thupi. Ma enzyme amenewa ndi ofunikira pokonza chakudya chamthupi ndi mafuta, komanso, kusintha kukhathamira kwa glucose, kusintha kayendedwe kazinthu zopindulitsa ndikulimbitsa minofu yaumunthu. Ngati ma enzyme oterewa m'thupi ngati cocarboxylase sikokwanira, ndiye kuti pali kuwonjezeka kowopsa kwa asidi komanso lactate m'magazi. Izi zimapangitsa kuti pakhale kusokonezeka kwa acid-base balance.

Cyanocobalamin imaperekedwa ngati michere yomwe ili ndi cobalt. Kuti thupi lizigwira ntchito bwino, chinthu ichi ndi chofunikira. Ntchito zake zingapo ndizophatikiza:

1. Kuchita nawo mwachangu mapuloteni, mafuta ndi chakudya. Kuphatikiza apo, chinthucho chimalimbikitsa kukonzanso kosintha mu minofu.
2. Zimatsitsa chisonyezo cha cholesterol m'magazi amwazi, komanso zimachotsa kuchuluka kwa mafuta mu chiwindi.
3. Zili ndi phindu pakugwira ntchito kwa chiwindi ndi dongosolo lamanjenje.

Chinthu china chofunikira chomwe chimapanga Kokarnit ndi disodium adenosine. Zabwino zake ndi monga:

• Kutsitsa magazi.
• Amakulitsa mtsempha wamagazi.
• Amachepetsa kuchitika kwa arrhythmias.

Mankhwala Kokarnit amapezeka ngati jekeseni wa jakisoni. Imakhala ndi mtundu wa ufa wa pinki, womwe umayenera kusungunuka usanaperekedwe. Kitayo imakhala ndi chosungunulira, komanso malangizo ogwiritsira ntchito. Kuphatikizika kolemera kwa mankhwalawa kumakupatsani mwayi woperekera chithandizo kwa munthu wodwala matenda osiyanasiyana. Ndi matenda ati omwe amagwiritsidwa ntchito ngati mankhwala, timaphunzira zambiri.

Zizindikiro zogwiritsidwa ntchito

Jekarnit jakisoni amatchulidwa kuti agwiritse ntchito pamaso pa matenda aliwonse awa:

• Mitsempha yama cell yotupa.
• Kufa ziwalo.
• Zowawa.
• Symbomatology ya ululu, yowonetsedwa monga chotupa cha mtima.
• Kupweteka kwambiri m'munsi.
• Matenda a mtima.
• Njira zotupa zomwe zimayamba mu minofu ya mtima.

Pamaso pa imodzi mwazomwe zili pamwambapa, mutha kugwiritsa ntchito mankhwalawa Kokarnit, koma pokhapokha poika katswiri kapena kukambirana naye. Mutha kupereka jakisoni wa Kokarnit kunyumba, ngati nthawi yomweyo pali chidziwitso chokwanira ndikuchita machitidwe.

Nthawi zambiri kugwiritsa ntchito Cocarnit zotsutsana

Malangizo ogwiritsira ntchito Kokarnit akuti kuyambitsa katemera ndizoletsedwa makamaka ngati wodwala ali ndi matenda otsatirawa:

• kulephera kwa mtima
• kutsika kwamtima,
• myocardial infaration
• sitiroko
• Mphumu ya bronchial,
• chotupa neoplasms,
• zilonda zam'mimba,
• matenda ashuga

Kugwiritsira ntchito mankhwalawa kumapangidwa ngati wodwalayo ali ndi tanthauzo lililonse la thupilo ku chinthu chilichonse chamankhwala. Kupatula pakukhazikitsa zovuta zomwe zimayenderana, kuyesa koyambirira ndikofunikira. Kuphatikiza apo, madokotala salimbikitsa kufunsa thandizo kuchokera ku mankhwalawa kwa amayi panthawi yomwe akubala mwana, komanso panthawi yoyamwitsa. Ngati pakufunika kugwiritsa ntchito mankhwalawa panthawi yotsekera, ndiye kuti mwana ayenera kuthandizidwa kwakanthawi kuti akwaniritsidwe.

Zomwe amagwiritsa ntchito mankhwalawa

Kapangidwe ka mankhwala Kokarnit palinso gawo lina monga lidocaine. Musanagwiritse ntchito mankhwalawa, ndikofunikira kuonetsetsa kuti wodwalayo samadwala. Ngati zotsatira za kapangidwe kake ka mankhwala ndizabwino, ndiye kuti mankhwalawa sayenera kuphatikizidwa.

Ndikofunikira kudziwa! Ngati ziwonetsero zimachitika, zizindikiro monga kutupa, kufooka kwa khungu, zotupa, kupumira msanga, komanso kuwonongeka kwa magazi kumachitika. Kuopsa kowonetsera thupi lanu ndikwakuti mankhwala amatha kupweteketsa anaphylactic, ndikutukuka komwe munthu angafe.

Mankhwalawa amapangidwira okhawo a mu mnofu makonzedwe. Musanagwiritse ntchito mankhwalawa, muyenera kutsegula zochulukazo ndi zosungunulira, kenako ndikuyimbira kuchuluka kwa syringe, ndikuwonjezera ndi osakaniza owuma a mankhwalawo. Mtundu ukatha ndikuwonjezera mu botolo ndi osakaniza owuma, simuyenera kuchotsa syringe ndi singano mumtsuko. Kuphatikizidwa kwa mankhwalawa kuyenera kusakanizika bwino mpaka kupangika mosasinthika kwatha, ndikuyika mu syringe.

Asanalowetse mankhwalawa m'misempha, tsamba la jakisoni liyenera kuthandizidwa ndi mowa. Jakisoni amatha kuyikidwa mu gluteus, koma singano yayitali imafunikira kuti mufikire minofu ya minofu mwachindunji. Mankhwala amalowetsedwa pang'onopang'ono kupatula kupangika kwa kuphatikizika kwa makulidwe a minofu ya adipose.

Mlingo wa tsiku lililonse wa mankhwala sayenera kupitirira 4 ml, ndiye ma ampoules awiri. Kutalika kwa kuthetseratu zizindikiro za ululu kumatha masiku 9, koma osatinso. Munthawi zonsezi, muyenera kulumikizana ndi katswiri yemwe adzakupatseni njira yina yothandizira mankhwalawa. Ngati chithandizocho sichikuthandizira kuti pakhale mphamvu zabwino, ndiye kuti dokotala amasankha poika mankhwala amphamvu kwambiri.

Mankhwala osokoneza bongo ndi zotsatira zake

Wopanga salimbikitsa kupereka mankhwalawo mopitilira muyeso wa malangizo. Kuchuluka kwa mankhwalawa sikungathandize wodwala. Ndipo zimathandizira kuti pakhale zosokoneza bongo zochuluka. Zizindikiro za mankhwala osokoneza bongo chifukwa cha kukula kwa zizindikiro zotsatirazi:

• kupezeka kwa mutu
• chizungulire
• kutopa,
• kulephera kudziwa
• pulmonary edema,
• asphyxia
• kutsitsa magazi
• kuchepa kowoneka bwino,
• chikomokere.

Ngati, mukalandira chithandizo cha mankhwalawo, chimodzi mwazizindikiro zomwe zapezeka pamwambapa, ndikofunikira kuti muleke kugwiritsa ntchito Cocarnit ndikuyitanitsa chithandizo chodzidzimutsa. Mankhwala ochepetsa bongo a Kokarnit kulibe, chifukwa chake, thandizo loyenerera kwa wodwala lidzaperekedwa malinga ndi zomwe zimachitika.

Mayendedwe ofunikira pakugwiritsira ntchito mankhwalawa

Pambuyo pakukonzekera kwa mankhwalawa, jakisoni amayenera kuwonedwa nthawi yomweyo. Kusungidwa kwotalikirana kwa mankhwala okonzekeredwa kumachepetsa mphamvu ya zotsatira zabwino. Pambuyo pokonza jakisoni, mtundu wake uyenera kukhala wofiyira. Ngati, mutakonzekera, mtundu wa jekeseni sugwirizana ndi chizolowezi, ndiye kuti kugwiritsa ntchito mankhwalawo sikuletsedwa. Wantchito woyenerera yekha ndi amene amafunika kupereka mankhwalawa, koma ngati pali chidziwitso choyenera kuchokera ku zomwe takumana nazo, kuyambitsa kwa mankhwalawo kumaloledwa kwa munthu wopanda maphunziro a udokotala (wachibale kapena mnzake wa wodwalayo).

Asanayambitse mankhwalawa, ndikofunikira kupaka mankhwala pakhungu la jakisoni. Ndi kusamala kwambiri, ndikofunikira kugwiritsa ntchito mankhwalawa motere:

• kutsika kwamtima,
• matenda kupuma dongosolo
• nthawi yantchito
• uchidakwa
• matenda a impso ndi chiwindi.
• ochepa matenda oopsa.

Kugwiritsa ntchito mankhwalawa pazinthu zilizonse pamwambapa kumabweretsa mavuto akulu. Ngati mumagwiritsa ntchito mankhwalawa kwa nthawi yayitali, ndiye kuti matenda a chiwindi akudwala samachotsedwa. Kupatula mapangidwe amtunduwu wa zovuta, pamene ntchito mankhwalawa amalembera masiku 9, zakudya zomwe zimapangidwa mu methionine ziyenera kuyambitsidwa muzakudya.

Ngati chithandizo chikuchitika mothandizidwa ndi Kokarnit, zizindikiro zotsatirazi ziyenera kuyang'aniridwa mosalephera:

1. Mlingo wa glucose.
2. Potaziyamu ndi magnesium m'thupi.
3. Madzi a m'magazi.

Kwa okonda khofi, muyenera kuchepetsa kuchuluka kwa kugwiritsidwa ntchito kwake pakumwa mankhwala osachepera.

Kuchita ndi mankhwala ena

Kufunika kwakukulu kuyenera kuperekedwa pazinthu monga kuyanjana kwa mankhwala ndi mankhwala ena. Wopanga ndi akatswiri sawalimbikitsa kuti azigwiritsa ntchito mankhwala a Kokarnit ndi mitundu ina ya mankhwalawa, chifukwa izi zimapangitsa izi:

1. Chiwopsezo chowonjezera cha hyperkalemia. Matenda oterewa amakula ngati mankhwala olumikizana nawo atengedwa ndi okodzetsa.
2. Kugwiritsa ntchito kwambiri glycosides kumapangitsa kuti ma pathologies apangidwe, komanso zizindikiro zamkati zamtima.
3. Kuchepetsa kuchuluka kwa lidocaine m'madzi am'magazi kudzera kuphatikiza kwa Pididine ndi Quinidine.
4. Ndi kuphatikiza kwa morphine, ndizotheka kuchititsa kupuma ntchito.
5. Chiwopsezo chowonjezeka cha magazi ngati muphatikizidwa ndi anticoagulants.
6. Kuphatikiza mankhwala ndi ma inhibitors kumathandizira kuthamanga kwa magazi.
7. Simungagwiritse ntchito Cocarnit limodzi ndi Xanthinol, chifukwa izi zimachepetsa kwambiri ntchito zakale.

Ndikofunikira kudziwa! Musanagwiritse ntchito mankhwalawa, muyenera kufunsa katswiri yemwe angakuuzeni zofunikira pakugwiritsa ntchito mankhwalawa.

Mtengo ndi chosungira

Mutha kugula mankhwala a Kokarnit pokhapokha pazoyenera kuchokera kwa dokotala. Mtengo wamankhwala jakisoni ndi ma ruble 720 a ma ampoules atatu. Mankhwalawa amapangidwa ndi opanga angapo, chifukwa chake mitengo yamitengo imatha kusiyanasiyana. Pofuna kuti musagwire ntchito yabodza, muyenera kugula mankhwala kokha mumafakitori otsimikizika.

Sungani mankhwalawo pokhapokha ngati pali ana ochepa. Kusungika mosayenera kwa mankhwalawo kumapangitsa kuti ikhale yosakhazikika, pambuyo pake kugwiritsa ntchito koletsedwa. Nthawi zambiri, alumali moyo wa mankhwalawo kuyambira tsiku lotulutsa ndi zaka 3 zosungidwa bwino. Pogula mankhwala, onetsetsani kuti mwatchera khutu tsiku lakumasulidwa. Tsiku lotha litatha, mankhwalawo amatha.

Ndikofunikira kudziwa! Kugwiritsa ntchito Cocarnitus kumayesedwa kwa ana omwe ali ndi zaka 18.

Pomaliza, ziyenera kudziwika kuti mankhwalawa ali ndi ma analogues, chifukwa chake ngati sichikupezeka mu Kokarnit pharmacy, ndiye kuti akhoza kusintha: Cardonate, Actovegin, Vitaxone, Milgamm.

Kumasulidwa mawonekedwe, mankhwala ma CD ndi kapangidwe kake

Kodi mankhwala a Kokarnit amagulitsidwa mwa mtundu wanji? Malangizowo akuti mankhwalawa ali mu mawonekedwe a lyophilisate pokonzekera yankho, komanso solvent (lidocaine) mu ampoules.

Zomwe zimapangidwira zimaphatikizapo nicotinamide, cocarboxylase, cyanocobalamin ndi adenosine triphosphate. Monga zowonjezera zina, glycine, propyl parahydroxybenzoate ndi methyl parahydroxybenzoate amagwiritsidwa ntchito.

Zolemba za Pharmacodynamic

Kodi ndi chida chiti chomwe tikulingalira? Kodi malangizowo akuti chiyani za iye? Kokarnit ndi zovuta zamavitamini ndi zinthu zomwe zimakhudza kagayidwe. Imakhala ndi neurometabolic ndi analgesic kwenikweni, komanso imakhudza gawo lopatsa chidwi.

Kuchita bwino kwa mankhwalawa kumachitika chifukwa cha kapangidwe kake. Onani mawonekedwe a chilichonse cha zinthuzo mwatsatanetsatane.

Nicotinamide imakhudza kagayidwe kazakudya ndi michere ya nayitrogeni, imatenga nawo mbali machitidwe a redox, komanso imalimbikitsa kuyendetsa kwa ATP m'maselo. Komanso, mankhwalawa ali ndi katundu wosintha. Motere, ndiwothandiza kwambiri ku matenda a neuropsychiatric, kukhumudwa, nkhawa komanso kuchepa chidwi.

Cocarboxylase ndi coenzyme yomwe imagwira gawo lalikulu pama metabolism a carbohydrate, imakhudza kaphatikizidwe kazinthu zama acid, kusintha trophism ya minofu, lipids ndi mapuloteni, komanso imalimbikitsa kuyamwa kwa glucose.

Adenosine triphosphate ndi zotumphukira za adenosine. Izi zimathandizira kagayidwe. Ndiye gawo lamphamvu kwambiri lamaselo. Ndi matenda a coronary, kuchepa kwa mphamvu kumayamba, komwe kumatha kuchepetsedwa chifukwa cha adenosine triphosphate. Kayendedwe kake ka maselo kumachitika chifukwa cha nicotinamide. Adenosine triphosphate amatha kugwiritsa ntchito antiarrhythmic, hypotensive ndi vasodilating.

Ponena za cyanocobalamin, imapanga ndipo imapeza mapuloteni, imayendetsa kagayidwe kazakudya zamafuta ndi mafuta. Zotsatira za izi ndikuchepa kwa cholesterol, komanso kupewa kwa hepatosis yamafuta.

Tiyeneranso kudziwa kuti cyanocobalamin imachulukitsa mphamvu ya maselo, yofunikira pakugwirira ntchito kwa ziwalo zopanga magazi, chiwindi ndi dongosolo lamanjenje.

Ndi matenda ati omwe amalembedwa ngati Kokarnit? Malangizo ogwiritsira ntchito (jakisoni akuyenera kuchitika kokha ndi akatswiri odziwa zaumoyo) akuwonetsa kuti zomwe zikuwonetsedwa ndi chida ichi ndi:

• mitsempha
• neuralgia yamavuto osiyanasiyana,
• sciatica, lumbago, sciatica,
• myalgia, tendonitis, bursitis,
• neuropathy (kuphatikizapo shuga),
• myocardiopathy, matenda a mtima a ischemic, myocarditis.

Tiyeneranso kunenanso kuti pa nthawi yoyembekezera mankhwalawa amagwiritsidwa ntchito pokhapokha ngati phindu la mayi wamtsogolo ndilokwera kwambiri kuposa chiwopsezo cha mwana wosabadwayo.

Contraindication

Kodi simuyenera kupereka mankhwala liti "Kokarnit"? Malangizowo akuti mankhwalawa amatsutsana mu:

• Hypersensitivity
• kwambiri mawonekedwe a ochepa matenda oopsa, komanso hypotension,
• erythrocytosis, erythremia,
• psoriasis
• kusokonezeka kwa mtima komanso kuchepa mtima kwambiri,
• myocardial infarction mu pachimake nthawi.

Sitinganene kuti mankhwalawa amafunsidwa mosamala kwa anthu omwe ali ndi gastritis, zilonda zam'mimba, gout ndi chiwindi. Palibe zambiri pakugwiritsa ntchito mankhwalawa kwa ana aang'ono.

Kuphatikiza apo, popereka mankhwala omwe atchulidwa, zotsatirazi zotsutsana za solocaine wa 0,5% ziyenera kukumbukiridwa: Adams-Stokes syndrome, sinus node kufooka, angina pectoris, Wolf-Parkinson-White syndrome, myasthenia gravis, epileptiform kwambiri aimpso kulephera ndi porphyria.

Kokarnit jakisoni: malangizo

Ndemanga za chida ichi zidzafotokozedwa pansipa.

Malinga ndi malangizo, mankhwalawa amayenera kuperekedwa pa intramuscularly mu 1 kapena 2 ampoules tsiku lililonse. Jakisoni amachitidwa m'maphunziro. Kutalika kwawo kumatengera kutha kwa matendawa.

Njira yothetsera mankhwalawa imagwiritsidwa ntchito mukangokonzekera. Komanso, ziyenera kukhala zofiira. Ngati utoto sunasinthe, ndiye kuti kugwiritsa ntchito mankhwalawo ndizoletsedwa.

Kugwiritsa ntchito mankhwala a Kokarnit, malangizo omwe amalembedwa pakatoni, maselo ofiira am'magazi ndi mapulateleti, nthawi yovomerezeka, uric acid, bilirubin ndi transaminases iyenera kuyang'aniridwa nthawi zonse.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zidachitika mutagwiritsa ntchito Kokarnit ndi ziti? Malangizo ogwiritsira ntchito akuwonetsa kuti mankhwalawa angayambitse:

• tachycardia
• mutu
• urticaria
• kufooka
• thukuta
• chizungulire
• zotupa pakhungu,
• anaphylactic shock,
• kuyabwa
• kutsegula m'mimba
• zotumphukira mtima thrombosis,
• pulmonary edema.

Tiyeneranso kudziwa kuti odwala omwe ali ndi hypersensitivity asanafike mankhwala amapanga mayeso a intradermal.

Mankhwala osokoneza bongo

Chidzachitike ndi mankhwala osokoneza bongo a Kokarnit ndi chiyani? Malangizo ogwiritsira ntchito (jakisoni amayenera kugwiritsidwa ntchito ndi katswiri yekha) kuti ngati mankhwalawo atengedwa pakamwa, mawonekedwe owopsa amatha kuchitika, omwe akuwonetsedwa ndi kupukusa pakhungu, kuyabwa, nseru, mutu, kusanza kapena kutentha kwa mtima.

Kuledzera kwa mankhwala osachiritsika, kuchuluka kwa uric acid ndi shuga, komanso maonekedwe a zilonda zam'mimba za duodenum.

Kuchita ndi mankhwala ena

Kodi ndingagwiritse ntchito mankhwala a Kokarnit (majekeseni) ndimankhwala ena? Malangizowo akuti cocarboxylase, omwe ndi gawo la mankhwalawo, amatha kukulitsa mtima ndi mtima wa mtima glycosides.

Ponena za nicotinamide, imatha kugwiritsa ntchito anticonvulsant katundu wa antiepileptic mankhwala (mwachitsanzo, Diazepam, Carbamazepine, Valproate).

Adenosine triphosphate limodzi ndi potaziyamu woleketsa okodzetsa, kukonzekera kwa potaziyamu ndi ACE zoletsa kumawonjezera chiopsezo cha hyperkalemia. Zimathandizanso kuchitapo kanthu (antianginal) a nitrate ndi beta-blockers.

Mukamamwa mankhwalawa ndi Dipyridamole, mphamvu yake yotsekemera imatheka.

Xanthinol nicotinate amachepetsa mphamvu ya adenosine triphosphate, ndipo Carbamazepine, m'malo mwake, amathandizira zotsatira zake.

Pamodzi ndi "Theophylline" ndi antagonism wa caffeine amawonetsedwa.

Kuthira kwa mankhwalawa kumachepetsedwa ndi kukonzekera kwa potaziyamu, cyanocobalamin aminoglycosides, antiepileptic mankhwala, salicylates ndi Colchicine.

The kuyamwa kwa cyanocobalamin yafupika pamene amatenga "Polymyxin", "Kanamycin", "Neomatsin" ndi "Tetracycline."

Cyanocobalamin imagwirizana ndi ascorbic acid, Riboflavin, Pyridoxine ndi mchere wazitsulo zolemera.

Kulera kwapakamwa kumachepetsa kuchuluka kwa cyanocobalamin m'magazi.

Mtengo ndi fanizo

Kodi mankhwalawa "Kokarnit" ndi angati? Malangizo ogwiritsira ntchito sapereka yankho ku funso. Mutha kuzipeza mu pharmacy yokha. Monga lamulo, mtengo wamtunduwu wa ma ampoules atatu amasiyana pakati pa ma ruble a 120-150.

Nchiyani chingalowe m'malo mwa Kokarnit metabolic solution? Malangizo, ndemanga zimati palibe zoyerekeza zamagulu a mankhwalawa. Kuti muthane ndi njira zofananazo, muyenera kufunsa dokotala (nthawi zambiri amalimbikitsa Ismizhen, Venohepanol, Threw, Orcipol, Sterillium, Dioflan, Collomac, Chondrosamine, Endofalk, " Secnidox ").

Tsopano mumadziwa mfundo za mankhwalawa "Kokarnit." Malangizo, analog ya mankhwalawa adaperekedwa pamwambapa.

Nthawi zambiri, chida ichi chimagwiritsidwa ntchito mu mitsempha, mtima ndi mitsempha. Akatswiri amati mankhwalawa amatha kuchepetsa kuchuluka kwa mabala, komanso kuthetsa ululu wa vertebrogenic.

Tiyeneranso kudziwa kuti mankhwalawa afotokozedwa okha mu zovuta za odwala omwe ali ndi discogenic lumbosacral radiculitis. Pankhaniyi, mankhwalawa ayenera kugwiritsidwa ntchito intramuscularly pa 2 ml patsiku kwa milungu iwiri.

Odwala sananene zotsatira za mankhwalawa.

Kutulutsa mawonekedwe ndi kapangidwe kake

Kokarnit akupezeka mu mawonekedwe a lyophilizate pokonza njira yothetsera makulidwe a intramuscular (i / m): a pinki yophweka, atapanganso pinki yankho lomveka bwino (187.125 mg iliyonse mu galasi lokwanira magalasi atatu, ma supoules atatu ndi ma phylophylisate atatu. 2 ml ndi zosungunulira, pakatoni mtolo 1 paketi.

Mbale 1 ili ndi:

• yogwira pophika: cocarboxylase - 50 mg, cyanocobalamin - 0,5 mg, triphosadenine disodium trihydrate - 10 mg, nicotinamide - 20 mg,
• othandizira zigawo: propyl parahydroxybenzoate, glycine, methyl parahydroxybenzoate.

Zosungunulira ndi lidocaine hydrochloride, madzi a jakisoni.

Mankhwala

Kuchita kwa Kokarnit kumachitika chifukwa cha zinthu zomwe zimasankhidwa mwapadera pazinthu zomwe zimagwira.

Cocarboxylase ndi coenzyme yomwe imapangidwa kuchokera ku thiamine (vitamini B₁) Ndi gawo la enboxme ya carboxylase, yomwe imayambitsa carboxylation ndi decarboxylation ya alpha-keto acids. Zimakhudza mosiyanasiyana kaphatikizidwe kazinthu ma acid, lipids ndi mapuloteni. Imalimbikitsa kuyamwa kwa glucose, kutsitsa zomwe zili lactic ndi pyruvic acid m'thupi, kukonza trophism yamitsempha yamanjenje.

Trifosadenin ndi zotumphukira za adenosine, ali ndi kagayidwe kachakudya, antiarrhythmic, hypotensive, vasodilating. Mothandizidwa ndi ATP (adenosine triphosphoric acid), minofu yosalala imapumulanso, kuthamanga kwa magazi (BP) kumachepa, ndipo mitsempha ya mitsempha imakonzedwa. Zimathandizira kukulitsa kagayidwe kazinthu komanso kupatsa mphamvu kwa minofu. Mphamvu ya vasodilating imawonetsedwa kuphatikiza pamitsempha yamagazi ndi chithokomiro.

Cyanocobalamin - Vitamini B₁₂, yemwe atalowa m'thupi amasintha kukhala mitundu iwiri ya coenzyme: 5-deoxyadenosyl cobalamin ndi methyl cobalamin. Methylcobalamin amatenga gawo lofunikira pazochita zoyambira za purine ndi pyrimidine, mwachitsanzo, pakusintha kwa homocysteine ​​kukhala methionine ndi S-adenosylmethionine. Kuperewera kwa mavitamini pamenepa kumatha kulipiriridwa ndi methyltetrahydrofolate acid, chifukwa cha izi pamakhala kuphwanya kwamaganizidwe a metabolic. 5-deoxyadenosyl cobalamin imakhudzidwa ndi zimachitika kagayidwe kazakudya komanso lipid metabolism, kukhala cofactor mu isomerization wa L-methylmalonyl coenzyme A mu succinyl coenzyme A. Kusowa kwa vitamini B₁₂ mu thupi limayambitsa kuphwanya mapangidwe a myelin sheath of neurons, kuchuluka kwa kugawa mwachangu maselo a epithelial ndi minofu ya hematopoietic.

Nicotinamide - mawonekedwe a vitamini PP, amatenga nawo mbali mu njira za redox mu cell. Amayang'anira kupuma kwamatenda, kusintha kagayidwe kazakudya ndi michere ya nayitrogeni.

Pharmacokinetics

Pambuyo pa makonzedwe a makolo, trifosadenin imalowa m'maselo a ziwalo. Pamenepo, imaphwanyidwa kukhala adenosine ndi phosphate yopanga ndi kutulutsa mphamvu. Zinthu zowola zimaphatikizidwa pambuyo pake ku ATP resynthesis.

Kulowetsedwa kwa cocarboxylase ndi i / m makonzedwe kumachitika mwachangu mthupi ndikulowerera kumisempha yambiri. Kutulutsa kwa michere kuwonongeka kwenikweni kumachitika kudzera impso.

Pambuyo poyang'anira i / m, cyanocobalamin imathamanga mwachangu komanso kwathunthu. Kupereka kwake kwa minofu kumachitika ndi transcobalamin I ndi II, momwe amamangirira m'magazi. 0,9% ya mlingo wotumizidwa umagwirizana ndi mapuloteni a plasma. Pambuyo poyang'anira i / m, kuchuluka kwambiri m'magazi kumatha kufikira ola limodzi. Anawakonza makamaka m'chiwindi. Amachotseredwa ndi bile kuchokera ku chiwindi kulowa m'matumbo, pomwe amadziwikanso m'magazi. Kuchotsa theka moyo ndi 500 masiku. Munthawi yayitali impso, 7%% imachotsedwa kudzera mu impso ndi 50% kudzera m'matumbo. Ngati aimpso ntchito, 0-7% imachotsedwa impso, 70-100% - ndi matumbo. Cyanocobalamin imadutsa chotchinga ndi kulowa mkaka wa m'mawere.

Kugawidwa kwa nicotinamide mu minyewa yonse kumachitika mwachangu, chinthucho chimatha kudutsa chotchinga komanso kulowa mkaka wa m'mawere. Chifukwa cha kagayidwe kachakudya mu chiwindi, nicotinamide-N-methylnicotinamide imapangidwa. Kutupa kwa chinthu kumachitika kudzera mu impso. Kuthetsa theka-moyo pafupifupi maola 1.3.

Voliyumu yogawa ndi pafupifupi 60 l, chilolezo chonse cha madzi a m'magazi ndi pafupifupi 0,6 l / min.

Malangizo ogwiritsira ntchito Cocarnit: njira ndi mlingo

Yankho lomaliza la mankhwalawa lakonzedwa kuti mupeze jakisoni wamitsempha (ozama mu minofu ya gluteal).

Pambuyo posakaniza lyophilisate ndi zosungunulira, yankho lake liyenera kukhala la pinki. Ngati mtundu wa yankho sukugwirizana, sungagwiritsidwe ntchito.

Yankho limakonzedwa pamaso pa mankhwala mwachindunji.

Osasunga yankho la mankhwalawo!

Dokotala amafotokoza kutalika kwa mankhwalawa komanso kuchuluka kwa kayendetsedwe ka Kokarnit poganizira chikhalidwe chake komanso kuuma kwa matendawa.

• kupweteka kwambiri kwa polyneuropathy: 1 ampoule 1 nthawi patsiku, nthawi yogwiritsidwa ntchito pothandizanso kupweteka kwambiri masiku 9,
• Zizindikiro zochepa za polyneuropathy: 1 ampoule 1 nthawi yotalika masiku 2-3. Kuthandizira kwa nkhuku kumatengera kuuma kwa matendawa ndipo kumatha kuyambira 3 mpaka 9 jakisoni kwa masiku 14 mpaka 14.

Kufunika kwamaphunziro obwereza kumatsimikiziridwa ndi adokotala.

Malangizo apadera

Pakakhala zovuta zotere, pitani kuchipatala.

Ndi mawonekedwe omwe ali ndi zotsatira zoyipa, Kokarnit iyenera kuthetsedwa.

Ngati atatha masiku 9 ogwiritsa ntchito mankhwalawa palibe njira yochiritsira kapena kuwonjezereka kwa chizindikiro cha matendawa, muyenera kuganizira kukonza kwa njira yochizira.

Pogwiritsa ntchito Kokarnit pakuwongolera mokwanira njira ya matenda a shuga, ndikofunikira kusintha mtundu wa othandizira a hypoglycemic.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Pa chithandizo, chithandizo chikuyenera kuchitika mukamachita zinthu zoopsa. Odwala omwe amatenga Kokarnit amayambitsa chizungulire, chisokonezo kapena zovuta zina zamanjenje sayenera kutenga nawo mbali poyendetsa magalimoto ndi ziwonetsero.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala Kokarnit:

• othandizira a hypoglycemic okhala ndi metformin amatha kuthana ndi mayamwidwe a cyanocobalamin ndikuwapangitsa kuchepa kwa kuchuluka kwake m'magazi,
• riboflavin, ascorbic acid, thiamine bromide, thiamine, mchere wamchere wachitsulo, pyridoxine, folic acid, othandizira magazi, chloramphenicol - sangathe kugwiritsidwa ntchito chifukwa chosagwirizana ndi cyanocobalamin,
• aminoglycosides, antiepileptic mankhwala, salicylates, colchicine, kukonzekera kwa potaziyamu kumapangitsa kuyamwa kwa cyanocobalamin,
• dipyridamole timapitiriza vasodilating zotsatira ndi zotsatira za trifosadenin,
• tiyi wa khofi, theophylline (zochokera ku purine) zitha kuyambitsa chidwi ndi mankhwalawo.
• Mlingo waukulu wa mtima glycosides ungakulitse chiopsezo cha zotsatira zosafunidwa kuchokera ku mtima,
• xanthinol nikotini amachepetsa mphamvu ya mankhwalawa,
• antihypertensives ndi sedative, tranquilizer mothandizidwa ndi nicotinamide amawonjezera achire zotsatira.

Zotsatira za Cocarnit ndi Thiamine Chloride ndi Cocarboxylase.

Ndemanga za Kokarnite

Ndemanga zochepa za Kokarnit zimatsimikizira kuwongolera kwa mankhwalawa pochiza matenda ashuga a polyneuropathy. Odwala omwe ali ndi matenda ashuga amalemba za kuthamanga kwa mankhwalawa, pamene kupweteka kwamiyendo ndi radiculitis kumatha pambuyo pakubayidwa pang'ono. Palibe zodandaula za kulekerera kosayenera ndi zochitika zovuta panthawi yamankhwala.

Popeza zigawo zikuluzikulu za mankhwalawa zimakhala ndi zochizira zosiyanasiyana, nthawi zambiri pamakhala kuwerengetsa wodwala amene amagwiritsa ntchito mankhwalawa matenda monga osteochondrosis, mtima pathologies, neuralgia ya lumbosacral spine. Kuphatikiza pakuwonjezera mphamvu kwa analgesic, kusintha pakukhalanso bwino ndikugwira ntchito kwa chiwindi kumadziwika. Mankhwala amachepetsa kuthamanga kwa magazi ndi cholesterol, ali ndi antiarrhythmic ndi vasodilator.

Cocarnit mu ampoules: mawonekedwe a mankhwalawa

Kokarnit amatanthauza - jakisoni mu ma ampoules. Imangopezeka mu mtundu wa lyophilisate wa jakisoni. Sipezeka piritsi, kuyimitsidwa, ndi mitundu ina. Ili ndi mavitamini a metabolic ndi zinthu zomwe zimathandizira kuti metabolism ifulumizane.

Zochita za mankhwala zikuphatikiza:

• kutsegula kwa oxidative njira mu thupi,
• kusintha kwa nayitrogeni kagayidwe,
• zotsatira zoyipa,
• kuchepa kwa lipotroteins atherogenic m'magazi,
• kupindika,

Mankhwalawa amawoneka ngati ufa wapinki, kuti jakisoni adzafunika kuchepetsedwa. Solvent ya ufa imabwera kwathunthu ndi mankhwalawo phukusi limodzi.

Osayesa kuchepetsa ufa wa Kokarnit ndi njira "zosinthika" - tsatirani malangizo, gwiritsani ntchito zosungunulira zomwe akupanga.

Zizindikiro zogwiritsa ntchito Cocarnit mu ampoules ndizosiyanasiyana. Thandizo la masabolism limafunikira pama matenda osiyanasiyana komanso munthawi yobwezeretsa mthupi.

Ngati mukufunikira kuti mulimbikitse kagayidwe, dokotala angakupatseni Cocarnit. Simungathe "kulemba" nokha.

Kuthandizira kaphatikizidwe

Mphamvu yothandizidwa ndi mankhwalawa imaperekedwa ndi kuphatikiza kwake michere ndi vitamini. Mulinso zinthu monga:

• trifosadenin (10 mg),
• cocarboxylase (50 mg),
• cyanocobalamin (0.5 mg),
• nicotinamide (20 mg),
• 5-deoxyadenosylcobalamin,
• odzalandira (madzi, lidocaine, glycine).

Chilichonse chomwe chimapangidwa chimagwira ntchito yake. Trifosadenin ndi cyanocobalamin zimathandizira kagayidwe, ndipo cocarboxylase amathandiza thupi kupanga asidi, mapuloteni, lipids, kusintha kwa glucose. 5-deoxyadenosylcobalamin amagwiritsidwanso ntchito mokhudzana ndi zochita za metabolic. Ndipo nicotinamide imathandizira minofu, kukhala imodzi mwazomwe zimachokera ku vitamini PP.

Kodi ngumu ya Kokarnit imagwiritsidwa ntchito bwanji?

Pakati pa odwala omwe ali ndi radiculitis ndi kupweteka kwa minofu, Cocarnit ndiofala kwambiri. Ngati ululu wamankhwala umatchulidwa kwambiri, gawo limodzi la mankhwalawa limaperekedwa kwa wodwala patsiku (mlingo ungathe kuwonjezeredwa malinga ndi dokotala). Mtengo wapakati si zoposa masiku 9. Pukuta ufa ndi njira yokhayo yomwe umabwera nayo. Jakisoniyo ndiwowawa, ngakhale lidocaine mu mawonekedwe, koma kupweteka kwa minofu kumachitika chifukwa chobwezeretsa kagayidwe.

The achire maphunziro a Kokarnit zimaphatikizapo 3 mpaka 9 jakisoni kuchepetsa mkhalidwe wodwalayo.

Ngati ululu wamankhwala sunatchulidwe motero, koma nkuwonekera, mankhwala amapatsidwa kuchuluka kwa jekeseni awiri am'modzi pa sabata kwa masabata awiri.

Njira yochizira imayang'aniridwa ndi dokotala. Ndikofunika kubaya anthu okhawo omwe amadziwa momwe angapangire. Ngati inu kapena okondedwa anu mulibe maluso apadera, funsani namwino kuchipatala komwe mukumuchiritsa, amathandizira kupereka jakisoni.

Mankhwala ofanana

Mafuta a mankhwalawa, omwe amadziwika kuti ndi othandizira ofanana, angagwiritsidwe ntchito ngati nkotheka kugula Cocarnit (kapena pali zotsutsana ndi kusalolera kwa munthu payekha). Mutha kuonana ndi dokotala kuti ndi njira yanji yomwe ingakukwaniritseni m'malo mwake.

Mwa mankhwala ofanana, mungapeze mankhwala otsika mtengo kuposa a Kokarnit, omwe ma ampoules awo amawononga ma ruble 600. Koma pali mankhwala komanso okwera mtengo, koma nthawi yomweyo amagwira ntchito kapena ndi oyenera makamaka kwa inu. Kulumikizana ndi dokotala musanagule mankhwala otere amafunika.

Kokarnit jakisoni

Mankhwala opititsa patsogolo kagayidwe kachakudya kagayidwe (Cocarnit) nawonso amakonzanso ulusi wamitsempha ya zotumphukira zamkati. Mankhwalawa amapangidwa ndi kampani ya ku Egypt E.I.P.I.Co, ndi gulu la othandizira a metabolic potengera zovuta za nicotinamide, cyanocobalamin, cocarboxylase ndi adenosine triphosphate.

Ampoules ali ndi zinthu zotsatirazi komanso zothandiza:

Utoto wapinki, yankho lokonzedwa, loonekera, pinki

Mkulu wa trifosadenine disodium trihydrate, mg / ml

Mkulu wa cocarboxylase, mg / ml

The kuchuluka kwa cyanocobalamin, mg / ml

Nikotinamide ndende, mg / ml

Zothandiza pazomwe zimapangidwira

Glycine, methyl ndi propyl hydroxybenzoate

Madzi, lidocaine hydrochloride

Ma ampoules atatu a 187 mg ufa wokhala ndi ma ampoules atatu a sol sol 2 ml pakiti iliyonse

Pa nthawi yoyembekezera

Madotolo atha kukuwuzani jakisoni wa Kokarnit pa nthawi yomwe ali ndi pakati, malinga ndi momwe zabwino zomwe amayi angapeze zimaposa chiwopsezo cha mwana wosabadwayo. Nthawi zina, kugwiritsa ntchito mankhwalawa mutanyamula mwana ndikuloledwa. Mukamayamwitsa, kugwiritsa ntchito mankhwalawa kumaletsedwa, chifukwa zinthu zofunikira zomwe zimapangidwira zimalowa mkaka wa m'mawere ndipo zimatha kuvulaza mwana.

Muubwana

Kugwiritsa ntchito mankhwalawa kumapangidwa mwa ana ndi achinyamata osakwana zaka 18. Izi ndichifukwa choti kafukufuku sanachitepo kanthu pakukwaniritsidwa komanso chitetezo cha mankhwalawa. Kugwiritsa ntchito jakisoni popanda chilolezo cha dokotala kumatha kuyambitsa kusakhudzidwa kochokera mkati mwa dongosolo la chapakati komanso lamkati.

Zolemba za Cocarnith

Palibe mawonekedwe a fanizo la mankhwala malinga ndi kapangidwe kake. M'malo oyandikira kwambiri a mankhwalawa ndi:

• Thiamine chloride - mtundu wovomerezeka wa vitamini B1, umaphatikizidwa ndi kagayidwe ka cocarboxylase, wobwezeretsanso kuchepa kwa chinthucho,
• Cocarboxylase - jakisoni wa kanthu wa coenzyme komanso katundu wa matenda a carbohydrate,
• Cardonate - makapisozi kutengera cocarboxylase,
• Vitaxone ndi cholowa m'malo mwa mankhwala achire. Amagwiritsidwa ntchito pochiza neuralgia.

Mtengo Kokarnita

Mutha kugula Kokarnit ku Moscow kudzera mumasitolo ogulitsa mankhwala kapena pa intaneti. Mtengo wa mankhwalawa umatengera mtundu wa mankhwala ndi msika wamalonda. Mitengo yoyenera ya mankhwalawo ndi mawonekedwe ake ndi:

Mtengo wamankhwala, ma ruble

Cocarnit, ma ampoules okhala ndi zosungunulira 3 + 3 ml

Thiamine hydrochloride 1 ml 10 ampoules

Cocarboxylase, 50 mg 5 ampoules

Margarita, mayi wazaka 39 Mayi anga ali ndi radiculitis. Palibe zovuta kupewetsa ululu ndi mapiritsi wamba, chifukwa chake timagwiritsa ntchito mankhwala Kokarnit. Adatilembera ndi madotolo. Pakabayidwa jakisoni m'minyewa, amayamba kunena kuti kupweteka kumachepa, kumakhala kosavuta kuti ayende. Chofunika kwambiri, kukonzekera kwa vitamini sikumayambitsa mavuto, kumalekereredwa bwino.

Ruslan, wazaka 66. Mankhwala Kokarnit adandipatsa mankhwala atazindikiritsa neuralgia. Msana wanga unali wopindika kuti sindingathe kuyenda, kuyenda kulikonse kunabweretsa ululu waukulu. Adotolo amabwera kunyumba yanga, ndikupereka jakisoni. Pambuyo pa jakisoni awiri, zidakhala zosavuta kwa ine, ndipo nditatha maphunziro a sabata ndidali wokonzeka kuthamanga - sizinandipweteke.

Vadim, wazaka 57. Myocarditis idapezeka chaka chatha. Zinali zovuta kuchita ntchito yanthawi zonse - mtima wanga unapweteka, kuphatikiza, kupuma movutikira, mavuto a kupuma adayamba. Pambuyo pakufalikira kwa matendawa, ndidakafika kuchipatala. Kumeneku ndidasankhidwa maphunziro a jakisoni a Kokarnit. Ndikabaya yankho mu matako, zimapweteka, koma ndinapilira chifukwa chotsatira. Ndikadali chithandizo.

Cyanocobalamin

M'magazi, cyanocobalamin imamangiriza ku transcobalamin I ndi II, yomwe imayipititsa ku minofu. Amayikidwa makamaka m'chiwindi. Kuyankhulana ndi mapuloteni a plasma - 90%. Mofulumira komanso kwathunthu odziwikiratu pambuyo makonzedwe a intramuscular and subcutaneous. Pazitali zabwino pambuyo jekeseni wa mnofu zimatheka pambuyo 1 ora.

Amachotseredwa ku chiwindi ndi bile m'matumbo ndikuikidwanso m'magazi. Kuchotsa theka moyo ndi 500 masiku. Amayamwa ndi ntchito yachibadwa ya impso - 7-10% ndi impso, pafupifupi 50% - m'matumbo. Ndi kuchepa kwa impso - 0-7% ndi impso, 70-100% - m'matumbo. Imalowa mkati mwa chotchinga cha mkaka wamkaka.

Nikotinamide

Imagawidwa mwachangu mu nsalu zonse. Imalowa mkatikati mwa chotchinga ndi mkaka wa m'mawere. Zimapangidwa m'chiwindi ndikupanga nicotinamide-N-methylnicotinamide. Amachotsa impso.

Moyo wa plasma theka ndi pafupifupi maola 1.3, kuchuluka kwa magawidwe osakhalitsa kuli pafupifupi malita 60, ndipo chilolezo chonsecho chili pafupifupi 0,6 l / min.

Mlingo ndi makonzedwe

Mankhwala amabayidwa intramuscularly kwambiri (mu gluteus minofu).

Muzochitika zowawa kwambiri, chithandizo ndikofunikira kuti muyamba ndi jekeseni wamitsempha ya 1 ampoule (2 ml) patsiku mpaka zizindikiro zamphamvu zithe. Kutalika kwa ntchito ndi masiku 9.

Pambuyo kusintha kwa zizindikiro kapena vuto la polyneuropathy: 1 wokwanira 2-3 pa sabata kwa masabata awiri. Njira yovomerezeka ya mankhwalawa ndi jakisoni 3-9, kutengera mphamvu ya matendawa.

Kutalika kwa chithandizo komanso kubwereza maphunziro kumatsimikiziridwa ndi dokotala kutengera mtundu ndi kuuma kwa matendawa.

Zizindikiro zosokoneza bongo

Trifosadenin: kupitilira muyeso waukulu tsiku lililonse (pafupifupi 600 mg kwa munthu wamkulu) kungayambitse kukula kwa zizindikiro zotsatirazi: chizungulire, kuchepa kwa magazi, kutsika kwakanthawi kokhudzana ndi chikumbumtima, arrhasmia, atrioventricular block II ndi III degree, asystole, bronchospasm, kusokonezeka kwamitsempha yamagazi, kusokonezeka kwa sinus bradycardia ndi tachycardia.

Cocarboxylase: Zizindikiro zotsatirazi zanenedwa pambuyo pakupereka mlingo wopitilira 100 njira yolimbikitsidwa: kuphipha kwa minofu, kufooka kwa minofu, ziwindi, arrhythmia.

Cyanocobalamin: pambuyo pa uchembere pakumwa mlingo waukulu, kusokonezeka kwa khungu ndi mawonekedwe a ziphuphu zakumaso zimawonedwa. Mukamagwiritsa ntchito Mlingo wambiri, n`zotheka kukulitsa hypercoagulation, kuphwanya kagayidwe ka purine.

Nicotinamide: mukamagwiritsa ntchito Mlingo waukulu, hyperpigmentation, jaundice, amblyopia, kufooka, kufalikira kwa zilonda zam'mimba ndi duodenum. Pogwiritsa ntchito nthawi yayitali, chitukuko cha steatohepatosis, kuchuluka kwa kuchuluka kwa uric acid m'magazi, kulekerera kwa glucose kunadziwika.

Kukhazikitsidwa kwa mankhwalawa kumayimitsidwa nthawi yomweyo, chithandizo cha mankhwala chimayikidwa, kuphatikizanso kukana.

Kuchita ndi mankhwala ena

Odwala omwe amagwiritsa ntchito hypoglycemic othandizira a gulu la Biguanide (metformin), chifukwa cha kuwonongeka kwa cyanocobalamin kuchokera m'matumbo am'mimba, kuchepa kwa kuchuluka kwa cyanocobalamin m'magazi kungawonedwe. Ndi othandizira ena a hypoglycemic, kuyanjana kwa mankhwala sikufotokozedwa.

Cyanocobalamin imagwirizana ndi ascorbic acid, mchere wazitsulo zolemera, thiamine, thiamine bromide, pyridoxine, riboflavin, folic acid.

Simungagwiritse ntchito munthawi yomweyo cyanocobalamin ndi mankhwala omwe amalimbikitsa kuchuluka kwa magazi.

Kuphatikiza apo, kugwiritsa ntchito nthawi imodzimodziyo kwa cyanocobalamin ndi chloramphenicol kuyenera kupewedwa.

Aminoglycosides, salicylates, antiepileptic mankhwala, colchicine, kukonzekera kwa potaziyamu kumachepetsa mayamwidwe a cyanocobalamin.

Ndi kuphatikiza kwa mankhwala omwe ali ndi trifosadenine ndi dipyridamole, mphamvu ya dipyridamole imatheka, makamaka vasodilating.

Dipyridamole imawonjezera mphamvu ya trifosadenin.

Zovuta zina zimawonetsedwa pogwiritsa ntchito mankhwalawa pamodzi ndi purine zotumphukira (caffeine, theophylline).

Simungathe kulowa nthawi yomweyo ndi mtima glycosides pamiyeso yayikulu, chifukwa chiopsezo chokhala ndi zotsatira zoyipa kuchokera mu mtima zimachulukirachulukira.

Pogwiritsa ntchito munthawi yomweyo ndi xanthinol nicotinate, zotsatira za mankhwala zimachepetsedwa.

Nicotinamide imayambitsa mphamvu ya zomwe zimatha kusuntha, ma tranquilizer, komanso mankhwala a antihypertensive.