Momwe mungagwiritsire ntchito mankhwala Katena?
Makapu amodzi ali:
Makapisozi 100 mg: ntchito: gabapentin - 100 mg,
zokopa: lactose monohydrate, wowuma chimanga, talc,
chipolopolo cha kapisozi: titanium dioxide (E 171), gelatin.
Makapisozi 300 mg: ntchito: gabapentin - 300 mg,
zokopa: lactose monohydrate, wowuma chimanga, talc,
chipolopolo cha kapisozi: titanium dioxide (E 171), utoto wachitsulo wachikasu (E 172), gelatin.
Makapisozi 400 mg: ntchito: gabapentin - 400 mg,
obwera: lactose monohydrate, wowuma chimanga, talc,
chipolopolo cha kapisozi: utoto wa titanium dioxide (E 171), utoto wachikasu wachitsulo (E 172), utoto wofiira wa oxide (E172), gelatin.
Makapisozi 100 mg: oyera crystalline ufa mu chipewa cha kapisozi yoyera, kukula 3.
Makapisozi 300 mg: oyera makhiristu ufa mu chipewa cha chikasu chachikaso, kukula 1.
Makapisozi 400 mg: oyera makhristalo ufa mu chipewa cha lalanje kapisozi, kukula 0.
Mankhwala
Mankhwala
Gabapentin ndi ofanana mu dongosolo la neurotransmitter gamma-aminobutyric acid (GABA), koma momwe amagwirira ntchito ndizosiyana ndi zina mwa mankhwala ena omwe amalumikizana ndi GABA receptors, kuphatikizapo valproate, barbiturates, benzodiazepines, GABA transaminase inhibitors, aga agonists, and GABA agon inhibitors, and Mitundu ya Production ya GABA: ilibe katundu wa GABAergic ndipo siyikhudza kutengeka ndi kagayidwe ka GABA. Kafukufuku woyamba adawonetsa kuti gabapentin imamangiriza ku α2-δ kugwiritsira ntchito njira zama calcium zomwe zimadalira magetsi ndikuletsa kuyenda kwa ma ioni a calcium, omwe amathandiza kwambiri kupezeka kwa ululu wa neuropathic. Njira zina zomwe zimakhudzidwa ndi zochita za gabapentin mu ululu wa neuropathic ndi: kuchepa kwa kufa kwa glutamate-neurons, kuchuluka kwa kaphatikizidwe ka GABA, komanso kupondereza kutulutsidwa kwa ma neurotransmitters a gulu la monoamine. Makulidwe ofunikira kwambiri a gabapentin samamangirira kwa receptors a mankhwala ena wamba kapena ma neurotransmitters, kuphatikizapo GABAA, GABAA, benzodiazepine, glutamate, glycine kapena N-methyl-D-aspartate receptors. Mosiyana ndi phenytoin ndi carbamazepine, gabapentin simalumikizana ndi njira za sodium.
Pharmacokinetics
Zogulitsa
The bioavailability wa gabapentin siogwirizana ndi mankhwalawa, kotero ndi kuchuluka kwa magazi kumachepa. Pambuyo pakukonzekera kwa pakamwa, kuchuluka kwakukulu (Cmax) kwa gabapentin mu plasma kumatheka pambuyo pa maola 2-3. Mtheradi wa bioavailability wa gabapentin m'mapiritsi ndi pafupifupi 60%. Chakudya, kuphatikiza chomwe chili ndi mafuta ambiri, sichikhudzanso ma pharmacokinetics. Kuchotsa kwa gabapentin ku plasma kumafotokozedwa bwino pogwiritsa ntchito mtundu wa mzere.
Kugawa
Pharmacokinetics sasintha pogwiritsa ntchito mobwerezabwereza, kutsata kwa plasma mozungulira kunganenedweratu kutengera zotsatira za mlingo umodzi wa mankhwalawo. Gabapentin sikugwirizana kwenikweni ndi mapuloteni a plasma (
- Chithandizo cha ululu wa neuropathic mwa akulu (wazaka 18 ndi akulu). Kuchita bwino komanso chitetezo mwa odwala osakwanitsa zaka 18 sizinakhazikitsidwe.
- Monotherapy ya khunyu pang'ono khunyu ndi popanda yachiwiri generalization mu akulu ndi ana opitirira zaka 12. Kuchita bwino komanso chitetezo cha monotherapy mwa ana ochepera zaka 12 sizinakhazikitsidwe.
- Monga chida chothandizira matenda a khunyu khunyu komanso popanda yachiwiri generalization mu akulu ndi ana a zaka 3 kapena kupitirira. Chitetezo ndikuyenda bwino kwa mankhwala owonjezera a gabapentin mwa ana osaposa zaka 3 sizinakhazikitsidwe.
Mimba komanso kuyamwa
Palibe chidziwitso chokhudza chitetezo cha mankhwalawa panthawi yomwe ali ndi pakati, chifukwa chake, kugwiritsa ntchito kwa gabapentin pa nthawi yomwe ali ndi pakati kumatheka pokhapokha ngati phindu lomwe lingaperekedwe kwa amayi likuwonetsa kuwopsa kwa mwana wosabadwayo.
Gabapentin amamuchotsa mkaka wa m'mawere, kotero kuyamwitsa kuyenera kusiyidwa panthawi ya chithandizo.
Mlingo ndi makonzedwe
Mlingo woyambirira ndi 900 mg wa tsiku patsiku atatu Mlingo wofanana, ngati ndi kotheka, kutengera mphamvu yake, mankhwalawo amayamba kukula mpaka kufika pa 3600 mg / tsiku. Kuchiza kumayamba pang'onopang'ono ndi mlingo wa 900 mg / tsiku (300 mg katatu patsiku) kapena masiku atatu oyamba mlingo ungakulidwe pang'onopang'ono mpaka 900 mg tsiku lililonse malinga ndi dongosolo lotsatira:
Tsiku loyamba: 300 mg kamodzi patsiku
Tsiku lachiwiri: 300 mg kawiri pa tsiku
Tsiku lachitatu: 300 mg katatu patsiku
Akuluakulu ndi ana opitilira zaka 12 Mlingo wothandiza - kuyambira 900 mpaka 3600 mg tsiku lililonse. Mankhwalawa amatha kuyambitsidwa ndi mlingo wa 300 mg katatu patsiku patsiku loyamba kapena pang'onopang'ono ukuwonjezeka mpaka 900 mg molingana ndi chiwembu chomwe chatchulidwa pamwambapa (onani gawo "Kupweteka kwa Neuropathic mwa akulu"). Pambuyo pake, mlingowo ungathe kuwonjezeka mpaka kufika pa 3600 mg / tsiku mu waukulu katatu. Pazitali pakati pakati Mlingo ndi katatu Mlingo wa mankhwala sayenera upambana maola 12 kuti tipewe kuyambiranso. Kulekerera kwabwino kwa mankhwala muyezo mpaka 4800 mg / tsiku kunadziwika.
Ana a zaka 3-12 : Mlingo woyambirira wa mankhwalawa umasiyana 10 mpaka 15 mg / kg / tsiku, womwe umayamwa Mlingo wofanana katatu katatu patsiku ndipo umayamba kugwira ntchito mkati mwa masiku atatu. Mlingo wothandiza wa gabapentin mwa ana azaka 5 ndi kupitilira 25-25 mg / kg / tsiku mu Mlingo wofanana mu katatu. Mlingo wothandiza wa gabapentin mwa ana a zaka 3 mpaka 5 ndi 40 mg / kg / tsiku mu Mlingo wofanana mu katatu. Kulekerera kwabwino kwa mankhwala mu Mlingo mpaka 50 mg / kg / tsiku ndi ntchito yayitali. Pazitali pakati pakati Mlingo wa mankhwala sayenera kupitirira maola 12 kuti kupewa kuyambiranso.
Palibe chifukwa chowongolera kuchuluka kwa gabapentin mu plasma. Kukonzekera kwa Katena ® kungagwiritsidwe ntchito limodzi ndi anticonvulsants ena osaganizira zakusintha kwa plasma yake kapena ndende ya anticonvulsants ena mu seramu.
Mlingo wosankhidwa chifukwa cha kulephera kwa impso
Kwa odwala omwe ali ndi vuto la aimpso, kuchepetsedwa kwa mlingo wa gabapentin malinga ndi tebulo:
Chilolezo cha Creatinine (ml / min) | Mlingo watsiku ndi tsiku (mg / tsiku)* |
>80 | 900-3600 |
50-79 | 600-1800 |
30-49 | 300-900 |
15-29 | 150**-600 |
Kuchita ndi mankhwala ena
Pogwiritsa ntchito nthawi yomweyo ya gabapentin ndi morphine, pamene morphine amatengedwa maola 2 asanatenge gabapentin, panali kuwonjezeka pakati pa malo omwe ali pansi pa pharmacokinetic pamapindikira "nthawi" (AUC) ya gabapentin ndi 44% poyerekeza ndi gabapentin monotherapy, yomwe imagwirizanitsidwa ndi kuwonjezeka kwa njira yolowera ululu ( kuyesa kopanikizira ozizira). Kufunika kwamankhwala chifukwa cha kusinthaku sikunachitike; mawonekedwe a pharmacokinetic a morphine sanasinthe. Zotsatira zoyipa za morphine mukamamwa ndi gabapentin sizimasiyana ndi zomwe zimamwa morphine molumikizana ndi placebo. Malangizo apaderaNdi kuphatikiza pamodzi ndi morphine, kuchuluka kwa gabapentin kumatha kuchitika mwa odwala. Pankhaniyi, ndikofunikira kuyang'anitsitsa odwala kuti apange chizindikiro cha kukhumudwa kwa chapakati mantha dongosolo (CNS) ngati kugona. Pankhaniyi, mlingo wa gabapentin kapena morphine uyenera kuchepetsedwa mokwanira (onani "Kuyanjana ndi mankhwala ena"). Ndi kuphatikiza kwa gabapentin ndi ma anticonvulsants ena, zotsatira zoyipa zabodza zinajambulidwa pakupanga mapuloteni mumkodzo pogwiritsa ntchito timiyeso ta Ames N-Multistix SG ®. Kuti mudziwe mapuloteni mumkodzo, tikulimbikitsidwa kugwiritsa ntchito njira ina yapadera yodumphira mpweya ndi sulfosalicylic acid. Kukopa pa luso loyendetsa magalimoto ndi zida Malinga ndi zotsatira za kafukufuku wazachipatala, akukhulupirira kuti zotsatira za betahistine pa kuthekera koyendetsa galimoto ndi zina mwa zinthu sizikupezeka kapena ndizosafunikira, popeza palibe zotsatira zomwe zikukhudza kuthekera kumeneku. Kutulutsa FomuMakapisozi 100 mg, 300 mg, 400 mg. Zizindikiro zogwiritsidwa ntchitoKhunyu: khunyu yolumikizana komanso yopanda mphamvu yachiwiri kwa akulu ndi ana opitilira zaka 12 (monotherapy), kugwidwa mwachidule komanso popanda kutsekemera kwachiwiri kwa akuluakulu (mankhwala owonjezera), mawonekedwe osagwirizana ndi ana a zaka zopitilira 3 (mankhwala ena). Ululu wa neuropathic kwa odwala okulirapo zaka 18. Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizoMkati, ngakhale zakudya. Khunyu Akuluakulu ndi ana opitirira zaka 12: mlingo woyambirira wa Katena ndi 300 mg katatu pa tsiku tsiku loyamba, mlingo wogwira ndi 900-3600 mg / tsiku. Mlingo wambiri watsiku ndi tsiku ndi 3600 mg (kwa 3 Mlingo wofanana). Pazitali pakati pakati Mlingo kupereka mankhwala 3 pa tsiku sayenera upambana 12 hours. Kusankhidwa malinga ndi dongosolo lotsatirali ndikotheka (gawo la kusankha mankhwalawa). Pa mlingo wa 900 mg: patsiku loyamba - 300 mg 1 nthawi patsiku, wachiwiri - 300 mg 2 kawiri pa tsiku, kachitatu - 300 mg katatu pa tsiku, pa mlingo wa 1200 mg: 400 mg 1 nthawi patsiku, 400 mg 2 pa tsiku, 400 mg katatu patsiku tsiku loyamba, lachiwiri ndi lachitatu, motero. Ana a zaka 3-12 zaka: ogwira mlingo - 25-35 mg / kg / tsiku 3 Mlingo wofanana. Mutha kupereka gawo limodzi mwa magawo atatu: 10 mg / kg / tsiku loyamba, 20 mg / kg / tsiku lachiwiri ndi 30 mg / kg / tsiku lachitatu. Pakufufuza kwakanthawi kachipatala, kulolera mankhwala osokoneza bongo mpaka 40-50 mg / kg / tsiku kunali kwabwino. Ndizotheka kugwiritsa ntchito chiwembu: ndi kulemera kwa thupi la 17-25 makilogalamu - 600 mg / tsiku, motero, 26-25 kg - 900 mg / tsiku, ndi 37-50 kg - 1200 mg / tsiku, ndi makilogalamu 51-72 - 1800 mg / tsiku . Neuropathy mwa akulu: mlingo woyambirira wa Katena ndi 300 mg katatu patsiku, ngati kuli kotheka, mlingo umakulitsidwa pang'onopang'ono mpaka kufika pa 3600 mg / tsiku. Odwala omwe ali ndi vuto la impso: ndi CC zoposa 60 ml / mphindi - 400 mg katatu pa tsiku, ndi CC kuchokera 30 mpaka 60 ml / mphindi - 300 mg kawiri pa tsiku, ndi CC kuyambira 15 mpaka 30 ml / mphindi - 300 mg 1 nthawi patsiku, ndi CC zosakwana 15 ml / mphindi - 300 mg tsiku lililonse. Ndikulimbikitsidwa kuti odwala akudwala hemodialysis omwe sanalandire gabapentin pang'onopang'ono kwa 300-400 mg, kenako 200-300 mg maola 4 aliwonse a hemodialysis. ZambiriKhunyu imadziwika ndi kugwidwa mobwerezabwereza kapena kusokonezeka kwa chikumbumtima (somnambulism, chizungulire chakumadzulo, kuzizira). Komanso, matendawa amadziwika ndi kusintha pang'onopang'ono kwa kusintha kwamunthu komanso matenda a khunyu. Nthawi zina matenda ngati amenewa amakhumudwitsa ma psychoses omwe amapezeka pachimake kapena mawonekedwe osakhazikika. Amatha kutsagana ndimatenda okhudzana monga, mwachitsanzo, mantha, kupsa mtima, kukhumba, kukondweretsedwa kwakukulu, chisangalalo, kuyerekezera zinthu. Pochitika kuti kukulitsa kwa khunyu kumachitika chifukwa cha matenda amadzimadzi, ndiye kuti amalankhula za khunyu. Pochita zachipatala, nthawi zambiri amakumana ndi zotupa za khunyu. Cholinga chotsimikiza pamkhalidwewu chimangokhala chaubongo kokha mu ubongo. Kodi khunyu imatha kuchiritsidwa? Kuzindikira ndi kuchiritsa matendawa kumachitika ndi epileptologists ndi neurologists. Akatswiri akuti sizingatheke kuthetsa matenda amtunduwu. Komabe, pali mankhwala ochepa omwe amatha kupondereza kupweteka kwa neuropathic ndikusintha moyo wa wodwalayo. Chimodzi mwa zinthu zoterezi ndi Katena (300 mg). Malangizo, ndemanga, analogues ndi zina mwa chida ichi zaperekedwa pansipa. Kuphatikizika, kunyamula ndi kutulutsira mawonekedweKodi mankhwala a Katena amagulitsidwa pamitundu iti? Ndemanga za odwala zimanena kuti chida choterechi chimapezeka m'mafakisoni mwa mawonekedwe a makapisozi. Mlingo wa mankhwalawo womwe ungafunsidwe ukhoza kukhala wosiyana. Makapisozi 100 mg (No. 3 kukula) ndi oyera, 300 mg (No. 1 kukula) ndi achikaso, ndipo 400 mg (No. 0 kukula) ndi lalanje. Zomwe zili mu mankhwalawa ndi ufa wowoneka bwino wa kristalo. Makapisozi amaikidwa m'matumba ndi ma paketi a makatoni, motero. Kodi ndi chiyani chomwe chimagwiritsidwa ntchito popanga mankhwala a Katena? Ndemanga za akatswiri akuti kuthamanga kwa mankhwalawa kumakhudzana mwachindunji ndi chosakaniza chake chachikulu - gabapentin. Komanso, kuphatikiza kwa wothandiziridwayo kumaphatikizapo zinthu zina monga chimanga wowuma, talc ndi lactose monohydrate. Ponena za zipolopolo za kapisozi, zimakhala ndi gelatin, titanium dioxide (E171) ndi utoto wachikasu / wofiira wachitsulo. Zotsatira za pharmacologicalKodi wothandizira antiepileptic ngati Katena amagwira ntchito bwanji? Ndemanga za akatswiri, komanso malangizo omwe aphatikizidwa ali ndi chidziwitso kuti mphamvu yothandizirana ndi mankhwalawa imachitika chifukwa cha kupezeka kwa gabapentin mmenemo, kutanthauza chinthu chomwe chimafanana ndi dongosolo la neurotransmitter GABA kapena otchedwa gamma-aminobutyric acid. Komabe, ziyenera kudziwidwa kuti magwiridwe antchito a mankhwalawa ndi osiyana ndi mphamvu ya mankhwala ena omwe amalumikizana ndi GABA receptors. Malinga ndi malangizo, gabapentin imatha kumangiriza ku α2-δ subunit yamagetsi odziyimira pawokha a calcium, komanso kuletsa kuyenda kwa Ca ions, yomwe ndi imodzi mwazomwe zimapangitsa kupweteka kwa neuropathic. Katundu winaKodi nchifukwa chiyani Katena ndi wotchuka kwambiri? Ndemanga za madokotala ndi odwala akuti kumwa mankhwalawa kumathandiza kwambiri wodwalayo. Izi zimachitika makamaka chifukwa chakuti ndikumva kupweteka kwa neuropathic, zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimatha kuchepetsa kufa kwa glutamate-cell, kukulitsa kaphatikizidwe ka GABA, komanso kuletsa kutulutsidwa kwa ma neurotransmitters a gulu la monoamine. Mu mankhwalawa achire, mankhwalawo omwe samafunsidwa samamangiriza ma neurotransmitter receptors, kuphatikizapo benzodiazepine, glutamate, N-methyl-D-aspartate, glycine, GABAA ndi GABAA receptors. Mosiyana ndi mankhwala ngati Carbamazepine ndi Phenytoin, Katena (ndemanga yake ili pansipa) samayanjana ndi njira za Na. Zolemba za PharmacokineticKodi zinthu zomwe zikuchitika mu Catena (300 mg) zimamwa? Malangizo ndi kuwunika kwa akatswiri zimanena kuti gabapentin amatengedwa kutaya chakudya. Pambuyo pakamwa makapisozi, pazotheka ambiri pazogwira pophika m'magazi zimafikiridwa patatha maola atatu.Mtheradi bioavailability wa mankhwala pafupifupi 60%. Kuyamwa munthawi yomweyo (kuphatikizapo zakudya zamafuta ambiri) sizikhala ndi vuto lililonse pa pharmacokinetic. Yogwira pophika mankhwala samamangiriza mapuloteni a plasma. Odwala omwe ali ndi khunyu, kugwiritsidwa ntchito kwake mu madzi amchere ndi pafupifupi 20% ya omwe ali ndi madzi a m'magazi. Excretion wa gabapentin imachitika kudzera muimpso. Zizindikiro zakusintha kwachilengedwa m'thupi la munthu sizikupezeka. Gabapentin satha kukopa ma oxidase, omwe amaphatikizidwa ndi kagayidwe kamankhwala ena. Kuchoka kwa mankhwalawa ndi liniya. Hafu ya moyo wake sizidalira kuchuluka kwa mankhwalawa ndipo ndi pafupifupi maola 5-7. Kuvomerezeka kwa Gabapentin kumachepetsedwa mwa okalamba, komanso odwala omwe ali ndi vuto laimpso. The yogwira pophika mankhwala amachotsedwa magazi pa hemodialysis. Kuzungulira kwa plasma kwa gabapentin mwa ana ndi chimodzimodzi ndi kwa akulu. Zisonyezo za kutenga makapisoziNdi nthawi ziti pamene wodwala angaikidwe mankhwala ngati Katena (300 mg)? Malangizo ndi malingaliro akuti zinthu zotsatirazi ndi chizindikiro cha kugwiritsa ntchito mankhwalawa:
Contraindication kutenga makapisoziKodi simayenera kutenga Katena liti? Malangizo ndi ndemanga zimanena kuti mankhwalawa amawonongeka kwa ana osakwana zaka zitatu. Amaletsedwanso kuti azigwiritsidwa ntchito powona wodwala amene ali ndi chidwi chachikulu ndi zigawo za mankhwala. Mosamala kwambiri, mankhwalawa amaperekedwa kwa anthu omwe ali ndi vuto la impso. Mankhwala "Catena": malangizo ntchitoKuunika kwa akatswiri ndi malangizo ogwiritsa ntchito akuti mankhwala omwe amafunsidwawa ndi mankhwala othandiza komanso otchuka a antiepileptic. Kulowetsa mkati ndikololedwa mosasamala kanthu ndi chakudya. Chepetsani mankhwalawa, lembani mankhwalawo, kapena m'malo mwake ndi mankhwala ena, pang'onopang'ono sabata limodzi. Ndi ululu wa neuropathic, muyeso woyamba wa mankhwalawa (mwa akulu) uyenera kukhala 900 mg (mu katatu). Ngati mphamvu zomwe zapezedwa sizokwanira, ndiye kuti mankhwalawa amawonjezeka pang'onopang'ono. Mlingo wapamwamba tsiku lililonse wa Katena ndi 3600 mg. Kutalika kwa nthawi pakati pa kaperekedwe kasitomala sikuyenera kupitirira maola 12, popeza pali chiopsezo chobwereza. Ndi chitukuko cha magwiridwe a ana a zaka 3-12, mankhwalawa mankhwala koyamba mlingo wa 10-15 mg / kg (ogaŵikana 3 waukulu. Kupitilira masiku atatu, mlingo umakulitsidwa pang'onopang'ono (kwa wogwira kwambiri). Kodi ndi chiyani china chomwe muyenera kudziwa musanayambe kumwa Catena? Malinga ndi akatswiri, sikofunikira kuyang'anira kuchuluka kwa mankhwalawa panthawi ya mankhwala. Mankhwala omwe amafunsidwa amatha kugwiritsidwa ntchito limodzi ndi anticonvulsants ena. Zotsatira zoyipaZotsatira zoyipa zomwe mankhwala a Katena angayambitse (300 mg) zimabweretsa? Ndemanga amati mutamwa mankhwalawa, ndizotheka kukhazikitsa zotsatirazi (chimodzi kapena zingapo nthawi imodzi):
Kuyanjana kwa mankhwala osokoneza bongoKodi ndingatenge makapisozi a Katena ndi mankhwala ena? Kafukufuku wa akatswiri akuwonetsa kuti pamene mukumwa mankhwalawa ndi maantacid, mayamwidwe a gabapentin pamimba amachepetsa. Mukamagwiritsa ntchito limodzi ndi Felbamate, theka la moyo womaliza limatha kukula. Ndikofunikira kudziwa!Kutha kwadzidzidzi kwa chithandizo chamankhwala osokoneza bongo mwa anthu omwe agwidwa ndi gawo limodzi kumayipitsa kukula kwa udindo. Chifukwa chake, ngati kuli kofunikira kuchepetsa mlingo, lembani gabapentin kapena m'malo mwake ndi mankhwala ena, izi ziyenera kuchitika pang'onopang'ono, sabata limodzi. Makapisozi "Katena" sichiyimira chida chothandiza pochotsa kukakamira kwa abscess. Kugwiritsa ntchito komweko kwa mankhwalawo limodzi ndi mankhwala ena a anticonvulsant nthawi zambiri kumayambitsa zotsatira zoyipa zabodza, zomwe zimachitika kuti mudziwe mapuloteni mumkodzo. Chifukwa chake, pa mankhwala tikulimbikitsidwa kugwiritsa ntchito njira yodziwika bwino yolowera kwa sulfosalicylic acid. Anthu omwe ali ndi vuto la impso, komanso omwe ali ndi hemodialysis, amafunika kusintha dongosolo. Odwala okalamba angafunikenso kusintha kuchuluka kwa mankhwalawa, chifukwa m'gulu ili la odwala kuchepa kwa impso. Chitetezo ndikuyenda bwino kwa mankhwala a khunyu mothandizidwa ndi mankhwala a Katen mwa odwala achinyamata, komanso mwa ana ochepera zaka 12, sanakhazikitsidwe. Pa mankhwala ndi mankhwala otere, mowa umaletsedwa. Mankhwala "Catena": ndemanga za madokotala ndi odwala, analoguesZofanizira zamankhwala zomwe zikufunsidwa ndi: Eplirintin, Gabagamm, Gabapentin, Neurontin, Tebantin, Konvalis, Egipentin. Malinga ndi akatswiri, mankhwalawa "Katena" ndi mankhwala othandizira antiepileptic, omwe amadziwika kwambiri ndi anthu omwe nthawi zambiri amakhala akuvutika ndi kukomoka. Ponena za odwala, amathandizira mokwanira malingaliro a madokotala. Komabe, ndemanga zoyipa zimapezeka pakati pa ndemanga zabwino. Malinga ndi odwala ambiri, njira yofunika kwambiri yobweretsera mankhwalawo ndi yochulukirapo (poyerekeza ndi mankhwala ofananawo). Akatswiri amati mankhwalawa, omwe amagwiritsidwa ntchito monga gabapentin, ali ndi zotsutsana zochepa zogwiritsidwa ntchito, komanso zoyipa zomwe zimawonetsedwa ndi dongosolo lamanjenje. Kutulutsa mafomu ndi kapangidwe kakeMitundu ingapo ya makapisozi ikugulitsidwa, kutengera zomwe zimapezeka m'thupi - gabapentin (100 mg, 300 mg, 400 mg). Thupi limakhudza mwachindunji chifukwa chachikulu cha kupweteka kwa neuropathic - kutuluka kwa calcium ion. Mwansanga komanso moyenera amachotsa kugwidwa ndi zizindikiro zina za khunyu. Malangizo ogwiritsira ntchito Katena: Mlingo ndi malamulo ovomerezekaKumwa mapiritsi sikudalira kudya. Muyenera kuvomereza motere: Pa ululu wa neuropathic, mlingo womwe umalimbikitsa odwala kuposa zaka 12 ndi 300 mg katatu patsiku. Nthawi zina, mlingo umatha kuwonjezeka mpaka 3600 mg / tsiku. Ndi khunyu pang'ono, odwala omwe ali ndi zaka 12 akuwonetsedwa akutenga 900-3600 mg / tsiku. Mankhwalawa amatha kuyamba ndi 300 mg katatu patsiku. Mlingo wapamwamba ndi 4800 mg / tsiku. Kwa ana kuyambira zaka 3 mpaka 12, mlingo umachepetsedwa mpaka 10-15 mg / kg / tsiku. Kulandila kuyenera kugawidwa katatu. Mutha kuwonjezera pang'onopang'ono mlingo wake mpaka 50 mg / kg / tsiku. Mankhwala, palibe chifukwa chowunika kuchuluka kwa yogwira ntchito m'magazi. Kusintha kwa Mlingo sikofunikira pakugwiritsa ntchito anticonvulsants ena. Pharmacokinetics ndi pharmacodynamicsKatena ndi mankhwala anticonvulsant omwe zochita zake zimaponderezedwa kupweteka kwa neuropathic. Gawo lalikulu - gabapentin, lomwe ndi gawo lazogulitsa, limagwira ntchito pazoyenda za calcium ion, zomwe zimakhudzidwa mwachindunji pakupezeka kwa zizindikiro za ululu wa neuropathic. Chifukwa cha kuchuluka kwa zomwe zimachitika mthupi la wodwalayo, kukhudzika, zizindikiro za khunyu komanso kupweteka kwam'mimba zimadutsa mwachangu. Mankhwalawa amachotseredwa kudzera impso. Chifukwa chake, mankhwalawa "Catana" ali ndi analgesic, anticonvulsant ndi anticonvulsant. Zotsatira zoyipaZotsatira zoyipa: erythema multiforme, matenda a Stevens-Johnson.
Ana, pa mimba ndi mkaka wa m`mawerePalibe chidziwitso chogwiritsa ntchito mankhwalawa amayi apakati, motero, gabapentin iyenera kugwiritsidwa ntchito pokhapokha ngati phindu lomwe limayembekezera kwa mayi likubweretsa chiwopsezo kwa mwana wosabadwayo. Gabapentin amachotseredwa mkaka wa m'mawere, momwe zimakhudzira mwana wakhanda sakudziwika, chifukwa chake, panthawi yoyamwitsa, kuyamwitsa kuyenera kusiyidwa. Zochita ZamankhwalaPankhani yogwiritsira ntchito cimetidine, kuchepa kwapang'onopang'ono kwa aimpso a gabapentin ndikotheka, koma izi mwina sizikhala ndi matendawo.
Palibe kuyanjana kunawonedwa pakati pa gabapentin ndi valproic acid, phenytoin, phenobarbital, carbamazepine. Zolemba zogwiritsira ntchitoOdwala omwe ali ndi matenda ashuga ayenera kuonana ndi dokotala kuti asinthe mlingo wa mankhwala a hypoglycemic. Munthawi yonse ya ntchito ya Katen, kuyang'anira wodwala ndikofunikira, chifukwa mankhwalawa angayambitse kukhumudwa ndi kudzipha. Ndikofunika kwambiri kuyang'anira kuchuluka kwa mankhwalawa omwe adotchulidwa ndi dokotala kuti mupewe kuchitika kwakayipa. Kutha msanga kwa mankhwalawa kumatha kuyambitsa matenda. Ngati kuli kofunika kuchepetsa mlingo, muyenera kufunsa dokotala kuti akonze dongosolo lokwanira. Wodwala yemwe amamwa mankhwalawa saloledwa kuyendetsa magalimoto. MomwemonsoZofananira zonse za Catena:
Mankhwala othandizira antiepileptic ndi awa:
MankhwalaKatundu wogwira wa Catena ndi gabapentin, chinthu chofananira ndi neurotransmitter gamma-aminobutyric acid (GABA). Komabe, momwe amagwirira ntchitoyo amasiyana ndi mphamvu ya mankhwala ena omwe amagwirizana ndi ma GABA receptors, kuphatikizapo barbiturates, GABA uptake inhibitors, GABA agonists, valproate, GABA transaminase inhibitors, benzodiazepines ndi mitundu ya mankhwala a GABA, popeza gabapentin alibe GABAergic katundu, sasokoneza kagayidwe ndi kugwidwa kwa GABA. Malinga ndi kafukufuku woyambirira, gabapentin imamangiriza ku α2-δ -igawo lamayendedwe a calcium omwe amadalira mphamvu yamagetsi ndikuletsa kuyenda kwa ayoni a calcium, omwe ndi omwe amachititsa kupweteka kwa neuropathic. Kuphatikiza apo, ndikumva kupweteka kwa neuropathic, gabapentin ali ndi njira zina zochitira, monga: amachepetsa kufa kwa mitsempha ya glutamate, kumawonjezera kaphatikizidwe ka GABA ndikulepheretsa kutulutsidwa kwa ma neurotransmitters a gulu la monoamine. Pazofunikira zazikulu zamankhwala, mankhwalawa samamangirira ma receptor a mankhwala ena wamba ndi ma neurotransmitters, kuphatikizapo benzodiazepines, glutamate, glycine, N-methyl-D-aspartate, GABAA ndi GABAMu. Mosiyana ndi carbamazepine ndi phenytoin, gabapentin simalumikizana ndi njira za sodium. Malangizo ogwiritsira ntchito Katena: njira ndi mlingoMakapisozi amayenera kumwedwa pakamwa, ngakhale zakudya. Kuchepetsa mlingo, kusiya Katena kapena m'malo mwake ndi wothandizila wina ayenera pang'onopang'ono, kwa sabata limodzi. Ndi ululu wa neuropathic mwa akulu, muyeso woyamba wa tsiku lililonse ndi 900 mg - 300 mg katatu patsiku. Ngati vutoli silikwanira, mlingo wake umakulitsidwa pang'onopang'ono. Mlingo wovomerezeka watsiku ndi tsiku ndi 3600 mg. Mutha kuyamba kulandira mankhwalawa tsiku lililonse ndi 900 mg kapena kuonjezera pang'onopang'ono masiku atatu oyamba monga mwatsatanetsatane:
Ndi kugundana pang'ono mwa akulu ndi achinyamata azaka 12, Katena amagwira ntchito mwanjira zosiyanasiyana za 900-600 mg.Mutha kuyamba kulandira chithandizo mwachangu ndi 900 mg (300 mg katatu patsiku) kapena kuonjezera pang'onopang'ono masiku atatu oyamba malinga ndi zomwe tafotokozazi. M'tsogolo, ngati kuli kotheka, pitilizani kuonjezera mlingo, mpaka muyezo wa tsiku ndi tsiku wa 3600 mg (m'magawo ofanana mu 3 mgulu wogawika). Kutalikirana pakati Mlingo sayenera kupitirira maola 12, popeza pali chiopsezo cha kukomoka kwatsopano. Kulekerera kwabwino kwa gabapentin mu Mlingo watsiku ndi tsiku mpaka 4800 mg kunadziwika. Ndi kupweteka pang'ono kwa ana a zaka 3 mpaka 12, Katana amamulembera koyamba mankhwala osachepera 10-15 mg / kg mu 3 mg. Pafupifupi masiku atatu, mlingo umakulitsidwa pang'onopang'ono mpaka umagwira kwambiri. Mu ana a zaka 5 zakubadwa nthawi zambiri amakhala 25-25 mg / kg / tsiku, mwa ana a zaka 3-5 - 40 mg / kg / tsiku (mu 3 Mlingo wofanana). Pogwiritsa ntchito nthawi yayitali, kulekerera kwabwino kwa gabapentin mu Mlingo wa tsiku ndi tsiku mpaka 50 mg / kg kunadziwika. Pofuna kupewa kukomoka mobwerezabwereza, nthawi yayitali pakati pa mulingo sayenera kupitirira maola 12. Palibe chifukwa chowongolera kuchuluka kwa mankhwalawa panthawi ya mankhwala. Katena angagwiritsidwe ntchito limodzi ndi anticonvulsants ena, osasintha kuchuluka kwa mankhwala mu seramu. Kwa odwala omwe amalephera kupezekanso impso, tsiku lililonse Katena amatsimikiza kutengera chilolezo chaininine (CC, ml / min):
* Fotokozerani Katena 300 mg tsiku lililonse tsiku lililonse. Odwala omwe sanagwiritsepo ntchito kale gabapentin ndipo ali ndi hemodialysis amamulembera Katena muyezo wokhwima wa 300-400 mg, ndiye kuti 200-300 mg amagwiritsidwa ntchito maola 4 aliwonse a hemodialysis gawo. Mimba komanso kuyamwaChitetezo cha gabapentin pa nthawi yomwe ali ndi pakati sichinakhazikitsidwe, kotero Catena amalembedwa pokhapokha ngati phindu lomwe lingachitike pabwino lomwe lingachitike mtsogolo lingakhale lalikulu kuposa zoopsa zomwe zingachitike. Gabapentin amadutsa mkaka wa m'mawere, chifukwa chake, kudyetsa kuyenera kusiyidwa ngati chithandizo chikufunika pa mkaka wa m'mawere. Gwiritsani ntchito paubwanaKaten amatsutsana pogwiritsa ntchito:
Kuletsa kwa zaka kumachitika chifukwa chakusowa kwa chidziwitso pakugwiritsa ntchito ndi chitetezo cha Katena malinga ndi zisonyezo pazaka zina. Ndemanga za KatenMalinga ndi ndemanga, Katena ndi antiepileptic yothandiza. Zowonongekazo zimaphatikizapo mtengo wokwera poyerekeza ndi zokonzekera zomwe zimakhala ndi carbamazepine, komabe, mosiyana ndi iwo, gabapentin ali ndi zotsutsana zochepa, malinga ndi ndemanga, zimayambitsa zovuta zochepa kuchokera ku dongosolo lamanjenje. Kupanga ndi mawonekedwe a kumasulidwaMankhwala a Katen ali ngati mapiritsi okhala ndi kapisozi omwe amakhala achikasu achikuda ndipo amakhala ndi osakaniza a ufa. Zophatikizira za mankhwalawa: Zopanga zosanjidwa pamwamba: Zotsatira zoyipaMankhwala Katena angayambitse chiwonetsero chazovuta za thupi, zomwe zikuwonetsedwa muzizindikiro zotsatirazi: Njira ndi mawonekedweMankhwala a Katen ali ngati mapiritsi omwe amagwiritsidwa ntchito pakamwa chifukwa cha khunyu komanso ululu wa neuropathic. Malangizo ogwiritsira ntchito mankhwalawa amapezeka mu malangizo omwe mungagwiritse ntchito, omwe amabwera ndi Katena. Kuphatikiza apo, muyezo ndi nthawi yothetsera mankhwalawa imatha kutsimikiziridwa ndi adokotala, omwe akupatseni mankhwalawo payekha atapima mayeso, kusonkhanitsa mayeso ndikuzindikiritsa chomwe chimayambitsa vutoli. Muthanso kusiya kugwiritsa ntchito malonda, muyenera kusiya pang'onopang'ono sabata limodzi. Momwemonso, muyenera kusiya kugwiritsa ntchito chida ichi kupita ku mankhwala ena ofanana. Mankhwalawa sayenera kugwiritsidwa ntchito nthawi imodzi ndi mankhwala ena antiepileptic, chifukwa izi zimatha kukhudza kuchuluka kwa mapuloteni mumkodzo. Odwala omwe ali ndi matenda a impso, komanso odwala omwe akumwa chithandizo mothandizidwa ndi zida zapamiyendo, amafunika kugwiritsa ntchito mankhwalawa. Kuphatikiza apo, odwala okalamba amafunikira kusintha kwa mankhwalawa, chifukwa mwa odwala oterowo ntchito ya impso imatha kuchepetsedwa, zomwe zikutanthauza kuti nthawi yochoka imachulukanso. Mankhwala amakhudzanso dongosolo lamanjenje ndi kuthamanga kwa zochitika zama psychomotor, chifukwa chake, pakachitika mankhwala, odwala ayenera kukana kuyendetsa magalimoto, komanso kugwira ntchito yomwe imafunikira chidwi chachikulu. Mankhwala sayenera kulembedwa kwa ana azaka zosaposa zaka zitatu. Pambuyo pazaka zitatu, mankhwalawa amayenera kuperekedwa kwa ana pokhapokha ngati lingaliro la adokotala, komabe, zoopsa zonse ziyenera kukumbukiridwa. Kuchita ndi mankhwala enaMankhwala Katen sangathe kumwa nthawi imodzi ndi awa: BongoMankhwala osokoneza bongo amatha kuyambitsa zizindikiro zosasangalatsa: Mankhwala a Catena ali ndi mitundu ingapo ya kapangidwe kake ndi mankhwala: Malo osungiraNdikulimbikitsidwa kuti musungidwe mankhwalawo pamalo osiyanitsidwa ndi ana ndikuwongolera magwero a kutentha osaposa 25 digiri Celsius. Alumali moyo wa mankhwalawa ndi zaka zitatu kuyambira tsiku lopangira mankhwalawa. Tsiku lotha ntchito ndikusunga, mankhwalawo sangathe kugwiritsidwa ntchito ndipo ayenera kutayidwa malinga ndi mfundo zaukhondo. Chilolezo cha Pharmacy LO-77-02-010329 cha pa June 18, 2019 |