Finlepsin 400 retard - malangizo * ogwiritsidwa ntchito

Popanda malangizo a dokotala, mitundu yotsatirayi ya mankhwala othandiza ndi yoyipa ya 4lepsin 400. Chonde tsatirani Mlingo womwe dokotala wakupatsani, chifukwa mwanjira ina Finlepsin 400 wosabwezera sangakhale ndi zotsatira zochizira!

Zingati komanso kangati muyenera kumwa Finlepsin 400

Chithandizo cha Finlepsin 400 retard chimayamba mosamala, ndikuwapatsa mankhwala osokoneza bongo aliyense payekhapayekha, kutengera mtundu ndi zovuta za chithunzi. Ndiye kuti mankhwalawo amawonjezedwa pang'onopang'ono mpaka mlingo wothandiza kwambiri wokonza ufike. Mulingo woyenera wa mankhwalawa kwa wodwala, makamaka ndi mankhwala ophatikiza, amatsimikiza ndi plasma yake. Malinga ndi anapeza, achire kuchuluka kwa finlepsin 400 achiwonjezera mumadzi am'magazi ndi 4-12 μg / ml.

Sinthani antiepileptic imodzi ndi finlepsin 400 retard iyenera kuchitika pang'onopang'ono, kuchepetsa mlingo wa mankhwala omwe kale mumagwiritsidwa ntchito. Ngati ndi kotheka, wothandizira antiepileptic amagwiritsidwa ntchito kokha pa monotherapy. Njira ya chithandizo imayang'aniridwa ndi dokotala waluso.

Mlingo wovomerezeka womwe anthu ambiri amawalandira ndi 400-11200 mg wa finlepsin 400 reters pa tsiku, womwe umagawidwa mu 1-2 kamodzi pa tsiku. Kuchulukitsa kuchuluka kwa tsiku ndi tsiku kwa 1400 mg sikumveka. Mlingo wambiri watsiku ndi tsiku sayenera kupitirira 1600 mg, chifukwa Mlingo wokwanira umachulukitsa zotsatira zoyipa.

Nthawi zina, mlingo wofunikira wa mankhwalawa ungasinthe kwambiri kuchokera pamankhwala oyambitsidwa ndikukonzanso, mwachitsanzo, chifukwa cha kuthamanga kwa metabolism chifukwa cha kuphatikizidwa kwa microsomal chiwindi, kapena chifukwa cha mankhwala omwe amaphatikizana ndi mankhwala.

Popanda malangizo apadera kuchokera kwa dokotala, amatsatira malangizo otsatirawa:

Chithandizo cha anticonvulsant

Kwakukulu, akuluakulu, koyamba mapiritsi a 1 / 2-1 achibwebweta (ofanana ndi 200-400 mg wa carbamazepine) amawonjezedwa pang'onopang'ono kukhala muyeso wa mapiritsi atatu a 3 retard (ofanana ndi 800-1200 mg wa carbamazepine).

Dongosolo lotsatira la dosing ndikulimbikitsidwa.

Akuluakulu amayesedwa m'mawa / madzulo200-300 mg madzulo 200-600 mg 400-600 mg Ana ndi omwe amawalemberaonani kuyambira 6 mpaka 10 madzulo200 mg madzulo200 mg m'mawa 200-400 mg Zaka 11 mpaka 15 zam'mawa / madzulo200 mg madzulo200-400 mg 400-600 mg

Kwa ana ochepera zaka 6, chithandizo choyambirira komanso chothandizira, mapiritsi osagwira ntchito kwa nthawi yayitali amapezeka. Chifukwa chokhala ndi osakwanira omwe amapezeka ndi mapiritsi achire, samalimbikitsidwa kwa ana azaka izi.

Kupewa koyambitsa matenda olimbitsa thupi m'chipatala

Pafupifupi tsiku lililonse piritsi limodzi limakhala limodzi mpaka limodzi m'mawa, madzulo piritsi limodzi la 3 limaperekedwa (lolingana ndi 600 mg ya carbamazepine). Woopsa milandu, m'masiku oyamba, mlingo utha kuwonjezereka mpaka mapiritsi 1 ndi 1/2 a retard 2 pa tsiku (lolingana 1200 mg ya carbamazepine).

Finlepsin 400 retard sayenera kuphatikizidwa ndi mankhwala a sedative-hypnotic. Malinga ndi zofuna zamankhwala, komabe, ngati kuli kotheka, finlepsin 400 retard ikhoza kuphatikizidwa ndi zinthu zina zomwe zimagwiritsidwa ntchito pochotsa zakumwa.

Pa mankhwala, ndikofunikira kuwunika pafupipafupi zomwe zimapezeka mu 400 za pllema yamagazi.

Pokhudzana ndi kukulitsa zotsatira zoyipa kuchokera pakatikati komanso pamazida amanjenje (onani zochitika zakumwa zoledzera mu gawo "Zotsatira zoyipa"), odwala amafufuzidwa bwino.

Trigeminal neuralgia, genuin glossopharyngeal neuralgia

Mlingo woyambirira ndi mapiritsi a retard 1 / 2-1 (ofanana ndi 200-400 mg wa carbamazepine), omwe mpaka ululuwo utazimiririka, amawonjezeredwa ndi pafupifupi mapiritsi a 1-2 omwe akufanana ndi 400-800 mg ya carbamazepine), omwe amagawidwa pawiri limodzi Mlingo patsiku.Pambuyo pake, pagawo lina la odwala, chithandizo chitha kupitilizidwa ndi mlingo wotsika wokonza, womwe umatha kupewetsa kupweteka kwa piritsi la 1/2 kubwereza 2 kawiri patsiku (lofanana ndi 400 mg ya carbamazepine).

Kwa odwala okalamba komanso olemekezeka, Finlepsin 400 retard amapatsidwa piritsi loyambirira la 1/2 la retard kamodzi patsiku (lofanana ndi 200 mg ya carbamazepine).

Ululu wa matenda ashuga a m'mimba

Pafupifupi tsiku lililonse mupeze piritsi la 1/2 m'mawa ndi piritsi 1 patsiku lamadzulo (lolingana ndi 600 mg ya carbamazepine). Mwapadera, Finlepsin 400 retard ikhoza kutumizidwa piritsi 1 ndi 1/2 piritsi 2 kamodzi patsiku (lolingana 1200 mg ya carbamazepine).

Epileptiform kugunda angapo sclerosis

Pafupifupi tsiku lililonse mlingo 1 / 2-1 mapiritsi 2 pa tsiku (lolingana 400-800 mg wa carbamazepine).

Kupewa kwamadera okhumudwitsa

Mlingo woyambirira, womwe, monga lamulo, nawonso wokwanira ngati mlingo wokonzera, ndi mapiritsi 1 / 2-1 patsiku (lolingana ndi 200-400 mg ya carbamazepine). Ngati ndi kotheka, mankhwalawa akhoza kuchuluka kwa piritsi limodzi katatu pa tsiku (lolingana ndi 800 mg ya carbamazepine).

Odwala omwe ali ndi vuto lalikulu la mtima, kuwonongeka kwa chiwindi ndi impso, komanso okalamba amapatsidwa mankhwala ochepa.

Kodi muyenera kumwa motani ndi Finlepsin 400

Mapiritsi okhala ndi retard amakhala ndi poyambira pogawa, amatengedwa nthawi yakudya kapena itatha, kutsukidwa ndimadzi okwanira (mwachitsanzo, kapu yamadzi).

Mapiritsi a retard amatha kutengedwa atatha kupatukana kwawo koyambirira m'madzi (mwanjira ya kuyimitsidwa). Nthawi yayitali imapitirira pambuyo poti piritsi limasungunuka m'madzi.

Nthawi zina, kufalitsa mlingo wa tsiku ndi tsiku mu 4-5 kamodzi pa tsiku zimawoneka zothandiza kwambiri. Chifukwa cha izi, mitundu ya osagwiritsa ntchito nthawi yayitali ndi yoyenera bwino.

Mukatenga nthawi yayitali bwanji kuti mutenge Finlepsin 400

Kutalika kwa nthawi ya ntchito kumatengera zomwe wodwalayo angagwiritse ntchito.

Khunyu imachiritsidwa kwa nthawi yayitali. Dokotala wodziwa bwino ayenera kusankha pa kusamutsa kwa wodwala ku Finlepsin 200 retro, nthawi yogwiritsira ntchito komanso kufafaniza kwake. Mwambiri, mutha kuyesa kuchepetsa mlingo wa mankhwalawo kapena kusiya kumwa mankhwalawo pasanapite nthawi yotalikirapo patatha zaka zitatu.

Chithandizo chimayimitsidwa ndi kuchepa kwapang'onopang'ono kwa mlingo wa mankhwalawa kwa zaka 1-2. Pankhaniyi, ana ayenera kuganizira kuwonjezeka kwa thupi. Zizindikiro za EEG siziyenera kuwonongeka.

Mankhwalawa neuralgia, zinali zofunikira kupereka mankhwala a 200lepsin 200 mu muyeso wokonzanso, wokwanira kuchepetsa ululu, kwa milungu ingapo. Mwa kuchepetsa mosamala mlingo, ndikofunikira kudziwa ngati chikhululukiro chofulumira cha zomwe matendawa adachitika zidachitika. Ndi kuyambiranso kwa kupweteka kwamankhwala, chithandizo chimapitilizidwa ndi mlingo wakale wokonza.

Kutalika kwa mankhwalawa kupweteka kwa matenda ashuga a m'mimba ndipo khunyu imagwira mu angapo sclerosis ndi chimodzimodzi kwa neuralgia.

Chithandizo cha mowa achire matenda ndi finlepsin 200 achiyimitsidwa amasiya pang'onopang'ono mlingo kuchepetsa kwa masiku 7-10.

Kupewera kwa magawidwe okhumudwitsa amachitika kwa nthawi yayitali.

Zolakwika pakugwiritsa ntchito mankhwala osokoneza bongo

Ngati mumayiwala kumwa kamodzi pamankhwala, ndiye mukangozindikira, tengani nthawi yomweyo. Zitachitika izi mutamwa mlingo wotsatira, ndiye kuti mukulumpha, ndipo pambuyo pake muyesenso kulowa muyezo wolondola. Palibe vuto, mutatha kamodzi kuiwalika, musatenge mlingo wachiwiri wa Finlepsin 400 retard. Ngati mukukayika, lemberani othandizira azaumoyo kuti akuthandizeni!

Zomwe muyenera kuganizira ngati mukufuna kusokoneza kapena kuimitsa kaye chithandizo

Kusintha mankhwalawo nokha kapena ngakhale kuyimitsa mankhwalawo popanda kuyang'aniridwa ndi kuchipatala ndiopsa! Pankhaniyi, zizindikiro za matenda anu zingayambenso. Musanasiye kumwa Finlepsin 400 Dzikhazikitseni nokha, muyenera kufunsa dokotala za izi.

Zoyenera kuchita ngati finlepsin 400 retard yatengedwa kwambiri

Mankhwala osokoneza bongo a bongo amafuna chithandizo chamankhwala mwadzidzidzi. Chithunzi chowonjezera cha Finlepsin 400 retard chimadziwika ndi kuwonjezeka kwa zotsatira zoyipa monga kunjenjemera (kugwedezeka), kugwidwa komwe kumachitika ubongo ukasekerera (kupweteka kwa mtima), kukwiya, komanso kupuma komanso mtima ndi ntchito yochepetsedwa nthawi zambiri. (nthawi zina imakweza) kuthamanga kwa magazi, kuchuluka kwa mtima (tachycardia) ndi kusokonezeka kwa zokoka mu mtima (atrioventricular block, ECG changes), kusokonezeka kwa chikumbumtima mpaka kulephera kupuma ndipo kumangidwa mtima. Nthawi zina, leukocytosis, leukopenia, neutropenia, glucosuria kapena acetonuria adayang'aniridwa, omwe adakhazikitsidwa ndi zomwe zasinthidwa ndikuwonetsa mayeso a labotale.

Palibe mankhwalawa enieni a mankhwalawa omwe angapangitse poizoni wa 400 womwe umapweteka. Chithandizo cha mankhwala osokoneza bongo a finlepsin 400 retard, monga lamulo, amachitika malinga ndi mawonekedwe owawa kuchipatala.

Zotsatira zoyipa zowonedwa nthawi zambiri zimachitika ndi mankhwala ophatikiza kuposa monotherapy. Kutengera mlingo komanso makamaka kumayambiriro kwa chithandizo, zotsatirazi mavuto angachitike:

Central Nervous System / Maganizo

Kusokonezeka kwa chikumbumtima, kusokonezeka kwa chikumbumtima (kugona), chizungulire, kutopa, kusokonekera kwa miyendo ndi kusuntha (cerebellar ataxia) ndi mutu wambiri zimachitika kawirikawiri. Odwala okalamba amatha kusokonezeka komanso kuda nkhawa.

Nthawi zina, kukhumudwa koipa, chikhalidwe chankhanza, kufooka kwa malingaliro, kusokonezeka kwa zolinga, komanso kusokonezeka kwapang'onopang'ono (kuyerekezera zinthu mosiyanasiyana) ndi tinnitus zimawonedwa. Pochiza ndi finlepsin 400 retard, ma psychent aposachedwa amatha kugwira ntchito.

Kusunthika kwakamodzi sikamachitika kawirikawiri, monga kugwedezeka kwa maula, kuchepa kwa minofu, kapena kupindika kwa eyeboni (nystagmus). Kuphatikiza apo, mu odwala okalamba komanso ndi zotupa za mu ubongo, kusokonezeka kwa magalimoto oyanjanitsidwa kumatha kuchitika, monga kusunthira kosunthika mu dera la rotolitic mu mawonekedwe a grimacing (rotolitic dyskinesias), kayendedwe kazungulira (choreoathetosis). Zina mwazovuta za kuyankhula, zomverera zabodza, kufooka kwa minyewa, zotupa zamitsempha (zotumphukira zamitsempha), komanso kuwonetsedwa kwa ziwalo zam'munsi zamiyendo (paresis) ndi zovuta zamaganizidwe owoneka zinanenedwa.

Zambiri mwa zinthu izi zimazimiririka pazokha pakatha masiku 8 mpaka 14 kapena atachotsetsa kwakanthawi. Chifukwa chake, ngati nkotheka, finlepsin 400 retard imayikidwa mosamala, kuyambira mankhwalawa ndi Mlingo wotsika, kenako ndikuwonjezera pang'onopang'ono.

Maso

Nthawi zina, panali zotupa za maso zomwe zimakhudzana ndi maso (conjunctivitis), nthawi zina zosokoneza pang'onopang'ono (kusokonezeka kwa malo amaso, kupenyerera kawiri, kusawona bwino). Milandu yakuwombera kwa mandala awanenedwapo.

Odwala omwe ali ndi glaucoma, ndikofunikira kuyeza kukakamiza kwazonse.

Propulsion dongosolo

Nthawi zina, ululu unkawonedwa molumikizana ndi minyewa (arthralgia, myalgia) komanso kupindika kwa minofu. Izi zidasowa pambuyo pakutha kwa mankhwalawo.

Khungu komanso mucous nembanemba

Milandu yokhudzana ndi khungu losokonezeka lomwe limachitika pakhungu kapena popanda kutentha imanenedwapo, monga kawirikawiri kapena pafupipafupi uritisaria (urticaria), kuyabwa, nthawi zina kukula kapena kukhumudwa kwa khungu (Exfoliative dermatitis, erythroderma), necrosis ya pakhungu pakhungu. Lyell), photosensitivity (photosensitivity), redness pakhungu ndi ma polymorphic totupa mu mawonekedwe amalo ndi mapangidwe amitsempha, okhala ndi zotupa, zotupa za erythema multiforme, erythema nodosum, Johnson), kukha magazi petechial pakhungu, ndipo zokhudza zonse lupus erythematosus (lupus erythematosus mwiniwakeyo).

Mwazinthu zodzipatula kapena zosowa, kuwonongeka kwa tsitsi (alopecia) ndi thukuta (diaphoresis) kunadziwika.

Dongosolo la circulatory and lymphatic

Pokhudzana ndi mawonekedwe a hypersensitivity pochizira mafupa a 400le, kuwonjezera, zosokoneza zotsatirazi mu chithunzi cha magazi zimatha kuchitika: kawirikawiri kapena zimachulukitsa (leukocytosis, eosinophilia) kapena kuchepa (leukopenia) mu kuchuluka kwa leukocytes kapena mapulateleti. Malinga ndi zolembedwazi, mtundu woperewera wa leukopenia nthawi zambiri umawoneka (wosakhalitsa pafupifupi 10% ya milandu, komanso wopitilira 2% milandu).

Amanenedwa pamilandu yakutali yamatenda a magazi, nthawi zina ngakhale yomwe imawopseza moyo, monga agranulocytosis, aplastic anemia, komanso mitundu ina ya magazi (hemolytic, megaloblastic), komanso kuwonjezeka kwa ndulu ndi ma lymph node.

Ndi mawonekedwe a leukopenia (nthawi zambiri neutropenia), thrombocytopenia, matupi awo am'mimba totupa (exanthema) ndi malungo a retlepsin okwana 400 adatha.

Matumbo

Nthawi zina pamakhala kusowa kwa chilimbikitso, pakamwa pouma, nseru ndi kusanza, kutsegula m'mimba kapena kudzimbidwa sikumachitika kawirikawiri. Nkhani zapadera za kupweteka kwam'mimba komanso zotupa za mucous membrane wa oropharynx patity (stomatitis, gingivitis, glossitis) zanenedwapo. Izi zimadutsa zokha patatha masiku 8-14 atalandira chithandizo chamankhwala kapena pambuyo poti kuchepetsedwa kwakanthawi kwa mlingo wa mankhwalawo. Amatha kupewedwa ndikukhazikitsidwa koyambirira kwa mankhwalawa otsika a mankhwala ndi kuwonjezeka pang'onopang'ono.

Pali zisonyezo m'mabuku zomwe carbamazepine nthawi zina imapangitsa kutupa kwa kapamba (kapamba).

Chiwindi ndi bile

Nthawi zina kusintha kwa zizindikiro zamtundu woyesera kumapezeka, nthawi zina jaundice amapezeka; kawirikawiri, mitundu yambiri ya hepatitis (cholestatic, hepatocellular, granulomatous, osakanikirana) imachitika.

Nkhani ziwiri za porphyria pachimake zafotokozedwa.

Hormonal, madzi ndi mchere kagayidwe

Nkhani za kuchuluka kwa mabere mwa abambo (gynecomastia) ndi kutulutsa kwamkaka kuchokera mu tiziwalo ta mammary mu azimayi (galactorrhea) akuti.

Finlepsin 400 retard ingakhudze magawo a ntchito ya chithokomiro (triiodothyronine, thyroxine, mahomoni opatsirana a chithokomiro ndi thyroxine yaulere), makamaka akaphatikizidwa ndi mankhwala ena a antiepileptic.

Chifukwa cha zochita za finlepsin 400 retard, zomwe zimachepetsa kuthira kwamkodzo kuchokera mthupi (antidiuretic athari), nthawi zina, kuchepa kwa seramu sodium (hyponatremia) kumatha kuwonedwa, limodzi ndi kusanza, kupweteka mutu komanso kusokonezeka.

Milandu yapadera yowoneka ngati edema ndi kuwonjezeka kwa thupi inawonedwa. Finlepsin 400 retard imatsitsa kuchuluka kwa calcium ya seramu. Nthawi zina, izi zimapangitsa kuti mafupa azikhala ofewa (osteomalacia).

Ziwalo zopumira

Zochitika zosiyana paziwopsezo zambiri zamapapu kumankhwala, limodzi ndi kutentha thupi, kufupika kwa mpweya (dyspnea), chibayo ndi pulmonary fibrosis, amafotokozedwa.

Matendawa

Nthawi zambiri pamakhala kuperewera kwa impso, komwe kumanenedwa ndi kuchuluka kwamapuloteni mu mkodzo (proteinuria), maonekedwe a magazi mumkodzo (hematuria), kutsika kwa zotupa za mkodzo (oliguria), kawirikawiri zimayamba kulephera kwa impso. Mwinanso kusokonezeka kumeneku kumachitika chifukwa cha mankhwala. Nthawi zina dysuria, polakiuria ndi kwamikodzo posungira.

Kuphatikiza apo, pali milandu yodziwika yokhudzana ndi kugonana, monga kusabala komanso kuchepa kwa kugonana.

Mtima wamtima

Nthawi zina, makamaka kwa anthu okalamba kapena odwala omwe ali ndi vuto la mtima wofatsa, kuchepa kwa mtima (bradycardia), kusokonezeka kwa mtima, komanso kuwonjezeka kwa matenda a mtima.

Nthawi zambiri pamakhala kuphwanya komwe kumachitika mu mtima (atrioventricular block), pazinthu zina zokhazokha zomwe zimayendera limodzi ndi kukomoka. Kuphatikiza apo, nthawi zina, kuthamanga kwa magazi kumachepa kapena kukwera. Kutsika kwa magazi kumachitika makamaka pogwiritsa ntchito mankhwalawa.

Kuphatikiza apo, vasculitis, thrombophlebitis, ndi thromboembolism adawonedwa.

Hypersensitivity zimachitika

Kuchedwa kukhudzika kwa hypersensitivity kwa mankhwalawa sikumachitika, kumachitika ndi malungo, zotupa pakhungu, kutupa kwamitsempha, zotupa zam'mimba, kupweteka kwa molumikizana, kuchuluka kwa leukocytes m'mitsempha yamapazi, chiwindi chokwanira ndi ndulu, ndikusintha kwa magwiridwe antchito a chiwindi. kuphatikiza, komanso kumaphatikizanso ziwalo zina mothandizidwa, monga mapapo, impso, kapamba ndi myocardium.

Nthawi zina, kwambiri pachimake anachita ndi aseptic kutupa kwa amuna okhala ndi myoclonus ndi eosinophilia.

Ngati mukuwona zoyipa zomwe sizinatchulidwe mu zomangazi, chonde dziwitsani dokotala kapena katswiri wazamankhwala izi.

Njira zoyenera kuchitidwa ndi zovuta

Ngati mukuwona zotsatirazi zomwe zatchulidwa pamwambapa, muuzeni adotolo anu omwe adzatsimikizire kuuma kwawo ndikuchitapo kanthu pothana nazo (onaninso gawo la "Njira zopewera kugwiritsa ntchito"). Makamaka pakakhala malungo, zilonda zapakhosi, khungu lawo siligwirizana ndi zotupa zopindika komanso / kapena chimfine ngati ululu pakupereka mankhwala a finlepsin 400 retard, muyenera kufunsa dokotala komanso kusanthula chithunzi cha magazi.

Ndi kukula kwambiri matupi awo sagwirizana, finlepsin 400 retard yomweyo imathetsedwa.

Ngati masinthidwe ena a chithunzi cha magazi apezeka (leukopenia, kawirikawiri neutropenia, thrombocytopenia), zotupa za pakhungu (exanthema) ndi zotsekemera zotsekemera 400 zimachotsedwa.

Ngati pali zizindikiro za kuwonongeka kwa chiwindi kapena matenda operewera, monga kufooka, kusadya, nseru, khungu la chikasu kapena kukulitsa chiwindi, nthawi yomweyo funsani kwa dokotala.

Tsiku lotha ntchito

Zaka zitatu
Moyo wa alumali wa mapiritsi a retard umawonetsedwa pa zojambulazo zokulungidwa ndi zotumphukira komanso pa katoni.
Pambuyo pa nthawi yomwe mwayikayo, musagwiritse ntchito mapiritsi ambiri achibwezereni phukusili.

Mankhwala amasungidwa ndi ana!

Finlepsin 400 retard amabwera m'matayala otetezeka osavomerezeka ndi ana ndi zojambulazo zokulirapo. Ngati zingakuvuteni kufinya piritsi la retard, ndiye musanachite izi, tikukulangizani kuti pang'ono pang'ono mupangire zojambulazo.

Malo osungira

Mankhwalawa amasungidwa pansi pazovomerezeka.

Kutulutsa Mafomu

Finlepsin 400 retard imapezeka m'matumba a 50, 100, ndi mapiritsi a 200 achibwezere.

Katundu

Mankhwala a antiepileptic (dibenzazepine derivative), omwe amakhalanso ndi standardotymic, antimaniacal, antidiuretic (odwala matenda a shuga insipidus) ndi analgesic (odwala neuralgia). Limagwirira ntchito limalumikizidwa ndi blockade yamagetsi yamagetsi-gated Na +, yomwe imatsogolera kukhazikika kwa membrane wa neuron, kulepheretsa kuwoneka kwa serial kutulutsidwa kwa ma neurons ndi kuchepa kwa kuphatikizika kwa synaptic. Imalepheretsa kupangidwanso kwa Na + -kudalira kothandizirana mu ma neurons a depolarized.Kuchepetsa kumasulidwa kwa glotamate yosangalatsa ya neurotransmitter amino acid, kumakulitsa kufupika kwapang'onopang'ono, ndi zina zotero. amachepetsa chiopsezo chodwala. Imawonjezera kuyendetsa kwa K +, modulates voltage-gated Ca2 + njira, zomwe zingayambenso anticonvulsant zotsatira za mankhwala. Amawongolera umunthu wa khunyu ndipo pamapeto pake umawonjezera kulumikizana kwa odwala, amathandizira kukhazikika kwawo. Itha kutumikiridwa ngati mankhwala othandizira komanso kuphatikiza ndi mankhwala ena a anticonvulsant. Ndiwothandiza kugwidwa koyang'ana (pang'ono komanso kovuta), kutsagana kapena kutsagana ndi kutsata kwachiwiri, kwa kugunda kwamtundu wa tonic-clonic, komanso kuphatikiza mitundu iyi (nthawi zambiri sikugwira ntchito pakukoka kwazing'ono - malis, kukhalapo ndi kugwidwa myoclonic) . Odwala omwe ali ndi khunyu (makamaka ana ndi achinyamata) amakhala ndi zotsatira zabwino pazizindikiro za nkhawa komanso kukhumudwa, komanso kuchepa kwa kusakwiya komanso kukwiya. Zotsatira zakugwirira ntchito mwamphamvu ndi ntchito yama psychomotor zimadalira mlingo ndipo zimasiyana kwambiri. Kukhazikika kwa anticonvulsant zotsatira kumasiyana kwa maola angapo mpaka masiku angapo (nthawi zina mpaka mwezi umodzi chifukwa chogwiritsa ntchito kagayidwe kachakudya). Pogwiritsa ntchito neuralgia yofunikira komanso yachiwiri ya trigeminal nthawi zambiri imalepheretsa kuwoneka kwa ululu. Kuthandiza kuthetsa ululu wa neurogenic pakuuma kwa msana, pambuyo pa zoopsa za patresthesias ndi postherpetic neuralgia. Kupumula kwamankhwala mu trigeminal neuralgia kumadziwika pambuyo pa maola 8-72. Ndi vuto lochotsa zakumwa, limakulitsa cholumikizira (chomwe nthawi zambiri chimachepetsedwa pamenepa) komanso kumachepetsa zovuta zakuonekera kwazachipatala za matenda (kuwonjezereka kwa irritability, kunjenjemera, matenda osokoneza bongo). Odwala odwala matenda ashuga insipidus kumabweretsa kulipira mwachangu madzi bwino, amachepetsa diuresis ndi ludzu. Ntchito ya antipsychotic (antimaniacal) imayamba pambuyo pa masiku 7-10, mwina chifukwa cha kuletsa kwa kagayidwe ka dopamine ndi norepinephrine. Fomu yotalikira ya magazi imathandizira kukonzanso kwa carbamazepine m'magazi popanda "nsonga" ndi "ziphuphu", zomwe zimathandizira kuchepetsa pafupipafupi komanso kuopsa kwa zovuta zovuta zamankhwala, kuonjezera mphamvu ya chithandizo chamankhwala ngakhale mutagwiritsa ntchito Mlingo wocheperako. Dr. mwayi wofunikira wa fomu yotalikilapo ndikuti mungatenge ma 1-2 tsiku limodzi.

Zisonyezero zogwiritsidwa ntchito:

• khunyu: kugwidwa pang'ono ndi zizindikiro zoyambira (khunyu yolimba), kugwidwa kwakanthawi kokhala ndi zovuta zovuta (kukomoka kwa psychomotor), kugwidwa kwakukulu, makamaka koganizira koyambira (kukomoka kwakukulu pakugona, kusokoneza khunyu), mitundu yosiyanasiyana ya khunyu,
• trigeminal neuralgia,
• kupweteka kwa paroxysmal kwa vuto losadziwika lomwe limatuluka mbali imodzi ya muzu wa lilime, pharynx ndi palate yofewa (genuin glossopharyngeal neuralgia),
• kupweteka ndi zotupa za zotumphukira zam'mitsempha ya matenda a shuga (kupweteka kwa matenda amitsempha ya m'mimba),
• khunyu yopweteka kwambiri mu angapo sclerosis, monga nkhope yamkati mu negegia yotupa, kupindika kwamitsempha, kuyankhula kwa paroxysmal ndi zovuta kusuntha (paroxysmal dysarthria ndi ataxia), kusapeza bwino (paroxysmal paresthesia) ndi zovuta zowawa,
• kuletsa kukula kwa kugwidwa mwamphamvu mu matenda ochotsa mowa,
• psychoses (makamaka m'maboma azomvera, kupsinjika kwa hypochondriacal). Kupewa kwachiwiri kwa othandizira komanso ma proizoaffective psychoses.

Chenjezo: kupewa kupewetsa kwa kugwidwa mwamphamvu ndi matenda achotsekera mowa, finlepsin amagwiritsidwa ntchito mchipatala.

Zomwe Mungagwiritse Ntchito:

Pokhudzana ndi kupezeka kwa mavuto, komanso kupezeka kwa hypersensitivity kwa mankhwalawa, tikulimbikitsidwa, makamaka pogwiritsa ntchito nthawi yayitali, kusanthula kayendedwe ka magazi ndikuwonetsetsa ntchito ya chiwindi ndi impso. Izi zimachitika musanayambe chithandizo, ndiye mumwezi woyamba wamankhwala kamodzi pa sabata, kenako kamodzi pamwezi. Pambuyo pa miyezi isanu ndi umodzi yoyambirira ya mankhwalawa, zowongolera izi zimachitika kawiri pachaka 2.

Momwemonso, kuphatikizidwa kwa mankhwala a Finlepsin 400 retro komanso mankhwala ena antiepileptic m'magazi amayenera kuyang'aniridwa nthawi zonse pamankhwala othandizira ndipo ngati kuli kotheka, mupeze Mlingo wa tsiku ndi tsiku.

Kutha kwa mankhwalawa ndi mankhwala a retlepsin 400 omwe ali ndi odwala omwe ali ndi khunyu ndipo kusamutsira kwina kwa antiepileptic mankhwala sikumachitika mwadzidzidzi, koma pang'onopang'ono kumachepetsa mlingo.

Odwala omwe ali ndi glaucoma, kupanikizika kwa intraocular kumayang'aniridwa nthawi zonse. Tiyenera kukumbukira kuti zoyipa za finlepsin 400 retard pothana ndi vuto lodziletsa zakumwa zoledzeretsa zili zofanana ndi zizindikiro za kusiya ndipo zimatha kusokonezeka nawo.

Ngati milandu yapadera yolepheretsa magawo a manic-depressing osakwanira mphamvu ya lithiamu imodzi, mafotokozedwe 400 a mankhwalawa ayenera kuyikidwa limodzi, ndiye kuti mupewe kuyanjana kosafunikira (onani "Kuchita ndi mankhwala ena"), ndikofunikira kuonetsetsa kuti kuchuluka kwa carbamazepine sikupitilira m'magazi am'magazi (8 μg / ml), mankhwala a lithiamu adasungidwa m'malo otsika achire (0.3-0.8 mEq / l), mankhwala a antipsychotic adachitika zoposa masabata 8 apitawa , komanso kotero kuti sichichitika chimodzimodzi.

Kugwiritsa ntchito mankhwalawa pogwiritsira ntchito makina komanso mukamagwira ntchito osasunga malamulo otetezeka

Pokhudzana ndi kukhalapo kwa zoyipa kuchokera ku dongosolo lamanjenje loyambirira kumayambiriro kwa chithandizo, monga chizungulire, kugona, kusakhazikika kwa mutu komanso kupweteka kwa mutu, pamene mankhwalawa amagwiritsidwa ntchito mu Mlingo wambiri komanso / kapena akaphatikizidwa ndi mankhwala ena omwe amakhudza dongosolo lamanjenje apakati, finlepsin Zowonjezera 400, ngakhale zitagwiritsidwa ntchito moyenera - mosasamala momwe mankhwalawo amathandizira matenda - zimatha kusintha magwiridwe anuwo kuti musathenso kutenga nawo mbali m'msewu AI kapena yokonza makina.

Simungathenso kuthanso mwachangu komanso mwachangu zochitika zamwadzidzidzi. Simuyenera kuyendetsa galimoto kapena zoyendera zina! Simuyenera kugwiritsa ntchito zida zamagetsi kapena zida zamakono! Simuyenera kugwira ntchito osasamala za chitetezo! Makamaka kumbukirani kuti mowa ungakulepheretseni kuthekera kwanu kuchitapo kanthu mwachangu mukakhala mumsewu.

Zotsatira zoyipa:

Zotsatira zoyipa zowonedwa nthawi zambiri zimachitika ndi mankhwala ophatikiza kuposa monotherapy. Kutengera mlingo komanso makamaka kumayambiriro kwa chithandizo, zotsatirazi mavuto angachitike:

Central Nervous System / Maganizo

Odwala omwe ali ndi glaucoma, ndikofunikira kuyeza kukakamiza kwazonse.

Nthawi zina, ululu unkawonedwa molumikizana ndi minyewa (arthralgia, myalgia) komanso kupindika kwa minofu. Izi zidasowa pambuyo pakutha kwa mankhwalawo.

Khungu komanso mucous nembanemba

Mwazinthu zodzipatula kapena zosowa, kuwonongeka kwa tsitsi (alopecia) ndi thukuta (diaphoresis) kunadziwika.

Dongosolo la circulatory and lymphatic

Ndi mawonekedwe a leukopenia (nthawi zambiri neutropenia), thrombocytopenia, matupi awo am'mimba totupa (exanthema) ndi malungo a retlepsin okwana 400 adatha.

Pali zisonyezo m'mabuku zomwe carbamazepine nthawi zina imapangitsa kutupa kwa kapamba (kapamba).

Nkhani ziwiri za porphyria pachimake zafotokozedwa.

Hormonal, madzi ndi mchere kagayidwe

Nkhani za kuchuluka kwa mabere mwa abambo (gynecomastia) ndi kutulutsa kwamkaka kuchokera mu tiziwalo ta mammary mu azimayi (galactorrhea) akuti.

Zochitika zosiyana paziwopsezo zambiri zamapapu kumankhwala, limodzi ndi kutentha thupi, kufupika kwa mpweya (dyspnea), chibayo ndi pulmonary fibrosis, amafotokozedwa.

Kuphatikiza apo, pali milandu yodziwika yokhudzana ndi kugonana, monga kusabala komanso kuchepa kwa kugonana.

Nthawi zina, makamaka kwa anthu okalamba kapena odwala omwe ali ndi vuto la mtima wofatsa, kuchepa kwa mtima (bradycardia), kusokonezeka kwa mtima, komanso kuwonjezeka kwa matenda a mtima.

Kuphatikiza apo, vasculitis, thrombophlebitis, ndi thromboembolism adawonedwa.

Hypersensitivity zimachitika

Nthawi zina, kwambiri pachimake anachita ndi aseptic kutupa kwa amuna okhala ndi myoclonus ndi eosinophilia.

Ngati mukuwona zoyipa zomwe sizinatchulidwe mu zomangazi, chonde dziwitsani dokotala kapena katswiri wazamankhwala izi.

Njira zoyenera kuchitidwa ndi zovuta

Ndi kukula kwambiri matupi awo sagwirizana, finlepsin 400 retard yomweyo imathetsedwa.

Ngati masinthidwe ena a chithunzi cha magazi apezeka (leukopenia, kawirikawiri neutropenia, thrombocytopenia), zotupa za pakhungu (exanthema) ndi zotsekemera zotsekemera 400 zimachotsedwa.

Ngati pali zizindikiro za kuwonongeka kwa chiwindi kapena matenda operewera, monga kufooka, kusadya, nseru, khungu la chikasu kapena kukulitsa chiwindi, nthawi yomweyo funsani kwa dokotala.

Mogwirizana ndi mankhwala ena:

Ndi makhwala ati omwe amasintha zotsatira za Finlepsin 400 retard kapena ndimankhwala ati omwe amasintha retlepsin 400 retard?

Pokhudzana ndi kukulitsa zotsatira zoyipa kuchokera ku dongosolo lamkati lamanjenje, kugwiritsidwa ntchito kwa mafupipafupi 400 omwe amapezeka ndi monoamine oxidase inhibitors (othandizira okhumudwa) ayenera kupewedwa. Mukasintha kuchoka pamankhwala amodzi kupita kwina, amapuma pochita masiku 14!

Zotsatira za finlepsin 400 zimayambiranso pamankhwala ena am'magazi

Finlepsin 400 retard ikhoza kuwonjezera zochita za michere ina ya chiwindi ndipo potero amachepetsa mphamvu ya mankhwala ena a m'magazi am'magazi.

Chifukwa chake, mphamvu za mankhwala ena omwe amagwiritsidwa ntchito nthawi imodzi, omwe kapangidwe kake kama kemikali pafupi ndi finlepsin 400 retard, amatha kufooka kapena kuwonetsa konse.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala a Finlepsin 400, malinga ndi zofunikira zamankhwala, ngati kuli kofunikira, konzani Mlingo wa zinthu zotsatirazi: , prednisolone, dexamethasone), cyclosporine (chida cholumikizira chitetezo cha mthupi pambuyo pakuzungulirana kwa chiwalo), digoxin (chida chothandizira matenda a mtima), tetras cyclins, monga doxycycline (mankhwala opha maantibayotiki), felodipine (mankhwala ochepetsa magazi), haloperidol (mankhwala ochiritsira matenda amisala), imipramine (mankhwala ochepetsa nkhawa), methadone (painkiller), theophylline (mankhwala ochizira matenda oopsa kupuma thirakiti), ma anticoagulants, monga warfarin, fenprocoumon, dicumarol. Monga mankhwala ena akale a antiepileptic, finlepsin 400 retard imatha kufooketsa mphamvu ya kulera kwa mahomoni (mankhwala kuti apewe kutenga pakati, omwe amatchedwa "piritsi"). Kuwoneka kwa magazi akuchulukirachulukira kukusonyeza kuthekera kwakukwana kwa mahomoni kutengera pakati. Chifukwa chake, muzochitika zoterezi, ndikulimbikitsidwa kugwiritsa ntchito njira zina zoletsa matenda osagwiritsa ntchito mahomoni.

Finlepsin 400 retard imatha kuwonjezeka ndikuchepetsa kuchuluka kwa phenytoin m'madzi am'magazi, chifukwa chomwe, mwapadera, chisokonezo chimatha kukula kwa chikomokere.

Kuchepetsa ndende ya finlepsin 400 omwe amapezeka m'madzi am'magazi ndi mankhwala ena

Mlingo wa finlepsin 400 retard mu plasma wamagazi ukhoza kutsika: phenobarbital, primidone, valproic acid, theophylline.

Kumbali ina, valproic acid ndi primidone zimatha kukulitsa gawo la pharmacologically yogwira metabolite (metabolic product of finlepsin 400 retard) carbamazepine - 10,11 - epoxide mu seramu yamagazi.

Chifukwa cha kukhudzika kwa wina ndi mnzake, makamaka pogwiritsa ntchito mankhwala angapo antiepileptic, tikulimbikitsidwa kuwongolera zomwe zili m'madzi a plasma ndipo, ngati kuli kofunikira, sinthani mlingo wa finlepsin 400 retard.

Kuwonjezeka kwa ndende ya finlepsin 400 omwe amapezeka m'madzi a m'magazi ndi mankhwala ena

Zinthu zotsatirazi zitha kukulitsa kuchuluka kwa mitundu inayi ya follepsin 400 m'magazi am'magazi: maantibayotiki - macrolides, monga erythromycin, josamycin (zinthu zomwe zimagwiritsidwa ntchito pochiza matenda a bakiteriya),isoniazid (mankhwala ochizira chifuwa chachikulu), othandizira calcium, monga verapamil, diltiazem (mankhwala ochizira angina pectoris), acetazolamide (mankhwala ochizira glaucoma), viloxazine (mankhwala ochepetsa matenda opatsirana pogonana), danazol gonadotropin timadzi totupa, nicotinamide muyezo waukulu mwa anthu akuluakulu (vitamini B gulu), mwina cimetidine (mankhwala wochizira zilonda zam'mimbazi) ndi desipramine njira compressively).

Kuchulukitsidwa kwa kuchuluka kwa ma follepsin 400 omwe amapezeka m'madzi a m'magazi kungathandizire kukulitsa zomwe zatchulidwa mu gawo la "Zotsatira Zotsatira" (mwachitsanzo, chizungulire, kutopa, kusatetezeka, kupenya kawiri). Chifukwa chake, zizindikiro zotere zikadzachitika, kuchuluka kwa carbamazepine m'madzi a m'magazi kumayang'aniridwa ndipo ngati kuli koyenera, mlingo umachepetsedwa.

Kugwiritsa ntchito pamodzi kwa mankhwala a retlepsin 400 retisc komanso ma antipsychotic (mankhwala ochizira matenda amisala) kapena metoclopramide (mankhwala ochizira matenda am'mimba) kungayambitse matenda obwera chifukwa cha mitsempha.

Kumbali ina, mwa odwala omwe amathandizidwa ndi ma antipsychotic, Finlepsin 400 retard amatha kuchepetsa mankhwalawa m'magazi am'magazi ndipo potero amawonjezera chithunzi cha matendawa. Chifukwa chake, adotolo angaone kuti ndikofunikira kuwonjezera mlingo wa antipsychotic wolingana.

Amawonetsedwa kuti makamaka pogwiritsa ntchito lifiyamu munthawi yomweyo (mankhwala othandizira komanso kupewa matenda ena amisala) ndi retlepsin 400 retard, mphamvu ya zinthu zonse zomwe zimawononga mphamvu yamanjenje imatha kupitilizidwa. Chifukwa chake, pazinthu zotere, ndikofunikira kuyang'anitsitsa mosamala zomwe zili m'magazi onse a m'magazi. Mankhwala am'mbuyomu omwe ali ndi antipsychotic ayenera kusiyidwa masabata 8 isanayambike mankhwala ndi mankhwalawa, ndipo sayenera kuchitika nawo. Ndikofunikira kuyang'anira kuwoneka kwa zotsatirazi za zotsatirapo zamagetsi a m'mitsempha: gait chosatsimikizika (ataxia), kupindika kapena kunjenjemera kwa mawonekedwe amaso (yopingasa nystagmus), kuchuluka kwa minyewa, kuwonekera kwake kwa minofu ya minofu imodzi .

Finlepsin 400 retard imatha kupititsa patsogolo zotsatira za isoniazid, zomwe zimawononga chiwindi.

Kugwiritsidwa ntchito kophatikizira kwa finlepsin 400 retard ndi diuretics (hydrochlorothiazide, furosemide) kungayambitse kuchepa kwa sodium mu seramu yamagazi.

Finlepsin 400 retard ikhoza kuthana ndi mphamvu ya mankhwala omwe amatsitsimutsa minofu (minyewa yopuma), monga pancuronium. Chifukwa cha izi, kuthetseratu mwachangu kwa neuromuscular blockade ndikotheka. Chifukwa chake, odwala omwe amathandizidwa ndi opuma minofu amayang'aniridwa ndipo ngati kuli koyenera, mulingo wowonjezereka wa mankhwalawa.

Ndi munthawi yomweyo kugwiritsa ntchito isotretinoin (chinthu chogwiritsidwa ntchito pochizira ziphuphu) ndi Finlepsin 400 retard, zomwe mafupa a 400le omwe amapezeka mu seramu yamagazi amayenera kuyang'aniridwa.

Finlepsin 400 retard mwina imathandizira kutulutsa (kuchotsedwa) kwa mahomoni a chithokomiro ndikuwonjezera kufunikira kwa odwala omwe amachepetsa chithokomiro. Chifukwa chake, mwa odwala omwe amalandila chithandizo chothandizira, kumayambiriro ndi kumapeto kwa chithandizo ndi mawonekedwe a finlepsin 400, zizindikiro za chithokomiro ndizotsimikiza. Ngati ndi kotheka, konzani mlingo wa mankhwala a chithokomiro.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala antidepressant monga serotonin reuptake blockers (antidepressant mankhwala, monga fluoxetine) ndi finlepsin 400 retard, poizoni serotonin matenda amatha.

Dziwani kuti izi zingakhale zofunikanso kwa mankhwala omwe amwedwa posachedwa musanayambe chithandizo ndi finlepsin 400 retard.

Zomwe ndizosangalatsa, mbale ndi zakumwa zomwe muyenera kukana

Pa mankhwala a finlepsin 400 retard, muyenera kusiya kumwa mowa, chifukwa amatha kusintha mosasinthika ndikuwonjezera mphamvu ya retlepsin 400 retard.

Zoyipa:

Finlepsin 400 retard imaphatikizidwa milandu: kukhalapo kwa kuwonongeka kwa mafupa, kusokonezeka kwa zokoka mu mtima (atrioventricular block), mankhwala odziwika a hypersensitivant kapena mankhwala ena amtundu wina (onani "Composition"), komanso pachimake. gawo la porphyria (chilema cholowa m'malo mwa porphyrins).

Final 400 ya Finlepsin sayenera kugwiritsidwa ntchito nthawi imodzi ndi kukonzekera kwa lithiamu (onani "Kuyanjana ndi Mankhwala Omwe").

Popeza Finlepsin 400 retard imatha kupangitsa kukomoka kwatsopano kapena kulimbitsa mitundu yapadera yakukwaniritsidwa (komwe kumadziwika kuti kulibe), sikulimbikitsidwa kuyika kwa odwala omwe ali ndi mavuto amtunduwu.

Ndi nthawi ziti zomwe mungalandire Finlepsin 400 pokhapokha mutakumana ndi dokotala?

Pansipa zikuwonetsedwa kuti mutha kutenga Finlepsin 400 pokhapokha pokhapokha pokhapokha musamala kwambiri. Chonde funsani ndi dokotala wanu za izi. Izi zikugwiranso ntchito pazochitika zomwe zatchulidwazi zachitika nanu kale.

Finlepsin 400 retard sayenera kugwiritsidwa ntchito nthawi imodzi ndi Mao zoletsa. Mankhwalawa ndi Mao zoletsa aima posachedwa kuposa masiku 14 isanayambike chithandizo ndi finlepsin 400 retards.

Pambuyo pofanizira mosamala za chiopsezo chamankhwala ndikuyembekezeredwa kopindulitsa, komanso ndikuwonetsetsa mosamala koyenera, mawonekedwe a finlepsin 400 angagwiritsidwe ntchito matenda a ziwalo zopanga magazi (matenda a hematological), kuphwanya kwambiri mtima, chiwindi ndi impso (onani "Zotsatira zoyipa" ndi "Mlingo" ,, kusokoneza metabolism.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Pa nthawi yoyembekezera, Finlepsin 400 retard imagwiritsidwa ntchito pokhapokha kuyerekeza mosamala kuopsa kwa chithandizo chamankhwala ndikuyembekeza zopindulitsa kuchokera kwa dokotala.

Ngati mayi ali ndi pakati kapena atangoyamba kumene kubereka, makamaka pakati pa 20 ndi tsiku la 40 la kubereka, kutha kwa Finlepsin 400 kumafotokozedwera muyezo wotsika kwambiri wolamulira. Mlingo wa tsiku ndi tsiku, makamaka nthawi yayitali kwambiri ya pakati, umagawidwa pawiri Mlingo wochepa womwe umatenge tsiku. Ndikulimbikitsidwa kuwongolera kuchuluka kwa yogwira mankhwala mu seramu yamagazi.

Nthawi zina, pokhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo a carbamazepine, kulakwitsa kwa mwana wosabadwayo kwatchulidwa, komanso kugawanika kwa msana.

Ngati ndi kotheka, muyenera kupewa kuphatikiza mitundu inayi ya 400lepin ndi mankhwala ena a antiepileptic kapena mankhwala ena, chifukwa izi zimawonjezera chiopsezo cha kusokonezeka kwa fetal.

Pokhudzana ndi kulimbikitsa mphamvu ya carbamazepine, zitha kukhala zofunikira kuti mupatseni folic acid musanayambe komanso panthawi yoyembekezera.

Pofuna kupewa zovuta za m'matumbo mwa makanda, prophylactic makonzedwe a vitamini K amalimbikitsidwa kwa amayi masabata omaliza a mimba kapena kwa mwana wakhanda akangobadwa. Ngati mukufuna kukhala ndi mwana, onetsetsani kuonana ndi dokotala.

Finlepsin 400 retard imadutsa mkaka wa mayiyo, koma ochepa kwambiri kotero kuti akagwiritsidwa ntchito pazithandizo zochizira, kwakukulu, sizowopsa kwa khanda.Pokhapokha ngati mwana wachepetsa thupi kapena kugona msanga (sedation) mwa mwana, kuyamwitsa kumayimitsidwa.

Kugwiritsa ntchito mankhwalawa kwa ana ndi odwala okalamba

Chifukwa cha kuchuluka kwa ntchito yogwira komanso kusazindikira kwa kugwiritsa ntchito mapiritsi, kubwezeretsa Finlepsin 400 osaperekedwa sikuyenera kutumizidwa kwa ana osakwana zaka 6.

Odwala okalamba, finlepsin 400 retard imadulidwa muyezo.

Bongo

Zolakwika pakugwiritsa ntchito mankhwala osokoneza bongo

Zomwe muyenera kuganizira ngati mukufuna kusokoneza kapena kuimitsa kaye chithandizo

Zoyenera kuchita ngati finlepsin 400 retard yatengedwa kwambiri

Malo osungira:

Alumali moyo wa mankhwala ndi zaka 3.
Moyo wa alumali wa mapiritsi a retard umawonetsedwa pa zojambulazo zokulungidwa ndi zotumphukira komanso pa katoni.
Pambuyo pa nthawi yomwe mwayikayo, musagwiritse ntchito mapiritsi ambiri achibwezereni phukusili.

Mankhwala amasungidwa ndi ana!

Mankhwalawa amasungidwa pansi pazovomerezeka.

Kupanga ndi mafomu omasulira

Mapiritsi olimbitsa thupi omwe akhala akuchita kwa nthawi yayitali amaphatikizapo 400 mg carbamazepine. Malinga ndi malongosoledwe, zida zina zilinso:

Talcum ufa
Crospovidone
MCC
Triacetin
Nzeru zabwino Si
Methacrylate kopolymers
Stearic Acid Mg.

Mapiritsi okhala ndi lathyathyathya oyera kapena oyera achikasu amayikidwa mchimake cha ma PC 10,.

Kuchiritsa katundu

Mankhwala osokoneza anticonvulsant, omwe amagwira ntchito omwe amachokera ku zinthu zotere monga tricyclic iminostilbene. Kuphatikiza pa antiepileptic zotsatira, psychotropic komanso zotchulidwa za neurotropic zimawonedwa.Kuwonetsera kwa achire zotsatira zimagwirizanitsidwa ndi chopinga cha njira yotumizira kukoka pakati pa ma synapses, potero kuchepetsa kufalikira. Mukamamwa Mlingo wambiri wa carbamazepine, pamakhala kuchepa kwamphamvu kwa mphamvu ya pambuyo. Mankhwalawa amathandizira kuchepetsa kupweteka kwapakati ndi neuralgia ya trigeminal, izi zimachitika chifukwa chakuchepa kwa kufalikira kwa zopatsirana zomwe zimakwiyitsa mwachindunji mkatikati mwa msana, womwe umapezeka m'mitsempha ya trigeminal.

Popeza mankhwalawa ali ndi vuto losaopsa pa osmoreceptors okha, zotsatira zoyipa zimalembedwa mu shuga insipidus.

Mutatha kumwa mapiritsiwo, mankhwalawo amagwira pang'onopang'ono ndipo pafupifupi kwathunthu. Mitengo yayikulu kwambiri ya plasma ya carbamazepine inalembedwa pambuyo pa maola 4-6. Ndizofunikira kudziwa kuti kuchuluka kwa plasma ya carbamazepine sikudalira motsatana mlingo wa mankhwala, pankhani ya milingo yapamwamba, ndipo plasma yokhotakhota palokha imakhala ngati mawonekedwe.

Pankhani ya kumwa mapiritsi okhala nthawi yayitali, ndizotheka kukwaniritsa kuchuluka kwa plasma ya carbamazepine poyerekeza ndi kugwiritsa ntchito mapiritsi wamba. Nthawi zambiri, kutsata koyenera kumachitika pambuyo pa masiku 2-8.

Chizindikiro chomangiriza mapuloteni a plasma chimalembedwa pamlingo wa 70-80%. Gawo lomwe limagwira limadutsa mu zotchinga, ndikuyenda mkaka wa m'mawere.

Pakangotha kugwiritsa ntchito kamodzi mankhwala osokoneza bongo, theka la moyo limatha kuposa maola 36. Pakutalika kwa chithandizo, chizindikirochi chimatha kuchepetsedwa ndi theka, izi zimachitika makamaka chifukwa cha kuphatikizidwa kwa microsomal hepatic enzymes.

Pakangotha kugwiritsa ntchito mankhwala kamodzi, pafupifupi 72% ya mulingo wovomerezeka umachotsedwa impso (mu mawonekedwe a metabolites), zotsalira ndi ndowe, zochepa - momwe zimakhalira kale.

Malangizo ogwiritsira ntchito

Mtengo: kuchokera 174 mpaka 350 rubles.

Mankhwala amatengedwa pakamwa, mapiritsi amafunika kutsukidwa ndi madzi okwanira. Kuti zitheke, piritsi imathanso kusungunuka m'madzi, kenako kumwa njira yotsatirayo. Imafotokozedwa mu Mlingo wa tsiku lililonse wa 400-1200 mg, wogawika mu 1-2 ntchito patsiku.

Tiyenera kudziwa kuti mlingo waukulu kwambiri patsiku suyenera kupitirira 1.6 g.

Khunyu

Monotherapy nthawi zambiri amalimbikitsa. Choyamba, amalembedwa kuti azamwa mankhwala ochepa, mtsogolomo amawonjezeredwa mpaka pomwe mawonekedwe achire owonekera amawonekera. Ngati Finlepsin adalembedwa kuwonjezera pa antiepileptic mankhwala, mlingo umachulukana pang'onopang'ono, mungafunike kusintha mlingo wa mankhwala ena.

Mukaphonya mlingo wotsatira, kumwa mapiritsi mwachangu, monga momwe mukukumbukira. Osamwa kawiri mlingo wa mankhwalawa.

Akuluakulu amayamwa kumwa 200 mg00 mg tsiku lonse, ndikuwonjezera pang'onopang'ono mpaka mawonekedwe atakwaniritsidwa. Pakukonzanso mankhwala, 800 mg ndi mankhwala - 1.2 g ya mankhwala patsiku, pafupipafupi kuvomereza tsiku lililonse ndi 1-2 p.

Kwa ana azaka 6 mpaka 15, mlingo woyamba wa tsiku lililonse ndi 200 mg, kuchuluka kwake kumachitika ndi 100 mg patsiku. Ndi mankhwala okonza, ana a zaka 6 mpaka 10 akulimbikitsidwa kuti atenge mankhwala a 400-600 mg, ana a akulu msinkhu wazaka 11 - 11 ndi mankhwala a 600 mg - 1 g ya mankhwalawa.

Kutalika kwa mankhwala a antiepileptic kumatsimikiziridwa payekhapayekha ndipo zimatengera momwe wodwalayo alili komanso momwe ntchitoyo imathandizira. Kuchepetsa mulingo wa mankhwala kapena kumaliza kwathunthu kwa mankhwalawa ndikotheka patatha zaka 2-3 kusowa kwa khunyu.

Mankhwalawa amamalizidwa pochepetsa pang'onopang'ono kuchuluka kwa mankhwalawa kwa zaka 1-2, ndikuwongolera kwa EEG ndikofunikira. Mu ana, pochepetsa mlingo wa mankhwalawa, ndikofunikira kuganizira kusintha kwa kulemera ndi zaka.

Idiopathic glossopharyngeal, trigeminal neuralgia

Poyamba, akuwonetsedwa kumwa mlingo wa 200-400 mg patsiku, pafupipafupi kugwiritsa ntchito ndi 2 r. Kukula kwa Mlingo kumachitika musanapumule ululu, nthawi zambiri 400-800 mg ya mankhwala amatengedwa. Potsatirazi, odwala ambiri amalangizidwa kumwa 400 mg a Finlepsin.

Odwala okalamba, komanso anthu omwe ali ndi chizolowezi chambiri chogwira ntchito, amawonetsedwa kumwa mlingo wochepa wa 200 mg wa mankhwala kamodzi patsiku.

Kupweteka kwamatenda a shuga

Ndikulimbikitsidwa kumwa 600 mg tsiku lililonse (imwani 1/3 tsiku lililonse m'mawa, ena onse madzulo). Simalimbikitsidwa kuti muzimwa 600 mg kawiri pa tsiku.

Chithandizo chochotsa mowa (wodwala akhale m'chipatala)

Tsiku lonse, akuwonetsedwa kuti atenga mankhwala a 600 ml, pafupipafupi oyang'anira ndi 2 r. Woopsa, atha kuwonjezera kuchuluka kwa 1.2 g, pafupipafupi kugwiritsa ntchito mankhwalawa ndi chimodzimodzi.

Kugwiritsa ntchito munthawi yomweyo mankhwala ena omwe amagwiritsidwa ntchito kuti athetse chiwonetsero cha kusiya kumwa, kupatula mankhwala omwe ali ndi mphamvu yosokoneza komanso yopusitsa, sikuwululidwa.

Panthawi yamankhwala, mudzafunika kuwunika chizindikiro cha plasma cha carbamazepine.

Popeza kupezeka kwa mawonekedwe owoneka kuchokera ku dongosolo lamanjenje lamkati ndi autonomic NS ndikotheka, kuwunikira mosamala mkhalidwe wa wodwala ndikofunikira.

Khunyu kupweteka motsutsana ndi maziko a kupitirira kwa ziwalo zingapo

Pafupifupi, 200-400 mg ndi mankhwala, mankhwalawa amatengedwa kawiri patsiku. Kutalika kwa chithandizo ndi Finlepsin amatsimikiza payekhapayekha.

Psychoses (chithandizo chamankhwala ndi kupewa)

Choyambirira, komanso kusunga mlingo nthawi zambiri chimakhala 200-400 mg. Ngati ndi kotheka, muyenera kuiwonjezera mpaka 400 mg.

Mimba, HB

Pa nthawi yobereka komanso mkaka wa m'mawere, kumwa mankhwalawa ndikotheka ngati kuchuluka kwazopindulitsa zomwe zimaposa zoopsa.

Ngati pakufunika kugwiritsa ntchito mankhwalawa kwa masiku 2040. lipatseni kuchuluka kwa mapiritsi mu muyeso wochepa. Ndikofunikira kuswa Mlingo wa tsiku ndi tsiku mumagawo ochepa omwe amatengedwa masana. Izi zidzafunika kuyang'anira plasma ndende ya Finlepsin.

Osati kawirikawiri, mwa ana omwe amayi awo amathandizidwa ndi mankhwalawa, kuwonongeka kunapezeka, pena pake panali kugawanika kwa msana.

Pofuna kupewa kupezeka kwa zovuta za hemorrhagic mu makanda, ndikofunikira kuwonjezera pazomwe zimakonzekera amayi potengera vit. K, ndizothekanso kuchitira chithandizo chatsopano mwa akhanda.

Finlepsin amadutsa mkaka wa m'mawere, koma mulingo wocheperako, chifukwa chake sangakhale ndi vuto lililonse mthupi la mwana. Ngati mwana wakhanda wayamba kulemera pang'ono, kugona kwambiri kumalembedwa, kuyamwitsa kuyenera kuyimitsidwa.

Contraindication ndi Kusamala

Simuyenera kutenga carbamazepine ndi:

Fupa lodziwika bwino
Zovuta Zamakhalidwe A Mtima
Kuchuluka kwazinthu zomwe zikugwira ntchito, kwa othandizira owonetsa antidepressant
Kuwonetsera kwapakati pa porphyria.

Popeza kuti mankhwalawa amatha kuyambitsa kukoka kwapadera, motere, cholinga chake chimaphatikizidwa mwa anthu omwe adapezeka ndi mitundu iyi ya kukomoka.

Mankhwala amafunika kugwiritsidwa ntchito mosamala pazovuta za sodium metabolism, matenda angapo a ziwalo zopanga magazi, kuwonongeka kwa CVS, dongosolo la impso, ndi chiwindi.

Kuchita mankhwala osokoneza bongo

Kulandila ndi zoletsa za CYP3A4 isoenzyme yeniyeni kungapangitse kuwonjezeka kwa plasma ya carbamazepine, komanso kupezeka kwa zizindikiro zoipa.

Kugwiritsa ntchito kwa inducers kwa CYP3A4 isoenzyme imatha kupititsa patsogolo kusintha kwa kagayidwe ka mankhwala a Finlepsin ndikuchepetsa ndende yake ya plasma, ndikutsatira kuchepa kwa zovuta zamankhwala. Ndipo chifukwa chakuzimitsa kwawo, kuchepa kwa kuchuluka kwa biotransfform ya carbamazepine palokha ndikuwonjezereka kwa plasma index kungathe kujambulidwa.

Felbamate imatha kutsitsa plasma kuchuluka kwa carbamazepine, pomwe kuchuluka kwa metabolites ake kumakulitsidwa ndipo seramu ya felbamate imachepa.

Kudya kwa isotretinoin kumakhudzanso bioavailability, komanso chilolezo chogwira ntchito cha Finlepsin, kotero muyenera kuyang'anira chidziwitso cha plasma cha carbamazepine.

Carbamazepine plasma msinkhu ndi chinawonjezeka ndi ntchito munthawi yomweyo macrolides, azoles, zoletsa protease, loratadine, isoniazid, terfenadine, fluoxetine, danazol, nicotinamide, diltiazem, dextropropoxyphene, cimetidine madzi manyumwa, propoxyphene, felodipine, verapamil, viloksazina, fluvoxamine, acetazolamide, desipramine.

Primidone yokhala ndi valproic acid amatha kuthamangitsa gawo lalikulu la Finlepsin polumikizana ndi mapuloteni a plasma, pomwe kuchuluka kwa metabolites omwe amapanga akuwonjezeka. Mukamwa valproic acid, chisokonezo chitha kuwoneka, wodwalayo amatha kugwa.

Pogwiritsa ntchito Finlepsin, kuchepa kwa plasma ndende ya mankhwalawa ndizotheka:

GKS
Digoxin
Clobazam
Acproic Acid
Primidon
Tetracyclines
Alprazolam
Oxcarbazepine
Ethosuximide
Cyclosporin
Mankhwala a estrogen-progestogen
Methadone
Theofylline
Haloperidol
Risperidone
Ma Anticoagulants omwe amatengedwa pakamwa
Calcium calcium blockers
Trimadol
Lamotrigine
Tricyclic antidepressants
Felbamate
Tiagabin
Topiramat
Tramadol
Mapuloteni oletsa
Olanzapine
Intraconazole
Midazolam
Clozapine
Levothyroxine
Ziprasidone
Praziquantel.

Minyezi ya carbamazepine yowonjezera ya plasma imawonedwa ndi cisplatin, primidone, doxorubicin, phenobarbital, meduximide, theophylline, phenytoin, rifampicin, fensuximide. Clonazepam, kukonzekera kochokera ku wort ya St. John, valproic acid, valpromide, oxcarbazepine, kumatha kuyambitsa zotsatira zomwezo.

Osati kawirikawiri, kuchepa kwakukulu kwa plasma ya phenytoin amalembedwa motsutsana ndi maziko a carbamazepine mankhwala, komanso kuwonjezeka kwa mefenitoin.

Njira zochokera ku gulu la tetracycline zimatha kuchepetsa kuchiritsa kwamphamvu pogwiritsa ntchito carbamazepine.

Finlepsin amachepetsa kulekerera kwa mankhwala okhala ndi Mowa.

Ngakhale mukumwa mankhwala a Li, ndizotheka kupititsa patsogolo zotsatira zamagulu a mankhwalawa.

Mankhwala amawonjezera kwambiri hepatotoxic zotsatira za isoniazid.

Kugwiritsa ntchito paracetamol kungakulitse chiwopsezo cha maselo a chiwindi ndikuchepetsa mphamvu yothandizidwa ndi mankhwalawa potithandizira kusintha kwa kagayidwe kachakudya.

Mankhwala amatha kuthandizira kusintha kwa kagayidwe kachakudya ka mankhwala operekera opaleshoni, chiopsezo cha zotsatira za hepatotoxic chikuwonjezeka.

Pali nkhawa yomwe imakhumudwitsa dongosolo lamanjenje lamkati, komanso kuchepa kwa mphamvu ya anticonvulsant ya carbamazepine panthawi ya mankhwala omwe ali ndi phenothiazine, clozapine, molindone, antidepressants ochokera pagulu lachitatu, maprotiline, ndi haloperidol.

Mankhwala a Myelotoxic amalimbikitsa hematotoxicity ya carbamazepine.

Kutenga diuretics kungayambitse hyponatremia.

Mankhwala atha kuwonjezera kuchulukitsa kwa mahomoni a chithokomiro.

Finlepsin imathandizira kusintha kwa metabolic kwa praziquantel, anticoagulants, COC, ndi zinthu zopangidwa ndi folic acid.

Ndizofunikira kudziwa kuti Finlepsin imafooketsa mphamvu yopuma yopweteketsa minofu.

Mao inhibitors amalimbikitsa mwayi wama hyperthermic komanso mavuto oopsa, Hypotive syndrome, nthawi zina, zotsatira zakupha zimakhala zotheka.

Wothandizila kuchiza khunyu imathandizira mapangidwe a nephrotoxic metabolites a mankhwala monga methoxyflurane.

Zotsatira zoyipa ndi bongo

Nthawi zambiri, maonekedwe osokoneza amakhudzana ndi mankhwala osokoneza bongo, komanso kusintha kwa plasma yogwira ntchito ya Finlepsin. Nthawi zambiri, kuphwanya malamulo kuchokera ku NS kumajambulidwa: ataxia, ulesi, kugona kwambiri, mawonekedwe a mutu. Kupezeka kwa ziwopsezo sikumatsutsidwa (zotupa zamtundu wa urticaria, erythroderma). Mbali ya hematopoietic system, itha kukhalanso zakuphwanya:

Lymphadenopathy
Kuwonetsedwa kwa eosinophilia
Kukula kwa leukocytosis kapena leukopenia
Zizindikiro za thrombocytopenia.

M`mimba thirakiti amatha kuyankha ndi kugunda nseru, pafupipafupi kusanza, mucous nembanemba mkamwa, ndi kuchuluka kwa chiwindi michere. Pakhoza kukhala kutsegula m'mimba kapena kudzimbidwa.

Kusungidwa kwamphamvu, kusinthasintha kwa thupi, edema, ndi hyponatremia amathanso kulembedwa. Zoyipa zomwe zingakhalepo mwa CVS (ziwopsezo za angina), ziwalo zam'malingaliro, genitourinary system, komanso minculoskeletal system.

Mutatha kumwa mankhwala osokoneza bongo osaneneka, zizindikiro zimatha kuonedwa zomwe zikusonyeza kuphwanya kachitidwe ka CVS, ziwalo zam'maganizo ndi dongosolo la kupuma. Kuwonongeka kwa mawonekedwe a kuwona, kuletsa kwa chapakati mantha, mapapu, kuwonekera kwa bradycardia, kusinthasintha kwa magazi, maonekedwe a kuyerekezera zinthu m'magazi, kusokonekera kwambiri, kusokonekera kwamkodzo, kupumitsidwa pafupipafupi kwa mseru komanso kusanza.

Chithandizo cha mankhwala chimayikidwa, nthawi zina kuchipatala kumafunika.

Carbamazepine

ALSI Pharma, Russia

Mtengo kuyambira 50 mpaka 196 rubles.

Mankhwala amakhala ndi anticonvulsant kanthu. Amagwiritsidwa ntchito ngati khunyu, chiwonetsero cha matenda ashuga, kuwachotsa mowa, mikhalidwe yamankhwala. Chosakaniza chophatikizika ndi chimodzimodzi mu Finlepsin, momwe limagwirira ntchito za mankhwala ndizofanana. Amapezeka piritsi.

Ubwino:

Kuthetsa nkhawa
Zimalimbikitsa Kulankhulana Kwodekha
Ntchito Kluver-Bucy syndrome.

Chuma:

Sichisonyezedwa chipika cha atrioventricular block
Zitha kupangitsa kuti anthu azimva mawu
Chenjezo limaperekedwa kwa Prostatic hyperplasia.

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.

Kuphatikiza kwa Finlepsin retard pothandizira antiepileptic mankhwala kuyenera kuchitika pang'onopang'ono, pomwe Mlingo wa mankhwala omwe amagwiritsidwa ntchito sasintha kapena, ngati pakufunika, umasinthidwa.

Kwa akuluakulu, mlingo woyambirira ndi 100-200 mg 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 ukuwonjezeka mwachangu, ndi kukonza mankhwala a matenda akhungu - pang'onopang'ono (kusintha kulolerana).

Zotsatira za pharmacological

Mankhwala a antiepileptic (dibenzazepine derivative), omwe amakhalanso ndi standardotymic, antimaniacal, antidiuretic (odwala matenda a shuga insipidus) ndi analgesic (odwala neuralgia).

Limagwirira ntchito limalumikizidwa ndi blockade yamagetsi yamagetsi-gated Na +, yomwe imatsogolera kukhazikika kwa membrane wa neuron, kulepheretsa kuwoneka kwa serial kutulutsidwa kwa ma neurons ndi kuchepa kwa kuphatikizika kwa synaptic. Imalepheretsa kupangidwanso kwa Na + -kudalira kothandizirana mu ma neurons a depolarized. Kuchepetsa kumasulidwa kwa glotamate yosangalatsa ya neurotransmitter amino acid, kumakulitsa kufupika kwapang'onopang'ono, ndi zina zotero. amachepetsa chiopsezo chodwala. Imawonjezera kuyendetsa kwa K +, modulates voltage-gated Ca2 + njira, zomwe zingayambenso anticonvulsant zotsatira za mankhwala.

Amawongolera umunthu wa khunyu ndipo pamapeto pake umawonjezera kulumikizana kwa odwala, amathandizira kukhazikika kwawo. Itha kutumikiridwa ngati mankhwala othandizira komanso kuphatikiza ndi mankhwala ena a anticonvulsant.

Ndiwothandiza kugwidwa koyang'ana (pang'ono komanso kovuta), kutsagana kapena kutsagana ndi kutsata kwachiwiri, kwa kugunda kwamtundu wa tonic-clonic, komanso kuphatikiza mitundu iyi (nthawi zambiri sikugwira ntchito pakukoka kwazing'ono - malis, kukhalapo ndi kugwidwa myoclonic) .

Odwala omwe ali ndi khunyu (makamaka ana ndi achinyamata) amakhala ndi zotsatira zabwino pazizindikiro za nkhawa komanso kukhumudwa, komanso kuchepa kwa kusakwiya komanso kukwiya. Zotsatira zakugwirira ntchito mwamphamvu ndi ntchito yama psychomotor zimadalira mlingo ndipo zimasiyana kwambiri.

Kukhazikika kwa anticonvulsant zotsatira kumasiyana kwa maola angapo mpaka masiku angapo (nthawi zina mpaka mwezi umodzi chifukwa chogwiritsa ntchito kagayidwe kachakudya).

Pogwiritsa ntchito neuralgia yofunikira komanso yachiwiri ya trigeminal nthawi zambiri imalepheretsa kuwoneka kwa ululu. Kuthandiza mpumulo wa ululu wa neurogenic pakuuma kwa msana, pambuyo pa zoopsa za patresthesias ndi postherpetic neuralgia.Kupumula kwamphamvu mu trigeminal neuralgia kumadziwika pambuyo pa maola 8-72.

Pankhani ya kusiya kumwa mowa, kumawonjezera poyambira kutsimikiza

Odwala odwala matenda ashuga insipidus kumabweretsa kulipira mwachangu madzi bwino, amachepetsa diuresis ndi ludzu.

Ntchito ya antipsychotic (antimaniacal) imayamba pambuyo pa masiku 7-10, mwina chifukwa cha kuletsa kwa kagayidwe ka dopamine ndi norepinephrine.

Fomu yotalikira ya magazi imathandizira kukonzanso kwa carbamazepine m'magazi popanda "nsonga" ndi "ziphuphu", zomwe zimathandizira kuchepetsa pafupipafupi komanso kuopsa kwa zovuta zovuta zamankhwala, kuonjezera mphamvu ya chithandizo chamankhwala ngakhale mutagwiritsa ntchito Mlingo wocheperako. Dr. mwayi wofunikira wa fomu yotalikilapo ndikuti mungatenge ma 1-2 tsiku limodzi.

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.

Kuchepetsa mwadzidzidzi kutenga Finlepsin retard kungayambitse khunyu. 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 Finlepsin retard ndi chithandizo, ndikofunikira kuphunzira chiwindi, makamaka 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 opatsirana kudzera pakamwa, chifukwa chake amayi omwe ali ndi zaka zobereka ayenera kugwiritsa ntchito njira zina zodzitetezera pakati pamankhwala.

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, koma chithandizo chiyenera kusiyidwa ngati leukopenia kapena leukopenia wapita patsogolo.

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 chiwonetserochi kumafunikira.

Ndikulimbikitsidwa kuti musiye kugwiritsa ntchito ethanol.

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

Ngakhale ubale pakati pa mlingo wa carbamazepine, kugwiritsidwa ntchito kwake mwamphamvu ndi matenda kapena kulolerana kuli kochepa kwambiri, komabe, kutsimikiza kwokhazikika kwa kuchuluka kwa carbamazepine kungakhale kothandiza muzochitika zotsatirazi: kuwonjezeka kwambiri kwa pafupipafupi pakuwukira, kuti muwone ngati wodwala akumwa mankhwalawo moyenera pa mimba, mankhwala a ana kapena achinyamata, ndi akuganiza malabsorption a mankhwala, ndi akuwoneka kukula kwa poizoni zimachitika ngati wodwala maet 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.

Mimba komanso kuyamwa

Ngati ndi kotheka, Finlepsin retard imalembedwa kwa azimayi amisinkhu yobala mwa njira ya monotherapy, munthawi yochepa, chifukwa pafupipafupi kusinthika kwa kubereka kwa akhanda kuchokera kwa amayi omwe anatenga antiepileptic chithandizo ndikokwanira kuposa monotherapy.

Mimba ikachitika, ndikofunikira kuyerekeza phindu lomwe mungayembekezere la chithandizo chamankhwala ndi zovuta zomwe zingatheke, makamaka munthawi yoyamba kubereka.

Amadziwika kuti ana a amayi omwe ali ndi vuto la khunyu amakhala okonzekera kutukuka kwa intrauterine, kuphatikizapo kusokonekera. Kubwezeretseka kwa Finlepsin kumatha kuwonjezera mwayi wamavuto awa. Pali malipoti apadera a matenda obadwa nawo komanso kusokonezeka, kuphatikizapo kusatsekedwa kwa ziphuphu zakumaso (spina bifida). Mankhwala othandizira antiepileptic amalimbikitsa kuchepa kwa folic acid, omwe nthawi zambiri amawonedwa panthawi yomwe ali ndi pakati, omwe amatha kukulitsa vuto la kubadwa kwa ana, chifukwa chake, kutenga folic acid kumalimbikitsidwa asanachitike pakati pa nthawi yomwe akukonzekera komanso pakati. Pofuna kupewa zovuta za hemorrhagic mwa ana akhanda, ndikulimbikitsidwa kuti amayi omwe ali m'milungu yotsiriza ya mimba, komanso akhanda, apatsidwe vitamini K.

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