Mankhwala Gabapentin: malangizo ntchito

Kufotokozera kogwirizana ndi 04.02.2015

Dzina lachi Latin: Gabapentin
Code ya ATX: N03AX12
Chithandizo: Gabapentin
Wopanga: PIK-PHARMA, Canonfarm Production CJSC (Russia), Aurobindo Pharma (India), Erregierre S.p.A. (Italy)

Mu 1 kapisozi gabapentin 300 mg

Calcium calcium hydrogen phosphate, mbatata wowuma, macrogol, magnesium stearate - monga maipi.

Zizindikiro zogwiritsidwa ntchito

monotherapy zozama at khunyu mwa akulu ndi ana azaka 12,
wowonjezera mankhwala zozama ndi khunyu mwa akulu,
wowonjezera mankhwala kulimbana ndi khunyu mwa ana azaka zitatu,
migraine,
kupweteka kwa m'mimba (neuralgia postherpetic, matenda ashuga, atatu, okhudzana ndi HIV, chidakwa, ndi msana stenosis),
kuchepa kwa kukula kwamafunde mkati kusintha kwa thupi.

Contraindication

lakuthwa kapamba,
Hypersensitivity mankhwala
galactose tsankho kapena malabsorption wa shuga ndi galactose,
zaka mpaka zaka 3 ndi kukomoka kwakukulu,
zaka mpaka 12 zaka ndi postherpetic neuralgia,
mimba.

Zotsatira zoyipa

kuchuluka HERE, tachycardia,
dyspepsia, nseru, kupweteka pamimba, pakamwa lowuma, kuvuta, kudzimbidwa kapena kutsegula m'mimba, kapamba, chisangalalo, gingivitis,
myalgiakupweteka kumbuyo
kugona, chizungulire, nystagmuskuchuluka kutopandi chisangalalo, dysarthria, gkupweteka kwa tini, kukhumudwachisokonezo Hyperkinesia,nkhawa, kusowa tulo,
rhinitis, pharyngitis, chifuwa,
kwamikodzo kugona, kusokonekera kwamphamvu,
kuwonongeka kwamawonekedwe, tinnitus,
khungu zotupachokhumudwitsa erythema,
kunenepa kwambiri, kutupa kutupa.

Kuchita

Kugwiritsa ntchito pamodzi mankhwala ena antiepileptic kumaloledwa (Phenobarbital, Carbamazepine, Phenytoin, Valproic Acid) ndi njira zakulera zamkamwa. Pankhaniyi, pharmacokinetics ya gabapentin sasintha.

Maantacidids amachepetsa kukhathamiritsa kwa mankhwalawa, motero kumwa mankhwala akuluakulu ndi ma antacid amafalikira pakapita nthawi.

Mankhwala a Myelotoxic amachulukitsa hematotoxicity ya gabapentin.

Molumikizana ndi morphine morphine pharmacokinetics sizinasinthe. Komabe, kusintha komwe kumachitika pakati pa dongosolo lamanjenje kuyenera kuyang'aniridwa.

Kumwa mowa kumatha kukulitsa zovuta zoyambira pakatikati wamanjenje (ataxia, stupor).

Malangizo apadera

Ngati kuli kofunika kuletsa mankhwalawo, kuchepetsa mlingo kuyenera kuchitika pang'onopang'ono (mu masabata 1-2), popeza kusiya mankhwala kungapangitse epistatus. Pakati pa nthawi yovomerezeka, ndizovomerezeka kugwiritsa ntchito molingana ndi ziwonetsero zovuta, pomwe phindu kwa mayi limaposa chiwopsezo kwa mwana wosabadwayo.

Ngati ataxia, chizungulire, kunenepa kwambiri, kuwodzera kumaonekera mwa akulu, komanso kugona ndi kudana ndi ana, chithandizo chikuyenera kutha. Pa chithandizo, muyenera kupewa kuyendetsa.

Kutulutsa mawonekedwe ndi kapangidwe kake ka mankhwala

Gabapentin amapezeka mu mawonekedwe a kapisozi pakamwa. Mankhwalawa amawaika m'matumba apulasitiki amtundu wa 50 kapena 100 kapena m'matumba a zidutswa 10-15 m'bokosi lamatoni.

Kapisozi iliyonse imakhala ndi chinthu yogwira - gabapentin 300 mg, komanso zinthu zingapo zothandiza: calcium stearate, gelatin, titanium dioxide, cellcose ya microcrystalline.

Gwiritsani ntchito pochita zachipatala

Gabapentin adapangidwa ku Parke-Davis ndipo adafotokozedwa koyamba mu 1975. Pansi pa dzina la mtundu wa Neurontin, idavomerezedwa koyamba mu Meyi 1993 kuti athandize matenda a khunyu ku UK ndipo adagulitsidwa ku United States mu 1994. Pambuyo pake, gabapentin inavomerezedwa ku United States kuti ichiritse matenda a postherpetic neuralgia mu Meyi 2002. Mu Januwale 2011, United States idavomereza mtundu wa gabapentin wosasunthika woyang'anira kamodzi patsiku pansi pa dzina la Gralise. Gabantine anacarbil pansi pa dzina lodziwika kuti Horizant, lomwe lili ndi vuto lalikulu kwambiri la bioavailability, adayambitsidwa ku United States kuti athandize matenda osakhazikika miyendo mu Epulo 2011 ndipo adavomerezedwa kuti athandizidwe pambuyo pa postherpetic neuralgia mu Juni 2012.

Gwiritsani ntchito pochita zachipatala

Gabapentin amagwiritsidwa ntchito makamaka pothandiza kukomoka komanso kupweteka kwa neuropathic. Izi zimathandizidwa makamaka ndi pakamwa, kafukufuku akuwonetsa kuti "kasitomala si koyenera." Amavomerezedwanso m'mapulogalamu ambiri osadziwika, monga chithandizo cha nkhawa, kusowa tulo komanso kupuma. Komabe, pali nkhawa za mtundu wa mayesedwe omwe adachitika ndi umboni wa zina mwa izi, makamaka ngati agwiritsidwa ntchito ngati chikhazikitso cha matenda osokoneza bongo.

Pharmacological zimatha mankhwala

Gabapentin ndi mankhwala okhala ndi tanthauzo la anticonvulsant. Mothandizidwa ndi mankhwalawa odwala omwe ali ndi khunyu, amachepetsa chiopsezo chobwereza mobwerezabwereza.

Mankhwalawa amagwiritsidwa ntchito pochiza akuluakulu ndi ana pochiza matenda amtundu wa m'mimba komanso ululu wamitsempha.

Mankhwala

Mwapangidwe, gabapentin ndi ofanana ndi GABA neurotransmitter (gamma-aminobutyric acid), koma momwe amagwirira ntchito amasiyana ndi mankhwala ena omwe amalumikizana ndi GABA receptors (valproic acid, barbiturates, benzodiazepines, GABA uptake inhibitors, GABA transaminase inhibitors, and agonists of agonists of Gonists of Gonors of Gonors of Gonors of Gonors of Gonors of Gonors of Gonors of Gonamin of Fomu za GABA).

Gabapentin alibe malo a GABAergic ndipo sasokoneza kukoka komanso kagayidwe ka GABA. Malinga ndi kafukufuku woyambirira, chinthucho chimamangiriza kwa í₂-δ-kugonjera njira zama calcium zomwe zimadalira mphamvu zamagetsi ndikuchepetsa kuyenda kwa calcium ion, zomwe zimagwira gawo lofunikira pakupanga kupweteka kwa neuropathic.

Njira zina zochitira ululu wa neuropathic:

kuchuluka kwa GABA,
kutsika kwa glutamate wodalira kufa kwa ma neurons,
kukakamiza kumasulidwa kwa ma neurotransmitters a gulu la monoamine.

Mu makulidwe ambiri a gabapentin okhala ndi ma receptor a mankhwala wamba kapena ma neurotransmitters, kuphatikizapo GABA receptors_MuGABA_A, glycine, glutamate, N-methyl-D-aspartate, kapena benzodiazepine receptors, samamanga.

Gabapentin, mosiyana ndi carbamazepine ndi phenytoin, samayanjana ndi njira za sodium mu vitro. Munthawi ya mankhwala a in vitro, mayeso ena a vitro amawonetsa chidwi cha zotsatira za glutamate receptor agonist N-methyl-D-aspartate, koma pokhapokha pakukumana kwa 100 μmol, komwe sikupezeka mu vivo. Gabapentin pang'ono amachepetsa kutulutsa kwa monoamine neurotransmitters.

Pharmacokinetics

The bioavailability wa gabapentin sikuti amadalira mlingo ndipo amachepetsa ndi kuchuluka kwa mlingo. C_max (pazipita kuchuluka kwa thunthu) gabapentin mu plasma pambuyo pakamwa makonzedwe amapezeka mu maola 2-3. Mtheradi bioavailability pafupifupi 60%. Chakudya, kuphatikiza ndi kuchuluka kwamafuta, sichikhudzanso magawo a pharmacokinetic.

Kuchotsa kwa zinthu kuchokera ku madzi a m'magazi kumafotokozedwa bwino pogwiritsa ntchito mtundu wa mzere. T_1/2 (kuchotsa theka-moyo) kuchokera ku plasma kuchuluka kwa maola 5-7 ndipo sizimatengera mlingo. Pogwiritsa ntchito mobwerezabwereza, magawo a pharmacokinetic sasintha. Mtengo wa kufanana kwa plasma mozungulira unganenedwe kutengera zotsatira za mlingo umodzi wa mankhwalawo.

Gabapentin sikuti amangomanga mapuloteni a plasma (80 - 900-2400 mg patsiku,

KK 50-79 - 600-1200 mg patsiku,

KK 30-49 - 300-600 mg patsiku,

KK 15-29 - 300 mg patsiku kapena 300 mg patsiku tsiku lililonse,

Mlingo ndi makonzedwe

Gabapentin Vidal ayenera kugwiritsidwa ntchito mosamala ndikutsatira malangizo a dokotala. Kumwa makapisozi musanapemphe kaye kwa akatswiri sikulimbikitsidwa, chifukwa mankhwalawa ali ndi zotsutsana zambiri komanso zoyipa zomwe zimangokulitsa vutoli ndikukulitsa mkhalidwe wa wodwalayo. Malangizo ogwiritsira ntchito Gabapentin musanatenge makapisozi amafunikira kuti muphunzire.

Mankhwalawa amamwa pakamwa. Mlingo wa tsiku ndi tsiku umatengera zaka za wodwalayo, matenda omwe amamuvutitsa, kupezeka kwa matenda olimba. Mlingo ndi njira yogwiritsira ntchito mankhwalawa ndi awa:

Ndi khunyu:

akulu, ana ochokera zaka 12: kapisozi imodzi ya 300 mg katatu patsiku,
mlingo waukulu tsiku lililonse ndi 3600 mg, wogwira - kuchokera 900 mpaka 3600 mg,
magawo pakati pakulandila ndalama - osapitirira maola 12,
kusankha mlingo wa munthu kuloledwa (tsiku loyamba la mankhwala - 1 kapisozi 300 mg, wachiwiri - makapisozi awiri 300 mg mu 2 Mlingo wogawika, wachitatu - makapisozi atatu 300 mg mu 3 mg waukulu.
ana kuyambira zaka 3 mpaka 12: 25–35 mg / kg katatu pa tsiku.

Ndi neuralgia:

akulu, ana: 1 kapisozi 300 mg katatu patsiku,
ndiye mlingo umakulitsidwa mpaka 3600 mg,
Kupitilira muyeso wa 3600 mg ndi oletsedwa.

Kuyanjana kwa mankhwala osokoneza bongo

Amaloledwa kumwa mankhwala amkamwa ndi mankhwala ena antiepileptic ndi mankhwala nthawi yomweyo: carbamazepine, phenobarbital, phenytoin. Mankhwalawa samakhudza ma pharmacokinetics mapiritsi. Kudya ma antacid ndi ma sorbents kumachepetsedwa bwino, chifukwa amachepetsa bioavailability wa Gabapentin. Ngati maantacid ndi ma sorbents ndi ofunikira kwambiri pa mankhwalawa, ndiye kuti muyenera kumwa ndi mankhwala osiyanawo ndi maola awiri mpaka atatu.

Mankhwala a Myelotoxic, monga maacacid, amagwiritsidwa ntchito mosamala chifukwa amathandizira pakuwonjezera kwake hematotoxicity. Ngati mumwa mankhwalawo limodzi ndi morphine, ndiye kuti ma pharmacokinetics a morphine sasintha, koma muyenera kuwongolera mosiyanitsa zomwe zimachitika chifukwa cha mantha. Mowa mukamamwa Gabapentin umakulitsa zovuta, chifukwa chomwa mowa osavomerezeka.

Bongo

Zizindikiro zotsatirazi zikuwonetsa kuchuluka kwa mankhwalawa tsiku lililonse:

kusokonekera kwa mawu
kugona
chizungulire
masomphenya apawiri
ulesi,
phokoso mokhumudwa.

Chithandizo cha mankhwala osokoneza bongo ndi chizindikiro. Mwanjira ina, madokotala amapereka thandizo, amayang'ana kwambiri zomwe akuwonetsa. Zochita izi:

chifuwa cham'mimba,
hemodialysis
Kulandila kwa amatsenga.

Kugwiritsa ntchito mankhwalawa panthawi yapakati komanso poyamwitsa

Mankhwalawa sanalembedwe kuti athandizidwe azimayi panthawi yomwe akuyembekezera mwana chifukwa chakuchepa kwa chidziwitso chokwanira pa chitetezo cha ntchito ya kapisozi pa mwana wosabadwayo komanso kukula kwa mimba. Kafukufuku wa Zinyama adawonetsa kuti kugwiritsa ntchito kwa nthawi yayitali ya Gabapentin panthawi yapakati, kuchepa kwa kukula kwa mwana wosabadwayo m'mimba kumawonedwa.

Mankhwalawa amalowerera mkaka wa m'mawere, motero kugwiritsa ntchito mkaka wa m'mawere sikulimbikitsidwa kwambiri chifukwa chosowa chidziwitso chokhudzana ndi mphamvu ya ma kapisolo pamthupi la mwana.

Ngati mankhwala a anticonvulsant akufunika, azimayi oyembekezera komanso odzola amayenera kupita kwa dokotala kuti asankhe njira ina.

Zotsatira zoyipa

Poyerekeza ndi kugwiritsa ntchito mankhwalawa Gabapentin, zotsatirazi zoyipa zimawonedwa kawirikawiri odwala:

Kuchokera kumbali yamanjenje - kugona, kufoka, chizungulire, kusokonekera kwa kayendetsedwe, kunjenjemera kwa malekezero, kumverera kopanda mantha, kusayang'anira zomwe zikuchitika, paresthesia, kuchepa mphamvu.
Kuchokera mmimba dongosolo - nseru, kusanza, kupumula kwambiri, kudzimbidwa kapena kutsekula m'mimba, kupweteka kwa hypochondrium, chitukuko cha kapamba, kuchuluka kwa chiwindi, kuchuluka kwa mpweya, matenda a chisa,
Kuchokera kumbali yamtima ndi mitsempha yamagazi - kusintha kwa kuthamanga kwa magazi (kuchepa kapena kuwonjezeka), mtima arrhythmias, kumverera kwa "kuthamanga" pankhope ndi miyendo,
Pa gawo la kupuma - kutupa kwa mucous nembanemba wa mucous, kupuma movutikira, chifuwa,
Kuchokera ziwalo zamkodzo ndi njira yoberekera - yafupika chilakolako chogonana, kwamikodzo, kusokonezeka kwa impso,
Kusintha kwa chithunzi cha magazi - magazi achepetsa kuchuluka kwa leukocytes, kuchepa magazi.

Nthawi zina, mukamalandira chithandizo, odwala amakumana ndi zotupa pakhungu, urticaria, ndi angioedema.