Momwe mungagwiritsire ntchito mankhwala a Tebantin?

Mitundu ya Tebantin - makapisozi a Coni-Snap: gelatin yolimba, kapu yofiirira, mtundu wa thupi zimatengera mlingo wa mankhwalawa, makapisozi amadzazidwa ndi mafuta oyera kapena pafupifupi oyera makhiristo (ma PC 10.

Mlingo wa 100 mg: kukula kwa kapisozi No. 3, thupi loyera,
Mlingo wa 300 mg: kukula kwa kapisozi No. 1, thupi lachikasu lopepuka,
Mlingo wa 400 mg: kukula kwa kapisozi No. 0, thupi la chikasu cha lalanje.

1 kapisozi muli:

yogwira mankhwala: gabapentin - 100, 300 kapena 400 mg,
othandizira zigawo: talc, lactose monohydrate, magnesium stearate, pregelatinized starch,
chivundikiro cha kapisozi: utoto wamchere wachitsulo (E172), utoto wachitsulo wachikasu (E172), titanium dioxide (E171), gelatin,
thupi la kapisozi: utoto wazitsulo wofiyira (E172) ndi utoto wachikuda chachitsulo (E172) - Mlingo wa 300 ndi 400 mg, titanium dioxide (E171), gelatin.

Mankhwala

Gabapentin ndi chinthu cha lipophilic, kapangidwe kake kofanana ndi kapangidwe ka gamma-aminobutyric acid neutrotransmitter (GABA). Nthawi yomweyo, malinga ndi momwe amagwirira ntchito, gabapentin amasiyana ndi mankhwala ena omwe amalumikizana ndi ma GABA receptors: samawonetsa katundu wa GABA-wolakwika ndipo samakhudzana ndikuyamba komanso kagayidwe ka GABA.

Malinga ndi kafukufuku woyambirira, gabapentin imatha kumangiriza ku α2-δ kugwiritsira ntchito njira zamagetsi zamagetsi zamagetsi ndikuletsa kuyenda kwa ma ioni a calcium, omwe amathandiza kwambiri kupezeka kwa ululu wa neuropathic. Kuchita kwa gabapentin mu ululu wa neuropathic kumakhalanso chifukwa cha njira zotsatirazi:

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

M'malingaliro ofunikira kwambiri, gabapentin sangathe kumanga ma receptor a mankhwala wamba kapena othandizira (kuphatikizapo GABA receptors_A ndi GABA_Mu, N-methyl-D-aspartate, glycine, glutamate kapena benzodiazepine). Mosiyana ndi carbamazepine ndi phenytoin, mankhwalawa samatha kuyanjana ndi njira za sodium mu vitro.

Kuyesa kwina kwa vitro kukuwonetsa kuti gabapentin imatha kuzindikira pang'ono zotsatira za glutamate receptor agonist N-methyl-D-aspartate, koma mapangidwe awa ndiowona pokhazikika kuposa 100 μmol, yomwe singatheke mu vivo.

Gabapentin amatha kuchepetsa pang'ono kutulutsidwa kwa monoamine neurotransmitters ndikusintha zochitika za enzymes glutamate synthetase ndi GABA synthetase mu vitro. Kafukufuku mu makoswe akuwonetsa kuwonjezeka kwa metabolism ya GABA m'malo ena a ubongo, komabe, kufunika kwa izi pakuchitika kwa anticonvulsant ntchito ya gabapentin sikunakhazikitsidwe. Mu nyama, chinthuchi chimatha kulowa mosavuta mu minyewa ya muubongo ndikutchingira kugwidwa komwe kumayamba chifukwa cha majini kapena kupangidwa ndi mankhwala (kuphatikiza GABA synthesis inhibitors) kapena ma elekitrojeni apamwamba.

Pharmacokinetics

Mankhwalawa amatengeka mwachangu, ndipo ndende ya plasma yayitali imawonedwa pambuyo pa maola atatu. Pambuyo mobwerezabwereza makonzedwe, kuti mukwaniritse ndende zambiri, ndikofunikira 1 ora limodzi ndi limodzi mlingo. Mtheradi bioavailability wa gabapentin mu makapisozi ndi pafupifupi 60%. Ndi kuwonjezeka kwa mlingo wa mankhwalawa, bioavailability wa mankhwala amachepa.

Kugwiritsa ntchito pamodzi kwa Tebantin ndi chakudya, kuphatikizapo zakudya zamafuta kwambiri, kumawonjezera C_max ndi AUC ya gabapentin pofika 14% ndipo nthawi yomweyo sizikhudza kwambiri mankhwala a pharmacokinetics.

Mukamatenga 300-4800 mg wa gabapentin, muyezo wa AUC ndi C_max kuchuluka ndi kuchuluka kwa mankhwala. Pa Mlingo osapitirira 600 mg, kupatuka kwa mzere wazowonetsa zonse ndizochepa, ndipo pamlingo waukulu kukwera sikofunika kwambiri.

Ndi pakamwa limodzi, kuchuluka kwa mankhwalawa kwa ana a zaka 4 mpaka 12 ndi chimodzimodzi ndi kwa achikulire. Chiyanjano chofanana ndi Mlingo wobwereza chinakwaniritsidwa pambuyo masiku awiri ndi awiri ndipo chinapitilira nthawi yonse yamankhwala.

Mu thupi la munthu, gabapentin kwenikweni samapukusidwa. Kuphatikiza apo, mankhwalawa alibe mphamvu yothandizira kuphatikiza ma enzymes a chiwindi ndi ntchito yosakanikirana, yomwe imakhudzidwa ndi kagayidwe ka mankhwala.

Gabapentin sangathe kumanga mapuloteni a plasma (ochepera 3%), ndipo voliyumu yake yogawa ndi malita 57.7. Kuchuluka kwa gabapentin mu madzi ammagazi ndi 20% ya ndende mu plasma mu equilibrium. Vutoli limatha kudutsa chotchinga magazi ndi kulowa mkaka wa m'mawere.

Kutupa kwa Tebantine kuchokera ku plasma kumayanjana. Kuchotsa hafu ya moyo sikudalira mlingo ndipo amapanga maola 5 mpaka 7. Chilolezo cha plasma, chilolezo cha impso, ndi mlingo wa chimbudzi cha gabapentin mosalekeza ndizofanana molingana ndi kupezeka chilolezo cha creatinine. Gabapentin amachotsedwa osasinthika kudzera impso, ndikuwachotsanso ku plasma pa hemodialysis.

Okalamba odwala ndi odwala mkhutu aimpso ntchito, gabapentin chilolezo cha plasma amachepetsa. Ndi creatinine chilolezo chochepera 30 ml / min, theka la moyo ndi pafupifupi maola 52. Mankhwala a odwala mkhutu aimpso ntchito ndi iwo hemodialysis, kusintha kwa mlingo tikulimbikitsidwa.

Zizindikiro zogwiritsidwa ntchito

khunyu khunyu khunyu kapena popanda yachiwiri generalization ana oposa zaka 12 ndi akulu odwala - monotherapy kapena zina mankhwala,
khunyu pang'ono khunyu ndi yachiwiri generalization (kapena popanda iyo) ana 3 zaka - wowonjezera mankhwala
kupweteka kwa neuropathic mwa odwala akuluakulu azaka zopitilira 18 - chithandizo ndi chithandizo.

Contraindication

kutupa kwa kapamba (kapamba) mu mawonekedwe owopsa,
mkaka wa m'mawere (nthawi yoyamwitsa),
zaka za ana mpaka zaka 3 (mitundu yonse yamankhwala),
Ana azaka 3 - 3 (monotherapy),
lactose tsankho, kufupika kwa lactase, shuga-galactose malabsorption,
Hypersensitivity kwa gabapentin ndi zigawo zothandizira za mankhwalawa.

Mosamala, mankhwalawa amayenera kuperekedwa kwa odwala omwe ali ndi vuto laimpso.

Pa nthawi yoyembekezera, Tebantin amagwiritsidwa ntchito pokhapokha ngati zabwino zomwe mayi akuyembekezeredwa zimaposa chiwopsezo kwa mwana wosabadwayo.

Kukakamira pang'ono mwa ana opitirira zaka 12 ndi akulu

Kwa ana opitirira zaka 12 ndi odwala achikulire, njira yofunika kwambiri yotsatsira antiepileptic nthawi zambiri imaperekedwa ndi mlingo wa 900-1200 mg / tsiku, masiku angapo atayamba kutumidwa.

Mlingo wovomerezeka watsiku ndi tsiku ndi ndondomeko yayikulu (A):

Ine tsiku: 300 mg - 1 nthawi patsiku, 1 kapisozi 300 mg kapena katatu patsiku, 1 kapisozi 100 mg,
Tsiku la II: 600 mg - 2 kawiri pa tsiku, kapisozi imodzi 300 mg kapena katatu patsiku, makapisozi awiri 100 mg,
Tsiku la III: 900 mg - katatu patsiku kwa kapisozi imodzi 300 mg kapena katatu pa tsiku kwa makapisozi atatu 100 mg,
Tsiku la IV komanso kupitirira apo: mlingo utha kuwonjezeka mpaka 1200 mg, ndikugawidwa Mlingo wofanana mu 3 Mlingo (mwachitsanzo, katatu patsiku, 1 kapisozi 400 mg).

Mlingo wina wamagulu (B): patsiku la 1 la mankhwala, mankhwalawa amayamba - 900 mg wa gabapentin patsiku, wogawidwa pazigawo zitatu za kapisozi imodzi ya 300 mg, tsiku lotsatira mlingowo utha kuwonjezeka mpaka 1200 mg patsiku ndi kupitirira (kutengera zotsatira zake) zimawonjezeka patsiku ndi 300-400 mg, koma osapitilira muyeso wa tsiku ndi tsiku wa 2400 mg (ndi kudya katatu). Kugwiritsa ntchito bwino kwa chitetezo cha mankhwalawa sikumveka bwino.

Kusintha pang'ono mwa ana a zaka 3 mpaka 12 ndi thupi lolemera kuposa 17 kg

Tebantin amagwiritsidwa ntchito mwa ana kuyambira zaka 3 mpaka 12 wokhala ndi thupi> 17 makilogalamu kuti awonjezere zochizira, popeza mulibe deta yokwanira pa chitetezo ndi kuyenera kwa kugwiritsidwa ntchito kwake mgulu lino ngati monotherapy.

Mlingo wovomerezeka wa tsiku lililonse wa mankhwalawa 25-25 mg / kg ndipo umagawidwa pawiri.

The chiwembu posankha njira yogwira pophika: tsiku 1 - 10 mg / kg / tsiku, tsiku la 2 - 20 mg / kg / tsiku, tsiku la 3 - 30 mg / kg / tsiku. Ngati ndi kotheka, mtsogolo, tsiku ndi tsiku mlingo wa gabapentin utha kuwonjezeredwa mpaka 35 mg / kg / tsiku, ndikugawidwa pazigawo zitatu. Malinga ndi kafukufuku wazachipatala wa nthawi yayitali, kulekerera kwabwino Mlingo mpaka 40-50 mg / kg / tsiku kumatsimikiziridwa.

Koyamba dosing regimen mpaka achire Mlingo wa gabapentin afikire (amalimbikitsidwa tsiku lililonse la gabapentin kutengera kulemera kwa thupi):

ana masekeli 17-25 kg (600 mg patsiku): 1st tsiku - 200 mg 1 nthawi patsiku, 2nd tsiku - 200 mg 2 kawiri pa tsiku, tsiku la 3 - 200 mg katatu pa tsiku,
ana olemera kuposa 26 kg (900 mg patsiku): 1st tsiku - 300 mg kamodzi patsiku, 2nd tsiku - 300 mg 2 kawiri pa tsiku, tsiku la 3 - 300 mg katatu pa tsiku.

Kuthandizira Mlingo wa Tebantin (kulemera kwa mwana / kumwa): 17-25 makilogalamu- 600 mg / tsiku, 26-36 kg-- 900 mg / tsiku, 37-50 kg-- 1200 mg / tsiku, 51-72 kg-- 1800 mg / tsiku.

Kupweteka kwamitsempha

Mankhwalawa neuropathic ululu, mulingo woyenera kwambiri wa mankhwala amathandizidwa ndi dokotala kudzera munjira yokhudzana ndi gawo limodzi la mayankho a wodwalayo, kulekerera kwa mankhwalawa komanso kugwira ntchito kwake. Mlingowo umatha kufika mpaka 3600 mg patsiku (pazambiri).

Mlingo wovomerezeka watsiku ndi tsiku ndi ndondomeko yayikulu (A):

Ine tsiku: 300 mg - 1 nthawi patsiku, 1 kapisozi 300 mg kapena katatu patsiku, 1 kapisozi 100 mg,
Tsiku la II: 600 mg - 2 kawiri pa tsiku, kapisozi imodzi 300 mg kapena katatu patsiku, makapisozi awiri 100 mg,
Tsiku la III: 900 mg - katatu patsiku kwa kapisozi imodzi 300 mg kapena katatu pa tsiku kwa makapisozi atatu 100 mg.

Njira ina ya dosing yothandizira zochizira kwambiri (B): patsiku la 1, mlingo woyambira tsiku lililonse ndi 900 mg wa gabapentin (wogawidwa mu 3 Mlingo), ndiye kuti mlingowo ungakulidwe patadutsa masiku 7 mpaka 1800 mg tsiku lililonse.

Kuti mukwaniritse kufunika kwa analgesic, nthawi zina, mlingowo ungathe kuwonjezeka mpaka kufika pa 3600 mg tsiku lililonse, womwe umagawidwa pazigawo zitatu. Pazoyesa zamankhwala zomwe zikupitilira, mlingo unakulitsidwa mpaka 1800 mg kwa sabata 1, ndipo mpaka 2400 ndi 3600 mg, motsatana, kwa wachiwiri ndi wachitatu.

Odwala ofooka, odwala omwe ali ndi thupi lochepa kapena ngati gawo lina lasintha, mlingo wa Tebantin umaloledwa kuchulukitsa ndi 100 mg patsiku.

Kulephera kwa impso ndi chilolezo cha creatinine (CC)

Pharmacological zimatha mankhwala Tebantin

Gabapentin ndi chithunzi cha GABA. Lipophilicity ya molekyulu ya gabapentin imathandizira kulowa kwake kudzera mu BB. Makina enieni a zochita sakudziwika. Gabapentin amamanga mapuloteni othandizira pogwiritsa ntchito njira zamagetsi zomwe zimadalira mphamvu yamagetsi ndipo, mwakutero, amasintha zochita za calcium njira ndi kutulutsidwa kwa ma neurotransmitters. Makina otere amatha kukhala ngati chandamale cha gabapentin pomwe mphamvu ya analgesic iwonekera. Gabapentin amasintha zochitika za GABA synthetase ndi glutamate synthetase mu vitro. Malinga ndi kafukufuku, gabapentin imathandizira kapangidwe ka GABA mu minofu ya muubongo. Kuthiridwa kwa mankhwalawa sikudalira nthawi yakudya. Pafupifupi, kuchuluka kwakukulu kwa gabapentin m'madzi am'magazi kumatha pafupifupi maola atatu pambuyo pakulankhula kamodzi kwa Tebantin, mosasamala kanthu za mawonekedwe ndi mlingo. Nthawi yofika pakulowerera kwambiri mankhwalawa mobwerezabwereza ndi pafupifupi ola limodzi osapitilira kamodzi.
Ndi Mlingo wobwereza wa mankhwalawa, magawo a machulukitsidwe amafikiridwa pambuyo pa masiku 1-2 ndipo akupitiliza nthawi yonse ya chithandizo.
Mankhwala opangidwa ndi pharmacokinetic a gabapentin (kupatuka kwina mu%) panthawi yodzala chifukwa chotsatira maola 8 aliwonse amaperekedwa pansipa.

400 mg (n = 11)

Cmax - kuchuluka kwa plasma ndende,
Tmax - nthawi yofunika kufikira Cmax,
T1 / 2 - theka moyo,
AUC (0 - ∞) - dera lomwe lili munthawi ya ndende ndi nthawi yopotera,
Ae ndi kuchuluka kwa gabapentin komwe kumachitika mumkodzo,
ND - muyeso sunachitike.

The bioavailability wa gabapentin sikuti amadalira mlingo. Pambuyo mobwerezabwereza (katatu patsiku) muyezo wa 300-600 mg, woyenera kulandira mankhwala, pafupifupi 60%.
Mu chiwindi cha munthu, kagayidwe ka metabolap kamakhala kochepa, mankhwalawa sayambitsa kuphatikizidwa kwa michere ya chiwindi yomwe imakhudzana ndi njira za oxidative.
Gabapentin samangiriza mapuloteni a plasma ndipo amalowa mofulumira mu BBB. The ndende yoyezera mu cerebrospinal madzimadzi ndi 20% ya ndende mu madzi am`magazi pa machulukitsidwe.
Kupatula kwa gabapentin kuchokera mthupi kumachitika kokha kudzera mu impso m'malo osasinthika. Hafu ya moyo wa gabapentin T1 / 2 s ndi maola 5-7. Zizindikiro zowonongera za gabapentin, T1 / 2, komanso chilolezo chaimpso sizimayimira palokha pakumwa mankhwalawa ndipo sizisintha pambuyo Mlingo wobwereza.
Kusintha kwokhudzana ndi zaka mu ntchito ya impso mu okalamba, komanso kuwonongeka kwa impso kwa odwala, kuwonetseredwa kuchepa kwa chilolezo cha creatinine, kutsitsa kuchepa kwa plasma chilolezo cha gabapentin komanso kuwonjezeka kwa nthawi yake. Malingana ndi kuchepa kwa chilolezo cha creatinine, kuchuluka kwa chimbudzi cha gabapentin, plasma ndi chilolezo cha impso kumachepa. Chifukwa chake, tikulimbikitsidwa kusankha kuchuluka kwa gabapentin kutengera chilolezo chain. Gabapentin amatha kuchotsedwa mu madzi am'magazi ndi hemodialysis.

Kugwiritsa ntchito mankhwala Tebantin

Chithandizo cha kupweteka kwa neuropathic akuluakulu
Poganizira momwe mankhwalawo amathandizira komanso kulekerera, adokotala amamuwonjezera mlingo woyenera wowonjezera pakuwonjezera pang'onopang'ono. Kutengera momwe wodwalayo amayankhira, mlingo waukulu umatha kufika pa 3600 mg / tsiku.
Malangizo othandizira:

a) tsiku la 1 - 300 mg ya gabapentin (1 kapisozi 300 mg 1 nthawi patsiku kapena 1 kapisozi 100 mg katatu pa tsiku).
Patsiku la 2 - 600 mg ya gabapentin (1 kapisozi 300 mg 2 kawiri pa tsiku kapena 2 makapisozi 100 mg katatu pa tsiku).
Pa tsiku la 3 - 900 mg ya gabapentin (1 kapisozi 300 mg katatu pa tsiku kapena 3 makapisozi 100 mg katatu pa tsiku),
b) ndikumva ululu kwambiri patsiku la 1, mutha kutenga kapisozi imodzi 300 mg katatu, komwe kofanana ndi 900 mg ya gabapentin patsiku. Kenako, mkati mwa sabata limodzi, mlingo wa tsiku ndi tsiku utha kuwonjezereka mpaka 1800 mg.

Nthawi zina, mungafunikire kuwonjezera kuchuluka kwa mankhwalawa. Mlingo wa tsiku ndi tsiku sayenera kupitirira 3600 mg ndipo uyenera kugawidwa mu 3 Mlingo. Kwa odwala omwe ali ndi vuto lalikulu, kufooka kapena kufalikira kwa ziwalo, muyezo umangokulitsidwa ndi 100 mg.
Odwala okalamba, malinga ndi kuchepa kwa zaka zomwe zimayenderana ndi kupezeka kwa creatinine chilolezo, odwala omwe ali ndi vuto la impso (creatinine chilolezo ≤80 ml / min) ndi odwala omwe akudwala hemodialysis, mlingo wa mankhwalawa umayenera kusankhidwa payekha malinga ndi dongosolo lotsatira:
Mlingo woyenera wa gabapentin wochepetsedwa waimpso

Mlingo wa tsiku ndi tsiku wa gabapentin, wowerengera 3 Mlingo patsiku, mg / tsiku

* Pakadutsa masiku awiri aliwonse, imwani mankhwalawa 100 mg katatu patsiku (kufunika kumeneku chifukwa cha kusowa kwa makapisozi okhala ndi 150 mg ya gabapentin).

Mlingo wa hemodialysis: hemodialysis odwala omwe sanamwe kale gabapentin akulangizidwa kuti apereke mlingo wokhutiritsa wa 300-400 mg, ndiye kuti maola 4 aliwonse a hemodialysis ayenera kupatsidwa 200-300 mg wa mankhwala. Patsiku lomwe dialysis singachitike, gabapentin sayenera kumwedwa.
Makapisozi a Tebantin amatengedwa pakamwa popanda kutafuna komanso kumwa madzi ambiri. Makapisozi amatha kumwedwa limodzi ndi zakudya komanso pakati pa chakudya. Mukamamwa mankhwalawa katatu patsiku, nthawi yopuma iyenera kupitirira maora 12. Ngati wodwalayo aiwala kumwa mankhwalawa, dokotalayo akuganiza ngati akufunika kuikonzanso.
Ngati chithandizo cha maantacid okhala ndi aluminiyamu ndi / kapena magnesium chikuchitika nthawi yomweyo, makapisozi a Tebantin sayenera kumwedwa osapitirira 2 mawola atatha kumwa maantacidiyenti kuti mupewe kusintha kosagwirizana ndi bioavailability wa gabapentin.
Kutalika kwa mankhwalawa kumatengera zovuta zamankhwala, nthawi zambiri chithandizo chanthawi yayitali chimafunikira. Kuwonongeka kwa Tebantin kapena kusintha kwa mankhwala ena oletsa antiepileptic nthawi zonse kumachitika pang'onopang'ono, osachepera sabata 1, kupatula ngati palibe chomwe chikuwonetsa kukomoka kwa khunyu.
Khunyu
Nthawi zambiri, antiepileptic zotsatira zimachitika mankhwala akamagwiritsa ntchito tsiku lililonse 900-0000 mg. Kufunikira kwa plasma ndende ya mankhwalawa kutha kupezeka m'masiku ochepa pogwiritsa ntchito manambala omwe ali pansipa.
Malangizo ochepetsa mankhwala
a) tsiku la 1 - 300 mg ya gabapentin (1 kapisozi 300 mg 1 nthawi patsiku kapena 1 kapisozi 100 mg katatu pa tsiku).
Patsiku la 2 - 600 mg ya gabapentin (1 kapisozi 300 mg 2 kawiri pa tsiku kapena 2 makapisozi 100 mg katatu pa tsiku).
Pa tsiku la 3 - 900 mg ya gabapentin (1 kapisozi 300 mg katatu pa tsiku kapena 3 makapisozi 100 mg katatu pa tsiku).
Patsiku la 4 - onjezani mlingo kukhala 1200 mg, imwani Mlingo 3 wogaika, ndiye kuti 1 kapisozi 400 mg 3 katatu patsiku,
b) patsiku la 1, mutha kuyamba ndi kutenga kapisozi imodzi 300 mg katatu, komwe kofanana ndi 900 mg ya gabapentin patsiku. Kenako tsiku ndi tsiku mlingo ungathe kuchuluka kwa 1200 mg.
Kutengera mphamvu zomwe zapezeka, mankhwalawa amatha kuwonjezeredwa tsiku lililonse ndi 300-400 mg, pomwe mlingo wa tsiku ndi tsiku womwe umatengedwa mu 3 Mlingo sayenera kupitirira 2400 mg wa gabapentin, popeza pakadali pano palibe kuchuluka kwa kuchuluka kwa mankhwalawa Mlingo waukulu.
Chithandizo cha ana a zaka 3-12 zaka
Mlingo wovomerezeka tsiku lililonse wa ana opitirira zaka 5 ndi 25-5 mg / kg / tsiku, kwa ana a zaka 3 ndi 4 - 40 mg / kg / tsiku. Mlingo wa tsiku ndi tsiku umagawidwa pawiri. Mlingo wovomerezeka wa 1 makilogalamu olemera a thupi amaperekedwa pagome. 1.
Gome 1
Kukonzekera Mlingo wa gabapentin wa ana 3 zaka

Mlingo watsiku ndi tsiku, mg

Mlingo wogwira umatsimikiziridwa mkati mwa masiku atatu motere: patsiku la 1, 10 mg ya gabapentin imayikidwa pa 1 kg ya kulemera kwa thupi, pa 2nd - 20 mg / kg / tsiku komanso pa 3 - 30 mg / kg / tsiku (tebulo. 2). Kupitilira apo, ngati kuli kotheka, mlingo wa tsiku ndi tsiku utha kuwonjezereka mpaka 3540 mg / kg, kutengera zaka. M'maphunziro azachipatala, odwala amalekerera mokwanira chithandizo cha nthawi yayitali pamankhwala a 40-50 mg / kg / tsiku.
Gawo 2
Mlingo woyamba wa gabapentin wa ana azaka 3 mpaka 12

Kulemera makilogalamu

Mlingo watsiku ndi tsiku, mg

Kulemera makilogalamu

Zotsatira zoyipa za mankhwala Tebantin

Kuchokera kumbali yamanjenje yapakati: kugona, chizungulire, kutopa ndi kusokonezeka kwa kayendedwe ka kayendedwe (ataxia), nystagmus, kusawona bwino (diplopia, amblyopia), kupweteka mutu, kunjenjemera, kamwa yowuma, dysarthria, amnesia, kuganiza kwamisala, nkhawa, nkhawa.
Kuchokera m'mimba: kusanza, kusanza, kudya.
Kuchokera pamtima: Vasodilation.
Kuchokera kumagazi: leukopenia.
Kuchokera kumbali ya kagayidwe: zotumphukira edema.
Kuchokera ku minculoskeletal system: mafupa owononga, myalgia.
Kuchokera pakapumidwe: chifuwa, pharyngitis, kupuma movutikira, rhinitis.
Pa khungu: ziphuphu, kuyabwa, zotupa.
Kuchokera ku genitourinary system: kusabala.
Ena: kunenepa kwambiri, asthenia, paresthesia, kusowa tulo, kupweteka pamimba ndi msana, kumva kutentha.
Pa mankhwala a gabapentin, hemorrhagic pancreatitis, mitundu ina ya thupi lawo siligwirizana (Stevens-Johnson syndrome, erythema multiforme).

Malangizo apadera ogwiritsira ntchito mankhwala a Tebantin

Mankhwalawa sathandiza ndi kukhudzidwa koyambirira, mwachitsanzo, ngati kulibe. Pogwiritsa ntchito munthawi yomweyo ndi mankhwala ena antiepileptic, kusintha kwa chiwindi kwa ntchito kunadziwika. Kumwa mankhwalawa kumakhudza kuchuluka kwa shuga m'magazi (hypo- kapena hyperglycemia). Chifukwa chake, ndikofunikira kuyendetsa chizindikirocho mwa odwala omwe ali ndi matenda osokoneza bongo kuti athe kusintha kwa mlingo wa gabapentin.
Odwala ndi mkhutu aimpso ntchito, gabapentin zotchulidwa akuchepetsa.
Pa mankhwala, matenda akuwonetsa hemorrhagic pancreatitis. Chifukwa chake, pamene zizindikiro zoyambirira za kapamba zimapweteka (kupweteka kwam'mimba m'matumbo, mseru, kusanza mobwerezabwereza), gabapentin iyenera kusiyidwa. Wodwala amayenera kufufuzidwa mosamala (mayeso a zamankhwala ndi a labotale) kuti adziwe ngati ali ndi vuto la pancreatitis pachimake. Pakadali pano, palibe zambiri zomwe zingagwiritsidwe ntchito ndi gabapentin pancreatitis yayitali. Zikatero, funso loti mupitilizabe mankhwala a gabapentin kapena kusiya ndiye kuti ndi lingaliro la adokotala.
Ndi tsankho la lactose, ziyenera kukumbukiridwa kuti kapisozi ya 100 mg ili ndi 2214 mg wa lactose, 300 mg - 66.43 mg, 400 mg - 88.56 mg.
Kutenga Tebantin pa nthawi yomwe ali ndi pakati kumatheka pokhapokha kuwunika mozama za chiopsezo / phindu la mayi ndi mwana.
Gabapentin akudutsa mkaka wa m'mawere. Kuchiza ndi mankhwalawa panthawi ya mkaka wa m'mawere kumapangidwa chifukwa cha zovuta zoyambira ana.
Pewani kuyendetsa ndikugwira ntchito yomwe imakhudzana ndi chiwopsezo chowonjezereka, makamaka panthawi yoyambirira yamankhwala, ndikuwonjezeka kwa mlingo komanso kusinthana ndi mankhwala ena antiepileptic.
Mowa umatha kukulitsa zovuta za zotsatira zoyipa za gabapentin kuchokera ku dongosolo lamanjenje (mwachitsanzo, kuyambitsa kugona).
Ndi kusanthula kochulukitsa kasanu ndi kawiri mu protein yonse mu mkodzo pogwiritsa ntchito chingwe cha litmus, zotsatira zabwino zabodza ndizotheka. Muzochitika zoterezi, ndikofunikira kutsimikizira zotsatila pogwiritsa ntchito njira ina yowunikira, mwachitsanzo, pogwiritsa ntchito mayeso a Biuret (mayeso a Biuret) kapena njira ya turbidimetric.

Mogwirizana ndi mankhwala a Tebantin

Panalibe kusintha kwakukulu pamlingo wa phenytoin, carbamazepine, valproic acid ndi phenobarbital m'magazi amwazi, omwe amagwiritsidwa ntchito ngati mankhwala oyambira antiepileptic osakanikirana ndi gabapentin.
Gabapentin sasokoneza machitidwe a norethindrone - ndi / kapena ethinyl estradiol okhala ndi pakamwa kulera, koma akamagwiritsidwa ntchito limodzi ndi mankhwala ena antiepileptic omwe amachepetsa mphamvu, njira zakulera ziyenera kuyembekezeredwa.
Mankhwala okhala ndi aluminiyumu kapena asidi a magnesium amatha kuchepetsa bioapentin bioavailability ndi 24%. Tebantin makapisozi sayenera kumwedwa osapitirira maola awiri mutamwa maantacid.
Ndi munthawi yomweyo kugwiritsa ntchito gabapentin ndi cimetidine, kuwonongeka kwa impso kumachepetsa.

Mankhwala osokoneza bongo a Tebantin, zizindikiro ndi chithandizo

Zitha kuwonetsa chizungulire, diplopia, kugona, kusinza, ndi kutsekula m'mimba. Mankhwala othandizira amachita. Gabapentin amachotsedwa m'thupi pogwiritsa ntchito hemodialysis, chizindikiritso chake chitha kuchepa m'chipatala odwala kapena kuchepetsa aimpso.

Zotsatira zoyipa

CNS (dongosolo lamkati lamanjenje):

kugona,
chizungulire,
nystagmus
ataxia
kuwonongeka kwa mawonekedwe (amblyopia, diplopia),
kunjenjemera
mutu
dysarthria,
kusokoneza kwamalingaliro,
amnesia
kukhumudwa
kutengeka mtima
kumverera kwa nkhawa
kusakwiya ndikukula chisangalalo chamanjenje,
chikumbumtima
nthano
kuchepa kwa chidwi
hypo- kapena areflexia,
udani ndipo Hyperkinesis (mwa odwala osakwana zaka 12).

kusintha kwa kuthamanga kwa magazi (mbali iliyonse)
Vasodilation.

GIT (matumbo am'mimba):

nseru,
chisangalalo
kusanza,
hemorrhagic kapamba,
kukomoka
kutsegula m'mimba kapenakudzimbidwa
kulakalaka
gingivitis
kuyuma mkamwa
kusintha kwa dzino enamel kapena kugonjetsedwa kwake.

myalgia
mafupa olimba kwambiri
arthralgia.

erythema multiforme exudative,
Matenda a Stevens-Johnson
malungo.

kuphwanya shuga m'magazi,
kuchuluka kwa transaminase ntchito.

kutupa kwa nkhope
kunenepa
kupweteka kwam'mimba
zotumphukira edema,
kupweteka kumbuyo
asthenia
malungo
chinangwa
Zizindikiro zachilengedwe chimfine.

Tebantin, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Tebantin akuwonetsedwa pakamwa. Mapiritsiwo amezedwa lonse, osasamala chakudyacho. Mlingo gabapentin Kutalika kwa nthawi ya mankhwala kumatsimikiziridwa ndi kupezeka kwa adokotala, kutengera matenda ndi njira ya matendawa. Kwa odwala omwe akuvutika khunyu Mlingo wa mankhwalawa umasankhidwa payekha.

Akuluakulu odwala ndi achinyamata opitirira zaka 12 akulimbikitsidwa kuti azikhala ndi mlingo wokwanira wokonza 900 mg00 mg tsiku lililonse. Mankhwala akukonzekera imatsimikizika masiku angapo a mankhwalawa pogwiritsa ntchito chiwembu chomwe chatchulidwa pansipa: 1st tsiku la mankhwala - tsiku lililonse ndi 300 mg yogwira ntchito yogapinin (1 kapisozi ya mankhwala Tebantin 300 mg). Tsiku lachiwiri la mankhwala - tsiku lililonse ndi 600 mg (1 kapisozi wa 300 mg kapena 2 makapisozi 100 mg mu 100 mg waukulu). Tsiku lachitatu la mankhwala - tsiku ndi tsiku mlingo ndi 900 mg (1 kapisozi 300 mg mu katatu). Kuyambira tsiku la 4 la mankhwala, 900 mg (akhoza kuchuluka mpaka 1200 mg) wa Gabapentin ndi mankhwala tsiku lililonse.

Pali njira ina yosankhira munthu wa mlingo wa Tebantin, pomwe amalimbikitsa kumwa mlingo woyamba wa 900 mg (300 mg katatu patsiku). Pambuyo, mlingo woyambirira umapatsidwa gawo, umachulukana tsiku lililonse ndi 300-400 mg, ndikuyimitsa mukafuna kuthandizidwa. Mlingo wautali womwe umatengedwa umagawika patatu. Mulingo waukulu wa Tebantin patsiku ndi 2400 mg malinga ndi zomwe zimagwira. Palibe deta pa chitetezo ndi kuchuluka kwa Mlingo wowonjezera pa mlingo waukulu.

Odwala azaka 5 mpaka 12 akuvutika khunyuNdikulimbikitsidwa kuti muyambe kulandira chithandizo cha mankhwala oyamba tsiku lililonse 10 mg / kg, ndikuchulukitsa (20 mg / kg) patsiku lachiwiri la chithandizo. Patsiku lachitatu, mlingo umakwera kufika pa 25-35 mg / kg ndipo umakhalabe pamlingo uwu ndi kusintha komwe kungachitike ndi dokotala malinga ndi momwe wakwaniritsidwira. At khunyu ana 3 - 4 zaka analimbikitsa tsiku mlingo gabapentinndi 40 mg / kg yolemera. Mankhwala othandizira amatsimikiza pang'onopang'ono masiku opitilira atatu, kuyambira pa kutenga 10 mg / kg yoyamba pa mlingo womwe umafunikira, ndikuwonjezera mlingo woyambira osapitirira kawiri tsiku limodzi. Mlingo wambiri watsiku ndi tsiku kwa odwala a m'badwo uno sayenera kupitirira 50 mg / kg ya thupi.

Odwala achikulire akalandira chithandizo neuralgiaMonga ulamuliro, tikulimbikitsidwa kuti tichite maphunziro a mitundu Mlingo wa 900-1800 mg. Malinga ndi zomwe akuwonetsa komanso ndi kulekerera bwino kwa mankhwalawa, mlingo wa Tebantin ukhoza kuwonjezeka mpaka 3600 mg. Chithandizo cha mankhwalawa chimayamba ndi mlingo wa 300 mg patsiku, ndikuwonjezera pang'onopang'ono mlingo wa mankhwalawa tsiku lililonse ndi 300 mg, mpaka tsiku lililonse la 900 mg lipite (tsiku lachitatu). Ngati mlingo wa tsiku ndi tsiku wa 900 mg ndi osathandiza, mutha kuwonjezereka (mpaka 1800 mg) kwa masiku 7. Mlingo gabapentin, yomwe imaposa 300 mg patsiku, imagawidwa m'magulu angapo (makamaka pamitundu itatu). Njira yina yothandizira ndikutsatira muyeso wa tsiku ndi tsiku wa 900 mg wogawidwa m'mitundu itatu (3 mapiritsi a 300 mg aliyense).

At kusakhazikika ndi kusowa kwa contraindication pang'onopang'ono (kupitirira masiku 7) kuonjezera mlingo mpaka 1800 mg. Malangizo a mankhwalawa amagwiritsidwa ntchito kupweteka kwambiri. Malangizo ogwiritsira ntchito Tebantin 300 mg ndi neuralgia akuwonetsa mlingo waukulu wa tsiku ndi tsiku wa 3600 mg. Tiyenera kukumbukira kuti ndi zovuta kwambiri wodwalayo, kuchepa pang'ono, komanso pambuyo pake kupatsidwa ziwalo, tsiku lililonse mlingo wa mankhwalawa ukhoza kuwonjezereka osaposa 100 mg patsiku. Mungafunike kusintha kwa mankhwala a Tebantin, okalamba odwala. Ndi matenda a impso, tsiku lililonse gabapentin, monga nthawi yonse ya chithandizo, imatsimikiziridwa ndi adokotala okha ndipo zimatengera zizindikiro KK (chilolezo cha creatinine mu ml / min).

KK 80 ndi pamwambapa - osaposa 3600 mg,
KK 50-79 - zosaposa 1800 mg,
KK 30-49 - osapitirira 900 mg,
KK 15-29 - zosaposa 600 mg,
KK ochepera 15 - osaposa 300 mg.

Mlingo wa tsiku lililonse wa mankhwalawa umagawidwa katatu. Ngati sipakufunika kugwiritsa ntchito mlingo waukulu, Tebantin amapatsidwa mankhwala a 100 mg katatu patsiku ndipo amatengedwa tsiku lililonse lililonse (300 mg patsiku ndikupumula kwa maola 24). Panthawi yoikidwiratu gabapentinodwala CC osakwana 15 akuchita izi hemodialysis ndipo kale osamwa mankhwalawa, ndikulimbikitsani kumwa mankhwala okwanira (300-400 mg).

Pambuyo pa gawo lililonse hemodialysismaola 4, kumwa 200-300 mg wa mankhwala. M'masiku opanda hemodialysisTebantin salandiridwa. Kuchoka kwa mankhwala Tebantin, komanso kusamutsa wodwala wina mankhwala antiepileptic ntchitoikuchitika pang'onopang'ono, chifukwa cha chiwopsezo cha khunyu.

Kuchita

Ndi kuphatikiza kwa Tebantin ndi mankhwala ena antiepileptic (valproic acid, phenytoin, phenobarbital, carbamazepine) kukhazikika kwawo m'mwazi sikusintha. Mukasankhidwa ndi kulera kwamlomo Gabapentin sasokoneza kugwira ntchito kwawo, komabe, mukamagwiritsa ntchito mankhwala osakaniza ndi antiepileptic mankhwala ena omwe amachepetsa mphamvu ya pakamwa kulera, kuchepa kwawo kumakhala kotheka.

Kutha kwa impso kwa Gabapentin kumachepa tikamatengedwa Cimetidine. Mankhwala a Antacid, kukonzekera komwe kumakhala ndi magnesium kapena aluminium (acid-neutralizing) kungakhudze bioavailability wa Gabapentin, ndikuchepetsa ndi 24%. Pankhaniyi, amalimbikitsa kuti asamamwe Tebantin pasanathe maola 2 mutatha ntchito maantacid.

Zotsatira zoyipa za Tebantin kuchokera ku dongosolo lamanjenje zapakati zimatha kupititsa patsogolo zakumwa zomwe zimakhala ndi mowa, komanso mankhwala omwe amakhudza dongosolo lamanjenje lamkati. Ndikotheka kupeza zotsatira zabodza pamayeso a labotale, mothandizidwa ndi mayeso a litmus, pakusanthula kwa mapuloteni athunthu mumkodzo. Zambiri zakuwunika kotero ziyenera kutsimikizika pogwiritsa ntchito njira zina zofufuzira.

Ndemanga za Tebantin

Ndemanga za Tebantin pamaforamu, ngati mankhwala ochizira khunyu khunyuwotsutsana kwambiri. Ena amawunikira ngati mankhwala ndiwabwino komanso amawona kuchepa kwa pafupipafupi komanso mphamvu ya kuukiridwa, pomwe ena samva kusintha kulikonse pamatenda awo. Mwinanso izi zimachitika chifukwa cha njira yolakwika yolangira mankhwala ndikusankhidwa kwa munthu payekha Mlingo wothandizira.

Ndemanga za odwala kupweteka kwa m'mimba Tebantin akuti ndiwothandiza kwambiri, malinga ndi malingaliro onse a madokotala omwe amapezeka. Mwa zina zoyipa, mapapu amadziwika kwambiri. chizungulire ndi kugona.

Kufotokozera, katundu ndi mawonekedwe

Mankhwala Tebantin amawerengedwa ngati mankhwala anticonvulsant ndi painkiller. Cholinga chachikulu ndicho kuponderezana khunyu komanso pang'ono mwa akulu ndi ana, komanso kupewa kuwonekera kwawo. Kuphatikiza apo, mankhwalawa amaperekedwa kwa odwala omwe ali ndi neuropathy ndi neuropathic ululu syndrome monga analgesic. Mosiyana ndi ma analogi ambiri ndi othandizira ena, makapisozi akusonyeza zotsutsana zingapo ndipo samayambitsa zotsatira zoyipa, ndikuwonetsetsa.

Chofunikira kwambiri pa mankhwalawa ndi gabapentin, womwe umapangidwa m'mapiritsi a gelatin a 100, 300 ndi 400 milligrams. Thupi ndi imodzi mwazifanizo za gamma-aminobutyric acid.

Gabapentin amawonetsa ntchito ya analgesic ndi antiepileptic, ali ndi machitidwe a neuroprotective. Mamolekyu a chigawocho amagonjera mosavuta chotchinga cha magazi-ubongo, chifukwa ndi lipophilic.

Makina a zochita za gabapentin samamveka bwino; pali umboni wa kusintha kwaposachedwa kwa kayendedwe ka calcium komanso kumasulidwa kwa ma neurotransmitters.

The bioavailability wa chinthu mpaka 60%, pazipita ndende amafika pambuyo maola atatu muyezo limodzi mlingo. Kulimbikira kwamankhwala othandizira kumachitika tsiku lachiwiri ndipo kumakhalabe munthawi yonse ya chithandizo.

Hafu ya moyo wa chinthucho ndi pafupifupi maola 5-6, kutulutsa kwathunthu kumachitika makamaka kudzera mu impso. 20% ya ndende ya plasma imawonedwa mu madzi a synovial.

Kuchepetsa theka la moyo mwa anthu okalamba, komanso odwala omwe ali ndi vuto laimpso komanso (kapena) kulephera kwa chiwindi, kumawonjezeka.

Mankhwala amapezeka mu mawonekedwe a makapisozi mu chipolopolo cha gelatin. Phukusi la mankhwalawa limaphatikizapo kuchokera ku 50 mpaka 100 Mlingo, tchuthi chimachitika chifukwa cha mankhwala. Mtengo wapakati pazomanga ma cell ku Russia ndi ma ruble 750-800. Wopanga - Gideon Richter OJSC. 1103, Budapest, Hungary.

Zizindikiro ndi cholinga chachikulu

Cholinga chachikulu cha mankhwalawa ndikuchepetsa kukomoka ndi kupweteka kwa chikhalidwe cha neuropathic ndi khunyu. Akulu ndi ana, Tebantin amagwiritsidwa ntchito pothandiza matenda a khunyu ndi neuropathy motere:

Kuchepetsa kukhudzana pang'ono kapena popanda kulumikizika kwachiwiri. Monga monotherapy kapena chowonjezera mwa odwala omwe ali ndi zaka 12.
Poyerekeza khunyu odwala ndi popanda yachiwiri generalization monga adjunct odwala azaka 3 mpaka 12.

Chifukwa chake, mankhwalawa amadziwikiratu ngati mankhwala osokoneza bongo kapena amayamba ndi mankhwala ovuta. Zaka zochepa zodwala ziyenera kukhala zaka zitatu. Mwa ana, mankhwalawa amagwira ntchito ngati mankhwala owonjezera; zotsatira za monotherapy sizimamveka bwino.

Njira Zosankhira Mlingo

Mapiritsi amayenera kumwedwa pakamwa popanda kutafuna ndi madzi pang'ono. Mlingo wosankha mlingo umatsimikiziridwa ndi mawonekedwe, zaka ndi thupi la wodwalayo. Kuwerengeredwa kwa muyezo:

Kuchepetsa ululu wa neuropathic, regimen yotsatira yamankhwala imagwiritsidwa ntchito:

tsiku loyambakatatu patsiku pa kapisozi 100 mg kapena kamodzi pa kapisozi 300 mg,
chachiwiri: makapisozi awiri amililita 300 kapena milingo itatu ya makapisozi awiri a 200 mg
chachitatu: makapisozi atatu a 300 mg patsiku.

Njira ina yothandizira (yopweteka kwambiri ululu) imakhudza kudya kwa tsiku ndi tsiku mamiligalamu 900 a mankhwalawo, wogawika patatu. Mlingo wapamwamba kwambiri ndi 1800 mg mukamagwiritsa ntchito sabata limodzi. Mkhalidwe wofunikira ndi kuwonjezeka pang'onopang'ono kwa mlingo komanso kuchepa kwapang'onopang'ono.

Kuti mukwaniritse achire komanso ma analgesic kwenikweni, kuchuluka kwamankhwala mpaka 3600 amaloledwa pamawu a dokotala. Zikatero, kuchuluka kwa mankhwalawa kumagawidwanso katatu. Komabe, odwala ofooka atachitidwa opaleshoni, komanso anthu omwe ali ndi vuto loonda kwambiri samalimbikitsidwa kuti atenge mamiligirama 100 a Tebantin patsiku.

Malangizo a chakudya samakhudza mayamwidwe azinthu zomwe zimapangidwa.

Kusankha kwa munthu payekha malinga ndi zoletsa komanso contraindication ndikotheka. Makamaka, njirayi imafunikira kuti impso ndi chiwindi zisathe komanso kupitirira zaka 50. Kulandilanso kutumizidwa pakamwa katatu patsiku.

Zoyipa Zoyipa Zoyipa

Zotsatira zoyipa zoyipa zimachitika mkati mwa mantha ndi mtima. Zowonetsedwa nthawi zambiri:

kugona ndi kuwonongeka kwathunthu,
chizungulire ndi migraine
kunjenjemera
dysarthria,
kuchuluka psychoemotional chisangalalo,
Vasodilation
kuthamanga kwa magazi,

Sizotheka kuwonongeka kwamawonekedwe, kusokonezeka kwa dongosolo logaya chakudya (kusisita, kusanza ndi kusanza, kusakhazikika kwa chilimbikitso, kutsegula m'mimba, kudzimbidwa, kapamba, pakamwa pouma). Mawonetsero ena owawa nthawi zina:

arthralgia,
mafupa olimba
leukopenia
pharyngitis, rhinitis,
kupuma pang'ono komanso kutsokomola
kulira m'makutu
thupi lawo siligwirizana ndi kuchuluka kwa zotumphukira (zotupa pakhungu, malungo, erythema)

Ndi chiwonetsero chovuta cha zovuta, kuchuluka kwa zilonda ndi khungu, zimaloledwa kusintha mlingo molingana ndi mawonekedwe a wodwala. Ndi kukokomeza kwamphamvu Mlingo wofotokozedwa ndi malangizo, mawonetseredwe akuwonekera kwambiri ndi kugona, kupweteka mutu, chizungulire, kuwona kawiri ndikotheka. Kuti muthane ndi vutoli, hemodialysis, symptomatic mankhwala imagwiritsidwa ntchito. Mankhwala enieni a Tebantin sanapangidwe.

Mndandanda wa mankhwalawa ku Russian pharmacies

Ngati ndi kotheka, mutha kusankha fanizo la mankhwala a Tebantin malinga ndi zomwe zimagwira ntchito, komanso kapangidwe kake. Zolocha m'malo ambiri zimagulitsidwa kudzera mu makeke ammadzi okha ndi mankhwala a dokotala.

Dzinalo	Zogwira ntchito	Wopanga	Mtengo (ma ruble)
Pregabalin Richter	Pregabalin	Gideon Richter OJSC (ku Hungary), a George Richter-RUS CJSC (Russia)	350-400
Gabagamm	Gabapentin	Artesan Pharma (Germany)	350-400
Lameki	Lamotrigine	GlaxoSmithKlein Trade (Russia)	500-600
Keppra	Levetiracetam	UCB Pharma (Belgium)	800-900
Seisar	Lamotrigine	Alkaloid AD (Republic of Makedonia)	700-900
Wimpat	Lacosamide	UCB Pharma S.A. (Belgium)	1000-1200

Ma Analogs ndi othandizira ayenera kusankhidwa kuti galapentin asalole, kusakwanira kwa Tebantin kapena kuwoneka koyipa pambuyo pamavuto. Kusankhidwa kumeneku kumachitika ndi adotolo potengera zomwe akuwonetsa komanso zomwe wodwala akuchita. Si mankhwala onse omwe amagwiritsidwa ntchito mu ana.

Chofunikira mukamagwiritsa ntchito Tebantin

Tebantin amathandizira komanso amachepetsa kukokana, kupweteka kwa khunyu ndi neuropathy mwa akulu ndi ana omwe amagwiritsidwa ntchito mwadongosolo. Ubwino wa mankhwalawa ndi ochepa omwe amalimbana ndi contraindication omwe ali ndi mphamvu zambiri poyerekeza ndi analogues ndi zina. Kusankhidwa kwa Mlingo kumatha kukhala njira zovuta, zomwe zimatengera umunthu wa wodwala, zaka komanso thupi. Ndikofunikanso kuganizira zovuta za chithandizo cha ana.

Kodi tebantine

Katundu wogwira kuchokera pakuphatikizidwa kwa mankhwalawa ali ndi mawonekedwe ofanana ndi γ-aminobutyric acid (GABA), omwe amadziwika kuti neurotransmitter okhala ndi zoletsa zina. Cholinga choyambirira cha opanga a gabapentin chinali kubwereza kapangidwe ka mankhwala a GABA. Koma ngati momwe zinapangidwira, ndiye kuti palibe momwe mungagwiritsire ntchito. GABA imakhudza mwachindunji malo opangira ubongo. Ndipo momwe gabapentin amachepetsa ululu samadziwikabe. Malinga ndi mtundu wina, amalepheretsa calcium kuti isalowe m'maselo a cortical, ndipo malinga ndi lina, imalepheretsa kupangika kwa ma synapses atsopano. Kuphatikiza apo, zimayambitsa kuchepa kwa kufa kwa mitsempha ndipo zimathandizira pakupanga kwapadera kwa GABA.

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Zomwe zimathandiza

Zizindikiro zazikulu za Tebantin ndikumva kuwawa kwa mitsempha komanso matenda a khunyu omwe amapezeka m'gawo limodzi la ubongo. Zomwe zimapangidwazo sizikugwiritsidwa ntchito ngati kugwidwa kukuwonjezeredwa, ndikukhala ndi minyewa yambiri yamatumbo, kutayika kwa chikumbumtima. Chifukwa chake, izi:

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Kukokana kwanuko kwa odwala azaka zopitilira 12.
Zochizira zowonjezera ndi kupezeka kwa matenda omwewo mwa akulu.
Chithandizo cha mitundu ya khunyu, yodziwika ndi zovuta zapadera komanso kusakhazikika kwa ana kuyambira zaka zitatu.

Zokhudzana ndi ululu wamitsempha wam'mimba womwe umayamba chifukwa cha ma speptor ululu, nthawi zambiri amakumana ndi oledzera, odwala Edzi, odwala matenda ashuga, odwala omwe ali ndi vuto la shingles kapena stenosis ya ngalala ya msana. Koma kuziimitsa ndi Tebantin ndikuloledwa kwa odwala omwe ali ndi zaka 18 zokha.

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Madokotala azachipatala amatha kupereka mankhwala kwa azimayi omwe ali ndi vuto lalikulu logomoka, makamaka ngati chithandizo chamankhwala cholowetsa mahomoni chalephera. Mothandizidwa ndi gabapentin, kugona kwawo kumakhazikika, kutenthedwa kwamphamvu kumacheperachepera, ndipo thanzi lonse limakhala bwino.

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Malangizo ogwiritsira ntchito

Mlingo wa Tebantin ndi mapiritsi okhala ndi 300 mg yogwira pophika. Amadzazidwa ndi wowuma wa sodium carboxymethyl, magnesium stearate ndi microcrystalline cellulose. Makapisozi amaphatikizidwa ndi chipolopolo cha gelatin chokhala ndi chitsulo ndi mankhwala a titaniyamu. Amaledzulidwa onse asanadye kapena atatha kudya, otsukidwa ndi madzi. Zotsatira za mankhwalawa sizomwe zimachitika nthawi yomweyo, muyenera kudikirira pafupifupi maola awiri ndi atatu.

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Dokotalayo ndi amene amamuuza mtundu wa mankhwalawa komanso muyezo wake. Zitha kukhala motere:

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Kwa ana kuyambira zaka 6 mpaka 12, kuwerengera kumachitika malinga ndi mtundu wanthawi zonse wa 10-15 mg / kg ndi kulemera kwa 25-25 mg m'masiku atatu otsatirawo. Mlingo wa tsiku ndi tsiku umagawidwa pawiri. The pakati pakati pawo ndi osachepera 12 maola.
Akuluakulu ndi achinyamata amamwa mapiritsi atatu patsiku, koma muyenera kuyamba ndi imodzi ndikuwonjezera pang'onopang'ono.

Nthawi zina ndi ululu waukulu muyenera kutenga mpaka makapisozi 12 patsiku, koma kuyamba kwa chithandizo kumakhala kosasinthika.

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Zomwe zimagwiritsidwa ntchito sizimagwira ndi mapuloteni a plasma ndipo, pambuyo maola 6,7, zimatuluka mkodzo. Odwala omwe ali ndi vuto la urological, kuthetseratu mankhwala kumachedwetsedwa. Afunika chisamaliro chapadera komanso chisamaliro posankha mitundu.

Mapeto azithandizo ali ofanana ndi chiyambi, pang'onopang'ono kwa masabata angapo kapena miyezi. Ndi kukana kwambiri kwa Tebantin ndi mankhwala ena antiepileptic, chiwopsezo chakuti kukokana azidzawonjezeka. Pamodzi ndi iwo akhoza kuwoneka:

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ngati fuluwenza
ochepa matenda oopsa
tachycardia
mutu
thukuta kwambiri
nkhawa
chisokonezo,
kusowa tulo
Photophobia.

Kusintha kulikonse kwa maukadaulo kuyenera kukhala kwamaganizidwe komanso osakwiya.

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Pa nthawi yomwe mayi ali ndi pakati, adokotala amawunika kuchuluka kwa zoopsa ndi phindu la mankhwalawa. Mu nyama zoberekera, mankhwalawa adawonetsa kawopsedwe ake ku njira yolera. Chiwopsezo chomwe chilipo kwa anthu sichinakhazikitsidwe.

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Mu malangizo ogwiritsa ntchito Tebantin 300 mg, zimadziwika kuti chinthucho chili mkaka wa m'mawere, koma sichinaphunzire zotsatira zomwe zingayambitse khanda. Ngati kuli kofunikira kutenga anticonvulsant, kuyamwa kuyenera kusokonezedwa.

Mtengo wa Tebantin

Mitengo sikungotengera kapangidwe kamankhwala, komanso mtundu wa mankhwala. Phukusi la mapiritsi 50 opanga ku Russia mutha kugulira ma ruble 400, ndipo kwa achijeremani muyenera kulipira kawiri.

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Odwala nthawi zina amadandaula za nkhawa zopanda pake, kusowa kwa chidwi, kugona, makamaka kumapeto kwa maphunziro. Awa ndi zizindikiro zakuchoka. Ichi ndi chifukwa chake kupendekera kwapang'onopang'ono kumalimbikitsidwa, ndipo antidepressants amatengedwa atalandira chithandizo. Madokotala nthawi zambiri amalabadira bwino mankhwalawa.

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Malingaliro a Doctor

Tebantin watsegula njira zatsopano pochizira ululu wamitsempha yamagazi ndi zina. Ili ndi zabwino zambiri:

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kulowa kosavuta kudzera mu chotchinga cha magazi,
kusowa kwa mgwirizano ndi mapuloteni amwazi,
chimbudzi,
kupezeka
ogwira kutsimikiziridwa mu machitidwe komanso mayesero azachipatala,
kulekerera kwabwino
kugwiritsa ntchito mosavuta.

Zomwe zimagwiritsidwa ntchito sizikhudza ma enzymes a chiwindi ndi mosemphanitsa. Mankhwalawa ndi chisankho chabwino pochiza odwala okalamba, chifukwa cha mbiri yabwino ya pharmacokinetic komanso chitetezo chachikulu. Zotsatira zoyipa sizitchulidwa pang'ono poyerekeza ndi carbamazepines. Pakatha sabata, wodwalayo amasintha.

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Zachidziwikire, Tebantin siwopanda. Koma zimathandizira opanga kuthana ndi mavuto akuluakulu ngati mankhwala ena alibe mphamvu kapena kuwopseza ndi mndandanda wautali wa contraindication ndi zotsatira zoyipa.

Mlingo ndi makonzedwe

Makapisozi amatengedwa pakamwa, mosasamala kanthu za zakudya, samata, kumeza lonse ndikusambitsidwa ndimadzi okwanira.

Panthawi ya kukomoka pang'ono, kuonetsetsa antiepileptic zotsatira kwa odwala ndi ana opitirira zaka 12, Tebantin ndi mankhwala 900 mg00 mg tsiku. Malangizo othandizira:

Njira A: tsiku loyamba - 300 mg (100 mg katatu patsiku kapena 300 mg kamodzi), tsiku lachiwiri - 600 mg (200 mg katatu patsiku kapena 300 mg kawiri patsiku), tsiku lachitatu - 900 mg (300 mg katatu patsiku), tsiku lachinayi - 1200 mg (400 mg katatu patsiku),
Njira B: tsiku loyamba - 900 mg (300 mg katatu patsiku), pamasiku otsatirawa, mutha kuwonjezera kuchuluka kwa tsiku ndi tsiku mpaka 1200 mg (400 mg katatu patsiku).

Mlingo wapamwamba wa Tebantin wa tsiku ndi tsiku ndi 2400 mg (800 mg katatu patsiku).

Monga mankhwala owonjezera a kuperewera pang'ono, ana a zaka 3 mpaka 12 ndi thupi lolemera kupitilira 17 kg amawonetsedwa 25-25 mg / kg patsiku la thupi patsiku, logawidwa pazigawo zitatu. Mlingo woyambitsa:

ana a zaka 3 mpaka 12 wazakudya zolemera makilogalamu 17-25: tsiku loyamba - 200 mg patsiku kamodzi, tsiku lachiwiri - 200 mg kawiri patsiku, tsiku lachitatu - 200 mg katatu patsiku,
ana a zaka 3 mpaka 12 ndi thupi lolemera kuposa 26 makilogalamu: tsiku loyamba - 300 mg patsiku kamodzi, tsiku lachiwiri - 300 mg kawiri pa tsiku, tsiku lachitatu - 300 mg katatu patsiku.

Kuyambira tsiku lachinayi la mankhwala, mlingo wa tsiku ndi tsiku wa gabapentin utha kuwonjezeredwa mpaka 35 mg / kg patsiku katatu. Malinga ndi kafukufuku wazachipatala, Mlingo wa mankhwalawa pa 40-50 mg / kg patsiku anali wololedwa ndi odwala.

Mlingo wolimbikitsidwa tsiku lililonse kwa ana azaka zitatu mpaka 12, onenepa.

17-25 makilogalamu - 600 mg aliyense
26-25 makilogalamu - 900 mg aliyense
37-50 kg - 1200 mg aliyense
51-72 kg - 1800 mg aliyense.

Kwa ululu wa neuropathic mwa odwala akuluakulu azaka zopitilira 18, mlingo wa Tebantin umakhazikitsidwa ndi titration, poganizira momwe mankhwalawa amathandizira komanso kulolera kwa mankhwalawa. Mlingo wapamwamba wa tsiku ndi tsiku ndi 3600 mg wa tsiku katatu.

Malangizo othandizira:

Njira A: tsiku loyamba - 300 mg (100 mg katatu patsiku kapena 300 mg kamodzi), tsiku lachiwiri - 600 mg (200 mg katatu patsiku kapena 300 mg kawiri patsiku), tsiku lachitatu - 900 mg (300 mg katatu patsiku)
Chiwembu B (cha ululu waukulu): tsiku loyamba - 900 mg (300 mg katatu patsiku), m'masiku 7 otsatira, mutha kuwonjezera mlingo wa tsiku ndi tsiku mpaka 1800 mg tsiku lililonse.

Odwala omwe ali ndi thupi lochepa, ofooka anthu ndi odwala omwe adagwidwa ndi ziwalo, zimawonjezera mlingo pang'onopang'ono, osaposa 100 mg patsiku.

Pakulephera kwa impso (ngati creatinine chilolezo chimakhala chochepera 80 ml / mphindi), anthu okalamba omwe ali ndi kuchepa kwa creatinine chilolezo komanso odwala hemodialysis, mlingo wa Tebantin umasankhidwa payekhapayekha, poganizira kuchuluka kwa vuto la impso.

Kuyanjana kwa mankhwala osokoneza bongo

Mukaphatikiza gabapentin ndi mankhwala ena antiepileptic omwe amachepetsa mphamvu yoletsa kubereka pakamwa, ndizotheka kuchepetsa kapena kuimitsa mphamvu yoletsa kubereka ya mankhwala omwe amagwirizana.

Makapisozi amayenera kumwedwa patatha maola awiri mutatenga maantacid okhala ndi aluminiyamu kapena magnesium, chifukwa akamagwiritsira ntchito nthawi yomweyo, amachepetsa bioavailability wa gabapentin ndi 24%.

Cimetidine pang'ono amachepetsa kuchotsa kwa impso za gabapentin, zomwe sizofunika kwenikweni.

Pogwiritsa ntchito nthawi yomweyo ndi Mowa ndi mankhwala omwe amakhudza dongosolo lamanjenje lamkati, ndizotheka kuwonjezera zovuta za Tebantin kuchokera ku dongosolo lamkati lamanjenje.

Tikaphatikizidwa ndi anticonvulsants ena, pakhala pali zotsatira zabodza zotsimikizira kuti mapuloteni onse mu mkodzo amagwiritsa ntchito mayeso ocheperako (tikulimbikitsidwa kugwiritsa ntchito njira zina).