Trometamol (trometamol)

Fomula C4H11NO3, dzina la mankhwala: 2-amino-2- (hydroxymethyl) -1,3-propanediol.
Gulu lamagulu: metabolites / oyang'anira amadzi-electrolyte bwino ndi acid-base state.
Machitidwe diuretic, kubwezeretsa zamchere boma magazi.

Mankhwala

Trometamol ili ndi malo ogulitsa. Tromethamol ikaperekedwa kudzera mu mtsempha wamagazi imachulukitsa magazi a mchere ndipo amachepetsa zomwe zili ndi haidrojeni, motero amachepetsa acididemia. Trometamol kulowa mkati mwa cell membrane, imathandiza kuthetsa intracellular acidosis, ili ndi osmotic diuretic ndi hypoglycemic. Trometamol amavomereza proton. Trometamol sikuti imachulukitsa kuchuluka kwa kaboni dayokisi m'magazi, mosiyana ndi sodium bicarbonate. Trometamol itha kugwiritsidwa ntchito popuma komanso metabolic acidosis. Trometamol imalimbikitsa diuresis ndipo imapukusidwa kwathunthu ndi impso osasinthika, pambuyo maola 8 75% ya mankhwala atachotsedwa m'thupi. Alkalization wa mkodzo ndi osmodiuretic kanthu amathandizira kuchotsa ofooka acid m'thupi. Trometamol imadutsidwa osasinthika ndipo simalowa m'mimba mwake, kotero, monga osmotic diuretics, imachulukitsa diresis ndipo, ndikusungidwa kosungika kwa glomerular, imachotsedweratu mwachangu. Zotsatira za impso ntchito zingakhale zofunika mu oliguria ndi metabolic acidosis. Pambuyo pakukonzekera pakamwa, samayamwa, imagwira ntchito ngati saline laxative.

Matenda omwe amaphatikizidwa ndi metabolic ndi acidosis wosakanikirana (kuthiridwa magazi kwakukulu, mantha, kutulutsa kwina, peritonitis, kuwotcha, kapamba), matenda ashuga ketoacidosis, panthawi yopatsanso mphamvu ndikutsitsimutsanso nthawi ya acidosis, poyizoni ndi barbiturates, salicylates, salicylates, mowa, pofuna kupewa acidosis poika allopurinol.

Mlingo wa trometamol ndi Mlingo

Trometamol imayendetsedwa pamitseko ya madontho 120 pamphindi, kuwonjezeka kwa chiwongolero sikulimbikitsidwa kupewa kupewa koyipa (makonzedwe achangu amaloledwa pazochitika zapadera (mwachitsanzo, kuti athetse acidosis mu kumangidwa kwamtima). Mlingo wa trometamol umakhazikitsidwa payekhapayekha kutengera mtundu womwe umagwiritsidwa ntchito, kuchuluka kwa thupi la wodwalayo, ndi kuchepa kwa maziko. Mulingo waukulu ndi 1.5 g / kg patsiku. Mobwerezabwereza makonzedwe a trometamol amatha pambuyo masiku awiri mpaka atatu.
Kuyika kwa trometamol m'malo oyipa kungayambitse kukula kwa minofu ya m'thupi.
Pa chithandizo, pamakhala ngozi ya kupuma.
Mwa ana akhanda, kugwiritsa ntchito mankhwalawa kumatheka pokhapokha ngati phindu lomwe limakhalapo lamankhwala likupitirira ngozi zomwe zingatheke.
Pa mankhwala, ndikofunikira kuwongolera kuchuluka kwa shuga, bicarbonate ndi ma electrolyte amwazi, acid-base state, plasma ionogram, kukakamiza pang'ono kwa kaboni dayokisi, ndi kukakamiza diuresis.

Zotsatira zoyipa za trometamol

Zomwe zimachitika: phlebitis, venous spasm, mkwiyo wa mitsempha, hemolysis, thrombophlebitis, necrosis yakomweko.
Matenda a metabolism: hypokalemia, hyponatremia, hypochloremia, hypoglycemia.
Zina: Hypotension, kulephera kupuma, kupuma, kupuma pakati, kupsinjika kwa magonero (kuphatikizapo nseru, kusanza), kufooka kwathunthu.

Kugwirizana kwa trometamol ndi zinthu zina

Trometamol imafooketsa mphamvu ya barbiturates, anticoagulants osalunjika (zotumphukira za coumarin), ma salicylates.
Trometamol imawonjezera zotsatira za ma tridclic antidepressants, narcotic analgesics, chloramphenicol, macrolides (oleandomycin, erythromycin), aminoglycosides.
Ndi kuphatikiza kwa mankhwala a trometamol ndi antidiabetesic, zotsatira za hypoglycemic zitha kupititsidwa patsogolo (kuphatikiza ndi kukula kwa hypoglycemia), motero ndikofunikira kupewa kugwiritsidwa ntchito kapena kuchepetsa mankhwalawa antidiabetes.

Bongo

Ndi mankhwala osokoneza bongo a trometamol, kusintha kosagwirizana kumawonjezera (kufooka kwapafupipafupi, kupanikizika, kupuma kwakanthawi, kupuma, nseru, hypoglycemia, kusanza, kukazinga kwa asidi-msingi komanso kutsikira kwa madzi mu electrolyte. Mankhwala othandizira ndi ofunikira ngati pakufunika kuthandizira mpweya wabwino. Palibe mankhwala enieni.

Pharmacology

Ndi IV makonzedwe, amachepetsa kuchuluka kwa ma hydrogen ion ndikuwonjezera magazi amchere, potero amachotsa acididemia, amalowa m'matumbo ndipo amathandizira kuthetsa intracellular acidosis, amachotsedwa kwathunthu ndi impso osasinthika ndikuwonjezera diuresis. Ikaperekedwa, imagwira ntchito ngati mchere wa saline.

Kutulutsa mafomu ndi kapangidwe kake

Mlingo wa mankhwalawa ndi njira yothetsera kulowetsedwa. M'mawonekedwe ake ndimadzimadzi omveka bwino, opanda khungu lopanda ma cell achilendo. Palibe fungo lililonse. Zomwe zili mu fomu ya mlingo zimaphatikizira zogwira ntchito ndi zina zowonjezera. Zothandizira zothandizira zimakhala ngati zokhazikika, zimasunga mphamvu zonse zachilengedwe za zinthu zomwe zimagwira.

Kwa 1 lita imodzi ya mawonekedwe:

• zosaposa 36,5 g za tromethamol fosfomycin,
• 0,37 g wa potaziyamu mankhwala ena,
• osapitirira 1.75 g wa sodium hydrochloride.

Zomwe zili pamwambazi ndizofunikira. Othandizira ndi:

• acetic acid (osapitirira 99%),
• madzi oyeretsedwa.

Fomu ya mulingo imathiridwa mumtsuko (1 l) wagalasi wowonekera. Pamwamba pa botolo mumasindikizidwa modabwitsa ndi cholembera cha mphira ndi zojambulazo.

Acid-base bwino komanso alkalization | Momwe mungapangire thupi

Momwe mungadziwire mwachangu kuchuluka kwa kuphwanya kwa pH kunyumba?

Kuyesa kosavuta kwa kudziwa acid-base moyenera pogwiritsa ntchito kupuma

Zotsatira za pharmacological

Mankhwala omwe amaphatikizidwa ndi achire othandizira amachepetsa mphamvu ya zamchere pochepetsa ma ayoni a hydrogen. Zinthu zomwe zimagwira, zomwe ndi gawo la mankhwalawa, ndizovomereza proton. Pamene ayoni a sodium amaloledwa kulowa mthupi, hydrocarbonate imachira, zomwe zimapangitsa kukakamira kwa kaboni kaboni pa kupuma acidosis.

Acid-base balance imakhazikitsidwa chifukwa cha kukhoza kwa mankhwalawa kuti azitha kusokoneza acidity ndi pH.

Pankhaniyi, zinthu zomwe zimapangitsa kuti ma oxidation a asidi achilengedwe azichoka mofulumira.

Pharmacokinetics

Ndi kulowetsedwa, mankhwalawo amalowa mwachindunji m'magazi, omwe amawanyamula kudzera minofu yofewa. Kwambiri achire zotsatira zimatheka pambuyo 1.5-2 mawola mtsempha wa magazi makonzedwe. Mankhwalawa amasiya thupi osasinthika ndi mkodzo. Ngati wodwala akuvutika ndi kutuluka kwa mkodzo, tikulimbikitsidwa kuti tichotse mankhwalawa pogwiritsa ntchito mankhwala okakamiza. Kuchotsa theka moyo kumatenga maola 6-8.

Zizindikiro zogwiritsidwa ntchito

Zizindikiro zazikuluzomwe zimagwiritsidwa ntchito ndi kupuma komanso metabolic acidosis. Malinga ndi malangizo, mankhwalawa amatha kuchitika ndi ma pathologies monga:

• kutentha kwa digiri ya 3-4,
• postpartum acidosis,
• mankhwala acidosis,
• poyizoni ndi salicylates, mowa wa methyl ndi barbiturates,
• cell acidosis, yomwe imayambira maziko a hypoglycemia,
• dziko lodzidzimutsa
• matenda edema,
• edema yam'mapapo mwanga,
• Kulephera kwaimpso pambuyo pa opaleshoni.

Awa ndi mankhwala a zovuta zingapo, zomwe zimagwiritsidwa ntchito mu mafupa, mitsempha, opaleshoni ya msana, chithandizo cha khansa kwa ana ndi akulu, kuphatikizapo opareshoni kuti asunge ziwalo zamkati mu oncology. Kuphatikiza pakubwezeretsanso acid-base usawa, mankhwalawa amakhazikika ku CBS.

Contraindication

Ndi zotsutsana kwathunthu zotchulidwa mu zosindikiza, kugwiritsa ntchito mankhwalawa ndikosavomerezeka. Izi zikuphatikiza:

• zaka zaana (mpaka miyezi 12),
• Hypersensitivity
• ma alkaloses,
• kugwedezeka (gawo lamafuta),
• emphysema
• hypokalemia
• kutopa kwambiri
• hyponatremia.

Ngati wodwala walephera kwambiri aimpso, kugwiritsa ntchito koletsedwa.

Momwe mungatengere trometamol

Mtundu wa dosage umakhudzanso kukhuthala kwakanthawi kwamphindi 60. Ngati pazifukwa zaumoyo pakufunika kubwereza pafupipafupi, ndiye kuti mlingo uyenera kuchepetsedwa. Mankhwala othandizira amatsimikiziridwa payekhapayekha, kutengera kuchuluka kwa matendawo.

Rimage regimen imawerengeredwa potengera thupi la wodwala. Mankhwala othandizira tsiku lililonse sayenera kupitirira 36 g / kg, omwe ndi ofanana ndi 1000 ml. Muyeso wa tsiku ndi tsiku wa ana osakwana zaka 12 sayenera kupitirira 20-30 ml.

Ndi matenda ashuga

Mulingo waukulu tsiku lililonse kwa odwala matenda ashuga sayenera kupitilira 10-15 g pa 10 makilogalamu. Mlingo wapamwamba umafunika kuwonjezera sodium chloride. Ndi chiopsezo chowonjezereka cha hypoglycemic chikomokere, insulin ndi dextrose monga njira yothetsera vutoli ziyenera kuperekedwa nthawi yomweyo ndi mankhwalawo.

Zotsatira zoyipa za trometamol

Nthawi zambiri, mankhwalawa amaloledwa ndi odwala. Zotsatira zoyipa zimakhudzana ndi maziko a mankhwalawa osankhidwa molakwika:

• mkwiyo wamakoma amitsempha yamagazi
• kupanikizika
• kubwezera
• thrombophlebitis pa jekeseni malo,
• Kutsitsa pang'ono pang'ono
• kuchuluka kwa pH
• hypochremia,
• hyponatremia.

Pakulephera kwa impso, potaziyamu amakakamizidwa kunja kwa maselo mwachangu.

Zokhudza mphamvu pakuwongolera njira

Kugwiritsira ntchito mankhwalawa panthawi yakukonzanso pambuyo pochita opaleshoni komanso kuchitapo kanthu kochepa kwa opaleshoni kungayambitse kuthamanga kwa zochitika zama psychomotor. Sikulimbikitsidwa kuyendetsa magalimoto munthawi yogwiritsira ntchito mankhwalawa.

Malangizo apadera

Mankhwala sayenera kugwera m'malo oyipa. Pankhaniyi, chiwopsezo cha kukulitsa minofu necrosis chikukula. Ngati atagwiritsidwa ntchito molakwika, wodwalayo amatha kupsinjika. Kuwona kuchuluka kwa glucose ndikofunikira, ma ioni a seramu amayenera kuchitidwa pafupipafupi. Mankhwala, kuchuluka kwa bicarbonate kumatha kuchuluka.

Ngati wodwala ali ndi vuto la diuretic, ndikofunikira kuchititsa kukakamiza okakamiza.

Kukhazikitsidwa mwachangu kwa mankhwalawa kumawonjezera chiopsezo cha pathologies kuchokera ku hematopoietic system.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo ndi antidiabetesic kumawonjezera chiopsezo cha hypoglycemia. Sikulimbikitsidwa kusakaniza yankho mu chidebe chimodzi ndi mankhwala ena. Pakusakanikirana mokakamizidwa, ndikofunikira kulabadira mtundu wa yankho: ngati madziwo akhala amtambo kapena ofunda akuwonekera, amaletsedwa kulowa wodwalayo.

Mankhwalawa amatha kupititsa patsogolo ntchito zama mankhwala angapo, kuphatikizapo narcotic analgesics, aminoglycosides, maantibayotiki (Biseptrim, Monural), chloramphenicol, NSAIDs (Dexketoprofen), antidepressants atatu.

Njira yothetsera kulowetsedwa limodzi ndi ma anticoagulants osakanikirana (ma coumarin ofanana nawo) ma salicylates ndi barbiturates amatha kuchepetsa ntchito yotsiriza.

Kuyenderana ndi mowa

The yogwira zinthu mu kipimo mawonekedwe amatha kupititsa patsogolo ntchito za Mowa, potero zimapangitsa kukula kwa kuledzera kwamphamvu m'thupi. Munthawi yogwiritsira ntchito, ndikofunikira kuti musamwe zakumwa zoledzeretsa.

Mankhwalawa ali ndi analogue ya 1 yokhala ndi mitundu yambiri. Zotsalira zonse zili ndi njira yofananira yothandizirana ndi zoyambirira ndipo zimatha kukhala zosiyanasiyana. Zofananira zamankhwala:

Ma analogu ndi mapangidwe a zoyeserera ali ndi zotsutsana, pamaso pake momwe ntchito sizingatheke.

Kodi ndingagule popanda kulandira mankhwala?

M'mayiko ena ogulitsa pa intaneti, mutha kugula mankhwala osagwiritsa ntchito mankhwala. Pankhaniyi, ziyenera kukumbukiridwa kuti chiyambi cha mankhwala omwe adagulidwa pa intaneti sichitsimikiziridwa ndi chilichonse.

Chenjezo la trometamol ya mankhwala

Kuwunika zomwe zili ndi shuga ndi ma electrolyte amwazi, KShchS ndiyokakamiza.

Trometamol N - mankhwala opangidwa kuti akonze acidosis. Wothandizirayo amagwiritsidwa ntchito mwaukazitape, ndiko kuti, wothandizidwa pakhungu. Ndidzawunikiranso owerenga malangizo a "Popular About Health" omwe amapangira mankhwala awa.

Chifukwa chake, malangizo a trometamol N:

Kodi mawonekedwe a trometamol N ndi mawonekedwe omasulidwa ndi chiyani ?

Mankhwala Trometamol N amapezeka mu yankho lomveka bwino la kulowetsedwa, madzi amtundu, osanunkhira bwino, sayenera kukhala ndi tizinthu tochita kupanga. Zinthu zomwe zimagwiritsidwa ntchito mankhwalawa ndi: trometamol, potaziyamu calcium, sodium chloride. Mu kapangidwe ka trometamol N, pakati pazinthu zothandizira, kupezeka kwa glacial acetic acid kumatha kudziwika, komanso madzi a jekeseni.

Mankhwalawa amasindikizidwa 500 milliliters m'mabotolo agalasi, omwe amawaika m'makatoni. Mankhwala azitsamba azichotsedwa m'malo amdima. Moyo wa alumali ndi zaka ziwiri, kenako yankho lake liyenera kutayidwa. Mankhwala amagulitsidwa ku dipatimenti yolemba mankhwala.

Kodi trometamol H chochita ndi chiyani ?

Kuchita kwa trometamol N kumathandiza kuchepetsa kuchuluka kwa haidrojeni mthupi. Zomwe zimagwiritsidwa ntchito ndizomwe zimatchedwa zovomereza za proton. Mankhwala othandiza a metabolic ndi kupuma acidosis. Mankhwala amuchotsetsa impso ndi 75 peresenti.

Kodi zikuwonetsa chiyani kuti trometamol H ?

Mu umboni wa trometamol N, matanthauzidwe ake amatanthauza kugwiritsidwa ntchito kwa metabolic ndi kupuma acidosis, komwe kumachitika kwambiri:

Gwedeza dziko
Postpartum acidosis,
Zowopsa
Ndi matenda otupa
Kupezeka kwa kuikidwa acidosis chifukwa chothiridwa magazi nthawi yayitali,
Kukula kwa cell acidosis kumbuyo kwa matenda a hyperglycemic chikomokere,
Mukamagwiritsa ntchito njira zomwe zimatchedwa extracorporeal circulation,
Pulmonary edema woopsa komanso wankhanza,
Kupha poizoni ndi methyl mowa, kuphatikiza apo, barbiturates kapena salicylates.

Kuphatikiza apo, mankhwalawa Trometamol N amagwira ntchito bwino pakukula kwa a postoperative aimpso.

Kodi zotsutsana ndi trometamol H ndi ziti? ?

Mu contraindication, trometamol N, malangizo ake ogwiritsira ntchito amaphatikizapo zoletsa izi:

Musagwiritse ntchito yankho la chaka chimodzi,
Ndi hypersensitivity pazigawo zama mankhwala,
Ndi hyponatremia,
Osakupatsani mankhwala a alkalosis,
Ndi hypokalemia,
Kulephera kuwongolera komwe kumatchedwa kulipidwa, makamaka, ndi emphysema,
Ndi kuchepa mphamvu kwa thupi,
Gawo lotsirizira ladzidzidzi.

Mosamala, mankhwalawa amagwiritsidwa ntchito pakuwonjezera impso kapena kwa chiwindi.

Kodi kugwiritsidwa ntchito ndi Mlingo wa trometamol H ndi chiyani? ?

Kugwiritsa ntchito kwa trometamol N kumapangidwira kulowetsedwa kosalekeza, komwe kumachitika kwa ola limodzi. Ngati mukufuna kugwiritsa ntchito mankhwalawa tsiku lotsatira, mulingo woyenera umachepetsedwa. Dokotala amakhazikitsa mlingo kutengera kuopsa kwa acidosis.

Pokhapokha ngati tinafotokozeredwe mwanjira ina, nthawi zambiri muyezo wa trometamol N umasiyana kuchokera pa 5 mpaka 10 mamililita a trometamol N pa kilogalamu ya thupi / ola limodzi, lomwe lofanana ndi 500 ml / h. Pankhaniyi, tsiku lililonse mlingo waukulu sayenera kupitirira 1.5 g / kg. Ngati pali vuto lojowina hypoglycemia, ndiye kuti insulini yokhala ndi dextrose solution iyenera kuperekedwa.

Zotsatira zoyipa za trometamol H ?

Mwachilengedwe, mankhwala a trometamol N amaloledwa bwino ndi odwala. Ngati kulowetsedwa kwa mankhwalawa kumachitika mwachangu mokwanira, izi zimatha kuyambitsa kukwiya kwa ma venous malinga, hemolysis siyimasankhidwa, kuphatikiza, kuthamanga kwa magazi kumachepa, kukulitsa kwa venospasm ndi hypokalemia kuli ndi chikhalidwe, komanso kukulitsa kwa thrombophlebitis, chifukwa cha kukhumudwa kwa minofu yam'deralo, sichimaphatikizidwa.

Ndi kuchepa msanga kwa kukakamira pang'ono kwa kaboni dayokisaidi komanso kuwonjezeka kwa phindu la pH, kupuma kwamphamvu kumatha kupezeka. Ndi kuwonjezeka kwa diuresis, motsutsana ndi kukhazikitsidwa kwa mankhwala, wodwalayo amatha kukhala ndi hyponatremia, komanso hypochloremia. Ndi chitukuko cha zotsatira zoyipa za trometamol N, wodwalayo ayenera kupita ku chithandizo chamankhwala.

Trometamol N - bongo

Zizindikiro zakuchulukirapo kwa trometamol N: kufooka kwapafupipafupi, kuchepa kwamankhwala kumadziwika, kupuma kumalembedwa, hypoglycemia imatsimikiziridwa mu labotale, kuphwanya malire a madzi-electrolyte ndi chikhalidwe, kuphatikiza, mulingo wa acid-base ungasinthe. Mankhwalawa kulibe. Wodwalayo adapangidwa kuti azigwiritsa ntchito mitundu yambiri ya chizindikiro. Ngati vutolo likufuna, ndiye kuti mupatseni mpweya wabwino.

The ingress ya mankhwala Tromethamol N mu malo omwe amatchedwa paravenous angayambitse minofu ya m'deralo necrosis, motere, jekeseni wa mankhwalawa amayenera kuchitika mosamala. Kuphatikiza apo, pofuna kupewa kukulitsa zotsatira zoyipa, ndikofunikira kuyambitsa mankhwalawa pang'onopang'ono. Kuwongolera mwachangu ndikotheka kokha ndi acidosis, pomwe kumangidwa kwamtima kwachitika.

Musanagwiritse ntchito mankhwala a Tromethamol H, muyenera kuonetsetsa kuti palibe njira iliyonse yothetsera vutoli, kuwonjezera, kukhulupirika kwa vial sikuyenera kusokonezedwa. Pokonzekera kugwiritsa ntchito mankhwalawa, ndikofunikira kuwunika kuchuluka kwa glucose m'magazi, komanso kudziwa kuchuluka kwa ma bicarbonates, ndipo zomwe zimatchedwa kukakamizidwa diuresis ziyeneranso kuchitika.

Momwe mungasinthire trometamol N, ndizofananira za mankhwalawa ?

Mankhwala trometamol amatanthauza analogues wa trometamol N.

Dzina la malonda: Trometamol N

Fomu ya Mlingo:

Kupanga pa 1 lita imodzi yankho
Zinthu zogwira ntchito:
trometamol - 36.30 g,
potaziyamu mankhwala enaake - 0,37 g,
sodium mankhwala enaake - 1,75 g.
Othandizira: acetic acid 99%, madzi a jakisoni.
K + - 5 Mm / L, Na + - 30 mM / L, C1 - - 35 mM / L.
Ziphunzitso za osmolarity: 470 mOsmol / l.

Kufotokozera: madzi owoneka bwino, opanda utoto kapena wopanda khungu, wopanda tinthu tina, wopanda fungo lamadzi.

Gulu la Pharmacotherapeutic:

Code ya ATX: B05BB03.

Mankhwala
Cholinga cha mankhwala omwe ali ndi trometamol N ndikuchepetsa kuchuluka kwa ma hydrogen ions pobweretsa mankhwala omwe amatsatira H +.

Tromethamol, yomwe ndi gawo la Tromethamol H, amavomereza proton: Tromethamol H 2 С0 3 Tromethamol-Н + + Ні0 3 -

Kugwiritsa ntchito kwa mfundo zakuchizira kwa trometamol kukuwonetsedwa, choyambirira, ngati kukhazikitsidwa kwa Na + ions komwe kumakhudzana ndi kubweranso kwa bicarbonate sikofunikira kwa electrolyte usawa, komanso kupuma acidosis, komwe kuyambitsa kwa bicarbonate kumakulitsanso kupanikizika kwa kaboni.

1 M trometamol imathandizira 1 M H 2 C0 3 ndipo imapatsa thupi 1 m bicarbonate. Chifukwa cha izi, kupanikizika pang'ono kwa kaboni ndi mpweya wambiri wa hydrogen ions kumachepetsedwa osakhudzana ndi mapapo. Chifukwa chake, trometamol ikhoza kugwiritsidwa ntchito popuma komanso metabolic acidosis.

Pharmacokinetics Tromethamol ndi trometamol-N + zimakhudzidwa ndi impso zosasinthika, pambuyo pa maola 8, 75% amachotsedwa m'thupi. Trometamol imadutsidwa osasinthika ndipo simalowa m'matumbo, chifukwa chake, monga osmotic diuretics, imachulukitsa diuresis ndipo, mwa kusefa kwakukhazikika, imatsitsidwa mwachangu. Zotsatira za impso ntchito monga njira ina yowonjezera ya trometamol ingakhale yofunikira mu metabolic acidosis ndi oliguria.

Zizindikiro zogwiritsidwa ntchito
Mitundu yayikulu ya metabolic ndi kupuma acidosis:

• postpartum acidosis,
• kuikidwa acidosis chifukwa chothiridwa magazi nthawi yayitali,
• cell acidosis yokhala ndi kukomoka kwa hyperglycemic,
• kuyaka kwambiri
• kugwiritsa ntchito njira zina zozungulira pochita opaleshoni yamtima,
• matenda edema,
• mitundu yoopsa ya edema yam'mapapo mwanga,
• ntchito a postoperative aimpso kulephera,
• poyizoni ndi barbiturates, salicylates ndi mowa wa methyl.

• Hypersensitivity pamagawo a mankhwala,
• ma alkaloses,
• kulephera kwambiri kwaimpso
• aakulu kulipidwa kupuma kulephera (emphysema)
• kugwedezeka m'masiku otsiriza,
• kutopa kwambiri
• hypokalemia
• hyponatremia,
• ana osakwana chaka chimodzi.

Chenjezo: Kuchepa kwapakati ndi / kapena chiwindi.

Mimba komanso kuyamwa
Kugwiritsa ntchito mankhwalawa panthawi yapakati komanso mkaka wa m'mawere kumatheka pokhapokha ngati phindu lomwe limaperekedwa kwa mayi likupereka chiwopsezo kwa mwana wosabadwayo kapena mwana.

Mlingo ndi makonzedwe
Mankhwalawa amapangidwira kukonzekera kwa mtsempha wa mankhwalawa kwa kulowetsedwa kwa nthawi yayitali. Ngati ndi kotheka, kuyambitsa pa tsiku lachiwiri komanso lotsatira, mlingo uyenera kuchepetsedwa.

Mlingowo umatsimikizika molingana ndi kuopsa kwa acidosis yomwe ilipo. Mogwirizana ndi kuchuluka kwa trometamol N yomwe imafunikira kulowetsedwa ndizofanana ndi kuchuluka kwa kuchuluka kwa kuchuluka koonjezera (BE) ndi kulemera kwa thupi, pokhapokha ngati tanena izi: 1 ml ya trometamol H = BE (mM / L) x kg body x x 2 (zokwanira 2 chifukwa kuchepa kwa mphamvu ya buffer mutatha kuwonjezera 100 mm acetate / l).

Kubera khungu
Ngati luso la momwe mungadziwiritsire ziwonetsero za asidi-m'magazi a magazi mulibe, ndiye kuti, ngati pali zisonyezo zamatenda, kubisala kwa khungu ndi Tromethamol N. kungachitike. 500 ml / h Mlingo wa tsiku ndi tsiku ndi -1000 (-2000) ml. Mlingo wa tsiku lililonse wa ana kuyambira chaka chimodzi ndi 10-20 ml ya trometamol N / kg thupi.

Mlingo wapamwamba ndi 1.5 g / kg / tsiku. Mukamagwiritsa ntchito Mlingo wambiri, ndikulimbikitsidwa (kupewa kuchepa kwa kuchuluka kwa ma elekitirodi m'magazi) kuwonjezera NaCl pamlingo wa 1 75 g ndi KC1 pamlingo wa 0,372 g pa 1 lita imodzi ya 3.66% yankho. Ngati pali chiopsezo cha hypoglycemia, tikulimbikitsidwa kupereka nthawi yomweyo 5-10 / o yankho la dextrose ndi insulin (kutengera 1 unit ya insulin pa 4 g ya dextrose youma).

Zotsatira zoyipa
Nthawi zambiri trometamol N imalekerera bwino. Ngati kuchuluka kwa kulowetsedwa ndikokwera kwambiri, zotsatirazi zitha kuchitika: kukwiya kwa makoma a mitsempha ndi hemolysis, mwina kuchepa kwa kuthamanga kwa magazi, hypokalemia, venospasm. Chifukwa cha kupsinjika kwa minofu, thrombophlebitis imatha kupezeka pamalo a jakisoni.

Kutsika msanga kwa kukakamira pang'ono kwa kaboni dayokisaidi komanso kuwonjezereka kwa pH kungayambitse kupsinjika. Pamenepa, ndi kupuma kwa acidosis, jakisoni wa trometamol H amalimbikitsidwa pokhapokha ngati angathe kutulutsa mpweya wam'mapapo. Chifukwa chakuwonjezeka kwa kutulutsa insulini ndikugwiritsa ntchito kwambiri shuga, hypoglycemia imatha kupezeka paliponse.

Chifukwa cha kuchuluka kwa diuresis, hyponatremia ndi hypochloremia zimatha kuchitika. Chifukwa cha hyperkalemia, yomwe imayamba chifukwa chakuthamangitsidwa kwa ma potaziyamu (makamaka, ndi kulephera kwa aimpso), komanso chifukwa cha kuchepa kwa potaziyamu, ngati kuli koyenera, kuwunika kwa potaziyamu mu seramu yamagazi ndikofunikira (onani malangizo apadera).

Bongo
Zizindikiro kufooka wamba, ochepa hypotension, kupuma, Hypoglycemia, mkhutu wamadzi-electrolyte bwino komanso acid-base balance.
Chithandizo: palibe mankhwala enieni. Kuchita chisonyezo chothandizira, ngati kuli kotheka, mpweya wabwino.

Kuchita ndi mankhwala ena
Pogwiritsa ntchito munthawi yomweyo mankhwala a trometamol H ndi mankhwala opatsirana, mungathe kuwonjezeka kwa vuto la hypoglycemic (chiwopsezo cha hypoglycemia), chifukwa chake, kugwiritsa ntchito nthawi yomweyo kapena kuchepetsa mankhwalawa okhudzana ndi mankhwala antidiabetes.

Mukasakaniza mu chidebe chomwecho ndi mankhwala ena, ziyenera kukumbukiridwa kuti mtengo wa pH wa yankho la trometamol H ndi 8.1-8.7, zomwe zingapangitse kuti pakhale kupendekera kosakanikirana.

Ngati turbidity kapena opalescence amawonekera posakanikirana trometamol N mu chiwiya chimodzi ndi zothetsera zina zoyimira makolo, ndiye kuti kuphatikiza koteroko sikungagwiritsidwe ntchito.

Mphamvu ya narcotic analgesics, aminoglycosides, macrolides (erythromycin, oleandomycin), chloramphenicol, tridclic antidepressants imatheka. Mphamvu ya yosalunjika anticoagulants (coumarin derivatives), barbiturates, salicylates pogwiritsa ntchito munthawi yomweyo trometamol N. imafooka.

Malangizo apadera
Ngati mankhwalawa alowa m'malo osokoneza thupi, amatha kutsogolera kukula kwa minofu ya m'thupi. Pali chiwopsezo cha chizolowezi cha kupuma (onani. Zoyipa).

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuthana ndi shuga wamagazi (chiwopsezo cha hypoglycemia), ma seramu ionograms, ndende ya bicarbonate, kupanikizika kwa kaboni kaboni ndi asidi-base base, komanso kukakamiza diuresis. Kugwiritsa ntchito mankhwalawa kwa akhanda kungatheke pokhapokha ngati phindu lomwe likukonzekera lipitilira chiopsezo.

Pofuna kupewa kukula kwa zoyipa, trometamol sayenera kutumizidwa pamlingo waukulu. Kuwongolera mwachangu (mpaka 60 ml / min) kumaloledwa pamilandu yapadera (mwachitsanzo, kuthetsa acidosis pa nthawi yomangidwa kwamtima).

Kutulutsa Fomu
Njira yothetsera kulowetsedwa. 500 ml iliyonse yamtundu wa I mabotolo agalasi owonekera (Hebr. F.), otsekedwa ndi mtundu I brkidutyl rabara Stopper (Heb. F.) kupyoza ndi kapu ya pulasitiki pansi pa aluminium-yomwe mumakhala ndi pulasitiki yonyamula botolo.
Mbale 10 pabokosi lamakhadi okhala ndi malangizo ogwiritsira ntchito (zipatala).

Malo osungira
Pamalo amdima pakutentha kosaposa 25 ° C. Pewani mankhwalawo patali ndi ana!

Tsiku lotha ntchito
Zaka 2
Osagwiritsa ntchito tsiku lanu litatha lomwe lasonyezedwa phukusi: Gwiritsani ntchito mayankho omveka bwino mu mbale zabwino!

Terms a Tchuthi cha Pharmacy
Ndi mankhwala.

Kampani yopanga
Berlin-Chemie AG Menarini Gulu Glienicker Veg 125 12489
Berlin Germany

Adilesi ya Oimira Office ku Russia
115162 Moscow, st. Shabolovka, nyumba 31, tsamba B

The analogues ya mankhwala trometamol n amaperekedwa, malinga ndi terminology yachipatala, yotchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira momwe zimakhudzira thupi. Mukamasankha mawu ofananitsa, osangoganizira mtengo wawo, komanso dziko lakapangidwe ndi mbiri ya wopanga.

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi ma syonyms a trometamol H, omwe ali ndi mawonekedwe ofanana, kotero mutha kusankha nokha m'malo mwake, mukuganizira mawonekedwe ndi mankhwalawa omwe mankhwalawo adauzidwa ndi dokotala. Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mu / mu, mawonekedwe a yankho la 3.66%, pafupifupi muyezo wa yankho la wodwala wokhala ndi thupi lolemera 60 kg ndi 500 ml / h (pafupifupi madontho 120 / mphindi). Mlingowo umawerengeredwa ndi njira: K = B x E, pomwe K ndi kuchuluka kwa yankho la trometamol (ml), B ndiye chosowa (mmol / l), E ndiye kulemera kwa thupi la wodwala (kg). Mlingo wapamwamba ndi 1.5 g / kg / tsiku. Mutha kubwezeretsanso osapitirira 48-72 maola atadutsa kale jekeseni, ngati kuli koyenera, kukhazikitsa tsiku loyambirira kumachepetsa mlingo. Mukamagwiritsa ntchito mlingo waukulu, ndikulimbikitsidwa (kupewa kuchepa kwa kuchuluka kwa ma elekitirodi m'magazi) kuwonjezera NaCl pamlingo wa 1.75 g ndi KCl pamlingo wa 0.372 g pa 1 lita imodzi ya 3.66% yankho. Ngati pali chiopsezo cha hypoglycemia, tikulimbikitsidwa kupereka nthawi yomweyo 5-10% yankho la dextrose ndi insulin (kutengera 1 unit ya insulin pa 4 g ya dextrose youma).

Mafunso, mayankho, ndemanga pa mankhwala Tromethamol N

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.

Tsiku lotha ntchito

Choyimira chokha

Pharmacological gulu la zinthu trometamol

Gulu la Nosological (ICD-10)

Makhalidwe a chinthu trometamol

White makristalo ufa. Sungunuka mosavuta m'madzi. Yankho lamadzimadzi limakhala ndi zamchere.

Pharmacology

Ndi IV makonzedwe, amachepetsa kuchuluka kwa ma hydrogen ion ndikuwonjezera magazi amchere, potero amachotsa acididemia, amalowa m'matumbo ndipo amathandizira kuthetsa intracellular acidosis, amachotsedwa kwathunthu ndi impso osasinthika ndikuwonjezera diuresis. Ikaperekedwa, imagwira ntchito ngati mchere wa saline.

Kugwiritsa ntchito mankhwala trometamol

Matenda omwe amaperekedwa ndi metabolic acidosis, kuphatikizapo matenda ashuga ketoacidosis, poyizoni ndi salicylates, barbiturates, methyl mowa, poika allopurinol (kupewa acidosis).

Contraindication

Hypersensitivity, kwambiri aimpso kulephera.

Zoletsa ntchito

Kulephera kwapakati komanso / kapena chiwindi, kulephera kupuma.

Zotsatira zoyipa za trometamol ya zinthu

Kulephera kwa kupumira, hypotension, kusokonekera kwa mitsempha, hypoglycemia.

Kuchita

Zimawonjezera zotsatira za narcotic analgesics, aminoglycosides, macrolides (erythromycin, oleandomycin), chloramphenicol, antidepressants ofooka, amachepetsa ma anticoagulants (coumarin ochokera kwa ena), barbiturates, salicylates.

Bongo

Amadziwika ndi zotsatira zoyipa (kupuma kwapafupipafupi, hypotension, nseru, kusanza, hypoglycemia). Mankhwalawa ndi chizindikiro.

Njira zoyendetsera

Chenjezo la trometamol ya mankhwala

Kuwunika zomwe zili ndi shuga ndi ma electrolyte amwazi, KShchS ndiyokakamiza.

Trometamol N - mankhwala opangidwa kuti akonze acidosis. Wothandizirayo amagwiritsidwa ntchito mwaukazitape, ndiko kuti, wothandizidwa pakhungu. Ndidzawunikiranso owerenga malangizo a "Popular About Health" omwe amapangira mankhwala awa.

Chifukwa chake, malangizo a trometamol N:

Kodi mawonekedwe a trometamol N ndi mawonekedwe omasulidwa ndi chiyani ?

Mankhwala Trometamol N amapezeka mu yankho lomveka bwino la kulowetsedwa, madzi amtundu, osanunkhira bwino, sayenera kukhala ndi tizinthu tochita kupanga. Zinthu zomwe zimagwiritsidwa ntchito mankhwalawa ndi: trometamol, potaziyamu calcium, sodium chloride. Mu kapangidwe ka trometamol N, pakati pazinthu zothandizira, kupezeka kwa glacial acetic acid kumatha kudziwika, komanso madzi a jekeseni.

Mankhwalawa amasindikizidwa 500 milliliters m'mabotolo agalasi, omwe amawaika m'makatoni. Mankhwala azitsamba azichotsedwa m'malo amdima. Moyo wa alumali ndi zaka ziwiri, kenako yankho lake liyenera kutayidwa. Mankhwala amagulitsidwa ku dipatimenti yolemba mankhwala.

Kodi trometamol H chochita ndi chiyani ?

Kuchita kwa trometamol N kumathandiza kuchepetsa kuchuluka kwa haidrojeni mthupi. Zomwe zimagwiritsidwa ntchito ndizomwe zimatchedwa zovomereza za proton. Mankhwala othandiza a metabolic ndi kupuma acidosis. Mankhwala amuchotsetsa impso ndi 75 peresenti.

Kodi zikuwonetsa chiyani kuti trometamol H ?

Mu umboni wa trometamol N, matanthauzidwe ake amatanthauza kugwiritsidwa ntchito kwa metabolic ndi kupuma acidosis, komwe kumachitika kwambiri:

Gwedeza dziko
Postpartum acidosis,
Zowopsa
Ndi matenda otupa
Kupezeka kwa kuikidwa acidosis chifukwa chothiridwa magazi nthawi yayitali,
Kukula kwa cell acidosis kumbuyo kwa matenda a hyperglycemic chikomokere,
Mukamagwiritsa ntchito njira zomwe zimatchedwa extracorporeal circulation,
Pulmonary edema woopsa komanso wankhanza,
Kupha poizoni ndi methyl mowa, kuphatikiza apo, barbiturates kapena salicylates.

Kuphatikiza apo, mankhwalawa Trometamol N amagwira ntchito bwino pakukula kwa a postoperative aimpso.

Kodi zotsutsana ndi trometamol H ndi ziti? ?

Mu contraindication, trometamol N, malangizo ake ogwiritsira ntchito amaphatikizapo zoletsa izi:

Musagwiritse ntchito yankho la chaka chimodzi,
Ndi hypersensitivity pazigawo zama mankhwala,
Ndi hyponatremia,
Osakupatsani mankhwala a alkalosis,
Ndi hypokalemia,
Kulephera kuwongolera komwe kumatchedwa kulipidwa, makamaka, ndi emphysema,
Ndi kuchepa mphamvu kwa thupi,
Gawo lotsirizira ladzidzidzi.

Mosamala, mankhwalawa amagwiritsidwa ntchito pakuwonjezera impso kapena kwa chiwindi.

Kodi kugwiritsidwa ntchito ndi Mlingo wa trometamol H ndi chiyani? ?

Kugwiritsa ntchito kwa trometamol N kumapangidwira kulowetsedwa kosalekeza, komwe kumachitika kwa ola limodzi. Ngati mukufuna kugwiritsa ntchito mankhwalawa tsiku lotsatira, mulingo woyenera umachepetsedwa. Dokotala amakhazikitsa mlingo kutengera kuopsa kwa acidosis.

Pokhapokha ngati tinafotokozeredwe mwanjira ina, nthawi zambiri muyezo wa trometamol N umasiyana kuchokera pa 5 mpaka 10 mamililita a trometamol N pa kilogalamu ya thupi / ola limodzi, lomwe lofanana ndi 500 ml / h. Pankhaniyi, tsiku lililonse mlingo waukulu sayenera kupitirira 1.5 g / kg. Ngati pali vuto lojowina hypoglycemia, ndiye kuti insulini yokhala ndi dextrose solution iyenera kuperekedwa.

Zotsatira zoyipa za trometamol H ?

Mwachilengedwe, mankhwala a trometamol N amaloledwa bwino ndi odwala. Ngati kulowetsedwa kwa mankhwalawa kumachitika mwachangu mokwanira, izi zimatha kuyambitsa kukwiya kwa ma venous malinga, hemolysis siyimasankhidwa, kuphatikiza, kuthamanga kwa magazi kumachepa, kukulitsa kwa venospasm ndi hypokalemia kuli ndi chikhalidwe, komanso kukulitsa kwa thrombophlebitis, chifukwa cha kukhumudwa kwa minofu yam'deralo, sichimaphatikizidwa.

Ndi kuchepa msanga kwa kukakamira pang'ono kwa kaboni dayokisaidi komanso kuwonjezeka kwa phindu la pH, kupuma kwamphamvu kumatha kupezeka. Ndi kuwonjezeka kwa diuresis, motsutsana ndi kukhazikitsidwa kwa mankhwala, wodwalayo amatha kukhala ndi hyponatremia, komanso hypochloremia. Ndi chitukuko cha zotsatira zoyipa za trometamol N, wodwalayo ayenera kupita ku chithandizo chamankhwala.

Trometamol N - bongo

Zizindikiro zakuchulukirapo kwa trometamol N: kufooka kwapafupipafupi, kuchepa kwamankhwala kumadziwika, kupuma kumalembedwa, hypoglycemia imatsimikiziridwa mu labotale, kuphwanya malire a madzi-electrolyte ndi chikhalidwe, kuphatikiza, mulingo wa acid-base ungasinthe. Mankhwalawa kulibe. Wodwalayo adapangidwa kuti azigwiritsa ntchito mitundu yambiri ya chizindikiro. Ngati vutolo likufuna, ndiye kuti mupatseni mpweya wabwino.

The ingress ya mankhwala Tromethamol N mu malo omwe amatchedwa paravenous angayambitse minofu ya m'deralo necrosis, motere, jekeseni wa mankhwalawa amayenera kuchitika mosamala. Kuphatikiza apo, pofuna kupewa kukulitsa zotsatira zoyipa, ndikofunikira kuyambitsa mankhwalawa pang'onopang'ono. Kuwongolera mwachangu ndikotheka kokha ndi acidosis, pomwe kumangidwa kwamtima kwachitika.

Musanagwiritse ntchito mankhwala a Tromethamol H, muyenera kuonetsetsa kuti palibe njira iliyonse yothetsera vutoli, kuwonjezera, kukhulupirika kwa vial sikuyenera kusokonezedwa. Pokonzekera kugwiritsa ntchito mankhwalawa, ndikofunikira kuwunika kuchuluka kwa glucose m'magazi, komanso kudziwa kuchuluka kwa ma bicarbonates, ndipo zomwe zimatchedwa kukakamizidwa diuresis ziyeneranso kuchitika.

Momwe mungasinthire trometamol N, ndizofananira za mankhwalawa ?

Mankhwala trometamol amatanthauza analogues wa trometamol N.

Dzina la malonda: Trometamol N

Dzinalo Losasamala:

Fomu ya Mlingo:

Kupanga pa 1 lita imodzi yankho
Zinthu zogwira ntchito:
trometamol - 36.30 g,
potaziyamu mankhwala enaake - 0,37 g,
sodium mankhwala enaake - 1,75 g.
Othandizira: acetic acid 99%, madzi a jakisoni.
K + - 5 Mm / L, Na + - 30 mM / L, C1 - - 35 mM / L.
Ziphunzitso za osmolarity: 470 mOsmol / l.

Kufotokozera: madzi owoneka bwino, opanda utoto kapena wopanda khungu, wopanda tinthu tina, wopanda fungo lamadzi.

Gulu la Pharmacotherapeutic:

Code ya ATX: B05BB03.

Mankhwala
Cholinga cha mankhwala omwe ali ndi trometamol N ndikuchepetsa kuchuluka kwa ma hydrogen ions pobweretsa mankhwala omwe amatsatira H +.

Tromethamol, yomwe ndi gawo la Tromethamol H, amavomereza proton: Tromethamol H 2 С0 3 Tromethamol-Н + + Ні0 3 -

Kugwiritsa ntchito kwa mfundo zakuchizira kwa trometamol kukuwonetsedwa, choyambirira, ngati kukhazikitsidwa kwa Na + ions komwe kumakhudzana ndi kubweranso kwa bicarbonate sikofunikira kwa electrolyte usawa, komanso kupuma acidosis, komwe kuyambitsa kwa bicarbonate kumakulitsanso kupanikizika kwa kaboni.

1 M trometamol imathandizira 1 M H 2 C0 3 ndipo imapatsa thupi 1 m bicarbonate. Chifukwa cha izi, kupanikizika pang'ono kwa kaboni ndi mpweya wambiri wa hydrogen ions kumachepetsedwa osakhudzana ndi mapapo. Chifukwa chake, trometamol ikhoza kugwiritsidwa ntchito popuma komanso metabolic acidosis.

Pharmacokinetics Tromethamol ndi trometamol-N + zimakhudzidwa ndi impso zosasinthika, pambuyo pa maola 8, 75% amachotsedwa m'thupi. Trometamol imadutsidwa osasinthika ndipo simalowa m'matumbo, chifukwa chake, monga osmotic diuretics, imachulukitsa diuresis ndipo, mwa kusefa kwakukhazikika, imatsitsidwa mwachangu. Zotsatira za impso ntchito monga njira ina yowonjezera ya trometamol ingakhale yofunikira mu metabolic acidosis ndi oliguria.

Zizindikiro zogwiritsidwa ntchito
Mitundu yayikulu ya metabolic ndi kupuma acidosis:

• postpartum acidosis,
• kuikidwa acidosis chifukwa chothiridwa magazi nthawi yayitali,
• cell acidosis yokhala ndi kukomoka kwa hyperglycemic,
• kuyaka kwambiri
• kugwiritsa ntchito njira zina zozungulira pochita opaleshoni yamtima,
• matenda edema,
• mitundu yoopsa ya edema yam'mapapo mwanga,
• ntchito a postoperative aimpso kulephera,
• poyizoni ndi barbiturates, salicylates ndi mowa wa methyl.

• Hypersensitivity pamagawo a mankhwala,
• ma alkaloses,
• kulephera kwambiri kwaimpso
• aakulu kulipidwa kupuma kulephera (emphysema)
• kugwedezeka m'masiku otsiriza,
• kutopa kwambiri
• hypokalemia
• hyponatremia,
• ana osakwana chaka chimodzi.

Chenjezo: Kuchepa kwapakati ndi / kapena chiwindi.

Mimba komanso kuyamwa
Kugwiritsa ntchito mankhwalawa panthawi yapakati komanso mkaka wa m'mawere kumatheka pokhapokha ngati phindu lomwe limaperekedwa kwa mayi likupereka chiwopsezo kwa mwana wosabadwayo kapena mwana.

Mlingo ndi makonzedwe
Mankhwalawa amapangidwira kukonzekera kwa mtsempha wa mankhwalawa kwa kulowetsedwa kwa nthawi yayitali. Ngati ndi kotheka, kuyambitsa pa tsiku lachiwiri komanso lotsatira, mlingo uyenera kuchepetsedwa.

Mlingowo umatsimikizika molingana ndi kuopsa kwa acidosis yomwe ilipo. Mogwirizana ndi kuchuluka kwa trometamol N yomwe imafunikira kulowetsedwa ndizofanana ndi kuchuluka kwa kuchuluka kwa kuchuluka koonjezera (BE) ndi kulemera kwa thupi, pokhapokha ngati tanena izi: 1 ml ya trometamol H = BE (mM / L) x kg body x x 2 (zokwanira 2 chifukwa kuchepa kwa mphamvu ya buffer mutatha kuwonjezera 100 mm acetate / l).

Kubera khungu
Ngati luso la momwe mungadziwiritsire ziwonetsero za asidi-m'magazi a magazi mulibe, ndiye kuti, ngati pali zisonyezo zamatenda, kubisala kwa khungu ndi Tromethamol N. kungachitike. 500 ml / h Mlingo wa tsiku ndi tsiku ndi -1000 (-2000) ml. Mlingo wa tsiku lililonse wa ana kuyambira chaka chimodzi ndi 10-20 ml ya trometamol N / kg thupi.

Mlingo wapamwamba ndi 1.5 g / kg / tsiku. Mukamagwiritsa ntchito Mlingo wambiri, ndikulimbikitsidwa (kupewa kuchepa kwa kuchuluka kwa ma elekitirodi m'magazi) kuwonjezera NaCl pamlingo wa 1 75 g ndi KC1 pamlingo wa 0,372 g pa 1 lita imodzi ya 3.66% yankho. Ngati pali chiopsezo cha hypoglycemia, tikulimbikitsidwa kupereka nthawi yomweyo 5-10 / o yankho la dextrose ndi insulin (kutengera 1 unit ya insulin pa 4 g ya dextrose youma).

Zotsatira zoyipa
Nthawi zambiri trometamol N imalekerera bwino. Ngati kuchuluka kwa kulowetsedwa ndikokwera kwambiri, zotsatirazi zitha kuchitika: kukwiya kwa makoma a mitsempha ndi hemolysis, mwina kuchepa kwa kuthamanga kwa magazi, hypokalemia, venospasm. Chifukwa cha kupsinjika kwa minofu, thrombophlebitis imatha kupezeka pamalo a jakisoni.

Kutsika msanga kwa kukakamira pang'ono kwa kaboni dayokisaidi komanso kuwonjezereka kwa pH kungayambitse kupsinjika. Pamenepa, ndi kupuma kwa acidosis, jakisoni wa trometamol H amalimbikitsidwa pokhapokha ngati angathe kutulutsa mpweya wam'mapapo. Chifukwa chakuwonjezeka kwa kutulutsa insulini ndikugwiritsa ntchito kwambiri shuga, hypoglycemia imatha kupezeka paliponse.

Chifukwa cha kuchuluka kwa diuresis, hyponatremia ndi hypochloremia zimatha kuchitika. Chifukwa cha hyperkalemia, yomwe imayamba chifukwa chakuthamangitsidwa kwa ma potaziyamu (makamaka, ndi kulephera kwa aimpso), komanso chifukwa cha kuchepa kwa potaziyamu, ngati kuli koyenera, kuwunika kwa potaziyamu mu seramu yamagazi ndikofunikira (onani malangizo apadera).

Bongo
Zizindikiro kufooka wamba, ochepa hypotension, kupuma, Hypoglycemia, mkhutu wamadzi-electrolyte bwino komanso acid-base balance.
Chithandizo: palibe mankhwala enieni. Kuchita chisonyezo chothandizira, ngati kuli kotheka, mpweya wabwino.

Kuchita ndi mankhwala ena
Pogwiritsa ntchito munthawi yomweyo mankhwala a trometamol H ndi mankhwala opatsirana, mungathe kuwonjezeka kwa vuto la hypoglycemic (chiwopsezo cha hypoglycemia), chifukwa chake, kugwiritsa ntchito nthawi yomweyo kapena kuchepetsa mankhwalawa okhudzana ndi mankhwala antidiabetes.

Mukasakaniza mu chidebe chomwecho ndi mankhwala ena, ziyenera kukumbukiridwa kuti mtengo wa pH wa yankho la trometamol H ndi 8.1-8.7, zomwe zingapangitse kuti pakhale kupendekera kosakanikirana.

Ngati turbidity kapena opalescence amawonekera posakanikirana trometamol N mu chiwiya chimodzi ndi zothetsera zina zoyimira makolo, ndiye kuti kuphatikiza koteroko sikungagwiritsidwe ntchito.

Mphamvu ya narcotic analgesics, aminoglycosides, macrolides (erythromycin, oleandomycin), chloramphenicol, tridclic antidepressants imatheka. Mphamvu ya yosalunjika anticoagulants (coumarin derivatives), barbiturates, salicylates pogwiritsa ntchito munthawi yomweyo trometamol N. imafooka.

Malangizo apadera
Ngati mankhwalawa alowa m'malo osokoneza thupi, amatha kutsogolera kukula kwa minofu ya m'thupi. Pali chiwopsezo cha chizolowezi cha kupuma (onani. Zoyipa).

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuthana ndi shuga wamagazi (chiwopsezo cha hypoglycemia), ma seramu ionograms, ndende ya bicarbonate, kupanikizika kwa kaboni kaboni ndi asidi-base base, komanso kukakamiza diuresis. Kugwiritsa ntchito mankhwalawa kwa akhanda kungatheke pokhapokha ngati phindu lomwe likukonzekera lipitilira chiopsezo.

Pofuna kupewa kukula kwa zoyipa, trometamol sayenera kutumizidwa pamlingo waukulu. Kuwongolera mwachangu (mpaka 60 ml / min) kumaloledwa pamilandu yapadera (mwachitsanzo, kuthetsa acidosis pa nthawi yomangidwa kwamtima).

Kutulutsa Fomu
Njira yothetsera kulowetsedwa. 500 ml iliyonse yamtundu wa I mabotolo agalasi owonekera (Hebr. F.), otsekedwa ndi mtundu I brkidutyl rabara Stopper (Heb. F.) kupyoza ndi kapu ya pulasitiki pansi pa aluminium-yomwe mumakhala ndi pulasitiki yonyamula botolo.
Mbale 10 pabokosi lamakhadi okhala ndi malangizo ogwiritsira ntchito (zipatala).

Malo osungira
Pamalo amdima pakutentha kosaposa 25 ° C. Pewani mankhwalawo patali ndi ana!

Tsiku lotha ntchito
Zaka 2
Osagwiritsa ntchito tsiku lanu litatha lomwe lasonyezedwa phukusi: Gwiritsani ntchito mayankho omveka bwino mu mbale zabwino!

Terms a Tchuthi cha Pharmacy
Ndi mankhwala.

Kampani yopanga
Berlin-Chemie AG Menarini Gulu Glienicker Veg 125 12489
Berlin Germany

Adilesi ya Oimira Office ku Russia
115162 Moscow, st. Shabolovka, nyumba 31, tsamba B

The analogues ya mankhwala trometamol n amaperekedwa, malinga ndi terminology yachipatala, yotchedwa "ma syonyms" - mankhwala osinthika omwe ali ndi chinthu chimodzi kapena zingapo zomwe zimagwira momwe zimakhudzira thupi. Mukamasankha mawu ofananitsa, osangoganizira mtengo wawo, komanso dziko lakapangidwe ndi mbiri ya wopanga.

Kufotokozera za mankhwalawa

Mndandanda wazofananira

Tcherani khutu! Mndandandandawu umakhala ndi ma syonyms a trometamol H, omwe ali ndi mawonekedwe ofanana, kotero mutha kusankha nokha m'malo mwake, mukuganizira mawonekedwe ndi mankhwalawa omwe mankhwalawo adauzidwa ndi dokotala. Perekani zokonda kwa opanga ku USA, Japan, Western Europe, komanso makampani odziwika bwino ochokera ku Eastern Europe: Krka, Gideon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.

Zotsatira Za Alendo

Alendo Performance Report

Alendo Amapereka Zotsatira Zotsatira

Alendo Akufotokoza Kuthokoza

Alendo amapereka malipoti pafupipafupi patsiku

Alendo Malingaliro

Alendo amapereka lipoti la kumaliza ntchito

Alendo amafotokoza za nthawi yolandila

Alendo atatu adafotokoza zaka za odwala

Alendo amawunika

Malangizo ovomerezeka ogwiritsira ntchito

Trometamol N N

Nambala yolembetsa:

Dzinalo Losasamala:

Fomu ya Mlingo:

Gulu la Pharmacotherapeutic:

Mankhwala

Zizindikiro zogwiritsidwa ntchito

Contraindication

Mimba komanso kuyamwa

Mlingo ndi makonzedwe

Zotsatira zoyipa

Bongo

Kuchita ndi mankhwala ena

Malangizo apadera

Kutulutsa Fomu

Malo osungira

Tsiku lotha ntchito

Tulutsani mawonekedwe, ma CD ndi kapangidwe ka Trometamol N

Njira yothetsera kulowetsedwa ndiyowonekera, yopanda utoto kapena yopanda utoto, tinthu tating'onoting'ono, yopanda fungo.

Othandizira: acetic acid 99%, madzi d / i.

500 ml - mabotolo (10) - makatoni.

Zisonyezo trometamol N

Mitundu yayikulu ya metabolic ndi kupuma acidosis:

• postpartum acidosis,
• kuikidwa acidosis chifukwa chothiridwa magazi nthawi yayitali,
• cell acidosis yokhala ndi kukomoka kwa hyperglycemic,
  kuyaka kwambiri
• kugwedeza
• kugwiritsa ntchito njira zina zozungulira pochita opaleshoni yamtima,
• matenda edema,
• mitundu yoopsa ya edema yam'mapapo mwanga,
• ntchito a postoperative aimpso kulephera,
• poyizoni ndi barbiturates, salicylates ndi mowa wa methyl.

Mlingo

Mankhwalawa adapangira kuti amupatse mtsempha wa magazi pokhapokha 1 ola limodzi.

Ngati ndi kotheka, kuyambitsa pa tsiku lachiwiri komanso lotsatira, mlingo uyenera kuchepetsedwa.

Mlingo umayikidwa kutengera kuuma kwa acidosis yomwe ilipo. Njira yosankhira yoyeserera ikuyang'aniridwa panjira yolamulidwa ndi acid-base boma. Momwemo, kuchuluka kwa trometamol N komwe kumafunikira kulowetsedwa kumakhala kofanana ndi kuwerengeka koyipa koonjezera (BE) ndi kulemera kwa thupi, pokhapokha ngati kukufotokozeredwa, ndi: 1 ml ya trometamol H = BE (mm / L) x kg thupi x 2

(coefficient 2 idapezeka ndikuchepetsa mphamvu ya buffer mutatha kuwonjezera 100 mm acetate / l).

Ngati luso la kudziwa momwe asidi-m'magazi alili magazi kulibe, ndiye kuti muli ndi umboni wa matenda, kubisala wakhungu ndi trometamol N.

Pokhapokha pokhapokha ngati munthu atamuuza kuti munthu wamkulu, ndiye kuti 5,5 ml ya trometamol N / kg thupi / h, yofanana ndi 500 ml / h. Mlingo watsiku ndi tsiku ndi 1000 (-2000) ml.

Mlingo wa tsiku lililonse wa ana kuyambira chaka chimodzi ndi 10-20 ml ya trometamol N / kg thupi.

Mlingo wapamwamba ndi 1.5 g / kg / tsiku.

Mukamagwiritsa ntchito Mlingo wambiri, ndikulimbikitsidwa (kupewa kuchepetsa kuchuluka kwa ma electrolyte m'magazi) kuwonjezera NaCl pamlingo wa 1.75 g ndi KCl pamlingo wa 0.372 g pa 1 lita imodzi ya 3.66% yankho.

Ngati pali chiopsezo cha hypoglycemia, tikulimbikitsidwa kupereka nthawi yomweyo 5-10% yankho la dextrose ndi insulin (kutengera 1 unit ya insulin pa 4 g ya dextrose youma).

Zotsatira zoyipa

Nthawi zambiri trometamol N imalekerera bwino. Ngati kuchuluka kwa kulowetsedwa ndikokwera kwambiri, zotsatirazi zitha kuchitika: kukwiya kwa makoma a mitsempha ndi hemolysis, mwina kuchepa kwa kuthamanga kwa magazi, hypokalemia, venospasm. Chifukwa cha kupsinjika kwa minofu, thrombophlebitis imatha kupezeka pamalo a jakisoni.

Kutsika msanga kwa kukakamira pang'ono kwa kaboni dayokisaidi komanso kuwonjezereka kwa pH kungayambitse kupsinjika. Pankhaniyi, ndi kupuma acidosis, kulowetsedwa kwa trometamol H ndikulimbikitsidwa pokhapokha ngati pali kuthekera kwa makina mpweya wabwino. Chifukwa cha kutulutsidwa kwa insulin kwambiri komanso kugwiritsa ntchito shuga pang'onopang'ono, hypoglycemia imayamba.

Chifukwa cha kuchuluka kwa diuresis, hyponatremia ndi hypochloremia zimatha kuchitika. Chifukwa cha hyperkalemia, yomwe imayamba chifukwa chakuthamangitsidwa kwa ma potaziyamu (makamaka, ndi kulephera kwa aimpso), komanso chifukwa cha kuchepa kwa potaziyamu, ngati kuli koyenera, kuwunika kwa potaziyamu mu seramu yamagazi ndikofunikira (onani malangizo apadera).

Kuyanjana kwa mankhwala osokoneza bongo

Pogwiritsa ntchito munthawi yomweyo mankhwala a trometamol H ndi mankhwala opatsirana, mungathe kuwonjezeka kwa vuto la hypoglycemic (chiwopsezo cha hypoglycemia), chifukwa chake, kugwiritsa ntchito nthawi yomweyo kapena kuchepetsa mankhwalawa okhudzana ndi mankhwala antidiabetes.

Mukasakaniza mu chidebe chomwecho ndi mankhwala ena, ziyenera kukumbukiridwa kuti mtengo wa pH wa yankho la trometamol H ndi 8.1-8.7, zomwe zingapangitse kuti pakhale kupendekera kosakanikirana.

Ngati turbidity kapena opalescence amawonekera posakanikirana trometamol N mu chiwiya chimodzi ndi zothetsera zina zoyimira makolo, ndiye kuti kuphatikiza koteroko sikungagwiritsidwe ntchito.

Mphamvu ya narcotic analgesics, aminoglycosides, macrolides (erythromycin, oleandomycin), chloramphenicol, tridclic antidepressants imatheka.

Mphamvu ya anti-coagulants yozungulira (coumarin derivatives), barbiturates, salicylates, yogwiritsidwa ntchito nthawi yomweyo ndi trometamol N., imafooka.