Zeptol (Zeptol)

Mankhwala othandizira antiepileptic ochokera ku tricyclic iminostilbene.
Mankhwala: ZEPTOL

The yogwira mankhwala: carbamazepine
ATX Encoding: N03AF01
KFG: Anticonvulsant
Nambala yolembetsa: P. 011348/01
Tsiku lolembetsa: 07.07.06
Mwini reg. Degree: Sun Pharmaceutical Industries Ltd.

Zeptol kumasulidwa mawonekedwe, mankhwala ma CD ndi zikuchokera.

Mapiritsi
1 tabu
carbamazepine
200 mg

Ma PC 10 - mizera ya aluminiyamu (10) - mapaketi a makatoni.

Mapiritsi okhala ndi burashi yokhazikika ya brown ndi ozungulira, biconvex, omwe ali pachiwopsezo mbali imodzi.

1 tabu
carbamazepine
200 mg

Omwe amathandizira: ethyl cellulose, cellcrystalline cellulose, starch, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, eudrazit E100, titanium dioxide, polyethylene glycol 6000, iron ironide, iron ironide.

Ma PC 10 - mapaketi opanda ma cell contour (3) - mapaketi a makatoni.

Mapiritsi okhala ndi burashi yokhazikika ya brown ndi ozungulira, biconvex, omwe ali pachiwopsezo mbali imodzi.

1 tabu
carbamazepine
400 mg

Omwe amathandizira: ethyl cellulose, cellcrystalline cellulose, starch, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, Eudraite E100, titanium dioxide, polyethylene glycol 6000, iron ironideide, yellow iron oxide, 2208 hydroxypropyl methyl cellulose.

Ma PC 10 - mapaketi opanda ma cell contour (3) - mapaketi a makatoni.

Kufotokozera kwa ZOTHANDIZA ZABWINO.
Zonse zomwe zaperekedwa zimangoperekedwa kuti mudziwe bwino za mankhwalawo, muyenera kufunsa dokotala zokhudzana ndikugwiritsa ntchito.

Pharmacological zochita za Zeptol

Mankhwala othandizira antiepileptic ochokera ku tricyclic iminostilbene. Amakhulupirira kuti zotsatira za anticonvulsant zimagwirizanitsidwa ndi kuchepa kwa mphamvu ya ma neurons kuti asunge kwambiri zochitika zomwe zingachitike mobwerezabwereza poyambitsa masodium njira. Kuphatikiza apo, kuletsa kwa ma neurotransmitter kumasulidwa ndi kutsekereza njira za preynaptic sodium komanso kukula kwa zinthu zina zomwe zimachepetsa kufalitsa kwa synaptic, zikuwoneka kuti ndizofunikira.

Imakhala ndi antimaniacal, antipsychotic zotsatira, komanso analgesic zotsatira zopweteka za neurogenic. Ma GABA receptors, omwe amatha kuphatikizidwa ndi njira za calcium, akhoza kutengapo gawo machitidwe, komanso zotsatira za carbamazepine pama neurotransmitter modulator system nawonso zikuwoneka kuti ndizofunikira.

Mphamvu yotsutsa ya carbamazepine imatha kuphatikizidwa ndi hypothalamic zotsatira za osmoreceptors, zomwe zimayendetsedwa kudzera mchinsinsi cha ADH, komanso chifukwa cha kuthana ndi vuto la aimpso.

Pharmacokinetics wa mankhwala.

Pambuyo pakumwa pakamwa, carbamazepine imangokhala yodzaza kwathunthu kuchokera kumimba. Kumangiriza kwa mapuloteni a plasma ndi 75%. Imagwira ma enzymes a chiwindi ndipo imathandizira kagayidwe kake.

T1 / 2 ndi maora 12-16. 70% amamuchotsa mkodzo (mwanjira ya metabolites) ndi 30% - yokhala ndi ndowe.

Zisonyezero zogwiritsidwa ntchito:

Matenda a khunyu: akuluakulu, osakanikirana, osakanikirana (kuphatikiza zazikulu ndi zozama) khunyu. Kupweteka kwamatenda makamaka kwa chiyambi cha neurogenic, kuphatikiza kofunikira mu triuralmural neuralgia, trigeminal neuralgia mu sclerosis yofunikira, glossopharyngeal neuralgia. Kupewa kuukira ndi vuto lochotsa mowa. Magwiridwe othandizira komanso osokoneza bongo (monga njira yoletsera). Matenda a diabetes a neuropathy. Matenda a shuga a insipidus apakatikati, polyuria ndi polydipsia ya chikhalidwe cha neurohormonal.

Mlingo ndi njira ya mankhwala.

Ikani payekha. Mukamamwa pakamwa kwa akulu ndi achinyamata azaka 15 ndi akulu, mlingo woyambayo ndi 100-400 mg. Ngati ndi kotheka, ndi kuganizira matenda, mlingo ukuwonjezeka osapitirira 200 mg / tsiku limodzi pakapita sabata 1. Pafupipafupi oyang'anira ndi nthawi 1-4 / tsiku. Mankhwala okonza nthawi zambiri amakhala ali ndi 600 mg00 mg / tsiku zingapo. Kutalika kwa chithandizo kumatengera zikuwonetsa, kuthandizira kwake, momwe wodwalayo amayankhira chithandizo.

Mwa ana osakwana zaka 6, 10-20 mg / kg / tsiku amagwiritsidwa ntchito mu Mlingo wogawika 2-3, ngati kuli koyenera komanso chifukwa chololera, mlingo umachulukitsa osapitilira 100 mg / tsiku limodzi pakapita sabata 1, makonzedwe okonza nthawi zambiri amakhala 250 -350 mg / tsiku ndipo sizidutsa 400 mg / tsiku. Ana a zaka zapakati pa 6 mpaka 12 - 100 mg 2 / tsiku tsiku loyamba, ndiye kuti mlingo umakulitsidwa ndi 100 mg / tsiku ndi nthawi 1 sabata. mpaka mulingo woyenera kwambiri, mlingo wokonzanso nthawi zambiri ndi 400-800 mg / tsiku.

Mlingo waukulu: mukamamwa pakamwa, akulu ndi achinyamata a zaka 15 ndi okalamba - 1,2 g / tsiku, ana - 1 g / tsiku.

Zeptol zoyipa:

Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: Nthawi zambiri - chizungulire, ataxia, kugona, kuthekera kupweteka kwa mutu, diplopia, chisokonezo pogona, osowa - kusuntha mwadzidzidzi, nystagmus, zina - oculomotor zosokoneza, dysarthria, zotumphukira neuritis, paresthesia, kufooka kwa minofu, zizindikiro paresis, kuyerekezera zinthu m`maganizo, kukhumudwa, kutopa, kuchita ukali, kusokonezeka kwa chikumbumtima, kuchuluka kwa psychosis, kusokoneza kusokoneza, conjunctivitis, tinnitus, hyperacusis.

Kuchokera pamimba: kukhumudwa, kuchuluka kwa GGT, kuchuluka kwa zamchere phosphatase, kusanza, pakamwa kowuma, kawirikawiri - kuchuluka kwa transaminases, jaundice, hepatitis ya cholestatic, kutsekula m'mimba, kuperewera, nthawi zina - kuchepa kwa chakudya, kupweteka pamimba, glossitis, stomatitis.

Kuchokera pamtima dongosolo: kawirikawiri - kusokonezeka kwa myocardial, nthawi zina - bradycardia, arrhythmias, AV blockade ndi syncope, kugwa, kulephera kwa mtima, mawonekedwe a kupindika kwa coronary, thrombophlebitis, thromboembolism.

Kuchokera pa hemopoietic dongosolo: leukopenia, eosinophilia, thrombocytopenia, osowa - leukocytosis, nthawi zina - agranulocytosis, aplasic anemia, erythrocytic aplasia, megaloblastic anemia, reticulocytosis, hemolytic anemia, granulomatous hepatitis.

Kuchokera kumbali ya kagayidwe: hyponatremia, kusungika kwamadzimadzi, kutupa, kuchepa thupi, kuchepa kwa plasma osmolality, nthawi zina - kuperewera kwapakati pa porphyria, kuperewera kwa asidi wa folic acid, kusokonezeka kwa calcium calcium, kuchuluka kwa cholesterol ndi triglycerides.

Kuchokera ku endocrine system: gynecomastia kapena galactorrhea, kawirikawiri - kusowa kwa chithokomiro.

Kuchokera kwamikodzo dongosolo: kawirikawiri - kusokonezeka kwa impso, zamkati nephritis ndi aimpso kulephera.

Kuchokera pakapumidwe: munthawi zina - dyspnea, chibayo kapena chibayo.

Thupi lawo siligwirizana: zotupa pakhungu, kuyabwa, kawirikawiri - lymphadenopathy, malungo, hepatosplenomegaly, arthralgia.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere.

Ngati ndi kotheka, gwiritsani ntchito panthawi yomwe muli ndi pakati (makamaka pa trimester yoyamba) komanso mkaka wa m`mawere ayenera kuganizira bwino za chithandizo chomwe mayi akuyembekezera komanso chiwopsezo kwa mwana wosabadwayo kapena mwana. Pankhaniyi, carbamazepine tikulimbikitsidwa kuti azigwiritsidwa ntchito ngati monotherapy mu Mlingo wothandiza kwambiri.

Amayi amisinkhu yobala mwana panthawi yochizira ndi carbamazepine akulimbikitsidwa kugwiritsa ntchito njira zolerera za mahomoni.

Malangizo apadera ogwiritsira ntchito Zeptol.

Carbamazepine sagwiritsidwa ntchito kukomoka kapena kuwononga khunyu pang'ono, kugwidwa ndi myoclonic kapena atonic epileptic. Sipamayenera kugwiritsidwa ntchito pochepetsa ululu wamba, monga prophylactic panthawi yayitali yotulutsidwa kwa trigeminal neuralgia.

Amagwiritsidwa ntchito mosamala ngati matenda obwera chifukwa cha mtima wamitsempha, matenda a chiwindi ndi / kapena ntchito ya impso, matenda a shuga, kuchuluka kwa kukakamira, ndi mbiri ya kusintha kwa hematological kugwiritsa ntchito mankhwala ena, hyponatremia, kusungika kwamikodzo, komanso chidwi chachikulu cha antidepressants atatu. , ndi zomwe zikuwonetsa mbiri ya kusokonezeka kwa chithandizo cha carbamazepine, komanso ana ndi odwala okalamba.

Chithandizo chikuyenera kuchitika moyang'aniridwa ndi dokotala. Ndi chithandizo chotenga nthawi yayitali, ndikofunikira kuwongolera chithunzi cha magazi, momwe chiwindi chimagwirira ntchito komanso impso, kuchuluka kwa ma electrolyte m'magazi amwazi, komanso kuyezetsa maso. Pafupipafupi kutsimikiza kwa kuchuluka kwa carbamazepine m'madzi a m'magazi tikulimbikitsidwa kuwunika momwe ntchito ikugwirira ntchito komanso chitetezo.

Osachepera milungu iwiri musanayambe mankhwala a carbamazepine, ndikofunikira kusiya mankhwala ndi mao inhibitors.

Munthawi ya chithandizo musalole kumwa mowa.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Pa chithandizo, munthu ayenera kupewa kuchita zinthu zomwe zingakhale zovulaza zomwe zimafunikira chidwi chochulukirapo, komanso kuthamanga kwa zochitika zama psychomotor.

Kugwirizana kwa Zeptol ndi mankhwala ena.

Ndi munthawi yomweyo kugwiritsa ntchito zoletsa za isoenzyme CYP3A4, kuchuluka kwa carbamazepine m'madzi amwazi.

Ndi kugwiritsa ntchito pamodzi kwa inducers a CYP3A4 isoenzyme system, ndizotheka kuthamangitsa kagayidwe ka carbamazepine, kuchepetsa kugwiritsidwa ntchito kwake m'magazi amwazi, komanso kuchepetsa njira yothandizira achire.

Ndi munthawi yomweyo kugwiritsa ntchito carbamazepine kumapangitsa kagayidwe ka anticoagulants, folic acid.

Pogwiritsa ntchito munthawi yomweyo ndi valproic acid, kuchepa kwa kuchuluka kwa carbamazepine ndi kuchepa kwakukulu kwa ndende ya valproic acid m'madzi a m'magazi kumatha. Nthawi yomweyo, kugwiritsidwa ntchito kwa carbamazepine metabolite, carbamazepine epoxide, kumawonjezeka (mwina chifukwa cha kuletsa kwake kusintha kwake kwa carbamazepine-10,11-trans-diol), yomwe imakhalanso ndi ntchito yotsutsana, kotero zotsatira za kuyanjanaku zimatha kuyendetsedwa, koma mawonekedwe osokoneza nthawi zambiri amapezeka - masomphenya osokoneza chizungulire, kusanza, kufooka, nystagmus. Pogwiritsa ntchito munthawi yomweyo valproic acid ndi carbamazepine, kukula kwa hepatotoxic kungatheke (mwachiwonekere, chifukwa cha kupangika kwa metabolite yachiwiri ya valproic acid, yomwe imakhala ndi hepatotoxic athari).

Pogwiritsa ntchito munthawi yomweyo, valpromide imachepetsa kagayidwe kake ka chiwindi cha carbamazepine ndi metabolite carbamazepine-epoxide chifukwa chopewera kwa enzyme epoxide hydrolase. Metabolite yotchulidwa imakhala ndi zochita za anticonvulsant, koma pakuwonjezereka kwa ndende ya plasma imatha kukhala ndi poizoni.

Pogwiritsa ntchito munthawi yomweyo ndi verapamil, diltiazem, isoniazid, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, mwina ndi cimetidine, acetazolamide, danazole, desipramine, nicotinamide (mu akulu, kokha muyezo waukulu), erythromycin, trolesamole (kuphatikizapo ndi itraconazole, ketoconazole, fluconazole), terfenadine, loratadine angakulitse kuchuluka kwa carbamazepine m'madzi am'magazi ndi chiopsezo cha mavuto (chizungulire, kugona, ataxi ine, diplopia).

Pogwiritsa ntchito munthawi yomweyo ndi hexamidine, mphamvu ya anticonvulsant ya carbamazepine imafooka, ndi hydrochlorothiazide, furosemide - ndizotheka kuchepetsa zofunikira za m'magazi, ndi njira yolerera ya mahomoni - ndizotheka kufooketsa mphamvu ya njira zakulera komanso kukula kwa magazi a acyclic.

Pogwiritsa ntchito nthawi yomweyo ndi mahomoni a chithokomiro, ndizotheka kuwonjezera kuthetseratu kwa mahomoni a chithokomiro, omwe ali ndi clonazepam, ndizotheka kuwonjezera chidziwitso cha clonazepam ndikuchepetsa chilolezo cha carbamazepine, ndikukonzekera kwa lifiyamu, kupititsa patsogolo mphamvu ya neurotoxic.

Pogwiritsa ntchito munthawi yomweyo primidone, kuchepa kwa kuchuluka kwa carbamazepine m'madzi a m'magazi kungatheke. Pali malipoti kuti primidone imatha kuwonjezera kuchuluka kwa plasma yogwira metabolac - - carbamazepine-10,11-epoxide.

Pogwiritsa ntchito munthawi yomweyo ndi ritonavir, mavuto a carbamazepine akhoza kupitilizidwa, ndi sertraline, kuchepa kwa kuchuluka kwa sertraline ndikotheka, ndi theophylline, rifampicin, cisplatin, doxorubicin, kuchepa kwa kuchuluka kwa carbamazepine m'magazi a plasma, ndi tetracycline.

Pogwiritsa ntchito munthawi yomweyo ndi felbamate, kuchepa kwa kuchuluka kwa carbamazepine m'madzi a m'magazi kungatheke, koma kuwonjezeka kwa kuchuluka kwa metabolite ya carbamazepine-epoxide, pomwe kuchepa kwa ndende mu plasma ya felbamate ndikotheka.

Ndi munthawi yomweyo kugwiritsa ntchito phenytoin, phenobarbital, kuchuluka kwa carbamazepine m'madzi amwazi kumachepa. Kuchepetsa mphamvu za zochita za anticonvulsant ndikotheka, ndipo nthawi zina, kulimbitsa kwake.

Mlingo ndi makonzedwe

Mapiritsi mkati, achikulire ndi achinyamata opitirira zaka 15 ndi khunyu ndi neuralgia mlingo woyambirira - 200 mg 1-2 kawiri pa tsiku ndi kuchuluka pang'onopang'ono kwa mlingo wa 100 mg ndi nthawi 1 sabata) mulingo woyenera kwambiri wa mankhwalawa - 600-1200 mg / tsiku (pazipita tsiku - 1.8 g). Ndi manic-depression psychosis mlingo woyamba ndi 400 mg / tsiku, logawidwa mu 2 Mlingo, ndi kuwonjezeka pang'onopang'ono mpaka 600 mg / tsiku (pazipita tsiku mlingo). Ana osakwana chaka chimodzi (2 kawiri pa tsiku) - 100-200 mg / tsiku, zaka 1-5 - 200-400 mg / tsiku, zaka 5-10 - 400-600 mg / tsiku, zaka 11-15 - 600-1000 mg / tsiku

Zojambula Zophatikizira Kumapeto: mkati, mkati mwakudya kapena mukatha kudya ndi madzi pang'ono. Ndi khunyu: Akuluakulu, mlingo woyambirira - 200 mg kawiri pa tsiku, ndiye kuti mlingo umakulitsidwa pang'onopang'ono - 400 mg 2-4 pa tsiku. Ana: pa mlingo wa 10-20 mg / kg, miyezi 4-12 - 100-200 mg mu Mlingo wa 1-2, zaka 1-5 - 200-400 mg mu Mlingo wa 1-2, wazaka 5-10 - 400-600 mg Mlingo wa 2-3, zaka 10-15 - 600-1000 mg mu 3 waukulu.

Trigeminal neuralgia: mlingo woyamba ndi 200-400 mg / tsiku, ndiye kuti muyezowo umakulitsidwa pang'onopang'ono, ngati pangafunike, mpaka 600-800 mg zingapo. Pambuyo pakutha kwa zowawa, mlingo umachepetsedwa mpaka 200 mg / tsiku.

Kupewa kwamatenda oyanjana: sabata yoyamba, mlingo wa tsiku ndi tsiku ndi 200-400 mg, piritsi lotsatira la tsiku lililonse limakulitsidwa (piritsi limodzi pa sabata) mpaka 1000 mg ndi kumwa kwa 3 mg.

Kutalika kwa chithandizo kumayikidwa payekhapayekha.

Kutulutsa mawonekedwe ndi kapangidwe kake

• mapiritsi: ozungulira, ozungulira, oyera, mbali imodzi yokhala ndi "ZEPTOL 200" ndi chamfer, mbali inayo ndi mzere wogawanika (ma PC 10. mu mzere wa aluminiyumu zojambulidwa, pamtundu wa makatoni a mizere 10),
• filimu yokhala ndi mapiritsi otulutsira mafilimu: biconvex, kuzungulira, bulauni, ndi chiopsezo mbali imodzi (ma PC 10. pamtundu wa aluminiyumu zojambulazo, pamtundu wa makatoni a mizere itatu).

Paketi iliyonse ilinso ndi malangizo ogwiritsira ntchito Zeptol.

Piritsi limodzi lili:

• yogwira mankhwala: carbamazepine - 200 mg,
• Zowonjezera zina: hypromellose 2910 (Metocel E5), colloidal silicon dioxide, microcrystalline cellulose, starch, povidone K 30, sodium propyl parahydroxybenzoate (sodium propyl paraben), bronopol, oyeretsedwa wa magnesium, sodium lauryl sodium.

Piritsi limodzi, kuchitapo kanthu nthawi yayitali, kuphatikizidwa ndi filimu, muli:

• yogwira mankhwala: carbamazepine - 200 kapena 400 mg,
• Zowonjezera zina: hypromellose 2208 (Metocel K4M) - pa mulingo wa 400 mg, microcrystalline cellulose, ethyl cellulose M50, wowuma chimanga, colloidal silicon dioxide, talc woyesa, magnesium stearate, croscarmellose sodium,
• kujambula kwamafilimu: kopolymer wa butyl methacrylate, dimethylaminoethyl methacrylate ndi methyl methacrylate (1: 2: 1) (Eudragit E-100), macrogol 6000 (polyethylene glycol 6000), utoto woyeretsa wa titc, magnesium stearate, titani diodium.

Mankhwala

Carbamazepine imachokera ku iminostilbene, yomwe imawonetsa anticonvulsant (antiepileptic) zotsatira ndi antidepressant (thymoanaleptic), zolimbitsa antipsychotic ndi standardotimic zotsatira. Mankhwala amasonyezanso katundu wa analgesic, makamaka kwa odwala omwe ali ndi trigeminal neuralgia.

Kupanga kwa chinthu yogwira sikumveka bwino. Amaganiziridwa kuti mphamvu yake yotsitsa imachitika chifukwa chakuchepa kwa mphamvu ya ma neurons kuti apereke pafupipafupi zomwe zimachitika mobwerezabwereza chifukwa cha zoletsa za ntchito zamayendedwe a sodium. Kuphatikiza apo, zikuwoneka kuti kuletsa kumasulidwa kwa ma neurotransmitters mwa kulepheretsa njira za preynaptic sodium komanso kutuluka kwa zothekera ndizofunikanso, zomwe zimapangitsa kutsika kwa kufalitsa kwa synaptic.

Makina ochitapo kanthu ka carbamazepine akhoza kuphatikizira gamma-aminobutyric acid receptors (GABA), omwe akhoza kuphatikizidwa ndi njira za calcium. Mwina, mphamvu yogwiritsidwa ntchito ndi zinthu za ma modulators a ma neurotransication siyofunika kwenikweni. Mphamvu yotsutsa ya carbamazepine imatha kugwirizanitsidwa ndi hypothalamic kwambiri pa osmoreceptors, yochititsidwa ndi kukopa kwa chinsinsi cha antidiuretic mahomoni (ADH), komanso chifukwa chokhudza mayendedwe a impso.

Kugwiritsa ntchito kwa antiepileptic mankhwala kunkadziwika pakukhudzidwa kwa matenda osiyanasiyana okomoka a tonic-clonic, oyang'ana pang'ono (osagwirizana), omwe amaphatikizidwa kapena osatsatiridwa ndi kuphatikiza kwachiwiri, komanso kuphatikiza kwa mitundu yapamwambayi. Monga lamulo, kugwiritsa ntchito Zeptol sikugwira ntchito pang'onopang'ono kukomoka - petit mal, myoclonic khunyu komanso kulibe.

Panthawi ya carbamazepine mankhwala a odwala omwe ali ndi khunyu (makamaka ana ndi achinyamata), kuchepa kwambiri kwa zizindikiro za nkhawa komanso kukhumudwa kunalembedwa, ndipo mankhwalawo adathandizanso kuchepa kwa kusakwiya komanso kukwiya. Mlingo wa mphamvu ya yogwira ntchito pa ma psychomotor indices ndi kuzindikira kwa ntchito zimatengera mlingo wake. Mphamvu ya anticonvulsant imayamba kuonekera patatha maola angapo kapena patadutsa masiku angapo (nthawi zina pafupifupi mwezi umodzi pambuyo pake chifukwa cha kuphatikizika kwa metabolism).

Potengera maziko a neuralgia yofunikira komanso yachiwiri, muzocitika zambiri, carbamazepine imatsutsana ndi kupweteka kwapweteka. Kuchepa mphamvu kwa ululu wamankhwala okhala ndi trigeminal neuralgia kumawonedwa pambuyo pa maola 8-72.

Zeptol imapereka njira yothandizira kuti mowa uchotsere chiwonjezero cha kukonzekera kosavuta, komwe, monga lamulo, kumachepetsedwa pamenepa, ndikuchepetsa kuopsa kwa zizindikiro za matendawa.

Ntchito ya antimaniacal (antipsychotic) imakhazikika pambuyo pa masiku 7-10 ndipo mwina imakhala chifukwa chotsutsana ndi kagayidwe ka norepinephrine ndi dopamine.

Kusungabe kokhazikika kwa carbamazepine m'magazi kumatsimikiziridwa ndikugwiritsa ntchito njira yayitali ya mankhwala 1-2 patsiku.

Masamba otulutsidwa

• khunyu: kugwidwa kosavuta / kosavuta pang'ono khunyu (kapena osazindikira), kugwidwa ndi matenda akhunyu.
• neurogenic ululu syndrome ndi trigeminal neuralgia,
• idiopathic neuralgia ya glossopharyngeal nerve, yofanana komanso atypical trigeminal neuralgia mu sclerosis yambiri ndi idiopathic trigeminal neuralgia,
• kupweteka kwa matenda ashuga a m'mimba, kupweteka kwamankhwala am'mitsempha yamafungo pamaso pa matenda a shuga, polyuria ndi polydipsia ya chikhalidwe cha neurohormonal motsutsana ndi matenda osokoneza bongo a shuga.
• matenda achotsekera kuledzera (kupweteka, kusokonekera kwambiri, nkhawa, kusokonezeka kwa tulo),
• pachimake manic machitidwe ndi chithandizo chothandizira matenda a kupuma kwamankhwala osokoneza bongo kuti ateteze kufooka kapena kufooketsa kuwonekera kwawo kwamankhwala.

Contraindication

Mtheradi wa mitundu yonse ya mlingo:

• matenda a m'mafupa hematopoiesis (magazi m'thupi, leukopenia),
• atrioventricular block (AV block),
• kuphatikiza ndi kukonzekera kwa lithiamu ndi monoamine oxidase inhibitors (MAO),
• Hypersensitivity pazinthu zilizonse za Zeptol, komanso zinthu zomwe zili ndi mawonekedwe a carbamazepine, mwachitsanzo, ma antidepressants atatu.

Zowonjezera zina zotsutsana ndi mapiritsi omwe akhala akuchita kwa nthawi yayitali:

• mbiri ya zochitika zoletsa fupa la hematopoiesis kapena mtundu uliwonse wa porphyria,
• zaka mpaka 4.

Zowonjezera zina zotsutsana za Zeptol mwa mapiritsi ndi porphyria pachimake (kuphatikizapo mbiri).

Wachibale (gwiritsani ntchito antiepileptic mankhwala mosamala):

• mtima wosalephera (CHF),
• aimpso kuwonongeka ndi / kapena chiwindi ntchito,
• kuswana kwa hyponatremia: adrenal cortex osakwanira, ADH hypersecretion syndrome, hypothyroidism, hypopituitarism,
• Prostatic hyperplasia,
• kuletsa kwa mafupa hematopoiesis, concomitant ntchito mankhwala (mbiri),
• kuchuluka kwazovuta zamitsempha,
• uchidakwa wogwira ntchito, chifukwa chifukwa cha kuchuluka kwa zopinga zamagetsi chapakati (CNS), kusintha kwa carbamazepine kumatheka.
• ukalamba
• kuphatikiza pamodzi ndi sedative-hypnotics.

Zeptol, malangizo ogwiritsira ntchito: njira ndi mlingo

Mapiritsi a Zeptol amatengedwa pakamwa ndi madzi pang'ono, mutatha kudya kapena pakati pa chakudya. Mankhwala atha kupatsidwa mankhwala onse a monotherapy komanso ngati gawo limodzi la chithandizo chokwanira.

Mapiritsi otetezedwa amasungidwa ayenera kumezedwa 1 lathunthu, kapena, ngati mankhwala adokotala, ½, osati kutafuna. Popeza mankhwala othandizira amamasulidwa pang'onopang'ono komanso pang'onopang'ono kuchokera pamapiritsi otulutsidwa nthawi yayitali, Zeptol iyenera kumwedwa kawiri pa tsiku, njira yabwino kwambiri yotsimikiziridwa ndi adokotala. Ngati pakufunika kusintha kuti musagwiritse ntchito mapiritsi a nthawi yayitali kupita pa njira yotalikirapo, malinga ndi zomwe munakumana nazo kuchipatala, odwala ena angafunikire kuchuluka kwa mankhwalawo omwe adagwiritsidwa ntchito kale.

Pochiza matenda a khunyu, ndikofunika kupaka mapiritsi a Zeptol mwanjira ya monotherapy. Ndikofunikira kuyamba kugwiritsa ntchito mankhwalawa ndi mlingo waung'ono wa tsiku ndi tsiku, womwe uyenera kuwonjezeka pang'onopang'ono mpaka zotsatira zomwe mukufuna zitheke. Posankha mulingo woyenera kwambiri, tikulimbikitsidwa kudziwa mulingo wa carbamazepine m'madzi a m'magazi. Pankhani ya Zeptol poika mankhwala oletsa antiepileptic, kutsatira kwake kumachitika pang'onopang'ono, pomwe Mlingo wa mankhwala omwe adalandilidwa kale sasintha, koma ngati pakufunika kutero, amakonza zoyenera. Ngati wodwalayo adayiwala kutenga mlingo wotsatira wa carbamazepine munthawi yake, uyenera kumwedwa nthawi yomweyo mutasiya izi, simungagwiritsenso ntchito Zeptol pawiri.

Mlingo wovomerezeka malinga ndi zisonyezo:

• khunyu: akulu amatenga Zeptol 1-2 kawiri pa tsiku koyamba kwa 100-200 mg, ndiye kuti mwambowu umakulitsidwa pang'onopang'ono mpaka 400-600 mg 2 kawiri pa tsiku, mlingo waukulu wa tsiku lililonse sayenera kupitirira 1600-2000 mg, mwa ana okulirapo zaka 4 phwando litha kuyamba ndi 100 mg ya 100, ndiye kuti sabata iliyonse mlingo ungathe kuwonjezeka ndi 100 mg, ana azaka 4 ndi ocheperapo amalembedwa Zeptol (mapiritsi) koyamba tsiku lililonse la 20-60 mg kenako ndikuwonjezera tsiku lililonse pofika 20- 20 60 mg, yothandizira Mlingo wa ana tsiku lililonse, imakhazikitsidwa pamlingo wa 1020 mg / kg, wogawidwa ndi n angapo phwando, analimbikitsa kukonzekera tsiku lililonse ana mapiritsi (kutengera zaka): zosakwana 1 chaka - 100-200 mg mu 1 mlingo, 1-5 zaka - 200-400 mg mu Mlingo wa 1-2, zaka 6-10 - 400-600 mg mu Mlingo wa 2-3, wazaka 11 mpaka 15- 600-1000 mg mu 2- Mlingo wa 3 mpaka 3, tikulimbikitsidwa kukonzanso Mlingo wa ana masiku onse mapiritsi owonjezera (muyezo zingapo): zaka 4-5 - 200-400 mg , Zaka 6 - 10 - 400-600 mg, zaka 11-16 - 600-1000 mg,
• trigeminal neuralgia ndi neurogenic ululu syndrome: 2 kawiri pa tsiku, 100-200 mg aliyense, mtsogolo mlingo wa tsiku ndi tsiku umatha kuchuluka osaposa 200 mg (mpaka 600-800 mg) mpaka ululu utatsitsimuka, ndiye kuti mlingo umachepetsedwa osagwira ntchito kwenikweni, kuyambika kwa maphunzirowa, zotsatira zabwino zimawonedwa pambuyo pa masiku 1-3, chithandizo cha nthawi yayitali, ngati kuchotsedwa kwachangu kwa carbamazepine, kupweteka kumatha kuyambiranso, mwa odwala okalamba, mlingo woyambirira uyenera kukhala 100 mg kawiri pa tsiku,
• diabetesic neuropathy, limodzi ndi zowawa: 2-5 kawiri pa tsiku, 200 mg (mapiritsi), 2 pa tsiku, 200- 300 mg (mapiritsi olimbikitsidwa),
• shuga insipidus (mapiritsi): kwa akulu, pafupifupi katatu patsiku, 200 mg aliyense,
• kupweteka ndi zotupa za zotumphukira zamitsempha motsutsana ndi matenda a shuga: 2 kawiri pa tsiku, 200-300 mg,
• idiopathic glossopharyngeal neuralgia, trigeminal neuralgia motsutsana ndi maziko a sclerosis ambiri ndi idiopathic trigeminal neuralgia (mapiritsi a nthawi yayitali): katatu patsiku, 200-400 mg,
• polyuria ndi polydipsia ya chikhalidwe cha neurohormonal ndi matenda a shuga a insipidus a genesis apakati (mapiritsi olimbikitsidwa): kwa akulu, avareji ya 200 mg kawiri pa tsiku, ana amachepetsa mlingo potengera zaka komanso kulemera kwa thupi,
• matenda olekanitsa zakumwa zoledzera: avareji ya 200 mg 2 kawiri patsiku, ovuta kwambiri masiku oyambira, mapiritsi amakula mpaka 600 mg 2 pa tsiku amaloledwa, kumayambiriro kwa chithandizo chamankhwala chodziwonetsa, Zeptol imagwiritsidwa ntchito limodzi ndi chithandizo cha detoxification ndi sedative and hypnotics (chlordiazepoxide, clumbwaazole), mutatha gawo lomaliza, mankhwalawa angagwiritsidwe ntchito monotherapy mode,
• Matenda okhudzana - chithandizo ndi prophylaxis (mapiritsi), matenda okhudzana ndi kupuma - kukonza mankhwalawa, mapiritsi owopsa a mankhwalawa: perekani 200 mg ya mg tsiku lililonse mkati mwa sabata loyamba la maphunzirowo, kenako onjezani mlingo mlungu uliwonse ndi 200 mg, kubweretsa 1000 mg patsiku, wogawika awiri.

Kutalika kwa mankhwala kukhazikitsidwa ndi adokotala, chithandizo chiyenera kumalizidwa pang'onopang'ono. Kusintha kutenga Zeptol kumafunika pang'onopang'ono, ndikuchepetsa pang'onopang'ono muyezo wa mankhwala apitawa.

Zotsatira zoyipa

Poyesa kuchuluka kwa zomwe zimachitika pazochitika zoyipa, zotsatirazi zidagwiritsidwa ntchito: nthawi zambiri - 10% kapena kuposerapo, nthawi zambiri - kuchokera pa 1% mpaka 10%, mwapang'onopang'ono - kuyambira 0.1% mpaka 1%, kawirikawiri - kuchokera pa 0,01% mpaka 0.1% , zosowa kwambiri - zosakwana 0.01%:

• CNS: Nthawi zambiri - kumva kutopa, chizungulire, kugona, ataxia, nthawi zambiri - madipulopu, kusokonezeka pogona (kuphatikizapo kusawona bwino), kupweteka mutu, pafupipafupi - nystagmus, kugwedezeka mwamphamvu kosafunikira (tics, kugwedezeka, kugwedezeka mwamphamvu - ma asterixis , dystonia), kawirikawiri - kusokonezeka kwa oculomotor, orsacial dyskinesia, kusokonezeka kwa mawu (dysarthria), paresthesias, zotumphukira za neuropathy, paresis, choreoathetosis, kawirikawiri kwambiri - kusokonezedwa kwamavuto, zilonda za antipsychotic,
• mtima dongosolo (CVS): kawirikawiri - kuchepa / kuwonjezeka kwa kuthamanga kwa magazi (BP), kusokonezeka kwa mtima, zosowa kwambiri - arrhythmias, bradycardia, AV block ndi kukomoka, CHF, thromboembolism (kuphatikizapo pulmonary artery), thrombophlebitis kugwa, kuchulukitsa kwa matenda a mtima (CHD),
• matenda amisala: kawirikawiri - nkhawa, kukwiya, kupsa mtima, kuwonera, kuyerekezera zinthu, kukhumudwa, kusokonezeka, kawirikawiri - kuyambitsa psychosis,
• hypersensitivity reaction (ndi chitukuko cha zomwe tafotokozazi, zosokonezeka zimawonedwa mosiyanasiyana), ziwalo zina (kuphatikizapo myocardium, kapamba, mapapu, impso, colon ), Kawirikawiri - meninjaitisi aseptic ndi myoclonus ndi eosinophilia zotumphukira, angioedema, anaphylactic anachita,
• thupi lawo siligwirizana: pafupipafupi - urticaria (kuphatikizapo kutchulidwa kwambiri), dermatitis, pafupipafupi - erythroderma, exfoliative dermatitis, kawirikawiri - kuyabwa, zokhudza lupus erythematosus, zosowa kwambiri - kuchepa kwa tsitsi, thukuta, ziphuphu, utoto, khungu , photosensitization reaction, erythema multiforme ndi nodosum, poyidermerm necrolysis, matenda a Stevens-Johnson, zochitika zokhazokha za hirsutism zidalembedwa (ubale wapadera wa mawonekedwe a kuphatikizika uku ndi kugwiritsidwa ntchito kwa Zeptol sikuti ndi pakamwa. kusinthidwa)
• hepatobiliary system: pafupipafupi - kuchuluka kwa ntchito ya gamma-glutamyltransferase (GGT) chifukwa cha kupatsidwa mphamvu kwa chiwindi (nthawi zambiri kulibe tanthauzo), kawirikawiri - ntchito yowonjezera ya alkaline phosphatase (ALP) m'magazi, pafupipafupi - kuchuluka kwama transaminase, kawirikawiri - chiwonongeko intrahepatic bile ducts, zomwe zimapangitsa kuchepa kwa iwo, jaundice, hepatitis ya parenchymal (hepatocellular), cholestatic kapena mtundu wosakanikirana, osowa kwambiri - chiwindi kulephera, granulomatous hepatitis,
• kupukusa m'mimba: kawirikawiri - kusanza, nseru, kawirikawiri - mkamwa wowuma, kawirikawiri - kudzimbidwa / kutsegula m'mimba, kawirikawiri - kupweteka kwam'mimba, kosowa kwambiri - stomatitis, glossitis, kapamba,
• ziwalo za hematopoietic: Nthawi zambiri - leukopenia, nthawi zambiri - eosinophilia, thrombocytopenia, kawirikawiri - kuperewera kwa asidi, lymphadenopathy, leukocytosis, osowa kwambiri - kuchepa kwa magazi, kuperewera kwa erythrocyte, aplasia gawo la porphyria, reticulocytosis,
• Dongosolo la genitourinary: chosowa kwambiri - kusungika kwamikodzo, kusokonekera pafupipafupi, nephritis, kusokonezeka kwa impso (oliguria, hematuria, albuminuria, kuchuluka kwa urea / azotemia), kulephera kwa impso, kuchepa kwa umuna ndi kusunthika, kusowa pogonana / kusabala,
• endocrine dongosolo ndi kagayidwe: kawirikawiri - kuchuluka kwa thupi, kuchepa kwamadzi, edema, kuchepa kwa magazi osmolarity ndi hyponatremia chifukwa cha zotsatira zofanana ndi ADH, zomwe nthawi zambiri zimayambitsa kuchepa kwa hyponatremia (kuledzera kwa madzi), komwe kumachitika ndi mutu, kusanza, ulesi , kusokonezeka kwa mitsempha ndi kusokonezeka, kawirikawiri - kuwonjezeka kwa milingo ya prolactin yokhala ndi galactorrhea kapena galactorrhea, gynecomastia, kusintha kwa zidziwitso za chithokomiro - kuchepa kwa zomwe zili ndi L-thyroxine (thyroxine, free thyroxine, triiodothyronine) ndikuwonjezereka kwa kuchuluka kwa mahomoni olimbikitsa chithokomiro (TSH) (nthawi zambiri samayendetsedwa ndi mawonetsedwe azachipatala), kufooka kwa mafupa (kuchepa kwa magazi a 25-hydroxycholecalciferol ndi calcium), komwe kumayambitsa cholesterol, kuphatikiza cholesterol, kuphatikizapo Cholesterol lipensracins yapamwamba kwambiri, ndi triglycerides,
• ziwalo zamalingaliro: zosowa kwambiri - conjunctivitis, kugundika kwa ma ndimu, kukhathamira kwa magazi, kumva kuwonongeka, kuphatikizapo tinnitus, kusintha kwa kuzindikira kwa phula, hypoacusia, hyperacusis,
• minofu: mafupa a minofu ndi mafupa: ochepa kufooka - kuchepa kwa minofu kapena kukokana, arthralgia.

Zotsatira zoyipa

Kumayambiriro kwa mankhwalawa kapena kugwiritsa ntchito mankhwalawa poyambira kuchuluka kwa mankhwalawa komanso chithandizo cha odwala okalamba, mitundu ina ya zovuta zimachitika mwachitsanzo, kuchokera ku chapakati mantha dongosolo (CNS) (chizungulire, kupweteka mutu, ataxia, kugona, kufooka kwa onse, diplopia) mbali ya m'mimba thirakiti (nseru, kusanza) kapena thupi lawo siligwirizana.

Mlingo wothandizidwa ndi Mlingo womwe umachitika pakadutsa masiku angapo umachitika pakangotha ​​masiku ochepa komanso pambuyo pochepetsedwa kwakanthawi mlingo wa mankhwala.

Mbali yamagazi: leukopenia thrombocytopenia, eosinophilia, leukocytosis, lymphadenopathy, kuperewera kwa asidi, agranulocytosis, aplasic anemia, pancytopenia, erythrocytic aplasia, kuchepa kwa magazi, megaloblastic anemia, pachimake porphyria, porphyria.

Kuchokera ku chitetezo chamthupi : akuchedwa-Type multi-organ hypersensitivity fever, zotupa za pakhungu, vasculitis, lymphadenopathy, zizindikiro zofanana ndi zamitsempha, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly ndikusintha kwa chiwindi ndi bile duct mofulumira. . Pakhoza kukhala zovuta zina kuchokera ku ziwalo zina (mwachitsanzo, chiwindi, mapapu, impso, kapamba, myocardium, colon), aseptic meningitis yokhala ndi myoclonus ndi zotumphukira za eosinophilia, anaphylactic reaction, angioedema, hypogammaglobulinemia.

Dongosolo la Endocrine : edema, kusungunuka kwa madzimadzi, kuchuluka kwa thupi, kuchepa kwa magazi m'magazi am'mimba chifukwa cha zotsatira zofanana ndi ADH, zomwe nthawi zambiri zimayambitsa matenda oopsa, omwe amayamba chifukwa cha kupha, kusanza, kupweteka mutu, kusokonezeka ndi mitsempha, kuchuluka kwa prolactin, limodzi ndi osayenda ndi mawonekedwe monga galactorrhea, gynecomastia, kusokonekera kwa mafupa kagayidwe (kuchepa kwa calcium ndi 25-hydroxycolecalciferol mu plasma yamagazi), kumabweretsa osteomalacia / osteoporosis nthawi zina - kuwonjezereka kwa kuchuluka kwa cholesterol, kuphatikiza kachulukidwe kwambiri lipoprotein cholesterol ndi triglycerides.

Kuchokera kumbali ya kagayidwe kazakudya ndi matenda: kuperewera kwa folate, kuchepa kwa chilimwe, porphyria pachimake (porphyria pachimake ndi porphyria wosakanikirana), porphyria wosapweteka kwambiri (kumapeto kwa khungu).

Kuchokera kumbali ya psyche: kuyerekezera zinthu (zowoneka kapena zowerengera), kukhumudwa, kutaya mtima, kuda nkhawa, kuchita ukali, kusokoneza, kusokoneza, kuyambitsa psychosis.

Kuchokera ku dongosolo lamanjenje: chizungulire, ataxia, kugona, kufooka, mutu, diplopia, kusowa malo okhala (mwachitsanzo, kusawona bwino), kusunthika kwina kosafunikira (mwachitsanzo, kunjenjemera, "kunjenjemera", kusowa kwa magazi, kusowa kwa maso, kusokonezeka kwa maonekedwe, kusokonekera kwa malankhulidwe. (mwachitsanzo dysarthria kapena mawu osakhazikika), choreoathetosis, zotumphukira zamitsempha, zotupa, kufooka kwa minofu ndi paresis, kuwonongeka kwa ululu, matenda oopsa a antipsychotic, aseptic meningitis ndi myoclonia ndi zotumphukira. eskoy eosinophilia, dysgeusia.

Kuchokera kumbali ya gawo la masomphenyawo: kusokonezeka kwa malo okhala (mwachitsanzo, masomphenya osasunthika), kugundana kwa mandala, conjunctivitis, kuchuluka kwazomwe zimachitika.

Mbali ya ziwalo zomva: mavuto a makutu, monga tinnitus, mphamvu zowonjezera zamalingaliro, kuchepa kwa chidwi champhamvu, kuzindikira kwa phula.

Kuchokera pamtima : intracardiac conduction chisokonezo ochepa matenda oopsa kapena ochepa hypotension bradycardia, arrhythmia, syncope blockade, circulatory kugwa, mtima kulephera, exacerbation wa ischemic matenda, thrombophlebitis, thromboembolism (mwachitsanzo pulmonary embolism).

Kuchokera ku kupuma : Pulmonary hypersensitivity reaction yokhala ndi kutentha thupi, kufupika, chibayo, kapena chibayo.

Kuchokera m'mimba: kusanza, kusanza, kukamwa kowuma, kutsekula m'mimba kapena kudzimbidwa, kupweteka kwam'mimba, glossitis, stomatitis, kapamba.

Kuchokera m'mimba: kuwonjezeka kwa gamma-glutamyltransferase (chifukwa cha kuphatikiza kwa enzyme ya chiwindi), kawirikawiri sakhala ndi tanthauzo lachipatala, kuwonjezeka kwa phosphatase yamagazi, kuchuluka kwa transaminases, hepatitis ya cholestatic, parenchymal (hepatocellular) kapena mitundu yosakanikirana, jaundice granulomat hepatitis.

Pa khungu ndi subcutaneous minofu: zilonda zamkati, urticaria, nthawi zina zoopsa, zotupa zamkaka, erythroderma, zokhudza zonse lupus erythematosus, kuyabwa kwa Stevens-Johnson syndrome, erythema epermosis, photosensitivity, erythema multiforme ndi nodosum, vuto la pakhungu la khungu, kuchepa kwa magazi, kuchuluka kwa magazi hirsutism.

Kuchokera ku minculoskeletal system : kufooka kwa minofu, arthralgia, kupweteka kwa minofu, kuphipha kwa minofu, kuchepa kwa mafupa (kuchepa kwa calcium ndi 25-hydroxycolcalcaliferol mu plasma yamagazi, komwe kungayambitse osteomalacia kapena osteoporosis).

Kuchokera pamikodzo: tubulointerstitial nephritis, aimpso kulephera, aimpso ntchito (albinuria, hematuria, oliguria, kuchuluka magazi urea / azotemia), kukodza pafupipafupi, kwamikodzo posungira.

Kuchokera ku kubereka : kusowa pogonana / kusabala / kukokoloka, kusokonekera kwa spermatogenesis (ndi kuchepa kwa chiwerengero / motility ya umuna).

Zophwanya wamba: kufooka.

Zizindikiro zasayansi: kuchuluka kwa gamma-glutamyltransferase (komwe kumachitika chifukwa cha michere ya chiwindi), yomwe nthawi zambiri ilibe tanthauzo la kuchipatala, kuchuluka kwa alkaline phosphatase m'magazi, kuchuluka kwa transaminases, kuchuluka kwa intraocular anzawo, kuchuluka kwa cholesterol yamagazi, kuchuluka kwa lipoproteins okwera kwambiri. kusintha kwa magazi pantchito ya chithokomiro: kuchepa kwa L-thyroxine (FT _4, T _4, T ₃ ) ndi mulingo wa mahomoni olimbikitsa chithokomiro, omwe, monga lamulo, samatsatiridwa ndi chiwonetsero chachipatala, kuchuluka kwa prolactin m'magazi, hypogammaglobulinemia.

Zotsatira zoyipa malinga ndi mauthenga ongobwera.

Matenda opatsirana komanso parasitic: kukonzanso kwa matenda a herpes virus VI.

Mbali yamagazi: kufooka kwa mafupa.

Kuchokera ku dongosolo lamanjenje: sedation, kukumbukira kuwonongeka.

Kuchokera m'mimba: mitengo.

Kuchokera ku chitetezo chamthupi : zotupa za mankhwala osokoneza bongo omwe ali ndi eosinophilia ndi zizindikiro za systemic (DRESS).

Pa khungu ndi subcutaneous minofu: pachimake kukhathamiritsa kwapadera chiberekero (AGEP), lichenoid keratosis, onychomadeus.

Kuchokera ku minculoskeletal system : zophulika.

Zizindikiro zasayansi: kuchepa kwa mafupa a minerals.

Bongo

Zizindikiro Zizindikiro ndi madandaulo obwera chifukwa cha mankhwala osokoneza bongo nthawi zambiri zimawonetsa kuwonongeka kwamitsempha yamkati, mtima ndi kupuma.

Pakati mantha dongosolo : kupsinjika kwa chapakati mantha dongosolo, kusokonezeka, kukhumudwa, kugona, kukhumudwa, kuyerekezera zinthu zina, kukomoka, masisitere olankhula, dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (woyamba), hyporeflexia (pambuyo pake), kukomoka, kusokonezeka kwa malingaliro, maseru mydriasis.

Machitidwe opatsirana: kupsinjika, pulmonary edema.

Matenda a mtima: tachycardia, ochepa hypotension, ochepa matenda oopsa, kusokonezeka kwa kulowetsedwa kwa zovuta kwa QRS, syncope yokhudzana ndi kumangidwa kwamtima, limodzi ndi kuwonongeka kwa chikumbumtima.

Matumbo: kusanza, kusunga chakudya m'mimba, kutsika kwa m'mimba.

Makina a minofu ndi mafupa: milandu yachilendo ya rhabdomyolysis yokhudzana ndi poizoni wa carbamazepine akuti.

Njira yamikodzo : kwamikodzo posungira, oliguria kapena anuria madzimadzi posungira, kuchepa thupi chifukwa cha zotsatira za carbamazepine, zofanana ndi ADH.

Kumbali ya zowonetsa zasayansi: hyponatremia, metabolic acidosis, hyperglycemia, kuchuluka kwa minyewa ya CPK ndikotheka.

Chithandizo. Palibe mankhwala enieni. Choyamba, chithandizo chikuyenera kukhala chogwirizana ndi momwe wodwalayo alili, kuchipatala kumasonyezedwa. Kuphatikizika kwa carbamazepine m'madzi a m'magazi kutsimikiza kutsimikiza poyizoni ndi wothandizirayo ndikuwunika kuchuluka kwa bongo.

Zomwe zili m'mimba zimachotsedwa, m'mimba zimatsukidwa, ndikuyambitsa makala. Kutuluka mochulukirapo kwa m'matumbo kumatha kubweretsa kuchepetsedwa kwa mayamwidwe ndikuwonekeranso kwa zizindikiro za kuledzera panthawi yobwezeretsa. Chithandizo chothandizira chazizindikiro chimagwiritsidwa ntchito m'chipinda chothandizira kwambiri, kuwunika ntchito za mtima, kukonza mavuto a electrolyte.

Malangizo apadera. Ndi chitukuko cha ochepa hypotension, makonzedwe a dopamine kapena dobutamine akuwonetsedwa, ndikupanga mtima wa mtima, chithandizo chiyenera kusankhidwa payekha, ndikupanga kukomoka, kuyang'anira kwa benzodiazepines (mwachitsanzo diazepam) kapena ma anticonvulsants ena, monga phenobarbital (mosamala chifukwa chakuwonjezeka kwa kupsinjika) paraldehyde, ndi kukula kwa hyponatremia (madzi kuledzera) - kuletsa magazi, kusamala kulowetsedwa kwa 0.9% sodium kolorayidi yankho. Njira izi zitha kukhala zothandiza poletsa ubongo edema.

Hemosorption pa kaboni sorbents tikulimbikitsidwa. Kusakwanira kwa kukakamiza diuresis ndi peritoneal dialysis akuti.

Ndikofunikira kuperekera mwayi wopititsa patsogolo zizindikiritso za mankhwala osokoneza bongo patsiku la 2 ndi 3 atayambika, chifukwa cha kuchepetsedwa kwa mankhwalawa.

Gwiritsani ntchito pa nthawi yoyembekezera kapena mkaka wa m'mawere.

Kukonzekera kwamlomo wa carbamazepine kumayambitsa kukula kwa zolakwika.

Mwa ana omwe amayi awo ali ndi khunyu, amakhala ndi vuto losakhazikika mu intrauterine, kuphatikizapo kusabereka.

Zitsogozo zotsatirazi ziyenera kutsatiridwa.

• Kugwiritsa ntchito mankhwalawa kwa amayi apakati omwe ali ndi khunyu kumafuna chisamaliro chapadera.
• Ngati mayi yemwe alandila Zeptol ali ndi pakati, akufuna kukhala ndi pakati kapena akufunika kugwiritsa ntchito mankhwalawa panthawi yomwe ali ndi pakati, phindu lomwe mungagwiritse ntchito mankhwalawa liyenera kuyesedwa mosamala pangozi yomwe ingachitike (makamaka munthawi yoyamba kubereka).
• Amayi azaka zakubala, ngati zingatheke, Zeptol iyenera kutumizidwa ngati monotherapy.
• Ndikulimbikitsidwa kupereka mankhwala ochepera kwambiri ndikuwunika kuchuluka kwa carbamazepine m'madzi a m'magazi.
• Odwala ayenera kudziwitsidwa za chiwopsezo chowonjezereka cha kubadwa mwatsopano ndipo ayenera kupatsidwanso mwayi wowunikira.
• Pa nthawi yoyembekezera, mankhwala othandizira antiepileptic sayenera kudodometsedwa, chifukwa kufalikira kwa matendawa kumaopseza thanzi la mayi ndi mwana.

Kuwona ndi kupewa. Amadziwika kuti panthawi ya kuperewera kwa folic acid amayamba. Mankhwala othandizira antiepileptic amatha kuwonjezera kuchepa kwa folic acid, ndichifukwa chake kupatsidwa folic acid kumalimbikitsidwa isanachitike komanso nthawi yapakati.

Makanda atsopano. Pofuna kupewetsa kusokonekera kwa ana akhanda, ndikulimbikitsidwa kupatsa vitamini K ₁ amayi masabata omaliza a mimba komanso mwana wakhanda.

Zovuta zingapo za kuyesedwa ndi / kapena kupuma kwa ana zatsopano zimadziwika, milandu ingapo ya kusanza, kutsekula m'mimba ndi / kapena kusowa kudya mwaubwino kwa ana akhanda omwe amagwirizana ndi kugwiritsa ntchito mankhwala Zeptol ndi anticonvulsants ena.

Kuyamwitsa. Carbamazepine akudutsa mkaka wa m'mawere (25-60% ya plasma concentration). Ubwino woyamwitsa ndi mwayi wokhala ndi zovuta zakakhanda mtsogolo ziyenera kuyesedwa mosamala. Amayi omwe amalandila Zeptol amatha kuyamwitsa, pokhapokha ngati mwana amawonekera kuti atenge mawonekedwe oyipa (mwachitsanzo, kugona kwambiri, khungu lawo siligwirizana).

Milandu yokhala ndi vuto losabereka mwa abambo ndi / kapena zodabwiza za spermatogeneis zanenedwapo.

Ana omwe amachotsedwa mwachangu a carbamazepine angafunike kugwiritsa ntchito Mlingo wambiri wa mankhwala (pa kilogalamu ya thupi) poyerekeza ndi akulu. Mapiritsi a Zeptol amatha kumwedwa kwa ana azaka 5.

Zolemba ntchito

Zeptol iyenera kugwiritsidwa ntchito poyang'anira, pokhapokha pofufuza phindu / chiopsezo, pokhapokha ngati odwala omwe ali ndi mtima, chiwopsezo cha hepatic kapena aimpso, kusintha kwa ma hematological osagwirizana ndi mankhwala ena m'mbiri ndipo odwala omwe ali ndi chithandizo chamankhwala osokoneza amayang'aniridwa mosamala.

General urinalysis ndi kutsimikiza kwa mulingo wa urea nayitrogeni m'magazi pachiyambi komanso pafupipafupi panthawi ya mankhwala akulimbikitsidwa.

Zeptol imawonetsa ntchito yofatsa ya anticholinergic, kotero odwala omwe ali ndi kukhudzika kwachulukidwe kachuma ayenera kuchenjezedwa ndikuwalangizidwa za ngozi yomwe ingachitike.

Tiyenera kukumbukira za kutseguka kwa ma psychent a psychent, ndi odwala okalamba - zokhudzana ndi momwe zingayambitsire chisokonezo ndi nkhawa.

Mankhwalawa nthawi zambiri amakhala osagwira chifukwa chotsalira (kukomoka pang'ono) komanso kugwidwa myoclonic. Milandu yodzipatula imawonetsa kuti kugwidwa kowonjezereka ndikotheka kwa odwala omwe akusowa kwa atypical.

Hematologic zotsatira. Kugwiritsa ntchito mankhwalawa kumalumikizidwa ndi kukula kwa agranulocytosis ndi aplastic anemia, komabe, chifukwa chochepa kwambiri pazomwe zimachitika, nkovuta kudziwa kuyesa komwe kumachitika mukamwa mankhwalawo.

Odwala ayenera kudziwitsidwa za zizindikiro zoyambirira za kawopsedwe ndi zizindikiro za kuthekera kwa hematologic, komanso zizindikiro za kukhudzana kwa khungu ndi chiwindi.

Ngati kuchuluka kwa leukocytes kapena mapiritsi amatsika kwambiri panthawi yamankhwala, mkhalidwe wa wodwalayo uyenera kuyang'aniridwa mosamala ndipo kuyesa kwa magazi kwa wodwalayo kuyenera kuchitidwa pafupipafupi. Kuchiza ndi Zeptol kuyenera kutha ngati wodwalayo akayamba leukopenia, womwe ndi woopsa, wopita patsogolo, kapena wothandizidwa ndi matenda, monga malungo kapena zilonda zapakhosi. Kugwiritsa ntchito mankhwalawa kuyenera kusiyidwa ngati zizindikiro za kuletsa kwa mafupa zikuwonekera.

Nthawi zambiri pamakhala kuchepa kwakanthawi kapena kosasunthika kwa kuchuluka kwa mapulosi kapena maselo oyera pamagazi pogwiritsa ntchito mankhwala a Zeptol. Komabe, nthawi zambiri, izi zimachitika kwakanthawi ndipo sizikuwonetsa kukula kwa aplasic anemia kapena agranulocytosis. Asanayambe chithandizo komanso nthawi ndi nthawi akukonzekera, kuyezetsa magazi kuyenera kuchitika, kuphatikizira kudziwa kuchuluka kwa mapulateleti (komanso, mwina, kuchuluka kwa reticulocytes komanso kuchuluka kwa hemoglobin).

Zoopsa zazakhungu. Zovuta zazikulu za dermatological, kuphatikiza poizoni wa epidermal necrolysis (TEN), matenda a Lyell, a Stevens-Johnson syndrome (SJS), ndi osowa kwambiri ndi kugwiritsa ntchito mankhwalawa. Odwala omwe ali ndi vuto lalikulu la dermatological angafunike kuchipatala, chifukwa izi zitha kupha. Milandu yambiri ya SJS / TEN imayamba mu miyezi ingapo yoyambirira ya mankhwala ndi Zeptol. Ndi chitukuko cha zizindikiro zomwe zikuwonetsa kuti pali vuto lalikulu la dermatological reaction (mwachitsanzo, SJS, matenda a Lyell / TEN), mankhwalawa ayenera kuyimitsidwa pomwepo ndipo njira zina zochiritsira ziyenera kutumizidwa.

Pali umboni wowonjezereka wa zotsatira za ma HLA osiyanasiyana pamalingaliro a wodwalayo pazovuta zomwe zimakhudzana ndi chitetezo cha mthupi.

Odwala omwe ali pachiwopsezo cha genetic, Zeptol amayenera kuyesedwa allele (HLA) -B * 1502 asanayambe chithandizo.

Allele (HLA) -B * 1502 imatha kukhala pachiwopsezo chotukuka kwa SJS / TEN mwa odwala aku China omwe amalandila mankhwala ena a antiepileptic omwe angagwirizane ndi kupezeka kwa SJS / TEN. Chifukwa chake, kugwiritsa ntchito mankhwala ena omwe amatha kuphatikizidwa ndi kupezeka kwa SJS / TEN kuyenera kupewedwa mwa odwala omwe ali ndi allele (HLA) -B * 1502, ngati njira zina zingagwiritsidwe ntchito.

Kuyankhulana ndi HLA-A * 3101

Anti leukocyte antigen imatha kukhala pachiwopsezo chotupa cha khungu, monga SJS, TEN, zotupa zamankhwala zotupa ndi eosinophilia ndi zizindikiro za systemic (DRESS), pachimake kwambiri cha pentulosis pentulosis (AGEP), maculopapular. Ngati kusanthula kumazindikira kupezeka kwa HLA-A * 3101 allele, ndiye kuti muyenera kupewa kugwiritsa ntchito mankhwalawa.

Malire Ochepetsa Kuwona

Zotsatira za genetic siziyenera kulowetsa m'malo moyenera pazachipatala ndi chithandizo cha odwala. Zina zomwe zimachitika ndi zomwe zimapangitsa kuti pakhale zotsatirazi zovuta za khungu, monga mlingo wa antiepileptic wothandizira, kutsatira dongosolo la mankhwala, komanso chithandizo chamankhwala. Zotsatira zamatenda ena ndi kuchuluka kwa kuwunika kwa khungu sizinaphunzire.

Zochitika zina zazakhungu.

Ndizothekanso kukula kwa kanthawi kochepa komanso komwe sikumaopseze thanzi, mwachidziwitso, pakumvekera kwapadera kapena maculopapular exanthema. Nthawi zambiri amadutsa patatha masiku angapo kapena milungu yambiri, onse pa mlingo womwewo komanso atatha kuchepetsa kumwa. Popeza zisonyezo zoyambirira za vuto lakelo zingakhale zovuta kwambiri kusiyanitsa ndi zofatsa, zomwe zimachitika mwachangu, wodwalayo ayenera kuyang'aniridwa kuti asiye kugwiritsa ntchito mankhwalawa ngati vutolo likukula.

Kupezeka kwa HLA-A * 3101 allele mu wodwala kumayenderana ndi kupezeka kovuta kwambiri pakhungu mpaka carbamazepine, monga hypersensitivity syndrome mpaka anticonvulsants kapena totupa zazing'ono (maculopapular rashes).

Hypersensitivity. Zeptol ikhoza kuyambitsa kusintha kwa hypersensitivity reaction, kuphatikiza mankhwala osokoneza bongo omwe amakhala ndi eosinophilia ndi systemic dalili (DRESS), mitundu yochepa pang'onopang'ono ya hypersensitivity reaction fever, zidzolo, vasculitis, lymphadenopathy, pseudolymphoma, arthralgia, leukopenia, eosinophilia ma ducts a bile (kuphatikiza kuwonongeka ndi kuzimiririka kwa ma ducts a intra-ductal), omwe amatha kuphatikizidwa mosiyanasiyana. Zothekera zimakhudzanso ziwalo zina (mapapu, impso, kapamba, myocardium, colon).

Kupezeka kwa HLA-A * 3101 alile mu wodwala kumayenderana ndi kupezeka kovuta kwambiri kwa carbamazepine kuchokera pakhungu, monga hypersensitivity syndrome mpaka anticonvulsants kapena totupa zazing'ono (maculopapular rashes).

Odwala omwe ali ndi vuto la hypersensitivity ku carbamazepine ayenera kudziwitsidwa kuti pafupifupi 25-30% ya odwala oterowo amatha kukhala ndi hypersensitivity reaction ku oxcarbazepine.

Pogwiritsa ntchito carbamazepine ndi phenytoin, kukula kwa mtanda hypersensitivity ndikotheka.

Mwambiri, pamene zizindikiro zikusonyeza hypersensitivity, mankhwala ayenera kuyimitsidwa yomweyo.

Ma Bout. Zeptol iyenera kugwiritsidwa ntchito mosamala kwa odwala omwe ali ndi mavuto osiyanasiyana omwe amapezeka ndi kutalikirana (mwachizolowezi kapena kwa atypical). Zikatero, mankhwalawa amathanso kukweza. Pofuna kukhumudwitsa, kugwiritsa ntchito mankhwalawa kuyenera kuyimitsidwa nthawi yomweyo.

Kuwonjezeka kwa pafupipafupi kwa kukomoka ndikotheka pakusintha kuchoka pamitundu yamkamwa kupita ku suppositories.

Ntchito ya chiwindi. Mankhwala othandizira, amafunikira kuwunika ntchito ya chiwindi koyamba komanso nthawi zina pamankhwala, makamaka odwala omwe ali ndi mbiri ya matenda a chiwindi komanso odwala okalamba.

Zizindikiro zina zomwe zimayesa magwiridwe antchito a chiwindi odwala omwe atenga carbamazepine atha kupitilira muyeso, makamaka gamma-glutamyltransferase (GGT). Izi mwina ndi chifukwa cha kuphatikizidwa kwa michere ya chiwindi. Kuphatikiza kwa enzyme kumathandizanso kuti chiwopsezo chochuluka cha milingo ya zamchere. Kuwonjezeka kotereku kwa ntchito ya hepatic metabolism sichizindikiro cha kuthetsedwa kwa carbamazepine.

Kusintha kokwanira kwa chiwindi chifukwa chogwiritsa ntchito carbamazepine ndizosowa kwambiri. Panthawi ya chizindikiro cha kukanika kwa chiwindi kapena matenda okhudzana ndi chiwindi, ndikofunikira kupenda wodwalayo mwachangu, ndikuletsa chithandizo cha Zeptol.

Impso. Ndikulimbikitsidwa kuwunika ntchito ya aimpso ndikudziwona kuchuluka kwa urea nayitrogeni koyambirira komanso nthawi yanthawi yamankhwala.

Hyponatremia. Milandu ya chitukuko cha hyponatremia wogwiritsa ntchito carbamazepine amadziwika. Odwala omwe ali ndi vuto la impso, amaphatikizidwa ndi kuchepetsedwa kwa sodium, komanso odwala omwe amathandizidwa nthawi yomweyo ndimankhwala omwe amachepetsa kuchuluka kwa sodium (monga diuretics, mankhwala omwe amathandizidwa ndi secretion yayikulu ya ADH), milingo ya sodium yoyenera iyenera kuyesedwa musanalandire chithandizo. M'tsogolomu, mulingo wa sodium uyenera kuwerengedwa pakatha masabata awiri alionse, ndiye - pakubwereza kwa mwezi umodzi m'miyezi itatu yoyambirira ya chithandizo kapena zovuta zamankhwala. Izi zimagwira makamaka kwa okalamba. Poterepa, kuchepetsa kuchuluka kwa madzi omwe amamwa.

Hypothyroidism. Carbamazepine imatha kuchepetsa kuchuluka kwa mahomoni a chithokomiro - motere, kuwonjezeka kwa kuchuluka kwa mankhwala a chithokomiro m'thupi kwa odwala omwe ali ndi hypothyroidism ndikofunikira.

Zotsatira za anticholinergic. Zeptol imawonetsa anticholinergic zochitika zolimbitsa thupi. Chifukwa chake, odwala omwe ali ndi vuto lochulukirapo la intraocular ndi posungira kwamikodzo amayenera kuyang'aniridwa mosamala pakumwa.

Zotsatira zam'maganizo. Kumbukirani kuthekera kwa psychosis yachilendo kukhala wotakataka, odwala okalamba - chisokonezo kapena kukongola.

Malingaliro odzipha ndi machitidwe. Pakhala pali umboni wa malingaliro ofuna kudzipha ndi chikhalidwe mwa odwala omwe amalandila antiepileptic mankhwala. Chifukwa chake, odwala ayenera kuyang'aniridwa kuti adziphe ngati ali ndi malingaliro ofuna kudzipha komanso ngati kuli koyenera, ayenera kulandira chithandizo choyenera. Odwala (ndi osamalira anzawo) ayenera kulangizidwa kuti akaonane ndi dokotala ngati zizindikirika za malingaliro ofuna kudzipha ndi khalidwe lanu.

Zotsatira za endocrine. Mwa kuphatikizidwa kwa michere ya chiwindi, Zeptol ikhoza kuyambitsa kuchepa mu achire zotsatira za estrogen ndi / kapena kukonzekera kwa progesterone. Izi zimatha kuthandizira kuchepa kwa mphamvu yakulera, kuyambiranso kwa zizindikiro, kapena kutsika magazi kapena kuona. Odwala omwe amatenga Zeptol ndi amene amathandizira kulera kwa mahomoni ayenera kulandira mankhwala omwe ali ndi ma maikulosite 50 a estrogen, kapena agwiritsidwe ntchito njira zina zosagwiritsa ntchito mahomoni pakuletsa kubereka.

Kuyang'anira kuchuluka kwa mankhwalawa m'magazi am'magazi. Ngakhale kuti kuphatikiza pakati pa kuchuluka ndi kuchuluka kwa carbamazepine m'magazi amwazi, komanso pakati pa msinkhu wa carbamazepine m'magazi am'magazi komanso kuthandizira kwachipatala komanso kulolera sikungakhale kodalirika, kuyang'anira kuchuluka kwa mankhwalawa m'magazi a m'magazi kungakhale koyenera pazochitika zotsatirazi: kuwonjezeka kwadzidzidzi pafupipafupi. kutsatira kwa wodwala, pa nthawi yoyembekezera, pochiza ana ndi achinyamata, ndikulakwa kwa kuyamwa, ndikuwakayikira komanso kugwiritsa ntchito mankhwala opitilira umodzi.

Kuchepetsa Mlingo ndi kusiya mankhwala. Kuchoka kwadzidzidzi kwa mankhwalawa kumayambitsa kukomoka. Ngati kuli kofunikira kusiya mwadzidzidzi mankhwala omwe ali ndi odwala omwe ali ndi khunyu, kusintha kwa mankhwala ena atsopano antiepileptic kuyenera kuchitika motsutsana ndi maziko a mankhwala ndi mankhwala oyenera (mwachitsanzo, diazepam kudzera m'mitsempha, pcttoin kapena mtsempha wamagazi.

Kuchepetsa Mlingo ndi kusiya mankhwala. Kuchoka kwadzidzidzi kwa mankhwalawa kungayambitse kugwidwa, kotero carbamazepine iyenera kutengedwa pang'onopang'ono kwa miyezi isanu ndi umodzi. Ngati ndi kotheka kusiya mankhwala kwa odwala omwe ali ndi khunyu, kusintha kwa mankhwala ena atsopano kuyenera kuchitika motsutsana ndi maziko a mankhwala omwe ali ndi mankhwala oyenera.

Malangizo apadera

Zochita za Zeptol nthawi zambiri zimakhala zopanda ntchito pokoka khunyu pang'ono (kusakhalapo) komanso kukomoka kwa myoclonic. Pamaso pa mitundu yosakanikirana ya khunyu, mankhwalawa ayenera kugwiritsidwa ntchito mosamala ndikuyang'aniridwa ndi achipatala pafupipafupi chifukwa choopsa cha kukodzedwa kwawo. Kulandila kwa Zeptolum kuyenera kuthetsedwa ngati kuwonjezereka kwa kuukira kwa khunyu kumawonedwa.

Panthawi yamankhwala, kuchepa kwakanthawi / kosalekeza kwa manambala a leukocytes kapena zambiri zopezeka m'mapuloteni titha kudziwika, nthawi zambiri kumakhala kwakanthawi koma osawonetsa kuwonekera kwa agranulocytosis kapena anemia aplastic. Maphunzirowa asanayambike, komanso pakachitika chithandizo, kuyezetsa magazi kwamankhwala kumafunika, kuphatikizapo kuwerengera kwamapulogalamu, komanso, reticulocytes, ndikuwona mulingo wa hemoglobin.

Odwala ayenera kudziwa zoyambirira za kawopsedwe ndi zizindikiro zomwe zimayambitsa zovuta za hematologic, komanso zizindikiro kuchokera pakhungu ndi chiwindi. Ndikofunikira kuonana ndi dotolo kuti mupeze zovuta monga zilonda zapakhosi, kutentha thupi, zotupa, zotupa zamkamwa, komanso mawonekedwe osokonekera a zotupa ndi zotupa. Pazifukwa za kukhumudwa kwambiri m'mafupa, Zeptol iyenera kuthetsedwa.

Asanayambe maphunziro a mankhwalawa komanso nthawi ndi nthawi pakukhazikitsa, ndikulimbikitsidwa kuti muphunzire zochitika za chiwindi, makamaka odwala okalamba ndi odwala omwe ali ndi mbiri ya zotupa zake. Ngati chiwopsezo cha chiwindi chomwe chikupezeka m'mbuyomu kapena kuwonekera kwa matenda a chiwindi chikupezeka, chithandizo chamankhwala chiyenera kuyimitsidwa nthawi yomweyo.

Chithandizo cha antiepileptic mankhwala nthawi zina chitha kuchitika ndikubwera kwa malingaliro ofuna kudzipha / malingaliro ofuna kudzipha. Popeza njira zomwe zimayambitsa kudzipha mukamagwiritsa ntchito mankhwalawa sizinakhazikitsidwe, chitukuko chake sichingalepheretsedwe pakumwa Zeptol. Odwala ndi antchito awo ayenera kuchenjezedwa za kufunika kofunafuna chithandizo chamankhwala posachedwa ngati akufuna kudzipha.

Odwala okalamba panthawi ya chithandizo amafunika kuyang'aniridwa chifukwa chachulukirachulukira cha zovuta zam'maganizo zam'mbuyo, zowonetsedwa ndi chisokonezo ndi kukhumudwa kwa psychomotor.

Kutha msanga kwa mankhwala a carbamazepine kungayambitse khunyu. Ngati kuchoka kwa Zeptol kuli kofunikira, wodwalayo ayenera kusamutsidwira ku mankhwala ena antiepileptic pamankhwala omwe ali ndi mankhwala oyenera milandu monga, phenytoin kutumikiridwa iv kapena diazepam wogwiritsidwa ntchito iv kapena rectally).

Panthawi yamankhwala, kukulira kwamphamvu kwamakutu (kuphatikizapo Stevens-Johnson syndrome, matenda a Lyell) kunali kosowa kwambiri. Kugwiritsa ntchito kwa Zeptol kuyenera kusiyidwa pomwepo ngati zizindikiro ndi zizindikilo zikuwoneka kuti zikukayikiridwa kuti zikuyambitsa zovuta izi. Ndi chitukuko cha zovuta zoopsa pakhungu, wodwala amayenera kupita kuchipatala. Monga lamulo, mawonekedwe a zovuta zotere adadziwika m'miyezi yoyamba yamaphunziro.

Malinga ndikuwunikira komwe kumagwiritsidwa ntchito Zeptol, odwala omwe ndi nzika zaku China ali ndi kulumikizana pakati pa pafupipafupi pakuchitika kwakhungu komwe kumayenderana ndi carbamazepine komanso kupezeka kwa jini ya leukocyte antigen (HLA) mu mtundu wa odwalawa HLA-B * 1502. Pochiza odwala a carbamazepine m'maiko aku Asia (Philippines, Malaysia, Thailand), komwe kuchuluka kwa zolembedwaku kudalembedwa, kuchuluka kwa zotsatira zoyipa zamankhwala kudadziwika (kuyambira kuyerekezera pafupipafupi "kawirikawiri" mpaka "kawirikawiri").

Odwala omwe angathe kunyamula HLA-B * 1502 allele (mwachitsanzo, anthu aku China), kuyezetsa kuyenera kuchitidwa kupezeka kwa genotype. Ndikulimbikitsidwa kuchitira mankhwala osokoneza bongo ponyamula izi zokhazokha pokhapokha ngati phindu la chithandizo limaposa chiopsezo cha zovuta. Oimira a Caucasoid, Negroid ndi Americaanoid awonetsa pang'ono zomwe zili pamwambapa.

Musanayambe mankhwala a Zeptol, muyenera kusiya kumwa zoletsa za MAO osachepera masiku 14 kapenanso kale ngati chithandizo chachipatala chilola.

Kuyanjana kwa mankhwala

• CYP3A4 isoenzyme inhibitors: kuchuluka kwa carbamazepine mu plasma ndipo chiopsezo cha zotsatira zoyipa chikuwonjezeka,
• inducers of CYP3A4 isoenzyme: carbamazepine metabolism is inapita patsogolo, zomwe zimapangitsa kuchepa kwa zomwe zili mu plasma ndikuchepetsa mphamvu yake yothandizira,
• antiepileptic mankhwala (vigabatrin, styrypentol), ma antidepressants (fluvoxamine, trazodone, desipramine, nefazodone, fluoxetine, viloxazine, paroxetine), antipsychotic (olanzapine), minofu restants (dantrolene, oxybutynin), antidepressonant Mlingo waukulu), azole derivatives (ketoconazole, voriconazole, fluconazole, itraconazole), HIV proteinase inhibitors (mwachitsanzo, ritonavir), antiulcer drug (cimetidine, omeprazole), calcium antagonists (diltiazem, verapamil), anti-glaucoma mankhwala osokoneza bongo (acetazolamide), macrolide maantibayotiki (clarithromycin, erythromycin, troleandomycin, josamycin), antihistamines (loratadine, terfenadine), antiplatelet agents (ticlopidine), analgesics komanso mankhwala osapinga-anti-antiidal anti-yotupa (NSAIDs), androprophenolf. plasma ndende ya carbamazepine, yomwe imatha kupangitsa kuti pakhale zovuta (kugona, chizungulire, ataxia), amafunika kuyang'anira ndikusintha kuchuluka kwa carbamazepine m'magazi,
• loxapine, primidone, quetiapine, valproic acid, progabid, valpromide, valnoktamide: zomwe plasma zili ndi carbamazepine-10,11-epoxide zimawonjezeka, kukulira kwa zosagwirizana zamtunduwu kumatheka, ndikofunikira kuyendetsa mulingo wa chinthu ichi m'magazi ndikusintha mlingo wa Zeptol,
• antiepileptics (mezuksimid, oxcarbazepine, fosphenytoin, fensuksimid, felbamate, phenytoin, primidone, phenobarbital mwina monga clonazepam), antituberculosis wothandizila (rifampicin), antineoplastic wothandizila (doxorubicin, cisplatin), retinoids (isotretinoin), bronchodilators (aminophylline theophylline) , Hypericum perforatum hypericum kukonzekera: kuchuluka kwa carbamazepine mu plasma ya magazi kumachepa, kungakhale kofunikira kusintha Mlingo wake,
• Maantibayotiki (doxycycline), NSAIDs, analgesics (paracetamol, buprenorphine, tramadol, methadone, phenazone), antiepileptic mankhwala (topiramate, clonazepam, felbamate, clobazam, ethosuximide, lamotrigine, valproic acid, matenda ashuga, dicumarol, warfarin, acenocoumarol, fenprocoumone), antidepressants (mianserin, bupropion, trazodone, citalopram, sertraline, nefazodone), tricyclic antidepressants (amitriptyline, imipramine, clomipramine, nortriptyline) onazole), mankhwala anthelmintic (praziquantel), antineoplastic othandizira (imatinib), antipsychotic (risperidone, clozapine, bromperidol, quetiapine, ziprasidone, haloperidol, olanzapine), immunosuppressants (everolimus, cyclosporidinospineospolospisospineosoline pesocivoline) , glucocorticosteroids (dexamethasone, prednisone), anxiolytics (midazolam, alprazolam), HIV proteinase inhibitors (saquinavir, ritonavir, indinavir), bronchodilators (theophylline), mahomoni oletsa kubereka, mankhwala omwe amachepetsa kuthamanga kwa magazi (felodipine) Reparata, zikuchokera chikukhudza esitirojeni ndi / kapena progesterone: zotheka kuchepetsa milingo plasma wa wothandizila izi kungafune kuwukonza Mlingo awo,
• phenytoin, mefenitoin: milingo ya phenytoin imatha kukwera / kuchepa, milingo ya mefenitoin ikhoza kuchuluka.

Carbamazepine amakumana ndi mankhwala ena / zinthu zomwe ziyenera kukumbukiridwa:

• isoniazid: hepatotoxicity yoyambitsidwa ndi izi imatha kuchuluka
• diuretics (furosemide, hydrochlorothiazide): maonekedwe a Hyponatremia wodziwika bwino amatha kuzindikirika,
• levetiracetam: imachulukitsa zovuta za carbamazepine,
• antipsychotic (thioridazine, haloperidol), kukonzekera kwa lithiamu kapena metoclopramide: kufupika kwa zosafunikira zamitsempha kumatha kuwonjezeka (ndikamaphatikizidwa ndi antipsychotic - ngakhale pakhale kuchuluka kwamankhwala othandizira a plasma).
• non-depolarizing muscle restants (pancuronium bromide): n`zotheka kuti carbamazepine iwonetse zosokoneza zochita za mankhwalawa, kuphatikiza kumeneku kungakhale kofunikira kuwonjezera kuchuluka kwa opuma minofu awa, kuyang'anira mosamala mkhalidwe wa wodwala ndikofunikira chifukwa chokwanira mofulumira kuposa momwe amayembekezerera kutsekemera kwa neuromuscularade,
• kulera kwa mahomoni: achire zotsatira za mankhwalawa zitha kuchepa chifukwa cha michere ya microsomal, pali malipoti akuti magazi amatuluka nthawi yayitali, ndikofunikira kusintha njira zina zakulera,
• ethanol: pakhoza kukhala kuchepa kwa kulolera kwake, munthawi ya chithandizo ndikofunikira kupewa kumwa mowa.

Zofanizira za Zeptol ndi: Carbamazepine, Carbalepsin retard, Carbamazepine retard-Akrikhin, Carbamazepine-Ferein, Carbamazepine-Acre, Finlepsin, Tegretol, Finlepsin retard, etc.

Ndemanga za Zeptol

Ndemanga zochepa za Zeptol ndizabwino. Odwala ambiri amati mankhwalawa amachepetsa kuopsa kwa khunyu, amawonetsa zabwino pazizindikiro za kupsinjika, amachepetsa kukwiya, komanso amathandizanso kupweteka kwa neurogenic ndikuchepetsa kukula kwa odwala omwe ali ndi trigeminal neuralgia. Zoyipa za Zeptol zimaphatikizapo zovuta zambiri zoyipa.