Neurontin - malangizo ogwiritsidwa ntchito

Mankhwala a Neurontin amapezeka m'mitundu yotere:

• Makapisozi 100 mg, 300 mg ndi 400 mg, kunja kwa makapisozi ndi zoyera (100 mg), achikasu opepuka (300 mg) kapena imvi-lalanje (400 mg), olembedwa kuti amtundu wamtambo kapena imvi (dzina lamankhwala, kuchuluka kwa zinthu zogwira ntchito ndi "PD "),
• Mapiritsi a 600 mg ndi 800 mg oyera okhala ndi mapiritsi oyera, ophatikizira, olembedwa zakuda (600 mg) kapena lalanje (800 mg).

Makapu onse awiri ndi mapiritsi a zidutswa 10 amadzaza matumba. Mapaketi amaikidwa mu makatoni okhala ndi zidutswa za 2, 5 kapena 10.

Mankhwala

Gabapentin, chinthu chogwira ntchito cha Neurontin, chimatha kupewa kukhudzika.

Kapangidwe ka gabapentin ndi kofanana ndi GABA, koma sikukhudza kagayidwe kake. Kamodzi m'thupi, imaphatikizana ndi alpha-2-beta yomwe imagwiritsa ntchito njira zama calcium zomwe zimadalira magetsi, zomwe zimapangitsa kuchepa kwa mayendedwe a ion calciumkomanso kuchepetsa mwayi wakukula kupweteka kwa m'mimba.

Gabapentin amachepetsa mulingo wa kufa kwa glutamate wodwala maselo amitsempha, amathandizira kupanga GABA, ndikuchepetsa kumasulidwa kwa ma neurotransmitters a gulu la monoamine.

Pharmacokinetics

Mulingo wambiri wa bioavailability ndi 60%, koma amachepetsa ndi kuchuluka kwa mlingo. Kuzindikira kwakukulu kwa plasma kumachitika pambuyo pa maola 2-3 mutatha kumwa mankhwalawo. Gabapentin pafupifupi samagwirizana ndi mapuloteni a plasma (osapitirira 3%).

Hafu ya moyo imakhala pafupifupi maola 5-7, ngakhale mutamwa. Amayidulira popanda kusinthidwa chifukwa cha impso.

Zizindikiro zogwiritsidwa ntchito

Kugwiritsa ntchito Neurontin kumawonetsedwa pamilandu yotere:

• kupweteka kwa m'mimba (Mankhwala amatha kuperekedwa kwa anthu azaka zopitilira 18),
• tsankho kukokana, mosasamala kanthu za kukhalapo kwa generalization yachiwiri (imatha kutengedwa kuchokera ku zaka 3 ngati kuwonjezera kwa chithandizo chachikulu, kuchokera pa 12 ngati monotherapy).

Zotsatira zoyipa

Kuchiza ndi Neurontin kumatha kuyambitsa zovuta kuchokera ku ziwalo zambiri komanso machitidwe amthupi:

• zam'mimba dongosolo: matenda a chopondapo, chisangalalokumvereranseru ndi kusanzapakamwa kowuma, kupweteka pamimba, matenda amano, kuchepa kwakuthwa kapena kuchuluka kwa chilakolako cha chakudya,
• zambiri: kufooka, mutu, chimfine ngati matenda, kupweteka m'malo osiyanasiyana a thupi, edema kumapeto kwa miyendo ndi nkhope, kuwonda,malungokuchepa kukana matenda opatsirana ndi ma virus,
• dongosolo lamanjenje: kukumbukira kwamkati, kuyankhula, kuganiza, malingaliro, chisokonezo, kugona, chizungulire, kugwedezeka, kukhumudwa, kusinthasintha kusowa tuloudani
• kupuma: kupuma movutikiraHypersensitivity matenda opatsirana a kupuma dongosolo,
  khungu: zotupa, kuyabwa,
• mtima: Vasodilationkuthamanga kwa magazi
• Dongosolo la hematopoietic: leukopenia, kuvulaza, chinangwa,
• dongosolo la minofu: mafupa olumikizirana mafupa, msana, minofu, chizolowezi cham'mbali.

Neurinu, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Mankhwalawa amatengedwa pakamwa ndi chakudya kapena nthawi ina iliyonse.

Malangizo a neuropathic ululu akuluakulu:

• tsiku loyamba - 1 ga 300 mg wa mankhwala,
• tsiku lachiwiri - Mlingo 2 wa 300 mg,
• tsiku lachitatu - Mlingo 3 wa 300 mg, nthawi zina Mlingo womwewo umaperekedwa kuyambira pa chiyambi,
• masiku otsatirawa - mlingo umadalira mphamvu ndi momwe thupi limakhalira - imasiyidwa yosasinthika kapena kuchuluka pang'onopang'ono - mlingo waukulu - 3,6 g patsiku.

Mlingo Wochepa kulanda mwa odwala azaka 12, amasankhidwa malinga ndi chiwembu chofanana ndi chomwe tafotokozazi. Pofuna kupewa kukonzansokulanda ndikofunikira kuwonetsetsa kuti nthawi yayitali pakati pa Mlingo wa mankhwalawa sichidutsa maola 12.

Zida za mankhwalawa kwa ana a zaka 3 mpaka 12:

• mlingo woyenera amawerengedwa malinga ndi kulemera kwa mwana,
• kuyambira tsiku loyamba akhazikitsidwe nthawi zitatu, komanso nthawi zopitilira maola 12,
• Mlingo woyambirira - 10-15 mg / kg patsiku,
• patatha masiku atatu, mlingo kuchokera koyambirira ukuwonjezeka,
• ogwira mlingo: zaka 3-5 - 40 mg / kg masana, 5-5 zaka - 25-35 mg / kg / tsiku.

Kutengera kupezeka kulephera kwa aimpsoMlingo ungachepe. Mukamawongolera, ndikofunikira kuyang'ana pa chiphaso creatinine.

Bongo

Mawonekedwe amtunduwu atha kuwonetsa kuchuluka kwa bongo:

• chizungulire,
• osamvetseka kapena mawu osokoneza,
• masomphenya apawiri
• kugonangakhale chitukuko chisanachitike kugona koopsa,
• kutsegula m'mimba.

Mankhwala osokoneza bongo, muyenera kuchitapo kanthu kuti muchepetse zizindikiro. Ngati munthu sagwira ntchito mokwanira, makamaka pamafomu owopsakulephera kwa aimpsoakuwonetsa akugwira hemodialysis.

Kuchita

Kuphatikizika kwa Neurontin ndi mankhwala ena sizimayambitsa kutulutsa kofunikira kuchokera mthupi kapena kusintha kwamachitidwe a mankhwala.

Ngati munthu atenga maantiacid omwe ali ndi aluminiyamu ndi magnesium, ndikofunikira kuti pakhale kusiyana pakati pa maola 2 pakati pa kumwa mankhwalawa ndi Neurontin. Kupanda kutero, bioavailability wa gabapentin akhoza kuchepa pafupifupi 20%.

Ndi munthawi yomweyo kugwiritsa ntchito Morphine kuwonjezereka kwa njira yolowera ndikutheka, koma izi sizikhala ndi kufunikira kwakutali. Osati kawirikawiri ndi kuphatikiza uku, ngati mlingo Morphine ndipo minyewa yamtali, imawoneka kugona. Pankhaniyi, ndikofunikira kuchepetsa mlingo wa imodzi mwa mankhwalawa.

Malangizo apadera

Mankhwalawa okalamba ndi odwala kulephera kwa aimpso Ndikofunika kuti muchepetse mulingo. Ngati wodwalayo akupsinjidwa hemodialysis, tisaiwale kuti ndi njirayi, gabapentin wachotsedwa bwino ku madzi a m'magazi, chifukwa chake, kusintha kwa mankhwalawa kungakhale kofunikira.

Ndiosafunika kuyendetsa magalimoto kapena kugwira ntchito ndi zinthu zomwe zimayenda nthawi ya mankhwala ndi Neurontin.

Patulani mankhwalawo kapena chepetsani pang'onopang'ono. Kuchepetsa mlingo wa mankhwalawa nthawi zambiri kumayambitsakusowa tulo, thukuta, nkhawakumva kuwawa, kupweteka m'malo osiyanasiyana a thupi, nthawi zina kukokana.

Pa mimba ndi mkaka wa m`mawere

Chitetezo ndikugwiritsa ntchito bwino kwa mimba kapena nthawi yoyamwitsa sikokwanira kungomaliza. Chifukwa chake, amalembedwa pokhapokha ngati pali chiopsezo chachikulu ku thanzi la mayi.

Mu mkaka wa m'mawere azimayi omwe amathandizidwa ndi Neurontin, gabapentin amapezeka. Momwe zimakhudzira mwana sakudziwika, kotero kudyetsa kuyenera kuyimitsidwa.

Contraindication

Malinga ndi malangizo, Neurontin imagawidwa mwa ana osakwana zaka zitatu. Mankhwala sayenera kumwa odwala hypersensitivity ku zigawo zikuluzikulu za mankhwala. Ndemanga ya Neurontin ikutsimikizira kuti mankhwalawa ayenera kumwedwa mosamala ngati kulephera kwa impso.

Mlingo ndi makonzedwe

Malinga ndi malangizo, Neurontin ikhoza kugwiritsidwa ntchito mosasamala kanthu za kudya. Ngati mukufuna kusintha Mlingo, ndiye kuti kusintha konse kumachitika pang'onopang'ono, bwino. Ndi ululu wa neuropathic, mlingo woyambirira wa Neurontin ndi 900 mg patsiku, uyenera kugawidwa pazidutswa zitatu. Ngati ndi kotheka, mlingo umakulitsidwa pang'onopang'ono mpaka 3,6 g patsiku. Ndi khunyu pang'ono, mulingo womwewo - kuyambira 900 mg mpaka 3,6 g patsiku. Izi zikugwira ntchito kwa onse akulu odwala ndi ana azaka khumi ndi ziwiri. Nthawi zambiri, mankhwalawa amagawidwa katatu, koma pakadali pano Mlingo wa mankhwalawa suyenera kupitirira maola khumi ndi awiri kuti musadzatsenso.

Kwa ana kuyambira zaka zitatu mpaka khumi ndi ziwiri, muyeso uyenera kukhala 10-15 mg pa 1 kg ya kulemera kwa thupi patsiku. Komanso, mankhwalawa Neurontin amaperekedwa katatu patsiku, mlingo umakulitsidwa pang'onopang'ono, osachepera masiku atatu.

Odwala omwe ali ndi vuto la aimpso ayenera kugwiritsa ntchito mlingo wochepa momwe angathere. Chithandizo chiyenera kuyang'aniridwa ndi dokotala.

Zolemba za Neurontin

Analogs amatchedwa mankhwala omwe ali ndi mankhwala omwewo. Mpaka pano, fanizo zotsatirazi za Neurontin zilipo pamsika wamankhwala azitsamba:

• Gabagamm
• Gabapentin
• Hapentek
• Katena
• Convalis
• Lepsitin
• Tebantin
• Egipentin
• Eplirontin.

Kuyanjana kwa mankhwala

Kugwiritsa ntchito pamodzi kwa Neurontin ndi ma aluminium ndi ma magnesium okhala ndi maacacid kumayendera limodzi ndi kuchepa kwa bioavailability wa gabapentin.

Akaphatikizidwa ndi hydrocodone, kuchepa kwa mlingo wa C max (kuchuluka kwambiri m'magazi) ndi AUC (kuchuluka kwa mankhwala omwe amapezeka m'madzi a m'magazi) kumawonedwa poyerekeza ndi hydrocodone monotherapy.

Fomu ya Mlingo:

mapiritsi okhala ndi filimu

Piritsi 1 600 mg lili:

Chithandizo: 600.0 mg gabapentin.

Othandizira: poloxamer 407 80.0 mg, Copovidone 64.8 mg, chimanga wowonda 49.2 mg, magnesium stearate 6.0 mg, filimu pachimake: oyera opadra YS-1-18111 24.0 mg talc 17.4 mg, hyprolose 6.6 mg, herbal wax (candelila) 0,6 mg.

Piritsi limodzi la 800 mg lili:

Chithandizo: 800.0 mg gabapentin.

Othandizira: poloxamer 407 106.7 mg, kopovidone 86.4 mg, wowuma

chimanga 65.6 mg, magnesium yakuwira 8.0 mg, kanemachipolopolo: oyera opadra YS-I-18111 32.0 mg talc 23.2 mg, hyprolose 8.8 mg, herbal wax (candelila) 0,8 mg.

Mlingo wa 600 mg: mapiritsi oyera okhala ndi mafilimu, omwe amalembedwa "NT" ndi "16". notch pakati pa zolemba mbali imodzi ndi notch mbali inayo.

Mlingo 800 mg: mapiritsi oyera okhala ndi mafilimu okhala ndi utoto, olemba "NT" ndi "26". notch pakati pa zolemba mbali imodzi ndi notch mbali inayo.

Mankhwala

Mankhwala

Gabapentin amalowa mosavuta mu minyewa ya muubongo ndikulepheretsa kukula kwa mitundu yosiyanasiyana ya nyama ya khunyu. Gabapentin alibe kuyanjana ndi ma GABA receptors_A (gamma-aminobutyric acid) ndi GABA ndipo sizikhudza kagayidwe ka GABA. Gabapentin samamangirira ma receptor a ma neurotransmitters ena omwe amapezeka mu ubongo ndipo sasokoneza mayendedwe a sodium.

Gabapentin ali ndi mgwirizano wapamwamba ndipo amamangira ku α-2-δ (alpha-2-delta) pogwiritsira ntchito njira zama calcium zomwe zimadalira magetsi ndipo amaganiza kuti kuyanjana kwa gabapentin ndi α-2-δ kumathandizira pakupanga mphamvu ya anticonvulsant ininyama. Mukayang'ana gulu lalikulu la ma molekyulu ojambulidwa pamankhwala awa, zidawonetsedwa kuti sub8it ndi yomwe ikufuna. Zotsatira zomwe zimapezeka m'mitundu ingapo yam'mbuyomu zimawonetsa kuti pharmacological ya gabapentin imatha kuzindikirika ndikumangiriza kwa α-2-δ polimbikitsa kuletsa kumasulidwa kwa ma neurotransmitters osangalatsa m'malo ena a dongosolo lamkati la mantha. Ntchito ngati izi zimapangitsa kuti anticonvulsant akhale gabapentin. Kufunika kwa njira izi za ntchito ya gabapentin chifukwa cha zovuta zake zotsutsana mwa anthu zimafunikabe kukhazikitsidwa. Mphamvu ya gabapentin imasonyezedwanso m'maphunziro angapo a preclinical mu mitundu ya zowawa. Amanenanso kuti kumangiriza kwa gabapentin ku α-2-δ subunit kumabweretsa zotsatira zingapo zingapo zomwe zimayambitsa vuto la analgesic pamitundu ya nyama. Mphamvu ya analgesic ya gabapentin imatha kuchitika pamlingo wamsana, komanso pamlingo wamalo apamwamba a ubongo kudzera muzochita ndi njira zotsika zomwe zimaletsa kufalikira kwa kupweteka kwamatenda. Kukula kwake kwa zinthu za gabapentin zomwe zimadziwika m'maphunziro oyambira sizikudziwika.

Kuchita Mwachipatala ndi Chitetezo

Monga gawo la kuyesedwa kwa kuchipatala kwa ana omwe ali ndi zaka 3 mpaka 12, kuyesedwa kwa kuchuluka, koma kusiyana kosadalirika pakubwereza kosaposa kwa 50% pagulu la gabapentin poyerekeza ndi gulu la placebo kunawonetsedwa. Kuwunikira kowonjezereka kwa pafupipafupi kuyankha kwa mankhwala kutengera zaka (poganizira zaka monga zosasintha mosasintha kapena pozindikira magulu am'mibadwo iwiri: zaka 3-5 ndi zaka 6-12) sizinawonetse kuchuluka kwaukalamba pakuwoneka bwino kwa mankhwala. Zotsatira za kuwunikira kowonjezerekazi zikuwonetsedwa pansipa.

* Gulu la anthu oti "lingachiritsidwe mwadala" (MITT) lidawerengedwa ngati kuchuluka kwa odwala onse omwe adasankhidwa mwachisawawa ku gulu lowerengera komanso kulandira madongosolo olanda kuti awunikenso kwa masiku 28 m'magawo oyambira ndi akhungu awiri.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, kuchuluka kwambiri kwa gabapentin mu plasma kumatheka mkati mwa maola awiri ndi atatu. The bioavailability wa gabapentin amayamba kuchepa ndi kuwonjezeka mlingo. Mtheradi wa bioavailability mutatenga makapisozi 300 mg ndi pafupifupi 60%. Zakudya, kuphatikiza zomwe zili ndi mafuta ambiri, sizikhala ndi vuto lililonse pakamerokentin. Ma pharmacokinetics a gabapentin sasintha ndikusinthasintha kwa mankhwalawa. Ngakhale kuti pamavuto azachipatala, kuchuluka kwa gabapentin mu plasma nthawi zambiri kumasiyanasiyana kwa 2-20 μg / ml, sizinalole kuneneratu za ntchito kapena chitetezo cha mankhwalawa. Ma paracokinetics magawo amaperekedwa pagome.

Gome.

Mwachidule avareji (CV,%) pharmacokinetics ya gabapentin muyezo wofanana ndi Mlingo wambiri wokhala ndi nthawi yayitali ya maola eyiti

Gabapentin samanga mapuloteni a plasma, ndipo voliyumu yake yogawa ndi malita 57.7. Odwala omwe ali ndi khunyu, kuchuluka kwa gabapentin mu cerebrospinal fluid (CSF) pafupifupi 20% ya osachepera plasma ndende. Gabapentin amadutsa mkaka wa amayi omwe akuyamwitsa.

Palibe deta pa kagayidwe ka gabapentin mthupi la munthu. Gabapentin samalimbikitsa kuyambitsa ma oxidases osayimira a chiwindi omwe ali ndi vuto la metabolism ya mankhwala.

Gabapentin amachotseredwa mosasinthika kokha chifukwa cha impso. Hafu ya moyo wa gabapentin ndiwodziyimira palokha pa mlingo womwe umatengedwa ndi maola 5 mpaka 7.

Mwa okalamba ndi odwala omwe ali ndi vuto laimpso, kutsimikizika kwa gabapentin ku plasma kumachepetsedwa. Kuchotsa kosalekeza, chilolezo cha plasma ndi chilolezo cha impso cha gabapentin ndizogwirizana mwachindunji kupangira chilolezo.

Gabapentin amachotsedwa ku plasma ndi hemodialysis. Odwala omwe ali ndi vuto la impso kapena omwe ali ndi hemodialysis amalangizidwa kuti asinthe mlingo wa mankhwalawa (onani gawo "Mlingo ndi Administration").

The pharmacokinetics ya gabapentin mu ana aphunziridwa mwa odzipereka a 50 athanzi omwe ali ndi chaka chimodzi mpaka zaka 12. Mokulira, kuchuluka kwa gabapentin mu plasma ya ana opitirira zaka 5 kuli kofanana ndi kwa akuluakulu akamagwiritsa ntchito mankhwala omwewo muyezo wofanana ndi kuwerengera kwa mg / kg thupi.

Pakufufuza kwa pharmacokinetics mwa ana 24 athanzi omwe ali ndi zaka 1 mpaka 48, mawonekedwe a mankhwalawo (AUC) anali pafupifupi 30%, C_mAh- kutsatsa pang'ono komanso kokwera kwambiri poyerekeza gawo lililonse la kulemera kwa thupi poyerekeza ndi zomwe zapezeka zolemba za kinetics za mankhwala kwa ana opitirira zaka 5.

Linearity / nonlinearity of pharmacokinetics parameter

The bioavailability wa gabapentin amachepetsa ndi kuchuluka kwa kuchuluka, komwe kumakhala kosagwirizana ndi magawo a pharmacokinetic, omwe amaphatikizapo index ya bioavailability (F), mwachitsanzo, Ae%, CL / F, Vd / F. Elimination pharmacokinetics (paramu magawo osaphatikizapo F, monga CLr ndi T1 / 2) akufotokozedwa bwino ndi mtundu wa mzere.

Kutalika kwa plasma kwa galapentin kuli kolosera kutengera data ya kinetics ndi mlingo umodzi.

Gwiritsani ntchito pa nthawi yoyembekezera komanso nthawi yoyamwitsa

Palibe zambiri pakugwiritsa ntchito mankhwalawa amayi apakati.

Chiwopsezo chachikulu chokhudzana ndi khunyu komanso mankhwala osokoneza bongo

Chiwopsezo cha kubereka ana okhala ndi vuto losabereka mwa amayi omwe amathandizidwa ndi anticonvulsants ukuwonjezeka ndi katatu. Nthawi zambiri pamakhala kutsekeka kwa milomo yapamwamba komanso mkamwa, kuwonongeka kwa mtima ndi vuto la neural chubu. Komanso, kutenga maanticonvulsants angapo atha kuphatikizidwa ndi chiwopsezo chachikulu cha kusokonezeka kwakukulu kuposa nkhani ya monotherapy. Chifukwa chake, ngati kuli kotheka, imodzi mwamankhwala ogwiritsa ntchito iyenera kugwiritsidwa ntchito. Amayi azaka zoyambira kubereka, komanso azimayi onse omwe angakhale ndi pakati, ayenera kufunsa katswiri woyenera. Ngati mayi akukonzekera kutenga pakati, kufunika kopitilira mankhwala anticonvulsant kuyenera kuwunikidwanso. Nthawi yomweyo, anticonvulsants sayenera kuthetsedwa mwachangu, chifukwa izi zimatha kuyambitsa kuyambanso ndi zovuta zoyipa kwa mayi ndi mwana. Nthawi zina, mwa ana omwe amayi awo amadwala khunyu, kuchedwa kukukula kumawonedwa. Komabe, ndizosatheka kudziwa ngati kuchepa kwakuthupi kumalumikizidwa ndi majini kapena zochitika zina, matenda a amayi, kapena mankhwala anticonvulsant.

Chiwopsezo cha Gabapentin

Poyeserera nyama, kuwopsa kwa mankhwala kwa mwana wosabadwayo kunawonetsedwa. Ponena za zoopsa zomwe zingachitike, anthu alibe deta. Chifukwa chake, gabapentin iyenera kugwiritsidwa ntchito pokhapokha ngati phindu lomwe lingapezeke kwa mayi likuwonetsa kuwopsa kwa mwana wosabadwayo.

Ndizosatheka kunena motsutsana za kulumikizana kwa gabapentin ndi chiwopsezo chowonjezereka cha kubereka kosagwiritsidwa ntchito panthawi yomwe ali ndi pakati chifukwa cha kukhalapo kwa khunyu komanso kugwiritsa ntchito pamodzi mankhwala ena antiepileptic munthawi iliyonse.

Gabapentin amuchotseredwa mkaka wa m'mawere, momwe zimakhudzira mwana wakhanda sakudziwika, chifukwa chake, panthawi yoyamwitsa, Neurontin iyenera kuyikidwa pokhapokha ngati phindu kwa mayi likuwonetsa kuwopsa kwa khanda.

Kafukufuku wazinyama sanawonepo zovuta za gabapentin pa chonde.

Mlingo ndi makonzedwe

Mwa zisonyezo zonse, njira yoyeserera ya mankhwalawa yakhazikitsidwa pagome 1. Izi zimaperekedwa kwa odwala akuluakulu ndi achinyamata azaka 12 ndi kupitirira. Chiwembu cha kukakamiza kwa ana osakwana zaka 12 imawonetsedwa pansipa.

Gawo No. 1 1 Njira yothetsera kuchuluka kwa mankhwalawa koyambirira kwa mankhwala

300 mg kamodzi tsiku lililonse

300 mg kawiri pa tsiku

300 mg katatu patsiku

Kuthetsa kwa mankhwala a gabapentin

Malinga ndi machitidwe azachipatala amakono, ngati pakufunika kuletsa mankhwala a gabapentin, izi ziyenera kuchitika pang'onopang'ono kwa sabata limodzi osatengera zisonyezo.

Ndi khunyu, chithandizo cha nthawi yayitali chimafunikira. Mlingo wa mankhwalawa umatsimikiziridwa ndi adotolo kutengera kutengera kwake kumathandizira komanso kuugwira mtima kwa mankhwalawo.

Akulu ndi ana a zaka zopitilira 12:

mu maphunziro azachipatala, mlingo wogwira unachokera ku 900 mpaka 3600 mg / tsiku. Mankhwalawa amatha kuyamba molingana ndi chiwembu chomwe chatchulidwa pamwambapa. 1 kapena ndi 300 mg katatu pa tsiku tsiku loyamba. Pambuyo pake, kutengera momwe wodwalayo amayankhira chithandizo ndi kulekerera kwa mankhwalawa, mlingo umatha kuwonjezeredwa ndi 300 mg / tsiku tsiku lililonse lililonse la 2-3, mpaka mpaka 3600 mg / tsiku. Mwa odwala ena, kuchuluka kwapang'onopang'ono kwa mlingo kungakhale koyenera. Nthawi yocheperako yomwe mungachulukitse mlingo mpaka 1800 mg / tsiku ndi sabata limodzi, 2400 mg / tsiku - masabata awiri, ndikukwaniritsa mlingo wambiri wa tsiku ndi tsiku wa 3600 mg / tsiku, masabata atatu amafunikira. Kuyesedwa kotseguka kwa Diltelnyh kwawona bwino kulolera kwa mankhwalawa mpaka mpaka 4800 mg / tsiku. Mankhwala okwanira tsiku lililonse azigawika magawo atatu. Pazitali pakati pakati Mlingo ndi katatu Mlingo wa mankhwala sayenera upambana maola 12 kuti tipewe kuyambiranso.

Ana a zaka 3-12: Mlingo woyambirira wa mankhwalawa umasiyana 10 mpaka 15 mg / kg / tsiku, womwe umayamwa Mlingo wofanana katatu katatu patsiku ndipo umayamba kugwira ntchito pafupifupi masiku atatu. Mlingo wothandiza wa gabapentin mwa ana azaka 5 ndi kupitilira 25-25 mg / kg / tsiku mu Mlingo wofanana mu katatu. Mlingo wothandiza wa gabapentin mwa ana a zaka 3 mpaka 5 ndi 40 mg / kg / tsiku muyezo wofanana mu 3 Mlingo wogawika. Kulekerera kwabwino kwa mankhwala mu Mlingo mpaka 50 mg / kg / tsiku ndi ntchito yayitali. Pazitali pakati pakati Mlingo wa mankhwala sayenera kupitirira maola 12 kuti kupewa kuyambiranso.

Palibe chifukwa chowongolera kuchuluka kwa gabapentin mu plasma. Itha kugwiritsidwa ntchito limodzi ndi ma anticonvulsants ena osaganizira kusintha kwa ndende ya plasma kapena kuchuluka kwa anticonvulsants ena mu seramu.

Chithandizochi chitha kuyamba pomwe malinga ndi chiwembu chalongosoledwera pamwambapa 1. Njira ina ya dosing - koyamba mlingo ndi 900 mg / tsiku atatu waukulu. Pambuyo pake, kutengera momwe wodwalayo amayankhira chithandizo ndi kulekerera kwa mankhwalawa, mlingo umatha kuwonjezeredwa ndi 300 mg / tsiku tsiku lililonse lililonse la 2-3, mpaka mpaka 3600 mg / tsiku. Mwa odwala ena, kuchuluka kwapang'onopang'ono kwa mlingo kungakhale koyenera. Nthawi yocheperako yomwe mungachulukitse mlingo mpaka 1800 mg / tsiku ndi sabata limodzi, 2400 mg / tsiku - masabata awiri, ndikukwaniritsa mlingo wambiri wa tsiku ndi tsiku wa 3600 mg / tsiku, masabata atatu amafunikira.

Pochizira zowawa za neuropathic ululu, mu machitidwe monga kupweteka kwa matenda ashuga a mtima ndi postherpetic neuralgia, kufunikira ndi chitetezo cha mankhwalawa kwa nthawi yayitali kuposa miyezi isanu yophunziridwa. Ngati wodwala akufunika kupitiliza chithandizo cha kupweteka kwapafupipafupi kwa miyezi isanu, dokotala wopezekayo amayenera kuwunika wodwalayo kuti adziwe momwe angafunikire chithandizo chowonjezera.

Malangizo pazisonyezo zonse

Odwala omwe ali ndi vuto lalikulu, mwachitsanzo, ngati kuchepa kwa thupi, kufalikira kwa ziwalo, ndi zina, mlingo uyenera kuchulukitsidwa pang'onopang'ono, pogwiritsa ntchito Mlingo wotsika kapena popanga nthawi yayitali musanakulitse mlingo.

Gwiritsani ntchito odwala okalamba (opitilira zaka 65)

Chifukwa cha kuchepa kwa matenda a impso, okalamba angafunikire kusintha kwa mlingo (kuti mumve zambiri onani tebulo 2). Kugona, zotumphukira edema ndi asthenia mwa odwala okalamba zimatha kuchitika pafupipafupi.

Gwiritsani ntchito odwala omwe ali ndi impso

Odwala omwe ali ndi vuto laimpso komanso / kapena odwala hemodialysis amalimbikitsidwa kuti achepetse mlingo wa gabapentin malinga ndi tebulo No. 2:

Tebulo nambala 2. Mlingo wa gabapentin mwa odwala akuluakulu kutengera ntchitoimpso