Fentanyl: cov lus qhia rau kev siv

Cov tshuaj muaj nyob hauv cov tshuaj muag ntau npaum li cas uas muaj cov tshuaj nquag thiab pab, uas hu ua transdermal kev kho mob systemntxiv rau hauv daim foos txhaj tshuaj siv.

Cov ntawv tso tawm ntawm Fentanyl:

• Kev daws rau kev txhaj tshuaj - 50 ml, 50 mcg / ml.
• Transdermal kev kho cov kab ke, qhov hu rau thaj chaw thaj tsam yog 4.2 cm 2 / 8.4 cm 2 / 16.8 cm 2 / 25.2 cm 2 / 33.6 cm 2. Cov tshuaj yeeb dej caw ua kom tso tawm ntawm ib qho nqi ntawm 12.5 / 25/50/75/100 μg / h. Ntawm thaj chaw sab nrauv, thaj xim xim daj yog Fentanyl 12.5 μg / teev / Fentanyl 25 μg / teev / Fentanyl 50 μg / teev / Fentanyl 75 μg / teev / Fentanyl 100 μg / teev. 1 TTC muaj 1,38 mg / 2.75 mg / 5.5 mg / 8.25 mg / 11 mg ntawm cov tshuaj nquag. Ib daim carton ntim 5 lub hnab ntim tau tshav kub.

Pharmacological kev txiav txim

Fentanyl yog yeeb tshuaj analgesicCov. Koob tshuaj 100 mcg (0.1 mg) (2 ml), kwv yees li 10 mg kev ua haujlwm analgesic morphine lossis 75 mg meperidine.

Lub ntsiab tseem ceeb kho yog analgesia thiab sedation. Thaum noj tshuaj, nws yuav tsum tau yug los rau hauv lub siab tias kev hloov pauv ntawm txoj pa thiab alveolar qhov cua ntawm lub ntsws yuav nyob ntev dua li cov nyhuv analgesic. Nrog cov koob tshuaj nce ntxiv, muaj qhov txo qis ntxiv pulmonary metabolismCov. Cov koob tshuaj ntau yuav ua rau apneaCov. Fentanyl thaum noj yog ntuav qis dua morphine thiab meperidine.

Pharmacodynamics thiab Pharmacokinetics

Cov tshuaj Pharmacokinetics tuaj yeem piav qhia tus qauv nrog peb theem:

• lub sijhawm xa tawm 1.7 feeb
• lub sij hawm xa tawm 13 feeb,
• tshem tawm ib nrab-lub neej ntawm 219 feeb.

Qhov ntim ntawm kev faib fentanyl yog 4 l / kg. Qhov kev khi ruaj khov ntawm cov ntshav protein poob nrog nce ionization ntawm cov tshuaj. Kev hloov pH tej zaum yuav cuam tshuam nws qhov kev faib tawm nruab nrab ntshav thiabcov leeg hauv nruab nrabCov. Cov tshuaj ua kom sib haum txhawm rau khaws cov leeg pob txha thiab cov nqaij mos adipose, tom qab uas nws maj mam tso tawm rau hauv cov ntshav. Fentanyl yog feem ntau hloov pauv hauv lub siab, ua rau pom lub siab. Kwv yees li 75% ntawm cov tshuaj tso ntshav yog raug tso zis nyob rau hauv cov zis feem ntau metabolitesCov. Tsawg dua 10% raug tso tawm hauv cov zis hauv lub cev. Kwv yees li 9% ntawm cov koob tau tawm hauv cov quav yog cov tshuaj metabolites.

Cov tshuaj pib ua yuav luag tam sim ntawd tom qab kev tso dej ntawm lub cev. Txawm li cas los xij, qhov ua hauj lwm siab tshaj plaws yog teev hauv ob peb feeb. Lub sijhawm ib txwm ntawm cov nyhuv analgesic yog los ntawm 30 feeb mus rau ib teev tom qab tso dej siab txog li 100 mcg (0.1 mg) (2 ml). Tom qab kev tswj hwm intramuscular, qhov pib ntawm kev ua ntawm cov khoom nquag yog pom los ntawm xya mus rau yim feeb, thiab lub sijhawm ua haujlwm ntev li ob teev.

Kev taw qhia rau kev siv fentanyl

• rau analgesic cov teebmeem ntawm lub sijhawm luv luv hauv kev ua tau zoo Tshuaj loog ntawm premedicationinduction thiab txij nkawm nyob rau hauv postoperative lub sijhawm,
• rau siv raws li lub zog tshuaj kho mobntxiv rau kev tso tshuaj kom tsaug zog lossis hauv zos
• rau kev sib xyaw nrog tshuaj thaiv qhov ncaujxws li Droperidol nrog premedication, raws li zoo li kev pab cuam nyob rau hauv dav dav thiab lub zos kom loog,
• rau siv li Tshuaj loog rau cov neeg mob uas muaj kev pheej hmoo siab, thaum ua cov haujlwm hnyav, piv txwv, ntawm lub siab.

Tsis tas li, kev qhia rau kev siv fentanyl yog hlab hlwb thiab cov txheej txheem orthopedicqhov twg tshuaj yog siv raws li cov tshuaj loog mob.

Cov Yuav Tsum Tau Ua

• cov neeg mob uas lub siab tsis haum rau opioid npaj,
• cov neeg mob nrog bronchial hawb pob,
• cov neeg mob nrogquav yeeb tshuaj,
• cov neeg mob uas tau mob los ntawm kev mob kev nyuab siab los ntawm lub chaw ua pa,
• thaum obstetric kev khiav hauj lwm,
• cov neeg mob nrog ua pa tsis ua hauj lwm,
• txhawj tsam neeg mob hnyuv tawm tsam.

Sab sij huam

Cov tshuaj no hauv qee qhov xwm txheej tuaj yeem ua rau qhov tshwm sim ntawm ntau qhov tshwm sim tsis zoo:

• kev txhim kho ntawm cov tshuaj yaj yeeb nrog kev siv tshuaj ntau dhau,
• loj heev ua pa ntawm lub cev,
• antihypertensive zoo,
• bradycardia,
• cov leeg mob luv
• pes nrab bronchoconstriction.

Cov lus qhia rau kev siv fentanyl

Ua raws li cov lus qhia rau Fentanyl, cov tshuaj yuav tsum yog tus kws kho mob pom zoo tsuas yog paub txog cov cai ntawm kev siv tshuaj pleev opioids muaj zog rau kev kho mob mob ntev.

Vim tias qhov kev pheej hmoo ntawm kev ua pa nyuaj, fentanyl tsuas yog raug siv rau cov neeg mob uas zam cov tshuaj no zoo. Thaum siv cov tshuaj no, nws yog ib qho tsim nyog yuav tau txo qis siv lwm yam tshuaj loog rau qhov tsawg li sai tau.

Lus Cim: Cov neeg mob raug txiav txim siab opioid tiv taus yog tias lawv tau noj tsawg kawg 60 mg. Morphine ib hnub, 30 mg Oxycodone ib hnub, 8 mg Hydromorphone txhua hnub los sis lwm yam opioids rau ib lim piam lossis ntev dua.

Nws yog ib qho tsim nyog yuav tsum tau sau tseg qhov ntau npaum li cas ntawm cov tshuaj rau txhua tus neeg mob ntawm tus kheej, noj mus rau hauv tus account yav dhau los ntawm kev tswj hwm analgesics lub sijhawm kho thiab qhov txaus ntshai rau cov neeg mob los tsim kev quav tshuaj yeeb tshuaj.

Thaum sau tshuaj rau ib qho tshuaj twg ntawm cov tshuaj no, tus kws tshaj lij yuav tsum ua tib zoo saib xyuas tus neeg mob cov tshuaj tiv thaiv, tshwj xeeb kev nyuaj siab mob ntsws, tshwj xeeb tshaj yog thaum thawj 24-72 teev tom qab pib kho, thaum ntshav siab los ntawm thaj pib tau nce mus txog nws qhov siab tshaj plaws.

Tsuas tshuaj

Hauv kev npaj rau kev ua haujlwm ntawm tus neeg mob laus: iv - 0.05-0.1 mg (ua ke nrog 2.5-5 mg ntawm droperidol) txog kaum tsib feeb ua ntej kev qhia ntawm tshuaj loog. Rau kev ntsuas tshuaj loog: iv - 0.05-0.2 mg rau txhua ib nrab teev.

Hauv kev npaj rau kev phais mob, menyuam yaus: 0.002 mg / kg lub cev hnyav. Rau kev ntsuas tshuaj loog: i / v - 0.01-0.15 mg / kg lossis i / m 0.15-0.25 mg / kg. Txhawm rau tswj kev ua kom loog: i / m - ntawm 0.001-0.002 mg / kg.

Lub thaj yog thov rau 72 teev ntawm thaj chaw tiaj tus ntawm daim tawv nqaij. Nyob rau tib lub sijhawm, nws yog qhov tseem ceeb heev uas thaj chaw ntawm daim tawv nqaij uas thaj ua rau thaj yog thov nrog cov plaub hau tsawg kawg nkaus thiab tsis muaj qhov pom tseeb ntawm kev tsis haum tawv.

Cov lus qhia tshwj xeeb

Fentanyl nyob rau hauv daim ntawv ntawm TTC yuav tsum tau siv rau qhov chaw mos, tawv nqaij thiab tsis muaj xim nrog lub tiaj tiaj, piv txwv li, hauv siab, nraub qaum lossis sab caj npab. Cov menyuam me thiab cov neeg nrog kev txawj ntse puasnws yog qhov zoo dua los thov lub thaj rau lub qaum rov qab los txo qhov ntxim nyiam ntawm qhov thaj raug tshem tawm tsis raug cai. Cov plaub hau ntawm thaj chaw thov yuav tsum tau muab tshem tawm ua ntej siv lub kaw lus, thiab nws tsis raug nquahu kom siv cov plaub hau rau qhov no. Daim tawv nqaij thaj chaw uas thaj yuav siv yuav tsum raug muab ntxuav ua ntej siv nrog dej sov tsis muaj kev ntxiv cov xab npum.

Fentanyl hauv daim ntawv ntawm TTS yuav tsum siv tam sim ntawd tom qab tshem lub thaj ntawm lub hnab ntim khoom. Koj tuaj yeem siv tsis tau cov tshuaj yog tias nws cov ntim muaj cov cim kev ua txhaum thiab depressurization.

Txhua thaj ntawm pob ntawv yuav tsum tau hloov pauv hauv 72 teev. Txhawm rau thov ib thaj tom ntej, koj yuav tsum siv daim tawv nqaij tshiab. Yog tias muaj teeb meem nrog lub nplaum ntawm cov ntug ntawm lub thaj, koj tuaj yeem thov cov band-pab rau kev kho.

Nws yog txwv tsis pub siv: siv cov khoom siv cua sov, piv txwv li, cua sov lossis hluav taws xob pam vov, nrog rau cov khoom siv hluav taws xob ncaj qha thiab lub teeb rau hauv thaj chaw kho kom zoo, ua kom sov, dej sov, da dej kub thiab tso dej kub.

Noj ntau dhau

Kev siv tshuaj ntau dhau ntawm cov tshuaj tuaj yeem tshwm sim nws tus kheej hauv daim ntawv ntawm:

• kev nyuaj siab mob ntsws
• tsaug zog
• poob rau hauv neeg ruamlossis rau leej twg
• mob leeg pob
• bradycardia
• hypotension.

Tsawg tsawg zaus, kev noj ntau dhau ntawm Fentanyl tuaj yeem ua rau neeg tuag taus.

Cov lus qhia tshwj xeeb

Fentanyl ntawm Wikipedia. Siv los ua tus neeg sawv cev tshuaj lom neeg

Ntxiv nrog rau qhov ntau npaum li cas ntawm cov ntawv tso tawm, muaj cov neeg paub thaum Fentanyl tau siv los ntawm cov kev pabcuam tshwj xeeb hauv cov roj av ua kom tshem tawm cov neeg phem. Thaum tso tawm qhov hostages raug ntes los ntawm cov neeg phem thaum lub sijhawm suab paj nruas Nord-Ost, cov kev pabcuam tshwjxeeb tau siv cov muaj pes tsawg leeg raws li kev saib xyuas neeg fentanylCov. Raws li qhov tshwm sim hauv cov kab mob no, cov neeg nyob sab hauv lub tsev hnov ​​mob xws li tsis meej pem, xeev siab, mob siab ntuav thiab ua pa tuag tes tuag taw. Raws li cov kws tshaj lij, cov kev tawm dag lub zog xws li muaj pes tsawg leeg tsis tuaj yeem ua txhaum.

Kev cuam tshuam nrog lwm yam tshuaj

Kev sib cuam tshuam nrog Antidepressants

Kev siv tib lub sijhawm ntawm Fentanyl nrog rau lwm tus neeg sawv cev uas cuam tshuam rau lub hauv nruab nrab cov hlab ntsha, nrog rau kev ua kom tsis haum plab, hypnotics, kev tawm tsam, kev ua kom loog, thiab opioids, tuaj yeem ua rau muaj kev pheej hmoo ntawm lub ntsws ua pa tsis ua hauj lwm, kev sib sib zog nqus, ua kom mob plab thiab tuag. Thaum kev sib xyaw ua ke nrog ib qho ntawm cov tshuaj saum toj no yog siv, qhov tshuaj ntawm ib lossis yuav tsum raug txo kom tsawg.

CYP3A4 Cov Tshuaj Kho Kom Raug Mob

Vim tias qhov isoenzyme CYP3A4 ua lub luag haujlwm tseem ceeb hauv cov metabolism ntawm fentanyl, cov tshuaj uas cuam tshuam rau kev ua haujlwm ntawm CYP3A4 tuaj yeem ua rau txo qis ntawm kev tshem tawm ntawm fentanyl, uas yuav ua rau muaj kev nce ntxiv ntawm cov tshuaj lom neeg hauv plasma thiab nce lub sijhawm ntawm cov teebmeem ntawm opioid tshuaj. Cov kev cuam tshuam zoo no tuaj yeem hais tawm nrog cov kev siv txuas ntxiv ntawm 3A4 inhibitors.

Inductors CYP3A4

Inducers ntawm CYP450 3A4 tuaj yeem ua rau Fentanyl metabolism, uas tuaj yeem ua rau kom cov tshuaj yaj yeeb nce ntxiv, txo qis ntawm cov tshuaj nyob rau hauv cov ntshav, qhov tsis muaj txiaj ntsig lossis, tej zaum, kev txhim kho ntawm kev thim rov qab cov leeg mob nyob rau hauv tus neeg mob nrog rau kev quav yeeb tshuaj tom qab yeeb tshuaj.

Monoamine Oxidase Cov Tshuaj Tiv Thaiv

Kev cuam tshuam ntawm Fentanyl nrog monoamine oxidase inhibitors tseem tsis nkag siab zoo, yog li kev siv tshuaj nyob hauv cov khoom siv hauv lub cev yog ncaj qha contraindicated.

Fentanyl Analogs

• Dolforin - ntxiv rau cov tshuaj nquag, muaj pes tsawg leeg ntawm TTC no suav nrog cov tshuaj lev cawv thiab kua qaub,
• Durogezik Matrix- muaj pes tsawg leeg tshuaj muaj xws li copolymer ntawm polyethylene terephthalate thiab ethylene yas acetate, polyacrylate thiab cov tshuaj nquag,
• Lunaldin - cov tshuaj analgesic uas muaj fentanyl,
• Faib haujlwm - ib qho tshuaj loog, tshuaj muaj zog uas yuav luag zoo xws li cov tshuaj piav,
• Fentadol - TTS nrog cov ntsiab lus ntawm cov tshuaj nquag fentanyl.

Cov Lus txheeb xyuas Fentanyl

Kev tshuaj xyuas ntawm cov tshuaj Fentanyl muaj ntau yam. Yeej, cov neeg mob tsis tuaj yeem tshuaj xyuas cov nyhuv ntawm qhov tshuaj vim tias qhov mob hnyav ntawm cov kabmob uas nws tau qhia. Feem ntau, cov kws tshaj lij tau hais txog Fentanyl siab heev, vim tias cov cuab yeej muab kev pab muaj txiaj ntsig hauv kev kho mob ntau yam mob, thiab tseem cia cov neeg mob tshem tawm qhov mob thaum kho thiab tom qab nws.

Nqe Fentanyl

Tus nqi ntawm cov tshuaj no yog tus heev, tab sis cov nyhuv analgesic uas nws tau offset los ntawm tus nqi. Hauv qee lub tsev muag tshuaj, koj tuaj yeem yuav ib txoj kev daws teeb meem rau kev tswj hwm kev quav dej thiab ntshav ntawm 2,290 rubles.

Kev Kawm: Nws kawm tiav hauv Rivne State Basic Medical College nrog kev kawm tiav qib hauv Tshuaj. Nws kawm tiav hauv Vinnitsa State Medical University. M.I. Pirogov thiab ib qho kev xyaum ua haujlwm raws nws.

Kev: Los ntawm 2003 txog 2013, nws ua haujlwm ua tus kws muag tshuaj thiab yog tus thawj coj ntawm lub tsev muag tshuaj kiosk. Nws tau txais ntawv thiab cov kev sib txawv rau ntau xyoo ntawm consciousious kev ua haujlwm. Cov lus qhia txog cov ncauj lus kev kho mob tau raug luam tawm hauv cov ntawv tshaj tawm hauv zos (ntawv xov xwm) thiab ntawm ntau qhov chaw hauv Is Taws Nem.

Tav su zoo, qhov twg kuv tuaj yeem yuav Durogezik lossis Fentanyl, nws puas tsim nyog tiag?

Tsuas tshuaj thiab tswj hwm

Tsuas yog cov kws kho mob uas muaj kev paub thiab kev paub hauv kev tuav cov tshuaj opioid muaj zog uas muaj peev xwm ua tau zoo tuaj yeem sau ntawv tshuaj thaum lawv siv los kho mob ntev.

Txij li thaum muaj qhov ntxim nyiam ntawm kev tshem tawm cov pa ntawm cov pa ua pa, cov tshuaj tsuas yog raug rau cov neeg uas muaj kev zam zoo rau cov tshuaj no. Thaum siv Fentanyl, nws yog qhov yuav tsum tau txo qis ntawm kev siv lwm yam tshuaj loog.

Cov neeg uas tiv taus cov tshuaj opioids yog cov neeg tau txhaj tshuaj txhua hnub nrog tsawg kawg 60 mg ntawm morphine, 30 mg ntawm oxygencodone, thiab tseem muaj 8 mg ntawm hydromorphone, lossis lwm yam tshuaj opioid li 7 hnub lossis ntev dua.

Kev xaiv cov feem rau txhua tus neeg mob yog nqa tawm ntawm tus kheej, suav txog keeb kwm yav dhau los ntawm kev siv tshuaj tiv thaiv thaum kho, nrog rau cov kev pheej hmoo rau qhov tshwm sim ntawm kev quav yeeb tshuaj hauv ib tus neeg.

Tom qab qhov tau teem tseg ntawm ib feem ntawm cov tshuaj, tus kws kho mob yuav tsum ua tib zoo saib xyuas tus neeg mob cov lus teb, piv txwv li, kev tsocai ntawm kev ua pa, tshwj xeeb tshaj yog thaum thawj 24-72 teev txij li pib kawm, thaum cov tshuaj nce mus txog nws qhov siab tshaj plaws hauv qhov dej.

Qhov ntau thiab tsawg ntawm cov qib noj.

Thaum lub sijhawm npaj ntawm ib tus neeg laus rau txoj kev phais mob, 0.05-0.1 mg ntawm cov tshuaj tau txais koob tshuaj (ua ke nrog droperidol (2.5-5 mg)). Qhov no yuav tsum tau kwv yees li 15 feeb ua ntej tswj hwm kev ua kom loog. Raws li kev phais mob ua kom loog: 0.05-0.2 mg ntawm cov tshuaj yog muab tshuaj rau txhua 30 feeb.

Xws li kev npaj tus menyuam rau kev phais mob, 0.002 mg / kg ntawm cov tshuaj yuav tsum raug tswj hwm. Txog kev phais mob ua kom loog, kev ntsuas tshuaj iv ntawm 0.01-0.15 mg / kg lossis iv txhaj tshuaj ntawm 0.15-0.25 mg / kg yog yuav tsum tau txhaj. Txhawm rau tswj kev ua kom loog, kev tswj hwm ntawm cov tshuaj 0.001-0.002 mg / kg ntawm cov tshuaj yog qhov tsim nyog.

Lub thaj yuav tsum tau ua ntawv thov rau daim tawv nqaij (thaj av tiaj) rau 72 teev. Ib qho tseem ceeb rau cov txheej txheem yog qhov tsawg kawg nkaus ntawm cov plaub hau ntawm lub chaw kho mob, nrog rau qhov tsis muaj daim ntawv ceeb toom pom qhov khaus ntawm qhov ua xua.

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Kev sib cuam tshuam nrog lwm yam tshuaj

Ua ke nrog cov tshuaj tiv thaiv kab mob.

Ua ke nrog lwm cov tshuaj uas cuam tshuam rau kev ua haujlwm ntawm lub hauv nruab nrab cov hlab ntsha (suav nrog kev ua kom tsis haum plab, hypnotics lossis tshuaj loog, opioids thiab kev siv tshuaj loog) tuaj yeem ua rau muaj qhov tshwm sim ntawm qhov tsis ua haujlwm ntawm lub nruab nrog kev ua pa, kev txhim kho ntawm kev ua kom tsaug zog thiab ua pa tsis xws luag, tuag taus. Nrog rau kev siv ua ke nrog ib qho ntawm cov txhais tau tias saum toj no, qhov loj npaum li cas ntawm ib qho ntawm lawv yuav tsum raug txo kom tsawg.

Cov tshuaj uas ua rau kom qeeb qeeb ntawm kev ua haujlwm ntawm CYP3A4.

Vim tias qhov tseeb tias CYP3A4 isoenzyme yog lub hauv paus tseem ceeb ntawm cov tshuaj metabolism hauv cov tshuaj, cov tshuaj uas qeeb nws cov haujlwm tuaj yeem txo qhov txiaj ntsig ntawm Fentanyl kev tshem tawm, vim qhov txiaj ntsig ntawm nws cov nuj nqis hauv plasma nce ntxiv thiab lub sijhawm ntawm opioid effect tau ntev. Cov teebmeem zoo sib xws yuav muaj zog ntau thaum ua ke nrog 3A4 inhibitors.

Tshuaj yeeb qaug rau kev coj ua haujlwm ntawm CYP3A4.

Cov ntsiab lus uas ntxias CYP450 3A4 tuaj yeem ua rau cov txheej txheem ntawm cov tshuaj metabolism, vim tias nws txoj kev ua kom pom tseeb nce ntxiv, thiab qib hauv plasma, ntawm qhov tsis sib xws, tsawg.Raws li qhov tshwm sim, nws tsis muaj qhov tshwm sim tshuaj tsawg lossis muaj tshwm sim ntawm kev tshem tawm tus mob nyob hauv cov neeg uas tom qab ntawd quav tshuaj.

Kev sib xyaw ua ke nrog IMAO.

Kev sib xyaw ntawm cov tshuaj nrog MAOI tseem tsis tau kawm txaus, uas yog vim li cas tib lub sijhawm siv cov tshuaj no yuav raug txwv tsis pub muaj.

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Tsuas tshuaj thiab tswj hwm

Fentanyl daws yog npaj rau kev tuav dej khov los yog intramuscular.

Hauv kev mob hnyav, cov tshuaj tau txhaj tshuaj ntawm 25-100 μg sib zog lossis intramuscularly (raws li tib txoj kev los yog ib txhij nrog cov tshuaj tiv thaiv kab mob).

Txog kev ntsuas ua ntej, Fentanyl yog muab rau cov tshuaj intramuscularly ntawm koob tshuaj 50–100 μg 30 feeb ua ntej kev ua haujlwm.

Rau cov tshuaj loog thaum pib qhia, cov tshuaj yog muab tshuaj rau ntawm 100-200 micrograms. Tom qab ntawd, txhua txhua 10-30 feeb, ib qho ntxiv 50-150 μg yog tswj hwm kom tau txais qhov xav tau ntawm qhov mob analgesia (ua ke nrog droperidol).

Thaum ua neuroleptanalgesia thaum tswj kev ua pa ntawm lub cev (piv txwv li, thaum lub qhov quav ntxiv thiab lub sijhawm ua haujlwm luv), thaum cov leeg so tsis tau siv, Fentanyl siv tom qab kev noj tshuaj neuroleptic ntawm 50 perg rau 10-20 kg ntawm lub cev hnyav. Hauv qhov no, kev ua pa rau lub cev yuav tsum raug tswj hwm thiab npaj rau kev kub ntxhov thiab kev siv lub tshuab tso pa tawm yuav tsum ua kom zoo. Kev txhaj tshuaj ntau dua ntawm Fentanyl (50–100 mcg / kg) tsuas yog siv tshwj xeeb rau kev qhib lub plawv phais.

Txog kev tso tshuaj kom tsaug zog thaum ua haujlwm hauv cov tshuaj loog hauv ib cheeb tsam, cov tshuaj no tau txhaj tshuaj los yog ua kom ntshav sai li ntawm 25-50 micrograms (feem ntau ua ke nrog antipsychotics). Yog tias tsim nyog, kev txhaj tshuaj Fentanyl rov qab ua dua txhua 20-30 feeb.

Cov menyuam yaus raug sau tshuaj rau cov tshuaj hauv qab no:

• npaj rau kev phais: 2 mcg / kg,
• kev phais mob ua kom loog: 150-250 mcg / kg intramuscularly lossis 10-150 mcg / kg ua ke nrog,
• kev saib xyuas ntawm kev phais mob ua ntej: 2 mcg / kg intramuscularly lossis 1-2 mcg / kg ua ke ncaj.

Neuroleptanalgesia

Fentanyl yog qhov hluavtaws analgesic muab tau los ntawm 4-aminopiperidine. Tus qauv tshuaj lom neeg yog qee qhov zoo xws li promedol. Nws muaj qhov muaj zog, tab sis luv-luv (nrog ib qho kev tswj hwm nkaus xwb) analgesic effect.

Tom qab kev tswj hwm ntawm cov ntshav, cov nyhuv siab tshaj plaws tau txhim kho tom qab 1-3 feeb thiab kav ntev li 15-30 feeb. Tom qab kev tswj hwm intramuscular, qhov siab tshaj plaws tshwm sim hauv 3-10 feeb.

Txog kev npaj tshuaj rau tshuaj loog (ua ntej npaj ua ntej), fentanyl yog muab rau ntawm koob tshuaj 0.05-0.1 mg (1-2 ml ntawm 0.005% daws) intramuscularly ib nrab ib teev ua ntej kev phais mob.

Hauv cov haujlwm hauv qab tshuaj loog hauv zos, fentanyl (feem ntau yog ua ke nrog cov tshuaj tiv thaiv kev tiv thaiv) tuaj yeem siv ua tshuaj loog ntxiv. 0.5-1 ml ntawm 0.005% kev daws teeb meem ntawm fentanyl raug muab tshuaj rau hauv qhov quav tshuaj los yog intramuscularly (yog tias tsim nyog, cov tshuaj tuaj yeem rov ua dua txhua 20-40 feeb).

Fentanyl tuaj yeem siv los daws qhov mob hnyav hauv myocardial infarction, angina pectoris, pulmonary infarction, lub raum thiab hepatic colic. Qhia cov tshuaj intramuscularly lossis intravenously 0.5-1-2 ml ntawm 0.005% kev daws. Fentanyl feem ntau siv rau lub hom phiaj no ua ke nrog cov tshuaj tiv thaiv kev puas hlwb.

Kev txhaj tshuaj fentanyl yog rov ua dua tom qab 20-40 feeb, thiab tom qab kev phais mob tom qab 3-6 teev.

Thaum siv fentanyl, tshwj xeeb tshaj yog nrog cov lus qhia sai sai rau txoj hlab ntshav, kev nyuaj siab mob ntsws tuaj yeem, uas tuaj yeem tshem tawm los ntawm kev tswj hwm ntawm naloxone.

Rau kev ua haujlwm tsis luv-tsis muaj kab noj hniav, thaum siv cov leeg ua kom lub zog tsis tas yuav ua haujlwm thiab neuroleptanalgesia yog ua thaum tswj lub cev tsis ua haujlwm, fentanyl raug tswj hwm ntawm tus nqi ntawm 1 ml ntawm 0.005% kev daws rau txhua 10 txog 20 kg ntawm lub cev qhov hnyav. Hauv qhov no, nws yog ib qhov tsim nyog los soj ntsuam qhov tsis txaus ntseeg ntawm kev ua pa. Nws yog qhov tsim nyog kom muaj peev xwm ua, yog tias tsim nyog, nkag siab ntawm lub cev thiab lub tshuab nqus cov pa ntawm lub ntsws. Thaum tsis muaj cov kev mob rau lub tshuab ua pa, kev siv fentanyl rau neuroleptanalgesia yog qhov tsis lees paub.

Lub cev kev sib thab, kev sib zog thiab txhav ntawm cov leeg ntawm lub hauv siab thiab nqua, bronchio spasm, hypotension, qhov ntswg txhaws txhaws kuj yuav pom. Bradycardia yog tshem tawm los ntawm atropine (0.5-1 ml ntawm 0.1% daws).

Cov neeg mob tau siv tshuaj insulin, corticosteroids thiab antihypertensive tshuaj yog muab rau hauv cov koob tshuaj qis dua.

Cov quav thiab quav ua yees (mob ntxiv rau lub hlwb) yuav ua rau fentanyl.

Nrog kev tiv thaiv kev sib chwv, fentanyl nkag mus rau hauv cov hlab ntshav los ntawm daim tawv nqaij, yog li nce kev saib xyuas yuav tsum tau ua thaum ua haujlwm nrog yeeb tshuaj. Qhov zoo tib yam yog pom zoo thaum soj ntsuam cov tsis paub txog tshuaj uas zoo li fentanyl.

Neuroleptanalgesia hloov |Cev xeeb tub thiab lactation

Thaum cev xeeb tub, Fentanyl tsuas yog siv rau hauv rooj plaub uas qhov kev cia siab pab rau leej niam muaj txiaj ntsig zoo dua rau kev muaj peev xwm ua rau tus me nyuam hauv plab thiab cov menyuam yug tshiab.

Cov tshuaj kis mus rau niam mis, yog li ntawd, thaum siv Fentanyl, kev pub mis niam yuav tsum tsis ua haujlwm ntxiv.

Cov poj niam ntawm kev ua me nyuam lub hnub nyoog thaum siv cov tshuaj yuav tsum ua tib zoo xaiv kev tswj kom tsis muaj menyuam.

Yeeb tshuaj sib cuam tshuam

Nrog rau kev siv ua ke ntawm Fentanyl nrog antihistamines nrog cov nyhuv sedative thiab ethanol, txoj kev pheej hmoo ntawm kev mob tshwm sim ntau ntxiv.

Benzodiazepines ncua sijhawm ntev rau tus neeg mob tawm ntawm neuroleptanalgesia, beta-blockers tuaj yeem txo qhov tsawg zaus thiab qhov hnyav ntawm cov kev tsis haum siab thaum siv Fentanyl hauv kev phais mob plawv, tab sis nce kev pheej hmoo ntawm bradycardia.

Nrog tib lub sijhawm siv nrog monoamine oxidase inhibitors, qhov kev pheej hmoo ntawm cov kev mob nyhav ntxiv, nrog rau cov tshuaj tiv thaiv kab mob, cov nyhuv ntawm cov tom qab nce ntxiv.

Thaum ua ke nrog cov leeg ua kom cov leeg ua kom mob, ua kom cov leeg ua kom tsis txhob ua haujlwm lossis tshem tawm, cov leeg ua kom so nrog vagolytic kev ua haujlwm txo qis kev pheej hmoo ntawm kev mob ntshav siab thiab lub cev bradycardia, thiab tuaj yeem ua rau muaj kev pheej hmoo ntawm kev mob ntshav siab, tachycardia, cov leeg ua kom cov leeg ua si tsis muaj vagolytic, tsis txhob txo qhov kev pheej hmoo ntawm hypotension thiab bradycardia, thiab nce kev pheej hmoo ntawm mob hnyav kev phiv tshuaj los ntawm cov hlab plawv.

Fentanyl yuav tsum tau siv nrog ceev faj tiv thaiv keeb kwm yav dhau los ntawm kev ua ntawm kev noj tshuaj tsaug zog, tshuaj tiv thaiv kev noj tshuaj thiab tshuaj rau cov tshuaj loog tshwj xeeb kom tsis txhob muaj kev tsuj ntawm cov kev ua haujlwm ntawm lub chaw ua pa, thiab ntev dhau los ntawm kev tiv thaiv ntawm lub hauv nruab nrab cov hlab ntsha. Dinitrogen oxide tsub kom cov leeg ua kom tawv ncauj, thiab tricyclic cov tshuaj tiv thaiv kab mob ua rau kom muaj kev cuam tshuam ntau ntxiv ntawm kev ua pa ntawm lub chaw ua pa.

Cov tshuaj yuav tsum tsis txhob siv nrog kev sib xyaw ua ke (narcotic analgesics) los ntawm pab pawg ntawm agonist antagonists ntawm opioid receptors (tramadol, nalbuphine thiab butorphanol) thiab agonists ib nrab (buprenorphine), vim tias muaj kev phom sij ntawm kev qaug zog ntawm analgesia.

Nrog rau cov kev kho kom haum nrog cov tshuaj tiv thaiv kab mob siab, glucocorticosteroids thiab insulin, Fentanyl yuav tsum siv rau hauv cov koob tshuaj txo qis. Cov tshuaj tiv thaiv analgesic thiab cov kev mob tshwm sim ntawm lwm cov opioid agonists (promedol, morphine) hauv kev kho mob ntau yam yog ua ke nrog kev ua thiab cuam tshuam ntawm Fentanyl.

Fentanyl analogues yog: Dolforin, Lunaldin, Fentadol Matrix, Fentadol Cov Dej, Cov Fendivia.

Tus nqi ntawm fentanyl hauv cov chaw muag tshuaj

Cov tshuaj tsis tuaj yeem yuav hauv cov khw muag khoom sib txuas, vim nws muaj rau tsev kho mob xwb. Txawm li cas los xij, nws paub tias tus nqi ntawm Fentanyl nyob ntawm 90-100 rubles rau ib pob ntawm cov tshuaj uas muaj 5 ampoules ntawm kev txhaj tshuaj rau qhov ntau npaum ntawm 50 μg / ml.

Pom qhov yuam kev hauv cov ntawv nyeem? Xaiv nws thiab nias Ctrl + Enter.

Cev xeeb tub thiab lactation

Muaj cov ntaub ntawv tsis txaus ntawm kev siv fentanyl hauv cov poj niam cev xeeb tub. Fentanyl hla lub tsho me nyuam hauv plab thaum cev xeeb tub. Cov kev tshawb fawb tsiaj tau qhia tias muaj kev ua me nyuam muaj tshuaj lom, tab sis qhov tseem ceeb ntawm cov ntaub ntawv tau txais rau tib neeg yog tsis paub. Siv lub caij nyoog ntev ntawm fentanyl thaum cev xeeb tub tuaj yeem ua rau kev nthuav dav ntawm cov tsos mob thim rov qab hauv cov menyuam tshiab, uas tuaj yeem tsim kev phom sij tau yog tias tsis kho. Yog tias koj yuav tsum tau noj tshuaj opioids mus ntev ntev hauv cov poj niam cev xeeb tub, koj yuav tsum ceeb toom rau tus neeg mob txog qhov kev pheej hmoo ntawm kev tsim muaj cov tsos mob tshem tawm ntawm cov menyuam mos, thiab tseem paub tseeb tias yuav muaj kev kho mob uas tsim nyog.

Kev siv fentanyl (iv lossis iv) thaum lub sijhawm yug menyuam (suav nrog kev phais menyuam) tsis pom zoo, vim tias fentanyl hla lub tsho me me, thiab tseem vim tias qhov chaw ua pa ntawm tus me nyuam yog qhov tshwj xeeb tshaj yog rau opiates. Nyob rau hauv kev txiav txim siab ntawm kev siv fentanyl, yuav tsum npaj cov tshuaj tiv thaiv kab mob tiv thaiv uas tsim nyog.

Fentanyl raug tawm hauv cov kua mis thiab tuaj yeem ua rau mob ntsws / ua pa nyuaj hauv cov menyuam yaus, yog li koj yuav tsum tsis kam pub mis tsis pub dhau 24 teev tom qab siv cov tshuaj. Txoj kev phom sij / txiaj ntsig ntawm kev pub niam mis tom qab siv fentanyl yuav tsum txiav txim siab.

Kev tiv thaiv kev nyab xeeb

Fentanyl tsuas yog siv los ntawm cov neeg muaj peev xwm ua tau zoo. Fentanyl tsuas yog yuav tsum tau sau tseg los ntawm cov kws tshwj xeeb uas paub txog txoj cai rau kev ua haujlwm ntev kev kho mob opioid, kev txheeb xyuas thiab tshem tawm hypoventilation, suav nrog kev kho nrog opioid receptor antagonists yog tias tsim nyog.

Fentanyl, zoo li lwm yam tshuaj opioid analgesics, tuaj yeem yog qhov kev tsim txom ob qho tib si thaum siv raws li cov cim qhia rau siv, thiab thaum nkag mus rau cov tshuaj tsis raug cai. Qhov kev pheej hmoo no yuav tsum tau txiav txim siab thaum sau ntawv, sau tshuaj thiab faib tshuaj rau hauv cov kis uas muaj kev txhawj xeeb txog kev siv tsis raug, tsim txom thiab lwm yam kev ua txhaum.

Cov neeg mob uas muaj kev pheej hmoo ntau dua ntawm kev tsim txom opioid suav nrog cov neeg mob tsev neeg muaj keeb kwm ntawm kev quav (nrog rau kev quav yeeb tshuaj los yog dej caw) los yog qee yam kev mob hlwb (piv txwv li, kev nyuaj siab heev). Ua ntej sau tshuaj opioid analgesics rau tus neeg mob, kev soj ntsuam kab mob kev pheej hmoo ntawm kev txhim kho opioid yuav tsum raug ntsuas. Txhua tus neeg mob uas tau txais tshuaj opioids yuav tsum raug soj ntsuam kom paub txog kev siv tsis tsim nyog, tsim txom, thiab txhim kho kev vam khom. Cov neeg mob uas muaj kev pheej hmoo ntau ntawm kev tsim txom opioid tau qhia kom tawm ntawm kev hloov kho opioid;

Kev txhawj xeeb txog kev tsim txom, kev vam khom thiab kev siv tsis raug yuav tsum tsis yog lub hauv paus rau qhov tsis ua hauj lwm ntawm kev kho mob kom raug.

Txawm li cas los xij, txhua tus neeg mob tau txais tshuaj opioid analgesics yuav tsum ua tib zoo saib xyuas txog cov cim ntawm kev quav tshuaj thiab tsim txom, vim tias muaj kev pheej hmoo ntawm kev quav, suav nrog kev siv opioid analgesics kom tsim nyog.

Tshaj dhau qhov kev pom zoo ntawm fentanyl yog qhov txiaj ntsig ntawm kev suav tsis yog thaum hloov tus neeg mob los ntawm lwm tus neeg mob opioid analgesic tuaj yeem ua rau kom tuag ntau dua ntawm thawj koob tshuaj.

Fentanyl yuav tsum tsis txhob siv los nplij rau mob ib ntus thiab mob me.

Kev siv tib lub sij hawm cov tshuaj uas cuam tshuam rau hauv nruab nrab lub paj hlwb yuav tsum muaj kev ntsuam xyuas tshwj xeeb thiab kev soj ntsuam.

Kev siv fentanyl tuaj yeem ua rau mob ntsws kev nyuaj siab, uas yog qhov koob tshuaj-siv tshuaj hauv qhov xwm txheej thiab tuaj yeem nres los ntawm qhov kev qhia ntawm tus tshwj xeeb antagonist - naloxone. Kev qhia txog kev noj tshuaj ntxiv ntawm naloxone tuaj yeem tsim nyog, vim hais tias kev nyuaj siab ntawm kev ua pa yuav nyob ntev dua li tus neeg tawm tsam ntev. Kev mob siab ntsws yog ib qho kev phom sij heev tshaj plaws ntawm kev kho nrog opioid receptor agonists, suav nrog fentanyl. Ib qho kev pheej hmoo siab tshaj plaws ntawm kev mob ntsws ua pa pom nyob rau cov neeg laus thiab cov neeg tsis muaj zog, feem ntau yog tom qab thov kev pib loj rau cov neeg mob uas tsis tau txais kev kho mob opioid yav dhau los los yog cov neeg mob opioids tau noj ib txhij nrog rau lwm cov tshuaj uas txwv kev ua pa. Kev nyuaj siab ntawm lub ntsws los ntawm opioids tshwm sim los ntawm qhov kev ua tsis tau zoo ntawm lub ntsws ua pa thiab lub ntsws ua pa poob qis, feem ntau hais tawm ntawm kev ua pa "tsis tsim nyog" (ua pa tob tob los cuam tshuam los ntawm qhov mob ib pliag ntev). Kev tswj hwm carbon dioxide rov qab vim tias kev ua pa nyuaj siab tuaj yeem txhim kho lub zog sedative ntawm opioids. Hauv qhov no, kev siv tshuaj ntau dhau nrog cov yeeb yaj kiab sedative thiab opioids yog qhov tshwj xeeb tshaj yog.

Kev mob ntsws hnyav muaj nrog kev ua pa nyuaj siab, uas tuaj yeem thev lossis rov ua dua tshiab tom qab lub sijhawm txiav. Vim li no, kev saib xyuas cov neeg mob ceev faj yog qhov tsim nyog, nrog rau qhov muaj cov khoom tsim nyog thiab muaj cov tshuaj thaiv tshwj xeeb rau kev rov ua dua tshiab. Kev ua kom tsaug zog thaum lub sij hawm tshuaj loog yuav hloov tus neeg mob cov lus teb rau CO concentration₂ thiab ua rau lub ntsws ua pa nyuaj siab tom qab lub sijhawm tau txiav txim siab.

Fentanyl yuav tsum tau ua nrog kev ceev faj heev rau cov neeg mob uas mob ob lub ntsws lossis mob ntsws tsis ua haujlwm, nrog rau cov neeg mob uas muaj qhov txo qis hauv lub ntsws ntau ntau, hypoxia, hypercapnia, lossis tus uas yav dhau los tau mob ntsws ua pa nyuaj. Hauv cov neeg mob no, txawm tias kev kho mob fentanyl li niaj zaus noj tau ntawm fentanyl tuaj yeem cuam tshuam txog kev ua pa ntawm lub cev ua pa kom txog hnub. Rau pawg no ntawm cov neeg mob, lwm txoj kev kho mob tsis siv tshuaj opioid yuav tsum raug txiav txim siab, thiab opioids yuav tsum tsuas yog kws kho mob tau saib xyuas kom zoo thiab tsawg kawg nkaus.

Lub taub hau raug mob thiab nce siab intracranial

Fentanyl yuav tsum tsis txhob raug tshuaj rau cov neeg mob uas tej zaum muaj kev cuam tshuam tshwj xeeb tshaj yog cov teeb meem intracranial ntawm kev nce qib hauv CO.₂Cov. Pawg no ntawm cov neeg mob suav nrog cov neeg uas muaj cov cim qhia ntxiv ntawm qhov mob siab intracranial, lub siab tsis hnov ​​qab, lossis tsis nco qab lawm. Cov tshuaj opioids yuav ua rau cov kev soj ntsuam soj ntsuam los ntawm cov neeg mob uas ua rau lub hlwb puas. Fentanyl yuav tsum tau ua ntawv kho nrog ceev faj rau cov neeg mob uas mob qog hlwb.

Kev ua kom cov leeg nruj, nrog rau cov leeg pectoral muaj peev xwm ua tau, uas tuaj yeem zam los ntawm kev ua raws li cov kev coj ua: kev ua haujlwm sai, ua kom loog nrog benzodiazepines, thiab siv cov leeg ua kom zoo.

Qhov tshwm sim ntawm myoclonic tsiv ntawm qhov tsis-epileptogenic xwm yog tau. Bradycardia, txog kev raug mob rau hauv lub cev, tuaj yeem tshwm sim yog tias tus neeg mob tau txais tshuaj tsis txaus ntawm anticholinergics lossis thaum fentanyl siv nrog cov leeg ua rau cov leeg nqaij uas tsis muaj vagolytic. Bradycardia tuaj yeem nres los ntawm kev qhia ntawm atropine.

Ntev nrog kev siv fentanyl, kev thev taus thiab tshuaj yaj yeeb tshuaj yuav tsim muaj.

Opioids tuaj yeem ua rau hypotension, tshwj xeeb tshaj yog rau cov neeg mob hypovolemia. Qhov tsim nyog ntsuas yuav tsum ua kom tswj tau cov ntshav siab nyob ruaj khov.

Zam tsis txhob txhaj tshuaj sai ntawm cov tshuaj opioid rau cov neeg mob uas muaj kev hloov pauv ntawm cov nqaij hauv lub cev: hauv cov neeg mob no, qhov hloov qis qis hauv lub plawv txhais tau tias qee lub sijhawm cov leeg ntshav txo qis.

Cov neeg mob uas tau siv tshuaj kho mob opioid ntev los yog tus neeg muaj opioid yuav tsum tau txhaj ntau dua ntawm fentanyl.

Kev txo koob tshuaj yog pom zoo rau cov neeg laus thiab cov neeg mob debilitated.

Kev siv fentanyl xav tau kev ceeb toom rau cov neeg mob uas muaj cov xwm txheej nram qab no: kev tswj tsis tau hypothyroidism, mob ntsws, txo cov dej tidal, kev haus cawv, ua rau lub siab lossis lub raum tsis ua haujlwm. Cov neeg mob zoo li no tseem xav tau kev soj ntsuam tom qab lub sijhawm ntev.

Thaum siv fentanyl ua ke nrog cov tshuaj tiv thaiv kev tiv thaiv (xws li droperidol), nws yog ib qho tsim nyog yuav tsum tau coj mus rau hauv tus lej qhov txawv ntawm lub sijhawm ua haujlwm ntawm cov tshuaj no. Nrog lawv siv ua ke, kev pheej hmoo ntawm hypotension nce. Cov tshuaj tiv thaiv kab mob tuaj yeem ua rau cov tsos mob hnyav ntxiv uas tuaj yeem tswj tau los ntawm kev siv tshuaj tiv thaiv kev tiv thaiv kev puas tsuaj.

Ib yam li lwm yam opioids, vim nws cov teebmeem anticholinergic, kev siv cov fentanyl tuaj yeem ua rau muaj kev nce siab hauv cov kua tsib lub plab thiab, muaj qee kis, spasm ntawm tus txha caj qaum ntawm Oddi tuaj yeem pom.

Hauv cov neeg mob nrog myasthenia gravis, koj yuav tsum ua tib zoo xav txog kev siv qee yam anticholinergics thiab tshuaj uas thaiv cov hlab hlwb xa mus ua ntej thiab thaum siv tshuaj loog, uas suav nrog kev tswj fentanyl.

Kev siv cov fentanyl thaum yug menyuam tuaj yeem ua rau mob ntsws ua pa hauv tus menyuam mos.

Muaj kev cuam tshuam nrog Cawv thiab Dej Caw

Fentanyl yuav muaj qhov sib ntxiv ntawm kev tawm tsam ntawm lub hauv nruab nrab cov hlab ntsha hauv lub luag haujlwm thaum tshuaj tiv thaiv tom qab cawv, lwm yam tshuaj opioids lossis tshuaj txhaum cai uas muaj qhov zoo sib xws ntawm lub hauv nruab nrab lub paj hlwb.

Siv rau menyuam yaus. Qhov kev nyab xeeb ntawm fentanyl tseem tsis tau muaj pov thawj hauv cov menyuam yaus hnub nyoog qis dua 2 xyoos. Fentanyl tsuas yog muab rau cov menyuam yaus hnub nyoog tshaj 2 xyoos thiab rau tus neeg uas tau opioid kam rau ua.

Ua kom loog rau cov menyuam yaus uas ua pa ntawm lub cev yuav tsum siv cov tshuaj loog rau qhov tshuaj pleev ib ce lossis ua rau qhov tshuaj loog (lossis ua ib feem ntawm txoj kev ua kom loog / ua kom loog), muab rau cov neeg ua haujlwm tsim nyog thiab khoom siv tau rau kev tso ntshav mus kuaj qhov quav thiab ua pa tawm. Kev tswj hwm kev nyab xeeb ntawm fentanyl, tshwj xeeb tshaj yog nyob hauv cov menyuam yaus, tuaj yeem ua rau lub cev tuag ntau dhau ntawm cov tshuaj.

Siv rau cov neeg laus. Cov ntaub ntawv tau txais thaum lub sijhawm tshawb fawb txog kev tswj hwm ntawm fentanyl qhia tias cov neeg laus laus yuav txo qis kev tshem tawm thiab ua kom ntev li ib nrab ntawm lub neej ntawm cov tshuaj, thiab ntxiv rau, cov neeg mob zoo li no yuav rhiab ntau dua li fentanyl dua li cov neeg mob hluas. Cov neeg laus yuav tsum tau ua tib zoo saib xyuas txhawm rau txheeb xyuas qhov tshwm sim ntawm kev siv fentanyl ntau heev, uas yuav xav tau kom txo qis hauv fentanyl.

Kev ceev faj yuav tsum tau siv rau kev siv fentanyl nrog rau cov tshuaj uas cuam tshuam rau serotonergic neurotransmitter system.

Kev tswj hwm nrog cov tshuaj serotonergic, xws li xaiv serotonin reuptake inhibitors, serotonin thiab norepinephrine reuptake inhibitors, nrog rau cov tshuaj uas cuam tshuam rau serotonin metabolism (suav nrog monoamine oxidase inhibitors), tuaj yeem ua rau muaj kev phom sij hauv lub neej ntawm serotonin syndrome.

Kev txhim kho ntawm serotonin syndrome tuaj yeem tshwm sim nrog kev siv cov tshuaj nyob rau hauv cov koob tshuaj pom zoo.

Kev nthuav qhia hauv chaw kho mob ntawm serotonin syndrome yuav suav nrog cov tsos mob hauv qab no:

- kev hloov pauv ntawm cov xwm txheej hauv lub hlwb (ntxhov siab vim arousal, pom kev sibtham, tsis nco qab),

- kev cuam tshuam ntawm cov leeg tsis txaus siab (tachycardia, ntshav ntshav hauv lub cev, hyperthermia),

- cov kev mob neuromuscular (hyperreflexia, kev tsis sib haum, cov leeg mob),

mob plab zom mov (piv txwv li, xeev siab, ntuav, raws plab).

Yog tias qhov kev txhim kho ntawm serotonin syndrome tau xav txog, kev siv fentanyl yuav tsum nres tam sim ntawd.

Cuam tshuam rau lub peev xwm tsav tsheb thiab lwm yam uas muaj peev xwm txaus ntshai. Tsav tsheb thiab koom nrog lwm cov kev phom sij uas muaj peev xwm tsuas yog ua tau yog tias muaj sijhawm txaus nyob rau lub sijhawm txij li thaum siv cov tshuaj.