Finlepsin: cov lus qhia rau kev siv

Raws li cov lus qhia rau Finlepsin, kev qhia rau nws siv yog:

• qaug dab peg (suav nrog cov tsis tuaj yeem, qaug zog, mob leeg nqaij myoclonic),
• idiopathic trigeminal neuralgia,
• raug thiab atypical trigeminal neuralgia tshwm sim los ntawm ntau yam mob sclerosis,
• idiopathic neuralgia ntawm lub hlab ntsha glossopharyngeal,
• mob manic mob (hauv daim ntawv ntawm monotherapy lossis kev kho mob sib txuas ua ke),
• theem-cuam tshuam rau kev cuam tshuam kev cuam tshuam,
• haus dej cawv haus cawv
• ntshav qab zib insipidus ntawm hauv paus chiv keeb,
• polydipsia thiab polyuria ntawm keeb kwm neurohormonal.

Cov Tshuaj Pom Zoo Finlepsin

Cov lus qhia rau Finlepsin piav qhia txog xws li cov qauv sib kis rau nws siv:

• hypersensitivity rau carbamazepine,
• ua txhaum ntawm pob txha hlwb hematopoiesis,
• sib quas ntus kab laug sab,
• siv cov MAO inhibitors sib tshooj,
• AV thaiv.

Finlepsin yuav tsum tau siv nrog ceev faj hauv decompensated lub plawv tsis ua hauj lwm, ADH mob siab tsis txaus, hypopituitarism, adrenal cortex tsis txaus, hypothyroidism, nquag haus cawv, laus hnub nyoog, daim siab tsis ua hauj lwm, nce siab intraocular.

Sab nyhuv ntawm finlepsin

Cov kev mob tshwm sim hauv qab no yog qhia thaum Finlepsin siv:

• nyob rau ib feem ntawm Cov Neeg Sawv Cev Hauv Lub Tebchaws: kiv taub hau, mob taub hau, tsis pom kev xav, nco qab, pom kev sib deev, sib deev, hyperkinesis, tsis tuaj yeem cuam tshuam txog kev sib cav,
• los ntawm lub plab zom mov: ntuav, xeev siab, nce siab hepatic transaminases,
• los ntawm CCC: nce los sis txo hauv ntshav siab, txo qis hauv plawv, kev ua txhaum ntawm AV conduction,
• los ntawm cov kab mob ntshav hematopoietic: txo qis ntawm cov neeg hauv hlwb, cov qe ntshav dawb, platelets,
• los ntawm ob lub raum: oliguria, hematuria, nephritis, edema, lub raum tsis ua haujlwm,
• los ntawm kev ua pa: pulmonitis,
• los ntawm cov kab mob endocrine: kev nce ntxiv ntawm cov qib prolactin, nrog los ntawm galactorrhea, gynecomastia, hloov qib ntawm cov thyroid hormones,
• lwm tus: kev tsis haum tshuaj, suav nrog Stevens-Johnson syndrome.

Qhov loj ntawm cov kev mob tshwm sim ua rau tsis zoo xyuas ntawm Finlepsin los ntawm cov neeg mob. Txhawm rau tiv thaiv lawv cov ntsej muag lossis kom txo tau qhov mob hnyav, koj tuaj yeem siv Finlepsin raws li cov lus qhia nyob rau hauv cov tshuaj txaus thiab nyob rau hauv kev saib xyuas mob nruj.

Txoj kev ntawm daim ntawv thov, ntau npaum ntawm finlepsin

Finlepsin yog rau kev siv qhov ncauj. Cov tshuaj pib rau cov laus yog 0.2-0.3 g ib hnub. Maj mam, qhov ntau dua qhov siab tau nce mus rau 1.2 g. Kev siv tshuaj ntau tshaj txhua hnub yog 1.6 g. Koob tshuaj txhua hnub tau muab rau hauv peb txog plaub koob, daim ntawv ntev - nyob rau hauv ib mus rau ob koob.

Finlepsin ntau npaum rau cov menyuam yog 20 mg / kg. Txog thaum muaj hnub nyoog 6 xyoo, Finlepsin ntsiav tshuaj tsis siv.

Kev cuam tshuam ntawm Finlepsin nrog lwm yam tshuaj

Kev siv tib txhij ntawm Finlepsin nrog MAO inhibitors yog qhov tsis lees txais. Lwm cov anticonvulsants tuaj yeem txo cov nyhuv anticonvulsant ntawm Finlepsin. Nrog rau kev tswj hwm ua ke ntawm cov tshuaj no nrog valproic acid, nws muaj peev xwm los tsim kev cuam tshuam ntawm kev nco qab, tsis nco qab. Finlepsin tsub kom lub tshuaj lom ntawm cov roj ntsha lithium. Nrog tib lub sijhawm siv macrolides, calcium channel blockers, isoniazid, cimetidine nrog Finlepsin, cov ntshav plasma concentration ntawm qhov kawg nce. Finlepsin txo cov haujlwm ntawm cov tshuaj tiv thaiv thiab cov tshuaj tiv thaiv kom txhob muaj zog.

Noj ntau dhau

Nrog kev noj tshuaj ntau dhau ntawm Finlepsin, qhov ua txhaum txoj kev nco qab, kev nyuaj siab ntawm lub ntsws ua pa thiab hlab plawv, ua rau cov ntshav tsis zoo, thiab lub raum puas yuav ua tau. Kev tsis tshwj xeeb: kev mob plab, siv tshuaj laxatives thiab enterosorbents. Vim tias lub peev xwm loj ntawm cov tshuaj los khi rau cov ntshav plasma protein, peritoneal dialysis thiab yuam diuresis nrog kev noj ntau dhau ntawm Finlepsin tsis muaj txiaj ntsig. Hemosorption ntawm thee sorbents yog nqa tawm. Hauv cov menyuam yaus me, tuaj yeem hloov ntshav tau.

Vim tias qhov muaj txiaj ntsig zoo ntawm cov tshuaj no, muaj peev xwm tau sau tseg hauv ntau qhov xwm txheej kho mob, kev tshuaj xyuas ntawm Finlepsin yog qhov zoo. Cov tshuaj muaj cov nyhuv antiepileptic zoo, ua kom loog rau lub neuralgia.

Cov lus qhia tshwj xeeb

Ua ntej siv cov tshuaj no, nws yog ib qho tsim nyog yuav tsum kawm cov lus qhia rau Finlepsin hauv kev nthuav dav.

Thaum xaiv cov tshuaj kho kom zoo, nws yog qhov tsim nyog los txiav txim siab ntshav ntshav ntawm carbamazepine. Kev tshem tawm sai ntawm cov tshuaj tuaj yeem ua rau qaug dab peg. Kev saib xyuas ntawm hepatic tramsaminases kuj tseem ceeb thaum sau ntawv Finlepsin. Raws li cov lus taw qhia nruj, Finlepsin tuaj yeem siv los ntawm cov neeg mob uas muaj kev mob siab ntawm intraocular, tab sis qhov ntsuas no yuav tsum tau saib xyuas.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Finlepsin yog muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj: puag ncig, nrog ib tug bevel, dawb, convex ntawm ib sab thiab nrog kev phom sij-qhov zoo li tsis sib xws - ntawm lwm qhov (10 pcs. Hauv cov hlwv, hauv pob ntawv ntim ntawm 3, 4 lossis 5 blisters).

Muaj pes tsawg leeg ib 1 ntsiav tshuaj:

• cov tshuaj nquag: carbamazepine - 200 mg,
• Cov khoom ua haujlwm pabcuam: gelatin, magnesium stearate, microcrystalline cellulose, croscarmellose sodium.

Cov Tshuaj Hauv Tshuaj

Finlepsin yog cov tshuaj tiv thaiv kev puas tsuaj. Nws kuj muaj cov tshuaj tiv thaiv kev puas hlwb, tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv kev ntxhov siab. Hauv cov neeg mob neuralgia, nws ua kom pom txoj nyhuv analgesic.

Lub tshuab ntawm kev ua ntawm carbamazepine yog vim qhov thaiv ntawm voltage-dependant sodium raws, uas pab ua kom ruaj khov ntawm cov qog ntawm overexcited neurons, ua rau inhibition ntawm cov dej tawm ntawm cov hlab ntsha hlwb thiab txo cov kev sib txuam ntawm impulses ntawm synapses. Kev ua ntawm carbamazepine tiv thaiv kev rov ua dua tshiab ntawm kev muaj peev xwm nyob hauv cov hlwb ua kom tsis muaj zog, txo qhov kev tso tawm ntawm glutamate (qhov zoo siab ntawm neurotransmitter amino acid), nce qhov qaug dab peg ntawm lub hauv nruab nrab lub paj hlwb thiab, vim li ntawd, txo qhov kev pheej hmoo ntawm kev qaug dab peg. Qhov ua rau anticonvulsant ntawm Finlepsin kuj tseem yog vim qhov hloov kho ntawm voltage-gated Ca 2+ channels thiab qhov nce ntawm K + conductivity.

Carbamazepine ua tau zoo hauv kev yooj yim thiab txoj kev qee ntu ntawm qaug dab peg (nrog lossis tsis muaj theem nrab dav dav), nrog tonic-cov chaw kho mob cov mob chua leeg ntawm cov mob vwm, thiab tseem thaum sib txuas nrog cov hom mob chua leeg. Cov tshuaj feem ntau tsis ua haujlwm lossis tsis muaj txiaj ntsig rau qhov mob me me (tsis tuaj, myoclonic qaug dab peg, petit mal).

Hauv cov neeg mob uas muaj mob vwm (tshwj xeeb yog menyuam yaus thiab menyuam hluas), cov tshuaj muaj feem cuam tshuam rau cov tsos mob ntawm kev nyuaj siab thiab ntxhov siab, thiab tseem yuav txo tau qhov kev txob taus thiab kev txhoj puab heev.

Finlepsin cov nyhuv ntawm psychomotor kev ua tau zoo thiab kev txawj ntse yog koob tshuaj.

Qhov ua haujlwm anticonvulsant ntawm cov tshuaj tshwm sim los ntawm ob peb teev mus rau ntau hnub, thiab qee zaum txog li ib hlis.

Hauv cov neeg mob nrog trigeminal neuralgia, Finlepsin, raws li txoj cai, tiv thaiv qhov tshwm sim ntawm kev tawm tsam mob. Kev qaug zog ntawm qhov kev mob tshwm sim tau pom nyob hauv thaj tsam li 8 mus rau 72 teev tom qab siv tshuaj.

Nrog rau kev tshem tawm dej cawv, carbamazepine nce ntau qhov kev txo qis rau kev tsim nyog, thiab tseem txo qhov mob hnyav hauv cov tsos mob xws li tshee, tshee tshee thiab tsis hnov ​​qab gait.

Qhov ua rau antipsychotic ntawm cov tshuaj tshwm sim tom qab 7-10 hnub, uas yuav cuam tshuam nrog inhibition ntawm cov metabolism hauv norepinephrine thiab dopamine.

Cov Tshuaj Pharmacokinetics

Carbamazepine yog maj mam tab sis ua kom tiav. Noj yuav luag tsis cuam tshuam rau qib thiab kev nrawm ntawm nqus. Qhov siab tshaj plaws ntshav ntshav tau mus txog 12 teev tom qab noj ib koob. Kev ua kom sib luag plasma sib luag tau mus txog tom qab 1-2 lub lis piam, uas nyob ntawm tus neeg cov yam ntxwv ntawm cov metabolism, nrog rau cov koob tshuaj, cov neeg mob thiab lub sijhawm kho.

Hauv cov menyuam yaus, carbamazepine khi rau cov ntshav plasma los ntawm 55–59%, rau cov laus - los ntawm 70-80%. Cov pom pom tseeb ntawm kev faib tawm ntawm cov tshuaj yog 0.8-1.9 l / kg. Carbamazepine hla lub chaw placental thiab tawm hauv cov kua mis (nws cov ntsiab lus hauv cov kua mis ntawm tus poj niam tu neeg mob yog 25-60% ntawm qhov kev txiav txim ntawm carbamazepine hauv ntshav).

Cov metabolism hauv cov tshuaj no tshwm sim hauv lub siab, feem ntau nyob ntawm txoj kev epoxy. Raws li qhov tshwm sim, cov metabolites tseem ceeb hauv qab no tau tsim: cov nquag metabolite - carbamazepine-10,11-epoxide, cov tshuaj tiv thaiv metabolite - ua ke nrog glucuronic acid. Raws li qhov tshwm sim ntawm cov khoom noj ntawm lub cev hloov pauv, qhov tsim ntawm lub cev tsis muaj zog, 9-hydroxymethyl-10-carbamoylacridane, muaj peev xwm ua tau. Qhov kev sib zog ntawm cov metabolite nquag yog 30% ntawm kev mloog ntawm carbamazepine.

Tom qab noj ib zaug tshuaj ntawm cov tshuaj, ib nrab-lub neej yog 25-65 teev, tom qab rov qab siv - 12-24 teev (nyob ntawm seb lub sijhawm kho mob). Hauv cov neeg mob uas ntxiv tau txais lwm cov tshuaj anticonvulsants (piv txwv li, phenobarbital lossis phenytoin), lub neej ib nrab raug txo mus rau 9-10 teev.

Tom qab txhaj ib zaug xwb ntawm Finlepsin, kwv yees li 28% ntawm cov koob tshuaj tau tso tawm hauv cov quav thiab 72% hauv cov zis.

Hauv cov menyuam yaus, vim kev ua kom sai ntawm kev tshem tawm cov carbamazepine, kev siv ntau dua ntawm cov tshuaj rau ib kg ntawm lub cev hnyav tuaj yeem xav tau.

Cov ntaub ntawv hais txog kev hloov pauv hauv Finacpsin tshuaj lag luam hauv cov neeg mob cov laus tsis muaj.

Tsuas tshuaj thiab tswj hwm

Finlepsin noj qhov ncauj nrog qhov dej txaus lossis lwm yam kua. Cov ntsiav tshuaj yuav tsum noj nrog cov zaub mov lossis tom qab noj mov.

Nrog qaug dab peg, cov tshuaj tau zoo dua yog daim ntawv tshuaj monotherapy. Thaum koom nrog Finlepsin rau kev kho tus mob ua kom tsis tu ncua, yuav tsum ceev faj thiab maj mam dhau los, yog tias tsim nyog, kho qhov koob tshuaj ntawm cov tshuaj uas siv.

Thaum hla cov koob tshuaj ntxiv, koj yuav tsum noj lub ntsiav tshuaj uas ploj lawm kom sai li sai tau thaum tus neeg mob nco qab qhov no. Koj tsis tuaj yeem siv tshuaj carbamazepine ob npaug.

Txog kev kho mob vwm, kev txhaj tshuaj thawj zaug ntawm Finlepsin rau cov laus thiab cov hluas uas muaj hnub nyoog tshaj 15 xyoos yog 200-400 mg ib hnub. Tom qab, qhov koob tshuaj yog maj mam nce kom txog thaum qhov kev kho mob qib siab tau ua tiav. Qhov nruab nrab ntawm kev saib xyuas cov tshuaj ntau npaum li ntawm 800 txog 1200 mg ib hnub hauv 1-3 koob. Qhov tshuaj ntau tshaj rau cov neeg laus yog 1600-2000 mg rau ib hnub.

Rau cov menyuam yaus uas muaj qaug dab peg, cov tshuaj tau sau tseg hauv cov koob tshuaj hauv qab no:

• cov menyuam muaj hnub nyoog 1-5 xyoos: 100-200 mg ib hnub ib zaug thaum pib kho, tom qab ntawd, lub koob tshuaj yog maj mam nce los ntawm 100 mg ib hnub twg kom txog thaum cov tshuaj kho tau tiav, kev saib xyuas txij li 200-400 mg rau ib hnub hauv ob peb koob tshuaj,
• cov menyuam hnub nyoog 6-10 xyoo: 200 mg rau ib hnub, yav tom ntej, ntau dua qhov koob tshuaj tau nce ntxiv los ntawm 100 mg rau ib hnub txog thaum cov nyhuv tshuaj xav tau tiav, kev saib xyuas txij nkawm yog 400-600 mg ib hnub hauv 2-3 koob,
• cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog 11-15 xyoo: 100-300 mg ib hnub, tom qab ntawd cov tshuaj tiv thaiv tsawg dua los ntawm 100 mg rau ib hnub kom txog thaum cov nyhuv xav tau tiav, kev saib xyuas txij nkawm yog 600-1000 mg rau ib hnub hauv 2-3 koob.

Yog tias tus me nyuam tsis tuaj yeem nqos Finlepsin ntsiav tshuaj tag nrho, nws tuaj yeem tsoo, zom lossis tshee rau hauv dej thiab haus cov tshuaj uas ua rau.

Lub sijhawm tiv thaiv ntawm cov tshuaj rau mob qaug dab peg yog nyob ntawm qhov ntsuas thiab tus neeg mob cov lus teb rau kev kho. Tus kws kho mob txiav txim siab ntawm lub sijhawm kho lossis tshem tawm ntawm Finlepsin ib leeg rau txhua tus neeg mob. Cov lus nug ntawm kev txo qhov koob tshuaj lossis ncua kev txiav yeeb tshuaj yog txiav txim siab tom qab 2-3 xyoos ntawm kev kho mob, thaum lub caij chua leeg tsis tuaj kiag li.

Cov koob tshuaj ntawm Finlepsin raug maj mam txo qis dua 1-2 xyoos, ua tib zoo saib xyuas qhov ntsuas electroencephalogram. Nrog rau qhov txo qis hauv cov koob tshuaj txhua hnub hauv cov menyuam yaus, nws yog qhov tsim nyog yuav tsum xav txog qhov muaj hnub nyoog nce hauv lub cev qhov hnyav.

Nrog idiopathic glossopharyngeal neuralgia thiab trigeminal neuralgia, thawj koob tshuaj yog 200-400 mg ib hnub. Yav tom ntej, nws yog nce ntxiv rau 400-800 mg hauv 1-2 koob tshuaj. Kev kho mob txuas ntxiv mus kom txog thaum qhov mob ploj tag. Hauv qee tus neeg mob, nws yog qhov siv tau cov carbamazepine hauv kev kho qis dua - 200 mg ob zaug ib hnub.

Hauv cov neeg mob laus thiab cov neeg mob siab txog qhov mob Finlepsin, cov tshuaj yog kws kho nyob rau hauv thawj zaug, uas yog 200 mg ib hnub twg hauv 2 koob tshuaj.

Kev kho mob ntawm kev tshem tawm cov cawv cawv muaj nyob hauv tsev kho mob. Cov tshuaj tau sau tseg nyob rau hauv qhov nruab nrab txhua hnub koob tshuaj 600 mg hauv 3 faib koob tshuaj. Hauv cov teeb meem tshwj xeeb tshaj yog, cov koob tshuaj carbamazepine tau nce rau 1200 mg ib hnub twg hauv 3 koob tshuaj sib faib. Yog tias tsim nyog, cov tshuaj yeeb yaj kiab tuaj yeem siv ua ke nrog lwm cov tshuaj rau kev kho mob ntawm tus neeg mob cawv haus syndrome. Kev kho mob yog nres maj tshaj li ntawm ib lub sijhawm 7-10 hnub. Thoob plaws txhua lub sijhawm ntawm txoj kev kho, tus neeg mob yuav tsum tau ua tib zoo saib xyuas vim tias kev tuaj yeem tsim kev phiv los ntawm cov leeg hlwb.

Rau qhov mob tshwm sim los ntawm kab mob ntshav qab zib neuropathy, Finlepsin yog tshuaj rau qhov nruab nrab txhua hnub yog 600 mg hauv 3 koob tshuaj. Hauv qee qhov tshwj xeeb, qhov tshuaj tau nce ntxiv rau 1200 mg ib hnub hauv 3 koob tshuaj faib.

Txog kev kho thiab tiv thaiv kev mob hlwb, carbamazepine yog raug sau tseg nyob rau hauv ib hnub 200-400 mg nrog kev nce ntxiv, yog tsim nyog, rau 800 mg ib hnub hauv 2 faib koob tshuaj.

Nrog qaug dab peg txuam nrog ntau yam mob sclerosis, Finlepsin raug kho nyob rau hauv ib koob ntawm 400-800 mg hauv 2 koob tshuaj.

Sab sij huam

Kev phiv los ntawm cov tshuaj los ntawm lub hauv nruab nrab cov hlab ntsha tuaj yeem yog qhov txiaj ntsig ntawm kev noj qab haus huv tshaj plaws ntawm cov carbamazepine lossis cov kev hloov pauv tsis tseem ceeb hauv cov tshuaj ntawm cov tshuaj hauv cov ntshav.

Thaum kho nrog Finlepsin, kev phiv los ntawm cov kab ke hauv qab no thiab cov kabmob yuav tshwm sim:

• lub plab zom mov: feem ntau qhuav lub qhov ncauj, ntuav, xeev siab, nce kev ua si ntawm alkaline phosphatase thiab gamma glutamyl transferase, qee zaum cem quav lossis zawv plab, mob plab, ua kom muaj mob ntawm daim siab enzymes, tsis tshua muaj stomatitis, gingivitis, glossitis, parenchymal thiab cholestatic kab mob siab, granulomatous mob siab, mob daj ntseg, daj ntseg, mob caj pas, kab mob siab,
• kev mob plawv: tsis tshua muaj - nce lossis tsawg dua ntawm cov ntshav siab, kev txhim kho lossis kev ua tsis zoo ntawm kev mob plawv tsis ua hauj lwm, bradycardia, exacerbation ntawm kev mob plawv, thromboembolic syndrome, mob intracardiac conduction kev cuam tshuam, atrioventricular block, nrog los ntawm kev tsaus muag, thrombophlebitis, vau,
• lub hauv paus hauv lub paj hlwb: feem ntau mob taub hau, tsaug zog, kiv taub hau, paresis ntawm kev pab, ataxia, qhov tsis muaj zog, qee zaum nystagmus, txawv txav ntawm lub cev, tsis tshua muaj - tsis qab los noj mov, hais lus tsis meej, ntxhov siab, mob leeg, psychomotor ntxhov siab, kev nyuaj siab, paresthesia, cov tsos mob paresis, hnov ​​lus lossis pom kev pom, oculomotor cuam tshuam, tsis meej pem, peripheral neuritis, kev coj tus cwj pwm tsis zoo, ua kom mob hlwb, choreoathetoid cuam tshuam,
• kev hnov ​​mob hauv nruab nrog cev: tsis tshua muaj tshwm sim - mob hlwb, txhaws ntawm lub lens, cuam tshuam hauv saj, hnov ​​lus tsis zoo, nce siab ntawm lub cev,
• Cov kab mob genitourinary: tsis tshua muaj - tso zis cia, tso zis ntau zaus, lub raum khiav tsis zoo, interstitial nephritis, txo qis potency, lub raum tsis ua haujlwm,
• musculoskeletal system: tsis tshua muaj - cramps, mob hauv cov leeg thiab pob qij txha,
• metabolism thiab endocrine system: feem ntau - nce hauv lub cev qhov hnyav, edema, hyponatremia, kua dej tsis sib haum, tsis tshua muaj - nce ntawm kev ua haujlwm ntawm cov thyroid stimulating hormone thiab prolactin, txo qis hauv cov concentration ntawm L-thyroxine, lub cev tsis muaj zog calcium thiab phosphorus metabolism hauv cov pob txha nqaij, hypertriglyceridemia, hypercholesterolemia, osteomalacia, hirsutism tsam mob txhab ntshav
• hematopoietic system: feem ntau - eosinophilia, thrombocytopenia, leukopenia, tsis tshua muaj - agranulocytosis, leukocytosis, reticulocytosis, hemolytic, megaloblastic thiab aplastic anemia, lymphadenopathy, splenomegaly, folic acid deficiency, tseeb erythrocyteramid
• kev ua xua: feem ntau - ua pob ua pob rau qee zaum, qee zaum - ntau lub cev ncua-hom hypersensitivity kev tsis haum, anaphylactoid kev ua xua, kev ua xua pneumonitis, Quincke's edema, aseptic meningitis, eosinophilic mob ntsws, tsis tshua muaj - khaus ntawm daim tawv nqaij, lom ua paug epidermal necrolysis, zoo li mob ntsws, mob ntsws, mob rau lub cev.
• lwm cov kev tawm tsam: pob txuv, kab plaub hau ploj, purpura, tawm hws ntau dhau, cuam tshuam cov tawv nqaij uas tsis muaj zog.

Cev xeeb tub thiab lactation

Nws yog qhov zoo dua rau cov poj niam ntawm kev yug menyuam muaj hnub nyoog los sau ntawv rau Finlepsin rau kev kho mob ntshav qab zib thiab kev noj qab haus huv qis tshaj plaws, txij li kev pheej hmoo ntawm kev tsis txaus ntseeg hauv cov menyuam mos uas lawv niam tau txais cov tshuaj tiv thaiv antiepileptic siab dua ntawm cov menyuam mos uas lawv niam tau txais tsuas yog carbamazepine.

Cov poj niam cev xeeb tub, tshwj xeeb tshaj yog nyob rau thawj peb lub hlis, cov tshuaj tau sau tseg nrog kev ceev faj, suav rau hauv cov ntsiab lus xav tau cov txiaj ntsig thiab qhov tshwm sim muaj. Finlepsin tej zaum yuav ua rau muaj kev pheej hmoo ntawm txoj kev loj hlob intrauterine ntau dua rau cov menyuam tshiab uas lawv niam muaj mob cuam vwm.

Antiepileptic siv yeeb tshuaj dhau los ua kom tsis muaj cov folic acid, uas feem ntau pom hauv cov poj niam cev xeeb tub, yog li ntawd, thaum npaj lub cev xeeb tub thiab thaum nws tshwm sim, kev tswj hwm ntawm folic acid pom zoo. Txhawm rau tiv thaiv hemorrhagic mob hauv cov menyuam mos, poj niam thaum kawg ntawm cev xeeb tub thiab cov menyuam tshiab tau pom zoo kom sau ntawv vitamin K₁.

Finlepsin kis mus rau niam mis, yog li muaj kev kho mob txuas ntxiv thaum lub sijhawm pub niam mis, cov txiaj ntsig kev cia siab rau leej niam thiab kev pheej hmoo rau tus menyuam yuav tsum raug ntsuas.

Yeeb tshuaj sib cuam tshuam

Qhov kev txiav txim siab ntawm carbamazepine hauv cov ntshav nce ntxiv nrog kev siv tib lub sijhawm ntawm Finlepsin nrog cov tshuaj thiab cov kev npaj ua ntej (kev kho ntawm cov tshuaj ntau npaum li cas ntawm carbamazepine lossis kev saib xyuas nws cov concentration hauv plasma yog qhov yuav tsum tau): felodipine, viloxazine, fluvoxamine, acetazolamide, desipramine, verapamil, dextropicentxxx tsuas yog rau cov laus thiab cov koob tshuaj siab), diltiazem, azoles, macrolides, loratadine, isoniazid, HIV tiv thaiv kab mob inhibitors, terfenadine, propoxyphene, kua txiv kab ntxwv qaub.

Cov tshuaj carbamazepine hauv cov ntshav txo qis nrog kev siv Finlepsin tib lub sijhawm nrog cov tshuaj thiab cov kev npaj ua ntej: phenytoin, metsuximide, theophylline, cisplatin, phenobarbital, primidone, rifampicin, doxorubicin, fensuximide, tejzaum valproic acid, clonazepazprodomx, oxononepazprodom, oxononep, oxon, oxonon, oxon

Carbamazepine tuaj yeem txo cov ntshav plasma ntau ntawm cov tshuaj hauv qab no: clonazepam, ethosuximide, valproic acid, dexamethasone, prednisolone, tetracyclines, methadone, theophylline, lamotrigine, tricyclic antidepressants, clobazam, digoxin, primrazolopololororolopramololerolopolololololololololololololol , HIV protease inhibitors, kev npaj hauv qhov ncauj uas muaj progesterone thiab / los yog estrogens, calcium blockers, tiagabine, levothyroxine, olazapine, risperidone, ciprasidone, oxcarbazepi n, praziquantel, tramadol, itraconazole, midazolam.

Nrog rau kev siv ua ke ntawm Finlepsin thiab lithium npaj, nws muaj peev xwm txhim kho cov nyhuv neurotoxic ntawm ob qho tshuaj, nrog tetracyclines - nws muaj peev xwm ua kom tsis muaj zog ntawm kev kho mob ntawm carbamazepine, nrog paracetamol - qhov kev pheej hmoo ntawm kev phiv los ntawm paracetamol rau lub siab nce thiab nws cov txiaj ntsig txo, nrog diuretics, hyponatremia yuav loj hlob, nrog ethan ethanol, nrog isoniazid - lub zog hepatotoxic ntawm isoniazid yog kho kom zoo, nrog cov tsis ua kom mob nqaij rau cov leeg nqaij - cov nyhuv ua kom tsis muaj zog. nqaij hnaiv, nrog myelotoxic tshuaj - carbamazepine enhanced haematotoxicity.

Cov nyhuv anticonvulsant ntawm Finlepsin txo qis nrog kev siv tib lub sijhawm nrog pimozide, haloperidol, clozapine, phenothiazine, molindone, maprotiline, thioxanthenes thiab tricyclic antidepressants.

Carbamazepine nrawm cov metabolism hauv kev tiv thaiv kev xeeb menyuam, kev siv tshuaj tua kabmob ua haujlwm, tshuaj loog, praziquantel thiab folic acid, thiab tseem tuaj yeem txhim kho cov zais ntawm cov thyroid hormones.

Cov qauv ntawm Finlepsin yog: Zeptol, Carbamazepine, Carbamazepine-Akrikhin, Carbamazepin-Ferein, Carbamazepine retard-Akrikhin, Tegretol TsR, Tegretol, Finlepsin retard.

Kev tshuaj xyuas rau Finlepsin

Cov neeg mob uas tau noj cov tshuaj rau ntau xyoo, nrog rau lawv cov txheeb ze, tawm hauv kev tshuaj xyuas zoo rau Finlepsin, txij li kev kho tus mob epilepsy yeej ploj mus vim yog txoj kev kho mob. Tib lub sijhawm, qee cov neeg mob tau sau tseg txog qhov tsis zoo ntawm cov tshuaj ntawm kev txawj ntse. Hauv kev tshwj xeeb, lawv tau sau tseg kev ua txhaum ntawm kev sib txuas lus thiab pom ntawm kev tsis quav ntsej.

Finlepsin tau pom tias yog ib qho kev kho mob zoo rau kev tawm tsam ceeb, tab sis gait tsis txaus ntseeg txuas ntxiv hauv qee cov neeg mob.

Pharmacological kev txiav txim

Cov tshuaj tiv thaiv kev puas hlwb (dibenzazepine derivative), uas kuj muaj cov tshuaj tiv thaiv kab mob, tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob, muaj cov nyhuv analgesic rau cov neeg mob neuralgia.

Lub tshuab ntawm kev ua yog txuam nrog qhov thaiv ntawm voltage-gated sodium channels, uas ua kom muaj kev nyob ruaj khov ntawm daim nyias nyias ntawm overexcited neurons, inhibition ntawm cov tsos ntawm cov feem ntawm kev puas tsuaj ntawm neurons thiab txo qis hauv synaptic impulse conduction. Tiv thaiv qhov rov tsim ntawm Na + -cov kev txiav txim siab lub peev xwm nyob rau hauv depolarized neurons. Txo qhov kev tso tawm ntawm qhov tsis txaus siab neurotransmitter amino acid - glutamate, nce qhov qis dua ntawm kev cuam tshuam ntawm lub hauv nruab nrab cov hlab ntsha txhaws thiab, yog li, txo qhov kev pheej hmoo ntawm kev tsim muaj tus mob qaug dab peg. Nws nce K + kev coj ua, hloov kho voltage-gated Ca 2+ channels, uas tseem tuaj yeem pab txhawb cov nyhuv anticonvulsant ntawm cov tshuaj.

Ua tau zoo rau focal (ib nrab) qaug dab peg (yooj yim thiab cov nyom), nrog lossis tsis nrog los ntawm kev muaj feem thib ob, rau kev kho tus mob feem ntau tonic-clonic kev qaug dab peg, nrog rau kev sib txuas ntawm cov hom qaug dab peg (feem ntau tsis muaj txiaj ntsig rau qhov chua leeg - Petit mal, qhaj thiab myoclonic chua leeg). Cov neeg mob qaug dab peg (tshwj xeeb tshaj yog rau cov menyuam yaus thiab cov hluas) muaj cov txiaj ntsig zoo ntawm cov tsos mob ntawm kev ntxhov siab thiab kev nyuaj siab, nrog rau kev txo qis ntawm kev txob taus thiab kev txhoj puab heev. Qhov cuam tshuam ntawm kev txawj ntse ua haujlwm thiab psychomotor kev ua tau zoo yog koob tshuaj. Qhov pib ntawm cov nyhuv anticonvulsant sib txawv los ntawm ob peb teev mus rau ntau hnub (qee lub sijhawm txog li 1 hlis vim kev pib-pib ntawm cov metabolism).

Nrog rau qhov tseem ceeb thiab theem nrab trigeminal neuralgia, carbamazepine feem ntau tiv thaiv qhov pib ntawm kev mob. Kev mob nyem hauv trigeminal neuralgia tau sau tseg tom qab 8-7 teev.

Yog hais tias haus dej haus cawv haus cawv, nws nce qhov pib ntawm qhov tsim nyog, uas feem ntau txo qis hauv cov mob no, thiab txo qhov mob tsis zoo ntawm cov chaw kuaj mob tshwm sim ntawm tus mob (nce siab, tshee, gait cuam tshuam).

Antipsychotic (antimaniacal) kev ua tom qab 7-10 hnub, tuaj yeem yog vim yog inhibition ntawm cov metabolism hauv dopamine thiab norepinephrine.

Daim ntawv teev cov tshuaj ntau dua ua rau muaj kev saib xyuas ntawm lub zog ruaj khov dua cov carbamazepine hauv cov ntshav thaum noj 1-2 zaug hauv ib hnub.

Cev xeeb tub thiab lactation

Thaum twg los xij tau, Finlepsin ard retard raug tso cai rau cov poj niam ntawm kev ua me nyuam lub hnub nyoog xws li tshuaj tua kab mob, hauv kev siv tshuaj tsawg kawg nkaus, qhov ntsuas mob tsis xwm yeem ntawm cov me nyuam yug tshiab los ntawm cov niam uas siv cov tshuaj tiv thaiv kev tiv thaiv kab mob siab dua rau kev kho tus mob monotherapy.

Thaum cev xeeb tub tshwm sim, nws yog ib qho tsim nyog los sib piv cov txiaj ntsig ntawm kev kho thiab qhov muaj peev xwm ua tau tshwm sim, tshwj xeeb tshaj yog nyob rau thawj lub hlis ntawm cev xeeb tub. Nws raug paub tias cov menyuam yaus ntawm leej niam uas muaj kev txom nyem los ntawm kev mob vwm tuaj yog thawj coj rau txoj kev loj hlob ntawm intrauterine, suav nrog kev ua tsis tiav. Finlepsin ® retard muaj peev xwm ua kom muaj kev pheej hmoo ntawm cov teeb meem no. Muaj cov ntaub ntawv sib cais ntawm kev muaj mob ntawm cov kab mob ua tsis taus pa thiab tsis meej, nrog rau tsis kaw qhov ntawm cov leeg caj qaum (txha nqaj qaum bifida).

Cov tshuaj antiepileptic nce folic acid deficiency, uas feem ntau pom thaum cev xeeb tub, uas tuaj yeem ua rau muaj qhov tsis zoo ntawm kev yug menyuam hauv menyuam yaus, yog li noj folic acid pom zoo ua ntej npaj lub sijhawm cev xeeb tub thiab thaum cev xeeb tub. Txhawm rau tiv thaiv hemorrhagic muaj teeb meem hauv cov menyuam mos, nws raug pom zoo tias cov poj niam nyob rau lub lim tiam kawg ntawm cev xeeb tub, nrog rau cov menyuam yug menyuam tshiab, yuav tsum tau muaj cov tshuaj vitamin K.

Carbamazepine hla mus rau niam mis, yog li cov txiaj ntsig thiab qhov tsis xav tau ntawm kev pub niam mis yuav tsum muab piv nrog kev kho mob txuas ntxiv. Nrog kev pub mis niam txuas ntxiv thaum noj cov tshuaj, koj yuav tsum tsim kev soj ntsuam rau tus menyuam hauv kev txuas nrog qhov muaj feem ua rau muaj kev phiv tshuaj (piv txwv li, nkees nkees heev, ua xua ntawm daim tawv nqaij).

Tsuas tshuaj thiab tswj hwm

Sab hauvlub sijhawm lossis tomqab noj mov nrog dej ntau. Rau kev yooj yim ntawm kev siv, lub ntsiav tshuaj (ntxiv rau nws ib nrab lossis peb lub hlis) tuaj yeem ua ntej yaj hauv dej los yog kua txiv, vim hais tias cov cuab yeej ntawm kev tso tawm ntev ntev ntawm cov tshuaj nquag tom qab kev zom cov ntsiav tshuaj hauv cov kua yog tswj hwm. Qhov ntau ntawm cov koob tshuaj siv yog 400–1200 mg / hnub, uas tau muab faib ua 1-2 koob tshuaj rau ib hnub.

Qhov siab tshaj plaws txhua hnub noj yuav tsum tsis pub tshaj 1600 mg.

Hauv qhov xwm txheej thaum ua tau, Finlepsin ard retard yuav tsum tau kho raws li kev kho mob monotherapy. Kev kho mob pib nrog kev siv tshuaj rau ib qho me me txhua hnub, uas tom qab ntawd maj mam nce ntxiv kom txog thaum pom qhov txiaj ntsig zoo tshaj plaws. Qhov sib ntxiv ntawm Finlepsin ® retard rau kev kho tus mob ua kom tsis tu ncua yuav tsum tau maj mam ua, thaum koob tshuaj ntawm cov tshuaj siv tsis hloov pauv, lossis yog tias tsim nyog, kho qhov tseeb. Yog tias tus neeg mob tau hnov ​​qab noj cov tshuaj txuas ntxiv ntawm lub sijhawm, lub sijhawm noj tshuaj ploj yuav tsum tau noj sai li sai tau thaum qhov kev zam no tau pom, thiab koj yuav tsum tsis txhob noj ob npaug ntawm cov tshuaj.

Cov neeg laus Qhov tshuaj thawj zaug yog 200-400 mg / hnub, tom qab ntawd qhov koob tshuaj yog maj mam nce mus txog thaum pom cov txiaj ntsig zoo tshaj plaws. Cov koob tshuaj saib xyuas yog 800–1200 mg / hnub, uas muab faib rau 1-2 zaug hauv ib hnub.

Cov menyuam. Thawj koob tshuaj rau cov menyuam yaus ntawm 6 mus rau 15 xyoo yog 200 mg / hnub, tom qab ntawd qhov koob tshuaj yog maj mam nce los ntawm 100 mg / hnub kom txog rau thaum cov txiaj ntsig zoo tshaj plaws tau tiav. Txhawb cov koob tshuaj rau cov menyuam muaj hnub nyoog 6-10 xyoo yog 400-600 mg / hnub (hauv 2 koob), rau cov menyuam hnub nyoog 11-15 xyoo - 600-1000 mg / hnub (hauv 2 koob).

Lub sijhawm siv yog nyob ntawm qhov ntsuas thiab tus neeg teb ntawm tus neeg mob rau kev kho. Qhov kev txiav txim siab hloov tus neeg mob mus rau Finlepsin ® retard, lub sijhawm siv nws thiab kev tshem tawm txoj kev kho mob yog coj tus kheej los ntawm kws kho mob. Lub sijhawm ntawm txo qis ntawm cov tshuaj lossis tso tseg kev kho mob yog txiav txim siab tom qab 2-3 xyoo lub sijhawm ntawm kev ua tsis tiav ntawm chua leeg.

Txoj kev kho mob tau nres, maj mam txo cov tshuaj rau ntawm 1-2 xyoos, nyob rau hauv kev tswj hwm ntawm EEG. Hauv cov menyuam yaus, nrog rau kev txo qis hauv cov tshuaj ib hnub, nce hauv lub cev qhov hnyav nrog lub hnub nyoog yuav tsum xav txog.

Ua rau mob hlwb neuralgia, idiopathic glossopharyngeal neuralgia

Qhov tshuaj thawj zaug yog 200-400 mg / hnub, uas tau muab faib ua 2 koob. Thawj koob tshuaj thawj tau nce ntxiv kom txog thaum qhov mob ploj zoo kiag li, qhov nruab nrab nce mus txog 400-800 mg / hnub. Tom qab ntawd, hauv qee qhov ntawm cov neeg mob, kev kho tuaj yeem txuas ntxiv nrog kev tswj xyuas qis dua ntawm 400 mg.

Finlepsin ard retard yog cov kws kho mob hauv cov neeg laus thiab cov neeg mob nkag rau Karabamazepine hauv ib koob li 200 mg ib zaug ib hnub.

Hnov mob ntshav qab zib neuropathy

Qhov nruab nrab cov tshuaj txhua hnub yog 200 mg thaum sawv ntxov thiab 400 mg rau yav tsaus ntuj. Hauv qee qhov tshwj xeeb, Finlepsin ® retard tuaj yeem kho nyob rau hauv ib koob ntawm 600 mg 2 zaug hauv ib hnub.

Kho mob hauv cawv tso rau hauv tsev kho mob

Qhov nruab nrab txhua hnub koob tshuaj yog 600 mg (200 mg thaum sawv ntxov thiab 400 mg thaum yav tsaus ntuj). Hauv cov xwm txheej hnyav, hauv thawj hnub, cov tshuaj muaj peev xwm nce ntxiv mus rau 1200 mg / hnub, uas tau muab faib ua 2 koob tshuaj.

Yog tias tsim nyog, Finlepsin ard retard tuaj yeem ua ke nrog lwm cov tshuaj uas siv los kho kev tshem tawm cawv, ntxiv rau sedative-hypnotics.

Thaum kho, nws yog ib qho tsim nyog yuav tsum soj ntsuam cov ntsiab lus ntawm cov carbamazepine hauv cov ntshav ntshav.

Hauv kev sib txuas nrog txoj kev txhim kho tau ntawm kev mob tshwm sim los ntawm lub hauv nruab nrab thiab lub zog ntawm lub paj hlwb, cov neeg mob tau ua tib zoo saib nyob hauv tsev kho mob.

Kab mob vwm uas huam ntau yam mob sclerosis

Qhov nruab nrab txhua hnub koob tshuaj yog 200-400 mg 2 zaug ib hnub.

Kev kho thiab tiv thaiv kev mob hlwb

Cov koob tshuaj thaum pib thiab cov txij nkawm feem ntau yog qhov qub - 200-400 mg / hnub. Yog tias tsim nyog, cov koob tshuaj yuav raug nce ntxiv rau 400 mg 2 zaug ib hnub.

Kev cuam tshuam nrog lwm yam tshuaj

Kev tswj hwm tib lub sijhawm ntawm carbamazepine nrog CYP3A4 inhibitors tuaj yeem ua rau muaj qhov nce ntxiv hauv nws cov ntshav tshuaj plasma thiab ua rau muaj kev tsis zoo. Kev siv CYP3A4 lub zog sib xyaw ua ke tuaj yeem ua rau muaj kev nrawm ntawm cov metabolism hauv carbamazepine, qhov kev txo qis ntawm cov pa carbamazepine hauv cov ntshav plasma thiab txo qis hauv kev kho mob, ntawm qhov tsis sib xws, lawv txoj kev tshem tawm tuaj yeem txo tus nqi ntawm biotransformation ntawm carbamazepine thiab ua rau muaj kev nce ntxiv hauv nws cov kev coj ua.

Cov ntsiab lus ntawm carbamazepine hauv plasma ntau ntxiv los ntawm verapamil, diltiazem, felodipine, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, cimetidine, acetazolamide, danazole, desipramine, nicotinamide (hauv cov neeg laus, tsuas yog nyob rau hauv siab dheev, eurothinry, ezythine, ezythine, ezyth, eine, ezythinry, eurothyryine, eurothyryine, eurothyryine, eurothyryine, erogen (itraconazole, ketoconazole, fluconazole), terfenadine, loratadine, isoniazid, propoxyphene, kua txiv kab ntxwv qaub, kis kab mob protease inhibitors siv los kho tus kab mob HIV (piv txwv li ritonavir) - kev noj tshuaj yog tsim nyog kho. thiab soj ntsuam ntshav ntau ntawm carbamazepine.

Felbamate txo qhov kev txiav txim siab ntawm carbamazepine hauv plasma thiab nce qhov kev txiav txim siab ntawm carbamazepine-10,11-epoxide, thaum tib lub sij hawm txo qis hauv cov concentration hauv ntshiab ntawm felbamate yog ua tau.

Qhov kev nkag siab ntawm carbamazepine yog txo los ntawm phenobarbital, phenytoin, primidone, metsuximide, fensuximide, theophylline, rifampicin, cisplatin, doxorubicin, tej zaum yog clonazepam, valpromide, valproic acid, oxcarbazepine thiab tshuaj ntsuab cov khoom muaj St. John's wort (Hypericum perforatum)Cov. Muaj peev xwm hloov chaw ntawm carbamazepine los ntawm valproic acid thiab primidone los ntawm lub koom haum nrog cov ntshav plasma protein thiab nce ntxiv ntawm cov tshuaj pharmacologically nquag metabolite (carbamazepine-10,11-epoxide). Nrog kev siv ua ke ntawm finlepsin nrog valproic acid, tshwj xeeb, tsis nco qab thiab tsis meej pem yuav tshwm sim. Isotretinoin hloov kho cov bioavailability thiab / lossis kev tshem tawm ntawm carbamazepine thiab carbamazepine-10,11-epoxide (kev saib xyuas ntawm cov concentration ntawm carbamazepine hauv ntshav yog tsim nyog).

Carbamazepine tuaj yeem txo cov ntshav plasma concentration (txo lossis txawm tias ua rau tsis zoo ntawm cov teebmeem) thiab xav tau koob tshuaj kho cov tshuaj hauv qab no: clobazam, clonazepam, digoxin, ethosuximide, primidone, valproic acid, alprazolam, corticosteroids (prednisolone, dexamethasone), cyclosporin, docyclicin, haloperidol, methadone, qhov ncauj npaj uas muaj estrogens thiab / los yog progesterone (xaiv lwm txoj kev tswj kom tsis txhob muaj menyuam yog tsim nyog), theophylline, qhov ncauj anticoagulants (warfarin, fenprocoumone, dicumar la), lamotrigine, topiramate, tricyclic antidepressants (imipramine, amitriptyline, nortriptyline, clomipramine), clozapine, felbamate, tiagabine, oxcarbazepine, protease inhibitors siv los kho mob HIV (indinavir, ritonavir, saquidine, saquidine. felodipine), itraconazole, levothyroxine, midazolam, olanzapine, praziquantel, risperidone, tramadol, ziprasidone.

Muaj peev xwm nce ntxiv los yog tsawg dua phenytoin hauv ntshav plasma tiv thaiv keeb kwm ntawm carbamazepine thiab nce qib mefenytoin. Nrog rau kev siv txeem carbamazepine thiab lithium npaj txhij, cov teebmeem ntawm neurotoxic ntawm ob qho tshuaj nquag tuaj yeem ua kom zoo dua.

Tetracyclines tuaj yeem ua raws li kev kho nyhuv ntawm carbamazepine. Thaum ua ke nrog paracetamol, qhov kev pheej hmoo ntawm nws cov kev ua rau lub siab ua rau lub siab nce ntxiv thiab cov tshuaj kho tau tsawg dua (nrawm cov metabolism ntawm paracetamol).

Kev tswj hwm tib lub sijhawm ntawm carbamazepine nrog phenothiazine, pimozide, thioxanthenes, mindindone, haloperidol, maprotiline, clozapine thiab tricyclic antidepressants ua rau muaj kev cuam tshuam ntau dua ntawm cov nyhuv hauv nruab nrab lub paj hlwb thiab ua rau lub cev tsis muaj zog ntawm cov tshuaj carbamazepine.

MAO inhibitors nce qhov kev pheej hmoo ntawm kev tsim hyperpyrethmic crises, hypertensive crises, qaug dab peg, thiab cov txiaj ntsig tuag taus (MAO inhibitors yuav tsum thim tsawg kawg 2 lub lis piam ua ntej lossis thaum cov carbamazepine tau sau tseg, lossis yog tias qhov xwm txheej tso cai, txawm tias lub sijhawm ntev dua).

Ib txhij tswj hwm nrog cov tshuaj diuretics (hydrochlorothiazide, furosemide) tuaj yeem ua rau tus mob hyponatremia, nrog cov lus kuaj mob.

Nws attenuates cov teebmeem ntawm qhov tsis-depolarizing nqaij relaxants (pancuronium). Kev siv los ntawm kev sib koom ua ke, nws yuav tsim nyog nce qhov koob tshuaj ntawm cov leeg ua kom lub zog, thaum ua tib zoo saib xyuas tus neeg mob nws yog qhov tsim nyog vim muaj kev txiav tawm ntawm cov nqaij ntshiv kom sai.

Carbamazepine txo cov tshuaj ethanol tiv thaiv.

Myelotoxic tshuaj ntxiv rau hematotoxicity ntawm cov tshuaj.

Nws ua rau lub cev metabolism hauv kev tsis ncaj ntawm anticoagulants, tshuaj tiv thaiv kev tiv thaiv qog, tshuaj folic acid, praziquantel, thiab tuaj yeem txhim kho kev tshem tawm cov thyroid hormones.

Nws nrawm cov metabolism hauv cov tshuaj rau tshuaj loog (enflurane, halotane, fluorotan) thiab muaj kev pheej hmoo ntawm hepatotoxic zoo, txhim kho kev tsim cov nephrotoxic metabolites ntawm methoxyflurane. Ua kom zoo rau cov kab mob hepatotoxic ntawm isoniazid.

Daim ntawv thov nta

Kev kho kab mob vwm pib ntawm kev teem sij hawm txhaj tshuaj qis, maj mam nce nws kom txog thaum cov nyhuv tshuaj tiav tau tiav.

Thaum xaiv cov tshuaj noj kom zoo dua, nws yog qhov tsim nyog los txiav txim siab qhov kev txiav txim siab ntawm carbamazepine hauv cov ntshav ntshav, tshwj xeeb tshaj yog nrog kev sib txuam nrog kev kho mob. Muaj qee kis, qhov zoo tshaj plaws koob tshuaj tuaj yeem ua rau txawv txav los ntawm cov koob pom zoo pib thiab txij nkawm, piv txwv, txuas nrog qhov induction ntawm microsomal daim siab mob siab los yog vim muaj kev cuam tshuam nrog kev kho ua ke.

Carbamazepine yuav tsum tsis txhob nrog cov tshuaj sedative-hypnotic. Yog tias tsim nyog, Finlepsin ard retard tuaj yeem ua ke nrog lwm cov tshuaj uas siv los kho dej cawv. Thaum kho, nws yog ib qho tsim nyog yuav tsum soj ntsuam cov ntsiab lus ntawm cov carbamazepine hauv cov ntshav ntshav. Hauv kev sib txuas nrog kev txhim kho kev mob tshwm sim los ntawm lub hauv nruab nrab thiab lub zog ntawm lub paj hlwb, cov neeg mob tau ua tib zoo saib nyob hauv tsev kho mob. Thaum hloov mus rau tus neeg mob mus rau carbamazepine, koob tshuaj ntawm cov tshuaj tiv thaiv kab mob ua ntej yuav tsum maj mam txo kom txog thaum nws tso tseg kiag li. Kev tsis ua sai sai ntawm carbamazepine tuaj yeem ua rau qaug dab peg. Yog tias nws yuav tsum tau txais kev kho mob sai sai, tus neeg mob yuav tsum tau hloov mus rau lwm cov tshuaj tiv thaiv kev puas tsuaj raws li kev ua txhaum ntawm cov tshuaj uas tau qhia nyob rau hauv cov xwm txheej zoo li no (piv txwv li, diazepam muab iv lossis kho, lossis phenytoin txhaj tshuaj iv).

Muaj ntau tus neeg mob ntuav, raws plab thiab / lossis cov khoom noj tsis txaus, ua kom yuag thiab / lossis kev nyuaj siab ua pa ntawm cov menyuam tshiab uas lawv niam noj carbamazepine ib txhij nrog rau lwm cov tshuaj anticonvulsants (tej zaum cov kev cuam tshuam no yog kev tshem tawm cov tsos mob ntawm cov menyuam mos). Ua ntej sau cov tshuaj carbamazepine thiab thaum kho, yuav tsum kawm txog lub siab ua haujlwm hauv lub siab, tshwj xeeb tshaj yog rau cov neeg mob uas muaj keeb kwm muaj kab mob siab, nrog rau cov neeg laus laus. Yog tias muaj neeg nce siab rau lub siab ua haujlwm lossis thaum lub siab ua haujlwm siab, cov tshuaj yuav tsum tau txiav tawm tam sim ntawd. Ua ntej pib kev kho mob, nws yog qhov yuav tsum tau kawm txog daim duab ntshav (suav nrog suav cov platelets, reticulocytes), theem ntawm cov hlau nyob hauv cov ntshav, kuaj cov zis dav dav, cov ntshav urea nyob rau hauv cov ntshav, ib qho electroencephalogram, kev txiav txim siab ntawm cov xaim hluav taws xob hauv cov ntshav (thiab ib ntus thaum kho, vim tias kev tsim kho tau ntawm hyponatremia). Tom qab, cov cim no yuav tsum tau saib xyuas thaum thawj lub hlis ntawm kev kho mob txhua lub lim tiam, thiab tom qab ntawd txhua hli.

Feem ntau, qhov txo qis qis los yog tsis tu ncua hauv platelet thiab / lossis cov qe ntshav dawb tsis yog harbinger ntawm qhov pib ntawm aplastic anemia los yog agranulocytosis. Txawm li cas los xij, ua ntej pib kev kho mob, nrog rau qee lub sijhawm hauv cov txheej txheem kev kho mob, kev kuaj ntshav hauv cov ntshav yuav tsum tau ua, suav nrog suav cov platelets thiab tejzaum reticulocytes, nrog rau kev txiav txim siab txog qib ntawm cov hlau hauv cov ntshav ntshav. Tsis muaj kev hloov pauv hloov asymptomatic leukopenia tsis xav kom thim tawm, txawm li cas los xij, kev kho mob yuav tsum tsis ua mus ntxiv yog tias muaj mob leukopenia lossis leukopenia tshwm sim, nrog rau cov tsos mob ntawm tus kab mob kis.

Carbamazepine yuav tsum thim tawm tam sim ntawd yog tias muaj qhov tsis haum lub ntsej muag lossis cov tsos mob tshwm sim, qhia tias kev loj hlob ntawm Stevens-Johnson syndrome lossis Lyell's syndrome. Cov tawv nqaij me me (cais cov macular lossis maculopapular exanthema) feem ntau ploj mus li ob peb hnub lossis ntau lub lim tiam, txawm hais tias muaj kev kho mob txuas ntxiv lossis tom qab txo cov koob tshuaj (tus neeg mob yuav tsum tau saib xyuas los ntawm kws kho mob zoo rau lub sijhawm no).

Lub sijhawm ua haujlwm ntawm cov teeb meem hlwb tsis txaus ntseeg yuav tsum tau coj mus rau hauv tus account, thiab hauv cov neeg mob laus, muaj peev xwm tsim kev tsis meej lossis kev ntxhov siab psychomotor.

Qee qhov xwm txheej, kev kho mob nrog cov tshuaj tiv thaiv kab mob tau nrog ua ke los ntawm qhov tshwm sim ntawm kev tua tus kheej / tua tus kheej lub siab. Qhov no kuj tau lees paub los ntawm kev kuaj meta-tsom xam ntawm cov kev soj ntsuam sim kho mob siv cov tshuaj antiepileptic. Txij li thaum cov txheej txheem ntawm kev tshwm sim ntawm kev tua tus kheej thaum siv cov tshuaj tiv thaiv kev mob tsis paub, lawv qhov kev tshwm sim tsis tuaj yeem txiav txim siab hauv kev kho mob ntawm cov neeg mob Finlepsin ® retard. Cov neeg mob (thiab cov neeg ua haujlwm) yuav tsum tau ceeb toom txog qhov yuav tsum tau saib xyuas qhov tshwm sim ntawm kev xav tua tus kheej / tus kheej tua tus kheej thiab, thaum muaj mob, nrhiav kev kho kom sai.

Tej zaum yuav muaj kev cuam tshuam cov txiv neej tsis txaus thiab / los yog cov phev txiv neej tsis txaus, txawm li cas los xij, kev sib raug zoo ntawm cov kev tsis txaus siab no nrog carbamazepine tseem tsis tau tsim. Cov tsos ntawm intermenstrual los ntshav nrog rau siv txig ntawm qhov ncauj txwv tsis pub muaj peev xwm ua tau. Carbamazepine tuaj yeem cuam tshuam loj heev rau kev ntseeg tau ntawm kev tiv thaiv qhov ncauj, yog li cov poj niam uas muaj hnub nyoog deev yuav tsum siv lwm txoj hauv kev tiv thaiv kev xeeb tub thaum kho. Yuav tsum tau siv cov carbamazepine nkaus xwb hauv kev saib xyuas mob.

Nws yog ib qho tsim nyog yuav tau qhia rau cov neeg mob txog cov cim ntxov ntawm kev lom, nrog rau cov tsos mob los ntawm daim tawv nqaij thiab daim siab. Tus neeg mob tau qhia txog qhov yuav tsum tau mus sab laj nrog tus kws kho mob tam sim ntawd yog tias muaj qhov tsis tsim nyog xws li kub taub hau, mob caj pas, tawm pob, txhaws ntawm lub qhov ncauj ntawm qhov ncauj, tsis muaj peev xwm tshwm sim ntawm nqaij doog, hemorrhage nyob rau hauv daim ntawv ntawm petechiae lossis purpura.

Ua ntej pib txoj kev kho mob, kev kuaj xyuas ophthalmic yog qhov pom zoo, suav nrog kev kuaj mob ntawm pob nyiaj thiab ntsuas ntawm kev mob siab ntawm intraocular. Yog tias muaj daim ntawv sau tshuaj rau cov neeg mob ua rau muaj kev cia siab ntau ntxiv, yuav tsum muaj kev tshuaj xyuas tas li ntawm qhov ntsuas no.

Cov neeg mob uas muaj cov kab mob plawv heev, mob rau daim siab thiab lub raum, nrog rau cov neeg laus yuav tau txais tshuaj tsawg dua ntawm cov tshuaj. Txawm hais tias kev sib raug zoo ntawm koob tshuaj carbamazepine, nws qhov kev xav thiab kev soj ntsuam kev ua haujlwm lossis kev pom zoo yog tsawg heev, txawm li ntawd los xij, kev txiav txim siab tsis tu ncua ntawm cov carbamazepine yuav pab tau zoo nyob rau cov xwm txheej hauv qab no: nrog rau qhov nce siab ntawm cov zaus ntawm kev tawm tsam, txhawm rau tshuaj xyuas seb tus neeg mob tau siv tshuaj kom yog, thaum cev xeeb tub, hauv kev kho mob ntawm menyuam yaus lossis tub ntxhais hluas, nrog kev tsis pom tseeb malabsorption ntawm cov tshuaj, nrog kev xav tias muaj kev txhim kho tshuaj lom yog tias tus neeg mob noj ultiple tshuaj.

Thaum kho nrog Finlepsin ard retard, nws pom zoo kom tsis txhob haus cawv.

Kev piav qhia ntawm daim ntawv ntau npaum, cov muaj pes tsawg leeg

Finlepsin ntsiav tshuaj muaj ib puag ncig puab, convex nto rau ntawm ib sab, ib qho chamfer kom yooj yim tawg hauv ib nrab, nrog rau xim dawb. Lub ntsiab lus tseem ceeb ntawm cov tshuaj yog carbamazepine, nws cov ntsiab lus hauv ib ntsiav tshuaj yog 200 mg. Tsis tas li, nws muaj pes tsawg leeg suav nrog kev pabcuam ntxiv cov khoom siv, uas suav nrog:

• Magnesium stearate.
• Nkaws
• Microcrystalline cellulose.
• Croscarmellose sodium.

Finlepsin ntsiav tshuaj tau ntim rau hauv ib lub blister ntim ntawm 10 daim. Daim npav pob ntawv muaj 5 lub hlwv (50 ntsiav tshuaj), thiab cov lus qhia qhia txog kev siv tshuaj.

Siv raws cai, ntau npaum cas

Finlepsin ntsiav tshuaj yog npaj rau kev tswj hwm qhov ncauj (kev tswj hwm ntawm qhov ncauj) thaum lub sijhawm lossis tom qab noj mov. Lawv tsis yog zom thiab ntxhua nrog dej txaus. Cov hom kev tswj hwm ntawm kev siv tshuaj thiab ntau npaum li cas yog nyob ntawm qhov ntsuas thiab hnub nyoog ntawm tus neeg mob:

• Epilepsy - Nws raug nquahu kom siv cov tshuaj raws li monotherapy. Nyob rau hauv qhov kev tshwm sim uas anticonvulsants ntawm lwm pharmacological pawg tau siv yav tas los lossis tau siv thaum lub sijhawm sau ntawv yuav ntawm Finlepsin ntsiav tshuaj, ntau npaum cov tshuaj pib nrog qhov tsawg kawg nkaus. Yog tias koj hla qhov ntau npaum, koj yuav tsum coj nws sai li sai tau, thaum koj tsis tuaj yeem siv ntau dua ob zaug koob tshuaj. Rau cov neeg laus, kev pib noj tshuaj yog 200-400 mg (1-2 ntsiav tshuaj), tom qab ntawd nws maj mam nce ntxiv kom ua tiav cov txiaj ntsig kho kom haum. Qhov kev saib xyuas txij nkawm yog 800-1200 mg rau ib hnub, muab faib ua 2-3 koob. Qhov ntau kawg noj txhua hnub yuav tsum tsis txhob ntau dua 1.6-2 g. Rau cov menyuam, qhov ntau npaum li cas nyob ntawm lub hnub nyoog. Rau cov menyuam hnub nyoog 1-5 xyoo - 100-200 mg nrog nce me ntsis ntawm 100 mg txhua txhua hnub kom txog thaum qhov kev kho mob zoo tshaj plaws tau tiav, feem ntau nce mus txog 400 mg, 6-12 xyoo - kev pib noj tshuaj yog 200 mg rau ib hnub nrog maj mam nce mus rau 400- 600 mg, 12-15 xyoo - 200-400 mg nrog rau maj mam nce mus rau 600-1200 mg.
• Trigeminal neuralgia - kev pib muab tshuaj yog 200-400 mg, nws yog maj mam nce mus rau 400-800 mg. Hauv qee kis, 400 mg txaus txaus los txo qhov mob hnyav heev.
• Cawv tshem tawm, cov kev kho mob uas tau nqa tawm hauv tsev kho mob lub chaw - kev muab tshuaj thawj yog 600 mg rau ib hnub, uas tau muab faib ua 3 koob tshuaj. Yog tias tsim nyog, nws tuaj yeem raug nce ntxiv rau 1200 mg ib hnub. Kev noj cov tshuaj yog nres maj. Siv tib txoj kev siv lwm yam tshuaj rau kev kho mob ntawm kev tshem tawm tus mob yog tso cai.
• Kev mob siab rau qhov mob ntshav qab zib mob neuropathy - qhov nruab nrab ib koob tshuaj txhua hnub yog 600 mg, nyob rau kis tshwj xeeb nws nce mus rau 1200 mg ib hnub twg.
• Epileptiform mob huam, txoj kev loj hlob ntawm uas yog provoked los ntawm ntau yam sclerosis - 400-800 mg ib hnub ib zaug.
• Kev tiv thaiv thiab kho mob hlwb - thaum pib thiab saib xyuas qhov ntau npaum ntawm 200-400 mg rau ib hnub, yog tias tsim nyog, nws tuaj yeem nce ntxiv txog 800 mg rau ib hnub.

Lub caij nyoog ntawm cov chav kawm ntawm kev kho mob nrog Finlepsin ntsiav tshuaj yog txiav txim siab ib tus zuj zus los ntawm tus kws kho mob koom nrog.

Cov yam ntxwv ntawm kev siv

Ua ntej sau ntawv ntawm cov ntsiav tshuaj Finlepsin, tus kws kho mob ua tib zoo nyeem cov lus qhia rau cov tshuaj thiab thim lus rau ntau qhov ntawm nws txoj kev siv kom raug:

• Kev kho kom zoo nrog ib hom tshuaj pib nrog qhov pib tshuaj tsawg kawg, uas yog maj mam nce ntxiv kom txog thaum kho kom zoo.
• Nrog rau cov tib neeg xaiv cov tshuaj kho mob, nws raug pom zoo tias qhov kev txiav txim siab ntsuas ntawm lub siab ntawm cov carbamazepine hauv cov ntshav yuav ua tau.
• Thaum noj Finlepsin ntsiav tshuaj, qhov pom ntawm kev tua tus kheej hauv tus neeg mob tsis tau txiav txim siab, uas yuav tsum tau ua tib zoo saib los ntawm kws kho mob.
• Nws tsis pom zoo kom muab cov tshuaj sib xyaw nrog cov tshuaj tsaug zog thiab tshuaj loog, zam rau lawv qhov kev siv rau kev kho mob ntawm kev tshem tawm cov tsos mob hauv kev haus dej cawv ntev.
• Thaum muab tshuaj rau Finlepsin ntsiav tshuaj thaum siv lwm cov tshuaj anticonvulsants, lawv cov tshuaj yuav tsum tau maj mam txo.
• Tawm tsam keeb kwm ntawm chav kawm ntawm kev kho cov tshuaj, kev tshuaj ntsuam lub sijhawm kom saib xyuas kev ua haujlwm ntawm lub raum, siab, thiab ntshav ntu yuav tsum tau nqa tawm.
• Ua ntej sau ntawv ntawm Finlepsin ntsiav tshuaj, nws raug nquahu kom ua qhov kev sim ntsuas kom paub meej nrog kev kuaj ntshav (biochemistry, kuaj tshuaj), tso zis. Tom qab ntawd xws li kev tshuaj ntsuam yog ntu tsis tu ncua.
• Nws yog ib qho tseem ceeb uas tswj cov naj npawb ntawm cov hlwb ib qhov ntim ntawm cov ntshav tawm tsam ntawm keeb kwm ntawm txoj kev kho mob ntev.
• Hauv cov neeg mob laus, tom qab pib noj cov ntsiav tshuaj Finlepsin, qhov kev pheej hmoo ntawm kev ua kom tsis pom kev (tsis pom kev zoo) nce siab.
• Kev muaj peev xwm ua txhaum nyob rau hauv tus txiv neej nrog kev mob ntxiv ib ntus vim kev siv tshuaj tsis raug cais, nyob hauv cov poj niam - qhov tsos ntawm intermenstrual los ntshav.
• Thaum pib ntawm qhov pib ntawm txoj kev kho nrog kev siv tshuaj, nrog rau lub sijhawm ib txwm kawm, nws yuav tsum kawm txog kev ua haujlwm ntawm lub cev ntawm kev ua haujlwm ntawm lub zeem muag.
• Thaum siv Finlepsin ntsiav tshuaj, cawv tsis pom zoo.
• Kev siv cov tshuaj rau cov poj niam cev xeeb tub yog ua tau tsuas yog tom qab teem caij kws kho mob rau kev kho mob nruj.
• Cov nquag ua ke ntawm cov tshuaj tuaj yeem cuam tshuam nrog cov tshuaj ntawm lwm pawg pharmacological, uas yuav tsum coj los ntawm tus kws kho mob ua ntej nws teem caij.
• Txij li thaum cov tshuaj muaj qhov cuam tshuam ncaj qha rau kev ua haujlwm ntawm lub cev ntawm lub paj hlwb, tom qab ntawd, tawm tsam keeb kwm ntawm nws txoj kev siv, nws tsis tuaj yeem koom nrog cov kev ua si txaus ntshai, txuas ntxiv nrog qhov xav tau kev ceev nrawm ntawm psychomotor cov tshuaj tiv thaiv thiab kev mloog zoo.

Finlepsin ntsiav tshuaj hauv cov khw muag tshuaj muaj nyob rau hauv cov ntawv sau tshuaj. Txhawm rau tiv thaiv kev txhim kho ntawm cov teeb meem thiab kev tsis zoo, nws tsis pom zoo kom siv lawv tus kheej.