Tegretol cr cov lus qhia rau kev siv, contraindications, phiv, tshuaj xyuas

Cov ntawv tso tawm:

• kua: dawb, khov, muaj cov ntxhiab tsw caramel (hauv cov iav dub ntim ntawm 100 ml, 1 lub raj mis hauv lub thawv ntawv cardboard ua tiav nrog ib rab diav tshuaj),,
• ntsiav tshuaj: tiaj, dawb, nrog ib lub ntsej muag, 200 mg txhua - puag ncig, cim rau ntawm ib sab - CG, ntawm sab - G / K, muaj kev pheej hmoo ntawm ib sab, 400 mg - qws-puab, kos cim ntawm ib sab - LR / LR , ntawm lwm qhov - CG / CG, ntawm ob sab ntawm kev pheej hmoo (10 pcs. hauv blisters, 3 lossis 5 blisters hauv cardboard lub thawv).

Lub thawv ntawv thawv kuj tseem muaj cov lus qhia rau kev siv Tegretol.

Nws muaj pes tsawg leeg 5 ml:

• cov tshuaj nquag: carbamazepine - 100 mg,
• Cov khoom siv pabcuam: macrogol stearate - 100 mg, caramel tsw-50 mg, hydroxyethyl cellulose (hyetellose) - 500 mg, sodium saccharinate - 40 mg, kua sorbitol - 25 000 mg, propylene glycol - 2.5 mg, Avicel RC 581 (microcrystalline cellulose + sodium carmellose) - 1000 mg, methyl paraben (methyl parahydroxybenzoate) - 120 mg, sorbic acid - 100 mg, propyl paraben (propyl parahydroxybenzoate) - 30 mg, dej ntshiab hauv qhov ntau txaus.

Composition 1 ntsiav tshuaj:

• cov tshuaj nquag: carbamazepine - 200 lossis 400 mg,
• Cov khoom siv pabcuam (200/400 mg): magnesium stearate - 3/6 mg, sodium carmellose - 10/20 mg, microcrystalline cellulose - 65/130 mg, colloidal silicon dioxide - 2/4 mg.

Daim ntawv tso tawm Tegretol tsr, ntim tshuaj thiab muaj pes tsawg leeg.

Cov ntsiav tshuaj uas pab tau-tso tawm, lo hauv cov xim cib xim txiv kab ntxwv, oval, me ntsis biconvex, nrog ib qho kev ceeb toom ntawm txhua sab, cim “HC” ntawm ib sab, thiab “CG” nyob rau lwm qhov.

1 tab
carbamazepine
200 mg

Cov kev zam: microcrystalline cellulose, sodium carmellose, polyacrylate dispersion 30% (Eudragit E 30 D), ethyl cellulose aqueous dispersion, talc, colloidal silicon dioxide anhydrous, magnesium stearate.

Cov lus sib xyaw ntawm lub plhaub: hypromellose, talc, titanium dioxide, cov roj taum (macrogol glycerylincinoleate), cov hlau oxide liab, hlau oxide daj.

10 Pcs. - hlwv (5) - pob khoom ntawm cardboard.

Cov tshuaj uas yuav pab tau-tso xim, xim av-txiv kab ntxwv-xim, oval, biconvex me ntsis, nrog ib qho kev ceeb toom ntawm txhua sab, sau npe tias “ENE / ENE” ntawm ib sab, “CG / CG” nyob rau lwm qhov.

1 tab
carbamazepine
400 mg

Cov kev zam: microcrystalline cellulose, sodium carmellose, polyacrylate dispersion 30% (Eudragit E 30 D), ethyl cellulose aqueous dispersion, talc, colloidal silicon dioxide anhydrous, magnesium stearate.

Cov lus sib xyaw ntawm lub plhaub: hypromellose, talc, titanium dioxide, cov roj taum (macrogol glycerylincinoleate), cov hlau oxide liab, hlau oxide daj.

10 Pcs. - hlwv (3) - pob khoom los ntawm cardboard.

LUS PUB HUAM TXHEEJ TXHEEM MOO ZOO.
Txhua cov lus qhia tau muab nthuav tawm tsuas yog ua rau kom paub txog cov tshuaj, koj yuav tsum sab laj nrog tus kws kho mob txog kev siv.

Pharmacological ua tegretol cr

Cov tshuaj antiepileptic muab tau los ntawm tricyclic iminostilbene. Nws ntseeg tau hais tias cov nyhuv anticonvulsant cuam tshuam nrog txo qis ntawm kev muaj peev xwm ntawm neurons kom muaj qhov xwm txheej siab ntawm kev rov ua dua li qhov peev xwm ua los ntawm inactivation ntawm sodium channels. Tsis tas li ntawd, kev txwv tsis pub cov neurotransmitter tso tawm los ntawm thaiv cov hlab ntsha presynaptic sodium channel thiab kev txhim kho ntawm kev ua cov peev xwm, uas nyeg txo synaptic kis tau, zoo li yog qhov tseem ceeb.

Nws muaj cov tshuaj tiv thaiv kab mob ib nrab, tiv thaiv kev tawm tsam, nrog rau qhov ua kom xau rau qhov mob neurogenic. GABA receptors, uas tej zaum yuav cuam tshuam nrog calcium calcium channel, tej zaum yuav koom nrog cov txheej txheem ntawm kev ua, thiab cov nyhuv ntawm carbamazepine ntawm neurotransmitter modulator systems kuj zoo li tseem ceeb.

Qhov antidiuretic nyhuv ntawm carbamazepine tej zaum yuav cuam tshuam nrog hypothalamic ntxim rau osmoreceptors, uas tau sib kho los ntawm kev zais ntawm ADH, thiab kuj yog vim muaj kev cuam tshuam ncaj qha rau lub raum plab hlaub.

Pharmacokinetics ntawm cov tshuaj.

Tom qab lub qhov ncauj tswj hwm, carbamazepine yog yuav luag yaim los ntawm cov hnyuv. Kev khi rau cov ntshav plasma protein yog 75%. Nws yog qhov ua rau lub siab ua haujlwm ntawm daim siab thiab txhawb nws tus kheej hauv cov metabolism.

T1 / 2 yog 12-29 teev. 70% raug tso tawm hauv cov zis (hauv kev siv lub cev tsis muaj zog) thiab 30% - nrog quav.

Kev taw qhia rau kev siv:

Epilepsy: loj, focal, sib xyaw (suav nrog kev loj thiab loj) epileptic qaug dab peg. Cov tsos mob mob feem ntau ntawm keeb kwm neurogenic, suav nrog qhov tseem ceeb trigeminal neuralgia, trigeminal neuralgia nyob rau hauv ntau yam sclerosis, qhov tseem ceeb glossopharyngeal neuralgia. Kev tiv thaiv ntawm kev tawm tsam nrog rau haus dej haus cawv kom tshem tawm. Cuam tshuam thiab schizoaffective psychoses (raws li kev tiv thaiv). Mob neuropathy mob nrog rau mob. Ntshav qab zib insipidus ntawm lub hauv paus pib, polyuria thiab polydipsia ntawm neurohormonal xwm.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

Nruab ib tus zuj zus. Thaum noj ntawm qhov ncauj rau cov laus thiab cov hluas hnub nyoog 15 xyoo thiab laus dua, qhov koob tshuaj thawj zaug yog 100-400 mg. Yog tias tsim nyog, thiab coj mus rau hauv qhov kev sim tshuaj, cov tshuaj tau nce siab tsis ntau tshaj 200 mg / hnub nrog kev ncua sij hawm ntawm 1 lub lis piam. Qhov ntau zaus ntawm kev tswj hwm yog 1-4 zaug / hnub. Cov koob tshuaj saib xyuas feem ntau yog 600-1200 mg / hnub hauv ntau koob. Lub sijhawm kho yog nyob ntawm qhov ntsuas, qhov ua tau ntawm kev kho, tus neeg mob cov lus teb rau kev kho.

Hauv cov menyuam yaus hnub nyoog qis dua 6 xyoo, 10-20 mg / kg / hnub siv nyob rau hauv 2-3 koob tshuaj sib cais, yog tias tsim nyog thiab coj mus rau hauv qhov kev nkag siab, qhov kev sib tw tau nce ntau tsis ntau tshaj 100 mg / hnub nrog ncua sijhawm 1 lub lis piam, txij nkawm tshuaj feem ntau yog 250 -350 mg / hnub thiab tsis pub tshaj 400 mg / hnub. Cov menyuam hnub nyoog 6-12 xyoo - 100 mg 2 zaug / hnub rau thawj hnub, tom qab ntawd cov koob tshuaj tau nce ntxiv los ntawm 100 mg / hnub nrog ncua sijhawm 1 lub lis piam. kom txog rau thaum cov nyhuv zoo tshaj, kev txij nkawm feem ntau yog 400-800 mg / hnub.

Cov koob tshuaj ntau tshaj plaws: thaum noj ntawm qhov ncauj, cov laus thiab cov hluas 15 xyoo thiab laus dua - 1.2 g / hnub, cov menyuam - 1 g / hnub.

Phiv los ntawm tegretol tsr:

Los ntawm ib sab ntawm lub hauv nruab nrab lub paj hlwb thiab peripheral lub paj hlwb: feem ntau - kiv taub hau, ataxia, tsaug zog, mob taub hau tau, diplopia, kev cuam tshuam kev cuam tshuam, tsis tshua muaj - kev tsis tuaj yeem txav, nystagmus, nyob rau qee kis - oculomotor cuam tshuam, dysarthria, peripheral neuritis, paresthesia, leeg tsis muaj zog, cov tsos mob paresis, pom kev xav, kev nyuaj siab, nkees, txhoj puab heev, ntxhov siab, tsis nco qab lawm, nce siab, ua kom mob hlwb, saj tsis taus, mob txhaws, paj hlwb, hyperacusis.

Los ntawm lub plab zom mov: xeev siab, nce GGT, nce kev ua si ntawm alkaline phosphatase, ntuav, lub qhov ncauj qhuav, tsis tshua - muaj kev ua si ntau dua ntawm transaminases, mob daj ntseg, cholestatic mob siab, mob raws plab lossis quav tawv, qee qhov - tsis tshua qab los noj mov, mob plab, glossitis, mob plab.

Los ntawm cov hlab plawv: tsis tshua muaj - myocardial conduction cuam tshuam, nyob rau qee kis - bradycardia, arrhythmias, AV blockade nrog syncope, vau, lub plawv tsis ua haujlwm, tshwm sim ntawm lub cev tsis txaus, thrombophlebitis, thromboembolism.

Los ntawm cov kab mob hemopoietic: leukopenia, eosinophilia, thrombocytopenia, tsis tshua muaj - leukocytosis, nyob rau qee kis - agranulocytosis, mob ntshav tsis txaus, erythrocytic aplasia, megaloblastic anemia, meicoblastic anemia, reticulocytosis, hemolytic anemia, granulomatous heemia.

Los ntawm ib sab ntawm cov metabolism: hyponatremia, kua dej tsis sib haum, edema, hnyav nce, txo ntshav plasma osmolality, qee kis - mob sib kis ceev, mob ntshav qab zib, folic acid tsis txaus, calcium metabolism tsis txaus, nce roj thiab triglycerides.

Los ntawm cov kab mob endocrine: gynecomastia lossis galactorrhea, tsis tshua muaj - kev ua haujlwm ntawm cov thyroid.

Los ntawm cov kab mob txeeb zis: tsis tshua muaj - mob raum lub raum, interstitial nephritis thiab lub raum tsis ua haujlwm.

Los ntawm cov txheej txheem ua pa: hauv qee kis - dyspnea, mob ntsws lossis mob ntsws.

Ua xua: ua pob khaus tawv, khaus, tsis tshua muaj - lymphadenopathy, ua npaws, mob hepatosplenomegaly, mob caj dab.

Siv thaum cev xeeb tub thiab lactation.

Yog tias tsim nyog, siv thaum cev xeeb tub (tshwj xeeb tshaj yog nyob rau thawj peb hlis) thiab lub sijhawm lactation yuav tsum ua tib zoo ntsuas cov txiaj ntsig ntawm kev kho mob rau leej niam thiab kev pheej hmoo rau tus menyuam lossis menyuam. Hauv qhov no, carbamazepine raug pom zoo kom siv tsuas yog kev kho mob monotherapy hauv kev siv koob tshuaj tsawg kawg nkaus.

Cov poj niam ntawm lub hnub nyoog yug menyuam thaum lub sijhawm kho nrog carbamazepine raug pom zoo kom siv cov tshuaj tsis xeeb menyuam.

Cov lus qhia tshwj xeeb rau kev siv Tegretol tsr.

Carbamazepine tsis yog siv rau atypical lossis dav dav me mob qaug dab peg, myoclonic lossis atonic epileptic qaug dab peg. Nws yuav tsum tsis txhob siv los daws qhov mob ib txwm, ua rau lub caij nyoog ntev ntawm kev tshem tawm ntawm trigeminal neuralgia.

Nws yog siv nrog ceev faj thaum muaj cov kab mob tsis ua haujlwm ntawm cov hlab plawv, mob siab rau lub siab thiab / lossis lub raum kev ua haujlwm, mob ntshav qab zib mellitus, muaj kev mob siab rau lub cev, muaj keeb kwm ntawm cov ntshav hloov mus rau kev siv lwm yam tshuaj, hyponatremia, tso zis cia, thiab nce siab rau tricyclic antidepressants , nrog cov cim qhia txog keeb kwm kev cuam tshuam ntawm kev kho carbamazepine, nrog rau cov menyuam yaus thiab cov neeg laus laus.

Txoj kev kho yuav tsum tau ua nyob ntawm kev saib xyuas ntawm kws kho mob. Nrog rau kev kho mob ntev, nws yog ib qho tsim nyog los tswj cov ntshav ntshav, lub xeev ua haujlwm ntawm lub siab thiab lub raum, cov tshuaj electrolytes hauv cov ntshav ntshav, thiab kev kuaj xyuas ophthalmological. Kev txiav txim siab ntu ntawm qib carbamazepine nyob rau hauv cov ntshav ntshav yog pom zoo kom saib xyuas qhov ua tau zoo thiab kev nyab xeeb ntawm kev kho.

Tsawg kawg 2 lub lis piam ua ntej pib kho carbamazepine, nws yog ib qho tsim nyog yuav tsum tau txiav kev kho mob nrog MAO inhibitors.

Thaum lub sijhawm kho tsis pub haus cawv.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Thaum kho, ib qho yuav tsum tsis txhob koom nrog cov kev ua phom sij uas yuav tsum muaj kev saib xyuas ntxiv, thiab qhov ceev ntawm lub cev kev xav.

Kev sib cuam tshuam tegretol tsr nrog lwm yam tshuaj.

Nrog rau kev siv ua ke ntawm cov tshuaj tiv thaiv ntawm isoenzyme CYP3A4, kev nce ntxiv ntawm kev nkag siab ntawm carbamazepine hauv cov ntshav ntshav yog ua tau.

Nrog rau kev siv sib txuam ntawm cov inducers ntawm CYP3A4 isoenzyme system, kev ua kom sai ntawm cov metabolism ntawm carbamazepine, qhov kev txo qis hauv nws cov concentration hauv cov ntshav ntshav, thiab qhov txo qis hauv kev kho mob yog qhov ua tau.

Nrog rau kev siv carbamazepine tib lub sij hawm stimulates cov metabolism ntawm anticoagulants, folic acid.

Nrog rau kev siv ib txhij nrog valproic acid, qhov txo qis hauv kev mloog ntawm carbamazepine thiab qhov tseem ceeb txo qis ntawm kev cuam tshuam ntawm valproic acid nyob rau hauv cov ntshav ntshav yog ua tau. Nyob rau tib lub sijhawm, qhov kev coj ua ntawm carbamazepine metabolite, carbamazepine epoxide, nce (tej zaum vim yog qhov inhibition ntawm nws hloov mus rau carbamazepine-10,11-trans-diol), uas kuj muaj cov dej ua anticonvulsant, yog li cov txiaj ntsig ntawm qhov kev sib txuam no tuaj yeem ua rau qib, tab sis cov kev tsis haum siab feem ntau tshwm sim - qhov muag plooj, kiv taub hau, ntuav, tsis muaj zog, nystagmus. Nrog rau kev siv cov valproic acid thiab carbamazepine tib lub sijhawm, kev txhim kho ntawm hepatotoxic nyhuv muaj peev xwm ua tau (thaj, vim muaj kev tsim cov khoom noj ntawm lub cev tshiab ntawm valproic acid, uas muaj cov kab mob hepatotoxic).

Nrog rau kev siv ua ke, valpromide txo qis cov metabolism hauv lub siab carbamazepine thiab nws cov metabolite carbamazepine-epoxide vim yog inhibition ntawm cov enzyme epoxide hydrolase. Cov kev teeb txheeb metabolite muaj cov kev ua haujlwm anticonvulsant, tab sis nrog qhov nce ntxiv ntawm plasma concentration nws tuaj yeem muaj cov nyhuv tsis zoo.

Nrog rau kev siv ua ke nrog verapamil, diltiazem, isoniazid, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, muaj peev xwm nrog cimetidine, acetazolamide, danazole, desipramine, nicotinamide (hauv cov neeg laus, tsuas yog hauv koob tshuaj), erythromycin, trolesamazole (suav nrog nrog itraconazole, ketoconazole, fluconazole), terfenadine, loratadine tuaj yeem nce qhov siab ntawm carbamazepine hauv ntshav ntshav nrog kev pheej hmoo ntawm phiv (kiv taub hau, tsaug zog, ataxi) kuv, diplopia).

Nrog rau kev siv tib lub sijhawm nrog hexamidine, cov tshuaj anticonvulsant ntawm carbamazepine tsis muaj zog, nrog hydrochlorothiazide, furosemide - nws muaj peev xwm txo cov sodium ntsiab lus hauv cov ntshav, nrog rau kev tiv thaiv tshuaj hormonal - nws yog qhov ua tau kom tsis muaj zog ntawm kev tiv thaiv thiab kev txhim kho ntawm acyclic los ntshav.

Nrog rau kev siv ib txhij nrog cov thyroid hormones, nws muaj peev xwm nce kev tshem tawm cov thyroid hormones, nrog clonazepam, nws yog qhov ua tau kom nce qhov tshem ntawm clonazepam thiab txo qhov tshem ntawm carbamazepine, nrog lithium npaj, kev sib nrig sib ntxiv ntawm cov nyhuv neurotoxic tau.

Nrog rau kev siv ua ke nrog primidone, ib qho kev txo qis hauv kev mloog ntawm carbamazepine hauv cov ntshav ntshav yog ua tau. Muaj cov ntaub ntawv hais tias primidone tuaj yeem ua rau lub plasma concentration ntawm qhov tshuaj pharmacologically nquag metabolite - carbamazepine-10,11-epoxide.

Nrog rau kev siv ib txhij nrog ritonavir, kev mob tshwm sim ntawm carbamazepine tuaj yeem ua kom zoo dua qub, nrog sertraline, qhov kev poob qis ntawm sertraline yog ua tau, nrog theophylline, rifampicin, cisplatin, doxorubicin, qhov kev txo qis ntawm carbamazepine hauv ntshav plasma yog ua tau, nrog tetracycline, cov cuam tshuam ntawm carbamazepine.

Nrog rau kev siv nrog felbamate, qhov kev txo qis hauv cov ntsiab lus ntawm carbamazepine nyob rau hauv cov ntshav ntshav yog qhov ua tau, tab sis kev nce siab hauv kev cuam tshuam ntawm cov nquag metabolite ntawm carbamazepine-epoxide, thaum txo qis hauv kev saib xyuas hauv lub plasma ntawm felbamate yog ua tau.

Nrog rau kev siv ua ke nrog phenytoin, phenobarbital, qhov concentration ntawm carbamazepine hauv cov ntshav ntshav poob qis. Kev sib nrig tsis muaj zog ntawm cov tshuaj tiv thaiv anticonvulsant ua tau, thiab qee zaus, nws txoj kev ua kom muaj zog.

Cov Tshuaj Hauv Tshuaj

Tegretol yog ib qho tshuaj tua kab mob thiab yog dibenzodiazepine derivative. Ntxiv rau cov nyhuv antiepileptic, cov tshuaj tseem muaj cov hlwb psychotropic thiab neurotropic.

Raws li tus neeg sawv cev antiepileptic, kev siv cov carbamazepine ua tau zoo rau kev kho mob ntawm focal (ib nrab) yooj yim / nyuaj mob epileptic qaug dab peg uas tshwm sim nrog / tsis muaj theem nrab dav dav, feem ntau tonic-clonic epileptic qaug dab peg, nrog rau kev sib txuas ntawm cov hom mob chua leeg.

Thaum lub sijhawm sim kho mob, nws tau pom tias nrog tegretol monotherapy hauv cov neeg mob vwm (tshwj xeeb tshaj yog siv hauv kev kho mob menyuam yaus), cov teebmeem psychotropic ntawm carbamazepine yog sau tseg, uas, tshwj xeeb, qhia tau nws tus kheej hauv kev muaj txiaj ntsig zoo rau cov tsos mob ntawm kev nyuaj siab thiab ntxhov siab, nrog rau kev txo qis kev ntxhov siab thiab kev npau taws. Cov. Raws li tus naj npawb ntawm cov kev tshawb fawb, cov nyhuv ntawm Tegretol ntawm kev ntsuas hlwb thiab lub hlwb kev ua haujlwm tau txiav txim siab los ntawm qhov koob tshuaj thiab muaj kev ua xyem xyav lossis tsis zoo. Lwm cov kev tshawb fawb tau tshaj tawm txog cov txiaj ntsig zoo ntawm carbamazepine rau kev saib xyuas, nco qab thiab muaj peev xwm kawm.

Tegretol ua cov neeg ua haujlwm neurotropic ua tau zoo nyob rau hauv ntau cov kab mob neurological.Hauv qee qhov, nws pab txhawm rau tiv thaiv kev mob mob hauv idiopathic / secondary trigeminal neuralgia. Ntxiv rau, kev siv cov carbamazepine tsuas yog tsim nyog los txo cov mob neurogenic nyob rau hauv ntau yam mob, suav nrog txha caj qaum dryness, mob tom qab lub cev thiab tom qab mob tom qab. Hauv cov neeg mob uas muaj kev haus cawv haus cawv, carbamazepine ua rau muaj qhov nce ntawm lub luag haujlwm ntawm kev npaj rov qab (nyob rau hauv tus mob no feem ntau txo qis) thiab txo qis ntawm qhov tshwm sim ntawm cov chaw kuaj mob tshwm sim ntawm tus mob (hauv daim ntawv ntawm kev zam txim siab, tshee tshee, mob plab). Ua tsaug rau Tegretol txoj kev kho, cov neeg mob ntshav qab zib insipidus ntawm lub hauv paus hauv paus muaj qhov tso zis thiab nqhis dej tsawg.

Raws li tus neeg sawv cev mob hlwb, kev siv Tegretol ua tau zoo rau cov neeg mob uas muaj kev cuam tshuam rau cov neeg mob, uas yog nyob rau hauv kev kho mob ntawm qhov mob tshwm sim, rau kev kho mob ntawm kev puas siab puas siab puas siab puas ntsws (mob li cas-kev nyuaj siab) ua rau mob (raws li kev kho mob monotherapy lossis hauv kev sib xyaw nrog lithium npaj, tshuaj tiv thaiv kab mob lossis tshuaj tiv thaiv kab mob). schizoaffective thiab manic psychoses (qhov twg nws siv ib txhij nrog tshuaj tiv thaiv kev puas hlwb), mob polychphic schizophrenia (mob ceev sai sai).

Lub tshuab ntawm kev ua ntawm Tegretol yog ua raws li qhov thaiv ntawm voltage-gated sodium channels, vim qhov kev ruaj khov ntawm cov qog ua ntawm overexcited neurons tshwm sim, inhibition ntawm cov khoom tsim tawm ntawm cov hluav taws xob ntawm cov neurons thiab txo qis ntawm kev sib txuas lus ntawm cov hluav taws xob.

Qhov ua haujlwm anticonvulsant ntawm carbamazepine feem ntau yog vim qhov kev nyob ruaj khov ntawm neuronal daim nyias nyias thiab qhov txo qis hauv kev tso tawm ntawm glutamate, qhov txo qis hauv kev ua haujlwm ntawm qhov zoo siab neurotransmitter amino acid glutamate, txij li glutamate yog tus neeg sib kho tseem ceeb, tsis muaj cov ntaub ntawv ntawm lub luag haujlwm ntawm aspartate.

Tegretol tsub kom qhov qaug dab peg tsawg kawg ntawm lub hauv nruab nrab cov hlab hlwb, yog li txo qhov muaj feem ua rau qaug dab peg. Lub zog txav ntau ntawm cov poov tshuaj, nrog rau cov kev hloov kho ntawm cov calcium calcium, uas tau ua kom los ntawm qhov muaj peev txheej siab, tuaj yeem pab txhawb cov nyhuv anticonvulsant ntawm cov tshuaj. Carbamazepine tshem tawm cov kev hloov pauv ntawm tus mob epileptic thiab, vim li ntawd, nce kev muaj peev xwm ntawm cov neeg mob thiab pab txhawb lawv cov kev ua kom rov zoo.

Tegretol tuaj yeem yog qhov tseem ceeb kho tus neeg sawv cev lossis siv nrog rau lwm cov tshuaj nrog cov tshuaj tiv thaiv anticonvulsant.

Cov Yuav Tsum Muaj

Cov tshuaj tiv thaiv tsis haum rau cov tshuaj ntawm cov tshuaj - carbamazepine lossis cov tshuaj zoo sib xws (piv txwv, tricyclic antidepressants) lossis lwm yam tshuaj, pob txha mob ntshav txha ntshav (ntshav qab zib, leukopenia), mob "sib deev" (xws li keeb kwm), AV thaiv, tib lub sij hawm tswj hwm ntawm MAO inhibitors.

Nrog ceev faj. Decompensated lub plawv tsis ua hauj lwm, dilution hyponatremia (ADH hypersecretion syndrome, hypopituitarism, hypothyroidism, adrenal tsis txaus), kev quav dej cawv siab heev (CNS kev nyuaj siab yog txhim kho, carbamazepine metabolism yog nce), mob pob txha mob hematopoiesis yog suppressed, thiab lub siab tsis ua haujlwm nrog kev mob ntshav siab, thiab , prostatic hyperplasia, mob siab intraocular.

Yuav siv li cas: noj ntau thiab hom tshuaj kho

Sab hauv, tsis hais txog ntawm pluas mov nrog me me ntawm cov kua.

Retard ntsiav tshuaj (ib ntsiav tshuaj tag nrho lossis ib nrab) yuav tsum nqos tag nrho, tsis tas yuav zom, nrog ib qho kua tsawg tsawg, 2 zaug hauv ib hnub. Hauv qee tus neeg mob, thaum siv cov ntsiav tshuaj retard, nws yuav tsim nyog los nce qhov tshuaj ntawm cov tshuaj.

Tshuaj qaug dab peg Nyob rau hauv rooj plaub uas qhov no ua tau, carbamazepine yuav tsum yog kws kho mob tshuaj tua kab mob. 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.

Koom nrog carbamazepine mus rau kev kho mob ua kom tsis tu ncua yuav tsum tau maj mam ua, thaum lub koob tshuaj ntawm cov tshuaj uas siv tsis hloov lossis, yog tias tsim nyog, kho.

Rau cov laus, qhov pib koob tshuaj yog 100-200 mg ntawm qhov tshuaj 1-2 zaug ib hnub. Tom qab ntawd qhov koob tshuaj yog maj mam nce ntxiv kom txog rau qhov ua kom tau txiaj ntsig zoo tshaj plaws (feem ntau 400 mg 2-3 zaug hauv ib hnub, ntau tshaj 1.6-2 g / hnub).

Cov menyuam yaus txij thaum 4 xyoo - hauv koob pib 20-60 mg / hnub, maj mam nce ntxiv los ntawm 20-60 mg txhua lwm hnub. Hauv cov menyuam muaj hnub nyoog laus dua 4 xyoos - hauv thawj koob 100 mg / hnub, qhov tshuaj ntau dua tau nce zuj zus, txhua lub lim tiam los ntawm 100 mg. Txhawb cov koob tshuaj: 10-20 mg / kg ib hnub (hauv ntau ntau zaug): rau 4-5 xyoos - 200-400 mg (hauv 1-2 koob), 6-10 xyoo - 400-600 mg (hauv 2-3 koob ), rau 11-15 xyoo - 600-1000 mg (hauv 2-3 koob).

Nrog trigeminal neuralgia, 200-400 mg / hnub yog kho nyob rau thawj hnub, maj mam nce los ntawm tsis ntau tshaj 200 mg / hnub kom txog rau thaum qhov mob tsis ua haujlwm (qhov nruab nrab 400-800 mg / hnub), thiab tom qab ntawd txo rau qhov kev siv tshuaj tsawg kawg. Yog tias muaj mob neurogenic keeb kwm, qhov pib noj yog 100 mg 2 zaug ib hnub ntawm thawj hnub, tom qab ntawd cov koob tshuaj tau nce tsis ntau tshaj 200 mg / hnub, yog tias tsim nyog, nce nws los ntawm 100 mg txhua 12 teev kom txog thaum qhov mob hnov ​​mob. Cov koob tshuaj txij nkawm yog 200-1200 mg / hnub hauv ntau qhov tshuaj.

Hauv kev kho cov neeg laus thiab cov neeg mob lub siab tsis zoo, qhov pib koob tshuaj yog 100 mg 2 zaug ib hnub.

Cawv tshem tawm tus mob syndrome: nruab nrab koob - 200 mg 3 zaug ib hnub, hauv cov kis loj, thaum thawj ob peb hnub, qhov tshuaj yuav nce ntxiv rau 400 mg 3 zaug ib hnub. Thaum pib ntawm kev kho mob rau cov tsos mob hnyav tshem tawm, nws raug nquahu kom muab tshuaj nrog cov tshuaj sedative-hypnotic (clomethiazole, chlordiazepoxide).

Ntshav qab zib insipidus: qhov nruab nrab koob rau cov neeg laus yog 200 mg 2-3 zaug ib hnub. Hauv cov menyuam yaus, lub koob tshuaj yuav tsum raug txo kom nruj raws li lub hnub nyoog thiab lub cev qhov hnyav ntawm cov menyuam.

Mob ntshav qab zib neuropathy, nrog rau mob: qhov nruab nrab koob yog 200 mg 2-4 zaug ib hnub.

Hauv kev tiv thaiv mob rov huam tuaj ntawm kev xav thiab schizoaffective psychoses - 600 mg / hnub hauv 3-4 koob.

Hauv kev mob hnyav thiab qhov tsis haum (bipolar) cuam tshuam, kev txhaj tshuaj txhua hnub yog 400-1600 mg. Qhov nruab nrab txhua hnub koob tshuaj yog 400-600 mg (hauv 2-3 koob). Hauv lub xeev kev mob siab, ntau npaum li cas ntawm cov tshuaj tau nce nrawm dua, nrog kev saib xyuas kev kho mob los ntawm kev cuam tshuam los ntawm kev cuam tshuam - maj mam (kom txhim kho qhov ua siab ntev).

Sab sij huam

Thaum ntsuas qhov ntau zaus ntawm kev tshwm sim ntawm ntau yam kev tsis zoo, cov ntsiab lus hauv qab no tau siv: ntau zaus - 10% thiab ntau zaus, feem ntau 1-10%, qee zaum 0.1-1%, tsis tshua muaj 0.01-0.1%, tsis tshua muaj neeg 0.01%.

Kev noj tshuaj ntau dhau vim qhov tsis zoo tshwm sim feem ntau ploj hauv ob peb hnub, ob leeg nthawv thiab tom qab kev txo qis ib ntus hauv cov tshuaj ntawm cov tshuaj. Kev txhim kho cov kev phiv tshuaj los ntawm lub hauv nruab nrab cov hlab ntsha tuaj yeem yog vim tus txheeb ze ntau dhau ntawm cov tshuaj lossis qhov hloov pauv nyob rau hauv cov concentration ntawm cov tshuaj nquag nyob hauv cov ntshav. Hauv cov xwm txheej zoo li no, nws raug nquahu kom saib xyuas cov tshuaj txhawm rau hauv cov ntshav.

Los ntawm sab ntawm lub hauv nruab nrab ntawm cov hlab ntsha hauv lub cev: feem ntau - kiv taub hau, ataxia, tsaug zog, asthenia, feem ntau - mob taub hau, paresis ntawm kev pab, qee zaum - txawv txav ntawm lub cev tsis xws luag (piv txwv li tshee, "fluttering" tshee tshee - asterixis, dystonia, tics), nystagmus, tsis tshua - orofacial dyskinesia , oculomotor cuam tshuam, hais lus tsis meej (piv txwv li dysarthria), choreoathetoid cuam tshuam, peripheral neuritis, paresthesias, myasthenia gravis thiab paresis cov tsos mob. Lub luag haujlwm ntawm carbamazepine yog cov tshuaj uas ua rau lossis cuam tshuam rau kev txhim kho ntawm cov neeg muaj kabmob siab, tshwj xeeb tshaj yog thaum nws tau sau ua ke nrog antipsychotics, tseem paub tsis meej.

Los ntawm qhov kev xav ntawm lub paj hlwb: tsis tshua muaj - pom kev sib deev (pom lossis hnov), kev nyuaj siab, poob qis, ntxhov siab, tus cwj pwm ntxhov siab, ntxhov siab, tsis meej, tsis tshua muaj tshwm sim - kev ua kom mob hlwb.

Kev tsis haum tshuaj rau cov tshuaj: feem ntau urticaria, qee zaum erythroderma, tsis tshua muaj mob lupus zoo li mob, khaus ntawm daim tawv nqaij, tsis tshua muaj exudative erythema multiforme (suav nrog Stevens-Johnson syndrome), tshuaj lom epidermal necrolysis (Lyell syndrome), tshuaj tiv thaiv kab mob.

Tsis tshua muaj, ntau yam hloov ncua-hom lub cev tsis haum lub cev nrog kub taub hau, tawm pob ntawm daim tawv nqaij, vasculitis (suav nrog erythema nodosum ua rau mob vasculitis), lymphadenopathy, muaj cov cim zoo li lymphoma, arthralgia, leukopenia, eosinophilia, ua haujlwm ntawm lub siab ua haujlwm thiab mob hepatosplenomegaly ( pom nyob rau hauv ntau yam kev sib txuas). Lwm yam khoom hauv nruab nrog (xws li mob ntsws, raum, mob thiav dab, myocardium, nyuv) kuj tseem tuaj koom nrog. Tsis tshua muaj - kev mob aseptic rau daim tawv nqaij myoclonus thiab peripheral eosinophilia, tshuaj tiv thaiv anaphylactoid, angioedema, kev tiv thaiv mob ntsws o lossis mob ntsws o eininophilic. Yog tias qhov kev ua xua saum toj no tshwm sim, kev siv tshuaj yuav tsum raug txiav tawm.

Hematopoietic plab hnyuv siab raum: feem ntau - leukopenia, feem ntau - thrombocytopenia, eosinophilia, tsis tshua muaj - leukocytosis, lymphadenopathy, folic acid deficiency, tsis tshua muaj tshwm sim - agranulocytosis, aplastic anemia, muaj tseeb erythrocytic aplasia, megaloblastic anemia, mob txaus los ntawm lub siab mob, mob ntshav qab zib. anemia

Los ntawm lub plab zom mov: feem ntau - xeev siab, ntuav, feem ntau - qhov ncauj qhuav, qee zaum - raws plab los yog cem quav, mob plab, tsis tshua muaj tshwm sim - glossitis, stomatitis, pancreatitis.

Nyob rau ib feem ntawm daim siab: ntau zaus - kev nce rau hauv cov dej num ntawm GGT (vim qhov induction ntawm qhov enzyme hauv lub siab), uas feem ntau tsis txawv, feem ntau - ib qho kev nce hauv cov kev ua ntawm alkaline phosphatase, qee zaum - ib qho kev nce ntawm kev ua si "mob siab" transaminases, tsis tshua muaj - kab mob siab cholestatic, parenchymal (hepatocellular) lossis hom sib xyaw, daj ntseg, tsis tshua muaj tshwm sim - kab mob siab, mob siab tsis ua haujlwm.

Los ntawm CCC: tsis tshua muaj - kev mob plawv rau hauv lub siab, txo qis lossis nce ntshav siab, tsis tshua muaj heev - bradycardia, arrhythmias, AV block nrog tsaus muag rau cov neeg mob, vau, aggravation lossis kev loj hlob ntawm lub plawv tsis ua haujlwm, exacerbation ntawm kev mob plawv (nrog rau kev tshwm sim lossis nce ntawm lub plawv nres), thrombophlebitis, mob ntsws thromboembolic.

Los ntawm cov kab mob endocrine thiab cov metabolism: feem ntau - edema, kua dej ceev, nce phaus, hyponatremia (ntshav plasma osmolarity tsis zoo vim muaj cov teebmeem zoo ib yam li ADH, uas muaj qee qhov tsis yooj yim ua rau cov ntshav tsis haum hyponatremia, nrog rau lub cev ntuav, ntuav, mob taub hau, tsis meej pem). thiab cov leeg mob hlwb), tsis tshua muaj tshwm sim - hyperprolactinemia (tej zaum yuav muaj nrog galactorrhea thiab gynecomastia), qhov kev txo qis ntawm L-thyroxine (tsis pub dawb T4, T4, T3) thiab nce siab ntawm TSH (feem ntau tsis nrog kev soj ntsuam cov kab mob), cuam tshuam ntawm cov calcium-phosphorus metabolism hauv cov pob txha mob (txo ntshav Ca2 + thiab 25-OH-colecalciferol): osteomalacia, hypercholesterolemia (suav nrog HDL roj) thiab hypertriglyceridemia.

Los ntawm cov kab mob genitourinary: tsis tshua muaj tshwm sim - interstitial nephritis, lub raum tsis ua haujlwm, lub raum tsis ua haujlwm (e.g. albuminuria, hematuria, oliguria, muaj zog urea / azotemia), tso zis ntxiv, tso zis cia, poob qis dua.

Los ntawm cov leeg musculoskeletal: tsis tshua muaj tshwm sim - arthralgia, myalgia lossis cramps.

Los ntawm cov kab mob hauv lub cev: tsis tshua muaj - cuam tshuam hauv saj, txhaws ntawm lub lens, mob caj dab, hnov ​​pob ntseg, suav nrog tinnitus, hyperacusis, hypoacusia, qhov kev hloov pauv ntawm kev pom ntawm lub suab.

Lwm yam: kev cuam tshuam ntawm cov tawv nqaij pigmentation, purpura, mob ntxau, tawm hws, alopecia. Tsis tshua muaj neeg kis tus kab mob hirsutism, tab sis qhov kev sib raug zoo ntawm tus mob no nrog carbamazepine tsis meej. Cov tsos mob: feem ntau cuam tshuam kev cuam tshuam ntawm cov hlab ntsha hauv nruab nrab, CVS, thiab lub tshuab ua pa.

Los ntawm sab nruab nrab ntawm lub hauv nruab nrab lub paj hlwb thiab lub cev ntawm lub cev - kev tsim txom ntawm lub hauv nruab nrab lub paj hlwb, tsis meej pem, tsaug zog, ntxhov siab, tsaus muag, tsaus muag, pom kev puas siab puas ntsoog ("pos huab" pem hauv ntej ntawm lub qhov muag), dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (pib), hyporeflexia (tom qab) ), ua kom mob hlwb, mob hlwb (psychomotor cuam tshuam, myoclonus, mob hypothermia, mydriasis).

Los ntawm CCC: tachycardia, txo qis ntshav siab, qee zaum nce ntshav siab, cuam tshuam hauv kev sib txuam nrog kev nthuav dav nrog kev nthuav dav QRS cov nyom, mob plawv.

Ntawm ib feem ntawm cov txheej txheem ua pa: kev nyuaj siab ntsws, ntsws ntsws ntsws.

Los ntawm lub plab zom mov: xeev siab thiab ntuav, ncua kev tshem tawm ntawm cov zaub mov los ntawm lub plab, txo lub zog ntawm cov nyuv.

Los ntawm cov kab mob urinary: urinary retention, oliguria lossis anuria, kua dej cia, hyponatremia dilution.

Qhov ntsuas pom: leukocytosis lossis leukopenia, hyponatremia, metabolic acidosis, hyperglycemia thiab glucosuria, nce ntxiv ntawm cov leeg nqaij ntawm KFK.

Kev Kho Mob: Tsis muaj ib qho tshuaj tua kab mob tshwj xeeb. Kev kho yog raws li tus neeg mob lub chaw kho mob, pw hauv tsev kho mob, kev txiav txim siab ntawm kev txiav txim siab ntawm cov carbamazepine hauv ntshav (kom paub tseeb tias muaj tshuaj lom nrog cov tshuaj no thiab ntsuas lub cev ntau dhau), mob plab zom mov, kev teem lub sij hawm qhib lub tshuab hluav ncaig (kev tshem tawm ntawm lub plab mus ntev yuav ua rau lub cev nqus tau mus ntev 2 thiab 3 hnub thiab rov thov dua) cov tsos ntawm cov tsos mob ntawm intoxication thaum lub sij hawm rov qab).

Raug yuam diuresis, hemodialysis, thiab peritoneal lim ntshav yog qhov tsis muaj txiaj ntsig (raug lim ntshav tau qhia nrog kev sib xyaw nrog kev lom loj thiab lub raum tsis ua haujlwm). Cov menyuam me yuav xav tau cov ntshav ntxiv. Cov tsos mob txhawb kev saib xyuas hauv chav saib xyuas mob siab, saib xyuas lub siab lub zog, lub cev kub, qhov tsis zoo ntawm lub plawv, lub raum thiab lub zais zis, kho cov teeb meem electrolyte. Nrog ib qho kev txo qis hauv cov ntshav siab: ib txoj hauj lwm nrog lub taub hau kawg txo qis, ntshav hloov chaw, nrog qhov tsis muaj txiaj ntsig - iv dopamine lossis dobutamine, nrog lub plawv dhia ua kom tsis sib haum - kev kho mob yog xaiv ib qho zuj zus, nrog kev tawm tsam - cov lus qhia ntawm benzodiazepines (piv txwv li diazepam), nrog kev ceev faj (vim tias muaj peev xwm nce siab hauv kev nyuaj siab kev ua pa me) cov lus qhia ntawm lwm cov tshuaj tiv thaiv (piv txwv li, phenobarbital). Nrog rau txoj kev loj hlob ntawm dilution hyponatremia (dej intoxication) - txwv tsis pub cov kua dej thiab qeeb tso kua ntshav ntawm 0.9% NaCl tov (tuaj yeem pab tiv thaiv kev txhim kho ntawm ceema). Pom zoo Hemosorption ntawm cov pa roj carbon monoxide.

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj coated. Cov ntsiav tshuaj muaj biconvex oval duab.

200 mg ntsiav tshuaj muaj nyob rau hauv cov thawv pob ntawm 50 daim. Sab hauv pob ntawm 5 blisters ntawm 10 daim.

Cov ntsiav tshuaj 400 mg muaj nyob rau hauv pob ntawm 30 daim. Sab hauv pob muaj 3 blisters ntawm 10 daim.

Cov lus qhia tshwj xeeb

Kev kho kab mob vwm pib ntawm kev teem caij txhaj tshuaj me me, ib tus zuj zus rau lawv kom ua tiav cov txiaj ntsig kho yam xav tau.

Nws raug nquahu los txiav txim siab qhov siab nyob hauv ntshav txhawm rau txhawm rau xaiv cov koob tshuaj kom zoo tshaj plaws, tshwj xeeb nrog kev sib txuas ua ke.

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 tu ncua cov tshuaj tam sim ntawd 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 kab mob hauv qab daim ntawv npog ntawm cov tshuaj qhia hauv cov xwm txheej zoo li no (piv txwv li, diazepam muab tshuaj rau txoj leeg lossis hauv qhov quav, lossis phenytoin muab 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 sib xyaw nrog lwm cov tshuaj anticonvulsants (cov kev coj ua no yuav yog qhov qhia tias "tshem tawm" cov kabmob 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 tseem yuav tsum ua qhov kev kawm txog cov ntshav ntshav (suav nrog platelet suav, reticulocyte suav), ntshiab Fe concentration, urinalysis, ntshav urea concentration, EEG, kev txiav txim siab cov ntshav electrolyte concentration (thiab qee zaus 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.

Carbamazepine yuav tsum thim tawm sai sai yog tias muaj qhov tsis haum lossis cov tsos mob tshwm sim uas xav tias yog tsim 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 hlis txawm hais tias muaj kev kho mob txuas ntxiv lossis tom qab txo cov koob tshuaj (tus neeg mob yuav tsum tau saib zoo los ntawm tus kws kho mob nyob rau lub sijhawm no).

Carbamazepine muaj qhov ua haujlwm tsis muaj zog anticholinergic, thaum kev kho mob rau cov neeg mob uas muaj kev mob siab ntxiv, nws txoj kev tshuaj xyuas tas li yog qhov tsim nyog.

Lub sijhawm ntawm kev ua haujlwm ntawm cov neeg mob hlwb tsis txaus ntseeg yuav tsum tau coj mus rau hauv tus lej, thiab hauv cov neeg mob laus, muaj peev xwm tsim kev tsis meej lossis npau taws.

Txog niaj hnub no, muaj cov ntawv tshaj tawm txawv ntawm cov txiv neej tsis muaj peev xwm thiab / los yog cov phev txiv neej tsis txaus (kev sib raug zoo ntawm cov kev tsis taus nrog carbamazepine tseem tsis tau tsim).

Muaj cov ntaub ntawv hais txog kev los ntshav rau cov poj niam thaum coj khaub ncaws hauv rooj plaub uas qhov ncauj tiv thaiv tau siv nyob rau tib lub sijhawm. Carbamazepine tuaj yeem cuam tshuam loj heev rau kev ntseeg tau ntawm cov tshuaj tiv thaiv qhov ncauj, yog li, cov poj niam muaj hnub nyoog deev yuav tsum siv lwm txoj hauv kev tiv thaiv kev xeeb tub thaum lub sijhawm kho.

Yuav tsum tau siv cov carbamazepine nkaus xwb hauv kev saib xyuas mob.

Nws yog ib qho tsim nyog yuav tsum tau qhia rau cov neeg mob txog cov tsos mob thaum ntxov ntawm kev muaj tshuaj lom neeg hauv kev muaj peev xwm ua rau cov ntshav tsis huv, nrog rau cov tsos mob ntawm daim tawv 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 ua npaws, mob caj pas, tawm pob, txhaws ntawm lub qhov ncauj ntawm qhov ncauj, ua rau mob doog ntshav, mob ntshav hauv daim petechiae lossis purpura.

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 qhov concentration ntawm Fe hauv cov ntshav cov 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.

Ua ntej pib txoj kev kho mob, nws raug nquahu kom ua qhov kev kuaj xyuas ophthalmological, suav nrog kev tshuaj xyuas cov nyiaj pob nrog lub pob hluav taws thiab ntsuas ntawm lub zog intraocular yog tias tsim nyog. 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.

Nws raug nquahu kom tso tseg kev siv ethanol.

Cov tshuaj nyob rau hauv daim ntawv ntev ntev tuaj yeem nqa ib zaug, thaum tsaus ntuj. Qhov xav tau nce cov koob tshuaj thaum hloov mus rau ntsiav tshuaj retard yog qhov tsawg kawg.

Txawm hais tias txoj kev sib raug zoo ntawm cov koob tshuaj, nws qhov kev xav thiab kev soj ntsuam kev ua haujlwm lossis kev thev taus me me heev, txawm li cas los xij, kev txiav txim siab tsis tu ncua ntawm kev txiav txim siab ntawm cov tshuaj carbamazepine yuav muaj txiaj ntsig zoo nyob rau cov xwm txheej nram qab no: nrog kev nce siab ntawm qhov nquag ntawm kev tawm tsam, txhawm rau tshuaj xyuas seb tus neeg mob noj tshuaj kom raug, thaum cev xeeb tub, hauv kev kho mob ntawm menyuam yaus lossis tub ntxhais hluas, nrog kev xav tias tsis muaj tshuaj tiv thaiv kev tsis haum tshuaj, nrog kev xav tias muaj kev txhim kho tshuaj lom yog tias tus neeg mob noj ob peb tshuaj.

Hauv cov poj niam uas muaj hnub nyoog yug me nyuam, carbamazepine yuav tsum siv cov tshuaj kho mob thaum tsim nyog (siv tshuaj tsawg kawg nkaus) - qhov ntau zaus ntawm kev mob plab yug me nyuam hauv cov menyuam mos yug los rau cov poj niam uas tau ua ke nrog cov tshuaj tiv thaiv kab mob siab dua rau cov neeg uas tau txais txhua yam tshuaj no ua kev kho mob hlwb.

Thaum cev xeeb tub tshwm sim (thaum txiav txim siab txog kev teem caij carbamazepine thaum cev xeeb tub), nws yuav tsum ua tib zoo los sib piv cov txiaj ntsig ntawm kev kho thiab nws qhov teeb meem tshwm sim, tshwj xeeb tshaj yog nyob rau thawj 3 lub hlis thaum cev xeeb tub. Nws raug paub tias cov menyuam yaus yug los ntawm leej niam nrog mob vwm sib kis tau mob siab rau hauv plab kev loj hlob tsis zoo, suav nrog kev ua tsis tiav. Carbamazepine, zoo li tag nrho lwm cov tshuaj tiv thaiv kev mob, tuaj yeem ua rau muaj kev pheej hmoo ntawm cov mob no. Muaj cov ntaub ntawv sib cais los ntawm tus neeg mob ntawm cov kab mob ua tsis taus pa thiab tsis zoo, suav nrog kev tsis kaw cov pob txha caj qaum (spina bifida). Cov neeg mob yuav tsum tau muab cov ntaub ntawv hais txog qhov ua tau los txhawm rau txhawm rau txhawm rau ua kom muaj qhov phom sij thiab muaj peev xwm los soj ntsuam kev kuaj mob ua ntej.

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 (ua ntej thiab thaum cev xeeb tub, folic acid ntxiv yog pom zoo). Txhawm rau tiv thaiv kev nce ntshav hauv cov menyuam yug tshiab, nws raug nquahu kom cov pojniam nyob hauv lub asthiv kawg ntawm cev xeeb tub, nrog rau cov menyuam yug menyuam tshiab, yuav tsum tau muaj cov tshuaj vitamin K1.

Carbamazepine kis mus rau niam cov kua mis; cov txiaj ntsig thiab qhov tsis xav tau ntawm kev pub niam mis yuav tsum muab piv nrog kev kho mob txuas ntxiv. Cov niam cov niam noj carbamazepine tuaj yeem pub mis rau lawv cov menyuam tau noj, muab tau tias tus menyuam raug soj qab rau kev txhim kho kev pheej hmoo tsis zoo (piv txwv, tsaug zog hnyav, kev tsis haum tshuaj tawv nqaij).

Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab koom nrog lwm yam kev phom sij uas yuav tsum muaj kev mloog zoo thiab ceev ntawm cov kev tiv thaiv psychomotor.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

hauv qhov ncauj tawm 10 pcs., hauv ib pob ntawv los ntawm daim ntawv 5 (200 mg txhua) lossis 3 lub hlwv (400 mg ib zaug).

Tsuas tshuaj thiab tswj hwm

Sab hauv lub sijhawm lossis tomqab noj mov, lossis nyob nruab nrab ntawm pluas noj, muaj haus me me.

Cov ntsiav tshuaj uas raug ncua ntev (tag nrho cov ntsiav tshuaj lossis ib nrab, yog li ntawv muab los ntawm kws kho mob) yuav tsum noj yam tsis muaj kev zom.

Cov tshuaj muaj peev xwm siv tau ob qho tib si los ntawm kev kho mob monotherapy, thiab yog ib feem ntawm kev sib xyaw ua ke.

Txij li thaum cov tshuaj nquag tso tawm los ntawm cov ntsiav tshuaj ntawm lub sijhawm ntev maj mam thiab maj mam, lawv tau muab tshuaj rau 2 zaug hauv ib hnub.

Muab hais tias cov tshuaj Tegretol ® CR tau sau tseg 2 zaug hauv ib hnub, kev kho mob zoo tshaj plaws yog txiav txim los ntawm tus kws kho mob raws li cov lus pom zoo.

Hloov chaw ntawm tus neeg mob los ntawm kev noj cov tshuaj Tegretol ® hauv txoj kev hloov cov ntsiav tshuaj kom tau txais Tegretol ® CR, lub caij nyoog tso tshuaj ntsiav

Cov kev tshawb fawb soj ntsuam pom tau hais tias nyob hauv qee cov neeg mob, thaum siv cov ntsiav tshuaj tso tawm ntev, nws yuav tsim nyog los nce qhov tshuaj ntawm cov tshuaj.

Muab cov tshuaj sib cuam tshuam thiab tshuaj thiab pharmacokinetics ntawm cov tshuaj antiepileptic, cov neeg laus yuav tsum tau xaiv nrog ceev faj.

Yog tias ua tau, cov tshuaj yuav tsum tau tsim tawm raws li kev kho mob monotherapy.

Cov tshuaj feem ntau tsis muaj txiaj ntsig rau qhov qaug dab peg me me (foob me me, ua tsis tau) thiab myoclonic qaug dab peg.

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.

Txhawm kom xaiv cov tshuaj noj kom zoo hauv qhov tshuaj, nws raug nquahu tias cov ntsiab lus ntawm cov khoom tseem ceeb hauv cov ntshav ntshav tau txiav txim siab.

Thaum Tegretol ® CR ntxiv rau lwm cov tshuaj tiv thaiv kev tiv thaiv kev noj tshuaj, qhov tshuaj ntawm Tegretol ® CR maj mam nce ntxiv. Yog tias tsim nyog, nqa tawm kev kho kom haum rau cov tshuaj.

Rau cov neeg laus, thawj koob tshuaj carbamazepine yog 100-200 mg 1 lossis 2 zaug ib hnub. Tom qab ntawd nws tau maj mam nce ntxiv kom ua tiav txoj kev kho kom zoo dua, feem ntau nws ua tiav ntawm koob tshuaj 400 mg 2-3 zaug ib hnub. Qee tus neeg mob yuav xav tau nce ntau ntxiv rau hauv ib hnub mus rau 1600 lossis 2000 mg.

Cov tshuaj Tegretol ® CR, siv tau ntev-tso cov tshuaj coated yuav tsum tau siv hauv cov menyuam yaus hnub nyoog 4 xyoos thiab laus dua. Hauv cov menyuam yaus hnub nyoog qis dua 3 xyoos, Cov tshuaj Tegretol pre zoo dua yog siv cov kua phoov vim qhov nyuaj ntawm kev siv tshuaj ntau hauv cov pawg hnub nyoog no. Hauv cov menyuam yaus hnub nyoog dhau 4 xyoos, kev kho mob tuaj yeem pib nrog kev siv 100 mg / hnub, qhov koob tshuaj tau nce qeeb zuj zus, los ntawm 100 mg ib lis piam.

Txij nkawm koob tshuaj rau cov menyuam yaus tau teeb tsa ntawm tus nqi ntawm 10-20 mg / kg / hnub (hauv ntau ntau zaug).

Rau cov menyuam yaus hnub nyoog 4-5 xyoos, koob tshuaj txhua hnub yog 200-400 mg, 6-10 xyoo - 400-600 mg, 11-15 xyoo - 600-1000 mg.

Lub cev tsis xis nyob

Thawj qhov kev siv yog 200-400 mg / hnub. Nws maj mam nce ntxiv txog thaum qhov mob ploj (feem ntau - 200 mg 3-4 zaug hauv ib hnub). Tom qab ntawd lub koob tshuaj yog maj maj txo kom tsawg kawg kev txij nkawm. Qhov pom zoo kom pib noj rau cov neeg mob laus yog 100 mg 2 zaug ib hnub.

Cawv kev haus dej haus cawv

Qhov tshuaj nruab nrab yog 200 mg 3 zaug ib hnub. Hauv cov xwm txheej hnyav, cov koob tshuaj yuav raug nce ntxiv hauv thawj ob peb hnub (piv txwv, 400 mg 3 zaug hauv ib hnub). Hauv kev tshwm sim loj heev ntawm kev tshem tawm cawv, kev kho mob pib nrog kev siv tshuaj yaj yeeb hauv kev sib xyaw nrog cov tshuaj uas muaj sedative thiab hypnotic nyhuv (piv txwv, clomethiazole, chlordiazepoxide). Tom qab daws cov theem mob, kev kho mob nrog cov tshuaj tuaj yeem txuas ntxiv ua kev kho mob monotherapy.

Polyuria thiab polydipsia ntawm neurohormonal xwm hauv ntshav qab zib insipidus ntawm hauv paus pib

Qhov nruab nrab koob rau cov neeg laus yog 200 mg 2-3 zaug ib hnub. Hauv cov menyuam yaus, lub koob tshuaj yuav tsum raug txo kom nruj raws li lub hnub nyoog thiab lub cev qhov hnyav ntawm cov menyuam.

Kev mob siab rau cov mob ntshav qab zib neuropathy

Qhov tshuaj nruab nrab yog 200 mg 2-4 zaug ib hnub.

Mob manic thiab kev pab txhawb kev kho mob los ntawm qhov muaj mob (bipolar)

Qhov tshuaj rau txhua hnub yog 400-1600 mg. Qhov nruab nrab txhua hnub koob tshuaj yog 400-600 mg (hauv 2-3 koob). Hauv lub xeev kev mob siab, qhov tshuaj yuav tsum tau nce ntxiv kom nrawm. Nrog kev kho kom zoo rau kev puas siab puas ntsws bipolar, txhawm rau kom ntseeg tau tias qhov ua kom tau zoo tshaj plaws, txhua qhov kev nce qib ntxiv yuav tsum muaj tsawg, qhov kev noj tshuaj txhua hnub yuav tsum tau nce zuj zus.

Cov lus qhia rau siv Tegretol (Txujci thiab ntau npaum li cas)

Cov lus qhia rau kev siv Tegretol tso cai rau koj noj cov ntsiav tshuaj thaum lub sijhawm noj mov lossis tom qab noj mov ib txhij nrog kua me me. Ntawm qaug dab pegyog tias ua tau, cov tshuaj yuav tsum ua raws li kev kho mob monotherapy.

Kev kho pib nrog kev siv qhov tshuaj me txhua hnub, uas tom qab ntawd maj mam nce mus rau qib siab zoo. Txhawm kom xaiv qhov zoo tshaj plaws, nws raug nquahu kom cov ntsiab lus ntawm cov tshuaj nquag hauv ntshav tau txiav txim siab.

Thaum cov tshuaj ntxiv rau cov tshuaj uas twb tau xaiv los kho, qhov no yuav tsum tau maj mam ua tiav, thiab cov koob tshuaj ntawm cov tshuaj siv feem ntau tsis hloov lossis kho qhov tseeb.

Thawj koob tshuaj rau cov neeg laus yog 100-200 mg 1-2 zaug ib hnub. Tom qab ntawd cov tshuaj tau maj mam nce ntxiv kom txog thaum qhov kev ua haujlwm tau zoo tshaj plaws, raws li txoj cai nws tau tiav nrog 400 mg rau ib hnub. Qee tus neeg mob yuav tau noj 1,6 grams lossis 2 gram ntawm cov tshuaj ib hnub.

Cov menyuam yaus hnub nyoog 4 xyoos thiab qis dua yuav tsum pib kho nrog 20-60 mg ntawm cov tshuaj ib hnub thiab nce ntau npaum li 20-60 mg rau hauv ib hnub.

Hauv cov menyuam muaj hnub nyoog tshaj 4 xyoos, kev kho mob tau tso cai pib nrog 100 mg rau ib hnub, ntau npaum cov tshuaj tau nce qeeb, los ntawm 100 mg ib hlis ib zaug.

Kev txhawb nqa cov tshuaj rau cov menyuam yaus yog 10-20 mg / kg ib hnub.

Thaum kho trigeminal neuralgia thawj koob tshuaj yog 200-400 mg rau ib hnub. Nws yog maj mam nce ntxiv kom txog thaum qhov mob rov zoo tuaj (200 mg rau 4 zaug hauv ib hnub), tom qab ntawd nws maj mam muab qis kom qis dua kev txhawb zog. Qhov pom zoo pib koob rau cov neeg laus yog 100 mg ob zaug hauv kev tub nkeeg.

Ntawm haus dej cawv tus qauv koob tshuaj yog 200 mg peb zaug ib hnub. Hauv tshwj xeeb yog mob hnyav, nyob hauv thawj ob peb hnub, kev noj tshuaj ntxiv yuav raug nce siab. Hauv kev tshwm sim loj heev ntawm kev tshem tawm cov cawv, kev kho pib nrog kev siv ntawm kev sib xyaw ntawm tegretol nrog sedative-hypnotic tshuajCov. Tom qab siv ceev xwmphem theem mob, Tegretol monotherapy tuaj yeem ua.

Ntawm ntshav qab zib insipidusqhov nruab nrab ntawm cov neeg laus thaj yog 200 mg ntawm cov tshuaj txog li 3 zaug hauv ib hnub. Hauv cov menyuam yaus, cov koob tshuaj yuav tsum tau txo kom raws li lub hnub nyoog thiab qhov hnyav ntawm cov menyuam.

Hauv kev kho mob uas mob ntshav qab zib neuropathy nrog rau qhov muaj mob, qhov ib txwm ib txwm ntawm cov tshuaj yog 200 mg txog plaub zaug hauv ib hnub.

Ntawm manic xeev mob hom thiab nrog kev kho kho ntawm kev puas siab puas ntsws bipolar, qhov koob tshuaj txhua hnub yog 400-1600 mg. Cov qauv muab tshuaj rau txhua hnub yog 400-600 mg.

Noj ntau dhau

Cov cim qhia ntawm kev haus luam yeeb ntau: ntxhov siab, kev nyuaj siab ntawm cov hlab ntsha hlwb, nkees nkees,disorientation, tso kev ntseeg,qhov muag plooj coma, dysarthriahais lus phem ataxia, nystagmus, dyskinesia, hyporeflexia, hyperreflexia, kev mob ntshav qab zib, mob ua paug, myoclonus, psychomotor cuam tshuam mydriasis,pulmonary edemakev nyuaj siab mob ntsws tachycardia, kub siab, cov hlab ntsha hypotension, raug ntes lub plawv, tsaus muag, ntuav, lub plab hnyuv kom tsawg, oliguria, tso zis cia, kam tuav, anuria, hyponatremia, hyperglycemia, metabolic acidosis,qib nce kev tsim tawm phosphokinase.

Tshaj kev kho mob: tsev kho mob, kev txiav txim siab qib carbamazepinenyob rau hauv cov ntshav los ntsuam xyuas qhov hnyav ntawm kev haus ntau dhau. Tshem tawm cov ntsiab lus ntawm lub plab, daim ntawv thov enterosorben, kev kho cov tsos mob, kev saib xyuas ntawm lub siab, kev txhim kho ntawm cov roj ntsha cuam tshuam. Tshwj xeeb tshuaj tiv thaiv kab mob tsis muaj nyob.

Tegretol, cov lus qhia rau kev siv: txoj kev thiab ntau npaum li cas

Tegretol noj ntawm qhov ncauj. Cov ntsiav tshuaj tau ntxuav nrog ib qho me me ntawm dej. Cov tshuaj yuav noj tau yam tsis xav noj mov.

Tej zaum kev siv Tegretol ua kev xav tshuaj lossis ua ke nrog lwm cov tshuaj.

Nws yog ib qho zoo uas yuav tsum tau noj cov kua qab zib (5 ml - 1 ntsuas diav - 100 mg) yog tias nqos tsis yooj yim lossis muaj qee qhov kev xaiv yuav tsum tau noj ntau. Thaum siv cov kua dej qab zib, qhov siab tshaj qhov kev xav tau yog ua tiav ntau dua thaum muab cov koob tshuaj hauv Tegretol.Txhawm rau kom tsis txhob muaj kev txhim kho ntawm qhov tshwm sim tsis zoo, nws raug nquahu kom pib kho nrog cov tshuaj me me, tom qab ntawd lawv tau nce zuj zus. Ua ntej siv, co lub raj mis nrog phoov.

Yog tias tus neeg mob hloov mus los ntawm kev noj cov ntsiav tshuaj mus rau hauv lub koob tshuaj syrup, koob tshuaj txhua hnub tsis hloov pauv, txawm li cas los xij, nws raug nquahu kom txo qhov luaj li cas ntawm ib zaug thiab nce ntau zaus noj Tegretol.

Nws yog ib qho tsim nyog yuav tsum tau xaiv cov koob tshuaj rau cov neeg laus uas muaj kev saib xyuas tshwj xeeb.

Yog tias ua tau, tegretol yuav tsum ua raws li kev kho mob monotherapy.

Thaum pib ntawm chav kawm, ib qho tshuaj me me txhua hnub raug muab tshuaj, uas tom qab ntawd tau nce qeeb.

Txhawm rau xaiv cov koob tshuaj zoo tshaj plaws, nws raug nquahu kom txiav txim siab ntshav ntshav ntawm cov tshuaj nquag hauv cov ntshav (feem ntau 0.004–0.012 mg / ml).

Thawj koob tshuaj Tegretol rau cov laus thiab cov menyuam hnub nyoog 16 xyoo yog 100-200 mg 1-2 zaug hauv ib hnub, qhov koob tshuaj nruab nrab zoo tshaj yog 2-3 zaug hauv ib hnub rau 400 mg. Qee zaum koj yuav tsum nce ntxiv rau qhov tshuaj txhua hnub rau 1600-2000 mg.

Lub cev tsis xis nyob

Thawj qhov tshuaj txhaj rau cov laus txhua hnub ntawm Tegretol yog 200-400 mg, rau cov neeg mob laus - 200 mg (100 mg 2 zaug hauv ib hnub). Nws yog maj mam nce ntxiv kom txog thaum qhov mob ploj, qhov nruab nrab koob yog 3-4 zaug hauv ib hnub, 200 mg ib koob. Qhov siab tshaj plaws tau tso cai rau noj txhua hnub yog 1200 mg. Tom qab ntawv sau ntawv tso cai koob tshuaj saib xyuas qhov zoo ntawm Tegretol.

Yog tias qhov mob ploj mus, txoj kev kho maj mam tso tseg kom txog thaum hnov ​​mob ntxiv.

Cawv kev haus dej haus cawv

Cov tshuaj nruab nrab txhua hnub ntawm Tegretol yog 3 zaug hauv ib hnub, 200 mg ib koob. Hauv cov xwm txheej loj, thawj ob peb hnub nws tau nce ntau (piv txwv li, nce mus txog 3 zaug hauv ib hnub, 400 mg ib zaug).

Tej zaum ua ke nrog siv nrog cov tshuaj nrog sedative thiab hypnotic teebmeem (piv txwv li, nrog chlordiazepoxide, clomethiazole). Tom qab mob hnyav daws teeb meem, kev kho nrog Tegretol txuas ntxiv raws li kev kho mob monotherapy.

Kev txiav tawm ntawm txoj kev kho

Kev txiav ntse ntawm kev noj cov tshuaj Tegretol tuaj yeem ua rau kev txhim kho mob vwm, yog li kev kho yuav tsum tau maj mam txiav tawm mus txog 6 lub hlis lossis ntev dua.

Yog tias tsim nyog, sai tshem tawm txoj kev kho mob hauv cov neeg mob qaug dab peg, hloov mus rau lwm cov tshuaj nrog tshuaj tiv thaiv kev tiv thaiv yuav tsum tau ua nyob rau hauv kev ua txhaum ntawm cov tshuaj uas qhia hauv cov kis no.

Kev siv tegretol hauv cov menyuam yaus

Qhov tseem ceeb qhia tias kev siv Tegretol hauv cov menyuam yog qaug dab peg.

Pom zoo kom pib txhaj tshuaj txhua hnub:

• txog li 4 xyoos: los ntawm 20 txog 60 mg, txhua lwm lwm hnub koob tuaj yeem nce ntxiv 20-60 mg,
• los ntawm 4 xyoo: 100 mg, tom qab ntawd qhov koob tshuaj tuaj yeem nce ntxiv los ntawm 100 mg ib lis piam.

Cov koob tshuaj txij nkawm tau teeb tsa ntawm ib zaug ntawm 10-20 mg / kg ib hnub, muab faib ua ob peb koob tshuaj:

• txog li 1 xyoos: 100-200 mg (1-2 koob tshuaj kua txiv),
• 1 years5 xyoos: 200–400 mg (1 d2 kua txiv tso 2 zaug),
• 6-10 xyoo: 400-600 mg (2 koob tshuaj kua txiv hauv 2-3 koob),
• 11–15 xyoo: 600–1000 mg (2-3 koob tshuaj tso rau hauv 3 koob; thaum siv 1000 mg, koj yuav tsum nce qhov koob tshuaj ntawm syrup los ntawm 5 ml),
• los ntawm 15 xyoo: los ntawm 800 txog 1200 (hauv ntau qhov teeb meem tsawg) mg.

Qhov siab tshaj plaws txhua hnub koob tshuaj Tegretol:

• txog 6 xyoo: 35 mg / kg,
• 6-15 xyoo: 1000 mg,
• los ntawm 15 xyoo: 1200 mg.

Txij li thaum, hais txog noj Tegretol rau lwm cov cim, cov menyuam tsis muaj cov ntaub ntawv tsim nyog ntawm cov ntaub ntawv txhim khu kev qha, nws raug nquahu tias cov tshuaj yuav raug siv raws li qhov hnyav thiab hnub nyoog ntawm tus menyuam, tsis tas yuav tsum dhau ntawm cov tshuaj kho mob saum toj no.