Amitriptyline - tshuaj tiv thaiv kev ntxhov siab rau cov mob hnyav ntawm kev nyuaj siab

Kev piav qhia cuam tshuam rau 22.09.2014

• Lub npe Latin: Ammitriptyline
• ATX Code: N06AA09
• Yam tshuaj muaj sia: Amitriptyline
• Chaw tsim tshuaj paus: Grindeks (Latvia), Nycomed (Denmark), Synthesis (Russia), Ozone (Russia), ALSI Pharma (Russia)

Dragees thiab cov ntsiav tshuaj Amitriptyline muaj 10 lossis 25 mg ntawm cov tshuaj nquag nyob hauv daim ntawv amitriptyline hydrochloride.

Cov tshuaj ntxiv hauv cov ntsiav tshuaj yog microcrystalline cellulose, talc, lactose monohydrate, silicon dioxide, magnesium stearate, pregelatinized hmoov txhuv nplej siab.

Cov tshuaj ntxiv hauv dragees yog: magnesium stearate, qos hmoov txhuv nplej siab, talc, polyvinylpyrrolidone, lactose monohydrate.

1 ml ntawm kev daws muaj 10 mg ntawm cov tshuaj nquag. Cov tshuaj ntxiv yog: hydrochloric acid (sodium hydroxide), dextrose monohydrate, dej rau infusion, sodium chloride, benzetonium chloride.

Pharmacodynamics thiab pharmacokinetics

Cov tshuaj txo qhov qab los noj mov, tshem tawm ntawm kev pw tsaug zog, muaj antiserotonin kev txiav txim. Cov tshuaj muaj cim tshaj tawm hauv nruab nrab thiab peripheral anticholinergic nyhuv. Antidepressant nyhuv ua tiav los ntawm kev nce qib ntawm serotonin hauv cov hlab hlwb thiab norepinephrine hauv cov lus sib dhos. Kev kho mus ntev ntev ua rau kev txo qis hauv kev ua haujlwm ntawm serotonin thiab beta-adrenergic receptors hauv lub hlwb. Amitriptyline txo qhov hnyav ntawm qhov kev nyuaj siab tshwm sim, ntxhov siabntxhov siab thaum ntxhov siab vim thiab poob siabCov. Los ntawm thaiv H2-histamine receptors hauv phab ntsa ntawm lub plab (parietal hlwb) muaj cov nyhuv antiulcer tau muab. Cov tshuaj yog tuaj yeem txo qhov kub ntawm lub cev, ua kom ntshav siab nrog cov tshuaj loog dav dav. Cov tshuaj tsis inhibit monoamine oxidase. Cov tshuaj tiv thaiv kev ntxhov siab tshwm tom qab 3 lub lis piam ntawm kev kho.

Qhov siab tshaj plaws ntawm ib yam khoom hauv cov ntshav tshwm sim tom qab ob peb teev, feem ntau yog tom qab 2-12. Nws hloov tawm metabolites nrog zis. Nws khi zoo nrog cov nqaijrog.

Cov Yuav Tsum Muaj

Raws li cov lus piav qhia, cov tshuaj tsis yog siv rau myocardial infarction, intolerance mus rau cov khoom siv tseem ceeb, nrog lub kaum ntse ntse lub ntsej muag kawmob qaug cawv nrog psychoactive, analgesic, hypnotics, nrog mob qaug cawv kom qaug cawv. Cov tshuaj yog contraindicated nyob rau hauv kev pub mis niam, kev ua txhaum loj ntawm kev ua haujlwm hauv intraventricular conduction, antioventricular conduction. Nrog pathology ntawm cov hlab plawv system, nrog inhibition ntawm cov pob txha mob hematopoiesis, manic-depressive lub hlwb, mob ntsws asthma, mob ntev cawv, txo lub cev muaj zog ntawm lub plab zom mov, mob stroke, mob siab thiab mob raum, Kev mob ntshav siab ntawm intraocular, tso zis tawm suab, mob prostatic hyperplasia, nrog kev kho ntshav ntawm lub zais zis, thyrotoxicosis, cev xeeb tub, qaug dab peg Amitriptyline yog cov kev ceev faj.

Noj ntau dhau

Qhia tau los ntawm cov leeg hlab hlwb: coma, hnov ​​qab, ntxiv zog tsaug zog, ntxhov siab vim, hnov ​​dhuav, ataxia, mob vwm, choreoathetosishyperreflexia dysarthria, kev ua kom nruj ntawm cov leeg nqaij, tsis meej pem, tsis meej pem, ua tsis tau zoo, puas tsuaj rau lub hlwb.

Cov cim ntawm kev siv ntau tshaj ntawm Amitriptyline nrog hlab plawv: ua txhaum ntawm intracardiac conduction, arrhythmia, tachycardia, poob hauv ntshav siab, poob siab, lub plawv tsis ua hauj lwmtsis tshua - mob plawv ntes.

Kuj tau sau tseg anusiaoliguria, tawm hws, hyperthermia, ntuav, txog siav, poob siab ntawm txoj hlab ntsws, cyanosis. Tej zaum yog raug tshuaj lom.

Txhawm rau kom zam dhau lub txim tsis zoo ntawm kev noj ntau dhau, kev kho mob lub plab zom zaub mov thiab kev tswj hwm ntawm cholinesterase inhibitors yuav tsum muaj qhov tshuaj tiv thaiv kev tsis haum tshuaj hnyav. Nws kuj tseem xav kom tswj cov dej-electrolyte tshuav nyiaj li cas, cov ntshav siab, soj ntsuam cov hlab plawv system, rov ua dua thiab ntsuas kev tiv thaiv, yog tias tsim nyog. Yuam kev diuresis, thiab hemodialysis tseem tsis tau pom tias muaj txiaj ntsig ntawm kev siv tshuaj ntau ntawm amitriptyline.

Kev sib txuam

Antihypertensive nyhuv, kev nyuaj siab mob ntsws, qhov cuam tshuam ua rau lub zog poob siab yog pom nrog kev sib koom ua ke ntawm cov tshuaj uas tiv thaiv cov hlab ntsha hauv nruab nrab: cov tshuaj loog dav dav, benzodiazepines, barbiturates, tshuaj tiv thaiv kab mob thiab lwm tus. Cov tshuaj txhim kho qhov mob muaj zog ntawm cov tshuaj anticholinergic thaum noj amantadine, antihistamines, biperiden, atropine, antiparkinsonian tshuaj, phenothiazine. Cov tshuaj txhim kho cov tshuaj anticoagulant ntawm indadione, coumarin derivatives, indirect anticoagulants. Txo cov khoom tsawg alpha blockersphenytoin. Fluvoxamine, fluoxetine nce qhov kev mloog ntxiv ntawm cov tshuaj hauv cov ntshav. Txoj kev pheej hmoo ntawm kev tsim muaj kev puas tsuaj rov qab nce, thiab lub hauv paus anticholinergic thiab sedative cov teebmeem tseem tau txhim kho nrog kev sib xyaw ua ke nrog kev kho mob benzodiazepines, phenothiazines, thiab cov tshuaj anticholinergic. Ib txhij txais tosmethyldopa, reserpine, betanidine, guanethidine, clonidine txo qhov mob hnyav ntawm lawv cov nyhuv hypotensive. Thaum noj cocaine, arrhythmia muaj kev txhim kho. Delirium tshwm sim thaum noj cov tshuaj acetaldehydrogenase inhibitors, disulfiram. Amitriptyline ua rau txoj kev muaj zog ntawm cov hlab plawv phenylephrinenorepinephrine epinephrineisoprenaline. Txoj kev pheej hmoo ntawm hyperpyrexia nce nrog kev siv cov tshuaj tiv thaiv kab mob, m-anticholinergics.

Cov lus qhia tshwj xeeb

Ua ntej ua kev kho mob, nws yog qhov tsim nyog los tswj qib theem ntawm cov ntshav siab. Kev tswj hwm hauv tsoomfwv ntawm amitriptyline yog tswj tshwj xeeb hauv kev saib xyuas mob hauv tsev kho mob. Thaum ntxov ntawm kev kho mob, yuav tsum tau pw lub txaj. Yuav tsum tau ua tiav qhov kev tsis kam noj tshuaj ethanol. Kev tsis lees txais txoj kev kho yuav ua tau tshem tawm cov mob syndromeCov. Cov tshuaj nyob rau hauv ib koob tshuaj ntau dua 150 mg rau ib hnub twg ua rau txo qis ntawm kev cuam tshuam ntawm kev ua si, uas yog qhov tseem ceeb xav txog thaum tsim muaj kev puas ntsoog mob rau cov neeg mob uas muaj lub siab xav ua ntej. Tej zaum kev txhim kho ntawm hypomanic los yog manic xeev nyob rau hauv cov tib neeg uas muaj kev voj voog, kev cuam tshuam rau kev cuam tshuam thaum lub caij muaj kev ntxhov siab. Yog tias tsim nyog, kev kho mob rov qab zoo li qub nrog cov koob tshuaj me me tom qab nres cov mob no. Kev ceev faj yuav tsum tau tawm dag zog hauv kev kho mob ntawm cov neeg mob noj cov tshuaj thyroid hormone kho nyob rau hauv kev kho mob ntawm cov neeg mob thyrotoxicosis vim muaj kev pheej hmoo ntawm kev tsim muaj cov teebmeem cardiotoxic. Cov tshuaj tuaj yeem ua rau kev loj hlob ntawm cov tuag tes tuag taw txoj hnyuv txuas rau hauv cov neeg laus, nrog rau kev muaj mob sib txawv. Nws yog qhov yuav tsum tau ceeb toom cov tshuaj loog txog kev siv amitriptyline ua ntej kev ua kom tsis txhob muaj tshuaj loog hauv zos lossis dav dav. Kev kho mus sij hawm ntev provokes kev loj hlob cariesCov. Muaj peev xwm ua tau nce ntxiv rau riboflavin. Amitriptyline hla mus rau hauv niam cov kua mis; hauv cov menyuam mos, nws ua rau tsaug zog ntau dua. Cov tshuaj muaj qhov cuam tshuam rau kev tsav tsheb.

Cov tshuaj yog piav nyob rau Wikipedia.

Pharmacological kev txiav txim

Kho kev nyuaj siab kho siab. Txo txo ​​kev ntxhov siab, mob lub siab txaus, mob lub siab. Lub hauv paus ntsiab lus ntawm kev txiav txim siab tiv thaiv kev nyuaj siab yog vim muaj qhov nce ntawm norepinephrine nyob rau hauv synapses thiab / lossis serotonin hauv nruab nrab lub paj hlwb (txo qis hauv lawv rov qab nqus). Kev sib txuam ntawm cov neurotransmitters tau pom vim yog kev tsuj ntawm lawv rov qab ntes los ntawm cov qog ntawm presynaptic neurons.

Qhov kev txiav txim ntawm tus tshuaj tiv thaiv tsis zoo tshwm sim hauv ob rau peb lub lis piam los ntawm kev pib tshuaj.
Amitriptyline muaj kev ua kom loog, M-anticholinergic, antihistamine, antiserotonin, timoleptic, anxiolytic thiab analgesic, antiulcer nyhuv.

Thaum lub sij hawm tshuaj loog, nws txo qis ntshav siab thiab lub cev kub.
Tsis inhibit monoamine oxidase.

Dosage Cov Ntawv

Amitriptyline yog tsim los ntawm ntau cov tuam ntxhab. Daim ntawv tseem ceeb ntawm kev siv tshuaj - ntsiav tshuaj, tov rau kev txhaj tshuaj:

• txhaj tshuaj tov - ampoules 20 mg / 2 ml, vials 10 mg / ml,
• ntsiav tshuaj ntawm 0.025 g
• qab zib coated ntsiav tshuaj 10 mg, 25 mg,
• ntsiav tshuaj, zaj duab xis-coated 10 mg, 25 mg, 50 mg, 75 mg,
• luag 25 mg
• pab txhawb-tso cov tshuaj ntsiav 50 mg.

Cov lus ntau ntawm cov tshuaj, nrog rau lub zog tshwj xeeb ntawm cov tshuaj nquag, tuaj yeem sib txawv.

Cov tshuaj sib xyaw ua ke ntawm kev txhaj tshuaj:

• tus neeg sawv cev nquag - amitriptyline hydrochloride,
• excipients - qabzib (dextrose), dej rau kev txhaj tshuaj.

Kev sib xyaw ntawm cov yeeb yaj kiab-coated ntsiav tshuaj:

• cov tshuaj nquag yog amitriptyline hydrochloride,
• excipients - magnesium stearate, talc, povidone, qos hmoov txhuv nplej siab, microcrystalline cellulose, lactose monohydrate.

Plhaub muaj pes tsawg leeg: propylene glycol, hypromellose, titanium dioxide, talc.
Muaj pes tsawg leeg ntsiav tshuaj:

• cov tshuaj nquag - amitriptyline,
• excipients - lactose, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, polyethylene glycol 6000, talc, polysorbate 80, colloidal silicon dioxide, hypromellose, titanium dioxide (E 171), carmoisine (E 122).

Muaj pes tsawg leeg tsub kom-tawm mus tshuaj ntsiav:

• cov tshuaj nquag yog amitriptyline hydrochloride,
• excipients - stearic acid, qab zib spheres, shellac (non-waxed shellac), talc, povidone.

Cov sib xyaw ua ke ntawm cov tshuaj ntsiav khoob yog gelatin, hlau zas hlau oxide liab (E 172), titanium dioxide (E 171).

• cov kev mob siab ntsws hnyav, tshwj xeeb tshaj yog cov tsos mob tshwm sim ntawm kev ntxhov siab, lub siab lub ntsws, pw tsaug zog: rov qab muaj dua (rov muaj dua), rov qab npau taws (tom qab kev puas siab puas ntsws), neurotic, tshuaj, nrog cawv haus cawv, ua rau muaj hlwb hauv lub hlwb, nrog rau thaum yau,
• schizophrenic kev puas siab puas ntsws ntawm kev xav, kev nyuaj siab hauv cov neeg mob schizophrenia,
• kev sib xyaw ua ke tsis txaus ntseeg ntawm lub siab lub xeev,
• tsis hnov ​​lus, kev ua si,
• nocturnal enuresis (tshwj tsis yog rau cov neeg mob txo lub suab ntawm phab ntsa ntawm lub zais zis),
• bulimia leeg
• mob mob mus ntev - mob mob rau cov neeg mob qog nqaij hlav, mob taub hau, mob rheumatic, mob atypical ntawm lub ntsej muag, postherpetic neuralgia, neuropathies ntawm ntau yam keeb kwm (mob ntshav qab zib, mob tom qab, lwm yam kev mob puas hlwb),
• mob taub hau
• mob taub hau prophylaxis,
• peptic rwj ntawm lub plab thiab duodenum.

Tricyclic cov tshuaj tiv thaiv kev ntxhov siab los ua thawj kab tshuaj rau kev cuam tshuam loj heev.

Txoj kev ntawm kev coj thiab ntau npaum

Amitriptyline noj ntawm qhov ncauj tsis tas yuav zom tom qab noj mov kom txo tus mob ntawm lub plab hnyuv.
Thawj koob tshuaj rau cov neeg laus yog 25-50 mg thaum mus pw, tom qab ntawd cov koob tshuaj ntau dua li 5-6 hnub rau 150-200 mg ib hnub hauv peb koob, ntau qhov loj tshaj plaws tau muab rau lub sijhawm pw. Yog tias tom qab 14 hnub tsis muaj kev txhim kho, qhov tshuaj txhua hnub yog nce rau 300 mg.

Yog tias cov cim ntawm kev nyuaj siab ploj, qhov koob tshuaj raug txo mus rau 50-100 mg ib hnub thiab kev kho mob txuas ntxiv mus yam tsawg peb lub hlis.
Hauv lub hnub nyoog laus, nrog cov mob sib khuav me, ib koob tshuaj 30-100 mg rau ib hnub yog tsim rau hmo ntuj, tom qab ua tiav lub cev muaj txiaj ntsig, lawv hloov mus rau qhov tsawg kawg yog siv tau ntawm 25-50 mg rau ib hnub.

Kev txhaj tshuaj yog maj mam muab ntawm ib koob ntawm 20-40 mg plaub zaug hauv ib hnub, maj mam hloov los ntawm kev noj haus. Lub sijhawm kho yog tsis ntau tshaj 6-8 lub hlis.
Nrog nocturnal enuresis:

• hauv cov menyuam muaj 6 txog 10 xyoo - 10 txog 20 mg ib hnub twg thaum tsaus ntuj,
• hauv cov menyuam yaus hnub nyoog 11-16 xyoo - 25-50 mg / hnub.

Cov menyuam yaus ua tshuaj tiv thaiv kab mob:

• txij li 6 txog 12 xyoos - 10-30 mg lossis 1-5 mg rau ib phaus ntawm qhov hnyav ib hnub,
• cov tub ntxhais hluas - 10 mg peb zaug ib hnub, yog tias tsim nyog - txog 100 mg rau ib hnub.

Txog kev tiv thaiv mob migraine, nrog mob neurogenic ntev, mob taub hau ntev - los ntawm 12,5 - 25 txog 100 mg rau ib hnub. Qhov siab tshaj plaws yuav tau noj thaum tsaus ntuj.

Sab sij huam

Ntxiv rau qhov cuam tshuam rau cov txheej txheem neural, amitriptyline yog tus cwj pwm los ntawm ntau cov kev cuam tshuam neurochemical uas txiav txim siab lawv cov kev phiv:

• antagonism hauv kev sib piv rau M1-cholinergic receptors txiav txim siab txhim kho tus mob anticholinergic syndrome - tachycardia, qhov ncauj qhuav, cuam tshuam kev pab cuam, cem quav, tso zis cia, tsis meej pem (delirium lossis hallucinations), txhaws txhaws txhaws tsis tau,
• thaiv ntawm alpha1-adrenergic receptors ua rau orthostatic circulatory ntshawv siab (kiv taub hau, qaug zog, tsaus muag ntawm nco qab, tsaus muag), reflex tachycardia,
• thaiv ntawm H1-histamine receptors - ua kom loog, hnyav tuaj,
• kev hloov pauv hauv ion metabolism hauv cov nqaij mos ntawm lub hlwb thiab lub siab txo qhov pib ntawm kev tsim txom cov khoom noj thiab muaj txiaj ntsig rau qhov tshwm sim ntawm cardiotoxic kev ua - lub suab sib luag ntawm kev cog lus thiab impulses rau myocardium yog ua txhaum.

Qhov hnyav ntawm cov kev mob tshwm sim feem ntau ua rau cov kws kho mob siv cov tshuaj tsis tsim nyog, thiab tseem ua rau cov neeg mob ua raws li txoj kev kho, uas txo cov kev kho mob kom zoo.

Vim txoj kev pheej hmoo ntawm kev lom loj heev los ntawm tricyclic cov tshuaj tiv thaiv kab mob, lawv raug xaiv los ntawm cov neeg mob uas muaj lub siab xav tua tus kheej kom paub lawv cov kev xav. Yog li, cov tshuaj tau muab tshuaj kom tus neeg mob tsis tuaj yeem sau kom txaus txaus rau kev tua tus kheej.

Amitriptyline analogues

Kev npaj uas nws lub ntsiab ua khoom xyaw yog amitriptyles yog Amizol, Elivel, Saroten retard. Conventionally, analogues ntawm cov tshuaj suav nrog cov tshuaj nyob rau pawg ntawm tricyclic antidepressants: imipramine, clomipramine, desipramine, doxepin, pipofesin, tianeptine. Txawm li cas los xij, lawv cov haujlwm pharmacological sib txawv.

Feem ntau, cov txiaj ntsig ntawm kev kho mob ntawm cov tshuaj tiv thaiv kev ntxhov siab, tshwj xeeb tshaj yog siv ntev ntev, tau paub los ntawm cov kev cuam tshuam nyuaj rau feem ntau ntawm cov neurotransmitter thiab receptor systems ntawm lub hlwb. Yog li ntawd, cov tib neeg cov spectrum ntawm lub hlwb, cov neurotropic thiab somatotropic cov tshuaj tiv thaiv kev nyuaj siab nyob ntawm qhov sib piv ntawm cov thawj thiab lub zog ntawm cov teebmeem no. Lawv cov nyiaj tso ua ke tso cai rau koj xaiv cov tshuaj yeeb yaj kiab tseeb hauv txhua kis, uas thaum kawg txiav txim qhov kev vam meej kev kho mob ntawm kev kho.

Saib xyuas! Cov lus piav qhia ntawm cov tshuaj yog hloov kho yooj yim thiab ntxiv cov qauv ntawm cov lus qhia ua haujlwm rau kev siv. Cov ntaub ntawv hais txog cov tshuaj no yog muab rau kev siv xov xwm nkaus xwb thiab yuav tsum tsis txhob siv raws li kev qhia ntawm kev siv tshuaj rau tus kheej.

Dosage daim ntawv

Coated ntsiav tshuaj, 25 mg

Ib ntsiav tshuaj muaj

cov tshuaj heev - amitriptyline hydrochloride nyob rau hauv cov nqe lus ntawm amitriptyline 25 mg,

tus zam: lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hypromellose, magnesium stearate, colloidal silicon dioxide, polyethylene glycol 6000, titanium dioxide (E 171), talc, polysorbate 80, carmoisin (E 122).

Cov ntsiav tshuaj hloov puag ncig, pleev xim, los ntawm lub teeb xim liab mus rau paj yeeb, nrog rau sab saud thiab qis ntawm cov khoom ntsej muag uas zoo. Ntawm kev txhaum hauv qab lub iav tsom iav koj tuaj yeem pom cov tub ntxhais ib puag ncig los ntawm ib txheej txuas ntxiv.

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Amitriptyline tau zoo nqus tawm ntawm lub plab hnyuv, qhov siab tshaj plaws ntshav ntshav mus txog li 6 teev tom qab kev tswj hwm ntawm qhov ncauj.

Lub bioavailability ntawm amitriptyline yog 48 ± 11%, 94.8 ± 0.8% yog txuam nrog cov plasma protein. Cov kev ntsuas no tsis nyob ntawm tus neeg mob lub hnub nyoog.

Ib nrab-lub neej yog 16 ± 6 teev, qhov ntim ntawm kev faib tawm yog 14 ± 2 l / kg. Ob lub cim nce siab ntxiv nrog nce hnub nyoog ntawm tus neeg mob.

Amitriptyline yog ua rau lub siab nyob rau hauv lub siab ntau rau cov metabolite tseem ceeb - nortriptyline. Metabolic txoj hauv kev muaj hydroxylation, N-oxidation, thiab kev sib txuas nrog glucuronic acid. Cov tshuaj tau tawm hauv cov zis, feem ntau hauv daim ntawv ntawm metabolites, nyob rau hauv daim ntawv dawb los yog sib xyaw ua ke. Qhov kev tshem tawm yog 12.5 ± 2.8 ml / min / kg (tsis yog nyob ntawm lub hnub nyoog ntawm tus neeg mob), tsawg dua 2% yog tawm hauv cov zis.

Cov Tshuaj Hauv Tshuaj

Amitriptyline yog ib qho tricyclic tshuaj tiv thaiv. Nws tau tshaj tawm antimuscarinic thiab sedative zog. Cov txiaj ntsig kho yog ua raws li qhov txo qis ntawm presynaptic reuptake (thiab, vim li ntawd, kev tsis muaj zog) ntawm norepinephrine thiab serotonin (5HT) los ntawm presynaptic cov leeg kawg.

Dua li ntawm qhov tseeb hais tias lub cev tiv thaiv kev ntxhov siab, raws li txoj cai, qhia tau nws tus kheej 10-14 hnub tom qab pib kev kho mob, kev cuam tshuam ntawm kev ua si yuav pom thaum ntxov li ib teev tom qab kev tswj hwm. Qhov no qhia tau tias cov txheej txheem ntawm kev ua tuaj yeem ua tiav lwm cov yam ntxwv pharmacological ntawm cov tshuaj.

Tsuas tshuaj thiab tswj hwm

Txoj kev kho yuav tsum pib nrog cov tshuaj me me, maj mam nce rau lawv, ua tib zoo saib xyuas cov chaw kuaj mob thiab cov tsos mob tsis nco qab zoo.

Cov neeg laus: Qhov pom zoo kom pib siv yog 75 mg rau ib hnub, noj tshuaj faib rau lossis faib thaum hmo ntuj. Ua raws li kev soj ntsuam cov tshuaj, cov koob tshuaj yuav raug nce ntxiv txog 150 mg / hnub. Nws raug nquahu kom txhaj tshuaj ntau ntxiv nyob rau thaum xaus ntawm ib hnub lossis thaum yuav mus pw.

Sedative kev ua feem ntau ua tau nws tus kheej sai sai. Cov nyhuv tshuaj tiv thaiv kev ntxhov siab ntawm cov tshuaj yuav tshwm sim tom qab 3-4 hnub, rau kev tsim nyog ntawm cov nyhuv, nws yuav siv sijhawm ntev txog 30 hnub.

Txhawm rau kom txo qis kev pheej hmoo ntawm rov huam, ib qho kev saib xyuas txij li 50-100 mg thaum yav tsaus ntuj lossis ua ntej yuav mus pw.

Cov Menyuam: Cov tshuaj tsis pom zoo rau cov menyuam yaus hnub nyoog qis dua 16 xyoo.

Cov neeg laus (laus dua 65 xyoos): qhov kev pom zoo kom noj thawj zaug yog 10-25 mg peb zaug ib hnub nrog nce nce ntxiv yog tias tsim nyog. Rau cov neeg mob ntawm pawg hnub nyoog no uas tsis tuaj yeem zam rau qhov siab siab, ib koob tshuaj txhua hnub ntawm 50 mg yuav raug txaus. Qhov yuav tsum tau txhaj tshuaj txhua hnub tuaj yeem sau rau ob peb koob tshuaj, lossis ib zaug, nyiam dua thaum yav tsaus ntuj lossis ua ntej yuav mus pw.

Cov ntsiav tshuaj yuav tsum nqos tag nrho yam tsis tau ntxo thiab haus nrog dej.

Cov tshuaj yuav tsum tau ua raws li cov lus tau hais tseg los ntawm kws kho mob, txij li kev txiav txim siab rau tus kheej ntawm kev kho mob tuaj yeem tsim kev phom sij rau kev noj qab haus huv. Qhov tsis muaj kev txhim kho nyob rau hauv tus neeg mob tus mob tuaj yeem pom txog 4 lub lis piam tom qab pib kho.

Sab sij huam

Zoo li lwm yam tshuaj, amitriptyline, cov ntsiav tshuaj coated, qee zaum tuaj yeem ua rau muaj kev tsis zoo hauv qee cov neeg mob, tshwj xeeb tshaj yog thaum sau rau thawj zaug. Tsis yog tag nrho cov kev mob tshwm sim thaum lub sijhawm kho nrog amitriptyline, qee qhov tshwm sim thaum siv lwm cov tshuaj uas yog koom nrog amitriptyline pawg.

Cov kev phiv tsis zoo yog muab faib los ntawm qhov tshwm sim ntau zaus: ntau zaus (> 1/10), feem ntau (ntawm> 1/100 txog 1/1000 txog 1/10000 rau