Durogezik cov lus qhia rau siv, contraindications, phiv, tshuaj xyuas

Lub Durogezic system muaj fentanyl depot yog npaj rau kev kho mob mus ntev ntawm cov mob mus ntev hauv cov neeg mob cancer. Lub ntsiab zoo yog tshuaj mob taub hau thiab tshuaj tsaug zogCov. Synthetic analgesic fentanyl cuam tshuam nrog opioid receptors. Ua txhaum kev xa ntawm lub zog ntawm cov kev mob hnyav mus rau thalamus thiab hypothalamus. Yog ib qho muaj zog (100 npaug) analgesic dua morphine.

Lub sijhawm tag nrho ntawm lub thaj 72 teev .Txoj kev tso tawm ntau ntxiv rau hauv cov txheej txheem ib puag ncig nyob ntawm thaj chaw ntawm thaj thiab yog 25, 50, 75 lossis 100 μg ib xuab moos.

Ntxiv rau, cov tshuaj inhibits qhov chaw ua pa, ua rau lub chaw ntuav, thiab ua kom lub plawv dhia. Zoo tsis ntxim rau cov ntshav siab. Txhawb cov suab taub kom sov, ua kom plab hnyuv thiab lub raum khiav ntshav. Ua rau muaj kev zoo siab thiab txhawb nqa qhov pib ntawm kev pw tsaug zog.

Cov Tshuaj Pharmacokinetics

Fentanyl raug tso tawm ntawm tus nqi tas li. Tom qab daim ntawv thov, nws lub plasma concentration nce dhau 12-24 teev, thiab tom qab ntawd tso tas li rau 48 teev ntxiv. Qeb kev nkag siab yog sib faib nrog ib qho me me ntawm daim ntaub. Equilibrium concentration yog txhawb los ntawm kev thov ntau dua ntawm TTS ntawm tib qhov loj me.

Tom qab tshem tawm ntawm TTC, qhov kev txiav txim siab poob qis. T1 / 2 yog thaj tsam li 17 teev. Teev maj mam ploj ntawm cov ntshav ntshav, raws li kev nqus ntawm fentanyl ntawm daim tawv nqaij txuas ntxiv mus. Hauv cov neeg mob debilitated, kev tshem tawm yog txo thiab T1 / 2 lengthens. Kev mob plab tshwm sim hauv daim siab, ob lub raum, hnyuv. 75% ntawm cov tshuaj tawm hauv cov zis, 9% nrog quav.

Kev ntsuas rau siv

• mob qog noj ntshav
• neuropathic mob (nrog mob ntshav qab zib polyneuropathy, tshuaj syringomyelialeeg kev raug mob ntau yam sclerosis),
• phantom mob mob, mob nrog mob caj dab thiab arthrosis.

Cov Yuav Tsum Tau Ua

• postoperative mob
• kev tsim txom ntawm nruab nrab ntawm kev ua pa,
• pseudomembranous mob plabtshwm sim los ntawm kev noj tshuaj tua kab mob (cephalosporins, tshuaj penicillins, lincosamides),
• ua kom raws plab,
• cev xeeb tub
• daim tawv nqaij puas rau ntawm qhov chaw thov,
• hnub nyoog txog 18 xyoo.

Nrog kev ceev faj, cov tshuaj raug xaj thaum lub sijhawm hlav hlwb, cov kab mob ntswsnce siab intracranial, raug mob hlwb, lub raum thiab daim siab ua hauj lwm, mob gallstone, hypothyroidism, prostatic hyperplasiamuaj mob loj, kom nqaim zis, quav cawv, tua tus kheej nyiam nyob hauv tus neeg mob, noj tshuaj insulin, MAO inhibitors, GKSantihypertensive tshuaj.

Sab sij huam

• tsaug zog kev nyuaj siab, lus txhais, ntxhov siab, mob taub hau, tsis meej pem, tsawg dua zoo siab, insomnia, amnesia, paresthesia,
• hypoventilationkev nyuaj siab mob ntsws bronchospasm, txog siav,
• xeev siab cem quav, biliary colicqhov ncauj qhuav dua zawv plab,
• bradycardia lossis tachycardia, ntshav siab lossis hypotensionkev tso zis cia
• xyuas lub cev thiab lub hlwb,
• cov kev ua hauv zos nyob rau hauv txoj kev ua pob, khaus thiab kev hyperemiadhau ib hnub tom qab tshem tawm ntawm TTC.

Nyob rau hauv cov ntaub ntawv ntawm abrupt cessation ntawm kev kho mob tsim "Tshem tawm cov tsos mob": xeev siab, ntuav, tshee, raws plab, ntxhov siab vim. Cov tsos mob tsis tshua muaj hais tawm yog tias qhov koob tau txo qis.

Durogezik, cov lus qhia rau kev siv (Txoj kev thiab ntau npaum li cas)

Lub Durogezik analgesic thaj yog thov rau sab saum toj, siv rau saum npoo ntawm daim tawv nqaij ntawm lub cev lossis caj npab hauv ntu qaum. Qhov chaw yuav tsum nrog me ntsis kab plaub hau, uas tau txiav ua ntej thov. Ua ntej thov lub thaj, daim tawv nqaij yuav tsum qhuav, tsis txhob siv xab npum, roj lossis pleev qhov qab.

Lub thaj yog glued tam sim ntawd tom qab tshem tawm hauv pob, nws tau nyem khov kho nrog koj lub xib teg mus rau qhov chaw ntawm daim ntawv thov rau 30 vib nas this. - Cov npoo yuav tsum ua kom zoo rau daim tawv nqaij. Cov txheej txheem tshiab yog nplaum rau lwm thaj chaw ntawm daim tawv nqaij. Hauv cov neeg mob uas tsis tau noj tshuaj opioids, koob tshuaj qis tshaj yog 25 μg / h. Thaum yuav mus los ntawm Hmoob Promedola cov koob tshuaj no tseem siv. Thaum hloov los ntawm lwm cov tshuaj yeeb tshuaj, qhov niaj hnub xav tau analgesics rau cov tshuaj dhau los yog xam. Txhua lub sijhawm teem tau los ntawm tus kws kho mob.

Tom qab thawj daim ntawv thov, qhov kev kub siab ntawm cov tshuaj nquag maj mam nce dhau 12-18 teev, yog li ntawd, tus neeg mob yuav tsum tau ua yeeb yam luv luv. Yog tias txog hnub 3 tus neeg mob tseem xav tau cov tshuaj loog ntxiv, tom qab ntawd koob tshuaj TTC tom ntej tau nce los ntawm 25 μg / h. Thaum TTS raug nres, cov tshuaj ntawm cov tshuaj txo qis zuj zus, yog li lwm cov tshuaj opioids raug muab nrog cov tshuaj tiv thaiv tsawg zuj zus.

Durogezik matrix tsis zoo li thaj chaw tshwj xeeb pov pob, nws tau ua ke ua ke - cov nplaum thiab fentanyl-muaj. Yog li ntawd, nws yog qhov hloov maj mam dua, yoog raws, tsis meej thiab siv tau yooj yim. Tsis tas li ntawd, nws muaj kev txhim kho cov nplaum nplaum zog. Qhov tsis muaj lub ntim dej nrog fentanyl thiab kev sib xyaw ua ke ntawm cov txheej txheem ua kom zoo tuaj yeem ua kom muaj kev nyab xeeb ntawm cov tshuaj, vim tias yog tias thaj ua rau tawg, tswj tsis tau tso tawm cov tshuaj thiab nws noj ntau dhau yog tsis yooj yim sua. Nws muaj nyob rau hauv ntau hom qauv nrog qhov ua tau zoo sib txawv. Thaum siv rau hauv cov txheej txheem hauv lub nruab nrab, 12.5, 25, 50, 75 lossis 100 μg ntawm cov tshuaj nquag rau ib teev yog feem tso tawm. Raws li koj tuaj yeem pom, ntau npaum li cas ntawm cov tshuaj ntau dua, uas ua rau cov txheej txheem xaiv cov koob tshuaj.

Noj ntau dhau

Manifests nws tus kheej bradypnea thiab apneakev nyuaj siab ntawm lub chaw ua pa, bradycardia, leeg ua kom leeg nruj, txo cov ntshav siab. TTC raug tshem tawm yog tsim nyog - pab ua pa tawm, tiv thaiv kev tswj hwm naloxoneCov. Kev kho mob nrog: kev taw qhia leeg ua kom mob, atropine nrog bradycardia.

Kev sib txuam

Txoj kev pheej hmoo ntawm hypoventilation, kev ua kom loog ntau dhau thiab txo cov ntshav siab thaum siv tshuaj nce siab, txo qhov ua haujlwm ntawm lub hauv nruab nrab cov hlab ntsha: opioid tshuaj loog, tranquilizers, tshuaj xaj thiab nrogtshuaj kho mob hauv tsev, phenothiazines, antihistamines, kev txhawb nqa cov leeg nruj.

Ib qho kev nce ntxiv hauv plasma concentration thiab lub sijhawm ua haujlwm ntawm lub thaj yog sau tseg thaum noj CYP3A4 inhibitors (ritonavir, Ketoconazole, troleandomycin, clarithromycin, itraconazole, Nelfinavir, Amiodarone, Verapamil, Nefadozone, diltiazem).

Durogezik txhim kho cov nyhuv antihypertensive tshuaj.

Txo cov nyhuv analgesic ntawm cov tshuaj buprenorphine, pentazocine, nalbuphine, naltrexone, naloxone.

Ua kom cov nqaij ib ce tshem tawm cov leeg txhav. Cov leeg ua kom so nrog lub cev vagolytic txo txoj kev pheej hmoo ntawm bradycardia thiab hypotension, qhov haujlwm tsis-vagolytic ua rau muaj kev pheej hmoo ntawm kev phiv tshuaj los ntawm CCC.

Qhov hno ntawm fentanyl yuav tsum tau txo thaum siv nrog GKS, tshuaj insulin thiab antihypertensive tshuaj.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Durogesic yog tsim nyob rau hauv kev hloov kho hom kabmob (TTC): cov ntawv sib dhos nrog lub ntsej muag sib npaug, txhais cov lus, hermetically kaw, muaj cov pob tshab gel, crystalline hais thiab huab cua npuas tau tso cai rau hauv cov gel, cov ntawv sau hauv lub plhaub sab nraud: paj yeeb, 0.025 mg / h, 0.05 mg / h - lub teeb ntsuab, 0.075 mg / h - xiav, 0.1 mg / h - grey (1 pc. Hauv cov hnab ntawm cov khoom sib xyaw, 5 hnab hauv ib lub thawv ntawv).

Cov muaj pes tsawg leeg ntawm 1 qhov system suav nrog:

• Cov khoom siv yam muaj sia: fentanyl - 2.5 mg, 5 mg, 7.5 mg lossis 10 mg,
• Ntu cov khoom siv: hydroxyethyl cellulose, ethyl cawv, dej lim.

Cov nyob ua ke ntawm cov kev haumxeeb txheej ntawm thaj:

• Txheej ntim: copolymer ntawm ethylene yas acetate thiab polyester,
• Cov dej ua haujlwm: ethanol (0.1 ml / 10 cm 2) thiab fentanyl (2.5 mg / 10 cm 2) raws li aqueous hydroxyethyl cellulose gel,
• Kev tso tawm cov qog: ethylene vinyl acetate (tswj cov nqi ntawm kev tso tawm ntawm cov tshuaj nquag),
• Silicone nplaum txheej coated nrog tiv thaiv kev tso tawm zaj duab xis: polyester thiab fluorocarbon diacrylate.

Tsuas tshuaj thiab tswj hwm

Tus kws kho mob xaiv cov tshuaj Durogezik ntau npaum li cas raws li tus neeg mob lub sijhawm thiab kev soj ntsuam cov kev hloov pauv tom qab thov TTC.

Lub thaj yog thov rau thaj chaw tiaj tiaj ntawm daim tawv nqaij ntawm qaum caj npab los yog pob tw. Rau kev thov, koj yuav tsum xaiv ib qho chaw nrog kab plaub hau tsawg tshaj plaws. Ua ntej siv, cov plaub hau ntawm qhov chaw thov yuav tsum txiav tawm (tsis txhob chais. Yog tias nws yog qhov yuav tsum tau ntxuav cov tawv nqaij ua ntej thov, tsis txhob siv xab npum, roj, tshuaj pleev lossis lwm yam rau qhov no, thiaj li tsis ua rau tawv nqaij lossis hloov pauv ntawm nws lub zog. Ua ntej daim ntawv thov, daim tawv nqaij yuav tsum tau qhuav txhua nrho.

Lub durogezik yog glued tam sim ntawd tom qab rho tawm los ntawm lub hnab ntim kaw, khov kho nws nrog xib teg rau 30 feeb ntawm qhov chaw thov. Koj yuav tsum paub tseeb tias cov ntaub ntawv zoo haum ntawm daim tawv nqaij, tshwj xeeb tshaj yog nyob ib ncig ntawm cov npoo.

Durogezik yog tsim rau kev siv tas mus li rau 72 teev. Cov txheej txheem tshiab tuaj yeem tsim kho ntxiv rau lwm thaj chaw ntawm daim tawv nqaij tsuas yog tom qab tshem tawm yav dhau los. Ntawm ib qho thiab tib thaj tsam ntawm daim tawv nqaij, thaj tuaj yeem tsuas tuaj yeem txhaws nrog qhov so ntawm ob peb hnub.

Hauv thawj daim ntawv thov, qhov ntau npaum (qhov loj me ntawm lub system) tau xaiv raws li tus neeg mob lub sijhawm, kev siv tshuaj opioid analgesics yav dhau los thiab qib siab ntawm lub siab tev taus. Yog tias tsis muaj tshuaj opioids tau sau tseg ua ntej, ib qho 25 μg / h thaj yuav tsum tau siv raws li kev siv thawj zaug. Koob tshuaj ib yam tshuaj yog tus neeg mob yav tas los tau txais Promedol.

Hauv cov neeg mob uas muaj opioid kam rau ua, thaum hloov los ntawm kev kho mob los ntawm niam txiv lossis qhov ncauj ntawm opioids mus rau Durogesic, cov koob tshuaj yog xam raws li yav dhau los 24-teev xav tau analgesia.

Rau qhov muaj kev hloov pauv zoo los ntawm ib cov tshuaj rau lwm qhov, kev kho mob yav dhau los yuav tsum tau maj mam txiav tawm tom qab daim ntawv thov ntawm thawj zaug tshuaj ntawm Durogezik.

Yog tias qhov mob txaus tsim nyog tsis tiav tom qab thov kev siv thawj koob, tom qab 3 hnub kev noj tshuaj tuaj yeem tau nce ntxiv ntawm 25 μg / h, txawm li cas los xij, tus neeg mob lub cev thiab qhov xav tau qhov mob ntxiv yuav tsum tau coj mus rau hauv tus account (qhov ncauj ntawm morphine ntawm 90 mg / hnub kwv yees sib xws rau 25 μg / h Durogesic) Cov. Txhawm rau kom tau txais koob tshuaj ntau dua 100 μg / h, ntau TTC tuaj yeem siv ib txhij.

Yog tias "tawg ntho" mob tshwm sim, cov neeg mob yuav xav tau ntxiv cov koob tshuaj luv luv ua kom loog. Qee tus neeg mob yuav xav tau lwm txoj kev los sis lwm txoj hauv kev tswj hwm opioid analgesics thaum siv koob tshuaj ntau dua 300 mcg / h.

Cov lus qhia tshwj xeeb

Cov neeg mob uas tau tsim muaj kev mob tshwm sim loj yuav tsum tau saib xyuas hauv tsev kho mob zoo ib hnub tom qab tshem tawm Durogezik.

Cov tshuaj, ob leeg ua ntej thiab tom qab siv, yuav tsum khaws cia kom tsis ncav cov menyuam yaus.

Lub thaj tsis tuaj yeem raug puas ntsoog rau hauv txhua txoj kev thiab muab faib ua ntu lossis txiav, vim tias qhov no tuaj yeem ua rau tsis tuaj yeem tso tawm fentanyl.

Yog tias nws tsim nyog yuav tsum tsis txhob siv Durogezik, nws txoj kev hloov nrog lwm cov tshuaj opioids yuav tsum tshwm sim maj mam kom tsis txhob muaj kev cuam tshuam ntawm kev tshem tawm tus mob.

Cov tshuaj yuav cuam tshuam rau lub hlwb thiab lub cev txoj haujlwm tseem ceeb thaum ua tiav cov haujlwm txaus ntshai, xws li tsav lub tsheb lossis ua haujlwm nrog cov tshuab. Thaum kho, ib tug yuav tsum tsis kam tsav tsheb thiab ua cov haujlwm txaus ntshai uas yuav tsum muaj kev kub siab mloog thiab ceev ntawm cov kev puas hlwb psychomotor los ntawm tus neeg mob.

Tom qab siv, lub thaj yuav tsum tau muab tais nrog cov nplaum sab hauv sab hauv ib nrab thiab xa rov qab rau tus kws kho mob rau kev puas tsuaj ntxiv hauv qhov tau teev tseg. Cov plasters uas tsis siv lawm yuav tsum rov qab rau tus kws kho mob pov tseg.

• Los ntawm cov tshuaj nquag - Durogezik Matrix, Lunaldin, Fendivia,
• Los ntawm cov tshuab ntawm kev nqis tes ua - Bupranal, Ultiva, Prosidol, Dipidolor, Morphine, Palexia, Nopan, Promedol, Scanan, Fentanyl thiab lwm yam opioid narcotic analgesics.

Cov lus qhia rau kev siv Durogesic: txoj kev thiab ntau npaum li cas

Durogezik yog thov tshuaj pleev. TTS yuav tsum ua ntawv thov rau qhov chaw qhuav, tiaj tiaj ntawm daim tawv nqaij ntawm qaum caj npab los yog pob tw. Rau kev thov, nws raug nquahu kom xaiv ib qho chaw nrog kab plaub hau tsawg tshaj plaws. Cov plaub hau ntawm qhov chaw thov yuav tsum tau txiav tawm (tsis txhob chais. Yog tias qhov chaw thov yuav tsum tau ntxuav ua ntej siv Durogezik, qhov no yuav tsum tau ua nrog dej huv tsis tas siv xab npum, tshuaj pleev, roj lossis lwm yam, vim tias lawv tuaj yeem ua rau tawv nqaij lossis hloov pauv ntawm nws lub zog.

Muab cov nplaum Durogezik them sai li sai tau tom qab tshem nws tawm ntawm lub hnab ntim khoom. TTS ntawm thaj chaw thov yuav tsum tau nias kom khov nrog koj xib teg rau 30 vib nas this. Koj yuav tsum paub tseeb tias cov ntaub ntawv zoo haum ntawm daim tawv nqaij, tshwj xeeb nyob ib ncig ntawm cov npoo.

Durogezik yog tsim los rau 72 teev ntawm kev siv tas mus li. Cov txheej txheem tshiab tuaj yeem tsim kho ntxiv rau lwm qhov chaw ntawm daim tawv nqaij tom qab tshem tawm qhov ua ntej nplaum. TTS tsuas tuaj yeem raug nplaum rau hauv tib qho tawv nqaij tsuas yog so ntawm ob peb hnub.

Cov koob tshuaj ntawm cov tshuaj tau xaiv ib tus zuj zus nyob ntawm tus neeg mob tus mob (nws yuav tsum tau rov ntsuas dua tom qab txhua daim ntawv thov ntawm TTC).

Thaum siv Durogezic thawj zaug, qhov loj me ntawm cov kab ke (koob tshuaj) tau xaiv raws li kev siv yav dhau los ntawm opioid analgesics, tus neeg mob thiab qhov tsis haum siab. Hauv cov neeg mob uas tsis tau noj tshuaj opioids yav dhau los, qhov tshuaj tiv thaiv qis tshaj plaws yog qhov tau hais thaum xub thawj - 0.025 mg / h. Tib koob tshuaj yog siv rau cov neeg mob uas tau txais Promedol yav dhau los.

Thaum hloov ntawm daim ntawv ntawm niam txiv los yog ncauj ntawm opioids mus rau Durogesic hauv cov neeg mob opioid kam rau ua, cov koob tshuaj tau muab xam rau tus kheej.

Qhov kev ntsuas thawj zaug ntawm qhov siab tshaj plaws ua haujlwm ntawm cov tshuaj tsis tuaj yeem nqa tawm ua ntej 24 teev tom qab thov, vim maj mam nce ntxiv ntawm qhov kev xav ntawm fentanyl hauv cov ntshav dej.

Txog kev hloov pauv zoo los ntawm ib cov tshuaj rau lwm qhov, kev kho mob yav dhau los yuav tsum tau maj mam txiav tawm tom qab daim ntawv thov ntawm thawj zaug tshuaj ntawm Durogesic.

Yog tias hnov ​​mob nrawm nrawm tom qab thov kev thov thawj zaug tsis tiav, tom qab 3 hnub txoj kev txhaj tshuaj muaj peev xwm nce ntxiv. Ntxiv mus, nws muaj peev xwm nce qhov koob tshuaj txhua 3 hnub. Ib lub sijhawm, cov tshuaj feem ntau tau nce siab li 0.025 mg / teev, txawm li cas los xij, tus neeg mob lub cev thiab qhov xav tau ntxiv rau qhov quav yuav tsum tau siv rau hauv (qhov ncauj noj txhua hnub ntawm 90 mg morphine kwv yees sib haum rau Durogesic koob tshuaj 0.025 mg / h). Yuav kom ua tiav cov koob tshuaj ntau dua 0.1 mg / h, ntau TTC tuaj yeem siv ib txhij. Qee lub sijhawm, thaum "tawg" rau mob, cov neeg mob yuav tsum tau txhaj tshuaj ntxiv luv luv ua kom loog. Qee tus neeg mob, thaum siv Durogesic koob tshuaj ntau dua 0.3 mg / h, tej zaum yuav xav tau cov tshuaj ntxiv los yog lwm txoj hauv kev tswj hwm opioid analgesics.

Cev xeeb tub thiab lactation

Cov ntaub ntawv hais txog kev siv Durogesic rau cov poj niam cev xeeb tub yog suav tias yog qhov tsis txaus. Nws yuav tsum tsis txhob raug tshuaj thaum cev xeeb tub, tshwj tsis yog muaj mob ceev.

Kev siv cov tshuaj hauv kev yug menyuam yog contraindicated, txij li fentanyl kov yeej cov teeb meem placental thiab tuaj yeem ua rau muaj kev cuam tshuam ntawm cov pa ua pa hauv cov menyuam mos.

Fentanyl nyob hauv cov kua mis, muaj cov nyhuv sedative thiab tuaj yeem ua rau muaj teeb meem ua pa rau menyuam yaus. Hauv qhov no, nws tsis pom zoo rau siv thaum lactation.

Yeeb tshuaj sib cuam tshuam

Nrog rau siv ua ke ntawm Durogezic nrog qee yam tshuaj, cov teebmeem hauv qab no tuaj yeem tshwm sim:

• Lwm yam tshuaj uas muaj lub ntsej muag ua rau lub hauv nruab nrab cov hlab ntsha, nrog rau opioids, hypnotics thiab sedatives, phenothiazines, cov tshuaj loog dav dav, nruab nrab cov leeg nqaij, ua rau lub cev tsis muaj zog, antihistamines nrog sedative teebmeem, haus dej cawv: muaj kev pheej hmoo ntawm kev txhim kho thiab nce hypoventilation, txo qis ntawm cov leeg ntshav. siab, ntau dhau kev ua kom tsaug zog (kev sib koom tes kho yuav tsum tau tshwj xeeb saib xyuas tus neeg mob),
• Muaj Peev Xwm Cytochrome P Inhibitors₄₅₀ CYP3A4 (ritonavir): kev nce siab ntawm fentanyl hauv cov ntshav, uas ua rau muaj peev xwm txhim kho lossis ua kom ntev li ntawm kev kho mob thiab qhov tshwm sim ntawm cov kev mob tshwm sim (kev sib xyaw tsis pom zoo),
• Nitrous oxide: ua rau cov leeg ua kom muaj zog,
• Buprenorphine: qhov txo qis ntawm cov nyhuv ntawm Durogesic,
• Monoamine oxidase inhibitors: nce kev pheej hmoo ntawm kev mob nyhav.

Thaum ua ke nrog cov tshuaj insulin, glucocorticosteroids thiab antihypertensive tshuaj, nws yog qhov tsim nyog los txo cov koob tshuaj fentanyl.

Durogezik cov duab yeeb yaj kiab yog: Lunaldin, Fendivia, Dolforin, Fentadol Cov Dej, Fentadol Matrix, Dolforin, Durogezik Matrix.

Kev txheeb xyuas txog Durogezik

Yeej, lub network nthuav tawm kev soj ntsuam zoo txog Durogezik. Cov neeg mob qhia yooj yim ntawm kev siv thiab siv tau zoo thiab ntev thiab ntev (cov tshuaj siv tau ntev txog 3 hnub) daws qhov mob ntawm kev mob, uas ua rau muaj kev txhim kho tseem ceeb hauv lub neej zoo. Hom kev ua kom loog no yog qhov kev xav tau rau ntau tus neeg mob piv rau kev txhaj tshuaj tiv thaiv kab mob.

Cov neeg mob uas tau noj yav tas los morphine hais lus sau cia tias Durogezic pom zoo dua. Nws tseem tso cai rau koj kom tshem tawm ntawm quav tawv, uas feem ntau yog ib qho kev tawm tsam ntawm kev noj tshuaj morphine uas muaj cov tshuaj. Txawm li cas los xij, cov tshuaj tseem muaj cov kev mob tshwm sim, cov uas xeev siab thiab ntuav feem ntau hais tawm, nyob rau hauv tus neeg mob cais, cem quav. Xeev siab feem ntau ploj nws tus kheej hauv 5-7 hnub, tab sis qee zaus cov neeg mob yuav tsum noj tshuaj antiemetics hauv kev txhaj tshuaj me me. Kev puas siab puas ntsws tsis txhim kho nrog kev siv tshuaj. Qee zaum, tom qab daim ntawv thov ntawm Dyurogezik, kev tsis haum tshuaj hauv zos yog pom hauv daim ntawv ntawm hyperemia, uas dhau los ntawm nws tus kheej lossis tom qab noj tshuaj antihistamines.

Cov lus qhia rau siv Durogezik (qauv thiab npaum li cas)

Cov koob tshuaj ntawm Durogezik yog xaiv ntawm tus kheej nyob ntawm seb tus mob ntawm tus neeg mob.

Thawj koob tshuaj (qhov loj me ntawm cov kab ke) rau kev siv thawj zaug yog xaiv raws li yav dhau los siv cov tshuaj opioid analgesics, tus neeg mob tus mob thiab qib siab ntawm kev zam.

Hauv cov neeg mob uas tsis tau noj tshuaj opioid analgesics yav dhau los, qhov kev siv tshuaj qis tshaj 25 μg / h yog siv raws li kev siv thawj zaug. Yog tias tus neeg mob tau txais yav dhau los ntawm Promedol, Durogesic tau sau tseg nyob rau tib qho.

Kev hloov ntawm daim ntawv ntawm niam txiv los yog ntawm ncauj ntawm opioid analgesics mus rau Durogesic hauv cov neeg mob uas ua siab ntev rau opioids yuav tsum tau ua nyob rau hauv qab no:

• Xam tus dhau los 24-teev qhov xav tau analgesia.
• Hloov cov nyiaj no rau qhov sib npaug ntawm qhov ncauj ntawm morphine raws li lub rooj 1. Txhua qhov ncauj thiab IM ntawm cov tshuaj opioid analgesics uas pom hauv lub rooj yog sib npaug hauv cov nyhuv analgesic rau 10 mg IM morphine.
• Xaiv cov tshuaj yuav tsum tau 24-teev ntawm morphine rau tus neeg mob thiab muab koob tshuaj ntawm Durogesic.

Koob xaiv thiab kho kev kho

TTS Durogezik yog qhov yuav tsum tau hloov nrog lub zog tshiab txhua txhua 72 teev. Qhov koob tshuaj tau tsim nyob ntawm qhov ua tiav ntawm qhov tsim nyog txhaj tshuaj loog.

Yog tias tshuaj loog tsis tiav tom qab siv cov tshuaj thawj zaug, tom qab 3 hnub qhov tshuaj yuav nce ntxiv. Tom qab ntawd lub koob txhaj tshuaj tuaj yeem nce nrog qhov luv ntawm 3 hnub. Feem ntau, qhov tshuaj tau nce ntxiv los ntawm 25 mcg / h nyob rau ib lub sijhawm.

Txhawm rau kom tau txais koob tshuaj ntau dua 100 μg / h, ntau TTCs tuaj yeem siv tau cov kev nkag siab.

Cov neeg mob niaj zaus yuav tsum tau txhaj ntxiv ntawm qhov ua yeeb yam luv luv thaum ua pob “tawg” tshwm sim. Qee tus neeg mob xav tau lwm txoj kev los sis lwm txoj hauv kev los ntawm opioid analgesics thaum siv koob tshuaj Durogesic ntau tshaj 300 mcg / h.

Sab sij huam

Kev siv cov tshuaj Durogezik tuaj yeem ua rau cov kev mob tshwm sim hauv qab no:

• Nruab nrab thiab ntu ntu mob hlwb: mob taub hau, tsaug zog, ntxhov siab, tsis meej xeeb, hnov ​​qab, tsis nco qab, kev nyuaj siab, qee zaum paresthesia, euphoria, amnesia, insomnia, tshee, ntxhov siab.
• Kab mob hlab ntsha hauv plawv: txo cov ntshav siab, txha ntshav, ntshav siab, tachycardia.
• Lub plab zom mov: qhov ncauj qhuav, xeev siab, cem quav, ntuav, dyspepsia, biliary colic (hauv cov neeg mob uas muaj keeb kwm ntawm lawv), qee zaum - raws plab.
• Kab mob ua pa: bronchospasm, hypoventilation thiab ua pa nyuaj siab (nrog kev siv tshuaj ntau dhau), hauv qee kis tsawg - ua tsis taus pa.
• Cov tshuaj tiv thaiv hauv zos: erythema, tawv nqaij ua pob thiab khaus ntawm qhov chaw ntawm daim ntawv thov.
• Lwm yam: ua kom tawm hws, tso zis cia, ua kom cov leeg nyob ib ntus (suav nrog pectoral), khaus, ua siab ntev, nrog rau kev mob hlwb thiab lub cev, nyob rau hauv cov xwm txheej tsawg, deev tsis txaus, asthenia thiab tshem tawm mob.

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

Qhov kho mob hloov kho (TTC) nrog qhov sib tiv tauj ntawm thaj tsam ntawm 10 cm2 thiab fentanyl tso tus nqi ntawm 25 μg / h yog cov duab plaub sib dhos nrog cov fab sib npaug, uas muaj pob tshab rau pob tshab, cov ntawv sau "25 μg / h" yog xim liab sab nraud ntawm thaj. 1 TTC fentanyl 2.5 mg
Cov muaj mob: hydroxyethyl cellulose, ethanol, cov dej huv.
Cov sib xyaw ua ke ntawm cov tiv thaiv sab nrauv lub plhaub TTC: ib lub tshuab luam ntawv ntawm polyester thiab ethylene vinyl acetate.
Cov muaj pes tsawg leeg ntawm cov pas dej muaj cov tshuaj nquag: ib cov kua dej aqueous gel raws li hydroxyethyl cellulose.
Kev sib xyaw ua ke ntawm kev tso tawm tso ntawm TTC, tswj kev tso tawm ntawm fentanyl: ethylene vinyl acetate.
Kev Sau Ua ke ntawm cov yeeb yaj kiab tiv thaiv: cov nplaum silicone nplaum txheej yog coated nrog zaj duab xis ntawm fluorocarbon diacrylate thiab polyester.
1 pc - hnab (5) - pob ntawm cardboard.
Qhov kev kho mob hloov pauv (TTC) nrog qhov sib tiv tauj ntawm thaj tsam ntawm 20 cm2 thiab fentanyl tso tawm ntawm 50 μg / h, yog qhov pom zoo muaj cov duab sib dhos nrog cov sib npaug, uas muaj pob tshab rau pob tshab, nyob sab nraud ntawm thaj yog muaj lub teeb ntsuab inscription “50 μg / h”. 1 TTC fentanyl 5 mg
Cov muaj mob: hydroxyethyl cellulose, ethanol, cov dej huv.
Cov sib xyaw ua ke ntawm cov tiv thaiv sab nrauv lub plhaub TTC: ib lub tshuab luam ntawv ntawm polyester thiab ethylene vinyl acetate.
Cov muaj pes tsawg leeg ntawm cov pas dej muaj cov tshuaj nquag: ib cov kua dej aqueous gel raws li hydroxyethyl cellulose.
Kev sib xyaw ua ke ntawm kev tso tawm tso ntawm TTC, tswj kev tso tawm ntawm fentanyl: ethylene vinyl acetate.
Kev Sau Ua ke ntawm cov yeeb yaj kiab tiv thaiv: cov nplaum silicone nplaum txheej yog coated nrog zaj duab xis ntawm fluorocarbon diacrylate thiab polyester.
1 pc - hnab (5) - pob ntawm cardboard.
Cov kev kho mob hloov pauv (TTC) nrog qhov sib tiv tauj thaj tsam ntawm 30 cm2 thiab fentanyl tso tawm ntawm 75 μg / h, yog qhov pom zoo muaj cov duab sib dhos nrog cov npawv sib npaug, uas muaj pob tshab rau pob tshab, cov ntawv sau "75 μg / h" yog xim xiav nyob sab nraud ntawm thaj. 1 TTS fentanyl 7,5 mg
Cov muaj mob: hydroxyethyl cellulose, ethanol, cov dej huv.
Cov sib xyaw ua ke ntawm cov tiv thaiv sab nrauv lub plhaub TTC: ib lub tshuab luam ntawv ntawm polyester thiab ethylene vinyl acetate.
Cov muaj pes tsawg leeg ntawm cov pas dej muaj cov tshuaj nquag: ib cov kua dej aqueous gel raws li hydroxyethyl cellulose.
Kev sib xyaw ua ke ntawm kev tso tawm tso ntawm TTC, tswj kev tso tawm ntawm fentanyl: ethylene vinyl acetate.
Kev Sau Ua ke ntawm cov yeeb yaj kiab tiv thaiv: cov nplaum silicone nplaum txheej yog coated nrog zaj duab xis ntawm fluorocarbon diacrylate thiab polyester.
1 pc - hnab (5) - pob ntawm cardboard.
Cov kab mob hloov kab mob (TTS) nrog qhov sib tiv tauj thaj tsam ntawm 40 cm2 thiab fentanyl tso tawm tus nqi ntawm 100 μg / h, yog qhov pom tseeb cov duab sib dhos nrog cov npawv sib npaug, uas muaj pob tshab rau pob tshab, nyob sab nraud ntawm thaj muaj qhov sau txho “100 μg / h”. 1 TTC fentanyl 10 mg
Cov muaj mob: hydroxyethyl cellulose, ethanol, cov dej huv.
Cov sib xyaw ua ke ntawm cov tiv thaiv sab nrauv lub plhaub TTC: ib lub tshuab luam ntawv ntawm polyester thiab ethylene vinyl acetate.
Cov muaj pes tsawg leeg ntawm cov pas dej muaj cov tshuaj nquag: ib cov kua dej aqueous gel raws li hydroxyethyl cellulose.
Kev sib xyaw ua ke ntawm kev tso tawm tso ntawm TTC, tswj kev tso tawm ntawm fentanyl: ethylene vinyl acetate.
Kev Sau Ua ke ntawm cov yeeb yaj kiab tiv thaiv: cov nplaum silicone nplaum txheej yog coated nrog zaj duab xis ntawm fluorocarbon diacrylate thiab polyester.
1 pc - hnab (5) - pob ntawm cardboard.

Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv.

Pharmacological ua Durogezik

Ib qho opioid analgesic rau kev siv transdermal. Fentanyl yog qhov hluavtaws analgesic uas sib cuam tshuam nrog feem ntau ntawm mu-opioid receptors. Nws yog rau npe II ntawm cov tshuaj yeeb tshuaj, tshuaj yeeb tshuaj thiab tshuaj lawv tus neeg tso cai, tau pom zoo los ntawm tsab cai ntawm tsoomfwv Lavxias No. 681 ntawm 06/30/98. Tsub kom ntau ntxiv cov haujlwm ntawm cov tshuaj tiv thaiv antinociceptive, nce qhov pib ntawm kev hnov ​​mob mob. Nws cuam tshuam kev xa ntawm kev tshaj tawm raws cov kev mob thiab tsis mob tshwj xeeb mus rau nuclei ntawm thalamus, hypothalamus, thiab amygdala complex.
Lub ntsiab kev kho mob ntawm cov tshuaj yog analgesic thiab sedative. Kev siv tshuaj loog tsawg kawg ntawm fentanyl hauv plasma hauv cov neeg mob uas tsis tau siv yav dhau los ua opioid analgesics yog 0.3-1.5 ng / ml. Lub sijhawm tag nrho ntawm cov tshuaj yog 72 teev
Nws muaj qhov cuam tshuam uas ua rau lub chaw ua pa tsis txaus, ua rau lub plawv dhia ceev, ua rau thaj chaw ntawm lub chaw mos thiab lub chaw ntuav. Ua kom lub suab nrov ntawm cov nqaij ntshiv ntawm cov pob txha, ua kom lub plab (suav nrog cov zis, zais zis, hnoos qeev ntawm Oddi), txo cov plab hnyuv kom muaj zog, txhim kho lub nqus dej ntawm cov hnyuv. Zoo tsis muaj kev cuam tshuam rau cov ntshav siab, txo cov ntshav khiav rov qab. Hauv cov ntshav nce cov ntsiab lus ntawm amylase thiab lipase.
Txhawb nqa qhov pib ntawm kev pw tsaug zog. Ua rau euphoria.
Tus nqi ntawm kev txhim kho ntawm kev quav tshuaj thiab thev taus rau cov nyhuv analgesic yog tus cwj pwm los ntawm tus neeg sib txawv.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

Cov koob tshuaj ntawm Durogezic yuav tsum tau xaiv ib tus zuj zus nyob ntawm tus mob ntawm tus neeg mob thiab nws qhov tsis txaus tom qab daim ntawv thov ntawm TTC raug tshuaj xyuas tas li.
Thawj koob tshuaj (qhov loj me ntawm cov kab ke) rau kev siv thawj zaug yog xaiv raws li yav dhau los siv cov tshuaj opioid analgesics, qib ntawm kev zam thiab qhov mob ntawm tus neeg mob.
Hauv cov neeg mob uas tsis tau noj tshuaj opioid analgesics yav dhau los, koob tshuaj qis tshaj plaws ntawm Durogesic, 25 μg / h, yog siv ua thawj koob. Cov tshuaj tau sau tseg rau hauv tib lub tshuaj yog tias tus neeg mob yav dhau los tau txais promedol.
Txoj kev hloov ntawm qhov ncauj los yog daim ntawv ntawm niam txiv ntawm opioid analgesics mus rau Durogesic hauv cov neeg mob uas ua siab ntev rau opioids yuav tsum tau ua raws cov qib hauv qab no.
1. Suav tshuaj ntawm 24-teev qhov xav tau analgesia.
2. Hloov qhov nyiaj no rau qhov sib npaug ntawm qhov ncauj ntawm morphine raws li cov lus 1. Txhua IM thiab noj ntawm opioid analgesics uas muab rau hauv cov lus no yog sib npaug hauv cov nyhuv analgesic rau 10 mg IM morphine.
3. Hauv cov lus 2, pom qhov yuav tsum tau txhaj 24 xuab moos ntawm morphine rau tus neeg mob thiab cov tshuaj txhaj ntawm Durogesic.
Cov lus 1. Hloov mus rau qhov sib npaug analgesic koob Lub npe ntawm cov tshuaj Sib piv Cov tshuaj analgesic koob tshuaj (mg) i / m * qhov ncauj Morphine 10 30 (nrog rau kev tswj hwm tsis tu ncua) ** 60 (nrog ib lossis ib ntus tswj) Omnopon 45 - Hydromorphone 1.5 7.5 Tshuaj txiav yeeb 10 20 Oxycodone 15 30 Levorphanol 2 4 Oxymorphone 1 10 (kho) Diamorphine 5 60 Petidine 75 - Codeine 130 200 Buprenorphine 0.3 0.8 (sublingual)

* Cov koob tshuaj ntawm qhov ncauj no raug pom zoo thaum hloov los ntawm niam txiv mus rau txoj kev tswj hwm ntawm ncauj.

** Qhov sib piv ntawm lub zog ntawm kev nqis tes ntawm morphine hauv kev siv tshuaj intramuscular / qhov ncauj ntawm kev tswj hwm, sib npaug li 1: 3, yog ua raws li cov kev paub hauv cov chaw kho mob tau txais hauv kev kho mob ntawm cov neeg mob uas mob mob.
Cov Lus 2. Pom zoo koob tshuaj Durogesic (nyob ntawm qhov ncauj noj ntawm morphine txhua hnub) * Qhov ncauj niaj hnub ntawm morphine (mg / hnub) Kev noj tshuaj ntawm Durogesic (/g / h) 2013-03-20

Lub Npe Tsis Muaj Npe International

Feem ntau kws kho mob sau ntawv muab tshuaj rau cov ntawv hauv Latin. Phentanylum (fentanyl) - lub npe ntawm cov tshuaj nquag ntawm cov tshuaj.

Durogezik yog ib qho ntawm cov tshuaj uas muaj analgesic thiab sedative cuam tshuam.

N02AB03 - kev cai rau cov hom paub tab thiab kho tshuaj.

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm cov duab plaub nrog cov pob tshab nkig uas muaj nyob hauv nws.

Cov tshuaj sib xyaw ua ke ntawm cov tshuaj suav nrog fentanyl. Tus nqi ntawm tso tawm ntawm cov neeg ua xiam hlwb yog 25 μg / h thiab 50 μg / h.

Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm cov duab plaub nrog cov pob tshab nkig uas muaj nyob hauv nws.

Nrog saib xyuas

Nws tsis pom zoo kom siv thaj chaw transdermal hauv ntau qhov teeb meem no:

1. Nyob rau hauv muaj ntawm mob ntsws ntev.
2. Thaum muaj kev kub siab intracranial nce.
3. Nrog rau qhov txo qis hauv cov ntshav siab.
4. Nrog lub raum tsis ua haujlwm lossis mob rau cov kabmob hepatic.
   Durogesic yog siv rau cov kev mob neuropathic uas tshwm sim nrog ntau yam sclerosis thiab mob ntshav qab zib polyneuropathy (cov kev hloov pauv hauv cov hlab ntaws).
   Cov tshuaj yog tawm rau mob hnyav hauv qhov mob qog ua hlav.
   Durogezik raug pom zoo thaum muaj mob phantom mob rau cov kab mob ntawm cov leeg hlwb.
   Durogesic tsis pom zoo rau siv rau hauv qhov muaj cov kab mob ntsws.
   Lub thaj tsis siv nyob rau hauv kev txiav txim ntawm nce intracranial siab.
   Durogezik tsis pom zoo rau kev txo ntshav siab.
   
   
   
   
   

Tso kua nplaum rau qhov twg

Cov khoom lag luam yuav tsum raug siv rau hauv qhov chaw qhuav ntawm daim tawv nqaij ntawm lub nqaj los yog xub pwg. Nws yog qhov tseem ceeb ua ntej mus chais plaub hau ntawm daim tawv nqaij. Koj tsis tuaj yeem siv ntau cov tshuaj pleev ib ce rau lub cev ua ntej siv thaj ua rau kom tsis txhob muaj kev fab tshuaj lossis txo qhov ua tau zoo ntawm kev kho mob ntawm cov tshuaj.

Nws tsis pom zoo los lo rau thaj av ntawm thaj chaw ntawm daim tawv nqaij, yam tsis tau saib xyuas lub sijhawm sib nrug (tsis ntau tshaj 5-7 hnub).

Siv thaum cev xeeb tub thiab lactation

Kev siv ntawm thaj ua rau yog contraindicated rau cov poj niam cev xeeb tub. Siv cov khoom lag luam thaum pub niam mis tuaj yeem ua rau cuam tshuam ntawm kev ua pa ntawm tus menyuam.

Kev siv ntawm thaj ua rau yog contraindicated rau cov poj niam cev xeeb tub.

Cawv tau zoo

Nws tsis pom zoo kom haus cawv thaum lub sijhawm kho opioid.

Nws tsis pom zoo kom haus cawv thaum lub sijhawm kho opioid.

Fentadol Matrix thiab Fendivia muaj fentanyl.