Cov lus qhia Zeptol rau kev siv, contraindications, phiv, tshuaj xyuas

Cov tshuaj antiepileptic muab tau los ntawm tricyclic iminostilbene.
Tshuaj: ZEPTOL

Cov tshuaj nquag ntawm cov tshuaj: carbamazepine
ATX Encoding: N03AF01
KFG: Anticonvulsant
Npe sau npe: P No. 011348/01
Hnub sau npe: 07.07.06
Tswv reg reg. Qib: Tshav Muag Khoom Tuam Txhab Lag Luam Ltd.

Zeptol tso tawm daim ntawv, ntim tshuaj thiab muaj pes tsawg leeg.

Ntsiav tshuaj
1 tab
carbamazepine
200 mg

10 Pcs - aluminium ib daim hlab (10) - pob ntawm cardboard.

Xim av-txheej pab-tso cov ntsiav tshuaj hloov puag ncig, biconvex, nrog kev pheej hmoo ntawm ib sab.

1 tab
carbamazepine
200 mg

Cov kev zam: ethyl cellulose, microcrystalline cellulose, hmoov txhuv nplej siab, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, eudrazit E100, titanium dioxide, polyethylene glycol 6000, liab hlau oxide, hlau oxide daj.

10 Pcs - pob tsis muaj contour ntawm tes (3) - pob khoom los ntawm cardboard.

Xim av-txheej pab-tso cov ntsiav tshuaj hloov puag ncig, biconvex, nrog kev pheej hmoo ntawm ib sab.

1 tab
carbamazepine
400 mg

Cov kev zam: ethyl cellulose, microcrystalline cellulose, hmoov txhuv nplej siab, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, Eudraite E100, titanium dioxide, polyethylene glycol 6000, liab hlau oxide, hlau oxide daj, 2208 hydroxypropyl methyl cellulose.

10 Pcs - pob tsis muaj contour ntawm tes (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 kev txiav txim siab ntawm Zeptol

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 ntau zaus 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.

Sab nyhuv ntawm Zeptol:

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 Zeptol.

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 cuam tshuam ntawm Zeptol nrog lwm cov 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 kev siv tib lub sijhawm ntawm valproic acid thiab carbamazepine, kev txhim kho ntawm hepatotoxic nyhuv muaj peev xwm ua tau (thaj, vim muaj kev tsim cov txheej txheem ntawm cov metabolite 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 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 txo qis ntawm carbamazepine hauv ntshav ntshav, nrog tetracycline, cuam tshuam ntawm carbamam.

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.

Tsuas tshuaj thiab tswj hwm

Ntsiav tshuaj sab hauv, cov neeg laus thiab cov hluas uas muaj hnub nyoog tshaj 15 xyoos nrog qaug dab peg thiab neuralgia thawj koob tshuaj - 200 mg 1-2 zaug hauv ib hnub nrog kev maj mam nce ntxiv (100 mg nrog ncua sijhawm 1 lub lis piam) mus rau kev kho mob kom zoo dua qub - 600-1200 mg / hnub (ntau kawg txhua hnub koob - 1.8 g). Nrog manic-depressive psychosis koob tshuaj thawj zaug yog 400 mg / hnub, muab faib ua 2 koob tshuaj, nrog kev maj mam nce mus rau 600 mg / hnub (qhov siab tshaj plaws ib hnub ib zaug). Cov menyuam hnub nyoog qis dua 1 xyoos (2 zaug hauv ib hnub) - 100-200 mg / hnub, 1-5 xyoos - 200-400 mg / hnub, 5-10 xyoo - 400-600 mg / hnub, 11-15 xyoo - 600-1000 mg / hnub

Coated Retard ntsiav tshuaj: sab hauv, thaum lossis tom qab noj mov nrog kua me ntsis. Nrog qaug dab peg: cov laus, cov koob tshuaj pib - 200 mg 1-2 zaug hauv ib hnub, tom qab ntawd cov tshuaj yog maj mam nce rau qhov zoo - 400 mg 2-4 zaug hauv ib hnub. Cov menyuam yaus: ntawm tus nqi ntawm 10-20 mg / kg, 4-12 hlis - 100-200 mg hauv 1-2 koob, 1-5 xyoo - 200-400 mg hauv 1-2 koob, 5-10 xyoo - 400-600 mg hauv 2-3 koob, 10-15 xyoo - 600-1000 mg hauv 3 koob.

Mob hlwb neuralgia: qhov kev pib siv yog 200-400 mg / hnub, tom qab ntawd qhov koob tshuaj yog maj mam nce ntxiv, yog tias tsim nyog, nce mus txog 600-800 mg nyob rau hauv ob peb koob tshuaj. Tom qab qhov ploj ntawm kev hnov mob, qhov koob tshuaj yog maj maj txo mus rau 200 mg / hnub.

Kev tiv thaiv ntawm kev cuam tshuam kev cuam tshuam: hauv thawj lub lis piam, koob tshuaj txhua hnub yog 200-400 mg, hauv koob tshuaj tom qab txhua hnub tau nce (los ntawm 1 ntsiav tshuaj hauv ib lub lis piam) txog 1000 mg thiab noj rau 3-4 koob.

Lub sijhawm tiv thaiv ntawm kev kho yog teem rau tus kheej.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

cov ntsiav tshuaj: tiaj, puag ncig, dawb, ntawm ib sab nrog tus cim "ZEPTOL 200" thiab ib qho bevel, ntawm lwm qhov uas muaj txoj kab sib faib (10 pcs. hauv ib daim ntawv ntawm txhuas ntawv nyiaj, hauv ib pob ntawv ntawm 10 strips),
zaj duab xis-coated txuas ntxiv cov ntsiav tshuaj: biconvex, puag ncig, lub teeb xim av, nrog kev pheej hmoo ntawm ib sab (10 pcs. hauv ib daim ntawv ntawm txhuas ntawv ci, hauv ib pob ntawv ntawm 3 daim hlau).

Txhua pob ntawv kuj muaj cov lus qhia rau kev siv Zeptol.

1 ntsiav tshuaj muaj:

cov tshuaj nquag: carbamazepine - 200 mg,
cov khoom siv ntxiv: hypromellose 2910 (Metocel E5), colloidal silicon dioxide, microcrystalline cellulose, pob kws nplej, povidone K 30, sodium propyl parahydroxybenzoate (sodium propyl paraben), bronopol, purified magnesium stearate, talc purified, sodium lauryl sulfate, sodium carboxymeth.

Hauv 1 lub ntsiav tshuaj, lub sijhawm ntev ua, zaj duab xis-txheej, muaj:

cov tshuaj nquag: carbamazepine - 200 lossis 400 mg,
cov khoom siv ntxiv: hypromellose 2208 (Metocel K4M) - rau qhov ntau ntawm 400 mg, microcrystalline cellulose, ethyl cellulose M50, pob kws nplej, colloidal silicon dioxide, purified talc, magnesium stearate, croscarmellose sodium,
zaj duab xis txheej: ib qho copolymer ntawm butyl methacrylate, dimethylaminoethyl methacrylate thiab methyl methacrylate (1: 2: 1) (Eudragit E-100), macrogol 6000 (polyethylene glycol 6000), huv si talc, magnesium stearate, titanium dioxide, hlau zas xim liab oxide thiab daj oxide.

Cov Tshuaj Hauv Tshuaj

Carbamazepine yog ib qho kev tso tawm ntawm iminostilbene, uas ua kom pom cov nyhuv anticonvulsant (antiepileptic) thiab cov tshuaj tiv thaiv kab mob (thymoanaleptic), muaj tshuaj tiv thaiv kab mob ib ce thiab kev tiv thaiv tsis zoo. Cov tshuaj kuj qhia tau txog cov khoom ua kom loog, tshwj xeeb hauv cov neeg mob nrog trigeminal neuralgia.

Lub tshuab ntawm kev txiav txim ntawm cov tshuaj nquag tsis to taub tag nrho. Nws tau kwv yees tias nws cov nyhuv anticonvulsant yog vim qhov txo qis ntawm lub peev xwm ntawm neurons los muab qhov siab ntawm qhov tshwm sim ntawm cov kev rov ua dua uas muaj peev xwm ua rau muaj kev cuam tshuam ntawm kev ua si ntawm sodium channel. Tsis tas li ntawd, nws zoo nkaus li thaiv qhov tso tawm cov neurotransmitters los ntawm inhibiting presynaptic sodium channel thiab rov tshwm sim ntawm qhov kev txiav txim siab zoo kuj tseem ceeb, uas ua rau txo qis ntawm kev xa xov synaptic.

Cov txheej txheem ntawm kev ua ntawm carbamazepine yog yuav cuam tshuam nrog gamma-aminobutyric acid receptors (GABA), uas tej zaum yuav cuam tshuam nrog cov calcium calcium. Tej zaum, qhov kev cuam tshuam tau siv los ntawm cov tshuaj nquag ntawm cov kab ke ntawm cov qauv ntawm cov neurotransmission tsis muaj qhov tseem ceeb. Qhov antidiuretic nyhuv ntawm carbamazepine tuaj yeem cuam tshuam nrog hypothalamic ntxim rau osmoreceptors, nqa los ntawm kev cuam tshuam lub zais cia ntawm antidiuretic hormone (ADH), thiab tseem ua rau muaj kev cuam tshuam ncaj qha rau lub raum plab hlaub.

Qhov ua tau zoo ntawm cov tshuaj antiepileptic tau sau tseg hauv kev kho mob ntawm tonic-clonic qaug dab peg, focal (ib nrab) mob leeg huam, uas tau nrog lossis tsis nrog los ntawm theem nrab dav dav, nrog rau kev sib txuas ntawm cov hom mob saum toj no. Raws li txoj cai, kev siv ntawm Zeptol yog qhov tsis muaj txiaj ntsig rau qhov me me qaug dab peg - petit mal, myoclonic qaug dab peg thiab tsis tuaj.

Thaum lub sijhawm kho carbamazepine rau cov neeg mob vwm (tshwj xeeb tshaj yog rau menyuam yaus thiab tub ntxhais hluas), qhov txo qis ntawm qhov kev mob tshwm sim ntawm kev ntxhov siab thiab kev ntxhov siab tau sau tseg, thiab cov tshuaj kuj tseem ua rau txo qis kev txob taus thiab kev txhoj puab heev. Qhov ntsuas ntawm lub zog ntawm cov tshuaj nquag ntawm psychomotor indices thiab kev txawj ntse ua haujlwm yog nyob ntawm nws cov koob tshuaj. Cov nyhuv anticonvulsant yuav pib tshwm sim tom qab ob peb teev lossis tom qab ob peb hnub (qee lub sijhawm yuav luag 1 lub hlis tom qab vim kev pib-pib ntawm cov metabolism).

Tawm tsam keeb kwm ntawm qhov tseem ceeb thiab theem nrab trigeminal neuralgia, feem ntau ntawm cov neeg mob, carbamazepine tawm tsam qhov tshwm sim ntawm kev hnov mob. Qhov ua kom tsis muaj zog ntawm kev hnov mob nrog trigeminal neuralgia yog pom tom qab 8-7 teev.

Zeptol muab rau kev haus cawv haus cawv muaj kev nce qib pib ntawm kev tuaj yeem tawm tsam, uas, raws li txoj cai, raug txo qis rau qhov xwm txheej no, thiab txo qhov mob hnyav ntawm cov tsos mob ntawm tus mob no (mob tshee, nce ntxiv kev chim siab, gait tsis meej).

Antimaniacal (kev ua haujlwm tiv thaiv kev ua haujlwm) yog tsau tom qab 7-10 hnub thiab tej zaum vim yog kev tsuj cov metabolism hauv norepinephrine thiab dopamine.

Kev tswj cov qib carbamazepine ntau nyob rau hauv cov ntshav yog ua kom paub tseeb los ntawm kev siv lub sijhawm ntev ntawm cov tshuaj 1-2 zaug hauv ib hnub.

Pab txhawb nqa cov ntsiav tshuaj

epilepsy: mob yooj yim / ib nrab ntawm cov qaug dab peg qaug dab peg (nrog lossis tsis nco qab txiav txim siab) nrog lossis tsis muaj theem nrab dav dav, feem ntau tonic-clonic qaug dab peg qaug dab peg, sib xyaw ntawm cov qaug dab peg,
cov leeg mob neurogenic thiab trigeminal neuralgia,
idiopathic neuralgia ntawm lub pob ntseg hlab ntsha, qhov raug thiab atypical trigeminal neuralgia hauv ntau yam sclerosis thiab idiopathic trigeminal neuralgia,
mob hauv cov ntshav qab zib neuropathy, mob hauv qhov txhab ntawm qhov hlab ntsha txhaws nyob rau hauv muaj ntshav qab zib mellitus, polyuria thiab polydipsia ntawm neurohormonal xwm tiv thaiv ntshav qab zib mellitus ntawm hauv paus chiv keeb,
haus dej cawv haus cawv (kev ua kom qaug, ntau dhau kev npau taws, ntxhov siab vim, pw tsaug zog),
mob hnyav rau cov neeg mob thiab txhawb txoj kev kho mob bipolar cuam tshuam rau kev tiv thaiv kom tsis txhob ua kom lub zog txav tsis taus lossis ua kom lub cev tsis muaj zog txaus los kho lawv cov kev kuaj mob.

Cov Yuav Tsum Tau Ua

Tsis rau tag nrho ob daim ntawv muab tshuaj:

kev cuam tshuam ntawm cov hlwb pob txha hematopoiesis (mob ntshav khov, mob leukopenia),
atrioventricular block (AV thaiv),
ua ke siv nrog lithium npaj thiab monoamine oxidase inhibitors (MAO),
muaj qhov tsis haum xeeb rau ib qho twg ntawm Zeptol, ntxiv rau cov tshuaj muaj cov qauv carbamazepine, piv txwv li, tricyclic antidepressants.

Cov tshuaj tiv thaiv ntxiv rau cov ntsiav tshuaj ua haujlwm ntev:

keeb kwm ntawm ntu ntawm inhibition ntawm pob txha hlwb hematopoiesis lossis ib yam ntawm cov porphyria,
hnub nyoog txog li 4 xyoos.

Ib qho ntxiv contraindication rau Zeptol nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj yog mob sib quas ntus porphyria (suav nrog hauv keeb kwm).

Tus txheeb ze (siv tshuaj antiepileptic nrog kev ceev faj):

decompensated mob plawv tsis ua hauj lwm (CHF),
ua rau lub raum thiab / lossis lub siab ua haujlwm,
kev tso tawm hyponatremia: tsis txaus adrenal cortex tsis txaus, ADH hypersecretion syndrome, hypothyroidism, hypopituitarism,
prostatic hyperplasia,
inhibition ntawm cov pob txha mob hematopoiesis, kev siv tshuaj kho mob (keeb kwm),
siab intraocular,
nquag haus cawv, vim hais tias vim qhov kev tsim txom ntawm kev ua tsis tau ntawm lub hauv nruab nrab cov hlab hlwb (CNS), cov biotransformation ntawm carbamazepine yog kho kom zoo,
laus lawm
ua ke siv nrog sedative-hypnotics.

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

Cov ntsiav tshuaj Zeptol noj ntawm qhov ncauj nrog kua me me thaum lub sijhawm, tom qab noj mov lossis nruab nrab ntawm cov pluas noj. Cov tshuaj muaj peev xwm tau sau tseg ob qho tib si hauv kev kho mob monotherapy thiab ua ib feem ntawm kev kho mob zoo.

Cov ntsiav tshuaj uas pab txhawb nqa-tso tawm yuav tsum nqos 1 tagnrho, lossis, yog tus kws kho mob sau ntawv, ½, tsis yog zom. Txij li cov tshuaj yeeb dej caw tso tawm maj mam thiab maj mam los ntawm lub sijhawm ntev-tso cov ntsiav tshuaj, Zeptol yuav tsum noj 2 zaug hauv ib hnub, kev kho mob zoo tshaj plaws yog txiav txim los ntawm tus kws kho mob. Yog tias nws yuav tsum tau hloov pauv los ntawm kev siv cov ntsiav tshuaj ib txwm ua rau noj ntev, raws li kev paub dhau los, qee cov neeg mob yuav tsum tau nce ntxiv ntawm cov tshuaj yav dhau los.

Hauv kev kho mob ntawm kev mob vwm, nws raug nquahu kom muab cov ntsiav tshuaj Zeptol hauv txoj kev kho tshuaj. Nws yog ib qho tsim nyog yuav tsum pib siv cov tshuaj nrog tshuaj me me txhua hnub, uas yuav tsum tau maj mam nce ntxiv kom txog thaum cov nyhuv xav tau tiav. Hauv kev xaiv cov tshuaj noj zoo tshaj plaws, nws raug nquahu kom txiav txim siab txog qib carbamazepine hauv ntshav ntshav. Cov xwm txheej ntawm Zeptol mus rau yav tas los ua qhov kev kho mob antiepileptic, nws txoj kev ua raws li tau maj mam, thaum cov tshuaj ntawm cov tshuaj uas twb tau txais tsis hloov, tab sis yog tias tsim nyog, lawv ua qhov tsim nyog kho. Yog tias tus neeg mob tsis nco qab noj tshuaj ntxiv ntawm carbamazepine kom raws sijhawm, nws yuav tsum ua sai li sai tau thaum qhov kev rho tawm no tau pom, txawm li cas los xij, koj tsis tuaj yeem siv ob zaug ntawm Zeptol.

Pom zoo kom noj tshuaj raws li cov cim:

epilepsy: cov neeg laus noj Zeptol 1-2 zaug ib hnub nyob rau hauv thawj zaug ntawm 100-200 mg, tom qab ntawd qhov koob tshuaj tau maj mam nce mus rau 400-600 mg 2 zaug hauv ib hnub, qhov siab tshaj plaws txhua hnub koob tshuaj yuav tsum tsis pub tshaj 1600-2000 mg, hauv cov menyuam yaus hnub nyoog qis dua 4 xyoos kev txais tos tuaj yeem pib nrog kev noj tshuaj 100 mg ib hnub, tom qab ntawd txhua lub lis piam tuaj yeem nce ntxiv los ntawm 100 mg, cov menyuam hnub nyoog 4 xyoos thiab qis dua tau xaj kom tau Zeptol (ntsiav tshuaj) hauv ib hnub pib ntawm 20-60 mg thiab tom qab ntawd nce nws ntxiv txhua lwm hnub los ntawm 20– 60 mg, txhawb cov tshuaj txhua hnub rau cov menyuam yaus, tau tsim kho ntawm tus nqi ntawm 10-20 mg / kg, faib los ntawm n ob peb txais txiaj ntsig, kev tu xyuas pom zoo kom noj tshuaj txhua hnub hauv cov menyuam rau cov ntsiav tshuaj (raws li hnub nyoog): tsawg dua 1 xyoos - 100-200 mg hauv 1 koob, 1-5 xyoos - 200-400 mg hauv 1-2 koob, 6-10 xyoo - 400-600 mg nyob rau hauv 2-3 koob, 11–15 xyoo –– 600–1000 mg hauv 2-3 koob, pom zoo kom noj tshuaj txhua hnub rau menyuam yaus rau kev ncua ncua cov ntsiav tshuaj (hauv ob peb koob): 4-5 xyoos - 200-400 mg , 6–10 xyoo - 400–600 mg, 11–15 xyoo - 600–1000 mg,
trigeminal neuralgia thiab mob neurogenic mob: 2 zaug hauv ib hnub, 100-200 mg txhua tus, yav tom ntej cov tshuaj txhua hnub tuaj yeem raug nce tsis ntau tshaj 200 mg (txog li 600-800 mg) txog thaum qhov mob txo qis, tom qab ntawd qhov koob tshuaj tau txo kom tsawg tshaj plaws, tom qab pib ntawm qhov pib, qhov tshwm sim zoo yog feem ntau pom tom qab 1-3 hnub, kev kho mob ntev, nyob rau hauv cov ntaub ntawv ntawm lub sijhawm ntxov ntawm carbamazepine, qhov mob yuav rov pib dua, hauv cov neeg laus, cov koob tshuaj yuav tsum yog 100 mg 2 zaug hauv ib hnub,
mob ntshav qab zib neuropathy, nrog mob: 2-4 zaug hauv ib hnub, 200 mg (ntsiav tshuaj), 2 zaug hauv ib hnub, 200-300 mg (txhawb kev tso tawm ntsiav tshuaj),
ntshav qab zib insipidus (ntsiav tshuaj): rau cov neeg laus, thaj tsam 2-3 zaug hauv ib hnub, 200 mg txhua,
mob nrog mob txhab ntawm cov hlab ntsha tawm tsam tiv thaiv ntshav qab zib mellitus: 2 zaug hauv ib hnub, 200-300 mg,
idiopathic glossopharyngeal neuralgia, trigeminal neuralgia tawm tsam keeb kwm yav dhau los ntawm ntau yam sclerosis thiab idiopathic trigeminal neuralgia (lub caij nyoog-ua cov ntsiav tshuaj): 2 zaug hauv ib hnub, 200-400 mg,
polyuria thiab polydipsia ntawm lub neurohormonal xwm nrog ntshav qab zib insipidus ntawm nruab nrab genesis (txhawb nqa-ntsiav tshuaj): rau cov neeg laus, qhov nruab nrab koob yog 200 mg 2 zaug hauv ib hnub, menyuam txo qhov koob tshuaj raws lub hnub nyoog thiab lub cev hnyav,
haus dej haus cawv tawm: qhov nruab nrab koob yog 200 mg 2 zaug hauv ib hnub, nyob rau hauv cov mob loj heev thaum thawj hnub ntawm chav kawm, ib koob tshuaj nce mus txog 600 mg 2 zaug ib hnub yog tau tso cai, thaum pib kho nrog qhov pom tseeb ntawm kev tshem tawm cawv, Zeptol yog siv ua ke nrog kev tiv thaiv kev kho mob thiab sedatives thiab hypnotics (chlordiazepoxide, clomethiazole), tom qab ua tiav ntawm cov mob loj, cov tshuaj yuav siv tau rau hauv hom tshuaj monotherapy,
kev cuam tshuam rau kev tsis sib haum xeeb - kev kho mob thiab prophylaxis (ntsiav tshuaj), bipolar muaj kev cuam tshuam tsis zoo - kev kho kev kho mob, kev mob tib neeg lub cev (cov tshuaj tiv thaiv-tso tawm ntsiav tshuaj): teem ib koob tshuaj 200-400 mg nyob rau thawj lub lim tiam ntawm chav kawm, tom qab ntawd nce koob tshuaj txhua lub lis piam los ntawm 200 mg, nqa mus rau 1000 mg ib hnub twg, tusyees faib ua 2 koob.

Lub sijhawm ntawm kev kho yog teem los ntawm tus kws kho mob koom, kev kho mob yuav tsum ua tiav maj mam. Hloov mus rau kev siv Zeptol yog qhov yuav tsum tau maj mam, nrog kev txo qis ntawm cov koob tshuaj ntawm cov tshuaj dhau los.

Sab sij huam

Hauv kev ntsuas qhov ntau zaus ntawm cov tshwm sim tsis zoo, cov ntsuas cov ntsiab lus hauv qab no tau siv: ntau zaus - 10% lossis ntau dua, feem ntau - ntawm 1% txog 10%, tsis xws luag - los ntawm 0.1% mus rau 1%, tsis tshua muaj - txij li 0.01% mus rau 0.1% , muaj tsawg kawg - tsawg dua 0.01%:

CNS: ntau heev - zoo nkaus li qaug zog, kiv taub hau, tsaug zog, ataxia, feem ntau - diplopia, kev ntxhov siab nyob hauv kev pab (suav nrog qhov pom kev plooj plooj), mob taub hau, tsis xws luag - nystagmus, txawv txav tsis tuaj yeem (tics, tshee, tshee tshee tshee - asterixis) , dystonia), tsis tshua muaj - oculomotor cuam tshuam, orofacial dyskinesia, hais lus tsis meej (dysarthria), paresthesias, peripheral neuropathy, paresis, choreoathetosis, tsis tshua muaj - saj cuam tshuam, malignant antipsychotic syndrome,
hlab plawv system (CVS): tsis tshua muaj - txo / nce hauv ntshav siab (BP), mob raum tsis sib haum, tsis tshua muaj leeg - arrhythmias, bradycardia, AV thaiv nrog tsaus muag, CHF, thromboembolism (suav nrog rau mob ntsws), thrombophlebitis cev qhuav dej, exacerbation ntawm mob plawv coronary (CHD),
kev puas siab puas ntsws: tsis tshua muaj - ntxhov siab, ntxhov siab, tsim txom, tsis nco qab, pom qhov muag / hnov lus zoo, kev nyuaj siab, tsis meej pem, tsis tshua muaj tshwm sim - kev ua kom mob hlwb,
hypersensitivity tshua (nrog rau txoj kev loj hlob ntawm cov tshuaj tiv thaiv tau qhia hauv qab no, kev kho mob nrog Zeptol yuav tsum tsis ua haujlwm ntxiv): tsis tshua muaj - ncua-ntau lub koom nrog hypersensitivity nrog daim tawv nqaij ua pob, ua npaws, leukopenia, arthralgia, eosinophilia, lymphadenopathy, vasculitis, cov tsos mob zoo li mob qog nqaij hlav, mob rau daim siab ua haujlwm thiab hepatosple kev tsis sib haum yog pom nyob rau hauv ntau yam kev sib txuas), lwm yam kabmob (nrog rau myocardium, mob caj pas, lub ntsws, lub raum, hnyuv tws ), Feem ntau yeej tsis - aseptic meningitis nrog myoclonus thiab peripheral eosinophilia, angioedema, anaphylactic cov tshuaj tiv thaiv,
kev tsis haum tshuaj: feem ntau heev - urticaria (suav nrog cov cim zoo), kev tsis haum dermatitis, ua tsis xws luag - erythroderma, exfoliative dermatitis, tsis tshua muaj - khaus, muaj kab mob lupus erythematosus, tsis tshua muaj tshwm sim - plaub hau poob, tawm hws, mob ntxau, ntshav, tawv nqaij , photosensitization tshua, erythema multiforme thiab nodosum, muaj cov tshuaj lom rau hauv lub cev, Stevens-Johnson syndrome, tus mob hirsutism raug kaw lawm (qhov kev sib raug zoo ntawm qhov tshwm sim ntawm qhov kev cuam tshuam no nrog kev siv Zeptol tsis yog lub qhov ncauj hloov tshiab)
hepatobiliary system: ntau zaus - muaj kev ua si ntau dua ntawm gamma-glutamyltransferase (GGT) los ntawm enzyme induction hauv lub siab (feem ntau tsis muaj qhov tseem ceeb hauv kev kho mob), feem ntau - nce kev ua si ntawm alkaline phosphatase (ALP) hauv cov ntshav, ua tsis tiav - muaj kev hloov pauv ntau, tsis tshua - rhuav tshem kev mob plab hnyuv tawm, ua rau muaj kev txo qis hauv lawv tus lej, mob daj ntseg, kab mob siab rau cov nqaij pob txha (kab mob siab), mob cholestatic lossis hom sib xyaw, feem ntau tsis tshua muaj - daim siab ua haujlwm, kab mob siab granulomatous,
plab zom mov: feem ntau heev - ntuav, xeev siab, feem ntau - qhov ncauj qhuav, tsis tshua muaj - cem quav / raws plab, tsis tshua muaj - mob plab, tsis tshua muaj heev - stomatitis, glossitis, pancreatitis,
hematopoietic plab hnyuv siab raum: feem ntau - leukopenia, feem ntau - eosinophilia, thrombocytopenia, tsis tshua muaj - folic acid tsis txaus, lymphadenopathy, leukocytosis, tsis tshua muaj tshwm sim - ntshav liab, muaj tseeb erythrocyte aplasia, aplastic / megaloblastic / hemolytic anemia, pancytopenia / agranulism. sib quas ntus porphyria, reticulocytosis,
Cov kab mob genitourinary: muaj tsawg kawg - kev tso zis tawm suab, tso zis ntau zaus, interstitial nephritis, lub raum tsis ua haujlwm (oliguria, hematuria, albuminuria, muaj urea / azotemia), lub raum tsis ua haujlwm, txo cov phev suav thiab kev ua kom muaj zog, kev sib deev tsis tuaj yeem / mob tsis ua haujlwm,
endocrine system thiab cov metabolism: feem ntau - nce hauv lub cev qhov hnyav, dej tuav cia, edema, txo ntshav osmolarity thiab hyponatremia vim muaj cov txiaj ntsig zoo li ADH, uas tsis tshua ua rau dilution hyponatremia (dej intoxication), uas tshwm sim nrog mob taub hau, ntuav, nkees , kev puas siab puas ntsws thiab tsis meej pem, muaj qhov tsis tshua muaj tshwm sim - kev nce qib ntawm cov ntshav prolactin nrog galactorrhea, gynecomastia lossis tsis muaj lawv, kev hloov pauv hauv cov kev ua haujlwm ntawm cov thyroid caj pas - txo qis hauv cov ntsiab lus ntawm L-thyroxine (thyroxine, dawb thyroxine, triiodothyronine) thiab kev nce qib ntawm cov thyroid stimulating hormone (TSH) (feem ntau tsis yog nrog cov kev soj ntsuam), ua rau cov pob txha tsis muaj zog (txo qis hauv 25-hydroxycholecalciferol thiab calcium), uas ua rau osteomalacia / osteoporosis, nce ntxiv ntawm cov cholesterol, suav nrog Cov roj (lipoproteins) uas muaj roj ntau, thiab triglycerides,
kev hnov mob hauv nruab nrog cev: tsis tshua muaj mob - pom pob txha caj qaum, txhaws lub ntsej muag, nce siab ntawm lub qhov muag, qhov tsis hnov lus, suav nrog tinnitus, kev hloov pauv ntawm qhov pom ntawm lub suab, hypoacusia, hyperacusis,
musculoskeletal system: tsis tshua muaj - mob leeg tsis muaj zog, tsis tshua muaj mob - mob leeg lossis mob plab, mob pob txha.

Kev phiv tshuaj

Thaum pib kho lossis thaum siv ntau dhau los ntawm kev pib siv tshuaj, nrog rau kev kho mob ntawm cov neeg laus, qee yam kev mob tshwm sim, piv txwv li, los ntawm lub hauv nruab nrab ntawm cov hlab ntsha (CNS) (kiv taub hau, mob taub hau, ataxia, tsaug zog, feem ntau tsis muaj zog, diplopia) sab ntawm pais plab hnyuv (xeev siab, ntuav) lossis ua xua ntawm daim tawv nqaij.

Kev noj tshuaj ntau-qhov muaj qhov tsis zoo tshwm sim feem ntau tshwm sim nyob rau ob peb hnub ob leeg kheej thiab tom qab txo qis ib ntus hauv cov tshuaj.

Ntshav: leukopenia thrombocytopenia, eosinophilia, leukocytosis, lymphadenopathy, folic acid deficiency, agranulocytosis, aplastic anemia, pancytopenia, erythrocytic aplasia, anemia, megaloblastic anemia, mob ntshav qab zib ntu, mob ntshav sib luag, mob plhaws, mob plhaws.

Los ntawm lub cev tiv thaiv kab mob : ncua-ntau yam-ua rau lub cev ua xua nrog ua npaws, tawm pob ntawm daim tawv nqaij, vasculitis, lymphadenopathy, cov tsos mob zoo li tus mob lymphoma, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly thiab hloov daim siab ua haujlwm thiab cov kua tsib lub ntsws ploj (kev rhuav tshem thiab ploj ntawm lub plab intrahepatic) Cov. Tej zaum yuav muaj kev cuam tshuam los ntawm lwm qhov hauv nruab nrog cev (piv txwv, mob siab, mob ntsws, mob raum, mob raum, myocardium, mob hnyuv tws), aseptic meningitis nrog myoclonus thiab peripheral eosinophilia, anaphylactic tshua, angioedema, hypogammaglobulinemia.

Endocrine system : edema, tso dej cia, nce phaus, hyponatremia thiab txo ntshav plasma osmolarity vim cov nyhuv zoo ib yam li ADH, uas muaj qee qhov teeb meem ua rau lub cev tsis muaj zog, uas yog nrog ua kom nkees, ntuav, mob taub hau, tsis meej pem thiab mob hlwb, nce qib ntawm cov ntshav prolactin, nrog lossis tsis nrog los ntawm cov kev mob tshwm sim xws li galactorrhea, gynecomastia, cuam tshuam ntawm cov pob txha metabolism (txo qis hauv cov calcium thiab 25-hydroxycolcalcaliferol hauv cov ntshav ntshav), uas ua rau osteomalacia / osteoporosis nyob rau qee kis - kev nce siab ntawm cov roj (cholesterol), suav nrog lipoprotein cov roj cholesterol siab thiab triglycerides.

Los ntawm sab ntawm cov metabolism thiab noj zaub mov tsis zoo: folate deficiency, tsis qab los, qab ntxiag porphyria (kev sib deev ntawm lub cev thiab cov nqaij ua si sib xyaw ua ke), tsis muaj kab mob siab (porphyria ua rau daim tawv nqaij lig).

Los ntawm ib sab ntawm lub psyche: pom kev zoo (pom lossis hnov lus), kev nyuaj siab, ploj, qab los sis ntxhov siab, ntxhov siab, ntxhov siab, tsis meej pem, ua kom mob hlwb.

Los ntawm lub paj hlwb: kiv taub hau, ataxia, nkees nkees, feem ntau tsis muaj zog, mob taub hau, kawm tiav, ua tsis tau qhov chaw nyob (piv txwv li qhov muag plooj), muaj qhov txawv txav (piv txwv li tshee, "viav vias" tshee, dystonia, tic), nystagmus, orofacial dyskinesia, qhov muag tsis pom kev, hais lus tsis meej (piv txwv li dysarthria lossis hais lus tsis meej), choreoathetosis, peripheral neuropathy, kab mob txha caj qaum, leeg tsis muaj zog thiab paresis, saj tsis taus, malignant antipsychotic syndrome, aseptic meningitis nrog myoclonia thiab periphery eskoy eosinophilia, dysgeusia.

Los ntawm sab ntawm cov khoom ntawm lub zeem muag: puas tab kaum ntawm kev pab (piv txwv li qhov muag plooj), sib dhos ntawm lub lens, mob caj dab, mob siab intraocular.

Ntawm ib sab ntawm cov kabmob uas tau hnov: hnov cov lus tsis zoo, xws li tinnitus, hnov lus zoo, ua rau hnov pob ntseg zoo, hnov qhov tsis hnov.

Los ntawm cov hlab plawv system : intracardiac conduction ua kev puas siab puas ntsws arterial hypertension lossis txoj hlab ntshav hypotension bradycardia, arrhythmia, syncope blockade, circulatory collapse, congestive heart tsis ua haujlwm, exacerbation ntawm ischemic kab mob, thrombophlebitis, thromboembolism (e.g. pulmonary embolism).

Los ntawm lub tshuab ua pa : Mob ntsws ntsig ntsws uas tsis haum lub cev tus cwj pwm kub taub hau, ua pa luv, mob ntsws, lossis mob ntsws.

Los ntawm cov hnyuv: xeev siab, ntuav, qhov ncauj qhuav, raws plab los yog cem quav, mob plab, glossitis, stomatitis, pancreatitis.

Los ntawm lub plab zom mov: kev nce qib ntawm gamma-glutamyltransferase (vim qhov pib ua rau lub siab enzyme), feem ntau tsis muaj qhov tseem ceeb hauv kev kho mob, kev nce ntxiv hauv cov ntshav alkaline phosphatase, kev nce siab hauv transaminases, mob siab rau cholestatic, kab mob txhaws nqaij (hepatocellular) lossis ntau hom sib xyaw, biliary huam ploj ploj syndrome, mob daj ntseg ntau tus kab mob siab.

Ntawm ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: dermatitis ua tsis haum, urticaria, qee zaum mob hnyav, ua rau lub ntsej muag dermatitis, erythroderma, kab mob lupus erythematosus, ua pob khaus Stevens-Johnson mob siab, tawm hws, nce hws, nce plaub hau, nce hws. hirsutism.

Los ntawm cov leeg musculoskeletal : cov leeg tsis muaj zog, mob caj dab, mob nqaij pob txha, mob nqaij pob txha, ua kom cov pob txha metabolism tsis zoo (txo cov calcium thiab 25-hydroxycolcalcaliferol hauv ntshav ntshav, uas tuaj yeem ua rau osteomalacia lossis osteoporosis).

Los ntawm cov kab mob urinary: tubulointerstitial nephritis, lub raum tsis ua haujlwm, lub raum tsis ua haujlwm (albuminuria, hematuria, oliguria, ntshav urea / azotemia), tso zis ntau zaus, tso zis tsis qab.

Los ntawm kev yug me nyuam : kev sib daj sib deev / impotence / erectile kawg ua haujlwm, lub cev tsis zoo ntawm cov phev (nrog rau tus lej / lub zog ntawm cov phev) tsawg dua.

Kev ua txhaum ntau: tsis muaj zog.

Kev ntsuas ntsuas: kev nce qib ntawm gamma-glutamyltransferase (tshwm sim los ntawm induction ntawm daim siab enzymes), uas feem ntau tsis muaj kev kuaj mob tseem ceeb, kev nce qib hauv alkaline phosphatase nyob rau hauv cov ntshav, nce transaminases, kev nce siab hauv intraocular siab, kev nce ntshav hauv cov roj cholesterol, nce lipoproteins ntshav ntau ntau, nce lipoproteins ntau hloov ntshav hauv cov thyroid muaj nuj nqi: ib qho kev txo qis L-thyroxine (FT _4, T _4, T ₃ ) thiab theem ntawm cov thyroid-stimulating hormone, uas, raws li txoj cai, tsis yog nrog cov kev sim hauv lub chaw kuaj mob, qhov nce ntawm qib prolactin hauv cov ntshav, hypogammaglobulinemia.

Kev phiv tshuaj raws cov lus dhau los.

Kis thiab cov kab mob cab: kev thiav ntawm tib neeg mob hom pob.

Ntshav: hlwb pob txha tsis ua haujlwm.

Los ntawm lub paj hlwb: sedation, nco qab tsis txaus.

Los ntawm cov hnyuv: tus kaus.

Los ntawm lub cev tiv thaiv kab mob : kev tawm tsam tshuaj nrog eosinophilia thiab cov tsos mob ntsig txog lub cev (DRESS).

Ntawm ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: mob hnyav rau qhov ua ntej pantulosis (AGEP), lichenoid keratosis, onychomadeus mob siab.

Los ntawm cov leeg musculoskeletal : pob txha lov.

Kev ntsuas ntsuas: txo hauv cov pob txha ntxhia.

Noj ntau dhau

Cov tsos mob Cov tsos mob thiab yws yws uas tshwm sim los ntawm kev noj ib ce ntau dhau kev cuam tshuam rau kev puas tsuaj rau lub hauv nruab nrab cov hlab ntshav plawv, lub plawv thiab lub ntsws ua pa.

Nruab nrab hauv lub paj hlwb : kev nyuaj siab ntawm lub hauv nruab nrab lub hlwb, tsis meej pem, poob siab theem ntawm kev nco qab, tsaug zog, ntxhov siab, pom kev tsis meej, tsis pom kev tsis meej, tsis meej pem, hais lus tsis meej, dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (thawj), hyporeflexia (tom qab), qaug dab peg, tsis meej pem, myoclonus, hypother mydriasis.

Kab mob ua pa: kev kho mob ntsws, ntsws ntsws qhuav.

Lub plawv mob: tachycardia, arterial hypotension, txog hlab ntsha tawg, ua rau muaj kev cuam tshuam nrog nthuav dav QRS txoj haujlwm, syncope cuam tshuam nrog mob plawv, nrog rau kev tsis nco qab.

Digestive huam: ntuav, khoom noj tuav hauv lub plab, txo lub zog ntawm cov nyuv.

Musculoskeletal system: raug rho tawm tus mob ntawm rhabdomyolysis cuam tshuam nrog kev phiv los ntawm carbamazepine tau tshaj tawm.

Cov kab mob zis : kev tso zis tawm suab, oliguria lossis anuria kua dej cia, ua kom lub cev qhuav dej vim cov nyhuv carbamazepine, zoo ib yam li hauv ADH.

Los ntawm ntsuas ntsuas: hyponatremia, metabolic acidosis, hyperglycemia, nce ntawm cov leeg ntawm CPK yog ua tau.

Kev Kho Mob. Tsis muaj ib qho tshuaj tua kab mob tshwj xeeb. Ua ntej tshaj, kev kho mob yuav tsum yog raws tus kws kho mob hauv chaw kho mob, tus mob pw hauv tsev kho mob. Qhov kev nkag siab ntawm carbamazepine hauv cov ntshav ntshav yog txiav txim siab kom paub meej tias yog lom nrog tus neeg sawv cev no thiab ntsuas qhov ntsuas ntau tshaj.

Cov ntsiab lus ntawm lub plab yog tshem tawm, lub plab yog ntxuav, thiab qhib lub tshuab hluav ncaig. Kev tshem tawm txoj hnyuv mus ntev yuav ua rau ncua sij hawm nqus thiab rov tshwm sim cov tsos mob ntawm intoxication thaum lub sijhawm rov qab. Cov tsos mob txhawb nqa kev kho mob yog siv nyob rau hauv kev saib xyuas mob siab, tshuaj xyuas lub plawv, kev kho ntawm cov roj ntsha tsis haum.

Cov lus pom zoo tshwj xeeb. Nrog rau kev txhim kho ntawm txoj kev mob ntshav hauv cov ntshav, kev tswj hwm ntawm dopamine lossis dobutamine yog qhia, nrog kev txhim kho ntawm lub plawv dhia tsis zoo, kev kho mob yuav tsum tau xaiv ib qho zuj zus, nrog kev txhim kho ntawm qaug dab peg, kev tswj hwm ntawm benzodiazepines (e.g. diazepam) lossis lwm yam anticonvulsants, xws li phenobarbital (nrog ceev faj vim muaj kev pheej hmoo ntawm kev ua pa nyuaj) lossis paraldehyde, nrog rau kev txhim kho hyponatremia (dej intoxication) - kev txwv ntawm cov dej ua kom tsawg, maj mam ceev faj infusion ntawm 0.9% sodium tshuaj dawb tov. Cov kev ntsuas no yuav pab tau hauv kev tiv thaiv kom txhob mob hlwb.

Pom zoo Hemosorption ntawm cov pa roj carbon monoxide. Kev tsis muaj peev xwm ntawm kev yuam diuresis thiab peritoneal lim ntshav tau qhia.

Nws yog ib qho tsim nyog yuav tsum tau muab rau qhov muaj peev xwm los txhawb cov tsos mob ntawm kev noj tshuaj ntau dhau ntawm hnub thib 2 thiab thib 3 tom qab nws pib, vim yog ncua tshuaj ntau ntxiv.

Siv thaum cev xeeb tub lossis lactation.

Kev tswj hwm qhov ncauj ntawm carbamazepine ua rau kev loj hlob ntawm tsis xws luag.

Hauv cov menyuam yaus uas lawv niam muaj kev mob vwm, muaj qhov nyiam txoj kev txhim kho txoj hlab hlwb, suav nrog kev tsis ua haujlwm ntawm lub neej.

Cov lus qhia hauv qab no yuav tsum tau ua raws.

Kev siv cov tshuaj rau cov poj niam cev xeeb tub uas muaj mob vwm yuav tsum tau saib xyuas tshwj xeeb.
Yog tias tus poj niam uas tau txais Zeptol cev xeeb tub, tab tom npaj lub cev xeeb tub, lossis yog tias nws yuav tsum tau siv cov tshuaj thaum cev xeeb tub, cov txiaj ntsig zoo ntawm kev siv tshuaj yuav tsum ua tib zoo ntsuas kev pheej hmoo (tshwj xeeb tshaj yog nyob rau thawj lub hlis ntawm cev xeeb tub).
Cov poj niam ntawm kev muaj me nyuam hnub nyoog yug me nyuam, yog tias ua tau, Zeptol yuav tsum tau kho raws li kev kho mob monotherapy.
Nws raug nquahu kom sau tshuaj kom tsawg li tsawg tau thiab saib xyuas qib ntawm carbamazepine hauv ntshav ntshav.
Cov neeg mob yuav tsum raug qhia paub txog kev pheej hmoo ntawm kev tsim muaj kab mob siab phem thiab yuav tsum tau muab txoj hauv kev kuaj ntsuas ua ntej yug menyuam.
Thaum cev xeeb tub, kev siv tshuaj tiv thaiv kab mob zoo yuav tsum tsis txhob cuam tshuam, vim tias kev ua kom lub cev tsis zoo tuaj yeem ua rau muaj kev noj qab haus huv ntawm leej niam thiab tus menyuam.

Soj ntsuam thiab kev tiv thaiv. Nws paub tias thaum cev xeeb tub folic acid tsis txaus yuav tshwm sim. Antiepileptic tshuaj tuaj yeem nce cov tshuaj folic acid tsis txaus, vim li no thiaj li pom cov tshuaj folic acid ntxiv ua ntej thiab thaum cev xeeb tub.

Yug Menyuam Mos. Txhawm rau tiv thaiv kev mob coagulation hauv cov menyuam yug tshiab, nws raug nquahu kom nqa tshuaj vitamin K ₁ leej niam nyob rau lub lim tiam dhau los ntawm cev xeeb tub thiab tus menyuam tshiab.

Ntau qhov teeb meem ntawm kev sim thiab / lossis kev nyuaj siab ntsws hauv cov menyuam tshiab tau paub, ntau tus mob ntuav, raws plab thiab / lossis tsis qab los ntawm cov menyuam mos yog cuam tshuam nrog kev siv Zeptol thiab lwm yam tshuaj anticonvulsants.

Kev pub niam mis. Carbamazepine hla mus rau hauv niam cov kua mis (25-60% ntshav ntshav). Qhov txiaj ntsig ntawm kev pub niam mis nrog kev ntxim nyiam ntawm kev phiv los ntawm cov menyuam hauv lub neej tom ntej yuav tsum tau ntsuas kom zoo. Cov niam uas tau txais tus mob Zeptol tuaj yeem pub niam mis tau, muab pom tias tus menyuam raug kuaj pom tias muaj qhov tshwm sim tsis zoo (piv txwv li, nkees nkees ntau dhau, ua xua ntawm tawv nqaij).

Cov neeg tsis muaj peev xwm ua tsis taus txiv neej thiab / lossis cov cim qhia txog roj ntsha kev tsis txaus ntseeg tau qhia tawm.

Cov menyuam yaus muab qhov sai dua ntawm carbamazepine tej zaum yuav tsum tau siv ntau dua ntawm cov tshuaj (ib phaus ntawm lub cev hnyav) piv nrog cov neeg laus. Cov ntsiav tshuaj Zeptol tuaj yeem siv rau menyuam yaus txij li 5 xyoos.

Daim ntawv thov nta

Zeptol tsuas yog siv nyob rau hauv kev tswj hwm, tsuas yog tom qab ntsuas qhov txiaj ntsig / qhov phom sij piv, qhia tias qhov xwm txheej ntawm cov neeg mob plawv, mob rau lub cev lossis mob raum, mob ntshav tsis zoo rau lwm cov tshuaj hauv keeb kwm thiab cov neeg mob tshuaj uas cuam tshuam nrog kev saib xyuas tau ua tib zoo saib xyuas.

Ib qho tso zis dav dav thiab kev txiav txim siab txog qib ntawm urea nitrogen rau hauv cov ntshav thaum pib thiab nrog qee zaus thaum kho mob tau pom zoo.

Zeptol ua rau pom cov tshuaj tiv thaiv mob me me, yog li cov neeg mob siab nyob hauv siab yuav tsum ceeb toom thiab sab laj txog qhov kev pheej hmoo.

Nws yuav tsum nco ntsoov txog qhov ua tau kom ua kom muaj kev mob hlwb, thiab hauv cov neeg laus - hais txog kev ua kom muaj kev kub ntxhov thiab kev ntxhov siab.

Cov tshuaj feem ntau tsis muaj txiaj ntsig rau qhov tsis tuaj kawm (mob me me) thiab myoclonic qaug dab peg. Cov teeb meem cais tshwj xeeb qhia tau tias nce chua leeg muaj peev xwm ua tau rau cov neeg mob qhaj atypical tsis tuaj.

Hematologic cuam tshuam. Kev siv cov tshuaj yog cuam tshuam nrog kev txhim kho ntawm agranulocytosis thiab mob ntshav tsis txaus, txawm li cas los xij, vim muaj cov xwm txheej tsis tshua muaj tshwm sim, nws nyuaj rau kev txheeb xyuas qhov kev pheej hmoo thaum noj cov tshuaj.

Cov neeg mob yuav tsum raug qhia paub txog cov tsos mob tshwm sim thaum ntxov ntawm kev mob toxicity thiab cov tsos mob ntawm kev mob tshwm sim los ntawm ntshav, nrog rau cov tsos mob ntawm lub cev thiab mob rau daim siab.

Yog tias cov lej ntawm leukocytes lossis platelets tsawg dua thaum kho, tus neeg mob yuav tsum tau ua tib zoo saib xyuas thiab ib qho kev kuaj ntshav ntawm tus neeg mob yuav tsum tau ua tas li. Kev kho mob nrog Zeptol yuav tsum tsis ua mus ntxiv yog hais tias tus neeg mob pib mob leukopenia, uas yog mob hnyav, nce zuj zus, lossis nrog cov lus tshawb pom, xws li kub cev lossis mob caj pas. Kev siv cov tshuaj yuav tsum tsis ua mus ntxiv thaum pom cov kev txwv ntawm kev ua haujlwm ntawm cov pob txha tuaj.

Feem ntau muaj kev txo qis ib ntus lossis tsis tu ncua hauv cov platelets lossis cov qe ntshav dawb hauv kev sib txuas nrog kev siv cov tshuaj Zeptol. Txawm li cas los xij, nyob rau hauv Feem ntau, cov xwm txheej no tsuas yog ib ntus thiab tsis qhia txog kev txhim kho ntawm aplastic anemia los yog agranulocytosis. Ua ntej pib txoj kev kho mob thiab tsis tseg thaum nws ua, yuav tsum kuaj ntshav, nrog rau kev txiav txim siab cov platelets (raws li, tej zaum, muaj pes tsawg tus reticulocytes thiab theem ntawm hemoglobin).

Cov tshuaj tiv thaiv mob dermatological hnyav. Cov tshuaj tiv thaiv mob hnyav, nrog rau cov tshuaj lom neeg mob ua paug (TEN), Lyell's syndrome, Stevens-Johnson syndrome (SJS) muaj tsawg heev nrog kev siv tshuaj. Cov neeg mob uas muaj kev mob nyhav heev yuav tsum tau mus pw hauv tsev kho mob, vim tias cov mob no yuav ua tau rau neeg tuag taus. Feem ntau ntawm tus mob SJS / TEN tau tshwm sim hauv thawj ob peb lub hlis ntawm kev kho mob nrog Zeptol. Nrog rau kev txhim kho cov tsos mob ntawm lub cim qhia txog kev mob tshwm sim hnyav (xws li, SJS, Lyell's syndrome / TEN), cov tshuaj yuav tsum tau txiav tam sim ntawd thiab lwm txoj kev kho yuav tsum raug kho.

Muaj cov pov thawj ntxiv ntawm cov nyhuv ntawm ntau HLA alleles ntawm tus neeg mob lub cev rau cov kev phiv tshuaj tiv thaiv kab mob uas tiv thaiv kab mob.

Hauv cov neeg mob uas muaj kev pheej hmoo tsis zoo, Zeptol yuav tsum kuaj xyuas rau allele (HLA) -B * 1502 ua ntej pib kho.

Allele (HLA) -B * 1502 tuaj yeem yog qhov phom sij rau txoj kev loj hlob ntawm SJS / TEN rau cov neeg mob Suav uas tau txais lwm cov tshuaj tiv thaiv kev mob uas yuav cuam tshuam nrog kev tshwm sim ntawm SJS / TEN. Yog li, kev siv lwm yam tshuaj uas tuaj yeem cuam tshuam nrog kev tshwm sim ntawm SJS / TEN yuav tsum zam rau cov neeg mob uas muaj allele (HLA) -B * 1502, yog tias siv lwm txoj kev kho.

Kev Sib Txuas Lus nrog HLA-A * 3101

Tib neeg leukocyte antigen tuaj yeem ua rau muaj kev pheej hmoo rau kev txhim kho cov tawv nqaij tsis zoo, xws li SJS, TEN, ua pob rau tshuaj mob nrog eosinophilia thiab cov tsos mob ntawm lub cev (DRESS), mob pob txaij dav dav exenthematous pustulosis (AGEP), mob pob qog maculopapular. Yog tias kev txheeb xyuas pom tias muaj cov HLA-A * 3101 allele, ces koj yuav tsum tsis txhob siv cov tshuaj no.

Kev Tshuaj Ntsuas Raws caj ces

Kev tshuaj ntsuam raws caj ces yuav tsum tsis hloov chaw soj ntsuam thiab kho tus neeg mob. Lwm qhov ua tau los ua lub luag haujlwm ntawm qhov tshwm sim ntawm cov kev mob tshwm sim ntawm daim tawv nqaij hnyav heev, xws li kev noj cov tshuaj tiv thaiv kab mob, ua raws li cov txheej txheem kev kho mob, thiab kho cov kev kho mob. Cov nyhuv ntawm lwm yam kab mob thiab qib ntawm kev saib xyuas cov tawv nqaij cuam tshuam tsis tau kawm.

Lwm qhov tshwm sim dermatological.

Nws tseem muaj peev xwm nthuav kev hloov pauv thiab cov uas tsis cuam tshuam rau kev noj qab haus huv, cov tshuaj tiv thaiv dermatological me me, piv txwv li, cais macular lossis maculopapular exanthema. Feem ntau lawv dhau mus tom qab ob peb hnub lossis ntau lub lim tiam, ob qho tib si ntawm kev noj tshuaj tib zaug thiab tom qab txo koob tshuaj. Txij li cov tsos mob tshwm sim thaum ntxov ntawm cov tshuaj tiv thaiv mob hnyav tuaj yeem nyuaj rau qhov sib txawv me me, cov tshuaj tiv thaiv sai, tus neeg mob yuav tsum tau saib xyuas kom tsis txhob siv tshuaj tam sim ntawd yog tias kev tawm tsam hnyav ntxiv.

Lub xub ntiag ntawm HLA-A * 3101 allele hauv tus neeg mob yog cuam tshuam nrog kev tshwm sim uas tsis tshua muaj kev phiv tshuaj los ntawm daim tawv nqaij mus rau carbamazepine, xws li kev mob siab tsis haum rau anticonvulsants lossis tawm pob me me (maculopapular pob).

Kev ua haujlwm tsis zoo. Zeptol tuaj yeem ua rau qhov tshwm sim ntawm kev tsis haum lub siab, nrog rau kev tawm tsam tshuaj nrog eosinophilia thiab cov tsos mob ntawm lub cev (DRESS), muaj ntau yam qeeb qeeb hypersensitivity cov tshuaj tiv thaiv nrog kub cev, tawm pob, vasculitis, lymphadenopathy, pseudolymphoma, arthralgia, leukopenia, eosinophilia, mob siab, mob siab, eosinophilia bile ducts (suav nrog kev rhuav tshem thiab ploj mus ntawm cov hnyuv duct), uas tuaj yeem tshwm sim hauv ntau yam kev sib txuas. Tsis tas li ntawd muaj txiaj ntsig rau lwm yam kabmob (ntsws, raum, tus kabmob, myocardium, nyuv).

Lub xub ntiag ntawm HLA-A * 3101 allele hauv tus neeg mob yog cuam tshuam nrog kev tshwm sim uas tsis tshua muaj kev cuam tshuam loj rau cov carbamazepine los ntawm daim tawv nqaij, xws li hypersensitivity syndrome rau anticonvulsants lossis ua pob ua pob me me (maculopapular pob).

Cov neeg mob uas muaj qhov tsis haum lub cev rau carbamazepine yuav tsum raug qhia paub tias kwv yees li 25-30% ntawm cov neeg mob ntawd kuj yuav muaj qhov tsis haum lub cev rau oxcarbazepine.

Nrog rau kev siv cov carbamazepine thiab phenytoin, kev txhim kho ntawm cov ntoo khaub lig siab dua yog qhov ua tau.

Feem ntau, thaum cov tsos mob pom zoo li qhov ua kom txo qis, cov tshuaj yuav tsum tau nres tam sim ntawd.

Kev sib tw. Zeptol yuav tsum tau siv nrog ceev faj hauv cov neeg mob mob sib xyaw ua ke uas suav nrog qhov tsis tuaj kawm ntawv (ib txwm lossis atypical). Hauv cov xwm txheej zoo li no, cov tshuaj tuaj yeem ua rau qaug dab peg. Yog tias ua txhaum kev qaug dab peg, kev siv cov tshuaj yuav tsum nres tam sim ntawd.

Ib qho kev nce ntawm qhov nquag ntawm qhov chua leeg yog tau thaum lub sij hawm hloov los ntawm qhov ncauj ntawm cov tshuaj mus rau kev txwv tsis pub.

Daim siab ua haujlwm. Thaum kho cov tshuaj, nws yog ib qho tsim nyog los soj ntsuam daim siab ua haujlwm thaum pib thiab qee zaus thaum kho, tshwj xeeb tshaj yog rau cov neeg mob uas muaj keeb kwm muaj kab mob siab thiab rau cov neeg laus.

Qee qhov ntsuas uas ntsuas qhov ua haujlwm ntawm lub siab ua haujlwm rau cov neeg mob noj carbamazepine tuaj yeem mus dhau qhov tsis muaj cai, tshwj xeeb tshaj yog gamma-glutamyltransferase (GGT). Qhov no tej zaum vim yog qhov induction ntawm daim siab enzymes. Enzyme induction kuj tseem tuaj yeem ua rau muaj kev nce qib hauv kev txo cov alkaline phosphatase ntau ntau. Xws li kev nce siab hauv kev ua haujlwm ntawm hepatic metabolism tsis yog qhov qhia tau rau kev tshem tawm carbamazepine.

Kev mob hnyav heev los ntawm daim siab vim yog siv cov carbamazepine yog qhov tsis tshua muaj tshwm sim. Thaum muaj cov tsos mob ntawm daim siab tsis ua haujlwm lossis mob siab ua haujlwm, nws yog qhov yuav tsum tau kuaj tus neeg mob sai sai, thiab tsum tsis txhob kho Zeptol.

Raum muaj nuj nqi. Nws raug nquahu kom ntsuas cov qog ua haujlwm thiab txiav txim siab txog qib ntshav urea nitrogen thaum pib thiab ntu sijhawm thaum kho.

Kev Hyponatremia. Cov kab mob ntawm kev txhim kho hyponatremia nrog kev siv cov carbamazepine yog paub. Hauv cov neeg mob uas lub raum tsis ua haujlwm, nws cuam tshuam nrog kev txo ntsev ntau ntxiv, nrog rau cov neeg mob uas tau txais kev kho mob ib ntus nrog cov tshuaj uas txo cov ntsev ntau ntxiv (xws li diuretics, tshuaj uas cuam tshuam nrog kev tsis zoo ntawm ADH), cov ntshav sodium yuav tsum ntsuas ua ntej kev kho mob. Hauv lub neej yav tom ntej, qib ntawm sodium yuav tsum ntsuas txhua 2 lub lis piam, tom qab ntawd - nrog lub caij nyoog ntawm 1 hlis thaum thawj 3 lub hlis ntawm kev kho mob lossis chaw kho mob uas xav tau. Qhov no siv feem ntau rau cov neeg laus laus. Hauv qhov no, tsuas pub siv dej tsawg.

Kev Hypothyroidism. Carbamazepine tuaj yeem txo qhov kev cia siab ntawm cov thyroid hormones txaus - hauv qhov no, kev nce ntxiv ntawm cov koob tshuaj qog hloov tshuaj kho hauv cov neeg mob hypothyroidism yog qhov tsim nyog.

Anticholinergic cov teebmeem. Zeptol ua rau muaj kev cuam tshuam ntawm anticholinergic. Yog li, cov neeg mob uas muaj kev mob siab thiab tso zis ntau ntxiv yuav tsum ua tib zoo saib xyuas lub sijhawm kho.

Mob hlwb. Nco ntsoov qhov zoo li kev pheej hmoo ntawm kev mob hlwb tsis dhau los ua neeg nquag, hauv cov neeg laus - ntxhov siab lossis arousal.

Kev xav tua tus kheej thiab tus cwj pwm. Muaj qee cov pov thawj ntawm kev xav tua tus kheej thiab tus cwj pwm hauv cov neeg mob tau txais cov tshuaj antiepileptic. Yog li, cov neeg mob yuav tsum kuaj xyuas qhov kev xav tua tus kheej thiab tus cwj pwm thiab, yog tias tsim nyog, kev kho mob tsim nyog yuav tsum raug kho. Cov neeg mob (thiab cov neeg saib xyuas) yuav tsum qhia rau tus kws kho mob yog tias pom muaj kev xav tua tus kheej thiab tus yam ntxwv tshwm sim.

Cov teebmeem endocrine. Los ntawm qhov induction ntawm daim siab enzymes, Zeptol yuav ua rau txo qis hauv kev kho tshuaj ntawm estrogen thiab / lossis progesterone npaj. Qhov no tuaj yeem ua rau txo qis kev muaj txiaj ntsig zoo, rov ua dua ntawm cov tsos mob, lossis hla kev los ntshav lossis pom. Cov neeg mob uas siv Zeptol thiab rau leej twg cev xeeb tub hormonal yog tsim nyog yuav tsum tau txais ib cov tshuaj uas muaj tsawg kawg 50 micrograms ntawm estrogen, lossis siv lwm txoj kev tsis muaj tshuaj tiv thaiv kev xeeb tub.

Saib xyuas qib ntawm cov tshuaj hauv ntshav ntshav. Dua li ntawm qhov tseeb tias kev sib txuam ntawm qhov ntau thiab cov theem ntawm carbamazepine hauv ntshav plasma, zoo li ntawm cov qib ntawm carbamazepine hauv ntshav plasma thiab cov chaw kho mob ua tau zoo thiab tsis tuaj yeem tsis ntseeg siab, soj ntsuam cov qib ntawm cov tshuaj hauv ntshav plasma yuav tsim nyog rau cov xwm txheej hauv qab no: nrog kev nce ceev ntawm cov zaus ntawm kev tawm tsam, tshawb xyuas kev ua raws cai ntawm tus neeg mob, thaum cev xeeb tub, hauv kev kho mob ntawm menyuam yaus thiab tub ntxhais hluas, nrog kev ua txhaum cai ntawm kev nqus, nrog kev ua kom muaj tshuaj lom thiab nrog ntau dua ib qho tshuaj.

Kev txo koob tshuaj thiab thim cov tshuaj. Kev tshem tawm sai ntawm cov tshuaj tuaj yeem ua rau qaug dab peg. Yog tias yuav tsum tau txiav tawm txoj kev kho mob tam sim ntawd nrog cov tshuaj ntawm cov neeg mob vwm, hloov mus rau cov tshuaj tiv thaiv tus kab mob tshiab yuav tsum tau ua tawm tsam tus keeb kwm yav dhau los ntawm kev kho nrog cov tshuaj tsim nyog (piv txwv, diazepam intravenously, rectally lossis phenytoin txhaj tshuaj).

Kev txo qis thiab cov tshuaj yeeb tshuaj. Kev tshem tawm sai ntawm cov tshuaj tuaj yeem ua rau qaug dab peg, yog li carbamazepine yuav tsum tau maj mam thim tawm hauv lub sijhawm 6 lub hlis. Yog tias nws yuav tsum tau txiav tawm tam sim ntawd cov tshuaj rau cov neeg mob qaug dab peg, qhov hloov mus rau cov tshuaj tiv thaiv tshiab yuav tsum tau ua tawm tsam keeb kwm ntawm kev kho nrog cov tshuaj uas tsim nyog.

Cov lus qhia tshwj xeeb

Qhov kev txiav txim ntawm Zeptol feem ntau tsis muaj txiaj ntsig hauv kev mob me me ntawm qaug dab peg (tsis tuaj) thiab myoclonic qaug dab peg. Nyob rau hauv lub xub ntiag ntawm cov sib xyaw ntawm cov kev puas ntsoog ntawm qaug dab peg, cov tshuaj yuav tsum tau siv nrog ceev faj thiab raug saib xyuas kev kho mob tsis tu ncua vim tias muaj feem yuav ua rau muaj kev pheej hmoo ntawm lawv cov amplification. Txais tos ntawm Zeptolum yuav tsum tau muab tshem tawm yog tias kev ua phem ntawm kev mob vwm tawm tsam.

Nyob rau lub sijhawm kev kho mob, qhov txo qis / tsis tu ncua ntawm cov leukocytes lossis platelets tuaj yeem raug sau tseg, feem ntau yog ua ib ntus thiab tsis muaj qhov tshwm sim ntawm agranulocytosis lossis aplastic anemia. Ua ntej pib lub chav kawm, nrog rau thaum lub sijhawm txheej txheem kev kho mob, kev kuaj ntshav hauv cov ntshav yuav tsum muaj, suav nrog suav cov platelets thiab, tej zaum, reticulocytes, thiab txiav txim siab txog qib hemoglobin.

Cov neeg mob yuav tsum raug qhia paub txog cov cim ua ntej ntawm kev mob toxicity thiab cov tsos mob ua rau muaj kev cuam tshuam txog hematologic, nrog rau cov tsos mob los ntawm daim tawv nqaij thiab lub siab. Nws yog qhov yuav tsum tau sab laj nrog kws kho mob yog tias muaj kev txhim kho ntawm qhov mob tsis zoo li mob caj pas, kub cev, tawm pob, txhaws ntawm lub qhov ncauj ntawm qhov ncauj, thiab tsis muaj dab tsi tshwm sim los ntawm kev mob ntshav thiab los ntshav. Nyob rau hauv cov ntaub ntawv ntawm cov cim ntawm mob hlwb txha hnyav, Zeptol yuav tsum tau lawm.

Ua ntej pib txoj kev kho mob thiab ntu thaum lub sijhawm nws pib siv, nws raug nquahu kom kawm cov haujlwm ntawm lub siab, tshwj xeeb tshaj yog nyob rau cov neeg laus thiab cov neeg mob uas muaj keeb kwm ntawm qhov mob txhab. Yog tias muaj kev nce ntxiv hauv kev ua haujlwm dhau los ntawm lub siab lossis qhov tshwm sim ntawm tus kab mob siab ua haujlwm, nrhiav kev kho nrog cov tshuaj yuav tsum nres tam sim ntawd.

Kev kho nrog cov tshuaj antiepileptic hauv qee kis tuaj yeem tshwm sim nrog kev tshwm sim ntawm kev tua tus kheej / kev xav tua tus kheej. Txij li cov txheej txheem ntawm kev tshwm sim ntawm kev tua tus kheej thaum siv cov tshuaj no tsis tau tsim, nws txoj kev loj hlob tsis tuaj yeem txiav txim siab thaum noj Zeptol. Cov neeg mob thiab lawv cov tub qhe yuav tsum tau ceeb toom txog qhov yuav tsum tau nrhiav kev pab kho mob sai sai yog tias pom tias muaj kev xav tua / mob siab.

Cov neeg laus thaum lub sij hawm kho tus mob yuav tsum tau saib xyuas vim muaj qhov ua tau txaus siab rau qhov tsis txaus siab lub siab ntsws, tsis meej pem thiab ua kom muaj kev ntxhov siab.

Kev tsis ua haujlwm sai ntawm kev kho carbamazepine tuaj yeem ua rau qaug dab peg. Yog tias tshem tawm sai ntawm Zeptol yog qhov tsim nyog, tus neeg mob yuav tsum pauv mus rau lwm cov tshuaj tiv thaiv kev mob thaum lub sij hawm kho nrog cov tshuaj uas tsim nyog rau cov xwm txheej zoo li no (piv txwv li, phenytoin siv tshuaj iv lossis diazepam siv iv lossis kho).

Thaum kho, kev txhim kho kev mob hnyav ntxiv (suav nrog Stevens-Johnson mob, Lyell's syndrome) tsis tshua muaj mob. Kev siv cov Zeptol yuav tsum tau txiav tawm tam sim ntawd yog tias pom thiab cov tsos mob tshwm sim uas xav tias ua rau cov teeb meem no. Nrog rau kev txhim kho cov kev phom sij ntawm daim tawv nqaij hnyav kawg, tus neeg mob yuav tsum coj mus tom tsev kho mob. Raws li txoj cai, qhov pom ntawm cov kev tsis zoo no tau sau tseg hauv thawj lub hlis ntawm chav kawm ntawm txoj kev kho.

Raws li kev txheeb xyuas yav dhau los ntawm kev siv Zeptol, cov neeg mob ntawm haiv neeg Suav muaj qhov sib txheeb ntawm qhov ntau zaus ntawm daim tawv nqaij hnyav cuam tshuam nrog carbamazepine thiab muaj cov tib neeg leukocyte antigen (HLA) hauv cov genome ntawm cov neeg mob HLA-B * 1502. Thaum kho cov neeg mob carbamazepine nyob hauv cov teb chaws ntawm thaj av Asia (Philippines, Malaysia, Thaib), qhov twg qhov xwm txheej ntawm cov kab mob no tau sau cia, qhov nce ntawm qhov tshwm sim ntawm kev mob dermatological loj heev tau sau tseg (los ntawm kwv yees qhov ntau "tsawg kawg" rau "tsis tshua muaj").

Hauv cov neeg mob uas muaj peev xwm thauj tau HLA-B * 1502 allele (piv txwv li, cov neeg ntawm haiv neeg Suav), kev xeem yuav tsum tau nqa tawm rau nws qhov muaj nyob hauv caj ces. Nws raug nquahu kom ua txoj kev kho tshuaj nyob rau hauv cov nqa khoom ntawm no allele tsuas yog tias xav paub txog cov txiaj ntsig ntawm kev kho mob ntev dhau qhov kev pheej hmoo ntawm kev mob. Cov sawv cev ntawm Caucasian, Negroid thiab Americanoid haiv neeg tau qhia me ntsis ntawm qhov sib txawv los saum toj no.

Ua ntej pib txoj kev kho mob Zeptol, koj yuav tsum tsum tsis txhob noj MAO inhibitors tsawg kawg 14 hnub lossis txawm tias ntxov dua, yog tias cov chaw kho mob tau tso cai.

Yeeb tshuaj sib cuam tshuam

CYP3A4 isoenzyme inhibitors: nce ntawm carbamazepine hauv ntshav thiab qhov kev pheej hmoo ntawm kev phiv yog nce,
qhov tsim nyog ntawm CYP3A4 isoenzyme: carbamazepine metabolism yog nrawm, uas ua rau txo qis hauv nws cov ntsiab lus hauv plasma thiab kev ua kom tsis muaj zog ntawm nws txoj kev kho mob,
cov tshuaj tiv thaiv kab mob (vigabatrin, styrypentol), tshuaj tiv thaiv kab mob (fluvoxamine, trazodone, desipramine, nefazodone, fluoxetine, viloxazine, paroxetine), antipsychotics (olanzapine), cov leeg ua kom mob hlwb (dantrolene, oxygenbutynin), tshuaj tiv thaiv kab mob, nicotine. siv tshuaj ntau), azole tshuaj ntsuab (ketoconazole, voriconazole, fluconazole, itraconazole), HIV tiv thaiv kab mob tiv thaiv kab mob (xws li ritonavir), siv tshuaj tiv thaiv antiulcer (cimetidine, omeprazole), calcium antagonists (diltiazem, verapamil), anti-glaucoma cov tshuaj (acetazolamide), tshuaj tua kab mob macrolide (clarithromycin, erythromycin, troleandomycin, josamycin), antihistamines (loratadine, terfenadine), tshuaj antiplatelet (ticlopidine), analgesics thiab non-steroidal anti-inflammatory drugs (NSAIDs), androprophenol (tshuaj tua kab mob), androprophenol plasma concentration ntawm carbamazepine, uas tuaj yeem ua rau muaj qhov tshwm sim ntawm qhov tshwm sim tsis zoo (tsaug zog, kiv taub hau, ataxia), nws yuav tsum tau soj ntsuam kom tsis tu ncua thiab kho cov qib carbamazepine hauv cov ntshav,
loxapine, primidone, quetiapine, valproic acid, progabid, valpromide, valnoktamide: cov plasma cov ntsiab lus ntawm carbamazepine-10,11-epoxide nce, kev txhim kho ntawm qhov tsis tsim nyog muaj peev xwm ua tau, nws yog qhov tsim nyog los tswj cov theem ntawm cov tshuaj no hauv cov ntshav thiab kho qhov koob ntawm Zeptol,
antiepileptics (mezuksimid, oxcarbazepine, fosphenytoin, fensuksimid, felbamate, phenytoin, primidone, phenobarbital, tej zaum raws li clonazepam), antituberculosis agents (rifampicin), antineoplastic agents (doxorubicin, cisplatin), retinoids (isotretinoin), bronchodilators (aminophylline, theophylline) , kev npaj ntawm St. John lub wort perforated (Hypericum perforatum): qib carbamazepine hauv cov ntshav ntshav poob qis, nws yuav tsim nyog hloov nws cov koob tshuaj,
cov tshuaj tua kab mob (doxycycline), NSAIDs, analgesics (paracetamol, buprenorphine, tramadol, methadone, phenazone), cov tshuaj antiepileptic (topiramate, clonazepam, felbamate, clobazam, ethosuximide, lamotrigine, valproic acid, ntshav qab zib, dicumarol, warfarin, acenocoumarol, fenprocoumone), antidepressants (mianserin, bupropion, trazodone, citalopram, sertraline, nefazodone), tricyclic antidepressants (amitriptyline, imipramine, clomipramine, nortriptyline) onazole), cov tshuaj anthelmintic (praziquantel), tshuaj antineoplastic (imatinib), tshuaj tiv thaiv kab mob (risperidone, clozapine, bromperidol, quetiapine, ziprasidone, haloperidol, olanzapine), tshuaj tiv thaiv kab mob (mob eurrolimus, cyclosporidroinin) , glucocorticosteroids (dexamethasone, prednisone), anxiolytics (midazolam, alprazolam), HIV protease inhibitors (saquinavir, ritonavir, indinavir), bronchodilators (theophylline), tshuaj tiv thaiv hormonal, tshuaj uas txo cov ntshav siab (felodipine) Reparata, ib tug muaj pes tsawg leeg muaj tshuaj thiab / los yog progesterone: tau txo nyob rau hauv ntshav ntau ntawm cov tshuaj mas siv yuav tsum tau kev kho ntawm lawv koob tshuaj,
phenytoin, mefenitoin: qib phenytoin yuav nce / txo, mefenitoin ntau ntau yuav nce.

Carbamazepine reacts nrog lwm cov tshuaj / tshuaj uas yuav tsum tau coj mus rau hauv tus account:

isoniazid: hepatotoxicity tshwm sim los ntawm cov tshuaj no yuav nce ntxiv
diuretics (furosemide, hydrochlorothiazide): cov tsos mob ntawm cov tsos mob hyponatremia yuav raug sau tseg,
levetiracetam: tej zaum yuav exacerbate cov tshuaj phiv los ntawm carbamazepine,
cov tshuaj tiv thaiv kev tiv thaiv kab mob (thioridazine, haloperidol), lithium npaj lossis metoclopramide: qhov nquag ntawm qhov tsis xav txog neurological yuav nce ntxiv (thaum ua ke nrog antipsychotics - txawm tias muaj ntshav ntau ntau ntawm cov tshuaj uas muaj),,
non-depolarizing cov leeg ua kom mob (pancuronium bromide): carbamazepine tuaj yeem nthuav tawm cov kev ua kom tsis haum rau cov kev ua haujlwm ntawm cov neeg sawv cev no, nrog kev sib xyaw no, nws yuav tsim nyog los nce cov koob tshuaj ntawm cov nqaij ntshiv, ua tib zoo saib xyuas ntawm tus neeg mob lub sijhawm yog qhov tsim nyog vim qhov xav tau sai dua qhov xav kom ua tiav ntawm neuromuscular blockade,
hormonal contraceptives: qhov ua kom tau txais txiaj ntsig ntawm cov tshuaj no yuav txo qis vim qhov pib ntawm microsomal enzymes, muaj cov ntaub ntawv hais txog los ntshav hauv lub sijhawm thaum coj khaub ncaws, nws yog qhov yuav tsum tau mus rau lwm txoj hauv kev tiv thaiv,
ethanol: tej zaum yuav muaj qhov txo qis hauv nws lub siab, thaum kho nws yog qhov yuav tsum yoo kom tsis txhob haus cawv.

Cov qauv ntawm Zeptol yog: Carbamazepine, Carbalepsin retard, Carbamazepine retard-Akrikhin, Carbamazepine-Ferein, Carbamazepine-Acre, Finlepsin, Tegretol, Finlepsin retard, thiab lwm yam.

Zeptol xyuas

Qhov kev kuaj xyuas ob peb ntawm Zeptol feem ntau zoo. Ntau tus neeg mob nco ntsoov tias cov tshuaj muaj txiaj ntsig txo cov kev pheej hmoo ntawm kev qaug dab peg, qhia tau cov txiaj ntsig zoo rau cov tsos mob ntawm kev nyuaj siab, txo kev chim siab, nrog rau txo cov mob neurogenic thiab txo qhov kev siv ntawm kev tawm tsam nrog trigeminal neuralgia. Qhov tsis zoo ntawm Zeptol suav nrog ntau cov kev mob tshwm sim.