Phapang ke efe pakeng tsa Finlepsin le Finlepsin Retard? Melao ea Finlepsin: litaelo tsa tšebeliso

Setsi sa Federal sa Neurosurgery

TREELISANG MOSA.

Empa o mosebelisi ea sa lumelloang.

Haeba u ngolisitse pejana, ebe "ngolla" (foromo ea ho kena karolong e kaholimo ho setsi). Haeba ke lekhetlo la hau la pele mona, ingolise.

Haeba u ingolisa, u tla tseba ho fumana likarabo melaetseng ea hau nakong e tlang, tsoela pele ka puisano ka lihlooho tse khahlisang le basebelisi ba bang le baeletsi. Ntle le moo, ngodiso e tla u lumella ho etsa mangolo a poraefete le baeletsi le basebelisi ba bang ba sebaka seo.

Tekanyetso le tsamaiso

100 mg ka shoalane 100 mg ka shoalane
Tekanyetso ea tlhokomelo ea 200-600 mg letsatsi le letsatsi hoseng 400-600 mg ka shoalane
200 mg hoseng ka 200-400 mg ka shoalane 200-400 mg hoseng 400-600 mg ka shoalane

Methapo ea tekanyetso e bontšitsoeng tafoleng ha ea lokela ho fetisoa.
Phekolo ea ho tlosa joala maemong a sepetlele.
Tekanyetso e tloaelehileng ea letsatsi le letsatsi e lumellana le 600 mg ea carbamazepine (200 mg hoseng le 400 mg ka shoalane).
Oho
Maemong a tebileng, matsatsing a pele, lethal dose le ka eketsoa ho 1200 mg ea carbamazepine ka letsatsi, e arotsoeng ka litekanyetso tse peli. Phokotso ea Finlepsin ha ea lokela ho kopanngoa le lithethefatsi tsa sedative-hypnotic. Haeba ho hlokahala, mokokotlo oa Finlepsin o ka kopanngoa le lintho tse ling tse sebelisoang ho phekola ho itlopa joala. Nakong ea kalafo, ho hlokahala hore ho hlahlojoe khafetsa litaba tsa carbamazepine ka plasma ea mali. Mabapi le nts'etsopele ea litla-morao tse tsoang mokhatlong oa methapo ea kutlo le ea boithaopo, bakuli ba hlahlojoa ka hloko sepetlele.
Trigeminal neuralgia, idiopathic neuropathy ea mokokotlo oa glossopharyngeal.
Motsoako oa pele ke 200-400 mg ea carbamazepine ka letsatsi, e arotsoe ka litekanyetso tse peli. Tekanyetso ea pele e eketseha ho fihlela bohloko bo nyamela ka ho feletseng, ka karolelano ho fihlela ho 400-800 mg ea carbamazepine ka letsatsi. Kamora moo, karolong e itseng ea bakuli, kalafo e ka tsoela pele ka tekanyetso e tlase ea tlhokomelo ea 400 mg ea carbamazepine.
Finardpsin retard e beoa ho bakuli ba tsofetseng le bakuli ba amehang ka karabamazepine ka tekanyetso ea pele ea 100 mg carbamazepine (1/2 tablet ea 200 mg) makhetlo a 2 ka letsatsi.
Bohloko ho lefu la tsoekere.
Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 200 mg hoseng le 400 mg ea carbamazepine ka shoalane. Maemong a ikhethang, mokokotlo oa Finlepsin o ka khethoa ka tekanyetso ea 600 mg ea carbamazepine makhetlo a 2 ka letsatsi. Lefu la ho tsitsipana ha methapo ea methapo ea methapo maling le methating e mengata.
Oho
Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 400 - 800 mg ea carbamazepine, e arotsoe ka litekanyetso tse peli.
Phekolo le thibelo ea psychosis
Tekanyetso ea pele, hangata e tsamaellanang le tekanyetso ea tlhokomelo, ke 200-400 mg ea carbamazepine ka letsatsi. Ha ho hlokahala, lethal dose lena le ka eketsoa ho 800 mg ea carbamazepine ka letsatsi, e arotsoe ka litekanyetso tse peli.
Nako ea ts'ebeliso e itšetlehile ka matšoao le karabelo ea motho ka mong ho ea lithethefatsi. Lefu la ho akheha le phekoloa ka nako e telele. Ngaka e ikhethang e lokela ho etsa qeto ea phetisetso ea mokuli ho ea Finlepsin retard, nako ea tšebeliso le ho hlakoloa ha eona nyeoeng ka 'ngoe. Tekanyo ea moriana e ka fokotsoa kapa ea khaotsa ho phekoloa ka mokhoa o sa feteng ka mor'a ho se ts'oaroe ke lilemo tse 2-3.
Phekolo e emisoa ke ho fokotseha butle-butle ha tekanyetso ea moriana bakeng sa lilemo tse 1-2. Maemong ana, bana ba lokela ho nahana ka keketseho ea boima ba 'mele. Matšoao a Electroencephalogram ha a lokela ho senyeha.
Ka kalafo ea neuralgia, ho bohlokoa ho fana ka mokokotlo oa Finlepsin ka lethal dose le lekaneng ho imolla bohloko, bakeng sa libeke tse 'maloa. Ka ho theola tekanyetso, hoa hlokahala ho fumana monyetla oa ho khutla ha matšoao. Ka ho qala ho utloa bohloko, kalafo e ntse e tsoela pele ka tekanyetso ea tlhokomelo.
Nako ea kalafo bakeng sa bohloko ho lefu la tsoekere le methapo ea methapo ea sethoathoa le ho ruruha ha sethoathoa ho sclerosis e ngata e tšoana le bakeng sa neuralgia.
Phekolo ea Finlepsin e khutlisetsang lefu la ho tlohela lino tse tahang e emisoa ka phokotso ea butle-butle ka nako e fetang matsatsi a 7-10.

Litlhokahalo tsa polokeho

Finlepsin Retard - sethethefatsi bakeng sa kalafo ea lefu la sethoathoa la libenzazepine. E na le antidepressant, antipsychotic, vasopressin-like action. Ho batho ba nang le ts'oaetso ea methapo ea kutlo, e khetholloang ke ho opeloa ke lehlaba sebakeng sa polokelo ea methapo, e bontša phello ea analgesic. Phello ea meriana e bakoa ke ho se sebetse ha liteishene tse nang le sodium e nang le methapo e ngata haholo, ka lebaka leo metso ea methapo e mengata ea thabo e tsitsitseng, motsoako oa li-neurons tse latellanang tse latellanang o tlatselletsoang. E thibela glutamate, amino acid e nang le ts'ebetso ea methapo ea kutlo, ho kena sebakeng se kenellanang, mme e sututsa mohopolo oa ho ts'oaroa ha bokong, ka tsela eo e fana ka matla a antiepileptic. E khothaletsa sephethephethe se sebetsang sa transmembrane sa ions tsa potasiamo. Ho batho ba nang le lefu la sethoathoa (haholo-holo bakeng sa bana le bacha), lithethefatsi li fokotsa ho tšoenyeha, ho teba ha lipontšo tse nyahamisang, ho teneha hoa fokotseha, 'me mabifi a nyamela. Kameho ea ts'ebetso ea kelello le litšobotsi tsa psychomotor e hlahisoa ke tekanyetso ea moriana o nkuoeng. Phello ea anticonvulsant e qala ho hlaha ka bongata ho tloha lihora tse 3-4 ho isa matsatsing a 'maloa (maemong a mang - ho fihlela matsatsi a 30). Ka lefu la hangover, e sututsa boikemisetso ba ts'ebetso ea ts'ebetso ea ts'ebetso tlase ho ts'usumetso ea joala, e hatella matšoao a ho tlohela (e tlosa thabo e matla, ho thothomela ho sa tsitsang ha menoana, ho tepella ka ho feteletseng.

Matla a antipsychotic a hlaha kamora matsatsi a 7-10. Ho qala ha nako e telele joalo ka ts'ebeliso ea lithethefatsi ka mokhoa ona ho ka amahanngoa le khatello ea dopamine le norepinephrine metabolism. Finlepsin Retard ke foromo ea nako e telele ea litekanyetso e fanang ka litekanyo tse tsitsitseng tsa ntho e sebetsang plasma e nang le khafetsa ea tsamaiso ea makhetlo a 1-2 ka letsatsi. Ka tsamaiso ea molomo ea sethethefatsi, sethethefatsi se kenella hanyane ka hanyane empa se kenelletse ka botlalo ka mpeng ea mokokotlo (boteng ba litaba tsa lijo ka mpeng ea mpa ha bo na phello e phatlalalitsoeng ka lebelo le phetheho ea ho monya). Khokahanyo e phahameng ea karolo e sebetsang maling e bonoa lihora tse 32 kamora ts'ebetso. Bonyane halofo ea bophelo ba motho o nka lihora tse ka bang 70. Ho tlosa mmele ho tsoa 'meleng ho etsoa haholo ke liphio, mme ka tekanyo e tlase, ka mala. Nako e lekaneng ea ho ja e ba le hang kapa ka mor'a lijo. E lumelloa ho hlakola letlapa kapa karolo ea lona ka metsing pele ho tsamaiso: nako ea lithethefatsi ha e utloe bohloko ke sena. Ho amoheloa hangata - makhetlo a 1-2 ka letsatsi. Mokhoa oa lithethefatsi o qala ka tekanyetso e nyane ea letsatsi le letsatsi ka keketseho e latellanang ho fihlela karabelo e boletsoeng ea kalafo e fihlelleha.

Thutela-litso

Motsoako oa litlhare oa antiepileptic o tsoang ho tricyclic iminostilbene. Ho lumeloa hore phello ea anticonvulsant e amahanngoa le ho fokotseha ha bokhoni ba li-neurons ho boloka boemo bo phahameng ba menyetla ea bohato bo pheta-phetoang ka ho inactivation of lodium channels. Ntle le moo, thibelo ea tokollo ea neurotransmitter ka ho thibela liketane tsa sodium ea preynaptic le nts'etsopele ea lintho tse ka u thusang, tseo ka nako eo li fokotsang phetiso ea synaptic, ho bonahala e le tsa bohlokoa.

E na le litekanyetso tse leka-lekaneng tsa antimaniacal, antipsychotic, hammoho le phello ea analgesic bakeng sa bohloko ba neurogenic. Li-receptor tsa GABA, tse ka 'nang tsa amahanngoa le liteishene tsa calcium, li ka ameha mekhoeng ea ts'ebetso, mme phello ea carbamazepine lits'ebetsong tsa li-modotine tsa neurotransmitter le eona e bonahala e le bohlokoa.

Phello ea antidiuretic ea carbamazepine e kanna ea amahanngoa le phello ea hypothalamic ho osmoreceptors, e arolelanoang ka secretion ea ADH, hape le ka lebaka la phello e tobileng ho li-renal tubules.

Mofumahali

Kamora ho tsamaisoa ka molomo, carbamazepine e batla e nkiloe ka botlalo ho tsoa ho tšilo ea lijo. Ho kopanya liprotheine tsa plasma ke 75%. Ke mofuta oa li-enzymes tsa sebete 'me o tsosa metabolism ea eona.

T 1/2 ke lihora tse 12- 29. 70% e qheletsoe ka har'a moroto (ka tsela e sa sebetseng ea metabolites) le 30% e nang le mantle.

Fomu ea tokollo

Matlapa a nkileng nako e telele ho tloha ho o mosoeu ho ea ho o mosoeu o nang le 'mala o moputsoa, ​​o boreleli, o bataletseng, o nang le metsero e chitja, o nang le mela ea liphoso tse bopehileng ka mahlakoreng a mabeli le likotopo tse 4 lehlakoreng la sefahleho.

Baeti: kopolymer ea ethyl acrylate, methyl methacrylate le trimethylammonioethyl methacrylate (1: 2: 0.1) (Eudragit RS30D), triacetin, talc, kopolymer ea methaconic acid le ethyl acrylate (1: 1) (Eudragit L30D-55) cellcryoseine. magnesium stearate.

Li-pcs tse 10 - lithutsoana (5) - lipakete tsa karete.
Li-pcs tse 10 - Liphutheloana tsa lithutsoana (5) - lipakete tsa karete.
Li-pcs tse 10 - Liphutheloana tsa lithutsoana (3) - lipakete tsa karete.
Li-pcs tse 10 - Liphutheloana tsa lithutsoana (4) - lipakete tsa karete.

Kenya ka bonngoe. Ha ho nooa ka molomo ho batho ba baholo le ba lilemong tsa bocha ba lilemo tse 15 le ho feta, tekanyetso ea pele ke 100-400 mg. Haeba ho hlokahala, le ho nahana ka phello ea tleliniki, lethal dose le eketseha ka nako e sa feteng 200 mg / letsatsi ka karohano ea beke e le 'ngoe. Khafetsa ea tsamaiso ke linako tse 1-4 / ka letsatsi. Motsoako oa tlhokomelo hangata o ba 600-1200 mg / ka letsatsi ho litekanyetso tse 'maloa. Nako ea kalafo e itšetlehile ka matšoao, katleho ea kalafo, karabelo ea mokuli kalafong.

Ho bana ba ka tlase ho lilemo tse 6, 10-20 mg / kg / letsatsi e sebelisoa ka tekanyetso e arohaneng ea 2-3, haeba ho hlokahala ebile e nahanela mamello, lethal dose le eketseha ka se fetang 100 mg / ka letsatsi ka nako ea beke e le 'ngoe, tekanyo ea tlhokomelo e hangata e le 250 -350 mg / letsatsi mme ha e fetise 400 mg / letsatsi. Bana ba lilemo li 6-12 - 100 mg makhetlo a 2 / letsatsi ka letsatsi la pele, ebe lethal dose le eketseha ka 100 mg / ka letsatsi le nako ea beke e le 'ngoe. ho fihlela phello e nepahetseng, tekanyo ea tlhokomelo e hangata ke 400-800 mg / ka letsatsi.

Palo e phahameng: ha ho nkuoa ka molomo, baholo le bacha ba lilemo tse 15 le ho feta - 1,2 g / letsatsi, bana - 1 g / letsatsi.

Tšebelisano

Ka tšebeliso e tšoanang ea li-inhibitors tsa isoenzyme CYP3A4, keketseho ea khatello ea carbamazepine plasma ea mali e khonahala.

Ka tšebeliso e tšoanang ea li-inducers tsa CYP3A4 isoenzyme system, ho ka khoneha ho potlakisa metabolism ea carbamazepine, ho fokotsa mokokotlo oa eona ho plasma ea mali, le ho fokotsa phello ea kalafo.

Ka tšebeliso e tšoanang ea carbamazepine e matlafatsa metabolism ea li-anticoagulants, folic acid.

Ka tšebeliso ea nako e le 'ngoe le valproic acid, ho fokotseha ha khatello ea carbamazepine le ho fokotseha ho hoholo hoa khatello ea "valproic acid" plasma ea mali hoa khoneha. Ka nako e ts'oanang, ts'ubuhlellano ea carbamazepine metabolite, carbamazepine epoxide, ea eketseha (mohlomong e le ka lebaka la thibelo ea phetoho ea eona ea carbamazepine-10,11-trans-diol, eo hape e nang le ts'ebetso ea anticonvulsant, kahoo litlamorao tsa ts'ebelisano ena li ka hlahisoa, empa litla-morao tsa maikutlo li hlaha hangata - pono e fifalitsoeng, ho tsekela, ho hlatsa, bofokoli, nystagmus Ka tšebeliso e tšoanang ea valproic acid le carbamazepine, nts'etsopele ea phello ea hepatotoxic e khonahala (ho hlakile, ka lebaka la ho thehoa ha metabolite ea bobeli ea valproic acid, e nang le phello ea hepatotoxic).

Ka tšebeliso ea nako e le 'ngoe, valpromide e fokotsa metabolism ka har'a sebete sa carbamazepine le metabolite ea eona ea carbamazepine-epoxide ka lebaka la thibelo ea enzyme epoxide hydrolase. Metabolite e boletsoeng e na le ts'ebetso ea anticonvulsant, empa ka keketseho e kholo ea mahloriso a plasma e ka ba le chefo.

Ka tšebeliso e le 'ngoe le verapamil, diltiazem, isoniazid, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, cimetidine, acetazolamide, danazole, desipramine, nicotinamide (ho batho ba baholo, feela ka tekanyetso e phahameng), erythromycin, truzeroycin, trolezcin, trcinerocin. ho kenyelletsa le itraconazole, ketoconazole, fluconazole), terfenadine, loratadine, keketseho ea khatello ea carbamazepine maling a mali e ka etsahala ka kotsi ea litla-morao (ho tsekela, ho otsela, ataxia, diplopia).

Ka tšebeliso e tšoanang le hexamidine, phello ea anticonvulsant ea carbamazepine e fokola, ka hydrochlorothiazide, furosemide - hoa khoneha ho fokotsa litaba tsa sodium maling, ka lithibela-pelehi tsa lihormone - ho khonahala ho fokolisa phello ea lithibela-pelehi le nts'etsopele ea mali a acyclic.

Ka tšebeliso e tšoanang ka lihormone tsa qoqotho, ho ka etsahala ho eketsa ho felisoa ha li-hormone tsa qoqotho, ka clonazepam, ho khonahala ho eketsa ho hlakileng ha clonazepam le ho fokotsa ho hlakisoa ha carbamazepine, ka litokisetso tsa lithium, ntlafatso e lumellanang ea phello ea methapo ea methapo.

Ka tšebeliso ea nako e le 'ngoe le primidone, ho fokotseha ha khatello ea carbamazepine ho plasma ea mali hoa khoneha. Ho na le litlaleho tsa hore primidone e ka eketsa mahloriso a plasma ea metabolacology e sebetsang ea caracamazepine-10,11-epoxide.

Ka tšebeliso ea nako e le 'ngoe le ritonavir, litlamorao tsa carbamazepine li ka ntlafatsoa, ​​ka sertraline, ho fokotseha ha khatello ea sertraline ho ka khoneha, ka theophylline, rifampicin, cisplatin, doxorubicin, ho fokotseha ha mahloriso a carbamazepine ho plasma ea mali, ka litlamorao tsa lefu la mmele.

Ka tšebeliso e le 'ngoe le felbamate, ho fokotseha ha khatello ea carbamazepine ka plasma ea mali hoa khoneha, empa keketseho ea khatello ea metabolite e sebetsang ea carbamazepine-epoxide, ha nako e ntse e fokotseha ea mahloriso ho plasma ea felbamate e ka etsahala.

Ka tšebeliso e le 'ngoe le phenytoin, phenobarbital, khatello ea carbamazepine e plasma ea mali e fokotseha. Ho fokolisa hoa matla ha ketso ea anticonvulsant hoa khoneha, mme maemong a sa tloaelehang, ho matlafatsoa hoa eona.

Litlamorao

Ho tloha lehlakoreng la tsamaiso ea methapo e bohareng le tsamaiso ea methapo ea methapo: hangata - ho tsekela, ho tšaba, ho otsela, ho opa ke hlooho, diplopia, likhathatso tsa bolulo, ka seoelo - ho sisinyeha ka boomo, nystagmus, maemong a mang - oculomotor ferekanyi, dysarthria, peripheral neuritis, paresthesia, bofokoli ba mesifa, matšoao paresis, hallucinations, khatello ea maikutlo, mokhathala, boitšoaro bo mabifi, ho ferekana kelellong, ho akheha kelellong, kelello e eketsehileng, ho senyeha ha tatso, conjunctivitis, tinnitus, hyperacusis.

Ho tsoa ho tsamaiso ea tšilo ea lijo: ho nyekeloa ke pelo, ho eketseha ha GGT, ts'ebetso e eketsehileng ea alkaline phosphatase, ho hlatsa, molomo o omileng, ka seoelo - ts'ebetso e eketsehang ea transaminase, jaundice, hepatitis ea cholestatic, ho hlaba kapa ho sokela, maemong a mang - ho fokotseha takatso ea lijo, bohloko ba ka mpeng, glossitis, stomatitis.

Ho tsoa ho tsamaiso ea pelo: ka seoelo - ho ba le tšisinyeho ea maikutlo a myocardial, maemong a mang - bradycardia, arrhythmias, AV blockade e nang le syncope, ho oa, ho nyekeloa ke pelo, lipontšo tsa ho haella ha coronary, thrombophlebitis, thromboembolism.

Ho tsoa ho tsamaiso ea hemopoietic: leukopenia, eosinophilia, thrombocytopenia, ka seoelo - leukocytosis, maemong a mang - agranulocytosis, anemia ea aplasiki, erythrocytic aplasia, anemia ea anemia, reticulocytosis, anemia hepatitis.

Ho tloha ka lehlakoreng la metabolism: hyponatremia, ho boloka mokelikeli, edema, ho eketsa boima ba 'mele, ho fokotseha ha osmolality ea plasma, maemong a mang - porphyria e matla, khaello ea folic acid, mathata a calcium metabolism, cholesterol le triglycerides e matla.

Ho tloha ts'ebetsong ea endocrine: gynecomastia kapa galactorrhea, ka seoelo - dysfunction ea thyroid.

Ho tsoa ts'ebetsong ea moroto: ka seoelo - ts'ebetso ea renal e sa sebetseng hantle, nephritis ea methapo le ho se sebetse hantle ha renal.

Ho tsoa ts'ebetsong ea phefumoloho: maemong a mang - dyspnea, pneumonitis kapa pneumonia.

Bohloko bo bakoang ke ho ruruha: lekhopho la letlalo, ho hlohlona, ​​ka seoelo - lymphadenopathy, feberu, hepatosplenomegaly, arthralgia.

Lefu la ho akheha: Ho ts'oaroa ha sethoathoa ho hoholo, ho tsepame Letšoao la bohloko hangata ka tšimoloho ea neurogenic, ho kenyeletsoa neuralgia ea bohlokoa ea trigeminal, neuralgia ea trigeminal ho sclerosis e ngata, neuralgia ea bohlokoa ea glossopharyngeal. Thibelo ea litlhaselo tse nang le lefu la ho itlopa joala. Li-psychoses tse amehang le tse hlokang kelello (joalo ka mokhoa oa thibelo). Lefu la tsoekere la lefu la tsoekere le bohloko. Lefu la tsoekere la tlhaho ea tlhaho, polyuria le polydipsia ea tlhaho ea neurohormonal.

Bokhachane le pelehi

Haeba ho hlokahala, sebelisa nakong ea bokhachane (haholo-holo ka nako ea pele ea ho pepa) le nakong ea pelehi e lokelang ho lekanya melemo ea kalafo e lebelletsoeng ho mme le kotsi ho lesea kapa lesea. Tabeng ena, carbamazepine e khothalletsoa ho sebelisoa feela e le monotherapy ka tekanyetso e sebetsang e tlase.

Basali ba lilemo tsa ho ba le bana nakong ea kalafo le carbamazepine ba khothalletsoa ho sebelisa lithibela-pelehi tse seng li-hormone.

Litaelo tse khethehileng

Carbamazepine ha e sebelisoe ho tsietsana ha sethoathoa kapa ho ruruha ho hoholo ha sethoathoa, myoclonic kapa atonic epileptic. Ha ea lokela ho sebelisoa ho imolla bohloko bo tloaelehileng, joalo ka prophylactic nakong ea nako e telele ea tšoarelo ea methapo ea methapo ea kutlo.

E sebelisoa ka hloko ha ho tšoaroa ke mafu a kopaneng a methapo ea pelo, ts'ebetso e matla ea sefuba le / kapa ts'ebetso ea meno, lefu la tsoekere, ho eketseha ha khatello ea methapo, le nalane ea maikutlo a hematological ts'ebelisong ea lithethefatsi tse ling, hyponatremia, ts'ebetso ea moroto, le kutloelo-bohloko e eketsehang ho li-antidepressants tsa tricyclic , e nang le matšoao a nalane ea ho sitisoa ha kalafo ea carbamazepine, hammoho le bana le bakuli ba tsofetseng.

Phekolo e lokela ho etsoa tlasa taolo ea ngaka. Ka kalafo ea nako e telele, hoa hlokahala ho laola setšoantšo sa mali, boemo bo sebetsang ba sebete le liphio, mokokotlo oa li-electrolyte maling a mali le tlhahlobo ea mahlo. Boikemisetso ba nako le nako ba boemo ba carbamazepine maling a mali bo khothalletsoa ho lekola katleho le polokeho ea kalafo.

Bonyane libeke tse 2 pele o qala kalafo ea carbamazepine, ho hlokahala ho emisa kalafo le li-inhibitors tsa MAO.

Nakong ea kalafo u se ke ua lumella tšebeliso ea joala.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Nakong ea kalafo, motho o lokela ho hana ho etsa lintho tse kotsi tse hlokang tlhokomelo e eketsehileng, le lebelo la karabelo ea psychomotor.

BarekingSar . Finlepsin retard ke anticonvulsant derivative ea trincil iminostilbene. E bonts'a ts'ebetso ea antiepileptic, neurotropic le psychotropic. Phello ea kalafo e bakoa haholo ke thibelo ea phetisetso ea transaptic, 'me ka lebaka leo, ho fokotseha hoa ts'oaetso ea litlhaselo tse matla. Libakeng tse phahameng haholo, carbamazepine e baka ho fokotseha hoa bokhoni ba ka morao ho tetanic. Ho khutla ha Finlepsin ho fokotsa botebo ba bohloko ba ho utloa bohloko ka ho arohana ha neuralgia. Sena se bakoa ke ho sitisa phetiso ea kutloelo-bohloko ea kutloelo-peleho mokokotlong oa mokokotlo oa mokokotlo oa methapo ea kutlo. Ka lefu la tsoekere, "retleidin retard" e na le tšusumetso e matla, mohlomong ka lebaka la phello ea hypothalamic ho osmoreceptors.

Mofumahali Kamora ho tsamaisoa ka molomo, carbamazepine e ananeloa butle ebile e batla e felletse.

Nako ea halofo ea bophelo ke lihora tse 8,5 mme e na le bophara bo fapaneng (lihora tse 1,72-12). Kamora tekanyetso e le 'ngoe ea C max, carbamazepine e plasma ea mali ho batho ba baholo e fihlella kamora lihora tse 4-16 (hangata haholo kamora lihora tse 35), ho bana kamora lihora tse ka bang 4-6. ha e sebelisoa ka tekanyetso e phahameng, mokokotlo oa plasma o na le sebopeho sa sehlaba.

Ha ho sebelisoa matlapa a nako e telele a ho lokolla, khatello e fokolang ea carbamazepine e plasma ea mali e fumanoa ho feta ka matlapa a tloaelehileng.

Khatello ea tekano e fihlelloa kamora matsatsi a 2-8. Ha ho na khokahano e haufi pakeng tsa tekanyetso ea carbamazepine le khoholeho e tsitsitseng ho lekanang ho plasma ea mali.

Mabapi le kalafo e amang maikutlo le e nang le chefo ea carbamazepine plasma ea mali, ho bontšoa hore ho ts'oaroa ho ka nyamela ka tekanyo ea plasma ea 4-12 μg / ml. Khokahano ea lithethefatsi maling a mali a fetang 20 μg / ml, e mpefatsa setšoantšo sa lefu lena.

Finlepsin e khutla ha e le moqoqong oa ntho e sebetsang ka plasma ea mali ea 5-18 μg / ml e tlosa bohloko ba neuralgia ea trigeminal.

70-80% ea carbamazepine e tlama liprotheine tsa plasma. Karolo ea carbamazepine e sa tsitsang le liprotheine ka bongata ba 50 μg / ml e lula e le kamehla. 48-53% ea metabolite carbamazepine-10, 11-epoxide e kopantsoeng e kopantsha liprotheine tsa plasma. Khatello ea carbamazepine ho CSF ​​ke 33% ea mahloriso a plasma.

Carbamazepine e tšela sethibela sa placental mme e tšeloa ka lebese la matsoele.

Kamora ho nka tekanyetso e le 'ngoe, carbamazepine e qhaloa ho plasma ea mali ka lihora tse 36. Kamora kalafo ea nako e telele, T ½ e fokotseha ka 50% ka lebaka la ho kenella ha li-enzymes tsa sebete sa microsomal.

Ho batho ba phetseng hantle, tumello e felletseng ho plasma ea mali e ka ba 19.8 ml / h / kg boima ba 'mele, ho bakuli ba nang le monotherapy - ba ka bang 54,6 ml / h / kg, ho bakuli ba nang le kalafo e kopaneng - ba ka bang 113.3 ml / h / kg

Kamora taolo e le 'ngoe ea molomo ea carbamazepine, karolo ea mashome a supileng a metso e supileng ea litekanyetso li hlahisoa ho tsoa' meleng ke liphio. Li-28% tse setseng li qheleloa ka thipa hammoho le makhopho, hanyane - hofetohile. Ke karolo ea 2-3 lekholong feela ea ntho e kentsoeng moroto ke carbamazepine e sa fetoheng.

lefu la sethoathoa: ho ts'oaroa ka mokhoa o rarahaneng kapa o sa arohaneng (ka ho se tsebe kapa ka ho lahleheloa ke kelello) ka ho ts'oaroa ka kakaretso, ho ts'oaroa ka kakaretso ke mofuta o fapaneng oa tshusumetso.

Finlepsin retard e ka sebelisoa e le monotherapy hape e le karolo ea kalafo e kopaneng.

Maemo a matla a manic, kalafo e tšehetsang mafu a amanang le ho ferekana e le ho thibela ho phahama kapa ho fokotsa ho teba ha lipontšo tsa kliniki tsa ho eketseha.

Matšoao a ho itlopa joala.

Idiopathic trigeminal neuralgia le neuralgia ea trigeminal ho sclerosis e mengata (e tloaelehileng le ea atypical).

Idiopathic neuralgia ea mokokotlo oa glossopharyngeal.

Mofuta oa Finlepsin o laetsoe ka molomo, hangata tekanyetso ea letsatsi le letsatsi e lokela ho aroloa ka litekanyetso tse peli. O ka noha moriana nakong ea lijo, ka mor'a lijo kapa lipakeng tsa lijo le metsi a fokolang.

Pele ho qala kalafo, bakuli ba morabe oa China Han kapa bakuli ba hlahang Thai ba lokela, haeba ho khonahala, ho hlahlojoa HLA-B * 1502, kaha ho ts'oaroa hona ho ka baka nts'etsopele ea lefu le matla le amanang le carbamazepine le amanang le Stevens-Johnson.

Lefu la ho akheha Phekolo e qala ka ho sebelisa tekanyetso e tlase ea letsatsi le letsatsi, e ntan'o eketseha butle-butle (e fetoloe, ho nahanoa ka litlhoko tsa mokuli ka mong) ho fihlela phello e ntle e fihlella.

Maemong moo sena se ka khonehang, retard ea Finlepsin e lokela ho khethoa e le monotherapy, empa ha e sebelisoa le lithethefatsi tse ling, ho khothalletsoa mofuta o tšoanang oa keketseho e tsoanang butle ea tekanyetso ea lithethefatsi. Haeba Finlepsin retard e eketsoa kalafo e teng ea antiepileptic, lethal dose le lokela ho eketsoa butle butle, ha litekanyetso tsa lithethefatsi tse sebelisitsoeng li sa fetoloe kapa ho fetoloa haeba ho hlokahala.

Ho khetha tekanyetso e nepahetseng ea moriana, ho ka ba molemo ho tseba hore na sehlahisoa se sebetsang hakae kahara lero la mali. Phekolo ea kalafo ea lithethefatsi ho plasma ea mali e lokela ho ba 4-12 μg / ml.

Ho bakuli ba bang, ka ts'ebeliso ea matlapa a khutlang, ho ka hlokahala ho eketsa tekanyetso ea moriana.

Batho ba baholo Motsoako oa pele o khothalelitsoeng ke 100-200 mg makhetlo a 1-2 ka letsatsi, 'me butle-butle lethalamo le eketseha ho fihlela phello e nepahetseng e fumaneha, hangata tekanyetso ea letsatsi le letsatsi ke 800-1200 mg, e arotsoe ka litekanyetso tse peli. Bakuli ba bang ba ka 'na ba hloka lethal dose ea Finlepsin retard e fihlang ho 1600 mg kapa esita le 2000 mg / ka letsatsi.

Bakuli ba baholo. Ka lebaka la ts'ebelisano ea lithethefatsi le li-pharmacokinetics tse fapaneng tsa lithethefatsi tsa antiepileptic, bakuli ba tsofetseng ba lokela ho khethoa ka hloko ho litekanyetso tsa retardpsin retard.

Bana ba lilemo li 5. Ka tloaelo, kalafo e lokela ho etsoa ka tekanyo ea boima ba 'mele ea 10-20 mg / kg ka letsatsi (ka litekanyetso tse' maloa).

Bana ba lilemo li 5-10 - 400-600 mg / ka letsatsi.

Bana ba lilemo li 10-15 - 600-1000 mg / ka letsatsi.

Maemo a manic a matla le kalafo e tšehetsang ea mathata a amanang le bothata. Lenane la litekanyo ke 400-1600 mg / letsatsi ho litekanyetso tse peli tse arohaneng.

Ka tloaelo, kalafo e etsoa ka tekanyetso ea 400-600 mg / ka letsatsi ho litekanyetso tse peli tse arohaneng. Phekolo ea maemo a hlobaetsang a manic, lethal dose ea Finlepsin retard e lokela ho eketsoa ka potlako ho 800 mg / ka letsatsi. Ka kalafo ea ho lokisa lefu la ho ferekanya kelello, ho khothaletsoa keketseho ea butle-butle ea litekanyetso tse tlase ho netefatsa mamello e nepahetseng.

Lefu la ho tlohela joala. Karolelano ea litekanyetso ke 600 mg / letsatsi ho litekanyetso tse peli tse arohaneng. Maemong a tebileng, lethal dose le ka eketsoa matsatsing a 'maloa a pele (mohlala, ho fihlela ho 1200 mg / letsatsi, le arotsoe ka litekanyetso tse peli). Pontšong e matla ea ho khaotsa joala, kalafo e qala ka ho kopana ha Finlepsin retard le lithethefatsi tse tlatsetsang (mohlala, Cl. Prazazole, chlordiazepoxide), ho latela litaelo tse boletsoeng ka holimo tsa litekanyetso. Kamora hore karolo ea bohloeki e phethe, kalafo ka Finlepsin retard e ka tsoela pele e le monotherapy.

Idiopathic trigeminal neuralgia le neuralgia ea trigeminal ho sclerosis e mengata (e tloaelehileng le ea atypical). Idiopathic neuralgia ea mokokotlo oa glossopharyngeal. Motsoako oa pele oa Finlepsin Retard ke 200-400 mg / ka letsatsi (makhetlo a 100 mg makhetlo a 2 ka letsatsi bakeng sa bakuli ba tsofetseng). E lokela ho eketseha butle butle ho fihlela bohloko bo nyamela (hangata ho fihlela tekanyetso ea 400-800 mg, e arotsoe ka litekanyetso tse 1-2). Maemong a mang, ho ka hlokahala tekanyetso ea letsatsi le letsatsi ea 1600 mg. Kamora ho felisoa ha bohloko, lethalinyana le lokela ho fokotsoa hanyane ka hanyane ho lokisoa hanyane.

Finlepsin Retard ha ea lokela ho khethoa:

• ka hypersensitivity e thehiloeng ho carbamazepine kapa lithethefatsi tse tšoanang le lik'hemik'hale (li-antidepressants tsa tricyclic), kapa likarolo tse ling tsa lithethefatsi,
• ka AV block,
• nalane ea thibelo ea ts'ebetso ea marapo,
• bakuli ba nang le nalane ea hepatic porphyria (jk., porphyria e ngata haholo, porphyria e tsoakiloeng, porphyria ea letlalo ea morao-rao),
• hammoho le MAO inhibitors,
• hammoho le voriconazole, ha kalafo e ka se sebetse.

litla-morao tse tsebisoang hangata li etsahetse ka kalafo e kopaneng ho fapana le kalafo ea monotherapy. Ho latela lethal dose mme haholo-holo qalong ea kalafo, litla-morao tse ling li ka hlaha. Ka kakaretso, ba nyamela ba le bang kamora matsatsi a 8-14 kapa kamora ho fokotsa tekanyetso ea nakoana.

Karolong ea mali le tsamaiso ea methapo ea kutlo: leukocytosis, eosinophilia, leukopenia, thrombocytopenia, folic acid e haelloang, agranulocytosis, aplastic anemia, pancytopenia, erythrocytic aplasia, anemia, anemia, megaloblastic anemia, acute intermittent porphyria.

Ho tsoa ho sesole sa 'mele: litšoelesa tsa lithethefatsi tse nang le eosinophilia le matšoao a systemic (DRESS), ho liehisa hypersensitivity ea litho tse ngata le feberu, lesapo la letlalo, vasculitis, lymphadenopathy, matšoao a tšoanang le lymphoma, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly le litla-morao tse sa foleng tsa mats'oafo, mathata a sa foleng. li-bile ducts (tšenyo le ho nyamela ha methapo ea mokokotlo ea intrahepatic), meningitis ea aseptic e nang le myoclonus le eosinophilia ea peripheral, anaphylactic karabelo, angioedema, hypogammaglobulinemia. Ho ka ameha litho tse ling tsa 'mele (mohlala, sebete, mapheo, liphio, manyeme, mala a maholo).

Ho tsoa tsamaisong ea endocrine: edema, mokelikeli oa metsi, ho boloka boima ba 'mele, ho fokotsa boima ba' mele, ho fokotseha ha mali le ho fokotseha ha mali ka bongata ka mpeng ea carbamazepine, e ts'oanang le ketso ea li-hormone tsa antidiuretic, eo ka linako tse ling e lebisang ho lefu la khatello ea mali, le tsamaeang le lefu la ho hlatsa, ho hlatsa, hlooho, pherekano le mathata a methapo ea kutlo, litekanyetso tsa prolactin tse nang le kapa. ntle le matšoao a kliniki a joalo ka galactorrhea le gynecomastia, litlamorao tse sa tloaelehang tsa liteko tsa ts'ebetso ea qoqotho: ho fokotseha hoa boemo ba L-thyroxine (FT 4, T 4, T 3) le keketseho ea TSH, eo hangata e tsamaeang ntle le lipontšo tsa tleliniki, metabolism e senyehileng ea masapo le mokokotlo oa 25-hydroxycolecalciferol maling a mali, e lebisang ho osteomalacia / osteoporosis, keketseho ea cholesterol, ho kenyelletsa cholesterol ea HDL le triglycerides. Ho fokotseha ha maemo a plasma a vithamini ea B ea 12 tlasa ts'usumetso ea carbamazepine le keketseho ea maemo a homocysteine ​​le tsona li tlalehiloe.

Ho tloha ka lehlakoreng la metabolism le mathata a ho ja: khaello ea folate, takatso ea lijo e fokotsehile, porphyria e hlobaetsang, porphyria e sa foleng.

Ka lehlakoreng la psyche: hallucinations (pono kapa maikemisetso), khatello ea maikutlo, ho hloka takatso ea lijo, ho tšoenyeha, ho ba mabifi, ho ferekana, ho ferekana kelellong, pherekano, ho eketseha ha kelello ea kelello, ho fetoha ha maikutlo, joalo ka khatello ea maikutlo kapa maikutlo a feto-fetohang, phobias, ho hloka tšusumetso, ho sisinyeha ha boithati, joalo ka asterixis.

Ho tsoa tsamaisong ea methapo: bofokoli bo akaretsang, ho tsekela, ho ferekana, ho otsela, ho akheha, ho khathala, ho opeloa ke hlooho, ho sisinyeha ka tsela e sa tloaelehang (mohlala. ho thothomela, ho thothomela, "dyskinesia", ho nahana butle, mathata a ho bua (jk. dysarthria kapa puo e tsitsitseng), choreoathetosis, peripheral neuropathy, paresthesia, bofokoli ba mesifa le paresis, ho senyeha ha tatso, malignant antipsychotic syndrome, ho senyeha ha mohopolo, mathata a ts'oaetso le a cerepatar, ao ka linako tse ling a tsamaeang le hlooho e bohloko. oh bohloko.

Ho tloha lehlakoreng la setho sa pono: conjunctivitis, bolulo bo senyehileng (diplopia, pono e fifalitsoeng), khatello e eketsehileng ea methapo, ho tšoloha lense, retinotoxicity, oculomotor.

Karolong ea setho sa kutlo le lisebelisoa tse katiloeng: ho senyeha ha kutlo, tinnitus, tinnitus, hyperacusis, hypoacusia, pono e senyehileng ea molumo oa lentsoe.

Ho tsoa ho tsamaiso ea pelo le pelo: ho kenella ka hare ho litaba tsa methapo ea kutlo, bradycardia, arrhythmia, ho mpefala ha lefu la pelo, ho nyekeloa ke pelo, ho putlama ha mali, AV blockade e nang le syncope, hypertension kapa hypotension, vasculitis, thrombophlebitis, thromboembolism (mohlala, pulmonary embolism).

hypersensitivity e tsoang matšoafong, e khetholloang ka ho eketseha ha mocheso oa 'mele, ho hema hanyane, pulmonitis kapa pneumonia. Ha ho e-ba le karabelo e joalo ea hypersensitivity, lithethefatsi li lokela ho khaotsa.

ho fokotseha takatso ea lijo, molomo o ommeng, ho nyekeloa ke pelo, ho hlatsa, lets'ollo, ho qhekella, bohloko ba ka mpeng, stomatitis, gingivitis, glossitis, pancreatitis, colitis.

Boloetse bo amanang le lefu la hepatitis: liphetoho mats'oao a tlhahlobo ea sebete e sebetsang (maemo a eketsehang a phetisetso ea gamma-glutamyl, maemo a eketsehang a alkaline phosphatase, transaminases), jaundice, mefuta e fapaneng ea hepatitis (cholestatic, hepatocellular, granulomatous, e kopaneng), bophelo bo kotsi ba hepatitis, ho hloleha ha sebete.

Ka lehlakoreng la letlalo le mafura a potolohileng: allergic dermatitis, urticaria, pruritus, exfoliative dermatitis, erythroderma, necrosis ea letlalo le boreleli le blistering (lefu la Lyell), photosensitivity, redding ea letlalo le nang le polymorphic rashes ka sebopeho sa mathe le sebopeho sa li-node, tse nang le hemorrhages. Stevens-Johnson), li-hemechial tse kenang ka har'a letlalo le lupus erythematosus (e hasantsoeng lupus erythematosus, alopecia), diaphoresis, liphetoho mefuteng ea letlalo, makhopho, hirsutism, vasculitis, pu pura, e ile ea eketseha ho fufuleloa, a hlobaetsang le generalized exanthematous pustulosis (AGEP), lichenoid keratosis, onihomadez.

Ho tsoa ts'ebetsong ea musculoskeletal: arthralgia, myalgia, mesifa crump, bohloko ba mesifa, fractures, fokotseha letsoalo la mineral mineral.

Ho tsoa liphio le pampitšana ea ho ntša metsi: proteinuria, hematuria, oliguria, dysuria, polakiuria, ho boloka mmele, ho ruruha ha methapointerstitial nephritis, ho se sebetse hantle ka mokokotlo, ho eketsa mali urea / azotemia, ho ntša metsi khafetsa.

Ho tsoa kemisong ea bokhachane le litšoelesa tse anyesang: tlolo ea spermatogenesis (ka ho fokotseha ha palo le / kapa sepheo sa spermatozoa), ho se sebetse hantle ha erectile, ho hloka matla, ho fokotse takatso ea thobalano.

Tšoaetso le tšoaetso: ho nchafatsoa hoa mofuta oa vaerase ea herpes ea mofuta oa VI.

Ho kheloha ha liphetho tsa liteko tsa laboratori: hypogammaglobulinemia.

carbamazepine e lokela ho fuoa feela tlasa tlhokomelo ea bongaka, feela kamora ho hlahloba palo ea melemo / kotsi mme e behiloe leihlo le hlokolosi la bakuli ba nang le nalane ea lefu la pelo, ho senyeha kapa chefo ea mokokotlo, ho se utloane ho amanang le lithethefatsi tse ling kapa bakuli ba nang le kalafo ea carbamazepine.

Carbamazepine e bonts'a ts'ebetso e bonolo ea anticholinergic, ka hona, bakuli ba nang le khatello e eketsehileng ea intraocular ba lokela ho lemosoa le ho botsoa ka lintlha tse ka bang teng.

E lokela ho hopoloa ka ts'ebetso e ka khonehang ea li-psychoses tsa morao-rao, le kamanong le bakuli ba tsofetseng - mabapi le ts'ebetso ea pherekano le nts'etsopele ea khatello ea maikutlo e tsosang.

Hangata lithethefatsi ha li na thuso bakeng sa ho ba sieo ha motho a le sieo. Maemo a mang a supa hore ho ts'oaroa ho eketsehileng ho ka hlaha ho bakuli ba sa sebetseng hantle ka nako e itseng.

Litlamorao tsa Hematologic. Ts'ebeliso ea lithethefatsi e amana le nts'etsopele ea agranulocytosis le anemia ea aplasiki, empa ka lebaka la maemo a tlase haholo a maemo ana, ho thata ho lekola kotsi e kholo ha o nka carbamazepine.

Bakuli ba lokela ho tsebisoa ka matšoao a pele a chefo le matšoao a ho senyeha hoa hematologic, hammoho le matšoao a dermatological le sebete. Mokuli o lokela ho hlokomelisoa hore maemong a tšohanyetso a kang feberu, 'metso, marapo a letlalo, liso tsa molomo, leqeba le hlahang habonolo, ho supa hemorrhages kapa hemorrhagic purpura, o lokela ho etela ngaka hang-hang.

Haeba palo ea li-leukocytes kapa liplatelete e fokotseha haholo nakong ea phekolo, boemo ba mokuli bo lokela ho hlahlojoa ka hloko, 'me tlhahlobo e akaretsang ea mali ea mokuli le eona e lokela ho etsoa. Phekolo ka carbamazepine e tlameha ho khaotsa haeba mokuli a e-ba leukopenia, e matla haholo, e tsoelang pele, kapa e tsamaisana le lipontšo tsa kliniki, tse kang feberu kapa 'metso. Ts'ebeliso ea carbamazepine e lokela ho emisoa ha matšoao a thibelo ea ts'ebetso ea marapo a hlaha.

Nako le nako kapa hangata ho ba le ho fokotseha hoa nakoana kapa ho tsitsitseng palong ea liplatelese kapa leukocytes mabapi le ho nka carbamazepine. Leha ho le joalo, boholo ba linyeoe tsena, bohlola ba bona bo ile ba netefatsoa mme ha bo supe nts'etsopele ea anemia kapa agranulocytosis. Pele o qala kalafo le nako le nako nakong ea boitšoaro ba eona, tlhahlobo ea mali e lokela ho etsoa, ​​ho kenyelletsa le qeto ea palo ea liplatele (hape, mohlomong, palo ea reticulocytes le boemo ba hemoglobin).

Boitšoaro bo matla ba dermatological. Liphetoho tse tebileng tsa dermatological, ho kenyelletsa le chefo ea epidermal necrolysis (TEN) kapa lefu la Lyell, Stevens-Johnson syndrome (SJS), li etsahala ka seoelo le carbamazepine. Bakuli ba nang le karabelo e kholo ea dermatological ba ka hloka ho kena sepetlele, kaha maemo ana a ka beha bophelo kotsing mme a ba le phello e bolaeang. Boholo ba linyeoe tsa SJS / TEN li hlaha nakong ea likhoeli tse 'maloa tsa pele tsa kalafo le carbamazepine. Ka nts'etsopele ea matšoao le matšoao a bontshang karabelo e mpe ea dermatological (SJS, lefu la Lyell / TEN), carbamazepine e lokela ho emisoa hanghang mme ho sebelisoe kalafo e 'ngoe.

Pharmacogenomics. Ho na le bopaki bo ntseng bo eketseha ba phello ea lits'oants'o tse fapaneng tsa HLA ka tekanyo ea mokuli bakeng sa karabelo e mpe e amanang le tsamaiso ea 'mele ea ho itšireletsa mafung.

Puisano le (HLA) -B * 1502. Boithuto bo fumanehang ho bakuli ba Machaena a morabe oa Khan ba bontšitse khokahano e boletsoeng pakeng tsa karabelo ea letlalo ea SJS / TEN e amanang le carbamazepine le ho ba teng ha leukocyte antigen (HLA), allele (HLA) -B * 1502 ho bakuli bana. Khafetsa litlaleho tse mabapi le nts'etsopele ea SJS (eseng ka seoelo haholo) ke tšobotsi ea linaha tse ling tsa Asia (mohlala, Taiwan, Malaysia le Philippines), moo allele (HLA) -B * 1502 e atileng har'a baahi. Palo ea bakuli ba allele ena har'a baahi ba Asia ke> 15% Philippines, Thailand, Hong Kong le Malaysia, ≈10% - ho Fr. Taiwan, e batla e le 4% - ka Leboea la China, ≈2-4% - Asia Boroa (ho kenyeletsoa India) le foromo ea Tekanyetso: & matlapa a Palo:

Letlapa le le leng le na le:

ntho e sebetsang : carbamazepine 200 mg kapa 400 mg,

baamohelang : ethyl acrylate, methyl methacrylate le trimethylammonioethyl methacrylate kopolymer (Eudragit ® RS 30 D), triacetin, talc, methaconic acid le ethyl acrylate Copolymer (Eudragit ® L 30 D-55), cellcose ya cellcose.

Matlapa a lokisitsoeng a lokolloang 200 mg:

Matlapa a lokolotsoeng a 400 mg: ho tloha ho o mosoeu ho ea ho o mosoeu o nang le tint e 'mala o mosehla, matlapa a chitja a chitja a nang le likhutlo, a nang le mela ea liphoso tse bopehileng ka mahlakoreng a mabeli le likonopo tse 4 lehlakoreng la lehlakore.

Sehlopha sa Pharmacotherapeutic: moemeli oa antiepileptic ATX: & nbsp

Pharmacodynamics: Setlhare sa antiepileptic (dibenzazepine derivative), seo hape se nang le antidepressant, antipsychotic and antidiuretic effect, se na le phello ea li-analgesic ho bakuli ba nang le neuralgia. Mochine oa ts'ebetso o amahanngoa le blockade ea lisele tsa sodium-gated sodium, e lebisang ho tsitsitseng ea membrane ea li-neurons tse tebileng, thibelo ea ponahalo ea li-serial discharges tsa neuron le ho fokotseha ha ts'ebetso ea mokokotlo oa synaptic. E thibela ho etsoa botjha ha bokhoni ba ts'ebetso ba Na + - ho itšetleha ka ts'ebetso ho li-neuron tse senyehileng. Fokotsa ho lokolloa ha glutamate e thabisang ea neurotransmitter amino acid, e eketsang tsitsipano e fokotsehileng ea ts'ebetso ea methapo e bohareng mme, ka hona, e fokotsa kotsi ea ho ts'oaroa ke sethoathoa. E eketsa sephetho sa K +, e tsamaisa liteishene tse nang le motlakase oa motlakase oa G 2, hape e ka kenya letsoho phello ea anticonvulsant ea lithethefatsi.

E sebetsa bakeng sa ho ts'oaroa ka botebo (ka karolo e itseng) le e rarahaneng, e tsamaeang kapa e sa tsamaeeng le kakaretso ea kakaretso, bakeng sa ho ts'oaroa ka kakaretso ke tonic-clonic, hape le bakeng sa ho kopanya mefuta ena ea ho ts'oaroa (hangata ha ho na thuso bakeng sa ho ts'oaroa hanyane - peto ea mal, ho ba sieo le ho ts'oaroa ka mokhoa o nyarosang. )

Bakuli ba nang le lefu la sethoathoa (haholoholo baneng le lilemong tsa bocha) ba na le phello e ntle matšoao a ho tšoenyeha le khatello ea maikutlo, hammoho le ho fokotseha ha ho teneha le ho ba mabifi.

Kameho ea ts'ebetso ea kelello le ts'ebetso ea psychomotor e itšetlehile ka tekanyetso. Qaleho ea phello ea anticonvulsant e fapana ho tloha lihora tse 'maloa ho isa matsatsing a' maloa (ka linako tse ling ho fihlela khoeli e le 'ngoe ka lebaka la auto-induction ea metabolism).

Ka neuralgia ea bohlokoa le ea bobeli maemong a mararo e thibela ponahalo ea litlhaselo tsa bohloko.

Phokotso ea bohloko ho neuralgia ea trigeminal e bonoa ka mor'a lihora tse 8-72.

Ka lefu la ho itlopa joala, e eketsa monyetla oa ho ikemisetsa ho ikemiselitseng, hangata e fokotsoang boemong bona, mme e fokotsa botebo ba lipontšo tsa bongaka tsa lefu lena (ho teneha ho hoholo, ho thothomela, ho sitisoa hoa kelello).

Ketso ea antipsychotic (antimaniacal) e hlaha kamora matsatsi a 7-10, e kanna ea ba ka lebaka la thibelo ea metabolism ea dopamine le norepinephrine.

Foromo ea litekanyetso tsa nako e telele e tiisa ho boloka motsoako o tsitsitseng oa carbamazepine maling ha o nooa habeli ka letsatsi.

Ho thipa ho tsamaea butle empa ho felletse (ho ja ha ho ame haholo tekanyo ea ho monya). Kamora tekanyetso e le 'ngoe ea letlapa, khatello e phahameng e fihlella ka mor'a lihora tse 32. Boleng bo boholo ba kakaretso ea ntho e sa fetoheng e sebetsang ka mor'a tekanyetso e le' ngoe ea 400 mg ea carbamazepine e ka bang 2,5 μg / ml. Tekanyo ea tekano ea lithethefatsi ho plasma e fihlelloa kamora libeke tse 1-2 (tekanyo ea katleho e ipapisitse le litšobotsi tse ikhethang tsa metabolism: ho kenella ka hare ho ts'ebetso ea li-enzyme tsa sebete, hetero-induction ke lithethefatsi tse ling tse sebelisitsoeng ka nako e le ngoe), hammoho le boemo ba mokuli, tekanyo ea lithethefatsi le nako ea kalafo. Phapang e kholo ea motho ka mong litekanyetsong tsa khatello ea tekano maemong a phekolo e bonoa: ho bakuli ba bangata, litekanyetso tsena li tloha ho 4 ho isa ho 12 μg / ml (17-50 olmol / l). Ho tsepamisa mohopolo ho carbamazepine-10,11-epoxide (metabolacology e sebetsang metabolite) ke hoo e ka bang 30% ea mahloriso a carbamazepine. Puisano le liprotheine tsa plasma ho bana - 55-59%, ho batho ba baholo - 70-80%. Bophahamo bo bonahalang ba karolelano ke 0,8-1.9 l / kg. Likhakanyo li thehiloe mokelikeling oa mokomkomere le mathe, tse lekanang le palo ea ntho e sebetsang e sa koaheleng liprotheine (20-30%). E kenella ka har'a sethopo sa placental. Phokotso ea lebese la matsoele ke 25-60% ea plasma.

E tšelisoa ka har'a sebete, haholo tseleng ea epoxy le ho thehoa ha methapo e ka sehloohong: carbamazepine-10,11-epoxide e sa sebetseng le tšebeliso ea "glucuronic acid" e sa sebetseng. Leihloenzyme ea mantlha e fanang ka biotransformation ea carbamazepine ho carbamazepine-10,11-epoxide ke cytochrome P450 (CYP3A4). Ka lebaka la liphetoho tsena tsa metabolic, metabolite ea 9-hydroxymethyl-10-carbamoylacridane le eona e thehiloe, e nang le ts'ebetso e fokolang ea pharmacological. e ka susumetsa metabolism ea eona.

Nako ea halofo ea bophelo kamora ho kenella ka tekanyetso e le 'ngoe ke lihora tse 60-100 (karolelano ea lihora tse ka bang 70), ka tšebeliso ea nako e telele, halofo ea bophelo e fokotsehile ka lebaka la ho kenyelletsa tsamaiso ea enzyme ea sebete. Kamora taolo e le 'ngoe ea molomo ea carbamazepine, karolo ea mashome a mabeli a metso e supileng lekholong (85%) ea lethal dose e nkoang e qheletsoe ka har'a moroto' me 28% e na le makhopho, athe 2% ea lethal dose e nkuoeng e kotsitsoe ka har'a moroto joalo ka carbamazepine e sa fetoheng, mme e ka bang 1% ka sebopeho sa metabolite ea 10.11-epoxy.

Ha ho na bopaki ba hore pharmacokinetics ea phetoho ea carbamazepine ho bakuli ba tsofetseng.

Lefu la ho akheha: ho ts'oaroa ka kakaretso (ntle le ho ba sieo), mefuta e fapaneng ea lefu la ho akheha (ho ruruha ho bonolo le ho rarahana), ho tsitsa ka kakaretso,

Trigeminal neuralgia,

Idiopathic glossopharyngeal neuralgia,

Bohloko bo nang le tšenyo ea methapo ea kutlo ho lefu la tsoekere, bohloko bo amanang le lefu la tsoekere,

Ho tsitsipana ha sethoathoa ka ho hlaseloa ke lefu la ho hlaba mokokotlo ka makhetlo a mangata, ho tsitsipana hoa sefahleho le mathata a ho ferekana (paroxysmal dysarthria and ataxia), paroxysmal paresthesias le ho opeloa ke bohloko,

Lefu la ho tlohela joala (ho tšoenyeha, ho tsitsipana, khatello ea maikutlo, ho tšoenyeha ha boroko),

Mathata a kelello (a amanang le mathata a amanang le kelello le mathata a kelello, likotsi tsa tsamaiso ea methapo ea maoto).

Hypersensitivity ho carbamazepine le likarolo tse ling tsa lithethefatsi, hammoho le li-antidepressants tsa li-tricyclic,

Mathata a masapo a hematopoiesis (anemia, leukopenia),

Acph intermittent porphyria (ho kenyelletsa le nalane)

Tsamaiso e ts'oanang ea litokisetso tsa lithium le li-inhibitors tsa MAO.

Ho fokotseha ha pelo ho sa feleng,

Ho tsoala hyponatremia (ADH hypersecretion syndrome, hypopituitarism, hypothyroidism, adrenal cortex insuffence),

Khaello ea tšebetso ea sebete le a liphio,

Bokhoba ba tahi bo sebetsang (khatello ea maikutlo ea CNS ea matlafala, metabolism ea carbamazepine ea eketseha),

Thibelo ea masapo a hematopoiesis ka meriana (nalane),

Prostatic hyperplasia

Keketseho ea khatello ea methapo,

Hammoho le sedative-hypnotics.

Bokhachane le pelehi:

Nako tsohle ha ho khonahala, Finlepsin® retard e fuoe basali ba lilemo tsa ho ba le bana ka mokhoa oa monotherapy, ka tekanyetso e sebetsang e tlase haholo, hobane khafetsa liphoso tsa masea tse tsoang ho bo-'mè ba nkileng kalafo ea antiepileptic li phahame ho feta ka kalafo ea monotherapy.

Ha ho ima ho hlaha, melemo ea kalafo e lebelletsoeng le mathata a teng li lokela ho bapisoa, haholoholo molemong oa pele oa boimana.Hoa tsebahala hore bana ba bo-'mè ba nang le lefu la sethoathoa ba rerile ho ba le mathata a nts'etsopele ea intrauterine, ho kenyelletsa le mathata. Phokotso ea Finlepsin ® e khona ho eketsa kotsi ea likotsi tsena. Ho na le litlaleho tse ikhethileng tsa linyeoe tsa maloetse a amanang le tlhaho le ho se sebetse hantle, ho kenyelletsa ho se koaloe ha li-artebral arches (spina bifida).

Lithethefatsi tsa antiepileptic li eketsa khaello ea folic acid, e atisang ho utluoa nakong ea kemolo, e leng se ka eketsang tšenyo ea bofokoli ba tlhaho ho bana, ka hona ho nka folic acid ho khothalletsoa pele ho nako ea kemolo le nakong ea kemolo. Bakeng sa ho thibela mathata a hemorrhagic ho masea a sa tsoa hlaha, basali ba libeke tsa ho qetela tsa moimana, hammoho le masea, ba khothalletsoa ho fana ka vithamine K1.

Carbamazepine e fetela lebese la matsoele, ka hona melemo le litlamorao tse sa batleheng tsa ho anyesa li lokela ho bapisoa le kalafo e tsoelang pele. Ka ho tsoela pele ho anyesa ha o ntse o sebelisa moriana, o lokela ho theha leihlo bakeng sa ngoana mabapi le monyetla oa ho ba le mathata a itseng (mohlala, ho otsela haholo, ho etsa lintho ka letlalo le honyenyane).

Tekanyetso le tsamaiso:

Ka hare, nakong ea lijo kapa ka mor'a ho ja, ho noa metsi a mangata.

Bakeng sa tšebeliso e bonolo, letlapa (hammoho le halofo kapa kotara) le lona le ka qhibiliha ka metsing kapa ka lero, kaha thepa ea ts'ebetso ea nako e telele ka mor'a ho qhala letlapa ka mokelikeli e bolokiloe. Mefuta e mengata ea litekanyetso li sebelisoa ke 400-1200 mg ka letsatsi, e ajoang ka tekanyetso ea 1-2 ka letsatsi.

Tekanyo e phahameng ea letsatsi le letsatsi ha ea lokela ho feta 1600 mg.

Neng le neng ha ho khonahala, Finlepsin® retard e lokela ho beoa e le monotherapy. Phekolo e qala ka ho sebelisa tekanyetso e nyane ea letsatsi le letsatsi, eo ka mor'a moo e eketsoang butle butle ho fihlela phello e ntle e fihlella. Ho kenyelletsoa ha Finlepsin® retard ho kalafo e ntseng e tsoela pele ea antiepileptic ho lokela ho etsoa butle butle, ha litekanyetso tsa lithethefatsi tse sebelisitsoeng li sa fetoloe kapa, haeba ho hlokahala, li khalemeloe. Haeba mokuli a lebetse ho nka tekanyetso e latelang ea moriana ka nako e loketseng, moriana o hlotsoeng o lokela ho nkuoa hang hang hang ha o utloa sena, 'me u ke ke ua nka tekanyetso habeli ea moriana.

Motsoako oa pele ke 200-400 mg ka letsatsi, joale lethal dose le eketseha butle-butle ho fihlela phello e ntle e fumaneha. Tekanyetso ea tlhokomelo ke 800-1200 mg ka letsatsi, e arotsoe ka litekanyetso tse 1-2 ka letsatsi.

Tekanyetso ea pele bakeng sa bana ho tloha ho lilemo tse 6 ho isa ho 15 ke 200 mg ka letsatsi, ebe butle-butle lethalamo le eketsoa ka 100 mg ka letsatsi ho fihlela phello e ntle e fihlella.

Matšoao a ho sebelisoa

Finlepsin e khothalletsoa mafu a 'maloa a kenyeletsang:

• neuralgia
• lefu la sethoathoa
• maemo a fapa-fapaneng a tšosang
• maemo a kelello
• ho itlopa joala

Ngaka e etsa tumellano ea motho ka mong ho latela litaelo le lipontšo tsa tliliniki. Boitlhokomelo ba lithethefatsi ha bo khothaletsoe ka kotloloho.

Contraindication

Finlepsin ha e khothalletsoe ho:

• ho se mamellane ho e 'ngoe ea likarolo kapa ho li-atidepressants (tricyclic)
• Ts'ebeliso e kopanetsoeng ea li-inhibitors tsa MAO kapa litokisetso tsa lithium
• mafu a masapo a hematopoiesis
• AV blockade
• porphyria e hlobaetsang

Ka hlokolosi e kholo, matlapa a ngoletsoe:

• ka tlolo ea liphio, sebete, tsamaiso ea pelo le pelo
• bakuli ba tsofetseng
• Ts'ebeliso e tšoanang ea methapo ea kutlo kapa lipilisi tsa ho robala
• khatello e eketsehileng (intracranial, intraocular)
• mafu a tšoelesa ea senya
• joala bo sa feleng

Litla-morao tsa kopo Finlepsin e ka fana ka tlolo efe kapa efe ea litaelo tsa ho sebelisoa, ho etsa mohlala. Ho phapang ena, ho ka lemohuoa ho ferekana ha ts'ebetso ea methapo le tsamaiso ea methapo ea kutlo le tsamaiso ea hematopoietic. Ho sitoa ho latela litaelo tse boletsoeng ka mokhoa ona ho ka baka mathata a nakoana feela ka lebaka la ho opeloa ke hlooho kapa ho nyekelwa ke pelo, empa hape le mathata a tebileng haholoanyane: leukocytosis, leukopenia, jj.

Finlepsin e na le carbamazepine e ka sehloohong (ntho e ka sehloohong e sebetsang) le likarolo tse thusang: magnesium stearate, gelatin, croscarmellose sodium, MCC, jj. Sebopeho sa lithethefatsi ke matlapa. Moriana o khothaletsoa ho nooa feela joalo ka ha u laetsoe ke ngaka le ho latela litaelo ka botlalo.

Matlapa a Finlepsin: litaelo tsa hore li sebelisoe

Finlepsin matlapa ho latela litaelo tsa tšebeliso a reretsoe ho tsamaisoa ka molomo, ntle le ho bua ka tšebeliso ea lijo. Ho latela boholo ba maemo kapa maloetse le setšoantšo sa kakaretso sa bongaka, batho ba baholo ba ka fuoa bonyane 200 mg (1 pilisi, kalafo ea pele), kalafo ea tlhokomelo e kenyeletsa ho sebelisa lithethefatsi ka tekanyetso ea 800-1200 mg ka letsatsi (e arotsoe ka litekanyetso tse 'maloa). Tekanyetso e kholo e lumelletsoeng ke 1.2-2 g Pele ho fela, litekanyetso tsa lithethefatsi li fokotseha butle-butle. Ho latela litaelo, ho khaotsa ho amoheloa ho ka baka litlamorao tse mpe. Bana, motheong oa lipontšo, ho khothaletsoa ho qala ho nka ka litlhare "Finlepsin Khutlela "litekanyetso tsa 200 mg (analogue).

Nka neuralgia?

Finlepsin e thusa ka neuralgia ea trigeminal, empa bakuli ba bang ba boletse hore sena se lebisitse ho sa tsotelleng, ho lebisitseng ho fokotseha ha puisano ea sechaba. Maemong afe kapa afe, ho khethoa ho etsoa ke setsebi, ka hona, haeba litla-morao tse sa rateheng li bonts'oa, o lokela ho emisa ho nka moriana mme o botse ngaka ea hau hape.

Ka boimana mme bana ba ka khona?

Nakong ea kemolo, basali ba fuoa, haeba ho khoneha, monotherapy ka tekanyetso e fokolang (kalafo ka sethethefatsi se le seng). Sena se fokotsa menyetla ea hore ngoana a tsoaloe a bile a le teng. Ho khethoa ha tumello ea thuto ho khethoa feela ke ngaka e eang, ho latela matšoao a mokuli. Likeletso tse tšoanang, ho ea ka litaelo tsa tšebeliso, le tsona li bonts'oa nakong ea kemolo.

Ho ngola ho khothalletsoa bana Finlepsin Retard (analogue) matlapeng a litekanyetso tsa 200 mg:

• Lilemo tse 1-5 - tekanyo e phahameng ke 400 mg ka letsatsi (qala ho nka, butle-butle eketsa lethal dose ho tloha ho 200 ho isa ho 400 mg)
• 6-10 - Tekanyetso ea letsatsi le letsatsi ea 600mg
• Lilemo tse 11-15 - letsatsi le leng le le leng la 1000 mg le ka lumelloang letsatsi ka leng

Finlepsin Retard

Ho latela litaelo tsa tšebeliso Finlepsin Ba qala ho nka moputso ka hloko, butle-butle ba eketsa lethal dose. Tekanyetso ho latela lipontšo: botebo ba lefu lena, mofuta oa ponahatso, lilemo le litšobotsi tsa 'mele. Maemong a mang, hoa utloahala ho nka sebaka se seng Finlepsin Ha u khutlela ho analogue, ke ngaka feela e ka etsang qeto e joalo.

Finlepsin le joala lia lumellana?

Ho pakoa hore motsoako o ka sehloohong oa lithethefatsi o fokotsa phello ea ethanol. Leha ho le joalo, ho latela litaelo tsa tšebeliso, ha ho kgothaletswe ho kopanya matlapa le tšebeliso ea lino tse tahang - tšokelo ea litla-morao le mathata a tebileng a eketseha.

Litšoantšo tsa mantlha tsa lithethefatsi Finlepsin (matlapa):

• Carbalepsin Retard (INN)
• Zeptol
• Qekisa
• Tegretol
• Zagretol
• Stazepine

Ke ngaka feela e teng e ka fanang ka matšoao le ho fana ka analog bakeng sa tšebeliso. Ho latela litaelo tsa ts'ebeliso, boits'ebetso ha bo khothalelitsoe feela.

Khemisi e boka bokae?

Setlhare ke moriana mme se fanoa feela ka taelo ea ngaka. Litsenyehelo tsa lithethefatsi li fapana ka li-ruble tse 200-280 (ho latela litekanyetso le li-pharmacy margin).

Matšoao a ho sebelisoa Finlepsin e kholo. Litsebi li hlokomela ts'ebeliso ea eona e phahameng kalafong ea maemo le mafu a mangata ka ho khomarela litaelo ka botlalo, joalo ka bopaki ba litlhahlobo tsa bona tse ntle.

Litlhahlobo tsa bakuli li tšoana hantle le sephetho sa lingaka, empa ho sa sebetse hantle, litlamorao tse joalo ka tšebetso e fokotsehileng ea mahlale, taolo e sa tsitsang, jj.

Mofuta oa Finlepsin

Moetsi o fana ka moriana ka tsela ea matlapa a nang le 200 mg ea carbamazepine e le motsoako o sebetsang. Ntho ena e na le phello liseleng tsa boko, e thibelang ho hlaha hoa tšusumetso ea methapo. Ka lebaka lena, Finlepsin e fana ka litlamorao tse latelang tsa kalafo:

• anticonvulsant, ho kenyeletsa le lefu la sethoathoa,
• anti-manic, fokotsa ho tšoenyeha, ho teneha, lipontšo tsa khatello ea maikutlo,
• anesthetic bakeng sa ho ruruha ha likarolo tse fapaneng tsa tsamaiso ea methapo, mohlala, ka lefu la mokokotlo.

Setlhare se boetse se laeloa ho ikemisetsa ho ts'oaroa ka letsoalo le bakoang ke ho khaotsa ho tsuba, ho bakoang ke botaoa ba joala bo sa foleng.

Finlepsin e bontšoa bakeng sa maloetse a latelang:

• lefu la sethoathoa, ho kenyelletsa le mefuta ea lona e tsoakiloeng,
• ho tsitsipana ha methapo ho etsahalang ka sclerosis e ngata, paresthesia, diazartria le li-pathologies tse ling,
• bohloko bo amanang le lefu la ho ruruha le ho senya methapo ea kutlo, ho kenyeletsoa le ho ts'oaroa ke lefu la tsoekere.
• neuralgia ea tlhaho e sa tsejoeng,
• Mathata a kelello, ho kenyeletsa le a bakoang ke ho taoa hoa mmele,
• e le karolo ea kalafo e phethahetseng ea matšoao a bang teng.

Moriana o na le likhohlano tse ngata, ka hona o ke ke oa li sebelisa ntle le taelo ea ngaka. Har'a maemo a 'mele ao ho sa khothalletsoang hore a sebelisoe Finlepsin ke hematopoiesis, block ea atrioventricular, porphyria, le ho se mamellane ha likarolo tsa moriana.

Khahlano le semelo sa kalafo le Finlepsin, nts'etsopele ea karabelo e mpe ho tsoa ho tšilo ea lijo, methapo, methapo ea pelo, tsamaiso ea methapo le methapo ea mali hoa khoneha. Lethathamo la litlamorao li telele. Haeba ho na le matšoao a fosahetseng, khaotsa ho nka matlapa 'me u ee ngakeng.

Finlepsin ha e khothalletsoe haeba ho na le tlolo ea sebopeho sa mali, block ea atrioventricular, porphyria, ho se mamellane ka seqo ho likarolo tsa moriana.

Papiso ea lithethefatsi

Meriana e joalo ka mekhoa e mengata, empa e na le liphapang.

Litokisetso li na le motsoako o tšoanang o sebetsang, li na le matšoao a tšoanang bakeng sa tšebeliso. Ha e khothalletsoe hore e sebelisoe ka maemo a tšoanang a 'mele le a' mele. Litlamorao tse ka bakoang ke meriana le tsona lia tšoana.

Meriana e hlahisoa ke moetsi a le mong - khampani ea transva ea Teva. Meriana ena ka bobeli ea fumaneha ka ngakeng.

Phapang ke efe?

Phokotso ea Finlepsin e fapana le ea pele ho eona ka ketso ea nako e telele. Ha e se e le 'meleng, likarolo tsa eona li lokolloa butle-butle, ka lebaka leo litlamorao tsa lithethefatsi li bolokiloeng nako e telele. Sena se ama litlamorao - menyetla ea ho hlaha ha bona e ea fokotseha.

Ho khutla ha Finlepsin ho baka litlamorao tse ngata, ho kenyelletsa ho nyekeloa pelo, ho hlatsa, ho otsela, ho ferekana le mathata a pono.

Tlhahlobo ea Mamello

Marina ea lilemo li 27, Ryazan o re: “Ke ile ka tlameha ho kopana le Finlepsin ha mohoe oa ka a mo koenya. O ne a sa ruruha, empa a tšoana le a joalo. Ngaka e laetse moriana ona, e re ha e sebelisoe feela ke bakuli ba nang le lefu la sethoathoa, empa le batho ba nang le ts'ebetso e phahameng. Mohoe-moholo o ile a qala ho nka lipilisi, empa a qala ho tletleba ka hore o lula a tsitsipane le ho nyekeloa le pelo. Ke ile ka tlameha ho khutlela ho ngaka e neng e laetse Finlepsin retard. Ntate o mamella lipilisi tsena hantle. ”

Irina, ea lilemo li 41, Voronezh: “Finlepsin o ile a fuoa monna oa hae ka mor'a ho otloa ke lefu la hemorrhagic. Spouse e nka lipilisi bakeng sa khoeli ea bobeli. Ha a tletleba ka litla-morao. Molekane o ikutloa a thabile, ngaka e tiisa hore litholoana tsa kalafo li ntle. ”

Lingaka li lekola retlepsin le Finlepsin retard

Igor, setsebi sa bophelo bo botle ba 'mele, ea lilemo li 45, Nizhny Novgorod: "Lithethefatsi tsena ka bobeli li sebetsa hantle, li mamelloa ke bakuli haholo. Theko e theko e tlaase. ”

Vladimir, ngaka ea methapo ea kutlo, ea lilemo li 51, Bryansk: “Ho latela lefu le boemo ba bophelo ba mokuli, ke fa Finlepsin kapa analogue ea ketso ea nako e telele. Ke lumela hore litlhare ka bobeli lia sebetsa. Litla-morao li teng, empa ha se hangata, haeba mokuli a lumellana le litlhahiso tsa bongaka. Ntho e 'ngoe hape ke theko ea meriana: e fumaneha ho motho e mong le e mong. ”