Mokhoa oa ho nka (lino-mapholi) li-capsules tsa Saroten retard

Ha u nka li-capot tsa Saroten Retard, ho kgothaletsoa ho e nooa ka metsi. Li-capsule, leha ho le joalo, li ka buloa mme se ka hare ho sona (li-pellets) se ka nooa ka molomo ka metsi. Li-pellets ha lia lokela ho hlafuna.

Ketsahalo e sithabetsang. Maemo a sithabetsang a schizophrenia. E khethoa hang ka letsatsi lihora tse 3-4 pele a robala.

Phekolo le Saroten Retard e lokela ho qala ka pilisi e le 'ngoe ea 50 mg ka shoalane. Haeba ho hlokahala, kamora beke beke tekanyetso ea letsatsi le letsatsi e kanna ea eketsoa hanyane ka hanyane ho isa ho li-2 - 3 li-mantsiboea (100-150 mg). Kamora ho fihlella ntlafatso e tšoailoeng, tekanyetso ea letsatsi le letsatsi e ka fokotsoa hore e sebetse bonyane, hangata ho fihla ho li-capsules tsa 1-2 (50-100 mg / ka letsatsi).

Hangata phello ea khatello ea maikutlo e fetoha ka mor'a libeke tse 2 ho isa ho tse peli. Phekolo ea khatello ea maikutlo ke letšoao, ka hona, ho khothalletsoa ho tsoela pele ts'ebeliso ea litlhare tsa kalafo, ho kenyelletsa le Saroten Retard, kamora ho fihlela sephetho se boletsoeng ka nako e lekaneng ea nako ho fihlela ho likhoeli tse 6 ho qoba ho khutlela morao. Ho bakuli ba nang le khatello ea maikutlo ea morao-rao (unipolar), ho ka hlokoa taolo ea nako e telele ea Saroten, ho fihlela lilemo tse 'maloa, litekanyetsong tsa tlhokomelo tse nang le phello e khahlanong le ho khutlela morao.

Bakuli ba tsofetseng (ba fetang lilemo tse 65)

K'habeche e le 'ngoe ea 50 mg ka shoalane.

Mosebetsi oa liphio o theohileng

Amitriptyline e ka fanoa ka litekanyetso tse tloaelehileng bakeng sa bakuli ba nang le bothata ba ho phekoloa ke methapo.

Mosebetsi oa sebete o fokotsehile

Ho hlokahala hore ho sebelisoe tlhokomeliso ha ho sebelisoa lithethefatsi ho bakuli ba nang le ts'ebetso ea sebete e sa sebetseng hantle, mahloriso a serum amitriptyline a lokela ho hlahlojoa nako le nako ha ho khonahala.

Kamora ho khaotsa ho phekoloa, ho tlosoa hoa lithethefatsi ho khothalletsoa ho etsoa butle butle ka libeke tse 'maloa bakeng sa ho qoba nts'etsopele ea "ho tlosoa" (bona karolo ea "Litla-morao").

Ketso ea pharmacological

Amitriptyline ke antidepressant e boima. Amine ea tertiary, amitriptyline, ho vivo e batlang e lekana ho thibela ho khutlisetsoa ha norepinephrine le serotonin mokokotlong oa "presynaptic nerve". Metabolite ea eona e ka sehloohong, nortriptyline, e thibela ho khutlisetsoa ha norepinephrine ka mokhoa o tšoanang ho feta serotonin. Amitriptyline e na le m-anticholinergic, antihistamine le thepa ea ho hlohlona, e ntlafatsa ts'ebetso ea catecholamines.

Saroten Retard e ntlafatsa boemo ba pherekano ea methapo, ts'ebeliso ea eona e sebetsa hantle haholo kalafong ea khatello ea maikutlo le lefutso, empa e ka fokotsa le matšoao a mafu a mang a sithabetsang.

Ka lebaka la phello ea eona ea ho qhekella, Sarotin Retard e loketse hantle kalafo ea khatello ea maikutlo le khatello ea maikutlo, ho tsofala, ho tšoenyeha le likhathatso tsa boroko. Ha e le molao, phello ea meriana e thethefatsang maikutlo e etsahala nakong ea libeke tse 2 ho isa ho tse 2

Mofumahali

Ka lebaka la tokollo e liehang ea amitriptyline ho li-capsules tsa ts'ebetso, ho tsepamisa maikutlo ha eona ea plasma ho eketsa ho potlaka,

boholo ba mahloriso ana a ka bang 50% ha a bapisoa le matlapa a lokolloang hanghang. Keketseho e kholo ea plasma ea mali (T_tlhokomeliso) e fihlella nakong ea lihora tse 4.

Li-bioavailability tsa molomo: tse ka bang 48%. Nortriptyline e thehiloeng nakong ea "metabolism metabolism" e boetse e na le phello ea antidepressant.

Bophahamo bo bonahalang ba karolelano ke hoo e ka bang 14 l / kg. Tekanyo ea ho tlama liprotheine tsa plasma e ka ba 95%.

Amitriptyline le nortriptyline li haola le tšitiso ea placental.

Metabolism ea amitriptyline e etsoa haholo-holo ka lebaka la demethylation (isoenzymes CYP2D19, CYP3A) le hydroxylation (isoenzyme CYP2D6), 'me e lateloa ke khokahano le glucuronic acid. Metabolism e tšoauoa ka polymorphism ea liphatsa tsa lefutso. Metabolite e ka sehloohong ke amine ea bobeli - nortriptyline. Li-metabolites cis- le trans-10-hydroxyamitriptyline le cis- le trans-10-hydroxynortriptyline li tšoauoa ka profil e ts'oanang ea ts'ebetso ho nortriptyline, leha ts'ebetso ea eona e sa buuoe hanyane. Demethylnortriptyline le amitriptyline-I-oxide li teng ka har'a plasma maemong a sa tsotelleng, metabolite ea morao-rao ha e na mesebetsi ea meriana. Ha ho bapisoa le amitriptyline, li-metabolites tsohle li na le phello ea m-anticholinergic e fokolang haholo.

Bophelo ba halofo ea amitriptyline ke lihora tse 16 (± 6). Bophelo ba halofo ea nortriptyline ke lihora tse 31 (± 13). Kakaretso e hlakileng ea amitriptyline ke 0.9 l / min.

E hloekisoa haholo ke liphio. Ha e fetohe, hoo e ka bang 2% ea tekanyetso e amoheloang ea amitriptyline e hulitsoe.

Amitriptyline le nortriptyline li hlahisoa ka lebese la matsoele. Karolelano ea karolelano ea lebese la matsoele le plasma ea mali e ka bang 1: 1.

Tekanyetso ea plasma e lekanang ea amitriptyline le nortriptyline ho bakuli ba bangata e fihlelloa nakong ea matsatsi a 7-10. Ha u sebelisa li-capsules tse lokollang nako e telele mantsiboea, khatello ea amitriptyline e fihla ho boleng ba eona bo phahameng bosiu ebe ea fokotseha mots'eare, ha mahlakore a nortriptyline a lula a tsitsitse motšehare.

Phekolo eohle ea phekolo ea plasma ea amitriptyline le nortriptyline kalafong ea khatello ea maikutlo ke 370-925 nmol / L (100-250 ng / ml). Likhakanyo tse kaholimo ho 300-400 ng / ml li amahanngoa le kotsi e kholo ea ho ferekana ha pelo le ho hlaha ha AV block le QRS hola

Bakuli ba nang le ts'oaetso ea renal

Ts'ebetso ea renal e senyehileng ha e ame pharmacokinestic, shedgiptilina kapa nortriptyline, leha ho le joalo, tlhahiso ea metabolites e fokotseha butle.

Bakuli ba nang le ts'ebetso ea sebete e sa sebetseng

Ts'ebetso ea sebete e sa sebetseng e ka fokotsa metabolism ea li-antidepressants tsa li-tricyclic. .

Tlhahiso-leseling ea polokeho ea Preclinical

Li-antidepressant tsa Tricyclic li na le chefo e matla haholo.

Boithuto ba chefo e bonts'itse hore chefo e matla ea amitriptyline ka foromo ea dosage e tsitsitseng e tlase haholo ha e bapisoa le tekanyetso e ts'oanang ea amitriptyline ka tokollo ea hanghang.

Bakeng sa lilemo tse fetang 40 ha o ne o sebelisoa nakong ea bokhachane, ho ne ho sa tlaleheloe liphoso tse tebileng tsa tlhaho kapa tsa tlhaho.

Matšoao a ho sebelisoa

Ho sithabela maikutlo (haholo-holo ka matšoenyeho, ho ruruha le likhathatso tsa boroko, ho kenyeletsoa bongoaneng, ho emisa, ho se sebetse hantle, ts'ebetso ea methapo, lithethefatsi, le likotsi tsa mokokotlo oa tlhaho, ho itlopa joala), psychoses ea kelello le mathata a kelello a ferekaneng, boits'oaro (tšebetso) le tlhokomelo), nocturnal enuresis (ntle le ho bakuli ba nang le bladder hypotension), bulimia mothosa, syndrome ea bohloko bo sa foleng (bohloko bo sa foleng ho bakuli ba mofets'e, migraine, mafu a ramatiki, bohloko ba atypical tikolohong eo. le batho, postherpetic neuralgia, post-traumatic neuropathy, lefu la tsoekere kapa lefu le leng la methapo ea kutlo, hlooho ea hlooho, migraine (thibelo), peptic ulcer le 12 duodenal ulcer.

Contraindication

Hypersensitivity, e sebelise hammoho le li-inhibitors tsa MAO le libeke tse 2 pele ho qala kalafo, myocardial infarction (linako tse mpe le tse tlase), joala bo bobebe, ho tahoa haholo ka lipilisi tsa ho robala, lithethefatsi tsa analgesic le psychoactive, glaucoma e koehileng haholo, tlolo e mpe ea AV le intraventricular conduction (blockade) Gisa, AV block II sethala), ho lactation, lilemo tsa bana (ho fihlela lilemo tse 6 - foromo ea molomo, ho fihlela lilemo tse 12 ka i / m le iv) .C tlhokomeliso. Ho lemalla joala bo sa foleng, asthma, psychic-depress psychosis, khatello ea masapo a hematopoiesis, mafu a CVD (angina pectoris, arrhythmia, pelo block, CHF, myocardial infarction, arterial hypertension), stroke, e fokolitse ts'ebetso ea motor motor (kotsi ea ho thatafala ha mala ka hare). , Ho ba le sebete le / kapa ho se sebetse hantle ka mpeng, thyrotoxicosis, hyperplasia ea masapo a mokokotlo, mokokotlo oa moroto, hypotension ea bladder, schizophrenia (psychosis e ka sebetsoa), lefu la sethoathoa, boimana (haholo-holo ke trimester), botsofe.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

Ka hare, ntle le ho hlafuna, hang kamora ho ja (ho fokotsa ho teneha ha mucosa ea gastric). Tekanyetso ea pele bakeng sa batho ba baholo ke 25-50 mg bosiu, ebe lethal dose le eketseha ka matsatsi a 5-6 ho isa ho 150-200 mg / letsatsi ho litekanyetso tse 3 (karolo e phahameng ea lethal dose e nkuoa bosiu). Haeba ho se na ntlafatso ka mor'a libeke tse peli, lethal dose ea letsatsi le letsatsi e eketsoa ho 300 mg. Haeba matšoao a khatello ea maikutlo a nyamela, tekanyo e fokotsoa ho 50-100 mg / ka letsatsi mme kalafo e ntse e tsoela pele bonyane likhoeli tse 3. Botsofaling, ka mathata a fokolang, ho fanoa ka tekanyo ea 30-100 mg / mots'eare (bosiu), kamora ho fihlela phello ea kalafo, ba fetohela lethal dose le sebetsang - 25-50 mg / letsatsi.

Intramuscularly kapa iv (ente butle butle) ka tekanyetso ea 20-40 mg makhetlo a 4 ka letsatsi, butle-butle e nka sebaka sa ho kenella. Nako ea kalafo ha e fetang likhoeli tse 6-8.

Ka li-enuresis tsa bosiu ho bana ba lilemo li 6-10 - 10-20 mg / letsatsi bosiu, lilemo tse 11-16 - 25-50 mg / letsatsi.

Bana joaloka antidepressant: ho tloha ho lilemo tse 6 ho isa ho tse 12 - 10-30 mg kapa 1-5 mg / kg / letsatsi hanyane ka hanyane, lilemong tsa bocha - 10 mg makhetlo a 3 ka letsatsi (haeba ho hlokahala, ho fihlela 100 mg / ka letsatsi).

Bakeng sa thibelo ea migraine, le bohloko bo sa foleng ba tlhaho ea neurogenic (ho kenyelletsa le hlooho e telele ea nako e telele) - ho tloha ho 12,5-25 ho isa ho 100 mg / ka letsatsi (lethal dose le phahameng le nkuoa bosiu).

Litlamorao

Litlamorao tsa anticholinergic: pono e fifalitsoeng, ho holofala ha bolulo, mydriasis, khatello e eketsehileng ea methapo (feela ho batho ba nang le kemiso ea kameho ea tikoloho - sekhutlo se phapusing ea kamore ea kantle), tachycardia, molomo o omileng, pherekano, delirium kapa hallucinations, ho ruruha, ho sitisoa ha mala ho fokotse mofufutso.

Ho tsoa ts'ebetsong ea methapo: ho otsela, asthenia, ho akheha, ho tšoenyeha, ho ferekana, ho bona hallucinations (haholo-holo ho bakuli le bakuli ba nang le lefu la Parkinson), ho tšoenyeha, ho ferekana, ho tšoenyeha ha koloi, boemo ba manic, boemo ba hypomanic, ho ba mabifi, ho senyeha ha mohopolo, ho nyenyefatsoa , ho tepella maikutlo ho eketsehileng, ho fokotsa bokhoni ba ho tsepamisa maikutlo, ho hloka boroko, litoro tsa "bosiu", ho luma, asthenia, ts'ebetso ea matšoao a psychosis, hlooho, myoclonus, dysarthria, ho thothomela Hum kalse mohbat ka mesifa, haholo-holo matsoho, liphaka, matsoho, hlooho le leleme, neuropathy pheriferale (paresthesia), myasthenia gravis, myoclonus, ataxia, lefu extrapyramidal, matsapa 'me intensification la sethoathoa, EEG fetoha.

Ho tloha lehlakoreng la CCC: tachycardia, palpitations, kizunguzungu, orthostatic hypotension, liphetoho tsa nonspecific tsa ECG (ST karohano kapa T wave) ho bakuli ba se nang lefu la pelo, arrhythmia, khatello ea khatello ea mali (le fokotsehile kapa le eketsehile khatello ea mali), ho kenella ka hare ho tsebetso ea methapo (ho atoloha ha ramatiki QRS, liphetoho lipakeng tsa PQ, blockade ea maoto a bundle ea Hae).

Ho tsoa ho ts'ebetso ea lijo: ho nyekeloa ke pelo, ho ba le hepatitis ka seoelo (ho kenyelletsa tšebetso ea sebete e sa sebetseng hantle le jaundice ea cholestatic), ho otla ha pelo, ho hlatsa, gastralgia, takatso e matla ea lijo le boima ba 'mele kapa ho fokotsa takatso ea lijo le boima ba' mele, stomatitis, phetoho ea tatso, lets'ollo, ho fifatsa leleme.

Ho tloha tsamaisong ea endocrine: keketseho ea boholo (edema) ea li-testicles, gynecomastia, keketseho ea boholo ba litšoelesa tsa mammary, galactorrhea, ho fokotseha kapa ho eketseha ha libido, ho fokotseha ha potency, hypo- kapa hyperglycemia, hyponatremia (ho fokotseha tlhahiso ea vasopressin), le lefu la ho hloka mamello ea lekaneng.

Ho tsoa lithong tsa hemopoietic: agranulocytosis, leukopenia, thrombocytopenia, purpura, eosinophilia.

Boitlhotlhollo: Ho ruruha ha letlalo, ho hlohlona ha letlalo, urticaria, photosensitivity, ho ruruha ha sefahleho le leleme.

Tse ling: ho kuta moriri, tinnitus, edema, hyperpyrexia, ho ruruha ha li-lymph node, ho bolokoa ha urine, polakiuria, hypoproteinemia.

Matšoao a ho tlohela: ho khaotsa ka tšohanyetso kamora kalafo ea nako e telele - ho nyekeloa, ho hlatsa, ho opeloa ke hlooho, mala, mala, mathata a ho robala, litoro tse sa tloaelehang, ho tsosa ho sa tloaelehang, ho hlakoloa butle-butle ka mor'a kalafo ea nako e telele - ho teneha, ho tšoenyeha ha koloi, likhathatso tsa boroko, litoro tse sa tloaelehang.

Khokahano le tsamaiso ea lithethefatsi ha e e-so theoe: lupus-like syndrome (lefu la ramatiki le fetohang, ponahalo ea lithibela-mafu tse thibelang likokoana-hloko le lebaka la rheumatoid e ntle), ts'ebetso ea sebete e senyehileng, Ageusia.

Litla-morao tsa lehae mabapi le tsamaiso ea iv: thrombophlebitis, lymphangitis, sensation e tukang, ho hlaseloa ke letlalo le mefuta. Matšoao Ho tloha lehlakoreng la tsamaiso ea methapo e ka hare: ho otsela, ho hlohlona, ho akheha, ho ferekana kelellong, ho tšoenyeha, ho ferekana kelellong, ho fokotseha bokhoni ba ho tsepamisa mohopolo, ho ferekanya kelello, pherekano, dysarthria, hyperreflexia, ho satalla ha mesifa, choreoathetosis, lefu la sethoathoa.

Ho tsoa ho CCC: ho fokotseha ha khatello ea mali, tachycardia, arrhythmia, ho kenella ka hare ho intracardiac conduction, liphetoho tsa ECG (haholo-holo QRS), ho ts'oaroa, ho nyekeloa ke pelo, tšobotsi ea tahlehelo ea tahi e thata ea "tricyclic" antidepressant.

Tse ling: khatello ea maikutlo a ho hema, ho hema hanyane, cyanosis, ho hlatsa, hyperthermia, mydriasis, ho fufuleloa ho eketsehileng, oliguria kapa anuria.

Matšoao a nts'etsapele lihora tse 4 kamora ho ba le overdose, ho fihla hofihlella kamora lihora tse 24 le matsatsi a ho qetela a 4-6. Haeba ho belaelloa overdose, haholo ho bana, mokuli o lokela ho kena sepetlele.

Phekolo: Tsamaiso ea molomo: Tsamaiso ea molomo, ts'ebetso ea mashala a ts'ebetso, ts'oaetso le ts'ehetso e matla, ka litlamorao tse matla tsa anticholinergic (ho fokotseha ha khatello ea mali, arrhythmias, coma, myoclonic epileptic ente) - ho kengoa hoa kotsi ea ho ts'oaroa ha likholomo tsa mmele. ), ho boloka khatello ea mali le tekanyo ea motlakase oa metsi. Taolo ea mesebetsi ea CCC (ho kenyeletsoa ECG) bakeng sa matsatsi a 5 e bontšoa (ho khutlela morao ho ka hlaha ka nako ea lihora tse 48 kapa kamora moo), kalafo ea anticonvulsant, mochini oa moea o kenang, le mehato e meng ea ho tsosa. Hemodialysis le diuresis tse qobelloang ha li na thuso.

Litaelo tse khethehileng

Pele o qala kalafo, taolo ea khatello ea mali e ea hlokahala (ho bakuli ba nang le khatello ea mali e tlase kapa e boima haholo e ka fokotseha le ho feta), nakong ea kalafo, taolo ea mali a pherekano (maemong a mang, agranulocytosis e ka nts'etsapele, ka hona e khothalletsoa ho beha setšoantšo sa mali, haholoholo mocheso o eketsehileng oa 'mele, nts'etsopele ea matšoao a kang a ntaramane le' metso o bohloko), ka kalafo ea nako e telele - taolo ea mesebetsi ea CVS le sebete. Ho batho ba tsofetseng le ba kulang ba nang le mafu a CCC, ho laola lebelo la pelo, khatello ea mali, ECG e bonts'oa. Liphetoho tse sa hlokeng letho ka tšohanyetso li ka hlaha ho ECG (boreleli ba leqhubu la T, khatello ea karolo ea S-T, ho atoloha ha QRS tataiso).

Tšebeliso ea botsoali e ka etsahala sepetlele feela, tlasa tataiso ea ngaka, ka phomolo ea bethe matsatsing a pele a kalafo.

Ho hlokahala tlhokomeliso ha ka tšohanyetso e ea sebakeng se otlolohileng ho tloha boemong ba ho bua leshano kapa ba ho lula.

Nakong ea kalafo, ethanol e lokela ho behelloa ka thoko.

Abela pele ho feta matsatsi a 14 kamora ho tlosoa ha li-inhibitors tsa MAO, ho qala ka litekanyetso tse nyane.

Ka ho khaotsa ka tšohanyetso tsa tsamaiso ka mor'a kalafo ea nako e telele, nts'etsopele ea "ho tlosoa" hoa khoneha.

Amitriptyline ho litekanyetso tse kaholimo ho 150 mg / ka letsatsi e fokotsa monyako oa ts'ebetso ea ho ts'oaroa (kotsi ea ho ts'oaroa ha sethoathoa ho bakuli ba reriloeng esale pele, hammoho le ho ba bang, e lokela ho nahanoamabaka a rerang ho hlaha ha lefu le ferekanyang, ho etsa mohlala, likotsi tsa ts'ebetso ea etiology efe kapa efe, ts'ebeliso e ts'oanang ea lithethefatsi tsa antipsychotic (antipsychotic), nakong ea ho hana ha ethanol kapa ho tlohela lithethefatsi tse nang le thepa ea anticonvulsant, joalo ka benzodiazepines).

Ho sithabela maikutlo ho tebileng ho bontšoa ke kotsi ea liketso tsa ho ipolaea, tse ka phehellang ho fihlela tšoarelo ea bohlokoa e fihlella. Ntlheng ena, qalong ea kalafo, ho ka bonts'oa motsoako le lithethefatsi tse tsoang sehlopheng sa benzodiazepine kapa lithethefatsi tsa antipsychotic le tlhahlobo ea bongaka e sa khaotseng (ho laela basebeletsi ba tšepahalang ho boloka le ho fana ka lithethefatsi).

Ho bakuli ba nang le mathata a amanang le cyclic, nakong ea karolo e sithabetsang, maemo a manic kapa hypomanic a ka ba teng nakong ea kalafo (phokotso ea litekanyetso kapa ho tlosoa hoa lithethefatsi le lengolo la litlhare tsa li-antipsychotic li hlokahala). Kamora ho emisa maemo ana, haeba ho na le matšoao, kalafo ka ho tekanyetso e tlase e ka qalisoa hape.

Ka lebaka la litlamorao tse ka bakoang ke lefu la pelo, ho hlokahala tlhokomeliso ha ho phekoloa bakuli ba thyrotooticosis kapa bakuli ba fumanang litokisetso tsa lihomone tsa qoqotho.

Hammoho le kalafo ea electroconvulsive, e fanoa feela ka tlhokomelo e hlokolosi ea bongaka.

Ho bakuli ba nahanang ka nako e telele le bakuli ba tsofetseng, ho ka qholotsa nts'etsopele ea lithethefatsi tsa lithethefatsi, haholoholo bosiu (kamora ho khaoloa ha moriana, ba nyamela kamora matsatsi a 'maloa).

E ka baka ho hema ka mpeng, haholo ho bakuli ba nang le ho ruruha ho sa feleng, ba tsofetseng kapa ho bakuli ba qobelloang ho boloka phomolo betheng.

Pele o etsa opereishene ka kakaretso kapa ea lehae, ngaka e robatsang mahlo e lokela ho lemosoa hore mokuli o nka amitriptyline.

Ka lebaka la ts'ebetso ea anticholinergic, ho fokotseha ha lacrimation le ho eketseha ha tekanyo ea mucus ka sebopeho sa mokelikeli oa lacrimal ho ka khoneha, ho ka lebisang ho senyeha ha corneal epithelium ho bakuli ba sebelisang lilense tsa ho ikopanya.

Ka tšebeliso ea nako e telele, keketseho ea liketsahalo tsa meno ea meno e bonoa. Tlhokahalo ea riboflavin e kanna ea eketseha.

Phuputso ea ho hlahisa liphoofolo e bontšitse phello e mpe ho lesea, 'me lithuto tse lekaneng le tse laoloang ka tieo ho basali ba baimana ha li e-so tšoaroe. Ho basali baimana, moriana o lokela ho sebelisoa feela haeba molemo o ikemiselitseng ho mme o pepesa kotsi e ka bang teng ho lesea.

E kenella ka lebeseng la mpa mme e ka baka ho otsela ho masea.

Bakeng sa ho qoba nts'etsopele ea "ho tlosoa" hoa "masea a sa tsoa tsoaloa (ho bonahatsoa ke ho hema hanyane, ho otsela, mala" colic "," irotension "kapa" hypertension "(" hypertension ") kapa" hypertension "(" hypertension "kapa" hypertension "(" hypertension ") kapa" hypertension "(" hypertension "kapa" hypertension "(" hypertension ") kapa" hypertension "(" hypertension ") kapa" hypertension "(" hypertension "kapa" hypertension ").

Bana ba amehile haholo ka ho sebelisa lithethefatsi tse ngata tse feteletseng, tse lokelang ho nkuoa li le kotsi li bile li ka ba bolaea.

Nakong ea kalafo, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea psychomotor.

Tšebelisano

Ka ts'ebeliso e kopaneng ea ethanol le lithethefatsi tse sithabetsang tsamaiso ea methapo e bohareng (ho kenyelletsa li-antidepressants, barbiturates, benzadiazepines le anesthetics ka kakaretso), keketseho e kholo ea phello ea inhibitory tsamaisong ea methapo ea methapo, khatello ea maikutlo le phetoho ea hypotensive e ka etsahala.

E eketsa kutloisiso ea lino tse tahang tse nang le ethanol.

E eketsa phello ea anticholinergic ea lithethefatsi ka ts'ebetso ea anticholinergic (mohlala, phenothiazines, lithethefatsi tsa antiparkinsonia, amantadine, atropine, biperidene, antihistamines), e eketsang kotsi ea litlamorao (ho tloha tsamaisong ea methapo e kholo, pono, mala le lesapo la mokokotlo).

Ha e kopantsoe le li-antihistamines, clonidine, keketseho ea phello ea inhibitory tsamaisong ea methapo e ka hare, e nang le atropine, e eketsa menyetla ea ho kenella ka mpeng ea mala le lithethefatsi tse bakang karabelo ea extrapyramidal e eketsa ho teba le khafetsa ea litlamorao tsa extrapyramidal.

Ka ts'ebeliso e tšoanang ea amitriptyline le anticoagulants e sa tobang (coumarin kapa li-indadione derivatives), keketseho ea ketsahalo ea anticoagulant ea ho qetela e ka etsahala.

Amitriptyline e ka eketsa khatello ea maikutlo e bakoang ke corticosteroids.

Ha e kopantsoe le lithethefatsi tsa anticonvulsant, ho ka etsahala ho eketsa phello ea inhibitory tsamaisong ea methapo e bohareng, ho theola monyako bakeng sa ts'ebetso e nang le tšusumetso (ha e sebelisoa ka tekanyetso e phahameng) le ho fokotsa ts'ebetso ea morao.

Lithethefatsi bakeng sa kalafo ea thyrotooticosis li eketsa kotsi ea agranulocytosis.

E fokotsa ts'ebetso ea phenytoin le alpha-blockers.

Inhibitors ea microsomal oxidation (cimetidine) lengole T1 / 2, eketsa kotsi ea litlamorao tsa chefo ea amitriptyline (phokotso ea litekanyetso ka 20-30% e ka hlokoa), inducers ea microsomal sebete enzymes (barbiturates, carbamazepine, phenytoin, nicotine le contracepriers tsa molomo) e fokotsa plasmaation fokotsa katleho ea amitriptyline.

Fluoxetine le fluvoxamine e eketsa khatello ea amitriptyline ho plasma (phokotso ea litekanyetso tsa amitriptyline ka 50% e kanna ea hlokahala).

Ha e kopantsoe le li-anticholinergics, phenothiazines le benzodiazepines - ho matlafatsoa hoa litlamorao tsa ho hlekefetsa le bohareng ba anticholinergic le kotsi e eketsehang ea ho ts'oaroa ha sethoathoa (ho theola monyako oa ts'ebetso ea ho tsietsana), phenothiazines, ho feta moo, e ka eketsa kotsi ea lefu la methapo ea methapo ea kutlo.

Ka tšebeliso e tšoanang ea amitriptyline le clonidine, guanethidine, betanidine, reserpine le methyldopa - ho fokotseha hoa phello ea hypotensive ea morao-rao, ka koae - kotsi ea ho fetoha ha pelo.

Lithethefatsi tse nang le lithethefatsi tse thibelang pelehi ka molomo tsa estrogen le estrogens li ka eketsa bioavailability ea amitriptyline, lithethefatsi tse thibelang (tse kang quinidine) li eketsa menyetla ea ho ferekana ha morethetho (mohlomong ho theola metabolism ea amitriptyline).

Ts'ebeliso e kopaneng le disulfiram le li-inhibitors tse ling tsa acetaldehydrogenase e halefisa delirium.

Ha e lumellane le li-inhibitors tsa MAO (keketseho e ka bang teng khafetsa ea linako tse ling tsa hyperpyrexia, ho tsitsipana ho matla, likotsi tse matla le lefu la mokuli).

Pimozide le probucol li ka eketsa pelo ea pelo, e bonahatsoang ka ho eketsa nako ea Q-T ho ECG.

E ntlafatsa phello ea lefu la sethoathoa, norepinephrine, isoprenaline, ephedrine le phenylephrine ho CVS (ho kenyeletsoa ha lithethefatsi tsena e le karolo ea li-anesthetics tsa lehae) le ho eketsa menyetla ea likotsi tsa morethetho oa pelo, tachycardia, le khatello e matla ea methapo ea kutlo.

Ha e sebelisoa ka kopanelo le alpha-adrenostimulants bakeng sa tsamaiso ea methapo kapa bakeng sa ho sebelisa ophthalmology (ka tsamaiso ea bohlokoa ea tsamaiso), phello ea vasoconstrictor ea morao e ka eketseha.

Ha e kopantsoe le lihormone tsa qoqotho - ntlafatso e lumellanang ea phello ea kalafo le litlamorao tse kotsi (kenyelletsa pelo ea pelo le phello e matlafatsang tsamaisong ea methapo ea kutlo).

M-anticholinergics le lithethefatsi tsa antipsychotic (antipsychotic) li eketsa kotsi ea hyperpyrexia (haholo nakong ea leholimo le chesang).

Ka tumellano e kopanetsoeng le lithethefatsi tse ling tsa hematotoxic, keketseho ea hematotoxicity ea khonahala.

Saroten Retard (Saroten Retard) - foromo ea ho lokolla, sebopeho le polasetiki

Li-capsule tsa ketso ea nako e telele ke li-gelatin tse thata, sa boholo ba 2, opaque, e nang le 'mele le sekoaelo sa' mala o bosootho bo bofubelu, litaba tsa ka har'a likhase tsa lipalesa li pellets ho tloha ho hoo e batlang e le tšoeu ho isa ho mosehla.

1 likhahla. amitriptyline hydrochloride 56.55 mg, e tsamaellanang le litaba tsa amitriptyline 50 mg.

Ba tlisoang ke sena: lijo-thollo tse tsoekere (libaka tse tsoekere), acid e tsoekere, khetla e sa khotsoang (waxac), talc, povidone.

Moetso oa khetla ea capsule: gelatin, dae oxide e khubelu (E172), titanium dioxide (E171).

Saroten Retard (Saroten Retard) - pharmacokinetics

Bioavailability ea molomo ea amitriptyline e ka bang 60%. Plasma e tlamang protheine e ka ba 95%. Khokahano ea amitriptyline e serum ea mali e fihlela boleng ba eona bo phahameng haholo ho feta ha u nka Saroten matlapeng, kamora lihora tse 4-10, kamora moo, leha ho le joalo, e lula e tsitsitse nako e telele.

Ka tekanyetso e lekanang, litekanyetso tsa boleng ba khatello ea motsoako oa plasma li tlase ha o nka li-capsules, tse amanang le phello e mpe ea cardiotoxic ea Saroten Retard.

Amitriptyline metabolism e etsoa ka demethylation le hydroxylation. Nortriptyline e nkoa e le metabolite e ka sehloohong ea amitriptyline. T1 / 2 ea karolelano ea li-amitriptyline lihora tse 25 (lihora tse 16-40), T1 / 2 ea nortriptyline - lihora tse ka bang 27. Css e thehiloe kamora libeke tse 1-2. Amitriptyline e pepesoa haholo ka moroto 'me, ka karolo e itseng, e na le mantle. Amitriptyline le nortriptyline li tšela mokoallo oa placental 'me ka bongata li nyelisoa lebese la matsoele.

Matšoao a ts'ebeliso ea lithethefatsi

Ho sithabela maikutlo, haholoholo ka matšoenyeho, ho ferekana, le likhathatso tsa boroko:

Phekolo ea khatello ea maikutlo le makhopho a mofuta o mong oa ho ferekana kelellong, botong
dysphoria le khatello ea joala,
khatello ea maikutlo e sebetsang
khatello ea maikutlo ea methapo
kalafo ea khatello ea maikutlo ea schizophrenic (hammoho le li-antipsychotic),
mathata a bohloko a sa foleng.

Saroten Retard (Saroten Retard) - mofuta oa litlhare

Ha o nka li-capsules tsa Saroten Retard, ho khothalletsoa hore o e noe ka metsi. Li-capsule, leha ho le joalo, li ka buloa mme se ka hare ho sona (granules) se ka nooa ka molomo ka metsi. Li-granules li thibetsoe ho hlafuna.

Bakeng sa kalafo ea khatello ea maikutlo, ho laetsoe nako e le 'ngoe / lihora tse 3-4 pele ho nako ea ho robala ho litekanyetso tse lumellanang le 2/3 ea litekanyetso tsa Saroten matlapeng.

Batho ba baholo ba lokela ho qala kalafo ka Saroten Retard ka kopi e le 'ngoe ea 50 mg ka shoalane. Haeba ho hlokahala, kamora libeke tse 1-2, tekanyetso ea letsatsi le letsatsi e ka eketsoa ho li-capsules tse 2-3 ka shoalane (100-150 mg). Kamora ho ntlafatsa ntlafatso e tšoailoeng, litekanyetso tsa letsatsi le letsatsi li ka fokotsoa hore li sebetse hanyane, hangata ho fihla ho li-capsules tsa 1-2 (50-100 mg /). Ka kalafo ea khatello ea maikutlo, ho khothalletsoa ho tsoela pele ho sebelisa litlhare tsa meriana, ho kenyeletsa le Saroten Retard, kamora ho fihlela sephetho se boletsoeng bakeng sa likhoeli tse ling tsa 4-6. Ka litekanyetso tsa tlhokomelo tse nang le litlamorao tse khahlano le ho khutlela morao, Saroten Retard e ka nkuoa nako e telele, ho fihlela lilemo tse 'maloa.

Batho ba tsofetseng ba lokela ho qala kalafo le Saroten ka matlapa - 30 mg / (3 ho isa ho 10 mg). Matsatsing a 'maloa, ho ka etsahala hore u fetole ho nka likotopo tsa Saroten Retard. Tekanyetso ea letsatsi le letsatsi ke li-capsules tse 1-2 (50-100 mg), tse nkuoa mantsiboea.

Mathateng a bohloko a sa foleng a batho ba baholo, litekanyetso tsa letsatsi le letsatsi ke li-capsules tsa 1-2 (50-100 mg), tse nkuoa mantsiboea. Ho a khonahala ho qala kalafo ka ho nka Saroten matlapeng a 25 mg hang hang ka shoalane.

Litla-morao tse amanang le phello ea anticholinergic: ho omella le / kapa tatso e bohloko molomong, ho nyekeloa ke pelo, ho hlatsa, stomatitis, ka seoelo - cholestatic jaundice, pono e fifalitsoeng, khatello e eketsehileng ea intraocular, tachycardia, ho qhekella, hangata haholo - ho bolokoa ha moroto. Hangata li hlaha qalong ea kalafo, ebe, haholo-holo, lia fokotseha.

Ho tloha lehlakoreng la tsamaiso ea methapo ea pelo: tachycardia, arrhythmias, orthostatic hypotension, mafu a intracardiac conduction, a tlalehiloeng ho ECG feela, empa a sa bonahale ka ho hlaka.
Ho tloha lehlakoreng la tsamaiso ea methapo e bohareng: ho otsela, bofokoli, khatello ea maikutlo, ho opeloa ke hlooho, ho tsekela. Mathata ana, a atisang ho hlaha qalong ea kalafo ea amitriptyline, a fokotseha nakong ea kalafo. Haholo-holo hangata, haholo ha ho sebelisoa litekanyetso tse phahameng tsa pele, ho tsitsipana, ho ferekanya, pherekano, ho tsofala, ho bona lipono, mathata a tsoang kantle ho mmele, ho thothomela le makhopho a ka ba teng, ka seoelo a ho tšoenyeha.

Litla-morao: Ho lekhopho la letlalo, ho hlohlona ho ka etsahala.

Ba bang: ho nyekeloa ke pelo, ho fufuleloa, ho nona ka boima ba 'mele, ho fokotsa libido ho ka hlaha.

Contraindication

infarction ea morao-rao ea morao-rao,
lefu la pelo le tsamaisoang ke pelo
chefo e matla haholo ke joala, li-barbiturates kapa opiates,
angle-shutter glaucoma,
sebelisa hammoho le li-inhibitors tsa MAO le ho fihlela libeke tse 2 kamora ho tlohela,
hypersensitivity ho amitriptyline.

Saroten Retard - Litaelo tse Khethehileng

Saroten Retard e lokela ho laeloa ka hloko ho bakuli ba nang le mathata a ho tšoha, ho boloka mokokotlo, hypertrophy ea tšoelesa ea senya, lefu le matla la sebete kapa lefu la pelo le hyperthyroidism.

Ho ba le tšusumetso e matla, e ka ama bokhoni ba ho laola koloi le mekhoa e meng. Bakuli ba nkang Saroten Retard ba lokela ho lemosoa esale pele ke ngaka mabapi le karolo ena ea lithethefatsi.

Saroten Retard - Ho feta tekano

Matšoao Khatello kapa khatello ea methapo ea kutlo. Lipontšo tse matla tsa li-anticholinergic (tachycardia, li-membrane tse omileng tsa mucous, ho boloka mokokotlo) le li-cardiotoxic (arrhythmias, hypotension ea methapo ea pelo, ho hloleha ha pelo). Mathata a ho ferekanya. Hyperthermia.

Phekolo. Se nkoang e le sesupo. E tlameha ho etsoa sepetlele. Ka tsamaiso ea molomo ea amitriptyline, sefuba sa sefuba se lokela ho etsoa kapele kamoo ho ka khonehang mme mashala a sebetsang a lokela ho laetsoa. Mehato e tlameha ho nkuoa ho boloka methapo ea ho phefumoloha le ea pelo. Ho beha leihlo ts'ebetso ea pelo nakong ea matsatsi a 3-5 hoa hlokahala. Epinephrine (adrenaline) ha ea lokela ho beoa maemong a joalo. Bakeng sa mathata a ts'episang, diazepam e kanna ea sebelisoa.

Saroten Retard (Saroten Retard) - tšebelisano ea lithethefatsi

Amitriptyline e ka ntlafatsa litlamorao tsa ethanol, barbiturates le lintho tse ling tse sithabetsang tsamaiso ea methapo e bohareng.

Tšebeliso e kopaneng le li-inhibitors tsa MAO e ka lebisa khatellong ea khatello ea mali.

Kaha amitriptyline e ntlafatsa litlamorao tsa li-anticholinergics, tsamaiso e tšoanang le bona e lokela ho qojoa.

E ntlafatsa litlamorao tsa sympathomimetics of epinephrine (adrenaline), norepinephrine (norepinephrine), ka lebaka la sena, anesthetics ea lehae e nang le lintho tsena ha ea lokela ho sebelisoa ka nako e le ngoe le amitriptyline.

E ka fokotsa phello ea antihypertensive ea clonidine, betanidine, le guanethidine.

Ha e kopantsoe le li-antipsychotic, ho lokela ho hopoloa hore li-antidepressants tsa li-tridclic le li-antipsychotic ka bobeli li thibela metabolism e 'ngoe, li theola monyako oa ho ikemisetsa ho tsitsipano.

Ka ts'ebeliso e ts'oanang le cimetidine, ho theoha butle-butle metabolism ea amitriptyline, keketseho ea khatello ea eona maling a mali le nts'etsopele ea litlamorao tse chefo e kanna ea ba teng.