Amitriptyline Nycomed - litaelo tsa semmuso bakeng sa tšebeliso

Amitriptyline Nycomed: litaelo tsa tšebeliso le litlhahlobo

Lebitso la Latin: Amitriptyline-Nycomed

Khoutu ea ATX: N06AA09

Motsoako o sebetsang: amitriptyline (Amitriptylinum)

Mohlahisi: Takeda Pharma A / S (Denmark), Nycomed Danmark ApS (Denmark)

Ho nchafatsa litlhaloso le foto: 10/22/2018

Litheko makaleng a litlhare: ho tloha li-ruble tse 54.

Amitriptyline Nycomed - sethethefatsi se nang le ts'ebetso ea antidepressant.

Sokolla foromo le sebopeho

Mofuta oa litekanyetso tsa tokollo ea Amitriptyline Nycomed:

• matlapa a koahetsoeng (likotoana tse 50 e mong le e mong ka libotlolong tsa khalase tse lefifi, botlolo e le 1 ka lebokoseng la karete)
• matlapa a koahetsoeng ka filimi: e tšoeu, biconvex, e chitja (50 e ngoe le e ngoe ka libotlolong tsa khalase tse lefifi, botlolo e le 'ngoe ka lebokoseng la karete.

Ntho e sebetsang ka sebopeho sa 1 letlapa, le koahetsoeng / filimi e koahetsoeng: amitriptyline - 10 kapa 25 mg.

Lintho tse thusang mabapi le sebopeho sa 1 tafole e koahetsoeng: cellcrystalline cellulose, polypropylene glycol, starch ea litapole, magnesium stearate, lactose monohydrate, titanium dioxide, talc, methyl hydroxypropyl cellulose, starch ea lijalo, gelatin, croscarmellose sodium, polyvidone e hloekisitsoeng.

Likarolo tse thusang mabapi le sebopeho sa 1 letlapa, filimi e koahetsoeng (10/25 mg):

• mantlha: magnesium stearate - 0,25 / 0,5 mg, povidone - 0,83 / 0,6 mg, talc - 2.25 / 4,5 mg, "cellcrystalline cellulose" - 9.5 / 18 mg, starch ea litapole - 28 , 2/38 mg, lactose monohydrate - 27 / 40.2 mg,
• khetla: propylene glycol - 0,2 / 0,3 mg, titanium dioxide - 0,8 / 0,9 mg, hypromellose - 1,2 / 1,4 mg, talc - 0,8 / 0.9 mg.

Mofumahali

Amitriptyline Nycomed ke e 'ngoe ea li-antidepressants tse rarahaneng tse tsoang sehlopheng sa li-inhibitors tse se nang khetho ea monoamine reuptake inhibitors. E na le tšebeliso ea timeoanaleptic le sedative.

Mochine oa ts'ebetso o amana le keketseho ea litaba tsa serotonin le norepinephrine ho synaptic cleft tsamaisong ea methapo e bohareng. Ho bokellana ha li-neurotransmitters tsena ho etsahala ka lebaka la thibelo ea ho khutlisetsoa ha bona ka morao ke li-membrane tsa li-neurons tsa "presynaptic neurons".

Amitriptyline ke blocker ea li-alpha-1-adrenergic receptors, li-receptors tsa H1-histamine, M1- le M2-muscarinic cholinergic receptors. Ho ipapisitsoe le seo ho thoeng ke monoamine hypothesis, ho na le kamano pakeng tsa tšebetso ea li-neurotransmitters ho li-synapses tsa mokokotlo le molumo oa maikutlo.

Khopolo-taba e hlakileng pakeng tsa khatello ea plasma ea amitriptyline maling le phello ea tleleniki ha e bontšoe, empa ho ka etsahala hore phello e nepahetseng ea kliniki e fihlellehang ka bongata ho tloha ho 100 ho isa ho 260 μg / L.

Phokotso ea kliniki ea khatello ea maikutlo e fihlella ka mor'a libeke tse 2-6 tsa kalafo (kamora nako ea ho lekana ha plasma maling e fihlisoa).

Amitriptyline Nycomed e boetse e na le phello e kang quinidine ho bolokoeng ba pelo.

Mofumahali

Amitriptyline kamora tsamaiso ea molomo e kenelle ka botlalo le ka potlako ho tsoa pampiring ea mpa. Ho fihlella mahloriso a mangata a plasma (C_max) e bonoa lihora tse 2-6 kamora tsamaiso.

Khetla ea plasma ea amitriptyline maling a bakuli ba fapaneng e ka fapana haholo. Bioavailability ea amitriptyline e batla e le 50%. Hoo e ka bang 95% ea ntho e tlama liprotheine tsa plasma. Nako ea ho fihla kholehong e phahameng (Tc_max) kamora ho kenella ke lihora tse 4, karolelano ea ho lekana ke matsatsi a ka bang 7 ho tloha qalong ea kalafo. Boholo ba khaso - hoo e ka bang 1085 l / kg. Ntho ena e tšela placenta ebe e tšeloa ka lebese la matsoele.

Metabolism e etsahala sebeteng, hoo e ka bang 50% e tšeloa matla nakong ea karolo ea pele ka sebete. Ntle le moo, amitriptyline e feta N-demethylation ka cytochrome P450 ka sebopeho se latelang sa metabolite e sebetsang - nortriptyline. Ntho le metabolite ea eona e sebetsang li-hydroxylated ho sebete. N-hydroxy-, 10-hydroxymetabolite ea amitriptyline, 10-hydroxynortriptyline le eona e na le mosebetsi. Amitriptyline le nortriptyline li kopantsoe le glucuronic acid (li-conjugates ha li sebetse). Ntho e ka sehloohong e khethollang ho pepesetsoa ha renal le ho kenella ha plasma maling ke tekanyo ea hydroxylation. Karolong e nyane ea bakuli, hydroxylation e liehang ho bonoa (e na le boemo ba liphatsa tsa lefutso). Ka boteng ba mosebetsi o nang le mathata a hepatic, halofo ea bophelo ba amitriptyline / nortriptyline ho plasma ea mali e eketsehile.

Half-life (T1 / 2) ea amitriptyline e tsoang plasma ea mali e tloha lihora tse 9 ho isa ho tse 46, nortriptyline e tloha lihora tse 18 ho isa ho tse 95.

Excretion e etsahala haholo ka sebopeho sa metabolites ke liphio le ka mala. Ka sebopeho se sa fetoheng, ke karolo e nyane feela ea tekanyetso e nkoang e hlahlojoa lipelong. Ka ts'ebetso ea renal e sa sebetseng hantle, metabolism ea amitriptyline le nortriptyline ha e fetohe, leha ho felisoa ha bona ho lieha ho theoha. Amitriptyline ho tsoa ho plasma ea mali ka dialysis ha e tlosoe (ka lebaka la puisano le liprotheine tsa mali).

Contraindication

• myocardial infarction (ho kenyeletsa nalane ea morao-rao)
• acute delirium
• joala bo bongata haholo
• ho tahoa haholo le lithethefatsi ka lipilisi tsa ho robala, li-analgesic le psychotropic,
• angle-shutter glaucoma,
• arrhythmias
• mathata a intraventricular / atrioventricular conduction,
• ho se mamellane ha lactose, ho haelloa ke lactase le malabsorption ea glucose-galactose,
• Prostate hyperplasia e bolokiloeng ka moroto,
• bradycardia
• hypokalemia
• paralytic bowel obstruction, pyloric stenosis,
• congenital elongated QT syndrome, hammoho le phekolo e kopaneng le lithethefatsi tse lebisang katolosong ea nako ea QT,
• phekolo ea ho kopanya le li-inhibitors tsa monoamine oxidase, ho kenyelletsa le matsatsi a 14 pele o sebelisoa,
• lilemo tse 18
• lebone
• ho se mamellane ha motho ka mong likarolo tsa moriana.

Setsoalle (ka khetho ea Amitriptyline Nycomed, tlhokomeliso le tlhokomelo ea bongaka li hlokahala):

• mafu a mali le tsamaiso ea pelo le pelo, ho kenyelletsa angina pectoris le lefu la methapo ea methapo,
• kh'amera e hlobaetsang ea k'hamera ea leihlo le kamera e ka pele ea leihlo,
• angle-shutter glaucoma,
• khatello e eketsehileng ea methapo,
• ho bolokoa ka moroto
• Prostatic hyperplasia,
• lefu la sethoathoa (tšebeliso ea Amitriptyline Nycomed e ka lebisa ho fokotseha ha monyako o kholisang),
• maemo a tšosang
• hyperthyroidism
• blotder hypotension,
• schizophrenia
• lefu la ho ferekana kelellong
• ts'ebetso ea sefuba kapa ea liphio.
• joala bo sa foleng,
• Phekolo ea meriana e kopaneng le lipilisi tsa ho robala le litlamorao tsa antipsychotic.
• boimana
• botsofali.

Litaelo tsa ho sebelisoa Amitriptyline Nycomed: mokhoa le litekanyetso

Matlapa a Amitriptyline Nycomed 25 mg kapa 10 mg a nooa ka molomo, haholo-holo hang ka mor'a lijo. Matlapa a Chew ha a lokela ho ba joalo.

Mokhoa o tloaelehileng oa litekanyetso ho bakuli ba baholo ke: qalong ea kalafo - 25-50 mg ho litekanyetso tse 2 tse arohaneng, haeba ho hlokahala, tekanyetso ea letsatsi le letsatsi e nyoloha butle ho isa ho 200 mg, nako ea ts'ebeliso ke likhoeli tse 6 kapa ho feta (molemong oa ho thibela ho khutla hape).

Tekanyetso ea pele ea letsatsi le letsatsi ea Amitriptyline Nycomed bakeng sa bakuli ba tsofetseng ke 25-30 mg ho lethal dose le le leng (bosiu). Haeba ho hlokahala, ho fihlela phello ea kalafo e fumaneha, tekanyetso letsatsi le leng le le leng e eketsoa ho 50-10 mg ka letsatsi. Ho khethoa ha thupelo ea bobeli ho hloka tlhatlhobo e eketsehileng.

Ka ho hloleha ha sebete, Amitriptyline Nycomed e fanoe ka tekanyo e fokotsoang.

Ho qoba ponahalo ea lefu la ho tlohela (ka mokhoa oa hlooho ea hlooho, likhathatso tsa boroko, ho teneha le bophelo bo botle ba bokuli), lithethefatsi li lokela ho tlosoa butle butle. Matšoao a boletsoeng ha se sesupo sa hore o tla sebelisa lithethefatsi kapa che.

Litlamorao

Tse ling tsa litlamorao tse latelang tse sa rateheng (ka ho khetheha, ho thothomela, ho opeloa ke hlooho, ho fokotseha ka sekhahla sa thobalano le nako ea tlhokomelo, ho sokela) e kanna ea ba matšoao a khatello ea maikutlo, 'me hangata li fella ka phomolo ea khatello ea maikutlo.

Ho feta 50% ea bakuli nakong ea ts'ebeliso ea Amitriptyline Nycomed ba ka ba le bothata bo bong kapa a mang a latelang. Lithethefatsi li ka lebisa ho hola hoa maikutlo a mabe, a ts'oanang le a bakang li-antidepressants tse ling.

Liphetoho tse ka ba teng tse mpe (> 10% - hangata haholo,> 1% le 0,1% le 0,01% le

Bongata

Matšoao a bosholu ba lithethefatsi a ka hlaha ka tšohanyetso kapa a hola butle. Lihoreng tsa pele tse 2, mokuli o na le ho ferekana kelellong kapa ho otsela, ho bona lintho ka tsela e potelletseng, hammoho le matšoao ka lebaka la ketsahalo ea anticholinergic ea amitriptyline (tachycardia, ho omella ha mucous membrane, feberu, mydriasis, ho ts'oaroa moroto, ho ferekana le ho fokolloa ke matla a mala. Kamora moo, ho hloleha ho phefumoloha, ho ka ba le ts'ebetso e matla ea ts'ebetso ea methapo ea methapo e kholo le kelello e sa sebetseng.

Bakuli ba fapaneng ba na le karabelo e fapaneng haholo litabeng tsa bongoana haholo, bakuli ba bana ba bangata ba tloaetse ho arabela le ho tsietsana ha pelo le methapo.

Ho tloha lehlakoreng la tsamaiso ea methapo ea pelo, overdose ea Amitriptyline Nycomed e bonahatsoa ke flutter le ventricular fibrillation, ventricular tachyarrhythmia. Liphetoho tse latelang li bonoa ho ECG: katoloso ea mochini oa QRS, ho inversion kapa flattle ea T wave, ho lelefatsa nako ea PR, khatello ea maikutlo ea karolo ea ST, ho lelefatsa nako ea QT, le maemo a fapaneng a blockade ea intracardiac conduction (ho fihlela ho tšoaroa ha pelo). Mokuli a ka ba le hypotension ea methapo, ho nyekeloa ke pelo, hypokalemia, ho thothomela ha pelo, metabolic acidosis, ho tšoenyeha ho matla, ataxia, pherekano le ho felloa ke tšepo. Ho robala ka matla le hona ho ka etsahala.

Tabeng ea ho nka Amitriptyline Nycomed ka tekanyo e phahame haholo ho feta e bolokehileng, kapa ponahalo ea matšoao a kalafo e feteletseng, a lipontšo le a tšehetsang a laetsoe. Phekolo ea lithethefatsi e lokela ho khaotsa. Mokuli o hlatsoa ka mpeng 'me o fuoa mashala a sebetsang (le haeba ho se ho fetile nako e itseng a qeta ho nka amitriptyline). Mokuli o lokela ho betoa leihlo ka hloko, ho sa tsotelehe boemo bo bonahalang bo le botle. Ho bohlokoa ho laola sekhahla sa ho phefumoloha le sekhahla sa pelo, boemo ba ho tseba le boholo ba khatello ea mali. Hoa hlokahala ho hlahloba khafetsa likhakanyo tsa likhase le li-elektrone maling. Netefatsa moea o tloaelehileng, 'me haeba ho hlokahala, u etse moea o mongata oa moea. ECG e beiloe leihlo bakeng sa matsatsi a 3-5 ka mor'a ts'ebeliso e feteletseng. Ventricular arrhythmias, ho nyekeloa ke pelo, le katoloso e rarahaneng ea QRS e ka emisoa ka ho fetisetsa pH lehlakoreng la alkaline (ka ho etsa hyperventilation kapa ho fana ka tharollo ea sodium bicarbonate) le ho tsamaisa ka potlako tharollo ea sodium chloride (100-200 mmol Na +). Ho bakuli ba nang le li-ventricular arrhythmias, lithethefatsi tsa setso tsa antiarrhythmic li ka sebelisoa, mohlala, tsamaiso e kenelletseng ea 50-100 mg lidocaine (1-1,5 mg / kg), e lateloe ke ho kenella ka lebelo la 1-3 mg / min.

Haeba ho hlokahala, sebelisa defibrillation le cardioversion. Khalemelo ea ho haella ha potoloha ho etsoa ka tharollo ea ho fetoloa hoa plasma, mme maemong a boima, ka infbutamine infusion (lethalinyana la pele ke 2-3 μg / kg / min, le lateloe ke keketseho ea lona, ​​ho latela phello e fumanoeng). Ho feto-fetoha le moea o ferekaneng ho ka emisoa ka diazepam.

Phekolo ea metabolic acidosis e tloaelehile. Ho buoa ka letsoho ho tlosa amitriptyline maling ha ho na thuso, kaha ho na le thepa e sa lefelloeng ka plasma e tlaase.

Ho bakuli ba baholo, ho tahoa ho lekana kapa ho tebileng le lithethefatsi ho fetoha ka mor'a ho nka 500 mg kapa ho feta ea amitriptyline. Haeba u nka 1000 mg kapa ho feta, sephetho se bolaeang se ka etsahala.

Litaelo tse khethehileng

Pele o qala kalafo le Amitriptyline Nycomed, ho hlokahala ho laola khatello ea mali, joalo ka batho ba nang le labile kapa khatello e tlase ea mali, e ka fokotseha le ho feta.

Bakuli ha baa lokela ho ema hanyane (ho nka boemo bo otlolohileng) ho tloha boemong ba ho bua leshano kapa ba ho lula. Boithuto (bongata ba lipatlisiso ke bakuli ba lilemo tse 50 le ho feta) ba bonts'itse hore ts'ebeliso ea li-antidepressants tsa tricyclic le li-inhibitors tse khethiloeng tsa serotonin li eketsa menyetla ea ho robeha ha masapo, empa mokhoa oa ts'ebetso ena le tekanyo ea kotsi ha li tsejoe.

Nakong ea kalafo, ho khothalletsoa ho laola ho hlophisoa ha mali a potoloho (haholo-holo ka nts'etsopele ea li-millillitis, feberu kapa ponahalo ea matšoao a kang flu), le kalafo e telele, ts'ebetso ea sebete le tsamaiso ea methapo ea pelo. Ho bakuli ba nang le mafu a methapo ea pelo le bakuli ba tsofetseng, ho hlokahala ho laola ECG, khatello ea mali le sekhahla sa pelo.

Amitriptyline e sebelisoa ka tlhokomeliso ka nako e ts'oanang le li-inducers kapa inhibitors ea cytochrome P₄₅₀ CYPZA4.

Nakong ea phekolo, hoa hlokahala ho qhelella tšebeliso ea lino tse tahang.

Ho tlosa lithethefatsi ho lokela ho etsoa butle butle, hobane ho khaotsa ho amoheloa ka tšohanyetso, haholo-holo kamora ho qeta nako e telele, ho ka lebisa nts'etsong ea lefu la ho tlohela.

Ketsahalo ea M-anticholinergic ea amitriptyline e ka baka tlhaselo ea khatello e eketsehileng ea intraocular. Hape hoa khoneha ho fokotsa lacrimation le ho eketsa palo ea mucus ka har'a mokelikeli oa lacrimal, o ka lebisang tšenyehelong ea mokokotlo oa kantle ho batho ba sebelisang lilense tsa ho ikopanya.

Tloaelong ea bongaka, ketsahalo ea lefu ka lebaka la arrhythmia e hlahang lihora tse 56 kamora hore lithethefatsi tse ngata li hlalosoa.

Ho bakuli ba nang le tloaelo ea ho ipolaea, kotsi ea ho ipolaea e phehella kalafo ho fihlela ntlafatso e kholo ea matšoao a khatello ea maikutlo e fihlelloa. Kaha kalafo ea amitriptyline e qala ho hlaha feela kamora libeke tse 2-2 tsa kalafo, ho lekola bakuli ba tloaetseng ho ipolaea ho hlokahala ho fihlela boemo ba bona bo ntlafala. Batho bao pejana ba kileng ba hlahisa menahano ea ho ipolaea kapa liketsahalo tsa ho ipolaea, hammoho le ho leka ho ipolaea pele ba qala kalafo kapa nakong ea kalafo, ba lokela ho ba tlasa tlhokomelo ea bongaka kamehla. Kabo ea lithethefatsi ho bakuli ba joalo e etsoa feela ke batho ba lumelletsoeng. Amitriptyline Nycomed (joalo ka li-antidepressants) ka boeona e ka eketsa khafetsa ea ho ipolaea ho bakuli ba ka tlase ho lilemo tse 24, ka hona, pele ho fana ka litlhare ho bakuli ba ka tlase ho lilemo tse 24, ho bohlokoa ho tseba hore na melemo ea ts'ebeliso ea eona le kotsi ea ho ipolaea ke efe.

Ho batho ba nang le lefu la ho ferekana kelellong, amitriptyline e ka baka karolo ea manic. Haeba ho na le matšoao a boloi, moriana o lokela ho emisoa.

Ho bakuli ba fumanang li-antidepressants tse tharo kapa tse ling ka nako e le 'ngoe le meriana e thibelang litho tsa lehae, menyetla ea ho theoha ha khatello ea mali le nts'etsopele ea arrhythmia e kanna ea eketseha. Ke ka lebaka leo ho leng bohlale ho hlakola sethethefatsi sena pele ho ts'ebetso e reriloeng ea ho buuoa. Maemong a ts'ohanyetso a ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ohanyetso e lokela ho tsebisoa ka ho sebelisa amitriptyline.

Moriana o ka ama ketso ea insulin mme o fetola khatello ea mali maling ka mor'a ho ja. Ho bakuli ba nang le lefu la tsoekere mellitus, ho ka hlokahala hore ba lokise kalafo. Boemo ba khatello ea maikutlo ka bo bona bo ka fetola metabolism ea glucose.

Batho ba noang Amitriptyline Nycomed ba lokela ho tsebisa ngaka ea bona ea meno ka ho sebelisa moriana.Molomo o omileng o ka baka ho ruruha, liphetoho molomong oa molomo, likhalase tsa meno le maikutlo a tukang ka hanong. Bakuli ba eletsoa hore ba etele ngaka ea meno khafetsa.

Bokhachane le pelehi

Boiphihlelo ba tleliniki le Amitriptyline Nycomed ho basali baimana bo lekanyelitsoe. Polokeho ea amitriptyline bakeng sa lesea le sa tsoa emoloa e-so ka e thehoa.

Setlhare ha se khothaletsoe ho laeloa nakong ea kemaro, haholoholo ho li-trimesters tsa I le III, ntle le haeba maemong ao phaello e lebelletsoeng ho mme e le phahameng ho feta kotsi e ka bang teng ho lesea. Hoa hlokahala ho hlokomelisa mosali oa moimana ka kotsi e kholo ea litlamorao tse mpe tsa lithethefatsi ho lesea le ntseng le tsoela pele ho hlaha. Litekanyetso tse phahameng tsa li-antidepressants tsa tricyclic tse sebelisitsoeng trimester ea boraro li ka lebisa ho tsitsipano ea methapo ho masea a sa tsoa hlaha. Litaba tse ka thoko tsa ho otsela li tlalehiloe ho masea ao bo-'m'a bona ba ileng ba nortriptyline nakong ea kemolo, le linyeoe tsa ho boloka moroto ho masea a sa tsoa tsoaloa le tsona li hlokometsoe.

Lithutong tsa liphoofolo, litla-morao tsa lithethefatsi li ile tsa bonoa kamora ho nka tekanyetso makhetlo a 'maloa ho feta tekanyetso e tloaelehileng ea kalafo bathong.

Amitriptyline e pepesoa nakong ea lebese, kahoo ho anyesa ho lokela ho emisoa nakong ea kalafo le moriana.

Ho sebelisana le lithethefatsi

Amitriptyline Nycomed e baka tšitiso ea tsamaiso ea methapo e bohareng ke lithethefatsi tse latelang: narcotic le bohareng analgesics, antipsychotic, anticonvulsants, hypnotics and sedatives, joala le anesthetics ka kakaretso.

Lithethefatsi tse thibelang CYP2D6 isoenzyme (isoenzyme ea mantlha eo li-antidepressants tsa li-metabolism li entsoeng ka eona) li ka thibela metabolism ea amitriptyline le ho eketsa mahloriso a eona a plasma. Lithethefatsi tse joalo li kenyelletsa: li-antipsychotic, lithethefatsi tsa morao-rao tsa antiarrhythmic (propafenone, procainamide, esmolol, amiodarone, phenytoin), serotonin reuptake inhibitors (ntle le citalopram, e leng thibelo e fokolang haholo), P-blockers.

Amitriptyline Nycomed e hanyetsanoe hore e sebelisoe ka mokhoa o ts'oanang le li-inhibitors tsa MAO, kaha motsoako o joalo o lebisa ho nts'etsopele ea serotonin syndrome, e kenyelletsang spasms ha thabo, myoclonus, khatello ea kelello e nang le letsoalo le ferekaneng. Moriana o ka qala ho sebelisoa libeke tse 2 kamora ho khaotsa ho phekoloa ka li-inhibitors tsa MAO tse ke keng tsa fetoloa, le tse 1 kamora ho felisoa ha moclobemide (inhibitor ea MAO e khutliselitsoeng). Ka lehlakoreng le leng, kalafo e nang le inhibitors ea MAO e ka qala pele ho feta libeke tse 2 kamora ho hlakoloa ha Amitriptyline Nycomed. Maemong a mabeli le a bobeli, kalafo e nang le li-inhibitors tsa MAO le amitriptyline e qala ka litekanyetso tse nyane, tse ileng tsa eketseha hanyane ka hanyane.

Setlhare ha se khothalletsoe ho sebelisoa ka nako e le ngoe le lithethefatsi tse latelang:

• audiathomimetics (adrenaline, isoprenaline, phenylephhedrine, norepinephrine, ephedrine, dopamine): litlamorao tsa lithethefatsi tsena tsamaisong ea pelo li matlafatsoa,
• li-adrenergic blocking agents (methyldopa, clonidine): ho fokolisa matla a antihypertensive a li-adrenergic blocking agents ho ka etsahala,
• m-anticholinergics (melemo ea phenothiazine, atropine, lithethefatsi tsa antiparkinsonian, biperiden, H blockers₁-histamine receptors): amitriptyline e ka ntlafatsa litlamorao tsa lithethefatsi tsena ka mpeng, lesapo la mokokotlo, sebopeho sa pono le tsamaiso ea methapo e kholo, ts'ebeliso e kopaneng e lokela ho qojoa ka lebaka la kotsi ea ho eketseha ho matla ha mocheso le tšitiso ea mala.
• lithethefatsi tse lelefatsang nako ea maqhubu a QT (li-antiarrhythmic lithethefatsi, li-antipsychotic tse ling, li H blockers₁histamine receptors, anesthetics, sotalol, chloral hydrate): menyetla ea ho nts'etsopele ea li-ventricular arrhythmias ea eketseha,
• Litlolo tsa lithium: hoa khoneha ho eketsa chefo ea lithium, e bonahatsoang ke ho ts'oaroa ke tonic-clonic, ho thothomela, monahano o fosahetseng, ho nahana ka lintho tse itseng, ho thatafalloa ke ho hopola le litla-morao tsa antipsychotic.
• antifungal agents (terbinafine, fluconazole): khatello ea serum ea amitriptyline ea eketseha le chefo ea lithethefatsi tse amanang le eona ea eketseha.

Amitriptyline Nycomed e sebelisoa ka tlhokomeliso ka nako e ts'oanang le lithethefatsi tse latelang:

• lithethefatsi tse thibelang tsamaiso ea methapo e kholo (li-analgesics tse matla, sedative le hypnotics, ethanol le lithethefatsi tse nang le ethanol): hoa khoneha ho eketsa thibelo ea mesebetsi ea methapo e kholo ea methapo,
• inducers ea microsomal sebete enzymes (carbamazepine, rifampicin): amitriptyline metabolism e ka eketseha mme mahloriso a eona a plasma a ka fokotseha, a qetellang a lebisa ho fokolleng ha phello ea antidepressant,
• antipsychotic: thibelo ea methapo ea methapo e ka etsahala, e ka bakang ho fokotseha ha monyako oa ho tsitsa mme ea lebisa ho nts'etsopele ea ho ts'oaroa (ka linako tse ling tokiso ea li-antipsychotic le amitriptyline ea hlokahala),
• li-blockers tse liehang ho feta tsa calcium calcium, methylphenidate, cimetidine: plasma ea bongata ba amitriptyline e eketseha le chefo ea eona e eketseha.
• lipilisi tsa ho robala le li-antipsychotic: tšebeliso e tšoanang ea amitriptyline, lipilisi tsa ho robala le li-antipsychotic ha li khothaletsoe (haeba ho hlokahala, ts'ebeliso ea motsoako ona e lokela ho ba hlokolosi haholo),
• valproic acid: bongata ba amitriptyline le nortriptyline (e ka hloka ho fokotseha hoa tekanyo ea lithethefatsi),
• sucralfate: ho monya amitriptyline hoa fokola 'me phello ea eona ea ho fokotsa mathata e felisitsoe,
• phenytoin: metabolism ea phenytoin ha e thibeloe 'me ho eketseha ha eona chefo (ataxia, ho thothomela, nystagmus le hyperreflexia hoa khoneha),
• Litokisetso tsa hypericum perforatum: metabolism ea amitriptyline e sebete e sebetsoa mme mahloriso a eona a mangata ho plasma a fokotseha (tokiso ea li-amitriptyline e ka hlokahala).

Li-Analoggues tsa Amitriptyline Nycomed ke Amitriptyline, Amitriptyline Zentiva, Amitriptyline Grindeks, Vero-Amitriptyline, Amitriptyline-Ferein, Saroten retard, jj.

Foromo ea boholo:

matlapa a koahetsoeng ka filimi

Letlapa le le leng le koahetsoeng ka filimi 10 mg le na le:
ntho e sebetsang: amitriptyline hydrochloride 11.3 mg ho latela amitriptyline 10 mg,
Baeti: magnesium stearate 0,25 mg, povidone 0.83 mg, talc 2.25 mg, microcrystalline cellulose 9.5 mg, litapole starch 28.2 mg, lactose monohydrate 27.0 mg,
khetla: propylene glycol 0,2 mg, titanium dioxide 0,8 mg, hypromellose 1,2 mg, talc 0,8 mg.
Letlapa le le leng le koahetsoeng ka filimi e 25 mg le na le:
ntho e sebetsang: amitriptyline hydrochloride 28.3 mg ho latela amitriptyline 25 mg,
Baeti: magnesium stearate 0.5 mg, povidone 0,6 mg, talc 4.5 mg, microcrystalline cellulose 18.0 mg, litapole starch 38.0 mg, lactose monohydrate 40.2 mg,
khetla: propylene glycol 0,3 mg, titanium dioxide 0,9 mg, hypromellose 1.4 mg, talc 0,9 mg.

Tlhaloso

Matlapa, a bosoeu ba filimi, a chitja, a biconvex.

Litlhahlobo mabapi le Amitriptyline Nycomed

Setlhare se na le litlhahlobo tse ntle le tse mpe. E khothalletsoa hore e sebelisoe ke basebelisi ba ka bang 75%. Melemo ea mantlha ea antidepressant: katleho, mamello e ntle, theko e tlase. Setlhare sena se felisa ho tšoenyeha, se thusa ka bohloko bo sa feleng, ho hlobaela le ho tšoha, ho thoba, ho hlasimolla tšebetso ea methapo, ho imolla khatello ea maikutlo le khatello ea kelello.

Likotsi tsa Amitriptyline Nycomed, ho ea ka bakuli, li ka ba le litlamorao (ho eketsa takatso ea lijo le ho nona haholo, molomo o omileng, tsebe ea leleme, ho fokotseha ha khatello ea mali, ho otsela, jj.). Basebelisi ba bang ba tletleba ka ho haella ha sesebelisoa. Lithethefatsi li na le li-contraindication tse ngata, li fanoa feela ka taelo ea ngaka, ho lemalla ho ka khona, kahoo, ho tlosoa butle-butle ho hlokahala - tsena ke likotsi tse ka sehloohong tse boletsoeng litlhahlobisong.

Melemo ea pharmacological

Amitriptyline ke antidepressant e boima e tsoang sehlopheng sa li-inhibitors tse se nang khetho ea monoamine. E na le phello e matla ea thymoanaleptic le sedative.
Mofumahali
Mochine oa ts'ebetso ea antidepressant ea amitriptyline e amana le keketseho ea litaba tsa norepinephrine le serotonin ho synaptic cleft tsamaisong ea methapo e bohareng (CNS).
Ho bokellana ha li-neurotransmitters tsena ho etsahala ka lebaka la thibelo ea ho ts'oaroa ha bona ka tsela e fapaneng hape ka li-membrane tsa li-neurons tsa "presynaptic neurons".
Amitriptyline ke blocker ea Ml le M2 muscarinic cholinergic receptors, H1 histamine receptors le α1 adrenergic receptors. Ho ea ka seo ho thoeng ke monoamine hypothesis, ho na le kamano pakeng tsa molumo oa maikutlo le tšebetso ea li-neurotransmitters ho li-synapses tsa boko.
Khopolo-taba e hlakileng pakeng tsa khatello ea amitriptyline plasma ea mali le phello ea tleleniki ha e bontšoe, empa phello e nepahetseng ea kliniki, ho bonahala, e fihlelleha maemong a fapaneng a 100-260 μg / L.
Ho fokola ha tleliniki ea khatello ea maikutlo ho fihlelloa kamora nako ea ho lekanyetsoa ha mahlahana a plasma, kamora libeke tse 2-6 tsa kalafo.
Ntle le moo, amitriptyline e na le phello e kang quinidine ho bolokoeng ba pelo.
Mofumahali
Suction
Kamora ho tsamaisoa ka molomo, amitriptyline e kenella ka potlako mme e kenella ka botlalo ho tsoa pampiring ea mala. Palo e kholo ea plasma ea mali (Cmax) e fihlella ka nako ea lihora tse 2-6 kamora ts'ebetso.
Tsamaiso
Khatello ea amitriptyline maling a mali a bakuli ba fapaneng e fapana haholo.
Bioavailability ea amitriptyline e batla e le 50%. Amitriptyline ho isa tekanyo e kholo (95%) e tlama liprotheine tsa plasma. Nako ea ho fihla maemong a phahameng a khatello ea kelello (TCmax) kamora ho tsamaisoa ka molomo ke lihora tse 4, 'me khatello ea tekano e batla e le beke kamora ho qala kalafo. Bophahamo ba thomello ke hoo e ka bang 1085 l / kg. Ka bobeli amitriptyline le nortriptyline li tšela placenta 'me li pepesetsoa lebeseng la matsoele.
Metabolism
Amitriptyline e tšelisoa ka har'a sebete 'me e matlafalitsoe haholo (hoo e ka bang 50%) lekgetlo la pele ha e feta ka har'a sebete. Ka nako e ts'oanang, amitriptyline e feta N-demethylation ka cytochrome P450 ka sebopeho sa metabolite e sebetsang - nortriptyline. Ka bobeli amitriptyline le nortriptyline le tsona li hydroxylated ka har'a sebete. Nitroxy le 10-hydroxymetabolite amitriptyline le 10-hydroxynortriptyline le tsona li mafolofolo. Ka bobeli amitriptyline le nortriptyline li kopantsoe le glucuronic acid, 'me li-conjugates tsena ha li sebetse.
Selo sa mantlha se khethollang tumello ea renal, 'me, ka hona, khatello ea mali ka bongata, ke sekhahla sa hydroxylation. Karolong e nyane ea batho, hydroxylation e ikemiselitseng ka tlhaho ea tlhaho e bonoa. Bakeng sa bakuli ba nang le ts'ebetso ea sebete e sa sebetseng, halofo ea bophelo ba amitriptyline le nortriptyline ho plasma ea mali e eketseha.
Ho tsala
Half-life (T1 / 2) e tsoang ho plasma ea mali ke lihora tse 9-46 bakeng sa amitriptyline le lihora tse 18-95 bakeng sa nortriptyline.
Amitriptyline e pepesoa haholo ke liphio le ka mpeng ka sebopeho sa metabolites. Ke karolo e nyane feela ea tekanyetso e amoheloang ea amitriptyline e qhekelloang liphihlelong tse sa fetoloang. Ho bakuli ba nang le bothata ba ho sebetsa ha renal, mofufutso oa amitriptyline le nortriptyline o lieha, le ha metabolism joalo e sa fetohe. Ka lebaka la kamano ea eona le liprotheine tsa mali, amitriptyline ha e tlosoe ho plasma ea mali ka dialysis.

Matšoao a ho sebelisoa

• Autism
• hypochondria
• khatello ea maikutlo
• schizophrenic psychosis,
• bulimia mothosa
• bedwetting,
• syndromes ea bohloko bo sa foleng
• lefu la ulceric ulcer
• migraine prophylaxis.

Har'a lenane lohle la mathata a tebileng a ho tšoha, ho lokela ho hopoloa hore moriana o laetsoe ke litsebi esita le bakuli ba mofets'e hore ba fokotse bohloko. Mabakeng a tlolo ea boemo ba maikutlo le boits'oaro, ho tšoenyeha ho eketsehileng, ho ferekana ha boroko le ho sithabela maikutlo ho sa tsotelloeng, pheko e thusa 100%, ho bohlokoa ho hopola feela hore ha e qala ho nka khato hang-hang.

Litheko tsa li-amitriptyline nycom ka litlolong tsa meriana ho la Moscow

Lingaka li lekola mabapi le amitriptyline nycomed

Phihlelo ea ho sebelisa Amitriptyline e le moemeli ea eketsehileng kalafong ea bohloko ba vertebrogenic e lebisitse qetong mabapi le katleho ea moriana ona ho bakuli ba nang le bohloko bo sa feleng bo sa foleng. Phello e teng ea thetso e kentse letsoho ho tloaelehileng ho robala nakong ea mantsiboea ho ja moriana ona.

Amitriptyline. Ena ke ea pele. Mme, bobeli, e kanna ea etsoa ka lisebelisoa tse "hloekileng" haholo ho tsoa ho li-amitriptyline tsohle tse fumanehang sebakeng sa Kemerovo. E na le litekanyetso tsa 10 mg, e bonolo haholo ha e fuoa bakuli ba nang le ts'ebetso e matla ea boikemelo le (kapa) ka ho se tsotelle mabapi le "antidepressants".

Mathata a tloaelehileng a amitriptyline: cardiotoxicity, litekanyetso tse eketsehileng tsa prolactin maling, eketseha boima ba 'mele, ho thehoa ha cystitis ho ka etsahala.

Amitriptyline e ntle ka ho fetisisa 'marakeng oa sebaka sa Kemerovo.

Hangata ho baka ho otsela le litla-morao tsa cholinergic: ho imeloa hloohong, ho boloka metsi ka moroto, ho sokela.

E 'ngoe ea li-antidepressants tse matla ka ho fetisisa, tse nang le phello e phatlalatsang khahlanong le matšoenyeho. E sebetsa hantle maemong a bohloko a morao a sithabetsang, khatello ea maikutlo, khatello ea maikutlo le khatello ea maikutlo. E ka sebelisoa bakeng sa linaha tse nang le matšoenyeho a sithabetsang, le ho hloka boroko.

Maikutlo a mamello mabapi le Nycomed amitriptyline

Ha ke lakatse hore mang kapa mang a utloe seo ke se utloileng ka lebaka la moriana ona o mobe! Ngaka e ile ea re ke tla khutsa, empa ha ea ka ea hlokomelisa hore ke tla ba meroho. Sena sea tšosa! Ho sa tsotelehe mehopolo ea ho ipolaea e ntlhahetseng, Amitriptyline e ne e le eona e molato. Ho tšosa!

Setsebi sa kelello se ile sa mpha Amitriptyline ho fokotsa tlhaselo ea migraine. Moriana ona o fumaneha ho ngaka feela, 'me ke ne ke sa e rate, hobane ha lipilisi li fela, o hloka ho ea tleleniking, ho ema nako e khuts'oane, ebe o ea feela ho eena meriana. Empa ena ke halofo ea mathata feela, ho e nka ka likhoeli tse tšeletseng, joalo ka ha ngaka e laetse, ho ne ho sena ts'ebetso e le ngoe, ho se na litlhaselo tse ling hape, le tsona ha lia ka tsa qala ho lutla habonolo. E kanna ea sebetsa mafu a mang, empa ha ho joalo ho nna.

Ka selemo sa 2017, ke ile ka tobana le boemo bo makatsang haholo, bo ts'oanang le ho nyekeloa ke pelo, empa joalo ka ha ho ile ha etsahala hamorao - tlhaselo ea letsoalo. Ke ile ka isoa sepetlele, ka ts'ebetso ea methapo, moo ngaka e ile ea mpeela lipilisi tsena, tekanyetso ea pele e ne e le halofo ea pilisi bosiu ebe e ea nyoloha butle, hoo ke ileng ka e nka ho latela moralo 0.5 0.5 1 (hoseng, thapama le mantsiboea ), qalong ho ne ho na le ho otsela ho tebileng, ho robala hantle haholo ebile ho utloahala, ho robala ka bang! Liphetho li ile tsa bonahala ka ho hlaka libekeng tse peli, ha ke iphumana ke nahana hore mohopolo oa ka o motle hoo ho seng o kileng oa etsahala! Ke ne ke thabetse lintho tse kang ho hlasimoloha ha letsatsi, ho fifala ha makhasi le 'mino o neng o sa ka oa tsosa maikutlo a matla nakong ena. E, hape, ke bile le litoro tse hlakileng tse mebala-bala! Hamorao, tekanyetso e ile ea fokotsoa, ​​moriana o nthusa haholo, o ile oa nterohola.Empa o hloka ho mamela maemo a hau, hobane ke motho ka mong.

Bophelong ba ka ke ile ka kopana le lefu le kang khatello ea maikutlo. Ke fumane ngaka ea mafu a kelello, 'me a' ngolla Amitriptyline. Setlhare se hlile se lokile, se loantšana le ho tšoenyeha, se tlosa ho hloka boroko. Ke ne ke behiloe tekanyetso ea 20 mg bosiu le 10 mg mots'eare, mme kapele ke ile ka lula feela ho litekanyetso tsa bosiu. Moriana, leha o tsofetse, empa o sebetsana le mosebetsi oa ona. Batho ba bangata ba tšaba litlamorao, ke ne ke sena bona, ho otsela feela, empa ho ne ho le letsohong la ka, hobane Ka nako e telele o ile a tšoaroa ke ho hlobaela.

"Amitriptyline" e laetsoe ke setsebi sa bongaka, e tšoenyehile ka matšoenyeho. Setlhare se hantle, haeba se laetsoe hantle e ea thusa. Ho bohlokoa ho noa pilisi ea ho qetela ho fihlela lihora tse 20,00, ho seng joalo ho baka thabo ea tsamaiso ea methapo, ho hloka boroko. Haeba ho otsela ho hlaha, tachycardia - litekanyetso li lokela ho fokotsoa. 1/4 ea 10 mg makhetlo a 2 ka letsatsi le 1/2 ea 10 mg bosiu e fane ka phello e ntle e sa feleng. Ho ne ho se na litla-morao ntle le tachycardia.

Thutela-litso

Antidepressant ho tsoa sehlopheng sa metsoako ea li-tricyclic, e nkiloeng ka dibenzocycloheptadine.

Mochine oa ts'ebetso ea antidepressant o amahanngoa le ho eketseha ha khatello ea norepinephrine ho li-synapses le / kapa serotonin tsamaisong ea methapo ea kutlo ka lebaka la ho sitisa ho khutla ha methapo ea methapo ea methapo ena. Ka tšebeliso ea nako e telele, e fokotsa ts'ebetso ea tšebetso ea li-receptor tsa β-adrenergic le li-serotonin receptors bokong, e tloaetse phetisetso ea adrenergic le serotonergic, 'me e khutlisetsa botsitso ba litsamaiso tsena, tse ferekaneng linaheng tse tepelletsang. Libakeng tse nang le khatello ea maikutlo, e fokotsa matšoenyeho, ho ferekana le matšoao a sithabetsang.

E boetse e na le phello ea li-analgesic, tseo ho lumeloang hore li bakoa ke liphetoho menahanong ea li-monoamine tsamaisong ea methapo ea methapo, haholo serotonin, le phello ea litsamaiso tsa opioid tsa endo native.

E na le phello e phatlalalitsoeng le bohareng ba anticholinergic, ka lebaka la tumellano e phahameng ea li-receptor tsa m-cholinergic, phello e matla ea ho susumetsa e amanang le tumellano ea histamine H₁-receptors, le ts'ebetso ea thibelo ea alpha-adrenergic.

E na le phello ea antiulcer, mochine oa eona o bakoang ke bokhoni ba ho thibela histamine H₂-receptors liseleng tsa parietal tsa mpa, hape e na le phello ea mokokotlo le m-anticholinergic (maemong a peptic ulcer ea mala le duodenum, e fokotsa bohloko, 'me e potlakisa pholiso ea liso tsa ka mpeng).

Ho sebetsa hantle ho tsa boroko ho bonahala ho bakoa ke ketso ea anticholinergic, e lebisang keketseho ea bokhoni ba borashe ba ho otlolla, ho susumetsa ka kotloloho ho β-adrenergic, ts'ebetso ea li-agonists tsa α-adrenergic, e tsamaellanang le keketseho ea molumo oa sphincter le ho thibela bohareng ba serotonin.

Mokhoa oa ts'ebetso ea bongaka ho bulimia mothosa ha o so thehiloe (mohlomong o ts'oanang le oa khatello ea maikutlo). Katleho e hlakileng ea amitriptyline ho bulimia e bontšoa ho bakuli ntle le khatello ea maikutlo le boteng ba eona, ha ho fokotseha ha bulimia ho ka bonoa ntle le bofokoli bo tšoanang ba khatello ea maikutlo ka boeona.

Ha o etsa opereishene ka kakaretso, e theola khatello ea mali le mocheso oa 'mele. Ha e thibele MAO.

Matla a antidepressant a hlaha nakong ea libeke tse 2-3 kamora ho qala ts'ebeliso.

Tšebelisano

Ka tšebeliso e le 'ngoe le lithethefatsi tse nang le phello e sithabetsang tsamaisong ea methapo ea kutlo, keketseho e kholo ea phello ea inhibitory tsamaisong ea methapo ea kutlo, antihypertensive effect, le khatello ea maikutlo ea ho hema hoa khoneha.

Ka tšebeliso e le 'ngoe le lithethefatsi tse nang le ts'ebetso ea anticholinergic, keketseho ea litlamorao tsa anticholinergic e ka etsahala.

Ka tšebeliso e le 'ngoe, hoa khoneha ho eketsa phello ea mahlahana a nang le kutloelo-bohloko tsamaisong ea pelo le pelo le ho eketsa menyetla ea ho ba le pelo e matla ea methapo ea pelo, tachycardia, le khatello e matla ea methapo ea kutlo.

Ka tšebeliso e le 'ngoe le lithethefatsi tsa antipsychotic (antipsychotic), metabolism e thibelloa ka bobeli, ha monyako oa ho ikemisetsa ho ts'oaroa o fokotseha.

Ka tšebeliso e ts'oanang le li-antihypertensive agents (ntle le clonidine, guanethidine le li-derivatives tsa bona), hoa khoneha ho eketsa phello ea antihypertensive le kotsi ea ho holisa hypotension ea orthostatic.

Ka tšebeliso e ts'oanang le li-inhibitors tsa MAO, nts'etsopele ea bothata ba khatello ea mali e ka etsahala, ka clonidine, guanethidine - ho fokotseha hoa phello ea hypotensive ea clonidine kapa guanethidine ho ka etsahala, ka barbiturates, carbamazepine - ho fokotseha ha phello ea amitriptyline ka lebaka la keketseho ea metabolism ea eona e ka khonahala.

Ho hlalosoa nyeoe ea nts'etsopele ea serotonin syndrome e sebelisoang ka nako e le 'ngoe le sertraline.

Ka tšebeliso e tšoanang le sucralfate, ho kenella ha amitriptyline hoa fokotseha, ka fluvoxamine, khatello ea amitriptyline maling a mali le menyetla ea litla-morao e eketseha, ka fluoxetine, mokokotlo oa amitriptyline plasma ea mali le litla-morao tse nang le chefo e matla ea posidine ea posidine ea posidine ea posidine ea posidine ea posidine ea posidineine ofostidineine. amitriptyline metabolism, e nang le cimetidine - hoa khoneha ho fokotsa metabolism ea amitriptyline, ho eketsa khatello ea eona ho plasma ea mali le ho nts'etsapele t ksicheskih litla.

Ka tšebeliso e tšoanang le ethanol, phello ea ethanol e matlafatsoa, ​​haholoholo matsatsing a 'maloa a pele a kalafo.

Bokhachane le pelehi

Amitriptyline ha ea lokela ho sebelisoa nakong ea bokhachane, haholo-holo ho li-trimesters tsa I le III, ntle le maemong a tšohanyetso. Lithuto tsa bongaka tse lekaneng le tse laoloang ka tieo tsa polokeho ea amitriptyline nakong ea kemolo ha li e-so tšoaroe.

Kamohelo ea amitriptyline e lokela ho hlakoloa butle-butle bonyane libeke tse 7 pele tsoalo e lebelletsoeng e le ho qoba nts'etsopele ea lefu la ho tlohela ho lesea.

Lithutong tsa liteko, amitriptyline e bile le phello ea teratogenic.

E kopantsoe nakong ea lebollo. E pepesoa lebeseng 'me e ka baka ho otsela ho masea.

Li-analog le litšenyehelo

"Amitriptyline Nycomed" (25 mg) matlapeng a litlhare tsa bophelo bo botle a jella li-ruble tse 50-70 ka pakete e ngoe. Hape, meriana e fumaneha ka tsela ea tharollo ea ente le infusion.

Amitriptyline (25 mg) e hlahisoa ka sebopeho sa letlapa ke lik'hamphani tse ngata tse tlas'a lebitso le le leng.

Kahoo, li-analogues tsa lithethefatsi tse tsoang k'hamphaning ea meriana "Nycomed" ke meriana e tsoang ho baetsi:

Hape, ho na le mofuta o theko e tlaase oa tlhahiso ea lapeng le matlapa a bitsoang "VERO-AMITRIPTILINE", a hlahisoang ke lik'hamphani tse ngata tsa kantle ho pharmacological.

Melao ea ho sebelisa

Ntle le mamello ea motho ka mong ho karolo efe kapa efe ea lithethefatsi, e thibetsoe ho e sebelisa:

• nakong ea boitšisinyeho le lactation,
• bana ba ka tlase ho lilemo tse tšeletseng
• nakong ea ho hlaphoheloa kamora ho hlaseloa ke lefu la pelo,
• ka glaucoma ea koaloang,
• ka lefu le matla la pelo,

Hape ho thibetsoe ka thata ho nka "Amitriptyline", joala, psychotropic, analgesic le lipilisi tsa ho robala hammoho.

Litlamorao

Kaha "Amitriptyline Nycomed" (25 mg), litaelo tsa tšebeliso li hlalositsoe e le "antidepressant" e matla haholo, lenane la litlamorao tsa eona tse sa rateheng le pharaletse haholo. Leha ho le joalo, ho ea ka litlhahlobo, ho bakuli ba bangata ha ba hlahe ho hang kapa ho ba le tsebiso e hlahang matsatsing a pele kamora ho qala kalafo.

Kahoo, moriana o ka baka likhathatso ho:

• tsamaiso ea methapo
• digisa
• pelo
• endocrine
• hematopoietic.

Hape, "Amitriptyline", thupelo e na le lethathamo le felletseng la litlamorao, e ka baka karohano e fapaneng ea mmele ho letlalo ka mokhoa oa ho sohloka, ho ruruha kapa ho hlohlona. Ntle le moo, ho bakuli ba bang, ho lahleheloa ke moriri, ho ruruha ha li-lymph node le tinnitus ho ile ha bonoa nakong ea lithuto.

Har'a litla-morao tse atileng haholo, bakuli ba khetholla lipontšo tsa ketsahalo ea anticholinergic. Tsena li kenyelletsa feela ho ba le letsoalo, molomo o omileng, tachycardia, pherekano, maemong a ikhethileng a hallucinations li ka etsahala.

Mathata a amanang le tsamaiso ea lijo tse amanang le tšilo ea lijo a kang ho nyekeloa ke pelo, liphetoho mokhoeng oa tatso, ho sitisoa ha takatso ea lijo, ho chesa ha pelo, stomatitis, lets'ollo ha li sa tloaeleha. Ke ka seoelo, bothata ba sebete le lefu la hepatitis le bonahatsoang ka tsela ena.

Karolong ea tšoelesa ea qoqotho, ho eketsoa ka sefuba ho basali le tlhekefetso ea bokhoni ba banna ho ka bonoa. Matla a tloaelehileng ho bong bofe kapa bofe ke ho fokotseha ha libido. Mosebetsing oa pelo, arrhythmias, tachycardia, kizungu, matšoao a se nang moeli nakong ea electrocardiogram joalo-joalo e ka bonahatsoa.

Ho lebisoa tlhokomelo e khethehileng lenaneng la lipontšo tse mpe tse ka hlahisoang ke tsamaiso ea methapo. Leha taba ea hore sethethefatsi se ikemiselitse ka kotloloho ho botsitso ba sona, boholo ba menyetla ea litlamorao e boetse e tsamaisana le eona.

Kahoo, bakuli ba ka ba le:

• ho tšoenyeha
• ho otsela
• ho tepella maikutlo ho eketsehileng
• ho akheha
• manic e re
• pherekano
• psychosis
• hlooho e bohloko
• ho hloka boroko
• litoro tsa bosiu torong
• ho tsubella ho eketsehileng ha lefu la sethoathoa.

Litlhahiso tse ling

Bakuli ba fumanang kalafo ea Amitriptyline ba lokela ho nahana hore ntho e sebetsang e ka baka pherekano nakong ea phetoho e bohale ea boemo bo otlolohileng, kahoo o lokela ho tsoha hantle ka linako tsohle. Hape, ka nako e telele ea kalafo le ho khaotsa kalafo, boholo ba bona bo ba le matšoao a bang teng ha motho a khaotsa ho tsuba.

Kaha lithethefatsi ha li lumellane le lithethefatsi tse thibelang MAO, ha lia lokela ho qala kalafo pele ho libeke tse 2 kamora ho khaotsa lithethefatsi tse kaholimo.

Lingaka li lokela ho lula li lemosoa ka ho sebelisa meriana ena hantle, hobane e khona ho ama litlamorao tsa meriana e meng. Hoa hlokahala hape ho qhelela ka thoko tsamaiso e le 'ngoe le ephedrine, phenylephrine le lintho tse tšoanang.

Ho bakuli ba tsofetseng, haholo ba shebang ho phomola betheng mme ba sisinyeha hanyane, lithethefatsi li ka baka tsitsipano ea ka mpeng. Kameho efe kapa efe e rarahaneng 'meleng ka mokhoa oa electrotherapy e lumelloa feela tlasa tlhokomelo e thata ea lingaka.

Tšebeliso ea nako e telele ea lithethefatsi e ka tsosa ponahalo ea li-caries le tlhoko ea ts'ebeliso e eketsehileng ea riboflavin.

Haeba moriana o fuoe mokuli tekong ea letsatsi le letsatsi ea lipilisi tse fetang 150 mg, ho ka etsahala hore mokokotlo oa ntho ena o be le keketseho e eketsehileng ea ho ts'oaroa ha sethoathoa le ponahatso e hlakileng ea letšoao le hlasimollang matšoao a mang. Ka tšebeliso ea nako e telele, ho boetse hoa hlokahala ho ela hloko hore bakuli ba ka ba le tšekamelo ea ho ipolaea, haholoholo ka ho khaotsa lithethefatsi ka matla.

Kopo tlasa maemo a itseng

Bongoaneng, moriana o sebelisoa feela ho tloha lilemong tsa lilemo tse 6 ka mokhoa oa litafole. Maro a ente a ka tlangoa le lithibelo tse kholo le ho feta. Li ka sebelisoa bakeng sa bana feela ho tloha lilemong tse 12.

Nakong ea kemolo, moriana o hanetsoe ho nka, hobane, ho ea ka lipatlisiso, o khona ho ba le phello e mpe ho nts'etsopele ea lesea. Tšebeliso ea moriana e lumelloa maemong a sa tloaelehang haholo mme ke feela ho trimester ea bobeli, haeba molemo o koahela ka botlalo kotsi e ka bang teng. Ho hlokahala hape ho emisa kalafo ka nako e le hore ngoana a se ke a ba le lefu la ho ikhula kamora ho hlaha. Moriana o lokela ho emisoa bonyane libeke tse 7 pele ho letsatsi le hlahang.

Nakong ea ho fepa, "Amitriptyline Nycomed" ha e sebelisoe ho hang, kaha e ka baka ho otsela le ho lemalla bana.

Ho bakuli ba tsofetseng, hangata lithethefatsi li baka tšitiso ea ka mpeng, e lokelang ho tlosoa ka mokhoa o hlakileng kapa ka ho tlosa e 'ngoe ka lithethefatsi. Hape botsofaling, ho ka ba le psychoses ea lithethefatsi, eo hangata e hlahang ka mor'a ho khaotsa lithethefatsi bosiu.

Litlhahlobo tsa "Amitriptyline Nycomed" (25 mg) tsa bakuli ba nang le boiphihlelo ba bokella tse tsoakiloeng. Boholo ba ba neng ba ntse ba phekoloa ka moriana ona ba ne ba sa khotsofala ka botlalo ka sephetho mme ba tsebiso e fokolang feela ea ho hlaba nako nakong ea kalafo. Theko e tlase, e fumanehang ho motho ofe kapa ofe, e khetholoha haholo har'a melemo ea moriana, haholoholo ha ho nahanoa hore tsela ea phekolo e nka likhoeli tse 'maloa. Ka kakaretso, esita le ho nahanela litšobotsi tse ling tse mpe, ehlile motho e mong le e mong o elelloa tšebetso ea eona. Setlhare sena se thusa bakuli ka nako e khuts'oane ho tlosa mafu a matla a kelello mme ba khutlisetse thabo ea bophelo.

Har'a li-minuse tsa matlapa, litlhahlobo li hlokomela litla-morao. Ke 'nete, tse ngata li bonts'a hore li feta ha nako e ntse e tsamaea, empa maemong a mang ha ho joalo. Haeba mokuli a sa khaotse ho senya litlatsetso tse mpe tse tsoang ho moriana, ho tla hlokahala hore o buisane le ngaka e le hore a ka e fumanela pheko e 'ngoe.

Ho joalo, hangata litlhahlobo tse mpe li fumanoa hangata ho batho ba ikemiselitseng ho inkela moriana, hobane li rekisoa ntle ho lengolo le tsoang ho ngaka. Ho tsoa ho tekanyetso e sa nepahalang e lekantsoeng hore ba na le mathata. Ho latela litlhahlobo tse tsoang ho lingaka, lipontšo leha e le life tse mpe li ka qojoa ka ho nahana ka nepo litšobotsi tsa 'mele le tlhahlobo ea mokuli.

Qeto

Leha e le hore lefatšeng la sejoale ho na le palo e kholo ea lithethefatsi tse fapaneng bakeng sa mathata a kelello, leha ho le joalo, o lula o hloka ho itšireletsa. Se ke oa ikimetsa ka mosebetsi o eketsehileng, haeba ho khonahala, leka ho tsamaea khafetsa, ho ea liketsahalong tsa setso, 'me u qete nako le baratuoa ba hau. Se ke oa lebala ka ho robala hantle. Mme ke ka hona feela u ke keng ua tšaba khatello ea maikutlo.

Sebelisa nakong ea bokhachane le nakong ea ho anyesa

Boimana
Boithuto ba liphoofolo bo bonts'itse litla-morao ka makhetlo a mangata ho feta tekanyetso e tloaelehileng ea motho.
Phihlelo ea kliniki le amitriptyline nakong ea kemolo e lekanyelitsoe.
Tšireletseho ea amitriptyline nakong ea kemolo ha e so theoe.
Amitriptyline ha e kgothaletswe nakong ya kemero, haholoholo nakong ea pele le ea boraro, ntle leha phaello e lebelletsoeng ho mme e feta kotsi e ka bang teng ho lesea.
Haeba lithethefatsi li sebelisoa ke basali ba bakhachane, ho hlokahala ho lemosa ka kotsi e kholo ea kamohelo e joalo ho lesea, haholo-holo ho trimester ea III ea kemaro. Ts'ebeliso ea litekanyetso tse phahameng tsa li-antidepressants tsa tricyclic ka nako ea boraro ea kemaro e ka lebisa ho tsitsipano ea methapo ho lesea.
Ho bile le maemo a ho otsela ho masea a sa tsoa hlaha ao bo-'m'a bona ba neng ba sebelisa nortriptyline (metabolite ea amitriptyline) nakong ea kemero, 'me ho ile ha hlokomeloa linyeoe tsa ho boloka moroto.
Ho anyesa
Ha u sebelisa amitriptyline, matsoele a lokela ho emisoa. Amitriptyline e fetela lebeseng la matsoele. Karolelano ea lebese la matsoele / plasma ke 0,4-1,5 ho lesea le anyesitsoeng. Litla-morao tse sa lebelloang li ka hlaha.

Tekanyetso le tsamaiso

Abela ka hare ntle le ho hlafuna (hang hang ka mor'a lijo).
Batho ba baholo
Tekanyetso ea pele ea letsatsi le letsatsi ke 25-50 mg, e arotsoe ka litekanyetso tse peli, kapa e le tekanyetso e le 'ngoe pele u robala. Haeba ho hlokahala, tekanyetso ea letsatsi le letsatsi e ka eketsoa hanyane ka hanyane ho 200 mg.
Hangata, kalafo e akaretsang e tloaetse ho ba likhoeli tse 6 kapa ho feta ho thibela ho khutla hape.
Ba tsofetseng
Batho ba baholo ba ameha haholo ka litlamorao tse sa rateheng tsa mitriptyline. Ka hona, bakeng sa bona, tekanyetso ea pele e khothalletsoang ke 25-30 mg / ka letsatsi, hangata 1 nako ka letsatsi (bosiu). Keketseho e 'ngoe ea lethal dose e lokela ho etsoa butle butle, ka letsatsi le leng le le leng, ho fihlela, haeba ho hlokahala, tekanyetso ea 50-100 mg / ka letsatsi, ho fihlela karabelo (phello) e fihlelle. Tlhahlobo e eketsehileng ea hlokahala pele ho fana ka tlhahlobo ea bobeli ea kalafo.
Ts'ebetso ea mokokotlo e sa sebetseng
Ha ho na le ts'ebetso ea renal e sa sebetseng hantle, moriana o ka sebelisoa tekanyong e tloaelehileng.
Ts'ebetso ea sebete e sa sebetseng
Bakeng sa bakuli ba nang le ho fokola ha hepatic, lethal dose la amitriptyline le lokela ho fokotsoa.
Nako ea kalafo
Hangata phello ea khatello ea maikutlo e hlaha kamora libeke tse 2 ho isa ho tse peli.
Phekolo ea antidepressant ke letšoao, ka hona e lokela ho ba telele, hangata bakeng sa likhoeli tse 6 kapa ho feta, ho thibela ho phetoa ha khatello ea maikutlo.
Hlakola
Moriana o lokela ho emisoa butle-butle e le ho qoba nts'etsopele ea "ho tlohela" lefu, joalo ka hlooho, mathata a ho robala, ho teneha le ho kula ka kakaretso. Matšoao ana ha se sesupo sa ho itšetleha ka lithethefatsi.

Litla-morao

Bakuli ba fetang 50% ba fumanang lithethefatsi Amitriptyline Nycomed ba ka ba le karabelo e le 'ngoe kapa tse' maloa tse latelang. Amitriptyline e ka baka litlamorao tse ts'oanang le tse bakoang ke li-antidepressants tse ling tsa tricyclic.
Tse ling tsa lintho tse re utloisisang bohloko tse thathamisitsoeng ka tlase tse kang ho opeloa ke hlooho, ho thothomela, ho fokotseha ha nako, ho sokela, le ho fokotseha ka sepheo sa ho etsa thobalano, e kanna ea ba matšoao a khatello ea maikutlo, mme hangata a nyamela ka khatello ea maikutlo e fokolang.
Liketsahalo tsa litla-morao li bontšoa e le: hangata khafetsa (> 1/10), hangata (> 1/100, 1/1000, 1/10 000, ho tsoa ho tsamaiso ea pelo:
Khafetsa: palpitations le tachycardia, orthostatic hypotension.
Khafetsa: arrhythmia (ho kenyelletsoa le phokotso ea conduction, ho lelefatsa nako ea QT), hypotension, AV block, conduction block maotong a mojaro oa hae.
Nako le nako: keketseho ea khatello ea mali.
Tse sa tloaelehang: myocardial infarction.
Ho tsoa tsamaisong ea methapo:
Khafetsa: sedative athari (lethargy, tloaelo ea ho robala), ho thothomela, ho tsekela, hlooho.
Khafetsa: fokotsa khatello ea kelello, ts'oenyeho ea tatso, paresthesia, matšoao a extrapyramidal: ataxia, akathisia, parkinsonism, dystonic reaction, dyskinesia ea nako e telele, ho khutla ha puo.
Nako le nako: cramps.
Ho tsoa ts'ebetsong ea moroto:
Khafetsa: ho bolokoa ka moroto.
Ka lehlakoreng la letlalo:
Khafetsa: hyperhidrosis.
Nako le nako: lekhopho, vasculitis ea letlalo, urticaria.
Tse sa tloaelehang: photosensitivity, alopecia.
Ho tsoa linthong tsa kutlo:
Khafetsa: fokotseho ea pono e fokotsehileng, bolulo bo senyehileng (likhalase tsa ho bala li ka hlokahala nakong ea kalafo).
Khafetsa: mydriasis.
Nako le nako: tinnitus, khatello e eketsehileng ea intraocular.
Tse sa tloaelehang: tahlehelo ea bokhoni ba bolulo, ho eketsoa ha glaucoma e sephara.
Boloetse ba kelello:
Khafetsa: pherekano (pherekano ho bakuli ba tsofetseng e tšoauoa ka ho tšoenyeha, ho khathatsoa ke boroko, ho hopola ka thata, ho ferekana kelellong, maikutlo a ferekaneng, delirium), pherekano.
Khafetsa: fokotsa nako ea tlhokomelo.
Nako le nako: ho senyeha hoa kelello, lefu la manic, hypomania, mania, letsoalo, ho tšoenyeha, ho hloka boroko, ho lora bosiu.
Tse sa tloaelehang: ho ba mabifi, delirium (ho batho ba baholo), hallucinations (ho bakuli ba lefu la kelello).
Ka seoelo: menahano ea ho ipolaea, boitšoaro ba ho ipolaea.
Ho tsoa lithong tsa hemopoietic:
Tse sa tloaelehang: ho thibela tšebetso ea moko oa masapo, agranulocytosis, leukopenia, eosinophilia, thrombocytopenia.
Ho tsoa ts'ebetsong ea tšilo ea lijo
Khafetsa: molomo o omileng, ho sokela, ho nyekeloa.
Khafetsa: Ho theoha ha marenene, ho ruruha ha molomo oa molomo, ho bola ha leino, ho tuka ha maikutlo ka hanong.
Nako le nako: lets'ollo, ho hlatsa, ho ruruha ha leleme.
Tse sa tloaelehang: ho ruruha ha mala, ho ruruha ha tšoelesa ea parotid, jaundice ea cholestatic, ho se sebetse hantle ha sebete, hepatitis.
Mathata a tloaelehileng:
Khafetsa: bofokoli.
Nako le nako: ho ruruha ha sefahleho.
Tse sa tloaelehang: feberu.
Ka lehlakoreng la metabolism:
Khafetsa: ho nona ho eketsa takatso ea lijo.
Tse sa tloaelehang: takatso e fokotsehileng.
Ka seoelo: lefu la ho se sebetse hantle ha secretion ea lihormone tsa antidiuretic.
Ho tsoa molemong oa ho hlahisa bana:
Khafetsa: ho fokolisa kapa ho eketsa takatso ea thobalano.
Khafetsa: ho banna - ho hloka matla, ho holofala hoa letsoalo.
Tse sa tloaelehang: ho banna - ejaculation e lietsitsoeng, gynecomastia, ho basali - galactorrhea, li-orgasm tse liehang, ho lahleheloa ke bokhoni ba ho etsa orgasm.
Matšoao a laboratori:
Khafetsa: Liphetoho tsa ECG, ho lelefatsa nako ea QT, katoloso ea mochini oa QRS.
Tse sa tloaelehang: ho kheloha tloaelo ea liteko tsa sebete, mosebetsi o eketsehileng oa alkaline phosphatase, transaminases.
Liphello tsa ho hlakola
Ho khaotsa ka tšohanyetso kalafo ka mor'a hore e sebelisoe nako e telele ho ka baka ho nyekeloa, ho opeloa ke hlooho le ho holofala.
Ho khaotsa butle-butle ha moriana ho ne ho amahanngoa le matšoao a nakoana joalo ka ho teneha, ho ruruha le ho tsitsinyeha ha boroko le libeke tse peli tse qalang tsa phokotso ea litekanyetso.
Ka makhetlo a mangata, linyeoe tsa "manic state" kapa "hypomania" li etsahala matsatsing a 2-7 kamora ho felisoa ha kalafo ea nako e telele ka li-antidepressants tsa triceclic.