Litaelo tsa Tegretol cr bakeng sa tšebeliso, li-contraindication, litla-morao, litlhahlobo

Mefuta ea litekanyetso:

• sirapo: e tšoeu, e viscous, e na le monko oa caramel (ka har'a libotlolo tsa khalase e lefifi ea 100 ml, botlolo e le 1 ka sekotong sa karete e felletseng ka khaba ea litekanyetso),
• matlapa: sephara, bosoeu, 'me a na le likarolo, 200 mg ka' ngoe - ho pota, a tšoaea lehlakoreng le leng - CG, ka lehlakoreng le leng - G / K, kotsing ka lehlakoreng le le leng, 400 mg - e entsoe ka lere, e tšoaea ka lehlakoreng le leng - LR / LR , ka lehlakoreng le leng - CG / CG, mahlakoreng ka bobeli a kotsi (li-pcs tse 10. ka marang-rang, lilakane tse 3 kapa tse 5 ka lebokoseng la karete ea karete).

Lebokose la karete e boetse e na le litaelo bakeng sa ts'ebeliso ea Tegretol.

Sirapo ea 5 ml sirapo:

• ntho e sebetsang: carbamazepine - 100 mg,
• likarolo tse thusang: macrogol stearate - 100 mg, caramel flavor - 50 mg, hydroxyethyl cellulose (hyetellose) - 500 mg, sodium saccharase - 40 mg, liquid sorbitol - 25 000 mg, propylene glycol - 2,5 mg, Avicel RC 581 (microcrystalline cellulose + sodium carmellose) - 1000 mg, methyl paraben (methyl parahydroxybenzoate) - 120 mg, sorbic acid - 100 mg, propyl paraben (propyl parahydroxybenzoate) - 30 mg, metsi a hloekisitsoeng ka bongata bo lekaneng.

Letlapa la 1

• ntho e sebetsang: carbamazepine - 200 kapa 400 mg,
• likarolo tse thusang (200/400 mg): magnesium stearate - 3/6 mg, sodium carmellose - 10/20 mg, cellcrystalline cellulose - 65/130 mg, colloidal silicon dioxide - 2/4 mg.

Fokotsa foromo Tegretol tsr, ho kenya lithethefatsi le sebopeho.

Matlapa a bolokiloeng a kentsoeng ka 'mala oa lamunu oa litene, a oval, biconvex hanyane, le notch lehlakoreng ka leng, a tšoailoeng "HC" ka lehlakoreng le leng le "CG" ka lehlakoreng le leng.

1 tab
carbamazepine
200 mg

Baeti: microcrystalline cellulose, sodium carmellose, polyacrylate dispersion 30% (Eudragit E 30 D), ethyl cellulose pompo ea metsi, talc, colloidal silicon dioxide anhydrous, magnesium stearate.

Sebopeho sa khetla: hypromellose, talc, titanium dioxide, oli ea castor (macrogol glycerylincinoleate), iron oxide e khubelu, iron oxide e mosehla.

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

Ho na le matlapa a lokolotsoeng a 'mala o bosootho bo loileng, o' mala o sootho oa lamunu, oval, biconvex hanyane, o nang le notch lehlakoreng ka leng, o ngotsoeng "ENE / ENE" ka lehlakoreng le leng.

1 tab
carbamazepine
400 mg

Baeti: microcrystalline cellulose, sodium carmellose, polyacrylate dispersion 30% (Eudragit E 30 D), ethyl cellulose pompo ea metsi, talc, colloidal silicon dioxide anhydrous, magnesium stearate.

Sebopeho sa khetla: hypromellose, talc, titanium dioxide, oli ea castor (macrogol glycerylincinoleate), iron oxide e khubelu, iron oxide e mosehla.

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

TLHOKOMELISO EA TLHALOSO EA SEBETSO.
Tlhahisoleseling eohle e fanoeng e hlahisoa feela bakeng sa ho tloaelana le moriana, o lokela ho buisana le ngaka ka monyetla oa ho e sebelisa.

Tshebetso ea khemisi ea tegretol cr

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.

Pharmacokinetics ea lithethefatsi.

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.

T1 / 2 ke dihora tse 12-29. 70% e pepesitsoe ka hara moroto (ka sebopeho sa metabolites e sa sebetseng) le 30% - e nang le makhopho.

Matšoao a sebeliso:

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.

Tekanyetso le tsela ea tsamaiso ea moriana.

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 / ka letsatsi li sebelisoa ka tekanyetso e arohaneng ea 2-3, haeba ho hlokahala ebile ho na le mamello, tekanyetso e eketsoa ka nako e sa feteng 100 mg / letsatsi ka karohano 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.

Litla-morao tsa tegretol tsr:

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, lets'ollo kapa ho sokela, maemong a mang - ho fokotseha takatso ea lijo, bohloko ba ka mpeng, glossitis, stomatitis.

Ho tsoa ho ts'ebetso ea pelo: ka seoelo - ho ba le pherekano ea myocardial conduction, 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, ho ruruha, 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.

Sebelisa nakong ea 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 ikhethang bakeng sa Tegretol tsr.

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.

Ho sebelisana le tegretol tsr le lithethefatsi tse ling.

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 Sistimi ea CYP3A4 isoenzyme, ho potlakisa metabolism ea carbamazepine, ho fokotseha ha eona ka bongata plasma ea mali, le ho fokotseha hoa phello ea kalafo ho khonahala.

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 li etsahala hangata - pono e sa bonahaleng, 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, mohlomong ka cimetidine, acetazolamide, danazole, desipramine, nicotinamide (ho batho ba baholo, feela ka tekanyetso e phahameng), erythromycin, trolesamole (ho kenyeletsoa le itraconazole, ketoconazole, fluconazole), terfenadine, loratadine, keketseho ea khatello ea carbamazepine plasma ea mali e ka etsahala ka kotsi ea litlamorao (ho tsekela, ho otsela, ataxi nna, 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 khatello ea plasma ea metabolacology e sebetsang ea caracamazepine-10,11-epoxide.

Ka tšebeliso ea nako e le 'ngoe le ritonavir, litla-morao 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 ho ka etsahala.

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.

Mofumahali

Tegretol ke e 'ngoe ea lithethefatsi tsa antiepileptic, ke deribative ea dibenzodiazepine. Ntle le phello ea antiepileptic, sethethefatsi sena se boetse se na le thepa ea psychotropic le neurotropic.

Joaloka moemeli oa antiepileptic, ts'ebeliso ea carbamazepine e sebetsa hantle kalafong ea ho ts'oaroa ka mokhoa o bobebe / o rarahaneng oa ho ruruha ho etsahalang ka / ntle le kakaretso ea kakaretso, ho ts'oaroa ka mokhoa o akaretsang oa tonic-clonic epileptic, hammoho le kopanyo ea mefuta ena ea ho ts'oaroa.

Nakong ea liteko tsa tleliniki, ho ile ha fumaneha hore ka tegretol monotherapy ho bakuli ba nang le lefu la sethoathoa (haholo-holo ha e sebelisoa liketsong tsa bana), ho ameha phello ea kelello ea carbamazepine, eo, haholoholo, e iponahatsang e le phello e ntle matšoao a khatello ea maikutlo le ho tšoenyeha, hammoho le ho fokotseha ha mabifi le ho teneha. . Ho latela liphuputso tse 'maloa, phello ea Tegretol ho matšoao a psychomotor le ts'ebetso ea kelello e lemohuoa ke tekanyetso mme o belaela kapa o fosahetse. Lithuto tse ling li tlalehile phello e ntle ea carbamazepine ho tlhokomelo, ho hopola le bokhoni ba ho ithuta.

Tegretol e le moemeli oa neurotropic e sebetsa maemong a mangata a methapo ea kutlo.Haholo-holo, e thusa ho thibela litlhaselo tsa bohloko ho idiopathic / secondary trigeminal neuralgia. Ntle le moo, ts'ebeliso ea carbamazepine e na le mabaka a ho fokotsa bohloko ba neurogenic maemong a fapaneng, ho kenyelletsa le ho omella ha lesapo la mokokotlo, paresthesia ea post-traumatic le neuralgia ea postherpetic. Ho bakuli ba nang le lefu la ho tlohela joala, carbamazepine e kenya letsoho ho eketseha ha monyetla oa ho bala ka mokhoa o tsitsitseng (maemong ana hangata e fokotseha) le ho fokotseha ha botebo ba lipontšo tsa bongaka ba lefu lena (ka mokhoa oa thabo, ho thothomela, mathata a gait). Ka lebaka la phekolo ea Tegretol, bakuli ba nang le lefu la tsoekere la insipidus ba tsoang bohareng ba na le ho fokotseha ha tlhahiso ea moroto le lenyora.

Joaloka moemeli oa psychotropic, ts'ebeliso ea Tegretol e sebetsa hantle ho bakuli ba nang le mathata a amanang le kalafo, e leng kalafong ea maemo a hlobaetsang a manic, bakeng sa kalafo ea kalafo ea mathata a amanang le ho ferekana (manic-depression) (joalo ka monotherapy kapa hammoho le litokisetso tsa lithium, antidepressants kapa antipsychotic), kalafong schizoaffective le manic psychoses (moo e sebelisoang ka nako e le 'ngoe le li-antipsychotic), acute polymorphic schizophrenia (liketsahalo tse potlakileng tsa baesekele).

Mochine oa ts'ebetso oa Tegretol o thehiloe ho blockade ea lisele tsa sodium tse gated-voltage, ka lebaka la moo ho tsitsitseng metsoako ea li-neuron tse oelengxcited ho etsahalang, thibelo ea tlhahiso ea methapo ea methapo ea methapo le ho fokotseha ha mokokotlo oa synaptic of pulses.

Phello ea anticonvulsant ea carbamazepine e bakoa haholo ke botsitso ba li-membrane tsa neuronal le ho fokotseha ha tokollo ea glutamate, ho fokotseha hoa ts'ebetso ea neurotransmitter amino acid glutamate, hobane glutamate ke mokena-lipakeng oa sehlooho;

Tegretol e eketsa tsitsipano ea methapo ea methapo ea methapo, ka tsela eo e fokotsa menyetla ea ho tsietsana. Ts'ebetso e eketsehang ea potasiamo, hammoho le phetisetso ea liteishene tsa khalsiamo, e hlahisoang ke bokhoni bo phahameng ba membrane, e ka kenya letsoho phello ea anticonvulsant ea lithethefatsi. Carbamazepine e felisa liphetoho tsa setho sa sethoathoa, ka lebaka leo, e eketsa boiketlo ba bakuli ebile e kenya letsoho ntlafatsong ea bona ea sechaba.

Tegretol e ka khethoa e le moemeli ea ka sehloohong oa phekolo kapa ea sebelisoa hammoho le lithethefatsi tse ling ka ketso ea anticonvulsant.

Contraindication

Hypersensitivity ho likarolo tsa lithethefatsi - carbamazepine kapa lithethefatsi tse tšoanang le lik'hemik'hale (mohlala, li-antidepressants) kapa ho motsoako leha e le ofe oa lithethefatsi, mokokotlo oa marapo hematopoiesis (anemia, leukopenia), porphyria ea pherekano (e kenyeletsang nalane), AV blockade, tsamaiso e ts'oanang ea li-inhibitors tsa MAO.

Ka tlhokomeliso. Ho hloleha ha pelo, ho hlapolla hyponatremia (ADH hypersecretion syndrome, hypopituitarism, hypothyroidism, adrenal insuffanele), joala bo tsoetseng pele (khatello ea maikutlo ea CNS e ea eketseha, metabolism ea carbamazepine e hatelletsoe, mme ho hloleha ha sebete ho amana le phokolo ea mali, mme , Prostatic hyperplasia, khatello e eketsehileng ea methapo.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

Ka hare, ho sa tsotelehe lijo ka sengoathoana se metsi.

Letlapa la retard (Letlapa lohle kapa halofo) le lokela ho metsoa kaofela, ntle le ho hlafuna, ka mokelikeli o fokolang, makhetlo a 2 ka letsatsi. Ho bakuli ba bang, ha u sebelisa matlapa a khutlang, ho ka hlokahala ho eketsa tekanyetso ea moriana.

Lefu la ho akheha Maemong moo sena se ka khonehang, carbamazepine e lokela ho khethoa 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 ikopanya le carbamazepine kalafong e ntseng e tsoela pele ea antiepileptic ho lokela ho etsoa butle butle, ha litekanyetso tsa lithethefatsi tse sebelisitsoeng li sa fetohe kapa, haeba ho hlokahala, li fetohe.

Bakeng sa batho ba baholo, tekanyetso ea pele ke 100-200 mg ea moriana makhetlo a 1-2 ka letsatsi. Ebe moriana o eketsoa hanyane ka hanyane ho fihlela phello e nepahetseng ea kalafo e fumaneha (hangata 400 mg makhetlo a 2-3 ka letsatsi, boholo ba 1,6-2 g / ka letsatsi).

Bana ba tsoang ho lilemo tse 4 - ka tekanyetso ea pele ea 20-60 mg / ka letsatsi, butle-butle ba eketseha ka 20-60 mg letsatsi le leng le le leng. Ho bana ba baholo ho feta lilemo tse 4 - ka tekanyetso ea pele ea 100 mg / ka letsatsi, lethal dose le eketseha butle butle, beke e 'ngoe le e ngoe ka 100 mg. Motsoako o tšehetsang: 10-20 mg / kg ka letsatsi (ka tekanyetso e 'maloa): lilemo tse 4-5 - 200-400 mg (ka litekanyetso tse 1-2), lilemo tse 6-10 - 400-600 mg (ka litekanyetso tse peli) ), bakeng sa lilemo tse 11-15 - 600-1000 mg (ka litekanyetso tse 2-3).

Ka neuralgia ea trigeminal, 200-400 mg / ka letsatsi e beoa ka letsatsi la pele, butle-butle e eketseha ka se fetang 200 mg / ka letsatsi ho fihlela bohloko bo khaotsa (ka karolelano 400-800 mg / ka letsatsi), ebe o fokotsoa ho tekanyo e tlase e sebetsang. Maemong a bohloko ba tšimoloho ea neurogenic, lethal dose la pele ke 100 mg makhetlo a 2 ka letsatsi ka letsatsi la pele, ebe lethalamo le eketseha ka se fetang 200 mg / ka letsatsi, haeba ho hlokahala, le le eketsa ka 100 mg ka mor'a lihora tse 12 ho fihlela bohloko bo kokobela. Tekanyetso ea tlhokomelo ke 200-1200 mg / ka letsatsi ho litekanyetso tse 'maloa.

Molemong oa kalafo ea bakuli ba tsofetseng le bakuli ba nang le hypersensitivity, lethal dose la pele ke 100 mg makhetlo a 2 ka letsatsi.

Syndrome ea ho tlohela joala: tekanyetso e tloaelehileng - makhetlo a 200 mg makhetlo a 3 ka letsatsi, maemong a boima, matsatsing a 'maloa a pele, lethal dose le ka eketsoa ho 400 mg makhetlo a 3 ka letsatsi. Qalong ea kalafo bakeng sa matšoao a matla a tlisoang ke ho ikhula, ho khothalletsoa ho fana ka litlhare hammoho le lithethefatsi tse tlisoang ke ho ruruha tse ling (clopoloazole, chlordiazepoxide).

Lefu la tsoekere: tekanyetso e tloaelehileng ea batho ba baholo ke 200 mg makhetlo a 2-3 ka letsatsi. Ho bana, lethal dose le lokela ho fokotsoa ho latela lilemo le boima ba 'mele ba ngoana.

Lefu la tsoekere le lefu la tsoekere, le tsamaeang le bohloko: tekanyetso e tloaelehileng ke 200 mg makhetlo a 2-4 ka letsatsi.

Thibelo ea ho khutla hape ka litekanyetso tse hlonepheng le tse sebetsanang le kelello - 600 mg / letsatsi ka tekanyetso ea 3-4.

Maemong a hlobaetsang a manic le mathata a amanang le "botolar", litekanyetso tsa letsatsi le letsatsi ke 400-1600 mg. Karolelano ea litekanyetso tsa letsatsi le letsatsi ke 400-600 mg (ho litekanyetso tse 2-3). Boemong bo matla ba manonyeletso, tekanyetso ea moriana e eketsoa ka potlako, ka kalafo ea ho lokisa mathata a amanang le mathata - butle-butle (ho ntlafatsa mamello).

Litlamorao

Ha ho lekola sekhahla sa ho hlaha hoa mefuta e fapaneng e fapaneng ea karabelo, ho sebelisitsoe gradation tse latelang: khafetsa - 10% le ho feta hangata, hangata%, ka linako tse ling ke 0,1-0%, ka seoelo 0,01-0.1%, ka seoelo haholo ke 0,01%.

Hangata karabelo e mpe e tsamaeang le tekanyetso ea meriana e nyamela kamora matsatsi a 'maloa, ka boikemisetso le kamora phokotso ea nakoana ea tekanyetso ea lithethefatsi. Nts'etsopele ea karabelo e mpe e tsoang ho tsamaiso ea methapo e kholo e ka ba ka lebaka la ts'ebeliso e feteletseng ea lithethefatsi kapa ho fetoha hoa maemo ho matla ha ho tebisoa ha ntho e sebetsang plasma. Maemong a joalo, ho khothalletsoa ho beha leihlo leihlo la lithethefatsi ho plasma.

Ho tloha lehlakoreng la ts'ebetso ea methapo e bohareng: khafetsa - ho tsekela, ho otsela, ho otsela, hangata - ho opeloa ke hlooho, linako tsa bolulo, ka linako tse ling - ho sisinyeha ho sa tsitsang ha motho (mohlala, ho thothomela, "ho fofa" ho thothomela - asterixis, dystonia, li-tics), nystagmus, hangata , likhathatso tsa oculomotor, mathata a puo (jk. dysarthria), mathata a choreoathetoid, peripheral neuritis, paresthesias, myasthenia gravis le matšoao a paresis. Karolo ea carbamazepine e le lithethefatsi tse bakang kapa tse tlatsetsang ho nts'etsopeleng ea malwetse a kotsi a antipsychotic syndrome, haholo ha e laetsoe hammoho le li-antipsychotic, e lula e sa tsejoe.

Ho tsoa karolong ea kelello: ka seoelo - hallucinations (tse bonoang kapa tse hlalosoang), khatello ea maikutlo, ho fokotseha takatso ea lijo, ho tšoenyeha, boits'oaro bo mabifi, ho ferekana, ho ferekanya kelello, hangata - ts'ebetso ea psychosis.

Liphetoho tse ka bakoang ke likarolo tsa sethethefatsi: khafetsa urticaria, ka linako tse ling erythroderma, lefu le sa tloaelehang la lupus, ho hlohlona letlalong, ka seoelo exudative erythema multiforme (ho kenyeletsoa le Stevens-Johnson syndrome), chefo e thibelang mafu ea methapo ea methapo (Lyell syndrome), photosensitivity.

Ka makhetlo a mangata, mefuta e mengata ea lietsahala ea mofuta oa lietsisa mofuta oa hypersensitivity e nang le feberu, lekhopho la letlalo, vasculitis (ho kenyelletsa erythema nodosum e le sesupo sa vasculitis ea letlalo), lymphadenopathy, matšoao a tšoanang le lymphoma, arthralgia, leukopenia, eosinophilia, ts'ebetso ea sebete le ts'oaetso ea sebete. e fumanoang ka metsoako e fapaneng). Ho ka ameha litho tse ling tsa 'mele (mohlala, mats'oafo, liphio, manyeme, myocardium, colon). Ka seoelo - meningitis ea aseptic e nang le myoclonus le eosinophilia, ho se sebetse hantle ka anaphylactoid, angioedema, pneumonitis ea allergic kapa pneumonia ea eosinophilic. Haeba litla-morao tsena li ka mpefala, tšebeliso ea lithethefatsi e lokela ho emisoa.

Litho tsa Hematopoietic: hangata khafetsa - leukopenia, hangata - thrombocytopenia, eosinophilia, ka seoelo - leukocytosis, lymphadenopathy, tlhahleho ea folic acid, hangata haholo - agranulocytosis, anemia ea aplasiki, anemia ea 'nete ea erythrocytic, anemia phokolo ea mali

Ho tsoa ho tsamaiso ea tšilo ea lijo: hangata khafetsa - ho nyekeloa, ho hlatsa, hangata - molomo o omileng, ka linako tse ling - lets'ollo kapa ho sokela, bohloko ba ka mpeng, ka seoelo - glossitis, stomatitis, pancreatitis.

Ka lehlakoreng la sebete: khafetsa haholo - keketseho ea ts'ebetso ea GGT (ka lebaka la ho kenella ha enzyme ena ka har'a sebete), eo hangata e sa tsotelleng, hangata - keketseho ea ketsahalo ea alkaline phosphatase, ka linako tse ling - keketseho ea mosebetsi oa "transaminase" ea "sebete", ka seoelo - hepatitis ea cholestatic, parenchymal (hepatocellular) kapa mofuta o tsoakaneng, jaundice, ka seoelo - granulomatous hepatitis, ho hloleha ha sebete.

Ho tsoa lehlakoreng la CCC: ho se ts'oanehe - ho ferekana hoa pelo, ho fokotseha kapa ho eketseha ha khatello ea mali, ka seoelo - bradycardia, arrhythmias, AV block e nang le maemo a ho akheha, ho oa, ho ts'oaroa kapa nts'etsopele ea lefu la pelo, ho mpefala ha lefu la pelo (ho kenyeletsa le ho hlaha kapa ho eketseha ha litlhaselo tsa angina), thrombophlebitis, thromboembolic syndrome.

Ho tloha tsamaisong ea endocrine le metabolism: khafetsa - edema, ho boloka mokelikeli, ho eketsa boima ba 'mele, hyponatremia (ho fokotseha ha osmolarity ka lebaka la phello e ts'oanang le ADH, eo maemong a sa tloaelehang e lebisang ho insution hyponatremia, e tsamaeang le mokoka, ho hlatsa, ho opisa hlooho, ho ferekanya kelello le mathata a methapo ea kutlo), ka seoelo - hyperprolactinemia (e ka tsamaellana le galactorrhea le gynecomastia), ho fokotseha ha mahloriso a L-thyroxine (mahala T4, T4, T3) le keketseho ea khatello ea TSH (hangata e sa tsamaeeng) lipontšo tsa kliniki), metabolism ea calcium-phosphorus e senyehileng ka har'a tishu ea masapo (e ile ea fokotseha plasma Ca2 + le 25-OH-colecalciferol): osteomalacia, hypercholesterolemia (ho kenyelletsa cholesterol ea HDL) le hypertriglyceridemia.

Ho tsoa ho tsamaiso ea genitourinary: hangata ka seoelo - interstitial nephritis, ho se sebetse hantle ha masapo, ts'ebetso ea mokokotlo oa mokokotlo (mohlala, albinuria, hematuria, oliguria, urea / azotemia), ho eketseha ha urination, urine ho boloka, ho fokotseha potency.

Ho tsoa tsamaisong ea musculoskeletal: ka seoelo - arthralgia, myalgia kapa cramps.

Ho tsoa liphoofolong tsa kutlo: ka seoelo - likhathatso ka tatso, leru la lense, conjunctivitis, ho senyeha ha kutlo, ho kenyeletsa tinnitus, hyperacusis, hypoacusia, liphetoho ponong ea molumo.

Tse ling: mathata a ho fifala ha letlalo, aimura, makhopho, mofufutso o eketsehileng, alopecia. Maemo a hirsutism a sa tloaelehang a tlalehiloe, empa kamano ea complication ena le carbamazepine ha e hlake. Matšoao: hangata a bontša mathata a tsamaiso ea methapo e kholo, CVS le tsamaiso ea ho hema.

Ho tloha lehlakoreng la tsamaiso ea methapo e bohareng le litho tsa methapo ea kutlo - ho sithabela ha tsamaiso ea methapo e kholo, ho soetseha, ho otsela, ho ruruha, ho bona lintho, ho akheha, ho ferekana kelellong, ho fifala hoa pono ("moholi" ka pel'a mahlo), dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (qalong), hyporeflexia (hamorao) ), ho tsitsipana, mathata a psychomotor, myoclonus, hypothermia, mydriasis).

Ho tsoa ho CCC: tachycardia, ho fokotseha ha khatello ea mali, ka linako tse ling ho ne ho eketsa khatello ea mali, ho ferekana ho kenelletseng ho intraventricular le ho atolosoa ha qalo ea QRS, ho ts'oaroa ha pelo.

Karolong ea sistimi ea ho phefumoloha: khatello ea maikutlo a ho hema, pulmona edema.

Ho tsoa ho tsamaiso ea tšilo ea lijo: ho nyekeloa le pelo le ho hlatsa, ho lieha ho nts'oa lijo ka mpeng, ho fokolitse matla a koloneng.

Ho tsoa ts'ebetsong ea moroto: ho boloka urine, oliguria kapa anuria, ho boloka mokelikeli, hyponatremia dilution.

Matšoao a laboratori: leukocytosis kapa leukopenia, hyponatremia, metabolic acidosis, hyperglycemia le glucosuria, keketseho ea karolo ea mesifa ea KFK.

Phekolo: ha ho na litlhare tse tobileng. Phekolo e ipapisitse le boemo ba bongaka ba mokuli, ho kena sepetlele, boikemisetso ba phepelo ea carbamazepine ho plasma (ho netefatsa chefo ka setlhare sena le ho lekola tekanyo ea ts'ebetso e ngata), ho phatloha ha mpa ea mpa, ho ts'oaroa ha mashala a ts'ebetsong (ho tlosoa ha nakoana ka sethong sa gastric ho ka lebisa ho liehisoa ho amoheloa ha matsatsi a 2 le a 3 mme a sebetsa hape). ponahalo ea matšoao a ho tahoa nakong ea ho hlaphoheloa).

Qobello ea diuresis, hemodialysis, le peritoneal dialysis ha e na thuso (dialysis e bontšoa ka motsoako oa chefo e matla le ho hloleha ha renal). Bana ba banyenyane ba ka hloka tšelo ea mali. Tlhokomelo ea matšoao a tšebetsang setsing sa tlhokomelo e matla, ho hlokomela mesebetsi ea pelo, mocheso oa 'mele, matla a khoheli, ts'ebetso ea liphio le senya, ho lokisa mathata a electrolyte. Ka ho fokotseha ha khatello ea mali: boemo bo emeng bo emisoa ke hlooho, lintho tse nkang sebaka sa plasma, ka ho se sebetse hantle - iv dopamine kapa dobutamine, ka pelo le methapo - kalafo e khethoa ka bonngoe, ka tsitsipano - ho hlahisoa ha benzodiazepines (mohlala, diazepam), ka tlhokomeliso (ka lebaka la keketseho ea khatello ea maikutlo phefumoloho) kenyelletso ea li-anticonvulsants tse ling (mohlala, phenobarbital). Ka nts'etsopele ea dilution hyponatremia (ho taoa ha metsi) - thibelo ea ho kenella ha metsi le ho kenella butle-butle ka tharollo ea 0.9% NaCl (ho ka thusa ho thibela nts'etsopele ea "edema"). Hemosorption ho carbon sorbents e khothalletsoa.

Lokolla liforomo le sebopeho

Setlhare se fumaneha ka mokhoa oa matlapa a koahetsoeng. Matlapa a na le sebopeho sa oval ea biconvex.

Matlapa a 200 mg a fumaneha ka har'a mekotla ea mabokose a likotoana tse 50. Ka har'a pakete ea lilakane tse 5 tsa likotoana tse 10.

Matlapa a 400 mg a fumaneha ka mekotleng ea likotoana tse 30. Ka har'a pakete 3 lithupa tsa likotoana tse 10.

Litaelo tse khethehileng

Monotherapy ea lefu la sethoathoa e qala ka ho khethoa ha litekanyetso tse nyane, 'me ka bomong li li eketsa ho fihlela sephetho se lakatsehang sa kalafo.

Ho bohlokoa ho tseba hore na khatello ea mali le "plasma" e joang e le hore u tsebe ho khetha lethal dose e nepahetseng, haholo-holo ka mofuta oa phekolo.

Ha u fetisetsa mokuli ho carbamazepine, litekanyetso tsa moriana oa antiepileptic tse boletsoeng esale pele li lokela ho fokotsoa butle butle ho fihlela li hlakoloa ka botlalo.

Ho khaotsa ka tšohanyetso ha moriana ho ka tsosa sethoathoa. Haeba ho hlokahala hore o emise ka tšohanyetso kalafo, mokuli o lokela ho fetisetsoa ho litlhare tse ling tsa antiepileptic tlasa sekoaelo sa lithethefatsi tse boletsoeng maemong a joalo (mohlala, diazepam e tsamaisoa kahare kapa ka rectally, kapa phenytoin e tsamaisitsoeng iv).

Ho na le maemo a mangata a ho hlatsa, lets'ollo le / kapa ho fokotseha hoa phepo e nepahetseng, ho tsitsinyeha ha maikutlo le / kapa khatello ea phefumoloho ho masea a bona bao bo-mme ba nkile carbamazepine ka mokhoa o tšoanang le li-anticonvulsants tse ling (litlhaloso tsena e kanna ea ba lipontšo tsa "ho tlosoa" ha bana ba sa tsoa hlaha).

Pele o fana ka carbamazepine le nakong ea kalafo, ho hlokahala hore ho etsoe lipatlisiso mabapi le ts'ebetso ea sebete, haholo ho bakuli ba nang le nalane ea lefu la sebete, hammoho le bakuli ba tsofetseng. Tabeng ea keketseho ea ho senyeha ha sebete ho teng kapa ha lefu le sebetsang la sebete le hlaha, moriana o lokela ho emisoa hanghang. Pele o qala kalafo, ho hlokahala hape ho etsa phuputso ea setšoantšo sa mali (ho kenyelletsa palo ea liplatele, palo ea reticulocyte), serum Fe mahloriso, urinalysis, mali urea mahloriso, EEG, boikemisetso ba mahloriso a serum electrolyte (le nako le nako nakong ea kalafo, hobane kholo ea kholo ea kholo ea hyponatremia). Kamora nako, matšoao ana a lokela ho beoa leihlo nakong ea khoeli ea pele ea kalafo beke le beke, mme e be ka khoeli le khoeli.

Carbamazepine e lokela ho tlosoa hanghang ha ho hlaha lintho kapa matšoao a ho kula ho belaelloang hore a nts'etsapele Stevens-Johnson syndrome kapa lefu la Lyell. Boitšoaro bo bobe ba letlalo (macular kapa maculopapular exanthema) hangata bo nyamela kamora matsatsi kapa libeke tse 'maloa esita le kalafo e tsoelang pele kapa kamora ho fokotseha ha tekanyetso (mokuli o lokela ho beoa leihlo le haufi le ngaka ka nako ena).

Carbamazepine e na le ts'ebetso e fokolang ea anticholinergic, ha e laeloa bakuli ba nang le khatello e eketsehileng ea intraocular, ho lekola nako le nako hoa hlokahala.

Monyetla oa ts'ebetso ea li-psychoses tse sa tsoa etsahala o lokela ho tsotelloa, le ho bakuli ba tsofetseng, monyetla oa ho thefuleha kapa ho hlasimoloha.

Ho fihla joale, ho bile le litlaleho tse arohaneng tsa tsoalo e holofetseng ea monna le / kapa spermatogenesis e holofetseng (kamano ea liphokotso tsena le carbamazepine ha e e-so thehoe).

Ho na le litlaleho tsa ho tsoa mali ho basali pakeng tsa ho ilela khoeli maemong a ho neng ho sebelisoa lithibela-pelehi ka molomo ka nako e le 'ngoe. Carbamazepine e ka ama hampe ts'ebetso ea lithethefatsi tse thibelang pelehi ka molomo, ka hona, basali ba lilemo tsa ho beleha ba lokela ho sebelisa mekhoa e meng ea ts'ireletso ea moimana nakong ea kalafo.

Carbamazepine e lokela ho sebelisoa feela tlas'a tlhokomelo ea bongaka.

Hoa hlokahala ho tsebisa bakuli ka matšoao a pele a chefo eo a ka bang le eona lipokellong tsa hematologic, le matšoao a tsoang letlalong le ho sebete. Mokuli o tsebisoa ka tlhokahalo ea ho ea ngakeng hang-hang le ngaka ha ho ka ba le mathata a itseng a kang feberu, 'metso, ho ruruha, ho ruruha ha mucosa ea molomo, sesosa sa ho longoa ke makhopho ka tsela ea petechiae kapa purpura.

Maemong a mangata, ho fokotseha ka nakoana kapa ho phehella ha lisele tse tšoeu tsa mali ha se tšitiso ea ho qaleha ha aplasiki anemia kapa agranulocytosis. Leha ho le joalo, pele o qala kalafo, hammoho le nako le nako nakong ea ts'ebetso ea kalafo, liteko tsa mali tsa kliniki li lokela ho etsoa, ​​ho kenyelletsa ho bala palo ea liplatelese mme mohlomong le li-reticulocytes, hammoho le ho khetholla mokokotlo oa Fe ho serum ea mali.

Leukopenia e sa tsoeleng pele ha e hloke ho khaotsa, leha ho le joalo, kalafo e lokela ho khaotsa haeba leukopenia e tsoelang pele kapa leukopenia e hlaha, e tsamaisana le matšoao a kliniki a lefu le tšoaetsanoang.

Pele o qala kalafo, ho kgothaletswa ho etsa tlhahlobo ea mahlo, ho kenyelletsa tlhahlobo ea fundus ka lebone la slit le tekanyo ea khatello ea methapo haeba ho hlokahala. Tabeng ea ho fana ka lithethefatsi ho bakuli ba nang le khatello e eketsehileng ea intraocular, ho hlokahala ho lekola kamehla letšoao lena.

Ho khothalletsoa ho tlohela tšebeliso ea ethanol.

Setlhare se ka nako e telele se ka nooa hang, bosiu. Tlhokahalo ea ho eketsa tekanyetso ha o fetohela matlapeng a khutlang e fumaneha seoelo haholo.

Leha kamano e teng lipakeng tsa lethalinyana la lithethefatsi, ho sebetsa ha lona ka bongata le ts'ebetso ea bongaka e le nyane haholo, leha ho le joalo, boikemisetso ba khafetsa ba khatello ea carbamazepine bo ka ba molemo maemong a latelang: ka keketseho e potlakileng ea khafetsa ea litlhaselo, ho sheba hore na mokuli o sebelisa moriana hantle kapa che. nakong ea bokhachane, kalafong ea bana kapa ea lilemong tsa bocha, ka ho belaelloa ha malaborption ea lithethefatsi, ka belaello ea mehopolo e nang le chefo haeba mokuli a ntse a e-noa lithethefatsi tse 'maloa.

Ho basali ba lilemo tsa ho ba le bana, carbamazepine e lokela ho sebelisoa e le monotherapy neng kapa neng ha ho khonahala (sebelisa tekanyetso e sebetsang e tlase) - khafetsa liphapang tsa masea ho basali ba hlahileng kalafo ea antiepileptic li phahame ho feta bakeng sa ba fumanang e 'ngoe ea litlhare tsena e le monotherapy.

Ha ho ima ho etsahala (ha u etsa qeto ea ho khethoa ha carbamazepine nakong ea kemolo), ho hlokahala hore u bapise ka hloko melemo ea phekolo le mathata a eona a ka hlahang, haholoholo likhoeling tse 3 tsa pele tsa kemaro. Hoa tsebahala hore bana ba tsoetsoeng ke bo-'mè ba nang le lefu la ho akheha ba rerile ho ba le mathata a ntlafatso ea intrauterine, ho kenyelletsa le ho senyeha. Carbamazepine, joalo ka lithethefatsi tse ling tsohle tsa antiepileptic, e ka 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). Bakuli ba lokela ho fuoa tlhaiso-leseling ka monyetla oa ho eketsa kotsi ea ho se sebetse hantle le bokhoni ba tlhahlobo ea bokhachane.

Lithethefatsi tsa antiepileptic li eketsa khaello ea folic acid, e atisang ho utluoa nakong ea kemolo, e leng se ka eketsang kotsi ea bofokoli ba tlhaho ho bana (pele le nakong ea kemaro, ho khothalletsoa tlatsetso ea folic acid). Bakeng sa ho thibela ho tsoa mali ka bongata ho masea a sa tsoa hlaha, ho khothalletsoa hore basali ba libeke tsa ho qetela baimana, hammoho le masea, ba fuoe vithamine K1.

Carbamazepine e fetela lebese la matsoele; melemo le litlamorao tse sa rateheng tsa ho anyesa li lokela ho bapisoa le kalafo e tsoelang pele. Bo-'mè ba noang carbamazepine ba ka anyesa masea a bona, ha feela ngoana a hlahlojoa hore na a ka hlaha joang (ka mohlala, ho otsela ho tebileng, ho hlaseloa ke letlalo ka linako tsohle).

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.

Sebopeho le mofuta oa tokollo

ka har'a lilakane tse 10 tsa li-PC., ka paketeng ea karete ea 5 (200 mg e ngoe le e ngoe) kapa lilakane tse 3 (400 mg ka ngoe).

Tekanyetso le tsamaiso

Ka hare nakong ea lijo kapa ka mor'a lijo, kapa lipakeng tsa lijo, ka mokelikeli o monyane.

Matlapa a lokolotsoeng (Letlapa le senotsoeng) kapa tafole e felletseng, haeba e laetsoe ke ngaka) a lokela ho nkoa ntle le ho hlafuna.

Moriana o ka sebelisoa ka bobeli ka mokhoa oa monotherapy, hape e le karolo ea kalafo e kopaneng.

Kaha ntho e sebetsang e lokolloa matlapeng a ketso ea nako e telele hanyane butle hanyane ka hanyane, e beoa makhetlo a mabeli ka letsatsi.

Ka lebaka la hore lithethefatsi Tegretol ® CR e laetsoe makhetlo a 2 ka letsatsi, mofuta o nepahetseng oa kalafo o khethoa ke ngaka ho latela litlhahiso.

Phetisetso ea mokuli ho nka Tegretol ® ka mokhoa oa matlapa a tloaelehileng ho nka Tegretol ® CR, matlapa a tsoang ka nako e telele

Phihlelo ea bongaka e bontša hore ho bakuli ba bang, ha ba sebelisa matlapa a lokolotsoeng nako e telele, ho ka hlokahala hore ba eketse tekanyetso ea moriana.

Ka lebaka la ts'ebelisano ea lithethefatsi le pharmacokinetics ea lithethefatsi tsa antiepileptic, bakuli ba tsofetseng ba lokela ho khethoa ka hloko.

Haeba ho khonahala, moriana o lokela ho khethoa e le monotherapy.

Hangata lithethefatsi ha li na thuso bakeng sa ho ts'oaroa hanyane (petit mal, abscess) le ho ts'oaroa ke myoclonic.

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 khetha tekanyetso e nepahetseng ea moriana, ho khothalletsoa hore ho hlongoe motsoako oa ntho e sebetsang ka plasma ea mali.

Ha Tegretol ® CR e eketsoa ho lithethefatsi tse ling tsa antiepileptic tse nkuoeng, lethalinyana la Tegretol ® CR le eketseha butle butle. Haeba ho hlokahala, etsa litokiso tse nepahetseng tsa litekanyetso.

Bakeng sa batho ba baholo, tekanyetso ea pele ea carbamazepine ke 100-200 mg 1 kapa makhetlo a 2 ka letsatsi. Ebe e eketsoa hanyane ka hanyane ho fihlela phello e nepahetseng ea kalafo, hangata e fumanoa ka tekanyo ea 400 mg makhetlo a 2-3 ka letsatsi. Bakuli ba bang ba ka hloka keketseho ea tekanyetso ea letsatsi le letsatsi ho 1600 kapa 2000 mg.

Tegretol ® CR ea lithethefatsi, matlapa a tlotsitsoeng a tšehelitsoeng a tlameha ho sebelisoa ho bana ba lilemo tse 4 le ho feta. Ho bana ba ka tlase ho lilemo tse 3, lithethefatsi Tegretol ® e sebelisoa ka mokhoa oa sirapo ka lebaka la mathata a ho sebelisa litekanyetso tsa litekanyetso tsa sehlopha sena sa lilemo. Ho bana ba ka holimo ho lilemo tse 4, kalafo e ka qala ka ts'ebeliso ea 100 mg / ka letsatsi, tekanyetso e eketseha butle butle, ka 100 mg ka beke.

Litlhoko tsa tlhokomelo bakeng sa bana ba behiloeng ka tekanyo ea 10-20 mg / kg / letsatsi (ka litekanyetso tse 'maloa).

Bakeng sa bana ba lilemo tse 4-5, tekanyetso ea letsatsi le letsatsi ke 200-400 mg, lilemo tse 6-10 - 400-600 mg, lilemo tse 11-15 - 600-1000 mg.

Trigeminal neuralgia

Motsoako oa pele ke 200-400 mg / ka letsatsi. E eketseha butle butle ho fihlela bohloko bo nyamela (hangata - makhetlo a 200 mg makhetlo a 3-4 ka letsatsi). Ebe moriana o ntse o fokotsoa butle-butle hore o lokisoe hanyane. Motsoako o khothalletsoang oa ho qala ho bakuli ba tsofetseng ke 100 mg makhetlo a 2 ka letsatsi.

Lefu la ho tlohela joala

Karolelano ea litekanyetso li 200 mg makhetlo a 3 ka letsatsi. Maemong a tebileng, lethal dose le ka eketsoa matsatsing a 'maloa a pele (mohlala, 400 mg makhetlo a 3 ka letsatsi). Pontšong e matla ea ho khaotsa joala, kalafo e qala ka ts'ebeliso ea lithethefatsi hammoho le lithethefatsi tse nang le tšusumetso le khatello ea kelello (mohlala, clopoloazole, chlordiazepoxide). Kamora ho rarolla karolo e hlobaetsang, kalafo le sethethefatsi e ka tsoela pele e le monotherapy.

Polyuria le polydipsia ea tlhaho ea neurohormonal ho lefu la tsoekere la insipidus ea mantlha

Tekanyetso e tloaelehileng ho batho ba baholo ke 200 mg makhetlo a 2-3 ka letsatsi. Ho bana, lethal dose le lokela ho fokotsoa ho latela lilemo le boima ba 'mele ba ngoana.

Lefu la ho opeloa ke lefu la tsoekere le lefu la tsoekere

Karolelano ea litekanyetso li 200 mg makhetlo a 2-4 ka letsatsi.

Maemo a manic a matla le kalafo e tšehetsang ea mathata a amanang le bothata

Sekhahla sa letsatsi le letsatsi ke 400-1600 mg. Karolelano ea litekanyetso tsa letsatsi le letsatsi ke 400-600 mg (ho litekanyetso tse 2-3). Boemong bo bobe ba manic, lethal dose le lokela ho eketsoa ka potlako. Ka kalafo ea tlhokomelo bakeng sa maloetse a phefumolohang, ho netefatsa mamello e phethahetseng, keketseho e 'ngoe le e' ngoe ea morao ea tekanyetso e lokela ho ba nyane, tekanyetso ea letsatsi le letsatsi e lokela ho eketseha butle butle.

Litaelo tsa ho sebelisa Tegretol (Mokhoa le litekanyetso)

Litaelo tsa Tegretol bakeng sa ts'ebeliso li u lumella ho nka litafole nakong ea lijo kapa ka mor'a lijo ka nako e le ngoe le metsi a manyane. Ho lefu la sethoathoahaeba ho khonahala, moriana o lokela ho nkuoa e le monotherapy.

Phekolo e qala ka ho sebelisa lethal dose le lenyane la letsatsi le leng le le leng, ebe le eketsoa hanyane ka hanyane ho fihla boemong bo nepahetseng. Ho khetha litekanyetso tse nepahetseng, ho kgothaletswa hore sethala sa ntho e sebetsang maling a khethoe.

Ha moriana o kenyelletsoa kalafong ea antiepileptic e seng e khethiloe, sena se tlameha ho etsoa butle butle, 'me litekanyetso tsa lithethefatsi tse sebelisoang hangata ha li fetohe kapa ho nepahala.

Tekanyetso ea pele bakeng sa batho ba baholo ke 100-200 mg makhetlo a 1-2 ka letsatsi. Ebe moriana o eketsoa hanyane ka hanyane ho fihlela phello e nepahetseng ea kalafo e etsahala, joalo ka molao o fihlelloa ka 400 mg ka letsatsi. Bakuli ba bang ba ka hloka ho nka ligrama tse 1,6 kapa tse peli tsa moriana ka letsatsi.

Bana ba lilemo tse 4 le ho feta ba lokela ho qala kalafo ka 20-60 mg ea moriana ka letsatsi le ho eketsa litekanyetso ka 20-60 mg ka letsatsi le le leng.

Ho bana ba ka holimo ho lilemo tse 4, phekolo e lumelloa ho qala ka 100 mg ka letsatsi, litekanyetso li eketseha butle, ka 100 mg hang ka beke.

Litekanyetso tse ts'ehetsang bana ke 10-20 mg / kg ka letsatsi.

Nakong ea kalafo trigeminal neuralgia tekanyetso ea pele ke 200-400 mg ka letsatsi. E ntse e eketseha hanyane ka hanyane ho fihlela bohloko bo kokobela (makhetlo a 200 mg ho isa ho a 4 ka letsatsi), ebe e theoleloa hanyane ka hanyane boemong ba tšehetso bo tlase. Motsoako oa pele oa batho ba holileng o khothalelitsoeng ke 100 mg habeli ho botsoa.

Ho ho itlopa joala Tekanyetso e tloaelehileng ke 200 mg makhetlo a mararo ka letsatsi. Maemong a boima haholo, litekanyetso li ka eketsoa matsatsing a 'maloa a pele. Lipontšo tse matla tsa ho tlohela joala, kalafo e qala ka ts'ebeliso ea tegretol le lithethefatsi tsa matla a ho ferekanya kelello. Kamora ho emisa karolo e boima, Tegretol monotherapy e ka etsoa.

Ho lefu la tsoekeretekanyetso ea batho ba baholo e tloaelehileng ke 200 mg ea moriana ho fihlela makhetlo a 3 ka letsatsi. Ho bana, litekanyetso li lokela ho fokotsoa ho latela lilemo le boima ba ngoana.

Ka kalafo lefu la tsoekere ka boteng ba bohloko, tekanyetso e tloaelehileng ea moriana ke 200 mg ho isa makhetlo a mane ka letsatsi.

Ho manic e re mofuta oa a hlobaetsang le kalafo ea ho lokisa mathata a ho phefumoloha, litekanyetso tsa letsatsi le letsatsi ke 400-1600 mg. Tekanyetso e tloaelehileng ea letsatsi le letsatsi ke 400-600 mg.

Bongata

Matšoao a ho feta: ho ruruha, khatello ea maikutlo, tsamaiso ea methapo, boroko,pherekano, hallucinations,pono e fifalitsoeng coma, dysarthriapuo e thetsang ataxia, nystagmus, dyskinesia, hyporeflexia, hyperreflexia, hypothermia, confulsion, myoclonus, mathata a psychomotor mydriasis,pulmonary edemakhatello ea maikutlo tachycardia, Hypertension, khatello ea maikutlo, ho tšoaroa ke pelo, ho akheha, ho hlatsa, ho fokotseha ha ts'ebetso ea mala. oliguria, ho boloka urine, ho boloka mokelikeli, anuria, hyponatremia, hyperglycemia, metabolic acidosis,keketseho ea boemo creatinine phosphokinase.

Phekolo ea overdose: ho kena sepetlele, boikemisetso ba boemo carbamazepinemaling ho lekola botebo ba bongoana bo feteletseng. Ho tlosa tse ka mpeng, ts'ebeliso enterosorben, kalafo ea matšoao, ho shebella pelo, khalemelo ea likhathatso tsa motlakase. E khethehileng antidote ha e eo.

Tegretol, litaelo tsa tšebeliso: mokhoa le litekanyetso

Tegretol e nkuoa ka molomo. Matlapa a hlatsuoa ka metsi a manyane. Moriana o ka nooa ho sa tsotelehe lijo.

Mohlomong ts'ebeliso ea Tegretol e le monotherapy kapa hammoho le lithethefatsi tse ling.

Ho bohlokoa ho nka sirapo (5 ml - 1 - khaba e lekantsoeng - 100 mg) haeba ho koenya ho le thata kapa maemong ao ho hlokahalang hore ho khethoe lethal dose ka hloko. Ha u sebelisa sirapo, ts'ebetso e phahameng haholo e fihlella ho feta ha lethal dose e nkuoa ka sebopeho sa Tegretol.Bakeng sa ho qoba nts'etsopele ea maikutlo a mabe, ho khothalletsoa ho qala kalafo ka litekanyetso tse nyane, kamora tsona li eketsoa butle butle. Pele o sebelisoa, sisinya botlolo ka sirapo.

Haeba mokuli a fetisoa ho tloha ho nka litafole ho ea moriong oa sirapo, lethal dose ea letsatsi le letsatsi ha le fetoloe, leha ho le joalo, ho kgothaletsoa ho fokotsa boholo ba tekanyetso e le 'ngoe le ho eketsa sekhahla sa ho nka Tegretol.

Hoa hlokahala ho khetha mofuta oa kalafo bakeng sa bakuli ba tsofetseng ba nang le tlhokomelo e khethehileng.

Haeba ho khoneha, tegretol e lokela ho nkoa e le monotherapy.

Qalong ea thupelo, ho fanoa ka lethalinyana le lenyenyane la letsatsi le letsatsi, le leng le eketsoa butle butle.

Bakeng sa ho khetha lethal dose e nepahetseng, ho kgothaletsoa ho tseba khakanyo ea plasma ea ntho e sebetsang maling (hangata 0.004-0.012 mg / ml).

Tekanyetso ea pele ea Tegretol ho batho ba baholo le bana ho tloha ho ba lilemo tse 16 ke 100-200 mg makhetlo a 1-2 ka letsatsi, tekanyo e nepahetseng e lekaneng ke makhetlo a 2-3 ka letsatsi bakeng sa 400 mg. Ka linako tse ling u hloka ho eketsa tekanyetso ea letsatsi le letsatsi ho 1600-2000 mg.

Trigeminal neuralgia

Motsoako oa pele oa batho ba baholo oa Tegretol ke 200-400 mg, ho bakuli ba tsofetseng - 200 mg (100 mg makhetlo a 2 ka letsatsi). Butle-butle e eketseha ho fihlela bohloko bo nyamela, tekanyetso e tloaelehileng ke makhetlo a 3-4 ka letsatsi, 200 mg ka 'ngoe. Sekhahla se phahameng se lumelletsoeng letsatsi ka leng ke 1200 mg. Ebe u fana ka tekanyetso e nepahetseng ea Tegretol.

Haeba bohloko bo fela, phekolo e felisoa hanyane ka hanyane ho fihlela tlhaselo e latelang ea bohloko e hlaha.

Lefu la ho tlohela joala

Tekanyetso e tloaelehileng ea letsatsi le letsatsi ea Tegretol ke makhetlo a 3 ka letsatsi, 200 mg ka 'ngoe. Maemong a boima, matsatsi a 'maloa a pele aa eketseha (mohlala, ho fihlela makhetlo a 3 ka letsatsi, 400 mg ka' ngoe).

Mohlomong tšebeliso e kopantsoeng le lithethefatsi tse nang le litlamorao tsa matla a ho hohlola le hypnotic (mohlala, le chlordiazepoxide, clamisoazole). Kamora hore karolo e mpe ea methapo e rarolle, kalafo le Tegretol e ntse e tsoela pele joalo ka monotherapy.

Tlhahlobo ea kalafo

Ho khaotsa ka matla ho nka Tegretol ho ka lebisa ho holofoleng ha sethoathoa, ka hona, kalafo e lokela ho hlakoloa butle butle ka likhoeli tse 6 kapa ho feta.

Haeba ho hlokahala, potlakela ho hlakola kalafo ho bakuli ba nang le lefu la sethoathoa, ho fetohela ho sethethefatsi se seng ka ts'ebetso ea antiepileptic ho lokela ho etsoa tlasa tataiso ea moriana o bontšitsoeng maemong ana.

Tšebeliso ea tegretol baneng

Letšoao le ka sehloohong la ts'ebeliso ea Tegretol ho bana ke lefu la sethoathoa.

Khothaletsa ho qala tekanyetso ea letsatsi le letsatsi:

• ho fihlela lilemo tse 4: ho tloha ho 20 ho isa ho 60 mg, ka letsatsi le leng le le leng lethal dose le ka eketsoa ka 20-60 mg,
• ho tloha lilemong tse 4: 100 mg, ebe lethalase le ka eketsoa ka 100 mg ka beke.

Litekanyetso li lokiselitsoe ka sekhahla sa 10-20 mg / kg ka letsatsi, e arotsoe ka litekanyetso tse 'maloa:

• ho fihlela selemo se le seng: 100-200 mg (litekanyetso tsa 1-2 tsa sirapo),
• Lilemo tse 1 - 1-5: 200-400 mg, (litekanyetso tse 2- 2 tsa sirapo ho lipilisi tse 2),
• Lilemo tse 6-10: 400-600 mg (litekanyetso tse 2 tsa sirapo ho litekanyetso tse 2-3),
• Lilemo tse 11 - 15: 600-11000 mg (litekanyetso tse 2-3 tsa sirapo ho litekanyetso tse 3; ha u sebelisa 1000 mg, o hloka ho eketsa tekanyetso ea sirapo ka 5 ml),
• ho tloha lilemong tse 15: ho tloha 800 ho isa ho 1200 (maemong a sa tloaelehang) mg.

Sekhahla se phahameng sa letsatsi sa Tegretol:

• ho fihlela lilemo tse 6: 35 mg / kg,
• Lilemo tse 6-15: 1000 mg,
• ho tloha lilemong tse 15: 1200 mg.

Kaha, mabapi le ho nka Tegretol bakeng sa matšoao a mang, bana ha ba na palo e lekaneng ea tlhaiso-leseling e tšepahalang, ho khothalletsoa hore moriana o sebelisoe ho latela boima le lilemo tsa ngoana, ntle le ho fetela ho litekanyetso tse kaholimo.