Mokhoa oa ho sebelisa lithethefatsi Saroten?

3- (10,11-dihydro-5H-dibenzoa, d annulled-5-ylidene) -N, N- dimethylpropane-1-amine hydrochloride

Foromo ea boholo:

lipapatso tsa nako e telele.

Ntho e sebetsang - amitriptyline hydrochloride 56.55 mg (e tsamaellanang le 50 mg ea amitriptyline).

Bahlomphehi - likhaba tsa tsoekere 123.074 mg, stearic acid 0,123 mg, shellac (e sa tlotsoang ka khetla ea shellac) 8.480-14.140 mg, talcum 16.016-29.610 mg, povidone 0.724-1.086 mg.

Sebopeho sa sekotlolo se se nang letho - gelatin 65.0 mg, dae oxide e khubelu (E 172) 0.98 mg, titanium dioxide (E 171) 0,33 mg.

li-capsules tse thata tsa gelatin, opaque, 'mele le li-brown red. Capsule size No. 2.

Litaba tsa Capsule - li-pellets ho tloha ho o mosoeu ho isa ho o mosehla.

Mali

Amitriptyline ke antidepressant e boima. Amitriptyline ke amine ea boemo bo phahameng, e lula sebakeng se bohareng ba li-antidepressants tsa li-triceclic, hobane e batla e sebetsa ka ho lekana ho vivo e le thibelo ea ho tšoaroa ha serotonin le norepinephrine ka li-endynaptic nerve endings. Metabolite ea mantlha ea nortriptyline e rarahaneng ke tšibollo e nang le tšusumetso ea norepinephrine, empa e boetse e thibela ho tšoaroa ha serotonin. Amitriptyline e na le thepa e matla ea li-anticholinergic, antihistaminergic le sedative ebile e na le litlamorao tsa catecholamines.

Thibelo ea karolo e potlakileng ea boroko (BDG) e nkoa e le sesupo sa ketsahalo e thibelang khatello ea kelello. Li-antidepressants tsa Tricyclic, hammoho le li-inhibitors tsa li-serotonin tse ikhethileng, li hatella karolo ea BDH le ho matlafatsa boroko bo tebileng ba butle-butle.

Amitriptyline e eketsa boemo ba maikutlo bo fokotsehang.

Ka lebaka la ts'ebetso ea eona ea mokokotlo, amitriptyline e bohlokoa haholo kalafong ea khatello ea maikutlo, e tsamaeang le matšoenyeho, ho ferekana, ho tšoenyeha le likhathatso tsa boroko.

Phello ea li-analgesic tsa lithethefatsi ha e tsamaisane le antidepressant, hobane analgesia e etsahala pejana ho feta liphetoho leha e le life tsa maikutlo, mme hangata ka lebaka la ho nka tekanyo e tlase haholo ho feta ho hlokahala ho netefatsa liphetoho tsa mohatsela.

Ho a khonahala ho phekola ka katleho lintlafatso tsa bosiu.

Ho fufuleloa Tsamaiso ea molomo ka moriana matlapeng e rera ho fihlella ha boemo bo holimo ho serum ea mali ka mor'a 4:00 (t _max = Lihora tse 3.89 ± 1.87, lihora tse 1,33-7.98). Kamora ho nka 50 mg, boleng bo bohareng ba C _max = 30.95 ± 9.61 ng / ml, bophara 10.85-45.70 ng / ml (111.57 ± 34.64 nmol / L, bophara 39.06-164, 52 nmol / L). Tekanyo e tloaelehileng ea bioavailability ke 53% (F _Abs = 0.527 ± 0.123, bophara 0.219-0.756). Tsamaiso. Plasma protein e tlamang ke hoo e ka bang 95%. Amitriptyline le metabolite ea eona e ka sehloohong - nortriptyline - kenella ka har'a motsoako oa placental. Metabolism. Amitriptyline metabolism e etsahala haholo ka demethylation (CYP2C19, CYP3A) le hydroxylation (CYP2D6), e lateloe ke khokahano le glucuronic acid. Ho feta moo, metabolism e tsebahala ka polymorphism e ikemiselitseng. Metabolite e ka sehloohong ke nortriptyline ea bobeli ea amine. Nortriptyline ke enhibitor e matla ea norepinephrine e fetang ea serotonin, ha amitriptyline e atleha ho thibela ho ts'oaroa ha li-neurotransmitters ka bobeli. Li-metabolites tse ling (cis le trans-10-hydroxyamitriptyline, hammoho le cc-transroxyinortriptyline) li tšoauoa ka profil e ts'oanang le ea nortriptyline, e nang le potency e tlase haholo. Demethylnortriptyline le amitriptyline-N-oxide li fumaneha ka bongata ka har'a mali plasma ka bongata bo fokolang feela, boo qetellong bo sa sebetseng ka botlalo.

Excretion e etsahala haholo ka moroto. Ho hlahisoa ha amitriptyline ho sa fetoloe ke liphio ha ho na taba (hoo e ka bang 2%).

Ho bo-mme ba anyang masea, amitriptyline le nortriptyline ba fetela lebeseng le lenyane. Karolelano ea khatello ea mali lebeseng le serum ea mali ho basali ke 1: 2. Palo e lekantsoeng ea letsatsi le letsatsi (amitriptyline + nortriptyline) e ka bang 2% ea tekanyetso ea amitriptyline, e amanang le boima ba 'mele ba ngoana (ka mg / kg).

Maemo a tsitsitseng a plasma a amitriptyline le nortriptyline a fumaneha ho bakuli ba bangata nakong ea beke e le 'ngoe. Boemong bona, boemo ba plasma ea mali nakong ea letsatsi bo lekana le amitriptyline le nortriptyline ha li phekoloa ka matlapa a tloaelehileng makhetlo a 3 ka letsatsi.

Bakuli ba seng ba tsofetse ba na le nako e telele ea halofo ea bophelo ka lebaka la metabolism e tlase haholo.

Ho senyeha ha sebete ka lebaka la ho teba ho hoholo ho ka fokotsa ho ruruha ha hepatic, e leng se lebisang tlhokomelong e phahameng ea lithethefatsi maling a mali.

Ho hloleha ka nama ha ho ame kinetics ea moriana.

Polymorphism. Metabolism ea sethethefatsi e itšetlehile ka liphatsa tsa lefutso (isoenzymes CYP2D6 le CYP2C19). Kamano ea Pharmacokinetic / pharmacodynamic. Phekolo ea kalafo ea plasma bakeng sa khatello e kholo ea khatello ea maikutlo ke 100-250 ng / ml (≈370-925 nmol / l) (mmoho le amitriptyline le nortriptyline).

Ho sithabela maikutlo haholo, haholo litšobotsi tsa matšoenyeho, ho ruruha le mathata a ho robala.

Maemo a sithabetsang ho bakuli ba nang le lefu la kelello hammoho le li-antipsychotic ho thibela ho eketsoa ha hallucinations le pariaid mania.

Matšoao a bohloko a sa foleng.

Kholofalo ea bosiu e sa sebetse ka ho ba sieo hoa lihlahisoa tsa tlholeho.

Contraindication

Hypersensitivity ho amitriptyline kapa eng kapa eng ea likarolo tsa moriana.

Haufinyane tjena o ile a hlokofatsoa ke myocardial infarction. Mofuta ofe kapa ofe oa "blockade" kapa "pelo" ea arrhythmias, hammoho le ho fokola hoa methapo ea methapo ea methapo.

Phekolo e tšoanang ka tšebeliso ea MAOI (MAO inhibitors) e hanyetsitsoe (bona Karolo "Ho sebelisana le lithethefatsi tse ling le mefuta e meng ea litšebelisano").

Ts'ebetso e ts'oanang ea amitriptyline le MAOI e ka baka nts'etsopele ea serotonin syndrome (motsoako oa matšoao, a ka kenyelletsang letsoalo la ho tšoenyeha, pherekano, ho thothomela, myoclonus le hyperthermia).

Phekolo ka amitriptyline e ka qala matsatsi a 14 kamora ho emisa ts'ebeliso ea li-MAOIs tse ke keng tsa qojoa, hape hape ha ho ka tlase ho letsatsi la 1 kamora ho tlosoa ha lithethefatsi tse khutlisetsang moclobemide le selegiline.

Phekolo ka ts'ebeliso ea MAOI e ka qala matsatsi a 14 kamora ho emisa amitriptyline.

Ho sebelisana le lithethefatsi tse ling le mefuta e meng ea litšebelisano

Li-inhibitors tsa MAO (tse sa khetheng, hammoho le ho khetha A moclobemide le B selegiline) - kotsi ea "serotonin syndrome" (bona karolo "Contraindication").

Sympathomimetics: amitriptyline e khona ho ntlafatsa litlamorao tsa pelo le adrenaline, ephedrine, isoprenaline, norepinephrine, phenylephrine le phenylpropanolamine.

Adrenergic neuron blockers: li-antidepressants tsa li-trikingclic li ka kena-kenana le litlamorao tsa antihypertensive tsa guanethidine, betanidine, reserpine, clonidine, le methyldopa.

Li-anticholinergics: li-antidepressants tsa li-tricyclic li khona ho ntlafatsa litlamorao tsa lithethefatsi tse joalo ka leihlo, ts'ebetso ea methapo ea methapo, mala le lesapo la mokokotlo, tšebeliso e ts'oanang ea bona bakeng sa kotsi e eketsehileng ea ho sitisoa ke mala, "hyperpyrexia" e lokelang ho qojoa.

Moriana e bakang ho eketsoa ha nako ea QT ea li-electrocardiograms, ho kenyelletsa le lithethefatsi tsa antiarrhythmic (quinidine), antihistamines (astemizole le terfenadine), meriana e meng ea antipsychotic (haholo pimozide le sertindole), cosapride, halofantrine le sotalolmiase ka li-antidepressants tsa li-tricyclic.

Lisebelisoa tsa antifungal, tse kang fluconazole le terbinafine, li eketsa bongata ba li-antidepressant tse ka har'a serum ea mali le ho teba ha chefo e kopanang. Ho bile le maemo a ho tepella le arrhythmias joalo ka torsade de point.

Metsoako e hlokang tlhokomelo e khethehileng

Matšoenyeho a CNS: amitriptyline e ka ntlafatsa litlamorao tsa joala, barbiturates le khatello e 'ngoe ea methapo ea methapo.

Matla a lithethefatsi tse ling ho li-pharmacokinetics tsa li-antidepressants tsa li-tricyclic

Li-antidepressants tsa Tricyclic, ho kenyelletsa le amitriptyline, li thehiloe ke sebete cytochrome P450 isoenzyme CYP2D6. CYP2D6 e tšoauoa ka polymorphism ho baahi mme ts'ebetso ea eona e ka hatelloa ke li-psychotropic tse ngata hammoho le lithethefatsi tse ling, tse kang li-antipsychotic, serotonin reuptake inhibitors ntle le citalopram (eo e leng fokola haholo isoenzyme inhibitor), β-adrenergic blockers, hammoho le lithethefatsi tsa antiarrhythmic . Li-isoenzymes CYP2C19 le CYP3A le tsona li kentse letsoho ho metabolism ea amitriptyline.

Li-Barbiturates, joalo ka lintho tse ling tse hlahisang enzyme, rifampicin le carbamazepine, li ka ntlafatsa metabolism 'me ka hona tsa baka ho fokotseha ha litaba tsa li-antidepressants tsa tricyclic ka plasma ea mali le ho fokotseha hoa phello ea li-antidepressant.

Cimetidine le methylphenidate, hammoho le litokisetso tsa li-blockchain tsa calcium, li eketsa litekanyetso tsa li-complexclic ka har'a plasma ea mali le chefo e tsamaellanang.

Li-antidepressant tsa Tricyclic le li-antipsychotic ka bobeli li hatella metabolism ka bomong, sena se ka lebisa ho theoha ha monyako oa ho ts'oaroa le ponahalo ea ho ts'oaroa.

Li-antifungal agents tse kang fluconazole le terbinafine li ile tsa eketsa litekanyetso tsa serum tsa amitriptyline le nortriptyline. Ka boteng ba ethanol, litefiso tsa plasma tsa mahala tsa amitriptyline le litekanyetso tsa nortriptyline li ile tsa eketseha.

Likarolo tsa ts'ebeliso

Amitriptyline ha ea lokela ho beoa ka nako e ts'oanang le li-inhibitors tsa MAO (bona likarolo "Contraindication" le "Ho sebelisana le lithethefatsi tse ling le mefuta e meng ea litšebelisano").

Ha u sebelisa litekanyetso tse phahameng tsa moriana, menyetla ea ho ba le pherekano ea morethetho oa pelo le khatello e matla ea methapo ea kutlo e eketseha. Ntshetsopele ea maemo a joalo e ka etsahala le ka tšebeliso ea litekanyetso tse tloaelehileng ho bakuli ba nang le mafu a pelo a teng.

Amitriptyline e lokela ho laeloa ka hloko ho bakuli ba nang le mathata a ts'ebetso ea methapo, ho boloka mokokotlo, hypertrophy ea methapo, boteng ba matšoao a paranoid, hammoho le mafu a matla a sebete kapa a pelo.

Ho sithabela maikutlo ho amana le kotsi e eketsehileng ea ho ipolaea. Kotsi e joalo e ka ba teng ho fihlela phallo e tsitsitseng e fihleloa 'me e hlaha ka mokhoa o ikemetseng nakong ea phekolo. Kaha ntlafatso e kanna ea se be teng libekeng tse 'maloa tsa pele tsa kalafo kapa nako e telele, bakuli ba lokela ho beoa leihlo haholo ho fihlela ntlafatso e joalo e etsahala. Ho tsoa phihlelong e akaretsang ea tleliniki, hoa tsebahala hore menyetla ea ho ipolaea e ka eketseha maemong a pele a ho hlaphoheloa. Bakuli ba nang le nalane ea liketsahalo tsa ho ipolaea kapa tekanyo e kholo ea menahano ea ho ipolaea pele kalafo e tsejoa e le kotsing e kholo ea ho ipolaea kapa ho leka ho ipolaea, mme ba lokela ho fumana tlhahlobo e haufi nakong ea kalafo. Tlhatlhobo ea meta ea liteko tsa bongaka tse laoloang ke placebo ho bakuli ba nang le mathata a kelello e bontšitse kotsi ea ho ipolaea ha ho sebelisoa li-antidepressants ha li bapisoa le placebo ho bakuli ba ka tlase ho lilemo tse 25.

Ho hlokahala tlhokomelo e khethehileng ha ho fana ka amitriptyline ho bakuli ba nang le hyperthyroidism kapa ba sebelisang litokisetso tsa lihomone tsa qoqotho, kaha ho ka khoneha nts'etsopele ea pelo ea pelo.

Bakuli ba tsofetseng ba kotsing e kholo ea ho holisa hypotension ea postural nakong ea kalafo le amitriptyline.

Ho bakuli ba nang le mathata a ho sithabetsoa ke manicrip, ho fetoha ha lefu lena mothong ho ka etsahala, ho tloha qalong ea mokhahlelo oa lefu la mokuli, kalafo ea amitriptyline e lokela ho emisoa.

Ha u sebelisa amitriptyline bakeng sa karolo e nyahamisang ea schizophrenia, keketseho ea matšoao a psychotic e ka etsahala. Amitriptyline e lokela ho fanoa hammoho le li-antipsychotic.

Ho bakuli ba nang le boemo bo sa tloaelehang ba botebo le boqhetseke ba kamore e ka ntle ea leihlo, litlhaselo tsa glaucoma e mpe ka lebaka la phokotso ea popi li ka halefisoa.

Ts'ebeliso ea li-anesthetics nakong ea phekolo e nang le li-antidepressants tsa triop / tetracyclic li ka eketsa kotsi ea ho fetoha ha arrhythmias le arterial hypotension. Haeba ho khonahala, khaotsa ho sebelisa amitriptyline matsatsi a 'maloa pele u buuoa. Haeba ho buuoa ka tšohanyetso ho ke ke ha qojoa, ho tsebisa mokuli ka kalafo ka kalafo ea amitriptyline hoa tlameha.

Joalo ka lithethefatsi tse ling tsa psychotropic, amitriptyline e khona ho fetola kutloisiso ea 'mele ho insulin le tsoekere, e hlokang ho lokisoa ha phekolo ea antidiabetesic ho bakuli ba nang le lefu la tsoekere.

Litlaleho tsa hyperpyrexia le tšebeliso ea li-antidepressants tsa li-tricyclic li tlalehiloe maemong a ho khethoa ka nako e ts'oanang le lithethefatsi tsa anticholinergic kapa antipsychotic, haholoholo nakong ea mocheso o chesang.

Ho khaotsa ka tšohanyetso kalafo ka mor'a ho phekoloa ka nako e telele ho ka baka matšoao a bang teng ka hlooho, malaise, ho hloka boroko le ho teneha.

Amitriptyline e lokela ho sebelisoa ka hloko ho bakuli ba nkang SSRIs.

Baeti: matlapa a moriana o nang le lactose monohydrate. Bakuli ba nang le mathata a lefutso a fumanehang ka mokhoa o sa tloaelehang ka tsela ea sensitivity ho galactose, khaello ea lactase kapa malabsorption ea glucose-galactose ha baa lokela ho nka sethethefatsi sena.

Sebelisa nakong ea bokhachane le pelehi

Amitriptyline ha ea lokela ho beoa nakong ea kemolo, ntle le haeba phaello e lebelletsoeng ho mokuli e sa fetele tlokotsi ea theattical ho lesea. Tsamaiso ea litekanyetso tse phahameng tsa li-antidepressants tsa tricyclic nakong ea boraro ea nako ea kemaro e ka lebisa ho mathata a methapo ea methapo ho masea. Ho masea a sa tsoa hlaha, ho ea ka litlaleho, ke maemo feela a ho otsela a ileng a thehoa ka lebaka la litlamorao tsa amitriptyline le ho bolokoa ha urine ka lebaka la ho pepesehela nortriptyline (amitriptyline metabolite), haeba moriana o ne o laetsoe basali baimana pele ho pelehi.

Moriba o fetela ka lebeseng la matsoele ka ho tsepamiso e tlase, ka hona, litlamorao tsa lona ho lesea ha li nka tekanyetso ea kalafo ha li na monyetla. Tekanyetso e fumanoeng ke ngoana e batla e le 2% ea tekanyetso ea 'm'a eona, e amanang le boima ba ngoana (mg / kg). Haeba ho hlokahala ka bongaka, ho anyesa ho ka tsoela pele nakong ea kalafo ea amitriptyline, empa ho hlahloba lesea ho khothalletsoa, ​​haholo-holo libeke tse 4 tsa pele kamora ho hlaha.

Matšoao a ho sebelisoa

Ho sithabela maikutlo (haholoholo ka matšoenyeho, ho ferekana, le likhathatso tsa boroko, ho kenyeletsabongoaneng, endo native ,umaneutional, reactive, neurotic, lithethefatsi, tse nang le ts'ebetso ea ts'ebetso ea ts'oaetso ea mokokotlo, ho tlosa joala), psychizophrenic psychoses, motsoako o kopaneng oa maikutlo, mathata a boitšoaro (ts'ebetso le tlhokomelo), li-enctis tsa bosiu (ntle le bakeng sa bakuli ba nang le hypotension ea bladder), bulimia amanosa, syndrome ea bohloko bo sa foleng (bohloko bo sa foleng ho bakuli ba mofetše, migraine, mafu a ramatiki, bohloko ba sefahleho sefahlehong, postalopetic neuralgia, post-traumatic neuropathy ia, lefu la tsoekere kapa neuropathy e 'ngoe), hlooho ea hlooho, migraine (thibelo), peptic ulcer ea mala le duodenum.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

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

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

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

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

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

Ketso ea pharmacological

Antidepressant (tricyclic antidepressant). E boetse e na le li-analgesic (tse bohareng ba mantlha), H2-histamine-blocking le antiserotonin, e thusa ho felisa ho sa sebetse hantle ha moriti oa bosiu le ho fokotsa takatso ea lijo.

E na le phello e matla ea phello le anticholinergic e matla, ka lebaka la tumellano e phahameng ea li-receptor tsa m-cholinergic, phello e matla ea ho susumetsa e amanang le tumellano ea H1-histamine receptors, le alpha-adrenergic blocking. E na le thepa ea lithethefatsi tsa antiarrhythmic tsa subgroup Ia, joalo ka quinidine ka tekanyetso ea kalafo, e fokotsa lebelo la ventricular (haeba ho na le overdose, e ka baka block ea intraventricular).

Mokhoa oa ts'ebetso ea antidepressant o amahanngoa le ho eketseha ha khatello ea norepinephrine ho li-synapses le / kapa serotonin tsamaisong ea methapo ea methapo (ho fokotseha ha mokhoa oa bona oa ho khutlisa). 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". Ka tšebeliso ea nako e telele, e fokotsa ts'ebetso ea tšebetso ea beta-adrenergic le serotonin receptors bokong, e tloaetse phetisetso ea adrenergic le serotonergic, hape e khutlisa botsitso ba lits'ebetso tsena tse senyehileng libakeng tse tepelletsang. Libakeng tse nang le khatello ea maikutlo, e fokotsa matšoenyeho, ho ferekana le matšoao a sithabetsang.

Mochine oa ts'ebetso ea antiulcer o bakoa ke bokhoni ba ho thibela li-receptor tsa H2-histamine liseleng tsa parietal tsa mpa, hammoho le ho ba le phello ea sedative le m-anticholinergic (maemong a peptic ulcer ea mala le duodenal ulcer, e fokotsa bohloko le ho potlakisa pholiso ea ulcers).

Ho sebetsa hantle ho tsa boroko ho bonahala ho bakoa ke ketso ea anticholinergic, ho lebisang ho eketseng ha bokhoni ba lesapo la mokokotlo ho otlolla, ho susumetsa ka kotloloho ho beta-adrenergic, ts'ebetso ea li-agonists tsa alpha-adrenergic, e tsamaeang le keketseho ea molumo oa sphincter, le ho thijoa ho hoholo ha serotonin.

E na le phello ea bohareng ea analgesic, eo ho lumeloang hore e bakoa ke liphetoho phetohong ea li-monoamine tsamaisong ea methapo ea methapo, haholo serotonin, le phello ea litsamaiso tsa opioid tsa endoid.

Mokhoa oa ts'ebetso bakeng sa bulimia mothosa ha o hlake (o ka tšoana le oa khatello ea maikutlo). Kameho e ikhethileng ea lithethefatsi ho bulimia ho bakuli ka bobeli ntle le khatello ea maikutlo le boteng ba eona e bontšoa, ha ho fokotseha ha bulimia ho ka bonoa ntle le bofokoli bo tšoanang ba khatello ea maikutlo ka bo bona.

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.

Litlamorao

Litlamorao tsa Anticholinergic: pono e fifalitsoeng, ho holofala ha bolulo, mydriasis, khatello e eketsehileng ea methapo (feela ho batho ba nang le kemiso ea kameho ea tikoloho - sekhutloane sa phaposi ea kamoreng), tachycardia, molomo o omileng, pherekano, ho thella kapa ho bona lipono, ho omella, ho thatafala ha mala. ho fokotse mofufutso.

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

Ho tsoa ho CCC: tachycardia, palpitations, kizunguzungu, orthostatic hypotension, liphetoho tse sa utloahaleng tsa ECG (ST interval or T wave) ho bakuli ba se nang lefu la pelo, arrhythmia, khatello ea methapo ea mali (e fokotsehile kapa e eketsehile khatello ea mali), intraventricular conduction implication (ho atolosoa ha sekhahla. QRS, liphetoho lipakeng tsa PQ, blockade ea maoto a bundle ea Hae).

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

Ho tloha tsamaisong ea endocrine: keketseho ea boholo (edema) ea li-testicles, gynecomastia, keketseho ea boholo ba litšoelesa tsa mammary, galactorrhea, ho fokotseha kapa ho eketseha ha libido, ho fokotseha ha potency, hypo- kapa hyperglycemia, hyponatremia (ho fokotseha tlhahiso ea vasopressin), secretion e sa lekanyetsoang.

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

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

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

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

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

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

Ho tsoa ho CCC: ho fokotseha ha khatello ea mali, tachycardia, arrhythmia, ho kenella kahare ho intracardiac, liphetoho tsa ECG (haholo-holo QRS), ho ts'oaroa ha pelo, ho se sebetse hantle ha pelo, tšobotsi ea tahlehelo ea tahi e thata ea pelo.

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

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

Phekolo: Tsamaiso ea molomo: Tsamaiso ea molomo, ts'ebetso ea makala a emisitsoeng, lipontšo le tšehetso, ka litlamorao tse matla tsa anticholinergic (ho fokotseha ha khatello ea mali, arrhythmias, komisi, ho ruruha ha myoclonic) - Tsamaiso ea lithibelo tsa cholineterase (physostigmine ha e khothaletsoe ka lebaka la kotsi e eketsehileng ea ho tsitsa. ), ho boloka khatello ea mali le tekanyo ea motlakase oa metsi. Taolo ea mesebetsi ea CCC (ho kenyeletsoa ECG) bakeng sa matsatsi a 5 e bontšoa (ho khutlela morao ho ka hlaha ka nako ea lihora tse 48 kapa kamora moo), kalafo ea anticonvulsant, mochini oa moea o kenang, le mehato e meng ea ho tsosa. Hemodialysis le diuresis tse qobelloang ha li na thuso.

Litaelo tse khethehileng

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

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

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

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

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

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

Amitriptyline ho litekanyetso tse kaholimo ho 150 mg / ka letsatsi e fokotsa ts'oaro ea ts'ebetso ea ts'oaetso (kotsi ea ho tšoaroa ke sethoathoa ho bakuli ba reriloeng esale pele, hammoho le ho na le mabaka a mang a rerang ho hlaha ha lefu la tsitsipano, mohlala, tšenyo ea ts'ebetso ea etiology leha e le efe, ha ts'ebeliso ea lithethefatsi tsa antipsychotic (antipsychotic) e lokela ho nahanoa nakong ea ho hana ethanol kapa ho tlosoa hoa lithethefatsi tse nang le thepa ea anticonvulsant, joalo ka benzodiazepines).

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

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

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

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

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

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

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

Ka lebaka la ts'ebetso ea anticholinergic, ho fokotseha ha lekhalo le ho eketseha ha sekhahla sa motsoako oa meokho ho ka khoneha, ho ka lebisang ho senyeha ha corneal epithelium ho bakuli ba sebelisang lilense tsa ho ikopanya.

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

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

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

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

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

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

Ka tlhokomelo

Mathata a amang maikutlo, ho lula moroto, hyperplasia ea masapo, lefu le matla la sebete kapa lefu la pelo, tšoelesa ea qoqotho ea tšoelesa ea senya (lefu la ho ferekana kelellong) ka mor'a ho tlohela karolo e sithabetsang), khatello ea methapo ea kutlo (ho batho ba nang le bothata ba ho hlaseloa habonolo - lehlakore le patisaneng

kamoreng ea ka ntle), joala bo sa foleng, khatello ea lesapo la mokokotlo, lesapo la mokokotlo, le fokotsehile ts'ebetso ea ts'ebetso ea mpa ea mpa (kotsi ea lefu la sethoathoa), tsamaiso ka nako e le 'ngoe le serotonin reuptake inhibitors (SSRIs), botsofali.

Tekanyetso le tsamaiso

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

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

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

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

Bakuli ba seng ba tsofetse (ba fetang lilemo tse 65) Mokotla o le mong oa 50 mg mantsiboea.

Mosebetsi oa liphio o theohileng

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

Mosebetsi oa sebete o fokotsehile

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

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

Sebelisa nakong ea bokhachane kapa leboteng

Amitriptyline ha ea lokela ho beoa nakong ea kemolo, ntle le haeba phaello e lebelletsoeng ho mokuli e sa fetele tlokotsi ea theattical ho lesea. Tsamaiso ea litekanyetso tse phahameng tsa li-antidepressants tsa tricyclic nakong ea boraro ea nako ea kemaro e ka lebisa ho mathata a methapo ea methapo ho masea. Ho masea a sa tsoa hlaha, ho ea ka litlaleho, ke maemo feela a ho otsela a ileng a thehoa ka lebaka la litlamorao tsa amitriptyline le ho bolokoa ha urine ka lebaka la litlamorao tsa nortriptyline (metabolite ea amitriptyline), haeba moriana o ne o laetsoe basali baimana pele ho pepa.

Moriba o fetela ka lebeseng la matsoele ka ho tsepamiso e tlase, ka hona, litlamorao tsa lona ho lesea ha li nka tekanyetso ea kalafo ha li na monyetla. Tekanyetso e fumanoeng ke ngoana e batla e le 2% ea tekanyetso ea 'm'a eona, e amanang le boima ba ngoana (mg / kg). Haeba ho hlokahala ka bongaka, ho anyesa ho ka tsoela pele nakong ea kalafo ea amitriptyline, empa ho hlahloba lesea ho khothalletsoa, ​​haholo-holo libeke tse 4 tsa pele kamora ho hlaha.

Bongata

Matšoao a Cardiac: arrhythmias (ventricular tachyarrhythmias, flutter-flicker, ventricular fibrillation). ECG hangata e bonts'a karohano ea PR e atolositsoeng, ho atolosoa ha QRS tataiso, ho atolosoa ha QT, ho hola kapa ho feto-fetoha ha wave ea T, khatello ea karolo ea ST, hammoho le likhahla tse fapaneng tsa pelo ho fihlela ho ts'oaroa ha pelo. Ntlafatso ea ts'ebetso ea QRS hangata e lumellana hantle le botebo ba chefo ka mor'a litekanyetso tse matla haholo. Ho nyekeloa ke pelo, khatello ea kelello ea methapo, ho tsitsinyeha ha pelo le lefu la pelo. Metabolic acidosis le hypokalemia lia eketseha. Kamora ho tsosa hape pherekano e ka khonehang, ho tšoenyeha ho tsosa, ho hallucinations le ataxia.

Phekolo: ho kenella sepetlele (setsing sa tlhokomelo e matla). Phekolo ena e na le matšoao ebile ea a tšehetsa. Ho tšolleloa mpa ka mpeng le mokelikeli o mong, esita le kamorao ho tsamaiso, hammoho le litokisetso tsa khabone tse hlahisitsoeng li bonts'itsoe. Ho bohlokoa ho lekola boemo ka hloko, le ha ho na le nyeoe e bonolo. Lekola boemo ba ho se tsebe, semelo sa ho otla, boleng ba khatello ea mali le ts'ebetso ea ho phefumoloha, ka linako tse khutšoane li lokela ho fumana se ka har'a li-electrolyte le likhase tsa mali. Etsa bonnete ba hore ho na le phallo ea moea moo ho hlokahalang. Ka kakaretso, kalafo e nang le moea o qobelloang e khothalletsoa ho thibela ho tšoaroa hoa phefumoloho. Tekolo e tsoelang pele ea ECG e lokela ho etsoa nakong ea matsatsi a 3-5. Ka keketseho ea karohano ea QRS, ho nyekeloa ke pelo, le phetoho ea mali ho ea lehlakoreng la alkaline e ka sebetsa (tsamaiso ea tharollo ea bicarbonate kapa hyperventilation) ka tsamaiso e potlakileng ea tharollo ea hypertonic ea sodium chloride (100-200 mmol Na +). Ka li-ventricular arrhythmias, ho ka etsahala ho sebelisa lithethefatsi tsa setso tsa antiarrhythmic, joalo ka 50-100 mg ea lidocaine (1-1,5 mg / kg) kahare, e lateloe ke ho kenngoa ka lebelo la 1-3 mg / min.

Haeba ho hlokahala, sebelisa Cardioversion le defibrillation. Ho haella ha potoloha ea potoloho ka thuso ea litheolelo tsa plasma, le maemong a tebileng, ka ho kenngoa ha dobutamine (pele ka tekanyo ea 2-3 μg / kg ka motsotso) ka keketseho ea lethal dose, ho latela phello. Ho hlohlona le ho tsitsipanya ho ka emisoa ke tsamaiso ea diazepam.

Kutloahalo ea litekanyetso tse feteletseng e haholo motho ka mong. Ka nako e ts'oanang, bana ba tloaetse haholo kholo ea kholo ea lefu la pelo le lekhotla.

Ho batho ba baholo, litekanyetso tsa 500 mg li ka baka ho tahoa ho lekanang, ha litekanyetso tse ka tlase ho 1000 mg li le kotsi.

Lintho tse fapaneng tse tla etsahala

Amitriptyline e ka baka litlamorao tse ts'oanang le tse etsahalang ha ho etsoa li-antidepressants tse ling tsa tricyclic. Tse ling tsa litlamorao tse thathamisitsoeng ka tlase (ho opeloa ke hlooho, ho thothomela, ho se tsotelle, ho sokela le ho fokotseha ha libido) le tsona e ka ba matšoao a khatello ea maikutlo mme hangata oa fokotseha ha mmuso oa khatello o ntlafala.

Likopano tse latelang li sebelisoa lethathamong le ka tlase. WHO e khethile mantsoe a MedDRA bakeng sa lihlopha tsa tsamaiso ea mekhatlo: hangata (> 1/10), hangata (> 1/100, 1/1000, 1/10 000,

Ho sebelisana le lithethefatsi tse ling:

Amitriptyline e ka ntlafatsa phello ea joala, barbiturates le lintho tse ling tse sithabetsang tsamaiso ea methapo e kholo.

Tšebeliso e kopaneng le li-inhibitors tsa MAO e ka lebisa khatellong ea khatello ea mali. Kaha amitriptyline e ntlafatsa ts'ebetso ea li-anticholinergics, tsamaiso e tšoanang le bona e lokela ho qojoa.

E ntlafatsa ts'ebetso ea sympathomimetics ea adrenaline, norepinephrine, jj., Ka lebaka la sena, anesthetics ea lehae e nang le lintho tsena ha ea lokela ho sebelisoa ka nako e le ngoe le amitriptyline.

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

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

Ka tšebeliso ea nako e le 'ngoe le cimetidine, hoa khoneha ho fokotsa metabolism ea amitriptyline, ho eketsa khatello ea mali ka plasma le nts'etsopele ea litlamorao tse chefo.

Mofumahali

Amitriptyline ke karolo ea sehlopha sa ba bararo. Ona ke mofuta oa amine ea tertiary, e leng eona ntho ea mantlha sehlopheng sa batho ba bararo, hobane e batla e sebetsa ka tsela e tšoanang ka vivo e le inhibitor ea serotonin le norepinephrine.

Sehlahisoa se ka sehloohong sa ho bola, nortriptyline, ke enhibitor e matla ea norepinephrine, empa e ka thibela ho ts'oaroa ha serotonin. Amitriptyline e na le thepa e matla ea li-anticholinergic, sedative le antihistaminergic, mme ka ho eketsehileng e khona ho hlahisa litlamorao tsa catecholamines.

Khatello ea DBD ea karolo ea boroko ke sesupo sa litlamorao tse sebetsang tsa litlhare tsa khatello ea maikutlo. Li-Tricyclics, le ho tlatsetsa ho tsona tse khethiloeng tsa serotonin reuptake inhibitors, hammoho le li-MAO, li thibela ts'ebetso ea karolo ea BDH, hape li ntlafatsa mohato oa boroko bo tebileng (wave-slowly).

Amitriptyline e ntlafatsa lefu le fokotsang mohopolo.

Litlamorao tse susumetsang tsa amitriptyline ke karolo ea bohlokoa ea ho phekola khatello ea maikutlo moo ho nang le thabo e eketsehileng, ho tšoenyeha, ho tšoenyeha le mathata a ho robala. Litlamorao tsa khatello ea maikutlo li qala ho hlaha kamora libeke tse 2 ho tloha ho qala kalafo, athe phello ea mokokotlo oa lithethefatsi ha e fokotsehe.

Melemo ea li-analgesic ea lithethefatsi ha e tsamaisane le lithethefatsi tsa antidepressant, hobane analgesia e qala haholo pejana ho feta hore liphetoho li fetoha. Hangata, tekanyo e tlase haholo e lekane ho fumana ts'ebetso ena ho feta ho fana ka liphetoho mokhoeng oa mokuli.

Mofumahali

Kamora tsamaiso ea ka hare, letšoao la bioavailability la amitriptyline le ka bang 60%. Plasma protein e tlamang ke hoo e ka bang 95%. Khokahano ea tlhoro kahare ho seramu ea mali ea karolo e sebetsang e fihla lihora tse ka bang 4-10 kamora ts'ebeliso mme e lula e tsitsitse.

Ts'ebetso ea metabolism ea karolo e sebetsang e etsahala ka hydroxylation, hammoho le demethylation. Sehlahisoa se ka sehloohong sa ho bola ke nortriptyline.

Bophelo ba halofo ea amitriptyline bo maemong a lihora tse 16 ho isa ho tse 40 (karolelano ke lihora tse 25), 'me halofo ea bophelo ba nortriptyline ke lihora tse ka bang 27. Khatiso ea mantlha ea kalafo e thehiloe kamora libeke tse 1-2.

Mofuta oa amitriptyline o hlaha haholo ka moroto, 'me ka holim'a moo, ka bongata bo nyane, bo qhekelletsoeng ka har'a mantle.

Amitriptyline, le eona nortriptyline, e ka feta ka har'a placenta le ho kenella ka lebese la matsoele ka litekanyetso tse nyane.

Litla-morao

Amitriptyline e ka baka litlamorao tse ts'oanang le tse bakoang ke li-antidepressants tse ling tsa tricyclic. Tse ling tsa litlamorao tse thathamisitsoeng ka tlase tse kang ho opeloa ke hlooho, ho thothomela, ho se tsotelle, ho sokela, le ho fokotseha ha libido, e ka ba matšoao a khatello ea maikutlo mme a atameleha ho fokotseha ka ntlafatso ea khatello ea maikutlo.

Boemo ba litlamorao bo bontšoa e le:

hangata haholo (> 1/10), hangata (ho tloha> 1/100 ho isa 1/1000 ho isa ho 1/10000 ho