Zeptol (Zeptol)

Motsoako oa litlhare oa antiepileptic o tsoang ho tricyclic iminostilbene.
Lithethefatsi: ZEPTOL

Ntho e sebetsang ea lithethefatsi: carbamazepine
ATX Encoding: N03AF01
KFG: Anticonvulsant
Nomoro ea ngoliso: P. 011348/01
Letsatsi la ho ngolisa: 07.07.06
Mong'a reg. Degree: Letsatsi la Liindasteri tsa Lihlahisoa tsa Letsatsi

Foromo ea tokollo ea Zeptol, sephutheloana sa lithethefatsi le sebopeho.

Lipilisi
1 tab
carbamazepine
200 mg

Li-pcs tse 10 - metsu ea aluminium (10) - lipakete tsa karete.

Matlapa a lokolotsoeng a brown-koae a tšehetsoeng a na le "li-biconvex" tse nang le kotsi lehlakoreng le le leng.

1 tab
carbamazepine
200 mg

Baeti: ethyl cellulose, cellcose ea microcrystalline, starch, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, eudrazit E100, titanium dioxide, polyethylene glycol 6000, oxide e khubelu ea iron, oxide oxide.

Li-pcs tse 10 - liphutheloana ntle le cell contour (3) - lipakete tsa karete.

Matlapa a lokolotsoeng a brown-koae a tšehetsoeng a na le "li-biconvex" tse nang le kotsi lehlakoreng le le leng.

1 tab
carbamazepine
400 mg

Baeti: ethyl cellulose, cellcose ea microcrystalline, starch, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, Eudraite E100, titanium dioxide, polyethylene glycol 6000, oxide e khubelu ea tšepe, oxide oxide, 2208 hydroxypropyl methyl cellulose.

Li-pcs tse 10 - liphutheloana ntle le cell contour (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.

Ts'ebetso ea pharmacological ea Zeptol

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

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

Litla-morao tsa Zeptol:

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, edema, ho nona ka boima ba 'mele, ho fokotseha ha osmolality ea plasma, maemong a mang - porphyria e matla, khaello ea folic acid, mathata a metabolism ea calcium, 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 ts'ebeliso ea Zeptol.

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 ha Zeptol 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 CYP3A4 isoenzyme system, ho ka khoneha ho potlakisa metabolism ea carbamazepine, ho fokotsa mokokotlo oa eona ho plasma ea mali, le ho fokotsa phello ea kalafo.

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

Ka tšebeliso ea nako e le 'ngoe le valproic acid, ho fokotseha ha khatello ea carbamazepine le ho fokotseha ho hoholo hoa khatello ea "valproic acid" plasma ea mali hoa khoneha. Ka nako e ts'oanang, ts'ubuhlellano ea carbamazepine metabolite, carbamazepine epoxide, ea eketseha (mohlomong e le ka lebaka la thibelo ea phetoho ea eona ea carbamazepine-10,11-trans-diol, eo hape e nang le ts'ebetso ea anticonvulsant, kahoo litlamorao tsa ts'ebelisano ena li ka hlahisoa, empa litla-morao 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 e ka eketsa khatello ea carbamazepine maling a mali le 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 mahloriso a plasma ea metabolacology e sebetsang ea caracamazepine-10,11-epoxide.

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

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

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

Tekanyetso le tsamaiso

Lipilisi ka hare, batho ba baholo le bacha ba fetang lilemo tse 15 ka lefu la sethoathoa le neuralgia Tekanyetso ea pele ke 200 mg makhetlo a 1-2 ka letsatsi le keketseho ea butle-butle ea tekanyetso (100 mg e nang le karohano ea beke e le 'ngoe) ho lethal dose e nepahetseng ea kalafo - 600-1200 mg / ka letsatsi (lethal dose le phahameng la letsatsi - 1,8 g). Ka khatello ea kelello ea manic Tekanyetso ea pele ke 400 mg / ka letsatsi, e arotsoe ka litekanyetso tse peli, mme keketseho ea butle butle ho isa ho 600 mg / letsatsi (lethal dose le leholo la letsatsi le letsatsi). Bana ba ka tlase ho selemo se le seng (makhetlo a 2 ka letsatsi) - 100-200 mg / letsatsi, lilemo tse 1-5 - 200-400 mg / letsatsi, lilemo tse 5-10 - 400-600 mg / letsatsi, lilemo tse 11-15 - 600-1000 mg / letsatsi

Litafole tse khutlisitsoeng tsa Retard: ka hare, nakong ea lijo kapa ka mor'a lijo tse nang le mokelikeli o monyane. Ka lefu la sethoathoa: batho ba baholo, tekanyetso ea pele - makhetlo a 200 mg ka makhetlo a mabeli ka letsatsi, ebe lethalinyana le eketseha hanyane ka hanyane - 400 mg makhetlo a 2-4 ka letsatsi. Bana: ka tekanyo ea 10-20 mg / kg, likhoeli tse 4-12 - 100-200 mg ka litekanyetso tsa 1-2, lilemo tse 1-5 - 200-400 mg ho litekanyetso tsa 1-2, lilemo tse 5-10 - 400-600 mg ho litekanyetso tse 2-3, lilemo tse 10-15 - 600-1000 mg ho litekanyetso tse 3.

Trigeminal neuralgia: tekanyetso ea pele ke 200-400 mg / ka letsatsi, joale lethal dose le eketseha butle-butle, haeba ho hlokahala, ho fihlela ho 600-800 mg ho litekanyetso tse 'maloa. Kamora ho nyamela ha bohloko, tekanyetso e fokotsoa ho 200 mg / ka letsatsi.

Thibelo ea mathata a amanang le mathata: bekeng ea pele, lethal dose ea letsatsi le letsatsi ke 200-400 mg, ka karolelano ea lethal dose ea letsatsi le letsatsi e eketseha (ka 1 letlapa le le leng ka beke) ho ea ho 1000 mg le ho nkuoa bakeng sa tekanyetso ea 3-4.

Nako ea kalafo e behiloe ka bonngoe.

Sokolla foromo le sebopeho

• matlapa: sephara, chitja, e tšoeu, ka lehlakoreng le leng le nang le "ZEPTOL 200" le bevel, ka lehlakoreng le leng - le mola o arohanang (li-pcs tse 10 ka mola oa foil ea aluminium, mokotleng oa karete ea mekotla e 10),
• Litafole tse lokolotsoeng lifiliming: biconvex, pota, bosootho bo bobebe, tse nang le kotsi ka lehlakoreng le leng (li-pcs tse 10. mokokotlong oa foil ea aluminium, ka lebokoseng la mekotla ea mela e meraro).

Sekete se seng le se seng se na le litaelo tsa ts'ebeliso ea Zeptol.

Letlapa le le leng le na le:

• ntho e sebetsang: carbamazepine - 200 mg,
• likarolo tse ling hape: hypromellose 2910 (Metocel E5), colloidal silicon dioxide, selicone cellulose, starch ea poone, povidone K 30, sodium propyl parahydroxybenzoate (sodium propyl paraben), bronopol, e hloekisitsoeng ea magnesium stearate, talc e hloekisitsoeng, sodium lauryl sodium.

Letlapeng le le leng le leng, ketso ea nako e telele, e koahetsoeng ka filimi, e na le:

• ntho e sebetsang: carbamazepine - 200 kapa 400 mg,
• likarolo tse ling hape: hypromellose 2208 (Metocel K4M) - tekanyetso ea 400 mg, "cellcrystalline cellulose" ethyl cellulose M50, starch ea poone, colloidal silicon dioxide, talc e hloekisitsoeng, magnesium stearate, croscarmellose sodium,
• ho kopitsa filimi: kopolymer ea butyl methacrylate, dimethylaminoethyl methacrylate le methyl methacrylate (1: 2: 1) (Eudragit E-100), macrogol 6000 (polyethylene glycol 6000), talc e hloekisitsoeng, magnesium stearate, titanium diode, oxide e putsoa.

Mofumahali

Carbamazepine ke derivative ea iminostilbene, e bonts'ang sephetho se phatlalalitsoeng sa anticonvulsant (antiepileptic) le antidepressant (thymoanaleptic), litekanyetso tse matla tsa antipsychotic le standardotimic. Setlhare se boetse se bonts'a thepa ea analgesic, haholo-holo ho bakuli ba nang le trigeminal neuralgia.

Mokhoa oa ts'ebetso oa ntho e sebetsang ha o utloisisehe ka botlalo. Ho nahanoa hore phello ea eona ea anticonvulsant e bakoa ke ho fokotseha ha bokhoni ba li-neuron ho fana ka khafetsa e phahameng ea ho hlaha ha ntho e pheta-phetoang ka lebaka la thibelo ea ts'ebetso ea liteishene tsa sodium. Ntle le moo, ho bonahala eka ho thibela ho lokolloa ha li-neurotransmitters ka ho thibela liketane tsa sodium ea presynaptic le ho hlaha ha bokhoni ba ts'ebetso le hona ho bohlokoa, ho lebisang ho fokotseheng ha phetiso ea synaptic.

Mochine oa ts'ebetso oa carbamazepine o kanna oa kenyelletsa li-gamma-aminobutyric acid receptors (GABA), e kanna ea amahanngoa le liteishene tsa calcium. Mohlomong tšusumetso e hlahisoang ke ntho e sebetsang tsamaisong ea li-modulators tsa neurotransication ha e na taba ea bohlokoa. Phello ea antidiuretic ea carbamazepine e ka amahanngoa le phello ea hypothalamic ho osmoreceptors, e etsoang ka tšusumetso ea secretion ea antidiuretic hormone (ADH), hape e hlahisoa ke phello e tobileng ho li-renal tubules.

Katleho ea lithethefatsi tsa antiepileptic e ile ea bonoa kalafong ea ho ts'oaroa ka bongata ha tonic-clonic, ho ts'oaroa (ho lekana) ha sethoathoa, se tsamaeang kapa se sa tsamaellaneng le kakaretso ea kakaretso, hammoho le mefuta e fapaneng ea ho haptjoa. E le molao, ts'ebeliso ea Zeptol ha e na thuso bakeng sa ho ts'oaroa hanyane - petit mal, myoclonic e ts'oaroang le ho ba sieo.

Nakong ea kalafo ea carbamazepine ho bakuli ba nang le lefu la sethoathoa (haholo-holo baneng le lilemong tsa bocha), ho fokotseha ho hoholo ha matšoao a ho tšoenyeha le khatello ea maikutlo ho tlalehiloe, 'me sethethefatsi se boetse se bakile ho fokotseha ha ho teneha le ho ba mabifi. Bophahamo ba tšusumetso ea ntho e sebetsang ho li-indices tsa psychomotor le ts'ebetso ea kelello bo itšetlehile ka tekanyetso ea eona. Tšusumetso ea anticonvulsant e ka qala ho hlaha kamora lihora tse 'maloa kapa kamora matsatsi a' maloa (ka linako tse ling e batla e le khoeli e le 'ngoe hamorao ka lebaka la ts'ebetso ea metabolism).

Khahlano le semelo sa neuralgia ea bohlokoa le ea bobeli ea boraro, maemong a mangata, carbamazepine e hanyetsa ho ba teng ha litlhaselo tsa bohloko. Ho fokola ha lefu la bohloko le neuralgia ea trigeminal ho bonoa kamora lihora tse 8-72.

Zeptol e fana ka tlhaiso ea ho tlosoa hoa joala e le keketseho ea monyetla oa ho ikemisetsa ho ts'oaroa, eo, joalo ka molao, e fokotsoang boemong bona, mme e fokotsa botebo ba matšoao a lefu lena (ho thothomela, ho teneha ho hoholo, mathata a gait).

Antimaniacal (tšebetso ea antipsychotic) e ts'oaroa kamora matsatsi a 7-10 mme e kanna ea ba ka lebaka la khatello ea metabolism ea norepinephrine le dopamine.

Ho boloka boemo bo tsitsitseng ba carbamazepine maling ho netefatsoa ka ho sebelisa mofuta oa nako e telele oa lithethefatsi makhetlo a 1-2 ka letsatsi.

Matlapa a lokolotsoeng a matla

• lefu la sethoathoa: ho ts'oaroa ka mokhoa o bobebe / o rarahaneng oa sethoathoa (ka ho lahleheloa ke letsoalo kapa ho hloka tsebo ea bobeli), ho ts'oaroa ke sethoathoa sa tonic-clonic epileptic, mefuta e fapaneng ea ho ts'oaroa,
• lefu la bohloko ba neurogenic le neuralgia ea trigeminal,
• idiopathic neuralgia ea glossopharyngeal nerve, neuralgia e tloaelehileng le ea atypical ea methapo e mengata ea methapo le idiopathic trigeminal neuralgia,
• ho opeloa ke lefu la tsoekere, ho opeloa ke methapo ea kutlo le boteng ba lefu la tsoekere, polyuria le polydipsia ea tlhaho ea neurohormonal khahlanong le lefu la tsoekere le lefu la tsoekere le bohareng.
• lefu la ho itlopa joala (ho tsitsipana, ho hlasimoloha ho hoholo, ho tšoenyeha, likhathatso tsa boroko),
• maemo a hlobaetsang a manic le kalafo e tšehetsang ea mathata a amanang le ho ferekana e le ho thibela ho ata kapa ho nyenyefatsa ho teba ha lipono tsa bona tsa bongaka.

Contraindication

Ehlile

• mafu a masapo a hematopoiesis (anemia, leukopenia),
• atrioventricular block (AV block),
• tšebeliso e kopaneng le litokisetso tsa lithium le monoamine oxidase inhibitors (MAO),
• hypersensitivity ho efe kapa efe ea likarolo tsa Zeptol, hammoho le lintho tse nang le sebopeho se kang carbamazepine, ho etsa mohlala, li-antidepressants tsa tricyclic.

Litlatsetso tse ling bakeng sa litafole tse nkileng nako e telele:

• nalane ea liketsahalo tsa thibelo ea masapo a hematopoiesis kapa mofuta leha e le ofe oa porphyria,
• lilemo ho isa ho lilemo tse 4.

Tlatsetso e 'ngoe ea Zeptol ka mokhoa oa matlapa ke porphyria ea nakoana (ho kenyeletsa nalane).

Setsoalle (sebelisa lithethefatsi tsa antiepileptic ka tlhokomeliso):

• pelo e sa sebetseng (CHF),
• ts'ebeliso e mpe ea renal le / kapa ea sebete,
• tlhahiso ea hyponatremia: ho haella ha adrenal cortex, syndrome ea methapo ea methapo ea methapo ea methapo ea kutlo, hypothyroidism, hypopituitarism,
• Prostatic hyperplasia,
• inhibition of marrow hematopoiesis, tšebeliso e tšoanang ea meriana (nalane),
• khatello e eketsehileng ea methapo,
• tšebeliso e mpe ea tahi, hobane ka lebaka la bokhoba ba ts'ebetso ea methapo ea methapo (CNS), biotransformation ea carbamazepine e ntlafalitsoe,
• botsofali
• tšebeliso e kopaneng le sedative-hypnotics.

Zeptol, litaelo tsa tšebeliso: mokhoa le litekanyetso

Matlapa a Zeptol a nooa ka molomo ka metsi a manyane ka nako ea lijo, kamora lijo kapa lipakeng tsa lijo. Moriana o ka laetsoa ka monotherapy hape e le karolo ea kalafo e phethahetseng.

Matlapa a lokisitsoeng a lokolotsoeng a tlameha ho metsoa a le 1, kapa, haeba a laetsoe ke ngaka, ½, a sa tshekeloa. Kaha ntho e sebetsang e lokolloa hanyane ka hanyane mme hanyane ka hanyane ho tsoa litafoleng tse lokolotsoeng nako e telele, Zeptol e lokela ho nooa makhetlo a 2 ka letsatsi, mofuta o nepahetseng oa kalafo o khethoa ke ngaka. Haeba ho hlokahala hore o tlohele ho sebelisa litafole tsa tloaelo ho ea ho nako e telele, ho ea ka boiphihlelo ba bongaka, bakuli ba bang ba ka hloka ho eketsa tekanyetso ea moriana e neng e nkuoe pele.

Ka kalafo ea lefu la sethoathoa, ho bohlokoa ho fana ka matlapa a Zeptol ka mokhoa oa monotherapy. Hoa hlokahala ho qala ho sebelisa lithethefatsi ka tekanyetso e nyane ea letsatsi le letsatsi, e lokelang ho eketsoa hanyane ka hanyane ho fihlela phello e lakatsehang e fihlelle. Ha ho khethoa lethal dose e nepahetseng, ho kgothaletsoa ho tseba hore na carbamazepine e maling plasma e joang. Tabeng ea ho khethoa ha Zeptol ho kalafo ea antiepileptic e neng e entsoe pele, ho khomarela ha eona ho etsoa butle butle, athe litekanyetso tsa meriana li se li sa fetohe, empa ha ho hlokahala, li etsa khalemelo e nepahetseng. Haeba mokuli a lebetse ho nka tekanyetso e latelang ea carbamazepine ka nako e loketseng, e lokela ho nkuoa hang hoba hang ha o fumana sena, leha ho le joalo, u ke ke ua sebelisa tekanyetso e habeli ea Zeptol.

Tekanyetso e khothalletsoang ho latela lipontšo:

• lefu la sethoathoa: batho ba baholo ba nka Zeptol makhetlo a 1-2 ka letsatsi ka tekanyetso ea pele ea 100-200 mg, ebe lethalinyana le eketseha butle ho isa ho 400-600 mg makhetlo a 2 ka letsatsi, lethal dose le leholo la letsatsi ha lea lokela ho feta 1600-2000 mg, ho bana ba baholo ho lilemo tse 4 kamohelo e ka qala ka tekanyetso ea letsatsi le letsatsi ea 100 mg, ebe beke ka 'ngoe lethalano le ka eketsoa ka 100 mg, bana ba lilemo tse 4 le ba nyane ba fuoa Zeptol (matlapa) ka tekanyetso ea letsatsi le letsatsi ea 20-60 mg mme ebe ba e eketsa letsatsi le leng le le leng ka 20- 60 mg, e ts'ehetsa litekanyetso tsa letsatsi le letsatsi bakeng sa bana, e thehiloe ka tekanyo ea 10-20 mg / kg, e arotsoe ke n likamohelo tse 'maloa, likhakanyo tse khothalelitsoeng tsa letsatsi le letsatsi ho bana bakeng sa litafole (ho latela lilemo): tlase ho selemo se le seng - 100-200 mg ka tekanyetso e le' ngoe, lilemo tse 1-5 - 200-400 mg ka tekanyetso ea 1-2, lilemo tse 6-10 - 400-600 mg ho litekanyetso tse 2-3, a le lilemo li 11 - 5--1-1000 mg ka litekanyetso tse 2-3, a khothaletsoa ho boloka litekanyetso tsa bana letsatsi le letsatsi bakeng sa litafole tse lokolotsoeng (litekong tse 'maloa): lilemo tse 4-5 - 200-400 mg Lilemo tse 6 - 10 - 400-600 mg, lilemo tse 11 - 15 - 600-1000 mg,
• trigeminal neuralgia le neurogenic pain syndrome: makhetlo a 2 ka letsatsi, 100-200 mg ka 'ngoe, ka nako e tlang lethathamo la letsatsi le letsatsi le ka eketseha ka se seng ho feta 200 mg (ho fihlela ho 600-800 mg) ho fihlela bohloko bo kokobela, ebe tekanyo eo e fokotsoa hore e se sebetse hantle, kamora ho qala ha thupelo, sephetho se nepahetseng se atisa ho bonoa kamora matsatsi a 1-3, kalafo ea nako e telele, maemong a ho tlosoa ha carbamazepine, bohloko bo ka khutlela hape, ho bakuli ba tsofetseng, tekanyo ea pele e lokela ho ba 100 mg makhetlo a 2 ka letsatsi,
• lefu la tsoekere le lefu la tsoekere le tsamaeang le bohloko: makhetlo a 2-5 ka letsatsi, 200 mg (matlapa), makhetlo a 2 ka letsatsi, 200- 300 mg (matlapa a lokollang),
• lefu la tsoekere (litafole): ho batho ba baholo, ka makhetlo a 2-3 ka letsatsi, 200 mg ka ngoe,
• bohloko le marang-rang a methapo ea kutlo e khahlano le lefu la tsoekere: makhetlo a 2 ka letsatsi, 200-300 mg,
• idiopathic glossopharyngeal neuralgia, trigeminal neuralgia khahlano le semelo sa sclerosis e ngata le idiopathic trigeminal neuralgia (matlapa a nkileng nako e telele): makhetlo a 2 ka letsatsi, 200-400 mg,
• polyuria le polydipsia ea tlhaho ea neurohormonal e nang le lefu la tsoekere la "genesis" ea mantlha (litafole tse tsitsitseng): ho batho ba baholo, tekanyetso e tloaelehileng ke makhetlo a 200 mg makhetlo a 2 ka letsatsi, bana ba fokotsa tekanyetso ho latela lilemo le boima ba 'mele,
• syndrome ea ho tlosa joala: tekanyetso e tloaelehileng ke makhetlo a 200 mg makhetlo a 2 ka letsatsi, maemong a boima matsatsing a pele a thupelo, tekanyetso e nyolohela ho 600 mg makhetlo a 2 ka letsatsi e lumelloa, qalong ea kalafo e nang le lipontšo tse matla tsa ho tlohela joala, Zeptol e sebelisoa hammoho le kalafo ea detoxation le sedative le hypnotics (chlordiazepoxide, clumbwaazole), kamora ho phethoa ha karolo e mpe haholo, lithethefatsi li ka sebelisoa ka mokhoa oa monotherapy,
• mathata a amanang le kalafo - kalafo le prophylaxis (matlapa), mathata a amanang le ho ferekana - pheko ea tlhokomelo, maemo a hlobaetsang a manonyeletso (matlapa a matlafatsang): beha litekanyetso tsa letsatsi le letsatsi tsa 200-400 mg ka beke ea pele ea thupelo, ebe o eketsa lethal dose beke le beke ka 200 mg, tlisa ho 1000 mg ka letsatsi, le eona e arotsoe ka litekanyetso tse peli.

Nako ea phekolo e behiloe ke ngaka e eang, kalafo e lokela ho phethoa butle butle. Ho fetohela ho nka Zeptol ho hlokahala butle butle, mme ho fokotseha butle butle ka tekanyetso ea moriana o fetileng.

Litlamorao

Ha ho lekola makhetlo a hlahang ha liketsahalo tse bohloko, ho sebelisitsoe gradation tse latelang: khafetsa - 10% kapa ho feta, khafetsa - ho tloha ho 1% ho isa ho 10%, hangata - ho tloha 0,1% ho isa ho 1%, ka seoelo - ho tloha 0,01% ho isa ho 0.1% , tse sa tloaelehang haholo - ka tlase ho 0,01%:

• CNS: khafetsa - maikutlo a ho tepella, ho tsekela, ho otsela, ataxia, khafetsa - diplopia, likhathatso tsa bolulo (ho kenyeletsa pono e fifalitsoeng), hlooho e bohloko, hangata - nystagmus, ho sisinyeha ho sa tsitsang ha boipheliso (litumelo, ho thothomela, ho thothomela ho ferekanyang - asterixis , dystonia), seoelo - likotsi tsa oculomotor, dyskinesia ea orofacial, mathata a puo (dysarthria), paresthesias, peripheral neuropathy, paresis, choreoathetosis, ka seoelo haholo - litla-morao tsa tatso, malignant antipsychotic syndrome,
• tsamaiso ea methapo ea pelo (CVS): ka seoelo - ho fokotseha / ho eketseha ha khatello ea mali (BP), ho ts'oaroa ha pelo le pelo, ho fokotseha haholo - arrhythmias, bradycardia, AV block ka ho akheha, CHF, thromboembolism (ho kenyeletsa le pulmonary artery), thrombophlebitis ho putlama, ho mpefala ha lefu la pelo (CHD),
• mathata a kelello: ka seoelo - ho tšoenyeha, ho ferekana, khatello ea maikutlo, ho ipolaisa tlala, ho bona lintho ka mahlo, ho sithabela maikutlo, ho ferekana kelellong, ka seoelo - ts'ebetso ea psychosis,
• hypersensitivity reaction (ka nts'etsopele ea karabelo e bontšitsoeng ka tlase, kalafo e nang le Zeptol e lokela ho emisoa): ka seoelo - lieha-mofuta oa li-hypersensitivity tse ngata tse nang le methapo ea letlalo, feberu, leukopenia, arthralgia, eosinophilia, lymphadenopathy, vasculitis, matšoao a tšoanang le lymphoma. litšila li bonoa ka mekhoa e fapaneng), litho tse ling (ho kenyeletsa myocardium, manyeme, matšoafo, liphio, kolone ), Seoelo - meningitis aseptic le myoclonus le eosinophilia pheriferale, angioedema, anaphylactic itšoara joang,
• karabelo: hangata khafetsa - urticaria (ho kenyelletsoa haholo) dermatitis, hangata - erythroderma, dermatitis e fumanehang ka seoelo, seoelo - ho senyeha ha moriri, mofufutso, makhopho, 'mala oa letlalo , ts'ebetso ea photosensitization, erythema multiforme le nodosum, chefo ea chefo e amanang le lefu la tlhaho, Stevens-Johnson syndrome, liketsahalo tse ikhethileng tsa hirsutism li tlalehiloe (kamano ea mabaka a ponahalo ea phetoho ena ka tšebeliso ea Zeptol ha se molomo. e ntlafalitsoe)
• sistimi ea hepatobiliary: hangata khafetsa - ts'ebetso e eketsehang ea gamma-glutamyltransferase (GGT) ka lebaka la ho kenella ha enzyme ka har'a sebete (hangata ha e na bohlokoa ba bongaka), hangata - ts'ebetso e eketsehileng ea alkaline phosphatase (ALP) maling, hangata - liprotheine tse eketsehang, ka seoelo - timetso intrahepatic bile ducts, e lebisang ho fokotseha hoa palo ea bona, jaundice, hepatitis ea parenchymal (hepatocellular), mofuta oa cholestatic kapa e tsoakiloeng, ka seoelo - ho hloleha ha sebete, lefu la sebete la sethoathoa,
• tsamaiso ea tšilo ea lijo: hangata khafetsa - ho hlatsa, ho nyekeloa ke pelo, hangata - molomo o omileng, ka seoelo - ho sokela / lets'ollo, ka seoelo - bohloko ba ka mpeng, bo sa tloaelehang haholo - stomatitis, glossitis, pancreatitis,
• hematopoietic litho tsa mmele: hangata haholo - leukopenia, hangata - eosinophilia, thrombocytopenia, ka seoelo - folic acid e haelloa, lymphadenopathy, leukocytosis, ka seoelo haholo - phokolo ea mali, 'nete ea erythrocyte aplasia, aplasiki / megaloblastic / hemolytic anemia, pancytopenia / agrenulocumeia interphytent porphyria, reticulocytosis,
• Sistimi ea lefu la genitourinary: e sa tloaelehang haholo - ho boloka urine, ho ntša metsi khafetsa, ho hlaseloa ka nephritis, ho senyeha ha sesapo (oliguria, hematuria, albinuria, ho eketseha ha urea / azotemia), ho se sebetse hantle ha masapo, ho fokotsa palo ea monna le ts'ebetso, ho se sebetse hantle ka thobalano.
• endocrine system le metabolism: khafetsa - ho eketseha ha boima ba 'mele, ho boloka mokelikeli, edema, ho fokotseha ha osmolarity le hyponatremia ka lebaka la phello e ts'oanang le ADH, eo hangata e isang ho insution hyponatremia (tšebeliso ea lino tse tahang tsa metsi), e etsahalang ka hlooho, ho hlatsa, mokhathala , mathata a methapo le ho ferekana kelellong, ka seoelo - keketseho ea prolactin ea mali e nang le galactorrhea, gynecomastia kapa kantle ho bona, liphetoho mesebetsing ea tšoelesa ea qoqotho - ho fokotseha ha litaba tsa L-thyroxine (thyroxine, mahala thyroxine, triiodothyronine) le keketseho ea boemo ba qoqotho ea qoqotho ea qoqotho (TSH) (hangata e sa tsamaisane le lipontšo tsa tleliniki), metabolism ea masapo a senyehileng (ho fokotseha hoa litekanyetso tsa mali tsa 25-hydroxycholecalciferol le calcium), e bakang osteomalacia / osteoporosis, keketseho ea cholesterol, ho kenyelletsa cholesterol Li-lipoprotein tse phahameng tsa cholesterol, le triglycerides,
• litho tsa methapo ea kutlo: tse sa tloaelehang haholo - conjunctivitis, leru la lense, khatello e eketsehileng ea methapo, ho senyeha ha litsebe, ho kenyelletsa tinnitus, liphetoho ponong ea molumo, hypoacusia, hyperacusis,
• Sistimi ea musculoskeletal: ka seoelo - mesifa ea mesifa, ka seoelo - bohloko ba mesifa kapa maqhubu, arthralgia.

Lintho tse fapaneng tse tla etsahala

Qalong ea kalafo kapa ha u sebelisa tekanyetso ea pele ea moriana le kalafo ea bakuli ba tsofetseng, ho ka hlaha mefuta e meng e fapaneng le mohlala, ho tloha tsamaisong ea methapo ea methapo (hlooho, hlooho, ataxia, ho otsela, bofokoli bo akaretsang, diplopia) lehlakoreng la mokokotlo oa mokokotlo (ho nyekeloa ke pelo, ho hlatsa) kapa ho ts'oaroa ke letlalo.

Hangata karabelo e mpe e tsamaeang le tekanyetso ea meriana e bakoa ke matsatsi a 'maloa ka boiketsetso le kamora phokotso ea nakoana ea lethal dose la lithethefatsi.

Lehlakore la mali: leukopenia thrombocytopenia, eosinophilia, leukocytosis, lymphadenopathy, folic acid e haellang, agranulocytosis, aplasia anemia, pancytopenia, erythrocytic aplasia, anemia, megaloblastic anemia, anemia ea porphyria, porphyriaho, porphyriaho.

Ho tsoa ho sesole sa 'mele : mofuta o liehang oa mefuta e mengata ea li-hypersensitivity tse nang le feberu, lesapo la letlalo, vasculitis, lymphadenopathy, matšoao a tšoanang le lymphoma, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly le phetoho ea ts'ebetso ea sebete le mofuta oa bile oa ho hlohlona oa duct) . Ho ka ba le mathata a tsoang litho tse ling (mohlala, sebete, matšoafo, liphio, manyeme, myocardium, colon), aseptic meningitis e nang le myoclonus le eosinophilia, anaphylactic reaction, angioedema, hypogammaglobulinemia.

Sistimi ea Endocrine : edema, ho boloka mokelikeli oa metsi, ho fokotsa boima ba 'mele, ho fokotsa boima ba' mele le ho fokotseha ha osmolarity ea plasma ka lebaka la phello e ts'oanang le ADH, eo maemong a sa tloaelehang e lebisang ho tšoaetso ea mali, e tsamaeang le lefu la ho hlatsa, ho hlatsa, hlooho, pherekano le mathata a methapo ea mali, litekanyetso tse eketsehang tsa prolactin, e tsamaeang le kapa e sa tsamaisane le liponahatso tse kang galactorrhea, gynecomastia, mathata a metabolism ea masapo (ho fokotseha hoa boemo ba calcium le 25-hydroxycolcalcaliferol maling a mali), e lebisa ho osteomalacia / osteoporosis maemong a mang - keketseho ea khoholeho ea cholesterol, ho kenyelletsa le letsoalo le phahameng la choleopolone le triglycerides.

Ho tloha ka lehlakoreng la metabolism le khaello ea phepo e nepahetseng: khaello ea folate, takatso ea lijo e fokotsehile, porphyria e mpe haholo (porphyria e ngata e kopaneng le porphyria e sa tsoakoang), porphyria e seng ea kahare (letlalo la morao la porphyria).

Ka lehlakoreng la psyche: hallucinations (tse bonoang kapa tse hlalosang mantsoe), khatello ea maikutlo, ho felloa ke takatso ea lijo, ho tšoenyeha, ho ba mabifi, ho ferekana, pherekano, ts'ebetso ea kelello.

Ho tsoa tsamaisong ea methapo: ho tsekela, ho tetebela, ho otsela, ho fokola ka kakaretso, ho opeloa ke hlooho, ho diplopia, ho senyeha ka bolulo (mohlala, pono e fifalitsoeng), ho sisinyeha ho sa tsitsang ha motho a etsa mohlala (mohlala, ho thothomela, "ho ferekana" "dyskinesia", "" "" "" "" "" "" "" "" "" "" "" "" "" "" "glutor," dyskinesia. (mohlala, dysarthria kapa puo e sa tsitsang), choreoathetosis, peropheral neuropathy, paresthesia, bofokoli ba mesifa le paresis, ho senyeha ha tatso, lefu le kotsi la antipsychotic, aseptic meningitis le myoclonia le periphery. eskoy eosinophilia, dysgeusia.

Ka lehlakoreng la setho sa pono: khathatso ea bolulo (mohlala, pono e fifalitsoeng), ho koaheloa ke lense, conjunctivitis, khatello e eketsehileng ea methapo.

Karolong ea litho tsa kutlo: mathata a kutlo, a joalo ka tinnitus, kutlo e eketsehileng ea kutlo, ho fokotseha ha kutloisiso ea kutlo, pono e senyehileng ea molumo.

Ho tsoa ho tsamaiso ea methapo ea pelo : intracardiac conductionokoneist arterial hypertension kapa arterial hypotension bradycardia, arrhythmia, syncope blockade, ho potoloha ho potoloha, ho nyekeloa ke pelo, ho mpefatsa ha lefu la ischemic, thrombophlebitis, thromboembolism (jk. pulmonary embolism).

Ho tsoa ts'ebetsong ea phefumoloho : Litlamorao tsa Pulmonary hypersensitivity tse tšoauoang ke feberu, ho hema hanyane, pneumonitis kapa pneumonia.

Ho tsoa ho tšilo ea lijo: ho nyekeloa ke pelo, ho hlatsa, molomo o omileng, lets'ollo kapa ho sokela, bohloko ba ka mpeng, glossitis, stomatitis, pancreatitis.

Ho tsoa ts'ebetsong ea tšilo ea lijo: keketseho ea gamma-glutamyltransferase (ka lebaka la ho kenella ha enzyme ea sebete), hangata ha e na bohlokoa ba bongaka, keketseho ea phosphatase ea mali, keketseho ea transaminase, hepatitis ea cholestatic, parenchymal (hepatocellular) kapa mefuta e tsoakaneng, syndrome ea ho hlaseloa ke lefu la sebete.

Ka lehlakoreng la letlalo le lisele tse nyane: allergic dermatitis, urticaria, ka linako tse ling e matla haholo, dermatitis, erythroderma, systemic lupus erythematosus, ho hlohlona ha Stevens-Johnson syndrome, chefo e matla ea methapo ea methapo le knotty, mathata a letlalo, lesapo la mokokotlo, lera le eketsehang, ho eketseha ha moriri, ho eketseha ha leruo hirsutism.

Ho tsoa tsamaisong ea musculoskeletal : bofokoli ba mesifa, arthralgia, bohloko ba mesifa, mesifa ea mesifa, masapo a senyehileng a masapo (ho theoha ha calcium le 25-hydroxycolcalcaliferol ho plasma ea mali, e ka lebisang ho osteomalacia kapa osteoporosis).

Ho tsoa ts'ebetsong ea moroto: tubulointerstitial nephritis, ho se sebetse hantle ha renal, ho senyeha ha sesapo (albinuria, hematuria, oliguria, ho eketsa mali urea / azotemia), ho ruruha khafetsa, ho boloka mokokotlo.

Ho tsoa ts'ebetsong ea kemolo : dysfunction / Ketso ya ho hloka thobalano / ho se sebetse hantle ha mmele, ho senyeha ha spermatogenesis (ka ho fokotseha hoa palo / sepheo sa botona).

Tlolo ea molao e tloaelehileng: bofokoli.

Matšoao a Laborator: keketseho ea gamma-glutamyltransferase (e bakoang ke ho kenella ha li-enzyme tsa sebete), eo hangata e se nang bohlokoa ba bongaka, keketseho ea boemo ba phofo ea alkaline maling, keketseho ea li-transaminase, keketseho ea khatello ea methapo, keketseho ea cholesterol ea mali, keketseho ea lipoprotein tse phahameng haholo. liphetoho tsa mali ts'ebetsong ea qoqotho ea hau: ho fokotseha ha L-thyroxine (FT _4, T _4, T ₃ ) le boemo ba qoqotho e matlafatsang ea qoqotho, eo, joalo ka molao, bo sa tsamaeang le lipontšo tsa kliniki, keketseho ea boemo ba prolactin maling, hypogammaglobulinemia.

Boitšoaro bo fosahetseng bo thehiloeng melaong e itlhahelang feela.

Mafu a tšoaetsanoang le likokoana-hloko: Nchafatso ea mofuta oa VI ea herpes ea motho.

Lehlakore la mali: masapo a masapo

Ho tsoa tsamaisong ea methapo: sedation, ho senyeha hoa mohopolo.

Ho tsoa ho tšilo ea lijo: prick.

Ho tsoa ho sesole sa 'mele : lekhopho la lithethefatsi le eosinophilia le matšoao a systemic (DRESS).

Ka lehlakoreng la letlalo le lisele tse nyane: acute generalized exanthematicsous pustulosis (AGEP), lichenoid keratosis, onychomadeus.

Ho tsoa tsamaisong ea musculoskeletal : likhathatso.

Matšoao a Laborator: ho fokotseha ha letsoalo la liminerale tsa masapo.

Bongata

Matšoao Matšoao le litletlebo tse tsoang ho overdose hangata li bonts'a tšenyo ea methapo ea methapo, pelo le methapo.

Tsamaiso ea methapo e bohareng : khatello ea maikutlo ea methapo e kholo ea methapo, ho ferekana kelellong, ho sithabela maikutlo, ho otsela, ho ferekana kelellong, pono e foufalitsoeng, puo e sa tsitsang, dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (pele), hyporeflexia (hamorao), ho ts'oaroa ha kelello, mafu a kelello mydriasis.

Sistimi ea boipelaetso: khatello ea maikutlo ea phefumoloho, edema ea pulmonary.

Ts'ebetso ea pelo: tachycardia, hypotension ea methapo ea kutlo, khatello ea methapo ea kutlo, ho tsitsinyeha ha moea le ho hola ha QRS tataiso, syncope e amanang le ho ts'oaroa ha pelo, e tsamaeang le ho akheha.

Phekolo ea lijo: ho hlatsa, ho boloka lijo ka mpeng, ho fokolitse matla a koloneng.

Sistimi ea musculoskeletal: ho tlalehiloe linyeoe tse ikhethileng tsa rhabdomyolysis tse amanang le litlamorao tsa chefo ea carbamazepine.

Tsamaiso ea methapo : ho boloka urineine, oliguria kapa ho boloka metsi a anuria, khatello ea mali ka lebaka la phello ea carbamazepine, e ts'oanang le ADH.

Karolong ea matšoao a laboratori: hyponatremia, metabolic acidosis, hyperglycemia, keketseho ea karolo ea mesifa ea CPK e khonahala.

Phekolo. Ha ho na litlhare tse tobileng. Taba ea mantlha, kalafo e lokela ho ipapisa le boemo ba sepetlele ba mokuli, ho bontšoa sepetlele. Khokahano ea carbamazepine plasma ea mali e ikemiselitse ho netefatsa chefo le moemeli enoa le ho hlahloba tekanyo ea ts'ebeliso e feteletseng.

Likarolo tsa ka mpeng lia nts'oa, mpa ea hlatsuoa, 'me mashala a ts'ebetso aa nkuoa. Ho tsoa ka nakoana ka har'a litaba tsa ka mpeng ho ka lebisa ho kenngoeng kapele le ho hlaheng matšoao a ho tahoa nakong ea pholiso. Phekolo e tšehetsang matšoao e sebelisoa sebakeng sa tlhokomelo e matla, ho lekola mesebetsi ea pelo, khalemelo ea mathata a electrolyte.

Litlhahiso tse khethehileng. Ka nts'etsopele ea hypotension ea arterial, tsamaiso ea dopamine kapa dobutamine e bontšoa, ka nts'etsopele ea pelo ea pelo, kalafo e lokela ho khethoa ka bonngoe, ka nts'etsopele ea ho tsitsa, tsamaiso ea li-benzodiazepines (jk. Diazepam) kapa li-anticonvulsants tse ling, tse joalo ka phenobarbital (ka tlhokomeliso) ka lebaka la khatello e matla ea khatello ea maikutlo paraldehyde, le nts'etsopele ea hyponatremia (joala ba metsi) - thibelo ea tšebeliso ea mali, ho kenella butle ka hloko ka tharollo ea 0,9% sodium chloride. Mehato ena e kanna ea thusa ho thibela edema ea boko.

Hemosorption ho carbon sorbents e khothalletsoa. Ho se sebetse hantle ha diuresis le dialysis tsa peritoneal ho tlalehiloe.

Hoa hlokahala ho fana ka monyetla oa ho tiisa matšoao a ts'ebeliso e feteletseng ka letsatsi la 2 le la 3 kamora ho qala, ka lebaka la ho lieha ha moriana.

Sebelisa nakong ea bokhachane kapa leboteng.

Tsamaiso ea molomo ea carbamazepine e baka nts'etsopele ea liphoso.

Ho bana bao bo-'m'a bona ba nang le lefu la sethoathoa, ho na le tloaelo ea ho holisa intrauterine ho kenyeletsoa le ho senyeha hoa tlhaho.

Litataiso tse latelang li lokela ho lateloa.

• Tšebeliso ea lithethefatsi bakeng sa basali ba bakhachane ba nang le lefu la sethoathoa e hloka tlhokomelo e khethehileng.
• Haeba mosali ea amohelang Zeptol a ima, a rera ho ima kapa a hloka ho sebelisa moriana nakong ea kemolo, melemo ea ho sebelisa moriana e lokela ho lekanngoa ka hloko le kotsi e ka bang teng (haholoholo nakong ea pele ea kemaro).
• Basali ba lilemo tsa ho ba le bana, haeba ho khonahala, Zeptol e lokela ho beoa e le monotherapy.
• Ho khothalletsoa ho fana ka tekanyetso e sebetsang ea bonyane le ho lekola boemo ba carbamazepine maling a mali.
• Bakuli ba lokela ho tsebisoa ka kotsi e eketsehang ea ho ba le mathata a tlhaho 'me ba lokela ho fuoa monyetla oa tlhahlobo ea bokhachane.
• Nakong ea kemolo, kalafo e sebetsang ea antiepileptic ha ea lokela ho kena-kenana, hobane ho ata ha lefu lena ho sokela bophelo ba 'm'e le ba ngoana.

Ho shebella le ho thibela. Hoa tsebahala hore nakong ea bokhachane ho haella ha folic acid ho ka hlaha. Lithethefatsi tsa antiepileptic li ka eketsa khaello ea folic acid, ke ka lebaka leo tlatsetso ea folic acid e khothalletsoang pele le nakong ea kemaro.

Bacha. Bakeng sa ho thibela mathata a ho fetoha ha tlhaho ho masea a sa tsoa hlaha, ho kgothaletsoa ho fana ka vithamine K ₁ bo-mme nakong ea libeke tsa ho qetela tsa moimana le lesea le sa tsoa hlaha.

Maemo a 'maloa a teko le / kapa ho tepella maikutlo ho masea a sa tsoa hlaha hoa tsebahala, linyeoe tse' maloa tsa ho hlatsa, lets'ollo le / kapa takatso e fosahetseng ea masea a sa tsoa hlaha e amana le ho nka Zeptol le li-anticonvulsants tse ling.

Ho anyesa. Carbamazepine e fetela lebese la matsoele (25-60% ea mahloriso a plasma). Melemo ea ho anyesa le menyetla ea ho ba le litlamorao ho lesea nakong e tlang e lokela ho lekanngoa ka hloko. Bo-'mè ba fuoang Zeptol ba ka anyesa, ha feela lesea le ka bonoa le nts'etsapele (ho etsa mohlala, ho otsela ho feteletseng, ho kula le letlalo).

Ho tlalehiloe nyeoe ea linyeoe tsa ho senyeha ho sa sebetseng hantle ho banna le / kapa matšoao a sa tloaelehang a spermatogeneis.

Bana ba fuoeng pheko e potlakileng ea carbamazepine ba ka hloka ho sebelisa litekanyetso tse phahameng tsa lithethefatsi (ka kilogram ea boima ba 'mele) ha ba bapisoa le batho ba baholo. Matlapa a Zeptol a ka nooa bakeng sa bana ho tloha ho lilemo tse 5.

Likarolo tsa ts'ebeliso

Zeptol e lokela ho sebelisoa tlasa taolo feela, feela kamora ho hlahloba sekhahla sa phaello / kotsi, ha feela boemo ba bakuli ba nang le lefu la pelo, la hepatic kapa renal, phello e mpe ea hematological ho lithethefatsi tse ling nalaneng mme bakuli ba nang le kalafo e kenelletseng ea lithethefatsi ba behiloe leihlo le nchocho.

Ho phekoloa ka kakaretso ka urinalization le boikemisetso ba boemo ba urea nitrojene maling maling qalong le ka sekhahla se itseng nakong ea kalafo ho khothalletsoa.

Zeptol e bonts'a ts'ebetso e bonolo ea anticholinergic, ka hona bakuli ba nang le khatello e eketsehileng ea intraocular ba lokela ho lemosoa le ho eletsoa ka kotsi e ka bang teng.

E lokela ho hopoloa ka ts'ebetso e ka khonehang ea li-psychoses tsa morao-rao, le ho bakuli ba tsofetseng - ka ts'ebetso e ka bang teng ea pherekano le matšoenyeho.

Hangata lithethefatsi ha li na thuso bakeng sa ho ba sieo (ho ts'oaroa hanyane le hanyane). Maemo a arohaneng a bontša hore ho ts'oaroa ho eketsehileng hoa khoneha ho bakuli ba sa sebetseng hantle ka nako e itseng.

Litlamorao tsa Hematologic. Tšebeliso ea lithethefatsi e amana le nts'etsopele ea agranulocytosis le anemia ea aplasiki, leha ho le joalo, ka lebaka la maemo a tlase haholo a maemo ana, ho thata ho lekola kotsi ha o sebelisa moriana.

Bakuli ba lokela ho tsebisoa ka matšoao a pele a ho chefo le matšoao a ho senyeha hoa hematologic, hammoho le matšoao a dermatological le sebete.

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

Hangata ho na le ho fokotseha hoa nakoana kapa ho phehellang hoa lipalo tsa liplatelete kapa lisele tse tšoeu tsa mali mabapi le ts'ebeliso ea lithethefatsi Zeptol. Leha ho le joalo, maemong a mangata, liketsahalo tsena ke tsa nakoana 'me ha li bonts'a nts'etsopele ea anemia kapa agranulocytosis. Pele o qala kalafo le nako le nako nakong ea boitšoaro ba eona, tlhahlobo ea mali e lokela ho etsoa, ​​ho kenyelletsa ho tseba palo ea liplatelete (hammoho le, mohlomong, palo ea reticulocytes le boemo ba hemoglobin).

Boitšoaro bo matla ba dermatological. Liphetoho tse tebileng tsa dermatological, ho kenyelletsa le chefo ea epidermal necrolysis (TEN), lefu la Lyell, Stevens-Johnson syndrome (SJS) ha li fumanehe haholo ka tšebeliso ea lithethefatsi. Bakuli ba nang le karabelo e matla ea dermatological ba ka hloka ho kena sepetlele, kaha maemo ana a ka bolaea. Maemo a mangata a SJS / TEN a hlaha likhoeling tse 'maloa tsa pele tsa kalafo le Zeptol. Ka nts'etsopele ea matšoao a bonts'a karabelo e mpe ea dermatological (jk., SJS, lefu la Lyell's syndrome / TEN), moriana o lokela ho emisoa hanghang mme ho sebelisoe kalafo e 'ngoe.

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

Ho bakuli ba kotsing ea lefutso, Zeptol e lokela ho etsa tlhahlobo ea allele (HLA) -B * 1502 pele e qala kalafo.

Allele (HLA) -B * 1502 e kanna ea ba kotsi bakeng sa nts'etsopele ea SJS / TEN ho bakuli ba Machaena ba fumanang lithethefatsi tse ling tsa antiepileptic tse ka amanang le ho hlaha ha SJS / TEN. Ka hona, ts'ebeliso ea lithethefatsi tse ling tse ka amanang le ho qala ha SJS / TEN e lokela ho qojoa ho bakuli ba nang le allele (HLA) -B * 1502, haeba ho ka sebelisoa mofuta o mong oa kalafo.

Puisano le HLA-A * 3101

Antigen leukocyte antigen e ka ba sesosa sa kotsi bakeng sa nts'etsopele ea karabelo e mpe ea letlalo, joalo ka SJS, TEN, lekhopho la lithethefatsi le eosinophilia le matšoao a systemic (DRESS), rute e matla e akaretsang ea methapo ea letsoho. Haeba tlhahlobo e lekola boteng ba HLA-A * 3101, joale u lokela ho hana ho sebelisa lithethefatsi.

Meeli ea Tlhahlobo ea liphatsa tsa lefutso

Liphetho tsa tlhahlobo ea lefutso ha lia lokela ho nka sebaka sa tlhahlobo le kalafo ea bakuli e loketseng. Lisosa tse ling li ka bapala karolo ea ho hlaha hoa liphetoho tse mpe tsa letlalo, joalo ka litekanyetso tsa moemeli oa antiepileptic, ho latela kalafo ea kalafo le kalafo e kopanetsoeng. Kameho ea maloetse a mang le boemo ba ho shebella mafu a letlalo ha a so ithute.

Boitšoaro bo bong ba letlalo.

Hape ho ka etsahala nts'etsopele ea nakoana le tse sa sokeng bophelo bo botle, ka dermatological reaction, ho etsa mohlala, macular kapa maculopapular exanthema. Hangata li feta kamora matsatsi kapa libeke tse 'maloa, litekanyetso tse tšoanang le kamora ho fokotsa tekanyetso. Kaha matšoao a pele a ho kula ho tebileng ho amanang le dermatological a ka ba thata haholo ho a khetholla ho tloha karabelo e bonolo, e potlakileng, mokuli o lokela ho beoa leihlo hore a khaotse ho sebelisa lithethefatsi haeba karabelo e mpefala.

Ho ba teng ha HLA-A * 3101 allele ho mokuli ho amahanngoa le ho hlaha ha lintho tse mpe tse mpe ho tloha letlalo ho ea ho carbamazepine, tse kang hypersensitivity syndrome ho anticonvulsants kapa rashes e nyane (maculopapular rashes).

Hypersensitivity. Zeptol e ka bakela nts'etsopele ea karabelo ea hypersensitivity, ho kenyelletsa le lekhopho la lithethefatsi le nang le eosinophilia le matšoao a systemic (DRESS), li-hypersensitivity tse potlakileng tsa butle-butle ka feberu, rash, vasculitis, lymphadenopathy, pseudolymphoma, arthralgia, leukopenia, eosinophilia, lefu la sebete, ho sebetsa ha sebete, ho sebetsa ha sebete, ho sebetsa ha sebete, ho sebetsa ha sebete. li-ducts tsa bile (ho kenyelletsa timetso le ho nyamela ha li-ducts tsa intra-ductal), tse ka hlahang ka mefuta e fapaneng. Hape phello e ka ba teng ho litho tse ling (matšoafo, liphio, manyeme, myocardium, colon).

Ho ba teng ha HLA-A * 3101 allele ho mokuli ho tsamaisana le ho hlaha ha maikutlo a mabe a tebileng ho carbamazepine e tsoang letlalong, joalo ka hypersensitivity syndrome ho anticonvulsants kapa li-rashes tse nyane (maculopapular rashes).

Bakuli ba nang le karabelo ea hypersensitivity ho carbamazepine ba lokela ho tsebisoa hore karolo e ka bang 25-30% ea bakuli ba joalo le bona ba ka ba le karabelo ea hypersensitivity ho oxcarbazepine.

Ka tšebeliso ea carbamazepine le phenytoin, nts'etsopele ea hypersensitivity ea bokhoni e ka khonahala.

Ka kakaretso, ha matšoao a bontša hypersensitivity, moriana o lokela ho emisoa hanghang.

Likepe. Zeptol e lokela ho sebelisoa ka hloko ho bakuli ba tsietsaneng e kopaneng e kenyelletsang ho ba sieo (tloaelo kapa atypical). Maemong a joalo, lithethefatsi li ka tsosa moferefere. Ha ho ts'oaroa ho ts'oaroang, ts'ebeliso ea lithethefatsi e lokela ho emisoa hanghang.

Keketseho ea leqhubu la ho ts'oaroa hoa khoneha nakong ea phetoho ho tloha mefuteng ea molomo ea lithethefatsi ho ea ho li-supplement.

Ts'ebetso ea sebete. Nakong ea phekolo ea lithethefatsi, ho hlokahala hore ho hlahlojoe ts'ebetso ea sebete maemong a qalang le nako le nako nakong ea phekolo, haholo ho bakuli ba nang le nalane ea lefu la sebete le ho bakuli ba tsofetseng.

Matšoao a mang a hlahlobang tšebetso e sebetsang ea sebete ho bakuli ba nkang carbamazepine a ka feta se tloaelehileng, haholo-holo gamma-glutamyltransferase (GGT). Mohlomong sena se bakoa ke ho kenngoa ha li-enzyme tsa sebete. Ho kenella ka enzyme ho ka lebisa le ho nyoloha ka tekanyo e phahameng maemong a alkaline phosphatase. Keketseho e joalo ea ts'ebetso e sebetsang ea hepatic metabolism ha se sesupo sa ho felisoa ha carbamazepine.

Litlamorao tse matla tse tsoang ho sebete ka lebaka la ts'ebeliso ea carbamazepine li fumaneha seoelo. Haeba ho na le matšoao a ho hlohlona kapa ho kula ho amang sebete sa lefu la sebete, ho hlokahala hore ho hlahlojoe mokuli ka potlako, le ho emisa kalafo ea Zeptol.

Ts'ebetso ea liphio. Ho khothaletsoa ho lekola ts'ebetso ea renal le ho tseba hore na nitrogen ea mali e kae qalong le nako le nako nakong ea phekolo.

Hyponatremia. Mabaka a ntlafatso ea hyponatremia ka tšebeliso ea carbamazepine a tsejoa. Ho bakuli ba nang le ts'ebetso ea renal e sa sebetseng, e amahanngoa le litekanyo tsa sodium e fokotsehileng, hammoho le bakuli ba tšoaroang ka nako e tšoanang le lithethefatsi tse fokotsang maemo a sodium (joalo ka diuretics, lithethefatsi tse amanang le secretion e sa lekaneng ea ADH), maemo a sodium ea mali a lokela ho lekanngoa pele ho kalafo. Nakong e tlang, boemo ba sodium bo lokela ho lekanngoa libeke tse ling le tse ling tse peli, ka nako eo - ka nako ea khoeli e le ngoe nakong ea likhoeli tsa 3 tsa kalafo kapa tlhoko ea kliniki. Sena se sebetsa haholo ho bakuli ba tsofetseng. Tabeng ena, fokotsa boholo ba metsi a sebelisitsoeng.

Hypothyroidism. Carbamazepine e ka fokotsa bongata ba lihormone tsa qoqotho - ntlheng ena, keketseho ea tekanyetso ea kalafo ea phetisetso ea li-hormone tsa qoqotho ho bakuli ba nang le hypothyroidism ea hlokahala.

Litlamorao tsa Anticholinergic. Zeptol e bonts'a mesebetsi e leka-lekaneng ea anticholinergic. Kahoo, bakuli ba nang le khatello e eketsehileng ea intraocular le ho boloka urine ba lokela ho betoa leihlo nakong ea kalafo.

Litlamorao tsa kelello. Hopola monyetla oa hore psychosis ea morao e ka bang mafolofolo haholoanyane ho bakuli ba tsofetseng - pherekano kapa thabo.

Menahano ea boitšoaro le boitšoaro. Ho bile le bopaki bo bong ba menahano ea ho ipolaea le boitšoaro ho bakuli ba fumanang lithethefatsi tsa antiepileptic. Ka hona, bakuli ba lokela ho hlahlojoa bakeng sa menahano le boitšoaro ba ho ipolaea, 'me haeba ho hlokahala, ho lokela ho fanoa kalafo e nepahetseng. Bakuli (le bahlokomeli) ba lokela ho eletsoa ho bona ngaka haeba ho hlaha matšoao a menahano ea boitšoaro le boitšoaro.

Litlamorao tsa Endocrine. Ka ho kenella ha li-enzyme tsa sebete, Zeptol e ka baka ho fokotseha hoa phello ea kalafo ea litokisetso tsa estrogen le / kapa progesterone. Sena se ka lebisa ho fokotseng katleho ea thibelo ea bokhachane, ho khutla hape ha matšoao, kapa ho tsoa mali kapa ho fifala. Bakuli ba nkang Zeptol le eo ho thibeletsanang le lihormone ho hlokahalang bakeng sa bona ba lokela ho fumana lithethefatsi tse nang le bonyane li-microgram tse 50 tsa estrogen, kapa ba sebelise mekhoa e meng eo e seng ea hormone ea ho thibela pelehi.

Ho lekola boemo ba lithethefatsi ho plasma ea mali. Leha taba ea hore khokahano lipakeng tsa litekanyetso le boemo ba carbamazepine maling a mali, le pakeng tsa boemo ba carbamazepine ka har'a plasma ea mali le ts'ebetso ea bongaka le mamello ha e tšepahale, ho lekola boemo ba moriana ho plasma ea mali ho kanna ha nepahala maemong a latelang: ka keketseho ea tšohanyetso khafetsa ea tlhaselo, hlahloba ho latela taelo ea mokuli, nakong ea kemaro, kalafong ea bana le ea bacha, ka ho belaela ka tlhekefetso ea ho amoheloa, ka litlatse tse belaelloang le ts'ebeliso ea lithethefatsi tse fetang e le 'ngoe.

Phokotso ea litekanyetso le ho tlosoa hoa lithethefatsi. Ho tlohela moriana ka tšohanyetso ho ka baka ts'abo. Haeba ho hlokahala ho khaotsa ka tšohanyetso kalafo le lithethefatsi tsa bakuli ba nang le lefu la sethoathoa, phetoho ea sethethefatsi se secha sa antiepileptic e lokela ho etsoa ho fapana le semelo sa kalafo ka sethethefatsi se loketseng (mohlala, diazepam kahare, rectally kapa phenytoin kahare).

Phokotso ea lithibela-mafu le lefu la ho tlosa lithethefatsi. Ho tlosoa ha moriana ka tšohanyetso ho ka baka ho ts'oaroa, kahoo carbamazepine e lokela ho tlosoa butle-butle ka nako e fetang likhoeli tse 6. Haeba ho hlokahala hore o tlohele lithethefatsi hang-hang ho bakuli ba nang le lefu la sethoathoa, phetoho ea moriana o mocha oa antiepileptic e lokela ho etsoa ho fapana le semelo sa kalafo ka lithethefatsi tse nepahetseng.

Litaelo tse khethehileng

Ketso ea Zeptol hangata ha e sebetse hantle ho tsietsing e nyane ea sethoathoa (ho ba sieo) le ho ts'oaroa ke myoclonic. Ha ho na le mefuta e kopaneng ea ho ts'oaroa ke sethoathoa, moriana o lokela ho sebelisoa ka hloko le ho beha tlhahlobo ea bongaka khafetsa ka lebaka la monyetla o ka hlahang oa ho holisoa. Ho amoheloa ha Zeptolum ho hloka ho hlakoloa haeba ho hlaseloa ka matla ha litlhaselo tsa sethoathoa.

Nakong ea kalafo, ho ka fokotseha ho fokotseha ha nakoana kapa ho phehella hoa lipalo tsa leukocytes kapa maemong a mangata, maemong a mangata ho ba hoa nakoana ebile ho sa supe ho ba teng hoa agranulocytosis kapa anemia ea aplasiki. Pele thuto e qala, hammoho le nakong ea ts'ebetso ea kalafo, ho hlokahala liteko tsa mali tsa kliniki, ho kenyelletsa ho bala palo ea liplatelese mme mohlomong, reticulocytes, le ho fumana boemo ba hemoglobin.

Bakuli ba lokela ho tsebisoa ka matšoao a pele a ho chefo le matšoao a amanang le mathata a hematologic, hammoho le matšoao a tsoang letlalong le sebete. Ho potlakile ho buisana le ngaka ha ho ka etsahala hore ho be le litlamorao tse mpe joalo ka 'metso, feberu, ho ruruha, ho ruruha ha mucosa ea molomo, le ponahalo e sa utloahaleng ea ho ruruha le ho ruruha. Mabapi le matšoao a khatello ea maikutlo a tebileng a moko, Zeptol e tlameha ho hlakoloa.

Pele o qala tsela ea kalafo le nako le nako nakong ea ts'ebetso ea eona, ho khothalletsoa ho ithuta ka ts'ebetso ea sebete, haholo ho bakuli le bakuli ba nang le nalane ea liso tsa eona. Haeba keketseho ea ho senyeha hoa tšebetso ea serethe kapa ts'ebetso ea lefu la sebete e sebetsang e fumaneha, kalafo ka sethethefatsi e lokela ho emisoa hanghang.

Kalafo e nang le lithethefatsi tsa antiepileptic maemong a mang e ka hlaha ka ho hlaha ha liteko tsa ho ipolaea / menahano ea ho ipolaea. Kaha tšebeliso ea boits'oaro ba ho ipolaea ha u sebelisa lithethefatsi tsena ha e e-so theoe, nts'etsopele ea eona e ke ke ea qheleloa ka thoko ha u ntse u nka Zeptol. Bakuli le basebeletsi ba bona ba lokela ho lemosoa ka tlhoko ea ho batla thuso ea bongaka hang ha ho bonahala matšoao a ho ipolaea.

Bakuli ba seng ba tsofetse nakong ea kalafo ba hloka ho betoa leihlo ka lebaka la ho senyeha ha kelello kelellong, ho bonahatsoang ke pherekano le khatello ea kelello.

Ho tlohela ka tšohanyetso phekolo ea carbamazepine ho ka baka ho tsukutloa hoa sethoathoa. Haeba ho hlokahala hore Zeptol e tlosoe ka potlako, mokuli o lokela ho fetisetsoa ho motsoako o mong oa antiepileptic nakong ea kalafo ka lithethefatsi tse loketseng linyeoe tse joalo (mohlala, phenytoin e tsamaisitsoeng iv kapa diazepam e sebelisitsoeng iv kapa rectally).

Nakong ea kalafo, nts'etsopele ea liphetoho tse mpe tsa dermatological (ho kenyeletsa le Stevens-Johnson syndrome, lefu la Lyell) e ne e sa tloaeleha haholo. Ts'ebeliso ea Zeptol e lokela ho emisoa hang hang haeba matšoao le matšoao a bonahala a belaelloa a bakang mathata ana. Ka nts'etsopele ea liphetoho tse mpe tsa bophelo tse behang bophelo ba motho kotsing, mokuli o lokela ho isoa sepetlele. Ha e le molao, ponahalo ea litšitiso tse joalo e ile ea bonoa likhoeling tsa pele tsa thupelo.

Ho latela tlhahlobo e khutlisetsang ts'ebeliso ea ts'ebeliso ea Zeptol, bakuli ba naha ea Chaena ba na le kamano lipakeng tsa khafetsa tsa karabelo e matla ea letlalo e amanang le carbamazepine le ho ba teng hoa gene ea leukocyte antigen (HLA) ka genome ea bakuli bana HLA-B * 1502. Ha ho phekola bakuli ba nang le carbamazepine linaheng tsa setereke sa Asia (Philippines, Malaysia, Thailand), moo ho atileng ho tlalehiloeng ha allele ena, ho ile ha hlokomeloa keketseho ea litlamorao tse mpe tsa dermatological (ho tloha ho hakanya hangata "ho sa tloaelehang" ho ea ho "seoelo").

Ho bakuli bao e kanna ea ba bakuli ba HLA-B * 1502 allele (mohlala, batho ba naha ea Chaena), tlhahlobo e lokela ho etsoa bakeng sa boteng ba eona ho genotype. Ho khothalletsoa ho etsa kalafo ea lithethefatsi ho bakuli ba allele ena ha feela phaello e lebelletsoeng ea kalafo e feta tlokotsi ea mathata. Baemeli ba mabelo a Caucasoid, Negroid le Americananoid ba bontšitse ho ata hanyane ha alamo.

Pele o qala kalafo ea Zeptol, o lokela ho emisa ho nka li-inhibitors tsa MAO bonyane matsatsi a 14 kapa esita le pejana haeba maemo a kliniki a lumela.

Ho sebelisana le lithethefatsi

• CYP3A4 isoenzyme inhibitors: litekanyetso tse eketsehileng tsa carbamazepine ho plasma mme kotsi ea litlamorao e eketsehile.
• li-inducers tsa CYP3A4 isoenzyme: metabolism ea carbamazepine e potlakisitsoe, e lebisang ho fokotseha ha litaba tsa eona ka plasma le ho fokolisa phello ea eona ea kalafo.
• li-antiepileptic lithethefatsi (vigabatrin, styrypentol), li-antidepressants (fluvoxamine, trazodone, desipramine, nefazodone, fluoxetine, viloxazine, paroxetine), li-antipsychotic (olanzapine), li-resteed tsa mesifa (dantrolene, oxybutynin), li-antidepressonant, meriana. tekanyetso e phahameng), azole derivatives (ketoconazole, voriconazole, fluconazole, itraconazole), HIV proteinase inhibitors (e.g. ritonavir), lithethefatsi tsa antiulcer (cimetidine, omeprazole), li-antagonists tsa calcium (diltiazem, verapamil), anti-glaucoma lithethefatsi (acetazolamide), lithibela-mafu tsa macrolide (clarithromycin, erythromycin, troleandomycin, josamycin), li-antihistamines (loratadine, terfenadine), li-antiplatelet agents (ticlopidine), analgesics le lithethefatsi tse seng tsa anti -idalidal (NSAIDs), androprophenolf androprophenolf. plasma mahloriso a carbamazepine, a ka bakang ho hlaha ha maikutlo a sa thabiseng (ho otsela, ho tsekela, ataxia), ho hlokahala hore ho be leihlo le ho lokisa boemo ba carbamazepine maling,
• loxapine, primidone, quetiapine, valproic acid, progabid, valpromide, valnoktamide: dikahare tsa plasma tsa carbamazepine-10,11-epoxide lia eketseha, nts'etsopele ea maikutlo a sa rateheng a ka etsahala, o hloka ho laola boemo ba ntho ena maling le ho ntlafatsa lethal dose ea Zeptol,
• antiepileptics (mezuksimid, oxcarbazepine, fosphenytoin, fensuksimid, felbamate, phenytoin, primidone, phenobarbital, mohlomong e le clonazepam), antituberculosis mahlahana (rifampicin), antineoplastic mahlahana (doxorubicin, cisplatin), retinoids (isotretinoin), bronchodilators (aminophylline, theophylline) , Litokisetso tsa Hypericum perforatum hypericum: boemo ba carbamazepine maling a mali bo fokotseha, ho ka hlokahala hore o fetole tekanyetso,
• lithibela-mafu (doxycycline), NSAIDs, analgesics (paracetamol, buprenorphine, tramadol, methadone, phenazone), lithethefatsi tsa antiepileptic (topiramate, clonazepam, felbamate, clobazam, ethosuximide, lamotrigine, valproic acid, lefu la tsoekere, dicumarol, warfarin, acenocoumarol, fenprocoumon), antidepressants (mianserin, bupropion, trazodone, citalopram, sertraline, nefazodone), tricyclic antidepressants (amitriptyline, imipramine, clomipramine, nortriptyline). onazole), lithethefatsi tsa anthelmintic (praziquantel), li-antineoplastic agents (imatinib), li-antipsychotic (risperidone, clozapine, bromperidol, quetiapine, ziprasidone, haloperidol, olanzapine), immunosuppressants (everolimus, cyclosporidinospineosololisideineosolosineulosineine cyclosporidinospine (pesolospusizosineine) , glucocorticosteroids (dexamethasone, prednisone), anxiolytics (midazolam, alprazolam), HIV protease inhibitors (saquinavir, ritonavir, indinavir), bronchodilators (theophylline), lithibela-pelehi tsa hormonal, lithethefatsi tse fokotsang khatello ea mali (felodipine) Reparata, ka sebopeho se se akaretsang estrogen bananeng le / kapa progesterone: khoneha ho fokotseha ha maemo lero la mali ea mahlahana tsena ka 'na hloka khalemelo ea tekanyetso ea bona,
• phenytoin, mefenitoin: maemo a phenytoin a ka eketseha / a fokotseha, maemo a mefenitoin a ka eketseha.

Carbamazepine e kopana le lithethefatsi kapa lintho tse ling tse lokelang ho tsotelloa.

• isoniazid: hepatotoxicity e hlahisoang ke ntho ena e ka eketseha
• diuretics (furosemide, hydrochlorothiazide): ponahalo ea hyponatremia ea matšoao e ka hlokomeloa,
• levetiracetam: e ka mpefatsa litlamorao tsa chefo ea carbamazepine,
• antipsychotic (thioridazine, haloperidol), litokisetso tsa lithium kapa metoclopramide: khafetsa ea litla-morao tse sa rateheng tsa methapo e ka eketseha (ha e kopantsoe le li-antipsychotic - leha e le maemong a kalafo ea plasma ea lintho tse sebetsang),
• non-depolarizing misuli restants (pancuronium bromide): ho ka etsahala hore carbamazepine e ka bonts'a ho hanyetsa ketso ea meriana ena, ka ho kopanya hona ho ka hlokahala ho eketsa tekanyetso ea li-sapuse tsena tsa mesifa, ho lekola ka hloko boemo ba mokuli ho hlokahala ka lebaka la ho potlakela ho phethehileng ho kopantsoeng ha neuromuscular blockade,
• lithibela-pelehi tsa hormonal: litlamorao tsa kalafo ea lithethefatsi tsena li ka fokotseha ka lebaka la ho kenella ha li-enzymes tsa microsomal, ho na le litlaleho tsa ho tsoa mali pakeng tsa ho ea matsatsing, ho hlokahala hore ho fetohe mekhoa e meng ea thibelo ea bokhachane,
• ethanol: ho ka ba le phokotso ea mamello ea eona, nakong ea phekolo ho hlokahala hore u hane ho noa joala.

Litšoantšo tse hlalosoang ke Zeptol ke: Carbamazepine, Carbalepsin retard, Carbamazepine retard-Akrikhin, Carbamazepine-Ferein, Carbamazepine-Acre, Finlepsin, Tegretol, Finlepsin retard.

Tlhahlobo ea Zeptol

Litlhahlobo tse 'maloa tsa Zeptol li ntle haholo. Bakuli ba bangata ba hlokometse hore lithethefatsi li fokotsa menyetla ea ho ts'oaroa ke sethoathoa, li bonts'a phello e ntle matšoao a khatello ea maikutlo, li fokotsa ho teneha, hape li fokotsa bohloko ba neurogenic le ho fokotsa matla a tlhaselo ka neuralgia ea trigeminal. Likotsi tsa Zeptol li kenyelletsa palo e kholo ea litla-morao.