Pehea e lawe ai (inu) nā kime auaka Saroten > He hoʻomaʻemaʻe a me ke pale aku

Ke lawe nei i kahi mau kapika a Saroten Retard, ʻoi aku ia e inu me ka wai. Akā, hiki ke wehe ʻia nā Capsules a hiki ke lawe ʻia ka manaʻo me nā wai a lākou i nā mea (pellets). ʻAʻole kaʻili ʻia nā peni.

Hōʻike Depresive. ʻO nā kūlana kaumaha ma schizophrenia. Ua kuhikuhi ʻia i hoʻokahi manawa ma kahi o 3-4 mau hola ma mua o ka hiamoe.

Pono e mālama ʻia me ka Saroten Retard me hoʻokahi capsule e 50 mg i ke ahiahi. Inā pono, ma hope o ka hebedoma e hiki ke hoʻonui iki ʻia ka nui o ka lā ma 2 - 3 mau pūleʻa i ke ahiahi (100-150 mg). Ma hope o ka loaʻa ʻana o ka hoʻomaikaʻi ʻana i ka hōʻailona, hiki ke hōʻemi ʻia ka nui o kēlā me kēia lā i ka hopena haʻahaʻa, ʻoi aku a hiki i ka 1-2 capsules (50-100 mg / lā).

Hoʻopuka pinepine ka hopena antidepressant ma hope o 2 mau hebedoma. Hoʻomaʻamaʻa ka Therapy no ke kaumaha, no laila, ʻoi aku e hoʻomau i ka hoʻohana ʻana i nā antidepressants, e like me Saroten Retard, ma hope o ka loaʻa ʻana o ka hopena i haʻi ʻia no kahi manawa kūpono o a hiki i ka 6 mau mahina e pale ai i ka hoʻi hou ʻana. I nā mea maʻi me ka hoʻihoʻi hou ʻana (unipolar), kahi alakaʻi lōʻihi o Saroten Retard e koi ʻia, a hala a hala i kekahi mau makahiki, i ka mālama ʻana i nā hōʻaiho i nā hopena anti-relaps.

Nā maʻi maʻi (ma lalo o 65 mau makahiki)

Hoʻokahi mau pahu kapooneono 50 mg i ke ahiahi.

Hōʻemi ka hana o kaʻili

Hiki i nā Amitriptyline ke kuhikuhi i nā maʻi maʻamau no nā maʻi me nā pilikia ʻole.

Hōʻemi ka hana o ka ate

Pono e mālama pono i ka wā e hoʻohana ana i ka lāʻau lapaʻau i nā mea maʻi me ka hana aho lēwa, ka ʻōpala ʻo amitriptyline e nānā ʻia ma nā manawa he hiki.

Ma ka hoʻopau ʻana o ka lāʻau, ʻike ʻia ka hōʻaila ʻana i ka lāʻau ma loko o kekahi mau hebedoma e pale ai i ke kūkulu hou ʻana o nā "hoʻihoʻi ʻia" (ʻike i ka ʻāpana "ʻaoʻao effects").

Ka hana lāʻau lapaʻau

ʻO Amitriptyline kahi antidepressant tricyclic. ʻO ka amine mākaukau, ʻo amitriptyline, i vivo e like me ka pale ʻana i ka hoʻomaʻamaʻa ʻana o ka norepinephrine a me serotonin i loko o ka presynaptic nerve ending. ʻO kāna metabolite koʻikoʻi, nortriptyline, ke kāohi nei i ka reuptake o ka norepinephrine e hoʻohālikelike hou aku i ka mana o ka serotonin. ʻO Amitriptyline kahi m-anticholinergic, antihistamine a me nā mea sedative, hoʻonui i ka hana a catecholamines.

Hōʻikaʻi ʻo Saroten Retard i ke ʻano o ke kaumaha o ka pathological, ʻoi aku ka maikaʻi o kona hoʻohana ʻana i ka mālama ʻana i nā mea hōʻeha endogenous a me ka atypical depression, akā hiki nō iā ia ke hōʻoluʻolu i nā hōʻailona o nā maʻi kaumaha ʻē aʻe.

Ma muli o kona hopena hoʻonāukiuki, kūpono ʻo Sarotin Retard i ka mālama ʻana i ke kaumaha me ka hopohopo, ke hoʻohaunaele, ka hopohopo a me nā wahi hiamoe. E like me ke kānāwai, ka hopena antidepressant e loaʻa i loko o he 2 wiki

Lapaʻau lāʻau

Ma muli o ka wikiwiki o ka hoʻokuʻu ʻana o ka amitriptyline mai capsules o ka hana, e hoʻonui nui ʻia kona plasma.

ʻO kēia kaila kiʻekiʻe loa ma kahi o 50% e hoʻohālikelike ʻia me nā papa me ka hoʻokuʻu koke. Ka ʻaila nui i loko o ke kaila plasma (T_tah) neʻe i loko o 4 mau hola.

Palapala bioavailability: e pili ana i ka 48%. Hoʻokumu ʻia ʻo Nortriptyline i ka manawa o ka presystemic metabolism ka hopena antidepressant.

ʻO ka nui ʻike ka hoʻoili ʻia e pili ana i 14 l / kg. ʻO ka palena o ka pilina o nā protein plasma e pili ana i ka 95%.

ʻO Amitriptyline a me nortriptyline e hele i ka paepae placental.

ʻO ka metabolism o ka amitriptyline e lawe nui ʻia ma muli o ka demethylation (isoenzymes CYP2D19, CYP3A) a me ka hydroxylation (isoenzyme CYP2D6), i ukali ʻia e ka hui kohu me ka glucoseururone acid. Hōʻike ka Metabolism i nā genetic polymorphism koʻikoʻi. ʻO ka metabolite nui e hana ai he lua amine - nortriptyline. ʻO nā metabolites cis- a me trans-10-hydroxyamitriptyline a cis- a me ka trans-10-hydroxynortriptyline e hōʻike ʻia e kahi ʻano hana like like me nortriptyline, ʻoiai naʻe ka hopena o kā lākou hopena. Aia ʻo Demethylnortriptyline a me amitriptyline-I-oxide i ka plasma i loko o nā hana hiki ʻole ke hoʻoliʻiliʻi, ʻo ka hana metabolito ʻoi loa ka hana ma ka hana lāʻau lapaʻau. Hoʻohālikelike ʻia me nā amitriptyline, nā hopena āpau i loaʻa i ka hopena m-anticholinergic i hōʻino iki.

ʻO ka hapalua hapalua o amitriptyline e like me 16 (± 6) hola. ʻO ka hapalua hapalua o nortriptyline e pili ana i ka 31 (± 13) hola. ʻO ka awelika huakaʻi o ka amitriptyline he 0.9 l / min.

Hoʻokuʻu ʻia ia i nā māka. Ke hoʻololi ʻia, ma kahi o 2% o ka ʻae i koho ʻia o ka amitriptyline e hoʻopau ʻia.

ʻO Amitriptyline a me nortriptyline i hoʻopili ʻia i ka waiū umauma. ʻO ka paneʻana i ka waiū umauma a me ka plasma koko e pili ana i ka 1: 1.

ʻO ka hoʻohālikelike plasma o ka kūlike amitriptyline a me nortriptyline i ka hapa nui o nā mea maʻi ua hōʻea i loko o nā lā 7-10. Ke hoʻohana nei i nā capsules-hoʻokuʻu i lōʻihi i ke ahiahi, ʻo ka ʻike ʻana i ka amitriptyline e hiki i ka waiwai nui loa i ka pō a hemo i ka wā o ke ao, ʻoiai ke hoʻomau nei ka paʻa o nā nortriptyline i ke ao.

ʻO ka holoʻokoʻa plasma therapeutic konsentrasyon o amitriptyline a me nortriptyline i ka mālamaʻana i ke kaumaha o ka 370-925 nmol / L (100-250 ng / ml). Hoʻopili ʻia nā mea koʻikoʻi ma luna o 300-400 ng / ml me ka nui o ka hoʻonui ʻia o ka haunaele o ka hōʻemi ʻana i ka puʻuwai a me nā hanana o AV block a me QRS hoʻonui

ʻO ka maʻi me ka hana renal impaired

ʻAʻohe huehue i ka hana ʻōmaʻomaʻo i ka pili ʻana i ka pharmacokinestic, shedgiptilina a i ʻole nortriptyline, akā naʻe, ua lohi ka hoʻonui ʻia o nā metabolites.

ʻO nā mea maʻi me ka hana pūlima hemahema

Hiki i ka hanaʻeha hopuna i hiki ke hoʻolohi i ka metabolism o nā antidepresi tricyclic. . ^ E Ha yM.

ʻO ka ʻikepili palekana preclinical

ʻO nā antidepresi Tricyclic ka nui o ka pehu.

Ua hōʻike ʻia nā haʻawina pale kino i ka loiloi o ke kīpē o ka amitriptyline i ke kau hoʻolaʻa ʻana i ka palapala hoʻomau i hoʻomāhuahua ai ka hoʻohālikelike ʻia me nā ʻano like o ka amitriptyline me ka hoʻokuʻu koke.

No nā 40 mau makahiki i ka wā i hoʻohana ʻia ai i ka wā hapai, ʻaʻole i hōʻike ʻia nā pōʻino hānau pinepine a koʻikoʻi paha.

Nā hōʻailona no ka hoʻohana ʻana

ʻO ka haʻahaʻa (ʻoi aku ka hopohopo, ke kaumaha a me ka hana hoʻoluhi, ʻo ia hoʻi me ka wā o ka wā kamaliʻi, endogenous, involutional, react, neurotic, lāʻau lapaʻau, me nā lolo o ka lolo, hōʻemi i ka wai), psychizophrenic psychoses, hoʻākoakoa i ka ʻehaʻeha kūwili, ke ʻano hana (ʻano) hana a me ka mālama pono), nocturnal enuresis (koe wale nō nā mea maʻi me ka hypotension bladder), bulimia nervosa, ʻeha hōʻeha i ka maʻi maʻi (ʻeha kaumaha i nā maʻi maʻi maʻi, migraine, maʻi maʻi, nā ʻeha atypical ma nā wahi. a me nā poʻe, postherpetic neuralgia, post-traumatic neuropathy, maʻi a i ʻole peripheral neuropathy), ʻeha, migraine (pale), ulia peptic a me 12 uluu duodenal.

Nā Hoʻohui

Hypersensitivity, hoʻohana pū me ka MAO inhibitors a me 2 mau pule ma mua o ka hoʻomaka ʻana o ka hoʻōla, ka myocardial infarction (ʻokoʻa a me ka subacute wā), hopohopo o ka waiʻona, ka hopohopo paʻa me nā paina hiamoe, analgesic a me ka psychoactive drug, angle-closure glaucoma, hōʻino maikaʻi loa o AV a me ka intraventricular conduction (blockade) Gisa, AV block II hana), lactation, makahiki o nā keiki (a hiki i 6 mau makahiki - puka waha, a hiki i 12 mau makahiki me i / m a me iv) .Ciʻi. Hukihiki, ʻehaʻeha, kaaniani bronchial, ka maʻi manic-depressive, manaʻo ʻana i ka ʻōpū o ka iwi hematopoiesis, nā maʻi CVD (angina pectoris, arrhythmia, heart block, CHF, myocardial infarction, arterial hypertension), ʻeha, hoʻemi i ka hana gastrointestinal motor (ʻeha o ka hana o ka ʻōpū o ka lolo. , ʻāhaʻi a / a i ʻole renal failed, thyrotoxicosis, prostatic hyperplasia, urinary retention, bladder hypotension, schizophrenia (psychosis may activated), epilepsy, hapai (ʻoi aku ʻo trimester), ʻōpio.

Pehea e hoʻohana ai: dosis a me ke ʻano o ka mālama ʻana

I loko, me ka ʻaihue ʻole ʻana, ma hope koke o ka ʻai ʻana (e hōʻemi i ka huhū o ka mucosa o ka ʻōpū). ʻO ka inikua mua no nā pākeke he 25-50 mg i ka pō, a laila hoʻonui ka nui ma luna o nā lā 5-6 a hiki i 150-200 mg / lā ma 3 mau pona (ʻo ka hapa nui o ka nui ma ka lā i lawe ʻia i ka pō). Inā ʻaʻohe holomua i loko o nā hebedoma 2, e hoʻonui ʻia ka nui o kēlā me kēia lā i 300 mg. Inā nalowale nā hōʻailona o ke kaumaha, ua hoʻemi ʻia ka nui o ka lāʻau ma 50-100 mg / lā a hoʻomau ʻia ka lāʻau no ka liʻiliʻi o 3 mau mahina. I ka wā ʻelemakule, me ka maʻi ʻehaʻeha, kahi pona o 30-100 mg / lā (i ka pō) i kuhikuhi ʻia, ma hope o ka hiki ʻana i ka hopena therapeutic, ua huli lākou i ka hopena haʻahaʻa loa - 25-50 mg / lā.

Intramuscularly a iv (i hoʻoluhi lohi ʻia) ma kahi pānaʻi o 20-40 mg 4 mau manawa i ka lā, e hoʻololi lōloi ʻia me ke kau ʻana. ʻAʻoleʻoi aku ka lōʻihi o ka mālamaʻana i nā mahina 6 mahina.

Me nā enuresis nocturnal i nā keiki 6-10 mau makahiki - 10-20 mg / lā i ka pō, 11-16 makahiki mau makahiki - 25-50 mg / lā.

ʻO nā keiki ma kahi antidepressant: mai 6 a 12 mau makahiki - 10-30 mg a i ʻole 1-5 mg / kg / lā i kahi hapa, i ka wā kamaliʻi - 10 mg 3 mau manawa i kahi lā (inā pono, a hiki i 100 mg / lā).

No ka pale ʻana i ka migraine, me nā maʻi maʻamau o kahi ʻano neurogen (me ke poʻo o ke poʻo lōʻihi) - mai ka 12.5-25 a 100 mg / lā (ka nui loa o ka nui i ka pō).

Nā hopena hopena

Nā hopena Anticholinergic: nā hiʻona blurred, paralysis of accommodation, mydriasis, piʻi intraocular pressure (wale nō i nā poʻe me kahi predicposition anatomical kūloko - kahi kuʻikiʻu liʻiliʻi o ka keʻena anterior), tachycardia, waha maloʻo, hilahila, delirium a hallucinations, constipation, paralytic intestinal bara, paʻakikī urinating ʻānō ka hanu ʻana.

Mai ka pūnaehana nūhou: ka ʻeha, ka asthenia, nāwaliwali, nā hopohopo, ke kaumaha, hallucitions (ʻoi aku hoʻi i nā poʻe maʻi maʻi a me nā mea maʻi me ka maʻi Parkinson) nā hopohopo, nā hopohopo, nā hopohopo motor, ka ʻāina manic, hoʻokaumaha hypomanic, hoʻonāukiuki, hōʻeha o ka hoʻomanaʻo ʻana, depersonalization , hoʻonui i ka manaʻo, hoʻohaʻahaʻa i hiki ke kāohi, ʻāina, "pōʻeleʻele" moeʻuhane, aʻokiʻō, asthenia, hoʻōla i nā hōʻailona o ka psychosis, ʻeha, myoclonus, dysarthria, tremor Paina nāʻiʻo, ka oi aku i ka lima, lima, ke poo a me na olelo,ʻike ākea neuropathy (paresthesia), myasthenia gravis, myoclonus, ataxia, extrapyramidal maʻi pale, hoʻonui a me intensification o kāʻili 'ana, EEG hoʻololi.

Mai ka ʻaoʻao CCC: tachycardia, palpitations, dizziness, orthostatic hypotension, nonspecific ECG loli (ST interval a T wave) i nā poʻe maʻi me ka maʻi ʻeha, arrhythmia, ka hana o ke koko (hōʻemi a hoʻonui i ke kaila koko), hoʻopiʻi ka maʻi o ka intraventricular (hoʻonui i ka paʻakikī QRS, hoʻololi i ka PQ interval, blockade o nā wāwae o ka pūpū o kāna).

Mai ka pūnaehana ʻana: ka hanu, paʻa ka maʻi hepatitis (e komo pū ana i ka hana aho pehu a me ka jaundice cholestatic), ka ʻulaʻī, ka luaʻi ʻana, ka gastralgia, hoʻonui i ka momona a me ke kino o ke kino a i ʻole ka hoʻēmi ʻana i ka makemake a me ke kino o ke kino, stomatitis, hoʻololi i ka maʻi, ʻeha a me ka pouli o ka ʻōlelo.

Mai ka pūnaehana endocrine: ka nui o ka nui (edema) o nā testicle, gynecomastia, he nui ka nui o nā kūmole kelepona, galactorrhea, kahi hōʻemi a hoʻonui paha i ka libido, ka hoʻohaʻahaʻa i ka potency, hypo- or hyperglycemia, hyponatremia (he hōʻemi i ka hana ʻana o vasopressin), a me ka hōʻemi ʻana i ka hoʻoweliweli ʻana ʻole.

Mai nā lālā hemopoietic: agranulocytosis, leukopenia, thrombocytopenia, purpura, eosinophilia.

He maʻi kūlohelohe: ʻāwili i ka ʻili, ke kau ʻana o ka ʻili, urticaria, photosensitivity, ka huehue o ka maka a me ka alelo.

ʻO nā mea'ē aʻe: nā lauoho lauoho, tinnitus, edema, hyperpyrexia, nā nīnū lymph nūnū, mālama i ka urinary, pollakiuria, hypoproteinemia.

ʻO ka hoʻihoʻi ʻana i nā hōʻailona: me ka hoʻokuʻu koke ʻana ma hope o ka lōʻihi o ka mālama ʻana - ka maʻi iki, ka luaʻi, ka maʻi ʻana, ka ʻeha, ka ʻeha, ka hiamoe hiamoe, nā moeʻuhane kūlohelohe, ke ala kūwaho, me ka wehe ʻana ma hope o ka mālama ʻana - ka huhū, ka hopohopo hopohopo, ke hiamoe ʻole, nā moeʻuhane maʻamau.

ʻAʻole paʻa i ka pilina me ka ʻoihana hoʻomalu: nā pua like-like ʻo lupus (like me ka melratory arthritis, ka ʻike ʻana i nā antibi antinuclear a me ka hopena rheumatoid maikaʻi), hana i ka puʻuwai hemahema, ageusia.

ʻO nā hopena kūloko i ke kulekele iv: thrombophlebitis, lymphangitis, ke puhi ʻana i ka sensation, a me ke ʻano kūlohelohe. Overdose. Nā Hoʻomaka Mai ka ʻaoʻao o ka lawelawe o ka pūnaehana kūloko: mau ka hiamoe, stupor, coma, ataxia, hallucinations, hopohopo, psychomotor agitation, hoʻemi i ka hiki ke kāohi, disorientation, confingth, dysarthria, hyperreflexia, muscle stiffness, choreoathetosis, epileptic syndrome.

Mai CCC: hoʻemi kahe koko, tachycardia, arrhythmia, ka hoʻopilikia ʻana i ka intracardiac conduction, hoʻololi ʻia ʻo ECG (ʻoi aku hoʻi ia QRS), nāwīlū, puʻuwai puʻuwai, ʻohiʻohi i ka hoʻonaninani antidepresan tricyclic, pīhoihoi, hōʻeha i ka naʻau ma nā hihia loaʻa pinepine ʻole.

ʻO nā mea'ē aʻe: ke ake o nā mea hanu, pōkole o ka hanu, cyanosis, luaʻi, hyperthermia, mydriasis, hoʻonui nui loa, oliguria a anuria.

Kūkulu nā ʻōhumu i nā hola 4 ma hope o ka overdose, hiki i ka lōʻihi ma hope o 24 mau hola a i nā lā 4-6 mau lā. Inā kānalua kekahi overdose, ʻoi aku hoʻi i nā keiki, pono ke mālama ʻia ka mea maʻi.

Hanaʻi: me ka waha o ka ihu: lavage gastric, hoʻokele ʻana i ka ulana i hoʻōla ʻia, hōʻailona a me ke kākoʻo kākoʻo, me nā hopena anticholinergic kino (hōʻemi i ke kahe koko, arrhythmias, coma, hoʻokuʻi myoclonic) - ka hoʻomalu ʻana i nā inhibitor cholinesterase (ʻaʻole i ʻōlelo ʻia ka physostigmine no ka hoʻonui nui ʻana o ka hopu. ), ka mālama ʻana i ke koko a me ke kaulike wai-electrolyte. Hōʻike nā mana o nā hana CCC (me ka ECG) no 5 mau lā (hiki i ka hoʻomaha ke hiki i loko o 48 mau hola a i hope paha), mea lapaʻau anticonvulsant, ventilation mechanical, a me nā hana resuscitation ʻē aʻe. ʻO Hemodialysis a me nā diuresis hoʻoikaika i mea ʻole ia.

Nā ʻōlelo kikoʻī

Ma mua o ka hoʻomaka ʻana i ka mālama ʻana, pono e mālama ʻia ke koko (i loko o nā mea maʻi me ka hoʻokahe koko haʻahaʻa a hiki ke emi iho i nā mea hou aʻe), i ka wā mālama ʻia pono e mālama i ke koko peripheral (i kekahi mau hihia, hiki i ka agranulocytosis ke hoʻomohala, a no laila e ʻōlelo ʻia e nānā i ke kiʻi koko, me ka nui o hoʻonui i ke kino o ke kino, ke kūkulu ʻana i nā hōʻailona like-like me nā ʻehaʻeha koʻikoʻi), me ka hoʻomehana lōʻihi - ka hoʻomohala i nā hana o ka CVS a me ka puʻuwai. I ka poʻeʻelemakule a me nā mea maʻi me nā maʻi CCC, kāohi i ka nui o ka naʻau, ke koko, ke hōʻike ʻia ka ECG. Hiki ke loli paha nā loli i ka ʻoihana ʻē aʻe ma ka ECG (hoʻoliʻiliʻi i ka nalu T, hōʻeha i ka māhele S-T, hoʻonui i ka paʻakikī QRS).

Hiki i ka hoʻohana makua wale nō ma o kahi hale mālama, ma lalo o ka mākaʻi o ke kauka, me ka hoʻomaha ʻana o ka moena i nā lā mua o ka maʻi maʻi.

Pono e nānā mua aku i ka neʻe koke ʻana i kahi kūlana kūʻē mai kahi noho a noho ʻole paha.

I ka wā mālama, pono ke haʻalele ʻia ka ethanol.

E hāʻawi i ʻole ma mua o 14 mau lā ma hope o ka hemo ʻana o ko MAO inhibitors, e hoʻomaka me nā dosis liʻiliʻi.

Me kahi hikiʻole o ka hoʻokele ʻana ma hope o ka mālama lōʻihi, hiki i ka hoʻomohala ʻana o ka maʻi "withdrawal".

ʻO ka Amitriptyline i nā dosis ma luna o 150 mg / lā e hōʻemi ana i ka paepae o ka hana hoʻomanawanui (ʻo ka loaʻa ʻana o nā mea ukana epileptic e pili ana i nā maʻi maʻi predisposed, a i mua hoʻi o kekahi, e pono e noʻonoʻonā mea i hōʻike mua i ka hanana ʻana o ka ʻanikūlū, no ka laʻana, nā hōʻeha o ka lolo o kekahi ʻano etiology, ka hoʻohana ʻana i nā lāʻau antipsychotic (antipsychotics), i ka manawa o ka hō hōʻole o ka etanol a i ʻole haʻalele i nā lāʻau lapaʻau e loaʻa ai nā waiwai anticonvulsant, e like me benzodiazepines).

Hōʻike ka maʻi kaumaha i ka hopena o nā hana suicidal, ka mea hiki ke kiʻi a hiki i ka loaʻa ʻana o ke kala koʻikoʻi. Ma kēia noʻonoʻo, i ka hoʻomaka ʻana o ka mālama ʻana, hiki i ka hui pū me nā lāʻau lapaʻau mai ka hui benzodiazepine a i ʻole nā mea kanu antipsychotic a me ka mālama mau ʻana i nā lāʻau lapaʻau.

I loko o nā mea maʻi me ka maʻi pākuʻi cyclic, i ka manawa o ka manawa kaumaha, hiki i ka manic a i ʻole hypomanic kūlana hoʻomohala i ka wā o ka maʻi (hōʻemi ʻia i ka hoʻoneʻe ʻana a hoʻolilo paha i nā lāʻau lapaʻau antipsychotic pono). Ma hope o ke kau ʻana i kēia mau kūlana, inā loaʻa nā hōʻailona, hiki ke hoʻomau ʻia ka mālama ʻana i nā dosis haʻahaʻa.

Ma muli o nā hopena cardiotoxic hiki loa, e koi ʻia ka mālama ʻana i ka wā e mālama ai i nā maʻi maʻi thyrotoxicosis a i nā mea maʻi e loaʻa ana i ka hoʻomākaukau ʻana i ka hormone thyroid.

I ka hui pū ʻana me ka hoʻolaʻa electroconvulsive, e kuhikuhi pū ʻia me ka mālama ʻana o ka maʻi lapaʻau.

I nā mea maʻi predisposed a me nā maʻi maʻi, hiki iā ia ke hoʻonāukiuki i ka hoʻomohala ʻana i nā maʻi psychoses, ʻoi loa ia i ka pō (ma hope o ka hōʻea o ka lāʻau lapaʻau, nalo lākou i loko o kahi mau lā).

Hiki i ka ʻalopili i ka palaki poloka paralytic, ka mea nui i nā mea maʻi me ka maʻi constipation, ʻo ka mea makua a i ʻole nā mea maʻi e koi ʻia e mālama i ka hoʻomaha moe.

Ma mua o ka alakaʻi ʻana i ka anesthesia ākea a i ʻole kūloko, pono e hoʻomanaʻo ʻia he ʻano anesthesiologist e lawe ana ka mea maʻi i ka amitriptyline.

Ma muli o ka hana anticholinergic, kahi i hoʻohaʻahaʻa i ka lacrimation a me ka hoʻonui pinepine ʻana i ka nui o ka huehue i ka hoʻopili ʻana o ka wai lacrimal hiki, hiki iā ia ke hana i ka hoʻopōʻino i ka epitheli corneal i loko o nā mea maʻi e hoʻohana ana i nā ʻāʻī pili.

Me ka hoʻohana mau ʻana, ʻike ʻia kahi mahuahua o nā pilikia o nā niho niho. Hiki ke hoʻonui ʻia ka pono no ka riboflavin.

Ua hōʻike ʻia kahi hōʻike no ka hoʻopiʻi ʻana i nā holoholona i hopena maikaʻi loa i ka maʻi ʻana, a ʻaʻole i mālama ʻia nā haʻawina kūpono i hoʻopaʻa ʻia i nā wahine hāpai. I nā wahine hāpai, pono ke hoʻohana ʻia ka lāʻau inā pono ka manaʻo nui i ka makuahine i ʻoi loa i ka hopena o ka wahine hāpai.

Komo ʻia i loko o ka waiū umauma a e hōʻeha paha i ka hiamoe i nā pēpē.

I mea e pale aku ai i ka hoʻomohala ʻana o ka maʻi "withdrawal" i nā keiki hou (i hōʻike ʻia e ka manawa o ka hanu, ka hiamoe, ka colinal intestinal, nui ka huhū a me ke ʻano, hypotension a hypertension, tremor a spastic phenomena), amitriptyline e hoʻopau iki ʻia a ma kahi o 7 mau hebedoma ma mua o ka hānau ʻana i manaʻo ʻia.

Hoʻopili loa nā keiki i ka overdose aʻa, kahi e noʻonoʻo ai i ka mea weliweli a me ka hōʻeha ʻana iā lākou.

I ka wā o ka mālama ʻana, pono e mālama ʻia i ka wā e alakaʻi ana i nā kaʻa a komo i nā hana ʻē aʻe ʻē aʻe e koi ai i ka nui o ka neʻe ʻana a me ka wikiwiki o ka hopena psychomotor.

Hoʻohui

Me ka hoʻohana pū ʻana o ka ethanol a me nā lāʻau hōʻeha e hoʻoneʻene i ke kikowaena kūwili (me nā antidepressants ʻē aʻe, barbiturates, benzadiazepines a me nā ʻano maʻamau), he hopena nui i ka hopena o ka inhibitory ma ka pūnaehana nīnaehana, hiki i ke ea a me ka hopena hypotensive.

Hoʻonui ka mahele i ka mea inu e loaʻa ai ka ethanol.

Hoʻonui i ka hopena anticholinergic i nā lāʻau me nā hana anticholinergic (no ka laʻana, ka phenothiazines, nā lāʻau antiparkinsonian, amantadine, atropine, biperidene, antihistamines), e hoʻonui ai i ka hopena o nā hopena o ka hopena (mai ka punawai nīpū o mua, ka ʻike, nā ʻōpū a me ka ʻoka).

Ke hui pū me ka antihistamines, clonidine, he mahuahua i ka hopena o ka inhibitory ma ka pūnao nūnū kaila, me ka atropine, e hoʻonui i ka pilikia o ka papaʻō o ka maʻi palaka, a me nā hua lāʻau e hōʻeha i ka hopena o ka extrapyramidal e hoʻonui i ka paʻakikī a me ka piʻi o nā hopena extrapyramidal.

Me ka hoʻohana like ʻana o ka amitriptyline a me nā kūlohelohe anticoagulants (Coumarin a i ʻole deradione derivatives), hiki ke hoʻonui ʻia ka hana anticoagulant o ka hope.

Hiki i ka Amitriptyline ke hoʻonui i ke kaumaha ma muli o corticosteroids.

Ke hui pū me nā hua lāʻau anticonvulsant, hiki i ka mea e hoʻonui ai i ka hopena o ka inhibitory ma ka nūnū o ka pūnaehana ma waena, e hoʻohaʻahaʻa i ka paepae no ka hana hoʻomanawanui (i ka wā e hoʻohana ʻia ai i nā hōkū kiʻekiʻe) a hōʻemi i ka hopena o ka hopena.

ʻO nā lāʻau lapaʻau no ka mālama ʻana i ka thyrotoxicosis e hoʻonui i ka hopena o ka agranulocytosis.

Hoʻemi i ka hopena o ka phenytoin a me nā alpha-blockers.

Nā mea hoʻohiwahiwa o ka microsomal oxidation (cimetidine) e hoʻolōʻihi i ka T1 / 2, hoʻonui i ka hopena o nā hopena o nā mea ʻawaʻawa o ka amitriptyline (e hoʻemi ʻia ka makeʻe i ka 20-30% e pono ai), nā mea hoʻonāukiuki o ka mikrosomal ate enzymes (barbiturates, carbamazepine, phenytoin, nikotine a me nā ʻikepili waha) e hoʻemi i ka hoʻoliʻi ʻana o ka plasma a hōʻemi i ka hopena o ka amitriptyline.

Hoʻonui ka Fluoxetine a me ka fluvoxamine i ka kukuna o ka amitriptyline i loko o ka pulu (e lawe ʻia kahi hōʻemi hoʻemi ʻia o amitriptyline e 50%).

Ke hui pū ʻia me nā anticholinergics, phenothiazines a me benzodiazepines - e hoʻoikaika i ka hopena o ka sedative a me nā anticholinergic hopena a me ka hoʻonui ʻia ʻana o ka hopu epileptic (e hoʻohaʻahaʻa ana i ka paepae o ka hana eʻe ai), nā phenothiazines, ma ke ʻano, hiki ke hoʻonui i ka hopena o ka neuroleptic malignant syndrome.

Me ka hoʻohana pū ʻana o ka amitriptyline me ka clonidine, guanethidine, betanidine, reserpine a me methyldopa - kahi hoʻohaʻahaʻa i ka hopena hypotensive o ka hopena, me ka kokela - ka hopena o ka arrhythmias puʻuwai.

Nā huaʻai e hoʻohālikelike i ka waha o ka estrogen a me ka estrogens hiki ke hoʻonui i ka bioavailability o ka amitriptyline, nā lāʻau antiarrhythmic (e like me ka quinidine) hoʻonui i ka hopena o ka hana kuʻuna (neʻe lohi ka metabolism o ka amitriptyline).

Hoʻohui hewa me ka disulfiram a me nā mea hoʻohui acetaldehydrogenase e hoʻonāukiuki i ka delirium.

ʻAʻole i pili ʻole me ka inhibitors MAO (hiki ke hoʻonui i ka nui o nā manawa o ka hyperpyrexia, nā hewa koʻikoʻi, nā kulana hypertensive a me ka make hoʻomanawanui).

Hiki i ka Pimozide a me ka probucol ke hoʻonui i nā arrhythmias cardiac, i hōʻike ʻia e hoʻolōʻihi i ka kikowaena Q-T ma ka ECG.

Hoʻonui ʻo ia i ka hopena ma ka epilephrine, norepinephrine, isoprenaline, ephedrine a me phenylephrine ma ka CVS (me ka wā o kēia mau lāʻau lapaʻau he ʻāpana o ka anesthetics kūloko) a hoʻonui i ka hopena o ka pilikia kuʻuna o ka puʻuwai, tachycardia, a me nā hypertension koʻikoʻi.

Ke hana pū ʻia me alpha-adrenostimulants no ka hoʻokele intranasal a i ʻole no ka hoʻohana ʻana i ka ophthalmology (me nā mea nui o nā ʻōmū o nā pūnohu), e hoʻonui ai ka hopena vasoconstrictor o ka mea hope.

Ke hui pū ʻia me nā hormone thyroid - kahi hoʻomohala pū i ka hopena therapeutic a me nā hopena o nā mea maʻi (e komo pū me ka arrhythmias cardiac a me ka hopena hoʻoulu ʻia i ka pūnaehana neʻe o ka pūnaehana).

Hoʻonui ka lāʻau M-anticholinergics a me nā lāʻau antipsychotic (antipsychotics) i ka nui o ka hōʻeha o ka hyperpyrexia (ʻoi aku hoʻi i ka wā wela).

Me ka manawa hui me nā lāʻau lapaʻau hematotoxic ʻē aʻe, hiki ke hoʻonui ʻia i ka hematotoxicity.

ʻO Saroten Retard (Saroten Retard) - hoʻokuʻu i ke kīmaha, ka hoʻonohonoho ʻana a me ka hoʻopili

ʻO nā capsules o ka hana lōʻihi he gelatin ka nui, ka nui no 2, opaque, me kahi kino a me ka uhi o ke kala ʻulaʻula, nā kiko o nā capsules he mau ʻāpana mai kahi keʻokeʻo a keʻokeʻo paha i ka melemele.

1 lānai. amitriptyline hydrochloride 56.55 mg, e pili ana i nā kiko o ka amitriptyline 50 mg.

Nā mea hoʻihoʻi: nā kūpeʻe gula (nā momona spheres), waikawa stearic, shellac (non-waxed shellac), talc, povidone.

ʻO ka hoʻonohonohoʻana o ka pūpū capsule: gelatin, hao dye oxide ʻulaʻula (E172), titanium dioxide (E171).

Saroten Retard (Saroten Retard) - pharmacokinetics

ʻO ka bioavailability o ka amitriptyline e pili ana i 60%. ʻO ka pilina protein protein e pili ana i ka 95%. ʻO ke kahe o ka amitriptyline i loko o ka serum koko me kona manawa eʻoi aku ka wikiwiki ma mua o ka lawe ʻana iā Saroten i nā papa, ma hope o ka 4-10 mau hola, ma hope o kēia manawa, e noho mau ana ia no kekahi manawa lōʻihi.

Ma nā kaulike like, ʻoi aku ka nui o nā kaila o ka ʻike o ka hoʻōla i ka plasma i ka wā e lawe ai i nā kapages, kahi e pili pū ana me ka hopena o ke kumu cardiotoxic haʻahaʻa o Saroten Retard.

Hoʻomoe ʻia ka hoʻololi ʻana ʻo Amitriptyline ma o ka demethylation a me ka hydroxylation. Ua manaʻo ʻia ʻo Nortriptyline ka mea nui e pili ana i ka amitriptyline. T1 / 2 o nā awelika amitriptyline 25 mau hola (16-40 mau hola), T1 / 2 o nortriptyline - e pili ana i nā hola 27. Ua hoʻokumu ʻia ʻo Css ma hope o 1-2 mau pule. Hoʻokaʻawale ʻia ʻo Amitriptyline me ka urine a, ma kahi ʻāpana me nā feces. ʻO Amitriptyline a me nortriptyline e hele i ka pale o ka placental a ma nā liʻiliʻi liʻiliʻi ua hoʻopili ʻia i ka waiū umauma.

Nā hōʻailona no ka hoʻohanaʻana i ka lāʻau lapaʻau

ʻO ke kaumaha, koʻikoʻi me ka hopohopo, ke kaumaha, a me nā hiamoe hiamoe.

ka mālama ʻana i nā mea kaumaha o ka endogenous e pili ana i ka ʻano o ka mono- a me ka bipolar type, involutional, masked and menopausal depressions,
ʻōpū a me ka palaualike o ke kaumaha,
hoʻohālikelike hou ʻana
maʻi pau ʻole
ka mālamaʻana i ke kaumaha schizophrenic (i hui pū me nā antipsychotics),
nā maʻi hōʻehaʻeha mau.

Saroten Retard (Saroten Retard) - ka palena regimen

Ke lawe nei i kahi kapaka a Saroten Retard, ua manaʻo ʻia e inu me ka wai. Akā, hiki ke wehe ʻia nā Capsules a hiki ke lawe ʻia ka ʻike a me kā lākou mau ʻike (nā granule) me ka wai. Hāʻawi ʻia nā Granule e ʻōmaka.

No ka mālamaʻana i ke kaumaha, ua kuhikuhi ʻia ka manawa 1 / 3-4 mau hola ma mua o ka hiamoe ʻana i nā pona e pili ana i ka 2/3 o ka nui o ka Saroten ma nā papa.

Pono nā poʻeʻelemakule e hoʻomaka i ka mālama ʻana me Saroten Retard me kahi 50 mg capsule i ke ahiahi. Inā pono, ma hope o 1-2 mau pule, hiki ke hoʻonui ʻia ka nui o ka lā i nā lā 2-3 i ke ahiahi (100-150 mg). Ma hope o ka loaʻa ʻana o kahi holomua hōʻailona, hiki ke hoʻemi ʻia ka nui o ka lā i kēlā me kēia i ka liʻiliʻi loa, pinepine a hiki i ka 1-2 capsules (50-100 mg /). Ma ka mālamaʻana i ke kaumaha, ua manaʻo ʻia e hoʻomau i ka hoʻohana ʻana i nā antidepressants, e like me Saroten Retard, ma hope o ka loaʻa ʻana o kahi hopena i haʻi ʻia no nā mahina 4-6 ʻē aʻe. I ka ʻoihana mālama ai ka hopena o nā hopena anti-relaps, hiki ke lawe ʻia ka Saroten Retard no ka manawa lōʻihi, a mau makahiki.

Pono ka poʻe elemakule e hoʻomaka i ka mālama ʻana me Saroten me nā papa - 30 mg / (3 a 10 mg). I kekahi mau lā, hiki i ke hoʻololi ke lawe i nā capsules Saroten Retard. ʻO ka dosage i kēlā me kēia lā he 1-2 mau kōmole (50-100 mg), i lawe i ke ahiahi.

I nā hopena hōʻeha o nā maʻi no ka pākeke, ʻo ke kaulike o ka lā he 1-2 capsules (50-100 mg), i lawe i ke ahiahi. Hiki ke hoʻomaka i ka mālama ʻana me ka lawe ʻana iā Saroten i nā papa he 25 mg hoʻokahi i ke ahiahi.

ʻO nā hopena ʻaoʻao e pili ana i ka hopena anticholinergic: ka maloʻo a me / a i ʻole ka ʻawaʻawa ʻawa i ka waha, nausea, luaʻi a me ka stomatitis, i ʻole kaʻai - cholestatic jaundice, blurred vision, hoʻonui intraocular pressure, tachycardia, constipation, nui loa pinepine - ka mālama kino urinary. Hōʻike pinepine lākou i ka hoʻomaka o ka mālama ʻana, a laila, ma ka nui o ka hoʻoemi.

Mai ka ʻaoʻao o ka ʻōnaehana cardiovascular: tachycardia, arrhythmias, orthostatic hypotension, intracardiac conduction disorders, hoʻopaʻa wale ʻia ma ka ECG, akā ʻaʻole like kino.
Mai ka ʻaoʻao o ka pūnaehana loko ma waena: nā luhiluhi, nāwaliwali, nā hemahema, nā hōʻeha, ka ʻōpū. ʻO kēia mau maʻi maʻamau, e hoʻomaka pinepine ana i ka hoʻomaka ʻana o ka ʻoihana amitriptyline, e hōʻemi ʻia i ka wā o ka mālama ʻana. Hoʻololi maʻamau, ʻoi aku ke hoʻohana ʻia nā mea inikua kiʻekiʻe, somnolence, disorientation, pupule, agitation, hallucinations, extrapyramidal disorders, nā kuʻi a me nā kīpī hiki ke ulu, ʻaʻole hopohopo.

He maʻi kūlohelohe: hiki ke ʻeha, ʻeha ka ʻeha.

ʻO kekahi: ʻano hanu, hoʻoheheʻe, loaʻa ke kaumaha, mahele ʻia ka libido.

Nā Hoʻohui

myocardial infarction hou,
maʻi maʻi maʻi pehu
nā huakini makeʻe e ka waiʻona, barbiturates a i ʻole opiates,
koki-kikina glaucoma,
hoʻohana pū me MAO inhibitors a hiki i 2 mau pule ma hope o ko lākou hoʻi ʻana i waho.
hypersensitivity i amitriptyline.

Saroten Retard - Nā Kauohaʻi kūikawā

Pono e hoʻohana ʻo Saroten Retard me ka mālama ʻana i nā mea maʻi me ka hoʻomanawanui a paʻa, mālama i ka urinary, prostert hypertrophy, maʻi o ka naʻau a me ka maʻi cardiovascular, a me ka hyperthyroidism.

Ke loaʻa i kahi hopena sedative, hiki ke hoʻopilikia i ka hiki ke mālama i ke kaʻa a me nā hana ʻē aʻe. ʻO nā mea maʻi e lawe ana iā Saroten Retard e pono e hōʻike maikaʻi ʻia e ke kauka e pili ana i kēia ʻano o ka lāʻau.

Saroten Retard - ʻOiau

Nā Hoʻomaka Kāʻe a hoʻonāukiuki paha o ke kaila poʻokela o nā kikowaena. Nā hōʻike hōʻike kūpono o anticholinergic (tachycardia, nā membrane mucous maloʻo, mālama ʻana i ka urinary) a me nā cardiotoxic (arrhythmias, hypotension arterial, hōʻeha o ka naʻau). ʻO nā maʻi hoʻohālikelike. Hyperthermia.

Hoʻomaʻamaʻa. Ua noʻonoʻo ʻia. Pono e halihali ma ka haukapila. Me ka hoʻokolohua waha ʻana i ka amitriptyline, pono e hana ʻia ka nui o ka gastrics i ka wā hiki ke hoʻolilo i ka ulana hoʻōla. Pono e lawe ʻia nā hana e mālama i ka ʻōhumu a me nā ʻōnaehana cardiovascular. Pono ke nānā ʻana i ka hana cardiac ma loko o 3-5 lā. ʻAʻole pono ʻo Epinephrine (adrenaline) i kēlā mau hanana. No nā maʻi kūpaʻa, hiki ke hoʻohana ʻia ʻo diazepam.

Saroten Retard (Saroten Retard) - pili pūlea

Hiki i ka Amitriptyline ke hoʻoikaika i nā hopena o ka ethanol, barbiturates a me nā mea'ē aʻe e hōʻeha ana i ka pūnaehana neʻe.

Hiki i ka hoʻohana like me nā MAO inhibitors ke alakaʻi i ka pilikia hypertensive.

No ka mea e hoʻonui ʻo amitriptyline i ka hopena o nā anticholinergics, pono e pale ʻia ka hoʻoku like ʻana me lākou.

Hoʻonui ʻo ia i nā hopena o ka sympathomimetics o ka epinephrine (adrenaline), norepinephrine (norepinephrine), ma muli o kēia, nā anesthetics kūloko i kēia mau mea pono e hoʻohana pū ʻia me ka amitriptyline.

Hiki i ka emi o ka hopena antihypertensive o ka clonidine, betanidine, a me ka guanethidine.

Ke hoʻonohonoho pono ʻia me nā antipsychotics, pono e noʻonoʻo i ka tricyclic antidepressants a me nā antipsychotics a pale pālua i ka metabolism o kēlā me kēia, e hoʻohaʻahaʻa ana i ka paepae no ka mākaukau paʻa.

Me ka hoʻohana like ʻana me ka cimetidine, kahi i hoʻohaʻahaʻa i ka metabolism o ka amitriptyline, ke piʻi nei ka nui o kona kaila i loko o ke koko koko a me ka ulu ʻana o nā hopena o nā mea make.