Ke ʻano lapaʻau ʻo Gabapentin: nā ʻōlelo no ka hoʻohana ʻana

ʻO ka wehewehe e pili ana i 04.02.2015

Palapala Latin: Gabapentin
ʻĀkau ATX: N03AX12
Mea waiwai: Gabapentin
Mea Hana: PIK-PHARMA, Canonfarm Production CJSC (Russia), Aurobindo Pharma (India), Erregierre S.p.A. (Italia)

A 1 kōpō Gabapentin 300 mg

ʻO ka calcium o ka hydrogen phosphate, ke kō kalato, macrogol, magnesium stearate - e like me ka mea hoʻopuka.

Nā hōʻailona no ka hoʻohana ʻana

monotherapy ʻike kikoʻī ma epilepsy i nā mākua a me nā keiki mai nā makahiki 12.
hana hou aku hopu palapala me ka epilepsy i nā pākeke,
hana hou aku epilepsy kūlia i na keiki mai 3 mau makahiki,
migraine,
ʻeha kaho ʻana (neuralgia postherpetic, maʻi maʻi, trigeminal, HIV-pili, alakino, me ka spinal stenosis),
ke emi ʻana o ka ulu ʻana o ka ʻeha i ka wā muhōkai.

Nā Hoʻohui

koi lōkohu,
keʻano ʻole o ka lāʻau,
galactose intolerance aiʻole malabsorption o ka glucose a me ka galactose,
mau makahiki a hiki i 3 mau makahiki me nā hopu pōkole epileptic,
i nā makahiki he 12 a me ka postherpetic neuralgia,
hapai.

Nā hopena hopena

hoʻonui HANʻI, tachycardia,
dyspepsia, kikia, ka ʻōpū o ka ʻōpū, ka malo maloʻo maloʻo, anorexia, constipation a i ʻole nā ninia, lōkohu, he ʻano hūnā, gingivitis,
myalgiaʻeha ke kaumaha
hiamoe, āhāhuʻe, nystagmusmāhuahua mea momonaa hue nui, hoʻēkohu, gʻehaʻeha, hōʻehahilahila hyperkinesia,hopohopo, insomnia,
rhinitis, pharyngitis, kahuʻai,
ka paʻuhū ʻana,
ʻikeʻia ke kala, tinnitus,
ʻili he wahi pehihuhū erythema,
uku kaumaha, paona ʻana, ka māla ʻana.

Hoʻohui

Hoʻohana ʻia ka hoʻohana like ʻana o nā lāʻau antiepileptic ʻē aʻe (Phenobarbital, Carbamazepine, Phenytoin, Valproic Acid) a me nā ʻākā lulu. I kēia hihia, ʻaʻole loli i ka pharmacokinetics o gabapentin.

Hoʻopau nā antacids i ka bioavailability o ka lāʻau, no laila ke lawe nei i ka lāʻau nui a me nā antacids e hoʻonui i ka wā.

Hoʻonui i nā lāʻau Myelotoxic i ka hematotoxicity o ka gabapentin.

E hui pū me papa inoa moraki ʻAʻole i loli ka morphine pharmacokinetics. Eia nō naʻe, ʻoi aku ka maikaʻi o nā hopena kūlohelohe mai ka pūnaehana nū o ka puni.

Hiki i ka inu ʻona ke hoʻonui i nā hopena ʻino mai ke kikowaena kūloko o ka pehu (ataxia, stupor).

Nā ʻōlelo kikoʻī

Inā pono e hoʻokuʻu i ka lāʻau lapaʻau, pono e hoʻemi ʻia ka hōʻemi ʻana i nā laʻala (i 1-2 mau pule), ʻo ka hoʻokaʻawale ʻana o ka maʻi e hiki ai ke hoʻonāukiuki i kahi epistatus. I ka wā hāpai ʻia, ʻae ʻia ke hoʻohana e like me nā ʻōmole koʻikoʻi, i ka wā e ʻoi aku ka maikaʻi o ka makuahine i ke kīpē ʻana.

Inā ka ataxia, dizziness, loaʻa ka paona, ke hiamoe nei i ka luhi i ka poʻeʻelemakule, a me ka hiamoe a me ka huhū i nā keiki, pono e hoʻōki ʻia ka mālama ʻana. I ka wā mālama, pono ʻoe e pale i ke kaʻa.

E hoʻokuʻu i ke ʻano a me ke ʻano o ka lāʻau lapaʻau

Loaʻa ka Gabapentin i loko o ka pime kapili no ka hoʻokō waha. Hoʻopili ʻia ka lāʻau lapaʻau ma loko o nā kēpili palila o 50 a 100 mau ʻāpana a i loko paha o nā lūlū o nā hapa he 10 -15 i loko o kahi pahu pahu.

ʻO kēlā me kēia mau kōpū he waiwai hoʻoneʻe - gabapentin 300 mg, a me kekahi lehulehu o nā mea kōkua: calcium stearate, gelatin, titanium dioxide, microcrystalline cellulose.

Hoʻohana ma ka hana lapaʻau

Ua kūkulu ʻia ʻo Gabapentin ma Parke-Davis a ua wehewehe mua ʻia i ka makahiki 1975. Ma lalo o ka inoa inoa inoa o Neurontin, ua apono mua ʻia ʻo Mei 1993 no ka mālama ʻana i ka epilepsy i UK a kūʻai ʻia i United States ma 1994. A ma hope iho, ua ʻae ʻia ʻo gabapentin i United States no ka mālama ʻana i ka neuralgia postherpetic i Mei 2002. I Ianuali 2011, ua ʻāpono ʻo ʻAmelika Hui Pū ʻIa i nā palapala hoʻolaʻa i ka gabapentin no ka hoʻokele hoʻokahi-lā i lalo o ka inoa inoa ʻo Gralise. Ua kau ʻia ʻo Gabantine anacarbil ma lalo o ka inoa inoa ʻo Horizant, nona ka bioavailability kiʻekiʻe, i hoʻolilo ʻia ma ʻAmelika no ka mālama ʻana i nā maʻi wāwae hoʻomaha i ka malama o ʻAkakopa 2011 a ua ʻae ʻia no ka mālama ʻana i ka neuralgia postherpetic i Iune 2012.

Hoʻohana ma ka hana lapaʻau

Hoʻohana nui ʻia ʻo Gabapentin e mālama i ka makeʻe ʻana me ka ʻeha neuropathic. Hoʻohana nui ʻia kēia ma ka waha, me ka noiʻi e hōʻike ana "ʻaʻole maikaʻi ka hoʻokele kūpono." Hoʻokuʻamaʻa ʻia ia no nā noi ʻana he nui, i ʻole e like me ka mālama ʻana o nā hana hoʻoluhi hopohopo, ʻāʻī a me nā maʻi bipolar. Eia nō naʻe, he hopohopo e pili ana i ka maikaʻi o nā hoʻokolohua i hana ʻia a me ka hōʻike no kekahi o kēia mau noi, ʻoi loa ia i ka manawa i hoʻohana ʻia he stabilizer ʻano no ka maʻi bipolar.

Pharmacological waiwai o ka lāʻau

ʻO Gabapentin kahi lāʻau lapaʻau me ka hopena anticonvulsant i'ōlelo ʻia. Ma lalo o ka hopena o ka lāʻau i ka poʻe maʻi me ka epilepsy, e hōʻemi ana i ka hopena o ka hoʻomohala ʻana i nā hoʻouka kaua.

Hoʻohana ʻia kēia lāʻau lapaʻau e mālama i nā pākeke a me nā keiki no ka mālama ʻana i ka ʻeha epilepsy a me ka hōʻeha ʻana o ka neuropathic e kū'ē ana i ke kumu o ke ahulau.

Lapaʻau lāʻau

Ma ka hana, like ka gabapentin e like me ka GABA neurotransmitter (gamma-aminobutyric acid), akā he ʻano ʻokoʻa ke ʻano o nā hana i nā lāʻau ʻē aʻe e pili pū ana me nā ʻĀlelo GABA (valproic acid, barbiturates, benzodiazepines, GABA uptake inhibitors, GABA transaminase inhibitors, a me nā agonists o nā agonists o GABA Nā puka GABA).

ʻAʻohe o Gabapentin i nā waiwai GABAergic a ʻaʻole i hoʻopilikia i ka uptake a me ka metabolism o GABA. Wahi a nā haʻawina mua, hoʻopaʻa ʻia ka waiwai i ka α₂-δ-subunit o nā kaila calcium-hilinaʻi a me ka hoʻohaʻahaʻa ʻana i ka kahe o nā calcium kalaiwa, he mea nui ka hana i ka hoʻomohala ʻana o ka ʻeha neuropathic.

ʻO nā hana ʻē aʻe o ka hana no ka ʻeha neuropathic:

hoʻonui mahuahua o GABA,
ka emi ʻana o ka make me ka huina o glutamate,
ka pale ʻana i ka hoʻokuʻu ʻana o ka neurotransmitters o ka hui monoamine.

I loko o nā kikinila lapaʻau koʻikoʻi o ka gabapentin me nā mea nānā no nā lāʻau maʻamau a me nā neurotransmitters, ʻo ia hoʻi o nā mea GABA_IGABA_A, Nā glycine, glutamate, N-methyl-D-aspartate, a i ʻole nā mea hoʻokipa benzodiazepine, ʻaʻole e hoʻopaʻa i ka mea paʻa.

ʻAʻole i pili ʻo Gabapentin, like me ka carbamazepine a me ka phenytoin, ʻaʻole i pili i ka hā o ka sodium ma ka vitro. I ka wā i loko o vitro therapy, hōʻike kekahi mau hōʻike i ka vitro hōʻike i kahi māhele o ka hopena o nā hopena o ka hopena agonist glutamate receptor N-methyl-D-aspartate, akā aia wale nō i ka hoʻokaʻina o> 100 μmol, ʻaʻole i loaʻa ka vivo. Ua hoʻemi ikiʻo Gabapentin i ka hoʻokuʻu ʻana o nā neurotransmitters monoamine.

Lapaʻau lāʻau

ʻAʻoleʻike ka bioavailability o ka gabapentin i ka kūlohelohe i ke ʻano a hōʻemi me ka hoʻonui ʻana i ka nui. C_max (ka uka nui o ka waiwai) gabapentin i ka plasma ma hope o ka hoʻokomo ʻia ʻana o ka waha ma 2-3 mau hola. ʻO ka bioavailability piha kūpono e pili ana i ka 60%. ʻO ka meaʻai, me ka loaʻa o ka nui o ka momona, ʻaʻole ia e pili i ka nui o ka parekasa pharmacokinetic.

ʻO ka wehe ʻana o nā mea mai ka plasma he mea wehewehe maikaʻi loa me ka hoʻohana ʻana i ka hoʻohālike laina. T_1/2 (e hānai i ka hapalua-ola) mai nā minamina plasma i nā hola 5-7 i hiki ʻole ke hilinaʻi i ka pākī. Me ka hoʻohana pinepine ʻana, ʻaʻole loli ka nui o nā pharmacokinetic. Hiki ke wānana i ka waiwai o ka likilibrium plasma ma muli o nā hopena o hoʻokahi hopena o ka lāʻau.

ʻAʻole paʻa ʻo Gabapentin i nā protein plasma (80 - 900-2400 mg i ka lā,

KK 50–79 - 600–1200 mg i ka lā,

KK 30-49 - 300-6600 mg i kēlā me kēia lā.

KK 15–29 - 300 mg i kēlā me kēia lā 300 mg i kēlā me kēia lā.

ʻLoe a me ke kākele

Pono e hoʻohana pono ʻia ʻo Gabapentin Vidal me ka pau loa o nā ʻōlelo a ke kauka hele mai. ʻAʻole kīnā ʻia nā ʻōpiopio ʻona ʻole i ke kūkā mua ʻana me ka loea, no ka mea he nui nā contraindications a me nā hopena ʻaoʻao e hiki ke hoʻopilikia wale i ke kūlana a me ka hoʻopilikia ʻana i ke kūlana o ka mea maʻi. ʻO ke kauoha e hoʻohana ʻia ʻo Gabapentin ma mua o ka lawe ʻana i nā kapsul e pono ai ke aʻo.

Lawe ʻia ka lāʻau lāʻau. Hoʻokumu ka dosis o kēlā me kēia lā i ka makahiki o ka mea maʻi, ka palaka e hoʻopilikiaʻole iā ia, ka hiki ʻana o nā maʻi concomitant. Eia ke ʻano ʻana a me ke ʻano o ka hoʻohana ʻana i ka lāʻau.

Me ka epilepsy:

makua, keiki mai nā makahiki 12: 1 mau kapule o 300 mg 3 mau manawa i kahi lā,
ʻO ka palena loa o kēlā me kēia lā he 3600 mg, kūpono - mai 900 a 3600 mg,
waena o waena o kēlā me kēia hoʻokipa o ke kālā - ʻaʻole iʻoi aku ma mua o 12 mau hola
ae ʻae ʻia ke koho ana o ka hapa kūlohelohe (ʻo ka lā mua o ka mālama ʻana - 1 kōlani 300 mg, ka lua - 2 mau pūnoi o 300 mg ma 2 mau kīnē i hoʻokaʻawale ʻia, ʻo ke kolu - 3 mau kapula o 300 mg ma 3 mau dute i hoʻokaʻawale ʻia).
keiki mai 3 a 12 mau makahiki: 25-35 mg / kg 3 mau manawa i ka lā.

Me ka neuralgia:

makua, keiki: 1 mau kiaʻi o 300 mg 3 mau manawa i ka lā,
laila ke hoʻonui ʻia ka nui i ka 3600 mg,
ʻaʻole i emi iki ka nui o 3600 mg.

Hoʻohui nūhou

ʻAe ʻia e lawe i nā kūmole waha a me nā lāʻau antiepileptic ʻē aʻe me ka lāʻau lapaʻau i ka manawa like: ʻo Caramaamaama, fenobarbital, phenytoin. ʻAʻole pili kēia mau lāʻau i ka pharmacokinetics o nā papa. ʻO ka komoʻana o nā antacids a me nā sorbents e hōʻemi loa ʻia, no ka mea e hoʻēmi ana i ka bioavailability o Gabapentin. Inā nui nā antacids a me nā sorbents i kaʻai, a laila pono ʻoe e lawe iā lākou a me ka lāʻau nui me ka hoʻokaʻawale o ka manawa he 2 a 3 mau hola.

ʻO ka lāʻau Myelotoxic, e like me nā antacids, e hoʻohana ʻia me ka mālama akahele no ka mea ke kōkua o ka nui i ka hematotoxicity. Inā lawe pū ʻoe i ka lāʻau lapaʻau me ka morphine, a laila ʻaʻole i loli ka pharmacokinetics o ka morphine, akā pono pono ʻoe e kaohi ʻia i nā hopena ʻino e hiki mai ana ma o ka ʻaoʻao o ka pūnaehana. Hoʻonui ka waiʻona i ka wā e lawe ai ʻo Gabapentin i nā hopena ʻino, no laila, ʻaʻole i kauoha ʻia ka inu ʻawa i ka wā mālama.

Ke keu

Hōʻike kēia mau hōʻailona i ka nui o ka nui o kēlā me kēia lā o ka lāʻau.

hoʻonā wahaʻōlelo
hiamoe
āhāhuʻe
ʻike wua
waiawai,
huhū.

Therapy ma ka hihia o kahi overdose a hōʻailona. I nā huaʻōlelo ʻē aʻe, hāʻawi nā kauka i ke kōkua, e noʻonoʻo ana i nā hōʻailona hōʻike. Hoʻolālā ʻia nā hana penei:

hihiki
hemodialysis
hoʻokipa a nā ʻōpio.

ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau i ka wā o ka hāpai a me ka umauma

ʻAʻole kuhikuhi ʻia kēia lāʻau lapaʻau no ka mālama ʻana o nā wahine i ka wā o ka kali ʻana o kahi keiki ma muli o ka loaʻa ʻole o ka ʻike pono ʻana i ka palekana o ka hana ikaika o nā capsule ma ka pūpū a me ka hoʻomohala ʻana. Ua hōʻike ʻia nā haʻawina holoholona holoholona me ka hoʻohana lōʻihi ʻana o Gabapentin i ka wā hāpai, kahi lohi i ka ulu a me ka hoʻomohala ʻana o ka pūpū i loko o ka ʻōpū.

Hoʻomoʻu ka lāʻau maikaʻi i ka waiū umauma, no laila ke kōkua ʻia ka hoʻohana ʻana i ka wā o ka lactation no ka loaʻa ʻole o ka ʻike maopopo e pili ana i ka hopena o nā capsules ma ke kino o ka pēpē.

Inā pono kahi terapi anticonvulsant, pono e nīnau aku ka wahine hapai a me ka lactating i ke kauka i mea e koho ai i kekahi ʻano lapaʻau.

Nā hopena hopena

E kū'ē i ka hope o ka hoʻohana o ka lāʻau Gabapentin, hoʻomohala pinepine ʻia ka hoʻomohala ʻana o nā hopena hope aʻe i loko o nā mea maʻi:

Mai ka ʻaoʻao o ka pīnaehana - ka ʻeha, hopohopo, hoʻomākeʻilihune, hoʻomohala i nā ʻano o nā neʻe, ke kua ʻana o nā kuʻekuʻe, nā manaʻo hopohopo i ka makaʻu, hopohopo i ka mea e hana nei, paresthesia, hoʻohaʻahaʻa i nā reflexes,
Mai ka pūnaehana hana ʻana - kaila, ka luaʻi, ka hoʻopiha nui, ka constipation a i ʻole ka ʻeha ʻana, nā ʻeha i ka hypochondrium kūpono, hoʻomohala i ka pancreatitis, hoʻonui i ka transaminases ate, nui aʻe kūkaʻi, pehuatitis, nā māka huakaʻi.
Mai ka ʻaoʻao o ka puʻuwai a me nā kīʻaha koko - he hoʻololi i ke kahe o ke koko (hoʻemi a hoʻonui ʻia paha), arrhythmias cardiac, he makai o ka "wikiwiki" i ka maka a me nā limu,
Ma ka ʻāpana o ka ʻōnaehana hanu - ka ihu o ka membrane maile o ka nasopharynx, ke oki o ka hanu, ka ʻōpū,
Mai nā kino o nā urinary a me ka hoʻopiʻi - i hoʻemi ai i ka makemake moekolohe, ka maʻi urinary incontinence, impalired renal function,
Ka loli o ke kiʻi o ke koko - ke emi ʻana o ka nui o nā keaka koko keʻokeʻo, ʻopi.

I nā hihia lohi, i ka wā o ka maʻi maʻi, ʻike ka poʻe maʻi i ka hōʻeha ma ka ʻili, urticaria, angioedema.