Ke ʻano lāʻau lapaʻau lāʻau: nā ʻōlelo no ka hoʻohana ʻana

Carbamazepine: nā ʻōlelo e hoʻohana ai a e loiloi

Palapala inoa Latin: Carbamazepine

ATX Code: N03AF01

ʻO ka papa hana: carbamazepine (carbamazepine)

Mea Hana: LLC Rosfarm (Lūkini), CJSC ALSI Pharma (Lūsia), OJSC Synthesis (Lūkini)

Hoʻouka i ka wehewehe a me ke kiʻi: 07/27/2018

ʻO nā kumukūʻai ma nā lāʻau lapaʻau: mai ka 58 mau rubles.

ʻO ka Carbamazepine kahi lāʻau lapaʻau me ka hopena psychotropic, antiepileptic effect.

E hoʻokuʻu i ke ʻano a me ka ʻano

Kuhi ʻia ka Carbamazepine i ke ʻano o nā papa (10, 15, 25 pcs. I loko o nā pōpoki blister, 1-5 mau ʻeke i kahi pahu pepa, 20, 30 mau pcs I loko o nā pā blister, 1, 2, 5, 10 mau pākeke i ka pahu. pūʻulu, 20, 30, 40, 50, 100 pcs. i ka ipu ʻauʻau, 1 hiki i ka pūlima pepa).

Aia ka hoʻonohonoho ʻana o ka papa pākuhi 1:

Mea waiwai waiwai: carbamazepine - 200 mg,
ʻO nā mea kōkua: talc - 3.1 mg, povidone K30 - 14.4 mg, colloidal silicon dioxide (aerosil) - 0.96 mg, polysorbate 80 - 1,6 mg, kālai kalato - 96.64 mg, magnesium stearate - 3 , 1 mg.

Lapaʻau lāʻau

ʻO ka Carbamazepine kahi derivative dibenzoazepine, ka mea i hiʻohiʻona e nā hopena antiepileptic, neurotropic a me psychotropic.

I kēia manawa, aʻoi wale ʻia ka ʻano o nā hana o kēia ʻano. Mālama i ka hoʻoiho synaptic o nā pulle hoihoi, pale i ka hoʻokuʻu ʻana o nā neurons, a alakaʻi i kahi kūlana paʻa o ka membrane o nā neurons overexcited. ʻO ka mea maʻamau, ʻo ka hana nui o ka hana o ka carbamazepine ka mea e pale ai i ka hoʻokumu ʻana o nā hana waiwai e hilinaʻi ʻia ana i ka sodium depolarized ma muli o ka "hana" blockade - hilinaʻi a me nā pololi o ka pono o ka sodium.

Ke hoʻohana nei i ka lāʻau lapaʻau e like me ka monotherapy i nā poʻe maʻi me ka epilepsy (ma ke ʻano he nui a nā keiki a me nā ʻōpio), ua ʻike ʻia kahi hopena psychotropic, i hōʻike ʻia i ka wehe ʻana i nā hōʻailona o ka hopohopo a me ke kaumaha, a me ka hoʻohaʻahaʻa i ka hōʻeha a me ka huhū. ʻAʻohe mea ʻike e like me ka hopena o ka carbamazepine ma luna o nā hana cognitive a me psychomotor: i kekahi mau noiʻi, ua hōʻike ʻia kahi hopena ʻelua a maikaʻi ʻole paha e pili ana i ka dosis, ua hōʻoia ʻia nā noiʻi ʻē aʻe i ka hopena maikaʻi o ka lāʻau lapaʻau ma ka hoʻomanaʻo a me ka nānā.

E like me ka mea hoʻoponopono neurotropic, maikaʻi ka carbamazepine i kekahi mau maʻi neʻe. No ka laʻana, me ka lua a me ka idiopathic nemogia trigeminal, e pale i ka hōʻea ʻana o nā hōʻeha ʻeha paroxysmal.

I ka poʻe maʻi me ka hoʻohaʻawale ʻaka ʻawaʻawa, hoʻonui ʻia ka carbamazepine i ka mākaukau o ka mākaukau, a me kēia ke hoʻemi i ka nui o nā maʻi, a me ka hōʻemi ʻana i ka maʻi o nā hōʻike kuʻuna o ka maʻi (ʻo kēia mau hana haunaele, hoʻoulu, hoʻonui ʻia irritability).

I nā maʻi me ka maʻi insipidus maʻi, hōʻemi ʻia ka carbamazepine i ka diuresis a kāpae i ka makewai.

Ma ke kumuhana he psychotropic, ua hoʻolaʻa ʻia ka lāʻau lapaʻau no ka hoʻopalike, a me ka mālama ʻana i nā kūlana manic, no ke kākoʻo ʻana i nā maʻi bipolar (manic-depressive) pilikia (hoʻohana pū ʻia ka pahu aama) a me ka lithium, antidepressant a me nā lāʻau antipsychotic), aʻo manic hoʻomanawanui i ka naʻau, i hele pū me ka neʻe wikiwiki, me ka hoʻouka ʻana o ka manic, i ka wā i hoʻohana ʻia ai ka carbamazepine i hui pū me nā antipsychotics, a me nā puʻe ʻana hoʻi o nā maʻi psychiz. ʻO ka hiki i ka lāʻau lapaʻau e hōʻoki i nā hōʻike manic e hiki ke wehewehe i ka hoʻokaʻawale ʻana o ke hoʻololi ʻana o ka norepinephrine a me ka dopamine.

Lapaʻau lāʻau

Me ka hoʻokolohua waha, ua hoʻohuihui ʻia ka carbamazepine i loko o ka pānao ʻana. ʻO ka lawe ʻana i ka lāʻau lapaʻau i ka papa ʻaina pū kekahi me ka hoʻowalewale lohi ʻana. Ma hope o hoʻokahi ala o 1 papa o ka carbamazepine, ma ka awelika, ʻoi ka nui o kona kaila ma hope o 12 mau hola. Ma hope o hoʻokahi o ka hopena o ka lāʻau i loko o kahi pona o 400 mg, ʻo ka hoʻohālikelikeʻana i ka lōʻihi o ke koena o ka carbamazepine i loli ʻole e like me ka 4,5 μg / ml.

Ke lawe nei i ka carbamazepine i ka manawa like me ka meaʻai, ke ʻano o ka pae a me ka helu o ka nalo ʻana o ka lāʻau lapaʻau, ʻaʻole i loli. Loaʻa ka ʻike ʻana o ka eka i ka mea waiwai i ka plasma i 1-2 mau pule. ʻO ka manawa o kona hoʻokō ʻana he kanaka hoʻokahi a hoʻoholo ʻia e ka pae o ka auto-induction o nā pūnao enzyme o nā pepama e ka carbamazepine, ke ʻano o ka mea maʻi ma mua o ka hoʻomaka ʻana o ka ʻano o ka hoʻōla, ka hopena o ka lāʻau lapaʻau, ka lōʻihi o ka therapy, a me ka hetero-induction e nā lāʻau ʻē aʻe i hoʻohana ʻia me ka hui ʻoama me kaamaama. Aia nā ʻokoʻa kūʻokoʻa i ka nui o nā waiwai o ka kūlike i ka ʻōpū o ka nui o nā hopena therapeutic: ma ka hapanui o nā maʻi, nā ʻōmole ma waena o 4 a 12 μg / ml (17-50 μmol / l).

Hoʻopaʻa ʻo Carbamazepine i ka paʻu placental. I ka aneane pau loa, ua hūnā ʻia ka nui o ka hoʻoili ʻana i ka punawai 0.8-11.9 l / kg.

Hoʻopili i nā metabolabolic o ka carbamazepine i loko o ka mōʻī. ʻO ke ala nui loa o ka biotransformation o ka waiwai ka epoxidation me ka hoʻokumu ʻana o nā metabolites, ʻo ia ka mea nui i waena o ka derivatif 10.11-transdiol a me ka huahana o kāna hui me ka hoʻoneʻe glucuronic. ʻO Carbamazepine-10,11-epoxide i ke kino o ke kanaka e hele ana i ka carbamazepine-10,11-transdiol me ke komo ʻana o ka epoxyhydrolase enzyai microsomal. ʻO ke kūlike o ka carbamazepine-10,11-epoxide, kahi mea metabolite kūlohelohe, kahi o 30% o nā kikoʻī o ka carbamazepine i loko o ke kaila koko. ʻO ka isoenzyme nui e pili ana i ka hoʻololi ʻana o ka carbamazepine i ka carbamazepine-10,11-epoxide i manaʻo ʻia ʻo ka cytochrome P4503A4. Ma kahi o nā kaʻina metabolic, kahi liʻiliʻi kekahi o nā metabolite i hana ʻia - 9-hydroxymethyl-10-carbamoylacridane.

ʻO kahi ala nui no ka molamine metabolika ʻo ka kāwili ʻana i ke ʻano o nā ʻano derivatives monohydroxylated, a me N-glucuronides, e hoʻohana ana i ka isoenzyme UGT2B7.

ʻO ka hapalua o ka ola o ka mea o ke ʻano o ka loli ma hope o ka lawelawe waha ʻana o ka lāʻau lapaʻau ma ka 36 hola mau hola, a ma hope o nā helu pinepine o ka lāʻau - e pili ana i nā hola 16-24, e pili ana i ka lōʻihi o ka therapy (ʻo ia ka hana o ka autoinduction o ka m mioxygenase system). Ua hōʻike ʻia i loko o nā mea maʻi e hoʻopili ai i ka carbamazepine me nā lāʻau lapaʻau ʻē aʻe e koi ai i nā enzyme o ka ate (no ka laʻana, ka phenobarbital, phenytoin), ka hapalua o ka ola o ka lāʻau i ka manawa nui a ʻaʻole iʻoi aku ma mua o 9-10 hola.

Me ka ka waha o ka waha o ka carbamazepine-10,11-epoxide, ʻo ka hapalua hapalua o kona ola ma kahi o 6 hola.

Ma hope o hoʻokahi kaʻi ʻana waha o ka carbamazepine ma kahi o ka 400 mg, ʻo 72% o ka waiwai e hoʻopio ʻia ma o nā aʻalolo a me 28% ma o nā ʻāpana. Ma kahi o 2% o ka nui o ka nui i lawe ʻia ma ka urine, e hōʻike ana i ka carbamazepine i loli ʻole, a ma kahi o 1% e like me ka 10.11-epoxy metabolite e hōʻike ana i ka hana metabolic. Ma hope o ka lawelawe waha hoʻokahi, 30% o ka carbamazepine i hoʻopili ʻia ma o nā ʻōpū ma nā hopena hope o ka kaʻina epoxidation.

Loaʻa nā keiki i ka carbamazepine wikiwiki, no laila, i kekahi manawa pono ke kuhikuhi i nā dosis kiʻekiʻe o ka lāʻau lapaʻau, i helu ʻia ia e pili ana i ke kaumaha o ke kino o ke keiki, a hoʻohālikelike ʻia me nā mea maʻi.

ʻAʻole ʻike nā ʻike e pili ana i nā loli i ka pharmacokinetics o ka carbamazepine i nā maʻi maʻi ʻelemakule i hoʻohālikelike ʻia me nā mea maʻi ʻōpio.

ʻAʻole i aʻo ʻia nā pharmacokinetics o ka carbamazepine i nā mea maʻi me nā maʻi o ka renal a me ka hepatic.

Nā hōʻailona no ka hoʻohana ʻana

ʻO ka make pū ʻana ʻo Epilepsy (koe wale nō ka hopu ʻana i ka flaccid a i ʻole myoclonic), ka haʻalele ʻana - ka lua a me ka mana nui o nā pāluna, ka hele pū ʻana me ka māhu tonic-clonic, ka pōkole puʻu me nā maʻi maʻalahi a paʻakikī, hui pū me nā mea ʻaihue (monotherapy a i hui pū me nā lāʻau ʻē aʻe me ka hana anticonvulsant).
Polyuria a me polydipsia me ka maʻi diabetes indipidus, ʻeha ʻeha me ka polyneuropathy maʻi maʻi, neuralgia trigeminal me ka lehulehu o ka sclerosis, idiopathic trigeminal neuralgia, ʻokoʻa hōʻea i ka wai, ʻatikala idiopathic glossopharyngeal neuralgia, ʻeha hopohopo,
ʻO nā maʻi e pili ana i ka phase-flow, e pili ana i nā maʻi schizoaffective, manic-depressive psychosis, etc. (pale).

Nā Hoʻohui

Palani Atrioventricular
Haki ka iwi healopoiesis o ka iwi iwi,
Porphyria pākuʻeha ākea (a me ka mōʻaukala)
E hoʻohana me ka monoamine oxidase inhibitors a no 14 mau lā ma hope o ko lākou haʻalele ʻana,
ʻŌpū a me ka lactation
ʻO ka hypersensitivity i nā mea o ka lāʻau, a me ka mea pono i nā lāʻau lapaʻau e like me ka mea hana ikaika (tricyclic antidepressants).

E like me nā ʻōlelo aʻoaʻo, pono ke hoʻohana ʻia ka carbamazepine ma ka manawa like i ka lawe ʻana i ka waiʻona, nā poʻe maʻi kahiko, ʻo ia hoʻi nā mea maʻi me ka puʻuwai kaumaha, dilution hyponatremia, piʻi iho i ka naʻau intraocular, pale ʻana i ka hematopoiesis pumehana i ka wā e lawe ana i ka lāʻau lapaʻau (mōʻaukala), ka hyperplasia prostatic, ʻeha ka hema. uhaola hooulu pila.

Nā hopena hopena

I ka wā o ka hoʻohana ʻana i ka carbamazepine, hiki i nā hopena aʻe ka hopena:

Pūnaehana pīhoihoi waena: ataxia, dizziness, palupalu maʻamau, nā ʻeha, ke hoʻopuka oculomotor, ʻeha, hōʻeha, ʻehaʻelima, noho kuʻuna, lūlū, orkacial dyskinesia, kelepona choreoathetoid, peripheral neuritis, dysarthria, paresthesia, paresis, nāwaliwali o ka naʻau,
Pūnaehana Cardiovascular: he hōʻemi a hoʻonui paha i ke koko, ke hoʻopuka ʻana o ka cardiac, hōʻemi, bradycardia, arrhythmias, atrioventricular block me ka maʻemaʻe, ka hoʻomohala a i ʻole ka ulu ʻana o ka puʻuwai naʻau congestive, exacerbation o ka maʻi naʻau coronary (me ka hoʻonui ʻana a i ka wā e hōʻeuʻeu mai i nā hoʻālaina angina), thrombotic thrombosis ,
Pūnaehana Digestive: waha maloʻo, luaʻi, nuka, constipation a maʻi paha, ʻeha ka ʻōpū, ʻōpū o ka ʻōpū, ka huehue, pancreatitis,
Pūnaehana genitourinary: renal failed, interstitial nephritis, impaired renal function (hematuria, albuminuria, oliguria, azotemia / nui urea), mālama urinary, hoʻonui urination, impotence / hana hoʻopunipuni,
ʻO ka system endocrine a me ka metabolism: ka hyponatremia, ka nui o ka momona, ka edema, ka hoʻonui ʻana i ka pae prolactin (e like pū me ka hoʻomohala ʻana i ka galactorrhea a me ka gynecomastia), kahi hōʻemi i ka pae o L-thyroxine (free T4, TK) a me ka hoʻonui ʻana i ka pae o ka hormone thyroid-stimulating (maʻamau me ka ʻike ʻole ʻana i nā mea lapaʻau. hui pū), osteomalacia, nā hōʻeha o ka metabolism calcium-phosphorus i ka iwi o ka iwi (e hoʻohiolo ana i ka manaʻo o 25-OH-cholecalciferol a me ka ehi ʻia o ka calcium ma ke koko plasma), hypertriglyceridemia, hypercholesterolemia,
ʻŌnaehana musculoskeletal: arthralgia, cramps, myalgia,
Hōʻaha: ʻoi aku ka hana o ka gamma-glutamyl transferase (ma ke ʻano he kānāwai, ʻaʻohe manaʻo koʻikoʻi), ka hana nui o ka phosphatase alkaline a me ka "ate" transaminases, hepatitis (granulomatous, kāwili ʻia, cholestatic a parenchymal (hepatocellular) ʻano), hōʻeha ate,
Hemopoietic o nā hui: thrombocytopenia, leukopenia, leukocytosis, eosinophilia, lymphadenopathy, aplastic anemia, puhipihi intermittent, agranulocytosis, anemia megaloblastic, aplas erythrocytic maoli, hemolytic anemia, reticulocytosis
Nā hui ʻai ʻuhane: nā hoʻololi i ka ʻike ʻana i ka pitch, ke ao ana o ka lens, nā mea ʻalā i ka ʻono, conjunctivitis, hypo- a i ka hyperacusia,
Manaheʻe noʻonoʻo: hopohopo, hallucitions, hōʻeha momona, hoʻoweliweli, ʻano hoʻonaninani, disorientation, ʻūhā, hoʻoulu o ka psychosis,
Nā hopena alerine: lupus-like syndrome, exfoliative dermatitis, urticaria, Stevens-Johnson syndrome, erythroderma, toxic epidermal necrolysis, photosensitivity, nodular a me erythema multiforme. He maha nā ʻōhua i ke ʻano o ka maʻi hemo me ka vasculitis, ka ʻala, ka lymphadenopathy, ka ʻili o ka ʻili, eosinophilia, nā lymphoma-like nā maʻi, leukopenia, arthralgia, ka hana naʻau i hoʻololi ʻia a me ka hepatosplenomegaly hiki (ʻo kēia mau hōʻailona hiki ke kū mai i nā ʻano hui like). ʻO nā hui kino ʻē aʻe, e like me ke keiki, nā ʻōpū, ka myocardium, pancreas, a me ka ʻōpū, hiki ke komo pū kekahi. Kēia loa - meningitis aseptic me myoclonus, angioedema, anaphylactic hopena, hoʻonaninau a hypersensitivity o nā māmā, ke ʻano, e like me ka pōkole o ka hanu, ke maʻi, ka maʻi pneumonitis a i ʻole nā maʻi ʻaʻe.
Nā mea ʻē aʻe: purpura, paleʻai pigmentation, hōʻeuʻeu, ʻeha, alopecia.

Ke keu

Me kahi overdose o ka carbamazepine, ʻike nui ʻia nā hōʻailona like ʻole:

mai ka pūnaehana cardiovascular: kiʻekiʻe a haʻahaʻa paha ke koko, tachycardia, maʻi hōʻemi, ke kaʻa ʻia ʻana me ka hoʻolaha ʻana o ka puʻuwai QRS, hopu lima a nāwaliwali, hoʻonāukiuki ʻia e ka hopu lima,
mai ka ʻaoʻao o ka pūnaehana nū waena: mydriasis, konupepa, pohō o ka pūnaehana ʻōlima, hypothermia, disorientation i ka lewa, ahukui, ʻano hoʻomalelele, nā kahawai, ʻike ʻole, coma, myoclonus, dysarthria, slurred speech, ataxia, blurred vision, nystagmus, hyperreflexia (ma ka manawa mua) a me ka hyporeflexia (ma aneʻi), nā wahi psychomotor, dyskinesia, seizures,
mai ka ʻeha o ka gastrointestinal: hōʻemi iki ʻia o ka hoʻokaʻawale ʻana o ka meaʻai mai ka ʻōpū, ka luaʻi ʻana, ka hoʻowalewale o ka ʻōpū,
mai ka ʻōpū o ka hanu: ke kaumaha o ke ala o ka ʻōpū, ka edema pulmonary,
mai ka urinary system: intoxication wai (dilution hyponatremia) pili i ka hopena o ka carbamazepine, like like me ka hana o ka hormone antidiuretic, mālama hoʻomalu, mālama i ka urinary, anuria a oliguria paha.
nā hoʻololi i nā ʻōnaehana laboratorium: ka hiki ʻana o ka hoʻomohala ʻana o ka hyperglycemia a i ʻole ka metabolic acidosis, hoʻonui i ka hana o ka hapa muscular o ka phosphokinase creatine.

ʻAʻole maopopo ka antidote kiko'ī i ka carbamazepine. Pono ke ʻano o ka mālama ʻana i kahi overdose ma ke ʻano o ke ʻano o ka mea maʻi, a ua ʻōlelo ʻia e hoʻokomo ʻia i loko o ka haukapila.

Pono e hoʻokaʻawale i ke kūlohelohe Plasma e hōʻoia i ka make ʻana i ka lāʻau lapaʻau a loiloi i ka paʻakikī o kahi overdose.

Pono e holoi a me ka hoʻokuʻu ʻana i nā mea i loko o ka papa, a me ke kau ʻana i ke kaola. ʻO ka haʻalele ʻana i ka ʻeha o ka gastric e hāʻawi pinepine i ka lohi ʻana i ke kau ʻana, hiki iā ia ke alakaʻi i ka hoʻomohala ʻana o nā hōʻailona o ka ʻalā i ka wā hoʻolaʻa. ʻO ke kākoʻo kākoʻo Symptomatic, ka mea i lawe ʻia i ka waihona mālama pilikino a hele pū ʻia me ka nānā ʻana i ka hana cardiac a me ka hoʻoponopono maikaʻi ʻana i ka haunaele ʻana i ka pae wai-electrolyte, hāʻawi pū kekahi i nā hopena maikaʻi.

Me ka hypotension aractial maʻi, hōʻike ʻia ka hoʻokele intravenous o dobutamine a i ʻole dopamine. Me ka hoʻomohala ʻana o ka arrhythmia, ke koho pono ʻia ka mālama ʻana.I ka loaʻa ʻana o nā mea hoʻohālikelike, e kauoha ʻia e lawelawe ai i ka benzodiazepines, no ka laʻana, diazepam a i ʻole nā mea anticonvulsants e like me ka paraldehyde a me ka phenobarbital (hoʻohana ʻia ka poʻe me ka akahele ma muli o ka nui o ka hopena o ke kaumaha o ka hanu).

Inā hoʻomohala ka mea maʻi i ka inu wai (hyponatremia), pono e hoʻopiʻi ka hoʻomoʻi ʻana i ka wai a mālama ʻia ka waihona o ka sodium chloride 0.9% ma kahi o nā mea he nui ka pale ʻana i ka hoʻomohala ʻana o ka hanaʻino o ka lolo. Hāʻawi ka Hemosorption i nā sorbents i nā hopena maikaʻi. ʻO ka dialy peritoneal, hemodialysis, a me nā diuresis ikaika i manaʻo ʻia he mea lawa ʻole ka lawe ʻana i ka carbamazepine mai ke kino. I ka lā lua a me ke kolu o ka lā ma hope o ke ʻano o nā hōʻailona o kahi overdose, e hoʻonui ʻia kona mau hōʻailona, i wehewehe ʻia e ka lohi ʻana o ka lāʻau lapaʻau.

Nā ʻōlelo kikoʻī

Ma mua o ka hoʻomaka ʻana me ka hoʻohana ʻana iā Carbamazepine, pono ʻoe e hana i kahi hoʻokolohua: kahi hōʻike maʻamau o ka urine a me ke koko (me ka helu helu reticulocytes, platelets), hoʻoholo ʻana i ka pae hao, ka uila a me ka electrolytes i loko o ka serum koko. I ka wā e hiki mai ana, pono e nānāʻia kēia mau kuhikuhi i ka hebedoma i ka malama mua o ka mālama ʻana, a laila - hoʻokahi manawa i ka malama.

Ke kohoʻana i ka carbamazepine i nā poʻe maʻi me ka piʻi ʻana o ke koikoi intraocular, pono ia manawa e kāohi iā ia.

Pono e ho'ōla ʻia ka Therapy inā ulu ʻia ka leukopenia holomua a ʻole leukopenia paha, i hele pū ʻia me nā hōʻailona lapaʻau o kahi maʻi infectious (ʻaʻole holomua ka asymptomatic leukopenia e koi ʻole a pau ʻole o ka carbamazepine).

I ka wā o ka mālama ʻana, pono e mālama ʻia i ka wā e alakaʻi ana i nā kaʻa a hoʻokō i nā ʻano ʻē aʻe ʻē aʻe o ka hana e pono ai ka hoʻonui ʻana o ka nānā a me nā hopena psychomotor wikiwiki.

ʻŌpū a me ka lactation

Ua hōʻike ʻia i hānau ʻia nā keiki i hānau ʻia me ka maʻi maʻi o ka epilepsy i ke kiʻekiʻe o ka maʻi ulu ʻana o ka intrauterine, e komo pū ana nā malformations developmental. ʻAʻohe manaʻo e hiki ai i ka carbamazepine ke hoʻoikaika i kēia predisposition, ʻoiai eia i kēia manawa ke hōʻoia hope loa nei o kēia mea i loaʻa i nā hoʻokolohua lapaʻau e mālama ʻia me ka koho ʻana i ka lāʻau e like me monotherapy.

Aia nā hōʻike o nā hihia o nā maʻi congenital, nā hana hōʻino, me nā spina bifida (ʻaʻole pani ʻia o nā pā kani vertebral), a me nā mea hou aku e like me nā hypospadias, nā hemahema o ka hoʻomohala ʻana o ka ʻōnaehana cardiovascular a me nā ʻōnaehana kino, a me nā mea hana craniofacial.

Pono e hoʻohana pono i ka carbamazepine me ka akahele ʻana i nā wahine hāpai me ka epilepsy. Inā lilo ka wahine e lawe i ka lāʻau lapaʻau a hoʻolālā paha e lilo i ka hānai, a inā pono e hoʻohana i ka carbamazepine i ka wā hāpai ʻana, e hāmama ʻia e noʻonoʻo pono i ka pōmaikaʻi ʻia o ka pono no ka mālama ʻana i ka makuahine a me ka loaʻa ʻana o nā hopena hoʻopiʻi, ʻoiai ma ka trimester mua o ka hapai.

Me ka hiki i nā maʻi lapaʻau e lawa ai, pono e kuhikuhi ʻia nā mea maʻi o ka wā o ka hoʻohālikelike i ka carbamazepine e like me ka monotherapy, ʻoiai ʻo ka pinepine o nā mau huaʻawaʻi o ka pēpē i ka wā o ka hui o ka hui antiepileptic ʻoi aku ka kiʻekiʻe ma mua o ka monotherapy.

Pono e kuhikuhi i ka lāʻau lapaʻau i loko o ka hopena haʻahaʻa loa. Pono ʻoe e nānā maʻamau i nā kiko o ka hana ikaika i ka kaila koko.

Pono e ʻike nā poʻe maʻi i ka hoʻonui nui o nā hemahema. Eia kekahi, pono lākou i ka maʻi antenatal.

I ka wā hapai, ua hoʻohālikelike ʻia ka hōʻemi ʻana o ka maʻi antiepileptic maikaʻi loa, no ka mea, ua hiki i ka hoʻomohala ʻana o ka maʻi ke loaʻa ka hopena maikaʻi ʻole i ka makuahine a me ka hapā.

Aia nā manaʻo hōʻike e hoʻonui ai ka carbamazepine i ka nele o ka folic acid e ulu ana i ka wā hāpai. Hiki i kēia ke kōkua i ka hoʻonui ʻana i ka loaʻa ʻana o nā ʻōpiopio hānau i nā keiki i hānau ʻia i nā wahine i lawe i kēia lāʻau lapaʻau. No laila, ma mua o ka wā o ka wā e hāpai ʻia ai, e aʻo ʻia e lawe i nā dosis hou o ka waikawa folic.

ʻOiai ʻo ia ka hopena pale i pale ai i ka huhū nui o nā pēpē, ʻo nā wahine i nā hebedoma hope o ka hānau ʻana, me nā pēpē hou, e hāʻawi ʻia i ka vitamin K₁.

Ua hōʻike ʻia he mau hihia o ka hoʻohālikelike o ke kikowaena o ka papa hanu a me / a me nā mea pōkole epileptic i loko o nā pēpē hou i hui pū ʻia e ko lāua mau māmā ka hoʻohālikelike a me nā ʻano anticonvulsants. ʻO nā kīʻaha o ka maʻi, ka luaʻi a me ka hoʻoemi ʻana i ka makemake i nā pēpē hou i lawe mau ʻia nā makuahine i ka carbamazepine i kekahi manawa. Ua manaʻo ʻia aia kēia mau hōʻike he hōʻike i ka haʻalele o kāna maʻi i nā pēpē.

Kuhi ʻia ka Carbamazepine i ka waiū umauma, ʻo kona pae ma loko o 25-60% o ka pae o ka waihona i loko o ke kaila koko. No laila, e manaʻo ʻia e hoʻohālikelike i nā pōmaikaʻi a me nā hopena hikiʻole ke loaʻa ka wā o ka umauma ma ka wā lōʻihi me ka lāʻau lapaʻau. ʻOiai e lawe ana i ka carbamazepine, hiki i nā makuahine ke hōʻuluʻulu i kā lākou mau keiki, akā inā nānā mau lākou i nā hopena ʻaoʻao (no ka laʻana, ka hopena pālea i nā ʻili a me ka hōʻeha nui).

Hoʻohui nūhou

Me ka hoʻohana like ʻana o ka carbamazepine me kekahi mau lāʻau lapaʻau, hiki i nā hopena kūpono ʻole:

Nā mea paʻa CYP3A4: hoʻonui i ka kukuna plasma i ka carbamazepine,
Dextropropoxyphene, verapamil, felodipine, diltiazem, viloxazine, fluoxetine, fluvoxamine, desipramine, cimetidine, danazole, acetazolamide, nicotinamide (ma loko wale nō o nā dosis kiʻekiʻe i nā pākeke), macrolides (josamycin, erythromycaineine, ainoloholohamaloca ), loratadine, terfenadine, isoniazid, hua waina, propoxyphene, HIV protease inhibitors i hoʻohana ʻia i ka maʻi HIV: hoʻonui i ka kukū plasma o ka carbamazepine,
Pelbamate, fensuximide, fenobarbital, primidone, phenytoin, metsuximide, theophylline, cisplatin, rifampicin, doxorubicin, hiki paha: valpromide, clonazepam, waikawa valproic, oxcarbazepine a me ka hoʻomākaukau ʻana i nā lāʻau me ka hypericum hyperfin,
ʻO ka neʻe Valproic a me ka primidone: ka haʻaleleʻana o ka carbamazepine mai i nā protein plasma a me ka hoʻonui i ka paena o ka metabolite hoʻonaninani ʻo ka farmacologically (carbamazepine-10,11-epoxide),
Isotretinoin: he loli o ka bioavailability a me / a i ʻole ke kala ʻana o ka carbamazepine a me ka carbamazepine-10,11-epoxide (pono i ka nānā ʻana o ke kukuna plasma),
Clobazam, clonazepam, primidone, ethosuximide, alprazolam, valproic acid, glucocorticosteroids (prednisone, dexamethasone), haloperidol, cyclosporine, doxycycline, methadone, lāʻau lapaʻau waha e loaʻa ana i ka progesterone a / a he lāʻau lapaʻau e pono ai, he pono e kūlohelohe i nā hana. fenprocoumone, warfarin, dicumarol), topiramate, lamotrigine, antidepressants tricyclic (imipramine, nortriptyline, amitriptyline, clomipramine), felbamate, clozapine, tiagabin, protease inhibitors, Hoʻohana ʻia i ka mālama ʻana i ka maʻi maʻi HIV (ritonavir, indinavir, saquinavir), oxcarbazepine, itraconazole, blockers channel kalapona (kahi pūʻulu dihydropyridones, no ka laʻana, felodipine), midazolam, levothyroxine, praziquantel, olazapine, risperidone, ko lākou manaʻo o ka tramidone hōʻemi a hoʻopau paha i ke kiʻekiʻe ʻana o kā lākou hopena, pono paha ke hoʻoponopono ʻana i nā inane noi)
Phenytoin: hoʻonui a hoʻemi paha i kona pae plasma,
Mefenitoin: ke hoʻonui (i nā hihia koʻikoʻi) o kona pae i ke koko koko,
Paracetamol: hoʻonui i ka nui o ka hopena o kāna mau hopena i loko o ka puhaka a me ka hoʻohaʻahaʻa ʻana i ka hoʻomaʻamaʻa therapeutic (hana i ka metabolism o paracetamol)
Phenothiazine, pimozide, thioxanthenes, molindone, haloperidol, maprotiline, clozapine a me nā antidepressants tricyclic: hoʻonui i ka hopena inhibitory i ka pūnaehana puni waena a hoʻonāwaliwali i ka hopena anticonvulsant o ka carbamazepine,
Diuretics (furosemide, hydrochlorothiazide): hoʻomohala pū i hui pū ʻia me nā hōʻike kino o ka hyponatremia,
Non-depolarizing relaxants kalamay (pancuronium): kahi hōʻemi i ko lākou hopena,
Ethanol: kahi emi i kona ahonui,
Antirectagulants kuʻikuʻi, contraceptives hormonal, waikawa folic: hoʻōla i ka metabolism,
Meo no ka anesthesia aoao (enflurane, halotane, fluorotan): wikiwiki ka hana o ka metabolism me ka hoʻonui nui o nā hopena hepatoxic,
Methoxiflurane: hoʻonui hoʻonui i ka nephrotoxic metabolites,
Isoniazid: hoʻonui i ka hepatotoxicity.

ʻO ka hui pūʻana Carbamazepine e loaʻa: Finlepsin, retard Finlepsin, Tegretol, Tegretol TsR, Zeptol, Karbaleks, Karbapin, Mezakar, Timonil.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau
ʻO ka lāʻau antiepileptic, derivative dibenzazepine. Me ka hopena antiepileptic, loaʻa ka hopena i ka hopena neurotropic a me ka psychotropic.

ʻO ke ʻano o nā hana a nā kāpena o ka carbamazepine i kēia manawa i wehewehe wale ʻia. Hoʻomake ʻo Carbamazepine i nā membrane o nā neurons overexcited, kāpae i nā hoʻokuʻu waikila o nā neurons a hōʻemi i ka hoʻowaliwua ʻia o ka synaptic o nā pulesa hoihoi. Eia paha, ka hana nui o ka hana o ka carbamazepine i mea e pale ai i ka loaʻa ʻana o nā mana kūpono e pākuʻi ʻia o ka sodium e hoʻohālikelike ʻia i nā neurons i hoʻohālikelike ʻia ma muli o ka blockade o nā kahe sodium-gated open.

Ma ka hoʻohana ʻia ʻana o ka maʻi monotherapy i nā maʻi me ka epilepsy (maʻa mau i nā keiki a me nā ʻōpio), ua ʻike ʻia kahi hopena psychotropic o ka lāʻau lapaʻau, ka mea i loaʻa i kahi hopena maikaʻi i nā hōʻailona o ka hopohopo a me ke kaumaha, a me ka hoʻohaʻahaʻa i ka irritability a me ka uluʻana. ʻAʻohe data ʻike ʻole e pili ana i ka hopena o ka lāʻau ma ka hana cognitive a me ka psychomotor: i kekahi mau noiʻi, ua hōʻike ʻia kahi hopena a i ʻole ka hopena, ka mea i hilinaʻi ʻia ma ka hopena o ka lāʻau;

E like me ka mea hoʻoponopono neurotropic, maikaʻi ka lāʻau i nā nui o ka maʻi neʻe. No laila, no ka laʻana, me ka idiopathic a me ka neuralgia trigeminal trigeminal, pale ʻo ia i ke ʻano o nā hōʻeha ʻeha paroxysmal.

I ka hihia o ka hoʻoneʻeʻana i ka waiʻona, hoʻāla ka lāʻau i ka paepae o ka mākaukau paʻa, kahi i hōʻemi ʻia ai kēia ʻano, a me ka hōʻemi ʻana i nā mānoanoa o nā hōʻike hou ʻana o ka maʻi, e like me ka nui o ka irritability, pīhoihoi, a me nā hana ʻoi.

I nā maʻi me ka maʻi insipidus maʻi, hōʻemi ka lāʻau i ka diuresis a me ka makewai. Ma ke kumuhana he psychotropic, maikaʻi ka lāʻau lapaʻau i nā hopena hoʻopalapula, ʻo ia hoʻi, i ka mālama ʻana i nā kūlana manic, a me ke kākoʻo ʻana o nā maʻi bipolar (manic-depressive) pilikia (e like me ka monotherapy a me ka hoʻohui pū me nā antipsychotics, antidepressants a i nā mea hoʻohana lithium). nā kuʻi ʻana o ka psychosis schizoaffective, me ka hamani manic, kahi i hoʻohana ʻia ai e hui pū me ka antipsychotics, a me ka manic-depressive psychosis me nā pōkole wikiwiki.

ʻO ka hiki i ka lāʻau lapaʻau e hōʻoki i nā hōʻike manic e pili paha i ka pale ʻana o ke hoʻololi ʻana o ka dopamine a me norepinephrine.

Lapaʻau lāʻau
Hoʻopau
Ma hope o ka hoʻopale ʻana i ka waha, ua hoʻoulu ʻia ka carbamazepine i kahi kokoke loa, ke hele mālie nei ka hoʻoulu ʻana (ʻaʻole pili ka ʻai i ka helu a me ka pae o ka absorption). Ma hope o hoʻokahi pākahi, kūʻai nui ka nui (C_max hiki ma hope o 12 mau hola. Ma hope o kahi lawelawe hoʻokahi waha o 400 mg o ka carbamazepine, ka nui o ka nui o ka C_maxmea he 4.5 μg / ml. Loaʻa ka ʻai kaulike o ka lāʻau i ka plasma ma hope o 1-2 mau pule. ʻO ka manawa o kona hoʻokō ʻana he mea kū hoʻokahi a kau aku ia i ka degere o ka auto-induction o nā pehu enzim system by carbamazepine, hetero-induction e nā lāʻau ʻē aʻe i hoʻohana pū ʻia, me ka noho ʻana o ka mea maʻi ma mua o ka hoʻomaka ʻana o ka hopena, ka hopena o ka lāʻau a me ka lōʻihi o ka mālama ʻana. ʻO nā mea nui i waena o nā kūloko kūpono o ka kūloko i ka laulā therapeutic i nānā ʻia: ma ka hapa nui o nā mea maʻi, nā helu ma waena o 4 a 12 μg / ml (17-50 μmol / l).

Kahele.
Hoʻolaha i nā protein o ka plasma i nā keiki - 55-59%, i nā pākeke - 70-80%. I loko o nā cerebrospinal fluid (ma hope aʻe i kapa ʻia ʻo CSF) a me ka lawaiʻa, hoʻāla ʻia ka ʻike ʻana i ka nui o ka nui o nā mea ikaika me ka protein (20-30%). Penetrates ma o ka paepae placental. ʻO ka hoʻoulu ʻana i ka waiū umauma he 25-60% o kēlā me ka plasma. Hāʻawi ʻia i ka hoʻopili piha ʻana o ka carbamazepine, ʻo ka ʻike ākea ka ʻike he 0.8-1.9 l / kg.

Hāpai.
Hoʻomili ka Carbamazepine i loko o ka pulu. ʻO ke ala nui o ka biotransformation ke ala epoxydiol, ma muli o ke ʻano o ka hoʻokumu ʻana o nā metabolites nui: ka 10.11-transdiol derivative a me kāna konohiki me ka glucoseur acid. ʻO ka hoʻololi ʻana o ka carbamazepine-10,11-epoxide i ka carbamazepine-10,11-transdiol i ke kino o ke kanaka me ka hoʻohana ʻana i ka epoxyhydrolase enzyai microsomal.

ʻO ke kūlike o ka carbamazepine-10,11-epoxide (pharmacologically active metabolite) ma kahi o 30% o ke kūlike o ka carbamazepine i ka plasma. ʻO ka isoenzyme nui e hāʻawi ana i ka biotransformation o ka carbamazepine i ka carbamazepine-10,11-epoxide ka cytochrome P450 ZA4. Ma muli o kēia mau hopena metabola, ua hana pū ʻia ka nui o nā metabolite, 9-hydroxymethyl-10-carbamoylacridane. ʻO kahi ala hou o ka hana metabolila o ka carbamazepine ka hoʻomohala ʻana i nā ʻano derivatives monohydroxylated, a me N-glucuronides, ma lalo o ka mana o ka isoenzyme UGT2B7.

Leʻaleʻa.
ʻO ka hapalua hapalua o nā caramazepine i loli ʻole (T_1/2) ma hope o ka lawelawe waha ʻana o ka lāʻau lapaʻau ʻia he 25-65 mau hola (ma ka manawa kokoke i 36 mau hola), ma hope o nā minamina hou - i ka manawa 16-24 mau hola ma waena o ka lōʻihi o ka mālama ʻana (ma muli o ka autoinduction o nā ʻōnaehana m izaoxygenase o ka ate). I ka poʻe maʻi e lawe ana i nā lāʻau lapaʻau ʻē aʻe e koi ana i ka hoʻoliʻiliʻi o ka mikrosomal (e.g., phenytoin, phenobarbital) i ka manawa like, T_1/2 haʻawaʻiolaamaamaama he 9-10 mau hola. Ma hope o ka hoʻokūkū waha hoʻokahi o 400 mg o ka carbamazepine, he 72% o ka nui i lawe ʻia ma loko o ka urine a ʻo 28% i nā feces. Ma kahi o 2% o ka nui o ka nui i lawe ʻia ma ka urine i loko o ke ʻano o ka caramazepine i loli ʻole, ma kahi o 1% i loko o ka ʻano o ka metabolacactically hoʻoikaika 10.11-epoxy metabolite. Ma hope o ka lawelawe waha hoʻokahi, 30% o ka carbamazepine e hoʻopiʻi ʻia i loko o ka urine ma ka ʻano o nā huahana hope o ke ala o ka epoxydiol.

Pharmacokinetics i loko o nā hui hoʻomanawanui pilikino.
I nā keiki, ma muli o ka lawe wikiwiki ʻana o ka carbamazepine, pono e hoʻohana ʻia ka hoʻohana ʻana i nā kaha kiʻekiʻe o ka lāʻau lapaʻau i kilokileka o ke kaumaha o ke kino, a hoʻohālikelike ʻia me nā pākeke.

ʻAʻohe mea iʻike i ka loli o ka pharmacokinetics o ka hoʻololi o ka carbamazepine i nā maʻi maʻi makua (hoʻohālikelike ʻia me nā ʻōpio ʻōpio). ʻAʻole ʻike nā ʻikepili ma ka pharmacokinetics o ka carbamazepine i nā mea maʻi me ka renal impaired a i ʻole hepatic function.

Hoʻohana i ka wā hāpai a i ka wā o ka umauma.

No nā wahine o ka wā hānau, ua ʻōlelo ʻia ka carbamazepine e like me ka monotherapy inā hiki, ma ka hopena haʻahaʻa haʻahaʻa loa, ʻoiai ʻo ka nui o ka mau ʻana o ka mau huaʻelima o nā pēpē mai nā makuahine i lawe i ka lapaʻau antiepileptic hui ʻia ʻoi aku ka kiʻekiʻe ma mua o ka monotherapy.Aia i nā lāʻau lapaʻau i ʻāpana o ka hui hoʻohui, hiki i ka ulu ʻana o ka hoʻomohala ʻana i ka maʻi malia e hoʻohui ai, ʻoiai inā ua hoʻohui ʻia ka valproate i ka lāʻau maʻi.

Hoʻopili koke ʻo Carbamazepine i ka placenta a hana i ka piʻi pinepine ʻana i ka pūpū a me nā lolo o ka pūpū. ʻO ka mālama pinepine ʻana i ka neʻe o ka waiwai ikaika i ka plasma koko, ua ʻōlelo ʻia ʻo EEG.

I ka wā e loaʻa ai ka hapai, pono e hoʻohālikelike i ka pono o ka lapaʻau ʻia a me nā hoʻopiʻi hiki paha, ʻoi aku hoʻi i ka trimester mua o ka hāpai ʻana. Ua ʻike ʻia na keiki o nā makuahine e loaʻa ana i ka epilepsy i predisposed i ka ulu ulu ʻana o ka hana hōʻeuʻeu a me ke kino, me ka malformations. Hiki i ka Carbamazepine ke hoʻonui i ka hopena o kēia mau pilikia. Aia kekahi hōʻike kūʻokoʻa o nā hihia o nā maʻi a me nā malformations, e komo me ka pani ʻole ʻana o nā arai vertebral (spina bifida) a me nā mea hou aku paha: mau hemahema i ka hoʻomohala ʻana i nā hana craniofacial, cardiovascular a me nā polokalamu kino, nā hypospadias.

Wahi a ka rehina o ka ʻAmelika ʻAmelika Hema, ʻo ka loaʻa ʻana o nā hewa maikaʻi ʻole e pili ana i ka hōʻino ʻana o nā hana e koi ana i ka hoʻomaʻamaʻa, lāʻau lapaʻau a hoʻomaʻemaʻe paha paha, i hōʻike ʻia i loko o nā hebedoma 12 ma hope o ka hānau ʻana, ʻo 3.0% i waena o nā wahine hāpai e lawe ana i ka carbamazepine e like me ka monotherapy o ka ma ka wā mua. 1.1% ma waena o nā wahine hāpai i lawe ʻole i nā lāʻau antiepileptic.

Pono ka mālama ʻana ʻo Carbamazepine-Akrikhin i nā wahine hāpai i ka epilepsy me ka mālama nui. Pono nā Carbamazepine-Akrikhin e hoʻohana pono ʻia ma ka liʻiliʻi ʻokoʻa loa. Hoʻomaopopo pinepine ʻia ka mālamaʻana i ke kāʻei o ka waiwai ikaika i ka plasma koko. Ma ka hihia o ka hoʻomanawanui anticonvulsant, pono ka wahine hāpai i mālama i ka liʻiliʻi o ka carbamazepine i loko o ke kaila koko (therapeutic range 4-12 gg / ml), ʻoiai, aia nā mea e pili ana i ka hopena e pili ana i ka hopena o ka hoʻomohala ʻana i ka malenations congenital (ma ka laʻana, ʻo ka neʻe ʻana o ka malformations ka wā e hoʻohana ai i ka hopena ma lalo o 400 mg mai kēlā me kēia lā ma lalo iho me nā kaha haʻahaʻa o nā kiʻekiʻe).

Pono e hoʻomaopopo ʻia nā mea maʻi e pili ana i ka hiki ke hoʻonui ʻia o ka hōʻino ʻana a me ka pono, e pili ana kēia, no ka maʻi antenatal.

I ka wā hāpai ʻana, ʻaʻole pono e hoʻōla ʻia ka mālama antiepileptic maikaʻi loa, no ka mea me ka hoʻomohala ʻia o ka maʻi hiki ke loaʻa ka hopena maikaʻi ʻole i ka makuahine a me ka pēpē.

Hoʻonui ka lāʻau antiepileptic i ka nele o ka folic acid, i ʻike pinepine ʻia i ka wā hāpai, hiki iā ia ke hoʻonui i ka nui o ka hānau ʻana o ka hānau ʻana i nā keiki, no laila, ʻo ka lawe ʻana i ka waikawa folic e ʻōlelo ʻia ma mua o ka wahine i hoʻolālā ʻia a i ka wā hāpai. I mea e pale ai i nā hoʻopiʻi hemorrhagic i nā mea hou, ua ʻōlelo ʻia i nā wahine i nā mau pule hope o ka wā o ka hāpai ʻana, me nā pēpē hou,

Ua hōʻike ʻia he mau hihia o ka hopu epileptic a me / a i ʻole ka hanu i ka poʻe hānau hou i lawe a nā makuahine i ka lāʻau i ka manawa like pū me nā anticonvulsants ʻē aʻe. Hoʻohui ʻia, ua hōʻike ʻia kekahi mau hihia o ka luaʻi, nā maʻi a me nā maʻi maikaʻi ʻole i nā pēpē hou i loaʻa i ka mau momama ʻo carbamazepine. Ma muli paha o kēia mau ʻano hōʻike e hōʻike ai i ka huki hou i ka pēpē.

Hele ʻo Carbamazepine i ka waiū umauma, ʻo ka manaʻo i loko o ia mea he 25-60% o ka ʻike ʻana i ka plasma koko, no laila, nā pōmaikaʻi a me nā hopena kūpono ʻole o ka umauma i hoʻohālikelike ʻia i loko o ka pōʻaiapau o ka hoʻomau ʻana o ka hana. Me ka umauma hoʻomau i ka wā e lawe nei i ka lāʻau lapaʻau, pono ʻoe e hoʻokumu i ka nānā ʻana no ke keiki e pili ana i ka hiki ke hoʻomohala ʻana i nā hopena ʻino (ʻoi aku ka hoʻohuhōlohi, hoʻohālikelike nui ʻia, ʻano loea. I nā keiki i loaʻa i ka carbamazepine antenatally a i ʻole ka waiū umauma, ua hōʻike ʻia nā hihia o ka hepatitis cholestatic, a no laila, pono nā ʻano o nā keiki e nānā ʻia me kahi kaulahao o ka hopena o ka hopena o ka hopena hepatobiliary. Pono e hōʻike ʻia nā mea maʻi o ka wā hānau keiki e pili ana i ka emi ʻana o ka hiki o nā mea hoʻohālikelike waha i ka wā e hoʻohana ana i ka carbamazepine.

ʻLoe a me ke kākele.

Hāʻawi i ka launa pū me nā lāʻau lapaʻau a me nā pharmacokinetics o nā lāʻau antiepileptic, pono e koho ʻia nā mea maʻi ma ka akahele.

Epilepia
I nā hihia kahi e hiki ai kēia, pono ke kuhikuhi ʻia ka lāʻauamaama me ʻAmelika. Hoʻomaka ka hoʻolālā ma ka hoʻohana ʻana i kahi liʻiliʻi o kēlā me kēia lā, kahi e hoʻonui mālie a hiki i ka hopena maikaʻi loa. No ka koho ʻana i ka palena kiʻekiʻe o ka lāʻau lapaʻau, ʻoi ʻia ke koho ʻana i ka ʻike o ka mea hana i ka plasma koko. I ka mālamaʻana i ka epilepsy, e koi ʻia kahi nui o ka carbamazepine, e pili ana i ka nui o ka plasma kukala o ka carbamazepine i kahi pae o 4-12 μg / ml (17-50 μmol / L). ʻO ka hoʻokomoʻana o ka lāʻau Carbamazepine-Akrikhin i ka hoʻomau i ka antiepileptic therapy e pono e hana lohi ʻia, ʻoiai nā ʻano o nā lāʻau i hoʻohana ʻia ʻaʻole i loli a i ʻole, inā pono, pololei. Inā poina ka mea maʻi e lawe i kahi ma hope o ke ʻano o ka lāʻau lapaʻau i ka manawa kūpono, pono koke e lawe ʻia ka nui hala i ka manawa ua ʻike ʻia kēia hala ʻole, a pono ʻoe e lawe i ka pālua ʻelua o ka lāʻau.

Nā pākeke
ʻO 200 ka hopena mua he 200-400 mg 1 a i 2 mau manawa i ka lā, a laila hoʻonui mālie ka ʻaha a hiki i ka hopena kūpono loa. ʻO ka lāʻau mālama mālama he 800-1200 mg i kēlā me kēia lā, i hoʻokaʻawale ʻia i 2-3 mau lā i kēlā me kēia lā.

E na keiki.
ʻO ka dosis mua loa no nā keiki mai 4 a 15 mau makahiki he 200 mg i kēlā me kēia lā (i kekahi nui o nā helu), a laila e hoʻonui pinepine ʻia ka nui o ka 100 mg i kēlā me kēia lā a hiki i ka hopena hopena.

Nā kahu mālama mālama no nā keiki he 4-10 mau makahiki - 400-600 mg i kēlā me kēia lā, no nā keiki he 11-15 mau makahiki - 600-1000 mg i kēlā me kēia lā (i kekahi mau doka).

Ka papa kuhikuhi ʻia ka papa kuhikuhi kau aʻe:
ʻApiopio: ʻo ka dosis mua loa he 200-300 mg i ke ahiahi, ʻo ka mālama mālamaʻana he 200-600 mg i ke kakahiaka, 400-600 mg i ke ahiahi.

ʻO nā keiki mai ka 4 a 10 mau makahiki: ka hoʻomaka mua - 200 mg i ke ahiahi, ka mālama mālama ʻia - 200 mg i ke kakahiaka, 200-400 mg i ke ahiahi, nā keiki mai 11 a 15 mau makahiki: i ka wā mua - 200 mg i ke ahiahi, ka mālama mālama ʻia - 200 -400 mg i ke kakahiaka, 400-600 mg i ke ahiahi. ʻO nā keiki mai 15 a 18 paha makahiki: regimen dos 800-1200 mg / lā, nui loa i kēlā me kēia lā -1200 mg / lā.

Kālai ka lōʻihi o ka hoʻohana ʻana i nā hōʻike a me ke pane kūʻokoʻa o ka mea maʻi i ka mālama ʻana. ʻO ka hoʻoholo e hoʻoneʻe i ka mea maʻi i Carbamazepine-Akrikhin, ʻo ka lōʻihi o kona hoʻohana ʻana a me ka hoʻopau ʻia ʻana o ka mālama ʻana ke kaʻina hoʻokahi e ke kauka. ʻO ka hopena o ka hōʻemi ʻana i ka nui o ka lāʻau a i ʻole ke kāpae nei i ka mālamaʻana e manaʻo ʻia ma hope o kahi makahiki o 2-3 mau makahiki o ka waiho ʻole ʻana o ka hopu.

Hoʻomaʻamaʻa ka hoʻomaʻamaʻa, hoʻoemi kaulike i ka make o ka lāʻau no 1-2 mau makahiki, ma lalo o ka mākaʻikaʻi ʻana o kahi EEG. I nā keiki, me ka hoʻohaʻahaʻa ʻana i kēlā me kēia lā o ka lāʻau, pono ke hoʻonui i ka paona i ke kino me ka makahiki.

Neuralgia Trigeminal, idiopathic glossopharyngeal neuralgia.
ʻO ka dosis ma mua he 200-400 mg i kēlā me kēia lā, i hoʻokaʻawale ʻia i 2 mau pahuhopu. Hoʻonui ʻia ka ʻōmua mua a hiki i ka ʻeha ʻana o ke kaumaha, ma ka awelika a hiki i ka 400-800 mg i kēlā me kēia lā (3-4 mau lā i ka lā). Ma hope o kēlā, i kekahi mahele o nā mea maʻi, hiki ke hoʻomau ʻia ka mālama ʻana me kahi hoʻohaʻahaʻa haʻahaʻa o 400 mg.

ʻO ka nui loa e hōʻike ʻia ai he 1200 mg / lā, ma ka hiki ʻana i ka holomua lapaʻau, e hoʻohaʻahaʻa ʻia ka nui o ka lāʻau a hiki i ka hōʻeha ʻana o ka eha.

No nā mea maʻi a me nā poʻe maʻi e pili ana i ka carbamazepine, ʻĀina ʻo Carbamazepine-Akrikhin i ʻōlelo mua i ka 100 mg mau manawa i ka lā i kēlā lā, a laila hoʻonui mālie ka ʻaha a hiki i ka ʻeha ʻana o ka ʻeha, hoʻonā ʻia ka hopena ma kahi o 200 mg 3-4 mau manawa i ka lā. A laila, pono e hōʻemi i ka make i ka mālama liʻiliʻi.

Me ka neuralgia trigeminal i kēia māhele o nā mea maʻi, ʻo ka nui loa e hōʻike ʻia ana ʻo 1200 mg / lā. Inā hoʻoholo ka ʻehaʻeha, pono e hoʻokuʻu ʻia ka lāʻau me ka lāʻau a hiki i ka hōʻeha ʻana o ka ʻeha.

Ka hopena o ka hoʻoneʻe ʻana i ka ʻeha ma ka haukapila.
ʻO ka awelika nui o kēlā me kēia lā he 600 mg (200 mg 3 mau manawa i ka lā). I nā pilikia koʻikoʻi, hiki i ka lā mua, hiki ke hoʻonui ʻia i ka nui i 1200 mg i kēlā me kēia lā, ka mea i hoʻokaʻawale ʻia i 3 mau puhaka. Inā pono, hiki ke hui pū me Kapbamazepine-Akrikhin me nā mea ʻē aʻe e hoʻohana ai e mālama ai i ka hoʻōki ʻana i ka wai ʻokoʻa, koe wale nō ʻo sedative-hypnotics. I ka wā o ka mālamaʻana, pono ia e kiaʻi pinepine i nā kiko o ka carbamazepine i loko o ke koko koko. I ka pilina me ka hiki ke hoʻomohala ʻia o nā hopena ʻaoʻao mai ka kikowaena waena a me ka pūnaha hoʻonaʻauao autonomic, e nānā pono ʻia nā mea maʻi i kahi ʻōlapa.

Nā kūlana manic a me ke kōkua kākoʻo ʻana i nā pilikia o ka hoʻopili (bipolar).
ʻO 400 dosis o kēlā me kēia lā he 400-1600 mg. ʻO ka awelika o kēlā me kēia lā he 400-600 mg (ma nā 2-3 mau kakana).

I kahi kūlana koʻikoʻi, pono e hoʻonui nui ʻia ka nui o ka nui. Me ka mālama mālama ʻana no nā maʻi bipolar, i mea e hōʻoia ai i ka hoʻomanawanui ʻana, pono ka nui o ka hoʻonui ʻia ʻana ma kēlā me kēia lā, e hoʻonui pinepine ʻia ka nui o kēlā me kēia lā.

Ke kohi nei i ka lāʻau.
Hiki i ka haʻalele ʻana o ka lāʻau ke hoʻowalewale i ka lawe pōkole epileptic. Inā pono e pani i ka lāʻau lapaʻau i ka mea maʻi me ka epilepsy, pono ke lawe ʻia i ka hoʻololi i kekahi lāʻau antiepileptic hou ma lalo o ka uhi o ka lāʻau i hōʻike ʻia i kēlā mau hihia (no ka laʻana, dia lawelawe ʻia ka diazepam intravenously a pololei paha, a i ʻole hoʻi phenytoin i lawelawe ʻia ma ke ʻano).

Loaʻa ka hopena.

ʻO ka hana mau i ke kuhi piliʻole he mau nalo i loko o kekahi mau lā, ʻelua a kūwaho a ma hope o ka hōʻemi ʻana i ka manawa o ka hopena o ka lāʻau. ʻO ka hoʻomohala ʻana o nā hopena ʻino loa mai ka pūnao o ka nūnaehana waena paha ka hopena o ka hoalohui nui ʻana o ka lāʻau a i ʻole ka nui o ke ʻano o ka paʻakikī o ka hoʻoulu ʻana o ka hana ikaika i ka plasma koko. I ia mau hihia, ua ʻōlelo ʻia e kāohi i ka ʻike o ka mea hoʻoikaika i ka kaila koko.

I ka loiloi ʻana i ka ʻike pinepine ʻana o nā ʻano maikaʻi ʻole, ua hoʻohana ʻia nā kekelē e pili ana i kēia: mau pinepine - 10% a i ʻole, pinepine - 1-10%, i kekahi manawa -0.1-1%, loaʻa -0.01-0.1%, loa-loaʻa ʻole 0.01%

ʻO ka hoʻomohala ʻana o nā hopena ʻino loa mai ka pūnao o ka nūnaehana hopena paha he hopena ia o ka hoalohui pili i ka hopena o ka lāʻau a i ʻole ka nui o ke ʻano o ka nui o ke kaila o ka carbamazepine i loko o ke kaila koko.

Mai ka pūnaehana neʻe o waena: ka pinepine - dizziness, ataxia, drowsiness, general weakness, headache, paresis of accommodation, kadang anomalous involuntary gerakan (no ka laʻana, weliweli, "fluttering" tremor - asterixis, dystonia, tics), nystagmus, luhi - ahulau (ʻike ʻike a i ʻole auditory), nā makehewa, ka nalo ʻana o ka ʻōpū, nā hopohopo, ka hoʻonaninani, ka psychomotor agitation, disorientation, activation of psychosis, orofacial dyskinesia, oculomotor disturb, speech speech (eg, dysarthria or slurred speech), choreoathetoid disorders, peripheral Palapala, paresthesia, Muscle nawaliwali, a me ka paresis o na symptoms, ia mea loa pohihihi - ono haunaele, neuroleptic malignant maʻi pale, dysgeusia.

Nā maʻi kūwaha: pinepine pinepine - dermatitis kūloko, pinepine - urticaria, i kekahi manawa - dermatitis exfoliative, erythroderma, he nui ke kino o nā hopena o ke ʻano he hypersensitivity me ke kuni, rashes ʻiliʻu, vasculitis (komo i ka nodryum erythema, me kahi hōʻike ʻana o ka vasculitis o ke kino), lymphadenopathy, nā hōʻailona, , arthralgia, leukopenia, eosinophilia, hepatosplenomegaly a me nā mākaʻikaʻi i hoʻololi ʻia o ka hana ate (i ʻike ʻia kēia mau mea i nā hui like ʻole). ʻO nā hui ʻē aʻe (e.g. baga, ʻeha, pancreas, myocardium, colon), aseptic meningitis me myoclonus a peripheral eosinophilia, reaksi anaphylactoid, angioedema, pneumonitis allergic a me nā eosinophilic pneumonia i komo pū kekahi. Ke kū ʻia nei nā hopena kūloko o ka maʻi ma luna, ʻaʻole pono ke hoʻowalewale i ka lāʻau, ka hōʻemi - like me ka lupus-like syndrome, ka ʻeha o ka ʻili, erythema multiforme exudative (e pili ana i ka maʻi Stevens-Johnson), ka erythema nodosum, nāʻino o ka epacmal epidermal (ʻ syndromelelo o Lyell), photosensitivity.

Mai nā ʻekopa hemopoietic: ka pinepine leukopenia, thrombocytopenia, eosinophilia, lihukuhioka leukocytosis, lymphadenopathy, kakina acid folic, agranulocytosis, anemia aplastic, marina erythrocytic aplasia, megaloblastic anemia, uaua intermittent porphyria, reticulocytemia, langka hematocytosis jarang. porphyria, porphyria variegated.

Mai ka pūnaehana hana ʻana: pinepine ka manawa, ka luaʻiʻi, ka waha maloʻo, hoʻonui i ka hoʻōla o ka gamma-glutamyl transferase (ma muli o ke ʻano o ka hoʻoulu ʻana o kēia enzyme i loko o ka ate), ka mea maʻamau ʻaʻole ia he mau kaukaʻi, hoʻonui i ka hana o ka alkaline phosphatase, i kekahi manawa - hoʻonui i ka hana o ka transaminases hepatic, ʻeha a paʻa paha, ʻeha ʻeha, līpī - glossitis, gingivitis, stomatitis, pancreatitis, hepatitis of cholestatic, parenchymal (hepatocellular) a i ʻole ʻano ʻano hui, jaundice, granulomatous hepatitis, hōʻōloʻe o ka ate, luku ʻole i ka bile intrahepatic. x ducts me ka ho'ēmi ʻana i kā lākou helu.

Mai ka pūnaehana cardiovascular: ʻolua - pilikia hilahila hōʻemi, hoʻemi a hoʻonui paha i ke kahe o ke koko, bradycardia, arrhythmias, atrioventricular block me ka nāwaliwali, hāʻule, hōʻeha a hoʻomohala ana i ka hana naʻau puʻuwai, hōʻemi o ka maʻi naʻau coronary (me ka hanana ʻana a i ʻole ka hoʻonui ʻana o ka hoʻouka ʻana i ka angina), thrombophlebitis, thromboembolism nā maʻi maʻi

Mai ka ʻōnaehana endocrine a me ka metabolism: ka pinepine - edema, mālama ka wai, hoʻonaninua, nā hyponatremia (he hōʻemi i ka osmolarity plasma ma muli o kahi hopena e like me ka hana a antidiuretic hormon, i nā hanana lohi e alakaʻi i ka hyponatremia dilute, hoʻopili ʻia me ka lethargy, utuka, hōʻeha, hōʻeha a me nā pilikia neʻe). ka hoʻonui ʻana o ka ʻike prolactin (e hele pū me ka galactorrhea a me ka gynecomastia), kahi hōʻemi i ke kahe o L-thyroxine a me ka hoʻonui ʻana i ka ʻike o ka hormone thyroid-hoʻouluulu (maʻa mau ʻaʻole i hele pū ʻia e ka haumania E hoike ana), ka haunaele o ka kalipuna-phosphorus pūnao ma ka iwi nā'aʻaʻa (emi ma ka lehulehu o ke kalipuna, a 25-0N, cholecalciferol wai koko): osteomalacia, osteoporosis, hypercholesterolemia (me kiʻekiʻe-pa apŘ lipoprotein naʻokoko), a me gipertrigpitseridemiya lymphadenopathy, hirsutism.

Mai ka pae genitourinary: lohi, interstitial nephritis, renal failed, impalired renal function (e.g., albuminuria, hematuria, oliguria, hoʻonui urea / azotemia), hoʻonui urination, mālama i ka urinary, hōʻemi potency, spermatogenesis impaired (hoʻoli ka helu sperm a me ka motility).

Mai ka ʻōnaehana musculoskeletal: nāʻaihua pinepine loa, ʻaʻole nāwaliwali o ka naʻau, arthralgia, myalgia, aiʻole nā māka.

Mai nā ʻike: ka pinepine - nā pilikia o ka noho ʻana (me ka ʻike maka blurred), ka liʻiliʻi - ʻono ʻole i ka ʻono, hoʻonui kūloko intraocular, uwila ʻana o ka lens, conjunctivitis, mālama hewa, a me ka ʻiketinnitus, hyperacusis, hypoacusia, hoʻololi i ka hoʻomaopopo ʻana i ka pitch.

Nā pilikia mai ka ʻōpū o ka hanu, ka umauma a me nā ʻōpū mediastinal: ākea loa - kūlike ka maʻi hypersensitivity e ke ʻano, i ke ʻano o ka hanu ʻana, nā pneumonitis a i ʻole nā maʻi pneumonia.

Nā ʻikepili a me ka ʻikepili kōkua: ākea loa - hypogammaglobulinemia.

Nā ʻili: nā hōʻeha o ka pigmentation o ka ʻili, purpura, nā miki, kaʻala, alopecia.

ʻO nā hanana ʻino e like me ka nānā ʻana o ka post-marketing (ʻike pinepine ʻole)
ʻO ka hanana ʻōnaehana maʻi: kahiʻano lāʻau me nā eosinophilia a me nā ʻōnaehana kūloko.

Nā pilikia mai ka ʻili a me nā kiko kikoʻī. pustulosis neʻoulala maʻamau maʻamau, keratosis lichenoid, onychomadesis.

Nā maʻi maʻi a me ka maʻi parasit: reactivation o herpes simplex type type 6.

Nā pilikia mai ke koko a me ka ʻōnaehana lymphatic: aʻae iwi ka hopena.

Nā kuhihewa o ka ʻōnaehana nerve: hoʻomanaʻo hoʻomanaʻo.

Nā maʻi hōʻeha o Gastrointestinal: lāʻau lāʻau.

Nā kuhihewa o ka musculoskeletal a me ka hoʻopili pili; iala.

Hoʻopili pū me nā lāʻau ʻē aʻe.

E hoʻonui i nā kukuna o ka carbamazepine i loko o ke kō koko verapamil, diltiazem, felodipine, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, nefazodone, paroxetine, trazodone, olanzapine, cimetidine, omeprazole, acetazolamide, danazole, desipramine, nicotinamide ( , troleandomycin), ciprofloxacin, styripentol, vigabatrin, azoles (itraconazole, ketoconazole, fluconazole, voriconazole), terfenadine, loratadine, isoniazid, propoxyphene, oxybutynin, dantrolene, ticlopedin hoʻohana ʻia no ka mālama ʻana i ka maʻi maʻi HIV (no ka laʻana, ritonavir) - hoʻoponopono ʻia i ka hoʻoponopono ʻia dosage a nānā aku paha i ka ʻike ʻana o ka carbamazepine i loko o ka plasma e pono ai.

Ua hoʻemi ʻo Felbamate i ka hoʻoneʻeneʻe o ka carbamazepine i ka plasma a hoʻonui i ke kao o ka carbamazepine-10,11-epoxide, aʻo kahi hoʻokaʻawale manawa o ka neʻe i ka serum o ka felbamate hiki.

Ke hōʻemi nei i nā hopena e hiki ke hoʻonui i ka kūpaʻa o ka carbamazepine-10,11-epoxide i ka plasma koko: loxapine, quetiapine, primidone, progabide, vaproic acid, valnoktamide a me valpromide.

Ma muli o ka hoʻonui ʻana o ka ʻike o ka ʻaamaama-10.11-epoxide i loko o ke kaila koko hiki ke alakaʻi i ka hopena ʻino (no ka laʻana, he kaumaha, he mau helehelena, ataxia, diplopia), i kēia mau kūlana ke hoʻoponopono ʻia ka hopena o ka lāʻau lapaʻau a / a i ʻole ʻike i ke ʻano o ka carbamazepine-10.11. -epoxide i loko o ka plasma.

Hoʻemi ʻia ka manaʻo o ka carbamazepine phenobarbital, phenytoin (eʻaloʻana intoxication phenytoin a me ka hanana subtherapeutic nā hoʻohui like o ka carbamazepine paipai wai koko lehulehu o ka phenytoin E e ole oi ma mua o 13 .mu.g / ML mua ohui i ka Inc carbamazepine), fosphenytoin, primidone, metsuksimid, fensuksimid, theophylline, aminophylline, rifampicin, cisplatin, doxorubicin, nā mea hiki: clonazepam, valpromide, vaproic acid, oxcarbazepine a me ka hoʻomākaukau ʻana i nā mea kanu i loaʻa iā St. John's wort (Hypericum perforatum).

Me ka hoʻohana like ʻana me nā lāʻau lapaʻau aʻe, e koi ʻia ka hoʻoponopono ʻana o ka lāʻau carbamazepine.

Aia ka hiki o ka haʻalele o ka carbamazepine me ka waikohu valproic a me ka primidone ma muli o nā protein o ka plasma a me ka hoʻonui ʻana o ka piʻi ʻana o ka metabolite hoʻoikaika pharmacologically active (carbamazepine-10,11-epoxide). Me ka hoʻohana pū ʻana o ka carbamazepine me ka valproic acid, i nā hihia kūʻokoʻa, hiki i ka coma a me ka hilahila. Hoʻololi ʻo Isotretinoin i ka bioavailability a me / a i ʻole ke kala ʻana o ka carbamazepine a me ka carbamazepine-10,11-epoxide (ka nānā ʻana i ke kukuna o ka carbamazepine i ka plasma mea pono).

Hiki i ka Carbamazepine ke hōʻemi i ka neʻe i ka plasma (e hōʻemi a hōʻemi paha i nā hopena pae) a koi aku i ka hoʻoponopono ʻana i nā lāʻau lapaʻau e hiki mai ana: clobazam, clonazepam, digoxin, ethosuximide, primidone, zonisamide, valproic acid, alprazolam, glucocorticosteroids (prednisolone, dexamethasone), cyclosporin, tetracycline, tetracycline, tetracycline, tetracycline methadone, hana hoʻomākaukau waha no ka estrogens a me / a progesterone (ke koho pono ʻana i nā ʻano hana ʻē aʻe o ka contraception he pono), theophylline, oral anticoagulants (warfarin, fenprocoumone, dicumarol, aceno Umarolum), lamotrigine, topiramate, antidepresan tricyclic (imipramine, amitriptyline, nortriptyline, clomipramine), bupropion, citalopram, mianserin, sertraline, clozapine, felbamate, tiagabine, oxarbazepine, inhibitor HIV, inhibitors ), nā mea lapaʻau no ka mālama ʻana i nā maʻi o ka ʻōnaehana cardiovascular ("lohi" nā hakahaka saluran kalepa (he pūʻulu o dihydropyridones, no ka laʻana, felodipine), simvastatin, atorvastatin, lovastatin, cerivastatin, ivabradine), rakonazola, levothyroxine, midazolam, olanzapine, ziprasidone, aripiprazole, paliperidone, praziquantel, risperidone, tramadol, ziprasidone, buprenorphine, phenazone, aprepitant, albendazole, imatinib, cyclophosphamide, lapatinib, everolimus, tacrolimus, sirolimus, temsirolimus, tadapafila. Aia paha ke hoʻonui a hoʻemi ʻana i ka pae o ka phenytoin i loko o ke koko koko e kū ana i ka mea i kua o ka carbamazepine a me ka hoʻonui i ka pae o mefenitoin. Me ka hoʻohana like ʻana o ka mahama a me ka hoʻomākaukau ʻana o ka carbamazepine a i ka lithium a i ʻole ka metoclopramide, hiki ke hoʻonui ʻia nā hopena neurotoxic o nā mea ikaika ʻelua.

Hiki ke komo ka Tetracyclines i ka hopena therapeutic o ka carbamazepine. Ke hui pū me ka paracetamol, i ka nui o ka hopena o ke aʻalopiko i ka puhaka e hoʻonui ai i ka pehu a me ka hoʻohaʻahaʻa i ke ʻano therapeutic (e hoʻolōʻihi ana i ka metabolism o paracetamol). ʻO ka hui like ʻana o ka carbamazepine me ka phenothiazine, pimozide, thioxanthenes, mindindone, haloperidol, maprotiline, clozapine a me nā tricyclic antidepressants e alakaʻi i ka hopena o ka hopena o ka inhibitory ma ka pūnaehana ʻōiwi a me ka nāwaliwali i ka hopena anticonvulsant o ka carbamazepine. Hāpai ka poʻe hoʻonaʻau ʻo Monoamine i ka hopena o ka ulu ʻana i nā kūmaha hyperpyretic, nā hōʻeha hypertensive, ka hopu, a me ka make (pono e hoʻopau ʻia nā inhibitor monoamine ma mua o ke kuhikuhi ʻana i ka carbamazepine ma kahi o 2 mau hebedoma paha, inā paha ke kūlana haumania, ʻoi aku no kahi manawa lōʻihi). ʻO ka lawelawe manuahi me ka diuretics (hydrochlorothiazide, furosemide) hiki ke alakaʻi i ka hyponatremia, i hoʻopili ʻia e nā hōʻike maʻi. Ua komo i ka hopena o ka hoʻomaha a i ʻole depolarizing kalamale (pancuronium). I ka hoʻohana ʻana i kēlā hui like ʻole, pono paha e hoʻonui i ka hopena o ka hoʻomaha ʻana o nā musio, ʻoiai ka mākaʻikaʻi ʻana i ke ʻano o ka mea maʻi e pono ai ma muli o ka hiki ʻana o ka wikiwiki wikiwiki o ka hoʻomaha ʻana o ka ʻāʻī. Me ka hana like o ka carbamazepine i hui pū me ka levetiracetam, i kekahi mau kūlana, kahi i hoʻonui ʻia ai ka hopena o ka hopena o ke kūama o ka carbamazepine.

Hōʻemi ka Carbamazepine i ka hoʻomanawanui etanol.

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

Hoʻonui ia i ka metabolism o nā anticoagulants kūlike, hormonal contraceptives, folic acid, praziquantel, a hiki ke hoʻonui i ka hoʻopau ʻana o nā hormone thyroid.

Hoʻonui ia i ka metabolism o nā lāʻau lapaʻau no ka hana (enflurane, halotane, fluorotan) a hoʻonui i ka hopena o nā hopena hepatotoxic, hoʻonui i ka hoʻokumu ʻana o nā metabolites nephrotoxic o methoxyflurane. Hoʻonui i ka hopena hepatotoxic o isoniaeid.

Hoʻohui a me nā hopena serological. ^ E Ha yM. Hiki i ka Carbamazepine ke alakaʻi i kahi hopena maikaʻi-maikaʻi o ka hoʻoholo ʻana i ka neʻe o ka perphenazine e ka chromatography wai hoʻokaʻawale kiʻekiʻe. ʻO Carbamazepine a me ka carbamazepine 10.11-epoxide hiki ke alakaʻi i kahi hopena hewa-maikaʻi o ka hoʻoholo ʻana i ka neʻe ʻana o kahi antidepressant tricyclic e ka polarization fluorescence immunoassay.

ʻLoe a me ke kākele

ʻO nā papa Carbamazepine e kuhi ʻia no ke hoʻohana waha me nā meaʻai.

No ka mālamaʻana i ka epilepsy, ua kuhikuhi ʻia nā pākeke i ka lāʻau lapaʻau ma kahi o ka hopena mua o 1 papa 1-2 mau manawa i ka lā. A ʻōlelo ʻia nā poʻe ʻelemakule e lawe i nā papa he ½ 1-2 mau manawa i ka lā. Ma hope aku, e hoʻonui pinepine ʻia ka lāʻau a hiki i ka papa ʻaina 2 mau manawa 2-3 i ka lā. ʻO ka lōʻihi loa o kēlā me kēia lā o ka carbamazepine, ʻaʻole pono eʻoi aku ma mua o 6 papa.

ʻO ka helu ma kēlā me kēia lā o ka carbamazepine no nā keiki ma lalo o 1 makahiki he 0.5-1 papa pākahi i kēlā me kēia lā, 1-5 makahiki - 1-2 papa, 5-10 mau makahiki - 2-3 papa, 10-15 mau makahiki - 3-5 papa. Pono e hoʻokaʻawale ʻia ka nui o ka lā i kēlā me kēia.

No ka mālamaʻana i nā syndromes neuralgia a me nā hōʻeha o nā ʻano genesis, ʻo ka nui o kēlā me kēia lā he 1-2 mau papa o ka carbamazepine, i ʻoka ʻia i 2-3 dosis. 2-3 mau lā ma hope o ka hoʻomaka ʻana o ka lāʻau lapaʻau, hiki ke hoʻonui ʻia ka nui i 2-3 papa. ʻO ka lōʻihi loa o ka lāʻau 7 7 lā mau lā. Ma hope o ka hoʻomaikaʻi ʻana i ke kūlana o ka mea maʻi, e hoʻohaʻahaʻa ʻia ka nui o ka pau i ka liʻiliʻi. Hoʻokomo ʻia nā kahuʻi no ka mālama lōʻihi.

I ka hihia no ka haʻaleleʻana i ka maʻi, e like me nā ʻōlelo i kauoha ʻia, ʻōlelo ʻia ka carbamazepine e lawe i 1 papa 3 mau manawa i ka lā. I nā hihia koʻikoʻi, ma ka lā ʻekolu mau lā, ke noi ʻia kahi nui o ka lāʻau lapaʻau - 2 mau papa 3 mau manawa i ka lā.

No ka mālamaʻana i ka polydipsia a me ka polyuria ma ka diabetes insipidus, pono e kau i kekahi papa i nā manawa 2-3 i ka lā.

Hoike hōkeo

Pono e hoʻoulu ʻia ka lāʻau me ka caramazepine me nā liʻiliʻi liʻiliʻi, e hoʻolōʻihi ʻia iā lākou i ka pae therapeutic e pono ai.

I loko o ka wā o ka mālama ʻana me kēia lāʻau lapaʻau, ka mea ia e hōʻole i ka hana ʻana i nā hana e pono ai ka hoʻonui ʻana o ka manaʻo, ʻoiai ua pili ka lāʻau lapaʻau i nā hana o nā ʻoihana sentral.

Hōʻike nā ʻōlelo no ka carbamazepine pono e mālama i ka lāʻau lapaʻau i loko o kahiʻeleʻele, mālie a mai ka hiki ʻana o nā keiki. ʻO 36 mau malama ka nohoola.

Pākuʻi a me nā ʻōlelo hoʻi

E hoʻokō i ka hopena therapeutic maikaʻi loa, ʻo ka carbamazepine e like me ka monotherapy i kauoha ʻia me nā liʻiliʻi liʻiliʻi me kā lākou ulu. I ka hui pūʻana no ka hoʻoponopono hoʻoponopono ʻia, pono ia e hoʻoholo i ka ʻike ʻana o ka carbamazepine i loko o ke koko koko. ʻAʻole hiki ke hoʻopau ʻia ka lāʻau me ka caramazepine, no ka mea, ua hoʻopaʻa pinepine ʻia nā hopu pōkole hou. Akā inā pono ka lāʻau i ka huki ʻana, a laila lawe pono ʻia ka mea maʻi i nā lāʻau antiepileptic ʻē aʻe. No laila, i ka wā e mālama ai me ka carbamazepine, pono ia e nānā i ka helu o ke koko a me ka hana ponoʻī.

Hōʻike ka Carbamazepine i kahi hopena anticholinergic iki, no laila e pono ke hoʻomalu ʻia ke kaomi intraocular i loko o ka manawa holoʻokoʻa o ka hopena. Hiki i ka Carbamazepine ke hōʻemi i ka hopena o nā mea hoʻohālikelike waha, no laila pono e hoʻohana ʻia nā ala hou e pale aku ai i ka wā hāpai.

Hoʻohana ʻia ka Carbamazepine e hoʻomaʻamaʻa i nā hōʻailona huki e kū mai ka hoʻokaʻa ʻana i ka waiʻona. Hoʻonui ka lāʻau lāʻau i ke kūlana olakino o ka mea maʻi. Akā ke hoʻohana pono ʻia ka lāʻauamaama no nā pahuhopu wale nō i loko o kahi haukapila, ʻoiai ke hui pū ʻana o kēia mau mea ʻelua e alakaʻi i ka hoʻoulu kūleʻa ʻana o nā mea pīpī.

Hiki i ka lāʻau lapaʻau ke'āpono i ka ʻike. No laila, i ka wā o nā mea lapaʻau me kēia lāʻau lapaʻau, pono ia e pale i nā hana ʻeha, ke alakaʻi ʻana i nā kaʻa, a me ka hana e koi nui aku.

Ka kuʻikahi me nā lāʻau lapaʻau ʻē aʻe

ʻO ka lawe ʻana i ka mea hiki ke hoʻokūkū CYP 3A4 hiki ke alakaʻi i ka hoʻonui ʻana i ka ʻaila plasmaamaamaama. ʻO ka lawe ʻana i nā inducers o ka isoenzyme CYP 3A4 a me ka carbamazepine hiki ke alakaʻi i ka hoʻoemi o ke kaohi o ka lāʻau antiepileptic a hoʻokaʻawale i kona metabolism. ʻO ka hoʻohana like ʻana o ka carbamazepine me nā lāʻau lapaʻau e metabolized ana e ka CyP 3A4 isoenzyme e hoʻopili ana i ka hoʻonāukiuki o ka hana a ka hōʻemi o kēia mau lāʻau i ka plasma.

ʻO nā lāʻau lapaʻau e hoʻonui ai i ka kao o ka carbamazepine: ibuprofen, macrolide antibiotics, dextropropoxyphene, danazol, fluoxetine, nefazodone, fluvoxamine, trazodone, paroxetine, viloksazin, loratadine, vigabatrin, stiripentol, azoles, terfenadine, quetiapine, loxapine, isoniazid, olanzapine, mea hoʻomaʻi protease nā mea kūpale no ka iapaau ana o HIV, verapamil, omeprazole, acetazolamide, diltiazem, dantrolene, oxybutynin, nicotinamide, ticlopidine. ʻO ka Primidone, ka cimetidine, ka valproic acid, desipramine hiki i ka hopena like.

ʻO nā lāʻau lapaʻau e hōʻemi ai i ka kaila o ka carbamazepine: paracetamol, methadone, tramadol, antipyrine, doxycycline, anti-coagulants (oral), bupropion, trazodone, citalopram, antidepressants (tricyclics), clonazepam, clobazam, lamotrigine, felbamate, etosuximide, primamidazidone, azamidazidone imatinib, praziquantel, itraconazole, haloperidol, olanzapine, bromperidol, quetiapine, ziprasidone, ritonavir, saquinavir, ritonavir, indinavir, alprazolam, blockers kahalula, theophylline, midazolam, perazolam , glucocorticosteroids, sodium levothyroxine, everolimus, cyclosporine, progesterone, estrogens.

ʻO nā hui e noʻonoʻo.

Isoniazid + carbamazepine - hoʻonui i ka hepatotoxicity.

Levetiracetam + carbamazepine - i hoʻonui ʻia i ka maʻi o ka carbamazepine.

Hoʻomākaukau Carbamazepine + lithium, metoclopramide, haloperidol, thioridazan a me nā mea hou aku - he kuʻina o ka nui o ka hopena neʻokeʻo ponoʻī.

Carbamazepine + diuretics, e like me ka furosemide, hydrochlorothiazide - ka uluʻana o ka hyponatremia me nā maʻi lapaʻau koʻikoʻi.

ʻO ka Carbamazepine + hoʻomaha relants - kaohi ʻana o ka hana a nā mea hōʻoluʻolu o ka iwi, ka mea i hoʻopau koke i kā lākou hopena therapeutic, akā hiki ke hoʻoponopono ʻia ke kūlana ma ka hoʻonui ʻana i kā lākou laʻa i kēlā me kēia lā.

ʻO ka wai huaʻai Carbamazepine + - kahi hoʻonui i ke kiʻekiʻe o ka carbamazepine i loko o ka plasma.