Zeptol (Zeptol)
ʻO ka lāʻau antiepileptic i hele mai i ka iminostilbene tricyclic.
Keʻano: ZEPTOL
ʻO ka mea ikaika o ka lāʻau lapaʻau: carbamazepine
ATX Encoding: N03AF01
KFG: Anticonvulsant
Ka helu kākau: P No. 011348/01
Lā hoʻopaʻa inoa: 07.07.06
Mea ʻai reg. Leka: Sun Pharmaceutical Industries Ltd.
Hoʻolaha puka Zeptol, pahu paʻi a me ka ʻano.
Nā Palaki
1 kōpō
carbamazepine
200 mg
10 kamepiula - nā kihi alumini (10) - nā kāʻei o ka pahu.
Hoʻopuni nā ʻāpana āpau a me nā kala i hoʻokuʻu ʻia, nā biconvex, me ka loaʻa ʻole o ka ʻaoʻao.
1 kōpō
carbamazepine
200 mg
Nā mea kū'ē: ethyl cellulose, microcrystalline cellulose, starch, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, eudrazit E100, titanium dioxide, polyethylene glycol 6000, oxide iron redide, yellow iron oxide.
10 kamepiula - nā pākeke me ka ʻole o ka contour cell (3) - nā ʻeke pepa.
Hoʻopuni nā ʻāpana āpau a me nā kala i hoʻokuʻu ʻia, nā biconvex, me ka loaʻa ʻole o ka ʻaoʻao.
1 kōpō
carbamazepine
400 mg
Nā mea kūlike: ethyl cellulose, microcrystalline cellulose, starch, talc, magnesium stearate, silicon dioxide, croscarmellose sodium, Eudraite E100, titanium dioxide, polyethylene glycol 6000, oxide iron redide, yellow iron oxide, 2208 hydroxypropyl methyl cellulose.
10 kamepiula - nā pākeke me ka ʻole o ka contour cell (3) - nā ʻeke pepa.
KAHANA NUI O NA KANANUI UIKI.
Hōʻike ʻia nā ʻike a pau no ka familiarization wale nō me ka lāʻau lapaʻau, pono ʻoe e kamaʻilio i ke kauka e pili ana i ka hiki ke hoʻohana.
ʻO ka hana lāʻau lapaʻau o Zeptol
ʻO ka lāʻau antiepileptic i hele mai i ka iminostilbene tricyclic. Ke manaʻoʻiʻo ia e pili pū ana ka hopena anticonvulsant me ka hoʻokaʻawale ʻana i ka hiki o nā neurons e mālama i kahi kiʻekiʻe o ka hiki ke hana hou ʻia ma o ka hana sodium. Eia kekahi, ʻo ka paleʻana o ka hoʻokuʻu ʻana o ka neurotransmitter e ke kāohi ʻana i nā kanika sodium presynaptic a me ka hoʻomohala ʻana o nā hana e hana ai, ʻo ia hoʻi e hōʻemi ai i ka hoʻoili ʻana o synaptic, he mea nui ia.
Loaʻa ia ia nā hopena antimaniacal, antipsychotic hopena, a me kahi hopena analgesic no ka hōʻeha o ka neurogen. ʻO GABA ka mea i hoʻopili ʻia, me ka pili i nā kahawai calcium, e pili ana i nā lawelawe o ka hana, a ʻo ka hopena o ka carbamazepine ma nā ʻano o nā modulator neurotransmitter e like me he mea nui.
ʻO ka hopena antidiuretic o ka carbamazepine e pili ana me ka hopena hypothalamic ma osmoreceptors, i hoʻokaʻawale ʻia e ka neʻe ʻana o ADH, a pili pū kekahi i nā hopena koʻikoʻi i nā tubula renal.
ʻO ka Pharmacokinetics o ka lāʻau.
Ma hope o ka lawelawe ʻana i ka waha, ua hoʻopau like ʻia ka carbamazepine mai ka ʻōpala ʻana. ʻO ka pilina ʻana i ka protein plasma he 75%. He mea hoʻonāukiuki ia i nā aʻalima a me ka hoʻoulu ʻana i kona ake ponoʻī.
ʻO T1 / 2 he mau hola 12-29. Hoʻopau ʻia ka 70% i ka urine (ma ke ʻano o nā metabolite ʻaʻole paʻa) a me 30% - me nā feces.
Nā hōʻailona no ka hoʻohana ʻana:
ʻO Epilepsy: nui, kīwaha, kāwili ʻia (me ka nui a me ka nui kumu hoʻokele) epileptic. ʻO ka maʻi ʻeha e loaʻa mai i ka neʻe ʻana mai ka neurogen, me ka pono neuralgia trigeminal, trigeminal neuralgia i loko o ka lehulehu sclerosis, pono glossopharyngeal neuralgia. ʻO ka pale ʻana i ka hoʻouka ʻana me ka maʻi haʻalele hauwa. ʻO nā psychoses kūpono a me nā skizoaffective (me ke ʻano o ka nānā ʻana). ʻO ka neuropathy Diabetic me ka ʻeha. ʻO ka maʻi maʻi indipidus o ke kumu waena, polyuria a me polydipsia o ke ʻano neurohormonal.
ʻO ka dosis a me ke ala o ka hoʻokele lāʻau.
E hoʻonohonoho hoʻokahi. I ka wā e lawe kolohe ai no nā pākeke a me nā ʻōpio he 15 a ʻoi aku ka makahiki, ʻo ka hopena mua loa he 100-400 mg. Inā kūpono, a noʻonoʻo i ka hopena lapaʻau, hoʻonui ʻia ka lāʻau lapaʻau ma mua o 200 mg / lā me kahi manawa o 1 pule. ʻO ka holo pinepine o ka hoʻokele he 1-4 mau manawa / lā. ʻO ka dosis mālama mālama maʻamau ʻo 600-1200 mg / lā i kekahi mau koina. Ma muli o ka hōʻike ʻana i ka hōʻike, ka pono o ka mālama ʻana, ka pane a ka mea maʻi i ka lāʻau.
I nā keiki ma lalo o ka 6 mau makahiki, ʻo 10-20 mg / kg / lā e hoʻohana ʻia ana i ka mahele i 2-3 mau ʻāpana, inā pono a me ka noʻonoʻo ʻana i ka ahonui, hoʻonui ʻia ka pāʻai e ʻoi aku ma mua o 100 mg / lā me kahi manawa o 1 hebedoma, ʻo ka nui o ka mālama mālama ʻia 250 -350 mg / lā a ʻaʻole iʻoi aku i 400 mg / lā. ʻO nā keiki i hala 6-12 mau makahiki - 100 mg 2 mau lā / lā i ka lā mua, laila hoʻonui ʻia ka nui e 100 mg / lā me kahi 1 mau pule. a hiki i ka hopena kūpono loa, ʻo ka maʻi mālama ma ka maʻamau ʻo 400-800 mg / lā.
Nā kuʻuna nui loa: i ka wā e lawe ai ma ka ʻōlelo maʻamau, ʻo nā pākeke a me nā ʻōpio he 15 mau makahiki a ʻoi aku - 1.2 g / lā, nā keiki - 1 g / lā.
Nā hopena ʻaoʻao o Zeptol:
Mai ka ʻaoʻao o ka pūnaehana nīkini waena a me nā ʻōnaehana hoʻoneʻe peripheral: pinepine - dizziness, ataxia, drowsiness, hiki ke kaumaha, ka diplopia, ka noho hoʻomaha ʻana, ʻokoʻa - ʻonanekōkō o ka neʻe ʻana, nā nystagmus, i kekahi mau hihia - nā pilikia oculomotor, dysarthria, peripheral neuritis, paresthesia, ʻōpū hōʻeha, ʻehaʻelima. paresis, halapaa, hopohopo, luhi, hoʻoweliweli, ʻūhā, ʻike ʻole ʻia, hoʻonui i ka psychosis, ʻeha hoʻomaʻamaʻa, conjunctivitis, tinnitus, hyperacusis.
Mai ka pūnaehana hana ʻana: nausea, hoʻonui ʻia GGT, nui ka hana o ka phosphatase alkaline, luaʻi, waha maloʻo, ʻuʻuku - hoʻonui i ka hana o ka transaminases, jaundice, hepatitis cholestatic, ʻeha a i ʻole constipation, i kekahi mau hihia - hoʻemi i ka momona, ʻeha o ka ʻōpū, glossitis, stomatitis.
Mai ka pūnaehana cardiovascular: loaʻa - pilikia ʻole ka haunaele myocardial, i kekahi mau hihia - bradycardia, arrhythmias, AV blockade me ka syncope, nānaka, ka hewa puʻuwai, nā hōʻike o ka poʻina coronary, thrombophlebitis, thromboembolism.
Mai ka papa hemopoietic: leukopenia, eosinophilia, thrombocytopenia, jarang - leukocytosis, i kekahi mau hihia - agranulocytosis, anemia aplastic, erythrocytic aplasia, megaloblastic anemia, reticulocytosis, hemolytic anemia, granulomatous hepatitis.
Mai ka ʻaoʻao o ka hana o ka metabolism: hyponatremia, mālama ka wai, edema, loaʻa ka nui, hoʻohaʻahaʻa i ka osmolality plasma, i kekahi mau hihia - i ka porphyria intermittent aʻai, nāʻaila kūmole huakalula, hoʻonui i ka cholesterol a me ka triglycerides.
Mai ka pūnaehana endocrine: gynecomastia a galactorrhea, ʻaʻole pilikia - thyroid dysfunction.
Mai ka ʻōnaehana urinary: jarang - hana ʻole nā māla o ka hana, interstitial nephritis a me ka pana ʻole ʻole.
Mai ka papa hana hanu: ma kekahi mau hihia - dyspnea, pneumonitis a pneumonia paha.
He maʻi kūloko: ke ana o ka ʻili, kaʻeha, līpeke - lymphadenopathy, maʻi, ka hepatosplenomegaly, arthralgia.
Hoʻohana i ka wā hāpai a me ka lactation.
Inā pono, e hoʻohana i ka wā o ka wā ʻo ka wahine hāpai (ʻoi aku hoʻi i ka trimester mua) a i ka wā lactation e noʻonoʻo pono i nā pōmaikaʻi o ka mea i manaʻo ʻia no ka mālama ʻana i ka makuahine a me ka pilikia i ka wahine hāpai a i ʻole keiki. I kēia hihia, ʻōlelo ʻia ka carbamazepine e hoʻohana wale ʻia e like me ka monotherapy i nā lāʻau koʻikoʻi liʻiliʻi.
Manaʻo nā wahine o ka hānau keiki ʻana i ka wā o ka mālama ʻana me ka carbamazepine e hoʻohana i nā contraceptives non-hormonal.
ʻO nā ʻōlelo kūikawā no ka hoʻohana ʻana iā Zeptol.
ʻAʻole hoʻohana ʻia ʻo Carbamazepine no ka lawe pōkole epileptic liʻiliʻi a i ʻole ka lehulehu, lawe ʻana i ka make myoclonic aicic poiki epileptic. ʻAʻole pono e hoʻohana pono e hōʻoluʻolu i nā ʻeha maʻamau, ʻo ia kahi prophylactic i ka manawa lōʻihi o ke kala ʻana i nā neuralgia trigeminal.
Hoʻohana ia me ka mālama pono i nā maʻi concomitant o ka maʻi cardiovascular, paʻa i ke kino ikaika a me / a hana paha i ka hana ʻana, ka maʻi diabetes mellitus, i hoʻonui ʻia ke kaila intraocular, me ka mōʻaukala o ka hematological kūlia i ka hoʻohana ʻana i nā lāʻauʻokoʻa ʻē aʻe, hyponatremia, noho hoʻomau i ka urinary, a me ka hoʻonui nui ʻana i ka antidepressants tricyclic. , me nā hōʻike ʻana o ka mōʻaukala o nā hōʻoki ʻana i ka mālama ʻana o ka lāʻau carbamazepine, me nā keiki a me nā maʻi maʻi.
Pono e hana ʻia ka lāʻau lapaʻau ma lalo o ka nānā o kekahi kauka. Me ka lōʻihi o ka mālama ʻana, pono e mālama i ke kiʻi o ke koko, ke kūlana hana o ke akeʻa a me nā ʻōpū, ke ʻike ʻana o nā electrolytes i ka plasma koko, a me kahi hoʻokolokolo ophthalmological. Hoʻomaopopo iki ka manawa o ka pae o ka carbamazepine i loko o ke kaila koko e nānā i ka pono a me ka palekana o ka mālama ʻana.
Ma kahi o 2 mau pule ma mua o ka hoʻomaka ʻana o ka lāʻau caramazepine, pono ia e pani i ka mālama ʻana me ka MAO inhibitors.
I ka wā mālama o ka mālama ʻana, ʻaʻole i ʻae ʻia ka hoʻohana ʻana i ka waiʻona.
Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini
I ka wā o ka mālama ʻana, pono e pale kekahi i ka hana ʻana i nā hana e hikiʻole ai ke koi nui ana, a me ka wikiwiki o ka hopena psychomotor.
Hoʻohui ʻia o Zeptol me nā lāʻau lapaʻau ʻē aʻe.
Me ka hoʻohana like ʻana o ka poʻe pale o ka isoenzyme CYP3A4, hiki i ka nui o ke kaila o ka carbamazepine i loko o ke koko koko.
Me ka hana like o nā inducers o ka pūnaehana isoenzyme CYP3A4, ka wikiwiki o ka metabolism o ka carbamazepine, kahi hoʻokaʻawale i kona kaohi ʻana i ke koko koko, a me ka hoʻolilo ʻana i ka hopena therapeutic hiki.
Me ka hoʻohana pinepine ʻana o ka carbamazepine e hoʻonāukiuki i ka hana o ka anticoagulants, ka waika folic.
Me ka hoʻohana like ʻana me ka waika valproic, hiki ke hoʻokaʻawale ʻia ka manaʻo o ka carbamazepine a me kahi hoʻēmi nui ʻana i ka ʻike ʻana o ka hoikama valproic i loko o ke koko koko. I ka manawa like, ʻoi ka ʻike o ka metabolama o ka carbamazepine, kāliaamaamaamaamaamaama, akā ua hoʻonui ʻia nā hopena ʻokoʻa - ʻike kūmaha ka ʻaoʻao. hōpuhi, hoʻopuka, nāwaliwali, nystagmus. Me ka hoʻohana like ʻana o ka pā pono valproic a me ka carbamazepine, hiki i ka hoʻomohala ʻana o ka hopena hepatotoxic (ʻike ʻia, ma muli o ke kūkulu hou ʻana o ka metabolite lua o ka wai valproic, he hopena hepatotoxic).
Me ka hoʻohana pinepine ʻana, hoʻemi ka valpromide i ka hana metabolism i loko o ke ake o ka carbamazepine a me kāna metabolite carbamazepine-epoxide ma muli o ke kaohi ʻana o ka hydroxase epoxide. ʻO ka metabolite i koho ʻia me ka hana anticonvulsant, akā me ka hoʻonui nui o ka neʻe plasma e hiki iā ia ke loaʻa i ka hopena oʻa.
Me ka hoʻohana pū ʻana me ka verapamil, diltiazem, isoniazid, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, paha me ka cimetidine, acetazolamide, danazole, desipramine, nicotinamide (i nā pākeke, ma nā ʻano kiʻekiʻe), erythromycin, trole (me ka itraconazole, ketoconazole, fluconazole), terfenadine, loratadine e hoʻonui i ka ʻai o ka carbamazepine i loko o ka mela koko me ka hopena o ka hopena o nā ʻokoʻa (dizziness, drowsiness, ataxi me, diplopia).
Me ka hoʻohana like ʻana me ka hexamidine, ua nāwaliwali ka hopena anticonvulsant o ka carbamazepine, me ka hydrochlorothiazide, furosemide - hiki iā ia ke hōʻemi i ka hoʻōkena sodium i loko o ke koko, me nā mea hoʻohālikelike hormonal - hiki iā ia ke hoʻonāwaliwali i ka hopena o nā contraceptives a me ke kūkulu ʻana o ke kaila acyclic.
Me ka hoʻohana like ʻana me ka hormone thyroid, hiki ke hoʻonui i ka hoʻopau ʻana o nā hormone thyroid, me ka clonazepam, hiki ke hoʻonui i ka hoʻomaʻemaʻe ʻana o nā clonazepam a hoʻēmi i ka hoʻomaʻemaʻe o ka carbamazepine, me ka hoʻomākaukau ʻana o lithium, hiki i ka hoʻonui pū ʻana o nā hopena neurotoxic.
Me ka hoʻohana like ʻana me ka primidone, hiki ke hoʻoneʻe iho nei i ka ʻike o ka mau ʻoama ma ka lāʻauama i loko o ke koko plasma. Aia kekahi mau manaʻo e hoʻonui paha ka primidone i ka hoʻoliʻi plasma o ka metabolite hoʻoikaika i ka pharmacologically - carbamazepine-10,11-epoxide.
Me ka hoʻohana like ʻana me ka ritonavir, hiki ke hoʻonui ʻia i nā hopena ʻaoʻao o ka carbamazepine, me ka sertraline, a hiki ke hōʻemi i ka ʻai ʻana o ka sertraline, me ka theophylline, rifampicin, cisplatin, doxorubicin, he ʻemi i ka hoʻoliʻi ʻana o ka carbamazepine i loko o ke koko koko, me ka tetracycline, hiki i ka hopena o ka carbamazepine.
Me ka hoʻohana like ʻana me ka felbamate, hiki ke hoʻohaʻahaʻa i ka manaʻo o ka carbamazepine i loko o ke kaila koko, akā hiki ke hoʻonui ʻia i loko o ke kao o ka metabolite hoʻoikaika o ka mau ʻoama o ka carbamazepine-epoxide.
Me ka hoʻohana like ʻana me ka phenytoin, phenobarbital, ke emi nei ka ʻike ʻana i ka carbamazepine i loko o ke koko koko. ʻO ka palupalu mutual o ka hana anticonvulsant hiki, a i nā hanana liʻiliʻi, ʻo kona hoʻoikaika.
ʻLoe a me ke kākele
Nā Palaki i loko, i nā pākeke a me nā ʻōpio he 15 a keu paha me ka epilepsy a me nā neuralgia ka inumua mua - 200 mg 1-2 mau manawa i ka lā me ka hoʻonui haʻahaʻa i ka wai (100 mg me kahi manawa o 1 wiki) i ka hopena therapeutic maikaʻi loa - 600-1200 mg / lā (kiʻekiʻe i kēlā me kēia lā - 1.8 g). Me ka psychosis manic-depressive ʻO ka inumua mua loa he 400 mg / lā, i hoʻokaʻawale ʻia i 2 mau puʻupuʻu, me kahi hoʻonui e hoʻonui i ka 600 mg / lā (nui i kēlā me kēia lā). ʻO nā keiki ma lalo o 1 mau makahiki (2 mau manawa i ka lā) - 100-200 mg / lā, 1-5 mau makahiki - 200-400 mg / lā, 5-10 mau makahiki - 400-600 mg / lā, 11-15 mau makahiki - 600-1000 mg / lā
Nā ʻletslelo Kūleʻa Kūlea: i loko, i ka manawa a ma hope o ka ʻaina me kahi waiʻuʻuku iki. Me ka epilepsy: pākeke, ʻo ke kau mua ma mua - 200 mg 1-2 mau manawa i ka lā, a laila hoʻonui ka nui i ka momona - 400 mg 2-4 mau lā i ka lā. Ke keiki: ma ka helu o 10-20 mg / kg, 4-12 mahina - 100-200 mg ma 1-2 dosis, 1-5 makahiki - 200-400 mg ma 1-2 mau dona, 5-10 mau makahiki he nui - 400-600 mg i 2-3 mau wā, 10-15 makahiki - 600-1000 mg ma 3 pākēn.
ʻO neuralgia antigeminal: ʻo ka maʻa mua loa he 200-400 mg / lā, a laila e hoʻonui mālie ka nui, inā pono, a hiki i ka 600-800 mg i nā papa he nui. Ma hope o ka nalowale ʻana o ka hōʻeha, ua hoʻemi ʻia ka nui o ka lāʻau ma 200 mg / lā.
Kākoʻo i ka hopena pili: i loko o ka pule mua, he 200-400 mg kēlā me kēia lā, e hoʻonui ʻia ai ka nui o kēlā me kēia lā (e ka 1 papa i kēlā me kēia pule) i 1000 mg a lawe ʻia no 3-4 mauʻu.
Hoʻonohonoho ka lōʻihi o ka mālamaʻana i kēlā me kēia.
E hoʻokuʻu i ke ʻano a me ka ʻano
- papa: pihi, pōʻai, keʻokeʻo, ma kahi ʻaoʻao me ka hōʻailona "ZEPTOL 200" a me kahi bevel, ma ka ʻaoʻao me ka laina hoʻokaʻawale (10 mau p. i loko o kahi kaula o ka alumini foil, ma loko o kahi pūlaki pepa he 10 mau kihi).
- nā pālani pale-kala i hoʻokuʻu ʻia: biconvex, hoʻopuni, kukui aniani, me ka pilikia o kekahi ʻaoʻao (10 mau p. i loko o kahi kiko o ka alumini foil, ma loko o kahi pūlaki pepa o 3 mau kihi).
Aia pū i kēlā me kēia pā ka pahuhopu no ka hoʻohana ʻana o Zeptol.
Pākaukau 1 papa:
- mea waiwai: carbamazepine - 200 mg,
- Nā kumuhana hou: hypromellose 2910 (Metocel E5), colloidal silicon dioxide, microcrystalline cellulose, mais starch, povidone K 30, sodium propyl parahydroxybenzoate (sodium propyl paraben), bronopol, purified magnesium stearate, talc purified, sodium lauryl sulfate, sodium carium.
I ka papa 1 i ka hana hoʻomohala a paʻa i nā kiʻiʻoniʻoni.
- mea waiwai: carbamazepine - 200 a i 400 mg,
- Nā kumuhana hou: hypromellose 2208 (Metocel K4M) - no kahi kaila o 400 mg, cellulose microcrystalline, ethyl cellulose M50, mais palaoa, colloidal silicon dioxide, purc talc, magnesium stearate, croscarmellose sodium,
- palaule kiʻi: he copolymer o butyl methacrylate, dimethylaminoethyl methacrylate a me methyl methacrylate (1: 2: 1) (Eudragit E-100), macrogol 6000 (polyethylene glycol 6000), ka purea purc, ka magnesium stearate, titanium dioxide, iron dye red oxide.
Lapaʻau lāʻau
ʻO Carbamazepine kahi huaʻala o ka iminostilbene, ka mea e hōʻike ana i ka hopena anticonvulsant (antiepileptic) a me nā hopena antidepressant (thymoanaleptic), ka hopena antipsychotic a me nā hopena normotimic. Hōʻike pū ʻia ka lāʻau lapaʻau i nā waiwai analgesic, keu i nā mea maʻi me ka neuralgia trigeminal.
ʻAʻole maopopo i ke ʻano o ka hana o ka hana ikaika. Ua manaʻo ia me kāna hopena anticonvulsant ma muli o ka emi ʻana o ka hiki i nā neurons e hāʻawi i kahi kiʻekiʻe o ka ulu ʻana o nā hana kinikina hou ma muli o ke kaohi ʻana o ka hana o nā pā sodium. Eia kekahi, e pale ana i ka hoʻokuʻu ʻia o ka hoʻokuʻu ʻana o nā neurotransmitters ma o ka pale ʻana i nā kahiki sodium presynaptic a he mea nui hoʻi ka ulu ʻana o nā hana hana, ka mea e hōʻemi ai i ka hoʻoiho ʻana i ka hoʻopili synaptic.
ʻO ka hana o ka hana o ka carbamazepine e pili ana i nā ʻae ʻāmaʻaila o ka acid gamma-aminobutyric (GABA), ka mea e hui pū ʻia me nā kano kalima. I ka manawa, hoʻomohala ʻia ka mana e ka mea ikaika ma ka ʻōnaehana o ka modulators o ka neurotransmission, ʻaʻohe mea nui. Hiki ke pili me ka hopena antidiuretic o ka carbamazepine me ka hopena hypothalamic i ka osmoreceptors, i lawe ʻia e ka neʻe ʻana o ka huna o ka hormone antidiuretic (ADH), a i hoʻopiʻi ʻia hoʻi e ka hopena pololei i nā tubula renal.
ʻO ka hopena o nā lāʻau antiepileptic i ʻike ʻia i ka mālama ʻana i ka hopu kai tonic-clonic, ʻo ka mea kikoo (a me nā mea) kuʻi epileptic, ka mea i hui pū ʻia a ʻaʻole i hele pū ʻia e ka generalization lua, a me ka hui pū ʻana me nā ʻano o nā mea e kau nei ma luna. Ma ke kānāwai, ʻaʻole pono ka hoʻohana ʻana o Zeptol no nā kaʻe liʻiliʻi - petit mal, kuihue myoclonic a me nā kīnā.
I ka wā o nā ʻoihanaamaamaama i nā maʻi me ka epilepsy (ʻoi aku hoʻi i nā keiki a me nā ʻōpio), ʻo ka hōʻemi o ka hōʻeha o nā hōʻailona o ka hopohopo a me ke kaumaha, a ua kōkua hoʻi ka lāʻau i ka hōʻemi o ka huhū a me ka hoʻohālikelike. ʻO ka mahele o ka hopena o ka hana ikaika ma ka helu mōhala psychomotor a me nā hana cognitive pili i kona ʻano. Hiki ke hoʻomaka ka hopena anticonvulsant ma hope o kekahi mau hola a hala paha kekahi mau lā (i kahi mau manawa kokoke i 1 mahina ma hope o ka haʻalulu o ka metabolism).
E kū'ē i ka maikaʻi o ke neuralgia a me nā mea neʻe no ka neʻeʻana o trigeminal, ma ka nui o nā hihia, ka hopena o ka carbamazepine i ka hopena o nā hōʻeha ʻeha. ʻO ka nāwaliwali o ka maʻi ʻeha me ka neuralgia trigeminal i nānā ʻia ma hope o 8-75 hola.
Hāʻawi ʻo Zeptol no ka hoʻohaʻahaʻa ʻokoʻa i ka waiʻona i ka nui o ka mākaukau o ka ʻāhewa ʻana, ka mea, ma ke ʻano he lula lā, ua hōʻemi ʻia i kēia ʻano, a me ka hōʻemi ʻana i nā mānoanoa o kēia mau maʻi (ka weliweli, nui aʻe nā huhū, nā hana gait).
Hoʻoholo ʻia ʻo Antimaniacal (hana antipsychotic) ma hope o 7-10 mau lā a ma ke ʻano o ka pani ʻana o ka metabolism o norepinephrine a me ka dopamine.
Mālama i ka pae ʻoi aʻe o ka mau ʻoama me ka maikaʻi o ka mau ʻoama me ka maikaʻi o ka mau ʻoihana.
Hoʻohana ʻia nā papa papa
- epilepsy: nā paʻihā maʻalahi a me ka paʻakikī o ka epileptic (me ka ʻole o ka nalowale o ka ʻike) me ka ʻole o ka mana ʻōlima, ka hopu poʻopala epiceptic e pili ana i ka waiwai,
- ʻalaʻeha ka maʻi ʻalani a me ka neuralgia trigeminal,
- iduralathic neuralgia o ka lau glossopharyngeal nerve, maʻamau a me atypical trigeminal neuralgia i loko o ka maha sclerosis a me ka idiopathic trigeminal neuralgia,
- ʻeha i loko o ka maʻi neuropathy maʻi, ʻeha i loko o nā haʻalulu o nā nipoli peripheral i mua o ka maʻi mellitus, polyuria a me polydipsia o kahi ʻano neurohormonal e kūlia i ka maʻi mellitus o ke kumu waena,
- Hōʻemi i ka waiʻona alkohol (hōʻeha, nui i waho, ke kaumaha, nā hiamoe hiamoe),
- ʻano hana manic a me ke kākoʻo kākoʻo ʻana o nā maʻi bipolar affective e pale ai i ka exacerbations a i ʻole e hoʻonāwaliwali i ka nui o kā lākou hōʻike lapaʻau ʻana.
Nā Hoʻohui
ʻAʻohe no nā palapala inua ʻelua:
- nā hana hōʻeha o ka iwi hematopoiesis (anemia, leukopenia),
- atrioventricular block (AV block),
- Hoʻohui hui pū me nā mākau lithium a me nā monoamine oxidase inhibitors (MAO),
- hypersensitivity o kekahi o nā ʻāpana o Zeptol, a me nā mea i loaʻa ke ʻano like-like o ka carbamazepine, no ka laʻana, ka tricyclic antidepressants.
ʻO nā contraindications hou no nā papa hana lōʻihi.
- ka mōʻaukala o nā hanana o ka pale ʻana o ka iwi he maramoa hematopoiesis a i ʻole kekahi ʻano o ka hemphia,
- makahiki a hiki i 4 mau makahiki.
ʻO kahi contraindication hou aʻe no Zeptol i ke ʻano o nā papa he uukui penmyrent intermittent (me ka mōʻaukala).
Kuhi (hoʻohana i ka lāʻau antiepileptic me ka mālama):
- decompensated pilikia hōʻalo o ka naʻau (CHF),
- pilikia hāpau a me / a hana pāpaʻi,
- pua hyponatremia: adrenal cortex insufficiency, ADH hypersecretion syndrome, hypothyroidism, hypopituitarism,
- ka huehuki,
- ka pale ʻana i ka ʻai hematopoiesis iwi, hoʻopau ʻana i nā lāʻau (mōʻaukala),
- hooulu ae la ka paa intraocular,
- ka hana alakino maʻi, no ka hiki ʻana i ka hoʻopukuhū ʻana o ka ʻōnaehana nerve waena (CNS), ua hoʻolōʻihi ʻia ka biotransformation o carbamazepine,
- hiʻona kiʻekiʻe
- me ka hoʻohana pū ʻana me sedative-hypnotics.
ʻO Zeptol, nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana: ke ʻano a me ka helu ʻana
Lawe ʻia nā papa Zeptol me ka waha me ka liʻiliʻi liʻiliʻi i ka wā ma hope o ka pāʻina a i ʻole ma waena o ka papaʻaina. Hiki ke kuhikuhi ʻia ka lāʻau lapaʻau ma loko o ka monotherapy a ma ke ʻano he hanana nui.
Pono e hoʻokaʻawale ʻia nā papa hoʻihoʻi ʻia i ka piha holoʻokoʻa, a i ʻole, inā i kauoha ʻia e ke kauka, ½, ʻaʻole ʻāʻī ʻia. ʻOiai ka hoʻokuʻu ʻia ʻana o ka mea hana a nā lōlihi loa mai nā papa hemo lōʻihi, pono ke lawe ʻia ʻo Zeptol i 2 mau manawa i ka lā, e hoʻoholo ʻia e ke kauka ka hopena maikaʻi loa. Inā pono e hoʻololi i ka hoʻohana ʻana i nā papa maʻamau i ka lawe ʻana i kahi lōʻihi lōʻihi, e like me ka ʻike loea, hiki i kekahi mau maʻi ke hoʻonui i kahi hala o mua o ka lāʻau.
I ka mālamaʻana o ka epilepsy, ʻoi aku ia e kuhikuhi i nā papa Zeptol i ke ʻano o ka monotherapy. Pono e hoʻomaka e hoʻohana i ka lāʻau lapaʻau me kahi liʻiliʻi liʻiliʻi o kēlā me kēia lā, pono e hoʻonui lohi a hiki i ka loaʻa ʻana o ka hopena makemake. I ke koho ʻana o ka hopena kūpono loa, ʻoi aku ia e hoʻoholo i ke kiʻekiʻe o ka lāʻauamaama i loko o ke koko koko. I ka hihia o Zeptol i ka hopena antiepileptic i alakaʻi ʻia i mua, lawe ʻia ana kona hoʻomau ʻia ʻana, ʻoiai nā ʻano o nā lāʻau lapaʻau i loaʻa i ke loli, akā inā pono, hana lākou i ka hoʻoponopono kūpono. Inā poina ka mea maʻi e lawe i ke ʻano o ka hopena o ka carbamazepine i kahi manawa kūpono, pono e lawe koke ʻia a hiki ke ʻike ʻia kēia hala ʻole, eia naʻe, ʻaʻole hiki iā ʻoe ke hoʻohana i kahi pālua ʻelua o Zeptol.
Palapala ʻia e like me nā hōʻike ʻana:
- epilepsy: lawe aku nā pākeke iā Zeptol 1-2 mau manawa i ka lā ma kahi mua o 100-200 mg, a laila hoʻonui mālie ka nui i ka 400-600 mg 2 mau manawa i ka lā, ʻaʻole pono ka nui o ka lā ma mua o 1600-2000 mg, i nā kamaliʻi ʻoi aku he mau makahiki 4. hiki ke hoʻomaka ʻia ka hoʻokipa ʻia me kahi maʻi o kēlā me kēia lā he 100 mg, a laila i kēlā me kēia pule e hoʻonui ʻia ka nui e ka 100 mg, nā keiki mai ka 4 mau makahiki a ʻo ka ʻōpio ke kuhikuhi ʻia iā Zeptol (nā papa) i kahi maʻi wai i kēlā me kēia lā o 20-60 mg a laila e hoʻonui iā ia i kēlā me kēia lā i ka 20 o kēlā me kēia lā. 60 mg, e kākoʻo ana i nā koina o kēlā me kēia lā no nā keiki, ua hoʻopaʻa ʻia ma ka helu o 10-20 mg / kg, hoʻokaʻawale ʻia e n kekahi mau haʻawina, nā hana mālama mālama ʻia i kēlā me kēia lā i nā keiki no nā papa (ma muli o ka makahiki): emi ma lalo o ka makahiki 1 - 100-200 mg i 1 pākaʻi, 1-5 mau makahiki - 200-400 mg ma 1-2 mau kala, 6-10 mau makahiki - 400-600 mg i nā wai he 2-3, 11-15 mau makahiki –-6600-1000 mg ma ka 2-3 mau pākaʻi, kuhi ʻia i nā mālama i kēlā me kēia lā i nā keiki no nā papa e hoʻokuʻu ʻia (i kekahi mau doka): 4-5 mau makahiki - 200-400 mg , 6-10 mau makahiki - 400–600 mg, 11-15 mau makahiki - 600-1-1000 mg,
- ʻeha ʻo neuralgia a me nā maʻi neʻe o ka neurogen: 2 mau manawa i ka lā, 100-200 mg pākahi i kēlā me kēia, i ka wā e hiki mai ana ka nui o ka lā i kēlā me kēia ma mua o 200 mg (a i ka aneane 600-800 mg) a hiki i ka hoʻomaha ʻana o ke kaumaha, a laila hoʻemi ʻia ka nui i ka liʻiliʻi loa. ma hope o ka hoʻomaka ʻana o ka papa, ʻike ʻia ka hopena maikaʻi ma hope o nā lā 1-3, ka lōʻihi o ka mālama ʻana i ka wā lōʻihi, inā e hoʻihoʻi iki ma mua o ka carbamazepine, e hoʻomaka ka ʻeha, ma nā maʻi maʻi makua, ʻo ka hopena mua ma 100 mg 2 mau manawa i ka lā.
- neuropathy maʻi maʻi, i hele pū ʻia me ka ʻeha: 2-4 mau manawa i ka lā, 200 mg (nā papa), ʻelua mau manawa i ka lā, 200-300 mg (nā kākoʻo i hoʻokuʻu ʻia).
- diabetes insipidus (nā papa): no nā pākeke, ma ka awelika 2-3 mau lā i ka lā, 200 mg kēlā me kēia,
- ʻeha me nā ʻeha o nā nīnipeka peripheral e kū'ē i ka maʻi mellitus: 2 mau lā i ka lā, 200-300 mg,
- neuralgia idiopathic glossopharyngeal, neuralgia trigeminal e pili ana i ke kumu o ka lehulehu o ka sclerosis a me ka idiopathic trigeminal neuralgia (mau papa hana lōʻihi): 2 mau lā i ka lā, 200-400 mg,
- polyuria a me polydipsia o ke ʻano neurohormonal me ka diabetes insipidus o nā kikowaena genesis (mau pūpū i hoʻokū ʻia i hoʻolaʻa ʻia): no nā pākeke, ʻo ka nui ma ka awelika he 200 mg 2 mau manawa i ka lā, e hōʻemi nā keiki i ka maʻi ma muli o ka makahiki a me ke kaumaha o ke kino,
- ʻO ka maʻi hōʻemi ʻemi waiʻona: ʻo ka nui o ka make ma ka 200 mg 2 mau manawa i ka lā, i nā hihia koʻikoʻi i nā lā mua o ka papa, e piʻi ka nui ma luna o 600 mg 2 mau manawa i kahi lā, i ka hoʻomaka ʻana o ka maʻi me nā hōʻike koʻikoʻi o ka hoʻemi hōʻalo ʻemi, hoʻohana ʻia ʻo Zeptol i ka hui pū me ka mālama detoxification a sedatives a me ka hypnotics (chlordiazepoxide, clomethiazole), ma hope o ka pau ʻana o ke ʻano o ka maʻi maʻi, hiki ke hoʻohana ʻia ka lāʻau lapaʻau ma ke ʻano monotherapy,
- pilikia pili - ke mālama ʻana a me ka prophylaxis (nā papa), nā maʻi pāpaʻi bipolar - mālama i ka mālama ʻana, ke kūlana manic ka maʻi (nā papa hoʻomau ʻia i hoʻokuʻu ʻia) i koho ʻia i kēlā lā i kēia lā he 200-400 mg i loko o ka pule mua o ka papa, a laila e hoʻonui ka nui i kēlā me kēia pule i kēlā me kēia pule e 200 mg. e lawe mai ana i ka 1000 mg i kēlā me kēia lā, hoʻokaʻawale ʻia i 2 mau wā.
Hoʻonohonoho ʻia ka lōʻihi o ke kauka ʻana e ke kauka, e pono e hoʻopau pono i ka mālama ʻana. Ke hoʻololi nei i ka lawe ʻana iā Zeptol e koi lohi, me kahi hoʻohaʻahaʻa nui ʻana i ka pauna o ka lāʻau mua.
Nā hopena hopena
I ka loiloi ʻana i ka ʻike pinepine ʻana o nā hanana ʻino, ua hoʻomaʻamaʻa ʻia nā ʻano helu aʻe hoʻi: pinepine pinepine - 10% a i ʻole, pinepine ʻia - mai ka 1% a 10%, pinepine ʻole - mai 0.1% a i ka 1%, loaʻa ʻole - mai 0.01% a 0.1% , luhi pinepine - ʻoi loa ma mua o 0,01%:
- CNS: ka manawa pinepine loa - ka luhi o ka luhi, kūlohelohe, ke hiamoe nei, ataxia, pinepine - diplopia, nā pilikia i ka noho ʻana (me ka ʻike ʻana i ka blurred), ka ʻeha, ka pinepine - nystagmus, nā hana hikiʻole iā abnormal (tics, tremors, fluttering tremors - asterixis , dystonia), līkeke - hoʻoweliweli oculomotor, orofacial dyskinesia, ʻeha hopohopo (dysarthria), paresthesias, peripheral neuropathy, paresis, choreoathetosis, aneane pinepine loa - ʻeha nā pīhoihoi, malignant antipsychotic syndrome,
- cardiovascular system (CVS): ka liʻiliʻi - hōʻemi / hoʻonui i ke kahe o ke koko (BP), nā hana hōʻemi hoʻokaʻawale ia ʻana o ka cardiac, loaʻa pinepine ʻole - arrhythmias, bradycardia, AV poloka me ka palupalu, CHF, thromboembolism (komo i ka pulmonary artery), thrombophlebitis hiolo, hoʻopau i ka maʻi naʻau coronary (CHD),
- nā hana noʻonoʻo: pilikia - nā hopohopo, ke kuāhuā, ka hoʻohālikelike, ka anorexia, ʻike leʻa / ʻike auditory, ʻehaʻeha, hōʻeha, ʻeha loa - hoʻōla i ka psychosis,
- Nā ke ʻano o ka hypersensitivity (me ka hoʻomohala ʻana i nā hopena i hōʻike ʻia ma lalo nei, e hoʻōki ʻia me ka maʻi ʻo Zeptol): i ʻole - ke kau ʻana i ke ʻano o ka hypertensitivity multi-organ me nā ʻūlū o ka ʻili, ke kuni, leukopenia, arthralgia, eosinophilia, lymphadenopathy, vasculitis, hōʻailona e like me ka lymphoma, hoʻololi i ke ʻano o ka ʻekena hemo a me ka hepatospl ʻike ʻia nā hana like ʻole i nā hui like ʻole), nā hui ʻē aʻe (me ka myocardium, pancreas, māmā, ʻōpū, ʻōpū ), Kākaʻikahi ka - aseptic meningitis me ka myoclonus a me kaʻike ākea eosinophilia, angioedema, anaphylactic naoh,
- kūwaho ka hopena: pinepine loa - urticaria (me ka nui o ka haʻi ʻia), dermatitis kūloko, pinepine - erythroderma, dermatitis exfoliative, līwī - hōʻeha, systemus lupus erythematosus, ke loaʻa pinepine loa - ka pohō lauoho, luhiluhi, ʻōpala, ʻulaʻula, pigmentation o ka ʻili. , ka pona photosensitization, erythema multiforme a me ka nodosum, nā mea ʻāoʻi o ka nekrolysis epidermal, Stevens-Johnson syndrome, ua hoʻopaʻa ʻia nā hihia o ka hirsutism (kahi pilina kumu o kēia ʻano hoʻopiʻi a me ka hoʻohana ʻana iā Zeptol ʻaʻole waha. hōʻano hou)
- ʻO ka ʻōnaehana hepatobiliary: pinepine pinepine - ka hana nui o ka gamma-glutamyltransferase (GGT) ma muli o ka hoʻoulu ʻana o ka enzyme i ka palu (maʻa mau ka ʻike koʻikoʻi), pinepine - hoʻonui ʻia o ka alkatine phosphatase (ALP) i loko o ke koko, pinepine - hoʻonui i ka transaminases, ʻokoʻa - luku ʻole nā puʻu bile intrahepatic, e alakaʻi ana i ka hōʻemi o kā lākou helu, jaundice, hepatitis o ka parenchymal (hepatocellular), kolestatic a ʻano ʻano like ʻole, ʻokoʻa loa - maikaʻi ʻole lōkuhi, ka hepatitis granulomatous.
- hoʻoweliweli ʻāwili: pinepine pinepine - ka luaʻi, ka lua, ke ʻano pinepine - ka waha maloʻo, ʻolua - constipation / maʻi, ʻeha - ʻeha o ka ʻōpū, ʻeha loa - stomatitis, glossitis, pancreatitis,
- hematopoietic organitions: pinepine pinepine - leukopenia, pinepine - eosinophilia, thrombocytopenia, jarang - keʻaole folic acid, lymphadenopathy, leukocytosis, langka loa - anemia, erythrocyte aplasia, aplastic / megaloblastic / hemolytic anemia, pancytopenia / agranulocosisosis intermittent porphyria, reticulocytosis,
- Pūnaehana genitourinary: loaʻa pinepine loa - mālama i ka urinary, maʻamau urination, interstitial nephritis, maʻi renal function (oliguria, hematuria, albuminuria, hoʻonui urea / azotemia), renal failed, hoʻoneʻe i ka helu sperm a me ka motility, hana hewa / impotence.
- system endocrine a me metabolism: pinepine - e hoʻonui i ka nui o ke kino, mālama ka wai, edema, hoʻemi i ka osmolarity o ke koko a me ka hyponatremia ma muli o kahi hopena e like me ADH, ka mea maʻamau ke alakaʻi nei i ka dilule hyponatremia (hana i ka wai), ka mea me ka hōʻeha, ka luaʻi, ka lethargy , ʻeha ka maʻi neurological a me ka hōʻeha, ʻokoʻa loa - ka mahuahua o ka pae prolactin koko me ka galactorrhea, gynecomastia a i ʻole lākou, e hoʻololi i ka hana o ka hana thyroid - he hōʻemi i loko o nā manaʻo o L-thyroxine (thyroxine, free thyroxine, triiodothyronine) a me ka hoʻonui ʻana i ka pae o ka hormone hoʻoulu i ka thyroid (TSH) (maʻa mau ʻaʻole i hele pū ʻia e nā hōʻike pilikino), ka hoʻonāukiuki ʻana o nā iwi o ka iwi (ka hoʻemi ʻana i nā pae koko o 25-hydroxycholecalciferol a me ka calcium), ke kumu no ka osteomalacia / osteoporosis, he hoʻonui i ka kolamu, Kālā i māla nui ai nā lipoproteins, a me nā triglycerides,
- nā hui kuikila: ke ʻano nui loa - conjunctivitis, uhi ʻana o ka ʻōpū, hoʻonui i ka naʻau intraocular, hoʻopiʻi ka lohe ʻana, me ka tinnitus, nā hoʻololi i ka ʻike, pitch, hypoacusia, hyperacusis,
- musculoskeletal ʻōnaehana: paʻakikī - nāwaliwali o ka naʻau, ʻeha loa - ʻeha ʻana a i ʻole ʻehaʻī, arthralgia.
ʻO nā hopena ʻino
I ka hoʻomaka ʻana o ka hoʻōla a i ka wā e hoʻohana nui ai ka nui o ka hopena mua o ka lāʻau, a me ka mālama ʻana i nā mea maʻi ma waena o nā maʻi, a i ʻole kekahi ʻano hanana ʻino e kū nei, no ka laʻana, mai ke kikowaena kūloko o ka pūnaehana (CNS) (dizziness, headache, ataxia, drowsiness, nāwaliwali maʻamau, diplopia) ʻaoʻao o ka gastrointestinal tract (maʻi holoʻokoʻa, luaʻi) a i ʻole ke ʻano kino ʻokoʻa.
ʻO ka hana ʻino e pili ana i ka maʻi maʻamau e hana i loko o kekahi mau lā i ka manawa like a ma hope o ka hoʻohaʻahaʻa iki ʻana i ka hopena o ka lāʻau.
Kekahi koko: leukopenia thrombocytopenia, eosinophilia, leukocytosis, lymphadenopathy, kakī i ka waikawa folic, agranulocytosis, aplastic anemia, pancytopenia, erythrocytic aplasia, anemia, megaloblastic anemia, acute intermittent porphyria, mixed porphyria, porphyrph, pyrphia porphyria, porphyria
Mai ka pā kūlohelohe : pani-type multi-organ hypersensitivity me ke kuni, rashes ka ʻili, vasculitis, lymphadenopathy, hōʻailona e like me ka lymphoma, arthralgia, leukopenia, eosinophilia, hepatosplenomegaly a me ke kaumaha o ka hana a me ka bile duct mawala syndrome (luku a me ka neʻe ʻana o nā kumu intrahepatic) . ^ E Ha yM. Aia nā maʻi mai nā hui ʻē aʻe (no ka laʻana, ka puʻu, nā palu, nā ʻōpū, ka pancreas, myocardium, colon), aseptic meningitis me myoclonus a me peripheral eosinophilia, reaksi anaphylactic, angioedema, hypogammaglobulinemia.
ʻŌnaehana Endocrine : edema, mālama i ka wai, hōʻemi ke kaupaona, hyponatremia a me ka hoʻohaʻahaʻa ʻana i ka osmolarity plasma ma muli o kahi hopena e like me ADH, ka mea i loaʻa i nā hihia lohi ke hele i ka hyperhydration, ka mea i hele pū me ka lethargy, ka luaʻi, hōʻeha, ka haunaele a me nā pilikia neʻe, hoʻonui nui i ke kiʻekiʻe o ka prolactin koko. hui pū ʻole a i ʻole pū ʻia e nā hōʻike like ʻole me ka galactorrhea, gynecomastia, nā hōʻeha o ka metabolism o nā iwi (ka hoʻemi ʻana ma ka pae o ka calcium a me 25-hydroxycolcalcaliferolol i ke koko koko), ka mea, alakaʻi i ka osteomalacia / osteoporosis i kekahi mau kūlana - kahi mahuahua o ka neʻe o ka kolamu, e komo ana me ka kiʻekiʻe lipoprotein kūloko a me ka triglycerides.
Mai ka ʻaoʻao o ka metabolism a me ka pōʻino: ka nele i ka folate, hoʻoneʻe i ka makemake, a me ka porphyria ʻoliʻi (ʻo ka poʻopela intermittent pili a me ka porphyria i hui pū ʻia), ka nonphula o ka nonphula (ʻokiʻoki ʻoniʻoni ʻoni.
Mai ka psyche: nā hallucinations (ʻike a i ʻole auditory), nā kaumaha, ka nalo o ka ʻono, ka hopohopo, ke kūleʻa, ka hoʻomākeʻaka, ka haunaele, ka hoʻāla ʻana o ka psychosis.
Mai ka ʻōnaehana hoʻonāukiuki: hōʻeha, ataxia, ke hiamoe nei, nāwaliwali laulā, nā māhā, ka diplopia, ka noho ʻana o ka pilikia (no ka hoʻohālikelike ʻia ʻana o nā maka), ka neʻe ʻana o ka pīhoihoi (ʻano hoʻohālikelike, "fluttering" tremor, dystonia, tic), nystagmus, orofacial dyskinesia, mau ʻōpū lele, ʻike ʻole. (e.g. dysarthria a slurred speech), choreoathetosis, peripheral neuropathy, paresthesia, humuhumu nā pelu a me ka paresis, ʻono hoʻonaninani, nā antipsychotic malignant syndrome, aseptic meningitis me myoclonia a me periphery eskoy eosinophilia, dysgeusia.
Mai ka ʻaoʻao o ke kino o ka hihiʻo. nā wahi o ka noho ʻana (no ka laʻana, ka hihiʻo blurred), ʻohu ana o nā lens, conjunctivitis, i hoʻonui ʻia ke kaila intraocular.
Ma ka ʻāpana o nā hui hoʻolohe: nā maʻi lohe, e like me ka tinnitus, hoʻonui i ka naʻau auditory, ka hoʻohaʻahaʻa i ka ʻike auditory, i ka ʻike maka.
Mai ka pūnaehana cardiovascular : intracardiac conduction disturb arterial hypertension or arterial hypotension bradycardia, arrhythmia, syncope blockade, circulatory collapse, congestive heart failed, exacerbation of ischemic disease, thrombophlebitis, thromboembolism (e.g. pulmonary embolism).
Mai ka papa huhū : Heʻano hopena o ke ʻano hypersensitivity pulmonary e ke ʻano, i ke ʻano o ka hanu ʻana, nā maʻi o ka pneumonitis, a i ʻole nā maʻi pneumonia.
Mai ka hāliʻi ʻana o ka huina: nausea, luaʻi, waha maloʻo, ʻeha a paluhiko ʻole ʻana, ʻeha o ka ʻōpū, glossitis, stomatitis, pancreatitis.
Mai ka pūnaehana hana ʻana: ka mahuahua o ka gamma-glutamyltransferase (ma muli o ka hōʻemi o ka hoʻonaninani o ka ate), ma mua o ka loaʻa ʻole o ka maʻi koʻikoʻi, he piʻi nui i ka phosphatase alkaline, he nui nā transaminases, hepatitis of cholestatic, parenchymal (hepatocellular) a i ʻole nā ʻano i hui pū ʻia, biliary tract mawala lesema, jaundice granulomatous hepatitis, ʻōpū.
Ma ka ʻāpana o ka ʻili a me ka kiko. dermatitis aleritisia, urticaria, kekahi manawa nui, exfoliative dermatitis, erythroderma, systemic lupus erythematosus, itching Stevens-Johnson syndrome, necrolysis epicmalic, photosensitivity, erythema multiforme a me ka knotty, ka hōʻeha o ka ʻili o ka ʻula, ka ʻōpū, ka ʻūhā, nui ka ʻalaʻawa, nui ka momona, hoʻoluhi.
Mai ka ʻōnaehana musculoskeletal : nāwaliwali o ka puʻuwai, arthralgia, ʻehaʻeha o ka naʻau, nā mākīwaha o nā iwi, nā mea hoʻonaninani o ka iwi hema (hoʻemi i ka calcium a me 25-hydroxycolcalcaliferol i loko o ke koko koko, hiki iā ia ke alakaʻi i ka osteomalacia a i ka osteoporosis).
Mai ka urinary system: tubulointerstitial nephritis, renal failed, malia functioningal (albuminuria, hematuria, oliguria, hoʻonui urea / azotemia), pinepine urination, urinary retention.
Mai ka ʻōnaehana hana hānau : kelepona hana kūpono / impotence / hana erectile, hoʻopiʻi spermatogenesis (me ka hoʻēmi ʻana i ka helu / motility sperm).
Nā kipi maʻamau: nāwaliwali.
Nā hōʻailona kuhikuhi: ka hoʻonui nui ʻana o ka gamma-glutamyltransferase (i kumu o ka ʻaina o ka enzyme o ka ate), ʻaʻohe o nā hōʻailona koʻikoʻi, he nui ka kiʻekiʻe o ka phosphatase alkaline i loko o ke koko, kahi hoʻonui i nā transaminases, ka nui o ke kaila intraocular, ka nui o ke kolamu koko, ke hoʻonui ʻana i nā kiʻekiʻe lipoproteins, hoʻololi i ke koko i ka hana thyroid: kahi hōʻemi i L-thyroxine (FT 4, T 4, T 3 ) a me ka pae o ka hormone thyroid-stimulating, ka mea ma ke ʻano he kānāwai, ʻaʻole i hele pū ʻia e nā hōʻike kulekele, he nui o ka pae o ka prolactin i loko o ke koko, hypogammaglobulinemia.
ʻO nā hopena ʻino e pili ana i nā ʻōlelo kuʻuna.
Nā maʻi maʻi a me ka maʻi parasit: ʻO ka hoʻonā hou ʻana o nā maʻi herpes manu type VI.
Kekahi koko: iwi hana iwi hōʻoki.
Mai ka ʻōnaehana hoʻonāukiuki: sedation, palapala hoʻomanaʻo.
Mai ka hāliʻi ʻana o ka huina: lāʻau lāʻau.
Mai ka pā kūlohelohe : makeke lāʻau me ka eosinophilia a me nā ʻōnaehana systemic (DRESS).
Ma ka ʻāpana o ka ʻili a me ka kiko. pustulosis exanthematous kaulike (AGEP), keratosis lichenoid, onychomadeus.
Mai ka ʻōnaehana musculoskeletal : huʻi.
Nā hōʻailona kuhikuhi: hōʻemi i ka hoʻoliʻiliʻi ʻana o nā iwi.
Ke keu
Nā Hoʻomaka Nā hōʻailona a me nā hoʻopiʻi ala i loaʻa mai i ka overdose e hōʻike pinepine i ka pōʻino i ke kikowaena kūloko, cardiovascular a me nā ʻōnaehana.
Pūnaehana pīhoihoi waena : nā lilo o ka pūnaehana nū nui, hōʻeha, nā haʻahaʻa o ka ʻike, hopohopo, hoʻomākeʻaka, hallucinations, coma blurred vision, slurred speech, dysarthria, nystagmus, ataxia, dyskinesia, hyperreflexia (mua), hyporeflexia (ma hope), kuihui, ʻōpū o ka psychomotor, myoclonus, hypothermia puaa.
Pūnaehana lawelawe: ʻōpū hanu, polema pulmonary.
Pūnaehana Cardiovascular: tachycardia, hypotension arterial, hypertension arterial, hoʻopiʻi ka hopena me ka hoʻonui ʻana i ka paʻakikī QRS, syncope e pili ana me ka paʻa hopu ʻana, me ka nalowale o ka ʻike.
ʻĀpana kikoʻī: hoʻohuka, mālama i ka ʻai ma loko o ka ʻōpū, hoʻemi ʻia ka motility o ka ʻōpū.
ʻŌnaehana musculoskeletal: ua hōʻike ʻia nā hihia o ka rhabdomyolysis e pili ana i ka hopena o ka hopena o ka carbamazepine.
ʻŌnaehana papa maʻi : mālama uria, oliguria a i ʻole he aniani o ka noho ʻana, ka hoʻoneʻe ʻana ma muli o ka hopena o nā carbamazepine, i like pū me ka ADH.
Ma ka ʻāpana o nā hōʻailona hōʻike. ʻO ka hyponatremia, metabolic acidosis, hyperglycemia, hiki ke hoʻonui i ka hapa o nā mākala o ka CPK.
Hoʻomaʻamaʻa. ʻAʻohe mea antidote kikoʻī. ʻO ka mea mua, pono e kau ʻia ka hoʻomaʻamaʻa ʻana i ke ʻano o ka maʻi o ka mea maʻi, hōʻike ka haukapila. Hoʻoholo ʻia ka manaʻo o ka carbamazepine i loko o ke koko koko e hōʻoia i ka hiki ʻana me kēia mākaʻi a loiloi i ka pae o ka overdose.
Hoʻokuʻu ʻia nā manaʻo o ka ʻōpū, lawe ʻia ka ʻōpū, a lawe ʻia ka ulana. Hiki i ka haʻalele ʻana i ka ʻeha o ka gastric hiki ke alakaʻi i ka hoʻohemo ʻana a me ka puka hou ʻana o nā hōʻailona o ka hoʻōla i ka wā hoʻōla. Hoʻohana ʻia ka maʻi kākoʻo maʻi Symptomatic i ka waihona mālama mālama kino, ka nānā ʻana o nā hana naʻau, hoʻoponopono ʻia i nā pilikia o ka electrolyte.
Nā manaʻo loea. Me ka hoʻomohala ʻana o ka hypotension arterial, hōʻike ʻia ka lawelawe ʻana o ka dopamine a i ʻole dobutamine, me ka hoʻomohala ʻana o ka arrhythmias cardiac, pono ke koho pono ʻia ka hoʻōla ʻana, me ka hoʻomohala ʻana o ka makeʻe, ka hoʻomalu ʻana o nā benzodiazepines (e.g. diazepam) a i ʻole nā anticonvulsants ʻē aʻe, e like me ka phenobarbital (me ka mālama ʻana ma muli o ka piʻi nui ʻana o ka hanu. paraldehyde, me ka hoʻomohala ʻana o ka hyponatremia (hana wai i loko o ka wai) - ka palena o ka hoʻopiʻi ʻana i ka wai, hoʻolōʻihi i ka infusion mālama i ka hopena o ka sodium chloride. Hiki paha i kēia mau hana ana i ka pale ʻana i ka edema lolo.
Hoʻomaopopo ʻia ka hemosorption ma nā sorbents carbon. ʻO ka pono o ka diuresis kōpae a me nā dialysis peritoneal i hōʻike ʻia.
Pono e hoʻolako no ka hiki ke hoʻoikaika i nā hōʻailona o kahi overdose ma ka lā 2 a me ka lā 3 ma hope o kona hoʻomaka ʻana, ma muli o ka lohi o ka hōʻemi ʻana i ka lāʻau.
Hoʻohana i ka wā hāpai a lactation.
Hoʻopuka waha i nā carbamazepine e hōʻeha i ka hoʻomohala ʻana.
I loko o nā keiki e loaʻa ana ka mau makuahine i ka epilepsy, aia ka manaʻo i ka hoʻomohala ʻana i ka hanana intrauterine, e komo pū ana me ka malenations congenital.
Pono e ukali ʻia nā ʻōlelo pili.
- Pono ka hoʻohana ʻana i ka lāʻau lapaʻau no nā wahine hāpai me ka epilepsy.
- Inā he wahine ka mea e hoʻokipa nei iā Zeptol e hāpai ʻia ana i ka wahine hāpai, a i ʻole he mea pono ia e hoʻohana i ka lāʻau lapaʻau i ka wā hapai, pono nā pōmaikaʻi o ka hoʻohana ʻana i ka lāʻau lapaʻau e kau ʻia ma mua o kahi hiki o ke ʻona (ʻoi aku hoʻi i ka trimester mua o ka hāpai ʻana.
- ʻO nā wahine o nā makahiki hānau, inā hiki, pono ʻo Zeptol e kuhikuhi i ka monotherapy.
- Hoʻoulu ʻia e kuhikuhi i ka palena liʻiliʻi liʻiliʻi a nānā pono i ka pae o ka lāʻauamaama i loko o ke koko koko.
- Pono e ʻike ʻia nā mea maʻi e pili ana i ka hoʻonui ʻia o ka hoʻomohala ʻana i ka malenation congenital a hāʻawi ʻia i ka manawa kūpono o ka nānā ʻana o antenatal.
- I ka wā hāpai, ʻaʻole pono e hoʻopaʻa ʻia nā ʻoihana antiepileptic maikaʻi loa, no ka mea e hoʻoweliweli ka nui o ka maʻi i ka olakino o ka makuahine a me ke keiki.
Nānā a me ke kāohi. Ua ʻike ʻia aia a hiki i ka wā hapai ka maʻi folic e ulu aʻe. Hiki i nā lāʻau antiepileptic ke hoʻonui i ka nele o ka folic acid, ʻo ia ke kumu e hōʻike ʻia ai ka hoʻohui hoʻohui folic ma mua a i ka wā hāpai.
Nā keiki hānau hou. I mea e pale ai i nā maʻi coagulation i nā keiki hou, ua ʻōlelo ʻia e kuhikuhi i ka vitamina K 1 na makuahine i ka hebedoma hope o ka hāpai a me kahi pēpē hānau hou.
Ua ʻike ʻia kekahi mau hihia o ka hoʻokolokolo a me / a i ʻole ka hanu i ka poʻe hānau hou hou, nui mau hihia o ka luaʻi, ʻeha ʻana a / a i ʻole ʻoliʻoli maikaʻi i nā poʻe hou keiki e pili pū ana me ka lawe ʻana iā Zeptol a me kekahi mau anticonvulsants.
Haumakua. Loaʻa ka Carbamazepine i ka waiū umauma (25-60% o ka neʻe ʻana o ka plasma). ʻO nā pōmaikaʻi o ka umauma me ka hiki ʻana o ka hoʻopilikia i nā hopena o ke keiki i ka wā e hiki mai ana e kaupaona ʻia. Hiki i nā māmā e loaʻa iā Zeptol ke umauma, ke hoʻolako ʻia e nānā ka pēpē e hoʻomohala i nā hanana ʻino (ʻoi aku ka hoʻohālike, ka momona nui, ʻona kūlohelohe).
Ua hōʻike ʻia nā kuʻuna o nā kūlana hānai i nā kāne a me / a i ʻole nā mana spermatogenesis hōʻailona.
E nā keiki, i hāʻawi ʻia i ka wikiwiki o ka carbamazepine, pono ia e hoʻohana i ka hoʻohana ʻana o nā kaha kiʻekiʻe o ka lāʻau (i ka kilokileka o ke kaumaha o ke kino) hoʻohālikelike ʻia me nā pākeke. Hiki ke lawe ʻia nā papa Zeptol no nā keiki mai 5 mau makahiki.
Nā hiʻohiʻona noi
Hoʻohana ʻia ʻo Zeptol ma lalo o ka kaohi, aia wale nō ma hope o ka loiloi ʻana i ka hopena o ka hopena / pōpilikia, hāʻawi ʻia i ke ʻano o nā mea maʻi me ka maʻi cardiac, hepatic a i ʻole paha, i kahi hopena hematological a me nā lāʻau ʻē aʻe i ka mōʻaukala a me nā mea maʻi me ka lāʻau lapaʻau i hoʻopau ʻia i nānā pono ʻia.
Kēia urinalysis maʻamau a me ka hoʻoholo ʻana o ka pae o ka urea nitrogen i ke koko i ka hoʻomaka a me kekahi mau ʻano neʻe i ka wā o ka mālama ʻia.
Hōʻike ʻo Zeptol i ka hana anticholinergic palupalu, no laila e pono e hōʻike ʻia nā mea maʻi me ka piʻi ʻana o ka intraocular pressure, e kūkākūkā me ka hopena e pili ana.
Pono e hoʻomanaʻo ʻia no ka hiki o ka hoʻokaʻawale ʻana o nā psychoses latent, a i nā mea maʻi maʻi makua - e pili ana i ka hiki ke hoʻomau i ka haunaele a me ka hopohopo.
ʻOi aku ka maikaʻi o ka lāʻau no nā absences (lawe liʻiliʻi ʻia) a me nā makana myoclonic. Nā hōʻike kaʻawale ka mea i hiki ke piʻi ka piʻi ʻana i nā mea maʻi me nā absent atypical.
Nā hopena Hematologic. ʻO ka hoʻohana ʻana i ka lāʻau pili me ka hoʻomohala ʻana i ka agranulocytosis a me ka anemia aplastic, eia naʻe, ma muli o ka haʻahaʻa o kēia mau kūlana, hikiʻole ke loiloi i ka hopena inā lawe ʻia ka lāʻau.
Pono e ʻike ʻia nā mea maʻi e pili ana i nā hōʻailona o nā palaka a me nā hōʻailona o nā maʻi hematologic hiki loa, me nā hōʻailona no ka dermatological a me nā hopena ate.
Inā emi iki ka nui o nā leukocytes a i ʻole platelets i ka wā o ka hōʻola, pono e nānā pono ʻia ke ʻano o ka mea maʻi a me nā hōʻike koko ākea o ka mea maʻi e hoʻomau mau ʻia. Pono e hoʻokuʻu ʻia ka lāʻau me Zeptol inā hoʻomohala ka mea maʻi i ka leukopenia, he mea koʻikoʻi, holomua, a i ʻole pū me nā hōʻailona maʻi, e like me ke kaʻe a me ka ʻehaʻeha. Pono e hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau inā kū ʻia nā hōʻailona o ke kaohi ʻana o nā hana a ka ʻoihana wahine.
Hōʻike pinepine ʻia a hōʻemi a hoʻomau mau paha i ka helu o nā platelets a i ʻole nā keʻena koko keʻokeʻo e pili ana me ka hoʻohana ʻana i ka lāʻau Zeptol. Eia nō naʻe, i ka hapa nui, he mau iki kēia mau hanana a ʻaʻole i hōʻike i ka hoʻomohala ʻana o ka anemia aplastic a i ʻole agranulocytosis. Ma mua o ka hoʻomaka ʻana i ka hoʻolaʻa a me nā manawa maʻamau i ka wā e mālama ai, e pono ai ka hoʻokolohua o ke koko, me ka hoʻoholo ʻana i ka helu o nā platelets (ʻo ia hoʻi, hiki paha i ka helu o reticulocytes a me ka pae o ka hemoglobin).
ʻO nā hopena dermatological kūpono. ʻO nā hopena dermatological weliweli, e komo pū ana me ka lāliʻi epidermal necrolysis (TEN), kahi o ka maʻi o Lyell, ʻo ke ʻano o Stevens-Johnson syndrome (SJS), he mea maʻamau loa me ka hoʻohana ʻana i ka lāʻau. ʻO nā maʻi me nā hopena dermatological koʻikoʻi e pono ai i ka hānai ʻana, no ka mea e hiki ke make kēia mau kūlana. Loaʻa ka hapa nui o SJS / TEN i nā mahina mua o ka mālama ʻana me Zeptol. Me ka hoʻomohala ʻana i nā hōʻailona e hōʻike ana i kahi hopena dermatological koʻikoʻi (e.g., SJS, Lyell's syndrome / TEN), pono e hoʻokaʻawale i ka lāʻau lapaʻau a pono e kuhikuhi ʻia nā lāʻau lapaʻau hou.
Aia ka hoʻonui pinepine ʻana o ka hopena o nā ʻemela o ka HLA i pili i ka propensity o ka mea maʻi no nā hopena maikaʻi loa e pili ana me ka ʻoihana.
I nā poʻe maʻi e pili ana i ka hopena, pono e hoʻāʻo ʻia ʻo Zeptol no allele (HLA) -B * 1502 ma mua o ka hoʻomaka ʻana o ka mālama ʻana.
ʻO Allele (HLA) -B * 1502 e lilo paha i ke kuleana no ka hoʻomohala ʻana o ka SJS / TEN i nā poʻe maʻi Kina i loaʻa i nā lāʻau antiepileptic ʻē aʻe e pili pū ana me ka hopena o SJS / TEN. No laila, ke hoʻohana pono ʻia nā hoʻohana o nā lāʻau ʻē aʻe e pili ana me ka hanana ʻana o SJS / TEN i nā mea maʻi i loaʻa i kahi alele (HLA) -B * 1502, inā hiki ke hoʻohana ʻia nā lāʻau lapaʻau ʻē aʻe.
Ke kamaʻilio ʻana me ka HLA-A * 3101
Hiki i ke kanaka leukocyte antigen ke kumu pilikia no ka hoʻomohala ʻana i nā hopena ʻalalala o ka ʻili, e like me SJS, TEN, ʻōpena o ka lāʻau me ka eosinophilia a me nā ʻōlapa ʻōwili (DRESS), ke ākea nui o exenthematous pustulosis (AGEP), ka ʻōmole maculopapular. Inā ʻike ka loiloi i ka loaʻa ʻana o ka HLA-A * 3101 allele, a laila pono ʻoe e hōʻalo i ka hoʻohana ʻana i ka lāʻau lapaʻau.
Hoʻopau i nā palena a genetic
ʻAʻole pono nā hualoa o nā hōʻike scetic e pani i nā nānā kulekele kūpono a me ka mālama ʻana i nā maʻi. ʻO nā kumuhana ʻē aʻe e hana i ka hopena i ka hōʻeha ʻana o kēia mau hōʻino kino o ka ʻili, e like me ka pauku ʻana o ke ʻano antiepileptic, ʻae ʻana i ka regimen mālama, a me ka hoʻoulu ʻana. ʻAʻole i aʻo ʻia ka hopena o nā maʻi e like me ka pae o ka nānā ʻana i nā maʻi o ka ʻili.
ʻO nā hopena dermatological ʻē aʻe.
ʻO ia nō hoʻi ka hoʻomohala ʻana o ka transient a me nā mea ʻaʻole hoʻoweliweli i ka olakino, nā maʻi dermatological e hoʻohālike ai, no ka laʻana, ka papale macular a maculopapular exanthema. ʻO ka pinepine maʻa lākou i hala ma hope o kekahi mau lā a i ʻole hebedoma, ma ke ʻano like a me ke ʻano o ka hōʻemi ʻana o ka pau. Ma muli o nā hōʻailona kumu o nā ʻano dermatological ʻoi loa ka paʻakikī o ka hoʻokaʻawale ʻana mai ke ʻano maʻalahi, ʻano wikiwiki, pono e nānā ʻia ka mea maʻi e hoʻōki koke i ka hoʻohana ʻana i ka lāʻau inā hōʻalo ka hopena.
ʻO ka hele ʻana o ka HLA-A * 3101 allele ma ka mea maʻi e pili ana i ka hanana ʻana o nā hopena ʻinoʻino loa mai ka ʻeha a hiki i ka carbamazepine, e like me ka hypersensitivity syndrome i nā anticonvulsants a i ʻole rashes liʻiliʻi (maculopapular rashes).
Hypersensitivity. Hiki i ka Zeptol ke hoʻonāukiuki i ka hoʻomohala ʻana o nā hopena hypersensitivity, e pili ana i ka lāʻau hōʻalo me ka eosinophilia a me nā ʻōnaehana systemic (DRESS), he maha nā ʻano hopena hypersensitivity hopohopo me ke maʻi, ka hopohopo, vasculitis, lymphadenopathy, pseudolymphoma, arthralgia, leukopenia, eosinophilia, ate function, eosinophilia, ate nā kumukua bile (me ka make a me ka nalo o nā kumu intra-ductal), hiki ke hana ʻia i nā hui like ʻole. Hiki kekahi hopena hopena i nā hui kino (nā pūpū, nā pēpē, ka pancreas, myocardium, colon).
ʻO ka noho ʻana o ka HLA-A * 3101 allele i ka mea maʻi e pili ana i ka hanana ʻana o nā hopena kūʻē ʻoi loa i ka carbamazepine mai ka ʻili, e like me ka hypersensitivity syndrome i nā anticonvulsants a i ʻole rashes liʻiliʻi (maculopapular rashes).
ʻO ka poʻe maʻi me nā hopena hypersensitivity e pili ana i ka carbamazepine e pono e hoʻomaopopo ʻia ma kahi o 25-30% o kēlā mau maʻi e loaʻa pū kekahi maʻi hypersensitivity i ka oxcarbazepine.
Me ka hoʻohanaʻana o carbamazepine a me ka phenytoin, hiki i ka hoʻomohala ʻana o ka cross hypersensitivity.
I ka laulā, i ka wā e kuhikuhi ai nā hōʻailona i ka hypersensitivity, pono e hoʻokaʻawale i ka lāʻau.
Nā ʻōhua. Pono e hoʻohana ʻo Zeptol me ka akahele i ka poʻe maʻi me nā mea hoʻomohala i hui pū ʻia me nā mea i komo ʻole (maʻamau a i ʻole atypical). I kēlā mau kūlana, hiki i ka lāʻau lapaʻau ke hoʻonāukiuki i nā holo. I ka hihia no ka hoʻonāukiuki ʻana, pono e hoʻokaʻawale ke hoʻohana o ka lāʻau.
Hiki ke hoʻonui i ke kao o nā manawa hopu i ka wā o ke kao ʻana mai ka hana waha o ka lāʻau i nā Supositories.
Hālina hana. I ka wā o ka lāʻau lapaʻau, pono ia e nānā i ka hana o ka ate ma kahi pae mua a ma ka manawa maʻamau i ka wā o ka hoʻolaʻa ʻana, ʻoi aku hoʻi i nā mea maʻi me ka mōʻaukala o ke akeʻa a me nā maʻi maʻi maʻi.
Kekahi mau hōʻailona e loiloi i ke ʻano hana o ke ake i nā mea maʻi e lawe ana i ka carbamazepine e hele ma mua o ke ʻano maʻamau, i ka gamma-glutamyltransferase (GGT). Loaʻa paha kēia ma muli o ka hoʻonāukiuki o nā huina o ka naʻau. Hiki ke hoʻoulu ʻia ʻo Enzyme i ke hoʻonui ʻana i ka hoʻonui ʻana i ka pae o ka phosphatase kiʻekiʻe. ʻO kēlā hoʻonui hoʻonui i ka hana o ka hana hepatic metabolism, ʻaʻole ia kahi hōʻailona no ka hoʻopau ʻana o ka carbamazepine.
ʻO nā hopena ʻino loa mai ka palu ma muli o ka hoʻohanaʻana i nā carbamazepine kahi ākea loa. Ma kahi o nā hōʻailona o ka hepatic disfunction a me nā maʻi hōʻola ikaika, pono ia e hoʻokau koke i ka mea maʻi, a ho'ōki i ka mālama ʻana iā Zeptol.
Hola a kaʻili. Noea ia e loiloi i ka hana renal a hoʻoholo i ke kiʻekiʻe o ka urea nitrogen i ka hoʻomaka a me ka manawa i ka wā o ka hopena.
Hyponatremia. No nā kumu o ka hoʻomohala ʻana o ka hyponatremia me ka hoʻohana ʻana i nā carbamazepine. I loko o nā mea maʻi me ka hana renal impaired, pili ia i ka hoʻololi me ka nui o ka sodium, a me nā mea maʻi e lapaʻau ʻia pū me nā lāʻau e hōʻemi ana i ka kiʻekiʻe o ka sodium (e like me ka diuretics, nā lāʻau lapaʻau e pili pū ana me ka nele o ka ADH), pono e ʻike ʻia nā paʻakai sodium ma mua o ka mālama ʻana. I ka wā e hiki mai ana, e ana ʻia ka pae o ka sodium i kēlā me kēia 2 hebedoma, a laila - me ka huakaʻi o ka 1 mahina i ka wā o 3 mau mahina o ka mālama ʻana i ka maʻi lapaʻau paha pono. Hoʻopau pili kēia i nā maʻi maʻi. I kēia hihia, palena i ka nui o ka wai i hoʻopau ʻia.
Hypothyroidism. Hiki i ka Carbamazepine ke hōʻemi i ka neʻe o ka hormone thyroid - ma kēia mea, pono ke hoʻonui ʻia ma ka lāʻau hoʻoliʻi hoʻololi a ka maʻi thyroid i nā mea maʻi me ka hypothyroidism pono.
Nā hopena Anticholinergic. Hōʻike ʻo Zeptol i ka hana anticholinergic hana. No laila, ʻo nā mea maʻi me ka hoʻonui ʻana i ke kaomi intraocular a me ka mālama ʻana i ka urinary pono e nānā pono ʻia i ka wā o ka hōʻola.
Nā hopena noʻonoʻo. Hoʻomaopopo i ka hiki ʻana o ka psychosis latent e lilo i ikaika, i nā maʻi maʻi makua - nā hū a i ʻole kaʻili.
ʻO nā manaʻo a me nā lawehala. Ua loaʻa kekahi mau hōʻike no ka noʻonoʻo suicidal a me ke ʻano i nā maʻi i loaʻa i nā lāʻau antiepileptic. No laila, pono e nānā ʻia nā mea maʻi no nā manaʻo a me ke ʻano suicidal a inā pono, pono e kuhikuhi ʻia nā hana kūpono. Pono e ʻōlelo ʻia nā mea maʻi (a me nā kahu hānai) e ʻike i ke kauka inā inā loaʻa nā hōʻailona o nā manaʻo suicidal a me ke ʻano.
Nā hopena hopena endocrine. Ma o ka hoʻonāukiuki o nā huina o ka huina, hiki i ka Zeptol ke hōʻemi i ka hopena o ka hopena therapeutic o ka estrogen a me / a hoʻomākaukau ʻana progesterone. Hiki i kēia ke hana i ka hoʻohaʻahaʻa i ka hana contraceptive, hoʻomaha ʻana i nā hōʻailona, a i ʻole ke kahakaha ʻana a i ʻole ke kani ʻana a i ʻole. ʻO nā mea maʻi e lawe iā Zeptol a no ia mea he mea kūpono i ke kūpaʻa hormonal e pono ke loaʻa i kahi lāʻau i loaʻa ma ka liʻiliʻi loa 50 micrograms o ka estrogen, a hoʻohana i nā hana non-hormonal hou o ka contraception.
Ka nānāʻana i ke kiʻekiʻe o ka lāʻau i loko o ke koko koko. ʻOiai ka pono o ka pilina ma waena o ka nui a me ka pae o ka carbamazepine i loko o ke kaila koko, a me ka pae o ka pae o ka carbamazepine i loko o ke kaila plasma a me ka hopena o ka lapaʻau a me ka hoʻomanawanui, ʻaʻole pono ka mālama ʻana, ka mālama ʻana i ke pae o ka lāʻau i ka plasma koko e kūpono paha i kēia mau hihia: me ka piʻi nui o ka neʻe ʻana o nā hōʻeha ʻana, e nānā ka hana me ke ahonui, ma ka wā hāpai, i ka mālama ʻana i nā keiki a me nā wā'ōpiopio, me ka hoʻopiʻi hewa ʻole ʻana o ke komo ʻana, me ka hoʻopiʻi ʻia ʻana o nā mea make a me ka hoʻohana ʻia o keu aku i ka lāʻau hoʻokahi.
ʻO ka hōʻemi ʻana a me ka hoʻoneʻe ʻana i ka lāʻau. Hiki i ka wehe koke ʻana i ka lāʻau ke hoʻonā i ka hopu. Inā pono e hoʻokuʻi koke i ka lāʻau lapaʻau me ka lāʻau lapaʻau o ka maʻi epilepsy, pono e hoʻoneʻe ʻia ke hoʻololi ʻana i kahi lāʻau antiepileptic hou e kū'ē i ke kīpili o ka hopena me ka lāʻau kūpono (no ka laʻana, diazepam intravenously, ʻaki a i ʻole phenytoin intravenously).
ʻO ka hoʻohaʻahaʻa ʻana a me ka haʻalele ʻana i nā lāʻau lapaʻau. Hiki i ka hue huhū ʻana o ka lāʻau lapaʻau ke hiki ke hoʻokaʻawale i kahi pōkole, no laila e hoʻihoʻi iki ʻia ka carbamazepine i ke manawa o 6 mau mahina. Inā pono e hoʻokuʻu koke i ka lāʻau lapaʻau no nā poʻe maʻi me ka epilepsy, ʻo ka neʻe ʻana i kahi lāʻau hou antiepileptic e lawe ʻia i ke kūkaʻi o ka maʻi lapaʻau me nā lāʻau kūpono.
Nā ʻōlelo kikoʻī
ʻO ka hana a Zeptol i ka maʻamau ʻole i loko o nā hopu pīkē liʻiliʻi epileptic (absences) a me ka hopu Myoclonic. Ma ka hoʻohālikelike ʻia o nā ʻano hoʻohālikelike epileptic, pono e hoʻohana ʻia ka lāʻau lapaʻau me ka mālama aka a kau i ka nānā koʻikoʻi lapaʻau ma muli o ka hiki mai o kā lākou hoʻonui ʻana. Pono ke kau ʻia ʻo Zeptolum inā ʻike ʻia ka nui o ka hoʻouka kaua epileptic.
I ka wā mālama, hiki ke ʻike i kahi emi o ka leukocytes a i ʻole platelets, i ka nui o nā hihia he wā iki a ʻaʻole ia e kuhikuhi i ka hanana o agranulocytosis a i kahi anemia aplastic. Ma mua o ka hoʻomaka ʻana o ke papa, me ia hoʻi i ka wā e mālama ai, e pono ai nā ʻike koko lapaʻau, e helu ana i ka helu o nā platelets a, hiki paha, nā reticulocytes, a me ka hoʻoholo i ka pae o hemoglobin.
Pono e ʻike ʻia nā mea maʻi e pili ana i nā hōʻailona o nā mua o ka maʻi o nā huapalapala a me nā hōʻailona i loaʻa i ka maʻi hematologic, a me nā hōʻailona no ka ʻili a me ka puʻuwai. ʻOiaiʻaʻole ia e nīnau aku i ke kauka i ka hoʻomohala ʻana o nā hopena maikaʻi ʻole e like me ka ʻehaʻeha, ke kuni, ka ʻōpala, ka ʻōpala o ka wahaosa waha, ka hemorrhages causeless a me ka hemorrhages. I kahi o nā hōʻailona o ke kaumaha o ka ʻōpū o ka iwi, pono ke hoʻopau ʻia Zeptol.
Ma mua o ka hoʻomaka ʻana o ka papa o ka mālama ʻana a me kēlā me kēia manawa i ka wā o kona hoʻokō ʻana, e noi ʻia e noi i nā hana o ka ate, ʻoi aku hoʻi i nā poʻe maʻi maʻi a me nā mea maʻi me kahi mōʻaukala o kāna mau ʻeha. Inā loaʻa ka nui o nā maʻi lawelawe o ke kala a i ʻole he hanana nui o ka maʻi ma ke ʻano, e hoʻopau koke ʻia ka mālama ʻana me ka lāʻau.
ʻO ka maʻi lapaʻau me nā lāʻau antiepileptic i kekahi mau mea hiki ke tupu me ka hiki ʻana o nā hoʻāʻo / suicidal manaʻo. Ma ke ʻano o ka ulu ʻana o ka hana suicidal i ka wā e hoʻohana ʻole ʻia ai kēia mau lāʻau, ʻaʻole hiki ke hoʻokele ʻia kāna hoʻomohala aʻo ka lawe ʻana iā Zeptol. Hoʻomaʻamaʻa ʻia nā mea maʻi a me kā lākou mau kauwā e pili ana i ka pono e ʻimi koke i ke kōkua olakino inā he mau hōʻailona o nā manaʻo kuhihewa / inclinations.
Pono nā poʻe maʻi ma mua o ka mālama ʻana e pono ai ke nānā ʻia ma muli o ka hikiwawe o nā maʻi noʻonoʻo latent, i hōʻike ʻia e ka hilahila a me ka noʻonoʻo psychomotor.
Hoʻopilikia ke kūpaʻa o ka hoʻokele carbamazepine e hiki i nā mea hoʻokūkū epileptic. Inā makemake nui ka haʻalele ʻana o Zeptol, pono e hoʻoneʻe i ka mea maʻi i kekahi lāʻau antiepileptic i ka wā o ka mālama ʻana me ka lāʻau lapaʻau kūpono no kēlā mau hihia (no ka laʻana, ʻo phenytoin e lawelawe ai i ka iv a me ka Diazepam ua hoʻohana o iv a i ʻole.
I ka wā mālama, ʻo ka hoʻomohala ʻana o nā hopena dermatological koʻikoʻi (me ka maʻi Stevens-Johnson syndrome, ʻo Lyell's syndrome) ke ʻano nui loa. Pono e hoʻokuʻu koke ʻia ka hoʻohana ʻana iā Zeptol inā ʻike nā hōʻailona a me nā hōʻailona hoʻolilo. Me ka hoʻomohala ʻana o nā hopena ʻehaʻeha o ke ola, pono e lawe ʻia ka mea maʻi i ka haukapila. Ma ke kānāwai, ua ʻike ʻia ka ʻike ʻia o nā maʻi like i nā malama mua o ka papa o ka ʻoihana.
Wahi a ka loiloi retrospektif o ka hoʻohana ʻana iā Zeptol, ua loaʻa i ka poʻe maʻi o ka lahui Kina i ka pilina ma waena o ka pinepine o nā ʻano ʻeha ʻeha e pili ana i ka carbamazepine a me ka hele ʻana o ka huaʻani leukocyte antigen (HLA) i ke ʻano o kēia mau mea maʻi HLA-B * 1502. Ke mālama nei i ka poʻe maʻi me ka carbamazepine ma nā ʻāina o ka ʻĀsia Asia (Philippines, Malaysia, Thailand), kahi i kākau ʻia ai ka laha o kēia alele, ua piʻi ka nui o ka ulu ʻana o ka hopena dermatological effects (mai ke kuhi ʻana i ke alapine "loaʻa pinepine" a "pinepine").
I ka poʻe maʻi e hiki ai i nā mea lawe aku ʻo ka HLA-B * 1502 allele (no ka laʻana, ka poʻe o ka lahui Kina), hana ʻia nā hoʻokolohua no ka hana ʻana i loko o ka genotype. Manaʻo ʻia e lawe i ka lāʻau lapaʻau lāʻau i loko o nā mea lawe i kēia allele wale nō inā he meaʻoi aku ka pōmaikaʻi o ka lāʻau ma mua o ka hiki o ka pilikia. Ua hōʻike ʻia nā ʻelele o nā iwi Caucasoid, Negroid a me ʻAmelikaidana.
Ma mua o ka hoʻomaka ʻana i ke ʻano ʻo Zeptol, pono ʻoe e ho'ōki i ka lawe ʻana i ka MAO inhibitors ma kahi o 14 mau lā a i ʻole ma mua, inā e ʻae ʻia ke kūlana haumania.
Hoʻohui nūhou
- CYP3A4 inhibitors isoenzyme: māhuahua nā kiʻekiʻe o ka carbamazepine i loko o ka plasma a ua hoʻonui ʻia ka hopena o nā ʻaoʻao,
- inducers o CYP3A4 isoenzyme: wikiwiki ka wikiwiki o ka metabolama, ke alakaʻi nei i ka emi ʻana o kona waihona i ka plasma a me ka nāwaliwali o kāna hopena therapeutic,
- nā lāʻau antiepileptic (vigabatrin, styrypentol), antidepressants (fluvoxamine, trazodone, desipramine, lanzodone, fluoxetine, viloxazine, paroxetine), antipsychotics (olanzapine), nā mea hōʻalolo o nā musula (dantrolene, oxybutynin), antotepides dosis nui), derivatives azole (ketoconazole, voriconazole, fluconazole, itraconazole), HIV protease inhibitors (e.g. ritonavir), nā lāʻau lapaʻau antiulcer (cimetidine, omeprazole), calcium antagonists (diltiazem, verapamil), anti-glaucoma nā lāʻau lapaʻau (acetazolamide), nā mālamalama macrolide (clarithromycin, erythromycin, troleandomycin, josamycin), antihistamines (loratadine, terfenadine), nā antiplatelet agents (ticlopidine), analgesics a me nā lāʻau lapaʻau anti-inflammatory (NSAIDsandr), a me karopropine ʻO ka hoʻoliʻi plasma o ka carbamazepine, ka mea e hiki ai ke hoʻonāukiuki i ka hopena o nā hopena maikaʻi (hoʻohemo, kūlohelohe, ataxia), pono ia e nānā pinepine a hoʻoponopono i ke kiʻekiʻe o ka carbamazepine i loko o ke koko,
- loxapine, primidone, quetiapine, valproic acid, progabid, valpromide, valnoktamide: ka hui o ka plasma o ka carbamazepine-10,11-epoxide i hoʻonui, hiki ke hoʻomohala i ka hana kūpono ʻole, pono ke kāohi i ke kiʻekiʻe o kēia mau mea i loko o ke koko a hoʻoponopono i ka hopena o Zeptol,
- antiepileptics (mezuksimid, oxcarbazepine, fosphenytoin, fensuksimid, felbamate, phenytoin, primidone, phenobarbital, paha me clonazepam), antituberculosis konohiki (rifampicin), antineoplastic konohiki (doxorubicin, cisplatin), retinoids (isotretinoin), bronchodilators (aminophylline, theophylline) , ka hoʻomākaukau ʻana i ka wort a St John wort perforated (Hypericum perforatum): i hoʻemi ka nui o ka carbamazepine i loko o ke koko koko, pono paha e hoʻololi i kona mau hewa.
- antibiotics (doxycycline), NSAIDs, analgesics (paracetamol, buprenorphine, tramadol, methadone, phenazone), nā lāʻau antiepileptic (topiramate, clonazepam, felbamate, clobazam, ethosuximide, lamotrigine, valproic acid, maʻi diabetes, dicumarol, warfarin, acenocoumarol, fenprocoumon), antidepressants (mianserin, bupropion, trazodone, citalopram, sertraline, nefazodone), antidepressants tricyclic (amitriptyline, imipramine, clomipramine, nortriptyline), antifungal onazole), nā lāʻau anthelmintic (praziquantel), nā mea hana antineoplastic (imatinib), antipsychotics (risperidone, clozapine, bromperidol, quetiapine, ziprasidone, haloperidol, olanzapine), immunosuppressants (everolimus, cyclosporidido) , glucocorticosteroids (dexamethasone, prednisone), anxiolytics (midazolam, alprazolam), HIV protease inhibitors (saquinavir, ritonavir, indinavir), bronchodilators (theophylline), contraceptives hormonal, lāʻau hōʻemi e hoʻohaʻahaʻa i ke koko (felocipine) Reparata, he haku mele ec estrogen a / a progesterone: hiki ka ho'ēmiʻana i ka wai koko pae o kēia mau Luna e koi? Iaea o ko lākou nā māhele,
- phenytoin, mefenitoin: piʻi nui nui ka ʻai o ka phenytoin, piʻi i nā kiʻekiʻe mefenitoin.
Hoʻokomo ʻia nā Carbamazepine me nā lāʻau lapaʻau / nā mea e pono ai e mālama.
- isoniazid: hiki i ka hepatotoxicity i kumu e ulu ai kēia mea
- diuretics (furosemide, hydrochlorothiazide): ʻike ʻia ke ʻano o ka hōʻailona hyponatremia.
- levetiracetam: hiki i nā mea hoʻōla i nā hopena o nā hopena o ka carbamazepine,
- antipsychotics (thioridazine, haloperidol), mākaukau lithium a metoclopramide: ʻo ka nui o nā hopena neʻokeʻo hiki ke hoʻonui (i hui pū ʻia me nā antipsychotics - a i mua hoʻi o ka pae therapeutic plasma o nā hana ikaika).
- ka hoʻonaninani ʻana i ka hōʻuluʻulu ʻana o ka lālani (pancuronium bromide): hiki i ka carbamazepine ke hōʻike i ka antagonism i ka hana a kēia mau lāʻau, me kēia hoʻohui e pono ai i ka hoʻonui ʻana i nā ʻōmole o kēia mau musia hoʻomaha, e kiaʻi pono ana i ke kūlana o ka mea maʻi ma muli o ka hiki ke wikiwiki hou ma mua o ka mea i hoʻomaka ʻia ka hopena neuromuscular blockade,
- nā mea hoʻohālikelike hormonal: hopena i ka hopena o kēia mau lāʻau e hōʻemi ma muli o ka hoʻonāukiuki ʻana o nā hua ona microsomal, aia nā hōʻike e pili ana i ke koko i ka wā ma waena o ke kāne helehelena, pono no e hana i nā ala ʻē aʻe o ka contraception.
- ethanol: aia paha he hopena i kona hoʻomanawanui, i ka wā o ka ʻoihana e pono ai e pale i ka inu ʻula.
ʻO nā hui o Zeptol nā: Carbamazepine, Carardepsin retard, Carbamazepine retard-Akrikhin, Carbamazepine-Ferein, Carbamazepine-Acre, Finlepsin, Tegretol, Finlepsin retard, etc.
Hōʻikeʻike Zeptol
ʻO nā loiloi liʻiliʻi o Zeptol he maikaʻi loa. Hoʻomaopopo ka nui o nā mea maʻi ʻo ka lāʻau lapaʻau e hōʻemi pono i ka hōʻemi o ka hopu epileptic, hōʻike i ka hopena maikaʻi i nā hōʻailona o ke kaumaha, hoʻēmi i ka huhū, me ka hōʻoluʻolu ʻana i ka hōʻeha neurogen a hōʻemi i ka nui o nā hōʻeha me nā neuralgia trigeminal. Loaʻa nā hemahema o Zeptol i kahi nui o nā hopena ʻaoʻao.