Iphilisi i induna ebusweni, "Roaccutane": izibuyekezo, izithombe ngaphambi nangemva imfundo

Njalo ingane phakathi nesikhathi sokuthomba bebhekene nenkinga induna noma ukubonakaliswa ngokwesayensi induna. Othile kalula asiza izinqubo yezimonyo in kanye isenzo lokugcilwe kuto ngco. Abantu bonke laba manipulations yesimo isikhumba ingakuthuthukisi. ukukhubazeka Muhle ngesimo namaqhubu, nezinduna kanye izibazi kuzo iqhubeka waze waba mdala kakhulu. Kulokhu, lo muntu ahlangabezane hhayi kuphela ngokomzimba, kodwa futhi kubangela ukucinana okukhulu ngokomzwelo. Izinkinga ngesikhumba ukugxambukela azethembe futhi ujabulele ngokugcwele ukuphila. Ezimweni lapho zonke ezinye izindlela ukulawula ukukhombisa ubuze babo, odokotela linqume izidakamizwa iziguli "Roaccutane". Ukubuyekeza, izithombe ngaphambi nangemva ukwelashwa nalezi amaphilisi ziholela esiphethweni esebenza zabo eziphakemeyo. Nokho, kuyafaneleka inombolo enkulu yemiphumela emibi kanye nesidingo sokuqapha gqwa nemingcele kwamakhemikhali umthamo wegazi lesiguli.

"Roaccutane" wathola wokubuyekezwa okuvumelekile odokotela. Ochwepheshe bathi: ngokungabi bikho Izimo, kanye nokuhambisana ngokuphelele nazo zonke izincomo isiguli ine umphumela omuhle zokwelapha kanye yezimonyo.

Kuyini lokhu imithi?

"Roaccutane" - ithebhulethi izibuyekezo ikakhulukazi omuhle ngendlela - kuyinto belungiselela ukwelashwa oqondile induna namaqhubu. Lezi amaphilisi aqukethe obomvu luhlaza ukumiswa, ingxenye eyinhloko okuyinto isotretinoin e isamba 10 mg noma 20 mg (kuncike amafomu wokukhishwa). Ngaphezu kwalokhu ukulungiselela retinoid yakhiwa izingxenye ezengeziwe, phakathi lapho uwoyela soybean, ngengcina yezinyosi, glycerol, gelatin, amazambane isitashi futhi ahlukahlukene izinga ukudla nodayi. "Roaccutane" kuboniswa ekwelapheni amafomu ezinzima induna ezingeke wamagciwane izindlela ezivamile.

Njengoba imisebenzi izidakamizwa?

Eqinisweni ezithakazelisayo: odokotela namanje abazange esiphethweni mshini esiqondile isenzo "Roaccutane" izidakamizwa. Ukubuyekeza, izithombe ngaphambi nangemva ukwelashwa nale ejenti ugqozi odokotela abaningi batusa iziguli zabo iphethini kuyinkimbinkimbi induna. Isotretinoin, okungukufa stereoisomer trans-retinoic acid, has miphumela elandelayo emzimbeni womuntu:

• kuvimbela umsebenzi ngokweqile nezindlala sebaceous.

• Ukuncishiswa ubukhulu.

• Ingabe umphumela anti-inflammatory esikhumbeni.

Kungani induna kwakhiwa?

I epithelium ukuthi ihlanganisa isibani izinwele, luyakhula futhi exfoliated. Amaseli ke corneocytes, uphawu umdlavuza imbobo yi-keratin sebum. Lokhu kuholela ekwakhekeni comedones, kulandele ukunamathela impendulo ukuvuvukala. Sebum kuyinto ozithandayo zokukhula nendawo kanti ukukhiqizwa kabusha uhlobo Propionibacterium acnes amagciwane. Bangabaholi izimfanelo esiyinhloko ukuvela izindawo eziningi, ububomvu kanye nezinye izenzakalo ezingajabulisi esibhekana elikulesi sihloko.

Izidakamizwa "Roaccutane" libuyekeza ukuthi odokotela sesibonakala, dermatologically waqinisekisa ikhono layo ukucindezela ekwandeni sebocytes. Isebenzisa ezingeni physiologically evamile yokuzihlukanisa kwamangqamuzana ngokwemisebenzi yawo lamaseli EPITHELIAL. "Roaccutane" kunciphisa umsebenzi sebum futhi ngaleyo ndlela ukukhula kwamagciwane wayeka, yisishiso isuswe, umphumela omuhle yezimonyo abayifunayo.

Yini pharmacokinetics lokhu izidakamizwa?

Isotretinoin amuncwa umzimba kusuka pheshana emathunjini, futhi emakamu esiphezulu itholwa egazini amahora 2-4 ngemva kokuphathwa. Kukhona ezinye izici ukusetshenziswa "Roaccutane" izidakamizwa. Izibuyekezo uvumele izazi ukwenza lesi siphetho: ithebhulethi kungcono uphuze emva kokudla. Lokhu kwandisa bioavailability of isotretinoin ezikhathini 2 uma ziqhathaniswa yokwamukela imithi esiswini esingenalutho.

The main isithako iyona Lubophela ephelele kakhulu Amaprotheni egazi futhi akheka ukwakha imikhiqizo ezine eziyinhloko. isotretinoin ezibonisiwe futhi metabolites yayo umchamo kanye endleni enkathini eyiminyaka amahora 19 kuya 29. Ukubuyiselwa okuqukethwe bokuphila retinoids e abantu kwenzeka emva 2 amaviki ekupheleni inkambo ukwelashwa.

Ngayiphi umthamo ukuthatha imithi?

Mayelana kwalokho, kangakanani ukuthatha "Roaccutane" (amaphilisi), ungezwa izimpendulo ezahlukene. Kumele kuqashelwe ukuthi le umbandela kuphela esabekwa udokotela ukuba khona esekelwe ezimweni ngazinye isimo lesiguli.

I nomuthi "Roaccutane" izilinganiso, isithombe ngaphambi nangemva ukwelashwa, eyaqinisekisa kahle yaso ephezulu, ngokuvamile kuthathwe kanye noma kabili ngosuku ngomlomo.

Ukuba khona Dynamics ukwelashwa, futhi side effects kuncike isimo sokuqala nesineke futhi umthamo okhethiwe. Lezi isimo sidinga indlela siqu indlela linqume izidakamizwa "Roaccutane". Izibuyekezo odokotela basikisela ukuthi kusukela uhlale kangcono umthamo ubuncane ebalwa kusukela olinganise 0.5 mg isotretinoin ngayinye 1 kg esisindo nesineke amahora angu-24. Ngokwezibalo, inombolo isilinganiso prescribers - 0.5-1.0 mg isisindo / umzimba kg ngosuku. Uma ngezinga induna e isiguli kwachazwa ngokuthi kunzima ke kunikezelwe izilinganiso ezinkulu - ukuze 2.0 mg / kg ngosuku. Ngaphezu kwalokho, kulezi zimo uqale nge inani elincane - 10 mg / usuku futhi, uma kufaneleka, lande laba ngu-1 mg esisindo / kg amahora angu-24.

Kukhona i elilungile lwemithi "Roaccutane" imithi induna. Izibuyekezo odokotela akhombise inani izidakamizwa 120-150 mg / esisindo kg, kwasakazwa ku yonke inkambo yokuhle. Ngakho-ke, isikhathi sokwelashwa incike okuhloswe umthamo wansuku zonke imithi. Ngokuvamile isikhathi amasonto 16-24 kungenzeka ukufeza isithombe cishe ephelele kuthethelelwe induna. Uma isiguli idlulisa oqokiwe reception ezimbi uhlelo, umthamo wansuku zonke kwadingeka liyancipha futhi kwandisa isikhathi yokwelapha.

Empeleni, omunye Inkambo yokwelashwa "Roaccutane" izidakamizwa - izibuyekezo, izithombe ngaphambi nangemva qinisekisa leli qiniso - anele ukunyamalala ephelele induna. Nokho, uma isiguli ukubuyela ngokuphelele ekubhemeni kucace, Udokotela angase anikeze isiguli isikhathi sesibili zokwelapha. Kulokhu, umthamo kanye nobude besikhathi sokwelashwa ngemithi izidakamizwa uhlala ingashintshiwe.

Isikhathi umphumela yezimonyo, okunikeza amaphilisi induna ngobuso bakhe, "Roaccutane" impendulo evela kodokotela neziguli ubheke amaviki angu-8. Ngakho-ke, isidingo kabusha ukuphathwa kuba sobala kuphela ngemva kwalesi sikhathi futhi wayengazange esimisiwe.

Kuke kwenzeke yini kube ukweqisa izidakamizwa?

Uma isiguli Udlule umthamo letiphakanyisiwe uma lithatha izidakamizwa "Roaccutane", yokusetshenziswa, kobufakazi nesineke ukhombe ukuvela izimpawu hypervitaminosis uvithamini A. Le siqedwa ngokugeza esiswini, okuyilona elidingekayo ukuze ikhiqize emahoreni ambalwa wokuqala ngemuva kwesigameko imithi ukusetshenziswa ngokweqile.

Umuthi baxhumana neminye imithi?

Kanyekanye reception "Roaccutane" futhi uvithamini A kuholela hypervitaminosis zokugcina, ngakho le nhlanganisela kufanele kugwenywe.

Contraindicated therapy lihambisana isotretinoin futhi tetracyclines, njengoba kuholela ekwandeni e ingcindezi intracranial.

Kaningi, nokuncipha ukusebenza kwe-progesterone, elibangela induna amaphilisi "Roaccutane". Izibuyekezo lodokotela ibonisa ukuthi ukwelashwa kwabantu abayizigidi ezingama leli thuluzi kumele kusetshenziswe amaphilisi umuthi nge amazinga ama-hormone ephakeme nezindlela ukusetshenziswa okuvimbelayo inzalo.

Uma isiguli isebenzisa ekwelapheni "Roaccutane" lendawo ejenti keratolytic noma exfoliants, kungase kube ukucasuka kwesikhumba.

Kungenzeka yini ukusebenzisa izidakamizwa kwabesifazane abakhulelwe?

"Roaccutane" (amaphilisi, ukubuyekezwa zazo abaningi ugqozi yokuhlola ukusebenza kwabo ngokwakho) inesimiso kubaluleke kakhulu: basuke ngokuphelele contraindicated ngesikhathi sokukhulelwa. Isotretinoin has anamandla teratogenic. Ukwelashwa, ngisho ngemithamo iDemo nabancane awokuthi kungabangela kombungu sina fetus.

Leli qiniso contraindication ngenxa zomuthi kwabesifazane yokuzala abangafuni bahlangabezane nalezi zidingo ezilandelayo:

• Ukuba khona ifomu ezinzima induna ukuthi is hhayi iqedwe by ukwelashwa ezivamile.

• Owesifazane othile uyaqonda ngokuphelele futhi uyahambisana nazo zonke izincomo udokotela.

• Yena unolwazi udokotela ngezingozi sokukhulelwa ngesikhathi yokwelapha "Roaccutane" kanye ngenyanga ngemva kwalokho, isidingo i kokubonisana eziphuthumayo nge onguchwepheshe uma kwenzeka kuyiqiniso nje ebamba isisu.

• Owesifazane othile uyaziqaphela zincishiswe noma ukulahlekelwa ingqikithi ukusebenza kwe nokukhandela imbeleko.

• Yena uyaqonda essence isidingo udokotela ecacisiwe izinyathelo.

• Owesifazane uyaqonda ukubaluleka Ukuvikelwa baqhubeka ekukhulelweni ngesikhathi imithi oyinikiwe, ngenyanga ngaphambi nangemva kwakhe, kanye nesidingo ukusebenzisa zombili izindlela 2 inzalo (kuhlanganise isithiyo).

• owesifazane has a yi test ukukhulelwa ezazingezinhle kumele itholwe zingakapheli izinsuku 11 ngaphambi kokwelashwa. Futhi, lolu zokukhwabanisa kumele kwenziwe njalo ngenyanga ngesikhatsi ukwelashwa kanye 5 amaviki ngemva kokuqedwa kwalo.

• Kumele uqale ukwamukela izidakamizwa kuphela amahora 2-3 elandelayo isikhathi normal menstrual.

• Owesifazane othile ngempela kumele uvakashele udokotela njalo ngenyanga.

• Zonke izinto ezingenhla ezifanelekayo okuphindaphindiwe course of ukwelashwa "Roaccutane".

Qiniseka ukuthi sihlanganise zokuvimbela inzalo ethembekile nge "Roaccutane" ikhambi induna. ochwepheshe lezivakashi ukhombe isidingo mkhosi okuqinile imithetho yibo bonke abesifazane, ngisho nalabo ungathathi izinto zokuvimbela inzalo ngenxa yokungabi nenzalo, amenorrhea, bahlupheke hhayi ukuba ocansini. Ungafaki nesineke bodwa ababethola hysterectomy zabhekana.

Yini okumelwe zikhunjulwe udokotela?

Udokotela kufanele bazazi amaqiniso abanye isimo nesineke ngaphambi ukwelashwa lokuqoka "Roaccutane" yakhe. ochwepheshe lezivakashi basikisela ukuthi ukuze ugweme izimo ezingalindelekile, udokotela kufanele be kasibili impela izikhundla ezilandelayo:

• Isiguli kuyinto ifomu ngempela ezinzima induna ezingeke wamagciwane ezinye izindlela zokwelapha izici ezibaluleke kakhulu, okuwukuthi imihlola nodulocystic noma konglobatnye eziholela nezibazi.

• Abesifazane ukukhulelwa test yi ezazingezinhle sathathwa ngaphambi imithi oyinikiwe, ngesikhatsi ukwelashwa kanye 5 amaviki ngemva kokuqedwa kwalo. Zonke lezi idatha nge inkomba usuku yokuhlaziya lokwelekelela bodokotela.

• Iziguli ngempela osebenza inzalo (1, futhi mhlawumbe 2), indlela isithiyo liyadingeka. Lo mthetho usebenza isikhathi izinyanga ngaphambi kokwelashwa, inkambo nezinsuku ezingu-30 emva kokwelashwa.

• Owesifazane othile usiqonda ngokugcwele isidingo ukuhambisana nayo yonke izinyathelo ukuvimbela ukukhulelwa.

• Isiguli onazo zonke nenqubo abalwe ngenhla.

Ikakhulukazi ukuntuleka ukuqapha yokukhulelwa

Kufanele kuqashelwe ukuthi ukuhlolwa sokukhulelwa, ukuzwela 25 libhekene Mme / ml, kubalulekile ukukhiqiza ku 3 izinsuku lokuqala umjikelezo wokuya esikhathini.

Ngaphambi Yiqiniso lwenyanga isiguli kufanele uqale ukuphuza nokukhandela imbeleko. Ukukhulelwa ukuhlolwa ngosuku sokuqokwa, "Roaccutane", nosuku lokushicilelwa kwayo nodokotela umphumela eqoshiwe bodokotela.

Phakathi ukwelashwa, isiguli liyadingeka ukuvakashela udokotela zonke izinsuku 28 nge isheke esiyisibopho ukungabi khona ukukhulelwa. Ukuhlolwa okufanayo Kwenziwa emva amasonto 5 ekupheleni yokwelapha.

"Roaccutane" kobufakazi nesineke lapho ukukhuluma mayelana nomphumela walo omuhle yezimonyo, omiswe kadokotela kuphela esikhathini esiyizinsuku ezingu-30. Uma ufuna ukuqhubeka yokwelapha, kutuswa ukuphinda isivivinyo sokukhulelwa.

Ngingaba ukuthatha amadoda imithi?

ukwelashwa Induna for amadoda izidakamizwa "Roaccutane" kuyafaneleka, kodwa isiguli Kumelwe niqaphele ukuba ngakususi yokuvuma zomuthi Ngamanye amazwi okungokwakho kuhlala. Exposure zomuthi oketshezini kwesidoda uphansi futhi akakwazi ukukhombisa izakhiwo teratogenic.

Indlela ukuhlela ukukhulelwa?

abesifazane abaningi bayakhathazeka ngemiphumela kanjani ukukhulelwa luyoqhubeka ngemva "Roaccutane". Izibuyekezo lodokotela abonisa ukuthi ukuhlela ukuba akhulelwe usungaqala kuka inyanga eyodwa ngemuva kokuphela uze uwaqede yokwelashwa.

Uma kuhambisana zonke izinyathelo ekhulelwe inkathi eyingozi, owesifazane kufanele baqaphe ukuba khona ingozi enkulu yokuba fetus ezinzima CNS pathologies ka esimiso senhliziyo nemithambo yegazi, ubuso kanye nezindlala endocrine. Ngakho-ke, ziqondiswe udaba wokulondoloza ingane.

Izidakamizwa "Roaccutane" akufanele athathwe abesifazane ngesikhathi lactation, njengoba ludlulele ngaphakathi ubisi lwebele.

Yini enomthelela ongemuhle singenzeka?

Ziningi kakhulu inani elikhulu amathuba okuba nemiphumela engemihle okungase kwenzeke e isiguli usebenzisa "Roaccutane" izidakamizwa. Imiyalelo, ukubuyekezwa kodokotela neziguli ubheke imiphumela elandelayo engathandeki:

• Ukucindezeleka, waqinisa intracranial, ikhanda elibuhlungu, nokuquleka.

• Yenza uhlelo lokunciphisa kobukhulu emini twilight umbono, isifo samehlo, ukuzwa ukungakhuli.

• Ukwephula kwesihlalo, isicanucanu, ukuvuvukala wamathumbu isifo, pancreatitis, ukopha.

• Isifo sokulahlekelwa yigazi, izinguquko count platelet, erythrocyte sedimentation isilinganiso, hematocrit, neutropenia futhi leucopenia.

• bronchospasm.

• Ubuhlungu amalunga nemisipha, hyperostosis, tendonitis, Arthritis.

• ukuqubuka, i-erythema izinhlungu, ukulunywa, ukujuluka, lesikhumba, thinning kanye nezinwele, photoallergy.

• Isikhumba esomile kanye nolwelwesi lwamafinyila sezindebe, ekhaleni, pharynx futhi umphimbo, amehlo.

• izinguquko imingcele laboratory: ukhulisa izinga cholesterol, triglyceride, Esilula, Hyperglycemia.

• lefundo noma wendawo ukutheleleka streptococcal.

• hematuria, vasculitis, hypersensitivity, lymphadenopathy.

• Stevens-Johnson syndrome, erythema multiforme, ezinobuthi epidermal necrolysis.

Lesi sidakamizwa is contraindicated?

Izidakamizwa "Roaccutane" is contraindicated ku lezi zifo ezilandelayo nezimo:

• Hyperlipidemia uhlobo inkulumo.

• Ukukhulelwa kanye lactation.

• Hypervitaminosis A.

• Ukwelashwa tetracycline izidakamizwa.

• Ukuhluleka Isibindi.

• Izinga ekhulile yemiphumela kuvelana izidakamizwa.

• Izingane kuze yobudala engu-12.

Ngokunakekela asebenzayo izidakamizwa zaphathwa isiguli sikashukela, ukuba umlutha wotshwala, lipid iziyaluyalu, ukucindezeleka kanye nokukhuluphala ngokweqile.

Ukuphumelela kule izidakamizwa akuyona ungaqiniseki. "Roaccutane", izibuyekezo, izithombe kanye nemigqondo okuyinto efakazela ukuthi ukubonakaliswa yayo esingenakuqhathaniswa zokwelapha kanye yezimonyo, usenza simethembe ukwelapha induna, ngisho nezinto okunzima kakhulu. Nokho, ukuqaphela yonke imiphumela emibi izidakamizwa okuyinto aluhambelani nokukhulelwa kanye lactation, kanye khona eziningi Izimo. Inhloso yalesi izidakamizwa yenziwa kuphela udokotela ukuba khona, ubani omisa ngabanye Isikali nesineke kanye nesikhathi yokwelapha.