Umuthi 'valparin ": yokusetshenziswa, ukwakheka, omqondofana, anomqondo ofanayo. Izibuyekezo sokulungiselela

Kungani ngidinga imithi "valparin"? Yokusetshenziswa, omqondofana nokubonakaliswa kulo muthi ezichazwe kulesi sihloko.

Ukuma kanye nokwakheka

Yini fomu esivela izidakamizwa "valparin"? I-Tablet - it is kuleli fomu zomuthi okukhulunywa angathengwa ngaleso ekhemisi. Bona abonise isenzo isikhathi eside, esiyindilinga biconvex umumo, futhi umbala enamathela emhlophe.

Lokho ingxenye izidakamizwa "valparin"? Umhlahlandlela inikeza ukuthi ithuluzi iqukethe valproic acid kanye sodium valproate. Lihlanganisa excipients ezilandelayo: glycerol, colloidal Silicon dioxide, evdragit E-100, hydroxypropylmethylcellulose, polyethylene glycol 1500, ethylcellulose, sodium saccharin, Silicon dioxide hydrate, evdragit HHAYI-30D, ama-titanium dioxide futhi talc.

Thenga amaphilisi ingabonwa emapheshana yizicucu 10 isixha amakhadibhodi ngokulandelana.

izidakamizwa

ingabe lesi sidakamizwa "valparin" kanjani? Yokusetshenziswa (ukwakheka kusho iye echazwe ngenhla) Lithi kuyinto umuthi anticonvulsant. Uqukethe valproate okuqukethwe sodium kukhuliswa Gaba ebuchosheni, okuyinto enomthelela ukwanda yayo izinzwa postsynaptic.

Kufanele futhi wazi ukuthi ingxenye okukhulunywa inomthelela ezokuthutha potassium ion yonkana ulwelwesi neuronal. Le nqubo suppresses ukuthuthukiswa kanye ukusabalala excitation nabanesithuthwane e yezinzwa.

Kufanele ukuthi sodium valproate kuyalithinta anticonvulsant e izinhlobo ezahlukene isithuthwane.

Izidakamizwa "valparin" akusho ifa sine nemiphumela okuyiluthayo, futhi kungukuthi ezicindezelayo maphakathi umoya. Ngaphezu kwalokho, isithako yayo asebenzayo ayinayo imiphumela emibi kwenhliziyo, izinga lokushisa emzimbeni wesiguli, umfutho wegazi kanye nokusebenza kwezinso.

I izakhiwo kinetic zomuthi

Yiziphi izici pharmacokinetic zomuthi has "valparin"? Umhlahlandlela uthi ngemuva kokuthatha amaphilisi ngaphakathi ukukhululwa elawulwa lomcebo asebenzayo iqala ngokushesha, futhi ngemva kwamahora angu-2-8, ifinyelela esiphezulu plasma ezingeni.

Bioavailability izindlela kubhekwe 100%.

Umthelela zokwelapha zomuthi livela kuphela ngemva kokufinyelela valproic acid lokuhlushwa igazi, ilingana 45-100 mg / l. It nanela ukuthi izenzo zokwelapha kanye kwemithi ye esebenzisa elawulwa ukukhululwa core wengxenye akusho ngaso sonke isikhathi kuxhomeke lokuhlala plasma.

Ukuxhumana kubhekwe zemithi plasma amaprotheni cishe 85-90%. It is akheka esibindini futhi okukhipha kanye nomchamo. Kulesi-pass lokuqala umzimba siyenzeka.

Isigamu-ukuphila ye-ejenti kuyinto amahora mayelana 9-20. Ezinganeni, le nkathi sinciphile.

Izinkomba yokwamukelwa

Kungaphansi kwaziphi izimo izidakamizwa ephumelela kunazo iziphatha "valparin"? Yokusetshenziswa, real ochwepheshe abanolwazi umbiko ukuthi wathi nomuthi ikhiqizwa ngqo ekwelapheni isithuthwane generalized, kuhlanganise lezi zinhlobo ezilandelayo ukuhlaselwa:

• myoclonic;
• usuke ungekho;
• atonic;
• tonic-clonic.

Futhi, lolu izidakamizwa ezinqunyiwe isithuthwane ngokwengxenye, ikakhulukazi, ku:

• ukuquleka yesibili generalized;
• kuhlangene noma nokuquleka elula.

Ngaphezu kwalokho, amaphilisi bavamise esetshenziswa lapho syndromes ethize (Lennox-Gastaut syndrome, West).

Uvala ukusetshenziswa amaphilisi

It has iyiphi Izimo izidakamizwa "valparin"? Ngokwe-ticondziso letivela ithuluzi, khona imingcele eziningi ukusetshenziswa:

• ngesikhathi sokukhulelwa;
• iziyaluyalu obukhulu kwamanyikwe;
• thrombocytopenia;
• ukusha kwesibindi kohlobo oyingozi noma ezingamahlalakhona;
• porphyria;
• Ezimweni asebenzayo-hepatitis (izidakamizwa genesis);
• ibele;
• yobudala izingane kuze kube iminyaka emithathu;
• hypersensitivity kuya izidakamizwa, kufaka phakathi valproic acid.

Anticonvulsant "valparin": yokusetshenziswa

Umthamo zomuthi ikhethwa kumuntu ngamunye, kuya esisindo futhi sidala kangakanani isiguli.

Ngokuvamile, i-isiqalo omdala umthamo kuyinto 600 mg zomuthi ngosuku. Esikhathini esilandelayo kule nombolo kukhuphuke ngo-200 mg (zonke izinsuku ezintathu ukufeza umphumela oyifunayo).

eyamukelayo kaningi kusho olucutshungulwayo kuyizikhathi 1-2 ngosuku. Umkhawulo Isikali Isincomo 1-2 g zomuthi ngosuku.

Tablets "valparin", yokusetshenziswa okuyinto zidingidwa kulesi iphepha kufanele kugwinywe iyonke, baphuze esincane amanzi afudumele.

Ngo abantu abadala eziyalezweni nokushintsha kokudla nokufakwa kwaleli thuluzi kufana eziyalezweni nokushintsha kokudla nokufakwa ezigulini omdala, kodwa akhethiwe umuntu ngamunye.

Ukuze izingane enesisindo 20 kg umthamo kokuqala nomuthi kuyinto 400mg ngosuku. Kuyadingeka ukuba ukwandisa inani kancane kancane ukufeza umphumela oyifunayo (mayelana 20-30 mg / kg ngosuku, 1-2 ngemithamo).

Ingane nesisindo 20 kg nika imithi anticonvulsant akuvunyelwe.

Izenzo-uhlamvu

Yiziphi imiphumela emibi imbangela "valparin" ithebhulethi? Yokusetshenziswa azisa ukuthi ukuthathwa lokhu izidakamizwa iziguli womuntu umuntu angezwa imiphumela engathandeki:

• komzimba: Stevens-Johnson syndrome, ukuqubuka kwesikhumba, i-erythema multiforme, pruritus, isikhumba, photosensitivity.
• wokugaya ukudla: isicanucanu, isifo sokusha kwesibindi, ukuhlanza, ukuqunjelwa, uhudo, pancreatitis.
• uhlelo ezalayo: amenorrhea yesibili, esikhathini okungajwayelekile.
• CNS: ikhoma, ukundindizela, ataxia, ukwazi kahle.
• uhlelo hemopoietic: kwegazi, platelet wokuhlanganisa okusithiyayo, thrombocytopenia, leukopenia, neutropenia, kwehle fibrinogen.
• Okunye: kwesisindo, ukuqothuka kwezinwele, creatinine serum, hyperammonemia.

anticonvulsant Overdose

Yini zimpawu zingatholakala uma nithatha ebulilini lesi sidakamizwa "valparin"? Yokusetshenziswa (amaphilisi angathengwa ngasiphi ekhemisi on kadokotela) uveza ukuthi usuku ukweqisa izidakamizwa ngamabomu noma ngephutha izidakamizwa ngaphansi ukucatshangelwa umbiko akuvamile. Njengomthetho, ukuhlukumeza we nokushintsha kokudla nokufakwa umuthi kunomthelela ukubukeka isicanucanu, isiyezi, ukuhlanza, ukukhishwa isisu, ukucindezeleka zokuphefumula, ikhoma, futhi hyporeflexia.

Ukuqeda izimo esinjalo isiguli ezinqunyiwe lavage esiswini kanye namalahle isebenze. Uma kunesidingo, ukuphathwa nesineke wenziwa ngendlela yokwelapha lingaze futhi hemodialysis.

Ukuxhumana nezinye izidakamizwa

Kungakhathaliseki engena nokuxhumana nezinye izidakamizwa imithi "valparin"? Yokusetshenziswa yazisa isiguli ukuthi valproate sodium indlela abangenza ngayo umphumela antipsychotics, antidepressant nezidakamizwa antiepileptic.

Ngokungafani nezinye anticonvulsants , abaqondanga izidakamizwa ikhuthaza hepatic enzyme lokungeniswa, ngakho-ke akusenzi ukuphumelela kwezindlela zokuvimbela inzalo ngomlomo.

Ngo reception okucishe kufane nalokhu "warfarin" kanye sodium valproate kwehle iphesenti sesibopho ukuthobisa plasma amaprotheni kuqala.

I asebenzayo izidakamizwa izidakamizwa kubhekwa ukwazi ukushintsha plasma lokuhlala lamotrigine, futhi phenytoin. Lapho kuhlanganiswa nama-amagama ahlobene of acetylsalicylic acid anticoagulant futhi antiplatelet umphumela buyathuthuka.

Ngekusetjentiswa kanyekanye "valparin" kusukela Ethanol nezinye izidakamizwa ezikucindezelayo CNS ivaliwe (isib mao inhibitor iyona tricyclic antidepressant, izidakamizwa antipsychotic) Kungenzeka sithuthukiswe CNS ukucindezeleka.

Utshwala nezinye izidakamizwa hepatotoxic kwandisa ingozi yokungenwa ukulimala kwesibindi.

ekwakhiweni Okubukwe kwandisa nenxenye ukuphila "lamotrigine" futhi kubambezela umzimba wayo futhi suppresses enzyme hepatic. Ngokuqondene nalokhu isigamu-ukuphila zomuthi kungase kukhule kufika emahoreni angu-70 ezigulini omdala futhi kufike kumahora angu-45 - izingane.

"Valparin" uyakwazi ukunciphisa imvume "zidovudine" ngo-40%. Ngaphezu kwalokho, ingxenye-ukuphila layo akashintshi.

Mao inhibitors antidepressant, tricyclic nezidakamizwa antipsychotic (neuroleptics), kanye nezinye izidakamizwa ukuthi aphansi kokuquleka nombundu, kakhulu ukunciphisa ukuphumelela nomuthi kubhekwe.

Ibele nokukhulelwa

Ngokusho kochwepheshe, ukusetshenziswa kwezidakamizwa "valparin" ngesikhathi sokukhulelwa kuphela kungenzeka uma izinzuzo ehlosiwe komama esizayo kakhulu lidlula engaba ingozi ingane.

Lapho ethola izidakamizwa ngesikhathi sokukhulelwa, qiniseka ukuqhuba zokuqapha ezikhethekile kokubeletha umbungu.

Ukusebenzisa izidakamizwa ngesikhathi lactation is hhayi Kunconywa.

ulwazi oluthile

Ngaphambi kokuthi uqale ukwelashwa izimali, qiniseka bonana nodokotela wakho kuqala.

Ngo inqubo kokuthola imithi anticonvulsant kudinga ukuqapha evamile ye bilirubin egazini, amylases nama-platelet, kanye transaminases isibindi (zonke izinyanga ezingu-3).

Ngokusho kochwepheshe, valproic acid uyakwazi ezivimbela platelet wokuhlanganisa. Lokhu kwandisa kakhulu ingozi lenyuka igazi coagulation isikhathi ukopha. Kuyadingeka ukuba acabangele amathuba yezinkinga ezihlobene ukopha esikhathini postoperative, abantu abathola i-sodium valproate.

Uma impatho eside lokhu izidakamizwa e iziguli zingase ziqale ukopha okuvele hematoma kwakhiwa. Kulokhu, amaphilisi kufanele simiswe ngokushesha.

Njengoba kushiwo ngenhla, i-sodium valproate, umuthi ngokuvamile kubangela pancreatitis, futhi ikhuthaza ukuphazamiseka kokusebenza kwesibindi (ngokuvamile ezinyangeni zokuqala ezingu-6 zokwelashwa). Kule ndaba, ekuqaleni ukwelashwa kuyadingeka ukuze ukuqapha isimo isiguli pancreatic, kanye ukuqapha njalo umsebenzi ukuhlolwa isibindi, kanye nezinga prothrombin.

Ukungasebenzi kahle kwesibindi kanye ukwehluleka hepatic e seziguli ezithola sodium valproate kungabonakala nasemkhakheni izingane abanesifo sokuwa e izifo umzimba futhi esiwohlozayo, retardation engqondo organic ubuchopho izicubu egunjini lokuhlolwa kwezifo.

Ngo okwashiwo izimpawu ezifana ukucobeka, ubuthakathaka imakwe, ukuvuvukala, nokuhlanza, jaundice, kufanele ngokushesha umise ukusebenzisa we nomuthi.

Ekwelapheni "valparin" isiguli kufanele niqaphele kakhulu lapho esebenza imishini kuyingozi. Lokhu kungenxa yokuthi i-nomuthi asebenzayo uyakwazi ukunciphisa okuhlushwa.

Imigomo nemibandela isitoreji

Anticonvulsant amaphilisi "valparin" akhishwa Pharmacy kuphela kadokotela kadokotela. Kufanele kwi kude nezingane futhi bavikelekile umswakama kanye at lokushisa hhayi ngaphezulu kuka-30.

Impilo eshalofini zomuthi olucutshungulwayo sekuyiminyaka emithathu (kusukela usuku ukwakhiwa).

Nomuthi "valparin": analogue, omqondofana

Umuthi okukhulunywa ngalo lapha lingase indawo? Bomcondvofana kanye analogue kuleli thuluzi, kunezindlela eziningi. Lezi zihlanganisa imithi ezilandelayo: "Apilepsin" "Depakine," "Atsediprol" "Depakine Enterik" "Depakine Chronosphere" "Depakine Chrono", "Dipromal", "Konvulsofin", "Konvuleks", "Orphir" "Enkorat", "Everiden", "Enkorat Chrono".

Njengoba kunjalo nge "valparin", lezi zimali kumele athathwe kuphela kuma-oda likadokotela, in the imithamo Kunconywa ngokuqinile.

Umbono abathengi kanye nezifundiswa

Yini odokotela bathi ngalokhu imithi, njenge "valparin"? ochwepheshe lezivakashi abonisa ukuthi izidakamizwa iphumelela kakhulu futhi kuwusizo, ikakhulukazi isithuthwane generalized futhi ngokwengxenye.

Njengoba abathengi, iningi lazo livumelana ne umbono udokotela. Iziguli baye bame kwelokuthi lokhu eyamukelayo kusho kusiza ukuthuthukiswa ngokushesha futhi basakaza abacindezela excitation (nabanesithuthwane) by izinzwa. Nokho, kufanele kuphawulwe ukuthi ukusetshenziswa kwalesi izidakamizwa ngokuvamile kubangela engemihle. Ngokusho kumpendulo yekhasimende, ngokuvamile ezenzeka ukusabela ezingezinhle yilezi: isikhumba njengemithi yokungezwani komzimba nokuthile, isicanucanu, ukuntuleka kwegazi emzimbeni, futhi isisindo somzimba. Uma uhlangabezana lezi zimpawu kufanele axhumane ngokushesha ne udokotela.