Saroten retard: umarni don amfani

Lokacin ɗaukar caphin ɗin Saroten Retard, yana da kyau a sha shi da ruwa. Capsules, koyaya, ana iya buɗewa kuma za'a iya ɗaukar abubuwan da ke ciki (pellets) a baki da ruwa. Kada ayi tufatar da ƙwayoyin cuta.

Abun bacin rai. Yanayin baƙin ciki a cikin schizophrenia. An wajabta shi sau ɗaya a rana sau 3-4 kafin lokacin kwanciya.

Jiyya tare da Saroten Retard ya kamata a fara da capsule 50 MG daya da yamma. Idan ya cancanta, bayan mako guda ana iya ƙara yawan ƙwayar yau da kullun zuwa 2 - 3 capsules da yamma (100-150 mg). Bayan cimma nasarar ci gaba, ana iya rage adadin yau da kullun zuwa mafi ƙarancin tasiri, yawanci har zuwa 1-2 capsules (50-100 mg / day).

Tasirin maganin antidepressant yawanci yana tasowa bayan makonni 2-4. Hanyar warkewa don rashin damuwa alama ce ta asali, sabili da haka, an bada shawarar ci gaba da amfani da maganin cututtukan cututtukan ciki, ciki har da Saroten Retard, bayan cimma sakamako da aka ambata na isasshen lokacin har zuwa - watanni 6 don kaucewa sake komawa. A cikin marasa lafiya da ke fama da matsalar rashin kwanciyar hankali (wanda ba a san shi ba), ana iya buƙatar gudanar da dogon lokaci na Saroten Retard, har zuwa shekaru da yawa, a cikin magungunan kulawa waɗanda ke da tasirin koma-baya.

Tsofaffi mara lafiya (fiye da 65 shekara)

Capaya daga cikin maganin kafe 50 na maraice.

Rage aikin koda

Ana iya ba da Amitriptyline a cikin abubuwan da aka saba don marasa lafiya da gazawar koda.

Rage aikin hanta

Dole ne a yi taka tsantsan lokacin amfani da miyagun ƙwayoyi a cikin marasa lafiya da ke fama da rauni na hanta, ya kamata a sanya ido a cikin mafi yawan ƙwayoyin magani a duk lokacin da ya yiwu.

Bayan an dakatar da magani, ana bada shawarar cire magani a hankali a wasu makonni domin gujewa ci gaban "janyewar" (duba sashin "Side effects").

Aikin magunguna

Amitriptyline magani ne mai tricyclic. Amine na zamani, amitriptyline, a cikin vivo kusan daidai yake hana sake farfado da norepinephrine da serotonin a cikin ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa. Babban metabolite dinsa, northriptyline, yana hana sake farfadowa da norepinephrine kwatankwacin karfi fiye da serotonin. Amitriptyline yana da m-anticholinergic, antihistamine da kayan kwantar da hankali, yana inganta aikin catecholamines.

Saroten Retard yana inganta yanayin rashin damuwa, amfani da shi ya fi tasiri a cikin maganin cutarwa da rashin damuwa, amma kuma yana iya rage alamun sauran rikicewar damuwa.

Sakamakon tasirin magani, Sarotin Retard ya dace sosai don magance damuwa ta damuwa tare da damuwa, tashin hankali, damuwa da damuwa na bacci. A matsayinka na mai mulkin, tasirin maganin yana faruwa a tsakanin makonni 2-4

Pharmacokinetics

Saboda jinkirin ƙaddamar da amitriptyline daga capsules na aikin, ƙwaƙƙwaran ƙwayar plasma yana ƙaruwa da azumi,

wannan matsakaicin maida hankali shine kusan 50% idan aka kwatanta da Allunan tare da fitarwa nan take. Matsakaicin mafi girman hankali a cikin jini na jini (T_tah) an kai shi cikin awa 4.

Bioavailability na baka: kusan 48%. Nortriptyline wanda aka kirkira a yayin aikin metabolism shima yana da tasirin antidepressant.

Apparentararrawar bayyananniyar rarrabawa shine kusan 14 l / kg. Matsakaicin ɗaukar nauyin sunadaran plasma kusan 95%.

Amitriptyline da northriptyline sun haye shingen placental.

Hanyar metabolism na amitriptyline ana aiwatar dashi musamman saboda demethylation (isoenzymes CYP2D19, CYP3A) da hydroxylation (isoenzyme CYP2D6), tare da haɗuwa da glucuronic acid. Ana amfani da kwayoyin ma'adinin ta hanyar mahimmancin ƙwayoyin halittar jini. Babban metabolite mai aiki shine amine na biyu - northriptyline. Abubuwan metabolites cis-da trans-10-hydroxyamitriptyline da cis- da trans-10-hydroxynortriptyline suna sanannu da bayanin ayyukan iri ɗaya zuwa ga Northriptyline, kodayake tasirin su yana da ƙarancin sanarwa. Demethylnortriptyline da amitriptyline-I-oxide suna nan a cikin plasma a cikin sakaci mai sakaci, ma'adinin na ƙarshe ba shi da kusanci da aikin magunguna. Idan aka kwatanta da amitriptyline, duk metabolites suna da tasirin m-anticholinergic mai mahimmanci.

Rabin rayuwar amitriptyline kusan awanni 16 (± 6) ne. Rabin rayuwar waqe-waqe kusan 31 (± 13) ne. Matsakaicin cikakken amitriptyline shine 0.9 l / min.

Ana cire shi da kodan. Ba canzawa, kimanin 2% na yarda da amitriptyline an keɓe.

Amitriptyline da northriptyline an kebe su cikin madara. Matsakaicin taro a cikin madara nono da jini na jini shine kusan 1: 1.

An daidaita yawan ƙwayoyin cutar plasma na amitriptyline da northriptyline a cikin mafi yawan marasa lafiya a cikin kwanakin 7-10. Lokacin amfani da kabilu masu tsawan-fito da maraice, maida hankali ga amitriptyline ya kai matsayin mafi girman darajarsa a cikin dare kuma yana raguwa a cikin rana, yayin da maida hankali akan northriptyline ya kasance tsayayye yayin rana.

Jimlar maganin plasma mai kwantar da hankali na amitriptyline da northriptyline a cikin magance rashin damuwa shine 370-925 nmol / L (100-250 ng / ml). Taro yana sama da 300-400 ng / ml an danganta shi da haɓakar haɗarin rikicewar zuciya da faruwar tashin AV da fadada QRS

Marasa lafiya tare da nakasa aiki na renal

Renarancin aikin na yara mai lalacewa baya tasiri a kan magunguna, ko zubar da jini ko kuma a arewa, duk da haka, hawan metabolites yana yin saurin sauka.

Marasa lafiya tare da nakasa aikin hanta

Liverarancin hanta mara nauyi na iya rage haɓaka ƙwayoyin magungunan ƙwayoyin cuta na tricyclic antidepressants. .

Bayanai na Tsare na Haraji

Magungunan rigakafin cutar Tricyclic suna da mummunan guba.

Karatuttuka masu guba sun nuna cewa mummunan hadarin amitriptyline a cikin takaddar sakin tsari yana da matukar raguwa idan aka kwatanta da kashi daya na amitriptyline tare da sakin nan take.

Fiye da shekaru 40 lokacin da aka yi amfani da shi yayin daukar ciki, ba a ba da rahoton matsalar haihuwa ko lahanin haihuwar ba.

Alamu don amfani

Rashin damuwa (musamman tare da damuwa, tashin hankali da hargitsi na bacci, ciki har da lokacin ƙuruciya, endogenous, yarda, sakewa, neurotic, miyagun ƙwayoyi, tare da raunuka na kwayoyin, cirewar barasa), psychotic schizophrenic, rikicewar motsin rai, halin halayyar (aiki) rikicewa. da hankali), nocturnal enuresis (ban da marasa lafiya da ciwon mafitsara), bulimia nervosa, ciwo mai raunin ciwo (mara ciwo a cikin marasa lafiya na kansa, migraine, cututtukan rheumatic, zafi na rashin lafiya a yankin da mutane, postherpetic neuralgia, post-traumatic neuropathy, diabetic or other na gefe neuropathy), ciwon kai, migraine (rigakafin), peptic ulcer da 12 duodenal ulcer.

Contraindications

Hypersensitivity, amfani tare da masu hana MAO da makonni 2 kafin farawar jijiyoyin cuta, myocardial infarction (m da sub sub lokaci), m barasa maye, m maye tare da kwayoyin hana barci, analgesic da psychoactive kwayoyi, kusurwa rufewa glaucoma, tsananin takewar AV da intraventricular hanya (toshewa) Gisa, AV block II mataki), lactation, shekarun yara (har zuwa shekaru 6 - nau'i na baka, har zuwa shekaru 12 tare da i / m da iv) .C Tsanantawa. Cututtukan shan ƙwayoyi, asma, damuwa na mutum, damuwa daga damuwa, cututtukan CVD (angina pectoris, arrhythmia, toshewar zuciya, CHF, hauhawar jini na mahaifa, hauhawar jijiyoyin jini), bugun jini, raguwar aikin motsi na ciki (rage haɗarin ƙwayar jijiyoyin ciki na ciki), , hanta da / ko gazawar koda, thyrotoxicosis, prostatic hyperplasia, riƙewar urinary, hypotension, schizophrenia (psychosis na iya kunnawa), amai, ciki (musamman ma na watanni uku), tsufa.

Yadda ake amfani: sashi da hanya na jiyya

A ciki, ba tare da tauna ba, nan da nan bayan cin abinci (don rage haushi na mucosa na ciki). Maganin farko na manya shine 25-50 mg da daddare, sannan ana karuwa da kashi a cikin kwanaki 5-6 zuwa 150-200 mg / rana a cikin allurai 3 (ana daukar mafi girman kashi a cikin dare). Idan babu ci gaba a cikin makonni biyu, ana ƙaruwa da kullun zuwa 300 MG. Idan alamun ɓacin rai sun shuɗe, an rage kashi zuwa 50-100 mg / rana kuma ana ci gaba da warkarwa don akalla watanni 3. A cikin tsufa, tare da rikice-rikice masu laushi, ana sanya kashi 30-100 mg / rana (da dare), bayan sun isa tasirin warkewa, suna canzawa zuwa mafi ƙarancin tasiri - 25-50 mg / day.

Intramuscularly ko iv (allura a hankali) a kashi na 20-40 MG sau 4 a rana, a hankali yana maye gurbin maye. Tsawon lokacin jiyya bai wuce watanni 6-8 ba.

Tare da nocturnal enuresis a cikin yara 6-10 shekara - 10-20 mg / rana da dare, shekaru 11-16 - 25-50 mg / rana.

Yara a matsayin maganin antidepressant: daga 6 zuwa 12 shekara - 10-30 mg ko 1-5 mg / kg / day fractionally, a cikin balaga - 10 MG sau 3 a rana (idan ya cancanta, har zuwa 100 mg / rana).

Don rigakafin cututtukan migraine, tare da raɗaɗin raunin yanayin yanayin neurogenic (gami da ciwon kai mai tsawo) - daga 12.5-25 zuwa 100 MG / rana (ana ɗaukar adadin mafi yawa da daddare).

Side effects

Anticholinergic effects: blurred hangen nesa, paralysis of accommodation, mydriasis, ƙara matsa lamba cikin jijiya (kawai a cikin mutane tare da yanayin anatomical predisposition - wani kunkuntar kusurwa na farjin ɗaki), tachycardia, bushe bakin, rikicewa, delirium ko hallucinations, maƙarƙashiya, paralytic hanji toshewa, wahalar urinating rage gumi.

Daga tsarin mai juyayi: nutsuwa, asthenia, fainting, tashin hankali, disorientation, hallucinations (musamman a cikin tsofaffi marasa lafiya da marasa lafiya da cutar ta Parkinson), damuwa, tashin hankali, tashin hankali, yanayin damuwa, yanayin manic, yanayin mamayewa, tashin hankali, rashin ƙwaƙwalwar ƙwaƙwalwa, ɓatarwa , ƙaruwar baƙin ciki, rage ƙarfin hankali, rashin bacci, mafarkai "mafarki mai ban tsoro", rawar jiki, asthenia, kunna alamun bayyanar cutar psychosis, ciwon kai, myoclonus, dysarthria, rawar jiki Fir tsokoki, musamman da makamai, hannuwa, shugaban da kuma harshe, gefe neuropathy (paresthesia), myasthenia gravis, myoclonus, ataxia, extrapyramidal ciwo, hanzari da kuma intensification na seizures, EEG canjãwa.

Daga gefen CCC: tachycardia, palpitations, dizziness, orthostatic hypotension, rashin canje-canje ECG (rashin matsakaici na ST ko T Tushe) a cikin marasa lafiya ba tare da cututtukan zuciya ba, arrhythmia, lability na jini (ragewa ko haɓaka haɓakar jini), rikicewar ƙwayar jijiya QRS, canje-canje a cikin tazara na PQ, toshewar ɓoyayyen ɓoyayyensa).

Daga tsarin narkewa: tashin zuciya, da wuya hepatitis (ciki har da aikin hanta mai narkewa da cholestatic jaundice), ƙwannafi, amai, gastralgia, ƙaruwar ci da hauhawar jiki ko rage abinci da hauhawar jiki, stomatitis, canjin ɗanɗano, zawo, baƙin duhu.

Daga tsarin endocrine: karuwa a cikin girman (edema) na testicles, gynecomastia, karuwa a cikin girman mammary gland, galactorrhea, raguwa ko karuwa a libido, raguwa a cikin ikon, hypo- ko hyperglycemia, hyponatremia (raguwa a cikin samar da vasopressin), da cutar rashin daidaituwa.

Daga gabobin hemopoietic: agranulocytosis, leukopenia, thrombocytopenia, purpura, eosinophilia.

Allergic halayen: fatar fata, itching na fata, urticaria, daukar hoto, kumburi da fuska da harshe.

Sauran: asarar gashi, tinnitus, edema, hyperpyrexia, kumburi kumburi, riƙewar urinary, pollakiuria, hypoproteinemia.

Drawararrun bayyanar cututtuka: tare da sokewa kwatsam bayan magani na dogon lokaci - tashin zuciya, amai, gudawa, zazzabi, zazzabi, damuwa, bacci, baƙon abu, tare da sokewa bayan tsawaita magani - tashin hankali, damuwa mai hawa, hargitsin bacci, mafarkai da ba a sani ba.

Ba a kafa dangantakar da ke tattare da kula da magunguna ba: cutar lupus-like syndrome (arthritis na ƙaura, bayyanar cututtukan ƙwayoyin cuta da ingantaccen ƙwaƙwalwar rheumatoid), ƙarancin aiki na hanta, tsufa.

Abubuwan da suka shafi gida don gudanarwa na iv: thrombophlebitis, lymphangitis, ƙonewa mai ƙonewa, halayen fata na rashin lafiyan. Kwayar cutar Daga gefen tsarin juyayi na tsakiya: nutsuwa, wawanci, coma, ataxia, hallucinations, tashin hankali, tashin hankali na psychomotor, rage karfin hankali, rarrabuwa, rikicewa, dysarthria, hyperreflexia, tsaurin tsoka, choreoathetosis, cututtukan cututtukan zuciya.

Daga CCC: rage karfin jini, tachycardia, arrhythmia, rauni intracardiac, canje-canjen ECG (musamman QRS), girgiza, bugun zuciya, halayyar shaye-shayen cututtukan cututtukan cututtukan jini, girgiza, gazawar zuciya a lokuta masu wuya.

Sauran: rashin lafiyar numfashi, gajeriyar numfashi, cyanosis, amai, hauhawar jini, mydriasis, haɓaka mai ɗaci, oliguria ko anuria.

Bayyanar cututtuka na haɓaka sa'o'i 4 bayan yawan zubar da jini, ya kai mafi girma bayan sa'o'i 24 da kwanakin 4-6. Idan ana zargin yawan wuce gona da iri, musamman a yara, ya kamata a kwantar da maraice a asibiti.

Jiyya: tare da gudanarwa na baka: lavage na ciki, gudanar da gawayi na aiki, maganin alamomi da tallafi, tare da mummunan tasirin cutar anticholinergic (raguwar jini, arrhythmias, coma, myoclonic epileptic seizures) - gabatarwar cholinesterase inhibitors (physostigmine ba a ba da shawarar ba saboda karuwar haɗarin kamawa ), tsayar da hawan jini da ma'aunin ruwa. Ana nuna ikon sarrafa ayyukan CCC (gami da ECG) na tsawon kwanaki 5 (sake dawowa na iya faruwa a cikin awanni 48 ko kuma daga baya), maganin cututtukan anticonvulsant, iska mai motsa jiki, da sauran matakan sake farfadowa. Hemodialysis da tilasta diuresis basu da tasiri.

Umarni na musamman

Kafin fara magani, kulawar hawan jini ya zama dole (a cikin marasa lafiya da ke da karancin jini ko labile zai iya raguwa sosai), a lokacin aikin jiyya, yanayin kulawa na cikin gida (a wasu lokuta, agranulocytosis na iya haɓaka, sabili da haka ana bada shawara don saka hoton hoton jini, musamman tare da increasedara yawan zafin jiki, haɓaka cututtukan alamomi kamar alamomin cututtukan fata da ciwon makogwaro), tare da tsawan magani - kula da ayyukan CVS da hanta. A cikin tsofaffi da marasa lafiya da cututtukan CCC, iko da ƙimar zuciya, hawan jini, an nuna ECG. Canje-canje marasa mahimmanci na asibiti na iya faruwa akan ECG (smoothing of the T wave, bacin rai na S-T, faɗaɗa hadaddun QRS).

Yin amfani da Parenteral zai yiwu ne kawai a asibiti, karkashin kulawar likita, tare da hutawa a cikin kwanakin farko na maganin.

Ana buƙatar taka tsantsan lokacin da zai matsa zuwa wani wuri a tsaye daga wuri na kwance ko zaune.

Yayin jiyya, ya kamata a cire ethanol.

Sanya ba a cikin kwanaki sama da 14 ba bayan cirewar masu hana MAO, fara da kananan allurai.

Tare da dakatar da kulawa na kwatsam bayan jiyya na tsawan lokaci, haɓakar cutar "cirewa" mai yiwuwa ne.

Amitriptyline a allurai sama da 150 MG / rana yana rage bakin kofa don aiki mai tsauri (hadarin kamuwa da cuta a cikin marassa lafiyar, da kuma a gaban wasu, yakamata a yi la’akari da shiabubuwan da ke haifar da fargaba kan abin da ya faru na rashin damuwa, alal misali, raunin kwakwalwa na kowane etiology, amfani da magungunan antipsychotic (antipsychotics) lokaci guda, lokacin ƙi ethanol ko karɓar magunguna waɗanda ke da kaddarorin asirin, kamar benzodiazepines).

Ana nuna mummunar ɓacin rai a cikin haɗarin ayyukan kashe kansa, wanda zai iya dagewa har sai an sami gagarumin gafartawa. Dangane da wannan, a farkon magani, ana iya nuna haɗuwa tare da kwayoyi daga ƙungiyar benzodiazepine ko magungunan antipsychotic da kulawar likita na yau da kullun (koya wa amintattun jami'ai don adanawa da fitar da kwayoyi).

A cikin marasa lafiya da ke haifar da rikice-rikicen cyclic, a lokacin lokacin damuwa, yanayin manic ko hypomanic na iya haɓakawa yayin aikin jiyya (rage kashi ko karɓar magani da kuma sayan magungunan antipsychotic ya zama dole). Bayan dakatar da waɗannan yanayin, idan akwai alamun, ana iya sake farawa a cikin allurai kaɗan.

Saboda yiwuwar tasirin cututtukan zuciya, ana buƙatar taka tsantsan lokacin kula da marasa lafiya na thyrotoxicosis ko marasa lafiya da ke karbar shirye-shiryen hodar iblis.

A hade tare da warkaswa na lantarki, an wajabta shi ne kawai tare da kulawa da kulawa da hankali.

A cikin marasa lafiya da aka riga aka tsara da kuma marasa lafiya tsofaffi, zai iya tayar da haɓakar ƙwaƙwalwar ƙwayar cuta, galibi da dare (bayan katse magungunan, sun ɓace a cikin 'yan kwanaki).

Zai iya haifar da raunin hanji, musamman a cikin marasa lafiya da ke fama da maƙarƙashiya, tsofaffi ko kuma a cikin marasa lafiya waɗanda aka tilasta su kula da hutawa na gado.

Kafin gudanar da maganin kashe maganin janar ko na gida, yakamata a gargadi likitan likitan dabbobi da cewa mai haƙuri yana ɗaukar amitriptyline.

Sakamakon aikin maganin anticholinergic, raguwa a cikin lacrimation da dangi na karuwa a cikin adadin gamsai a cikin haɗarin ƙwayar lacrimal yana yiwuwa, wanda zai iya haifar da lalacewar epithelium na mahaifa a cikin marasa lafiya ta amfani da ruwan tabarau na tuntuɓar.

Tare da yin amfani da tsawan lokaci, ana ƙaruwa da haɓakar abin da ke faruwa na likitan hakori. Mayarin buƙatar riboflavin na iya ƙaruwa.

Binciken nazarin halittar dabbobi ya nuna mummunar illa ga tayin, kuma ba a gudanar da nazarin ingantaccen nazari a cikin mata masu ciki. A cikin mata masu juna biyu, yakamata a yi amfani da magani idan amfanin da aka yi niyya ga mahaifiya ya fi ƙarfin haɗarin tayin.

Tana shiga cikin nono mai iya haifar da nutsuwa a cikin jarirai.

Don guje wa ci gaba da ciwo na "cirewa" a cikin jarirai (wanda aka nuna ta ƙarancin numfashi, amai, ciwon hanji, haɓakar jijiyoyin jiki, hauhawar jini ko hauhawar jini, rawar jiki ko firgici), a hankali ana soke amitriptyline aƙalla 7 makonni kafin haihuwar da ake tsammanin.

Yara sun fi kula da yawan ƙwayar cuta, wanda ya kamata a yi la’akari da haɗari da haɗari mai mahimmanci a gare su.

A lokacin jiyya, dole ne a kula sosai lokacin tuki motoci da shiga wasu ayyukan masu haɗari waɗanda ke buƙatar haɓakar jawo hankali da saurin halayen psychomotor.

Haɗa kai

Tare da haɗakar amfani da ethanol da kwayoyi waɗanda ke damun tsarin juyayi na tsakiya (ciki har da sauran magungunan antidepressants, barbiturates, benzadiazepines da maganin rashin lafiya na gaba ɗaya), haɓaka mai mahimmanci a cikin sakamako mai hanawa a cikin tsarin juyayi na tsakiya, raunin numfashi da tasirin hypotensive yana yiwuwa.

Sensara haɓaka ga shaye-shayen da ke ɗauke da ethanol.

Effectara tasirin magungunan anticholinergic na kwayoyi tare da aikin anticholinergic (alal misali, phenothiazines, magungunan antiparkinsonian, amantadine, atropine, biperidene, antihistamines), wanda ke kara haɗarin tasirin sakamako (daga tsarin juyayi na tsakiya, hangen nesa, hanji da mafitsara).

Lokacin da aka haɗu tare da antihistamines, clonidine, haɓaka sakamako mai hanawa akan tsarin jijiyoyi na tsakiya, tare da atropine, yana ƙara haɗarin ciwon sikila, da kwayoyi waɗanda ke haifar da ƙarin halayen extrapyramidal suna ƙaruwa tsananin da kuma tasirin tasirin extrapyramidal.

Tare da yin amfani da amitriptyline da anticoagulants na lokaci guda (coumarin ko abubuwan indadione), haɓaka ayyukan anticoagulant na ƙarshen yana yiwuwa.

Amitriptyline na iya ƙaruwa da baƙin ciki wanda ya haifar da corticosteroids.

Lokacin da aka haɗu tare da magungunan anticonvulsant, yana yiwuwa a ƙara tasirin hana ƙwaƙwalwa a kan tsarin juyayi na tsakiya, rage ƙararrawa don ayyukan motsa jiki (lokacin da ake amfani da shi a cikin manyan allurai) da rage tasiri na ƙarshen.

Magunguna don maganin thyrotoxicosis suna ƙara haɗarin agranulocytosis.

Rage tasiri na phenytoin da alpha-blockers.

Masu hana microidal oxidation (cimetidine) tsawan T1 / 2, haɓaka haɗarin haɗarin cutarwa na amitriptyline (ana iya buƙatar rage kashi 20-30%), masu haifar da enzymes na microsomal (barbiturates, carbamazepine, phenytoin, nicotine da maganin hana cin hanci) rage ƙwayoyin plasma da rage tasiri na amitriptyline.

Fluoxetine da fluvoxamine suna ƙara yawan haɗuwar amitriptyline a cikin plasma (ana iya buƙatar rage amitriptyline da kashi 50%).

Lokacin da aka haɗu tare da anticholinergics, phenothiazines da benzodiazepines - haɗin gwiwa na ƙarfafa jijiyoyi da tasirin anticholinergic na tsakiya da haɓaka haɗarin kamuwa da cuta (gurɓata ƙarshen ayyukan hanzari), phenothiazines, a Bugu da kari, na iya ƙara haɗarin cutar cututtukan zuciya.

Tare da amfani da amitriptyline lokaci guda tare da clonidine, guanethidine, betanidine, reserpine da methyldopa - raguwa a cikin tasirin sakamako na ƙarshen, tare da cocaine - haɗarin matsalar arrhythmias.

Magungunan hana daukar ciki na kwayar cutar kwayar roba da estrogens na iya haɓaka bioavailability na amitriptyline, magungunan antiarrhythmic (kamar quinidine) suna ƙara haɗarin rikicewar rudani (mai yiwuwa rage jigilar metabolism na amitriptyline).

Yin amfani da haɗin gwiwa tare da disulfiram da sauran masu hana acetaldehydrogenase suna haifar da tashin hankali.

Rashin daidaituwa tare da masu hana MAO (yiwuwar karuwa a cikin yawan lokutan hyperpyrexia, tsauraran raɗaɗi, rikicewar hauhawar jini da mutuwar haƙuri).

Pimozide da probucol na iya haɓaka arrhythmias na zuciya, wanda aka bayyana a tsawance Tsarin Q-T akan ECG.

Yana haɓaka tasirin a kan cutar epilephrine, norepinephrine, isoprenaline, ephedrine da phenylephrine akan CVS (gami da lokacin da waɗannan magungunan sun kasance ɓangare na rashin lafiyar gida) da haɓaka haɗarin rikicewar bugun zuciya, tachycardia, da hauhawar jijiya mai ƙarfi.

Lokacin amfani da haɗin gwiwa tare da alpha-adrenostimulants don gudanarwar intranasal ko don amfani da ophthalmology (tare da ɗaukar hoto mai mahimmanci), tasirin vasoconstrictor na ƙarshen na iya ƙaruwa.

Lokacin da aka haɗu tare da ƙwayar thyroid - haɓaka haɗin gwiwa game da tasirin warkewa da tasirin mai guba (sun haɗa da cututtukan zuciya da sakamako mai ƙarfafawa a cikin tsarin juyayi na tsakiya).

M-anticholinergics da magungunan antipsychotic (antipsychotics) suna ƙaruwa da haɗarin hyperpyrexia (musamman a cikin yanayin zafi).

Tare da alƙawarin haɗin gwiwa tare da wasu magungunan hematotoxic, haɓakawa na hematotoxicity yana yiwuwa.

Saroten Retard (Saroten Retard) - sakin sakin, tsari da shirya shi

Capsules na tsawaita aiki sune gelatin mai wuya, girman No. 2, opaque, tare da jiki da murfi mai launin ja-ruwan kasa, abubuwan da ke cikin kwalliyar sune fulats daga kusan fari zuwa launin rawaya.

Kafa 1. amitriptyline hydrochloride 56.55 MG, wanda ya dace da abun da amitriptyline 50 MG.

Mahalarta: hatsi sukari (sukari), stearic acid, shellac (mara shellac), sitc, povidone.

Abun da keɓaɓɓen kwaskwaridi: gelatin, baƙin ƙarfe mai narkewar jan ƙarfe (E172), titanium dioxide (E171).

Saroten Retard (Saroten Retard) - kantin magani

Ingancin bioavailability na amitriptyline shine kusan 60%. Tabbatar da furotin na Plasma kusan kashi 95%. Mayar da hankali na amitriptyline a cikin jijiyar jini ya kai matsayin mafi ƙima a hankali fiye da ɗaukar Saroten a cikin allunan, bayan awoyi 4-10, bayan wannan, duk da haka, yana da kwanciyar hankali na dogon lokaci.

A daidai allurai, matsakaicin dabi'u na maida hankali a cikin ƙwayar plasma sun kasance ƙasa yayin ɗaukar capsules, wanda ke hade da ƙananan sakamako na zuciya na Saroten Retard.

Amitriptyline metabolism ana aiwatar dashi ta hanyar demethylation da hydroxylation. Nortriptyline an dauki babban metabolite na amitriptyline. T1 / 2 na amitriptyline aƙalla 25 na sa'o'i 25 (awanni 16-40), T1 / 2 na northriptyline - kimanin awanni 27. An kafa Css bayan makonni 1-2. Amitriptyline an kebe shi musamman tare da fitsari kuma, a wani ɓangare, tare da feces. Amitriptyline da northriptyline sun haye shingen placental kuma a cikin adadi kaɗan an keɓance su cikin madara.

Alamu don amfani da miyagun ƙwayoyi

Damuwa, musamman tare da damuwa, tashin hankali, da damuwa a cikin bacci:

• lura da endogenous depressions na mono- da bipolar nau'in, yarda, masked da kuma menopausal depressions,
• dysphoria da buguwa,
• reactive ciki
• rashin damuwa neurosis
• lura da rashin lafiyar schizophrenic (a hade tare da cututtukan zuciya),
• raunin azaba.

Saroten Retard (Saroten Retard) - tsarin sashi

Lokacin ɗaukar capsules na Saroten Retard, an ba shi shawarar sha shi da ruwa. Capsules, duk da haka, za'a iya buɗewa kuma abubuwan da ke ciki (granules) ana iya ɗauka ta baka da ruwa. An hana Granules tauna.

Don magance ciwon ciki, an wajabta shi 1 sau / awa 3-4 kafin lokacin bacci a allurai wanda yake daidai da 2/3 na yawan maganin Saroten a cikin allunan.

Ya kamata tsofaffi su fara jiyya tare da Saroten Retard tare da capsule 50 MG da yamma. Idan ya cancanta, bayan makonni 1-2, za a iya ƙara yawan suturar yau da kullun zuwa 2-3 capsules da yamma (100-150 mg). Bayan cimma nasarar ci gaba, ana iya rage sashi na yau da kullun zuwa mafi ƙarancin tasiri, sau da yawa har zuwa capsules 1-2 (50-100 mg /). A cikin magance rashin jin daɗi, ana ba da shawarar ci gaba da amfani da maganin ɓarna, ciki har da Saroten Retard, bayan cimma sakamako mai faɗi don wani watanni 4-6. A cikin allurai na kulawa waɗanda ke da tasirin dawo da cutar, ana iya ɗaukar Saroten Retard na dogon lokaci, har zuwa shekaru da yawa.

Ya kamata tsofaffi su fara jiyya tare da Saroten tare da allunan - 30 mg / (3 zuwa 10 mg). A cikin 'yan kwanaki, zai yuwu canzawa zuwa ɗaukar kayatattun capsules na Saroten. Maganin yau da kullun shine capsules 1-2 (50-100 mg), wanda aka dauka da maraice.

A cikin raunin raunin da ya shafi tsofaffi, yawan maganin yau da kullun shine 1-2 capsules (50-100 mg), wanda aka ɗauka da maraice. Yana yiwuwa a fara jiyya tare da ɗaukar Saroten a cikin allunan 25 MG sau ɗaya da maraice.

Abubuwa masu illa da ke tattare da tasirin cutar anticholinergic: bushewa da / ko ɗanɗano mai ɗaci a cikin bakin, tashin zuciya, amai, stomatitis, da wuya - cholestatic jaundice, hangen nesa, haɓaka ƙwayar jijiyoyin ciki, tachycardia, maƙarƙashiya, yawanci sau da yawa - riƙewar urinary. Yawancin lokaci suna bayyana a farkon magani, to, akasarinsu, raguwa.

• Daga gefen tsarin zuciya: tachycardia, arrhythmias, orthostatic hypotension, rikicewar ƙwayar intracardiac, an yi rikodin kawai akan ECG, amma ba bayyananne ba a asibiti.
• Daga gefen tsarin juyayi na tsakiya: nutsuwa, rauni, rashi mai yawa, ciwon kai, farin ciki. Wadannan rikice-rikice, sau da yawa waɗanda ke faruwa a farkon maganin amitriptyline, suna raguwa yayin jiyya. Commonlyarancin yau da kullun, musamman idan aka yi amfani da babban matakin farko, rashin tsoro, tashin hankali, rikicewa, tashin hankali, abubuwan tunani, rikicewar cuta, tashin hankali da cramps na iya faruwa, da wuya damuwa.

Allergic halayen: fatar fata, itching yiwuwa.

Sauran: tashin zuciya, zufa, hauhawar nauyi, rage libido na iya faruwa.

Contraindications

• kwanannan rashin samun cikas,
• bugun zuciya
• m guba da barasa, barbiturates ko opiates,
• kusantar kusa da kusurwa
• yi amfani tare da masu hana MAO har zuwa makonni 2 bayan sun dawo,
• rashin hankali ga amitriptyline.

Saroten Retard - Umarnin Na Musamman

Ya kamata a tsara Saroten Retard tare da taka tsantsan ga marasa lafiya da ke fama da rikicewar ciki, riƙewar urinary, hauhawar prostate, hanta mai zafi ko cututtukan zuciya, da cututtukan zuciya.

Samun tasirin magani, zai iya shafar ikon sarrafa motar da sauran hanyoyin. Yakamata a gargadi marassa lafiya da ke shan Saroten Retard bayani game da wannan fannin maganin.

Saroten Retard - overdose

Kwayar cutar Tsanantawa ko tashin hankali na tsarin juyayi na tsakiya. Bayyanar bayyanar cututtukan anticholinergic (tachycardia, membranes na bushe, riƙewar urinary) da cututtukan zuciya (arrhythmias, hypotension artpot, bugun zuciya). Rashin rikicewar cuta. Hauhawar jini.

Jiyya. Anyi la'akari da Symptomatic. Dole ne a gudanar da shi a asibiti. Tare da gudanar da baka na amitriptyline, yakamata a yi layya da wuri-wuri kuma gawayi ya kamata a wajabta shi. Dole ne a dauki matakai don kula da tsarin numfashi da na zuciya da jijiyoyin jini. Kulawa da aikin zuciya cikin kwanaki 3-5 abun so ne. Bai kamata a rubuta allurar epinephrine (adrenaline) a cikin irin waɗannan halayen ba. Don rikicewar damuwa, ana iya amfani da diazepam.

Saroten Retard (Saroten Retard) - hulɗa da miyagun ƙwayoyi

Amitriptyline na iya haɓaka sakamakon ethanol, barbiturates da sauran abubuwa waɗanda ke lalata tsarin juyayi na tsakiya.

Yin amfani da haɗin gwiwa tare da masu hana MAO na iya haifar da rikici na hauhawar jini.

Tun da amitriptyline yana inganta tasirin maganin anticholinergics, ya kamata a guji kulawa ta lokaci guda tare da su.

Yana haɓaka tasirin abin juyayi na maganin juyawar ƙwayar epinephrine (adrenaline), norepinephrine (norepinephrine), sakamakon wannan, an hana amfani da magungunan cikin gida wanda ke ɗauke da waɗannan abubuwan a lokaci guda tare da amitriptyline.

Wataƙila rage tasirin rigakafi na clonidine, betanidine, da guanethidine.

Lokacin da aka rubuta shi tare da maganin rigakafin ƙwayoyin cuta, ya kamata a ɗauka a hankali cewa maganin tricyclic antidepressants da antipsychotics suna hana juna haɓakar metabolism, rage darajar bakin lokaci don ɗaukar hankali.

Tare da yin amfani da lokaci guda tare da cimetidine, raguwa a cikin metabolism na amitriptyline, haɓaka cikin haɗuwarsa a cikin jini jini da haɓaka tasirin mai guba.