Pentilin na miyagun ƙwayoyi: umarnin don amfani

A ciki, yayin ko bayan abinci, cinye duka, 400 MG 2-3 sau a rana, ba shakka - aƙalla makonni 8.

A ciki / a ciki ko a cikin: allura: 50-100 mg / day (a cikin ruwan gishiri) na mintuna 5. A / cikin ko a / cikin jiko: 100-400 mg / rana (a cikin saline na jiki), tsawon lokacin jiko na ciki - minti 90-180, a / a - 10-30 na minti, matsakaicin adadin yau da kullun na 800 da 1200 mg, bi da bi. Ci gaba da jiko - 0.6 mg / kg / h na tsawon awanni 24, matsakaicin adadin yau da kullun na 1200 MG.

Tare da Cl creatinine ƙasa da 10 ml / min, ana rage rage kashi 50 zuwa 70%. Ga marasa lafiya akan hemodialysis, magani yana farawa tare da kashi na 400 mg / rana, wanda aka haɓaka zuwa al'ada tare da tazara tsakanin akalla kwanaki 4.

Formaddamar da tsari da abun da ke ciki

• bayani don gudanarwa na ciki da wucin gadi: nuna gaskiya, mara launi ko dan rawaya mai launi (5 ml a cikin ampoules, ampoules 5 a cikin kumfar bakin ko keken filastik, 1 blister ko tire a cikin kwali na kwali),
• Allunan na tsawan mataki, fim mai rufi: m, biconvex, fararen (inji mai kwakwalwa 10. a cikin bororo, a cikin kwali kwali 2 blisters).

Abun hadewar 1 ampoule na maganin Pentilin (5 ml):

• abu mai aiki: pentoxifylline - 100 MG,
• ƙarin abubuwan da aka gyara: sodium hydrogen phosphate dihydrate, sodium dihydrogen foshate dihydrate, sodium chloride, disodium edetate, ruwa don allura.

Abun ciki na 1 kwamfutar hannu Pentilin:

• abu mai aiki: pentoxifylline - 400 MG,
• ƙarin abubuwan da aka gyara: magnesium stearate, hypromellose, macrogol 6000, silicon dioxide anhydrous colloidal,
• harsashi: hypromellose, macrogol 6000, talc, titanium dioxide E171.

Pharmacodynamics

Pentoxifylline - abu mai aiki na Pentilin - maganin antispasmodic daga rukunin purine wanda ke haɓaka ƙirar rheological (rashin ruwa) da microcirculation jini. Hanyar aiwatar da miyagun ƙwayoyi shine saboda ikonta na hana phosphodiesterase da haɓaka taro na AMP a cikin platelet da ATP a cikin ƙwayoyin jan jini, yayin da za a sami ƙarfin makamashi, sakamakon wanda vasodilation ke tasowa, jigilar ƙwayar jijiyoyin jiki yana raguwa, bugun bugun jini na gaba yana raguwa, bugun jini da ƙarancin minti na jini yana ƙaruwa, yayin da ƙwanƙwasa zuciyar ba ta da muhimmanci yana canzawa.

Pentoxifylline yana diba da jijiyoyin zuciya, wanda ke kara isar da iskar oxygen zuwa myocardium (sakamako na antianginal), da jijiyoyin jini na huhu, wanda ke inganta oxygenation na jini.

A miyagun ƙwayoyi na kara sautin na tsokoki na numfashi, musamman diaphragm da tsokoki na ciki.

Yana inganta microcirculation na jini a cikin wurare masu rauni na jijiyoyin jiki, yana haɓaka haɓakar ƙwayar ƙwayar erythrocyte, yana rage danko jini.

Tare da mummunan tashin hankali na jijiyoyin mahaifa (bayyana tsinkaye), Pentilin yana tsawaita hanyar tafiya, yana kawar da jijiyoyin wuya na maraƙi da zafi a hutawa.

Pharmacokinetics

Pentoxifylline yana haɗuwa sosai a cikin ƙwayoyin jini da hanta. Bayan gudanar da baki, an kusan tunawa da shi daga hancin gastrointestinal. Tsarin foda na tsawanta yana samar da ci gaba da sakin abubuwan da ke tattare da ƙwayoyi da kuma ɗaukar sutturar ta.

Pentoxifylline ya shawo kan hanyar farko ta hanta, sakamakon haifar da babban aiki biyu na pharmacologically metabolites: 1-3-carboxypropyl-3,7-dimethylxanthine (metabolite V) da 1-5-hydroxyhexyl-3,7-dimethylxanthine (metabolite I), plasma maida hankali wanda shine 8 da 5 sau mafi girman pentoxifylline, bi da bi.

Pentoxifylline da metabolites dinsa basa ɗaukar sunadaran plasma.

A miyagun ƙwayoyi a cikin tsawan tsari ya kai matsakaicin taro a cikin awanni 2-4. An rarraba shi daidai. Cire rabin rayuwar shine awa 0.5-1.5.

Rabin rayuwar pentoxifylline bayan kashi na 100 na kwayar cuta shine kimanin awa 1.1. Yana da babban adadin rarraba (bayan jinkiri na mintina 30 na 200 MG - 168 L), kazalika da tsabtatawa mai yawa (4500-5100 ml / min).

Kashi 94% na kashin da aka karɓa shine kodan ya bankare ta hanyar metabolites (galibi metabolite V), kusan 4% - ta hanji. A wannan yanayin, har zuwa 90% na kashi an cire shi a cikin farkon 4 hours. Rashin metabolites yana rage gudu a cikin marasa lafiya tare da raunin ƙwayar cuta mai girma. Idan akwai aiki na hanta mai lalacewa, rabin rayuwar pentoxifylline yana da tsawo kuma bioavinta yana ƙaruwa.

Pentoxifylline an keɓe shi a cikin madara.

Alamu don amfani

• ji rauni na jijiyoyin bugun jini,
• na kullum, da kuma kasala mai rarrafewar jini a cikin retina da choroid,
• najasasshen ƙwayar cuta na asali na ischemic,
• kauda endarteritis,
• rikicewar wurare na gefe saboda cututtukan atherosclerosis, ciwon sukari mellitus (ciwon sukari na angellathy),
• ciwon zuciya (paresthesia, cutar Raynaud),
• cututtukan fata trophic nama saboda raunin jijiyoyin jiki ko microcirculation na jijiya (frostbite, post-thrombophlebitis syndrome, trophic ulcers, gangrene),
• discirculatory da atherosclerotic encephalopathies.

Contraindications

• basur,
• bashin ciki,
• babban zub da jini
• m cutar basur,
• mai zafi arrhythmias,
• sarrafa jini,
• m yawaitar infarction,
• mai rauni atherosclerotic raunuka na cututtukan zuciya da jijiyoyin jini,
• porfria
• ciki, lactation,
• shekaru zuwa shekaru 18
• hypersensitivity ga abubuwan Pentilin ko wasu methylxanthines.

• jijiyoyin jini,
• na kullum zuciya
• aikin lalacewa mara kyau (keɓantaccen ɗaukar hoto a ƙasa 30 ml / min),
• mai lalata hanta,
• tendencyarin haɓakar zub da jini, gami da amfani da maganin tsufa, rikicewar tsarin coagulation na jini, bayan da aka gudanar da ayyukan tiyata na kwanan nan,
• peptic ulcer na ciki da duodenum don Allunan.

Magani don allura

A cikin hanyar mafita, ana gudanar da Pentilin a cikin ciki ko a cikin intraarterially.

Likita ya kayyade hanyar gudanarwa da mafi kyawun magunguna ga kowane mara lafiya, gwargwadon tsananin matsalar cutar sankarau da kuma haƙurin mutum na pentoxifylline. Ana aiwatar da jiko na ciki a cikin matsayi na supine.

A matsayinka na mai mulki, ga marasa lafiyar manya, ana gudanar da maganin a cikin jika sau 2 a rana (safe da yamma), 200 mg (2 ampoules na 5 ml kowane) ko 300 mg (3 ampoules na 5 ml kowace) a cikin 250 ko 500 ml na 0.9% sodium chloride bayani ko maganin ringer. Dole ne a gwada karfin jituwa tare da sauran mafita na jiko dabam, amma bayyanannun hanyoyin kawai za a yi amfani da su.

Tsawon jiko na aƙalla minti 60 na adadin ƙwayar pentoxifylline 100 mg. Kwayoyin da aka shigar a ciki na iya raguwa a gaban cututtukan concomitant, alal misali, gazawar zuciya. A cikin irin waɗannan halayen, yana da daraja amfani da babban ɓoyayyen maraba don sarrafa jiko.

Bayan jiko na rana, idan ya cancanta, an tsara allunan 400 MG allunan a ƙari - 2 inji mai kwakwalwa. Idan an yi infusus guda biyu a tsaka-tsakin lokaci, to za a iya ɗaukar kwamfutar hannu 1 da wuri (da misalin ƙarfe 12 na yamma).

A cikin yanayin inda jiko na ciki saboda yanayin asibiti za'a iya aiwatar da su sau ɗaya kawai a rana, ƙarin gudanar da Pentilin a cikin allunan a cikin adadin inji 3 mai yiwuwa. (Allunan 2 a tsakar rana, 1 da yamma).

A cikin mawuyacin hali, alal misali, tare da gangrene, trophic ulcers na III - IV bisa ga rarrabuwa na Fontaine - Lerish - Pokrovsky, ciwo mai zafi a hutawa, an nuna tsayayyen gudanarwar magungunan ƙwayar cuta - na tsawon awanni 24.

Magungunan da aka ba da shawarar don sarrafawar ciki: a farkon jiyya - 100 MG na pentoxifylline a cikin 50-100 ml na 0.9% maganin sodium chloride, a kwanakin da ke gaba - 100-400 mg a cikin 50-100 ml na 0.9% maganin sodium chloride. Adadin gudanarwa shine 10 MG / minti, tsawon lokacin tafiyarwa shine minti 10-30.

A lokacin rana, zaku iya shigar da miyagun ƙwayoyi a cikin adadin har zuwa 1200 MG. A wannan yanayin, ana iya kirga adadin mutum gwargwadon tsari mai zuwa: 0.6 MG na pentoxifylline da kilogiram na nauyin jiki a awa daya. Don haka, kashi na yau da kullun zai zama 1000 MG don haƙuri tare da nauyin jiki na 70 kilogiram, 1150 MG don haƙuri tare da nauyin jikin 80 kg.

Marasa lafiya tare da gazawar koda, dangane da haƙurin mutum na miyagun ƙwayoyi, rage kashi ta 30-50%.

Hakanan ana buƙatar rage zafin jiki a cikin marasa lafiya da ke fama da rauni na hanta, yayin da ya kamata a yi la'akari da haƙurin mutum na Pentilin.

An ba da shawarar fara jiyya tare da ƙananan allurai tare da karuwa a hankali a cikin marasa lafiya da ƙarancin jini, kazalika a cikin marasa lafiya da ke haifar da rage karfin jini (alal misali, tare da mummunan cututtukan zuciya, hemodynamically gagarumin tsinkaye na tasoshin cerebral).

Ya kamata a sha allunan kwayar Pentilin 400 a baki, bayan cin abinci: haɗiye duka kuma sha ruwa mai yawa.

Yawan shawarar da aka bada shawarar shine kwamfutar hannu 1 2 ko sau 3 a rana. Karka wuce kashi biyu na rana na 1200 MG.

Marasa lafiya tare da gazawar na koda

Form sashi

400 MG allunan da aka rufe fim

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abu mai aiki - pentoxifylline 400 MG,

magabata: hypromellose, macrogol 6000, magnesium stearate, silicon dioxide colloidal anhydrous,

harsashi abun da ke ciki: hypromellose, macrogol 6000, titanium dioxide (E 171), talc.

Allunan mai siffa-mai launi tare da farfajiyar biconvex, mai rufi tare da farin fim ɗin fim

Kayan magunguna

Pharmacokinetics

Bayan gudanar da baki, pentoxifylline yana cikin sauri kuma yana ɗaukar hankali. Batun bioavailability na allunan pentoxifylline na tsawon lokaci shine kusan 20%. Cin abinci yana yin jinkiri, amma baya rage cikakkiyar ƙarfin sha na ƙwayoyi.

Matsakaicin yawan plasma yana faruwa ne a cikin awanni 2 zuwa 4. Pentoxifylline an cire shi a cikin madara, an gano shi a cikin sa'o'i 2 bayan gudanarwa, a duka - ba canzawa ba kuma a cikin hanyar metabolites.

Pentoxifylline yana metabolized a mafi yawan hanta a cikin hanta kuma zuwa ƙaramin matakin a cikin sel jini. Tana yin aiki da karfi a bayyane ta farko. Plasma yawaita na metabolites masu aiki sune 5 da 8 sau mafi girma daga maida hankali na pentoxifylline. Ana amfani dashi ta hanyar sarrafawa (ta hanyar α-keto reductase) da hadawan abu da iskar shaka.

Ana amfani da kwayar zarra a cikin fitsari (kusan kashi 95%). Kusan 4% na kashi da aka ɗauka an watsa shi ta hanyar feces. A cikin matsalar tabarbarewa na dan adam, an rage saurin narkewar metabolites. Tare da lalata cututtukan hepatic, rabin-rayuwa yana da tsawo kuma bioavailability yana ƙaruwa. A wannan batun, don guje wa tarawar ƙwayar cuta a jikin irin waɗannan masu haƙuri, ya kamata a rage kashi.

Pharmacodynamics

Pentoxifylline yana inganta halayen rheology na jini ta hanyar lalata nakuda na ƙwayoyin jini, yana hana haɗuwar platelet da rage haɓakar hauhawar jini. Hanyar aiwatar da pentoxifylline don inganta halayen rheological jini ya haɗa da haɓaka ƙwayoyin jan jini a cikin matakan ATP (adenosine triphosphate), cAMP (cyclo-adenosine monophosphate) da sauran cyclic nucleotides. Pentoxifylline yana rage ragewar wahalar jini da jini ta hanyar rage yawan zazzabin fibrinogen. Irin wannan raguwa a cikin ƙwayar fibrinogen shine sakamakon karuwa a cikin aikin fibrinolytic da raguwa a cikin aikin sa. Bugu da ƙari, ta hanyar hana enzymes membrane-daure phosphodiesterase (wanda ke haifar da karuwa a cikin ƙwaƙwalwar cAMP) da haɗin thromboxane, pentoxifylline mai ƙarfi yana hana haɗuwa da tilasta plateletcation kuma a lokaci guda yana ƙarfafa tsarin haɗin prostacyclin (prostaglandin I2).

Pentoxifylline yana rage yawan samar da interleukin a cikin monocytes da macrophages, wanda ke rage tsananin zafin kara kuzari. Pentoxifylline yana inganta yanayin jijiyoyin jini da haɓakar jini, yana ƙaruwa da matsin lamba na dogayen ƙwayar jijiyoyin jini a cikin tsokoki na ƙwanƙwashin cutar ischemic da ke gudana a cikin maɓallin cerebral cortex da ruwa na cerebrospinal, a cikin retinap na marasa lafiya tare da retinopathy.

Side effects

Wadannan sune maganganu masu illa da suka faru a lokacin gwaji na asibiti da kuma lokacin cinikin bayan-bayan.
Daga tsarin zuciya. Arrhythmia, tachycardia, angina pectoris, rage karfin jini, hauhawar jini.
Daga tsarin lymphatic da tsarin jini. Thrombocytopenia, thrombocytopenic purpura, aplastic anemia (bangare ko cikakkiyar dakatarwar samuwar dukkan sel jini), pancytopenia, wanda zai iya zama mai mutuwa.
Daga tsarin juyayi. Dizziness, ciwon kai, aseptic meningitis, rawar jiki, paresthesias, cramps.
Daga cikin hanji. Ciwan ciki, jiwar matsin lamba a ciki, rashin tsoro, tashin zuciya, amai, ko zawo.
A wani ɓangaren fata da ƙwayoyin subcutaneous. Itching, redness na fata da urticaria, guba mai narkewa mai narkewa da cutar Stevens-Johnson.
Take hakkin aiki na jijiyoyin jiki. Sensation na zafi (flailers mai zafi), zub da jini, guguwar gefe.
Daga tsarin rigakafi. Anafarin kwayoyin anaphylactic, halayen anaphylactoid, angioedema, bronchospasm da tashin hankali anaphylactic.
A wani ɓangaren hanta da kuma gall mafitsara. Maganin ƙwayar cutar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta.
Rashin hankali Bacin rai, tashin hankalin bacci, abubuwan shakatawa.
Daga gefen gabobin hangen nesa. Ragewar gani, conjunctivitis, basur, kashin baya.
Wasu. An ba da rahoton cututtukan hypoglycemia, gumi mai yawa, da zazzabi.

Ciki

Babu isasshen gogewa tare da miyagun ƙwayoyi Pentiline mata masu juna biyu. Sabili da haka, ba a ba da shawarar yin Pentilin a lokacin daukar ciki ba.
Pentoxifylline a cikin adadi kaɗan ya wuce zuwa cikin madara. Idan an yi Pentilin, a daina shayar da jarirai.

Yin hulɗa tare da wasu kwayoyi

Ana iya inganta tasirin rage yawan sukari na jini a cikin insulin ko na maganin antidi mai narkewa. Sabili da haka, ya kamata a kula da marasa lafiya waɗanda suke karɓar magani don ciwon sukari.
A cikin lokacin cinikin bayan, an ba da rahoton lokuta na ƙara yawan aikin anticoagulant a cikin marasa lafiya waɗanda aka bi da su tare da pentoxifylline da anti-bitamin K. Lokacin da aka tsara ko canza ƙwayar pentoxifylline, an bada shawara don saka idanu akan aikin anticoagulant a cikin wannan rukuni na marasa lafiya.
Pentiline na iya haɓaka tasirin sakamako na magungunan rigakafin jini da sauran magunguna, wanda zai haifar da raguwar hauhawar jini.
Yin amfani da pentoxifylline da theophylline a lokaci guda a cikin wasu marasa lafiya na iya haifar da ƙaruwa a cikin matakan theophylline a cikin jini. Sabili da haka, yana yiwuwa a ƙara mita da kuma ƙara bayyanar da halayen halayen da ake kira theophylline.
Ketorolac, meloxicam.
Amfani da pentoxifylline da ketorolac lokaci guda zai iya haifar da haɓaka cikin lokacin prothrombin kuma yana kara haɗarin zubar jini. Har ila yau hadarin na zub da jini na iya ƙaruwa tare da amfani da pentoxifylline na lokaci guda da meloxicam. Saboda haka, magani na lokaci ɗaya tare da waɗannan kwayoyi ba da shawarar ba.

Yawan abin sama da ya kamata

Alamar farko ta yawan zubar jini Pentiline sune tashin zuciya, amai, amai, tachycardia, ko rage karfin jini.Kari akan haka, alamomin kamar zazzabi, tashin hankali, jin zafi (fitilun mai zafi), asarar rai, cutar ƙwaiƙayi, tashin zuciya da toshewar launin ruwan kofi shima na iya zama alamar alamar zubar jini.
Jiyya. Domin kula da yawan zubar da cutar da kuma hana faruwar cutar, gaba daya takamaiman aikin likita da kuma daukar matakai na tiyata ya zama dole.

Siffofin aikace-aikace

A farkon alamun cutar anaphylactic / anaphylactoid dauki, magani tare da pentoxifylline ya kamata a daina kuma nemi shawarar likita.

Musamman kulawa da hankali na likita ana buƙatar marasa lafiya tare da cututtukan zuciya, jijiyoyin jini, cututtukan zuciya, da waɗanda ke da ciwon zuciya ko tiyata.

Game da pentoxifylline, marasa lafiya da raunin zuciya ya kamata su fara kaiwa ga matakin biyan diyya na jini.

Ga marasa lafiya da ke tattare da tsarin lupus erythematosus (SLE) ko kuma cututtukan haɗuwa da ke haɗuwa, ana iya tsara pentoxifylline ne kawai bayan yin cikakken nazarin yiwuwar haɗarin da fa'idoji.

Sakamakon haɗarin basur tare da amfani da pentoxifylline na lokaci guda da maganin anticoagulants, sanya idanu a hankali da kuma sa ido akai-akai game da abubuwan haɗuwa da jini (rabo na ƙasa da ƙasa (MES)) ya zama dole.

Tunda akwai haɗarin haɓakar ƙosasshen ƙwayar cuta ta aplastic yayin maganin tare da pentoxifylline, saka idanu na yau da kullun na ƙididdigar jini ya zama dole.

A cikin marasa lafiya da ke fama da ciwon sukari da karɓar magani tare da insulin ko maganganun hypoglycemic jami'in, lokacin amfani da manyan magungunan pentoxifylline, yana yiwuwa a ƙara tasirin waɗannan kwayoyi akan sukarin jini (duba ɓangaren "hulɗa tare da wasu kwayoyi da sauran nau'ikan hulɗa").

A cikin marasa lafiya da gazawar renal (keɓantar da keɓaɓɓen ƙasa da 30 ml / min) ko lalatawar hanta mai ƙarfi, ana iya jinkirta fitarwar pentoxifylline. Ana buƙatar saka idanu sosai.

Marasa lafiya tare da renal gazawar. A cikin marasa lafiya da gazawar renal (keɓantar da keɓaɓɓen kasa da 30 ml / min), titition na allurai har zuwa 50-70% na daidaitaccen kashi ya kamata a aiwatar da la'akari da haƙuri na mutum, alal misali, amfani da pentoxifylline 400 MG sau 2 a rana maimakon 400 MG sau 3 a rana.

Marasa lafiya tare da tsananin lalata hanta. A cikin marasa lafiya da mummunan raunin hanta, shawarar don rage kashi ya kamata likita ya kamata, yin la'akari da tsananin cutar da haƙuri a cikin kowane haƙuri.

Musamman lura sosai wajibi ne don:

• marasa lafiya da ciwo mai zurfi arrhythmias,
• marasa lafiya da infarction na myocardial
• marasa lafiya da ciwon suga,
• marasa lafiya da tsananin atherosclerosis na cerebral da na jijiyoyin jini, musamman tare da concomitant jijiya hauhawar jini da cardiac arrhythmias. A cikin waɗannan marasa lafiya, lokacin amfani da miyagun ƙwayoyi, harin angina, arrhythmias da hauhawar jijiya mai yiwuwa,
• marasa lafiya tare da gazawar renal (yardawar keɓaɓɓen ƙasa 30 ml / min.),
• marasa lafiya da gazawar hanta mai yawa,
• marasa lafiya da ke da muradin zub da jini, ya haifar, alal misali, ta hanyar jiyya tare da cututtukan cututtukan cututtukan mahaifa ko rikicewar ƙwayar jini. Don zub da jini - duba sashin "Contraindications",
• marasa lafiya da tarihin cututtukan cututtukan cututtukan ciki da na duodenal, marasa lafiya waɗanda suka yi kwanan nan tiyata a asibiti (ƙara haɗarin zubar jini, wanda ke buƙatar saitaccen tsarin kula da haemoglobin da matakan jini)
• marasa lafiya waɗanda aka kula dasu lokaci guda tare da pentoxifylline da bitamin K antagonists (duba sashe “Haɗawa da wasu kwayoyi da sauran nau'ikan hulɗa”),
• marasa lafiya waɗanda aka bi da su a lokaci guda tare da pentoxifylline da wakilai na hypoglycemic (duba sashe "Haɗa tare da wasu kwayoyi da sauran nau'ikan hulɗa").

Yi amfani da lokacin daukar ciki da lactation

Tunda babu ƙwarewar amfani da amfani da pentoxifylline a cikin mata masu juna biyu, bai kamata a tsara shi ba lokacin daukar ciki.

Yayin shayarwa, pentoxifylline ya shiga cikin madarar nono. Koyaya, jariri yana karɓar ƙananan adadi kaɗan. Don haka, ba makawa cewa amfani da pentoxifylline yayin shayarwa ana nuna cewa yana da wani tasiri ga jariri.

Thearfin yin tasiri akan ƙimar amsawa lokacin tuki motoci ko wasu hanyoyin

Pentilin ba shi da tasiri ko kaɗan a cikin ikon tuƙin mota da sauran hanyoyin. Koyaya, a cikin wasu marasa lafiya zai iya haifar da jin zuciya, sabili da haka, a kaikaice rage psychophysical ikon tuki mota da sauran hanyoyin. Har sai marasa lafiya sun gano yadda suke amsa magani, ba a ba su shawarar hawa mota ko yin aiki tare da wasu hanyoyin.