Yadda za a yi amfani da maganin Simbalta?

Abin takaici, kowace shekara yawan mutanen da ke fuskantar talauci, juyayi da raunin hankali ba sa ƙaruwa. Yana da wuya a faɗi menene dalilin, amma hanzari na rayuwa, aiki mai ɗorewa, rashin fahimta a cikin iyali, matsaloli a rayuwar mutum - duk wannan na iya ba da kwarin gwiwa don firgita da damuwa, damuwa ko haifar da ciwon ciki ko ɓacin rai.

Tare da irin waɗannan cututtukan ko tuhumarsu, yana da mahimmanci a tuntuɓar masu ilimin psychotherapists, neurologists. Sau da yawa, idan ba tare da taimakonsu ba, mutum ba zai iya fita daga halin zalunci ba ya ci gaba da rayuwa ta al'ada. Bugu da ƙari, sau da yawa waɗannan cututtukan suna juya zuwa bala'i: kisan kai, mutuwa, saboda yanayin rashin bege, rashin farin ciki da ma'ana a rayuwa.

Mafi yawan lokuta, don dawo da jikin mutum, likitoci sun bada shawarar daukar tafarkin magungunan hana daukar ciki, wanda cikin kankanin lokaci zai iya dawo da mutum daga rayuwa.

Ofaya daga cikin magungunan ƙungiyar maganin antidepressant shine magani na Simbalta, wanda likitoci suka tsara sau da yawa ga marasa lafiya.

Simbalta magani ne mai mahimmanci, liyafar wacce ba ta karɓa ba tare da nadin likita da saka idanu akai-akai game da yanayin haƙuri!

Tsarin magani

Koyarwar miyagun ƙwayoyi Symbalta ta ba da rahoton cewa sakamakon maganin yana da alaƙa da aiwatar da sake aiwatar da maganin serotonin, kamar sauran magunguna masu irin wannan yanayin. Idan muna magana game da sunan duniya na miyagun ƙwayoyi, to ana iya samunsa a ƙarƙashin sunan Duloxetine. Yana da wannan abu mai aiki.

Contraindications

Kamar yadda yake a kowane magani, Magungunan ƙwayar cuta tana da contraindications. A cikin cututtuka da yanayin masu zuwa, magani tare da wannan magani ba a aiwatar da shi:

• tare da kara hankalin mai aiki ga duloxetine,
• amfani da kwayoyi - MAO hana,
• yayin shayarwa,
• tare da bayyanar cututtuka na kusurwa glaucoma,
• a karkashin shekara 18 years.

Tsanani kuma kawai a karkashin kulawa na likita, ana iya amfani da miyagun ƙwayoyi a cikin yanayin rikicewar halin manic da hypomanic, ba kawai a halin yanzu ba, har ma a cikin anamnesis. Wannan ya shafi cututtukan fata (ciki har da tarihin likita). A karkashin kulawa na likita ya kamata ya zama marasa lafiya tare da koda da kuma hepatic kasawa, tare da haɗarin haɓaka kusurwa glaucoma.

A lokacin daukar ciki, an wajabta maganin a gwargwadon umarnin ƙwararrun likita. Idan akwai yiwuwar karuwar kashe kansa, zaku iya amfani da Simbalta kawai a ƙarƙashin kulawar likita.

Matsaloli da ka iya haifar da magani

Magungunan suna da matukar mahimmanci, saboda umarnin Simbalta ya ƙunshi cikakken jerin abubuwan sakamako masu illa da zasu iya bayyana lokacin kula dasu.

1. A cikin kusan 10% na lokuta (kuma ana ɗauka wannan a matsayin amsawa akai-akai), tsananin damuwa, damuwa na barci (duka rashin bacci, da kuma matsanancin nutsuwa), tashin zuciya, bushewar baki, maƙarƙashiya, da ciwon kai na iya faruwa yayin ɗaukar Simbalt.
2. Mafi yawan marasa amfani a tsakanin marasa lafiya da ke shan miyagun ƙwayoyi suna amai, gudawa, raguwar ci da kuma nauyin jiki a kan wannan yanayin, rawar jiki, gumi, raguwar motsa jima'i, matsalolin hangen nesa a cikin hotunan marasa haske, mata suna da fitilu masu zafi, kuma maza sun rage rashin ƙarfi, cuta mai amo .
3. Marasa lafiya tare da masu ciwon sukari yayin shan jiyya tare da Simbalt na iya samun tsawan matakan glucose na jini yayin daukar gwajin ciki.

Bugu da ƙari, sakamako masu illa na iya faruwa lokacin da aka dakatar da miyagun ƙwayoyi: tsakanin alamun cirewa, marasa lafiya sun ba da rahoton ciwon kai, tsananin farin ciki, da tashin zuciya.

A yanayin shaye-shayen magunguna, amai, raguwar ci, daskararra, rashi, rawar jiki yana yiwuwa. Ba a gano maganin rigakafin magungunan Simbalta ba, saboda haka, a yayin jiyya, ya kamata su tsayar da lura da yadda likita ya tsara.

Yadda ake shan magani

Amincewa da Simbalta bai dogara da cin abinci ba. Hanyar miyagun ƙwayoyi shine maganin capsule. Dole ne a hadiye su ba tare da murƙushewa ko cin abinci ba. Rage ruwa a cikin ruwa ko cakuda abinci ba da shawarar ba.

Yawancin lokaci ana wajabta sau ɗaya a rana a kashi 60 na MG. Idan ya cancanta, ƙara kashi zuwa 120 MG kuma ɗaukar magani sau biyu a rana. Ana amfani da sashi na 120 MG a matsakaici don amfanin yau da kullun.

A cikin gazawar koda, an rage kashi na farko zuwa 30 MG kowace rana.

Ya kamata a tuna cewa shan Simbalta yana hana halayen psychomotor, na iya rage aikin ƙwaƙwalwar ajiya.

Saboda haka, yayin jiyya tare da wannan maganin maganin ɓarna, yakamata mutum ya iyakance aiki a cikin haɗarin haɗari inda ake buƙatar ƙara yawan kulawa da saurin amsawa.

Formaddamar da tsari da abun da ke ciki

Form sashi - capsules: wuya, gelatin, opaque:

• 30 MG: girman No. 3, tare da shudi mai shudi wanda akan sanya lambar shaida "9543" tare da fenti mai launin kore, da kuma wani farin shari'ar wanda aka sa alama a matsayin "30 MG" a cikin tawada kore,
• 60 MG: girman A'a. 1, tare da shudi mai shudi wanda akan sanya lambar shaida “9542” tare da farin tawada da kuma wani lamari mai launin kore wanda akan sa sigogin shine “60 MG” cikin farin tawada.

Abun cikin capsules: pellets daga fari zuwa launin toka-fari.

Shigowar shirye-shiryen: kwanshin kwalliya 14 a cikin bororo, a cikin kwali na kwali na 1, 2 ko 6 murhun.

Abubuwan da ke aiki: duloxetine (a cikin nau'i na hydrochloride), a cikin kabarin 1 - 30 ko 60 mg.

• abubuwan maganin kabilu: triethyl citrate, sukari mai girma, sukari, hypromellose, succinate, hypromellose acetate, talc, farin fari (hypromellose, titanium dioxide),
• harsashi: gelatin, indigo carmin, sodium lauryl sulfate, titanium dioxide, da baƙin ƙarfe dye oxide yellow - in capsules 60 MG,
• overprint: 30 mg capsules - TekPrint ™ SB-4028 kore mai tawada, 60 alli capsules - TekPrint ™ SB-0007P farin tawada.

Alamu don amfani

• na cikin damuwa damuwa (GAD),
• bacin rai
• nau'in jin zafi na cututtukan zuciya na zuciya,
• ciwo mai raɗaɗi na tsarin musculoskeletal (wanda ya haɗa da osteoarthritis na haɗin gwiwa da fibromyalgia, da kuma ciwo mai raɗaɗi a cikin ƙananan baya).

Sashi da gudanarwa

Allunan ya kamata a sha a baka: a hadiye duka kuma a sha da ruwa. Cin abinci ba ya tasiri da tasiri na miyagun ƙwayoyi, duk da haka, allunan bai kamata a ƙara abinci ko a haɗasu da ruwa ba!

Nagari hanyoyin bada shawara:

• ɓacin rai: matakin farko da daidaitaccen tabbatarwa - 60 MG sau ɗaya a rana. Mafi yawan lokuta ana lura da ci gaba bayan makonni 2-4 na shan miyagun ƙwayoyi, duk da haka, don guje wa sake dawowa, ana bada shawarar a ci gaba da jinya na watanni da yawa. A cikin maimaita yanayin rashin jin daɗi a cikin marasa lafiya waɗanda ke amsa daidai ga magani tare da duloxetine, magani na dogon lokaci a kashi 60-120 mg yana yiwuwa,
• yawan damuwa na damuwa: maganin da aka ba da shawarar shine 30 MG, idan tasirin bai isa ba, an kara shi zuwa 60 MG. Game da matsalar rashin kwanciyar hankali, farawa da kuma kulawa ta yau da kullun ita ce 60 MG, tare da isasshen amsa ga warkewa, an karu zuwa 90 ko 120 MG. Don guje wa sake komawa ciki, ana bada shawarar a ci gaba da jinyar watanni da yawa,
• nau'i mai raɗaɗi na jijiyoyin mahaifa: farawa da daidaitaccen ma'aunin kulawa - 60 MG sau ɗaya a rana, a wasu yanayi yana yiwuwa a ƙara yawan yau da kullun zuwa 120 MG. Ana aiwatar da kimantawa ta farko game da amsawar maganin warkewa bayan watanni 2 na magani, sannan - aƙalla sau ɗaya a kowane watanni 3,
• ciwo mai raunin ciwo na musculoskeletal tsarin: makon farko na magani - 30 MG sau ɗaya a rana, sannan 60 MG sau ɗaya a rana. Yin amfani da allurai mafi girma ba ya samar da ingantacciyar sakamako, amma ana danganta shi da cutarwar da ta shafi mummunan sakamako. Tsawon lokacin jiyya har zuwa watanni 3. Yanke shawara akan bukatar tsawaita aikin tiyata daga likitocin da ke halartar taron.

A cikin makonni biyu na farko na magani na GAD, an tsara marasa lafiya tsofaffi Simbalt a cikin adadin yau da kullun na 30 MG, to, tare da haƙuri mai kyau, ana ƙaruwa da kashi zuwa 60 MG. Lokacin da ake tsara magungunan don wasu alamomi, tsofaffi ba sa buƙatar gyaran kashi.

Ya kamata a guji rage matsalar rashin lafiya daga jiyya, tunda ciwon sikira na iya haɓaka. An bada shawara don rage kashi a hankali na tsawon makonni 1-2.

Side effects

Yawancin sakamako masu illa suna da laushi ko matsakaici, ya faru a farkon jiyya kuma a yayin aikin jiyya, tsananin zafinsu yana raguwa koyaushe.

A cikin karatun asibiti, an lura da mummunan sakamako daga tsarin da ke gaba da gabobin:

• Gastrointestinal fili: sau da yawa - bushe bakin, tashin zuciya, maƙarƙashiya, yawanci dyspepsia, amai, ciwon ciki, zawo, flatulence, infrequently - belching, dysphagia, gastritis, gastroenteritis, gastrointestinal na jini, da wuya - mummunan numfashi stomatitis, na jini,
• Hankalin hanta da biliary fili: akai-akai - mummunan lalacewar hanta, hepatitis, da wuya - jaundice, hanta hanta,
• Tsarin abinci mai gina jiki da abinci mai gina jiki: sau da yawa - asarar ci, a lokaci-lokaci - hyperglycemia, da wuya - hyponatremia, bushewar jiki, ciwo na rashin isasshen ƙwayar cuta ta ADH (hormone antidiuretic),
• Tsarin zuciya: sau da yawa - hyperemia, palpitations, infrequently - karuwar hawan jini, orthostatic hypotension, tachycardia, ƙarshen sanyi, fainting, farhythmia na sama, da wuya - rikicin hauhawar jini,
• Tsarin numfashi: sau da yawa - jin zafi a cikin oropharynx, yawning, na lokaci-lokaci - hanci hanci, ji da ƙarfi a cikin makogwaro,
• Tsarin Musculoskeletal: sau da yawa tsaurin tsoka, rauni na kashin wuya, raunin tsoka, mara nauyi a wuya, da wuya trismus,
• Fata da ƙananan ƙwayar cuta: sau da yawa - itching, fashin baki, sweating, infrequently - contact dermatitis, photoensitivity, urticaria, bruising, gumi mai sanyi, gumi na dare, da wuya - angioedema, Stevens-Johnson syndrome, da wuya - ungulu nama,
• Tsarin Urinary: sau da yawa - yawan urination, akai-akai - dysuria, nocturia, raunana fitsari, kwararar urinary, wahalar fara urination, da wuya - warin fitsari wanda ba a saba gani ba,
• Jini da mammary gland: sau da yawa - lalata erectile, infrequently - dysfunction jima'i, cin zarafi, jinkirta kawowa, jin zafi a cikin testicles, rashin daidaituwa, zubar jini, da wuya - galactorrhea, bayyanar cututtuka na menopause, hyperprolactinemia,
• Tsarin mara amfani da jijiyoyin jiki: sau da yawa - ciwon kai, rashin bacci, farin ciki, bacci, yawanci damuwa, tashin hankali, rashin damuwa, raguwar libido, mafarkai na yau da kullun, paresthesias, rawar jiki, rashin saurin rashin hankali, dyskinesia, rage ingancin bacci, akathisia, lethargy , asarar hankali, dysgeusia, restless kafafu syndrome, myoclonus, bruxism, apathy, suicidal tunani, disorientation, da wuya tashin hankali psychomotor, convulsions, serotonin ciwo, extrapyramidal cuta, hallucinations, kara The m hali, mania, rashin jituwa da zãlunci,
• Gabobin jijiyoyin jiki: sau da yawa - tinnitus, wahayin gani, wanda ba shi da yawa - hangen nesa mai rauni, mydriasis, jin zafi a cikin kunnuwa, vertigo, da wuya - bushe idanu, glaucoma,
• Tsarin Endocrine: da wuya - hawan jini,
• Tsarin rigakafi: da wuya - rashin lafiyar jiki, halayen anaphylactic,
• Bayanai daga dakin gwaje-gwaje da nazari na kayan aiki: sau da yawa - raguwa a cikin nauyin jiki, a wani lokaci - karuwa a cikin taro na potassium a cikin jini, karuwa a cikin taro na bilirubin, creatine phosphokinase, alkaline phosphatase, hepatic transaminases da gamma-glutamyl transferase, karuwa a jikin jiki, karɓar ƙwayar cuta na hanta hanzari, haɓaka haɓaka hanzarin haɓaka, haɓaka hanzarin haɓaka, jini cholesterol
• Cututtukan cututtukan cututtukan fata: na kullun - laryngitis,
• Rashin jituwa gaba ɗaya: sau da yawa - ƙarancin gajiya, sau da yawa - canji na dandano, faɗuwa, mara wuya - jin sanyi, ƙwanƙwasa, jin zafi, ƙishirwa, malaise, raunin da ba a taɓa ji ba, jijiyar wuya, zafin kirji.

Tare da sokewa na kwatsam na miyagun ƙwayoyi, a mafi yawan lokuta, magungunan Sybalta suna haifar da "cirewa" ciwo, wanda aka nuna ta hanyar bayyanar cututtuka masu biyo baya: tashin hankali, damuwa, rauni, damuwa, damuwa, tashin hankali, tashin hankali, tashin hankali, tashin hankali, tashin hankali, tashin hankali, tashin hankali, tashin hankali, tashin hankali, tashin zuciya, amai ko amai, zawo, vertigo da hyperhidrosis.

Umarni na musamman

A yayin jiyya tare da Simbalt a cikin marasa lafiya da ke fama da hauhawar jini ko wasu cututtukan zuciya, ana ba da shawarar sarrafa hawan jini.

Marasa lafiya da ke da haɗarin kashe kansa yayin magunguna su kasance ƙarƙashin kulawar likita.

Yayin aikin jiyya, ana yin taka tsantsan yayin aiki da kayan aikin injiniya da kuma lokacin aiki tare da kayan haɗari.

Hulɗa da ƙwayoyi

Bai kamata a yi amfani da magungunan Simbalta ba tare da lokaci guda tare da inhibitors na monoamine oxidase, kuma a cikin kwanaki 14 bayan ficewarsu saboda haɗarin haɓakar cutar ta serotonin. Bayan katse duloxetine, aƙalla kwanaki 5 ya kamata ya faɗi kafin alƙawarin inhibitors na monoamine oxidase.

An tsara Duloxetine tare da taka tsantsan kuma a cikin ƙananan allurai lokaci guda tare da masu hana CYP1A2 isoenzyme (misali, maganin rigakafin quinolone), kwayoyi waɗanda galibi metabolized ne ta tsarin CYP2D6 isoenzyme kuma suna da kunkuntar yanayin warkewa.

Tare da gudanarwa na lokaci daya tare da wasu hanyoyi / abubuwa na aikin serotonergic, haɓakar cutar serotonin mai yiwuwa ne.

Ana amfani da Symbolt na miyagun ƙwayoyi tare da taka tsantsan a lokaci guda tare da maganin rigakafi na tricyclic (amitriptyline ko clomipramine), triptans ko venlafaxine, tramadol, St John's wort, tryptophan da finidine.

Ta yin amfani da magungunan anticoagulants da magungunan antithrombotic sau ɗaya, haɗarin zub da jini na iya ƙaruwa, saboda haka, an tsara duloxetine tare da waɗannan magunguna tare da taka tsantsan.

A cikin masu shan sigari, yawan duloxetine a cikin plasma ya ragu da kusan 50% idan aka kwatanta da masu shan sigari.

Kungiyar magunguna

Simbalta yana cikin rukunin magungunan cututtukan fata. Subungiyoyin ƙananan ƙwayoyi sune zaɓin serotonin da norepinephrine reuptake inhibitors. Kamar yawancin magunguna a cikin wannan rukuni, Symbalta yana da rauni mai ƙarfi don hanawa da sake farfado da dopamine, wanda ke haifar da adadin sakamako masu illa na miyagun ƙwayoyi.

Kayan magunguna

Symbalta ta kasance rukuni ne na zaɓi na serotonin da noradrenaline reuptake inhibitors. Wannan yana nufin cewa miyagun ƙwayoyi sun zaɓi shigar da abubuwa biyu kawai daga sararin samaniya na tsarin juyayi zuwa cikin neurons: norepinephrine da serotonin. Koyaya, kamar yawancin wakilai na wannan rukunin, bayyanar cutar tana shafar metabolism na dopamine.

Wadannan matsakanci guda uku: serotonin, norepinephrine da dopamine - sune ke da alhakin yanayin motsa rai na kwakwalwa. Tare da raguwa a cikin tattarawarsu, bacin rai, damuwa, damuwa a cikin bacci da matsaloli iri iri da kuma halayyar haɓaka. A wannan yanayin, yana da mahimmanci don rage taro ba cikin sel ba, amma a cikin sarari tsakanin su.

Symbalt yana ƙara yawan abubuwan da ke tsakani tsakanin ƙwayoyin, wanda hakan ke haifar da ƙaruwa a hankali cikin haɗarinsu ta sel da kuma narkar da su a cikin tsaka tsakiyan. Wannan kayan yana haifar da haɓaka yanayi tare da gudanar da tsarin kulawa da miyagun ƙwayoyi da rage damuwa.

Simbalta yana da iyakantaccen jerin abubuwan alamomi don amfani. Dalilin miyagun ƙwayoyi ya barata cikin waɗannan abubuwan:

• Jiyya don rikicewar damuwa na yau da kullun, halin yanzu na matsanancin damuwa,
• Guda guda daya na tsananin bacin rai,
• Mai tsananin ciwo jijiya,
• Neuropathies a cikin marasa lafiya da ciwon sukari mellitus,
• Rashin damuwa.

Ba a amfani da Simbalta wajen magance raunin da ya shafi matsakaici zuwa matsakaici, ba a amfani da shi don hana ɓacin rai da magance rashin bacci. Hakanan an shawarci masu haƙuri da ke amfani da phobias suyi magani tare da magungunan wuta. Gabaɗaya, ana amfani da Symbalta a cikin yanayi inda magani tare da wasu jamiái bazai isa ba.

Yawan abin sama da ya kamata

A gwaje-gwaje na asibiti, babu wani mummunan sakamako da aka gani tare da yawan zubar da jini. Haɓaka matakin da aka ba da shawarar zai iya haifar da ci gaban cututtukan ƙwayar cuta na serotonin, tare da yanayin ƙoshin lafiya, abubuwan shakatawa da kuma abubuwan da ke cikin ruwa. Kari akan haka, cin zarafin sani zai yuwu har zuwa rashin daidaituwa. Sau da yawa tare da karamin yawan abin sama da ya wuce, nutsuwa, amai, da kuma yawan hauhawar zuciya. A cikin lokuta masu saurin kamuwa, cututtukan jinƙai.

Babu takamaiman magani don yawan zubar da jini. Ana yin maganin detoxification.

Umarnin don amfani

Don rikicewar damuwa da ciwo na kullum, matsakaicin warkewa shine 60 MG. Ya kamata miyagun ƙwayoyi ya bugu sau ɗaya a rana, a zabi da safe ko da yamma. A cikin taron cewa wannan magani ba shi da tasiri, sashi yana ƙaruwa zuwa matsakaicin yiwu - 120 mg. A wannan yanayin, ana raba maganin yau da kullun zuwa kashi biyu - safe da maraice, kwalliya ɗaya. Za'a iya kimanta tasirin magani bayan makwanni 8.

Don matsalar damuwa, farawa ya fara raguwa. A wannan yanayin, ana wajabta Symbolta 30 MG sau ɗaya a rana. Game da gazawar magani, ana iya ninka kashi biyu, ana iya raba shi kashi biyu. A hankali, zaku iya ƙara yawan sashi zuwa wani 30 MG, sannan kuma wani 30 MG, kai zuwa matsakaicin adadin 120 na MG. Ba a bada shawarar wuce wannan ƙimar saboda haɗarin sakamako masu illa. Tasirin da ake tsammanin zai bayyana bayan makonni 4 na gudanarwa.

Ana wanke ƙafafun ruwa tare da ruwa mai yawa, yawan abinci ba ya shafar shan ƙwayoyi.

Akwai 'yan analogues kaɗan waɗanda suke da aiki iri ɗaya kamar sihiri, waɗannan sun haɗa da:

Bugu da kari, akwai magunguna wadanda wani bangare ne na rukuni guda na harkar magunguna kuma suna da irin wannan tsari na aiki. Wadannan sun hada da:

Duk waɗannan magungunan ba su da musayarwa.

Regina P.: “Na dauki Symbalt na tsawon watanni shida dangane da matsananciyar damuwa. Magungunan sun taimaka min, amma ba nan da nan ba. Kimanin farkon wata na kasance ina jin tsoro da ciwon kai, amma ban lura da tasirin maganin ba. Kimanin wata daya daga baya, duk tasirin gefen ya wuce, kuma yanayin ya fara inganta a hankali. Na ɗauki Simbalt tsawon watanni 4 har sai da na kawar da baƙin ciki gaba ɗaya. ”

Denis M.: “Na fara shan Simbalt saboda yawan damuwa. Ina fama da matsalar damuwa tun daga ƙuruciyata kuma a wasu lokatai ake kulawa da ni a asibiti. Ya dauki 30 MG, amma babu wani sakamako. Lokacin da aka kara sashi, damuwata ta fara raguwa, amma rawar jiki na hannu da kafafu suka bayyana, hawan jini ya fara karuwa. Dole na daina shan Simbalt kuma na canza zuwa wani magani. ”

Yin bita daga likita hauka: “A cikin kasuwannin gida na maganin rashin yarda, Symbalta ba shine mashahuri magani ba. Yana yin faɗa sosai sosai ko da lokuta na rashin ƙarfi, amma akwai matsaloli da yawa. Da farko dai, babban adadin sakamako masu illa suna iyakance dalilin cutar. Dole ne mai haƙuri ya fara yin nazari sosai kafin ya karɓi magani. Bugu da kari, alamar yakamata a fara ɗauka a asibiti kawai a ƙarƙashin kulawa. Wannan yana da alaƙa da haɓakar haɗarin ƙoƙarin kashe kansa a cikin marasa lafiya masu rauni tare da matsananciyar damuwa. A matsayinka na mai mulkin, likitoci sun fi son magunguna masu aminci, ta amfani da alamun cuta a matsayin hanyar adanawa. Abokan yamma sun ba da alama sau da yawa. ”

Pharmacodynamics

Duloxetine maganin rigakafi ne, serotonin da norepinephrine reuptake inhibitor, kuma maganin hana daukar ciki shine rashin ƙarfi. Maganin ba shi da alaƙa mai mahimmanci ga histaminergic, dopaminergic, adrenergic da cholinergic receptors.

A cikin ɓacin rai, tsarin aiwatar da duloxetine ya danganta ne da hanawar sake farfado da ƙwayoyin serotonin da norepinephrine, saboda wanda noradrenergic da serotonergic neurotransmission yana ƙaruwa a cikin tsarin juyayi na tsakiya.

Abun yana da kayan aiki na tsakiya don dakatar da jin zafi, don raɗaɗin etiology na neuropathic etiology wannan an bayyana shi da yawa ta hanyar ƙaruwa a ƙofar jijiyar jin zafi.

Pharmacokinetics

Duloxetine bayan maganin baka yana da kyau. Baƙon zai fara sa'o'i 2 bayan shan Simbalta. Lokaci don isa C_max (matsakaicin maida hankali ne akan abu) - 6 hours. Cin C_max Ba shi da wani tasiri, yayin da akwai ƙaruwa a cikin lokacin da yake ɗauka don isa ga wannan alamar har zuwa awanni 10, wanda a kaikaice yana rage matakin sha (kamar kusan 11%).

Apparentarar bayyanawar rarraba duloxetine kusan lita 1640. Abun yana da alaƙa da lafiyar furotin plasma (> 90%), galibi tare da albumin da α₁acid globulin. Rashin lafiya daga hanta / kodan ba sa tasiri ga ƙimar da za a iya ɗaukar garkuwar plasma.

Duloxetine yana aiki metabolism, metabolites dinsa an kebe sune a cikin fitsari. A isoenzymes CYP2D6 da CYP1A2 suna ɗaukar tushen manyan metabolites guda biyu - 4-hydroxyduloxetine glucuronide da 5-hydroxy, 6-methoxyduloxetine sulfate. Basu mallaki aikin magani ba.

T_1/2 (rabin rayuwa) na abu - awa 12. Matsakaicin yarda shine 101 l / h.

A cikin marasa lafiya tare da mummunan rauni na aikin haya (a cikin matakin ƙarancin raunin ƙarancin koda) yana fuskantar gwajin hemodialysis, ƙimar C_max da AUC (watsawa na matsakaici) na duloxetine yana ƙaruwa sau 2. A cikin waɗannan halayen, wajibi ne don la'akari da yiwuwar rage yawan ƙwayar Simbalta.

Tare da alamun asibiti na gazawar hanta, za a iya raguwar raguwa a cikin metabolism da excretion na kayan.

Haɗa kai

Sakamakon hadarin cutar serotonin Kada a yi amfani da miyagun ƙwayoyi tare da masu hana MAO da kuma wani makonni biyu bayan katsewa MAO masu hanawa.

Hadin gwiwa tare da yuwuwar masu hana enzymeCYP1A2da CYP1A2 na iya haifar da karuwa a cikin abubuwan magani.

Yakamata a yi taka tsantsan lokacin amfani dashi tare da sauran magunguna waɗanda ke shafar tsarin mai juyayi, gami da giya.

A cikin mafi yawan lokuta, yayin amfani da wasu serotonin masu haɓaka hanawa da magungunan serotonergic bayyanar zai yiwu cutar serotonin.

Yakamata a yi taka tsantsan yayin amfani da Alamar magunguna tare da ƙwayoyin enzyme.CYP2D6.

Hadin gwiwa tare da anticoagulants zai iya tayar da faruwar cutar jini da ke hade da hulɗa da yanayin harhada magunguna.

Ra'ayoyi game da Simbalt

Nazarin likitoci game da Simbalt da sake dubawa game da Simbalt a kan dandalin tattaunawar suna kimanta maganin a matsayin magani bacin rai da jijiyaKoyaya, ƙwayar tana da wasu ƙayyadaddun iyakoki saboda amfani mai haɗari "cirewa" ciwo.

Simbalta, umarnin don amfani: hanyar da sashi

Ana ɗaukar maganin capsules na baka ne ba tare da la'akari da abinci ba, ana haɗiye shi gabaɗaya, ba tare da cinye membrane na ciki ba.

• ɓacin rai: kashi na farko da tabbatarwa - 60 mg sau ɗaya a rana. Tasirin warkewa galibi yakan faru bayan makonni 2-4 na jiyya. Nazarin asibiti a kan yiwuwa da amincin allurai a cikin kewayon sama da 60 MG zuwa 120 MG kowace rana a cikin marasa lafiya waɗanda ba su amsa maganin farko ba su tabbatar da ci gaba a yanayin mai haƙuri ba. Don hana sake dawowa, ana bada shawara don ci gaba da ɗaukar alamun Symbol na makonni 8-12 bayan kai ga amsa ga warkewar cutar. Marasa lafiya tare da tarihin rashin kwanciyar hankali da ingantacciyar amsa ga maganin duloxetine an nuna sun dauki Symbalt a cikin kashi 60-120 MG kowace rana na dogon lokaci,
• naƙasasshen damuwa na damuwa: kashi na farko shine 30 MG kowace rana, tare da isasshen amsa ga warkewa, zaku iya haɓaka har zuwa 60 MG, wanda shine gwargwadon kulawa don yawancin marasa lafiya. Matsayi na farko da tabbatarwa na marasa lafiya da ke fama da rashin kwanciyar hankali shine 60 MG kowace rana. Tare da haƙuri mai kyau na rashin lafiya, ana nuna karuwa a kashi 90 mg ko 120 MG don cimma nasarar asibitin da ake so. Bayan an sami iko a kan yanayin haƙuri, ya kamata a ci gaba da kulawa don makonni 8-12 don hana sake dawowa da cutar. Ga marasa lafiya tsofaffi, ya kamata a ɗauki kashi na farko na 30 MG don makonni biyu kafin canzawa zuwa 60 MG ko fiye da kowace rana,
• nau'in ciwo na cututtukan cututtukan cututtukan zuciya na zuciya: farawa da kuma tabbatarwa - 60 MG sau ɗaya a rana, idan ya cancanta, ana iya ƙaruwa. Ya kamata a kimanta tasirin warkewa bayan makonni 8 na amfanin yau da kullun na Simbalta. Idan babu cikakkiyar amsa a farkon farawar, bayan wannan lokacin, inganta babu tabbas. Yakamata likita ya kimanta tasirin asibiti akai-akai, kowane mako 12,
• ciwo mai raɗaɗi na tsarin musculoskeletal: kashi na farko shine 30 MG 1 lokaci ɗaya na mako ɗaya, sannan an wajabta mai haƙuri 60 mg 1 lokaci kowace rana. Hanyar magani shine makonni 12. Ma'aikacin halartar likitan ne daban-daban ke yin amfani da kuzarin amfani da mafi tsawo, yin la'akari da haƙurin Simbalta da yanayin haƙuri na mai haƙuri.

A cikin gazawar renal tare da CC 30-80 ml / min, ba a buƙatar daidaita sashi ba.

Sakamakon haɗarin cirewar ciwo, dakatar da jiyya ya zama dole ta hanyar rage yawan alamun Alamar a tsakanin makonni 1-2.

Haihuwa da lactation

• ciki: Za'a iya amfani da Symbalta ne kawai a karkashin kulawa ta likitanci a cikin yanayi inda amfanin ga uwa ya fi ƙarfin haɗari ga tayin, tunda ƙwarewar amfani da miyagun ƙwayoyi a cikin wannan rukuni na marasa lafiya ba a fahimta sosai,
• lactation: far yana contraindicated.

Yayin jiyya tare da duloxetine, a cikin taron tsarawa ko farawar ciki, ya zama dole a sanar da likitanka game da wannan.

Amfani da zabin hana kwayoyin hana daukar ciki wanda yake hana haihuwa yayin haila, musamman ma a matakai na gaba, na iya kara yiwuwar tashin hankali na huhu a jarirai.

A yanayin amfani da mahaifiyar Simbalta ta mahaifiyarta a wani mataki na gaba na daukar ciki a jarirai, ana iya lura da cirewar cututtukan, wanda ake nunawa da rawar jiki, saukar karfin jini, matsaloli na ciyarwa, karuwar rashin lafiyar jijiyoyin jiki, tashin zuciya, da kuma matsananciyar damuwa. Yawancin waɗannan rikice-rikice ana lura da su sosai yayin haihuwa ko a fewan kwanaki na farko bayan haihuwa.