I-Amitriptyline 25 isiza ekuqedeni izimpawu zokudangala nezinye izimo ze-pathological ezavela ngokumelene nesizinda sokuphazamiseka kwengqondo nokuphazamiseka. Izinzuzo zifaka inani eliphansi nenani elincane le-contraindication, ngenxa yokuthi ubukhulu bommenzeli bunwebeka. Kusukela kokuqokwa, ungathola umthamo womuthi (25 mg).
Igama Lezwe elingafanele
I-Amitriptyline.
I-ATX
N06AA09.
Khipha amafomu nokwakheka
Ungathenga umuthi ngesisombululo kanye namathebulethi. I-Amitriptyline hydrochloride iyasebenza. Ukuhlushwa kwawo kuyahlukahluka, kuya ngesakhiwo sento. Ithebhulethi eyi-1 iqukethe u-25 mg we-amitriptyline. Iphakethe ama-pcs angama-50.
Ukuqoqwa kwengxenye esebenzayo ku-1 ml yento ewuketshezi kungu-10 mg. Umthamo wama-ampoules anesisombululo ngu-2 ml. Ngakho-ke, inani eliphelele le-amitriptyline liyi-20 mg. Umuthi ukhiqizwa ngale ndlela emaphaketheni ama-ampoules ayi-5 no-10.
I-Amitriptyline 25 isiza ekuqedeni izimpawu zokudangala nezinye izimo ze-pathological ezavela ngokumelene nesizinda sokuphazamiseka kwengqondo nokuphazamiseka.
Isenzo se-Pharmacological
Leli thuluzi libhekisele kwabokulwa nezifo. Inhloso yawo eyinhloko ukususa izimpawu zezimo ezicindezelayo. Ezinye izakhiwo:
- okhathazayo;
- sedative;
- i-timoleptic.
I-Amitriptyline iyakwazi ukuba nomphumela wokuphumula emzimbeni uma kukhathazeka, uvalo, ukukhathazeka. Ukungezwani komgogodla kuncishisiwe ngenxa yokuvinjwa kokuphindwaphindwa kwama-neurotransmitters, afaka i-serotonin, i-norepinephrine. Le nqubo ikhula ngokubamba iqhaza kokuphela kwezinzwa kwama-neurons. Ngaphansi kwethonya le-amitriptyline, ukunqwabelana kwama-monoamines ku-synaptic cleft kuyasheshiswa. Ngaphezu kwalokho, le nto ithuthukisa impendulo ye-postynaptic.
Sedation kungenxa yokwehla kokuzwela kokuthatheka kwangaphandle. Kodwa-ke, imisebenzi yansuku zonke yesiguli iyancipha. Ukwehla kwesibindi sezinzwa kuyaphawulwa. Umphumela we-antidepressant uboniswa ngenxa yokwehla komsebenzi wama-receptors athile obuchopho.
Ngesikhathi esifanayo, inqubo yokudlulisela i-beta-adrenergic ne-serotonin iyabuyiselwa. Ukwehla kwamandla okubonisa kokudangala nakho kungenxa yokubuyiselwa kwesimo sokulingana kwalezi zinhlelo. Ngaphezu kwalokho, ukusebenza kwe-M-choline ne-histamine receptors kuvinjelwe.
Isici somuthi ukukwazi ukukhombisa izakhiwo ezihlukile ngenxa yokuphathwa kwemithamo ehlukahlukene. Isibonelo, ngaphansi kwezimo ezithile, umphumela we-antidepressant unikezwa. Uma ulungisa umthamo, kuvezwa impahla evuselelayo. Kulesi simo, umphumela uphikisana nokuvukela phansi.
Ngakolunye uhlangothi, ngemuva koshintsho ekuqoqweni kwe-amitriptyline ku-plasma, izakhiwo ezivuselelayo ziba buthaka.
Kunzima ukucacisa kahle uhla lwemithamo lapho ubukhulu bomphumela wokuqina buyehla futhi umphumela wokuqina uqiniswa, ngoba inani elanele lomuthi linqunywa ngawodwana.
Ngaphezu kwalokho, ezinye izakhiwo zivezwa ngesikhathi sokwelapha. Ziphinyiselwa kancane, kepha ngenxa yalokhu, i-Amitriptyline isiza ukukhulisa imisebenzi yezinye izidakamizwa, kanye nayo esetshenziswayo. Ngakho-ke, lo muthi usiza ukuvumelanisa umsebenzi wokuchama, ubonise impahla ebuthakathaka ye-analgesic, futhi inhibits iphango.
I-Pharmacokinetics
Umuthi udonswa ngokushesha. Amathebulethi awanawo umthelela omubi emgodini wokugaya ukudla, okubangelwa impahla ye-antiulcer (ngokususelwa kumshini wemiphumela ye-M-anticholinergic kanye ne-sedative). I-bioavailability ye-amitriptyline iyisilinganiso: 30-60%. I-metabolite esebenzayo yale nto iboniswa yi-bioavailability ephakeme: 40-70%.
Ithuluzi liqala ukusebenza ngokushesha: ngemuva kwamahora ama-2, izinqubo ezisebenza ngaphansi komshini wokusebenza kwe-Amitriptyline zenziwa zasebenza. Naphezu kwesivinini esikhulu sokufinyelela ekuhlolweni kwe-plasma ephakeme yento esemqoka, umuthi uqeda izimpawu zesimo esidabukisayo kanye nokunye ukuphazamiseka kwengqondo ngemuva kwamasonto ayi-2-3.
Umuthi uqeda izimpawu zokudangala nezinye izifo zengqondo ngemuva kwamasonto angama-2-3.
I-Amitriptyline icishe ibopha ngokuphelele amaprotheni egazi (aze afike ku-96%). Le nto ingena ezindaweni ezahlukahlukene zemvelo, ngenxa yokuthi ubukhulu bokusetshenziswa kwayo buncishisiwe. Ukuguqulwa kwengxenye esebenzayo kwenzeka ngokubamba iqhaza kwesibindi. Ngenxa yalokhu, ama-metabolites asebenzayo futhi angasebenzi ayakhululwa. Ezinye zazo zibonisa indawo yokuhlala, yokulwa nokuqina kokudambisa amandla kanye ne-amitriptyline, kanti ezinye ziphakeme kunale nto ngokusebenza kahle (ngokwesibonelo, i-nortriptyline).
Ukuphila kwesigamu somuthi ku-plasma kuyehluka ngokuya ngesimo sezinso, ngoba lesi sitho sinomthwalo wokukhipha izakhi ezisebenzayo nezingasebenzi emzimbeni. Lezi zinto zikhishwa ngaphakathi kwamahora ayi-10-44. Ngaphezu kwalokho, impilo yesigamu se-nortriptyline yinde. I-ejenti isuswe ngokuphelele emzimbeni kuphela ngemuva kwamasonto ama-2.
Yenzelwe ini?
Injongo eyinhloko ukwelashwa kokudangala. Ngaphezu kwalokho, i-Amitriptyline iyasebenza ekwelapheni ukuphazamiseka kwezifo ezahlukahlukene: okubangelwa ukuphazamiseka kokusebenza kwengqondo, ukuhlukunyezwa kwezidakamizwa ezinezimpawu (tranquilizer, sedatives nezinye izinto), izimbangela zangaphakathi, i-neurosis, njll. Lesi sidakamizwa siqeda izimpawu hhayi nje zokucindezelwa, kepha futhi ezinye izimo ze-pathological. Kubhalwe njengengxenye yokwelapha okuyinkimbinkimbi emacaleni amaningi:
- i-psychosis ngemuva kwe-schizophrenia;
- usizi ngokomzwelo;
- i-alcohol hangover;
- kwehlise ukunakwa, kwanda imisebenzi yansuku zonke;
- i-envesis ebangelwa ukuphazamiseka kwengqondo;
- ikhanda
- i-migraine prophylaxis;
- i-bulimia (icasulwe ukungaphazamiseki ngokomzimba);
- i-neuropathy yathuthukiswa ngemuva kwesizungu;
- i-neuralgia ecasulwa yi-herpes zoster lapho itheleleke nge-herpes;
- izifo zesisu ne-duodenum, kufaka phakathi isilonda se-peptic.
Ngokuthi umuthi ubonakala ngomphumela olinganiselayo we-analgesic, ungasetjenziswa ebuhlungwini, ngokwesibonelo, ngesikhathi sokuqothuka kwe-osteochondrosis noma umdlavuza. Kodwa-ke, kulezi zimo, i-amitriptyline ichazwa kuphela njengengxenye yokwelapha okuyinkimbinkimbi.
Contraindication
Imikhawulo eminingana lapho usebenzisa ithuluzi:
- ukungabekezelelani kwezakhi ezakhiwayo: i-hypersensitivity to amitriptyline ne-lactose kuvame ukukhula;
- ubuthi be-ethanol;
- i-subacute, izikhathi ezimbi ze-infyoction ye-myocardial;
- ezinye ze-pathologies zezitho zombono (ikakhulukazi, i-angle-ukuvalwa kwe-glaucoma);
- ukwephula kwenhliziyo;
- izingane ezingaphansi kweminyaka engu-6;
- ukungahambi kahle kwe-galactose, i-glucose-galactose malabsorption, ukuntuleka kwe-lactase.
Ngokunakekela
Ukuphulwa okuhlobene:
- ukwehluleka kanzima kokuphefumula;
- ukusetshenziswa kabi kotshwala njalo;
- i-schizophrenia
- isithuthwane, sihambisana nezimo ezethusayo;
- ukwephulwa kohlelo lwe-hematopoietic;
- ukuphazamiseka kwengqondo okuguquguqukayo;
- i-ventricular arrhythmia;
- ukwehluleka kwenhliziyo;
- Ubuhlungu besifuba;
- unhlangothi, i-myocardial infarction (umlando);
- umfutho wegazi ophakeme
- ukwanda kwengcindezi kwizitho zombono;
- ukwephulwa komsebenzi wesibeletho wesisu, amathumbu;
- ukusebenza ngokweqile kokuthuthukiswa kwezicubu zomgogodla;
- i-thyrotooticosis;
- i-pathology ye-bladder, enomthelela wokuchama okungahambi kahle.
Ungayithatha kanjani i-Amitriptyline 25?
Izibhebhe akufanele zihlafunwe. Bathathwa emva kokudla.
I-Amitriptyline umthamo wethamo wezingane ezingama-25
Umuthi usetshenziswa ekwelapheni ukuphazamiseka okuhlukahlukene, irejimeni yokwelashwa esimweni ngasinye ihlukile. Imiyalo esetshenzisiwe:
- i-nocturnal enursis ngokumelene nesizinda sokuphazamiseka kwengqondo: i-10-20 mg ngosuku ngaphambi kokulala kwezingane kusuka eminyakeni eyi-6 kuye kweyi-10, engama-50 mg ngosuku ezigulini ezisukela eminyakeni eyi-10 kuye kweli-16;
- ukwelashwa kwezimo ezahlukahlukene ze-pathological ekuphazamisekeni kwengqondo: izingane ezisukela eminyakeni engu-6 kuya kwengu-12 ubudala zinqunywa u-10-30 mg ngosuku noma ama-1-5 mg / kg wesisindo, iziguli ezingaphezulu kweminyaka engu-12 ubudala - 100 mg ngosuku.
Ishedyuli yokushona kwabadala
Umthamo wokuqala: 25-75 mg ngosuku. Inani elinconyiwe lomuthi ngosuku: 150-200 mg. Ngezimo ezahlukahlukene zokugula, irejimeni yokwelashwa iyaguqulwa:
- Ukudana komoya: umthamo wokuqala wansuku zonke ungama-300 mg, bese uyancipha kancane kancane ngaphezulu kwamaviki ama-4, inkambo yokwelashwa iyizinyanga ezintathu;
- ukuphazamiseka kwengqondo okubuthakathaka, ukwelashwa kwasebekhulile: 25-100 mg ngosuku;
- Ubuhlungu be-etiologies ehlukahlukene: 100 mg ngosuku.
Amacwecwe athathwe ngaphandle kokuhlafuna.
Ukuthatha umuthi wesifo sikashukela
Ithuluzi linconyelwe ukusetshenziswa, kepha ukunakekelwa kufanele kuthathwe ngesikhathi sokwelashwa. Uma kunesidingo, umthamo we-amitriptyline uyalungiswa (ngawodwana).
Isikhathi esingakanani?
Ukwenza ngcono kungabonakala emahoreni ambalwa ngemuva kokuthatha umthamo wokuqala. Inani eliphakeme lokusebenza kahle litholakala emavikini ayi-2-3. Umphumela ugcinwa izinsuku eziyi-14 ngemuva kokukhanselwa kwemali.
Ungayikhansela kanjani i-Amitriptyline 25?
Kuyadingeka ukunciphisa kancane kancane umthamo womuthi. Lokhu kungathatha amaviki ambalwa. Inkambo yokwelapha akufanele iphazanyiswe kungazelelwe. Kulokhu, ubungozi bezimpawu zokuhoxa luyanda.
Imiphumela emibi
I-Arrhythmia, i-tachycardia iyakhula, engabangelwa ukwephulwa komsebenzi wokuqothuka kwemisipha yenhliziyo. Kuvela isimo sokuphuza, kubonakale izimpawu zokuntuleka kokusebenza kwenhliziyo, ukuphefumula.
Amapheshana wesisu
Isifo sokushaya kwenhliziyo, i-anorexia ngenxa yokulahlekelwa isifiso sokudla, ukulahlekelwa ukunambitheka, ubuhlungu besisu, izihlalo ezikhululekile, noma, ukuqubuka okungapheli.
Izitho zeHematopoietic
Shintsha ekwakhekeni kwegazi.
Isistimu yezinzwa ephakathi
Ubuhlungu bekhanda, ubuthakathaka obujwayelekile, ukwanda kwesimo sengqondo (ukuqubuka, amaphupho amnyama, ukudideka, ukubona umehluko, ukukhuphuka kokukhathazeka nokudideka), ukwethuka, ukulahleka kokuzwa, kanye nokuphazamiseka kwengqondo (hypomania, mania).
Ngasohlangothini lwe-metabolism
I-Hypo-, hyperglycemia.
Allergies
Ukuqunjelwa, ukulunywa - izimpawu ezihambisana ne-urticaria. Ama-Angioedema nezimpawu zokusabela elangeni nazo ziyaqashelwa.
Umthelela ekhonweni lokulawula izindlela
Ngesikhathi sokulashwa nge-Amitriptyline, umuntu kufanele enqabe ukushayela imoto.
Ngesikhathi sokulashwa nge-Amitriptyline, umuntu kufanele enqabe ukushayela imoto.
Imiyalo ekhethekile
Ngesikhathi sokulashwa ngomuthi, ukuqapha ejwayelekile kwamapharamitha amakhulu egazi kuyenziwa.
Imithamo emikhulu yezidakamizwa yehlisa umkhawulo womsebenzi owethusayo. Lokhu kufanele kubhekwe ngesikhathi sokuhoxiswa kwama-anticonvulsants.
Ukunciphisa ukuthambekela kwemicabango yokuzibulala, esigabeni sokuqala, i-amitriptyline ihlanganiswa nama-antipsychotic noma neqembu le-benzodiazepine.
Uma kukhona ukuhlinzwa, kufanele wazise odokotela ababulala izinzwa ngeqiniso lokuphuza umuthi okukhulunywa ngawo.
Isicelo sokusebenza kokulimala kwezinso
Umuthi ubekwa ngokuqapha ekwakheni izifo zalesi sitho. Lokhu kungenxa yokuthi izinso zibambe iqhaza ku-metabolism ye-amitriptyline.
Sebenzisa ebudaleni
Ukuqapha kuyelulekwa lapho welapha iziguli ezineminyaka engu-50 nangaphezulu.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Lapho ukuncelisa ibele, umuthi awusetshenziswa, ngoba i-amitriptyline idlula ebisini lobisi futhi ingangena emzimbeni wosana olusanda kuzalwa.
Ngesikhathi sokukhulelwa, umuthi uvunyelwe ukuthathwa, kepha ukuqapha njalo ku-trimester yokuqala kuyadingeka.
Sebenzisa umsebenzi wesibindi okhubazekile
Umuthi ubekwa ngokuqapha ezifweni zalesi sitho.
Ukweqisa
Ukwanda kwesilinganiso esinconyiwe somuthi ekwelapheni izingane kufile. Umuthi uqinisa ubukhulu bezimpawu ezingezinhle kubantu abadala. Ukuqeda imiphumela emibi, isisu siyagezwa, ukwelashwa kufanele kuphazanyiswe. Uketshezi lufakwa emzimbeni.
Ukuxhumana nezinye izidakamizwa
Ukwelashwa kwe-Amitriptyline kuqedwa emavikini ama-2 ngaphambi kokuqala kokwelashwa nge-MAO inhibitors. Ukusetshenziswa ngasikhathi sinye kwalezi zimali kuqinisekisiwe.
Uma ezinye izidakamizwa ezinezakhiwo ezifanayo zibekwa kanye ne-Amitriptyline, umphumela walesi sidakamizwa uyathuthukiswa.
I-ejenti okukhulunywa ngayo ifaka isandla ekwandeni komsebenzi we-anticholinergics.
Ukuhambisana notshwala
Umuthi awuhlanganisiwe neziphuzo eziqukethe utshwala.
Ama-Analog
Izinto ezingezansi zomenzeli okukhulunywa ngazo:
- USaroten
- I-Doxepin;
- I-Amitriptyline Nycomed.
Imibandela yekhefu lekhemisi
Umuthi kadokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Cha.
Intengo ye-amitriptyline 25
Izindleko ngama-ruble angama-20-60.
Izimo zokugcina zomuthi
Ukushisa okunconyelwayo - akukho ngaphezu kwe- + 25 ° ะก. Izingane akufanele zithole umuthi.
Isikhathi sokuphelelwa yisikhathi
Izici zomuthi zihlala iminyaka emi-3 kusukela ngosuku lokukhishwa.
Umkhiqizi
I-ALSI Pharma, eRussia.
Ukubuyekezwa ku-amitriptyline 25
Izazi Zengqondo
UPedak A.A., oneminyaka engama-35 ubudala, uPerkov
Ngibheka umuthi njengosebenza kakhulu phakathi kwezifo ezinciphisayo. Kuvame ukuhlanganiswa nezinye izindlela, futhi ezimweni eziningi, ukusabela okungalungile akwenzeki. Inzuzo intengo ephansi.
Izyumov S.V., oneminyaka engama-46, uSaratov
Umuthi ungowendawo yonke, uyasebenza. Okubi yisidingo sokusebenzisa njengengxenye yokwelashwa okuyinkimbinkimbi kwama-pathologies amaningi. Ngaphezu kwalokho, ithuluzi livusa ukuthuthukiswa kwemiphumela emibi eminingana.
Iziguli
UVeronika, oneminyaka engama-33, uSaransk
Umuthi unikeza umphumela wesikhashana. Ngokudangala okukhulu, wasiza ngokushesha, kepha ngemuva kokuhoxa, izimpawu zabuya ngamandla amengeziwe.
U-Olga, oneminyaka engama-39, uBryansk
Umuthi osebenzayo. Lapho ngiqala ukukuthatha ngokuhambisana nesizinda sokungazinzi ngokomzwelo, ngazizwa ngingenandaba ngokuphelele nalokho okwakwenzeka eduze kwami, kwakukhona ukozela, ubuthakathaka. Angizange ngithande umphumela wokwelashwa, ngizokusho okuningi - bengisesaba ukuqhubeka nenkambo yokwelashwa.
