Uyisebenzisa kanjani i-Gabagamm yezidakamizwa?

IGabagma ingeyeqembu lezidakamizwa ze-antiepileptic. Isisekelo yi-drugapapentin esebenzayo, enomphumela we-anticonvulsant. Ngokungafani nezinye izidakamizwa ezinomphumela ofanayo, amaphilisi weGabagamma awathinti umqubuko we-gamma-aminobutyric acid. Ekwenzeni kwezokwelapha, umuthi uvunyelwe ukuthi usetshenziswe yiziguli ezingaphezu kweminyaka eyi-12 ukuqeda ukubanjwa okuyingxenye, kusuka eminyakeni eyi-18 - ekwelapheni ubuhlungu be-neuropathic.

Igama Lezwe elingafanele

UGabapentin.

IGabagma ingeyeqembu lezidakamizwa ze-antiepileptic.

I-ATX

N03AX12.

Khipha amafomu nokwakheka

Umuthi wenziwa ngesimo samaphilisi, ahlanganiswe ngegobolondo le -gelatin elilukhuni, lokulawulwa komlomo.

Amakhandlela

Amayunithi emithi aqukethe i-100, 300 noma i-400 mg yesakhi esisebenzayo se-gabapentin. Njengoba kusetshenziswa izakhi ezengeziwe zokwenziwa kwegobolondo elingaphandle:

• i-talc;
• ushukela wobisi;
• isitashi sommbila;
• titanium dioxide.

Ngokuya ngomthamo, amaphilisi ahlukaniswa ngombala: phambi kwe-100 mg ye-gabapentin, i-gelatin coating ihlala imhlophe, ku-200 mg iyiphuzi ngenxa yedayi esekelwe ku-iron oxide, i-300 mg iwolintshi. Ngaphakathi kwamaphilisi kuyimpuphu emhlophe.

Umuthi wenziwa ngesimo samaphilisi, ahlanganiswe ngegobolondo le -gelatin elilukhuni, lokulawulwa komlomo.

Uhlobo olungekho

Umuthi awenziwanga ngendlela yamatafula.

Isenzo se-Pharmacological

Ukwakheka kwamakhemikhali kwe-gabapentin kucishe kufane ne-neurotransmitters GABA (i-gamma-aminobutyric acid), kepha inxanxathela yeGabagamma isebenza ngezimpawu zemithi. Izinto zokwelapha azihlangani ne-aminalon njengezinye izidakamizwa (i-barbiturates, derivatives of GABA, Valproate) futhi azinazo izimfanelo ezimbi ze-GABA. IGabapentin ayithinti ukwephulwa nokuthathwa kwe-γ-aminobutyric acid.

Ezifundweni zemitholampilo, kwavezwa ukuthi into esebenzayo ibopha ekungeneni kwe-delta yeziteshi ze-calcium, ngenxa yalokho ukugeleza kwe-calcium ions kuncipha. Futhi, iCa2 + idlala indima enkulu ekwakhekeni kwezinhlungu ze-neuropathic. Ngokuhambisana nokwenqatshelwa kweziteshi ze-calcium, i-gabapentin ivimbela ukubopha kwe-glutamic acid kuma-neurons, ukuze ukufa kweseli yezinzwa kungenzeki. Ukukhiqizwa kwe-GABA kuyanda, ukukhishwa kwama-neurotransmitters kweqembu le-monoamine kuyancipha.

Ngokuphathwa ngomlomo, igobolondo elingaphandle liqala ukuwohloka ngaphansi kwesenzo se-enzyme yamathumbu, kuthi kukhishwe i-gabapentin engxenyeni esondelene yamathumbu amancane.

I-Pharmacokinetics

Ngokuphathwa ngomlomo, igobolondo elingaphandle liqala ukuwohloka ngaphansi kwesenzo se-enzyme yamathumbu, kuthi kukhishwe i-gabapentin engxenyeni esondelene yamathumbu amancane. Into esebenzayo ithunjwa yi-microvilli. IGabapentin ingena egazini, lapho ifinyelela khona ekuqothulweni kwe-plasma ephezulu kungakapheli amahora angama-2-3. Kubalulekile ukukhumbula ukuthi i-bioavailability iyancipha ngomthamo owandayo futhi ifinyelela isilinganiso esingu-60%. Ukudla akuthinti izinga lokuphelele kanye lokufakwa komuthi.

Ukuqedwa kwesigamu sempilo kwenza amahora angama-5-7. Umuthi ufinyelela ekugxileni kokulingana ngethamo elilodwa. Izinga lokubopha kwe-gabapentin kumaprotheni e-plasma liphansi - lingaphansi kuka-3%, ngakho-ke umuthi usatshalaliswa kwizicubu ngendlela engashintshiwe. Umuthi uthululwa usebenzisa uhlelo lobuchwephesha ngendlela yoqobo lwayo, ngaphandle kokuguqulwa ku-hepatocytes.

Okuphilisayo

Umuthi ungoweqembu lezidakamizwa ze-antiepileptic. Ezigulini ezineminyaka engaphezu kwengu-12 ubudala, iGabagamm ichazwa njengengxenye yokwelashwa okuhlanganisiwe yokulwa nokuqothuka okuyingxenye, ebonakala ngokuba khona noma ukungabi bikho kokujwayelekile kwesibili. Kubantu abadala, amaphilisi anqunyelwe i-postherpetic neuralgia kanye ne-pain syndrome ngokumelene nesizinda se-neuropathy yesifo sikashukela.

Ezigulini ezineminyaka engaphansi kwengu-12 ubudala, iGabagamm ichazwa njengengxenye yokwelapha okuhlanganisiwe yokulwa nokuqothuka okuyingxenye.

Contraindication

Umuthi awunqunyelwe uma kukhona ukwanda kokucasuka kwezicubu zeziguli ezintweni zezakhi zeGabagamma. Ngenxa yokuba khona kwe-lactose ekwakhiweni kwayo, umuthi ubekwa ngemithi ukuze usetshenziswe ezigulini ezinenkinga yokuthola ushukela wobisi kanye ne-galactose, ngokuntuleka kwe-lactase ne-malabsorption ye-monosaccharides.

Ngokunakekela

Akunconyelwe noma kuqashelwe kufanele kusetshenziswe lapho kuthathwa iziguli ezinezifo zemvelo yengqondo noma ukwehluleka kwezinso.

Ungayithatha kanjani iGabagamma

Umuthi uphuzwa ngomlomo, kungakhathalekile ukuthathwa kokudla. Uma udinga ukukhansela umuthi, kufanele uyeke ukusebenzisa i-Gabagamm kancane kancane phakathi nesonto. Ukwelashwa kwezidakamizwa ngokukhuphuka komthamo kwenziwa uma kwenzeka ukukhathala kweziguli, isisindo somzimba ophansi noma esimweni esibi sesiguli, kufaka phakathi nobuthakathaka esikhathini sokuvuselelwa ngemuva kokufakelwa. Esimweni esinjalo, kuyadingeka ukuqala ngomthamo we-100 mg.

Uhlobo lokwelashwa lusungulwa udokotela ngokuya ngesimo sesiguli nesithombe somtholampilo se-pathology.

Ngoshukela

Umuthi awuthinti izinga likashukela we-plasma futhi awuguquli ukuhanjiswa kwe-insulin ngamaseli e-beta wepancreas, ngakho-ke asikho isidingo sokuphambuka kunqubo yonyango enconyiwe lapho kukhona isifo sikashukela mellitus.

Imiphumela emibi

Imiphumela emibi ezimweni eziningi yenzeka ngerejimthi yemithamo ekhethwe ngokungafanele noma ukuphambuka okuvela kwizincomo zezokwelapha. Mhlawumbe ukuthuthukiswa komkhuhlane wezidakamizwa, ukukhuphuka kokujuluka, izinhlungu ezindaweni ezahlukahlukene zomzimba.

Kusuka ezicutshini zemisipha

Umuthi awuthinti uhlelo lwe-musculoskeletal, kepha ngomonakalo oqondile ohlelweni lwezinzwa, izinhlungu emisipha nasekuhlanganeni, kungavela amathambo omthambo.

Izitho zeHematopoietic

Ngokushintshwa kwamapharamitha wesistimu ye-hematopoietic, i-thrombocytopenic purpura ingavela, ihambisane nokulimala, ukuncipha kwenani lezinto ezakhiwe egazini.

Amapheshana wesisu

Ukuphendula okungalungile endaweni yokugaya ukudla kubonakaliswa yilezi zinto ezilandelayo:

• Ubuhlungu be-epigastric;
• i-anorexia;
• ukuthopha, ukuhudula, ukugabha;
• ukuvuvukala kwesibindi;
• umsebenzi owengeziwe we-hepatocytic aminotransferases;
• i-jaundice ngokumelene nesizinda se-hyperbilirubinemia;
• i-pancreatitis
• i-dyspepsia kanye nomlomo owomile.

Njengomphumela wecala ovela emgodini wesisu, i-anorexia kungenzeka.

I-Flatulence iyinkomba yemiphumela emibi yomuthi.

I-pancreatitis ingavela futhi njengethonya lemiphumela.

Isistimu yezinzwa ephakathi

Ngokuvimbela uhlelo lwezinzwa, kungenzeka:

• Isiyezi
• ukwephulwa komkhondo wokunyakaza;
• choreoathetosis;
• ukulahleka kwezikhalazo;
• imibono;
• ukulahleka kokulawulwa kwengqondo-kwengqondo;
• ukwehla kokusebenza kwengqondo, ukucabanga okungahambi kahle;
• i-paresthesia.

Ezimweni ezingavamile, i-amnesia iyakhula, imvamisa yokuxhuzula ngokuxhuzula iyanda.

Kusuka ohlelweni lokuphefumula

Mhlawumbe ukuthuthukiswa kokuphefumula komoya, inyumoniya. Ngokugomeka okubuthakathaka, izinqubo ezithathelwanayo, izifo ezibangelwa amagciwane, i-pharyngitis, nokuqothuka kwamakhala kungaqhamuka.

Engxenyeni yesikhumba

Ezimweni ezikhethekile, induna, i-edema yangaphakathi, i-erythema, ukulunywa kanye nokuqunjelwa kungenzeka.

Kusuka ohlelweni lwezitho zofuzo

Ezimweni ezingavamile, iziguli ezithintekayo zingahle zibe nezifo zokuhamba komchamo, ukuncipha kwama-erections, i-enuresis (ukuqubuka komchamo), kanye nokwehluleka kwezinso okubi kakhulu.

Ezimweni ezingavamile, iziguli ezisengozini yokulimala zingathola izifo ezithinta umchamo.

Kusuka ohlelweni lwezinhliziyo

Mhlawumbe ukuthuthukiswa kwezimpawu ze-vasodilation, ukukhuphuka kwenhliziyo nokwanda komfutho wegazi.

Allergies

Uma isiguli sithambekele ekuqubuleni komzimba, kungenzeka ukuthi sikhule nge-Quincke edema, ukushaqeka kwe-anaphylactic, i-angioedema, iStevens-Johnson syndrome kanye nokuphendula kwesikhumba.

Umthelela ekhonweni lokulawula izindlela

Ngokubheka ubungozi bokusabela okungekuhle ohlelweni oluphambili lwezinzwa (CNS) ngesikhathi sokwelashwa kwezidakamizwa, kunconyelwa ukunciphisa isikhathi somsebenzi ngamadivayisi angaba yingozi noma ayinkimbinkimbi, ukushayela imoto nokwenza imisebenzi edinga ukugxila nokushesha kokuphendula okuvela esigulini.

Imiyalo ekhethekile

Naphezu kokungabikho kwesifo sokuhoxiswa ngesikhathi sokwelashwa ngezidakamizwa nge-gabapentin, kunengozi yokuphindaphinda kwama-izicubu zemisipha ezigulini ezinomhlobo oyingxenye yomsebenzi owethusayo. Kubalulekile ukukhumbula ukuthi lesi sidakamizwa asilona ithuluzi eliphumelelayo ekulweni nesifo sokuwa.

Ngokulashwa okuhlangene neMorphine, kuyadingeka ukwandisa umthamo weGabagamm ngemuva kokubonana nodokotela. Kulokhu, isiguli ngaso sonke isikhathi kufanele sibe ngaphansi kokuqashwa okuqinile kwezokwelapha ukuvimbela ukuqala kwezimpawu zokucindezelwa kwesistimu yezinzwa ephakathi (ukozela). Ngokuthuthukiswa kwezimpawu zokuphazamiseka kohlelo lwezinzwa, kuyadingeka ukunciphisa umthamo wazo zombili lezi zidakamizwa.

Ngokulashwa okuhlangene neMorphine, kuyadingeka ukwandisa umthamo weGabagamm ngemuva kokubonana nodokotela.

Ekuqhubekeni kwezifundo zaselaborathic, umphumela ongalungile wamanga wokuba khona kwe-proteinuria ungaqoshwa, ngakho-ke, lapho kubekwa iGabagamma kanye nezinye izidakamizwa, kubalulekile ukucela abasebenzi belebhu ukuthi benze ucwaningo ngendlela ethile yokuthola i-sulfosalicylic acid.

Sebenzisa ebudaleni

Abantu abaneminyaka engaphezu kwengu-60 ubudala abadingi ukwengeza ngaphezulu komthamo.

Ukunquma iGabagamma ezinganeni

Lesi sidakamizwa asinconywa ezinganeni nakwentsha engaphansi kweminyaka engu-18 ubudala, ngaphandle kwamacala okuqothuka okuyingxenye.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Izifundo zemitholampilo ngemiphumela yomuthi ekukhuleni kwe-embryonic azenziwanga. Ngakho-ke, i-gabapentin inqunyelwe abesifazane abakhulelwe kuphela ezimweni ezibucayi, lapho umphumela omuhle wesidakamizwa noma ingozi empilweni kamama udlula ingozi yokulimazeka kwe-intrauterine.

UGabapentin ubekelwe abesifazane abakhulelwe kuphela ezimweni ezimbi kakhulu.

Into esebenzayo iyakwazi ukuthululwa obisini lukamama, ngakho-ke ukuncelisa ibele kufanele kushiywe ngenkathi kwelashwa izidakamizwa.

Isicelo sokusebenza kokulimala kwezinso

Lapho kukhona ukwehluleka kwezinso, irejimeni yemithamo iyalungiswa ngokuya ngesakhiwo selinineine (Cl).

Ukweqisa

Ngokuhlukumezeka komuthi ngenxa yomuthi owodwa womthamo omkhulu, kuvela izimpawu zokweqisa:

• Isiyezi
• ukuphazamiseka kokusebenza okubukwayo okuhlukaniswa izinto;
• inkinga yokukhuluma;
• ubuqili;
• ukozela
• isifo sohudo

Ubungozi obungenzeka benyuke noma bukhuphuke ngokunye ukusabela okuhle. Umuntu ohlukunyeziwe kumele alaliswe esibhedlela ukuze akhishwe esiswini, inqobo nje uma amaphilisi lawo ephuzwe ngomlomo emahoreni angama-4 adlule. Isimpawu ngasinye se-overdose siqedwa ngokwelashwa okubonakalayo. I-Hemodialysis iyasebenza.

Nge-overdose yesidakamizwa, ukozela kungenzeka.

Ukuxhumana nezinye izidakamizwa

Ngokusetshenziswa okufanayo kweGabagamm nezinye izidakamizwa, lokhu kulandelayo okulandelayo kwenzeka:

1. Uma uthatha iMorphine amahora ama-2 ngaphambi kokusebenzisa i-gabapentin, ungangezelela ukuqina kokugcina ngo-44%. Kulokhu, kwandiswe umkhawulo wobuhlungu. Akukho okubaluleka komtholampilo okutholakele.
2. Ngokuhlanganiswa nama-antacid kanye namalungiselelo aqukethe usawoti we-magnesium ne-aluminium, i-bioavailability ye-gabapentin incishiswa ngo-20%. Ukugwema ukwenza buthaka umphumela wezokwelapha, kunconywa ukuthatha amaphilisi we-Gabagamma ngemuva kwamahora ama-2 ngemuva kokuthatha ama-antacid.
3. I-Probenecid ne-cimetidine ayinciphisi amazinga e-excretion kanye ne-serum yento esebenzayo.
4. I-Phenytoin, izindlela zokuvimbela inzalo ngomlomo, i-phenobarbital ne-carbamazepine azithinti ukugcwala kwe-plasma ye-gabapentin.

Ukuhambisana notshwala

Ngesikhathi sokulashwa kwezidakamizwa, kwenqatshelwe ukuphuza utshwala. I-Ethanol ekwakhiweni kophuzo oludakayo inomphumela oqinile wokuvinjezelwa kuhlelo oluphambili lwezinzwa futhi ibangela imiphumela emibi.

Ama-Analog

Izifanekiso zomuthi zifaka:

• Katena
• UGabapentin;
• Neurontin;
• Tebantin;
• Convalis.

Ukushintshela komunye umuthi kuvunyelwe kuphela ngemuva kokubonisana nodokotela ngokusebenza okuphansi kweGabagamm noma ngokubonakala kwemiphumela engemihle.

Njenge-analogue, ungasebenzisa i-Neurinu.

Izimo zeholide Gabagamm kusuka ekhemisi

Umuthi awuthengiswa ngaphandle kwemithi kadokotela.

Ngingakwazi ukuthenga ngaphandle kadokotela

Ngenxa yengozi eyandayo yokucindezelwa kohlelo lwezinzwa oluphakathi kanye nokuvela kokungaphenduki kahle kwezinye izitho, ukuthengiswa kwamahhala kweGabagamm kukhawulelwe.

Intengo yeGabagma

Izindleko ezijwayelekile zomuthi ziyehluka kusuka kuma-ruble angama-400 kuye kwangama-1150.

Izimo zokugcina zomuthi

Kunconywa ukugcina i-anticonvulsant emazingeni okushisa afinyelela ku- + 25 ° C endaweni epholile enomswakama ophansi.

Isikhathi sokuphelelwa yisikhathi

Iminyaka emithathu

Umkhiqizi weGabagma

I-Werwag Pharma GmbH & Co KG, eJalimane.

Kunconywa ukugcina i-anticonvulsant emazingeni okushisa afinyelela ku- + 25 ° C endaweni epholile enomswakama ophansi.

Ukubuyekezwa ku-Gabagamma

U-Izolda Veselova, oneminyaka engama-39, eSt

Amakhebuli eGabagma anqunywa maqondana namagatsha e-neuralgia 2. Udokotela wathi umthamo usethwe ngokuya ngezinga lokusebenziseka okuhle. Ngokwami, kwadingeka ngithathe amaphilisi angafika ku-6 ngosuku. Kufanele kuthathwe ngokulandelana okwandayo: ekuqaleni kwezokwelapha, kwaqala ngamaphilisi angama-1-2 ezinsukwini ezingama-7, emva kwalokho lenyuka idosi. Ngikubheka njengekhambi eliphumelelayo lokuquleka. Angibonanga imiphumela emibi ngesikhathi sokwelashwa. Ukuncipha kumile.

UDominika Tikhonova, oneminyaka engama-34, uRostov-on-Don

Wathatha i-Gabagma njengoba kuchazwe udokotela oyi-neurologist maqondana ne-trigeminal neuropathy. ICarbamazepine yayingaphumeleli esimweni sami. Amakhandlela asize ngamaqhinga okuqala. Inkambo yokwelashwa ngezidakamizwa yahlala izinyanga ezi-3 kusukela ngoMeyi 2015. Naphezu kwesifo esingamahlalakhona, izinhlungu nezimpawu ze-pathology zidlulile.Okuwukuphela kokudonsayo intengo. Kumakhompiyutha angama-25 kwadingeka ngikhokhe ama-ruble ayi-1200.