I-Fendivia yiqembu le-narcotic analgesics. Njengoba into esebenzayo iqukethe i-opiate. Ngenxa yalesi sakhi, kunikezwa ukwehla kobukhulu besifo sezinhlungu.
Igama Lezwe elingafanele
UFentanyl (ngesiLatini - Fentanyl).
I-Fendivia yiqembu le-narcotic analgesics.
I-ATX
N02AB03.
Khipha amafomu nokwakheka
Ukulungiswa kuhlongozwa ngesimo sesisombululo somjovo (ophathwe ngaphakathi futhi ngaphakathi nangaphakathi). Uma uthengiswa ungathola i-transdermal patch. UFentanyl usebenza njengendawo esebenza ngayo. Kunikezwa izinhlobo ezahlukene zomuthi. Umthamo wento esebenzayo ungahluka (mg): 1.38; 2.75; 5.5; 8.25; 11. Amandla wokukhishwa kwe-fentanyl nawo ayahlukahluka (μg / h): 12.5; 25; 50; 75; 100.
Isichibi simbozwe ngefilimu evikelayo; iqukethe ezinye izinto ekwakhiweni:
- dimethicone;
- dipropylene glycol;
- hyprolose.
Isenzo se-Pharmacological
Ingxenye eyinhloko ekwakhiweni yiqembu lama-opioid agents. Inomphumela we-analgesic. Ngenxa yokuba yidakamizwa ye-narcotic, umuthi okukhulunywa ngawo usetshenziswa ngokuqapha ngokuya ngezinkomba eziqinile zodokotela. Isenzo se-pharmacological sisekelwe emandleni wokuthokozisa ama-opiate receptors wesistimu yezinzwa ephakathi, izicubu, nentambo yomgogodla. Ngaphansi kwethonya le-fentanyl, umkhawulo wobuhlungu uyakhuphuka, ngenxa yokuthi ukumelana komzimba ezintweni ezingezinhle nezangaphandle kuyanda.
Ukulungiswa kuhlongozwa ngesimo sesisombululo somjovo (ophathwe ngaphakathi futhi ngaphakathi nangaphakathi).
Elinye ikhono lezinto ezisebenzayo ukwephula uchungechunge lokudlulisela okucashile kuyinkimbinkimbi ye-hypothalamus, thalamus, amygdala. Izakhiwo eziyinhloko zesidakamizwa: i-analgesic ne-sedative. Umuthi ngasikhathi sinye wehlisela ukuqina kobuhlungu be-neuropathic futhi unomphumela wokuphumlisa ngokwanda kwe-excitability kanye nezinye izimpawu zokuphazamiseka kwemizwa.
Ngaphansi kwethonya le-fentanyl, kuye kwaguqulwa ushintsho ekufakweni kombala kobuhlungu. Ngaphezu kwalokho, amaphilisi okulala ayakhonjiswa. Ubungako bethonya lesakhi esisebenzayo esigulini kuya ngokuthi umthamo we-fentanyl kanye nezinga lokuzwela lomzimba. Kwesinye isikhathi, kanye ne-anesthetic, effect sedative, i-euphoria iyaziveza. Lapho kusetshenziswa kakhulu lesi sidakamizwa, iba yingozi enkulu yokwakha ukubekezelela komzimba emiphumeleni yento esebenzayo. Ngemuva kokusebenzisa okuphindaphindiwe, ukuncika entweni esebenzayo kungenzeka.
Ngaphansi kwethonya le-fentanyl, kuphakama ukusabela okungekuhle: umsebenzi wokuphefumula uvinjelwe, futhi ezinye izikhungo (i-vagus nokuhlanza), ngakolunye uhlangothi, ziyajabula. Omunye umphumela oyingozi ukwanda kwezwi lezicubu zama-sphincters ahlukahlukene kanye ne-urethra, kanye nesinye. Ngenxa yalokhu, ukuphazamiseka kohlelo lomchamo kuyavela. Ngasikhathi sinye, ukuthuthukiswa kwezinqubo ezingezinhle ezilandelayo kuphawuliwe:
- ukugaya ukudla okuhamba kancane ngenxa yokwehla kwezinga lokuqina kwamathumbu;
- ukuphuma kwegazi okungahambi kahle ezinso;
- amanzi avela emathunjini adonswa ngenkuthalo ngokwengeziwe;
- ushintsho ekushweni kwenhliziyo;
- i-hypertension ye-arterial;
- ukugcwala kwe-amylase, i-lipase egazini inyuka.
Ngaphansi kwethonya le-fentanyl, amaphilisi okulala abonakaliswa ngokungeziwe.
I-Pharmacokinetics
Inani eliphakeme lomsebenzi litholakala kungakapheli amahora ayi-12-14 ngemuva kokuthola umthamo womuthi. Umphumela wokwelapha uphikelela ezinsukwini ezintathu ezilandelayo. Uma umuthi usetshenziswa kaninginingi, okuhlushwa kugcinwa njalo. Lapho kusetshenziswa isichibi, inani lezinto ezisebenzayo ku-plasma ngqo lincike ngosayizi walo. Kulokhu, izinga lokugunda nalo lihlukile. Ngakho-ke, lapho kwenziwa isicelo endaweni yesifuba, ukumuncwa kuqine kakhulu.
Amaphrotheni aphezulu abopha egazini ayaziwa - aze afike ku-84%. Ngaphezu kwalokho, i-fentanyl idlulela kubisi lwebele, i-fetus ngesikhathi sokukhulelwa. Uma ingena esibindini, isakhi esiyinhloko siguqulwa ngokukhishwa okulandelayo kwento engasebenzi. Inqubo yokususa i-fentanyl emzimbeni iyasebenza ngemuva kokuthi isichibi sisusiwe. Isigamu sempilo singamahora angama-17, ezigulini ebuntwaneni - isikhathi eside. Ngokuphathwa kwe-intravenous, into isuswa emzimbeni ngokushesha.
Inani elikhulu liyakhululwa ngesikhathi sokuchama. Ingxenye encane yesidakamizwa isuswa ngesikhathi sokuhamba kwamathumbu. Ingxenye eyinhloko idalulwe ngendlela yama-metabolites.
Izinkomba zokusetshenziswa
Inhloso eyinhloko yesidakamizwa ukususa izimpawu ezingathandeki ezimweni ze-pathological ngendlela engapheli, uma ihambisana nobuhlungu obukhulu. Kunqunyiwe lapho kuthathwa khona ukwelashwa kwe-opioid yesikhathi eside. Isibonelo, i-Fendivia ithathwa isifo samathambo, i-neuropathy, i-chickenpox (patch).
IFendivia ithathwa isifo samathambo.
Isilinganiso somjovo sibanzi ngandlela-thile: i-anesthesia yangaphambi kokuhlinzwa, izinhlungu zezakhi zofuzo ezihlukene (ukusebenza kwenhliziyo engalapheki, ukululama ekuhlinzwa, ukuhlukumezeka, i-oncology), okungafani nesimo esingamahlalakhona. Futhi, umuthi osefomini loketshezi ungabekelwa ama-antipsychotic.
Contraindication
Ukungathandeki kwaleli thuluzi kunenombolo enkulu yemikhawulo ngokuphelele yokusebenzisa:
- ukungaphenduki okuhle kokuthile kokuthile okusebenzayo;
- umsebenzi wokuphefumula okhubazekile;
- ukuguqulwa kwesembozo esingaphandle nangesikhathi se-irradiation, kufaka phakathi (kwephakethe);
- i-stool evulekile ngesikhathi sokwelashwa ngama-antibiotic ngama-penicillin, i-cephalosporins, i-lincosamides;
- ukuphazamiseka kokugaya ukudla okunobuthi;
- ukulimala okukhulu ohlelweni lwezinzwa oluphakathi.
Ngokunakekela
Inani lemikhawulo ethile yokusetshenziswa iyaphawulwa:
- ukukhuphuka kwengcindezi ye-intracranial;
- izifo ezingapheli zamaphaphu;
- bradyarrhythmia;
- ukulimala kobuchopho noma ukuvuvukala;
- ukwanda kwengcindezi yegazi;
- colic esibindini, izinso;
- ukwakheka kwe-calculi emgodini;
- ukuphazamiseka kwe-thyroid (hypothyroidism);
- Ubuhlungu besisu be-etiology engaziwa;
- i-benign hypertrophy yezicubu zomgogodla wendlala;
- ukwanda kokushisa komzimba isikhathi eside, okuholela ekushiseni ngokweqile (ngokwesibonelo, ngenkathi uvakashela i-sauna);
- utshwala noma umlutha wezidakamizwa;
- ukuncipha kwe-lumen ye-urethra;
- isimo esibucayi esivamile sesiguli.
Ungayisebenzisa kanjani iFendivia
Umthamo wengxenye esebenzayo unqunywa ngokuhlukile. Inani le-fentanyl lincike esimweni sesiguli, ukuba khona / ukungabikhona kwesipiliyoni ngokusetshenziswa kokuqala kwe-narcotic analgesics. Lapho usebenzisa isichibi, i-integument yangaphandle iyahlanzwa futhi yomiswe. Ama-detergents akufanele asetshenziswe, amanzi ahlanzekile anele. Isikhumba akufanele sakhiwe.
Umthamo wokuqala ngu-12,5 noma 25 mg. Ngemuva kwalokho yandiswa ngesiketheni esisha ngasinye. Isilinganiso esiphezulu se-fentanyl yansuku zonke singama-300 mg. Uma kunesidingo sokwenyusa umthamo, cabanga ngezimali eziwuketshezi. Ukugwema izimpawu zokuhoxiswa, kunconywa ukunciphisa inani lezinto ezisebenzayo kancane.
Ukuthinta kuphi
Isithako esisebenzayo simunca kangcono emuva eliphezulu, izingalo.
Ungashintsha kanjani
Isikhathi sokusetshenziswa kwesichibi esingu-1 amahora angama-72. Ngemuva kwalokho, kwenziwa okunye esikhundleni. Uma umphumela wokwelapha uthambile, umkhiqizo uguqulwa ngemuva kwamahora angama-48. Ngaphezu kwalokho, i-patch elandelayo ifakiwe endaweni entsha. Uma lokhu kunconywa kungabhekwa, ukuqina kwefentanyl kuyanda. Ngenkambiso yokususa isichibi, kufanele igoqwe ngezindawo ezinamathele ngaphakathi futhi zichithwe.
Ngoshukela, umuthi ungasetshenziswa, kepha njengoba kuyalelwe udokotela.
Kungenzeka ukusika
Ukuthola umphumela omuhle, ungephuli ubuqotho besibaya.
Bangaki abaguli abanomdlavuza abahlala eFendivia
Isidakamizwa sisetshenziswa kuze kutholakale umphumela wokwelapha ofunekayo. Lapho kuvela izimpawu zokubekezelelana, ishintshelwa kwelinye ikhambi.
Sebenzisa isifo sikashukela
Umuthi ungasetshenziswa, kepha njengoba kuchazwe udokotela futhi inqobo nje uma isikhumba singonakalisiwe.
Imiphumela emibi
Ithuluzi linomthelela ekuthuthukisweni kwemiphumela emibi eminingana.
Amapheshana wesisu
Isicanucanu esilandelwa ukuhlanza, ubuhlungu besisu, ukuphazamiseka kwesisu, ukuncipha kokugaya, ulwelwesi lwe-mucous lomlomo olomile. Izimpawu zokuvinjezelwa kwamathumbu akuvamile ukwenzeka.
Ukuthatha i-Fendivia kungaholela ekulahlekelweni yisifiso sokudla.
Engxenyeni ye-metabolism kanye nokudla okunempilo
Iziguli eziningi zibonisa izimpawu ze-anorexia: ukunciphisa isisindo, ukulahlekelwa isifiso sokudla, ukuthuthukiswa kokuphazamiseka kwamathumbu emathunjini.
Isistimu yezinzwa ephakathi
Ukomela, ikhanda kanye nesiyezi, imilente eqhaqhazelayo, inkumbulo ekhubazekile, imisipha, ukudideka nokuqina.
Kusuka ohlelweni lomchamo
Kubambezeleka ukuchama.
Kusuka ohlelweni lokuphefumula
Ukuphefumula, umsebenzi wokuphefumula okhubazekile; ukuboshwa kokuphefumula kuyaqabukela kwenzeka, umoya omncane owanele wamaphaphu ubonakala.
Engxenyeni yesikhumba
I-Hyperhidrosis, ukulunywa, i-erythema, izinqubo zokuvuvukala esikhunjeni, i-eczema.
Ukuthatha i-Fendivia kungaholela ku-eczema.
Kusuka ohlelweni lwezitho zofuzo
Ukwephulwa komsebenzi wobulili.
Kusuka ohlelweni lwezinhliziyo
Shintsha izinga lokushaya kwenhliziyo, ukugqama kwenombolo yangaphandle.
Kusuka ohlelweni lwe-musculoskeletal kanye nezicubu ezithintekayo
Ukusonta kwemisipha, cramping.
Engxenyeni yesibindi ne-biliary
Colic.
Allergies
I-allergic, i-dermatitis. Izimpawu: hyperemia, ukulunywa, ukuqubuka.
Umthelela ekhonweni lokulawula izindlela
Umuthi uthinta imisebenzi eminingi yomzimba ebalulekile. Ngalesi sizathu, izimoto akufanele ziqhutshwe ngesikhathi sokwelashwa. Noma kunjalo, ayikho imikhawulo eqinile.
Imiyalo ekhethekile
Umuthi usetshenziswa uhlangana nezinye izidakamizwa.
Ngokuthi umuthi ungena obisini lukamama nange-placenta, ubungozi bokuthola izimpawu ezingezinhle enganeni buphakeme impela.
Uma ukusabela okungesihle ezingxenyeni sekukhule, isiguli kufanele siqashelwe amahora angama-24 alandelayo, ngenxa yezinga eliphansi lokuqedwa kwe-fentanyl.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi unqunyelwe, kepha njengezinyathelo sokugcina. Isetshenziselwa izizathu zezempilo, lapho izinzuzo zikhulu kakhulu kunokulimala okungenzeka. Ngokwelashwa ngesikhathi sokukhulelwa, kunengozi yokuthola ukuhoxa enganeni ngemuva kokuzalwa.
Ngokuthi umuthi ungena obisini lukamama nange-placenta, ubungozi bokuthola izimpawu ezingezinhle enganeni buphakeme impela.
Ukuqokwa kwe-Fendivia ezinganeni
Umuthi uvunyelwe ukusetshenziswa. Kuvunyelwe ukunquma kusuka eminyakeni emibili. Izingane ezingaphezulu kweminyaka engu-16 zingasebenzisa umthamo wabantu abadala. Iziguli ezingaphansi kweminyaka engu-16 ubudala zinqunywa umuthi uma imithamo yomlomo ye-morphine ibikade isetshenziswa ngaphambili (okungenani ama-30 mg ngosuku).
Sebenzisa ebudaleni
Ngesikhathi sokulashwa, inqubo yokuthola i-fentanyl yehlisa ijubane. Lokhu kuholela ekwandeni kancane kancane kokuhlushwa kwaso. Ngalesi sizathu, umthamo kufanele ubuyekezwe. Umuthi uvunyelwe ukusetshenziswa kuphela uma inzuzo idlula ukulimala. Ukwelashwa kufanele kuqale ngomuthi ka-12,5 mg.
Ebudaleni, umuthi uvunyelwe ukusetshenziswa kuphela uma inzuzo idlula ukulimala.
Uma kwenzeka ukungasebenzi kahle kwezinso
Kunobungozi bokugxila okwandisiwe kwe-serum fentanyl. Ngalesi sizathu, umthamo wokuqala wesidakamizwa ngesikhathi sokwelapha ngu-12,5 mg.
Ngokungasebenzi kahle kwesibindi
Ithuluzi lisebenzisa ngokuqapha, ngoba ukugcwala kwento esebenzayo egazini kuyanda. Inkambo yokwelashwa iqala ngenani lomuthi - 12,5 mg.
Ngesifo senhliziyo
Ithuluzi livunyelwe ukusetshenziselwa, kepha ukugadwa kochwepheshe kuyadingeka.
Ukweqisa
Uma inani lezinto ezisebenzayo lenyuka kakhulu, isichibi siyasuswa, into ethile eyi-antagonist (naloxone) iyabhalwa. Umthamo wokuqala ngu-0,4-2 mg (ngaphakathi emzimbeni). Uma kunesidingo, ukwelashwa kuqhutshwa ukuphathwa okuphindaphindiwe komphikisi njalo ngemizuzu emi-3. Enye indlela ukulethwa kwekhambi le-naloxone ngethon (2 g yalesi sihlanganiswa kuxutshwe no-500 ml we-sodium chloride 0,9%).
Enye indlela ukulethwa kwekhambi le-naloxone ngethon (2 g yalesi sihlanganiswa kuxutshwe no-500 ml we-sodium chloride 0,9%).
Ukuxhumana nezinye izidakamizwa
Ukuqoqwa kwengxenye esebenzayo kunyuka ngaphansi kwethonya lama-cytochrome P450 3A4 inhibitors. Futhi ukusetshenziswa kwe-cytochrome inducers, okuphambene nalokho, kusiza ukunciphisa okuqukethwe umuthi osegazini.
Ungasebenzisi ama-inhibitors we-MAO, ama-agonists ahlanganisiwe nabaphikisi, izidakamizwa ze-serotonergic kanye neFendivia.
Ukuhambisana notshwala
Ungaphuzi iziphuzo eziqukethe utshwala ngesikhathi sokwelashwa nomuthi okukhulunywa ngawo.
Ama-Analog
Imithi esebenzayo:
- UDolforin;
- Durogezik;
- I-Fentanyl.
Izimo zeholide Fendivia kusuka ekhemisi
Umuthi umuthi.
Uma kwenzeka isifo senhliziyo, umkhiqizo uvunyelwe ukusetshenziswa, kepha kuyadingeka ukuba kuqashwe ochwepheshe.
Ngingakwazi ukuthenga ngaphandle kadokotela
Cha.
Intengo yeFendivia
Izindleko ziyahlukahluka kusuka kuma-ruble angama-4900 kuya kwangama-6400.
Izimo zokugcina zomuthi
Ibanga lokushisa eliphakanyisiwe: + 25 ° С.
Isikhathi sokuphelelwa yisikhathi
Impilo yeshalufini yesidakamizwa yiminyaka emi-2 kusuka ngosuku okhiphe ngalo.
Umkhiqizi waseFendivia
I-LTS Lohmann Therapie-Systeme, eJalimane.
Ukubuyekezwa mayelana ne-Fendivia
Ukuhlaziywa kwabathengi nochwepheshe kuzokuvumela ukuthi wenze umbono ophelele mayelana nomuthi.
Odokotela
UDanilov I.I., oncologist, oneminyaka engama-49 ubudala, uVladivostok
Ithuluzi lenza umsebenzi walo - lisuse izinhlungu. Okubi kufaka phakathi ijubane eliphansi lokwenza, ngoba i-fentonil ikhishwa kancane kancane: okokuqala ingena ekwakhiweni kwe-integument yangaphandle bese kuphela egazini. Naphezu kokubukeka kwayo, leli khambi lingaba yingozi ngenxa yokuphazamiseka kwamasosha omzimba (ukusabela kwe-anaphylactoid ukuthuthukisa).
UVerilova A.A., udokotela ohlinzayo, oneminyaka engama-53 ubudala, iSt
Ngisebenzisa umuthi ngokungafanele ngenxa yefomu engalungile. Wenza kancane. Ngaphezu kwalokho, izindleko ziphezulu. Uma sicabangela izakhiwo zalo eziphambili, khona-ke ukusebenza kwaleli thuluzi akulona eliphansi kuma-analogues kwezinye izindlela.
Iziguli
U-Eugene, oneminyaka engama-33, uPenza
Umuthi uyingozi impela, njengama-opiate amaningi. Isikhathi esithile ngemuva kokuqala kokwelashwa, wayeka ukusiza. Ngifunde ngentuthuko engabakhona yokubekezelela into esebenzayo, kepha angizange ngicabange ukuthi i-analgesic ye-narcotic ingayeka ngokushesha ukufeza umsebenzi wayo. Kwakufanele ngishintshele kwi-analogue.
UVeronika, oneminyaka engama-39, eMoscow
Nge-oncology, isiza kabi. Umphumela uhlala wesikhashana, emva kwalokho kuyadingeka ukuthi ushintshe isichibi ngaphambili, okuyinkinga, ngoba ingasasebenza isikhathi esingaphezu kwesingu-1 ngaphakathi kwamahora angama-48. Ngenxa yalesi sizathu, udokotela unikeze omunye umuthi.
