Uyisebenzisa kanjani i-Duloxetine yezidakamizwa?

I-Duloxetine iyisidakamizwa esisebenza ngezindlela ezibuhlungu zesifo sikashukela sokudangala kanye nokudangala okuhlukahlukene. Ngenxa yokusebenza kwayo okuphezulu, lo muthi uthole izinhlelo eziningi zokwelashwa.

I-Duloxetine iyisidakamizwa esisebenza ngezindlela ezibuhlungu zesifo sikashukela sokudangala kanye nokudangala okuhlukahlukene.

Igama Lezwe elingafanele

Izwekazi elingahlanganyeli konke lihambisana ngokuphelele nokuhweba.

Igama lamakhemikhali lomuthi ngu (γS) -N-Methyl-γ- (1-naphthyloxy) -2-thiophenpropanamine.

NgesiLatin: Duloxetine.

I-ATX

I-ATX: N06AX21.

Khipha amafomu nokwakheka

Umuthi lo ukhiqizwa emabhodleleni ama-gelatin aqinile, isembozo nomzimba wawo upendiwe ngombala oluhlaza okwesibhakabhaka. Ngaphakathi kwelebuli kukhona ama-microsanules ayindilinga anemibala e-milky noma ephuzi.

Into esebenzayo imelwe yi-duloxetine. Izithako ezisizayo zingokulandelayo:

• i-hypromellose;
• i-mannitol;
• isitashi;
• titanium dioxide;
• sucrose;
• i-lauryl sulfate;
• utshwala be-cetyl.

I-capsule ye-gelatin yenziwa kusuka ku-gelatin, titanium dioxide ngokufakwa kodayi oluhlaza obunamalungelo obomvu u-V.

Umuthi ukhishwa emigqonyeni ye-gelatin enzima yombala oluhlaza okwesibhakabhaka.

Isenzo se-Pharmacological

Into esebenzayo ivimbela ukuphinda kuthathwe i-norepinephrine, i-serotonin ne-dopamine (ngokwengxenye). Lokhu kuholela ekuqokeleleni kwalezi zindawo ezisebenza ngama-neurotransmitters futhi kwandise ukuhanjiswa kwazo ohlelweni lwezinzwa oluphakathi. Umuthi uyakwazi ukwandisa umkhawulo wezinhlungu ngobuhlungu obukhula nge-neuropathy.

I-Pharmacokinetics

Ngemuva kokuphathwa komlomo umuthi, izinto ezisebenzayo ziqala ukudonswa ngemuva kwamahora ama-2. Ngemuva kwamahora ayi-6, kugxilwa kakhulu. Inani lemithi esegazini ayinciphi lapho kudliwa, kepha isikhathi sokufika ekuhlolweni okukhulu kakhulu singakhuphuka size sifike emahoreni ayi-10.

Inani lemithi esegazini ayinciphi lapho kudliwa.

Izinto ezisebenzayo ziboshwe ngamaprotheni e-plasma. I-Pathology yesibindi nezinso ayithinti umsebenzi wale nqubo. Ukukhishwa kwesidakamizwa emzimbeni wesiguli kwenziwa ngomchamo. Ukuqedwa kwesigamu sempilo kufinyelela emahoreni ayi-12.

Izinkomba zokusetshenziswa

I-Duloxetine imiselwe i-:

• izinhlobo zobuhlungu be-peripheral diabetesic neuropathy;
• Ukudana
• ama-syndromes obuhlungu obungapheli besistimu ye-musculoskeletal (ama-syndromes anjalo abonwa nge-fibromyalgia, i-osteoarthritis yejoyi ehlanganayo, ubuhlungu obungapheli bendawo engezansi);
• inkinga yokukhathazeka ejwayelekile.

I-Duloxetine imiselwe ukucindezelwa.

Isidakamizwa sisetshenziswa ekwelapheni i-osteoarthritis yejoyi ehlanganyele.

I-Duloxetine iyasebenza ekuphazamisekeni kokukhathazeka okujwayelekile.

Contraindication

Ngokusho kwemiyalo esemthethweni yomuthi, phakathi kokuphambana yilezi:

• i-glaucoma evaliwe engagunyaziwe;
• iminyaka efinyelela eminyakeni eyi-18;
• ukwehluleka kwesibindi (ngemuva kokuthatha i-20 mg yesidakamizwa, ubude be-duloxetine bukhuphuke ngo-15% ngokuqhathaniswa nedatha ye-classical);
• hypersensitivity ku-fructose;
• ukuntuleka kwe-isomaltase ne-sucrase;
• i-glucose-galactose malabsorption;
• isigaba esibulalayo sokwehluleka kwezinso okungamahlalakhona;
• umfutho wegazi ongalawulwa.

Ngokunakekela

Ukulungiswa komdosi nokuqapha ejwayelekile kwezokwelapha kuyadingeka uma isiguli sine-pathologies ethile:

• umfutho wegazi we-intraocular;
• ingozi enkulu yokuthuthukisa i-angle-ukuvalwa kwe-glaucoma;
• ukuphazamiseka kwengqondo ngokuphefumula kanye ne-mania;
• umsebenzi wokuphazamiseka wezinso, ukwehluleka kwezinso (ukucaciswa kwe-creatinine 30 ml / min), i-hemodialysis;
• isikhathi sokukhulelwa kweziguli;
• imicabango yokuzibulala noma ukuzama ukuzibulala emlandweni;
• iminyakazo
• ingozi eyandayo ye-hyponatremia (lesi sigaba sifaka abantu asebekhulile, iziguli ezinesifo sokuqina kwemizwa, ukomisa umzimba, isifo sokungasebenzi kahle kwehomoni ye-antidiuretic).

Ukulungiswa kwe-dose kuyadingeka kwi-intraocular hypertension.

Lapho uphuza umuthi ngesikhathi sokukhulelwa, kudingeka ukuthi kuqashwe njalo odokotela.

Ukuqapha kufanele kuthathwe uma kunomlando wokuthathwa kokuthile.

Ungayithatha kanjani i-duloxetine?

Amaphilisi womuthi enzelwe ukuphathwa ngomlomo. Zigwinyiwe bese zigezwa ngamanzi ngengilazi.

Ama-granules angaphakathi kwe-capsule akufanele asuswe futhi ahlanganiswe nemikhiqizo noma uketshezi ukudala ukumiswa.

Lokhu kuchazwa yiqiniso lokuthi umuthi kufanele uchitheke futhi ungeniswe emathunjini. I-enteric gelatin capsule isiza ukufeza lokhu.

Umthamo ojwayelekile wansuku zonke wezidakamizwa, ovame ukulandela odokotela, ufinyelela ku-30-60 mg. Le mali ayihlukaniswe izingxenye eziningi, kepha isetshenziselwa ukuphatha ngasikhathi sinye. Ukusetshenziswa kwomuthi akuxhomekile ekudleni kokudla.

Ngokuya ngokuxilongwa nesimo sesiguli esivamile, umthamo wansuku zonke ungalungiswa futhi ufinyelele ku-120 mg. Kulokhu, leli nani kufanele lihlukaniswe ngemithamo emi-2.

Amakhompiyutha ayagwinywa bese egeza phansi ngengilazi yamanzi.

Ukuthatha umuthi wesifo sikashukela

Ucwaningo luye lwabonisa ukusebenza ngempumelelo kwomuthi ezinhlotsheni ezibuhlungu ze-neuropathy yesifo sikashukela. Uma kungekho contraindication, iziguli ezinesifo sikashukela zingathatha umthamo wansuku zonke ojwayelekile.

Zingaki izinsuku ezikhonjiswayo?

Ukuphila kwesigamu kwezakhi ezisebenzayo kufinyelela emahoreni ayi-12.

Imiphumela emibi yeDuloxetine

Eminye yemiphumela emibi ejwayelekile ekuphuzeni lo muthi ibizwa ngokuthi ukuphathwa ikhanda, isicanucanu, isiyezi, umlomo owomile, ukozela okwandayo, ukwehla kwesisindo.

Ezigulini eziningi, lezi zimpawu zabonakala zisezingeni eliphansi futhi kuphela ekuqaleni kokwelashwa. Kukhona ushintsho ngesilinganiso sama-enzyme wesibindi, ezimweni ezingandile, i-parasitic (fungus) kanye nezifo ezithathelwanayo (laryngitis, abezindaba ze-otitis) kungenzeka.

Amapheshana wesisu

Ukusuka ohlelweni lokugaya ukudla, ukuvela okulandelayo kokuphuza umuthi kungavela: isisu esidabukisayo, isicanucanu, ukugabha, ukoma okwandisiwe kwe-mucosa yomlomo, ukuphazamiseka kwesitulo (ukuqunjelwa noma isisu), i-flatulence, i-dyspepsia.

Lapho uthatha umuthi, isicanucanu kungenzeka.

Mhlawumbe ukuthuthukiswa kwe-gastritis, i-gastroenteritis, i-stomatitis, i-hepatitis, ukwehluleka kwesibindi, ukubukeka kwe-belching, ukwephulwa kwemizwa yokunambitha.

Akuvamile ukutholwa: ukuba khona kwegazi esihlalweni, ukuphefumula okubi, ukopha kwesisu kanye ne-jaundice.

Isistimu yezinzwa ephakathi

Phakathi kwemiphumela emibi ejwayelekile: ukozela, ukuphathwa ikhanda, ukucindezelwa, i -resthesia, isiyezi, ukuqwasha, ukukhathazeka, ukuthuthumela kwemikhawulo, ukubulala, ukuyaluza.

Kaningi, iziguli zikhononda ngokungahambi kahle kokukhathazeka, i-dyskinesia, i-myoclonus, ukuphazamiseka kokulala, ukubulala, ukugqwala, ukudideka esikhaleni, ukugxupheka okungahambi kahle.

Kwesinye isikhathi iziguli zikhononda ngokuphazamiseka kokulala ngenkathi uthatha umuthi.

Intukuthelo, ulaka, i-mania, ukwehluleka, ukuthambekela kokuzibulala, ukukhathazeka kwe-psychomotor ne-serotonin syndrome akuvamile ukuba kukhule.

Kusuka ohlelweni lokuphefumula

Imiphumela emibi evela ohlelweni lokuphefumula imbalwa. Imvamisa, iziguli eziphuza umuthi zikhononda ngokuqunjelwa. Kwezinye izimo, umuzwa wokucindezela kwe-pharynx kanye ne-nosebleeds uyaphawulwa.

Engxenyeni yesikhumba

Imiphumela emibi ejwayelekile ukujuluka ngokweqile komzimba, ukuqubuka.

Okungatholakali kakhulu i-hemcuthaous hemorrhage, i-photosensitivity (ukuzwela ukukhanya kwelanga), i-urticaria, ukubukeka kokujuluka kokubandayo, isikhumba sokuxhumana, isifo se-Stevens-Johnson kanye ne-angioedema.

Umphumela wecala ovame kakhulu ukujuluka komzimba ngokweqile.

Kusuka ohlelweni lwezitho zofuzo

Ngokusho kwemiyalo yomuthi, kaningi kuba khona buthakathaka kokusebenza kwe-erectile, ubunzima bokufeza umuzwa we-orgasm, wehlise isifiso sobulili.

I-dysuria ephawuleke kaningi, ukugcinwa komchamo, i-nocturia, ukuphuma kwesisu, ukuqubuka komchamo, ukuphazamiseka kwemizwa, izifo zangasese, ukopha kowesifazane.

Kuyaqabukela, kube nezimpawu zokunqamuka kokuya esikhathini nokushintsha kwephunga lomchamo.

Kusuka ohlelweni lwezinhliziyo

Izimpawu ezijwayelekile kakhulu zibandakanya ukushushuluza nokushaya kwenhliziyo okusheshayo.

Okungajwayelekile kakhulu ukwehluleka, izimpawu ze-tachycardia, umkhuhlane obandayo nomfutho wegazi ophakeme.

Phakathi kwezinto ezingavamile ezibizwa ngokuthi yi-atrial fibrillation, i-supraventricular arrhythmia kanye nesifo se-hypertensive.

Ngesikhathi sokulashwa ngomuthi, iziguli azivami ukuba nephutha.

Uhlelo lwe-Endocrine

Ezimweni ezingavamile, i-hypothyroidism iba khona.

Kusuka ohlelweni lwe-musculoskeletal

Umphumela ojwayelekile kakhulu wohlelo lwe-musculoskeletal ukubonakala kokuncipha kwemisipha, izinhlungu emisipha nasemathanjeni, umuzwa wokuqina.

Ukusonta kwemisipha kuvela kaningi.

ITrismus iyivelakancane kakhulu.

Allergies

Ngokuzwela okwengeziwe kwesiguli entweni eyodwa noma eziningi ekwakhiweni komuthi, ukubonakaliswa komzimba kuyenzeka. Ezimweni ezingavamile, kutholakala ukusabela kwe-anaphylactic.

Umthelela ekhonweni lokulawula izindlela

Uma welashwa nge-Duloxetine, kunobungozi bokuqina, ukwephulwa kokuphendula kwengqondo, kanye neminye imisebenzi yokuqonda. Ngenxa yalesi sizathu, iziguli kufanele zenqabe ukushayela imoto futhi zenze imisebenzi engaba yingozi.

Ekwelashweni kweDuloxetine kufanele ikuyeke ukushayela.

Imiyalo ekhethekile

Inkambo yomuthi kufanele igcwaliswe kancane kancane ngokunciphisa umthamo. Ngaphandle kwalokho, ukuthuthukiswa kwesifo sokuhoxiswa kungenzeka.

Ngenxa yokuthi akunakwenzeka ukwehlisa umthamo ukuya ku-15 mg, isikhathi ngaphambi kokuphathwa sikhulisiwe.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Ezimweni zokwelapha, akukho datha ngomphumela womuthi empilweni nasekwenziweni kwesibeletho, ngakho-ke, akunconywa ukunquma iDuloxetine. Ukukhishwa kuyizimo lapho inzuzo kamama yokuphuza umuthi idlula engcupheni yokuthola umntwana. Lapho unquma umuthi ngesikhathi sokuqunjelwa, ukunqunywa kufanele kuyekwe.

Lapho kunqunywa isithasamakhambi sabesifazane besikhathi sokuzala, isiguli kufanele sixwayiswe ngesidingo sokuvimbela inzalo ngempumelelo.

Lapho unquma umuthi ngesikhathi sokuqunjelwa, ukunqunywa kufanele kuyekwe.

Ukunquma i-Duloxetine ezinganeni

Umuthi awubekelwe izingane kanye nentsha engaphansi kweminyaka engu-18.

Sebenzisa ebudaleni

I-overdose ye-Duloxetine

Umuthi wansuku zonke wokwelapha, onconywa ukuthi weqiswe, ngu-1.2 g. Ukungezelela lo muthi (kokubili nge-monotherapy kanye nokuhlanganiswa nezinye izidakamizwa) kubangela lezi zimpawu ezilandelayo:

• ukubanjwa yi-clonic
• ukozela
• i-serotonin syndrome;
• coma
• i-tachycardia;
• ukuhlanza

Kuchazwa icala elilodwa lokweqisa (umthamo 3 g), lilandelwe ngomphumela obulalayo.

Alikho ikhambi elithize lalokhu okusebenzayo, ngakho-ke izinyathelo eziningana zithathwa ukuze kuzinze isimo sesiguli.

1. Ukuhlanzwa kwesisu (ukugabha ukugabha) kunengqondo uma umuthi uthathwe muva nje.
2. Ukuthatha amalahle ocushiwe kunciphisa ukumuncwa komuthi.
3. Ukwenza ukwelashwa okubonakalayo kuya ngokuboniswa.

Ukweqisa kwemithi kungadala ukozela.

Ukuxhumana nezinye izidakamizwa

Uma uhlanganiswa nezinye izidakamizwa, kungadingeka ukuthi uguqule imvamisa yokuphatha noma umthamo.

Ngama-CYP1A2 inhibitors. Le nhlanganisela ivame ukukhulisa ukukhuphuka kokuhlushwa kwento esebenzayo ku-plasma. Ukuqapha okwandayo kufanele kuqashelwe lapho kuhlangene neTolterodine ne-Desipramine.

Namanye antidepressants. Ukuphatha ngokubambisana akunconywa, kufaka phakathi neParoxetine yezidakamizwa. Lokhu kuholela ekunciphiseni ekucaceni.

Ngama-inhibitors we-MAO, i-Moclobemide. Uhlelo lokusebenza aluthandeki, ngenxa yokuthuthukiswa kokuqina kwemisipha, i-hyperthermia, ikhesa, i-myoclonus. Ezimweni ezinzima, ukufa kungenzeka.

Ngama-benzodiazepines, i-ethanol, izidakamizwa ze-antipsychotic, phenobarbital. Inhlanganisela enjalo ayinconywa.

Ngama-antiplatelet agents kanye nama-anticoagulants. Ezimweni ezinjalo, ukopha kungenzeka. Ngemuva kokuthatha umuthi ngeWarfarin, kungenzeka ukuthi kukhuphuke i-INR.

Ukuqapha kufanele kusetshenziswe lapho kunqunywa i-antidepressant ene-clomipramine, iSt John wort, i-pethidine, i-triptanam, i-Amitriptyline, i-Venlafaxine ne-Tramadol, i-Zinnat.

Ukuhlanganiswa kwe-clotrimazole akubangeli izinguquko ezishiwo esenzweni.

Ngemuva kokuthatha umuthi ngeWarfarin, kungenzeka ukuthi kukhuphuke i-INR.

Ukuphathwa ngokubambisana kweDuloxetine neParoxetine akunconyiwe.

Ukuhlanganiswa kwe-clotrimazole akubangeli izinguquko ezishiwo esenzweni.

Ukuhambisana notshwala

Isikhathi sokulashwa ngeDuloxetine, kufanele wenqabe ukuphuza utshwala. Ngaphandle kwalokho, kunengozi enkulu yemiphumela emibi ehlukahlukene.

Ama-Analog

Izidakamizwa ezifanayo ekwakhekeni nasezenzweni ziyi-Duloxetine Canon ne-Symbalta.

Izidakamizwa ezilandelayo zinemiphumela efanayo:

• Deprim forte;
• IVenlaxor;
• IGelarium Hypericum;
• Trittiko;
• IVelaxin;
• I-Xel;
• I-Amitriptyline;
• I-Fluoxetine.

Ngamunye wale mishanguzo ubonakala ngezinto ezisebenzayo nezici zokusebenzisa. Ngalesi sizathu, kufanele uthintane nodokotela wakho ngaphambi kokufaka umuthi esikhundleni somuthi.

Umuthi ofanayo wokwakheka yiS Symbalta.

Imibandela yekhefu lekhemisi

Ngokwemiyalo esemthethweni yokusetshenziswa, lo muthi uyatholakala ngokubhaliwe.

Ngingakwazi ukuthenga ngaphandle kadokotela?

Ukwehlwaya i-Duloxetine ngaphandle kwencwadi akunqunyelwe.

Intengo yeDuloxetine

Izindleko zomuthi zincike kwinani lamaphilisi amaphakethe.

Emakhemisi aseMoscow, izindleko ezimaphakathi:

• Amaphilisi we-14 (30 mg) - ama-ruble ayi-1000;
• Amaphilisi angama-28 (60 mg) - ama-ruble angama-2100.

Izimo zokugcina zomuthi

Izidingo zokugcina: izinga lokushisa + 15 ... + 25 ° C, ukuntuleka kwelanga ngqo nomswakama.

Isikhathi sokuphelelwa yisikhathi

Ngokuya ngemithetho yokubeka, amaphilisi asetshenziselwa iminyaka emi-3 kusukela ngosuku lokukhishwa.

Umkhiqizi

Umenzi walo mkhiqizo wezokwelapha iCanonfarm Production CJSC. Le nkampani itholakala esifundeni saseMoscow (Schelkovo).

Kukhona ezinye izinkampani ezimbalwa ezikhiqiza lo muthi. Phakathi kwabo kunenkampani iGlenmark.

Ukubuyekezwa kweDuloxetine

Odokotela baphendula kahle kulo muthi, ochazwa ukusebenza kahle okuphezulu kanye nemiphumela ehlukahlukene ebanzi. Iziguli eziningi nazo zijabule ngendlela elashwa ngayo.

Odokotela

U-Olga, isazi sezinzwa, isipiliyoni sezokwelapha iminyaka engu-13, eMoscow.

Inzuzo yalo muthi ukusebenza kwayo ekulweni nobuhlungu obungapheli bama-etiologies ahlukahlukene. Zilungele iziguli ezinesifo sikashukela. Akuvamisile ukubekwa njenge-antidepressant, ngoba kunemithi elula. Okubi ngumbengo wezindleko eziphakeme, ngoba kudingeka inkambo ende.

Imvamisa, iziguli eziphuza umuthi zikhononda ngokuqunjelwa.

Iziguli

UNikolay, oneminyaka engama-40, uTyumen

I-Duloxetine inqunywe ngudokotela ngenxa yokucindezeleka okwandayo. Ezinsukwini ezimbalwa ekuqaleni kwezifundo kwaba nokuhlaselwa kwenhliziyo okuncane, kepha ukwelashwa akuzange kuphazanyiswe. Ngemuva kwezinsuku ezimbalwa, imiphumela emibi yanyamalala ngokuphelele. Intengo iphakeme kakhulu, kepha umuthi usebenza ngempumelelo kunezimali zamakhambi, ngakho-ke izindleko zinesizathu.