I-Tricyclic antidepressant ene-antihistamine, isenzo se-anticholinergic. Kusetshenziselwa ukwelapha hhayi kuphela isimo sokudabukisa, kepha futhi nama-somatoform neuroses ngomonakalo wamapheshana wesisu, uhlelo lwe-bronchopulmonary nezinye izitho zomzimba.
Igama
Igama lomhlaba jikelele: Amitriptyline.
I-ATX
Ama-antidepressants, N06A A09.
Khipha amafomu nokwakheka
Amaphilisi
I-25 mg yento esebenzayo kwithebhulethi eyodwa iyatholakala emaphaketheni ama-20, 50, ama-100 ama-PC.
I-Amitriptyline isetshenziselwa ukwelapha hhayi izimo ezicindezelayo kuphela, kepha futhi nama-somatoform neuroses.
Amafomu wokukhishwa angatholakali
Isixazululo se-10 mg / ml 10 ama-ampoules we-2 ml wemijovo ye-intramuscular. Ama-Dragees wezingane ze-10 no-25 mg, iphakethe lama-50 PC.
Indlela yokusebenza
I-Tricyclic compound. Umphumela wayo uyabonakala ngenxa yokuvimba ukuvimbela kabusha kwama-neurotransmitters - i-adrenaline, i-norepinephrine, i-serotonin, i-dopamine. Ngenxa yalokhu, izinto ezifakwe kuhlu ziku-cleaptic cleft isikhathi eside futhi ziyanqwabelana. Isimo siyathuthuka, umsebenzi wobuchopho uyaqina.
Ine-anticholinergic, antihistamine effect, ngenxa yayo isetshenziswa njengephilisi lokulwa, lokulwa nokukhathazeka neleyokulala. Kuyi-timoanaleptic, Ilungisa ukudangala okucindezelayo nge-predominance yakho konke ukucashunwa kanye nokuvinjwa. Imiphumela evuselelayo nevinjelayo ohlelweni lwezinzwa incike kumthamo.
I-Pharmacokinetics
Kukhishwe emgodini wokugaya ukudla. Ukuhlushwa okuphezulu kutholakala emahoreni angama-2-12 ngemuva kokuphatha. Ukudla akuphazamisi ukumuncwa Umuthi. Iningi lazo - ama-92-95% abopha amaprotheni e-plasma.
Ingena ngegazi-brain and hematoplacental barriers, kanye nobisi lwebele.
I-Metabolism yenzeka esibindini, ikhishwa yizinso. Ukuqedwa kwesigamu sempilo kungamahora angama-40-75.
Yini edingekayo
Kubhekiswa ku-psychoanaleptics. Kusetshenziswa ekwelapheni ukudangala kwanoma ikuphi i-etiology, ngokuyinhloko i-endo native, lapho ibhalansi yama-neurotransmitters iphazamiseka khona. Isetshenziselwa i-asthenovegetative syndrome, i-schizophrenic psychosis, ukuphazamiseka kwengqondo, okuhambisana nokukhathazeka, ukuqwasha.
I-Amitriptyline isetshenziselwa ukuphazamiseka kwengqondo okuhambisana nokukhathazeka.
Njengethuluzi eline-anticholinergic action, relives cramps in irritable bowel syndrome, hyperactive neurogenic bladder, enuresis. Inomphumela wokulwa nokuvuvukala ngenxa yomphumela we-antihistamine.
Yehlisa i-acidity yesisu, ibonisa umphumela we-M-anticholinergic kanye ne-H1-histamine-blocking, evumela ukuthi isetshenziselwe izilonda zesisu kanye nezilonda ze-duodenal (njengokubonakaliswa kwe-somatoform neurosis).
Isetshenziselwa i-asthma ye-bronchial - inomphumela we-antiallergic futhi inwebeka i-bronchi, inciphisa ukucasuka kwabo kwe-mucus.
Umphumela wayo we-analgesic ubuye uvezwe nge-fibromyalgia, ikhanda (i-migraines). Iphelisa ukuphazamiseka kwengqondo, ukukhathazeka, ukuqwasha. Impahla ye-antidepressant yokunciphisa ukukhiqizwa kwe-hormone yokuxinzelela - i-cortisol - isunguliwe, ivikela amaseli obuchopho ekufeni.
Kusetshenziswa njenge-antidepressant yezinkinga zokudla - i-anorexia, i-bulimia, kanye ne-neurocirculatory dystonia.
Ngenxa yebhalansi phakathi kwemiphumela yokuvusa nokuvusa amandla, i-Amitriptyline ayibangeli zimpawu ezikhiqizayo - ama-hallucinations, ukuqamba, i-mania, i-hypomania - ngokungafani ne-Imipramin.
I-Amitriptyline isiza ukuqeda ukuqwasha.
Contraindication
Umuthi uphulwa ngemithi uma kwenzeka kuba ne-hypersensitivity kuwo, isifo sokuqina kwenhliziyo, isifo senhliziyo, ukwehluleka kwesibindi, ukungasebenzi kahle kwesibindi (kufaka ne-porphyria), i-manic psychoses, ukwelashwa nge-monoamine oxidase inhibitors (kungakapheli amasonto amabili kuphele ukuyeka ukusetshenziswa).
Awukwazi ukuthatha lesi sidakamizwa kubantu besifazane abakhulelwe nezingane ezingaphansi kweminyaka engu-16.
Ungayithatha kanjani
Uhlobo lomthamo lunqunywa ngokuya ngesifo sokugula kanye nobudala beziguli.
Uhlobo lomthamo wabantu abadala
Ukwelapha ukudangala, kusetshenziswa umthamo we-25 mg, ngesikhathi sezinsuku ezingama-5-6 olandelayo uyandiswa kuze kube yilapho kutholakala umphumela wokwelapha.
Ngokwelashwa kwasekhaya, umthamo omkhulu ngu-200 mg.
Ngemuva kokuthuthuka, umthamo wehliswa kancane kancane uye ekusebenzeni okuncane, imvamisa 50-100 mg ngosuku. Imvamisa yokuphatha ihlala izikhathi ezingama-2-3 ngosuku noma kanye ebusuku, ngoba kukhona iphilisi lokulala.
Ukuphindaphindeka kokuphuza umuthi izikhathi ezingama-2-3 ngosuku noma kanye kanye ebusuku.
Uma usuku lokwamukelwa luphuthelwe, ukwamukelwa okulandelayo kwenziwa kungashintshiwe. Inkambo yokwelashwa iyizinyanga ezingama-3-6. Kubantu asebekhulile, ukwelashwa kuqala ngomthamo we-25 mg, ukwanda kancane kancane, ngoba umthwalo ohlelweni lwenhliziyo kungenzeka.
Ukudonswa kwerejimeni yezingane
Izingane zineminyaka eyi-6 kuya kwe-10-30 mg ngosuku noma zibheka isisindo sika-1-5 mg / kg ngosuku.
Ukuthatha umuthi wesifo sikashukela
Ngenxa yesenzo esandayo se-adrenaline, i-antidepressant inyusa izinga le-glucose egazini, ngakho-ke, ku-mellitus yesifo sikashukela, umthamo ukhuphuka ngokucophelela, ulawula le nkomba.
Malini okuvumelekile
Igcinwe emzimbeni amahora angama-80-150. Ngemuva kwalesi sikhathi, isivele ibonisiwe.
Ungayikhansela kanjani i-amitriptyline
I-Cancellation syndrome ibonakaliswa ukungahambi kahle, ukuqwasha, ikhanda, i-asthenia. Ngakho-ke, ukuhoxiswa komuthi kufanele kwenzeke ngobumnene - umthamo wehliswa kancane kancane.
Isifo sokuhoxa sikhonjiswa ikhanda.
Imiphumela emibi
Ezilungwini ezahlukahlukene, imiphumela emibi iziveza ngezindlela ezihlukile.
Amapheshana wesisu
Umphumela we-anticholinergic uhambisana nokuncipha kokushona phansi, umlomo owomile, ukuncipha kwe-acidity yesisu, isicanucanu, ukuhlanza, ukubambezela ukusebenza kwezimoto, ukushisa kwenhliziyo. Mhlawumbe ukukhula kwe-ileus ekhubazekile, ukuqunjelwa, isifo sohudo.
Izitho zeHematopoietic
Yehla ngenombolo ye-leukocytes namaplatelet, i-eosinophilia.
Ngasohlangothini lwe-metabolism
Ukuqina kwesisindo, ukuvuvukala komlenze, i-gynecomastia nokunye ukuphazamiseka kwe-endocrine, ukukhuphula ushukela wegazi.
Isistimu yezinzwa ephakathi
Isiyezi, ubuthakathaka, ukuwa kwamathambo, i-tinnitus, amaphupho amabi. Izinkinga nge-yegilo yegilo (hypothyroidism), ukuthatha lo muthi kudala isimo se-manic noma i-hypomania. Mhlawumbe wandise ukudangala ngomkhuba wokufuna ukuzibulala. Ngobhubhane, kungavusa ukwanda kokuqaqamba kokuwa.
Izinkinga nge-yegilo yegilo (hypothyroidism), ukuthatha lo muthi kudala isimo se-manic.
Allergies
Ngokuzwela okwengeziwe, kubangela ukuqhuma kwesikhumba, ukulunywa, kwesinye isikhathi i-edema kaQuincke, ukusabela kwe-anaphylactoid, ukuphefumula komoya.
Imiyalo ekhethekile
Ukuthatha umuthi ezimweni ezahlukahlukene kudinga ukuqaphela.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ayikwazi ukusetshenziswa ngesikhathi sokukhulelwa nokuqunjelwa. Imiphumela engaba khona yemiphumela enobuthi ebuchosheni be-fetus ekhulayo, izinsana.
Sebenzisa ebudaleni
Zisetshenziswa ngokuqapha, ngoba ekugugeni kukhona ingozi yokuqhamuka nomfutho wegazi ophakeme kanye nokuhlaselwa kwe-myocardial infarction.
Ngokungasebenzi kahle kwesibindi
Ukwelashwa kwenziwa ngaphansi kokulawulwa kwe-ACT, ALT, i-bilirubin eqondile, i-alkaline phosphatase, amazinga we -xaxlutaminase. Uma kunesidingo, kusetshenziswa ama-hepatoprotectors.
Uma kwenzeka ukungasebenzi kahle kwesibindi, ukwelashwa nge-Amitriptyline kwenziwa ngaphansi kokulawulwa kwezinga le-AcT, i-Alt.
Ngomsebenzi wokuphazamiseka wezinso
I-Creatinine ne-urea esegazini kuyaqashwa.
Umthelela ekhonweni lokulawula izindlela
Umphumela we-Hypnotic unciphisa ukugxilisa ingqondo.
Ukuhambisana notshwala
Ngcono ubuthi be-ethanol. Akuhambisani notshwala.
Ukweqisa
Iziveza njengezimpawu zamehlo, ukulahleka kwengqondo, ukuthuthukiswa kwe-ileus ekhubazekile, ukwehluleka, ukwehla kwezinga lokushisa lomzimba, i-palpitations.
Uma kwenzeka unobuthi, ukukhohlisa noma ukufa kungenzeka.
Kuyadingeka lavage esiswini, diuresis ngenkani, hemodialysis.
Ukuxhumana nezinye izidakamizwa
Kwenqatshelwe ukusebenzisa i-antidepressant ene-MAO inhibitors (iFurazolidone, iSt John's wort, njll.), Ama-antidepressants ama-tricyclic (Clomipramine, Imipramine), ama-sympatholytics - i-Reserpine, ama-SSRIs (i-Clozapine, njll.) - i-serotonin syndrome kungenzeka.
Ukusetshenziswa kwe-antidepressant ene-MAO inhibitors, ama-anticepressants ama-tricyclic, ama-sympatholytics akuvunyelwe.
Iqhakambisa umphumela wokuvimbela ohlelweni oluphambili lwezinzwa lotshwala, ama-antipsychotic (Atarax, Triftazin), ama-barbiturates, izidakamizwa zesifo sikaParkinson. Yehlisa ubukhulu bomphumela we-antihypertensive we-beta-blockers nezinye izidakamizwa kwehypertension. Yehlisa umsebenzi wama-anticonvulsants.
Ama-Barbiturates ne-carbamazepine anciphisa ukugcwala komuthi, asheshise ukuphuma kwawo, i-cimetidine, kunalokho, inengxenye ekugcineni kwayo egazini. Ukusetshenziswa okuvumelanayo neSurralfate kunciphisa ukumuncwa.
Lapho kuhlanganiswa ama-hormone e-thyroid, ukwanda kokuqina kokuqina kwe-arrhythmia ne-psychomotor, ukuphawulwa kwesigqi senhliziyo, ne-tachycardia kuyaphawulwa.
Ukuvumelana neGrandaxin kusetshenziselwa ukwelapha ukuqwasha, ukudonsa okwandayo. Ngama-block we-anticholinergic - ukuthuthukiswa kokuvinjwa kwamathumbu okhubazekile.
Analogs of amitriptyline
Into esebenzayo ikhiqizwa yizinkampani eziningana (i-Nycomed, Grindeks, Ozone, Zentiva) njengengxenye yamalungiselelo we-analog e-Anafranil, Saroten, Doxepin, Clofranil, njll.
Imibandela yekhefu lekhemisi
Ikhishwe ngumbhalo.
Ngingakwazi ukuthenga ngaphandle kadokotela
Kwamanye amakhemisi, umuthi uthengiswa ngaphezulu kwekhawuntara.
Intengo
Izindleko zokufaka amaphilisi angama-50 ngama-ruble angama-21-30. Ama-ampoules ayi-10 ml, ama-10 mg / ml abiza ama-ruble angama-52.
Imigomo nemibandela yokugcinwa komuthi i-Amitriptyline
Gcina endaweni eyomile enamazinga okushisa angadluli ku-25 ° C. Gwema kude nezingane. Impilo yeshelf iyiminyaka emithathu.
Ukubuyekezwa mayelana ne-amitriptyline
Ukubuyekezwa kwabo bobabili ochwepheshe neziguli zabo mayelana nomuthi muhle kakhulu.
Izazi Zengqondo
IVlasov V.A.
Umuthi awubizi futhi uyasebenza. Imiphumela eminingi emibi ayikwazanga ukugwemeka noma ngenxa yocwaningo amashumi amaningi eminyaka. Kufakazelwe isikhathi nokuzilolonga. Kodwa-ke, ayilungele zonke iziguli, ezinye zingase zibangele isifiso sokuzibulala, ngakho-ke kungakuhle ukuthi zisebenzise ukwelashwa ngokungazelele.
Andreev A.L.
Utshengise ukusebenza kwakhe hhayi ekucindezelekeni kuphela, kepha futhi naku-psychosomatic pathology - iziguli ezinezilonda zesisu, i-asthma, i-bowel canelable syndrome ziyalulama lapho zithathwa. Kodwa-ke, umlutha wesidakamizwa kungenzeka.
Iziguli
Michael K.
Lesi siphikisi esisiza ngobuhlungu. Nginenkinga yamathumbu angadabuki. Lesi sidakamizwa sibuye sithuthukise imizwa.
UDmitry Sh.
Kube khona isilonda esiswini, ingcindezi emsebenzini ivuse ukubukeka kwayo. Udokotela wezitho zomzimba uye wanquma lesi sidakamizwa. Emiphumeleni emibi, ngibona ukozela kanye nokwehla okuncane kwe-libido ne-potency.
