Gabagamma ndi m'gulu la antiepileptic mankhwala. Maziko ake ndi yogapentin yogwira, yomwe imakhala ndi anticonvulsant. Mosiyana ndi mankhwala ena omwe ali ndi vuto lofananalo, makapisozi a Gabagamma samakhudza kagayidwe ka gamma-aminobutyric acid. Muzochita zamankhwala, mankhwalawa amaloledwa kugwiritsidwa ntchito ndi odwala azaka zopitilira 12 kuti athetse khunyu pang'ono, kuyambira wazaka 18 - mankhwalawa ululu wamitsempha.
Dzinalo Losayenerana
Gabapentin.
Gabagamma ndi m'gulu la antiepileptic mankhwala.
ATX
N03AX12.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapangidwa mwa mawonekedwe a makapisozi, wokutira ndi chipolopolo cholimba cha gelatin, kuti azilankhula pakamwa.
Makapisozi
Zida zamankhwala zimakhala ndi 100, 300 kapena 400 mg yogwira ntchito ya gabapentin. Monga zida zina zopangira chipolopolo chakunja zimagwiritsidwa ntchito:
- talc;
- shuga mkaka;
- wowuma chimanga;
- titanium dioxide.
Kutengera ndi kuchuluka kwake, makapisozi amasiyanitsidwa ndi mitundu: pamaso pa 100 mg ya gabapentin, kuphatikiza kwa gelatin kumakhalabe koyera, pa 200 mg ndi chikasu chifukwa cha utoto wozikidwa ndi iron oxide, 300 mg ndi lalanje. Mkati mwa makapisozi mumapezeka ufa oyera.
Mankhwalawa amapangidwa mwa mawonekedwe a makapisozi, wokutira ndi chipolopolo cholimba cha gelatin, kuti azilankhula pakamwa.
Mtundu wosapezeka
Mankhwalawa sanapangidwe monga mapiritsi.
Zotsatira za pharmacological
Kapangidwe kamakemedwe a gabapentin pafupifupi kofanana ndi neurotransmitters GABA (gamma-aminobutyric acid), koma gulu la yogwira la Gabagamma limadziwika ndi mankhwala. Zinthu zamankhwala sizimayenderana ndi aminalon ngati mankhwala ena (barbiturates, zotumphukira za GABA, Valproate) ndipo zilibe mikhalidwe ya GABA-yolakwika. Gabapentin samakhudzana ndi kuwonongeka komanso kuthana kwa γ-aminobutyric acid.
M'maphunziro azachipatala, zidawululidwa kuti chinthu chomwe chimagwira chimamangiriridwa ku njira zamtundu wa calcium, chifukwa cha momwe ma calcium ions amachepera. Nayo, Ca2 + imathandizanso kwambiri pakupanga ululu wa neuropathic. Kufanana ndi kuletsa kwa njira zama calcium, gabapentin imalepheretsa kumangiriza kwa glutamic acid ku ma neurons, kotero kuti kufa kwa mitsempha sikumachitika. Kupanga kwa GABA kumawonjezera, kumasulidwa kwa ma neurotransmitters a gulu la monoamine amachepetsa.
Ndi makonzedwe apakamwa, chigoba chakunja chimayamba kuwonongedwa pansi pamatumbo enanso, ndipo gabapentin imatulutsidwa m'chigawo chaching'ono cha m'matumbo aang'ono.
Pharmacokinetics
Ndi makonzedwe apakamwa, chigoba chakunja chimayamba kuwonongedwa pansi pamatumbo enanso, ndipo gabapentin imatulutsidwa m'chigawo chaching'ono cha m'matumbo aang'ono. Zomwe zimagwira zimagwidwa ndi microvilli. Gabapentin amalowa m'magazi, pomwe amafikira kuchuluka kwa plasma mkati mwa maola awiri. Ndikofunika kukumbukira kuti bioavailability imatsika ndi kuchuluka kwa mankhwalawa ndikufikira pafupifupi 60%. Kudya sikukukhudzira kuchuluka kwa mankhwalawa komanso kuyamwa kwa mankhwalawa.
Kuchotsa hafu ya moyo kumapangitsa maola 5-7. Mankhwalawa amafikira pamlingo wofanana komanso umodzi. Kuchuluka kwa kumanga kwa gabapentin ku mapuloteni a plasma kumakhala kotsika - kochepera 3%, kotero mankhwalawo amagawidwa mu minofu m'njira yosasinthika. Mankhwalawa amachotseredwa pogwiritsa ntchito kwamikodzo mawonekedwe ake oyambirira, osasinthika mu hepatocytes.
Zomwe amachiritsa
Mankhwala ndi a gulu la antiepileptic mankhwala. Kwa odwala omwe ali ndi zaka zopitilira 12, Gabagamm imafotokozedwa ngati gawo limodzi la mankhwalawa polimbana ndi kugwidwa pang'ono, komwe kumadziwika ndi kukhalapo kapena kusakhalapo kwachiwiri. Akuluakulu, mapiritsi amathandizidwa ndi postherpetic neuralgia ndi ululu syndrome motsutsana ndi maziko a matenda ashuga.
Kwa odwala omwe ali ndi zaka zosaposa 12, Gabagamm amadziwika kuti ndi gawo limodzi la mankhwalawa polimbana ndi kukomoka pang'ono.
Contraindication
Mankhwalawa sanatchulidwe ngati pali chiwopsezo cha minyewa ya wodwalayo pazinthu zomwe zimapangidwa ku Gabagamma. Chifukwa cha kupezeka kwa lactose mu kapangidwe kake, mankhwalawa amaphatikizidwa kuti agwiritsidwe ntchito kwa odwala omwe ali ndi cholowa cha mkaka wa shuga ndi galactose, chifukwa cha kuperewera kwa lactase ndi malabsorption a monosaccharides.
Ndi chisamaliro
Sitikulimbikitsidwa kapena kusamalidwa kuyenera kuthandizidwa pakumwa odwala omwe ali ndi vuto la psychotic chikhalidwe kapena kulephera kwa impso.
Momwe mungatenge Gabagamm
Mankhwala amatengedwa pakamwa, mosasamala kanthu za kudya. Ngati mukufuna kusiya mankhwala, muyenera kusiya kugwiritsa ntchito Gabagamm pang'onopang'ono sabata limodzi. Mankhwala osokoneza bongo omwe ali ndi kuchuluka kwa mankhwalawa amachitika ngati wodwalayo watopa, kuchepa thupi kapena kuchepa kwambiri kwa wodwalayo, kuphatikizapo kufooka panthawi yobwezeretsa pambuyo poti muwonjezere. Muzochitika zoterezi, ndikofunikira kuyamba ndi mlingo wa 100 mg.
Njira yochizira imakhazikitsidwa ndi adotolo kutengera mtundu wa wodwalayo komanso chithunzi cha chipatala.
| Matendawa | Chithandizo cha mankhwala |
| Ululu wa neuropathic mwa odwala akuluakulu | Tsiku mlingo koyamba gawo la mankhwala ukufika 900 mg ndi pafupipafupi makonzedwe 3 pa tsiku. Ngati ndi kotheka, chizolowezi cha tsiku ndi tsiku chizitha kuchuluka mpaka 3600 mg. Ndikulimbikitsidwa kuti muyambe kulandira chithandizo popanda kuchepetsa mlingo malinga ndi chiwembu: 300 mg katatu patsiku. Pankhaniyi, odwala omwe ali ndi thupi lofooka ayenera kuwonjezera kuchuluka kwa tsiku ndi tsiku mpaka 900 mg kwa masiku atatu molingana ndi njira ina yothandizira:
|
| Kusintha pang'ono mwa anthu opitirira zaka 12 | Ndikulimbikitsidwa kutenga kuchokera 900 mpaka 3600 mg patsiku. Mankhwala osokoneza bongo tsiku loyamba limayamba ndi kuchuluka kwa 900 mg, logawidwa mu 3 waukulu. Kuchepetsa chiopsezo cha kukokana minofu, kuyimitsidwa pakati pa kaperekedwe ka kapisozi sikuyenera kupitirira maola 12. M'masiku otsatirawo a mankhwala, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa mpaka 3,6 g). |
Ndi matenda ashuga
Mankhwalawa sakukhudzanso shuga wa plasma ndipo sasintha mahandidwe obisika a insulin ndi maselo a beta a kapamba, chifukwa chake palibe chifukwa chofuna kupatuka pamankhwala omwe amalimbikitsidwa a matenda a shuga.
Zotsatira zoyipa
Zotsatira zoyipa nthawi zambiri zimachitika ndi mlingo wosankhidwa bwino kapena kupatuka ku chithandizo chamankhwala. Mwina kukula kwa malungo a mankhwala, kuchuluka thukuta, kupweteka m'malo osiyanasiyana a thupi.
Kuchokera minofu ndi mafupa
Mankhwalawa sakukhudza dongosolo la musculoskeletal, koma ndi kuwonongeka kwamitsempha, ululu m'misempha ndi mafupa, mafupa owongoka amatha kuwonekera.
Hematopoietic ziwalo
Ndi kusintha kwa magawo a hematopoietic dongosolo, thrombocytopenic purpura imatha kuwoneka, limodzi ndi kuphulika, kuchepa kwa chiwerengero cha zinthu zomwe zimapangidwa m'magazi.
Matumbo
Zotsatira zoyipa zamagetsi zimadziwika ndi zochitika zotsatirazi:
- kupweteka kwa epigastric;
- matenda a anorexia;
- kusanza, kutsegula m'mimba, kusanza;
- kutupa kwa chiwindi;
- kuchuluka kwa hepatocytic aminotransferases;
- jaundice motsutsana maziko a hyperbilirubinemia;
- kapamba
- dyspepsia ndi pakamwa lowuma.
Pakati mantha dongosolo
Ndi zoletsa zamanjenje, ndizotheka:
- Chizungulire
- kuphwanya kwamtundu wakuyenda;
- choreoathetosis;
- kutayika kwa malingaliro;
- kuyerekezera;
- kutayika kwa kuwongolera kwakumatha;
- kuchepa kwamphamvu kwa ntchito, kuganiza bwino;
- paresthesia.
Nthawi zina, amnesia amakula, kufalikira kwa khunyu kumawonjezeka.
Kuchokera ku kupuma
Mwina kukula kwa kufupika, chibayo. Ndi kufooka kwa chitetezo chathupi, njira zopatsirana, matenda a viral, pharyngitis, ndi kuchulukana kwammphuno kumatha.
Pa khungu
Mwapadera, ziphuphu zakumaso, zotupa zam'mimba, erythema, kuyabwa ndi zotupa zimatha kuchitika.
Kuchokera ku genitourinary system
Nthawi zina, odwala omwe amatha kugwira matendawa amatha kudwala matenda amkodzo, amachepetsa ma erections, enuresis (kukodza kwamikodzo), komanso kulephera kwa impso.
Nthawi zina, odwala omwe amatha kugwira matendawa amatha kudwala matenda amkodzo thirakiti.
Kuchokera pamtima
Mwina kukula kwa zizindikiro za vasodilation, kuchuluka kwa mtima ndi kuchuluka kwa magazi.
Matupi omaliza
Ngati wodwalayo amakonda kuchita ziwopsezo zonse zamkati, n`zotheka kukhala ndi Quincke edema, anaphylactic mantha, angioedema, Stevens-Johnson syndrome komanso khungu.
Zokhudza mphamvu pakuwongolera njira
Poganizira za chiopsezo chosagwirizana ndi gawo lamkati la mankhwalawa (CNS) munthawi yamankhwala, ndimalimbikitsidwa kuti muchepetse ntchito ndi zida zowopsa kapena zovuta, kuyendetsa galimoto komanso kuchita zinthu zomwe zimafuna kuti wodwala azigwirira ntchito mwachangu komanso mwachangu.
Malangizo apadera
Ngakhale kuti pali achire achire mankhwala pa mankhwala a gabapentin, pali chiopsezo cha kubwerezanso minofu kukokana kwa odwala omwe ali ndi gawo lochita kupweteka. Ndikofunika kukumbukira kuti mankhwalawa si chida chothandiza polimbana ndi khunyu.
Ndi chithandizo chophatikizidwa ndi Morphine, amafunika kuwonjezera kuchuluka kwa Gabagamm atatha kufunsa dokotala. Pankhaniyi, wodwalayo ayenera kuyang'aniridwa mosamalitsa kuchipatala kuti ateteze kuyambika kwa zizindikiro za kukhumudwa kwa chapakati mantha dongosolo. Ndi kukula kwa zizindikiro za matenda amanjenje, ndikofunikira kuchepetsa mlingo wa mankhwalawa.
Ndi chithandizo chophatikizidwa ndi Morphine, amafunika kuwonjezera kuchuluka kwa Gabagamm atatha kufunsa dokotala.
M'maphunziro a labotale, zotsatira zoyipa zabodza la kukhalapo kwa proteinuria zitha kulembedwa, chifukwa chake, poika Gabagamma palimodzi ndi anticonvulsants ena, ndikofunikira kufunsa ogwira ntchito labotale kuti achite kafukufuku mwanjira yeniyeni kuti akonzekere sulfosalicylic acid.
Gwiritsani ntchito mu ukalamba
Anthu opitilira zaka zopitilira 60 sakusowa kuti athe kuwonjezera mlingo.
Kupereka Gabagamm kwa Ana
Mankhwalawa ali osavomerezeka kwa ana ndi achinyamata osakwana zaka 18, kupatulapo milandu ya kugwidwa pang'ono.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Kafukufuku wazachipatala wazokhudza mphamvu ya mankhwalawa pa kukula kwa embryonic sanachitike. Chifukwa chake, gabapentin imalembedwa kwa amayi apakati pokhapokha ngati pali zovuta zambiri, pomwe zotsatira zabwino za mankhwalawo kapena zoopsa ku moyo wa mayi zimaposa chiopsezo cha kusokonezeka kwa chiberekero cha mwana wosabadwayo.
Gabapentin amaperekedwa kwa amayi apakati omwe ali ndi vuto kwambiri.
Mankhwala othandizira amatha kupaka mkaka wa mayi, kotero kuyamwitsa kuyenera kusiyidwa pakumwa mankhwala.
The ntchito aimpso kuwonongeka
Pamaso pa kulephera kwa impso, mulingo wa mankhwalawa umasinthidwa malinga ndi chilolezo cha creatinine (Cl).
| Cl, ml / mphindi | Mlingo wa tsiku ndi tsiku wogawidwa 3 Mlingo |
| opitilira 80 | 0.9-3.6 g |
| kuyambira 50 mpaka 79 | 600-1800 mg |
| 30-49 | 0.3-0.9 g |
| kuyambira 15 mpaka 29 | 300 mg ndi mankhwala ndi maola 24. |
| zosakwana 15 |
Bongo
Ndi mankhwalawa chifukwa cha limodzi mlingo waukulu, Zizindikiro za mankhwala osokoneza bongo zimawonekera.
- Chizungulire
- mawonekedwe amtundu wamachitidwe osokonezedwa ndi kugawanika kwa zinthu;
- kusokonezeka kwa mawu;
- ulesi;
- kugona
- kutsegula m'mimba
Chiwopsezo chowonjezeka kapena chowonjezereka cha zovuta zina. Wovutitsidwayo amayenera kugonekedwa kuchipatala kuti amuchotsere m'mimba, malinga ndi momwe makapisozi amatengedwa pakamwa maola 4 omaliza. Chizindikiro chilichonse cha bongo chimathetsedwa kudzera mwa chithandizo. Hemodialysis imagwira ntchito.
Ndi mankhwala osokoneza bongo ambiri, kugona kungachitike.
Kuchita ndi mankhwala ena
Ndi kugwiritsidwa ntchito komweko kwa Gabagamm ndi mankhwala ena, izi zimachitika:
- Ngati mutenga Morphine maola 2 musanagwiritse ntchito gabapentin, mutha kukulitsa nkhawa yotsiriza ndi 44%. Pankhaniyi, kuwonjezeka kwa njira yolowera kumawonedwa. Palibe kufunikira kachipatala komwe kwakhazikitsidwa.
- Kuphatikiza ndi maantacid okhala ndi kukonzekera komwe kumakhala mchere wa magnesium ndi aluminium, bioavailability wa gabapentin imachepetsedwa ndi 20%. Pofuna kupewa kufooketsa mankhwalawa, tikulimbikitsidwa kuti mutenge mapiritsi a Gabagamm pambuyo 2 mawola mutamwa maantacid.
- Probenecid ndi cimetidine samachepetsa kuchuluka kwa ma seramu ndi chinthu china chogwira ntchito.
- Phenytoin, kulera kwapakamwa, phenobarbital ndi carbamazepine sikukhudza plasma ndende ya gabapentin.
Kuyenderana ndi mowa
Panthawi yamankhwala, mumaletsedwa kumwa mowa. Ethanol mu kapangidwe ka zakumwa zoledzeretsa zimakhala ndi mphamvu zoletsa zamkati mwa dongosolo lamanjenje ndipo zimachulukitsa zotsatira zoyipa.
Analogi
The fanizo la mankhwala akuphatikiza:
- Katena
- Gabapentin;
- Neurontin;
- Tebantin;
- Convalis.
Kusinthira ku mankhwala ena amaloledwa pokhapokha kukaonana ndi azachipatala ndi ogwira ntchito pang'ono a Gabagamm kapena kuwoneka koyipa.
Monga analogue, mutha kugwiritsa ntchito Neurontin.
Miyezo ya tchuthi Gabagamm kuchokera ku mankhwala
Mankhwalawa sagulitsidwa popanda mankhwala a dokotala.
Kodi ndingagule popanda kulandira mankhwala?
Chifukwa cha chiwopsezo chowonjezeka cha kupsinjika kwa dongosolo lamanjenje chapakati komanso kuwoneka kwa zochita zina zoipa kuchokera kwa ziwalo zina, kugulitsa kwaulere kwa Gabagamm ndizochepa.
Mtengo wa Gabagamm
Mtengo wapakati wa mankhwalawa umasiyana ndi ma ruble 400 mpaka 1150.
Zosungidwa zamankhwala
Ndikulimbikitsidwa kusunga anticonvulsant pamatenthedwe mpaka + 25 ° C pamalo abwino ozizira okhala ndi chinyezi chochepa.
Tsiku lotha ntchito
Zaka zitatu
Wopanga wa Gabagamm
Werwag Pharma GmbH & Co KG, Germany.
Ndikulimbikitsidwa kusunga anticonvulsant pamatenthedwe mpaka + 25 ° C pamalo abwino ozizira okhala ndi chinyezi chochepa.
Ndemanga pa Gabagamm
Izolda Veselova, wazaka 39, St. Petersburg
Makapisozi a Gabagamma adalembedwa mogwirizana ndi nthambi za neuralgia 2. Dotoloyo anati mlingo wake umakhazikitsidwa kutengera mtundu wa zabwino. M'malo mwanga, ndinayenera kutenga makapisozi 6 patsiku. Iyenera kuchitika mosamala: kumayambiriro kwa mankhwalawa, idayamba ndi makapisozi awiri kwa masiku 7, pambuyo pake mlingowo unakula. Ndimaona kuti ndi njira yothandiza ya kukhudzika. Sindinazindikire zovuta zilizonse panthawi ya chithandizo. Kukokana kunayima.
Dominika Tikhonova, wazaka 34, Rostov-on-Don
Adatenga Gabagamma monga adanenedwa ndi katswiri wazokhudza matenda amitsempha yama bongo. Carbamazepine sanali kuchita bwino pa vuto langali. Makapisozi anathandizira ndimazinthu oyamba. Njira ya mankhwala osokoneza bongo idatenga miyezi itatu kuyambira Meyi Meyi. Ngakhale kuti ali ndi matenda osachiritsika, kupweteka ndi zizindikiro za matenda zidutsa.Chobwereza chokha ndicho mtengo. Kwa mabotolo 25 ndinayenera kulipira ma ruble 1200.
