Pofuna kuthana ndi vuto la kupweteka kwapakati komanso munthawi yopanga opaleshoni, kugwiritsa ntchito Fentanyl ndi chifukwa. Mankhwalawa ndi a gulu la opioid narcotic analgesics, chifukwa chake, imatha kukhala ndi zotsatira zoyipa ndipo imapangitsa kudalira. Kugwiritsa ntchito mankhwalawa kungakhale koopsa, chifukwa chake amagwiritsidwa ntchito pokhapokha ngati dokotala akutsimikiza kuti mulibe kuchuluka kwa zomwe mwatsimikiza.
Dzinalo
INN ndipo dzina la mankhwalawo ndi Fentanyl. Dzina la mankhwalawa ku Latin ndi Fentanyl.
Pofuna kuthana ndi vuto la kupweteka kwapakati komanso munthawi yopanga opaleshoni, kugwiritsa ntchito Fentanyl ndi chifukwa.
ATX
M'magulu apadziko lonse a ATX, mankhwalawa ali ndi code N01AH01.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapezeka m'mitundu iwiri ya mankhwalawa - chigamba (transdermal Therapeutic system) ndi yankho la intravenous and intramuscular management. Chofunikira chachikulu cha Fentanyl ndi pawiri wa dzina lomweli.
Mankhwalawa amapangidwa m'mitundu iwiri yamtundu, imodzi mwazo ndi chigamba (transdermal Therapeutic system).
Monohydrate, citric acid ndi madzi okonzekera amaphatikizidwanso mu yankho la jakisoni. Zogwirizira zimaphatikizapo zigawo zomatira, kumbuyo ndi filimu yoteteza. Yankho la Fentanyl 0,005% limapezeka m'mapulogalamu a 2 ndi 10 ml. Katoniyo amakhala ndi ma 5 kapena 10 ampoules. Matumba amapezeka ndi malo olumikizirana a 4,2 cm² mpaka 33.6 cm². Mu makatoni amakhazikitsidwe, amawonetsedwa 5.
Zotsatira za pharmacological
Machitidwe a analgesic ntchito ya fentanyl mu mlingo wa 0 mg ndi wofanana ndi 10 mg ya morphine. Chithandizo chogwira ntchito cha mankhwalawa chimakhudza ma opioid receptors a chapakati mantha dongosolo ndi zotupa zamitsempha. Mankhwalawa amathandizira msanga kupweteka, chifukwa amachepetsa kufalitsa ululu wazizindikiro m'mitsempha ya m'mitsempha ya chapakati yamanjenje yomwe imawunikira.
Mankhwalawa amathandizira msanga kupweteka, chifukwa amachepetsa kufalikira kwa mitsempha kupita ku ma cell amitsempha yama neva.
Chithandizo cha opioid ichi chimasintha malingaliro a zopweteka. Mankhwalawa amakhala ndi vuto lopatsa chidwi. Mankhwala samangokhala ndi kutchulidwa komwe kumatchulidwa kuti analgesic komanso kusinitsa mphamvu, kumatha kuyambitsa chisangalalo, kotero ndizotheka kukulitsa kudalira kwakuthupi komanso kwamaganizidwe. Kuphatikiza apo, kugwiritsa ntchito mankhwalawa mobwerezabwereza, kulekerera zinthu zomwe zimachitika ku Fentanyl kumatha kuchitika.
Pharmacokinetics
Yogwira ntchito ya mankhwala ndi mafuta sungunuka. Kugawa kwa mankhwalawo pambuyo pa kupangika sikusiyana, ndipo poyambira matha amapezeka impso, chiwindi ndi ziwalo zina zomwe zimagwira magazi. Pambuyo pake, imakhutitsa minofu ina ya thupi. Kuphatikiza kwakukulu kwa mankhwalawa m'magazi kumadziwika kale patatha mphindi 3 pambuyo pakubayidwa m'mitsempha, ndipo ndikakulowetsedwa mu minofu, imafika pachimake pakatikati pa ola.
Pakulowetsedwa mu minofu, chikhazikitso cha zinthuzo chimafika pachimake pakatha theka la ola.
Mulingo wambiri wothanirana ndi magazi m'magazi umatha pafupifupi maola awiri. Munthawi imeneyi, analgesic zotsatira zimawonedwa. Kagayidwe kazinthu zomwe zimagwira ntchito zimachitika m'chiwindi. Mankhwalawa amachotsedwa makamaka ndi mkodzo. Mpaka 10% ya mlingo amachotsedwa osasinthika. Mukangogwiritsa ntchito kamodzi, mankhwalawa amachotsedwa mu maola 6-12. Mukamagwiritsa ntchito chigamba, zinthu zomwe zimagwira zimaperekedwa kwa chapakati mantha am'mitsempha ndi mitsempha yotalika kwa maola osachepera 72.
Njira iyi ya kaperekedwe ka mankhwala imakupatsani mwayi wokhala ndi chidwi chake m'magazi nthawi yayitali.
Zizindikiro zogwiritsidwa ntchito
Chizindikiro chodziwika bwino chogwiritsa ntchito fentanyl ndi neuroleptanalgesia. Iyi ndi njira yodutsitsa thupi yomwe wodwalayo amadziwa, koma samamva kupweteka ndipo samva chilichonse. Njira yofananira yothandizira kupweteka imagwiritsidwa ntchito pazinthu zingapo zakuzindikira ndikupanga maopaleshoni, kuphatikizapo pamimba.
Mankhwalawa amagwiritsidwa ntchito pochita opaleshoni.
Kwa mankhwala opaleshoni yakumalo, zigamba zimagwiritsidwa ntchito nthawi zambiri. Mankhwalawa amatha kugwiritsidwa ntchito ngati mankhwala opha anthu omwe amatenga ma antipsychotic ndi ma tranquilizer, kuphatikiza Droperidol ndi Xanax. Kuphatikiza apo, ndikulowetsa wodwala mu opaleshoni, kuphatikiza kwa Fentanyl ndi Propofol ndikotheka.
Nthawi zambiri kugwiritsa ntchito Fentanyl kumasonyezedwa kuti kuthetseratu kupweteka kwa oncology mwa akulu ndi ana. Ndi zotupa zopanda ntchito zomwe sizingathetsedwe ndi radiation ndi chemotherapy, wothandizirayu amatha kugwiritsidwa ntchito ngati chigamba. Kuphatikiza apo, amaloledwa kugwiritsa ntchito mankhwala kuti athetse kupweteka kwambiri ndi myocardial infarction. Kugwiritsa ntchito Fentanyl ndikoyenera kuti kuchotsedwa kwa matenda am'mimba kupweteka m'njira zosiyanasiyana, ngati sizingatheke kukwaniritsa zabwino pogwiritsa ntchito mankhwala ena.
Kugwiritsa ntchito Fentanyl ndikoyenera kuti kuchotsedwa kwa matenda amkati ululu, ngati kugwiritsa ntchito mankhwala ena sikunathandize.
Contraindication
Kugwiritsa ntchito Fentanyl ndikosavomerezeka pochiza anthu omwe ali ndi mphumu ya bronchial komanso matenda opumira kwambiri. Simungagwiritse ntchito chida ngati odwala ali ndi vuto loti siligwirizana ndi hypersensitivity pamagulu a mankhwala. Kugwiritsa ntchito Fentanyl ngati mankhwala opangira opaleshoni yotsimikizika sikulimbikitsidwa.
Sikovomerezeka kugwiritsa ntchito mankhwalawa pochiza anthu omwe ali ndi vuto losokoneza bongo komanso hypersensitivity kwa mankhwalawa.
Kodi kutenga fentanyl?
Pafupifupi mphindi 15 wodwalayo asanachitike opareshoni, mankhwala a iv amagwiritsidwa ntchito mu mlingo wa 0,05 mpaka 0.1 mg wa kilogalamu ya thupi. Pa opaleshoni, mtsempha wa mtsempha wa magazi amachitika pa mlingo wa 0,05 mpaka 0,2 mg wa pa kilogalamu iliyonse ya thupi pakatha mphindi 30 zilizonse. Kwa pathologies ophatikizidwa ndi kupweteka kwambiri, mafupa a Fentanyl amagwiritsidwa ntchito, omwe amamangiriridwa pakhungu kwa maola makumi asanu ndi awiri ndi awiri.
Kwa pathologies ophatikizidwa ndi kupweteka kwambiri, mafupa a Fentanyl amagwiritsidwa ntchito, omwe amamangiriridwa pakhungu kwa maola makumi asanu ndi awiri ndi awiri.
Ndi matenda ashuga
Pa mankhwala oletsa kupweteka kwa odwala omwe ali ndi matenda a shuga, anesthesia amawonetsa kugwiritsa ntchito Fentanyl kuphatikiza Propofol ndi Diazepam. Mlingo amasankhidwa payekha.
Zotsatira zoyipa
Nthawi zambiri, motsutsana ndi momwe ntchito mankhwalawa imagwiritsidwira ntchito, kusokonezeka kwa mitsempha ndi kuchepa kwa magazi kumawonedwa. Nthawi zina, chifukwa cha zomwe mankhwalawa amachitika, kumangidwa kwamtima kumachitika. Zotsatira zoyipa ndizothekanso kuchokera ku ziwalo zina ndi machitidwe ena.
Nthawi zina, chifukwa cha zomwe Fentanyl amachita, kumangidwa kwamtima kumachitika.
Matumbo
Mukatha kugwiritsa ntchito mankhwalawa, mwayi wokhala ndi colic biliary ndiwokwera. Kuphatikiza apo, vuto la chopondapo, nseru, komanso kusanza kumachitika nthawi zambiri.
Hematopoietic ziwalo
Matenda a m'mafupa ndi osowa kwambiri.
Pakati mantha dongosolo
Mukamagwiritsa ntchito Fentanyl, kuwonjezeka kwa kuthamanga kwazovuta zam'mimba komanso kupweteka pamutu pafupipafupi ndizotheka. Kuphatikiza apo, kugona, mkhalidwe wokondweretsedwa ndi kuwonongeka kwakuthupi kungakhale zotsatira zina.
Kuchokera kwamikodzo
Nthawi zambiri, odwala omwe amathandizidwa ndi Fentanyl amakhala ndi vuto logona kwamkodzo.
Kuchokera ku kupuma
Mankhwalawa amakhumudwitsa malo opumira muubongo, chifukwa chake, kupuma kumatheka.
Matupi omaliza
Zonsezi pogwiritsa ntchito yankho komanso kugwiritsa ntchito zigamba, zotupa pakhungu zimatha kuchitika. Nthawi zina, laryngospasm ndi edincke's edema zimachitika.
Mukamagwiritsa ntchito njirayi, komanso pogwiritsira ntchito zigamba, zotupa pakhungu zimatha kuchitika.
Malangizo apadera
Kugwiritsa ntchito fentanyl zigamba kumafuna kukanidwa kwathunthu pakukhazikitsa dzuwa. Kuchokera kukacheza ku sauna ndi kusamba kuyenera kusiyidwa. Simungagwiritse ntchito mankhwalawa chifukwa cha opaleshoni chifukwa cha makina owongolera.
Kuyenderana ndi mowa
Pa mankhwala ndi Fentanyl, mowa uyenera kutayidwa.
Zokhudza mphamvu pakuwongolera njira
Kuyendetsa galimoto pamene mukumenyedwa ndi Fentanyl kuyenera kutayidwa.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Kuchiza ndi Fentanyl ndikosavomerezeka panthawi yomwe ali ndi pakati, popeza chiwopsezo kwa mwana wosabadwayo ndichokwera kwambiri chifukwa chakuwonjezeka kwa matendawa. Ngati mayi amamwa mankhwalawa pakubala kwa mwana, wakhanda amatha kuwonetsa kuti ali ndi matendawa. Ngati mukufuna kugwiritsa ntchito mankhwalawa mutabereka mwana, muyenera kukana kuyamwitsa mwana.
Chida chitha kugwiritsidwa ntchito pochiza anthu okalamba pakalibe matenda a kupuma, impso ndi chiwindi.
Kupangira Fentanyl kwa Ana
Pochita opaleshoni ya ana, mankhwalawa amagwiritsidwa ntchito Mlingo wa 0.002 mg / kg. Pa opaleshoni, mtsempha wa magazi a mankhwala osokoneza bongo a 0,1 mpaka 0,15 mg wa pa kilogalamu angathe kutsimikizika. Intramuscular makonzedwe mu 0,15 mpaka 0,25 mg n`zotheka.
Gwiritsani ntchito mu ukalamba
Chida chitha kugwiritsidwa ntchito pochiza anthu okalamba pakalibe matenda a kupuma, impso ndi chiwindi.
Bongo
Ngati mumagwiritsa ntchito mlingo waukulu wa mankhwalawo, kulephera kupuma kungachitike. Kuphatikiza apo, mwa odwala ena motsutsana ndi maziko osokoneza bongo a opiate awa, hypotension ndi minofu yolimba imawonedwa. Woopsa milandu, kukula kwa stupor, zopweteka ndi chikomokere ndikotheka.
Ngati mumagwiritsa ntchito mlingo waukulu wa mankhwalawo, kulephera kupuma kungachitike.
Kuchita ndi mankhwala ena
Kugwiritsa ntchito fentanyl ndimankhwala ena omwe amachepetsa, amatha kuchepetsa nkhawa, komanso ma opioids, kumawonjezera chiopsezo cha mavuto. Wodwala akamagwiritsa ntchito CYP3A4 inhibitors mukamagwiritsa ntchito Fentanyl, kuchuluka kwa otsiriza m'magazi kudzakulitsidwa, zomwe zidzakulitse nthawi yayitali. Kuwongolera nthawi imodzi kwa CYP3A4 inducer kumabweretsa kuchepa kwa ntchito ya opiate.
Analogi
Mankhwala omwe amathandizanso ndi Fentanyl akuphatikizapo:
- Durogezik.
- Fentadol
- Fendivia.
- Dolforin.
- Lunaldin.
Analogue ya mankhwala atha kukhala Lunaldin.
Kupita kwina mankhwala
Mankhwalawa amagawidwa m'mafakisoni motsogozedwa.
Kodi ndingagule popanda kulandira mankhwala?
Pogula ndalama kuchokera kwa ogulitsa omwe siosagwirizana, pali mwayi waukulu wokhala ndi mankhwala abodza kapena omwe atha ntchito.
Mtengo wa Fentanyl
Ku Russia, mtengo wa yankho la Fentanyl umachokera ku ruble 125 mpaka 870. Mtengo wa patch ndi kuyambira 1800 mpaka 4700 rubles.
Zosungidwa zamankhwala
Kutentha kwambiri kwa mankhwalawa ndi 25 ° C.
Tsiku lotha ntchito
Mutha kusunga mankhwala osaposa zaka 4.
Ndemanga za Fentanyl
Oksana, wazaka 29, Murmansk
Mitundu ya Fentanyl ndiyofunikira kwambiri kuchirikiza anthu omwe ali ndi khansa. Mayi anga nawonso anali ndi matenda. Ululuwo unali wosapirira. Mankhwalawa atatha kutumizidwa, adatha kugona mokwanira ndikuyamba kudya. Mtengo wamawonekedwe ndiwambiri, koma chipangizocho chimapereka bwino.
Grigory, wazaka 45, Moscow
Nditachita ngozi ndinakumana ndi mavuto ambiri ndi msana. Mankhwala omwe si a narcotic sanachepetse ululu. Moyo wakhala wosapirira. Kukonzanso zinthu kunali kovuta. Anangokhala bwino madokotala atamuuza Fentanyl. Chidachi chakhala chikugwiritsidwa ntchito kwa mwezi wopitilira. Atasiya kugwiritsa ntchito mankhwalawa. Sindinamve chilichonse choganiza.
