Cov tshuaj "valparin": cov lus qhia rau kev siv, muaj pes tsawg leeg, txhais, muaj sib npaug. Xyuas ntawm kev npaj

Vim li cas kuv yuav tsum tau noj tshuaj "valparin"? Cov lus qhia rau kev siv, txhais thiab indications ntawm cov tshuaj no yog piav nyob rau hauv no tsab xov xwm.

Tus duab thiab muaj pes tsawg leeg ntawm lub

Yuav ua li cas daim ntawv no yog xam qhovkev nyob rau hauv cov tshuaj "valparin"? Ntsiav tshuaj - nws yog nyob rau hauv daim ntawv no ntawm cov tshuaj nyob rau hauv lo lus nug koj yuav tau nyob tej chaw muag tshuaj. Lawv muaj ib lub caij nyoog txiav txim, ib puag ncig biconvex zoo, thiab ib tug dawb xim txheej.

Hais tias ib feem ntawm cov tshuaj "valparin"? Phau Ntawv Qhia hais tias lub cuab tam muaj valproic acid thiab sodium valproate. Nws kuj muaj xws li cov nram qab no cam: glycerol, colloidal silicon dioxide, evdragit E-100, hydroxypropylmethylcellulose, polyethylene glycol 1500, ethylcellulose, sodium saccharin, silicon dioxide hydrate, evdragit TSIS-30D, titanium dioxide thiab talc.

Yuav ntsiav tshuaj yuav tsum tau saib nyob rau hauv ib daim hlab ntawm 10 daim nyob rau hauv ib tug duab los qhia nras feem.

Cov tshuaj

Yuav ua li cas yog qhov tshuaj "valparin"? Cov lus qhia rau kev siv (pes tsawg leeg txhais tau tias twb tau piav saum toj no) hais tias nws yog ib qho anticonvulsant tshuaj. Nws muaj ib tug sodium valproate cov ntsiab lus ntawm pab GABA nyob rau hauv lub hlwb, uas muaj txhawb mus rau nws nce nyob rau hauv postsynaptic neurons.

Peb kuj yuav tsum nco ntsoov tias cov kev tivthaiv nyob rau hauv lo lus nug influences lub thauj ntawm poov tshuaj ions nyob neuronal week. Qhov no txoj kev suppresses txoj kev loj hlob thiab kis ntawm epileptic excitation nyob rau hauv paj fibers.

Nws yuav tsum raug hais tias sodium valproate muaj ib tug anticonvulsant nyhuv nyob rau hauv ntau hom qaug dab peg.

Tshuaj "valparin" tsis muaj tus sedative thiab hypnotic los, thiab yog tsis depressing qhov chaw ntawm lub ua tsis taus pa. Nyob rau hauv tas li ntawd, nws active ingredient muaj tsis muaj kev phiv los ntawm cov lub plawv dhia, lub cev kub ntawm tus neeg mob, nws cov ntshav siab thiab raum muaj nuj nqi.

Cov kev tig tau thaj chaw ntawm cov tshuaj

Yuav ua li cas yog cov pharmacokinetic yam ntxwv ntawm cov tshuaj muaj "valparin"? Phau Ntawv Qhia neeg pab leg ntaubntawv hais tias tom qab noj cov tshuaj hauv ib tug tswj kev tso tawm ntawm active tshuaj pib tam sim ntawd, thiab tom qab 2-8 teev, nce mus txog ib tug tshaj plaws ntshav theem.

Bioavailability txhais tau tias pom tau hais tias 100%.

Tus kho nyhuv ntawm cov tshuaj zoo nkaus li tsuas yog tom qab ncav qhov valproic acid concentration nyob rau hauv cov ntshav, sib npaug zos rau 45-100 mg / l. Nws yuav tau menyuam hais tias cov tshuaj thiab pharmacological kev ua ntawm cov txhais tau tias cov tshuaj tswj tso tub ntxhais tivthaiv tsis yeej ib txwm nyob ntawm seb cov ntshav ntau.

Kev sib txuas lus xam tau tias yog tshuaj rau ntshav cov nqaijrog yog kwv yees li 85-90%. Nws yog metabolized nyob rau hauv daim siab thiab yog tso zis ua ke nrog cov zis. Nyob rau hauv no ua ntej pass metabolism yog cai.

Ib nrab-lub neej ntawm tus neeg saib xyuas yog hais txog 9-20 teev. Nyob rau hauv cov me nyuam, qhov no lub sij hawm yog txo.

Indications rau kev txais neeg kawm

Nyob rau hauv dab tsi tej yam kev mob qhov zoo tshaj tshuaj behaves "valparin"? Cov lus qhia rau kev siv, tiag tiag txog tej tub txawg daim ntawv qhia uas hais tias medicament yog ua rau cov kev kho mob ntawm generalized, qaug dabpeg, nrog rau cov nram qab no ntawm tawm tsam:

• myoclonic;
• qhaj ntawv;
• atonic;
• tonic-clonic.

Tsis tas li ntawd, qhov no tshuaj yog tshuaj rau ib nrab, qaug dabpeg, thiab ntau yeej, nyob rau ntawm:

• theem nrab generalized qaug dab peg;
• ua ke los yog yooj yim qaug dab peg.

Nyob rau hauv tas li ntawd, ntsiav tshuaj feem ntau saib siv thaum muaj ib tug kev syndromes (Lennox-Gastaut syndrome, West).

Bans kev siv cov ntsiav tshuaj

Nws muaj tej yam contraindications tshuaj "valparin"? Raws li cov lus qhia los ntawm lub cuab tam, muaj ntau ntau yam kev txwv txog kev siv:

• thaum lub sij hawm cev xeeb tub;
• mob loj heev mob nyob rau hauv lub pancreas;
• thrombocytopenia;
• kab mob siab mob los yog mob;
• porphyria;
• active kab mob siab mob (tshuaj genesis);
• kev pub niam mis;
• muaj hnub nyoog ntawm cov me nyuam txog peb lub xyoos;
• npau taws me ntsis mus rau yeeb tshuaj, xws li mus valproic acid.

Anticonvulsant "valparin": cov lus qhia rau kev siv

Cov tshuaj ntawm cov tshuaj yog xaiv ib lub zuj zus, nyob ntawm seb lub cev hnyav thiab muaj hnub nyoog ntawm tus neeg mob.

Feem ntau, rau cov neeg laus starting koob tshuaj yog 600 mg ntawm cov tshuaj ib hnub twg. Nyob rau hauv lub qab no tooj nce los ntawm 200 mg (txhua txhua peb hnub mus cuag tej yam tshwm sim).

Multiplicity txais txhais tau tias nyob rau hauv saib xyuas yog 1-2 lub sij hawm ib hnub. Qhov siab tshaj plaws pom zoo ntau npaum li 1-2 g ntawm cov tshuaj ib hnub twg.

Ntsiav tshuaj "valparin", cov lus qhia rau kev siv uas yog xam tau tias yog nyob rau hauv daim ntawv no yuav tsum tau nqos raws li ib tug tag nrho, haus dej haus ib me me ntawm dej sov.

Nyob rau hauv cov neeg laus cov dosing regimen ntawm qhov cuab tam yog zoo li tus dosing regimen nyob rau hauv neeg laus cov neeg mob, tab sis xaiv rau ib tug neeg zus.

Rau cov me nyuam mos uas 20 kg thawj zaug koob tshuaj medicament yog 400mg ib hnub twg. Nws yog tsim nyog yuav ua tau kom tus nqi maj mam mus cuag tej yam tshwm sim (txog 20-30 mg / kg ib hnub twg, nyob rau hauv 1-2 koob).

Child uas mus txog 20 kg muab anticonvulsant tshuaj txwv tsis pub.

Kev nqis tes ua los ntawm-cim

Yuav ua li cas yog cov kev phiv ua "valparin" ntsiav tshuaj? Cov lus qhia rau kev siv ceeb toom uas qhov tsawg ntawm cov tshuaj no nyob rau hauv tib neeg cov neeg mob tej zaum yuav muaj undesirable los:

• Cov kev tsis haum: Stevens-Johnson syndrome, tawv nqaij sawv pob, erythema multiforme, pruritus, daim tawv nqaij, photosensitivity.
• Digestive system: xeev siab, kab mob siab, ntuav, quav tawv, raws plab, pancreatitis.
• Me nyuam system: amenorrhea theem nrab, lus ua poj niam.
• Cns: coma, tshee, ataxia, impaired nco qab.
• hemopoietic system: anemia, platelet aggregation inhibition, thrombocytopenia, leukopenia, neutropenia, tsis fibrinogen.
• Lwm yam: koj qhov hnyav nce, plaub hau poob, ntshiab creatinine, hyperammonemia.

overdose anticonvulsant

Yuav ua li cas cov tsos mob yuav tshwm sim thaum noj siab koob tshuaj ntawm cov tshuaj "valparin"? Cov lus qhia rau kev siv (ntsiav tshuaj yuav tau muas ntawm tej chaw muag tshuaj rau cov tshuaj) argues tias rau hnub tim ntawm txhob txwm los yog yuam overdose ntawm cov tshuaj nyob rau hauv kev saib xyuas tau qhia tsis tshua. Raws li ib tug txoj cai, ua txhaum ntawm lub dosing ntawm cov tshuaj txhawb mus rau lub tsos ntawm xeev siab, kiv taub hau, ntuav, raws plab, ua pa nyuaj siab, coma, thiab hyporeflexia.

Yuav kom tshem tawm tej yam kev mob rau tus neeg mob yog tus kws kho pais plab lavage thiab tshuab txais charcoal. Yog hais tias tsim nyog, tus neeg mob kev kho mob yog nqa tawm nyob rau hauv daim ntawv ntawm cov symptomatic txoj kev kho thiab hemodialysis.

Sis nrog lwm yam tshuaj

Seb nkag mus rau hauv kev sis raug zoo nrog lwm yam tshuaj tshuaj "valparin"? Cov lus qhia rau kev siv qhia tus neeg mob hais tias cov sodium valproate kom nrov loj cov nyhuv ntawm antipsychotics, antidepressants thiab antiepileptic tshuaj.

Tsis zoo li lwm yam anticonvulsants , xam tau tias yog tsis siv yeeb tshuaj txhawb hepatic enzyme induction, thiab yog li ntawd nws tsis txo cov hauj lwm zoo ntawm qhov ncauj contraceptives.

Nyob rau hauv thaum uas tig mus txais tos ntawm "warfarin" thiab sodium valproate poob qhov feem pua ntawm losis tswvyim dabtsi rau ntshav cov nqaijrog thawj.

Lub active tshuaj yam khoom uas yog xam tau tias yog yuav hloov ntshav ntau ntawm lamotrigine, thiab phenytoin. Thaum nws yog nrog lub derivatives ntawm acetylsalicylic acid anticoagulant thiab antiplatelet cov nyhuv yog kho kom zoo.

Nrog simultaneous siv "valparin" los ntawm ethanol thiab lwm yam tshuaj uas mluas Cns kaw (e.g., Mao inhibitors yog lub tricyclic antidepressants, antipsychotic yeeb siv tshuaj) tej zaum yuav kho kom zoo Cns kev nyuaj siab.

Haus dej cawv thiab lwm yam hepatotoxic tshuaj ua rau kom cov kev pheej hmoo ntawm lub siab puas.

Saib formulation tsub kom lub ib nrab-lub neej "lamotrigine" thiab slows cia nws metabolism thiab suppresses hepatic enzymes. Nyob rau hauv kev twb kev txuas nrog rau qhov no ib nrab-lub neej ntawm cov tshuaj yuav tau nce mus txog rau 70 teev nyob rau hauv neeg laus cov neeg mob thiab mus txog rau 45 teev - cov me nyuam.

"Valparin" yog tau txo tus clearance "zidovudine" los ntawm hais txog 40%. Ntxiv mus, nws ib nrab-lub neej tsis hloov.

Mao contact lenses antidepressants, tricyclic thiab antipsychotic tshuaj (neuroleptics), raws li zoo raws li lwm yam tshuaj uas txo cov qaug dab peg chaw pib, considerably txo cov hauj lwm zoo ntawm qhov suav hais tias medicament.

Kev pub niam mis thiab cev xeeb tub

Raws li kws txawj, kev siv ntawm cov tshuaj "valparin" thaum lub sij hawm hnub no tsuas tau yog hais tias tus npaj cov kev pab cuam mus rau lub neej yav tom ntej leej niam ho tshaj lub peev xwm uas yuav muaj rau tus me nyuam.

Thaum tau txais cov tshuaj thaum lub sij hawm cev xeeb tub, yuav tsum tau ua ib tug tshwj xeeb thaum xyuas ntawm lub fetus.

Siv cov tshuaj thaum lub sij hawm lactation yog tsis pom zoo.

Cov ntaub ntawv

Ua ntej koj yuav pib kev kho mob ntawm cov nyiaj, koj yuav tsum mus tham nrog koj tus kws kho mob.

Nyob rau hauv tus txheej txheem ntawm tau txais anticonvulsant tshuaj yuav tsum xyuas ntawm bilirubin nyob rau hauv cov ntshav, amylases thiab platelets, raws li zoo raws li lub siab transaminases (txhua txhua 3 lub hlis).

Raws li kws txawj, valproic acid muaj peev xwm sawv ntawm inhibiting platelet aggregation. Qhov no zoo heev tsub kom qhov uas yuav muaj zog ntshav coagulation lub sij hawm rau los ntshav. Nws yog tsim nyog los noj mus rau hauv tus account lub yuav ua rau muaj teeb meem uas yog txuam nrog rau los ntshav nyob rau hauv lub postoperative lub sij hawm, nyob rau hauv cov neeg uas tau txais sodium valproate.

Yog hais tias ntev-lub sij hawm kev kho mob ntawm cov tshuaj no nyob rau hauv cov neeg mob tej zaum yuav tsim txawj los ntshav thiab hematoma tsim. Nyob rau hauv cov ntaub ntawv no, cov tshuaj yuav tsum tau nres sai li sai tau.

Raws li hais saum toj no, sodium valproate, ib tug yeeb tshuaj feem ntau ua rau pancreatitis, thiab kuj txhawb kev cuam tshuam ntawm daim siab muaj nuj nqi (feem ntau yog nyob rau hauv thawj 6 lub hlis ntawm kev kho mob). Nyob rau hauv no hais txog, thaum pib ntawm txoj kev kho yog tsim nyog los saib xyuas tus txheej xwm ntawm pancreatic mob cancer neeg mob, raws li tau zoo raws li rau tu ncua saib xyuas daim siab muaj nuj nqi xeem, thiab cov theem ntawm prothrombin.

Mob ntawm lub siab thiab hepatic tsis ua hauj lwm nyob rau hauv cov neeg mob uas tau txais sodium valproate tau cai nyob rau hauv cov me nyuam nrog tau qaug dab peg hauv metabolic thiab kab mob, hlwb ruamqauj thiab organic hlwb cov ntaub so ntswg pathology.

Nyob rau hauv lub soj ntawm xws tej yam tshwm sim raws li nkees, cim tsis muaj zog, o, thiab ntuav, daj ntseg, yuav tsum tam sim ntawd txhob siv cov medicament.

Nyob rau hauv cov kev kho mob ntawm "valparin" tus neeg mob yuav tsum tau ceev faj heev thaum ua hauj lwm nrog yus machinery. Qhov no yog vim lub fact tias lub active medicament muaj peev xwm sawv ntawm kev txo concentration.

Cov ntsiab lus uas thiab tej yam kev mob ntawm cia

Anticonvulsant tshuaj "valparin" dispensed nyob rau hauv pharmacies tsuas yog nyob rau tus kws kho mob tshuaj. Lawv yuav tsum tau muab cia rau hauv ncav tsis cuag ntawm cov me nyuam thiab muaj kev tiv thaiv los ntawm dej thiab ntawm ib tug kub tsis ntau tshaj li 30 degrees.

Lub txee lub neej ntawm cov tshuaj nyob rau hauv saib xyuas yog peb xyoo (ntawm hnub uas siv).

Medicament "valparin": analogues, txhais

Cov tshuaj nyob rau hauv lo lus nug yuav hloov? Txhais thiab analogues nyob rau hauv qhov cuab tam, muaj ntau ntau yam. Cov no muaj xws li nram qab no tshuaj: "Apilepsin" "Depakine," "Atsediprol" "Depakine Enterik" "Depakine Chronosphere" "Depakine Chrono", "Dipromal", "Konvulsofin", "Konvuleks", "Orphir" "Enkorat", "Everiden", "Enkorat Chrono".

Raws li yog cov ntaub ntawv nrog "valparin", cov nyiaj no yuav tsum tau coj tsuas yog nyob rau tus kws kho mob txiav txim, nyob rau hauv lub pom zoo noj tshuaj npaum cas nruj me ntsis.

Lub tswv yim ntawm cov kev pab thiab cov tub txawg

Yuav ua li cas cov kws kho mob hais txog cov tshuaj no, xws li "valparin"? Guest cov kws txawj qhia tias cov tshuaj no zoo heev thiab npaum, tshwj xeeb yog nyob rau hauv generalized thiab ib nrab qaug dab peg.

Raws li rau tau txais kev pab, feem ntau ntawm lawv pom zoo nrog lub tswv yim ntawm tus kws kho mob. Cov neeg mob ceg tias qhov no txais txhais tau tias tswj lub ceev ceev txoj kev loj hlob thiab kis suppressing excitation (epileptic) los ntawm neurons. Txawm li cas los, nws yuav tsum tau muab sau tseg tias kev siv ntawm cov tshuaj no feem ntau yog ua rau kev phiv. Raws li neeg tawm tswv yim, lub feem ntau tshwm sim cov nyom tshua yog: daim tawv nqaij ua xua, xeev siab, anemia, thiab qhov hnyav nce. Yog hais tias koj muaj kev cov tsos mob yuav tsum tam sim ntawd hu rau ib tug kws kho mob.