"Phenytoin": yokusetshenziswa, analogs, Ukwakheka

Kuyini umuthi ezifana "Phenytoin" Yokusetshenziswa, analogs zingabameleli nge isithako efanayo esebenzayo izokwethulwa ngezansi.

izakhiwo Chemical nangohlobo

"Phenytoin" nge isithako efanayo esebenzayo kuyinto imithi eqeda sokuwa. Kuyinto esuselwe hydantoin, esondelene kakhulu barbituric acid (e zabo isakhiwo sazo sekhemikhali).

Ingqikithi embuzweni afakwe ohlwini semithi ebalulekile WHO, kanye uhlu emithi ebalulekile.

Phenytoin (yokusetshenziswa zomuthi ahlanganisa uzobe emelelwa ngemuva kwalokhu) ukuthi kuhlelwe 1908. Futhi kuphela 1937-th ke izakhiwo anticonvulsant Kwatholakala.

Le into is a powder (crystalline) abanebala elimhlophe okuyinto cishe zingaxazululeki emanzini. Le ngxube kungenzeka ziyoncibilika isixazululo 1% alikhali caustic.

Okwamanje ukukhulula amaphilisi ngomlomo "Phenytoin" kanye kusho kwezokuphatha parenteral.

kwemithi

Kanjani lesi sidakamizwa "Phenytoin"? Yokusetshenziswa kubonisa ukuthi anazo ejenti anticonvulsant, antiarrhythmic, antiepileptic futhi imisipha relaxant izakhiwo.

umsebenzi Anticonvulsant lokhu lokulungiselela kunalokho okusezingeni eliphezulu. Nokho, ukuqashwa kwakhe akakubangeli ukozela kanye ukucobeka.

Phenytoin ngokuthi bio-kagesi ngempumelelo isimame. Uma uthatha ebulilini ketshezi, kungaholela ukubambisana abampofu ukunyakaza komuntu.

Kubhekwe indlela oyenza isebenze CNS, kwandisa excitability nombundu, ine isinyathelo antiarrhythmic enhliziyweni, futhi kunciphisa izinga ukudlula pulses of block ugongolo legatsha futhi Purkinje zesivikelo sesifuba.

Lo mshini wezenzo zomuthi

Ngokusekelwe kulokho umphumela umuthi "Phenytoin"? Ukufundiswa uthi isimiso umphumela wawo umzimba womuntu akukaqondwa ngokugcwele. Nokho, ochwepheshe bangase baphikise ngokuthi okuyisici esiyinhloko leli thuluzi yikhono layo usimamise ulwelwesi (neuronal) zokuxhumana kobuchopho ka ezinzwa futhi umzimba.

Ngenxa imiphumela enjalo, umuthi Ungakhawulela ukusabalala excitation neuronal kanye ukunciphisa umsebenzi kokuquleka.

Izici izimali

I ikhambi emangalisayo "Phenytoin"? Yokusetshenziswa ibika ukuthi imfuyo yayo asebenzayo kuthinta ganglia autonomic, emgogodleni ubuchopho izicubu, inhliziyo, kuhlanganise uhlelo lwayo conductive, imizwa neuropathy imisipha abushelelezi emathunjini bese inhliziyo izitsha.

Ukuthola lokhu izidakamizwa kunciphisa sodium lokuhlushwa izinzwa, lula yezokuthutha sodium ion emangqamuzaneni, futhi wehlise intracellular calcium ukunyakaza.

Kumele kuqashelwe futhi ukuthi imithi kubhekwe kuthinta ekusebenzeni fibroblasts, amaseli glial, futhi endocrine. Kwathiwa wathola ikhono layo ukusheshisa isilonda ukuphulukisa, ukucindezela umsebenzi ka-receptor (glutamate), ukuthuthukisa umoya-mpilo emangqamuzaneni, izicubu izitho nemibandela hypoxia ubuthi ubuthi.

Umuthi at ngemithamo zokwelapha has toning ngokulinganisela futhi uthulisa futhi ayiluthi.

kinetics

Ingabe phenytoin izidakamizwa amuncwa umzimba? Yokusetshenziswa (uhlobo ukukhululwa kwe igama elifanayo izidakamizwa iye elishiwo ngenhla) uthi ekuphathweni ngomlomo ingxenye izidakamizwa lokhu sasivumela esikuthola kalula umzimba wesiguli. Nokho, imingcele pharmacokinetic kubhekwe izindlela ingahluka kakhulu ngamaqembu ahlukene iziguli.

I lokuhlushwa eliphezulu kakhulu izidakamizwa egazini kutfolakala ngekhatsi amahora 5-14 (kufika emahoreni angu-28 ukuze ekwakhiweni ithebhulethi). Umthelela ekuphathweni ngomlomo izidakamizwa siyenzeka Ngemva kokuba kudlule cishe ihora, futhi ngemva kokuphathwa emthanjeni - emva kwamaminithi ambalwa.

Cishe u-80% we ketshezi esebenzayo lihlotshaniswa plasma amaprotheni. Abantu ne isifo sezinso, izinga ongafinyelela 43%.

Ngokusho imiyalelo izimali angabacwasi ngokushesha kuyalinqoba kusivimbeli gazi ebuchosheni. Kulokhu, it is kwasakazwa cishe zonke izicubu kanye izitho.

Mayelana 5% phenytoin is ngokukhishwa ngu nezinso. Mayelana compounds ezisele, it is akheka esibindini futhi iguqulwe ibe paraoksifenily alisebenzi futhi glucuronides, okuyinto ke ziyaphuma umzimba kanye Bile.

kufanele ngisebenzisa kanjani imithi "Phenytoin"? Ukusetshenziswa kwalesi izidakamizwa ikhonjiswa nge pentobarbital, amavithamini D K, kanye nezinye protivoepileptikami. Kuphela kuleli cala ukuthi kuyoba kahle ngangokunokwenzeka.

ubufakazi

Kwezinye izimo, sebenzisa izidakamizwa kanye isithako, njengoba phenytoin? Yokusetshenziswa (amaphilisi kanye isixazululo kufanele bancome udokotela abanolwazi kuphela) likhombisa izinkomba ezilandelayo:

• isithuthwane;
• isikhathi emva kokuhlinzwa kanye nokwethuka (njengoba izidakamizwa zokuvimbela);
• ventricular kanye arrhythmia supraventricular, okuyinto kwabangelwa ukweqisa izidakamizwa of antidepressant futhi glycosides inhliziyo;
• isimo epilepticus ne esinqunyiwe nokuquleka eziyinkimbinkimbi futhi nokuquleka tonic-clonic;
• UMeniere Syndrome;
• neuralgia trigeminal, kuhlanganise ukumelana carbamazepine;
• izilonda emathunjini noma engaphathekile wamathumbu syndrome (e ukwehluleka enye indlela yokwelapha);
• thuthuva yokucabanga izinqubo, nokugula ngengqondo, ezibangela ukuziphatha okuyinqaba;
• strabismus futhi ukufiphala;
• normal inqubo ukuvuselelwa (ukusha, caries zamazinyo, ulceration futhi scleroderma);
• relapsing imfiva kanye hypothalamic syndrome.

Izimo

imithi Okubukwe kungenzeka ingasetshenziswa uma:

• cachexia noma leukopenia;
• lactation;
• isibindi ezinzima nesifo sezinso;
• ukumelwa inhliziyo, AV-nokuvinjelwa 2nd noma degree 3rd, bradycardia;
• hypersensitivity ukuba izinto asebenzayo;
• porphyria;
• syndrome ka Morgagni-Adams-Stokes;
• sokukhulelwa.

Futhi, ngokuqapha in iziguli ngifundise ngesifo sikashukela, ukuba umlutha wotshwala, lapho i-lupus erythematosus noma komzimba okukhulu.

Medicine "Phenytoin": yokusetshenziswa

Umthamo zomuthi kuyakhethwa ngamunye kuncike eminyakeni yobudala lesiguli kanye nesifo.

Lapho izifo nabanesithuthwane umthamo kufanele kube izikhathi eziningana ngaphansana isithuthwane. Medicine e ifomu iphilisi kuthathwe kuphela ngezikhathi zokudla.

Umthamo nsuku zonke iziguli omdala kufana amaphilisi 1-3 (ihlukaniswe 2-3 ngemithamo). Uma kudingeka, le nombolo zingandiswa kuze 4 amaphilisi ngosuku.

Umthamo esiphezulu imithi ngelanga kuyinto amaphilisi 8. Kulokhu, ngesikhathi isiguli kuphela baphuze amaphilisi 3.

Ekwelapheni izingane ezingaphansi kweminyaka engu-5 bona ukhethe ¼ ithebhulethi kabili ngosuku. Izingane eminyakeni 5-8 - in esilinganayo, kodwa izikhathi 3 noma 4 ngosuku.

Izingane eziye zaphetha engu-8, kutuswa ukunikeza 1-2 amaphilisi 2 ngemithamo ahlukaniswe.

Isikhathi ukwelashwa nge leli thuluzi kuchazwa kuphela nguchwepheshe.

Izenzo-uhlamvu

Imithi phenytoin kungabangela imiphumela elandelayo engathandeki:

• Skin njengemithi yokungezwani komzimba nokuthile, morbilliform ukuqubuka (kufanele ayeke izidakamizwa ukuze akhulule izimpawu).
• ukusabela kabi komzimba iguliswa (akuvamile kwenzeka), imfiva, ukuqhuma isikhumba olubanzi, Stevens-Johnson syndrome, erythema angioedema, i-hepatitis.
• Hyperplasia Gingival, macrocytosis, osteomalacia, megaplasticheskaya kwegazi, thrombocytopenia, pancytopenia, hirsutism, anaemia haemolytic, lymphadenopathy.
• iziyaluyalu Dose-kuncike isimiso sezinzwa esiyinhloko, iso, izindebe nezinkophe fibrillation, ukukhathazeka ataxia, isiyezi, liqhaqhazela, ukuqwasha, ukucasuka, esihlasela isimiso sezinzwa (ezenzeka nge isikhathi eside ebulilini).
• Hypertrichosis, coarsening izici zobuso, hyperpigmentation, ukuncipha emzibeni, Arthritis.

Kufanele kuphawulwe ukuthi uma ethola komthamo wokuqala, isiguli singase ukuthuthukisa elandelayo emibi ye izinkinga zesisu, ekuphakameni enzyme isibindi, isicanucanu, dyspepsia, gastralgia futhi kolwelwesi. Ukuvela imiphumela enjalo kungagwenywa uma uthathe amaphilisi ngesikhathi ukudla kuphela.

amacala ukweqisa izidakamizwa

Isicelo zomuthi ngayo imithamo ephezulu izikhathi nokunwetshiwe kungaholela ukuthuthukiswa ataxia, nystagmus, hyperkinesis, esihlasela isimiso sezinzwa, futhi diplopia. Futhi, isiguli bangase balwisane inzuzo yisithuthwane ngokulandelana kwawo, Hyperglycemia, futhi stupor.

Kumele kuqashelwe ukuthi le ketshezi lingekho ikhambi ethize. Ukwelashwa okufanele kwenziwe ngokuvumelana yezimpawu ezibonakala.

ulwazi oluthile

Kulaba izimali ayikwazi evele khansela iziguli nesifo sokuwa, njengoba lokhu kungase kubangele ukuba ukuthuthukiswa yalesi sifo. Uma ufuna bayenqaba ukwamukela ke (isibonelo, komzimba noma hypersensitivity), kufanele usebenzise imithi eqeda kokuquleka ngolunye uhlobo lothando.

Ukwelashwa kusho kubhekwe kuthinta cholesterol, bilirubin, phosphatase ane-alikhali, enzyme isibindi, ushukela egazini, i-calcium serum futhi i-hormone thyroxine.

Njengoba kushiwo ngenhla, phenytoin izidakamizwa is akheka esibindini, Nokho ngesikhathi reception yayo kudinga ukunakekelwa okukhethekile kubantu abane yokwehluleka kwesibindi.

Uma umuntu kwake waphawula hypersensitivity kuya anticonvulsants hydantoin ke ketshezi zingenza yokungezwani komzimba.

Phakathi ukwelashwa, isiguli akuvunyelwe ukuba ukushayela imoto futhi enze umsebenzi enobungozi.

Analogs kanye nokubuyekeza

Yini esikhundleni izidakamizwa antiepileptic "Phenytoin"? Analogue lokhu ejenti aqukethe isithako efanayo esebenzayo. Le mishanguzo zihlanganisa lezi ezilandelayo: "Difenin", "diphenylhydantoin" futhi "Dilantin".

Izibuyekezo Iningi iziguli ezineminyaka engaphansi kwengu okubheka fair. Bathi izidakamizwa idluliswe ngempela kalula. Ngaphezu kwalokho, it has a esincane akaphelelwa impahla yayo anticonvulsant ngisho nangemva ukuphatha isikhathi eside.

Kufanele futhi wazi ukuthi kukhona okuningi wokubuyekezwa okuvumelekile salokhu imoto, ezashiya iziguli wawuthatha e therapy eziyinkimbinkimbi.