Sodium valproate: iresiphi, imiyalelo, ifomu ukukhululwa, mshini wezenzo, ifomula

Noma yimuphi ukuphazamiseka ukusebenza kwesimiso semizwa esiyinhloko zidinga ukunakekelwa eduze. Ukuze ulwe izinkinga ezinjalo athuthukile imithi mass nezimiso ezahlukene isinyathelo ebuchosheni. Omunye wabo iyona "Sodium valproate".

Izingxenye ezisemqoka nangohlobo

The main isithako zomuthi - usawoti sodium ka valproic acid - kuyinto crystalline powder emhlophe esihle abangenalo iphunga. Lokhu okungukuthi ukukhululwa uhlobo lesi sidakamizwa "Sodium valproate". Formula - S8N15NAO2. Kalula encibilikayo otshwaleni namanzi.

Umthengi inikezwa amaphilisi kanye kabili ungqimba polyethylene izikhwama. Emincane kakhulu ivolumu kungenzeka in iphasela single - 0.5 kg. ASC Eminye: 1, 2, 5, 10, 20, 25, 30, 40, 50, 65 kg.

pharmacodynamics

izidakamizwa Antiepileptic - umsebenzi oyinhloko ukulungiswa "Sodium valproate". Lo mshini wezenzo kusekelwe ukwanda olulindelekile amazinga Gaba (acid acid, kuyinto neurotransmitter ezibalulekile inhibitory e, elezinye izilwane ezincelisayo) ku CNS ngu ezivimbela Gaba-transaminase nokwehlisa reuptake we ketshezi izicubu ingqondo. Umphumela yale nqubo, ngokusobala, ukunciphisa excitability futhi ezifweni motor izindawo zobuchopho ekuthuthukiseni nokuquleka.

Sodium valproate kungaba nomphumela tranquilizing ukuze sinciphise ukukhathazeka, ngcono iziguli kwemizwelo, isimo sabo sengqondo. Ngaphezu kwalokho, ibonisa umphumela antiarrhythmic. Umuthi kubonisa ukusebenza kahle eliphezulu ngabikho nokuquleka (uphawu yisithuthwane ngokulandelana kwawo, uhlobo olulodwa isiwombe nabanesithuthwane) kanye psevdoabsansah kungokwesikhashana, kepha cishe akunamthelela isimo iziguli ukuthuthukiswa lengqondo ka nokuquleka.

Ngokuya ihogela ithonya zomuthi

Isicelo main of the nomuthi "Sodium valproate" imfundo manual ulawula yisithuthwane ngokulandelana kwawo, kokubili njengoba monotherapy futhi elihlangene ukwelashwa samuntu. Umuthi isetshenziswa khona ukuquleka generalized (polymorphic, t esikhulu convulsive. D.), Futhi ebalulekile esinqunyiwe (motor, lengqondo t. D.). Ngaphezu kwalokho, izidakamizwa ezinqunyiwe iziyaluyalu convulsive zivame ukuhambisana izifo eziphilayo isimiso sezinzwa somzimba womuntu disorder ngokuvamile kuyahambisana abanesifo sokuwa e Ukudlikizela febrile futhi tics ehlise iziguli-izingane.

Sodium valproate Umhlahlandlela uncoma ukwamukela iziguli ezine- ukwenama-bacindezeleke zamanje okuguquguqukayo ezimweni lapho isifo refractory ukuze ukwelashwa nge lithium kanye neminye imithi.

Ukuze ukwazi ukusebenzisa leli imithi?

Ngo ezinjalo eziyinkimbinkimbi imikhiqizo njengoba anti-nabanesithuthwane, kukhona njalo othile uhlu contraindications yabo ukusetshenziswa. Umuntu angeke alithole ukuthatha ejenti, abayazi hypersensitivity ukuba into ezifana valproic acid (sodium valproate, ngokwawo futhi kuhlanganisa sodium yayo usawoti). Isizathu sokuba non-ukusetshenziswa kuba khona okuthile okungahambi kahle emzimbeni ukusebenza iziguli isibindi kanye / noma amanyikwe. Kufanele futhi ukugqamisa kuleli qembu izifo Hepatitis (zonke izinhlobo - acute, okungamahlalakhona, izidakamizwa, njll, kuhlanganise umlando umndeni ..).

Akukona linqume izidakamizwa ngesikhathi diathesis oluhambisana, porphyria (cishe 99% amacala ukuphambuka lezinceku ebonakaliswa ukwephulwa sombala umzimba ngokuqukethwe okusezingeni eliphezulu ku igazi nezicubu of porphyrins).

sodium valproate nokukhulelwa

Ukusetshenziswa kwezidakamizwa e senyanga yokuqala sokukhulelwa is contraindicated. Ngo udokotela senyanga eyesibili neyesithathu ngeke akunikeze imithi for yokufuna "Sodium valproate" kadokotela kuphela uma izinzuzo olulindelekile kumama idlula ingozi umntwana.

Iziguli kufanele aziswe ukuthi valproic acid kungase kubangele ukuthuthukiswa eziningi kombungu esizalweni ku-fetus. Ngaphezu kwalokho, lokhu izidakamizwa is excreted ku ubisi lwebele (okuhlushwa bengase bazikhandlele 10% lemali eziqukethwe plasma kamama). Ngakho-ke, ukuncelisa ngesikhatsi ukwelashwa ngemithi equkethe valproic acid ukwakheka, kuvunyelwe kuphela ezimweni ngekucindzetelwa kakhulu.

Ngenxa izincomo jikelele abagada kukhona eminyakeni abo okuzala, ukusetshenziswa kwezindlela ezikahle noma zindlela zokuvimbela inzalo zingqubuzana.

imiphumela engathandeki

Ezigulini ngemithi "Sodium valproate" imfundo manual liqukethe ulwazi mayelana imiphumela engemihle engase ibe izinhlelo ezahlukene eziyishumi nemitshingo.

ukuphendula Okungenzeka phezu ingxenye isimiso sezinzwa esiyinhloko kungenzeka liqhaqhazela, izinguquko isimo, ukuziphatha, kusebentisana kahle, ukozela, isiyezi, ubuhlungu bekhanda, ukucasuka, ukungahlaliseki futhi injabulo engavamile.

I Cishe ukusabela Git - ukungakuthandi ukudla, dyspepsia, isicanucanu, ukuhlanza, uhudo, amajaqamba encane wamathumbu noma indawo esiswini. Akuvamile ukuzwa ukuqunjelwa noma pancreatitis. Ngo abesifazane, umjikelezo wokuya esikhathini uwubufakazi kungenzeka. Ngokuvamile nendawo ukuba isisindo iyehla iyenyuka kwelinye direction noma kwenye. Coagulation uhlelo angaphendula thrombocytopenia, esengeziwe edingekayo ukuze kunqandwe ukopha. Dermatological ngeziphambeko kungenzeka njengoba Alopecia (ukulahlekelwa sokugembula izinwele), iguliswa - ukuqubuka esikhumbeni.

umthamo lwemithi

Isimiso isilinganiso esithathwa esigulini ngasinye esokuba ngabanye. "Sodium valproate" ukubhalisa kabani ukuma - in ifomu powder iqondiswa kuncike isisindo emzimbeni. Isikali kokuqala abadala kanye nezingane enesisindo esingamakhilogremu angaphezu 25 kg kuba 10-15 mg ngayinye isisindo amakhilogramu umzimba (umthamo nsuku zonke). Uma awaveli ukuba iyiphi izigameko ezingezinhle ezavela kancane kancane (zonke izinsuku 3-4) umthamo bangavuselwa 200 mg / usuku. kuze kube yileso sikhathi, kuze yalokho emitholampilo abalulekile izotholwa. Isilinganiso umthamo wansuku zonke angaba ngu-30 mg / kg.

Ukwelashwa Regimen nemithi - 2-3 izikhathi ngosuku ngezikhathi zokudla.

Futhi wayekwenza isabelo sodium valproate ngemithambo yegazi (ukulungiselela ovumelekile - 400-800 mg) noma ukumnika (25 mg / kg enkathini eyiminyaka 24, 36, 48 amahora).

esiphezulu umthamo kungenzeka nokwelashwa kweziguli omdala nezingane nokuba esisindo abangaphezu kuka-25 kg - 50 mg / kg ngosuku. Uma nganoma isiphi isizathu kubalulekile (umthamo) ukwanda, imfuneko uwukunakekela lokuhlushwa valproate ku yokwakheka oketshezini olungenambala lwegazi. Uma ngabe le izinga kuka 200 mg / l - umthamo kumele kungancipha.

Ukweqiwa ngokweqile

Uma ngasizathu simbe kwakukhona okweqa umthamo kuvunyelwe "Sodium valproate" (iresiphi okulula Latin ukuqonda kude hhayi zonke iziguli), kukhona uchungechunge izimpawu akunakungatshazwa. Ukusabela ezivamile thuthuva ka ngefanelo nangokuvumelana nokulinganisela, retardation, Myasthenia Gravis (pathologically ukukhathala), hyporeflexia, nystagmus (iso okungalindelekile iyehla iyenyuka at imvamisa high), miosis (ukusikwa umfundi), inhliziyo block, equlekile.

Ukwelashwa Kwenziwa endaweni esibhedlela futhi lavage esiswini kuyinto (ngempumelelo uma enterally kungakapheli amahora 10-12), ukunikeza diuresis osmotic (yenqwaba umchamo nge lokuhlushwa eliphezulu osmotic ingxenye esebenzayo) futhi ukusekela ezibalulekile zomzimba. nomphumela omuhle ukunika hemodialysis.

Ukuxhumana nezinye izinto

Ngo isicelo parallel nezinye neuroleptics, imithi yokucindezeleka nezidambisa mao inhibitor, nemikhiqizo ahlukahlukene benzodiazepine ethanol kanye sodium valproate ukwandisa ukusebenza inhibitory ku isimiso sezinzwa esiyinhloko. Ukusetshenziswa ahlangene izidakamizwa izidakamizwa hepatotoxic, ama-ejenti antiplatelet, anticoagulants, angase avuse nethonya kakhudlwana lezi izinto.

eyamukelayo Umfuziselo valproic acid nomthofu phenobarbital ukuba displacement we yokugcina kusukela ephonsa plasma amaprotheni. Umphumela - uwakhuphule (phenobarbital) lokuhlala e-plasma.

Ngokuvamile, i-sodium valproate ongangena nokuxhumana ezihlukahlukene imithi, Nokho yokwamukela kungenzeka (noma engamukeleki) ka nalokho okwenzeka nezinye izidakamizwa isiguli kufanele azise udokotela okwelaphayo.

imiyalelo Special

Uma kuthathwe izinyathelo ezinkulu imithi enqunyiwe iziguli izifo kwesibindi kanye kwamanyikwe (noma ukuba kwabo emlandweni), izingane ezineminyaka engaphansi kwengu-3 (ingozi esiphezulu hepatotoxicity, kodwa kuyancipha njengoba ekhula). Kumele kukhunjulwe ukuthi ematfuba okuvela kuyo imiphumela emibi evela isibindi lenyuka phakathi kuhlanganiswe yokwelapha anticonvulsant.

unake kakhulu empilweni yabo kumele kube iziguli ukuthatha "Sodium valproate" nokuba igazi dyscrasias. Organic ubuchopho isifo, kwezinso e nokusebenza kwezinso, hypoproteinemia - kukhona futhi esibucayi engcupheni imiphumela emibi.

Phakathi nezinyanga zokuqala eziyisithupha yokwelashwa nge-sodium valproate kubalulekile ukuba ngokuqhubekayo nokuqapha isimo igazi coagulation uhlelo, isibindi, neuropathy igazi isithombe.

Abantu imithi oyiphuzayo anticonvulsant, sodium yokwelapha valproate kumele kuqale kancane kancane, ukuze athole i umthamo ngempumelelo cishe 12-14 izinsuku kamuva. Ngemva kwalokho, nje kudingeka kancane kancane ukukhansela wathola ngaphambilini izidakamizwa anticonvulsant. Uma amalungiselelo anjalo kungukuthi isicelo ngaphambi isiguli, umthamo eliphumelelayo yi emitholampilo ukuze ingafinyelelwa ngesonto.

Against isizinda ukusetshenziswa kwezidakamizwa Kufanele siqaphelisise lapho ukuphathwa komgwaqo futhi umsebenzi, odinga ukujula ukunakwa nesivinini lengqondo ukusabela.

Futhi okubaluleke ...

Isisekelo ukusebenza kwanoma yimuphi umuthi antiepileptic (hhayi okuhlukile kanye sodium valproate) - kadokotela enquma udokotela.

Kuphela umsebenzi wezempilo e bezokwazi ukuhlola zonke izici futhi unquma ukuqhuba yokwelapha nge izidakamizwa ethile. Isitatimende Hlukanisa kwenjongo igcwele izimpahla sína kakhulu, imiphumela engemihle kakhulu isimo sezempilo - kuze kube ikhoma nokufa.