Valproic acid: yokusetshenziswa, analogs kanye nokubuyekeza

Valproic acid (sodium valproate) uyilungu leqembu kuqhathaniswa entsha ye anticonvulsants, ezingafani nalezo ezisetshenziselwa ngaphambilini antiepileptics kokubili isakhiwo zamakhemikhali isimiso wokusebenza.

incazelo efana

Lokhu chemical ukuthi kuhlelwe 1882, i Analogue valeric acid Dr. W. Barton. Siqukethe Iinqhema ezi-2 cut. Amashumi eminyaka, valproic acid isetshenziswa kuphela endaweni yokucwaninga njengoba uketshezi inert compounds ahlukahlukene organic. Protivosudorzhnye impahla yayo zitholwe yisikhohliso.

Valproic acid ketshezi futhi esobala emazingeni okushisa okuvamile. Ngakho-ke uyakwazi ukusabela ezifana sodium hydroxide noma magnesium valproate nge isizinda ukwakha usawoti, okuyinto into okuqinile. Lokhu kwaziswa, eqinisweni, yilokho 2-propylvaleric acid kanye sodium yayo usawoti. Ngokungafani nezinye antiepileptics, limelela kwakwakhe nitrogen-mahhala. Lo mshini wezenzo lokhu acid nosawoti yalo, elihlobene ne nethonya esithile umzimba ye-gamma-aminobutyric acid, kuyinto inhibitor of enzyme transferase.

Ukwakhiwa okuyinto yakhiwa valproic acid, bese ngihlaliswa convulsive ukuphendula excitatory motor izindawo zobuchopho. Lokhu kungenxa yokuthi ketshezi kwandisa okuqukethwe gamma-aminobutyric acid kwemizwa uhlelo izakhiwo. Valproic acid, abonisa izilinganiso ekulenzeni libe namandla anticonvulsant ekwelapheni izimo ezihlobene iqembu fatty acid.

Izimpawu valproic acid, analogue yayo

Valproic acid, echaza isiqondiso imiphumela yayo eziyinkimbinkimbi womuntu, ikhiqizwa ngamagama ahlukene. Izidakamizwa eyaziwa kakhulu, okuhlanganisa into okungukuthi "Depakine," "Konvuleks", "Konvulsofin", "Orfilin", "Deprakin", "epilation", "Everiden", "Enkorat", "Apilepsin", "valparin XP "," Dipromal ". Kokuqendwa umthamo amafomu kungenzeka ngesimo acid noma sodium yayo usawoti, eyaziwa ngokuthi i-sodium valproate. Umsebenzi walo izidakamizwa is hhayi ziyancipha. Valproic acid, analogue zazo engenhla, ezithathwe ngomlomo ngokushesha ngemva kokudla. Yonke imithi eyiqukethe, esikuthola ngokushesha. Kakade emva 2 amahora acid livela plasma. Kuyinto kahle lingena ngokusebenzisa izicubu izithiyo. iminonjana asalayo ketshezi kunqunywa i-cerebrospinal fluid kanye nakwezinye imvelo eziningi zangaphakathi. Kutholwe yayo amniotic fluid (amniotic fluid) kubantu besifazane abakhulelwe.

Umgomo we operation

can kanjani izenzo valproic acid? Imiyalelo kule izidakamizwa akukuniki impendulo eqondile embuzweni wokuthi iyini indlela ithonya zayo zokwelapha. Lokhu kungenxa yokuthi ochwepheshe ungakabi ngokugcwele uhlole nethonya layo ushintsho izakhiwo sodium siteshi. Kulokhu, valproic acid likhona uhlu kwemithi ebalulekile futhi ebalulekile abantu.

Ithonya Lako womuntu

Akukhona nje esetshenziselwa isithuthwane valproic acid. ekusetshenzisweni lo mhlahlandlela imithi kubonisa ukuthi unakho ukusebenza anticonvulsant hhayi kuphela. Ithuthukisa isimo nesimo imibono engokwengqondo yomuntu. Ochwepheshe bathi mayelana nokuba khona acid ingxenye tranquilizing. Ngokungafani nezinye imikhiqizo yalolu hlobo, ke kwehlise neluvalo, ngaphandle kokudala mioleraksantnogo noma ukupholisa. Lokhu kungenxa wesenzo ku ulwelwesi postsynaptic. Ngakho ukuyiveza ezinzwa ngiyibona ukudluliswa izinqubo.

Ukuze izinhlobo ezincane isithuthwane ngokuvamile kungagcini ukuthatha valproic acid noma omunye analogs yayo. Ezimweni ezimbi kakhulu izidakamizwa is kuhlangene nezinye izidakamizwa antiepileptic.

Valproic isithuthwane acid

Lokhu ukulungiselela isetshenziswa izinhlobo ezihlukahlukene zokubusa ngesimiso isithuthwane. Ngakho reception yayo kusekelwe iphethini udokotela aqine. Valproic acid, yokusetshenziswa okhombisa ukusebenza kwayo izindlela ezihlukene zokubiza isifo, isetshenziswa kwezinye izimo ngemithamo ehlukene. Futhi, ngokuvamile enqunyiwe, futhi nokuquleka eqondile.

Ukusebenzisa izidakamizwa

Valproic acid, isiqondiso lapho ukuqokwa izidakamizwa kudinga nodokotela wakho futhi ukunamathela ngokuqinile izidakamizwa zemithi, isicelo ezimweni ezinjalo:

• zokuvimbela yezinkinga ezahlukene isithuthwane;

• izimo convulsive ayedabuka izifo athile CNS;

• khona tic kwemizwa;

• Ukugula ukwenama-bacindezeleke, akuyona amenable ukuba ngemithi equkethe lithium;

• Izimo okwenzeka kuzo convulsive ayedabuka ebuntwaneni.

Valproic acid ukwakhiwa eyiqukethe, kumele kuphela kulawulwa udokotela ukuba khona. Kwaze kwaba yilapho sebeshiye yonke ucwaningo oludingekayo kanye nesineke ukuhlola Uchwepheshe uzokwazi ukukhetha umthamo iphephile futhi isebenza ngempumelelo zomuthi.

ukukhululwa Ifomu

Valproic acid, ifomu ukukhululwa okuyinto ehlukile, abakhiqizi ezahlukene Agcwele kanje:

• Tablets, amaphilisi camera, oncibilikayo emathunjini. Ziqukethe 150, 200, 300, 500 mg valproic acid (sodium valproate).

• Amaphilisi Abonayo 150, 300 mg.

• Medicine (isiraphu) eliqukethe u-50 noma 300 ml izidakamizwa 1 ml.

Ukuhambelana nezinye izidakamizwa

Valproic acid uyakwazi ngcono umphumela nezinye anticonvulsants futhi izindlela protivoelepticheskih, neuroleptics, antipsychotics, antidepressant, kanye notshwala. Uma uthola lo imithi angeke ukuphuza utshwala. Valproic analogs acid zomuthi, salicylic acid kanye anticoagulants nomthelela inhibitory kwi ukulinganiswa (inhlangano) nama-platelet. Lapho injected emathunjini le nomuthi ngokushesha angena egazini. Ngakho ukusetshenziswa valproic acid lihambisana ukudla kancane kunciphisa ekulenzeni libe namandla.

side effects

Ngezinye izikhathi nomuthi kubangela imiphumela eminingi engemihle njengezindlela ezifana isicanucanu, ukuhlanza, ukungakuthandi ukudla, nobukhali ubuhlungu esiswini, uhudo. Ukuze siphendule le nemibandela ingasebenza esigubuzele noma antispasmodics. Valproic acid kungabangela ukucindezeleka jikelele kanye ukukhathala, ngakho-ke kuyaqabukela elibekelwe abantu behileleka besebenza kanzima ngokomzimba nangokwengqondo. Ukuthola izidakamizwa ngezinye izikhathi kuholela iziyaluyalu isimiso sezinzwa, okuyinto azibonakali ngesimo eliqhaqhazelayo kwamalungu omzimba, ngisho izithombe yokuhlukanisa futhi ukuphazamiseka visual, ukozela, ikhanda, isiyezi, ukuyaluza, ukunganakwa, futhi isimo sokucindezeleka.

Kwezinye izimo, edonsa le izidakamizwa kuholela nemiphumela ezilandelayo: ukwehla nokwenyuka isisindo somzimba, ukubukeka komzimba nezinto, zesikhashana nezinwele, ukuphazamiseka kokuya esikhathini, izinguquko hemogram. Ezingavamile kodwa kabi kakhulu imithi emizimbeni lokhu izindlela ethola ezibhekwa ukuba ungabe usasebenza kahle kwesibindi noma amanyikwe, ukunciphisa igazi ekunqandeni. umphumela Hepatotoxic kungenzeka kakhulu uma ethola lokhu izidakamizwa kanyekanye ne clonazepam, phenobarbital.

Lapho usebenzisa i-valproic acid Kumele kukhunjulwe ukuthi iziguli sikashukela ke kungahlanekezela umphumela ukuhlaziywa umchamo, okwandisa nokuqukethwe kwalo zemizimba ketone. Ngokuba nokuvimbela yezinkinga ezihlukahlukene ngesikhatsi ukwelashwa ukucacisa njalo okuqukethwe egazini bilirubin, enzyme isibindi, platelet count.

Izimo

Valproic acid, ezidayisa izidakamizwa ekhawunteni ngaphandle kadokotela, has Izimo sina. Lezi zihlanganisa:

• ukungasebenzi kwamanyikwe futhi isibindi;

• porphyria;

• oluhambisana diathesis;

• isici esiyingqayizivele;

• I senyanga yokuqala nokukhulelwa;

• isikhathi yokudla (isidakamizwa ludlulele ngaphakathi ubisi lwebele).

Ngo II no III senyanga yokukhulelwa, le izidakamizwa ezinqunyiwe ngemithamo ezincane futhi ngenxa yezizathu ezingathí sina kuphela, ngoba kweqa placenta futhi kungathinta umntwana ongakazalwa.

Lapho ethola valproic acid kufanele ukuqapha ngokucophelela isebenze ukulawula isibindi igazi ekunqandeni kanye platelet wokuhlanganisa. Phakathi ukwelashwa, lo muntu wesifazane izidakamizwa abaya ocansini, kumele kusetshenziswe ukuvimbela ukukhulelwa, indlela onokwethenjelwa kunayo yonke inzalo.

isicelo kohlelo

Amalungiselelo equkethe lokhu acid, zithathwa ngoba izikimu ezahlukene. Ukweqiwa kahle akhethiwe ngamunye. Kukhethwa umthamo lwemithi kuthinta lesiguli isimo, isisindo kanye nobudala. Ezimweni eziningi, ekuqaleni izifundo abadala nezingane enesisindo esingamakhilogremu angaphezu 25 kg, iqondiswa at 10-15 mg / kg ngosuku. Ngemva kwalokho umthamo masonto onke zomuthi luyanda 5-10 mg / kg, eyilethe esiphezulu - 30 mg / kg. I umthamo wansuku zonke izingane - 20-50 mg / kg. Ngo kwathatha ukwelashwa ukwelashwa valproic acid nezinye izidakamizwa anticonvulsant kuyehla kancane kancane. Umthamo esiphezulu valproic acid akufanele futhi iyophakama kuno-50 mg / kg ngosuku.

Kukhona ziyizinhlobo ezihlukene zezinhlanganisela ukukhululwa zomuthi. Ukuphatha i-intravenous kuhilela ukwamukela 400-800 mg sodium valproate ngosuku. Kuwo wonke yokwelapha kuyadingeka ukuze kutholakale izinga izidakamizwa egazini. Ngokusho cwaningo, kungase izinguquko ezenziwe eziyalezweni ukwelashwa.

Indlela laba scheme:

• Izingane ezineminyaka 3: Ngo ngesonto lokuqala isiphuzo 150 mg 1 k. ngosuku, okwesibili - 150 mg 2 k. ngelanga, kanti eyesithathu - ku 150 mg 3 k. ngosuku.

• Izingane 3 - 10 iminyaka e ngesonto lokuqala ukuthatha 450 mg, okwesibili - mg 600, kanti kowesithathu - 900 mg ngosuku. Ngokusho kwenye i-kokuthola wesifunda 300, 450, 600, 900 mg ngelanga, ngokulandelana, emasontweni 1, 2, 3 no-4.

• Ngemva kweminyaka engu-10: e ngesonto lokuqala isiphuzo 600 mg, okwesibili - 900, wesithathu - 1200 mg ngosuku. Ngokusho kwenye i-kokuthola wesifunda 300, 600, 900, 1200 mg ngelanga, ngokulandelana, emasontweni 1, 2, 3 no-4.

Ezigulini ngaphambilini baphathwe nezinye anticonvulsants, valproic acid iqondiswa ngemithamo emincane. Ngesikhathi esifanayo inani izindlela kuyehla. Umthamo yesondlo abadala - 900-1200 mg. Valproic Acid, amaphilisi kanye amaphilisi okuyinto ebekiwe iminyaka kuphela emva 10, ezithathwe 2-4 Ukweqiwa. Ezinganeni evamise ebekiwe imithi noma isiraphu nale izidakamizwa.

"Depakinum" (valproic acid)

On ukudayiswa kunezinhlobo ezahlukene izidakamizwa ne acid, kodwa omunye ethandwa kakhulu iyona "Depakine." Pharmacy, kukhona izinhlobo eziningana imithi: "Chrono", "300 Enterik", "Hrononosfera elimbudumbudu" nabanye. bangabaphingi bonke ukuhluka esebenzayo isithako okuqukethwe kanye nefomu. "Depakine" okunqunyiwe njengenhlangano anticonvulsant futhi izidakamizwa kwemizwelo-eliletha ukuthula. It is kahle elisungulwe ekwelapheni isifo sokuwa, iziyaluyalu okuguquguqukayo, generalized nokuquleka tonic-clonic, myoclonus, ukucindezeleka, wayehlushwa ikhanda. Iphinde isetshenziselwe ekwelapheni ubuhlungu neuropathic. Muva nje, izidakamizwa uphenyo njengoba izidakamizwa ngokumelene izinhlobo ezithile umdlavuza futhi ukutheleleka nge-HIV.

Valproic edepho acid

Phakathi valproic acid izidakamizwa "Depakine" futhi analogue yayo zihamba phambili. Lokhu kungenxa yokuthi kunomphumela isikhathi eside. Ukusetshenziswa kwalesi ukulungiselela kuholela ukuncipha ukuvama okuvela nokuquleka convulsive. futhi kunciphisa ngobubi bawo futhi kusiza ukugeleza. "Depakine" kunciphisa ingozi yokuba nezinkinga ezinkulu nakakhulu.

Izinqubo metabolization valproic acid eyenziwa amangqamuzana isibindi. Lapho ethola izinto wesiko isigamu-ukuphila cishe 6-8 amahora. izidakamizwa Modern singalondoloza lokuhlushwa zokwelapha ngempahla asebenzayo emzimbeni amahora angu-16. Izinga excretion of valproic acid kuncike kakhulu kokusebenza kwesibindi. Valproic acid, libuyekeza mayelana nomphumela omuhle okwengeziwe esigulini ngasinye ngamandla akhe. Lokhu kungenxa yokuthi njalo umzimba uhlukile futhi ingathatha lento nabanye ngeziphambeko kusukela kuyinsakavukela.