Ọgwụ ọgwụ carbamazepine: ntuziaka maka ojiji

Carbamazepine: ntuziaka maka ojiji na nyocha

Aha Latin: Carbamazepine

Koodu ATX: N03AF01

Ngwakọta ọrụ: carbamazepine (carbamazepine)

Onye na-emeputa ihe: LLC Rosfarm (Russia), CJSC ALSI Pharma (Russia), OJSC Synthesis (Russia)

Na-emelite nkọwa na foto: 07/27/2018

Ahịa dị n'ụlọ ahịa ọgwụ: site na 58 rubles.

Carbamazepine bụ ọgwụ nwere mmetụta psychotropic, mmetụta antiepileptik.

Mwepụta wepụtara ya na ihe mejupụtara

A na-emepụta carbamazepine n'ụdị mbadamba (10, 15, PC 25) N'ime ngwugwu na-acha uhie uhie, 1-5 na-eme igbe kaadi, igbe 20, 30. Na ngwugwu bliri, 1, 2, 5, 10 na ngwungwu. mkpọ, 20, 30, 40, 50, 100 PC. n'ime ike, 1 nwere ike na kaadiboodu).

Ngwakọta nke mbadamba 1 gụnyere:

Ihe na-arụ ọrụ: carbamazepine - 200 mg,
Ihe ntinye aka: talc - 3.1 mg, povidone K30 - 14.4 mg, colloidal silicon dioxide (aerosil) - 0.96 mg, polysorbate 80 - 1.6 mg, stachi nduku - 96.64 mg, magnesium stearate - 3 , 1 mg.

Mlọ ọgwụ

Carbamazepine bụ ọgwụ dibenzoazepine, bụ nke e ji mara antiepileptik, neurotropic na mmetụta psychotropic.

N’oge ugbu a, a na-amụ usoro nke ihe eji arụ ọrụ a. Ọ na-egbochi mgbasa nke synaptik nke ọsụsọ na-akpali akpali, na-egbochi ịmịnye ọbara nke neurons, ma na-ewetara akpụkpọ ahụ nke neurons nke na-emetụta oke. Ikekwe, ihe bụ isi sistem nke carbamazepine bụ igbochi nguzobe ikike sodium na-enwe ike n'ahụ akwara dị n'ihi mgbochi “ihe” - mgbochi na sistemụ sodium.

Mgbe ị na-eji ọgwụ ahụ eme ihe dị ka monotherapy na ndị ọrịa nwere ọrịa akwụkwụ (ọkachasị, ụmụaka na ndị nọ n'afọ iri na ụma), a hụrụ mmetụta psychotropic, gosipụtara na mkpocha nke mgbaàmà nke ụjọ na ịda mba, yana mbelata nke oke iwe na oke iwe. Enweghị ozi na-enweghị mgbagha na mmetụta nke carbamazepine na cognitive na ọrụ psychomotor: n'ọmụmụ ihe ụfọdụ, ekpughere mmetụta abụọ ma ọ bụ nke ọjọọ na-adabere na ya, ọmụmụ ndị ọzọ gosipụtara mmetụta dị mma nke ọgwụ ahụ na ebe nchekwa na nlebara anya.

Dị ka onye nnọchianya neurotropic, carbamazepine dị irè na ụfọdụ ọrịa akwara ozi. Dịka ọmụmaatụ, ya na nke abụọ na idiopathic trigeminal neuralgia, ọ na-egbochi ịmalite mbibi mgbu mgbu paroxysmal.

N'ime ndị ọrịa nwere nsogbu ị alcoholụ mmanya, carbamazepine na-ewelite ọnụ ụzọ ịdị njikere, nke na nke a na-ebelata n'ọtụtụ oge, ma na-ebelata ogo ngosipụta nke ọrịa ahụ (nke a gụnyere oke ọgba aghara, ịma jijiji, iwe iwe).

N'ime ndị ọrịa nwere ọrịa insipidus nke ọrịa shuga, carbamazepine na-ebelata diureis ma kpochapụ akpịrị ịkpọ nkụ.

Dịka onye nnọchi anya psychotropic, enyere ọgwụ ahụ maka nsogbu ndị metụtara nsogbu, gụnyere ịgwọ ọrịa manic ọnọdụ, maka nkwado na-enye nsogbu nke ihe imetụ ụbụrụ (manic-depress) (a na-eji carbamazepine dịka monotherapy na n'otu oge na lithium, antidepressant ma ọ bụ ọgwụ antipsychotic), ebe manic ntụpọ obi mgbawa, ya na ngwangwa ọsọ, ya na ịwakpo manic, mgbe ejiri carbamazepine tinye ya na ọgwụ mgbochi, yana yana ọgụ nke ọrịa schizoaffective psychosis. Enwere ike ịkọwa ike nke ọgwụ iji wepụ ihe ngosipụta nwoke site na mgbochi nke mgbanwe norepinephrine na dopamine.

Mlọ ọgwụ

Site na nchịkwa ọnụ, a na-abanye carbamazepine na ngọngọ diges. Theakingụ ọgwụ ahụ n'ụdị mbadamba ụdọ na-esonye na nnabata nwayọ. Mgbe otu carbamazepine dị otu mbadamba ọgwụ, na nkezi, a na-ekpebi oke ya ka elekere 12 gachara. Mgbe otu ọgwụ inụrịrị na ọgwụ ọgwụ ruru 400 mg, ọnụego uru nke mkpokọta carbamazepine kachasị agbanwebeghị bụ ihe dịka 4.5 μg / ml.

Mgbe ị na-a carụ carbamazepine n'otu oge, nri, ogo na ọnụego nnabata nke ọgwụ na-agbanwe agbanwe. A na-emeta nhazi nke ihe dị na plasma n'ime izu 1-2. Oge ihe ọ rụpụtara bụ nke onwe ya wee kpebie ya site na ogo onwe ya na-ebute sistem enzyme nke imeju site na carbamazepine, ọnọdụ onye ọrịa tupu mmalite nke ọgwụgwọ ahụ, ọnụọgụ ọgwụ ahụ, oge ọgwụ, yana hetero-induction nke ọgwụ ndị ọzọ ejiri jikọtara ya na carbamazepine. E nwere ọdịiche dịrịta iche nke abụọ n'ime ụkpụrụ nke ịha nhatanha n'ọtụtụ usoro ọgwụgwọ: n'ọtụtụ ndị ọrịa, ndị gosipụtara ihe a sitere na 4 ruo 12 μg / ml (17-50 μmol / l).

Carbamazepine na-agafe ihe mgbochi placental. Ebe ọ bụ na ọ na-agbachasị agbachapụ agbachapụ, ụda nkesa dị ka ọ dị 0.8-1.9 l / n'arọ.

A na-eme metabolism nke carbamazepine na imeju. Mostzọ kachasị mkpa nke biotransformation nke ihe ahụ bụ ịba ụba site na nguzobe nke metabolites, ihe bụ isi n'etiti ya bụ usoro nke 10.11-transdiol na ngwaahịa nke conjugation ya na glucuronic acid. Carbamazepine-10,11-epoxide n'ime ahụ mmadụ na-abanye na carbamazepine-10,11-transdiol na ntinye nke microsomal enzyme epoxyhydrolase. Ntinye uche nke carbamazepine-10,11-epoxide, nke bụ metabolite na-arụ ọrụ, bụ ihe dịka 30% nke ọdịnaya nke carbamazepine na plasma ọbara. A na - ahụta ihe dị na isoenzyme maka ntụgharị nke carbamazepine na carbamazepine-10,11-epoxide bụ cytochrome P4503A4. N'ihi usoro metabolic, etolitekwara obere metabolite ọzọ - 9-hydroxymethyl-10-carbamoylacridane.

Importantzọ ọzọ dị mkpa maka metabolism carbamazepine bụ usoro nke usoro dị iche iche nke monohydroxylated, yana N-glucuronides si eji UGT2B7 isoenzyme.

Ọkara ndụ nke ihe na-arụ ọrụ n'ụdị agbanweghị agbanwe mgbe otu nchịkwa ọnụ nke ọgwụ ahụ dị na awa 36, yana mgbe ọ repeatedụ ọgwụ ahụ ugboro ugboro - ihe dịka awa 16-24, dabere na oge ọgwụgwọ (nke a bụ n'ihi autoinduction nke usoro monooxygenase imeju). E gosiputara na ndi oria na ijiko carbamazepine na ogwu ndi ozo na eme ka enzymes imeju (dika ọmụmaatụ, phenobarbital, phenytoin), ọkara ndụ ọgwụ a n'ofe anaghị agafe elekere 9-10.

Site na nchịkwa ọnụ nke carbamazepine-10,11-epoxide, nkezi ọkara ndụ ya bụ ihe dị ka awa 6.

Mgbe otu mkpụrụ ọgwụ carbamazepine na-ejikwa otu ọgwụ mee ihe n'ụzọ 400 mg, 72% nke ihe ahụ na-apụta site na akụrụ yana 28% site na eriri afọ. Ihe dị ka pacenti abụọ nke ọgwụ aere dị na mmamịrị ahụ, na-anọchite anya carbamazepine na-agbanweghi agbanwe, na ihe dịka 1% n'ụdị nke 10.11-epoxy metabolite na-egosipụta ọrụ metabolic. Mgbe otu mkpụrụedịrị ọnụ gasịrị, 30% nke carbamazepine na-apụ apụ site na akụrụ dịka ngwaahịa njedebe nke usoro mmanụ.

Havemụaka nwere mkpochasị ngwa ngwa nke carbamazepine, yabụ, mgbe ụfọdụ, ọ dị mkpa ịkọ ọgwụ kachasị elu nke ọgwụ ahụ, nke a na-agbakọ dabere na oke ahụ nwata ahụ, ma e jiri ya tụnyere ndị ọrịa okenye.

Ihe omuma banyere mgbanwe na pharmacokinetics nke carbamazepine na ndi ọrịa agadi ma e jiri ya tụnyere ndi oria ndi okenye.

Oru akwukwo nke ulo ogwu nke carbamazepine na ndi oria akwara na hepatic no rue akwukwo.

Ihe ngosi maka ojiji

Akwụkwụ na-adọ (ma e wezụga ihe ọdịdọ ma ọ bụ myoclonic, ọnụnọ) - ụdị ọdịdọ na nke jikọtara ya na ọnya ụbụrụ na-akpata ọnya na-adịghị ala ala na mgbaàmà dị mfe ma sie ike, ọdịdọ dị iche iche (monotherapy ma ọ bụ yana ọgwụ ndị ọzọ na usoro anticonvulsant.),
Polyuria na polydipsia nwere insipidus ọrịa shuga, ọrịa mgbu na polyneuropathy na-arịa ọrịa mamịrị, trigeminal neuralgia nwere otutu sclerosis, idiopathic trigeminal neuralgia, syndrome ịkwụsịtụ mmanya, ọrịa idiopathic glossopharyngeal neuralgia, nsogbu na-emetụta,
Nsogbu ndị na-emetụta oge a, gụnyere nsogbu schizoaffective, psychosis depicent psychosis, wdg. (mgbochi).

Ihe ngbanwe

Ihe mgbochi nke ọnụnọ
Imebi ụmị ọkpụkpụ,
Nnukwu ọnụnọ porphyria (gụnyere akụkọ ihe mere eme)
Ojiji jiri monoamine oxidase inhibitors mee ya na o bu ubochi iri na ano mgbe hapuruchara ya,
Ime na lactation
Ọgwụ na ọgwụ ndị mejupụtara ọgwụ ahụ, yana ọgwụ ọgwụ ndị yiri ọgwụ na-arụ ọrụ (tricyclic antidepressants).

Dịka ntuziaka ahụ si dị, a ga-eji carbamazepine kpachara anya n'otu oge ahụ ị takingụ mmanya, ndị ọrịa agadi, yana ndị ọrịa nwere nnukwu nkụchi obi, dilution hyponatremia, ịba ụba intraocular pressure, inhibition nke ụmị ọkpụkpụ ahụ n'oge ị na-a medicationụ ọgwụ (akụkọ ihe mere eme), hyperplasia prostatic, imeju imeju. ụkwara akwara na-adịghị ala ala.

Nsonaazụ

N'oge a na-eji carbamazepine, mmetụta ndị ọzọ na-esote nwere ike ịmalite:

Sistemụ akwara nke etiti: ataxia, dizzness, adịghị ike nke izugbe, ụra, ihe mgbakasị ahụ oculomotor, isi ọwụwa, nystagmus, paresis ebe obibi, tics, tremors, orofacial dyskinesia, choreoathetoid, loiisialia, dysarthria, paresthesia, paresis, muscle muscle,
Usoro obi: mbelata ma ọ bụ mmụba nke ọbara mgbali, nsogbu obi, ọgba aghara, bradycardia, arrhythmias, ngọngọ nke akwara na nkụda mmụọ, mmepe ma ọ bụ na-akawanye njọ nke mkpọchi obi, iwe ọkụ nke ọrịa obi obi (yana mmụba ma ọ bụ ihe omume ọgụ nke angina), thrombotic thrombosis. ,
Usoro nri: akpọnwụ akpọnwụ, ọgbụgbọ, ọgbụgbọ, afọ ntachi ma ọ bụ afọ ọsịsa, ọnya afọ, stomatitis, glossitis, pancreatitis,
Usoro genitourinary: ọdịda akụrụ, ọgbụgbọ nephritis, arụ ọrụ gbasara akụrụ (hematuria, albuminuria, oliguria, azotemia / urea), njide nke urinary, mmụba nke urination, enweghi ike / dysfunction mmekọahụ,
Usoro endocrine na metabolism: hyponatremia, uru dị arọ, edema, mmụba nke prolactin larịị (ikekwe n'otu oge na mmepe nke galactorrhea na gynecomastia), mbelata nke ọkwa L-thyroxine (T4, TK n'efu) yana mmụba nke ọkwa homonụ na-akpali akpali (ọ na-enweghị ezigbo ngosipụta nke ụlọ ọgwụ. soro), osteomalacia, nsogbu nke calcium-phosphorus metabolism na anụ ahụ (na-agbadata ntinye nke 25-OH-cholecalciferol na ionized n'ụdị calcium na plasma ọbara), hypertriglyceridemia, hypercholesterolemia,
Usoro akwara: arthralgia, cramps, myalgia,
Imeju: ịba ụba nke ntụgharị nke gamma-glutamyl (dịka iwu, ọ nweghị uru ọria), mmụba nke alkaline phosphatase na “imeju” transaminases, ịba ọcha n'anya (granulomatous, agwakọta, cholestatic ma ọ bụ parenchymal (hepatocellular) ụdị), mmebi imeju,
Akụkụ Hemopoietic: thrombocytopenia, leukopenia, leukocytosis, eosinophilia, lymphadenopathy, aplastic anemia, nnukwu ọrịa na-efe efe, agranulocytosis, megaloblastic anemia, real erythrocytic aplasia, hemolytic anemia, hemolytic anemia, hemolytic anemia, reticulocytosis
Akụkụ anụ ahụ: mgbanwe dị na nghọta nke olulu, igwe ojii nke oghere, ọgba aghara na uto, conjunctivitis, hypo- ma ọ bụ hyperacusia,
Mpaghara uche: nchekasị, ihe ijuanya, enweghị agụụ, ịda mba, agwa ime ihe ike, mgbakasị ahụ, oke iwe, ịgbalite mmụọ,
Mmeghachi omume nfụkasị ahụ: lupus-like syndrome, exfoliative dermatitis, urticaria, Stevens-Johnson syndrome, erythroderma, necrolysis na-egbu egbu, fotoensitivity, nodular na erythema multiforme. Ọrịa hypesensitivity na-egbu oge na vasculitis, ahụ ọkụ, lymphadenopathy, akpịrị anụ ahụ, eosinophilia, ọrịa metụtara lymphoma, leukopenia, arthralgia, ọrụ imeju gbanwere na ọrịa ịba ọcha n'anya (ngosipụta ndị a nwere ike ime na njikọta dị iche iche). Akụkụ ahụ ndị ọzọ, dị ka akụrụ, ngụgụ, myocardium, pancreas, na eriri afọ, nwekwara ike itinye aka. Ọ na-esikarị ike - mgbochi mkpọnwụ na myoclonus, angioedema, mmeghachi omume anaphylactic, mmeghachi omume umeji ngụgụ, nke eji ume iku ume, ahụ ọkụ, pneumonitis ma ọ bụ oyi baa,
Ihe ozo: purpura, nsogbu akpukpo aru, sweating, acne, alopecia.

Dodoụbiga ya ókè

Site na mmịnye nke carbamazepine, a na-ahụkarị mgbaàmà ndị a:

si usoro obi: ọbara mgbali elu ma ọ bụ nke dị ala, tachycardia, nsogbu nke usoro mgbatị ahụ, tinyere mgbasa nke usoro QRS, njide obi na nkụda mmụọ, site na njide obi.
site n'akụkụ nke sistemụ akwara: mydriasis, nkwarụ, nkụda mmụọ nke sistemụ etiti, hypothermia, disorientation na oghere, hallucinations, oke iwe, ụra, mmụọ adịghịzi, coma, myoclonus, dysarthria, slurred, ataxia, blurred hanger, nystagmus, hyperreflexia (at the first stage) na hyporeflexia (nke dị n'okpuru ebe a), steeti psychomotor, dyskinesia, ọdịdọ,
site na eriri afọ: mbelata nke mwepu nri si na afọ, vomiting, oke nke eriri afọ,
site na sistem iku ume: ndakpọ nke etiti akụkụ okuku ume na akụkụ akpa ume,
sitere na sistemụ urinary: mmịnye mmiri (hypoatremia dilution) metụtara ya na carbamazepine, nke a na-eme na homonụ antidiuretic, njigide mmiri, njigide urinary, anuria ma ọ bụ oliguria,
mgbanwe na plọg Laboratory: mmepe nke hyperglycemia ma ọ bụ metabolic acidosis, ọrụ na-abawanye ụba nke akwara uru nke creatine phosphokinase ga-ekwe omume.

Amabeghị ọgwụ mgbochi carbamazepine. Usoro ọgwụgwọ ịdoụbiga ọgwụ ike ókè kwesịrị ịdabere na ọnọdụ ụlọ ọgwụ onye ọrịa, a na-atụ aro ka etinye ya n'ụlọ ọgwụ.

Plasma carbamazepine ịta kwesịrị ikpebisi ike ikwenye nsi ọgwụ yana inyocha ogo ị ofụbiga mmanya ókè.

Ọ dị mkpa ịsacha afọ ma wepụpụ ihe dị n’ime ya, werekwa unyi na-arụ ọrụ. Evacuchụpụ ihe ndị dị n'ime afọ na-atụnye ụtụ n'inwe oge na-egbu oge, nke nwere ike ibute mmepe nke mgbaàmà nke egbu egbu n'oge oge mgbake. Usoro ọgwụgwọ Symptomatic, nke a na-arụ na ngalaba nlekọta ahụike ma sorokwa na-enyocha ọrụ ọfụma na ijizi nlezianya nke ọgba aghara na nguzo mmiri-electrolyte, na-enyekwa ezigbo nsonaazụ.

N'iburu ọnya ọgbụgba akwara ozi, a na-egosipụta njikwa ọgwụgwọ dobutamine ma ọ bụ dopamine. Site na mmepe nke arrhythmia, a na-ahọrọ ọgwụgwọ n'otu n'otu.N'ihe banyere ihe ọdịdọ ahụ, a na-atụ aro ka ọ na-achịkwa benzodiazepines, dịka ọmụmaatụ, diazepam ma ọ bụ ọgwụ anticonvulsants ndị ọzọ dị ka paraldehyde ma ọ bụ phenobarbital (a na-eji nke ikpeazụ akpachara anya n'ihi oke ịba ụba nke iku ume).

Ọ bụrụ na onye ọrịa azụlitela mmịpụta mmiri (hyponatremia), nchịkwa mmiri kwesịrị ịnwe mmachi yana ekwesịrị iji nlezianya jikwaa 0.9% sodium chloride ngwọta intravenly, nke n'ọtụtụ ọnọdụ na-egbochi mmepe nke ụbụrụ. Hemosorption na sọlfọ na-enye nsonaazụ dị mma. A na-ahụta akwara Peritoneal, hemodialysis, na diuresis a na-amanye arụpụtaghị nke ọma na-ewepụ carbamazepine n'ahụ. N'ụbọchị nke abụọ na nke atọ mgbe ọdịdị nke ihe ọ signsụseụbiga mmanya ókè gasịrị, mgbaàmà ya nwere ike ịka njọ, nke a kọwara site na nkwụsịtụ ọgwụ ahụ.

Ntụziaka pụrụ iche

Tupu ịmalite iji Carbamazepine, ịkwesịrị ịme nyocha: nyocha niile gbasara mmamịrị na ọbara (gụnyere ịgụta nke reticulocytes, platelet), mkpebi nke ọkwa iron, ịta ụrọ na electrolytes n'ọbara ọbara. N’ọdịnihu, a ga-enyocha akara ndị a kwa izu n’oge ọnwa mbụ a gwọchara ya, na mgbe ahụ - otu ugboro n’ọnwa.

Mgbe ị na-edepụta ndị ọrịa nwere nrụgide intraocular na-ede carbamazepine, ọ dị mkpa ịchịkwa ya kwa oge.

A ga-akwụsị usoro ọgwụgwọ ahụ ma ọ bụrụ na ọ ga-aga n'ihu leukopenia ma ọ bụ leukopenia, nke na-esochi akara ngosipụta nke ọrịa na-efe efe (enweghị asymptomatic leukopenia anaghị achọ ịkwụsị carbamazepine).

N'oge usoro ọgwụgwọ, a ga-akpachara anya mgbe ị na-anya ụgbọ ala ma na-arụ ụdị ọrụ ndị ọzọ dị ize ndụ nke chọrọ ntinye uche ka ukwuu na mmeghachi omume psychomotor ngwa ngwa.

Ime na lactation

Ekwuputara na umuaka ndi amuru site na oria oria n’akparita aru nwere ohere di elu nke nsogbu oria intrauterine, tinyere nmeghari etolite. Enwere ihe akaebe na carbamazepine nwere ike ịkwalite atụmanya a, ọ bụ ezie na ugbu a enweghị nkwenye ikpeazụ nke eziokwu a nke a gaara enweta na nnwale ụlọ ọgwụ a na-achịkwa na ọgwụ ọgwụ dị ka monotherapy.

Enwere akụkọ banyere ikpe nke ọrịa afọ, mmebi, gụnyere spina bifida (enweghị mmechi nke vertebral arches), yana ọrịa ọgbụgba, dịka hypospadias, ntụpọ na mmepe nke sisitemu obi na sistem akụkụ ahụ ndị ọzọ, yana ihe arụ nke craniofacial.

Ọ dị mkpa iji carbamazepine jiri nlezianya na ụmụ nwanyị dị ime na-arịa ọrịa. Ọ bụrụ na nwanyị na-a theụ ọgwụ ahụ tụụrụ ime ma ọ bụ na-eme atụmatụ ime, ọ bụrụ na ọ dị mkpa iji carbamazepine n'oge afọ ime, a na-atụ aro ka ị jiri nlezianya tụọ uru atụmanya a na-enweta maka ọgwụgwọ maka nne na ihe ọghọm nke nsogbu nwere ike ịdapụta, ọkachasị n’oge ọnwa atọ mbụ nke ịtụrụ ime.

Site n'ịgwọ arụmọrụ zuru ezu, a ga-enyerịrị ndị ọrịa afọ ọmụmụ ka carbamazepine dị ka nanị monotherapy, ebe ọ bụ na ugboro ugboro nke ajọ ọrịa nwa ebu n'afọ na-emekọ ihe ọnụ ka ọ na - ejikọ ya na monotherapy.

Ọ dị mkpa ka ịde ọgwụ ahụ na ntakịrị opekempe. Ikwesiri ileba anya na ihe dị n'ime akụrụngwa nọ n'ọrụ.

Ndi oria kwesiri ima ihe obula banyere akuko ojoo. Ọ bụkwa ihe dị mma maka ha n’ịchọpụta ọrịa afọ.

N'oge afọ ime, nkwụsị nke ọgwụ antiepileptik dị irè, ebe ọ bụ na ọrịa nwere ike inwe mmetụta na-adịghị mma n'ahụ nne na nwa ebu n'afọ.

Enwere ihe akaebe na carbamazepine na-akwalite ụkọ folic acid nke na-amalite n’oge ime. Nke a nwere ike inye aka mee ka mmerụ ahụ dị ịmụ nwa na ụmụaka ndị amụrụ ụmụ nwanyị na-a thisụ ọgwụ a. Ya mere, tupu oge ime, mgbe ọ dị ime, ọ ga-adị mma ka ị were ọgwụ ndị ọzọ folic acid.

Dịka ihe mgbochi iji gbochie mmụba ọbara ọgbụgba n'ime ụmụ amụrụ ọhụrụ, a ga-enye ụmụ nwanyị izu ikpeazụ izu ime yana ụmụ amụrụ ọhụrụ Vitamin K.₁.

Otutu ikpe ndi dara ada nke akụkụ okuku ume na / ma obu ihe ọdịdọ n’ime ụmụ amụrụ ọhụrụ ndị nne akọwaworo carbamazepine na ọgwụ anticonvulsants ndị ọzọ. A na-ahụta ikpe nke afọ ọsịsa, vom na / ma ọ bụ belata agụụ n'ime ụmụ amụrụ ọhụrụ ndị nne ya na-ebu carbamazepine mgbe ụfọdụ. A na-eche na mmeghachi omume ndị a bụ ngosipụta nke ọrịa mbupu ọrịa na ụmụ amụrụ ọhụrụ.

A na-ekpebi Carbamazepine na mmiri ara, ọ nwere ọkwa ya bụ 25-60% nke ogo ihe ahụ na plasma ọbara. Ya mere, a na-atụ aro ka atụlee uru na nsonaazụ na-adịghị mma nke ị ofụ nwa n’oge ọgwụgwọ ogologo oge yana ọgwụ. Mgbe ha na-a carụ carbamazepine, ndị nne nwere ike inye ụmụ ha ara, mana naanị ma ọ bụrụ na a na-enyocha ya mgbe niile maka nsonaazụ (dịka ọmụmaatụ, mmeghachi ahụ nfụkasị anụ ahụ na oke ụra).

Mkparịta ụka ọgwụ ọjọọ

Site n'iji nke carbamazepine na-aultụkwa ọgwụ ụfọdụ, mmetụta ndị na-adịghị mma nwere ike ime:

Ihe ndị na-egbochi CYP3A4: ịmụba ọnụ ọgụgụ plasma nke carbamazepine,
Dextropropoxyphene, verapamil, felodipine, diltiazem, viloxazine, fluoxetine, fluvoxamine, desipramine, cimetidine, danazole, acetazolamide, nicotinamide (naanị na ọnụ ọgụgụ dị elu nke ndị okenye), macrolides (josamycin, cryriromoszozozozozozozo, lrytiozozozozozoozoa, orythromycinzozozozozozoa, ), loratadine, terfenadine, isoniazid, ihe ọpeụpeụ mkpụrụ osisi, propoxyphene, ndị na-egbochi nje HIV nke a na-eji agwọ ọrịa HIV: ịba ụba plasma ịta nke carbamazepine,
Pelbamate, fensuximide, phenobarbital, primidone, phenytoin, metsuximide, theophylline, cisplatin, rifampicin, doxorubicin, ikekwe: valpromide, clonazepam, valproic acid, oxcarbazepine na nkwadebe ya na hypericum hyperfin,
Acidproproic na primidone: mwepu nke carbamazepine site na protin plasma na mmụba nke mkpokọta ọgwụ na-arụ ọrụ (carbamazepine-10,11-epoxide),
Isotretinoin: mgbanwe na bioavailability na / ma ọ bụ nhichapụ nke carbamazepine na carbamazepine-10,11-epoxide (ọ dị mkpa itinye nlebara anya plasma).
Clobazam, clonazepam, primidone, ethosuximide, alprazolam, valproic acid, glucocorticosteroids (prednisone, dexamethasone), haloperidol, cyclosporine, doxycycline, methadone, ọgwụ ndị nwere progesterone na / ma ọ bụ ọgwụgwọ estrogen ahụ, ụzọ mgbochi ya dị mkpa fenprocoumone, warfarin, dicumarol), topiramate, lamotrigine, tricyclic antidepressants (imipramine, northriptyline, amitriptyline, clomipramine), felbamate, clozapine, tiagabin, protease inhibitors, nke a na-eji ya na ọgwụgwọ nke nje HIV (ritonavir, indinavir, saquinavir), oxcarbazepine, itraconazole, ndị na-egbochi calcium (otu dihydropyridones, ọmụmaatụ, felodipine), midazolam, levothyroxine, praziquantel, olazapine, risperidonema, itinye uche, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya, nlebara anya nke ha, nlebara anya nke ha anya mbelata ma ọ bụ ọbụna na-enwe mmetụta zuru ezu nke mmetụta ha, mgbazi nke usoro ọgwụgwọ etinyere nwere ike ịchọrọ),
Phenytoin: bawanye ma ọ bụ ibelata na ọkwa plasma ya,
Mefenitoin: mmụba (n'ọnọdụ ndị dị ụkọ) nke ọkwa ya na plasma ọbara,
Paracetamol: mmụba n'ihe ọghọm nke nsonaazụ ya yana nsị na mbelata arụmọrụ ọgwụgwọ (na-eme ka metabolism nke paracetamol kwụsị).
Phenothiazine, pimozide, thioxanthenes, molindone, haloperidol, maprotiline, clozapine na tricyclic antidepressants: na-abawanye mmetụta inhibitory na sistemụ akwara na-ebelata ike mmetụta anticonvulsant nke carbamazepine,
Diuretics (furosemide, hydrochlorothiazide): mmepe tinyere ihe ngosipụta nke ọrịa hyponatremia,
Ndị na - anaghị eme ka akwara dị jụụ (pancuronium): mbelata mmetụta ha,
Etaniol: mbelata na ntachi obi ya,
Anticoagulants na-apụtaghị ìhè, mgbochi nke homonụ, folic acid: mee ngwangwa metabolism,
Ntughari maka ogwu ogbugba izugbe (enflurane, halotane, fluorotan): meziputara metabolism na nsogbu puru iche nke oria ojoo,
Methoxiflurane: ịba ụba nke nephrotoxic metabolites,
Isoniazid: ịba ụba hepatotoxicity.

Carbamazepine analogues gụnyere: Finlepsin, Finlepsin retard, Tegretol, Tegretol TsR, Zeptol, Karbaleks, Karbapin, Mezakar, Timonil.

Ngwongwo ogwu

Mlọ ọgwụ
Ọgwụ antiepileptik, usoro ọgwụ nke dibiazepine. Na antiepileptik, ọgwụ ahụ nwekwara mmetụta neurotropic na psychotropic.

Ka achoputara uzo nke carbamazepine di ugbua. Carbamazepine na - akwagide akpụkpọ ahụ nke neurons nke na - emebiga ihe ókè, na - ebelata ọbara nke neurons, ma na - ebelata mbufe synaptik nke na - akpali akpali ọsụsọ. Eleghị anya, usoro bụ isi nke carbamazepine bụ igbochi ike ị nweta ike sodium nwere ike naịala akwara n'ihi mgbochi nke ọwa mmiri sodium nke ghere oghe.

Mgbe ejiri ya dị ka monotherapy na ndị ọrịa nwere ọrịa akwụkwụ (ọkachasị na ụmụaka na ndị nọ n’afọ iri na ụma), a chọpụtara mmetụta psychotropic nke ọgwụ ahụ, nke gụnyere nsonaazụ ọma na mgbaàmà nke ụjọ na ịda mba, yana mbelata nke oke iwe na oke iwe. Enweghị data doro anya banyere mmetụta ọgwụ a nwere na ọgụgụ isi na ọrụ psychomotor: n'ọmụmụ ihe ụfọdụ, gosipụtara mmetụta abụọ ma ọ bụ nke na-adịghị mma, nke dabere na oke ọgwụ ahụ; n'ọmụmụ ihe ndị ọzọ, gosipụtara mmetụta dị mma nke ọgwụ ahụ na nlebara anya na ebe nchekwa.

Dị ka onye nnọchianya neurotropic, ọgwụ dị irè n'ọtụtụ ọrịa ọrịa akwara ozi. Ya mere, dịka ọmụmaatụ, ya na idiopathic na Second trigeminal neuralgia, ọ na-egbochi ọdịdị nke mgbu mgbu paroxysmal.

N'ihe banyere nkwụghachi mmanya na-egbu egbu, ọgwụ a na-eme ka ọnụ ụzọ ịdị njikere, nke n'ọnọdụ a na-ebelata, ma na-ebelata ogo ngosipụta nke ọrịa ahụ, dịka mgbakasị ụba, ụjọ, na ọgba aghara.

N'ime ndị ọrịa nwere insipidus ọrịa shuga, ọgwụ ahụ na-ebelata diureis na akpịrị ịkpọ nkụ. Dị ka onye nnọchianya psychotropic, ọgwụ ahụ dị irè na nsogbu ndị metụtara nsogbu, ya bụ, n'ịgwọ ọnọdụ manic, yana nkwado nkwado nke ihe imerụ ahụ na - emetụta mmụọ (ya bụ monotherapy yana yana antipsychotics, antidepressants ma ọ bụ ọgwụ lithium), mwakpo nke schizoaffective psychosis, yana mwakpo manic, ebe ejiri ya na antipsychotics, yana manic-depress psychosis na ngwa ngwa.

Ike nke ọgwụ iji wepụ ihe ngosipụta manic nwere ike ịbụ n'ihi mgbochi nke mgbanwe nke dopamine na norepinephrine.

Mlọ ọgwụ
Orkpachara anya
Mgbe nchịkwa ọnụ gachara, a na-amịkọrọ carbamazepine ihe fọrọ nke nta ka ọ bụrụ, ịmịcha ahụ na-ewere nwayọ nwayọ (nri oriri anaghị emetụta ọnụego na nzere). Mgbe otu ugboro gasịrị, ntinye uche kachasị (C_max ruru mgbe awa iri na abụọ gachara. Mgbe otu nchịkwa ọnụ nke 400 mg nke carbamazepine, ọnụ ahịa nkezi nke C_maxbụ ihe dịka 4.5 μg / ml. A na-enweta ịta ahụhụ nke ọgwụ na plasma mgbe izu 1-2 gachara. Oge nke ihe omuma ya bu nke mmadu ma dabere na ogo nke induction nke sistem enzyme nke imeju site na carbamazepine, usoro intereti site na ogwu ndi ozo ejiri mee n’otu oge, ya na onodu onye oria tupu oge ogwugwu, udiri ogwu ahu na oge ọgwụgwọ. A na-ahụta ọdịiche dị iche iche nke mmadụ na ogo ịta ahụhụ na usoro ọgwụgwọ: n'ọtụtụ ndị ọrịa, ụkpụrụ ndị a sitere na 4 ruo 12 μg / ml (17-50 μmol / l).

Nkesa.
Dabere na protein plasma na ụmụaka - 55-59%, na ndị okenye - 70-80%. Na mmiri cerebrospinal (nke a na-akpọ CSF) na mmiri, ana-etinye ihe n'usoro dabere na oke nke ihe na-arụ ọrụ adịghị na protein (20-30%). Penetrates site na ihe mgbochi placental. Ntinye uche na mmiri ara ara bu 25-60% nke ahụ na plasma. N'inye nnabata nke carbamazepine zuru oke, oke nkesa nkesa pụtara 0.8-1.9 l / kg.

Metabolism.
Carbamazepine bụ metabolized n'ime imeju. Mainzọ nke biotransformation bụ ụzọ izizi nke hydroxydiol, n'ihi nke etolitewo metabolites: usoro nke 10.11-transdiol na conjugate ya na glucuronic acid. Ntughari nke carbamazepine-10,11-epoxide ka carbamazepine-10,11-transdiol n’ahụ mmadụ na-eme site na iji microsomal enzyme epoxyhydrolase.

Ntinye uche nke carbamazepine-10,11-epoxide (metabolite na-arụ ọrụ metabolite) bụ ihe dịka 30% nke ịta ahụhụ nke carbamazepine na plasma. Isi isoenzyme nke na-enye carbamazepine nke carbamazepine-10,11-epoxide bụ bioto transperatyil nke P450 ZA4. N'ihi mmeghachi omume metabolic ndị a, a na-akwụkwa obere ihe nke metabolite ọzọ, 9-hydroxymethyl-10-carbamoylacridane. Importantzọ ọzọ dị mkpa nke metabolism carbamazepine bụ nguzobe nke usoro dị iche iche nke monohydroxylated, yana N-glucuronides, si nwee ike UGT2B7 isoenzyme.

Ojiji.
Ndụ ọkara nke carbamazepine na-agbanweghị agbanwe (T_1/2) mgbe otu mkpụrụokwu ọgwụ si 25-65 awa (na nkezi banyere 36 awa), mgbe ugboro ugboro onunu ogwu - na nkezi 16-24 awa dabere na oge nke ọgwụgwọ (n'ihi autoinduction nke monooxygenase usoro nke imeju). N'ime ndị ọrịa na-a drugsụ ọgwụ ọjọọ ndị ọzọ na - eme ka enzymes imeju microsomal (dịka ọmụmaatụ, phenytoin, phenobarbital) n'otu oge, T_1/2 carbamazepine dịkarịa ala, awa 9-10. Ka otu nchịkwa ọnụ nke 400 mg nke carbamazepine, 72% nke ọgwụ a takenụbara dị na mmamịrị yana 28% na feces. Ihe dị ka 2% nke ọgwụ a isụrụ dị na mmamịrị n'ụdị carbamazepine na-agbanweghị agbanwe, ihe dịka 1% n'ụdị ọgwụ ọgwụ 10.11-epoxy metabolite. Mgbe otu nchịkwa otu, 30% nke carbamazepine na-apụ apụ na mmamịrị n'ụdị ngwụcha ngwaahịa nke ụzọ epoxydiol nke metabolism.

Pharmacokinetics na otu ndị ọrịa.
Na ụmụaka, n'ihi mkpochasị ngwa ngwa nke carbamazepine, enwere ike ịchọ ọgwụ nke elu ọgwụ kwa kilogram nke oke ahụ, ma e jiri ya tụnyere ndị okenye.

Enweghị ihe akaebe na ọgwụ ọgwụ nke carbamazepine na-agbanwe na ndị ọrịa agadi (ma e jiri ya tụnyere ndị okenye na-eto eto). Achọpụtaghị data dị na pharmacokinetics nke carbamazepine na ndị ọrịa nwere akwara nwere nsogbu ma ọ bụ ọrụ hepatic.

Jiri n’oge ime na n’oge a na-enye nwa ara.

Mgbe ọ bụla enwere ike, ndị nwanyị mụrụ nwa ka a na-enyezi carbamazepine n'ụdị monotherapy, na ntakịrị opekempe, ebe ọ bụ na ọnụọgụ mmebi iwu nke ụmụ amụrụ ọhụrụ sitere n'aka ndị nne ejirila ọgwụgwọ antiepileptik elu karịa nke monotherapy.Dabere na ọgwụ ndị so na usoro njikọta ọgwụ, ihe ọghọm nke ịmalite imebi ihe ịmụ nwa nwere ike ịbawanye elu, ọkachasị mgbe agbakwunyere valproate na ọgwụgwọ.

Carbamazepine na-abanye n'ime Plasilia ngwa ngwa ma mepụta itinye uche n'ihe na umeji na akụrụ nke nwa ebu n'afọ. Nyochaa oge niile maka itinye uche n'ihe dị na plasma ọbara, EEG ka akwadoro.

Mgbe ime dị, ọ dị mkpa ịtụle uru a tụrụ anya na ọgwụgwọ na nsogbu ndị ọ ga-ekwe omume, ọkachasị n'oge ọnwa atọ mbụ nke ịtụrụ ime. A maara na ụmụaka ndị nne na-arịa akwụkwụ na-enwe nsogbu intrauterine na-eto eto, gụnyere mmejọ. Carbamazepine nwere ike ịbawanye ohere nke nsogbu ndị a. Enwere akụkọ dịpụrụ adịpụ nke ikpe gbasara ọrịa na ọrịa na-adịghị ala ala, gụnyere na-abụghị mmechi nke vertebral arches (spina bifida) na nsogbu ọgbụgba ndị ọzọ: mmerụ ahụ na mmepe nke akụkụ craniofacial, akwara obi na sistem ndị ọzọ, hypospadias.

Dabere na Americanlọ Ọrụ Ebere na North American Pregnant, ihe kpatara oke arụrụala metụtara arụmọrụ chọrọ ịwa ahụ, ọgwụ ma ọ bụ ọgwụgwọ ịchọ mma, nke a chọpụtara n'ime izu iri na abụọ mgbe amụrụ nwa, bụ pasent 3.0 n’ime ụmụ nwanyị dị ime na-ewere carbamazepine na oge mbụ dị ka monotherapy, yana 1.1% n'etiti ndị inyom dị ime na-a notụghị ọgwụ ọ bụla.

Ekwesịrị iji nlezianya na-emeso Carbamazepine-Akrikhin ọgwụgwọ nke ụmụ nwanyị dị ime. Ekwesịrị iji Carbamazepine-Akrikhin dị ntakịrị opekempe. A na-atụ aro ka itinye uche n'ihe mgbe niile n'ihe gbasara akụrụngwa ọbara dị na plasma. N'ihe banyere nchịkwa anticonvulsant dị irè, nwanyị dị ime kwesịrị ịnwe obere mkpokọ carbamazepine na plasma ọbara (usoro ọgwụgwọ 4-12 μg / ml), ebe enwere akụkọ banyere ọghọm nwere ike ịdabere na ịbawanye n’ihu site na ịba n’ihu ịmụ nwa (dịka ọmụmaatụ, ugboro ugboro nke njehie mgbe ị na-eji ihe na-erughị 400 mg kwa ụbọchị dị ala karịa ka a na -ebe elu).

Ekwesịrị ịgwa ndị ọrịa banyere ohere ịbawanye n'ihe ize ndụ nke malformations na mkpa, na nke a, maka nyocha nke afọ.

N'oge afọ ime, ọgwụgwọ ọgwụ dị irè agaghị egbochi ya, ebe ọ bụ na ọrịa na-eto eto nwere ike nwee mmetụta na-adịghị mma n'ahụ nne na nwa ebu n'afọ.

Ọgwụ Antiepileptic na-abawanye ụkọ folic acid, nke a na-ahụkarị n’oge afọ ime, nke nwere ike ime ka mmerụ ahụ dị n’ọbara pụta n’ahụ ụmụaka, yabụ na-atụ aro ị takingụ folic acid n’ihu ịtụrụ ime na n’oge ime. Iji gbochie nsogbu ọbara ọgbụgba n'ime ụmụ amụrụ ọhụrụ, a na-atụ aro ka ndị ụmụ nwanyị n’izu ikpeazụ nke afọ ime, yana ụmụ amụrụ ọhụrụ, ka ha depụta vitamin K.

A kọwawo ọtụtụ ọrịa ọdịdọ na / ma ọ bụ nkụda mmụọ na ụmụ amụrụ ọhụrụ ndị nne ya weere ọgwụ ahụ n'otu oge na anticonvulsants ndị ọzọ. Na mgbakwunye, ọtụtụ ikpe ọgbụgbọ, afọ ọsịsa na / ma ọ bụ hypotrophy na ụmụ amụrụ ọhụrụ ndị nne ha nwetara carbamazepine. Ikekwe mmeghachi omume ndị a bụ ngosipụta nke ọrịa mbugharị na ụmụ amụrụ ọhụrụ.

Carbamazepine na-abanye n'ime mmiri ara, ihe a na-eme na ya bụ 25-60% nke ịta ụbara na plasma ọbara, yabụ uru ekwesịrị ịba uru maka ị inụ ara ara na ọnọdụ nke usoro ọgwụgwọ na-aga n'ihu. Site n’ịnọgide na-a breastụ ara mgbe ị na-a theụ ọgwụ ahụ, ịkwesịrị igosipụta nlezianya maka nwatakịrị ahụ na o nwere ike ịmalite mmeghachi omume ọjọọ (dịka ọmụmaatụ, ụra ụra siri ike, mmeghachi ahụ anụ ahụ). N'ime ụmụaka ndị natara carbamazepine antenatally ma ọ bụ mmiri ara ara, a na-akọwa okwu banyere ọrịa ịba ọcha n'anya, yabụ, a ga-enyocha ụmụaka dị otú ahụ na usoro nchọpụta nke mmetụta ndị sitere na sistemụ ịba ọcha n'anya. A dọrọ ndị ọrịa oge ịmụ nwa gbasara ịbelata ọgwụ mgbochi ọgwụ a na-ekwu n'ọnụ mgbe ha na-eji carbamazepine.

Usoro onunu ogwu na nhazi.

Nyere mmekorita ogwu nke ogwu na ogwu ndi ozo na ogwu nke ogwu anakpo ndi okenye, aghaghi iji nlezianya họrọ ya.

Akwụkwụ na-adọ
N'ọnọdụ ebe nke ga-ekwe omume, ekwesịrị ịkọ carbamazepine-Akrikhin dị ka monotherapy. Ọgwụgwọ na-amalite site n'iji obere ọgwụ kwa ụbọchị, nke na-eji nwayọ nwayọ nwayọ ruo mgbe a ga-enweta nsonaazụ kachasị mma. Ka ịhọrọ ọgwụ kachasị mma, a na-atụ aro ka itinye uche nke ihe na - arụ ọrụ n'ime plasma ọbara. N'ime ọgwụgwọ Akwụkwụ na-adọ, achọrọ ọgwụ carbamazepine, nke kwekọrọ na mkpokọta plasma nke carbamazepine na ọkwa nke 4-12 μg / ml (17-50 μmol / L). Ekwesịrị iji nnabata nke ọgwụ Carbamazepine-Akrikhin na ọgwụ na-aga n'ihu na-aga n'ihu iji nwayọọ nwayọọ, ebe usoro ị drugsụ ọgwụ ndị a na-eji agbanwe agbanwe ma ọ bụ, ọ bụrụ na ọ dị mkpa, na-agbazi. Ọ bụrụ na onye ọrịa echefuru ị doseụ ọgwụ ọzọ na oge a, a ga-ewere ọgwụ ahụ echefuara ozugbo ị chọpụtara ihe omimi a, ị nweghị ike ị takeụ ọgwụ okpukpu abụọ.

Ndị okenye
Usoro izizi bụ 200-400 mg 1 ma ọ bụ ugboro abụọ kwa ụbọchị, mgbe ahụ, a na-eji nwayọọ nwayọọ mụbaa dose ahụ ruo mgbe arụpụtara ezigbo ya. Usoro nlekọta ahụ bụ 800-1200 mg kwa ụbọchị, nke kewara n'ime usoro 2-3 kwa ụbọchị.

Childrenmụaka.
Ọgwụ nke mbụ maka ụmụaka site na afọ 4 ruo 15 bụ 200 mg kwa ụbọchị (n'ọtụtụ usoro), mgbe ahụ, a ga-eji nwayọ gbagote ọgwụ site na 100 mg kwa ụbọchị ruo mgbe arụpụtara oke.

Usoro mmezi maka ụmụaka 4-10 dị afọ - 400-600 mg kwa ụbọchị, maka ụmụaka 11-15 dị afọ - 600-1000 mg kwa ụbọchị (n'ọtụtụ usoro).

A na-atụ aro usoro nhazi dosing:
Ndị okenye: ọgwụ mbụ bụ 200-300 mg na mgbede, usoro nlekọta bụ 200-600 mg n'ụtụtụ, 400-600 mg na mgbede.

Frommụaka sitere na afọ 4 ruo 10: ọgwụ mbụ - 200 mg na mgbede, usoro mmezi - 200 mg n'ụtụtụ, 200-400 mg na mgbede, ụmụaka site na afọ 11 ruo 15: ọgwụ mbụ - 200 mg na mgbede, dose mmezi - 200 -400 mg n'ụtụtụ, 400-600 mg na mgbede. Frommụaka site na afọ iri na ise ruo afọ iri na asatọ: usoro usoro onunu ogwu 800-1200 mg / ụbọchị, otu kachasị kwa ụbọchị -1200 mg / ụbọchị.

Ogologo oge eji na-adabere na ngosipụta na nzaghachi nke onye ọrịa na ọgwụgwọ. Mkpebi ịbufe onye ọrịa ahụ na Carbamazepine-Akrikhin, oge ọ ga-eji na kagbuo ọgwụgwọ ahụ bụ nke dọkịta. A na-atụle ohere ị belata ọgwụ ma ọ bụ ịkwụsị ọgwụgwọ mgbe afọ 2-3 gasịrị nke enweghị ọdịdọ zuru ezu.

A kwụsịrị ọgwụgwọ, jiri nwayọ belata dose nke ọgwụ ahụ ruo afọ 1-2, n'okpuru nlekọta nke EEG. N’aka umuaka, na ibelata ogwu ubochi nke ubochi, a gha aba n’ebum n’ahu na ahu.

Trigeminal neuralgia, idiopathic glossopharyngeal neuralgia.
Ọgwụ nke mbụ bụ 200-400 mg kwa ụbọchị, nke kewara abụọ. Ọbara mbụ ebido ruo mgbe ihe mgbu kwụsịrị kpamkpam, na nkezi ruo ihe dịka 400-800 mg kwa ụbọchị (ugboro 3-4 n'ụbọchị). Mgbe nke ahụ gasị, n'otu akụkụ nke ndị ọrịa, enwere ike ịga n'ihu na ọgwụgwọ nlekọta dị ala nke 400 mg.

Ọgwụ kachasị atụ aro bụ 1200 mg / ụbọchị, mgbe ọ ruru ogo ụlọ ọgwụ, a ga-eji nwayọ belata ọgwụ ahụ ruo mgbe ọgụ mgbu ọzọ ga-apụta.

Maka ndị ọrịa agadi na ndị ọrịa nwere mmerụ ahụ na carbamazepine, a na-edobe Carbamazepine-Akrikhin na mbido ọgwụ nke 100 mg ugboro abụọ kwa ụbọchị, mgbe ahụ, a na-eji nwayọ nwayọ elu ruo mgbe ọnya ahụ kwụsịrị, nke a na-enwetakarị na 200 mg 3-4 ugboro n'ụbọchị. Na-esote, ikwesiri ka iwetulata ya were dozie obere oge.

Na trigeminal neuralgia na otu ndị ọrịa, ọgwụ a na-atụ aro ka ukwuu bụ 1200 mg / ụbọchị. Mgbe ị na-edozi syndrome mgbu, a ga-eji nwayọ kwụsị ịgwọ ọrịa ahụ ruo mgbe ọgụ mgbu ọzọ ga-apụta.

Ọgwụ n'ụlọ ọgwụ na-a withdrawalụ mmanya.
Nkezi nha kwa ụbọchị bụ mg mg (200 mg ugboro atọ n’ụbọchị). N'okwu ndị siri ike, na ụbọchị mbụ, enwere ike ịbawanye ọgwụ ahụ ruo 1200 mg kwa ụbọchị, nke kewara n'ime usoro 3. Ọ bụrụ na ọ dị mkpa, enwere ike ijikọ Kapbamazepine-Akrikhin na ọgwụ ndị ọzọ eji agwọ ọnya na-a alcoholụ mmanya, ewezuga ọgwụ ọgbụgba. N'oge ọgwụgwọ, ọ dị mkpa iji nlezianya nyochaa ọdịnaya nke carbamazepine na plasma ọbara. N'ihe banyere mmepe omume nke nsonaazụ ndị sitere na sistemụ akwara na akwara autonomic, a na-elezi ndị ọrịa anya n'ụlọ ọgwụ.

Ọnọdụ manic na-adịghị mma na ọgwụgwọ na-akwado ọrịa.
Ọgwụ kwa ụbọchị bụ 400-1600 mg. Nkezi, kwa ụbọchị bụ 400-600 mg (na 2-3 usoro).

N'ime ọnọdụ manic dị njọ, a ga-amụba dose ahụ ngwa ngwa. Site na usoro nlekọta mmezi maka nsogbu ọrịa ụbụrụ, iji wee hụ nnabata zuru oke, mmụba ọ bụla na-esote ya kwesịrị ịdị obere, kwa ụbọchị na-abawanye nwayọ.

Contkwụsị ọgwụ ahụ.
Ọgwụ ịkwụsị ọgwụ ahụ na mberede nwere ike ịkpalite ọdịdọ. Ọ bụrụ na ọ dị mkpa ịkwụsị ọgwụ ahụ na onye ọrịa nwere ọria, ọ ga-ebufe ntụgharị ihu ọzọ na ọgwụ mgbochi n'akụkụ ọgwụ nke egosi na ụdị ndị ahụ (dịka ọmụmaatụ, diazepam na-achịkwa intravenously ma ọ bụ n'akụkụ, ma ọ bụ phenytoin na-achịkwa intravenously).

Mmetụta akụkụ.

Mmeghachi omume ndị na-adịghị mma ị na-enwe na-apụkarị n'ime ụbọchị ole na ole, ma n'otu oge ma mgbe ha nwetachara oge ị temporaryụ ọgwụ ahụ. Mmeghari nke mmeghachi omume ojoo site na sistemụ akwara na-esite na ya nwere ike ịbụ nsonaazụ ọgwụ oke ma ọ bụ mgbanwe dị ukwuu na ịta nke ihe dị n'ọrụ na plasma ọbara. N'ọnọdụ ndị dị otú a, a na-atụ aro ka nyochaa nyocha nke ihe dị n'ọrụ na plasma ọbara.

N'ịlele ugboro ole ihe dị iche iche na - eme, a na - eji grad ndị a: ọtụtụ mgbe - 10% ma ọ bụ karịa, ọtụtụ mgbe - 1-10%, mgbe ụfọdụ -0.1-1%, adịkarịghị -0.01-0.1%, ọ dịkarịghị-obere 0.01%

Mmeghari nke mmeghachi omume ojoo site na sistemụ akwara na-esite na ya nwere ike ịbụ nsonaazụ ọgwụ oke ma ọ bụ mgbanwe dị ukwuu na mkpokọta carbamazepine na plasma ọbara.

Si n'etiti ụjọ usoro: mgbe mgbe - dizzness, ataxia, ụra, adịghị ike n'ozuzu, isi ọwụwa, paresis nke ụlọ, oge ụfọdụ, ihe na - adịghị mma (dịka ọmụmaatụ, ịma jijiji, "ịma mma") - oke ụjọ (asterixis, dystonia, tics), nystagmus, na - adịkarịghị - hallucinations (visual ma ọ bụ nyocha), ịda mba, ụkọ nri, nchekasị, akparamagwa agwa, nrụgide psychomotor, disorientation, rụọ ọrụ nke psychosis, orofacial dyskinesia, oculomotor aghara, ọgba aghara okwu (dịka dysarthria ma ọ bụ okwu nzuzu), nsogbu choreoathetoid, ọgba aghara Odide, paresthesia, muscle adịghị ike, na paresis n'ime ihe mgbaàmà, ọ bụ nnọọ obere - uto n'ọgba aghara, neuroleptic ajọ syndrome, dysgeusia.

Mmeghachi omume nfụkasị ahụ: otutu mgbe - ahuhu akpukpo ahu akpukpo aru, otutu mgbe - urticaria, oge ufodu - exfoliative dermatitis, erythroderma, Multi-organ reactions nke lebe-ụdị hypersensitivity with fever, skin rashes, vasculitis (gụnyere erythema nodosum, as ngosipụta nke vasculitis skin), lymphadenopathy, sign, , arthralgia, leukopenia, eosinophilia, hepatosplenomegaly na mgbanwe ndị na-egosi ọrụ imeju (ihe ngosi ndị a na-apụta na njikọta dị iche iche). Ọkpụkpụ ndị ọzọ (dịka ngụgụ, akụrụ, pancreas, myocardium, colon), menchication aseptic na myoclonus na eosinophilia na-emetụta, mmeghachi omume anaphylactoid, angioedema, pneumonitis nfụkasị ma ọ bụ oyibo eosinophilic nwekwara ike itinye aka. Ọ bụrụ na mmeghachi omume nfụkasị ahụ dị n'elu, a ga-akwụsị ị useụ ọgwụ ahụ, ọ na - adịkarị obere - lupus-like syndrome, itching of the skin, erythema multiforme exudative (gụnyere Stevens-Johnson syndrome), erythema nodosum, toxic epidermal necrolysis (ọrịa Lyell), photoensitivity.

Site na akụkụ ahụ dị na hemopoietic: mgbe mgbe leukopenia, thrombocytopenia, eosinophilia, lebecytosis adịkarịghị ala, lymphadenopathy, enweghi ike folic acid, agranulocytosis, aplastic anemia, ezigbo erythrocytic aplasia, megaloblastic anemia, nnukwu intermittent porphyria, reticulocytemia, retatouloicia templecius porphyria, variegated porphyria.

Site na nri digestive: oge ọgbụgbọ, ọgbụgbọ, akpịrị ịkpọ nkụ, ọrụ ịba ụba nke transferase gamma-glutamyl (n'ihi ntinye nke enzyme a na imeju), nke na-adịkarịghị arụ ọrụ dị mkpa, ịba ụba ọrụ nke alkaline phosphatase, mgbe ụfọdụ - ịba ụba nke ọrụ hepatic transaminases, afọ ọsịsa ma ọ bụ ntachi, afọ. mgbu, adịkarịghị - glossitis, gingivitis, stomatitis, pancreatitis, ịba ọcha n'anya nke cholestatic, parenchymal (hepatocellular) ma ọ bụ ụdị agwakọta, jaundice, granulomatous ịba ọcha n'anya, imeju imeju, mbibi nke intrahepatic bile x ducts na ọnụọgụ ọnụọgụ ha.

Si usoro obi: adịkarịghị - obi ọgbụgba akwara obi, ibelata ma ọ bụ ịrị elu ọbara ọgbụgba, bradycardia, arrhythmias, ngọngọ atrioventricular nwere nkụda mmụọ, ndakpọ, nhụjuanya ma ọ bụ mmepe nke nkụchi obi na-adịghị ala ala, oke iwe nke ọrịa obi obi (gụnyere ihe na-akpata ma ọ bụ mmụba nke ọgụ angina), thrombophlebitis, thromboembolism ọrịa

Site na usoro endocrine na metabolism: ọtụtụ mgbe - edema, njigide mmiri, ibu ibu, hyponatremia (mbelata plasma osmolarity n'ihi mmetụta nke homonụ antidiuretic, nke na-adịghị ahụkebe na-eduga na dilution hyponatremia, na-esonyere ike ọgwụgwụ, ọgbụgbọ, isi ọwụwa, disorientation na nsogbu akwara), adịkarịghị - mmụba na ịta nke prolactin (enwere ike sonyere galactorrhea na gynecomastia), mbelata nke ịta L-thyroxine yana mmụba nke homonụ na-akpali akpali (ọ naghị abụkarị ndị ụlọ ọgwụ na-esonyere ya. E ngosipụta), disturbances nke calcium-site metabolism na ọkpụkpụ anụ ahụ (iju ke ịta nke calcium na 25-0N, cholecalciferol plasma): osteomalacia, osteoporosis, hypercholesterolemia (gụnyere elu-njupụta lipoprotein cholesterol), na gipertrigpitseridemiya lymphadenopathy, hirsutism.

Site na usoro mkpụrụ ndụ: adịkarịghị adị n'etiti ọbara ọgbụgba, nsogbu akụrụ, ọrụ akụrụ na-arụ ọrụ (dịka ọmụmaatụ, albuminuria, hematuria, oliguria, urea / azotemia), mmụba urination, njide urinary, ibelata ikike, nsogbu spermatogenesis (belata mmerụ nwoke na nwanyị.

Site na usoro mọzụlụ: oge ike ọgwụgwụ, adịghị ike anụ ahụ, arthralgia, myalgia, ma ọ bụ cramps.

Si uche: ọtụtụ mgbe - ọgba aghara nke ebe obibi (gụnyere ọhụhụ), adịkarịghị - ọgba aghara na uto, mmụba intraocular, nsogbu nke oghere, conjunctivitis, nsogbu ntị, gụnyeretinnitus, hyperacusis, hypoacusia, mgbanwe na nghọta nke pitch.

Ọrịa sitere na akụkụ okuku ume, obi na akụkụ ahụ: na-esikarị ike - mmeghachi omume afọ ojuju nke ahụ ọkụ, mkpụmkpụ nke iku ume, oyi baa ma ọ bụ na oyi baa.

Laabu na akụrụngwa data: dịkarịsịrị ala - hypogammaglobulinemia.

Ndị ọzọ: ọgba aghara nke ụcha akpụkpọ ahụ, purpura, ihe otutu, sweating, alopecia.

Ihe omume ojoo dịka nlele ahịa azụmaahịa (amaara ugboro ole)
Ọrịa sistemụ immune: ogwusi ogwu na eosinophilia na ngosiputa nke usoro.

Ọkpụkpụ sitere na anụ ahụ yana anụ ahụ dị n'okpuru ala: nnukwu ihe ana - eme eczematous pustulosis, lichenoid keratosis, onychomadesis.

Ọrịa na nje reactivation nke herpes simplex virus ụdị 6.

Ọrịa site na ọbara na sistem lymphatic: ụmkpụ ọkpụkpụ.

Mmebi nke usoro ụjọ ahụ: ebe nchekwa adighi.

Ọrịa eriri afọ: pricks.

Imebi akwara na uru ahụ: odimma.

Mmekọrịta na ọgwụ ndị ọzọ.

Mee ka mkpokọ carbamazepine na plasma ọbara verapamil, diltiazem, felodipine, dextropropoxyphene, viloxazine, fluoxetine, fluvoxamine, nefazodone, paroxetine, trazodone, olanzapine, cimetidine, omeprazole, acetazolamide, danazole, desipramine, okenye, nicotinamide , troleandomycin), ciprofloxacin, styripentol, vigabatrin, azoles (itraconazole, ketoconazole, fluconazole, voriconazole), terfenadine, loratadine, isoniazid, propoxyphene, oxybutynin, dantrolene, ticlopgragragraf, ticlopedgragraf, ticlopedgragrais, ticlopedgragraf, bụ ticlopedgragraf, ticlopedgragrais, ticlopedgragrais, ticlopedgragraf, bụ ticlopedgragraf, ticlopedgragrais, ticlopedgragraf, bụ ticlopedgragraf, ticlopedgragraf, ticlopedgragrais, ticlopedgragrais, ticlopedgragragragraf, bụ ticlopedgragragragraf, eji ya na ọgwụgwọ nke oria HIV (dịka ọmụmaatụ, ritonavir) - a chọrọ ndozi nke usoro onunu ogwu ma ọ bụ nlekota nke ịba uru nke carbamazepine na plasma.

Felbamate na-ebelata ịta nke carbamazepine na plasma ma na-eme ka ịta ahụhụ nke carbamazepine-10,11-epoxide pụta, ebe mbelata nke oge n'otu na mkpo nke felbamate ga-ekwe omume.

Ọgwụ nke nwere ike ime ka mkpokọ carbamazepine-10,11-epoxide dị na plasma ọbara: loxapine, quetiapine, primidone, progabide, vaproic acid, valnoktamide na valpromide.

Ebe ọ bụ na mmụba na mkpokọta nke carbamazepine-10.11-epoxide dị na plasma ọbara nwere ike ibute mmeghachi omume ọjọọ (dịka ọmụmaatụ, dizziness, iro ụra, ataxia, diplopia), n'ọnọdụ ndị a, a ga-edozi ọgwụ ọgwụ ahụ na / ma ọ bụ itinye uche nke carbamazepine-10.11 kwesịrị ikpebi mgbe niile. -epoxide na plasma.

Ista ahụ carbamazepine belatara phenobarbital, phenytoin (iji zere phenytoin ịxụbiga mmanya ókè na ntinye nke subtherapeutic concentrations nke carbamazepine, ihe a na-atụ aro ka playma nke phenytoin kwesịrị ịdị karịa 13 μg / ml tupu carbamazepine agbakwunye na usoro ọgwụgwọ), fosphenytoin, primidone ,finfinfinfinfinfinfinfincintafinfinfinfinfincintafinfinfinfinfinfindefindefinfinfinfinfinfindefinfinfinfindefinfinfinfinfinfinfinfinfinfindefinfinfinfinfinfinfinfinfinhinfinfinfinfinfinfinhinfinfinfinfinfinfinfinhinfinfinfinfinfinfinfinfinfinfinንም wiimepi nke klọf. enwere ike: clonazepam, valpromide, vaproic acid, oxcarbazepine na nkwadebe ahịhịa nwere St John's wort (Hypericum perforatum).

Iji otu oge iji ọgwụ ndị a dị n'elu, enwere ike ịchọ ndozi nke carbamazepine.

Enwere ike ịchụpụ nke carbamazepine nwere valproic acid na primidone n'ihi nchebe nke plasma na mmụba nke mkpokọta ọgwụ ọgwụ na-arụ ọrụ (carbamazepine-10,11-epoxide). Site na iji carbamazepine jikọtara ya na valproic acid, n'ọnọdụ ndị ọzọ, coma na ọgba aghara nwere ike ime. Isotretinoin gbanwere bioavailability na / ma ọ bụ nhichapụ nke carbamazepine na carbamazepine-10,11-epoxide (nyochaa nlebara anya nke carbamazepine na plasma dị mkpa).

Carbamazepine nwere ike belata ịta na plasma (iji belata ma ọ bụdị kpamkpam nke mmetụta) ma chọọ nhazigharị nke ọgwụ ndị a: clobazam, clonazepam, digoxin, ethosuximide, primidone, zonisamide, valproic acid, alprazolam, glucocorticosteroids (prednisolone, dexamethasone), cyclosporin tetracycline, tetracycline, tetracycline, tetracycline, tetracycline, tetracycline, tetracycline, tetracycline, tetracycline, tcyccycline methadone, nkwadebe ọnụ nwere estrogens na / ma ọ bụ progesterone (nhọrọ nke usoro ọgwụgwọ igbochi ọzọ dị mkpa), theophylline, ọgwụ anticoagulants (warfarin, fenprocoumone, dicumarol, aceno) Umarolum), lamotrigine, topiramate, tricyclic antidepressants (imipramine, amitriptyline, northriptyline, clomipramine), bupropion, citalopram, mianserin, sertraline, clozapine, felbamate, tiagabine, oxarbazepine, kariya, inyocha, nje HIV, inyocha, nje HIV ), ọgwụ iji gwọọ ọrịa nke akụrụngwa akwara (“nwayọ”) ndị na - egbochi calcium Channel (otu dihydropyridones, ọmụmaatụ, felodipine), simvastatin, atorvastatin, lovastatin, cerivastatin, ivabradine), ya rakonazola, levothyroxine, midazolam, olanzapine, ziprasidone, aripiprazole, paliperidone, praziquantel, risperidone, tramadol, ziprasidone, buprenorphine, phenazone, aprepitant, albendazole, imatinib, cyclophosphamide, lapatinib, everolimus, tacrolimus, sirolimus, temsirolimus, tadapafila. Enwere ohere ịbawanye ma ọ bụ ibelata ọkwa nke phenytoin na plasma ọbara megide ndabere nke carbamazepine ma nwekwuo ọkwa nke mefenitoin. N'iji oge nke carbamazepine na njikere lithium ma ọ bụ metoclopramide, enwere ike ịkwalite mmetụta neurotoxic nke ihe abụọ na-arụ ọrụ.

Tetracyclines nwere ike belata ọgwụgwọ ọgwụgwọ carbamazepine. Mgbe ejikọtara ya na paracetamol, ihe ọghọm nke nsí ya na imeju na-abawanye ma ọ ga-agbake ma na-agwọ ya (na-eme ka metabolism nke paracetamol kwụsị). Nlekọta oge nke carbamazepine nwere phenothiazine, pimozide, thioxanthenes, mindindone, haloperidol, maprotiline, clozapine na tricyclic antidepressants na-eduga na mmụba nke inhibitory mmetụta na sistemụ akwara na ụkọ nke anticonvulsant mmetụta nke carbamazepine. Ndị na-egbochi Monoamine oxidase na-abawanye ihe ize ndụ nke ịmalite ọgba aghara hyperpyretic, ọdụdọ mgbali elu, ọdịdọ, na ọnwụ (a ga-akagbu ihe mgbochi monoamine oxidase tupu ọ dị ka etinyere carbamazepine ma ọ dịkarịa ala izu abụọ ma ọ bụ, ọ bụrụ na ọnọdụ ahụike na-enye ohere, ọbụlagodi ogologo oge). Nlekọta nke imekota ihe n’otu oge n’olu na diuretics (hydrochlorothiazide, furosemide) nwere ike ibute hyponatremia, ya na ngosipụta nke ulo ogwu. Ọ na –emepụta nsonaazụ nke ndị na - anaghị eme ka ahụ dị jụụ (pancuronium). N'ihe banyere iji ụdị ngwakọta a, ọ nwere ike ịdị mkpa ka iwelie ọnya na-eme ka ahụ ghara iru ala, ebe ịlele ọnọdụ onye ọrịa anya dị mkpa n'ihi ekwe omume ịkwụsịtụ ngwangwa ngwa ngwa. Site n'iji nke carbamazepine na oge ya na levetiracetam, n'ọnọdụ ụfọdụ, enwere mmụba nke nsị carbamazepine.

Carbamazepine na-ebelata nnabata ethanol.

Ọgwụ Myelotoxic na-abawanye hematotoxicity nke ọgwụ.

Ọ na - eme ka metabolism nke anticoagulants na - apụtaghị ìhè, mgbochi nke homonụ, folic acid, praziquantel, ma nwee ike ịkwalite mkpochapụ homonụ thyroid.

Ọ na-eme ka metabolism nke ọgwụ na-agwọ ọrịa na-egbu egbu (enflurane, halotane, fluorotan) na-abawanye ohere nke hepatotoxic, na-eme ka e nwee metabolites nephrotoxic nke methoxyflurane. Enyere mmetụta hepatotoxic nke isoniaeid.

Mmekọrịta na mmeghachi omume serological. Carbamazepine nwere ike ibute nsonaazụ nke ụgha nke ikpebi ịta ahụhụ nke perphenazine site na mmiri chromatography dị elu. Carbamazepine na carbamazepine 10.11-epoxide nwere ike ibute nsonaazụ ụgha-nke ikpebi ntinye echiche nke ọgwụ tricyclic antioxide site na iji ọgwụ mgbochi mbipụta immlaoassay.

Usoro onunu ogwu na nhazi

Emebere mbadamba Carbamazepine maka nri ya.

Maka ọgwụgwọ nke Akwụkwụ na-adọ, a na-edenye ndị okenye ọgwụ na mbido 1 mbadamba 1-2 ugboro n'ụbọchị. A na-atụ aro ka ndị okenye ½ were ½ ngaji times 1-2 ugboro n'ụbọchị. Na-esote, a ga-eji nwayọ were dozie ya ruo mgbe a na-ewere mbadamba mbadamba abụọ ugboro abụọ n'ụbọchị. Oke kachasị kwa ụbọchị nke carbamazepine agaghị agafere mbadamba 6.

Thebọchị nke carbamazepine kwa ụbọchị maka ụmụaka n'okpuru afọ bụ mbadamba 0.5-1 kwa ụbọchị, afọ 1-5 - mbadamba 1-2, afọ 5-10 - mbadamba 2-3, afọ 10-15 - mbadamba 3-5. A ga-ekewa ubochi ubochi abuo.

Maka ọgwụgwọ nke neuralgia na syndromes mgbu nke mkpụrụ ndụ dị iche iche, ọgwụ kwa ụbọchị bụ 1-2 mbadamba carbamazepine, kewara abụọ. Daysbọchị 2-3 ka ebido ịgwụ ọgwụ ahụ, enwere ike ịbawanye ọnụọgụ abụọ rue mbadamba mbadamba abụọ. Ogologo oge ọgwụgwọ bụ 7-10 ụbọchị. Ka emechara ka ọnọdụ onye ọrịa dị ka ọ dị mma, ekwesịrị ịbelata dose ahụ ka ọ pere mpe. A na-atụ aro usoro mmezi mmebi ogologo oge.

N'ihe banyere nkwụghachi azụ, dịka ntuziaka ahụ si dị, a na-enye carbamazepine ka ọ were mbadamba mbido 1 ugboro 3 kwa ụbọchị. N'okwu ndị siri ike, n'ime ụbọchị atọ mbụ, a na-atụ aro ịba ụba nke ọgwụ ahụ - mbadamba 2 ugboro 3 kwa ụbọchị.

Maka ọgwụgwọ nke polydipsia na polyuria na insipidus ọrịa shuga, a ga-ewere otu mbadamba ugboro 2-3 n'ụbọchị.

Ozi ndi ozo

Ekwesiri iji obere carbamazepine gwọọ ya, were nwayọ wetara ha ọkwa ọgwụgwọ dị mkpa.

N'ime oge ọgwụgwọ a na ọgwụ, a na-atụ aro ka ọ ghara ịrụ ọrụ nke chọrọ itinyekwu uche n'ihe, ebe ọgwụ a na-emetụta ọrụ nke sistemụ akwara.

Ntụziaka maka carbamazepine na-egosi na ọ dị mkpa ịchekwa ọgwụ ahụ n'ọchịchịrị, dị jụụ ma nke ụmụaka agaghị eru. Ndụ shelf bụ ọnwa iri atọ na isii.

Utionskpachara anya na ntinye

Iji nweta ezigbo ọgwụgwọ ọgwụgwọ kachasị mma, etinyere carbamazepine dịka monotherapy na obere usoro iji ya nwayọ nwayọ. Na njikọta ọgwụgwọ maka ịhazigharị usoro, ọ dị mkpa iji chọpụta ntinye uche nke carbamazepine na plasma ọbara. Ọgwụgwọ na carbamazepine enweghị ike iwepụ ya na mberede, ebe ọ bụ na ọdịdọ ndị mgbe ochie na-edekarị ihe edere. Mana ọ bụrụ na ọgwụ ahụ achọrọ iwepu, mgbe ahụ, a ga-eburịrị onye ọrịa ahụ n'enweghị ọgwụ ọ bụla. Yabụ, n'oge ọgwụgwọ na carbamazepine, ọ dị mkpa iji nyochaa nha ọbara na ọrụ imeju.

Carbamazepine na-egosipụta mmetụta anticholinergic dị nro, yabụ, a ghaghị ịchịkwa mgbali ọbara n'ime oge ọgwụgwọ niile. Carbamazepine nwere ike belata nsonaazụ ọgwụ mgbochi, yabụ a ga-eji ụzọ nchebe ọzọ iji gbochie afọ ime.

A na-eji Carbamazepine agwọ ọrịa mgbapu na-ebilite na-egbu mmanya. Ọgwụ ahụ na-eme ka ọnọdụ onye ọrịa nwee mmetụta uche. Mana carbamazepine maka ebumnuche ndị dị otú a ga-eji ya naanị n'ụlọ ọgwụ, ebe ọ bụ na ngwakọta nke ihe abụọ a na-eduga na-akpali mkpali nke usoro ụjọ.

Ọgwụ nwere ike imetụta ịta. Ya mere, n'oge usoro ọgwụ a, ọ dị mkpa izere ihe omume dị egwu, ịnya ụgbọ ala, na ọrụ chọrọ nlebara anya.

Ndakọrịta na ọgwụ ndị ọzọ

Inweta CYP 3A4 mgbochi inenener nwere ike iduga n'ịba ụba plasma carbamazepine. Innweta ndị nwere CYP 3A4 isoenzyme ọnụ na carbamazepine nwere ike iduga n'ịbelata mkpokọta ọgwụ antiepileptik ma mee ka metabolism dịkwuo elu. Ojiji nke carbamazepine na ọgwụ nke CYP 3A4 isoenzyme na-emetụta, na-ebute ntinye nke metabolism na mbelata ọgwụ ndị a na plasma.

Ọgwụ ndị na-abawanye ịta ahụhụ nke carbamazepine: ibuprofen, macrolide ọgwụ nje, dextropropoxyphene, danazol, fluoxetine, nefazodone, fluvoxamine, trazodone, paroxetine, viloksazin, loratadine, vigabatrin, stiripentol, azoles, terfenadine, quetiapine, loxapine, isoniazid, olanzapine, malitere ịrịa protease inhibitors maka ọgwụgwọ nke HIV, verapamil, omeprazole, acetazolamide, diltiazem, dantrolene, oxybutynin, nicotinamide, ticlopidine. Primidone, cimetidine, valproic acid, desipramine nwere ike inwe otu mmetụta ahụ.

Ọgwụ ndị na -ebelata mkpụkọ carbamazepine: paracetamol, methadone, tramadol, antipyrine, doxycycline, anti-coagulants (onu), bupropion, trazodone, citalopram, antidepressants (tricyclics), clonazepam, clobazam, lamotrigine, felbamate, ethosuximide, azamziam, azamidam, azamidam, azamidam, azamidam, azamidam, azamamidam, zakamidam bụ ihe na-enweghị atụ imatinib, praziquantel, itraconazole, haloperidol, olanzapine, bromperidol, quetiapine, ziprasidone, ritonavir, saquinavir, ritonavir, indinavir, alprazolam, calcium channel blockers, theophylline, midazolam, perazolam , glucocorticosteroids, sodium levothyroxine, everolimus, cyclosporine, progesterone, estrogens.

Njikọ iji tụlee.

Isoniazid + carbamazepine - ịba ụba hepatotoxicity.

Levetiracetam + carbamazepine - mmụba nke carbamazepine na-egbu egbu.

Carbamazepine + njikere lithium, metoclopramide, haloperidol, thioridazan na ọgwụ mgbochi ndị ọzọ - mmụba n'ọnụ ọgụgụ mmeghachi omume akwara ozi na-achọghị.

Carbamazepine + diuretics, dị ka furosemide, hydrochlorothiazide - ihe omume nke hyponatremia nwere nnukwu mgbaàmà ọrịa.

Carbamazepine + na-eme ka ahụ ghara iru ala - na-egbochi mmezu nke akwara ahụ, nke na-akwụsị ngwa ọgwụgwọ ha ngwa ngwa, mana enwere ike idozi ọnọdụ ahụ site na ịbawanye kwa ụbọchị.

Ihe ọ graụpeụ mkpụrụ vaịn carbamazepine + - mmụba nke ọkwa carbamazepine na plasma.