Etu esi eji ọgwụ Fendivia mee ihe?

Nkọwa nke ụdị usoro onunu ogwu

Ogwe akụkụ nwere akụkụ anọ nwere oghere gburugburu nwere ihe nkiri nchebe na-ewepu Ihe nkiri nchebe karịrị patch. Ọkpụkpụ sinusoidal kewara fim na - ewepu ihe na - ewepu ya ụzọ abụọ.

Ejiri aha mmado ndị a gosipụta na ịmachi site na mbipụta agba:

1) Fendivia ™ 12.5 μg / h - kwachie (18 ± 0.5) mm dum, (24 ± 0.5) mm ogologo: "Fentanyl 12.5 .5g / awa" - akara agba aja aja,

2) Fendivia ™ 25 μg / h - kwachie (24.6 ± 0,5) mm dum, (37 ± 0,5) mm ogologo: "Fentanyl 25 μg / awa" - mbipụta uhie,

3) Fendivia ™ 50 μg / h - kwachie (34 ± 0.5) mm dum, (51.3 .3 0.5) mm ogologo: "Fentanyl 50 μg / awa" - akara akwụkwọ ndụ akwụkwọ ndụ,

4) Fendivia ™ 75 μg / h - kwachie (42 ± 0.5) mm n'obosara, (61,7 ± 0,5) mm ogologo: "Fentanyl 75 "g / awa" - ebipụta na-acha anụnụ anụnụ,

5) Fendivia ™ 100 μg / h - kwachie (49 ± 0.5) mm dum, (70 ± 0.5) mm ogologo: "Fentanyl 100 μg / awa" - isi awọ.

Ihe ngosi maka ojiji

Injection - ihe ngbu nke ọnya siri ike na oke (angina pectoris, infarction myocardial, ihe mgbu na ndị ọrịa kansa, trauma, ihe mgbu oge), prematication maka ụdị ọrịa anestesia dị iche iche na mgbakwunye na droperidol, antipsychotics (gụnyere n'oge ịwa ahụ anụ ahụ obi na oghere ime, nnukwu arịa, na akwara ozi, yana ọrịa akwara, orthopedic na arụmọrụ ndị ọzọ).

TTS bụ ọrịa mgbu na-adịghị ala ala nke nhụsianya siri ike na nkwụ ọtọ: ihe mgbu kpatara site n'ọrịa kansa, mgbu nke mkpụrụ ndụ dị iche, na-achọ analgesia na narcotic analgesics (dịka ọmụmaatụ, neuropathy, ogbu na nkwonkwo, ọrịa na-efe efe zoco, wdg).

Ihe ngbanwe

Ọrịa hypersensitivity, oké ịda mbà n'obi nke akụkụ okuku ume.

TTS - nnukwu ihe mgbu ma ọ bụ postoperative mgbu (enweghi ike ịhọrọ nhọrọ zuru oke maka oge ọgwụgwọ dị mkpirikpi, nke nwere ike ibute hypoventilation dị egwu ma ọ bụ nke na-eyi ndụ egwu), oke iwe ma ọ bụ nke mebiri emebi (na saịtị nke ngwa), afọ ọsịsa na-arịa pseudomembranous colitis kpatara cephalosporins, lincosamides, penisiliniins, nsị dyspepsia na-egbu egbu, nnukwu ịda mbà iku ume, ịtụrụ ime, lactation, afọ n'okpuru afọ 18.

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

Na / n'ime, n'ime / m. Ndị okenye na nkwadebe maka ịwa ahụ nkeji iri na ise tupu mmalite - iv, 0.05-0.1 mg nke fentanyl na 2.5-5 mg nke droperidol.

Maka ịkụnwụ ahụ izugbe - iv, 0.4-0.6 mg, iji nọgide na-agwọ ọrịa - iv, 0.05-0.2 mg kwa minit 20-30, maka enyemaka mgbu mgbe ịwa ahụ - iv - 0.05-0.1 mg, ma ọ bụrụ na ọ dị mkpa, ugboro ugboro doses mgbe awa 1 ma ọ bụ 2 gachara

Maka nnwere onwe mgbu na infarction myocardial - 0.1 mg yana 5 mg nke droperidol (maka nkeji 3).

Inmụaka na-akwado maka ịwa ahụ - 2 μg / n'arọ, maka ọrịa izugbe - 10-150 μg / kg iv ma ọ bụ 150-250 μg / kg iv, maka mmezi nke ọrịa izizi - 1-2 μg / kg iv 2 mcg / n'arọ v / m. Undermụaka ndị gbara afọ abụọ agbadighi ọgwụ usoro.

A na-etinyere patch a na mpaghara ruo awa 72 n'ime akpịsị anụ ahụ (anaghị ewe iwe, nwere obere ntutu, jiri mmiri dị ọcha hichaa ya ma ọ bụrụ na ọ dị mkpa, na-ejighị ihe nhicha ma kpọnwụọ kpamkpam) ma na-agbanye ya ike (mpaghara ngwa ọzọ). A na-ahọrọ dose ahụ n’otu n’otu. Maka ndị ọrịa na-ewerebeghị ọgwụ opiates, ọgwụ izizi bụ 25 μg / h, na ntachi obi maka opiates mgbe ọ na-agbanye na ọgwụgwọ fentanyl, a na-agbakọ ọgwụ mbụ ahụ dabere na tebụl ndị kwekọrọ, dabere na mkpa ịchọrọ nyocha kwa ụbọchị, ma ọ bụrụ na ejiri ihe karịrị 300 μg / h mee ihe, agbakwunye ma ọ bụ uzo ozo nke ochichi.

Omume ọgwụ

Nnyocha ọgwụ ọgwụ, opiate agonist receptor (nke kachasị nke bụ ndị na-anabata ya) nke sistemụ akwara etiti, akwara azụ na akwara akụkụ. Na-abawanye ọrụ nke usoro antinociceptive, na-eme ka ọnụ ụzọ nke mmetụta ihe mgbu dịkwuo elu.

Mmetụta ọgwụgwọ bụ isi nke ọgwụ ahụ bụ ọgwụ na-akụ ọgwụ. O nwere mmetụta na-akụda mmụọ na mpaghara iku ume, na-ebelata mgbatị obi, na-eme ka ogige n.vagus na etiti vomiting, na-eme ka ụda olu dị nro nke biliary tract, sphincters (gụnyere urera, ọnya na sphincter nke Oddi), na-eme ka mmịpụta nke mmiri si na eriri afọ. Na -ebelata ọbara mgbali, motility eriri afọ na usoro ọbara gbasara akwara. N'ime ọbara na-eme ka ịba ụba nke amylase na lipase, belata ịta nke STH, catecholamines, ADH, cortisol, prolactin.

Na-akwalite mmalite nke ụra (tumadi n'ihe banyere iwepụ ihe mgbu). Na-akpata obi ụtọ. Ọnụego mmepe nke ịdabere na ọgwụ na ịnagide ihe mmetụtara nwere nnukwu ọdịiche ndị mmadụ n'otu n'otu.

N'adịghị ka ndị nyocha opioid ndị ọzọ, ọ na-akpatakarị mmeghachi omume histamine.

Mmetụta analgesic kachasị na nchịkwa i.v. na-etolite mgbe minit 3-5, na m / m - mgbe minit 20-30 gasịrị, oge nke ọgwụ ahụ nwere otu nchịkwa i / v ruo 100 mcg bụ 0,5-1 h, yana nchịkwa m / m. dika usoro ogwu ndi ozo - 1-2 elekere, mgbe ị na - eji TTS - 72 awa

Nsonaazụ

Site na usoro iku ume: ọtụtụ oge - nkụda mmụọ, hypoventilation, ruo na njide iku ume.

Site na usoro ụjọ na akwara anụ ahụ: ọtụtụ mgbe - isi ọwụwa, iro ụra (gụnyere n'ime ụmụ amụrụ ọhụrụ), ọ na - adịkarị ala - ịda mba nke sistemụ akwara etiti (gụnyere mgbe a wasịrị ya ahụ), oke nhụjuanya nke sistemụ akwara na-esite, n ’ime mmụọ, ihe ọdịdọ, na - adịkarị ala - nzuzu anya na-ahụ anya, diplopia, nrọ doro anya, mfu ncheta, ugboro ole ejighi - ọgbaghara, ọgbụgba, hallucinations, isi ọwụwa, ọbara mgbali intracranial.

Site na usoro digestive: ọtụtụ oge - ọgbụgbọ, ọgbụgbọ, obere oge - flatulence, spasm nke sphincter nke Oddi, slowing gastric empt, constipation, biliary colic (n'ime ndị ọrịa nwere akụkọ banyere ha).

Site na CCC: ugboro ugboro - bradycardia, iwetulata ọbara mgbada, obere oge - igbochi ọrụ CCC, ruo njide obi.

Site na usoro urinary: spasm nke ureters, njigide nke urinary.

Mmeghachi omume nfụkasị - obere oge - nfụkasị dermatitis, laryngospasm, akpata oyi, pruritus, bronchospasm.

Mmeghachi omume mpaghara (mgbe ị na-eji patch): itching, rashes, flushing of skin (na-apụ n'anya n'ime awa 24 mgbe ewepụsịrị patch), na-ere ọkụ.

Ndị ọzọ: obere oge akwara ike (gụnyere akwara obi), ịsụsọ dị ukwuu, ị drugụ ọgwụ, nrịanrịa azụ (mgbu na-egbu mgbu, afọ ọsịsa, palpitations, rhinitis, sneezing, goose bumps, sweating, anorexia, ọgbụgbọ, ọgbụgbọ, ụjọ, ike ọgwụgwụ). mgbakasị ahụ, ịma jijiji, ụmụ akwụkwọ nwere mmetụta, adịghị ike izugbe), ndidi.

Ntụziaka pụrụ iche

Ekwesịrị iji ọgwụ ndị ọkachamara ruru eru ga-eji ọgwụ ahụ mee ihe. N'ime oge ọrụ, onye ọrịa chọrọ nlezianya nlezianya.

N'ime ndị ọrịa nwere ahụkarịlata oge ha na-arụ ọrụ ogologo oge ma ọ bụ n'ihe metụtara fentanyl ugboro ugboro, mmụba na oge nke omume ya ga-ekwe omume.

Ọ na-abawanye ọrụ nke plasma amylase na lipase n'ihi spasm nke sphincter nke Oddi na mmụba dị na sistemụ biliary (ọmụmụ nke enzymes ndị a kwesịrị ịrụ ma ọtụtụ awa tupu iji fentanyl, ma ọ bụ awa 24 mgbe nchịkwa ya gasịrị).

Nnyocha radionuclide na-akwụsịlata ọhụhụ nke usoro ịba ọcha n'anya site na spasm nke Oddi.

Ọ bụrụ na ọ dị mkpa, nhọpụta nke ọgwụ n’oge a na-enye nwa kwesịrị ịkwụsị inye ụmụ ara.

Ekwesighi iji patch a mee ihe maka nnukwu ihe mgbu ma ọ bụ postoperative mgbu (n'ihi ihe na-agaghị ekwe omume ịhọrọ ọgwụ maka obere oge ọgwụgwọ yana ihe ize ndụ nke hypoventilation), na ụmụ nwanyị nke ịmụ nwa ma chọọ nlezianya na ọrịa ngụgụ na-adịghị ala ala, gụnyere COPD (ikekwe obi ilu nke akụkụ okuku ume), nsụhọ mmụọ, coma, etuto ụbụrụ, bradyarrhythmias, imeju na akụrụ ime, na agadi na nwata.

Mgbe ị na-eji patch ahụ, a na-atụ aro ka ọ ghara ịdọrọ n'akụkụ ọkụ nke mpụga ọkụ (pọọsụ oku, saunas, bath bath, wdg).

N'oge ọgwụgwọ, ịkwesighi itinye aka n'ihe omume dị ize ndụ nke chọrọ nlebara anya na ọsọ nke mmeghachi omume psychomotor.

Mmekorita

Diitrogen oxide na-akwalite agịga akwara, ọgwụ tricyclic antidepressants, opiates, sedative na hypnotics, phenothiazines, ọgwụ anxiolytic (tranquilizer), ọgwụ maka ọgwụ ụfụ izugbe, izu ike akwara, antihistamines, nke nwere mmetụta ogwugwu na probol ndị ọzọ, ethanol. CNS ịda mba, hypoventilation, hypotension arterial, bradycardia, suppression center suppression, wdg).

Na-eme ka mmetụta nke ọgwụ mgbochi oke ọnụ. Ndị na - egbochi ihe belata nwere ike belata ugboro na ịdị njọ nke mmeghachi omume ọbara mgbali elu n'ịwa ahụ (gụnyere sternotomy), mana iwelie ihe egwu bradycardia.

Buprenorphine, nalbuphine, pentazocine, naloxone, naltrexone belata mmetụta analgodi nke fentanyl ma kpochapụ mmetụta ya na mpaghara iku ume.

Benzodiazepines na-eme ogologo oge ntọhapụ nke neuroleptanalgesia.

Ọ dị mkpa iji belata dose nke fentanyl mgbe ị na-eji insulin, corticosteroids, ọgwụ antihypertensive.

Ihe mgbochi MAO na - ebute nsogbu nke nnukwu nsogbu.

Oge izu ike akụrụngwa gbochiri ma ọ bụ wepụ akwara akwara, izu ike akụrụngwa nwere ihe m-anticholinergic (gụnyere pancuronium bromide) belata ihe egwu bradycardia na hypotension (ọkachasị mgbe ejiri beta-egbochi na vasodilators ndị ọzọ) ma nwee ike ịbawanye n'ihe egwu tachycardia, ọbara mgbali myorrheal. nke na - enweghị ọrụ m-anticholinergic (gụnyere suxamethonium) anaghị ebelata ihe ize ndụ nke bradycardia na hypotension (ọkachasị na ndabere nke akụkọ ntolite obi na-ebu ibu) ma bulie ohere nke nnukwu ozi oge mmetụta si CCC.

Mlọ ọgwụ

Fendivia ™ bụ ngwongwo transdermal nke na-eweta fentanyl usoro na-aga n'ihu ruo awa 72. Fentanyl bụ opioid analgesic nwere njikọ dịkarịsịrị maka ndị na-anabata opiate of nke sistemụ akwara etiti, akwara azụ, na akwara akụkụ. Na-abawanye ọrụ nke usoro antinociceptive, na-eme ka ọnụ ụzọ nke mmetụta ihe mgbu dịkwuo elu. Ọgwụ Fendivia ™ nwere mmetụta ọgwụ na-akụjụ ahụ. Fentanyl nwere mmetụta na-akụda mmụọ na mpaghara okuku ume, na-agbada ụda obi, na-eme ka ogige ahụ pụta n.vagus na etiti ọgbụgbọ, na-eme ka ụda olu dị nwayọ nke biliary tract, sphincters (gụnyere urethra, eriri afọ na sphincter nke Oddi), na - eme ka mmịpụta nke mmiri si na mgbaze. Na -ebelata ọbara mgbali, motility eriri afọ na usoro ọbara gbasara akwara. N'ime ọbara na-eme ka ịba ụba nke amylase na lipase, belata ịta STH, catecholamines, ACTH, cortisol, prolactin. Na-akwalite mmalite nke ụra (tumadi n'ihe banyere iwepụ ihe mgbu). Na-akpata obi ụtọ. Ọnụego mmepe nke ịdabere na ọgwụ na ịnagide ihe mmetụtara nwere nnukwu ọdịiche ndị mmadụ n'otu n'otu. Ọ dịkarịghị akpata mmeghachi omume akwara.

Mlọ ọgwụ

Obere opekata mpe nyocha nke fentanyl n'ọbara ọbara na ndị ọrịa na-ejighi ihe nyocha opioid mbụ bụ 0.3-1.5 ng / ml. Ugboro nke mmetụta na-achọghị ka ndị ọrịa dị otú ahụ na-abawanye site na itinye uche nke fentanyl n'ọbara ọbara dị elu karịa 2 ng / ml. Site na mmepe nke ndidi, ma opekata mpe ịche echiche fentanyl na-abawanye uru na ntinye uche nke mmeghachi omume na-adịghị mma.

Egwu. Mgbe emechara nke transdermal patch, ịbawanye fentanyl na ọbara ọbara na-abawanye nwayọ, na-enwekarị ọkwa n’agbata elekere iri na abụọ na iri na anọ, wee nọgide na-adịkarị ka oge elekere nke 72. Site na ntinye nke elekere elekere iri abụọ na asaa nke oghere transdermal, a na-enwetakarị ịcheta fentanyl n'ọbara ọbara, nke na-adịgide n'oge ụdi nke otu ahụ. Theta fentanyl n'ime ọbara bụ etu o si aba na transdermal patch. Mwepu nke fentanyl nwere ike ịdị iche iche dabere na ebe ntinye akwụkwọ. A hụrụ nwetụrụ ntakịrị fentanyl (ihe dị ka 25%) n'ọmụmụ ihe emere ndị ọrụ afọ ofufo dị mma n'oge ntinye nke patị na obi ma e jiri ya tụnyere ngwa dị n'ogwe aka na azụ.

Nkesa. Fentanyl na - ejikọ protein protein plasma site na 84%, gafere BBB, Plasenta na n'ime mmiri ara.

Metabolism. Fentanyl nwere lineet biotransformation kinetics ma metabolized n'ụzọ kachasị na imeju site na enzymes CYP3A4. Ihe bụ isi metabolite nke fentanyl bụ norfentanil, nke anaghị arụ ọrụ.

Ojiji. Mgbe mwepu nke transdermal patch, ịta nke fentanyl na ọbara ọbara na-ebelata nke nta nke nta. Ndi_1/2 fentanyl mgbe etinyere transdermal patch bụ awa 17 (awa iri na anọ ruo elekere iri na anọ) na ndị okenye na awa 22-25 na ụmụaka. Entnọgide na-anabata fentanyl site n'akpụkpọ ahụ akpụkpọ ahụ na-eduga n'ịgwụ nwayọọ iji ọgwụ ahụ si n'ọbara ọbara tụnyere ọchịchị iv. Ihe dị ka 75% nke fentanyl bụ nke a napụrụ na mmamịrị, tumadi n'ụdị metabolites, ihe na-erughị 10% adịghị agbanwe agbanwe, ihe dị ka 9% bụ ndị dị na feces, tumadi n'ụdị metabolites.

Otu Ndị Ọrịa Pụrụ Iche Pụrụ Iche

Ọkpụkpụ na-arụ ọrụ ma ọ bụ ọrụ akụrụ nwere ike ibute mmụba nke ọnụọgụ fentanyl. N'ime ndị agadi, ndị nwere nsogbu, ma ọ bụ ndị nwere nkụda mmụọ, mbelata fentanyl ga-ekwe omume, nke nwere ike ibute T_1/2 fentanyl.

Childrenmụaka. Dabere n’arụ ahụ, idozi (l / h / n'arọ) bụ 82% dị elu n’ime ụmụaka site na afọ 2 ruo 5 na 25% dị elu n’ime ụmụaka site na afọ isii ruo afọ iri ma e jiri ya tụnyere ụmụaka sitere na 11 ruo 16 afọ ndị nwere ụdị ahụ. otu nwechapụ ya na ndị okenye.

Ime na lactation

Emebebeghị nchekwa nke ọrịa transdermal na fentanyl n'oge ime. Ihe omumu banyere umu anumanu ehiputala ihe omimi nke omumu.

Ekwesịrị iji Fentanyl mee ihe n'oge afọ ime ma ọ bụrụ na ọ dị oke mkpa. Iji ogologo oge n'oge afọ ime nwere ike ibute mgbaafọ na ụmụ amụrụ ọhụrụ. O siri ike, enwere ihe mgbaàmà nke mgbapụta azụ na ụmụ amụrụ ọhụrụ ndị nne ha na-ejikarị fentanyl patine n'oge ịtụrụ ime.

Ekwesighi iji Fentanyl mee ihe n'oge oru na nnyefe (tinyere ngalaba cesarean), dikaỌ na - agafe na Plasenta ma nwee ike bute nkụda mmụọ nke nwa ebu n’afọ ma ọ bụ nwa amụrụ ọhụrụ.

Fentanyl na-apụ apụ na mmiri ara ara ma nwee ike ibute nsonaazụ na nkụda mmụọ na nwa a na-enye nwa ara. Yabụ na, ọ bụrụ na ọ dị mkpa, ịhapụ ọgwụ Fendivia ™ n'oge a na-enye nwa ara kwesịrị ịkwụsị inye nwa ara (maka oge niile o jirila ihe na-erughị awa 72 mgbe ojiji ikpeazụ).

Usoro onunu ogwu na nhazi

Ogwe transdermal na-ahapụ fentanyl n'ime awa 72. Ọnụego fentanyl bụ 12.5, 25, 50, 75 na 100 μg / h, nke bụ ihe dịka 0.3, 0.6, 1.2, 1.8 na 2.4 mg / ụbọchị, n'otu n'otu.

A na-ahọrọ usoro ọgwụ chọrọ fentanyl n'otu n'otu, na-eburu n'uche ọnọdụ onye ọrịa ahụ, ekwesịrị ịtụle ya mgbe niile. Ekwesịrị iji usoro ọgwụgwọ kachasị dị ala.

Nhọrọ usoro izizi

A na-ehiwe usoro ọgwụ fentanyl na mbụ dabere na ogo opioid na oge gara aga, yana iburu n'uche mmepe mmepe nke nnabata, ọgwụgwọ ọgwụ, ahụike na ọnọdụ ahụike nke onye ọrịa, i.e. oke ahụ, afọ na ogo ike ọgwụgwụ, ogo ọrịa ahụ.

Ndị okenye buru ụzọ jiri opioids

Iji nyefee ndị ọrịa natara opioids mbụ site na nchịkwa ọnụ ma ọ bụ nke nwere ike ime opioids gaa na transdermal patch, ekwesịrị iji tebụl 1. Ọ bụrụ na ọ dị mkpa, enwere ike ịgbanwe doti ahụ ma ọ bụ gbagoro elu site na 12.5 ma ọ bụ 25 μg / h iji họrọ ntakịrị kachasị dị irè dabere na nzaghachi onye ọrịa na mkpa maka enyemaka mgbu ọzọ.

Ndị okenye anaghị agwọ ọrịa opioids

Dịka iwu, a naghị akwado maka transdermal management maka ndị ọrịa na-anatabeghị opioids. Ekwesịrị ịtụle usoro nchịkwa ọzọ (ọnụ, parenteral). Iji gbochie ịdoụbiga mmanya ókè na ndị ọrịa na-enwetabeghị opioids, a na-atụ aro ka etinyere obere ọgwụ opioids ozugbo (gụnyere morphine, hydromorphone, oxycodone, tramadol na codeine), nke a ga-ahọpụta ka o wee dakọtara na transdermal patch maka mgbu mgbu. na usoro onunu ogwu nke 12.5 ma obu 25 mcg / h. Mgbe nke ahụ gasịrị, ndị ọrịa nwere ike ịgbanwere iji ọgwụ Fendivia ™.

N'ọnọdụ ebe nchịkwa nchịkwa nke opioids agaghị ekwe omume na iji transdermal patch dị ka usoro ọgwụgwọ ọ bụla ga-ekwe omume, iji Fendivia ™ kwesịrị ịmalite iji obere usoro nke 12.5 μg / h. N'ụdị ndị ahụ, achọrọ nlekọta pụrụ iche banyere onye ọrịa.

Enwere ihe ọghọm nke nkụda mmụọ ma ọ bụ na-eyi ndụ egwu ọ bụrụgodị na opekata mpe nke 12.5 μg / h nke Fendivia ™ na-eji ndị ọrịa na-enwetabeghị opioids.

Ntughari site na iwere opioids ndi ozo

Mgbe onye ọrịa na-agbanwe site na ọnụ ma ọ bụ nke na-eme ya nke nchịkwa opioid na ọgwụgwọ fentanyl, a na-agbakọ usoro mbụ nke Fendivia ™ dị ka ndị a.

1) Ekwesịrị ikpebi ọnụọgụ nyocha nke opioid nke onye ọrịa chọrọ n'oge awa 24 gara aga (mg / ụbọchị).

2) A ga-agbanye ego ole anabatara na mkpụrụ ọgwụ kwesiri ekwesi kwa ụbọchị (mg / ụbọchị) na tebụl 1.

A na-ekpebi ogo kwesịrị ekwesị nke fentanyl site na iji tebụl 2 na 3.

Ekwesighi iji tebụl abụọ na nke atọ gbanye site na oghere transdermal gaa na opioids ndị ọzọ iji zere ịkọ oke oke. Nke a nwere ike ime ka ịdoụbiga mmanya ókè.

Tebụl ntụgharị - ọnụọgụ maka ịtụgharị kwa ụbọchị nke opioids ejibu ya na ọgwụ ọnụ kwa ụbọchị ihe nrapụta nke morphine (mg / ụbọchị nke opioid × ọnụọgụ = ọnụọgụ ọgwụ kwa ụbọchị nke morphine)

na Ọrụ nke morphine nke ọnụ ma ọ bụ intramuscularly ji mee ihe na-adabere n'ahụmahụ ụlọ ọgwụ na ndị ọrịa nwere ọrịa mgbu na-adịghị ala ala.

b dabere na nyocha ya na otu nchịkwa i / m nke nyocha opioid ọ bụla edepụtara n'elu, duziri iji gosipụta ọrụ ha na-atụnyere morphine. Usoro onunu ogwu maka onu ghari, bu ogwu ogwu a na-atụ aro ya mgbe a na-agbanwe ya site na parenteral gaa n'uzo onu nke ochichi.

Usoro akwadoro nke Fendivia ™ dabere na onu ogwu ubochi obula nke morphine (maka ndi oria di nkpa na adighi ike ikwusi opioid: ngbanwe nke ngbanwe site na mophine nke ejizi nye ya na ojiji nke fentanyl bu 150: 1)

Usoro akwadoro nke Fendivia ™ dabere na onu ogwu ubochi nke morphine (maka ndi oria torosi ike na ogwugwo opioid nke oma: ihe ntughari nke sitere na mophine nke ejizi ya nye ya bu ihe eji eme ihe bu fentanyl bu 100: 1)

Enwere ike ime nyocha nke mbụ gbasara mmetụta ọgwụ ike Fendivia no tupu oge elekere iri abụọ na anọ gachara. Mmachi a bụ n'ihi eziokwu na mmụba na mkpokọta nke fentanyl n'ọbara ọbara na mbụ n'ime awa iri abụọ na anọ ka itinyechara oghere transdermal pụtara. Yabụ, mgbe ị na-agbanwe site na otu ọgwụ gaa na ọzọ, a ga-akwụsị usoro ọgwụgwọ gara aga iji nwayọ nwayọ mgbe etinyere ọgwụ nke mbụ nke Fendivia ™ ruo mgbe ọ ga-akwụsị ike.

Usoro ntụgharị na usoro ọgwụgwọ mmezi

Ekwesịrị iji dochie transdermal patch ọ bụla na awa 72 ọ bụla.

A na-ahọrọ ogwu ahụ n’otu n’otu rue mgbe oke ogo nke analgesia na nnagide ọgwụ Fendivia ™ ga-enweta. Ọtụtụ mgbe, na oge 1, ọnụọgụ ahụ na-abawanye site na 12.5 ma ọ bụ 25 mcg / h. Agbanyeghị, mgbe ị na-ahazigharị ọnya, ọ dị mkpa iburu n'uche ọnọdụ onye ọrịa na mkpa maka nyocha ọzọ (ọnụ ọgụgụ nke morphine 45 na 90 mg / ụbọchị dị ka usoro nke 12.5 na 25 μg / h nke Fendivia ™, n'otu n'otu). Mgbe ịbawanye usoro ahụ, onye ọrịa ahụ nwere ike ịchọ ihe ruru ụbọchị 6 iji nweta analgesia kwụsiri ike.

Maka nke a, mgbe ịba ụba nke ọgwụ, ọ dị mkpa iji transdermal patch nke usoro ịba ụba ọ dịkarịa ala ugboro abụọ maka awa 72. Naanị mgbe nke a gasịrị, mmụba ọzọ na-esote ga-ekwe omume ma ọ bụrụ na enweghi mgbu mgbu.

Iji mezuo ọnụọgụ karịrị 100 mcg / h, enwere ike iji ọtụtụ patder transdermal n'otu oge. Ọ bụrụ na ihe mgbu na - apụta, oge ụfọdụ ndị ọrịa nwere ike ịchọrọ usoro ọgwụgwọ ọzọ nke na - adịghị adị oge. Ọ bụrụ na usoro Fendivia ™ karịrị 300 mcg / h, ekwesịrị ịchebara echiche iji ma ọ bụ ụzọ ọzọ nke enyemaka mgbu ma ọ bụ ụzọ ọzọ nke nchịkwa nke nyocha nke opioid.

Naanị na mmalite ọgwụgwọ, ọ bụrụ na mgbe itinye ọgwụ mbụ ahụ ka enwere ntakịrị mbelata na mmetụta analgesic, enwere ike dochie patch ahụ mgbe awa 48 jiri otu umi, ma mgbe awa 72 a nwere ike ịbawanye dose ahụ.

Ọ bụrụ na ọ dị mkpa iji dochie oghere transdermal ruo elekere 72 (dịka ọmụmaatụ, ọ bụrụ na ejiri pech si apụ), kwachie otu ọgwụ ahụ ga-adị na mpaghara ọzọ nke anụ ahụ. Ọnọdụ yiri nke ahụ nwere ike ibute mmụba nke fentanyl na plasma ọbara, ya mere onye ọrịa ahụ chọrọ nlekọta anya.

Mgbe ị na-agbanwe site na ọgwụgwọ ogologo oge na morphine gaa na transdermal patch nwere fentanyl, enwere ike ịdọrọ ọrịa nwere ike inwe n'agbanyeghị mmetụta zuru oke. Mgbe akara ngosipụta pụtara, a na-atụ aro ka enye ndị ọrịa morphine dị mkpụmkpụ na obere usoro.

Nkwụsị nke Fendivia ™

Ọ bụrụ na ọ dị mkpa ịkwụsịtụ transdermal patch, mgbe ahụ, ekwesịrị idochi opioids ndị ọzọ nwayọ nwayọ, na-amalite site na obere ala ma jiri nwayọ na-abawanye ya. Nke a bụ n'ihi eziokwu ahụ bụ na ọdịnaya nke fentanyl n'ọbara ọbara mgbe iwepụchara transdermal patch na-agbada nwayọọ nwayọọ. Ọ dịkarịa ala awa 20 iji belata serum fentanyl site na pasent 50. E nwere iwu izugbe: ịkwesịrị iwepụ analgesia na nyocha opioid nke nta nke nta iji gbochie mgbaàmà ndọrọ ego (ọgbụgbọ, ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, nchegbu na akwara egwu).

Jiri ndị ọrịa agadi

Ekwesịrị iji nlezianya nyochaa ma lelee ndị ọrịa agadi. Ọ bụrụ na ọ dị mkpa, a ga-ebelata ọgwụ Fendivia ((lee “Ntuziaka Pụrụ Iche”). N'ime ndị ọrịa katarala ahụ na-enwetabeghị opioids, a ga-eji Fendivia ™ mee ihe naanị ma ọ bụrụ na uru ya karịrị ihe ọ bụla. Dị ka usoro ọgwụgwọ mbụ, naanị 12.5 mcg / h kwesịrị iji.

Jiri na ndị ọrịa nwere nsogbu imeju na akụrụ

Ekwesịrị iji nlezianya nyochaa ndị ọrịa nwere ọrụ imeju na akụrụ ma lelee anya maka ihe nrịbigara nke fentanyl ma, ọ bụrụ na ọ dị mkpa, ekwesịrị belata dose nke Fendivia ™ (lee “Ntuziaka Pụrụ Iche”).

N'ime ndị ọrịa nwere nsogbu imeju na akụrụ na-enwetabeghị opioids, a ga-eji Fendivia ™ mee ihe naanị ma ọ bụrụ na uru ya karịrị akarị. Dị ka usoro ọgwụgwọ mbụ, naanị 12.5 mcg / h kwesịrị iji.

Jiri na ndị ọrịa nwere ọrịa ọkụ / n'okpuru nduzi nke isi mmalite ọkụ

Ndị ọrịa nwere ahụ ọkụ nwere ike ịchọ ndozi nke fentanyl (lee "Ntuziaka Pụrụ Iche").

Jiri na ụmụ 16 afọ ma karịa

Usoro usoro ọgwụgwọ maka ụmụaka gafere afọ 16 yiri usoro usoro onunu ogwu maka ndi okenye.

Jiri na ụmụ si afọ 2 ruo 16

Ekwesịrị iji ọgwụ ahụ Fendivia ™ mee ihe naanị ụmụaka ndị natarala nha nha morphine ọnụ na usoro nke opekata mpe 30 mg / ụbọchị. Mgbe ị na-atụgharị site na nchịkwa ọnụ ma ọ bụ nke nchịkwa nke nyocha opioid gaa na transdermal patch nwere fentanyl na ụmụaka, a na-agbakọ usoro izizi site na iji tebụl 1 na 4.

Usoro akwadoro ịmalite Fendivia ™ maka ụmụaka dị afọ 2 ruo 16 afọ, dabere na ọgwụ ọnụ kwa ụbọchị nke morphine b.

iweghari na doses nke fentanyl karịa 25 mcg / h adịghị iche maka ụmụaka na ndị okenye (lee table 2).

b Na nnwale ụlọ ọgwụ, a na-eji ihe ngosipụta maka ọgwụ ọnụ kwa ụbọchị iji gbakọọ mbufe onye ọrịa na Fendivia ™.

N'ime ihe omumu abuo n’ime umuaka, eji nlezianya gbakọọ usoro ogwu achọrọ transdermal site na 30 ruo 44 mg / ụbọchị nke morphine, ọnụ ma ọ bụ ọnụ ọgụgụ nke ọgwụ opioid ndị ọzọ, dochiri otu transdermal patch na usoro onunu ogwu nke 12.5 μg / h. A na-eji usoro nnyefe a maka ụmụaka naanị mgbe eji dochie morphine ọnụ (ma ọ bụ ihe kwekọrọ na ya) site na ịmachi transdermal. Enweghị ike iji usoro ahụ nyefee site na fentanyl gaa na nyocha ndị ọzọ nke opioid, ebe ọ bụ na n'ọnọdụ a, ịdoụbiga ihe ókè nwere ike ime.

Mmetụta analgesic nke usoro mbụ nke transdermal patch na fentanyl eruteghị oke kachasị mma n'oge awa 24. Nke a mere, n'ime oge awa iri na abụọ mbụ ka ọ gbasịrị ọgwụ Fendivia ™, onye ọrịa ahụ kwesịrị ịnata usoro ọgwụgwọ ndị mbụ. N'ime awa iri na abụọ sochirinụ, a ga-enye ndị ọrịa ọgwụ nyocha dabere na mkpa ọgwụgwọ.

Ebe ọ bụ na ọkwa nke fentanyl dị n'ọbara ruru uru kachasị ya mgbe awa iri abụọ na abụọ gachara, a na-atụ aro ka o lebara ndị ọrịa anya maka ihe ọghọm, nke nwere ike ịgụnye ịda mbà iku ume ma ọ dịkarịa ala 48 awa mgbe ịmalite ọgwụ patder ma ọ bụ mgbe ịbawanye ọgwụ (lee "ntuziaka pụrụ iche") )

Nhọrọ a na-ahọrọ na usoro nlekọta mmezi na ụmụaka site na afọ 2 ruo 16

A ga-eji ntụ ntụ dochie transdermal site na nke ọ bụla n'ime awa 72. A na-ahọrọ ọgwụ ahụ n'otu n'otu ruo mgbe ogo kachasị dị n'ogo analgesia na nnagide ọgwụ Fendivia ™. Ọ bụrụ na analgesicic Fendivia ™ ezughi oke, a ga-enye ọgwụ morphine ma ọ bụ ọgwụ opioid ọzọ dị mkpụmkpụ. Dabere na mkpa ọzọ maka ịkụnwụ ahụ na ogo ihe mgbu nwatakịrị, ịba ụba nke ọgwụ ga-ekwe omume. Ekwesịrị ime mgbanwe nhazi nke nwayọ nwayọ, na mgbakwunye nke 12.5 mcg / h. Ọgwụ ahụ ekwesịghị ịrị elu karịa otu ugboro kwa awa iri abụọ na asaa.

Ekwesịrị itinye ya na transdermal patch ahụ dị larịị ma ọ bụ nke akpataghị anụ ahụ nke ogwe ma ọ bụ ubu. Azụ azụ bụ ebe kacha mma maka itinye transdermal patch na ụmụaka. Site na ngwa a, enwere ike iwepu ohere nke iwepu onwe site na umuaka.

Maka ngwa, a na-atụ aro ịhọrọ ebe nwere obere ntutu (ọkacha mma na-enweghị ntutu). Tupu itinye ntutu isi na ebe a ga-ebipụ ya (emela ntutu). Ọ bụrụ na a ga-asacha ebe a na-achọ ngwa tupu ị na-etinye oghere transdermal, ihe a kwesịrị iji mmiri dị ọcha mee ya. Ejila ncha, lotions, mmanụ, mmanya ma ọ bụ n’ụzọ ndị ọzọ, dị ka ha nwere ike ibute akpukpo aru ma ọ bụ gbanwee akụrụngwa ya. Tupu ngwa ahụ, akpụkpọ ahụ ga-adịrị asị kpamkpam.

Ebe ọ bụ na ihe nkiri mmiri na-echebe mmiri nke transdermal na-echebe ya, enweghị ike wepu ya n'oge obere oge ịsa ahụ.

Wepu ngwongwo transdermal site na ngwugwu ahụ site na ịkụchi akụkụ a ma ama na nso ọnụ aka nke akụ ahụ wee jiri nwayọ na-adọwa ngwugwu ahụ.

Ekwesịrị itinye transdermal patch ahụ ozugbo ewepụrụ ya na ngwugwu ahụ, na-enweghị imetụ akụkụ nrapado ya aka. Mgbe ewepụsịrị ihe nkiri ahụ na-echebe, a ga-eji nkwụchi aka wee tinye ya na ntinye aka ruo ihe dị ka sekọnd iri atọ. Gbaa mbọ hụ na oghere transdermal ahụ siri ike n’akpụkpọ anụ ahụ, ọkachasị n’akụkụ ọnụ ya. Enwere ike ịchọ ndozi ọzọ. Jiri mmiri dị ọcha sachaa aka gị.

Ekwesịrị eyikwasị patch ahụ ruo awa 72, mgbe nke a gasịrị, a ga-eji dochie ya ma ọ bụrụ na ọ ga-eji dochie ya. Ekwesịrị itinye oghere transdermal ọhụrụ na mpaghara ọzọ nke anụ ahụ, ghara ijide ebe ngwa ahụ gara aga. N'otu ebe nke ngwa, enwere ike itinye transdermal patch ọzọ ọzọ tupu mgbe ụbọchị asaa.

Nyochaa transdermal kwachie tupu eji.

A gaghị ekewa ma ọ bụ wedata transdermal patch (lee "Ntuziaka pụrụ iche").

Dodoụbiga ya ókè

Donwebiga ókè nke fentanyl na-egosipụta onwe ya n'ụdị mmụba na mmetụta ọgwụ ya, nke kachasị njọ bụ ịda mbà nke iku ume.

Ọrịa lethargy, coma, nkụda mmụọ nke akụkụ okuku ume na Cheyne-Stokes na-eku ume yana / ma ọ bụ cyanosis. Ihe mgbaàmà ndị ọzọ nwere ike ịgụnye hypothermia, ụda olu na-ebelata, bradycardia, hypotension art art. Ihe ịrịba ama nke egbu egbu gụnyere nnukwu ịgba ume, ataxia, miosis, ụfụ, na nkụda mmụọ.

Ọgwụgwọ: mwepu nke transdermal patch, ochichi nke otu antagonist - naloxone, ahụ ike ma ọ bụ nkwupute mmetụta na onye ọrịa, symptomatic na nkwado nkwado ọrụ dị egwu (gụnyere nchịkwa nke izu ike akwara, ikuku ikuku, na bradycardia - nchịkwa nke atropine, na mbelata ọbara mgbali elu - nwughari nke BCC )

Usoro akwadoro ịmalite maka ndị okenye bụ 0.4-2 mg iv naloxone. Ọ bụrụ na ọ dị mkpa, ịnwere ike inye otu ụdị ọgwụ ahụ kwa nkeji 2-3 ma ọ bụ ịkọpụta ogologo oge nchịkwa nke 2 mg nke naloxone etisasịwo na 500 ml nke sodium chloride 0.9% ma ọ bụ 5% dextrose solution (0.004 mg / ml). Ekwesịrị imeghari ọnụego nchịkwa na-eburu n'uche ihe ndị metụtara mmụọ nke mbụ na mmeghachi omume onye ọrịa.

Ọ bụrụ na agaghị ekwe omume nchịkwa intravenone, mgbe ahụ enwere ike ịnye ọgwụ naloxone intramuscularly ma ọ bụ s / c. Mgbe nchịkwa i / m ma ọ bụ s / c nke naloxone, mmalite nke ime ga-adị nwayọ ma e jiri ya tụnyere nchịkwa i / v. Nlekọta intramuscular na-enye nsonaazụ ogologo karịa nchịkwa ọgbụgba.

Ntugharị nke iku ume n'ihi oke ị mayụbiga mmanya ókè nwere ike ịdịte aka karịa mmetụta nke onye na-emegide opioid. Wepu mmetụta analgesic nwere ike ibute mmụba nke nnukwu ihe mgbu na mwepụta nke catecholamines. Ọ bụrụ na ọ dị mkpa, a ga-agwọ onye ọrịa na ngalaba nlekọta ahụike.

Usoro onunu ogwu:

usoro transdermal ọgwụgwọ (TTC)

Arụ Ọrụ:
Fendivia ™ 12.5 μg / hr: TTC ọ bụla nwere 1.38 mg nke fentanyl na patị 4.2 cm² ma wepụta fentanyl na ọnụego nke 12.5 μg / hr.
Fendivia ™ 25 μg / hr: TTC nke ọ bụla nwere 2.75 mg nke fentanyl na otu 8.4 cm² ma wepụta fentanyl na ọnụego 25 μg / hr.
Fendivia ™ 50 μg / hr: TTC nke ọ bụla nwere 5.50 mg nke fentanyl na otu 16.8 cm² ma wepụta fentanyl na ọnụego 50 ofg / hr.
Fendivia ™ 75 μg / hr: TTC nke ọ bụla nwere 8.25 mg nke fentanyl na otu 25.2 cm² ma wepụta fentanyl na ọnụego nke 75 μg / hr.
Fendivia ™ 100 μg / hr: TTC nke ọ bụla nwere 11.00 mg nke fentanyl na patị 33.6 cm² ma wepụta fentanyl na ọnụego 100 μg / hr.
Ndị e mere:
1) Ihe nkiri nchebe nke:
- ihe nkiri polyethylene terephthalate,
2) Ala mmiri esite:
- akwa oyi akwa silicone,
- dimethicone (E 900),
3) Microreserve nwere ihe eji arụ ọrụ:
- gepropylene glycol,
- hyprolose (E 463),
4) Hapụ akpụkpọ ahụ:
- ethylene na vinyl acetate copolymer,
5) Agba na-arapara oyi akwa:
- akwa oyi akwa silicone,
- dimethicone (E 900),
6) Ihe nkiri iwepu:
- ihe nkiri polyester nwere mkpuchi polymer nwere.

Ogwe akụkụ nwere akụkụ anọ nwere oghere gburugburu nwere ihe nkiri nchebe na-ewepu Ihe nkiri nchebe karịrị patch. Ọkpụkpụ sinusoidal kewara fim na - ewepu ihe na - ewepu ya ụzọ abụọ.
Ejiri aha mmado ndị a gosipụta na ịmachi site na mbipụta agba:
1) Fendivia ™ 12.5 μg / awa, kwachie 18 ± 0,5 mm dum, 24 ± 0,5 mm ogologo:
- "Fentanyl 12.5 μg / awa" - ebipụta agba aja aja,
2) Fendivia ™ 25 μg / h, kwachie 24.6 ± 0,5 mm n'obosara, 37 ± 0,5 mm ogologo:
- "Fentanyl 25 μg / awa" - akwụkwọ mbipụta uhie,
3) Fendivia ™ 50 μg / h, kwachie 34 ± 0,5 mm n'obosara, 51.3 ± 0,5 mm ogologo:
- "Fentanyl 50 μg / awa" - akwụkwọ ndụ akwụkwọ ndụ,
4) Fendivia ™ 75 mcg / h, kwachie 42 ± 0,5 mm n'obosara, 61.7 ± 0,5 mm ogologo:
- "Fentanyl 75 μg / awa" - ebipụta na-acha anụnụ anụnụ,
5) Fendivia ™ 100 μg / awa, kwachie 49 ± 0,5 mm n'obosara, 70 ± 0,5 mm ogologo:
- “Fentanyl 100 μg / awa” - ebipụta agba ntụ.

Ngwongwo ogwu

Mlọ ọgwụ
Fendivia ™ bụ ngwute transdermal nke na-enye usoro fentanyl na-aga n'ihu na awa 72 awa. Fentanyl bụ opioid analgesic nwere mmekọrịta dịkarịsịrị mkpa maka ndị na-anabata opiate of nke sistemụ akwara (CNS), akwara azụ na akwara anụ ahụ. Na-abawanye ọrụ nke usoro antinociceptive, na-eme ka ọnụ ụzọ nke mmetụta ihe mgbu dịkwuo elu. Ọgwụ Fendivia ™ nwere mmetụta ọgwụ na-akụjụ ahụ. Fentanyl nwere mmetụta na-akụda mmụọ na mpaghara iku ume, na-agbada ụda obi, na-eme ka ogige ahụ pụta. Ọkpụkpụ ọgbụgba na ebe ọgbụgbọ na-eto, na -eme ka ụda olu dị nwayọ nke akụkụ biliary, sphincters (gụnyere urethra, eriri afọ na sphincter nke Oddi), na - eme ka mmịpụ mmiri si eriri afọ (GIT). Lowers ọbara mgbali (BP), motility eriri afọ na usoro ọbara gbasara akụrụ.
N'ime ọbara, ọ na-eme ka ịba ụba nke amylase na lipase, belata ịta nke homonụ uto, catecholamines, hormone adrenocorticotropic, cortisol, prolactin. Na-akwalite mmalite nke ụra (tumadi n'ihe banyere iwepụ ihe mgbu). Na-akpata obi ụtọ. Ọnụego mmepe nke ịdabere na ọgwụ na ịnagide ihe mmetụtara nwere nnukwu ọdịiche ndị mmadụ n'otu n'otu. N'adịghị ka nyocha ndị ọzọ nke opioid, ọ na-ebute mmeghachi omume akwara dị obere.

Mlọ ọgwụ
Obere nyocha kachasị dị mma nke fentanyl n'ọbara ọbara na ndị ọrịa na-ejitabeghị ọgwụ opioid mbụ bụ 0.3-1.5 ng / ml. Ugboro nke mmetụta na-achọghị ka ndị ọrịa dị otú ahụ na-abawanye site na itinye uche nke fentanyl n'ọbara ọbara dị elu karịa 2 ng / ml. Site na mmepe nke ndidi, ma opekata mpe ịche echiche fentanyl na-abawanye uru na ntinye uche nke mmeghachi omume na-adịghị mma.
Mwepu: mgbe mbụ ngwa ngwa transdermal patch, ịta fentanyl na ọbara ọbara na-abawanye nwayọ, na-agbadata n’agbata elekere iri na abụọ na iri na anọ, ma na-anọgide n’otu oge maka oge elekere nke 72. Site na ntinye nke elekere elekere iri abụọ na asaa nke oghere transdermal, a na-enwetakarị ịcheta fentanyl n'ọbara ọbara, nke na-adịgide n'oge ụdi nke otu ahụ. Theta fentanyl n'ime ọbara bụ etu o si aba na transdermal patch. Mwepu nke fentanyl nwere ike ịdị iche iche dabere na ebe ntinye akwụkwọ. A hụrụ nwetụrụ obere fentanyl (ihe dị ka 25%) n'ọmụmụ ihe emere ndị ọrụ afọ ofufo dị mma n'oge a na-etinye mmachi ahụ na obi ma e jiri ya tụnyere ngwa dị n'ogwe aka na azụ.
Nkesa: fentanyl na-ejikọ protein protein site na pasent 84%, na-agafe ihe mgbochi ụbụrụ ọbara, Plasenta na n'ime mmiri ara.
Metabolism: fentanyl nwere linear biotransformation kinetics ma metabolized n'ụzọ kachasị na imeju site na enzymes CYP3A4. Ihe bụ isi metabolite nke fentanyl bụ norfentanil, nke anaghị arụ ọrụ.
Dradọrọ: mgbe mwepụ nke transdermal patch, ịta nke fentanyl na ọbara ọbara na-agbadata nke nta nke nta. Ndụ ọkara nke fentanyl mgbe etinyere na transdermal patch bụ awa 17 (awa 13-22) na ndị okenye yana awa 22-25 na ụmụaka. Ptionnọgide na-enweta fentanyl site n'akpụkpọ ahụ na-eme ka mkpụrụ ọgwụ dị nwayọ site n'ọbara ọbara ma e jiri ya tụnyere nchịkwa intravenous.
Ihe dị ka 75% nke fentanyl bụ nke a napụrụ na mmamịrị, ọkachasị n'ụdị metabolites, erughi 10% - agbanweghị. Ihe dị ka 9% dị na feces, tumadi n'ụdị metabolites.
Otu Ndị Ọrịa Pụrụ Iche Pụrụ Iche
Ọkpụkpụ na-arụ ọrụ ma ọ bụ ọrụ akụrụ nwere ike ibute mmụba nke ọnụọgụ fentanyl. N'ime ndị agadi, ndị ọrịa nwere nkụda mmụọ ma ọ bụ nke nwere nkụda mmụọ, mbelata nke fentanyl ga-ekwe omume, nke nwere ike ibute ndụ ogologo fentanyl.
Childrenmụaka
Dabere n’arụ ahụ, nwechapụ (l / h / n'arọ) bụ 82% dị elu na ụmụaka gbara afọ 2 ruo afọ 5 na 25% dị elu karịa ụmụaka gbara afọ 6 ruo 10 ma e jiri ya tụnyere ụmụaka gbara afọ 11 ruo 10 Afọ 16 ndị nwere otu nkọwa dị ka ndị okenye.

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

Ime
Emebebeghị nchekwa nke ọrịa transdermal na fentanyl n'oge ime. Ihe omumu banyere umu anumanu ehiputala ihe omimi nke omumu.
Ekwesịrị iji Fentanyl mee ihe n'oge afọ ime ma ọ bụrụ na ọ dị oke mkpa. Ogologo oge n'oge afọ ime nwere ike ibute "nkwụsị ọrịa" n'ime ụmụ amụrụ ọhụrụ. Ọ dịkarịghị adị, a kọrọ ihe mgbaàmà nke “iwepụ ọrịa” n'ime ụmụ amụrụ ọhụrụ ndị nne ha na-ejikarị fentanyl patịpe na oge ịtụrụ ime.
Ekwesighi iji Fentanyl mee ihe n'oge oru na nnyefe (tinyere ngalaba cesarean), dika Ọ na - agafe na Plasenta ma nwee ike bute nkụda mmụọ nke nwa ebu n’afọ ma ọ bụ nwa amụrụ ọhụrụ.
Ara
Fentanyl na-apụ apụ na mmiri ara ara ma nwee ike ibute nsonaazụ na nkụda mmụọ na nwa a na-enye nwa ara. Yabụ, ọ bụrụ na ọ dị mkpa, ịhapụ ọgwụ Fendivia ™ n'oge a na-enye nwa ara kwesịrị ịkwụsị inye nwa ara (maka oge niile ejiri ya ma ọ dịkarịa ala awa iri abụọ na asaa mgbe ị useụchara ikpeazụ).

Mmetụta akụkụ

A na-enyocha nchekwa nke patdermal na fentanyl na 1565 ndị ​​okenye na ụmụaka 289 ndị sonyere n'ọmụmụ ihe nyocha iri na otu banyere iji ọgwụ eme ihe maka ọgwụgwọ nke mgbu na-adịghị ala ala nke oncological na mkpụrụ ndụ oncological. Ndị ọrịa a natara opekata mpe otu ọgwụ transdermal nwere fentanyl, emesia enyocha nchekwa nke ọgwụ. Dabere na data nchekwa agbakọtara site na ọnwụnwa nke ụlọ ọgwụ, ihe kacha njọ (yana ọnụọgụ opekata mpe 10%) bụ ọgbụgbọ (35.7%), vomiting (23.2%), afọ ntachi (23.1) %), ura (15.0%), dizziness (13.1%) na isi ọwụwa (11.8%).
A na-ekewa mmeghachi omume ojoo dịka oge ihe a siri dị:
Ugboro ugboro (> 1/10)
Ugboro (> 1/100, 1/1000, 1 / 10,000,

Weputara udi ya na ihe mebere ya

A na-atụ aro otu ọgwụ ọgwụ n’ụdị ihe eji agwọ ọnya (nke a na-achịkwa ya na intramuscularly). Na irere ahia, inwere ike ichota transdermal patch. Fentanyl na-arụ ọrụ dị ka ogige na-arụ ọrụ. A na-enye nsụgharị dị iche iche nke ọgwụ ahụ. Usoro onodu ogwu nke aru oru nwere ike di iche (mg): 1.38, 2.75, 5.5, 8.25, 11. Ike nke mwepu nke fentanyl nwekwara ihe di iche (μg / h): 12.5, 25, 50, 75, 100.

Ejiri ihe nkiri kpuchie patchini, nwere ihe ndi ozo na ihe mejuputara:

Jiri nlezianya

Otutu ihe mgbochi ndi eji eme ihe ekwurula:

• ubara mgbali intracranial,
• ọrịa ngụgụ na-adịghị ala ala
• bradyarrhythmia
• ụbụrụ ma ọ bụ ọzịza,
• ọbara mgbali elu
• colic na imeju, akụrụ,
• nguzobe nke nkpuru mbu
• ọrịa thyroid (hypothyroidism),
• ihe mgbu nke abughi nke etiology,
• ọbara mgbali elu anụ ahụ,
• mmụba nke ahụ dị n'ofe oge, nke na-eduga gị kpom kpom (ma atụ, mgbe ị na-eleta sauna),
• mmanya ma ọ bụ ọgwụ ọjọọ riri ahụ,
• ibelata ure nke ure,
• ọnọdụ ikpere onye ọrịa.

Emeputa

LTS Lohmann Usoro Ahụike AG. Lohmannstrasse 2, D-56626, Andernach, Germany. LTS Lohmann Therapie-Systeme AG. Lohmannstrasse, 2, D-56626 Andernach, Germany.

Onye na-ahụ maka akwụkwọ ndebanye aha: Takeda Pharma A / S. Dubendal Alle 10, 2630 Taastrup, Denmark. Takeda Pharma A / S. Dybendal Alle 10, 2630 Taastrup, Denmark.

Ekwesịrị izipu ndị na-azụ ahịa na: Takeda Pharmaceuticals LLC. 119048, Moscow, abụrụ. Usacheva, 2, p.

Tẹ.: (495) 933-55-11, faksị: (495) 502-16-25.

Otu esi eji Fendivia

A na-ekpebi usoro onodu ogwu nke nọ n'ọrụ n'otu n'otu. Ole fentanyl dabere na ọnọdụ onye ọrịa, ọnụnọ / enweghị ahụmịhe ya na mmalite nke ọgwụ analgesics. Mgbe ị na-eji patch ahụ, a na-ehicha ihe dị mpụga ma kpochaa. Ekwesighi iji mmiri mee ihe, mmiri dị ọcha zuru ezu. Okpukpo ekwesighi imebi.

Usoro izizi bụ 12.5 ma ọ bụ 25 mg. Mgbe ahụ ọ na-abawanye na patch ọ bụla. Ọnụ ego kachasị ogologo nke fentanyl bụ 300 mg. Ọ bụrụ na ọ dị mkpa iwelie dose ahụ, tụlee ego n'ụdị mmiri mmiri. Iji zere ihe nrịba ama nke ndọrọ ego, a na-atụ aro ka ị belata nwayọ nwayọ nwayọ.

Esi agbanwe

Ogologo oge eji 1 patch bụ awa 72. Mgbe nke ahụ gasịrị, a na-edochi onye ọzọ. Ọ bụrụ na ọgwụgwọ ahụ adịghị ike, a na-agbanwe ngwaahịa ahụ mgbe awa 48 gachara. Ọzọkwa, a na-etinye patch ọzọ na ebe ọhụrụ. Ọ bụrụ na etinyeghị nkwanye ndụmọdụ a n'uche, ntinye nke fentanyl na-abawanye. N'ime mwepụ a, a ga-ejikọ ya na gburugburu siri ike ma tinye ya.

Enwere ọrịa shuga, enwere ike iji ọgwụ ahụ, mana dịka dọkịta si eduzi ya.

Ọkpụkpụ afọ

Na ọgbụgbọ na-esochi ọgbụgbọ, mgbu nke afọ, mkpọda ọnụnọ, mbelata mgbari, akpịrị akọrọ nke ọnụ. Mgbaàmà nke ihe mgbochi ụbụrụ adịghị adịkarị.

Fta Fendivia nwere ike ibute agụụ.

Mwepụta wepụtara ya na ihe mebere

A na-emepụta ọgwụ ahụ n'ụdị usoro transdermal ọgwụgwọ usoro (TTC): translucent rectangular patch with me gburugburu ọnụ na ihe nkiri nwere ike iwepu, nke dị ukwuu karịa oghere ahụ, a na-ekewa ihe nchebe ahụ ụzọ abụọ site na nsị sinusoidal, ịmachi 12.5 / 25/50 / 75/100 μg / h nwere ogologo 24/37 / 51.3 / 61.7 / 70 mm (± 0,5 mm ọ bụla) na obosara nke 18 / 24.6 / 34/42/49 mm (± 0,5 mm) nke ọ bụla), dị iche iche, a na-etinye aha ndị na-esonụ na patches site na mbipụta agba (dabere na nhapụta nke ihe nọ n'ọrụ): 12.5 μg / h - brown Fentanyl 12.5 μg / awa, 25 μg / h - Fentanyl 25 μg / awa acha ọbara ọbara, 50 μg / h - Fentanyl 50 μg / awa akwụkwọ ndụ akwụkwọ ndụ, 75 μg / h - Fentanyl 75 μg / awa ọkụ na-acha anụnụ anụnụ. , 100 μg / h - Fentanyl 100 μg / awa nke ọ bụla TTS na-etinye na akpa sealable okpomọkụ nke aluminom, akwụkwọ na polyacrylonitrile (PAN), na igbe kaadi 5 akpa na ntuziaka maka iji Fendivia.

Nchikota maka patch 1 (TTC):

• akụrụngwa arụmọrụ: fentanyl, ọdịnaya nke dị na 1 TTC bụ: 1.38, 2.75, 5.5, 8.25 ma ọ bụ 11 mg na patị na ntinye nke 12.5, 25, 50, 75 na 100 μg / h na ebe mpaghara kọntaktị nke 4.2, 8.4, 16.8, 25.2 na 33.6 cm², n'otu n'otu
• ihe nkiri na - ewepu onwe ya: ihe nkiri polyester nwere mkpuchi polymer nwere,
• ihe nkiri dịpụrụ adịpụ: ihe nkiri polyethylene terephthalate (ihe nkiri PET),
• micro tankị, gụnyere akụrụngwa nọ n'ọrụ: hyprolose (E463), dipropylene glycol,
• akwa mmiri / mmiri na-arata: dimethicone (E900), oyi akwa silicone,
• akpụkpọ anụ mgbapụta: copolymer nke vinyl acetate na ethylene.

Jiri n'oge ime na lactation

Edere ọgwụ ahụ, mana dịka ụzọ ikpeazụ. A na-eji ya maka ebumnuche ahụike, mgbe uru dị ukwuu karịa mmerụ ahụ enwere ike. Site na usoro ọgwụgwọ n'oge ime, enwere ihe ize ndụ nke ịmalite ime ndọrọ nwa na nwa mgbe a mụsịrị ya.

Nyere na ogwu abanye n’ime mmiri ara nne ya ma site na Plasenta, ihe omuma nke ibute oria ojoo n’aru nwa ahu di elu.

Jiri na agadi

N'oge ọgwụgwọ, usoro nhichapụ nke fentanyl na-akwụsịlata. Nke a na - eduga n'ịbawanye nwayọ nwayọ na itinye ya. Maka nke a, ekwesịrị inyocha dose ahụ. A kwadoro ọgwụ a maka iji naanị ma ọ bụrụ na uru ya karịrị ihe ọjọọ ahụ. Ọgwụgwọ kwesịrị ibido n ’ọgwụ nke 12.5 mg.

N’oge agadi, a kwadoro ọgwụ ahụ ka ọ jiri naanị ma ọ bụrụ na uru ya karịrị ihe ọjọọ ahụ.

Nyocha banyere Fendivia

Nyochaa nke ndị na - azụ ahịa na ndị ọkachamara ga - enye gị ohere ịme echiche zuru oke banyere ọgwụ.

Danilov I.I., oncologist, 49, Vladivostok

Ngwá ọrụ ahụ na-arụ ọrụ ya - na-ewepụ ihe mgbu. Ihe ọghọm ndị ahụ gụnyere obere ihe a na-eme, ebe ọ bụ na a na - ahapụ fentonil nwayọ: ọ buru ụzọ banye n'ụdị nke njikọ ahụ dị na mpụta naanị naanị n'ime ọbara. N'agbanyeghi udi ya, ogwugwo a nwere ike idi nsogbu n'ihi nsogbu nke usoro ahụ ji alụso ọrịa ọgụ (mmeghachi omume anaphylactoid na-etolite).

Verilova A.A., dọkịta na-awa ahụ, dị afọ 53, St. Petersburg

Ana m eji ọgwụ ahụ eme ihe ugboro ugboro n'ihi ụdị adịghị mma. Ọ na-eme nwayọ. Na mgbakwunye, ọnụ ahịa ahụ dị elu. Ọ bụrụ na anyị na-atụle ihe ndị bụ isi ya, yabụ arụmọrụ nke ọrụ a adịghị ala karịa analogues n'ụdị ndị ọzọ.

Fentanyl kwachie kama ọgwụ

Eugene, gbara afọ 33, Penza

Ọgwụ ahụ dị oke ize ndụ, dịka ọtụtụ opiates. Oge ụfọdụ mgbe ịmalite ọgwụgwọ, ọ kwụsịrị inye aka. Agụrụ m banyere mmepe ga-ekwe omume ịhapụ ihe dị n'ọrụ ahụ, mana echeghị na ọgwụ ọgwụ ọgwụ na-egbu egbu nwere ike ịkwụsị ọrụ ya ngwa ngwa. Ekwesịrị m ịgbanwee gaa na analog.

Veronika, 39 afọ afọ, Moscow

Na oncology, ọ na-enyere aka na-adịghị mma. Mmetụta ahụ dị mkpụmkpụ, mgbe nke a gasịrị ọ dị mkpa ịgbanwe patch ahụ obere oge, nke bụ nsogbu, n'ihi na enweghị ike itinye ya karịa oge 1 n'ime oge 48. Maka nke a, dọkịta ahụ nyere ọgwụ ọzọ.

Fendivia, ntuziaka maka ojiji: usoro na usoro onunu ogwu

A na-eji patịlo Fendivia eme ihe.

A na-ahapụ Fentanyl na ọnụego nke 12.5, 25, 50, 75 ma ọ bụ 100 ,g / h, nke bụ ihe dịka 0.3, 0.6, 1.2, 1.8 ma ọ bụ 2.4 mg kwa ụbọchị, n'otu n'otu.

A na-ekpebi usoro onunu ogwu n’otu n’otu, dabere n’ọnọdụ onye ọrịa ahụ, ekwesịrị inyocha ya mgbe ọ bụla ọ gachara. Ọ dị mkpa itinye ntakịrị opekempe.

A na-atụ aro ịmachi nwere fentanyl ka ọ dị na anụ ahụ dị larịị ma ọ bụ n'osisi akpachapụghị anya. Mụaka kwesịrị ịrapara ya n’elu azụ ha iji belata ihe ize ndụ nke iwepu onwe ha.

Ekwesịrị iji ntutu dị kacha nta họrọ saịtị maka ngwa ahụ. Tupu itinye TTS n'ọrụ, a ga-ebipụ ntutu dị na ntinye akwụkwọ ahụ (na-enweghị ịkpụ afụ ọnụ). Ọ bụrụ na ọ dị mkpa ịsa ebe ngwa tupu ịmịchaa kwachie, a ga-eji mmiri dị ọcha mee nke a. Ekwesighi iji lotions, ncha, mmanya, mmanụ ma ọ bụ ngwaahịa ndị ọzọ akwadoro, n'ihi na ha nwere ike ibute iwe anụ ahụ ma ọ bụ ịgbanwe mgbanwe na akụrụngwa ya. Tupu usoro a, akpụkpọ ahụ kwesịrị nkụ kpamkpam. Ebe ọ bụ na ekpuchichara ihe mkpuchi mmiri kpuchie patch, ị gaghị ewepụ ya na obere mmiri.

Ozugbo i wepụsịrị patch ahụ na akpa ahụ okpomoku ma wepu ihe na - enye nchebe, tụnye ya n’ahu n’akpa na-ejighi aka n ’ịkwụkwụ n’akụkụ ma jiri aka gị pịa ebe ngwa ahụ dị ihe dị ka sekọnd iri atọ. TTS kwesịrị dabara akpụkpọ ahụ, karịchaa akụkụ ya, ọ bụrụ na ọ dị mkpa, dozie ya ọzọ, wee jiri mmiri dị ọcha sachaa aka gị.

Emebere Fendivia maka iji ya rụọ ọrụ ruo awa 72. Achọrọ ntinye ọhụụ mgbe niile ka etinye ya na mpaghara akpụkpọ ahụ, na-ejighị ebe ngwa ahụ gara aga. Gluu ịmachi na otu saịtị ahụ nwere ike ikwugharị mbụ tupu mgbe ụbọchị asaa gasịrị.

E guzobere usoro mbụ na-eburu n'uche ogo ogo opioid na oge dị n'ihu ọgwụgwọ Fendivia, ihe ize ndụ nke ịmalite inwe ndidi, ịnabata ọgwụgwọ na ọgwụ ndị ọzọ, ahụike nke onye ọrịa yana ọnọdụ ahụike ya, afọ, ogo ahụ, ogo ahụ ike, ogo ike ọgwụgwụ na ogo ọnya ahụ.

Ọrịa ndị opioids emebeghị ka ejiri opioids mee ka ọ bụrụ ndị a tụrụ aro ka ụzọ transdermal ha si eme ihe, na nke a, ị kwesịrị ị na-amalite iji ọnụ na nchịkwa ọgwụ. Iji gbochie ịdoụbiga mmanya ókè, ha kwesịrị iji ọgwụ opioids ndị dị ala (nke gụnyere tramadol, oxycodone, hydromorphone, morphine, na codeine) dị ala. A choro itinye uzo onodu ogwu ndi okenye n’uzo di otua, dika odi n’enye ntuzi aka, odi ka 12.5 / 25 μg / h nke Fendivia. N'ọdịnihu, ndị ọrịa nwere ike ịmegharị ntụgharị maka iji transdermal patch.

N'ihe banyere mgbe a na-egbochi ọgwụ nchịkwa nke opioids ma ọ bụ na-anabataghị ya, a na-ahụkwa na iji ọgwụ TTC bụ naanị usoro ọgwụgwọ nwere ike, ọ dị mkpa ịmalite iji ọgwụgwọ dị ala - 12.5 μg / h.

Mgbe ị na-agbanye na ojiji nke transdermal patch, maka onye ọrịa nke jiri opioids nke ọnụ / parenteral na oge gara aga, ọ dị mkpa iji gosipụta ego nke analgesics opioid natara na mbụ, nke ọ chọrọ n'ime awa 24 gara aga (mg / ụbọchị). A ga-atụgharịrị maka ihe a ga-atụgharị na ọnụego ọgwụ kwa ụbọchị nke morphine (mg / ụbọchị) na-eji ọnụọgụ kwesịrị ekwesị.

A na-ehiwe nha ọgwụ morphine na-eme site na ịba ụba nke ọgwụ opioid site na ihe ndị a (opioid na-emebu na mg / ụbọchị e coefficient) ejirila na-emepụtaghachi kwa ụbọchị maka nchịkwa ọnụ / nchịkwa:

• morphine - 1 a / 3,
• fentanyl - - / 300,
• codeine - 0.15 / 0.23 b,
• diamondphine - 0,5 / 6 b,
• ketobemidone - 1/3,
• hydromorphone - 4/20 b,
• levorphanol - 7.5 / 15 b,
• oxycodone - 1.5 / 3,
• pethidine - - / 0.4 b,
• tramadol - 0.25 / 0.3,
• tapentadol - 0.4 / -,,
• methadone - 1.5 / 3 b.

a - ọrụ nke morphine nwetara ọnụ ma ọ bụ intramuscularly (IM) dabere na ahụmịhe ụlọọgwụ na ndị ọrịa nwere ọrịa mgbu na-adịghị ala ala.

b - dabere na nsonaazụ nke ọmụmụ enwetara na otu ọgwụ intramuscular nke ọgwụ ọ bụla n'ime ọgwụ ndị a iji chọpụta ọrụ ibe ha ma e jiri ya tụnyere morphine, ọgwụ ọnụ bụ usoro onunu ogwu a na-atụ aro mgbe ị na-agbanwe site na parenteral gaa n'ụzọ nke nchịkwa.

Establishedtọ usoro izizi nke fentanyl na-ehibe dabere na nrị kwa ụbọchị nke morphine.

Maka ndị okenye nọ n'ụlọ ọgwụ na-akwụsighị ike nke chọrọ opioid nnọchi, mgbanwe a na-esote site na mkpụrụ ọgwụ morphine kwa ụbọchị gaa na transdermal fentanyl na-atụ aro na ntụgharị ntụgharị nke 150 ÷ ​​1 morphine (mg / ụbọchị) - fentanyl (μg / h):

• erughị 90 - 12.5,
• 90–134 – 25,
• 135–224 – 50,
• 225–314 – 75,
• 315–404 – 100,
• 405–494 – 125,
• 495–584 – 150,
• 585–674 – 175,
• 675–764 – 200,
• 765–854 – 225,
• 855–944 – 250,
• 945–1034 – 275,
• 1035–1124 – 300.

Maka ndị ọrịa toro eto na-anara ọgwụgwọ a na-ekwenye nke ọma na opioids, mgbanwe a na-esote site na mkpụrụ ọgwụ morphine kwa ụbọchị gaa na transdermal fentanyl na ntughari nke 100 ÷ 1 morphine (mg / ụbọchị) - fentanyl (μg / h):

• erughị 44 - 12.5,
• 45–89 – 25,
• 90–149 – 50,
• 150–209 – 75,
• 210–269 – 100,
• 270–329 – 125,
• 330–389 – 150,
• 390–449 – 175,
• 450–509 – 200,
• 510–569 – 225,
• 570–629 – 250,
• 630–689 – 275,
• 690–749 – 300.

Ekwesịrị ime nyocha nyocha izizi kachasị nke Fendivia tupu oge elekere iri abụọ na anọ gachara. Ihe kpatara mmachi a bụ mmụba nwayọọ nwayọọ na mkpokọta nke fentanyl n'ọbara ọbara mbụ n'ime awa iri abụọ na anọ ka etinyechara patch ahụ. N'ihi nke a, n'oge mgbanwe site na otu ọgwụ ọgwụ na nke ọzọ, a ga-akwụsị ọgwụgwọ nke gara aga nwayọ nwayọ, mgbe etinyere usoro mbụ nke fentanyl wee ruo na nkwụsi ike nke mmetụta ya.

A ga-eji TTC dochie ya ọhụrụ kwa awa iri abụọ na asaa. A na-eme otu ụzọ n'ụzọ iri nke mmezi ya iche iche ruo mgbe enwetara ọkwa zuru oke, na-eburu n'uche ịnabata ọgwụ ahụ. Dịka iwu, enwere ike ịbawanye dose ahụ n'otu oge site na 12.5 ma ọ bụ 25 μg / h, dabere n'ọnọdụ onye ọrịa yana mkpa nyocha ọzọ (ọnụ ọgụgụ morphine na doses nke 45 na 90 mg / ụbọchị dị ka Fendivia na usoro nke 12.5 na 25 μg / h, n'otu n'otu). Nnukwu analgesia nwere ike ime ụbọchị 6 mgbe ịbawanye ọgwụ a. Yabụ, mgbe ịhazigharịrị ọnya, ọ ga-achọ iji mgbakwunye usoro onunu ogwu ọ dịkarịa ala ugboro abụọ maka awa 72, ma naanị, ọ bụrụ na ọ dị mkpa, mee ka ọ nwekwuo mmụba

Iji mepụta dose karịrị 100 μg / h, a na-ahapụ ka ịmee ka ọtụtụ ihe eji eme ihe. Mgbe ihe mgbu na-apụta, ọ nwere ike ịdị mkpa ịkọwa usoro ọzọ nke nyocha ngwa ngwa. Mgbe ị na-eji Fendivia na ọgwụ karịrị 300 μg / h, ọ dị mkpa ịtụle ohere nke iji ọgwụ ndị ọzọ / ndị ọzọ na-ahụ ihe mgbu ma ọ bụ ụzọ nke isi nye nchịkwa opioid.

Na nmalite usoro ọgwụgwọ, ma ọ bụrụ na ọnụ ọgụgụ dị ukwuu na mmetụta analgesic gasịrị mgbe etinyere ọgwụ nke mbụ, mgbe awa 48 gasịrị ị nwere ike dochie patch ahụ, ma mgbe awa 72 gasịrị, enwere ike ịbawanye dose ahụ.

Ọ bụrụ na patch achọpụtaghị ma ọ bụ na ọ dị mkpa iji dochie ya maka ihe ọzọ tupu awa iri abụọ na asaa agafee, enwere ike ịmachi ebe ọzọ nke anụahụ. N'okwu a, a ga-eji nlezianya nyochaa ọnọdụ onye ọrịa ahụ, n'ihi ihe ize ndụ nke mmụba na mkpokọta plasma nke ọgwụ.

Na ngbanwe ndabere nke ntụgharị sitere na ọgwụgwọ ogologo oge na morphine gaa na ọgwụgwọ na transdermal patch, syndrome syndrome nwere ike ịmalite, ọbụlagodi na enwere ike nyocha zuru oke. Ọ bụrụ na nsogbu a bidoro, a na-atụ aro ka ị gaa n’ihu na-a morụ ọgwụ morphine dị mkpụmkpụ n’usoro dị ala.

Ọ bụrụ na ọ dị mkpa ịkwụsị ọgwụ na transdermal patch, a ga-eji ntụ ntụ ndị ọzọ dochie ya, na-amalite site na obere ala, n'ihi nkwụsịlata ngwa ngwa serum fentanyl mgbe iwepu patch na iyi egwu nke ndọrọ ndọrọ. Iji belata mkpokọta fentanyl n'ime ọbara site na 50%, opekata mpe 17 ka achọrọ.

N'ime ụmụaka na ndị nọ n'afọ 2 ruo afọ 16, Fendivia nwere ike iji ya naanị n'ọnọdụ ndị ọrịa ewerelarịrị ọgwụ ọnụ na ọnụọgụ (na ọnụọgụ opekata mpe 30 mg / ụbọchị). Mgbe ị na-agbanwe site na iji ọgwụ ọnụ na / parenteral nke nyocha opioid gaa na patent nwere fentanyl, a na-agbakọ usoro mbụ n'ime ụmụaka dabere na ọnụ kwa ụbọchị nke morphine. Fendivia na dose nke 12.5 na 25 μg / h bụ morphine na ọgwụ ọnụ nke 30-444 na 45–134 mg / ụbọchị, n'otu n'otu. Ntugharị na ụmụaka iji fentanyl na usoro onunu ogwu karịrị 25 μg / h adịghị iche na nke ndị ọrịa okenye.

Site na otu transdermal patch nke 12.5 μg / h, naanị morphine nwere ike dochie ya mgbe a na -ewere ya ọnụ na 30-444 mg / ụbọchị ma ọ bụ nyocha ndị ọzọ opioid na nha anya. Agaghị enwe ike iji atụmatụ a bufee ụmụaka site na iji fentanyl gaa na nyocha ndị ọzọ nke opioid n'ihi nrịdị ọ bụla.

Ebe ọ bụ na mmetụta nke mmalite nke ịmịchi ahụ n'oge awa 24 mbụ eruteghị ọkwa zuru oke, mgbe ọ gbanwechara ọgwụgwọ Fendivia, ụmụaka kwesịrị ịnata analgesics gara aga na ọnụego mbụ. N'ime awa iri na abụọ sochirinụ, enwere ike iji ọgwụ nyocha mee ihe mgbe ọ dị mkpa. A na-edobe ọgwụ ahụ n'otu n'otu, mgbe ịmalite ọgwụgwọ, a ga-eji dochie patch ahụ na nke ọ bụla n'ime awa iri abụọ na asaa ọ bụla. Ọ bụrụ na ịkwesịrị ịbawanye dose ahụ, a na-arụ ọrụ mgbazi ya na ụmụaka nwayọ nwayọ, na mmụba nke 12.5 μg / h, na-enweghị ịba ụba karịa oge 1 na 72 awa. Maka ezughi oke nke ihe nyocha, enwere ike iji morphine ma ọ bụ ihe opioid analgesic na-eme obere oge enwere ike.

Ime na lactation

Data adịghị akwado nchekwa nke Fendivia n'oge afọ ime adịghị. Ka omumu akwukwo banyere umu anumanu, ekpughere oria mmuo. Iji transentmal patins na fentanyl na-eme ogologo oge n'oge afọ ime nwere ike ịkpalite mpụta nke ọrịa nkwụghachi n'ime ụmụ amụrụ ọhụrụ. Edekọ akụkọ dị iche iche gbasara ihe mgbaàmà nke ọrịa a na ụmụ amụrụ ọhụrụ ndị nne ha na-ejikarị TTC mgbe ha dị ime.

A na-anabata iji fentanyl n'oge afọ ime naanị n'ọnọdụ mberede. Achọghị Fendivia maka ojiji n'oge ọrụ na nnyefe (gụnyere site na akụkụ akwara), ebe ọgwụ ahụ na-abanye na Plasenta ma nwee ike ibute ume iku ume n’akpa nwa / amụrụ.

Achọpụtara ọgwụ a na mmiri ara ara ma nwee ike bute nkụda mmụọ na ịgba ume na nwa a na-enye nwa ara. Na njikọ a, ọ bụrụ na ọ dị mkpa iji Fendivia n'oge a na-enye ya ara, ọ dị mkpa ịkwụsịtụ inye nwa (maka oge niile ejiri ya, yana oge dịkarịa ala, awa 72 mgbe ngwa ikpeazụ ahụ gasịrị).

Jiri na nwata

A na - egbochi ọgwụ iji TTC n'ime ụmụaka na - erubeghị afọ abụọ, ebe ọ nweghị data na - egosi na nchekwa na arụmọrụ nke ọgwụgwọ. A na-atụ aro ka ndị dị afọ iri na isii gboo usoro ọgwụ dosing yiri nke ndị ọrịa okenye.

Ekwesịrị inye Fendivia ụmụaka karịa afọ abụọ na-anatabeghị ọgwụgwọ nke ọgwụ opioid. Iji ọgwụ ahụ ga-ekwe omume naanị ma ọ bụrụ na ụmụaka nwere nnabata opioid. Biko mara na ihe egwu nwere ike ịda mbà ma ọ bụ daa mbà na iku ume iku ume iku ume iku umere dị n'agbanyeghị oke anabatara. A na-atụ aro ka o nyochaa ndị ọrịa maka mmepe nke ihe ọghọm ọbụlagodi awa iri anọ na asatọ ka ebidochara ọgwụgwọ ma ọ bụ mgbe ịbawanye ọgwụ.

Mgbe ị na-ahọrọ saịtị nke ngwa ahụ, ekwesịrị ịkpachara anya ma jiri nlezianya lelee otú patchin si glued iji gbochie ya ilo mmiri na mberede.

Site na ịrụ ọrụ ọrụ imeju

Ebe ọ bụ na mgbanwe metabolic nke fentanyl na-adị na imeju, na ọnụnọ ọrụ ịba ọcha n'anya, mbelata nke mbelata ya ga-ekwe omume.

N'ihi ọghọm nke ịdoụbiga mmanya ókè nke arụ ọrụ dị adị, a ga-enyocha ndị ọrịa n'oge ọgwụgwọ. Ọ bụrụ na ọ dị mkpa, ịbelata ọgwụ fentanyl nwere ike ịchọ.

Ọgwụ mbụ nke Fendivia ekwesịghị gafere 12.5 mcg / h.

Mkparịta ụka ọgwụ ọjọọ

• usoro nke barbituric acid: ihe ọghọm nke nkụda mmụọ na-aka njọ, ihe a na-egbochi ọgwụ,
• ndị na-egbochi cytochrome P450 3A4 (CYP3A4) - nefazodone, nelfinavir, erythromycin, voriconazole, fluconazole, clarithromycin, ketoconazole, ritonavir, itraconazole, cimetidine, verapamil, ọkwa dị elu na-abawanye, na amiodarone na-abawanye, na-amụba n'ọbara, na-abawanye na ọbara, na-amụba n'ọbara, mee ihe, ma na-emekwa ka ohere nke mmeghachi omume dị njọ ghara ịba uru, gụnyere nnukwu ịda mbà n'obi. Achọrọ iji nyochaa onye ọrịa ahụ ma, ọ bụrụ na ọ dị mkpa, belata dose nke fentanyl ma ọ bụ kwụsị iji ya, na enweghị nlezianya anya, zere ọgwụ a jikọtara ọnụ. Oge dị n'etiti nkwụsị nke ọgwụgwọ na ndị na - egbochi CYP3A4 yana ngwa mbụ nke ịmachi ahụ kwesịrị ịbụ opekata mpe, 48,
• Ihe omumu nke CYP3A4 - phenobarbital, carbamazepine, rifampicin, phenytoin: ntinye nke fentanyl na plasma na-ebelata ma aria aru ike ya, n'ihi nke enwere ike idozi uzo. Nchikota a choro nlebara anya puru iche. Ọ bụrụ na akagbuola ọgwụgwọ conquitant na CYP3A4 inducer, ọ nwere ike ịdị mkpa iji belata ọgwụ fentanyl ma nyochaa onye ọrịa,
• Ihe mgbochi CNS - ọgwụ izugbe, ọgwụ opioids ndị ọzọ, hypnotics na mgbochi, phenothiazine dị iche iche, izu ike akwara, mgbakasị ahụ, mmanya, antihistamines nwere mmetụta dị jụụ: mmetụ ọgwụ mgbochi nwere ike ịmalite, hypotension, hypoventilation, sedative / coma nwere ike ime, kpachara anya. na-elele ọnọdụ ahụ
• ọgwụ serotonergic - nhọrọ nke serotonin reuptake inhibitors (SSRIs), serotonin na noradrenaline reuptake inhibitors (SSRIs), ndị na-egbochi MAO: a dịghị atụ aro ngwakọta a n'ihi egwu nke ịmalite ọrịa serotonin. Mgbe ejikọtara ya na MAO, mmụba na nsonaazụ ọgwụ narcotic dịkwa ekwe omume,
• nalbuphine, buprenorphine, pentazocine: mmetụta nke analgesic na-esighi ike, mgbapu ọrịa nwere ike ịdapụta na ndị ọrịa nwere ịdabere na opioid, a naghị atụ aro nkwonkwo ahụ,
• ntụsara ahụ akwara nwere vagolytic na-arụ ọrụ (gụnyere pancronium bromide): a na-ebelata ihe ize ndụ nke hypotension na bradycardia (ọkachasị mgbe ị na-eji beta-blockers na vasodilata ndị ọzọ) na egwu nke ọbara mgbali elu na tachycardia na-aka njọ,
• ntụsara ahụ akwara nke anaghị egosipụta ọrụ vagolytic (succinylcholine): ihe ọghọm nke ajọ ọrịa si na CCC na-aka njọ, ihe egwu bradycardia na hypotension (ọkachasị na akụkọ gbasara ike na-esighi ike) anaghị ebelata.