Etu esi eji ọgwụ Saroten eme ihe?

3- (10,11-dihydro-5H-dibenzo)a, d nkpagbu-5-ylidene) -N, N dimethylpropane-1-amine hydrochloride

Usoro onunu ogwu:

ogologo ndụ ihe capsules.

Ihe eji arụ ọrụ - amitriptyline hydrochloride 56.55 mg (nke kwekọrọ na 50 mg nke amitriptyline).

Ndị pụrụ iche - sugar spheres 123.074 mg, stearic acid 0.123 mg, shellac (shellac nke na-emeghị mkpụ) 8.480-14.140 mg, talcum 16.016-29.610 mg, povidone 0.724-1.086 mg.

Ngwakọta nke Capsule efu - gelatin 65.0 mg, iron dye oxide red (E 172) 0.98 mg, titanium dioxide (E 171) 0.33 mg.

ike, gelatin capsules, opaque, ahu na mkpuchi uhie-aja aja. Kapsule nno Nke 2.

Ọdịnaya nke Capsule - pellets site na ọ fọrọ nke nta ọcha ruo odo.

Ngwongwo ogwu

Amitriptyline bụ ọgwụ mgbochi tricyclic. Amitriptyline bụ amine nke obere ụlọ ọrụ, nwere ebe etiti n'etiti antidepressants tricyclic, ebe ọ bụ na ọ dị ihe ọ bụla na vivo dị ka onye na - egbochi mbido serotonin na norepinephrine site na njide akwara. Ihe bụ isi metabolite nke compound northriptyline bụ ihe dịtụ ike na-egbochi norepinephrine uptake, mana ọ na-egbochikwa ịroụ mmiri serotonin. Amitriptyline nwere anticholinergic siri ike, ihe antihistaminergic na ọgwụ na-akụjụ ahụ na-enwekwa mmetụta nke catecholamines.

A na-ahụta mmachi nke usoro ịrahụ ụra na-efe efe (BDG) bụ akara nke ọrụ antidepressant. Ihe mgbochi Tricyclic antidepressants, yana nhọrọ serotonin na MAOI reuptake inhibitors, na-ebelata oge BDH ma na-akwalite ụra miri emi.

Amitriptyline na-eme ka ọnọdụ uche mmadụ belata.

N'ihi mmetụta ogwugwo ya, amitriptyline dị ezigbo mkpa na ọgwụgwọ nke ịda mbà n'obi, na-esochi nchegbu, mkpasu iwe, nchekasị na nsogbu ụra.

Mmetụta analgesic nke ọgwụ ahụ esoghị na ọgwụ antidepressant, ebe ọ bụ na analgesia na - amalite n'oge tupu mgbanwe ọnọdụ ọ bụla, yana oge ị takingụ ọgwụ dị ala karịa oge ọ dị mkpa iji hụ na mgbanwe ọnọdụ.

Ọ ga - ekwe omume ịgwọta enctis enuresis nke ọma.

Orkpachara anya Nchịkwa nke ọgwụ ọgwụ na mbadamba ụrọ na-ekpebi mmezu nke ogo kachasị n'ọbara ọbara mgbe ihe dị ka elekere anọ nke 4 (t _max = 3.89 ± 1.87 awa, awa 1.03-7.98). Mgbe iwere 50 mg, uru nke C _max = 30.95 ± 9.61 ng / ml, nso 10.85-45.70 ng / ml (111.57 ± 34.64 nmol / L, nso 39.06-164, 52 nmol / L). Gburugburu bioavailability ọnụ bụ 53% (F _abiaghi = 0.527 ± 0.123, nso 0.219-0.756). Nkesa. Njikọ protein protein Plasma bụ ihe dịka 95%. Amitriptyline na isi metabolite ya - northriptyline - na-abanye n'ihe mgbochi placental. Metabolism. Amitriptyline metabolism na-adịkarị site na demethylation (CYP2C19, CYP3A) na hydroxylation (CYP2D6), na-esochi conjugation na glucuronic acid. Ọzọkwa, metabolism bụ ihe e jiri mara polymorphism kpebisiri ike. Ihe bụ isi metabolite bụ arụmọrụ nke abụọ nke amine northriptyline. Nortriptyline bụ ihe dị ike nke na-egbochi norepinephrine ọfụma karịa serotonin, ebe amitriptyline na-egbochi ihe ịga nke ọma nke neurotransmitters abụọ. Amalitere metabolites (cis na trans-10-hydroxyamitriptyline, yana cis na trans-10-hydroxyinortriptyline) site na profaịlụ kwekọrọ na nke northriptyline, nwere ikike dị obere. Demethylnortriptyline na amitriptyline-N-oxide dị na plasma ọbara naanị na obere, ihe nke ikpeazụ bụ enweghị ọrụ.

Nkpuru obi uto putara ihe na mmamiri. Mmepụta amitriptyline akụrụ na-agbanweghi site na akụrụ bụ nke akpachaghị anya (ihe dịka 2%).

N'ime ndị nne na-enye ụmụ ara, amitriptyline na northriptyline na-abanye na mmiri ara ara obere obere. Oke nke ntinye uche na mmiri ara ehi na ọbara ọbara n’ime ụmụ nwanyị bụ 1: 2. Ego ole a na-eme atụmatụ kwa ụbọchị (amitriptyline + northriptyline) nke enyere ụmụaka aka bụ ihe dịka 2% nke ọgwụ amitriptyline nne, na-emetụta oke ahụ nwata ahụ (na mg / n'arọ).

A na-enweta ọkwa ngụkọta nke plasma nke amitriptyline na northriptyline n'ọtụtụ ndị ọrịa n'ime otu izu. Na steeti a, ọkwa dị na plasma ọbara n'oge ụbọchị dị ka amitriptyline na northriptyline mgbe a na-eji mbadamba ụrọ eme ihe ugboro atọ n'ụbọchị.

Ndị ọrịa agadi nwere ogologo ndụ ọkara karịa n'ihi metabolism ike dị ala.

Mbibi nke imeju nke otu nsogbu nwere ike belata ịmị hepatic, nke na-eduga n'ịba ụba ọgwụ ahụ na plasma ọbara.

Mkpesa ntaramahụhụ anaghị emetụta kinetics nke ọgwụ.

Polymorphism. Metabolism nke ọgwụ na-adabere na mkpụrụ ndụ ihe nketa polymorphism (isoenzymes CYP2D6 na CYP2C19). Pharmacokinetic / mmekọrịta mmekọrịta. Nlekọta plasma ọgwụgwọ maka nnukwu nsogbu ọgbụgba bụ 100-250 ng / ml (≈370-925 nmol / l) (ọnụ na amitriptyline na northriptyline).

Obi mgbawa dị ukwuu, ọkachasị na njirimara njirimara nke nchegbu, nsogbu, na nsogbu ihi ụra.

Ọnọdụ ịda mbà n'obi ndị ọrịa nwere ọrịa schizophrenia na ọgwụ mgbochi iji gbochie iwe ọkụ na -akasị onwe ya na nkụda mmụọ.

Ọrịa mgbu na-adịghị ala ala.

Nocturnal na-ahụ maka enweghị ọnya na - efe efe.

Ihe ngbanwe

Hypersensitivity na amitriptyline ma ọ bụ ihe ọ bụla mejupụtara ọgwụ ahụ.

Na nso nso a tara ahụhụ myocardial infarction. Hydị ụdị mgbochi ọ bụla ma ọ bụ ọrịa obi, yana akwara ozi akwara.

N’otu oge a na-eji MAOI (MAO inhibitors) emekọrịta ihe (lee Nkebi “Mmekọrịta na ọgwụ ndị ọzọ na ụdị mmekọrịta ndị ọzọ”).

Nlekọta oge nke amitriptyline na MAOI nwere ike ime ka mmepe nke ọrịa serotonin (njikọta nke mgbaàmà, nke nwere ike ịgụnye mkpịsị ụjọ, ọgba aghara, oke ụjọ, myoclonus na hyperthermia).

Ọgwụgwọ na amitriptyline nwere ike ibido ụbọchị iri na anọ ka ịkwụsị ọrụ MAOI ndị na-abụghị nke mkparịta ụka, yana agaghị erukwa ụbọchị 1 mgbe iwepụ ọgwụ ọgwụ moclobemide na selegiline.

Ọgwụgwọ iji MAOI nwere ike ịmalite ụbọchị iri na anọ mgbe ị kwụsịrị amitriptyline.

Mmekọrịta ya na ọgwụ ọgwụ ndị ọzọ na ụdị mmekọrịta ndị ọzọ

MA inhibitors (nke na-abụghị nhọrọ, yana ịhọrọ A moclobemide na B selegiline) - ihe egwu nke "ọrịa serotonin" (lee mpaghara "Contraindications").

Sympathomimetics: amitriptyline nwere ike ịkwalite mmetụta nke adrenaline, ephedrine, isoprenaline, norepinephrine, phenylephrine na phenylpropanolamine.

Ihe mgbochi Adrenergic neuron: ọgwụ tricyclic antidepressants nwere ike igbochi mmetụta antihypertensive nke guanethidine, betanidine, reserpine, clonidine, na methyldopa.

Anticholinergics: tricyclic antidepressants na-enwe ike ịkwalite nsonaazụ nke ọgwụ ndị dị otú ahụ na anya, etiti ụjọ usoro, eriri afọ na eriri, ojiji ha n'otu oge maka ihe ize ndụ ka ukwuu nke mgbochi mkpọnwụ, hyperpyrexia kwesịrị izere.

Ọgwụ ndị na-eme ka ogologo oge nke oge QT nke elektrorokiograf, gụnyere ọgwụ antiarrhythmic (quinidine), antihistamines (astemizole na terfenadine), ụfọdụ ọgwụ antipsychotic (akpan akpan pimozide na sertindole), cisapride, halofantrine na sotalol nwere ike ime ka onodu nke ventric nke na ọgwụ tricyclic antidepressants.

Ndị ọrụ antifungal, dị ka fluconazole na terbinafine, na-abawanye mkpokọta nke antidepressants tricyclic dị n'ọbara ọbara yana ogo ogo nke egbu egbu. Enweela ikpe banyere nkụda mmụọ na arrhythmias dịka mkpochapụ azụ.

Ngwakọta chọrọ nlekọta pụrụ iche

CNS depressants: amitriptyline nwere ike ịkwalite mmetụta nke ị ofụ mmanya na-egbu egbu, barbiturates, na nkụda mmụọ ndị ọzọ.

Mmetụta nke ọgwụ ndị ọzọ na pharmacokinetics nke antidepressants tricyclic

A na - ahụ ọgwụ mgbochi Tricyclic, gụnyere amitriptyline, site na imeju cytochrome P450 isoenzyme CYP2D6. CYP2D6 bụ ihe e ji mara polymorphism na arụ ọrụ ya nwere ike ịkwụsị ya site na ọtụtụ psychotropic yana ọgwụ ndị ọzọ, dị ka antipsychotics, serotonin reuptake inhibitors with citalopram (nke bụ inhibitor isoenzyme dị ike), blo-adrenergic blockers, yana ọgwụ antiarrhythmic . Ndị nọpụrụ iche bụ CYP2C19 na CYP3A so na metabolism nke amitriptyline.

Barbiturates, dị ka ọgwụ enzyme ndị ọzọ, rifampicin na carbamazepine, nwere ike ịkwalite metabolism ma si otú ahụ mee ka mbelata ọdịnaya nke tricyclic antidepressants na plasma ọbara na mbelata mmetụta antidepressant.

Cimetidine na methylphenidate, yana nkwadebe nke ndị na-egbochi calcium channel, na-abawanye ọkwa nke tricyclic ogige na plasma ọbara na nsonaazụ kwekọrọ.

Ọgwụ antidepressants na antipsychotics na - egbochi metabolism nke ibe ha, nke a nwere ike ibute mbelata mbido ma ọdị nbi.

Ndị ọrụ Antifungal dị ka fluconazole na terbinafine mụbara ọkwa ọbara nke amitriptyline na northriptyline. Na ọnụnọ ethanol, nnuku plasma efu nke amitriptyline na nchịkọta nke northriptyline mụbara.

Njirimara ngwa

Ekwesighi iji ọgwụ amitriptyline dekọọ oge ahụ na ndị na - egbochi MAO (lee Nkebi "Contraindications" na "Mmekọrịta na ọgwụ ndị ọzọ na ụdị mmekọrịta ndị ọzọ").

Mgbe ị na-a doụ ọgwụ ọ highụ highụ ọgwụ dị elu, ohere nke ịmalite inwe obi ọgbụgba obi nwere oke mgbali elu. Mmepe nke ọnọdụ ndị dị otú ahụ kwere omume site na iji nke usoro onunu ogwu na ndị ọrịa nwere ọrịa obi dị adị.

Ekwesịrị iji usoro amitriptyline debe ndị ọrịa nwere nkwarụ, njide urinary, prostatic hypertrophy, hyperthyroidism, na ọnụnọ nke mgbaàmà paranoid, yana ọrịa imeju ma ọ bụ ọrịa obi.

E jikọtara obi ịda mba na ihe nwere ike igbu onwe ya. Ihe iyi egwu dị otú a nwere ike ịdị ruo mgbe a ga-enweta mgbaghara kwụsiri ike wee bilite n'oge oge ọgwụgwọ. N'ihi mmelite nwere ike ọgaghị eme n'ime izu ole na ole mbụ ọgwụgwọ ma ọ bụ ogologo oge, a ga-enyocha ndị ọrịa anya ruo mgbe mgbanwe dị otú ahụ bilitere. Site na ahụmịhe ụlọọgwụ n'ozuzu ya, amaara na ọghọm mmadụ igbu onwe ya nwere ike ịbawanye na mbido mgbake. Ndị ọrịa nwere akụkọ banyere igbu onwe ha ma ọ bụ nwee nnukwu echiche nke igbu onwe ha tupu amata na ha nwere nnukwu ihe egwu ma ọ bụ nwara igbu onwe ha, na ha kwesịrị ịnata nsochi n'oge ọgwụgwọ. Ntụle meta nke nyocha ọgwụ ahụhụ na-emegide mmụọ nke ndị ọrịa okenye nwere ọrịa uche gosipụtara nnukwu ohere nke omume igbu onwe ya na antidepressants ma e jiri ya tụnyere placebo na ndị ọrịa na-erubeghị afọ 25.

Achọrọ nlebara anya kachasị mkpa mgbe ị na-edepụta ndị amitriptyline na ndị ọrịa nwere hyperthyroidism ma ọ bụ ndị na-ewere nkwadebe homonụ thyroid, ebe ọ bụ na mmepe nke cardhyac arrhythmias kwere omume.

Ndị ọrịa agadi nwere ike ịnwe ike nke uto hypotension n'oge ọgwụgwọ na amitriptyline.

N'ime ndị ọrịa na-arịa ọrịa ịda mbà n'obi manic, mgbanwe nke ọrịa ahụ na usoro manic ga-ekwe omume, site na mmalite nke usoro manic nke ọrịa onye ọrịa ahụ, ekwesịrị ịkwụsị usoro amitriptyline.

Mgbe ị na-eji amitriptyline maka akụrụngwa nke schizophrenia, mmụba nke mgbaàmà psychotic ga-ekwe omume. Ekwesịrị iji ọgwụ amitriptyline tinye ya na ọgwụ mgbochi.

N'ime ndị ọrịa nwere ọnọdụ dị omimi na akụkụ dị warara nke ihu ihu, ọgụ nke nnukwu glaucoma n'ihi mbibi nwa akwụkwọ ga-ekwe omume.

Iji ọgwụ a na-egbu egbu n’oge ọgwụgwọ ya na ọgwụ mgbochi atọ / tetracyclic nwere ike ịbawanye ohere nke arrhythmias na hypotension. Ọ bụrụ na ọ ga - ekwe omume, kwusi iji amitriptyline ụbọchị ole na ole tupu ịwa ahụ. Ọ bụrụ n’ịwa ahụike mberede, enweghị ike ịkọwa onye na-agwọ ọgwụ banyere ọgwụ amitriptyline.

Dị ka ọgwụ ọgwụ psychotropic ndị ọzọ, amitriptyline nwere ike ịgbanwe mmetụta anụ ahụ na insulin na glucose, nke chọrọ mgbazi nke ọgwụgwọ antidiabetic na ndị ọrịa nwere ọrịa mellitus. Na mgbakwunye, ọrịa ịda mbà n'obi, n'ezie, nwere ike gosipụta onwe ya na mgbanwe na nguzozi glucose ahụ n'ahụ onye ọrịa.

A kọwo banyere ọrịa hyperpyrexia na iji ọgwụ tricyclic antidepressants na oge atọrọ n'otu oge na ọgwụ anticholinergic ma ọ bụ ọgwụ antipsychotic, karịsịa na ihu igwe na-ekpo ọkụ.

Esskwụsị ọgwụgwọ ozugbo ọgwụgwọ ogologo oge nwere ike ibute mgbaàmà nke ụdị isi ọwụwa, ụkwara, ehighị ụra na iwe.

Ekwesịrị iji amitriptyline jiri nlezianya mee ihe na ndị ọrịa na-ewere SSRI.

Ndị e mere: mbadamba ọgwụ ọgwụ nwere lactose monohydrate. Ndị ọrịa nwere ọrịa akụrụngwa na-adịghị ahụkebe n'ụdị anya nke galactose, ụkọ lactase ma ọ bụ malabsorption nke glucose-galactose ekwesịghị ị thisụ ọgwụ a.

Jiri n'oge ime na lactation

Amitriptyline ekwesighi ka edee ya n’oge afọ ime, ọ gwụla ma uru a tụrụ anya ya na onye ọrịa agaghị agafe n’ihu ihe nwa ebu n’afọ. Nlekọta nke oke ọgwụ mgbochi tricyclic antidepressants n'oge ọnwa atọ nke afọ ime nwere ike ibute nsogbu neurovascular na ụmụ ọhụrụ. N'ime ụmụ amụrụ ọhụrụ, dịka akụkọ si kwuo, ọ bụ naanị nsogbu amitriptyline na njigide urinary ka emere ka esi amata na ọ ga-eme ka ọ pụta ìhè na ọ ga - eme ka amịpụta nke ugwu ahụ ma ọ bụrụ na enyere ya ọgwụ ka ọ dịrị ụmụ nwanyị dị ime tupu ịmụ nwa.

Ọgwụ ahụ na-abanye n'ime mmiri ara ara n'ọtụtụ dị ala, yabụ, nsonaazụ ya na nwa ahụ mgbe ị na-a theụ usoro ọgwụgwọ adịghị ele anya. Ọgwụ nwatakịrị ahụ natara dị ihe dị ka 2% nke ọgwụ nne, na-ezo aka nha nwatakịrị ahụ (na mg / n'arọ). Ọ bụrụ na ọ dị mkpa na ahụike, a ka nwere ike ịga n'ihu na-a breastụ ara n'oge amitriptyline, mana a na-atụ aro ilekọta nwa ahụ, ọkachasị na izu anọ izizi ịmụ nwa.

Ihe ngosi maka ojiji

Obi erughị ala (ọkachasị na nchekasị, oke iwe, na nsogbu ịrahụ ụra, gụnyerena nwata, endogenous, na-ekwe, na-emeghachi omume, neurotic, ọgwụ, na mbibi ụbụrụ Organic, mwepụ mmanya), psychosis schizophrenic, nsogbu mmetụta uche, mgbakasị omume (ọrụ na nlebara anya), nocturnal enuresis (belụsọ ndị ọrịa nwere hypotension), bulimia nervosa, ọrịa mgbu na-adịghị ala ala (mgbu na-adịghị ala ala na ndị ọrịa cancer, migraine, ọrịa rheumatic, mgbu ihu ihu, postherpetic neuralgia, post-traumatic neuropathy ia, ọrịa mamịrị ma ọ bụ ọrịa neuropathy akụkụ ọzọ, isi ọwụwa, migraine (mgbochi), ọnya afọ na duodenum.

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

N'ime, na-enweghị ata ata, ozugbo ị risịrị nri (iji belata iwe nke mucosa gastric). Ọgwụ nke mbụ maka ndị okenye bụ 25-50 mg n'abalị, mgbe ahụ, a na-abawanye dose ahụ karịa ụbọchị 5-6 ruo 150-200 mg / ụbọchị na usoro atọ (a na-ewere akụkụ kachasị nke ọgwụ n'abalị). Ọ bụrụ na enweghị mmezi n’ime izu abụọ, a na-abawanye ọgwụ kwa ụbọchị ruo 300 mg. Ọ bụrụ na ihe ịrịba ama nke ịda mbà n’obi na-apụ n'anya, a na-ebelata ọgwụ ahụ ka ọ gaa na 50-100 mg / ụbọchị ma a na-aga n'ihu ọgwụgwọ maka ọnwa 3. N’oge agadi, na-enwe nsogbu dị nro, a na-atụ aro ọgwụ nke 30-100 mg / ụbọchị (n’abalị), mgbe ha rutesịrị ọgwụgwọ ahụ, ha na-agbanye na nke kacha nta dị irè - 25-50 mg / ụbọchị.

Intramuscularly ma ọ bụ iv (gbanyere ya nwayọ nwayọ) na dose nke 20-40 mg 4 ugboro kwa ụbọchị, jiri nwayọ dochie ya site na ingestion. Oge ọgwụgwọ agaghị ihe karịrị ọnwa 6-8.

Na nocturnal enuresis na ụmụ 6-10 dị afọ - 10-20 mg / ụbọchị n’abalị, 11-16 afọ - 25-50 mg / ụbọchị.

Asmụaka dị ka ọgwụ mgbochi: site na afọ isii ruo afọ iri na abụọ - 10-30 mg ma ọ bụ 1-5 mg / kg / ụbọchị na-esochi afọ iri na ụma - 10 mg ugboro atọ n'ụbọchị (ọ bụrụ na ọ dị mkpa, ruo 100 mg / ụbọchị).

Maka mgbochi nke migraine, yana mgbu na-adịghị ala ala nke ọdịdị akwara neurogenic (gụnyere isi ọwụwa ogologo oge) - site na 12.5-25 ruo 100 mg / ụbọchị (a na-ewere ọgwụ kachasị n'abalị n'abalị).

Omume ọgwụ

Antidepressant (tricyclic antidepressant). O nwekwara ụfọdụ analgesic (isi mmalite), H2-histamine-igbochi na ọgwụ antiserotonin, na - enyere aka wepu mgbatị ụra abalị ma belata agụụ.

O nwere oke anticholinergic siri ike na etiti anticholinergic, n'ihi ịdị n'otu dị elu maka ndị na-anabata m-cholinergic, mmetụta siri ike na-egbochi ọgbụgba metụtara njikọta maka ndị na-anabata H1-histamine, yana mmetụta mgbochi igbochi Alfa-adrenergic. O nwere njirimara nke ọgwụ antiarrhythmic nke subgroup Ia, dị ka quinidine na usoro ọgwụgwọ, na-agbada usoro ventricular (ma ọ bụrụ na ị doụbiga ya ókè, ọ nwere ike ime ka mgbochi intraventricular siri ike).

Usoro nke mmegide antidepressant nwere ihe jikọrọ ya na mmụba nke ịhapụ norepinephrine na synapses na / ma ọ bụ serotonin na sistemụ akwara dị ala (mbelata ihe ngbanwe ha). Nchịkọta nke ndị a neurotransmitters ndị a na - aputa ihe site na ihe mgbochi nke mkpochasị nke ọghọm nke mkpụrụedịịkịkị nke ikuku. Site na iji ogologo oge, ọ na-ebelata ọrụ ọrụ nke beta-adrenergic na ndị na-anabata serotonin na ụbụrụ, na-eme ka nnyefe adrenergic na serotonergic, ma na-eweghachi nguzozi nke usoro ndị a, nke na-agbagha na steeti ndị na-akụda mmụọ. Na steeti na-enwe nkụda mmụọ, ọ na-ebelata nchekasị, obi mgbawa na mgbaàmà nke obi mgbawa.

Usoro nke ihe mgbochi antiulcer bụ n'ihi ikike igbochi ndị na-anabata H2-histamine na mkpụrụ ndụ parietal, yana inwe ọgwụ na - egbochi ọgwụ na m-anticholinergic (ma ọ bụrụ na ọnya afọ na ọnya duodenal, ọ na - ebelata ihe mgbu ma na - eme ngwa ngwa ọnya ọnya).

Izi ezi nke ịkwa akwa bụ n'ihi ọrụ anticholinergic, na-eduga n'ịbawanye ike nke eriri afọ iji gbatịa, mkpali beta-adrenergic, ọrụ nke alfa-adrenergic agonists, tinyere mmụba nke ụda sphincter, yana mgbochi mgbochi nke serotonin.

O nwere mmetụta analgesic etiti, nke a kwenyere na ọ bụ n'ihi mgbanwe na mkpokọta nke monoamines na sistemụ akwara, karịsịa serotonin, yana mmetụta na sistemụ opioid endogenous.

Usoro nke bulimia nervosa edoghị anya (nwere ike ịdị ka nke ahụ maka ịda mbà n'obi). E gosipụtara mmetụta dị iche iche nke ọgwụ ọjọọ na bulimia na ndị ọrịa na-enweghị ịda mbà n'obi yana ọnụnọ ya, ebe enwere ike ịhụ mbelata nke bulimia na-enweghị nkụda mmụọ na-akụda mmụọ n'onwe ya.

Mgbe ị na - eme mgbatị akwara, ọ na - agbada ọbara mgbali elu na okpomoku. Ọ naghị egbochi MAO.

Mmetụta ọgwụ antidepressant na - etolite n'ime izu 2-3 mgbe mmalite nke iji.

Nsonaazụ

Anticholinergic utịp: ọhụhụ nrị, ọnya ụlọ, mydriasis, ịbawanye intraocular mgbali (naanị n’ime mmadụ nwere nsogbu anụ ahụ - akụkụ dị warara nke ụlọ ihu), tachycardia, akpọnwụ akpọnwụ, ọgba aghara, ọgba aghara ma ọ bụ nkwụchi, afọ ntachi, ahụ mkpọnwụ nke eriri afọ, nsogbu urinating belatara ịchafụ.

Site na usoro ụjọ ahụ: iro ụra, asthenia, nkụda mmụọ, nchekasị, nchekasị, ihe ndọghachi azụ (ọkachasị na ndị agadi agadi na ndị ọrịa nwere oria Parkinson), nchekasị, mkparị, ụjọ moto, steeti manic, steeti hypomanic, ime ihe ike, ncheta nchekasị, iwepụta echiche , ụba ịda mba, belata ikike itinye uche, ura ụra, nrọ "nrọ abalị", mkpọtụ, asthenia, mmegharị nke ihe mgbaàmà nke psychosis, isi ọwụwa, myoclonus, dysarthria, shoor. Igwe mọzụlụ, karịsịa ogwe aka, aka, na isi-ire, elu neuropathy (paresthesia), myasthenia gravis, myoclonus, ataxia, extrapyramidal syndrome, osooso na intensification nke ọdụdọ, Lee agbanwe.

Site na CCC: tachycardia, palpitations, dizziness, orthostatic hypotension, ECG mgbanwe na-enweghị isi (etiti oge ma ọ bụ ebili mmiri T) na ndị ọrịa na-enweghị ọrịa obi, arrhythmia, lability ọbara (belata ma ọ bụ na-amụba ọbara mgbali), nsogbu na-enweghị atụ intraventricular conduction (mgbasawanye nke ihe mgbagwoju anya. QRS, mgbanwe na etiti PQ, ihe mgbochi nke ukwu nke ukwu nke Ya).

Site na usoro nri: ọgbụgbọ, ọrịa ịba ọcha n'anya (gụnyere ọrụ imeju na cholestatic jaundice), obi mgbu, ọgbụgbọ, gastralgia, iri nri na ahuhu ma ọ bụ belata agụụ na ahụ gị, stomatitis, mgbanwe uto, afọ ọsịsa, ire nke ọchịchịrị.

Site na usoro endocrine: mmụba na nha (edema) nke testicles, gynecomastia, mmụba na nha nke mammary glands, galactorrhea, mbelata ma ọ bụ mmụba nke libido, mbelata ikike, hypo- ma ọ bụ hyperglycemia, hyponatremia (mbelata nke mmepụta vasopressin), enweghị omimi nke ADH.

Site na akụkụ ahụ na hemopoietic: agranulocytosis, leukopenia, thrombocytopenia, purpura, eosinophilia.

Mmeghachi omume nfụkasị ahụ: ọnya anụ ahụ, itching nke anụ ahụ, urticaria, onyonyo afọ, ọzịza nke ihu na ire.

Ihe ozo: ntutu isi, tinnitus, edema, hyperpyrexia, lymph nodes swollen, njide nke urinary, pollakiuria, hypoproteinemia.

Mwepu mgbapu: na mwepu mberede mgbe agbatịchara ọgwụgwọ - ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, isi ọwụwa, ịba, nsogbu ịrahụ ụra, nrọ na-adịghị ahụkebe, mgbagha nwayọ, na iwepụ nwayọ nwayọ mgbe ọgwụgwọ ogologo oge - mgbakasị ahụ, nchekasị ụgbọ ala, ọgba aghara ụra, nrọ na-enweghị atụ.

E guzobebeghị njikọ ya na nchịkwa ọgwụ: ọrịa lupus dị ka ọrịa (ọrịa ogbu na nkwonkwo, ọdịdị nke mgbochi antinuclear na ihe dị mma nke rheumatoid), ọrụ imeju na-arụ ọrụ, afọ ndụ.

Mmeghachi omume mpaghara maka nchịkwa iv: thrombophlebitis, lymphangitis, na-enwu ọkụ, mmeghachi ahụ anụ ahụ. Ọrịa Site n'akụkụ nke sistemụ akwara: ụra, nzuzu, coma, ataxia, hallucinations, ụjọ, ụjọ psychomotor, belatara ike itinye uche, mgbakasị, ọgba aghara, dysarthria, hyperreflexia, isi ike, choreoathetosis, ọrịa akwụkwụ.

Na akụkụ nke CCC: mgbada ọbara ọgbụgba, tachycardia, arrhythmia, oke intracardiac conduction, mgbanwe ECG (ọkachasị QRS), ujo, nkụchi obi, njirimara nke ị intoụbiga ihe ọ antụ antụ na-akpata tricyclic antidepressant, ujo, nkụda obi, n'ọnọdụ ndị a na-adịghị ahụkebe.

Ndị ọzọ: ịda mba iku ume, mkpụmkpụ nke iku ume, cyanosis, vomiting, hyperthermia, mydriasis, sweating mụbara, oliguria or anuria.

Mgbaàmà na-etolite 4 awa mgbe ịdoụbiga ya ókè, rute oke mgbe awa 24 gachara ụbọchị anọ gara aga. Ọ bụrụ na a na-enyo nfefere oke, ọkachasị ụmụaka, onye ọrịa kwesịrị ịga ụlọ ọgwụ.

Ọgwụ: site na nchịkwa ọnụ: nchịkwa eriri afọ, nchịkwa nke unyi na-arụ ọrụ, usoro ọgwụgwọ na usoro nkwado, na-enwe mmetụta anticholinergic siri ike (mbelata ọbara mgbali, arrhythmias, coma, myoclonic seizures) - nchịkwa nke cholinesterase inhibitors (a naghị atụ aro physostigmine n'ihi ohere dị ukwuu nke ọdụdọ. ), ịnọgide na-enwe ọbara mgbali na nguzo mmiri-electrolyte. E gosipụtara njikwa nke ọrụ CCC (gụnyere ECG) maka ụbọchị 5 (nlọghachi nwere ike ime n'ime awa 48 ma ọ bụ mgbe e mesịrị), ọgwụgwọ anticonvulsant, ikuku ikuku, na usoro nhachi ọzọ. Ọrịa akụrụngwa na akwara dialsis anaghị arụ ọrụ.

Ntụziaka pụrụ iche

Tupu ịmalite ọgwụgwọ, njikwa ọbara mgbali dị mkpa (na ndị ọrịa nwere ọbara mgbali elu ma ọ bụ labile, ọ nwere ike ibelata ọbụna karịa), n'oge ọgwụgwọ, njikwa ọbara nwere oke (n'ọnọdụ ụfọdụ, agranulocytosis nwere ike ịmalite, ya mere ọ na-atụ aro ka nyochaa ọbara ọbara, karịsịa na mụbara ahụ ọkụ, mmepe nke ụdị ihe mgbaàmà na ọnya mgbu), na usoro ọgwụgwọ ogologo oge - njikwa ọrụ nke CVS na imeju. N'ime ndị agadi na ndị ọrịa nwere ọrịa CCC, njikwa ọnụego obi, ọbara mgbali elu, egosi ECG. Mgbanwe ndị na-enweghị isi na-esite na ECG nwere ike ịpụta na ECG (smoothing of the T wave, depression of the S-T, mgbasa nke QRS complex).

Iji Parenteral mee ihe ga-ekwe omume naanị n'ụlọ ọgwụ, n'okpuru nlekọta nke dọkịta, yana izu ike n'ụbọchị mbụ nke ọgwụgwọ.

Achọrọ ịkpachara anya mgbe na-enweghị ike ịkwaga na ọnọdụ kwụ ọtọ site na ọnọdụ ụgha ma ọ bụ ọdụ.

N'oge ọgwụgwọ, ekwesịrị ịhapụ ethanol.

Nyefee ihe na-erughị ụbọchị iri na anọ ka ịlaghachite ndị na - egbochi MAO, na - amalite site na obere usoro.

Site na ịkwụsị nchịkwa na mberede mgbe ọgwụgwọ ogologo oge, mmepe nke ọrịa "ndọrọpụ" enwere ike.

Amitriptyline na usoro onyonyo dị elu karịa 150 mg / ụbọchị na-ebelata ọnụ ụzọ nke nhịahụ (ihe egwu nke ọrịa ọdịdọ na ndị ọrịa a na-eche echiche, yana ọnụnọ nke ihe ndị ọzọ na-ekwupụta ihe kpatara ọnya, dịka ọmụmaatụ, mmebi ụbụrụ nke etiology ọ bụla, ebe ojiji nke ọgwụ antipsychotic (antipsychotics). n'oge a na-ajụ ethanol ma ọ bụ wepụ ọgwụ ọgwụ nwere ihe anticonvulsant, dị ka benzodiazepines).

Ihe eji amata oke nsogbu nke igbu onwe ya, nke nwere ike idigide rue mgbe nwetere mgbaghara dị mkpa. N'akụkụ a, na mmalite ọgwụgwọ, enwere ike igosipụta nchikota ya na ọgwụ sitere na benzodiazepine ma ọ bụ ọgwụ antipsychotic na nlekọta ahụike mgbe niile (na-agwa ndị ọrụ tụkwasịrị obi ịchekwa ma nye ọgwụ).

N'ime ndị ọrịa nwere nsogbu ọgbụgba cyclic, n'oge oge ịda mbà n'obi, ọnọdụ manic ma ọ bụ hypomanic nwere ike ịmalite n'oge usoro ọgwụgwọ (mbelata dose ma ọ bụ mwepụ ọgwụ na ndenye ọgwụ ọgwụ antipsychotic dị mkpa). Mgbe ịkwụsị ọnọdụ ndị a, ọ bụrụ na enwere ihe ngosi, enwere ike ịmaliteghachi ọgwụgwọ na obere doses.

N'ihi mmetụta ọrịa obi nwere ike ịdị, achọrọ ịkpachara anya mgbe ị na-agwọ ndị ọrịa thyrotoxicosis ma ọ bụ ndị ọrịa na-anata ọgwụ homonụ.

Na mgbakwunye na usoro elektrokovulsive, a na-enye ya ọgwụ naanị nlezianya na-ahụ maka nlekọta ahụike.

N'ime ndị ọrịa a na-atụ anya ya na ndị ọrịa meworo agadi, ọ nwere ike ịkpasu mmepe nke psychoses ọgwụ, tumadi n'abalị (mgbe ịkwụsị ọgwụ ahụ, ha na-apụ n'anya n'ime ụbọchị ole na ole).

O nwere ike ibute ihe mgbochi afọ na-eme mkpagharị, ọkachasị n’etiti ndị ọrịa nwere afọ mgbu, ndị agadi ma ọ bụ ndị ọrịa a na-amanye ka ha hie ụra.

Tupu ịme anesthesia izugbe ma ọ bụ mpaghara, ekwesịrị ịdọ aka ná ntị onye ọrịa ọgwụ ọgwụ na onye ọrịa na-ewere amitriptyline.

N'ihi ihe anticholinergic, mbelata nke lacrimation na mmụba nke oke nke imi na nchịkọta nke lacrimal ọ ga-ekwe omume, nke nwere ike ibute mmebi nke epithelium corneal na ndị ọrịa na-eji lenses kọntaktị.

Site na iji ogologo oge, a na-abawanye na ihe omume nke ezé caries hụrụ. Enwere ike ịbawanye mkpa maka riboflavin.

Ọmụmụ banyere omumu nke ụmụ anụmanụ kpughere mmetụta dị njọ na nwa ebu n’afọ, na enwebeghị ọmụmụ ihe zuru oke ma na-achịkwa nke ọma n’ime ụmụ nwanyị dị ime. N'ime ụmụ nwanyị dị ime, a ga-eji ọgwụ ahụ naanị ma ọ bụrụ na ebumnuche ebumnuche ya na nne ya karịrị akarị n'ihe nwa ebu n’afọ.

Ọ bara n’ime mmiri ara ara nwere ike bute ụra n’etiti ụmụ ọhụrụ.

Iji zere mmepe nke ọrịa "ndọrọpụ" na ụmụ amụrụ ọhụrụ (emere ka ọ pụta ìhè na mkpụmkpụ ume, nkụda mmụọ, eriri afọ, mgbakasị ahụ erughị ala, hypotension ma ọ bụ ọbara mgbali, oke ma ọ bụ spastic phenomena), a ga-eji nwayọọ nwayọọ kagbuo amitriptyline opekata mpe izu asaa tupu amụọ nwa.

Aremụaka na-ahụkarị maka oke ị toụ oke, nke ekwesiri ilebara anya dị ize ndụ ma nwee ike igbu ha.

N'oge usoro ọgwụgwọ, a ga-akpachara anya mgbe ị na-anya ụgbọ ala ma na-eme ihe ndị ọzọ nwere ike ịdị ize ndụ chọrọ mgbanye uche na ọsọ nke mmeghachi omume psychomotor.

Jiri nlezianya

Ọrịa ọgbụgba, ọnya ụkwara, hyperplasia prostatic, imeju siri ike ma ọ bụ ọrịa obi, hyperfunction thyroid, ihe mgbaàmà isi ọwụwa, ọgbụgba na-emetụta ọnya (mgbe ọ nwesịrị usoro ịda mba), ọbara mgbali intraocular (n'ime ndị nwere nsogbu anụ ahụ - akụkụ dị warara

ọnụ ụlọ), ọgbụgbọ na-egbu egbu, mgbochi nke ụmị ọkpụkpụ, hypotension nke eriri afọ, ụkwara ume ọkụ, mbelata ọrụ moto nke eriri afọ (ihe ize ndụ nke ụlọ mkpọnwụ), nchịkwa nke oge na serotonin reuptake inhibitors (SSRIs), ime agadi, ịtụrụ ime.

Usoro onunu ogwu na nhazi

Mgbe ị na-ewere okpu a na-akpọ Saroten Retard, a na-atụ aro ị withụ ya na mmiri. Emegheri okpu, agbanyeghi ighe emeghe ma were otutu onu ha mee ihe nile (pellets). Ekwesighi iji ata.

Ihe omume obi ilu. Ọnọdụ ịda mbà n'obi na schizophrenia. Edere ya otu ugboro n’ụbọchị 3-4 tupu ụra.

Ekwesịrị iji otu capsule 50 mg malite mgbatị ọgwụgwọ na Saroten. Ọ bụrụ na ọ dị mkpa, ka otu izu gasịrị, enwere ike ịbawanye ọgwụ kwa ụbọchị ruo capsules 2 - 3 na mgbede (100-150 mg). Mgbe ị rụzuru akara a kara aka, enwere ike belata ọgwụ kwa ụbọchị ka ọ bụrụ nke kachasị arụ ọrụ, ọ na-abụkarị 1-2 capsules (50-100 mg / ụbọchị).

Mmetụta ọgwụ antidepressant na-etolite mgbe izu abụọ gachara ruo izu anọ.Usoro ọgwụgwọ maka ịda mba bụ ihe nnọchianya, ya mere, a na-atụ aro ka ọ nọgide na-eji ọgwụ antidepressants, gụnyere Saroten Retard, mgbe ọ rụchara nsonaazụ akpọpụtara maka oge zuru ezu - ruo ọnwa 6 iji zere nlọghachi. N'ime ndị ọrịa nwere nsogbu ịlaghachi kwa mgbe (enweghị nke pụrụ iche), enwere ike ịchọ nlekọta ogologo oge nke Saroten Retard, ruo ọtụtụ afọ, na usoro mmezi nke nwere mmetụta nlọghachi nlọghachi.

Ndị ọrịa agadi (karịrị afọ 65) Otu capsule 50 mg na mgbede.

Arụ ọrụ akụrụ

Enwere ike ịkọwa Amitriptyline na usoro ọgwụgwọ ọ bụla maka ndị ọrịa nwere ọdịda akụrụngwa.

Nrụsị nke imeju na-ebelata

Ekwesịrị ịkpachara anya mgbe ị na-eji ọgwụ ahụ eme ihe na ndị ọrịa nwere ọrụ imeju, a ga-enyocha nlebara ọbara nke serum amitriptyline oge ọ bụla enwere ike.

Terkwụsị ọgwụgwọ, a na-atụ aro ka mwepu ọgwụ ahụ ka ejiri nwayọ nwayọ rụọ ọrụ karịa ọtụtụ izu iji zere mmepe nke mmeghachi omume “ndọrọ ego” (lee mpaghara “Side side”).

Jiri n’oge ime ma ọ bụ n’ịra

Amitriptyline ekwesighi ka edee ya n’oge afọ ime, ọ gwụla ma uru a tụrụ anya ya na onye ọrịa agaghị agafe n’ihu ihe nwa ebu n’afọ. Nlekọta nke oke ọgwụ mgbochi tricyclic antidepressants n'oge ọnwa atọ nke afọ ime nwere ike ibute nsogbu neurovascular na ụmụ ọhụrụ. N'ime ụmụ amụrụ ọhụrụ, dịka akụkọ si kwuo, ọ bụ naanị nsogbu amitriptyline na njide nke urinary ka enyere site na nsonaazụ nke northriptyline (metabolite nke amitriptyline), ọ bụrụ na enyere ọgwụ ndị inyom ọgwụ ka ha tụrụ ime tupu ịmụ nwa.

Ọgwụ ahụ na-abanye n'ime mmiri ara ara n'ọtụtụ dị ala, yabụ, nsonaazụ ya na nwa ahụ mgbe ị na-a theụ usoro ọgwụgwọ adịghị ele anya. Ọgwụ nwatakịrị ahụ natara dị ihe dị ka 2% nke ọgwụ nne, na-ezo aka nha nwatakịrị ahụ (na mg / n'arọ). Ọ bụrụ na ọ dị mkpa na ahụike, a pụrụ ịnọgide na-enye nwa ara n'oge amitriptyline, mana a na-atụ aro ilekọta nwa ahụ, ọkachasị na izu anọ mbụ mgbe amuchara nwa.

Dodoụbiga ya ókè

Mgbapụta nke Cardiac: arrhythmias (ventricular tachyarrhythmias, flutter-flicker, ventricular fibrillation). Otu ECG na-egosipụtakarị oge dị ogologo nke PR, mgbasawanye nke QRS mgbagwoju anya, ndọtị nke QT, mgbasa ma ọ bụ ngabiga nke ebili mmiri T, ịda mba nke ST, yana ọkwa dịgasị iche nke ngọngọ obi ruo mgbe njide obi. Nbawanye nke ebe obibi QRS na-agbadata n'ụzọ doro anya na ogo nke oke mgbe oke ọgwụ oke. Ọkpụkpụ obi, ọbara ọgbụgba, akwara umeji. Metabolic acidosis na hypokalemia na-abawanye. Mgbe itetare ọzọ ọgba aghara nwere ike, nchekasị, hallucinations na ataxia.

Ọgwụ: ụlọ ọgwụ (na ngalaba nlekọta ahụ ike). Ọgwụgwọ a bụ Symptomatic ma na-akwado. Gastric na-ekpochapụ afọ na ọnya, ọbụlagodi n'ọgwụgwụ mgbe emesịrị nchịkwa, yana nhazi carbon ndị arụ ọrụ na-egosi. Ọ dị mkpa iji nlezianya nyochaa ọnọdụ ahụ, ọbụlagodi na ọ nwere okwu dị nro. Nyochaa ọnọdụ nke mmụọ, ọdịdị nke nsị, ọnụ ahịa ọbara mgbali na arụ ọrụ iku ume, na obere oge kwesịrị ikpebi ọdịnaya electrolytes na gas dị n'ọbara. Gbaa mbọ hụ na ikuku ikuku ma ọ bụrụ na ọ dị mkpa site na intubation. Na mkpụmkpụ, a na-atụ aro ịgwọ ikuku nwere ikuku iji gbochie njide iku ume. Ekwesịrị ileba anya ECG n'ime ụbọchị 3-5. Site na mgbasawanye nke oge QRS, nkụda obi, na arrhythmias ventricular, ntụgharị pH nke ọbara gaa n'akụkụ ihu alkaline nwere ike ịdị irè (nchịkwa nke bicarbonate ngwọta ma ọ bụ hyperventilation) na njikwa ngwa ngwa nke ngwọta hypertonic nke sodium chloride (100-200 mmol Na +). Na arrhythmias ventricular, ọ ga-ekwe omume iji ọgwụ antiarrhythmic ọdịnala, dịka 50-100 mg nke lidocaine (1-1.5 mg / kg) intravenously, sochiri infusion na ọsọ nke 1-3 mg / min.

Ọ bụrụ na ọ dị mkpa, tinye cardioversion na defibrillation. Ezigbo nsogbu mgbasa mgbasa site n'enyemaka nke ndị nọchiri plasma, na n'ọnọdụ ndị siri ike, site na mgbakwunye nke dobutamine (nke mbụ na ọnụego nke 2-3 μg / kg kwa nkeji) yana mmụba na dose, dabere na nsonaazụ ahụ. Nchịkwa diazepam nwere ike ịkwụsị mkpali na nkụchi.

Nghọta dị ukwuu maka oke onunu ogwu bụ n'ụzọ dị ukwuu n'otu n'otu. N'otu oge ahụ, ụmụaka na-enwekarị mmasị na mmepe nke ihe ịtụnanya obi na ụlọ ikpe.

N'ime ndị okenye, usoro onunu ogwu nke 500 mg nwere ike ime ka egbu egbu ruo na oke nha, ebe ọnụọgụ ntakịrị ihe na-erughị 1000 mg na-egbu egbu.

Mmeghachi omume ọjọọ

Amitriptyline nwere ike ibute mmetụta ndị yiri nke ahụ na-apụta mgbe ị na-ewere ọgwụ antidepressants ndị ọzọ. Ufodu mmetụta ndi edepụtara n'okpuru (isi ọwụwa, ịma jijiji, enweghị ntị, afọ ntachi, na mbelata nke libido) nwekwara ike ịbụ mgbaama nke ịda mba ma na-agbadata mgbe ọnọdụ ịda mba na-akawanye mma.

Ejiri nzukọ ndị a na ndepụta dị n'okpuru. WHO họọrọ usoro MedDRA maka klaasị sistemụ otu: ọtụtụ mgbe (> 1/10), ọtụtụ mgbe (> 1/100, 1/1000, 1/10 000,

Mmekọrịta na ọgwụ ndị ọzọ:

Amitriptyline nwere ike ịkwalite nsonaazụ mmanya, barbiturates na ihe ndị ọzọ na-ewute sistemụ akwara etiti.

Iji otu olu na MAO inhibitors nwere ike ibute nsogbu ọgbụgba. Ebe ọ bụ na amitriptyline na-eme ka ihe omume anticholinergics dịkwuo mma, a ga-ezere nchịkwa nke ha n'otu oge.

Ọ na - eme ka ihe omume ọmịiko nke adrenaline, norepinephrine, wdg, dị ka nsonaazụ a, a ga-ejighị ọgwụ ndị mpaghara nwere ihe ndị a n'otu oge na amitriptyline.

Nwere ike belata mmetụta antihypertensive nke clonidine, betanidine, na guanethidine.

Mgbe edekọtara ọgwụ ọgwụ ọgwụ, ekwesịrị iburu n'uche na ọgwụ mgbochi tricyclic na antipsychotics na - egbochi metabolism nke ibe ha, na - wedata ọnụ ụzọ maka ịdị njikere nke mmụọ.

Iji otu oge eji cimetidine, ọ ga-ekwe omume belata metabolism nke amitriptyline, mee ka ịta ụba ya na plasma ọbara na mmepe nke nsonaazụ ndị na-egbu egbu.

Mlọ ọgwụ

Amitriptyline bụ akụkụ nke otu tricyclic. Nke a bụ ụdị amine nke tertiary, nke bụ ihe dị mkpa na ụdị tricyclic, n'ihi na ọ fọrọ nke nta ka ọ bụrụ ọrụ na vivo ka ọ bụrụ onye na - egbochi serotonin na norepinephrine na - ebuli ya.

Ihe kacha mebie emebi, north nortyline, bụ ihe mgbochi kachasị ike nke norepinephrine uptake, mana ọ nwere ike igbochi nsogbu serotonin. Amitriptyline nwere ihe anticholinergic dị egwu, ọgwụ na-agwọ ọrịa na antihistaminergic, na mgbakwunye na ọ nwere ike ịmịpụta mmetụta nke catecholamines.

Mwepu nke DBD nke oge ihi ura bu ihe iriba ama na nchoputa nke ihe ngbochu ogwu. Tricyclics, na mgbakwunye na ha nhọrọ serotonin reuptake inhibitors, yana MAOIs, na-egbochi usoro BDH, ma na-emekwa ka usoro nke ụra dị omimi (nwayọ nwayọ).

Amitriptyline na-eme ka ọrịa ọnọdụ uche belata.

Mmetụta ọgbụgba nke amitriptyline bụ akụkụ dị mkpa nke ịgwọ ịda mbà n'obi na-enwe obi ụtọ, nchekasị, na nsogbu ihi ụra. Mmetụta ọgwụ antidepressant na-amalite ịpụta mgbe izu 2-4 gachara site na nmalite ọgwụgwọ, ebe mmetụta ọgwụ ọjọọ anaghị ebelata.

Ngwakọta nke ọgwụ ọgwụ adịghị ọgwụ ọgwụ antidepressant, ebe ọ bụ na analgesia na-amalite n'oge tupu mgbanwe mgbanwe ọnọdụ. Ọtụtụ mgbe, obere ọgwụ dị ala ezuola iji nweta nsonaazụ a karịa inye mgbanwe na ọnọdụ onye ọrịa.

Mlọ ọgwụ

Mgbe nchịkwa mpaghara, ihe ngosipụta bioavailability nke amitriptyline dị ihe dịka 60%. Njikọ protein protein Plasma bụ ihe dịka 95%. Ọnụ ọgụgụ kachasị elu n'ime ọbara ọbara nke akụkụ ahụ nọ n'ọrụ na-eru ihe dị ka awa 4-10 mgbe ejiri ya wee na-akwụsi ike.

Usoro metabolism nke akụrụngwa na-arụ ọrụ na-apụta site na hydroxylation, yana demethylation. Ihe kacha ere decomposition bụ northriptyline.

Ọkara nke amitriptyline dị na elekere 16–40 elekere (nkezi bụ awa 25), ọkara ndụ nke northriptyline bụ ihe dịka 27 awa. A na-ehiwe obere akwụkwọ nke ọgwụgwọ ọgwụgwọ mgbe izu 1-2 gachara.

Mwepu amitriptyline pụtara ọkachasị na mmamịrị, na mgbakwunye, n'obere ọnụọgụ, dị na feces.

Amitriptyline, ya na ya kwa nortriptyline, nwere ike ịgafe na Plasenta ma banye n’ime mmiri ara ara na obere usoro.

Mmetụta akụkụ

Amitriptyline nwere ike ibute nsonaazụ ndị yiri nke ndị ọzọ na-akpata antidepressants aghụghọ ndị ọzọ. Effectsfọdụ mmetụta ọjọọ ndị edepụtara n'okpuru, dị ka isi ọwụwa, ịma jijiji, enweghị nchekasị, afọ ntachi, na mbelata nke libido, nwekwara ike ịbụ mgbaàmà nke ịda mbà n'obi ma na-agbadata site na mmezi nke ịda mbà.

E gosipụtara ntụpọ ndị ọzọ dị ka:

ugboro ugboro (> 1/10), ọtụtụ mgbe (site>> 1/100 ruo 1/1000 ruo 1/10000 ruo