Hauv kab lus no, peb yuav txiav txim siab cov lus qhia rau kev siv, nqe thiab tshuaj xyuas rau cov tshuaj "Difenin". "Difenin" yog ib yam tshuaj uas tsim nyob rau hauv cov ntsiav tshuaj. Nws yog siv nyob rau hauv kev kho mob ntawm qaug dab peg, ventricular arrhythmia, trigeminal neuralgia. Lub ntsiab active ingredient nyob rau hauv cov tshuaj yog phenytoin.
Phau ntawv qhia rau Difenin qhia peb li cas?
Cov tshuaj thiab tso tawm daim ntawv
Cov lus piav qhia ntawm "Difenin" hauv cov lus qhia rau kev siv yog cov ncauj lus kom ntxaws heev. Cov khw tsim cov tshuaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj. Cov lus qhia rau kev siv cov tshuaj "Difenin" (analogues muaj cov nyhuv zoo sib xws) piav qhia hauv qab no. Lub ntsiab tseem ceeb ntawm cov khoom xyaw yog phenytonin nyob rau hauv tus nqi ntawm 100 mg rau 1 ntsiav tshuaj. Talc, qos starch, sodium bicarbonate, magnesium stearate yog siv los ua cov khoom ntxiv.
Cov ncauj lus kom ntxaws ntawm "Difenin" tau qhia hauv cov lus qhia. Cov lus qhia txog kev siv cov cuab yeej yuav nthuav tawm hauv qab no.
Pharmacological action
Cov tshuaj muaj cov tshuaj tiv thaiv kab mob, tshuaj tiv thaiv arrhythmic, cov leeg nqaij so, cov nyhuv analgesic.
"Difenin" yog cov tshuaj tiv thaiv kab mob zoo heev. Txawm li cas los xij, nws tsis ua rau muaj kev cuam tshuam hypnotic thaum piv nrog lwm cov tshuaj siv hauv kev kho mob vwm. Qhov txo qis hauv kev ua kom muaj zog yog vim qhov kev ua ntawm lub ntsiab tivthaiv - phenytoin. Cov khoom no ua rau muaj kev zoo siab ntawm cerebellum, yog li ua kom muaj kev tiv thaiv kab mob uas cuam tshuam rau cerebral cortex.
Cov tshuaj "Difenin" ua kom muaj qhov mob hnyav hauv qhov tshwm sim ntawm trigeminal neuralgia. Thaum noj, lub sijhawm ntawm qhov mob tshwm sim los ntawm tus kab mob no txo qis. Tsis tas li ntawd, excitation thiab zaus ntawm qhov tshwm sim ntawm kev tso tawm rov qab yog txo.
Cov tshuaj muaj peev xwm ua kom qhov mob hnyav hauv qhov tshwm sim ntawm trigeminal neuralgia. Thaum noj cov tshuaj, lub sijhawm ntawm qhov mob tshwm sim tus yam ntxwv ntawm tus kab mob no raug txo, qhov kev zoo siab thiab qhov zaus ntawm kev tso tawm raug txo qis.
Cov nyhuv antiarrhythmic yog vim muaj peev xwm ntawm "Difenin" kom txo qis ventricular automatism, txo lub sijhawm refractory, thiab txo cov membrane excitability.
YPharmacokinetics
Lub sijhawm lub sijhawm uas lub ntsiab lus tseem ceeb ntawm "Difenin" yog nqus mus rau hauv tus neeg mob cov ntshav yog qhov sib txawv, uas yog, hloov tau. Piv txwv li, saib qhov siab tshaj plaws concentrationphenytoin hauv cov ntshav tuaj yeem yog 3-12 teev tom qab noj tshuaj ntawm qhov ncauj. Kev faib tawm ntawm phenytoin tshwm sim hauv txhua lub cev thiab cov ntaub so ntswg. Nws cuam tshuam rau hauv nruab nrab lub paj hlwb thiab nkag mus rau hauv cov kua cerebrospinal. Kev tso tawm ntawm cov tshuaj no tshwm sim nrog rau cov qaub ncaug, plab hnyuv thiab hnyuv, kua mis thiab phev. Ib qho kev cuam tshuam rau phenytoin kuj yog qhov teeb meem placental. Thaum noj "Difenin" thaum cev xeeb tub, nws cov concentration hauv cov ntshav ntawm leej niam yuav sib npaug ntawm cov ntshav ntawm tus menyuam hauv plab.
Metabolization ntawm phenytoin tshwm sim nrog kev koom tes ntawm daim siab enzymes. Ib nrab-lub neej ntawm cov tshuaj tshwm sim hauv 24 teev. Yog tias kev kho mob ntev ntev, qhov kev tshem tawm tag nrho ntawm cov tshuaj yuav tshwm sim tsis pub dhau peb hnub tom qab qhov kawg ntawm kev noj.
Qhov no tau piav qhia meej hauv cov lus qhia rau "Difenin". Analogues ntawm cov tshuaj muaj cov nyhuv zoo sib xws.
Kev qhia
Raws li cov lus qhia rau kev siv, Difenin ntsiav tshuaj raug sau rau kev nkag yog tias muaj cov lus qhia hauv qab no:
- Lub plawv dhia tsis xwm yeem tshwm sim los ntawm cov kab mob hauv nruab nrab ntawm lub paj hlwb los yog tshwm sim los ntawm kev siv tshuaj ntau dhau los ntawm pab pawg ntawm plawv glycosides.
- YTrigeminal neuralgia.
- Epilepsy. Tshwj xeeb, nrog kev qaug dab peg loj, uas nrog rau cov xwm txheej tsis nco qab.
- Kev kho thiab tiv thaiv kev qaug dab peg hauv kev phais mob hlwb.
Contraindications rau noj
Raws li cov lus qhia rau kev siv qhia, "Difenin" yog contraindicated rau cov neeg mob uas muaj:
- Porphyria (ib yam ntawm cov kab mob caj ceslub siab).
- Adams-Stokes syndrome.
- Nyob rhiab heev rau cov tshuaj uas tsim cov tshuaj.
- siab, raum tsis ua haujlwm.
- Cachexia. Nws yog ib qho txaus ntshai heev depletion ntawm lub cev. Nws tsim tawm tsam keeb kwm yav dhau los ntawm cov kab mob ntawm cov qog nqaij hlav.
- Atrioventricular block (II thiab III degrees).
"Difenin" tuaj yeem raug sau nrog ceev faj heev thiab nyob rau hauv kev saib xyuas ze ntawm tus kws kho mob uas tuaj koom rau cov menyuam yaus uas muaj cov tsos mob ntawm rickets, cov neeg mob ntshav qab zib mellitus, cov neeg laus, cov neeg mob uas muaj kev quav dej caw ntev, lub siab tsis zoo thiab lub raum ua haujlwm.
Txoj kev thov thiab siv tshuaj
Raws li cov lus qhia rau kev siv, "Difenin" yuav tsum tau noj thaum noj mov lossis tom qab nws. Ua raws li cov lus pom zoo no yuav zam kom tsis txhob muaj qhov ua rau khaus ntawm lub plab.
Cov koob tshuaj ntawm thawj theem ntawm kev kho mob rau cov neeg laus yog 3-4 mg ib kilogram ntawm tus neeg mob qhov hnyav. Txais tos ib hnub ib zaug. Sij hawm dhau mus, kom ua tiav cov txiaj ntsig kho mob xav tau, qhov ntau npaum li cas yuav nce ntxiv. Feem ntau, kev saib xyuas koob tshuaj yog nyob rau theem ntawm 200-500 mg ib hnub. Kev txais tos tuaj yeem nqa tau ib lossis ntau zaus thaum nruab hnub.
Hauv kev kho cov menyuam yaus, thawj koob tshuaj yuav tsum yog 5 mg ib kilogram ntawm tus neeg mob qhov hnyav. Kev txais tos yog nqa tawm ob zaug ib hnub. Tom qab ntawd, koob tshuaj nce ntxiv, tab sis tsis tuaj yeem ntau dua 300 mg ib hnub. Qibnoj tshuaj noj - 4-8 mg / kg ib hnub twg.
Side effects
Nyob rau ntu no peb yuav saib cov kev mob tshwm sim. Thaum kawg ntawm tsab xov xwm, peb yuav tham txog tus nqi thiab analogues ntawm Difenin.
Cov lus qhia rau kev siv thiab tshuaj xyuas paub meej tias cov teebmeem hauv qab no tsis zoo yuav tshwm sim thaum kho nrog tshuaj:
- Hematopoietic system mob: agranulocytosis, megaloblastic anemia, thrombocytopenia, leukopenia, thiab lwm yam.
- Kab mob plab thiab plab zom mov: xeev siab, ntuav, tsis qab los noj mov, cem quav, gingival hyperplasia, tshuaj lom kab mob siab, kab mob siab tsis suav nrog.
- Cov kab mob hauv lub paj hlwb tuaj yeem tshwm sim raws li cov leeg tsis muaj zog, lub siab hloov pauv, insomnia, ataxia, nystagmus, ua tsis taus pa, tsis meej pem, ntxhov siab, tsis sib haum xeeb, mob taub hau, kiv taub hau.
- Ntau yam kev ua xua tshwm sim nyob rau hauv daim ntawv ntawm kub taub hau, pob khaus ntawm daim tawv nqaij, nyob rau hauv tsawg zaus - ntshav liab lossis bullous dermatitis, nrog rau kab mob siab. Nws yog ib qho tsim nyog sau cia tias qee zaum cov tshuaj tiv thaiv los ntawm dermis yog nrog los ntawm cov pob liab liab zoo ib yam li cov uas tshwm sim nrog kub taub hau thiab qhua pias.
Qhov no tau lees paub los ntawm cov lus qhia rau kev siv thiab tshuaj xyuas ntawm Difenin.
Ntau tshaj
koob tshuaj 2-5 grams yog tuag rau ib tug neeg. Cov tsos mob dhau los tshwm sim li:
- Nystagmus (ntawm qhov siab ntawm 20 micrograms ntawm cov khoom xyaw nquag rau ib milliliter ntawm cov ntshav ntshav).
- Ataxia(ntawm qhov concentration ntawm cov tshuaj nquag 30 mcg / ml).
- Dysarthria (ntawm qhov concentration ntawm cov tshuaj nquag 40 mcg / ml).
Nyob rau hauv rooj plaub ntawm overdose, qhov tshwm sim ntawm tshee, hyperreflexia, tsaug zog, hais lus slurred, xeev siab, ntuav, hypotension, coma tsis raug cais tawm. Kev tuag tshwm sim los ntawm kev txhim kho ntawm cov hlab plawv tsis ua haujlwm thiab ua pa tsis ua haujlwm.
Kev kho mob ntau dhau suav nrog kev siv hluav taws xob hluav taws xob ntawm qhov pom zoo kom noj tshuaj lom, laxatives, thiab kho cov tsos mob. Tam sim no, cov tshuaj tiv thaiv tshwj xeeb rau cov tshuaj tsis paub. Thaum lub sijhawm mob hnyav, tus neeg mob yuav tsum tau ua kom muaj kev saib xyuas tsim nyog ntawm kev ua haujlwm ntawm cov hlab plawv, ua pa. Dialysis yog qhia raws li cov lus qhia siv rau Difenin (Diphenine).
cov lus qhia tshwj xeeb rau kev nkag
Xaiv qhov xav tau ntau npaum li cas nrog kev saib xyuas zoo. Nws yuav tsum nco ntsoov tias qhov ntau npaum li cas tuaj yeem ua rau muaj qhov tsis txaus ntseeg ntawm cov ntshav siab. 7-10 hnub tom qab pib kev kho mob vwm nrog cov tshuaj no, kev tshuaj xyuas yuav tsum tau ua los txiav txim siab qhov concentration ntawm cov tshuaj hauv tus neeg mob cov ntshav.
Siv "Difenin" rau kev kho mob monotherapy ntawm kev tsis tuaj kawm ntawv, nrog rau kev kho ua ke nrog kev loj hlob ntawm kev tsis tuaj thiab tonic-clonic qaug dab peg yuav tsum tsis txhob ua.
Cov kws kho mob tshwj xeeb tsis pom zoo siv cov tshuaj hauv cov neeg mob uas kuaj pom porphyria, vim tias qhov ua rau muaj peev xwm ua tau.kab mob.
Kev kho mob ntev tuaj yeem ua rau txo qis ntawm cov pob txha pob txha, kev txhim kho pob txha, pob txha pob txha, osteomalacia. Hauv qhov no, thoob plaws hauv chav kawm ntawm kev kho mob nrog Difenin, nws yog ib qho tsim nyog los tswj cov qib phosphorus thiab calcium hauv tus neeg mob cov ntshav. Pom zoo kom noj cov tshuaj sib npaug nrog cov ntsiab lus ntawm vitamin D.
Thaum kho cov neeg mob menyuam yaus thaum lub sijhawm muaj kev loj hlob hnyav, kev pheej hmoo ntawm kev tsim cov teebmeem tsis zoo los ntawm cov ntaub so ntswg sib txuas ntxiv.
Thaum lub sijhawm kho, thawj lub hlis, thiab tom qab ntawd txhua 6 lub hlis, kev kuaj ntshav, alkaline phosphatase, daim siab enzymes yuav tsum tau ua. Nws yog ib qho tseem ceeb los tswj lub xeev ntawm cov thyroid caj pas. Nrog rau kev tshem tawm sai sai ntawm Difemin, kev qaug dab peg tuaj yeem tshwm sim.
Yog tias muaj cov cim qhia tias muaj kev tsis haum tshuaj rau cov tshuaj, lossis cov cim qhia ntawm kev txhim kho ntawm Stevens-Johnson lossis Lyell syndromes, cov tshuaj yuav tsum txiav tawm.
Kev kho rau cov neeg laus thiab cov neeg mob uas lub raum tsis zoo thiab lub siab ua haujlwm cuam tshuam nrog kev hloov pauv ntau npaum li cas.
Qhov concentration ntawm phenytoin hauv cov ntshav tau nce ntxiv hauv kev haus cawv ntau heev. Yog hais tias intoxication yog ntev, nws txo. Thaum lub sijhawm kho, tus neeg mob yuav tsum tsis txhob haus dej haus ethyl. Analogues yuav tsum tau txais.
Cov lus qhia rau kev siv "Difenin" qhia tias kev kho mob tuaj yeem nrog cov tshuaj lom los ntawm lub hauv paus paj hlwb.
Nyob tsawgcov mob thaum noj Difenin lossis cov tshuaj antiepileptic zoo sib xws, tus neeg mob yuav muaj kev xav tua tus kheej. Yuav tsum ceeb toom tus neeg mob txog qhov no ua ntej.
Thaum keeb kwm ntawm kev noj phenytoin hauv cov ntshav ntshav, qhov concentration ntawm T4 yuav txo qis, qhov concentration ntawm qabzib, GGT (gamma-glutamyl transpeptidase) thiab alkaline phosphatase tuaj yeem nce ntxiv.
"Difenin" muaj peev xwm ua rau muaj kev loj hlob ntawm hyperglycemia yog tias pom muaj tshuaj lom ntawm cov ntsiab lus tseem ceeb hauv cov ntshav. Hauv qhov no, nws raug txwv tsis pub coj mus rau keeb kwm ntawm convulsions lossis hypoglycemia tshwm sim los ntawm cov teeb meem metabolic. Kev siv tshuaj antiepileptic ua rau muaj kev pheej hmoo ntawm kev tsim kab mob xws li exfoliative dermatitis hnyav. Tus kab mob no nrog eosinophilia, kub taub hau, kab mob tshwm sim. Nws tsis suav nrog txoj kev loj hlob ntawm kev ua neej tsis zoo, kev tuag. Qhov tshwm sim ntawm cov cim qhia no suav nrog kev kuaj xyuas tag nrho ntawm tus neeg mob thiab kev tshem tawm tag nrho ntawm Difenin.
Cov tshuaj tuaj yeem ua rau muaj qhov tshwm sim ntawm jaundice, leukocytosis, hepatomegaly, eosinophilia. Kev nce qib ntawm transaminases tsis suav nrog. Yog tias cov tsos mob ntawm cov kab mob no tshwm sim, nws raug nquahu kom tsis txhob noj tshuaj.
Cov kab mob hematopoietic tuaj yeem ua rau Difenin kho nrog thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, pancytopenia. Qee zaum, kev tuag tshwm sim. Cov neeg mob ntawm Hodgkin tus kab mob, pseudolymphomas, benign lymph node hyperplasia, lymphadenopathy tau raug tshaj tawm.
Pom zoo thaum lub sijhawm noj tshuajtxwv tsis pub tsav tsheb thiab cov txheej txheem nyuaj, nrog rau kev ua ub ua no txaus ntshai.
Siv thaum cev xeeb tub thiab pub niam mis
Txhua qhov kev kho mob nrog tshuaj, yuav tsum muaj kev tiv thaiv kab mob. Thaum pub niam mis, cov tshuaj tsis pom zoo. Yog li nws hais hauv cov lus qhia rau kev siv tshuaj "Difenin"
Cov menyuam yaus hnub nyoog qis dua 3 xyoos, cov tshuaj nruj me ntsis txwv tsis pub. Cov neeg laus yuav tsum tau kho nrog ceev faj heev. Yuav tsum tau hloov koob tshuaj.
Kev sib tham nrog lwm cov tshuaj
Phenytoin ho txhim kho cov nyhuv inhibitory ntawm lwm cov tshuaj ntawm lub hauv paus paj hlwb.
Kev nce qib ntawm cov ntsiab lus tseem ceeb hauv cov ntshav tuaj yeem pom thaum noj Difenin nrog Trazodone, Tolbutamide, Sulfonamide, Sulfinpyrazone, Succinimide, salicylates, estrogens, Fluoxetine, Omeprazole ", "Methylphenidate", "Isoniazid", "Halothane", blockers ntawm histamine H1 receptors, "Dicumarol", "Diazepam", "Chlordiazepoxide", "Chloramphenicol", "Metronidazole", "Itraconazole", "Miconazole", "Ketoconazole", "Fluconazole", "Amphotericin B. "," Amiodarone ". Cov nyhuv kho ntawm "Difenin" hauv qhov nonce, qhov kev pheej hmoo ntawm cov kev mob tshwm sim nce.
Phenytoin tuaj yeem hloov kho cov tshuaj tiv thaiv kab mob, vitamin D, Rifampicin, Quinidine, tshuaj tiv thaiv qhov ncauj, estrogens, Furosemide, Doxycycline, Digitoxin, Dicumarol, glucocorticosteroids, Clozapine.
Parallel noj nrog "Acetazolamide" provokes rickets, osteomalacia.
Kev siv nrog cov tshuaj acyclovir txo cov txiaj ntsig ntawm phenytoin.
Cov ntsiab lus ntawm cov khoom tseem ceeb yuav txo qis thaum noj Theophylline, Pyridoxine, Vigabatrin, Sucralfate, Reserpine, folic acid, Carbamazepine, Difemin.
Cov ntsiab lus ntawm cov tshuaj tseem ceeb tuaj yeem nce ntxiv thaum noj Cimetidine, Phenylbutazone, Felbamate, Ritonavir, Clarithromycin, Imipramine, Disulfiram, Nifedipine, Diltiazem.
Kev siv phenytoin thiab paracetamol txo qis qhov ua tau zoo ntawm qhov kawg.
Cov lus qhia siv rau "Difenin" lees paub qhov no.
Cov tshuaj tau muab tso rau hauv cov khw muag tshuaj nruj me ntsis raws li tus kws kho mob muab tshuaj.
Tus nqi ntawm cov tshuaj yuav txawv nyob ntawm thaj tsam ntawm kev muag thiab cov ntsiav tshuaj hauv pob. Tus nqi nruab nrab ntawm ib pob"Difenin", uas muaj 20 ntsiav tshuaj, fluctuates ntawm 50 rubles. Qhov no tsis tau qhia hauv cov lus qhia rau kev siv rau Difenin. Raws li kev txheeb xyuas, tus nqi tsim nyog rau ntau.
Analogues
Cov qauv analogues ntawm "Difenin" tsis muaj tam sim no. Analogues raws li cov txheej txheem ntawm kev txiav txim muaj xws li cov tshuaj xws li Fengidon, Eptoin, Solantil, Difantoin. Kev txiav txim siab los hloov cov tshuaj nrog nws cov analogue tuaj yeem ua los ntawm tus kws kho mob nkaus xwb.
Cia
Khaws cov tshuaj rau hauv qhov chaw qhuav, tsaus nti kom deb ntawm cov menyuam yaus. Cia kub - los ntawm 5 mus rau 30 degrees Celsius. Raws li qhov kev pom zoo khaws cia, cov tshuaj khaws nws cov khoom rau 4 xyoos txij li hnub teeb meem.
Reviews about "Difenin"
Cov neeg mob kho nrog Difenin tawm tswv yim zoo feem ntau. Nws raug sau tseg tias txawm tias siv cov tshuaj mus ntev tsis cuam tshuam rau nws txoj kev kho mob. Kev qaug dab peg yog txo qis thaum kho nrog tshuaj.
Txawm li cas los xij, qee tus neeg mob qhia txog kev noj qab haus huv tsis zoo thaum hloov tshuaj thiab hloov los ntawm phenytoin mus rau cov tshuaj tiv thaiv kab mob zoo sib xws. Cov txiaj ntsig zoo tshaj plaws yog ua tiav nrog kev kho mob sib xyaw siv cov tshuaj sib txawv.
Peb tau tshuaj xyuas cov lus qhia siv rau Difenin, nqe, tshuaj xyuas thiab analogues.
