Cov tshuaj siv tshuaj ntawm kev npaj kho mob "Allopurinol" yog txhawm rau txo qis cov kua qaub saturation thiab tiv thaiv kev tso tawm thiab kev loj hlob ntawm cov hu ua urates, vim muaj kev cuam tshuam rau cov txheej txheem ntawm kev tsim cov uric acid nyob rau hauv lub cev. lub cev. Raws li cov lus qhia rau kev siv "Allopurinol-EGIS" 100 thiab 300 mg, nrog rau lwm cov tuam txhab, cov lus qhia tseem ceeb rau kev sau tshuaj muaj xws li kev tiv thaiv thiab kev kho mob ntawm gout (tshwj tsis yog lub sijhawm exacerbation thiab o), urolithiasis hauv ob lub raum, oncotherapy thaum kho yoo mov.
Tag nrho cov tshuaj analogues ntawm cov tshuaj saum toj no ib txoj hauv kev los yog lwm qhov muaj cov tshuaj lom neeg cov tshuaj allopurinol, qhov sib txawv ntawm lawv nyob rau hauv ntau yam khoom siv nrog cov khoom, uas ua rau muaj kev cuam tshuam cov nyhuv ntawm cov ntsiab lus ntawm ntau concentrated los yog me ntsis ntxim rau cov lub cev. Lawm, qhov sib txawv ntawm cov khoom cuam tshuam ncaj qha rau tus nqi ntawm cov tshuaj.
Pharmacodynamics
"Allopurinol" thiab nws lub ntsiab metabolite oxypurinol cuam tshuam cov biosynthesis ntawm uric acid, muaj urostatic zog, uas yog raws li ntau lub peev xwm los rhuav tshem cov protein xanthine oxidase, uas ua rau txo qis hauv uric acid thiab uric acid. txhawb kev tawg ntawm urates.
YPharmacokinetics
Cov tshuaj no absorbed nyob rau hauv lub Upper esophagus nyob rau hauv ib lub sij hawm luv luv. Tom qab siv sab hauv, cov tshuaj tshwm sim hauv cov ntshav plasma tom qab ib nrab teev mus rau ib teev. Lub bioavailability ntawm cov tshuaj yog nyob rau hauv thaj tsam ntawm 67-90%.
Peak saturation tau mus txog tom qab ib teev thiab ib nrab. Cov tshuaj xyaum tsis ua ke nrog cov proteins hauv plasma. Tus nqi ntawm nws qhov sib txawv yog nyob rau hauv daim duab ntawm 1.3 l / kg.
Tus neeg sawv cev sai sai (ib nrab lub neej los ntawm cov ntshav ntshav yog ob teev) oxidizes los ntawm xanthine oxidase thiab aldehyde oxidase rau oxypurinol, uas tseem suav tias yog ib qho muaj zog inhibitor ntawm xanthine oxidase, tab sis ib nrab-lub neej ntawm cov metabolite tuaj yeem kav ntev. los ntawm kaum peb mus rau peb caug teev. Muab qhov ntev ib nrab-lub neej, tej zaum yuav muaj ib tug gradual build-up thaum pib ntawm kev kho kom txog rau thaum equilibrium saturation mus txog. Hauv cov neeg mob uas lub raum ua haujlwm zoo, qhov nruab nrab ntawm qhov siab yog tsib mus rau kaum mg / l tom qab noj tshuaj. "Allopurinol" feem ntau yog tawm los ntawm ob lub raum, thaum tsawg dua 10% ntawm cov khoom raug tshem tawm hauv daim ntawv tsis hloov pauv. Kwv yees li 20% yog tawm hauv cov quav. Cov tshuaj nquag raug tso tawm hauv cov zis hauv daim ntawv tsis hloov pauv tom qab tubular reabsorption.
Cov lus qhia rau kev sivCov ntsiav tshuaj "Allopurinol" ("EGIS", "Teva", "Nycomed", thiab lwm yam), kev tshuaj xyuas uas zoo, hais tias pathologies ntawm ob lub raum ua rau muaj kev nce hauv ib nrab ntawm lub neej ntawm oxypurinol, vim li no, cov neeg mob. nrog rau lub raum tsis ua haujlwm yuav tsum ua raws li cov lus qhia txog kev noj tshuaj.
Kev qhia
Tshuaj xyuas thiab cov lus qhia rau kev siv "Allopurinol" hauv cov ntsiav tshuaj pom zoo noj:
Cov neeg mob hnub nyoog tshaj 18 xyoo. Kev kho mob ntawm txhua hom hyperuricemia uas tsis yog tswj los ntawm kev noj zaub mov kom raug, nrog rau cov nyiaj uric acid nyob rau hauv thaj tsam ntawm tsib puas thiab tsib caug micromol / l thiab ntau dua; cov kab mob txhawb nqa los ntawm kev nce ntxiv ntawm uric acid, tshwj xeeb yog gout, urate nephropathy thiab urate urolithiasis; theem nrab hyperuricemia ntawm ntau yam keeb kwm; thawj thiab theem nrab hyperuricemia hauv ntau yam hemoblastoses
Cov menyuam yaus thiab cov tub ntxhais hluas hnyav dua 15 kilograms. Secondary hyperuricemia ntawm ntau yam keeb kwm; urate nephropathy, uas tshwm sim los ntawm kev kho mob qog noj ntshav; Lesch-Nyhan kab mob thiab qhov tsis txaus ntawm adenine phosphoribosyl transferase
Cov menyuam yaus thiab cov tub ntxhais hluas hnyav dua 45 kilograms. Secondary hyperuricemia ntawm ntau yam keeb kwm; urate nephropathy, uas tshwm sim los ntawm kev kho cov kab mob ntshav; Congenital enzyme deficiency, tshwj xeeb tshaj yog Lesch-Nyhan dysgenitalism thiab tsis muaj adenine phosphoribosyltransferase
YContraindications
High susceptibility to "Allopurinol" lossis ib qho ntawm cov khoom xyaw ntawm cov tshuaj.
Cov kab mob hnyav ntawm lub raum ua haujlwm (creatinine tshem tawm tsawg dua 2 ml / min) thiab daim siab.
Yog tias creatinine tshem tawm tsawg dua 20 ml / min, tsis txhob siv 300 mg ntsiav tshuaj.
Yuav siv li cas?
Ib hnub yog txiav txim siab ntawm tus kheej hauv kev sib txuas nrog qib siab ntawm uric acid. Txhawm rau txo qhov kev pheej hmoo ntawm kev tshwm sim theem nrab, kev kho yuav tsum pib ntawm 100 mg ib zaug ib hnub thiab nce ntxiv yog tias qib uric acid tsis txaus txo.
Hauv cov lus qhia rau kev siv "Allopurinol" (300 mg) cov lus qhia hauv qab no tau qhia:
- rau qhov mob me, 0.1 g rau 0.2 g ib hnub;
- rau cov mob hnyav hnyav - los ntawm 0.3 g txog 0.6 g ib hnub;
- rau qhov mob hnyav - los ntawm 0.7 g txog 0.9 g ib hnub.
Yog tias ib hnub ntau tshaj 300 mg, nws yuav tsum muab faib ua ob peb koob (tsis pub ntau tshaj 300 mg ib zaug).
Thaum xam cov koob tshuaj ntawm ib tus neeg mob lub cev hnyav, siv koob tshuaj 2-10 mg / kg.
Cov menyuam yaus thiab cov hluas. Qhov ib hnub yog 0.01 g / kg ntawm lub cev hnyav, muab faib ua peb koob. Qhov loj tshaj plaws noj txhua hnub yog 0.4 mg. Siv 0.1g ntsiav tshuaj
hnub nyoog laus. Vim tias tsis muaj cov ntaub ntawv tshwj xeeb hais txog kev siv tshuaj hauv pawg neeg mob no, nws raug nquahu kom siv cov tshuaj kho mob qis tshaj plaws. Yuav tsum tau coj mus rau hauvsaib xyuas qhov tshwm sim ntawm pathology ntawm lub raum ua haujlwm hauv cov neeg laus.
Pathology ntawm lub raum. Txij li thaum cov tshuaj thiab nws cov metabolites raug tso tawm los ntawm ob lub raum, yog tias lawv lub luag haujlwm yog pathological, kev noj tshuaj ntau dhau yuav yog qhov tsis raug xaiv kom raug.
Nyob raum mob hnyav, qhov siab tshaj plaws txhua hnub koob tshuaj yog 0.1 g. Ib koob tshuaj 0.1 g tau txais nrog lub sijhawm ntau tshaj ib hnub (txhua ob peb hnub).
Cov neeg mob lub siab ua haujlwm.
Cov neeg mob uas muaj kab mob siab yuav tsum tau muab cov koob tshuaj qis tshaj plaws. Kev soj ntsuam ib ntus ntawm kev kuaj lub siab ua haujlwm raug pom zoo thaum pib kho.
Pills ntawm 0.3 g yuav tsum tsis txhob muab rau cov neeg mob no vim yog cov ntsiab lus siab ntawm cov khoom ua haujlwm.
Cov tshuaj yuav tsum tau noj tom qab noj mov, tsis txhob zom, nrog rau dej kom ntau.
Lub sijhawm ntawm kev kho mob nyob ntawm seb tus kab mob no. Txhawm rau tiv thaiv kev tsim cov pob zeb oxalate thiab urate thiab hauv thawj hyperuricemia thiab gout, kev kho mob ntev yuav tsum tau siv rau feem ntau. Rau theem nrab hyperuricemia, ib chav kawm luv raug pom zoo nyob ntawm qhov nce qib ntawm uric acid.
Ntau tshaj
Twb tom qab noj ib koob tshuaj nees nkaum grams, qee zaum pom cov tsos mob xws li ntuav, xeev siab, raws plab thiab kiv taub hau. Hauv lwm qhov xwm txheej, kev noj 22.5 g tsis ua rau cov txiaj ntsig tsis zoo. Tom qabKev noj haus ntev ntev ntawm 0.2-0.4 g ib hnub twg, cov neeg mob lub raum tsis ua haujlwm tau piav qhia txog cov tsos mob hnyav ntawm kev qaug cawv (dermatological cov tshuaj tiv thaiv, ua npaws, kab mob siab, eosinophilia thiab mob raum tsis ua haujlwm). Nyob rau hauv cov ntaub ntawv ntawm ib tug overdose, lub zog ntawm xanthine oxidase yog heev suppressed, tab sis tsuas yog nyob rau hauv cov ntaub ntawv ntawm complex siv ntawm 6-mercaptopurine thiab azathioprine, cov nyhuv ntawm cov tshuaj yog nrog los ntawm cov teeb meem tseem ceeb..
Raws li cov lus qhia rau kev siv, yog xav tias muaj kev noj tshuaj ntau dhau, tus neeg mob yuav tsum tau ntxuav plab, ua rau xeev siab, lossis siv cov hluav taws xob hluav taws xob thiab sodium phosphate.
kev tawm tsam tsis zoo
Hauv cov lus qhia rau kev siv Allopurinol, cov kev mob tshwm sim muaj raws li hauv qab no.
Thaum pib ntawm kev kho mob, kev tawm tsam ntawm gout tuaj yeem tshwm sim.
Cov tshuaj me me no tshwm sim ntau dua thaum lub raum thiab / lossis lub siab tsis txaus lossis thaum ua ke nrog ampicillin lossis amoxicillin.
Dermatology: Stevens-Johnson syndrome, toxic epidermal necrolysis; alopecia, furunculosis, angioedema, plaub hau depigmentation. Feem ntau cov tshuaj tiv thaiv kab mob dermatological (kwv yees li 4%) tshwm sim thaum lub sijhawm kho thiab tuaj yeem qhia tau tias yog pob liab liab. Yog tias cov tshuaj tiv thaiv no tshwm sim, cov tshuaj yuav tsum tau txiav tam sim ntawd. Txawm tias tom qab cov tsos mob txo qis, koj tuaj yeem sau tshuaj rau hauv koob tshuaj tsawg (piv txwv li, 50 mg ib hnub). Yog tias tsim nyog, qhov nokoob tshuaj tuaj yeem nce ntxiv raws sijhawm. Nyob rau hauv qhov tshwm sim ntawm ib tug thib ob tshwm sim ntawm ib tug dermatological ua pob liab vog, cov tshuaj yuav tsum tau txiav, raws li loj hypersensitivity phenomena yuav tshwm sim.
Lub cev tiv thaiv kab mob: ncua sij hawm-hom hypersensitivity tshwm sim nrog ua npaws, ua pob khaus thiab lwm yam kab mob uas cuam tshuam rau kev noj qab haus huv (rov qab nce hauv transaminases thiab alkaline phosphatase); cholangitis thiab xanthine pob zeb; anaphylactic shock.
Liver: Lub siab ua haujlwm txawv txav xws li asymptomatic o ntawm lub siab ua haujlwm ntawm lub siab mus rau kab mob siab (xws li daim siab tuag thiab kab mob siab granulomatous).
plab hnyuv: ntuav, xeev siab, raws plab; Hematemesis, steatorrhea, stomatitis.
Ntshav: Mob pob txha mob pathology yog qhov tsawg kawg nkaus, tshwj xeeb tshaj yog rau cov neeg mob lub raum tsis txaus; Tsis tshua muaj kev hloov pauv hauv cov ntshav suav, muaj tseeb erythrocyte aplasia.
Nervous system: ataxia, peripheral kab mob, gustatory cuam tshuam, coma, migraine, neuropathy, torpor, kiv taub hau, lethargy, loog.
Cov kab mob plawv: bradycardia, arterial hypertension.
Kev sib tham nrog lwm yam tshuaj
"Allopurinol" ncua kev tshem tawm ntawm probenecid. Kev ua tau zoo ntawm cov tshuaj txo qis thaum siv cov tshuaj uas tuaj yeem tshem tawm uric acid.
Kev siv ib txhij ntawm "Allopurinol" thiab "Captopril" tuaj yeem ua rau muaj kev pheej hmoo ntawm cov kab mob dermatological, tshwj xeeb tshaj yog mob ntev.mob raum.
Cov nyhuv ntawm cov tshuaj tiv thaiv coumarin (coumarin) tuaj yeem nce ntxiv, vim li no, kev soj ntsuam ntau zaus ntawm cov ntshav txhaws yog qhov tsim nyog, nrog rau kev txo qis ntawm cov tshuaj coumarin derivatives.
Nyob rau hauv pathology ntawm lub raum ua haujlwm, tshwj xeeb tshaj yog nrog kev siv tshuaj sib xyaw, cov nyhuv hypoglycemic ntawm chlorpropamide tuaj yeem ntev, uas yuav tsum tau txo cov koob tshuaj.
Nyob rau hauv qhov tseem ceeb, cov tshuaj inhibits theophylline metabolism, vim li no, thaum pib ntawm kev kho Allopurinol lossis nrog kev nce ntawm nws cov koob tshuaj, cov qib plasma theophylline yuav tsum tau saib xyuas.
Thaum siv tshuaj nrog cytostatics, kev hloov pauv hauv cov ntshav tshwm sim ntau dua li kev tswj hwm ntawm cov tshuaj nquag. Vim li no, cov ntshav yuav tsum tau saib xyuas ntawm lub sijhawm luv.
Nrog txoj kev siv tshuaj nrog vidarabine, tsib caug feem pua ntawm cov ntshav plasma ntev ntev, vim li ntawd, kev sib xyaw ua ke yuav tsum tau siv nrog ceev faj txhawm rau kom tsis txhob muaj qhov tshwm sim ntawm qhov tshwm sim theem nrab. Thaum siv cov tshuaj, qhov concentration ntawm cyclosporine hauv plasma tuaj yeem nce ntxiv - qhov nce hauv qhov hnyav ntawm cov tshuaj tiv thaiv thib ob rau cyclosporine tau txais.
Cov tshuaj txhawb kev sib sau ntawm cov hlau hauv daim siab hlwb. Yuav tsum txo cov hlau supplementation.
"Allopurinol" tuaj yeem ua rau muaj qhov hnyav ntawm cov tshuaj me me ntawm cov tshuaj, tshwj xeeb tshaj yog thaum siv tib lub sijhawm nrog kev hem thawj captopril. Qhov tshwm sim ntawm cov tshuaj tiv thaiv kab mob tuaj yeem nce ntxiv, tshwj xeeb tshaj yog nyob rau hauv lub raum tsis ua haujlwm tas mus li.
Analogues
Analogues ntawm cov tshuaj tsis muaj tsawg dua kev kho nws tus kheej. Tus nqi ntawm cov tshuaj no yog pheej yig heev. Ntawm cov feem ntau siv analogues ntawm Allopurinol, cov lus qhia rau kev siv thiab tshuaj xyuas uas zoo ib yam li cov tshuaj tau piav qhia, koj tuaj yeem nres ntawm Purinol, Sanfipurol, Zilorik.
Purinol
Ua hauv cov ntsiav tshuaj, tswj kev sib pauv ntawm uric acid. Cov lus qhia tseem ceeb rau kev siv yog gout lossis gouty mob caj dab. Thaum noj cov tshuaj no, qhov exacerbation ntawm cov txheej txheem inflammatory thiab kev sib cais ntawm cov pob zeb hauv lub zais zis nrog kev tawm mus ntxiv. Yog li ntawd, thaum kho nrog Purinol, pom zoo kom haus dej ntau.
Allopurinol-EGIS
Cov tshuaj siv tau zoo tshaj plaws hauv cov ntsiab lus ntawm kev txo qis ntawm uric acid hauv cov tshuaj ntsuam xyuas zoo sib xws yog, raws li cov lus qhia rau kev siv, "Allopurinol-EGIS". Hauv kev tshuaj xyuas, ob tus neeg mob thiab kws kho mob tau lees paub tias cov tshuaj muaj zog heev thiab tuaj yeem ua rau muaj kev mob hnyav ntawm gout, yog li Colchicine tau pom zoo rau cov neeg laus thiab cov neeg mob raum pathology. Nws kuj raug sau tseg rau kev kho mob gout thiab raum pob zeb.
Allopurinol Nycomed
Siv ua tshuaj tiv thaivtsim thiab loj hlob ntawm pob zeb nyob rau hauv lub urea thiab tsub kom lawv excretion nyob rau hauv cov zis. Ib tug yam ntxwv feature ntawm cov tshuaj no yog nws sai sai (ib los yog ob teev) nqus thiab ua tiav nqus los ntawm lub plab hnyuv ib ntsuj av.
Allopurinol Teva
Pom zoo rau gout, oncopathology, thiab, tseem ceeb, rau kev tswj hwm ntawm purine metabolism hauv cov menyuam yaus. Cov tshuaj yog cov concentrated heev, yog li nws raug tso cai faib cov ntsiav tshuaj rau ntau qhov chaw.
Zilorik
Ib tshuaj uas nws cov tshuaj ua haujlwm yog txo qis tag nrho cov qib ntawm urate hauv lub cev thiab tiv thaiv nws cov khoom tso rau hauv lub cev. Cov tshuaj, vim nws cov khoom sib xyaw ua ke, xyaum tsis ua rau muaj kev phiv, tab sis tsis raug tshuaj rau tus neeg intolerance.
Sanfipurol
Ib tshuaj uas tswj cov txheej txheem metabolic ntawm uric acid. Nws yog siv los ua ib qho analogue rau gout, raum pob zeb, nephropathy, leukemia. Thaum kho nrog Sanfipurol, nws raug nquahu kom haus txog li ob litres dej ib hnub.
Kev kho mob nrog kev siv "Allopurinol" thiab nws cov analogues pib, raws li txoj cai, nrog cov tshuaj me me txhua hnub thiab yog contraindicated thaum cev xeeb tub thiab lactation. Nws yuav tsum raug sau tseg tias kev teem sijhawm thiab ntau npaum ntawm cov tshuaj saum toj no yog tsim los ntawm tus kws kho mob tshwj xeeb.
Yog li, kab lus sib thamCov lus qhia rau kev siv "Allopurinol" 100 thiab 300 mg.
