"Montelukast" - tshuaj xyuas cov tshuaj tuaj yeem pom tau yooj yim ntawm cov rooj sib tham thematic thiab cov vev xaib mob siab rau qhov teeb meem ntawm kev mob ntsws asthma - qhov no yog classic leukotriene D4 receptor antagonist. Cov tshuaj yog siv dav hauv ob qho tib si hauv kev kho mob yooj yim thiab txhawm rau tiv thaiv tus yam ntxwv ntawm tus kab mob. Qhov sib npaug sib npaug tso cai rau cov tshuaj siv los kho cov neeg mob yuav luag txhua hnub nyoog.
Ib daim foos
Muaj ntau ntau yam vim li cas Montelukast tau txais kev tshuaj xyuas zoo. Txawm li cas los xij, thawj yam uas ua rau koj lub qhov muag yog, ntawm chav kawm, ntau yam ntawm cov ntsiav tshuaj uas tsim los ntawm lub npe lag luam no.
Tam sim no, peb lub thev naus laus zis matrices dominate. Peb tab tom tham txog cov tshuaj yeeb yaj kiab txheej txheem (1 chav tsev muaj 10 mg ntawm cov tshuaj nquag) thiab lawv cov chewable counterparts (4 mg thiab 5 mg ntawm cov reagent, feem). Lub hauv paus hauv paus hauv ob qho tib si yog sodium montelukast, tab sis muaj pes tsawg leeg ntawm cov khoom pab cuam sib txawv me ntsis - mannitol thiab aspartame tsis yog.tam sim no nyob rau hauv cov qauv npaj yuav nqos tam sim ntawd thaum noj.
Nyob rau hauv cov lus, cov lus nug ntawm fakes uas tam sim no thiab ces tshwm nyob rau hauv lub khw muag tshuaj chains feem ntau pops nyob rau hauv cov lus. Koj tuaj yeem tiv thaiv koj tus kheej los ntawm cov khoom cuav yog tias koj ua tib zoo saib xyuas cov khoom lag luam tshuaj raws sijhawm.
Yog li, tshwj xeeb, cov tshuaj chewable nrog 4 milligrams ntawm cov khoom xyaw nquag muaj cov duab oval thiab cov xim liab dawb (cov lus piav qhia sib haum rau cov ntsiav tshuaj nrog cherry tsw; qhov sib txawv tau txais thaum siv lwm yam khoom qab zib), thiab raws li cim nyob rau hauv daim ntawv ntawm tus naj npawb "4" ntawm ib sab. Analogues, nyob rau hauv uas lub ntsiab active ingredient yog 1 mg ntau, yog puag ncig thiab cim nrog ib tug "tsib". Cov ntsiav tshuaj nrog lub plhaub geometrically zoo li lub duab plaub; lawv yog beige thiab naj npawb "10".
YPharmacological affiliation
"Montelukast" (xyuas piav qhia txog cov xwm txheej uas cov reagent provoked complex allergies yog tsis tshua muaj heev) yog ib tug neeg sawv cev ntawm pab pawg neeg ntawm anti-bronchoconstrictor tshuaj. Lub algorithm ntawm nws qhov kev txiav txim tso cai rau peb hais txog "kev sib raug zoo" nrog intermediates / prostaglandins thiab thromboxanes.
Lub luag haujlwm tseem ceeb ntawm cov tshuaj yog los thaiv cov cysteyl leukotriene "sensors" ntawm cov hlab ntsws. Nws yog cov receptors uas tswj cov kev ua haujlwm siab ntawm lub bronchi thaum lub sij hawm kev loj hlob ntawm mob hawb pob, thiab lawv kuj txhawb lub synthesis ntawm secretion, uas ces accumulates thiab complicates lub mucous daim nyias nyias.
Kev noj zaub mov tsis tu ncua ua rau txo qis hauv qhov tseem ceebQhov hnyav ntawm cov tsos mob tawm tsam keeb kwm yav dhau los ntawm kev txo qis hauv cov neeg mob hawb pob (raws li ntau tus neeg mob nco ntsoov, kev hloov pauv zoo tau pom nyob rau thawj hnub ntawm kev kho mob).
Metabolic nta
"Montelukast" (kev tshuaj xyuas ntawm cov kws muag tshuaj qhia tias qhov kev xaiv tiag tiag ntawm cov khoom sib tw yog txwv los ntawm txoj cai tswj hwm tus nqi ntawm cov tuam txhab, uas yog, cov tshuaj sib txawv ntawm tus kheej, muaj cov qauv tsim qauv ntawm cov khoom tseem ceeb, yog ob peb zaug kim dua. cov tshuaj piav qhia), nkag mus rau hauv cov ntshav plasma, zoo kawg nkaus khi rau nws cov proteins. Hauv chav kawm ntawm kev tshawb fawb soj ntsuam, cov txiaj ntsig tau sau tseg ntawm qib 99.37%. Nyob rau tib lub sijhawm, nws bioavailability yog ncaj qha nyob ntawm daim ntawv thev naus laus zis ntawm kev tso tawm. Piv txwv li, cov khoom xyaw ntawm 5-milligram ntsiav tshuaj yog 73% absorbable, thaum cov yeeb yaj kiab-coated analogues, uas muaj 2 zaug ntau cov tshuaj nquag, tsuas yog 64%..
Ib qho xwm txheej zoo sib xws nrog ib nrab-lub neej ntawm cov tshuaj reagent: cov khoom ntawm cov tshuaj chewable, raug rau cov metabolism, tawm hauv lub cev 2 teev tom qab noj, thiab cov ntsiab lus ntawm cov ntsiav tshuaj ib txwm tom qab 180-200 feeb. Nyob rau tib lub sijhawm, plasma clearance txawv ntawm 43-45 ml / feeb. Thiab, nthuav, tsuas yog 0.2% ntawm cov koob tshuaj yog thauj los ntawm cov zis. Cov hnyuv, rau kev sib piv, - ntau dua 85%.
Los ntawm cov lus ntawm cov kws tshaj lij tau lees paub nws ua raws li cov txheej txheem pharmacokinetic ua haujlwm sib luag hauv cov neeg mob ntawm ob leeg poj niam txiv neej, thiab qhov ntawdua ib qho kev hloov kho loj rau lub hnub nyoog thiab lub raum pathologies thaum xam qhov niaj hnub ntawm cov tshuaj tsis tas yuav tsum tau. Tab sis kev ua haujlwm tsis zoo hauv daim siab, tshwj xeeb tshaj yog thaum muaj mob hnyav, tsim nyog tau txais kev saib xyuas ntxiv thaum kos lub sijhawm kho.
Cov lus qhia rau cov tshuaj
Thaum siv cov tshuaj "Montelukast" yog qhov tseeb, kev tshuaj xyuas (cov tshuaj tau pom zoo rau cov menyuam yaus hauv daim ntawv chewable; nws raug nquahu kom sau cov tshuaj yeeb yaj kiab tshwj xeeb rau cov neeg laus thiab cov tub ntxhais hluas) sab laug ntawm cov rooj sab laj, tau kawg, pab kom nkag siab. Txawm li cas los xij, tsuas yog coj los ntawm lwm tus neeg lub tswv yim yog qhov yuam kev loj, vim tias tsis muaj kev sab laj nrog kws kho mob, nws yuav luag tsis tuaj yeem "qhia" hom mob hawb pob, thiab qhov tseem ceeb tshaj, nrhiav seb qhov ua rau nws tshwm sim.
Raws li cov lus qhia raug cai, lub voj voog ntawm cov tsos mob, mob thiab lwm yam mob tau piav qhia raws li hauv qab no:
- bronchial spasms provoked los ntawm kev tawm dag zog ntau dhau;
- seasonal/chronic rhinitis of allergic origin;
- bronchial hawb pob;
- xav tau kev tiv thaiv.
noj tshuaj zoo tshaj
"Montelukast" (kev tshuaj xyuas tsis zoo yog qhov nyuaj heev los nrhiav, vim tias cov khoom muaj txiaj ntsig tau ntev tau siv los ua ib feem ntawm ntau cov tshuaj tshwj xeeb) tau noj hauv qhov ncauj, ib hnub ib zaug, yam tsis tau hais txog "kev noj tshais - pluas su - noj hmo" teem caij.
Rau 4mg thiab 5mg chewable ntsiav tshuaj, cov cai hauv qab no siv tau:
- cov menyuam yaus hnub nyoog 2 txog 5 xyoos: 1 units ntawm cov tshuaj (4 mg) ib hnub twg, thaum pw tsaug zog, kom txog thaum tswj cov tsos mob tiav, thiab yuav tsum ncua sijhawm ntawm chav kawm rau 2-4 lub lis piam kom sib sau ua ke. cov nyhuv tau;
- tus neeg mob hnub nyoog 6 txog 14 xyoos: zoo ib yam, tab sis ib koob tshuaj 5 mg.
Rau cov tshuaj yeeb yaj kiab, cov lus pom zoo hauv qab no siv:
- Cov neeg laus thiab menyuam yaus hnub nyoog qis dua 15 xyoos uas muaj mob hawb pob lossis mob rhinitis: 1 units (10 mg ntawm cov tshuaj) / hnub, yav tsaus ntuj;
- tiv thaiv spasms: tib koob tshuaj rau 14-28 hnub.
Side effect
"Montelukast" cov lus qhia (kev tshuaj xyuas paub meej tias txawm tias ua raws li cov kev cai ntawm cov lus qhia, cov tshuaj tiv thaiv atypical rau qhov muaj cov khoom xyaw tsis tuaj yeem txiav txim siab tag nrho) ua rau nws yog cov tshuaj muaj txiaj ntsig zoo, tab sis nrog cov kev cai. tias qhov tsis zoo "lus teb" los ntawm kab mob hauv ib tus neeg mob tseem ua tau.
Acceptable Scenario:
- GIT: raws plab, qhov ncauj qhuav, mob plab, xeev siab;
- lub plawv thiab cov kab mob: pom pom qhov nce hauv lub plawv dhia;
- tawv nqaij: pob khaus, khaus khaus, hauv zos hematomas;
- kab mob ua pa: rhinorrhea thiab hnoos hnyav;
- CNS: kiv taub hau, nkees nkees, kev nyuaj siab hloov pauv nrog ntau dhaupsychomotor agitation;
- musculoskeletal system: arthralgia thiab myalgia (nrog rau convulsions)
- lwm yam: cov tsos mob ntawm tus mob ua pa nyuaj thiab mob khaub thuas.
Kev txwv thiab contraindications
"Montelukast" (cov lus qhia rau kev siv cov kev tshuaj xyuas pom qhov zoo tshaj plaws, thiab cov ntaub ntawv muaj nyob rau hauv nws, los ntawm qhov pom ntawm lub hom phiaj, tsis muaj cov lus nug los ntawm cov tswv cuab ntawm lub rooj sab laj) tsis raug sau tseg yog tias:
- pom pom qhov tsis txaus siab rau cov tshuaj muaj pes tsawg leeg (txoj cai yog cuam tshuam rau txhua hom ntsiav tshuaj);
- kuaj pom muaj cov kab mob tsis tshua muaj tshwm sim, suav nrog cov uas lub cev tsis nqus galactose, lossis ntsib qhov tsis txaus lactase tseem ceeb (qhov kev txwv no tsis siv rau cov tshuaj chewable);
- tus neeg mob tus mob hnyav dua los ntawm phenylketonuria;
- tus neeg mob muaj hnub nyoog qis dua ob xyoos (hnub nyoog txwv rau ntsiav tshuaj yog 15).
Ntau dhau: cov tsos mob thiab kev kho mob
Cov kev tshawb fawb tau qhia: "Montelukast" 4 mg (kev tshuaj xyuas txog daim ntawv luam ntawm cov reagent, qhov tseeb, zoo ib yam rau cov lus uas tau hais rau chewable analogues uas muaj 5 mg ntawm cov tshuaj nquag), thaum noj txhua hnub. Kev noj ntau dhau, nws muaj qhov cuam tshuam tib yam rau lub cev, nrog rau 10 mg ntsiav tshuaj. Cov tsos mob tshaj plaws ntawm kev siv tshuaj ntau dhau yog pom nyob rau hauv cov neeg mob ntawm pab pawg hluas. Cov neeg laus, txawm tias thaum noj 200 mg / hnub rau 5 lub hlis, tsis tau ceeb toom txog qhov tshwm sim tsis zoo.
Nyob rau hauv ib ntus cais, ib qho kev qhia nce ntxivtshuaj concentration yog:
- nqhis dej tsis txaus;
- drowsy;
- mob plab;
- ntua;
Kev kho mob yog raws li daim duab soj ntsuam pom. Tsis muaj ntaub ntawv hais txog kev ua haujlwm ntawm hemodialysis.
Kev cuam tshuam tshuaj yeeb thiab cov analogues nrov tshaj plaws
"Montelukast" 5 mg (kev tshuaj xyuas ntawm cov qauv chewable tshuav los ntawm cov kws kho menyuam yaus npau taws rau lub tswv yim tias cov tshuaj no tsis xav tsis thoob tsim nyog los ntawm cov niam txiv hluas), zoo li lwm hom leukotriene receptor antagonist, thaum siv nyob rau hauv parallel nrog profile reagents pab txhawb kev ua kom nrawm ntawm qhov muaj zog zoo: cov tsos mob ntawm bronchial hawb pob ua rau tsis muaj suab nrov, tus naj npawb ntawm kev tawm tsam txo. Txawm li cas los xij, kev tshem tawm sai sai ntawm kev kho mob raws li kev nqus tau corticosteroids tsis pom zoo.
Tsis muaj qhov hloov pauv tseem ceeb hauv cov txheej txheem pharmacokinetic cuam tshuam nrog theophylline thiab prednisol tau pom. Tab sis kev nqus nrog "kev koom ua ke" nrog phenobarbital poob los ntawm ntau npaum li 40%.
Reagents uas inhibit qhov kev sib txuas ntawm CYP3A4 isoenzyme yuav tsum tsuas yog siv raws li kev saib xyuas kho mob.
Cov qauv qauv uas feem ntau pom ntawm muag:
- Moncasta.
- "Singlon".
- "Singular".
- Ektalust.
- Singulex.
"Singular" lossis "Montelukast": tshuaj xyuas ntawm cov kws kho mob thiab kws tshuaj
Raws li cov kws tshuaj paub txog, kev tsis sib haum xeeb ntawm cov tshuaj saum toj no muaj kev nyab xeeb dua thiab siv tau zoo dua yog qhov tsis muaj txiaj ntsig, txij li"Singular" thiab "Montelukast" muaj tib lub hauv paus tshuaj. Nws tsuas yog hais tias thawj lub npe lag luam tau dhau daim ntawv sau npe patent, thiab qhov thib ob yog thoob ntiaj teb. Cov kws kho mob thiab cov neeg mob, txawm li cas los xij, xav txog qhov sib txawv, thiab xav txog cov tshuaj uas tau muab faib rau hauv INN yog tib txoj kev daws teeb meem.
