"Phenytoin": malangizo ntchito, analogs, Kaonekedwe

Kodi tingachite mankhwala monga "Phenytoin" Malangizo ntchito, analogs wothandizira ndi yemweyo yogwira pophika Adzaperekedwa pansipa.

katundu mankhwala ndi maonekedwe a

"Phenytoin" ndi chimodzimodzi yogwira pophika ndi mankhwala odana ndi khunyu. Ndi ndilochokera ku hydantoin, pafupi kwambiri chidulo barbituric (mankhwala kapangidwe awo).

Thunthu amenewa m'gulu mndandanda wa mankhwala ofunika ndi WHO, komanso mndandanda wa mankhwala ofunika.

Phenytoin (malangizo ntchito mankhwala ndi chigawo adzakhala ankaimira hereinafter) anali apanga mu chaka cha 1908. Ndipo kokha kwa 1937-TH kuti katundu anticonvulsant ankagwidwa.

mankhwala ndi ufa (crystalline) mtundu woyera umene uli pafupifupi insoluble m'madzi. pawiri Izi zikhoza zidzasungunuka mu njira 1% ya soda caustic.

Panopa kumasula mapiritsi m'kamwa "Phenytoin" komanso zikutanthauza kuti makonzedwe parenteral.

mankhwala

Kodi mankhwala "Phenytoin"? Malangizo ntchito limasonyeza kuti nyamayi wothandizila anticonvulsant, antiarrhythmic, antiepileptic ndi minofu katundu anasiya.

ntchito Anticonvulsant kukonzekera izi m'malo okwezeka. Komabe, udindo wake sayambitsa kugona ndi ulesi.

Phenytoin otchedwa ogwira zamera-magetsi stabilizer. Akavala mlingo waukulu wa mankhwala, zikhoza kuyambitsa kugwirizana osauka kuyenda anthu.

njira ankaona imayendetsa ndi CNS, kumaonjezera excitability pakhomo, ali ndi kanthu antiarrhythmic pa mtima, komanso kumachepetsa mlingo wa ndime ya nyemba za chipika mtengo nthambi ndi Purkinje ulusi.

Limagwirira cha zochita za mankhwala

Malinga ndi zomwe zotsatira mankhwala "Phenytoin"? Malangizo limanena kuti mfundo za zotsatira thupi akadali asanamvetsetse. Komabe, akatswiri amanena kuti mbali yofunika ya chida ichi ndi mphamvu yake ziziyenda nembanemba (okhudza mitsempha) kugwirizana synaptic maselo mitsempha ndi thupi.

Chifukwa zotsatira zimenezi, mankhwala akhoza kuchepetsa kufala kwa malemeredwe okhudza mitsempha komanso kuchepetsa ntchito kudwala.

Features ndalama

Machiritso chidwi "Phenytoin"? Malangizo ntchito inanena kuti mankhwala ake yogwira amakhudza ganglia autonomic, msana ndi ubongo minofu, mtima, kuphatikizapo dongosolo lawo conductive, misempha zotumphukira ndi yosalala minofu ya m'mimba ndi mtima ziwiya.

Kulandira mankhwala kumachepetsa ndi sodium ndende mu manyuroni, atsogolere mayendedwe a ayoni ndi sodium ku maselo, komanso kuchepa kayendedwe okhudza maselo ambiri calcium.

Tikumbukenso kuti mankhwala ankaona zimakhudza ntchito fibroblasts, maselo glial, ndi endocrine. Komanso anapeza mphamvu yake imathandizira bala machiritso, kupondereza ntchito ya maselo (glutamate), kusintha kotunga mpweya ku maselo, zimakhala ndi ziwalo mu zikhalidwe za hypoxia ndi poizoni poizoni.

Mankhwala pa mlingo achire ali zolimbitsa toning ndi utatha ndipo si osokoneza.

kinetics

Kodi phenytoin mankhwala imatsala? Malangizo ntchito (a mtundu wa amasulidwe dzina yemweyo mankhwala wakhala dzina lake pamwamba) limanena kuti utsogoleli m'kamwa wa mankhwala chigawo cha ichi mwachilungamo mosavuta chosakanikirana ndi thupi la wodwalayo. Komabe, magawo pharmacokinetic ankaona njira zingasiyane ndi za magulu osiyana odwala.

Ndende apamwamba mankhwala magazi zimatheka pasanathe maola 5-14 (mpaka 28 maola chiphunzitso piritsi). Zotsatira za makonzedwe m'kamwa mankhwala zimawonedwa pambuyo pa ola limodzi, ndipo pambuyo makonzedwe mtsempha - patapita mphindi pang'ono.

Pafupifupi 80% ya mankhwala yogwira amagwirizana ndi mapuloteni madzi a m'magazi. Anthu ndi matenda a impso, mlingo angafikire 43%.

Malinga ndi lamulo la ndalama mwachilungamo msanga chililaka ndi magazi ubongo chotchinga. Mu nkhani iyi, ndi anagawira pafupifupi zimakhala ndi ziwalo.

Za 5% ya phenytoin ndi outputted ndi impsozo. Mokhudzana ndi mankhwala otsala, izo zimapukusidwa mu chiwindi ndi n'kukhala paraoksifenily wofooka ndi glucuronides kenako kutuluka thupi limodzi ndi ya ndulu ya.

Kodi ndimagwiritsa ntchito mankhwala "Phenytoin"? Kugwiritsa ntchito mankhwala zikusonyezedwa ndi pentobarbital, mavitamini D ndipo K, komanso protivoepileptikami ena. Only mu nkhani iyi adzakhala opindula ngati nkotheka.

umboni

Nthawi zina, ntchito mankhwala ndi pophika yogwira, monga phenytoin? Malangizo ntchito (mapiritsi ndi njira ayenera amalangiza mokha dokotala) akusonyeza zizindikiro zotsatirazi:

• khunyu;
• nthawi pambuyo opaleshoni ndi zoopsa (monga mankhwala otetezera);
• yamitsempha yamagazi ndi supraventricular arrhythmia, umene anachititsa ndi ambiri osokoneza wa antidepressants ndi glycosides mtima;
• udindo epilepticus ndi khunyu tsankho zovuta zimandilimbikitsa-clonic kukomoka;
• syndrome Meniere ndi;
• trigeminal neuralgia, kuphatikizapo kulimbikira kuti carbamazepine;
• anam'peza matenda a m'matumbo kapena azitsegula (mu kupanda mankhwala ena);
• zipolowe za maganizo, matenda okhudza ubongo, matenda khalidwe;
• strabismus ndi khungu;
• nthenda kusinthika ndondomeko (amayaka, caries mano, ulceration ndi matendawa);
• relapsing malungo ndi matenda hypothalamic.

contraindications

mankhwala ankaona mwina ntchito pamene:

• cachexia kapena leukopenia;
• mkaka wa m'mawere;
• aakulu chiwindi ndi matenda a impso;
• mtima kulephera, AV-anatseka misewu ya 2 kapena digiri 3, bradycardia;
• hypersensitivity kuti yogwira;
• porphyria;
• syndrome wa Morgagni-Adams-Stokes;
• mimba.

Komanso, kusamala odwala ndi shuga, uchidakwa, pamene lupus erythematosus kapena hyperthermia.

Medicine "Phenytoin": malangizo ntchito

Mlingo wa mankhwala amusankha payekha malinga m'badwo wodwalayo ndi matenda.

Pamene matenda akhunyu mlingo ayenera kangapo poyerekeza ndi khunyu. Medicine mu mawonekedwe mapiritsi kokha pa chakudya.

Mlingo tsiku odwala wamkulu chimachititsa mapiritsi 1-3 (ogaŵikana Mlingo 2-3). Ngati ndi kotheka, nambala iyi akhoza ziwonjezeke kwa mapiritsi 4 tsiku.

Mlingo pazipita mankhwala patsiku ndi mapiritsi 8. Pankhaniyi, pa nthawi wodwala yekha mapiritsi 3.

Mankhwalawa ana osaposa zaka 5 iwo adzaika ¼ piritsi kawiri pa tsiku. Kids zaka 5-8 - mu yofanana, koma nthawi 3 kapena 4 pa tsiku.

Ana amene anakwanitsa zaka 8, Ndi bwino kupereka mapiritsi 1-2 mu 2 Mlingo wogawanika.

Kutalika kwa mankhwala ndi chida ichi limanenedwa yekha ndi katswiri.

Zochita ndi-khalidwe

Mankhwala phenytoin zikhoza zotsatirazi zotsatira osafunika:

• Khungu ziwengo, zidzolo morbilliform (ayenera kusiya mankhwala kuti matenda).
• Aakulu thupi lawo siligwirizana (kawirikawiri zikayamba), malungo, yaikulu kuphulika khungu, Stevens-Johnson syndrome, erythema angioedema, matenda a chiwindi.
• Gingival hyperplasia, macrocytosis, osteomalacia, megaplasticheskaya magazi m'thupi, thrombocytopenia, pancytopenia, hirsutism, haemolytic magazi m'thupi, lymphadenopathy.
• matenda mlingo amadalira a dongosolo chapakati mantha, diso, milomo ndi zikope fibrillation, nkhawa, ataxia, chizungulire, kugwedeza tulo, irritability, neuropathy chipangizo (zikuchitika ndi Mlingo yaitali mkulu).
• Hypertrichosis, coarsening wa nkhope, hyperpigmentation, kuwonda, nyamakazi.

Tiyeneranso kukumbukira kuti pamene kulandira mlingo woyamba, wodwala angathe zotsatira zotsatirazi mbali matenda a m'mimba, kukwezedwa kwa michere chiwindi, nseru, dyspepsia, gastralgia ndi gastritis. Zikamera wa zotsatira akhoza kupewedwa ngati inu kumwa mankhwala lokha pa chakudya.

Nthawi cha mankhwala osokoneza bongo

Ntchito mankhwala ankaona pa mlingo waukulu kwa nthawi yaitali kungachititse kuti chitukuko cha ataxia, nystagmus, hyperkinesis, neuropathy chipangizo, ndi diplopia. Komanso, wodwala akhoza kusonyeza khunyu phindu, hyperglycemia, ndi stupor.

Tikumbukenso kuti mankhwala palibe adakalibe yeniyeni. Therapy ayenera idzachitika mogwirizana ndi zizindikiro za kuwonetseredwa.

tsatanetsatane

Ndalama sangakhoze mwadzidzidzi kuletsa odwala khunyu, ngati zimenezi zikhoza chitukuko cha matendawa. Ngati mukufuna akana kulandira (mwachitsanzo, chifuwa kapena hypersensitivity), muyenera kugwiritsa ntchito odana ndi kulanda mankhwala a mtundu wina.

Kuchiza ankaona amakhudza mafuta m'thupi, bilirubin, phosphatase zamchere, michere chiwindi, shuga, seramu kashiamu ndi timadzi thyroxine.

Monga tanena phenytoin mankhwala ndi zimapukusidwa mu chiwindi Koma pa phwando ake amafuna kusamalidwa kwa anthu ndi kulephera chiwindi.

Munthu amene kale anati hypersensitivity kuti anticonvulsants hydantoin, ndiye thunthu n'zothekanso ziwengo.

Pa mankhwala, mtima ndikoletsedwa kuyendetsa galimoto ndi kuchita ntchito woopsawo.

Analogs ndi ndemanga

Kodi m'malo antiepileptic mankhwala "Phenytoin"? Analogues wa wothandizila muli yemweyo yogwira pophika. Mankhwalawa ndi izi: "Difenin", "diphenylhydantoin" ndi "Dilantin".

ndemanga odwala ambiri pansi kulingalira ndi chilungamo. Iwo amanena kuti mankhwala ndi anasamutsidwa mosavuta. Komanso, ali ndi zochepa ndipo sasiya katundu anticonvulsant ngakhale pambuyo makonzedwe yaitali.

Tiyenera kuona kuti pali zambiri ndemanga zabwino galimoto iyi, imene yatsala odwala amene anatenga izo mu mankhwala zovuta.