Yokusetshenziswa, impendulo analog "Ketanova"

Kungani liqoke analog "Ketanova" wathi izidakamizwa ngokwayo? Lokhu uzofunda kusukela materials kwe-athikili. Siphinde ukwethula kini ukuba yokusetshenziswa imithi, ukunikeza ulwazi kwifomu ukukhululwa, ukusabela ezingezinhle, ukubunjwa, Izimo, izindleko nokunye.

Ukwakheka, emabhokisini ifomu ukukhululwa

Analogue "Ketanova" futhi emelelwa ithuluzi ngokwayo ingase ibe uhlobo oluhlukile ngokuphelele yokukhululwa. Isabelo incike ubunjalo ubuhlungu, indawo indawo yabo futhi ngezimo zesiguli.

Okwamanje, izidakamizwa "Ketanov" itholakala amafomu ezimbili ezihlukene. Thina sicabangele ngasinye sazo kabanzi.

• amaphilisi Film-camera. Uphiko asebenzayo we umuthi ketorolac tromethamine. Ngokuqondene izingxenye elisizayo, ke zihlanganisa corn isitashi, magnesium stearate, microcrystalline cellulose futhi colloidal Silicon dioxide. Ukwakheka enamathela ifilimu yakhiwa amaphilisi hydroxypropylmethylcellulose, amanzi ahlanzekile, polyethylene glycol, ama-titanium dioxide futhi talc hlamba. Kufanele kuqashelwe ukuthi i-analog ezinjalo "Ketanova" ngokuthi "Ketorolac", iqukethe ketshezi asebenzayo efanayo. ukulungiselela Okubukwe ithunyelwa aluminium amashashaza, okuyinto ezibekwe inqwaba amakhadibhodi. Omunye iphakheji kungenzeka kusuka eziyishumi ukuze izingalo eziyikhulu namashumi amaphilisi.

• Ukufakwa "Ketanov". Imijovo, analogue zazo kukhonjisiwe ngezansi, futhi aqukethe lo isithako njengoba ketorolac tromethamine. Ngaphezu kwalokho, ikhambi kufaka ukubunjwa yayo futhi izingxenye asizayo ngesimo sodium chloride, amanzi umjovo, disodium edetate, Ethanol kanye sodium hydroxide. Imithi okuthengiswa izitsha eziyisikhombisa eyodwa ngemililitha. Ibhokisi kungenzeka izitsha eziyisikhombisa emihlanu noma eyishumi.

I izakhiwo pharmacodynamic ka isidambisa-zinhlungu

Yini izakhiwo pharmacodynamic abhekwa izidakamizwa futhi okulingana yayo? "Ketanov" (amaphilisi kanye imijovo) has a liphinyiselwe umphumela analgesic. Umuthi anezakhi ngokulinganisela antipyretic futhi eqeda ukuvuvukala.

Ngokusho ochwepheshe, isimiso isinyathelo zomuthi elihlobene ne okusithiyayo (non-abakhethayo) umsebenzi enzyme Cox-2 kanye Cox-1. Le nqubo kwenzeka ezicutshini neuropathy. ukuchayeka okunjalo kubangela okusithiyayo of PG biosynthesis, modulators ie thermoregulation, ubuhlungu ukuzwela nokuvuvukala.

amaphilisi Isicelo "Ketanov" noma abaphathi esicutshini yesixazululo ikhuthaza kumiswa racemic ingxube [-] S- no- [+] R-enantiomers. Phela, umphumela analgesic zomuthi kungenxa kuphela [-] S-ukuma.

Kufanele kube waphawula ikakhulukazi ukuthi i nomuthi asebenzayo akusho sicindezeleke emishinini yokuphefumula, akunamthelela la mangqamuzana opioid, awusebenzi ifa umphumela anxiolytic futhi sine futhi akabubangeli nokulutheka.

Yini odinga ukukwazi ngaphambi kokuthatha lesi umkhiqizo noma okufana naso? "Ketanov" (amaphilisi kanye imijovo) ekuqineni umphumela wawo analgesic ifaniswe kuphela ukuthi ka-morphine. Ngokusho kochwepheshe, lokhu kusho kakhulu esiphakeme kunazo zonke ezinye izidakamizwa ezingekho steroidal.

Ngemva bomlomo noma esicutshini ekuphathweni analgesic umphumela siyenzeka ihora nengxenye, ngokulandelana. Umthelela esiphezulu zomuthi kufezwa ngokusebenzisa imizuzu 60-120.

izakhiwo pharmacokinetic

Umuthi yokuqala, kanye nanoma yikuphi Analogue "Ketanova" ngemva kokungenisa ugxile pheshana emathunjini kunalokho kahle. I lokuhlushwa eliphezulu kakhulu izidakamizwa egazini kufinyelelwe ngemva amane imizuzu emva amaphilisi kokungenisa kokuzila (10 mg). Kufanele kuqashelwe ukuthi ukudliwa kokudla oily futhi okungenamsoco kungaba kakhulu ukunciphisa okuhlushwa esiphezulu zomuthi egazini bese ugcine impumelelo yakhe ngesikhathi imizuzu ayisithupha.

Mayelana 99 amaphesenti izimali nakanjani plasma amaprotheni. Lapho empeleni isibalo khulula hypoalbuminemia izakhi ezikulesi inyuka igazi. Ngokuphathelene bioavailability zomuthi, kumayelana 80-100%.

Uma abaphathi esicutshini ngokushesha futhi ngokuphelele angena izidakamizwa egazini "Ketanov". Analogs (Ukraine ibilokhu esikhiqiza kuphela "Ketorolac") njengoba ugxile kahle.

Ngemva ujove esicutshini 30 mg zomuthi siphezulu kakhulu emakamu 1,75-3,2 micrograms yayo / ml bese usebenzisa 60 mg - 3,25-5,75 g / ml. Ubuningi esiphezulu izidakamizwa egazini sibizwa ebonwe imizuzu 15-20 futhi 35-65, ngokulandelana.

Kungakhathaliseki izidakamizwa ingena phakathi ubisi lwebele? Futhi kuyabiza, futhi ezishibhile Analogue "Ketanova", futhi wayebheka izidakamizwa kalula ukungena ubisi lwebele. Lokhu kwenzeka ngokushesha emva komthamo wokuqala nomuthi e isamba 10 angu. I lokuhlushwa eliphezulu kakhulu izidakamizwa e ubisi izilinganiso kufinyelelwe emva kwemizuzu engu-120 futhi 7.3 ng / l.

Mayelana 50% umthamo iqondiswa zomuthi is akheka esibindini. Ngenxa yalokho, metabolites ngasebenzi akhiwa. Chief phakathi kwabo kukhona gidroksiketorolak wesifunda futhi glucuronides. Ivamise izinso (cishe 91%) futhi emathunjini (mayelana 6%).

Impilo isigamu zomuthi in iziguli umsebenzi evamile kwezinso kuyinto amahora mayelana 5.4. Lokhu value abahlukene anda asebekhulile futhi liyancipha abasha.

isibindi akunamthelela nenxenye ukuphila zomuthi. Kufanele kuqashelwe ukuthi le izidakamizwa aliveli inqubo isebenzisa umshini wezinso.

izinkomba

Asho izidakamizwa "Ketanov"? Analogue kwezidakamizwa kubalulekile kakhulu impumuzo yesikhashana ubuhlungu zasezindaweni ezihlukahlukene.

Ngakho, nomuthi kubhekwe engabelwe kona:

• ubuhlungu nasezinkingeni ezilandela ngemva kokuhlinzwa (kufaka ngemuva udokotela wamathambo, izifo zabesifazane kanye lesisu);
• amazinyo (kufaka ngemuva kokuhlinzwa amazinyo);
• ubuhlungu syndromes ngemuva kokuthola ukwa, dislocation, futhi ezithambile izicubu ukulimala;
• ubuhlungu kwangemva kokubeletha;
• ubuhlungu syndromes okwenzeka osteoarthritis;
• ubuhlungu syndromes ezibangela umdlavuza;
• sciatica.

Bambalwa abantu bazi, kodwa ukusetshenziswa amaphilisi "Ketanov" futhi isixazululo komjovo lingakhonjiswa obungapheli syndromes. izidakamizwa ezinjalo kuphela ezidingekayo zokuqeda ukungakhululeki yesikhashana. Ukuthatha izidakamizwa isikhathi eside isikhathi akuvunyelwe.

Izimo

Njengoba eminye imithi non-steroidal ukulungiselela "Ketanov" lisetshenziswe ubuhlungu has Izimo eziningi ezahlukene. Yingakho ngaphambi kokuba uyisebenzise kufanele uxhumane nodokotela wakho futhi ufunde imiyalelo. Ichaza Izimo ezilandelayo:

• izilonda erosive futhi esidalwa yizilonda emathunjini sibe yokusetshenziswa pheshana emathunjini, ikakhulukazi esigabeni oyingozi, hypocoagulation (kuhlanganise hemophilia) kanye isilonda peptic;
• ukuzwela Ukwandiswa ukuze ketorolac nesineke kanye nezinye ama-NSAID, bronchospasm, ukuntuleka kwamanzi emzimbeni, angioedema, aspirin isifuba somoya, hypovolemia (kungakhathaliseki ukuthi iyini imbangela nesenzakalo yayo);
• isibindi noma sezinso (at ukuhluleka), ikakhulukazi plasma creatinine at 50 mg / l;
• oluhambisana unhlangothi (esolwa noma waqinisekisa), oluhambisana diathesis, kwengozi Ukuphinda noma ukopha (kufaka ngemuva kokuhlinzwa), ukusetshenziswa concomitant nezinye ama-NSAID, hematopoiesis kahle;
• yobudala engaphansi kwengu-16;
• Phakathi nenkathi yokukhulelwa, le nqubo lokuzalwa futhi ngesikhathi lactation;
• Ukwelashwa nokuvikelwa ubuhlungu chronic syndromes uhlamvu;
• izinzwa ngaphambi nje kokuba ahlinzwe futhi phakathi kwabo (ngenxa kwengozi ukopha).

Asinakusho ukuthi nomuthi asebenzayo ezinqunyiwe ngokuqapha in iziguli cholecystitis, isifuba somoya bronchial, ezingamahlalakhona ukuhluleka kwenhliziyo, ukuhlinzwa kwezinso (plasma creatinine esingaphansi 50 mg / l), umfutho wegazi ophakeme, isifo sokusha kwesibindi kohlobo asebenzayo, cholestasis, sepsis, lupus letindzala lupus, kanye nasebekhulile (engaphezu kwengu-65) kanye nalabo polyp e ulwelwesi lwesisu, kwenze nasopharynx nekhala.

Izidakamizwa "Ketanov": yokusetshenziswa

Analogs yindlela efanayo izindlela kwesicelo kanye umthamo. Kodwa ukuze ugweme overdoses ngaphambi kokusetshenziswa yabo Kunconywa ukuba aye kudokotela.

Kumelwe ngiphuze kangakanani amaphilisi "Ketanov"? Leli fomu zomuthi kuyadingeka ukuthatha olulodwa setemlomo (10 mg). Uma kudingekile (isib nge oqinile ubuhlungu syndrome) nomuthi umthamo kungenziwa kabili. Nokho, kufanele kuphawulwe ukuthi umthamo nsuku zonke zomuthi kumele singeqi 40 mg.

Lapho ukungenisa isikhathi izidakamizwa sifundo izinsuku ezinhlanu (hhayi ngaphezulu).

Uma ngesizathu esisodwa noma ngesinye isiguli awukwazi ukuthatha yetemlomo zomuthi (isb, khona erosive noma izilonda emathunjini isisu, wamathumbu), khona-ke kunikezelwe isixazululo umjovo. ifomu okunjalo iqondiswa intramuscularly.

Ekuqaleni yokwelapha izidakamizwa asetshenziswe okungenani imithamo ngempumelelo ukuthi baye bakhethwa ngokuhambisana ukushuba ubuhlungu syndromes futhi impendulo isiguli. Uma kudingekile, isiguli anqunyiwe analgesics ezengeziwe opioid.

A olulodwa Isikali ekwakhiweni ngoba umjovo owodwa esicutshini:

• abantu abangaphansi kweminyaka engu-65 ubudala - mayelana ayi-10-30 mg (kuye ngokuthi ukushuba ubuhlungu);
• abantu abaneminyaka engaphezu kuka-65, kanye in iziguli kahle izinso umsebenzi - 10-15 mg.

Isikali nangemva kokuyalwa kaningi ekuphathweni esicutshini:

• abantu 65 - mayelana ayi-10-30 mg, bese inani elifanayo njalo ngemva kwamahora amane kuya eziyisikhombisa;
• abantu abaneminyaka engama-65 kanye in iziguli kahle izinso umsebenzi - 10-15 mg njalo emahoreni 4-7.

Umthamo wansuku zonke zomuthi lapho zaphathwa intramuscularly ukuba abadala kumele singeqi 90 mg. Ukuze ezigulini esezikhulile kanye nalabo kahle izinso umsebenzi kubalulekile inciphise mg-60. Ubude yokwelashwa akufanele kube amalanga angaphezulu kwamahlanu.

Phakathi aphuma ekuphathweni esicutshini zomuthi phezu imithi ku umthamo Imininingwane yansuku zonke zombili lezi zinhlobo akufanele idlule 90 mg abadala kanye 60 mg ngoba iziguli esezikhulile noma iziguli eziphathwa kahle izinso umsebenzi.

Izimpawu ze-ukweqisa izidakamizwa

At ngemithamo ephakeme of nomuthi kusho isiguli waphawula ukuhlanza, ubuhlungu besisu, ukusebenza kwezinso, lactic umzimba, isicanucanu, kolwelwesi erosive kanye isilonda peptic.

Njengoba ekwelapheni izimo ezinjalo usebenzisa lavage esiswini kanye ukwethulwa adsorbents ahlukahlukene. Futhi ukwelashwa okunezimpawu (ie ukusekela imisebenzi ebalulekile zomzimba).

izidakamizwa ekuhlanganyeleni

Lapho isicelo ahlangene izidakamizwa ngaphansi ukucatshangelwa namanye ama-NSAID, isiguli singase ukuthuthukisa imiphumela emibi kwalokho, futhi anticoagulants (kuhlanganise "heparin" ngemithamo emincane futhi "Pentoxifylline") - ukopha.

Uma ukusetshenziswa concomitant zomuthi ziqala ACE inhibitor, kungase kube ukushayisana kwe-izinso.

Kufanele kuphawulwe ukuthi ukusetshenziswa kwezidakamizwa kokubuyekezwa, nge "Probenecid" kwandisa isigamu-ukuphila ketorolac okuhlushwa yayo plasma.

Uma uthatha le imithi nge lithium, kungenzeka ukuba wehlise imvume kwezinso of lithium futhi ukwandisa lokuhlushwa yayo yi-plasma, kodwa "Furosemide" - ukwehlisa umphumela wawo isisu.

Phakathi isicelo "Ketorolac" asikho isidingo ngokuthatha opioid analgesics.

I Analogue engcono

"Ketanov" - lena enamandla kakhulu futhi ngempumelelo izidakamizwa analgesic, okuyinto okuthengiswa cishe yonke drugstores. Ekhuluma analogs yayo, kunzima ukuqamba umuthi ephumelela kunazo. Ngakho-ke, ngempumuzo okusheshayo ubuhlungu syndrome ngokuvamile odokotela linqume ukuba iziguli zabo Isidakamizwa. Kodwa uma ngenxa yezizathu ezithile izidakamizwa is contraindicated kuwe, sincoma ukuthi esikhundleni salo "Ketorolac". Kuye intengo yezwe-nomkhiqizi leli thuluzi ingase ibe khona ehlukile. Izindleko ukupakisha amaphilisi Russian kuqala ruble 20, Ukraine - 35, futhi Indian - 45.

Yini enye kubhekwa umuthi ungayithola enye? Ingabe inemithwalo nezinye Analogue? "Ketanov" ngaphandle kadokotela, ungahlala ukuthenga kule ekhemisi. Ngo ncamashi ngendlela efanayo ungathenga abezindaba efanayo ezifana "Adolor", "Torolak", "imithi Akyular", "Toradol", "Dolak", "Ketofril", "Dolomin", "Ketorolac tromethamine-Farmaplant", "Ketadrop "" Ketorolac tromethamine, "" Ketalgin "," Ketorolac--Eskom "," Ketokam "," Ketorolac-Verte "," Ketolak "," Ketorolac-OBL "," Ketorolac Rompharm "," Ketorol "nabanye.

Izindleko le mithi kungaba ephakeme original futhi ngezansi. Khumbula ukuthi lesi sidakamizwa "Ketanov" (amaphilisi 10) angathengwa ruble 50-70. Kufanele ukuthi it is hhayi Kunconywa ukuthatha ke uma bebona kunesidingo siqu.

Yikuphi ithuluzi ukuyisebenzisa ukuze ukukhululeka ubuhlungu zendawo? Ingabe ikhona ifomu elihambisana the "Ketanov" izidakamizwa? Wamafutha (analogs ka wathi agents izibhebhe ziye ethulwa ngenhla) ngempahla asebenzayo esifanayo kunzima ukuthola. Nokho, kusekuningi izidakamizwa engasetshenziswa ihlelwe ngokulandelana kwezihloko. Lena 2% imithi ngokuthi "Ketorol" (eyenziwe India). indlela enjalo itholakala 30 amalutshwana kusiya amashubhu futhi ngokushesha ususa noma isiphi syndromes ubuhlungu (lapho isicelo ihlelwe ngokulandelana kwezihloko).

Uphenyo amaphilisi ezinhlungu

Manje uyazi ukuthi kuyinto izidakamizwa "Ketanov", okuyiwona wona kuhloswe. Kufanele kuqashelwe ukuthi cishe zonke iziguli Izibuyekezo of the nomuthi akhayo. Abantu ababeka njalo besebenzisa amaphilisi noma isixazululo umjovo "Ketanov" sisho ukuthi izidakamizwa ezifana aqede ngokushesha ngempela iyiphi syndromes ubuhlungu.

Njengoba kuboniswa kwezokwelapha, umphumela izinzwa kuthathe amahora 12-15 (ngezinye izikhathi eside). Emva kwalesi sikhathi, amaphilisi kufanele liphindwe (uma ubuhlungu awuphasiswa).

Nokho, akunakwenzeka ukuba akhulume iqiniso lokuthi lokhu izidakamizwa, njengamanye ama-NSAID, kukhona okuningi amathuba okuba nemiphumela engemihle. Ngokusho izimpendulo iziguli, ngezinye izikhathi lokhu imithi kubangela nesicanucanu ubuhlungu besisu. Kulokhu, ochwepheshe batusa ukuba esikhundleni yetemlomo lomjovo izidakamizwa. Phela, noma ubani akuyona imfihlo ukuthi ama-NSAID kungabangela izinkinga ezinkulu esiswini (isib, laba kanjani nesandla ukuvela izilonda noma erosions).

Kufanele kuphawulwe ukuthi iziguli eziningi ikakhulukazi yamjabulisa amathuluzi intengo yokubika. Uma ucabanga ukuthi kubalulekile ukuthatha yesikhathi esisodwa, futhi lokho kuthatha isikhathi esifushane, a ibhamuza nge amaphilisi kungaba okwanele u-Adalberto isikhathi eside. Kuyefana nasendleleni ifomu nemijovo zomuthi.