Cov lus qhia rau kev siv, tawm tswv yim thiab analog "Ketanova"

Yog vim li cas xaiv ib tug analog "Ketanova" thiab hais tias cov tshuaj nws tus kheej? Qhov no koj yuav kawm tau los ntawm cov ntaub ntawv ntawm qhov tsab xov xwm. Peb kuj qhia koj mus rau cov lus qhia rau kev siv ntawm cov tshuaj, muab cov ntaub ntawv nyob rau hauv qhov kev tso tawm daim ntawv no, phiv tshuaj, muaj pes tsawg leeg, contraindications, nqi thiab thiaj li nyob.

Muaj pes tsawg leeg, ntim, tso daim ntawv

Analogue "Ketanova" thiab sawv cev los ntawm lub cuab tam rau nws tus kheej tej zaum yuav muaj sib txawv kiag li daim ntawv tso. Cov hauj lwm nyob rau qhov xwm ntawm tus mob, qhov chaw ntawm lawv qhov chaw nyob thiab mob ntawm tus neeg mob.

Tam sim no, cov tshuaj "Ketanov" yog muaj nyob rau hauv ob hom sib txawv. Peb xav txog txhua yam ntawm no nyob rau hauv ntau yam.

• Zaj duab xis-coated ntsiav tshuaj. Lub active feem ntawm cov tshuaj yog ketorolac tromethamine. Raws li rau lub koom haum pab Cheebtsam, ces lawv muaj xws li cov pob kws starch, magnesium stearate, microcrystalline cellulose thiab colloidal silicon dioxide. Muaj pes tsawg leeg ntawm zaj duab xis txheej comprises hydroxypropylmethylcellulose ntsiav tshuaj, purified dej, polyethylene glycol, titanium dioxide thiab talc lim. Nws yuav tsum tau muab sau tseg hais tias xws li analog "Ketanova" raws li "Ketorolac", muaj tib active tshuaj. Saib npaj marketed nyob rau hauv txhuas blisters, uas yog muab tso rau hauv ib pawg ntawm cov duab los qhia. Ib pob yuav tsum yog los ntawm kaum rau ib puas ntsiav tshuaj.

• Txhaj "Ketanov". Tshuaj, analogues ntawm uas muaj qhia hauv qab no, kuj muaj qhov no active ingredient li ketorolac tromethamine. Nyob rau hauv tas li ntawd, cov tshuaj muaj xws li nyob rau hauv nws muaj pes tsawg leeg thiab koom haum pab cheebtsam hauv daim ntawv ntawm sodium tshuaj dawb, dej kev txhaj tshuaj, disodium edetate, ethanol thiab sodium hydroxide. Tshuaj yog muag nyob rau hauv vials ntawm ib tug milliliter. Lub thawv tej zaum yuav tsib los yog kaum vials.

Lub pharmacodynamic thaj chaw ntawm ib tug analgesic

Yuav ua li cas pharmacodynamic khoom no xam tau tias yog ib tug yeeb tshuaj thiab nws sib npaug? "Ketanov" (ntsiav tshuaj thiab tshuaj) muaj ib tug hais analgesic nyhuv. Cov tshuaj muaj ntsis antipyretic thiab anti-inflammatory zog.

Raws li cov kws txawj, lub hauv paus ntsiab lus ntawm kev txiav txim ntawm cov tshuaj txuam nrog inhibition (non-xim) ua si ntawm lub enzyme COX-2 thiab COX-1. Qhov no txoj kev tshwm sim nyob rau hauv peripheral ntaub so ntswg. Tej raug ua inhibition ntawm PG biosynthesis, piv txwv li modulators thermoregulation, mob rhiab heev thiab o.

Daim ntawv thov ntsiav tshuaj "Ketanov" los yog intramuscular thawj coj ntawm cov tshuaj txhawb tsim ntawm ib tug racemic sib tov [-] S- thiab [+] R-enantiomers. Incidentally, lub analgesic nyhuv ntawm cov tshuaj yog vim tsuas mus [-] S-zoo lawm.

Nws yuav tsum tau tshwj xeeb yog muab sau tseg tias active medicament tsis mluas ua pa, muaj tsis ntxim rau cov opioid receptors, nws tsis muaj anxiolytic thiab sedative nyhuv thiab tsis ua rau dependence.

Yuav ua li cas koj yuav tsum paub ua ntej yuav noj cov khoom no los yog qhov sib npaug? "Ketanov" (tshuaj thiab tshuaj) rau lub zog ntawm nws analgesic nyhuv yog piv tsuas hais tias ntawm morphine. Raws li kws txawj, qhov no txhais tau tias ho superior rau tag nrho lwm cov uas tsis yog-tshuaj tshuaj.

Tom qab qhov ncauj los yog intramuscular thawj coj analgesic cov nyhuv yog cai nyob rau hauv ib teev thiab ib nrab, ntsig txog. Qhov siab tshaj plaws cov nyhuv ntawm cov tshuaj no yog tiav los ntawm 60-120 feeb.

pharmacokinetic zog

Tus thawj yeeb tshuaj, raws li zoo raws li tej analogue "Ketanova" tom qab haus es zoo absorbed nyob rau hauv txoj hnyuv ib ntsuj av. Qhov siab tshaj plaws concentration ntawm cov tshuaj nyob rau hauv cov ntshav yog mus txog tom qab txog plaub caug feeb tom qab haus yoo mov ntsiav tshuaj (10 mg). Nws yuav tsum tau muab sau tseg tias tau ntawm oily thiab junk zaub mov yuav txo tau lub siab tshaj plaws concentration ntawm cov tshuaj nyob rau hauv cov ntshav thiab kom nws kawm tau ntawv zoo nyob rau caum feeb.

Hais txog 99 feem pua ntawm cov nyiaj ua txhua yam rau ntshav proteins. Thaum lub xov tooj ntawm free hypoalbuminemia tshuaj nyob rau hauv cov ntshav qab. Nrog kev xav txog cov bioavailability ntawm cov tshuaj, nws yog hais txog 80-100%.

Yog hais tias intramuscular thawj coj yog sai thiab tag absorbed rau hauv cov hlab ntsha tshuaj "Ketanov". Analogs (Ukraine tau ua xwb "Ketorolac") raws li tau zoo absorbed.

Tom qab intramuscular txhaj ntawm 30 mg ntawm cov tshuaj yog nws siab tshaj plaws concentration 1,75-3,2 micrograms / ml thiab siv 60 mg - 3,25-5,75 g / ml. Qhov siab tshaj plaws concentration ntawm cov tshuaj nyob rau hauv cov ntshav yog cai nyob rau hauv 15-20 thiab 35-65 feeb, ntsig txog.

Seb tshuaj penetrates mus rau hauv niam cov kua mis? Thiab kim, thiab pheej yig analogue "Ketanova", thiab nws suav hais tias cov tshuaj yuav tau yooj yim mus rau mus rau hauv niam cov kua mis. Qhov no tshwm sim tam sim ntawd tom qab thawj koob ntawm medicament nyob rau hauv ib tug npaum li ntawm 10 milligrams. Qhov siab tshaj plaws concentration ntawm cov tshuaj nyob rau hauv cov mis nyuj ntawm ib tug ntau npaum mus txog tom qab txog 120 feeb thiab yog 7.3 ng / l.

Hais txog 50% ntawm cov muab koob tshuaj ntawm cov tshuaj yog metabolized nyob rau hauv lub siab. Raws li ib tug tshwm sim, tsaug zog metabolites raug tsim. Chief ntawm lawv yog koog tsev kawm ntawv gidroksiketorolak thiab glucuronides. Lawv feem ntau ob lub raum (kwv yees li 91%) thiab los ntawm cov hnyuv (txog 6%).

Lub ib nrab neej ntawm cov tshuaj nyob rau hauv cov neeg mob uas ib txwm raum ua hauj lwm yog hais txog 5.4 teev. Qhov no tus nqi yog markedly nce nyob rau hauv cov neeg laus thiab nyob rau hauv cov tub ntxhais decreases.

siab muaj tsis ntxim rau cov ib nrab-lub neej ntawm cov tshuaj. Nws yuav tsum tau muab sau tseg tias cov tshuaj tsis tshwm sim nyob rau hauv tus txheej txheem ntawm kev lim ntshav.

indications

Dab tsi yog meant tshuaj "Ketanov"? Analogues ntawm cov tshuaj thiab nws yog ib qhov tsim nyog rau short-term nyem ntawm qhov mob los ntawm ntau yam keeb kwm.

Yog li, qhov suav hais tias medicament kws kho rau:

• postoperative mob (xws li tom qab orthopedic, gynecological thiab mob plab phais);
• hniav (xws li tom qab phais nyob rau hauv kev kho hniav);
• mob syndromes tom qab tau txais puas, dislocation, thiab nqaij mos raug mob;
• postpartum mob;
• mob syndromes tshwm sim nyob rau hauv osteoarthritis;
• mob syndromes uas ua rau mob cancer;
• sciatica.

Ob peb cov neeg paub, tab sis txoj kev siv cov ntsiav tshuaj "Ketanov" thiab injectable tshuaj tsis qhia nyob rau hauv mob mob syndromes. Tej tshuaj no tsuas tsim nyog rau cov tshem tawm ntawm luv luv-term tsis xis nyob. Noj cov tshuaj tshaj ib tug ntev lub sij hawm ntawm lub sij hawm yog txwv tsis pub.

Contraindications

Raws li lwm yam uas tsis yog-tshuaj tshuaj npaj "Ketanov" siv nyob rau hauv mob muaj ntau yam sib txawv contraindications. Uas yog vim li cas ua ntej koj yuav siv nws koj yuav tsum tau nrog koj tus kws kho mob thiab nyeem cov lus qhia. Nws qhia txog cov nram qab no contraindications:

• erosive thiab ulcerative txhab ntawm tus mob huam, tshwj xeeb tshaj yog nyob rau hauv lub mob nyob ntev, hypocoagulation (xws li hemophilia) thiab peptic rwj;
• Nce rhiab heev rau tus neeg mob ketorolac thiab lwm yam narcotics yuav muab, bronchospasm, lub cev qhuav dej, angioedema, aspirin mob hawb pob, hypovolemia (tsis hais ntawm qhov ua rau ntawm nws tshwm sim);
• siab los sis mob raum (nyob rau ntawm lub tsis ua hauj lwm), tshwj xeeb tshaj yog ntshav creatinine ntawm 50 mg / l;
• hemorrhagic stroke (xav tias los yog paub tseeb hais tias), hemorrhagic diathesis, kev raug mob ntawm tsis tshua mob heev los yog los ntshav (xws li tom qab phais), concomitant siv ntawm lwm narcotics yuav muab, impaired hematopoiesis;
• muaj hnub nyoog nyob rau hauv 16 xyoo;
• Thaum lub sij hawm cev xeeb tub, cov me nyuam yug txheej txheem thiab thaum lub sij hawm lactation;
• Kev kho mob ntawm tus kab mob mob syndromes cim;
• tshuaj loog ua ntej kev phais thiab thaum lub sij hawm lawv (vim hais tias ntawm qhov raug mob ntawm los ntshav).

Peb tsis tau hais tias lub active medicament yog tshuaj nrog ceev faj nyob rau hauv cov neeg mob uas cholecystitis, bronchial hawb pob, mob hauv lub plawv tsis ua hauj lwm, lub raum lag luam (ntshav creatinine tsawg tshaj li 50 mg / l), kub siab, active kab mob siab, cholestasis, sepsis, mauj lupus lupus, raws li zoo raws li nyob rau hauv cov neeg laus (65 xyoo) thiab cov neeg uas polyps nyob rau hauv lub sab hauv ntawm lub nasopharynx thiab qhov ntswg.

Tshuaj "Ketanov": cov lus qhia rau kev siv

Analogs muaj zoo xws li cov txhais tau tias ntawm txoj kev ntawm daim ntawv thov thiab ntau npaum. Tab sis nyob rau hauv kom tsis txhob overdoses ua ntej lawv siv yog pom zoo kom mus ntsib ib tug kws kho mob.

Yuav ua li cas kuv yuav tsum tau haus dej haus ntsiav tshuaj "Ketanov"? Qhov no daim ntawv ntawm cov tshuaj yog tsim nyog los noj ib zaug xwb qhov ncauj (10 mg). Yog hais tias tsim nyog (e.g., nrog ib tug muaj zog mob syndrome) medicament koob tshuaj yuav tsum ob npaug. Txawm li cas los, nws yuav tsum tau muab sau tseg tias hnub ntau npaum ntawm cov tshuaj yuav tsum tsis txhob ntau tshaj 40 mg.

Thaum haus ntawm cov tshuaj kawg ntev yog tsib hnub (tsis ntau).

Yog hais tias yog ib tug vim los yog lwm tus neeg mob yuav tsis siv sij hawm lub qhov ncauj hauv daim ntawv ntawm cov tshuaj (e.g., nyob rau hauv lub xub ntiag ntawm erosive los yog ulcerative txhab ntawm lub plab, plob tsis so tswj), ces nws yuav muab ib cov tshuaj cov kev txhaj tshuaj. Tej daim ntawv no yog muab intramuscularly.

Thaum pib ntawm yeeb tshuaj kho siv nyob rau hauv qhov tsawg kawg nkaus zoo noj tshuaj npaum cas uas tau raug xaiv nyob rau hauv raws li cov kev siv ntawm cov mob syndromes thiab cov lus teb ntawm tus neeg mob. Yog hais tias tsim nyog, tus neeg mob yog cov tshuaj thiab ntxiv opioid analgesics.

Ib tug tib ntau npaum formulation rau ib intramuscular txhaj:

• cov neeg nyob rau hauv 65 lub xyoos ntawm hnub nyoog - txog 10-30 mg (nyob ntawm seb cov kev siv ntawm qhov mob);
• cov neeg tshaj 65 xyoo, raws li zoo raws li nyob rau hauv cov neeg mob uas impaired raum muaj nuj nqi - 10-15 mg.

Ntau npaum tom qab rov intramuscular thawj coj:

• cov neeg mus rau 65 - txog 10-30 mg, thiab ces tus nqi qub txhua txhua plaub mus rau xya teev;
• cov neeg laus tshaj 65 xyoo thiab nyob rau hauv cov neeg mob uas impaired raum muaj nuj nqi - 10-15 mg txhua txhua 4-7 teev.

Lub sij hawm ntau npaum ntawm cov tshuaj thaum muab intramuscularly rau cov neeg laus yuav tsum tsis txhob ntau tshaj 90 mg. Rau cov neeg laus cov neeg mob thiab cov neeg uas muaj impaired raum muaj nuj nqi nws yog tsim nyog los txo tus nqi ntawm cov tuaj mus rau 60 mg. Lub caij ntawm kev kho mob yuav tsum tsis txhob yuav ntau tshaj li tsib hnub.

Thaum lub sij hawm kev hloov los ntawm lub intramuscular thawj coj ntawm cov tshuaj nyob rau hauv cov tshuaj rau hauv tag nrho cov hnub ntau npaum ntawm ob ntaub ntawv yuav tsum tsis txhob ntau tshaj 90 mg rau cov neeg laus thiab 60 mg rau cov neeg laus cov neeg mob los yog cov neeg mob uas impaired raum muaj nuj nqi.

tsos mob ntawm overdose

Thaum dua koob tshuaj hais tias medicament nyob rau hauv tus neeg mob yuav tsum tau cai ntuav, mob plab, hlaus lag luam, metabolic acidosis, xeev siab, erosive gastritis thiab peptic rwj.

Raws li kev kho mob ntawm xws tej yam kev mob uas siv cov pais plab lavage thiab cov kev taw qhia ntawm ntau yam adsorbents. Tsis tas li ntawd symptomatic txoj kev kho (ie txhawb qhov tseem ceeb heev functions ntawm lub cev).

tshuaj cov kev sib tshuam

Thaum tus txha daim ntawv thov ntawm cov tshuaj nyob rau hauv kev saib xyuas nrog lwm yam narcotics yuav muab, tus neeg mob tej zaum yuav tsim kev phiv los ntawm tas li ntawd, thiab anticoagulants (xws li "heparin" nyob rau hauv me me koob tshuaj thiab nrog "Pentoxifylline") - los ntshav.

Yog hais tias concomitant siv ntawm cov tshuaj ua nrog ACE inhibitors, tej zaum yuav muaj irregularities nyob rau hauv lub raum.

Nws yuav tsum tau muab sau tseg tias cov kev siv ntawm cov tshuaj nyob rau hauv kev ntsuam xyuas, nrog "Probenecid" tsub kom lub ib nrab-lub neej ntawm ketorolac thiab nws cov concentration nyob rau hauv ntshav.

Yog hais tias koj noj cov tshuaj no nrog lithium, nws yog ua tau kom txo tau lub raum clearance ntawm lithium thiab ua rau kom nws cov concentration nyob rau hauv cov ntshav, tab sis, nrog "Furosemide" - txos nws diuretic nyhuv.

Thaum lub sij hawm daim ntawv thov ntawm lub "Ketorolac" yog tsis muaj yuav tsum tau rau kev noj opioid analgesics.

Qhov zoo tshaj plaws analogue

"Ketanov" - qhov no yog ib tug heev muaj zog thiab zoo analgesic yeeb tshuaj, uas yog muag nyob rau hauv yuav luag tag nrho cov drugstores. Hais txog nws cov analogs, nws yog ib qhov nyuaj rau lub npe zoo tshaj plaws tshuaj. Yog li ntawd, rau qhov ceev ceev nyem mob syndrome feem ntau cov kws kho mob muab rau lawv cov neeg mob yog cov tshuaj. Tab sis yog hais tias rau ib co yog vim li cas cov tshuaj yog txhob rau koj, peb xav kom koj hloov nws nrog "Ketorolac". Nyob rau hauv lub teb chaws-Chaw tsim tshuaj paus nqi ntawm qhov cuab tam tej zaum yuav txawv. Tus nqi ntawm cov packing Lavxias teb sab ntsiav tshuaj pib nyob rau hauv 20 rubles, Ukrainian - 35, thiab Indian - 45.

Yuav ua li cas lwm tus yog suav tias yog ib tug yeeb tshuaj muaj peev xwm yuav hloov? Nws puas muaj lwm yam analogue? "Ketanov" tsis muaj ib tug tshuaj, koj yeej ib txwm yuav nyob rau hauv lub tsev muag tshuaj. Nyob rau hauv raws nraim tib yam txoj kev uas koj muaj peev xwm yuav xws zoo xws li cov xov xwm raws li "Adolor", "Torolak", "Akyular tshuaj", "Toradol", "Dolak", "Ketofril", "Dolomin", "Ketorolac tromethamine-Farmaplant", "Ketadrop "" Ketorolac tromethamine, "" Ketalgin "," Ketorolac-Eskom "," Ketokam "," Ketorolac-Verte "," Ketolak "," Ketorolac-OBL "," Ketorolac Rompharm "," Ketorol "thiab lwm tus neeg.

Tus nqi ntawm cov tshuaj yuav ua tau siab tus thawj thiab hauv qab no. Nco qab tias cov tshuaj "Ketanov" (10 ntsiav tshuaj) yuav tsum tau muas rau 50-70 rubles. Nws yuav tsum raug hais tias nws yog tsis pom zoo kom muab nws nyob rau ntawm lawv tus kheej kev txiav txim.

Uas cuab tam siv rau lub zos mob nyem? Puas muaj ib tug coj hauv daim ntawv ntawm cov "Ketanov" tshuaj? Tshuaj pleev (analogs ntawm hais tias cov neeg ua hauj nyob rau hauv lub ntsiav tshuaj muaj tau hais saum toj no) nrog tib yam kom nquag plias yam khoom uas yuav tsis yooj yim mus nrhiav tau. Txawm li cas los, tseem muaj ib cov tshuaj uas yuav siv tau topically. Qhov no yog 2% ntawm cov tshuaj hu ua "Ketorol" (ua nyob rau hauv Is Nrias teb). Xws li ib tug txhais tau tias yog muaj nyob rau hauv 30-gram hlab thiab sai sai tshem tawm muaj mob syndromes (thaum ua ntawv thov topically).

Xyuas ntawm painkillers

Tam sim no koj paub tias yog ib tug yeeb tshuaj "Ketanov", rau cov uas nws yog npaj. Nws yuav tsum tau muab sau tseg uas zoo tag nrho cov neeg Xyuas ntawm lub medicament zoo. Cov neeg uas tsis tseg siv cov ntsiav tshuaj los yog cov tshuaj cov kev txhaj tshuaj "Ketanov" lub xeev hais tias xws li ib tug yeeb tshuaj heev sai eliminates muaj mob syndromes.

Raws li qhia los ntawm cov kev kho mob xyaum, cov nyhuv uas cov kev ua kom loog kav rau 12-15 teev (tej zaum ntev). Tom qab lub sij hawm no, cov tshuaj yuav tsum tau rov qab (yog hais tias tus mob yog tsis tau dhau).

Txawm li cas los, nws yog tsis yooj yim sua tsis hais qhov tseeb hais tias cov tshuaj no, ib yam li lwm narcotics yuav muab, nws muaj nws ib tug ntau ntawm cov kev phiv. Raws li cov lus teb ntawm cov neeg mob, tej zaum cov tshuaj no ua rau xeev siab thiab mob plab. Nyob rau hauv cov ntaub ntawv no, kws txawj pom zoo kom hloov lub qhov ncauj hauv daim ntawv ntawm cov tshuaj txhaj. Tom qab tag nrho, rau tus twg los tsis yog ib tug tsis pub leejtwg paub uas narcotics yuav muab yuav ua rau teeb meem loj rau hauv lub plab (xws li, ua rau kom cov tsos ntawm ulcers los yog erosions).

Nws yuav tsum raug sau tseg hais tias muaj ntau cov neeg mob tshwj xeeb txaus siab nqi qhia cov cuab yeej. Xav tias nws yog tsim nyog los noj ib tug ib-lub sij hawm, thiab muaj li luv luv lub sij hawm ntawm lub sij hawm, ib tug sawv hlwv nrog tshuaj tej zaum yuav txaus rau ib tug heev lub sij hawm ntev. Tib yam siv rau lub tshuaj daim ntawv ntawm cov tshuaj.