Valproic acid: cov lus qhia rau kev siv, analogs thiab xyuas

Valproic acid (sodium valproate) belongs rau ib tus tshiab pawg ntawm anticonvulsants, differing los ntawm cov neeg siv yav tas los antiepileptics ob lub tshuaj qauv thiab cov ntsiab cai ntawm lub lag luam.

piav qhia ntawm lub substance

Qhov no tshuaj yog tsim nyob rau hauv 1882, nyob rau hauv ib tug analogue valeric acid Dr. W. Barton. Nws muaj 2 pawg ntawm txiav. Rau ntau xyoo lawm, valproic acid yog tsuas yog siv nyob rau hauv lub laboratory raws li lub inert kuab ntawm ntau yam organic tebchaw. Protivosudorzhnye nws cov khoom nyob sab los ntawm ib tug fluke.

Valproic acid yog kua thiab pob tshab ntawm chav tsev kub. Yog li ntawd nws muaj peev xwm sawv ntawm reacting nrog ib lub hauv paus xws li sodium hydroxide los yog magnesium valproate tsim tau ib cov ntsev, uas yog ib tug khoom substance. Qhov no cov ntaub ntawv uas, nyob rau hauv qhov tseeb, yog 2-propylvaleric acid thiab nws cov sodium ntsev. Tsis zoo li lwm yam antiepileptics, nws nruab nrab yog ib tug nitrogen-dawb compound. Lub mechanism ntawm qhov kev txiav txim ntawm no acid thiab nws ntsev, txuam nrog ib tug kev cawv rau cov metabolism ntawm gamma-aminobutyric acid, yog ib tug inhibitor ntawm lub transferase enzyme.

Formulations uas yog tsim los ntawm cov valproic acid, thiab nws txo qis convulsive cov tshuaj tiv thaiv excitatory lub cev muaj zog qhov chaw ntawm lub paj hlwb. Qhov no yog vim lub fact tias cov tshuaj yeeb dej caw tsub kom cov ntsiab lus ntawm gamma-aminobutyric acid nyob rau hauv lub paj hlwb lug. Valproic acid, uas qhia kev ntawm nws anticonvulsant hauj lwm zoo nyob rau hauv cov kev kho mob ntawm tej yam kev mob uas muaj feem rau cov pab pawg neeg ntawm fatty acids.

Cov yam ntxwv ntawm valproic acid, nws analogues

Valproic acid, uas qhia txog cov kev qhia ntawv rau nws cov complex los ntawm cov tib neeg, yog ua nyob rau hauv ntau lub npe. Qhov zoo tshaj plaws-paub tshuaj, uas muaj xws li ib yam khoom uas yog "Depakine," "Konvuleks", "Konvulsofin", "Orfilin", "Deprakin", "epilation", "Everiden", "Enkorat", "Apilepsin", "valparin XP "," Dipromal ". Lub tiav lawm ntau npaum ntaub ntawv tej zaum nws yuav nyob rau hauv daim ntawv ntawm acid los yog nws cov sodium ntsev, lub npe hu ua sodium valproate. Cov kev ua ntawm cov tshuaj no yog tsis txo. Valproic acid, analogues ntawm uas yog saum toj no, coj lus tam sim ntawd tom qab noj mov. Tag nrho cov tshuaj uas muaj nws, yog sai sai absorbed. Twb tom qab 2 xuaj moos uas qhov acid zoo nkaus li nyob rau hauv ntshav. Nws yog zoo penetrates los ntawm cov ntaub so ntswg teeb meem. Qhov seem ib co kua nplaum ntawm cov tshuaj yeeb dej caw yog txiav txim nyob rau hauv lub hlwb txha nqaj qaum dej thiab nyob rau hauv ntau lwm nrog ib puag ncig. Nws kuaj nyob rau hauv amniotic kua (amniotic kua) nyob rau hauv cev xeeb tub cov poj niam.

hauv paus ntsiab lus ntawm cov lag luam

Yuav ua li cas tau ua valproic acid? Cov lus qhia rau cov tshuaj no tsis muab ib tug leej lo lus teb rau cov nqe lus nug ntawm yog dab tsi lub mechanism ntawm nws cov tshuaj cawv. Qhov no yog vim lub fact tias cov kws txawj yog tsis tau tag nrho tshawb nws tej yam nyob rau hauv qhov kev hloov nyob rau hauv sodium channel zog. Nyob rau hauv cov ntaub ntawv no, valproic acid yog muaj nyob rau hauv daim ntawv teev cov tshuaj uas yog qhov tseem ceeb thiab tseem ceeb rau cov neeg.

Nyhuv rau tib neeg

Tsis tsuas yog siv tau rau cov qaug dab peg valproic acid. nyob rau kev siv ntawm cov tshuaj no daim ntawv qhia nws hais tias nws muaj tsis tau tsuas yog anticonvulsant nyhuv. Nws pab txoj kev mus ob peb vas thiab kev puas hlwb lub xeev ntawm ib tug neeg. Kws txawj hais tias txog lub xub ntiag ntawm lub acid tivthaiv tranquilizing. Tsis zoo li lwm yam cov ntawm no lub siab zoo, nws thiaj li ntxhov siab vim, tsis tas yuav ua mioleraksantnogo los yog ua kom loog. Qhov no yog vim nws txiav txim rau postsynaptic membrane. Yog li suppressed paj impulse kis tau tus mob dab.

Rau cov me ntaub ntawv ntawm cov qaug dab peg feem ntau yog tas rau kev noj valproic acid los yog ib tug ntawm nws analogs. Nyob rau hauv ntau loj heev zaum cov tshuaj ua ke nrog rau lwm cov antiepileptic tshuaj.

Valproic acid qaug dab peg

Tej kev npaj no yog siv nyob rau hauv ntau yam ntaub ntawv ntawm qaug dab peg. Yog li nws txais tos yog raws li nyob rau hauv lub tsim qauv kws kho mob. Valproic acid, cov lus qhia rau kev siv uas qhia nws cov hauj lwm zoo ntawm ntau yam ntaub ntawv ntawm tus kab mob, yog siv nyob rau hauv tej rooj plaub nyob rau hauv txawv koob tshuaj. Tsis tas li ntawd, nws yog feem ntau cov tshuaj, thiab nyob rau hauv focal qaug dab peg.

Siv cov tshuaj

Valproic acid, cov kev qhia ntawv uas lub sij hawm ntawm cov tshuaj yuav tsum tau koj tus kws kho mob thiab nruj kev ua raws li kev siv yeeb tshuaj kiag, thov nyob rau hauv xws li mob:

• kev tiv thaiv los ntawm ntau yam teeb meem nyob rau hauv qaug dab peg;

• convulsive tej yam kev mob originating nyob rau hauv tej yam cov kab mob ntawm lub Cns;

• muaj ib tug tshee tic;

• manic-depressive mob, yog tsis amenable rau kev kho mob nrog cov tshuaj uas muaj lithium;

• convulsive tej yam kev mob originating nyob rau hauv thaum yau.

Valproic acid thiab formulations muaj nws, yuav tsum tau heev dua lwm yam tshuaj los ntawm cov kws kho mob. Tsuas yog tom qab tag nrho cov tsim nyog kev tshawb fawb thiab tus neeg mob kev ntsuam xyuas tshwj xeeb yuav tsum tau xaiv ib tug muaj kev ruaj ntseg thiab zoo koob tshuaj ntawm cov tshuaj.

tso tawm daim ntawv

Valproic acid, qhov kev tso tawm daim ntawv uas yog sib txawv, sib txawv manufacturers yog tau ntim raws li nram no:

• Ntsiav tshuaj, coated ntsiav tshuaj, soluble nyob rau hauv cov hnyuv. Lawv muaj 150, 200, 300, 500 mg valproic acid (sodium valproate).

• Tsiav tshuaj 150, 300 mg.

• Tshuaj (kua syrup) uas muaj 50 los yog 300 ml ntawm cov tshuaj nyob rau hauv 1 ml.

Compatibility nrog lwm yam tshuaj

Valproic acid peev xwm ntawm mus pab tau txoj cov nyhuv ntawm lwm yam anticonvulsants thiab protivoelepticheskih txhais tau tias, neuroleptics, antipsychotics, antidepressants, thiab dej caw. Thaum koj tau txais cov tshuaj no tsis tau haus dej haus cawv. Valproic acid analogs ntawm cov tshuaj, salicylic acid thiab anticoagulants muaj ib tug inhibitory ntxim rau cov aggregation (lub koom haum) platelets. Thaum txhaj mus rau hauv cov hnyuv lub medicament yog sai absorbed rau hauv cov hlab ntsha. Yog li cov kev siv ntawm valproic acid nyob rau hauv ua ke nrog nrog lwm cov zaub mov dog dig thiaj li nws cov hauj lwm zoo.

phiv

Lub medicament tej zaum ua rau muaj kev phiv xws li xeev siab, ntuav, poob qab los noj mov, thiab qhov ntawm kev mob nyob rau hauv lub plab, raws plab. Nyob rau cov tej yam kev mob thov enveloping los yog antispasmodics. Valproic acid yuav ua rau ib tug general kev nyuaj siab thiab nkees heev, li ntawd nws yog tsis tshua muaj tshuaj rau cov neeg koom nyob rau hauv khiav lub cev thiab kev puas hlwb ua hauj lwm. Tau txais cov tshuaj tej zaum kuj ua rau yus mob ntawm poob siab system, uas manifest lawv tus kheej nyob rau hauv daim ntawv ntawm ib tug co ntawm nqua, phua dluab thiab kev ua cuam tshuam, nkees nkees, mob taub hau, kiv taub hau, ntxhov siab, apathy, thiab kev nyuaj hauv lub xeev.

Nyob rau hauv tej rooj plaub, qhov tsawg ntawm cov tshuaj no ua rau yus lub nram qab no txim: ib tug txo thiab ib qho kev nce nyob rau hauv lub cev hnyav, cov tsos ntawm kev tsis haum tshuaj, ib ntus plaub hau poob, coj khaub irregularities, kev hloov nyob rau hauv lub hemogram. Tsis tshua muaj tab sis loj heev tshwm sim los ntawm no tau txais txhais tau tias pom tau hais tias malfunction ntawm lub siab los yog txiav, txo cov ntshav txhaws. Hepatotoxic nyhuv yog feem ntau yuav thaum tau txais cov tshuaj no ib txhij nrog clonazepam, phenobarbital.

Thaum uas siv cov valproic acid yuav tsum nco ntsoov tias nyob rau hauv ntshav qab zib cov neeg mob nws yuav pauv lub txiaj ntsim ntawm tus tsom xam ntawm cov zis, nce nws cov ntsiab lus ntawm ketone lub cev. Rau kev tiv thaiv los ntawm ntau yam teeb meem thaum lub sij hawm kev kho mob tsis tu ncua txiav txim seb lub ntsiab lus nyob rau hauv cov ntshav ntawm bilirubin, daim siab enzymes, platelet suav.

Contraindications

Valproic acid, uas tshuaj muag tom khw tsis muaj cov tshuaj, muaj loj contraindications. Cov muaj xws li:

• kawg ntawm lub pancreas thiab siab;

• porphyria;

• hemorrhagic diathesis;

• idiosyncrasy;

• Cov thawj peb lub hlis uas cev xeeb tub;

• noj lub sij hawm (lub tshuaj kis mus rau hauv niam cov kua mis).

Nyob rau hauv II thiab III peb lub hlis uas cev xeeb tub, cov tshuaj no yog tshuaj nyob rau hauv me me koob tshuaj thiab tsuas yog rau cov loj vim li cas, vim hais tias nws crosses lub tsho me nyuam thiab yuav cuam tshuam rau me nyuam hauv plab.

Thaum tau txais valproic acid yuav tsum ua tib zoo saib xyuas tus ua tau hauj lwm siab tswj cov ntshav txhaws thiab platelet aggregation. Thaum lub sij hawm txoj kev kho, cov tshuaj no cov poj niam uas yog kev sib deev active, yuav tsum tau siv los mus tiv thaiv cev xeeb tub, feem ntau txhim khu kev qha txoj kev pov.

daim ntawv thov ntawm lub tswvyim

Npaj muaj no acid, yog npaum li cas rau txawv schemes. Pom koob xaiv ib lub zuj zus. Qhov kev xaiv ntawm ntau npaum regimen muaj feem xyuam rau tus neeg mob tus mob, qhov hnyav thiab muaj hnub nyoog. Nyob rau hauv Feem ntau, thaum ntxov nyob rau hauv lub chav kawm nyob rau hauv cov neeg laus thiab cov me nyuam uas ntau tshaj 25 kg, xeem nyob rau 10-15 mg / kg ib hnub twg. Tom qab txhua lub limtiam koob tshuaj ntawm cov tshuaj yog nce nyob ntawm 5-10 mg / kg, coj los rau siab tshaj plaws - 30 mg / kg. Lub hnub koob tshuaj rau cov me nyuam - 20-50 mg / kg. Nyob rau hauv kev hloov mus rau kev kho mob nrog valproic acid kev kho mob nrog rau lwm cov anticonvulsant tshuaj yog txo maj. Qhov siab tshaj plaws koob tshuaj valproic acid yuav tsum tsis txhob muaj ntau tshaj li 50 mg / kg ib hnub twg.

Muaj ntau yam ntaub ntawv ntawm kev tso tawm ntawm cov tshuaj. Tso dej thawj coj yuav tau txais 400-800 mg sodium valproate ib hnub twg. Thoob plaws hauv lub chav kawm ntawm kev kho yog tsim nyog los mus txiav txim rau theem ntawm kev siv yeeb tshuaj nyob rau hauv cov ntshav. Raws li ntsuam, kev kho me ntsis tej zaum yuav ua rau cov kev kho mob regimen.

Schedule ntawm lub tswvyim:

• Cov me nyuam hnub nyoog 3: Nyob rau hauv thawj lub lim tiam ntawm haus 150 mg ntawm 1 p. ib hnub twg, nyob rau hauv lub thib ob - 150 mg ntawm 2 p. ib hnub twg, thiab lub thib peb - nyob rau hauv 150 mg ntawm 3 p. ib hnub twg.

• Cov me nyuam 3 - 10 xyoo: nyob rau hauv thawj lub lim tiam ntawm kev noj 450 mg, nyob rau hauv lub thib ob - 600 mg, thiab nyob rau hauv lub thib peb - 900 mg ib hnub twg. Raws li mus rau lwm lub tau txais Circuit Court 300, 450, 600, 900 mg ib hnub twg, ntsig txog, nyob rau hauv 1, 2, 3 thiab 4 lub lis piam.

• Tom qab 10 lub xyoos: nyob rau hauv thawj lub lim tiam ntawm haus 600 mg, nyob rau hauv lub thib ob - 900, nyob rau hauv lub thib peb - 1200 mg ib hnub twg. Raws li mus rau lwm lub tau txais Circuit Court 300, 600, 900, 1200 mg ib hnub twg, ntsig txog, nyob rau hauv 1, 2, 3 thiab 4 lub lis piam.

Rau cov neeg mob yav tas los kho nrog rau lwm cov anticonvulsants, acid valproic muab nyob rau hauv me me koob tshuaj. Nyob rau tib lub sij hawm lub xov tooj ntawm lwm txhais tau tias yog txo. Cov txij nkawm koob tshuaj rau cov neeg laus - 900-1200 mg. Valproic Acid, ntsiav tshuaj thiab tshuaj uas yog tshuaj tsuas yog tom qab 10 xyoo, coj nyob rau hauv 2-4 koob tshuaj. Rau cov me nyuam feem ntau tus kws kho tshuaj los yog syrup nrog cov tshuaj no.

"Depakinum" (valproic acid)

Ntawm kev muag khoom muaj ntau cov tshuaj nrog lub acid, tab sis ib qho ntawm feem nrov yog cov "Depakine." Nyob rau hauv khw muag tshuaj, muaj ntau ntau hom tshuaj: "Chrono", "300 Enterik", "Hrononosfera granules" thiab lwm tus neeg. lawv yog cov tag nrho sib txawv me ntsis active ingredient cov ntsiab lus thiab daim ntawv. "Depakine" tshuaj raws li ib tug anticonvulsant thiab mus ob peb vas-stabilizing tshuaj. Nws yog zoo tsim nyob rau hauv cov kev kho mob ntawm, qaug dabpeg, bipolar mob, generalized tonic-clonic qaug dab peg, myoclonus, kev nyuaj siab, migraine mob taub hau. Nws kuj yog siv rau cov kev kho mob ntawm neuropathic mob. Tsis ntev los no, cov tshuaj soj ntsuam raws li ib tug yeeb tshuaj tiv thaiv hom mob cancer thiab kab mob HIV.

Valproic acid depot

Cov valproic acid tshuaj "Depakine" thiab nws cov analogues yog nyob rau hauv siab thov. Qhov no yog vim lub fact tias nws muaj ib lub caij nyoog zoo. Kev siv txoj kev npaj no yuav ua rau ib tug txo nyob rau hauv lub zaus ntawm tshwm sim ntawm convulsive qaug dab peg. nws kuj txo lawv heev thiab tswj cov khiav. "Depakine" thiaj li muaj cov kev pheej hmoo ntawm kev tsim loj teeb meem.

Dab metabolization valproic acid nqa mob hlwb. Thaum tau txais cov tshuaj txoj kev cai uas ib nrab-lub neej yog kwv yees li 6-8 teev. Niaj hnub nimno cov tshuaj yuav muaj ib tug kho concentration ntawm active tshuaj nyob rau hauv lub cev mus rau 16 teev. Tus nqi ntawm feem ntawm valproic acid nyob lom zem ntau nyob rau hauv daim siab muaj nuj nqi. Valproic acid, uas xyuas txog ib tug ntau zoo ntxim rau txhua tus neeg mob nyob rau hauv nws tus kheej. Qhov no yog vim lub fact tias txhua txhua lub cev yog cim thiab muaj peev xwm coj cov khoom no nrog ib co hloov los ntawm lub cai.