I-Lamotrigine, Ithebhulethi Yomlomo

-Delile

• Izexwayiso ezibalulekile
• Izexwayiso ze-FDA
  
• Ezinye izexwayiso
• Yini i-lamotrigine?
• Kungani kusetshenziswa
• Isebenza kanjani
• Imiphumela emibi yeLamotrigine
• Imiphumela emibi ejwayelekile
• Imiphumela emibi kakhulu
• ILamotrigine ingaxhumana neminye imithi
• Imithi yokwelapha umuthi
• Isidakamizwa senhliziyo
• Izidakamizwa ze-HIV
• Izindlela zokuvimbela inzalo ngomlomo
• Isidakamizwa sofuba
• Izexwayiso zeLamotrigine
• Isexwayiso somzimba
• Izexwayiso zabantu abanezimo ezithile zempilo
• Izexwayiso kwamanye amaqembu
• Ungayithatha kanjani i-lamotrigine
• Amafomu wezidakamizwa namandla
• Isilinganiso sokuquleka kwabantu abanesithuthwane
• Isilinganiso sokuphazamiseka kwengqondo okuguquguqukayo
• Ukucatshangelwa okukhethekile komthamo
• Isikali izixwayiso
• Thatha njengoba kuqondisiwe
• Ukucatshangelwa okubalulekile kokuthatha i-lamotrigine
• Jikelele
• Isitoreji
• Ukugcwalisa kabusha
• Ukuvakasha
• Ukuzilawula
• Ukuqapha komtholampilo
• Ukutholakala
• Ngaphambi kokugunyazwa
• Ingabe zikhona ezinye izindlela?

Amaphuzu avelele we-lamotrigine

1. Ithebhulethi yomlomo yeLamotrigine iyatholakala njengezidakamizwa ezinamagama futhi njengemithi ejwayelekile. Amagama omkhiqizo: Lamictal, Lamictal XR, Lamictal CD, futhi I-Lamictal ODT.
2. ILamotrigine iza ngezindlela ezine: amaphilisi omlomo akhishwa ngokushesha, amaphilisi omlomo akhishwa enwetshiwe, amaphilisi omlomo angahlaziyeki, namaphilisi ahlukaniswa ngomlomo (angachithwa olimini).
3. Ithebhulethi yomlomo yeLamotrigine ngumuthi kadokotela osetshenziselwa ukwelapha izinhlobo ezithile zokuquleka kubantu abanesithuthwane. Ibuye isetshenziselwe ukwelapha isifo se-bipolar.

Izexwayiso ezibalulekile

Izexwayiso ze-FDA

• Lesi sidakamizwa sinesixwayiso sebhokisi elimnyama. Lesi yisexwayiso esibi kakhulu esivela ku-Food and Drug Administration (FDA). Isexwayiso sebhokisi elimnyama sazisa odokotela neziguli ngemiphumela yezidakamizwa engaba yingozi.
• Ukuqhuma okusongela ukuphila: Lesi sidakamizwa singadala ukuqhuma okungajwayelekile kepha okubucayi okungasongela impilo. Lokhu kuqhuma kungenzeka noma nini, kepha kungenzeka kakhulu ukuthi kwenzeke phakathi kwamasonto amabili kuya kwayisishiyagalombili okuqala kwalesi sidakamizwa. Musa ukwandisa umthamo wakho walesi sidakamizwa ngokushesha kunokuba udokotela wakho akutshele. Udokotela wakho kungenzeka ukuthi uyeke ukuthatha lo muthi ngesikhathi sokuqala sokuqubuka.

Ezinye izexwayiso

• Ukusabela komzimba okusongela ukuphila: Ezimweni ezingavamile, lo muthi ungadala ukusabela okweqile kwamasosha omzimba okubizwa nge-hemophagocytic lymphohistiocytosis (HLH). Lokhu kusabela kuholela ekuvukeleni okukhulu emzimbeni wonke, futhi ngaphandle kokwelashwa ngokushesha, kungadala ukufa. Izimpawu ezijwayelekile zifaka phakathi umkhuhlane, ukuqubuka, nama-lymph node akhulisiwe, isibindi nobende. Kubandakanya ukwehla kokubalwa kwamaseli egazi, ukwehla kokusebenza kwesibindi, nezinkinga zokuvala igazi.
• Isexwayiso sokulimala komzimba: Lesi sidakamizwa singadala izinkinga ezinkulu ezingxenyeni ezithile zomzimba wakho. Lokhu kufaka phakathi isibindi sakho namaseli akho egazi.
• Isixwayiso sokuzibulala: Lesi sidakamizwa singadala imicabango yokuzilimaza. Shayela udokotela wakho uma ubona noma yiluphi ushintsho oluzumayo emoyeni, ekuziphatheni, emicabangweni noma emizweni yakho.

Yini i-lamotrigine?

I-Lamotrigine ngumuthi kadokotela. Iza ngezinhlobo ezine okufanele zithathwe ngomlomo (ngomlomo): amaphilisi omlomo akhishwa ngokushesha, amaphilisi omlomo akhishwa isikhathi eside, amaphilisi omlomo ahlafunwayo, namaphilisi ahlukaniswa ngomlomo (angachithwa olimini).

ILamotrigine iyatholakala njengezidakamizwa ezibizwa ngegama I-Lamictal, ILamictal XR (ukukhululwa okunwetshiwe), I-CD kaLamictal (okuhlafunwayo), futhi I-Lamictal ODT (ancibilike olimini). Iphinde itholakale njengezidakamizwa ezijwayelekile. Imithi ejwayelekile ijwayele ukubiza ngaphansi kwezinguqulo zamagama. Kwezinye izimo, kungenzeka zingatholakali ngawo wonke amandla noma amafomu njengezidakamizwa zegama lomkhiqizo.

I-Lamotrigine ingasetshenziswa njengengxenye yokwelashwa okuhlanganayo. Lokhu kusho ukuthi ungadinga ukuyithatha neminye imithi.

Kungani kusetshenziswa

I-Lamotrigine isetshenziselwa ukwelapha izinhlobo ezithile zokuquleka kubantu abanesithuthwane. Ingasetshenziswa ngokuhlangana neminye imishanguzo yokuthambisa. Noma ingasetshenziswa yodwa lapho ushintsha kusuka kweminye imishanguzo yokuthithibalisa.

ILamotrigine isetshenziselwa ukwelashwa isikhathi eside kwesifo semizwa esibizwa ngokuthi yi-bipolar disorder. Ngalesi simo, umuntu unezimo eziphakeme ngokweqile ngokomzwelo futhi uphansi.

Isebenza kanjani

ILamotrigine ingeyesigaba semithi ebizwa ngama-anticonvulsants noma i-antiepileptic drugs (AEDs). Isigaba semithi siyiqembu lemithi esebenza ngendlela efanayo. Le mithi ivame ukusetshenziselwa ukwelapha izimo ezifanayo.

Kubantu abanesithuthwane, lo muthi unciphisa ukukhishwa kwento ebuchosheni bakho eyaziwa njenge-glutamate. Lesi senzo sivimbela ama-neurons asebuchosheni bakho ukuthi angasebenzi kakhulu. Ngenxa yalokho, ungahle ube nokuquleka okumbalwa.

Kubantu abanesifo se-bipolar, lo muthi ungathinta ama-receptors athile ebuchosheni bakho asiza ukulawula imizwa yakho. Lokhu kungehlisa inani leziqephu zemizwa onazo.

Imiphumela emibi yeLamotrigine

Ithebhulethi yomlomo yeLamotrigine ingadala ukozela. Ungashayeli, sebenzisa imishini esindayo, noma wenze ezinye izinto eziyingozi uze wazi ukuthi lo muthi ukuthinta kanjani.

ILamotrigine nayo ingadala eminye imiphumela emibi.

Imiphumela emibi ejwayelekile

Imiphumela emibi ejwayelekile engenzeka ngokusetshenziswa kwe-lamotrigine ifaka:

• isiyezi
• ukozela
• ikhanda
• ukubona kabili
• ukungaboni kahle
• isicanucanu nokuhlanza
• isifo sohudo
• ubuhlungu besisu
• inkathazo ngokulinganisela nokuxhumanisa
• inkathazo yokulala
• ukuhlungu obusemhlane
• ikhala eligcwele
• Umphimbo obuhlungu
• umlomo owomile
• imfiva
• ukuqubuka
• ukuthuthumela
• ukukhathazeka

Uma le miphumela imnene, ingahle ihambe zingakapheli izinsuku ezimbalwa noma amasonto ambalwa. Uma zinzima kakhulu noma zingahambi, khuluma nodokotela wakho noma usokhemisi.

Imiphumela emibi kakhulu

Shayela udokotela wakho ngokushesha uma unemiphumela emibi kakhulu. Shayela u-911 uma izimpawu zakho zizizwa zisongela impilo noma uma ucabanga ukuthi unezimo eziphuthumayo zezokwelapha. Imiphumela emibi kanye nezimpawu zayo zingafaka okulandelayo:

• Ukuqubuka okukhulu kwesikhumba okubizwa ngeStevens-Johnson syndrome kanye ne-epidermal necrolysis enobuthi. Izimpawu zingafaka:
  • ukushwabana noma ukuxebuka kwesikhumba sakho
  • isifuba
  • ukuqubuka
  • izilonda ezibuhlungu emlonyeni wakho noma eduze kwamehlo akho
• I-Multi-organ hypersensitivity, ebizwa nangokuthi ukusabela kwezidakamizwa nge-eosinophilia kanye nezimpawu zesistimu (DRESS). Izimpawu zingafaka:
  • imfiva
  • ukuqubuka
  • ukuvuvukala kwezindlala
  • ubuhlungu obukhulu bemisipha
  • ukutheleleka okuvamile
  • ukuvuvukala kobuso bakho, amehlo, izindebe, noma ulimi
  • ukulimaza noma ukopha okungavamile
  • ubuthakathaka noma ukukhathala
  • ukuphuzi kwesikhumba sakho noma ingxenye emhlophe yamehlo akho
• Ukubalwa kwamaseli egazi aphansi. Izimpawu zingafaka:
  • ukukhathala
  • ubuthakathaka
  • ukutheleleka okuvamile noma ukutheleleka okungeke kuphele
  • ukulinyazwa okungaqondakali
  • ukuphuma kwamakhala
  • ukuphuma ezinsinini
• Izinguquko kumzwelo noma ekuziphatheni. Izimpawu zingafaka:
  • imicabango ngokuzibulala
  • imizamo yokuzilimaza noma ukuzibulala
  • ukudangala noma ukukhathazeka okusha noma kuba kubi kakhulu
  • ukungahlaliseki
  • ukwethuka
  • inkathazo yokulala
  • intukuthelo
  • ukuziphatha okunolaka noma okunodlame
  • ubuhlanya obusha noma obubi kakhulu
  • indlela yokuziphatha eyingozi noma imizwa
  • ukwanda okwedlulele komsebenzi nokukhuluma
• I-Aptic meningitis (ukuvuvukala kolwelwesi oluhlanganisa ubuchopho bakho nentambo yomgogodla). Izimpawu zingafaka:
  • ikhanda
  • imfiva
  • isicanucanu nokuhlanza
  • intamo elukhuni
  • ukuqubuka
  • ukuzwela kakhulu ekukhanyeni kunokujwayelekile
  • izinhlungu zemisipha
  • Ukugodola
  • ukudideka
  • ukozela
• I-hemophagocytic lymphohistiocytosis (i-HLH, ukusabela kwamasosha omzimba okusongela impilo). Izimpawu zingafaka:
  • imfiva ephezulu, imvamisa ingaphezu kuka-101 ° F
  • ukuqubuka
  • ama-lymph node akhulisiwe

Ukuzikhulula: Inhloso yethu ukukunikeza imininingwane efanelekile futhi yamanje. Kodwa-ke, ngoba izidakamizwa zithinta umuntu ngamunye ngokuhlukile, asikwazi ukuqinisekisa ukuthi lolu lwazi lubandakanya yonke imiphumela emibi engaba khona. Lolu lwazi aluyithathi indawo yeseluleko sezokwelapha. Hlala uxoxa ngemiphumela emibi engaba khona nomhlinzeki wezokunakekelwa kwempilo owazi umlando wakho wezokwelapha.

ILamotrigine ingaxhumana neminye imithi

Ithebhulethi yomlomo yeLamotrigine ingaxhumana neminye imithi, amavithamini, noma amakhambi okungenzeka ukuthi uthatha. Ukusebenzisana kulapho into iguqula indlela umuthi osebenza ngayo. Lokhu kungaba yingozi noma kuvimbele umuthi ukuthi usebenze kahle.

Ukusiza ukugwema ukuxhumana, udokotela wakho kufanele aphathe yonke imithi yakho ngokucophelela. Qiniseka ukuthi utshela udokotela wakho ngayo yonke imithi, amavithamini, noma amakhambi owathathayo. Ukuthola ukuthi lo muthi ungahlangana kanjani nokunye okuthathayo, khuluma nodokotela wakho noma usokhemisi.

Izibonelo zemithi engadala ukuhlangana ne-lamotrigine zibalwe ngezansi.

Imithi yokwelapha umuthi

Ukuthatha eminye imishanguzo yokulwa ne-lamotrigine kungehlisa izinga le-lamotrigine emzimbeni wakho. Lokhu kungathinta ukuthi i-lamotrigine isebenza kahle kangakanani. Izibonelo zale mithi zifaka:

• carbamazepine
• lindokuhle
• i-primidone
• mthombeni

I-Valproate, ngakolunye uhlangothi, angakhuphula izinga le-lamotrigine emzimbeni wakho. Lokhu kungadala ukwanda kwemiphumela emibi engaba yingozi.

Isidakamizwa senhliziyo

I-Dofetilide isetshenziselwa ukwelapha ama-arrhythmias enhliziyo. Uma isetshenziswa nge-lamotrigine, amazinga e-dofetilide emzimbeni wakho anganyuswa. Lokhu kungadala ama-arrhythmias abulalayo.

Izidakamizwa ze-HIV

Ukuthatha i-lamotrigine ngemithi ethile esetshenziselwa ukwelapha i-HIV kungehlisa izinga le-lamotrigine emzimbeni wakho. Lokhu kungathinta ukuthi i-lamotrigine isebenza kahle kangakanani. Izibonelo zale mithi zifaka:

• lopinavir / ritonavir
• atazanavir / ritonavir

Izindlela zokuvimbela inzalo ngomlomo

Ukuthatha i-lamotrigine ngenhlanganisela yokuvimbela inzalo yomlomo (leyo equkethe i-estrogen ne-progesterone) kungehlisa izinga le-lamotrigine emzimbeni wakho. Lokhu kungathinta ukuthi i-lamotrigine isebenza kahle kangakanani.

Isidakamizwa sofuba

I-Rifampin isetshenziselwa ukwelapha isifo sofuba. Uma isetshenziswa nge-lamotrigine, ingehlisa izinga le-lamotrigine emzimbeni wakho. Lokhu kungathinta ukuthi i-lamotrigine isebenza kahle kangakanani.

Ukuzikhulula: Inhloso yethu ukukunikeza imininingwane efanelekile futhi yamanje. Kodwa-ke, ngoba izidakamizwa zisebenzisana ngokwehlukile kumuntu ngamunye, asikwazi ukuqinisekisa ukuthi lolu lwazi lubandakanya konke ukuxhumana okungenzeka. Lolu lwazi aluyithathi indawo yeseluleko sezokwelapha. Hlala ukhuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana nokuhlangana okungenzeka ngayo yonke imishanguzo kadokotela, amavithamini, amakhambi kanye nezithasiselo, kanye nemithi oyithenga uphuza yona.

Izexwayiso zeLamotrigine

Lesi sidakamizwa siza nezixwayiso eziningana.

Isexwayiso somzimba

Lesi sidakamizwa singadala ukusabela okweqile komzimba. Izimpawu zingafaka:

• ukuqubuka
• inkinga yokuphefumula
• ukuvuvukala kobuso bakho, umphimbo, ulimi
• isifuba
• ukulunywa
• izilonda ezibuhlungu emlonyeni wakho

Uma uthuthukisa lezi zimpawu, shayela ku-911 noma uye egumbini lezimo eziphuthumayo eliseduze.

Ungaphinde uwuthathe lo muthi uma ngabe uke waba nokungezwani komzimba nawo. Ukuyithatha futhi kungaba yingozi (kungadala ukufa).

Izexwayiso zabantu abanezimo ezithile zempilo

Kubantu abanesifo sesibindi: Lesi sidakamizwa sicutshungulwa isibindi sakho. Uma isibindi sakho singasebenzi kahle, isidakamizwa esiningi singahlala emzimbeni wakho isikhathi eside. Lokhu kukubeka engozini yokwanda kwemiphumela emibi. Udokotela wakho angehlisa isilinganiso sakho salesi sidakamizwa.

Kubantu abanesifo sezinso: Lesi sidakamizwa sisuswa emzimbeni wakho ngezinso zakho. Uma izinso zakho zingasebenzi kahle, umuthi omningi ungahlala emzimbeni wakho isikhathi eside. Lokhu kukubeka engcupheni yokwanda kwemiphumela emibi. Udokotela wakho angehlisa isilinganiso sakho salesi sidakamizwa. Uma izinkinga zakho zezinso zinzima, udokotela wakho angayeka ukusebenzisa kwakho lesi sidakamizwa, noma angahle angakuniki nhlobo.

Izexwayiso kwamanye amaqembu

Kwabesifazane abakhulelwe: Lesi sidakamizwa singumuthi wesigaba C sokukhulelwa. Lokho kusho izinto ezimbili:

1. Ukucwaninga ngezilwane kukhombise imiphumela emibi embungwini lapho umama ethatha umuthi.
2. Akuzange kube nezifundo ezanele ezenziwe ebantwini ukuze kuqinisekiswe ukuthi umuthi ungawuthinta kanjani umbungu.

Khuluma nodokotela wakho uma ukhulelwe noma uhlela ukukhulelwa. Lesi sidakamizwa kufanele sisetshenziswe kuphela uma inzuzo engaba khona iqinisekisa ubungozi obungaba khona.

Uma ukhulelwa ngenkathi usebenzisa lesi sidakamizwa, shayela udokotela wakho ngokushesha.

Kwabesifazane abancelisayo: Lesi sidakamizwa sikhona obisini lwebele futhi singadala imiphumela emibi kakhulu enganeni enceliswa ibele. Tshela udokotela wakho uma uncelisa ingane yakho ibele. Buza mayelana nendlela engcono yokondla ingane yakho ngenkathi ukule mithi.

Uma uncelisa ngenkathi usebenzisa lo muthi, bukela ingane yakho eduze. Bheka izimpawu ezifana nenkinga yokuphefumula, iziqephu zesikhashana lapho ukuphefumula kuyeka, ukulala ngokweqile, noma ukuncela kabi. Shayela udokotela wengane yakho ngokushesha uma kukhona kulezi zimpawu.

Okwezingane: Akwaziwa ukuthi inguqulo ekhishwa ngokushesha yalesi sidakamizwa iphephile futhi iyasebenza yini ekwelapheni ukuquleka ezinganeni ezingaphansi kweminyaka engu-2. Futhi akwaziwa ukuthi inguqulo ekhishwe isikhathi eside yalesi sidakamizwa iphephile futhi iyasebenza yini ezinganeni ezingaphansi kweminyaka eyi-13.

Ngaphezu kwalokho, akwaziwa ukuthi inguqulo ekhishwa ngokushesha yalesi sidakamizwa iphephile futhi iyasebenza yini ekwelapheni ukuphazamiseka kwe-bipolar ezinganeni ezingaphansi kweminyaka eyi-18.

Ungayithatha kanjani i-lamotrigine

Yonke imithamo engenzeka kanye namafomu ezidakamizwa kungenzeka angafakwa lapha. Umthamo wakho, ifomu, nokuthi uthatha kangaki umuthi kuzoya ngokuthi:

• iminyaka yakho
• isimo esilashwa
• ubunzima besimo sakho
• ezinye izimo zezokwelapha onazo
• ukuthi usabela kanjani esilinganisweni sokuqala

Amafomu wezidakamizwa namandla

Okujwayelekile: I-Lamotrigine

• Ifomu: ithebhulethi yomlomo
• Amandla: 25 mg, 50 mg, 100 mg, 150 mg, 200 mg
• Ifomu: ithebhulethi ehlafunwayo
• Amandla: 2 mg, 5 mg, 25 mg
• Ifomu: ithebhulethi ehlukaniswa ngomlomo (ingaqedwa ngolimi)
• Amandla: 25 mg, 50 mg, 100 mg, 200 mg
• Ifomu: ithebhulethi ekhishwa enwetshiwe
• Amandla: 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 300 mg

Umkhiqizo: I-Lamictal

• Ifomu: ithebhulethi yomlomo
• Amandla: 25 mg, 100 mg, 150 mg, 200 mg

Umkhiqizo: I-CD kaLamictal

• Ifomu: ithebhulethi ehlafunwayo
• Amandla: 2 mg, 5 mg, 25 mg

Umkhiqizo: I-Lamictal ODT

• Ifomu: ithebhulethi ehlukaniswa ngomlomo (ingaqedwa ngolimi)
• Amandla: 25 mg, 50 mg, 100 mg, 200 mg

Umkhiqizo: ILamictal XR

• Ifomu: ithebhulethi ekhishwa enwetshiwe
• Amandla: 25 mg, 50 mg, 100 mg, 200 mg, 250 mg, 300 mg

Isilinganiso sokuquleka kwabantu abanesithuthwane

Isikali sabadala (iminyaka eyi-18-64 iminyaka)

Ifomu lokukhishwa ngokushesha (amaphilisi, amaphilisi ahlafunwayo, amaphilisi ahlukaniswa ngomlomo)

• UKUTHATHA nge-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-25 mg ngosuku.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo wakho ngo-25-50 mg kanye ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha u-100-400 mg ngosuku.
• AKUTHATHI i-carbamazepine, i-phenytoin, i-phenobarbital, i-primidone, noma i-valproate:
  • Amaviki 1-2: Thatha ama-25 mg ngosuku.
  • Amaviki 3–4: Thatha ama-50 mg ngosuku.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo wakho ngama-50 mg kanye ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha ama-225-375 mg ngosuku, ngemithamo emibili ehlukanisiwe.
• UKUTHATHA i-carbamazepine, i-phenytoin, i-phenobarbital, noma i-primidone kanye ne-NOT TAKING valproate:
  • Amaviki 1-2: Thatha ama-50 mg nsuku zonke.
  • Amaviki 3–4: Thatha i-100 mg ngosuku, ngemithamo emibili ehlukanisiwe.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo wakho nge-100 mg kanye ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha ama-300-500 mg ngosuku, ngemithamo emibili ehlukanisiwe.

Ifomu lokukhishwa okunwetshiwe (amaphilisi)

• UKUTHATHA nge-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-25 mg ngosuku.
  • Isonto 5: Thatha ama-50 mg ngosuku.
  • Isonto 6: Thatha i-100 mg ngosuku.
  • Isonto 7: Thatha i-150 mg ngosuku.
  • Isondlo: Thatha ama-200-250 mg ngosuku.
• AKUTHATHI i-carbamazepine, i-phenytoin, i-phenobarbital, i-primidone, noma i-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-50 mg ngosuku.
  • Isonto 5: Thatha i-100 mg ngosuku.
  • Isonto 6: Thatha i-150 mg ngosuku.
  • Isonto 7: Thatha ama-200 mg ngosuku.
  • Isondlo: Thatha ama-300-400 mg ngosuku.
• UKUTHATHA i-carbamazepine, i-phenytoin, i-phenobarbital, noma i-primidone kanye ne-NOT TAKING valproate:
  • Amaviki 1-2: Thatha ama-50 mg ngosuku.
  • Amaviki 3–4: Thatha i-100 mg ngosuku.
  • Isonto 5: Thatha ama-200 mg ngosuku.
  • Isonto 6: Thatha ama-300 mg ngosuku.
  • Isonto 7: Thatha ama-400 mg ngosuku.
  • Isondlo: Thatha ama-400-600 mg ngosuku.

Ukuguqulwa kusuka ekwelashweni okuhlanganisayo kuya ku-monotherapy

Udokotela wakho angakhetha ukumisa eminye imishanguzo yokulwa nezidakamizwa futhi uthathe i-lamotrigine yodwa. Lokhu kufakwa kuzokwehluka kulokho okuchazwe ngenhla. Udokotela wakho uzokwengeza kancane umthamo wakho we-lamotrigine futhi anciphise kancane imithamo yeminye imithi yakho yokulwa nezidakamizwa.

Ukuguqulwa kusuka ekukhipheni ngokushesha kuye ekukhishweni okwandisiwe (XR) lamotrigine

Udokotela wakho angakushintshela ngqo kwifomu ekhishwa ngokushesha ye-lamotrigine iye kufomu ekhishwe isikhathi eside (XR). Lokhu kufakwa kuzokwehluka kulokho okuchazwe ngenhla. Uma usushintshele kufomu le-XR, udokotela wakho uzokuqapha ukuze aqiniseke ukuthi ukuquleka kwakho kuyalawuleka. Udokotela wakho angashintsha isilinganiso sakho ngokuya ngokuthi uphendula kanjani ekwelashweni.

Isilinganiso sengane (iminyaka eyi-13-17 iminyaka)

Ifomu lokukhishwa ngokushesha (amaphilisi, amaphilisi ahlafunwayo, amaphilisi ahlukaniswa ngomlomo)

• UKUTHATHA nge-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-25 mg ngosuku.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo wakho ngama-25-50 mg kanye ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha u-100-400 mg ngosuku.
• AKUTHATHI i-carbamazepine, i-phenytoin, i-phenobarbital, i-primidone, noma i-valproate:
  • Amaviki 1-2: Thatha ama-25 mg ngosuku.
  • Amaviki 3–4: Thatha ama-50 mg ngosuku.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo wakho ngama-50 mg kanye ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha ama-225-375 mg ngosuku, ngemithamo emibili ehlukanisiwe.
• UKUTHATHA i-carbamazepine, i-phenytoin, i-phenobarbital, noma i-primidone kanye ne-NOT TAKING valproate:
  • Amaviki 1-2: Thatha ama-50 mg nsuku zonke.
  • Amaviki 3–4: Thatha i-100 mg ngosuku, ngemithamo emibili ehlukanisiwe.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo wakho nge-100 mg kanye ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha ama-300-500 mg ngosuku, ngemithamo emibili ehlukanisiwe.

Ifomu lokukhishwa okunwetshiwe (amaphilisi)

• UKUTHATHA nge-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-25 mg ngosuku.
  • Isonto 5: Thatha ama-50 mg ngosuku.
  • Isonto 6: Thatha i-100 mg ngosuku.
  • Isonto 7: Thatha i-150 mg ngosuku.
  • Isondlo: Thatha ama-200-250 mg ngosuku.
• AKUTHATHI i-carbamazepine, i-phenytoin, i-phenobarbital, i-primidone, noma i-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-50 mg ngosuku.
  • Isonto 5: Thatha i-100 mg ngosuku.
  • Isonto 6: Thatha i-150 mg ngosuku.
  • Isonto 7: Thatha ama-200 mg ngosuku.
  • Isondlo: Thatha ama-300-400 mg ngosuku.
• UKUTHATHA i-carbamazepine, i-phenytoin, i-phenobarbital, noma i-primidone kanye ne-NOT TAKING valproate:
  • Amaviki 1-2: Thatha ama-50 mg ngosuku.
  • Amaviki 3–4: Thatha i-100 mg ngosuku.
  • Isonto 5: Thatha ama-200 mg ngosuku.
  • Isonto 6: Thatha ama-300 mg ngosuku.
  • Isonto 7: Thatha ama-400 mg ngosuku.
  • Isondlo: Thatha ama-400-600 mg ngosuku.

Ukuguqulwa kusuka ekwelashweni okuhlanganisayo kuya ku-monotherapy

Udokotela wakho angakhetha ukumisa eminye imishanguzo yokulwa nezidakamizwa futhi uthathe i-lamotrigine yodwa. Lokhu kufakwa kuzokwehluka kulokho okuchazwe ngenhla. Udokotela wakho uzokwengeza kancane umthamo wakho we-lamotrigine futhi anciphise kancane imithamo yeminye imithi yakho yokulwa nezidakamizwa.

Ukuguqulwa kusuka ekukhipheni ngokushesha kuye ekukhishweni okwandisiwe (XR) lamotrigine

Udokotela wakho angakushintshela ngqo kwifomu ekhishwa ngokushesha ye-lamotrigine iye kufomu ekhishwe isikhathi eside (XR). Lokhu kufakwa kuzokwehluka kulokho okuchazwe ngenhla. Uma usushintshele kufomu le-XR, udokotela wakho uzokuqapha ukuze aqiniseke ukuthi ukuquleka kwakho kuyalawuleka. Udokotela wakho angashintsha umthamo wakho ngokuya ngokuthi uphendula kanjani ekwelashweni.

Isilinganiso sengane (iminyaka engu-2-12)

Ifomu lokukhishwa ngokushesha (amaphilisi, amaphilisi ahlafunwayo, amaphilisi ahlukaniswa ngomlomo)

• UKUTHATHA nge-valproate:
  • Amaviki 1-2: Thatha u-0.15 mg / kg ngosuku, ngamanani ahlukaniswe ngo-1-2.
  • Amaviki 3–4: Thatha u-0.3 mg / kg ngosuku, ngamanani ahlukaniswe ngo-1-2.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo ngo-0.3 mg / kg ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha u-1-5 mg / kg ngosuku, ngemithamo ehlukaniswe ngo-1-2 (ubukhulu obungama-200 mg ngosuku).
• AKUTHATHI i-carbamazepine, i-phenytoin, i-phenobarbital, i-primidone, noma i-valproate:
  • Amaviki 1-2: Thatha u-0.3 mg / kg ngosuku, ngamanani ahlukaniswe ngo-1-2.
  • Amaviki 3–4: Thatha i-0.6 mg / kg ngosuku, ngemithamo emibili ehlukanisiwe
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo ngo-0.6 mg / kg ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha u-4.5-7.5 mg / kg ngosuku, ngemithamo emi-2 ehlukanisiwe (ubuningi obungama-300 mg ngosuku).
• UKUTHATHA i-carbamazepine, i-phenytoin, i-phenobarbital, noma i-primidone kanye ne-NOT TAKING valproate:
  • Amaviki 1-2: Thatha i-0.6 mg / kg ngosuku, ngemithamo emibili ehlukanisiwe.
  • Amaviki 3–4: Thatha i-1.2 mg / kg ngosuku, ngemithamo emibili ehlukanisiwe.
  • Isonto 5 kuya phambili: Udokotela wakho uzokwandisa umthamo ngo-1.2 mg / kg ngosuku njalo ngesonto elilodwa kuya kwamabili.
  • Isondlo: Thatha u-5-15 mg / kg ngosuku, ngemithamo emi-2 ehlukanisiwe (ubuningi obungama-400 mg ngosuku).

Ifomu lokukhishwa okunwetshiwe (amaphilisi)

Akuqinisekisiwe ukuthi i-lamotrigine iphephile futhi iyasebenza ekusetshenzisweni ezinganeni ezingaphansi kweminyaka eyi-13. Akufanele isetshenziswe kulezi zingane.

Isilinganiso sengane (iminyaka yobudala engu-0-1)

Ifomu lokukhishwa ngokushesha (amaphilisi, amaphilisi ahlafunwayo, amaphilisi ahlukaniswa ngomlomo)

Akuqinisekisiwe ukuthi lezi zinhlobo ze-lamotrigine ziphephile futhi zisebenza kahle ezinganeni ezingaphansi kweminyaka engu-2. Akufanele zisetshenziswe kulezi zingane.

Umthamo omkhulu (oneminyaka engama-65 nangaphezulu)

Abantu abadala bangase bacubungule izidakamizwa kancane. Umthamo ojwayelekile wabantu abadala ungadala ukuthi amazinga omuthi emzimbeni wakho abe phezulu kunokujwayelekile. Lokhu kungaba yingozi. Ukusiza ukugwema lokhu, udokotela wakho angakuqala ngomthamo ophansi noma uhlelo oluhlukile.

Isilinganiso sokuphazamiseka kwengqondo okuguquguqukayo

Isikali sabadala (iminyaka eyi-18-64 iminyaka)

Ifomu lokukhishwa ngokushesha (amaphilisi, amaphilisi ahlafunwayo, amaphilisi ahlukaniswa ngomlomo)

• UKUTHATHA nge-valproate:
  • Amaviki 1-2: Thatha ama-25 mg nsuku zonke.
  • Amaviki 3–4: Thatha ama-25 mg ngosuku.
  • Isonto 5: Thatha ama-50 mg ngosuku.
  • Isonto 6: Thatha i-100 mg ngosuku.
  • Isonto 7: Thatha i-100 mg ngosuku.
• AKUTHATHI i-carbamazepine, i-phenytoin, i-phenobarbital, i-primidone, noma i-valproate:
  • Amaviki 1-2: Thatha ama-25 mg ngosuku.
  • Amaviki 3–4: Thatha ama-50 mg ngosuku.
  • Isonto 5: Thatha i-100 mg ngosuku.
  • Isonto 6: Thatha ama-200 mg ngosuku.
  • Isonto 7: Thatha ama-200 mg ngosuku.
• UKUTHATHA i-carbamazepine, i-phenytoin, i-phenobarbital, noma i-primidone kanye ne-NOT TAKING valproate:
  • Amaviki 1-2: Thatha ama-50 mg ngosuku.
  • Amaviki 3–4: Thatha i-100 mg ngosuku, ngemithamo ehlukanisiwe.
  • Isonto 5: Thatha ama-200 mg ngosuku, ngemithamo ehlukanisiwe.
  • Isonto 6: Thatha ama-300 mg ngosuku, ngemithamo ehlukanisiwe.
  • Isonto 7: Thatha kufika ku-400 mg ngosuku, ngemithamo ehlukanisiwe.

Isilinganiso sengane (iminyaka yobudala engu-0-17)

Amafomu akhishwa ngokushesha (amaphilisi, amaphilisi ahlafunwayo, amaphilisi ahlukaniswa ngomlomo)

Akuqinisekisiwe ukuthi lezi zinhlobo ze-lamotrigine ziphephile futhi zisebenza kahle ezinganeni ezingaphansi kweminyaka eyi-18 ekwelapheni ukuphazamiseka kwengqondo okuguquguqukayo. Akufanele zisetshenziswe kulezi zingane ekwelapheni ukuphazamiseka kwengqondo okuguquguqukayo.

Umthamo omkhulu (oneminyaka engama-65 nangaphezulu)

Abantu abadala bangase bacubungule izidakamizwa kancane. Umthamo ojwayelekile wabantu abadala ungadala ukuthi amazinga omuthi emzimbeni wakho abe phezulu kunokujwayelekile. Lokhu kungaba yingozi. Ukusiza ukugwema lokhu, udokotela wakho ukuqala kwami ​​kumthamo ophansi noma isheduli yokulinganisa ehlukile.

Ukucatshangelwa okukhethekile komthamo

• Kubantu abanesifo sesibindi: Uma unezinkinga zesibindi ezilinganiselayo kuya kwezinzima, udokotela wakho angehlisa isilinganiso sakho se-lamotrigine.
• Kubantu abanesifo sezinso: Uma unezinkinga zezinso, udokotela wakho anganciphisa isilinganiso sakho se-lamotrigine. Uma izinkinga zakho zezinso zinzima, khuluma nodokotela wakho mayelana nokuthi kufanele usebenzise lesi sidakamizwa.

Isikali izixwayiso

Umthamo wakho wokuqala we-lamotrigine akufanele ube ngaphezu kwesilinganiso sokuqala esinconyiwe. Futhi, umthamo wakho akufanele wengezwe ngokushesha okukhulu. Uma umthamo wakho uphezulu kakhulu noma unyuke ngokushesha okukhulu, usengozini enkulu yokuqubuka kwesikhumba okungathi sína noma okusongela ukuphila.

Uma uthatha lo muthi ukwelapha ukuquleka futhi kufanele uyeke ukuwuthatha, udokotela wakho uzokwehlisa kancane umthamo wakho okungenani amasonto amabili. Uma umthamo wakho ungehliswa kancane kancane futhi uncishisiwe, uzoba sengozini enkulu yokuba nokuquleka okwengeziwe.

Ukuzikhulula: Inhloso yethu ukukunikeza imininingwane efanelekile futhi yamanje. Kodwa-ke, ngoba izidakamizwa zithinta umuntu ngamunye ngokuhlukile, asikwazi ukuqinisekisa ukuthi lolu hlu lubandakanya yonke imithamo engenzeka. Lolu lwazi aluyithathi indawo yeseluleko sezokwelapha. Hlala ukhuluma nodokotela wakho noma usokhemisi ngemithamo ekufanele.

Thatha njengoba kuqondisiwe

Ithebhulethi yomlomo yeLamotrigine isetshenziselwa ukwelashwa isikhathi eside. Kuza nezingozi uma ungayithathi njengokuyalelwe.

Uma uyeka ukuthatha umuthi ngokungazelelwe noma ungawuthathi nhlobo: Uma uthatha lo muthi ukwelapha ukuquleka, ukumisa umuthi ngokungazelelwe noma ukungawuthathi nhlobo kungadala izinkinga ezinkulu. Lokhu kufaka ingozi eyengeziwe yokuhlaselwa. Zifaka nengozi yesimo esibizwa nge-status epilepticus (SE). Nge-SE, ukubanjwa okufushane noma okude kwenzeka imizuzu engama-30 noma ngaphezulu. I-SE yisimo esiphuthumayo sezokwelapha.

Uma uthatha lo muthi ukwelapha ukuphazamiseka kwe-bipolar, ukumisa umuthi ngokungazelelwe noma ukungawuthathi nhlobo kungadala izinkinga ezinkulu. Isimo sakho noma indlela oziphatha ngayo ingase ibe yimbi kakhulu. Ungadinga ukuthi ungeniswe esibhedlela.

Uma uphuthelwa imithamo noma ungaphuzi umuthi ngesikhathi: Imithi yakho kungenzeka ingasebenzi kahle noma ingayeka ukusebenza ngokuphelele. Ukuze lo muthi usebenze kahle, inani elithile lidinga ukuba semzimbeni wakho ngaso sonke isikhathi.

Uma uthatha kakhulu: Ungaba namazinga ayingozi omuthi emzimbeni wakho. Uma ucabanga ukuthi uthathe kakhulu lo muthi, shayela udokotela wakho noma funa ukuholwa yi-American Association of Poison Control Centers ku-1-800-222-1222 noma ngethuluzi labo eliku-inthanethi. Kepha uma izimpawu zakho zinzima, shayela ku-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha.

Okufanele ukwenze uma uphuthelwa umthamo: Thatha ngokushesha kwakho lapho ukhumbula. Uma ukhumbula amahora ambalwa ngaphambi kwesikhathi somthamo wakho olandelayo, thatha umthamo owodwa kuphela. Ungalokothi uzame ukubamba ngokuthatha amaphilisi amabili ngasikhathi sinye. Lokhu kungaholela emiphumeleni emibi eyingozi.

Ungasho kanjani ukuthi umuthi uyasebenza: Uma uthatha lo muthi ukwelapha ukuquleka, kufanele ube nokuquleka okumbalwa, noma ukuquleka okuncane kakhulu. Yazi ukuthi ungahle ungawuzwa umphumela ophelele walesi sidakamizwa amasonto ambalwa.

Uma uthatha lo muthi ukwelapha ukuphazamiseka kwe-bipolar, kufanele ube neziqephu ezimbalwa zemizwa eyeqisayo. Yazi ukuthi ungahle ungawuzwa umphumela ophelele walesi sidakamizwa amasonto ambalwa.

Ukucatshangelwa okubalulekile kokuthatha i-lamotrigine

Gcina lokhu kubheka engqondweni uma udokotela wakho ekunika i-lamotrigine.

Jikelele

• Zonke izinhlobo zalesi sidakamizwa zingathathwa ngokudla noma ngaphandle kokudla.
• Thatha lo muthi ngesikhathi (izi) esinconywe ngudokotela wakho.
• Ungakwazi ukusika noma ukuchoboza amaphilisi omlomo ahlafunwayo futhi ajwayelekile. Akufanele uchoboze noma usike amaphilisi akhululiwe noma ahlukaniswe ngomlomo.

Isitoreji

• Gcina amaphilisi okomlomo, ahlafunekayo, nakhishwe isikhathi eside ekamelweni lokushisa ku-77 ° F (25 ° C).
• Gcina amaphilisi ahlukaniswa ngomlomo ezingeni lokushisa eliphakathi kuka-68 ° F no-77 ° F (20 ° C no-25 ° C).
• Gcina le mithi ikude nokukhanya.
• Ungayibeki le mithi ezindaweni ezinomswakama noma ezinomswakama, njengezindlu zangasese.

Ukugcwalisa kabusha

Imibhalo kadokotela yalomuthi iyagcwaliseka. Akudingeki ukuthi unikezwe umuthi omusha kadokotela ukuze ugcwaliswe futhi lo muthi. Udokotela wakho uzobhala inani lama-refill eligunyazwe kudokotela wakho.

Ukuvakasha

Lapho uhamba nemithi yakho:

• Ngaso sonke isikhathi phatha imithi yakho. Lapho undiza, ungalokothi uwufake esikhwameni esihloliwe. Yigcine esikhwameni sakho sokuthwala.
• Ungakhathazeki ngemishini ye-X-ray yesikhumulo sezindiza. Abakwazi ukulimaza umuthi wakho.
• Ungadinga ukukhombisa abasebenzi bezindiza ilebula lekhemisi lemithi yakho. Ngaso sonke isikhathi phatha isitsha sokuqala esinelebula kadokotela.
• Ungafaki lo muthi egumbini legilavu ​​lemoto yakho noma uwushiye emotweni. Qinisekisa ukugwema ukwenza lokhu lapho isimo sezulu sishisa kakhulu noma sibanda kakhulu.
• Gwinya amaphilisi akhishwa njalo futhi enwetshiwe ephelele. Uma unenkinga yokugwinya, khuluma nodokotela wakho. Kungaba nolunye uhlobo lwalesi sidakamizwa ongasithatha.
• Uma uthatha ithebhulethi ehlakazeka ngomlomo, ibeke ngaphansi kolimi lwakho bese uyihambisa emlonyeni wakho. Ithebhulethi izoncibilika ngokushesha. Ingagwinywa ngamanzi noma ngaphandle kwawo.
• Amathebulethi angahlafunwayo angagwinywa aphelele noma ahlafunwe. Uma uhlafuna amaphilisi, phuza amanzi amancane, noma ijusi yezithelo exutshwe namanzi, ukusiza ngokugwinya. Amaphilisi lawo angahlanganiswa namanzi, noma ijusi yezithelo exutshwe namanzi. Faka amaphilisi ku-1 ithisipuni ketshezi (noma anele ukumboza amaphilisi) engilazini noma isipuni. Linda okungenani umzuzu owodwa noma kuze kuphele nya amaphilisi. Bese uxuba ikhambi ndawonye bese uphuza lonke inani.

Ukuzilawula

Ukuqapha komtholampilo

Udokotela wakho uzokuqapha. Ngesikhathi sokwelashwa kwakho nalesi sidakamizwa, ungahle ube nokuhlolwa kokuhlola:

• Izinkinga zesibindi: Ukuhlolwa kwegazi kuzosiza udokotela wakho anqume ukuthi kuphephile yini ukuthi uqale ukuthatha umuthi, nokuthi uma udinga umthamo ophansi.
• Izinkinga zezinso: Ukuhlolwa kwegazi kuzosiza udokotela wakho anqume ukuthi kuphephile yini ukuthi uqale ukuthatha umuthi, nokuthi uma udinga umthamo ophansi.
• Ukusabela kwesikhumba okunzima: Udokotela wakho uzokuqapha ngezimpawu zokuphendula kwesikhumba okunzima. Lokhu kusabela kwesikhumba kungasongela impilo.
• Imicabango yokuzibulala nokuziphatha: Udokotela wakho uzokuqapha ngemicabango yokuzilimaza noma yokuziphatha okuhlobene. Shayela udokotela wakho uma ubona noma yiluphi ushintsho oluzumayo emoyeni, ekuziphatheni, emicabangweni noma emizweni yakho.

Ngaphezu kwalokho, uma uthatha lo muthi ukwelapha ukuquleka, wena nodokotela wakho kuzodingeka ukuthi niqaphele ukuthi unesifo sokuwa kangaki. Lokhu kuzokusiza uqiniseke ukuthi lo muthi uyakusebenzela.

Futhi uma uthatha lo muthi ukwelapha ukuphazamiseka kwe-bipolar, wena nodokotela wakho kuzodingeka ukuthi niqaphele ukuthi uneziqephu zemizwa kangaki. Lokhu kuzokusiza uqiniseke ukuthi lo muthi uyakusebenzela.

Ukutholakala

Akuwona wonke amakhemisi agcina lo muthi. Lapho ugcwalisa incwadi kadokotela, qiniseka ukuthi ushayela phambili ukuze uqiniseke ukuthi ikhemisi lakho liyawuphatha.

Ngaphambi kokugunyazwa

Izinkampani eziningi zomshuwalense zidinga ukugunyazwa kwangaphambili kwezinhlobo ezithile zalesi sidakamizwa. Lokhu kusho ukuthi udokotela wakho uzodinga ukuthola imvume enkampanini yakho yomshuwalense ngaphambi kokuba inkampani yakho yomshuwalense ikhokhele incwadi kadokotela.

Ingabe zikhona ezinye izindlela?

Kuneminye imithi etholakalayo yokwelapha isimo sakho. Ezinye zingakulungela kangcono kunabanye. Khuluma nodokotela wakho ngezinye izinketho zezidakamizwa ezingakusebenzela.

Ukuzikhulula: I-Healthline yenze yonke imizamo yokuqinisekisa ukuthi lonke ulwazi luyiqiniso, luphelele futhi lusesikhathini.Kodwa-ke, le ndatshana akufanele isetshenziswe njengokungena esikhundleni solwazi nobungoti bochwepheshe bezokunakekelwa kwezempilo onelayisense. Kufanele uhlale uthintana nodokotela wakho noma omunye uchwepheshe wezokunakekelwa kwempilo ngaphambi kokuthatha noma imuphi umuthi. Imininingwane yezidakamizwa equkethwe lapha ingashintsha futhi ayihloselwe ukumboza konke ukusetshenziswa okungaba khona, izinkomba, izixwayiso, izexwayiso, ukuxhumana kwezidakamizwa, ukungezwani komzimba, noma imiphumela emibi. Ukungabikho kwezixwayiso noma olunye ulwazi lomuthi othile awukhombisi ukuthi inhlanganisela yezidakamizwa noma yezidakamizwa iphephile, iyasebenza, noma ilungele zonke iziguli noma konke ukusetshenziswa okuthile.