Amitriptyline: 7 yam koj yuav tsum paub

Amitriptyline: 7 yam koj yuav tsum paub

Tshuaj kho mob los ntawm Carmen Fookes, BPharm. Hloov kho zaum kawg thaum lub Tsib Hlis 12, 2021.

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1. Nws ua haujlwm li cas

  • Amitriptyline tau siv los kho kev nyuaj siab thiab xav tias ua haujlwm los ntawm kev nce qib ntawm serotonin thiab/lossis norepinephrine hauv lub hlwb.
  • Amitriptyline yog ib pawg ntawm cov tshuaj hu ua tricyclic antidepressants.

2. Upsides

  • Tej zaum yuav siv rau kev kho mob ntawm kev nyuaj siab loj (MDD).
  • Tej zaum yuav raug siv tawm ntawm daim ntawv lo (qhov no txhais tau tias nws tsis yog daim ntawv pov thawj pom zoo los ntawm FDA; txawm li cas los xij nws yuav muaj txiaj ntsig zoo hauv tsev kho mob) rau kev kho lwm yam mob xws li mob ntev, mob fibromyalgia, lossis tsis tsaug zog. Amitriptyline tuaj yeem siv ntxiv rau lwm txoj kev kho lossis qhov kev kho mob lwm yam tsis tau ua haujlwm.
  • Pom zoo los ntawm WHO tus mob khaub thuas rau mob hlab ntsha cuam tshuam tsis teb rau cov tshuaj zoo li opioid (xws li morphine).
  • Generic amitriptyline muaj.

3. Kev poob qis

Yog tias koj muaj hnub nyoog 18 txog 60 xyoos, tsis noj lwm yam tshuaj lossis tsis muaj lwm yam kev mob nkeeg, cov kev mob tshwm sim uas koj yuav ntsib ntau yam suav nrog:



  • Qhov ncauj qhuav, mob taub hau, cem quav, raws plab, thiab kev sib deev tsis zoo.
  • Tej zaum yuav ua rau muaj kev pheej hmoo ntawm kev xav tua tus kheej lossis tus cwj pwm hauv cov tub ntxhais hluas (zoo ib yam li lwm cov tshuaj tiv thaiv kev nyuaj siab).
  • Tej zaum yuav ua rau tsaug zog thiab cuam tshuam rau tus neeg lub peev xwm tsav tsheb lossis siv tshuab; qee tus neeg yuav tsim kev ua siab ntev rau cov txiaj ntsig no.
  • Kev pheej hmoo ntawm kev cuam tshuam los ntawm lub plawv, cov leeg nruj, tshee, qaug dab peg, ua rau lub zog nce ntxiv, hnyav lossis poob, poob plaub hau, tawv nqaij ua pob, thiab ua pob.
  • Kev sib cuam tshuam lossis siv tshuaj ntau dhau tuaj yeem ua rau mob serotonin syndrome (cov tsos mob suav nrog kev ntxhov siab, kev xav tsis meej, lub plawv dhia nrawm, kiv taub hau, tshee tshee, xeev siab, ntuav, raws plab). Lwm qhov tsos mob tsawg, neuroleptic malignant syndrome (NMS) tau tshaj tawm tom qab pib lossis nce koob tshuaj amitriptyline. Cov tsos mob suav nrog cov leeg nruj, ua npaws, hloov pauv lub siab, lub plawv dhia nrawm, thiab tshee.
  • Tej zaum yuav ua rau pom cov tsos mob tshem tawm nrog kev tshem tawm sai (cov tsos mob suav nrog xeev siab, mob taub hau, pw tsis tsaug zog, thiab nkees nkees). Cov no tsis yog qhia txog kev quav yeeb quav tshuaj. Taper dosage tawm qeeb hauv kev saib xyuas kev noj qab haus huv. Cov xwm txheej tsis tshua muaj tshwm sim ntawm mania tau tshaj tawm hauv 2 txog 7 hnub tom qab txiav kev kho mob ntev nrog tricyclic antidepressants, xws li amitriptyline.
  • Tej zaum yuav tsis haum rau qee tus neeg suav nrog cov uas nyob rau theem rov zoo tom qab myocardial infarction, tsis pom kev puas siab puas ntsws bipolar, keeb kwm ntawm qaug dab peg, tso zis tso zis, lossis lub qhov muag kaw qhov muag. Tsis txhob siv cov tshuaj amitriptyline ntau hauv cov neeg uas muaj kab mob plawv. Kev saib xyuas ze yog pom zoo thaum muab rau cov neeg uas muaj kab mob cov thyroid.
  • Tej zaum yuav ua rau cov menyuam kawm ntawv me me, uas tuaj yeem ua rau ntu ntawm lub qhov muag kaw qhov muag.
  • Tej zaum yuav cuam tshuam nrog ob peb lwm yam tshuaj suav nrog cov tshuaj uas tau hloov pauv los ntawm cov enzymes CYP2D6 lossis lwm yam tshuaj uas ua rau lub siab lossis nrog cov tshuaj anticholinergic phiv (xws li lub qhov ncauj qhuav, tso zis tso zis, qhov muag tsis pom kev, cem quav). Kub taub hau heev (hyperpyrexia) tau tshaj tawm thaum amitriptyline tau muab tshuaj antipsychotics lossis tshuaj anticholinergic.
  • Tsis pom zoo siv rau menyuam yaus.
  • Tsis txhob siv thaum cev xeeb tub tshwj tsis yog cov txiaj ntsig zoo tshaj qhov txaus ntshai. Amitriptyline tau pom tias hla txoj hlab ntaws thiab tau muaj ob peb daim ntawv ceeb toom ntawm cov xwm txheej tsis zoo, txawm hais tias tsis muaj kev sib raug zoo vim li cas.

Nco tseg: Feem ntau, cov neeg laus lossis menyuam yaus, cov neeg uas muaj qee yam mob (xws li teeb meem rau lub raum lossis lub raum, mob plawv, ntshav qab zib, qaug dab peg) lossis cov neeg uas noj lwm yam tshuaj muaj kev pheej hmoo ntawm kev tsim ntau yam kev phiv. Saib daim ntawv teev cov kev mob tshwm sim



4. Kab hauv qab

Amitriptyline yog cov tshuaj tiv thaiv kev nyuaj siab zoo tab sis tuaj yeem ua rau tsaug zog thaum xub thawj thiab tshem tawm cov tsos mob nrog kev tshem tawm sai.

5. Cov lus qhia

  • Ua raws nraim li koj tus kws kho mob tau hais tseg. Yog tias amitriptyline ua rau koj tsaug zog, tham nrog koj tus kws kho mob txog kev noj tshuaj ntau dua tom qab yav tav su lossis yav tsaus ntuj kom txo qis kev ua kom nruab hnub.
  • Nyeem phau ntawv qhia tshuaj uas muab los ntawm koj lub tsev muag tshuaj uas qhia koj txog amitriptyline. Yog tias koj muaj lus nug ntxiv, nrog koj tus kws kho mob lossis kws muag tshuaj tham.
  • Tsis txhob nres tam sim ntawd vim tias muaj cov tsos mob tshwm sim. Txo cov tshuaj maj mam dhau lub lis piam mus rau lub hlis yog pom zoo.
  • Qhia rau koj tus kws kho mob yog tias koj qhov kev nyuaj siab hnyav dua lossis yog koj txhim kho kev xav tua tus kheej, tshwj xeeb yog thawj ob peb lub hlis ntawm kev kho. Tsis tas li, saib xyuas rau serotonin syndrome.
  • Qhia tej yam tsis zoo tshwm sim rau kws kho mob.
  • Tej zaum yuav ua rau muaj kev pheej hmoo ntawm tshav kub; tiv thaiv koj tus kheej los ntawm tshav ntuj thaum nyob nraum zoov.
  • Tsis txhob noj lwm yam tshuaj nrog amitriptyline kom txog thaum xub thawj nrog koj tus kws kho mob lossis kws muag tshuaj hais tias cov no sib xws.
  • Qhia koj tus kws kho mob yog tias koj cev xeeb tub lossis npaj yuav cev xeeb tub, lossis pub niam mis.

6. Teb thiab ua tau zoo

  • Qhov siab tshaj plaws ntawm amitriptyline tau mus txog hauv 4 txog 8 teev. Amitriptyline tau hloov pauv mus rau cov metabolite nquag (nortriptyline) yog li cov teebmeem ntawm amitriptyline yog siv tau ntev. Cov tshuaj antidepressant yuav siv sijhawm ntau lub lis piam los tsim.

7. Kev sib tham

Cov tshuaj uas cuam tshuam nrog amitriptyline tuaj yeem txo nws cov txiaj ntsig, cuam tshuam ntev npaum li cas nws ua haujlwm rau, nce cov kev mob tshwm sim, lossis muaj qhov cuam tshuam tsawg dua thaum siv nrog amitriptyline. Kev sib cuam tshuam ntawm ob hom tshuaj tsis yog ib txwm txhais tau tias koj yuav tsum tsis txhob noj ib yam ntawm cov tshuaj; txawm li cas los xij, qee zaum nws ua. Tham nrog koj tus kws kho mob txog yuav ua li cas tswj kev sib tham tshuaj.



tswj cov tshuaj ua xyoo 1970

Cov tshuaj nquag uas tuaj yeem cuam tshuam nrog amitriptyline suav nrog:

  • anticoagulants (ntshav thinner), xws li warfarin, lossis lwm yam tshuaj uas muaj cov ntshav ua kom ntshav qis xws li tshuaj aspirin lossis NSAIDs
  • anticonvulsants, xws li phenytoin, phenobarbital, lossis primidone
  • antipsychotics (xws li butyrophenones, phenothiazines, lossis thioxanthenes) thiab atypical antipsychotics (piv txwv li, olanzapine, quetiapine, ziprasidone)
  • ib yam tshuaj twg uas yuav ua rau tsaug zog, xws li benzodiazepines (piv txwv li, diazepam, lorazepam), thawj cov tshuaj antihistamines (xws li doxylamine lossis promethazine), metoclopramide, lossis opioids (xws li codeine, morphine)
  • tshuaj aspirin
  • bupropion
  • buspirone
  • cimetidine
  • cisapride hmoov
  • diuretics, xws li furosemide
  • disulfiram
  • ipratropium
  • lithium
  • cov tshuaj uas yuav cuam tshuam rau lub plawv dhia los ntawm QT ncua sijhawm, xws li amiodarone, encainide, flecainide, lossis pimozide
  • cov tshuaj uas ntxias lossis txwv CYP2D6 xws li amiodarone, bupropion, lossis duloxetine
  • lwm yam antidepressants, xws li tricyclic antidepressants (xws li, clomipramine), monoamine oxidase inhibitors (xws li, isocarboxazid, phenelzine, thiab tranylcypromine), venlafaxine, thiab SSRIs (xws li, paroxetine, sertraline)
  • lwm yam tshuaj uas cuam tshuam rau serotonin, xws li amphetamines, fentanyl, lithium, tramadol, triptans (piv txwv li, almotriptan, eletriptan, lossis sumatriptan), lossis St. John's Wort
  • lwm tus, xws li tshuaj HIV (fosamprenavir, ritonavir), fluconazole, lossis procyclidine
  • topiramate.

Tej zaum yuav txhim kho cov cawv thiab cuam tshuam ntawm lwm qhov kev nyuaj siab hauv CNS. Tsis txhob haus cawv lossis siv tshuaj tsis raug cai lossis ua si ua si thaum noj amitriptyline.

Nco ntsoov tias daim ntawv teev npe no tsis suav nrog txhua qhov thiab suav nrog tsuas yog cov tshuaj uas tuaj yeem cuam tshuam nrog amitriptyline. Koj yuav tsum xa mus rau cov ntaub ntawv sau tseg rau amitriptyline rau cov npe ua tiav ntawm kev sib cuam tshuam.



Cov neeg ua tim khawv

Amitriptyline. Hloov kho 02/2021. Lifestar Pharma LLC https://www.drugs.com/pro/amitriptyline.html

Cov ntaub ntawv ntxiv

Nco ntsoov, khaws qhov no thiab lwm yam tshuaj kom tsis txhob ncav cuag menyuam yaus, tsis txhob faib koj cov tshuaj nrog rau lwm tus, thiab siv amitriptyline nkaus xwb rau qhov qhia qhia.

Ib txwm sab laj nrog koj tus kws kho mob kom ntseeg tau tias cov ntaub ntawv tso tawm ntawm nplooj ntawv no siv rau koj tus kheej li xwm txheej.

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