AMBROBENE sirop 100 ml 15 mg/5 ml
AMBROBENE sirop 100 ml 15 mg/5 ml qo'llanmasi
Farmakokinetikasi
Ichga qabul qilingandan so'ng ambroksol me'da-ichak traktidan deyarli to'liq so'riladi. Maksimal kontsentratsiyaga ichga qabul qilingandan 1-3 soat o'tgach erishiladi. Tizim oldi metabolizmi tufayli ambroksolning mutlaq biologik kira olishligi ichga qabul qilingandan so'ng taxminan 1/3 ga kamayadi. Shu munosabat bilan hosil bo'lgan metabolitlar (dibromoantranil kislotasi, glyukuronidlar kabi) buyraklarda eliminatsiya qilinadi. Plazma oqsillari bilan bog'lanishi taxminan 85 % (80-90 %) ni tashkil qiladi. Plazmadan yarim chiqarilish davri 7 dan 12 soatgacha o'zgarib turadi. Ambroksol va uning metabolitlarining umumiy yarim chiqarilish davri taxminan 22 soatni tashkil qiladi.
Asosan buyraklar orqali metabolitlar ko'rinishida chiqariladi - 90 %, 10 % dan kamrog'i o'zgarmagan holda chiqariladi.
Plazma oqsillari bilan yuqori bog'lanishni, katta taqsimlanish hajmini va to'qimalardan qonga sekin qayta taqsimlanishni hisobga olgan holda, dializ yoki jadallashtirilgan diurezda ambroksolning sezilarli darajada chiqarilishi sodir bo'lmaydi.
Og'ir jigar kasalliklari bo'lgan bemorlarda ambroksol klirensi 20-40 % ga kamayadi. Og'ir buyrak funktsiyasi buzilishi bo'lgan bemorlarda ambroksol metabolitlarining yarim chiqarilish davri ortadi.
Ambroksol orqa miya suyuqligiga va yo'ldosh to'sig'i orqali o'tadi, shuningdek ko'krak sutiga ajralib chiqadi.
Nojo'ya samaralari
Umumiy buzilishlar:
Kam hollarda (? 0,1 % dan
Juda kam hollarda (
Oshqozon-ichak trakti tomonidan:
Kam hollarda (? 0,1 % dan
Boshqalar:
Kam hollarda (? 0,1 % dan
Maxsus saqlash sharoitlari
Balg'am ko'chishini qiyinlashtiruvchi yo'talga qarshi dori vositalari bilan kombinatsiyalamaslik kerak.
2 yoshgacha bo'lgan bolalarda preparatni qo'llash faqat shifokor tayinlovi bo'yicha mumkin. Ambrobene preparati qo'llanilganda juda kam hollarda Stivens-Djonson sindromi va Layell sindromi kabi og'ir shakldagi teri reaksiyalari kuzatilgan. Teri qoplamalari yoki shilliq qavatlar o'zgarganda darhol shifokorga murojaat qilish va preparat qabul qilishni to'xtatish kerak.
Kaloriyaliligi 1 g sorbitolga 2,6 kkalni tashkil qiladi. Sorbitol yengil surgusimon ta'sir ko'rsatishi mumkin. 1 o'lchov stakanchasi (5 ml sirop) 2,1 g sorbitol saqlaydi, bu 0,18 NB ga to'g'ri keladi.
Transport vositalarini va mexanizmlarni boshqarish qobiliyatiga ta'siri:
Hozirgi vaqtgacha transportni haydash va mashina hamda mexanizmlarni boshqarish qobiliyatiga ta'siri ma'lum emas.
Qo'llanilishi mumkin bo'lmagan holatlar
- Ambroksolga yoki yordamchi moddalardan birortasiga yuqori sezuvchanlik;
- homiladorlik (I trimestr);
- saxaraza/izomaltaza tanqisligi, fruktozani o'zlashtiraolmaslik, glyukoza-galaktoza malabsorbtsiyasi.
Ehtiyotkorlik bilan:
Bronxlar motor faoliyatining buzilishi va balg'am hosil bo'lishining kuchayishi (kiprikchalarning harakatsizligi sindromida), me'da va 12-barmoqli ichak yara kasalligi zo'rayish davrida, homiladorlik (II-III trimestr), laktatsiya davri.
Buyrak faoliyati buzilgan yoki og'ir jigar kasalliklari bo'lgan bemorlar Ambrobeneni alohida ehtiyotkorlik bilan, qabullar orasidagi katta intervallarga rioya qilgan holda yoki preparatni kamroq dozada qabul qilishlari kerak.
Homiladorlik va laktatsiya:
Homiladorlik:
Homiladorlik davrida ambroksolni qo'llash bo'yicha ma'lumotlar yetarli emas. Xususan, bu homiladorlikning birinchi 28 haftasiga tegishli. Hayvonlarda o'tkazilgan tadqiqotlar teratogen ta'sirni aniqlamadi.
Homiladorlikda (II-III trimestr) Ambrobeneni qo'llash faqat shifokor ko'rsatmasi bo'yicha, xavf/foyda nisbati sinchkovlik bilan baholangandan keyin mumkin.
Emizish davri:
Hayvonlarda o'tkazilgan tadqiqotlar shuni ko'rsatdiki, ambroksol ko'krak sutiga o'tadi. Emizish davridagi ayollarda preparatni qo'llash yetarlicha o'rganilmaganligi sababli, Ambrobene preparatini qo'llash faqat shifokor ko'rsatmasi bo'yicha, xavf/foyda nisbati sinchkovlik bilan baholangandan keyin mumkin.
Dori vositalarining o'zaro ta'siri
Ambroksol va yo'talga qarshi vositalar bir vaqtda qo'llanilganda yo'tal refleksi bostirilishi tufayli sekret turg'unligi yuzaga kelishi mumkin. Shuning uchun bunday kombinatsiyalarni ehtiyotkorlik bilan tanlash kerak.
Ambroksol va amoksitsillin, Sefuroksim, eritromitsin va doksitsiklin antibiotiklari birga qabul qilinganda balg'am va bronxial sekretda oxirgilarining konsentratsiyasi oshadi.
Dozirovkasi
2 yoshgacha bo'lgan bolalarga kuniga 2 marta 14 o'lchov stakanchasi (2,5 ml sirop) qabul qilish kerak (kuniga 15 mg ambroksol).
2 yoshdan 6 yoshgacha bo'lgan bolalarga kuniga 3 marta 44 o'lchov stakanchasi (2,5 ml sirop) qabul qilish kerak (kuniga 22,5 mg ambroksol).
6 yoshdan 12 yoshgacha bo'lgan bolalarga kuniga 2-3 marta 1 o'lchov stakanchasi (5 ml sirop) qabul qilish kerak (kuniga 30 - 45 mg ambroksol).
Kattalar va 12 yoshdan katta bolalarga davolashning birinchi 2-3 kunida kuniga 3 marta 2 o'lchov stakanchasi (10 ml sirop) qabul qilish kerak (kuniga 90 mg ambroksol). Terapiya samarasiz bo'lganda kattalar dozani kuniga 2 marta 4 o'lchov stakanchasigacha (20 ml sirop) oshirishlari mumkin (kuniga 120 mg ambroksol). Keyingi kunlarda kuniga 2 marta 2 o'lchov stakanchasi (10 ml sirop) qabul qilish kerak (kuniga 60 mg ambroksol).
Davolash davomiyligi kasallikning kechishiga qarab individual ravishda tanlanadi. Ambrobeneni shifokor tayinlovisiz 4-5 kundan ortiq qabul qilish tavsiya etilmaydi. Preparatning mukolitik ta'siri ko'p miqdorda suyuqlik qabul qilinganda namoyon bo'ladi. Shuning uchun davolash paytida ko'p suyuqlik ichish tavsiya etiladi.Dozani oshirib yuborishSimptomlari:
Ambroksol dozasi oshirib yuborilganda intoksikatsiya belgilari aniqlanmagan. Asabiy qo'zg'alish va diareya haqida ma'lumotlar mavjud.
Ambroksol kuniga 25 mg/kg gacha dozada ichga qabul qilinganda yaxshi o'zlashtiriladi.
Og'ir dozani oshirib yuborish holatida so'lak oqishining kuchayishi, ko'ngil aynishi, qusish, arterial qon bosimining pasayishi mumkin.
Davolash:
Qusishni chaqirish, oshqozonni yuvish kabi intensiv terapiya usullari faqat og'ir dozani oshirib yuborish hollarida, preparat qabul qilingandan keyingi birinchi 1-2 soat ichida qo'llanilishi kerak. Simptomatik davolash ko'rsatilgan.
Hajm/og'irlik
AMBROBENE sirop 100 ml 15 mg/5 ml o'xshash dorilari
AMBROBENE sirop 100 ml 15 mg/5 ml xususiyatlari
Ambrobene boshqa chiqarish shakllari
AMBROBENE sirop 100 ml 15 mg/5 ml analoglari
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