Gabapentin HmoovYog daim hmoov ntawm gabapentin, nrog nws cov qauv tivthaiv yog gabapentin (tshuaj siv lub npe: 1- (dog dig) cyclohexanyour acid, molecular cov qauv: c ₉ h ₁₇ tsis ₂). Nws yog tus dawb kom tawm dawb crystalline hmoov, tsw ntxhiab, iab me ntsis hauv saj, thiab soluble nyob rau hauv dej. Nws yog ib qho kev ua yeeb yam ntawm gamma aminobutyric acid (Gaba), tab sis tsis yog Gaba Receptor Egonist, thiab nws cov kev ua haujlwm tau sib txawv ntawm cov tshuaj tiv thaiv. Nws tau kho cov teebmeem los ntawm kev cuam tshuam rau Neurotransmitter tso thiab cov khoom siv hluav taws xob. Cov tshuaj no yog siv rau kev kho cov neeg mob Epilepsy uas tsis tuaj yeem tsim los ntawm cov neeg mob ethility uas tsis tuaj yeem tsim los ntawm cov neeg phem uas urileps nrog cov neeg qaug dej paug uas tom qab dhau los ua dav dav. Los ntawm kev tswj hwm neurotransmitter tso, qhov zaus thiab mob qaug zog ntawm epileptic qaug dab peg tuaj yeem txo.
Nyob rau tib lub sijhawm, peb lub tuam txhab tsis tsuas yog muab cov hmoov dawb, tab sis kuj cov ntsiav tshuaj thiab cov tshuaj. Yog tias xav tau, thov koj xav tiv tauj peb txhua lub sijhawm.
Cov ntaub ntawv ntxiv ntawm kev sib txuas lus:
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Gabapentin Hmoovyog gamma aminobutyric acid (gaba) ua rau cov tshuaj siv tshuaj lom neeg zoo sib xws rau Gaba tab sis ib qho tshwj xeeb mechanism ntawm kev nqis tes ua. Raws li daim ntawv hmoov, Gabapentin exerts kho teebmeem los ntawm kev tswj hwm NeuroTrical kev ua si thiab neuronal hluav taws xob ua si, thiab nws cov tseem ceeb siv cov nyiaj no loj:
Kev Kho Mob Epilepy
Gabapentin yog ib qho kev ua yeeb yam zoo nkauj ntawm gamma aminobutyric acid (GABA), nrog cov qauv tshuaj lom neeg uas muaj qhov sib khi ua ke rau lub ntsej muag lipophilic cyclohexylamine nplhaib. Raws li cov tshuaj thib ob ntawm kev ua yeeb yam, cov tshuab kev ua ntawm Gabapentin txawv ntawm cov tshuaj antiepileptically xws li carbamazeliepine. Txawm hais tias Gabapentin tsis ncaj qha khi rau Gaba receptors, nws txhim kho txoj kev nyob hauv qab no:
Kev txhawb nqa tsis yog Vesaug Pas Gaba Tso Tawm: Ua Ntej Synaptic Gap Gaba concentration thiab ntev nws inhibitory Postsynaptic muaj peev xwm (IPSP) ntev.
Kev txwv ntawm Gaba Transaminase kev ua si: txo Gaba kev ua tsis taus thiab nce Gaba qib hauv lub hlwb. Cov kev sim tsiaj tau pom tias Gabapentin tuaj yeem nce cov kev xav ntawm Gaba hauv Cerebrospinal kua los ntawm 30% -50%.
Kev tswj hwm Gaba synthease: Txhim Kho Glutamate Decaramate Decaramate Decaramate (GAD) kev ua si thiab txhawb Gaba ntau lawm.
Calcium flockade
Gabapentin khi rau ₂ Δ subunit ntawm voltage yog nyob rau inhibiting calcium ion influx thiab txo cov neuronal overexcitation. Cov tshuab hluav taws xob no ua si lub luag haujlwm tseem ceeb hauv kev tswj hwm epileptic, tshwj xeeb nrog cov kev sib txawv ntawm glutamate kho mob zoo siab synaptic kis tau zoo nkauj.
Ntshav-lub hlwb thaiv kev nkag
Gabapentin muaj siab li lipid solubility thiab tuaj yeem hla dhau los ntawm cov ntshav ntawm lub hlwb. Cov concentration ntawm Cerebrosn
Kev qhia thiab chaw kho mob txoj haujlwm ntawm Gabapentin nyob rau hauv kev kho mob ntawm epilepsy
Cov Lus Qhia Tseem Ceeb
Gabapentin Hmoovfeem ntau yog siv rau kev kho mob ntawm ob hom Epilepyy Cov Neeg Mob:
Ib nrab seizes: suav nrog cov kev qaug dab peg uas yooj yim (tsis nco qab) thiab cov kev xav tsis zoo), nrog rau kev saib xyuas kev saib xyuas ib puag ncig.
Refractory Spractory: Raws li kev kho cov tshuaj uas tsis muaj txiaj ntsig lossis tsis muaj cov tshuaj tiv thaiv cov tshuaj ib txwm muaj xws li carbamazepine thiab phenytoin sodium.
Soj ntsuam muab
Qhov kev kho mob uas ua rau cov neeg mob vwm: Hauv cov neeg mob urilepsiny, Gabapentin tuaj yeem txo cov kev qaug dab peg los ntawm 50% hauv 25% -50 ntawm cov neeg mob, nrog kev ua tau ruaj khov ntev.
Haum rau cov menyuam yaus thiab cov menyuam yaus: Gabapentin tau pom muaj kev nyab xeeb thiab kev ua kom muaj kev nyab xeeb hauv cov menyuam yaus muaj hnub nyoog qis dua 3 xyoos, thiab cov tshuaj uas yuav tsum raug hloov kho raws li lub cev hnyav (10-30mg / kg / hnub).
Soj ntsuam muab
Cov pab pawg tshwj xeeb zoo:
Cov neeg mob uas muaj cov neeg mob raum tsis tsim nyog: qhov ntau npaum li cas yuav tsum tau hloov kho raws li kev kho ntshav tawm tsam, tab sis kev ntsuas ntshav tshuaj tsis tas yuav raug saib xyuas (vim yog linear cov yam ntxwv).
Cov neeg mob laus: Vim tias yuav txo qis hauv metabolic tus nqi, nws raug nquahu kom pib nrog qhov qis (100mg / hnub) thiab maj mam ua rau cov tshuaj zoo.
Ua ke kho lub tswv yim thiab synergistic meterism ntawm gabapentin
Ua ke siv nrog cov tshuaj tiv thaiv kab mob
Kev tiv thaiv ntawm postherpetic neuralgia (phab): / Lub tshuab yuav cuam tshuam nrog cov nyhuv neuroprotective ntawm gabapentin thiab symicistic antiviral antiviral cuam tshuam ntawm kev ua phem.
Ua ke siv nrog opioid tshuaj
Neuropathic qhov mob kev kho mob: kev sib xyaw ua ke ntawm Gabapentin (1800Mg / hnub) thiab morphine ntawm cov tshuaj mob cancer mob tuaj yeem txo qis ntawm 30%, nrog rau 25% txo qis hauv qhov tshwm sim.
Ua ke nrog kev siv tshuaj tiv thaiv kev ntxhov siab
Fibromyalgia Kev Kho Mob: Kev sib xyaw ua ke ntawm Gabapentin (1800Mg / hnub) thiab duloxetine (60mg / hnub) tuaj yeem ua tiav cov pab pawg kho nrog cov pab pawg ib leeg (45%).
Neuralgia kho
Tshaj tawm herpetic neuralgia (phn)
Kev kuaj mob: Gabapentin yog FDA pom zoo ua ntej-kev kho mob rau PHN, nrog kev ua tau zoo dua li cov kev ua piv txwv ib txwm muaj xws li amitriptyline thiab carbamazine.
Mechanism ntawm kev ua: inhibit calcium raws ciam dorsal horn neurons thiab txo kev mob teeb meem hnoos qeev. Txhim kho Gabaergic kev ua si thiab inhibit mob lub teeb liab kev sib kis.
Cov ntaub ntawv pov thawj kuaj mob: Rand Randolized tswj kev sim (RCT) muaj kev cuam tshuam nrog ntau dua 50%, kev pw tsaug zog tau zoo dua li yog qhov tsis zoo tshaj yog qhov qis dua li ntawm cov pab pawg sib txawv. Cov kev tshawb fawb taug kev ntev tau pom tias Gabapentin tuaj yeem txo qhov kev rov ua dua ntawm PHN los ntawm kev tiv thaiv ntawm FEEM MASSOPATHIC qhov mob.
Mob ntshav qab zib neuropathy
Qhia tias: Gabapentin yog cov tshuaj kho mob kev pab rau cov ntshav qab zib uas cov neeg mob ntshav qab zib (cov neeg mob ntshav qab zib nrog cov neeg mob ntshav qab zib.
Mechanism ntawm Kev Ua: Tsis muaj kev tso tawm calcium raws, txo glutamate tso tawm los ntawm cov leeg kawg, thiab txo qhov mob hypersensitivity. Txhim kho Gabaergic Inshibition thiab txhim kho kev ua haujlwm rau lub zog.
Cov ntaub ntawv pov thawj kuaj mob: Randomized tswj tau kev sim ntawm 49 tus neeg mob uas tau ua tiav ntawm 72.7%, tus mob Pauv Hloov nrog cov pab pawg kho nrog Mecobalamin ib leeg (33.3%). Neuroelecrophysiological soj ntsuam tau qhia tias Gabapentin tuaj yeem txhim kho lub cev muaj zog ua haujlwm (MPV)
Trigeminal neuralgia
Kev kho mob hauv tsev kho mob: Gabapentin tuaj yeem siv ua cov tshuaj ua ntej rau kev ua haujlwm ib leeg lossis ua ke anticonvulsants xws li carbamazepine thiab oxcarbazepine.
Mechanism ntawm kev ua: inhibit calcium raws nyob rau hauv trigeminal channel tract neurons thiab txo qhov txawv txav. Thaiv cov kis mob ntawm qhov mob ntawm lub teeb tsa los ntawm kev ua haujlwm trigeminal mus rau hauv nruab nrab lub paj hlwb.
Cov ntaub ntawv pov thawj kho mob: kev kawm txog atypical trigeminal neuralgia tau pom nrog Gabapentin (1200-2400M / hnub) Thaum siv gabapentin ib leeg, kwv yees li ntawm 60% ntawm cov neeg mob tuaj yeem ua tiav cov tshuaj tswj, tab sis ntau dua cov tshuaj (ntau dua lossis sib npaug nrog 2400mg / hnub) yuav tsum muaj.
Kev mob hlwb neuropathic mob: Gabapentin muaj peev xwm txo qhov mob neuropathic hauv cov tshuaj muaj mob cancer lossis muaj cov kev mob tshwm sim tseem ceeb.
Qhov kev raug mob ntsws txha caj qaum, txawm tias tsis tau pom zoo los ntawm FDA, ntau yam kev tshawb fawb tau txo cov qhab nia mob (VAS txo ntawm 40% -50% hauv cov neeg mob txha caj qaum.
Phantom Limb Mob: Gabapentin tuaj yeem txhim kho kev xav tau mob thiab pw tsaug zog zoo rau cov neeg mob phaantom lim dej los ntawm kev tswj hwm tus txha caj qaum.
Kev pab txhawb rau kev mob hlwb
Cov kev ntxhov siab dav dav (GAD): Ib qho kev tshawb nrhiav dig muag ob tog Cov txiaj ntsig tau pom tias tom qab 8 lub lis piam ntawm kev kho nrog Gabapentin (600-1800mg / hnub) ua ke nrog kev xaiv Hamilton (SSRI)<0.01), and the effect was faster (significant in the second week).
Kev ntxhov siab ntxhov siab (tu siab): Qhov kev qhib phau ntawv xaiv cov cim nrog 25 tus neeg mob tu siab. Tom qab 12 lub lis piam ntawm kev kho nrog Gabapentin (900Mg / hnub), 72% ntawm cov neeg mob ua kom muaj kev zam txim siab lossis muaj 3 tus neeg mob tsis txaus siab (tsuas yog 3 tus neeg mob tsis muaj kev ntxhov siab). Gabapentin txo kev ntxhov siab ntsig txog kev tsim kho los ntawm kev cuam tshuam ntawm Amygdala Prefrontal Cortex Circuit; Lub caij no, nws cov txiaj ntsig sedative muaj peev xwm txo cov tsos mob ib txwm muaj xws li palpitations thiab kev txiav txim siab ntawm cov xwm txheej.
Kev Puas Tsuaj Bipolar: Kev Kho Mob Txuas Ntxiv rau Manic thiab Depressive Fab Kis
Raug tshuaj xyuas nrog rau cov kev tshawb fawb 40 xyoo (900-3600 -80%, tshwj xeeb rau cov neeg mob lub cev tsis muaj kev ntxhov siab lossis quav yeeb quav tshuaj. Nws cov nyhuv anti yog zoo dua rau carbamazepine (600mg / hnub), tshwj xeeb yog hauv kev txhim kho lub zog psychomotor.
Bipolar Kev Nyuaj Siab: Ob daim ntawv qhib qhib tau pom tias Gabapentin (900-1800mg / hnub) ua ke nrog cov tsos mob kev nyuaj siab hauv 5 ntawm 8 tus neeg mob nrog kev nyuaj siab bipolar; Lwm txoj kev kawm txog 22 tus neeg mob pom tias kev sib xyaw ua ke ntawm Gabapentin thiab Lamotrigine tuaj yeem ua tiav cov qhab nees sib txo ntau dua lossis sib npaug nrog 68% ntawm cov neeg mob. Lub pathophysiological ntawm kev puas siab puas ntsws bipolar muaj kev cuam tshuam nrog cov kev ua si uas muaj txiaj ntsig zoo, thiab cov kev ua kom siab glutamic, thiab siab subacellular calcium ion concentration.Gabapentin Hmoovtuaj yeem kho cov kev txawv txav saum toj no los ntawm kev nce gabafergic ntau, yog thaiv cov calcium channel tso tawm, yog li cuam tshuam nrog anti manic thiab anti depressive cuam tshuam.
Cim npe nrov: Cov hmoov uas muag, cov chaw muag khoom, chaw tsim khoom, Hoobkas, lag luam wholesale, yuav, nqe, loj, loj, rau muag