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الاستطباب
ﻛﻤﺴﺎﻋﺪ ﻟﻠﺤﻤﻴﺔ ﻓﻲ ﻋﻼﺝ ﺍﺭﺗﻔﺎﻉ ﺍﻟﻜﻮﻟﻴﺴﺘﺮﻭﻝ ﻓﻲ ﺍﻟﺪﻡ . ﺍﻟﻤﺮﺿﻰ ﺍﻟﻤﻌﺮﺿﻴﻦ ﻟﻠﺈﺻﺎﺑﺔ ﺑﺄﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ ﺍﻟﺈﻛﻠﻴﻠﻴﺔ ( ﻣﻊ ﺍﻭ ﺑﺪﻭﻥ ﺇﺭﺗﻔﺎﻉ ﻛﻮﻟﻴﺴﺘﺮﻭﻝ ) , ﺑﻤﺎ ﻓﻴﻬﻢ ﻣﺮﺿﻰ ﺍﻟﺴﻜﺮﻱ , ﺍﻟﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻟﺪﻳﻬﻢ ﻗﺼﺔ ﺳﺎﺑﻘﺔ ﻟﻼﺻﺎﺑﺔ ﺑﺎﻟﺴﻜﺘﺔ ﺍﻟﺪﻣﺎﻏﻴﺔ ﺃﻭ ﺑﻤﺮﺽ ﻗﻠﺒﻲ ﻭﻋﺎﺋﻲ ﺁﺧﺮ , ﺃﻣﺮﺍﺽ ﺍﻟﺸﺮﺍﻳﻴﻦ ﺍﻟﻤﺤﻴﻄﻴﺔ , ﺃﻭ ﺑﻮﺟﻮﺩ ﻣﺮﺽ ﻗﻠﺒﻲ ﺇﻛﻠﻴﻠﻲ, ﻟﻠﺘﻘﻠﻴﻞ ﻣﻦ ﺧﻄﺮ ﺍﻟﻮﻓﺎﺓ ﺍﻟﻘﻠﺒﻲ ﺍﻟﻮﻋﺎﺋﻲ , ﺍﻟﺤﺎﻻﺕ ﺍﻟﻘﻠﺒﻴﺔ ﺍﻟﻮﻋﺎﺋﻴﺔ ﺍﻟﺄﺳﺎﺳﻴﺔ ﺑﻤﺎ ﻓﻴﻬﺎ ﺍﻟﺴﻜﺘﺔ ﻭ ﺍﻟﺪﺧﻮﻝ ﻟﻠﻤﺸﻔﻰ ﻧﺘﻴﺠﺔ ﺧﻨﺎﻕ ﺻﺪﺭ .
مضاد الاستطباب
ﻣﺮﺽ ﻛﺒﺪﻱ ﻓﻌﺎﻝ ﺃﻭ ﺍﺭﺗﻔﺎﻉ ﻣﺴﺘﻤﺮ ﻏﻴﺮ ﻣﻔﺴﺮ ﻟﻠﺘﺮﺍﻧﺲ ﺍﻣﻴﻨﺎﺯ . ﺍﻟﺤﻤﻞ ﻭ ﺍﻟﺈﺭﺿﺎﻉ . ﺍﻟﺤﺴﺎﺳﻴﺔ ﻟﻠﺪﻭﺍﺀ .
الآثار الجانبية
ﺃﻟﻢ ﺑﻄﻨﻲ , ﺍﻣﺴﺎﻙ , ﻧﻔﺨﺔ , ﺻﺪﺍﻉ ﻭ ﻭﻫﻦ . ﻏﺜﻴﺎﻥ , ﺍﺳﻬﺎﻝ , ﻃﻔﺢ ﺟﻠﺪﻱ , ﻋﺴﺮ ﻫﻀﻢ , ﺣﻜﺔ , ﺗﺴﺎﻗﻂ ﺍﻟﺸﻌﺮ , ﺩﻭﺧﺔ , ﺗﺸﻨﺠﺎﺕ ﻋﻀﻠﻴﺔ , ﺃﻟﻢ ﻋﻀﻠﻲ , ﻣﺬﻝ , ﺍﻋﺘﻼﻝ ﺍﻋﺼﺎﺏ ﻣﺤﻴﻄﻴﺔ , ﺇﻗﻴﺎﺀ ﻭ ﻓﻘﺮ ﺩﻡ .
ﻧﺎﺩﺭﺍ : ﺍﻋﺘﻼﻝ ﻋﻀﻠﻲ , ﺍﻧﺤﻼﻝ ﺍﻟﻌﻀﻼﺕ ﺍﻟﻤﺨﻄﻄﺔ , ﺍﻟﺘﻬﺎﺏ ﻛﺒﺪ /ﻳﺮﻗﺎﻥ , ﻣﺘﻼﺯﻣﺔ ﻓﺮﻁ ﺗﺤﺴﺲ .
التداخلات الدوائية
ﻣﺜﺒﻄﺎﺕ ﺍﻟﺴﻴﺘﻮﻛﺮﻭﻡ p3A4 , ﻛﻴﺘﻮﻛﻮﻧﺎﺯﻭﻝ , ﺇﺭﻳﺜﺮﻭﻣﺎﻳﺴﻴﻦ , ﺗﻴﻠﻴﺜﺮﻭﻣﺎﻳﺴﻴﻦ , ﻛﻼﺭﻳﺜﺮﻭﻣﺎﻳﺴﻴﻦ , ﻣﺜﺒﻄﺎﺕ HIV protease , ﻧﻴﻔﺎﺯﻭﺩﻭﻥ , ﺳﻴﻜﻠﻮﺳﺒﻮﺭﻳﻦ , ﻏﻴﻤﻔﻴﺒﺮﻭﺯﻳﻞ , ﺍﻟﻔﻴﺒﺮﺍﺕ ﺍﻟﺄﺧﺮﻯ , ﻧﻴﺎﺳﻴﻦ , ﺃﻣﻴﻮﺩﺍﺭﻭﻥ ﺃﻭ ﻓﻴﺮﺍﺑﺎﻣﻴﻞ , ﺩﻳﻠﺘﻴﺎﺯﻳﻢ , ﻋﺼﻴﺮ ﺍﻟﻜﺮﻳﻔﻮﻥ, ﻣﺸﺘﻘﺎﺕ ﺍﻟﻜﻴﻮﻣﺎﺭﻳﻦ .
التحذيرات
ﺧﻄﻮﺭﺓ ﺍﻟﺈﺻﺎﺑﺔ ﺑﺎﻋﺘﻼﻝ ﻋﻀﻠﻲ ﺃﻭ ﺍﻧﺤﻼﻝ ﺍﻟﻌﻀﻼﺕ ﺍﻟﻤﺨﻄﻄﺔ . ﻳﺠﺐ ﺍﻟﺘﻮﻗﻒ ﻋﻦ ﺍﻟﺪﻭﺍﺀ ﺑﺸﻜﻞ ﻣﺆﻗﺖ ﻗﺒﻞ ﺃﻳﺎﻡ ﻣﻦ ﺍﺟﺮﺍﺀ ﺍﻱ ﻋﻤﻞ ﺟﺮﺍﺣﻲ ﻛﺒﻴﺮ ﻭ ﻋﻨﺪ ﻭﻗﻮﻉ ﺃﻱ ﺣﺎﻟﺔ ﻃﺒﻴﺔ ﺃﻭ ﺟﺮﺍﺣﻴﺔ . ﺗﻘﻴﻴﻢ ﻣﺴﺘﻮﻯ ﺍﻟﺘﺮﺍﻧﺲ ﺍﻣﻴﻨﺎﺯ ﻓﻲ ﺍﻟﺪﻡ , ﺍﺫﺍ ﺍﺭﺗﻔﻊ ﺍﻟﻰ 3 ﺍﺿﻌﺎﻑ ﺍﻟﻤﺴﺘﻮﻯ ﺍﻟﻄﺒﻴﻌﻲ ﺑﺸﻜﻞ ﻣﺴﺘﻤﺮ ﻳﺠﺐ ﺍﻟﺘﻮﻗﻒ ﻋﻦ ﺗﻨﺎﻭﻝ ﺍﻟﺪﻭﺍﺀ . ﺍﻟﻤﺮﺿﻰ ﺍﻟﺬﻳﻦ ﻳﺘﻨﺎﻭﻟﻮﻥ ﻛﻤﻴﺔ ﻛﺒﻴﺮﺓ ﻣﻦ ﺍﻟﻜﺤﻮﻝ ﺃﻭ ﻟﺪﻳﻬﻢ ﻗﺼﺔ ﺳﺎﺑﻘﺔ ﻟﻠﺈﺻﺎﺑﺔ ﺑﻤﺮﺽ ﻛﺒﺪﻱ , ﺍﻟﺄﻃﻔﺎﻝ ﻭ ﻛﺒﺎﺭ ﺍﻟﺴﻦ .
الجرعة
10 ﺍﻟﻰ 80 ﻣﻠﻎ ﻳﻮﻣﻴﺎ ﻛﺠﺮﻋﺔ ﻭﺣﻴﺪﺓ ﻣﺴﺎﺀ . ﻻ ﻳﺠﺐ ﺗﻌﺪﻳﻞ ﺍﻟﺠﺮﻋﺔ ﻗﺒﻞ 4 ﺍﺳﺎﺑﻴﻊ ﻣﻦ ﺑﺪﺀ ﺗﻨﺎﻭﻝ ﺍﻟﺪﻭﺍﺀ , ﺍﻟﺠﺮﻋﻰ ﺍﻟﻌﻈﻤﻰ 80 ﻣﻠﻎ ﻳﻮﻣﻴﺎ .
ﺍﻟﻤﺮﺿﻰ ﺍﻟﻤﺼﺎﺑﻴﻦ ﺃﻭ ﺍﻟﻤﻌﺮﺿﻴﻦ ﺑﺸﻜﻞ ﻛﺒﻴﺮ ﻟﻠﺈﺻﺎﺑﺔ ﺑﺄﻣﺮﺍﺽ ﺍﻟﻘﻠﺐ ﺍﻟﺘﺎﺟﻴﺔ : 40 ﻣﻠﻎ ﻳﻮﻣﻴﺎ ﻣﺴﺎﺀ .
ﺇﺭﺗﻔﺎﻉ ﺍﻟﻜﻮﻟﻴﺴﺘﺮﻭﻝ ﺃﻭ ﺍﺭﺗﻔﺎﻉ ﺍﻟﺸﺤﻮﻡ : ﺟﺮﻋﺔ ﺍﻟﺒﺪﺍﻳﺔ 10 ﺍﻟﻰ 20 ﻣﻠﻎ ﻳﻮﻣﻴﺎ ﻣﺴﺎﺀ ﺛﻢ ﺗﺨﺼﺺ ﺍﻟﺠﺮﻋﺔ ﺣﺴﺐ ﺍﺳﺘﺠﺎﺑﺔ ﺍﻟﻤﺮﻳﺾ .
ﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﻟﻤﺘﺰﺍﻣﻦ ﻣﻊ ﺍﻟﺴﻴﻜﻠﻮﺳﺒﻮﺭﻳﻦ , ﺍﻟﻐﻴﻤﻔﻮﺑﺮﻭﺯﻳﻞ , ﺩﺍﻧﺎﺯﻭﻝ , ﺍﻟﻔﻴﺒﺮﺍﺕ ﺍﻟﺄﺧﺮﻯ (ﻋﺪﻯ ﺍﻟﻔﻴﻨﻮﻓﻴﺒﺮﺍﺕ ) ﺃﻭ ﺍﻟﻨﻴﺎﺳﻴﻦ (ﺃﻛﺜﺮ ﻣﻦ 1 ﻍ ﻳﻮﻣﻴﺎ ) : ﺍﻟﺠﺮﻋﺔ ﺍﻟﻌﻈﻤﻰ 10 ﻣﻠﻎ ﻳﻮﻣﻴﺎ .
ﺍﻻﺳﺘﺨﺪﺍﻡ ﺍﻟﻤﺘﺰﺍﻣﻦ ﻣﻊ ﺍﻻﻣﻴﻮﺩﺍﺭﻭﻥ ﺍﻭ ﺍﻟﻔﻴﺮﺍﺑﺎﻣﻴﻞ : ﺍﻟﺠﺮﻋﺔ ﺍﻟﻌﻈﻤﻰ 20 ﻣﻠﻎ ﻳﻮﻣﻴﺎ .
ﻣﺮﺿﻰ ﺍﻟﻘﺼﻮﺭ ﺍﻟﻜﻠﻮﻱ ﺍﻟﺤﺎﺩ ( ﺗﺼﻔﻴﺔ ﺍﻟﻜﺮﻳﺎﺗﻴﻨﻴﻦ ﺃﻗﻞ ﻣﻦ 30 ﻣﻞ ﺑﺎﻟﺪﻗﻴﻘﺔ ) : ﻳﺠﺐ ﺍﻟﺤﺬﺭ ﺍﺫﺍ ﺗﺠﺎﻭﺯﺕ ﺍﻟﺠﺮﻋﺔ 10 ﻣﻠﻎ ﻳﻮﻣﻴﺎ .
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