#1
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Àíàëãèí è Äåìèäðîë
Äîáðûé âå÷åð êîëëåãè.Ïîäñêàæèòå ïîæàëóéñòà èç êàêîãî ðîçùåòà Âû â ñâîåé ïðàêòèêå íàçíà÷àåòå(åñëè êîíå÷íî íàçíà÷àåòå)àíàëüãèí è äèìåäðîë â óíèâåðñèòåòå ãîâîðÿò ÷òî 0,1ìë íà ãîä æèçíè.Íî ÿ íå äóìàþ ÷òî òàêàÿ äîçà åôèêòèâíà íàïðèìåð ïðè òåìïåðàòóðå ó ðåáåíêà.Çàðàíèå ñïàñèáî.
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#2
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Âîçìîæíî ñòîèò âñïîìíèòü, äëÿ íà÷àëà, ÷òî àíàëüãèí (òåì áîëåå â ñî÷åòàíèè ñ äèìåäðîëîì) íå âõîäèò íè â îäèí ñòàíäàðò îêàçàíèÿ ïîìîùè äåòÿì. Áîëåå òîãî, â öèâèëèçîâàííîì ìèðå îí çàïðåùåí ê ïðèìåíåíèþ ó äåòåé!
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Ñ óâàæåíèåì, Âàëåðèé Âàëåðüåâè÷ Ñàìîéëåíêî |
#3
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Öèòàòà:
âî-âòîðûõ, 0,1 ÷åãî? |
#4
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Êñòàòè, êîãäà ìíå âíóòðèìûøå÷íî ââîäèëè äëÿ ïîñëåîïåðàöèîííîãî îáåçáîëèâàíèÿ àíàëüãèí ÿ ïîíÿë ñàêðàëüíûé ñìûñë åãî íàçíà÷åíèÿ. Óêîëû áûëè ñàìè ïî ñåáå íàñòîëüêî áîëåçíåííû, ÷òî î òîì, ÷òî ó òåáÿ ÷òî-òî áîëåëî äî ýòîãî ïðîñòî çàáûâàåøü.
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#5
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Ìíîãîóâàæàåìûé Âàëåðèé Âàëåðüåâè÷ Âû áû íåìîãëè áû ìíå ñêèíóòü ññûëêó íà íîðìàòèâíûé àêò òàêîãîçàïðåòà íà àíàëüãèíþ.
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#6
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#7
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Íåìîãëè áû Âû ïðîïèñàòü ññûëî÷êó íà íîðìàòèâíûé àêò êîòîðûé çàïðèùÿåò èñïîëüçûâàíèå àíàëüãèíà
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#8
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ß òàê ïîíèìàþ, ÷òî àíãëèéñêèé â Êèåâå óæå çíàþò ëó÷øå, ÷åì ðóññêèé.
À ïîñêîëüêó Îìåðèêà è Óêðàèíà - áõàé-áõàé, òî ïîëó÷èòå îìåðèêàíñêèå íîðìàòèâíûå äîêóìåíòû: Öèòàòà:
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#9
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Öèòàòà:
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] è ýòî äàëåêî íå âñå... Ìîæíî òàêæå âîñïîëüçîâàòüñÿ ïîèñêîì ïî ôîðóìó, ÷òîáû íàéòè îáñóæäåíèÿ àíàëüãèíà è ïî÷åìó îí äàâíî çàïðåùåí â áîëüøèíñòâå ñòðàí ìèðà. |
#10
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Êñòàòè, â ñåòè åñòü çàìå÷àòåëüíàÿ ïåðåâîäíàÿ êíèæêà, î÷åíü õîðîøî ðàñêðûâàþùàÿ ãëàçà (ñïåðâà íàïèñàë "ïðî÷èùàþùàÿ ìîçãè", ïîòîì èñïðàâèë íà áîëåå êîððåêòíîå) Èñêðåííå ðåêîìåíäóþ Ýíäðþ ×åòëè "ïðîáëåìíûå ëåêàðñòâà" [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
Õîòÿ, ñòðîãî ïî òåêñòó Âû ïðàâû - à Ðîññèè àíàëüãèí ïî-ïðåæíåìó ðàçðåøåí....
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Ñ óâàæåíèåì, Âàëåðèé Âàëåðüåâè÷ Ñàìîéëåíêî |
#11
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Óâàæàåìûå êîëëåãè, óâàæàåìûé Lupus Doc.
Ìåòàìèçîë çàïðåùåí â USA, íî îí íå çàïðåùåí â Åâðîïå. Êàê ìíå ñêàçàëè íà ìîåé íîâîé ðàáîòå (íå áåç âàøåé ïîìîùè, óâàæàåìûé LupusDoc) ïî ðåãèñòðàöèè ëåêàðñòâ, ìåòàìèçîë çàïðåùåí òîëüêî â äâóõ åâðîïåéñêèõ ñòðàíàõ, è ÷òî ýòî èçâå÷íàÿ âîéíà àíàëüãèíà ñ ïàðàöåòàìîëîì. Íåñìîòðÿ íà æåñòêèé êîíòðîëü FDA, â àìåðèêàíñêîì ñïðàâî÷íèêå PDR Physician Desk Reference ÿ íå íàøëà, íàïðèìåð, àìïèöèëëèíà, íî çàòî â êîíöå òàì áûë âíóøèòåëüíûé ñïèñîê ïèùåâûõ äîáàâîê. Ïîíèìàþ, ÷òî ïðèâîæó ìíåíèå îòäåëüíîãî ýêñïåðòà, íî àêàä. À.È. Âîðîáåâ â ãàçåòå "Ìîñêîâñêèé äîêòîð" ñ÷èòàåò ïàðàöåòàìîë îïàñíûì ëåêàðñòâîì è ãîâîðèò, ÷òî äîëãî áîðîëñÿ ïðîòèâ çàêóïîê ïàðàöåòàìîëà Ðîññèåé. Ìîãó óêàçàòü íîìåð ãàçåòû.  ïîäòâåðæäåíèå ñëîâ ïðèâîæó ññûëêó: ...À âîò èíåòåðåñíî, ïîêà âî ìíîãèõ ñòðàíàõ àíàëüãèí çàïðåùàþò è ïðåäóïðåæäàþò î åãî ïîáî÷íûõ ýôôåêòàõ, ÂÎÇ òåì âðåìåíåì ïóáëèêóåò òàêèå âîò äàííûå: These studies certainly suggest that the risks from adverse reactions to metamizole are similar to those posed by paracetamol, a drug widely reputed to be safe. According to the CIOMS IV conclusion “Newer methods of epidemiological studies have shown that the risk of agranulocytosis (1.7 per million) due to metamizole was exaggerated in the 70’s” (9). A randomized, double blind, multinational study involving 555 children showed that metamizole and ibuprofen were significantly more effective than paracetamol in achieving normal body temperatures; metamizole produced a significantly greater temperature reduction than ibuprofen and paracetamol, and helped maintain low tempera-tures for a longer duration(11). An editorial on the report from this study commented that drugs such as metamizole were perhaps unjustly deleted from our pharmacopoeia because of imprecise studies of adverse side effect; some of the older therapeutic agents such as metamizole may be identified as having clinical utility in children(12 , âçÿòóþ îòñþäà http://forums.rusmedserv.com/showthr...EB%FC%E3%E8%ED À ïàðàöåòàìîë äåéñòâèòåëüíî ãîðàçäî ñëàáåå àíàëüãèíà ñíèæàåò òåìïåðàòóðó, ýòî ÿ äàâíî çàìåòèëà.
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Èñðàôèëîâà Øàõëà Þñèôîâíà. Òåðàïåâò, ïóëüìîíîëîã. |
#12
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Öèòàòà:
Öèòàòà:
Öèòàòà:
Ìåòàìèçîë ÍÅ âêëþ÷åí â ñïèñîê Essential Drugs, ÍÅ ðåêîìåíäîâàí ÂÎÇ ê èñïîëüçîâàíèþ. Öèòàòà:
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#13
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È âñå-òàêè ÂÎÇ íå îïðåäåëèëñÿ ñî ñâîåé ïîçèöèåé â îòíîøåíèè àíàëüãèíà.
Îíè îñòîðîæíè÷àþò. Äåëî â òîì, ÷òî ïîñëå òîãî, êàê øâåäàìè áûëî çàÿâëåíî, ÷òî ïðèìåíåíèå àíàëüãèíà ïîâûøàåò ðèñê ðàçâèòèÿ àãðàíóëîöèòîçà, áûëî ïðîâåäåíî áîëüøîå èññëåäîâàíèå International Agranulocytosis and Aplastic Anaemia (IAAA), ãäå ïîêàçàëè, ÷òî ðèñê ðàçâèòèÿ àãðàíóëîöèòîçà ïðè ïðèìåíåíèè àíàëüãèíà ñâîäèòñÿ ê 1.1 íà ìèëëèîí. Ïîñëå ýòîãî àíàëüãèí âíîâü áûë ðàçðåøåí ê ïðèìåíåíèþ, íî øâåäû âíîâü âçÿëèñü çà èññëåäîâàíèÿ è âíîâü çàÿâèëè, ÷òî ðèñê ãîðàçäî âûøå, êàê ìèíèìóì 1 ê 1439, ÷òî ïðèâåëî ê ïîâòîðíîìó çàïðåòó àíàëüãèíà. Íî âîò â ÷åì çàãâîçäêà - íå îñòàëñÿ îòâå÷åííûì âîïðîñ, ïî÷åìó òàêàÿ ðàçíèöà â ðåçëóüòàòàõ? Òî ëè ó ñêàíäèíàâîâ åñòü ãåíåòè÷åñêàÿ ïðåäðàñïîëîæåííîñòü ê òàêîé ðåàêöèè, è ïîòîìó èìåííî â øâåäñêèõ èññëåäîâàíèÿõ òàêîé âûñîêèé ðèñê îïðåäåëÿåòñÿ, òî ëè International Agranulocytosis and Aplastic Anaemia ñîâåðøåííî íåïðàâèëüíî ïðîâåëè èññëåäîâàíèå.  èòîãå ÂÎÇ ïðîñòî ðåøèë ïîêà îòëîæèòü âûâîäû, ïîêà íå áóäóò ïðîâåäåíû îïÿòü èññåëåäîâàíèÿ, íî òîëüêî íà ýòî ðàç íå â ñêàíäèíàâñêèõ ñòðàíàõ. "The present publication provides evidence for the claims of a high risk of agranulocytosis with metamizole in Swedish patients. The study does not, however, clarify whether Scandinavians are genetically at a greater risk for such reactions. Comparative studies in various countries with more diverse. issue further and until this data is available, other drugs should be considered as first-line analgesics." Íî çàìåòüòå, íåò íè ñëîâà î ïîëíîì çàïðåòå, åñòü òîëüêî âûâîä î ïðåïàðàòàõ âûáîðà ïåðâîé ëèíèè. WHO Pharmaceuticals Newsletter No. 3, 2002 18 ( â ñåòè åñòü) |
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#15
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