Belladonna
Kelas obat: Agen Antineoplastik
Panganggone Belladonna
Penyakit Ulkus Peptik
Tambahan ing perawatan penyakit ulcer peptik; Nanging, ora ana data konklusif sing mbantu penyembuhan, nyuda tingkat kambuh, utawa nyegah komplikasi ulkus peptik. Kanthi tekane terapi sing luwih efektif kanggo ngobati penyakit ulcer peptik, antimuskarinik mung nduweni kegunaan winates ing kondisi iki.
Wis digunakake ing kombinasi karo obat liyane (contone, fenobarbital); Nanging, ora ana data sing ndhukung keunggulan preparat kombinasi tinimbang antimuskarinik mung.
Gangguan Motilitas GI
Pengobatan gangguan fungsional saka motilitas GI (contone, sindrom irritable bowel) lan gangguan usus neurogenik; Nanging, khasiat diwatesi. Gunakake mung yen langkah-langkah liyane (contone, diet, sedasi, konseling, ameliorasi faktor lingkungan) kurang utawa ora ana gunane.
Wis digunakake ing kombinasi karo obat liyane (contone, fenobarbital) ing perawatan. saka gangguan fungsional motilitas GI kayata sindrom irritable bowel; Nanging, terapi gabungan kasebut ora nduweni bukti khasiat sing cukup.
Gunakake kanthi ati-ati banget, yen kabeh, ing perawatan hipermotilitas lan diare sing ana gandhengane karo gangguan GI kayata enterocolitis akut.
Pain
Wis digunakake rektal ing kombinasi karo Opium ing patients unresponsively nonopiate analgesik kanggo relief gejala saka Moderate pain abot sawise surgery GU lan kanggo relief saka pain disebabake spasm ureter.
Sindrom Parkinsonian
Pengobatan kasus sindrom parkinsonian sing entheng utawa minangka tambahan kanggo terapi liyane; nanging, antimuskarinik umume wis diganti karo obat dopaminergik.
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Carane nggunakake Belladonna
Administrasi
Atur kanthi lisan utawa rektal.
Administrasi Oral
Administrasi oral minangka tincture belladonna utawa ekstrak utawa minangka tablet konvensional utawa extended-release utawa solusi lisan (elixir) sing ngandhut alkaloid belladonna ing kombinasi tetep karo obat liyane (contone, fenobarbital). ).
Wêdakakêna ekstrak Belladonna digunakake sacara ekstemporan kanggo nyiapake kapsul, bubuk, utawa tablet kanggo administrasi oral.
Daun Belladonna dhewe ora digunakake minangka agen terapeutik amarga ana risiko overdosis alkaloid. antimuskarinik kanthi gampang dititrasi.
Administrasi Rectal
Basahi supositoria rektum sing ngandhut belladonna lan opium nganggo banyu sadurunge dilebokake dubur.
Dosis
Titrasi dosis kanthi ati-ati nganti efek terapeutik bisa ditindakake utawa efek sing ora bisa ditindakake. Dosis sing luwih dhuwur tinimbang sing disaranake bisa uga dibutuhake kanggo efek terapeutik. Gunakake dosis efektif sing paling murah.
Pasien Anak
Dosis Umum OralTingtur Belladonna: Dosis awal biasane 0,1 mL (0,03 mg alkaloid godhong belladonna) saben kg saben dina utawa 2,5 mL (0,75 mg alkaloid saka rwaning belladonna) saben m2 saben dina, diwenehi ing 3 utawa 4 dosis dibagi; ora ngluwihi 3,5 mL (1,05 mg alkaloid godhong belladonna) saben dina.
Penyakit Ulkus Peptik lan Gangguan Motilitas GI OralTingtur Belladonna: Dosis awal biasane 0,1 mL (0,03 mg alkaloid saka godhong belladonna ) saben kg saben dina utawa 2,5 mL (0,75 mg alkaloid saka rwaning belladonna) saben m2 saben dina, diwenehi ing 3 utawa 4 dosis dibagi; ora ngluwihi 3,5 mL (1,05 mg alkaloid saka rwaning belladonna) saben dina.
Alkaloid Belladonna lan fenobarbital (contone, elixir Donnatal): Diwenehi saben 4-6 jam adhedhasar bobot lan gejala. (Deleng Tabel 1.)
Tabel 1. Dosis Awal Pediatrik Alkaloid Belladonna lan Fenobarbital (contone, elixir Donnatal)hBobot Badan
Dosis Saben 4 Jam
Dosis Saben 6 Jam
4,5 kg
0,5 mL
0,75 mL
9,1 kg
1 mL
1,5 mL
13,6 kg
1,5 mL
2 mL
22,7 kg
2,5 mL
3,75 mL
34 kg
3,75 mL
5 mL
45,4 kg
5 mL
7,5 mL
Nyeri Nyeri Sawise Operasi GU utawa Disebabake dening Spasme Ureteral RectalRemaja ≥13 taun: 16,2 mg ekstrak belladonna (0,203 mg alkaloid saka godhong belladonna) kanthi kombinasi tetep karo 30 utawa 60 mg opium (1 supositoria) sepisan utawa kaping pindho saben dina.
Dewasa
Dosis Umum OralEkstrak Belladonna: Dosis awal biasa yaiku 15–30 mg (0,187–0,374 mg alkaloid saka godhong belladonna) 3 utawa 4 kali dina.
Tingtur Belladonna: Dosis awal biasane 0,6–1 mL (0,18–0,3 mg alkaloid saka rwaning belladonna) 3 utawa 4 kali dina.
Penyakit Ulkus Peptik lan Gangguan Motilitas GI OralEkstrak Belladonna : Dosis awal biasanipun yaiku 15–30 mg (0.187–0.374 mg alkaloid godhong belladonna) 3 utawa 4 kali dina.
Tingtur Belladonna: Dosis awal biasa yaiku 0.6–1 mL (0.18–0.3 mg saka alkaloid saka godhong belladonna) 3 utawa 4 kaping saben dina.
Tablet utawa solusi langsung-release (elixir) ngemot alkaloid belladonna lan fenobarbital (contone, Donnatal): 1 utawa 2 tablet utawa 5 utawa 10 mL saka elixir 3 utawa 4 kaping dina.
Tablet extended-release ngemot alkaloid belladonna lan fenobarbital (Donnatal Extentabs): Dosis biasa yaiku 1 tablet saben 12 jam; bisa menehi 1 tablet saben 8 jam yen dituduhake.
Nyeri Nyeri Sawise Operasi GU utawa Disebabake Spasme Ureteral Rectal16,2 mg ekstrak belladonna (0,203 mg alkaloid saka rwaning belladonna) ing kombinasi tetep karo 30 utawa 60 mg opium (1 supositoria) sepisan utawa kaping pindho saben dina.
Batesan Resep
Pasien Anak
Tingtur Belladonna: Maksimum 3,5 mL (1,05 mg alkaloid saka godhong belladonna) saben dina.
Wong diwasa
Supositoria sing ngandhut ekstrak belladonna ing kombinasi tetep karo 30 utawa 60 mg opium: Maksimum 64,8 mg ekstrak belladonna (0,812 mg alkaloid saka godhong belladonna; padha karo 4 supositoria) saben dina.
Populasi Khusus
Gagal Hepatik
Ora ana rekomendasi dosis hepatik khusus kanggo belladonna.
Yen digunakake ing kombinasi tetep karo fenobarbital, gunakake dosis awal sing cilik.
Aja nggunakake supositoria belladonna lan opium ing penyakit ati sing abot.
Gagal Ginjal
Ora ana rekomendasi dosis ginjel khusus kanggo belladonna.
Aja nggunakake supositoria belladonna lan opium ing penyakit ginjel sing abot.
Pasien Geriatri
Sesuaikan dosis adhedhasar toleransi lan respon pasien.
Pènget
Kontraindikasi
Pènget / PancegahanPènget
Efek Thermoregulatory
Paparan suhu lingkungan sing dhuwur bisa nyebabake sujud panas amarga kringet suda. Tambah risiko hipertermia ing pasien sing demam.
DiareMungkin minangka tandha awal obstruksi usus sing ora lengkap, utamane ing pasien ileostomi utawa kolostomi; ing kasus iki, panggunaan bakal ora cocog lan bisa uga mbebayani.
Ngantuk lan Pandangan KaburBisa njalari rasa ngantuk, pusing, utawa paningal kabur. Kinerja aktivitas sing mbutuhake kewaspadaan mental lan koordinasi fisik bisa uga ora bisa ditindakake.
Toksisitas Utama
OverdosisAksi kaya curare bisa kedadeyan (contone, blokade neuromuskular sing nyebabake kelemahan otot lan bisa kelumpuhan).
Pancegahan Umum
Panganggone Kombinasi TetepNalika belladonna digunakake ing kombinasi tetep karo fenobarbital utawa opium, nimbang ati-ati, pancegahan, lan kontraindikasi sing ana gandhengane karo agen sing bebarengan.
Penyakit sing bebarenganGunakake kanthi ati-ati ing pasien hipertiroidisme, neuropati otonom, penyakit hepatik utawa ginjel, CHD, CHF, aritmia jantung, utawa hipertensi.
Efek GIAti-ati banget ing infeksi GI sing dikenal utawa sing dicurigai amarga motilitas GI mudhun lan retensi organisme penyebab lan/utawa racun.
Ati-ati banget ing kolitis ulcerative entheng nganti moderat amarga ditindhes. motilitas usus lan asile ileus paralitik lan megacolon beracun.
Ati-ati ing ulkus lambung amarga telat ngosongake lambung lan kemungkinan stasis antral.
Ati-ati ing refluks esofagus lan hernia hiatal amarga motilitas lambung mudhun lan tekanan sphincter esofagus ngisor sing ndadékaké retensi lambung lan aggravation refluks. Sawetara manufaktur nyatakake yen belladonna dikontraindikasi ing pasien kasebut.
Gangguan GUAti-ati banget ing pasien karo uropati obstruktif parsial amarga nada lan amplitudo kontraksi ureter lan kandung kemih mudhun lan asil retensi urin. (Deleng Kontraindikasi ing Caution.)
Efek PernafasanAti-ati karo antimuskarinik sing diwenehake sacara sistemik ing pasien sing lemah karo penyakit paru kronis amarga nyuda sekresi bronkial bisa nyebabake inspissasi lan pembentukan sumbat bronkial.
Sindrom Down , Paralisis Spastik, lan Karusakan OtakSensitivitas tambah kanggo efek antimuskarinik (contone, mydriasis, efek kronotropik positif). (Deleng Panganggone Pediatrik ing Caution.)
Populasi Spesifik
KandhutanKategori C.
LaktasiOra dingerteni manawa belladonna disebarake menyang susu. Ati-ati yen digunakake ing wanita nursing.
Panggunaan PediatrikKeamanan belladonna ditetepake ing pasien pediatrik.
Keamanan lan khasiat ekstrak belladonna ora ditetepake ing bocah-bocah. Produsen nyatakake yen suppositories belladonna lan opium ora dianjurake kanggo bocah-bocah ≤12 taun.
Bocah-bocah sing lumpuh spastik utawa karusakan otak bisa uga nambah sensitivitas kanggo efek antimuskarinik (contone, mydriasis, efek chronotropic positif).
Bayi lan bocah cilik bisa uga kena pengaruh beracun saka antikolinergik.
Panggunaan GeriatrikGunakake kanthi ati-ati.
Pasien geriatrik utamané rentan kanggo efek antimuskarinik (cons, constipation, tutuk garing, retensi urin). Kebingungan mental lan / utawa kasenengan utamane ing pasien geriatrik. Kasenengan, agitasi, utawa ngantuk bisa uga sanajan dosis cilik.
Gangguan HepatikGunakake kanthi ati-ati ing penyakit ati.
Gagal GinjalGunakake kanthi ati-ati ing penyakit ginjel.
Efek Samsaya Awon
Ngantuk, xerostomia, tachycardia, palpitasi, pusing, gemeter, ragu-ragu lan retensi urin, nyuda kringet, konstipasi, ketegangan okular, fotofobia, penglihatan kabur, mydriasis.
Apa obatan liyane bakal mengaruhi Belladonna
Obat-obatan kanthi Efek Antikolinergik
Efek aditif akibat saka blokade kolinergik (contone, xerostomia, penglihatan kabur, konstipasi). Saran babagan kemungkinan nambah efek antikolinergik lan ngawasi kanthi ati-ati.
Efek ing Penyerapan GI Obat
Kanthi nyandhet motilitas saluran GI lan ndawakake wektu transit GI, antimuskarinik duweni potensi kanggo ngowahi panyerepan GI saka macem-macem obat.
Obat Spesifik
Obat
Interaksi
Komentar
Amantadine
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Antacid
Bisa ngganggu penyerapan belladonna
Administrasi belladonna paling sethithik 1 jam sadurunge antacid
Agen antiaritmia (antikolinergik)
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Antidepresan, trisiklik
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Antihistamin (antikolinergik) (kalebu Meclizine)
Aditif efek antikolinergik
Kabari pasien babagan kemungkinan iki
Agen antiparkinsonian (antimuskarinik)
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Kortikosteroid
Kamungkinan peningkatan TIO
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Digoxin (larut alon)
Konsentrasi digoxin serum bisa tambah
Gunakake solusi oral digoxin (elixir) utawa tablet sing larut kanthi cepet (contone, Lanoxin)
Amati kanthi teliti kanggo tandha-tandha keracunan digitalis
Glutethimide
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Ketoconazole
Peningkatan pH lambung nyuda penyerapan ketokonazol
Administrasi belladonna paling ora 2 jam sawise ketokonazol
Bisa tambah metabolisme GI levodopa lan nyuda konsentrasi sistemik
Setel dosis levodopa yen belladonna diwiwiti utawa dihentikan
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Pelumpuh otot (antikolinergik)
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Fenotiazin
Efek antikolinergik aditif
Kabari pasien babagan kemungkinan iki
Kalium klorida
Transit GI sing kalem potentiate efek GI sing ora becik saka kalium klorida oral ( utamané tablet wax-matrix)
Ati-ati yen digunakake bebarengan; monitor kemungkinan lesi mukosa GI
Disclaimer
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