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შემადგენლობა
კეტოროლის ერთი ტაბლეტი შეიცავს აქტიური ნივთიერების - კეტოროლაკის 10 მგ-ს.
**მოქმედების მექანიზმი**
არანარკოტიკული ანალგეტიკი, გამოხატული ტკივილგამაყუჩებელი, ანთების საწინააღმდეგო და ანტიაგრეგაციული თვისებებით. კეტოროლის მოქმედება დამყარებულია ფერმენტ ციკლოოქსიგენაზას ინჰიბირებასა და პროსტაგლანდინების სინთეზის დათრგუნვაზე. სისტემური ტკივილგამაყუჩებელი მოქმედება მნიშვნელოვნად აღემატება ანთების საწინააღმდეგო ეფექტს. არ ახასიათებს სედაცია, არ მოქმედებს ოპიოიდურ რეცეპტორებზე, არ იწვევს სუნთქვის ცენტრის დათრგუნვას და არ ახდენს გავლენას ფსიქომოტორულ ფუნქციებზე. კეტოროლი შიგნით მიღებისას სწრაფად და მთლიანად აბსორბირდება კუჭ-ნაწლავის ტრაქტიდან, 10 მგ პრეპარატის მიღებისას Cmax მიიღწევა საშუალოდ 44 წთ-ში; კეტოროლის 99 %-ზე მეტი უკავშირდება პლაზმის ცილებს. პრეპარატის ელიმინაცია ხდება ბიოტრანსფორმაციის გზით და ძირითადად თირკმლების საშუალებით.
ჩვენებები
საშუალო და ძლიერი ინტენსივობის ტკივილის სინდრომი: პოსტოპერაციულ პერიოდში, ძვლებისა და კუნთების ტკივილი (დაჭიმვა, ღრძობა, მოტეხილობა, რბილი ქსოვილების ტრავმა, მიალგია, იშიალგია, ოსტეოართროზის გამწვავება); კბილის ტკივილი, ონკოლოგიური დაავადებების თანმხლები ტკივილი.
მიღების წესები და დოზები
დოზირება ხდება ინდივიდუალურად ტკივილის სინდრომის სიძლიერის მიხედვით. ერთჯერადი დოზა შეადგენს 10 მგ-ს, მაქსიმალური დღიური დოზა - 90 მგ. ჩვეულებისამებრ: 10 მგ ყოველ 4-6 სთ-ში ერთხელ. ძლიერი ტკივილის დროს: 20-30 მგ 3-4-ჯერ დღეში, მაქსიმალური დღიური დოზა - 120 მგ. 50 კგ-ზე ნაკლები წონისა და 65 წელს გადაცილებულ ავადმყოფებში ან თირკმლის დისფუნქციის მქონე პირებში რეკომენდებული მაქსიმალური დოზაა 60 მგ/დღეში. პრეპარატის ტაბლეტირებული ფორმის მიღების მაქსიმალური ხანგრძლივობაა 7 დღე.
გვერდითი მოვლენები
დისპეფსიური მოვლენები, გასტრიტი, კნტ-ის ეროზიულ-წყლულოვანი დაზიანებანი; ძილიანობა, თავბრუსხვევა; თირკმლის მწვავე უკმარისობა, ნეფროზული სინდრომი, ინტერსტიციული ნეფრიტი, შრატში კრეატინინისა და შარდოვანას მატება; სისხლდენის ხანგრძლივობის გაზრდა; კანზე გამონაყარი.
უკუჩვენება
კეტოროლის დანიშვნის უკუჩვენებებია - პრეპარატისადმი მაღალი მგრძნობელობა, 16 წლამდე ბავშვთა ასაკი, კუჭისა და თორმეტგოჯა ნაწლავის წყლულოვანი დაავადება (გამწვავების ფაზაში), ღვიძლისა და თირკმლების ფუნქციის გამოხატული დარღვევები, ანამნეზში სისხლის შედედების დარღვევის არსებობა, `ასპირინული~ ასთმა, ორსულობა, ლაქტაცია (მკურნალობის პერიოდში საჭიროა ძუძუთი კვების შეწყვეტა).
განსაკუთრებული მითითებები
პრეპარატი სიფრთხილით ინიშნება ავადმყოფებში, რომელთაც ანამნეზში აღენიშნებათ კუჭ-ნაწლავის ტრაქტიდან სისხლდენები და ეროზიულ-წყლულოვანი დაავადებანი, ღვიძლის, თირკმლებისა და ძვლის ტვინის ფუნქციათა დარღვევები, გულის ქრონიკული უკმარისობა, ბრონქული ასთმა, ბრონქოობსტრუქციული სინდრომი, ანგიონევროზული შეშუპება. პაციენტებში სისხლის შემდედებელი ფუნქციის დარღვევით კეტოროლი ინიშნება თრომბოციტების რაოდენობის მუდმივი კონტროლის ქვეშ. პრეპარატი არ ინიშნება პრემედიკაციის მიზნითა და სამეანო პრაქტიკაში ტკივილგამაყუჩებლის სახით. კეტოროლი შეუთავსებელია ლითიუმის პრეპარატებთან, პენტოქსიფილინთან, პრობენეციდთან, ანტიკოაგულანტებსა და სხვა ანთების საწინააღმდეგო არასტეროიდულ საშუალებებთან კომბინაციაში. ნორმოვოლემიის მქონე პაციენტებში იწვევს ფუროსემიდის დიურეზული ეფექტის შემცირებას. ამფ-ის ინჰიბიტორებთან კომბინაციაში იზრდება თირკმლების ფუნქციის დარღვევის შესაძლებლობა. დოზის გადაჭარბებისას: ერთჯერადი დოზის მიღების შემდეგ განვითარებული სიმპტომატოლოგია - მუცლის ტკივილი, გულისრევა, ღებინება, ჰიპერვენტილაცია, პეპტიკური წყლულებისა და/ან ეროზიული გასტრიტის წარმოშობა, თირკმლების ფუნქციის დარღვევა.
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