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ტროპიკამიდი / TROPICAMID | მედიკამენტები | vidal.ge
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იხილეთ აფთიაქების ჩამონათვალი

ტროპიკამიდი / TROPICAMID
შემადგენლობა

1 მლ 
ტროპიკამიდი . . . . . . . . . 5 მგ

1 მლ 
ტროპიკამიდი . . . . . . . . . 10 მგ
დამხმარე ნივთიერებები: 
ნატრიუმის ქლორიდი, ტილენთიამინ-ტეტრაძმარმჟავას ორნატრიუმიანი მარილი, ქლორიანი ბენზალკონიუმი, მარილმჟავა, საინექციო წყალი.

ფარმაკოლოგიური თვისებები
ტროპიკამიდი აბლოკირებს ფერადი გარსისა და ცილიარული სხეულის მ-ქოლინორეცეპტორებს, იგი იწვევს მიდრიაზის განვითარებასა და აკომოდაციის დამბლას. ატროპინთან შედარებით პრეპარატის მიდრიაზული მოქმედება, ასევე მის მიერ გამოწვეული აკომოდაციის დამბლა არსებითად ხანმოკლეა. ტროპიკამიდი ნაკლებად ზემოქმედებს თვალშიდა წნევაზე, მაგრამ მოსალოდნელია ამ უკანასკნელის მომატება პრეპარატის გამოყენების შემდეგ, რაც უნდა იქნას გათვალისწინებული დახურულკუთხოვანი გლაუკომით შეპყრობილ პაციენტებში. 
პრეპარატის მიღებიდან 5-10 წთ-ის შემდეგ ვითარდება მიდრიაზი, რომელიც მაქსიმუმს აღწევს 15-20 წთ-ის შემდეგ. გუგების გაფართოება შენარჩუნებულია 1 სთ-ის განმავლობაში 0.5% ხსნარის გამოყენებისას, ხოლო 2სთ-ის განმავლობაში _ 1% ხსნარის გამოყენებისას.
აკომოდაციის დამბლის გამოსაწვევად აუცილებელია ხშირი ინსტილაცია. 1% ხსნარის 2-ჯერ ინსტილაციის შემდეგ აკომოდაციის დამბლის მაქსიმუმი საშუალოდ ვითარდება 25 წთ-ის შემდეგ და ნარჩუნდება 30 წთ-ის განმავლობაში. აკომოდაციის დამბლის სრული კუპირება იწყება 3 სთ-ის შემდეგ.
სისტემურ სისხლის მიმოქცევაში აქტიური ნივთიერების შეწოვის შედეგად შესაძლებელია სისტემური ხასიათის გვერდითი მოვლენების განვითარება (მოუსვენრობა, აგზნებადობა, პირის სიმშრალე, დიზურია, ჰიპერთერმია). სისტემური გვერდითი მოვლენები აღენიშნებათ ახალშობილებსა და ჩვილ ბავშვებს, აგრეთვე ხანდაზმულებს.

ჩვენებები
- პრეპარატი გამოიყენება დიაგნოსტიკური მიზნით ოფთალმოსკოპიური და რეფრაქციული გამოკვლევებისას;
- ქირურგიული ჩარევის წინ გუგების გაფართოებისათვის (კატარაქტას ექსტრაქცია, ბადურასა და მინისებრ სხეულზე ოპერაცია) და ლაზერული ოპერაციების (ბადურას ლაზეროკოაგულაცია) დროს;
- პრეპარატი გამოიყენება თვალის ანთებითი დაავადების დროს, როგორც კომპლექსური თერაპიის კომპონენტი და ოპერაციის შემდგომ პერიოდში სინექიების განვითარების პროფილაქტიკისათვის.

მიღების წესები და დოზები
დიაგნოსტიკის მიზნით გუგის გაფართოებისათვის 1% ხსნარის 1 წვეთს ან 0.5% ხსნარის 2 წვეთს აწვეთებენ 5 წთ-იანი ინტერვალით. 10 წთ-ის შემდეგ შესაძლებელია ოფთალმოსკოპიის ჩატარება. არასაკმარისი ეფექტის დროს (სინათლის დიდი ინტენსივობის შემთხვევაში უკანა სინექიების გახლეჩვის მიზნით) რეკომენდებულია პრეპარატის კომბინაცია ფენილეფრინთან.
რეფრაქციის განსაზღვრისათვის პრეპარატს იწვეთებენ 6-ჯერ 6-12 წთ-იანი ინტერვალით. დაახლოებით 25-50 წთ-ის განმავლობაში აღინიშნება აკომოდაციის დამბლა და გამოკვლევის ჩატარება დასაშვებია.
მკურნალობის მიზნით პრეპარატის ჩაწვეთება რეკომენდებულია ექიმის კონსულტაციით.
პრეპარატის სისტემურ სისხლის მიმოქცევაში აბსორბციის შესამცირებლად მისი ჩაწვეთებისთანავე საჭიროა მსუბუქად დავაფიქსიროთ თითი საცრემლე პარკზე რამდენიმე წთ-ის განმავლობაში.
ჩვილ და 6 წლამდე ასაკის ბავშვებში აუცილებელია გამოვიყენოთ 0.5%-იანი ხსნარი.
დღენაკლულ ბავშვებში ცალკეულ შემთხვევებში აღინიშნებოდა ტროპიკამიდის სისტემური ანტიქოლინერგული ზემოქმედება (შარდის გამოყოფის და დეფეკაციის დარღვევა, ტაქიკარდია), რომელიც ძლიერდებოდა პრეპარატის განმეორებითი გამოყენების შემთხვევაში. ზემოთ აღნიშნული გვერდითი მოვლენების აღმოფხვრა შესაძლებელია ნატრიუმის ქლორიდის იზოტონურ ხსნარში (1:1) განზავებით.

გვერდითი მოვლენები
ადგილობრივი რეაქციები: აკომოდაციის დარღვევა, მხედველობის სიმახვილის დაქვეითება, ოფთალმოტონუსის მომატება, დახურულკუთხოვანი გლაუკომის მწვავე შეტევა, ალერგიული რეაქციები.
სისტემური გვერდითი მოვლენები: მოუსვენრობა, აგზნება, პირის სიმშრალე, დიზურია, ჰიპერთერმია, ტაქიკარდია.

უკუჩვენება
- გლაუკომა, განსაკუთრებით დახურულკუთხოვანი, აგრეთვე შერეული პირველადი გლაუკომა; - პრეპარატის შემადგენლობაში შემავალი კომპონენტების მიმართ მომატებული მგრძნობელობა.

ორსულობა და ლაქტაცია
ტროპიკამიდის თვალის წვეთები ორსულობის პერიოდში გამოიყენება მხოლოდ იმ შემთხვევაში, როდესაც დედისათვის სასარგებლო შედეგი მკვეთრად სჭარბობს ნაყოფზე ზემოქმედების პოტენციურ რისკს.

განსაკუთრებული მითითებები
პრეპარატის გამოყენების შედეგად გამოწვეულმა აკომოდაციის ცვლილებამ და გუგების გაფართოებამ შეიძლება გამოიწვიოს მხედველობის სიმახვილის დაქვეითება, ამიტომ მძღოლებს საღამოს და ღამის საათებში ეკრძალებათ სატრანსპორტო საშუალებების მართვა. პრეპარატის გამოყენების წინ პაციენტმა აუცილებლად უნდა მოიხსნას კონტაქტური ლინზები, რომლის გამოყენება დასაშვებია პრეპარატის გამოყენებიდან 30 წთ-ის შემდეგ.

ჭარბი დოზირება
ტროპიკამიდის ადგილობრივი გამოყენების დროს ჭარბი დოზირების შესახებ მონაცემები არ არსებობს.
ტროპიკამიდის ჭარბი დოზირების ან მოწამვლის (პრეპარატის პერორალურად მიღების დროს) შემთხვევაში ტიპიურ სიმპტომებს წარმოადგენს: კანისა და ლორწოვანი გარსის სიმშრალე, ტაქიკარდია, გუგების გაფართოება, აგზნება, კრუნჩხვები, ხოლო მაღალი დოზით მიღების შემთხვევაში – კომა და სუნთქვის დათრგუნვა.
ჭარბი დოზირების სიმპტომების გამოვლენისას აუცილებელია კუჭის დაუყოვნებლივ ამორეცხვა და გააქტივებული ნახშირის მიღება. გარდა ამისა, რეკომენდებულია ვენაში 1-2 მგ ფიზოსტიგმინის ინექცია. ამ საშუალების გამოყენების გამეორება რეკომენდებულია ერთი საათის შემდეგ. კრუნჩხვების დროს აუცილებელია 10-20 მგ დიაზეპამის ვენაში ინექცია. ჰიპერთერმიის გამოვლენისას საჭიროა გამაგრილებელი ფიზიკური ღონისძიებების ჩატარება

სხვა წამლებთან ურთიერთქმედება
პრეპარატისა და ნაწილობრივ ქოლინომაბლოკირებელი მოქმედების მქონე ანტიჰისტამინური, ტრიციკლური და ტეტრაციკლური ანტიდეპრესიული საშუალებების, აგრეთვე პროკაინამიდის, ქინიდინისა და მაო-ს ინჰიბიტორების ერთდროული გამოყენებისას აღინიშნება მათი ანტიქოლინერგული მოქმედების გაძლიერება.
ტროპიკამიდის მოქმედებით გამოწვეული აკომოდაციის დამბლა ძლიერდება სიმპატომიმეტურ პრეპარატებთან მისი კომბინაციისას, ხოლო მცირდება პარასიმპატომიმეტურ საშუალებებთან ერთდროული გამოყენებისას.
პაციენტებში თვალის წინა კამერის ვიწრო კუთხით, ტროპიკამიდთან ერთად ნიტრატების, ნიტრიტების, დიზოპირამიდისა და ჰალოპერიდოლის ერთდროული გამოყენებისას შეიძლება აღინიშნოს თვალშიდა წნევის მომატება.

შენახვის პირობები და ვადები
პრეპარატი ინახება 15-25oC ტემპერატურაზე, სინათლისა და ბავშვებისაგან დაცულ ადგილას. 
ვარგისიანობის ვადა - 3 წელი. 
ფლაკონის გახსნის შემდეგ პრეპარატი გამოყენება შეიძლება 4 კვირის განმავლობაში.

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