Галоперидол-рихтер Таблетки, коробка, 50 шт, 1,5 мг, для приема внутрь

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Доза зависит от клинической реакции больного. Чаще всего это означает постепенное повышение дозы в острой фазе заболевания, в случае поддерживающих доз - постепенное снижение дозы, чтобы обеспечить наименьшую эффективную дозу. Высокие дозы применяют лишь в случаях неэффективности меньших доз. Ниже предлагаются средние дозы. Начальная суточная доза для взрослых составляет 1.5-5 мг, разделенная на 2-3 приема. При необходимости дозу постепенно увеличивают на 1.5-3 мг (в резистентных случаях до 5 мг) до достижения необходимого терапевтического эффекта. Максимальная суточная доза - 100 мг. В среднем терапевтическая доза составляет 10-15 мг/сутки, при хронических формах шизофрении - 20-40 мг/сутки, в случае необходимости дозу можно увеличить до 50-60 мг/сутки. Максимальная доза – 100 мг/сутки. В среднем продолжительность курса лечения - 2-3 мес. Поддерживающие дозы (вне обострения) - от 0.5-0.75 мг до 5 мг/сутки (дозу снижают постепенно). При острых психозах - разовая доза 1.5-5 мг (до 10 мг) в таблетках, как правило, через каждые 4-8 часа. Суточная доза при пероральном применении препарата - не более 100 мг. Поддерживающая терапия: внтурь - от 0.5 мг до 20 мг/сутки. Применяется минимальная доза, способная поддержать ремиссию. При непсихотических нарушениях поведения, синдроме Жиля де ля Туретта - внутрь, вначале 0.05 мг/кг/сутки в 2-3 приема, затем дозу постепенно увеличивают 1 раз каждые 5-7 дней до общей дозы 0.075 мг/кг/сутки. При детском аутизме - внутрь 0.025-0.05 мг/кг/сутки. При тиках, хорее Гентингтона - внутрь 0.025-0.05 мг/кг/сутки. При отсутствии эффекта в течение 1 месяца лечение продолжать не рекомендуется. При длительно сохраняющейся и устойчивой к терапии рвоте - по 1.5-2 мг 2 раза/сутки. Пожилым или ослабленным пациентам назначают 1/3-1/2 обычной дозы для взрослых, дозу увеличивают не чаще, чем каждые 2-3 дня. Детям с массой тела 60 кг и более при психотических расстройствах - внутрь 0.05 мг/кг/сутки в 2-3 приема, при необходимости с учетом переносимости дозу постепенно увеличивают 1 раз каждые 5-7 дней до общей дозы 0.15 мг/кг/сутки."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны нервной системы: головная боль, головокружение, бессонница или сонливость (различной степени выраженности), тревога, акатизия, эйфория, депрессия, судорожные расстройства, экстрапирамидные расстройства, при длительном лечении - поздняя дискинезия (причмокивание и сморщивание губ, надувание щек, быстрые и червеобразные движения языка, неконтролируемые жевательные движения, неконтролируемые движения рук и ног), поздняя дистония (учащенное моргание или спазмы век, необычное выражение лица или положение тела, неконтролируемые изгибающиеся движения шеи, туловища, рук и ног) и злокачественный нейролептический синдром (гипертермия, мышечная ригидность, затрудненное или учащенное дыхание, тахикардия, аритмия, повышение или снижение АД, повышенное потоотделение, недержание мочи, судорожные расстройства, угнетение сознания). Со стороны сердечно-сосудистой системы: при применении в высоких дозах - снижение АД, ортостатическая гипотензия, аритмии (желудочковые аритмии типа \"пируэт\"), изменения на ЭКГ (удлинение интервала QT, признаки трепетания и мерцания желудочков), случаи внезапной смерти. Со стороны пищеварительной системы: при применении в высоких дозах - снижение аппетита, сухость во рту, гипосаливация, тошнота, рвота, диарея или запоры, нарушение функции печени, вплоть до развития желтухи. Со стороны системы кроветворения: транзиторная лейкопения или лейкоцитоз, агранулоцитоз, эритропения и тенденция к моноцитозу. Со стороны мочевыделительной системы: задержка мочи (например, при гиперплазии предстательной железы), периферические отеки. Со стороны половой системы и молочной железы: боли в грудных железах, гинекомастия, гиперпролактинемия, нарушение менструального цикла, снижение потенции, повышение либидо, приапизм. Со стороны органа зрения: катаракта, ретинопатия, нечеткость зрения. Со стороны обмена веществ: гипонатриемия, гипер- или гипогликемия. Дерматологические реакции: макуло-папулезные и акнеобразные изменения кожи, фотосенсибилизация. Аллергические реакции: бронхоспазм, ларингоспазм. Прочие: алопеция, увеличение массы тела, тепловой удар."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При передозировке препарата возможно появление острых нейролептических реакций. Симптомы: ригидность мышц, тремор, сонливость, снижение, иногда повышение АД, в тяжелых случаях - коматозное состояние, угнетение дыхания, шок, удлинение интервала QT на ЭКГ, аритмия. Особо должно настораживать повышение температуры тела, которое может быть одним из симптомов злокачественного нейролептического синдрома. В тяжелых случаях передозировки могут наблюдаться различные формы нарушения сознания, вплоть до комы, судорожные реакции. Лечение: при приеме внутрь - промывание желудка, активированный уголь. При угнетении дыхания может потребоваться ИВЛ. При снижении АД и коллапсе - для поддержания кровообращения в/в вводят плазму или концентрированный альбумин, допамин или норэпинефрин. Эпинефрин в этих случаях применять категорически запрещается, т.к. его введение может спровоцировать выраженную гипотензию. Для купирования экстрапирамидных симптомов - центральные м-холиноблокаторы и противопаркинсонические лекарственные средства. В/в вводят диазепам, раствор декстрозы, ноотропы, витамины группы В и С. Диализ неэффективен. Специфического антидота нет."}}]},{"id":10,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Парентеральное введение должно проводиться под строгим контролем врача, особенно у пациентов пожилого и детского возраста. По достижении терапевтического эффекта следует перейти на пероральную форму лечения. Назначение антипсихотических препаратов (в т.ч. галоперидола) для лечения психотических расстройств, связанных с деменцией у пожилых пациентов, вызывает риск смерти. В течение 10-недельного плацебо-контролируемого клинического исследования смертность в группе пациентов, получавших антипсихотические препараты, составила около 4.5%, по сравнению с частотой около 2.6% в группе плацебо. Большинство смертельных случаев имели сердечно-сосудистые (например, сердечная недостаточность, внезапная смерть) и/или инфекционные (например, пневмонии) причины. Наблюдательные клинические исследования показали, что терапия традиционными нейролептиками может увеличить смертность. Во время лечения следует регулярно осуществлять мониторинг ЭКГ, формулы крови, печеночных проб. Поскольку галоперидол может вызывать удлинение интервала QT, следует соблюдать осторожность при наличии риска пролонгирования интервала QT (синдром удлиненного интервала QT, гипокалиемия, применение препаратов, вызывающих удлинение интервала QT), особенно при парентеральном введении. В связи с тем, что галоперидол метаболизируется в печени, важно проявлять осторожность при назначении препарата пациентам с нарушением функции печени. Известны случаи развития судорог, вызванных галоперидолом. Больным эпилепсией и больным, в состояниях, предрасполагающих к развитию судорожного синдрома (алкоголизм, травма головного мозга в анамнезе), препарат следует назначать с особой осторожностью. Для купирования экстрапирамидных расстройств назначают противопаркинсонические средства (циклодол), ноотропы, витамины, их применение продолжают и после отмены галоперидола, если они выводятся из организма быстрее, чем галоперидол, во избежание усиления экстрапирамидных симптомов. При развитии поздней дискинезии не следует резко отменять препарат, рекомендуется постепенное снижение дозы. Лечение прекращают постепенно во избежание возникновения синдрома отмены. Необходимо соблюдать осторожность при выполнении тяжелой физической работы, приеме горячей ванны (возможно развитие теплового удара вследствие подавления центральной и периферической терморегуляции в гипоталамусе). Во время лечения не следует принимать \"противопростудные\" безрецептурные препараты (возможно усиление м-холиноблокирующих эффектов и риска возникновения теплового удара). Следует защищать открытые участки кожи от избыточного солнечного излучения вследствие повышенного риска фотосенсибилизации. Противорвотное действие может маскировать признаки лекарственной токсичности и затруднять диагностику состояний, первым симптомом которых является тошнота. Во время лечения препаратом употребление алкоголя не рекомендуется. Влияние на способность к вождению автотранспорта и управлению механизмами: во время применения препарата запрещается управлять транспортными средствами и заниматься другими видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Антипсихотическое средство (нейролептик), производное бутирофенона. Обладает выраженным антипсихотическим действием, блокирует постсинаптические допаминовые рецепторы в мезолимбических и мезокортикальных структурах головного мозга. Высокая антипсихотическая активность сочетается с умеренным седативным эффектом (в небольших дозах оказывает активирующее действие) и выраженным противорвотным действием. Не обладает антигистаминергической или антихолинергической активностью. Седативное действие обусловлено блокадой α-адренорецепторов ретикулярной формации ствола головного мозга, противорвотное действие - блокадой допаминовых D2-рецепторов триггерной зоны рвотного центра, гипотермическое действие и галакторея - блокадой допаминовых рецепторов гипоталамуса. В результате воздействия на базальные ганглии вызывает экстрапирамидные расстройства (дистонию, акатизию, паркинсонизм). Длительное применение сопровождается изменением эндокринного статуса, в передней доле гипофиза увеличивается продукция пролактина и снижается выработка гонадотропных гормонов. Галоперидол высокоэффективен при лечении галлюцинаций и бреда. 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