Симптоматическое лечение хронических нарушений функций головного мозга при синдромах деменции со следующими ведущими симптомами: нарушение памяти, концентрационной способности и мышления, быстрая утомляемость, недостаточность побуждений и мотиваций, аффективные расстройства. Первичная дегенеративная деменция, сосудистая деменция и смешанные формы. Симптоматическая ...
Абсолютные: повышенная чувствительность к пиритинолу. Относительные: заболевания почек в анамнезе, выраженные нарушения функции печени, выраженныеизменения картины периферической крови, острые аутоиммунные заболевания, например системная красная волчанка, миастения, пемфигус.
Ноотропный препарат. Повышает патологически сниженный метаболизм в тканях головного мозга, что обусловлено повышением захвата и утилизации глюкозы, повышает метаболизм нуклеиновых кислот и высвобождение ацетилхолина в синапсах нервных клеток, улучшает холинергическую передачу в нервной ткани. Пиритинол способствует стабилизации структуры клеточных мембран нейронов и их функции за счет ингибирования лизосомальных ферментов, предотвращая этим образование свободных радикалов. Энцефабол улучшает реологические свойства крови, повышает пластичность эритроцитов путем увеличения содержания АТФ в их мембране, что приводит к снижению вязкости крови и улучшению кровотока. Улучшает кровообращение в ишемизированных участках мозга, увеличивает их оксигенацию, интенсифицирует обмен глюкозы в первично ишемизированных участках мозга. В результате улучшаются показатели памяти и восстанавливаются нарушенные обменные процессы в нервной ткани, что способствует полноценному функционированию ее клеток.
Показания к применению
Симптоматическое лечение хронических нарушений функций головного мозга при синдромах деменции со следующими ведущими симптомами: нарушение памяти, концентрационной способности и мышления, быстрая утомляемость, недостаточность побуждений и мотиваций, аффективные расстройства. Первичная дегенеративная деменция, сосудистая деменция и смешанные формы. Симптоматическая терапия хронических нарушений умственной работоспособности. Посттравматическая энцефалопатия. Церебральный атеросклероз. Последствия энцефалита. Задержка психического развития, церебрастенический синдром, энцефалопатия у детей.
Противопоказания
Абсолютные: повышенная чувствительность к пиритинолу. Относительные: заболевания почек в анамнезе, выраженные нарушения функции печени, выраженныеизменения картины периферической крови, острые аутоиммунные заболевания, например системная красная волчанка, миастения, пемфигус.
Применение при беременности и в период грудного вскармливания
При необходимости применения Энцефабола при беременности или в период лактации (грудного вскармливания) следует соотнести предполагаемую пользу для матери и потенциальный риск для плода или младенца. Пиритинол проникает через плацентарный барьер, в незначительных количествах выделяется с грудным молоком. В экспериментальных исследованиях не установлено наличия тератогенного или эмбриотоксического действия пиритинола.
Способ применения и дозы
Режим дозирования устанавливают индивидуально, в зависимости от тяжести состояния и эффективности терапии. Принимать препарат следует во время или после еды. При нарушениях сна последнюю дневную дозу не следует принимать вечером или на ночь. Длительность лечения зависит от клинической картины заболевания. Для взрослых средняя доза составляет 600 мг/сут (по 2 таб. 3 раза/сут). Новорожденным Энцефабол назначают с 3 дня после рождения по 20 мг в сутки в течение месяца, препарат следует давать утром. Детям в возрасте от 2 месяцев дозу увеличивают на 20 мг каждую неделю до тех пор, пока суточная доза не достигнет 100 мг. Детям в возрасте от 1 года до 7 лет назначают в суточной дозе от 50 мг до 300 мг в зависимости от показаний. Для детей старше 7 лет суточная доза составляет от 50 мг до 600 мг (1-2 таб. 1-3 раза/сут). При острых состояниях и назначении препарата в высоких дозах заметный терапевтический эффект достигается уже через несколько часов или суток. При хронических заболеваниях (в т.ч. последствия черепно-мозговой травмы или при деменции) заметный терапевтический успех достигается после 2-4 недель лечения. Оптимальный и устойчивый эффект наступает обычно через 6-12 недель. Длительность лечения при хронических заболеваниях должна составлять не менее 8 недель. У новорожденных с высоким риском развития перинатальной патологии средняя продолжительность лечения составляет 6 месяцев, при этом через 3 месяца следует проверить наличие показаний для дальнейшего лечения.
Побочное действие
При приеме Энцефабола в соответствии с показаниями и в рекомендуемых дозах побочных явленийожидать не следует. Иногда - реакции повышенной чувствительности различной степени тяжести высыпания на коже илислизистых, зуд, тошнота, рвота, диарея, повышение температуры тела, нарушение сна. Редко - повышенная возбудимость, потеря аппетита, головная боль, головокружение, утомляемость, изменение вкуса, нарушение функций печени (повышение уровня трансаминаз, холестаз).
Передозировка
Симптомы: усиление побочных эффектов. Лечение: промывание желудка, назначение активированного угля. При необходимости проводят симптоматическую терапию.
Особые указания
У пациентов с ревматоидным артритом и другими хроническими заболеваниями суставов имеет место повышенная чувствительность к соединениям, в состав которых входит SH-группа, в т.ч. к пиритинолу. У этих пациентов повышен риск возникновения реакций повышенной чувствительности, иммунопатологических реакций, а также нарушений вкусовой чувствительности и функции печени. При проведении лечения этой категории пациентов необходим систематический контроль общих анализов крови, мочи, функционального состояния печени, иммунологических показателей. Не следует назначать суспензию Энцефабола пациентам с непереносимостью фруктозы, т.к. в состав препарата входит сорбол. Реакции повышенной чувствительности к препарату могут возникнуть у пациентов с гиперчувствительностью к D-пеницилламину, поскольку последний имеет сходство с пиритинолом по химическому строению (тиоловые группы). Использование в педиатрии: Не рекомендуют назначать препарат вечером и на ночь детям с повышенной возбудимостью. Влияние на способность к вождению автотранспорта и управлению механизмами: При использовании Энцефабола по показаниям, как правило, отсутствуют ограничения для тех видов деятельности, которые требуют повышенного внимания, быстрых психомоторных реакций. Однако учитывая вероятность индивидуальных различий реакции отдельных пациентов на препарат, в начале лечения и при повышении дозы следует учитывать возможность нарушения скорости психомоторных реакций.
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