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当前位置:药品说明书与价格首页 >> 神经内科 >> 多发性硬化症 >> 药品目录 >> 巴氯芬片|Lioresal(Baclofen Tablets)

巴氯芬片|Lioresal(Baclofen Tablets)

2010-06-05 01:38:39  作者:新特药房  来源:中国新特药网天津分站  浏览次数:434  文字大小:【】【】【
简介: 【药品名称】:枢芬 【通 用 名】:巴氯芬片 【枢芬规格】:10mg*10片 【枢芬单位】:盒 【枢芬价格】:23.5元 【枢芬生产企业】:宁波市天衡制药有限公司 【药品名称】商品名 ...

英文药名: Lioresal(Baclofen Tablets)

中文药名: 巴氯芬片

生产厂家: Novartis

巴氯芬片药品名称

Lioresal 巴氯芬

规格

巴氯芬片 10mg,20mg; 注射剂 2mg/ml X 5ml
药理作用

本药是一个高效的作用在脊髓部位的肌肉松弛剂,其作用机制和药理学特性均与其他肌肉松弛剂不同。巴氯芬抑制单突触和多突触反射传递,它可能是通过刺激GABAB受体,而抑制兴奋性氨基酸如谷氨酸和天门冬氨酸的释放。神经肌肉传递不受巴氯芬的影响。巴氯芬具有抗感受伤害作用,对伴有骨骼肌痉挛的神经系统疾患,本药的临床作用为缓解反射性肌肉挛缩,对痛性阵挛、自动症和阵挛有明显缓解作用。本药能改善病人的活动能力,使病人生活较易自理,更有利于主动和被动的物理治疗。
药代动力学

本药的活性物质巴氯芬在胃肠道中吸收迅速而完全,单剂量口服10 mg、20 mg和30 mg巴氯芬,0.5-1.5小时后,其血浆峰浓度分别平均约为180、340和650 ng/mL,相应血药浓度曲线下面积(AUCs)与剂量大小成比例增加,其值分别为1140、2350和3350 ng x小时/mL。巴氯芬的分布面积为0.7 L/kg,脑脊液中活性物质浓度约比血浆中的低8.5倍。巴氯芬的血浆清除半衰期平均为3-4小时,其血清蛋白结合率约为30%。大部分巴氯芬以原型排出,在72小时内,摄入量中约75%经肾脏排出,其中代谢物约占5%,摄入量的其余部分,包括占5%的代谢物从粪便排出,主要代谢产物为β-(p-氨苯)-γ-羟丁酸,无药理活性。
适应症

多发性硬化症的骨骼肌痉挛状态。感染性、退行性、外伤性、肿胀或原因不明的脊髓疾病引起的痉挛状态,例如:痉挛性脊髓麻痹、肌萎缩性侧索硬化症、脊髓空洞症、横贯型脊髓炎、外伤性截瘫或麻痹、脊髓压迫、脑源性肌阵挛,特别是小儿脑性瘫痪,以及脑血管意外、肿瘤或退行性脑病引起的肌痉挛。
用法用量

应从小剂量开始,逐渐增加剂量,根据个体病情的不同,制定适当的每日剂量,既能使阵挛、屈肌和伸肌痉挛状态减轻,又能维持足够的肌张力,使病人能自主活动,并尽可能减少副反应。本药应在进餐时用少量液体送服,将每日用量分次服用,成人至少分3次,儿童分4次。
对成人患者,原则上初始剂量用每日3次,每次5 mg。应逐渐小心增加剂量,每隔3日增加剂量,每日3次,每次增加5 mg,直至所需剂量。
对该药敏感的患者,宜再降低其初始每日用量(15 mg或10 mg),并放慢增加剂量的速度。通常合适的剂量范围为每日30-75 mg,住院病人可能需要加至每日100-120 mg。
肾功能损害或长期血液透析病人,应使用特别小的剂量,即每日约5 mg。
由于老年或脑源性痉挛状态的患者更易发生副反应,对这些病例,建议极为小心地制订治疗计划,并于严密监护下用药。
儿童的用药剂量为0.75-2 mg/kg体重/日,对10岁以上儿童,每日最大剂量可达2.5 mg/kg体重。通常治疗开始时每次2.5 mg,每日4次,大约每隔3天小心增加剂量,直至达到儿童个体需要量。推荐的每日维持治疗量如下:
12个月至2岁儿童:10-20 mg;
2-10岁儿童:30-60 mg(最大量70 mg)。
任何疑问,请遵医嘱!
不良反应

副作用主要见于治疗开始时,剂量增加过快、剂量过大或年老患者。这些副作用常为暂时性,减少剂量后可减弱或消失,其程度也较轻,一般不需停药。对有神经病史患者或伴有脑血管疾病(如中风)和年老患者,副作用可能较为严重。
中枢神经系统:治疗开始时常出现日间镇静、嗜睡和恶心等副作用,偶然出现口干、呼吸抑制、头晕、无力、虚脱、精神错乱、晕眩、恶心、呕吐、头痛和失眠。
神经病学和/或精神学的表现:偶然或罕见报导有:欣快、抑郁、感觉异常、肌痛、肌无力、共济失调、震颤、眼球震颤、调节紊乱、幻觉、恶梦,上述症状常难以与疾病本身的表现相区别。可能会降低惊厥阈,并引起惊厥发作,癫痫患者尤应注意。
胃肠道:偶有轻度的胃肠功能紊乱(便秘、腹泻)。
心血管系统:偶会发生低血压、心血管功能降低。
泌尿生殖系统:偶见或罕见排尿困难、尿频、遗尿,这些常难以与疾病本身的表现相区别。
其它副作用:罕见或个别病例有视力障碍,味觉障碍、多汗、皮疹、肝功能损害。某些病人对药物可显反常的反应而表现为痉挛状态加重。可能会出现肌张力过低,使病人更难于行走或照料自己,这种情况通常在调节剂量后可缓解(如减少日间剂量,可能的话增加夜间剂量)。
禁忌症

已知对巴氯芬过敏者禁用。
注意事项

痉挛状态合并精神障碍,精神分裂症或意识错乱状态的病人,因为病情可能恶化,应慎用,并对病人进行严密监护。对伴有癫痫的痉挛状态患者,除继续使用适量的抗惊厥药治疗外,可在适当的监护下使用本药。
对于消化性溃疡或有该病史的患者,以及患有脑血管病、呼吸、肝、肾功能衰竭者,也应慎用。因神经调节紊乱而影响膀胱排空的病人,使用本药治疗期间可有改善,因此,对已患有括约肌张力过高,而可能发生急性尿潴留的病人,应慎用本药。有报告显示,使用本药特别是长期使用者突然停药,可发生焦虑、意识错乱、幻觉、精神病、躁狂或偏执状态、惊厥(癫痫持续状态)、心动过速,并且可出现反跳现象,使痉挛状态一过性加重。除非发生严重的副作用,应通过逐渐减少剂量而终止治疗(大约需1-2周以上)。
由于有报告显示,在极个别病例中可引起血谷草转氨酶、碱性磷酸酶和血糖升高,对肝病或糖尿病患者应定期作有关实验室检查,以确证上述已有的疾病与药物的诱导无关。
本药之镇静作用可使患者的反应能力受影响,应激性降低,因此患者驾驶车辆或操纵机器时应小心。
孕妇及哺乳期妇女用药

在妊娠期间,尤其在最初三个月,只有在抢救生命时才能使用本药。应仔细权衡治疗对母亲和胎儿之间的利弊。巴氯芬可通过胎盘屏障,母亲服用治疗剂量的本药,活性物质可进入乳汁,但量甚少,对婴儿影响不大。
药物相互作用

与其它作用于中枢神经系统药物或酒精合用时,可增加镇静作用。当与三环类抗抑郁药合用时,可加强本药的作用,引起明显的肌张力过低。本药和降压药合用可使血压下降作用加强。帕金森氏病(震颤麻痹)患者,同时接受本药和左旋多巴加比多巴治疗,有报告引起精神错乱、幻想和激动不安。
药物过量

体征和症状
主要表现为中枢神经抑制如嗜睡、意识模糊、呼吸抑制、昏迷,容易发生的症状还有精神错乱、幻觉、激越、调节紊乱、瞳孔反射消失;全身性肌张力过低、肌阵挛、反射消失;惊厥;周围血管扩张、低血压、心动过缓、低体温;恶心、呕吐、腹泻、流涎;乳酸脱氢酶、谷草转氨酸和碱性磷酸酶升高。如同时服用各种作用在中枢神经系统的物质或药物(例如酒精、安定、三环类抗抑郁药),可使上述情况恶化。
治疗
目前尚缺乏特异性解毒药。从胃肠清除药物(催吐、洗胃、昏迷病人在洗胃前应行气管插管);给予活性碳,如需要,给予轻泻剂;有呼吸抑制者,给予人工呼吸,并给予心血管功能支持疗法。由于本药主要经肾脏排泄,应大量输液,如有可能,加用利尿剂。如有惊厥,应小心静脉注射安定。

包装规格:
10mg*100 片/盒

• Molecular formula of lioresal is C10H12ClNO2
• Chemical IUPAC Name is 4-amino-3-(4-chlorophenyl)-butanoic acid
• Molecular weight is 213.661 g/mol
• Lioresal available : 10mg tablets, 25mg tablets

Lioresal, also known genetically as baclofen, is used as a muscle relaxant and is commonly prescribed to patients that suffer from muscle spasms, pain and stiffness from multiple sclerosis. The common form of Lioresal is a white, scored tablet of 10 mg or a capsule of 20 mg.

This medication cannot be prescribed universally, anyone that is allergic to baclofen or anyone who has had kidney disease, a history of blood clotting or anyone who epilepsy or a history of seizures may not be able to take this medication or the dosage may have to be adjusted by the physician. Children under the age of twelve should not be prescribed this medication and older adult may be more sensitive to the medication.

Lioresal has received the pregnancy rating of C from the Food and Drug Administration and therefore the medication may or may not be harmful to an unborn child. It is undetermined whether the medication can be transferred through breast feeding. Any pregnant woman should inform the physician of the existing condition prior to the prescription of the medicine.

This medication should be taken exactly as prescribed and should the dosage should never be exceeded by dosage or by length of consumption, unless approved by the physician. Lioresal can be taken with or without food and the label on the prescription should be followed as closely as possible If a dose is accidentally skipped and it is not close to the next scheduled dose, take the missed dose as soon as remembered. If the dose is close to the next prescribed dose, then skipped the missed dose and take only the next prescribed dose. Emergency medical help should be sought if there is a suspicion of an overdose. The symptoms of an overdose include, but are not limited to dilated or pinpoint pupils, faint or shallow breathing, muscle weakness, vomiting, drowsiness, fainting or coma.

The severe side effects that may be experienced when taking this medication can be but are not limited to uneven heartbeat, seizures, confusion and hallucinations. If any of these symptoms occur seek emergency medical attention immediately. The less severe side effects that can occur are, but are not limited to drowsiness, dizziness, weakness, tired feeling, headache, nausea, constipation, more frequent urination and insomnia. The user should not take this medication when they have to operate any motor vehicle or heavy equipment. This medication should not be taken when involved in any activities that required alertness or muscle tone to ensure balance and physical safety. Any other bothersome or unusual side effect should be report to the prescribing physician. If the muscular symptoms do not show improvement within 2 weeks then this should be reported to the prescribing physician.

Lioresal may react to other prescription drugs such as pain killers, narcotics, cold medicines, medications for seizures, antidepressants and any other medication that have the side effects that include drowsiness and dizziness. Vitamins, herbal supplements and over-the-counter medications may also react to Lioresal; a full medical and prescription drug disclosure will help the physician to eliminate the chances of adverse reactions to other medications from occurring. Do not drink alcohol when taking this medication. Professional medical advice is necessary when the cessation of this medicine is to occur. A slow weaning process may be needed to stop taking this drug, if Lioresal has been taken for a long period of time. If the medication is suddenly stopped, some of the withdrawal symptoms that may occur are hallucinations and seizures. Any additional information is available upon request from the physician and pharmacist.

责任编辑:admin


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