Сертралин - мощный и селективный ингибитор обратного захвата серотонина (5НТ). В клинических дозах сертралин блокирует захват серотонина в тромбоцитах человека. Сертралин не обладает сродством к мускариновым (холинергическим), серотониновым, дофаминовым, гистаминовым, бензодиазепиновым и адренергическим рецепторам. Сертралин не вызывает лекарственную зависимость, не оказывает м-холиноблокирующего и кардиотоксического действия. Не усиливает активность симпатической нервной системы. В отличие от трициклических антидепрессантов не увеличивает массу тела.
Показания к применению
Острая или хроническая сосудистая или метаболическая церебральная недостаточность: атеросклероз. Тромбоз или эмболия сосудов головного мозга. транзиторные церебральные ишемические приступы. Острая или хроническая периферическая сосудистая недостаточность: облитерирующие заболеваниясосудов конечностей. Синдром Рейно. другие синдромы, характеризующиеся нарушением периферического кровообращения. Головная боль.
Применение при беременности и в период грудного вскармливания
Адекватных и хорошо контролируемых исследований безопасности сертралина при беременности не проводилось, поэтому применение возможно только в случаях, когда ожидаемая польза для матери превышает возможный риск для плода. Неизвестно, выделяется ли сертралин с грудным молоком, поэтому не рекомендуется применение в период лактации. Отдельные исследования показали, что у грудных детей, матери которых в период вскармливания получали сертралин, его уровень в плазме крови незначителен или не определяется, в то время как концентрации в грудном молоке превышают концентрации в крови матери. Женщинам детородного возраста в период лечения сертралином следует применять надежные методы контрацепции. В экспериментальных исследованиях не выявлено тератогенного и мутагенного действия сертралина. Однако в дозах, приблизительно в 2.5-10 раз превышавших максимальные суточные клинические дозы, сертралин вызывал задержку оссификации костной ткани плода, возможно, как результат влияния на материнскую особь. При введении сертралина в дозах, примерно в 5 раз превышавших максимальные клинические дозы, наблюдалось снижение выживаемости новорожденных.
Способ применения и дозы
Внутрь препарат назначают по 5-10 мг 3 раза/сут с одинаковыми интервалами между приемами в течение длительного периода времени. Для улучшения всасывания препарат следует принимать в промежутках между приемами пищи. В некоторых случаях целесообразно начинать лечение с парентерального введения препарата (Сермион пор.лиоф.д/ин. 4 мг фл. 4 мл [с р-лем] уп. 4 Пфайзер ) с последующим переходом на прием внутрь в период поддерживающей терапии. Для удобства дозирования можно использовать препарат Сермион табл.п.о. 5 мг уп. 30 Пфайзер.
Побочное действие
Со стороны сердечно-сосудистой системы редко - ощущение жара и приливы крови к лицу. Со стороны ЦНС редко - сонливость, бессонница. Со стороны пищеварительной системы редко - слабо выраженные желудочные расстройства.
Передозировка
Тяжелых симптомов при передозировке сертралина не выявлено даже при назначении препарата в больших дозах. Симптомы передозировки: тремор, дезориентация, неусидчивость, мышечный гипертонус, гиперрефлексия, миоклонические подергивания сначала в стопах, затем распространяются по всему телу, спазмы в животе, метеоризм, диарея, тошнота, рвота, диспепсия. Лечение передозировки: специфических антидотов нет. Для уменьшения абсорбции возможно промывание желудка, использование активированного угля. Необходимо обеспечить нормальную проходимость дыхательных путей, оксигенацию и вентиляцию легких. Следует контролировать функции жизненно важных органов, осуществлять проведение симптоматической и поддерживающей терапии.
Особые указания
Серлифт не следует назначать совместно с ИМАО, а также в течение 14 дней после прекращение лечения ИМАО. После отмены Серлифта в течение 14 дней не назначают ИМАО. Во время лечения Серлифтом необходимо соблюдать осторожность при управлении автотранспортом и потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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