У взрослых: Купирование психомоторного возбуждения и агрессивных состояний, особенно при хроническом алкоголизме или в пожилом возрасте. Интенсивный хронический болевой синдром. У взрослых и детей старше 6 лет: Различные типы хореи, синдром Жилля де ла ТуреттаУ детей старше 6 лет: Расстройства поведения с ажитацией и агрессивностью.
Противопоказания
Повышенная чувствительность к тиаприду или к другим компонентам препарата. Диагностированные или подозреваемые пролактин-зависимые опухоли, например: пролактинома гипофиза и рак груди. Диагностированная или подозреваемая феохромоцитома. В комбинации с сультопридом
Беременность (I триместр)Период лактацииДетский возраст (до 6 лет)Гипертонический кризВыраженная ...
Действующее вещество: Тиаприд (Tiapridum)Концентрация действующего вещества (мг): 100
Фармакологические свойства
Антипсихотический препарат (нейролептик). оказывает снотворное, седативное, анальгезирующее действие. устраняет дискинезии центрального происхождения.антипсихотическое действие обусловлено блокадой допаминовых d2-рецепторов мезолимбической и мезокортикальной системы.обладает выраженным анальгетическим эффектом, как при интероцептивной, так и при экстероцептивной боли. седативное действие обусловлено блокадой адренорецепторов ретикулярной формации ствола головного мозга; противорвотное действие - блокадой допаминовых d2-рецепторов триггерной зоны рвотного центра; гипотермическое действие - блокадой допаминовых рецепторов гипоталамуса.
Показания к применению
У взрослых: Купирование психомоторного возбуждения и агрессивных состояний, особенно при хроническом алкоголизме или в пожилом возрасте. Интенсивный хронический болевой синдром. У взрослых и детей старше 6 лет: Различные типы хореи, синдром Жилля де ла ТуреттаУ детей старше 6 лет: Расстройства поведения с ажитацией и агрессивностью.
Противопоказания
Повышенная чувствительность к тиаприду или к другим компонентам препарата. Диагностированные или подозреваемые пролактин-зависимые опухоли, например: пролактинома гипофиза и рак груди. Диагностированная или подозреваемая феохромоцитома. В комбинации с сультопридом
Беременность (I триместр)Период лактацииДетский возраст (до 6 лет)Гипертонический кризВыраженная почечная и/или печеночная недостаточностьВ комбинации с дофаминергическими агонистами (амантадин, апоморфин, бромокриптин, каберголин, энтакапон, лизурид, перголид, пирибедил, прамипексол, хинаголид, ропинирол), за исключением больных, страдающих болезнью Паркинсона. В комбинации с лекарственными средствами, которые могут вызывать нарушение ритма сердца: антиаритмические препараты Iа класса (хинидин, гидрохинидин, дизопирамид) и III класса (амиодарон, соталол, дофетилид, ибутилид), некоторые нейролептики (тиоридазин, хлорпромазин, левомепромазин, трифлуоперазин, циамемазин, амисульприд, сульпирид, пимозид, галоперидол, дроперидол), а также со следующими препаратами: леводопа, бепридил, цисаприд, дифеманил, эритромицин, мизоластин, внутривенный винкамин, спарфлоксацин, моксифлоксацин.
Применение при беременности и в период грудного вскармливания
Препарат противопоказан в I триместре беременности и в период лактации. Относительно влияния на мозг плода нейролептиков, применяемых при беременности, данных не имеется. Не рекомендуется применять тиаприд во II и III триместрах беременности. Однако если существует необходимость применения препарата, то рекомендуется по возможности ограничить дозу и продолжительность лечения. При продолжительном лечении и/или применении препарата в высоких дозах и/или при поздних сроках беременности следует контролировать неврологические функции новорожденного. Неизвестно, выделяется тиаприд с грудным молоком, поэтому при необходимости применения препарата в период лактации грудное вскармливание следует прекратить.
Способ применения и дозы
Только для взрослых и детей старше 6 лет. Необходимо всегда подбирать минимальную эффективную дозу. Если позволяет состояние больного, лечение следует начинать с низкой дозы, затем постепенно повышая ее. Купирование психомоторного возбуждения и агрессивных состояний, особенно при хроническом алкоголизме или в пожилом возрасте: У взрослых: 200 - 300 мг/сутки, курс лечения 1 - 2 месяца. В пожилом возрасте: 50 мг два раза в сутки. Дозу можно постепенно увеличивать на 50 -100 мг каждые 2-3 дня до максимальной суточной дозы 300 мг. Хорея, синдром Жилля де ла ТуреттаУ взрослых: 300 - 800 мг/суткиЛечение следует начинать с дозы - 25 мг в сутки, затем медленно повышать ее до достижения минимальной эффективной дозы. У детей старше 6 лет: 3-6 мг/кг/суткиИнтенсивный хронический болевой синдром. Обычная доза для взрослых составляет 200 - 400 мг/сутки. Расстройства поведения с ажитацией и агрессивностью у детей в возрасте старше 6 лет -доза составляет 100 - 150 мг/сутки.
Побочное действие
Астения, утомляемость (9,4%)Сонливость (6,6%)Бессонница (4,4%)Ажитация, психомоторное возбуждение (3,7%)Апатические состояния (2,8%)Головокружение (2,6%)Головная боль (2%)Синдром Паркинсона: тремор (2,3%), повышение артериального давления, брадикинезия (1,2%), гиперсаливация (1,2%). Значительно реже: Ранняя дискинезия и дистония (спазматическая кривошея, окулогирные кризы, тризм), акатизия (0,9%). Эти симптомы обычно являются обратимыми после отмены препарата или назначения антихолинергических противопаркинсонных средств. Поздняя дискинезия (стереотипные непроизвольные движения языка, лица и конечностей) возникающая при длительном применении (антихолинергические противопаркинсонические средств, назначаемые в качестве корректоров могут ухудшить состояние больного). Гиперпролактинемия и сопряженные с ней расстройства (<0,2%): аменорея, галакторея, набухание грудных желез, боль в груди, импотенция или нарушения эякуляции, Увеличение массы телаУдлинение интервала QTМерцательная аритмияПостуральная гипотензияЗлокачественный нейролептический синдром.
Передозировка
Симптомы: избыточное седативное действие, сонливость, угнетение сознания вплоть до комы, артериальная гипотензия, экстрапирамидные симптомы. Лечение: отмена препарата, промывание желудка (при отравлении таблетками), симптоматическая и дезинтоксикационная терапия, мониторинг за жизненно важными функциями организма, особенно сердечной деятельности (риск удлинения интервала QТ) до полного исчезновения симптомов интоксикации. При тяжелых экстрапирамидных симптомах - антихолинергические препараты. Поскольку тиаприд слабо подвергается диализу, для удаления активного вещества не рекомендуется применять гемодиализ. Антидот тиаприда неизвестен.
Особые указания
ЗНС характеризуется бледностью, гипертермией, ригидностью мышц, дисфункцией периферической нервной системы, нарушением сознания. Признаки дисфункции периферической нервной системы, такие как повышенное потоотделение и лабильность АД, могут предшествовать наступлению гипертермии и, следовательно, представлять собой ранние, предупреждающие сигналы. Некоторые факторы риска, такие как обезвоживание или органическое поражение мозга, несмотря на то, что такое действие нейролептиков может объясняться идиосинкразией, по-видимому, являются предрасполагающими. Тиаприд вызывает дозозависимое удлинение интервала QТ. Известно, что этот эффект увеличивает риск серьезных желудочковых аритмий, он усиливается на фоне брадикардии, при гипокалиемии, а также в случае врожденного или приобретенного удлинения интервала QТ (при комбинации с препаратами, удлиняющими интервал QТс). До начала применения препарата следует провести коррекцию гипокалиемии. Следует обеспечить контроль клинической картины, электролитного баланса и ЭКГ. При экстрапирамидном синдроме, вызванном нейролептиками, вместо применения агонистов допаминовых рецепторов следует назначать антихолинергические препараты. Влияние на способность к вождению автотранспорта и управлению механизмамиВ период лечения пациенты должны воздерживаться от занятий потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций
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Интенсивный хронический болевой синдром. У взрослых и детей старше 6 лет: Различные типы хореи, синдром Жилля де ла ТуреттаУ детей старше 6 лет: Расстройства поведения с ажитацией и агрессивностью."}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к тиаприду или к другим компонентам препарата. Диагностированные или подозреваемые пролактин-зависимые опухоли, например: пролактинома гипофиза и рак груди. Диагностированная или подозреваемая феохромоцитома. В комбинации с сультопридом"}},{"type":"paragraph","data":{"text":"Беременность (I триместр)Период лактацииДетский возраст (до 6 лет)Гипертонический кризВыраженная почечная и/или печеночная недостаточностьВ комбинации с дофаминергическими агонистами (амантадин, апоморфин, бромокриптин, каберголин, энтакапон, лизурид, перголид, пирибедил, прамипексол, хинаголид, ропинирол), за исключением больных, страдающих болезнью Паркинсона. 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