زائر
atmxetine hydhide
(at h mx' ah teen)
Stattea
Pegnany ategy
Dg ass
Seetive nepinephine eptake inhibit
Theapeti atins
Seetivey bks the eptake f nepinephine at the nena synapse. The mehanism by whih this atin has a theapeti effet in attentin defiit hypeativity disde (ADHD) is nt ndestd.
Indiatin
· Teatment f ADHD as pat f a tta teatment pgam
ntaindiatins and atins
· ntaindiated with hypesensitivity t atmxetine nstitents f Stattea; se f MA inhibits within the past 14 days; naw-ange gama
· se atisy with hypetensin, tahyadia, adivasa eebvasa disease, pegnany, atatin
Phamakinetis
te
nset
Peak
a
apid
1–2 h
Metabism: Hepati; T12: 5 h
Distibtin: May ss paenta; may pass int beast mik
Exetin: ine and fees
Avaiabe fms
apses--5, 10, 18, 25, 40, 60 mg
Dsages
ADTS AND HIDEN > 70 KG
40 mgday P, inease afte a minimm f 3 days t a taget tta daiy dse f 80 mg P given as a singe dse in the mning tw eveny divided dses, in the mning and ate aftenn eay evening; afte 2–4 wk, tta dsage may be inease t a maximm f 100 mgday if needed.
PEDIATI PATIENTS < 70 KG
Initia dse 0.5 mgkgday P, inease afte a minimm f 3 days t a taget tta daiy dse f appximatey 1.2 mgkgday P as a singe daiy dse in the mning; may be given in tw eveny divided dses in the mning and ate aftenn eay evening. D nt exeed 1.4 mgkg 100 mgday, whiheve is ess.
PATIENTS WITH HEPATI IMPAIMENT
F mdeate hepati impaiment, ede dsage t 50% f the nma dse; f sevee hepati impaiment, ede dsage t 25% f the nma dse.
Advese effets
· NS: aggessin, iitabiity, ying, smnene, dizziness, headahe, md swings, insmnia
· V: papitatins
· GI: dy mth, nasea, dyspepsia, fatene, deeased appetite, nstipatin, ppe abdmina pain, vmiting
· Dematgi: dematitis, ineased sweating
· G: inay hesitatin, inay etentin, dysmenhea, eetie pbems
· espiaty: gh, hinhea, sinsitis
· the: feve, igs, sinsitis, weight ss, myagia
Inteatins
Dg-dg
· Pssibe ineased sem eves if mbined with ptent YP2D6 inhibits--paxetine, fxetine, qinidine; mnit and adjst dsage f atmxetine t 0.5 mgkgday with a taget dse f 1.2 mgkgday f hiden < 70 kg 40 mgday with a taget dse f 80 mgday f hiden > 70 kg adts
· isk f neepti maignant syndme if mbined with MA inhibits; d nt mbine with an MA inhibit and d nt give atmxetine within 14 days f sing an MA inhibit
Nsing nsideatins
Assessment
· Histy: hypesensitivity t atmxetine nstitents f Stattea; se f MA inhibits within the past 14 days; naw-ange gama, hypetensin, tahyadia, adivasa eebvasa disease, pegnany, atatin
· Physia:T; skin--, esins; ientatin, affet; P, BP, astatin; , adventitis snds; bwe snds, nma tpt
Inteventins
· Ense ppe diagnsis befe administeing t hiden f behavia syndmes: dg shd nt be sed nti the ases and nmitants f abnma behavi (eaning disabiity, EEG abnmaities, negia defiits) ae ed t.
· Ense that dg is being sed as pat f an vea teatment pgam inding edatin and psyhsia inteventins.
· Aange t intept dg dsage peidiay in hiden being teated f behavia disdes t detemine if symptms e at an intensity that waants ntined dg theapy.
· Mnit gwth f hiden n ng-tem atmxetine theapy.
· Administe dg befe 6 PM t pevent insmnia if that is a pbem.
· Mnit bd pesse eay in teatment, patiay with adt patients.
· Aange f nst with sh nse f sh-age patients eeiving this dg.
· Sggest the se f ntaeptives f wmen f hidbeaing age wh ae sing this dg.
Teahing pints
· Take this dg exaty as pesibed. It an be taken ne a day in the mning, if advese effets ae a pbem, the dg an be taken in tw eveny divided dses in the mning and in the ate aftenn eay evening.
· Take dg befe 6 PM t avid night-time seep distbane.
· Avid the se f ah and ve-the-nte (T) dgs, inding nse dps, d emedies, and heba theapies whie taking this dg; sme f these pdts ase danges effets. If y fee that y need ne f these pepaatins, nst y heath ae pvide.
· These side effets may : dizziness, insmnia, mdiness (these effets may beme ess pnned afte a few days, avid diving a a engaging in ativities that eqie aetness if these , ntify y heath ae pvide if these ae pnned bthesme); headahe (anagesis may be avaiabe t hep) ss f appetite, dy mth (sma feqent meas, sking n sgaess zenges have been knwn t hep).
· The effets f this dg n the nbn baby ae nt knwn, wmen f hidbeaing age ae advised t se ntaeptives.
· ept papitatins, dizziness, weight ss, sevee dy mth and diffity swawing, pegnany.
Advese effets in Itai ae mst mmn; thse in Bd ae ife-theatening.
(at h mx' ah teen)
Stattea
Pegnany ategy
Dg ass
Seetive nepinephine eptake inhibit
Theapeti atins
Seetivey bks the eptake f nepinephine at the nena synapse. The mehanism by whih this atin has a theapeti effet in attentin defiit hypeativity disde (ADHD) is nt ndestd.
Indiatin
· Teatment f ADHD as pat f a tta teatment pgam
ntaindiatins and atins
· ntaindiated with hypesensitivity t atmxetine nstitents f Stattea; se f MA inhibits within the past 14 days; naw-ange gama
· se atisy with hypetensin, tahyadia, adivasa eebvasa disease, pegnany, atatin
Phamakinetis
te
nset
Peak
a
apid
1–2 h
Metabism: Hepati; T12: 5 h
Distibtin: May ss paenta; may pass int beast mik
Exetin: ine and fees
Avaiabe fms
apses--5, 10, 18, 25, 40, 60 mg
Dsages
ADTS AND HIDEN > 70 KG
40 mgday P, inease afte a minimm f 3 days t a taget tta daiy dse f 80 mg P given as a singe dse in the mning tw eveny divided dses, in the mning and ate aftenn eay evening; afte 2–4 wk, tta dsage may be inease t a maximm f 100 mgday if needed.
PEDIATI PATIENTS < 70 KG
Initia dse 0.5 mgkgday P, inease afte a minimm f 3 days t a taget tta daiy dse f appximatey 1.2 mgkgday P as a singe daiy dse in the mning; may be given in tw eveny divided dses in the mning and ate aftenn eay evening. D nt exeed 1.4 mgkg 100 mgday, whiheve is ess.
PATIENTS WITH HEPATI IMPAIMENT
F mdeate hepati impaiment, ede dsage t 50% f the nma dse; f sevee hepati impaiment, ede dsage t 25% f the nma dse.
Advese effets
· NS: aggessin, iitabiity, ying, smnene, dizziness, headahe, md swings, insmnia
· V: papitatins
· GI: dy mth, nasea, dyspepsia, fatene, deeased appetite, nstipatin, ppe abdmina pain, vmiting
· Dematgi: dematitis, ineased sweating
· G: inay hesitatin, inay etentin, dysmenhea, eetie pbems
· espiaty: gh, hinhea, sinsitis
· the: feve, igs, sinsitis, weight ss, myagia
Inteatins
Dg-dg
· Pssibe ineased sem eves if mbined with ptent YP2D6 inhibits--paxetine, fxetine, qinidine; mnit and adjst dsage f atmxetine t 0.5 mgkgday with a taget dse f 1.2 mgkgday f hiden < 70 kg 40 mgday with a taget dse f 80 mgday f hiden > 70 kg adts
· isk f neepti maignant syndme if mbined with MA inhibits; d nt mbine with an MA inhibit and d nt give atmxetine within 14 days f sing an MA inhibit
Nsing nsideatins
Assessment
· Histy: hypesensitivity t atmxetine nstitents f Stattea; se f MA inhibits within the past 14 days; naw-ange gama, hypetensin, tahyadia, adivasa eebvasa disease, pegnany, atatin
· Physia:T; skin--, esins; ientatin, affet; P, BP, astatin; , adventitis snds; bwe snds, nma tpt
Inteventins
· Ense ppe diagnsis befe administeing t hiden f behavia syndmes: dg shd nt be sed nti the ases and nmitants f abnma behavi (eaning disabiity, EEG abnmaities, negia defiits) ae ed t.
· Ense that dg is being sed as pat f an vea teatment pgam inding edatin and psyhsia inteventins.
· Aange t intept dg dsage peidiay in hiden being teated f behavia disdes t detemine if symptms e at an intensity that waants ntined dg theapy.
· Mnit gwth f hiden n ng-tem atmxetine theapy.
· Administe dg befe 6 PM t pevent insmnia if that is a pbem.
· Mnit bd pesse eay in teatment, patiay with adt patients.
· Aange f nst with sh nse f sh-age patients eeiving this dg.
· Sggest the se f ntaeptives f wmen f hidbeaing age wh ae sing this dg.
Teahing pints
· Take this dg exaty as pesibed. It an be taken ne a day in the mning, if advese effets ae a pbem, the dg an be taken in tw eveny divided dses in the mning and in the ate aftenn eay evening.
· Take dg befe 6 PM t avid night-time seep distbane.
· Avid the se f ah and ve-the-nte (T) dgs, inding nse dps, d emedies, and heba theapies whie taking this dg; sme f these pdts ase danges effets. If y fee that y need ne f these pepaatins, nst y heath ae pvide.
· These side effets may : dizziness, insmnia, mdiness (these effets may beme ess pnned afte a few days, avid diving a a engaging in ativities that eqie aetness if these , ntify y heath ae pvide if these ae pnned bthesme); headahe (anagesis may be avaiabe t hep) ss f appetite, dy mth (sma feqent meas, sking n sgaess zenges have been knwn t hep).
· The effets f this dg n the nbn baby ae nt knwn, wmen f hidbeaing age ae advised t se ntaeptives.
· ept papitatins, dizziness, weight ss, sevee dy mth and diffity swawing, pegnany.
Advese effets in Itai ae mst mmn; thse in Bd ae ife-theatening.