se KPATKA XAPAKTEPHCTHKA HA mpoaygtaRé/ 1. HME HA JEKAPCTBEHHA MPOAYKT Tlenoxca 500 mg grenaupann Taber Levoxa 500 mg film-coated tablets 2 KAMECTBEH H KOJIMYECTBEH ChCTAB Borsa guamupaua TaGneTKa chaLpKa aKTHBHO BeUIecTBO xeBOGOKcaLwH (levofloxacin) 500 mg, Karo 512,46 mg newosproxcann xemuxssapar (levofloxacin hemihydrate). 0 car Beaxa Gumupana TaGnetka chmupxca 7,68 mg aaxrosa MOHOXMapar. 3a TRAMs CHUCEK Wa HOMOUIEUTe BeUecTBa BHOKTE TONKA 6.1 3, JEKAPCTBEHA ®OPMA ‘Ouamupana TaGaera Pososu, enuncosnzHH, B0RWOUSTEKHANK TaGreTKH, C JeMTeRHa Yepra OT exHATa cTpaHa H MapKAPOBKA “L* or apyrara crpana, c pasmepu 8 x 16 mn, ‘TaGnerxata Mome aa OBne pasneneua wa 7Be paBul NOsK. KAMHW4HH AHA 4.1 Tepaneotaame noxesamaa Tips sxspacran aesodnoxcaitns € mpenHasHaNeHn sa TeveHNe Ha cmemHNTe HHIpEKIUNH (BX. TONKY 4.4 5.1: © ocrap MuenouedpiT M YoromNeHH HIERN Ha niKoNEHTE reve (sx, TOK 4.4) ‘© xpouurien Gaxreparen mpocratir; ¢ —Muxanatopen arrpaxe: npodnraxtinxa oxen excnosHin m novenme (Bxx. TO"KA 4.4), Tipu wo6poenwre no-zony noxasasHs Tewoxca TpaGna Aa ce HaNlon3HA CAMO KoraTO ce CMHTA 3a ‘enoAaXonsmia ynoTpeGaTa Ha APYTH aTHBakTepHaNHM CpeACTBA, KONTO OGHYAlLHO ce NpeNlOpBARAT 3a ewenue Ha Tesw HuieKuu, ocrep Gaxrepuasien cHHYSuT; ‘ocTpa exsattepOaitis Ha xpoumatia oScrpyxtuaia GeroxpoGHa Gaslecr, BKMOWHTENHO GPOHXHT; TMHeEMOHHS, MpHAOGiTTA B OOulecTBOTO; YONOKHEHN MADEKUMM Ha KORKATA M MEKHTE THKANW/YCIORHENM HHEKINM Ha KOKATA M KOXKHMTE eXpyKTYPMS *— Meycnommen turovir (Box, To¥Ka 4.4). ToGneniusre aenodroKcatun MOraT CbIUO a ce HANONSBAT 34 SaRBpUTRAHE Ha TeNeOHHL TatinenT#, KONTO ca MloKasaTH TIOOGpeHKe Cie MpBORAMAIHA TepAnis MATpAREH Hepodaoxcaumnn. Nooo 1‘TpaGea na ce ssewar npensna ofpuuvanmre yxasanns 3a ynoTpeSa Ha anTNGakTepHaAHM cpencTBa. 42° osmposxa m wavun wa upaaoxenue ‘TaGnereure nexodmoxcauml ce mpueMaT eaHH HAM jBa MTA mBeBHO. JoxaTa saNHCH OF auaa H TeKeCrTa va uuexUaTa n 4yBCTBHTeMHOCTTa Ha Mpexronaracwna NaTOreH, ‘TaGnetkwre nevodnoxcaummn Morar cbuno Ha Ce HaITow3par 28 SABBpulBaHe Ha NeYeGHHA Kype MPH ‘MalWleHTH, KOWTO ca noKasaiH TonOGpeHNe Cre” MspROHaNaMHa TepamAg ¢ MHTpaBeHO3HO NPHNOXeH Jesodroxcause; nepopamure napentepanin hopMn ca GHOEKBURATEHTHN MOFAT Ja Ce MpuAAraT & ‘eaHH H CBU 203K. Toauponxa Mipenopessar ce caemure 2osH 3a nesodnokcaune: Aoaupoera npu nayuenmu c nopaina GeGpeuna dynxyun (kpeamununoe knupouc > 50 ml/min) ‘Octup Gaxtepraren emiyant Twenna aosa (Bsanucumoct or Texecrra Ha mexaperta) ‘500 mg emtioxpatHo AKeBHO Tipoxeaxureawocr na sevennero! (» sapncamoer o7 TexeerTa 10-14 an ‘Octpa exsamepbanns 1a xpoumtest Gpouxr 300'mg envioxpario meni 7-10 nam Heycoxued uneTHT 250 mg enwoxpaTHo aHesHO 3 HH Tipwao6ura ® oGutecTs0TO BNeBMONA 500mg enMH HATH Ra ITBTH AHEBHO 7-14 aun Tinexoue@put 300 mg ennoxparao nuepHo 7-10 aan Venoneny HEGexiH Ha orpenurennata cucTeMa ‘500 mg entioxparo aesHo 7-14 aan ‘Xpounvew Gaxrepuae 300 mg ennioxpatHo aneBHO 28 aa 3500 mg eam mx asa moTH ANEBHO 7-14 ae ‘TipombmawreatocrTa Ha NEveHueTO BKTO'BA HNTPaBeHOsHO H NepOpamHO NPWAOKeHKE TeveNHe. 300 mg enuoxpamHo aHeBHO 8 cempenint Bpeneto, Heo6xonuMo 3a MpeMunanaue OT WHTpaReuosHO Ha Nepopaivo AeYeHHe JaBUCH OT KTHAMUHATA ‘curTyAUM, HO OGuKHOBEHO € 2 0-4 su. Cuewuaniy nomnaumy Tlayuexmu c napyuena 6e6pewna dyncyua Tipu naiwenmu c xpeamunusos xugrenc <50 ml/min dosupoaxama mpaGea 0a Grde cvodparena cvc cheduama crema Pexum na nosmpane 250 mgua24aaca | 500 mga 24 vaca Kpeatusannon Tiepsonawaawa nosa: | Tipsowavanna nosa: | ITspsows sauppac 250 mg 300 mg 500 my ‘50-20 mi/min (Chea KoeTo: ‘Cues Koto! 125 mg/24.a. 250 mg/24 4.19-10 ml/min ‘Caren xoeTo: Caen Koeto: ‘Caen Keto: 125 mg/48 4. 125 mg/24 5. 125 mg/l2-5. <10 ml/min (Crea xoero: ‘Cen KoeTo: ‘Caen xoeto: ea. xemonmamea n | 125 mg/484, 125 mg/24 4. 125 mg/24 4. CAPD* He ce HaNATa Mpmaaraxe Ha AOMBANUTEMHM ROSH CAEN XEMORMANLA HIM NPONEIAHTE TAA Yepedena vepuodpobna pynxyun He ce nasara xopirapaxe na o3aTa pH naumMeHTH c yapenena HeponpoGua dyEKUMA, TBH KATO AeBodsOKCANHH He ce MeTAGOHSHpA B HAYHTEMHA CTENCH B MePHHA APOH, a Ce EKCKPeTHpa OCHOBHO “pes Gx6peunre, Tonyaayus ¢ emapvecka sespacm He ce naara KopeKiua Ha TOSMpOBKATa, OcBEH B CayYaHTe Ha Hapyulena OsOpeuna byHKIMT (Bx. Touka 4.4 ,,Tenauntnra m pyntypa na cyxouaiana” m,Yomomxapante ua QT uHTepsaa”), Tleduampuina nonyaayun Tipuatoxennero ua nesodoxcaunn © nporHsonoKesaHo MPH eUa H YHOU (Bx, TOHKa 4.3). Hawnn wa mpanoxenme TaGnetknte nesodroxcanms ce npHeMaT ues, Ges Na ce BBYAT ¢ NOCTATHIHO KOMHYECTBO TeHOCT. TaGnerkwte morar a ce pasnenAT no AerHTENHATa WepTa.c eM aNaMTApaHe Ha NosRposKaTa, [Tpwemar ce Ho upeMe Ha xpatiewe HTH Mexkay xpailenHeTa. Jleworhaoxcauma TaGnerkx TpaGua Ja Graar Mpwemaau Hall-anKo 2 Yaca MpeaM uni crea MpHEM Ha MPOAYKTH, CEISPRAILM AKETESHH H UHAKOBH COMM, MarHESMH HM ayMinHl ChrropoauNN AHTHALMA HH AnxauosHt (CAMO ZHAaHOSHHOBN NPORYKTH, B CBCTABA Na KONTO BAMSAT Gydepupainn cpencTsa, CbaEpAAUIn anywanAll aa Maresull) M eykpandat, THM KaTO TesM MponykTH Morar Aa KaMansT aGcopOtyiaa My (mx. ToaKa 4.5). 43° Tpotaponoxesanus Tlesoproxcanus TaGnerKa He Tpx6Ba Xa ce wANONSBAT: ¢ApWnauwenra, coppxayscrouTent KEM TeBOAOKCAMIMH HAM APYTH XIHONOMH WH KEM HAKOE OT OMOMIHATE BeMecTBa, H36poeHH B TOUKA 6.1; ‘© mpi naumenrn c enmixencus; © pu nauyenta c anamnesa 2a cyxoxuME YapemAastus, cobpaanu ¢ NpHAATaHe Ha ¢yopoxunononH; TIpat neta w7H OHO; To Bpeme Ha Gpemenioct; © pw iepaan 4.4 Cnenuaann npeaynpemaem Mpeanasau Mepkn mpH ynorpeGa ‘YnorpeGara Ha nesoduioxcaunn TpaGea 1a ce W36KTBa MPH TaLIWeNTH, KOHTO Ca WMaNH CepHOsHH HeNETANM PeAKLIN B MFHANOTO NH YroTpeGa Ha MpoaykCTH, ChEpHAILN XHHONOHH WH qayopoxuniononn (ek. tosKa 4.8), Jlevennero Ha TesH TalNeHTH ¢ esOgTOKCaNETH TpxGea sa ce ‘caMo npH mutica Ha alTepHaTHBHH BBSMOAHOCTH 38 neveHMe H Cen BMMMATETHA OLlEHKA Ha rotuomiennero monsa/pacx (wk. cbtt0 TOUKa 4.3).Puck om pesucmenmocm Tonga e seposTHoctra MeTHuMANH-pesticTeNTHHTe S. aureus 2a NPHTExaBaT KO-peaHCTeHTHOCT CIpAMO éayopoxnkoronn, axnowremHo 1esopoKcalts. Ilo 123M npHYMHa, neBodOKCALMK He Ce npenopEBA 34 NevenHe Ha AoKasaHH HAH NozosHpann MRSA Hirexuutl, JoKaTO TaGopaTopHTe pesyaTTaTH He OTHEPART NYBCTBHTETHOCTTa Ha MHKPOOPTaHNSMHTe KEM stesoqLOKCALUN (5 B CaySAH, Ye OBwaliMnTE penopssbai aTAOaKTepKaNHM CpescTBA 2a NeYeUHe Ha RN EKWLH, NPHNEEHEH oT MRSA ca erionxonmuu). Tenodnoxecaiun Moxe fa ce usnom3ea 38 meYenMe Ha OcTbp OaxtepuaneH CHHYSHT H oCTpa exsauepOamKA Ha XpOHHYeH GpoHXT, AKO TesH HHDEKIMM ca MpARKINO NKArHOCTMMpAHK, PesncrentHocrra a E, coli (wall-vecTaar naroren, MpHmHaBant MiKeKUMTH Ha HKOWENTE ISTH) KM ‘ryopoxntozorn eapupa 8 pamrkste wa Esponetickns coios, IIpH mpennucaane ce npenlopsana na ce Remar MpenBHA JOKATHHTe AHHH 3a pasmMpocTpaxenne Ha pesueTeNTHOCT Ha E. coli KEM ‘bryopoxmiononn. Hexaaamopen axmpaxe YnorpeSara npH xopa ce ocowasa Ha in vitro naHHuTe 3a ¥yBcTaHTeMHOcT Ha Bacillus anthracis H Ha excnepHMentanuuTe 2aHiM BEPXY KHBOTHH SacrHO C OrpaNKyeKH AHHH pH xopa. TIpM eveHHETO ce caspar HauHoNAAHHTe WHIM Me;AyHAPOAHH KOHCEHCYCHH DOKYMENTH NO OTHOLICHRE Ha neweHHETO Ha antpaxe. Tpodeascumentu, uneanidusupau u nomenyuanio neoSpamunu cepuosiu nencenanu nekapomeeni eaxyuat (CeoGiiasa ce 3a Mioro pesKH CRYYaH Ha NPOMbIOKHTEMM (NPOMRDIKABAMI MECEMI HTK OMA, NHBanNzuISEpaMIM 4 NoTeHIGATHO HeoGpaTuMn CEpHOSHH HEKETAHK NeKapeTBeHM PeaKUMH, Sacre PASIHSEH, NOHAKOTA MHOTO CHCTEMH B OpranncsMa (myCKY:HO-CKeneTHA, HEPBHa CHICTEMA, NCWXHKA H ‘CeTHBHH Oprail) NpH NANVCHTH, NOAYYABALUH XHHOAOHH H GutyOPOxMHORONH, ResanncHMO OT TAXHATA BESpACT M Reve CbULECTBYBAINNTe PUCKOBH dakTOpH. JleBodTOKcaUN TpAOBA Ta ce cnpe Hesa6asHO MPH MoPBHTe MpHsHALM WIM CHMMTOMH Ha BCsKA CepHOaHa HEKeTAHa PeAKKIMA KETO NaWEHTHTE TpAOBA Za Ce OCHBETBAT Ma CE CBDPIKAT C TEXHIX ACKAP, NEAMHCAN s€KAPCTBOTO, 3a ChBET. Tendunumnu u eyxoorcussu pynmyps ‘Tennmuur 1 paskecuaue Ha cyxorxiie (no-cnleumaHo axtnecoBO cyxoxumHe, HO Ges Ja ce orpanisana ‘camo m0 wero), TlonsKoTa ABYCTAIHO, MOKe 1a Ce NORY'H OULe B PaMKHTE Ha 48 Yaca OT sanOMBAHE Ha JetenneTo ¢ xHHOnOKH ayopoxHHOTONH kaTO HMa CBOILCHHA 3a TAKHBA, PASBATH CC OPH 0 ‘WaKONKo Meceua Ces NPeKpaTABAHE Ha eseNMeTO, PKCKET OT TERIHENT H PASKECBAHE Ha CYKOXKATHE Ce HOBHUABA NPM NO-ERSPACTHM NANWENTH, NPA NaIWeHTH, KOMTO MpMeNaT AKEBHH AO3K reBOSAOKCALH OT 1000 mg, naunexTH ¢ 6x6pesHO YapexKMAHe, NALWEHTH € TpAHCIUIANTHpAH COMKAeK OpraH H TAKHE, ekysauin epmbTorBawo ¢ KopTuKocreponAn, [lo TasH npHYHNa comBTeTBAMATa ynoTpeBA Ha Kopraxocrepowan rpaOpa xa ce usGarBa, Tipu mepans npisuak Ha TenAHHNT (Hamp. ComesHeHO noAyBaHe, BEsnaneHHe) neveHHETO C nenopxoKcannt TpaGwa 1a ce MpexparH Hi na ce OOMMCAM antepHaTHBKO MeveHMe, SacerHaTumT(re) xpatinnk(ut) Tpx6na aa Gpne(at) aexysan(n) no nonxoaAK HaXnH (Hanp. OGesnBHxBante). He TpaGea na ce HSNOMSBAT KOPTHKOCTEPOHLAH, ako Ce MOSRAT NPHSHANIH Ha TERARHONATHE, Tawuenmu @ cmapecka eespacm TIpw nauuenta » craptecka psspact anepitTe 203M TpxOBA aa GoAar KOPHTMpaNH CErIACHO KANpBHCA Ha xkpearnnntia (Bx, Touxa 4.2). IIpx Tesi nanveHTH ce H3HCKBA BHINMaTETHO MOHHTOpHpaHe MPH wasnayanaue Ha nesodiroKcauH.Clostridium diffcile-ceypsano saGonneane Twapus, ocoGexo ako e Texxka, YNOPHTa H/HIH € KBPBABH MpHMECH, NO BpeMe Ha WIH CileM NeNeHTHE ¢ AepospTOKcaLLHH (BKINOSHTEHO HAKONKO CEMA CHE TEYEHHCTO), MORE Ha GbE CHMIITOM HA Clostridium difficile-caspsano saGonxsante (CDAD). Texectra a CDAD sapupa no cremren or steka 20 -xnBOTOSACTpaMTaBaINa, KATO Hall-TewKATa opMa e IIceRTOMEMOpaHOGeH KoAT (Bx. TONKA 4,8), ETO Samo € BAKHO TASH AMArHOSA Ma Ce MMA NPENBAN MPH NENKEHTH C TIOABA Ha TeNKA JMAPHA TO BpeMe HK ‘c1en ewenne ¢ nesodpaoxcann, Ipx cosHenne nm ToTEEpaTenHe 3a CDAD semnara tpaGea na ce pekpatu ynorpeGara Ha nesodmoxcaume # HesaGanHo Za ce sanouHe nomxonama Tepamna. [px TaKasa ‘KMMBWEHA CHTYAKIAK Ca TIPOTHBOMOKAIAHH 3a YOTPeOA MPORYKTH, KOHTO NOTHCKAT NepHcTanTHKaTa. Tlayuenmu npedpasnoaoscenu Kam cepuose Xunononure Morat 2a nomoxaT repHoBiis npar H TOBA Aa AoBee AO NpHnambu. JlenosnOKcaLH € TMpoTHmonOKd3aH NpH naulueHTH € aaMHiesa 3a eNANeLICHA (Bx. TONKA 4.3) H KAKTO APYTHTe XHHONOHH, ‘TpaGaa ja ce WSHIONSBa C NORALICHO BHMMaHHe TPH NaLIMeHTA, NpeNpAATOTOKEHM KEM FHPIOBE HTH ‘eAHOBPeMeHHO ¢ aKTHBITH neulecTBa, KONTO MOMWKAEAT TopYOBHA Mpar, KATO TeospAIHH (Bx. TONKA 4.5). B cayuall Ha kousyacusn ropyose (Bx. Tosxa 4.8), neveHHeTo ¢ Zeso}noxcaUAH TpaGsa 2a ce npeyeranoni. Trayuenmu c deduyum na evioxox0-6-ociam dexudpozenasa Tlausentute c 1aTeHTHH WH H34BeHH AedeKTH B AKTHBHOCTTA Ha FMOKO30-6-ochat Aexnnporenasara Morar ja poss CKIOHHOCT KEM XeMOMITHIHM peaKILAM IPH JeSEHIHe C XHHONOHOBH altTHBaxtepHamtt ‘cpeacrna. IIpH npanarave Ha NewodboxcaltHH MpM TesH NallMeHTH TpsGBa fa Ce USBLPUIBA RHEMATENRO -MouHTOpHpane, ocoGeHO sa nossa Ha xeMOmHSA. Tayueumu ¢ e6pewo yepexcoane JTlesosnoxcanue ce exnnarinpa npeaHNHo apes GLOpeunre, Nopall KOeTO MPH TaNlHeHTH ¢ GEGpeHHH apyntenvs € HeoGxonuMo zosaTa Ja ce opirapa (8x. To¥Ka 4.2). Peaxyuu na ceperupscmeumesiocm Tlesodnoxcatnt Moxe fla MpHNHHH CepHosiH, NOTEHLMANHO hATaTHM peaKIUIM Ha CApBXHYBcrAMTEMHOCT (anpumep axraoenem 20 atadi1aKTHMeH WoX), KOHTO NOHAKOTa HACTENBAT Colem HaYaHATa 1038 (suxre Towa 4.8), [anyesruTe tpaGna HesaGanio 2a npexpatat nevenmeTo Mm 1a Ce CBEpaT ¢ JeKyBalus CH Tekap HAM ¢ Rekap OT Gepsa MOMOLL, KOHTO ie MPILIOXKAT ChOTBETHHTE CTETIHA MEPKE. Teaexu xootenu neocexanu pearwue Teaxks KOH Heenan peaxunn (SCARS), BkmowsantH ToKCHHa enitaepMamHa Nexponisa (TEN: apectHa oule KaTO cituzpom Ha Lyell), cHHiapom Ha Stevens Johnson (SIS) m nexapcrperia peaKuAs ¢ ‘cosHHOdHINs H cHCTeMEH cHMTITOMH (DRESS), KOHTO Mowe a ca AUBOTOSACTpANIABALLM WK C neTaNeH axon, Ce cho6ulanaT BBB BpESKA c ynOTpeBara Ha NeBOdMOKcalMME (Bx. TOHKa 4.8). IIpH MpennucHaHeTo Ha JTexaperBeHs MpoAYKT nauHenTHTe Tpx6na Aa Oar HHOPNUpALH 9a IpHOMAWHTE H CHNNTOMATE a ‘TERKH KOXHM PeaXHUNH H la Ob2aT HaGmORABAHH C TOBHIIEHO BHEMAIKE, AKO ce TORBRT NHAHANM ‘CHMMTOMM, HOKasaTENHH 3a TeSH PeaKWMAK, IPATOREHMETO Ha JLeBOXpIOKCALIAN TPAOBA HesaGABHO HA Ce peycranosi # 2a ce OOMucAN aTTepHATHBHO neveNHe. AKO NalIMeRTET € paseiul cepHosHa PeaKIINE, aro nanpumep SIS, TEN nan DRESS npu ynorpeGara na nenodbioxcaiuin, aevetne c nenodnoKcatt ie TpaGpa 7a ce sarto¥sa OTHOBO NpH TOIH MaLIKeHT. Fucenuresur Kaxto npy pewaku xuHononH, ce coGuaba 3a NaPYLICHHA B HUBETA Ha KPEOHATA 3AKAp, BKMOBALU, kaKTo XHTOTaHKeMHA, Taka H XHMEpraHKeMHs (BX. TOwKA 4.8), OGMKHOBEHO MH sRaGeTHU npanara compTeraauya Tepanns ¢ nepopanii xinormaKeMHHRK cpencrsa (Hanp. TW wacymn, CnoSuasann ca caysai Ha xaniormmKesiia koma, [Tpenopoa ce REHM: pocneganane Ha TIOKO3aTa B KPBATA MpH NaLIMeHTH ¢ AHABeT.Tpeonazaane om chomonyecmsumennocm Tipu aewenne c resodtoxcannn e HaGmoaasata hotouyscraurenHocr (sx. roux 4.8). C nen pentespave of GorocericHGMANSAMLHA NO BpeMe Ha neveHHeTO c seBOAToKCAUMH M 48 Haca Cae ‘Mpexparapavero My ce npenopbiBa NeuNeHTHTe 1a He ce HSAaraT MeMYAHHO Na CHITA COTBITGeba CHET 4sc1H Ha naxyeTBenM UV so (HampuMep YarpasomeToRa naMna, cONApHYM). Tayuenmu na aevenue ¢ axmazonucmu na eumanun K Tlopagu BysMoxkHo noBMulaBave Ha NoKasaTeaHTe 3a koarynauna (PT/INR) w/a yoRaxKaBaHe Ha KBPREHETO MPH NAUHEHTH, NeKYBAHH C TeBOMMOKcAUMH B KOMOMHALLA C aHTaroHMcTH Ha BHTANH K (anpumep sappapan), noxasaTesitre 3a KoaryNauuts TpxGea Ja ce NpocnensReT pu eswoBpeMeHHO NpanoxeHWe Ha TEI neKapcrea (Bx. Toma 45). Tletccomunnu peaxyut Tipy naunenta, npHemauin xHHor0HH, BKI. AeBo*>roKcanHH, ca HAOMORaBAHK NCHXOTHEHE peaxH. B MHOTO Penk cny'an Te MporpecMpaT 0 CYMNNANH MHLCKH H TloReeHM, MORAKOTA OPH czlex NpHAreKe a exHoKparita 2038 nenod>roxcautt (Bx, ToHKa 4.8). B cny¥all, 4e naunensT passe NOTOGEH Peaxuvit, MpHemBT Ha Tesod7OKcaNMH TpsGRa 7a Ce MpeyCTAHOBH H Za ce NpeANpHeMAT NoMXoARLUN Mepkn. [penopssa ce nonmuteno BHHMaHKe, axo TeBompOKCaluNH Ce NpHNara NpH NCHKOTHNARH TMAWIMCHTH ITH TPH MALWeHTH c aHaMHesa 3a TICHXHMHM Sa6onABAHHR. Vounseasane ua QT unmepeara BuuManve ce wsicksa MpH npAnoxeHNe Ha ¢pIYOPOXHHOAOHH, BKA. AesOXpTOKCAIHAN, MPH ALRESTH C PHCKOBH GakTopi 3a yaWKaBaHe Ha QT wHTEpBala, KATO HanpHMep: © sponer cauapo Ha yarnamen QT wxrepea; * — eanonpementto mparoxenne c eKapeTna, 34 KOHTO € HBECTHO, He yarDKABaT QT HETepBATA (amp. arruapinseun xase Ia w IIL, TpHODRKMBOHM aNtTHsenpecaHTH, MaKPONHM, AETHICHXOTHUL). © Hexopurspan enextpomates ancGamanc (Hanp. XHNOKaAMeMHA, xHMOMarHesHeMHa); © copuewno-chyoen sadonssanus (Hanp. cophewna HenOcTaTB4HOcT, MAapKT Ha MHOKEp Aa, GpannKapans). Tlaunenri a crapiecka sispact H xKeHH ca no-AYBCTEHTEAHH KM cpexcTaa, KONTO Yaremkapat QT MHTepBaa, Nopag KoeTO Ce USHCKBA NOBHINeHO BHHMAHHe, KOTSTO MIpH TASH TlOMynANHs NaNweHTH Ce H3nOn3Ba MeBopROKcauMH (BX. TOUKH 4.2 Tayuenmu ¢ cmaprecka enspacm, 4.5, 4.8 # 4.9). Tepupepna neeponanua (Cro6masa ce 3a cyan Ha ceropHa WAH ceMOMOTOPHA NOTHHeSpoTaTHs, BOAEUIM 10 MapecTesHH, xunoecTesus, minecresua HH cxABOCT NPU NANMeHTH, NPHEMALK XHHOIOH H IYOPOXIHOROH. Tlansenrire, xowTo npwemar nesodsioxKcanmad, TpxGsa Aa Ooaar MOcBRETBAHH a HAKOpMIKpAT CBOR Jekap, NpeaH a MPOMBAKAT NeyeHHETO, aKO Ce TORBAT CHMMTOMH Ha HeBporaTHa, KATO Gonka, ycemane ‘3a napene, mpasyuKaute, HSTpEMBaHe HAN caGocT, 3a Ra ce NpeTOTEpATH PasBHTHETO Ha NOTEHNHANHO eoSpaTao saGorsmare (mx, TouKa 4.8). XenamoGuruapnu napywenua ‘CayaH a YepHonpobtia Hexposa 20 dbaranua vepnompoGua HegocTaTEHHOCT ca ZOKNATBANH ¢ eBoIOKCALH, NpeRHMHO NPM NaLWeHTH C TEXKH CHITCTHAIM 3AO0TARANHS, HAM. CeNCHC (BX. ‘rouka 4.8), TlaunenTHre tpaGna 1a GbIar NOCKRETBAHH a NIPeyCTAHORAT NeWEHHETO H ja Ce CRPKAT Che ‘9BOR JeKap, axO ce NORBAT NPHSMANLH H CHMTITOMH Ha SEPHONPOGHO sAGONABAKE, KATO aHOPeNCHA, HKTED, ‘ToMHa ypuia, cupOex wim GonesteH KopeM. O6ocmpane na muacmenun zpasuc ‘@ayopoxmiononitre, skMOMTEAKO TeBOHTOKcAUNH, MPHTEABAT HepBHO-MyCKYAMH G1l0¥s e ‘Noo‘cnyan 4 Heo6xomuMoct ot nopnoMaraxe Ha qMITaNeTO, JlesodoKcaMHH He Ce MpeTtopbusa 3a ynoTpeGa ‘Mp€ nauyeuTH ¢ aaMnesa 3a MuacTeHMs TpaBHc. Spumeniu napyuenua Axo ce naGmonasat yapemiane wa 3peuveto Ham HAKAKRK CeKTH BEPKY OMMTE, MAKMeNTHTe TpaGna 2a Gnat xoncysrTupatit nesaSasto OT CreuMaIHCT NO OMK GoeCTH (BX. TOMKH 4.7 H 4.8). Cynepunperyur ‘Ynorpebara Ha nesodroKcaumt, ocoGeHO AKO € MPONBRAHTENTHA, MORE Na NOEE AO CBPEXPACTEX HA ewyBcrewTenty opraniaMn. Axo flo speMe Ha eHeHMeTO BLaHHKHE CynepHHieKUNs, TpsORA a ce ‘eeMaT noaxoAAKIA MeprT. Bauanue eepxy aaGopamopnume uscnedeanist Tips naueHTH, nexyBanu creBogTOKcaLHH, ONpeResTHeTO Ha ONHATH B YpHHATA MOXE NA NOKEKE ‘Sanumso-NonoKHTeNHM pesyATATH H 2a ce HATORN NOTERPANARANICTO Ka NOAYYeTHTE NOSHTHBIT esysTaTH pH TecTa c To-CneUMgHNTH MeTOR. Jlesorpnoxcanan moxe ja nHxHGupa pacrexka Ha Mycobacterium tuberculosis W cHeROBATEAHO MOKE 28 ‘nage amunso orpauatenan pesyaTaTH pe GaxTepHonorH4sa AMaTHOCTiKa Ha TyOePKY.A0%a, Anespusna u ducexayuesr na dopmama u pezypermayua/nedocmameynoem Ha cepdewHume Kran EnijemHonorHsHitTe mpoy4saHHa NOKEABaT NOBMUIEH PACK OT AKESPUAMA H AMCEKALLUS Ha AOpTaTa, ‘ocoGento npa nauHeHTH B CTapecKa BESPACT, KAKTO M OT PeTyPFHTAU Ha AOPTHATA M MHTpATHATA KAMA ‘exea ynorpeGa Ha dayopoxniorouH. Ceo6weHH ca cny‘an Ha axeBprcMa H ZHIcexauHK Ha aopTaTa, ToHRKOra YoTOKWEHH OpARK paskEcBawe (BKOGHTENHO ¢ MeTAeH H3KOM) H (Peryprorantea/MenOCTaTBHROCT Ha HAKOM OT CPACHHHTE KIAMA TPH TAUIMEHTH, MpHENALUN ‘Qayopoxmiozonn (wx. TouKa 4.8). Creyonateno dbayopoxnnonowuTe TpaGsa na ce nanonsBaT camo ceN BituMaTeAHa OUeHKa Ha ‘ChOTHOMIeHMETO OMBa/pHCK H Ce OGMHCARHE Ha APYTH TepANeBTHYHH BESMOAHOCTH MPH NalWeHTH C onoxrremia awnava avaMHesa 3a aHeNpusMa WK BpOneHO 3aOONTRAHE Ha CHPNeNHUTE KAA, HIM Mp# NaninenTa, AMArHOCTANUPARH ¢ MpemUMeCTBAUIA axtespasMA WHITH NCEKANHER Ha AOpTaTa HIM saGonmpave Ha COpAeYAHTe KiaNM, HK NpH HANMYHe HA APYTH PHCKOBH axTOPH HAM SAGOnADAHLAA ‘mpenpasnonarau ~ KaKTO 3a aHeNpH3Ma, TaKG M 3a AMCeKaIINR Ha ZOpTaTa H 3a peryprinrauHA/HenOCTaTRYHOCT Ha copacure Kiama (Hap. HepyileHHA Ha cBeAMHUTeNHaTA THKAH, Hap. CHEIpON 1a Marfan wm cunapow Ha Ehlers-Danlos, cuapom ta Turner, Gonect Ha Behcet, xuiepTonns, pepMaronneHt apTpat, Hw ZoMamHMTENHO - nH avlespusma # mHceKanHa Ha aopTata (wanp. CbHOBH KapyineHMs, HAND. apTepHHT Ha Takayasu, THrARTOKAeTRHeH apTepART, WIM HSBECTHA aTepockeposa HumK CARAPON Ha Sjogren), wt ROWsAHHTeHO ~ Mpa peryprirrauus/neaocrarsuMocr Ka copaenHuTe KaanM (Hanp. HHeKuUODeH eHJOKEpAT). Puckst or aHempisma W quceKautx Ha aoprara W TAXHOTO PAICKCRAHE MODKE ChINO A CE NOBMUIK MA TauleHTH, HeKyBaHM eLHOBPEMeHHO Che EHCTEMHIM KOPTUKOCTEPOKALK. Tipu sxesania Gorka » kopeMa, MpbAHHA Kou Han ropGa nattHeHTHTe TpsbNa Na GEAaT NocBBETBANH Aa ce KoHcynmupar HesaGaBHo C sekap B creo orneneHHe, Tlaunestwre rpaGna 1a Guar nocbeeTsann ja NoTHpeaT HeseOaRHo MeRNUNHCKA OMOIY B cnyHal Ha ‘ocTpa ACHES, nossa Ha copleSHeHe (namMHTAUNN) HAM PAsBATHE Ha OTOK Ha KOPEMA Han AOTHHTE paloma. Tomoms axmosaTlannenta peaks uaczercTvenH npoGneMH wa HeNOHOCHMOCT KDM TaNAKTOSA, MNeH AKTADEH NeApHINT ¥HIE PmjoxosHo-ranaxrosHa ManaGeopGis ne TpAGBa Aa NpHeMar TOBA neKepeTBO. Hampuit Toa nexapeTbo ceabpxa no-manxo of | mmol HaTpui (23 mg) Ha gummupana TaGreTKa, T.c. Mowe Ja Ce ‘Kae, We MpaKTHeckH He comBpKA HATpH, 45° Boanmonelicrame ¢ apyru aexapernenu npoaykra x Apyre open ‘BOWAHHe Ha APYTH AKTHREH petlectaa BEpxy nepodmoxKcalby Teorpunsn, den6yipen wi nodobau HCITBC Tipe KiMaHiHo mpoyyparte He ca Ha6mogaBaHH AapMaKOKAHeTHUHE BauMOneHCTBHA MeKAY ResodaoKcaunH HW TeopuAHH. Boe nak € BESMO-KHO Ja HACTEITH H3paseHo cHMDKaBaHe Ha TbPYOBHa Mpar TIpH eAHOEPeMeHHO IPHIOXEHHE Ha XHHONOHH H TeOMTAA, HECTepOUANH MPOTUBOBBSNAAUTENH ‘neaperba MMH ApyrH ¢PeACTBA, KOMTO NOKIDKARAT TsPORHA NAF. Koxyentpanuure Ha nesodpaoKcaynt ca ¢ okor0 13% Mo-BHCOKH pH HAAHIHe Ha henSydhex, oTKOAKOTO pu cawoctoseno npioxesue, TipoBenewud 1 yunemudiot Tipobexeunx # wxMeTHAIHH HMaT CTATHCTHYECKH SHAMIM etheKT BUPKY EnHMMUNpANCTO Ha esodmoxcatine, BLOpedHKsT KAMPBHC Ha AeBOpTOKcaMHE ce MORMKABA OT MUMeTHANH (24%) H mpoGenewAa (34%), Tona e Taka, 3ailoro H sbeTe NeKapeTsa Morar 2a Groxupat OnGpennata TyOyAKA ‘cexpeuus Ha nesodoxcauun. Bompekn Toa ¢ cxaGo neposTHo CTATRCTHHECKN InANANHTe KIHETHYHH PAMTHKH NH HoCHeMBANHTE B MpOYsBARETO NOM Aa EMAT KIHENHO SHANEHNC. Heo6xonsiMo e NosuureHo BHHMARKe, KOTaTO enodOKcalTAH Ce MpHara ENFOBPENeHHO ¢ seKapCToa, Koro Hwa edexr BEpXY TyGyanara GsOpeuta cexpeuta, KaTO NPOGeHeUNA # LNMETIULAH, OCOGEHO TPH aNpeHTH ¢ GEOpedHO yEpeRLTAHE. Bsanmogelicn 2Keresnu con, yunxosu com, maznesuil unu arymuunul cedepocauju aumuayudy, Qudanosun ‘Ycnossaveto Ha sesospOKcALIMH ce MaMarIaNa SHa4NTEHO MPH EAHOEPeMEHHOTO MpATOKEHHE Ha Repo NOKcALHH TAGNETEH C KENEOHH COMM, AHTHALIAAH, COADPOKALLM AIIYMMHHA Wk MaTHESHA HII ‘Avanos (camo MpOAYKTH Ha aHMaNOsHH c OyepHN areHTH, CoMEpRALM ALyMUHEH HTH MarHesHtl). Tipu enuospementioto mpunoxeHne Ha GayopOXIHONORH ¢ My:ITHBHTAMHHM, CHABPAAMTM WHRK € [BBSMOKKHO NepopasiHaTa MM aGcopEiwex Aa ce HAMA. TpenopEHBa Ce MPOAYKTH, CRMBPIKAUH ABy- 11M ‘TpuBANeNTHN KATHOHN KATO 2KeNe3HM COAM, IMHKOBH COM, ANTHANAM, CoMDPKALNH MAFHESHH MM ayumi nam 2AZaHOSHH (CAMO MPOAYKTH Ha mWIAHOsHT ¢ Oy Pepin areHTH, CEEpRALK ATYMHHLAH ‘A marwegufl) a He ce MpeMar 2 aca npeaH HAM Chex MpHeMa Ha NenodpacKcaltAH TabNETKH (BH. ‘Towka 4.2). Kamuesure comm HMaT MHKHMaIEH efexT BBPXY aGcopGuss Ha NeROd>roKcaMIMK coe nepopamio npRiomeHHe. Oyxpaxgam Browanmunoctra na TaGzerkuTe nesodyioxKcaun € sHawuTenio HawaseHa, Korero ce MpwTaraT eationpemeno cbc cyxparpar. Ako naunenToT mpnesa cyxpandar H ewodnoKcanpt € Hall-n06pe eyxpandar 2a ce npwewa 2 vaca even npwema wa AenoproxcautMH TaOIeTKN (BX. TO;KS 4.2). Apyea snavuua unpopmayua Kamen apwaxonornan npoysBanna moxassar, ve dapmaKoxineruxara na nepodOKcALA HE Ce TopssBa B KTHHNHO SHAYEMA CTEMEH MPH eMHOBPEMEHHO MpHAOKENHe Ha eBO}IOXCALIH CHC caeqniTe ekapersa: xaaues KapGOHET, ZHTOKCHE, FHHOCHRIAMIA, PAMITHTEE.‘Baum na tepod.roxeaum BuOXY pvrH seKaperpeHH NPOAYKTH Luxnocnopues Bpenero Ha Mony:xup0r Ha umKocTIOpHH ce yaemKaBa ¢ 33%, MPH enHOBpEMENHO MpIROWCHHE eBodaokcalHE. Anmazonucmu na Bumasur K Tlosuuesi noxasatenu 3a xoaryaanua (PT/INR) wan yabmxeto Kepsexte, Konto Morat fia Goat TexxkH Ce HaGTIORABAT MDH MAUEHTH, eKYBAHTH C TeBODTOKCAIUIA B KOMOHHAUHA C AHTAOHNCTH Ha suramnn K (nanpemep sapapus). [lo Tass MpHuMHa, MpH NaMHeHTH, HeKYBAHH ¢ AHTArORUCTH Ma surramnn K tectosete 3a oaryaaunx TpxGpa a ce npocnenssar (Bk. ToaKa 4.4). JTlexapemsa, 3a Koumo e ussecmuo, ve yowtacasam QT uxmepeara Tlesospnoxcauny, noao6Ho wa ApyrH SryopoxsHonORK, TpsGBa Zé Ce NpHTara c NOBHIMIeHO BHHMAHHE Inpw mauvreHtH, npewains 1eKapCTBa, 32 KOHTO © HsBeCTHO we YEAKaBaT QT HETepRATA (HANPHMED antnapwT maint kxrac Taw IIT, TPHUAKCIHMHH aHTHAeNpecarTH, MAkKPOMUUT, aHTATICHXOTHIA) (BK. ‘roxxa 4.4), Apyea peneeanmsa unopmayua B mpoyseante 3a GapmakokHHeTH'Ho BIaNMONCHCTBHE ce YcTANOBKBA, Ye NeBOdNOKCALIMH He OKa3Ba ‘BIHaHHe BEPXY GapMaxoxuueTHKara Ha TeosuAHH (kollTO € cyBcrpat 2a CYP1A2), KoeTO oKa3Ba, He enoguioxcauas we e CYPA2 uuxxGurop, ‘Tbyru dopwn ne ssaumozeliorane Xpana Hawa kananano sHasuwn ssanMorelicrans c xpana. TaGzerkiTe aesodOKcaNMN Morar 7a ce npAnaraT HesaBcuMo OT mpHeNa wa xpana. 4.6 @epruaurer, Gpemenuocr m kLpMen ‘Bpemennocr Taste 3a ynorpesa Ha xesoduoxcaxnn npH Speen xxenu ca orpanaenu. TIpx npoyanasua wEpXY 2KHBOTHH 38 PenpOnYKTHBHA TOKCHAHOCT He ce HAGMOAABA PAK RH HENpAK YepExNaM e*hex (BH. Towa 5.3). Bunpexa Tova, nopaan mumcata Ha ZaNHH Mpx Xopa H opaaH eKCNePHMEHTATHO YCTANOBEH PECK OT YBpeAJAHHX Ha HOCeUIMTe xPYULATH MPH PACTALINK OpraHMSEM Cie” NpHTaraHe Ha yOPOXHHOTOR hesodaoxcanun we TpxOaa 7A ce HsTION3Ba npH OpeMesHH EHH (BX. TONKA 4.3 H 5.3). Kepmene Tlepodpaoxcawytn e npoTiponoKasatt 3a ynorpeGa pH KYpMeulH xen. HaMa AOCTATEHHO HHopMamtis 38 excKpeuHaTa Ha eBodmoKcauHl B Mali4MHOTO MARKO, HO ADYTH GiayOPOXRHOTOHK Ce eKCKPETUPAT B ati4nnoTo Maako. Tlopaay auncara Ha slaHNit npH xopa H nopanit ExcnepHMeHTAHO YCTAHOHEH PUCK OT ‘YEPeRAAHHA Ha HOCELMTe XPYUWIH MPH PACTALIMS OPraHUseM CIeA MpHAaraKe Ha bayopoxnHoronA TeporhoKcaun We TpxGBa 2a Ce H3NOASBA TPH KEIM, KOHTO KEPMT (BX. TOKH 4.3 # 5.3). Pepruanrer Tlesopnoxcauss we mpeawssiKea yapexiane na eprHnHTeTa HAM PenpomyXTHBHOCTTA ITpH TExORE. 4.7 Espextm pepxy enocoStoerra 3a mropmpan paGora c mamunn Hisxou neaxenanin peaxun (Hamp. sanantoct/sHeHe Ha cBxT, CoALIKBOCT, SpHTe=H Hay Napyuiar enocoSHocTra 4a nalviewa 2a KOHeHTPAUA Ha BHHMARHETO H PeaKUMNTe, @ ‘NooeHK B cHTyatUM, KEJeTO TeoH CnocoBHOCTH ca OT CLuLecTHEHO sHaNeNHe (RAMP. WosupaHle H paGora.c awa). 48° Hewenamn aexapcroens peaxnma QGo6wenwe Ha npoduna Ha Gesonachocr uopmauusra ro-nony ce ocHosaza Ha AHHH OT KAMMHYHH Npoy¥BANN MPH NOReYE OF 8.300 maxnenTa H OT excTeHsHBeH NOCTMapkeTHHTOB OnHT. 3K ne Tipy raxwata ouenxa © wsnonssana cneawara ecrora: saoro wets (2 1/10), Hecta (= 1/100 x0 < 1/10), eects (2 1/1 000 x0 < 1/100), peau (> 1/10 000 0 < 1/1 000), moro pena (< 1/10 000), ¢ Henspectia Yecrora (OT HaNHUINHTe Aan He Moe 7a Grime Hampapena OMeHKa). Tipu rpynupane no wectoTa weacenanure nexapcTBeHH peaKiinn cé HS6pOABAT B KNSXONAI pen no oTuouleHve Ha TinciaTa cepHosuocr. ‘Cneremo- Weers Heseera Peaxa C wenspectaa opranan secrora renacope inexuair Mixones mrdecranen mudexuan, BKI, Candida aniexpra Tlosna Ha pesucTeHtin MHKpOOpraHHaMH Hapymienis wa Tlesxonenua | TpoGountonenna | Tlanuntonenna xpesra H Eosunopanis | Heyrponenss Arpanynounrosa sapere Xemomerusnra cuctema, anes Hapyinenns wa ‘Auruoenent ‘AuadunaKTHIeN myanara Capsxuyscranremaoct | mox" cnctema (px. TouKa 4.4) Auabnaaxronsen wox*) (wx. Towra 4.4) Hapyiienna wa ‘Caapow wa eunoxpHanaTa HeatexnaTita cexpeulas encrema ua auranmyperiien xopwox (SIADH) Hapymenna wa "Anopexci ‘Xinormuxems, Xuneprankevnx weraGonmma 1 mpacrasecks npn | Xunoramxemuana xpakienero awa6erins (mx. Towa | koma (ex. ToHKA 4.4) 44) Tremxneiin Hiicomima | Besnoxoilcrso | Tlewxorwamm peaxumn | TlemxoTwaan Mapytseris™ Ceetosnue wa — | (wanp. © peaxun coc oGepkawocr >amounnanAn, cxnomHocr 3a Hepauoct nrapasios) ‘camonapanseae, Tlenpecan skoNHTeTHO Busbyaa ‘Oya None HeoSuvakun coma Hom xouneapa 10Hapyiens na sepsuara cucrema* Taapobome Cueropsprex ‘ComHonenTHocT ‘Tpenop Tucreysna ‘Kousyncan (ox. Town 4.3 44.4) Tlapectesns Tlepacpepna censopa epponatas (ox. TowKa 4.4) Consomotopaa ‘nepudepua epponaras (wx. ‘oura 4.4) Tlapocuns, src. aHOCMHS Twcxsesna Exerpannpannit vapyinenm Areyaia Coxon Benurwena erpaxpannaasia ameprows Hapyarewas wa ounre* ‘Sparenu” napywienna, xaTO saMoreHO pene (sx. ToxKka 4.4) Tipexoawa saryba wa pene (je. romKa 44) Yaenr Hapywenia ia YyXOTO Ht ‘aaGupwerra® ‘Tannryc BaryGa wa enya Hapyurenna a onyxa ‘Cxpaeanu apynienma** Taxnxapana Tannaranan Kanepua ‘TaxHKapans, KoxTo Mowe 2a xoBeze 20 ‘eepneven apect Kamepa apwrans torsades de pointes (cooSuanane "Mpewnano np THaMWeHTH ¢ PHCKOBH ‘axropi 3a yabmxapane Ha QT urteppana) ‘Yaomxasane Ha QT wereppana ua EKT (ox. Town 4.4. 14.9) Cea0BH | wapymennat* ‘Xunotowna ‘Pecnuparopai, Tpbann Mennacranam | wapyuesus ucnues Bpouxocraxa Anepruvex nkesMonuT ‘Cromaunno- pewitn Hapymenis Tapus, Tlospunane Tanexe Boaxu 6 oGnacrra 4a xopema Tmenencus Onarysenuns Koxctunayus ‘Kepsaza anapaa, KOsTO B MHOrO peaKH ‘omy4an Mowe 2a Soe "XenatoOwmmap- | Tosmmena | Topumenn SKearennya w Texan aa wapymenus | crotinocra | crotiuocTa Ha epxopoGun a GuxupySuea 8 yapexains, epHioapo6- | xppsra BRmownTenHO caysan ute exaHMH va arama ocrpa (ALT/AST, epkoapo6ua amwama emocrarbAHoct, ‘docdatasa, IRpesuMo MpH GGT) aLWeHTH ¢ TEKH cometeTpaint SsaGonsmants (wx. ‘Towa 4.4) Xenarar. Hapymenna wa ‘O6pHB Tlexaperena peacix | Toxcusa xoxara 1 Tipypmrye Cc eosMHodunns 4 cenmnepmasiia nonkoxaiara Yprexapua cuctemim cmnromn | wexpomisa roxant® ‘Xunepxunposa | (DRESS) (nx. Cunapon na Stevens- ‘rouxa 4.4) Johnson ‘Ouxcupana Epurema sexaperaena epynuaa | mymrmbopme Peaxun a orouyecreuteaHoct (wx. to4Ka 4.4) Tlepxoumroxaactien Rackyaur Crowarur Hapymenna na “Apipanirus Cronin PaGnomnonasa MycKyaito- Muanras yapeanus (6x. Pyntypa na ‘exereriara ‘Tome 4.3 14.4), ann. | eyxoxnmns (Hamp. wa euctema 1 ‘renausura (amp. | AxwaeconoTo ‘cheamnMTemiaTa ‘TeNAMRT Ha ‘eyxoxnne) (x. ‘Toxan* ‘AxnutecosoTo romn 4.3 04.4) cyxoxnane) Pynrypa Ha surement ‘Myckyawa cna6oct, | Pyntypa Ha myckya xosro moxe tae ot | Aprpat ‘cnenwamio sHaveHHe Inpw manesrra Muacretma rpaanc (ex. T0¥Ka 4.4), Hapyuienn na Trosiienn ‘Ocrpa GrOpesa GnOpewrre crofiuocta Ha | egocrarssoct maxownre ‘cepymuts (nanp. nenegerane mera xpearnnin mirepetananeR nedput) ‘O6iH ‘Acreninx Tipexcit ‘Bonka (@xi. Gomka & Napyurens H oGnacrra ua rep6a, egexrit Ha repaute MacroTo Ka xpatiunusere) npanoxenne* * Asapunacrann 1 alagymeKTOWHN peaxtpTH NoHAKOTa Morar na Ce HADmMONaEAT ne, mspsata nose, Koxwo-amraswsnn peakunn MoHaKora Morar 7a ce HaGmOnaBaT caeA MpHEM Ha M5 2 ‘Nooo* CroGmapa ce 3a wioro peak cay¥aH Ha MPORBAWTENMHM (NO MEceUM WAH rOMMHLY), uARARANESHpANI M moTenyarHo HeoGpaTHMH CepHO3H sMEKAPCTBEHH PeaKIUNK, JACSTAIN HAKONIKO, NOHSKOTA MHOTO ‘cHicreMo-opraninn m7acone H ceTHpa (BKMONHTTEMO PeaKLUMH KATO TEHANHAT, PASKCBAHE Ha cyxouauie, aprpasris, Go.rka kpaliHHWHTe, HapyIeHHe Ha NOKOAKaTa, HeBpOnaTHN, CBEPSAHH c Tapectesita, empects, yMopa, HAapyIeHMe Ha NaMeTTa, HapyIICHHA Ha CbHR H YBpeAualle Ha CAyxA, SpenHeTo, BKyCa u OGoHAHMeTO) EBB BpBaka c yNOTpeGATa Ha XUHONOHK H ()MYOPOXHHOHIONM, B KOH Ccay'tal, HesaBH(cHMo OT Beve CpinecTByBamuTe puckoBM axropuH (Bx. TO¥Ka 4.4). ‘** Tipu naunewture, mpemauun dayopoxHHonOHH, ca CLOOUeHH cay¥aH Ha aHeBpHSMa M AACEKaM HO aoprara, nOwAKOra YeaOxieHH NopagH paakecpatie (BKIONHTENHO € NeTANeH MOXOA) H eryprirrants/Heqocrars4HOcT Ha HAKOM OT CBPAYHHTE KaaNH (wx. TONKA 4.4). Apyrn wexcenan sexapersen peaxun, caepsan ¢ ynorpeGara Ha XHHOTOHH: © mpacrsmn na nopdupaa mpa nanHeHTH ¢ ropdapns ‘CroStasane wa nogosupany HekenaMy peaxuin ‘CoSmasaneTo Ha nonosipaHH HEKCNaHH peaKIIHH cen paspelaBaHe sa yrlorpeGa Ha NexapcTaeHH Npoayxr e saxo. Topa nosB0K68 1a NpONDMKH HAGAONeHHETO Ha CLOTHOWIEHNCTO OT8/pHEK 9a JleKapCTBCHHA nponykt. OT MeaHIHCKHTe CeUWAMHCTH ce HSHCKBa Ja CROOuIaRaT BeAKA MOAOSHpAHA HexezaHa peaxuns apes Hsmuamurenia areuns no nekapctsara, ya. ,Jlamax Fpyen” Ne 8. 1303 Corpus, ‘Ten.: 02 8903417, yeGcalir: www.bda.bg. 4.9 Dpeaosupane ‘Toxcukonoruentite H KAHHMKO~papMaKOTOTHaHHTE HICACNBANHA MPH AMBOTHH, MPOBENCHH B ‘cynparepanestHunn 2osH, NoKasBar, He Hall-BAKHHTe MpHSHALU, KOHTO MOTAT 2a Ce ONAKBAT ces CCTPO MpenosHpave ¢ TesopnoKcanmy ca cHMMITOMH OT CTpaHa Ha MeHTpANHATa HepBHa CHCTEMA, KATO ‘OGepKaHOCT, SaMaliBaHe, HapyWEHHA B CBSHARMETO H KOHBYACHBHE TpYORe, YamIKABAHE Ha QT HHTepBaa, KAKTO Ht CHMMTOMH OT CTPawia Ha CTOMALIHO-HPeBHMA TPAKT, KATO TATEHE M EpOsI HA ‘cTOMaMUNaTa MHTaBHIa. B noctwapxeranrosua nepHon ca HaGmonasaHn peaxii or crpava Ha IHC: cectosaie Ha oepkanocr, XOHBYACHH, XAMOTUNNATINH H TPEMOP. Tipx npeaosupane, rpsGna 7a ce mposene cumnromarHsno zeverne, TlopaqH BEIMOKHOCT OT ‘yatuonxagane Ha QT myTepaara TpaGea 2a Gone sbsezex EKT MonuTopaer. 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AGcomorHaTa SHoKanHuHOcT € 99-100%. Tipwemst wa xpana oxa3na HesHayMTeseH ecbexT BHpxy Crenexta Ha pesopOusna Ha NeBodsoKcaunH. Steady-state ce noctura x0 48 waca crea mpanarane ra 500 mg enlloxpaTHo Wi NBYKDATHO. Pasmpenenenue Jlesopnoxcanum ce caypsea c naasMenaTe npoTesHH npHEAKsHTERHO B 30-40%. Caen emHOKpATHO ‘MHoroKpaTHo AosHpaHe wa 500 mg cpeanusr oGem Ha pasnpeneremne € 100 I, KOETO TOKASBA MIEPOKO Pasmpeenenue TenecHHTe TKAEH, TIponkpatie p TeKAHH M TemecHHTe Te4HOCTH: Jlesosnoxeayu neverpupa 8 GpouxHaHara Murasnua H GpoHxHATHNK CekpeT, B anBeonapHUTe Maxpodar, GexonpoSuara TeKaH, KoMaTa (TeuHOCTTa Ha KOAHHTE MExyp#.), MPOCTATHATa TEKAH 1 _ypauata. TIpormnsa 5 HesHaNMTesHa CTeneH B Lepe6pocrHuasHata TeHHOCT. Buorpanedopwannis Tlenodnoxcansn ce weraGomnsHpa B HesHaYNTeTHa CTeTeR No NesMeTHAT-nepodMOKCALHR newoppxoxcauy N-oxcua. Koantlecrnoro na metaGomiTTe € nO-MasIKO OT 5% OT AO3ATA, KORTO Ce ‘exexpeTnpa c ypiiaTa. 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