{"id":9349,"date":"2012-04-09T18:00:00","date_gmt":"2012-04-09T18:00:00","guid":{"rendered":""},"modified":"2021-09-28T05:38:18","modified_gmt":"2021-09-28T07:38:18","slug":"ambroksolio-hidrochloridas-kosulio-ir-skrepliavimo-gydymo-pasirinkimas","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/ambroksolio-hidrochloridas-kosulio-ir-skrepliavimo-gydymo-pasirinkimas\/9349\/","title":{"rendered":"Ambroksolio hidrochloridas \u2013 kosulio ir skrepliavimo gydymo pasirinkimas"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Dr. Saulius Sadauskas<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Kauno 2-oji klinikin\u0117 ligonin\u0117<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">Kosulys<\/a> ir gleivi\u0173 hipersekrecija \u2013 svarb\u016bs daugelio plau\u010di\u0173 lig\u0173 simptomai, turintys \u012ftakos sergamumui ir mirtingumui [1]. L\u0117tin\u0117 gleivi\u0173 sekrecija, sergant plau\u010di\u0173 infekcija, pvz., LOPL (<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/letine-obstrukcine-plauciu-liga\/4463\">l\u0117tin\u0117 obstrukcin\u0117 plau\u010di\u0173 liga<\/a>), yra svarbus mirtin\u0105 baigt\u012f prognozuojantis po\u017eymis (santykin\u0117 rizika padid\u0117ja 3,5 karto). Tai paskatino kurti vaistus, veikian\u010dius kv\u0117pavimo tak\u0173 gleivin\u0117se vykstan\u010dius procesus ir lengvinan\u010dius kosul\u012f bei skrepliavim\u0105. Vienas pasirenkam\u0173j\u0173 preparat\u0173 gal\u0117t\u0173 b\u016bti ambroksolio hidrochloridas (<i>Flavamed<\/i>), kurio teigiamos savyb\u0117s pagr\u012fstos klinikiniais tyrimais.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">Kosulys<\/a> ir gleivi\u0173 hipersekrecija<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">Kosulys<\/a> \u2013 refleksas, sukeliantis \u012fkv\u0117pim\u0105 ir staig\u0173 kv\u0117pavimo raumen\u0173 susitraukim\u0105, susiaurinant\u012f balso ply\u0161\u012f bei \u012feig\u0105 \u012f nos\u012f,kr\u016btin\u0117s l\u0105stos sienos vidinio sl\u0117gio padid\u0117jim\u0105 ir oro i\u0161siver\u017eim\u0105 pro susiaur\u0117jus\u012f balso ply\u0161\u012f. J\u012f sukelia gerkl\u0173, rykl\u0117s, stempl\u0117s, pleuros, i\u0161orin\u0117s klausomosios landos, nervini\u0173 centr\u0173 smegenyse dirginimas. Tai yra svarbus apsauginis mechanizmas, \u0161alinantis bronch\u0173 sekret\u0105 bei svetimk\u016bnius. Epizodi\u0161kai kosti apie 40 proc., o pastoviai \u2013 apie 10 proc. \u017emoni\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Da\u017eniausios patologin\u0117s kosulio prie\u017eastys:<\/span><\/i><\/p>\n<ul style=\"margin-top: 0cm;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">patologiniai vir\u0161utini\u0173 ir apatini\u0173 kv\u0117pavimo tak\u0173 procesai (kv\u0117pavimo tak\u0173 u\u017edegimas \u2013 svarbiausia kosulio ir skrepliavimo prie\u017eastis medicinin\u0117je praktikoje, pvz.: bronchitas, astma, rinitas, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/sinusitas\/4393\">sinusitas<\/a>, pneumonija);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">dirgikliai (pvz.: r\u016bkymas, dulk\u0117s, sausas oras);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">vir\u0161kinimo sistemos patologija (ypa\u010d gastroezofaginis refliuksas);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">pleuros lapeli\u0173 dirginimas (pvz.: pleuritai, uremija);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">kardiologin\u0117 patologija (pvz.: \u0161irdies nepakankamumas, ydos);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">vaistai (pvz.: AKF inhibitoriai, beta adrenoreceptori\u0173 blokatoriai);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">centrin\u0117s kilm\u0117s <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> (pa\u017eeidus kosulio reflekso smegen\u0173 centrus);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">psichogeninis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> (pripratimas kos\u0117ti, patologinio kosulio imitacija (pvz.: vaikams d\u0117mesio atkreipimo priemon\u0117, isterijos priepuolis)).<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Virus\u0173 sukeltas bronchitas da\u017eniausiai pasitaiko ikimokyklinio am\u017eiaus vaikams ir da\u017enai yra nuolatinio vaik\u0173 kosulio prie\u017eastis. Tiek vaikams, tiek suaugusiesiems <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> gali b\u016bti vienintelis gastroezofaginio refliukso simptomas. D\u0117l ausieskosulio reflekso kosul\u012f gali provokuoti svetimk\u016bniai, sieros kam\u0161\u010diai ausyse.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Atsikos\u0117jim\u0105 lengvinantys vaistai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Vaistai, lengvinantys kosul\u012f ir skrepliavim\u0105, pagal supaprastint\u0105 klasifikacij\u0105 klasifikuojami taip:<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Atsikos\u0117jim\u0105 lengvinantys vaistai (didina mucin\u0173 sekrecij\u0105, gleivi\u0173 i\u0161siskyrim\u0105):<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 ambroksolio hidrochloridas (pvz.: <i>Flavamed, Brontex<\/i>);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 guaifenezinas (pvz.: <i>Robitussin, Tussin<\/i>);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 bromheksinas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Mukolitikai (ma\u017eina gleivi\u0173 klampum\u0105):<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 N acetilcisteinas (pvz.: <i>ACC, Mucofluid<\/i>);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 karbocisteinas (pvz.: <i>Fluditec, Rhinathiol<\/i>);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 dorsanum alfa (pvz.: <i>Pulmozyme<\/i>).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Mukokinetikai (didina gleivi\u0173 mobilum\u0105):<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 beta 2 adrenoreceptoriai (pvz.: <i>Salbutamol<\/i>);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 surfaktantas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochlorido istorija<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Vienas labiausiai tyrin\u0117t\u0173 bei vartojam\u0173 medicinos praktikoje preparat\u0173 yra ambroksolio hidrochloridas. Jau prie\u0161 3 000 met\u0173 Indijoje, Indokinijoje (Ajurvedos medicina) kosuliui gydyti buvo gaminamos rie\u0161utini\u0173 justicij\u0173 lap\u0173 (alkaloidas vazicinas) sultys, ekstraktai. Apie 1960 metus i\u0161 vazicino buvo i\u0161skirtas bromheksinas, o v\u0117liau, ie\u0161kant dar geresnio preparato, buvo gautas ambroksolio hidrochloridas (a\u0161tuntasis veiklus bromheksino metabolitas, ambroksolio hidrochloridas (C13H18Br2N2O \u00d7 HCl, chemini\u0173 med\u017eiag\u0173 santrump\u0173 tarnybos registro (CAS) Nr. 23828-92-4) \u2013 pakeistasis benzilaminas, \u2013 yra veiklusis bromheksino hidrochlorido N-desmetilo metabolitas (2-amino-3,5-dibromo-N-metilbenzilamino chloridas), kuris yra sintetinis vazicino \u2013 i\u0161 <i>Adhatoha vasica <\/i>augal\u0173 r\u016b\u0161ies i\u0161gaunamo veiklaus komponento \u2013 darinys. Ambroksolio hidrochloridas skiriasi nuo bromheksino tuo, kad cikloheksilo \u017eiedo para-trans pad\u0117tyje metilo grup\u0117 yra pakeista hidroksilo grupe. Ambroksolio hidrochloridas, lyginant su vazicinu, yra dukart veiksmingesnis bei 20 kart\u0173 ma\u017eiau toksi\u0161kas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochlorido veikimo mechanizmai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Pagrindiniai ambroksolio hidrochlorido veikimo mechanizmai yra sekretolitinis (skatina ma\u017eo klampumo gleivi\u0173 gamyb\u0105) ir mukolitinis (ma\u017eina gleivi\u0173 klampum\u0105). Klinikiniais tyrimais buvo atrastos ir kitos medicinos praktikoje vertingos savyb\u0117s, kaip antai: sekretomotorinis (skatina mukociliarin\u012f klirens\u0105), antiadhezinis (normalizuoja surfaktant\u0105, slopina gleivi\u0173 sukibim\u0105 su gleivine), u\u017edegim\u0105 slopinantis, oksidacin\u012f stres\u0105 ma\u017einantis, analgezinis poveikiai, antibiotik\u0173 penetracijos \u012f plau\u010di\u0173 audinius gerinimas [2-4].<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochlorido sekretomotorinis, antiadhezinis poveikiai labai svarb\u016bs \u0161alinant gleives i\u0161 bronch\u0173, trukdant virus\u0173 plitimui (ma\u017eina infektyvum\u0105). Ma\u017eindamas \u012fvairi\u0173 u\u017edegimo \u017eymen\u0173 koncentracijas (pvz.: leukotrien\u0173, interleukin\u0173, tumoro nekroz\u0117s faktoriaus, citokin\u0173, lipopolisacharozi\u0173, elastaz\u0117s, mieloperoksidazi\u0173, laisv\u0173j\u0173 radikal\u0173), skatindamas surfaktanto, imunoglobulin\u0173 (IgA, IgG) gamyb\u0105 ir apsaugodamas alfa-1 antitripsin\u0105, ambroksolio hidrochloridas slopina u\u017edegim\u0105 ir kartu saugo plau\u010di\u0173 audinius nuo pa\u017eeidimo. Nustatyta, kad ambroksolio hidrochloridas turi vietin\u012f nuskausminam\u0105j\u012f poveik\u012f (veikimas grind\u017eiamas Na kanal\u0173 blokavimu neuronuose) rykl\u0117je, gerkl\u0117je, trach\u0117joje. Itin teigiama papildoma ambroksolio hidrochlorido savyb\u0117 \u2013 jis gerina pagrindini\u0173<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">bronchitui gydyti vartojam\u0173 antibiotik\u0173 (pvz.: amoksicilino, eritromicino, cefuroksimo) patekim\u0105 \u012f plau\u010dius, taip u\u017etikrindamas j\u0173 klinikin\u012f poveik\u012f (3 pav.). Ambroksolio hidrochlorido preparatai kai kuriems pacientams suma\u017eino bronch\u0173 reaktyvum\u0105. Remiantis AMETHIST tyrimu, ambroksolio hidrochloridas 25 proc. suma\u017eino LOPL pa\u016bm\u0117jim\u0173 per metus skai\u010di\u0173 sergantiesiems sunkesne ligos forma.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochlorido saugumas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Klinikiniai tyrimai su ambroksolio hidrochloridu atliekami nuo 1973 met\u0173. Vaisto saugumas pagr\u012fstas apie 100 klinikini\u0173 tyrim\u0173 rezultatais (apie 15 000 pacient\u0173). Periodin\u0117 Saugumo ataskaita remiasi beveik 5 mln. pacient\u0173 patirtimi. Pripa\u017einta, kad ambroksolio hidrochloridas \u2013 saugus ir gerai toleruojamas preparatas, retai sukeliantis \u0161alutini\u0173 poveiki\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Reti nepageidaujami rei\u0161kiniai <\/span><\/i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">(0,1 proc. iki &lt; 1 proc.):<\/span><\/p>\n<ul style=\"margin-top: 0cm;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l4 level1 lfo2; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">padid\u0117jusio jautrumo reakcijos (odos b\u0117rimas, veido paburkimas, nie\u017eulys);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l4 level1 lfo2; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">kar\u0161\u010diavimas;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l4 level1 lfo2; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">pykinimas ar v\u0117mimas;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l4 level1 lfo2; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">pilvo skausmas.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Labai reti \u0161alutiniai rei\u0161kiniai <\/span><\/i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">(&lt; 0,001 proc.):<\/span><\/p>\n<ul style=\"margin-top: 0cm;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l4 level1 lfo2; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">anafilaksin\u0117s reakcijos;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l4 level1 lfo2; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">sunkios odos reakcijos.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochloridas ir kiti preparatai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Lyginant su bromheksinu, ambroksolio hidrochloridas pasi\u017eymi:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">geresniu bioprieinamumu (67 proc. vs. 20 proc.);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">ilgesniu pusin\u0117s eliminacijos laiku;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">geresniu metabolizmu (metabolitai neaktyv\u016bs, o bromheksino yra ir aktyvi\u0173 metabolit\u0173);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l3 level1 lfo3; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">labiau ma\u017eina laisv\u0173j\u0173 radikal\u0173 kiek\u012f audiniuose.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Lyginant su acetilcisteinu, ambroksolio hidrochloridas taip pat turi prana\u0161um\u0173:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">geresnis bioprieinamumas (acetilcisteinas intensyviau metabolizuojamas \u017earnyne);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">ilgesnis pusin\u0117s eliminacijos laikas;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">greitesn\u0117 veikimo prad\u017eia;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">geresn\u0117 s\u0105veika su antibiotikais (acetilcisteinas, atvirk\u0161\u010diai, gali pabloginti antibiotik\u0173 veikim\u0105);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">acetilcisteinas gali sukelti bronchospazm\u0105 (atsargiai skirti alergi\u0161kiems pacientams), ilginti nitrat\u0173 veikim\u0105 (atsargiai skirti sergant i\u0161emine \u0161irdies liga), ma\u017einti trombocit\u0173 agregacij\u0105 (galimas <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kraujavimas\/43826\">kraujavimas<\/a>), sukelti \u0117duon\u012f (d\u0117l sud\u0117tyje esan\u010dios sacharoz\u0117s), pa\u016bminti opalig\u0117s eig\u0105 (ardo disulfidines jungtis, esan\u010dias skrand\u017eio apsaugin\u0117se gleiv\u0117se);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l0 level1 lfo4; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">ambroksolio hidrochloridas turi daugiau (anks\u010diau min\u0117t\u0173) papildom\u0173 teigiam\u0173 savybi\u0173.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u012evair\u016bs vartojami augaliniai preparatai (pvz.: gebeni\u0173, \u010diobreli\u0173, mirtolio, sud\u0117tini\u0173 \u017eolini\u0173 preparat\u0173) neturi ai\u0161ki\u0173 moksliniais tyrimais paremt\u0173 efektyvumo \u012frodym\u0173 arba jie nepakankami.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Juos vartojant b\u016bna pana\u0161us, lyginant su ambroksolio hidrochloridu, \u0161alutini\u0173 rei\u0161kini\u0173 da\u017enis, be to, n\u0117ra ai\u0161kus j\u0173 papildomas poveikis.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochlorido vartojimo aspektai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Pagrindiniai praktiniai ambroksolio hidrochlorido vartojimo aspektai:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\" type=\"disc\">\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">atsargiai vartoti esant sunkiam inkst\u0173, kepen\u0173 pa\u017eeidimui;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">atsiradus alergijos simptomams, nedelsiant nutraukti vaisto vartojim\u0105;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">gydymo efektyvumo kontrol\u0117 po 4\u20135 dien\u0173;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">alergi\u0161kiems pacientams rekomenduojamos tablet\u0117s;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">neslopinti kosulio reflekso \u2013 neskirti tuo pa\u010diu metu kosul\u012f lengvinan\u010di\u0173 ir slopinan\u010di\u0173 preparat\u0173;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">jei vartoja antibiotikus \u2013 geriau ambroksolio hidrochloridas;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">jei vartoja nvnu (nesteroidinius vaistus nuo u\u017edegimo) \u2013 geriau ambroksolio hidrochloridas (ma\u017eiau pavojaus skrand\u017eio dirginimui);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">sergant astma \u2013 saugiau rinktis ambroksolio hidrochlorid\u0105 (acetilcisteinas gali sukelti bronchospazm\u0105);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo5; tab-stops: list 36.0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">sergant opalige \u2013 saugiau rinktis ambroksolio hidrochlorid\u0105 (ma\u017eiau dirginama skrand\u017eio gleivin\u0117 (disulfidin\u0117s jungtys, kurias ardo acetilcisteinas, yra ir apsaugin\u0117se skrand\u017eio gleiv\u0117se).<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><b><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Ambroksolio hidrochlorido preparatai<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Vienas ambroksolio hidrochlorido preparat\u0173 yra <i>Flavamed<\/i>, gaminamas ir \u0161nyp\u0161\u010diam\u0173j\u0173 table\u010di\u0173 formos, kuri\u0173 gali b\u016bti skiriama tik 2 kartus per dien\u0105 (did\u017eiausia doz\u0117 120 mg\/d.).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Flavamed <\/span><\/i><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">vartojimo rekomendacijos:<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tablet\u0117s (po 30 mg):<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 ma\u017eos: patogu nuryti (nekramtant, po valgio);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 be konservant\u0173: tinka alergi\u0161kiems<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 vaikams;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 tinka sergantiesiems cukriniu diabetu;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 pirm\u0105sias 2\u20133 d. vartoti po 1\/2 tab. (6\u201312 m.) 3 k.\/d., v\u0117liau 2 k.\/d.;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 pirm\u0105sias 2\u20133 d. vartoti po 1 tab. (&gt; 12 m.) 3 k.\/d., v\u0117liau 2 k.\/d.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Tirpstan\u010diosios tablet\u0117s (po 60 mg):<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 skanios (vy\u0161ni\u0173 skonio);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 kartu suvartojamas papildomas kiekis skys\u010di\u0173, tai ypa\u010d svarbu per\u0161alus, taip pat vaikams;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 &gt; 12 m. vartoti po 1\/2 tab. 3 k.\/d., v\u0117liau 2 k.\/d. po valgio (did\u017eiausia doz\u0117 suaugusiesiems 120 mg\/d.).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">Sirupas (po 30 mg\/5 ml \u2013 100 ml):<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 skanus (avie\u010di\u0173 skonio);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 neturi laktoz\u0117s;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u2022 &gt; 12 m. vartoti po 1 \u0161auk\u0161t\u0105 3 k.\/d., v\u0117liau 2 k.\/d. po valgio (did\u017eiausia doz\u0117 suaugusiesiems 120 mg\/d.).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; margin: 0cm 0cm 0pt;\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT;\">\u017durnalas \u201eFarmacija ir laikas\u201c<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p style=\"text-align: justify; margin: 0cm 0cm 0pt; mso-layout-grid-align: none\" class=\"MsoNormal\"><span style=\"font-family: Arial; font-size: 10pt; mso-ansi-language: LT; mso-fareast-language: LT\">Kosulys ir gleivi\u0173 hipersekrecija &ndash; svarb\u016bs daugelio plau\u010di\u0173 lig\u0173 simptomai, turintys \u012ftakos sergamumui ir mirtingumui [1]. L\u0117tin\u0117 gleivi\u0173 sekrecija, sergant plau\u010di\u0173 infekcija, pvz., LOPL (l\u0117tin\u0117 obstrukcin\u0117 plau\u010di\u0173 liga), yra svarbus mirtin\u0105 baigt\u012f prognozuojantis po\u017eymis (santykin\u0117 rizika padid\u0117ja 3,5 karto). Tai paskatino kurti vaistus, veikian\u010dius kv\u0117pavimo tak\u0173 gleivin\u0117se vykstan\u010dius procesus ir lengvinan\u010dius kosul\u012f bei skrepliavim\u0105. Vienas pasirenkam\u0173j\u0173 preparat\u0173 gal\u0117t\u0173 b\u016bti ambroksolio hidrochloridas (<i>Flavamed<\/i>), kurio teigiamos savyb\u0117s pagr\u012fstos klinikiniais tyrimais.<o:p><\/o:p><\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[2916,96,3276,2917,797,3274,3275,517,3273,259,125,110,64,138],"site":[],"post_item_type":[27345],"class_list":["post-9349","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-acetilcisteinas","tag-alergijos","tag-alergiskiems-pacientams","tag-bromheksinas","tag-eliminacijos","tag-gleivese","tag-hidrochlorido-preparatai","tag-kosulys","tag-metabolitas","tag-preparatai","tag-rukymas","tag-sergantiesiems","tag-tabletes","tag-vaistai"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/9349","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=9349"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/9349\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=9349"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=9349"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=9349"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=9349"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=9349"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}