{"id":10314,"date":"2020-04-23T05:02:45","date_gmt":"2020-04-23T02:02:45","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/gabapentin\/"},"modified":"2025-02-10T15:32:37","modified_gmt":"2025-02-10T13:32:37","slug":"gabapentin","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/gabapentin\/","title":{"rendered":"\u0413\u0430\u0431\u0430\u043f\u0435\u043d\u0442\u0438\u043d"},"content":{"rendered":"<p><span style=\"font-size: medium;\"><strong><em>Informatii generale si recomandari pentru testare<\/em><\/strong><\/span><\/p>\n<p><span style=\"font-size: medium;\">In practica medicala curenta este recunoscuta din ce in ce mai mult importanta determinarii periodice a nivelului in sange al multora din medicamentele administrate, fie datorita potentialului crescut de reactii adverse, fie compliantei reduse a pacientilor.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Monitorizarea terapeutica a unui medicament (Therapeutic Drug Monitoring, TDM) are drept scop mentinerea concentratiei acestuia in <strong>intervalul terapeutic<\/strong>, definit ca acel interval de valori ale nivelului in ser, plasma sau sange integral in care medicamentul respectiv isi exercita efectele clinice cu reactii adverse minime pentru majoritatea pacientilor.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Conceptul de TDM se refera astfel la masurarea concentratiei medicamentelor pentru a optimiza si adapta tratamentul la nivel individual (terapie personalizata). Pentru realizarea acestei tinte terapeutice este important sa se cunoasca pentru medicamentele administrate date legate de:<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">-<span style=\"text-decoration: underline;\">farmacocinetica<\/span>: studiaza efectele medicamentului asupra organismului (relatia doza-efect);<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">-<span style=\"text-decoration: underline;\">farmacodinamica<\/span>: studiaza efectele organismului asupra medicamentelor (absorbtie, distributie etc);<strong><em>\u00a0<\/em><\/strong><\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">-<span style=\"text-decoration: underline;\">farmacogenetica<\/span>: studiaza modelul genetic al metabolizarii medicamentelor luand in considerare variatiile individuale.<strong><em>\u00a0<\/em><\/strong><\/span><\/p>\n<p><span style=\"font-size: medium;\">Pentru a obtine rezultate pentru concentratiile medicamentoase cu utilitate clinica este important ca proba sa fie recoltata in asa numita <strong>\u201esteady state\u201d<\/strong> (stare de echilibru) in care rata de medicament ce patrunde in organism este egala cu cea eliminata. Atunci cand o doza fixa de medicament este administrata la intervale de timp regulate, acesta se va acumula in organism in cursul fazei de absorbtie pana este atinsa starea de echilibru; perioada de timp necesara pentru a se ajunge la <em>steady state<\/em> depinde de\u00a0 <strong>timpul de injumatatire al medicamentului (T<sub>1\/2<\/sub>)<\/strong>, adica timpul in care concentratia medicamentului in sange se reduce la jumatate. La randul sau T<sub>1\/2 <\/sub>depinde de rata de metabolizare si excretie. In conditiile unei distributii rapide si uniforme a medicamentului in organism (cinetica de ordinul I), precum si in absenta unei doze de incarcare, este nevoie de un interval de timp echivalent cu cel putin 5 T<sub>1\/2<\/sub>\u00a0 pentru a obtine <em>steady state<\/em> (<em>vezi fig. 20.3.1<\/em>)<sup>1;2;4<\/sup>.<\/span><span style=\"font-size: medium;\">\u00a0<a title=\"\" href=\"\/wp-content\/uploads\/2009\/08\/mediacam1.jpg\" rel=\"wpdevart_lightbox lightbox-gallery-ojB3fcTe\" data-=\"\" data-rl_title=\"\" data-rl_caption=\"\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/mediacam1.jpg\" alt=\"-\" width=\"497\" height=\"298\"><\/a><\/span><\/p>\n<p><a class=\"shutterset_9502 cboxElement\" title=\"\u0413\u0430\u0431\u0430\u043f\u0435\u043d\u0442\u0438\u043d\" href=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2009\/08\/mediacam1.jpg\" rel=\"wpdevart_lightbox lightbox[9502] nofollow noopener\" data-rel=\"lightbox-gallery-zoJGF0jU\" data-rl_title=\"\" data-rl_caption=\"\" target=\"_blank\"><img decoding=\"async\" src=\"\/wp-content\/uploads\/2009\/08\/mediacam1.jpg\" alt=\"-\" width=\"497\" height=\"298\"><\/a><\/p>\n<p><span style=\"font-size: small;\">Fig 20.3.1 Obtinerea <strong>\u201e<\/strong>steady state<strong>\u201d<\/strong><\/span><\/p>\n<p><span style=\"font-size: medium;\">Acest proces poate fi rezumat astfel:<\/span><\/p>\n<p><span style=\"font-size: medium;\">\u00a0\u00a0 k<\/span><\/p>\n<p><span style=\"font-size: medium;\">D\u2192E\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 D = concentratia medicamentului\u00a0 E = forma excretata a medicamentului<\/span><\/p>\n<p><span style=\"font-size: medium;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 k = constanta de disparitie a lui D<\/span><\/p>\n<p><span style=\"font-size: medium;\">\u0423<sub>1\/2<\/sub> = 0.693\/k<\/span><\/p>\n<p><span style=\"font-size: medium;\">Asa cum reiese din ecuatie, T<sub>1\/2 <\/sub>este o constanta<sub> \u00a0<\/sub>si nu depinde de concentratia medicamentului. Daca T<sub>1\/2 <\/sub>este cunoscut se poate calcula modul de impartire a dozelor si intervalul de timp la care trebuie administrate pentru a se atinge nivelul terapeutic.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Totusi, unele medicamente sunt metabolizate printr-un alt tip de cinetica decat cea de ordinul I, suferind mai intai o metabolizare in ficat, urmata de o distributie multicompartimentala in organism (medicamentul are o anumita rata de distributie plasmatica\u00a0 si o rata diferita de distributie tisulara). In aceste cazuri timpul necesar pentru a atinge <em>steady state <\/em>poate sa fie diferit de echivalentul a 5 T<sub>1\/2<\/sub> .<\/span><\/p>\n<p><span style=\"font-size: medium;\">Cu exceptia urgentelor medicale, in cazurile in care se modifica dozele administrate si se adauga sau se scot medicamente asociate, se va astepta obtinerea unei noi stari de echilibru inainte de recoltarea probei pentru monitorizarea terapeutica. Intr-un mod similar, se va astepta aceeasi perioada de timp pana cand un medicament aflat in <em>steady state <\/em>se va elimina din organism la intreruperea administrarii<sup>2<\/sup>.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Odata atinsa starea de echilibru probele de sange pot fi recoltate in doua momente diferite:<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">-in momentul nivelului maxim (<em>peak samples<\/em>): la 2-3 ore dupa administrarea unei doze orale, la 30-60 minute dupa o doza administrata intravenos, la 2-4 ore dupa o doza administrata intramuscular sau la 1-1 si \u00bd ore dupa o doza administrata intranazal;<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">-in momentul nivelului minim (<em>trough samples<\/em>): imediat inaintea administrarii urmatoarei doze; acest moment este recomandat in majoritatea cazurilor.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Monitorizarea terapeutica a medicamentelor este indicata in special in urmatoarele situatii:<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 perturbarea relatiei doza-efect;<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 esec in obtinerea efectului terapeutic sau suspectarea unei intoxicatii;<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 efect imposibil sau foarte greu de confirmat clinic (de exemplu in cazul imunosupresoarelor);<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 interval terapeutic ingust (de exemplu in cazul glicozidelor);<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 complianta redusa a pacientilor (persoane varstnice sau cu boli psihice);<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 prezenta unor afectiuni care afecteaza absorbtia, distributia, metabolizarea si excretia medicamentelor;<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 administrarea simultana de medicamente care prezinta aceeasi cale de eliminare;<\/span><\/p>\n<p style=\"padding-left: 30px;\"><span style=\"font-size: medium;\">\u2022 copii si persoane varstnice la care este afectat volumul de distributie: redus in cazul varstnicilor si crescut la copii.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Clasele de medicamente pentru care se recomanda in mod special TDM sunt urmatoarele:<\/span><\/p>\n<ul>\n<li><span style=\"font-size: medium;\">glicozide cardiace: digoxin. digitoxin;<\/span><\/li>\n<li><span style=\"font-size: medium;\">antiaritmice:\u00a0 amiodarona, flecainida, procainamida, chinidina;<\/span><\/li>\n<li><span style=\"font-size: medium;\">antiastmatice: teofilina;<\/span><\/li>\n<li><span style=\"font-size: medium;\">antibiotice: aminoglicozide, vancomicina;<\/span><\/li>\n<li><span style=\"font-size: medium;\">antivirale: medicamentele pentru infectia HIV, ganciclovir;<\/span><\/li>\n<li><span style=\"font-size: medium;\">anticonvulsivante: fenobarbital, carbamazepin, fenitoin, acid valproic, gabapentin, primidona, lamotrigin;<\/span><\/li>\n<li><span style=\"font-size: medium;\">medicamente psihotrope: litiu, antidepresive triciclice, neuroleptice;<\/span><\/li>\n<li><span style=\"font-size: medium;\">imunosupresoare: ciclosporina, tacrolimus, sirolimus, everolimus, acid micofenolic, azatioprina;<\/span><\/li>\n<li><span style=\"font-size: medium;\">citostatice: methotrexat<sup>1;2<\/sup>.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-size: medium;\">In tabelul de mai jos sunt precizate pentru anumite medicamente T<sub>1\/2<\/sub>, intervalul de timp necesar pentru a se ajunge la <em>steady state<\/em>, tipul de proba pentru TDM si stabilitatea acesteia, intervalul terapeutic<sup>1;4<\/sup>:<\/span><\/p>\n<table class=\"wp-block-table w-100\" border=\"1\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>MEDICAMENT<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>\u0423<sub>1\/2<\/sub><\/strong><strong>\u00a0<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>T pana la steady state<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>Tip proba<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>Stabilitate proba<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>Metoda de determinare<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>Interval terapeutic<\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0414\u0438\u0433\u043e\u043a\u0441\u0438\u043d<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">36-48 h<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7-10 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">ECLIA<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">0.9-2 ng\/mL<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Amiodarona<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">26-107 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Nu se aplica<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">0.5-2 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Flecainida<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">12-27 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3-6 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">0.2-0.8 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Teofilina<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">7-11 ore (adult);\u00a0\u00a0<\/span><span style=\"font-size: medium;\">1-8 ore (copil)<\/span><\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">15-55 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5-40 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">&lt; 1 an:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5-10 mg\/L<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u2265 1 an:\u00a0\u00a0\u00a0<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-20 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0412\u0430\u043d\u043a\u043e\u043c\u0438\u0446\u0438\u043d<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3-8 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">1-2 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">FPIA<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5 \u2013 10 \u00b5g\/mL<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u00a0<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Carbamazepin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">14-47 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-19 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7-12 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-4 zile (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">4-10 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><a title=\"\u0412\u0430\u043b\u044c\u043f\u0440\u043e\u0435\u0432\u0430\u044f \u043a\u0438\u0441\u043b\u043e\u0442\u0430\" href=\"\/ru\/acid-valproic\/\">\u0412\u0430\u043b\u044c\u043f\u0440\u043e\u0435\u0432\u0430\u044f \u043a\u0438\u0441\u043b\u043e\u0442\u0430<\/a><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">9-16 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7-13 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-4 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-4 zile (copil)<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"54\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">7 zile la 2-8\u00b0C<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">CEDIA<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">50-100 mg\/L<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0422\u043e\u043f\u0438\u0440\u0430\u043c\u0430\u0442<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">19-23 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">1-10 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Etosuximid<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">50-60 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">30 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-12 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">6-10 zile (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">40-100 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><a title=\"\u0424\u0435\u043d\u043e\u0431\u0430\u0440\u0431\u0438\u0442\u0430\u043b\" href=\"\/ru\/fenobarbital\/\">\u0424\u0435\u043d\u043e\u0431\u0430\u0440\u0431\u0438\u0442\u0430\u043b<\/a><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">81-117 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">40-70 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">17-24 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-15 zile (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">10-40 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0424\u0435\u043d\u0438\u0442\u043e\u0438\u043d<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">18-22 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7-29 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">4-8 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-5 zile (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">&lt;14 ani:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">10-20 mg\/L<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">&gt;14 ani:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">6-14 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>\u0413\u0430\u0431\u0430\u043f\u0435\u043d\u0442\u0438\u043d<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>5-7 ore (adult);<\/strong><\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>4-6 ore (copil)<\/strong><\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>1-2 zile (adult);<\/strong><\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><strong>1-2 zile (copil)<\/strong><\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"54\"><span style=\"font-size: medium;\"><strong>\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/strong><\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\"><strong>7 zile <\/strong><strong>la 2-8\u00b0C<\/strong><\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\"><strong>HPLC<\/strong><\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\"><strong>2 \u2013 10 \u00b5g\/mL<\/strong><\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u041b\u0430\u043c\u043e\u0442\u0440\u0438\u0434\u0436\u0438\u043d<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">15-30 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">30 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3-10 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3-10 zile (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">&lt;14 ani:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5-15 mg\/L<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">&gt;14 ani:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">1-5 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u041f\u0440\u0438\u043c\u0438\u0434\u043e\u043d<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3-7 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">4-6 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">16-60 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">20-30 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">HPLC<\/span><\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5-15 mg\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Amitriptilina<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-51 ore<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">2-6 zile<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"54\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">50-300 \u00b5g\/L<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u041b\u0438\u0442\u0438\u0439<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">14-30 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-7 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\"><em>8 ore<\/em> la temperatura camerei; <em>24 ore<\/em> la 2-8\u00b0C; <em>6 luni<\/em> la -18\u00b0C.<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">ISE<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Mania acuta: 0.6-1.2 mmol\/L.<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u2022 Protectie impotriva viitoarelor episoade la pacientii cu afectiune bipolara: 0.8-1.0 mmol\/L.<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u2022 Depresie: 0.5- 1.5 mmol\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Clomipramin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">12-36 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">3 saptamani<\/span><\/td>\n<td valign=\"top\" width=\"54\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">90-250 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Clozapina<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">4-66 ore<\/span><\/td>\n<td valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">Nu se aplica<\/span><\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/td>\n<td valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">350-600 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Olanzapin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">21-54 ore (adult \u226465 ani);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">32-81 ore (adult &gt;65 ani)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u00a0la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">\u00a010-80 \u00b5g\/L<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Doxepin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-25 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2.5-5 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">20-150 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Imipramin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">6-20 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-5 zile<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"54\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">45-150 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Maprotilin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">36-105 ore<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">14 zile<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">7 zile la 2-8\u00b0C<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">125-200 \u00b5g\/L<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Trimipramin<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">16-39 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Nu se aplica<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">150-350 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Haloperidol<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">41-41 ore (lactat);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">14-28 zile (decanoat)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3-9 zile (lactat);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">nu se aplica<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">7 zile\u00a0la 2-8\u00b0C<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">5-16 \u00b5g\/L<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Risperidon<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">3 ore (fast metabolizer risperidon); 21 ore (fast metabolizer9-hidroxi-risperidon); 20 ore (slow metabolizer risperidon); 30 ore (slow metabolizer 9-hidroxi-risperidon);<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">1 zi (fast metabolizer risperidon); 5-6 zile\u00a0 (fast metabolizer9-hidroxi-risperidon); 5 zile (slow metabolizer risperidon); nu se aplica (slow metabolizer 9-hidroxi-risperidon).<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">7 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la 2-8\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">10-120 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Ciclosporina A<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">6-27 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-6 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Sange EDTA<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"96\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la -20\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Intervalul terapeutic variaza in functie de tipul transplantului si perioada de timp de la transplant.<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Pentru afectiuni dermatologice si reumatologice:&lt;100 \u00b5g\/L<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Pentru sindrom nefrotic: 60-160 \u00b5g\/L.<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Tacrolimus<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">4-35 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">4-12 ore (copil)<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">2-6 zile (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u00a0<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">nu se aplica la copil<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Sange EDTA<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">5 zile<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">la -20\u00b0C<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u2013 in primele 2 luni de la transplant:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">15-20 \u00b5g\/L<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u2013 dupa\u00a02 luni de la transplant:<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-15 \u00b5g\/L<\/span><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u0438\u0440\u043e\u043b\u0438\u043c\u0443\u0441 \u0432 \u043a\u0440\u043e\u0432\u0438<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">46-78 ore<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">5-7 zile<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Sange EDTA<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">5 zile la -20\u00b0C<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">LC-MS\/MS<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">4-20 \u00b5g\/L<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Acid micofenolic<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">8-18 ore (adult);<\/span><\/p>\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">variabil la copil<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Nu se aplica<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">7 zile la 2-8\u00b0C<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">HPLC<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">1-3.5 \u00b5g\/mL<\/span><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"103\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Methotrexat<\/span><\/p>\n<\/td>\n<td valign=\"top\" width=\"84\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">Cinetica bifazica<\/span><\/p>\n<\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"84\"><span style=\"font-size: medium;\">-<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"54\">\n<p style=\"text-align: center;\"><span style=\"font-size: medium;\">\u0421\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0430<\/span><\/p>\n<p><span style=\"font-size: medium;\">\u00a0<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"96\"><span style=\"font-size: medium;\">7 zile la 2-8\u00b0C protejat de lumina<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"66\"><span style=\"font-size: medium;\">FPIA<\/span><\/td>\n<td style=\"text-align: center;\" valign=\"top\" width=\"103\"><span style=\"font-size: medium;\">Se asociaza cu un risc crescut de toxicitate:- valorile &gt; 5-10\u00a0 \u00b5mol\/L la 24 h de la admistrare;- valorile &gt; 0.5-1\u00a0 \u00b5mol\/L la 48 h de la administrare;- valorile &gt; 0.2\u00a0 \u00b5mol\/L la 72 h de la administrare.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"font-size: medium;\">ECLIA = metoda imunochimica cu detectie prin chemiluminiscenta<\/span><\/p>\n<p><span style=\"font-size: medium;\">HPLC = cromatografie de lichide sub inalta presiune<\/span><\/p>\n<p><span style=\"font-size: medium;\">LC-MS\/MS = cromatografie de lichide cuplata cu spectrometrie de masa<\/span><\/p>\n<p><span style=\"font-size: medium;\">FPIA = fluorescent polarization immunoassay (metoda imunochimica cu detectie prin fluorescenta polarizata)<\/span><\/p>\n<p><span style=\"font-size: medium;\">CEDIA = cloned enzyme donor immunoassay (metoda imunoenzimatica care utilizeaza tehnologia ADN-ului recombinant)<\/span><\/p>\n<p><span style=\"font-size: medium;\">ISE = ion selective electrode (metoda potentiometrica)<\/span><\/p>\n<p><span style=\"font-size: medium;\"><strong><span style=\"text-decoration: underline;\">Anticonvulsivante<\/span><\/strong><\/span><\/p>\n<p><span style=\"font-size: medium;\">Sunt medicamente utile in tratamentul epilepsiei, in special pentru crizele <em>grand mal<\/em>, <em>petit mal<\/em>, psihomotorii, precum si in unele afectiuni cum ar fi <em>tic douloureux<\/em> (nevralgia de trigemen). Desi mecanismul de actiune al acestor medicamente nu a fost elucidat, se pare ca toate, posibil cu exceptia fenobarbitalului, blocheaza influxul de sodiu in neuronii a caror membrana este afectata. In plus, unele medicamente si in special fenitoinul blocheaza de asemenea influxul secundar de calciu in aceste celule. Fenobarbitalul si, posibil, fenitoinul stabilizaeaza membrana neuronilor afectati.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Multe din anticonvulsivante exercita efect asupra convulsiilor <em>grand mal<\/em>, insa sunt ineficace asupra celor de tip <em>petit mal<\/em>. Doar etosuximidul si acidul valproic au un efect terpeutic in aceste conditii.<\/span><\/p>\n<p><span style=\"font-size: medium;\">In concluzie, desi mecanismul de actiune al anticonvulsivantelor pare sa fie similar, acestea difera in ceea ce priveste specificitatea<sup>2<\/sup>.<\/span><\/p>\n<p><span style=\"font-size: medium;\"><strong>\u0413\u0430\u0431\u0430\u043f\u0435\u043d\u0442\u0438\u043d<\/strong><\/span><\/p>\n<p><span style=\"font-size: medium;\">Este un medicament antiepileptic utilizat in tratamentul convulsiilor, neuropatiilor, precum si al altor afectiuni neurologice si psihice. Desi este considerat un analog de acid gama-amino butiric (GABA), gabapentin nu se leaga de receptorii GABA si nici nu afecteaza captarea neuronala sau continutul de GABA; mecanismul sau de actiune nu este cunoscut.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Gabapentin circula in principal nelegat de proteinele plasmatice. Spre deosebire de majoritatea medicamentelor antiepileptice nu este metabolizat hepatic, fiind eliminat renal aproape in intregime. Timpul de injumatatire este de 5-7 ore la adultii cu functie renala normala.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Datorita acestor particularitati, gabapentinul nu prezinta interactiuni farmacocinetice cu alte antiepileptice.<\/span><\/p>\n<p><span style=\"font-size: medium;\">Reactiile adverse sunt rare \u2013 somnolenta, ameteala, ataxie, astenie\u00a0 \u2013 si se remit de obicei in timp<sup>3<\/sup><\/span>.<\/p>\n<p><span style=\"font-size: small;\">\u00a0<\/span><\/p>\n<p><span style=\"font-size: small;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/p>\n<p><span style=\"font-size: small;\">1. Laborator Synevo. Referinte specifice tehnologiei de lucru utilizate. 2010. Ref Type: Catalog.<\/span><\/p>\n<p><span style=\"font-size: small;\">2. Matthew R. Pincus, Naif Z. Abraham. Toxicology and Therapeutic Drug Monitoring. In Henry\u2019s Clinical Diagnosis and Management by Laboratory Methods, Saunders-Elsevier, 21st Edition, 2007, 308-320.<\/span><\/p>\n<p><span style=\"font-size: small;\">3.\u00a0\u00a0Mayo Clinic\/Mayo Medical LaboratoriesTest Catalogs and Guides. Gabapentin, Serum. www.mayomedicallaboratories.com. Ref Type: Internet Communication.<\/span><\/p>\n<p><span style=\"font-size: small;\">4. Quest Diagnostics. Therapeutic Drug Monitoring. Drug Half-Life, Steady State, and Recommended Sample Collection Time. www.questdiagnostics.com. Ref Type: Internet Communication.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>\u0413\u0430\u0431\u0430\u043f\u0435\u043d\u0442\u0438\u043d \u2013 \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u044d\u043f\u0438\u043b\u0435\u043f\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442, \u043a\u043e\u0442\u043e\u0440\u044b\u0439 \u043f\u0440\u0438\u043c\u0435\u043d\u044f\u044e\u0442 \u0432 \u043b\u0435\u0447\u0435\u043d\u0438\u0438 \u0441\u0443\u0434\u043e\u0440\u043e\u0433, \u043d\u0435\u0439\u0440\u043e\u043f\u0430\u0442\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u0431\u043e\u043b\u0435\u0439. \u041f\u043e \u0441\u0442\u0440\u0443\u043a\u0442\u0443\u0440\u0435 \u044d\u0442\u043e \u0445\u0438\u043c\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0430\u043d\u0430\u043b\u043e\u0433 \u0413\u0410\u041c\u041a, \u043a\u043e\u0442\u043e\u0440\u044b\u0439, \u043e\u0434\u043d\u0430\u043a\u043e, \u043d\u0435 \u0432\u0437\u0430\u0438\u043c\u043e\u0434\u0435\u0439\u0441\u0442\u0432\u0443\u0435\u0442 \u043f\u0440\u044f\u043c\u043e \u0441 \u0413\u0410\u041c\u041a-\u0440\u0435\u0446\u0435\u043f\u0442\u043e\u0440\u0430\u043c\u0438 \u0438 \u043d\u0435 \u0432\u043b\u0438\u044f\u0435\u0442 \u043d\u0430 \u043d\u0435\u0439\u0440\u043e\u043d\u0430\u043b\u044c\u043d\u044b\u0439 \u0437\u0430\u0445\u0432\u0430\u0442 \u0438\u043b\u0438 \u0434\u0435\u0433\u0440\u0430\u0434\u0430\u0446\u0438\u044e \u0413\u0410\u041c\u041a. \u0422\u043e\u0447\u043d\u044b\u0439 \u043c\u0435\u0445\u0430\u043d\u0438\u0437\u043c \u0434\u0435\u0439\u0441\u0442\u0432\u0438\u044f \u0433\u0430\u0431\u0430\u043f\u0435\u043d\u0442\u0438\u043d\u0430 \u0434\u043e \u043a\u043e\u043d\u0446\u0430 \u043d\u0435 \u0438\u0437\u0443\u0447\u0435\u043d, \u043f\u0440\u0435\u0434\u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u043e, \u0441\u0432\u044f\u0437\u0430\u043d \u0441 \u0435\u0433\u043e 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