Pharmaceutical Technology I Lecture 4: Elixirs PDF

Made with Xodo PDF Reader and Editor Pharmaceutical Technology I Department of pharmaceutics Lecture no. 4 Elixirs Prepared by MSC.Teeba F.Abdulkareem  Made with Xodo PDF Reader and Editor  Elixirs are clear, sweetened hydroalcoholic solutions(5-40% v\v) intended for...

Made with Xodo PDF Reader and Editor Pharmaceutical Technology I Department of pharmaceutics Lecture no. 4 Elixirs Prepared by MSC.Teeba F.Abdulkareem  Made with Xodo PDF Reader and Editor  Elixirs are clear, sweetened hydroalcoholic solutions(5-40% v\v) intended for oral use and are usually flavored to enhance their palatability.  Compared with syrups, elixirs are usually less sweet and less viscous because they contain a lower proportion of sugar and consequently are less effective than syrups in masking the taste of medicinal substances.  However, because of their hydroalcoholic character, elixirs are better able than aqueous syrups to maintain both water-soluble and alcohol-soluble components in solution.  Also, because of their stable characteristics and the ease with which they are prepared (by simple solution), from a manufacturing standpoint, elixirs are preferred to syrups.  Made with Xodo PDF Reader and Editor  Each elixir requires a specific blend of alcohol and water to maintain all of the components in solution.  Naturally, for elixirs containing agents with poor water solubility, the proportion of alcohol required is greater than for elixirs prepared from components having good water solubility.  In addition to alcohol and water, other solvents, such as glycerin and propylene glycol, are frequently employed in elixirs as adjunctive solvents.  Although many elixirs are sweetened with sucrose or with a sucrose syrup, some use sorbitol, glycerin, and/or artificial sweeteners.  Elixirs having a high alcoholic content usually use an artificial sweetener, such as saccharin, which is required only in small amounts, rather than sucrose, which is only slightly soluble in alcohol and requires greater quantities for equivalent sweetness.  ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫اﻹﻛﺴﻴﺮ‪ :‬ﺷﺮح ﻣﻔﺼﻞ‬ ‫اﻹﻛﺴﻴﺮ ﻋﺒﺎرة ﻋﻦ ﻣﺤﺎﻟﻴﻞ ﻛﺤﻮﻟﻴﺔ ﻣﺎﺋﻴﺔ ﺻﺎﻓﻴﺔ ﻣﺤﻼة ﺗﺤﺘﻮي ﻋﻠﻰ ﻧﺴﺒﺔ ﺗﺘﺮاوح ﺑﻴﻦ ‪ % 5‬إﻟﻰ ‪ % 40‬ﻣﻦ اﻟﻜﺤﻮل ﺑﺎﻟﺤﺠﻢ ) ﺣﺠﻢ ‪ /‬ﺣﺠﻢ(‪.‬وﻫﻲ ﻣﺨﺼﺼﺔ ﻟﻺﻋﻄﺎء ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﻢ وﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺘﻢ ﻧﻜﻬﺘﻬﺎ ﻟﺘﻌﺰﻳﺰ ﻣﺬاﻗﻬﺎ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻠﻬﺎ أﺳﻬﻞ ﻓﻲ اﻻﺳﺘﻬﻼك‪ُ.‬ﺗﺴﺘﺨﺪم اﻹﻛﺴﻴﺮ ﻓﻲ اﻟﻤﻘﺎم اﻷول ﻛﻤﺮﻛﺒﺎت ﻹﻋﻄﺎء اﻟﻤﻮاد اﻟﻄﺒﻴﺔ اﻟﺘﻲ ﻗﺪ ﺗﻜﻮن ذات ﻗﺎﺑﻠﻴﺔ ﺿﻌﻴﻔﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪.‬‬ ‫اﻟﻤﻘﺎرﻧﺔ ﺑﺎﻟﺸﺮاب‬ ‫ﻣﻘﺎرﻧﺔ ﺑﺎﻟﺸﺮاب‪ ،‬ﺗﻜﻮن اﻹﻛﺴﻴﺮ أﻗﻞ ﺣﻼوة وأﻗﻞ ﻟﺰوﺟﺔ ﺑﺸﻜﻞ ﻋﺎم‪.‬ﺗﺘﻜﻮن اﻟﺸﺮاب ﻋﺎد ًة ﻣﻦ ﻧﺴﺒﺔ أﻋﻠﻰ ﻣﻦ اﻟﺴﻜﺮ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻠﻬﺎ أﻛﺜﺮ ﻓﻌﺎﻟﻴﺔ ﻓﻲ إﺧﻔﺎء اﻟﻄﻌﻢ ﻏﻴﺮ اﻟﺴﺎر ﻟﻠﻤﻜﻮﻧﺎت اﻟﻄﺒﻴﺔ اﻟﻨﺸﻄﺔ‪.‬ﻋﻠﻰ اﻟﻨﻘﻴﺾ ﻣﻦ ذﻟﻚ‪ ،‬ﺗﺤﺘﻮي اﻹﻛﺴﻴﺮ ﻋﻠﻰ ﻧﺴﺒﺔ ﺳﻜﺮ أﻗﻞ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻠﻬﺎ أﺧﻒ ﻓﻲ اﻟﻄﻌﻢ واﻟﻤﻠﻤﺲ‪.‬وﻣﻊ ذﻟﻚ‪ ،‬ﻋﻠﻰ اﻟﺮﻏﻢ ﻣﻦ ﻛﻮﻧﻬﺎ أﻗﻞ ﻓﻌﺎﻟﻴﺔ ﻓﻲ إﺧﻔﺎء اﻟﻄﻌﻢ‪ ،‬ﻓﺈن اﻹﻛﺴﻴﺮ ﻣﻔﻀﻞ ﻋﻨﺪﻣﺎ ﺗﺘﻄﻠﺐ‬ ‫اﻟﺘﺮﻛﻴﺒﺔ إذاﺑﺔ اﻟﻤﻜﻮﻧﺎت اﻟﻘﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء واﻟﻜﺤﻮل‪.‬ﺗﺴﻤﺢ اﻟﻄﺒﻴﻌﺔ اﻟﻜﺤﻮﻟﻴﺔ اﻟﻤﺎﺋﻴﺔ ﻟﻺﻛﺴﻴﺮ ﻟﻬﺎ ﺑﺤﻤﻞ ﻫﺬه اﻟﻤﻜﻮﻧﺎت ﻓﻲ اﻟﻤﺤﻠﻮل ﺑﺸﻜﻞ أﻓﻀﻞ ﻣﻦ اﻟﺸﺮاب اﻟﻤﺎﺋﻲ‪.‬‬ ‫اﻟﺬوﺑﺎن وﻣﺤﺘﻮى اﻟﻜﺤﻮل‬ ‫ﺗﺘﻤﺜﻞ إﺣﺪى اﻟﻤﺰاﻳﺎ اﻷﺳﺎﺳﻴﺔ ﻟﻠﻤﺴﺘﺤﻀﺮات اﻟﻄﺒﻴﺔ ﻓﻲ ﻗﺪرﺗﻬﺎ ﻋﻠﻰ اﻻﺣﺘﻔﺎظ ﺑﺎﻟﻤﻮاد اﻟﻘﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء واﻟﻜﺤﻮل ﻋﻠﻰ ﺣﺪ ﺳﻮاء‪.‬وﻫﺬه اﻟﺨﺎﺻﻴﺔ ﻣﻬﻤﺔ ﺑﺸﻜﻞ ﺧﺎص ﻋﻨﺪﻣﺎ ﺗﻜﻮن اﻟﻤﻜﻮﻧﺎت اﻟﻨﺸﻄﺔ ﻓﻲ ﺗﺮﻛﻴﺒﺔ ﻃﺒﻴﺔ ﺿﻌﻴﻔﺔ اﻟﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪.‬وﻳﺘﻢ ﺗﺤﺪﻳﺪ ﻛﻤﻴﺔ اﻟﻜﺤﻮل ﻓﻲ اﻟﻤﺴﺘﺤﻀﺮات اﻟﻄﺒﻴﺔ ﻣﻦ ﺧﻼل ﻗﺎﺑﻠﻴﺔ ذوﺑﺎن اﻟﻤﻜﻮﻧﺎت اﻟﻤﺸﺎرﻛﺔ‪.‬وﻋﻨﺪﻣﺎ ﺗﻜﻮن اﻟﻤﺎدة اﻟﻨﺸﻄﺔ ﺿﻌﻴﻔﺔ اﻟﺬوﺑﺎن‬ ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫ﻓﻲ اﻟﻤﺎء‪ ،‬ﻳﻠﺰم وﺟﻮد ﻧﺴﺒﺔ أﻋﻠﻰ ﻣﻦ اﻟﻜﺤﻮل ﻟﻀﻤﺎن اﺳﺘﻘﺮار اﻟﻤﺤﻠﻮل‪.‬وﻋﻠﻰ اﻟﻌﻜﺲ ﻣﻦ ذﻟﻚ‪ ،‬إذا ﻛﺎﻧﺖ اﻟﻤﻜﻮﻧﺎت ﺗﺘﻤﺘﻊ ﺑﻘﺎﺑﻠﻴﺔ ﺟﻴﺪة ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪ ،‬ﻓﻴﻤﻜﻦ ﺗﻘﻠﻴﻞ ﻣﺤﺘﻮى اﻟﻜﺤﻮل‪.‬‬ ‫اﺳﺘﺨﺪام اﻟﻤﺬﻳﺒﺎت اﻹﺿﺎﻓﻴﺔ‬ ‫ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ اﻟﻜﺤﻮل واﻟﻤﺎء‪ ،‬ﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺘﻢ إﺿﺎﻓﺔ ﻣﺬﻳﺒﺎت أﺧﺮى إﻟﻰ اﻟﻤﺴﺘﺤﻀﺮات اﻟﻄﺒﻴﺔ ﻟﺘﺤﺴﻴﻦ ﺧﺼﺎﺋﺺ ذوﺑﺎﻧﻬﺎ‪.‬وﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺘﻢ اﺳﺘﺨﺪام ﻣﺬﻳﺒﺎت ﻣﺜﻞ اﻟﺠﻠﺴﺮﻳﻦ واﻟﺒﺮوﺑﻴﻠﻴﻦ ﺟﻠﻴﻜﻮل ﻛﻤﺬﻳﺒﺎت إﺿﺎﻓﻴﺔ‪.‬ﺗﻌﻤﻞ ﻫﺬه اﻟﻤﺬﻳﺒﺎت ﻋﻠﻰ ﺗﻌﺰﻳﺰ ﻗﺎﺑﻠﻴﺔ ذوﺑﺎن ﻣﻜﻮﻧﺎت ﻣﻌﻴﻨﺔ‪ ،‬وﺿﻤﺎن اﻻﺳﺘﻘﺮار‪ ،‬وﻗﺪ ﺗﺴﺎﻫﻢ ً‬ ‫أﻳﻀﺎ ﻓﻲ اﻟﺤﻼوة اﻟﻌﺎﻣﺔ ﻟﻠﻤﻨﺘﺞ‪.‬‬ ‫اﻟﻤُ ﺤﻠﻴﺎت ﻓﻲ اﻹﻛﺴﻴﺮ‬ ‫ﻋﺎد ًة ﻣﺎ ﻳﺘﻢ ﺗﺤﻠﻴﺔ اﻹﻛﺴﻴﺮ ﻟﺘﺤﺴﻴﻦ ﻣﺬاﻗﻪ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻠﻪ أﻛﺜﺮ ﻗﺒﻮ ﻻً ﻟﺪى اﻟﻤﺮﺿﻰ‪.‬ﻳﺘﻢ ﺗﺤﻠﻴﺔ اﻟﻌﺪﻳﺪ ﻣﻦ اﻹﻛﺴﻴﺮ ﺑﺎﺳﺘﺨﺪام اﻟﺴﻜﺮوز أو ﺷﺮاب اﻟﺴﻜﺮوز‪ ،‬وﻫﻤﺎ ﻣﻦ ﻋﻮاﻣﻞ اﻟﺘﺤﻠﻴﺔ اﻟﺸﺎﺋﻌﺔ‪.‬وﻣﻊ ذﻟﻚ‪ ،‬ﺗﺴﺘﺨﺪم ﺑﻌﺾ اﻹﻛﺴﻴﺮ ﻣُ ﺤﻠﻴﺎت ﺑﺪﻳﻠﺔ ﻣﺜﻞ اﻟﺴﻮرﺑﻴﺘﻮل أو اﻟﺠﻠﺴﺮﻳﻦ أو اﻟﻤُ ﺤﻠﻴﺎت اﻟﺼﻨﺎﻋﻴﺔ‪.‬ﻋﻨﺪﻣﺎ ﻳﻜﻮن ﻣﺤﺘﻮى اﻟﻜﺤﻮل ﻓﻲ اﻹﻛﺴﻴﺮ ﻣﺮﺗﻔﻌًﺎ ﺑﺸﻜﻞ ﺧﺎص‪ ،‬ﻳﺘﻢ ﺗﻔﻀﻴﻞ اﻟﻤُ ﺤﻠﻴﺎت اﻟﺼﻨﺎﻋﻴﺔ ﻣﺜﻞ‬ ‫ﻼ ﻓﻲ اﻟﻜﺤﻮل‪ ،‬ﻛﻤﻴﺔ أﻛﺒﺮ ﻟﺘﺤﻘﻴﻖ ﻧﻔﺲ اﻟﺤﻼوة‪.‬‬‫اﻟﺴﻜﺮﻳﻦ‪.‬اﻟﺴﻜﺮﻳﻦ ﻓﻌﺎل ﻟﻠﻐﺎﻳﺔ ﻓﻲ اﻟﺘﺤﻠﻴﺔ ﺑﻜﻤﻴﺎت ﺻﻐﻴﺮة‪ ،‬ﺑﻴﻨﻤﺎ ﻳﺘﻄﻠﺐ اﻟﺴﻜﺮوز‪ ،‬اﻟﺬي ﻳﺬوب ﻗﻠﻴ ً‬ ‫ﻣﺰاﻳﺎ اﻹﻛﺴﻴﺮ ﻓﻲ اﻟﺘﺼﻨﻴﻊ‬ ‫ﻧﻈﺮا ﻟﺘﺮﻛﻴﺒﺘﻬﺎ اﻟﻜﺤﻮﻟﻴﺔ اﻟﻤﺎﺋﻴﺔ اﻟﻤﺘﻮازﻧﺔ‪ ،‬ﻳﻤﻜﻦ أن ﺗﺪﻋﻢ اﻹﻛﺴﻴﺮات إذاﺑﺔ‬ ‫أﺧﻴﺮا‪ً ،‬‬ ‫ً‬ ‫ﻛﻴﻤﻴﺎﺋﻴﺎ ﻣﻦ اﻟﺸﺮاب اﻟﻤﺎﺋﻲ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻠﻬﺎ ﺧﻴﺎ ًرا أﻛﺜﺮ ﻣﻼءﻣﺔ ﻟﻠﺘﺨﺰﻳﻦ ﻃﻮﻳﻞ اﻷﻣﺪ وﺟﻮدة اﻟﻤﻨﺘﺞ اﻟﺜﺎﺑﺘﺔ‪.‬‬ ‫ً‬ ‫ﻣﻦ وﺟﻬﺔ ﻧﻈﺮ اﻟﺘﺼﻨﻴﻊ‪ ،‬ﻳُﻔﻀﻞ اﻹﻛﺴﻴﺮ ﻋﻠﻰ اﻟﺸﺮاب ﻟﻌﺪة أﺳﺒﺎب‪.‬أو ﻻً‪ ،‬ﻣﻦ اﻟﺴﻬﻞ ﺗﺤﻀﻴﺮ اﻹﻛﺴﻴﺮ ﻷﻧﻪ ﻳﺘﻄﻠﺐ ﻓﻘﻂ إذاﺑﺔ ﺑﺴﻴﻄﺔ ﻟﻠﻤﻜﻮﻧﺎت‪.‬ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ذﻟﻚ‪ ،‬ﺗﻤﻴﻞ اﻹﻛﺴﻴﺮ إﻟﻰ أن ﺗﻜﻮن أﻛﺜﺮ اﺳﺘﻘﺮا ًرا‬ ‫ﻣﺠﻤﻮﻋﺔ أوﺳﻊ ﻣﻦ اﻟﻤﻜﻮﻧﺎت اﻟﻄﺒﻴﺔ‪ ،‬ﻣﻤﺎ ﻳﻘﻠﻞ ﻣﻦ اﻟﺤﺎﺟﺔ إﻟﻰ ﺗﺮﻛﻴﺒﺎت ﻣﻌﻘﺪة‪.‬‬ ‫ﻼ ﻣﺘﻌﺪد اﻻﺳﺘﺨﺪاﻣﺎت ﻟﻺﻋﻄﺎء ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﻢ ﻟﻠﻤﻮاد اﻟﻄﺒﻴﺔ‪ ،‬وﺧﺎﺻﺔ ﻋﻨﺪﻣﺎ ﺗﻜﻮن اﻟﻤﻜﻮﻧﺎت اﻟﻨﺸﻄﺔ ﺿﻌﻴﻔﺔ اﻟﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪.‬ﻃﺒﻴﻌﺘﻬﺎ اﻟﻤﺴﺘﻘﺮة واﻟﻤﺤﻼة واﻟﻤﻨﻜﻬﺔ ﺗﺠﻌﻠﻬﺎ وﻇﻴﻔﻴﺔ وﻟﺬﻳﺬة‪ ،‬ﻓﻲ ﺣﻴﻦ ﺗﻮﻓﺮ ﺳﻬﻮﻟﺔ ﺗﺼﻨﻴﻌﻬﺎ ﻣﺰاﻳﺎ ﻛﺒﻴﺮة ﻣﻘﺎرﻧﺔ ﺑﺄﺷﻜﺎل اﻟﺠﺮﻋﺎت اﻟﺴﺎﺋﻠﺔ اﻷﺧﺮى ﻣﺜﻞ اﻟﺸﺮاب‪.‬‬ ‫وﻓﻲ اﻟﺨﺘﺎم‪ ،‬ﺗﻮﻓﺮ اﻹﻛﺴﻴﺮات ﺣ ً‬ ‫‪.1‬دﻣﺞ ﻣﺮﻛﺒﺎت دواﺋﻴﺔ ﻏﻴﺮ ﻗﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن‪ :‬ﻳﻤﻜﻦ ﻟﻺﻛﺴﻴﺮ إذاﺑﺔ اﻷدوﻳﺔ اﻟﻘﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء واﻟﻜﺤﻮل‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻠﻬﺎ ﻣﻨﺎﺳﺒﺔ ﻟﻸدوﻳﺔ اﻟﺘﻲ ﻻ ﺗﺬوب ﻓﻲ اﻟﻤﺎء‪.‬‬ ‫‪.2‬ﺗﺮﻛﻴﺒﺎت اﻷدوﻳﺔ اﻟﻤﺮﻛﺰة‪ :‬ﻳﻤﻜﻦ ﻟﻺﻛﺴﻴﺮ ﻋﺎﻟﻲ اﻟﻜﺤﻮل أن ﻳﺤﺘﻮي ﻋﻠﻰ ﻣﺤﺎﻟﻴﻞ دواﺋﻴﺔ ﻣﺮﻛﺰة‪ ،‬ﻣﻤﺎ ﻳﺘﻴﺢ ﺗﺮﻛﻴﺒﺎت أﻛﺜﺮ ﻗﻮة‪.‬‬ ‫‪.3‬اﻟﺤﻔﺎظ ﻋﻠﻰ اﻟﺬات‪ :‬ﺗﺘﻤﺘﻊ اﻟﻘﺎﻋﺪة اﻟﻜﺤﻮﻟﻴﺔ اﻟﻤﺎﺋﻴﺔ ﺑﺨﺼﺎﺋﺺ ﺣﺎﻓﻈﺔ‪ ،‬ﻣﻤﺎ ﻳﻘﻠﻞ ﻣﻦ اﻟﺤﺎﺟﺔ إﻟﻰ ﻣﻮاد ﺣﺎﻓﻈﺔ إﺿﺎﻓﻴﺔ‪.‬‬ ‫وﺳﻜﺮا ﻣﻘﺎرﻧﺔ ﺑﺎﻟﺸﺮاب‪ ،‬ﻣﻤﺎ ﻗﺪ ﻳﺠﻌﻠﻪ أﺳﻬﻞ ﻓﻲ اﻟﺒﻠﻊ‪.‬‬ ‫ً‬ ‫‪.4‬اﻟﻠﺰوﺟﺔ اﻟﻤﻨﺨﻔﻀﺔ وﻣﺤﺘﻮى اﻟﺴﻜﺮ‪ :‬اﻹﻛﺴﻴﺮ أﻗﻞ ﺳﻤﻜًﺎ‬ ‫ﻋﻴﻮب اﻹﻛﺴﻴﺮ‪:‬‬ ‫‪.1‬ﻏﻴﺮ ﻣﻨﺎﺳﺐ ﻟﺠﻤﻴﻊ اﻟﻤﺮﺿﻰ‪ :‬ﻳُﻤﻨﻊ اﺳﺘﺨﺪام اﻹﻛﺴﻴﺮ اﻟﺬي ﻳﺤﺘﻮي ﻋﻠﻰ ﻧﺴﺒﺔ ﻋﺎﻟﻴﺔ ﻣﻦ اﻟﻜﺤﻮل ﻟﻠﻤﺮﺿﻰ اﻷﻃﻔﺎل وأوﻟﺌﻚ اﻟﺬﻳﻦ ﻳﺘﻨﺎوﻟﻮن أدوﻳﺔ ﻣﺜﻞ ﻣﻀﺎدات اﻻﻛﺘﺌﺎب‪ ،‬ﺑﺴﺒﺐ اﻟﺘﻔﺎﻋﻼت اﻟﻤﺤﺘﻤﻠﺔ‪.‬‬ ‫‪.2‬ﻋﺪم اﺳﺘﻘﺮار اﻟﻤﻜﻮﻧﺎت‪ :‬إذا ﻟﻢ ﻳﺘﻢ ﺗﺨﺰﻳﻨﻬﺎ ﺑﺸﻜﻞ ﺻﺤﻴﺢ )ﻓﻲ أﻣﺎﻛﻦ ﺑﺎردة(‪ ،‬ﻓﻘﺪ ﻳﺘﻘﻠﺐ ﺗﺮﻛﻴﺰ اﻟﻤﻜﻮﻧﺎت اﻟﻨﺸﻄﺔ وﻏﻴﺮ اﻟﻨﺸﻄﺔ‪ ،‬ﻣﻤﺎ ﻳﺆدي إﻟﻰ اﻧﺨﻔﺎض اﻟﻔﻌﺎﻟﻴﺔ‪.‬‬ ‫‪.3‬ﺧﻄﺮ اﻟﺘﺮﺳﻴﺐ‪ :‬ﻗﺪ ﻳﺆدي ﺗﺒﺨﺮ اﻟﻜﺤﻮل ﺑﻤﺮور اﻟﻮﻗﺖ إﻟﻰ ﺗﺮﺳﺐ اﻷدوﻳﺔ ﻏﻴﺮ اﻟﻘﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪ ،‬ﻣﻤﺎ ﻳﻌﺮض اﺳﺘﻘﺮار اﻹﻛﺴﻴﺮ وﻓﻌﺎﻟﻴﺘﻪ ﻟﻠﺨﻄﺮ‪.‬‬  Made with Xodo PDF Reader and Editor Advantages Disadvantages Insoluble drug compounds can be incorporated into They cannot be administered to pediatric patients the hydroalcoholic vehicle. and patients on antidepressant medication. Drug concentrates can be prepared in high-alcohol- The concentration of active and inactive ingredients containing elixirs. may vary if not preserved in cool places. Hydroalcoholic vehicles can be self-preserving. Water-insoluble drug compounds may precipitate They are less viscous and contain a lower due to alcohol evaporation. proportion of sugar.  Made with Xodo PDF Reader and Editor  All elixirs contain flavorings to increase their palatability, and most elixirs have coloring agents to enhance their appearance.  For most elixirs, one or two teaspoonfuls (5 or10 mL) provides the usual adult dose of the drug.  Because of their usual content of volatile oils and alcohol, elixirs should be stored in tight, light-resistant containers and protected from excessive heat.  Elixirs can be :  Nonmedicated Elixirs.  Medicated Elixirs.  Made with Xodo PDF Reader and Editor ‫اﻟﺘﻌﺒﺌﺔ اﻟﻤﺮﺗﺠﻠﺔ ﻟﻠﻮﺻﻔﺎت اﻟﻄﺒﻴﺔ اﻟﺘﻲ ﺗﻨﻄﻮي ﻋﻠﻰ‬  Nonmedicated elixirs may be useful to the pharmacist in the extemporaneous filling of prescriptions involving: a. The addition of a therapeutic agent to a pleasant-tasting vehicle. b. Dilution of an existing medicated elixir.  In selecting a liquid vehicle for a drug substance, the pharmacist should be concerned with the solubility and stability of the drug substance in water and alcohol.  If a hydroalcoholic vehicle is selected, the proportion of alcohol should be only slightly above the amount needed to effect and maintain the drug’s solution.  When a pharmacist is called on to dilute an existing medicated  elixir, the nonmedicated elixir which is selected as the diluent should have approximately the same alcoholic concentration as the elixir being diluted.  The three most commonly used nonmedicated elixirs were aromatic elixir, compound benzaldehyde elixir, and isoalcoholic elixir.  Made with Xodo PDF Reader and Editor  Medicated elixirs are employed for the therapeutic benefit of the medicinal agent.  Most official and commercial elixirs contain a single therapeutic agent.  The main advantage of having only a single therapeutic agent is that the dosage of that single drug may be increased or decreased by simply taking more or less of the elixir, whereas when two or more therapeutic agents are present in the same preparation, it is impossible to increase or decrease the dose of one without an automatic and corresponding adjustment in the dose of the other, which may not be desired.  For patients required to take more than a single medication, many physicians prefer them to take separate preparations of each drug so that if an adjustment in the dosage of one is desired, it may be accomplished without the concomitant adjustment of the other. ‫ ﻓﻴﻤﻜﻦ ﺗﺤﻘﻴﻖ ذﻟﻚ دون اﻟﺘﻌﺪﻳﻞ اﻟﻤﺼﺎﺣﺐ ﻟﻠﺪواء اﻵﺧﺮ‬،‫ ﻳﻔﻀﻞ اﻟﻌﺪﻳﺪ ﻣﻦ اﻷﻃﺒﺎء ﺗﻨﺎول ﻣﺴﺘﺤﻀﺮات ﻣﻨﻔﺼﻠﺔ ﻟﻜﻞ دواء ﺑﺤﻴﺚ إذا رﻏﺒﻮا ﻓﻲ ﺗﻌﺪﻳﻞ ﺟﺮﻋﺔ أﺣﺪ اﻷدوﻳﺔ‬،‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﻤﺮﺿﻰ اﻟﺬﻳﻦ ﻳﺤﺘﺎﺟﻮن إﻟﻰ ﺗﻨﺎول أﻛﺜﺮ ﻣﻦ دواء واﺣﺪ‬  ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫اﻹﻛﺴﻴﺮ ﻋﺒﺎرة ﻋﻦ ﻣﺴﺘﺤﻀﺮات ﺳﺎﺋﻠﺔ ﺗﺆﺧﺬ ﻋﻦ ﻃﺮﻳﻖ اﻟﻔﻢ وﺗﺤﺘﻮي ﻋﻠﻰ ﻧﻜﻬﺎت ﻟﺘﺤﺴﻴﻦ اﻟﻤﺬاق وﻏﺎﻟ ًﺒﺎ ﻣﻮاد ﺗﻠﻮﻳﻦ ﻟﺘﺤﺴﻴﻦ اﻟﻤﻈﻬﺮ‪.‬اﻟﺠﺮﻋﺔ اﻟﻨﻤﻮذﺟﻴﺔ ﻟﻠﺒﺎﻟﻐﻴﻦ ﻫﻲ ﻣﻦ ‪ 5‬إﻟﻰ ‪ 10‬ﻣﻞ‪ ،‬أو ﻣﻠﻌﻘﺔ ﺻﻐﻴﺮة إﻟﻰ ﻣﻠﻌﻘﺘﻴﻦ ﺻﻐﻴﺮﺗﻴﻦ‪.‬وﻷن اﻹﻛﺴﻴﺮ ﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺤﺘﻮي ﻋﻠﻰ‬ ‫زﻳﻮت ﻣﺘﻄﺎﻳﺮة وﻛﺤﻮل‪ ،‬ﻓﻴﺠﺐ ﺗﺨﺰﻳﻨﻪ ﻓﻲ ﺣﺎوﻳﺎت ﻣﺤﻜﻤﺔ اﻟﻐﻠﻖ وﻣﻘﺎوﻣﺔ ﻟﻠﻀﻮء وﻣﺤﻤﻴﺔ ﻣﻦ اﻟﺤﺮارة‪.‬‬ ‫اﻹﻛﺴﻴﺮ ﻳﺄﺗﻲ ﻓﻲ ﺷﻜﻠﻴﻦ‪:‬‬ ‫‪ 1‬اﻹﻛﺴﻴﺮ ﻏﻴﺮ اﻟﺪواﺋﻲ ﻋﺒﺎرة ﻋﻦ ﻗﻮاﻋﺪ ﺳﺎﺋﻠﺔ ﻻ ﺗﺤﺘﻮي ﻋﻠﻰ أي ﻣﻜﻮﻧﺎت ﻃﺒﻴﺔ ﻓﻌﺎﻟﺔ‪.‬ﻳﺴﺘﺨﺪم اﻟﺼﻴﺎدﻟﺔ ﻫﺬه ﻹﻋﺪاد وﺻﻔﺎت ﻃﺒﻴﺔ ﻣﺨﺼﺼﺔ )ﻣﺮﺗﺠﻠﺔ(‪.‬وﻫﻲ ﻣﻔﻴﺪة ﺑﻄﺮﻳﻘﺘﻴﻦ رﺋﻴﺴﻴﺘﻴﻦ‪:‬‬ ‫دواء ﻻ ﻃﻌﻢ ﻟﻪ ﺟﻴﺪً ا‪ ،‬ﻳﻤﻜﻦ ﻟﻠﺼﻴﺪﻟﻲ ﻣﺰﺟﻪ ﺑﺈﻛﺴﻴﺮ ﻏﻴﺮ دواﺋﻲ‪ ،‬واﻟﺬي ﻳﻜﻮن ﻣﺬاﻗﻪ أﻓﻀﻞ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻞ اﻟﺪواء أﺳﻬﻞ ﻋﻠﻰ اﻟﻤﺮﻳﺾ ﺗﻨﺎوﻟﻪ‪.‬‬ ‫ً‬ ‫‪.1‬إﺿﺎﻓﺔ دواء إﻟﻰ ﺳﺎﺋﻞ ذي ﻣﺬاق ﻟﻄﻴﻒ‪ :‬إذا وﺻﻒ اﻟﻄﺒﻴﺐ‬ ‫‪.2‬ﺗﺨﻔﻴﻒ إﻛﺴﻴﺮ دواﺋﻲ ﻣﻮﺟﻮد‪ :‬ﻓﻲ ﺑﻌﺾ اﻷﺣﻴﺎن ﻗﺪ ﻳﺤﺘﺎج اﻟﻤﺮﻳﺾ إﻟﻰ ﻧﺴﺨﺔ أﺿﻌﻒ ﻣﻦ اﻹﻛﺴﻴﺮ ) ﺳﺎﺋﻞ دواﺋﻲ(‪.‬ﻓﻲ ﻣﺜﻞ ﻫﺬه اﻟﺤﺎﻻت‪ ،‬ﻳﻤﻜﻦ ﻟﻠﺼﻴﺪﻟﻲ ﺗﺨﻔﻴﻒ اﻹﻛﺴﻴﺮ اﻟﺪواﺋﻲ ﺑﺎﺳﺘﺨﺪام إﻛﺴﻴﺮ ﻏﻴﺮ دواﺋﻲ‪.‬‬ ‫اﻋﺘﺒﺎرات رﺋﻴﺴﻴﺔ ﻟﻠﺼﻴﺎدﻟﺔ‪:‬‬ ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫ﻋﻨﺪ اﺧﺘﻴﺎر ﺳﺎﺋﻞ )إﻛﺴﻴﺮ ﻏﻴﺮ ﻃﺒﻲ( ﻟﺨﻠﻄﻪ ﻣﻊ ﻋﻘﺎر‪ ،‬ﻳﺤﺘﺎج اﻟﺼﻴﺪﻟﻲ إﻟﻰ اﻟﺘﺄﻛﺪ ﻣﻦ أن اﻟﻌﻘﺎر ﻳﻤﻜﻦ أن ﻳﺬوب ﺟﻴﺪً ا ﻓﻲ ﻛﻞ ﻣﻦ اﻟﻤﺎء واﻟﻜﺤﻮل ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻻﺳﺘﻘﺮار‪.‬‬ ‫إذا ﻛﺎن اﻟﻤﺤﻠﻮل اﻟﻤﺨﺘﺎر ﻳﺤﺘﻮي ﻋﻠﻰ ﻛﻞ ﻣﻦ اﻟﻤﺎء واﻟﻜﺤﻮل )ﻛﺤﻮل ﻣﺎﺋﻲ(‪ ،‬ﻓﻴﺠﺐ أن ﺗﻜﻮن ﻛﻤﻴﺔ اﻟﻜﺤﻮل ﻛﺎﻓﻴﺔ ﻓﻘﻂ ﻹﺑﻘﺎء اﻟﻌﻘﺎر ﻣﺬا ﺑًﺎ‪ ،‬وﻟﻜﻦ ﻟﻴﺲ ﺑﺸﻜﻞ ﻣﻔﺮط‪.‬‬ ‫ﻋﻨﺪ ﺗﺨﻔﻴﻒ إﻛﺴﻴﺮ ﻃﺒﻲ‪ ،‬ﻳﺠﺐ أن ﻳﺤﺘﻮي اﻹﻛﺴﻴﺮ ﻏﻴﺮ اﻟﻄﺒﻲ )اﻟﻤﺴﺘﺨﺪم ﻛﻤﺨﻔﻒ( ﻋﻠﻰ ﻧﻔﺲ ﻣﺤﺘﻮى اﻟﻜﺤﻮل ﺗﻘﺮﻳ ًﺒﺎ ﻣﺜﻞ اﻹﻛﺴﻴﺮ اﻟﻄﺒﻲ اﻷﺻﻠﻲ‪ ،‬ﺣﺘﻰ ﻳﻈﻞ اﻟﻤﺤﻠﻮل ﻣﺘﻮاز ًﻧﺎ‪.‬‬ ‫اﻹﻛﺴﻴﺮ ﻏﻴﺮ اﻟﻄﺒﻲ اﻟﺸﺎﺋﻊ‪:‬‬ ‫ﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺴﺘﺨﺪم اﻟﺼﻴﺎدﻟﺔ ﻫﺬه اﻷﻧﻮاع اﻟﺜﻼﺛﺔ ﻣﻦ اﻹﻛﺴﻴﺮ ﻏﻴﺮ اﻟﻄﺒﻲ ﻟﻠﺨﻠﻂ أو اﻟﺘﺨﻔﻴﻒ‪:‬‬ ‫اﻹﻛﺴﻴﺮ اﻟﻌﻄﺮي‪ :‬إﻛﺴﻴﺮ ﻣﻨﻜﻪ ﻳﻌﺰز اﻟﻄﻌﻢ‪.‬‬ ‫إﻛﺴﻴﺮ اﻟﺒﻨﺰاﻟﺪﻫﻴﺪ اﻟﻤﺮﻛﺐ‪ :‬ﻳﺤﺘﻮي ﻋﻠﻰ اﻟﺒﻨﺰاﻟﺪﻫﻴﺪ ﻟﻨﻜﻬﺔ ﻟﻄﻴﻔﺔ ﺗﺸﺒﻪ اﻟﻠﻮز‪.‬‬ ‫اﻹﻛﺴﻴﺮ اﻟﻜﺤﻮﻟﻲ اﻟﻤﺘﺴﺎوي‪ :‬ﻣﺰﻳﺞ ﻣﺤﺪد ﻳﺤﺘﻮي ﻋﻠﻰ ﻧﺴﺒﺔ ﻣﺘﻮازﻧﺔ ﻣﻦ اﻟﻜﺤﻮل‪ ،‬وﻣﻨﺎﺳﺐ ﻟﻠﺘﺨﻔﻴﻒ‪.‬‬ ‫ﺑﺎﺧﺘﺼﺎر‪ ،‬ﺗﺴﺎﻋﺪ اﻹﻛﺴﻴﺮ ﻏﻴﺮ اﻟﻄﺒﻲ اﻟﺼﻴﺎدﻟﺔ ﻋﻠﻰ اﺑﺘﻜﺎر أدوﻳﺔ ﻣﺨﺼﺼﺔ ذات ﻣﺬاق أﻓﻀﻞ أو ﺗﺮﻛﻴﺰ أﻗﻞ‪ ،‬ﻣﻊ ﺿﻤﺎن ﺛﺒﺎت اﻟﻤﺤﻠﻮل‪.‬‬ ‫‪ 2‬اﻹﻛﺴﻴﺮ اﻟﻄﺒﻲ‪ :‬ﻫﻮ ﻋﺒﺎرة ﻋﻦ إﻛﺴﻴﺮ ﻳﺤﺘﻮي ﻋﻠﻰ ﻋﻘﺎر ﻣﻌﻴﻦ أو ﻋﺎﻣﻞ ﻋﻼﺟﻲ ﻣﺨﺼﺺ ﻟﻼﺳﺘﺨﺪام اﻟﻄﺒﻲ‪.‬ﺗﺤﺘﻮي ﻣﻌﻈﻢ اﻹﻛﺴﻴﺮ اﻟﻄﺒﻲ ﻋﻠﻰ ﻋﻘﺎر ﻧﺸﻂ واﺣﺪ ﻓﻘﻂ‪.‬ﺗﺴﻤﺢ ﺗﺮﻛﻴﺒﺔ اﻟﺪواء اﻟﻮاﺣﺪ ﻫﺬه ﺑﺘﻌﺪﻳﻞ ﺟﺮﻋﺔ ﻫﺬا اﻟﻌﻘﺎر اﻟﻤﻌﻴﻦ ﺑﺴﻬﻮﻟﺔ‪.‬ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎل‪ ،‬إذا‬ ‫اﺣﺘﺎج اﻟﻤﺮﻳﺾ إﻟﻰ زﻳﺎدة أو ﺗﻘﻠﻴﻞ دواﺋﻪ‪ ،‬ﻓﻴﻤﻜﻨﻪ ﺑﺒﺴﺎﻃﺔ ﺗﻨﺎول ﻛﻤﻴﺔ أﻛﺒﺮ أو أﻗﻞ ﻣﻦ اﻹﻛﺴﻴﺮ دون اﻟﺘﺄﺛﻴﺮ ﻋﻠﻰ اﻷدوﻳﺔ اﻷﺧﺮى‪.‬‬ ‫ﺗﻠﻘﺎﺋﻴﺎ ﺟﺮﻋﺔ اﻷدوﻳﺔ اﻷﺧﺮى‪ ،‬وﻫﻮ أﻣﺮ ﻏﻴﺮ ﻣﺮﻏﻮب ﻓﻴﻪ‪.‬ﻟﺬﻟﻚ‪ ،‬ﻳﻔﻀﻞ اﻟﻌﺪﻳﺪ ﻣﻦ اﻷﻃﺒﺎء وﺻﻒ إﻛﺴﻴﺮ ﻣﻨﻔﺼﻞ ﻟﻜﻞ ﻋﻘﺎر ﻟﻠﺴﻤﺎح ﺑﺘﻌﺪﻳﻞ اﻟﺠﺮﻋﺔ اﻟﻔﺮدﻳﺔ‪.‬‬ ‫ً‬ ‫ﻋﻠﻰ اﻟﻨﻘﻴﺾ ﻣﻦ ذﻟﻚ‪ ،‬إذا اﺣﺘﻮى اﻹﻛﺴﻴﺮ ﻋﻠﻰ ﻋﻘﺎرﻳﻦ أو أﻛﺜﺮ‪ ،‬ﻓﺈن ﺗﻌﺪﻳﻞ ﺟﺮﻋﺔ ﻋﻘﺎر واﺣﺪ ﻣﻦ ﺷﺄﻧﻪ أن ﻳﻐﻴﺮ‬  Made with Xodo PDF Reader and Editor  Antihistamine Elixirs:  Antihistamines are useful primarily in the symptomatic relief of certain allergic disorders.  They suppress symptoms caused by histamine, one of the chemical agents released during the antigen–antibody reaction of the allergic response. ‫ﻣﻌﺪل اﻹﺻﺎﺑﺔ واﻟﺸﺪة‬  The incidence and severity of these effects do vary somewhat with the drug and the dose.  The most common untoward effect is sedation, and patients taking antihistamines should be warned against engaging in activities requiring mental alertness, such as driving an automobile or tractor or operating machinery.  Other common adverse effects include dryness of the nose, throat, and mouth; dizziness; and disturbed concentration.  Made with Xodo PDF Reader and Editor  Among the most sedating antihistamines are diphenhydramine and doxylamine.  In fact, diphenhydramine is used as a sleep aid in numerous OTC products for its ability to cause drowsiness.‫ ﻳﺘﻢ اﺳﺘﺨﺪام دﻳﻔﻴﻨﻬﻴﺪراﻣﻴﻦ ﻛﻤﺴﺎﻋﺪ ﻟﻠﻨﻮم ﻓﻲ اﻟﻌﺪﻳﺪ ﻣﻦ اﻟﻤﻨﺘﺠﺎت اﻟﺘﻲ ﻻ ﺗﺴﺘﻠﺰم وﺻﻔﺔ ﻃﺒﻴﺔ ﻟﻘﺪرﺗﻪ ﻋﻠﻰ اﻟﺘﺴﺒﺐ ﻓﻲ اﻟﻨﻌﺎس‬،‫ﻓﻲ اﻟﻮاﻗﻊ‬  Most antihistaminic agents are basic amines.  By forming salts through interaction with acid, the compounds are rendered water soluble.  These salt forms are used in elixirs, so the elixirs of the antihistamines are not required to contain a large proportion of alcohol; because the acid salts of the antihistamines are used, the pH of these elixirs is on the acid side and must remain so if the drugs are to remain freely soluble in water.  ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫ُﺗﺴﺘﺨﺪم ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ ﻟﺘﺨﻔﻴﻒ أﻋﺮاض اﻟﺤﺴﺎﺳﻴﺔ ﻋﻦ ﻃﺮﻳﻖ ﻗﻤﻊ ﺗﺄﺛﻴﺮات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ‪ ،‬وﻫﻲ ﻣﺎدة ﻛﻴﻤﻴﺎﺋﻴﺔ ﻳﺘﻢ إﻃﻼﻗﻬﺎ أﺛﻨﺎء اﻻﺳﺘﺠﺎﺑﺎت اﻟﺘﺤﺴﺴﻴﺔ‪.‬وﻋﺎد ًة ﻣﺎ ﻳﺘﻢ ﺗﺼﻨﻴﻊ ﻫﺬه اﻟﻤﻀﺎدات ﻟﺠﻌﻞ أدوﻳﺔ ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ ﻗﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن وﺳﻬﻠﺔ اﻹﻋﻄﺎء‪.‬‬ ‫اﻵﺛﺎر اﻟﺠﺎﻧﺒﻴﺔ اﻟﺸﺎﺋﻌﺔ‪:‬‬ ‫ً‬ ‫وﺧﺎﺻﺔ ﻣﻊ ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ ﻣﺜﻞ دﻳﻔﻴﻨﻬﻴﺪراﻣﻴﻦ ودوﻛﺴﻴﻼﻣﻴﻦ‪ ،‬واﻟﺘﻲ ﻣﻦ اﻟﻤﻌﺮوف أﻧﻬﺎ ﺗﺴﺒﺐ اﻟﻨﻌﺎس‪.‬ﻳﺠﺐ ﻋﻠﻰ اﻟﻤﺮﺿﻰ اﻟﺬﻳﻦ ﻳﺴﺘﺨﺪﻣﻮن ﻫﺬه اﻷدوﻳﺔ ﺗﺠﻨﺐ اﻷﻧﺸﻄﺔ اﻟﺘﻲ ﺗﺘﻄﻠﺐ اﻟﻴﻘﻈﺔ‪ ،‬ﻣﺜﻞ اﻟﻘﻴﺎدة أو ﺗﺸﻐﻴﻞ‬ ‫اﻟﺘﺨﺪﻳﺮ ﻫﻮ اﻷﺛﺮ اﻟﺠﺎﻧﺒﻲ اﻷﻛﺜﺮ ﺷﻴﻮﻋً ﺎ‪،‬‬ ‫اﻵﻻت‪.‬‬ ‫ﺗﺸﻤﻞ اﻵﺛﺎر اﻟﺠﺎﻧﺒﻴﺔ اﻟﺸﺎﺋﻌﺔ اﻷﺧﺮى ﺟﻔﺎف اﻷﻧﻒ واﻟﺤﻠﻖ واﻟﻔﻢ‪ ،‬واﻟﺪوﺧﺔ‪ ،‬وﺻﻌﻮﺑﺔ اﻟﺘﺮﻛﻴﺰ‪.‬‬ ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫اﻟﺬوﺑﺎن واﻟﺘﺮﻛﻴﺐ‪:‬‬ ‫ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ ﻫﻲ ﻋﺎد ًة أﻣﻴﻨﺎت أﺳﺎﺳﻴﺔ‪.‬ﻟﺠﻌﻠﻬﺎ ﻗﺎﺑﻠﺔ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪ ،‬ﻳﺘﻢ ﺗﺤﻮﻳﻠﻬﺎ إﻟﻰ أﺷﻜﺎل ﻣﻠﺤﻴﺔ ﻋﻦ ﻃﺮﻳﻖ اﻟﺘﻔﺎﻋﻞ ﻣﻊ اﻷﺣﻤﺎض‪.‬ﺗﺬوب ﻫﺬه اﻷﺷﻜﺎل اﻟﻤﻠﺤﻴﺔ ﺑﺴﻬﻮﻟﺔ‪ ،‬ﻣﻤﺎ ﻳﻌﻨﻲ أن اﻟﻤﻀﺎدات ﻻ ﺗﺤﺘﺎج إﻟﻰ ﻧﺴﺒﺔ ﻋﺎﻟﻴﺔ ﻣﻦ اﻟﻜﺤﻮل ﻟﻠﺤﻔﺎظ ﻋﻠﻰ‬ ‫اﻟﺬوﺑﺎن‪.‬‬ ‫ﺣﻤﻀﻴﺎ ﻟﻠﺤﻔﺎظ ﻋﻠﻰ ﻗﺎﺑﻠﻴﺔ اﻷدوﻳﺔ ﻟﻠﺬوﺑﺎن وﻓﻌﺎﻟﻴﺘﻬﺎ‪.‬ﻳﻀﻤﻦ اﻟﺤﻔﺎظ ﻋﻠﻰ ﻫﺬه اﻟﺤﻤﻮﺿﺔ ﺛﺒﺎت ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ ﻓﻲ اﻟﻤﺤﻠﻮل‪.‬‬ ‫ً‬ ‫ﻧﻈﺮا ﻷن ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ ﻫﺬه ﺣﻤﻀﻴﺔ ﻓﻲ أﺷﻜﺎﻟﻬﺎ اﻟﻤﻠﺤﻴﺔ‪ ،‬ﻓﻴﺠﺐ أن ﻳﻈﻞ اﻟﺮﻗﻢ اﻟﻬﻴﺪروﺟﻴﻨﻲ ﻟﻺﻛﺴﻴﺮ‬ ‫ً‬ ‫ﻣﺤﻠﻮﻻ ً‬ ‫ﻓﻌﺎﻻ ﻟﻸﻋﺮاض اﻟﺘﺤﺴﺴﻴﺔ وﻟﻜﻨﻬﺎ ﻗﺪ ﺗﺴﺒﺐ اﻟﻨﻌﺎس‪ ،‬ﻟﺬا ﻳﺠﺐ اﺗﺨﺎذ اﻻﺣﺘﻴﺎﻃﺎت اﻟﻼزﻣﺔ‪.‬ﺗﻢ ﺗﺼﻤﻴﻢ ﺗﺮﻛﻴﺒﺘﻬﺎ ﻟﻠﺤﻔﺎظ ﻋﻠﻰ ﺛﺒﺎت اﻟﻤﻜﻮﻧﺎت اﻟﻨﺸﻄﺔ وﻗﺎﺑﻠﻴﺘﻬﺎ ﻟﻠﺬوﺑﺎن ﻓﻲ اﻟﻤﺎء‪ ،‬دون اﻟﺤﺎﺟﺔ إﻟﻰ اﻟﻜﺜﻴﺮ ﻣﻦ اﻟﻜﺤﻮل‪.‬‬ ‫ً‬ ‫ﺑﺎﺧﺘﺼﺎر‪ ،‬ﺗﻮﻓﺮ ﻣﻀﺎدات اﻟﻬﻴﺴﺘﺎﻣﻴﻦ‬ ‫‪1. Antihistamines are basic: These drugs are naturally alkaline (basic), meaning they don’t dissolve well in water on their own.‬‬ ‫‪2. Making them water-soluble: To make them dissolve in water, they are often turned into salt forms. This happens by reacting the basic antihistamine with an acid, which creates a salt that is‬‬ ‫‪water-soluble.‬‬ ‫‪3. Why the solution needs to stay acidic: Since the antihistamine is now in its salt form (made by reacting with an acid), the solution needs to stay slightly acidic. If the solution becomes too basic‬‬ ‫‪(alkaline), the drug could revert to its original, non-soluble form, and it wouldn’t dissolve well in water. So, keeping the elixir acidic helps ensure the drug stays dissolved and effective.‬‬ ‫‪In short, the elixir needs to stay slightly acidic so that the salt form of the antihistamine remains stable and can dissolve properly in water‬‬  Made with Xodo PDF Reader and Editor  The barbiturates are sedative and hypnotic agents that are used to produce various degrees of central nervous system depression.  As the dose of these drugs is increased, the effects go from sedation to hypnosis to respiratory depression, the last being the cause of death in fatal barbiturate overdosage.  Barbiturates are administered in small doses in the daytime as sedatives to reduce restlessness and emotional tension ‫ﺗﻘﻠﻴﻞ اﻟﻘﻠﻖ واﻟﺘﻮﺗﺮ اﻟﻌﺎﻃﻔﻲ‬  The appropriate dose for this purpose is the amount that alleviates anxiety or tension but does not produce drowsiness or lethargy. ‫اﻟﻜﻤﻴﺔ اﻟﺘﻲ ﺗﺨﻔﻒ اﻟﻘﻠﻖ أو اﻟﺘﻮﺗﺮ وﻟﻜﻨﻬﺎ ﻻ ﺗﺴﺒﺐ اﻟﻨﻌﺎس أو اﻟﺨﻤﻮل‬  Greater doses of the barbiturates may be given before bedtime as hypnotics to relieve insomnia. ‫أرق‬  Made with Xodo PDF Reader and Editor ‫ﺗﺄﺛﻴﺮات ﻣﻨﻮﻣﺔ‬  Barbiturates have been classified according to the duration of their hypnotic effects, that is, long-acting, intermediate-acting, short-acting, or ultrashort-acting agents.  The long-acting barbiturates, including phenobarbital, are considered most useful in ‫اﻟﺘﺨﺪﻳﺮ اﻟﻨﻬﺎري‬ ‫ﻋﻼج ﺑﻌﺾ اﻟﺤﺎﻻت اﻟﺘﺸﻨﺠﻴﺔ‬ maintaining daytime sedation and in treating some convulsive states and least useful as hypnotics. ‫ﻣﻨﻮﻣﺎت ﻣﻐﻨﺎﻃﻴﺴﻴﺔ‬  The intermediate-acting barbiturates include amobarbital; they are used primarily for short- term daytime sedation and are effective in treating insomnia.  The barbiturates classified as short-acting include secobarbital; they are used similarly to the intermediate-acting barbiturates.  The ultra–short-acting barbiturates, including thiopental, are given intravenously to induce anesthesia.  Made with Xodo PDF Reader and Editor  The most common untoward effects in patients taking barbiturates are drowsiness and lethargy. ‫اﻟﻨﻌﺎس واﻟﺨﻤﻮل‬  Large doses may produce residual sedation resembling the hangover following alcohol intoxication. ‫ﻗﺪ ﺗﺆدي اﻟﺠﺮﻋﺎت اﻟﻜﺒﻴﺮة إﻟﻰ ﺣﺪوث ﺗﺨﺪﻳﺮ ﻣﺘﺒﻘﻲ ﻳﺸﺒﻪ ﺻﺪاع اﻟﻜﺤﻮل ﺑﻌﺪ اﻟﺘﺴﻤﻢ ﺑﺎﻟﻜﺤﻮل‬  Prolonged use of barbiturates may lead to psychic or physical dependence..‫ إﻟﻰ إﺳﺎءة اﺳﺘﺨﺪام اﻟﻤﺨﺪرات ﺑﺸﻜﻞ ﻗﻬﺮي ﻣﻊ أﻋﺮاض اﻧﺴﺤﺎب ﺷﺪﻳﺪة ﺑﻌﺪ اﻻﻣﺘﻨﺎع ﻋﻦ ﺗﻌﺎﻃﻴﻬﺎ‬،‫ ﻟﺪى اﻷﻓﺮاد اﻟﻤﻌﺮﺿﻴﻦ ﻟﺬﻟﻚ‬،‫ﻳﺆدي ﻫﺬا اﻻﻋﺘﻤﺎد‬  This dependence, in susceptible individuals, leads to compulsive abuse of the drug with severe withdrawal symptoms following abstinence.  In heavy chronic users, abrupt withdrawal may lead to convulsions, delirium, and occasionally to coma and death. ‫ وﻓﻲ ﺑﻌﺾ اﻷﺣﻴﺎن إﻟﻰ اﻟﻐﻴﺒﻮﺑﺔ واﻟﻮﻓﺎة‬،‫ ﻗﺪ ﻳﺆدي اﻻﻧﺴﺤﺎب اﻟﻤﻔﺎﺟﺊ إﻟﻰ اﻟﺘﺸﻨﺠﺎت واﻟﻬﺬﻳﺎن‬،‫ﻓﻲ ﺣﺎﻟﺔ اﻟﻤﺴﺘﺨﺪﻣﻴﻦ اﻟﻤﺰﻣﻨﻴﻦ اﻟﺸﺪﻳﺪﻳﻦ‬  ‫اﻟﺒﺎرﺑﻴﺘﻮرات‪ :‬ﻧﻈﺮة ﻋﺎﻣﺔ وﺗﺄﺛﻴﺮات‬ ‫اﻟﺒﺎرﺑﻴﺘﻮرات ﻫﻲ أدوﻳﺔ ﺗﺴﺘﺨﺪم ﻛﻤﻬﺪﺋﺎت )ﻟﺘﺨﻔﻴﻒ اﻷرق واﻟﻘﻠﻖ( وﻣﻨﻮﻣﺎت )ﻟﻌﻼج اﻷرق(‪ ،‬وﺗﺆﺛﺮ ﻋﻠﻰ اﻟﺠﻬﺎز اﻟﻌﺼﺒﻲ اﻟﻤﺮﻛﺰي‪.‬اﻋﺘﻤﺎدً ا ﻋﻠﻰ اﻟﺠﺮﻋﺔ‪ ،‬ﺗﺘﺮاوح ﺗﺄﺛﻴﺮاﺗﻬﺎ ﻣﻦ اﻟﺘﻬﺪﺋﺔ اﻟﺨﻔﻴﻔﺔ إﻟﻰ اﻟﻨﻮم اﻟﻌﻤﻴﻖ )اﻟﺘﻨﻮﻳﻢ اﻟﻤﻐﻨﺎﻃﻴﺴﻲ(‪ ،‬وﻓﻲ اﻟﺤﺎﻻت اﻟﻘﺼﻮى‪،‬‬ ‫اﻻﻛﺘﺌﺎب اﻟﺘﻨﻔﺴﻲ اﻟﺬي ﻳﻤﻜﻦ أن ﻳﺆدي إﻟﻰ اﻟﻮﻓﺎة ﻓﻲ ﺣﺎﻻت اﻟﺠﺮﻋﺔ اﻟﺰاﺋﺪة‪.‬‬ ‫اﻻﺳﺘﺨﺪاﻣﺎت واﻟﺠﺮﻋﺎت‪:‬‬ ‫ﺗﺴﺎﻋﺪ اﻟﺠﺮﻋﺎت اﻟﺼﻐﻴﺮة أﺛﻨﺎء اﻟﻨﻬﺎر ﻋﻠﻰ ﺗﻘﻠﻴﻞ اﻟﻘﻠﻖ واﻟﺘﻮﺗﺮ دون اﻟﺘﺴﺒﺐ ﻓﻲ اﻟﻨﻌﺎس‪.‬‬ ‫ﻳﺘﻢ ﺗﻨﺎول ﺟﺮﻋﺎت أﻛﺒﺮ ﻗﺒﻞ اﻟﻨﻮم ﻟﻠﻤﺴﺎﻋﺪة ﻓﻲ اﻟﻨﻮم )ﻛﻤﻨﻮﻣﺎت( ﻟﻸﺷﺨﺎص اﻟﺬﻳﻦ ﻳﻌﺎﻧﻮن ﻣﻦ اﻷرق‪.‬‬ ‫اﻟﺘﺼﻨﻴﻒ ﺣﺴﺐ ﻣﺪة اﻟﺘﺄﺛﻴﺮ‪:‬‬ ‫‪.1‬ﺗﺴﺘﺨﺪم اﻟﺒﺎرﺑﻴﺘﻮرات ﻃﻮﻳﻠﺔ اﻟﻤﻔﻌﻮل )ﻣﺜﻞ اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل( ﻟﻠﺘﻬﺪﺋﺔ أﺛﻨﺎء اﻟﻨﻬﺎر واﻻﺿﻄﺮاﺑﺎت اﻟﺘﺸﻨﺠﻴﺔ‪ ،‬وﻟﻜﻨﻬﺎ ﻟﻴﺴﺖ ﻓﻌﺎﻟﺔ ﺑﻨﻔﺲ اﻟﻘﺪر ﻓﻲ ﻋﻼج اﻷرق‪.‬‬ ‫‪.2‬ﺗﺴﺘﺨﺪم اﻟﺒﺎرﺑﻴﺘﻮرات ﻣﺘﻮﺳﻄﺔ اﻟﻤﻔﻌﻮل )ﻣﺜﻞ اﻷﻣﻮﺑﺎرﺑﻴﺘﺎل( ﻟﻠﺘﺨﺪﻳﺮ ﻗﺼﻴﺮ اﻷﻣﺪ وﻋﻼج اﻷرق‪.‬‬ ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫‪.3‬ﺗﻌﻤﻞ اﻟﺒﺎرﺑﻴﺘﻮرات ﻗﺼﻴﺮة اﻟﻤﻔﻌﻮل )ﻣﺜﻞ ﺳﻴﻜﻮﺑﺎرﺑﻴﺘﺎل( ﺑﺸﻜﻞ ﻣﺸﺎﺑﻪ ﻟﻠﺒﺎرﺑﻴﺘﻮرات ﻣﺘﻮﺳﻄﺔ اﻟﻤﻔﻌﻮل‪ ،‬اﻟﻤﺴﺘﺨﺪﻣﺔ ﻟﻠﺘﺨﺪﻳﺮ واﻷرق‪.‬‬ ‫‪.4‬ﻳﺘﻢ إﻋﻄﺎء اﻟﺒﺎرﺑﻴﺘﻮرات ﻗﺼﻴﺮة اﻟﻤﻔﻌﻮل ﻟﻠﻐﺎﻳﺔ )ﻣﺜﻞ اﻟﺜﻴﻮﺑﻨﺘﺎل( ﻋﻦ ﻃﺮﻳﻖ اﻟﻮرﻳﺪ ﻟﺘﺤﻔﻴﺰ اﻟﺘﺨﺪﻳﺮ أﺛﻨﺎء اﻟﻌﻤﻠﻴﺎت اﻟﺠﺮاﺣﻴﺔ‪.‬‬ ‫اﻵﺛﺎر اﻟﺠﺎﻧﺒﻴﺔ واﻟﻤﺨﺎﻃﺮ‪:‬‬ ‫ﻣﺴﺘﻤﺮا‪ ،‬ﻣﺸﺎﺑﻬً ﺎ ﻟـ "ﺻﺪاع اﻟﻜﺤﻮل"‪.‬‬ ‫ً‬ ‫ﺗﺨﺪﻳﺮا‬ ‫ً‬ ‫ﺗﺸﻤﻞ اﻵﺛﺎر اﻟﺠﺎﻧﺒﻴﺔ اﻟﺸﺎﺋﻌﺔ اﻟﻨﻌﺎس واﻟﺨﻤﻮل‪.‬ﻳﻤﻜﻦ أن ﺗﺴﺒﺐ اﻟﺠﺮﻋﺎت اﻟﻌﺎﻟﻴﺔ‬ ‫ﻳﻤﻜﻦ أن ﻳﺆدي اﻻﺳﺘﺨﺪام اﻟﻤﻄﻮل إﻟﻰ اﻻﻋﺘﻤﺎد اﻟﻨﻔﺴﻲ أو اﻟﺠﺴﺪي‪ ،‬ﻣﻤﺎ ﻳﺴﺒﺐ اﻹدﻣﺎن وأﻋﺮاض اﻻﻧﺴﺤﺎب اﻟﺸﺪﻳﺪة ﻋﻨﺪ اﻟﺘﻮﻗﻒ ﻋﻦ ﺗﻨﺎول اﻟﺪواء‪.‬‬ ‫ﻳﻤﻜﻦ أن ﻳﻌﺎﻧﻲ اﻟﻤﺴﺘﺨﺪﻣﻮن اﻟﻤﻔﺮﻃﻮن ﻣﻦ أﻋﺮاض اﻧﺴﺤﺎب ﺧﻄﻴﺮة‪ ،‬ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺘﺸﻨﺠﺎت واﻟﻬﺬﻳﺎن‪ ،‬وﻓﻲ اﻟﺤﺎﻻت اﻟﻘﺼﻮى‪ ،‬اﻟﻐﻴﺒﻮﺑﺔ أو اﻟﻤﻮت إذا ﺗﻮﻗﻔﻮا ﻓﺠﺄة‪.‬‬ ‫إﻛﺴﻴﺮ اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل‪ :‬ﻧﻈﺮة ﻋﺎﻣﺔ وﺗﺮﻛﻴﺒﺔ‬ ‫إﻛﺴﻴﺮ اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل ﻋﺒﺎرة ﻋﻦ ﺗﺮﻛﻴﺒﺔ ﺳﺎﺋﻠﺔ ﺗﺤﺘﻮي ﻋﻠﻰ ‪ %0.4‬ﻓﻴﻨﻮﺑﺎرﺑﻴﺘﺎل‪ ،‬واﻟﺘﻲ ﺗﻮﻓﺮ ﺣﻮاﻟﻲ ‪ 20‬ﻣﺠﻢ ﻣﻦ اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل ﻟﻜﻞ ‪ 5‬ﻣﻞ )ﻣﻠﻌﻘﺔ ﺻﻐﻴﺮة(‪.‬‬ ‫اﻟﺘﺮﻛﻴﺐ‪:‬‬ ‫اﻟﻨﻜﻬﺔ‪ :‬ﻋﺎدة ﻣﺎ ﻳﺘﻢ ﻧﻜﻬﺘﻪ ﺑﺰﻳﺖ اﻟﺒﺮﺗﻘﺎل ﻟﺘﺤﺴﻴﻦ ﻣﺬاﻗﻪ‪.‬‬ ‫اﻟﺘﻠﻮﻳﻦ‪ :‬ﻣﻠﻮن ﺑﺎﻟﻠﻮن اﻷﺣﻤﺮ ﺑﺎﺳﺘﺨﺪام ﺻﺒﻐﺔ ﻣﻌﺘﻤﺪة ﻣﻦ إدارة اﻟﻐﺬاء واﻟﺪواء‪.‬‬ ‫ً‬ ‫ﻣﺬاﻗﺎ‪.‬‬ ‫اﻟﺘﺤﻠﻴﺔ‪ :‬ﻣﺤﻠﻰ ﺑﺎﻟﺸﺮاب ﻟﺠﻌﻠﻪ أﻛﺜﺮ‬ ‫اﻟﺬوﺑﺎن‪:‬‬ ‫ﻳﺤﺘﻮي اﻹﻛﺴﻴﺮ ﻋﻠﻰ ﺣﻮاﻟﻲ ‪ %14‬ﻣﻦ اﻟﻜﺤﻮل‪ ،‬ﻣﻤﺎ ﻳﺴﺎﻋﺪ ﻋﻠﻰ إذاﺑﺔ اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل‪.‬ﻫﺬا اﻟﻤﺤﺘﻮى ﻣﻦ اﻟﻜﺤﻮل ﻫﻮ اﻟﺤﺪ اﻷدﻧﻰ اﻟﻤﻄﻠﻮب ﻟﻠﺤﻔﺎظ ﻋﻠﻰ اﻟﺪواء ﻓﻲ اﻟﻤﺤﻠﻮل‪.‬‬ ‫ﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺘﻢ إﺿﺎﻓﺔ اﻟﺠﻠﺴﺮﻳﻦ ﻟﺘﻌﺰﻳﺰ ﻗﺎﺑﻠﻴﺔ ذوﺑﺎن اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل ﺑﺸﻜﻞ أﻛﺒﺮ‪ ،‬ﻣﻤﺎ ﻳﻀﻤﻦ ﺑﻘﺎء اﻟﺪواء ﻣﺬاﺑًﺎ ﺑﺸﻜﻞ ﺻﺤﻴﺢ ﻓﻲ اﻹﻛﺴﻴﺮ‪.‬‬ ‫اﻟﺠﺮﻋﺔ واﻟﺘﺄﺛﻴﺮات‪:‬‬ ‫اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل ﻫﻮ ﻋﺒﺎرة ﻋﻦ ﺑﺎرﺑﻴﺘﻮرات ﻃﻮﻳﻠﺔ اﻟﻤﻔﻌﻮل ﺗﺪوم آﺛﺎرﻫﺎ ﻟﻤﺪة ﺗﺘﺮاوح ﻣﻦ ‪ 4‬إﻟﻰ ‪ 6‬ﺳﺎﻋﺎت‪.‬‬ ‫اﻟﺠﺮﻋﺎت اﻟﻤﻌﺘﺎدة ﻟﻠﺒﺎﻟﻐﻴﻦ ﻫﻲ‪:‬‬ ‫‪ 30‬ﻣﺠﻢ ﻛﻤﻬﺪئ ) ﻟﺘﻘﻠﻴﻞ اﻟﻘﻠﻖ واﻷرق(‪.‬‬ ‫‪ 100‬ﻣﺠﻢ ﻛﻤﻨﻮم ) ﻟﺘﺤﻔﻴﺰ اﻟﻨﻮم(‪.‬‬ ‫ﺗﻌﺪﻳﻼت اﻟﺠﺮﻋﺔ‪:‬‬ ‫ﺗﺘﻴﺢ ﻗﻮة اﻹﻛﺴﻴﺮ ﺗﻌﺪﻳﻞ اﻟﺠﺮﻋﺔ ﺑﺴﻬﻮﻟﺔ ﻟﻤﺠﻤﻮﻋﺎت ﻣﺨﺘﻠﻔﺔ ﻣﻦ اﻟﻤﺮﺿﻰ‪ ،‬ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻟﺮﺿﻊ واﻷﻃﻔﺎل وﺑﻌﺾ اﻟﺒﺎﻟﻐﻴﻦ‪ ،‬ﻣﻤﺎ ﻳﺴﻤﺢ ﺑﻌﻼج ﻣﺨﺼﺺ ﻟﺘﺤﻘﻴﻖ اﻟﻤﺴﺘﻮى اﻟﻤﻨﺎﺳﺐ ﻣﻦ اﻟﺘﺨﺪﻳﺮ‪.‬‬  Made with Xodo PDF Reader and Editor  Phenobarbital elixir is formulated to contain phenobarbital 0.4%, which provides about 20 mg of drug per teaspoonful (5 mL) of elixir.  The elixir is commonly flavored with orange oil, colored red with an FDA-approved colorant, and sweetened with syrup.  The official elixir contains about 14% alcohol, which is used to dissolve the phenobarbital. However, this amount is almost the very minimum required to keep the phenobarbital in solution.  Therefore, glycerin is often added to enhance the solubility of phenobarbital.  Phenobarbital is a long-acting barbiturate with a duration of action of about 4 to 6 hours, a usual adult dose as a sedative of about 30 mg and a hypnotic dose of about 100 mg.  The strength of the elixir permits convenient adjustment of dosage to achieve the proper degree of sedation in the treatment of infants, children, and certain adults. :‫ ﻫﺬا ﻣﻬﻢ ﻟـ‬.‫ ﻣﻤﺎ ﻳﻌﻨﻲ أن ﻣﻘﺪﻣﻲ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﻳﻤﻜﻨﻬﻢ ﺑﺴﻬﻮﻟﺔ ﻗﻴﺎس اﻟﻜﻤﻴﺔ اﻟﺼﺤﻴﺤﺔ ﻣﻦ اﻟﺪواء ﻟﺘﺤﻘﻴﻖ اﻟﻤﺴﺘﻮى اﻟﻤﻄﻠﻮب ﻣﻦ اﻟﺘﺨﺪﻳﺮ‬،‫ﺗﺴﻤﺢ ﻗﻮة إﻛﺴﻴﺮ اﻟﻔﻴﻨﻮﺑﺎرﺑﻴﺘﺎل ﺑﺘﻌﺪﻳﻞ اﻟﺠﺮﻋﺎت ﺑﺴﻬﻮﻟﺔ‬.‫ ﻟﺬﻟﻚ ﻳﻤﻜﻦ ﻗﻴﺎس اﻹﻛﺴﻴﺮ ﺑﻜﻤﻴﺎت أﺻﻐﺮ ﻟﻀﻤﺎن اﻟﺴﻼﻣﺔ واﻟﻔﻌﺎﻟﻴﺔ‬،‫ ﻏﺎﻟ ًﺒﺎ ﻣﺎ ﻳﺤﺘﺎﺟﻮن إﻟﻰ ﺟﺮﻋﺎت أﻗﻞ ﻣﻦ اﻟﺒﺎﻟﻐﻴﻦ‬:‫اﻟﺮﺿﻊ واﻷﻃﻔﺎل‬.‫ﺑﻨﺎء ﻋﻠﻰ اﺣﺘﻴﺎﺟﺎﺗﻬﻢ أو ﻇﺮوﻓﻬﻢ اﻟﺼﺤﻴﺔ اﻟﻤﺤﺪدة‬ ً ‫أﻳﻀﺎ إﻟﻰ ﺟﺮﻋﺎت ﻣﺨﺘﻠﻔﺔ‬ً ‫ ﻗﺪ ﻳﺤﺘﺎج ﺑﻌﺾ اﻟﺒﺎﻟﻐﻴﻦ‬:‫ﺑﻌﺾ اﻟﺒﺎﻟﻐﻴﻦ‬.‫ ﻣﻤﺎ ﻳﺴﻤﺢ ﻟﻤﻘﺪﻣﻲ اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔ ﺑﺘﺨﺼﻴﺺ اﻟﺠﺮﻋﺔ ﻟﻌﻼج ﻓﻌﺎل ﻟﻠﺘﺨﺪﻳﺮ ﻓﻲ ﻣﺠﻤﻮﻋﺎت ﻣﺨﺘﻠﻔﺔ ﻣﻦ اﻟﻤﺮﺿﻰ‬،‫ ﺗﺠﻌﻞ ﺗﺮﻛﻴﺒﺔ اﻹﻛﺴﻴﺮ ﻣﺮﻧﺔ‬،‫ﻓﻲ اﻷﺳﺎس‬  ‫‪Made with Xodo PDF Reader and Editor‬‬ ‫اﻟﺪﻳﺠﻮﻛﺴﻴﻦ‪ :‬ﻧﻈﺮة ﻋﺎﻣﺔ وﺗﺮﻛﻴﺒﺔ اﻹﻛﺴﻴﺮ‬ ‫اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﻫﻮ ﺟﻠﻴﻜﻮﺳﻴﺪ ﻣﻨﺸﻂ ﻟﻠﻘﻠﺐ ﻣﺸﺘﻖ ﻣﻦ أوراق ﻧﺒﺎت ‪.Digitalis lanata‬ﻳﺴﺘﺨﺪم ﻓﻲ اﻟﻤﻘﺎم اﻷول ﻟﺘﻘﻮﻳﺔ اﻧﻘﺒﺎﺿﺎت اﻟﻘﻠﺐ وﻳﻮﺻﻒ ﻋﺎدة ﻷﻣﺮاض اﻟﻘﻠﺐ‪.‬‬ ‫اﻟﺨﺼﺎﺋﺺ‪:‬اﻟﻤﻈﻬﺮ‪ :‬اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﻋﺒﺎرة ﻋﻦ ﻣﺴﺤﻮق ﺑﻠﻮري أﺑﻴﺾ‪.‬‬ ‫اﻟﺬوﺑﺎن‪ :‬ﻻ ﻳﺬوب ﻓﻲ اﻟﻤﺎء وﻟﻜﻨﻪ ﻳﻤﻜﻦ أن ﻳﺬوب ﻓﻲ ﻣﺤﺎﻟﻴﻞ اﻟﻜﺤﻮل اﻟﻤﺨﻔﻔﺔ‪.‬ﻳﺤﺘﻮي إﻛﺴﻴﺮ اﻟﺪﻳﺠﻮﻛﺴﻴﻦ اﻟﺮﺳﻤﻲ ﻋﻠﻰ ﺣﻮاﻟﻲ ‪ % 10‬ﻣﻦ اﻟﻜﺤﻮل ﻟﻠﻤﺴﺎﻋﺪة ﻓﻲ اﻟﺤﻔﺎظ ﻋﻠﻰ اﻟﺪواء ﻓﻲ اﻟﻤﺤﻠﻮل‪.‬‬ ‫ﺗﺮﻛﻴﺒﺔ اﻹﻛﺴﻴﺮ‪:‬ﻳﺠﺐ أن ﻳﺤﺘﻮي اﻹﻛﺴﻴﺮ ﻋﻠﻰ ﻣﺎ ﺑﻴﻦ ‪ 4.5‬إﻟﻰ ‪ 5.25‬ﻣﺠﻢ ﻣﻦ اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﻟﻜﻞ ‪ 100‬ﻣﻞ‪ ،‬وﻫﻮ ﻣﺎ ﻳﺘﺮﺟﻢ إﻟﻰ ﺣﻮاﻟﻲ ‪ 0.25‬ﻣﺠﻢ ﻣﻦ اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﻓﻲ ﻛﻞ ﻣﻠﻌﻘﺔ ﺻﻐﻴﺮة ﺳﻌﺔ ‪ 5‬ﻣﻞ‪.‬‬ ‫ﻻ ﺗﻮﺟﺪ ﻃﺮﻳﻘﺔ رﺳﻤﻴﺔ ﻟﺘﺤﻀﻴﺮ إﻛﺴﻴﺮ اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﻣﺤﺪدة ﻓﻲ دﺳﺘﻮر اﻷدوﻳﺔ اﻷﻣﺮﻳﻜﻲ ) ‪.(USP‬‬ ‫اﻟﺠﺮﻋﺔ‪:‬‬ ‫اﻟﺠﺮﻋﺔ اﻟﻔﻤﻮﻳﺔ اﻷوﻟﻴﺔ‪ :‬اﻟﺠﺮﻋﺔ اﻷوﻟﻴﺔ اﻟﻨﻤﻮذﺟﻴﺔ ﻟﻠﺒﺎﻟﻐﻴﻦ ﻫﻲ ﺣﻮاﻟﻲ ‪ 1.5‬ﻣﻠﻎ ﻣﻦ اﻟﺪﻳﺠﻮﻛﺴﻴﻦ‪.‬ﺟﺮﻋﺔ اﻟﺼﻴﺎﻧﺔ‪ :‬ﺑﻌﺪ اﻟﻌﻼج اﻷوﻟﻲ‪ ،‬ﺗﻜﻮن ﺟﺮﻋﺔ اﻟﺼﻴﺎﻧﺔ ﺣﻮاﻟﻲ ‪ 0.5‬ﻣﻠﻎ‪.‬اﻋﺘﺒﺎرات اﻟﺴﻼﻣﺔ‪:‬اﻟﺴﻤﻴﺔ‪ :‬اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﺳﺎم‪ ،‬ﻟﺬﻟﻚ ﻳﺠﺐ ﺣﺴﺎب ﺟﺮﻋﺘﻪ ﺑﻌﻨﺎﻳﺔ وﻣﺮاﻗﺒﺘﻬﺎ ﻟﻜﻞ ﻣﺮﻳﺾ ﻟﻤﻨﻊ اﻟﺴﻤﻴﺔ‪.‬ﺷﻜﻞ اﻟﺠﺮﻋﺔ اﻟﻤﻔﻀﻞ‪ :‬ﻳﻤﻴﻞ ﻣﻌﻈﻢ اﻟﺒﺎﻟﻐﻴﻦ إﻟﻰ اﺳﺘﺨﺪام أﻗﺮاص اﻟﺪﻳﺠﻮﻛﺴﻴﻦ ﺑﺪ ﻻً ﻣﻦ اﻹﻛﺴﻴﺮ ﺑﺴﺒﺐ‬ ‫ﺻﻌﻮﺑﺔ ﻗﻴﺎس ﺟﺮﻋﺎت اﻟﺴﻮاﺋﻞ ﺑﺪﻗﺔ ﺑﺎﺳﺘﺨﺪام ﻣﻠﻌﻘﺔ ﺷﺎي ﻣﻨﺰﻟﻴﺔ‪ ،‬واﻟﺘﻲ ﻳﻤﻜﻦ أن ﺗﺨﺘﻠﻒ ﻓﻲ اﻟﺤﺠﻢ واﻟﺤﺠﻢ‪.‬اﻟﻤﻠﺨﺺ‪:‬اﻟﺪﻳﺠﻮﻛﺴﻴﻦ دواء ﻣﻬﻢ ﻟﻮﻇﺎﺋﻒ اﻟﻘﻠﺐ‪ ،‬ﻟﻜﻦ ﺗﺮﻛﻴﺒﺔ اﻹﻛﺴﻴﺮ وﺟﺮﻋﺘﻪ ﺗﺘﻄﻠﺐ دراﺳﺔ ﻣﺘﺄﻧﻴﺔ ﺑﺴﺒﺐ اﻟﺴﻤﻴﺔ اﻟﻤﺤﺘﻤﻠﺔ‪ ،‬ﻣﻤﺎ ﻳﺠﻌﻞ اﻟﺠﺮﻋﺎت اﻟﺪﻗﻴﻘﺔ ﺿﺮورﻳﺔ ﻟﺴﻼﻣﺔ اﻟﻤﺮﻳﺾ‪.‬‬ ‫‪ Digoxin is a cardiotonic glycoside obtained from the leaves of Digitalis lanata. It is a white‬‬ ‫‪crystalline powder that is insoluble in water but soluble in dilute alcohol solutions.‬‬ ‫‪ The official elixir contains about 10% alcohol.‬‬ ‫‪ No official method of preparation is indicated for Digoxin Elixir, USP; however, it is required‬‬ ‫‪to contain 4.5 to 5.25 mg of digoxin per 100 mL of elixir, or about 0.25 mg/5 mL teaspoonful.‬‬ ‫‪‬‬ ‫‪The usual oral adult dose of digoxin as a cardiotonic agent is about 1.5 mg on initial therapy‬‬ ‫‪and about 0.5 mg for maintenance therapy.‬‬ ‫‪ Digoxin is poisonous, and its dose must be carefully determined and administered to each‬‬ ‫‪individual patient.‬‬ ‫‪ Adults generally take digoxin tablets rather than the elixir, which must be measured by the‬‬ ‫‪highly variable household teaspoon.‬‬ Made with Xodo PDF Reader and Editor  The elixir is generally employed for children, and the commercial product available for this purpose is packaged with a calibrated dropper to facilitate accurate dosing.  Digoxin is one of many drugs available in more than a single dosage form.  The prescriber frequently has the choice of a solid dosage form—a tablet or capsule—or a liquid.  Figure below shows the differences noted in one study of the serum digoxin levels following administration of 0.5 mg of digoxin by oral tablet and oral solution having an elixirlike vehicle.  It can be readily observed that the serum digoxin levels following administration of the oral solution were considerably greater than from the oral tablet. Made with Xodo PDF Reader and Editor ‫ﺗﺸﻨﺠﺎت وﺗﻘﻠﺼﺎت‬،‫ﻣﻌﺪه‬ Made with Xodo PDF Reader and Editor Made with Xodo PDF Reader and Editor