BHaTpeuHO yhaTCTBO: MHq}OpMaLiMM 3a I{OpMCHMKOT

Pe6Mb 44 MMi{porpaMM/0,5 ml pacTBop 3a MHjeRTMpaibe Bo naTpoHMHTepq)epoH 6eTa-1 a

BHi"aTenHo npovMTajTe ro oBa ynaTCTBo npeA /]a noLIHeTe Aa ro 3eMaTe nei{oT6MAejkM CoApxM BaxHM MHd)opMaL+MM 3a Bac- HyBajTe ro ynaTCTBOTo. Moxe6M ke 6MAe noTpe6Ho Aa ro npo"TaTe noBTopHo.- AKo MMaTe AonoJiHMTen" npaLiJarba, o6paTeTe ce I(aj BauMOT JieKap, cpapMaueBT MJ"

MeAMLiMHCKa cecTpa.- OBoj ]iei( BM e npenMLuaH JiMilHo BaM. He MM ro flaBajTe Ha Apy" JiML+a. Moxe Aa MM

HaLiJTeTM, AypM M aKo HMBHMTe cMMnTOMM ce Mc" co BauMTe.- J]oKonity ce nojaBaT HecaKa" fiejcTBa, KOHcyJi"pajTe ce co JieKap, cpapMaLieBT MJ"

MeAML|MHcl(a CecTpa. oBa " BithyiiyBa M HecaKaHMTe AejcTBa I(oM He ce HaBeAe" Bo

ynaTCTBOTo. BMAeTe AeJl 4.

oBa ynaTCTBO co[]pxM:1. LIJTo npeTCTaByBa pe6McP M 3a uTo ce ynoTpe6yBa2. LIJTO Mopa Aa 3HaeTe npe/I Aa ro ynoTpe6MTe pe6Mq)3. KaKo /]a ro ynoTpe6yBaTe pe6Mdy4. Mox" HecaKa" AejcTBa5. IlyBaLbe Ha pe6Mq]6. CoApxMHa Ha naKyBattie M AonoJi"TeJi" noAaTOL|M

1. LJJTo npeTCTaByBa Pe6Mq) M 3a LUTo ce ynoTpe6yBa

Pe6Mq) npMnaFa Ha rpynaTa JieKOBM no3Ha" KaKo MHTepcpepo". TMe ce npMPOA"cyncTaHLiMM KOM " npeHecyBaaT cMrHaJiMTe noMefy KneTKMTe. MHTepd)epo"Te "npoM3BefiyBa caMMOT opraHM3aM M MMaaT eceHUMjaiiHa yiiora Bo MMyHoiioLi]KMOT cMCTeM.npeKy MexaHM3MM KOM He ce noTnoJiHo jac", MHTepd)epo"Te noMaraaT Aa ce J"MMTMpaOiiiTeryBatbeTo Ha L+eHTpaiiHMOT HepBeH cMCTeM noBp3aHO cO MyjiTMniia cKiiep03a.

Pe6M® e BMcoKo npoHMCTeH pacTBopJ"B npoTemu Koj e cJiMileH Ha npMPoAHMOTMHTep®epoH 6eTa Koj ce co3AaBa Bo iioBeilKOTo Teiio.

Pe6McP ce ynoTpe6yBa npM TpeTMaH Ha MyJi"nJia CKJiepo3a. floKaxaH0 e f|eKa "HaMaJiyBa 6pojoT M jaiMHaTa Ha HanaAMTe M ja 3a6aByBa nporpecMjaTa Ha i"BaJIMAMTeTOT.MCTo TaKa e o/]o6peH 3a ynoTpe6a Kaj naL|MeH" KOM 4oxMBeaJie e4MHeiJeH KJiMHMIIKMHacTaH 3a Koj MMa ro/ieMa BepojaTHocT Eel(a e npB 3HaL( Ha MyJiTMnJia CKJiepo3a.

2. uTo Mopa Aa 3HaeTe npeA Aa ro ynoTpe6MTe Pe6Mq)

He ynoTpe6yBajTe Pe6Mq)

• 4oKonKy cTe anep"ii" Ha npMpo/]eH M" peKOM6MHaHTeH MHTepd)epoH 6eTa MJ" Ha6Mno Koja cocTojKa Ha oBoj Jiei{ (BMAeTe AeJl 6).• AOKonKy cTe BO TeuKa AenpecMBHa cocToj6a.

npeAynpe4yBaiba M npeTna3iiMBocT

CoBeTyBaiTe ce co BauMOT JieKap, CbapMaHeBT M" MeAAa ro KoPMCTMTe Pe6McP.

• Pe6Mq) cMee 4a ce ynoTpe6yBa caMo nod JieKapcKa K* ..` i:' ,,-., yt: `\, I? *:i-fii{¥:£

noilHeTe

• npefl 3anouHyBaLbe Ha TpeTMaH co pe6McP B"MaTejiHo npo"TajTe " M onefleTe "CoBe"Te AaAe" Bo f|eJIOT "KaKo fla ro ynoTpe6yBaTe Pe6M¢" co L|efl Aa ce MMHMMM3MpapM3MKOT On nojaBa Ha HeKpo3a Ha MecTOTO Ha MHjeRTMpaH>e (OLUTeTyBalbe Ha KOxaTa MTKMBOTO) LUTO e 3a6eiiexaHO Kaj naLiMeH" Tpe"pa" cO pe6M¢. rlpM nojaBa Hanpo6neMa"H" iioKan" peaKL+MM KOHTaK"pajTe ro BaLL"oT iieKap.• npefi ynoTpe6a Ha pe6McP MHcPopMMpajTe ro BaLUMOT neKap M" cbapMaHeBT AOKonKycTe ajiep"u" (xMnepceH3i"B") Ha 6MJio Koj JieK.• 3a BpeMe Ha BauMOTTpeTMaH Moxe fla ce nojaBaT KPB" 3rpy"yBalt>a BO Ma"TeKPB" cafloBM. OBMe KPB" 3rpy"yBait>a MOxe Aa BJ"jaaT Ha Baii"Te 6y6pe3M. OBa Moxef|a Ce jaBM HeKOJIKy Hef|e" flo Hel(oJIKy roAM" no noHeTOKOT Ha Tepa"ja co Pe6McP.BaLi"oT JieKap Moke j]a no6apa MC"TyBaba 3a cJieAeibe Ha KPBHMOT npM"coK, KPBTa(6poj Ha TpoM6oLiM") M 6y6pexHa d]yHKLiMja

MHq)opMMpajTe ro JieKapoT floKOJiKy MMaTe 3a6oJiyBalbe Ha

• KOcKeHa CPL+eBMHa

• 6y6pe3M• upHAP06® CPHe

• "peoMAea• floKOJIKy cTe MMaJie AenpecMja• floKOJIKy i"aTe MCTopMja Ha enrmen"H" HanaAM,

Co Lien JieKapoT BHMMaTeJiHo Aa ro cJieAM TpeTMaHOT M eBeHTyaJiHOTo BJiou]yBatbe Ha oBMeCOCT0j6M.

J]py" nei{oBM M Pe6McP

MHcPopMMpajTe ro BaLUMOT JieKap M" a)apMaLieBT AOKOJiKy 3eMaTe, HeoAaMHa CTe 3eMaJieM]" Mo"e6M ke KopMc"Te 6MJio KOM flpy" JieKOBM.

oco6eHo M3BecTeTe ro Bau"oT IieKap fioKoliny ynoTpe6yBaTe aH"enMiien"L+M Mj"aH"AenpecMBM.

BpeMeHocT i4 Aoeibe

AOKOJiKy cTe 6PeMe", MMCJiMTe AeKa Moxe Aa cTe 6peMe" M" nncoBeTyBajTe ce co BaiJJMOT JieKap MJ" CpapMaL|eBT npefl fla noHHeTei;kThJe-:I; -oH-;K};a-a-T uJTe" ed)eK" bp3 AoeHMTe HOBopoAeHiiMiba/Moxe /ia ce ynoTpe6yBa 3a BpeMe Ha Aoelbe.

ynpaByBalbe co Bo3i4no M KopMCTelbe Ha MauJMHM

EcpeK"Te Ha caMaTa 6oJiecT M" Ha TpeTMaHOT MoxaT Aa BJ"jaaT Bp3____.__E_ .._ ,,-,,,, J|,|J ®^ ,I-\+,\,|\, ,I ,-,.- _ -..-. __ . __ _

cnoco6HocT 3a ynpaByBalbe Ha Bo3MJi6 M" ynoTpe6a Ha MaLLMHM. 3a oBpa3roBapaTe co Baii"oT JieKap AOKOJiKy CTe 3arpMxeHM.

Pe6Mq) coApxM 6eH3Mii aJil{oxon

Pe6Mcb coflpxM 2,5 mg 6eH3Mn aJIKoxofl Bo CeKoja flo3a. He cMee Aa ce flaBa Kaj'npeABpeMeHO Pof|e" f|eLia M" HOBoPOAeHM. MOxe fia npeAM3BMKa TOKCMH" peaKLiMM Kaj

/]oeHl+MLba M Aeua Ao 3 roAMUJHa Bo3pacT.

I,L`

3. KaKo []a ro ynoTpe6yBaTe Pe614cb

OBoj JieK e 3a MyJi"Ao3Ha ynqTpe6a.

2

Cei(orau ynoTpe6yBajTe ro Pe6McP ToiiHo TaKa KaKo iJJTo BM Kaxaii iieKapoT. AKo He cTeCMryp" npoBepeTe co Bai]]MOT iieKap.

J]o3Mpaibe

nauueHmu KOu ucKycu]]e e6uHeueH Ki]uHui+Ku HacmaHBoo6MHaeHo Ao3Mpait>e e 44 MMKporpaMM (12 MMJiMo" IE) AaBaH 3 na" HeAeJIHo.

r]auueHmu co Myi]muni]a cKiTepo3aBoo6MilaeHo Ao3Mpahae e 44 MMKporpaMM (12 MMJiMo" lE) /]aBaH 3 na" HeAeJiHo.

noHMCKOTo Ao3MpaLbe o/I 22 MMKporpaMM (6 MMiiMo" lE) AaBaH 3 na" HeAejiHo celipenopailyBa Kaj naLiMeH" KOM He MoxaT Aa TOJiepMpaaT noBMcoKa Ao3a.

Pe6Mq) Tpe6a Aa ce ynoTpe6yBa 3 na" HeAeJiHo, M AOKOJiKy e Bo3MoxHo:• Mc"Te TPM AeHa ceKoja HeAena (co HajManKy 48 iiaca nay3a, Ha np. noHeAeJi"K,

CpeAa, neTOK)• BO MCTO BpeMe oA AeHOT (HajAo6po HaBeiiep)

ynoTpe6a I{aj AeLia M "Heji|epi4 (2 Ao 17 ro4MLLiHa Bo3pacT)

He ce M3BeAe" a)opMan" tonMHMiiKM McnMTyBaha Kaj /]eHa M" "HejLiepM. KaKO M Aa e,nocToeHi(MTe KJiMHMHKM noAaTOLiM cyrepMpaaT AeKa 6e36eAHoc"oT npoq)MJi I(aj AeL|a M"HejLiepM KOM npMMaaT Pe6Md) 22 MMitporpaMM MJ" Pe6Mq) 44 MMKporpaMM 3 na"HeAeiiHo e ciiMiieH Kaito Kaj 803pacHMTe.

ynoTpe6a Kaj 4eL|a (nod 2 roAMLLJHa Bo3pacT)

He ce npenopaiiyBa ynoTpe6a Ha Pe6McP i{aj AeLia nofl 2 roAMLiJHa Bo3PacT.

Ha"H Ha ynoTpe6a• Pe6Mcp e HaMeHeT 3a cy6KyTaHo (nod KoxHo) MHjeK"paibe.

• llpBOTO Mrij.eK"PaLbe Mopa 4a ce M3Be4e noA Ha43op Ha cooABeTHoKBai"cPMKyBaHo 3ApaBCTBeHo i"Lie. rloctie cooflBeTHa o6yKa, BMe, iijieH Ha

¢aMM"jaTa, npMjaTeJi MJ" HeryBaTeri Moxe Aa " ynoTpe6yBaTe Pe6Mq) naTpoHMTeco BauMOT aBTormjeKTop 3a a/]MMHMCTPMpaLbe Ha JieKOT Bo AOMau" ycJioBM.rlaTpoHOT Tpe6a Aa ce KopMc" Mi" co Pe6MCMapT eiieKTpoHCKMOT MHjeKTop Mi" coPe6MCJiajA MaHyeJiHOTo neHKaJio 3a MHj.eRTMpabe, 3aBMCHo on AoCTanHoCTa BoBauaTa 3eMja. 4oKonKy MMaTe cna6 BM4 He Tpe6a Aa ro KopMCTMTe Pe6Mcnaj/IAOKOJIKy HeMaTe no4PLJJKa oA J"L+e Co 4o6ap BM4.

• HenocHo ynaTCTBo 3a ynoTpe6a ke 6MAe o6e36e4eHo co BaueTO MeAML|MHCKoCpeACTBo(Pe6MCMapT, Pe6MCJlajA). Be MOJIMMe Aa " CJieAMTe BHMMaTeJIHo.

• KpaTKo ynaTCTBo 3a KaKO Aa ce KoPMCTaT naTPO"Te 9~9¥~¥

AafleHo noAOJie.

npe6 6a 3anoHHeme

• TerfuenHO M3MMTe " paueTe co canyH M BOAS.

• M3BaAeTe ro pe6Mq) naTpoHOT OA 6J"cTep Hal(`',``gr`t-:t:I,5-i::ii;

3

nJiacTMiiHMOT I(anaK.

04 0BMe HanpaBM e

\`!+gThp*T5e€K,a`¥±9#'roo4ne"Te

• rlpoBepeTe (BeflHau no BaAeibe oA ®pMXMAep) AaJ" naTpoHOT He e ciiyiiajHo3aMp3HaT Bo naKyBaLbeTo MJiM Bo anapaTOT. CaMo 6MCTap Ao onaJiecLieHTeH

pacTBop 6e3 npMcycTBo Ha HecTMilKM M 6e3 BMAJIMBM 3HauM Ha pacnaFabe Moxe Aace KOpMCTM.

• 3a Aa ce cTaBM naTpoHOT Bo anapaTOT (MeAML+MHCKOTo cpeACTBo) M /]a ce M3BeAe

MHjeK"paibeTo cjiefieTe ro rlpMpail"KOT 3a ynoTpe6a o6e36eAeH co BaueToMeAMLiMHcito cpeACTBo.

Kaoe 6a ao uHjeKmupame Pe6u¢

• OA6epeTe MecTO Ha MHjeK"patt,e. JleKapoT ke Bi"M noco"MoxHMTe MecTa Ha MHjeK"paLE>e fao6pM MecTa ce ropHMOT Pen o46yTOBMTe M AoiiHMOT a6fioMeH). rlpenopail"Bo e Aa BOAMTeeBM/]eHL+Mja M Aa " MeHyBaTe MecTaTa Ha MHjeK"PaH>e, 3a Aa He ceMHjeRTMpa 04Pe4eH npe4en npellecTo, KaKo 6M ce MMHMMM3Mpaii

PM3MKOT oA HeKpo3a Ha MecTOTo Ha MHjeK"paLbe.

3ABEJIELIIKA: He KopMCTMTe MecTa KaAe ilyBCTByBaTe AeKa MMa rpyTKM,iiBopoBM Mi" 6oni{a; pa3roBapajTe Co BauMOT Jlei(ap MJ" 3ApaBCTBeH

pa6oT"K 3a oHa i]JTo ke ro HajAeTe.

• rlpeA MHjeKLiMjaTa, Mc"cTeTe ro co ajiKOxoii MecTOTO HarmjeK"paitie. rloueKai.Te Aa ce McyLUM KoxaTa. floKoiiKy ocTaHeMaiio KoiiMilecTBo aJiKoxon Ha KoxaTa, Moxe Aa noiiyBCTByBaTeneuKaLbe,

KaKo Oa eo uHjeKmupame Pe6udJ

BaLUMOT JieKap Re BM Kaxe Kai{o /]a ja oA6epeTe ToilHaTa /]o3a oA 22 MMitporpaMM. BeMOJiMMe 4a " npoi]MTaTe M MHCTpyKL+MMTe Bo rlpMpail"KOT 3a ynoTpe6a Ha BaueToMeAML"HCKo cpeACTBo.

BauMOT tieKap Moxe fia BM npenMLiJan Pe6MCMapT MJ" Pe6McriajA MeAMUMHCKoCpecflTBo. floKOJIKy BM npenMLiJaJi Pe6MCMapT BMAeTe ro AeJloT "4oKanKy KopucmunePe6uCMapm" . Bo onpc)rTviBHCITo Bvip|ere ro pienor p|enor "L|oKonKy Kopucmume_Pe6ucnaj6''\

"EOKonKy Kopucmume Pe6uCMaprrf'

® Be MOJiMMe Aa ripoBepMTe npe4aJ" 403aTa noKaxaHa Ha eKpo4roBapa Ha npenMLJJaHaTa 403MMKporpaMM

•9A``a`IiI-' `-`_-I-~. '6P

1`44..,..I:,-I-i ,-,. ;i,'' *

•` \:'-,

Fi-d;I;ire:-;.+o pe6MCMapT nod npa;\`a-r6ri-`G0orBo oAHoc Ha KoxaTarlpM"cHeTe ro KonveTO 3a MHjeRTMpalbe. 3aBpeMe Ha MHjeRTMpaibeTO I(OniieTO ke cBe" cO3eiieHa cBeTnMHa.rloiieKajTe AOAeKa 3eiieHOTO cBeTiio He ceMCKiiyi". Toa 3HauM AeKa rmjeK"patbeTo e3aBPLLleHo.

TprHeTe ro Pe6MCMapT oA MecTOTo Ha

KOpuc_prume Pe6ucna

4

Be Mo]IIIMe z[a IIpoBepHTe IIpe;I HHjeK"palbeTo z|aTmz|03aTa IIOKaxaHa Ha ;|03HHOT IIp03Opel| o;I IIOMaraTIOTOIIOKaryBa o.5 ml (inTo o;|roBapa Ha IIpeHHmaHaTa ;|o3aoH 44 MHKpoxpaMH)3a6oz[eTe ja HrTlaTa Bo Ko"aTa KaKo inTo BH KarajlBallmoT ]IeKap.

HpxeTe ro Pe6HC]Iaj;I I|BpcTo H IIPHTIICHeTe ro KolltleToHa jlH3ralbe Ha cTpaHaTa oH IIOMarajloTo.

HPxeTe ro Pe6H CJlaj;I Ha MecTo ;|o;|eKa "0" He ceIIojaBH Ha ;|o3HHOT npo3opel|, IIOToa IIoqeKajTe 1 oCeKyHZ|H IIpe;I o;|CTpaHyBaH]e Ha HrjlaTa o;I KoxaTa.TprHeTe ro Pe6HC]Iaj;I o;I MecTOTo Ha IIHjeK"palbe.

rlocne uHjeKmupalbemo Ha Pe6uct)• M3BaAeTe ja MrJiaTa M oficTpaHeTe ja cnopeA MHCTpyKLiMMTe Bo rlpMpaii"KOT 3a

ynoTpe6a Koj BM e flafleH co BaueTo MeAMLiMHCKo cpeACTBo.• HexHO MacMpajTe ro MecTOTO Ha MHjeK"paibe co cyB naMyK rmi"a3a.• llyBajTe ro BaueTO MeflMLirmcKo cpeACTBO Koe coApxM naTPoH o/I Pe6Md), KaKO IJJTo

e HaBeAeHo Bo AerioT 5: "llyBaibe Ha Pe6McP"

flol(OJiKy MMaTe AonoJiHMTen" npaLi]ahaa KOHcymMpajTe ce co BauMOT iieKap, Me/]MLii"ci(acecTpa M" cpapMaLieBT,

J]oKoni{y npMMMTe noBeke Pe6M® oTi{oiiKy uTo e noTpe6Ho

Bo onyiiaj Ha npeAo3Mpaibe, BeflHau KOHTaK"pajTe ro BauMOT iieKap.

J]oi{onry cTe 3a6opaBMne Aa npi"MTe Pe6Md}

floKOJiKy nponylJJTMTe Ao3a, npoAorlxeTe Co mjeK"Paibe Co AeHOT 0A HapeAHaTanJiaHMpaHa Ao3a. He 3eMajTe AynJia Ao3a 3a Aa ja HaAOMecTMTe 3a6opaBeHaTa.

J]oi{onKy npecTaHeTe Aa npMMaTe Pe6M®

Eq)eRTMTe Ha Pe6Mq) Moxe 4a He " npMMeTMTe BeAHaLJJ. 3aToa, He Tpe6a Aa npeKMHeTe Co

ynoTpe6a Ha Pe6Mq), ryny Aa npoAoiixMTe Aa ro ynoTpe6yBaTe pefloBHo 3a Aa ce nocTMrHecaKaHMOT pe3yJiTaT. floKoiiKy He cTe cMryp" 3a KopMCTa, Be MoiiMMe KOHcyTi"pajTe ce coBauMOT jieitap.

He Tpe6a Aa ro npeKMHeTe TpeTMaHOT 6e3 npBo Aa ro KOHTaKTMpaTe BauMOT rieKap.

floKOJiKy MMaTe Hejac" npaLi]aHDa noBP3a" 3a ynoTpe6aTa Ha JieKOT, KOHcyJi"pajTe ce coBauMOT jiertap, a)apMaL+eBT Mi" Me4MLiMHCKa cecTpa.

4. MoxHM.\Hecai{a" /]ejcTBa

KaKo cMTe JieKOBM, oBoj JieK MOxe Aa npeAM3BMKaKaj ceKoj.

5

He ce jaByBaaT

BeAHaLu M3BecTeTe ro BauMOT nel{ap M npel{MHeTe Aa npl"aTe Pe6McP 4oi(oiiKynovyBCTByBaTe 614no I{oe o|] cne[]HMTe CepMo3HM Hecai(a" 4ejcTBa :

• CepMo3" aiTep"cKM (xrmepceH3M"BHoCT) peaKu". floKOJiKy Be/]Hau nonpMMaLbeTo Pe6McP oce"Te o4HeHaAex TeLLJKOTMM co 4MLLJeH>eTo, Koe Moxe Aa CenojaBM noBp3aHo cO OTeKyBatbe Ha J"LieTo, ycHM, ja3MK Mi" rpiio, OcMn, ileLLiaLbe noLieiioTO Teiio M HyBCTBO Ha cna6OcT Mj" HecBecTMLia, KOHTaK"pajTe ro BeAHauBauMOT JieKap MJ" no6apajTe MTHa MeAML|MHCKa noMou. OBMe peaKHMM ce pemKw

(Moxe fia ce jaBaT Kaj 1 Ha 1.000 iiyfe).

BeAHau M3BecTeTe ro BauMOT IieKap AOKoiiKy noiiyBCTByBaTe 6Miio Koe oncJieAHMTe Mox" cMMnTOMM Ha np06JleMM co lipHMOT flp06: xoJiTMLia

(noxomyBaLbe Ha itoxaTa MJ" 6enKMTe Ha oiMTe), i]"PoKo pacnpocTpaHeToileuJaH9e, ry6erbe Ha aneTMT npMApyxeHo co raAerbe M noBpakarbe M iiecHoco3AaBaibe Ha MOAPMHKM Ha KOxaTa. TeuKM npo6JleMM co LipHMOT Apo6 MoxaT Aa6MAaT noBp3a" Co CJleAHMTe 3HaLiM, Ha np.: noTeLUKOTMM npM i{oHLieHTPMparbe,nocnaHocT M KOH¢y3Mja.

J]enpecMjaTa e i/ecma (Moxe Aa ce jaByBa Ao 1 Ha 10 iiyfe) I(aj TpeTMpa"naLiMeH" co MyiiTMnria cKJiepo3a. floi(oni(y Ce iiyBCTByBaTe AenpecMBHo MJiMi"aTe caMoy6MCTBeHM MMcnM, Be4Hau M3BecTeTe ro BauMOT JieKap.

Pa3roBapajTe co BauMOT nel{ap 4ol{onl(y novyBCTByBaTe 6MJio i{oe o[] CneAHMTeHecal{a" AejcTBa:

Ci"nTOMM HaiiMi( Ha rpMn, KaKo rJiaBo6oiiKa, TeMnepaTypa, MopHMLiM, Myci(yri" M6oJiKM Bo 3riio6oBM, 3aMoP M raAeH>e Ce MHoey iJecmu (Moke Aa ce jaByBaaT KajnoBeke oA 1 Ha 10 nyFe).

oBMe cMMnTOMM ce o6MiJHo yMepeHM, noiiec" ce Ha noileTOKOT Ha TpeTMaHOT M ceHaMaJiyBaaT npM KOH"HyMpaHa ynoTpe6a.

3a Aa ce HaMaJiaT oBMe cMMnTOMM BauMOT JieKap Moxe Aa Be nocoBeTyBa Aa3eMaTe aHTMnMpeTMiieH aHaJireTMK npen 4o3aTa Ha Pe6McP M Ao 24 iiaca nociiecei{oja MHjeKLiMja.

PeaKL|MM Ha MecTOTo Ha MHjel{"pait.e BKiiyilyBaaT L|pBeHMJio, OTOK, 6rBocnaiieHMe, 6oJiKa M pa" Ha KoxaTa M ce MHoey I/ecmu.PeaKL+"Te Ha MecTOTo Ha rmjeK"pafoe o6MiiHo ce HaMaJiyBaaT co TeKoBpeMeTo.ouTeTyBalbe Ha TKMBOTO (Heitpo3a), ancuec M Maca Ha MecTOTO Ha MHjeHe6oo6ut+aeHu (Moxe /]a Ce ce jaByBaaT Kaj.1 Ha 100 iiyfe).

BMAeTe " npenopaKMTe 80 AeJioT "rlpeAynpeAyBaiba M npeTna3J"BocT"MMHMMM3MpaTe pM3MKOT oA peaitL+MM Ha MecTOTo Ha rmjeK"patbe.

MecTOTo Ha MHjeRTMpaibe Moxe Aa ce MHq]ML+Mpa (noManry vecmo); KoxaTa Mox6-~Aa cTaHe oTeiieHa, HanHaTa M LiBpcTa M ueiiaTa pe"ja Moke /]a 6MAe MHory 6oiiHa.floKonKy noilyBCTByBaTe HeKoj qu oBMe CMMnTOMM, KOHTaK"pajTe ro BauMOT iiei{ap3a cOBeT.

04peAe" Bpe4HOC" Ha Jla60PaTopMcl{M TecTOBM MoxaT Aa ce npoMeHaT. OBMenpoMe" reHepaJiHo He " 3a6ene>KyBa nauMeHTOT (6e3 cMMnTOMM), Boo6MHaeHo ce

peBeb3m6MJiH,M M yMepe" M HajilecTo He 6apaaT noce6eH TpeTMaH.

BbojoT Ha epMTpouMTM, JieyKOLiM" M" TpoM6oLiM" Moxe Aa ce HaMaliaT Mi"Hoe+]MHeHHo (MHoey t/ecmo) MJ" cMTe o/]ef]Hau toemro). Mox" cMMnTOMM KOMpe3yJi"paaT o4 oBMe npoMe" MoxaT 4a 6M/]aT 3aMop, HaMalieHa cnoco6HocT 3a6op6a npoTMB MHcpeKLiMM, MoflpMHKM Mj" Hepa3jacHeTo KPBapetbe.

6

MoxaT Aa 6MAaT HapyLIJe" TecTOBMTe 3a a)yHKLiMjaTa Ha UPHMOT Apo6 (MHoayt+ecmo). rlpMjaBeHo e M BocnaiieHMe Ha LipHMOT Apo6 (He6oo6uttaeHo). floKOJiKy

noiiyBCTByBaTe cMMnTOMM KOM cyrepMpaaT 3a6onyBarbe Ha L+PHMOT Apo6, Kar(o

ry6elbe aneTMT npMflpyxeH co Apy" cMMnTOMM KaKo rafleibe, noBpakaibe, xoJiTMLia,Be MOJiMMe BeAHau KOHTaK"pajTe ro BauMOT JieKap (BMAeTe norope "BeAHauM3BecTeTe ro BauMOT JieKap.„").

3a6onyBaibe Ha TMpeoMAeaTa e He8oo6wvaeHo. ®yHKL|MjaTa Ha TMpeoMAHaTa>KJle3Aa MOxe fla 6MAe 3roJleMeHa MJ" HaMaJieHa. OBMe npoMe" Bo atITMBHocTa HaTMpeoMAeaTa naLiMeHTOT He " 3a6ene}KyBa peiMCM HMKorau KaKo cMMnTOMM; cenaKBauMOT JieKap Moke f]a npenopaila cooABeT" TecTOBM.

MC nceyflo-PeJianc (Heno3Hama ¢peff¢eHt{u/.a): nocTOM MoxHocT Ha noiieTOK HaTpeTMaHOT co Pe6Mq) /]a noiiyBCTByBaTe cMMnTOMM KOM noTceTyBaaT Ha peJianc HaMyTiTMniia cKTiepo3a. Ha np. MycKyl"Te Moxe Aa 6MAaT MHory HanHa" MJ" MHoryona6M, CnpeilyBajkM Be Aa ce 4BMXMTe KaKo uTo caKaTe. Bo HeKOM onyiiaM Bar(BMTecMMnTOMM ce noBp3aHM co TeMnepaTypa Mi" cMMnTOMM HaJiMK Ha rpMn KOM CeonMLiJa" npeTxoAHo. floKonKy 3a6eJiexMTe HeKoj oA oBMe HecaKa" AejcTBapa3roBapajTe co BaLUMOT JieKap.

J]py" Mox" Hecal{aHM AejcTBa BrmyLlyBaaT:MHory iiec" (MOxe Aa Ce jaBaT Kaj noBeke oA 1 Ha 10 nyfe):• rnaBo6onLta

llec" (Moke Aa ce jaBaT Kaj 1 Ha 10 iiyfe):• Heco"L+a (HapyuyBaLbe npM c"eibe)• rlpoi"B , raAetbe, noBpakaHDe• lleuaitie, oCMn (Kox" epynL+MM)• BoiiKa BO MycKyi" M 3rmo6oBM• 3aMop, TeMneparypa, Mop"L+M• ry6MTOKHaKOca

HeBoo6Muae" (Moxe Aa ce jaBaT Kaj 1 Ha 100 nyfe):• yp"KapMja• E"nen"ii" Hana4M• Bocnaiie"e Ha Lip"oT Apo6 (xena""c)• rloTeuKO"M co flMueibe• KoaryiiaLiMja Ha KPBTa KaKO Ana6oKa BeHCKa TpoM6o3a• HapyuyBaiba Ha pe"HaTa (3aflHMOT AeJi Ha oKOTo) KaKO Bocnane"e M"

Koaryi"paLbe Ha KPBTa cO nocrieAMVHM HapyLliyBaH>a Ha BM4oTBMAOT, ry6eLbe Ha BMAOT)

• 3roJieMeHo noTeLbe

PeTKM (Moke Aa ce jaBaT Kaj 1 Ha 1.000 Jiyfe):CaMoy6MCTBeHM M4eM

CepMo3" Kox" peaKLiMM - HeKOM co iie3MM Ha MyKo3a_ _I_.__. .-' '._-.-' .-' I__-`' -----.. '_-._.. __ --__-.'. .._ ...,. `___

8;35:33Mr?T#6aoi:HBH°a¥::#:eoE£::#ecHaMflu°HBaMnKy°pMnyp°ax:=Mfl:eBMh\#E#'REi*fiat?i`'eHcMHApoM). CMMnTOMMTe Moxe 4a BKTiyvyBaaT: 3roiieMeHa nojaBa Ha Mo4pMHKM,I(pBapetbe, TpecKa, eKCTpeMHa ona6ocT, rjia'Bo6otiKa, BPTorJiaBMLia M3aLIJeMeTeHoCT. BauMOT JieKap Moxe Aa oTKPMe npoMe" Bo BauaTa KPB MJiM

a)yHKLiMjaTa Ha BauMTe 6y6pe3M.Lupus erythematosus npeAM3BMKaH oA IieKOT: HecaKaH e¢eKT npM AOJiroTpajHa

ynoTpe6a Ha Pe6Md}. CMMnTOMMTe MoxaT Aa BrmyilyBaaT MycKyJiHa 6oJiKa, 6oJiKa

Ha 3rJio6 M OTOK, M ocMn. MCT0 Tai(a Moke Aa noilyBCTByBaTe Apy" 3HaLiM KaKonoKaHeHa TeMnepaTypa, ry6MTOK Ha TexMHa M 3aMop. 06MiiHo cMMnTOMMTeMciie3HyBaaT 3a eAHa flo ABe He/]eJ" no npeKi"yBatbe Ha TpeTMaHOT.CTBapaibeTo Ha Jiy3" Ha 6y6pe3MTe Moxe Aa ja HaMaJ" BauaTa 6y6pexHacpyHKLiMja.

floKonl(y 3a6enexMTe HeKOM oA cJieAHMTe cMMnTOMM :o 3aneHeTaypMHao 3aMOPo OTOLiM, oco6eHo Ha 3rJio6oBMTe M oilHMTe KanaL+M, M Ao6MBarbe Ha TexMHaM3BecTeTe ro BaLUMOT iieKap 6MAejkM Toa Moxe Aa ce 3HaLiM Ha Mox" npo6neMMco 6y6pe3MTe.

CJieA"Te HecaKaHM fiejcTBa ce npMjaBeHM 3a MHTepcbepoH 6eTa (Heno3HaTacppeKcpeHUMja)

BPTorTiaBMLia

HepBo3ary6MTOK Ha arieTMT

flMJiaTaLiMja Ha KPB" caAOBM M naJii"TaHMjaHepeAOBHoCT M/MJ" npoMe" Bo MeHCTpyajieH LiMKiiycrlyiiMOHapHa apTepMCKa xMnepTeH3Mja -3a6oJiyBaLbe co cepMo3Ho cTecHyBarbe HaKPBHMTe ca4oBM Bo 6enMTe 4po6oBM LJJTo pe3yliTMpa co BMcoK itpBeH npMTMcoK BoKPBHMTe cafioBM KOM ja HocaT KPBTa ofl cpLieTo Ao 6enMTe 4po6oBM. rlyliMOHapHaapTepMCKa xMnepTeH3Mja e 3a6eJiexaHa Bo pa3j"ilHM BpeMMH>a oA TpeTMaHOT,BKTiyilyBajkM M HeKoriKy ro/]M" no 3arioilHyBaLbe Ha TpeTMaH co Pe6McP.BocnalieHMe Ha MacHOTo TKMBo nod KoxaTa (na"Kyiiy"c) LUTo Moxe Aa ja HanpaBMKoxaTa 4a Ce llycTByBa TBPAa M MoxHo e 4a Ce Pa3BMjaT 60nHM HPBe" rpyTKM M"McriaKHaTM AeJioBM oA KoxaTa

He Tpe6a Aa ro npeKi"eTe MJM npoMeHMTe TpeTMaHOT 6e3 fia ce nocoBeTyBaTe co BauMOTJlel(ap.

J]eL|a M "Heji|epMHecaKaHMTe AejcTBa I(aj Eel+a M "HejLiepM Ce C"u" I(aKo oHMe 3a6enexa"803pacHMTe.

npMjaByBalbe Ha Hecai{aHM AejcTBa

floKOJIKy 3a6eJiexMTe 6Mno Koe HecaKaHo AejcTBo, KOHcyJi"pajTe ro BancpapMaueBT M" MeAML+MHCKa CecTpa. oBa " BithyilyBa M HecaKaHMTe AejBHece" Bo ynaTCTBOTo. HecaKaHMTe PeaKHMM on JieKOBMTe Moxe Aa " nAMpeKTHo Bo HaLiMOHaii"oT LieHTap 3a cpapMaKOBM"iiaHL+a npM AreHLiMj€MeAML+MHCKM CpeflcTBa (yJl.CB.KMPMJi M MeTOAMj 6p.54 KaT 1) Mi" Ilo eiieKnpeKy Be6 cTpaHaTa Ha AreHLiMjaTa http://malmed.gov.ink/. Co npMjaByBatbe HaAejcTBa noMaraTe FLa ce 06e36eAaT noBeke MH¢opMaL+MM 3a 6e36e/]HocTa Ha oBoj iieK.

5. IIycaue Ha pe6Mq)llyBajTe ro i]eKOT noAaJieny o4 BMAMK M AocpaT Ha 4eHa.

He ro ynoTpe6yBajTe JieKOT no noMi"yBaLbe Ha POKOT Ha ynoTpe6a Koj e o6ene}KaH HanaKyBatbeTo no EXP.

LJyBajTe rb Bo ®pM>KMqep (2°C- 8 °C).

He ro 3aMp3HyBajTe. (3a 4a ce eJiMMMHMDa onviiaiHo 3aMD3HVBalbe. He ro vvBaiTe Bo6nM3MHa Ha KOMODaTa 3a 3aMD3HVBaLbe).

rty;;I(2C

Ce ynoTpe6M Bo POK oA 28 AeHa nociie npBOTo MHjeK"paitie.

eflMLii"cKOTo cpeACTBo (Pe6MCMapT Mi" Pe6Mciiajfl) Koe co/]pxM npe"oAHo HanoJiHeTco Pe6Mq) Mopa Aa ce ilyBa Bo Ky"jaTa 3a iiyBart>e Ha cpe4cTBOTo Bo ®pMXM4ep

8 °C). Co LLen 3a aM6ynaLiTCKa yn6Tpa6a, MoireTe 4a ro M3Ba4MTe Pe6Md] onbT€-O:

a)PMXMflep M Moke Aa ce HyBa Ao 25 a C, caMo eAHau HajAOJiro Ao 14 AeHa. Pe6M¢ noToaMopa Aa ce llyBa Bo cPpMXMAep M Aa ce McitopMc" npeA POKOT Ha ynoTpe6a.

I+yBajTe ro 80 OpM"HanHaTa aM6aiiaxa, 3a Aa ro 3aLi]TMTMTe on cBeTJiMHa.

He ro ynoTpe6yBajTe iieKOT AOKoiiKy 3a6eiiexMTe BMAJiMBM 3HauM Ha pacnafalee KaK0

floKOJiKy TeilHoCTa CoAPxM HecTMLiM MiiM e 3aMaTeHa.

JleKOBMTe He Tpe6a 4a ce oTCTpaHyBaaT co oTna4Ha Bo4a M" co AOMaLJJeH OTna4.npauajTe ro BauMOT cpapMaueBT I(aKo Aa " oTCTpaHMTe iieKOBMTe Koi4 He BM ce noBekenoTpe6". oBMe MepKM fe noMorHaT 3a 3au]TMTa Ha OKoiiMHaTa.

6. CoApxMHa Ha nat(yBaLbe M /]onoliHMTeliHM hoAaTOL|M

LJJTo coi]pxM Pe6Mdy

• AK"BHaTa cyncTaHLiMja e MHTepcpepoH 6eTa-1 a. CeKoj naTpoH cofipxM 132MMKporpaMM, LJJTo of]roBapa Ha 36 MMJiMo" MHTepHaL+MOHaii" eAi"MLiM (lE)MHTepcpepoH 6eTa-1 a.

OcTaHa" cocTojKM ce MaHMToii, noiioKcaMep 188, Jl-Me"o"H, 6eH3M+I aJii(oxoJi,HaTPMyM aL+eTaT, oLieTHa KMceiiMHa, HaTPMyM xM/]poi(CMA M BOAa 3a MHjeKL+L".

Kal{o M3rneAa Pe6Mdy M coApxMHa Ha naKyBalbe

rlpeTxOAHO HanoiiHeTMOT naTpOH ("n I cTaKno) cO cTonep (ryMa) M 3aneilaTeH 3aTBOpaii

(aiiyMM"yM M xaiio6y"ji ryMa) Koj coApxM 1,5 ml pacTBop 3a MHjeRTMparbe. Pe"cTPMpaHoe naKyBaitte co 4 naTpoHM.

rlaTpoHOT Tpe6a Aa ce KopMc" Mi" co Pe6MCMapT ejiRTpoHCKMOT MHjeKTop MrM coPe6MCJiajA MaHyeJiHOTo neHKaJio 3a MHjeK"patbe. oBMe MeAML+MHCKM cpeACTBa ceHa6aByBaaT offleJIHo. He cMTe MeflML|MHCKM cpeACTBa ce AocTan" Ha cMTe na3apM.

HaLIMH Ha M3AaBarbe Ha Jlel{oT

Jlel(OT MOxe Aa Ce npMMeHyBa caMo Bo 3ApaBCTBeHa opra"3aLiMja (3)

J]aryM Ha nocneAHa peBM3Mja Ha ynaTCTBOTo

AnpMn 2020

HOCMTeiioT Ha oAo6peHi4e 3a cTaBalbe Bo npoMeT

BApyc AooeJi,

yJl. CKy" 6p.57,

CKonje, M_aKe4oHwia' PeueHMe 6p.11-11888/2 oA 11.01.2019

npoM3BOAMTen

Merck Serono S.p.A.-MOAyibo (BapM), MTa"ja

/ Merck Serono S.A .-Ay6oHe, LIJBajLiapMja