{"id":54720,"date":"2023-09-20T10:02:51","date_gmt":"2023-09-20T10:02:51","guid":{"rendered":"https:\/\/medsname.com\/galamer\/"},"modified":"2026-05-01T10:49:12","modified_gmt":"2026-05-01T10:49:12","slug":"galamer","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/galamer\/","title":{"rendered":"Galamer"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Galamer?<\/h3>\n<p style=\"margin:0;\"><strong>Galamer<\/strong> je peror\u00e1ln\u00ed tableta od Sun Pharma obsahuj\u00edc\u00ed <strong>galantamine 4 mg<\/strong> \u2014 dvoj\u00fa\u010dinkov\u00fd l\u00e9k, kter\u00fd sou\u010dasn\u011b <strong>inhibuje acetylcholinester\u00e1zu<\/strong> a <strong>pozitivn\u011b moduluje nikotinov\u00e9 receptory ACh<\/strong>. Pou\u017e\u00edv\u00e1 se k symptomatick\u00e9 l\u00e9\u010db\u011b <strong>m\u00edrn\u00e9 a\u017e st\u0159edn\u011b t\u011b\u017ek\u00e9 Alzheimerovy choroby<\/strong>. Pomal\u00e1 titrace: <strong>4 mg dvakr\u00e1t denn\u011b po dobu 4 t\u00fddn\u016f \u2192 8 mg dvakr\u00e1t denn\u011b po dobu 4 t\u00fddn\u016f \u2192 12 mg dvakr\u00e1t denn\u011b jako udr\u017eovac\u00ed d\u00e1vka<\/strong>. <strong>U\u017e\u00edvejte s j\u00eddlem<\/strong> pro sn\u00ed\u017een\u00ed gastrointestin\u00e1ln\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f (nej\u010dast\u011bj\u0161\u00ed vedlej\u0161\u00ed \u00fa\u010dinky v\u0161ech inhibitor\u016f AChE). Maxim\u00e1ln\u00ed udr\u017eovac\u00ed d\u00e1vka je <strong>16 mg\/den p\u0159i st\u0159edn\u011b t\u011b\u017ek\u00e9m po\u0161kozen\u00ed jater nebo ledvin<\/strong>. Stejn\u011b jako u v\u0161ech inhibitor\u016f AChE, nikdy nep\u0159est\u00e1vejte n\u00e1hle.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Galamer?<\/h2>\n<p>Galamer jsou peror\u00e1ln\u00ed tablety od Sun Pharma obsahuj\u00edc\u00ed <strong>galantamin hydrobromid 4 mg<\/strong>. Galantamin je mezi inhibitory cholinester\u00e1zy pou\u017e\u00edvan\u00fdmi u Alzheimerovy choroby unik\u00e1tn\u00ed, proto\u017ee m\u00e1 <strong>dva dopl\u0148kov\u00e9 mechanismy<\/strong>: reverzibiln\u011b inhibuje acetylcholinester\u00e1zu (standardn\u00ed cholinergn\u00ed mechanismus) a nav\u00edc p\u016fsob\u00ed jako <strong>pozitivn\u00ed alosterick\u00fd modul\u00e1tor nikotinov\u00fdch acetylcholinov\u00fdch receptor\u016f<\/strong>, zesiluje \u00fa\u010dinek acetylcholinu na t\u011bchto synaps\u00edch.<\/p>\n<p>Galamer od spole\u010dnosti Sun Pharma je 4 mg tableta galantaminu \u2014 po\u010d\u00e1te\u010dn\u00ed d\u00e1vka pro 8t\u00fddenn\u00ed titraci u m\u00edrn\u00fdch a\u017e st\u0159edn\u011b t\u011b\u017ek\u00fdch forem Alzheimerovy choroby. Titrujte po dobu 8 t\u00fddn\u016f na udr\u017eovac\u00ed d\u00e1vku 16 mg\/den nebo 24 mg\/den. V\u017edy u\u017e\u00edvejte s j\u00eddlem, abyste minimalizovali nevolnost. Galantamin je schv\u00e1len pro <strong>m\u00edrn\u00e9 a\u017e st\u0159edn\u011b t\u011b\u017ek\u00e9 Alzheimerovy choroby<\/strong> \u2014 stejn\u00fd rozsah z\u00e1va\u017enosti jako donepezil a rivastigmin. Je p\u0159irozen\u011b z\u00edsk\u00e1v\u00e1n z cibul\u00ed sn\u011b\u017eenek a narcis\u016f (p\u016fvodn\u011b izolov\u00e1n z <em>Galanthus<\/em>) a po desetilet\u00ed se pou\u017e\u00edval ve v\u00fdchodn\u00ed Evrop\u011b p\u0159ed schv\u00e1len\u00edm pro Alzheimerovu chorobu na Z\u00e1pad\u011b.<\/p>\n<h2 class=\"wp-block-heading\">Jak Galamer funguje?<\/h2>\n<p>Alzheimerova choroba je charakterizov\u00e1na postupnou ztr\u00e1tou cholinergn\u00edch neuron\u016f v baz\u00e1ln\u00edm p\u0159edn\u00edm mozku. Galantamin to \u0159e\u0161\u00ed dv\u011bma dopl\u0148kov\u00fdmi mechanismy:<\/p>\n<ul>\n<li><strong>Reverzibiln\u00ed inhibice AChE<\/strong> \u2014 zvy\u0161uje hladiny synaptick\u00e9ho acetylcholinu u zb\u00fdvaj\u00edc\u00edch cholinergn\u00edch synaps\u00ed (stejn\u00fd mechanismus jako donepezil a rivastigmin).<\/li>\n<li><strong>Pozitivn\u00ed alosterick\u00e1 modulace nikotinov\u00fdch ACh receptor\u016f<\/strong> \u2014 galantamin se v\u00e1\u017ee na samostatn\u00e9 m\u00edsto nikotinov\u00fdch receptor\u016f a zesiluje jejich reakci na acetylcholin. Tento dvojit\u00fd mechanismus m\u016f\u017ee vysv\u011btlovat, pro\u010d n\u011bkte\u0159\u00ed pacienti reaguj\u00ed na galantamin po ne\u00fasp\u011bchu s jin\u00fdmi inhibitory AChE, a\u010dkoli p\u0159\u00edm\u00e9 srovn\u00e1vac\u00ed studie ukazuj\u00ed podobn\u00fd celkov\u00fd kognitivn\u00ed p\u0159\u00ednos.<\/li>\n<li><strong>Dvakr\u00e1t denn\u011b<\/strong> \u2014 galantamin m\u00e1 krat\u0161\u00ed polo\u010das (~7\u20138 hodin) ne\u017e donepezil, proto vy\u017eaduje dvakr\u00e1t denn\u00ed d\u00e1vkov\u00e1n\u00ed pro stabiln\u00ed hladiny v plazm\u011b.<\/li>\n<\/ul>\n<p>N\u00e1stup kognitivn\u00edho p\u0159\u00ednosu: viditeln\u00fd p\u0159i <strong>6\u201312 t\u00fddn\u016f<\/strong> udr\u017eovac\u00ed d\u00e1vce 16\u201324 mg\/den; vrchol\u00ed po 6 m\u011bs\u00edc\u00edch.<\/p>\n<h2 class=\"wp-block-heading\">Pou\u017eit\u00ed a indikace<\/h2>\n<ul>\n<li><strong>M\u00edrn\u00e1 demence u Alzheimerovy choroby<\/strong> \u2014 inhibitor cholinester\u00e1zy prvn\u00ed volby<\/li>\n<li><strong>St\u0159edn\u011b pokro\u010dil\u00e1 demence u Alzheimerovy choroby<\/strong> \u2014 prvn\u00ed volba, \u010dasto kombinovan\u00e1 s memantinem v pozd\u011bj\u0161\u00ed st\u0159edn\u011b pokro\u010dil\u00e9 f\u00e1zi<\/li>\n<li><strong>Vaskul\u00e1rn\u00ed demence (sm\u00ed\u0161en\u00fd typ)<\/strong> \u2014 mimor\u00e1mcov\u00fd m\u00edrn\u00fd p\u0159\u00ednos<\/li>\n<\/ul>\n<p>Galamer je <strong>ne<\/strong> indikov\u00e1n pro: t\u011b\u017ekou Alzheimerovu chorobu (v t\u00e9to f\u00e1zi je licencov\u00e1n pouze donepezil), m\u00edrnou kognitivn\u00ed poruchu, frontotempor\u00e1ln\u00ed demenci (zhor\u0161uje behavior\u00e1ln\u00ed p\u0159\u00edznaky), demenci u Parkinsonovy choroby (rivastigmin m\u00e1 indikaci v r\u00e1mci schv\u00e1len\u00fdch indikac\u00ed) nebo jako kognitivn\u00ed enhancer u zdrav\u00fdch dosp\u011bl\u00fdch.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Galameru a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed \u2014 POSTUPN\u00c1 TITRACE<\/h2>\n<p>Galamer je dostupn\u00fd ve form\u011b <strong>4 mg<\/strong> tablet. Galantamin m\u00e1 ze v\u0161ech inhibitor\u016f AChE nejagresivn\u011bj\u0161\u00ed gastrointestin\u00e1ln\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky \u2014 postupn\u00e1 titrace je nezbytn\u00e1.<\/p>\n<p><strong>Standardn\u00ed 8t\u00fddenn\u00ed titrace:<\/strong><\/p>\n<ul>\n<li><strong>T\u00fddny 1\u20134:<\/strong> 4 mg dvakr\u00e1t denn\u011b (celkem 8 mg\/den) s j\u00eddlem<\/li>\n<li><strong>T\u00fddny 5\u20138:<\/strong> 8 mg dvakr\u00e1t denn\u011b (celkem 16 mg\/den) s j\u00eddlem \u2014 minim\u00e1ln\u00ed \u00fa\u010dinn\u00e1 udr\u017eovac\u00ed d\u00e1vka<\/li>\n<li><strong>T\u00fddny 9 a d\u00e1le (pokud je tolerov\u00e1no):<\/strong> 12 mg dvakr\u00e1t denn\u011b (celkem 24 mg\/den) \u2014 maxim\u00e1ln\u00ed d\u00e1vka<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Jak spr\u00e1vn\u011b u\u017e\u00edvat Galamer<\/h3>\n<ol>\n<li><strong>U\u017e\u00edvejte s j\u00eddlem<\/strong> \u2014 toto je nejd\u016fle\u017eit\u011bj\u0161\u00ed pravidlo pro sn\u00e1\u0161enlivost. J\u00eddlo zpomaluje vst\u0159eb\u00e1v\u00e1n\u00ed a v\u00fdrazn\u011b sni\u017euje nevolnost. Rann\u00ed d\u00e1vku u\u017e\u00edvejte s sn\u00eddan\u00ed a ve\u010dern\u00ed d\u00e1vku s ve\u010de\u0159\u00ed.<\/li>\n<li><strong>Dvakr\u00e1t denn\u011b, v odstupu 12 hodin.<\/strong> D\u016fle\u017eit\u00e1 je pravidelnost \u2014 krat\u0161\u00ed polo\u010das galantaminu znamen\u00e1, \u017ee vynechan\u00e9 d\u00e1vky zp\u016fsobuj\u00ed znateln\u00e9 cholinergn\u00ed abstinen\u010dn\u00ed p\u0159\u00edznaky.<\/li>\n<li><strong>Pijte dostatek tekutin<\/strong> \u2014 nevolnost a zvracen\u00ed b\u011bhem titrace m\u016f\u017ee u star\u0161\u00edch pacient\u016f zp\u016fsobit dehydrataci.<\/li>\n<li><strong>Polykejte cel\u00e9 s vodou.<\/strong> Tablety lze rozd\u011blit, pokud jsou r\u00fdhovan\u00e9.<\/li>\n<li><strong>Pokud jsou gastrointestin\u00e1ln\u00ed ne\u017e\u00e1douc\u00ed \u00fa\u010dinky nesnesiteln\u00e9<\/strong>, vra\u0165te se k p\u0159edchoz\u00ed d\u00e1vce na dal\u0161\u00ed 4 t\u00fddny p\u0159ed op\u011btovn\u00fdm pokusem o zv\u00fd\u0161en\u00ed titrace.<\/li>\n<li><strong>Maxim\u00e1ln\u00ed udr\u017eovac\u00ed d\u00e1vka je 16 mg\/den<\/strong> u pacient\u016f se st\u0159edn\u011b t\u011b\u017ekou jatern\u00ed (Child-Pugh B) nebo st\u0159edn\u011b t\u011b\u017ekou ren\u00e1ln\u00ed (eGFR 9\u201359 ml\/min) poruchou. Vyvarujte se u t\u011b\u017ek\u00fdch poruch.<\/li>\n<li><strong>Pokud je l\u00e9\u010dba p\u0159eru\u0161ena na v\u00edce ne\u017e 3 dny<\/strong>, restartujte na 4 mg dvakr\u00e1t denn\u011b a znovu titrujte. Vynech\u00e1n\u00ed re-titrace po p\u0159eru\u0161en\u00ed zp\u016fsobuje z\u00e1va\u017en\u00e9 gastrointestin\u00e1ln\u00ed p\u0159\u00edznaky.<\/li>\n<li><strong>Dohled pe\u010dovatele je kl\u00ed\u010dov\u00fd.<\/strong> Pacienti s Alzheimerem z\u0159\u00eddka zvl\u00e1daj\u00ed d\u00e1vkov\u00e1n\u00ed dvakr\u00e1t denn\u011b bez pomoci. Pou\u017e\u00edvejte t\u00fddenn\u00ed organiz\u00e9r na l\u00e9ky napln\u011bn\u00fd pe\u010dovatelem.<\/li>\n<li><strong>Znovu vyhodno\u0165te po 6 m\u011bs\u00edc\u00edch<\/strong> form\u00e1ln\u00edm kognitivn\u00edm testov\u00e1n\u00edm (MMSE nebo MoCA).<\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky p\u0159\u00edpravku Galamer<\/h2>\n<p><strong>B\u011b\u017en\u00e9 (nejvy\u0161\u0161\u00ed gastrointestin\u00e1ln\u00ed z\u00e1t\u011b\u017e ze v\u0161ech inhibitor\u016f AChE \u2014 nejhor\u0161\u00ed b\u011bhem titrace):<\/strong><\/p>\n<ul>\n<li>Nevolnost, zvracen\u00ed (\u010dast\u011bj\u0161\u00ed ne\u017e u donepezilu)<\/li>\n<li>Pr\u016fjem<\/li>\n<li>Anorexie a \u00fabytek hmotnosti<\/li>\n<li>Z\u00e1vrat\u011b, bolesti hlavy<\/li>\n<li>Nespavost, \u017eiv\u00e9 sny<\/li>\n<li>\u00danava<\/li>\n<li>Svalov\u00e9 k\u0159e\u010de<\/li>\n<li>Bradykardie<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9, ale d\u016fle\u017eit\u00e9:<\/strong><\/p>\n<ul>\n<li>Synkopa a p\u00e1dy<\/li>\n<li>\u00danik mo\u010di<\/li>\n<li>Zhor\u0161en\u00ed astmatu nebo CHOPN<\/li>\n<li>Gastrointestin\u00e1ln\u00ed krv\u00e1cen\u00ed (zejm\u00e9na p\u0159i u\u017e\u00edv\u00e1n\u00ed NSAID)<\/li>\n<li>T\u0159es<\/li>\n<\/ul>\n<p><strong>Vz\u00e1cn\u00e9, ale vy\u017eaduje okam\u017eitou l\u00e9ka\u0159skou pomoc:<\/strong><\/p>\n<ul>\n<li><strong>Stevens-Johnson\u016fv syndrom a akutn\u00ed generalizovan\u00e1 exantemat\u00f3zn\u00ed pustul\u00f3za (AGEP)<\/strong> \u2014 vz\u00e1cn\u00e9, ale dokumentovan\u00e9 z\u00e1va\u017en\u00e9 ko\u017en\u00ed reakce. P\u0159eru\u0161te l\u00e9\u010dbu a vyhledejte pohotovostn\u00ed p\u00e9\u010di p\u0159i v\u00fdskytu puch\u00fd\u0159nat\u00e9 vyr\u00e1\u017eky, eroz\u00ed sliznic nebo rozs\u00e1hl\u00fdch pustul.<\/li>\n<li>T\u011b\u017ek\u00e1 bradykardie a \u00fapln\u00fd srde\u010dn\u00ed blok<\/li>\n<li>K\u0159e\u010de<\/li>\n<li>T\u011b\u017ek\u00e9 zvracen\u00ed vedouc\u00ed k ruptu\u0159e j\u00edcnu (velmi vz\u00e1cn\u00e9)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a opat\u0159en\u00ed<\/h2>\n<ul>\n<li><strong>Z\u00e1va\u017en\u00e9 ko\u017en\u00ed reakce:<\/strong> vz\u00e1cn\u00e9, ale dokumentovan\u00e9 Stevens-Johnson\u016fv syndrom a AGEP. Okam\u017eit\u011b p\u0159eru\u0161te l\u00e9\u010dbu a vyhledejte pohotovostn\u00ed p\u00e9\u010di p\u0159i v\u00fdskytu puch\u00fd\u0159nat\u00e9 vyr\u00e1\u017eky nebo vyr\u00e1\u017eky na sliznic\u00edch.<\/li>\n<li><strong>Kardi\u00e1ln\u00ed:<\/strong> galantamin zpomaluje srde\u010dn\u00ed frekvenci. Opatrnost u syndromu nemocn\u00e9ho sinu, AV bloku druh\u00e9ho nebo t\u0159et\u00edho stupn\u011b nebo nevysv\u011btliteln\u00e9 synkopy. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby prove\u010fte v\u00fdchoz\u00ed EKG.<\/li>\n<li><strong>T\u011b\u017ek\u00e9 jatern\u00ed nebo ren\u00e1ln\u00ed posti\u017een\u00ed:<\/strong> vyvarujte se (Child-Pugh C nebo eGFR &lt; 9 ml\/min). P\u0159i st\u0159edn\u011b t\u011b\u017ek\u00e9m posti\u017een\u00ed omezte d\u00e1vku na 16 mg\/den.<\/li>\n<li><strong>Peptick\u00fd v\u0159ed, sou\u010dasn\u00e9 p\u0159edepisov\u00e1n\u00ed NSAID:<\/strong> zv\u00fd\u0161en\u00e9 riziko gastrointestin\u00e1ln\u00edho krv\u00e1cen\u00ed. U pacient\u016f s vysok\u00fdm rizikem sou\u010dasn\u011b p\u0159edepi\u0161te PPI.<\/li>\n<li><strong>Astma a CHOPN:<\/strong> opatrnost u \u0161patn\u011b kontrolovan\u00e9ho onemocn\u011bn\u00ed \u2013 cholinergn\u00ed aktivace m\u016f\u017ee zhor\u0161it bronchokonstrikci.<\/li>\n<li><strong>Anestezie:<\/strong> informujte anesteziologa o u\u017e\u00edv\u00e1n\u00ed galantaminu. Prodlu\u017euje \u00fa\u010dinek depolarizuj\u00edc\u00edch svalov\u00fdch relaxanci\u00ed (sukcinylcholin).<\/li>\n<li><strong>Mo\u010dov\u00e1 obstrukce (BPH):<\/strong> zv\u00fd\u0161en\u00fd tonus detruzoru m\u016f\u017ee zp\u016fsobit urgentn\u00ed mo\u010den\u00ed nebo retenci.<\/li>\n<li><strong>Historie z\u00e1chvat\u016f:<\/strong> u\u017e\u00edvejte opatrn\u011b \u2013 cholinergn\u00ed aktivace m\u016f\u017ee sn\u00ed\u017eit pr\u00e1h z\u00e1chvat\u016f.<\/li>\n<li><strong>Podpora pe\u010dovatele:<\/strong> nezbytn\u00e9 pro dodr\u017eov\u00e1n\u00ed l\u00e9\u010dby a monitorov\u00e1n\u00ed vedlej\u0161\u00edch \u00fa\u010dink\u016f.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace \u2013 Kdo by NEM\u011aL u\u017e\u00edvat Galamer<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na galantamin nebo jakoukoli pomocnou l\u00e1tku tablety<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed (Child-Pugh C)<\/li>\n<li>T\u011b\u017ek\u00e9 ren\u00e1ln\u00ed selh\u00e1n\u00ed (eGFR &lt; 9 ml\/min)<\/li>\n<li>Aktivn\u00ed peptick\u00fd v\u0159ed (do zahojen\u00ed)<\/li>\n<li>T\u011b\u017ek\u00e1 symptomatick\u00e1 bradykardie, syndrom nemocn\u00e9ho sinu, AV blok druh\u00e9ho nebo t\u0159et\u00edho stupn\u011b (bez kardiostimul\u00e1toru)<\/li>\n<li>T\u011b\u017ek\u00e1 nekontrolovan\u00e1 astma nebo CHOPN<\/li>\n<li>Ned\u00e1vn\u00e1 nevysv\u011btliteln\u00e1 synkopa<\/li>\n<li>Historie t\u011b\u017ek\u00e9 ko\u017en\u00ed reakce (SJS, AGEP, TEN) na jak\u00fdkoli l\u00e9k<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Kombinujte s<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u00da\u010dinek<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Co d\u011blat<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Anticholinergika (oxybutynin, tolterodin, amitriptylin, difenhydramin, hyoscyamin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159\u00edmo antagonizuj\u00ed mechanismus galantaminu \u2013 l\u00e9\u010dba selh\u00e1v\u00e1<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyhn\u011bte se kombinaci. P\u0159epn\u011bte l\u00e9ky na inkontinenci na mirabegron.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Betablok\u00e1tory, blok\u00e1tory kalciov\u00fdch kan\u00e1l\u016f (verapamil, diltiazem), digoxin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Aditivn\u00ed riziko bradykardie a AV bloku<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sledujte srde\u010dn\u00ed frekvenci a EKG.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Dal\u0161\u00ed inhibitory AChE (donepezil, rivastigmin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kumulativn\u00ed cholinergn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky, \u017e\u00e1dn\u00fd dodate\u010dn\u00fd benefit<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pou\u017e\u00edvejte pouze jeden inhibitor cholinester\u00e1zy sou\u010dasn\u011b.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Memantin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Standardn\u00ed kombinace u st\u0159edn\u011b pokro\u010dil\u00e9 Alzheimerovy choroby \u2014 aditivn\u00ed kognitivn\u00ed benefit<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Standardn\u00ed dopln\u011bk. Viz <a href=\"https:\/\/medsbase.com\/cs\/admenta\/\">Admenta<\/a>.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00e9 inhibitory CYP3A4 (ketokonazol, ritonavir, klarithromycin, erytromycin) a inhibitory CYP2D6 (paroxetin, fluoxetin, chinidin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zvy\u0161uj\u00ed hladinu galantaminu \u2014 v\u00edce vedlej\u0161\u00edch \u00fa\u010dink\u016f<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sni\u017ete d\u00e1vku galantaminu o 50 %, pokud je kombinace nevyhnuteln\u00e1.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sukcinylcholin a depolariza\u010dn\u00ed neuromuskul\u00e1rn\u00ed blok\u00e1tory (anestezie)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">V\u00fdrazn\u011b prodlou\u017een\u00e1 paral\u00fdza<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Informujte anesteziologa o galantaminu. Zva\u017ete alternativu nedepolarizuj\u00edc\u00edho typu.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">NSAID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sklon ke krv\u00e1cen\u00ed do tr\u00e1vic\u00edho traktu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pokud mo\u017eno se vyhn\u011bte; sou\u010dasn\u011b p\u0159edepi\u0161te inhibitor protonov\u00e9 pumpy.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Antipsychotika<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zv\u00fd\u0161en\u00e9 riziko neuroleptick\u00e9ho malign\u00edho syndromu<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pou\u017eijte nejni\u017e\u0161\u00ed mo\u017enou d\u00e1vku.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Pokyny k uchov\u00e1v\u00e1n\u00ed<\/h2>\n<ul>\n<li>Skladujte p\u0159i pokojov\u00e9 teplot\u011b, <strong>15\u201325\u00b0C<\/strong>. Chra\u0148te p\u0159ed sv\u011btlem a vlhkost\u00ed.<\/li>\n<li>Tablety uchov\u00e1vejte v p\u016fvodn\u00edm blistru a\u017e do pou\u017eit\u00ed.<\/li>\n<li>Neskladujte v koupeln\u011b \u2013 vlhkost zkracuje trvanlivost.<\/li>\n<li>Uchov\u00e1vejte mimo dosah d\u011bt\u00ed a pacient\u016f, kte\u0159\u00ed nemus\u00ed ch\u00e1pat, \u017ee se jedn\u00e1 o l\u00e9ky.<\/li>\n<li>Nepou\u017eit\u00e9 tablety vra\u0165te do l\u00e9k\u00e1rny k likvidaci.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy na MedsBase<\/h2>\n<p>Dal\u0161\u00ed l\u00e9ky na Alzheimerovu chorobu a demenci skladem na MedsBase:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/aricep\/\"><strong>Aricep (donepezil 5 \/ 10 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donect\/\"><strong>Donect (donepezil 10 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/donemax\/\"><strong>Donemax (donepezil 10 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/admenta\/\"><strong>Admenta (memantin 5 mg)<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/rivamer-2\/\"><strong>Rivamer (rivastigmin 1,5 mg)<\/strong><\/a><\/li>\n<\/ul>\n<p>U\u017eite\u010dn\u00e9 \u010dten\u00ed: <a href=\"https:\/\/medsbase.com\/cs\/everything-you-need-to-know-about-alzheimers-disease\/\">V\u0161e, co pot\u0159ebujete v\u011bd\u011bt o Alzheimerov\u011b chorob\u011b<\/a> \u00b7 <a href=\"https:\/\/medsbase.com\/cs\/everything-to-know-about-dementia\/\">V\u0161e, co pot\u0159ebujete v\u011bd\u011bt o demenci<\/a> \u00b7 <a href=\"https:\/\/medsbase.com\/cs\/7-ways-to-protect-your-brain-health-as-you-age\/\">7 zp\u016fsob\u016f, jak chr\u00e1nit zdrav\u00ed sv\u00e9ho mozku s p\u0159ib\u00fdvaj\u00edc\u00edm v\u011bkem<\/a> \u00b7 <a href=\"https:\/\/medsbase.com\/cs\/best-foods-for-a-healthy-brain-and-improved-memory\/\">Nejlep\u0161\u00ed potraviny pro zdrav\u00fd mozek a lep\u0161\u00ed pam\u011b\u0165<\/a>.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d se mus\u00ed Galamer u\u017e\u00edvat s j\u00eddlem?<\/h3>\n<p>Potrava v\u00fdrazn\u011b zpomaluje absorpci galantaminu a sni\u017euje jeho maxim\u00e1ln\u00ed plazmatickou koncentraci \u2013 to je nejv\u00fdznamn\u011bj\u0161\u00ed faktor ovliv\u0148uj\u00edc\u00ed sn\u00e1\u0161enlivost. U\u017e\u00edv\u00e1n nala\u010dno zp\u016fsobuje galantamin u v\u011bt\u0161iny pacient\u016f silnou nevolnost a zvracen\u00ed. P\u0159i u\u017e\u00edv\u00e1n\u00ed s sn\u00eddan\u00ed a ve\u010de\u0159\u00ed je stejn\u00e1 d\u00e1vka dob\u0159e tolerov\u00e1na. Toto je nej\u010dast\u011bj\u0161\u00ed d\u016fvod, pro\u010d pacienti \u201cnesn\u00e1\u0161ej\u00ed\u201d galantamin.<\/p>\n<h3 class=\"wp-block-heading\">Kdy uvid\u00edm j\u00e1 nebo m\u016fj rodinn\u00fd p\u0159\u00edslu\u0161n\u00edk v\u00fdsledky u\u017e\u00edv\u00e1n\u00ed Galameru?<\/h3>\n<p>Viditeln\u00e9 zlep\u0161en\u00ed kognitivn\u00edch funkc\u00ed se objevuje <strong>6\u201312 t\u00fddn\u016f<\/strong> po dosa\u017een\u00ed udr\u017eovac\u00ed d\u00e1vky 16 mg\/den nebo vy\u0161\u0161\u00ed; vrchol \u00fa\u010dinku nast\u00e1v\u00e1 po 6 m\u011bs\u00edc\u00edch. Stejn\u011b jako donepezil je galantamin symptomatickou terapi\u00ed \u2013 stabilizuje kognitivn\u00ed funkce obvykle po dobu 6\u201318 m\u011bs\u00edc\u016f. Po 6 m\u011bs\u00edc\u00edch prove\u010fte p\u0159ehodnocen\u00ed pomoc\u00ed form\u00e1ln\u00edho kognitivn\u00edho testov\u00e1n\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Galamer vs donepezil \u2013 kter\u00fd je lep\u0161\u00ed?<\/h3>\n<p>Oba prok\u00e1zaly srovnateln\u00e9 zlep\u0161en\u00ed kognitivn\u00edch funkc\u00ed ve srovn\u00e1vac\u00edch studi\u00edch. <strong>Donepezil:<\/strong> jednou denn\u011b, lep\u0161\u00ed gastrointestin\u00e1ln\u00ed sn\u00e1\u0161enlivost, schv\u00e1len tak\u00e9 pro t\u011b\u017ekou Alzheimerovu chorobu. <strong>Galantamin:<\/strong> dvakr\u00e1t denn\u011b, du\u00e1ln\u00ed mechanismus \u00fa\u010dinku (moduluje tak\u00e9 nikotinov\u00e9 receptory), pouze pro m\u00edrnou a\u017e st\u0159edn\u011b t\u011b\u017ekou Alzheimerovu chorobu. Donepezil je obvykle prvn\u00ed volbou z hlediska pohodl\u00ed a sn\u00e1\u0161enlivosti; galantamin je vhodn\u00fd pro pacienty, kte\u0159\u00ed jej dob\u0159e sn\u00e1\u0161ej\u00ed nebo nereagovali na donepezil.<\/p>\n<h3 class=\"wp-block-heading\">Lze Galamer kombinovat s memantinem?<\/h3>\n<p>Ano \u2014 standardn\u00ed dopl\u0148kov\u00e1 terapie u st\u0159edn\u011b pokro\u010dil\u00e9 Alzheimerovy choroby. Galantamin + memantin poskytuje aditivn\u00ed kognitivn\u00ed benefit bez v\u00fdznamn\u00e9 interakce. <a href=\"https:\/\/medsbase.com\/cs\/admenta\/\">Admenta (memantin)<\/a> je standardn\u00ed kombinac\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d je titrace tak pomal\u00e1?<\/h3>\n<p>Galantamin m\u00e1 ze v\u0161ech inhibitor\u016f AChE pou\u017e\u00edvan\u00fdch u Alzheimerovy choroby nejvy\u0161\u0161\u00ed v\u00fdskyt gastrointestin\u00e1ln\u00edch ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f. 8t\u00fddenn\u00ed titrace (4 mg 2\u00d7 denn\u011b \u2192 8 mg 2\u00d7 denn\u011b \u2192 12 mg 2\u00d7 denn\u011b) umo\u017e\u0148uje GI traktu adaptovat se v ka\u017ed\u00e9 f\u00e1zi. Vynech\u00e1n\u00ed titrace zp\u016fsobuje nesnesiteln\u00e9 nevolnosti, zvracen\u00ed a pr\u016fjmy, kter\u00e9 vedou v\u011bt\u0161inu pacient\u016f k ukon\u010den\u00ed l\u00e9\u010dby.<\/p>\n<h3 class=\"wp-block-heading\">Jak\u00e1 je maxim\u00e1ln\u00ed d\u00e1vka p\u0159\u00edpravku Galamer?<\/h3>\n<p>24 mg\/den (12 mg dvakr\u00e1t denn\u011b) je maxim\u00e1ln\u00ed schv\u00e1len\u00e1 d\u00e1vka pro zdrav\u00e9 dosp\u011bl\u00e9. Omezte na <strong>16 mg\/den<\/strong> (8 mg dvakr\u00e1t denn\u011b) u pacient\u016f se st\u0159edn\u011b t\u011b\u017ekou jatern\u00ed (Child-Pugh B) nebo st\u0159edn\u011b t\u011b\u017ekou ren\u00e1ln\u00ed (eGFR 9\u201359 ml\/min) nedostate\u010dnost\u00ed. P\u0159i t\u011b\u017ek\u00e9 nedostate\u010dnosti se zcela vyhn\u011bte pod\u00e1v\u00e1n\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Mohu vysadit Galamer, pokud nepom\u00e1h\u00e1?<\/h3>\n<p>Proberte s p\u0159edepisuj\u00edc\u00edm l\u00e9ka\u0159em. Pokud form\u00e1ln\u00ed kognitivn\u00ed testov\u00e1n\u00ed po 6 m\u011bs\u00edc\u00edch neprok\u00e1\u017ee benefit, lze galantamin postupn\u011b vysadit. Stejn\u011b jako u donepezilu m\u016f\u017ee n\u00e1hl\u00e9 vysazen\u00ed zp\u016fsobit zhor\u0161en\u00ed kognitivn\u00edch funkc\u00ed \u2014 sni\u017eujte d\u00e1vku postupn\u011b na 8 mg\/den po dobu 2\u20134 t\u00fddn\u016f, pot\u00e9 na 4 mg\/den, a pak l\u00e9\u010dbu ukon\u010dete.<\/p>\n<h3 class=\"wp-block-heading\">Co l\u00e9ky s anticholinergn\u00edm \u00fa\u010dinkem, kter\u00e9 ji\u017e u\u017e\u00edv\u00e1m?<\/h3>\n<p>B\u011b\u017en\u00e9 anticholinergn\u00ed l\u00e9ky, kter\u00e9 <strong>p\u0159\u00edmo ru\u0161\u00ed<\/strong> \u00fa\u010dinek galantaminu, zahrnuj\u00ed: oxybutynin a tolterodin (p\u0159i hyperaktivn\u00edm mo\u010dov\u00e9m m\u011bch\u00fd\u0159i), amitriptylin a nortriptylin, difenhydramin (Benadryl) a hyoscyamin. Po\u017e\u00e1dejte sv\u00e9ho l\u00e9ka\u0159e o revizi v\u0161ech u\u017e\u00edvan\u00fdch l\u00e9k\u016f. Pro p\u0159\u00edznaky mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e je mirabegron neanticholinergn\u00ed alternativou.<\/p>\n<h3 class=\"wp-block-heading\">Je vz\u00e1cn\u00e1 ko\u017en\u00ed reakce (Stevens\u016fv-Johnson\u016fv syndrom) skute\u010dn\u011b d\u016fvod k obav\u00e1m?<\/h3>\n<p>Velmi vz\u00e1cn\u00e1, ale dokumentovan\u00e1 \u2014 pops\u00e1na v kazuistik\u00e1ch, pravd\u011bpodobnost m\u00e9n\u011b ne\u017e 1 p\u0159\u00edpad na 10 000 pacient\u016f. Varov\u00e1n\u00ed je d\u016fle\u017eit\u00e9, proto\u017ee pokud se objev\u00ed puch\u00fd\u0159nat\u00e1 vyr\u00e1\u017eka, eroze sliznic nebo rozs\u00e1hl\u00e9 pustuly, pacient pot\u0159ebuje neodkladnou pohotovostn\u00ed p\u00e9\u010di \u2014 SJS a AGEP mohou b\u00fdt fat\u00e1ln\u00ed. P\u0159i prvn\u00edch zn\u00e1mk\u00e1ch neobvykl\u00e9 vyr\u00e1\u017eky l\u00e9\u010dbu okam\u017eit\u011b p\u0159eru\u0161te a vyhledejte l\u00e9ka\u0159sk\u00e9 vy\u0161et\u0159en\u00ed je\u0161t\u011b tent\u00fd\u017e den.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Chronick\u00e1 onemocn\u011bn\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/valprol-cr\/\">Valprol-CR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/primox\/\">Primox<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tricort\/\">Tricort<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/modvigil\/\">Modvigil<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/seroflo-inhaler\/\">Seroflo Inhaler<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zlep\u0161uje pam\u011b\u0165ov\u00e9 funkce<br \/>\n\u2705 Zvy\u0161uje kognitivn\u00ed schopnosti<br \/>\n\u2705 Zpomaluje progresi Alzheimerovy choroby<br \/>\n\u2705 Zvy\u0161uje hladinu acetylcholinu<br \/>\n\u2705 Podporuje zdrav\u00ed mozku<\/p>\n<p>Galamer obsahuje Galantamine.<\/p>","protected":false},"featured_media":54721,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3772,3141,3223],"product_tag":[3773,3774],"class_list":{"0":"post-54720","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-alzheimers-treatment","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_tag-galamer","10":"product_tag-galantamine","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/54720","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=54720"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/54721"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=54720"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=54720"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=54720"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=54720"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}