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2009 4

opioidebisopioidebisopioidebisopioidebisopioidebisopioidebisopioidebisopioidebis klasifikaciaklasifikaciaklasifikaciaklasifikaciaklasifikaciaklasifikaciaklasifikaciaklasifikacia opioiduropioiduropioiduropioiduropioiduropioiduropioiduropioidur receptorebzereceptorebzereceptorebzereceptorebzereceptorebzereceptorebzereceptorebzereceptorebzemoqmedebismoqmedebismoqmedebismoqmedebismoqmedebismoqmedebismoqmedebismoqmedebis tipistipistipistipistipistipistipistipis mixedviTmixedviTmixedviTmixedviTmixedviTmixedviTmixedviTmixedviT

nn agonistebiagonistebiagonistebiagonistebiagonistebiagonistebiagonistebiagonistebi-- morfiumimorfiumi ((ZlieriZlieriZlieriZlieriZlieriZlieriZlieriZlieri))-- heroiniheroini-- metadonimetadoni-- mepiridinimepiridini ((demerolidemeroli))-- fentanilifentanili ((sublimazisublimazi))-- oqsimorfinioqsimorfini ((numorfininumorfini))-- hidromofini(dilaudidihidromofini(dilaudidi))-- propoqsifenipropoqsifeni ((darvonidarvoni))-- kodeinikodeini ((meTilmorfiumimeTilmorfiumi))

((sustisustisustisustisustisustisustisusti))

nn agonistagonistagonistagonistagonistagonistagonistagonist--------antagonistebiantagonistebiantagonistebiantagonistebiantagonistebiantagonistebiantagonistebiantagonistebi

-- nalbufininalbufini ((nubaininubaini))

-- butorfanolibutorfanoli ((stadolistadoli, , moradolimoradoli))

-- pentazocinipentazocini ((TalviniTalvini, , leqsirileqsiri))

-- buprenorfinibuprenorfini ((bupreneqsibupreneqsi, , subuteqsisubuteqsi, , norfininorfini))

nn antagonistebiantagonistebiantagonistebiantagonistebiantagonistebiantagonistebiantagonistebiantagonistebi

–– naloqsoninaloqsoni ((narkaninarkani))

-- naltreqsoninaltreqsoni ((treqsanitreqsani, , reviarevia))

zogierTizogierTizogierTizogierTizogierTizogierTizogierTizogierTi narkotikulinarkotikulinarkotikulinarkotikulinarkotikulinarkotikulinarkotikulinarkotikulisaSualebissaSualebissaSualebissaSualebissaSualebissaSualebissaSualebissaSualebis moqmedebismoqmedebismoqmedebismoqmedebismoqmedebismoqmedebismoqmedebismoqmedebis

xangrZlivobaxangrZlivobaxangrZlivobaxangrZlivobaxangrZlivobaxangrZlivobaxangrZlivobaxangrZlivoba

nn heroiniheroini –– 66--8 8 sTsT;;

nn metadonimetadoni –– 2424--36 36 sTsT;;

nn buprenorfinibuprenorfini -- 24 24 sTsT;;

nn dilaudididilaudidi –– 33--4 4 sTsT;;

nn kodeinikodeini –– 33--4 4 sTsT;;

nn demerolidemeroli –– 22--3 3 sTsT;;

nn fentanilifentanili –– 11--2 2 sTsT..

zogierTizogierTizogierTizogierTizogierTizogierTizogierTizogierTi narkotikulinarkotikulinarkotikulinarkotikulinarkotikulinarkotikulinarkotikulinarkotikulisaSualebissaSualebissaSualebissaSualebissaSualebissaSualebissaSualebissaSualebis moxmarebisasmoxmarebisasmoxmarebisasmoxmarebisasmoxmarebisasmoxmarebisasmoxmarebisasmoxmarebisas

damokidebulebisdamokidebulebisdamokidebulebisdamokidebulebisdamokidebulebisdamokidebulebisdamokidebulebisdamokidebulebisCamoyalibebaCamoyalibebaCamoyalibebaCamoyalibebaCamoyalibebaCamoyalibebaCamoyalibebaCamoyalibeba

nn heroiniheroini-- 33--5 5 inieqciainieqcia;;

nn morfiumimorfiumi –– 1010--15 15 inieqciainieqcia;;

nn opiumisopiumis nayeninayeni –– 22--3 3 kvirakvira;;

nn kodeinikodeini -- 11--1,5 1,5 TveTveararegularuliararegularuligamoyenebagamoyeneba..

rodisrodisrodisrodisrodisrodisrodisrodis SeiZlebaSeiZlebaSeiZlebaSeiZlebaSeiZlebaSeiZlebaSeiZlebaSeiZleba ganviTardesganviTardesganviTardesganviTardesganviTardesganviTardesganviTardesganviTardesopioidebiTopioidebiTopioidebiTopioidebiTopioidebiTopioidebiTopioidebiTopioidebiT zedozirebazedozirebazedozirebazedozirebazedozirebazedozirebazedozirebazedozireba????????

nn opioidisopioidis sxvasxva jgufisjgufis narkotikTannarkotikTan

SerevisasSerevisas muSaobsmuSaobs principiTprincipiT 2+2=52+2=5nn CveuliCveuli dozisdozis momatebisasmomatebisas;;

nn janmrTelobisjanmrTelobis mdgomareobismdgomareobis gauaresebagauareseba((sxvadsxvasxvadsxva qronikuliqronikuli daavadebebisdaavadebebisarsebobisasarsebobisas -- hepatitebihepatitebi, , SidsiSidsi))

nn narkotikisnarkotikis sisufTavesisufTave ((SemadgenlobaSemadgenloba))

nn ganmeorebiTiganmeorebiTi dozisdozis miRebamiReba maSinmaSin, , rodesacrodesac sawyisisawyisi dozisdozis moqmedebismoqmedebisefeqtiefeqti jerjer arar dasrulebuladasrulebula

opioiduriopioiduriopioiduriopioiduriopioiduriopioiduriopioiduriopioiduri zedozirebiszedozirebiszedozirebiszedozirebiszedozirebiszedozirebiszedozirebiszedozirebis niSnebiniSnebiniSnebiniSnebiniSnebiniSnebiniSnebiniSnebi

nn siarulissiarulis gaZnelebagaZneleba ((barbaciTbarbaciT siarulisiaruli););

nn metyvelebismetyvelebis gaZnelebagaZneleba;;

nn sunTqvissunTqvissunTqvissunTqvissunTqvissunTqvissunTqvissunTqvis daTrgunvadaTrgunvadaTrgunvadaTrgunvadaTrgunvadaTrgunvadaTrgunvadaTrgunva ((((((((wuTSiwuTSiwuTSiwuTSiwuTSiwuTSiwuTSiwuTSi <10<10<10<10<10<10<10<10--------ze) an ze) an ze) an ze) an ze) an ze) an ze) an ze) an apnoeapnoeapnoeapnoeapnoeapnoeapnoeapnoe;;;;;;;;nn pulsispulsis SenelebaSeneleba, art. , art. wneviswnevis daqveiTebadaqveiTeba;;

nn xmaurianixmauriani sunTqvasunTqva;;

nn mkrTalimkrTali, , namianinamiani kanikani;;

nn cianozicianozi ((warziduliwarziduli nawilebisnawilebis galurjebagalurjeba););

nn gulisreva/piRebinebagulisreva/piRebineba;;

nn miozimiozimiozimiozimiozimiozimiozimiozi ((((((((midriazimidriazimidriazimidriazimidriazimidriazimidriazimidriazi aRkveTisaRkveTisaRkveTisaRkveTisaRkveTisaRkveTisaRkveTisaRkveTis sindromissindromissindromissindromissindromissindromissindromissindromis drosdrosdrosdrosdrosdrosdrosdros););););););););

nn ugonougono mdgomareobamdgomareoba ((kodeiniTkodeiniT mowamvlisasmowamvlisas sunTqvissunTqvismoSlamoSla dada art. art. wneviswnevis daqveiTebadaqveiTeba SesaZlebeliaSesaZlebeliaganviTardesganviTardes SenarCunebuliSenarCunebuli cnobierebiscnobierebis fonzefonze););

nn sikdilissikdilis mizezimizezi -- sunTqvissunTqvis mwvavemwvave ukmarisobaukmarisoba..

gafrTxilebagafrTxilebagafrTxilebagafrTxilebagafrTxilebagafrTxilebagafrTxilebagafrTxileba!!!!!!!!

nn gamoiyeneTgamoiyeneT naklebinaklebi dozadoza, , TuTu TqvenTqvenuaxloesuaxloes warsulSiwarsulSi gaiareTgaiareT detoqsidetoqsi, , axlaxansaxlaxans gamoxvediTgamoxvediT cixidancixidan, an , an xarTxarT

avadavad ((gaqvTgaqvT C C hepatitihepatiti an an aivaiv--infeqciainfeqcia)!)!

nn ecadeTecadeT mudmivadmudmivad erTidaimaveerTidaimavedilerisgandilerisgan SeiZinoTSeiZinoT narkotikinarkotiki!!

nn CaitareTCaitareT sacdelisacdeli inieqciainieqcia!!

nn inieqciisasinieqciisas nu nu iqnebiTiqnebiT martomarto!!

nn arar CaketoTCaketoT karikari, , datoveTdatoveT RiaRia!!

nn daurekeTdaurekeT vinmevinme sandosando pirovnebaspirovnebas!!

naloxone (Narcannaloxone (Narcan®®))nn opiatebisopiatebis antagonistiantagonisti, ,

romelicromelic xasiaTdebaxasiaTdebaopiatebiTopiatebiT ((heroinisheroinis) ) zedozirebisaszedozirebisas maTmaTsawinaaRmdegodsawinaaRmdegod moqmedebismoqmedebisefeqtiTefeqtiT; ;

nn legalurialegaluria dada arar arisarismkacrimkacri aRricxvisaRricxvispreparatipreparati; ;

nn iniSnebainiSneba medicinismedicinis muSakismuSakismiermier;;

TuTuTuTuTuTuTuTu SeatyveTSeatyveTSeatyveTSeatyveTSeatyveTSeatyveTSeatyveTSeatyveT, , , , , , , , romromromromromromromrom megobarimegobarimegobarimegobarimegobarimegobarimegobarimegobarizedozirebuliazedozirebuliazedozirebuliazedozirebuliazedozirebuliazedozirebuliazedozirebuliazedozirebulia

nn damSviddiTdamSviddiT;;

nn gamoiZaxeTgamoiZaxeT saswrafosaswrafo daxmarebadaxmareba;;

nn isaubreTisaubreT garkveviTgarkveviT dada mSvidadmSvidad;;

nn arar ekamaToTekamaToT;;

nn uTxariTuTxariT maTmaT::

-- zustizustizustizustizustizustizustizusti misamarTimisamarTimisamarTimisamarTimisamarTimisamarTimisamarTimisamarTi,,,,,,,,

-------- dazaralebulidazaralebulidazaralebulidazaralebulidazaralebulidazaralebulidazaralebulidazaralebuli ugonodaaugonodaaugonodaaugonodaaugonodaaugonodaaugonodaaugonodaa,,,,,,,,

-------- arararararararar sunTqavssunTqavssunTqavssunTqavssunTqavssunTqavssunTqavssunTqavs, an , an , an , an , an , an , an , an lurjialurjialurjialurjialurjialurjialurjialurjia........

usafrTxousafrTxousafrTxousafrTxousafrTxousafrTxousafrTxousafrTxo mdebareobamdebareobamdebareobamdebareobamdebareobamdebareobamdebareobamdebareoba

TuTuTuTuTuTuTuTu TqvenTqvenTqvenTqvenTqvenTqvenTqvenTqven gaqvTgaqvTgaqvTgaqvTgaqvTgaqvTgaqvTgaqvT naloqsoninaloqsoninaloqsoninaloqsoninaloqsoninaloqsoninaloqsoninaloqsoni ((((((((narkaninarkaninarkaninarkaninarkaninarkaninarkaninarkani))))))))

SeafaseTSeafaseT sunTqavssunTqavs TuTu araara pirovnebapirovneba??TuTu arar sunTqavssunTqavs

qq pirvelpirvel rigSirigSi CaatareTCaatareT xelovnurixelovnurisunTqvasunTqva, , gulisgulis arapirdapiriarapirdapiri masaJimasaJi..

TuTu sunTqavssunTqavsnn moamzadeTmoamzadeT naloqsonisnaloqsonis 1 1 saineqciosaineqcio

dozadoza (0.4 mg);(0.4 mg);nn gaukeTeTgaukeTeT inieqciainieqcia kunTSikunTSi, , venaSivenaSi, ,

kanqveSkanqveS; ; TuTu giZneldebaTgiZneldebaT venaSivenaSiinieqciainieqcia, nu , nu dakargavTdakargavT drosdros, , gaakeTeTgaakeTeTinieqciainieqcia kunTSikunTSi an an kanqveSkanqveS..

-- mxarzemxarze, , dundulozedunduloze,,-- kunTovankunTovan midamoSimidamoSi,,-- zedazeda meoTxedSimeoTxedSi..

SeinarCuneTSeinarCuneT sunTqvasunTqva!!

naloxonenaloxone ((NarcanNarcan®®) ) -- dozirebadozirebadozirebadozirebadozirebadozirebadozirebadozireba

nn idealuriaidealuria naloqsonisnaloqsonis dozadoza rocarocaaRadgensaRadgens filtvebisfiltvebis ventilaciasventilaciasaRkveTisaRkveTis ((lomkislomkis) ) mdgomareobismdgomareobis gareSegareSe..

nn erTerT jerzejerze SeiyvaneTSeiyvaneT standartulistandartuli dozadoza

-- 0.4 mg 0.4 mg -- kunTebSikunTebSi, an , an

-- 0.1 mg 0.1 mg -- intravenuradintravenurad, an , an

-- 0.8 mg 0.8 mg -- kanqveSkanqveS, ,

romrom minimumamdeminimumamde davidesdavides mwvavemwvave aRkveTisaRkveTis((lomkalomka) ) mdgomareobaSimdgomareobaSi gadasvlagadasvla..

saWiroasaWiroasaWiroasaWiroasaWiroasaWiroasaWiroasaWiroa TuTuTuTuTuTuTuTu araaraaraaraaraaraaraara meoremeoremeoremeoremeoremeoremeoremeore inieqciainieqciainieqciainieqciainieqciainieqciainieqciainieqcia????????

nn inieqciisinieqciis gameorebagameoreba SesaZlebeliaSesaZlebelia pirvelipirveliinieqciidaninieqciidan 2 2 wuTSiwuTSi. .

nn magrammagram -- mniSvnelovaniamniSvnelovania davakvirdeTdavakvirdeT aRdgaaRdgaTuTu araara sunTqvasunTqva ((wuTSiwuTSi 1010--ze ze metimeti), ), movidamovidaTuTu araara gonsgons. .

eqimieqimieqimieqimieqimieqimieqimieqimi movidamovidamovidamovidamovidamovidamovidamovida

nn auxseniTauxseniT eqimseqims yvelaferiyvelaferi racrac iciTiciT ((raranarkotikinarkotiki moixmaramoixmara, , rodisrodis, , ramdeniramdeni dadaa.Sa.S.); .);

nn vinaidanvinaidan, , miuxedavadmiuxedavad dazaralebulisdazaralebulisgonzegonze mosvlisamosvlisa, , TuTu intoqsikaciaintoqsikacia iyoiyogamowveuligamowveuli xangrZlivmoqmedixangrZlivmoqmedi narkotikiTnarkotikiT((metadonimetadoni, , pentazocinipentazocini) ) SesaZlebeliaSesaZlebeliaeqimmaeqimma naloqsoninaloqsoni ganmeorebiTganmeorebiT gamoiyenosgamoiyenosramdenjermeramdenjerme. .

nn auxseniTauxseniT rara saxissaxis daxmarebadaxmareba CautareTCautareTdazaralebulsdazaralebuls dada rara drodro gavidagavida masmasSemdegSemdeg;;

nn ramdeniramdeni mg mg naloqsonisnaloqsonis inieqciainieqcia gaukeTeTgaukeTeTdada rodisrodis;;