盐酸帕罗西汀片

盐酸帕罗西汀片 types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 盐酸帕罗西汀片 核准日期:2006年11月17日 修订日期:2007年11月23日 2009年9月30日 2010年07月09日 2010年10月01日 药品名称: [药典]【通用名称】 盐酸帕罗西汀片 【商品名称】 赛乐特? Seroxat? [药典]【英文名称】 Paroxetine Hydrochloride Tablets 【汉语拼音】 Yan Suan Pa Luo Xi Ting Pian 警示语: 自杀倾向和抗抑郁药物 抑郁和某些精神障碍本身与自杀风险的增加有关。对抑郁症(MDD)和其他精神障碍的短期临床试验结果显示，与安慰剂相比，抗抑郁药物增加了儿童、青少年和青年(?24岁)患者自杀倾向(自杀意念和自杀的行为)的风险。任何人如果考虑将盐酸帕罗西汀片或其他抗抑郁药物用于儿童、青少年和青年(?24岁)，都必须在其风险和临床需求之间进行权衡。短期的临床试验没有显示出，与安慰剂相比年龄大于24岁的成年人使用抗抑郁药物会增加自杀倾向的风险;而在年龄65岁及以上的成年人中，使用抗抑郁药物后，自杀倾向的风险有所降低。必须密切观察所有年龄患者使用抗抑郁药物治疗开始后的临床症状的恶化、自杀倾向、行为的异常变化。应建议家属和看护者必须密切观察并与医生进行沟通。盐酸帕罗西汀片未被批准用于儿童患者(见【注意事项】-警告，临床症状的恶化和自杀风险)。 成份: 盐酸帕罗西汀 化学名称为(-)-反式-4-(4-氟苯基)-3-{[3，4(甲二氧基)苯氧基]甲基}哌啶盐酸盐。 结构式: 分子式:CHNOF?HCl 19203 分子量:365.84 所属类别: 化药及生物制品 >> 抗精神失常药 >> 抗抑郁药 >> 选择性5-羟色胺再摄取抑制药 性状: types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 本品为白色椭圆形，双面凸起的薄膜包衣片。 适应症: 治疗各种类型的抑郁症，包括伴有焦虑的抑郁症及反应性抑郁症。常见的抑郁症状:乏力、睡眠障碍、对日常活动缺乏兴趣和愉悦感、食欲减退。 治疗强迫性神经症。常见的强迫症状:感受反复和持续的可引起明显焦虑的思想、冲动或想象、从而导致重复的行为或心理活动。 治疗伴有或不伴有广场恐怖的惊恐障碍。常见的惊恐发作症状:心悸、出汗、气短、胸痛、恶心、麻刺感和濒死感。 治疗社交恐怖症/社交焦虑症。常见的社交焦虑的症状:心悸、出汗、气短等。通常表现为继发于显著或持续的对一个或多个社交情景或表演场合的畏惧，从而导致回避。 治疗疗效满意后，继续服用本品可防止抑郁症、惊恐障碍和强迫症的复发。 规格: 每片20mg(以CHFNO计算) 19203 用法用量: 口服，建议每日早餐时顿服，药片完整吞服勿咀嚼。 成人: 抑郁症: 一般剂量为每日20mg。服用2,3周后根据病人的反应，某些病人需要加量，每周以10mg量递增，根据国外经验每日最大量可达50mg，应遵医嘱。 强迫性神经症: 一般剂量为每日40mg，初始剂量为每日20mg，每周以10mg量递增。根据国外经验每日最大剂量可达60mg。 惊恐障碍: 一般剂量为每日40mg，初始剂量为每日10mg，根据病人的反应，每周以10mg量递增，每日最大剂量可达50mg。一般认为惊恐障碍治疗早期其症状有可能加重，故初始剂量为10mg。 社交恐怖症/社交焦虑症: 一般剂量为每日20mg，若对20mg无反应的患者可根据病人临床反应，每周以10mg量递增，根据国外经验每日最大剂量可达50mg。剂量改变至少有一周的间歇期。 sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 本品与所有的抗抑郁药一样，治疗期间应根据病情调整剂量。病人应治疗足够长时间以巩固疗效，抑郁症痊愈后应维持治疗至少几个月，强迫性神经症和惊恐障碍所需维持治疗的时间更长。停药方法与其它精神科药物相似，需逐渐减量，不宜骤停。 帕罗西汀的停药 和其他精神药物一样，本品一般不宜突然停药(参见【注意事项】和【不良反应】部分)。近期临床试验中采用的逐渐减量停药是:以周为间隔逐渐减量，每周的日用剂量比上周的日用剂量减少10mg，每周减量1次。 当日用剂量减至每日20mg时，病人按该剂量继续用药1周，然后停药。如果减量或停药后出现不能耐受的症状，可以考虑恢复到前次的用药剂量治疗。然后，医生可以继续进行减量方案，但减量的速度要更加缓慢。 肾/肝功损害: 由于严重肾功能损害(肌酐清除率<30ml/分)或严重肝损害的病人，服用本品后血药浓度较健康人高。因此推荐剂量为每日20mg，如果需要增加剂量，也应限制在服药范围的低限。 不良反应: 下面所列的不良反应中，有些可能会随着治疗时间延长而减轻或减少，一般不会导致停药。下面列出了各个器官系统的药物不良反应。发生率的定义为:很常见 (?1/10)，常见 (?1/100，<1/10)，不常见(?1/1,000，<1/100)，罕见(?1/10,000， <1/1,000)，很罕见(<1/10,000)，包括个别报道。常见和不常见事件的发生率一般根据临床试验中帕罗西汀治疗组病人(>8000)的安全性汇总资料来判断，一般是指与安慰剂组相比额外增多的发生率。罕见和很罕见事件一般根据上市后资料来判断，是指率而不是真正的发生率。 血液和淋巴系统 不常见:异常出血，主要见于皮肤和粘膜(多为瘀斑)、贫血，白细胞减少、淋巴结病、紫癜症。 罕见:异常红细胞、嗜碱粒细胞增多、出血时间延长、嗜酸红细胞过多、低色素性贫血、缺铁性贫血、白细胞增多。淋巴水肿、淋巴细胞异常、淋巴细胞增多，小细胞性贫血，单核细胞增多、正常红细胞性贫血、血小板增多、血小板减少。 免疫系统 不常见:过敏反应(包括荨麻疹和血管水肿)。 内分泌系统 罕见;糖尿病，甲状腺肿、甲状腺功能亢进、甲状腺机能减退、甲状腺炎; 很罕见:抗利尿激素分泌异常综合征(SIADH)。 types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 代谢和营养 常见:胆固醇水平升高，食欲减退，体重增加。 不常见:浮肿(外周性水肿、SGOT升高、SGPT升高、口渴、体重减轻; 罕见:碱性磷酸酶升高、胆红素血症、BUN升高、肌酐磷酸激酶升高、脱水、Y-球蛋白升高、痛风、血钙过多、高胆固醇血症、高血糖、高钾血症、高磷(酸盐)血症、低钙血症、低血糖、低钾血症、低钠血症、酮症、乳酸脱氢酶升高、非蛋白氮(NPN)升高。 报告的低钠血症主要见于老年病人，有时由抗利尿激素分泌异常综合征(SIADH)所致。 精神异常 常见:嗜睡，失眠和兴奋、异常的梦境(包括梦魇)。 不常见:意识模糊、幻觉。 罕见: 躁狂反应。 这些症状可能有基础疾病所致。 神经系统 常见:眩晕、震颤、头痛、情绪不稳定。 不常见:锥体外系症状、异常思维、酗酒、共济失调、肌张力障碍、运动障碍、欣快感、敌意、幻觉、肌张力亢进、感觉迟钝、运动功能减退、协调不能、淡漠、性欲增强、躁狂反应、神经症、麻痹、偏执。 罕见:惊厥、静坐不能、不宁腿综合征、异常步态、运动不能、厌恶社交、失语症、舞蹈手足徐动症、口周感觉异常、谵妄、妄想、复视、药物依赖性、发音困难、肌束震颤、癫痫大发作、惊厥、痛觉过敏、歇斯底里症、躁狂-抑郁反应、脑脊膜炎、脊髓炎、神经痛、神经病、眼球震颤、外周神经炎、精神病性抑郁症、精神病、反射减弱、反射增强、木僵、斜颈、牙关紧闭症、撤药综合征。 很罕见:血清素综合征(症状可能包括兴奋、意识模糊、多汗、幻觉、反射亢进、肌阵挛、颤抖性心动过速和震颤)。 有些病人报告有锥体外系症状，包括口面部肌张力异常，这些病人有时伴有基础的运动障碍，或者在使用精神安定药物。 眼 常见:视力模糊。 不常见:瞳孔散大(见【注意事项】)。 很罕见:急性青光眼。 心血管系统 常见:高血压、心动过速。 不常见:窦性心动过速、体位性低血压、心动过缓、血肿、低血压、偏头痛、直立性低血压、 晕厥: 罕见:心绞痛、节性心律不齐、心房颤动、束支传导阻滞、脑缺血、脑血管意外、充血性心力衰竭、心脏传导阻滞、心输出量低、心肌梗塞、心肌缺血、苍白、静脉炎、肺栓塞、室上性期前收缩、血栓性静脉炎、血栓、静脉曲张、血管性头痛、室性期前收缩。 sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 呼吸系统、胸腔和纵隔 常见: 打哈欠。 不常见:哮喘、支气管炎、呼吸困难、鼻出血、换气过度、肺炎、呼吸道流感。 罕见:肺气肿、咯血、打嗝、肺纤维化、肺水肿(痰量增多、喘鸣和语音改变。 消化系统 很常见:恶心。 常见:便秘、腹泻、呕吐、口干。 不常见:夜磨牙症、结肠炎、吞咽困难、嗳气、胃炎、胃肠炎、牙龈炎、舌炎、多涎、肝功能异常、直肠出血、溃疡性口炎。 罕见:口疮性口炎、血性腹泻、食欲过盛、贲门痉挛、胆石病、十二指肠炎、肠炎、食管炎、粪便嵌塞、大便失禁、牙龈出血、呕血、肝炎、回肠炎、肠阻塞、肠梗阻、黄疸黑粪症、口腔溃疡、消化性溃疡、唾液腺增大、涎腺炎、胃溃疡、口炎、舌变色、舌肿、龋齿。 很罕见:胃肠道出血。 肝胆系统 罕见:肝脏转氨酶升高。 很罕见:肝脏事件 (如肝炎、有时伴有黄疸和/或肝功能衰竭)。 有肝脏转氨酶升高的报道。也收到了上市后的肝脏事件报告(如，肝炎、有时伴有黄疸和/或肝功能衰竭)，这些报告很罕见 。如果肝功能实验指标持续升高应当考虑停用帕罗西汀。 皮肤和皮下组织 常见:出汗、瘙痒。 不常见:皮疹、粉刺、脱发、接触性皮炎、干性皮肤、出血斑、湿疹、单纯疱疹、光敏感性、荨麻疹。 罕见:血管性水肿、结节性红斑、多形红斑、剥脱性皮炎、霉菌性皮炎、疖病、带状疹，多毛症、斑丘疹、皮脂溢、皮肤变色、皮肤肥厚、皮肤溃疡、出汗减少和水泡大疱疹。 很罕见:光敏反应。 肾脏和泌尿生殖系统 很常见:性功能障碍。 不常见:尿潴留、尿失禁、闭经、乳房痛、膀胱炎、排尿困难、血尿、月经过多、夜尿、多尿、脓尿、尿急、阴道炎。 罕见:高催乳素血症,溢乳、流产、乳房萎缩、乳房胀大、子宫内膜病、附睾炎、纤维囊性乳腺病、肾结石、肾痛、白带、乳腺炎、子官不规则出血、肾炎、少尿症、输卵管炎、尿道炎、管型尿、子宫痉挛、尿结石、阴道出血和阴道念珠菌性疾病。 全身和给药部位反应 常见:虚弱无力、体重增加。 不常见:寒战、面部浮肿、全身乏力、颈痛。 罕见:肾上腺素能药物综合征、蜂窝组织炎、念珠菌病、颈强直、骨盆痛、腹膜炎、脓毒症types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 和溃疡。 很罕见:外周水肿。 肌骨骼系统: 常见:关节痛。 不常见:关节炎、关节病。 罕见:滑囊炎、肌炎、骨质疏松症、全身抽搐、腱鞘炎、手足抽搐。 特异感觉: 常见:耳鸣。 不常见:适应异常、结膜炎、耳痛、眼痛、角膜结膜炎、瞳孔扩大、中耳炎。 罕见:弱视、瞳孔大小不等、眼睑炎、白内障、结膜水肿、角膜溃疡、耳聋、眼球突出、眼出血、青光眼、听觉过敏、夜盲、外耳炎、嗅觉倒错、畏光、上睑下垂、视网膜出血、味觉丧失和视野缺损。 停用帕罗西汀的症状 常见: 眩晕、感觉障碍、睡眠障碍、焦虑、头痛。 不常见:兴奋、恶心、震颤、意识模糊、出汗、腹泻。 和其他许多精神药物一样，停用本品(特别是突然停药时)可能会发生眩晕、感觉障碍(包括感觉异常、电休克感觉和耳鸣)、睡眠障碍(包括强烈的梦境)、兴奋或焦虑、恶心、头痛、震颤、意识模糊、腹泻和出汗等症状。在大多数病人中，这些事件为轻到中度，为自限性。未发现哪组病人发生这些症状的危险性较高，因此建议如果不再需要帕罗西汀治疗时，应当逐渐减量停药(参见【用法用量】及【注意事项】)。 儿童临床研究中的不良事件: 在儿童的临床研究中，至少有2%的患者报告有下述不良事件发生，发生率至少为安慰剂的两倍:情绪不稳定(包括自我伤害，自杀念头，自杀企图，哭泣和情绪波动)、敌意、食欲减退、震颤、出汗、痉挛和激动。自杀念头和自杀倾向主要见于患有重性抑郁症的青少年的临床试验中。敌意多见于患有强迫性神经症的儿童，特别是12岁以下的儿童。 试验中采用了逐渐减量的给药方案(每周以日剂量10mg递增，降至每日剂量10mg，并继续服用一周后停药)。在逐渐减量期间或停药时，至少有2%的患者报告有下述不良反应发生，发生率至少为安慰剂的两倍:情绪不稳、神经过敏、眩晕、恶心和腹痛(参见【注意事项】)。 上市后报告:自药品上市以来已经收到服用本品患者发生不良事件的自发报告，上面未列出的，可能与药物无因果关系的不良事件包括。急性胰腺炎，肝功能化验指标升高(最严重病例是由于肝坏死导致的死亡，和与严重肝功能障碍有关的转氨酶显著升高)。格-巴二氏综合征，中毒性表皮坏死松懈症，阴茎异常勃起。抗利尿激素分泌异常综合征，催乳素血症的症状，溢乳。神经阻滞剂恶性综合征样事件、5-羟色胺综合征。锥体外系症状包括静坐不能、运动迟缓、齿轮样强直、张力失调、张力亢进、与哌迷清合并用药有关的动眼神经危象。颤sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 抖和牙关紧闭。癫痫持续状态，急性肾衰竭、肺动脉高压。变应性肺泡炎、过敏反应、子痫、喉痉挛、视神经炎、卟啉症、心室纤颤、室性心动过速(包括尖端扭转型室性心动过速)、血小板减少症、溶血性贫血、造血功能损伤性不良事件(包括再生障碍性贫血、全血细胞减少症、骨髓发育不良和粒细胞缺乏症)和血管炎综合征(例如过敏性紫癜)。在同时服用本品和苯妥英4周后，收到1例苯妥英血药浓度升高的报告。还有1例在美托洛尔长期治疗中加用本品后发生了严重低血压的报告。 禁忌: 已知对本品及其赋形剂过敏者禁用。 本品不能与单胺氧化酶抑制剂合用(包括抗生素类药物利奈唑胺，一种可逆，非选择性的单胺钮化酶抑制剂)或在以单胺氧化酶抑制剂进行治疗结束后两周内使用。同样，在以本品进行治疗结束后两周内亦不得使用单胺氧化酶抑制剂(详见【药物相互作用】)。 本品不能与甲硫哒嗪合用(因为与其他抑制肝脏细胞色素P450同工酶CYP450 2D6的药物一样。 本品可引起甲硫哒嗪的血浆浓度升高(见【药物相互作用】)。单独使用甲硫哒嗪可导致QTc间期延长(并伴有严重的室性心律不齐(例如心电图表现穗尖现象(波峰扫曲)和猝死。 本品不应与哌谜清(pimozide)合并使用(见【药物相互作用】)。 注意事项: 警告 临床病情恶化和自杀风险: 成人或儿童重度抑郁症(MDD)患者无论是否服用抗抑郁药物(都可能会出现抑郁症状恶化和,或出现自杀意念和自杀行为(自杀倾向)(患病期间这种危险性持续存在(直至病情得到显著缓解。自杀是抑郁及某些其他精神疾病的一种已知风险，这些疾病本身就是发生自杀最强烈的预测因子。长期以来一直认为抗抑郁药治疗的早期会诱导某些患者病情恶化和出现自杀倾向(抗抑郁药物(SSRls类和其他种类)的短期(安慰剂对照临床试验数据的综合分析显示，在儿童(青少年以及青年患者(18 - 24岁)中，这些药物会增加重度抑郁症和其他精神疾病患者的自杀意念和自杀行为(自杀倾向)(抗抑郁药物的短期临床试验显示(与安慰剂相比较(在24岁以上的成人患者中自杀风险没有升高，在65岁以上的成人息害中自杀风险反而有下降。 在儿童和青少年重度抑郁症，强迫症或其他精神类疾病的患者中(安慰剂对照临床试验的综合分析资科(包括了9种抗抑郁药物(在4400例患者中进行的24项短期临床试验(在成人重度抑郁症或其他精神类疾病的患者中，安慰剂对照临床试验的综合分析，则包括了1 1种抗抑郁药物(在超过77000多例患者中进行的295项短期临床试验(中位持续时间为2个月)(不同药物之间的自杀风险不同，但几乎所有试验药物在较年轻患者中的自杀风险都有升高的趋势;不同适应症之间的绝对自杀风险也不同的，以重度抑郁症的发生率为最高。在年龄分层以及各适应症之间的风险差异(药物与安慰剂之间)相对稳定，这些差异详见表1(每1 000例治疗患者中自杀例数的药物-安慰剂差异)。 types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 在任何儿童相关的临床试验中(未出现自杀现象，在成人临床试验中有自杀情况(但这些数据尚不足以评价该药物对自杀的影响作用。 目前尚不知道在较长期用药时(如几个月以上)(自杀风险是否会增加，但是在成人抑郁症患者中进行的安慰剂对照维持治疗临床试验数据证明，使用抗抑郁药物可以延缓抑郁症的复燃。 所有接受抗抑郁药物治疗的患者都应当接受适当的监测，严密观察是否出现了病情恶化，自杀倾向和行为异常变化，特别是在疗程开始的最初几个月内，或者是在改变用药剂量的时候(增加或减少剂量)。 在因重度抑郁症以及其他适应症而接受抗抑郁药物治疗的成人和儿童患者中，不论是否属于精神疾病。受试者都曾报告出现过以下症状:焦虑、激越、惊恐发作、失眠、易怒、敌意、攻击性、冲动、静坐不能(静坐困难)、轻度躁狂、躁狂症。尽管这些症状与临床上抑郁症的病情恶化和,或自杀风险的因果关系尚未得到证实。但是这些症状可能会是自杀行为的前兆。 如果患者的抑郁症病情持续恶化，出现自杀意念,行为，出现抑郁加重征象或自杀先兆，特别是当这些症状属于重度、突发或新出现的时候。应该考虑变更治疗方案，包括可能需停止用药。 如果决定停止治疗，由于本品有停药风险，应在尽可能快速的情况下逐渐减量，要注意突然停药会出现某些症状(参见【注意事项】和【用法用量】)。 在因重度抑郁症或其他适应症(不论是否属于精神疾病)接受抗抑郁药物治疗的过程中，要告诫家属或护理人员，应当密切监测患者的兴奋、易怒，行为异常变化或上述的其他症状，以及自杀倾向等，要及时地将这些症状报告给医务人员或医疗机构。家属或护理人员每天都要进行病情监测。 为了减少用药过量的风险，处方本品时应该选最小剂量的片剂，并与良好的患者管理措施相配套。 筛查双相情感障碍患者:重度抑郁发作可能是双相情感障碍的最初表现，—般认为(尽管尚sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 未经对照临床试验所证实)，在有双相情感障碍危险的患者中单用抗抑郁药物治疗重度抑郁发作，可能会增加其混合,躁狂发作加重的可能性。关于上述的症状是否也会发生这种转变尚不清楚。在开始应用抗抑郁药物治疗以前，应当对患者做充分的筛查，确定他们是否具有发生双相情感障碍的危险:这种筛查应当包括详细的精神病病史、以及自杀，双相情感障碍和抑郁症的家族史。应当注意，本品尚未批准用于治疗双相情感障碍。 与单胺氧化酶抑制剂可能的相互作用。在接受一种5-羟色胺再摄取抑制剂的患者中(联合使用单胺氧化酶抑制剂(MAOI)时，已有出现严重的，甚至是致命性反应的报告，这些反应包括高热、僵直、肌阵挛，伴有生命体征快速波动的自主神经不稳定。精神状态改变(包括极度兴奋发展到谵妄和昏迷)。在最近停用此类药物而开始一种单胺氧化冀抑制剂治疗的患者中，也有这些反应的报告(有些病例表现为类似神经阻滞剂恶性综合征的特征。尚没有单胺氧化酶抑制剂与本品相互作用的人体试验资料(有限的动物实验资料提示，帕罗西汀与单胺氯化酶抑制剂类药物联合使用(能在升高血压和诱发行为兴奋方面发挥协同作用。因此不推荐本品与单胺氧化酶抑制剂(包括抗生素类药物利奈唑胺(一种可逆(非选择性的单胺氧化酶抑制剂)合用，也不推荐在停用单胺氧化酶抑制剂两周内使用本品(参见【禁忌】)(在本品停用至少两周后才能使用单胺氧酶抑制剂。 5-羟色胺综合征:在应用SNRls和SSRls(包括本品)治疗的患者中(可能会发生危及生命的5-羟色胺综合征，特别是与5-羟色胺能药物(包括阿米替林)以及影响5-羟色胺代谢的药物(包括单胺氧化酶抑制剂类)合用时更易发生5-羟色胺综合征的表现包括有精神状态改变(如兴奋(幻觉、昏迷)(自主神经不稳定(如心动过速、血压不稳定、高热)、神经肌肉异常(如反射亢进、共济失调)和,或胃肠道症状(如恶心、呕吐、腹泻)。 禁忌本品与单胺氧化酶抑制剂类合用治疗抑郁症(参见【注意事项】)。 当本品与5-羟色胺受体激动剂(阿米替林)合用时，需谨慎并密切监测临床病情，尤其是在治疗初期以及增加剂量时(参见【注意事项】)。 不推荐本品与5-羟色胺前体物质(如色氨酸)合用(参见【注意事项】)。 与甲硫哒嗪可能的相互作用:单独使用甲硫哒嗪会延长QTc间期(出现严重的室性心律失常。如尖端扭转型室性心动过速以及猝死。这个作用似乎与剂量有相关性。 一项体内试验显示(抑制CYP2D6的药物(如帕罗西汀)能使甲硫哒嗪血浆水平升高，因此不推荐帕罗西汀和甲硫哒嗪合用(参见【禁忌】和【注意事项】)。 妊娠用药: 致畸作用:流行病学调查显示，在妊娠头三个月暴露于抗抑郁药物的母亲所生婴儿中，心血管方面的先天性畸形的危险性升高(如室间隔缺损(VSDs)和房间隔缺损(ASDs))，通常，间隔缺损病变的严重程度。从有症状需要外科手术治疗的病变，到没有症状或可以自然痊愈的病变。对于在服用帕罗西汀期间妊娠的妇女，应考虑该药可能对胎儿造成的伤害，只有在衡量帕罗西汀治疗受益大于潜在风险时方可继续使用，否则就需停用帕罗西汀，而选择其他抗抑types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 郁药物(参见【注意事项】)(对于妊娠或处于妊娠前三个月中的妇女，只有在先考虑了其他可用的治疗选择之后，才能开始使用帕罗西汀治疗。 一项根据瑞典全国注册登记资料进行的临床试验，评价了6,896例于妊娠初期暴露于抗抑郁药物的妇女(5,123例妇女暴露于SSRls，其中815例暴露于帕罗西汀)所生的婴儿与全部注册登记人群相比较，在 妊娠初期暴露于帕罗西汀的婴儿中心血管畸形的风险增加(主要是VSDs和ASDs) (OR 1.8;95%可信区间:1.1 - 2.8)(在妊娠初期暴露于帕罗西汀的婴儿中心血管畸形比例为2%(而全部注册人群的心血管畸形比例为1%(在这些暴露于帕罗西汀的婴儿中，先天性畸形的总风险率并没有增加。 在一项单独的回顾性队列研究中(采用美国国家健康总署的资料评价了5,956例婴儿，婴儿的母亲在妊娠的前三个月内应用了帕罗西汀或其他抗抑郁药物(应用帕罗西汀的患者n=815)。研究显示，与其他抗抑郁药相比较(帕罗西汀具有增加心血管畸形风险的趋势(OR l.5, 95%可信区间:0.8 - 2.9)。在妊娠前3个月内使用帕罗西汀和其他抗抑郁药时(心血管畸形的发生率分别为1.5%和1%(在母亲妊娠前三个月服用了帕罗西汀的12例出现心血管畸形婴儿中(有9例患有VSDs(这项研究还提示，与其他抗抑郁药物相比较(帕罗西汀增加了主要先天性畸形的总风险(包插心血管缺陷)(OR: 1.81 95%可信区间:1.2 -2.8)(在母亲妊娠前3个月使用过帕罗西汀的婴儿中(全部先天性畸形的发生率为4%(在母亲妊娠前3个月内使用过其他抗抑郁药物的婴儿中(全部先天性畸形的发生率为2%。 动物试验:在器官形成期，给予大鼠50mg/kg/日或兔6mg/kg/日剂量的帕罗西汀生殖试验中(这些剂量是人体最大推荐剂量(MRHD)的8倍(大鼠)和2倍(兔)(试验中没有发现致畸作用(但是当于妊娠期最后三个月给药至哺乳期时(哺乳期前4天仔鼠的死亡数量增加。当剂量为1mg/kg/日或者接近1/6的1mg/m2人体最大推荐剂量(MRHD)时(亦可出现这种作用。没有测定一仔鼠死亡的无效剂量。仔鼠的死亡原因也不清楚( 非畸形作用:于妊娠末期三个月内暴露于本品和其他SSRls、或5一羟色胺•去甲肾上腺素再摄取抑制剂(SNRls)的新生儿(会因出现并发症而需要延长住院时间(延长呼吸支持和管饲的时间(这些并发症可于出生后迅速发生(已有报告中的临床所见包括有呼吸窘迫，发绀，呼吸暂停、癫痫发作(体温波动(喂食困难(呕吐，低血糖(肌张力减退(肌张力亢进、反射亢进，震颤。发抖(易激惹和持续哭闹(这些特征都与SSRls和SNRls的直接毒性作用相一致(或可能与一种药物的停药综合征相一致(需要注意的是(在某些病例中的临床表现是与5-羟色胺综合征相一致的(参见【注意事项】)。 在妊娠后期暴露于SSRls的新生儿中(发生新生儿持续性肺动脉高压(PPHN)的风险增加。在—般人群中，每1000例活胎可出现1-2例PPHN(并与新生儿的发病率和死亡率相关联。在一项回顾性病例对照临床试验中(有377例妇女所生的婴儿在出生时患有PPHN(而836例妇女所生的婴儿出生时健康(与妊娠期没有暴露于抗抑郁药物的婴儿相比较(在妊娠第20周后暴露于SSRls的婴儿中发生PPHN的风险几乎高出6倍(目前尚无确定的证据证实妊娠期暴露于SSRls有发生PPHN的风险。而这项试验也是首次对这一潜在风险进行研究。在这项试验中(纳入的暴露于单一种类的SSRls的病例数不足(故不能确定SSRls是否都具有相sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 同的PPHN风险水平。在暴露于帕罗西汀或其他SSRls的妊娠患者中，还有发生早产的上市后报告(当于妊娠晚期应用帕罗西汀治疗时(医师应当认真考虑潜在的风险和治疗受益。医师还应当注意到(在一项前瞻性纵向研究中(201例有重度抑郁症病史的妇女在妊娠初期情绪正常(但是在妊娠期间(与继续进行抗抑郁症治疗的妊娠妇女相比较(停用了抗抑郁药物的妇女更容易出现重度抑郁症复发或病情恶化。 躁狂和双相情感障碍 重性抑郁发作可能是双相情感障碍的最初表现(一般认为(尽管未被对照试验所证实)单用抗抑郁药物治疗这样的重性抑郁发作在有双相情感障碍危险的病人中可能会增加其混合,躁狂发作加重的可能性(在开始用抗抑郁症药物治疗以前(应当对病人傲充分的筛查(确定他们是否有发生双相情感障碍的危险(这种筛查应当包括详细的精神病病史(包括自杀(双相情感障碍和抑郁症的家族史。应当注意未批准本品用于治疗双相情感障碍(和所有抗抑郁药物一样，本品也应当慎用于有躁狂病史的病人， 骨折:关于服用抗抑郁药包括SSRls有骨折风险的流行病学研究表明其跟骨折有一定的相关性(该风险发生在治疗过程中并在治疗早期是最大的(骨折被认为有可能发生在服用本品的患者中。 静坐不能:罕见的情况下(使用本品或其他SSRls可能会出现静坐不能(其特征表现为烦躁不安的内心感受和精神运动性兴奋(例如常常由于自觉苦恼(不能静坐或安静站立(这种情况最可能发生于治疗的前几周内。 血清素综合征,抗精神病药物恶性综合征 罕见的情况下，帕罗西汀治疗可能会发生血清素综合征或抗精神病药物恶性综合征样事件(特别是与其他血清素能药物和,或抗精神病药物合用时。因为这些综合征可能导致潜在的致命性问(所以如果发生这些事件(特征表现为多种症状组合，如高热(强直(肌阵挛(自主神经不稳定(可能有生命体征的快速波动，精神状态改变(包括意识模糊(烦躁、极度兴奋，进展到谵妄和昏迷)(应当停用本品，采取支持对症治疗。帕罗西汀不能与血清素前体物质(如L-色氨酸，羟色胺酸)合用，因为两者合用有发生血清素能综合征的危险(见【禁忌】和【药物相互作用】)。 心脏 心脏病患者应用本品通常应注意观察。 癫痫 与其它精神科药物一样(癫痫患者慎用。 癫痫发作 总的来说(使用本品治疗过程中癫痫发作的发病率<0.1%。癫痫发作的病人应停止用药。 青光眼 types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 与其它选择性5-HT再摄取抑制剂(SSRls)相比，本品可能会引起瞳孔扩大，房角变窄的青光眼患者应慎用。 儿童和青少年(年龄小于18岁) 在儿童和青少年的重性抑郁障碍和其他精神疾病患者中，自杀意念和行为的风险增加与抗抑郁药物的治疗相关。在本品的儿童和青少年临床试验中(与安慰剂治疗者相比(帕罗西汀治疗的患者中自杀迹象(自杀企图和自杀念头)以及敌意(主要表现为攻击性(对抗行为和发怒)相关的不良事件比较多见(见【不良反应】)(目前还缺乏对儿童和青少年的生长(成熟，认知和行为发育的长期安全性资料。 成年人的临床病情恶化和自杀风险 年轻的成年人(尤其是患有重性抑郁障碍的年轻的成年人(在使用帕罗西汀治疗期间(可能增加自杀行为出现的风险。一项对患有精神疾病的成年人与安慰剂对照试验分析显示:与安慰剂对照，使用帕罗西汀治疗的年轻的成年人(预定义年龄范围18~24岁)自杀行为几率较高(17/776 [2.19%]比5/542 [0.92%])(尽管这个差异没有统计学意义(在较大年龄组中(25—64岁(以及等于或大于65岁)(没有观察到这样的增加(患有重性抑郁障碍的成年人(所有年龄)使用帕罗西汀治疗(与使用安慰剂对照，自杀行为的几率增加具有统计学意义(118455 [0.32%】比1/1978【0.05%】l所有的事件为自杀企图)(然而，因帕罗西汀所致(8/11)自杀企图大多散发生在18—30岁的年轻的成年人中。这 些重性抑郁障碍的数据表明在患有精神疾病的年轻的成年人群观察到的较高自杀几率有可能外延到24岁以上的人群中( 抑郁症患者无论是否服用抗抑郁药物(都可能出现抑郁症状恶化(和,或出现自杀意念和自杀行为(自杀迹象)(这种危险性持续存在，直到病情显著缓解。在恢复的早期自杀危险性可能升高(这是所有抗抑郁药物治疗普遍的临床经验。其他用帕罗西汀治疗的精神疾病也可能有自杀行为的危险性升高(并且(这些情况也可能与重性抑郁障碍合并存在。此外，有自杀行为或自杀念头病史的病人(年轻的成年人以及开始治疗前表现出明显的自杀意念的病人出现自杀念头或自杀企图的危险性较高。整个治疗期间应当监测所有病人，注意是否出现临床恶化(包括出现新的症状)和自杀迹象(特别是在疗程开始的时候(或者改变用药剂量的时候(增加或减少)。应该告诫病人(和病人的看护人员)(注意监测病情恶化(包括出现新的症状)和,或出现自杀意念,行为或自我伤害念头的情况，一旦出现这些症状(要立即寻求医疗建议。应该意识到一些症状的出现(例如兴奋(静坐不能或躁狂)可能与基础疾病状态或药物治疗有关(参见静坐不能(躁狂和双相情感障碍。不良反应)。 如果患者出现临床恶化(包括出现新的症状)(和,或出现自杀意念,行为，特别是那些严重，突然发生或新出现的症状(应该考虑变更治疗方案(包括可能停用药物。 电休克疗法(ECT) 目前尚无有关本品和电休克联合治疗的临床经验。然而(罕见正服用SSRls患者可延长ECT治疗诱发的癫痫发作和,或继发癫痫的报道。 低钠血症 罕见低钠血症的报道，主要在老年患者中发生。低钠血症症状通常在停药后可得到逆转。 sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 低钠血症的体征和症状包括有头痛，精力不集中，记忆障碍，意识模糊，虚弱，站立不稳可能会跌倒。在严重或急性病例中，体征和症状还包括有幻觉、晕厥，癫痫发作、昏迷(呼吸停止和死亡。 出血 有服用本品后(出现皮肤和粘膜出血(包括胃肠道出血)的报道，故应谨慎与增加出血危险性的药物合用(已知和可能具有出血倾向的病人懊用本品( 单胺氧化酶抑制剂 停用单胺氧化酶(MAO)抑制剂治疗至少2周后(才可开始谨慎应用帕罗西汀(并且本品治疗的用药剂量应当逐渐增加(直到达到理想效果(见【禁忌】和【药物相互作用】)。 肾脏损害,肝脏损害 严重肾功能损害或肝功能损害的病人应当慎用(见【用法用量】)。 驾驶,操纵机器 临床经验证明(服用本品后(对认知或精神运动功能没有影响(然而与所有精神活性药物一样(服药的病人在驾车或操纵机器时(应小心谨慎( 成年人停用帕罗西汀治疗的症状 成年人的临床试验中(帕罗西汀治疗的病人停药时30%的病人有不良事件(安慰剂组的病人有20%有不良事件(发生停药症状的情况与物质滥用出现的药物威瘾或药物依赖所产生的症状不同。头晕(感觉障碍(包括感觉异常(电休克感觉和耳鸣)，睡眠障碍(包括强烈的梦境)(兴奋或焦虑(恶心(震颤(意识模糊(出汗，头痛，腹泻已有报道。这些症状一般为轻中度，但是部分病人的症状可能较重。这些情况往往发生于停药后的前几天(但是也有很罕见的报告这些症状发生于意外漏服1次药物的病人中(这些症状—般是自限性的，常常在2周内消退，虽然某些人的症状可能延长(2-3个月或更长)。因此，建议停用本品的时候(应当根据病人的需要，在几周或几个月的时间内逐渐减量停药(见【用法用量】)。 儿童和青少年停用帕罗西汀的症状 儿童和青少年的临床试验中(帕罗西汀治疗的病人停药时32%的病人有不良事件(安慰剂组的病人24%有不良事件(停用本品时报告发生率至少占病人的2%(发生率至少为安慰剂组2倍的事件包括:情绪不稳定(包括自杀意念(自杀企图，情绪改变和流泪)(神经质，头晕，恶心和腹痛(见【不良反应】)。 孕妇及哺乳期妇女用药: 生育:一些临床试验表明SSRls(包括帕罗西汀)可能会影响精于的质量(这样的影响看起来是治疗中止后是可逆的(精子质量的变化可能会影响一些男性的生育能力。 妊娠和哺乳期:动物研究表明，本品无任何致畸性，也无选择性胚胎毒性作用。近期对妊娠头三个月暴露于抗抑郁药物后的妊娠结果进行的流行病学研究报告，与使用帕罗西汀相关的先天畸形的危险性升高，尤其是在心血管方面的(如，房室间隔缺损)。该数据表明母亲暴露于帕罗西汀下(婴儿发生心血管缺陷的风险约为1/50(而一般人群的预期风险约为1/100。 对于妊娠妇女或计划怀孕的妇女，处方医生只有在衡量帕罗西汀潜在受益大于潜在风险时方types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 可使用(否则需选择可替代的治疗措施(如果妊娠妇女需停止使用帕罗西汀(处方医生应参见【用法用量】-帕罗西汀的停药和【注意事项】—成年人停用帕罗西汀治疗的症状。暴露于帕罗西汀或其他SSRls的妊娠妇女中已经有早产的报告，虽然尚未明确早产与药物治疗的因果关系。如果母亲持续到妊娠晚期仍在使用本品(则应当观察新生儿的情况，因为妊娠后三个月的晚期暴露于帕罗西汀或其他SSRls的新生儿中已经有并发症的报告(但是(与药物治疗的因果关系尚未得到证实(已报道的临床发现包括。呼吸窘迫、紫绀、呼吸暂停。癫痫发作(体温不稳定(喂哺困难(呕吐(低血糖、张力过高，张力过低，反射亢进(曩颤，神经过敏，烦躁(昏睡(经常哭和嗜睡(某些情况下(报告的症状被描述为新生儿撤药症状。大多数情况下(据报道这些并发症是发生于分娩后即刻或不久(<24小时)。 流行病学研究已经表明在怀孕期间尤其是怀孕后期使用选择性5-HT再摄取抑制剂(包括帕罗西汀)(与会增加新生儿持续性肺动脉高压的风险。在怀孕后期使用过选择性5-HT再摄取抑制剂的人群中，据报道增加的风险高出普通人群(比率是每1000妇女中有1-2人)4到5倍以上(少量帕罗西汀经乳汁排出。 在已发表的研究中(母乳喂养的婴儿中血清浓度无法检出(<2ng/ml)或很低(<4ng/ml)。这些婴儿中没有药物效应的体征。尽管如此，赛乐特@仍不能用于哺乳期(除非有证据说明母亲的预期受益大于可能对婴儿的风险。 儿童用药: 本品不可用于年龄小于18岁的儿童或青少年(参见【注意事项】)。 老年用药: 在老年受试者中，可出现本品血浆浓度升高。 起始剂量应该与成人起始剂量相同，并可根据患者反应，每周以10mg递增至每日最大剂量40mg。 药物相互作用: 0. 1(临床研究表明，帕罗西汀的吸收和药代动力学不受下列因素影响或者只有不明显的影响(即，这种影响很小不需要改变给药方案): 食物 制酸剂 地高辛 普萘洛尔 2(血清素能药物 和其它选择性5-HT再摄取抑制剂(SSRIs)药物一样，和血清素能药物(包括单胺氧化酶抑制剂，L-色胺酸，曲坦类药物，曲马多，利奈唑胺，SSRIs，锂和St(John's Wort-贯叶连翘-制剂)合用可能导致5-HT相关效应(血清素综合征:见【禁忌】及和【注意事项】的发生。 这些药物与本品合用的时候需要慎重，需要密切监测临床病情。 sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 3(药物代谢酶:药物代谢酶的诱导剂或抑制剂可影响本品的代谢和药代动力学，当本品与已知的药物代谢酶抑制剂合用时，应考虑使用剂量范围的低限。而当本品与已知的药物代谢酶诱导剂(如:卡马西平、利福平、苯巴比妥、苯妥英)合用时，则无须考虑调整初始剂量。随后剂量的调整应视临床反应(疗效及耐受性)而定。 Fosamprenavir/利托那韦:本品与Fosamprenavir/利托那韦合用时会显著降低帕罗西汀的血浆浓度，应根据临床效果(耐受性和有效性)进行任何的剂量调整。 4(酒精:帕罗西汀不增加酒精引起精神和运动机能掼害，但是不推荐本品与酒精合用。 5(与大多数抗抑郁药一样，本品不能与单胺氧化酶抑制剂合用。服用本品前后两周内不能使用单胺氧化酶抑制剂。在停用单胺氧化酶抑制剂两周后开始服用本品时应慎重，剂量应逐渐增加。 6(抗惊厥药:卡马西平，苯妥英，丙戊酸钠。合用这些药物对癫痫病人中的药代动力学/药效学特征似乎没有什么影响。 7(帕罗西汀对CYP2D6的抑制效能 和其他抗抑郁药物(包括其他SSRIs)一样，帕罗西汀会抑制肝脏细胞色素P450酶CYP2D6。抑制CYP2D6可能导致合用的经该酶代谢的药物血浆浓度升高。这些药物包括某些三环类抗抑郁药(如，阿米替林，去甲替林，丙咪嗪和地昔帕明)、吩噻嗪类精神安定药物(如，奋乃静和硫利达嗪，见【禁忌】、利培酮、阿托西汀、某些1c类的抗心律失常药(如，普罗帕酮和氟卡尼)和美托洛尔。 CYP3A4 稳态条件下帕罗西汀和细胞色素CYP3A4的底物特非那定合用的体内相互作用研究表明，帕罗西汀对特非那定的药代动力学没有影响。类似的体内相互作用研究发现帕罗西汀对阿普唑仑的药代动力学没有影响，阿普唑仑对帕罗西汀的药代动力学也没有影响。帕罗西汀与特非那定、阿普唑仑和其他作为CYP3A4底物的药物合用不会有害。 8(丙环定:每天给药帕罗西汀会显著增加丙环定的血浆浓度。如果发现抗胆碱能效应，丙环定的剂量应当减少。 9(哌迷清(Pimozide) 一项单次低剂量(2毫克)哌迷清与帕罗西汀联合给药的试验显示，哌迷清水平升高。然而哌迷清与帕罗西汀相互作用机制不明，并且由于哌迷清治疗指征狭窄和已知它能延长QT间期，因此严禁哌迷清与本品合并使用(见【禁忌】)。 types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 10(三环抗抑郁药(TCAs) 因为帕罗西汀能够抑制TCA代谢，故慎用于与三环抗抑郁药(TCAs)合用(TCA与本品合用时要减少TCA剂量，需要监测血浆TCA浓度( 11(与血浆蛋白高度结合的药物:由于帕罗西汀与血浆蛋白高度结合(服用另一种与蛋白高度结合药物的患者在使用本品时(其他药物的游离浓度会升高(就有可能导致不良事件。相反，其他蛋白高度结合药物置换出来的帕罗西汀也会引起不良反应。 12.影响止血的药物(如NSAIDs(阿司匹林和华法林)。血小板释放的5(羟色胺在止血中起重要作用。病例对照和队列分析流行病学研究证明，干扰5-羟色胺再摄取的抗精神病药物应用与上消化道出血有关(同时还证明了联合使用NSAID或阿司匹林会增加出血的风险。SSRls或SNRls与华法林合用时(抗凝作用发生变化，其中包括出血增加。接受华法林治疗的患者当开始或停止使用帕罗西汀时(均需密切观察患者病情。 药物过量: 现有资料表明，本品有较大的安全范围。曾有单次服用本品2000mg或与其它药物合用(包括酒精)药物过量的报道。过量服用本品后的经验表明，除了不良反应部分提到的那些症状，恶心、呕吐、瞳孔散大、发热、血压变化、头痛、不自主肌肉收缩、激动、焦虑和心动过速已有报道。偶有昏迷或心电图变化的事件报道，但很罕见危及生命，多发生在合用其它精神科药物时(伴有或不伴有酒精)。 无特殊的解毒药，可按其它抗抑郁药物过量的常规方法处理。患者可以根据临床适用的方法或国家中毒控制中心的推荐来处理。 药理毒理: 药理作用 盐酸帕罗西汀为抗抑郁症药，是强效，高选择性5-HT再摄取抑制剂(可使突触间隙中5-HT浓度升高(增强中枢5-羟色胺能神经功能。仅微弱抑制去甲肾上腺素和多巴胺的再摄取(与毒蕈碱受体或α1、α2、β-肾上腺素受体、多巴胺受体(D)、5-HT受体、 5-HT受体和组212胺(H)受体几乎没有亲和力。对单胺氧化酶无抑制作用。 1 毒理研究 遗传毒性: 帕罗西汀Ames试验，小鼠淋巴瘤试验，程序外DNA合成试验(人淋巴细胞染色体畸变试验、小鼠微核试验及大鼠显性致死试验结果均为阴性。 生殖毒性: 给予帕罗西汀15mg/kg/天(以mg/m2计算，是治疗抑郁症临床推荐剂量的2.9倍)(大鼠的受孕率下降(在2到52周的毒性研究中(发现雄性大鼠生殖道不可逆损伤(50mg/kg/天时可见附睾管上皮空泡(2 Smg/kg/天时伴随摘子生成抑制的肇丸输糟管萎缩)。器官形成期大鼠和家兔分别给予帕罗西汀50mg/kg/天和6mg/kg/天(以mg/m2计算(分别相当于治疗抑郁症临床推荐剂量8和2倍)(未见致畸作用(但是在大鼠妊娠后三个月及整个哺乳期连续给药(哺乳期的前4天，幼鼠死亡增加(该作用发生在1g/kg/天(死亡原因尚不清楚。未能确定造成大鼠幼鼠死亡的无影响剂量。 sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 致癌性 在啮齿类动物掺食法给药两年的致癌性试验中(小鼠和大鼠的给药剂量分别达25mg,kg天和20mg/kg天(以mg/m2计算，分别相当于治疗抑郁症临床推荐剂量3.9倍)(结果可见高剂量组雄性大鼠网状细胞瘤发生率显著增加(对照(低(中和高剂量组分别为1/0, 0/50.0/50和4/50)(淋巴网状内皮细胞瘤发生率呈剂量依赖性增加。雌性大鼠未见影响。小鼠中肿瘤数呈现剂量相关性增加(但出现肿瘤的小鼠数量未见药物相关性增加(这些发现与人类的相关性尚不清楚。 药代动力学: 帕罗西汀盐酸盐溶液口服后吸收完全。每日口服本品30mg(连续服用30天(平均清除半衰期约为21小时(CV 32%)(帕罗西汀主要经代谢降解(其代谢产物无药理活性(在剂量增加时表现为非线性药代动力学过程。帕罗西汀部分是由CYP2D6代谢(代谢产物主要经尿液排泄，少量由粪便排泄(尚没有在CYP2D6缺陷患者(缺乏代谢型)中评价帕罗西汀药代动力学的资料。 吸收和分布 口服后本品能完全吸收(吸收后经首过代谢。正常男性每日口服本品30mg(大部分1 0天左右能达到稳态(极少数病人所需的时间稍长，稳态时的Cmax61.7g/ml(Tmax为5.2.hr,Cmax 14为30.7ng/ml。为21小时(CV 32%)。稳态Cmax和Cmax值是单剂量临床试验预测数值的6-倍。基于AUC口(2。计算的稳态药物暴露-则为单剂-临床试验预测数值的8倍(过度蓄积是由于帕罗西汀的代谢酶快速饱和的结果。 采用在单剂量给药的同时进食俄不进食的方法(研究了食物对帕罗西汀生物利用度的影响。与食物同服时(AUC略有增加(6%)(但Cmax增加较多(29%)(血浆浓度达峰时间从6.4小时缩短到4.9小时。本品95%与血浆蛋白结合(分布于全身各组织(包括中枢神经系统(仅1%留在体循环中。 代谢和排泄 其清除半衰期通常为24小时。本品经肝脏代谢，主要经肾脏排泄，少量由粪便排泄(其代谢物无活性。 帕罗西汀口服吸收后的主要代谢产物为氧化和甲基化的极性共价复合物(易于清除。与葡萄糖醛酸及硫酸盐的共价结合物为主(主要代谢产物已经分离出并确定。资料显示药物的代谢产物对5-羟色胺再掇入的活性抑制作用不足母药的1/50(CYP2D6参与了帕罗西汀的部分代谢(在临床用药剂量时(该酶的饱和使帕罗西汀剂量增加及疗程增加时的药代动力学过程表现为非线性。该酶对帕罗西汀代谢的作用提示了一些潜在的药物间相互作用可能(参见【注意事项】)。口服帕罗西汀溶液30mg剂量后10天(将近64%由尿液排泄(其中2%为母药(62%为代谢产物，大约有36%由粪便排泄(可能是经由胆汁)(其中大多数为代谢产物(母药不足1%。 贮藏: 遮光、密封，在干燥处保存。 包装: types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people types: one is the lack of capacity, "cannot be". Full stopped cutting Hou, some people spirit slack, in its bit not conspiracy to its political, not Dan thing, and not steward, and perfunctory, some cadres on innovation development "six big industry", and advance supply side structural reform, and "three to a drop a fill" and PPP mode, new knowledge not familiar, and not learning, and not study, skills panic, carried out work to no avail, and loss, on in there, by to. Second, lack of motivation, "don't want to". Pipe tightening now, not seeking privileges, some cadres enthusiasm weakened progressive consciousness, and do the work, look dry; some of the older, long-serving officials, ship to dock at the station, no longer willing to endure hardship to get tired, advance into the "remainder" State. In particular, some cadres do not clean all day, scary, absent-minded, in no mood for officers. Three acts as the lack of "dare". Some cadres responsibility consciousness not strong, can't play hardball face difficult problems, fear hit interests, and offend, fear work errors, and take risk, fear media hype, and into hot, encountered contradictions on around, met problem on hiding, see trouble on push, work up timid, and timid, and swayed, pursues more a thing than less a thing, not seeking active but seeking no had, even trying to avoidance thing avoidance accountability. Second, the dialectical strategy, positive change. Now some officials "for the officers not to" phenomenon has become a prominent issue, a few local and political ecology in a sub-healthy or unhealthy condition, colleagues of the circle, and the relationship, some people 铝塑泡罩，每板7片，每盒1板。 铝塑泡罩，每板10片，每盒1板。 有效期: 36个月 执行: 《中国药典》2010年版二部 批准文号: 国药准字H10950043 生产企业: 中美天津史克制药有限公司 sit, stood watching, slack. We can't wait, drag, dialectical, and strive for an early reverse. To strengthen education and training. Leading cadres should have a professional thinking, professionalism, professional way. District Committee party school and county level theoretical study Central Group of the Party Committee leaders to address gaps in knowledge, experience blind, weakness, precision of theoretical training, policy training, it training, management training, and regulatory training, highlights the pertinence and effectiveness of ensuring political qualities of leading cadres to keep up, thinking to keep up with, knowledge structure to keep up with and ability to keep up with, expert economic and social management. Discipline must be strengthened. Party committees at all levels should adhere to the overall strictness, discipline ... And political rules, effectively enhance political par core awareness, situation awareness, consciousness and awareness. To strengthen care and support. From "love" starts with protection on cadres, strict management of cadres at the same time, cadres on political motivation, work, psychological care, General relief, shelter, security, promoting the cadres and feel comfortable, confident, positive, and dare to play. To established fault-tolerant exemption mechanism, let officer of people not chilling, seriously implementation