Maninil ndi m'modzi mwa oimira kalasi yamankhwala ochepetsa shuga omwe amagwiritsidwa ntchito pokhalitsa shuga m'magazi.
Mwa mankhwala omwe alipo kuchokera ku gulu la mankhwala a sulfonylurea, Maninil amalamula nthawi zambiri.
Pharmacology yamakono imapatsa wodwala yemwe ali ndi matenda osokoneza bongo osiyanasiyana amankhwala.
Kusankha mtundu wa mankhwala kumachitika ndi adokotala.
Dokotalayo amasankha mankhwalawo pambuyo popenda mwatsatanetsatane za momwe wodwalayo alili pazoyeserera.
Zochokera ku sulfonylurea
Mankhwala amakono omwe amathandizidwa kuti athetse vuto ndikusintha shuga m'magazi a 2 mtundu wa shuga amagawika m'magulu akulu akulu:
- othandizira omwe amalimbitsa katemera wa pancreatic insulin secretionꓼ
- mankhwala omwe amalimbikitsa chidwi cha maselo kuti alowetse insulin, ndiye kuti, kukonza momwe maselo amafikira
- mankhwala omwe amalepheretsa mayamwidwe obwera ndi matumbo.
Kusankhidwa kwa mankhwalawa kupuma kwa dokotala yemwe amapita, yemwe amapereka mankhwala oyenera kwa wodwala aliyense (kapena angapo nthawi imodzi ndi zovuta mankhwala).
Pakati pa mankhwala omwe ali ndi kuthekera kokukulitsa kupanga kwa insulin ya mahomoni ndi kapamba, choyambirira, ndi mankhwala a sulfonylurea. Nthawi zambiri, akatswiri azachipatala amagwiritsa ntchito mankhwalawa mankhwala:
- Kutengera ndi zomwe zimagwira, glibenclamide (Maninyl). Oyimira ake odziwika kwambiri ndi mapiritsi a Maninil.
- Mothandizidwa ndi gliclazide (piritsi la diabeteson MV).
- Ndi chophatikizira chachikulu ndi glycidone, yomwe imapezeka m'mapiritsi a Glurenorm.
- Ndi yogwira pophika glimepiride (Amaril).
Chithandizo chachikulu chamankhwala chimawonedwa mu magawo a shuga m'magazi, chifukwa cha kukondoweza kwa kapamba kuti apange kuchuluka kwakukulu kwa insulin.
Tiyenera kudziwa kuti thupi la munthu aliyense ndi la munthu payekha, lomwe lingawonekere mosiyanasiyana pazotsatira zamankhwala zovomerezeka. Kuthekera kwa kusakhalapo kwa zotsatira zabwino sikumasiyanitsidwa.
Ndiye chifukwa chake, katswiri wazachipatala, potengera chidziwitso chakukula kwa matenda a wodwala aliyense, amasankha njira yoyenera kwambiri kwa iye.
Mankhwala okhala Mankhwala
Maninil mankhwalawa amagwiritsidwa ntchito mwachangu matenda a shuga a mtundu wodziyimira pawokha ndipo amaphatikizidwa m'gulu lachiwiri la sulfonylureas.
Pulogalamu yogwira piritsi imeneyi ndi gawo la glibenclamide. Kapangidwe kamankhwala Manin kamaphatikizidwa ndimagawo osiyanasiyana othandiza omwe alibe tanthauzo la achire.
Zofunikira zazikulu za mankhwalawa ndizowonetsera kwa pacreatic ndi extrapancreatic zotsatira.
Njira zotsatirazi zimachitika mthupi, ngati mungagwiritse ntchito ndikutenga Maninil:
- njira yolimbikitsira kupanga insulini ndi beta maselo a kapamba amakhala bwino
- pali zoletsa za kayendedwe ka gluconeogenesis ndi glycogeneis mu chiwindi,
- kuchuluka kwa maselo ndi minyewa kwa zomwe zimapanga insulin zimawonjezeka.
Kufotokozera kwa mankhwalawa kumawonetsa kuti Maninil, atagwira pakamwa, amathamangitsidwa m'matumbo. Komanso, kuthamanga kwa njirayi sikudalira kudya kwakanthawi komanso kuchuluka kwa chakudya m'mimba.
Mulingo wokwanira pazomwe zimagwira ntchito m'magazi am'magazi umatheka pafupifupi maola awiri ndi theka atatha kugwiritsa ntchito mankhwalawa.
Mankhwala amapezeka piritsi piritsi zingapo zosiyanasiyana, zomwe zitha kukhala:
- Maninyl 1.75 mg;
- Maninyl 3.5 mg;
- Maninil 5 mg.
Nambala, yomwe ikuwonetsedwa pafupi ndi dzina la piritsi, ikuwonetsa kuchuluka kwa zomwe zimaphatikizidwa piritsi limodzi. Momwemo, kuchuluka kwa mankhwalawa, kumalimbikiratu mphamvu ya mankhwala okhudzana ndi matenda ashuga.
Zizindikiro zogwiritsira ntchito mankhwalawa - matenda a shuga omwe amadalira insulin ngati monotherapy kapena pamodzi ndi mankhwala ena ochepetsa shuga, kupatula mankhwala a sulfonylurea ndi mankhwala osakanizidwa ndi dongo, angagwiritsidwe ntchito ngati chithandizo cha zakudya komanso zochitika zolimbitsa thupi sizingabweretse zotsatira zoyenera.
Malangizo ogwiritsira ntchito mapiritsi
Piritsi la manilin la matenda ashuga liyenera kumwedwa molingana ndi ndandanda inayake yoperekedwa ndi katswiri wazachipatala.
Mlingo wa mankhwalawa kwa munthu aliyense wakhazikitsidwa payekhapayekha kutengera kukula kwa njira ya matenda, kuchuluka kwa kuchuluka kwa shuga m'magazi musanadye chakudya, pamimba yopanda kanthu, m'badwo wa wodwalayo ndi machitidwe ake.
Musanagwiritse ntchito mankhwala, malangizo a boma amafotokoza kufunika kwa upangiri wamankhwala.
Kugwiritsa ntchito mankhwalawa kwa odwala matenda ashuga kumakhazikitsidwa motere:
- Mankhwala (mawonekedwe omasulidwa ndi Mlingo ndi 1.75 mg) pamagawo oyamba a mankhwalawa, ndikofunikira kumwa mapiritsi kamodzi kapena kawiri pa tsiku. Ngati, patatha nthawi, gulu ili la mankhwalawa silinabweretse zotsatira zomwe zimafunikira ndikuwonetsetsa kuti metabolism ya carbohydrate siinawonedwe, mulingo ungathe kuchuluka. Mlingo wowonjezera uyenera kuchitidwa pang'onopang'ono masiku angapo mpaka sabata. Kuchuluka kwa mankhwalawa kwa mankhwala patsiku sikuyenera kupitirira 10,5 mg ya yogwira ntchito.
- Maninyl 3.5 mg, monga momwe malangizowo amanenera, nthawi zambiri amagwiritsidwa ntchito ngati kuchuluka kwa mapiritsi okhala ndi mlingo wa 1.75 mg umapitilira zidutswa zitatu patsiku. Kuyambitsa mankhwala kuyenera kukhala hafu kapena piritsi limodzi patsiku. Pambuyo pake, katswiri wa zamankhwala asankha pakufunika kusintha njira iyi yamankhwala. Kuchuluka kwa mankhwalawa kwa mankhwala patsiku sikuyenera kupitirira 10,5 mg ya yogwira ntchito.
- Mapiritsi a Maninil 5 ali ndi gawo lalikulu kwambiri lazinthu zomwe zimapangidwa pakapangidwe kake. Njira yogwiritsira ntchito ndi Mlingo woyamba magawo a mankhwala ndi theka kapena piritsi limodzi masana. Pambuyo pake, kukhalapo kapena kusapezeka kwa zotsatira, ndizotheka kusintha njira zina. Mlingo woyenera wa tsiku lililonse wa maninil 5 (malangizo) sayenera kupitirira 15 mg yogwira ntchito.
Piritsi imatengedwa pakamwa ndi madzi pang'ono isanayambe chakudya. Ngati m'mbuyomu wodwalayo adagwiritsidwa ntchito pogwiritsa ntchito njira yina yochepetsera shuga, chithandizo chiyenera kuyambitsidwa ndi mlingo wochepa. Ngati mlingo wa tsiku ndi tsiku upitirire mapiritsi amodzi kapena awiri, mankhwalawa amatengedwa m'mawa. Pa mlingo waukulu, mlingo uyenera kugawidwa pawiri - m'mawa ndi madzulo.
Ngati mumwa mankhwalawo molondola ndipo osapitilira mlingo woyenera, mutha kuchepetsa chiopsezo cha hypoglycemia.
Kuwonetsedwa kwa zoyipa zosasangalatsa
Malangizo ogwiritsira ntchito Maninil akuwonetsa kuti kuyendetsedwa kosayenera kwa chinthu chamankhwala kungapangitse kukulitsa mawonekedwe owoneka osiyanasiyana, omwe ali zotsatira zoyipa.
Kusokonezeka pamagulu abwinobwino ka ziwalo ndi machitidwe osiyanasiyana kumatha kuchitika mosiyanasiyana komanso kuzungulira kosiyanasiyana.
Kuwonetsedwa kwa zovuta zina kumadalira mawonekedwe a thupi la wodwalayo.
Zoyipa zazikulu ndizoti:
- kuphwanya kwam'mimba kumawonekeranso ngati kumeta m'mimba, kupweteka pamimba, kutsekemera kwazitsulo,
- chitetezo cha mthupi chingayankhe molakwika pakuyamba kwa chithandizo cha mankhwalawa mu mawonekedwe a purpura, kuyabwa kwa khungu kapena urticaria, kuwonjezeka kwa gawo la photosensitivityꓼ
- zovuta zomwe zimachitika pakazungulira zimakhala ndi zizindikiro zotsatirazi - thrombocytopenia, hemolytic mtundu anemia, leukopenia, erythropenia,
- Mavuto amtundu wa chiwindi amatha kugwira ntchito ndipo matenda monga hepatitis amatha
- Kusankhidwa bwino kwa Mlingo wa mankhwalawa kumabweretsa kukula kwa hypoglycemia, zizindikiro zake zazikulu ndikuwoneka kwa kutentha, kutopa, manja akunjenjemera, kumva kutopa kwambiri komanso kuwonjezeka kwa kuwodzera,
- kuchuluka kwambiri kwa thupi.
Mankhwala osokoneza bongo omwe amapezeka palimodzi ndi zotsatirazi:
- Kuchulukitsa thukuta.
- Kumva njala mosalekeza.
- Kuyankhula molakwika komanso kuzindikira.
- Maonekedwe a mavuto ndi tulo.
- Hypoglycemia.
Monga thandizo loyamba, ndikofunikira kukhala pachibwenzi wodwalayo pang'ono, kenako ndikuyimbira ambulansi.
M'mikhalidwe yokhazikika, akatswiri azachipatala nthawi zonse amayang'anira kuchuluka kwa glucose ndikuchitapo kanthu kuti athetse vuto la hypoglycemic.
Kodi milandu ndi yoletsedwa liti?
Ngakhale pali mndandanda wazakudya zabwino za mankhwalawo, ndikofunikira kuganizira mitundu yonse ya zinthu zoyipa zomwe zingachitike mutagwiritsidwa ntchito.
Choyamba, ndikofunikira kulabadira mndandanda wa zoletsa zomwe chithandizo sichingachitike pogwiritsa ntchito Maninil
Maninil contraindication ndi ochulukirapo.
Milandu yayikulu ikuphatikiza:
- mtundu 1 chithandizo cha matenda ashuga,
- ngati mukuyang'ana matenda ashuga a ketoocytosis kapena mkhalidwe wa kholo la odwala matenda ashuga odwala.
- mawonetseredwe a hypoglycemia wodwala,
- Pamaso pa matenda a matenda opatsirana,
- matenda a chiwindi kapena impso amayamba.
- ngati pali tsankho kapena chiphunzitso cha hypersensitivity chimodzi kapena zingapo za mankhwalawa.
- leukopenia
- ali pambuyo pancreatic resection,
- pamaso pa lactose tsankho kapena lactase akusowa.
Mpaka pano, palibe chidziwitso chokwanira chokhudza momwe mankhwalawa amagwirira ntchito pochiza matenda a shuga kwa ana. Ichi ndichifukwa chake mankhwalawa sanalembedwe kwa odwala otere (mpaka zaka 18). Kuphatikiza apo, contraindication imaphatikizapo kumwa mankhwalawa kwa atsikana ndi amayi oyembekezera panthawi yoyamwitsa.
Komanso, mosamala kwambiri, mankhwalawa amalembedwera milandu motere:
- Ngati pali chiwopsezo cha hypoglycemia,
- Ngati pali zinthu zina zofunika kuvomerezedwa kwa wodwala kupita ku insulin,
- Pambuyo pa opaleshoni
Chenjezo silimakhala pakugwiritsa ntchito Maninil, ngati wodwala wavumbulutsa matenda am'mimba.
Mndandanda wa Maninil, umawunikira za mankhwalawa komanso mtengo wake
Ndemanga za Maninil ndizotsutsana. Pali malingaliro omwe mankhwalawa amawonetsa zotsatira zabwino, osawonetsa zoyipa. Anthu ena amawonetsa kusapezeka kwa zotsatira zabwino, ndipo monga chiwonetsero choyipa, kulemera mwachangu kumasiyanitsidwa. Thupi la munthu aliyense ndi la payekha, chifukwa chake ngati mankhwalawo sioyenera kukhala ndi matenda ashuga amodzi, izi sizitanthauza kuti mankhwalawo ndi osathandiza.
Mpaka pano, mtengo wa Maninil ndi ma ruble zana limodzi makumi anayi. Mankhwalawa akuphatikizidwa ndi gulu la mankhwalawa. Izi zimachitika kuti pakufunika kugwiritsa ntchito ma Maninil analogues kapena ma syonms.
Chingalowe m'malo mwa Maninil ndi chiti chomwe chili bwino pakati pa sulfonylureas?
Zoyimira ziwiri zazikulu za mankhwalawa ziyenera kudziwika - Glibamide ndi Glibenclamide. Ali ndi kapangidwe kameneka ngati mankhwala a Maninil. Momwemo, mapiritsi awa ali ndi zofanana ndipo ali ndi zisonyezo zofananira. Mapangidwe omwe amaphatikizidwa amathandizira kutsika kwa shuga m'magazi ndipo amalimbikitsa kupanga kwa insulin.
Analogues a Maninil ayenera kufufuzidwa ndi zochulukirapo (dzina lapadziko lonse), ndiye kuti, gawo lomwe limagwira.
Zomwe ndimankhwala othandizira odwala matenda a shuga ndizothandiza kwambiri angakuwuzeni katswiri muvidiyoyi.
