Chimodzi mwazomwe ndimapezeka mankhwala othandizira odwala matenda opatsirana m'gulu la sulfanylurea ndi Amaryl.
Chifukwa cha zogwira ntchito komanso zowonjezera, mankhwalawa amathandizira kuchepetsa kuchuluka kwa shuga ndikuchepetsa zovuta za zizindikiro za matenda ashuga.
Amaril wa mankhwala osokoneza bongo amavomerezedwa kuti agwiritsidwe ntchito pakamwa. Dzina lodziwika ladziko lonse la mankhwalawo ndi Amaryl. Mankhwalawa amapangidwa ku Germany, wopangayo ndi Aventis Pharma Deutschland GmbH.
Mankhwalawa amapezeka m'mapaketi osiyanasiyana kutengera kuchuluka kwa zinthu zomwe zikugwira:
- Amaryl 1 mg;
- Amaryl 2 mg;
- 3 mg amaril;
- Amaryl 4 mg.
Kukula kwa phukusi kumasiyanasiyana, kuchuluka kwa mapiritsi amtundu uliwonse - kuyambira 30 mpaka 120. Maonekedwe a mankhwalawa amasinthanso kutengera ndi kuchuluka kwa glimepiride ndi metformin. Mapiritsi okhala ndi 1 mg ya mankhwala othandizira ndi pinki, 2 mg ndiwobiriwira, 3 mg ndi achikaso. Mapiritsi a Amaril 4 mg ndi amtambo. Mawonekedwe a mapiritsi ndi osalala mbali ziwiri, chowulungika. Pamapiritsi, mosasamala kanthu za kuchuluka kwa yogwira, pali zolemba: "ff" ndi "NMK", zomwe zingathandize kusiyanitsa zabodza.
Kuphatikiza pa mankhwala wamba, palinso kuphatikiza - Amaril m. Amasiyana ndi Amaril mu kapangidwe kake. Kuphatikiza pa gawo lalikulu la glimepiride, kapangidwe kake ka mankhwalawa kamaphatikizanso gawo lina lokhala ndi vuto la hypoglycemic - metformin. Malonda ophatikizidwa amapezeka mu mitundu iwiri yokha:
- Glimepiride (1 milligram), metformin (250 mg).
- Glimepiride - 2 mg, metformin - 500 mg.
Mapiritsi a Amaryl M amawoneka ofanana, ngakhale mlingo wa glimepiride ndiwosiyana: mawonekedwe a mapiritsiwo ndi ozungulira, athyathyathya, mawonekedwe ake ndi oyera.
Yaikulu katundu mankhwala
Chofunikira chachikulu chomwe ndi gawo lamankhwala - glimepiride (dzina lachi Latin - Glimepiride) chimathandizira kutulutsidwa kwa insulin.
Chifukwa cha gawo ili, mankhwalawa ali ndi pancreatic.
Ndi kutulutsidwa kwa mahomoniwo m'maselo a beta, kuchepa kwakukulu kwa shuga m'magazi kumachitika. Njira yofananira yogwirira ntchito imalumikizidwa ndi kusintha kwa chidwi cha maselo a beta ku glucose.
Kuphatikiza pazomwe zimagwiritsidwa ntchito, zinthu zotsatirazi zimaphatikizidwa ndikuphatikizidwa kwa mankhwala:
- povidone;
- lactose monohydrate;
- indigo carmine;
- magnesium wakuba;
- microcrystalline mapadi.
Kuphatikiza apo, mankhwalawa amawongolera kupanga mahomoni a pancreatic. Ichi ndi chifukwa cha kulumikizana kwa glimepiride ndi metformin ndi njira za potaziyamu pa membala wam'mimba wa beta. Kumangika kwa gawo logwira ntchito kumapuloteni kumayang'anira zochitika zamsewu, ndiko, kutseka ndi kutsegulira.
Amaryl ili ndi extrapancreatic zotsatira - imasintha kugwiritsidwa ntchito kwa insulin ndi minofu ndi minyewa ya adipose. Izi zimachitika chifukwa chotseka njira ziwiri za potaziyamu mu membrane wa cell ndi kuchuluka kwa calcium m'maselo. Mphamvu ya extrapancreatic imapangitsa kuchepa kwa insulin kukana, komanso zimakhudza pang'ono kugwira ntchito kwa mtima ndi mitsempha yamagazi.
Kuphatikizika kwakukulu kwazinthu zomwe zimagwira ntchito kumatheka ndi kugwiritsa ntchito pafupipafupi. Mwachitsanzo, mukamatenga 4 mg ya glimepiride patsiku, kupindika kwakukulu kumatheka mu maola a 2,5.
Kumwedwa kwathunthu kwa mankhwalawa kumatheka pokhapokha atamwa. Kudya chakudya kumachepetsa njira yogwiritsira ntchito mankhwalawa, koma izi sizothandiza. Excretion wa glimepiride amadutsa matumbo ndi impso.
Mndandanda wazowonetsa ndi zotsutsana za kuvomerezedwa
Amaryl ali ndi zizindikiro zotsatirazi kuti agwiritse ntchito. Njira yayikulu ndiyo chithandizo cha matenda ashuga amtundu wa 2. Amaril ndi oyenera kwa odwala omwe safuna jakisoni wa insulin, komanso kwa iwo omwe akuwonetsedwa insulin kuti akhale bwino.
Pochiza matenda a shuga, mapiritsi a Amaryl amalembedwa makamaka ngati mankhwala oyenera. Koma ndi osakwanira kagayidwe kazakudya (makamaka ngati wodwala amupatsa mankhwala), Glimepiride osakanikirana ndi Metformin ndi mankhwala. Izi zitha kusintha bwino kagayidwe ka metabolic. Komanso, zotsatira zake zimakhala bwino kwambiri kuposa zomwe zimapezeka ndi mankhwala osiyana.
Zotsatira zabwino zomwe zidachitika chifukwa cha zovuta kuchipatala pogwiritsa ntchito Glimepiride ndi Metformin zidapangitsa kuti mankhwalawa apangidwe Amaryl M. Mankhwala amapatsidwa mankhwalawa ngati chithandizo cha matenda osokoneza bongo omwe ali ndi mankhwala ovuta, nchofunika kwa odwala.
Amaril yochepetsa shuga imatha kutengedwa ndi odwala omwe amafunikira jakisoni wambiri wa insulin. Nthawi yomweyo, kagayidwe kachakudya kamathandizanso, koma mlingo wa glimepiride tikulimbikitsidwa kuti ukhale wocheperako.
Monga mankhwala aliwonse, mankhwalawa sangatchulidwe kuti ndi otetezeka. Amaril ali ndi zotsutsana, ndipo mndandanda wawo ndi waukulu.
Choyamba, tikulimbikitsidwa kusamala kumwa mankhwalawo panthawi yoyamba ya chithandizo: panthawiyi, pali chiwopsezo cha kuchepa kwambiri kwa glucose. Ngati patapita nthawi chiopsezo cha hypoglycemia chikadalipo, tikulimbikitsidwa kusintha njira ina kapena chithandizo cha Amaril. Muyenera kukhala atcheru komanso ofunikira matenda ena, moyo wosayenera, zakudya zopanda thanzi.
Milandu yayikulu ikuperekedwa kwa Amaril ndi matenda otsatirawa:
- Matenda a shuga kapena kholo.
- Ketoacidosis.
- Matenda akulu a chiwindi ndi impso.
- Kusalolera kapena hypersensitivity kwa zigawo zikuluzikulu za mankhwala.
- Matenda operewera (kusakhazikika kwa lactose, kuchepa kwa lactase, ndi zina).
- Mimba Pakukonzekera kutenga pakati, njira yochiritsira imayenera kusinthidwa. Wodwalayo amapatsidwa jakisoni wa insulin, mankhwalawa sanadziwike.
- Panthawi yoyamwitsa, chithandizo cha insulin chimapitilira. Ngati chifukwa chilichonse mankhwalawa sakhala oyenera, Amaril amaperekedwa kwa wodwala, koma tikulimbikitsidwa kuti asiye kuyamwa.
Palibe mankhwala omwe amaperekedwa pochizira matenda a shuga a mtundu woyamba. Chotsutsana kwathunthu ndi zaka za ana. Palibe zambiri zamankhwala zololeza mankhwala kwa ana.
Chifukwa chake, mankhwalawa amathandizira ana odwala matenda ashuga.
Zotsatira zoyipa za kugwiritsa ntchito mankhwalawa
Chifukwa chotenga Amaril, zotsatira zoyipa zimatha kuchitika.
Nthawi zina, pamakhala zovuta zina pantchito ya ziwalo zosiyanasiyana za thupi.
Pa gawo la kagayidwe, kusintha kwa hypoglycemic kumawonedwa. Nthawi zambiri zimachitika mwachangu, koma ndizovuta kuchiza.
Mapiritsi ena a shuga amayambitsa kusokonezeka kwa chapakati mantha dongosolo.
Omwe amatenga Amaril ali ndi zofananira:
- Chizungulire
- chidwi;
- kusowa kwa mgwirizano;
- kuchedwetsa chochitikacho;
- kugona kusapeza;
- chisokonezo kapena kutayika kwa chikumbumtima;
- dziko lokhumudwa;
- kusokonekera kwa mawu;
- mantha, nkhawa, ndi zina zambiri.
Zotsatira za kumwa mankhwalawa ndikuphwanya chakudya cham'mimba ndizambiri. Amatha kuwonetsedwa ndi kupweteka m'mimba kapena m'mimba, nseru, kutsegula m'mimba, kusanza, kuchuluka kwanjala.
Chifukwa cha zotsatira za glimepiride, kutsika kwa glucose kumatha, komwe kungayambitse zovuta za ziwalo zam'maso, zomwe zingayambitse kuwonongeka kwa mawonekedwe.
Mankhwalawa amakhudza njira zopangira magazi, zomwe zimatha kuyambitsa zovuta monga:
- Anemia
- Supombocytopenia (yamitundu yosiyanasiyana).
- Pancytopenia.
Zocheperako ndizomwe zimachitika kawirikawiri:
- kuyabwa
- zotupa pakhungu;
- redness la pakhungu;
- vasculitis.
Mukamwa mankhwala a Amaril, zizindikiro za ziwengo zimakonda kufatsa ndipo zimadutsa mwachangu ndi chithandizo choyenera.
Koma ndikofunikira kwambiri kuyambitsa chithandizo munthawi yake: kuopsa kwa anaphylactic kukutsalira.
Malangizo ogwiritsira ntchito mankhwalawa
Kugwiritsa ntchito bwino ndikosatheka popanda kutsatira malangizo ogwiritsira ntchito Amaril. Lamulo lalikulu la kayendetsedwe kake ndikuti piritsiyo lisawonongeke. Tengani piritsi la Amaril 3 kwathunthu, ndi madzi ambiri kuti mukhale kosavuta kumeza.
Mulingo woyenera wa Amaril amawerengedwa payekhapayekha kwa wodwala. Chinsinsi chachikulu chomwe chimagwiritsidwa ntchito popereka mankhwalawa ndicho kuchuluka kwa shuga m'magazi. Mlingo wotsika kwambiri ndi womwe umaperekedwa, womwe ungathandize kuteteza kagayidwe kazinthu. Kuphatikiza pa kuchuluka kwa glucose, mu gawo la malangizo momwe mankhwalawo amagwiritsidwira ntchito akuwonetsa kuti kuwunika nthawi zonse osati kuchuluka kwa shuga, komanso hemoglobin ya glycated ndiyofunikira.
Pakhoza kukhala zochitika zina pomwe wodwalayo adayiwala kutenga mapiritsi a Amaril panthawi. Zikatero, kubwezeretsanso kuchuluka kwa mankhwalawa pochulukitsa kuchuluka sikulimbikitsidwa. Nthawi zambiri mulingo womwewo umakhala wofanana, mapiritsi osowa sawonjezedwanso. Ndikwabwino kukambirana ndi adokotala pasadakhale za zomwe zingachitike munyengo zotere.
Pa gawo loyamba la chithandizo, odwala amapatsidwa Amaryl 1 mg patsiku. Popita nthawi, ngati kuli kotheka, kuwonjezeka kwapang'onopang'ono kwa mlingo wa mankhwalawa ndi 1 mg ndikuloledwa, choyamba mpaka 6 mg patsiku, kenako mpaka 8 mg. Ndi ulamuliro wokhazikika wa matendawa, mulingo woyenera sapitilira 4 mg pa tsiku. Mlingo waukulu wopitilira 6 mg pa tsiku sukonzanso bwino. Kuchuluka kwa mankhwalawa mu 8 mg ndi mankhwala ochepa.
Kusiyanitsa pakati pa kuchuluka kulikonse kwa mlingo kumatsimikiziridwa ndi momwe wodwalayo alili ndi kuchuluka kwa kuchuluka kwa mankhwalawa omwe amwedwa, koma sayenera kukhala ochepera milungu iwiri.
Ndikofunikira kumwa mankhwala mukatha kudya, chifukwa mwanjira ina hypoglycemia ingachitike.
Mankhwala a Amaryl M ophatikizidwa amayenera kumwedwa molingana ndi mfundo yomweyo. Mlingo wa mankhwalawa womwe udanenedwa ndi mankhwala udagawidwa pawiri: m'mawa ndi madzulo, kapena amwedwa nthawi yomweyo. Nthawi zambiri, odwala amalimbikitsidwa kutenga Amaril 2m + 500 mg.
Kuchuluka kwa Amaril kuchokera ku matenda ashuga odwala okalamba amasankhidwa mosamala kwambiri, ndipo chithandizo chimachitika ndikuwonetsetsa impso.
Zowonjezera zamankhwala
Popereka Amaril kapena Amaril M, dokotala sayenera kungopereka malangizo a mankhwalawa moyenera, komanso kuchenjezanso za mavuto omwe angakhalepo. Chisamaliro makamaka chiyenera kuperekedwa ku chiwopsezo cha hypoglycemia, chomwe chingayambike ngati wodwalayo amaiwala kudya atangomwa Amaril. Popewa hypoglycemia, ndibwino kukhala ndi chidutswa cha shuga kapena maswiti.
Kuphatikiza pa kuchuluka kwa shuga komanso kuchuluka kwa shuga mumkodzo, wodwalayo ayenera kuyang'ana momwe impso ndi chiwindi zimagwirira ntchito.
Funso lodziwika ndiloti ngati ndizotheka kumwa mowa panthawi yamankhwala ndi Amaril. Ndikofunika kukumbukira kuti mowa nthawi zambiri umalekeredwa bwino pa nthawi ya matenda ashuga ndipo sugwirizana ndi mankhwala ambiri. Amaril nawonso ndi a amenewo. Zotsatira za kumwa mankhwala ndi mowa nthawi yomweyo zimatha kukhala zosayembekezeka. Nthawi zina, mphamvu ya mankhwalawo imakhala yokwezeka, ndipo mwa ena imachepetsedwa kwambiri. Chifukwa chake, mukalandira chithandizo, muyenera kusiya mowa ndi mankhwala ozunguza bongo.
Ponena za kulumikizana kwa Amaril ndi mankhwala ena, chilichonse pano chimatengera mtundu wa mankhwalawa. Kutenga mankhwala ena kumathandizira kukonza kwa Amaril, ena - kumachepetsa. Mndandanda wa onse omwe ndi mankhwala ena ndiwowonjezera. Chifukwa chake, ngati kuli koyenera, imwani mankhwala ena, ndikofunikira kudziwitsa dokotala yemwe akupezekapo za matendawo ndi mankhwalawo. Poterepa, adotolo azitha kusankha mankhwalawa omwe sangakhale ndi chidwi chambiri pakuyenda bwino kwa Amaril.
Zotsatira zilizonse zoyipa zikachitika, muyenera kusiya kumwa mankhwalawo ndi kupita kwa dokotala.
Dokotala yekha ndi amene angalimbikitse ma analogi a Amaril oyenerera.
Ndemanga za mankhwala
Pogwiritsa ntchito Amaril pa matenda a shuga a 2, ndemanga zidalandira zabwino kuchokera kwa ambiri odwala. Izi zikutsimikizira kuti, ngati mulingo woyenera, mankhwalawa amalimbana ndi hyperglycemia.
Kuphatikiza pakuchita bwino, ogula ambiri adatcha mitundu yosiyanasiyana ya mapiritsiyo ngati abwino a mankhwalawa - izi zimathandiza kuti asasokoneze mankhwalawo ndi mlingo wosiyana wa glimepiride.
Ndemanga zomwe zalandiridwa pa Amaril sizinangotithandizanso, komanso zovuta zomwe zawonetsedwa m'malamulo opita ku Amaril.
Nthawi zambiri, odwala omwe amamwa mankhwalawa amawonetsa zizindikiro za hypoglycemia:
- Zofooka.
- Kutentha.
- Kugwedezeka thupi lonse.
- Chizungulire
- Kuchulukitsa chilakolako.
Nthawi zambiri, chifukwa cha hypoglycemia mu shuga mellitus, pamakhala ngozi yotaya chikumbumtima. Chifukwa chake, iwo omwe amatenga Amaril amayenera kumanyamula nthawi zonse zinthu zokhala ndi shuga (monga maswiti), kuti ngati zingafunike azitha kuwonjezera msanga komanso akhale bwino. Komabe, malinga ndi madotolo, kusintha kwa mulingo wa shuga sichizindikiro cha kusathandiza kwa mankhwalawa. Zizindikiro zotere zikawoneka, ndikokwanira kusintha mlingo.
Vuto lodziwika kwa madalaivala omwe amakakamizidwa kumwa mankhwala a hypoglycemic ndiwakuipiraipira poyendetsa galimoto. Zotsatira zoyipa zofananazo zikuwonetsedwa mu malangizo omwe ali mndandanda wazotsatira zoyipa. Kuchepetsa kwake kumachitika chifukwa cha mphamvu ya glimepiride yamatsenga.
Mwa odwala omwe ali ndi matenda akale a shuga, mu ndemanga ya Amaril, ambiri adanenanso za vuto limodzi: ngakhale kuti Amaril amatsitsa shuga, mankhwala a shuga ndiokwera mtengo kwambiri, chifukwa mankhwalawa amatha kukhala ndi ndalama zambiri kuposa ena kupanga.
Mtengo ndi fanizo la mankhwala
Mutha kugula Amaril mu pharmacy yokhazikika yamzinda, koma pali pango limodzi: silikugulitsidwa. Komanso pakulandila mankhwala ena ambiri okhudzana ndi matenda ashuga, kuti mugule Amaryl muyenera kupereka mankhwala.
Funso lina lodziwika lomwe limasangalatsa anthu ambiri odwala matenda ashuga ndiloti Amaril amatenga ndalama zingati. Mtengo wa mankhwalawa zimadalira kuchuluka kwa mapiritsi omwe ali mumapakewo ndi kuchuluka kwa mankhwalawa. Chifukwa chake, mwachitsanzo, phukusi la mankhwalawa limakhala ndi mapiritsi 30, kutengera mlingo, kuchokera kuma ruble 200 mpaka 850. Nthawi yomweyo, Amaril 1 mg amawononga ma ruble 230-280, ma CD a Amaril mapiritsi 2 mg - 450-560 rubles, 3 mg - kwa ma ruble 630-830. Mapiritsi okwera mtengo kwambiri Amaril 4 mg 90 pcs. - zimawononga ma ruble 870-1080.
Amaril M angagulidwe ndi ma ruble 570-600. Ndikofunikira kudziwa kuti mapiritsi a Amaril 2mg + 500 mg atha kugulidwa pamtengo. Ndizovuta kwambiri kupeza Mlingo wotsika (1 mg + 250), chifukwa nthawi zambiri samayikidwa ndi madokotala, ndipo mwakutero, sagulitsidwa kwenikweni.
Pali mankhwala ambiri amomwemo. Ma fanizo ofala kwambiri:
- Glimepiride.
- Glucophage 850.
- Gliclazide.
- Diaformin.
- Guwa.
- Glucovans.
Mwachitsanzo, Amaril nthawi zambiri amasinthidwa ndi mankhwala Gliclazide (pln - Gliclazide). Ilinso m'gulu la sulfanylurea.Kuphatikizika kwa mankhwala kumaphatikizapo chokhacho chothandizira - gliclazide ndi zina zowonjezera. Mankhwalawa amakhudza maselo a beta, akusintha kupanga insulin. Kuphatikiza apo, mankhwalawa amathandizira ndi edema, monga momwe magazi amasinthira, amalepheretsa kuphatikizika kwa magazi, potero amachepetsa chiopsezo cha thrombosis ndi zovuta zina.
Zomwe mankhwala a hypoglycemic ndi othandiza kwambiri angauze katswiri muvidiyoyi.
