Mankhwala osokoneza bongo a Glimepiride (INN) kuchokera ku kampani yopanga mankhwala Pharmaceard amachepetsa kwambiri matenda a glycemia mwa odwala omwe ali ndi vuto la matenda a shuga 2.
Makamaka, wothandizira antidiabetes amathandiza ndi kusakwanira kwa mankhwala othandizira, masewera olimbitsa thupi komanso kuwonda. Monga mankhwala aliwonse, glimepiride ili ndi mitundu ina ya mankhwala yomwe dokotala ndi wodwala ayenera kudziwa.
Dzina Lachilatini chida ichi ndi Glimepiride. Gawo lalikulu la mankhwalawo ndi gulu la sulfonylureas. Wopangayo amawonjezeranso zochepa pazinthuzo: shuga ya mkaka (lactose), cellcose ya cellcrystalline, sodium lauryl sulfate, pregelatinized starch, magnesium stearate ndi utoto wina.
Pharmstandard amatulutsa antidiabetesic wothandizira piritsi la piritsi 1: 1, 2, 3 kapena 4 mg ya glimepiride).
Mankhwala amatengedwa pakamwa, kutsukidwa ndi madzi pang'ono. Pambuyo polowa m'thupi laumunthu, zomwe zimakhala zapamwamba kwambiri zimapezeka pafupifupi maola 2,5. Kudya pafupifupi sikukukhudza kuyamwa kwa glimepiride.
Zomwe zimagwiritsidwa ntchito pazofunikira zimawonetsedwa motere:
- Kuthandizira kupanga shuga yochepetsa shuga kuchokera kwa ma cell a beta a islets a Langerhans.
- Kuyankha kwabwino kwa maselo a beta pakukweza kwachilengedwe. Dziwani kuti kuchuluka kwa insulini yomwe amapangidwa ndi kochepa kwambiri poyerekeza ndi mankhwala azikhalidwe - mankhwala a sulfonylurea.
- Kuletsa kwa katulutsidwe wa shuga ndi chiwindi ndikuchepetsa mayamwidwe amachepetsa shuga a chiwindi.
- Kuchuluka kwa chiwopsezo cha chandamale cha ma adipose ndi minofu minofu pazotsatira za insulin.
- Glimeperid imawonjezera zomwe zili ndi ampo-tocopherol amkati, ntchito ya glutathione peroxidase, catalase, ndi superoxide dismutase. Izi zimabweretsa kuchepa kwa kukhazikika kwa kuphatikiza kwa oxidative, komwe kumakhala nthawi zonse ndi matenda a shuga a 2.
- Kusankha zoletsa za cycloo oxygenase, komanso kuchepa kwa kutembenuka kwa thromboxane A2 kuchokera ku arachidonic acid. Njirayi ili ndi antithrombotic zotsatira.
- Matenda a lipid komanso kuchepa kwa kuchuluka kwa malondialdehyde m'madzi am'magazi. Njira ziwirizi zimayambitsa mphamvu ya anti-atherogenic ya mankhwala.
Gawo limodzi mwa magawo atatu a metabolites a glimepiride amatsitsidwa ndi matumbo, ndipo magawo awiri mwa atatu - ndi impso.
Odwala omwe ali ndi matenda a impso, kutsimikizika kwa glimepiride kumawonjezera ndipo kuchuluka kwake kwapadera mu seramu yamagazi kumachepa.
Malangizo ogwiritsira ntchito mapiritsi
Mankhwala kuchokera kwa katswiri wothandizirana ndi vuto lalikulu lomwe mungagule mankhwala a Glimepiride. Pogula mankhwala, ndichizolowezi kulabadira mafotokozedwe omwe afotokozedwa m'mawu omwe aphatikizidwa.
Mlingo wa mankhwalawa komanso nthawi yayitali ya mankhwala amatsimikiziridwa ndi endocrinologist, potengera mlingo wa glycemia wodwala ndi mkhalidwe wake wathanzi. Mukamamwa Glimepiride, malangizo ogwiritsira ntchito ali ndi chidziwitso chakuti koyambirira kumwa 1 mg kamodzi patsiku. Kukwaniritsa njira zabwino zamankhwala, mulingo womwewo ungatengedwe kuti mukhale shuga wambiri.
Ngati mlingo wotsika kwambiri (1 mg) sugwira ntchito, madokotala amapatsa mankhwala 2 mg, 3 mg kapena 4 mg patsiku. Nthawi zina, mlingo umatha kuwonjezeredwa mpaka 3 mg kawiri patsiku moyang'aniridwa ndi dokotala.
Mapiritsi amayenera kumwedwa kwathunthu, osafunafuna ndi kutsukidwa ndi madzi. Ngati mungadumphe kumwa mankhwalawo, simungathe kuwonjezera kuchuluka kwake.
Kuphatikiza glimepiride ndi insulin, mlingo wa mankhwalawo womwe sufunsidwa suyenera kusintha. Mankhwala a insulin amapatsidwa mlingo wocheperako, pang'onopang'ono kuwonjezeka. Kugwiritsa ntchito mitundu iwiri yonse ya mankhwala kumafunika chisamaliro chapadera kuchokera kwa dokotala.
Pakusintha njira yothandizira, mwachitsanzo, chifukwa chosintha kuchokera kwa wogwirizira wina wodwala matenda ashuga kuti ayambe glimepiride, amayamba ndi mlingo wochepa (1 mg).
Milandu yosamutsa kuchokera ku insulin mankhwala kupita ku Glimepiride ndiyotheka, pamene wodwalayo asungabe chinsinsi cha ma cell a pancreatic beta mu mtundu 2 shuga. Moyang'aniridwa ndi dokotala, odwala amatenga 1 mg ya mankhwala kamodzi patsiku.
Pogula othandizira odwala matenda ashuga, muyenera kulabadira nthawi yake yomwe nthawi yake yakwana. Kwa glimepiride, ndi zaka 2.
Contraindication ndi zoyipa zimachitika
Monga mankhwala ena aliwonse, mankhwalawa a Glimepiride contraindication ndi zotsatira zoyipa akhoza kukhala chifukwa chomwe kugwiritsidwa ntchito koletsedwa kwa magulu ena a odwala.
Popeza mapangidwe a mapiritsiwa amaphatikizanso zinthu zomwe zimayambitsa matupi awo sagwirizana, chimodzi mwamaumbidwe apakati pa izi a hypoglycemic mankhwala ndi hypersensitivity zigawo zotere.
Kuphatikiza apo, kulandira ndalama kumaletsedwa pomwe:
- matenda ashuga ketoacidosis;
- matenda a shuga a insulin;
- matenda a shuga;
- kukanika kwa impso kapena chiwindi;
- kunyamula mwana;
- yoyamwitsa.
Opanga mankhwalawa achita maphunziro ambiri azachipatala komanso otsatsa malonda. Zotsatira zake, adakwanitsa kupanga mndandanda wazotsatira zoyipa, zomwe zimaphatikizapo:
- Zokhudza khungu (kuyabwa, zidzolo, urticaria).
- Matenda Am'mimba (m'mimba, kusanza, nseru, kupweteka m'mimba).
- Kuchepa kwa chiwindi (chiwindi, kuchuluka kwa michere ya chiwindi, jaundice, kulephera kwa chiwindi ndi cholestasis).
- Kutsika msanga kwa shuga (hypoglycemia).
- Hypersensitivity reaction (kuthamanga kwa magazi, kupuma movutikira, kugwedezeka).
- Kuchepetsa kuchuluka kwa sodium m'magazi.
- Kuchepa kwa mawonekedwe owoneka (nthawi zambiri amapezeka m'masabata oyamba azithandizo).
- Kusokonezeka kwa hematopoietic dongosolo (kukula kwa agranulocytosis, leukopenia, hemolytic anemia mu shuga mellitus, thrombocytopenia, pancytopenia).
Ngati mankhwala osokoneza bongo, hypoglycemia imachitika, kuyambira maola 12 mpaka 72. Chifukwa chotenga mlingo waukulu, wodwalayo amakhala ndi zotsatirazi:
- kupweteka m'mbali yakumanja;
- kupumirana mseru ndi kusanza;
- chisangalalo;
- kudzipereka mwa kufuna kwa minofu (kunjenjemera);
- kugona kwambiri;
- kupsinjika ndi kusowa kwa mgwirizano;
- chitukuko.
Zizindikiro zomwe zili pamwambazi nthawi zambiri zimayamba chifukwa cha kuyamwa kwa mankhwalawo m'mimba. Mankhwala, kutsuka kwa m'mimba kapena kusanza ndikofunikira. Kuti muchite izi, tengani ma carbon kapena ma adsorbents ena, komanso othandizira. Pakhoza kukhala milandu hospitalization wa wodwalayo ndi mtsempha wa magazi mkati.
Kuchita ndi mankhwala ena
Kwa odwala matenda ashuga ambiri, funso limabuka kuti Glimepiride angatengedwe ndi mankhwala ena kuphatikiza jakisoni wa insulin. Palibe chovuta kuyankha. Pali mndandanda womwe ungaganizidwe wa mankhwala omwe amatha kukhala ndi zotsatirapo zosiyanasiyana pakuyenda bwino kwa glimepiride. Chifukwa chake, ena amawonjezera mphamvu yake ya hypoglycemic, pomwe ena, m'malo mwake, amachepetsa.
Pankhani imeneyi, madokotala amalimbikitsa mwamphamvu kuti odwala awo azinena zakusintha kwawo monga thanzi lawo, komanso matenda aliwonse omwe ali ndi matenda ashuga.
Gome likuwonetsa mankhwala akuluakulu ndi zinthu zomwe zimakhudza glimepiride. Kugwiritsa ntchito nthawi imodzi ndikosayenera, koma nthawi zina zitha kutumikiridwa ndi kuyang'aniridwa ndi katswiri.
Mankhwala omwe amatha kupititsa patsogolo zotsatira za hypoglycemic ndi:
- jakisoni wa insulin;
- Fenfluramine;
- Fizates;
- zotumphukira za coumarin;
- Disopyramids;
- Allopurinol;
- Chloramphenicol;
- Cyclophosphamide;
- Feniramidol;
- Fluoxetine;
- Guanethidine;
- Mao zoletsa, PASK;
- Phenylbutazone;
- Sulfonamides;
- ACE zoletsa;
- anabolics;
- Mwina;
- Isophosphamides;
- Miconazole;
- Pentoxifylline;
- Azapropazone;
- Tetracycline;
- quinolones.
Mankhwala omwe amachepetsa mphamvu yochepetsera shuga mukamamwa pamodzi ndi glimepiride:
- Acetazolamide.
- Corticosteroids.
- Diazoxide.
- Zodzikongoletsera.
- Sympathomimetics.
- Zothandiza
- Progestogens.
- Phenytoin.
- Mahomoni a chithokomiro.
- Ma estrogens.
- Phenothiazine.
- Glucagon.
- Rifampicin.
- Zosangalatsa
- Nicotinic acid
- Adrenaline.
- Coumarin zotumphukira.
Ndikofunikanso kusamala ndi zinthu monga mowa ndi histamine H2 receptor blockers (Clonidine ndi Reserpine).
Zotumphukira za Coumarin zimatha kuwonjezera ndikuchepetsa glycemia mwa odwala.
Mtengo, ndemanga ndi fanizo la mankhwala
Mutha kugula mankhwalawa kupulogalamu wamba komanso patsamba lawopanga, mutatha kuwona chithunzi cha phukusi lapadera pasadakhale.
Ndizothekanso kulandira glimepiride pamawu okonda.
Kwa Glimepiride, mtengo umasiyanasiyana kutengera mtundu wa kuchuluka ndi kuchuluka kwa mapiritsi omwe ali phukusi.
Pansipa pali zambiri za mtengo wa mankhwalawa (Pharmstandard, Russia):
- Glimepiride 1 mg - kuchokera ku 100 mpaka 145 ma ruble;
- Glimepiride 2 mg - kuchokera ku 115 mpaka 240 ma ruble;
- Glimepiride 3 mg - kuchokera ku 160 mpaka 275 rubles;
- Glimepepiride 4 mg - kuchokera 210 mpaka 330 rubles.
Monga mukuwonera, mtengo ndizovomerezeka kwa wodwala aliyense, mosasamala kanthu momwe amapezera ndalama. Pa intaneti mutha kupeza ndemanga zosiyanasiyana zamankhwala. Monga lamulo, odwala matenda ashuga amakhutira ndi zomwe amamwa mankhwalawa, kupatula apo, muyenera kumwa kamodzi kokha patsiku.
Chifukwa cha zoyipa kapena kuponderezedwa, dokotala amatha kukupatsani zina zingapo. Mwa iwo, mankhwala omwe amagwirizana (omwe ali ndi chinthu chomwecho) ndi mankhwala a analog (omwe ali ndi magawo osiyanasiyana, koma okhala ndi zotsatira zofananira) amadziwika.
Zinthu zodziwika kwambiri zomwe zimapangidwa ndi izi:
- Mapiritsi a Glimepiride Teva - mankhwala othandiza omwe amachepetsa shuga m'magazi. Omwe amapanga kwambiri ndi Israel ndi Hungary. Mu Glimepiride Teva, malangizowa ali ndi malangizo ofanana ndi ogwiritsira ntchito. Komabe, mankhwalawa amasiyana ndi mankhwala apakhomo. Mtengo wapakati wa paketi imodzi ya Glimepiride Teva 3 mg No. 30 ndi ruble 250.
- Glimepiride Canon ndi mankhwala ena odalirika polimbana ndi matenda a glycemia komanso matenda a shuga. Kupanga kwa Glimepiride Canon kumachitikanso ku Russia ndi kampani yopanga mankhwala a Canonfarm Production. Glimepiride Canon alibe zosiyana zapadera, malangizowo akuwonetsa ma contraindication omwewo komanso zomwe zingavulaze. Mtengo wapakati wa Glimepiride Canon (4 mg No. 30) ndi 260 rubles. Mankhwala Glimepirid Canon ali ndi mitundu yambiri ya analogi ndipo amatha kukhala othandiza pamene mankhwalawo siabwino kwa wodwala.
- Guwa ndi mankhwala otchuka pakati pa odwala. Glimepiride, yomwe ndi gawo la mankhwala Altar, imalimbikitsa kutulutsa kwa insulin ndi maselo a beta. Guwa lili ndi mawonekedwe ofanana. Wopanga mankhwala a Altar ndi Berlin-Chemie. Mtengo wa 1tar wa Altar umakhala pamakwerero 250.
Pali mankhwala ambiri omwe ali ndi vutoli ofanana, mwachitsanzo:
- Metformin ndi wothandizira wotchuka wa hypoglycemic. Gawo lalikulu la dzina lomweli (metformin), limachepetsa mphamvu zama glucose ndipo pafupifupi silimayambitsa hypoglycemia. Komabe, Metformin ili ndi mndandanda wautali wa zotsutsana ndi zoyipa zake. Mtengo wapakati wa mankhwalawa Metformin (500 mg No. 60) ndi ma ruble 130. Popeza gawo ili ndi gawo la mankhwala ambiri, mutha kupeza mitundu yosiyanasiyana - Metformin Richter, Canon, Teva, BMS.
- Mankhwala ena a hypoglycemic - Siofor 1000, Vertex, Diabeteson MV, Amaril, etc.
Chifukwa chake, ngati pazifukwa zina glimepiride sichikwanira, ma analogu amatha kusintha. Komabe, chida ichi ndi chothandiza pakukula kwa hyperglycemia.
Zambiri pazamankhwala ochepetsa shuga kwambiri zimaperekedwa mu kanema munkhaniyi.
