Mankhwalawa adapangira kuti azigwiritsidwa ntchito pakamwa ndipo amagwirizana ndi zotumphukira za m'badwo wachitatu sulfonylurea.
Kutulutsidwa kwa mankhwalawa kumachitika m'njira zingapo.
Makampani opanga mankhwala a odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga masiku ano amapereka njira zotsatirazi zamankhwala:
- Amaril.
- Amaril M.
- Amaril m cf.
Yachilendo mawonekedwe a mankhwalawa zimaphatikizapo zikuchokera mmodzi yogwira pawiri - glimepiride. Amaryl m ndi kukonzekera kovuta, komwe kumaphatikizapo magawo awiri ogwira ntchito. Kuphatikiza pa glimepiride, Amaril m imaphatikizanso chinthu china chogwira ntchito - metformin.
Kuphatikiza pazomwe zimagwira, mawonekedwe a mankhwalawa amaphatikizanso zina zomwe zimathandizira.
Kapangidwe ka mankhwala akuphatikiza:
- lactose monohydrate;
- sodium carboxymethyl wowuma;
- povidone;
- crospovidone;
- magnesium wakuba.
Pamwambapa mapiritsiwo amaphatikizidwa ndi filimu, yomwe imakhala ndi izi:
- Hypromellose.
- Macrogol 6000.
- Titanium dioxide
- Carnauba sera.
Mapiritsi opangidwawo amakhala ndi mawonekedwe ozungulira, a biconvex okhala ndi chojambula pamtunda.
Amaril m amapangidwa m'mitundu ingapo yosiyanasiyana ya glimepiride ndi metformin.
Makampani opanga zamankhwala amatulutsa mankhwalawa muzosintha zotsatirazi:
- mawonekedwe a Amaril m 1 mg + 250 mg;
- mawonekedwe a Amaril m 2 mg + 500 mg.
Imodzi mwa mitundu ya mankhwala Amaryl m ndi nthumwi Amaryl m nthawi yayitali. Mankhwala amtunduwu amapangidwa ndi kampani ya mankhwala aku Korea.
Mphamvu ya mankhwalawa pa thupi la wodwalayo
Glimepiride yomwe ili mu mankhwalawa imakhudza minofu ya kapamba, kuchita nawo gawo la kayendedwe ka insulin, ndipo imathandizira kulowa kwake m'magazi. Kudya kwa insulini m'madzi am'magazi kumathandiza kuchepetsa shuga m'thupi la wodwala yemwe ali ndi matenda a shuga a 2.
Kuphatikiza apo, glimepiride imayendetsa njira zoyendetsera kashiamu kuchokera m'madzi am'magazi kupita m'maselo a pancreatic. Kuphatikiza apo, zoletsa zomwe zimapangitsa kuti pakhale yogwira mankhwala popanga ma atherosselotic zolembera pamitsempha yamagazi yamitsempha yamagazi.
Metformin yomwe ili m'makonzedwe amathandizira kuchepetsa shuga mumthupi la wodwalayo. Izi zimapangitsa kuti magazi aziyenda bwino m'magazi a chiwindi komanso zimathandizira kusintha kwa shuga ndi maselo a chiwindi kukhala glucogen. Kuphatikiza apo, metformin imakhala ndi phindu pakulowetsa shuga kwa madzi a m'magazi ndimaselo am'misempha.
Kugwiritsidwa ntchito kwa Amaril M mu mtundu 2 wa shuga kumalola nthawi yamankhwala kukhala ndi tanthauzo lalikulu mthupi lanu pogwiritsa ntchito mankhwala ochepetsa.
Izi sizofunika kwenikweni kuti thupi lizigwira ntchito bwino.
Pharmacodynamics ndi pharmacokinetics of glimepiride
Glimepiride imathandizira kubisala ndi kutulutsidwa kwa insulin m'maselo a pancreatic minitsi potseka njira zotsalira za potaziyamu za ATP. Kuchita izi kwa mankhwalawa kumapangitsa kuti maselo azitha kukondweretsedwa ndipo imathandizira kutsegulidwa kwa njira za calcium. Izi zimathandizira kuti chiwopsezo cha kutulutsidwa kwa insulin kuchokera ku maselo a beta ndi exocytosis.
Maselo a pancreatic akaphatikizidwa ndi pancreatic glimepiride, insulin imatulutsidwa m'madzi a m'magazi kwambiri kuposa, mwachitsanzo, motsogozedwa ndi glibenclamide. Kuchita kwa mankhwalawa kumalepheretsa kuchitika kwa zizindikiro za hypoglycemia m'thupi.
Glimepiride imathandizira kayendedwe ka glucose kupita ku minofu minofu maselo poyambitsa ma protein a mayendedwe a GLUT1 ndi GLUT4, omwe amapezeka mu cell membranes ya minofu minofu.
Kuphatikiza apo, glimepiride imathandizira kutulutsa shuga m'maselo a chiwindi ndikulepheretsa gluconeogeneis.
Kukhazikitsidwa kwa glimepiride m'thupi kumabweretsa kutsika kwa kuchuluka kwa lipid peroxidation.
Ngati Amaril m amatengedwa mobwerezabwereza Mlingo wa 4 mg tsiku lililonse, ndiye kuti kuchuluka kwambiri m'thupi la glimepiride kumafikira maola 2,5 mutatha kumwa mankhwalawa.
Glimepiride ili pafupi kupezeka kwathunthu. Kutenga mankhwalawa pakudya sikuti kumakhudza kwambiri kuchuluka kwa kuyamwa kwa magazi m'magazi kuchokera ku lumen ya m'mimba.
Kuchotsa kwa glimepiride kumachitika ndi impso. Pafupifupi 58% ya mankhwala omwe amapezeka mu metabolites amuchotsedwa ndi ziwalo izi, pafupifupi 35% ya mankhwalawa amachotsedwa m'thupi kudzera m'matumbo. Hafu ya moyo wa glimepiride kuchokera m'thupi ndi pafupifupi maola 5-6.
Kuwonekera kwa pawiri kuloza kuphatikizira mkaka wa m'mawere kudzera mu chotchinga cha m'mimba mwa mwana wosabadwayo kunaululidwa.
Kudzikundikira kwa mankhwala othandizira pakumwa mankhwalawa sikungachitike.
Pharmacodynamics ndi pharmacokinetics a metformin
Metformin ndi mankhwala osokoneza bongo a m'gulu la Biguanides. Kugwiritsa ntchito kwake kumakhala kothandiza pokhapokha ngati wodwala ali ndi mtundu wachiwiri wa matenda osokoneza bongo ndipo kaphatikizidwe ka beta-cell pancreatic insulin amasungidwa m'thupi.
Metformin silingakhudze minyewa ya pancreatic ndipo, chifukwa chake, siyikukhudzana ndi kapangidwe ka insulin. Mukamagwiritsa ntchito mankhwalawa achire, samatha kuyambitsa maonekedwe a hypoglycemia.
Kupanga kwa metformin pa thupi la munthu masiku ano sikumveka bwino.
Kukhazikitsidwa kuti gulu la mankhwala limatha kusokoneza ma receptor a cell of insulin-amadalira zotumphukira zimakhala zathupi, zomwe zimayambitsa kuwonjezeka kwa kuyamwa kwa ma cell a insulin ndipo, chifukwa chake, kuwonjezeka kwa kuphatikizidwa kwa glucose ndi maselo.
Mphamvu yoletsa mphamvu ya metformin pa njira ya gluconeogeneis idawululidwa; Kuphatikiza apo, panganoli limathandizira kuchepetsa kuchuluka kwamafuta acids amapangidwa m'thupi.
Kudya kwa metformin m'thupi kumabweretsa kutsika pang'ono kwa kudya ndipo kumachepetsa kuchuluka kwa glucose kuchokera ku lumen ya m'mimba m'mimba.
The bioavailability ya metformin yomwe idalowetsedwa m'thupi ndi pafupifupi 50-60%. Kuzindikira kwakukulu kumakwaniritsidwa maola 2,5 mutatha kumwa mankhwalawa.
Ndi munthawi yomweyo makonzedwe a metformin ndi chakudya, pamakhala kuchepa pang'ono pamlingo wolandirira ma protein m'magazi am'magazi.
Mankhwala samalumikizana ndi mapuloteni a plasma ndipo amagawidwa mwachangu mthupi lonse. Kuchoka m'thupi kumachitika chifukwa chogwiritsa ntchito impso ndi chimbudzi. Hafu ya moyo wa phula ndi maola 6-7.
Pamaso pa kulephera kwa impso, kukulitsa chidwi cha mankhwalawa ndizotheka.
Malangizo ogwiritsira ntchito mankhwalawa
Malangizo ogwiritsira ntchito mankhwalawa Amaryl m amasonyezeratu kuti mankhwalawa amavomerezedwa kuti azigwiritsidwa ntchito ngati wodwala ali ndi matenda ashuga a 2.
Mlingo wa mankhwalawa umatsimikizika malinga ndi kuchuluka kwa shuga m'magazi a m'magazi. Tikulimbikitsidwa, kugwiritsa ntchito njira zophatikizira monga Amaril m, kuti mupereke mlingo woyenera wa mankhwala ofunikira kuti mukwaniritse pazotheka zabwino.
Mankhwala ayenera kumwedwa nthawi 1-2 masana. Ndikofunika kumwa mankhwala ndi chakudya.
Mlingo wokwanira wa metformin mu gawo limodzi sayenera kupitirira 1000 mg, ndi glimepiride 4 mg.
Mlingo watsiku ndi tsiku wa mankhwala awa sayenera kupitilira 2000 ndi 8 mg, motsatana.
Mukamagwiritsa ntchito mankhwala omwe ali ndi 2 mg ya glimepiride ndi 500 mg ya metformin, kuchuluka kwa mapiritsi omwe amamwa patsiku sikuyenera kupitilira anayi.
Mankhwala onse omwe amwedwa patsiku amagawika pawiri.
Wodwala akangotenga kachakudya kena kamene kamakhala ndi glimepiride ndi metformin kuti atenge mankhwala ophatikizika a Amaril, mlingo woyenera kumwa mankhwalawo uyenera kukhala wochepa.
Mlingo wa mankhwala omwe atengedwa ngati kusintha kwa mankhwala osakanikirana amasinthidwa malinga ndi kusintha kwa shuga m'thupi.
Kuti muwonjezere Mlingo watsiku ndi tsiku, ngati kuli kotheka, mutha kugwiritsa ntchito mankhwala okhala ndi 1 mg ya glimepiride ndi 250 mg ya metformin.
Kuchiza ndi mankhwalawa ndikutalika.
Contraindging kugwiritsa ntchito mankhwalawa ndi awa:
- wodwala ali ndi matenda ashuga 1.
- Kupezeka kwa matenda ashuga ketoacidosis.
- Kukula m'thupi la wodwalayo chikomokere.
- Kukhalapo kwa zovuta zazikulu pakugwira ntchito kwa impso ndi chiwindi.
- Nthawi ya bere komanso nthawi ya mkaka wa m'mawere.
- Kukhalapo kwa tsankho la munthu pazigawo za mankhwala.
Mukamagwiritsa ntchito Amaril M m'thupi la munthu, zotsatirazi zimabweretsa:
- mutu
- kugona ndi kusokonezeka kwa tulo;
- mayiko achisoni;
- kusokonezeka kwa mawu;
- kunjenjemera miyendo;
- zosokoneza pakugwira ntchito kwa mtima;
- nseru
- kusanza
- kutsegula m'mimba
- Anemia
- thupi lawo siligwirizana.
Zotsatira zoyipa zikachitika, muyenera kufunsa dokotala za kusintha kwa mankhwalawa kapena kusiya mankhwala.
Zomwe zimagwiritsidwa ntchito ndi mankhwala Amaryl M
Dokotala wopita kuchipatala, yemwe amamulembera wodwala kuti amwe mankhwalawo, amakakamizidwa kuchenjeza za kuthekera kwa zotsatira zoyipa mthupi. Choyambitsa chachikulu komanso chowopsa cha zotsatira zoyipa ndi hypoglycemia. Zizindikiro za hypoglycemia zimayamba kudwala ngati amwa mankhwala osadya.
Pofuna kuletsa kupezeka kwa vuto la hypoglycemic mthupi, wodwalayo ayenera kukhala ndi maswiti kapena shuga mzidutswa. Dotolo afotokozere wodwalayo mwatsatanetsatane zomwe zizindikiro zoyambirira za mawonekedwe a hypoglycemic mthupi ndizo, popeza moyo wa wodwala umadalira kwambiri izi.
Kuphatikiza apo, panthawi ya chithandizo cha matenda a shuga a mtundu wachiwiri, wodwalayo ayenera kuyang'anira kuchuluka kwa shuga m'magazi.
Wodwala ayenera kukumbukira kuti mphamvu ya mankhwalawa imachepa pakakumana ndi zovuta, chifukwa chotulutsidwa kwa adrenaline m'magazi.
Zoterezi zimatha kukhala ngozi, mikangano kuntchito komanso m'moyo wa munthu ndi matenda omwe amatsatana ndi kukwera kwambiri kwa kutentha kwa thupi.
Mtengo, kuwunika kwa mankhwala ndi mawonekedwe ake
Nthawi zambiri, pali ndemanga zabwino za mankhwalawa. Kukhalapo kwa ndemanga zabwino zambiri kumatha kukhala umboni wa kugwiriridwa ntchito bwino kwa mankhwalawa mukamagwiritsa ntchito mlingo woyenera.
Odwala omwe amasiya ndemanga zawo za mankhwalawa nthawi zambiri amawonetsa kuti chimodzi mwazotsatira zoyipa zomwe zimachitika chifukwa chogwiritsidwa ntchito ndi Amaril M ndikokula kwa hypoglycemia. Pofuna kuti asaphwanye mlingo akamamwa mankhwalawo, opanga kuti athandize odwala amapaka mitundu yosiyanasiyana ya mankhwalawo mitundu yosiyanasiyana, yomwe imathandiza kuyenda.
Mtengo wa Amaril zimatengera Mlingo womwe uli momwemo.
Amaril m 2mg + 500mg ali ndi mtengo pafupifupi pafupifupi 580 rubles.
The fanizo la mankhwala ndi:
- Glibomet.
- Glucovans.
- Dianorm m.
- Dibizid-m.
- Douglimax.
- Glibenclamide.
- Duotrol.
Mankhwalawa onse ndi fanizo la Amaril m mu kapangidwe kazinthu. Mtengo wa analogi, monga lamulo, ndi wotsika pang'ono poyerekeza ndi mankhwala oyambayo.
Mu kanema munkhaniyi, mutha kudziwa zambiri zamankhwala ochepetsa shuga awa.
