GLIBENCLAMIDE: MALANGIZO OGWIRITSIRA NTCHITO, NDEMANGA, MTENGO

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Glibenclamide ndi gulu la othandizira pakamwa. Ili ndi njira yovuta yogwiritsira ntchito, yomwe imakhala yowonjezera-pancreatic ndi pancreatic.

Mphamvu ya pancreatic - pali kukondoweza kwa kutulutsidwa kwa insulin ndi maselo apadera a kapamba, pomwe kutulutsidwa kwa insulin kwachulukidwe kumawonjezereka, ndipo kupangika kwa glucagon m'maselo kumalepheretsa.

Mphamvu yowonjezera pancreatic imalumikizidwa ndi kuwonjezeka kwa zotumphukira za mphamvu ya zotumphukira ku mphamvu ya insulin, kuchepa kwa mapangidwe a shuga ndi glycogen m'chiwindi.

Mlingo wa insulin m'magazi umakwera pang'onopang'ono, ndipo kuchuluka kwa glucose kumacheperanso pang'ono, kotero mwayi wokhala ndi zovuta za hypoglycemic ndi wotsika. Kuchepetsa shuga kumayamba maola awiri mutatha kugwiritsa ntchito ndikufika pazomwe zimachitika pambuyo pa maola 8, nthawi yochita ndi maola 12.

Mukamamwa mankhwalawa, chiopsezo chokhala ndi retinopathy, mtima, nephropathy, komanso zovuta zilizonse za matenda a shuga mellitus (osagwirizana ndi insulin) zimachepa.

Glibenclamide imakhala ndi antiarrhythmic komanso mtima. Ikamamwa, imatsala pang'ono kwathunthu ndipo imatengedwa mwachangu kuchokera kugaya chakudya. Ikagwiritsidwa ntchito molumikizana ndi chakudya, mayamwidwe amatha kuchepa.

Zizindikiro zogwiritsidwa ntchito

Mellitus wosadalira insulin (mtundu 2) mwa akulu - amagwiritsidwa ntchito ngati monotherapy ngati kudya komanso kuchita masewera olimbitsa thupi ndizosakwanira.
Kuphatikiza mankhwala ndi insulin.

Contraindication

Glibenclamide imatsutsana mu milandu yotsatirayi:

insellinus wodwala matenda a shuga (mtundu 1), kuphatikiza ana ndi achinyamata;
matenda ashuga ketoacidosis;
matenda a shuga kapena chikomokere;
kuchotsedwa kwa kapamba;
hyperosmolar chikomokere;
kulephera kwambiri kwaimpso kapena chiwindi (mawonekedwe a creatinine chilolezo chochepera 30 ml / min);
kuwotcha kwakukulu;
kuvulala kwambiri zingapo;
othandizira opaleshoni;
matumbo kutsekeka;
paresis am'mimba;
malabsorption chakudya ndi kukula kwa hypoglycemia;
leukopenia;
kukulitsa chidwi chamtundu wa mankhwalawo, komanso othandizira ena a sulfonamide ndi zotumphukira za sulfonylurea;
mimba ndi mkaka wa m`mawere;
zaka mpaka 14.

Amayi omwe akukonzekera kutenga pakati, komanso kubereka mwana, ayenera kusinthana ndi insulin kapena kusiya kuyamwitsa.

Mlingo ndi makonzedwe

Glibenclamide iyenera kutsukidwa ndi madzi pang'ono. Dokotalayo ndi amene amadziwa kuchuluka kwa mankhwalawa komanso kuchuluka kwa mankhwalawa kuti akonze wodwala aliyense payekhapayekha, potengera zotsatira za kusanthula kwa shuga mumkodzo ndi magazi. Ndiwo malangizo omwe mungagwiritse ntchito omwe Glibenclamide imafunikira.

Mlingo woyambirira wa mankhwalawa ndi theka la piritsi (2.5 mg) kamodzi patsiku. Ngati ndi kotheka, mlingo wa tsiku ndi tsiku ungathe kuwonjezereka poonetsetsa kuchuluka kwa shuga m'magazi. Kuchulukitsa kwa mankhwalawa kuyenera kuchitika pang'onopang'ono ndi masiku angapo ndi 2,5 mg, mpaka mlingo wothandizidwa nawo utakwaniritsidwa.

Mlingo waukulu kwambiri ungakhale mapiritsi atatu patsiku (15 mg). Kuchulukitsa kuchuluka kumeneku sikukweza mphamvu ya hypoglycemic.

Ngati mankhwalawa ali mapiritsi 2 patsiku, ndiye kuti amamwa kamodzi m'mawa asanadye. Ngati mukufuna kugwiritsa ntchito kuchuluka kwa mankhwalawo, ndiye kuti ndibwino kuti muzichita mwanjira ziwiri, ndipo chiyezo chake chikhale 2: 1 (m'mawa ndi madzulo).

Okalamba odwala ayenera kuyamba kulandira chithandizo cha mankhwala ndi theka la mankhwala omwe amawonjezeredwa ndi kuwonjezeka kwa sabata limodzi osaposa 2.5 mg patsiku.

Ngati kulemera kwa thupi la munthu kapena moyo wake zasintha, mlingo uyenera kusintha. Komanso, kuwongolera kuyenera kuchitika ngati pali zinthu zomwe zimawonjezera mwayi wokhala ndi hyper- kapena hypoglycemia.

Ndi bongo wa mankhwalawa, hypoglycemia imayamba. Zizindikiro zake:

thukuta;
Kuda nkhawa
tachycardia ndi kuthamanga kwa magazi, kupweteka mumtima, arrhythmia;
mutu
kulakalaka kudya, kusanza, nseru;
kugona, kusasamala;
kupsa mtima ndi nkhawa;
kusokoneza chidwi;
kukhumudwa, kusokonezeka kwa chikumbumtima;
paresis, kugwedezeka;
kusintha kwamvekedwe;
kupweteka kwa chapakati genesis.

Nthawi zina, m'mawonekedwe ake, hypoglycemia imafanana ndi stroke. Akomoka kumayamba.

Mankhwala osokoneza bongo

Ndi hypoglycemia yofatsa mpaka yolimbitsa, itha kuyimitsidwa pang'onopang'ono kudya zakudya zamagulu (magawo a shuga, tiyi wokoma kapena madzi a zipatso). Chifukwa chake, odwala matenda ashuga ayenera kunyamula pafupifupi 20 g shuga (zidutswa zinayi za shuga).

Zokomera sizikhala ndi zochizira komanso hypoglycemia. Ngati wodwalayo ali ndi vuto lalikulu, ndiye kuti ayenera kupita kuchipatala. Onetsetsani kuti mwayambitsa kusanza ndikupereka mankhwala (madzi kapena mandimu ofunkhira sodium ndi makala oyambitsa), kuphatikiza mankhwala a hypoglycemic.

Zotsatira zoyipa

Kuchokera kumbali ya metabolism kungakhale:

hypoglycemia, nthawi zambiri usiku, limodzi ndi:

mutu
njala
nseru
kugona kusokonezedwa
zolota
nkhawa
kunjenjemera
kubisa thukuta lozizira kwambiri,
tachycardia
kusokonezeka kwa chikumbumtima
kutopa
malankhulidwe ndi masomphenya

Nthawi zina pamakhala kupsinjika ndi chikomokere, komanso:

kuchuluka kwa mowa;
kuchuluka kwa thupi;
dyslipidemia, kudzikundikira kwa minofu ya adipose;
kugwiritsa ntchito nthawi yayitali, kukula kwa hypofunction ya chithokomiro.

Kuchokera m'mimba:

kusanza, kusanza
kuwonda, kusapeza bwino komanso kumva kupweteka m'mimba;
ulemu, kutentha pa mtima, kutsekula m'mimba;
kuchuluka kapena kuchepa chilakolako cha chakudya;
Nthawi zina, chiwindi chimatha kusokonezeka, hepatitis, cholestatic jaundice, porphyria imayamba.

Kuchokera ku hemopoietic system:

kawirikawiri sipangakhale magazi aplasiki kapena hemolytic anemia;
lecopenia;
agranulocytosis;
pancytopenia;
eosinophilia;
thrombocytopenia.

Zotsatira zoyipa:

erythema multiforme, photosensitivity kapena exfoliative dermatitis sakhala;
mtanda-ziwopsezo kwa othandizira ngati thiazide, sulfonamides kapena sulfonylureas angachitike.

Zotsatira zina zoyipa:

hypoosmolarity;
hyponatremia;

Kusakwanira katemera wa antiidiuretic mahomoni, limodzi ndi:

chizungulire
kutupa kwa nkhope
manja ndi maapewa
kukhumudwa
ulesi
kukokana
stupor
chikomokere
matenda osakhalitsa (osakhalitsa).

Ngati pali zovuta zilizonse zosagwirizana ndi zochitika kapena zachilendo, ndiye kuti muyenera kufunsa dokotala wanu kuti mupeze chithandizo china ndi mankhwalawa, chifukwa tsopano Glibenclamide iyenera kuimitsidwa.

Zolemba ntchito

Dokotala amayenera kudziwa nthawi zonse zomwe wodwalayo adakumana ndi mankhwala omwe ali mgululi. Glibenclamide iyenera kugwiritsidwa ntchito nthawi zonse pokhapokha mulingo wovomerezeka. Awa ndi malangizo enieni ogwiritsira ntchito, mwanjira ina Glibenclamide sikulimbikitsidwa.

Dokotala ndi amene amawerengera kuchuluka kwa mankhwalawo, kugawa koyenera kwa masana ndi nthawi yogwiritsira ntchito, potengera momwe wodwala amayendera tsiku lililonse.

Kuti mankhwalawa athe kutsogola shuga wokwanira wamagazi, ndikofunikira kutsatira zakudya zapadera limodzi ndi kumwa mankhwalawo, kuchita zolimbitsa thupi komanso kuchepetsa thupi, ngati pakufunika. Zonsezi zizikhala ngati malangizo ogwiritsira ntchito.

Wodwala ayenera kuyesa kuchepetsa nthawi yomwe imagwiritsidwa ntchito padzuwa ndikuchepetsa kuchuluka kwa zakudya zamafuta.

Njira zopewera komanso zolakwika mukamamwa mankhwalawo

Kukhazikitsidwa koyamba kuyenera kutsatiridwa ndi kufunsa kwa dokotala, simungagwiritse ntchito mankhwalawa kwa nthawi yayitali kuposa nthawi yomwe mwalimbikitsa. Glibenclamide ndi analogues ziyenera kugwiritsidwa ntchito mosamala vuto la febrile syndrome, kusakwanira kwa adrenal, uchidakwa, matenda a chithokomiro (hyper- kapena hypothyroidism), vuto la chiwindi, komanso odwala okalamba.

Ndi monotherapy kwa zaka zoposa zisanu, kukana kwachiwiri kumayamba.

Kuyang'anira ma labotale

Mukamalandira mankhwalawa ndi glibenclamide, ndikofunikira kuyang'anira kuwunika konse komwe kumayikidwa m'magazi (pomwe mankhwalawo amasankhidwa, izi ziyenera kuchitidwa kangapo pa sabata), komanso mulingo wa glycated hemoglobin (osachepera miyezi itatu iliyonse), malo omwe izi ndizofunikira komanso glucose mkodzo. Izi zipangitsa kuti kuzindikira koyamba kapena kwachiwiri kukana mankhwalawa nthawi.

Muyeneranso kuwunika momwe magazi alowerera (makamaka zomwe zili m'maselo oyera a magazi ndi mapulateleti) komanso ntchito ya chiwindi.

Kuopsa kwa hypoglycemia kumayambiriro kwa mankhwala

Pa magawo oyambirira a mankhwalawa, chiopsezo chotenga matendawa chimawonjezeka, makamaka ngati zakudya sizinasungidwe kapena zakudya zosakhazikika. Zomwe zimathandizira pakupanga hypoglycemia:

kulephera kapena kusafuna kwa odwala, makamaka okalamba, kuti azigwirizana ndi dokotala ndikutenga Glibenclamide kapena fanizo lake;
kuperewera kwa zakudya m'thupi, kudya mosasamala kapena kudya;
kuphwanya malire pakati pa kudya zakudya ndi thupi;
zolakwika mu chakudya;
kumwa mowa, makamaka ngati pali vuto la kuperewera kwa m'thupi;
aimpso kuwonongeka;
chachikulu chiwindi ntchito;
bongo wa mankhwala;
matenda osawerengeka a endocrine dongosolo lomwe limakhudza kagayidwe kazakudya, komanso kutsutsana ndi malamulo a hypoglycemia, kuphatikizira kuchepa kwa pituitary ndi adrenocortical, kuwonongeka kwa chithokomiro;
kugwiritsa ntchito mankhwala enanso munthawi yomweyo.

Kutulutsa Fomu

Mapiritsi 50 aliwonse, amaikidwa mu botolo la pulasitiki kapena m'matumba a mabotolo asanu aliwonse okhala ndi mapiritsi 10, komanso mapiritsi 20 okhala ndi matuza a zidutswa 6 m'mpaketi.

Malo osungira

Mankhwalawa amayenera kusungidwa kuchokera kwa ana, kutetezedwa pakuwala. Kutentha kosungirako kumachokera ku madigiri 8 mpaka 25. Moyo wa alumali ndi zaka zitatu. Mankhwala omwe atha ntchito amaletsedwa.