Amaryl ili ndi glimepiride, yomwe ndi ya m'badwo watsopano, wachitatu, wa sulfonylurea derivatives (PSM). Mankhwalawa ndi okwera mtengo kwambiri kuposa glibenclamide (Maninil) ndi glyclazide (Diabeteson), koma kusiyana kwa mtengo kumatsimikiziridwa ndi kukwera kwambiri, kuchitapo kanthu mwachangu, kuthana ndi kufinya, komanso chiopsezo chochepa cha hypoglycemia.
Ndi Amaril, maselo a beta amatsitsidwa pang'onopang'ono kuposa mibadwo yam'mbuyomu ya sulfonylureas, kotero kupititsa patsogolo kwa shuga kumachepetsedwa ndipo chithandizo cha insulin chidzafunika pambuyo pake.
Ndemanga zomwe zimamwa mankhwalawa ndizabwino: amachepetsa shuga bwino, ndi osavuta kugwiritsa ntchito, amamwa mapiritsi kamodzi patsiku, osatengera mlingo. Kuphatikiza pa glimepiride koyera, kuphatikiza kwake ndi metformin kumapangidwa - Amaril M.
Malangizo achidule
| Machitidwe | Amachepetsa shuga m'magazi, zomwe zimakhudza mbali zake ziwiri:
Kuphatikiza apo, mankhwalawa amachepetsa chiopsezo cha thrombosis, amatulutsa cholesterol, komanso amachepetsa kupsinjika kwa oxidative. Amaryl amachotsedwamo pang'ono mkodzo, pang'ono kudzera m'matumbo, motero angagwiritsidwe ntchito mwa odwala omwe amalephera kupweteka kwa impso, ngati impsoyo yasungidwa pang'ono. |
| Zizindikiro | Matenda a shuga okha mitundu iwiri. Njira yofunikira yogwiritsira ntchito maselo a beta osungidwa pang'ono, omwe ali ndi zotsalira za insulin yawo. Ngati kapamba asiya kutulutsa mahomoni, Amaril sanalembedwe. Malinga ndi malangizo, mankhwalawa amatha kumwa ndi metformin ndi insulin. |
| Mlingo | Amaryl amapangidwa mu mawonekedwe a mapiritsi okhala mpaka 4 mg ya glimepiride. Kuti mugwiritse ntchito mosavuta, mulingo uliwonse umakhala ndi mtundu wake. Mlingo woyambira ndi 1 mg. Amawatenga masiku 10, pambuyo pake amayamba kukula pang'onopang'ono mpaka shuga atasintha. Mlingo wololedwa wambiri ndi 6 mg. Ngati sichikuperekera chiphuphu kwa anthu odwala matenda ashuga, mankhwala ochokera m'magulu ena kapena insulin amawonjezeredwa ku regimen yothandizira. |
| Bongo | Kuchulukitsa mlingo wambiri kumabweretsa hypoglycemia wa nthawi yayitali. Pambuyo matenda a shuga, amatha kubwereza masiku ena atatu. Nthawi yonseyi, wodwalayo amayenera kuyang'aniridwa ndi abale, omwe ali ndi mankhwala osokoneza bongo ambiri - kuchipatala. |
| Contraindication |
Amaryl amasiya kwakanthawi ndipo m'malo mwake amayamba jakisoni wa insulin panthawi yapakati komanso mkaka wa m`mawere, zovuta za matenda ashuga, kuyambira ketoacidosis mpaka hyperglycemic coma. Ndi matenda opatsirana, kuvulala, kuchuluka kwambiri m'maganizo, Amaril sangakhale okwanira kuteteza shuga, chifukwa chake mankhwalawa amathandizidwa ndi insulin, nthawi yayitali. |
| Kuopsa kwa hypoglycemia | Shuga wamagazi amatsika ngati wodwala matenda ashuwalawo adayiwala kudya kapena sanabwezeretse glucose yemwe adagwiritsa ntchito masewera olimbitsa thupi. Kuti matenda a glycemia achulukane, muyenera kudya chakudya chambiri, nthawi zambiri chidutswa cha shuga, kapu yamadzi kapena tiyi wokoma ndi wokwanira. Ngati kuchuluka kwa Amaril kwadutsa, hypoglycemia ikhoza kubwereza kangapo panthawi yamankhwala. Pankhaniyi, shuga atayamba kuphatikizika, amayesa kuchotsa glimepiride m'mimba: amayamba kusanza, kumwa adsorbents kapena mankhwala otupa. Mankhwala osokoneza bongo oopsa amapha; chithandizo cha hypoglycemia chimaphatikizira glucose yovomerezeka. |
| Zotsatira zoyipa | Kuphatikiza pa hypoglycemia, mukamamwa Amaril, vuto la chimbudzi limatha kuwonedwa (osakwana 1% ya odwala), chifuwa, kuyambira pakhungu ndi kuyabwa mpaka kugunda kwa anaphylactic (<1%), kusintha kwa chiwindi, kusintha kwa kapangidwe ka magazi (<0.1%) . |
| Mimba ndi GV | Malangizo mosamalitsa imaletsa chithandizo ndi Amaril pa nthawi ya pakati komanso HBV. Mankhwalawa amadutsa mu chotchinga chachikulu ndi kulowa m'magazi a fetal, amalowa mkaka wa m'mawere. Ngati wodwala woyembekezera kapena wodwala matenda ashuga sasiya kumwa mankhwalawa, mwana ali pachiwopsezo cha hypoglycemia. |
| Kuyanjana kwa mankhwala osokoneza bongo | Zotsatira za Amaril zimatha kusintha pogwiritsa ntchito munthawi yomweyo mankhwala ena: mahomoni, antihypertensive, maantibayotiki ena ndi othandizira. Mndandanda wathunthu ukupezeka mu malangizo ogwiritsira ntchito. |
| Kupanga | Pulogalamu yogwira ndi glimepiride (Amaril M ali ndi glimepiride ndi metformin), zida zothandizira pakupanga mapiritsi ndikuwonjezera moyo wa alumali: sodium glycolate, lactose, cellulose, polyvidone, stearate wa magnesium, utoto. |
| Wopanga | Sanofi Corporation, glimepiride imapangidwa ku Germany, mapiritsi ndi ma CD ku Italy. |
| Mtengo | Amaryl: 335-1220 rub. Mapiritsi 30, mtengo wake umatengera mlingo. Phukusi lalikulu kwambiri - mapiritsi 90 a 4 mg aliyense amatenga pafupifupi 2700 rubles. Amaril M: 750 rub. mapiritsi 30. |
| Kusunga | Zaka zitatu Mankhwalawa amayenera kusungidwa kuti asawonekere ana, chifukwa kugwiritsa ntchito kosagwirizana ndi Amaril kukhoza kukhala kovulaza thanzi. |
Malamulo Ovomerezeka
Mapiritsi a Amaryl amalembedwa pawiri:
- Ngati matenda ashuga sangakhale chaka choyamba, ndipo metformin sikokwanira kulipirira.
- Kumayambiriro kwa chithandizo, limodzi ndi metformin komanso zakudya, ngati hemoglobin yapamwamba yapezeka (> 8%). Pambuyo p kulipirira matendawa, kufunika kwa mankhwala a hypoglycemic kumachepa, ndipo Amaryl imathetsedwa.
Mankhwala amatengedwa ndi chakudya.. Mapiritsiwa sangaphwanyidwe, koma amagawika pakati pachiwopsezo. Chithandizo cha Amaril chimafuna kukonza kwa zakudya:
Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale
- Matenda a shuga -95%
- Kuthetsa kwa mitsempha thrombosis - 70%
- Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
- Kuthana ndi kuthamanga kwa magazi - 92%
- Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%
- Chakudya chomwe amamwa mapiritsi chizikhala chambiri;
- Palibe chifukwa choti mulumphe chakudya. Ngati sizinali zotheka kukhala ndi chakudya cham'mawa, kulandiridwa kwa Amaril kusamutsidwa ku chakudya chamadzulo;
- ndikofunikira kupanga yunifolomu yama protein m'magazi. Cholinga ichi chimakwaniritsidwa ndikudya pafupipafupi (pambuyo maola 4), kugawa kwamoto m'mbale zonse. Kutsika kwa chakudya kwa glycemic, kumakhala kosavuta kuti zitheke.
Amaril aledzera zaka zambiri osapuma. Ngati mulingo wambiri wachepetsa shuga, muyenera kusintha mankhwalawo ku insulin.
Nthawi yogwira
Amaryl ali ndi bioavailability kwathunthu, 100% ya mankhwalawo imafika pamalo ochitapo kanthu. Malinga ndi malangizo, kuchuluka kwa glimepiride m'magazi kumapangidwa pambuyo maola 2,5. Kutalika kokwanira kwa zochita kumapitilira maola 24, kukwera kwakukulu, mapiritsi a Amaril atali adzagwira ntchito.
Chifukwa cha nthawi yayitali, mankhwalawa amaloledwa kumwa kamodzi patsiku. Popeza kuti 60% ya anthu odwala matenda ashuga samatsata malangizo a dokotala, kumwa kamodzi kungathandize kuchepetsa kusowa kwa mankhwalawa ndi 30%, motero kusintha njira ya matenda ashuga.
Kuyenderana ndi mowa
Zakumwa zoledzeretsa zimakhudza Amaryl mosasamala, zimatha kuwonjezera ndikuchepetsa mphamvu yake. Chiwopsezo cha hypoglycemia yoika moyo pangozi imachuluka, kuyambira ndi kuledzera pang'ono. Malinga ndi odwala matenda ashuga, kumwa mowa mwauchidakwa ndi osaposa kapu ya vodika kapena kapu ya vinyo.
Zofananira za Amaril
Mankhwalawa ali ndi mitundu ingapo yotsika mtengo yofanana ndi yogwiritsira ntchito komanso Mlingo, wotchedwa ma generics. Kwenikweni, awa ndi magome a zokolola zapakhomo, kuchokera kuzinthu zomwe zimagulitsidwa kunja zomwe mutha kugula zokha za Croatia Glimepirid-Teva. Malinga ndi ndemanga, analogi za ku Russia sizili zoyipa kuposa momwe Amaril amatengera kunja.
| Zofananira za Amaril | Dziko lopanga | Wopanga | Mtengo wazochepa mlingo. |
| Glimepiride | Russia | Atoll Vertex Mankhwala Kompakitard-Leksredstva, | 110 |
| Glimepiride Canon | Kupanga kwa Canonfarm. | 155 | |
| Diamerid | Akrikhin | 180 | |
| Glimepiride-teva | Croatia | Pliva wa Khrvatsk | 135 |
| Glemaz | Argentina | Kimika Montpellier | sapezeka m'mafakisi |
Amaryl kapena Diabeteson
Pakadali pano, glimepiride komanso mtundu wautali wa glyclazide (Diabeteson MV ndi analogues) amawonedwa ngati PSM yamakono komanso yotetezeka. Mankhwalawa onse ndi ocheperako kuposa omwe amapangira omwe angayambitse hypoglycemia yayikulu.
Komabe, mapiritsi a Amaryl a shuga ndi abwino:
- zimakhudza kulemera kwa odwala ochepa;
- osatchulidwira zoipa pamtima;
- odwala matenda ashuga amafuna kuchuluka kwa mankhwalawa (mulingo wambiri wa odwala matenda ashuga pafupifupi 3 mg wa Amaril);
- kutsika kwa shuga mukamamwa Amaril kumayendetsedwa ndi kuchepa kwapansi kwa insulin. Kwa Diabeteson, chiwerengerochi ndi 0.07, cha Amaril - 0.03. Mu PSM yotsalira, chiwonjezerochi chimakhala choyipa: 0.11 cha glipizide, 0,16 kwa glibenclamide.
Amaryl kapena Glucophage
Kunena zowona, funso Amaril kapena Glucophage (metformin) siliyenera kuyankhidwa ngakhale. Glucophage ndi mawonekedwe ake a shuga 2 amalembedwa nthawi zonse koyamba, chifukwa amagwira bwino kwambiri kuposa mankhwala ena pazomwe zimayambitsa matendawa - insulin kukana. Ngati dokotala amalembera mapiritsi a Amaryl okha, luso lake ndilokayikira.
Ngakhale kuphatikiza chitetezo, mankhwalawa amakhudza mwachindunji kapamba, zomwe zikutanthauza kuti amafupikitsa kapangidwe ka insulin yanu. PSM imayikidwa pokhapokha ngati metformin singalekerere bwino kapena kuchuluka kwake sikokwanira kwa glycemia wabwinobwino. Monga lamulo, izi mwina zimatha kubwezera kwambiri matenda ashuga, kapena matenda okhalitsa.
Amaril ndi Yanumet
Yanumet, monga Amaryl, imakhudza magulu onse a insulin komanso kukana insulini. Mankhwala osokoneza bongo amasiyana mu kagwiritsidwe kake ndi kapangidwe ka mankhwala, kotero amatha kuthandizidwa limodzi. Yanumet ndi mankhwala atsopano, chifukwa chake amawononga ma ruble 1800. ya paketi yaying'ono kwambiri. Ku Russia, mayendedwe ake adalembetsa: Combogliz ndi Velmetia, omwe siotsika mtengo kuposa oyambira.
Nthawi zambiri, chiphuphu cha shuga chimatha kupezeka ndi kuphatikiza kwa metformin yotsika mtengo, zakudya, masewera olimbitsa thupi, nthawi zina odwala amafunikira PSM. Yanumet ndiyofunika kugula pokhapokha ngati mtengo wake siofunika ku bajeti.
Amaril M
Kusagwirizana ndi odwala matenda ashuga ndi mankhwala okhazikika ndiye chifukwa chachikulu chomwe kuwonongera kwa matenda ashuga. Kusintha kwa njira yochizira matenda ena aliwonse kumadwalitsa nthawi zonse zotsatira zake, chifukwa chake, mwa kusankha kwa odwala, mankhwala osakanikirana ndi omwe amakonda. Amaryl M ali ndi kuphatikiza komwe kumagwiritsidwa ntchito kwambiri pamankhwala ochepetsa shuga: metformin ndi PSM. Piritsi lililonse lili ndi 500 mg ya metformin ndi 2 mg ya glimepiride.
Ndikosatheka kuyesa bwinobwino zinthu zonse ziwiri zogwiritsidwa ntchito piritsi limodzi la odwala osiyanasiyana. Pakati gawo la shuga, metformin yambiri, glimepiride yocheperako imafunikira. Palibe oposa 1000 mg a metformin omwe amaloledwa pa nthawi, odwala omwe ali ndi vuto lalikulu ayenera kumwa Amaril M katatu patsiku. Kusankha mlingo weniweni, ndikofunikira kuti odwala omwe alangidwa azitenga Amaril padera pakudya cham'mawa komanso Glucofage katatu patsiku.
