Glibenclamide - malangizo pazomwe zili zoopsa komanso m'malo mwake

Glibenclamide ndi mtundu wotchuka kwambiri komanso wotchuka kwambiri wa sulfonylurea wokhala ndi zinthu zotsitsa shuga. Mu 2010, adalandira Mphotho Yotchuka ya Kreutzfeld, yomwe imaperekedwa chifukwa cha kufalitsa mankhwala. Mankhwala amatsata mokwanira mfundo zomwe okhazikitsidwa ndi komiti yosankhayi amagwira, kutsimikizika kwake kumatsimikiziridwa ndi kafukufuku wazaka zambiri komanso zamankhwala.

Ndi mankhwala ochepa omwe amatha kudzitamandira pazaka 20 pakuwunika komanso kufufuza mozama za zotsatira zakuchedwa zomwe zimagwiritsidwa ntchito. Mtengo wotsika wa mapiritsiwo umachepetsa mtengo wokwanira wodwala matenda ashuga. Malingana ndi momwe zimakhalira zotsika mtengo komanso zogwira ntchito, glibenclamide idaphatikizidwa pamndandanda wa mankhwala ofunikira omwe amagwiritsidwa ntchito pa matenda ashuga. Kupatula iye, Metformin ndi insulin okha ndi omwe adapatsidwa ulemu wotere.

Zisonyezero zakudikirira

Mtundu wachiwiri wa matenda ashuga ndi matenda opita patsogolo omwe amafunikira chithandizo chanthawi zonse. Ngakhale muzochitika zoyendetsa bwino glycemic, ntchito ya maselo a beta imangokulira pang'onopang'ono mwa odwala ndipo kuchuluka kwa insulin mkati mwawo kumachepa. Ndi shuga wokwezeka nthawi zonse, njira zowonongeka m'maselo zimathandizira. Kusintha koyamba kwa insulin katulutsidwe kumatha kupezeka panthawi yodziwitsa. Mwa odwala ena, sizimakhudza kwambiri kuchuluka kwa shuga, ndipo kulipiritsa matenda a shuga, zakudya zoyenera zokha, metformin ndi maphunziro akuthupi ndi okwanira.

Anthu omwe ali ndi matenda ashuga, omwe maselo abwinobwino sangathe kudzichitira okha komanso abale omwe adafa, ayenera kupereka mankhwala achinsinsi. Zimathandizira kapangidwe ka insulin, ndikupangitsa maselo kugwira ntchito mwachangu.

Ngati glibenclamide zotchulidwa:

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%

1. Mankhwalawa amadziwika kuti ndi amodzi achinsinsi kwambiri mwamphamvu, motero amawonetsedwa kwa odwala omwe ali ndi matenda osokoneza bongo omwe amachepetsa kwambiri insulin yawo, monga zikuwonekera ndi glycemia wokwera kwambiri panthawi yodziwitsa. Ndi matenda opatsirana a shuga a mellitus, kusintha sikuchitika nthawi yomweyo, shuga amayamba kuchepa pafupifupi masabata awiri. Anthu odwala matenda ashuga okhala ndi vuto laling'ono la hyperglycemia samapereka mankhwala atangopeza matenda ashuga.
2. Glibenclamide ikuwonetsedwa pakukulitsa kwa chithandizo kuwonjezera pa othandizira ena. Zakhala zikutsimikiziridwa kuti mankhwala angapo ochepetsa shuga omwe amakhudza zomwe zimayambitsa hyperglycemia ochokera kumbali zosiyanasiyana amagwira ntchito kwambiri kuposa amodzi. Kupititsa patsogolo kagayidwe ka metabolic, glibenclamide ikhoza kuphatikizidwa ndi insulin ndi mapiritsi aliwonse ochepetsa shuga, kupatula PSM ndi dongo.

Popereka mankhwala, muyenera kukumbukira kuti zimapangitsa maselo a beta kugwira ntchito molimbika. Malinga ndi kafukufuku, kukopa kotereku kumabweretsa kuchepa kwakanthawi kamoyo wawo. Popeza glibenclamide ndiyomwe ili yolimba kwambiri m'gululi, izi zosafunikira zimatchulidwa kwambiri kuposa izi mu PSM yamakono. Ngati wodwala matenda ashuga akufuna kupitiliza kuphatikiza insulini kwakanthawi kokwanira, chithandizo chokhala ndi glibenclamide chizikhazikitsidwa mpaka mankhwala ofooka atasiya kuwongolera matenda a shuga.

Momwe glibenclamide imachitikira

Kupanga kwa kanthu kwa glibenclamide kumamveka bwino ndikufotokozera mwatsatanetsatane malangizo a mankhwalawa. Zinthu zimalepheretsa njira za KATF zomwe zimakhala pamtundu wa maselo a beta, zomwe zimabweretsa kutsika kwa potaziyamu m'maselo, kufooketsa kuphatikizika kwa membrane ndi kulowa kwa calcium ion. Kuwonjezeka kwa kuchuluka kwa calcium mu cell kumapangitsa njira yotulutsidwa kwa insulin kuchokera mu madzi a cellellular, kenako kulowa m'magazi. Glucose imachepetsedwa chifukwa cha mphamvu ya insulin yochotsa m'mitsempha yamagazi kupita nayo minofu. Glibenclamide mwachangu kuposa ena a PSM omwe amamangirira beta-cell receptors, chifukwa chake amakhala ndi mphamvu yotsitsa shuga kwambiri.

Mphamvu ya mankhwalawa imawonjezeka ndi kuwonjezeka kwa mlingo. Zotsatira za glibenclamide sizimadalira glycemia, mankhwalawa amagwira ntchito mopitirira muyeso wa glucose komanso osakwanira, kotero mukamamwa, muyenera kusamala kwambiri momwe mungathere ndikuyezera shuga pamene zizindikiro zilizonse zofanana ndi hypoglycemic zikuchitika.

Kuphatikiza pa hypoglycemic yayikulu, kuphatikizika kwina kodziwika kumakhala kwa PSM yonse. Malinga ndi malangizo, glibenclamide pang'ono imachepetsa kukana kwa insulin kwa maselo am minofu ndi mafuta, zomwe zimapangitsa kuchepa kwamphamvu kwa glucose.

Zotsatira zamtima wamankhwala zimaphunziridwa mosiyana. Zinapezeka kuti glibenclamide imatha kutseka njira za KatiF osati ma cell a beta, komanso maselo amtima - cardiomyocyte. Mwachidziwitso, kuchita zotere kumatha kukulitsa zotsatira za vuto la mtima mwa odwala matenda ashuga. M'mayeso azachipatala, zotsatira zoyipa sizinatsimikizidwe. Komanso, adanena kuti antiarrhythmic zotsatira zake zimapezeka mu glibenclamide, yomwe imachepetsa kufa kwa nthawi yayikulu ya ischemia. Malinga ndi madotolo, ambiri a iwo amawopa kupereka mankhwala Glibenclamide pa matenda aliwonse am'mtima, ngakhale atapeza kafukufuku.

Kukonzekera kwa Glibenclamide

Odwala ambiri a shuga amadziwa bwino glibenclamide ndi Maninil, yomwe imapangidwa ku Germany ndi Berlin-Chemie. Mankhwalawa ndi achikale, ndipo kutenga nawo gawo kwachitika maphunziro ambiri omwe aphunzira kufunikira ndi chitetezo cha glibenclamide. Maninil ali ndi njira zitatu. Mapiritsi 1.75 ndi 3.5 mg, chinthu chomwe chikugwira ntchito chili m'njira yapadera, yolola kuti muchepetse glycemia ndi mlingo wotsika wa mankhwalawa. 5 mg maninyl imakhala ndi glibenclamide yapamwamba.

Ma Analogs ku Russia ndi:

• Statiglin ochokera ku Farmasintez-Tyumen ndi Glibenclamide ochokera ku kampani ya Ozon (reg. Satifiketiyi ndi ya Atoll LLC). Mankhwalawa ali ndi Mlingo wofananira, koma opanga sananene za kukhalapo kwa glibenclamide pazosankha zilizonse.
• Mapiritsi a Glibenclamide opangidwa ndi Moskhimpharmpreparaty, Pharmstandard-Leksredstva, Biosynthesis, Valenta Pharmaceuticals ali ndi gawo limodzi la 5 mg. Amatha kugawidwa kuti apeze theka la 2,5 mg.

Ndizofunikira kudziwa kuti ndizofanizira zapakhomo pokha, chifukwa mabizinesi amagula glibenclamide kunja, makamaka ku India. Kupatula kokha ndi Statiglin, yolembetsedwa mu 2017. Glibenclamide chifukwa imapangidwa ku Russia ku BratskKhimSintez bizinesi.

Ma analogi onse a Maninil amayesedwa kuti apange bioequivalence ndipo ali ndi mawonekedwe ofanana. Kuwona kwa odwala kumawonetsa kuti mankhwalawa ndi othandizanso, komabe odwala matenda ashuga amakonda kugula mankhwala oyambirirawo, chifukwa chotchuka kwambiri komanso mtengo wotsika.

Poyerekeza ndi ndemanga, kuphatikiza kwa glibenclamide ndi metformin ndikotchuka kwambiri. Zinthu zonsezi ndi gawo limodzi la zigawo ziwiri za mankhwala Glucovans, Glimecomb, Gluconorm. Metglib, Glibomet ndi ena.

Malangizo ogwiritsira ntchito

Malangizo ogwiritsira ntchito akutsimikiza kudziwa kufunika kwa glibenclamide payekhapayekha kwa wodwala aliyense:

1. Mlingo woyambira wabwino osaposa 2,5 mg, wambiri hyperglycemia - 5 mg. Amaloledwa kuyamba kulandira chithandizo ndi glibenclamide pokhapokha ngati glycemic ikuwongolera pafupipafupi komanso motsogozedwa ndi dokotala. Tisaiwale kuti mankhwalawa amatha kuyambitsa hypoglycemia, kuphatikizapo kwambiri. Mankhwalawa osachepera kumwa kamodzi patsiku, mphindi 20 asanadutse kadzutsa. Ma glibenclamide owoneka ngati ma Micron amatengedwa musanadye.
2. Ngati kuchuluka kwa shuga sikunabwerere mwakale mkati mwa sabata, mlingo umakulitsidwa pang'onopang'ono, ndikuwonjezera 1.75-2.5 mg kamodzi pa sabata. Pa mlingo wa mpaka 10 mg, glibenclamide amamwa m'mawa. Ngati mlingo waukulu ukufunika kulipiritsa matenda a shuga, mankhwalawa aledzera asanadye chakudya cham'mawa komanso asanadye. Kutenga glibenclamide musanagone kumaletsedwa ndi malangizo, chifukwa kumatha kuyambitsa hypoglycemia yausiku.
3. Mlingo waukulu ndi mapiritsi atatu a 5 mg. Awiri a iwo amamwa m'mawa, wina asanadye.

Zotsatira zoyipa

Pafupipafupi pazovuta zosagwiritsidwa ntchito pochiza ndi Glibenclamide ndizochepa. Mlingo woyenera komanso kutsatira malangizo ogwiritsa ntchito, zotsatira zoyipa zimapezeka pafupifupi 1% ya anthu odwala matenda ashuga, omwe amawonetsa chitetezo chachikulu cha mankhwalawa.

Hypoglycemia ndi kuchuluka kwa thupi ndizotsatira za kuperewera kwa zakudya m'thupi komanso kuchuluka kwa glibenclamide. Malinga ndi odwala matenda ashuga, ngati musintha zakudya zanu, kuwerengera kuchuluka kwa chakudya m'thupi lililonse, osadumpha chakudya, kukonzekera zokhwasula-khwasula nthawi yayitali, chiopsezo cha zotsatirazi chimatha kuchepetsedwa.

Kodi amalandila ndani?

Malangizowo amayambitsa kuletsa kutenga mapiritsi a Glibenclamide pazotsatirazi:

• ngati mankhwalawo kapena mawonekedwe ake kale anali ndi ziwengo;
• pamene wodwala matenda ashuga asowa ma cell a beta (mtundu 1 matenda ashuga, kapamba pancreatic);
• mu mkhalidwe wa kuwonongeka kovuta kwa matenda a shuga ndi ketoacidosis kapena pachiwopsezo chachikulu cha kuwonongeka chifukwa chovulala kwambiri komanso matenda;
• kwambiri aimpso ndi kwa chiwindi kusakwanira;
• vuto lactose tsankho, lomwe lili mu mankhwalawo ngati chothandizira;
• pa mimba, mkaka wa m`mawere;
• ana odwala matenda ashuga.

Ndi kusamala kwambiri, ndikofunikira kuchita chithandizo cha zovuta zamafuta a m'thupi, uchidakwa, matenda am'mimba, ukalamba, kutentha kwambiri.

Bongo

Mankhwala osokoneza bongo nthawi zonse amakhala ndi hypoglycemia. Poyamba, amatha kutha ndi njira yowonjezera pakamwa yopanga shuga. Ngati hypoglycemia yakula, malangizowo akutsimikizira kayendedwe ka glucagon. Nthawi yomweyo, odwala matenda ashuga amafunika kuthandizidwa mwachangu. Pogwiritsa ntchito mankhwala osokoneza bongo a Glibenclamide, shuga amatsika mobwerezabwereza masana, motero wodwalayo amapaka jekeseni wa shuga m'mitsempha ndikuwonetsetsa momwe alili.

Ma analogi ndi glibenclamide

Ma fanizo oyandikirana kwambiri a glibenclamide ndi ena omwe amapezeka ndi sulfonylureas. Pakadali pano, glyclazide, glimepiride imagwiritsidwa ntchito kwambiri, glycidone nthawi zambiri.

Mapulogalamu apiritsi a glibenclamide okwera mtengo kwambiri:

Gliptins, yomwe imapangitsanso kaphatikizidwe ka insulin, ndi okwera mtengo kwambiri a glibenclamide analogues. Glyptins ndi gawo la Januvii, Ongliza, Xelevia, Galvus, Trazhenty, chithandizo chawo chimagula ruble 1,500. pamwezi. Mankhwalawa sikuti amayambitsa hypoglycemia, musathandizire kuwonongeka kwa maselo a beta, koma osachepetsa shuga mwachangu monga glibenclamide. Malinga ndi ndemanga, glyptins amapereka zotsatira zabwino poyambirira sanali kwambiri glycemia.

Mtengo mumafakisi

Maninil okhala ndi glibenclamide yokhala ndi micronized pamafunika ma ruble 130-160. pa paketi iliyonse ndi mapiritsi 120. Maninil 5 mg adzakhala otsika mtengo, mtengo wa paketi ndi pafupifupi ma ruble 120. Mtengo wa ma analogu apanyumba ndi wotsikirapo: kuchokera ma ruble 26. mapiritsi 50 kapena ma ruble 92. mapiritsi 120. Chifukwa chake, ngakhale pa mlingo wokwanira, mtengo wa chithandizo sudzapitilira ma ruble 100. pamwezi.

Mankhwala Glibenclamide atha kupezeka mwaulere m'dera lililonse la Russia, ngati wodwala ali ndi matenda a shuga, ndipo adalembedwa ndi endocrinologist.

Ndemanga Zahudwala