Mankhwala a Antidiabetic Maninil

Mankhwala a oral sulfonylurea omwe amathandizira kuwongolera matenda a shuga a 2 ndi gulu la mitundu yambiri ya hypoglycemic. Ndipo, ngakhale kuti mankhwala am'badwo watsopano wokhazikika pa glimepiride (monga Amaryl) adapangidwa kale, Maninil (glibenclamide wakale m'mapangidwe ake) sanatayidwe. Kafukufuku waposachedwa awulula zatsopano zamankhwala apamwamba.

Mapiritsi a antidiabetesic a gulu la mankhwala a sulfonylurea amalimbikitsa zochitika zapakhansa ndipo si onse odwala matenda ashuga a mtundu 2 omwe ali oyenera, chifukwa chake muyenera kumvetsetsa mawonekedwe awo.

Maninil - mawonekedwe omasulidwa

Manilin, chithunzi chake chomwe chikuwonetsedwa mu gawo ili, chili ndi zinthu zoyambira glibenclamide ndi mafilimu:

• Methyl hydroxyethyl cellulose;
• Lactose Monohydrate;
• Wowuma mbatata;
• Magnesium wakuba;
• Silicon dioxide;
• Dye Ponceau 4R.

Kuzindikiritsa zomwe kampani yaku Germany yopanga mankhwala Berlin-Chemie (Menarini Gulu) pakuwoneka ndikosavuta: mapiritsi okhala ndi mawonekedwe okhala ndi pinki tinge amakhala ndi bevel komanso mzere wogawika mbali imodzi. Kutengera mlingo, piritsi limodzi limatha kukhala ndi 3.5-5 mg wa mankhwala othandizira.

Patsamba lamankhwala, mankhwala atha kugulidwa ndi mankhwala. Ku Maninil, mtengo wake ndi ndalama zambiri - kuchokera ku 140 mpaka 185 ma ruble. Mankhwalawa safuna mikhalidwe yapadera kuti isungidwe, koma kufikira kwa ana ndi kuwongolera dzuwa kuyenera kukhala kochepa. Moyo wa alumali wam'mapiritsi ndi zaka 3, mankhwala omwe adatha amatha.

Kuthekera kwama pharmacological

Ntchito yayikulu ya glibenclamide ndi kukondoweza kwa β-maselo a islets a Langerhans, omwe ali ndi udindo wopanga insulin yawoyawo. Zochita za Β-cell ndizofanana mwachindunji pamlingo wa glycemia komanso malo ake. Mukatha kugwiritsa ntchito, mapiritsiwo amatengedwa mwachangu ndi makhoma a matumbo. Kukula kwa kuchuluka kwa zomwe zili m'mimba komanso nthawi yakudzaza kwake ndi chakudya sizikhudzidwa. Ndi mapuloteni a plasma, mankhwalawa amabwera ndi 98%. Kuchuluka kwa mulingo wake mu seramu yamagazi kumawonedwa pambuyo pa maola 2 ndi theka ndikufika pazomwe 100 ng / ml. Hafu ya moyo imakhala pafupifupi maola awiri, mutatengedwa pa os - 7 maola. Kutengera ndi chithunzi cha matenda, odwala matenda ashuga nthawi imeneyi amatha maola 8 kapena 10.

Mankhwalawa amaphatikizidwa makamaka m'chiwindi, akusintha mothandizidwa ndiopanda ma cell m'magulu awiri a metabolites: 3-cis-hydroxy-glibenclamide ndi 4-trans-hydroxy-glibenclamide.

Zakhala zikuyesedwa kuti ma metabolites samayambitsa matenda a hypoglycemic, atachotsa impso ndi ma duc bile kuchokera mthupi kwathunthu masiku atatu.

Ngati chiwindi chikulephera, mankhwalawo amasungidwa m'magazi kwa nthawi yayitali. Ndi pathologies a impso ndi mkodzo, amachotsedwa pang'onopang'ono, nthawi yomwe zimatengera kuuma kwa magwiridwe antchito a thupi.

Makamaka, ndiofatsa modekha mawonekedwe aimpso kukanika, kukonzekera sikumakhazikika. Ndi creatinine chilolezo ≤30 ml / min, kuchuluka kwa kuthetsedwa kwa metabolites kumachepa, motero kuwonjezeka kwa msana wa mankhwala m'magazi. Mikhalidwe yofananira ndi Maninil imafuna kuti mankhwalawa atenge gawo kapena kutulutsa (nthawi zambiri, milandu ya basal insulin).

Maninil ndi ndani?

Mankhwalawa adapangira kuti azilamulira matenda a shuga a 2 (mawonekedwe osagwirizana ndi insulin). Mapiritsi amalembedwa kwa anthu odwala matenda ashuga kuwonjezera, pakakhala kuti sanakonzekere pambuyo poti asinthe (chakudya chochepa kwambiri cha carb, zolimbitsa thupi zokwanira, kukonza kulemera kambiri, kuwongolera zakukhosi, kutsatira kugona ndi kupuma).

Endocrinologist amalembera mankhwala, kuwerengera njira zochizira poganizira zakudya, zaka za odwala, magawo a matendawa, matenda amtunduwu, thanzi labwino komanso momwe thupi limayankhira mankhwala. Mlingo umakhazikitsidwa potengera mbiri ya wodwala.

Mlingo woyambira nthawi zambiri umaperekedwa ngati osachepera - theka la piritsi lolemera 5 mg kapena 3.5 mg patsiku. Chidwi chachikulu pa kusintha kwa mlingo kumaperekedwa kwa odwala asthenic omwe ali ndi zakudya zochepa zopatsa mphamvu, m'mbiri yomwe kumachitika ziwopsezo za hypoglycemic, komanso anthu omwe akuchita ntchito yayikulu. Sabata yoyamba yolamulira ya glycemic tsiku lililonse imafunikira. Dosing titration imachitika malinga ndi umboni wa mita komanso mwakufuna kwa dokotala.

Mankhwala achi Maninil pafupifupi 15 mg / tsiku, mapiritsi atatu a 5 mg kapena mapiritsi a 3.5 mg.

Maninil atalowa m'malo mwa mankhwala ena a hypoglycemic, amawongoleredwa ndi kumwa poyambira. Pambuyo pakutha kwa mankhwala am'mbuyomu, mawonekedwe a glucometer ndi zotsatira za kusanthula kwamkodzo pazinthu zachilengedwe, popanda mawonekedwe a mankhwala, zimafotokozedwa. Zomwe thupi limayang'anitsitsa ndi osachepera mlingo - 0,5 mapiritsi a 3.5 kapena 5 mg. Kutsatira zakudya ndi zina zofunikira pamoyo wathanzi ndizovomerezeka. Popewa zoyipa, mlingo wa mankhwala watsopano umakulitsidwa pang'onopang'ono. Wodwala matenda ashuga ayenera kumuuza adotolo zonse zakusintha kwaumoyo.

Malangizo ogwiritsira ntchito

Maninil amalimbikitsa kuti mugwiritse ntchito m'mawa, musanadye chakudya cham'mawa, muzitsuka mapiritsi anu ndi kapu yamadzi. Nthawi zonse zikaposa 2 ma PC / tsiku, zimagawika pawiri Mlingo 2: 1. Kuti mupeze chithandizo chokwanira kwambiri, ndikofunika kumwa mankhwalawa nthawi yomweyo.

Zotsatira zoyipa

Malinga ndi malingaliro a WHO, pafupipafupi pazovuta zomwe zimachitika chifukwa cha mankhwala zimawunikidwa pamlingo wapadera:

• Nthawi zambiri - kuchokera 10%;
• Nthawi zambiri - kuchokera 1 mpaka 10%;
• Nthawi zina - kuchokera ku 0,1 mpaka 1%;
• Kawirikawiri, kuchokera ku 0,01% mpaka 0,1%;
• Osowa kwambiri - mpaka 0,01% kapena milandu sanalembedwe konse.

Chiwerengero cha zochitika zoyipa kuchokera ku Maninil chimawerengeredwa mosavuta pagome.

Zosokoneza zowonekera nthawi zambiri zimawonedwa munthawi ya kusinthana ndi mankhwalawa ndikudziyendera nokha, popanda chithandizo chamankhwala. Matenda a dyspeptic mu mawonekedwe a mseru, kusanza, kutsekula m'mimba sikufuna kusintha kwa mankhwalawo komanso kumazimiririka pakapita nthawi.

Ngati pali mtundu wa ziwopsezo za ziwopsezo ku glibenclamide, pamakhala chiwopsezo cha intracranial cholestasis ndi zovuta mu mawonekedwe a kusweka bwino kwa chiwindi.

Matenda a pakhungu nthawi zambiri amasinthika, koma nthawi zina amatha kubweretsa chidwi chomwe chikuwopseza moyo wa odwala matenda ashuga.

Kuchokera ku Maninil, chifuwa ndi zovuta zina zimatha kuwonetsedwa ndi kuzizira, kutentha thupi, zizindikiro za jaundice, komanso kupezeka kwa mapuloteni poyesa mkodzo. Muzochitika zonse, kufunsa dokotala wofunikira ndikofunikira.

Nthawi zina, kuchepetsedwa kwa zosakaniza zonse zamagazi amalembedwa nthawi yomweyo. Mankhwala atathetsedwa, sizimangopita zokha. Kupha ziwopsezo ndizotheka ndi mankhwala ena omwe amachititsa kuti wodwala azikhala wodwala. Makamaka, utoto wa E124, womwe umagwiritsidwa ntchito popanga mankhwala, ndi wamphamvu kwambiri.

Maninil - zotsutsana

Mankhwalawa sanatchulidwe hypersensitivity ku zosakaniza za formula. Komanso sizikuwonetsedwa:

• Kwa allergies okodzetsa kapena mankhwala aliwonse a sulfonylurea, sulfonylamide kukonzekera, probenecid;
• Anthu odwala matenda ashuga a mtundu woyamba 1, omwe ali ndi maselo a β-cell;
• Ngati wozunzidwayo ali ndi metabolic acidosis, chikomokere;
• Amayi oyembekezera komanso oyembekezera;
• Odwala omwe ali ndi vuto lalikulu la chiwindi ndi impso (giredi 3);
• Kwa oledzera ndi omwe amamwa mowa (kuopseza kwa hypoglycemia).

Ndi kuledzera, kuledzera kwamphamvu kwa glibenclamide kumatheka, ndipo mkhalidwe wa kuledzera umaphimba zizindikiro za tsoka lomwe likubwera.

Ndi ntchito zam'mimba, kuvulala kwambiri, kutentha kwambiri, kumwa mapiritsi aliwonse a antidiabetes ndi oletsedwa. Amasinthidwa kwakanthawi ndi insulin, yomwe imakupatsani mwayi wosintha mosavuta komanso wambiri wa shuga mu plasma.

Palibe choletsa kotheratu pakuyendetsa magalimoto ndi zida zina zovuta panthawi yamankhwala ndi Maninil. Koma kuukira kwa hypoglycemic kumatha kusokoneza chidwi ndi malingaliro, makamaka pakaphatikizidwa ndi mankhwala ochepetsa shuga. Chifukwa chake, kuchuluka kwake kwa aliyense wodwala matenda ashuga ayenera kudzipenda.

Zotsatira Zogwiritsa Ntchito Mankhwala

Ndi chithandizo chofanana ndi glibenclamide ndi clonidine, komanso β-adrenergic blockers, reserpine, guanethidine, zizindikiro za hypoglycemia zomwe zikubwera zimaphimbidwa ndipo sizimalola kuti kukomoka kwa matenda ashuga kukhale.

Kugwiritsa ntchito mankhwala osokoneza bongo nthawi zonse komwe kumayambitsa kusokonezeka kwa chopondapo kumachepetsa glucometer ndikukulitsa mwayi wa hypoglycemia.

Limbikitsani kuthekera kwa glibenclamide mpaka kugunda kwa hypoglycemic, mutha kugwiritsa ntchito kufanana kwa insulini, zoletsa za ACE, mapiritsi ochepetsa shuga, mankhwala ozikidwa ndi mahomoni achimuna, mankhwala osokoneza bongo, antidepressants, β-blockers, clofibrate, mankhwala ozikidwa pa quinolone, coumarin, phenamine, disaminophen miconazole, PASK, pentoxifylline, perhexylin, pyrazolone, phenenecid, salicylates, sulfonamidamide mankhwala, maantibayotiki a kalasi ya tetracycline, tritokvalin, cytost tics.

Imalepheretsa ntchito ya mankhwala, kupititsa patsogolo matenda a hyperglycemic, kugwiritsa ntchito pamodzi kwa acetazolamides, β-adrenergic blocking agents, diazoxide, glucagon, barbiturates, diuretics, tubazide, glucocorticosteroids, phenothiazine gulu la mankhwala, phenytoin, nicotinate, mankhwala a mankhawala a mankhawala a mankhwala, ma phenytoin chithokomiro.

Mankhwala a gulu la Coumarin, ranitidine, gastric H2 receptor antagonists, pentamidine, reserpine amachita mosaganizira, kumakhala ngati othandizira kapena oletsa zochitika za glibenclamide.

Kuthandiza ndi bongo

Mankhwala osokoneza bongo a glibenclamide (onse omwe ali pachimake komanso omwe amakwiya) amapereka hypoglycemia yayitali - ndi mphamvu yayitali, yoopsa komanso yoopsa ya wozunzidwayo. Mawonetsedwe azachipatala a matenda a hypoglycemic, aliyense wodwala matenda ashuga ayenera kuzindikira molondola:

• Njala yosalamulirika;
• Manja ndi miyendo;
• Tachycardia;
• Kuchulukitsa nkhawa;
• Khungu loyera ndi mucous nembanemba.

Nthawi zina pali zovuta zosakhalitsa za chikumbumtima, paresthesia. Ngati wozunzidwayo sanapatsidwe chithandizo chamankhwala mwadzidzidzi, amayamba kudwala matenda opweteka kwambiri.

Kuzindikira za zotulukazi kumayamba ndi kusonkha zidziwitso za wovutikayo kuchokera kwa achibale odziwika ndi mankhwala omwe wodwala matenda ashuga ndi matenda ake adatenga. Kuyesedwa kwa labotale kumachitika.

Kuyang'ana kwa wolakwiridwayo kumakupatsani mwayi wofufuza momwe khungu limakhalira (kuzizira, kusakhazikika, kunyowa). Matenthedwe amatha kukhala abwinobwino kapena otsika. Kutengera kuzunza kwa kuukira, minyewa yam'mimba ya mtundu wa tonic kapena clonic, mawonekedwe osakhazikika, komanso kukomoka kumawonedwa.

Ngati wozunzidwayo akadali ndi chidwi, amatha kumwa tiyi wokoma ndi shuga wokhazikika, kudya zakudya zilizonse zothamanga (maswiti, makeke). Ngati vuto silinakhazikika, odwala matendawa amagonekedwa m'chipatala.
Ndi chikomokere kuchipatala, yankho la shuga 40% (40 ml) limayendetsedwa iv. Moyang'aniridwa ndi mayeso a labotale, kulowetsedwa kwa mothandizidwa ndi ochepa maselo owonjezera amoto amasintha.

Pali milandu yodziwika ya hypoglycemic yomwe imatenga nthawi yayitali komanso ikuchedwa, ikulimbikitsidwa ndi kuthekera kwakukulu kwa glibenclamide. Zinthu ngati izi zimafunikira kuti wodwala azimugonekera kuchipatala kwa masiku 10 kapena kupitiliza kuyang'anitsitsa glycemia ndi dalili.

Ngati wozunzidwayo adatenga mapiritsi owonjezera kamodzi mwangozi, ndikokwanira kutsuka m'mimba, perekani kwa munthu yemwe amamwa ndi kapu ya tiyi wokoma kapena madzi.

Mitu ya mankhwalawa

Ndi chophatikizira chomwechi ku Glibenclamide, Glibenclamide ndi Glibamide chitha kusintha Maninyl. Zizindikiro, contraindication, zoyipa ndizofanana. Malinga ndi code ya ATX ya 4th ku Maninil, Glidiab, Glyclazide, Diabetes, Glurenorm, yofanana ndi yothandizanso, imatha kukhala fanizo.

Malangizo owonjezera

Kwa odwala okhwima, anthu omwe ali ndi zakudya zochepa zama calorie, asthenics, odwala matenda ashuga okhala ndi chiwindi chofanana ndi matenda a impso, gawo loyambira la Maninil limatsitsidwa pang'ono chifukwa cha chiwopsezo cha hypoglycemia. Ngati odwala matenda ashuga asintha kulemera, moyo, njira zochiritsira zikuwunikidwanso.

Kuchita chidwi makamaka ndi odwala omwe ali ndi vuto la kusokonezeka kwa maganizo, matenda amisala ndi zina zomwe zimapangitsa kuti wodwala azigwirizana kwathunthu ndi dokotala. Kufufuza kwamankhwala kwamtunduwu wa odwala kuyenera kuchitika pafupipafupi. Kuwunika mbali zonse za momwe mankhwalawo amathandizira thupi, amathandizidwa kale ndi kufananiza ndi kutulutsidwa mwachangu kwa zinthu zomwe zimagwira.

Ngati wodwala matenda ashuga samata metformin, amapatsidwa mankhwala a glitazone monga rosiglitazone kapena pioglitazone. Ndi zowunikira zoyenera, mapiritsi a Maninil amathandizidwanso ndi mankhwala othandizira odwala omwe ali ndi vuto lina lililonse. Guarem kapena Acarbose, omwe, monga Maninil, amathandizira kapamba, sagwiritsira ntchito mankhwala ovuta.

Kugwiritsa ntchito nthawi yayitali kwa glibenclamide kumachotsa β-maselo, kumabweretsa necrosis, ndikuyamba kukhala wopanda tanthauzo kwa Maninil. Kuthandizira kapamba, wodwalayo amasamutsidwa kupita ku insulin (kwathunthu kapena pang'ono, kutengera mlingo wa atrophy yawo).

Kuunikira kwa mankhwala kwa madokotala ndi odwala matenda ashuga

About ndemanga za Maninil ndizosakanikirana. Madotolo amati ndi mankhwala achikhalidwe cha hypoglycemic okhala ndi umboni wamphamvu wochita bwino ndi chitetezo. Anthu odwala matenda ashuga sakhutira ndi kuwonjezereka kwakanthawi kotsimikizika komanso zotsatira zina zoyipa, koma ndikosiyana momwe angayang'anire mphamvu za mankhwalawa malinga ndi zotsatira za wodwala wina.

Malangizo omwe ali patsamba lino ndi malangizidwe osinthika a malangizo ovomerezeka, omwe cholinga chake ndi kuwazolowera, osati kuti mudzipangire nokha mankhwala. Kusankhidwa kwa mankhwalawa komanso kukonzekera njira zamankhwala ndizovomerezeka kwa dokotala.