Wothandizira kuchepetsa shuga: Glibenclamide

Glibenclamide ndi mankhwala omwe ali ndi hypoglycemic katundu kuchokera ku gulu lachigawo chachiwiri cha sulfonylurea. Lilinso ndi hypolipidemic zotsatira ndipo limachepetsa chiopsezo cha mtima wamanjenje.

Makhalidwe wamba

Dzina la mankhwala Glibenclamide pamafilimu apadziko lonse Lachilatini ndi Glibenclamide. Kunja, mankhwalawa ndi piritsi yapinki yopepuka mu mawonekedwe a disc yokhala ndi mzere wogawanitsa. Vutolo limatha kukhala ndi miyala ya marble yopanda zing'onozing'ono.

Mapiritsi okhala ndi mapaketi okhala ndi zidutswa 10. Mu bokosi limodzi mumatha kupezeka mbale 12 zotere.

Glibenclamide imatulutsidwa ndi mankhwala, imasungidwa panjira yokhazikika, popanda ana. Malangizowo anati moyo wa alumali - 5 zaka. Mankhwala omalizidwa sayenera kumwa.

Piritsi lirilonse limakhala ndi 5 mg ya glibenclamide ndi maipi mu mawonekedwe a lactose monohydrate, wowonda wa mbatata, magnesium stearate, polyvinylpyrrolidone, E 124.

Makampani opanga mankhwala ochokera kumayiko ena amapanga mankhwala othandizira:

• Anti-viral;
• Akrikhin HFK;
• Bivitech;
• ALSI Pharma;
• Biosynthesis

Imayambitsa ndi kampani yaku Ukraine. Kwa Glibenclamide, mtengo wamtengo muma Russian ma capini 270-350 rubles.

Zotsatira za pharmacological

Pharmacodynamics wa mankhwala

Oral hypoglycemic mankhwala. Ku Glibenclamide, limagwirira ntchito limatengera kukondoweza kwa kupanga insulin ndi ma pancreatic β-cell. Nthawi yomweyo, kukana kwa insulin kwa zotumphukira zimakhala kuchepa. Mankhwalawa amagwira ntchito ngati pali ma β-cell okwanira mu kapamba omwe amapanga mahomoni amkati. Amachepetsa mankhwala ndi kuphatikizira kwa kupatsidwa zinthu za m'magazi.

Makhalidwe a Pharmacokinetic

Kuchokera m'mimba thirakiti pambuyo pakukonzekera pakamwa pamimba yopanda kanthu, mankhwalawa amadziwikiridwa mwachangu, amaphatikiza mapuloteni amwazi ndi 95%. Kusintha kwa yogwira mankhwala kukhala munthawi ya metabolites kumachitika mu chiwindi. Excretion imayang'aniridwa ndi impso ndi bile ducts. Hafu ya moyo kuchokera pamagazi amachokera ola limodzi ndi theka mpaka maola atatu ndi theka. Shuga amawongolera mlingo umodzi wa mankhwalawa kwa maola osachepera 12.

Ndi hepatic pathologies, mankhwala osokoneza bongo amaletsa. Ngati kulephera kwa chiwindi kukufotokozedwera mu mawonekedwe ofooka, izi sizikhudza njira ya kuchotsa kwa metabolites; m'malo ovuta kwambiri, kudzikundikira kwawo sikuphatikizidwa.

Ndani akuwonetsedwa Glibenclamide

Hypoglycemic yakhazikitsidwa kwa odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda. Lemberani mankhwala, pokhapokha ngati zakudya zamafuta ochepa komanso minyewa yodalirika sizimapereka zotsatira zomwe mukufuna.

Mlingo ndi mankhwala

Glibenclamide tikulimbikitsidwa kuti mugwiritse ntchito mukangodya. The endocrinologist amawerengera mlingo kutengera zotsatira za kuyezetsa magazi kwa shuga, zaka za wodwalayo, kuopsa kwa matenda oyamba, matenda amtundu wa pakati komanso thanzi labwino.

Pa gawo loyamba la matendawa, muyezo wabwino ndi 2.5-5 mg / tsiku. Imwani mankhwalawa kamodzi mukatha kudya m'mawa. Ngati chiphuphu chonse cha glycemia sichingatheke, dokotala amatha kusintha mankhwalawa powonjezera 2,5 mg ya mankhwalawa patatha sabata limodzi. Mlingo wakumbuyo (mpaka 15 mg / tsiku) ndi wofanana ndi mapiritsi atatu. Mlingo wapamwamba kwambiri sakonda kutumikiridwa, ndipo palibe kuchuluka kwakukulu kwa glycemia.

Ngati wodwala matenda ashuga ali ndi kulemera kochepera 50 makilogalamu, woyamba kumwa mankhwala 2.5 mg, omwe amafanana ndi theka la piritsi. Ngati chizolowezi chatsiku ndi tsiku sichidutsa magawo awiri, amaledzera kwathunthu m'mawa pakudya kadzutsa, nthawi zina, mankhwalawa amagawidwa kawiri, m'mawa ndi madzulo muyezo wa 2: 1.

Glibenclamide ikasamutsidwa pambuyo pa chithandizo chopambana ndi mitundu ina ya mankhwala a hypoglycemic, mlingo woyambira udzakhala 2.5 mg kamodzi, m'mawa.

Mosachita bwino, mutha kusintha zomwe zimachitika mlungu uliwonse powonjezera 2,5 mg.

Ngati zotsatira za chithandizo cha mankhwala ena opatsirana pogwiritsa ntchito mankhwala osokoneza bongo sizikhutiritsa, mlingo woyambira uzikhala 5 mg m'mawa mukatha kudya. Ngati ndi kotheka, kusintha kwa 2,5-5 mg mlungu uliwonse ndikololedwa. Muyeso malire amakhalabe omwewo - 15 mg / tsiku.

Ngati mulingo wambiri watsiku ndi tsiku wa Glibenclamide, mukuwona zakudya zamafuta ochepa komanso zolimbitsa thupi zolimbitsa thupi, sizipereka chindapusa cha shuga 100, shuga imasamutsidwira ku regimen yokwanira yamankhwala. Chidakwa chachikulu chimaphatikizidwa ndi ma biguanides, insulin, ndi ena othandizira a hypoglycemic.

Ngati mankhwala amkati a shuga omwe ali ndi matenda ashuga omwe ali ndi vuto lachiwiri la matendawa atapanikizika kwathunthu, chithandizo chovuta sichikutsimikizirani zotsatira zofananazo ndi monotherapy ndi kukonzekera kwa insulin.

Ngati pazifukwa zina nthawi yoti mutenge Glibenclamide idasowa kwa ola limodzi kapena awiri, simungathe kumwa mankhwalawa mtsogolo. Mawa lotsatira, tengani mlingo wambiri, osalimbikitsa kuti muwonjezere kuchuluka kwake.

Zotsatira zoyipa

Ndi bongo wa mankhwala, hypoglycemic zikhalidwe zosiyanasiyana zovuta n`zotheka, kuphatikizapo chikomokere. Ndi kumwa mowa kwambiri ndi kamodzi kapena kawiri pa tsiku, kugwira ntchito mopitilira muyeso, mavuto a chiwindi, chithokomiro cha impso ndi impso, zotsatira zosafunikira ndizothekanso.

Contraindication pakugwiritsa ntchito mankhwala

Mankhwala opezeka mkalasi imeneyi samaperekedwa kwa anthu odwala matenda ashuga omwe ali ndi mtundu woyamba wa matenda ashuga, komanso mitundu yake yoyipa, ketoacidosis, chikomokere, matenda ashuga komanso momwe adalili kale.

Mankhwalawa sawonetsedwa kwa odwala omwe ali ndi matenda a chiwindi ndi impso, ngati ntchito yaimpso yafupika kukhala ya chini ya 30 ml / min.

Ngati wodwala matenda ashuga ali ndi chifuwa, hypersensitivity to thiazide diuretics ndi sulfonamides, dokotala amayeneranso kuganizira izi.

Panthawi ya matenda opatsirana, mankhwala ena, kuphatikizapo insulin, amalamulidwa kulipiritsa matenda a shuga. Therapy ya insulin imasonyezedwanso pakuwotcha kwambiri, kuvulala kowopsa, ndikuchita koopsa, kuphatikizapo kuphukira kwapancreatic.

Ndi mayamwidwe osauka a michere, paresis yam'mimba, matumbo kutsekeka, mankhwalawa amatsutsana.

Glibenclamine imathetsedwanso panthawi yapakati komanso yoyamwitsa.

Milandu yakuchulukirapo kwa Glibenclamide

Kugwiritsa ntchito mosamala magawo a mankhwalawa kumadzetsa vuto lalikulu la hypoglycemia, lomwe ndi loopsa pa moyo wa amene akumenyedwayo.

Zotsatira zofananazo zitha kupezeka ndikugwiritsa ntchito mankhwalawa motsutsana ndi zakudya zosakhazikika, ntchito yolimbitsa thupi, mphamvu ya mankhwala ena omwe amamwa molumikizana ndi Glibenclamide.

Zizindikiro za vuto la hypoglycemic:

• Njala yosalamulirika;
• Kuchepa kwa kugona;
• Mantha;
• Kutha;
• Kuchulukitsa thukuta;
• Mutu;
• Matenda a Dyspeptic;
• Hypertonicity;
• Kudzanja kwa dzanja;
• Tachycardia.

Kupatuka mu ntchito ya psyche yokhala ndi mavuto a endocrine kungathe kuwonetsedwa mukusokonezeka kwa chikumbumtima, kugona, kukhumudwa, kuyendetsa modekha, kusokonezeka chidwi, kuyang'ana kwambiri kawiri, kuchita mantha mukamayendetsa galimoto kapena kuwongolera njira, malo okhumudwitsa, mkwiyo, mavuto amitsempha yamagazi komanso ziwalo zopumira. chikomokere.

Onse mwamtheradi komanso osokoneza bongo, hypoglycemia imatchulidwa bwino kuyerekeza ndi mankhwala osokoneza bongo a m'badwo woyamba sulfanylurea.

Kuti muchepetse mkhalidwe wa wozunzidwayo mofatsa pang'ono pang'ono poukira, mungatengere mwachangu chakudya - maswiti, theka la kapu ya tiyi ndi shuga kapena madzi (osaneneka zotsekemera). Ngati njira zoterezi sizikwanira, shuga (40%) kapena Dextrose (5-10%) amalowetsedwa m'mitsempha, glucagon (1 mg) amalowetsedwa m'mitsempha. Diazoxide imatha kutengedwa pakamwa. Ngati wozunzidwayo amatenga acarbose, hypoglycemia ya m'mlomo imatha kuwongoleredwa kokha ndi shuga, koma osati ndi oligosaccharides.

Ngati wozunzidwa wa hypoglycemia akadali wachidziwitso, shuga amaperekedwa kuti agwiritsidwe ntchito mkati. Zikatayika, glucose amathandizidwa ndi iv, glucagon - iv, i / m komanso pakhungu. Ngati chikumbumtima chibwerera, pofuna kupewa kubwezeretsanso, munthu wodwala matenda ashuga ayenera kuperekedwa ndi zakudya zochokera ku chakudya chambiri.

Kuwunika kwa glycemia, pH, creatinine, elekitrodiya, urea nayitrogeni imayang'aniridwa nthawi zonse.

Zolemba zamankhwala ndi glibenclamide

1. Mankhwalawa akalandira mankhwala, odwala matenda ashuga ayenera kutsatira zakudya zovuta.
2. Pankhani ya matenda amitsempha yamagazi m'matumbo, chimfine, uchidakwa, mankhwalawa amayankhidwa mosamala.
3. Wodwala matenda ashuga ayenera kuyang'anitsitsa magawo ake. Mafuta a glucose amayenera kulembedwa osachepera kawiri patsiku (moyenera, mbiri ya glycemic imawunikidwa nthawi 5 / tsiku.). Mkodzo wa tsiku ndi tsiku uyenera kuyang'aniridwa kuti pakhale shuga ndi acetone.
4. Ndi hemodialysis, kusowa chakudya mutatha kumwa mankhwalawa, kuchuluka kwa thupi, kupanikizika, matenda a chiwindi ndi impso, kumwa mowa kwambiri, kusowa kwa pituitary komanso adrenal, makamaka kuphatikiza pazinthu zingapo, chiopsezo chokhala ndi glycemia yayikulu yosalamulirika. M'mikhalidwe yotere, kuwunika kosalekeza kwa ma glucometer ndi kusintha kwa mankhwalawa kwa mankhwala kumafunika.
5. Ma blockers a Β-adrenoreceptor, mankhwala omwe amawononga dongosolo lamanjenje, amatha kuphimba zizindikiro za hypoglycemia.
6. Mukakula, mankhwalawa amalimbikitsidwa muyezo wochepa (kuyambira 1 mg / tsiku), chifukwa mwayi wopeza glycemia m'gawoli ndiwokwera kwambiri chifukwa cha kufooka kwamikodzo dongosolo.
7. Pazizindikiro zoyambirira za chifuwa, mankhwalawa amathetsedwa ndipo antihistamines ndi mankhwala. Pa nthawi yonse ya chithandizo, ma radiation aukali a ultraviolet ayenera kupewedwa.
8. Pankhani ya chimfine, chibayo, poizoni, kuchuluka kwa matenda opatsirana (cholecystitis, pyelonephritis), kugunda kwa mtima ndi zina zovuta zam'mimba, NMC yayikulu, gangrene, komanso maopaleshoni akuluakulu odwala matenda ashuga, amawasokoneza insulin.
9. Pazonse, Glibenclamide sichikhudza kasamalidwe ka magalimoto, koma m'malo osazolowereka (pogwira ntchito pamavuto, kupanikizika, kutalika, ndi zina), chisamaliro chimayenera kutengedwa, popeza mkhalidwe womwe umayambitsidwa ndi kusintha kwa shuga m'magazi ungathe kupita nthawi iliyonse.
10. Kusamalidwa kwapadera kuyenera kuthandizidwa pakusintha mankhwala, kusankha mlingo woyenera, komanso kugwiritsa ntchito mankhwala mosiyanasiyana.

Glibenclamide analogues

Malinga ndi code ya ATX ya 4th ndi mankhwala a Glibenclamide match:

• Glurenorm;
• Konza;
• Amaryl;
• Gliclazide;
• Maninil;
• Glidiab;
• Glimepiride;
• Diabetes.

Monga zophatikiza pazizindikiro zosiyanasiyana, Glibenclamide ikufanana ndi mankhwala Glibex, Gilemal, Glibamide, Glidanil.

Zotsatira Zamachitidwe a Glibenclamide

Kutupa kwa glimenclamide kumachedwetsedwa, ndikumakulitsa kuthekera kwake kwa hypoglycemic, azopropanone, miconazole, kukonzekera kwa coumaric acid, oxyphenbutazone, mankhwala a sulfonamide gulu, phenylbutazone, sulfapyrazonfeniramidol.

Chithandizo chophatikizika ndi mitundu yina yochepetsera shuga, kuchepetsa kukana kwa insulin, kumawonetsa zotsatira zofananira.

Momwe amagwiritsidwira ntchito ngati mankhwala a anabolic, allopurinol, cimetidine, β-adrenoreceptor blockers, cyclophosphamide, guanethidine, clofibric acid, monoamine oxidase inhibitors, sulfonamides omwe ali ndi nthawi yayitali, salicylates, tetracyclines, mowa

Ngati barbiturates, chlorpromazine, rifampicin, diazoxide, epinephrine, acetazolamide, mankhwala ena a sympathomimetic, shuga , saluretics, mchere wa lithiamu, kuchuluka kwa mowa ndi mankhwala ofewetsa tuvi, mphamvu ya glimenclamide imachepa.

Zotsatira zosayembekezereka za kuyanjana ndi kugwiritsa ntchito kufanana zimawonetsedwa ndi otsutsana ndi H2 receptor.

Ndemanga za Glibenclamide

Pamisonkhano yamatenda, odwala matenda ashuga komanso madokotala nthawi zambiri amakambirana za momwe mitundu ingapo yamankhwala imathandizira. Omwe amapatsidwa chithandizo chamankhwala ngati mankhwalawa amadandaula kuti chiphuphu chake sichingakwaniritsidwe. Ndi zovuta mankhwala, ena amati Glibenclamide kwambiri ntchito.

Madokotala agogomezera kuti kusankha mulingo woyenera wa Glibenclamide, womwe ungakuthandizeni kukhala wathanzi kwa nthawi yayitali, kumafunikira njira yolumikizana, kumafunikira nthawi ndikuwunikira mayendedwe a glucose mamitidwe osiyanasiyana a wodwalayo. Muzochitika zotere, upangiri wa makalata sungakhale wothandiza kokha komanso ungakhale wowopsa.

Zambiri zokhudzana ndi mankhwalawa patsamba ndikutsimikizira komanso kuphatikiza, zimapezeka kuchokera kuzomwe zilipo ndipo sikuti ndizoyambitsa ndi kudziwonetsa nokha. Sadzalowe m'malo mwa uphungu wa endocrinologist.