AMARIL - MALANGIZO OGWIRITSIRA NTCHITO, MTENGO, NDEMANGA NDI FANIZO

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Malangizo Amaril malangizo ogwiritsira ntchito akupereka kuyesa ngati mankhwala am'badwo watsopano wamankhwala kuthana ndi matenda amtundu wa 2. Chimodzi mwabwino kwambiri lero chinali Glibenclamide-HB-419 kuchokera ku gulu la sulfonylurea. Oposa theka la odwala matenda ashuga omwe ali ndi mtundu wachiwiri adakumana nawo.

Amaril ndi mtundu wosinthika wa Glibenclamide, wopangidwa kuti ukwaniritse zofunikira zatsopano zowongolera "matenda okoma."

Pharmacological mawonekedwe a mankhwala

Amaryl ndi mankhwala a hypoglycemic omwe amathandiza kuwongolera dzuwa la plasma. Yogwira pophika mankhwala ndi glimepiride. Monga omwe adatsogolera, Glibenclamide, Amaril ndiwonso wochokera ku gulu la sulfonylurea, lomwe limalimbikitsa kaphatikizidwe ka insulin kuchokera ku maselo a b pancreatic a Langerhans.

Kuti akwaniritse zomwe akufuna, amatseka njira ya potaziyamu ya ATP ndi chidwi chochulukirapo. Sulfonylurea ikalumikizana ndi ma receptor omwe ali pamalimba a b-cell, zochitika za gawo la K-AT zimasintha. Kutsekedwa kwa njira za calcium ndi kuwonjezeka kwa kuchuluka kwa ATP / ADP mu cytoplasm kumatsutsa membrane depolarization. Izi zimathandizira kuti amasulidwe a calcium calcium komanso kuwonjezera kuchuluka kwa calcium.

Zotsatira za kukopa kwachidziwikire kwa ma granules achinsinsi, komwe ndi njira yotulutsira mankhwala ophatikizira pakati pa maselo, ndikutulutsa kwa insulin m'magazi.

Glimepiride ndi woimira m'badwo wachitatu wa sulfonylureas. Zimathandizira kutulutsa kwa mahomoni a pancreatic msanga, ndikuthandizira chidwi cha insulini cha mapuloteni komanso maselo a lipid.

Tizilombo tomwe timapanga mpweya umachepetsa mphamvu ya glucose pogwiritsa ntchito mapuloteni ochokera ku ma cell a cell. Ndi mtundu wodziimira payekha wa matenda a shuga, kusintha kwa shuga m'matupi kumachepetsedwa. Glimepiride imalimbikitsa kukwera kwa kuchuluka kwa mapuloteni oyendetsa ndikuwonjezera ntchito yawo. Mphamvu yamphamvu kwambiri ya kapamba imathandizira kuchepetsa kukana kwa insulin (insensitivity) kwa mahomoni.

Amaryl imalepheretsa kuphatikizika kwa glucogen ndi chiwindi chifukwa cha kuchuluka kwa kuchuluka kwa fructose-2,6-bisphosphate ndi antiaggregant (chopinga cha kupangidwa kwa thrombus), antiatherogenic (kuchepa kwa zizindikiro za "cholema" cholesterol) komanso antioxidant (kusinthika, kuthana ndi kukalamba). Njira za oxidation zimachepetsedwa chifukwa chowonjezeka pazomwe zimakhala za end-native b-tocopherol komanso ntchito ya antioxidant enzymes.

Ngakhale milingo yaying'ono ya Amaril imathandizira kwambiri glucometer.

Pharmacokinetics wa mankhwala

Popanga Amaril, gawo lalikulu lomwe limagwira ndi glimepiride kuchokera ku gulu la sulfonylurea. Povidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose ndi utoto wa E172, E132 amagwiritsidwa ntchito ngati ojambula.

Amaryl imayendetsa michere ya chiwindi 100%, kotero ngakhale kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwalawa sikuwopseza kudzikundika kwake pazinthu komanso minyewa. Zotsatira zakonzedwe, zotumphukira ziwiri za glipemiride zimapangidwa: hydroxymetabolite ndi carboxymethabolite. Metabolite yoyamba imapatsidwa mankhwala omwe amapereka chokhazikika cha hypoglycemic.

M'magazi, zomwe zimakhala pazomwe zimagwira ntchito zimawonedwa pakatha maola awiri ndi theka. Kukhala ndi bioavailability kotheratu, mankhwalawa saletsa odwala matenda ashuga posankha zakudya zomwe "adzipangira" mankhwalawo. Kuyesererako mwina konse kuli 100%.

Likukhalira kuti mankhwala pang'onopang'ono, mlingo wa kumasulidwa kwa zimakhala ndi madzi kuchokera ku mankhwala (chilolezo) ndi 48 ml / min. Kutha kwa theka-moyo kumachokera ku maola 5 mpaka 8.

Kupititsa patsogolo kwakukulu mu glycemic indices kumawonedwa ngakhale ndi zovuta ndi chiwindi, makamaka, mukulira (woposa zaka 65) komanso ndi vuto la chiwindi, kugwiritsidwa ntchito kwazomwe kumagwira ntchito ndizabwinobwino.

Momwe mungagwiritsire ntchito Amaryl

Mankhwala amapangidwa mwanjira ya mapiritsi ozungulira omwe ali ndi mzere wogawa, womwe umakulolani kuti mutha kugawa mlingo mosavuta pakati. Mtundu wa mapiritsiwo umatengera mlingo: 1 mg wa glimepiride - chipolopolo, 2 mg - khungu, 3 mg - chikasu.

Kapangidwe kameneka sikanasankhidwe mwamwayi: ngati mapiritsi amatha kusiyanitsidwa ndi mtundu, izi zimachepetsa chiopsezo cha kuchuluka mwangozi, makamaka mwa okalamba.

Mapiritsi amayikidwa m'matumba a 15 ma PC. Bokosi lililonse limatha kukhala ndi mitundu iwiri mpaka itatu.

Njira ya mankhwala ndi mankhwala ndi yayitali, ali ndi malingaliro ambiri. Mwachitsanzo, simungalumphe chakudya chotsatira mukamamwa mankhwalawo.

Zomwe mungagwiritse ntchito pa Amaril:

Piritsi (kapena gawo lake) limamezedwa lonse, kutsukidwa ndi madzi osachepera 150 ml. Mukangomwa mankhwala, muyenera kudya.
Endocrinologist amasankha dongosolo la mankhwalawa malinga ndi zotsatira za kusanthula kwa zinthu zachilengedwe.
Yambani maphunzirowa ndi ma Mlingo wocheperako wa Amaril. Ngati gawo la 1 mg patapita nthawi yochepa silikuwonetsa zotsatira zomwe zakonzedwa, mulingo umachulukitsidwa.
Mlingo umasinthidwa pang'onopang'ono, mkati mwa masabata 1-2, kotero kuti thupi likhale ndi nthawi yosinthira kuzatsopano. Tsiku ndi tsiku, mutha kuwonjezera kuchuluka kwa osaposa 1 mg. Mulingo waukulu wa mankhwalawa ndi 6 mg / tsiku. Mulingo wokhazikitsidwa ndi adokotala.
Ndikofunikira kukonza zomwe zimachitika ndikusintha kwa kulemera kwa odwala matenda ashuga kapena kuchuluka kwa mitsempha ya minofu, komanso ngati pali chiopsezo cha hypoglycemia (munthawi yanjala, kuperewera kwa chakudya, kuledzera, mavuto a impso ndi chiwindi.
Nthawi yogwiritsira ntchito komanso mlingo wake zimatengera mtundu wamoyo ndi mawonekedwe a kagayidwe. Nthawi zambiri, kamodzi pamakonzedwe a Amaril amadziwika tsiku lililonse ndi chakudya. Ngati chakudya cham'mawa chadzaza, mutha kumwa mapiritsi m'mawa, ngati chophiphiritsa - ndibwino kuphatikiza phwando ndi nkhomaliro.
Mankhwala osokoneza bongo amawopseza ndi hypoglycemia, pomwe glucose m'mimba amatsika mpaka 3.5 mol / L kapena kutsikira. Vutoli limatha kupitilira nthawi yayitali: kuchokera maola 12 mpaka masiku atatu.

Mapiritsi a Amaryl (phukusi la zidutswa 30) amapezeka kuti agulitse pamtengo:

260 rub - 1 mg aliyense;
500 rub - 2 mg aliyense;
770 rub. - 3 mg aliyense;
1020 rub. - 4 mg aliyense.

Mutha kupeza mapiritsi a mapiritsi 60, 90,120.

Mabokosi a Amaril amasungidwa kutentha firiji (mpaka madigiri 30) kwa zosaposa zaka zitatu. Zipangizo zothandizira sayenera kupezeka ndi ana.

Zina zomwe zimagwirizana ndi mankhwala

Anthu odwala matenda ashuga, makamaka "okhala ndi chidziwitso", monga lamulo, amakhala ndi zovuta zambiri zotsutsana: matenda oopsa, mtima ndi mtima, kusokonezeka kwa metabolic, impso ndi chiwindi. Ndi kitiyi, simuyenera kungomwa mankhwala ochepetsa shuga.

Pofuna kupewa nthenda yamitsempha yamagazi ndi mtima, mankhwala omwe ali ndi aspirin adayikidwa. Amaryl imachotsa phula mapuloteni, koma mulingo wake m'magazi sunasinthe. Zotsatira zonse zovuta za ntchito zovuta zimatha kuyenda bwino.

Kupititsa patsogolo ntchito AMARE Kuwonjezera yake insulin, Allopurinu, coumarin ofanana nawo, anabolic mankhwala, guanethidine, chloramphenicol, fluoxetine, fenfluramine, pentoxifylline, Feniramidolu, fibric asidi ofanana nawo, phenylbutazone, miconazole, azapropazone, probenecid, quinolones, oxyphenbutazone, salicylates, tetracycline, sulfinpyrazone, Tritocqualin ndi sulfonamides.

Amaril amachepetsa kuthekera kwa kuwonjezera Epinephrine, glucocorticosteroids Diazoxide, mankhwala othandizira, Glucagon, barbiturates, Acetazolamide, saluretics, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, ndi progestin.

Amaryl kuphatikiza histamine H2 receptor blockers, reserpine ndi clonidine imapereka zotsatira zosayembekezereka ndi madontho a glucometer mbali iliyonse. Zotsatira zomwezi zimapereka mowa ndi Amaril.

Mankhwalawa sasokoneza ntchito ya ACE inhibitors (Ramipril) ndi anticoagulant agents (Warfarin) mwanjira iliyonse.

Kugwirizana kwa Hypoglycemic

Ngati mankhwala ena aliwonse a hypoglycemic ayenera kusinthidwa ndi Amaril, muyeso wocheperako (1 mg) ndi mankhwala, ngakhale pokhapokha wodwalayo amalandira chithandizo chamankhwala chachikulu. Choyamba, momwe chamoyo cha matenda ashuga chimayang'aniridwa kwa masabata awiri, kenako mlingo umasintha.

Ngati wothandizila odwala matenda ashuga omwe ali ndi theka la moyo adagwiritsidwa ntchito pamaso pa Amaril kuti apewe kukula kwa hypoglycemia, payenera kukhala kupuma masiku angapo atachotsedwa.

Ngati wodwalayo adatha kusunga kapamba kuti apange mahomoni ake, ndiye kuti jakisoni wa insulin akhoza 100% kulowa Amaryl. Maphunzirowa amayambanso ndi 1 mg / tsiku.

Ngati njira yachikhalidwe yolipirira shuga ya Metformin sikulola kuwongolera kwathunthu shuga, 1 mg ya Amaril ikhoza kuwonjezeredwa. Ngati zotsatirazo sizikukhutiritsa, pang'onopang'ono zimasinthidwa mpaka 6 mg / tsiku.

Ngati chiwembu cha Amaril + Metformin sichinakwaniritse zoyembekezeredwa, chimasinthidwa ndi Insulin, ndikukhalabe chizolowezi cha Amaril. Jakisoni wa insulin amayamba ndi mlingo wochepera. Ngati zizindikiro za glucometer sizili zolimbikitsa, onjezani kuchuluka kwa Insulin. Kugwiritsanso ntchito limodzi kwamankhwala kumakhalabe koyenera, chifukwa zimakupatsani mwayi wochepetsa mphamvu ya mahomoni ndi 40% poyerekeza ndi mahomoni oyera.

Kuphatikiza pa Amaril, endocrinologist amakhalanso ndi njira zosankha: Amaperid, Glemaz, Diapyrid, Diameprid, Glimepiride, Diagliside, Reclide, Amix, Glibamide, Gllepid, Glayri, Panmicron, Glibenclamide, Gligenclad, Glliblik Dim, Dllimlik Dim Glimaril, Glyclazide, Manil, Maninil, Glimed, Glioral, Olior, Glynez, Glyrid, Gluktam, Glypomar, Glyrenorm, Diabeteson, Diabresid.

Kwa iwo omwe adapangidwira, ndipo omwe mankhwalawo sanalimbikitsidwe

Mankhwalawa adapangira zochizira matenda a shuga a mtundu wachiwiri. Amagwiritsidwa ntchito limodzi ndi monotherapy komanso mu zovuta kuchipatala motsatana ndi Metformin kapena Insulin.

Gawo logwira ntchito la Amaril limathetsa zotchinga za placenta, ndipo mankhwalawa amapatsanso mkaka wa m'mawere. Pachifukwachi, sioyenera amayi oyembekezera komanso ongoyamwa. Ngati mayi akufuna kukhala mayi, ngakhale asanakhale ndi pakati pa mwana, ayenera kusamutsidwira ku majakisoni a insulin popanda Amaril. Kwa nthawi yakudyetsa, nthawi zoyenera zimasungidwa, ngati pakufunika chithandizo ndi Amaril, kuyamwitsa kuyimitsidwa.

Kugwiritsira ntchito mankhwalawa odwala matenda ashuga komanso vuto lomwe lakhalapo pambuyo pa chikomokere ndilosavomerezeka. M'mavuto akulu a matenda ashuga (monga ketoacidosis), Amaryl sawonjezedwa. Mankhwalawa sioyeneranso kwa odwala matenda ashuga okhala ndi mtundu woyamba wa matenda.

Ndi magwiridwe antchito a impso ndi chiwindi, Amaril siothandiza, Amaril sakutchulidwa hem hemalalitis ndi matenda ashuga, komanso munthu payekha tsankho glipemiride kapena mankhwala ena a sulfonamide ndi sulfonylurea.

Ndi matumbo paresis kapena m'matumbo, kutsekeka kwa mankhwalawa kumasokonezeka, kotero Amaril sakulamula mavuto ngati awa pakukula. Amafuna kusinthana ndi insulin ndi kuvulala kambiri, maopaleshoni, matenda otentha kwambiri, kutentha kwambiri.

Amaril akhoza kukhala limodzi ndi hypoglycemic zimachitika. Nthawi zina odwala amadandaula chifukwa cha chizungulire, ena amachulukitsa kugona, pamakhala manjenjenje, thukuta kwambiri, komanso vuto lakulankhula. Mu matenda a shuga, nthawi zambiri mumakhala njala yosalamulirika, matenda osokoneza bongo, chisangalalo m'dera la chiwindi. Kutheka kwa vuto la mtima, chotupa pakhungu. Kutuluka kwa magazi nthawi zina kumangokulira.

Ndi matenda a shuga a 2, ndikofunikira kuwongolera momwe mungayambire Amaril, ndikutheka kwa hypoglycemia, kusintha kwa zakudya ndi zolimbitsa thupi.

Zotsatira za bongo

Kugwiritsa ntchito mankhwalawa kwakanthawi, komanso kumwa mopitirira muyeso, kumayambitsa hypoglycemia, zomwe zimafotokozedwa m'gawo lakale.

Wodwala matenda ashuga ayenera kukhala ndi cholembera chofotokoza bwino za matenda ake komanso china chake chochokera ku chakudya chambiri (maswiti, makeke). Madzi okoma kapena tiyi ndiwofunikanso, pokhapokha popanda zotsekemera zotengera. Woopsa, wodwalayo ayenera kuchipatala mwachangu kuti atulutsidwe chapamimba ndikuwongolera kwa odzipereka (adamulowetsa kaboni, zina ndi zina).

Zotsatira zoyipa

Nthawi zina, kugwiritsa ntchito Amaril kumayendera limodzi ndi zotsatira zoyipa mwanjira ya kutaya kwamaso, mavuto ndi njira yoyendera magazi, matenda a metabolic, matenda am'mimba.

Mwa zina zofala:

Glycemic syndrome, yodziwika ndi kuchepa mphamvu, kuwonongeka m'maganizo, kutaya masomphenya, arrhythmia, njala yosalamulirika, thukuta kwambiri.
Kusiyana kwazomwe zikuwonetsa shuga, zomwe zimapangitsa kuwonongeka kwa mawonekedwe.
Matenda a dyspeptic, kuphwanya mtundu wa defecation, ndikusowa mankhwala akachotsedwa.
Thupi lanu losiyanasiyana zovuta (zotupa pakhungu, kuyabwa, ming'oma, matumbo osavomerezeka, anaphylactic kugwedezeka, kuthamanga kwa magazi komanso kufupika kwa mpweya).

Kutenga Amaril kumakhudza kuthamanga kwa ma psychomotor reaction - kuyendetsa galimoto, komanso ntchito yofunikira kuti isamalidwe, makamaka koyambirira kwa chithandizo, sikugwirizana ndi Amaril chithandizo.

Maganizo a madokotala ndi odwala matenda ashuga okhudza Amaril

Ndemanga za a endocrinologists omwe amakumana ndi mawonetseredwe onse amatsenga omwe ali ndi vuto kwambiri, ali ndi mwayi wophunzira momwe odwala amathandizira kuti adziwe momwe amagwirira ntchito.

Malinga ndi madotolo, ndi njira yabwino yochiritsira, Amaril amathandizira kuti matenda a glycemic asinthidwe mwachangu kwambiri. Anthu odwala matenda ashuga omwe amamwa mankhwalawa amakhala ndi zodandaula za hypoglycemia pamene mulingo wosankhidwa bwino. Ndipo komabe, zokhudzana ndi mankhwala Amaril, ndemanga za odwala ndi zabwino.

Zinchenko A.I. Ndakhala ndikulimbana ndi matenda ashuga a 2 kwa zaka 7. Anakumana ndi mankhwala ambiri - kuyambira Metformin ndi Novonorm mpaka Insulin. Ndikutenga 2 mg ya Amaril tsopano. Kuti adokotala amvetsetse ngati mankhwalawo ndi oyenera kwa ine, ndimayeza shuga kangapo patsiku. Ndi magome awa, kuwerenga kwa mita kudatsika mpaka 4,6 mmol / L. Pofunsidwa komaliza, adatsitsa muyeso wanga ndikufotokozera kuti mankhwalawa amagwira ntchito m'njira ziwiri: imayang'anira kutulutsa kwa insulin yake ndikuthandizira chiwindi kuti chisinthe glucose kukhala glycogen yotetezeka.

Kovaleva Irina. Monga wodwala matenda ashuga ndimatha kumwa Amaril kale muyezo wa 3 mg. Kubwezera kotereku nthawi zina kumandilola kuchimwa ndikudya (supuni ya uchi kapena ayisikilimu kamodzi pa sabata). Sindikonda kukoma kwa zotsekemera, kotero ndimayesetsa kuchita popanda iwo. Ngati mita yandiwonetsa mtundu wa shuga masiku angapo, ndimasiya kumwa mapiritsi, ndimayesa kusintha zitsamba ndikukhometsa zakudya zanga. Ndikukhulupirira kuti mapiritsiwo adandithandizanso kutaya makilogalamu 8 owonjezera.

Zakudya zama carb otsika, masewera olimbitsa thupi, kuwongolera kunenepa kwambiri. Wodwala matenda ashuga ayenera kudziwitsa endocrinologist mu nthawi yokhudza mavuto, zizindikiro za hypo- ndi hyperglycemia zomwe zimachitika ndi Amaril.

Chithandizo chimaphatikizanso kudziyang'anira pawokha mayendedwe a shuga ndikuwunika ntchito za chiwindi, mayeso a labotale, makamaka kuyesa kwa hemoglobin ya glycated, yomwe masiku ano imadziwika kuti ndiyo njira yoyesera kwambiri yotsimikizira momwe wodwala alili ndi matenda a shuga. Izi zikuthandizira kuzindikira mulingo wokana Amaril pakukonzanso njira zamankhwala.

Mutha kuphunzira za zina za Amaril kuchokera video.

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