Chithandizo cha matenda amtundu wa 2 chimaphatikizanso kuphatikiza kwa mankhwala a hypoglycemic a magulu osiyanasiyana.
Izi zimaphatikizapo zochokera ku sulfonylurea.
M'modzi mwa oimira gululi ndi chlorpopamide.
Zambiri pazamankhwala
Chlorpropamide ndichinthu chogwira ntchito chomwe ndi cha m'badwo woyamba sulfonylurea. Gulu lake la mankhwala ndi la hypoglycemic popanga othandizira. Chlorpropamide samasungunuka m'madzi, koma, m'malo mwake, sungunuka ndi mowa.
Mosiyana ndi mibadwo ina ya sulfonylurea yotuluka, chlorpropamide imachita mwachidule. Kuti mukwaniritse mulingo woyenera wa glycemia, umagwiritsidwa ntchito waukulu.
Zotsatira zoyipa za kumwa mankhwalawa zimatchulidwa kwambiri kuyerekeza ndi Glibenclamide ndi ena oimira m'badwo wachiwiri. Kugwiritsa ntchito mosakwanira kupanga mahomoni (insulin) komanso kuchepa kwa minofu yomwe imayamba kugwira ntchito. Kuchiza ndi chlorpropamide kumathandizira odwala omwe ali ndi shuga wochepa kapena / kapena matenda a shuga 2.
Chlorpropamide ndi dzina la generic generic mankhwala. Amapanga maziko a mankhwalawo (ndi gawo lina). Amapezeka m'mapiritsi.
Zotsatira za pharmacological
Mankhwalawa ali ndi vuto la hypoglycemic. Katunduyo amamangiriridwa ku njira za potaziyamu, kumalimbikitsa kubisalira kwa insulin. Mu minofu ndi ziwalo zomwe zimatengedwa ndi insulin, kuchuluka kwa zolandilira timadzi timene timawonjezera.
Pamaso pa insulin ya insulin, kuchuluka kwa shuga kumachepa. Ili ndi ntchito yotsutsana. Chifukwa chachinsinsi cha insulin, kulemera kumachitika.
Kutumiza glycemia sikudalira shuga. Chlorpropamide, monga sulfonylureas, imakhala ndi ngozi za hypoglycemia, koma pang'ono.
Akaphatikizidwa ndi othandizira ena a hypoglycemic (biguanides, thiazolidinediones, onani kuyanjana ndi mankhwala ena), mlingo wotsirizira umachepetsedwa.
Limagwirira a zochita za sulfonylurea zotumphukira
Pharmacokinetics
Pambuyo polowa m'matumbo, chlorpropamide ndimatenga bwino. Pakatha ola limodzi, chinthucho chili m'magazi, ndizofunikira zake - pambuyo pa maola 2-4. Plasma mapuloteni omangira> 90%.
Mankhwalawa amagwira tsiku lonse ngati agwiritsidwa ntchito kamodzi. Kuchotsa theka-moyo pafupifupi maola 36. Imapakidwa makamaka mumkodzo (mpaka 90%).
Zizindikiro ndi contraindication
Zizindikiro zogwiritsidwa ntchito ndi shuga osadalira insulin, komanso insipidus ya shuga. Chlorpropamide adayikidwa panthawi yomwe mankhwala amathandizira pakudya, masewera olimbitsa thupi sanabweretse zotsatira zoyenera pakuwonetsa zizindikiro.
Mwa zina zotsutsana ndi kugwiritsa ntchito mankhwalawa ndi monga:
- Hypersensitivity kuti chlorpropamide;
- Mtundu woyamba wa shuga;
- Hypersensitivity ena sulfonylureas;
- kagayidwe ndi kukondera kwa acidosis;
- matenda a chithokomiro;
- ketoacidosis;
- chiwindi ndi vuto la impso;
- matenda opatsirana pachimake;
- mimba / mkaka wa m`mawere;
- kholo ndiome;
- zaka za ana;
- mobwerezabwereza kulephera kwa chlorpropamide mankhwala;
- zinthu pambuyo pancreatic resection.
Mlingo ndi makonzedwe
Mlingo umayikidwa ndi dokotala potengera njira ya matenda ashuga komanso kupuma kwa glycemia. Mukakwaniritsa chindapusa chokhazikika wodwala, amatha kuchepetsedwa. Monga lamulo, ndi matenda a shuga a mtundu 2, chizolowezi cha tsiku lililonse ndi 250-500 mg. Ndi matenda a shuga insipidus - 125 mg patsiku. Mukasamutsidwa kupita ku mankhwala ena, kusintha kwa mankhwalawo kumafunikira.
Malangizo ogwiritsira ntchito chlorpropamide amawonetsa kugwiritsa ntchito mankhwalawa theka la ola musanadye. Ndikofunikira kudya izi nthawi imodzi. Ngati mlingo umapereka mapiritsi ochepera a 2, ndiye kuti phwando limachitika m'mawa.
Kanema kuchokera kwa katswiri wokhudza matenda ashuga komanso momwe mungathanire:
Zotsatira zoyipa ndi bongo
Zotsatira zoyipa izi zitha kuchitika pakakonzedwe ka chlorpropamide:
- kusanza, kusanza, kupweteka m'mimba, kukhumudwa;
- hypoglycemia;
- hyponatremia;
- kulawa kwazitsulo mkamwa, kusowa kwa chakudya;
- kuwonongeka kwamawonekedwe;
- zotupa za khungu losiyana;
- hemolytic anemia;
- kuchuluka kwa chiwindi;
- thrombo-, leuko-, erythro-, granulocytopenia;
- mutu ndi chizungulire;
- kuchepetsa kupsinjika;
- kufooka, kusilira, kugona, nkhawa;
- cholestatic jaundice;
- kusungunuka kwa madzi mthupi;
- anaphylactic mantha.
Ndi hypoglycemia yofatsa / yolimbitsa, wodwala amatenga magalamu 20-30 a shuga. M'tsogolomu, mlingo umasinthidwa ndikuthanso kukonzedwanso.
Woopsa milandu, limodzi ndi chikomokere, kukomoka kumachitika ndi minyewa. Kuphatikiza apo, shuga amatha kutumikiridwa kudzera m'mitsempha kapena intramuscularly. Pambuyo poyimitsa hypoglycemia patangotha masiku awiri, zizindikiro zimayang'aniridwa pogwiritsa ntchito glucometer.
Zolemba ntchito
Musanakonzekere kukhala ndi pakati, muyenera kusiya chlorpropamide. Kuwongolera matenda a shuga a mtundu wachiwiri ndi insulin kumawerengedwa kuti ndiwo njira yoyenera kwambiri. Panthawi ya mkaka, amatsatira mfundo zomwezo.
Kutumiza kwa mankhwalawa kumapangidwa kuchokera hafu ya piritsi patsiku, ndiye kuti imayikidwa piritsi loyamba. Odwala omwe ali ndi vuto laimpso / kwa chiwindi ntchito amafunika kusintha kwa mlingo. Popereka mankhwala kwa anthu achikulire, zaka zawo zimawaganiziridwa.
Mukalipira ngongoleyo, muyenera kuchepetsa mankhwalawa. Kuwongolera kumachitidwanso ndikusintha kwa thupi, katundu, kusunthira kwina.
Chifukwa cha kusowa kwa chidziwitso cha chitetezo cha mankhwalawa, mankhwalawa saikidwa kwa ana. Ngati mukuvulala, musanayambe kugwira ntchito, munthawi ya matenda opatsirana, wodwalayo amasamutsira insulin kwakanthawi.
Osagwiritsa ntchito ndi Bozetan. Pali umboni kuti zidakhudza odwala omwe adalandira chlorpropamide. Adanenanso kuwonjezeka kwa hepatic indices (ma enzyme). Malinga ndi momwe mankhwalawa amagwiritsidwira ntchito, mankhwalawo amadzimadzi amadzimadzi am'maselo amachepetsa. Izi zimaphatikizira kudzikundikira kwawo, komwe kumayambitsa poizoni.
Kuchita ndi mankhwala ena
Biguanide Metformin
Pogwiritsa ntchito nthawi yomweyo chlorpropamide ndi mankhwala ena, zotsatira zake zitha kuchepa kapena kuwonjezeka. Kufunsidwa koyenera musanamwe mankhwala ena.
Kuwonjezeka kanthu mankhwala kumachitika pamene coadministered ndi insulin, mankhwala ena hypoglycemic, biguanides, coumarin ofanana nawo, phenylbutazone, mankhwala tetracycline, Mao zoletsa, fibrates, salicylates, miconazole, streroidami, mwamuna mahomoni, cytostatics, sulfonamides, opangidwa kuchokera quinolone, clofibrate, sulfinpyrazone.
Mankhwala otsatirawa amachepetsa mphamvu ya chlorpropamide: barbiturates, diuretics, adrenostimulants, estrogens, mapiritsi akulera, Mlingo waukulu wa nicotinic acid, diazoxide, mahomoni a chithokomiro, phenytoin, glucocorticosteroids, sympathomimetics, phenothiazine.
Chlorpropamide ndi othandizira a hypoglycemic omwe amatanthauza gawo limodzi la 1 m'badwo wa sulfonylurea. Poyerekeza ndi otsatira ake, imachepetsa shuga ndikuchepetsa kwake. Pakadali pano, mankhwalawa sagwiritsidwa ntchito.
