Glibenclamide: malangizo ogwiritsira ntchito othandizira a hypoglycemic

Glibenclamide ndi mankhwala a m'kamwa a hypoglycemic okhudzana ndi zotumphukira sulfonylureas. Limagwirira ntchito glibenclamide limakhudzanso kukondoweza kwa secretion insulin β maselo mkati kapambapowonjezera kutulutsidwa kwa insulin. Kwambiri, kufunikira kwake kumawonekera mu gawo lachiwiri la kupanga insulini. Izi zimawonjezera chidwi cha zotumphukira kuti ziwonjezere insulin, komanso kulumikizana kwake ndi maselo ojambulidwa. Kuphatikiza apo, glibenclamide imadziwika ndi mphamvu ya lipid yotsitsa komanso kuchepa kwa katundu wa thrombogenic magazi.

Mkati mwa thupi, kuyamwa mwachangu komanso kwathunthu kwa zinthuzo m'mimba mwake. Kuyankhulana ndi mapuloteni a plasma kumafanana ndi 95%. Kupenda mankhwalawa ikuchitika mu chiwindi, zomwe zimapangitsa kupangika kwa osagwira ntchito metabolites. Excretion amapezeka makamaka mu mkodzo ndi gawo - bile, mu mawonekedwe a metabolites.

Contraindication

Mankhwala osavomerezeka kuti agwiritsidwe ntchito ndi:

• Hypersensitivityto Glibenclamide kapena sulfonamides ndi thiazide okodzetsa,
• odwala matenda ashuga kapena okoma,
• ketoacidosis,
• kuwotcha kwakukulu
• kuvulala ndi kuchitapo kanthu,
• Matumbo ndi matumbo a m'mimba,
• Zakudya zamitundu mitundu.
• chitukuko achina,
• kuyamwa, kutenga pakati,
• matenda ashugaMtundu 1 ndi zina zotero.

Zotsatira zoyipa

Mankhwala ndi Glibenclamide, kukulitsa kwa zosafunikira zomwe zimakhudza ntchito ya endocrine, m'mimba, mantha, zotumphukira ndi hematopoietic system ndizotheka. Chifukwa chake, zitha kuoneka: hypoglycemiakusiyanasiyana kosiyanasiyana nseru, kutsegula m'mimbachiwindi ntchito, cholestasis, mutukufooka ndi kutopa chizungulire.

Kuwonetsedwa kwa thupi lawo siligwirizana komanso kukhudzana kwa matumbo mu mawonekedwe a: zotupa pakhungu, kuyabwa, photosensitization ndi zizindikiro zina ndizothekanso.

Malangizo ogwiritsira ntchito Glibenclamide (Njira ndi Mlingo)

Malangizo ogwiritsira ntchito Glibenclamide akuti mlingo wa mankhwalawa umakhazikitsidwa payekhapayekha ndipo zimatengera zaka, kuopsa kwa matendawa komanso msinkhu glycemia. Mapiritsi amatengedwa pakamwa, pamimba yopanda kanthu kapena maola awiri mutatha kudya.

Akuluakulu tsiku lililonse mlingo amakhala 2,5-15 mg, ndi pafupipafupi makonzedwe 1-3 patsiku.

Mlingo watsiku ndi tsiku pamwamba pa 15 mg sagwiritsidwa ntchito kawirikawiri, popanda kuwonjezeka kwakukulu mu zotsatira za hypoglycemic. Okalamba odwala amapatsidwa mlingo wa 1 mg kumayambiriro kwa mankhwalawa. Kusintha konse kuchokera ku mankhwala kupita kwina, kusintha kwa mlingo ndi zina, kuyenera kuchitika moyang'aniridwa ndi katswiri.

Bongo

Ngati bongo, kukula kwa hypoglycemia ndikotheka, komwe kumatha kuyenda ndi kumverera kwa njala, kufooka, nkhawa, mutu, chizungulire, thukuta, kugunda kwa mtimaminofu ikunjenjemera ubongo edemamalankhulidwe ndi masomphenya ndi zina zotero.

Chithandizo chimaphatikizapo kudya shuga mwachangu, msuzi wa zipatso, tiyi wowotcha otsekemera, madzi a chimanga, uchi - wofatsa.

Milandu yayikulu imafuna yankhoshuga 50% kulowetsedwa kosalekeza mu yankho la mitsempha Dextrose 5-10%, kuyambitsa Glucagon kudzera m'mitsempha Diazoxide mkati. Kuphatikiza apo, muyenera kuyang'anira kuchuluka kwa glycemia, kudziwa pH, creatinine, urea nayitrogeni, ma electrolyte.

Kuchita

Kuphatikiza ndi mankhwala antifungal mankhwala, fluoroquinolones, tetracyclines, chloramphenicol, H2-blockers, beta-blockers, ACE zoletsa ndi Mao,clofibrate, bezafibrate, probenecid, Paracetamol, ethionamide, anabolic steroids, pentoxifylline, allopurinol, cyclophosphamide, Reserpine, sulfonamide ndi Insulin amatha kuphatikiza hypoglycemia.

Ntchito mogwirizana barbiturates, phenothiazines, diazoxide, glucocorticoid ndi mahomoni a chithokomiro, estrogens, gestagens, glucagons, mankhwala a adrenomimetic, Mchere wa lithiamu, zotumphukira za nicotinic acid ndi saluretics itha kufooketsa mphamvu ya hypoglycemic.

Njira zomwe zimatha kuphatikiza mkodzo, mwachitsanzo: calcium chloride, ammonium chlorideMlingo waukulu ascorbic acid imatha kuwonjezera mankhwalawa. Kuphatikiza ndi Rifampicin imathandizira inactivation ndikuchepetsa kugwira ntchito kwake.

Malangizo apadera

Ndikulimbikitsidwa kuthandiza odwala omwe ali ndi vuto la chiwindi ndi impso, omwe ali ndi mavuto, matenda a adrenal gland kapena chithokomiro, komanso uchidakwa.

Kwa njira yonse yothandizira odwala, kuwunika mosamala kuchuluka kwa shuga m'magazi ndi kutulutsa shuga ndikofunikira.

Ngati hypoglycemia ikukula mwa odwala omwe ali ndi chikumbumtima, ndiye kuti shuga kapena shuga amapatsidwa pakamwa. Zikatere, chikumbumtima chimaperekedwa kudzera m'mitsempha, ndipo glucagon - kudzera m'mitsempha, mozungulira kapena kudzera mu mtsempha.

Munthu akachira, nthawi yomweyo wodwalayo amapatsidwa chakudya chambiri kuti apewe kuchepa kwa magazi pafupipafupi.

Kupanga ndi mafomu omasulira

Mu 1 tabu. mankhwala a antidiabetesic ali ndi 1.75 mg, 3.5 mg kapena 5 mg pazomwe zimagwira, zomwe ndi glibenclamide.

Komanso mumankhwala mulipo:

• Povidone
• Lactose Monohydrate
• Wowuma wa mbatata
• Magnesium wakuba
• Ponceau 4R.

Mapiritsiwo ndi ozungulira, amtundu wapinki pamtundu, amatha kutuluka. Mankhwalawa amapezeka mu botolo lagalasi lomwe lili ndi mapiritsi a 120, buku lina lowonjezera limasungidwa.

Kuchiritsa katundu

Ndizofunikira kudziwa kuti dzina la malonda a mankhwalawa limagwirizana ndi dzina la chinthucho. Mankhwalawa ali ndi vuto la hypoglycemic onse omwe ali ndi matenda a shuga 2, komanso anthu athanzi. Limagwirira ntchito limapangidwa chifukwa cha kuchuluka kwa insulini ndi β-cell ya kapamba chifukwa cha kukondoweza. Zoterezi zimatengera, choyamba, pamlingo wa glucose omwe amakhala pakati pa β-cell.

Mutatha kumwa mapiritsi, mphamvu yogwira imathamanga ndipo imafikira. Ndi chakudya, palibe kuchepa kwakukulu kwa kuchuluka kwa mayamwidwe a glibenclamide. Chizindikiro cha kulumikizana ndi mapuloteni a plasma ndi 98%. Kwambiri kuzungulira kwa chinthu mu seramu kumachitika pambuyo 2,5 maola. Kuchepa kwa kuchuluka kwa glibenclamide kulembedwa pambuyo pa maola 8-10 ndipo zimatengera mlingo wa mankhwala omwe wodwala amamwa. Kutha kwa theka la moyo kuli pafupifupi maola 7.

Kusintha kwa metabolism kwa glibenclamide kumachitika m'maselo a chiwindi, metabolites amapangidwa, omwe satenga nawo gawo pakuchepetsa mphamvu ya shuga yogwira ntchito. Kupukusa kwa zinthu za metabolic kumachitika ndi mkodzo, komanso ndi ndulu wofanana, kutulutsa kotsiriza kwa metabolites kumachitika pambuyo pa maola 45-72.

Anthu omwe ali ndi vuto la chiwindi, akuchedwa kuwonetsa glibenclamide. Odwala aimpso kulephera, chindapusa ofooka metabolites mwachindunji mu mkodzo kumawonjezera compensatory.

Malangizo ogwiritsira ntchito mapiritsi

Mtengo: kuchokera pa ma ruble 56 mpaka 131.

Mlingo wa mankhwalawa amatsimikiziridwa payekha poganizira zaka za wodwala, glycemia, komanso kuopsa kwa matendawa. Ndikulimbikitsidwa kumwa mapiritsi pamimba yopanda kanthu kapena mutatha kudya maola awiri mutatha kudya.

Nthawi zambiri, avareji ya tsiku ndi tsiku imasiyana pakati pa 2,5 mg - 15 mg. Pafupipafupi kugwiritsa ntchito mapiritsi ndi 1-3 p. tsiku lonse.

Kulandila kwa Mlingo wa tsiku ndi tsiku wa 15 mg ndipo pamwambapa mumawonetsedwa kwambiri, sikuti kumawonjezera kuchuluka kwa mankhwalawa. Okalamba amalimbikitsidwa kuti ayambe kulandira chithandizo cha 1 mg patsiku.

Kusintha kuchokera ku mankhwala amtundu wa antiidiabetes kapena kusinthanso kwa mankhwalawa kuyenera kuchitika moyang'aniridwa ndi dokotala.

Njira zopewera kupewa ngozi

Zochizira zochiritsira ziyenera kuchitika pang'onopang'ono kuwunika shuga ndi mkodzo.

Pa chithandizo, muyenera kukana kumwa zakumwa zoledzeretsa, chifukwa kupanga kwa hypoglycemia, komanso mawonekedwe a disulfiram-ngati, sikuchotsedwa.

Zizindikiro za hypoglycemia zikawoneka, zidzakhala zofunikira kulipirira kusowa kwa shuga mwa kukamwa kwa dextrose. Pofuna kukhala osazindikira, dextrose imaperekedwa kudzera m'mitsempha. Popewa kuyambiranso, ndikofunikira kulemetsedwacho ndi chakudya.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi: flat-cylindrical, okhala ndi mzere wogawika, oyera kapena oyera oyera otuwa kapena achikuda (ma PC 10. M'matumba, pabokosi la 1, 2, 3 kapena 5 mapepala, 20, 30 kapena 50) mu zitini zopangidwa ndi polima kapena galasi lakuda, pamtundu wa makatoni 1 akhoza).

The yogwira ndi glibenclamide, piritsi 1 - 5 mg.

Zothandiza: lactose monohydrate (mkaka wa shuga), magnesium stearate, povidone (ochepa maselo olemera polyvinylpyrrolidone medical), wowuma wa mbatata.

Pharmacokinetics

Mukamamwa pakamwa, glibenclamide imatenga gawo la 48-84% m'mimba. Pazitali kwambiri pazinthu zimatheka patadutsa maola 1-2 pambuyo pokhazikitsa. Kuchuluka kwa magawa ndi malita 9-10. Glibenclamide imamangiriza mapuloteni a plasma ndi 95-99%. Yake bioavailability ndi 100%, kotero mankhwalawa amatha kumwa nthawi yomweyo asanadye.

Glibenclamide imalowa molakwika kudzera mu chotchinga (placental barriers) ndipo pafupifupi imapangidwira kwathunthu m'chiwindi, ndikupanga ma metabolites awiri osagwira ntchito, omwe amachokera mu ndulu, ndipo enawo mumkodzo. Kuchotsa theka moyo kumasiyana 3 mpaka 10-16 maola.

Malangizo ogwiritsira ntchito Glibenclamide: njira ndi mlingo

Mapiritsi amatengedwa pakamwa 20-30 mphindi asanadye kapena maola awiri atatha kudya.

Dokotalayo amamulembera aliyense payekha matendawa, molingana ndi kuopsa kwa matenda ashuga, msinkhu wodwala komanso kuchuluka kwa glycemia.

Pafupifupi tsiku lililonse mlingo kuyambira 2,5 mpaka 15 mg, ndi pafupipafupi makonzedwe a 1-3. Nthawi zina, mankhwalawa amagwiritsidwa ntchito muyezo wa 15 mg patsiku, sizikhudza kwambiri kuwonjezeka kwa vuto la hypoglycemic.

Mlingo woyambirira wa odwala okalamba ndi 1 mg patsiku.

Mlingo woyamba wa mankhwalawa posintha kuchokera ku Biguanides ndi 2.5 mg patsiku.

Kubwezera kuphwanya kwa kagayidwe kazakudya pambuyo pakuchotsa kwa greatuanides, mlingo wa glibenclamide, ngati pakufunika, utha kuwonjezeka ndi 2.5 mg tsiku lililonse la 5-6. Kusintha kwa mankhwala ophatikiza ndi glibenclamide ndi biguanides kuyenera kukonzedwa pokhapokha ngati pakubwezeretsedwedwa mkati mwa milungu isanu ndi umodzi.

Zotsatira zoyipa

Kugwiritsa ntchito mankhwalawa kungayambitse zotsatirazi:

• Kuchokera ku dongosolo la endocrine: hypoglycemia mpaka chikomokere (mankhwala olondola, kutsatira mankhwalawa komanso zakudya zimachepetsa kukula kwake),
• Kuchokera kumachitidwe amanjenje: kawirikawiri - kupweteka mutu, chizungulire, kutopa, paresis, kufooka, kusamva bwino,
• Kuchokera mmimba: kumverera kolemetsa mu epigastric dera, nseru, kutsegula m'mimba, kawirikawiri - cholestasis, matenda a chiwindi,
• Kuchokera ku hemopoietic dongosolo: kawirikawiri - hematopoiesis, kukula kwa pancytopenia,
• Thupi lawo siligwirizana: kuyabwa, zotupa pakhungu,
• Dermatological zimachitika: kawirikawiri - photosensitivity.

Madokotala amawunika za glibenclamide

Mwa mankhwala ambiri omwe amadziwika kuti amathandizira odwala matenda a shuga, monga lamulo, amtundu wa 2-1, odwala adazindikira kuti Glibenclamide ikuyenda bwino. Ndinafunika kulumikiza mankhwala ena.

Malingaliro osokoneza okhudza mankhwalawo. Wina amakhala ndi mankhwalawa, wina alibe. Payekha, muyenera kuthetsa nkhaniyi ndi dokotala.

Ndemanga za odwala a Glibenclamide

Posachedwa, bambo anga adadwala matenda amtundu wa 2. Adagonekedwa kuchipatala chifukwa chobwezeredwa kwambiri. Panali 14. shuga ya magazi. Wopanga ma endocrinologist adalemba kugwiritsa ntchito metformin ndi glibenclamide (sindikukumbukira mayina omwe amagwiritsidwa ntchito pa mankhwala). Abambo anga akhala akugwiritsa ntchito mankhwala osokoneza bongo kwa miyezi itatu patsiku. Kwina patadutsa sabata atayamba kugwiritsa ntchito mankhwalawa, ndidayamba kudandaula za kupuma mseru nthawi zonse, koma, malinga ndi iye, izi sizofunika kwambiri poyerekeza ndikuti mankhwalawa amasungabe kuchuluka kwa shuga pa 6-7 (timagwiritsa ntchito glucometer nthawi zonse), kotero bambo anga akumva zokhutiritsa.

Matenda anga a shuga ali ndi zaka 5. Poyamba anali kuthandizidwa ndi metformin, koma sizinayende bwino - kunalibe zotsatirapo zoyipa, koma palibe zopambana zilizonse potengera matenda a shuga. Ndipo izi ngakhale kuti ndidakweza kawiri mlingo. Kenako zaka 2 zapitazo ndidasankhidwa glibenclamide, ndikuwonjezera pa metformin, ndipo kuyambira pamenepo zinthu zasintha. Palibe zotsatira zoyipa, koma zimamveka bwino ndipo shuga nthawi zambiri amakhala ochepera 7.

Osati kale kwambiri, ndimadwala, pafupifupi zaka 3-4, nditapezeka mwangozi pazachipatala, sindinkaganiza kuti nditha kudwala matenda ashuga. Tsopano ndine mlendo wokhazikika mumzinda wa Essentuki ndi njira zamankhwala. Koma ndimatenganso Glibenclamide, panjira, mankhwalawa adandilembera kuno mumzinda uno, adanena kuti anali othandiza kwambiri ndipo andithandiza. Ndinkamwa mankhwala ena omwe amachepetsa shuga m'magazi. Poyamba, ndinali ndi zotsatirapo zamtundu wa mseru komanso m'mimba, koma nditatha kugwiritsa ntchito nthawi yayitali, adayamba kutha, mwachidziwikire, adazolowera mankhwalawa. Koma koposa zonse, kuchuluka kwa shuga kumachepetsedwa kwambiri mukamamwa mankhwalawo, omwe amalembedwa ndi glucometer komanso thanzi labwino tsiku lonse.

Ndakhala ndikudwala matenda ashuga kwa zaka zoposa 15. Ndinayesa mankhwala osiyanasiyana ochepetsa shuga, koma Glibenclamide akadali woyenera kwambiri kwa ine. Zotsatira zoyipa za mseru komanso kusowa kwa chakudya m'masabata oyambilira, ndiye zonse zidatha. Amachepetsa shuga bwino ndikukula ndikukulolani kuti muzichita bwino. Zovuta zokhazokha - muyenera kuyeza shuga nthawi zonse. Koma kwa ine kwakhala chizolowezi monga chizolowezi.

Kufotokozera kwapfupi

Mankhwala ochepetsa shuga a glibenclamide mu kapangidwe kake ka mankhwala ndi am'badwo wa 2 wa zotuluka za sulfonylurea. Ndi "kuchepa" kwazonse zamankhwala izi (ndipo muzochita zamankhwala zakhala zikugwiritsidwa ntchito kuyambira 1969), kudalirika kwake komanso chidziwitso chake zimakulirakulirabe mpaka pano. Osangokhala kwinakwake kuseli, koma kukhala imodzi mwazithandizo zodziwika bwino zamatenda a shuga a 2. M'mayeso a labotale ndi zamankhwala, glibenclamide akadali muyeso wowunika momwe zinthu zatsopano zimapangidwira komanso njira zothandizira antidiabetic mankhwala, ndikuwonetsa katundu watsopano wopindulitsa. Makina a hypoglycemic zochita za glibenclamide, komanso mankhwala ena a gululi, adawerengera momwe amafotokozedwera molekyulu: mankhwalawa amalepheretsa mapangidwe a potaziyamu a cell a pancreatic which, omwe amachititsa kuti magawo a calcium apangidwe mu cell, omwe amachititsa kuti magawo a cell apangidwe ndi insulin ndi kumasulidwa kwa yotsirizira m'magazi ndi madzi othandizira. Mwa zonse zotumphukira za sulfonylurea, glibenclamide imakhala ndi mgwirizano wodziwika bwino kwambiri wolandila ma cell β maselo komanso mphamvu yamphamvu kwambiri ya hypoglycemic pakati pa zotumphukira zonse za sulfonylurea. Kutulutsa kwa insulini ndikofunikira kwambiri, ndiye kuchuluka kwa mtundu wovomerezeka wa mankhwalawo.Mankhwala onse a gawoli alinso ndi zomwe zimatchedwa zowonjezera-pancreatic, zomwe zimapangitsa kuti zotumphukira zimveke kwambiri ndi insulin komanso kusintha glucose komwe kumachitika ndi adipose ndi minofu minofu.

Izi zimathandizira kuti mayamwidwe ena azikhala ndi minofu (werengani: kutsitsa glycemia).

Chifukwa chake, glibenclamide, malinga ndi njira zingapo, imakhalabe yopikisana. Choyamba, ndiko kuchita bwino komwe kumatsimikiziridwa ndi kuyeseza kwa nthawi yayitali. Mankhwalawa amalepheretsa kufulumira kwa matenda ashuga, kuphatikiza myocardial infarction ndi microvascular complication. Glibenclamide imaphatikizidwa bwino ndi mankhwala ena, mwachitsanzo, metformin, ndipo ngati chiphuphu chakubala sichikwaniritsidwa, zotsatira zabwino zitha kupezeka kuchokera kuphatikiza kwapakati pa metformin + glibenclamide + glitazone. Glibenclamide imagwiritsidwa ntchito bwino kwa odwala okalamba omwe ali ndi "maluwa" a matenda oyanjana. Ndipo zomwe ndizofunika (komanso kwa anzathu ambiri - ofunikira kwambiri), mankhwalawa amapezeka kuchokera pamalingaliro azachuma. Ndiotsika mtengo kuposa "anzawo" ena amakono polimbana ndi matenda ashuga.

Mukamatenga glibenclamide, ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga chifukwa choopsa cha kusokonezeka kwa hypoglycemic. Ngati hypoglycemia "yaphimba" wodwalayo yemwe wamwa mankhwalawo, ndiye kuti ndikofunikira kuonetsetsa kuti glucose amalowa m'thupi mwake (pakamwa kapena jekeseni, kutengera mkhalidwe wake wodziwa). Kapenanso, sungani zakudya zamafuta ochulukirapo nthawi zonse.

Pharmacology

Oral hypoglycemic wothandizira, yemwe amapezeka m'badwo wachiwiri. Imayendetsa katulutsidwe ka insulin ndi β-cell ya kapamba, kumawonjezera kutulutsidwa kwa insulin. Machitidwe makamaka pa gawo lachiwiri la insulin. Zimawonjezera chidwi cha zotumphukira zimakhala ku insulin komanso kuchuluka kwake komwe kumamangiriza kulinga maselo. Imakhala ndi hypolipidemic kwambiri, imachepetsa magazi a magazi.

Kuchita mankhwala osokoneza bongo

Mankhwala a antimycotic oficic action, ethionamide, fluoroquinolones, Mao ndi ACE zoletsa, H2-blockers, NSAIDs, mankhwala a tetracycline, paracetamol, insulin, anabolic steroid mankhwala, cyclophosphamide, β-adrenergic blockers, clofibrate, reserpilamin, prober allopurinol, paracetamol, komanso chloramphenicol amatha kukulitsa zovuta za hypoglycemia.

Ma COC, barbiturates, glucagon, saluretics, kukonzekera malinga ndi mchere wa lithiamu, diazoxide, zotuluka za nicotinic acid, phenothiazines, komanso mankhwala a adrenomimetic amachepetsa mphamvu ya gloglycemic ya glibenclamide.

Zimatanthawuza kuti mkodzo wa asidi umakulitsa mphamvu ya mankhwalawa.

Rifampicin amalimbikitsa inactivation wa yogwira mankhwala ndipo amachepetsa ake achire zotsatira.

Mlingo ndi makonzedwe

Mlingo amasankhidwa payekha. Mkati, mphindi 20-30 musanadye, kumwa madzi ambiri. Mlingo woyamba ndi 2,5 mg / tsiku. Ngati ndi kotheka, mlingo umakulitsidwa pang'onopang'ono ndi 2,5 mg pa sabata kuti athe kulipira chakudya cha metabolism. Njira yokonza tsiku ndi tsiku ndi 5-10 mg, pazipita ndi 15 mg. Kwa odwala okalamba, muyeso woyamba ndi 1 mg / tsiku. Pafupipafupi oyang'anira ndi katatu pa tsiku.

Mafotokozedwe a magulu a nosological

Mitengo mumaofesi a mankhwala ku Moscow

Siyani ndemanga yanu

Chidziwitso Chaposachedwa Chosowa Chidziwitso, ‰

Amalembetsa Mankhwala Ovuta Komanso Ofunika

Satifiketi zokulembetsa za Glibenclamide

• LP-003742

• LP-000933

• FS-000940

• LS-002499

• P N014959 / 01-2003

• LSR-008753/09

• LS-000992

• LS-002056

• LS-001139

• P N002907 / 01

• P N001630 / 01-2002

• P N013959 / 01-2002

• P N012149 / 01-2000

• P N012093 / 01-2000

• P N011705 / 01-2000

• P N011400 / 01-1999

• S-8-242 N011172

• 010027

• 95/370/3

• 82/374/1

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Maumwini onse ndi otetezedwa.

Kugwiritsa ntchito malonda pazinthu sikuloledwa.

Chidziwitsochi cholinga chake ndi akatswiri azachipatala.

Kuyanjana kwa mankhwala osokoneza bongo

Kugwiritsa ntchito munthawi yomweyo sulfonamides, ma beta-blockers, allopurinol, ma anabolic othandizira, cimetidine, cyclophosphamide, clofibrate, isobarin, monoamine oxidase inhibitors (MAOs), salicylates, tetracyclines, ndi chloramphenicol amatha kupititsa patsogolo mphamvu ya mankhwala.

Glibenclamide ikhoza kuchepa komanso chiwopsezo cha kukhala ndi hyperglycemia mwa odwala omwe amatenga nthawi yomweyo chlorpromazine, barbiturates, diazoxide, phenothiazines, phenytoin, acetazolamide, glucocorticoids, glucagon, mankhwala a sympathomimetic, indomethacin, kuchuluka kwa mankhwala osokoneza bongo, ma salicepital. , mahomoni a chithokomiro, Mlingo wambiri wa mankhwala amphumo.

Ma analogi a Glibenclamide ndi awa: Glibeks, Glibamid, Gilemal, Glidanil, Betanaz, Antibet, Manin, Maninil, Maniglide.

Zisonyezero zakudikirira

Mtundu wachiwiri wa matenda ashuga ndi matenda opita patsogolo omwe amafunikira chithandizo chanthawi zonse. Ngakhale mikhalidwe yolamulira bwino glycemic, ntchito ya maselo a beta imangokulira pang'onopang'ono mwa odwala ndipo ma insulini kupanga mwa iwo amachepa. 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 odwala matenda ashuga, omwe maselo abwinobwino sangathe kudzichitira okha komanso abale omwe adafa, amayenera kuyika mankhwala achinsinsi. Zimathandizira kapangidwe ka insulin, ndikupangitsa maselo kugwira ntchito mwachangu.

Ngati glibenclamide zotchulidwa:

1. Mankhwalawa amadziwika kuti ndi amodzi achinsinsi kwambiri, motero amawonetsedwa kwa odwala matendawa omwe ali ndi insulini yochepetsetsa, 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 mbali 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 imapangitsa maselo a beta kugwira ntchito mwamphamvu kwambiri. 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 kusungitsa kaphatikizidwe ka insulin kwakanthawi kokwanira, chithandizo chokhala ndi glibenclamide chizikhazikitsidwa mpaka mankhwala ofooka atasiya kuwongolera matenda ashuga.

Momwe glibenclamide imachitikira

Kupanga kwa kanthu kwa glibenclamide kumamveka bwino ndikufotokozedwa mwatsatanetsatane mu malangizo a mankhwalawa. Katunduyu amatchinga njira za KATF zomwe zimakhala pamtundu wa beta-cell, 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 yotulutsa insulini 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 imachulukanso ndi mlingo wowonjezereka. 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 mu nthawi yovuta ya ischemia. Malinga ndi madotolo, ambiri a iwo amawopa kupereka mankhwala Glibenclamide a matenda aliwonse amtima wapezeka, ngakhale atapeza kafukufuku.

Kukonzekera kwa Glibenclamide

Anthu ambiri odwala matenda ashuga amadziwa bwino glibenclamide ndi Maninil, omwe amapangidwa 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 a 1.75 ndi 3.5 mg, chinthu chogwira ntchito chili m'njira yapadera yowunikira, yomwe imalola kuchepetsa glycemia ndi mlingo wotsika wa mankhwalawa. 5 mg maninyl imakhala ndi classical glibenclamide.

Ma Analogs ku Russia ndi:

• Statiglyn ochokera ku Pharmasintez-Tyumen ndi Glibenclamide ochokera ku kampani ya Ozone (atoll usajili ndi a 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 muyezo umodzi wa 5 mg. Zitha kugawidwa kuti mupeze 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.

Kodi amalandila ndani?

Malangizowo amayambitsa kuletsa kutenga mapiritsi a Glibenclamide pazotsatirazi:

• Ngati mankhwalawo kapena mawonekedwe ake m'mbuyomu anali ndi ziwengo,
• pomwe wodwala matenda ashuga alibe maselo a beta (mtundu 1 wa shuga, kapangidwe ka pancreatic),
• mkhalidwe wowonongeka pachimake kwa matenda a shuga ndi ketoacidosis kapena pachiwopsezo chachikulu cha kuwonongeka chifukwa chovulala kwambiri komanso matenda.
• Ndi aimpso kwambiri 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.

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. Gliptins ndi gawo la Januvii, Ongliza, Xelevia, Galvus, Trazhenty, chithandizo chawo chimagula ruble 1,500. pamwezi. Mankhwalawa sikuti amayambitsa hypoglycemia, musathandizire kuwononga maselo a beta, koma musachepetse shuga mwachangu monga glibenclamide. Malinga ndi ndemanga, glyptins amapereka zotsatira zabwino poyambirira sanali kwambiri glycemia.

Mtengo mumafakisi

Maninil okhala ndi glibenclamide yokhala ndi micronized pamafupipafupi 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 ku 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 pa Glibenclamide

Nthawi zambiri, ndemanga za Glibenclamide ndimakambirana a mankhwala othandizira odwala matenda a shuga. Odwala ambiri amati amamwa mankhwalawa ngati monotherapy, komabe, anthu ena amawamwa kuti ndi gawo limodzi la mankhwalawa, ndiye kuti, kuphatikizapo mankhwala ena a hypoglycemic. Nthawi zina odwala amakhala ndi mafunso chifukwa chogwiritsa ntchito kwambiri kapena kusakwanira kwa glibenclamide.

Akatswiri akukhulupirira kuti cholinga cha mankhwalawa chimayenera kukhala chawokha, ndipo njira zochiritsira ziyenera kusankhidwa pamavuto aliwonse.Chifukwa chake, kutenga Glibenclamide malinga ndi kuyanganira komwe kulipo kulibe kovuta ndipo kungakhale kovulaza. Zinthu zambiri ziyenera kukumbukiridwa, mwachitsanzo, shuga ya wodwalayo pazinthu zosiyanasiyana. Pokha pokha pachitika izi, zitha kuganiziridwa kuti kumwa mankhwalawa kumapangitsa kuti wodwalayo akhale bwino.