Maninil 5: malangizo ogwiritsira ntchito, ma fanizo ndi ndemanga, mitengo yamafesi ku Russia

Mankhwala Glibenclamide - (1- <4-2- (5-chloro-2-methoxybenzamido) ethylbenzene sulfonyl> -3-cycloxyxylurea) ndi othandizira a hypoglycemic. Amachepetsa kuchuluka kwa shuga m'magazi am'magazi onse mwa odwala omwe ali ndi mtundu wachiwiri wa shuga ndi odzipereka omwe ali ndi thanzi labwino chifukwa cha kuchuluka kwa insulin chifukwa cha maselo a pancreatic β-cell. Mphamvu ya gloglycemic ya glibenclamide imadalira kuchuluka kwa glucose m'malo ozungulira β-maselo a pancreatic islets a Langerhans. Imalepheretsa kutulutsidwa kwa glucagon ndi ma pancreatic α-cell ndipo imakhala ndi extrapancreatic athari, makamaka, imakulitsa chidwi cha insulin receptors kuti ikulowetse insulin mu zotumphukira, imathandizira kuchitapo kanthu kwa insulini kumbuyo kwa receptor level ndikuchepetsa kuchepa kwa ma receptor, komabe, kufunikira kwa zamankhwala izi sikunaphunzire.
Pharmacokinetics Pambuyo pakumwa pakamwa, imathamanga ndipo imatsala pang'ono kulowa. Kuyamwa nthawi imodzi sikumakhudza mayamwidwe a glibenclamide, koma kungayambitse kuchepa kwa kuchuluka kwa glibenclamide m'madzi a m'magazi. Kumangiriza ku plasma albumin - 98%. Cmax mu plasma ya magazi mutatenga 1.75 mg ya glibenclamide imatheka pambuyo pa maola 1-2 ndipo ndi 100 ng / ml. Pambuyo pa maola 8-10, ndende ya plasma imachepa, kutengera mlingo womwe umaperekedwa, ndi 5-10 ng / ml. Mu chiwindi, glibenclamide pafupifupi imasinthidwa kukhala zigawo zazikulu ziwiri: 4-trans-hydroxy-glibenclamide ndi 3-cis-hydroxy-glibenclamide. Ma metabolites onsewa amachotsedwa muyezo wofanana ndi mkodzo ndi bile mkati mwa maola 45-72. T1 / 2 ya glibenclamide ndi maola 2-5, koma amatha kupitilizidwa mpaka maola 8-10. Kutalika kwa kuchitapo, sikugwirizana ndi T1 / 2. Odwala omwe ali ndi vuto la chiwindi, plasma excretion imayamba pang'onopang'ono. Mu kulephera kwa aimpso, kutengera kuchuluka kwa vuto laimpso, kuwonongeka kwa metabolites mu mkodzo kumawonjezera kulipirira. Ndi kulephera kwapakati kwakhungu (creatinine chilolezo - 30 ml / min), kuchotsedwa kwathunthu sikungasinthe, ndi kulephera kwambiri kwaimpso, kukondoweza ndikotheka.

Zisonyezero zamankhwala Maninil

Mellitus wosadalira insulin (mtundu II), ngati sizingatheke kulipira zovuta za metabolic potsatira kudya koyenera ndikuwonjezera zochitika zolimbitsa thupi ndipo ngati sipafunikira chithandizo cha insulin. Ndi kukula kwachiwiri kukana glibenclamide, kuphatikiza mankhwala omwe ali ndi insulin kungachitike, komabe, sizingakhale ndi phindu pa insulin monotherapy.

Kugwiritsa ntchito mankhwala Maninil

Mankhwala amayenera kutumizidwa ndi adokotala okha ndikuonetsetsa kuti awongoletsa zakudya. Mlingo amatengera zotsatira za kafukufuku wa kuchuluka kwa shuga m'magazi ndi mkodzo.
Kukhazikitsidwa koyamba komanso kwina. Mankhwalawa amayamba, momwe angathere, ndi Mlingo wocheperako, choyambirira, zimakhudza odwala omwe ali ndi chizolowezi chowonjezera cha hypoglycemia ndi kulemera kwa thupi ≤50 kg. Ndikofunika kuti ndiyambitse mankhwalawa pogwiritsa ntchito mapiritsi a 1 / 2-1 a Maninil 3.5 (1.75-3,5 mg wa glibenclamide) kapena piritsi 1 la Maninil 5 (2,5 mg wa glibenclamide) kamodzi patsiku. Mlingowu umatha kuwonjezeka pang'onopang'ono ndi nthawi kuyambira masiku angapo mpaka sabata 1, mpaka mlingo wa achire utafika. Mlingo wothandiza kwambiri ndi 15 mg / tsiku (mapiritsi atatu a Maninil 5) kapena 10,5 mg wa glibenclamide (3 mapiritsi a Maninil 3.5).
Kusamutsa wodwala ndikugwiritsa ntchito mankhwala ena antidiabetes. Kusamutsa kulandira Maninil 3.5 kumachitika mosamala kwambiri ndipo kumayamba ndi piritsi 1/2 ya Maninil 3.5 (1.75-3,5 mg wa glibenclamide patsiku).
Sankhani. Odwala okalamba, odwala okhazikika kapena omwe alibe chakudya chokwanira, komanso ngati opuwala aimpso kapena kwa chiwindi, gawo loyambira ndi kukonza liyenera kuchepetsedwa chifukwa choopsa cha hypoglycemia. Kuphatikiza apo, ndi kuchepa kwa thupi la wodwalayo kapena kusintha kwa mtundu waumoyo, ndikofunikira kuthetsa vutolo.
Kuphatikiza ndi ena othandizira odwala matenda ashuga. Maninil amatha kutumikiridwa ngati monotherapy kapena kuphatikiza ndi metformin. Nthawi zina, ndi tsankho la metformin, kugwiritsa ntchito mankhwala ena a gulu la glitazone (rosiglitazone, pioglitazone) akhoza kuwonetsedwa. Maninil amathanso kuphatikizidwa ndi mankhwala apakamwa a antidiabetic omwe samalimbikitsa kutulutsa kwamkati mwa insulin ndi insulin (phula kapena acarbose). Ndi kukana kwachiwiri kwa glibenclamide (kuchepa kwa mankhwala a insulin chifukwa chakuchepa kwa maselo a β-maselo a maselo a Langerhans), mankhwala ophatikiza ndi insulin angagwiritsidwe ntchito. Komabe, ndi kufafaniza kwathunthu kwathunthu kwa insulin mu thupi, monotherapy yokhala ndi insulin imasonyezedwa.
Njira makonzedwe ndi kutalika kwa mankhwala. Mlingo wa tsiku lililonse wa mapiritsi 2 a Maninil amatengedwa popanda kutafuna ndi madzi okwanira (1 kapu yamadzi) 1 nthawi patsiku musanadye chakudya cham'mawa. Pa mlingo wapamwamba wa tsiku lililonse, tikulimbikitsidwa kuti tiziigawa mu 2 Mlingo wa 2: 1 m'mawa komanso madzulo. Ndikofunikira kumwa mankhwalawa nthawi iliyonse nthawi yomweyo. Mukadumpha ndikumwa mankhwalawo, simungathe kumwa mankhwalawa kawiri m'malo mwa omwe adasowa. Kutalika kwa mankhwalawa kumatengera njira ya matendawa. Pa chithandizo, ndikofunikira kuwunika pafupipafupi mawonekedwe a kagayidwe.

Zotsatira pa kugwiritsa ntchito mankhwala Maninil

Ngati chithandizo cha insulin chikufunika: insulin-basedabetes mellitus (mtundu I), metabolic acidosis, hyperglycemic precoma ndi chikomokere, kuwonongeka kwa zovuta za metabolic m'matenda opatsirana ndikugwirira ntchito, komanso boma pambuyo pancreatic resection, kukana kwathunthu kwachiwiri kwa glibenclamide mu mtundu II matenda a shuga.
Zotsutsa zina zimaphatikizira: kukanika kwambiri kwa chiwindi, kulephera kwaimpso ndi creatinine chilolezo cha ≤30 ml / min, hypersensitivity to glibenclamide, utoto wa Ponso 4R kapena magawo ena a mankhwala, komanso zotumphukira zina za sulfonylurea, sulfonamide, okodzetsa ndi phenenecid ndi kuyamwitsa.

Zotsatira zoyipa za maninil

Mukamaunika mavuto, zotsatirazi zamafupipafupi zimachitika monga maziko: nthawi zambiri (≥10%), nthawi zambiri (≤10% ndi ≥1%), nthawi zina (≤1% ndi ≥0.1%), kawirikawiri (≤0.1 % ndi ≥0.01%), kawirikawiri (≤0.01% kapena milandu sizikudziwika):
mbali ya kagayidwe: Nthawi zambiri - kuwonjezeka kwa kulemera kwa thupi, hypoglycemia, yomwe imatha kutengeka ndipo imayambitsa kupweteka kwambiri kwa hypoglycemic coma, yomwe imawopseza moyo wa wodwalayo. Zomwe zimachitika izi zimatha kukhala kuchuluka kwa mankhwala osokoneza bongo, chiwindi ndi matenda a impso, uchidakwa, kusakhazikika kwa chakudya (makamaka kulumpha chakudya), zachilendo zolimbitsa thupi, kuchepa kwa kagayidwe kachakudya chifukwa cha matenda a chithokomiro, anterior pituitary and adrenal cortex. Zizindikiro za Adrenergic zokhala ndi hypoglycemia zimatha kusakhalapo kapena kufatsa ndi hypoglycemia pang'onopang'ono, zotumphukira neuropathy, kapena concomitant therapy ndi sympatholytics (makamaka β-adrenergic receptor blockers). Zizindikiro za ma harbinger a hypoglycemia: hyperhidrosis, palpitations, kugwedezeka, kumva kwambiri kwa njala, kuda nkhawa, kupweteka kwa pakamwa, kupweteka kwa pakhungu, kupweteka kwa mutu, kugona, kusowa kwa magazi, kulumikizidwa mosasunthika, kusokonezeka kwa minyewa yamitsempha yamagetsi (malankhulidwe ndi masinthidwe, zomverera ndi magalimoto. ) Kuti mumve zambiri za boma la hypoglycemia, onani bongo. Ndi kugwiritsa ntchito nthawi yayitali, kukula kwa hypofunction ya chithokomiro kumatha,
mbali ya gawo la masomphenyawo: kawirikawiri - kuwonongeka kowoneka ndi malo ogona, makamaka kumayambiriro kwa chithandizo,
Kuchokera m'mimba: Nthawi zina - nseru, kumverera kwadzalo / chidzalo m'mimba, kusanza, kupweteka m'mimba, kutsekula m'mimba, kutsekeka, kumva zitsulo mkamwa. Kusintha uku ndikosachedwa ndipo sikutanthauza kuti mankhwalawo athetsedwe,
kuchokera ku hepatobiliary system: kawirikawiri - kuwonjezeka kwakanthawi kwa ASAT ndi ALAT, alkaline phosphatase, hepatitis ya mankhwala osokoneza bongo, intrahepatic cholestasis, mwina chifukwa cha matupi awo sagwirizana ndi mtundu wa hyperergic kuchokera kumbali ya hepatocytes. Matendawa amasintha pambuyo pakuchotsa mankhwalawa, koma atha kuyambitsa chiwopsezo cha chiwopsezo cha moyo,
pakhungu ndi minyewa yolimba: kuyamwa, zotupa za urticaria, erythema nodosum, corymboid kapena maculopapular exanthema, purpura, photosensitivity. Izi machitidwe a hypersensitivity amasinthidwanso, koma osowa kwambiri zomwe zingayambitse zovuta zowopsa, zomwe zimayendetsedwa ndi kupuma pang'ono komanso kuchepa kwakukulu kwa kuthamanga kwa magazi, mpaka pakukula. Osowa kwambiri - mawonekedwe a hypersensitivity zimachitika, zomwe zimayendera limodzi ndi zotupa pakhungu, arthralgia, kuzizira, proteinuria ndi jaundice, vasculitis,
Kuchokera kumagazi ndi dongosolo lamitsempha yamagazi: osowa - thrombocytopenia, kawirikawiri - leukopenia, erythropenia, granulocytopenia (mpaka kukula kwa agranulocytosis), mwanjira zina - pancytopenia, hemolytic anemia. Zosintha zomwe zidasindikizidwa m'magazi ndizosintha, koma sizowopsa ku moyo,
zovuta zina: kawirikawiri - ofooka okodzetsa, kusinthanso kwa proteinuria, hyponatremia, disulfiram ngati zochita, mtanda wa ziwengo ndi sulfonamides, sulfonamide zotumphukira ndi phenenecid. Utoto wa Ponso 4R umatha kuyambitsa mavuto osiyanasiyana.

Malangizo apadera ogwiritsira ntchito maninil

Maninil chithandizo amafunika kuyang'aniridwa kawirikawiri kuchipatala. Mukamagwiritsa ntchito mankhwalawa muyezo waukulu kapena mukamayigwiritsanso ntchito pakanthawi kochepa, ndikofunikira kuganizira mphamvu yanthawi yayitali kuposa momwe mumagwiritsira ntchito Mlingo wotsika.
Tiyenera kukumbukira kuti ndi munthawi yomweyo kugwiritsa ntchito Maninil ndi clonidine, β-adrenergic blockers, guanethidine ndi reserpine, malingaliro a wodwala azizindikiro zakutsogolo kwa hypoglycemia akhoza kukhala operewera.
Panthawi ya kuwonongeka kwaimpso kapena kwa chiwindi, kuchepa kwa chithokomiro, pituitary gland kapena adrenal cortex, chisamaliro chapadera chimafunika.
Kwa odwala okalamba, pamakhala chiopsezo cha hypoglycemia yayitali, motero, glibenclamide imayikidwa mosamala kwambiri komanso kuyang'aniridwa pafupipafupi kumayambiriro kwamankhwala, ndikofunika kuyamba kukonzekera sulfonylurea ndi nthawi yochepa. Ndi kulumikizana kovuta ndi wodwala (mwachitsanzo, ndi matenda a ubongo), chiopsezo chokhala ndi hypoglycemia chikuwonjezeka. Kuchulukana kwakanthawi pakati pa chakudya, chakudya chamagulu osakwanira, masewera olimbitsa thupi, kuchepa m'mimba kapena kusanza kungakulitse chiopsezo cha hypoglycemia. Mowa wokhala ndi mlingo umodzi wambiri komanso kuchuluka kwake kosalekeza kumatha kulimbikitsa kapena kufooketsa mphamvu ya Maninil. Kugwiritsa ntchito mankhwala osokoneza bongo nthawi zonse kumatha kubweretsa vuto la metabolism. Ngati mankhwalawa amatsatiridwa, mankhwala osakwanira a hypoglycemic akapezeka munthawi yovuta kapena yovuta, magazi a shuga amatha kuchuluka. Zizindikiro za hyperglycemia: polydipsia, kamwa yowuma, kukoka pafupipafupi, kuyabwa ndi khungu louma, matenda oyamba ndi khungu kapena matenda opatsirana. M'mikhalidwe yovuta kwambiri (kuvutika maganizo, opaleshoni, matenda opatsirana, omwe amaphatikizidwa ndi kuwonjezeka kwa kutentha kwa thupi), kagayidwe kamphamvu kangakhale kochulukirapo, komwe kumayambitsa matenda a hyperglycemia, nthawi zina amatchulidwa kotero kuti mwina pangafunike kusamutsa wodwalayo kwakanthawi kuti akhale ndi insulin. Wodwala ayenera kudziwitsidwa kuti ayenera kudziwitsa dokotala nthawi yomweyo za momwe matenda ena amathandizira Maninil.
Pankhani ya kuperewera kwa glucose-6-phosphate dehydrogenase, chithandizo ndi kukonzekera kwa sulfonylurea, kuphatikizapo glibenclamide, kungayambitse magazi a hemolytic, chifukwa chake ndikofunikira kusankha pazogwiritsa ntchito njira zina za sulfonylurea.
Ndi chibadwa cha galactose chosalolera, kuchepa kwa lactase kapena kufalitsa shuga / galactose, Maninil sayenera kugwiritsidwa ntchito.
Gwiritsani ntchito pa nthawi yoyembekezera Zotsimikizika.
Gwiritsani ntchito ana. Osagwiritsa ntchito.
Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena kugwiritsa ntchito njira. Ndi hypoglycemia, kuthekera kwakuya kwambiri ndi kuthamanga kwa zochita kumatha kuchepa, zomwe zimayenera kukumbukiridwa mukamayendetsa magalimoto ndikugwira ntchito ndi zina. Izi ndizofunikira kwambiri makamaka pakachitika pafupipafupi matenda a hypoglycemic kapena pakakhala kuti palibe malingaliro okwanira azizindikiro za hypoglycemia, pomwe kuli kofunikira kusankha pazofunsa magalimoto kapena magwiridwe antchito.

Mankhwala osokoneza bongo Maninil

Kuchulukitsa Glibenclamide (Kukula kwa machitidwe a hypoglycemic ndikotheka) ndikotheka kugwiritsa ntchito nthawi yomweyo ndimankhwala ena opatsirana pakamwa (metformin ndi acarbose) ndi insulin, ma inhibitors a ACE, ma anabolic steroid ndi mahomoni ogonana amuna, antidepressants (fluoxetine, MAO inhibitors), othandizira phenylbutazone adrenergic quinolone, chloramphenicol, clofibrate ndi ma analogi, disopyramide, fenfluramine, miconazole, PASK, pentoxifylline (ndi makina oyang'anira mu mankhwala ambiri), p ergexilin, pyrazolone derivatives, probenecid, salicylates, fibrate, sulfonamides, tetracycline mankhwala, tritokvalin, cytostatics (cyclophosphamide, ifosfamide, trophosphamide).
Kutsika kwa glibenclamide (Kukula kwa machitidwe a hyperglycemic) ndi kotheka kugwiritsa ntchito munthawi yomweyo ndi acetazolamide, β-adrenoreceptor blockers, barbiturates, diazoxide, chloramphenicol, phenylbutazone, oxyphenbutazone, azopropanone, sulfinpyrazone, miconazole, pheniramidase glucase, glugacononacase, glugazigraconigase, glugazigraconigase, glugazigracon, gluonazigracon, gluonazigrati, gluonazigrogoniti, pheniramidoncase, gluonazigrati, gluonazigrati, gluonazigrogoniti, phenramiduracone. phenytoin, rifampicin, mahomoni a chithokomiro, mankhwala osokoneza bongo a azimayi ogonana (gestagens, estrogens), sympathomimetics.
Otsutsa a H2 receptor amatha kufooketsa ndikuwonjezera mphamvu ya hypoglycemic ya mankhwala. Kuledzeretsa kumatha kukulitsa kapena kufooketsa zotsatira za hypoglycemic of glibenclamide.
Nthawi zina, pentamidine imatha kubweretsa kwambiri hypo- kapena hyperglycemia. Zochita za coumarin zotumphukira zimatha kukula komanso kuchepa.
Othandizira a sympatolytic, monga β-adrenergic blockers, reserpine, clonidine ndi guanethidine, ndikapitiliza kugwiritsidwa ntchito, amatha kuthandizira kuchepa kwa shuga m'magazi komanso zizindikiro za masogogoscemia.

Mankhwala ambiri osokoneza bongo Maninil, zizindikiro ndi chithandizo

Acid ndi glidenclamide yodwala yomwe imatha kupangitsa kuti matenda a hypoglycemia achuluke, azikhala nthawi yayitali. Hypoglycemia imatha kukhazikika chifukwa chodumpha chakudya, kuchuluka kwa masewera olimbitsa thupi komanso kuyanjana pakati pa mankhwala.
Zizindikiro za hypoglycemia: njala yayikulu, kusanza, kusanza, kufooka, nkhawa, matenda oopsa, kupweteka mutu, kusokonezeka kwa kugona, kusokonezeka kwa chidwi, kusokonezeka, kulumikizidwa, mgwirizano makina oyamba nako - ma antics, kuyenda modabwitsa, kuthamanga, kukokana, zizindikiro zoyang'ana - hemiplegia, aphasia, diplopia, kugona, chikomokere, kusokonezeka kwapakati pakukweza mtima ndi mtima ntchito dongosolo sudistoy). Ndi kupita patsogolo kwa hypoglycemia, kuchepa kwa chikumbumtima (hypoglycemic coma) ndikotheka, kodziwika ndi khungu lonyowa komanso lozizira pakhungu, tachycardia, hyperthermia, chisangalalo cha galimoto, hyperreflexia, mawonekedwe a Babinsky Reflex komanso kukula kwa paresis ndi kugwidwa.
Chithandizo. Hypoflycemia wodekha (popanda kutaya chikumbumtima), wodwalayo amatha kuthetsako yekha, akumatenga pafupifupi 20 g shuga, shuga kapena zakudya zopatsa mphamvu.
Ngati mwakumana ndi vuto mwangozi komanso mukakumana ndi wodwalayo, ndikofunikira kusanza, kuchita zamiseche (osakonzeka kukonzekera), liperekeni adsorbents ndi jakisoni wa shuga iv. Mu hypoglycemia yayikulu (kutayika kwa chikumbumtima), catheterization ya mtsempha uyenera kuchitidwa nthawi yomweyo. Mitsempha, 40-100 ml ya 40% shuga yankho limayendetsedwa ndi bolus, ndikutsatira kulowetsedwa kwa 5-10% shuga, ndipo ngati kupweteka kwamitsempha sikungatheke, i / m kapena s / 2-2 mg glucagon. Ngati wodwalayo sakudziwikanso, njira zomwe zili pamwambazi zimabwerezedwa, ngati pakufunika kutero, chithandizo champhamvu chimachitika. Popewa kubwereranso ku hypoglycemia pambuyo pakupumanso kwazaka 24 mpaka 48, mafuta azakudya amalembera mkati (20-30 g nthawi yomweyo komanso maola onse a 2) kapena kulowetsedwa mosakhalitsa kwa 520% ​​shuga. Mutha kulowa kwa maola 48 maola 6 aliwonse 1 mgamu a glucagon / m. Glycemia imayang'aniridwa pafupipafupi kwa maola osachepera 48 kuchokera kuchotsedwa kwa vuto lalikulu la hypoglycemic. Ngati chikumbumtima sichichira ndi mankhwala osokoneza bongo (mwachitsanzo, ndimayesedwe ofuna kudzipha), kulowetsedwa kosalekeza kwa 5-10% shuga kumachitika, kufunikira kwa plasma glucose pafupifupi 200 mg / dl. Pambuyo mphindi 20, kuyambiranso kwa shuga 40% ndikotheka. Ngati chithunzi cha chipatala sichisintha, ndikofunikira kuyambitsa matenda ozizwitsa, ndipo munthawi yomweyo chithandizireni ku matenda a ubongo edema (dexamethasone, sorbitol). Glibenclamide sichimapukusidwa panthawi ya hemodialysis.

Malangizo ogwiritsira ntchito

Kutenga Maninil, ngati piritsi lina lililonse la shuga, muyenera kutsatira zakudya.

Maninil ndi mankhwala okwera mtengo opangidwa ndi Berlin-Chemie AG / Menarini Gulu (Germany). Analogue yake yochokera ku Glimidstad yopangidwa ndi Arzneimittel AG (Germany) yalembedwanso. Zinali zosatheka kupeza mankhwalawa m'masitolo ogulitsa mankhwala panthawi yomwe analemba.

Mapiritsi a glibenclamide otsika mtengo amapangidwa ndi opanga ammayiko a CIS, mwachitsanzo, Atoll LLC (Russia). Mankhwala a ku Germany enieni Maninil ndi otsika mtengo kwambiri. Sizikupanga nzeru kusinthira kumalingaliro otsika mtengo. Chonde dziwani kuti mankhwalawa ali pamndandanda wamankhwala oyipa a shuga 2. Chifukwa chake, ndibwino kukana kutenga mapiritsi aliwonse omwe mankhwala ake ndi glibenclamide.

Maninil ali bwino? Mlingo watsiku ndi tsiku ndi 1.75, 3.5 kapena 5 mg?

Ichi ndi mankhwala osokoneza bongo, ngakhale mutamwa mankhwalawo. Komabe, m'mene mulingo waukulu, kuthothomoka kwathunthu kumachitika, ndipo matenda amtundu wa 2 asintha kukhala matenda ashuga amtundu woyamba. Werengani nkhani yoti: “Mapulogalamu Olakwika a Chiwopsezo cha shuga 2: Lemberani” kuti mumve zambiri. Mapiritsi otsika mtengo opangidwa ku Russia ndi mayiko a CIS atha kukhala oyipa kwambiri kuposa mankhwala omwe adagulitsa kunja.

Momwe mungatenge Maninil

Malangizowa akutsimikiza kumwa Maninil 2 pa tsiku - m'mawa ndi madzulo, musanadye, ndi madzi. Mapiritsi amatha kugawidwa pakati, koma osatheka. Mlingo woyenera umaperekedwa ndi dokotala. Odwala matenda a shuga sangachite izi pawokha, chifukwa mukalakwitsa ndi muyezo, pamakhala zotsatirapo zoyipa. Mutatha kumwa mankhwalawo, muyenera kudya, kuti shuga m'magazi asatayike kwambiri.

Odwala ambiri amakonda kudziwa kuchuluka kwa glibenclamide tsiku lililonse. Komabe, kuyesera kuchuluka kwa mankhwalawa nthawi zonse kumabweretsa zovulaza. Ngati glibenclamide yaying'ono kapena yapakatikati mlingo wayimitsa kuchepetsa shuga, muyenera kusintha ma jakisoni a insulin. Werengani apa chifukwa chake Maninil ndi mankhwala oyipa ndipo siyani kumwa. Phunzirani momwe mungachepetse shuga komanso magazi kuti asakhazikike popanda kumwa mapiritsi owononga.

Maninil kapena Diabeteson: ndibwino bwanji? Kodi ndingatenge nthawi yomweyo?

Maninil ndi Diabetes ndi mankhwala osokoneza bongo. Ndikwabwino osagwiritsa ntchito ina iliyonse kuchiritsa matenda ashuga a 2. Werengani apa mwatsatanetsatane zomwe zimabweretsa zowononga komanso zomwe mungathe kusintha. Maninil ndi Diabetes ali ndi zinthu zosiyanasiyana zogwira ntchito, koma amaphatikizidwa mgulu limodzi la sulfonylureas. Mankhwala onse omwe amagwera mgululi amachepetsa kwambiri magazi, koma osachepetsa kufa kwa odwala, koma m'malo mwake muwonjezere.

Mapiritsi okhudzana ndi nthawi yayitali Diabeteson MV, omwe amalimbikitsidwa kuti azimwedwa kamodzi patsiku, ndi owopsa kuposa Maninil, omwe amayenera kumwa kawiri pa tsiku. Koma izi sizitanthauza kuti muyenera kusintha kuchokera ku glibenclamide kupita ku Diabeteson MV. Gwiritsani ntchito njira yochizira matenda a shuga a 2, omwe safuna mankhwala oopsa kapena okwera mtengo.

Maninil kapena Glucophage: zili bwino?

Maninil ali pamndandanda wamankhwala oyipa a matenda a shuga a 2. Kuchokera polandila kuyenera kusiyidwa mwachangu. Glucophage (metformin) - m'malo mwake, ndi chida chofunikira komanso chofunikira kwambiri. Sizingochepetsa shuga m'mwazi, komanso zimachepetsa kukula kwa zovuta za shuga, komanso zimachepetsa chiopsezo cha kufa ndi vuto la mtima ndi zina.

Tsambali endocrin-patient.com imalimbikitsa kutenga mankhwala omwe adagulitsidwa kumene Glucofage. Ndikwabwino kuti tisasinthe ndikuchotsa mapiritsi a metformin apamwamba kwambiri. Ngati mukukumana ndi mavuto m'mawa m'mimba yopanda kanthu, samalani ndi mankhwalawa Glucofage Long.

Momwe mungatenge metformin ndi maninil nthawi imodzi?

Metformin ndi Maninil sayenera kumwedwa nthawi yomweyo. Metformin iyenera kusiyidwa mu mtundu wanu wa mankhwala a shuga 2, ndipo glibenclamide yoyipa iyenera kuchotsedwa msanga. Mwa kukonzekera kwa metformin, chisankho chabwino kwambiri ndi mankhwala oyambitsidwa kunja, Glucofage. Mapiritsi a Siofor nawonso amafunidwa kwambiri. Mwambiri, amatha kuchita zochepa kuposa Glucofage, komanso amathandizanso. Tsambali endocrin-patient.com silikulimbikitsa kutenga kukonzekera kwa metformin komwe kumachitika ku Russia ndi mayiko a CIS.

Zoyenera kuchita ngati Maninil sathandizira, samachepetsa magazi? Kodi m'malo mwake?

Maninil samachepetsa shuga m'magazi panthawiyo pamene kapamba wa wodwalayo atasiya kutulutsa insulin. Izi zikutanthauza kuti matendawa asintha kwambiri kukhala matenda ashuga 1. Kulandilidwa kwa glibenclamide ndi mankhwala ena oyipa kumabweretsa chitukuko chomvetsa chisoni mwa odwala omwe ali ndi T2DM. Panthawi yovuta, palibe mapiritsi omwe amathandizira. Muyenera kuyambitsa jakisoni mwachangu, apo ayi wodwalayo amatha kugwa ndikufa. Zimakhala zovuta kwambiri kuletsa kukhazikika kwa zovuta zovuta, ngakhale kugwiritsa ntchito insulin.

Ndemanga pa mankhwalawa

Mankhwala omwe adalowetsedwa Mananil si okwera mtengo. Chifukwa chake, odwala ambiri omwe ali ndi matenda a shuga a 2 amasankha mankhwalawa, osati mapiritsi a Diabeteson MV ndi mapiritsi a Amaryl omwe akupikisana nawo. Anthu ochulukirapo akamamwa mankhwalawo, chidziwitso chothandiza chokhudzana ndi zotsatira zake chimasonkhana kwakanthawi. Patsamba lolankhula ku Russia mutha kupeza ndemanga zambiri za anthu odwala matenda ashuga za mankhwala Maninil. Ambiri mwa iwo, odwala amadandaula kuti patatha zaka zingapo kutenga glibenclamide asiya kuthandiza. Kumayambiriro kwa chithandizo, amachepetsa shuga m'magazi, koma pambuyo pake amasiya kugwira ntchito.

Izi ndizachilengedwe chifukwa glibenclamide imatsika kapamba. Mothandizidwa ndi mankhwalawa, T2DM ya zaka 4 mpaka 10 imadutsa matenda ashuga akulu amitundu 1. Maninil ndi mankhwala ena onse amasiya kuthandiza. Wodwala alibe chochita kupatula kupaka insulin mu milingo yayikulu. Ndikosatheka kusiya kuyambika kwa zovuta za matenda ashuga.

Mukamawerenga ndemanga zabwino za Maninil, musawadalire. Chifukwa amalembedwa ndi anthu omwe angoyamba kumwa mankhwalawo. Pambuyo pazaka zingapo zovomerezeka, malingaliro a odwala matenda ashuga okhudza mankhwala glibenclamide nthawi zambiri amasintha. Koma ndachedwa. Chiwonongeko cha pancreatic sichingasinthe. Tsamba la endocrin-patient.com limalimbikitsa kugwiritsa ntchito mtundu wa sitepe yachiwiri ya matenda ashuga m'malo momwa mankhwala oyipa. Ndiwothandiza komanso amatetezeka.

Ndemanga 8 pa Maninil

Moni Muli ndi tsamba lachilendo komanso losangalatsa. Ndikukhulupirira kuti azindipatsa malangizo pa matenda anga. Ndili ndi zaka 59, kutalika 169 cm, kulemera kwa makilogalamu 87, ndakhala ndikudwala matenda a shuga 2 kwa zaka zosachepera 8. Zaka zonsezi amatenga Maninil pa 3.5 mg 2 kawiri pa tsiku. Chifukwa cha mapilitsi, shuga nthawi zonse anali m'malire abwino, osapitirira 6.5. Koma kwa miyezi yopitilira 3, zizindikiro mamawa pamimba yopanda kanthu zidakwera mpaka 6.5-7.5. Ndidayamba kusaka pa intaneti, ndidapeza tsamba lanu ndikusinthira kuzakudya zamafuta ochepa. Ndaletsanso Maninil, ndimatenga Glucophage 850 mg katatu pa tsiku m'malo mwake. Ngakhale izi, shuga sabwerera wamba. M'mawa zili pafupi 6.8. Ndiye ola limodzi mutadya pafupifupi 8.2. Pambuyo maola 2 - m'chigawo cha 7.5-8.0. Kuphatikiza pa matenda ashuga, palinso matenda oopsa, omwe ndimawongolera mothandizidwa ndi mankhwala osakanikirana. Ndimayenda pafupifupi 10 km pa sabata, ndimachita masewera olimbitsa thupi m'mawa. Kodi ndingabwezeretse bwanji shuga popanda matenda a insulini? Kapena kwachedwa kwambiri?

Ndidayamba kusaka pa intaneti, ndidapeza tsamba lanu ndikusinthira kuzakudya zamafuta ochepa. Maninil yathetsedwa,

Bwino pambuyo pake

Kodi ndingabwezeretse bwanji shuga popanda matenda a insulini? Kapena kwachedwa kwambiri?

Mukulemba kuti mwakhala mukutenga Maninil zaka 8, ndikuwonjezera zikondamoyo zanu ndimankhwala oyipawa.

Nthawi yabwino tsiku! Mayi anga, wazaka 69, ndi wodwala matenda ashuga komanso wovuta kwambiri. Kutalika kwake ndi kulemera kwake sindikukudziwa, koma momveka bwino. Amalandira mannin a matenda ashuga, ndi bisoprolol, valsartan, physiotens, amlodipine, komanso cardiomagnyl ndipo nthawi zina zylt (clopidogrel) chifukwa cha kuthamanga kwa magazi. Pafupifupi masiku 10 apitawa, shuga adayamba kukwera mpaka 10-15 ndipo nthawi yomweyo zovuta zamankhwala zimayamba kamodzi. Mwachidziwikire, mannyl asiya kuchitapo kanthu. Funso: Kodi misempha yamatenda oopsa imagwirizananso ndi izi?

Mwachidziwikire maninil asiya kugwira ntchito

Izi ndi zowona. Matendawa adasinthidwa kukhala mtundu woyamba wa shuga chifukwa chogwiritsa ntchito nthawi yayitali. Amayi anu amafunikira kuti ayambe kubaya insulini, apo ayi atha kudwala matenda ashuga.

Funso: Kodi misempha yamatenda oopsa imagwirizananso ndi izi?

Ili ndi funso la nzeru zomwe sizingayankhidwe ndendende. Ndipo samakhudza njira zamankhwala. Momwe mungagwiritsire matenda a shuga a 2 akufotokozedwera apa - Http: //endocrin-patient.com/lechenie-diabeta-2-tipa/. Izi zimapangitsa kuti shuga asamangokhala m'magazi, komanso kuthamanga kwa magazi.

Amalandira mannin a matenda ashuga, ndi bisoprolol, valsartan, physiotens, amlodipine, komanso cardiomagnyl ndipo nthawi zina zylt (clopidogrel) chifukwa cha kuthamanga kwa magazi.

Pazidziwitso zanu, mapiritsi a cardiomagnyl ndi mapiritsi ena a aspirin amalimbikitsidwa kuti azingotengedwa pokhapokha popewa kubwereza kwa mtima mobwerezabwereza, koma osati oyamba. Kuti mupeze Clopidogrel (sylt), payenera kukhala chifukwa chabwino, zotsatira zoyesedwa zopanda magazi, zomwe zikuwonetsa kuwopsa kwa kuundana kwa magazi. Kodi amayi anu adakwanitsa kuyesedwa? Mankhwala ena onse patsamba lanu ndi otetezeka kwambiri.

Mutha kumwa mapiritsi ochepa tsiku lililonse, koma izi sizingatenge moyo wabwino.

Moni Ndili ndi funso mwachindunji. Ndili ndi matenda ashuga a 2 posachedwa. The endocrinologist imangopanga glibenclamide - Maninil kapena ena ofanana nawo. Kuletsedwa mwamphamvu kutenga Siofor kapena Glyukofazh. Anatinso kuti mankhwalawa (metformin) kwa ine ndi osayenera chifukwa cha kapamba wofooka. Chowonadi ndi chakuti mtundu wachiwiri wa shuga unayamba pambuyo pancreatitis. Kodi kuikidwa kwa adotolo ndikolondola?

Kodi kuikidwa kwa adotolo ndikolondola?

Ili ndi funso la nzeru. Ngati metformin siili yoyenera kwa inu, ndiye kuti glibenclamide ndiyabwino kwambiri.

Chowonadi ndi chakuti mtundu wachiwiri wa shuga unayamba pambuyo pancreatitis.

Nayi njira yothandizira odwala matenda ashuga, kutengera zakudya zamafuta ochepa - http://endocrin-patient.com/lechenie-diabeta-2-tipa/. Matenda kapamba sikuti kuphwanya mfundo! Njira imeneyi imagwiritsidwa ntchito bwino ndi odwala ambiri omwe akudwala matendawa. Muyenera kukana 100% yokazinga (kuwotcha) ndi kusuta zakudya, komanso kutafuna chakudya mosamala, osamadya mwachangu. Yesetsani kuti musadye zilizonse zomwe zakonzedwa, kuphika nokha zakudya zathanzi. Ponena za mowa - ndi payekha.

Moni, Sergey. Mayi anga ali ndi zaka 59, kutalika 167 cm, kulemera kwa 79 kg. Amapezeka ndi matenda ashuga amtundu 2. Mankhwala, Maninil 500 mg kawiri pa tsiku. Amatsata chakudya, ndimatsatira izi. Zokhudza kuda kuzizira kwa shuga, makamaka akakhala wamanjenje. Osati nthawi zambiri, koma zimachitika kuti zimakwera mpaka 11-12, komanso modabwitsa. Kuchokera kudumphadumpha kotero, monga momwe ndikudziwira, endocrinologist adamupatsa Dibicor. Wakhala akumwa kwa sabata limodzi, shuga tsopano akuwoneka kuti ali pamlingo womwewo, koma adalumphanso. Mwina ndizomveka kulumikiza mankhwala ena?

Mwina ndizomveka kulumikiza mankhwala ena?

Choyamba, muyenera kuphunzira mosamala zolemba patsamba lino, ndikulemba ndemanga, kufunsa mafunso anzeru.

endocrinologist adamupatsa Dibicor kwa iye

Zizindikiro zogwiritsidwa ntchito

Kodi chimathandiza Maninil 5 ndi chiani? Malinga ndi malangizo, mankhwalawa amalembedwa motere:

• Type 2 shuga mellitus - monga monotherapy kapena monga gawo la mankhwala ophatikizika ndi mankhwala ena amkamwa a hypoglycemic, kupatula sulfonylureas ndi dongo.

Analogs Maninil 5, mtengo pama pharmacies

Ngati ndi kotheka, mutha kusintha Maninil 5 ndi analogue yogwira ntchito - awa ndi mankhwala:

1. Gilearm
2. Glibamide
3. Glibenclamide,
4. Glidanil
5. Glimidstad
6. Glitisol
7. Glucobene,
8. Daonil
9. Maniglide
10. Euglucon.

Mukamasankha analogues, ndikofunikira kumvetsetsa kuti malangizo ogwiritsira ntchito Maninil 5, mtengo ndi kuwunika, sagwiritse ntchito mankhwala omwe ali ndi vuto lofananalo. Ndikofunikira kupeza upangiri wa dokotala komanso kuti usasinthe popanda mankhwala.

Mtengo m'masitolo apamwamba aku Russia: Maninil 5 120 mapiritsi - kuchokera ku 77 mpaka 135 ma ruble, malingana ndi malo ogulitsa mankhwala a 683.

Pewani kufikira ana pa kutentha mpaka 25 ° C. Moyo wa alumali ndi zaka zitatu.

Zoyenera kufalitsa kuchokera ku mafakitala zimalembedwa ndi mankhwala.

Ndemanga pakugwiritsa ntchito Maninil 5 ndizabwino. Anthu omwe amamwa mankhwalawa ndipo madotolo amawona kuchuluka kwa mankhwalawa. Mu kuwunikako pali malipoti a kakulidwe kazomwe kamayambitsa kusanza ndi chizungulire - izi zitha kukhala chifukwa cha mulingo woyenera wa mankhwalawa.