Momwe mungagwiritsire ntchito mankhwala "Alatar" m'munda: momwe mungagwiritsire ntchito mankhwala ophera tizilombo

Ngakhale tifuna kukulitsa mbewu yabwino popanda mankhwala amtundu uliwonse, tsoka, izi sizotheka.

Nthawi zambiri ndi tizilombo toononga ndi matenda a mbewu mukuyenera kulimbana ndi mankhwala ophera tizilombo - mankhwala apadera apadera, ankakonda kupha tizirombo, mphutsi, mazira, komanso matumba ndi nkhupakupa.

Tizilombo toyambitsa matenda "Alatar": zambiri

Njira "Alatar" ndi ya gulu la mankhwala omwe ali ndi kukhudzana ndi matumbo. Ndioyenereradi kuyang'anira tizilombo m'munda ndi ndiwo zamasamba, kuteteza malowo ku matenda. Mankhwalawa amathandizira kupirira ndi nsabwe za m'masamba, njenjete za masamba, njenjete, kafadala, maluwa, kabichi, tinnitsa, rasipiberi ndi sitiroberi sitiroko ndi alendo ena osawadziwa.

Tizilombo toyambitsa matenda timene timapitilizidwa kugulitsa ngati ma emulsion okhathamiritsa omwe amaikidwa mu 5 ml ampoules kapena 25 ml Mbale. Kuti akonze yankho logwira, zomwe zili mumapulogalamuwo zimadzipaka m'madzi ochepa (pafupifupi 2-3 l), kenako ndikuwonjezera madzi ambiri mpaka izi zitheka. Chikhalidwe chilichonse chimafunikira kuchuluka kwa Alatar, monga momwe amafotokozedwera malangizo ake ogwiritsira ntchito. Komabe voliyumu yothetsera yonse iyenera kukhala 10 l (yankho lake liyenera kusakanikirana).

Yogwira pophika ndi limagwirira ntchito

Ngati mukukhulupirira ndemanga za nzika za chilimwe, ndiye "Alatar" imagwira ntchitozi bwino kwambiri kuposa njira zina zofananira. Zinali zotheka kukwaniritsa zotsatira zofananira chifukwa cha kupezeka kwa zinthu ziwiri zamphamvu mu kapangidwe kake: cypermethrin ndi malathion. Malathion (kapena karbofos) ndi m'gulu la gulu la organophosphorous wambiri. "Alatar" imateteza bwino mbewu ku ma aphid (kutanthauza kuti, nthawi zambiri imakhala pamalowo), komanso imatchinjiriza tizilombo komanso nkhupakupa.

Gawo lachiwirili ndi tizilombo toyambitsa matendawa, omwe amadziwika kuti ndi oyamba kwambiri ndipo amayambitsa ziwopsezo za matenda amanjenje, onse akuluakulu komanso mphutsi. Kuphatikiza apo, Alatar imaphatikizanso zomatira zapadera zomwe zimagwira ntchito yapadera - imalepheretsa yankho kuti isachotse masamba kapena kuwatsuka ndi mvula (Zambiri zokhudzana ndi izi zitha kupezeka m'mayendedwe ogwiritsira ntchito, omwe amaphatikizidwa ndi mankhwalawo, kapena malangizo ochokera pa netiweki).

Malangizo ogwiritsira ntchito mankhwala "Alatar" pazomera zam'munda

Monga taonera kale, zikhalidwe zosiyanasiyana zimafuna kuchuluka kwa mankhwala omwe afotokozedwawo, choncho musanapitirize ndi madzi akumwa, muyenera kudziwa kuchuluka kwake. Polankhula za malonda a Alatar ndi malangizo ake ogwiritsira ntchito, sitipanga matebulo, koma tangofotokozerani Mlingo wa mbewu zomwe zimapezeka kwambiri masiku ano.

Kabichi, mbatata, anyezi, kaloti, sitiroberi

Kabichi imatsanulidwa ndi Alatar pokhapokha mu nthawi yolima yomwe ikukula. Kuti akonze yankho la ntchito, zomwe zili mumapulogalamuwo (5 ml) zimaphatikizidwa ndi malita 4 a madzi, pomwe mbewuzo zimathiridwa ndi mankhwala. Kugwiritsa ntchito mankhwalawa pakadali pano ndi malita 4 pa 100 m². Kuchepetsa kabichi kumagwiritsidwa ntchito kuti athetse mavuto a batala oyera, njenjete za kabichi, scoops, kupindika, masamba a masamba.

Kuwaza ndi kuphika mbatata kuyenera kuchitika kokha ndi kuwoneka kwa tizirombo. Monga momwe zinaliri m'mbuyomu, kwa 100 m² mudzafunika malita 4 a madzi ogwiritsa ntchito, ndipo nthawi yogwirira ntchito ndi masiku 10. Tizilombo toyambitsa matenda timagwiritsa ntchito polimbana Colado mbatata ya mbatata ndi ng'ombe.

Njira yothanirana imakonzedweranso mogwirizana ndi chiwembu chofanana kupopera anyezi, kaloti ndi sitiroberi: 5 ml ya mankhwalawa iyenera kuchepetsedwa mu malita 4 a madzi. Muzochitika izi, mankhwala ophera tizilombo ku Alatar (malingana ndi malangizo) athandizira kuti athetse karoti tsamba fulakesi, anyezi kuuluka ndikuteteza mabulosi ku rasipiberi-sitiroberi kubala zipatso.

Kumwaza nthambi ya mtengo wa maapozi, ndi mitengo ya mapeyala ndi masipika, imachitika nthawi yogwira mitengo, itatha kumwa 5 ml ya mankhwalawa mu 10 l madzi. Pafupifupi, malita 5 okugwirira ntchito amagwiritsidwa ntchito pa mtengo umodzi: 3 l - kwa achinyamata toyesa ndi 6-8 l - pa kubzala wamkulu. Adani ambiri a mtengo wa maapulo ndi njenjete, kafadala, maluwa, njenjete, njenjete, mavuu, masamba a masamba, ndipo Alatar imagwirizana nawo bwino kwambiri.

Kuchitira currants ndi jamu, 5 ml ya mankhwalawa ayenera kuchepetsedwa m'madzi 5 a madzi.

Kukula kwa madzi akugwira ntchito mpaka 1 litre pachitsamba chilichonse, komwe kumathandiza kuchotsa nsabwe za m'masamba.

Mitengo yokongoletsera, zitsamba ndi mbewu zamaluwa

Njira ya Alatar imathandizanso kuchotsa tizirombo tikamakula tchire lokongoletsera ndi mitengo m'deralo. Zomera zotere zimafunikira chisamaliro chapadera, kotero zimapoperedwa katatu: zisanachitike kapena zitatha maluwa, komanso nthawi yakula. Kugwiritsira ntchito yankho lomalizidwa ndi 1.5 malita 10 m², ndipo kupopera mbewu mankhwalawa kumachitika bwino kwambiri m'mawa kapena nthawi yamadzulo (dzuwa litalowa), nyengo yofunda komanso yopanda mvula. Masamba onse azomera azikhala wothira bwino, maola 4-6 mvula isanayembekezere.

Kutentha kwabwino kwa njirayi kumawonedwa kuti ndi + 12 ... + 25 ° С. "Alatar" pakuwongolera tizilombo kumateteza mitengo yokongoletsa ku akuyamwa ndi tizirombo timadyedwe masamba, ma dipterans ndi pitani alendo osakumananso (Izi zikuwonekeranso mu malangizo). Kuthira mbewu zotere, 5 ml ya mankhwalawa (supule imodzi) imaphatikizidwa mu 3.5 l yamadzi.

"Alatar" ndi yoyeneranso kukonza mbewu zamkati, ndipo ngakhale mulingo woyenera wa maluwa m'miphika sutchulidwa mu malangizo ogwiritsira ntchito, iwo akhoza kuthiridwa ndi mawonekedwe omwewo omwe mumagwiritsa ntchito pokonza zitsamba zokongoletsa.

Ubwino wogwiritsa ntchito mankhwalawa "Alatar" kuwongolera tizilombo

Ma mankhwala onse omwe amagwiritsidwa ntchito masiku ano ali ndi zinthu zina zofunikira, koma za Alatara, poyerekeza ndi omwe akupikisana nawo Ili ndi zotsatirazi:

Ili ndi mphamvu zambiri, zomwe zimachitika makamaka chifukwa cha kupezeka kwa zinthu ziwiri zamphamvu zomwe zimathandizira kuti chiwonongeko chokwanira ngakhale cholimbana kwambiri ndi tizirombo ta mankhwala,
ili ndi zomatira zapadera zomwe zimalepheretsa kuchotsedwa kapena kuchotsedwa mwachisawawa kwa masamba masamba azomera zomwe zimagwiridwa,
Ili ndi nthawi yayitali yogwiritsira ntchito, yomwe imafotokozedwa ndi kuchepera kwa mankhwala a chinthucho (nthawi zambiri, 10 ml yamadzi ndi yokwanira kumtundu umodzi wokhala ndi voliyumu ya 5 ml).

Njira zodzitetezera pogwira ntchito ndi mankhwalawa

Pogwira ntchito ndi mankhwala aliwonse, njira zopewera chitetezo ziyenera kuonedwa nthawi zonse. Choyambirira, ndikwabwino kuti muchite kusinthaku mukakhazikika kapena kuti mphepo ibwere kuchokera kwa inu. Kachiwiri, onetsetsani kuti mwaphimba ndi zovala mbali zonse za thupi (valani magolovesi ndi chipewa). Magalasi ndi mpweya wopumira sangakhale wopepuka, chifukwa mutha kuteteza maso anu, kugaya chakudya ndi ziwalo zopumira. Komanso onetsetsani kuti mukamachita ndalamazi mulibe anthu kapena nyama pafupi.

Osasuta kapena kudya mukamapopera. Ngati, mosamala mosamala konse, mankhwalawo amatha kulowa m'maso kapena pakhungu, ayenera kutsukidwa ndi madzi oyera ambiri. Ngati kapangidwe kake katalowa mthupi kudzera mkamwa, muzimutsuka ndi madzi, imwani magalasi angapo a madzi ofunda kapena mkaka ndikuyika makala oyaka pa 1 g pa 1 makilogalamu a thupi. Zitatha izi, pakukhumudwitsa khoma lanyumba yakumapeto, kusanza ndikofunikira.

Mukamaliza ntchitoyo, sambani m'manja nthawi yomweyo ndi sopo, ndipo ngati zingatheke ndibwino kusamba.

Malo osungira ndi alumali moyo wa Alatara

"Alatar" ngati njira yothandizira nsabwe za m'masamba, nsikidzi, nkhupakupa ndi tizirombo tina zimaperekedwa mwa ma ampoules (5 ml) kapena 25 ml mbale. Mulimonsemo, alumali moyo wophunzirawo suyenera kupitirira zaka ziwiri. Nthawi yonseyi, phukusi lokhala ndi mankhwalawa liyenera kukhala m'chipinda chouma komanso chamtundu wa -5 ° С ... + 25 ° С, mosiyana ndi zakudya ndi mankhwala. Kuphatikiza apo, ana kapena ziweto sayenera kupita nazo. Komanso, malonda ake ayenera kutetezedwa ku moto.

Zowonadi, kugwira ntchito m'munda ndi m'munda sikungatchedwe kuti ntchito yophweka, kuwonjezera apo, zotsatira zomaliza sizitengera kulimbikira nthawi zonse. Kuphatikiza pa umunthu, nyengo ndi nyengo zimagwira ntchito yayikulu, koma izi sizitanthauza kuti muyenera kupirira. Popeza tidasinthira mbewu ndi Alatar muwathandiza kuthana ndi vuto limodzi lalikulupo - tizirombo, ndi mbewu zathanzi zimatha kulekerera mphepo yozizira kapena mvula.

Njira yogwiritsira ntchito

Kuwonjezeka kwina kwa mankhwalawa sikubweretsa kuwonjezeka kwa achire, koma pena pake mlingo waukulu wa tsiku ndi tsiku umatha kuchuluka mpaka 6 mg. Mlingo wonse wa tsiku ndi tsiku umatengedwa panthawi yayikulu (yoyamba) chakudya. Mapiritsiwo ayenera kutsukidwa ndi madzi okwanira. Ngati 1 mg ya glimepiride imayambitsa kukula kwa hypoglycemia, makamaka, kwa odwala oterewa pochiza matenda ashuga, chakudya chokwanira chikhala chokwanira. Mankhwala, pangafunike kuchepetsa kuchuluka kwa glimepiride, yomwe imalumikizidwa ndi kagayidwe kazachuma ndikuwonjezera mphamvu ya minofu ya insulin.
Mankhwala Altar angagwiritsidwe ntchito ngati monotherapy, komanso kuphatikiza ndi insulin kapena metformin.

Zotsatira zoyipa

Zotsatira zoyipa kuchokera pakumwa mankhwala Guwa zimatha kuchitika mozungulira dongosolo: kawirikawiri - leukopenia, thrombocytopenia, granulocytopenia, agranulocytosis, hemolytic anemia, pancytopenia. Zinthu zonse zimasinthidwa.
Pa mbali ya chitetezo chamthupi: munthawi zina, hypersensitivity reaction imawonedwa, kuwonetsa ochepa hypotension, kupuma, anaphylactic mantha. Osowa kawirikawiri, vasculitis yokhala m'mimba imatha kudziwika, komanso mawonekedwe amomwe amayambitsidwa ndi sulfonamides, zotumphukira za sulfonylurea kapena zinthu zina zokhudzana nazo.
Pa gawo la kagayidwe kake kakang'ono: kawirikawiri hypoglycemia.
Kuchokera kumbali yakuwonetseredwa koyambirira: kumayambiriro kwa chithandizo, kuwonongeka kwakumapeto kwa chiwonetsero chifukwa kusinthasintha m'magazi a glucose akhoza kujambulidwa.
Kuchokera mmimba: kusanza, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kumverera kwadzaza m'mimba. Zizindikirozi zimafuna kusiya kwa mankhwalawo.
Kuchokera ku hepatobiliary system: kuchuluka kwa michere ya chiwindi. Osowa kwambiri - jaundice, cholestasis, chiwindi kulephera, chiwindi.
Kuchokera pakhungu: kuyabwa, urticaria, exanthema, kawirikawiri - photosensitivity.
Zosokoneza za electrolyte: kawirikawiri - hyponatremia.

Contraindication

Contraindication kugwiritsa ntchito mankhwalawa Guwa ndi: ketoacidosis, mtundu wa matenda ashuga a shuga, kukomoka kwa matenda ashuga, matenda owopsa a chiwindi ndi impso, hypersensitivity to glimepiride ndi sulfonylureas ena. Hypersensitivity pazinthu zothandizira za Guwa.

Kuchita ndi mankhwala ena

Mukumwa mankhwalawo Guwa ndi mankhwala ena onse, kuwonjezeka kofooka kapena kosayenera kwa katundu wake wa hypoglycemic titha kudziwika. Glimepiride imapereka mphamvu yake kudzera mu cytochrome P450 2C9. Zimatsimikiziridwa kuti kugwiritsa ntchito kwa ophatikizira (mwachitsanzo, rifampicin) ndi cytochrome P450 2C9 inhibitors (fluconazole) kumakhudza kagayidwe ka glimepiride.
Kuwonjezeka kwa mphamvu ya hypoglycemic ya mankhwala a Altar kumawonedwa pakamagwiritsidwa ntchito munthawi yomweyo phenylbutazone, azapropazone, oxyphenbutazone, sulfinpyrazone, mankhwala opatsirana pakamwa, insulin, sulfanilamides yokhala ndi nthawi yayitali, mankhwalawa, mankhwala osokoneza bongo ndi mankhwala a anabolic. , chloramphenicol, phenenicide, coumarin anticoagulants, miconazole, fenflura mines, pentoxifylline (pa os waukulu Mlingo), ma fibrate, tritokvalin, zoletsa za ACE, fluoxetine, allopurinol, sympatholytic, cyclophosphamide, trophosphamide, ifosfamide, fluconazole. Kuchepa kwa mphamvu ya hypoglycemic ya mankhwala a Altar kumawonedwa pakamagwiritsidwa ntchito nthawi yomweyo ndi estrogens ndi progestogens, saluretics, thiazide diuretics, othandizira omwe amalimbikitsa ntchito ya chithokomiro cha chithokomiro, GCS, phenothiazine ndi chlorpromazine, epinephrine ndi sympathomimetics, nicotinic acid. , finitoin, diazoxide, glucagon, barbiturates, rifampicin, acetazolamide. Β-adrenergic blockers ndi H2-receptor blockers, reserpine ndi clonidine akhoza kufooketsa kapena kuwonjezera mphamvu ya hypoglycemic ya mankhwala Altar. Mothandizidwa ndi sympatholytics monga reserpine, guanethidine, clonidine, ndi β-adrenergic blockers, zotsatira za kulipidwa kwa adrenergic kutsika kwa kuchepa kwa glucose kungakhale kofooka kapena kusakhalapo. Glimepiride imafooketsa kapena kuwonjezera zomwe zimachitika chifukwa cha coumarin.

Bongo

Palinso kunjenjemera, hypertonicity, mydriasis, kusokonezeka kwa tulo, endocrine psychosyndrome (zovuta zamakhalidwe - mwachitsanzo, kupsa mtima, kusakhazikika, chisamaliro chochepa, kupsinjika, chisokonezo), kusakhulupirira mayendedwe, kusinthika kwachidziwikire, kusuntha, kutsutsana, zizindikiro (hemiplegia, diplopia, aphasia), kupsinjika, kugona, chikomokere, matenda amisala.
Chithandizo. Choyamba, zinthu zimatengedwa kuti zithetse mankhwalawa kuchokera mthupi: kusanza, kusanza, kugwiritsa ntchito sodium sulfate ndi kaboni yoyambitsa. Hypoglycemia popanda kutaya chikumbumtima chitha kuthetsedwera pakamwa 20 g shuga, shuga kapena zipatso. Woopsa mitundu ya hypoglycemia, limodzi ndi kufooka, kuyikidwa kwadzidzidzi kwa venous catheter ndikofunikira, pambuyo pake njira ya 20% shuga (40-100 ml) imaperekedwa. Ngati catheter sanayikidwe, 1-2 ml ya glucagon amatha kutumikiridwa mosakakamiza kapena m'mitsempha. Pambuyo kuchira kotheratu kwa chikumbumtima popewa kuyambiranso, ndikofunikira kumwa 20-30 g wama chakudya chilichonse pakadutsa maola 24-48. Pambuyo pakutha kwa boma la hypoglycemic, glucose imayang'aniridwa kwa maola 48. Zikachitika kuti kusowa kwa chikumbumtima kumapitilizabe, kulowetsedwa kwina kwa 5-10% shuga kumachitika. Ngati chithunzi cha chipatala sichingasinthe, muyenera kuganizira china, chosagwirizana ndi hypoglycemia, chifukwa cha kusazindikira. Mofananamo, ndikofunikira kuyendetsa mankhwalawa matenda a ubongo edema (sorbitol, dexamethasone) ndikuwunika momwe wodwalayo alili.

Kutulutsa Fomu

1 mg mapiritsi a 30, 60, 90, 120.
Mapiritsi a 2 mg No. 30, 60, 90, 120.
3 mg mapiritsi No. 30, 60, 90, 120.

Piritsi 1 imakhala ndi glimepiride 1, 2 kapena 3 mg.
Zosakaniza zina: lactose monohydrate, wowuma chimanga, sodium wowuma glycolate (mtundu A), polysorbate 80, povidone, talc, magnesium stearate.

Kufotokozera za mankhwala a Alatar

Alatar ndi mankhwala ogwirizana ndi mankhwala ophera tizilombo omwe ali ndi zochita zambiri.Chifukwa chakuvuta kwa magawo awiri a mankhwala a malathion ndi cypermethrin, chidacho chimachotsa mwachangu tizirombo ta mitundu 28 yomwe imapezeka kwambiri.

Popeza magawo awiriwa amathandizira bwino ntchito ya wina ndi mnzake, Alatar imalimbana bwino ndikuwoneka koyamba kwa kachilomboka, kuchuluka kwakukulu ndikukula.

Kupanga ndi mawonekedwe a kumasulidwa

Kuti muwonjezere kugwira ntchito kwa Alatar, kapangidwe kake kamaphatikizapo zinthu zazikulu komanso zothandiza:

Milatonin, yogwirizana ndi organic phosphate mankhwala. Gawoli limakhala ndi poyizoni wa tizilombo tambiri timene timadya masamba, zipatso ndi zokongoletsera.
Cypermethrin ndi mankhwala ogwirira ntchito a pyrethroid omwe mayendedwe ake amayambitsa ziwindi.
Zojambula zowonjezera pamtunda, kukonza zotsatira za zinthu ziwiri zoyambira,
Zosungunulira zowonjezera, kukhazikika kwa zinthu ndi zigawo za antioxidants.

Njira ya zochita pa tizirombo

Mankhwalawa, chifukwa chogwira ntchito mwachangu komanso mwachangu pazinthu ziwiri zogwira ntchito nthawi imodzi, amalowa m'matumbo a kachilombo, kapena mphutsi zimagwira pa dongosolo lamanjenje, ndikuyambitsa ziwengo. Chifukwa cha kusayenda bwino komanso kusatha kudya, tizilombo toyambitsa matenda timafa msanga.

Kuphatikiza apo, Alatar ili ndi zinthu zina zomatira zothandizidwa, chifukwa cha poizoni yemwe amatsamira pansi pamasamba ndikuyambira modalirika kwa nthawi yayitali. Ngakhale kuthilira kwambiri kapena mvula, mphamvu za Alatar sizikutha, chifukwa chifukwa chomatira zomata zimakhalabe pamasamba mutatha kulumikizana ndi madzi.

Mankhwala

Thupi glimepiride bwino amachepetsa shuga. Mankhwalawa amagwiritsidwa ntchito pochiza matenda a shuga. Gawo lolimbikira limagwira makamaka polimbikitsa kutulutsa kwa insulin kuchokera ku ma cell a pancreatic β. Kuchita izi kumachitika chifukwa cha kuchuluka kwa mayankho a β-cell kukondoweza ndi njira yothandizira thupi.

Glimepiride imathandizira katulutsidwe ka insulin mwa kukopa njira za potaziyamu, zomwe zimatengera zinthu za ATP (zomwe zimakhala mkati mwa nembanemba ya β-cell). Kuphatikiza apo, thunthu limakhala ndi extrapancreatic kwenikweni, limapangitsa chidwi cha zotumphukira za insulin, komanso kuchepetsa ziwopsezo za ku chiwindi.

Pharmacokinetics

Pambuyo pakulowetsa, glimepiride amawonetsa bioavailability wathunthu. Kudya pang'ono kumakhudza kuyamwa kwa mankhwalawa - kuchuluka kwake pankhaniyi kumachepetsedwa pang'ono. Makhalidwe abwino a seramu amadziwika pambuyo pa maola 2,5 atatha kulowetsa piritsi mkati. Peak yamtengo wapatali mkati mwa seramu yolumikizana mosiyanasiyana ndi kukula kwamankhwala.

Glimepiride ili ndi chizindikiro chotsika cha kuchuluka kwa magawidwe (pafupifupi 8.8 l), omwe ali ofanana ndi a albin. Mankhwalawa amakhalanso ndi mitundu yambiri ya mapuloteni (oposa 99%) ndi mitengo yotsika (48 ml / miniti).

Hafu ya moyo wa magazi seramu pafupifupi maola 5-8. Pambuyo pa limodzi mlingo wa mankhwala, ma radioacase otsatirawa adalembedwa: mkodzo, 58%, ndi ndowe, 35%. Potere, gawo losasinthika silidadziwika mkodzo.

Kuchita ndi mankhwala ena

Mukaphatikiza mankhwalawa ndi mankhwala ena, kuchepa kapena kuwonjezeka kosafunikira kwa zotsatira zake za hypoglycemic ndikotheka. Glimepiride imakhudza thupi mothandizidwa ndi hemoprotein P450 2C9. Zawululidwa kuti zochita za metabolism za chinthuchi zimakhudzidwa ndi omwe amathandizira pophatikiza (monga rifampicin) kapena ma inhibitors (monga fluconazole) a hemoprotein P450 2C9.

Kuwonjezeka kwa mphamvu ya hypoglycemic ya Altara kumachitika pakaphatikizidwe ndi sulfinpyrazone, komanso kuphatikiza ndi oxyphenbutazone, azapropazone ndi phenylbutazone. Zomwezi zimachitikanso ndikuphatikiza mankhwalawa ndimankhwala a hypoglycemic, ma tetracyclines, MAOI, sulfonamides (kutulutsa nthawi yayitali), insulin, PASK ndi salicylates. Kuphatikiza apo, mahomoni ogonana (wamwamuna) ndi othandizira a anabolic, mankhwala a antibacterial ochokera ku gulu la quinolone derivative, komanso probenicide, chloramphenicol, fenfluramine, coumarin anticoagulants ndi miconazole okhala ndi pentoxifylline (milingo yayikulu). Mndandandawu umaphatikizapo ACE inhibitors, fibrate, fluoxetine wokhala ndi tritokvalin, sympatholytics, allopurinol, trophosphamide ndi cyclophosphamide, komanso fluconazole ndi ifosfamide.

Kuchepa kwa mphamvu ya hypoglycemic ya mankhwala kumachitika ngati mukuphatikizana ndi progestogens ndi estrogens, komanso mankhwala a thiazide diuretic, saluretics, ntchito ya chithokomiro, mankhwala opatsirana, epinephrine ndi GCS, komanso sympathomimetics ndi phenothiazine ofanana ndi chlorpromazine. Komanso akaphatikizidwa ndi niacin ndi zotumphukira zake, phenytoin, mankhwala othandizira (pogwiritsa ntchito nthawi yayitali), glucagon ndi diazoxide, komanso rifampicin, barbiturates ndi acetazolamide.

Mankhwala omwe amaletsa β-adrenergic receptors ndi kuchotsedwa kwa H2, komanso, clonidine yokhala ndi reserpine imatha kuyambitsa komanso kufooketsa mphamvu ya hypoglycemic. Mothandizidwa ndi sympatholytics (pakati pawo clonidine wokhala ndi reserpine, mankhwala omwe amatchinga β-adrenergic receptors, komanso guanethidine), zotsatira za comprenatory adrenergic athari, zomwe zimapangitsa kuchepa kwama glucose, amatha kuchepa kapena kutha konse.

Glimepiride imayamba kuvuta kapena imayambitsa zotsatira za zotumphukira za coumarin.

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Zotsatira zoyipa

Gawoli lotsatirali limagwiritsidwa ntchito poyesa zovuta zomwe zimachitika: pafupipafupi> 1/10, nthawi zambiri:> 1/100 ndi 1/1000 ndi 1/10 000 ndi 1)

1) Thrombocytopenia, leukopenia, erythrocytopenia, granulocytopenia, agranulocytosis, hemolytic anemia, pancytopenia, yomwe, monga lamulo, imazimiririka mankhwala atatha.

2) Momwe thupi limagwirira ntchito zimatha kukhala zovuta kwambiri poyambapo kupuma pang'ono, kuthamanga kwa thupi, ndipo nthawi zina ndimomwe zimayambira.

3) Zotsatira za Hypoglycemic nthawi zambiri zimachitika nthawi yomweyo, zimatha kukhala zovuta komanso sizovuta kusintha nthawi zonse.

4) Kuwonongeka kochepa kwakanthawi kumatha kuwonedwa makamaka nthawi zoyambirira zamankhwala ndipo kumachitika chifukwa cha kusintha kwa kuchuluka kwa shuga m'magazi.

5) Madandaulo am'mimba omwe nthawi zina amachititsa kuti pakhale mankhwala.

6) Hepatitis imatha kuyambitsa chiwindi.

Gwiritsani ntchito panthawi yoyembekezera komanso mkaka wa m`mawere

Palibe deta yokwanira yogwiritsira ntchito glimepiride kwa amayi apakati, chifukwa chake sayenera kugwiritsidwa ntchito nthawi yonseyi.

Sichidziwike, glimepiride imadutsa mkaka wa m'mawere. Chifukwa chakuti ena sulfonylureas amalowa mkaka wa m'mawere, pamakhala chiwopsezo cha hypoglycemia mwa mwana, chifukwa chake, mukamagwiritsa ntchito glimepiride, kuyamwitsa kuyenera kuyimitsidwa.

Glimepiride sayenera kugwiritsidwa ntchito mwa ana chifukwa chosadziwa zambiri.

Kutopa ndi kuwongolera tizilombo?

M'dzikomo kapena mu nyumba za agogo, mbewa kapena tizirombo tina tawonongeka? Muyenera kulimbana nawo! Amanyamula matenda oopsa: salmonellosis, matenda a chiwewe.

Anthu ambiri okhala chilimwe akukumana ndi tizirombo tomwe timawononga mbewuyi ndikuwononga mbewuzo.

Zikatero, owerenga athu amalimbikitsa kugwiritsa ntchito zatsopano - the Pest Reject repeller.

Ili ndi zinthu izi:

Imathandizanso udzudzu, maphemwe, makoswe, nyerere, nsikidzi
Otetezeka kwa ana ndi ziweto
Kuchepetsa mphamvu, kusinthanso kumafunikira
Palibe zochita zowononga tizirombo
Dera lalikulu la chida

Zolemba zogwiritsira ntchito

Mapiritsi ayenera kugwiritsidwa ntchito nthawi yomweyo musanadye kapena zakudya.

Ndi kudya kosakhazikika kapena ngati chakudya chatuluka, kugwiritsa ntchito glimepiride kungayambitse hypoglycemia. Zizindikiro za hypoglycemia ndizotheka: kupweteka mutu, kugona kwambiri, nseru, kusanza, kutopa kwambiri, kugona, kugona tulo, kukwiya, kuphwanya chidwi, kuchuluka kwa nthawi, kupsinjika, chisokonezo, kuyankhula ndi kusokonezeka kwa mawonekedwe, aphasia, kugwedezeka, paresis, kusokonezeka kwa malingaliro, chizungulire, kusowa chithandizo, kulephera kudziletsa, kupuma, kukomoka, kugona komanso kuwonongeka kwa chikumbumtima ndi chitukuko chamakhosi ndi chikomokere, kupuma kosakhazikika, bradycardia.

Kuphatikiza apo, zizindikiro monga thukuta, khungu losakwiya, nkhawa, tachycardia, matenda oopsa, kuthamanga kwamtima, angina pectoris, komanso kusokonekera kwa mtima. Mawonetsero azachipatala owonetsa kwambiri hypoglycemia angafanane ndi mawonedwe azachipatala a sitiroko.

Mkhalidwe wa hypoglycemia nthawi zambiri umatha kuthetsedwa mwachangu ndi kudya shuga (shuga). Zoyimira m'malo zopanga shuga sizoyenera izi.

Kuchokera pa zomwe mwakumana ndi mankhwala ena a sulfonylurea, zimadziwika kuti hypoglycemia imatha kubwereranso ngakhale zitakhala zoyipa zoyambirira. Hypoglycemia yayitali kapena yayitali, yogwiritsa ntchito shuga kwakanthawi, imafunikira chithandizo chamankhwala mwachangu komanso, mwina, kuchipatala.

Zinthu zotsatirazi zimathandizira kukulitsa kwa hypoglycemia: kusafuna kwa wodwala kapena kulephera kugwirizanitsa ndi dokotala (makamaka okalamba), zakudya zosavomerezeka, zosavomerezeka, kudumphadumpha chakudya kapena kufa ndi njala, kusamva bwino pakati pa zochitika zolimbitsa thupi ndi kudya zakudya zamagulu ambiri, kusintha zakudya, kumwa mowa, makamaka kuphatikiza kulumpha chakudya, matenda aimpso, kuwonongeka kwa chiwindi, kuchuluka kwa glimepiride, matenda ena osaperekedwa a endocrine system, carbohydrate kagayidwe kapena kuchita ngati wotsutsa-wa hypoglycemia (zina kukanika kwa chithokomiro, kusakwanira kwa anterior pituitary kapena adrenal cortex), munthawi yomweyo mankhwala ena.

Pa mankhwala a glimepiride, kuwunika pafupipafupi magawo otsatirawa ndikofunikira: kuchuluka kwa magazi ndi mkodzo, kuchuluka kwa glycosylated hemoglobin, zizindikiro za chiwindi, chithunzi cha magazi (makamaka kuchuluka kwa leukocytes ndi mapulateleti).

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina

Odwala omwe ali ndi matenda a shuga, chifukwa cha mayiko otero a hypo- kapena hyperglycemia, komanso pokhudzana ndi kuwonongeka kwakanema, chidwi chitha kuchepetsedwa, chomwe chimatha kukhala chowopsa poyendetsa galimoto kapena njira zamakina. Chifukwa chake, ayenera kulangizidwa kuti azisamalira mosamala zomwe zingalepheretse hypoglycemia poyendetsa. Izi ndizofunikira kwambiri kwa odwala omwe nthawi zambiri amakhala ndi machitidwe a hypoglycemia kapena kuchepetsedwa kapena samakonda kuzindikira zomwe ndi zizindikiro za hypoglycemia. Zikatero, muyenera kuganizira zoyenera kuyendetsa.

Mankhwala

Mankhwala Glimepiride ndi othandizira a hypoglycemic omwe amagwiritsidwa ntchito pochiza odwala omwe samadwala matenda a shuga.

PharmacokineticsZogulitsa. The bioavailability wa glimepiride pambuyo pakamwa makonzedwe ake. Kudya sikumakhudzana kwambiri ndi mayamwa, koma kuchuluka kwa mayamwidwe kumachepa pang'ono. The ambiri ndende mu seramu (C _max ) pakulowa pambuyo pakumatha maola 2,5 (pafupifupi 0,3 μg / ml wowonjezera mobwerezabwereza pa 4 mg patsiku), komanso kulumikizana kwina pakati pa mlingo ndi C kumawonedwa _max komanso dera lomwe lili pansi pa ndende ya nthawi (AUC).

Kugawa. Mu glimepiride, voliyumu yaying'ono yogawa (pafupifupi malita 8.8) ndiyofanana ndendende ndi albumin, mapuloteni ambiri (> 99%) ndi chilolezo chochepa (pafupifupi 48 ml / min).

Kutetemera ndi kuchotsedwa. Hafu ya moyo wa seramu ili pafupifupi maola 5-8. Patatha muyezo umodzi wa glimepiride wokhala ndi cholembera wailesi, radioacaction inatuluka mkodzo (58%) ndi ndowe (35%). Chosakaniza chogwira ntchito mu mkodzo sichinawonekere. Ma metabolites awiri adadziwika mumkodzo komanso ndowe: hydroxy derivative ndi carboxypochidne glimepiride. Pambuyo potenga glimepiride, theka lomaliza la moyo wa metabolites awa anali maola 3-6 ndi maola 5-6, motsatana. Poyerekeza zolowetsa nthawi imodzi patsiku ndi kusinthika kwakanthawi kofanana sikunawululidwe, ndipo kusinthasintha kwake sikunali kwakukulu kwambiri. Palibe kukondoweza kwakukulu komwe kunadziwika. Chemacokinetics yofananira imawonedwa mwa amuna ndi akazi, komanso kwa odwala aang'ono ndi odwala omwe ali ndi zaka zopitilira 65.

Opanga

Kupanga Kwambiri:

Malo. X-17 / X-18, O.I.D.Ts., Mahatma Gandhi Udiog Nagar, Dubhel, Daman 396210, India.

Kupanga "zochuluka", zomaliza zomaliza, zopanga zingapo:

A.Menarini Kupanga Logistics & Services S.r.l.

Malo. Via Campo di Pile 67100 L'Aquila (AK), Italy.

A. Menarini Production Logistics & Services S.r.l.

Malo. Via Sete Santi 3, 50131 Florence (FI), Italy.

Kukhazikitsa Alatar

Alatar imakhala ndi zotsatirapo zosiyanasiyana zoyipa, imavulaza ma colorado, zolembera zamkati, azungu, scoops, masamba, aphid, makosi, kupindika, zovala zoyera, mavuvu, nkhupakupa ndi tizilombo tina tambiri timene timavulala m'munda ndi mbewu zapakhomo. Kugwiritsa ntchito mankhwalawa kungagawidwe pothandizidwa ndi mbewu zamkati, mbewu zamalonda.

Zomera zamkati

Chithandizo cha maluwa amkati ndi kukongoletsa tchire lanyumba chimachitika bwino kwambiri pogwiritsa ntchito Alatara. Koma kukonza kumafunikira kusamala kwapadera, popeza njirayi imachitika m'malo otsekedwa ndi mpweya wabwino.

Kupanga kwanyumba zamkati ndi Alatar kumachitika:

Chotsani nsabwe za m'masamba, zopondera, njenjete ndi tizilombo tina tomwe timadya maluwa ndi zitsamba,
Pofuna kuthana ndi tizilombo timene timatha kudya zokongoletsera m'nyumba,
Pofuna kupewa kuoneka ngati magazi ozizira komanso kuti asawabwezere.

Zomera zam'mera

M'minda ya dachas ndi masamba, Alatar imagwiritsidwa ntchito ndi wokonda dimba wina aliyense, chifukwa nayo, mavuto oterewa ndi maluwa, masamba ndi zipatso ndi mitengo ya mabulosi amathetsedwa:

Ikani chida pakuchotsa msuzi wa kachilomboka ka Colorado,
Kuthana ndi mitengo yodyeka ndi njenjete ndi timapepala,
Kupatula mawonekedwe ndi kulimbana ndi ma aphid wamba, achindunji komanso apamwamba,
Kupha tizirombo tomwe timavulaza zipatso ndi mabulosi monga maofesi,
Kuthetsa tizirombo todya mbewu zamasamba, m'chifanizo cha scoop, ntchentche kabichi, njereza, njenjete ndi masamba,
Kuonetsetsa chitetezo cha maonekedwe kapena kubweranso kwa tizilombo tonse totsala ndi ena ambiri.

Mitengo yogwiritsa ntchito

Kutengera ntchito yake ndikamagwiritsa ntchito mankhwala osokoneza bongo, kuchuluka kwake kwa nthawi yopopera mankhwalawa kumasinthanso.

Miyezo yayikulu yogwiritsira ntchito pokonza mbewu zamasamba osiyanasiyana:

Pofuna kuthana ndi colorado, weevil ndi tizilombo tina tomwe timadya zipatso zamasamba, 5 ml ampoule sitimadzipereka ndi malita 4 a madzi. Kumwaza kumachitika nthawi yamaluwa, ndikugwiritsa ntchito phulusa 4 malita a phulusa lomwe limapezeka pa 100m2.
Pozunzidwa ndi anyezi kuuluka, mankhwala awiri amachitika kale ndi yankho lomwelo la colorado.
Kuwonongeka kwa phesi ndi kapepala kumaphatikiza kukhathamiritsa ndi mulingo umodzi wa mankhwalawa, wothiriridwa mu 10 malita a madzi.Spray malita 5 nthawi yamaluwa.
Pofuna kuwononga nsabwe za m'masamba, 5 ml ya mankhwalawa imasungunuka 5 malita a madzi. Kufufuza zikuyenera kuchitika nthawi yakula pamlingo wa 1 lita imodzi shrub.
Kuteteza ndi kuchitira maluwa okongoletsera ndi zitsamba kumachitika ndi njira yothetsera kuchuluka kwa malita 10 amadzi mu botolo limodzi. Chitsamba chimodzi sichikhala ndi phulusa losaposa malita 5 pa 100 sq.m. malo obzalidwa.

Mankhwala

Njira yothira mbewu ikakonzeka, amayamba kuzunzidwa ndi magazi ozizira.

Malangizo a kupopera mbewu mankhwalawa ndi Alatar:

Kuwona mosamala kuchuluka kwa kupopera mbewu mankhwalawo ndi mankhwalawo, masamba a chomera amawathandizira pogwiritsa ntchito mfuti yoluka.
Kumwaza kumachitika m'masiku owuma ndikathilira,
Kuwongolera kwa mphepo kuyenera kukumbukiridwa, chifukwa mankhwalawo sayenera kupopera mbewu pomera mbewuzo,
Msewu suyenera kukhala wotentha kuposa madigiri 25 (kapena kutentha pang'ono kuposa 12 degrees), popeza kusayang'anira kutentha kwa nyengo kumakhala ndi zotsatira zoyipa nthawi yayitali yogwira mankhwala.

Njira zopewera kupewa ngozi

Mukamapopera munthu ayenera kukhala ndi chovala chotsekedwa ndi manja azitali zolimba. Nkhope imayenera kukhala ndi chigoba kapena kupumira, ndi magalasi, popeza kulumikizana ndi poizoni ndi mucous nembanemba kapena maso kumatha kusiya kuyaka.

Ngati Alatar idalowa pakhungu kapena mucous nembanemba, kapena maso - madera awa ayenera kutsanuliridwa nthawi yomweyo ndi madzi ambiri ofunda.

Kugula komanso kuchuluka kwa mankhwalawo?

Gulani Alatar si yovuta, ingofunsani za kupezeka kwa mankhwalawa mu shopu iliyonse yapadera. Komanso, mtengo wazogulitsa ndiwademokalase kwambiri, chifukwa botolo lomwe lili ndi 25 ml mudzafunika kulipira zosaposa ma 70-80 rubles.

Kapenanso mutha kupeza mankhwalawo pa intaneti. Chiwerengero zokwanira bwino zimapereka mwayi osati kungolamula mankhwalawo kunyumba, komanso kupereka malangizo pakugwiritsa ntchito kwake. Mtengo mumanetiwo udzasiyana ndi 40 mpaka 70 ma ruble 25 ml a Alatar.

Zotsatira za pharmacological

The yogwira ndi glimepiride - wogwira hypoglycemic wothandizila kugwiritsidwa ntchito pochiza odwala matenda a shuga mellitus. Glimepiride imalimbikitsa kutulutsa kwa insulin ndi ma pancreatic β-cell. Izi zimagwirizanitsidwa ndikuwonjezereka kwa maselo β masinthidwe achilengedwe a shuga. Glimepiride ali ndi bioavailability pambuyo pakamwa. Kudya sikukukhudzira kwambiri kuperewera kwa mankhwalawa, kumangokhala kuchepa pang'ono chabe kwa mayamwidwe. Pazipita ndende ya mankhwala seramu amalembedwa 2,5 mawola pakamwa. Ubale wolumikizana pakati pa Mlingo wa glimepiride ndi kuphatikiza kwake kwakukulu mu seramu yamagazi kumadziwika. Glimepiride ili ndi voliyumu yaying'ono yogawa (pafupifupi 8.8 L), yofanana ndi ya albin, yomanga kwambiri mapuloteni a plasma (oposa 99%) komanso chilolezo chochepa (48 ml / min).

Hafu ya moyo wa seramu pafupifupi 5-8 maola. Ndi makina amodzi okha a glimepiride okhala ndi cholembera wailesi, wa radioactivity wa mkodzo (58%) ndi ndowe (35%) walembedwa. Zinthu zosasinthika mumkodzo sizinadziwike. Poyerekeza Mlingo wambiri komanso umodzi, ma pharmacokinetics a mankhwalawa sanasinthe kwambiri, ndipo mawonekedwe amodzi oscillations sanasiyane kwambiri. Kupanga kofunikira sikudziwikanso konse. Mwa amuna ndi akazi, komanso mwa anthu a zaka zazing'ono ndi zakale (zopitilira 65), pharmacokinetics yofanana ya mankhwalawa imadziwika. Kuchepetsa kuchepa kwa kuchuluka kwa glimepiride mu seramu yamagazi kumaonedwa mwa anthu omwe ali ndi gawo lotsika la creatinine, lomwe limatha kuphatikizidwa ndikuchotsa mwachangu kwa chinthu chogwira (chifukwa chochepa kwambiri chomanga mapuloteni a plasma). Kuchuluka kwa mankhwalawa m'gululi la odwala sikuwoneka ngati kukuchitika.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi kuperekera pamodzi kwa mankhwala Altar ndi mankhwala ena, kuwonetsa kufooka kapena kosafunikira kwakadabwidwe kake kamatha kuzindikira. Glimepiride imapereka mphamvu yake kudzera mu cytochrome P450 2C9. Zimatsimikiziridwa kuti kugwiritsa ntchito kwa ophatikizira (mwachitsanzo, rifampicin) ndi cytochrome P450 2C9 inhibitors (fluconazole) kumakhudza kagayidwe ka glimepiride.
Kuwonjezeka kwa mphamvu ya hypoglycemic ya mankhwala a Altar kumawonedwa pakamagwiritsidwa ntchito munthawi yomweyo phenylbutazone, azapropazone, oxyphenbutazone, sulfinpyrazone, mankhwala opatsirana pakamwa, insulin, sulfanilamides yokhala ndi nthawi yayitali, mankhwalawa, mankhwala osokoneza bongo ndi mankhwala a anabolic. , chloramphenicol, phenenicide, coumarin anticoagulants, miconazole, fenflura mines, pentoxifylline (pa os waukulu Mlingo), ma fibrate, tritokvalin, zoletsa za ACE, fluoxetine, allopurinol, sympatholytic, cyclophosphamide, trophosphamide, ifosfamide, fluconazole.

Kuchepa kwa mphamvu ya hypoglycemic ya mankhwala a Altar kumawonedwa pakamagwiritsidwa ntchito nthawi yomweyo ndi estrogens ndi progestogens, saluretics, thiazide diuretics, othandizira omwe amalimbikitsa ntchito ya chithokomiro cha chithokomiro, GCS, phenothiazine ndi chlorpromazine, epinephrine ndi sympathomimetics, nicotinic acid. , finitoin, diazoxide, glucagon, barbiturates, rifampicin, acetazolamide.
Β-adrenergic blockers ndi H2-receptor blockers, reserpine ndi clonidine akhoza kufooketsa kapena kuwonjezera mphamvu ya hypoglycemic ya mankhwala Altar. Mothandizidwa ndi sympatholytics monga reserpine, guanethidine, clonidine, ndi β-adrenergic blockers, zotsatira za kulipidwa kwa adrenergic kutsika kwa kuchepa kwa glucose kungakhale kofooka kapena kusakhalapo. Glimepiride imafooketsa kapena kuwonjezera zomwe zimachitika chifukwa cha coumarin.