Diamerid mankhwala: malangizo ntchito > Chithandizo ndi kupewa

Fomu ya kutulutsidwa kwa Diameride ndi magome: flat-cylindrical, ndi bevel, malingaliro pang'ono ndi ovomerezeka, 1 ndi 3 mg iliyonse ndi yapinki yokhala ndi bulauni ya bulauni, 2 ndi 4 mg iliyonse imachokera kuchikasu kapena kuwala pang'ono mpaka mtundu wa zonona (m'mapaketi a 10 pcs. ., pamakatoni okhala ndi mapaketi atatu kapena 6).

Piritsi limodzi:

yogwira mankhwala: glimepiride - 1, 2, 3 kapena 4 mg (malinga ndi 100%),
othandizira zigawo (1/2/3/4 mg): mphamvu ya magnesium - 0,6 / 0.6 / 1,2 / 1,2 mg, lactose monohydrate - 78.68 / 77.67 / 156.36 / 155, 34 mg, croscarmellose sodium - 4.7 / 4.7 / 9.4 / 9.4 mg, povidone - 2,5 / 2,5 / 5/5 mg, poloxamer - 0,5 / 0,5 / 1 / 1 / mg, ma cellcose a microcrystalline - 12/12/24/24 mg, utoto wachikasu utoto okusayidi - 0 / 0,03 / 0 / 0,06 mg, utoto wofiyira wachitsulo - 0,02 / 0 / 0,04 / 0 mg

Contraindication

lactose tsankho, kufupika kwa lactase, shuga-galactose malabsorption,
leukopenia
matenda ashuga ketoacidosis, matenda a shuga
mtundu 1 shuga
zinthu limodzi ndi vuto la mayamwidwe chakudya ndi kukula kwa hypoglycemia (kuphatikizapo matenda opatsirana),
ntchito kuwonongeka kwa impso / chiwindi kwambiri Inde (kuphatikizapo iwo a hemodialysis,)
Mimba ndi kuyamwa
wazaka 18
munthu tsankho kwa zigawo zikuluzikulu za mankhwala, kuphatikizapo hypersensitivity ena sulfonylurea zotumphukira kapena sulfonamide mankhwala (mogwirizana ndi mwayi wa hypersensitivity zimachitika).

Kulemba Diameride kumafuna kusamala pamaso pa zofunikira zomwe zimafunikira kuti wodwalayo asinthire mankhwala a insulin, kuphatikiza kuwotcha kwakukulu, chithandizo chachikulu cha opaleshoni, kuvulala kwambiri, malabsorption a chakudya ndi mankhwala kuchokera m'matumbo am'mimba (gastric paresis, kutsekeka kwamatumbo).

Mimba ikachitika kapena ngati akukonzekera, mkazi amafunika kusamutsidwira ku insulin.

Mlingo ndi makonzedwe

Diameride imatengedwa pakamwa.

Mapiritsi amatengedwa popanda kutafuna, athunthu, ndimadzi okwanira (pafupifupi 100 ml). Mukatha kumwa mankhwalawa, kudumpha chakudya osavomerezeka.

Dokotalayo amawona mankhwalawa mosiyanasiyana payekha, kutengera zotsatira za kuyang'anira ndende ya magazi.

Kumayambiriro kwa mankhwala, diamerid imayikidwa 1 mg patsiku. Pambuyo pokwaniritsa chithandiziro chokwanira, mankhwalawa amalimbikitsidwa kuti atengedwe ngati njira yokonzanso.

Milandu yakusowa kwa glycemic control, mlingo wa tsiku ndi tsiku uyenera kukhala pang'onopang'ono (pang'onopang'ono pakadutsa masabata 1-2) ukuwonjezeka poyang'anitsitsa kuchuluka kwa shuga kwa 2, 3 kapena 4 mg patsiku. Mlingo wapamwamba umagwira pokhapokha pokhapokha. Zolemba malire - 6 mg patsiku.

Nthawi ndi pafupipafupi kumwa mankhwalawa zimatsimikiziridwa ndi adokotala. Njira yogwiritsira ntchito diamerid iyenera kuganizira za moyo wa wodwala. Mlingo wa tsiku ndi tsiku uyenera kumwa kamodzi pakudya musanadye kapena pakudya kadzutsa.

Diameride idapangidwa kuti ichitike kwakanthawi, komwe kuyenera kuchitika motsogozedwa ndi shuga m'magazi.

Milandu yakusowa kwa glycemic control mwa odwala omwe akutenga metformin, Diameride itha kuphatikizidwanso.

Mlingo wa metformin nthawi zambiri sasintha; kumayambiriro kwa mankhwala, diamerid iyenera kutumikiridwa muyezo wochepa, womwe umayamba pang'ono pang'ono mpaka wokwanira. Kuphatikiza mankhwala kuyenera kuchitika moyang'aniridwa ndi katswiri.

Ngati glycemic control siyingatheke mukamamwa mlingo wambiri wa Diameride ngati monotherapy, insulin yowonjezera ikhoza kutumikiridwa, yomwe imafotokozedwa muyezo woyambira kumayambiriro kwa mankhwala. Ngati ndi kotheka, kuwonjezeka kwapang'onopang'ono ndikotheka. Kuphatikiza mankhwala kuyenera kuchitika moyang'aniridwa ndi katswiri.

Posamutsa wodwala kuchokera ku mankhwala ena amkamwa a hypoglycemic kupita ku Diameride, mlingo wake woyamba wa tsiku lililonse uyenera kukhala 1 mg (ngakhale wodwalayo atachotsedwa pamtengo waukulu wa mankhwala ena amkamwa hypoglycemic). Kukula kulikonse kwa mlingo wa Diameride kuyenera kuchitika m'magawo molingana ndi malangizo omwe ali pamwambapa. Kugwiritsa, mlingo ndi nthawi ya ntchito ya hypoglycemic wothandizila ayenera kuganiziridwanso. Nthawi zina, makamaka mukamamwa mankhwala a hypoglycemic ndi moyo wautali wa moyo, kuyezetsa kwakanthawi kungafunike (kwa masiku angapo), zomwe zingathandize kupewa zotsatira zowonjezera zomwe zimawonjezera mwayi wa hypoglycemia.

Popanga insulin mankhwala mwa odwala omwe ali ndi matenda a shuga 2, kwinaku amalipiritsa matendawa ndikusunga chinsinsi cha pancreatic β-cell pazochitika zina, insulin ikhoza kulowa m'malo ndi Diamerid (kumayambiriro kwa chithandizo, mankhwala otsika kwambiri amagwiritsidwa ntchito). Kutanthauzira kuyenera kuchitika moyang'aniridwa ndi katswiri.

Zotsatira zoyipa

ziwalo zamawonedwe: kuchepa kwa mawonekedwe owoneka (osachedwa, monga lamulo, kumayambiriro kwa zamankhwala, chifukwa cha kusintha kwa kuchuluka kwa shuga m'magazi),
metabolism: kusintha kwa hypoglycemic (kumachitika patangotha nthawi yayitali Diamerid itatha ndipo imatha kupezeka mitundu yayikulu, sikumayimitsidwa mosavuta, maonekedwe awo amatsimikiziridwa ndi zinthu payekha, makamaka zakudya ndi mlingo womwe umagwiritsidwa ntchito),
hematopoietic dongosolo: thrombocytopenia (pang'ono kapena koopsa), leukopenia, granulocytopenia, erythrocytopenia, aplastic / hemolytic anemia, pancytopenia, agranulocytosis,
kugaya chakudya dongosolo: kusanza, nseru, kusokonekera / kupweteka kwa m'mimba, kupweteka kwam'mimba, kutsegula m'mimba.
zimachitika dermatological: Nthawi zina, porphyria mochedwa, photosensitivity,
thupi lawo siligwirizana: urticaria (monga kuyabwa, zotupa pakhungu, nthawi zambiri amakhala olimbitsa thupi, koma amatha kupita patsogolo, limodzi ndi kufupika, kutsika kwa magazi, mpaka chitukuko cha anaphylactic mantha, kumafunikira chisamaliro chamankhwala), zotumphukira za sulfonylureas kapena sulfonamides ena, matupi a vasculitis,
ena: nthawi zina - hyponatremia, asthenia, mutu.

Malangizo apadera

Odwala ayenera kutsatira mlingo wolemekezeka. Kutayika kwa gawo limodzi sikungakulipilitsidwe ndi kuperekera kwa mlingo wapamwamba.

Kupezeka kwa hypoglycemia pambuyo pa 1 mg ya diamerid kumatanthauza kutha kuyendetsa glycemia kokha kudzera muzakudya.

Pakabweza matenda a shuga a mtundu wa 2, kuwonjezeka kwa insulin sensitivity kumawonedwa. Pankhaniyi, munthawi yamankhwala, kufunika kwa Diameride kumatha kuchepa. Popewa kukula kwa hypoglycemia, muyenera kuchepetsa kwakanthawi mlingo kapena kusiya mankhwala. Kusintha kwa magazi kumafunikanso pazochitika zakusintha kwa kulemera kwa wodwalayo, momwe amakhalira, kapena zinthu zina zikawoneka zomwe zimapangitsa kuti chiwopsezo cha hyper- kapena hypoglycemia chidziwike.

Kuti mukwaniritse bwino kuchuluka kwa shuga m'magazi limodzi ndi mankhwala pafupipafupi, ndikofunikira kuti muzikhala ndi chakudya chokwanira komanso muzichita masewera olimbitsa thupi mokwanira komanso mokwanira.

Zizindikiro zamatenda a hyperglycemia zimaphatikizapo ludzu lokwera, kuchuluka kwa pafupipafupi kukodza, khungu lowuma komanso pakamwa louma.

M'masabata oyamba kugwiritsa ntchito Diamerid, mwayi wa hypoglycemia ungakulitse (muzochitika izi, makamaka kuwunika momwe wodwalayo amafunikira). Ngati mumadya mosasamala kapena kudya zakudya, hypoglycemia imatha kuchitika.

Zinthu zazikulu zomwe zimapangitsa kuti hypoglycemia iyambike:

kusafuna / kusakwanira (makamaka mu ukalamba) wa wodwala kuti azigwirizana ndi adotolo,
Mavuto a kudya, kuphatikiza kusintha kwa zakudya zomwe zili pachakudya, kuperewera kwa chakudya, kusowa zakudya m'thupi / kudwala, kudumpha chakudya,
kumwa mowa, makamaka pamodzi ndi kudumpha zakudya,
kusasamala pakati pa chakudya ndi zochita zolimbitsa thupi,
kuphwanya kwa chiwindi ntchito mu zovuta,
bongo wa diamerid,
kuwonongeka kwaimpso,
kuphatikiza pamodzi ndi mankhwala ena
matenda ena osawerengeka a endocrine dongosolo lomwe limakhudza kagayidwe kazakudya, kuphatikiza chithokomiro, kusowa kwa adrenal, kapena kusowa kwa pituitary.

Kupezeka / kuwonekera kwa zinthu zomwe zili pamwambapa, komanso zochitika za hypoglycemia, ziyenera kudziwitsidwa kwa adotolo, chifukwa muzochitika izi, makamaka kuwunikira mosamala za momwe odwala amafunikira. Ngati izi zilipo, kusintha kwa muyezo / mtundu wonse kungafunike. Njira zofananazo zimatengedwa pazochitika zodwala kapena zomwe moyo wa wodwala wasintha.

Odwala okalamba, odwala omwe ali ndi autonomic neuropathy kapena odwala omwe amalandira chithandizo nthawi yomweyo ndi guanethidine, beta-blockers, reserpine, clonidine, zizindikiro za hypoglycemia zimatha kutuluka kapena kusakhalapo kwathunthu.

Pafupifupi nthawi zonse, hypoglycemia imatha kuimitsidwa msanga chifukwa cha kudya zakudya zamagulu (shuga kapena shuga). Pankhaniyi, wodwalayo ayenera kukhala ndi shuga pafupifupi 20 g (zidutswa 4 za shuga). Pochiza hypoglycemia, zotsekemera sizothandiza.

Ngakhale kupambana koyambirira pakuimitsa hypoglycemia, kukula kwa kubwezeretsanso kwake kungawonedwe, komwe kumafunikira kuwunikira nthawi zonse wodwalayo. Mu hypoglycemia yayikulu, chithandizo chamankhwala chimayenera kuyang'aniridwa ndi katswiri, ndipo nthawi zina kuchipatala.

Pa mankhwala, kuwunika kawirikawiri ntchito ya chiwindi ndi chithunzi cha magazi ofunikira kuyenera kuchitika (makamaka, izi zimagwira pa kuchuluka kwa mapulosi ndi maselo oyera amwazi).

M'mikhalidwe yovuta (mwachitsanzo, kuvulala, opaleshoni, limodzi ndi matenda opatsirana a malungo), wodwalayo angafunikire kusamutsidwa kupita ku insulin.

Palibe chochitika chogwiritsa ntchito diamerid odwala omwe ali ndi vuto la kuwonongeka kwaimpso / kwa chiwindi mu milandu yayikulu kapena odwala hemodialysis (insulin ikuwonetsedwa).

Pa mankhwala, kuchuluka kwa shuga m'magazi, komanso kuchuluka kwa glycosylated hemoglobin, kuyenera kuyang'aniridwa nthawi zonse.

Zochitika zina zoyipa (mwa mtundu wa hypoglycemia, kusintha kwakukuru mu chithunzi cha magazi, mayankho owopsa, kuperewera kwa chiwindi) pazinthu zina kungakhale pangozi. Wina akakhala ndi vuto lalikulu / losayenera, wodwalayo ayenera kudziwitsa katswiri za iwo. Simuyenera kupitiliza kumwa mankhwalawo.

Kumayambiriro kwa maphunzirowa, mukasinthana ndi mankhwala ena kupita kwina kapena ndimawonekedwe a Diameride, kuchepa kwa chidwi ndi kuthamanga kwa zochitika zama psychomotor chifukwa cha hyper- kapena hypoglycemia kumatha kuchitika, zomwe zimakhudza kuyendetsa magalimoto. Odwala ayenera kuchitapo kanthu kuti apewe izi. Odwala omwe alibe / adachepetsa kuwonongeka kwa zizindikiro zakutsogolo amalangizidwa kuti akane kuyendetsa magalimoto.

Dzinalo Lopanda Padziko Lonse

Dzinalo losayenerera la mankhwalawa ndi glimepiride. Zikutanthauza chida chogwira ntchito ngati mankhwala. Katunduyu ndi m'badwo wachitatu wa sulfonylurea.

Diamerid ndi mankhwala omwe amagwiritsidwa ntchito kutsitsa glucose wamagazi.

Mndandanda wa mankhwalawa malinga ndi ATX (anatomical, achire komanso gulu la mankhwala) ndi A10BB12. Ndiye kuti, mankhwalawa ndi chida chomwe chimakhudza gawo logaya chakudya komanso kagayidwe, kamapangidwa kuti athetse matenda a shuga, amadziwika kuti ndi chinthu cha hypoglycemic, chotengera cha sulfonylurea (glimepiride).

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Monga ulamuliro, mlingo wa mankhwala amatsimikiza ndi chandamale cha shuga m'magazi. Mlingo wotsika kwambiri wokwanira kukwaniritsa zoyenera za metabolic uyenera kugwiritsidwa ntchito.

Pa mankhwala, ndikofunikira kudziwa pafupipafupi kuchuluka kwa shuga m'magazi. Kuphatikiza apo, kuwunika pafupipafupi milingo ya hemoglobin ya glycosylated kumalimbikitsidwa.

Kukhazikika kwa mankhwala osokoneza bongo, mwachitsanzo, kudumpha mlingo wotsatira, sikuyenera kuthandizidwa ndi kudya kwina kwa mlingo waukulu. Zochita za wodwalayo pakafunika zolakwa mukamamwa mankhwalawo (makamaka, polumphira mlingo wotsatira kapena kudumphira chakudya) kapena pamikhalidwe yomwe sizingatheke kumwa mankhwalawa ayenera kukambirana kaye ndi wodwalayo ndi dokotala.

Diameride imatengedwa pakamwa popanda kutafuna, kutsukidwa ndi madzi okwanira (pafupifupi 0,5 chikho).

Mlingo woyambirira ndi 1 mg ya glimepiride kamodzi patsiku. Ngati ndi kotheka, tsiku lililonse mlingo ungakulidwe pang'onopang'ono (pakadutsa milungu iwiri). Ndikulimbikitsidwa kuti kuwonjezeka kwa mlingo kuchitidwa ndikuwonetsetsa kuchuluka kwa shuga m'magazi komanso mogwirizana ndi gawo lotsatira: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg (- 8 mg).

Mlingo wambiri mwa odwala omwe ali ndi matenda a shuga ogwiritsidwa ntchito moyenera: Nthawi zambiri muyezo wa tsiku ndi tsiku wa odwala omwe ali ndi matenda opatsirana a shuga ndi 1-4 mg ya glimepiride. Mlingo wa tsiku ndi tsiku wopitilira 6 mg umagwira kwambiri mwa ochepa ochepa odwala.

Nthawi yovomerezeka komanso yogawa milingo tsiku lonse imatsimikiziridwa ndi dokotala, kutengera mtundu wa wodwala nthawi yayitali (nthawi yolemba, kuchuluka kwa zochitika zolimbitsa thupi).

Nthawi zambiri, mlingo umodzi wa mankhwalawa masana ndi wokwanira. Ndikulimbikitsidwa kuti pankhaniyi, mlingo wonse wa mankhwalawo uyenera kumwedwa musanadye chakudya cham'mawa chokwanira, kapena ngati sichinatenge panthawiyo, musanadye chakudya chachikulu choyamba.

Ndikofunika kuti musadumphe chakudya mutamwa mankhwalawa.

Popeza kuyendetsa bwino kagayidwe kachakudya kumalumikizidwa ndi kukhudzika kwa insulin, kufunika kwa glimepiride kumatha kuchepa panthawi ya chithandizo. Pofuna kupewa kukula kwa hypoglycemia, ndikofunikira kuchepetsa mlingo kapena kusiya kumwa mankhwalawa.

Momwe mankhwalawa amasinthidwe a mankhwalawa angafunikirenso:

- Kuchepetsa thupi la wodwala,

- kusintha kwa moyo wa wodwalayo (kusintha kadyedwe, nthawi ya chakudya, kuchuluka kwa zochita zolimbitsa thupi),

- kutuluka kwa zinthu zina zomwe zimatsogolera kukukula kwa hypoglycemia kapena hyperglycemia.

Chithandizo cha glimepiride nthawi zambiri chimachitika kwa nthawi yayitali.

Kusamutsa wodwala kuti atenge mankhwala ena amkamwa a hypoglycemic kupita ku Diamerid: palibe ubale weniweni pakati pa Mlingo wa glimepiride ndi ena othandizira pakamwa.Wothandizirana ndi hypoglycemic wothandizirana pakamwa ndi kulowetsedwa ndi glimepiride, tikulimbikitsidwa kuti njira zoikidwiratu zikupereka chimodzimodzi kwa nthawi yoyamba, ndiye kuti, mankhwalawa amayenera kuyamba ndi 1 mg (ngakhale wodwalayo atasinthira glimepiride ndi mlingo waukulu) mankhwala enanso a hypoglycemic opaka pakamwa. Kuchulukitsa kwa mlingo uliwonse kuyenera kuchitika m'magawo, kukumbukira kuyankha kwa glimepiride, malinga ndi malangizo omwe ali pamwambawa.

M'pofunika kuganizira mphamvu ndi kutalika kwa zotsatira za m'mbuyomu hypoglycemic wothandizira pakamwa. Kulowetsa chithandizo kungafunike kuti mupewe zovuta zilizonse zomwe zingapangitse chiopsezo cha hypoglycemia.

Gwiritsani ntchito limodzi ndi metformin

Odwala omwe ali ndi matenda osokoneza bongo omwe amawongolera osakwanira, akalandira mlingo waukulu wa glimepiride kapena metformin, mankhwalawa atha kuphatikizana ndi mankhwalawa. Pankhaniyi, chithandizo cham'mbuyomu chomwe chili ndi glimepiride kapena metformin chimapitilira mlingo womwewo, ndipo mlingo wowonjezereka wa metformin kapena glimepiride umayamba ndi mlingo wochepa, womwe umasungidwa malinga ndi gawo lazomwe limayang'anira metabolic mpaka mlingo waukulu wa tsiku lililonse. Kuphatikiza mankhwala kuyenera kuyang'aniridwa ndi achipatala.

Gwiritsani ntchito limodzi ndi insulin

Odwala omwe ali ndi matenda osokoneza bongo omwe amawongolera osakwanira, insulin imatha kuperekedwa nthawi yomweyo mutatenga mlingo waukulu wa tsiku ndi tsiku wa glimepiride. Pankhaniyi, mlingo womaliza wa glimepiride woperekedwa kwa wodwala amakhalabe wosasinthika. Pankhaniyi, chithandizo cha insulin chimayamba ndi milingo yotsika, yomwe imayamba kuwonjezeka pang'onopang'ono motsogozedwa ndi glucose m'magazi. Chithandizo chophatikiza chimafunika kuyang'aniridwa mosamala ndi madokotala.

Gwiritsani ntchito odwala omwe ali ndi impso

Pali chidziwitso chochepa pakugwiritsa ntchito diamerid mwa odwala omwe amalephera impso. Odwala omwe ali ndi vuto laimpso amatha kukhudzidwa kwambiri ndi hypoglycemic zotsatira za glimepiride.

Gwiritsani ntchito odwala omwe ali ndi vuto la chiwindi

Pali chidziwitso chochepa pakugwiritsa ntchito mankhwalawa chifukwa cha kulephera kwa chiwindi.

Gwiritsani ntchito ana

Zomwe zimagwiritsidwa ntchito mwa ana sizokwanira.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa amapezeka pamapiritsi. Mawonekedwe a mapiritsiwo ndi linda lathyathyathya wokhala ndi bevel. Utoto umatengera kuchuluka kwa zosakaniza piritsi; zitha kukhala zachikaso kapena zapinki.

Mapiritsi amatha kukhala ndi 1, 2, 3 mg kapena 4 mg ya mankhwala othandizira.

Omwe amathandizira ndi: lactose monohydrate, magnesium stearate, povidone, microcrystalline cellulose, poloxamer, croscarmellose sodium, utoto.

Phukusi limodzi lili ndi matuza atatu, iliyonse ya ma PC 10.

Zotsatira za pharmacological

Mankhwalawa ali ndi vuto la hypoglycemic. Kuchita kwa mankhwalawa kumakhazikika pakulimbikitsa kupanga kwa insulin ndi maselo a beta a pancreatic a Langerhans, komanso kukulitsa chidwi cha zolandilira minofu ku mahomoni ndikuwonjezera kuchuluka kwa mapuloteni a glucose transporter m'magazi. Kuchita pancreatic minofu, mankhwalawa amachititsa kukokoloka kwake ndikutsegulidwa kwa njira zama calcium zomwe zimadalira magetsi, chifukwa cha momwe ma cell amayambitsa.

Amachepetsa kuchuluka kwa gluconeogenesis m'chiwindi chifukwa cha kutsekeka kwa ma enzymes ofunikira, motero kukhala ndi zotsatira za hypoglycemic.

Mankhwala amakhudzanso kuphatikiza kwa maselo ambiri, kumachepetsa. Imalepheretsa cycloo oxygenase, kutsekereza kukhathamiritsa kwa arachidonic acid, kumakhala ndi antioxidant, kumachepetsa kuchuluka kwa lipid peroxidation.

Pharmacokinetics

Ndi kugwiritsa ntchito pafupipafupi, 4 mg tsiku lililonse, mlingo wokwanira wa mankhwala m'magazi umawonedwa pakatha maola awiri ndi atatu. Mpaka 99% ya zinthu zomwe zimamangidwa ndi mapuloteni a seramu.

Hafu ya moyo ndi maola 5-8, chinthucho chimapukusidwa mu mawonekedwe a metabolised, sichidziunjikira m'thupi. Amadutsa placenta ndikudutsa mkaka wa m'mawere.

Kodi kumwa diamerid?

Mukamamwa mankhwalawa, dokotala amayenera kuwunika kuchuluka kwa shuga m'magazi. Katswiriyu amawona kuchuluka kwa shuga m'magazi, omwe ayenera kumwa mankhwalawo. Mlingo wochepetsetsa womwe umagwiritsidwa ntchito, womwe ungagwire bwino ntchito.

Mankhwalawa amapezeka pamapiritsi. Mawonekedwe a mapiritsiwo ndi linda lathyathyathya wokhala ndi bevel.

Ndi matenda ashuga

Mlingo woyambirira ndi 1 mg patsiku. Ndi nthawi ya masabata 1-2, adokotala amawonjezera mlingo, ndikusankha zofunikira. Inunso simungathe, popanda kufunsa dokotala, kuyamba kumwa mankhwalawo kapena kusintha mankhwalawo, chifukwa ndi othandizira amphamvu, osagwiritsidwa ntchito molakwika omwe amakhala ndi zotsatirapo zoyipa.

Ndi shuga wolamulidwa bwino, mlingo wa mankhwalawa patsiku ndi 1-4 mg, kutsika kwakukulu sikumagwiritsidwa ntchito kwenikweni chifukwa chakuti amagwira ntchito kwa anthu ochepa okha.

Mukatha kumwa mankhwalawa, simuyenera kulumpha chakudya, chomwe chimayenera kukhala chofinya. Mankhwalawa ndiwotalikirapo.

Diameride tikulimbikitsidwa mtundu 2 shuga mellitus, ngati chithandizo ndi ochepa-carb zakudya ndi kuchita masewera olimbitsa thupi sapereka zotsatira zofunika.

Zokhudza mphamvu pakuwongolera njira

Mankhwalawa amakhudza kuthekera kwa kayendetsedwe ka kayendedwe chifukwa cha kupukusa kwa hypoglycemia, komwe kumayendetsedwa ndi kuchepa kwa ndende, kutopa kosalekeza komanso kugona. Kuthekera kochita ntchito yomwe imafunikira chisamaliro chokhazikika, kuphatikiza kuyendetsa magalimoto, kumachepetsedwa.

Gwiritsani ntchito mu ukalamba

Mu ukalamba, munthu samatha kulankhulana momasuka ndi dokotala, chifukwa chomwe adokotala sangadziwe momwe wodwalayo atamwa ndikuwongolera mlingo, womwe umakhudza kuyipa kwa chithandizo ndi mkhalidwe wa wodwalayo. Chifukwa chake, wodwalayo ayenera kumuuza dotolo zonse zakusintha kwa boma, podziwa kuti izi ndizofunikira choyamba kwa iye.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Pa nthawi yoyembekezera komanso nthawi yoyamwitsa, mankhwalawa amakwiriridwa chifukwa amatha kulowa mkati mwa chotchinga ndikuthira mkaka wa m'mawere, womwe umatha kuvulaza thupi la mwana wosalimba. Chifukwa chake, mayi yemwe adamwa mankhwalawa isanachitike, amapatsirana mankhwala a insulin.

Pa nthawi yoyembekezera komanso poyamwitsa, mankhwalawa amatsutsana

Mankhwala ochulukirapo a diamerid

Pankhani ya bongo, hypoglycemia imawonedwa, yomwe imayendetsedwa ndi mutu, kumva kufooka, kutuluka thukuta kwambiri, tachycardia, mantha ndi nkhawa. Ngati zizindikirozi zikuchitika, muyenera kudya zakudya zopatsa mphamvu mwachangu, mwachitsanzo, idyani shuga. Ngati mankhwala osokoneza bongo ali pachimake, ndikofunikira kutsuka m'mimba kapena kusanza. Mpaka boma lokhazikika lithe, wodwalayo amayenera kuyang'aniridwa ndi achipatala kuti ngati chiwopsezo chambiri chikubwera, dokotala atha kumuthandiza.

Kuchita ndi mankhwala ena

Mukamagwiritsa ntchito mankhwalawa ndi mankhwala ena, ndizotheka kufooketsa kapena kulimbitsa machitidwe ake, komanso kusintha kwa ntchito ya chinthu china, chifukwa chake ndikofunikira kudziwitsa adokotala za mankhwala omwe amagwiritsidwa ntchito. Mwachitsanzo:

Ndi munthawi yomweyo makonzedwe a glimepiride ndi insulin, othandizira ena a hypoglycemic, zotumphukira za coumarin, glucocorticoids, metformin, mahomoni ogonana, angiotensin-akatembenuza enzyme zoletsa, fluoxetine, etc., hypoglycemia yayikulu imatha.
Glimepiride ikhoza kuletsa kapena kupititsa patsogolo zotsatira za coumarin zotumphukira - anticoagulant othandizira.
Mafuta, ma laxatives, T3, T4, glucagon amatha kuchepetsa mphamvu ya mankhwalawa, kuchepetsa mphamvu ya mankhwalawa.
Ma H2 histamine receptor blockers amatha kusintha zotsatira za glimepiride.

Ndi munthawi yomweyo makonzedwe a glimepiride ndi insulin, ena othandizira a hypoglycemic, kukula kwa hypoglycemia ndikotheka.

Kuyenderana ndi mowa

Mlingo umodzi wa mowa kapena kugwiritsa ntchito nthawi zonse kumatha kusintha ntchito za mankhwalawo, kuonjezera kapena kuchepetsa.

Ma analogues ndi othandizira omwe amakhala ndi glimepiride ngati chinthu chogwira ntchito. Izi ndi mankhwala monga:

Amaril. Awa ndi mankhwala aku Germany, piritsi lililonse lomwe mumakhala mulingo wa 1, 2, 3 kapena 4 mg. Kupanga: Germany.
Glimepiride Canon, Yopezeka mu Mlingo wa 2 kapena 4 mg. Kupanga: Russia.
Glimepiride Teva. Amapezeka mu Mlingo wa 1, 2 kapena 3 mg. Kupanga: Croatia.

Diabetes ndi mankhwala osokoneza bongo a hypoglycemic, ali ndi vuto lofanana la hypoglycemic, koma zomwe zimagwira ndi zotumphukira za m'badwo wachiwiri.

Amaryl ndi analogue ya Diamerid. Awa ndi mankhwala aku Germany, piritsi lililonse lomwe mumakhala mulingo wa 1, 2, 3 kapena 4 mg.

Ndemanga za Diamerida

Musanagwiritse ntchito mankhwalawa, muyenera kudziwa za ndemanga zake.

Starichenko V. K. "Mankhwalawa ndi chida chothandiza kuti muchepetse matenda ashuga a mtundu wa 2. Chololedwa kugwiritsa ntchito mankhwalawo ndi insulin kapena ngati monotherapy. Ndi dokotala yekhayo amene angatchule ndikuwongolera mlingo."

Vasilyeva O. S. "Mankhwalawa amachepetsa kuchuluka kwa shuga m'magazi, kuthana ndi zovuta zomwe zimabweretsa chifukwa cha matenda ashuga. Katswiri wokhayo ndi amene ayenera kulemba mankhwalawo ndikuzindikira mtundu wa mankhwalawo."

Galina: "Magazi a shuga amawonjezeka kwambiri, mankhwala omwe ali ndi mphamvu yogwira glimepiride adalembedwa. Mapiritsi ndi omasuka, kumeza bwino, tsiku lililonse musanadye chakudya cham'mawa. Shuga wa m'magazi ndilobwinobwino, zizindikiro zosasangalatsa za matenda ashuga zatha."

Kuyanjana kwa mankhwala osokoneza bongo

Ndi kuphatikiza kwa Diameride ndi mankhwala / zinthu zina, zotsatirazi zingakhalepo (upangiri wa zamankhwala umafunika musanapange mankhwala aliwonse):

acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine ndi mankhwala ena a sympathomimetic, glucagon, laxatives (ogwiritsira ntchito nthawi yayitali, nicotinic acid, zotumphukira za nicotinic, ma estrojeni. , phenytoin, rifampicin, mahomoni a chithokomiro, mchere wa lithiamu: kufooketsa mphamvu ya hypoglycemic ndipo, chifukwa chake, kukulitsa kuchuluka kwa shuga m'magazi,
insulin, metformin kapena zina m'kamwa hypoglycemic wothandizira, angiotensin akatembenuka zoletsa enzyme, allopurinol, anabolic mankhwala timadzi chiwalo chachimuna, chloramphenicol, coumarin ofanana nawo, cyclophosphamide, trofosfamide ndi ifosfamide fenfluramine, fibrates, fluoxetine, sympatholytic (guanethidine), monoamine oxidase zoletsa, miconazole, pentoxifylline (ndi kholo makonzedwe a waukulu), phenylbutazone, azapropazone, oxyphenbutazone, probenecid, mankhwala a quinolone, salicylates ndi aminosalicylic acid, s Ulfinpyrazones, sulfonamides ena atatenga nthawi yayitali, tritokvalin, fluconazole: kuchuluka kwa hypoglycemic ndipo, chifukwa chake, mwayi wa hypoglycemia,
reserpine, clonidine, N blockers₂-histamine receptors: potentiation / ofooka kwa hypoglycemic zochita za diamerid,
mankhwala omwe amaletsa mafupa a hematopoiesis: mwayi wowonjezera wa myelosuppression,
zochokera ku coumarin: kulimbikitsa / kufooketsa zochita zawo,
beta-blockers, clonidine, reserpine, guanethidine: kufooketsa kapena kusowa kwa matenda a hypoglycemia,
mowa (osagwiritsidwa ntchito masiku onse): kuchuluka / kufooka kwa hypoglycemic zochita za diamerid.

Analogues a Diameride ndi: Glimepiride, Amaryl, Glemauno, Glime, Glemaz, Meglimid, Glymedeks ndi ena.

Mimba komanso kuyamwa

Glimepiride ndi contraindicated mu mimba. Ngati mayi wapezeka kuti ali ndi pakati kapena pokhapokha ngati ali ndi pakati, mkazi ayenera kuthandizidwa ndi insulin.

Chifukwa Popeza glimepiride amafukusidwa mkaka wa m'mawere, sayenera kufotokozedwa pa mkaka wa mkaka. Pankhaniyi, ndikofunikira kusinthira ku insulin mankhwala kapena kusiya kuyamwitsa.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Mlingo wa glimepiride pamapiritsi awa ukhoza kukhala wosiyana: 1, 2, 3 kapena 4 mg. Kuphatikiza apo, zinthu zotsatirazi zikuphatikizidwa:

cellcrystalline mapadi,
magnesium wakuba,
sodium croscarmellose,
mapadi okhala ndi ufa,
utoto.

Awa ndi miyala yosalala, yamafelemu, yokhala ndi chotupa (3 kapena 6) m'mizere 5 kapena 10.

Malangizo ogwiritsira ntchito

Mlingowo umaperekedwa ndi katswiri potengera deta ya zotsatira za kusanthula ndi zosowa za thupi.

Iyenera kumwedwa pamimba yopanda kanthu, musanadye, kumwa madzi ambiri osatafuna. Mlingo woyambirira ndi 1 mg kamodzi tsiku lililonse. Kupitilira apo, pakatha milungu iwiri, imatha kuchuluka. Mlingo wambiri watsiku ndi tsiku ndi 6 mg.

Fananizani ndi fanizo

Pali mankhwala angapo ofanana ndi omwe afotokozedwawa. Kukhala kofunikira kuzidziwa bwino ndi zomwe muli nazo ndikufanizira zomwe zachitikazo.

Diabeteson MV. Awa ndi mapiritsi okhala ndi gliclazide. Amapanga kampani "Service", France. Mtengo wa ma CD ndi ma ruble 300 ndipo pamwambapa. Iyi ndiye analogi yapafupi kwambiri muzinthu. Contraindication ndi muyezo, osavomerezeka kwa anthu okalamba.

Amaril. Mtengo wake umachokera ku ma ruble 300 mpaka 1000 phukusi lililonse (zidutswa 30). Kampani yopanga - Sanofi Aventis, France. Izi ndizophatikiza zochokera ku glimepiride ndi metformin. Chifukwa cha kuphatikiza kwa zinthu zimagwira mwachangu komanso mowongoka. Contraindication ndi muyezo, pali zovuta zambiri zoyipa.

NovoNorm. Mankhwala okhala ndi repaglinide. Pali mitundu itatu yamasulidwe, kutengera gawo la yogwira ntchito. Mtengo umayambira pa ma ruble a 180 phukusi lililonse. Wopanga - "Novo Nordisk", Denmark. Ichi ndi chida chotsika mtengo, chothandiza, koma chokhala ndi zotsutsana zingapo. Osakhala koyenera kwa ana, okalamba ndi amayi oyembekezera.

Glimepiride. Mtengo - kuchokera ku ruble 140 mpaka 390. Kampani yopanga mankhwala osokoneza bongo Pharmaceard, yopangidwa ndi kampani yaku Russia Vertex. Gawo lalikulu ndi glimepiride. Pali mitundu isanu pamsika yokhala ndi zinthu zosiyanasiyana zogwira ntchito. Imakhalanso ndi zofanana, zosakanikirana ndizofanana. Gwiritsani ntchito mosamala okalamba.

Maninil. Mankhwala ali ndi glibenclamide. Amapanga kampani "Berlin Chemie", Germany. Mtengo wotsika - ma ruble 120 a mapiritsi a 120. Ichi ndiye analogue wotsika mtengo kwambiri, pofotokoza za malo ndi kupezeka kwake. Milandu yomweyo.

Dokotala amasankha zomwe zingakhale bwino kwa wodwalayo ndikusamutsira ku mankhwala ena. Kudzipatsa nokha koletsedwa!

Maganizo a anthu odwala matenda ashuga omwe akudziwa zambiri pamankhwala amapezeka bwino. Anthu amawona kugwira bwino kwa mankhwalawa, owerengeka azotsatira zoyipa. Kwa ena, mankhwalawo sioyenera.

Olga: “Kwa nthawi yayitali ndakhala ndikuchiza matenda ashuga. Ndayesera mapiritsi ambiri, tsopano ndidayima ku Diamerida. Ndimagwiritsa ntchito Metformin, ndimakonda momwe mankhwalawo amathandizira. Shuga ndiwabwinobwino, osadandaula "mavuto". Ndipo koposa zonse, amagulitsidwa momasuka m'mafakisi. ”

Daria: “Ndinatenga Diameride kwa miyezi iwiri, shuga sanasinthe. Adotolo adati sanayenere mlandu wanga, ndipo adanenanso mankhwala ena. "

Oleg: “Dotolo adandiuza kuti ndimwe mapiritsi miyezi isanu ndi umodzi yapitayo. Zinthu zakhazikika. Kusinthasintha kwa shuga musadandaule; thanzi lonse ndilabwino.Ndizosangalatsa kuti awa ndi mankhwala opangira zoweta, omwe malinga ndi katundu ndi mtundu wake siwoipa kuposa ma analogues akunja. Nanga bwanji kuchulukirachulukira ngati mwayi utapezeka kuti ulandilidwa ndi mankhwala otsika mtengo wofanana ndi womwewo. ”

Elena: “Ndili ndi matenda ashuga a 2. Zakudya zokha ndi zomwe zasiya kuthandiza, choncho endocrinologist adasankha Diamerid, akunena kuti anali wa ku Russia, wopangidwa bwino. Ndipo ndakhala ndikumamuchitira kwa miyezi itatu. Ndizotheka kuti mutenge piritsi limodzi patsiku, ndipo zotsatira zake ndizitali. Shuga samadumphadumpha, hypoglycemia simachitika, zomwe ndizosangalatsa kwambiri. Ndipitilizabe kundichitira zabwino. ”

Pomaliza

Kuganizira maunikidwe ake komanso momwe amagwiritsidwira ntchito mankhwalawa, ndi othandiza. Amadziwika kuti chiwerengero cha mtengo wamtengo amalemekezedwa, ndikupanga zoweta sizitulutsa mankhwalawa. Odwala matenda ashuga, komanso akatswiri, adziwa kuti Diamerid imagwira onse mu monotherapy komanso molumikizana ndi mankhwala ena.