Maninil (Glibenclamide)

Matenda a shuga ndi imodzi mwamatenda akulu kwambiri amakono. Popanda mankhwala apadera, anthu omwe ali ndi vutoli sangapulumuke. Ndipo ,achidziwikire, chithandizo cha matenda ashuga chiyenera kusankhidwa moyenera. Nthawi zambiri, madokotala amapereka mankhwala othandiza "Maninil" kwa odwala. Malangizo ogwiritsira ntchito, mtengo, ndemanga, kufanana kwa mankhwalawa - tidzakambirana zonse izi pambuyo pake m'nkhaniyi.

Mankhwalawa amaperekedwa ngati mapiritsi. Chofunikira chake chachikulu ndi g libenclamide. Piritsi limodzi lazinthu izi limatha kukhala ndi 3.5 kapena 5 mg. Komanso, kapangidwe kamankhwala kamaphatikizira lactose, wowuma wa mbatata, silicon dioxide ndi zina zina. Kampani ya Berlin Chemi ikugwira nawo ntchito yotulutsa mankhwalawa.

Mankhwala "Maninil" ndi okwera mtengo. Mtengo wake ndi pafupifupi 150-170 p. mapiritsi 120.

Kodi milandu contraindication zotchulidwa

Kamodzi m'thupi la wodwalayo, mankhwalawa "Maninil" (mawonekedwe ake amatha kuchita mosiyana) amawonjezera chidwi cha insulin receptors. Ili ndi mphamvu yogwira mankhwalawa komanso zotsatira zina zabwino mthupi la wodwalayo. Maninil, mwa zinthu zina, amatha kulimbikitsa kupanga insulin.

Zisonyezo zogwiritsa ntchito mankhwalawa ndi mtundu 2 shuga. Mankhwalawa amatha kuperekedwa ndi endocrinologist. Zoyipa zomwe zimagwiritsidwa ntchito ndi:

mtundu 1 shuga

matenda a shuga

Mimba ndi kuyamwa

kupweteka kwambiri kwaimpso kapena chiwindi,

Kuchepetsa kuchuluka kwa maselo oyera.

Momwe mungagwiritsire ntchito

Mapiritsi 5 mg ali chimodzimodzi ndi mankhwalawa "Manin 3.5", malangizo ogwiritsira ntchito. Mtengo (analogies ya mankhwalawo ukhoza kukhala ndi mtengo wosiyana) mankhwalawa, monga tafotokozera kale, ndiokwera kwambiri. Kuphatikiza apo, madotolo amauza odwala kwaulere, mosiyana ndi otchipa otchipa, kawirikawiri. Ichi ndichifukwa chake odwala ambiri amakonda kudziwa ngati mankhwalawa ali ndi ma analogues otsika mtengo. Mankhwalawa amapezeka m'mafakitore. Koma tisanapitilize kufotokoza kwawo, tiwona malangizo ati omwe angagwiritsidwe ntchito ndi Manilin pachokha.

Dokotala amasankha muyeso wa mankhwalawa kwa wodwala payekha. Kuchuluka kwa mankhwalawa omwe amamwa patsiku kumadalira kuchuluka kwa shuga mumkodzo. Amayamba kumwa mankhwalawa nthawi zambiri ndi mlingo wochepera. Komanso, izi zimachulukirachulukira. Nthawi zambiri, poyambira, wodwalayo amapatsidwa theka la piritsi patsiku (kutengera zotsatira za kusanthula, 3.5 kapena 5 mg). Kenako, mlingo umakulitsidwa ndi osapitilira piritsi limodzi pa sabata kapena masiku angapo.

Ndemanga za "Maninil"

Ili ndi malangizo ogwiritsira ntchito mankhwalawa "Maninil". Makonda a mankhwalawa ndi ambiri. Koma "Maninil" odwala ambiri amawona mwina chida chabwino kwambiri pagulu lawo. Malingaliro a odwala omwe ali ndi matenda osokoneza bongo okhudzana ndi mankhwalawa adakula bwino. Zimathandiza, malinga ndi ogula ambiri, zabwino. Komabe, mwatsoka, mankhwalawa siabwino kwa onse odwala. Sikuti amapita kwa odwala ena.

Mulimonsemo, kupatula, odwala amalimbikitsa kumwa mankhwalawa kokha pa mlingo womwe adokotala amawalimbikitsa. Kupanda kutero, mankhwalawa angayambitse kuledzera.

Kodi ma fanizo a mankhwalawa "Manin" ndi ati?

Pali malo ena othandizira mankhwalawa pamsika wamakono. Ena a iwo apeza ndemanga zabwino za ogula, pomwe ena sanatero.

Nthawi zambiri, anthu odwala matenda ashuga amagwiritsa ntchito maimelo m'malo mwa "Maninil":

Nthawi zina odwala amakhala ndi chidwi chofuna kudziwa ngati pali analogue ya Manil 3.5 mg (mapiritsi) pamsika. Palibenso kufanana kwa mankhwalawa pamsika wamakono wamankhwala. Ma analogues ambiri amapangidwa pamaziko a zinthu zina zomwe zimagwira. Chifukwa chake, kuchuluka kwa mapangidwe omwe amapezeka m'mapiritsi olowa m'malo ndi kosiyana. Analogue yokhayo ya Maninil ndi Glibenclamide. Izi zokhazo zomwe zitha kugulidwa mu mlingo wa 3.5 mg.

Mankhwala "Glibenclamide"

Zizindikiro ndi zotsutsana za mankhwalawa ndizofanana ndendende ndi "Maninil" yomwe. Kupatula apo, kwenikweni, mankhwalawa ndi generic wake wotsika mtengo. Mankhwalawa ndi ofunika mumafakisi pafupifupi 80-90 p. Ngakhale zinthu zomwe zimagwiritsidwa ntchito ndizofanana kwa onsewa mankhwalawa, kuchotsa Maninil ndi Glibenclamide ndikololedwa kokha pazovomerezeka za dokotala. Matenda a shuga ndi matenda oopsa. Mankhwalawa amapangidwa ku Ukraine.

Maganizo a Odwala ku Glibenclamide

Monga Maninil, ndemanga (zoyerekeza za mankhwalawa ndi zinthu zina zogwira ntchito kwa odwala nthawi zambiri zimayipa), mankhwalawa kuchokera kwa ogula apeza zabwino. Kuphatikiza pakuchita bwino, machitidwe a zabwino za mankhwalawa, odwala ambiri amati mtengo wake wotsika komanso zovuta kugawa mapiritsi. Odwala ambiri amaganiza kuti mankhwala a Glibenclamide opangidwa ku Kiev ndi apamwamba kwambiri. Mapiritsi a Kharkov panthawi yogawa, mwatsoka, amatha kutha.

Mankhwala "A diabetes"

Mankhwalawa amapezeka mu mawonekedwe a mapiritsi oyera ozungulira. Chofunikira chake chachikulu ndi glycoside. Monga Maninil, Diabetes ndi m'gulu la zinthu zotsitsa shuga za m'badwo wotsiriza. Ubwino wawukulu wa mankhwalawa ndi, kuwonjezera pa kugwira ntchito, kusapezeka kwa mankhwala osokoneza bongo. Mosiyana ndi Maninil, Diabetes imakulolani kuti mubwezeretse nsonga zoyambirira ndikulepheretsa kukula kwa hyperinsulinemia. Ubwino wa chida ichi, poyerekeza ndi mankhwala ena ambiri a gululi, ndikuphatikiza kuti imatha kutsitsa cholesterol yamagazi.

Ndemanga pa "Diabeteson"

Kuchuluka kwa shuga m'magazi, malinga ndi odwala ambiri, mankhwalawa amathandizanso kwambiri. Zotsatira zoyipa, malinga ndi ogula, "Diabeton" imapereka kawirikawiri. Odwala ambiri amati zovuta za mankhwalawa makamaka ndimtengo wake wokwera mtengo. Muyenera kulipira zochulukirapo kuposa Maninil. Analogs (mtengo wa mankhwala omwe amagwiritsidwa ntchito popanga matenda ashuga amatha kukhala osiyanasiyana) wa mankhwalawa nthawi zambiri amakhala wotsika mtengo. Matenda a shuga ndi osiyana ndi ena pankhaniyi. Pali phukusi la mapiritsi 60 a chinthu ichi m'mafakitala a 300 r. Mankhwalawa ndi oyenera, monga mankhwala ambiri ochepetsa shuga, mwatsoka, osati kwa odwala onse.

Mankhwala "Metformin"

Mankhwalawa amapezekanso m'mapiritsi ndi ma pharmacies ndi zipatala. Chofunikira chake chachikulu ndi metformin hydrochloride. Kupanga kwamankhwala kwa wothandizirayo kumawonekera makamaka chifukwa kumachepetsa kuchuluka kwa shuga m'matumbo. Sapereka mphamvu iliyonse popanga insulin, monga Glibenclamide ndi Maninil. Chimodzi mwamaubwino osakayikitsa a mankhwalawa ndikuti samayambitsa maonekedwe a hypoglycemia m'thupi.

Ndemanga za Metformin

Odwala amatamanda mankhwalawa makamaka chifukwa chofatsa. Metformin yatulutsa ndemanga zabwino komanso chifukwa chakugwiritsa ntchito ndizotheka osati kungochiza matenda ashuga. Chimalimbikitsa kugwiritsa ntchito mankhwalawa komanso kuchepetsa kulemera kwa odwala. Monga Diabeteson, mankhwalawa, mwa zina, amachepetsa mafuta m'thupi m'magazi a odwala. Kuphatikiza kwa malonda ena kumawonekeranso mtengo wotsika kwambiri: mapiritsi 60 a Metformin amatenga pafupifupi 90 r.

Zina mwa zovuta za mankhwalawa, ogula amangoganiza kuti m'miyezi yoyamba kumwa, zimatha kuyambitsa matenda otsegula m'mimba. Zotsatira zoyipa zoterezi nthawi zina zimaperekedwa ndi Maninil palokha. Ma analogi ake nthawi zambiri amakhalanso osiyana mumtundu womwewo. Koma mavuto am'mimba mwa ambiri mwa mankhwalawa nthawi zambiri samatchulidwa.

Mankhwala "Glimepiride" ("Amaril")

Mankhwalawa amapangidwa pamaziko a chinthu chotchedwa glimepiride. Zimakhala ndi zovuta m'thupi la wodwalayo - zimapangitsa kuti pakhale zofunikira, zimalepheretsa kupanga shuga m'chiwindi, komanso zimapangitsa chidwi cha minofu kugwira ntchito ya mahomoni. Mankhwalawa amachepetsa kwambiri mwayi wokhala ndi matenda a shuga. Nthawi zambiri, Amaril amatchulidwa ndi madokotala nthawi yomweyo ngati Metformin. Kugulitsa lero palinso mankhwala, omwe ndi zovuta pazinthu zonse zomwe zimagwira. Amatchedwa Amaril M.

Ndemanga za Mankhwala

Malingaliro okhudzana ndi mankhwalawa kwa anthu odwala matenda ashuga ndi abwino kwambiri. Zomwe zimagwiritsidwa ntchito nthawi zambiri zimadziwika. Amakhulupirira kuti kugwiritsa ntchito mankhwalawa ndikwabwino ngati Metformin yokha siyithandiza. Makulidwe a mapiritsi a Amarin ndi akulu. Kuphatikiza apo, ali ndi chiopsezo. Chifukwa chake, kuwagawana ngati kuli kofunikira ndi kosavuta kwambiri.

Mankhwala "Glucophage"

Mankhwalawa amagwirizana ndi Metformin. Zomwe zimagwiritsidwa ntchito ndizofanana kwa iye. Zomwezo zimapita kuzisonyezo ndi ma contraindication. Monga Metformin, mankhwalawa amathandizanso thupi la wodwalayo. Amachepetsanso kulemera kwenikweni.

M'malo momaliza

Chifukwa chake, tidazindikira chomwe "Maninil" ndi (malangizo ogwiritsira ntchito, mtengo, analogues tsopano akukudziwani). Mankhwalawa, monga mukuwonera, ndi othandiza. Ambiri omwe amagwirizana nawo amayenera kuwunikiridwa bwino kwambiri kuchokera kwa odwala. Komabe, ndikofunikira kugwiritsa ntchito mankhwalawa ndikusintha ndi mankhwala ena omwe ali ndi zofanana zochizira, zofunikira, pokhapokha ngati adokotala akuwalimbikitsa.

Zotsatira za pharmacological

Oral hypoglycemic mankhwala ochokera pagulu la sulfonylurea zotumphukira za m'badwo wachiwiri.

Imathandizira katulutsidwe ka insulini pomanga ma cell a pancreatic β-cell membrane enieni, imachepetsa cholumikizira kukhudzana ndi shuga wa glucose, kumakulitsa chidwi cha insulini komanso kumangiriza kwake kwa maselo, kumakulitsa kutulutsidwa kwa insulini ndi chiwindi, potero kuchepetsa kuchuluka kwa shuga m'magazi. Machitidwe mu gawo lachiwiri la insulin katulutsidwe. Imalepheretsa lipolysis mu minofu ya adipose. Amakhala ndi lipid-kutsitsa kwake, amachepetsa mphamvu za magazi m'magazi.

Maninil® 1.5 ndi Maninil ® 3.5 mu mawonekedwe owonetsedwa ndi mawonekedwe apamwamba, makamaka mawonekedwe a glibenclamide, omwe amalola kuti mankhwalawa amvedwe kuchokera m'matumbo am'mimba mofulumira. Pokhudzana ndi kukwaniritsidwa koyambirira kwa Cmax ya glibenclamide mu plasma, zotsatira za hypoglycemic pafupifupi zimafanana ndikuwonjezereka kwa kuchuluka kwa shuga m'magazi mutatha kudya, zomwe zimapangitsa mphamvu ya mankhwalawa kukhala yofewa komanso yolimbitsa thupi. Kutalika kwa nthawi ya hypoglycemic ndi maola 20-24.

Hypoglycemic zotsatira za mankhwala Maninil® 5 amakula pambuyo 2 maola ndipo kumatenga 12 maola.

Pharmacokinetics

Pambuyo pakulowa kwa Maninil 1.75 ndi Maninil 3.5, kunyamula mwachangu komanso kotheratu kuchokera m'mimba kumawonedwa. Kutulutsidwa kwathunthu kwa chinthu cha microionised yogwira kumachitika mkati mwa mphindi 5.

Pambuyo pakulowa kwa Maninil 5, mayamwidwe am'mimba ndi 48-84%. Tmax - maola 1-2. Mtheradi wa bioavailability - 49-59%.

Kumanga mapuloteni a Plasma ndi oposa 98% a Maninil 1.75 ndi Maninil 3.5, 95% a Maninil 5.

Kutetemera ndi chimbudzi

Imakhala ngati imaphatikizidwa kwathunthu m'chiwindi ndikupanga ma metabolites awiri osagwira ntchito, amodzi omwe amatsitsidwa ndi impso, ndi ena ndi bile.

T1 / 2 ya Maninil 1.75 ndi Maninil 3.5 ndi maola 1.5-3.5, kwa Maninil 5 - 3-16 maola.

Mlingo

Dokotala amakhazikitsa mlingo wa mankhwalawo payekha malinga ndi kuchuluka kwa shuga m'magazi pamimba yopanda kanthu komanso maola awiri atatha kudya.

Mlingo woyambirira wa maninil 1.75 piritsi 1 / 2-1 1 nthawi patsiku. Ndi osakwanira moyang'aniridwa ndi dokotala, mlingo wa mankhwalawa umakulitsidwa pang'onopang'ono mpaka mlingo wa tsiku ndi tsiku wofunikira kukhazikitsa kagayidwe kake ka metabolism wafika. Pafupifupi tsiku lililonse mapiritsi 2 (3.5 mg). Mulingo wambiri watsiku ndi tsiku ndi mapiritsi atatu (mwapadera, mapiritsi 4).

Ngati ndi kotheka kutenga Mlingo wambiri, amasinthira kumwa Maninil 3.5.

Mlingo woyambirira wa Maninil® 3.5 ndi mapiritsi 1 / 2-1 1 nthawi patsiku. Ndi osakwanira moyang'aniridwa ndi dokotala, mlingo wa mankhwalawa umakulitsidwa pang'onopang'ono mpaka mlingo wa tsiku ndi tsiku wofunikira kukhazikitsa kagayidwe kake ka metabolism wafika. Pafupifupi tsiku lililonse mapiritsi atatu (10,5 mg). Pazipita tsiku lililonse mapiritsi 4 (14 mg).

Mankhwalawa amayenera kumwedwa musanadye, osafuna kutafuna ndikumwa madzi pang'ono. Mlingo wa tsiku ndi tsiku wa mapiritsi awiri ayenera kumwedwa kamodzi patsiku - m'mawa, asanadye chakudya cham'mawa. Mlingo wapamwamba umagawidwa pakudya zam'mawa ndi zamadzulo. Ngati mulumpha mlingo umodzi wa mankhwalawa, piritsi lotsatira liyenera kumwa nthawi yokhazikika, pomwe saloledwa kumwa kwambiri.

Mlingo woyambirira wa Maninil® 5 ndi 2.5 mg 1 nthawi patsiku. Ndi osakwanira, moyang'aniridwa ndi dokotala, mlingo wa mankhwalawa umakulitsidwa pang'onopang'ono ndi 2,5 mg patsiku ndi gawo la masiku 3-5 mpaka tsiku lililonse lofunikira pokhazikitsa metabolism ya carbohydrate. Mlingo wa tsiku ndi tsiku ndi 2,5-15 mg.

Mlingo woposa 15 mg wa pa tsiku osachulukitsa kukula kwa vuto la hypoglycemic la mankhwala.

Kwa odwala okalamba, pali chiopsezo chokhala ndi hypoglycemia, kotero kwa iwo koyamba mlingo uyenera kukhala 1 mg patsiku, ndipo mlingo wokonzanso uyenera kusankhidwa moyang'aniridwa ndi dokotala.

Pafupipafupi kumwa mankhwalawa Maninil® 5 ndi katatu pa tsiku. Mankhwala ayenera kumwedwa mphindi 20-30 asanadye.

Mukasintha kuchokera kwa othandizira ena a hypoglycemic omwe ali ndi mphamvu yofananira, Maninil® 5 imayikidwa malinga ndi chiwembu pamwambapa, ndipo mankhwala am'mbuyomu adathetsedwa. Mukamasintha kuchokera ku Biguanides, mlingo woyambirira wa tsiku ndi tsiku ndi 2,5 mg, ngati kuli kotheka, mlingo wa tsiku ndi tsiku umakulitsidwa tsiku lililonse la 5-6 ndi 2,5 mg mpaka kulipiridwa. Palibe kubwezeredwa mkati mwa masabata a 4-6, ndikofunikira kusankha pazamankhwala othandizira ndi insulin.

Zotsatira zoyipa

Chotsatira chovuta kwambiri pa mankhwalawa ndi Maninil® ndi hypoglycemia. Vutoli limatha kutenga nthawi yayitali komanso limathandizira kuti pakhale zovuta kwambiri (mpaka kukomoka kapena kutha kwambiri). Ndi njira yaulesi, odwala matenda ashuga polyneuropathy kapena ochiritsira othandizira achifundo, okhazikika a hypoglycemia amatha kukhala ofatsa kapena osakhalapo.

Zomwe zimayambitsa kukula kwa hypoglycemia zimatha kukhala: kuchuluka kwa mankhwala osokoneza bongo, chisonyezo cholakwika, chakudya chosamveka, odwala okalamba, kusanza, kutsegula m'mimba, kuthamanga kwa thupi, matenda omwe amachepetsa kufunikira kwa insulin (chiwopsezo cha chiwindi ndi ntchito ya impso, hypofunction ya adrenal cortex, pituitary kapena chithokomiro chithokomiro) , kumwa mowa mwauchidakwa, komanso kucheza ndi mankhwala ena.

Zizindikiro za hypoglycemia zimaphatikizapo njala yayikulu, thukuta lodzidzimutsa, kukoka kwa pakhungu, kupweteka pakamwa, kunjenjemera, kuda nkhawa kwambiri, kupweteka kwa mutu, kusokonezeka kwa matenda, kusokonezeka kwa tulo, kumva mantha, kulumikizana kwamisala, kusokonezeka kwa minyewa kwakanthawi (mwachitsanzo, kusokonezeka) masomphenya ndi malankhulidwe, mawonetseredwe a paresis kapena ziwalo kapena kusinthika kwa malingaliro. Ndi kupita patsogolo kwa hypoglycemia, odwala amatha kulephera kudziletsa komanso kuzindikira. Nthawi zambiri wodwala wotere amakhala ndi khungu lonyowa komanso wamatsenga.

Zotsatira zotsatirazi ndizothekanso.

Kuchokera pamatumbo am'mimba: kawirikawiri - nseru, kugona, kusanza, kutsekemera kwazitsulo mkamwa, kumva kupsinjika ndi chidzalo m'mimba, kupweteka kwam'mimba komanso kutsekula m'mimba, nthawi zina - kuwonjezeka kwakanthawi kwa ntchito ya michere ya chiwindi (GSH, GPT, ALP), mankhwala a chiwindi a hepatitis ndi jaundice.

Thupi lawo siligwirizana: zotupa, pruritus, urticaria, redness, Quincke's edema, zotupa zotupa pakhungu, zotupa zosasunthika pamalo akulu pakhungu, kuwonjezereka kwa dzuwa. Osowa kwambiri, kusintha kwa khungu kumatha kukhala ngati chiyambi cha kukhwima kwambiri kwamikhalidwe, limodzi ndi kufupika ndi kuchepa kwa kuthamanga kwa magazi kufikira atayamba kudabwitsidwa, komwe kumawopseza moyo wa wodwalayo. Milandu ina yokhudza kukhudzana kwakukulu komwe kumachitika ndi zotupa pakhungu, kupweteka kwapweteka, kutentha thupi, ma protein a mkodzo ndi jaundice amafotokozedwa.

Kuchokera hematopoietic dongosolo: kawirikawiri - thrombocytopenia, erythropenia, leukocytopenia, agranulocytosis, patali - hemolytic anemia kapena pancytopenia.

Zina: padera, kufooka okodzetsa, kuwoneka kwakanthawi kwamapuloteni mu mkodzo, kuwonongeka kwa mawonekedwe ndi malo ogona, komanso kuyimitsidwa kwamowa pambuyo pakumwa, kufotokozedwa ndi zovuta za ziwalo zozungulira ndi kupuma (kusanza, kumva kutentha kwa nkhope ndi thupi lakumwamba) , tachycardia, chizungulire, kupweteka mutu.

Contraindication pakumwa mankhwala a MANINIL ®

• mtundu 1 shuga
• matenda ashuga ketoacidosis, matenda a shuga komanso chikomokere,
• vuto pambuyo pancreatic resection,
• kukanika kwambiri kwa chiwindi,
• kukanika kwambiri kwaimpso (CC zosakwana 30 ml / min),
• zina zowawa kwambiri (mwachitsanzo, kubwezeretsa kwa kagayidwe kazakudya mu matenda opatsirana, kuwotcha, kuvulala kapena pambuyo pakuchitidwa maopaleshoni yayikulu ndikusonyeza mankhwala a insulin),
• leukopenia
• Matumbo, m'mimba,
• machitidwe omwe amaperekedwa ndi malabsorption chakudya ndi kukula kwa hypoglycemia,
• mimba
• mkaka wa m'mawere (yoyamwitsa),
• hypersensitivity ya glibenclamide ndi / kapena zotumphukira zina za sulfonylurea, sulfonamides, diuretics (diuretics) yokhala ndi gulu la sulfonamide mu molekyulu, ndi probenecid, popeza mawonekedwe amtanda amatha.

Mochenjera, mankhwalawa ayenera kuyambitsa matenda a febrile syndrome, matenda a chithokomiro (omwe ali ndi vuto la chithokomiro), kuchepa kwa chidwi cha anterior pituitary kapena adrenal cortex, uchidakwa, mwa odwala okalamba chifukwa chokhala ndi vuto la hypoglycemia.

Malangizo apadera

Ndikofunikira kuwunika pafupipafupi kuchuluka kwa shuga m'magazi pamimba yopanda kanthu ndikatha kudya.

Odwala ayenera kuchenjezedwa za kuwonjezeka kwa hypoglycemia nthawi yomweyo kudya kwa ethanol (kuphatikizapo kukula kwa discriram-syndrome: kupweteka kwam'mimba, nseru, kusanza, kupweteka mutu) komanso nthawi yanjala.

Dokotala ayenera kuganizira mosamala kuperekedwa kwa Maninil® kwa odwala omwe ali ndi vuto la chiwindi ndi impso, komanso hypothyroidism, anterior pituitary kapena adrenal cortex.

Kusintha kwa mankhwalawa Maninil ® ndikofunikira pakulimbitsa thupi ndi malingaliro, kusintha zakudya.

Pa chithandizo, sikulimbikitsidwa kuti mukhale padzuwa nthawi yayitali.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Mu nthawi mpaka mulingo woyenera utakhazikitsidwa kapena mukasintha mankhwalawo, komanso mankhwalawa Maninil ®, kuthekera koyendetsa galimoto kapena kuwongolera njira zosiyanasiyana, komanso kuchita zinthu zina zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa malingaliro ndi magalimoto. .

Bongo

Zizindikiro: Mankhwala osokoneza bongo a Maninil ®, komanso kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, amatha kuyambitsa hypoglycemia, yomwe nthawi zina imawopseza moyo wa wodwalayo.

Chithandizo: Matenda ofatsa a hypoglycemia, omwe ndi oyambilira ake, wodwalayo amatha kudzipatula podya shuga, kupanikizana, uchi, kumwa kapu ya tiyi kapena shuga. Chifukwa chake, wodwalayo ayenera kukhala naye nthawi zonse magawo a shuga osakanikirana kapena maswiti (maswiti). Zogulitsa zopangidwa ndi confectionery zopangidwa mwachindunji kwa odwala matenda a shuga sizithandiza pamikhalidwe yotere. Ngati wodwalayo sangachotsere yomweyo zizindikiro za hypoglycemia, ndiye kuti ayenera kuyimbira foni dokotala. Ngati mukumva chikumbumtima, 40% dextrose solution imayamwa / mu, i / m 1-2 mg glucagon. Pambuyo pakupezanso chikumbumtima, wodwalayo ayenera kupatsidwa chakudya chambiri m'zakudya zomanga thupi (pofuna kupewa kukonzanso kwa hypoglycemia).

Kuyanjana kwa mankhwala osokoneza bongo

Kuwonjezeka kwa hypoglycemic zotsatira za kukonzekera kwa Maninil® kuyenera kuyembekezeredwa muzochitika ngati chithandizo ndi ACE inhibitors, ma anabolic othandizira, mankhwala ena amkamwa a hypoglycemic (mwachitsanzo, acarbose, biguanides) ndi insulin, azapropasone, beta-blockers, quinine, quinolone, chloram. ndi ma analogi ake, coumarin derivatives, disopyramide, fenfluramine, pheniramidol, fluoxetine, MAO zoletsa, miconazole, PASK, pentoxifylline (muyezo waukulu ah kholo), perhexiline, pyrazolone derivatives, phenylbutazones, phosphamides (mwachitsanzo cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfinpyrazone, sulfanilamides, tetracyclines, tritokvalin, mowa.

Urine acidifying agents (ammonium chloride, calcium chloride) amalimbikitsa mphamvu ya maninil ® mankhwalawa pochepetsa kuchepa kwake ndikuwonjezera mphamvu yake.

Pamodzi ndi kuwonjezeka kwa zotsatira za hypoglycemic, beta-blockers, clonidine, guanethidine ndi reserpine, komanso mankhwala omwe ali ndi gawo lapakati lochita, amatha kufooketsa chidwi cha akatswiri a hypoglycemia.

Mphamvu ya hypoglycemic ya Maninil ® ingathe kuchepa ndi kugwiritsa ntchito pamodzi kwa barbiturates, isoniazid, cyclosporine, diazoxide, GCS, glucagon, nikotini (mapiritsi okwanira), phenytoin, phenothiazines, rifampicin, saluretics, acetazolamide, mahormoni achigololo, mahomoni. England chithokomiro, othandizira omvera, indomethacin ndi mchere wa lithiamu.

Kugwiritsa ntchito kwambiri mowa ndi mankhwala osokoneza bongo kungakulitse kuphwanya kwa kagayidwe kazakudya.

Otsutsa a H2 receptor amatha kufooketsa, kumbali imodzi, ndikuthandizira zotsatira za hypoglycemic za Maninil® mbali inayo.

Nthawi zina, pentamidine imapangitsa kuchepa kwamphamvu kapena kuchuluka kwa kuchuluka kwa shuga m'magazi.

Pogwiritsa ntchito munthawi yomweyo Maninil ®, zotsatira za zotumphukira za coumarin zitha kuchuluka kapena kuchepa.

Mankhwala omwe amalepheretsa mafupa a hematopoiesis kuonjezera chiopsezo cha myelosuppression ndikugwiritsa ntchito Maninil®.

Wodwala ayenera kudziwitsidwa ndi dokotala kuti athe kuyanjana.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwalawa amapangidwa ngati mapiritsi okhala ndi 1.75 mg, 3.5 mg kapena 5 mg ya glibenclamide.

Zothandiza pa Maninyl 1.75 ndi 3.5 ndi lactose monohydrate, mbatata wowuma, hemetellose, silicon colloidal dioxide, magnesium stearate, ponce utoto wa Ponso 4R, Maninil 5 - lactose monohydrate, chimanga wowuma, magnesium stearate, gelatin, talc Ponce 4R.

Zizindikiro zogwiritsidwa ntchito

Malinga ndi zomwe zafotokozedwa mu malangizo a Maninil, mankhwalawa adapangidwa kuti athandizidwe ndi matenda a shuga a 2, onse monga monotherapy komanso ngati gawo limodzi la mankhwala othandizira pakamwa limodzi ndi othandizira ena amkamwa a hypoglycemic, kupatulapo ma ironides ndi zotumphukira za sulfonylurea.

Mlingo ndi makonzedwe

Mlingo wa Maninil umatsimikiziridwa ndi adotolo kutengera ndi kuopsa kwa matendawa, msinkhu wa wodwalayo, kusala kwa shuga wamagazi komanso maola awiri atatha kudya.

Mlingo woyamba wa mankhwalawa ndi:

• Maninil 1.75 - mapiritsi 1-2 kamodzi patsiku,
• Maninil 3.5 ndi 5 - 1 / 2-1 tabu. kamodzi patsiku.

Ndiwosakwanira, mulingo wake umayamba kukula pang'onopang'ono mpaka kagayidwe kake kamene umagwira. Kuchulukitsa kwa mankhwalawa kumachitika pang'onopang'ono, pakadutsa masiku angapo mpaka sabata limodzi.

Mulingo wambiri watsiku ndi tsiku:

• Maninil 1.75 - mapiritsi 6,
• Maninil 3.5 ndi 5 - 3 mapiritsi.

Odwala ofooka, anthu okalamba, odwala kuchepa kwa zakudya, odwala chiwindi kapena matenda a impso, ndipo gawo loyambirira ndi lokonza liyenera kuchepetsedwa, chifukwa pamakhala chiwopsezo cha hypoglycemia.

Mapiritsi ayenera kumwedwa pamaso chakudya. Ngati tsiku ndi tsiku mumakhala mapiritsi a 1-2, nthawi zambiri amatengedwa kamodzi patsiku - m'mawa, asanadye chakudya cham'mawa. Mlingo wapamwamba uyenera kugawidwa pawiri - m'mawa ndi madzulo.

Ngati wodwala pazifukwa zina wasowa mlingo wotsatira, muyenera kumwa mapiritsi nthawi yomweyo. Imwani kawiri mlingo oletsedwa!

Zotsatira zoyipa

Malinga ndi ndemanga za odwala, Maninil atha kukhala ndi zovuta, monga:

• Hyperthermia, njala, kugona, tachycardia, kufooka, kusokonezeka kwa kayendedwe, kupweteka mutu, chinyezi pakhungu, kunjenjemera, mantha, nkhawa, kufooka kwakanthawi kwamitsempha, kulemera kwakanthawi (kuchokera kumbali ya metabolism),
• Kusanza, kupindika, kumva kupsinjika m'mimba, kupweteka m'mimba, kusanza, kulawa kwazitsulo mkamwa, kutsekula m'mimba (kuchokera kumimba yodyeka),
• Hepatitis, intrahepatic cholestasis, kuwonjezeka kwakanthawi kwa chiwindi michere (kuchokera pamimba ndi chiwindi),
• Kuyabwa, petechiae, urticaria, photosensitization, Matupi a vasculitis, purpura, anaphylactic, kugwidwa ndi matenda osiyanasiyana, limodzi ndi malungo, zotupa pakhungu, proteinuria, arthralgia ndi jaundice (kuchokera ku chitetezo chamthupi),
• Thrombocytopenia, pancytopenia, agranulocytosis, leukopenia, hemolytic anemia, erythropenia (kuchokera ku hematopoietic system).

Kuphatikiza apo, Maninil angayambitse diuresis yowonjezera, kusokonezeka kowoneka, kusowa kwa malo ogona, hyponatremia, kuchepa kwa proteinuria, mtanda wokhudzana ndi probenecis, sulfonamides, zotumphukira zochokera ku sulfonylurea ndi kukonzekera kwa diuretic komwe kumakhala ndi gulu la sulfonamide mu molekyulu.