Mankhwala Glibenclamide a shuga - malangizo ntchito

Type 2 matenda a shuga ndi matenda ofala ophatikizidwa ndi matenda ambiri. Njira yayikulu yothandizira ndi kuchita masewera olimbitsa thupi, kudya, kugwiritsa ntchito mankhwala osokoneza bongo. Chimodzi mwazomwe amamwa mankhwala a shuga a 2 ndi glibenclamide.

Zambiri pazamankhwala

Glibenclamide ndi mankhwala odziwika bwino omwe amachepetsa shuga omwe agwiritsidwa ntchito m'maiko osiyanasiyana, makamaka ku Russia, kuyambira chiyambi cha 70s. Ndi woimira wa sulfonylurea zotumphukira (m'badwo wachiwiri). Mankhwalawa amagwiritsidwa ntchito mochizira matenda a shuga a mtundu wachiwiri.

Mankhwala omwe aperekedwa akuwonetsa zinthu zina zopindulitsa thupi. Pazaka 45 zapitazi, mankhwala opatsirana oyambitsa matenda osokoneza bongo komanso mankhwala ena osokoneza bongo omwe ali ndi njira ina yogwirira ntchito awonekera pamsika wamankhwala. Koma Glibenclamide imayikidwabe ndi madokotala ndipo sataya kufunika kwake.

Mosiyana ndi omwe adatsogolera, mankhwalawa ndi ololera komanso othandizira. Imafotokozedwa ngati kulibe vuto la mankhwala osagwiritsa ntchito mankhwala osokoneza bongo komanso kukana mankhwalawa.

Pharmacological katundu ndi kapangidwe

Zotsatira za mankhwalawa ndi hypocholesterolemic, hypoglycemic. Imawonjezera kuchuluka kwa insulini yowonjezera ndi kapamba, imadzutsa ntchito ya maselo a beta a islet zida. Zinthu zimalepheretsa njira za potaziyamu zomwe zimadalira (njira za ATP).

Kukondoweza kwa granules zachinsinsi ndi insulin kumachitika ndipo, monga chotulukapo chake, zinthu zachilengedwe zimalowa m'magazi ndikutuluka kwa madzi.

Kuphatikiza pa zotsatira zazikulu, thunthu limakhala ndi mphamvu ya thrombogenic ndikuchepetsa cholesterol. Amapereka kufalikira mwachangu ndi mayamwidwe m'mimba. Kulumikizira mapuloteni a plasma kumachitika pafupifupi kwathunthu (98%). Mankhwala zimapukusidwa mu chiwindi. Kuzindikira kwakukulu m'magazi kumafika patatha maola awiri.

Katunduyu amagwira ntchito kwa maola 12. Hafu ya moyo pambuyo pakumwa pakamwa ndi maola 7, imatha masiku 2-3. Amachepetsa ndi ndulu ndi mkodzo. Ndi kuchepa kwa magwiridwe antchito a chiwindi, chimbudzi chimayamba kuchepa, ndipo ngati kulephera kwaimpso, m'malo mwake, kumawonjezeka.

Dzinalo lantchito yogwiritsidwa ntchito mu Latin ndi glibenclamide. Kutulutsa mawonekedwe: mapiritsi ozungulira ozungulira. Iliyonse imakhala ndi 5 mg yogwira ntchito.

Zizindikiro ndi contraindication

Chizindikiro chogwiritsira ntchito: shuga yosadalira insulin, malinga ngati palibe zotsatira za kukonza kwa shuga ndi mankhwala osagwiritsa ntchito mankhwala.

Contraindication kuti agwiritse ntchito akuphatikizapo:

tsankho pazinthu zomwe zikugwira,
chiwindi ntchito,
kagayidwe kake kamakonda kuphatikiza thupi,
precoma kapena matenda ashuga,
mimba
kuwonongeka kwaimpso,
nyere
wathunthu kubwereza mankhwala kulephera
shuga wodalira insulin (DM 1),
anthu osakwana zaka 18.

Malangizo ogwiritsira ntchito

Kusintha kwa glibenclamide kumachitika bwino, mankhwalawa amayikidwa ndi mapiritsi 0,5 patsiku. Okalamba omwe ali ndi vuto la ziwalo zolimbitsa thupi amalimbikitsidwa kuti awonjezere mlingo woyenera pang'onopang'ono.

Izi ndizowona makamaka kwa anthu olemera mpaka 50 kg. Tsiku lililonse, mlingo ndi 2.5-5 mg wa mankhwalawa (mpaka piritsi limodzi). Ngati ndi kotheka, onjezani mlingo pang'onopang'ono. Zomwe zimachitika tsiku lililonse zimakhala ndi mapiritsi atatu.

Mankhwalawa amatengedwa musanadye. Pa mlingo wopitilira piritsi limodzi, tikulimbikitsidwa kuti tizitsatira 2 2 1 (m'mawa: madzulo). Kulandila kumachitika nthawi imodzi popanda zopumira. Panthawi yamankhwala, mkhalidwe wa kagayidwe umayang'aniridwa.

Mosamala, mankhwalawa ayenera kugwiritsidwa ntchito ndi magulu otsatirawa a odwala:

ukalamba
anthu omwe ali ndi vuto la chiwindi,
odwala omwe amachepetsa chithokomiro,
ndi zizindikiro za matenda ammimba.

Mowa panthawi yamankhwala munjira yotsatirika imatha kukhudzidwa - kukulitsa kapena kufooketsa mphamvu ya mankhwalawa. Dye E124 imayambitsa ziwengo mu odwala omwe atengeka mosavuta. Ngati matenda aliwonse (kapena alipo) atapezeka, ndikofunikira kudziwitsa dokotala. Odwala sayenera kusiya kugwiritsa ntchito mankhwalawa kapena kusintha mlingo popanda kufunsa dokotala.

Zotsatira zoyipa ndi bongo

Zina mwazotsatira zoyipa:

kunenepa
kusanza, nseru, kulemera m'mimba, kuphwanya m'mimba,
Khungu, zotupa, kuchepa magazi,
chiwindi ntchito,
kuchuluka kwa magawo amisili,
kuwonongeka kwamawonekedwe
achina,
thupi lawo siligwirizana
thrombocytopenia, leukocytopenia, erythrocytopenia, granulocytopenia,
ofooka okodzetsa kwenikweni.

Mankhwala osokoneza bongo (kuchuluka kwa nthawi yayitali kapena kuchuluka kwa nthawi imodzi) nthawi zambiri kumabweretsa hypoglycemia.

thukuta
kukopa kwa pakhungu
kusalankhula bwino komanso kumva moperewera,
palpitations, kuzizira,
ndi boma lotukuka - hypoglycemic chikomokere.

Woopsa, ndikofunikira kutsuka m'mimba ndikubaya jakisoni wa shuga. Ngati ndi kotheka, glucagon imayang'aniridwa. Hypoflycemia yofatsa imatha kuthetsedwa pakudya shuga.

Kuchita ndi mankhwala ena ndi analogi

Mankhwala omwe amawonjezera mphamvu ya Glibenclamide ndi monga: Miconazole, antipatitisline, anabolic steroid, antidepressants, insulin ndi zingapo za matenda ashuga, mahomoni amuna.

Mankhwala omwe amachepetsa vutoli ndi monga: mahomoni a chithokomiro, corticosteroids, nicotinates, glucagon, beta-andrenoblockers, mahomoni ogonana achikazi, ma diuretics, barbiturates.

Mankhwala omwe angakhudze glibenclamide (kuwonjezera kapena, motsika, kutsika) akuphatikiza: Clonidine, Reserpine, H2 receptor blockers, pentamidine.

Malangizo ofanana:

analogue mtheradi ndi Maninil (mankhwala omwe ali ofanana),
gulu la mankhwala omwe ali ndi glimepiride - Amapirid, Amaril, Glibetic, Glimax, Diapride,
kukonzekera ndi Gliclazide - Glidia, Glicada, Gliclazide, Diagnizid, Panmicron-MV,
ndalama ndi Glipizidom - Glynez, Minidiab.

Zinthu zamavidiyo kuchokera kwa Dr. Malysheva okhudza zinthu zomwe zimachepetsa shuga mu shuga komanso zitha kugwiritsidwa ntchito ngati mankhwala owonjezera:

Maganizo a odwala

Kuchokera pa ndemanga za odwala omwe akutenga Glibenclamide, titha kunena kuti mtengo wa mankhwalawo ndiwotsika mtengo ndipo umatsitsa shuga bwino, koma pambuyo poti ugwiritsidwa ntchito, zotsatira zoyipa zimakonda kuwonekeranso m'misempha komanso kusowa kudya.

Ndakhala ndikudwala matenda ashuga kwa zaka 12. Mankhwala osiyanasiyana adapangidwira, koma Glibenclamide adakhala wofunikira kwambiri. Poyamba anali kuthandizidwa ndi Metformin - palibe zotsatira zapadera pa mtundu wa shuga ngakhale atakweza mlingo. Mutachotsa Glibenclamide. Zotsatira zoyipa zokhudzana ndi kusowa kwa chilimbikitso ndi mseru zinali m'mwezi woyamba, ndiye kuti zonse zidabwezeretseka. Mulingo wa shuga panthawi yogwiritsa ntchito mankhwalawa umachepa ndipo umakhalabe mkati 6. Masana ndimamva bwino, ndipo zimakondweretsa.

Irina, wazaka 42, Samara

Mayi anga apeza matenda ashuga a mtundu 2 posachedwapa. Dokotala wopezekapo nthawi yomweyo adamuuza Glibenclamide ndipo adamupatsa mankhwala. Pafupifupi sabata imodzi itatha kugwiritsidwa ntchito, ndinayamba kumva kusanza komanso kusowa kudya. Koma, monga akunenera, izi sizofunikira poyerekeza ndi kuti glucose amasungidwa pa 6-7. Pa chithandizo, kuwonjezera pa mishuga ya glucose, muyenera kuwunika magawo a chiwindi. Koma amayi, limodzi ndi Glibenklemin, akumva bwino.

Sergey, wazaka 34, Yekaterinburg

Matenda anga a shuga ali ndi zaka pafupifupi 6. Mwachilengedwe, shuga sakanakhoza kusintha. Ndinafunika kusankha mankhwala. Ndimamva kuthekera kokha kuchokera ku Glibenklemin - shuga amachepetsedwa kufika 6.5. (Nthawi zonse ndimagwiritsa ntchito mita). Izi zisanachitike, sindingathe kukwaniritsa chizindikiro chotere kwa nthawi yayitali, pansi pa 7 shuga sizinachepe konse. Pomaliza ndidatenga mankhwala anga. Poyamba ndinayamba kulemera pang'ono, koma kenako ndinasintha kadyedwe kanga. Mwa zina zoyipa: nthawi ndi nthawi nseru, nthawi zina - kutsegula m'mimba komanso kusowa kudya.

Oksana, wazaka 51, Nizhny Novgorod

Mtengo wa mankhwala oyambira umachokera ku 90 mpaka 120 ma ruble. Mankhwalawa amaperekedwa pokhapokha ngati mwalandira mankhwala.

Glibenclamide ndi mankhwala othandiza kuchepetsa matenda a shuga. Amathandizidwa ndi madokotala ndipo samataya kufunika kwake, ngakhale kupezeka kwa mankhwala a mtundu watsopano.

Tulutsani mawonekedwe, mawonekedwe ndi ma CD

Glibenclamide imapezeka mu mawonekedwe a mapiritsi oyera, achikasu pang'ono kapena amtundu wamtundu, mawonekedwe amitundu yosalala komanso yopumira pakati.

Mapiritsi amapezeka m'matumba okhala ndi maselo (ma 10 ma PC), Omwe ali mu bokosi la makatoni. Miyezo ya 20, 30, mapiritsi 50 ikhoza kuyikamo zitini za pulasitiki kapena galasi lakuda.

Piritsi 1 ili ndi 5 mg ya glibenclamide - yogwira ntchito. Zowonjezera zina, shuga mkaka (lactose monohydrate), povidone, wowuma wa mbatata, magnesium ndi calcium stearate zili.

Pang'onopang'ono sungunuka m'madzi ndi mowa.

Kuwona pamsika wamafuta kumawonetsa kuti mtengo wa mankhwala umadalira wopanga komanso dera lomwe amagulitsa. Chifukwa chake, ku Moscow, dera ndi St. Petersburg, zogulitsa zapakhomo zimaperekedwa pamitundu yama ruble 30-70, yomwe idatumizidwa (India) - kuchokera ku ma ruble 90.

M'madera, mtengo wa mankhwalawo ndiwokwera. Chifukwa chake, Glibenclamide yopangidwa ndi Russia imagulitsidwa kuchokera ku ma ruble 96, ndikugulitsidwa - ma ruble a 130-140.

Zotsatira za pharmacological

Oral ofanana ndi a m'badwo wachiwiri sulfonylurea. Imakhala ndi hypoglycemic (imachepetsa shuga wamagazi) ndi hypocholesterolemic (amachepetsa cholesterol).

Monga chithandizo china cha matenda ashuga, Glibenclamide imalimbikitsa maselo a pancreatic omwe amapanga insulin. Mosiyana ndi mankhwala a m'badwo woyamba, amadziwika ndi zochitika zapamwamba (zotsatira zimachitika mwachangu ndi mlingo wotsika umodzi), zimalekeredwa bwino.

Imachepetsa mphamvu ya maselo a pancreatic beta kuti asinthe kuchuluka kwa shuga m'magazi. Zimawonjezera insulin zomwe zili m'madzi a m'magazi ndipo zimachepetsa gawo lomaliza m'magazi. Njira yothetsera matendawa imachitika bwino, osayambitsa zochitika za hypoglycemic. Kuchulukitsa kuchuluka kwa kuwonongeka kwa glucose mu minofu ndi chiwindi, kumakhudza kupanga kwa glycogen (carbohydrate yovuta) mwa iwo. Amachepetsa ndende ya lipids, amawongolera lipolysis mu adipose minofu, ali ndi antidiuretic kwenikweni, amachepetsa chiopsezo cha magazi kuundana.

Ndi thupi kukana mankhwala ena a gululi, glibenclamide nthawi zambiri imakhala yogwira mtima. Peak ya achire ntchito amakhala pambuyo 1-2 maola, mpaka pazambiri pambuyo maola 7-8, ndipo kumatenga maola 8-12.

Pharmacokinetics

The yogwira thunthu pafupifupi odziwidwa kwathunthu kuchokera m'mimba thirakiti. Pafupifupi 100% yomangidwa ndi mapuloteni a plasma. Kuchotsa hafu ya moyo kumapangitsa maola 4-11. Mu chiwindi, limagawika zinthu ziwiri zosagwira: chimodzi chimaponyedwa mkodzo, chachiwiri - ndi bile kudzera m'mimba.

Mankhwala osokoneza bongo amathandizira kuthana ndi vuto la placental.

odwala mtundu wa 2 matenda ashuga ngati vuto la chakudya,
Ndi kukana kwa thupi kwa mankhwala ena a gululi,
odwala 30 mpaka insulin patsiku,
kuphatikiza ndi insulin.

Contraindication

mtundu 1 shuga
Hypersensitivity pamagawo a mankhwala,
ketoacidosis
wokongola komanso wokoma,
aimpso ndi chiwindi kulephera,
leukopenia
matumbo paresis,
malabsorption m'matumbo,
matumbo,
othandizira opaleshoni
matenda opatsirana
mimba ndi mkaka wa m`mawere.

Mlingo ndi kugwiritsa ntchito

Glibenclamide iyenera kumwedwa katatu patsiku 20-30 mphindi musanadye, kumwa madzi ambiri.

Poyamba, tsiku lililonse mlingo wa 2 mg ndi tsiku. Pokhapokha pakuchitika zovuta komanso kuti mukwaniritse zochizira zofunika, mulingo wambiri umachulukitsidwa kawiri pa mwezi.

Mankhwala othandizira kukonza amakhalapo 5-10 mg patsiku, koma osapitirira 15 mg.

Zofunika! Kwa odwala okalamba, tsiku ndi tsiku mlingo ndi 1 mcg.

Malangizo apadera

Mankhwala ayenera kumwedwa nthawi yomweyo.

Mankhwala, kuyang'anira kuchuluka kwa shuga kumafunika. Pokonzekera mankhwalawo komanso nthawi yoyamba pambuyo pawo, komanso panthawi yomwe ali ndi pakati, ndikofunikira kusiya Glibenclamide ndikusinthana ndi insulin. Tiyenera kukumbukira kuti kulera komanso glucocorticosteroids amachepetsa mphamvu ya mankhwalawa, ndipo beta-blockers imachulukirachulukira.

Ndi kugwiritsa ntchito mankhwalawa pafupipafupi, ndikofunikira kutsatira zakudya ndi tsiku. Muyenera kusiyiratu kumwa mowa.

Mosamala, mankhwalawa amaperekedwa kwa odwala omwe ali ndi vuto la chiwindi ndi impso.

Fananizani ndi fanizo

Mwa mankhwala omwe ali ndi vuto lofananalo, pali:

Glyclazide imasiyana ndi Glibenclamide ndi zinthu zomwe zimagwira. Amagwiritsidwa ntchito ngati mtundu wa shuga wodalira insulin. Imakhala ndi zotsutsana zochepa poyerekeza ndi mnzake. Chololedwa kuchokera zaka 18.

Matenda ashuga ndi mankhwala, monga kale mankhwala, - gliclazide. Iyo ili pafupifupi chithunzi chathunthu.

Diadeon. Chomwe chimagwiranso ntchito ndi gliclazide. Zimathandizira kuchepetsa shuga wamagazi, komanso zimachepetsa chiopsezo cha kuwundana kwa magazi m'mitsempha yaying'ono.

Ziphuphu. Zimasiyana ndi zinthu zomwe zatchulidwa pamwambapa, zomwe zimatchedwa "glycidone". Amanenanso mtundu wa matenda ashuga amtundu II.

Glibenclamide, mosiyana ndi ma analogues, amachepetsa cholesterol komanso kupewa thrombosis.

Kupenda kowunikira kumawonetsa kuti mankhwalawa ndi othandiza kwambiri, amadziwika ndi kuwonetsa pang'ono zoyipa. Pang'onopang'ono amachepetsa shuga.

Mu ndemanga, odwala makamaka amakambirana za kuchuluka kwa mankhwalawa komanso mogwirizana ndi mitundu ina ya mankhwala.

Akatswiri amavomereza kuti milandu iliyonse ndi yapadera komanso payekhapayekha, chifukwa chake ndizosatheka komanso cholakwika kupereka mankhwala osakhalapo.

Kusankhidwa kwa mankhwala apamwamba komanso othandiza pamafunika nthawi kuti achite maphunziro a labotale, kutifotokozere momveka bwino matendawa. Pambuyo pokhapokha titha kusiya njira ina iliyonse.