Amaril mankhwala a m'badwo watsopano > Chithandizo ndi kupewa

Amaryl ndi mankhwala osokoneza bongo a hypoglycemic omwe amathandizira kuwongolera misempha ya plasma. Yogwira pophika mankhwala ndi glimepiride. Monga omwe adatsogolera, Glibenclamide, Amaril ndiwonso wochokera ku gulu la sulfonylurea, lomwe limalimbikitsa kapangidwe ka insulin kuchokera ku maselo a b pancreatic a Langerhans.

Kuti akwaniritse zomwe akufuna, amatseka njira ya potaziyamu ya ATP ndi chidwi chochulukirapo. Sulfonylurea ikalumikizana ndi ma receptor omwe ali pamalimba a b-cell, zochitika za gawo la K-AT zimasintha. Kutsekeka kwa njira za calcium ndi kuwonjezeka kwa kuchuluka kwa ATP / ADP mu cytoplasm kumapangitsa kuti membrane awonongeke. Izi zimathandiza kumasula njira za calcium ndikuwonjezera kuchuluka kwa calcium ya cytosolic.

Zotsatira za kukopa kwachidziwikire kwa ma granules achinsinsi, komwe ndi njira yotulutsira mankhwala ophatikizira pakati pa maselo, ndikutulutsa kwa insulin m'magazi.

Glimepiride ndi woimira m'badwo wachitatu wa sulfonylureas. Zimapangitsa kuti amasulidwe mahomoni a pancreatic mwachangu, amathandizira chidwi cha insulini cha mapuloteni komanso maselo a lipid.

Tizilomboti timatulutsa michere timagulugasi timagwiritsa ntchito mapuloteni ochokera ku ma cell a cell. Ndi mtundu wodziimira payekha wa shuga, kusintha kwa shuga m'matipi kumachepetsedwa. Glimepiride imalimbikitsa kukwera kwa kuchuluka kwa mapuloteni oyendetsa ndikuwonjezera ntchito yawo. Mphamvu yamphamvu kwambiri ya kapamba imathandizira kuchepetsa kukanira kwa insulin (insensitivity) kwa mahomoni.

Amaryl imalepheretsa kuphatikizika kwa glucogen ndi chiwindi chifukwa cha kuchuluka kwa mphamvu ya fructose-2,6-bisphosphate ndi antiaggregant (chopinga cha kupangidwa kwa thrombus), antiatherogenic (kuchepa kwa zizindikiro za cholesterol "choyipa") komanso antioxidant (kusinthika, kuthana ndi kukalamba). Njira za oxidation zimachepetsedwa chifukwa chowonjezeka pazomwe zimakhala za end-native b-tocopherol komanso ntchito ya antioxidant enzymes.

Pharmacokinetics wa mankhwala

Popanga Amaril, gawo lalikulu lomwe limagwira ndi glimepiride kuchokera ku gulu la sulfonylurea. Povidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose ndi utoto wa E172, E132 amagwiritsidwa ntchito ngati ojambula.

Amaryl imayendetsa michere ya chiwindi 100%, kotero ngakhale kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwalawa sikuwopseza kudzikundikira kwake pazinthu komanso minyewa. Zotsatira zakonzedwe, zotumphukira ziwiri za glipemiride zimapangidwa: hydroxymetabolite ndi carboxymethabolite. Metabolite yoyamba imapatsidwa mankhwala omwe amapereka chokhazikika cha hypoglycemic.

M'magazi, zomwe zimakhala pazomwe zimagwira ntchito zimawonedwa pakatha maola awiri ndi theka. Kuwona zamtundu wathunthu wa bioavailability, mankhwalawa saletsa odwala matenda ashuga posankha zakudya zomwe "agwiritse" mankhwalawo. Mafuta adzakhala mulimonse 100%.

Kuwongolera kwakukulu kwa glycemic indices kumawonedwa ngakhale ndi zovuta ndi chiwindi, makamaka, mukulira (wazaka zoposa 65) komanso ndi vuto la chiwindi, kugwiritsidwa ntchito kwa chinthucho ndi kwachibadwa.

Momwe mungagwiritsire ntchito Amaryl

Mankhwala amapangidwa mwanjira ya mapiritsi ozungulira omwe ali ndi mzere wogawa, womwe umakulolani kuti mutha kugawa mlingo mosavuta pakati. Mtundu wa mapiritsiwo umatengera mlingo: 1 mg wa glimepiride - chipolopolo, 2 mg - khungu, 3 mg - chikasu.

Kapangidwe kameneka sikanasankhidwe mwamwayi: ngati mapiritsi amatha kusiyanitsidwa ndi mtundu, izi zimachepetsa chiopsezo cha bongo mwangozi, makamaka mwa okalamba.

Mapiritsi amayikidwa m'matumba a 15 ma PC. Bokosi lililonse limatha kukhala ndi mbale ziwiri mpaka 6.

Zomwe mungagwiritse ntchito pa Amaril:

Piritsi (kapena gawo lake) limamezedwa lonse, kutsukidwa ndi madzi osachepera 150 ml. Mukangomwa mankhwala, muyenera kudya.
Endocrinologist amasankha dongosolo la mankhwalawa malinga ndi zotsatira za kusanthula kwa zinthu zachilengedwe.
Yambani maphunzirowa ndi ma Mlingo wocheperako wa Amaril. Ngati gawo la 1 mg patapita nthawi yochepa silikuwonetsa zotsatira zomwe zakonzedwa, mulingowo umachuluka.
Mlingo umasinthidwa pang'onopang'ono, mkati mwa masabata 1-2, kotero kuti thupi likhale ndi nthawi yosinthira kuzatsopano. Tsiku lililonse, mutha kuwonjezera kuchuluka kwa osaposa 1 mg. Mulingo waukulu wa mankhwalawa ndi 6 mg / tsiku. Mulingo wokhazikitsidwa ndi adokotala.
Ndikofunikira kukonza zomwe zimachitika ndikusintha kwa kulemera kwa odwala matenda ashuga kapena kuchuluka kwa mitsempha ya minofu, komanso ngati pali chiopsezo cha hypoglycemia (munthawi yanjala, kuperewera kwa zakudya m'thupi, kumwa mowa kwambiri, mavuto a impso ndi chiwindi.
Nthawi yogwiritsira ntchito komanso mlingo wake zimatengera mtundu wamoyo ndi mawonekedwe a kagayidwe. Nthawi zambiri, kamodzi pamakonzedwe a Amaril amakhazikitsidwa patsiku limodzi ndi chakudya. Ngati chakudya cham'mawa chadzaza, mutha kumwa mapiritsi m'mawa, ngati chophiphiritsa - ndibwino kuphatikiza phwando ndi nkhomaliro.
Mankhwala osokoneza bongo amawopseza ndi hypoglycemia, pamene glucose m'mimba imatsika mpaka 3.5 mol / L kapena kutsikira. Vutoli limatha kupitilira kwa nthawi yayitali: kuchokera maola 12 mpaka masiku atatu.

Mapiritsi a Amaryl (phukusi la zidutswa 30) amagulitsidwa pamtengo wa:

260 rub - 1 mg,
500 rub - 2 mg aliyense
770 rub - 3 mg aliyense
1020 rub. - 4 mg aliyense.

Mutha kupeza mapiritsi a mapiritsi 60, 90,120.

Zina zomwe zimagwirizana ndi mankhwala

Anthu odwala matenda ashuga, makamaka "okhala ndi chidziwitso", monga lamulo, amakhala ndi zovuta zambiri zotsutsana: matenda oopsa, mtima ndi mtima, mavuto a metabolic, impso ndi chiwindi. Ndi kitiyi, simuyenera kungomwa mankhwala ochepetsa shuga.

Pofuna kupewa nthenda yamitsempha yamagazi ndi mtima, mankhwala omwe ali ndi aspirin adayikidwa. Amaryl imachotsa phula mapuloteni, koma mulingo wake m'magazi sunasinthe. Zotsatira zonse zovuta za ntchito zovuta zimatha kusintha.

Kupititsa patsogolo ntchito AMARE Kuwonjezera yake insulin, Allopurinu, coumarin ofanana nawo, anabolic mankhwala, guanethidine, chloramphenicol, fluoxetine, fenfluramine, pentoxifylline, Feniramidolu, fibric asidi ofanana nawo, phenylbutazone, miconazole, azapropazone, probenecid, quinolones, oxyphenbutazone, salicylates, tetracycline, sulfinpyrazone, Tritocqualin ndi sulfonamides.

Amaril amachepetsa kuthekera kuwonjezera Epinephrine, glucocorticosteroids Diazoxide, mankhwala othandizira, Glucagon, barbiturates, Acetazolamide, saluretics, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, ndi progestin.

Amaryl kuphatikiza histamine H2 receptor blockers, reserpine ndi clonidine imapereka zotsatira zosayembekezereka ndi madontho a glucometer mbali iliyonse. Zotsatira zomwezi zimapereka mowa ndi Amaril.

Mankhwalawa sasokoneza ntchito ya ACE inhibitors (Ramipril) ndi anticoagulant agents (Warfarin) mwanjira iliyonse.

Kugwirizana kwa Hypoglycemic

Ngati mankhwala ena aliwonse a hypoglycemic afunika kulowetsedwa ndi Amaril, muyeso wocheperako (1 mg) umaperekedwa, ngakhale pokhapokha wodwalayo amalandira chithandizo chamankhwala chachikulu. Choyamba, momwe chamoyo cha matenda ashuga chimayang'aniridwa kwa masabata awiri, kenako mlingo umasintha.

Ngati wothandizila odwala matenda ashuga omwe ali ndi theka la moyo adagwiritsidwa ntchito pamaso pa Amaril pofuna kupewa kukula kwa hypoglycemia, payenera kukhala kupuma masiku angapo atachotsedwa.

Ngati wodwalayo adatha kusunga kapamba kuti apange mahomoni ake, ndiye kuti jakisoni wa insulin akhoza 100% kulowa Amaryl. Maphunzirowa amayambanso ndi 1 mg / tsiku.

Ngati njira yachikhalidwe yolipira shuga ya Metformin siyilola kuwongolera kwathunthu matenda a shuga, mungathe kuwonjezera Amaril 1 mg. Ngati zotsatirazo sizikukwaniritsa, pang'onopang'ono zimasinthidwa mpaka 6 mg / tsiku.

Ngati chiwembu cha Amaril + Metformin sichinakwaniritse zoyembekezeredwa, chimasinthidwa ndi Insulin, ndikukhalabe chizolowezi cha Amaril. Jakisoni wa insulin amayambanso ndi mlingo wochepera. Ngati zizindikiro za glucometer sizili zolimbikitsa, onjezani kuchuluka kwa Insulin. Kugwiritsanso ntchito limodzi kwamankhwala kumakhalabe koyenera, chifukwa kumakupatsani mwayi wochepetsa mphamvu ya mahomoni ndi 40% poyerekeza ndi mahomoni oyera.

Kuphatikiza pa Amaril, endocrinologist amakhalanso ndi zosankha: Amaperid, Glemaz, Diapyrid, Diameprid, Glimepiride, Diagliside, Reclid, Amix, Glibamide, Gllepid, Glayri, Panmicron, Glibenclamide, Gligenclad, Glliblik Dimari Glimaril, Glyclazide, Manil, Maninil, Glimed, Glioral, Olior, Glynez, Glirid, Gluktam, Glypomar, Glyurenorm, Diabeteson, Diabresid.

Kwa iwo omwe adapangidwira, ndipo omwe mankhwalawo sanalimbikitsidwe

Mankhwalawa adapangira zochizira matenda a shuga a mtundu wachiwiri. Amagwiritsidwa ntchito limodzi ndi monotherapy komanso mu zovuta kuchipatala motsatana ndi Metformin kapena Insulin.

Gawo logwira ntchito la Amaril limagonjetsa chotchinga cha placenta, ndipo mankhwalawa amapatsanso mkaka wa m'mawere. Pachifukwachi, sioyenera kuti azimayi oyembekezera azikumbukira. Ngati mkazi akufuna kukhala mayi, ngakhale asanakhale ndi pakati pa mwana, ayenera kusamutsidwira ku insulin popanda Amaril. Kwa nthawi yakudyetsa, nthawi zoterezi zimasungidwa, ngati pakufunika chithandizo ndi Amaril, kuyamwitsa kuyimitsidwa.

Kugwiritsa ntchito mankhwalawa odwala matenda ashuga komanso vuto lomwe lisanafike pa chikomokere ndilosavomerezeka. M'mavuto akulu a matenda ashuga (monga ketoacidosis), Amaryl sawonjezedwa. Mankhwalawa sioyeneranso kwa odwala matenda ashuga okhala ndi mtundu woyamba wa matenda.

Ndi magwiridwe antchito a impso ndi chiwindi, Amaryl siothandiza, Amaril sakutchulidwa hem hemalalitis ndi matenda ashuga, komanso payekha tsankho la glipemiride kapena mankhwala ena a sulfonamide ndi gulu la sulfonylurea.

Ndi matumbo paresis kapena m'matumbo, kutsekeka kwa mankhwalawa kumasokonezeka, kotero Amaril sanalembedwe kuti achulukitse mavuto. Amafuna kusinthana ndi insulin komanso kuvulala kambiri, maopaleshoni, matenda otentha kwambiri, komanso kuwotcha koopsa.

Amaril akhoza kukhala limodzi ndi hypoglycemic zimachitika. Nthawi zina odwala amadandaula chifukwa cha chizungulire, ena amafooketsa kugona, pamakhala manjenjenje, thukuta kwambiri, komanso vuto lakulankhula. Ndi matenda a shuga, nthawi zambiri mumakhala mavuto osaneneka a njala, mavuto a kuuma, kusapeza bwino mchiwindi. Kutheka kwa vuto la mtima, chotupa pakhungu. Nthawi zina magazi amatuluka.

Zotsatira za bongo

Kugwiritsa ntchito mankhwalawa kwakanthawi, komanso kumwa mopitirira muyeso, kumayambitsa hypoglycemia, zomwe zimafotokozedwa m'gawo lakale.

Wodwala matenda ashuga ayenera kukhala ndi cholembera chofotokoza bwino za matenda ake ndi china chake kuchokera ku chakudya cham'thupi (maswiti, makeke). Madzi okoma kapena tiyi ndiwofunikanso, pokhapokha popanda zotsekemera zotengera. Woopsa milandu, wodwala ayenera kuchipatala mwachangu kuti akonzenso chapamimba ndi makonzedwe a absorbents (adamulowetsa kaboni, zina ndi zina).

Zotsatira zoyipa

Nthawi zina, kugwiritsa ntchito Amaril kumayendera limodzi ndi zotsatira zoyipa mwanjira ya kutaya kwamaso, mavuto ndi njira yoyendera magazi, matenda a metabolic, matenda am'mimba.

Zina mwazambiri:

Glycemic syndrome, yodziwika ndi kusweka, kusokonezeka kwa chidwi, kulephera kuwona, arrhythmia, njala yosalamulirika, thukuta kwambiri.
Kusiyana kwazomwe zikuwonetsa shuga, zomwe zimapangitsa kuwonongeka kwa mawonekedwe.
Matenda a dyspeptic, kuphwanya mtundu wa defecation, ndikusowa mankhwala akachotsedwa.
Thupi lanu losiyanasiyana zovuta (zotupa pakhungu, kuyabwa, ming'oma, matumbo osokoneza bongo, anaphylactic kugwedezeka, kuthamanga kwa magazi komanso kufupika kwa mpweya).

Kutenga Amaril kumakhudza kuthamanga kwa ma psychomotor reaction - kuyendetsa galimoto, komanso ntchito yofunikira kuti isamalidwe, makamaka poyambira chithandizo, sigwirizana ndi Amaril chithandizo.

Mitengo ya Amaryl m'masitolo ogulitsa mankhwala ku Moscow

mapiritsi	1 mg	30 ma PC	≈ 337 rub.
	2 mg	30 ma PC	≈ 648 rub.
	2 mg	Ma PC 90.	≈ 1585 rub.
	3 mg	30 ma PC	≈ ma ruble 947.4
	3 mg	Ma PC 90.	≈ ma ruble 2,408.5
	4 mg	30 ma PC	≈ 1240 rub.
	4 mg	Ma PC 90.	≈ 2959 RUB

Madokotala amawunika za amaryl

Kutalika 3.3 / 5

Kugwiritsa ntchito bwino

Mtengo / ubora

Zotsatira zoyipa

Mankhwala oyamba, chifukwa cha kupangika kochulukirapo, amakupatsani mwayi wolamulira kuchuluka kwa shuga m'magazi. Zabwino kwambiri zachinsinsi.

Mtengo wokwanira bwino wa gulu la mankhwalawa. Chiwopsezo chachikulu cha hypoglycemia. Imafuna kusankha kwa mankhwala.

Kutheka kwakukulu kumatheka limodzi ndi kugwiritsa ntchito metformin.

Ndemanga za Odwala Amaryl

Ndine wodwala matenda ashuga omwe ali ndi vuto, mtundu wachiwiri wa matenda ashuga, akhala akumwa Amaril zaka zingapo pa 3 mg pa tsiku. Chifukwa chake, sinditsatira kwenikweni chakudya, ndimathanso kugula china chokoma, mwachitsanzo, supuni ya uchi kapena gawo la ayisikilimu kangapo pa sabata. Nthawi zina ndimathira shuga ndi saccharin kapena stevia, sindimakonda kukoma kwawo, motero ndinaphunzira kumwa chilichonse popanda shuga. Poyerekeza ndi kumbuyo kwa kutenga "Amaril" shuga wamagazi ali pafupifupi mkati mwa malire, ndimadziletsa ndekha ndi glucometer. Sindikumva zovuta zilizonse zapadera. Ngati shuga ndiwabwinobwino kwa nthawi yayitali, ndimapuma pang'ono kutenga Amaril, ndiye kuti, ndimadya zakudya ndikumamwa masamba omwe amachepetsa shuga mwachitsanzo, mabulosi abwinobwino.

Mayi anga anali ndi matenda a shuga a mtundu wachiwiri, adamwa mankhwala enanso, koma posakhalitsa adasiya kuthandiza, adotolo adamuuza kuti ayese Amaryl, akapanda kuthandizira, adzabaya jakisoni. Ndidamvetsetsa kuchokera pakufotokozera kwa dotolo kuti pali zinthu ziwiri zofunikira pakukonzekera uku. 1 - imayang'anira kupanga insulin, 2 zinthu - zimapangitsa kuti thupi lisinthe shuga kukhala glycogen lotetezeka kwa odwala matenda ashuga. Mankhwalawa amathandiza mayi kuti azisungitsa shuga pamlingo pafupifupi chaka chimodzi, amatenga Amaryl. Komanso, mankhwalawa amawonetsedwa kwa anthu onenepa kwambiri a shuga, monga mayi anga. Tikukhulupirira kuti mankhwalawa athandiziranso patsogolo.

Zaka ziwiri zapitazo, Amayi adapezeka ndi matenda a shuga, ndipo nthawi yomweyo adamulembera Amaryl 2 mg. Mankhwalawa amathandizadi, modekha amachepetsa kuchuluka kwa shuga m'magazi. Mankhwala kuchokera kuvomereza kuvomereza bwino amathandizira mulingo wambiri wa shuga m'magazi. Nthawi zingapo zinali kuti, chifukwa cha kuchuluka kwa mankhwalawa kwa matenda oopsa, pamafunika kuwonjezera mlingo, kuyambira 2 mpaka 3 kapena 4 mg. Koma kenako amayi mosavuta adabwerera kwa 2 mg. Mankhwala osokoneza bongo, kwa zaka ziwiri, palibe vuto limodzi la Amaril lomwe amayi ake adakumana nalo.

Ineyo sindinakumanepo ndi izi, koma agogo anga omwalira anali ndi matenda ashuga. Moyo wake wonse (chikumbumtima changa, monga momwe ndikumbukirira) adadziponya yekha m'manja, kenako m'miyendo insulin. Ankangokhala moyo za iye. Amasinthasintha mapiritsi omwe amayenera kumwa nthawi yofananira ndi jakisoni. M'malo mwake, sizokayikitsa kuti ndimatenda monga momwe amayembekezera kuti achira, m'malo mwake ndikusunga boma lomwe lilipo. Mwakuti palibe zowonongeka. Amaryl adamupatsa ntchito. Mapale wamba, akuwoneka kuti amtundu wamtali, ndipo zowopsa zambiri zidachitika. Poyamba, palibe amene anazindikira kusintha kulikonse, koma atatha ... Adayamba kugona kwambiri, mphumu yake idakula. Ndipo sindikudziwa, mwina kuchokera ku mapiritsi kapena matenda a shuga amadzipangitsa okha kumverera, koma maonekedwe ake akuipiraipira. Sindikuganiza kuti mankhwalawa ndiabwino kwenikweni, sioyenera aliyense.Dokotala amayenera kuganizira zobera zonse, koma uwu ndi mankhwala aku Russia ...

Kufotokozera kwapfupi

Mankhwala a amaryl (INN - glimepiride) ndi mankhwala a antihyperglycemic ogwiritsira ntchito pakamwa kuchokera ku nthambi ya Germany ya bungwe lachipatala lapadziko lonse la Sanofi Aventis. Amaryl imalimbitsa ma cell a β-cell a pancreatic pancreatic kuti apange insulin yambiri, yomwe imatsitsa kuchuluka kwa glucose m'magazi: mankhwalawa amachepetsa mphamvu ya chidwi cha β-cell kwa glucose pa iwo. Malinga ndi Institute of Statistics in Healthcare padziko lapansi, pafupifupi anthu 20 miliyoni odwala matenda ashuga amatenga mankhwala a sulfonylurea - mankhwalawa omwe ali muyezo wowerengeka wa matenda ashuga a 2 pomwe ndizosatheka kulipiritsa matendawa pakukonza chakudya chophatikizidwa ndi masewera olimbitsa thupi okwanira. Zomwe zimachokera ku sulfonylureas zimagawidwa m'magulu a 1 ndi 2 mibadwo. Amaril ndi woimira "wave yatsopano" ya othandizira a hypoglycemic. Ngati tingayerekeze amaryl ndi woyimira wina wa m'badwo wa 2 wa sulfonylurea ofanana ndi glibenclamide (maninil), kuchuluka kwa insulini yotulutsidwa motsogozedwa ndi oyamba kumakhala kochepa, ndikuchepera pafupifupi kufanana kwa ndende ya glucose chifukwa chogwiritsa ntchito mankhwalawa onse. Izi zikusonyeza kuti amaryl ili ndi zabwino zake, makamaka, kuthekera kwake kolumikizira minofu motsutsana ndi insulin komanso kupezeka kwa ntchito ya insulinomimetic. Mwanjira ina, amaryl imakhala ndi mphamvu yofanana ndi glibenclamide mukamagwiritsa ntchito mlingo wotsika, sizimayambitsa kukhudzika kwa hypoglycemic, komanso imathandizira mafuta kagayidwe.

Amaryl ikupezeka mu mawonekedwe a piritsi. Pafupipafupi nthawi yake - 1 nthawi patsiku - ndi yabwino, makamaka kwa okalamba. Chifukwa kusinthasintha kwa kuchuluka kwa shuga m'magazi kumalumikizidwa ndi kumwa kwa chakudya chamagulu amoto, chinthu chofunikira kwambiri pakupeza zotumphukira za sulfonylurea ndikugwirizana kwake ndi dongosolo lazakudya. Pofuna kuwonjezera mphamvu ya amaryl ndi kutonthoza mtima

Mankhwala amawonetsedwa kuti agwiritse ntchito kamodzi patsiku chakudya chachikulu chisanachitike. Pa gawo loyambirira la ntchito amaryl, mankhwalawa amatengedwa mu 1 mg. Ngati zotsatira zomwe sizikuyembekezeredwa sizikwaniritsidwa, mlingowo umakulitsidwa motsatana mpaka 2, 3, 4, 6 ndipo, pomaliza pake, 8 mg mpaka kubwezeredwa koonekeratu kwa hyperglycemia kupezeka. Monga momwe amasonyezera, mlingo woyenera wa odwala ambiri amakhala pamtunda kuchokera pa 1 mpaka 6 mg. Zotsatira zina zolimbikitsa za maphunziro azachipatala ndi kusakhalapo kwa zotsatira zoyipa mukaphatikiza amaryl ndi calcium antagonists, ACE inhibitors, mankhwala omwe si a antiidal anti-kutupa, sulfonamides. Mzere wosiyana uyenera kunenedwa za anti-atherogenic mphamvu ya amaryl: mankhwalawa amateteza mawonekedwe a lipid, kuchepetsa kuchuluka kwa mafuta m'thupi komanso kuchepa kwa lipoproteins.

Pharmacology

Mankhwala a hypoglycemic amkamwa ndi omwe amapezeka m'badwo wachitatu sulfonylurea.

Glimepiride imachepetsa kuchuluka kwa shuga m'magazi, makamaka chifukwa cha kukondoweza kwa kutulutsa kwa insulin kuchokera ku β-cell ya kapamba. Zotsatira zake zimaphatikizidwa makamaka ndi kuwongolera kwa kuthekera kwa ma pancreatic β-cell poyankha kukondoweza kwa thupi ndi glucose. Poyerekeza ndi glibenclamide, milingo yotsika ya glimepiride imatulutsa insulini yocheperako ngati kuchepa pafupifupi kwa shuga m'magazi kumatheka. Izi zimapereka umboni wothandizira kukhalapo kwa extrapancreatic hypoglycemic zotsatira mu glimepiride (kuchuluka kwa chidwi cha minofu ndi insulinomimetic kwenikweni).

Katemera wa insulin. Monga zochokera ku sulfonylurea zina zonse, glimepiride imayendetsa katulutsidwe ka insulin polumikizana ndi njira zamtundu wa potaziyamu za ATP pama cell a β-cell. Mosiyana ndi zotumphukira zina za sulfonylurea, glimepiride imadzisankhira mapuloteni okhala ndi kulemera kwa ma kilogalamu 65 omwe amapezeka m'matumbo a β-cell a kapamba. Kuchita uku kwa glimepiride ndi mapuloteni omwe amamangiriza kwa iwo kumayendetsa kutsegulidwa kapena kutseka kwa njira zamtundu wa potaziyamu za ATP.

Glimepiride amatseka njira za potaziyamu. Izi zimayambitsa kukhumudwa kwa ma cell a β ndipo zimapangitsa kuti mayiyo azitseguka mwamphamvu kwambiri mwa calcium ndikuyenda kwa cell kwa cell. Zotsatira zake, kuwonjezeka kwa intracellular calcium ndende kumapangitsa kuti insulin itulutsidwe ndi exocytosis.

Glimepiride imathamanga mwachangu motero imakhala yolumikizana ndipo imamasulidwa ku mgwirizano womwe uli ndi zomanga thupi kuposa glibenclamide. Amaganizira kuti nyumbayi yomwe imasinthana kwambiri ndi glimepiride yokhala ndi mapuloteni omwe amamangirira kuti imatsimikizira mphamvu yake ya kumva kwa ma cell a β-glucose ndi chitetezo chawo ku desensitization ndi kufooka msanga.

Zomwe zimawonjezera chidwi cha minofu ku insulin. Glimepiride imapititsa patsogolo zotsatira za insulin pa mayamwidwe a glucose mwa zotumphukira zimakhala.

Insulinomimetic kwenikweni. Glimepiride imakhala ndi zotsatira zofanana ndi zomwe zimapangitsa kuti insulini ikhale ndi mayamwidwe amtunduwu komanso kutulutsidwa kwa glucose ku chiwindi.

Glucose wa Peripheral umatengedwa ndikuwutumiza mu ma cell a minofu ndi adipocytes. Glimepiride imawonjezera mwachindunji kuchuluka kwamamolekyu omwe amayendetsa glucose m'matumbo a plasma a maselo am'mimba ndi adipocytes. Kuwonjezeka kwa kudya kwamaselo am'magazi kumabweretsa kutseguka kwa glycosylphosphatidylinositol-enieni phospholipase C. Zotsatira zake, ndende ya calcium ya intracellular imachepa, ndikupangitsa kuchepa kwa ntchito ya protein kinase A, yomwe imayambitsa kukondoweza kwa metabolism ya glucose.

Glimepiride amalepheretsa shuga kuti chiwindi chiwonjezeke ndi kuchuluka kwa fructose-2,6-bisphosphate, zomwe zimalepheretsa gluconeogeneis.

Zokhudza kuphatikizidwa kwa kupatsidwa zinthu za m'mwazi. Glimepiride amachepetsa kuphatikiza kwa ma platelet mu vitro komanso vivo. Izi zikuwoneka kuti zimagwirizanitsidwa ndi kusankha kwa COX, komwe kumayambitsa mapangidwe a thromboxane A, chinthu chofunikira kwambiri cha kuphatikizira kwa maselo.

Antiatherogenic zotsatira. Glimepiride imathandizira kuti mitundu ya lipid ikhale yachulukidwe, imachepetsa mulde aldehyde m'magazi, zomwe zimapangitsa kuchepa kwakukulu kwa lipid peroxidation. Mu nyama, glimepiride imabweretsa kuchepa kwakukulu kwa mapangidwe a atherosranceotic malo.

Kuchepetsa zovuta za oxidative kupanikizika, komwe kumakhalapo mwa odwala omwe ali ndi matenda a shuga a 2. Glimepiride imawonjezera mulingo wa endo native α-tocopherol, ntchito ya catalase, glutathione peroxidase ndi superoxide dismutase.

Zokhudza mtima. Kudzera m'mayendedwe a potaziyamu a ATP, mapangidwe a sulfonylurea amakhudzanso mtima wamtima. Poyerekeza ndi zamtundu wa sulfonylurea zotumphukira, glimepiride imakhala yocheperako pamatenda a mtima, omwe angafotokozedwe ndi chikhalidwe chake cholumikizana ndi mapuloteni omanga a njira ya potaziyamu ya ATP.

Mwa odzipereka athanzi labwino, mlingo woyenera wa glimepiride ndi 0,6 mg. Mphamvu ya glimepiride ndi kumwa modalira ndi kubereka. Kuyankha kwakuthupi pakulimbitsa thupi (kuchepa kwa insulin katemera) wokhala ndi glimepiride kumakhalabe.

Palibenso kusiyana kwakukulu, kutengera kuti mankhwalawo amatengedwa mphindi 30 musanadye kapena nthawi yomweyo musanadye. Odwala omwe ali ndi matenda ashuga, kuwongolera kokwanira kwa metabolic kumatha kupezeka mkati mwa maola 24 ndi mlingo umodzi. Kuphatikiza apo, pakufufuza kwachipatala, odwala 12 mwa 16 omwe ali ndi vuto la impso (CC 4-79 ml / min) adakwanitsanso kuwongolera kokwanira ka metabolic.

Kuphatikiza mankhwala ndi metformin. Odwala omwe ali osakwanira kagayidwe kachakudya pogwiritsa ntchito kuchuluka kwa glimepiride, kuphatikiza mankhwalawa ndi glimepiride ndi metformin kungayambike. M'maphunziro awiri, popanga mankhwala osakanikirana, zimatsimikiziridwa kuti kuwongolera kwa metabolic kuli bwino kuposa momwe amathandizira aliyense mwa mankhwalawa mosiyana.

Kuphatikiza mankhwala ndi insulin. Odwala osakwanira kagayidwe kachakudya poyamwa glimepiride pazipita Mlingo, munthawi yomweyo mankhwala a insulin amayamba. Malinga ndi zotsatira za kafukufuku awiri, pogwiritsa ntchito kuphatikiza uku, kusintha komweko pakulamulira kagayidwe kachakudya kumakwaniritsidwa monga kugwiritsa ntchito insulin imodzi yokha. Komabe, kuphatikiza mankhwalawa kumafuna kuchepa kwa insulin.

Kutulutsa Fomu

Mapiritsiwa ndi pinki, oblong, lathyathyathya, okhala ndi mzere wogawika mbali zonse, olembedwa "NMK" ndi "h" yolembedwa mbali zonse ziwiri.

1 tabu
glimepiride	1 mg

Omwe amathandizira: lactose monohydrate - 68.975 mg, sodium carboxymethyl wowuma (mtundu A) - 4 mg, povidone 25 000 - 0,5 mg, microcrystalline cellulose - 10 mg, magnesium stearate - 0,5 mg, iron oxide ofiira (E172) - 0,2525 mg.

15 ma PC. - matuza (2) - mapaketi a makatoni.
15 ma PC. - matuza (4) - mapaketi a makatoni.
15 ma PC. - matuza (6) - mapaketi a makatoni.
15 ma PC. - matuza (8) - mapaketi a makatoni.

Monga lamulo, mlingo wa Amaril ® umatsimikiziridwa ndi kutsata kwa shuga m'magazi. Mankhwala ayenera kugwiritsidwa ntchito mu muyezo wochepa wokwanira kuti mupeze kuyamwa kwa metabolic.

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

Kuphwanya mankhwalawa, mwachitsanzo, kudumpha mlingo wotsatira, sikuyenera kupangidwa mwa kutsatira kwa mankhwalawa muyezo wapamwamba.

Dokotala ayenera kulangizira wodwalayo pasadakhale za zomwe zikuyenera kuchitidwa kuti mupewe zolakwika mutamwa Amaril ® (makamaka, polumphira mlingo wotsatira kapena kudumphira chakudya), kapena panthawi yomwe sizingatheke kumwa mankhwalawo.

Mapiritsi a Amaril ® ayenera kumwedwa wonse popanda kutafuna, kumwa madzi ambiri (pafupifupi chikho cha 1/2). Ngati ndi kotheka, mapiritsi a Amaril ® amatha kugawidwa pamodzi ndi zoopsa m'magawo awiri ofanana.

Mlingo woyambirira wa Amaril ® ndi 1 mg 1 nthawi / tsiku. Ngati ndi kotheka, mlingo wa tsiku ndi tsiku ungathe kuwonjezeka pang'onopang'ono (masabata awiri ndi awiri) poyang'anitsitsa shuga wamagazi ndi zotsatirazi: 1 mg-2 mg-3 mg-4 mg-4 mg-6 mg (-8 mg) patsiku .

Odwala omwe ali ndi mtundu 2 wa shuga wowongoleredwa, mlingo wa tsiku ndi tsiku nthawi zambiri umakhala wa 1-4 mg. Mlingo wa tsiku ndi tsiku wopitilira 6 mg umagwira kwambiri mwa ochepa ochepa odwala.

Dokotala amawona nthawi yomwe atenga Amaril ® komanso kugawa Mlingo masana, poganizira moyo wa wodwala (nthawi yakudya, kuchuluka kwa zochitika zolimbitsa thupi). Mlingo wa tsiku ndi tsiku umafotokozedwa mu 1 piritsi, nthawi zambiri musanadye chakudya cham'mawa kapena, ngati kumwa kwa tsiku ndi tsiku sikunatenge, nthawi yomweyo musanadye chakudya chachikulu. Ndikofunika kwambiri kuti musadumphe chakudya mutatenga mapiritsi a Amaril ®.

Chifukwa bwino kagayidwe kachakudya amagwirizanitsidwa ndi kuchuluka kwa insulin; munthawi ya chithandizo, kufunika kwa glimepiride kumachepetsedwa. Kuti mupewe kukula kwa hypoglycemia, ndikofunikira kuchepetsa mlingo kapena kusiya kumwa Amaril ®.

Momwe mankhwalawa a glimepiride angafunikire:

kuwonda
kusintha kwa moyo (kusintha kadyedwe, zakudya, kuchuluka kwa zochita zolimbitsa thupi),
zikamera za 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 Amaril ®

Palibe ubale uliwonse pakati pa Mlingo wa Amaril ® ndi mankhwala ena a pakamwa a hypoglycemic. Mukasamutsidwa kuchokera ku mankhwalawa kupita ku Amaryl ®, mlingo woyenera wotsatira tsiku lililonse ndi 1 mg (ngakhale wodwalayo atamupititsa ku Amaryl ® ndi mlingo waukulu wa mankhwala ena amkamwa a hypoglycemic). Kuchulukitsa kwa mlingo uliwonse kuyenera kuchitika m'magawo, kukumbukira kuyankha kwa glimepiride molingana ndi malangizo omwe ali pamwambawa. Ndikofunikira kuganizira kukula ndi kutalika kwa zotsatira za wothandizira wa hypoglycemic wothandizira. Kulowetsa chithandizo kungafunike kuti mupewe zowonjezera zomwe zimawonjezera chiopsezo cha hypoglycemia.

Gwiritsani ntchito limodzi ndi metformin

Odwala omwe ali ndi vuto losagwirizana ndi matenda a shuga, akamamwa glimepiride kapena metformin pazokwera Mlingo wa tsiku ndi tsiku, mankhwalawa amatha kuphatikizidwa. Pankhaniyi, chithandizo cham'mbuyomu chomwe chili ndi glimepiride kapena metformin chimapitilira pamlingo womwewo, ndipo mlingo wowonjezera wa metformin kapena glimepiride umayamba ndi mlingo wochepa, womwe umasungidwa malinga ndi gawo lachiwonetsero cha metabolic, mpaka mlingo waukulu wa tsiku lililonse. Kuphatikiza mankhwala kuyenera kuyambitsidwa ndikuyang'aniridwa ndi achipatala mosamala.

Gwiritsani ntchito limodzi ndi insulin

Odwala omwe ali ndi vuto losagwirizana ndi matenda a shuga, mankhwalawa amatha kuperekedwa nthawi yomweyo akamwa mankhwala a glimepiride pazipita tsiku lililonse. 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 chimachitika moyang'aniridwa ndi achipatala.

Odwala omwe ali ndi vuto laimpso amatha kuwona chidwi cha hypoglycemic momwe glimepiride. Zambiri pakugwiritsa ntchito Amaril ® kwa odwala omwe ali ndi vuto la Impso ndizochepa.

Zambiri pakugwiritsa ntchito Amaril ® kwa odwala omwe ali ndi vuto la chiwindi ndizochepa.

Bongo

Zizindikiro: ndi mankhwala osokoneza bongo, komanso kumwa kwa nthawi yayitali ndi glimepiride muyezo waukulu, hypoglycemia ikhoza kukhala yoopsa.

Chithandizo: hypoglycemia nthawi zambiri imatha kuyimitsidwa msanga chifukwa cha kudya zakudya zamagulu (shuga kapena chidutswa cha shuga, msuzi wa zipatso kapena tiyi). Pankhaniyi, wodwalayo ayenera kukhala ndi shuga pafupifupi 20 g (zidutswa 4 za shuga). Zomakoma sizothandiza pochotsa hypoglycemia.

Mpaka pomwe dokotala angaganize kuti wodwalayo ali pachiwopsezo, wodwalayo amafunika kuyang'aniridwa mosamala ndi madokotala. Tiyenera kudziwa kuti hypoglycemia ikhoza kuyambiranso pambuyo pobwezeretsanso kuchuluka kwa shuga m'magazi.

Wodwala yemwe akudwala matenda ashuga amathandizidwa ndi madotolo osiyanasiyana (mwachitsanzo, pomwe ali kuchipatala pambuyo pangozi, atadwala kumapeto kwa sabata), ayenera kuwauza za matenda ake komanso za chithandizo cham'mbuyomu.

Nthawi zina kuchipatala wodwala angafunike, ngakhale pokhapokha ngati pakufunika kusamala.Kuchuluka kwa mankhwala osokoneza bongo kwambiri komanso kuwonetsa kozama monga kuwonongeka kwa chikumbumtima kapena vuto lina lalikulu la mitsempha ndizofunikira kuchipatala ndipo zimafunikira chithandizo chamankhwala ndi kuchipatala.

Pofuna kutaya chikumbumtima, ndikofunikira iv kuyambitsa njira yokhazikika ya dextrose (glucose) (kwa akulu, kuyambira 40 ml ya yankho la 20%). Monga njira ina kwa achikulire, ndizotheka kupereka ma iv, sc kapena IM glucagon, mwachitsanzo, pa mlingo wa 0.5-1 mg.

Mankhwala a hypoglycemia chifukwa cha makonzedwe mwangozi a Amaril ® ndi makanda kapena ana aang'ono, mlingo wa dextrose uyenera kusinthidwa mosamala kuti mupewe kuwopsa kwa hyperglycemia, kukhazikitsidwa kwa dextrose kuyenera kuchitika pang'onopang'ono kuyang'anitsitsa ndende yamagazi.

Pankhani ya overdose ya Amaril ®, chapamimba thonje ndi kukhathamira kwa makala omwe adalowetsedwa angafunike.

Pambuyo pobwezeretsa mwachangu kuchuluka kwa shuga m'magazi, kulowetsedwa kwamphamvu kwa dextrose njira yotsikira ndikufunika kuti muchepetse kuyambiranso kwa hypoglycemia. Kuchuluka kwa shuga m'magazi mwa odwala oterowo kuyenera kuyang'aniridwa pafupipafupi kwa maola 24. Mzovulaza kwambiri wokhala ndi nthawi yayitali ya hypoglycemia, chiwopsezo cha kuchepa kwa shuga m'magazi chingakhalebe masiku angapo

Mankhwala akangopezeka kuti ali ndi vutoli, ndikofunikira kuti adziwitse dokotala za izi.

Kuchita

Glimepiride imapangidwa ndi kutenga gawo la CYP2C9 isoenzyme, lomwe liyenera kukumbukiridwa mukamagwiritsa ntchito mankhwalawa ndi inducers (mwachitsanzo rifampicin) kapena zoletsa (mwachitsanzo fluconazole) CYP2C9.

Kuthekera kwa kuchitapo kanthu kwa hypoglycemic ndipo, nthawi zina, kupititsa patsogolo kwa hypoglycemia komwe kumayenderana ndi izi kutha kuwonedwa pamene Amaril ® ikuphatikizidwa ndi imodzi mwazomwezi: insulin, othandizira ena a hypoglycemic oyendetsa pakamwa, ma A inhibitors, anabolic steroid ndi mahomoni ogonana amuna, chloramphenicol, coumarin. cyclophosphamide, disopyramide, fenfluramine, pheniramidol, fibrate, fluoxetine, guanethidine, ifosfamide, mao inhibitors, fluconazole, PASK, pentoxifylline (Mlingo waukulu wa makolo) , phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, clarithromycin, sulfanilamides, tetracyclines, tritokvalin, trophosphamide.

Kutsika kwa zochitika za hypoglycemic ndikuwonjezereka komwe kumalumikizana ndi shuga wamagazi kumatheka ndikaphatikizidwa ndi imodzi mwazomwezi: acetazolamide, barbiturates, glucocorticosteroids, diazoxide, diuretics, mankhwala a sympathomimetic (kuphatikiza epinephrine), glucagon, mankhwala othandizira ena ), nicotinic acid (muyezo waukulu), ma estrogens ndi progestogens, phenothiazines, phenytoin, rifampicin, mahomoni okhala ndi chithokomiro.

Mbiri H blockers₂ma receptors, beta-blockers, clonidine ndi reserpine amatha onse kupititsa patsogolo komanso kuchepetsa hypoglycemic zotsatira za glimepiride.

Mothandizidwa ndi othandizira achifundo, monga beta-blockers, clonidine, guanethidine ndi reserpine, zizindikiro za kutsutsa kwa adrenergic poyankha hypoglycemia zitha kuchepetsedwa kapena kulibe.

Potengera maziko a kutenga glimepiride, kulimbitsa kapena kufooketsa zochita za coumarin zotumphukira ndizotheka.

Kumwa mowa kamodzi kapena kosatha kumatha kukulitsa ndi kufooketsa mphamvu ya gloglycemic ya glimepiride.

Sequestrants ya bile acids: gudumu lakulumikizana limangiriza glimepiride ndi amachepetsa mayamwidwe glimepiride kuchokera m'mimba thirakiti. Pankhani yogwiritsa ntchito glimepiride, osachepera maola 4 musanayambe cadelovel, palibe mgwirizano womwe umawonedwa. Chifukwa chake, glimepiride iyenera kumwedwa osachepera maola 4 musanatenge magudumu.

Zotsatira zoyipa

Kuchokera kumbali ya metabolism: hypoglycemia ndiyotheka, yomwe, monga momwe zimagwiritsidwira ntchito zina zomwe zimachokera ku sulfonylurea, zimatha kupitilira. Zizindikiro za hypoglycemia - kupweteka mutu, njala, nseru, kusanza, kutopa, kugona, kusokonezeka kwa tulo, nkhawa, kukwiya, kusokonezeka kwa chidwi, kukhala tulo komanso kuthamanga kwa zochitika, kukhumudwa, kusokonezeka, kusokonezeka kwa mawu, aphasia, kusokonezeka kowoneka, kunjenjemera, paresis , kusokonezeka kwa malingaliro, chizungulire, kulephera kudziletsa, kutsekemera, kukokana kwa ubongo, kugona kapena kuwonongeka kufikira chikomokere, kupuma kosafunikira, bradycardia. Kuphatikiza apo, mawonetseredwe a adrenergic anti-regulation amatha kuchitika poyankha hypoglycemia, monga mawonekedwe a kuzizira, thukuta lomata, nkhawa, tachycardia, matenda oopsa, angina pectoris, palpitations, ndi kusokonekera kwa mtima. Mawonetsero azachipatala owonetsa kwambiri hypoglycemia angafanane ndi sitiroko. Zizindikiro za hypoglycemia pafupifupi nthawi zambiri zimatha atatha.

Kuchokera kumbali ya gawo la masomphenyawo: Kusokonezeka kwakanthawi kochepa chifukwa cha kusintha kwa kuchuluka kwa shuga m'magazi ndikotheka (makamaka kumayambiriro kwa chithandizo). Zomwe zimayambitsa ndikusintha kwakanthawi kwa ma lens, kutengera kuchuluka kwa shuga m'magazi, ndipo chifukwa cha izi, kusintha kwa mndandanda wa ma lenses.

Kuchokera pamatumbo am'mimba: kawirikawiri - nseru, kusanza, kumva kupsinjika kapena kuchuluka kwa epigastrium, kupweteka kwam'mimba, kutsekula m'mimba, zina - hepatitis, kuchuluka kwa michere ya chiwindi ndi / kapena cholestasis ndi jaundice, yomwe imatha kupita patsogolo pakulephera kwa chiwindi, koma atha kusintha momwe mankhwalawo atachotsedwa.

Kuchokera pa hemopoietic dongosolo: kawirikawiri - thrombocytopenia, nthawi zina - leukopenia, hemolytic anemia, erythrocytopenia, granulocytopenia, agranulocytosis ndi pancytopenia. Pogulitsa malonda pambuyo pa mankhwala, milandu yovuta ya thrombocytopenia yokhala ndi ziwalo zam'magazi ® amanenedwa kuti amatsutsana ndi pakati. Ngati mayi wapezeka kuti ali ndi pakati kapena pokhapokha ngati ali ndi pakati, mkazi ayenera kuthandizidwa ndi insulin.

Zakhazikitsidwa kuti glimepiride imatulutsidwa mkaka wa m'mawere. Pa nthawi ya mkaka wa m'mawere, muyenera kusamutsira mkaziyo ku insulin kapena kusiya kuyamwitsa.

Malangizo apadera

M'madera apadera opsinjika, monga kuvutika maganizo, chithandizo cha opaleshoni, matenda a febrile fever, metabolic control ikhoza kulemala mwa odwala omwe ali ndi matenda osokoneza bongo, chifukwa chake, kusungidwa kwakanthawi kwa mankhwala a insulin kungafunike kuti azitha kuyang'anira kagayidwe kachakudya.

M'milungu yoyamba yamankhwala, kuwonjezereka kwa chiwopsezo cha kukhala ndi hypoglycemia ndikofunikira, zomwe zimafunikira kuyang'anira kusamala kwa kuchuluka kwa shuga m'magazi.

Zomwe zimayambitsa chiopsezo cha hypoglycemia zimaphatikizapo:

kusafuna kapena kusatha kwa wodwala (nthawi zambiri kumawonedwa mwa odwala okalamba) kuti azithandizana ndi dokotala,
kuperewera kwa zakudya m'thupi, kudya mosazolowereka kapena kudumpha chakudya,
kusasamala pakati zolimbitsa thupi kudya chakudya
kusintha kwa zakudya
Zakumwa zoledzeretsa, makamaka kuphatikiza ndi zomwe zimatsala,
kuvulala kwambiri aimpso,
kwambiri kuwonongeka kwa hepatic (odwala omwe ali ndi chiwindi chachikulu, kusungunuka kwa insulin kumasonyezedwa, osachepera mpaka kagayidwe ka metabolic),
kuchuluka kwa glimepiride,
zovuta zina zowonongeka za endocrine zomwe zimasokoneza carbohydrate metabolism kapena adrenergic antigenergic poyankha hypoglycemia (mwachitsanzo, kusowa kwina kwa chithokomiro cha chithokomiro komanso England.
munthawi yomweyo kugwiritsa ntchito mankhwala ena
Kulandila kwa glimepiride posakhala zizindikiro zakulandila kwake.

Kuchiza ndi zotumphukira za sulfonylurea, zomwe zimaphatikizapo glimepiride, kungayambitse kukula kwa hemolytic anemia, chifukwa chake, odwala omwe ali ndi vuto la kuchepa kwa shuga-6-phosphate dehydrogenase, chisamaliro chapadera chiyenera kuchitika mukamapereka glimepiride, ndikofunikira kugwiritsa ntchito othandizira a hypoglycemic omwe si a sulfonylurea.

Pamaso pa zinthu zomwe zatchulidwa pamwambapa kuti mukulidwe kwa hypoglycemia, komanso ngati pali matenda omwe angatengere panthawi yamankhwala kapena kusintha kwa moyo wa wodwalayo, kusintha kwa glimepiride kapena chithandizo chonse chofunikira kungafunike.

Zizindikiro za hypoglycemia chifukwa cha kutsutsana ndi adrenergic chifukwa cha hypoglycemia ikhoza kukhala yofatsa kapena kusakhalapo ndi chitukuko cha pang'onopang'ono cha hypoglycemia, odwala okalamba, odwala omwe ali ndi vuto la dongosolo laumwini kapena odwala omwe amalandira beta-blockers, clonidine, reserpine , guanethidine ndi othandizira ena achifundo.

Hypoglycemia imatha kuthetsedwa mwachangu ndi kupezeka msanga kwa chakudya cham'mimba chambiri (glucose kapena sucrose). Monga momwe ena amachokera ku sulfonylurea, ngakhale atakwanitsa kupumula kwa hypoglycemia, hypoglycemia ikhoza kuyambiranso. Chifukwa chake, odwala ayenera kuyang'aniridwa mosalekeza. Mu hypoglycemia yayikulu, chithandizo chamanthawi yomweyo ndikuyang'aniridwa kuchipatala chofunikira, ndipo nthawi zina, kugonekedwa kwa odwala kuchipatala.

Mankhwalawa glimepiride, kuwunika pafupipafupi kwa chiwindi ndi chithunzi cha magazi (makamaka kuchuluka kwa leukocytes ndi mapulateleti) kumafunika.

Zotsatira zoyipa kwambiri monga hypoglycemia, kusintha kwakukuru m'magazi, kuthana kwambiri, komanso kulephera kwa chiwindi kungakhale pachiwopsezo cha moyo, chifukwa chake, ngati zoterezi zikuchitika, wodwalayo ayenera kudziwitsa adotolowo za iwo, kusiya kumwa mankhwalawo osayambiranso popanda udokotala .

Kugwiritsa Ntchito Kwa Ana

Zambiri pakukhudzika kwanthawi yayitali kwa mankhwalawa kwa ana sizikupezeka.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kumayambiriro kwa chithandizo, mutasintha mankhwalawa kapena kusasinthika kwa glimepiride, kuchepa kwa chidwi komanso kuthamanga kwa zochitika zama psychomotor chifukwa cha hypo- kapena hyperglycemia zitha kudziwika. Izi zimatha kukhudza kuwongolera magalimoto kapena kuwongolera makina osiyanasiyana.

Maganizo a madokotala ndi odwala matenda ashuga okhudza Amaril

Ndemanga za endocrinologists omwe amakumana ndi mawonetseredwe a matenda obisika ndizofunikira kwambiri, chifukwa ali ndi mwayi wofufuza momwe wodwala amvera kuti apereke lingaliro pazothandiza.

Malinga ndi madotolo, ndi regimen yoyenera yopanga mankhwala, Amaril amathandizira kupangitsa kuti glycemic indices isafike mokwanira. Anthu odwala matenda ashuga omwe amamwa mankhwalawa amakhala ndi zodandaula za hypoglycemia pamene mulingo wosankhidwa bwino. Ndipo komabe, zamankhwala Amaril, ndemanga za odwala ndi zabwino.

Zakudya zama carb otsika, masewera olimbitsa thupi, kuwongolera kunenepa kwambiri. Wodwala matenda ashuga ayenera kudziwitsa endocrinologist mu nthawi yokhudza mavuto, zizindikiro za hypo- ndi hyperglycemia zomwe zimachitika ndi Amaril.

Chithandizo chimaphatikizanso kudziyang'anira pawokha mayendedwe a shuga ndikuwunika ntchito za chiwindi, mayeso a labotale, makamaka kuyesa kwa hemoglobin ya glycated, yomwe masiku ano imadziwika kuti ndiyo njira yoyesera kwambiri yotsimikizira momwe wodwala alili ndi matenda a shuga. Izi zikuthandizira kuzindikira mulingo wokana Amaril pakukonzanso njira zamankhwala.

Mutha kuphunzira za zina za Amaril kuchokera video.