Mankhwala Diapiride: malangizo ntchito

Wothandizila hypoglycemic, soponylurea wa m'badwo wachitatu womwe umatenga nthawi yayitali. Mphamvu ya hypoglycemic ya mankhwala ndi chifukwa cha mapangidwe ovuta a pancreatic ndi extrapancreatic kanthu.

Pancreatic action imakhala polimbikitsa insulin katemera ndi ma pancreatic β-cell, omwe amaphatikizidwa ndi kusunthira ndi kutulutsidwa kwakukulu kwa insulin. Izi zimachitika chifukwa chakuti glimepiride, yokhala ndi malo ambiri, imagwirizanitsa ndikudula mapuloteni a β-cell a kapamba, omwe amalumikizidwa ndi njira zotengera potaziyamu za ATP, koma amasiyana ndi malo omwe amamangidwa nthawi zonse a 1st and 2nd sulfonylureas. Zotsatira zake, insulini imatulutsidwa ndi exocytosis, pomwe kuchuluka kwa insulin komwe kumakhala kochepa kwambiri poyerekeza ndi zomwe zimachokera ku miyambo ya sulfonylurea. Kuchepetsa kofatsa kotereku kwa glimepiride pa insulin secretion kumakhalanso ndi chiopsezo chochepa cha hypoglycemia.

The extrapancreatic mphamvu ya glimepiride imadziwika ndi zotsatira zake, zomwe zimatsogolera zomwe ndi kuwonjezeka kwa mphamvu ya zotumphukira (minofu ndi mafuta) kuti insulini ikukweza kuchuluka ndi ntchito ya mapuloteni omwe amayenda ndi glucose kudzera mu cell membrane, komanso kulepheretsa kwa kaphatikizidwe ka glucose mu chiwindi ndi kuwonjezeka kwa ndende ya intracoseular. β-phosphate choletsa gluconeogeneis. Zotsatira zina za glimepiride zimaphatikizira: kuchepa kwa kuphatikiza kwa maselo am'magazi chifukwa chosankha zoletsa COX komanso kutembenuka kwa arachidonic acid ku thromboxane A2, kuyambitsa kuphatikizana kwa mapulateleti, kuwonjezeka kwa gawo la endogenous α-tocopherol ndi zochitika za antioxidant enzymes (oxalase, glutasease, glutasease, glutasease, glutase, glutase, glutase, glutasease, glutaseidase, glutepaseide, glutepidide, glutepidide, glutepidide. kupsinjika, komwe kumadziwika pafupipafupi m'matenda a shuga, anti-atherogenic zotsatira chifukwa cha kuyambitsa kwatsatanetsatane C. phospholipase C.

Glimepiride sikulepheretsa kusintha kwa metabolism kwa myocardium kukhala ischemia (mosiyana ndi glibenclamide).

Upamwamba wa hypoglycemic wa mankhwalawa umawonekera patatha maola 2-3 pambuyo pa kuperekera, kumatha maola opitilira 24 ndipo umadalira mlingo.

Ndi Mlingo wambiri wa glimepiride tsiku lililonse la 4 mg, kuchuluka kwambiri m'magazi a seramu kumachitika pambuyo pa maola pafupifupi 2,5 ndi 309 ng / ml, pali ubale wolumikizana pakati pa mlingo komanso kuchuluka kwa glimepiride m'magazi, komanso pakati pa mlingo ndi gawo lomwe limaponderezedwa " - nthawi. ” Glimepiride ili ndi bioavailability mwamtheradi. Kudya kulibe vuto lililonse pakumizidwa, kupatula kuchepa pang'ono pang'onopang'ono pa kuchuluka kwa mayamwidwe.

Glimepiride imadziwika ndi kuchuluka kochepa pofalitsa (pafupifupi 8.8 L), pafupifupi wofanana ndi kuchuluka kogawika kwa albumin, kumanga kwambiri mapuloteni am'madzi am'magazi (oposa 99%) ndi chilolezo chochepa cha aininine (pafupifupi 48 ml / min). Glimepiride imalowa mkaka wa m'mawere ndipo kudzera mu chotchinga cha hematoplacental, sichilowa BBB. Glimepiride imapangidwa mwanjira zosiyanasiyana mu thupi kukhala ma metabolites awiri, omwe amapangidwa chifukwa cha kagayidwe ka glimepiride mu chiwindi ndipo ndi hydroxyl ndi carboxyl yotengera glimepiride. Hafu ya moyo glimepiride ake plasma ndende mu magazi seramu lolingana angapo dosing regimen ndi maola 5-8. mutatha glimepiride muyezo waukulu, theka moyo ukuwonjezeka. Pambuyo pakamwa limodzi la radiolabeled glimepiride, 58% anapezeka mu mkodzo ndi 35% mu ndowe. Zinthu zosasinthika mkodzo sizinapezeke. Hafu ya moyo wa hydroxyl ndi carboxyl metabolite wa glimepiride anali pafupifupi maola atatu ndi maola 5-6, motero.

Odwala omwe ali ndi vuto la impso (otsika a creatinine chilolezo), panali chizolowezi chowonjezera kutsimikiza kwa glimepiride ndi kuchepa kwakachepa kwa ndende yake m'magazi, zomwe mwina zimachitika chifukwa cha kufulumira kwa mankhwala chifukwa chomanga mapuloteni ochepa. Chifukwa chake, m'gulu lino la odwala palibe chiopsezo cha glumepiride.

Ma paracokinetic magawo a glimepiride ndi ofanana mwa odwala omwe ndi akazi osiyana zaka komanso osiyana zaka.

Type II shuga mellitus (osadalira insulini) mwa akulu monga monotherapy kapena osakanikirana ndi metformin kapena insulin.

Contraindication diapiride mapiritsi

kudziwika hypersensitivity zigawo zikuluzikulu za mankhwala ndi sulfonylurea zotumphukira kapena sulfonylamide kukonzekera

lembani matenda ashuga a shuga

matenda ashuga ketoacidosis, wodwala matenda ashuga

kwambiri aimpso ndi kwa chiwindi kuwonongeka

mimba ndi mkaka wa m`mawere

ana ochepera zaka 18

mankhwala zikuchokera zhne sulfonylurea tuyndylaryna nemese basқa sulfonylamidtik kukonzekera tarғa belgilі zhoғary sezmtaldy

insulin tәuдldi ndimayimira shuga wambiri

matenda ashuga ketoacidosis, wodwala matenda ashuga

bauyr zhne bүyrek ntchito za mwana ң auyr bұzylulary

zhktіlіk zhne kukhathamiritsa

18 jasқa deyingі balalarғa

Zotsatira zoyipa za mapiritsi a diapiride

Hypersensitivity zimachitikira - kuyabwa, zotupa ndi urticaria

mtanda ziwopsezo ndi sulfonylurea, sulfonamides kapena zina

kuchuluka kwa chiwindi michere

Kusintha kwakanthawi m'maso kumatha kuchitika chifukwa cha kusintha kwa kuchuluka kwa shuga m'magazi, makamaka kumayambiriro kwa chithandizo

zolimbitsa kwambiri thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, hemolytic magazi m'thupi ndi pancytopenia, zomwe nthawi zambiri zimatha pambuyo kusiya ntchito

Hypoglycemic reaction yomwe imachitika nthawi zambiri nthawi yomweyo, imatha kukhala yolimba kwambiri ndipo sikuti imavuta kukonzedwa. Kupezeka kwa izi zimatengera, monga nthawi zina zamankhwala amtundu wa hypoglycemic, pazinthu zomwe zimachitika, monga zakudya komanso mlingo

Matupi a vasculitis, hypersensitivity zimachitika kuyambira zazing'ono mpaka kukula kwa dyspnea, kutsika kwa magazi, nthawi zina mantha

kusanza, kusanza, kutsegula m'mimba, kupanikizika kapena kumva kuti mwadzaza m'mimba, kupweteka m'mimba, komwe nthawi zina kungafune kuleka chithandizo

chiwindi ntchito (mwachitsanzo, kusayenda kwa ndulu ndi jaundice), chiwindi, chomwe chimatha kupita patsogolo pakulephera kwa chiwindi

Hypersensitivity kuti kuwala

kutsika kwa kuchuluka kwa sodium mu seramu yamagazi

Zhoғary sezimtaldyқ reaktylary - қysynu bөrtpe zhene esekzhem

sulphonylurea, sulphonamidetermen nemese tekte

bauyr Fermentteri deңgejіnің zhoғarylauy

gluандағы glucose deңgejііnің өzgeruіne bailanysty, әсіресеемдеудің басында көрудің уақытша бұзылалары туындауы мүмкін

orthashadan auyr derezhey denging thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, hemolytic anemia, wamkazi pancytopenia, olar етdette emdeoudi totatannanne kejin zhoala

kөp zhadaylarda birden tuyndaytyn hypoglycemiaқ reactionar auyr tүrhe anuі zhne tүzetuge үnemi kөne bermeuі mүmkіn. Panali machitidwe ambuye ы tuyndauy hypoglycemia қ emdeudіқ basқa tүrlerі kesіne de, tamқtanu zhne doodalau kuwala ектив subjective і sharttarғa ndi bailanysty

allergalsқ vasculitis, eleusenden dyspnoeus damuymen, arterialsқ қrysymnyң tөmendeuіmen kүrdelіlerіne deyngі zhғғary sezmtaldyқ reaktylary, keide - mantha

Zhurek Ainuy, құsu, kutsegula m'mimba, asқazandaғy қysym nemese unyinji wa ketu sezimі, іштің ауыруы, keide emdeudі toқtatudy қazet etuim mүmkіn

bauyr қyzmetіnің bұzyluy (malingaliro өт ірікілісі және сарғаю), hepatitis, ol bauyr zhetkіlіksіzdіgіne deіn үdeuі mүmkіn

жарыққа жоғары сеімталдық

қан sarysuyndaғy sodium mөlsherіnің tөmendeuі

Malangizo apadera ogwiritsa ntchito

Kuchita bwino kwa matenda ashuga kumadalira kuti wodwalayo azitsatira zakudya zoyenera, kuchita masewera olimbitsa thupi pafupipafupi, komanso kuyang'anira magazi ndi mkodzo wa mkodzo nthawi zonse. Kusayang'anira kudya kwa odwala sikungalipiridwe chifukwa chomwa mapiritsi kapena insulin.

Diapiride iyenera kumwedwa pasanadutse kapena zakudya. Ngati chakudya chimachitika nthawi iliyonse nthawi kapena osiyiratu, kumwa mankhwalawa kumayambitsa hypoglycemia. Zizindikiro zimatha kutsitsidwa nthawi zonse ngati chakudya (shuga) chimatengedwa mwachangu.

Zomakoma zotsekemera sizithandiza.

Zomwe zidachitika ndi zina za sulfonylurea zochokera kumayiko ena zikuwonetsa kuti kukonzanso kwa hypoglycemia ndikotheka, ngakhale atachita bwino poyamba pazomwe adachita.

Hypoglycemia yayitali kapena yayitali, yomwe imatha kuchepetsedwa kwakanthawi pang'ono ndi shuga, imafunikira chithandizo chamankhwala, ndipo nthawi zina kuchipatala.

Zomwe zimathandizira kupezeka kwa hypoglycemia ndi: kukayikira kapena (pafupipafupi mwa odwala okalamba) kulephera kuchita mgwirizano ndi dokotala, kuperewera kwa zakudya m'thupi, kudya kosamveka bwino kapena kusowa kudya, kusala kudya, kusintha kwa zakudya, kusasamala pakati pazochita zolimbitsa thupi ndi kudya, kumwa mowa kwambiri, makamaka kuphatikiza ndi kudya kosadukiza, aimpso komanso kuwonongeka kwa chiwindi, mankhwala osokoneza bongo a Diapirid, matenda ena osaperekedwa ndi endocrine omwe amakhudza Amakhala ndi kagayidwe kazakudya, kapena kusintha kwa hypoglycemia (mwachitsanzo, kukanika kwa chithokomiro, kusakwanira kwa ntchito ya anterior pituitary or adrenal cortex), kugwiritsa ntchito mankhwala ena (onani gawo "Drug Interaction").

Kuchiza ndi Diapiride kumafuna kuyang'anira magazi ndi mkodzo pafupipafupi. Kuphatikiza apo, tikulimbikitsidwa kuwongolera kuchuluka kwa hemoglobin ya glycosylated.

Pogwiritsa ntchito mankhwalawa, kuyang'anira chiwindi kawiri kawiri ndikuwunika kwa chithunzi cha magazi (makamaka kuchuluka kwa leukocytes ndi mapulateleti) ndikofunikira.

M'mikhalidwe yovuta (mwachitsanzo, pangozi, maopareshoni ofunikira, matenda omwe amayenda ndi malungo), kusinthana kwakanthawi kwa wodwala kupita ku insulin kungasonyezedwe.

Palibe chidziwitso pakugwiritsa ntchito Diapiride mwa odwala omwe ali ndi vuto la chiwindi kwambiri kapena omwe akuwonetsedwa. Odwala omwe ali ndi vuto lalikulu la impso kapena hepatic ayenera kusamutsidwa kupita ku insulin.

Tiyenera kukumbukira kuti zizindikiro za hypoglycemia zitha kubisika kapena kusowa kwa okalamba omwe ali ndi vuto lauronomic kapena mwa omwe nthawi yomweyo amalandila chithandizo ndi β-adrenergic receptor blockers, reserpine, clonidine, guanethidine kapena ena achifundo. Ngati vutoli silikwanira kapena zotsatira zake zachepa, ngati chithandizo cha nthawi yayitali chikuphatikizidwa ndi metformin kapena insulin.

Pankhani ya kubwezeredwa kwa matenda a shuga, chidwi cha insulini chikuwonjezeka, chifukwa chake, kufunika kwa mankhwalawa kumatha kuchepa panthawi ya chithandizo. Kuti mupewe kukula kwa hypoglycemia, ndikofunikira kuchepetsa mlingo kapena kuletsa mankhwalawo. Kusintha kwa Mlingo kuyeneranso kuchitika posintha kulemera kwamthupi la wodwalayo kapena momwe akukhalira, kapena pazinthu zina zomwe zimapangitsa hypo- kapena hyperglycemia.

Odwala omwe ali ndi chibadwa cha galactose chosowa, kuperewera kwa lactase kapena kuyamwa kwa glucose-galactose, sayenera kumwa Diapiride.

Қant diabetіn emdeudің sәttіlіgі emdelushіnің sәykesіnshe tamaқtanu ratsionyn saқtauyna, ұdayy Dene belsendіlіgіne, Sondalo-AK қan anasintha neseptegі shuga deңgeyіnің tұraқty baқylanuyna baylanysty. Nauқastardyң emdәm saқtamauynyң ornyn piritsi zamkati nemese insulinind қabyldau argyly toltyru mүmkіn еес.

Diapiridti monga isherden bіraz bұryn nemese ngati ife kesіnde қabyldau Jaeger ngati іshu ретr rette әr tүrlі uaқytta oryn alsa nemese mүldem zhyberilip alsa, kukonzekera қabyldau hypoglycemia tuғyzuy mүmkіn. Jaeger bіrden kөmіrsular (қant) қabyldasa, chizindikiro cha daryn үnemі derlіk tez ңіlddetuge boladi.

Zhasandy tәttіlendіrgіshter Yeshanday әser Bermaidi.

Basқa sulfonylurea tuyndylaryn қoldanu tәzhіribesі, tіrele қabyldanғan sharalardyң bastapқydғy sәttіlіgіne қaramastan, hypoglycemiaң Kayta damuy mүmkіnekendі.

Қanttyң әdettegi mәlsherin paydalanyp tek uaқytsha ғana basu болa bolatyn auyr nemese ұza созa coned hypoglycemia dereu dәrі-dәrmekpen emdeoudі, al keide - auruhanaғa zhatyyutudyut.

Gipoglikemiyanyң tuyndauyna yқpal etetіn faktorlar mynalar bolyp tabylady: dәrіgermen yntymaқtasudy қalamau Nemesu (kөbіnese egde zhastaғy emdelushіlerde) mүmkіndіgі bolmau, toyyp tamaқ іshpeu, zhүyelі tamaқtanbau Nemesu Mac іshudі zhіberіp alu, ashyғu kezeңі, tamaқtanu rezhimіnің өzgeruі, Dene zhүktemelerі anasintha kөmіrsulardy paydalanu arasyndaғy teңgerіmnің bұzyluy, mowa, әsіresе іshudі jіberіp alumen bіrge paydalanu, bүyrek әne bauyr ntchito za mwana ң Ortash bұzylulary, Diapiridtің artyқ dzozalanuy, endocrindyk үенyenің kөmіrsulardy lizmіne әser etetіn keybіr kompensatsiyalanbaytyn bұzylystary, Nemes gipoglikemiyanyң kerі regulyatsiyasy (mysaly, қalқansha popanda funktsiyasynyң keybіr bұzylulary, gipofizdің aldyңғy bөlіgіnің Nemesu bүyrek үstі bezі қyrtystarynyң zhetkіlіksіzdіgі) keybіr dәrіlіk zattardy bir mezgіlde қabyldau ( "Dәrіlermen өzara әrekettesuі" bөlіmіn қaraңyz).

Diapiridpen emdeu қan amuna neseptegi glucose deейgeyіn tұraқty tүrde baқılap oteruda ezhet ety. Bұdan өzge, glycosyldengen hemoglobin mөlsherin baқylauғa alu ұsynilady.

Mankhwala ғoldanғan kezhe bauyr worksya әәne shetkergi қan kөrіnіsіn (әsіrese leukocytter men thrombocytosis sanyn) ұdayy bakylap otyu қyazht.

Kupsinjika jaғdailarinda (malingaliro, jazatayim jaғdaylarda, mafuta opaleshoni othamanga, қyzbamen қatar zүretіn ұқұқpalarda) nauқasty uaқytsha insulating ayustyru kөrsetiluu mіmkіn.

Ntchito za Bauyr za mwana ң auyr bұzylulary bar nemes dialysis kөrsetilgen edelushіlerge Diapiridti қoldanuғa қatyty mәlіmetter zh ж. Bүyrektің nemese bauyrdy kүrdeli zhetkіlіksіzdіgі bar nauқastardy insulindy қabyldauғa ayystru kerek.

Vegetative neuropathy bar nemesis β-adrenergic receptor neuromuscular blocker, reserpinmen, clonidinmen, guanethidinmen nemesse basa sympatholytictermen biology meningitis minyo hypoglycaemia hypoglycaemia Jäger әseri zhitkіlіksіz nemese әseri tөmendegen bolsa, ұзақемдеу жғғдайында, metforminmen nemese insulinman bіrіktіru ұsynylad.

Диабant diabetіnің kutayikira ғ zhaydayynda insulin sezіmtaldyқ artada, soғan bailanisty emdeu үderіsіnde drugқa қazhettіlіk tөmendeuі mүmkіn. Hypoglycemiaң damuyn boldyrmau үshіn dozasyn der kezіnde tөmenddetu nemesa mankhwala toқtatu kerek. Dozasyn tүzetudі emdelushіnің dene salmaғy өzgergen nemese onyң өmir sүru tәsili өzgergen kездеde de, Sondai-aқ basқa malingaliro a hyperglycemia tuғyzuy mүmіkіnar jaғе paydaғ.

Sirek tұқym алаualaytyn galaktosany kөter almaushyly, lactase zhetkіlіksіzdіgі bar nemesa glucose-galactose sіңuі bұzylғan emdelushіlerge Diapiridtі қabyldauva bolmaida.

Mlingo ndi njira yoyendetsera

Mankhwalawa amagwiritsidwa ntchito mwa akulu.Mlingo umatengera zotsatira za magazi ndi kuwunika kwa mkodzo. Nthawi zambiri, diapiride imagwiritsidwa ntchito nthawi 1 patsiku. Mankhwala tikulimbikitsidwa kuti kumwedwa pasanadutse kapena panthawi yopumira m'mawa kapena, ngati palibe chakudya cham'mawa, nthawi yayitali isanayambike kapena nthawi yoyamba kudya. Piritsi liyenera kumezedwa popanda kutafuna, kutsukidwa ndi madzi. Ngati mulingo wotsatira wa mankhwalawo wasowa, mulingo sayenera kuwonjezeka pa mlingo wotsatira.

Mlingo woyambirira ndi 1 mg ya glimepiride patsiku. Ngati kumwa koteroko kumakupatsani mwayi wowongolera kuchuluka kwa shuga, imagwiritsidwa ntchito ngati kukonza. Ngati glycemic control siili bwino, mulingo uyenera kuchuluka mpaka 2, 3 kapena 4 mg wa glimepiride patsiku m'magawo (pakadutsa masabata a 1-2). Ngati wodwalayo ali ndi vuto la hypoglycemic pakumwa mankhwalawa 1 mg patsiku, izi zikutanthauza kuti matendawo amatha kuwongoleredwa potsatira kudya. Mlingo wapamwamba 4 mg pa tsiku umapereka zotsatira zabwino pokhapokha. Mulingo woyenera kwambiri ndi 6 mg wa diapiride patsiku.

Ngati mulingo wa metformin wokwanira tsiku lililonse uperekanso chithandizo chokwanira, mutha kuyambiranso ndi glimepiride. Kutsatira njira yapita ya metformin, mankhwalawa amayenera kuyamba ndi ochepa mankhwala, omwe amatha kuwonjezeredwa pang'onopang'ono mpaka kufika pazokwanira tsiku lililonse, poganizira mphamvu ya metabolic yoyenera. Kuphatikiza mankhwala kuyenera kuchitika moyang'aniridwa ndi achipatala.

Ngati mulingo wambiri wa tsiku ndi tsiku wa Diapiride sapereka chiwonetsero chokwanira cha glycemic, ngati kuli kotheka, chithandizo cha insulin chitha kuyamba. Kutsatira mlingo wapitalo wa glimepiride, chithandizo cha insulini chiyenera kuyamba ndi mlingo wotsika, womwe ungathe kuwonjezereka, umayang'ana gawo lolakalaka la metabolic control. Kuphatikiza mankhwala kuyenera kuchitika moyang'aniridwa ndi achipatala. Kupititsa patsogolo chiwongolero cha matenda a shuga kumayendera limodzi ndi chidwi cha insulin, motero kufunika kwa glimepiride kumatha kuchepa panthawi yamankhwala. Pofuna kupewa hypoglycemia, mlingo uyenera kuchepetsedwa pang'onopang'ono kapena chithandizo chikuyenera kusokonezedwa palimodzi. Kuwunikanso kwa Mlingo kungakhale kofunikira ngati thupi la wodwalayo kapena kusintha kwa moyo kapena zosintha zina zingakhudze chiopsezo cha hypo- kapena hyperglycemia.

Mankhwala ena amkamwa amatha kusinthidwa kuti diapiride. Pakusintha kotere, mphamvu ndi theka la moyo wa wothandizira wakale ziyenera kukumbukiridwa. Nthawi zina, makamaka ngati mankhwala a antiidiabetesic amakhala ndi moyo wautali (mwachitsanzo, chlorpropamide), tikulimbikitsidwa kudikirira masiku angapo musanatenge Diapiride. Izi zimachepetsa chiopsezo cha zotsatira za hypoglycemic chifukwa chowonjezera cha othandizira awiri. Mlingo woyambirira wovomerezeka ndi 1 mg ya glimepiride patsiku. Mlingo mutha kuwonjezeka pang'onopang'ono poganizira momwe mankhwalawo amachitikira.

Kukonzekera kwa Heresectergoldanada. Dozasa Kan amuna neseptegі glucose құramyn taldau әtyzhelerіne baylanysty. 1dette Diapiridti tәuligine 1 ret қoldanady. Zidakwa za toyymdy taңғy astan bіraz bұryn nemese taңғy ngati kesіnde nemese, jäger taңғy ngati bolmas, alғashқy negіzgі ngati іsherden bіraz bұryn nemese ngati іshu kesіnde қabyldau ұsynylady. Mapiritsi shaynamay, sұyyқtyқpen іshіp zhtu kerek. Jäger akukonzekera kesekti қabyldau zhіberіlіp alsa, kelesі қabyldaғan keshe dozasyn arttyrmau kerek.

Mlingo wa bastapy tuligine 1 mg glimepiridtіradydy. Jäger Mundai dosasy қant deңgejіn talapқa sa baқylauғa mүmkіndіk zipatso, ony demeusiem retіnda Koldanady. Eger glykemiyalyқ baқylau ңtayly bolyp tabylmasa, kadhaaasyn tәulіgіne 2, 3 nemese 4 mg glimepiridke deyn satylap (1-2 apta aralıtarman) adzapatsidwa arttyru. Jaeger nauқasta akukonzekera 1uligine 1 mg wa қabyldauғa hypoglycemia қ anachita ba, ma als, bұl auruda tech emdәm ұstanudyң kөmegimen ғana baқylauғa bolatynyn kөrsetedі. Tәulіgіne 4 mg asatyn Mlingo tek jekelegen zhadaylarda ғana үzdіk nәtyzhe kutsogolo. Ең жоғарғы Mlingo wa Mlingo - тыулігіне 6 mg Diapiride.

Mlingo wa Eger metforminnін ең жңңарәы тәуліктік Mlingo wofanana wamoyo glycemia қ baқylauda қamtamasyz etpese, glimepiridpen қatarlas emdi bastauғa bolyady. Metforminnіd aldyңғy dozasyn mdziko otyryp, kukonzekera қabyldaudy tөmen dozasynan bastau kerek, ony keyin ика baкаylaudyң қazhetti deңgeyyn baғdarғa ala otyryp arttyruғa bolyda. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek.

Jaeger Diapiridtің еғ жoғарәы тәуліктік kuchuluka kwa shuga m'magazi a baқylaudy қamtamasyz etpes, қ insulinman қatarlas emdeoudi bastauғa bolydy. Glimepiridtің aldyңғy dozasyn syүyene otyryp, insulin emdeudі tөmen dozasynan bastau kerek, ony keyin ика baқylaudyң қazhetti deңgeyin baғdarғa ala otyryp artyruғa. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek. Diabetesty baқylaudy jaқsartu insulin sezmtaldyқtyң artuymen қatar zhredі, sondyқtan emdeu maphunziro kazіnde glimepiridke қazhettіlіk azayuy mүmkіn. Hypoglycemia boldyrmau masatynda dozasyn birtіndep azaytu nemese emdeudі mүlddem totatu kerek. Dozasyn Kayta

Ishu agyly қabyldanatyn basқa hypoglycemia agentterden әdette Diapiridke kөshugu bolada. Mұndai auysu kesіnde aldyңғy dәrіnің kүshі amuna zhartylai shyғarylu keseңіn esker kerek. Kay zhadaylarda, іsіrese jäger kishuga сыars kukonzekera ң zhartylı shyғarylu keseңi ұzaқ bolsa (malingaliro, chlorpropamide), Diapiridtі қabyldauda bastardyң aldynda bіrneshe kүn kүte tұru. Бұл ікі agentт additivetik ісerіnің saldarynan hypoglycemiaуп reactionar іаупін аtse Mlingo wa Ұsynylatyn bastapқ - tәuligine 1 mg glimepiride. Mankhwala a Dozasyn ndi yogwira eskere otyryp, satylap arttyruғa bolyady.

Zochita Zamankhwala

The munthawi yomweyo, Diapiride ndi mankhwala ena amachititsa kufooka ndi kuwonjezeka kwa hypoglycemic zotsatira za glimepiride. Chifukwa chake, mankhwala ena ayenera kumwedwa kokha ndi kuvomereza (kapena monga akuwongolera) dokotala. Glimepiride imapangidwa pogwiritsa ntchito cytochrome P450 2C9 (CYPC9). Amadziwika kuti chifukwa cha munthawi yomweyo makina a inducers (mwachitsanzo rifampicin) kapena CYPC9 inhibitors (mwachitsanzo fluconazole), kagayidwe kameneka kangasinthe. Kafukufuku wokhudzana ndi vivo adawonetsa kuti fluconazole, imodzi mwa zoletsa zazikulu kwambiri za CYPC9, imakulitsa AUC ya glimepiride ndi theka.

Limbikitsani mphamvu ya glimepiride ndi kugwiritsa ntchito munthawi yomweyo: phenylbutazone, azapropazone ndi oxyphenbutazone, sulfinpyrazone, insulin ndi pakamwa antidiabetic, ena opanga nthawi yayitali sulfonamides, metformin, tetracyclines, salicylates ndi p-aminosalicylic acid, mao inhibitors, anabolic steroids ndi abambo aamuna mahomoni, cholinergicokosininoicinocininoleninooiniclencininocininocinocininocininocinoncinocininocininocininoo ndi tiziti tiziti , miconazole, fenfluramine, pentoxifyline (waukulu Mlingo wa makolo), michere, tritokvalin, ACE zoletsa, fluconazole, fluoxetine, allopurinol, sympatholytics, cyclophosph ID, disopyramide, feniramidol, guanethidine, ifosfamide pas.

Chepetsani mphamvu ya gloglycemic ya glimepiride mukamagwiritsa ntchito: estrogens ndi progestogens, saluretics, thiazide diuretics, mahomoni a chithokomiro komanso mankhwala osokoneza bongo omwe amachititsa kuti chithokomiro chizigwira ntchito, corticosteroids ndi glucocorticoids, zotengera za phenothiazine, chlorpromazine, epinephrine ndi sympathomimetics, nicotinic acid (Mlingo wambiri) ndi zotumphukira zake, glucagon ntchito), phenytoin, diazoxide, glucagon, barbiturates ndi rifampicin, acetazolamide.

H2 receptor antagonists, beta-blockers, clonidine ndi reserpine amatha kukhala ndi mwayi komanso amachepetsa mphamvu ya hypoglycemic. Mothandizidwa ndi sympatholytics, monga beta-blockers, clonidine, guanethidine ndi reserpine, chiwonetsero cha adrenergic reverse regulation ya hypoglycemia chitha kuchepa kapena kutha. Kumwa mowa kumatha kukulitsa kapena kufooketsa mphamvu ya hypoglycemic ya glimepiride.

Diapiridti belgіlі bіr dәrіlіk zattarmen bіr mezgіlde қabyldau glimepiridtің hypoglycemia қсерінің әлсіреуін де, күшеюін де туғызуы мүмк. Sondy Stan basқa kukonzekera kwa dokotala tech d techrіgerdің kelіsіmіmen (nemese taayyndauymen) ғana Koldanu kerek. Glimepiride P450 2C9 (CYPC9) cytochromes ң kmegimen metabolizdenedі. СYPC9 inductorlaryn (malingaliro ofunafuna) nemez tezhegіshterіn (malingaliro a fluconazold) bir mezgilda kabyldaudyң saldarynan metabolism өzgeruі mүmkіn kenen belgіlі. Vn vivo раzara әrekettesulerin sertteu әtyzheleri, СYPC9 ң күшті тежегіштерінің бірі fluconazole, glimepiridtі AUC екі есеге жуық арттыратыннөө.

Bіr mezgіlde қoldanғanda glimepiridtің әсerіn kүsheytedі: Phenylbutazone, azapropazone zhane oxyphenbutazone, sulfinpyrazone, insulin zhane іshіletіn diabetke қarsy preparattar, ұzaқ әser etetіn keybіr sulfonamidter, metformin, tetratsiklinder, salitsilattar zhane tsa-aminosalitsil қyshқyly Mao tezhegіshterі, anabolikalyқ steroidtar zhane erlerdің zhynystyқ gormondary, hinolondyқ antibiotikter, chloramphenicol, probenecid, coumarindek anticoagulantar, miconazole, fenfluramine, pentoxifyline (makolo omvera), fibrattar, tritokvalin, AӨF tezhegіshterі, fluconazole, fluoxetine, allopurinol, sympathy itikter, cyclophosphamide, disopyramide, feniramidol, guanethidine, ifosfamide PASҚ.

Bіr mezgіlde қoldanғanda glimepiridtің hypoglycemiaқ әсерін төмендетеді: Estrogender zhane progestagender, saluretikter, tiazidtіk diuretikter, қalқansha popanda gormondary zhane қalқansha popanda қyzmetіn kөtermeleytіn preparattar, kortikosteroidtar zhane glyukokortikoidtar, phenothiazine tuyndylaryn, chlorpromazine, Epinephrine zhane simpatomimetikter, chikonga қyshқyly (zhoғary dozalary) zhane onyң tuyndylary, glucagon, іsh zhүrgіzgіsh dәrіler (ұzaқ Uayyt Koldanu), phenytoin, diazoxide, glucagon, barbiturattar zhene rifampicin, acetazolamide.

Н2-receptor lardң antagonists, beta-blocker, clonidine men reserpine hypoglycemia әserin әleuettendіruі de, tөmendueti de mүmkіn. Beta-blocker, clonidine, guanethidine, akazi amakhalanso, akuwonekera sympatholyticterdin әserinen hypoglycemia ң adrenergic қ Keri malamulo a ana ң kңrіnіsі azayu nemese zhғaluy mүmkіn. Mowa Paidalanu glimepiridtің hypoglycemiaқ әсerіn kтуshaituі nemese әlsіretuі mүmkіn.

Zotsatira za pharmacological

Wothandizila hypoglycemic, wotengedwa wa sulfonylurea wam'badwo wachitatu wokhalitsa. Kutsitsa kwa shuga kwa mankhwalawa kumachitika chifukwa cha kupangika kovuta kwa pancreatic ndi extrapancreatic kanthu. Pancreatic action imakhala polimbikitsa insulin katemera ndi ma pancreatic β-cell, omwe amaphatikizidwa ndi kusunthira ndi kutulutsidwa kwakukulu kwa insulin. Izi zimachitika chifukwa chakuti glimepiride, yokhala ndi malo ambiri, imagwirizanitsa ndikudula mapuloteni a ß-cell a kapamba, omwe amalumikizidwa ndi njira zotsalira za potaziyamu a ATP, koma amasiyana ndi malo omwe amamangidwa nthawi zonse a 1st and 2nd sulfanylureas. Zotsatira zake, insulini imatulutsidwa ndi exocytosis, pomwe kuchuluka kwa insulin komwe kumakhala kotsika kuli kochepa kwambiri poyerekeza ndi zochitika za miyambo ya sulfanylurea. Kuchepetsa kofatsa kotereku kwa glimepiride pa insulin secretion kumapereka chiopsezo chochepa cha hypoglycemia. Mphamvu ya extrapancreatic ya glimepiride imadziwika ndi zochitika zosiyanasiyana, zomwe zimatsogolera zomwe ndizowonjezera mphamvu ya zotumphukira (minofu ndi mafuta) kuti insulini iwonjezeke kuchuluka ndi ntchito ya mapuloteni omwe amayenda ndi glucose kudzera mu cell membranes, komanso kuletsa kwa kaphatikizidwe ka glucose mu chiwindi ndi kuwonjezeka kwa intracular. β-phosphate choletsa gluconeogeneis. Zotsatira zina za glimepiride zimaphatikizanso: kuchepa kwa kuphatikiza kwa maselo othandiza magazi kuundana chifukwa cha kusankha kwa zoletsa za cycloo oxygenase komanso kutembenuka kwa arachidonic acid ku thromboxane A2, komwe kumapangitsa kuti magazi azigwirizana, kuwonjezeka kwa gawo la endo native α-tocopherol ndi zochitika za antioxidant enzymasease. kupsinjika, komwe kumakhalapo mellitus ya shuga, anti-atherogenic zotsatira zake tivatsii yeniyeni phospholipase C. glimepiride si ziletsa anatengera kagayidwe kachakudya kuti m'mnyewa wamtima ischemia (mosiyana glibenclamide). Mphamvu yayikulu yovomerezeka ya mankhwalawa imawonekera patatha maola 2-3 pambuyo pa kuperekera, kumatha maola opitilira 24 ndipo umadalira mlingo.
Pharmacokinetics
Ndi Mlingo wambiri wa glimepiride muyezo wa tsiku ndi tsiku wa 4 mg, kuchuluka kwambiri m'magazi a seramu kumachitika pambuyo pa maola pafupifupi 2,5 ndipo ndi 309 ng / ml, pali ubale wolumikizana pakati pa mlingo komanso kuchuluka kwakukulu kwa glimepiride m'magazi, komanso pakati pa mlingo ndi malo omwe amaponderezedwa " Nthawi. " Glimepiride ili ndi bioavailability mwamtheradi. Kudya kulibe vuto lililonse pakumizidwa, kupatula kuchepa pang'ono pang'onopang'ono pa kuchuluka kwa mayamwidwe. Glimepiride imadziwika ndi gawo lotsika kwambiri (pafupifupi 8.8 L), pafupifupi lofanana ndi kuchuluka kwa kugawa kwa albumin, kumanga kwambiri mapuloteni a plasma (oposa 99%) ndi chilolezo chotsika (pafupifupi 48 ml / min). Glimepiride amamuchotsa mkaka wa m'mawere ndikuwoloka chotchinga. Amalowa bwino kudzera mu zotchinga mu magazi. Glimepiride imapangidwa mwachilengedwe mu thupi kukhala ma metabolites awiri, chifukwa cha kagayidwe ka glimepiride m'chiwindi ndikuyimira hydroxylated ndi carboxylated of glimepiride. Hafu ya moyo wa glimepiride pa plasma wozungulira mu seramu yolingana ndi ma dosing angapo ndi maola 5-8. Mutatha glimepiride muyezo waukulu, theka la moyo limakulitsidwa. Pambuyo pamilingo imodzi yamilomo ya glimepiride yokhala ndi cholembera wa radioactive, 58% inapezeka mu mkodzo ndi 35% mu ndowe. Zinthu zosasinthika mkodzo sizinapezeke. Hafu ya moyo wa hydroxylated ndi carboxylated metabolite wa glimepiride anali pafupifupi maola 3-6 ndi maola 5-6, motsatana. Odwala omwe ali ndi vuto la impso (otsika a creatinine chilolezo), panali chizolowezi chowonjezera kutsimikiza kwa glimepiride komanso kutsika kwake kozungulira m'magazi, komwe, mwanjira zonse, kumachitika chifukwa cha kuchotseka kwa mankhwalawa chifukwa cha kutsika kwa mapuloteni. Chifukwa chake, m'gulu lino la odwala palibe chiopsezo chowonjezereka cha glimepiride. Ma paracokinetic magawo a glimepiride ndi ofanana mwa odwala omwe ndi akazi osiyana zaka komanso osiyana zaka.

Njira yogwiritsira ntchito

Kwa akuluakulu: Gawani chakudya cham'mawa chamasana kapena chamasana. Mapiritsiwo amameza osafuna kutafuna, osambitsidwa ndi madzi okwanira (pafupifupi chikho cha 1/2). Ndikofunika kwambiri kuti musadumphe chakudya mutatha Diapiride. Mlingo woyambira ndi kukonzanso, nthawi ya makonzedwe ndikugawa tsiku lililonse mlingo umayikidwa payekhapayekha malinga ndi zotsatira za kutsimikiza kwa magazi mu magazi ndi mkodzo.Mlingo woyambirira wa Diapiride ndi 1 mg pakamwa nthawi imodzi patsiku. Ngati ndi kotheka, kuwonjezeka kwa tsiku ndi tsiku mlingo kumachitika ndikuwonetsetsa kuchuluka kwa shuga m'magazi, pang'onopang'ono kumawonjezera mlingo uliwonse masabata 1-2 malinga ndi chiwembu: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg. Nthawi zina, tsiku ndi tsiku mlingo wa Diapiride ukhoza kuwonjezeka mpaka 8 mg. Nthawi zambiri mlingo wa tsiku ndi tsiku umagwiritsidwa ntchito kamodzi. Kwa odwala omwe ali ndi shuga wambiri, gawo lililonse la mankhwalawa limakhala loti 1-4 mg wa glimepiride, koma mwa ena mwa odwala omwe zotsatira zoyenera zimatheka mukamamwa Mlingo wa 6 mg kapena kupitilira. Mlingo wambiri watsiku ndi tsiku ndi 6 mg, nthawi zina - 8 mg. Mankhwalawa amagwiritsidwa ntchito kwanthawi yayitali. Pankhani ya kubwezeredwa kwa shuga, chidwi cha minofu kuti insulin ichuluke, chifukwa chake kufunika kwa glimepiride kumatha kuchepa, komwe kumafunikira kuchepetsedwa kwa kanthawi kochepa kapena kusiya mankhwala (kutengera zotsatira za kusanthula kwa magazi ndi mkodzo wa mkodzo). Kusintha kwa thupi la wodwalayo kapena moyo wake, komanso mawonekedwe a zinthu zomwe zikuwonjezera pachiwopsezo cha kukhala ndi hypo- kapena hyperglycemia, kusintha kwa mankhwalawa ndikofunikira.
Gwiritsani ntchito limodzi ndi metformin. Diapiride yosakanikirana ndi metformin imalembedwa ngati kuchuluka kwa shuga m'magazi kumakhala kosakhazikika mwa odwala omwe akupezeka ndi metformin monotherapy. Ndikusungabe mlingo wa metformin pamlingo womwewo, chithandizo cha Diapiride chimayamba ndi mlingo wochepa wa 1 mg, ndikuwonjezera pang'onopang'ono mlingo kutengera mlingo womwe mukufuna wa 6 mg.
Gwiritsani ntchito limodzi ndi insulin. Diapiride osakanikirana ndi insulin amadziwika kuti sizingatheke kukwaniritsa kuchuluka kwa shuga m'magazi potenga mlingo waukulu wa Diapiride monga monotherapy kapena kuphatikiza ndi mlingo waukulu wa metformin. Komanso, motsutsana ndi malekezero a mlingo womaliza wa Diapirid woperekedwa kwa wodwala, chithandizo cha insulin chimayamba ndi mlingo wocheperako, ndikuwonjezereka kwapang'onopang'ono kwa mlingo wa insulin mothandizidwa ndi magazi. Kuphatikiza chithandizo kumafunika kuyang'aniridwa kuchipatala. Ndikusungabe nthawi yayitali glycemic control, kuphatikiza mankhwalawa kumatha kuchepetsa kufunafuna kwa insulin ndi 40%.
Kusamutsa wodwala kupita ku Diapiride kuchokera kwa wothandizira wina wamkamwa wa hypoglycemic. Palibe ubale weniweni pakati pa Mlingo wa glimepiride ndi mankhwala ena amkamwa a hypoglycemic. Mukasamutsidwa kuchokera ku mankhwalawa (kuphatikizapo milingo yayitali) kupita ku Diapiride, mlingo woyambirira wa glimepiride uyenera kukhala 1 mg. Kukula kulikonse kwa muyezo wa Diapiride kuyenera kuchitika m'magawo, chifukwa cha momwe thupi limayendera. Mlingo womwe umagwiritsidwa ntchito komanso nthawi yayitali ya zotsatira za m'milomo ya hypoglycemic wothandizira uyenera kukumbukiridwa. Nthawi zina, makamaka mothandizidwa ndi mankhwala aposachedwa a hypoglycemic omwe ali ndi moyo wautali wa moyo (mwachitsanzo, chlorpropamide), zingakhale zofunikira kwakanthawi (kwa masiku angapo) kusiya mankhwala kuti mupewe zowonjezera zomwe zimawonjezera chiopsezo cha hypoglycemia.

Kusamutsa wodwala kuchokera ku insulin kupita ku Diapiride. Pazochitika zapadera, odwala omwe ali ndi matenda osokoneza bongo omwe amadalira shuga (mtundu II) amalandila chithandizo cha insulin, pomwe amalipiritsa matendawa ndikusunga chinsinsi cha pancreatic β-cell, akhoza kuwonetsedwa kuchokera ku insulin kupita ku Diapiride. Kusamutsa ku Diapiride kuyenera kuchitika moyang'aniridwa ndi achipatala. Pankhaniyi, muyeso woyamba wa Diapiride ndi 1 mg. Kutalika kwa mankhwalawa nthawi iliyonse kumatsimikiziridwa ndi dokotala. Palibe zinachitikira ndi kugwiritsa ntchito mankhwalawa mankhwalawa ana.

- Mtundu wachiwiri wa matenda a shuga a mellitus (osadalira insulini) mwa akulu ngati monotherapy kapena osakanikirana ndi metformin kapena insulin.

Kutulutsa Fomu

Mapiritsi
Piritsi 1 ili ndi 2 mg, kapena 3 mg, kapena 4 mg ya glimepiride, ma excipients: lactose monohydrate, microcrystalline cellulose (102), sodium starch glycolate, povidone (25), magnesium stearate. Mapiritsi Diapiride 2 mg mophatikiza amakhala ndi chitsulo oxide chikasu, indigo carmine, Diapiride 3 mg - iron oxide chikasu, Diapiride 4 mg - Indigo carmine.

Zomwe zili patsamba lomwe mukuwona zimapangidwa kuti zidziwitso zokha komanso sizimalimbikitsa kudzipatsa mankhwala mwanjira iliyonse. Chidacho chimapangidwa kuti chizolowere akatswiri azachipatala kuti awonjezere zambiri zamankhwala ena, potero amawonjezera luso lawo. Kugwiritsa ntchito mankhwala osokoneza bongo "Diapyrid" mosakayikira limapereka mwayi wofunsana ndi katswiri, komanso malingaliro ake pa njira yogwiritsira ntchito ndi kuchuluka kwa mankhwala omwe mumasankha.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapangidwa mwanjira ya mapiritsi okhala ndi mitundu yosiyanasiyana ya yogwira ntchito. Pakhadikhadi phukusi pali miyala 30 m'matumba. Piritsi 1 ili ndi 2, 3 kapena 4 mg ya glimepiride (yogwira mankhwala). Mapiritsi okhala ndi Mlingo wa 2 mg ndiwobiliwira, 3 mg ndi kuwala achikasu, 4 mg ndi kuwala kwamtambo.

Zomwe mapiritsiwo akuphatikizira:

lactose monohydrate,
cellcrystalline mapadi,
sodium wowuma glycolate,
povidone
oxide wachikasu wachikasu
magnesium wakuba,
indigo carmine.

Pharmacokinetics

Pambuyo pakulowetsa, glimepiride imalowetsedwa m'matumbo ndikuyamba kulowa m'magazi. Kudya sikuchepetsa kuyamwa kwa mankhwalawa. Izi zimafika pachimake kwambiri m'madzi a m'magazi mkati mwa 2-2,5 maola.

Pambuyo pakulowetsa, glimepiride imalowetsedwa m'matumbo ndikuyamba kulowa m'magazi.

Glimepiride imadziwika ndi zomangira zabwino zama protein (99%). Kagayidwe ka mankhwala kumachitika chiwindi. Zomwe zimayambira metabolites zimachotsedwa impso ndi matumbo. Mankhwalawa amachotsedwa m'thupi pakatha maola 10-16. Ngakhale mukutenga Diapiride, kudzikundikira kwa zinthu m'thupi sikumawonedwa (ngakhale ndikugwiritsa ntchito nthawi yayitali).

Ndi chisamaliro

Moyang'aniridwa ndi dokotala, mankhwalawa amagwiritsidwa ntchito kuchitira ntchito mwachangu, kuledzera, kutentha thupi, chithokomiro cha chithokomiro, kuchepa kwa adrenal komanso matenda oopsa.

Pambuyo pochita opaleshoni yayikulu, kuvulala, kuwotcha, odwala amalangizidwa kuti asinthane ndi insulin.

Kodi kutenga diapiride?

Mankhwala amatengedwa pakamwa ndi madzi ochepa. Iwo m`pofunika kuphatikiza makonzedwe a mapiritsi ndi chakudya kupewa matenda am'mimba.

Ndi matenda ashuga

Ngati mankhwalawa amachokera ku mtundu wachiwiri wa shuga a shuga osagwirizana ndi insulin, mankhwalawa amatengedwa katatu patsiku. Kumayambiriro kwa mlingo, mlingo ndi 1 mg malinga ndi glimepiride. Ngati zili zokwanira kutulutsa shuga m'magazi, ndiye kuti mlingowo sukuwonjezeka.

Ndi osakwanira kwenikweni, mlingo umakulitsidwa pang'onopang'ono mpaka 2, 3 kapena 4 mg. Nthawi yocheperako pakati pa kusintha kwa mlingo uyenera kukhala wosachepera masiku 7. Nthawi zina odwala amapatsidwa 6 mg ya glimepiride patsiku (pazovomerezeka tsiku lililonse mlingo).

Madokotala atha kuperekera mankhwala othandizira pamodzi ndi metformin kapena insulin kuti akwaniritse kwambiri. Kumwa mankhwalawa kungapangitse kuti insulin ichuluke. Pankhaniyi, mlingo umachepetsedwa kapena kuthetsedwa kwathunthu.

Pa mbali ya gawo la masomphenyawo

Pa chithandizo, kusokonezeka kwakanthawi kwakanthawi (kusokonezeka kwakanthawi) kumachitika. Zomwe zimayambitsa izi ndizosintha m'magazi.

Ngati mankhwalawa amachokera ku mtundu wachiwiri wa shuga a shuga osagwirizana ndi insulin, mankhwalawa amatengedwa katatu patsiku.

Hematopoietic ziwalo

Zotsatira zoyipa kuchokera ku hematopoietic system:

thrombocytopenia
leukopenia
kuchepa magazi
granulocytopenia,
erythrocytopenia,
agranulocytosis,
pancytopenia.

Pakati mantha dongosolo

Kuchokera pakati mantha dongosolo anati:

mutu
chizungulire
chisokonezo,
kusowa tulo
kutopa,
mavuto
kutsika kwa ma psychomotor
kusokonekera kwa mawu
kugwedezeka miyendo,
kukokana.

Kuchokera kumbali ya kagayidwe

Zotsatira zoyipa zama metabolism zimawonetsedwa ndi hypoglycemia.

Panthawi ya makonzedwe, thupi limayambitsa mavuto:

Khungu
urticaria
zotupa
Matupi a vasculitis.

Gwiritsani ntchito mu ukalamba

Chidacho chimaloledwa kugwiritsidwa ntchito kwa odwala azaka zosiyanasiyana, kupatula ana. Koma anthu achikulire ogwiritsa ntchito mapiritsi nthawi yayitali amatha kuyamba kukhala ndi hypoglycemia. Popewa matenda amenewa, madokotala amapatsa odwala okalamba zakudya zapadera komanso kuchuluka kwa mankhwalawa (ngati zingatheke).

Mankhwala osokoneza bongo a Diapiride

Mankhwala osokoneza bongo amatsogolera ku mawonekedwe a hypoglycemic (kutsika kwamphamvu kwa shuga). Pankhaniyi, wodwalayo amamva kutopa, kugona, chizungulire. Kutayika kotheka. Kuti athetse vuto la bongo, amayamba kugwiritsa ntchito mankhwalawa.

Mankhwala osokoneza bongo amatsogolera ku mawonekedwe a hypoglycemic (kutsika kwamphamvu kwa shuga).

Kuchita ndi mankhwala ena

Mankhwala ayenera kumwedwa mosamala limodzi ndi mankhwala monga:

Fluconazole
Phenylbutazone.
Azapropazone.
Sulfinpyrazone.
Oxyphenbutazone.
Pentoxifylline.
Tritokvalin.
Disopyramides.
Fenfluramine.
Khalid.
Maanticoagulants ochokera ku gulu la coumarin.
Salicylates.
Ma antidepressants (Mao inhibitors).
Fibates.
Fluoxetine.
Cyclophosphamide.
Feniramidol.
Ifosfamide.
Miconazole
Tetracycline ndi mankhwala a quinolone.
Mankhwala ena a hypoglycemic.
Anabolic steroids.
ACE zoletsa.
PASK (para-aminosalicylic acid).

Pogwiritsa ntchito nthawi imodzi ndalamazi, mphamvu ya Diogiride imatheka. Kutsika kwa mphamvu ya mankhwalawa kumawonedwa ndikutenga limodzi ndi Phenothiazine ndi zotumphukira zake, estrogens ndi progestogens, glucagon, nicotinic acid, corticosteroids, barbiturates, Phenytoin, Acetazolamide, diuretics ndi mankhwala ochizira chithokomiro.

Mimba

Osagwiritsa ntchito mankhwalawa Diapiride pa mimba. Ngati wodwala yemwe akutenga glimepiride akukonzekera kutenga pakati kapena ali ndi pakati, ayenera kusamutsidwira ku insulin chithandizo msanga.
Popeza mankhwala ena a sulfonylurea amatsimikiziridwa mkaka wa m'mawere, tikulimbikitsidwa kuti chithandizo chokhala ndi glimepiride chisiyike chifukwa choopsa cha hypoglycemia mu makanda atsopano.

Mlingo

2 mg, 3 mg, ndi mapiritsi 4 mg

Piritsi limodzi lili

yogwira mankhwala: glimepiride (micronised) molingana ndi 100% - 2 mg, 3 mg ndi 4 mg,

Mapiritsi a 2 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (mtundu A), povidone (25), iron (III) oxide chikasu (E 172), indigo carmine (E 132), magnesium stearate,

Mapiritsi 3 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (mtundu A), povidone (25), iron (III) yellow oxide (E 172), magnesium stearate,

Mapiritsi a 4 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (mtundu A), povidone (25), indigo carmine (E 132), magnesium stearate.

Mapiritsi okhala ndi mawonekedwe ozungulira okhala ndi lathyathyathya, ochokera pamtunda wobiriwira mpaka wobiriwira (muyeso wa 2 mg), kuchokera kutuwa wachikasu mpaka chikasu (pa mulingo wa 3 mg), kuchokera pa mtundu wa buluu kupita pamtambo wamtambo (pa mulingo wa 4 mg), wokhala ndi mphindikati ndi notch. Pamwamba pa miyala, munalowa

Diapiride bongo mu mapiritsi

Mankhwala osokoneza bongo amatha kupititsa ku hypoglycemia, yomwe imatha maola 12 mpaka 72, ndipo pambuyo poyambanso kuoneka bwino. Zizindikiro zimatha kuchitika patatha maola 24 mutatha kumwa mankhwala. Monga lamulo, odwala otere ayenera kukhala kuchipatala.

Zizindikiro za hypoglycemia: nseru, kusanza ndi kupweteka m'mimba, kunjenjemera, kusokonezeka kwa mawonekedwe, kusokonekera, kugona, kugona tulo, kuda nkhawa, kukwiya, kusamala chidwi ndi nthawi yokhudzana, kukhumudwa, kusokonezeka, kusalankhula komanso vuto la masomphenya, aphasia, paresis, kusokonezeka kwa chidwi, chizungulire, kusathandiza, kulephera kudziletsa, kupuma, kukoka kwa ziwalo, kusiya kuzindikira mpaka kukula kwa chikomokere, kupuma kosakhazikika komanso bradycardia. Kuphatikiza apo, zizindikiro za kusintha kwa kusintha kwa adrenergic monga kutuluka thukuta, nkhawa, tachycardia, matenda oopsa, zotupa, angina pectoris ndi mtima wabwino zingawonedwe. Chithunzi cha chipatala cha matenda oopsa a hypoglycemic chingafanane ndi sitiroko.

Artyқ dosalanuy hypoglycemia ғ alyp keluy mүmkіn, ol 12-den 72 saғatқa dejin sozulyuy, әne alғashқy zhқsaruynan keyіn қaita bіlіnі mүmkіn. Mankhwala mptsіңuіnen keyin 24 saғattan soң bіlіnuі mүmkіn. Әdette, mұndai emdelušіler chipatala cha bolu tiis.

Mphatso Za Hypoglycemia: Zhurek Ainu құsu zhane asқazan tұsynyң auyruy, kugwedeza, kөru bұzylystary, қimyl-қozғalys үylesіmіnің bұzyluy, ұyқyshyldyқ, ұyқynyң bұzyluy, mazasyzdyқ, ozbyrlyқ, zeyіn shoғyrlandyru zhane anachita uaқyttarynyң bұzyluy, maganizo, baғdarsyzdyқ, sөyleu zhane kөru bұzylystary, aphasia, paresis, sezmtaldyқtyң bұzyluy, bass ainaluy, sharasyzdyқ, өзін-өзі baқylay almau, delirium, ubongo іrysular, coma damuyna deyngі esten tanu, үstіrtіn tynys alu jane bradik. Bұdan өzge, terleu, үreilenu, tachycardia, arterialsқ matenda oopsa, үurek қaқuyn sezinu, angina pectoris әәerek arrhythmias owala keri adrenergialқ malamulo a Belgler baiқaluy mүmkіn. Auyr hypoglycemiaқ ұstamanyң zipatalaқ kөrіnіsі sitiroko іske saluy mүmkіn.

Zochita zamankhwala osokoneza bongo

Amapangitsanso mphamvu ya glimepiride ndi kugwiritsa ntchito munthawi yomweyo: phenylbutazone, azapropazone ndi oxyphenbutazone, sulfinpyrazone, insulin ndi mankhwala amkamwa antidiabetic, ena ochita sulfonamides, metformin, tetracyclines, salicylates ndi p-aminosalicylic acid, mankhwala a manicosis. Chloramphenicol, probenecid, coumarin anticoagulants, miconazole, phenfluramine, pentoxifyline (mlingo waukulu wa makolo), ma fibrate, tritokvalin, ACE zoletsa, fl uconazole, fluoxetine, allopurinol, sympatholytics, cyclophosphamide, disopyramide, pheniramidol, guanethidine, isophosphamide, PASK.

Kuchepetsa mphamvu ya hypoglycemic ya glimepiride kugwiritsa ntchito munthawi yomweyo: estrogens ndi progestogens, saluretics, thiazide diuretics, mahomoni a chithokomiro ndi mankhwala omwe amalimbikitsa ntchito ya chithokomiro, corticosteroids ndi glucocorticoids, phenothiazine zotumphukira, chlorpromazine, epinephrine komanso ma exacomimics. , glucagon, laxatives (kugwiritsa ntchito nthawi yayitali), phenytoin, diazoxide, glucagon, barbiturates ndi rifampicin, acetazolamide.

H2 receptor antagonists, beta-blockers, clonidine ndi reserpine amatha kukhala ndi mwayi komanso amachepetsa mphamvu ya hypoglycemic.Mothandizidwa ndi sympatholytics, monga beta-blockers, clonidine, guanethidine ndi reserpine, chiwonetsero cha adrenergic reverse regulation ya hypoglycemia chitha kuchepa kapena kutha. Kumwa mowa kumatha kukulitsa kapena kufooketsa mphamvu ya hypoglycemic ya glimepiride.

Glimepiride imatha kuwonjezera ndikuchepetsa mphamvu ya zotumphukira za coumarin.

Zotsatira zoyipa

Kuchokera kumbali ya kagayidwe: hypoglycemia (mutu, njala, nseru, kusanza). Pafupipafupi - kumverera kotopa, kugona, kusokonezeka kwa kugona, kuda nkhawa, kukwiya, kusokonezeka chidwi ndi kuyankha, kukhumudwa, kusokonezeka, kusokonezeka kwa malingaliro, chizungulire, kugwirizanitsa mwamphamvu, kulephera kudziletsa. Osati kawirikawiri - delirium, kukokana kwa ziwalo, kusazindikira, chikomokere, kupuma kosakhazikika, bradycardia. Kuphatikiza apo, chifukwa cha makina a mayankho a adrenergic, nthawi zina zimakhala ngati izi: kuzizira, thukuta lomata, tachycardia, matenda oopsa, angina pectoris, kusokonezeka kwa mtima.

Kuchokera m'mimba: nseru, kusanza, kumva kuwawa kapena kusokonezeka kwa epigastrium, kupweteka kwam'mimba, kutsegula m'mimba, kawirikawiri, kuwonjezeka kwa zochitika za hepatic transaminases, kuwonongeka kwa chiwindi (cholestasis ndi jaundice), hepatitis, ndi kulephera kwa chiwindi.

Kuchokera kumagazi: thrombocytopenia (pang'ono mpaka kwambiri), kawirikawiri leukopenia, hemolytic kapena aplastic anemia, erythrocytopenia, granulocytopenia, agranulocytosis ndi pancytopenia (chifukwa cha myelosuppression).

Kuchokera kumbali ya gawo la masomphenyawo: kuchepa kwa mawonekedwe kwakanthawi chifukwa cha kusintha kwa kuchuluka kwa shuga m'magazi (makamaka poyambira chithandizo).

Zotsatira zoyipa: pruritus, urticaria, zidzolo, kawirikawiri dyspnea, kutsika magazi, matupi awo a vasculitis, photosensitivity. Thupi lawo siligwirizana ndi pseudo. Mtanda-ziwopsezo ndizotheka ndi zina za sulfonylurea, sulfonamides.

Ngati zovuta zoyipa zikuchitika, mankhwalawo amachotsedwa ndipo chidziwitso cha mankhwala chimachitika.

Zochita

Kulimbikitsa mphamvu ya hypoglycemic ya glimepiride zitha kudziwika ndi munthawi yomweyo kugwiritsa ntchito insulin kapena mankhwala ena a hypoglycemic, ma ACE inhibitors, allopurinol, anabolic steroids ndi mahomoni ogonana amuna, omwe ali ndi chloramphenicol, zotumphukira za coumarin, cyclo-, tro- ndi isophosphamide, phenfluramine, pheniramidol, fibetinum, fibetinum, fibetinum , miconazole, pentoxifylline (ndi makulidwe a makolo pamitunda yayitali), ndi phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, su akhala akuchita lfanilamides, tetracyclines, tritocqualin.

Kuchepa kwa mphamvu ya hypoglycemic ya glimepiride zotheka kugwiritsa ntchito munthawi yomweyo ndi acetazolamide, barbiturates, corticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) ndi zina za sympathomimetics, glucagon, mankhwala othandizira (ntchito yayitali), nicotinic acid (protein yayikulu) ndi ma protein ambiri. , phenothiazine, phenytoin, rifampicin, mahomoni a chithokomiro, mchere wa lithiamu, chlorpromazine.

Onse kulimbitsa ndi kufooka kwa hypoglycemic zotsatira za glimepiride zitha kudziwika ndi kugwiritsa ntchito nthawi imodzi ndi histamine H blockers₂zolandilira, clonidine ndi reserpine, ndimodzi kapena osagwiritsa ntchito mowa.

Poyerekeza ndi kugwiritsa ntchito glimepiride, kuwonjezeka kapena kufooka kwa zochitika za coumarin zitha kudziwika.

Mankhwala

Ishke қabyldaғan kemede glimepiride tolyғymen sіңedі, ngati іshu sіңuіne eleeleul durezhde әser etpeydi. Concentrationан sarysuyndaғy ezhoғar концентрацияy ndende ya mwana wa ішке қыabyldaannan keyin 2,5 saғattan soңethedі. Taralu kөlemi tөmen (8.8 ml), chilolezo - 48 ml / mphindi, plasma aқuyzdarymen bailanysuy - 99% -dan astam, zhartyly shygarylu keseeni - 5-8 saғatқa zhuyқ. Kukonzekera kwa Zhoғary dozalard қabyldaғannan kein жарırtylai shyғarylu kezңңi artady.

Bauyrda glimepiridtің hydroxyldengen tuyndylaryna deіn metabolizdenedі, olar nesepte de (mankhwala ң bir rettіk dozasynyң 58% ғa zhuyғy), nәzhiste de (35-40%) anyқtalady. Kukonzekera bir ret қabyldaғanda zhne birneshe kүn қatarynan tәulіgіne 1 ret қoldanғanda pharmacokinetics sinda aytarlyқtay ayyrmashylyқ bayalmaғan. Mankhwala zhinaқtalmaydy. Zhas shamalarymen zhynystary әә үү лү Pharm Pharm л Pharm Pharmр ac Pharm ac Pharm

Ntchito za Bүyrek za sonң bұzylouy bar edelushіlerde glimepiride chilolezo zaluso amuna onyң ortasha ndende ya sonң tөmendeuіne beyimdіlіk bajalada.