Amaryl M - mankhwala othandiza omwe amathandiza kuchepetsa shuga m'magazi

Pankhondo yolimbana ndi matenda ashuga pali Amaril wogwira ntchito ku Germany. Cholinga chake chachikulu ndikuchepetsa kuchuluka kwa shuga m'magazi kuti akhale ovomerezeka. Madokotala amapereka Amaril kwa odwala omwe apezeka ndi mtundu wachiwiri wa matenda osokoneza bongo omwe amagwiritsa ntchito mayeso a diagnostic. Kuti mukwaniritse bwino kwambiri kuchokera ku chithandizo, muyenera kumwa mankhwalawo, kutsatira mosamalitsa mankhwala omwe adokotala adapereka osapitirira nthawi yokhazikika. Kupanda kutero, wodwalayo akuwopsezedwa ndi zovuta ndi zovuta za njira ya matendawa.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Zizindikiro ndi contraindication

Mapiritsi a Amaryl apeza momwe angagwiritsire ntchito pochiza matenda amodzi okha - mtundu II shuga mellitus kapena omwe amadziwika kuti ndi shuga osadalira insulini. Matenda a shuga amtunduwu sangathe kuthandizidwa ndi insulin, chifukwa chake Amaril M wophatikiza mankhwala adapangidwa. Sikulimbikitsidwa kugwiritsa ntchito mankhwala ochepetsa shuga kwa anthu omwe ali ndi vuto limodzi, komanso omwe apezeka ndi matenda a impso ndi chiwindi, kuperewera kwa lactase ndi malabsorption (kusamwa bwino) shuga. Amaryl imatsutsana mu mtundu woyamba wa matenda a shuga komanso kupindika - matenda ashuga ketoacidosis (owonjezera matupi a ketone m'magazi). Palibe mankhwala omwe amaperekedwa kuti athandize odwala matenda ashuga omwe ali ndi amayi, oyamwitsa kapena odwala ochepa.

Momwe mungagwiritsire ntchito ndi kumwa?

Ndikulimbikitsidwa kutenga Amaril chifukwa cha matenda a shuga pokhapokha mutakambirana ndi dokotala woyenera yemwe, pamaziko a kuchuluka kwa shuga wamagazi, amapereka mankhwala otetezeka komanso othandiza. "Amaryl" amagwiritsidwa ntchito pochiza matenda amishuga amtundu wa 2 monga monotherapy komanso nthawi yomweyo ndi mankhwala ena. Childs, maphunzirowa amayamba ndi yaying'ono Mlingo, pang'onopang'ono kuwonjezera iwo tsiku lililonse - 4 mg. Mwazowopsa, mlingo ungathe kuwonjezeka mpaka 8 mg pa tsiku.

Kusintha mlingo wa mankhwalawa pokhapokha poyeza shuga.

Panthawi ya matenda a shuga, wodwalayo ayenera kuyeza glucose m'magazi, kotero kuti poyamba akachulukitsa, sinthani mlingo wa Amaril. Imwani mapiritsi m'mawa musanadye kaye koyamba kapena mwachindunji pakudya. Osamatafuna, ndikumeza lonse, ndipo nthawi zonse muzimwa theka la madzi.

Zotsatira zoyipa

Mukamagwiritsa ntchito mapiritsi a Amaril, zinthu zotsatirazi zingachitike:

• kutsika kwa shuga, maselo oyera am'magazi, ma granulocytes, mapulateleti m'magazi,
• akukumbutsa
• kuwonongeka kwa maselo ofiira a magazi kapena kuchepa kwawo m'magazi,
• kuchepa kwamitundu yonse yam'magazi m'magazi,
• kupweteka ndi kusasangalala pamimba,
• thupi lawo siligwirizana
• zithunzi
• kuchuluka kwa michere ya chiwindi,
• chiwindi ntchito.

Ogonjera

Ngati sizotheka kugwiritsa ntchito mankhwala opangira Amaril pochiza matenda ashuga, madokotala amatenga mankhwala ofanana ndi chinthu chogwira ntchito komanso gulu la mankhwala. Chifukwa chake, imodzi mwanjira zotsatirazi zimatha kusintha Amaryl yotsitsa shuga:

• Pali zithunzi zambiri za Amaril, m'modzi mwa iwo ndi Glemaz.

Malangizo apadera

Kutenga "Amaryl" kusintha matenda a shuga, ndikofunikira kuwunika pafupipafupi kuchuluka kwa shuga, kugwira ntchito kwa impso ndi chiwindi, komanso kuwunika momwe magazi amathandizira kuti kuchepa kwa kuchuluka kwa mapulateleti, hemoglobin ndi maselo ofiira amwazi. Ndizofunikira kudziwa kuti mphamvu ya mankhwalawa imatha kuchepa ngati wodwala akukumana ndi zovuta zambiri ndipo izi zimachitika chifukwa cha kutulutsidwa kwa adrenaline yambiri m'magazi.

Ndikotheka kulimbikitsa kapena kufooketsa zochita za Amaril, ngati mukugwiritsidwa ntchito molumikizana ndi mankhwala ena. Chifukwa chake, ndikofunikira kudziwitsa adotolo za mankhwala omwe amamwa kuti adokotala athetse mlingo waukulu kapena asankhe mankhwala ena omwe nthawi zambiri amagwirizana ndi Amaril. Panthawi ya matenda a shuga, ndikofunikira kuthetseratu mowa, popeza ethyl mowa wama kapangidwe kake umachepetsa mphamvu ya mankhwala a hypoglycemic. Mapiritsi amayenera kusungidwa pamalo abwino, otetezedwa pakuwala komanso osafikirika kwa ana aang'ono. Kuti mankhwala a Amaril akhale abwino momwe angathere matenda a shuga, muyenera kutsatira zakudya zopatsa thanzi, khalani ndi moyo wachangu ndikutsatira malingaliro onse a dokotala.

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa shuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda aposachedwa a shuga. Werengani nkhani >>

Mankhwala

Glimepiride imathandizira kuchepetsa glucose wamagazi (makamaka chifukwa cha kukondoweza kwa kutulutsa kwa insulin ndi ma pancreatic β-cell). Izi zimachitika makamaka chifukwa chakuti ma pancreatic β-cell amawongolera kuthekera poyankha kukoka kwa thupi kwa shuga. Poyerekeza ndi glibenclamide, milingo yotsika ya glimepiride imayambitsa kutuluka kwa milingo yotsika ya insulin yokhala ndi kuchepa kofanana kwa glucose, komwe kumawonetsa kuchepa kwa hypoglycemic zotsatira za glimepiride (kuchuluka kwa chidwi cha insulinomimetic).

Katemera wa insulin

Monga zotumphukira zina za sulfonylurea, glimepiride imakhudza katemera wa insulin pochita pa njira za ATP zotengera potaziyamu pancreatic β-cell membrane.

Kusiyana kochokera kuzinthu zina za sulfonylurea ndizogwirizanitsa posankha glimepiride ndi mapuloteni okhala ndi kulemera kwamakilogalamu 65 ndipo ali mgulu la ma cell a β-cell. Mphamvu ya glimepiride imakuthandizani kuti musinthe njira yotseka / kutsegulira njira za potaziyamu ya ATP yozama. Amaryl atseka njira zam potaziyamu, zomwe zimapangitsa kuti maselo a β-athere, ndikutsegulira mayendedwe amagetsi ndi calcium komanso kulowa calcium. Ndi kuwonjezeka intracellular calcium ndende, insulin katulutsidwe ndi exocytosis imayendetsedwa. Poyerekeza ndi glibenclamide, glimepiride imamangiriza mwachangu komanso pafupipafupi ndipo imamasulidwa ku ma protein limodzi. Mwina, kusinthasintha kwakukulu kwa glimepiride ndi mapuloteni amalimbikitsa chidwi cha β-cell ku glucose, ndikuwatetezanso kuti asamataye mtima komanso athetse kufooka msanga.

Insulinomimetic kwenikweni

Zotsatira za glimepiride ndizofanana ndi mphamvu ya insulini pakukoka kwa glucose pogwiritsa ntchito zotumphukira zake komanso kutuluka kwake pachiwindi.

Tizilombo tofiyira timatenga glucose tikamayendetsa m'maselo a minofu ndi adipocytes. Glimepiride imachulukitsa kuchuluka kwa mamolekyulu omwe amayendetsa glucose ndikuyambitsa glycosylphosphatidylinositol-enieni a phospholipase C. Zotsatira zake, kuchuluka kwa calcium kwambiri kumachepa, zomwe zimapangitsa kuchepa kwa protein kinase A ntchito komanso kusangalatsa kwa kagayidwe ka glucose. Mothandizidwa ndi glimepiride, kutulutsa kwa glucose kuchokera ku chiwindi kumalepheretsa (chifukwa cha kuchuluka kwa zomwe zili mu fructose-2,6-bisphosphate kuletsa gluconeogeneis).

Antiatherogenic zotsatira

Glimepiride imasinthasintha zomwe zimakhala ndi lipids, zimachepetsa kuchuluka kwa malondialdehyde m'magazi, chifukwa chomwe lipid peroxidation imachepetsedwa kwambiri. Mu maphunziro a nyama, zidapezeka kuti kutenga glimepiride kumachepetsa kwambiri mapangidwe a atherosulinotic malo.

Glimepiride imapereka kuchepa kwa kupsinjika kwa oxidative nkhawa yokhala ndi matenda a shuga 2, kumawonjezera kuchuluka kwa alpha-tocopherol amkati, komanso zochitika za catalase, superoxide dismutase ndi glutathione peroxidase.

Zokhudza mtima

Zomwe zimachokera ku sulfonylureas zimakhudza gawo lamtima wamtima, zimakhudza njira za ATP zotha kudziwa potaziyamu. Poyerekeza ndi zina zotumphukira za sulfonylurea, glimepiride imadziwika ndi zotsatira zotsika kwambiri pamtima, zomwe zimatha kuphatikizidwa ndi njira inayake yolumikizirana ndi mapuloteni a njira za potaziyamu a ATP.

Mlingo wothandiza kwambiri mwa odzipereka wathanzi ndi 0.6 mg. Zotsatira za glimepiride zimatheka komanso zimadalira mlingo.

Mukamamwa Amaril, kusintha kwa zochita zolimbitsa thupi (kutsitsa insulin secretion) kumasungidwa.

Palibe deta yodalirika pakusiyana kwa nthawi yomwe mumamwa mankhwalawa (mukamamwa mwachindunji musanadye kapena 0,5 maola musanadye). Mu shuga mellitus, kamodzi kokha kwa Amaril kumatha kuyendetsa kagayidwe kokwanira ka tsiku limodzi. Mu kafukufuku wazachipatala wokhudzana ndi odzipereka a 16 omwe ali ndi vuto la aimpso (kulengedwa kwa creatinine kuyambira 4 mpaka 79 ml / min), kuyendetsa bwino kwa metabolic kunakwaniritsidwa mwa odwala 12.

Kuphatikiza mankhwala ndi metformin

Ndi osakwanira kagayidwe kachakudya odwala kutenga pazipita mlingo wa glimepiride, pali kuthekera kwa kuphatikiza mankhwala ndi metformin ndi glimepiride. M'maphunziro awiri, kuphatikiza chithandizo kunawonetsa kuwonjezeka kwa kayendedwe ka metabolic poyerekeza ndi chithandizo chosiyana ndi chilichonse cha mankhwalawa.

Kuphatikiza mankhwala ndi insulin

Ndi osakwanira kagayidwe kachakudya odwala kutenga pazipita mlingo wa glimepiride, pali kuthekera kwa kuphatikiza mankhwala ndi metformin ndi insulin. M'maphunziro awiri, kuphatikiza chithandizo kunawonetsa kuwonjezeka kwa metabolic control ofanana ndi insulin monotherapy. Komanso, kuphatikiza mankhwala kumafuna kuchepetsedwa kwa insulin.

Pharmacokinetics

Mu milandu ya mobwerezabwereza makonzedwe a glimepiride pa 4 mg tsiku, nthawi yofika pazipita ndende yamagazi seramu ndi pafupifupi maola 2,5, ndipo kuchuluka kwa plasma ndende yogwira ntchito ndi 309 ng / ml. Pazipita plasma ndende ya glimepiride ndi dera pansi pa pharmacokinetic pamapindikira "ndende - nthawi" linearly zimatengera mlingo wa Amaril. Ndi mkamwa makonzedwe a glimepiride, wathunthu bioavailability amawonekera. Mafuta sakudalira kwenikweni pakudya (pokhapokha kuchepa pang'ono kwa mayamwidwe). Glimepiride ili ndi gawo lotsika kwambiri lazogawa (

8.8 L), yomwe ili pafupifupi wofanana ndi kuchuluka kwa kugawa kwa albumin. Zinthu zomwe zimagwiritsidwa ntchito zimadziwika ndi kuchuluka kwakukulu kokumanga kwa mapuloteni a plasma (oposa 99%) ndi chilolezo chochepa (

48 ml / mphindi). Amatsimikizidwa ndi seramu ndende ndikuwongolera mobwerezabwereza Amaril, theka la moyo limachokera ku maola 5 mpaka 8. Pankhani ya Mlingo wambiri, theka-moyo limachulukana.

Chifukwa cha kukonzanso kwamkamwa kamodzi kwa glimepiride, 58% ya mankhwalawa imayendetsedwa ndi impso, ndi 35% ya matumbo kudzera m'matumbo. Mu mkodzo, glimepiride yosasinthika siyikupezeka.

Mu ndowe ndi mkodzo, metabolites awiri opangidwa m'chiwindi adapezeka (makamaka ndi kutenga nawo gawo kwa CYP2C9 isoenzyme), ina yomwe ndi yochokera mu carboxy, ndipo inayo ndi yotulutsa ma hydroxy. Pambuyo pamlomo makonzedwe, kudwala kotsala kochedwa theka moyo wa metabolites awa anali a 5-6 ndi maola 3-5, motero.

Chogwira chimadutsana ndi zotchinga ndikuchotsedwa mkaka wa m'mawere.

Poyerekeza Mlingo wa glimepiride umodzi komanso zingapo, panalibe kusiyana kwakukulu pama paracokinetic magawo, ndipo kusiyana kwawo kocheperako kunawonedwa mwa osiyanasiyana odwala. Palibe kufunikira kwakukulu kogwira ntchito.

Odwala a mibadwo yosiyana ndi jenda, magawo a pharmacokinetic ndi ofanana. Mu vuto la impso (ndi lowinine chilolezo), kuchuluka kwa glimepiride ndi kutsika kwake kwapakati ndende yamagazi seramu ndikotheka. Mwakutheka konse, izi zimachitika chifukwa cha kuchuluka kwa kutulutsa kwa mankhwalawa chifukwa chomanga mapuloteni ochepa. Chifukwa chake, m'gulu ili la odwala palibe chiopsezo cha kuphatikizika kwa Amaril.

Zizindikiro zogwiritsidwa ntchito

Malinga ndi malangizo, Amaryl amalembera mtundu wa 2 shuga.

Pulogalamu yogwira glimepiride imathandizira kupanga insulin ndi kapamba ndi kulowa kwake m'magazi. Insulin, imachepetsa kuchuluka kwa shuga m'magazi. Glimepiride imasintha kagayidwe ka potaziyamu m'maselo, komanso amathandizira kupewa mapangidwe a atherosclerotic zolembera pazitseko zamitsempha yamagazi.

Contraindication

Amaryl amatsutsana mu matenda otsatirawa:

• Mtundu woyamba wa matenda a shuga 1
• Matenda ashuga ketoacidosis (kuphatikizika kwa mtundu woyamba wa shuga)
• Matenda akulu a impso ndi chiwindi,
• Matenda a shuga ndi mtundu wake
• Glucose-galactose malabsorption, kuchepa kwa lactase, tsankho la galactose,
• Zaka za ana
• Kusalolera kwamunthu aliyense ku gawo lililonse la Amaril,
• Mimba komanso kuyamwa.

Malangizo ogwiritsira ntchito Amaril: njira ndi mlingo

Malinga ndi malangizo, Amaryl amayenera kumwa mkamwa osatafuna, nthawi yomweyo isanayambe kapena nthawi ya nkhomaliro, kumwa madzi ambiri (osachepera ½ chikho). Kumwa mankhwalawo kuyenera kumangirizidwa pakudya, chifukwa chake kutsika kwakukulu kwa shuga m'magazi ndikotheka.

Mlingo wa wodwala aliyense umasankhidwa payekha ndi dokotala wopezeka, kutengera kuchuluka kwa shuga m'magazi.

Chithandizo chimayamba nthawi zambiri ndi osachepera mlingo wa Amaril - 1 mg patsiku. Kutengera momwe wodwalayo alili, dokotala amatha pang'ono pang'onopang'ono (kamodzi pa masabata awiri ndi awiri) kuonjezera Mlingo wa Amaril, kutsatira dongosolo: 1-2-3-4-6 mg. Mlingo wofala kwambiri ndi 1-4 mg patsiku.

Ngati wodwalayo adayiwala kulandira mlingo wa tsiku ndi tsiku, ndiye kuti mlingo wotsatira suyenera kuchuluka. Zochita ngati mwaphwanya mwanjira ya chithandizo chamankhwala muyenera kukambirana ndi adokotala pasadakhale.

Pogwiritsa ntchito Amaril, kuwongolera shuga la magazi ndikofunikira.

Bongo

Mankhwala osokoneza bongo kapena mankhwala okhala ndi mphamvu yayitali ya glimepiride, pamakhala ngozi yotha kukhala ndi hypoglycemia yoopsa kwambiri.

Mukazindikira mankhwala osokoneza bongo, pitani kuchipatala msanga. Pafupifupi nthawi zonse, hypoglycemia imatha kuimitsidwa msanga chifukwa cha kudya zakudya zamagulu (shuga, shuga, tiyi kapena msuzi wa zipatso), motero wodwalayo ayenera kukhala ndi magawo anayi a shuga (20 g shuga).Okometsa pachipatala cha hypoglycemia sikugwira ntchito.

Wodwala amayenera kuyang'aniridwa ndi achipatala mpaka dokotala atasankha kuti palibe chowopsa. Kuyenera kukumbukiridwa kuthekera kwa kuyambiranso kwa hypoglycemia pambuyo pobwezeretsa shuga m'magazi.

Pochiza wodwala yemwe ali ndi matenda ashuga ndi madotolo osiyanasiyana (mwachitsanzo, kumapeto kwa sabata kapena akavomerezedwa kuchipatala chifukwa cha ngozi), ayenera kudziwitsa za matenda ake, komanso zamankhwala am'mbuyomu.

Nthawi zina, kugonekedwa ku chipatala kungafunike. Mankhwala osokoneza bongo omwe ali ndi vuto lalikulu (kuwonongeka kwa chikumbumtima kapena matenda ena okhudzana ndi mitsempha) amatanthauza zochitika zamankhwala zadzidzidzi ndipo amafunika kuchipatala mwachangu komanso kuchiritsa.

Wodwala akakhala kuti sakudziwika, njira yokhazikika ya glucose (dextrose) yama 20% imaperekedwa kudzera mwa akulu (kwa akulu, mlingo wa 40 ml wa yankho umasonyezedwa). Akuluakulu, njira yina yopangira njira yochizira ndi mtsempha wa magazi, mu mnofu kapena m'mitsempha kapena m'magazi a 0.5 mpaka 1 mg.

Ngati Amaril atengedwa mwangozi ndi ana aang'ono kapena makanda, mlingo wa dextrose womwe umayendetsedwa pa hypoglycemia uyenera kusinthidwa mosamala kwambiri poganizira kuchuluka kwa vuto la hyperglycemia. Kukhazikitsidwa kwa dextrose kuyenera kuchitika pang'onopang'ono kuwunika kwa magazi m'magazi.

Pankhani ya mankhwala osokoneza bongo, phokoso lam'mimba ndi kupezeka kwa makala okhazikitsidwa angafunike.

Kubwezeretsa mwachangu kwa shuga m'magazi kumafunika kukakamiza kokhazikika kwa njira yochepetsetsa ya dextrose pofuna kupewa kuyambiranso kwa hypoglycemia. Odwala otere, kuchuluka kwa shuga m'magazi kuyenera kuyang'aniridwa tsiku lililonse. Woopsa nthawi yayitali hypoglycemia, chiopsezo chochepetsa shuga kukhala wolimba kwambiri chimakhalabe masiku angapo.

Mimba komanso kuyamwa

Pa nthawi yoyembekezera, kugwiritsa ntchito Amaril kumatsutsana. Akakhala ndi pakati kapena pokhapokha ngati ali ndi pakati pa mankhwala, mkazi amayenera kupita ku insulin.

Popeza glimepiride amafukusidwa mkaka wa m'mawere, kugwiritsa ntchito Amaril pakuyamwa kumatsutsana. Pankhaniyi, kusintha kwa insulin kapena kutha kwa kuyamwitsa kwasonyezedwa.

Kuyanjana kwa mankhwala osokoneza bongo

Glimepiride imapangidwira ndi isoenzyme CYP2C9 ya cytochrome P4502C9 system, yomwe iyenera kukumbukiridwa ikagwiritsidwa ntchito limodzi ndi inducers (mwachitsanzo rifampicin) kapena CYP2C9 inhibitors (mwachitsanzo fluconazole). Akaphatikizidwa ndi mankhwala otsatirawa, njira yowonjezera ya hypoglycemic imatha kukhazikika, ndipo nthawi zina kukhazikika kwa hypoglycemia chifukwa cha izi: insulin ndi mankhwala ena a hypoglycemic operekera pakamwa, angiotensin-kutembenuza ma enzyme inhibitors, mahomoni ogonana amuna, mahomoni osakanikirana, zotumphukira za coumarin, chloramphenicol, disopramide, , pheniramidol, fenfluramine, fluoxetine, fibrate, ifosfamide, guanethidine, monoamine oxidase inhibitors, fluconazole, pentoxifylline (mu Kuonera kwambiri parenteral), p-aminosalicylic asidi, azapropazone, phenylbutazone, probenecid, oxyphenbutazone, salicylates, quinolones, clarithromycin, sulfinpyrazone, tetracyclines, sulfonamides, trofosfamide, tritokvalin.

Akaphatikizidwa ndi mankhwala omwe ali pansipa, njira ya hypoglycemic imatha kufooka, komanso kuwonjezeka kwa glucose wamagazi omwe amagwirizanitsidwa ndi izi: acetazolamide, glucocorticosteroids, barbiturates, diuretics, epinephrine, mankhwala ena a sympathomimetic, glucagon, nicotinic acid (waukulu Mlingo) milandu yogwiritsa ntchito nthawi yayitali), progestogens, estrogens, rifampicin, phenytoin, phenothiazines, mahomoni okhala ndi chithokomiro.

Mukamagwiritsa ntchito limodzi ndi beta-blockers, N blockers₂-histamine zolandilira, clonidine ndi reserpine, zonse zomwe zimafooketsa komanso kuwonjezera mphamvu ya hypoglycemic ya glimepiride ndizotheka.

Mukamamwa mankhwala ochepetsa chisoni (beta-blockers, guanethidine, reserpine ndi clonidine), zizindikiro za kutsutsa kwa adrenergic ndi hypoglycemia zitha kusowa kapena kuchepera.

Kugwiritsira ntchito pamodzi kwa glimepiride ndi coumarin komwe kumapangitsanso chidwi kumatha kufooketsa kapena kufooketsa zotsatira zam'mbuyo.

Ngati mukumwa mowa kamodzi kapena mosalekeza, vuto la hypoglycemic la glimepiride limatha kukula komanso kuchepa.

Gwiritsani ntchito ndi bile acid sequestrants: kwa gudumu lokonda, kulumikizana ndi glimepiride, kumachepetsa kuyamwa kwake kuchokera m'matumbo am'mimba, pogwiritsa ntchito glimepiride maola 4 musanatenge mawu ogwiritsira ntchito gudumu.

Mankhwala otsatirawa ndi fanizo za Amaril: Glemaz, Glymedeks, Meglimid, Diamerid, Glemauno.

Ndemanga za Amaril

Kafukufuku wa Amaril akuwonetsa kuti chinsinsi chogwiritsira ntchito mankhwalawa ndikusankhidwa koyenera kwa mankhwalawo komanso mtundu wa mankhwala. Nthawi yomweyo, malipoti ena ali ndi chidziwitso kuti poyambira kutenga Amaril mwa odwala, kuchuluka kwa shuga m'magazi kunasintha kwambiri. Malinga ndi akatswiri, izi zitha kuthana ndi kusintha kwamankhwala ndi dokotala (osavomerezeka ndi mankhwalawa, chiwopsezo chokhala ndi zovuta za matendawa chimakulanso).

Yaikulu katundu mankhwala

Chofunikira chachikulu chomwe ndi gawo lamankhwala - glimepiride (dzina lachi Latin - Glimepiride) chimathandizira kutulutsidwa kwa insulin.

Chifukwa cha gawo ili, mankhwalawa ali ndi pancreatic.

Ndi kutulutsidwa kwa mahomoniwo m'maselo a beta, kuchepa kwakukulu kwa shuga m'magazi kumachitika. Njira yofananira yogwirira ntchito imalumikizidwa ndi kusintha kwa chidwi cha maselo a beta ku glucose.

Kuphatikiza pazomwe zimagwiritsidwa ntchito, zinthu zotsatirazi zimaphatikizidwa ndikuphatikizidwa kwa mankhwala:

• povidone
• lactose monohydrate,
• indigo carmine
• magnesium wakuba,
• microcrystalline mapadi.

Kuphatikiza apo, mankhwalawa amawongolera kupanga mahomoni a pancreatic. Ichi ndi chifukwa cha kulumikizana kwa glimepiride ndi metformin ndi njira za potaziyamu pa membala wa cell wa beta. Kumangika kwa gawo logwira ntchito kumapuloteni kumayendetsa zochitika zamsewu, ndiko, kutseka ndi kutsegulira.

Amaryl ili ndi extrapancreatic zotsatira - imasintha kugwiritsidwa ntchito kwa insulin ndi minofu ndi minyewa ya adipose. Izi zimachitika chifukwa chotseka njira ziwiri za potaziyamu mu membrane wa cell ndi kuchuluka kwa calcium m'maselo. Mphamvu ya extrapancreatic imapangitsa kuchepa kwa insulin kukana, komanso zimakhudza pang'ono kugwira ntchito kwa mtima ndi mitsempha yamagazi.

Kuphatikizika kwakukulu kwazinthu zomwe zimagwira ntchito kumatheka ndi kugwiritsa ntchito pafupipafupi. Mwachitsanzo, mukamatenga 4 mg ya glimepiride patsiku, kupindika kwakukulu kumatheka mu maola a 2,5.

Kumwedwa kwathunthu kwa mankhwalawa kumatheka pokhapokha atamwa. Kudya chakudya kumachepetsa njira yogwiritsira ntchito mankhwalawa, koma izi sizothandiza. Excretion wa glimepiride amadutsa matumbo ndi impso.

Mndandanda wazowonetsa ndi zotsutsana za kuvomerezedwa

Amaryl ali ndi zizindikiro zotsatirazi kuti agwiritse ntchito. Njira yayikulu ndiyo chithandizo cha matenda ashuga amtundu wa 2. Amaril ndi oyenera onse kwa odwala omwe safuna jakisoni wa insulin, komanso kwa iwo omwe akuwonetsedwa insulin kuti akhale bwino.

Pochiza matenda a shuga, mapiritsi a Amaryl amalembedwa makamaka ngati mankhwala oyenera. Koma ndi osakwanira kagayidwe kazakudya (makamaka ngati wodwala amupatsa mankhwala), Glimepiride osakanikirana ndi Metformin ndi mankhwala. Izi zitha kusintha bwino kagayidwe ka metabolic. Poterepa, zotsatira zake zimakhala bwino poyerekeza ndi zomwe zidapezeka ndi mitundu yina ya mankhwala.

Zotsatira zabwino zomwe zidachitika chifukwa cha zovuta kuzipatala pogwiritsa ntchito Glimepiride ndi Metformin zidapangitsa kuti mankhwalawa apangidwe Amaryl M. Mankhwala amapatsidwa mankhwalawa ngati chithandizo cha matenda osokoneza bongo omwe ali ndi mankhwala ovuta, nchofunika kwa odwala.

Amaril yotsitsa shuga imatha kumwa odwala omwe amafunika jakisoni wa insulin nthawi zonse. Nthawi yomweyo, kagayidwe kachakudya kamakonzanso bwino, koma mlingo wa glimepiride tikulimbikitsidwa kuti ukhale wotsika.

Monga mankhwala aliwonse, mankhwalawa sangatchulidwe kuti ndi otetezeka. Amaril ali ndi zotsutsana, ndipo mndandanda wawo ndi waukulu.

Choyamba, tikulimbikitsidwa kusamala kumwa mankhwalawo panthawi yoyamba ya chithandizo: panthawiyi, pali chiwopsezo cha kuchepa kwambiri kwa glucose. Ngati patapita nthawi chiopsezo cha hypoglycemia chikadalipo, tikulimbikitsidwa kusintha njira ina kapena chithandizo cha Amaril. Muyenera kusamala komanso ndi matenda ena, moyo wosayenera, zakudya zopanda thanzi.

Matenda otsatirawa (kapena machitidwe a thupi) ndizopinga zazikulu pakusankhidwa kwa Amaril:

1. Matenda a shuga kapena kholo.
2. Ketoacidosis.
3. Matenda akulu a chiwindi ndi impso.
4. Kusalolera kapena hypersensitivity kwa zigawo zikuluzikulu za mankhwala.
5. Matenda operewera (kusakhazikika kwa lactose, kuchepa kwa lactase, ndi zina).
6. Mimba Pakukonzekera kutenga pakati, njira yochiritsira imayenera kusinthidwa. Wodwalayo amapatsidwa jakisoni wa insulin, mankhwalawa sanadziwike.
7. Panthawi yoyamwitsa, chithandizo cha insulin chimapitilira. Ngati chifukwa chilichonse mankhwalawa sakhala oyenera, Amaril amaperekedwa kwa wodwala, koma tikulimbikitsidwa kuti asiye kuyamwa.

Mankhwala samatchulidwa pochiza matenda a shuga a mtundu woyamba. Chotsutsana kwathunthu ndi zaka za ana. Palibe zambiri zamankhwala zololeza mankhwala kwa ana.

Chifukwa chake, mankhwalawa amathandizira ana odwala matenda ashuga.

Zotsatira zoyipa za kugwiritsa ntchito mankhwalawa

Chifukwa chotenga Amaril, zotsatira zoyipa zimatha kuchitika.

Nthawi zina, pamakhala mwayi wogwira bwino ntchito ziwalo zosiyanasiyana za thupi.

Pa gawo la kagayidwe, kusintha kwa hypoglycemic kumawonedwa. Nthawi zambiri zimachitika mwachangu, koma ndizovuta kuchiza.

Mapiritsi ena a shuga amayambitsa kusokonezeka kwa chapakati mantha dongosolo.

Omwe amatenga Amaryl ali ndi zofanana ndi izi:

• chizungulire
• chidwi
• kuphwanya mgwirizano
• kuchedwetsa chochitikacho
• kugona kuwonongeka
• chisokonezo kapena kutayika kwa chikumbumtima
• dziko lokhumudwa
• kusokonekera kwa mawu
• mantha, nkhawa, ndi zina zambiri.

Zotsatira za kumwa mankhwalawa ndikuphwanya chakudya cham'mimba ndizambiri. Amatha kuwonetsedwa ndi kupweteka m'mimba kapena m'mimba, nseru, kutsegula m'mimba, kusanza, kuchuluka kwanjala.

Chifukwa cha zotsatira za glimepiride, kutsika kwa glucose kumatha, komwe kungayambitse vuto la ziwalo zam'maso, zomwe zingayambitse kuwonongeka kwa mawonekedwe.

Mankhwalawa amakhudza njira zopangira magazi, zomwe zimatha kuyambitsa zovuta monga:

1. Anemia
2. Supombocytopenia (yamitundu yosiyanasiyana).
3. Pancytopenia.

Zocheperako ndizomwe zimachitika kawirikawiri:

• kuyabwa
• zotupa pakhungu
• redness pakhungu,
• vasculitis.

Mukamwa mankhwala a Amaril, zizindikiro za ziwengo zimakonda kufatsa ndipo zimadutsa mwachangu ndi chithandizo choyenera.

Koma ndikofunikira kwambiri kuyambitsa chithandizo munthawi yake: kuopsa kwa anaphylactic kukutsalira.

Malangizo ogwiritsira ntchito mankhwalawa

Kugwiritsa ntchito bwino ndikosatheka popanda kutsatira malangizo ogwiritsira ntchito Amaril. Lamulo lalikulu la kayendetsedwe kake ndikuti phalepo lisaphwanyidwe. Tengani piritsi la Amaril 3 kwathunthu, ndi madzi ambiri kuti mukhale kosavuta kumeza.

Mulingo woyenera kwambiri wa Amaril amawerengedwa payekhapayekha kwa wodwala. Chinsinsi chachikulu chomwe chimagwiritsidwa ntchito popereka mankhwalawa ndicho kuchuluka kwa shuga m'magazi. Mlingo wochepetsetsa womwe umatchulidwa womwe ungathandize kuteteza matenda a metabolic. Kuphatikiza pa kuchuluka kwa glucose, mu gawo la malangizo momwe mungagwiritsire ntchito mankhwalawa kumawonetsa kuti kuwunika nthawi zonse osati kuchuluka kwa glucose, komanso hemoglobin ya glycated ndiyofunikira.

Pakhoza kukhala zochitika zina pomwe wodwalayo adayiwala kutenga mapiritsi a Amaril panthawi. Zikatero, kubwezeretsanso kuchuluka kwa mankhwalawa pochulukitsa kuchuluka sikulimbikitsidwa. Nthawi zambiri mulingo womwewo umakhala wofanana, mapiritsi osowa sawonjezedwanso. Ndikwabwino kukambirana ndi adokotala pasadakhale za zomwe zingachitike munyengo zotere.

Pa gawo loyamba la chithandizo, odwala amapatsidwa Amaryl 1 mg patsiku. Popita nthawi, ngati kuli kotheka, kuwonjezeka kwapang'onopang'ono kwa mlingo wa mankhwalawa ndi 1 mg ndikuloledwa, choyamba mpaka 6 mg patsiku, kenako mpaka 8 mg. Ndi ulamuliro wokhazikika wa matendawa, mulingo woyenera sapitilira 4 mg pa tsiku. Mlingo waukulu wopitilira 6 mg pa tsiku sukonzanso bwino. Kuchuluka kwa mankhwalawa mu 8 mg ndi mankhwala ochepa.

Kusiyanitsa pakati pa kuchuluka kulikonse kwa mlingo kumatsimikiziridwa ndi momwe wodwalayo alili ndi kuchuluka kwa kuchuluka kwa mankhwalawa omwe amwedwa, koma sayenera kukhala ochepera milungu iwiri.

Ndikofunikira kumwa mankhwala mukatha kudya, chifukwa mwanjira ina hypoglycemia ingachitike.

Mankhwala a Amaryl M ophatikizidwa amayenera kumwedwa molingana ndi mfundo yomweyo. Mlingo wa mankhwalawa womwe udanenedwa ndi mankhwala udagawidwa pawiri: m'mawa ndi madzulo, kapena amwedwa nthawi yomweyo. Nthawi zambiri, odwala amalimbikitsidwa kutenga Amaril 2m + 500 mg.

Kuchuluka kwa Amaril kuchokera ku matenda ashuga odwala okalamba amasankhidwa mosamala kwambiri, ndipo chithandizo chimachitika ndikuwonetsetsa impso.

Zowonjezera zamankhwala

Popereka Amaril kapena Amaril M, dokotala sayenera kungopereka malangizo a mankhwalawa moyenera, komanso kuchenjezanso za zovuta zomwe zingachitike. Chisamaliro makamaka chiyenera kuperekedwa ku chiwopsezo cha hypoglycemia, chomwe chingayambike ngati wodwalayo angaiwale kudya atangomaliza kumwa Amaril. Kuti mupewe hypoglycemia, ndibwino kukhala ndi chidutswa cha shuga kapena maswiti nanu.

Kuphatikiza pa kuchuluka kwa shuga komanso kuchuluka kwa shuga mumkodzo, wodwalayo ayenera kuyang'ana momwe impso ndi chiwindi zimagwirira ntchito.

Funso lodziwika ndiloti ngati ndizotheka kumwa mowa panthawi yamankhwala ndi Amaril. Ndikofunika kukumbukira kuti mowa nthawi zambiri umalekeredwa bwino pa mankhwala a shuga ndipo sungaphatikizidwe ndi mankhwala ambiri. Amaril nawonso ndi a amenewo. Zotsatira za kumwa mankhwala ndi mowa nthawi yomweyo zimatha kukhala zosayembekezeka. Nthawi zina, mphamvu ya mankhwalawo imakhala yokwezeka, ndipo mwa ena imachepetsedwa kwambiri. Chifukwa chake, mukalandira chithandizo, muyenera kusiya mowa ndi mankhwala omwe amamwa mowa.

Ponena za kulumikizana kwa Amaril ndi mankhwala ena, chilichonse pano chimatengera mtundu wa mankhwalawa. Kutenga mankhwala ena kumathandizira kukonza kwa Amaril, ena - kumachepetsa. Mndandanda wa onse omwe ndi mankhwala ena ndiwowonjezera. Chifukwa chake, ngati ndi kotheka, imwani mankhwala ena, ndikofunikira kudziwitsa dokotala yemwe akupezekapo za matendawa ndi mankhwala omwe amwe. Poterepa, adotolo azitha kusankha mankhwalawa omwe sangakhale ndi chidwi chambiri pakugwira ntchito kwa Amaril.

Zotsatira zilizonse zoyipa zikachitika, muyenera kusiya kumwa mankhwalawo ndi kupita kwa dokotala.

Dokotala yekha ndi amene angalimbikitse ma analogi a Amaril oyenera.

Ndemanga za mankhwala

Pogwiritsa ntchito Amaryl pa matenda a shuga a 2, ndemanga zinalandira kuchokera kwa odwala ambiri. Izi zikutsimikizira kuti, ngati mulingo woyenera, mankhwalawa amalimbana ndi hyperglycemia.

Kuphatikiza pakuchita bwino, ogula ambiri adatcha mitundu yosiyanasiyana ya mapiritsiyo ngati abwino a mankhwalawa - izi zimathandiza kuti asasokoneze mankhwalawo ndi mlingo wosiyana wa glimepiride.

Ndemanga zomwe zalandiridwa pa Amaril sizinangotithandizanso, komanso zovuta zomwe zawonetsedwa m'malamulo opita ku Amaril.

Nthawi zambiri, odwala omwe amamwa mankhwalawa amawonetsa zizindikiro za hypoglycemia:

1. Zofooka.
2. Kutentha.
3. Kugwedezeka thupi lonse.
4. Chizungulire
5. Kuchulukitsa chilakolako.

Nthawi zambiri, chifukwa cha hypoglycemia mu shuga mellitus, pamakhala ngozi yotaya chikumbumtima. Chifukwa chake, iwo omwe amatenga Amaril amayenera kumanyamula nthawi zonse zinthu zokhala ndi shuga (mwachitsanzo, maswiti), kuti, ngati zingafunike, azitha kuwonjezera misanga yawo ndikupanga thanzi. Komabe, malinga ndi madotolo, kusintha kwa mulingo wa shuga sichizindikiro cha kusathandiza kwa mankhwalawa. Zizindikiro zotere zikawoneka, ndikokwanira kusintha mlingo.

Vuto lodziwika kwa madalaivala omwe amakakamizidwa kuti achite ma hypoglycemic othandizira limakhala likuipiraipira poyendetsa galimoto. Zotsatira zoyipa zofananazo zikuwonetsedwa mu malangizo omwe ali mndandanda wazotsatira zoyipa. Kutsika kwake kumachitika pofotokoza chifukwa cha glimepiride yamatsenga.

Mwa odwala omwe ali ndi matenda akale a shuga, mu ndemanga ya Amaril, ambiri adanenanso za vuto limodzi: ngakhale kuti Amaril amatsitsa shuga, mankhwala a shuga ndiokwera mtengo kwambiri, chifukwa mankhwalawa amatha kukhala ndi ndalama zambiri kuposa ena kupanga.

Mtengo ndi fanizo la mankhwala

Mutha kugula Amaril mu pharmacy yokhazikika yamzinda, koma pali phanga limodzi: silikugulitsidwa. Monga mankhwala ena othandizira odwala matenda ashuga, muyenera kupereka mankhwala kuti mugule Amaryl.

Funso lina lodziwika lomwe limasangalatsa anthu ambiri odwala matenda ashuga ndiloti Amaril amawononga ndalama zingati. Mtengo wa mankhwalawa zimadalira kuchuluka kwa mapiritsi omwe ali mumapakewo ndi kuchuluka kwa mankhwalawa. Chifukwa chake, mwachitsanzo, phukusi la mankhwalawa limakhala ndi mapiritsi 30, kutengera mlingo, kuchokera kuma ruble 200 mpaka 850. Nthawi yomweyo, Amaril 1 mg amawononga ma ruble a 230-280, ma CD a Amaril mapiritsi 2 mg - 450-560 rubles, 3 mg - kwa ma ruble 630-830. Mapiritsi okwera mtengo kwambiri Amaril 4 mg 90 pcs. - zimawononga ma ruble 870-1080.

Amaril M angagulidwe ndi ma ruble 570-600. Ndikofunikira kulingalira kuti pamtengo wotere mutha kugula mapiritsi a Amaril 2mg + 500 mg. Ndizovuta kwambiri kupeza mlingo wocheperako (1 mg + 250), chifukwa nthawi zambiri samayikidwa ndi madokotala, ndipo mwakutero, sagulitsidwa kwenikweni.

Pali mankhwala ambiri amomwemo. Ma fanizo ofala kwambiri:

Mwachitsanzo, Amaril nthawi zambiri amasinthidwa ndi mankhwala Gliclazide (pln - Gliclazide). Ilinso m'gulu la sulfanylurea. Kuphatikizika kwa mankhwala kumaphatikizapo chokhacho chothandizira - gliclazide ndi zina zowonjezera. Mankhwalawa amakhudza maselo a beta, akusintha kupanga insulin. Kuphatikiza apo, mankhwalawa amathandizira ndi edema, monga momwe magazi amasinthira, amalepheretsa kuphatikizika kwa magazi, potero amachepetsa chiopsezo cha thrombosis ndi zovuta zina.

Zomwe mankhwala a hypoglycemic ndi othandiza kwambiri angauze katswiri muvidiyoyi.

Mankhwala a Amaril

Mankhwalawa ndi am'chipatala komanso am'magulu a mankhwala a pakamwa a hypoglycemic a m'badwo wachitatu sulfonylurea. Amaryl amakhala atatenga nthawi yayitali. Kuphatikizidwa, limodzi ndi zotsatira zazikulu za antioxidant kanthu komanso kuthana ndi mtima wamagetsi, kunapangitsa kuti mankhwalawa agwiritsidwe ntchito kwambiri pothana ndi matenda amtundu wa 2 osagwirizana ndi matenda a metformin monotherapy.

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwala amaperekedwa pamsika mumitundu inayi yamasulidwe, iliyonse yomwe imapangidwira chithandizo cha matenda a shuga, kutengera mtundu wa wodwalayo:

1. Amaryl, 1 mg: mapiritsi a pinki oblong a fomu yosalala, mbali zonse ziwiri pali chiopsezo chogawana, chilembo "h"Ndipo lolemba" NMK ".
2. Amaril, 2 mg: magome obiriwira obiriwira a mawonekedwe osyasyalika, mbali zonse pali chiopsezo chogawanitsa, chilembo "h"Ndipo lolemba" NMM ".
3. Amaril, 3 mg: mapiritsi achikasu achikasu ndi mapiritsi a mawonekedwe amiyala, mbali zonse ziwiri pali chiopsezo chogawana, zilembo "h" ndi lolemba "NMN".
4. Amaril, 4 mg: mapiritsi abuluu oblong, mawonekedwe osalala, mbali zonse ziwiri pali chiopsezo chogawana, zilembo "h" ndi zolemba "NMO".

lactose monohydrate, sodium carboxymethyl wowuma, povidone, microcrystalline cellulose, magnesium stearate, utoto wofiirira ndi wachikasu chitsulo okusayidi, indigo carmine

Mlingo ndi makonzedwe

Amaryl amatengedwa pakudya kapena musanadye, asamba ndi madzi. Pa gawo loyamba la kuvomereza, pamakhala chiopsezo cha hypoglycemia, kotero kuyang'anira kwa adokotala ndikofunikira. Mlingo wa glimepiride umatsimikiziridwa ndi zotsatira za kudziwa kuchuluka kwa shuga mu mkodzo ndi magazi. Kulandila kumayamba ndi piritsi limodzi (1 mg glimepiride) patsiku. Kupitilira apo, pamene vuto la glycemic control likupezeka, mlingo umakwera mpaka 2 mg kapena kupitilira. Kutalikirana pakati pa kuwonjezeka ndi masabata 1-2. Mulingo waukulu ndi 6 mg tsiku lililonse. Mankhwala osakanikirana a insulin amangoperekedwa ndi adokotala.

Mowa ndi Amaryl

Mankhwalawa amakhudza kwambiri shuga. Izi zimapangidwanso pakukonzanso kwakukulu mothandizidwa ndi mowa. Zotsatira za hypoglycemic zitha kuchuluka kapena kuchepa, ndipo ndizovuta kulosera zomwe zawonetsedwa, zomwe zimapangitsa kuti oletsedwa asamwe mowa pamene akumwa mankhwalawo.

Zofananira za Amaril

Mankhwala othandizira omwe amapezeka pano akuphatikizapo mankhwala a sulfonylurea ogwirizana ndi matenda a shuga a mtundu wachiwiri. Analogs of means:

• Glimepiride - mankhwala okhala ndi dzina lofanana,
• Diagninide - mankhwala ochepetsera shuga omwe amachokera paziphuphu,
• NovoNorm - mankhwala ochokera kunja, akuphatikizanso repaglinide,
• Glidiab - mankhwala achi Russia ozikidwa pa glimepiride,
• Diabetes ndi mankhwala ochokera kunja kwa matenda ashuga.

Amaril kapena Diabeteson - zomwe zili bwino

Mankhwala onsewa amapatsidwa mtundu wachiwiri wa matenda a shuga ndipo amapezeka piritsi. Amasintha matendawa kuti apange insulin, amalimbikitsa kumva kukoka kwa minofu, mafuta am'munsi komanso chisonyezo cha nthawi kuchokera pakudya kupita ku kutulutsidwa kwa insulin. Ngati wodwala wasokoneza ntchito yaimpso, mankhwalawa amachepetsa mapuloteni mu mkodzo. Kusiyana pakati pa mankhwala ndi mtengo - Diabeteson ndiyotsika mtengo.