CHISONI

Glycidone ndi glipizide - oimira mankhwala ochepetsa shuga ochokera ku gulu la sulfonylurea. Kodi glycidone kapena glipizide amachita zinthu ziti? Mupeza yankho m'nkhani ya lero. Moni abwenzi! Lero ndikufuna kumaliza kulankhula za mankhwala a gulu la sulfonylurea, koma osati za mankhwala ochepetsa shuga ambiri, popeza pali magulu ochepa omwe sanaperekedwe ndi chidwi changa.

Monga mukukumbukira, ndalemba kale za oimira gulu lalikululi m'mabuku a "Diabeteson MV kapena Gliclazide", "Glimepiride pothana ndi matenda a shuga 2", komanso za maninil munkhani yolembedwa kuti "Mankhwala ochepetsa shuga m'moyo wa munthu wodwala matenda ashuga," ngati ngati simunawerenge chilichonse, ndikupemphani.

Glycvidone ndi glipizide si mankhwala otchuka kwambiri pochiza matenda a shuga. Amawerengedwa ngati mankhwala osokoneza bongo ochepetsera shuga, ngakhale makina ochita glycidone ndi glipizide ali ofanana ndi anzanga amphamvu kwambiri: mannil kapena shuga. Ndiye kuti, amathandizanso maselo a pancreatic beta, kukulitsa katemera wa insulin. Mankhwalawa onse samadziwika ngati monotherapy, nthawi zambiri monga gawo la mankhwala ophatikiza.

Zachidziwikire, mayina "glycidone", "glipizide" ndi osagwirizana ndi mayiko ena onse, ndipo mu pharmacy mungathe kuwapeza pansi pa mayina ena ogulitsa kale.

Glycvidone = Glenrenorm

Glycvidone nthawi zambiri amapezeka pansi pa dzina la Glyurenorm, koma mutha kupeza mankhwala okhala ndi dzina lofananira lapadziko lonse lapansi. Amapezeka pamapiritsi pa 30 mg. Mlingo woyambirira ndi piritsi 1/2 patsiku, ndiye kuti muyezo ndi / kapena pafupipafupi wa makonzedwe umakulitsidwa pang'onopang'ono. Mulingo waukulu wa glurenorm ndi mapiritsi 4 patsiku (120 mg / tsiku). Mankhwalawa amatengedwa mphindi 30 asanadye, kuti amalore ndi kuyamwa. Kuchuluka kwa chochitikachi kumachitika pachimake pakulowetsedwa kwa chakudya - pambuyo pa maola 1.5-2, nthawi yochitapo kanthu ili pafupifupi maola 8-10.

Mbali yodziwika bwino ya glycidone ndikuti imapangidwira kwathunthu m'chiwindi ndikufukuka m'matumbo. Kudzera impso, ndi 5% yokha ya mankhwalawa omwe amachotsedwa, zomwe zimapangitsa kuti odwala omwe ali ndi vuto la impso azigwiritsa ntchito mopanda mantha.

Popeza mankhwalawo alibe mphamvu zambiri, angagwiritsidwe ntchito poyambira kwa matenda a shuga a odwala popanda kulemera kwambiri, pomwe kuchuluka kwa shuga m'magazi sikokwanira kwambiri. Ngati glurenorm sangathe, mankhwala ena kuchokera pagululi amatchulidwa, kapena amasinthidwa ndi mankhwala ochokera ku gulu lina.

Monga mankhwala onse ochepetsa shuga, glycidone ali ndi zotsutsana zomwezo:

• mtundu 1 shuga
• mimba
• kuyamwa
• ketoacidosis kapena ketoacidotic chikomokere

• hypoglycemia (shuga wotsika wamagazi)
• kusanza
• kusowa kwa chakudya
• thupi lawo siligwirizana
• leukopenia
• mutu

Glipizide = minidiab

Mutha kupeza glipizide muma pharmacie pansi pa dzina "minidiab" kapena "glibenesis." Piritsi lokha ndilapadera. Ili ndi piritsi lokhala ndi mphamvu yotulutsa zinthu zomwe zimagwira, i.e., yogwira - glibenesis, imatulutsidwa pang'onopang'ono, kudutsa njira yayitali yamatumbo, potero imapereka kuchepa kosavuta kwa shuga m'magazi ndikuwonjezera. Zofanana zimawonedwa mu matenda a shuga.

Glipizide imapezeka m'mapiritsi a 5 mg. Imayamba kugwira ntchito pambuyo pa mphindi 15-30, motero ndikofunikira kuti muzitenga mphindi 15-30 musanadye. Kuchuluka kwake kumachitika pambuyo pa maola 1.5-2, kumatsalira m'magazi mpaka maola 20. Zotsatira zake zimawerengeka patatha maola awiri mutatha kudya ndi mita ya shuga m'magazi.

Yambani kutenga 5 mg patsiku, pang'onopang'ono kukulira kutengera mlingo wa glycemia. Mlingo wambiri watsiku ndi tsiku uli mpaka 40 mg. Mlingo wa tsiku ndi tsiku utha kugawidwa mu Mlingo wa 2-3.

Contraindication ndi zoyipa ndizofanana ndi glycidone (glurenorm).

Monga ndidanenera kale, mankhwalawa amagwira ntchito bwino kwambiri molumikizana ndi mankhwala ena a antipyretic ochokera m'magulu ena. Mwachitsanzo, ndibwino ndi metformin, mlingo womwe umatsimikiziridwa ndi adokotala, komanso thiosalidinedione (actos, avandium) kapena insulin.

Mwambiri, izi ndi zonse zomwe ndimafuna kunena za glycidone ndi glipizide. Ndi chidziwitso ichi, mutha kuwunika momwe mankhwalawo amagwiritsidwira ntchito ndipo ngati sangathe, asintheni kukhala mankhwala amphamvu. Kunena zowona, sindinkawagwiritsa ntchito mankhwalawa, nthawi zambiri matenda a shuga.

Koma m'magawo osiyanasiyana omwe amapitilira mu njira zosiyanasiyana, ndizotheka kuti kuwonjezera pa iwo mulibe china chokwanira chodziwitsa dokotala. Zimachitika kuti mankhwalawa akukwanira bwino ndipo mulingo wotsekemera wamagazi ndi okhazikika, ndiye kuti simukuyenera kuyang'ana zabwino kuchokera pazabwino, koma modekha mankhwalawa.

Mwa njira, ndayiwaliratu kusiya ulalo womwe unalembedwa pamankhwala aposachedwa a matenda ashuga kwa iwo omwe sanawerengebe ndipo adakhala koyamba pa blog. Nkhaniyi ndi "Kuongolera Malangizo Pachithandizo Cha Matenda A shuga."

Kodi mumakonda bwanji nkhaniyo? Ndidzakondwera kwambiri ngati mungagawane ndi anzanu kudzera pazinthu zothandizira anthu. ma network kuti iwo omwe akufunika, ngati inu, alandire zofunikira zokhudzana ndi matenda a shuga. Kuti muthe kukhala bwino, pansi pa nkhaniyi pali mabatani amawu ochezera kwambiri otchuka. ma ntaneti omwe mungalembetsedwe kale.

Ndi chisangalalo ndi chisamaliro, endocrinologist Dilara Lebedeva

Zotsatira za pharmacological

Glipizide - wothandizira pakamwa wa hypoglycemic, amatanthauza za zotumphukira za m'badwo wachiwiri. Imathandizira kubisika kwa insulin ndi beta-endocrinocyte ya kapamba, kumawonjezera kutulutsidwa kwa insulin.

Zimawonjezera kukhudzika kwa minofu ku insulin. Ili ndi hypolipidemic, fibrinolytic katundu, imalepheretsa kuphatikiza kwa maselo ambiri. Kuchitikaku kumayambira mphindi 10-30 mutamwa mankhwalawa.

Type 2 shuga mellitus (ndi kulephera kwa zakudya mankhwala).

Kugwiritsa

Mlingo umayikidwa payekha kutengera chithunzi cha matenda. Mlingo woyamba wa tsiku lililonse ndi 2.5-5 mg. Mlingo umodzi wambiri ndi 15 mg. Mlingo wapamwamba wa tsiku ndi tsiku ndi 45 mg. Pafupipafupi makonzedwe ndi 2-4 r / tsiku 30 mphindi asanadye.

Mukamapereka mankhwala a glipizide atatha kugwiritsa ntchito insulin kapena ma hypoglycemic othandizira, kudya mwachangu kwa glipizide m'magazi kuyenera kuganiziridwa ndipo mlingo uyenera kuyendetsedwa molingana ndi msinkhu wa glycemia 2-4 r / tsiku m'masiku 4-5 oyamba. Ndi chitukuko cha hypoglycemia, ngati wodwalayo akudziwa, shuga (kapena yankho la shuga) amapatsidwa mkati.

Pofuna kutaya chikumbumtima, glucose wamitsempha kapena glucagon sc, intramuscularly kapena kudzera m'mitsempha amathandizira. Pambuyo podziwikanso, ndikofunikira kuti wodwalayo adye chakudya chamagulu ambiri kuti mupewe kukonzanso kwa hypoglycemia. Ndi kuvulala, matenda oopsa, kulowererapo kwakukulu, wodwalayo ayenera kusamutsidwa kuti azigwiritsa ntchito insulin.

Zotsatira zoyipa

- Osowa - hypoglycemia (makamaka okalamba, odwala ofooka, osakhazikika pakudya, kumwa mowa, chiwindi ndi impso), zizindikiro za dyspeptic, kupweteka kwa mutu, komwe kumatha ndi kusintha kwa mlingo.

- Ma khungu a khungu samachitika kawirikawiri, amakhala ndi mawonekedwe osakhalitsa, kusiya mankhwala sikofunikira.
- Ndi osowa kwambiri - hematopoiesis.

Zambiri pazambiri

Ichi ndi chipangizo chopangira hypoglycemic.

Glipizide siyingasungunuke m'madzi kapena mowa, komabe, yankho la NaOH (0,1 mol / L concentration) ndi dimethylformamide sungunulani gawo ili bwino. Izi zimapangidwa m'mapiritsi wamba komanso mapiritsi olanditsa.

Mankhwala akangolowa m'thupi la odwala matenda ashuga, amalimbikitsa kutulutsa kwa insulin pogwiritsira ntchito maselo a beta.

Glipizide amachita motere:

1. Amachepetsa shuga ndi glycosylated hemoglobin pamimba yopanda kanthu.
2. Amawonjezera kulolera kwa glucose, komanso mpaka pang'ono - chilolezo chamadzimadzi aulere.
3. Amachepetsa mwayi wa hyperglycemia mukatha kudya.

Chosakaniza chogwira sichikhudza metabolidi ya lipid. Kutsegulira kwake kumayamba pambuyo pa mphindi 30 kuvomerezedwa ndikupitilira tsiku lonse. Kuzindikira kwakukulu kwa chinthu kumawonedwa pambuyo pa maola atatu ndi atatu pakumwa.

Tiyenera kudziwa kuti Glipizide ndibwino kuti musagwiritse ntchito mukamadya, popeza mayamwidwe ake onse amayamba kuchepa. Kuphatikizika kwa zinthu kumachitika m'chiwindi.

Gawolo limapukusidwa monga metabolite limodzi ndi ndowe ndi mkodzo, kuphatikizapo osasinthika - pafupifupi 10%.

Malangizo ogwiritsira ntchito

Musanagwiritse ntchito zokonzekera zomwe muli ndi glipizide, muyenera kufunsa dokotala kapena endocrinologist. Ndi dokotala yekha yemwe angawunikenso moyenera kugwiritsa ntchito chida china.

Mukamagula mankhwalawo, muyenera kuwerenga kabuku kosamalitsa mosamala. Mlingo woyambirira ndi 5 mg, womwe umaperekedwa kamodzi patsiku asanadye kapena pambuyo chakudya. Popita nthawi, mukakhala ndi thanzi labwinobwino la shuga, mulingo ungathe kuchepetsedwa mpaka 15 mg, ndikugawa makonzedwe a mankhwalawa kangapo.

Malangizowo akuti ngati mankhwalawo adaphonya, koma maola angapo atadutsa kale momwe mulili, mankhwala ayenera kutumikiridwa mwachangu. Koma ngati tsiku latha, muyenera kutsatira njira zonse zamankhwala.

Odwala okalamba komanso odwala matenda a chiwindi ayenera kugwiritsa ntchito mankhwalawa osachepera - 2,5 mg patsiku, ndi mapiritsi a nthawi yayitali - kuyambira 5 mpaka 10 mg kamodzi, makamaka m'mawa.

Monga mankhwala ena onse, Glipizide iyenera kusungidwa kutali ndi ana m'malo otetezedwa kuti asakhale ndi chinyezi kutentha kwa firiji.

Contraindication ndi zomwe zingavulaze

Mitundu ina ya odwala matenda ashuga sangathe kulandira mankhwalawa.

Malangizo omwe aphatikizidwa ali ndi contraindication okhudzana ndi kukhudzidwa ndi vuto la munthu, matenda ashuga, mtundu wodwala wa insulin, ketoacidosis, malungo, opaleshoni yaposachedwa, pakati komanso nthawi yoyamwitsa.

Muzovuta kwambiri, kugwiritsa ntchito Glipizide ndikotheka pakubala kwa mwana. Koma kugwiritsa ntchito kwake kuyenera kuti kuthetsedwe mwezi umodzi tsiku lobadwa lisanachitike.

Pa yoyamwitsa, kumwa mankhwalawa ndizoletsedwa.

Kufunsidwa kwa dokotala musanagwiritse ntchito Glipizide ndikofunikira, chifukwa kuperewera molakwika kwa mankhwalawa kumatha kubweretsa zotsatirapo zambiri zosavomerezeka:

• mutu, kusokonezeka kwa chikumbumtima, kutopa, kutaya mtima, chizungulire, kupsinjika, paresthesia, nkhawa, kupweteka kwa m'maso ndi conjunctivitis,
• kusanza, mseru, kusanza, zosayenera zamagazi mundulu, kudzimbidwa, dyspepsia ndi anorexia,
• kuyabwa, zotupa ndi ming'oma,
• pharyngitis, rhinitis ndi dyspnea,
• mogwirizana ndi mtima dongosolo ndi magazi mapangidwe: arrhythmia, syncope, kudziwa kutentha kwamphamvu ndi matenda oopsa,
• komanso glycemia wa mtundu 2 wa shuga wambiri mpaka kukomoka kwa glycemic.
• zokhudzana ndi genitourinary system: utachepa chilakolako chogonana komanso dysuria.

Kuphatikiza apo, zovuta zina zimatha - kupweteka, ludzu losatha, myalgia, arthralgia, thukuta, kupweteka kwa thupi.

Mtengo, ndemanga ndi fanizo

Popeza glipizide ndichinthu chogwira ntchito, mankhwala ambiri okhala ndi zoterezi amatha kupezeka pamsika wa Russia. Mwachitsanzo, Glucotrol CL ndi Glibenez Retard. Kutengera mtundu wa kumasulidwa, mtengo wa mankhwalawa Glucotrol CL umachokera ku rubles 280 mpaka 360, ndi Glibenez Retard - kuchokera ku ruble 80 mpaka 300.

Ndemanga za anthu ambiri odwala matenda ashuga omwe adamwa mankhwalawa ndizokhutiritsa. Komabe, ambiri adazindikira kuti achire zotsatira za glipizide zimatsika pakapita nthawi, chifukwa chake nthawi zambiri zimagwiritsidwa ntchito limodzi ndi mankhwala ena a matenda ashuga. Mwa zabwino za mankhwalawa amatha kusiyanitsidwa mosavuta ndikugwiritsa ntchito mitengo yokhulupirika ya mankhwala omwe ali ndi glipizide.

Mu milandu ngati mankhwala amodzi sangakhale oyenera chifukwa chophatikizana kapena kusachita bwino, dokotala amakupatsani analogue. Mankhwalawa akuphatikizapo:

Popanda kuvomerezedwa ndi dokotala, kudzipereka nokha sikofunika. Kukonzekera komwe kumakhala ndi glipizide kumatha kukhala osokoneza thupi. Mukamagwiritsa ntchito moyenera mankhwalawa, mutha kusintha kuchuluka kwa shuga ndikuchotsa zizindikiro za matenda ashuga. Komanso sitiyenera kuyiwala zamankhwala olimbitsa thupi a shuga ndi zakudya zoyenera.

Mu kanema munkhaniyi, adokotala azikambirana za mankhwala osokoneza bongo.

Pharmacology

Imalimbikitsa kutulutsa kwa insulin kuchokera ku ma cell a yogwira pancreatic beta. Amachepetsa kuchuluka kwa hemoglobin ya glycosylated komanso kusala kudya kwa glucose mwa odwala omwe ali ndi mitundu komanso mitundu yambiri ya matenda osokoneza bongo omwe samatengera insulin. Kuchepetsa hyperglycemia pambuyo chakudya, kumawonjezera kulolerana kwa glucose komanso chilolezo chamadzimadzi aulere (pang'ono pang'ono). Kuyankha kwa insulinotropic kumayamba pakapita mphindi 30 kuchokera pakamwa, kutalika kwa nthawi limodzi ndi limodzi kumafikira maola 24. Sikuwakhudza ma lipid mawonekedwe am'magazi.

Poyeserera makoswe ndi mbewa zapamwamba nthawi 75 kuposa MPD, sizilimbikitsa carcinogeneis ndipo sizikhudza chonde (makoswe). Kafukufuku wachitika pa mabakiteriya, ndipo mu vivo , sanawululire katundu wa mutagenic.

Fomu yochita zinthu mwachangu imalowetsedwa mwachangu komanso mokwanira. Kudya sikukhudza mayamwidwe athunthu, koma kumachepetsa kwa mphindi 40. C_max mtima 1-3 mawola limodzi. T_1/2 ndi maola 2 - 2. Atatenga mawonekedwe a pang'onopang'ono, amawonekera m'magazi patatha maola 2-3, C_max Imafikiridwa pambuyo pa maola 6 - 12. Amalumikiza mapuloteni am'madzi ndi 98-99%. Kuchuluka kwa magawo pambuyo pa utsogoleri wa iv ndi 11 L, average T_1/2 - Maola 2-5. Chuma chonse atalandira jakisoni imodzi ya iv ndi 3 l / h. Biotransformed mu chiwindi (ndi gawo loyambirira - pang'ono). Zosakwana 10% zimachotsedwa mu mkodzo ndi ndowe, pafupifupi 90% imachotsedwa mu mawonekedwe a metabolites ndi mkodzo (80%) ndi ndowe (10%).

Zotsatira zoyipa za chinthu Glipizide

Kwa pang'onopang'ono mawonekedwe a glipizide:

Kuchokera wamanjenje ndi ziwalo zam'maganizo: chizungulire, kupweteka mutu, kusowa tulo, kugona, kuda nkhawa, kusokonezeka, kusokonezeka, kupweteka kwa mutu, kupsyinjika, chophimba pamaso pa maso, kupweteka kwa maso, kupweteka kwa mitsempha, zotupa zam'mimba.

Kuchokera pamtima ndi magazi (hematopoiesis, hemostasis): syncope, arrhythmia, ochepa matenda oopsa, kumva kutentha kwamphamvu.

Kuchokera kumbali ya kagayidwe: hypoglycemia.

Kuchokera m'mimba: matenda a anorexia, nseru, kusanza, kumva kupsinjika mu epigastric dera, dyspepsia, kudzimbidwa, kuphatikizika kwa magazi mu chopondapo.

Pa khungu: zotupa, urticaria, kuyabwa.

Kuchokera pakapumidwe: rhinitis, pharyngitis, dyspnea.

Kuchokera ku genitourinary system: dysuria, watsika libido.

Zina: ludzu, kunjenjemera, zotumphukira edema, kupweteka kwapadera kwakanthawi mthupi, arthralgia, myalgia, kukokana, thukuta.

Mtundu wofulumira wa glipizide:

Kuchokera wamanjenje ndi ziwalo zam'maganizo: mutu, chizungulire, kugona.

Kuchokera pamtima ndi magazi (hematopoiesis, hemostasis: leukopenia, agranulocytosis, thrombocytopenia, pancytopenia, hemolytic kapena aplastic anemia.

Kuchokera kumbali ya kagayidwe: matenda a shuga insipidus, hyponatremia, matenda a porphyrin.

Kuchokera mmimba: nseru, kusanza, kupweteka kwa epigastric, kudzimbidwa, cholestatic hepatitis (chikasu madontho a khungu ndi sclera, kusungunuka kwa chopondapo ndi kuziziritsa kwamikodzo, kupweteka kwa hypochondrium yoyenera).

Pa khungu: erythema, zotupa za maculopapular, urticaria, photosensitivity.

Zina: kuchuluka kwa ndende ya LDH, zamchere phosphatase, yosalunjika bilirubin.

Kuchita

Maminolo ndi glucocorticoids, amphetamines, anticonvulsants (hydantoin derivatives), katsitsumzukwa, baclofen, calcium antagonists, carbonic anhydrase inhibitors (epetepholamide), chlortalidone, njira yolerera pakamwa, epinephrine, ethacinic acid, giurimide, thymoside gland, triamteren ndi mankhwala ena omwe amayambitsa hyperglycemia. Anabolic steroids ndi androgens amalimbikitsa ntchito za hypoglycemic. Ma anticoagulants osadziwika, NSAIDs, chloramphenicol, clofibrate, guanethidine, Mao inhibitors, probenecid, sulfonamides, rifampicin kuwonjezera kuchuluka kwa gawo lamagazi m'magazi (chifukwa chakuchotsa mapuloteni a plasma) ndikuwonjezera mapangidwe a biotransfform. Ketonazole, miconazole, sulfinpyrazone block inactivation ndikuwonjezera hypoglycemia. Poyerekeza ndi zakumwa zakumwa, kukula kwa matenda a disulfiram-like (kupweteka kwam'mimba, nseru, kusanza, kupweteka mutu) ndikotheka. Mankhwala a Antithyroid ndi myelotoxic amawonjezera mwayi wokhala ndi agranulocytosis, wotsiriza, kuwonjezera - thrombocytopenia.

Bongo

Chithandizo: kusiya kwa mankhwala, kudya shuga ndi / kapena kusintha kwa zakudya ndi kuyang'aniridwa kwamatenda a glycemia, ndi vuto lalikulu la hypoglycemia (chikomokere, kukomoka) - kuchipatala, kuyamwa kwa 50% kulowetsedwa kwa shuga ndi kulowetsedwa munthawi yomweyo (iv drip) ya 10% yankho glucose kuonetsetsa kuchuluka kwa shuga m'magazi pamwamba pa 5.5 mmol / l, kuwunika glycemia ndikofunikira pakatha masiku 1-2 wodwala atachoka. Kutsegula m'mimba sikothandiza.