Golda MV > Mankhwala

Mankhwala amapezeka mu mawonekedwe a mapiritsi okhala ndi mawonekedwe osinthika: oyera kapena oyera ndi tint wachikasu, kuzungulira, pang'onopang'ono, pang'onopang'ono, wokhala ndi bevel, pa mapiritsi okhala ndi mulingo wa 60 mg pali chiopsezo cholekanitsidwa (pa mulingo wa 30 mg: 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 120, 150, 180, 200 kapena 300 ma PC mu zitini, pamakatoni olembetsedwa 1 akhoza, ma PC 10 m'matumba, pamakadi okhala ndi zikwama 10, pazitupa 60 mg: 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, 84, 90, 100, 120, 125, 140, 150, 180, 250, kapena 300 ma PC.azitini, pabokosi la makatoni 1 ikhoza, m'matumba a chithuza: ma PC 10, Per ma carton pack mapaketi a 7, ma pc 7, mu bokosi lamatoni 2, 4, 6, 8 kapena 10. Pakiti iliyonse ilinso ndi malangizo ogwiritsira ntchito Golda MV).

Piritsi limodzi lili:

yogwira mankhwala: gliclazide - 30 kapena 60 mg,
othandizira zigawo: lactose monohydrate, sodium carboxymethyl starch (mtundu C), hypromellose 2208, colloidal silicon dioxide, magnesium stearate.

Mankhwala

Golda MV ndi mankhwala osokoneza bongo a hypoglycemic. Gliclazide, chomwe imagwira ntchito, ndichinthu chosinthika kuchokera ku sulfonylurea cha m'badwo wachiwiri. Amasiyanitsidwa ndi mankhwala ofanana ndi kukhalapo kwa mphete ya N ya heterocyclic yokhala ndi chomangira cha endocyclic. Glyclazide imapangitsa kuti insulin itulutsidwe ndi ma cell a beta a Langerhans, kuchepetsa kuchuluka kwa shuga m'magazi. Pambuyo pazaka ziwiri zamankhwala, zotsatira zowonjezera kuchuluka kwa insulin ndi C-peptide zikuchulukirachulukira.

Pamodzi ndi momwe zimapangidwira kagayidwe kazakudya, zimakhala ndimphamvu ya hemovascular. Mtundu wachiwiri wa matenda ashuga a shuga, gliclazide imathandizira kubwezeretsanso kutulutsa kwa insulin poyambira kuthamanga kwa glucose ndikuwonjezera gawo lachiwiri la insulin secretion. Katemera wa insulini amakula kwambiri pamasamba a kukondoweza chifukwa cha kudya ndi glucose.

Mphamvu ya govlazide ya gliclazide imawonetsedwa ndi chiopsezo chochepetsedwa cha chotengera cham'mimba chaching'ono. Mwapang'onopang'ono amalepheretsa kuphatikiza kwa kupatsidwa zinthu za m'magazi komanso zomatira, zimachepetsa kuchuluka kwa ma cell a ma cell (ma cell a thromboxane B2, beta-thromboglobulin). Amathandizira kuwonjezera ntchito ya minofu plasminogen activator, imathandizira kubwezeretsa kwa fibrinolytic ntchito ya mtima endothelium.

Odwala omwe ali ndi glycemic hemoglobin (Hb_A1c) ochepera 6.5%, kugwiritsa ntchito gliclazide kumawongolera kwambiri glycemic, kuchepetsa kwambiri tizilombo komanso matenda a shuga a mtundu wachiwiri.

Cholinga cha gliclazide pofuna kuwongolera glycemic kwambiri imaphatikizapo kuwonjezera mlingo wake kuphatikiza ndi chithandizo chamankhwala (kapena m'malo mwake) asanawonjezere metformin, thiazolidinedione derivative, alpha-glucosidase inhibitor, insulini kapena othandizira ena a hypoglycemic. Zotsatira zakuchipatala zawonetsa kuti, motsutsana ndi kagwiritsidwe ntchito ka gliclazide muyezo wa tsiku ndi tsiku wa 103 mg (mlingo waukulu ndi 120 mg), chiopsezo cha kuphatikizika kwa zovuta zazikulu za macro- ndi microvascular ndi 10% kutsika kuposa momwe amalembera.

Ubwino wakuwongolera kwambiri glycemic mukamamwa Golda MV imaphatikizanso kuchepa kwakukulu kwa matenda amisempha monga 14%), nephropathy (mwa 21%), zovuta za impso (pofika 11%), microalbuminuria (pofika 9%) , macroalbuminuria (30%).

Pharmacokinetics

Pambuyo pa Golda MV atengedwa pakamwa, glycazide imangodzaza, plasma yake imakwera pang'onopang'ono ndikufika paphiri mu maola 6-12. Zakudya zomwezi munthawi yomweyo sizikhudza mayamwidwe, kusiyanasiyana kwa anthu sikungathandize. Gliclazide muyezo wa mpaka 120 mg amadziwika ndi mgwirizano pakati pa mlingo wovomerezeka ndi AUC (dera lomwe limaphatikizidwa ndi nthawi ya pharmacokinetic pamapindikira).

Kumangiriza kumapulogalamu amadzi a m'magazi - 95%.

Kuchuluka kwa magawo ndi pafupifupi malita 30. Mlingo umodzi wa gliclazide umatsimikizira kuti kuphatikizika kwa magazi m'magazi kumakhala kosatha kwa maola 24.

Gliclazide imapangidwa makamaka mu chiwindi. Palibe metabolites yogwira m'madzi a m'magazi.

Kutha hafu ya moyo ndi maola 12-20.

Imafufutidwa makamaka kudzera mu impso mu mawonekedwe a metabolites, osasinthika - osakwana 1%.

Mwa odwala okalamba, kusintha kwakukulu pamagawo a pharmacokinetic sikuyembekezeredwa.

Zizindikiro zogwiritsidwa ntchito

mankhwalawa mtundu 2 matenda a shuga - posakhalapo ndi mphamvu yokwanira yochizira, zolimbitsa thupi ndi kuchepa thupi,
kupewa mavuto a odwala omwe ali ndi matenda a shuga 2 - kuchepetsa chiopsezo cha microvascular (retinopathy, nephropathy) ndi macrovascular (myocardial infarction, stroke) pathologies kudzera pakulimbana kwambiri kwa glycemic.

Contraindication

mtundu 1 shuga
matenda a shuga, kukomoka kwa matenda ashuga,
matenda ashuga ketoacidosis,
kulephera kwambiri kwa aimpso,
kulephera kwambiri kwa chiwindi,
Mankhwala othandizira ndi miconazole,
kuphatikiza mankhwala ndi danazol kapena phenylbutazone,
kobadwa nako lactose tsankho, galactosemia, shuga-galactose malabsorption,
nthawi yapakati
yoyamwitsa
wazaka 18
kusalolera payekha kuti sulfonylurea zotumphukira, sulfonamides,
Hypersensitivity pamagawo a mankhwala.

Mapiritsi a Gold Golide ayenera kugwiritsidwa ntchito mosamala odwala okalamba omwe ali ndi vuto losakhazikika komanso / kapena osavomerezeka, matenda oopsa a mtima wamtima (matenda a mtima ofunikira, kufalikira kwa matenda atherosclerosis, kuchepa kwamatenda a carotid), kuchepa kwa glucose-6-phosphate dehydrogenase, aimpso ndi / kapena Kulephera kwa chiwindi, kuchepa kwa magazi kwa adrenal kapena pituitary, hypothyroidism, chithandizo chazitali ndi glucocorticosteroids (GCS), uchidakwa.

Golda MV, malangizo ogwiritsira ntchito: njira ndi mlingo

Mapiritsi a GV MV amatengedwa pakamwa, kumeza lonse (osafuna kutafuna), makamaka pakudya kwam'mawa.

Mlingo wa tsiku ndi tsiku umatengedwa kamodzi ndipo uyenera kukhala wambiri kuyambira 30 mpaka 120 mg.

Simungabwezeretse mwamwayi mwaphonya mlingo wotsatira muyezo lotsatira, kumwa mlingo wowonjezereka.

Mlingo wa gliclazide umasankhidwa payekhapayekha, poganizira kuchuluka kwa shuga m'magazi ndi index ya Hb_A1c.

Mlingo woyenera: mlingo woyambirira ndi 30 mg (piritsi 1 lagolide Golide MV 30 mg kapena piritsi la Gold MV 60 mg). Ngati mulingo wosonyezedwayo umapereka chiwongolero chokwanira cha glycemic, ndiye kuti utha kugwiritsidwa ntchito ngati mankhwala akukonzanso. Palibe zokwanira matenda pambuyo masiku 30 a mankhwala, mlingo woyambirira umachulukitsidwa pang'onopang'ono mu zowonjezera 30 mg (mpaka 60, 90, 120 mg). Mwapadera, ngati kuchuluka kwa shuga kwa wodwalayo sikunachepetse pambuyo masiku 14 ochizira, mutha kupitiliza kukweza mlingo masiku 14 pambuyo poyambitsa makonzedwe.

Mlingo wapamwamba tsiku lililonse ndi 120 mg.

Ngati musiya kumwa mapiritsi a glyclazide omwe mwamasulidwa msanga pa 80 mg, muyenera kuyamba kumwa mapiritsi osinthidwa ndi mlingo wa 30 mg, limodzi ndi mankhwala mosamala.

Mukasinthira ku Golda MV ndi mankhwala ena a hypoglycemic, nthawi yosinthira nthawi zambiri sikufunika. Mlingo woyamba wa gliclazide mu mapiritsi osinthika amasinthidwa ayenera kukhala 30 mg, ndikutsatira titration malinga ndi kuchuluka kwa shuga m'magazi.

Mukamasulira, mlingo ndi theka la moyo wa hypoglycemic wam'mbuyomu uyenera kukumbukiridwa. Ngati mankhwala a sulfonylurea omwe ali ndi moyo wautali, atha kusintha, ndiye kuti onse omwe amayamba kugwiritsidwa ntchito ndi hypoglycemic amatha kuyimitsidwa kwa masiku angapo. Izi zimapewa hypoglycemia chifukwa chowonjezera cha glycoslazide ndi zotumphukira za sulfonylurea.

Kugwiritsa ntchito kwa Golda MV kuphatikiza mankhwala omwe ali ndi alpha-glucosidase inhibitors, biguanides kapena insulin akuwonetsedwa.

Odwala okalamba (opitilira 65) safuna kusintha kwa mlingo.

Pofatsa pang'ono komanso kulephera kwa impso, kusintha kwa mankhwalawa sikofunikira.

Ndikulimbikitsidwa kugwiritsa ntchito mlingo wochepa (30 mg) wa gliclazide wa nthawi yayitali pochiza odwala omwe ali pachiwopsezo cha matenda a hypoglycemia, chakudya chosasinthika kapena chosasinthika, matenda oopsa a mtima kapena a hypocrroidism, matenda oopsa a mtima, nthawi yayitali komanso glucocorticosteroids (GCS).

Kugwiritsa ntchito Golda MV kuwonjezera pa zakudya komanso kuchita masewera olimbitsa thupi kuti mupewe zovuta za matenda a shuga 2 kuyenera kuyambitsidwa ndi mlingo wa 30 mg. Kuti tikwaniritse kuwongolera kwambiri glycemic ndikuwongolera milingo ya Hb_A1c Mlingo woyambirira ungathe kuwonjezeka pang'onopang'ono mpaka muyeso wa 120 mg tsiku lililonse. Cholinga cha mankhwalawa chifukwa cha kuwongolera kwambiri glycemic kumawonetsedwa limodzi ndi metformin, alpha-glucosidase inhibitor, thiazolidinedione yotengera, insulin ndi ena othandizira a hypoglycemic.

Zotsatira zoyipa

Ndi zosemphana ndi chakudya chotsatira kapena kudya kwina kosamvetseka, zizindikiro zotsatirazi za hypoglycemia zitha kuwoneka: kutopa kwambiri, kumva kupweteka kwambiri, kupweteka mutu, kusachedwa kuyankha, kusanza, kusanza, kusokonezeka, kusokonekera, kusokonezeka, chisokonezo, kupsinjika, kusawona bwino komanso kuyankhula, paresis, aphasia, kugwedezeka, kulephera kudziletsa, kuzindikira kwa kusokonezeka, kumva kusowa pogwira, kukhudzika, kupuma kosasunthika, bradycardia, kugona, kugona, kugona St, imfa ya chikumbumtima, chikomokere (kuphatikizapo oopsa), adrenergic ayankhe - kuchuluka thukuta, nkhawa, clammy khungu la thupi, tachycardia, kuthamanga magazi (magazi), arrhythmia, palpitations, angina pectoris. Zotsatira zakufufuza kwamankhwala zikuwonetsa kuti mukamagwiritsa ntchito mankhwalawa pofuna kuthana ndi vuto la glycemic, hypoglycemia imachitika pafupipafupi kuposa poyang'anira glycemic. Milandu yambiri ya hypoglycemia pagulu lolimbana ndi glycemic imachitika motsutsana ndi maziko a insulin.

Kuphatikiza apo, kugwiritsa ntchito Golda MV, zotsatirazi zoyipa zingakhale:

Kuchokera m'mimba thirakiti: kupweteka kwam'mimba, nseru, kusanza, kutsegula m'mimba, kudzimbidwa,
Kuchokera ku machitidwe am'mimba komanso ozungulira: kawirikawiri - thrombocytopenia, kuchepa magazi, leukopenia, granulocytopenia,
Kuchokera ku hepatobiliary system: kuchuluka kwa zamchere phosphatase, ACT (aspartate aminotransferase), ALT (alanine aminotransferase), hepatitis, cholestatic jaundice,
mbali ya gawo la masomphenyawo: kusokonezeka kowoneka kwakanthawi (pafupipafupi kumayambiriro kwa chithandizo),
Dermatological zimachitika: kuyabwa, zidzolo, maculopapular zidzolo, urticaria, erythema, edema ya edi, kupweteka kwakukulu (kuphatikizapo Stevens-Johnson syndrome, poermal necrolysis yoopsa),
zina (zotsatira zoyipa zokhudzana ndi sulfonylurea zotumphukira): hemolytic anemia, erythrocytopenia, agranulocytosis, mziwengo vasculitis, pancytopenia, hyponatremia, jaundice, chiwindi kwambiri.

Bongo

Zizindikiro: ndi bongo, chizindikiritso cha hypoglycemia chimakula.

Chithandizo: kusiya kuchuluka kwa matendawa a hypoglycemia (wopanda matenda am'mitsempha komanso chikumbumtima), ndikofunikira kuwonjezera kudya kwa mafuta, kuchepetsa kuchuluka kwa Golda MV ndi / kapena kusintha kadyedwe. Kusamalidwa mosamala kwadwala komwe wodwala akuwonetsa.

Ndi kuwoneka kwambiri kwa machitidwe a hypoglycemic (chikomokere, kukhudzika ndi zovuta zina zam'mitsempha yamitsempha), kugonekedwa kuchipatala kumafunikira.

Kusamalira mwadzidzidzi chithandizo cha hypoglycemic coma kapena kukayikira kwake kumaphatikizapo jakisoni wambiri (iv) wa 20-30% dextrose (glucose) mu mlingo wa 50 ml, ndikutsatiridwa ndi iv kukamwa kwa 10% dextrose solution, yomwe imasunga kuchuluka kwa shuga m'ndende magazi pamwamba 1 g / l. Kuwunikira mosamala momwe wodwalayo akuwonera ndikuwunika kuchuluka kwa shuga m'magazi kuyenera kupitilizidwa kwa maola 48 otsatira.

Kutsegula m'mimba sikothandiza.

Malangizo apadera

Golda MV iyenera kukhazikitsidwa pokhapokha ngati wodwalayo amadya chakudya cham'mawa, ndipo zakudya zopatsa thanzi ndizokhazikika. Izi zimaphatikizidwa ndi chiopsezo chachikulu cha kukhala ndi hypoglycemia, kuphatikiza mitundu yayitali komanso yayitali yomwe imafunikira kuchipatala komanso iv ikupereka yankho la dextrose masiku angapo. Mukamadya Golda MV, ndikofunikira kwambiri kuti zitsimikizire kuti kudya chakudya chokwanira m'thupi ndi chakudya. Zakudya zoperewera, kudya mosakwanira, kapena zakudya zopanda thanzi zomwe zimapangitsa kuti thupi likhale ndi hypoglycemia. Nthawi zambiri, chitukuko cha hypoglycemia chimawonedwa mwa anthu omwe amatsata zakudya zochepa zopatsa mphamvu, akamamwa thupi kwambiri, akamamwa mowa, kapenanso pochita ndi othandizira angapo a hypoglycemic nthawi imodzi. Nthawi zambiri, zakudya zamafuta ambiri (kuphatikizapo shuga) zimathandizira kuchepetsa zizindikiritso za hypoglycemia. Pankhaniyi, m'malo mwa shuga siothandiza. Tiyenera kukumbukira kuti hypoglycemia ikhoza kubwereranso. Chifukwa chake, ngati hypoglycemia ili ndi vuto lotchulidwa kapena lalitali, ngakhale mutakhala kuti mumadya zakudya zokhala ndi vuto lozola thupi, muyenera kufunsa chithandizo chamankhwala mwadzidzidzi.

Mukasankha Golda MV, adotolo ayenera kudziwitsa wodwalayo mwatsatanetsatane za mankhwalawa komanso kufunika kotsatira mokwanira mankhwala, kudya moyenera komanso kuchita masewera olimbitsa thupi.

Zomwe zimayambitsa kukula kwa hypoglycemia ndikulephera kwa wodwala kapena kusafuna (makamaka kukalamba) kutsatira malingaliro a dotolo ndikuwongolera mwadongosolo shuga, magazi osakwanira, kusintha kwa zakudya, kudumpha chakudya kapena kuperewera kwa chakudya, kusakwanira pakati pazochita zolimbitsa thupi ndi kuchuluka kwa chakudya chakumwa, kulephera kwambiri kwa chiwindi , kulephera kwa aimpso, mankhwala osokoneza bongo, kusowa kwa pituitary ndi adrenal komanso / kapena matenda a chithokomiro.

Kuphatikiza apo, hypoglycemia ikhoza kuyambitsa kuyanjana kwa gliclazide ndi mankhwala othandizira. Chifukwa chake, wodwalayo ayenera kuvomerezana ndi dokotala aliyense pakumwa mankhwala aliwonse.

Mukasankha Golda MV, adotolo ayenera kudziwitsa wodwalayo ndi abale ake mwatsatanetsatane za zoopsa zomwe zingachitike komanso chithandizo cha mankhwala omwe akubwera, zomwe zimayambitsa ndi zizindikiro za hypoglycemia, kufunika kotsatira zakudya zomwe zalimbikitsidwa komanso magawo a masewera olimbitsa thupi, kulangizidwa pakudziyang'anira pafupipafupi kuchuluka kwa shuga m'magazi.

Kuti muwone kuyang'anira glycemic, Hb iyenera kuyesedwa pafupipafupi._Alc.

Tiyenera kukumbukira kuti chifukwa chophatikizika ndi hepatic komanso / kapena kulephera kwambiri kwaimpso, vuto la hypoglycemia limatha kupitilira nthawi yayitali ndipo limafunikira chithandizo choyenera nthawi yomweyo.

Kuwongolera kwa glycemic kumatha kufooka chifukwa cha kutentha, matenda opatsirana, kuvulala kapena kuchitapo kanthu kwakukulu. M'mikhalidwe imeneyi, ndikofunikira kusamutsa wodwala kupita ku insulin.

Kuperewera kwa gliclazide pambuyo povomerezeka kwakanthawi kumatha chifukwa cha kukana kwachiwiri kwa mankhwala, zomwe zimachitika chifukwa cha kufalikira kwa matendawa kapena kuchepa kwa mayankho azachipatala. Pozindikira kukana kwachiwiri kwa mankhwala, ndikofunikira kuwonetsetsa kuti wodwalayo amatsatira zakudya zomwe zimayikidwa ndikuwunikira kuchuluka kwa mtundu wa Golda MV womwe watengedwa.

Ndi kuchepa kwa glucose-6-phosphate dehydrogenase, kugwiritsa ntchito mankhwala a sulfonylurea kumawonjezera chiopsezo cha hemolytic anemia. Chifukwa chake, pochiza odwala omwe ali ndi vuto la glucose-6-phosphate dehydrogenase, othandizira a gulu lina ayenera kukondedwa.

Kuyanjana kwa mankhwala osokoneza bongo

miconazole: makonzedwe a miconazole kapena kugwiritsa ntchito mawonekedwe a gel pakamwa pakhungu amachititsa kuwonjezeka kwa hypoglycemic zotsatira za gliclazide, zomwe zingayambitse kukula kwa hypoglycemia mpaka kukomoka.
phenylbutazone: kuphatikiza ndi mitundu yamkamwa ya phenylbutazone kumawonjezera mphamvu ya hypoglycemic ya Golda MV, chifukwa chake, ngati sizingatheke kupereka mankhwala ena odana ndi kutupa, ndikofunikira kusintha mlingo wa glyclazide onse munthawi ya kuyang'anira phenylbutazone komanso atachotsa.
Mowa: kumwa zakumwa zoledzeretsa kapena mankhwala okhala ndi ethanol amalepheretsa zochitika, zomwe zingayambitse kuchuluka kwa hypoglycemia kapena kukula kwa chikomokere kwa hypoglycemic,
othandizira ena a hypoglycemic (insulin, acarbose, metformin, thiazolidinediones, dipeptidyl peptidase-4 zoletsa, glucagon-like peptide-1 receptor agonists), beta-blockers, fluconazole, angiotensin akatembenuza enzyme inhibitors (oletsa othandizira, enaprilap)₂-histamine receptors, monoamine oxidase inhibitors, sulfonamides, clarithromycin, mankhwala osapweteka a antiidal: kuphatikiza kwa mankhwalawa ndi glycazide kumayendera limodzi ndi kuwonjezeka kwa kuchitikira kwa Golda MV komanso chiwopsezo cha hypoglycemia,
danazol: mphamvu ya diabetogenic ya danazol imathandizira kufooketsa mphamvu ya gliclazide,
chlorpromazine: Mlingo wambiri tsiku lililonse (woposa 100 mg) wa chlorpromazine amachepetsa katemera wa insulin, zomwe zimapangitsa kuti magazi azikhala ndi shuga. Chifukwa chake, ndi concomitant antipsychotic mankhwala, kusankha kwa mlingo wa gliclazide ndikuwongolera mosamala glycemic, kuphatikiza pambuyo posiya ntchito kwa chlorpromazine, ndikofunikira,
tetracosactide, GCS yogwiritsira ntchito mwatsatanetsatane komanso mwanjira yapamwamba: kuchepetsa kulolerana kwa chakudya, kumathandizira kuwonjezeka kwa glycemia komanso chiopsezo chotenga ketoacidosis. Kusamala mosamala kwamagazi a glucose amafunikira, makamaka kumayambiriro kwa kuphatikizana kwa mankhwala, ngati kuli kotheka, kusintha kwa gliclazide,
ritodrin, salbutamol, terbutaline (iv): ziyenera kudziwika kuti beta₂-adrenomimetics imachulukitsa kuchuluka kwa shuga m'magazi, chifukwa chake, akaphatikizidwa nawo, odwala amafunikira kudziletsa nthawi zonse, ndikotheka kusamutsa wodwala kuti apange insulin mankhwala,
warfarin ndi ma anticoagulants ena: gliclazide imathandizira pakuwonjezeka kwakukulu mu zotsatira za anticoagulants.

Ma Analogs a Golda MV ndi awa: Diabetalong, Glidiab, Gliclada, Gliclazide Canon, Gliclazide MV, Gliclazide-SZ, Gliclazide-Akos, Diabeteson MB, Diabinax, Diabefarm, Diabefarm MV, etc.

Ndemanga za Golide MV

Ndemanga za Golide MV ndizotsutsana. Odwala (kapena abale awo) akuwonetsa kukwaniritsa msanga kwa mphamvu yochepa yochepetsera shuga pamene akumwa mankhwalawo, pomwe pali chiopsezo chowonjezereka cha hypoglycemia ndi zina. Kuphatikiza apo, kupezeka kwa ma contraindication kumawerengedwa kuti ndi vuto.

Pa makonzedwe a Golda MV, bwino.