MANINIL 3

m'mabotolo agalasi okhala ndi ma PC a ma PC 120., mumapaketi okhala ndi botolo 1 kapenanso mumtundu wa matcheni 10 kapena 20 ma PC.

m'mabotolo agalasi okhala ndi ma PC a ma PC 120., mumapaketi okhala ndi botolo 1 kapenanso mumtundu wa matcheni 10 kapena 20 ma PC.

m'mabotolo agalasi okhala ndi ma PC a ma PC 120., mu paketi yamatoni 1 a botolo kapena mu chikhomo cha ma PC 20, mu paketi a makatoni 1, 2, 3, 4 kapena 6.

Pharmacokinetics

Atamwa Maninil 3.5, kutulutsa mwachangu komanso kokwanira kwathunthu kumawonedwa. Kutulutsidwa kwathunthu kwa chinthu cha microionised yogwira kumachitika mkati mwa mphindi 5.
Kumanga mapuloteni a Plasma ndi oposa 98% a Maninyl 3,5, 95%.
Imakhala ngati imaphatikizidwa kwathunthu m'chiwindi ndikupanga ma metabolites awiri osagwira ntchito, amodzi omwe amatsitsidwa ndi impso, ndi ena ndi bile.
T1 / 2 ya Maninyl 3.5 ndi maola 1.5-3,5.

Njira yogwiritsira ntchito

Maninil 3.5 kumwa mkamwa, m'mawa ndi madzulo, musanadye, osafuna. Mlingo umayikidwa payekha, kutengera kuopsa kwa matendawa.
Mlingo woyamba ndi mapiritsi 1 / 2-1, pafupifupi piritsi limodzi. patsiku, pazipita - 3, pokha pokha - mapiritsi 4. patsiku.
Mlingo wa tsiku ndi tsiku mpaka mapiritsi awiri. Nthawi zambiri amatengedwa kamodzi (m'mawa), apamwamba - amagawidwa awiri Mlingo (m'mawa ndi madzulo).

Zotsatira zoyipa

Hypoglycemia ndiyotheka (ndikudumpha chakudya, mankhwala osokoneza bongo, ndikulimbitsa thupi, komanso kumwa kwambiri).
Kuchokera mmimba thirakiti: nthawi zina - nseru, kusanza, zina - cholestatic jaundice, hepatitis.
Kuchokera hemopoietic dongosolo: kawirikawiri - thrombocytopenia, granulocytopenia, erythrocytopenia (mpaka pancytopenia), nthawi zina - hemolytic anemia.
Thupi lawo siligwirizana: chosowa kwambiri - zotupa pakhungu, kutentha thupi, kupweteka kwapawiri, proteinuria.
Zina: kumayambiriro kwa chithandizo, vuto logona kwakanthawi ndilotheka. Nthawi zina, photosensitivity.

Contraindication

Contraindication kugwiritsa ntchito mankhwalawa Maninil 3.5 ndi: hypersensitivity (kuphatikizapo mankhwala a sulfonamide ndi zotumphukira zina za sulfonylurea), mtundu wa 1 shuga mellitus (wodalira insulin), kagayidwe kazakudya (ketoacidosis, precoma, chikomokere), boma pambuyo pancreatic resection, chiwindi chachikulu ndi matenda a impso, ena pachimake zinthu (mwachitsanzo, kubwezeretsa kwa kagayidwe kazakudya matenda opatsirana, kuwotcha, kuvulala kapena pambuyo pakuchitidwa maopaleshoni yayikulu pakusonyeza mankhwala a insulin), leukopenia, kutsekeka kwamatumbo, h m'mimba, machitidwe limodzi ndi kuphwanya mayamwidwe chakudya ndi chitukuko cha hypoglycemia, pakati ndi nthawi yoyamwitsa.

Kuchita ndi mankhwala ena

Kulimbikitsa mphamvu ya Hypoglycemic ya mankhwala Maninil 3.5 zotheka pogwiritsa ntchito ACE zoletsa, ma anabolic othandizira ndi mahomoni ogonana amuna, ena othandizira pakamwa (mwachitsanzo, acarbose, biguanides) ndi insulin, azapropazone, NSAIDs, beta-blockers, quinolone derivatives, chloramphenicol, clomofiber, disopyramide, fenfluramine, antifungal mankhwala (miconazole, fluconazole), fluoxetine, Mao zoletsa, PASK, pentoxifylline (mlingo waukulu wa makulidwe a makolo kudya), perhexiline, pyrazolone derivatives, phosphamides (mwachitsanzo, cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfonamides, tetracyclines ndi tritoqualin.
Urine acidifying agents (ammonium chloride, calcium chloride) amalimbikitsa mphamvu ya Maninyl wa mankhwalawa pochepetsa kuchepa kwake ndikuwonjezera mphamvu yake.
Mphamvu ya hypoglycemic ya mankhwala Maninil ingathe kuchepa ndi kugwiritsa ntchito nthawi yomweyo barbiturates, isoniazid, diazoxide, GCS, glucagon, nicotinates (muyezo waukulu), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, mahomoni achilengedwe, mahomoni okhathamira mahomoni, kuchuluka kwa maselo m'thupi, maselo mahomoni, kuchuluka kwa maselo m'thupi. blockers a pang'onopang'ono calcium njira, lifiyamu salt.
Otsutsa a H2 receptor amatha kufooketsa, kumbali imodzi, ndipo, kumbali yake, amalimbikitsa mphamvu ya hypoglycemic ya Maninil.
Nthawi zina, pentamidine imapangitsa kuchepa kwamphamvu kapena kuchuluka kwa kuchuluka kwa shuga m'magazi.
Pogwiritsa ntchito pamodzi ndi mankhwalawa, Maninil amatha kukulitsa kapena kufooketsa mphamvu ya zotumphukira za coumarin.
Pamodzi ndi kuchuluka kwa zochitika za hypoglycemic, beta-blockers, clonidine, guanethidine ndi reserpine, komanso mankhwala omwe ali ndi kachipangizidwe kazinthu zazikulu, amatha kufooketsa chidwi cha zizindikiro za hypoglycemia.

Bongo

Ndi kupita patsogolo kwa hypoglycemia, wodwalayo atha kulephera kudziletsa komanso chikumbumtima, kukula kwa vuto la hypoglycemic.
Chithandizo: vuto la hypoglycemia wofatsa, wodwalayo ayenera kutenga chidutswa cha shuga, chakudya kapena zakumwa zomwe zili ndi shuga wambiri (kupanikizana, uchi, kapu ya tiyi wokoma) mkati. Pofuna kutaya chikumbumtima, ndikofunikira kubaya iv glucose - 40-80 ml ya 40% dextrose solution (glucose), ndiye kulowetsedwa kwa 5-10% dextrose solution. Kenako mutha kuwonjezera 1 mg wa glucagon mu / mu, / m kapena s / c. Ngati wodwalayo sakudziwikanso, ndiye kuti izi zitha kubwerezedwanso;

Kutulutsa Fomu

Maninil 3.5 - mapiritsi.
Kuyika - m'mabotolo agalasi a ma PC 120., Pachikwangwani pamakatoni 30 kapena 60 ma PC.

Piritsi 1 Maninil 3.5 Muli zinthu zothandiza: glibenclamide (munthawi yowonetsedwa) 3.5 mg.
Omwe amachokera: lactose monohydrate, wowuma wa mbatata, gimetellosa, colloidal silicon dioxide, magnesium stearate, kapezi wa utoto (Ponso 4R) (E124)

Zotsatira za pharmacological

Ili ndi pancreatic ndi extrapancreatic zotsatira. Ntchito ya pancreatic imawonetsedwa mu kukondoweza kwa insulin yopanga ma cell a pancreatic beta, ndipo ntchito yowonjezera imawonetsedwa pakuwonjezeka kwa chidwi cha minofu insulin receptors (chifukwa cha kukondoweza kwa tyrosine kinase) kwa insulin, ndi kuponderezana kwa gluconeogeneis ndi glycogenolysis m'chiwindi.

Clinical Pharmacology

Mawonekedwe ojambulidwa amapereka kukwaniritsidwa koyambirira kwa C_max , kuchuluka kwa zotsatira za hypoglycemic kwenikweni kumagwirizana ndi nsonga ya postprandial hyperglycemia, yomwe imatsimikizira kukhudzika kwa thupi kuphatikiza ndi T yafupikitsidwa._1/2 amachepetsa chiopsezo cha hypoglycemia. Kufunika kwa tsiku ndi tsiku kwa glibenclamide kumatha kuchepa 30-30%.

Njira zopewera kupewa ngozi

Amagwiritsidwa ntchito mosamala pofikira pa febrile syndrome, matenda a chithokomiro (omwe ali ndi vuto la chithokomiro), kuchepa kwa matenda anterior pituitary kapena adrenal cortex, uchidakwa, mwa odwala okalamba chifukwa chokhala ndi vuto la hypoglycemia. Kuyang'anira achipatala pafupipafupi ndikofunikira. Pa mankhwala, muyenera kutsatira zakudya. Kutenga Maninil sikusintha chakudya. Pa chithandizo, sikulimbikitsidwa kuti muzichita zinthu zomwe zimafunikira chidwi ndi kuthamanga kwa zochitika zama psychomotor, kuti muzikhala padzuwa nthawi yayitali. Kusintha kwa mlingo ndikofunikira pakulimbitsa thupi ndi malingaliro, kusintha zakudya.

Mlingo ndi njira ya mankhwala.

Mlingo umayikidwa payekha, kutengera zaka, kuopsa kwa matenda ashuga, kudya glycemia komanso maola awiri mutatha kudya.

Mlingo wapakati ndi 2,5-15 mg / tsiku, pafupipafupi makonzedwe ake ndi katatu / tsiku. Tengani mphindi 20-30 musanadye. Mlingo woposa 15 mg / tsiku, umagwiritsidwa ntchito nthawi zina ndipo suyambitsa kuchuluka kwa zotsatira za hypoglycemic.

Kwa odwala okalamba, muyeso woyamba ndi 1 mg / tsiku.

Mukasintha kuchokera ku Biguanides, muyeso woyamba wa glibenclamide ndi 2,5 mg / tsiku. Biguanides iyenera kuthetsedwa, ndipo mlingo wa glibenclamide, ngati pakufunika, utha kuwonjezeredwa ndi 2,5 mg masiku asanu ndi limodzi aliwonse a66 kuti ulipidwe ndikuphwanya chakudya cha metabolism. Popanda kulipidwa milungu isanu ndi umodzi, ndikofunikira kukonza mankhwala osakanikirana ndi glibenclamide ndi biguanides.

Zotsatira zoyipa za Maninil 3.5:

Kuchokera ku endocrine system: hypoglycemia mpaka chikomokere (chiwonetsero chake cha kukula kwake chimawonjezeka ndikuphwanya malamulo a dosing komanso zakudya zosakwanira).

Thupi lawo siligwirizana: zotupa pakhungu, kuyabwa.

Kuchokera pamatumbo am'mimba: nseru, kutsegula m'mimba, kumva kupsinjika kwa gawo la epigastric, osowa - kuwonongeka kwa chiwindi, cholestasis.

Kuchokera kumbali ya dongosolo lamkati lamanjenje ndi zotumphukira zamanjenje: kawirikawiri - paresis, zovuta zam'mutu, mutu, kutopa, kufooka, chizungulire.

Kuchokera pa hematopoietic dongosolo: kawirikawiri - matenda a hematopoiesis mpaka kukula kwa pancytopenia.

Dermatological zimachitika: kawirikawiri - photosensitivity.

Malangizo apadera ogwiritsira ntchito Maninil 3.5.

Amagwiritsidwa ntchito mosamala odwala omwe ali ndi matenda a chiwindi ndi impso (kuphatikizapo mbiri), komanso kutentha thupi, matenda a chithokomiro, chithokomiro, komanso uchidakwa wambiri.

Mankhwala, kuwunika pafupipafupi magazi a glucose ndi kuperewera kwamkodzo tsiku lililonse ndikofunikira.

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.

Odwala omwe amatenga glibenclamide ayenera kupewa kumwa mowa. Pankhani yakumwa mowa, makulidwe azomwe amachitika ngati disulfiram, komanso hypoglycemia, ndizotheka.

Kugwirizana kwa Maninil 3.5 ndi mankhwala ena.

Kulimbikitsa mphamvu ya hypoglycemic ya glibenclamide ndikotheka ndikugwiritsa ntchito nthawi imodzi ya beta-blockers, othandizira ma anabolic, allopurinol, cimetidine, clofibrate, cyclophosphamide, isobarin, MAO inhibitors, sulfonamides, salicylates, ma-chloramphenicol, ethane.

Kuchepa kwa machitidwe a glibenclamide ndikukula kwa hyperglycemia ndikotheka ndikugwiritsa ntchito nthawi imodzi ya barbiturates, chlorpromazine, phenothiazines, phenytoin, diazoxide, acetazolamide, glucocorticoids, sympathomimetics, glucagon, indomethacin, ma diceidacid, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi ambiri, magawo am'magazi am'mimba, masekisiti am'madzi am'mimba, masekitini am'magazi, ma grid. Mlingo waukulu wa mankhwala ofewetsa thukuta.