Diabetesalongzen, pezani, gulani

Dzina la malonda akukonzekera: Diabetesalong

Dongosolo losavomerezeka: Gliclazide (Gliclazide)

Fomu ya Mlingo: Mapiritsi Otulutsidwa Omasulidwa

Chithandizo: Gliclazide (Gliclazide)

Gulu la Pharmacotherapeutic: Hypoglycemic wothandizira pakamwa makonzedwe a gulu la sulfonylurea a m'badwo wachiwiri.

Katundu

Oral hypoglycemic mankhwala, omwe amapezeka m'badwo wachiwiri.

Zimapangitsa secretion ya insulin ndi kapamba, imachepetsa kuchuluka kwa glucose m'magazi, imakulitsa mphamvu ya insulin-secretory ya glucose ndikuwonjezera chidwi cha zotumphukira zimakhala ndi insulin. Pambuyo pa chithandizo chazaka ziwiri, odwala ambiri samayamba kumwa mankhwala osokoneza bongo (kuchuluka kwa insulin ndikubisalira kwa C-peptides kumakhalabe.

Amachepetsa nthawi kuchokera pakudya mpaka kuyamba kwa insulin. Imabwezeretsa chiyambi choyambirira cha insulin katulutsidwe poyamwa kudya kwa glucose (mosiyana ndi zina za sulfonylurea, zomwe zimakhudza gawo lachiwonetsero chachiwiri). Zimathandizanso gawo lachiwiri la insulin secretion. Kuchepetsa kukwera kwa hyperglycemia mukatha kudya (kumachepetsa postprandial hyperglycemia).

Glyclazide imawonjezera chidwi cha zotumphukira zimakhala ku insulin (i.e., ili ndi kutchulidwa kwa extrapancreatic athari). Mu minofu minofu, mphamvu ya insulini pakukoka kwa glucose, chifukwa cha kusintha kwamphamvu kwa minyewa kupita ku insulin, imachulukitsidwa kwambiri (mpaka + 35%), chifukwa glycazide imalimbikitsa ntchito ya minofu ya glycogen synthetase.

Amachepetsa mapangidwe a shuga m'chiwindi, amateteza kusuntha kwa shuga.

Kuphatikiza pa kukhudza kagayidwe kazakudya, gliclazide imathandizanso kukoka kwam'mimba. Mankhwala amachepetsa chiopsezo cha mtsempha wamagazi ochepa, mtima endothelial ntchito ndi kuchuluka kwa minofu plasminogen activator.

Glyclazide ili ndi antioxidant katundu: imachepetsa mulingo wa lipid peroxides mu plasma, imawonjezera ntchito ya maselo ofiira am'magazi a superoxide dismutase.

Chifukwa cha mawonekedwe a mlingo, tsiku lililonse mapiritsi a Diabetesalong 30 mg amapereka njira yothandizira yochizira gliclazide mu madzi am'magazi kwa maola 24.

Pambuyo pakamwa, gliclazide imadzaza kwathunthu kuchokera m'mimba. Kudya sizimakhudza mayamwidwe. The kuchuluka kwa yogwira mu madzi am`magazi pang'onopang'ono ukuwonjezeka pang'onopang'ono, ukufika pazipita ndi kufika paphiri 6-12 mawola kumwa mankhwala Kusiyanasiyana kwamunthu aliyense kumakhala kotsika. Ubale pakati pa kumwa ndi kuchuluka kwa mankhwalawa m'magazi am'magazi ndikudalira kwapanthawi.

Kugawa komanso kagayidwe

Plasma kumanga mapuloteni pafupifupi 95%.

Amapukusidwa mu chiwindi ndikuwachotsa makamaka ndi impso. Palibe metabolites yogwira mu plasma.

Kuchotseredwa ndi impso kumachitika makamaka mu mawonekedwe a metabolites, osakwana 1% ya mankhwalawa amachotsedwa osasinthika.

T1 / 2 ndi pafupifupi maola 16 (maola 12 mpaka 20).

Pharmacokinetics mu milandu yapadera yamankhwala

Okalamba, palibe kusintha kwakukulu pamawonekedwe a pharmacokinetic komwe kumawonedwa.

Zisonyezo zogwiritsidwa ntchito:

- Type 2 shuga mellitus kuphatikiza mankhwala ochizira zakudya osakwanira komanso kuchita masewera olimbitsa thupi.

Zoyipa:

- lembani matenda ashuga 1

- matenda ashuga ketoacidosis, matenda a shuga, matenda a shuga,

Akuluakulu aimpso komanso / kapena kulephera kwa chiwindi,

- wazaka mpaka 18

- nthawi yoyamwitsa (mkaka wa m'mawere),

- kobadwa nako lactose tsankho, lactase akusowa kapena shuga-galactose malabsorption,

- Hypersensitivity to gliclazide kapena aliyense wokonda mankhwala, kupita kwa ena a sulfonylurea, kuti sulfonamides.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa nthawi imodzi limodzi ndi phenylbutazone kapena danazole.

Mochenjera: kukalamba, kusakhazikika komanso / kapena kusamva bwino, matenda oopsa a mtima (kuphatikizapo mtima wamatumbo, atherosulinosis), hypothyroidism, adrenal kapena pituitary insuffence, hypopituitarism, renal ndi / kapena kulephera kwa chiwindi, chithandizo chotalikilapo ndi corticosteroids, uchidakwa, kusowa kwa glucose-6-phosphate dehydrogenase.

Mimba komanso kuyamwa

Palibe zinachitikira ndi gliclazide pa nthawi yapakati. Zomwe zimagwiritsidwa ntchito pazinthu zina za sulfonylurea panthawi yapakati ndizochepa.

Mu maphunziro a nyama yothandizira, teratogenic zotsatira za gliclazide sizinadziwikebe.

Kuchepetsa chiopsezo cha kubadwa mwatsopano, kuwongolera koyenera (chithandizo choyenera) cha matenda osokoneza bongo ndikofunikira.

Mankhwala a Oral hypoglycemic pa nthawi yoyembekezera sagwiritsidwa ntchito. Mankhwala osankhidwa pochiza matenda a shuga mwa amayi apakati ndi insulin. Ndikulimbikitsidwa kuti m'malo mankhwalawa pakhale kumwa kwa mankhwala a hypoglycemic ndi insulin mankhwala onse omwe ali ndi pakati, komanso ngati kutenga pakati kumachitika pakumwa mankhwalawo.

Poganizira kusowa kwa chidziwitso cha kudya kwa gliclazide mkaka wa m'mawere ndi chiopsezo chotenga neonatal hypoglycemia, kuyamwitsa kumayesedwa panthawi ya mankhwala.

Gwiritsani ntchito ntchito yolakwika ya chiwindi

Ndi kusamala pakulephera kwa chiwindi.

- aimpso kwambiri ndi / kapena kulephera kwa chiwindi.

Gwiritsani ntchito ntchito yolakwika yaimpso

Odwala wofatsa pang'ono komanso aimpso kulephera, mankhwala zotchulidwa chimodzimodzi Mlingo wa odwala ndi yachibadwa aimpso ntchito. Kulephera kwambiri kwa aimpso, Diabetesalong imaphatikizidwa.

Gwiritsani ntchito ana

Odwala ana osakwana zaka 18.

Gwiritsani ntchito odwala okalamba

Kwa odwala omwe sanalandire chithandizo cham'mbuyomu (kuphatikizapo kwa anthu achikulire zaka 65), mlingo woyambira ndi 30 mg. Ndiye kuti mankhwalawa amasankhidwa payekhapayekha mpaka njira yothandizidwa itakwaniritsidwa.

Mogwirizana ndi mankhwala ena:

Glyclazide imawonjezera zotsatira za anticoagulants (warfarin); kusintha kwa antactagulant kungafunike.

Miconazole (wokhala ndi makonzedwe oyenera komanso akagwiritsa ntchito gel osakaniza pakamwa) amakulitsa mphamvu ya hypoglycemic ya mankhwala (hypoglycemia ikhoza kukhala mpaka kukomoka).

Phenylbutazone (kayendedwe kazinthu) amakulitsa mphamvu ya hypoglycemic ya mankhwala (amachoka chifukwa cha mapuloteni a plasma komanso / kapena amachepetsa kuchotsa kwa thupi), kuwongolera kwa glucose ndi kusintha kwa glyclazide ndikofunikira, onse pakukonzekera kwa phenylbutazone komanso atachotsedwa.

Mankhwala okhala ndi Ethanol ndi ethanol omwe amalimbikitsa hypoglycemia, poletsa zovuta zomwe zimachitika, angathandizire kukulitsa kukomoka kwa hypoglycemic.

Mukumwa mankhwala ena a hypoglycemic (insulin, acarbose, biguanides), ma beta-blockers, fluconazole, ACE inhibitors (capopril, enalapril), histamine H2 receptor blockers (cimetidine), Mao inhibitors, hypoglycemic ndi sulfanilamides ndikulemba chiwopsezo cha hypoglycemia.

Pogwiritsa ntchito danazol, zotsatira za matenda a shuga zimadziwika. Ndikofunikira kuyendetsa kuchuluka kwa glucose wamagazi ndikusintha mlingo wa gliclazide, ponse pa nthawi ya danazol pambuyo poti wachoka.

Chlorpromazine mu Mlingo wambiri (woposa 100 mg / tsiku) amawonjezera shuga m'magazi, akumachepetsa katulutsidwe ka insulin. Ndikofunikira kuyendetsa shuga wamagazi ndikusintha mlingo wa gliclazide, onse munthawi ya makonzedwe a chlorpromazine atachokanso.

GCS (systemic, intraarticular, nje, rectal management) imakulitsa shuga wamagazi ndikuthekera kwa ketoacidosis (kuchepa kwa kulekerera kwa chakudya chamoto). Ndikofunikira kuyendetsa shuga wamagazi ndikusintha mlingo wa gliclazide onse munthawi ya makonzedwe a GCS komanso atachotsedwa.

Ritodrine, salbutamol, terbutaline (iv) kuwonjezera magazi. Mphamvu ya shuga yamagazi imalimbikitsa ndipo ngati nifunikira, kusamutsa wodwala kupita ku insulin.

Mlingo ndi makonzedwe:

Mankhwalawa amangogwiritsidwa ntchito pochiza akuluakulu.

Mapiritsi a Diabetesalong omwe amasinthidwa amasintha 30 mg amatengedwa pakamwa nthawi imodzi / tsiku pakudya kadzutsa.

Kwa odwala omwe sanalandire chithandizo cham'mbuyomu (kuphatikizapo kwa anthu achikulire zaka 65), mlingo woyambira ndi 30 mg. Ndiye kuti mankhwalawa amasankhidwa payekhapayekha mpaka njira yothandizidwa itakwaniritsidwa.

Kusankhidwa kwa Mlingo uyenera kuchitika molingana ndi mulingo wa shuga m'magazi atangoyamba chithandizo. Kusintha kwa mtundu wina uliwonse kumachitika pakatha milungu iwiri.

Mlingo wa tsiku ndi tsiku wa mankhwalawa umatha kukhala 30 mg (1 tabu.) Mpaka 90-120 mg (3-4 tabu.). Mlingo wa tsiku ndi tsiku sayenera kupitirira 120 mg (mapiritsi 4).

Diabetesalong amatha m'malo mwa mapiritsi a gliclazide otulutsidwa (80 mg) Mlingo wa mapiritsi 1 mpaka 4 / tsiku.

Ngati mwaphonya mtundu umodzi kapena zingapo za mankhwalawa, simungatenge kumwa kwakukulu pa tsiku lotsatira (tsiku lotsatira).

Mukasinthira mankhwala ena a hypoglycemic ndi mapiritsi a Diabetalong® 30 mg, palibe kusintha kwakanthawi kofunikira. Muyenera kusiya kumwa mankhwala tsiku lililonse ndipo tsiku lotsatira mungayambe kumwa mankhwalawa.

Ngati wodwalayo alandila chithandizo kale ndi sulfonylureas wokhala ndi moyo wautali, ndiye kuti kuwunika mosamala (kuwunika shuga) kwa masabata 1-2 ndikofunikira kupewa hypoglycemia chifukwa chotsatira chotsalira cha chithandizo chotsatira.

Diabetesalong ikhoza kugwiritsidwa ntchito limodzi ndi biguanides, alpha glucosidase inhibitors kapena insulin.

Odwala wofatsa pang'ono komanso aimpso kulephera, mankhwala zotchulidwa chimodzimodzi Mlingo wa odwala ndi yachibadwa aimpso ntchito. Kulephera kwambiri kwa aimpso, Diabetesalong imaphatikizidwa.

Odwala omwe ali pachiwopsezo cha kukhala ndi hypoglycemia (zakudya zosakwanira kapena zopanda thanzi, zovuta za endocrine zowonongeka - kuchepa kwa thupi ndi vuto la adrenal, hypothyroidism, kuthetsedwa kwa glucocorticosteroids atatha nthawi yayitali komanso / kapena kukonzekera kwadzaoneni, matenda oopsa a mtima dongosolo / kwambiri matenda a mtima, carotid arteriosulinosis, kufala kwa matenda atherosulinosis /) tikulimbikitsidwa kugwiritsa ntchito mlingo wochepa (30 mg 1 nthawi / tsiku) wa mankhwala a Diabetalong.

Malangizo apadera:

Kuchiza kumachitika pokhapokha limodzi ndi kalori yotsika, yochepa-carb.

Ndikofunikira kuwunika pafupipafupi kuchuluka kwa shuga m'magazi pamimba yopanda kanthu ndikatha kudya, makamaka masiku oyamba a mankhwalawa.

Diabetesalong imatha kutumikiridwa kokha kwa odwala omwe amalandira chakudya chokhazikika, chomwe chimaphatikizapo chakudya cham'mawa komanso kudya chakudya chokwanira.

Popereka mankhwala, muyenera kukumbukira kuti chifukwa cha kudya kwa sulfonylurea, zotupa za hypoglycemia zimatha kukhazikika, ndipo nthawi zina zimakhala zovuta komanso zimatenga nthawi yayitali, zomwe zimafuna kugonekedwa kwa chipatala ndi shuga kwa masiku angapo. Hypoglycemia nthawi zambiri imayamba kudya zakudya zochepa zopatsa mphamvu, pambuyo pochita masewera olimbitsa thupi kwa nthawi yayitali kapena mwamphamvu, mutamwa mowa, kapenanso kumwa mankhwala angapo a hypoglycemic nthawi imodzi.

Kuti mupewe kukula kwa hypoglycemia, muyenera kusankha mosamala komanso mosamala payekha, komanso kupatsa wodwalayo chidziwitso chonse chamankhwala omwe akufuna.

Ndi kuphatikiza kwa thupi ndi kwamalingaliro, posintha zakudya, kusintha kwa mankhwala a diabetesalong ndikofunikira.

Makamaka chidwi ndi machitidwe a mankhwala a hypoglycemic ndi anthu okalamba, odwala omwe salandira chakudya chokwanira, omwe amakhala ndi chifowoka chokwanira, odwala omwe ali ndi vuto losakwanira.

Beta-blockers, clonidine, reserpine, guanethidine amatha kuphimba mawonetseredwe azachipatala a hypoglycemia.

Odwala ayenera kuchenjezedwa za chiwopsezo chowonjezereka cha hypoglycemia milandu ya ethanol, NSAIDs, ndi njala.

Pankhani ya ethanol (mowa), amathanso kukhala ndi discriram-like syndrome (kupweteka kwam'mimba, nseru, kusanza, kupweteka mutu).

Kuchitapo kwakukulu kwa maopareshoni ndi kuvulala, kuwotcha kwakukulu, matenda opatsirana omwe ali ndi febrile syndrome kungafune kuthetsedwe kwa mankhwala apakamwa a hypoglycemic ndi kuikidwa kwa insulin.

Kukula kwa kukana kwachiwiri kwa mankhwalawa ndikotheka (kuyenera kusiyanitsidwa ndi koyambirira, komwe mankhwalawo samaperekanso kuyembekezera kachipatala koyamba).

Potengera momwe mankhwalawo amathandizira Diabetesalong, wodwalayo ayenera kusiya kumwa ndi / kapena mankhwala okhala ndi ethanol ndi zakudya.

Pa mankhwala ndi Diabetesalong, wodwalayo ayenera kudziwa kuchuluka kwa glucose ndi glycosylated hemoglobin m'magazi, ndi glucose zomwe zili mkodzo.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Munthawi ya chithandizo, chisamaliro chimayenera kuchitika poyendetsa magalimoto ndi kuchita zina zomwe zingakhale zoopsa zomwe zimafuna kuti anthu azisamalira komanso azithamanga kwambiri.

Zotsatira zoyipa:

Hypoglycemia (kuphwanya malamulo a dosing komanso kudya mokwanira): kupweteka mutu, kutopa kwambiri, njala, kutuluka thukuta kwambiri, kufooka, kugona, kukwiya, nkhawa, kusokonekera, kusokonezeka kwa chidwi, kulephera. kuyang'ana pang'ono komanso kuchitapo pang'ono, kukhumudwa, kuwona kwakhungu, aphasia, kugwedezeka, paresis, kusokonezeka kwa malingaliro, chizungulire, kudziona ngati wopanda thandizo, kulephera kudziletsa, kuwongolera, kugwedezeka, kusachita zambiri. imelo kupuma, bradycardia, kukomoka, chikomokere.

Kuchokera pamimba: kukhumudwa, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kudzimbidwa (zovuta za izi zimatsika ndikamadya chakudya), kawirikawiri - chiwindi ntchito (chiwindi, kuchuluka kwa hepatic transaminase, alkaline phosphatase, cholestatic jaundice - amafunikira kusiya mankhwala.

Kuchokera hemopoietic ziwalo: chopinga wa marow hematopoiesis (magazi m'thupi, thrombocytopenia, leukopenia, granulocytopenia).

Thupi lawo siligwirizana: kuyabwa kwa khungu, urticaria, zotupa pakhungu, kuphatikizapo maculopapular ndi ng'ombe zamphongo), erythema.

Zina: kuchepa kwa mawonekedwe.

Zotsatira zoyipa zina za sulfonylurea zotumphukira: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, alculgic vasculitis, chiwopsezo cha chiwindi.

Bongo

Zizindikiro:

Chithandizo: ngati wodwala akudziwa, tengani shuga mkati.

Mwina chitukuko cha matenda oopsa a hypoglycemic, limodzi ndi chikomokere, kukomoka kapena matenda ena amanjenje. Ngati zizindikiro zotere zikuwoneka, chithandizo chamankhwala chodzidzimutsa ndi kuchipatala mwachangu ndikofunikira.

Ngati kukomoka kwa hypoglycemic kukayikiridwa kapena kupezeka, wodwalayo amapweteka msanga ndi 50 ml ya 40% dextrose (glucose) yankho. Kenako, yankho la 5% dextrose (glucose) limayendetsedwa kudzera m'mitsempha kuti magazi azikhala ndi magazi okwanira.

Pambuyo podziwikanso, ndikofunikira kuti mupatse wodwalayo chakudya chambiri m'zakudya zamafuta ochepa (kuti mupewe kukonzanso kwa hypoglycemia). Kuwunikira mosamala kuchuluka kwa shuga wamagazi ndikuwunika kwa wodwalayo kuyenera kuchitidwa kwa maola osachepera 48. Pambuyo pa nthawi yino, kutengera mtundu wa wodwalayo, adokotala amafunikira pakuwunika ntchito zina.

Kutsegula m'mimba sikugwira ntchito chifukwa cha kutchulidwa kwa gliclazide kwa mapuloteni a plasma.

Tsiku lotha ntchito: Zaka zitatu

Zoyenera kufalitsa kuchokera ku malo ogulitsa mankhwala: Ndi mankhwala.

Wopanga: SYNTHESIS, OJSC (Russia)