Glidiab: shuga mellitus, contraindication ndi zovuta zimachitika

Zithandizo zochiritsika zomwe zimakwaniritsidwa pamene Glidiab amatengedwa ndi chifukwa cha ntchito ya glycoslide yomwe ikuphatikizidwa, yomwe ndi gawo lachiwiri la sulfonylurea. Mosiyana ndi mankhwala am'badwo woyamba, amadziwika ndi kugwira ntchito kwakukulu komanso kuwopsa pang'ono, ndipo mphamvu yake yotsitsa shuga imatsimikiziridwa ndikuti mothandizidwa ndi gliclazide:

• Pali kuwonjezeka kwa katemera wa insulin m'mimba mwa kapamba, komwe, pogwiritsa ntchito mapuloteni olandilira, amapanga shuga m'magulu amthupi, amalimbikitsa kutseguka kwa kapangidwe ka glycogen m'chiwindi, minofu ndi kuletsa gluconeogeneis,
• Kupanga kwa shuga kuchokera ku minofu ya adipose mu chiwindi kumalepheretsa,
• Kuchita kwa insulin kuzungulira m'magazi kumalimbikitsidwa,
• Kugwiritsidwa ntchito kwa glucose pogwiritsa ntchito minofu ndi chiwindi
• Njira za hydrolytic kusweka kwa mafuta (lipolysis) mu adipose minofu ndizoletsa.

Ndemanga ya Glidiab, yopangidwa ndi madotolo ndi odwala, ikuwonetsa kuti pamene mukumwa mankhwalawa, mphamvu ya zotumphukira kuti insulin iwonjezeke, ntchito ya intracellular enzymes (kuphatikizapo glycogen synthetase yomwe ilipo mu minofu minofu) imalimbikitsidwa, ndipo nthawi pakati pa chakudya ndikuchepetsedwa kwambiri chiyambi chobisika ndi tiziwopsezo timatupa tating'onoting'ono ta insulin (mwakulankhula kwina, mwa kuchuluka kwa insulin). Komanso, mosiyana ndi mankhwala ena omwe amachokera ku sulfonylurea (kuphatikizapo glibenclamide ndi chlorpropamide) ndipo zimakhudza gawo lachiwonetsero lachiwiri, Glidiab amathandizira kubwezeretsa kutulutsa kwa insulin koyambirira komanso kuchepetsa kuchuluka kwa shuga m'magazi a seramu.

Kuphatikiza pa kukhudza kagayidwe kazachilengedwe, mankhwalawa amathandizanso kukweza magazi m'magazi, kumachepetsa kuphatikiza ndi kuphatikizika kwa maselo ambiri, ndikuchepetsa kukula kwa parietal thrombi.

Kuphatikiza apo, malinga ndi malangizo, Glidiab:

• Kuchepetsa zomwe zimasinthidwa mwa mtima.
• Zimalepheretsa kukula kwa microthrombosis,
• Imachepetsa mphamvu ya mtima ku adrenaline,
• Imasinthasintha njira ya thupi parietal fibrinolysis njira (kusungunuka kwamaunda ndi kuwundana kwamagazi),
• Amachepetsa kuchuluka kwa cholesterol m'magazi, potero imachepetsa kukula kwa atherosulinosis ndikuwonjezera mphamvu yake (ndiye kuti, imakhala ndi anti-atherogenic),
• Zimalepheretsa kukula kwa matenda ashuga retinopathy osagwirizana kwambiri.

Ndemanga za Glidiab zimatsimikizira kuti kugwiritsa ntchito kwakanthawi shuga mu nephropathy kungachepetse kwambiri mapuloteni pakuwunika kwamikodzo.

Mankhwalawa sachititsa kuti thupi lizikula, chifukwa zimakhudza kwambiri nsonga zoyambirira za kupangika kwa insulin chifukwa cha timimba ta endocrine ndipo sikuti timayambitsa hyperinsulinemia. Odwala a Glidiab onenepa, mosiyana ndi izi, atadya zakudya zapadera amatha kuchotsa mapaundi owonjezera.

Glidiab Pharmacokinetics

Ndi pakamwa makonzedwe a mapiritsi a Glidiab, zinthu zomwe zimapezeka mmatumbo zimayamwa bwino kuchokera m'mimba. Pambuyo pakudya limodzi lokha 80 mg, pazambiri kuchuluka kwa gliclazide m'madzi am'magazi kumaonedwa pambuyo pa maola anayi. Ndondomeko ya biotransfform imachitika m'chiwindi, komwe ma metabolites asanu ndi atatu amapangidwa ndi oxidation, hydroxylation ndi glucuronidation omwe sangathe kutsitsa glucose, pomwe amodzi mwa metabolites omwe amachokera amathandizira kusintha kwapang'onopang'ono.

70% ya metabolites amachotseredwa makamaka ndi impso ndi mkodzo, 12% iliyonse - yomwe ili ndi matumbo panthawi yamatumbo. Osasinthika ndi impso, 1% ya gliclazide imachotsedwanso. Kutha kwa theka la moyo kumapanga maola 8 mpaka 11.

Zizindikiro zogwiritsidwa ntchito

Malangizo a Glidiab akuwonetsa kuti mankhwalawa amalimbikitsidwa kwa odwala omwe ali ndi vuto la matenda ashuga a 2 omwe amachepetsa mphamvu, limodzi ndi mitundu yoyambirira ya matenda a shuga a shuga. Nthawi yomweyo, kugwiritsidwa ntchito kwake kumaloledwa ngati othandizira monotherapeutic, ndipo monga gawo la zovuta mankhwala, kutanthauza kugwiritsa ntchito mankhwala ena omwe ali ndi vuto la hypoglycemic.

Mapiritsi a Glidiab amathanso kupatsidwa mankhwala ena a hypoglycemic ngati prophylactic pazovuta zosiyanasiyana zamagazi a magazi.

Contraindication

Mankhwala ali osiyanasiyana angapo contraindication. Chifukwa chake, ndizoletsedwa kupereka Glidiab:

• Odwala a shuga a Type 1
• Ndi matenda ashuga a ketoacidosis,
• Ndili ndi matenda ashuga komanso chikomokere,
• Odwala ndi insuloma,
• Anthu omwe ali ndi vuto la impso ndi chiwindi.
• Mitundu yayikulu ya microangiopathy,
• Matenda opatsirana
• Ndili ndi kuvulala komanso kuchitapo kanthu maopareshoni ambiri
• Anthu omwe ali ndi hypersensitivity kuti amachokera ku sulfonylurea ndi kukonzekera kwa sulfonamide,
• Amayi pa nthawi yoyembekezera komanso mkaka wa m'mawere.

Mlingo ndi makonzedwe

Kwa wodwala aliyense, muyezo woyenera wa tsiku ndi tsiku wa Glidiab amatsimikiziridwa ndi dokotala aliyense payekhapayekha potengera momwe thupi lake limakhalira, zaka zake komanso momwe matendawo alili. Makamaka, amakhala ndi chidwi ndi chithunzi cha matenda ndi zizindikiro za glycemia, zomwe zimawonetsedwa m'mawa popanda kanthu komanso maola awiri atatha kudya.

Mlingo woyamba wa tsiku ndi tsiku wa Glidiab nthawi zambiri amakhala 80 mg, pafupifupi tsiku lililonse ndi 160 mg, ndipo pazokwanira ndi 320 mg. Kuchulukitsa kwa madyerero ndi 2. Kumwa mapiritsi kumalimbikitsidwa m'mawa komanso madzulo theka la ola musanadye.

Zotsatira zoyipa

Ndemanga za Glidiab ndi umboni kuti, nthawi zina, kumwa mankhwalawa kumatha kukhala limodzi ndi zovuta zoyipa.

Odwala ena amakhala ndi chifuwa, kukwiya, kusanza, kusanza, kumva kupweteka komanso kupweteka m'dera la epigastric. Supombocytopenia, leukopenia, agranulocytosis kapena kuchepa kwa magazi nthawi zina zimatha kuchitika (monga lamulo, zochitika zonsezi zimatha kusintha).

Mankhwala

The yogwira pophika mankhwala ali m'gulu la hypoglycemic wothandizira, zomwe ntchito yake imachitika chifukwa cha maselo a kapamba. Glidiab amatipatsa zoterezi pamthupi, monga:

1. Maselo a pancreatic amalimbikitsidwa ndi insulin katulutsidwe.
2. Zimawonjezera kukhudzika kwa minofu ku insulin, yomwe imalola kukwaniritsa zotsatira zabwino mutatha kugwiritsa ntchito mankhwalawa.
3. Kuchepetsa kutalika kwa nthawi kuchokera pomwe chakudya chimalowa mthupi mpaka pancreas ipanga insulini, kuphatikizanso kugaya.
4. Amachepetsa kuphatikiza kwa maselo komanso kuphatikiza, zomwe zimathandiza kupewa matenda a mtima wama mtima ogwirizana ndi mapangidwe a magazi.
5. Amachepetsa mphamvu ya mtima khoma zolandilira zotsatira za adrenaline.
6. Imayambitsa kuchepa kwa proteinuria pamaso pa nephrotic syndrome.

Ubwino wabwino wa mankhwalawa ndi chakuti, ngati ntchito yayitali, kuchuluka kwa thupi sikumakula, zomwe zimachitika pamaso pa matenda a shuga. Kutengera ndi zakudya zomwe zimalimbikitsidwa, Glidiab amathandizira kukhazikika pathupi.

Kodi glidiab amawoneka bwanji?

Kukula kwa retinopathy kumachepetsedwa, komwe kumathandiza wodwala kukhalabe ndi masomphenya. Poyerekeza ndi kugwiritsidwa ntchito kwa nthawi yayitali, kukhathamiritsa kwa miyendo ndikuyenda bwino, komwe kumathandiza kuchepetsa chiwonetsero cha polyneuropathy. Ndi mlingo woyenera wa mankhwalawa, zovuta zoyipa za shuga zimachepetsedwa.

Atatha kutenga mapiritsiwo mkati, amatsitsidwa ndikugaya, kulowa m'magazi ambiri. Kuwonjezeka kwa kuchuluka kwa mankhwalawa kumachitika pang'onopang'ono, komwe kumachotsa kukulira kwatsoka la mtima ndi mtima (nseru, chizungulire, ndi zina zambiri).

Kuzindikira kwakukulu kumakwaniritsidwa maola 6-12 mutatha kumwa mapiritsi. Kudya sikukhudza mayamwidwe ndi magawidwe azigawo zomwe zimagwiritsa ntchito mankhwalawa.

Hafu ya moyo ili pafupifupi maola 16. Izi zimakuthandizani kuti mumwe mankhwalawa kamodzi patsiku, ndipo mphamvu yake imagwira tsiku lonse.

Mankhwala omwe amagwira ntchito ndi gliclazide, omwe piritsi limodzi lili 30 mg. Zothandiza:

• cellcrystalline mapadi,
• hypopellose,
• silika
• magnesium wakuba.

Mapiritsiwo ndi osalala-am-cylindrical ndi chamfer pakati. Atadzaza mizere cell 10 ma PC.

Zisonyezero zakudikirira

Mankhwala ndi mankhwala pamaso pa mtundu 2 shuga, komanso kuthetsa zotsatirazi:

• ochepa matenda oopsa
• matenda amtima
• nephrotic syndrome.

Musanagwiritse ntchito mankhwalawa, ndikulimbikitsidwa kufunsa katswiri.

Njira zogwiritsira ntchito

Pali mitundu iwiri ya Glidiab: wokhazikika ndi Glidiab MV. Kusiyana kwa kukonzekera kumangokhala muyezo ndi mawonekedwe a makonzedwe.

Mlingo woyamba wa tsiku lililonse wa shuga wopita patsogolo ndi 80 mg tsiku lililonse. Itha kuwonjezeka pang'onopang'ono posakhala ndi chithandizo chamankhwala. Mlingo wapamwamba tsiku lililonse wa mankhwala ndi 320 mg. Imagawidwa mu ma Mlingo angapo nthawi zonse, zomwe zimakupatsani mwayi wokhala ndi shuga m'magazi ena ngakhale mutamwa mafuta.

Ndikulimbikitsidwa kuti mutenge Gladiab mukangodzuka m'mawa ndi madzi pang'ono. Pamaso pa pathologies a impso, kusintha kwa mankhwalawa sikofunikira.

Glidiab MV

Mankhwalawa amatha nthawi yayitali, motero, piritsi limodzi patsiku la 30 mg. Palibe achire zotsatira, kuchuluka kwa mlingo wa mpaka 120 mg patsiku ndikololedwa. Njirayi imachitika pang'onopang'ono, ndikuwonjezera theka la piritsi tsiku sabata iliyonse.

Glidiab MV ali ndi zochita nthawi yayitali

Ndikulimbikitsidwa kumwa mapiritsi m'mawa mutatha kadzutsa kapena mukamadya. Pofuna kusowa kwa ntchito, ndikofunikira kufunsa dokotala za kuthekera kusintha kwa Mlingo.

Ubwino waukulu wa mankhwalawa ndikuti ukhoza kugwiritsidwa ntchito limodzi ndi othandizira ena a hypoglycemic, omwe samavulaza thanzi.

Bongo

Ngati bongo wa mankhwala osokoneza bongo, zofunika ziwiri zovuta zimachitika: hypoglycemia ndi pancytopenia. Poyambirira, shuga ya magazi amatsika kwambiri. Kachiwiri, kuphatikiza kwa mafupa m'magazi kumachepetsedwa, komwe kumapangitsa njira zonse za metabolic. Pamodzi, izi zitha kubweretsa chitukuko cha chikomokere cha matenda ashuga komanso zotsatira zoyipa.

Wodwalayo akazindikira, amapatsidwa zakudya zokhala ndi shuga kuti achulukitse kuchuluka kwa shuga m'magazi. Mkhalidwe wopanda tanthauzo umafunikira kukoka kwa glucose ndikuwunikira magawo amomwe amwazi a biochemical.

Kuchita ndi mankhwala ena

Glibiad MV imaphatikizidwa bwino ndi mankhwala ena omwe ali ndi katundu wa hypoglycemic, koma ndi chithandizo chovuta ndikofunika kuganizira kuchuluka kwa mankhwalawa kuti musapangitse kukula kwa shuga wotsika kwambiri.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwalawa ndi mankhwala a NSAID, pali khungu la khungu, pallor ndi zizindikiro zina za kuchepa magazi, kuphatikizapo chizungulire komanso kusowa kudya.

Sulfanilamides kuphatikiza ndi Glibiad amalimbikitsa shuga wochepa wa m'magazi, zomwe zimawonjezera chiopsezo chokhala ndi vuto la hypoglycemic.

Pogwiritsa ntchito munthawi yomweyo ndi ma fibrate, kuchuluka kwa mankhwala a hypoglycemic kumawonjezeka kangapo.

Ndi kusamala kwambiri, mankhwalawa amaphatikizidwa ndi glucocorticosteroids, chifukwa chomaliza chingayambitse kukula kwa matenda a shuga.

Mankhwala a Hormonal omwe adapangidwira kuti athe kukonza matenda a endocrine amasankhidwa pamlingo wocheperako, popeza mukamayanjana ndi Glidiab, kuthandizira kwachangu kumachepa kangapo.

Theophylline ndi salicylic acid amachokera kangapo amalimbikitsa mphamvu ya mankhwalawa, omwe angayambitse kukula kwa hypoglycemia.

Ndi zoletsedwa kuphatikiza Miconazole ndi mankhwala ena a antifungal ndi Glidiab

Ndi zoletsedwa kuphatikiza Miconazole ndi mankhwala ena a antifungal ndi Glidiab, omwe akuphatikizira kukula kwa chikomokere cha matenda ashuga komanso zotsatira zomwalira mwadzidzidzi.

Komanso, musagwiritse ntchito mankhwala osokoneza bongo komanso mankhwalawa ngati mowa, chifukwa mamolekyulu amtundu wa ethanol amalimbikitsa kuphwanya kwina kwa thupi, zomwe zimakhudza kapamba.

Ma blockers a Adrenergic polumikizana ndi Glidiab amatha kumasula zizindikiro za hypoglycemia, zomwe zimawonjezera chiopsezo chokhala ndi zochitika zadzidzidzi.

Barbiturates pafupifupi zimalepheretsa zochitika za mankhwala Glidiab MV, chifukwa chake, sizigwiritsidwa ntchito limodzi chifukwa cha kusowa kwa achire zotsatira zake.

Kutengera malingaliro onse a katswiri, mapiritsi a Glidiab angathandize kuchepetsa kuchuluka kwa shuga m'magazi, komanso kuchepetsa chiwonetsero cha matenda ashuga. Mankhwala olimbitsa thupi sayenera kudzipatula kwathunthu, chifukwa pamakhala chiopsezo chambiri chotengera zochita zoyipa.