Mankhwala a Hypoglycemic Maninil ndi mitundu yake

Kuphatikiza apo, imachepetsa gluconeogeneis wa hepatic ndi glycogenolysis, imalepheretsa kuchuluka kwa gluolose, komanso kumachepetsa magazi. Kutalika kwa hypoglycemic zotsatira zopangidwa ndi mankhwala 2 mawola pambuyo makonzedwe ali pafupifupi maola 12.

Mapiritsi Glibenclamide Maninyl 3.5 mg

Chithandizo chotsitsa shuga cha Maninil - glibenclamide, chowonetsedwa mwa mawonekedwe owoneka, ali ndi mphamvu yokhudza thupi, yolowa msanga ndi 48-84%. Mutatha kumwa mankhwalawa, kutulutsidwa kwathunthu kwa glibenclamide kumachitika mkati mwa mphindi 5. Yogwira pophika imaphwanyidwamo m'chiwindi ndikupukusidwa ndi impso ndi bile.

Mankhwala amapangidwa piritsi ndi mitundu yosiyanasiyana ya yogwira piritsi 1:

Mapiritsiwo ndi amtali-cylindrical mawonekedwe, ndi chamfer ndi chizindikirocho chimayikidwa pamalo amodzi, mtundu wake ndi wapinki.

Wopanga mankhwalawa ndi FC Berlin-Chemie; m'mafakisoni mumaperekedwa mankhwala okha. Mankhwalawa amadzaza m'mabotolo agalasi yowonekera, ma PC 120 aliyense. Iliyonse, mabotolo omwewo amadzaza pamakatoni. Chinsinsi cha Latin ku Maninil ndi ichi: Maninil.

Malinga ndi kafukufuku, kutsatira mlingo wokwanira mukamamwa mankhwalawa kumachepetsa mwayi wokhala ndi mtima ndi zovuta zina zomwe zimayambitsidwa ndi matenda osagwirizana ndi insulin, kuphatikiza ndi anthu omwe amafa ndi matendawa.

Analogs popanga ndi chisonyezo chogwiritsidwa ntchito

Mndandanda womwe uli pamwambapa wa analogies ya mankhwala, omwe akuwonetsa Maninil amaloweza, ndizabwino kwambiri chifukwa zimakhala ndi zinthu zomwe zimagwirizana ndipo zimagwirana molingana ndi chisonyezo chogwiritsidwa ntchito

Analogs mwa chisonyezo ndi njira yogwiritsira ntchito

Kuphatikizika kosiyanasiyana, kungagwirizane mukuwonetsa komanso momwe mungagwiritsire ntchito

Kodi mungapeze bwanji analogue yotsika mtengo ya mankhwala okwera mtengo?

Kuti mupeze analogue yotsika mtengo kwa mankhwala, a generic kapena ofanana, choyambirira timalimbikitsa kulabadira kapangidwe kake, zomwe ndi zinthu zomwezi zomwe zikugwiritsidwa ntchito ndikuwonetsa. Zomwe zimagwiritsidwanso mosiyanasiyana ndi mankhwalawa zimawonetsa kuti mankhwalawo ndi ofanana ndi mankhwalawo, monga mankhwala ena kapena mitundu ina. Komabe, musaiwale za zovuta zomwe zimagwiritsidwa ntchito ndi mankhwala ofanana, omwe angakhudze chitetezo ndi kugwiranso ntchito. Musaiwale za malangizo a madotolo, kudzipereka nokha kungawononge thanzi lanu, chifukwa chake onani dokotala wanu musanagwiritse ntchito mankhwala.

Zizindikiro zogwiritsidwa ntchito

Manilin akuwonetsedwa akuwonetsa mtundu wa insulin yodziyimira payokha ya matenda a shuga (a mtundu wachiwiri). Itha kutumikiridwa ngati mlingo woyima pawokha kapena kuphatikiza ndi mankhwala ena a hypoglycemic. Chosiyana ndi makina olumikizana ndi ma glinides ndi zotumphukira za sulfonylurea.

Mawonekedwe a mlingo ndi makonzedwe

Kulowetsedwa kwa Maninil kumalimbikitsidwa musanadye, kutsukidwa osafwidwa.

Mlingo watsiku ndi tsiku umatsimikiziridwa ndi endocrinologist payekhapayekha:

1. Ngati sichidutsa mapiritsi awiri patsiku, ndiye kuti mankhwalawo amayenera kumwa kamodzi, makamaka m'mawa - asanadye chakudya cham'mawa,
2. mukamapereka mankhwala okwanira, kugwiritsa ntchito mankhwala kumachitika mu 2 Mlingo - m'mawa - musanadye chakudya chamadzulo komanso madzulo - musanadye chakudya chamadzulo.

Zomwe zimafunikira posankha chithandizo cha mankhwalawa ndi kuchuluka kwa zaka, kuuma kwa matendawa, komanso kuchuluka kwa shuga m'magazi pamimba yopanda kanthu ndikatha kudya pambuyo pa maola awiri.

Pankhani yotsika mtengo wa mankhwala omwe dokotala angagwiritse ntchito, angasankhe kuiwonjezera. Njira yowonjezerera mlingo mpaka mulingo woyenera imachitika pang'onopang'ono - kuyambira masiku awiri mpaka asanu ndi awiri, kuyang'aniridwa ndi dokotala.

Pankhani yosinthira ku Maninil kuchokera ku kukonzekera kwina kwa mankhwala ndi hypoglycemic effect, kayendetsedwe kake kamayikidwa muyezo woyambirira, ngati kuli koyenera, kumawonjezeka, kumachitika mosamala komanso moyang'aniridwa ndi achipatala.

Mlingo Woyamba wa Maninil:

• yokhala ndi 1.75 mg yogwira pophika - ndi mapiritsi 1-2 kamodzi patsiku. Mlingo wapamwamba siwopitilira mapiritsi 6 patsiku,
• yokhala ndi 3.5 mg yogwira ntchito - piritsi 1 / 2-1 kamodzi patsiku. Mlingo waukulu ndi mapiritsi atatu patsiku,
• yokhala ndi 5 mg yogwira pophika - ndi piritsi 1 time nthawi imodzi patsiku. Mlingo woyenera wololera tsiku lonse ndi mapiritsi atatu.

Okalamba (wazaka zopitilira 70), omwe amatsatira malamulo oletsa kudya, komanso omwe ali ndi vuto lochepa kwambiri laimpso kapena chiwindi, tikulimbikitsidwa kugwiritsa ntchito Mlingo wochepetsedwa wa mankhwalawa chifukwa choopseza hypoglycemia.

Ngati mukusowa muyezo umodzi, mankhwalawa a Maninil amapangidwa muyezo wofanana (wopanda kuwonjezeka) pa nthawi yanthawi zonse.

Zotsatira zoyipa

Matenda a shuga amawopa mankhwalawa, ngati moto!

Muyenera kungolemba ...

Maonekedwe akusokonezeka pakuchitika kwa makina ena pomwe akutenga Maninil samawonedwa kawirikawiri. Mawonekedwe awo apang'ono amatha.

• kuchokera m'mimba - mawonekedwe a mseru, kupindika, kumva kupsinjika m'mimba, mawonekedwe a chitsulo chamkamwa, kutsekula m'mimba,
• kuchokera ku chiwindi - mu mawonekedwe a chiwindi michere, kukula kwa intrahepatic cholestasis kapena hepatitis,
• kuchokera kumbali ya kagayidwe - mu mawonekedwe a kuwonda kapena hypoglycemia yokhala ndi zizindikiro zake - kunjenjemera, kutuluka thukuta, kusokonezeka kwa tulo, nkhawa, migraine, masomphenya kapena kuyankhula,
• pa chitetezo chokwanira - mu mawonekedwe osiyanasiyana amisala pakhungu - petechiae, kuyabwa, hyperthermia, photosensitivity ndi ena,
• kuchokera ku hematopoietic dongosolo - mu mawonekedwe a thrombocytopenia, hemolytic anemia, erythrocytopenia,
• pa mbali ya ziwalo - mwanjira yophwanya malo okhala.

Mfundo yofunika mukamamwa Maninil ndikusunga kwambiri malangizo a kuchipatala okhudzana ndi kadyedwe komanso plasma glucose wokha. Ngati bongo wambiri, hypoglycemia imatha kukhala ndi zizindikiro zake.

Pakakhala vuto la mankhwala osokoneza bongo, timalimbikitsidwa kudya shuga pang'ono kapena zakudya zopatsa mphamvu zam'mimba zomwe zimapezeka mosavuta. Pazokhudza mitundu yoopsa ya bongo, iv jekeseni wa shuga yakhazikitsidwa. M'malo mwa shuga, IM kapena subcutaneous jakisoni wa glucagon ndizovomerezeka.

Chiwopsezo cha hypoglycemia chimawonjezeka ngati:

• mowa
• chakudya
• nthawi yayitali pakudya,
• kusanza kapena kudzimbidwa,
• kulimbitsa thupi kwambiri.

Zizindikiro za hypoglycemia zitha kuphimbidwa ndikumamwa Maninil ndimankhwala omwe amakhudza dongosolo lamanjenje kapena amachepetsa kuthamanga kwa magazi.

Zotsatira za Maninil zitha kuchepetsedwa pomwe zimagwiritsidwa ntchito ndi barbiturates, njira zolerera komanso mankhwala ena okhala ndi mahomoni. Ndipo m'malo mwake, kugwiritsa ntchito ma anticoagulants munthawi yomweyo, ma reserpine, ma tetracyclines, anabolic steroids amatha kupititsa patsogolo ntchito zake.

Zolepheretsa ndi zotsutsana

Pochita ndi Maninil, tikulimbikitsidwa kupewa kutalikirana ndi dzuwa nthawi yayitali, komanso kusamala poyendetsa galimoto, kuchita zina zomwe zimafunikira chidwi, chidwi, komanso kugwira ntchito mwachangu.

Mankhwala a hypoglycemic amapatsirana chifukwa cha kukhalapo:

• shuga wodalira insulin
• kulephera kwa chiwindi
• matumbo,
• matenda ashuga ketoacidosis,
• matenda a shuga kapena matenda a mtima,
• paresis am'mimba
• leukopenia
• lactose tsankho ndi kusowa kwa lactase,
• kuchuluka kwa ntchito yogwira - glibenclamide kapena zinthu zina zomwe zimaphatikizidwa ndi mankhwala,
• Hypersensitivity ku PSM, komanso sulfonamides ndi okodzetsa okhala ndi zotumphukira za gulu la sulfonamide,
• kuchotsedwa kwa kapamba.

Kutseka kwa Maninil ndi kulowetsedwa ndi insulin kupangidwa ngati:

• matenda opatsirana oyenda limodzi ndi mawonekedwe owoneka,
• njira zowukira
• kuwotcha kwakukulu,
• kuvulala
• pakati kapena kufunika yoyamwitsa.

Mosamala, mankhwalawa amayenera kumwedwa pamaso pa kukanika kwa chithokomiro, adrenal cortex, kuledzera kwamphamvu chifukwa cha mowa.

Mankhwala a hypoglycemic amaphatikizidwa mwa ana.

Momwe mungasinthire Maninil: analogues ndi mtengo

Monga mankhwala ambiri, Maninil ali ndi mawu ofanana. Mofananamo ali ndi mitundu ingapo yochepetsa shuga, yogwira yogwira yomwe ndi glibenclamide.

Maninyl 3,5 analogu ndi awa:

• Glibomet - kuchokera ku ruble 339,
• Glibenclamide - kuchokera ma ruble 46,
• Maninil 5 - kuchokera ku ruble 125.

Odwala okhudzana ndi analogues ali ndi mafunso angapo, mwachitsanzo, ndibwino - Maninil kapena Glibenclamide? Pankhaniyi, zonse ndizosavuta. Glibenclamide ndi Maninil. Chachiwiri chokha ndi mtundu waukadaulo wapamwamba kwambiri woyamba.

Ndipo chiti ndibwino - Maninil kapena Glidiab? Pankhaniyi, palibe yankho lachilendo, chifukwa zambiri zimatengera momwe munthu wodwalayo alili.

Mndandanda wa Maninil wa mtundu 2 wa shuga kudzera pakuchiritsa:

• Amaril - kuchokera ku ma ruble a 350,
• Vazoton - kuchokera ma ruble 246,
• Arfazetin - kuchokera ma ruble 55,
• Glucophage - kuchokera ku ma ruble 127,
• Listata - kuchokera ku ruble 860,
• Diabeteson - kuchokera ma ruble 278,
• Xenical - kuchokera ma ruble 800,
• ndi ena.

Posankha analogue ya Maninil, akatswiri amalimbikitsa kupatsa chidwi ndi mankhwala omwe amapangidwa ndi makampani opanga mankhwala aku Japan, America ndi Western Europe: Gideon Richter, Krka, Zentiv, Hexal ndi ena.

Malangizo a Maninil

MALANGIZO
pa kugwiritsa ntchito mankhwalawa
Maninil

Kutulutsa Fomu
Mapiritsi

Kupanga
Piritsi limodzi lili:
Zinthu zomwe zimagwira ntchito: glibenclamide (mumawonekedwe owonetsedwa) 1.75 mg.
Omwe amachokera: lactose monohydrate, wowuma wa mbatata, gimetellosa, colloidal silicon dioxide, magnesium stearate, kapezi wa utoto (Ponso 4R) (E124)

Kulongedza
m'mabotolo agalasi a ma PC 58., mu paketi okhala ndi ma 30 kapena 60 ma PC.

Zotsatira za pharmacological
Mankhwala
Oral hypoglycemic mankhwala ochokera pagulu la sulfonylurea zotumphukira za m'badwo wachiwiri.
Imathandizira katulutsidwe ka insulini pomangirira ku ma pancreatic β-cell membrane enieni olandilira, kumachepetsa cholumikizira kukhudzana ndi shuga wa glucose, kumakulitsa chidwi cha insulini komanso kumangiriza kwake kwa maselo, kumakulitsa kumasulidwa kwa insulin, kumakulitsa mphamvu ya insulini pakukoka kwa glucose ndi chiwindi, potero kuchepetsa kuchuluka kwa shuga m'magazi. Machitidwe mu gawo lachiwiri la insulin katulutsidwe. Imalepheretsa lipolysis mu minofu ya adipose. Amakhala ndi lipid-kutsitsa kwake, amachepetsa mphamvu za magazi m'magazi.
Maninil® 1.5 ndi Maninil ® 3.5 mu mawonekedwe owonetsedwa ndi mawonekedwe apamwamba, makamaka mawonekedwe a glibenclamide, omwe amalola kuti mankhwalawa amvedwe kuchokera kumimba othamanga mofulumira. Pokhudzana ndi kukwaniritsidwa koyambirira kwa Cmax ya glibenclamide mu plasma, zotsatira za hypoglycemic pafupifupi zimafanana ndi kuchuluka kwa glucose m'magazi mutatha kudya, zomwe zimapangitsa mphamvu ya mankhwalawa kukhala yofewa komanso yolimbitsa thupi. Kutalika kwa nthawi ya hypoglycemic ndi maola 20-24.
Hypoglycemic zotsatira za mankhwala Maninil® 5 amakula pambuyo 2 maola ndipo kumatenga 12 maola.

Pharmacokinetics
Zogulitsa
Pambuyo pakulowa kwa Maninil 1.75 ndi Maninil 3.5, kunyamula mwachangu komanso kotheratu kuchokera m'mimba kumawonedwa. Kutulutsidwa kwathunthu kwa chinthu cha microionised yogwira kumachitika mkati mwa mphindi 5.
Pambuyo pakulowa kwa Maninil 5, mayamwidwe am'mimba ndi 48-84%. Tmax - maola 1-2. Mtheradi wa bioavailability - 49-59%.
Kugawa
Kumanga mapuloteni a Plasma ndi oposa 98% a Maninil 1.75 ndi Maninil 3.5, 95% a Maninil 5.
Kutetemera ndi chimbudzi
Imakhala ngati imaphatikizidwa kwathunthu m'chiwindi ndikupanga ma metabolites awiri osagwira ntchito, amodzi omwe amatsitsidwa ndi impso, ndi ena ndi bile.
T1 / 2 ya Maninil 1.75 ndi Maninil 3.5 ndi maola 1.5-3.5, kwa Maninil 5 - 3-16 maola.

Maninil, zikugwiritsa ntchito
Type 2 shuga mellitus (osadalira insulini) osagwiritsa ntchito mankhwalawa pakudya, kuchepa thupi kunenepa kwambiri komanso kuchita masewera olimbitsa thupi okwanira.

Contraindication
Hypersensitivity (kuphatikizapo mankhwala a sulfonamide ndi zotumphukira zina za sulfonylurea), mtundu wa 1 shuga mellitus (wodalira insulini), kagayidwe kake ka metabolic (ketoacidosis, precoma, chikomokere), zotupa zapakhosi, chiwindi ndi matenda a impso, zina (mwachitsanzo, kuwonongeka kwa chakudya cha carbohydrate metabolism matenda opatsirana, kuwotcha, kuvulala kapena pambuyo pochita maopaleshoni akuluakulu pakusonyeza mankhwala a insulin), leukopenia, kutsekeka kwamatumbo, m'mimba. Motsatira limodzi ndi malabsorption chakudya ndi kukula kwa hypoglycemia, pakati ndi nthawi yoyamwitsa.

Mlingo ndi makonzedwe
Maninyl 1.75 amatengedwa pakamwa, m'mawa ndi madzulo, asanadye, osafuna kutafuna. Mlingo umayikidwa payekha, kutengera kuopsa kwa matendawa.
Mlingo woyamba ndi piritsi 1/2, pafupifupi mapiritsi awiri. patsiku, pazipita - 3, pokha pokha - mapiritsi 4. patsiku. Ngati kuli kofunikira kutenga Mlingo wapamwamba wa mankhwalawa (mpaka 14 mg / tsiku), amasinthana ndi 3.5 mg maninil.

Mimba komanso kuyamwa
Mankhwalawa amayesedwa kuti agwiritse ntchito panthawi yoyembekezera komanso panthawi yoyamwitsa.
Mimba ikachitika, mankhwalawo ayenera kusiyidwa.

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.

Malangizo apadera
Pa chithandizo ndi Maninil ®, ndikofunikira kutsatira mosamalitsa zomwe adotolo amafufuza pankhani ya kadyedwe ndi kudziyang'anira pawekha wamagazi.
Kudziletsa kwakanthawi kochepa kwa chakudya, kusakwanira kwa chakudya chamagulu, kuchita masewera olimbitsa thupi, kutsegula m'mimba kapena kusanza kumayambitsa chiopsezo cha hypoglycemia.
Kugwiritsa ntchito nthawi yomweyo mankhwala osokoneza bongo, kumachepetsa kuthamanga kwa magazi (kuphatikiza ma beta-blockers), komanso zotumphukira za m'mitsempha, kumatha kubisa zizindikiro za hypoglycemia.
Odwala okalamba, chiopsezo chokhala ndi hypoglycemia ndiwokwera pang'ono, motero, kusankha mosamala kwambiri kwa mankhwalawa ndikuwunika pafupipafupi kuchuluka kwa shuga m'magazi pamimba yopanda kanthu ndikatha kudya, makamaka kumayambiriro kwa chithandizo, ndikofunikira.
Mowa umatha kukulitsa kukula kwa hypoglycemia, komanso kukhazikitsa njira yofanana ndi disulfiram (nseru, kusanza, kupweteka kwam'mimba, kumva kutentha pamaso ndi thupi lakumtunda, tachycardia, chizungulire, kupweteka kwa mutu), motero muyenera kupewa kumwa mankhwalawa Maninil ®.
Kuchita maopaleshoni akuluakulu komanso kuvulala, kuwotcha kwambiri, matenda opatsirana omwe ali ndi febrile syndrome kungafune kutha kwa mankhwalawa a hypoglycemic mankhwala ndi makonzedwe a insulin.
Pa chithandizo, kukhudzana ndi dzuwa nthawi yayitali sikulimbikitsidwa.

Kukopa pa kuyendetsa magalimoto ndi njira zina zofunika kuwonjezera chidwi cha anthu
Pa chithandizo, odwala ayenera kusamala poyendetsa magalimoto ndi zochitika zina zowopsa zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Kuyanjana kwa mankhwala
Kupititsa patsogolo kwa hypoglycemic zotsatira za Maninil ® ndikotheka ndikutenga ACE zoletsa, ma anabolic othandizira ndi mahomoni ogonana amuna, ena othandizira pakamwa (mwachitsanzo, acarbose, biguanides) ndi insulin, azapropazone, NSAIDs, beta-adrenergic blocking agents, chlorofibrinol derivatives, chinofenolivivin analogues, coumarin zotumphukira, disopyramide, fenfluramine, mankhwala antifungal (miconazole, fluconazole), fluoxetine, MAO zoletsa, PA SC, pentoxifylline (Mlingo wambiri wa makulidwe a makolo), perhexylin, zotumphukira za pyrazolone, phosphamides (mwachitsanzo cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfonamide, tetracyclines ndi tritoqualin.
Urine acidifying agents (ammonium chloride, calcium chloride) amalimbikitsa mphamvu ya maninil ® mankhwalawa pochepetsa kuchepa kwake ndikuwonjezera mphamvu yake.
Mphamvu ya hypoglycemic ya Maninil ® ingathe kuchepa ndi kugwiritsa ntchito pamodzi kwa barbiturates, isoniazid, diazoxide, GCS, glucagon, nicotinates (muyezo waukulu), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, estrogen contraceprogen, estrogen estrogen. , blockers a pang'onopang'ono calcium njira, lifiyamu salt.
Otsutsa a H2 receptor amatha kufooketsa, kumbali imodzi, ndikuthandizira zotsatira za hypoglycemic za Maninil® mbali inayo.
Nthawi zina, pentamidine imapangitsa kuchepa kwamphamvu kapena kuchuluka kwa kuchuluka kwa shuga m'magazi.
Pogwiritsa ntchito munthawi yomweyo Maninil ®, zotsatira za zotumphukira za coumarin zitha kuchuluka kapena kuchepa.
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
Zizindikiro: hypoglycemia (njala, hyperthermia, tachycardia, kugona, kufooka, chinyezi pakhungu, kusokonekera koyenda kwamanjenje, kunjenjemera, nkhawa zambiri, mantha, kupweteka mutu, kuchepa kwa minyewa yamitsempha yamafupa (mwachitsanzo, zovuta zamawonedwe ndi zolankhula, paresis kapena ziwalo kapena kusinthika kwa malingaliro.) Ndi kupita patsogolo kwa hypoglycemia, odwala amatha kulephera kudziletsa komanso chikumbumtima, kukula kwa chikumbumtima cha 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;

Malo osungira
Sungani pamalo amdima pa kutentha osaposa 25 ° C.

Tsiku lotha ntchito
Zaka zitatu