I-Gliclazide MV isidakamizwa esisebenzayo se-hypoglycemic esisiza ukuqinisa amazinga kashukela ezigulini ezinefomu lesibili likashukela.
Njengoba ama-90% abo bonke abantu abanesifo sikashukela emhlabeni behlushwa yile ndlela yokusebenza kwengqondo, umbuzo wokusetshenziswa okuyikho kwezidakamizwa ezinciphisa ushukela kanye nokuqedwa kwezimpawu ezihambisana nalokhu "isifo esimnandi" kuhlala kusebenza.
Ngaphambi kokufaka isicelo ekwelapheni i-Gliclazide MV, zonke izinkomba, imithamo, ama-contraindication, ukulimala okungenzeka, kuyini intengo emakethe yemithi, ukubukeza kanye nokufana komuthi kufanele kufundwe.
Izici ezijwayelekile zomuthi
I-Gliclazide MV yi-ejenti yomlomo eyisusa sulfonylurea yesizukulwane sesibili. Amalungiselelo aleli qembu kade asetshenziswa kwezokwelapha, kusukela ngawo-1950. Ngesikhathi seMpi Yesibili Yomhlaba, le mishanguzo yayisetshenziselwa ukulwa nezifo ezahlukahlukene, futhi ngamathuba kuphela lapho umphumela wazo we-hypoglycemic watholakala.
Izwe lokukhiqizwa kwalo muthi yiRussia. I-Glyclazide MV 30 mg kumathebulethi okuwukuphela kwesimo semithamo ekhiqizwa yinkampani yezamayeza. Isifinyezo i-MV imele Ukukhishwa Okuguquliwe. Lokhu kusho ukuthi amaphilisi e-MV afakwa esiswini amahora amathathu, bese engena egazini bese ehlisa ukugcwala kweglucose egazini. Izidakamizwa ezinjalo zinomphumela omnene kakhulu ekwehliseni ushukela, ngakho-ke, mancane kakhulu amathuba okuholela esimweni se-hypoglycemia (kuphela i-1% yamacala).
Umuthi i-Gliclazide MV ngesikhathi sokusetshenziswa unemiphumela emihle emzimbeni wesiguli:
- Kuthuthukisa ukukhiqizwa kwe-insulin ngama-pancreas.
- Yehlisa ushukela wegazi.
- Inomphumela oyimfihlo we-insulin we-glucose.
- Kwandisa ukuthikamezeka kwezicubu kwehomoni.
- Iqinisa izinga le-glycemia esiswini esingenalutho.
- Yehlisa ukukhiqizwa kweshukela.
- Ithinta i-microcirculation kanye ne-carbohydrate metabolism.
Ngaphezu kwalokho, umuthi unciphisa amathuba okuqhekeka kwegazi emithanjeni.
Imiyalo yokusebenzisa umuthi
Kulesi simo, ukwelashwa okuzenzakalelayo akunakwenziwa, udokotela kuphela, ngemuva kokuthola usizo lomuthi kanye nokulimazeka komzimba wesiguli, ongakunikeza amaphilisi we-GVclazide MV.
Ngemuva kokuthintana nodokotela, udinga ukuthenga umuthi obhalwe phansi, iphakethe lawo liqukethe amaphilisi angama-60. Umuthi usetshenziswa ezimeni ezinjalo:
- Ekwelapheni isifo sikashukela esinga-insulin, lapho ukondleka okufanele nokuvivinya umzimba kungakwazi ukubhekana nokuncipha kokuhlushwa kweglue glucose.
- Ngokuvimbela imiphumela ye-pathology - nephropathy (umsebenzi wezinso okhubazekile) kanye ne-retinopathy (ukuvuvukala kwe-retina yezimpawu zamehlo).
Imiyalo yokusebenzisa iqukethe lonke ulwazi oludingekayo mayelana namathebulethi, odinga ukuwafunda ngokucophelela. Umthamo wokuqala weziguli osanda kuqala ukwelashwa, futhi kubantu abaneminyaka engaphezu kwengama-65 ungama-30 mg ngosuku. Zidliwa ngesikhathi sebhulakufesi. Ngemuva kwamasonto amabili elashwa, udokotela uthatha isinqumo sokuthi uyolandisa yini umthamo. Izici ezimbili zithonya lokhu - izinkomba ze-glucose kanye nobunzima besifo sikashukela. Ngokuvamile, umthamo wehluka kusuka ku-60 kuya ku-120 mg.
Uma isiguli siphuthele ukuphuza umuthi, khona-ke umthamo ophindwe kabili akufanele uthathwe kunoma yikuphi. Uma kunesidingo sokushintsha ukubamba kwe-Gliclazide MV nezinye izidakamizwa ezinciphisa ushukela, khona-ke ukwelashwa kuyashintsha kusuka ngosuku olulandelayo. Le nhlanganisela kungenzeka nge-metformin, insulin, kanye ne-alpha glucosidase inhibitors. Iziguli ezinokwehluleka kokulinganisa ukwehluleka kwe-renal zithatha imithamo efanayo. Lezo ziguli ezisengozini ye-hypoglycemia zisebenzisa umuthi ngemithamo ephansi kakhulu.
Amathebulethi kufanele avikelwe endaweni engatholakali yezingane ezincane, ekushiseni komoya okungadluli kwe-25C. Umuthi ufanele iminyaka emithathu.
Ngemuva kosuku lokuphelelwa yisikhathi, ukusetshenziswa kwalo kwenqatshelwe ngokuphelele.
Contraindication kanye nemiphumela emibi
Njengayo yonke eminye imithi, i-Gliclazide MV ine-contraindication eminingana ehlobene ne:
- Uhlobo 1 sikashukela;
- ukungabekezeleli okuthile kwento esebenzayo nezinye izinto;
- ukuzala ingane nesikhathi sokuxoshwa;
- ifomu elibi lokuhluleka kwe-reso nesibindi;
- ukusetshenziswa kwe-miconazole;
- ketoacidosis;
- I-hypersmolar coma;
- i-precoma;
- i-lactase enganele;
- ukungabekezelelani kwemvelo kokuzala;
- izingane ezingaphansi kweminyaka engu-18;
- i-glucose-galactose malabsorption.
Futhi, ngaphambi kokuthatha amaphilisi, ukubonisana nodokotela okuphoqelekile kuyadingeka, ngoba uhlu olulandelayo lwembula leyo mizila lapho ukusetshenziswa komuthi kufanele kuhlolwe khona ngudokotela. Futhi, ngokuqaphela, amaphilisi adliwa ngabantu abanjalo:
- iziguli ezingondleki kahle noma ukudla okungalingani;
- iziguli ezihlushwa i-endocrine pathologies;
- abantu abenqabile ukusebenzisa ama-hypoglycemic agents ngemuva kokusetshenziswa isikhathi eside;
- iziguli ezinama-pathologies ezinhliziyo;
- iziguli ezine-glucose-6-phosphate dehydrogenase yokushoda;
- abantu bayimilutha yotshwala;
- iziguli ezinokwehluleka kwe-renal noma kwesibindi.
Lesi sidakamizwa sinohlu olukhulu kakhulu lwemiphumela emibi, okungukuthi:
- umuzwa wendlala;
- ikhanda kanye nesiyezi;
- ubuthakathaka, ukozela;
- ukungavikeleki kwemisipha etholakalayo;
- ukwanda kokujuluka kokujuluka;
- arrhythmia, bradycardia kanye palpitations;
- ukungaphatheki kahle, ukuvusa imizwa, nokudangala;
- ukwanda kwengcindezi yegazi;
- ukungakwazi ukugxila;
- umbono ongaboni kahle, ukuzwa noma ukusebenza kwemisipha;
- ukungakwazi ukuba nesakho;
- ukoma nokufelwa;
- ukungezwani komzimba (ukuqubuka, urticaria, ukulunywa, i-erythema);
- ukuphazamiseka kokugaya ukudla (ubuhlungu besisu, ukuqunjelwa, isifo sohudo, isicanucanu nokuhlanza).
Cishe yonke le miphumela emibi ihlotshaniswa ne-hypoglycemia enzima. Ngakho-ke, ukusebenzisa umuthi uwedwa akunconywa kakhulu.
Ukweqa ngokweqile kanye nokuxhumana namanye ama-ejenti
Ukweqisa kwalo muthi kungaholela esimweni esibi se-hypoglycemic. Izimpawu zayo zingafaka ukubukeka kokuhlaselwa, ukuphazamiseka kwemizwa, kanye nokukhubazeka. Lapho-ke ukulashwa esibhedlela okuphuthumayo kwesiguli kuyadingeka. Uma udokotela esola noma enquma ukukhohlisa kwe-hypoglycemic, isiguli sifakwa ngesisombululo se-dextrose (40-50%) emthanjeni. Ngemuva kwalokho unikezwa i-dropper ene-5% solution yento efanayo ukuze kuqiniswe izinga le-glucose.
Ngemuva kokuba isiguli sisangulukile, sidinga ukudla ukudla okuqukethe ama-carbohydrate okugaya ukudla ukugwema ukwehla okuphindaphindiwe kwamazinga kashukela. Ezinsukwini ezimbili ezilandelayo, isiguli kufanele sigadiwe ikakhulukazi, kufaka phakathi ukugcwala kweglucose egazini. Izenzo ezengeziwe ezihlobene nokwelashwa kweziguli zinqunywa udokotela ohambelayo.
I-Gliclazide MB ixhumana nezidakamizwa ngezindlela ezihlukile, isibonelo:
- Ama-anticoagulants - athuthukisa isenzo sawo nge-gliclazide yezinto.
- I-Danaziol - ukuthuthukiswa komphumela wesifo sikashukela.
- I-Phenylbutazone inyusa umphumela we-hypoglycemic we-gliclazide.
- I-Miconazole kufanele ithathwe ngobumnene nge-gliclazide, ngoba ingaholela ekwakhiweni kwethonya.
- I-Ethanol kanye nokuphuma kwayo - okwandisa isenzo se-hypoglycemic, kwesinye isikhathi i-coma yesifo sikashukela kungenzeka.
- I-Chlorpromazine kwimithamo emikhulu ikhulisa ushukela, kuvimbela ukwenziwa kwehomoni.
- I-GCS iphinde inyuse amazinga kashukela futhi iholele ekuthuthukisweni kwe-ketoacidosis.
Le mithi elandelayo, kanye ne-Gliclazide MV, ineqhaza ekunciphiseni kokugxilwa koshukela egazini kushukela futhi kwezinye izimo kuholela esimweni se-hypoglycemic. Lokhu, okokuqala, ukusetshenziswa okuhlangene ne:
- i-fluconazole;
- i-insulin, i-acarbose, i-biguanides;
- ama-beta-blockers;
- I-H2 histamine receptor blockers (cimetidine);
- i-angiotensin eguqula ama-enzyme inhibitors;
- i-monoamine oxidase inhibitors;
Ngaphezu kwalokho, i-Gliclazide ngokuhlanganiswa nezidakamizwa ezingeyona i-steroidal anti-inflammatory noma i-sulfonamides ingavusa i-hypoglycemia.
Izindleko nokufana kwezidakamizwa
Njengoba lesi sidakamizwa sakhiqizwa ngumenzi wasekhaya, intengo yaso ayiphezulu. Umuthi ungathengwa ekhemisi noma u-oda online esitolo se-inthanethi, ngenkathi wethula incwadi kadokotela. Izindleko zomuthi iGliclazide MV (30 mg, izingcezu ezingama-60) zisukela kuma-ruble ayi-117 kuya kwangama-150. Ngakho-ke, noma ngubani onomholo ophakathi nendawo angakwazi ukuyikhokhela.
Izithonjana zalesi sidakamizwa izidakamizwa eziqukethe i-gliclazide esebenzayo yezinto. Lokhu kufaka phakathi uGlidiab MV, Diabeteson MV, Diabefarm MV. Kufanele kuqashelwe ukuthi amaphilisi we-Diabeteson MV (30 mg, izingcezu ezingama-60) abiza impela: izindleko ezivamile ngama-ruble angama-300. Futhi umphumela walezi zidakamizwa ucishe ufane.
Esimweni lapho isiguli sinokuphikisana ne-gliclazide yento noma umuthi uyingozi, udokotela kuzodingeka ukuthi ayiguqule irekhodi lokwelashwa. Ukuze wenze lokhu, angabeka umuthi ofanayo, ozokhiqiza nomphumela we-hypoglycemic, ngokwesibonelo:
- I-Amaryl M noma i-Glemaz enezithako ezisebenzayo ze-glimepiride;
- I-gluluorm ene-glycidone esebenzayo yezinto;
- Maninil ne-ingredient glibenclamide esebenzayo.
Lolu hlu olungaphelele lwazo zonke izichazayo, imininingwane eningiliziwe ingatholwa kwi-Intanethi noma ubuze udokotela wakho.
Isiguli ngasinye sikhetha ikhambi elilungile elisuselwa ezintweni ezimbili - inani lentengo kanye nokwelashwa.
Umbono weziguli mayelana nomuthi
Kulezi zinsuku, izidakamizwa eziseqoqweni lesizukulwane sesibili se-sulfonylurea, ezibandakanya umuthi iGliclazide MV, sezisetshenziswa kakhulu. Lokhu kungenxa yokuthi yize amaphilisi enemiphumela emibi eminingi, avela kaningi kakhulu.
Ucwaningo lwesayensi lufakazele umphumela omuhle wesidakamizwa ku-microcirculation. Ngaphezu kwalokho, umuthi uvimbela ukuthuthukiswa kwezinkinga eziningi:
- i-microvascular pathologies - i-retinopathy kanye nephropathy;
- isifo sikashukela se-Microangiopathy;
- ukukhuphuka kokudla okuhlanganisiwe;
- ukunyamalala kwe-vascular stasis.
Ngokuqhathanisa nokubuyekezwa kweziguli eziningi, singagqamisa izincomo ezithile zokusebenzisa umuthi:
- amaphilisi angcono ukuwasebenzisa ngemuva kokudla ibhulakufesi;
- ibhulakufesi kufanele libe nenani elikhulu lama-carbohydrate;
- awukwazi ukubulawa yindlala usuku lonke;
- ubhekene nobunzima bomzimba, udinga ukushintsha umthamo.
Futhi, ukubuyekezwa kwabanye abanesifo sikashukela kubonisa ukuthi ukunamathela ekudleni okunekhalori ephansi nokwenza umsebenzi omuhle kakhulu ngokomzimba kungadala i-hypoglycemia. Lokhu kuyasebenza nakulabo abaphuze utshwala ngenkathi bephuza amaphilisi. Ingozi yokwehla okukhulu kwamazinga kashukela wegazi nayo ivela kubantu asebekhulile.
Isifo sikashukela sishiya ukuphawula kwabo ukuthi umuthi ulula kakhulu ukuwusebenzisa uma uqhathanisa ne-gliclazide ejwayelekile, umthamo wawo ophindwe kabili. Umthamo owodwa ngosuku unikeza umphumela omncane futhi ophumelelayo, wehlise izinga le-glucose kahle. Kodwa-ke, kube nezimo zokuthi ngemuva kokusetshenziswa isikhathi eside kwalo muthi (cishe iminyaka engu-5), umphumela wawo waba ongaphumeleli, futhi udokotela wabeka ezinye izidakamizwa ukuze zishintshe ngokuphelele i-Gliclazide MV noma ukwelashwa okuyinkimbinkimbi.
IGliclazide MV iyi-ejenti enhle kakhulu ye-hypoglycemic ephungula kancane kancane ushukela wegazi. Yize ine-contraindication kanye nemiphumela emibi, ubungozi bokusabela okungalungile yi-1%. Isiguli akufanele sizidele, kuphela udokotela, ebheka izimfanelo ezithile zesiguli, ongabeka umuthi osebenzayo. Ekwelapheni uhlobo lwesifo sikashukela sohlobo 2 ngosizo lwe-Gliclazide MV, kuyadingeka futhi ukulandela ukondleka okufanele nendlela yokuphila esebenzayo. Ngakho-ke, ngokubheka yonke imithetho, isiguli sizokwazi ukugcina lesi sifo ku "gauntlet" futhi simvimbele ekuphatheni impilo yakhe!
Imininingwane nge-Gliclazide MV inikezwe kuvidiyo ekulesi sihloko.
