I-Maninil 5: imiyalo esetshenziswayo, ukubuyekezwa kodokotela kanye nesifo sikashukela

UManinil ungomunye wabamele isigaba sezidakamizwa ezinciphisa ushukela ezisetshenziselwa ukugcina amazinga adingekayo eglucose egazini.

Emithini esetshenziswayo eqenjini lokukhipha i-sulfonylurea, umuthi iManinil uvame ukusetshenziswa kakhulu.

I-pharmacology yanamuhla inikeza isiguli isifo sikashukela izinhlobo ezahlukene zemithi yokwelashwa.

Ukuzikhethela kohlobo oluthile lomuthi kwenziwa ngudokotela ohambelayo.

Udokotela ukhetha lo muthi ngemuva kokuhlaziywa okuningiliziwe kwemininingwane yesimo sesiguli etholwe ngesikhathi sokuhlolwa.

Okususelwa ku-sulfonylurea

Izidakamizwa zesimanje ezimiselwe ukuqeda izimpawu futhi zenze amazinga e-glucose ajwayelekile kuhlobo 2 lwesifo sikashukela ahlukaniswe ngombandela ngamaqembu amakhulu amaningi:

• ama-ejenti akhulisa i-pancreatic insulin secretionꓼ
• izidakamizwa ezandisa ukuzwela kwamangqamuzana ekungeneni i-insulin, okungukuthi, lithuthukisa umphumela wazo emazingeni amaselula
• Imithi evimbela ukumunwa kwama-carbohydrate angenayo ngamathumbu.

Ukukhethwa komuthi kusele kudokotela ohambelayo, onikeza umuthi ofanele isiguli esifanele (noma abaningana ngasikhathi sinye ukwelashwa okuyinkimbinkimbi).

Phakathi kwemithi ekwazi ukukhulisa ukukhiqizwa kwe-insulin yama-pancreas, okokuqala, izidakamizwa ze-sulfonylurea derivatives. Imvamisa, ochwepheshe bezokwelapha basebenzisa le mithi elandelayo elandelayo yokwelashwa:

1. Kususelwa kwinto esebenzayo, i-glibenclamide (Maninyl). Ummeleli wayo ithandwa kakhulu ngamacwecwe eManinil.
2. Ngaphansi kwethonya le-gliclazide (izidakamizwa ezenziwe nge-Diabeteson MV).
3. Isithako esikhulu esisebenzayo yi-glycidone, etholakala kumathebulethi eGlurenorm.
4. Nge-ingredient glimepiride (Amaril) esebenzayo.

Umphumela omkhulu wokwelapha ubonwa ekujuleni kwamazinga kashukela wegazi, ngenxa yenqubo yokuvuselela ama-pancreas ukukhiqiza inani elikhulu le-insulin ye-hormone.

Kumele kuqashelwe ukuthi umzimba womuntu ngamunye ungumuntu ngamunye, ongakhonjiswa ngezindlela ezihlukene ngomphumela wezindlela zokwelashwa ezamukelekayo. Amathuba wokungabikho komphumela omuhle awafakiwe.

Kungakho, uchwepheshe wezokwelapha, esuselwa olwazini ngokuthuthuka kwezifo zesiguli ngasinye, ukhetha inketho efaneleke kakhulu kuye.

Amakhemikhali ka-Maninil

Isidakamizwa Maninil sisetshenziselwa kakhulu isifo sikashukela sefomu elizimele le-insulin futhi sifakiwe eqenjini le-sulfonylureas yesizukulwane sesibili.

Into esebenzayo yepilisi enjalo iyingxenye ye-glibenclamide. Ukuqanjwa kwesidakamizwa Manin kufaka phakathi izakhi zokusiza ezingefani ezingenamphumela ekhulunyiwe yokwelapha.

Izici eziphambili zesidakamizwa ukubonakaliswa kwemiphumela ye-pacreatic kanye ne-extrapancreatic.

Izinqubo ezilandelayo zenzeka emzimbeni, uma ufaka futhi uthatha iManinil:

• inqubo yokukhuthaza ukukhiqizwa kwe-insulin ngamaseli e-beta we-pancreas ayathuthuka
• kukhona ukuvimbela kwezinqubo ze-gluconeogenesis ne-glycogeneis esibindini,
• ukuzwela kwamangqamuzana nezicubu ekwenyukeni kwe-insulin.

Ukuchazwa kwesidakamizwa kukhombisa ukuthi iManinil, ngemuva kokuphathwa ngomlomo, igxila emathunjini ngokushesha. Ngaphezu kwalokho, ijubane lale nqubo alixhomekile ekudleni kokudla kanye nenani lokudla esiswini.

Izinga eliphakeme kakhulu lokugcotshwa kwengxenye esebenzayo eplasma yegazi itholakala cishe amahora amabili nesigamu ngemuva kokusetshenziswa komuthi.

Umuthi uyatholakala ngesimo sethebhulethi emithanjweni ehlukahlukene, okungaba:

1. Maninyl 1.75 mg;
2. Maninyl 3.5 mg;
3. Maninil 5 mg.

Inombolo, ekhonjiswa eceleni kwegama lethebhulethi, ibonisa inani lezithako ezisebenzayo ezifakiwe kuthebhulethi eyodwa. Ngakho-ke, lapho ukhuphula umthamo, uyaqina umthelela we-hypoglycemic kanye nemithi elwa nesifo sikashukela.

Izinkomba zokusetshenziswa kwalesi sidakamizwa - i-mellitus yesifo sikashukela yefomu elizimele le-insulin njenge-monotherapy noma kanye nezinye izidakamizwa ezinciphisa ushukela, ngaphandle kokuphuma kokunye kwe-sulfonylurea nezidakamizwa zobumba, zingasetshenziswa lapho ukwelashwa kokudla kanye nokusebenza komzimba okusebenzayo kungalethi imiphumela edingekayo.

Imiyalo yokusebenzisa amaphilisi

Ithebhulethi ye-manilin yesifo sikashukela kufanele ithathwe ngokuya ngohlelo oluthile olunikezwe uchwepheshe wezokwelapha.

Umthamo womuthi womuntu ngamunye ubekwa ngokuhlukile ngokuya ngobukhulu bokuthuthuka kwenqubo ye-pathological, izinga lokugxila kwe-glucose egazini ngaphambi nangemva kokudla, esiswini esingenalutho, isigaba sobudala seziguli nezimpawu zomuntu ngamunye.

Ngaphambi kokuthatha umuthi, imiyalo esemthethweni isho isidingo seseluleko sokwelashwa esedlule.

Ukusetshenziswa kwesidakamizwa sikashukela kusungulwa ngale ndlela elandelayo:

1. Umuthi (ifomu lokukhulula nomthamo ngu-1.75 mg) ezigabeni zokuqala zokwelashwa, kubalulekile ukuthatha amaphilisi kanye noma amabili kanye ngosuku. Uma, ngemuva kokuphelelwa yisikhathi, leli qembu lezidakamizwa alizange lilethe umphumela ofiselekile futhi nokuqondakala kwe-carbohydrate metabolism akubonwa, umthamo ungandiswa. Imithamo yokwandisa kufanele yenziwe kancane kancane ngezikhathi ezithile kusuka ezinsukwini eziningana kuya ngesonto. Isilinganiso esiphezulu somuthi ngosuku akufanele singeqi ku-10.5 mg wengxenye esebenzayo.
2. IManinyl 3.5 mg, njengoba imiyalelo isho, imvamisa isetshenziswa uma inani eliphelele lamaphilisi elinomthamo ongu-1.75 mg lidlula izingcezu ezintathu ngosuku. Ukuqala ukwelashwa kufanele kube yisigamu noma ithebhulethi eyodwa ngosuku. Ngemuva kwalokho, uchwepheshe wezokwelapha unquma ngesidingo sokwenza ushintsho kule nkambo yokwelashwa. Isilinganiso esiphezulu somuthi ngosuku akufanele singeqi ku-10.5 mg wengxenye esebenzayo.
3. Amathebhulethi we-5 Maninil anenani elikhulu kakhulu lezinto ezisebenzayo ekwakhekeni kwazo. Indlela yokusebenzisa nomthamo ezigabeni zokuqala zokwelashwa uhhafu noma ithebhulethi eyodwa phakathi nosuku. Kamuva, lapho sikhona noma singekho imiphumela, kungenzeka ukuba wenze ushintsho kunhlobo enjalo. Umthamo ophelele wansuku zonke wesidakamizwa iManinil 5 (imiyalelo) akufanele ube ngaphezu kwama-15 mg ento esebenzayo.

Ithebhulethi ithathwa ngomlomo nenani elincane lamanzi ngaphambi kokuqala kokudla. Uma ngaphambili isiguli besilashwa sisebenzisa enye i-ejenti ekwehlisa ushukela, ukwelashwa kufanele kuqalwe ngemithamo emincane. Uma umthamo wansuku zonke ungeqi kwethebhulethi elilodwa noma amabili, umuthi uphuza ekuseni. Emuthweni ophakeme, umthamo kumele uhlukaniswe kabili - ekuseni nakusihlwa.

Uma uphuza umuthi ngendlela efanele futhi ungeqi imithamo ebekiwe, unganciphisa ubungozi be-hypoglycemia.

Ukubonakaliswa kokungaphenduki okuhle

Imiyalo yokusebenzisa iManinil ikhombisa ukuthi ukuphathwa okungafanele komkhiqizo wezokwelapha kungaholela ekwakhiweni kwezimpawu eziningi ezingezinhle, okuyimiphumela emibi.

Ukuphazamiseka ekusebenzeni okujwayelekile kwezitho nezinhlelo ezahlukahlukene kungavela ngokuvama nokuqina.

Ukubonakaliswa kwemiphumela ethile emibi kuncike ezimweni ezithile zomzimba wesiguli.

Ukuphendula okungathandeki okuyinhloko kufaka phakathi:

• ukwephulwa komgodi wokugaya ukudla kuboniswa ngesimo sokuzwa kwesisindo esiswini, Ubuhlungu esiswini, ukunambitheka kwensimbi emgodleni womlomo, i-belching, isicanucanu, ukuhlanza noma isifo sohudo,
• amasosha omzimba angaphendula ngendlela engeyiyo ekuqaleni kokuqala kokwelashwa ngendlela ye-purpura, ukulunywa kwesikhumba noma i-urticaria, ukukhuphuka kwezinga le-photosensitivityꓼ
• imiphumela emibi evela ohlelweni lokujikeleza kwezimpawu inezimpawu ezilandelayo - i-thrombocytopenia, i-hemolytic hlobo anemia, i-leukopenia, i-erythropenia,
• izinkinga ngokusebenza kwesibindi okujwayelekile zingaqala futhi izifo ezinjenge-hepatitis zingakhula
• Ukukhetha okungafanele komthamo wesidakamizwa kuholela ekuthuthukisweni kwe-hypoglycemia, izimpawu zayo eziyinhloko ukubonakala komkhuhlane, ukukhathala, izandla eziqhaqhazelayo, umuzwa ojwayelekile wokukhathala ngezinga elandayo lokuqina.
• ukwanda okubukhali kwesisindo somzimba.

I-drug overdose ihambisana nalezi zimpawu ezilandelayo:

1. Kukhulisa umjuluko.
2. Umuzwa ongapheli wendlala.
3. Inkulumo engasebenzi kahle.
4. Ukubonakala kwezinkinga ngokulala.
5. I-Hypoglycemia

Njengosizo lokuqala, kuyadingeka ukuthandana nesiguli ushukela omncane, bese ushayela i-ambulensi.

Ezimweni zokuma, ochwepheshe bezokwelapha njalo baqapha amazinga eglucose futhi bathathe izinyathelo zokuqeda isimo se-hypoglycemic.

Kukweziphi izimo ukunqatshelwa kwemithi?

Yize kunohlu olukhulu kakhulu lwezindawo ezinhle zomuthi, kuyadingeka ukuthi unake zonke izinhlobo zezinto ezingezinhle ezingaba khona ngemuva kokuwusebenzisa.

Okokuqala, kubalulekile ukuthi unake uhla lwezinqatshelo lapho ukwelashwa kungeke kwenziwa ngeManinil

Ukuphikiswa kweManinil kukhulu kakhulu.

I-contraindication eyinhloko ifaka okulandelayo:

• thayipha ukwelashwa kwesifo sikashukela esingu-1,
• uma ubheka i-ketoocytosis yesifo sikashukela noma isimo sokhokho onesifo sikashukela esigulini,
• ukubonakaliswa kwe-hypoglycemia esigulini,
• phambi kwama-pathologies wesimo esithathelwanayo,
• kuqhuma isifo sesibindi noma sezinso,
• uma kukhona ukungabekezeleli noma i-hypersensitivity engxenyeni eyodwa noma eziningi zomuthi,
• i-leukopenia
• esimweni ngemuva kokuphindwa futhi kwe-pancreatic,
• lapho kukhona ukungabekezelelani kwe-lactose noma ukuntuleka kwe-lactase.

Kuze kube manje, akukho mininingwane eyanele yokuthi lo muthi usebenza kanjani ekwelapheni isifo sikashukela ezinganeni. Kungakho ukwelashwa kungabekelwa iziguli ezinje (ukuya kufinyelela eminyakeni eyishumi nesishiyagalombili). Ngaphezu kwalokho, ama-contraindication afaka nokuthatha umuthi wamantombazane nabesifazane abakhulelwe ngesikhathi sokuncelisa.

Futhi, ngokuqapha ngokweqile, umuthi unqunyelwe ezimweni ezinjalo:

1. Uma kunengozi eyandayo ye-hypoglycemia,
2. Uma kunezici ezidinga ukuhanjiswa okugunyaziwe kwesiguli ekuphathweni kwe-insulin,
3. Ngemuva kokuhlinzwa

Ukuqapha akubeki lapho kufakwa iManinil, uma isiguli siveze izifo zohlelo lokugaya ukudla.

Ama-Analogues weManinil, abukeza mayelana nomuthi nezindleko zawo

Ukubuyekezwa mayelana neManinil kuyimpikiswano. Kunemibono yokuthi umuthi ukhombisa umphumela omuhle, kuyilapho ungakhombisi ukusabela okubi. Abanye abantu bakhombisa ukungabikho komphumela omuhle, futhi njengokubonakaliswa okungathandeki, inzuzo esheshayo iyahlukaniswa. Umzimba womuntu ngamunye, ngakhoke, uma umuthi ungalungele ushukela owodwa, lokhu akusho ukuthi umuthi awusebenzi.

Kuze kube manje, intengo yeManinil icishe ibe ngama-ruble ayikhulu namashumi amane. Umuthi ufakwa eqenjini lemithi yesabelomali. Kwenzeka ukuthi kunesidingo sokusebenzisa ama-analog ama-Maninil noma amagama afanayo.

Yini engathatha isikhundla seManinil futhi yikuphi okungcono phakathi kwama-sulfonylureas?

Izindawo ezimbili ezibalulekile zomuthi kufanele ziphawulwe - i-Glibamide ne-Glibenclamide. Banesakhiwo sabo isithako esisebenzayo esifanayo somuthi iManinil. Ngokufanelekile, la mabhebhulethi anezici ezifanayo futhi anezinkomba ezifanayo zokuzisebenzisa. Ukwakheka okubekwe etafuleni kusiza ukwehlisa amazinga kashukela egazi futhi kugqugquzele ukukhiqizwa kwe-insulin.

Ama-Analogues weManinil kufanele afunwe ngobuningi (igama lezwe), okungukuthi, isakhi salo esisebenzayo.

Imiphi imishanguzo yesifo sikashukela esebenza ngempumelelo kakhulu izotshela uchwepheshe kule vidiyo ekulesi sihloko.