Enye yezidakamizwa ezijwayelekile ze-antidiabetesic eqenjini le-sulfanylurea yi-Amaryl.
Ngenxa yezingxenye ezisebenzayo nezengeziwe, umuthi uyasiza ukunciphisa ukunakekelwa koshukela futhi unciphisa ngempumelelo ukuqina kwezimpawu zesifo sikashukela.
I-Amaril yezidakamizwa ethathe izidakamizwa yamukelwa ukusetshenziswa komlomo. Igama elijwayelekile lomuthi jikelele yi-Amaryl. Umuthi ukhiqizwa eJalimane, umenzi yi-Aventis Pharma Deutschland GmbH.
Umuthi uyatholakala ngamaphakeji ahlukene ngokuya ngenani lezinto ezisebenzayo:
- I-Amaryl 1 mg;
- I-Amaryl 2 mg;
- Ama-3 mg amaril;
- I-Amaryl 4 mg.
Usayizi wepakeji ungahluka, inani lamathebulethi ngakunye - lisuka ku-30 liye kwangama-120. Ukubukeka kwesidakamizwa nakho kuyahlukahluka ngokuya nge-glimepiride ne-metformin. Amatafula ane-1 mg wezithako ezisebenzayo apinki, 2 mg aluhlaza, 3 mg aphuzi. Amathebhulethi we-Amaril 4 mg aluhlaza okwesibhakabhaka. Uhlobo lwamacwecwe ayicaba ezinhlangothini ezimbili, okusaqanda. Kumathebhulethi, ngaphandle kokuxakaniseka kwengxenye esebenzayo, kukhona umbhalo oqoshwe: "ff" ne "NMK", ongasiza ukuhlukanisa inkohliso.
Ngaphezu komuthi ojwayelekile, kukhona ohlanganisiwe - i-Amaril m. Uhlukile kwi-Amaril ekwakhiweni kwawo. Ngaphezu kwengxenye eyinhloko ye-glimepiride, ukwakheka kwalesi sidakamizwa kufaka nenye ingxenye enomphumela we-hypoglycemic - metformin. Umkhiqizo ohlanganisiwe utholakala ngezinketho ezimbili zemithamo kuphela:
- I-Glimepiride (1 milligram), metformin (250 mg).
- I-Glimepiride - 2 mg, metformin - 500 mg.
Amathebulethi e-Amaryl M abukeka efanayo, noma ngabe umthamo we-glimepiride uhlukile: ukuma kwamatafula kuyindilinga, kuyacaba, umbala umhlophe.
Izici eziphambili zomuthi
Isithako esikhulu esisebenzayo esiyingxenye yesidakamizwa - i-glimepiride (igama lesiLatini - i-Glimepiride) sikuthinta ngamandla ukukhishwa kwe-insulin.
Ngenxa yale ngxenye, isidakamizwa sinomphumela we-pancreatic.
Ngokukhishwa kwe-hormone kumaseli we-beta, ukwehla okukhulu kwamazinga kashukela wegazi kwenzeka. Indlela efanayo yokusebenza ihambisana nokuthuthuka kokuzwela kwamaseli we-beta ku-glucose.
Ngaphezu kwengxenye eyisebenzayo, izinto ezengeziwe ezengeziwe zifakiwe ekwakheni umuthi:
- i-povidone;
- i-lactose monohydrate;
- indigo carmine;
- i-magnesium stearate;
- i-microcrystalline cellulose.
Ngaphezu kwalokho, umuthi ulawula ukukhiqizwa kwe-pancreatic hormone. Lokhu kungenxa yokusebenzisana kwe-glimepiride ne-metformin eneziteshi ze-potassium kulwelwesi lwe-beta cell. Ukubopha kwengxenye esebenzayo kumaphrotheni kulawula umsebenzi wesiteshi, okungukuthi, ukuvala nokuvula.
I-Amaryl inomphumela we-extrapancreatic - ithuthukisa ukusetshenziswa kwe-insulin ngemisipha nezicubu ze-adipose. Lokhu kwenzeka ngenxa yokuvimba iziteshi ze-potassium kulwelwesi lweseli kanye nokwanda kokudla kwe-calcium emangqamuzaneni. Umphumela we-extrapancreatic ubangela ukwehla kokumelana ne-insulin, kodwa futhi kuthinta kancane ukusebenza kwenhliziyo nemithambo yegazi.
Ukuqoqwa okuphezulu kakhulu kwento esebenzayo kutholakala ngokusetshenziswa njalo. Isibonelo, lapho uthatha i-4 mg ye-glimepiride ngosuku, ukugxilisa okuphezulu kakhulu kutholakala emahoreni angama-2,5.
Ukumunca ngokuphelele umuthi kutholakala kuphela lapho uphathwa ngomlomo. Ukudla ukudla kubambezela inqubo yokutholwa umuthi, kepha lo mphumela awunakwa. I-Excretion ye-glimepiride idlula emathunjini nasezinso.
Uhlu lwezinkomba kanye ne-contraindication yokwamukelwa
I-Amaryl inezinkomba ezilandelayo ezisetshenziswayo. Eyokuqala ukwelashwa kwesifo sikashukela sohlobo 2. I-Amaril inesizathu sokuba iziguli ezingadingi imijovo ye-insulin, nakulabo abakhonjiswa i-insulin ukuze bathuthukise inhlala-kahle yabo.
Ekwelapheni isifo sikashukela, amaphilisi e-Amaryl anqunywa ngokuyinhloko njengomuthi oyinhloko. Kodwa ngokulawula okunganele kwe-metabolic (ikakhulukazi uma isiguli sinqunyelwe umthamo womuthi), i-Glimepiride ngokuhlanganiswa ne-Metformin inqunyelwe. Lokhu kungathuthukisa kakhulu ukulawulwa kwe-metabolic. Ngaphezu kwalokho, imiphumela ingcono kakhulu kunaleyo etholwe ngomuthi ohlukile.
Umphumela omuhle owatholakala ngenxa yokwelapha okuyinkimbinkimbi usebenzisa i-Glimepiride ne-Metformin kubangele ukuthi kuqalwe umuthi oyinkimbinkimbi u-Amaryl M. Kunikezwa umuthi ngalo muthi uma ukwelashwa kwesifo sikashukela mellitus ngemithi eyinkimbinkimbi kudingekile, okulungele iziguli.
Umuthi okwehlisa ushukela i-Amaril ungathathwa yiziguli ezidinga imijovo ye-insulin ejwayelekile. Ngasikhathi sinye, ukulawulwa kwe-metabolic nakho kuyathuthuka, kepha umthamo we-glimepiride uyanconywa ukuthi wehliswe.
Njenganoma imuphi umuthi, umuthi awukwazi ukubhekwa uphephe ngokuphelele. I-Amaril ine-contraindication, futhi uhlu lwabo lukhulu kakhulu.
Okokuqala, kuyanconywa ukuba uqaphele ukuphuza umuthi esigabeni sokuqala sokwelashwa: ngalesi sikhathi, kukhona ubungozi bokwehla okukhulu kwamazinga kashukela. Uma ngokuhamba kwesikhathi ingozi ye-hypoglycemia ihlala, kunconyelwa ukuthi ushintshe uhlobo lokulashwa noma umthamo we-Amaril. Udinga ukunaka futhi kudingekile kwezinye izifo, indlela yokuphila engalungile, ukudla okungalinganiseli.
I-contraindication eyinhloko ukuqokwa kwe-Amaril yilezi zifo ezilandelayo (noma izimo zomzimba):
- Isifo sikashukela noma idlozi likashukela.
- I-ketoacidosis.
- Isibindi esibucayi nesifo sezinso.
- Ukungabekezeleli noma i-hypersensitivity ezingxenyeni eziphambili noma ezengeziwe zomuthi.
- Izifo ezingafakwanga njengefa (ukungabekezeleli kwe-lactose, ukuntuleka kwe-lactase, njll).
- Ukukhulelwa Ngesikhathi sokuhlela ukukhulelwa, irejimeni yokwelashwa kumele ithathelwe indawo. Isiguli sidluliselwa kumijovo ye-insulin, umuthi awuchaziwe.
- Ngesikhathi sokuncelisa, ukwelashwa kwe-insulin kuyaqhubeka. Uma ngabe ngasizathu simbe le ndlela yokwelashwa ingafanele, u-Amaril unqunyelwe isiguli, kodwa kunconyelwa ukumisa ukukhipha isisu.
Asikho isidakamizwa esikhonjelwe ekwelapheni isifo sikashukela sohlobo I. Ukuphikisana okuphelele kungunyaka wezingane. Ayikho imininingwane yomtholampilo ngokubekezelela izidakamizwa ezinganeni.
Ngakho-ke, ekwelashweni kwesifo sikashukela ezinganeni, ukuqondana okuphephile komuthi kuvame ukunikezwa.
Imiphumela emibi yokusebenzisa umuthi
Njengomphumela wokuthatha i-Amaril, imiphumela emibi ingavela.
Kwezinye izimo, kungenzeka ukuthi kungasebenzi kahle ekusebenzeni kwezitho nezinhlelo zomzimba ezahlukahlukene.
Ngokwengxenye ye-metabolism, ukusabela kwe-hypoglycemic kuyabonakala. Ngokuvamile kwenzeka ngokushesha okukhulu, kepha kunzima kakhulu ukwelapha.
Amanye amaphilisi kashukela abangela ukuphazamiseka kwesistimu yezinzwa ephakathi.
Labo abathatha i-Amaril banezimpawu ezifanayo:
- Isiyezi
- ukunakwa okungahambi kahle;
- ukuntuleka kokuxhumana;
- ukubambezela ukusabela;
- ukungalali kahle;
- ukudideka noma ukulahlekelwa ukwazi;
- isimo sokudangala;
- ukukhubazeka kwenkulumo;
- uvalo, ukukhathazeka, njll.
Imiphumela yokuthatha umuthi njengokwephula umgudu wokugaya ukudla imvama. Zingavezwa kobuhlungu esiswini noma esiswini, isicanucanu, isifo sohudo, ukugabha, indlala eyandayo.
Ngenxa yemiphumela ye-glimepiride, ukwehla kwezinga le-glucose kungenzeka, okungathinta kabi isimo sezitho zombono, ezingadala ukungaboni kahle.
Umuthi uthinta izinqubo zokwakheka kwegazi, ezingadala ubungozi bezinguquko ezinjengokuthi:
- I-Anemia
- I-Thrombocytopenia (yobulukhuni obuhlukahlukene).
- I-Pancytopenia.
Okuncane okuvame ukusabela okujwayelekile komzimba:
- ukulunywa
- ukuqhuma kwesikhumba;
- ubomvu besikhumba;
- i-vasculitis.
Ngemuva kokuphuza umuthi we-Amaril, izimpawu zokwaliwa yilezi zivame kakhulu ukuba mnene futhi zidlule ngokushesha ngokulashwa okufanele.
Kepha kubaluleke kakhulu ukuqala ukwelashwa ngesikhathi esifanele: ingozi yokushaqeka kwe-anaphylactic isalokhu.
Imiyalo yokusebenzisa umuthi
Ukwelashwa okusebenzayo akunakwenzeka ngaphandle kokulandela imiyalo yokusebenzisa i-Amaril. Umgomo oyisisekelo wokuphatha ukuthi ithebhulethi akufanele ichotshozwe. Thatha ithebhulethi ye-Amaril 3 ngokuphelele, namanzi amaningi ukuze kube lula ukugwinya.
Umthamo ofanele we-Amaril ubalwa ngokuhlukile kwesiguli. Ipharamitha esemqoka esetshenziswayo lapho kunqunywa umuthi ukuhlukunyezwa koshukela egazini. Kumiselwe umthamo ophansi kakhulu, ongasiza ukujwayeza ukulawulwa kwe-metabolic. Ngaphezu kwezinga le-glucose, esigabeni semiyalo indlela yokusebenzisa umuthi ikhombisa ukuthi ukuqapha njalo kwezinga le-glucose hhayi kuphela, kepha ne-glycated hemoglobin iyadingeka.
Kungenzeka kube nezimo lapho isiguli sikhohlwa ukuthatha amaphilisi e-Amaril ngesikhathi. Ezimweni ezinjalo, ukuphindisela inani lesidakamizwa ngokuphinda kabili umthamo akunconywa. Imvamisa imithamo ihlala ifana, amaphilisi aphuthelwe awaphindwanga. Kungcono ukukhuluma nodokotela kusenesikhathi ngezenzo ezimweni ezinjalo.
Esigabeni sokuqala sokwelashwa, iziguli zinqunyelwe i-Amaryl 1 mg ngosuku. Ngokuhamba kwesikhathi, uma kunesidingo, ukukhuphuka kancane kancane komthamo wezidakamizwa nge-1 mg kuvunyelwe, okokuqala kuze kufike ku-6 mg ngosuku, bese kuthi kube ngu-8 mg. Ngokulawulwa okujwayelekile kwesifo, umthamo omkhulu awudluli ku-4 mg ngosuku. Umthamo omkhulu we-6 mg ngosuku awuvami ukunikeza ukuthuthuka okuphawuleka. Inani lomuthi ku-8 mg linqunyelwe ezimweni ezihlukile.
Ukuhamba phakathi kokukhuphuka ngakunye komthamo kunqunywa yisimo sesiguli kanye nokusebenza kahle kwenani lemithi elithathiwe, kepha akufanele ibe ngaphansi kwamasonto ayi-1-2.
Kuyadingeka ukuthatha umuthi ngemuva kokudla, ngoba kungenjalo i-hypoglycemia.
Umuthi ohlangene we-Amaryl M kufanele uthathwe ngokuya ngomgomo ofanayo. Umthamo womuthi oboniswe ngomuthi uhlukaniswe ngemithamo emi-2: ekuseni nakusihlwa, noma uphuza ngokugcwele. Ngokuvamile, iziguli zinconywa ukuthatha i-Amaril 2m + 500 mg.
Inani le-Amaril kusuka kwisifo sikashukela ezigulini ezikhulile likhethiwe ngokuqapha ngokweqile, futhi ukwelashwa kwenziwa ngokubheka njalo kwezinso.
Imininingwane yezidakamizwa ezingezekile
Lapho unquma i-Amaril noma i-Amaril M, udokotela akufanele anikeze imiyalo ngokusetshenziswa okufanele kwesidakamizwa, kodwa futhi axwayise ngemiphumela emibi engaba khona. Ukunakwa okubaluleke kakhulu kufanele kukhokhwe engcupheni ye-hypoglycemia, engakhula uma isiguli sikhohlwa ukudla ngokushesha ngemuva kokuthatha i-Amaril. Ukugwema i-hypoglycemia, kungcono ukuba nocezu ushukela noma uswidi.
Ngokungezelela ezingeni likashukela nokugxila kwe-glucose kumchamo, isiguli kufanele sihlole njalo ukusebenza kwezinso nesibindi.
Umbuzo ojwayelekile ukuthi kungenzeka yini ukuthatha utshwala ngesikhathi sokwelashwa ne-Amaril. Kuhle ukukhumbula ukuthi utshwala buvame ukungabekezelelwa kahle ngesikhathi sokulashwa kwesifo sikashukela futhi asihlanganisi nezidakamizwa eziningi. I-Amaril nayo ingeyalabo. Imiphumela yokuphuza umuthi notshwala ngasikhathi sinye ingalungiswa. Kwezinye izimo, ukusebenza kahle kwomuthi kuba ngaphezulu, kanti kwezinye kuncishiswa kakhulu. Ngakho-ke, ngesikhathi sokwelashwa, kufanele ulahle utshwala nezidakamizwa ezenzelwe utshwala.
Ngokuqondene nokusebenzisana kwe-Amaril nezinye izidakamizwa, konke lapha kubuye ngohlobo lomuthi. Ukuthatha imithi ethile kuthuthukisa ukusebenza kwe-Amaril, abanye - kunciphisa ukusebenza. Uhlu lwazo zombili kanye nezinye izidakamizwa lubanzi kakhulu. Ngakho-ke, uma kunesidingo, thatha eminye imishanguzo, kuyadingeka ukwazisa udokotela oholayo mayelana nokuxilongwa kanye nomuthi owuphuzwayo. Kulokhu, udokotela uzokwazi ukukhetha umuthi ongeke ube nomthelela omkhulu ekusebenzeni kwe-Amaril.
Uma kwenzeka kuba nemiphumela emibi, kufanele uyeke ukuthatha umuthi futhi ubonane nodokotela.
Udokotela kuphela ongancoma ama-analog angama-Amaril afanele.
Ukubuyekezwa mayelana nomuthi
Ngesikhathi sokusetshenziswa kwe-Amaril ngesifo sikashukela sohlobo 2, ukubuyekezwa kutholwe kukuhle ezigulini eziningi. Lokhu kufakazela iqiniso lokuthi, ngomthamo ofanele, umuthi ulwa ngempumelelo ne-hyperglycemia.
Ngaphezu kokusebenza kahle, abathengi abaningi babize umbala ohlukile wezibhebhe ngekhwalithi efanelekile yomuthi - lokhu kusiza ukungadidanisi umuthi ngomthamo ohlukile we-glimepiride.
Ukubuyekezwa okutholwe ku-Amaril akuqinisekisile ukusebenza kwawo kuphela, kepha nemiphumela emibi ekhonjisiwe kwimiyalo eya e-Amaril.
Imvamisa, iziguli ezisebenzisa umuthi zikhombisa izimpawu ze-hypoglycemia:
- Ubuthakathaka.
- Tremor.
- Ukuthuthumela emzimbeni wonke.
- Isiyezi
- Ukwanda kwesifiso sokudla.
Imvamisa, ngenxa ye-hypoglycemia ku-mellitus yesifo sikashukela, kunengozi yokulahlekelwa ukwazi. Ngakho-ke, labo abathatha i-Amaril kufanele baphathe njalo imikhiqizo equkethe ushukela (njengamaswidi), ukuze uma kunesidingo bangakhuphula ngokushesha amazinga abo kashukela futhi bathuthukise inhlala-kahle yabo. Kodwa-ke, ngokusho kodokotela, ukushintshwa kwezinga likashukela akuyona inkomba yokungasebenzi komuthi. Lapho kuvela izimpawu ezinjalo, kwanele ukulungisa umthamo.
Inkinga ejwayelekile kubashayeli abaphoqelelwa ukuthi baphuze izidakamizwa ze-hypoglycemic ukusabela okuthuthukayo lapho ushayela imoto. Umphumela ofanayo ofanayo uboniswa kwimiyalo ohlwini lwemiphumela emibi engaba khona. Ukwehla kokuphendula kungenxa yomthelela we-glimepiride ohlelweni lwezinzwa.
Phakathi kweziguli ezinesifo sikashukela esidala, ekubuyekezweni kwe-Amaril, abaningi baphawula iphuzu elinye elibi: yize kusebenza kahle ukuthi i-Amaril yehlisa ushukela, umuthi wesifo sikashukela ubiza kakhulu, ngoba umuthi ungabiza ngaphezulu kokufana okuthile, kufaka phakathi owaseRussia. ukukhiqiza.
Amanani nezifanekiswane zomuthi
Ungathenga i-Amaril ekhemisi ejwayelekile yedolobha, kepha kukhona i-caveat eyodwa: ayithengiswa. Kanye nokwamukela ezinye izidakamizwa eziningi ze-antidiabetes, ukuze uthenge i-Amaryl kufanele ulethe incwadi kadokotela.
Omunye umbuzo odumile othakazelela abanesifo sikashukela abaningi ukuthi ubiza malini u-Amaril. Intengo yomuthi kuleli cala izoncika kwinani lamathebulethi amaphakethe kanye nomthamo womuthi. Ngakho-ke, isibonelo, iphakethe lomuthi wezindleko zamathebulethi angama-30, ngokuya ngethamo, kusuka kuma-ruble angama-200 kuye kwangama-850. Ngesikhathi esifanayo, i-Amaril 1 mg ibiza isilinganiso sama-ruble angama-230-280, ukufakwa kwamacwecwe e-Amaril 2 mg - ama-ruble angama-450-560, ama-3 mg - ama-ruble ayi-630-830. Amathebhulethi abiza kakhulu i-Amaril 4 mg 90 pcs. -babiza isilinganiso sama-ruble ayi-870-1080.
I-Amaril M ingathengwa ngama-ruble angama-570-600. Kubalulekile ukucabanga ukuthi amaphilisi e-Amaril 2mg + 500 mg angathengwa ngale ntengo. Kunzima kakhulu ukuthola umthamo ophansi (1 mg + 250), ngoba imvamisa onqunyelwe odokotela, futhi ngenxa yalokho, ayithengiswa kangako.
Kunezidakamizwa eziningi zesenzo esifanayo. Ama-analogues ajwayelekile kakhulu:
- I-Glimepiride.
- IGlucophage 850.
- I-Gliclazide.
- I-Diaformin.
- I-Altar.
- Ama-Glucovans.
Isibonelo, i-Amaril ivame ukufakwa esikhundleni somuthi iGliclazide (pln - Gliclazide). Ibuye ibe ngeqembu le-sulfanylurea.Ukwakheka komuthi kufaka kuphela into esebenzayo - i-gliclazide nezinye izinto ezengeziwe. Umuthi uthinta amaseli we-beta, athuthukisa ukukhiqizwa kwe-insulin. Ngaphezu kwalokho, lesi sidakamizwa sisiza nge-edema, njengoba sithuthukisa ukubumbana kwegazi, sinqanda ukunamathela kweplatelet, ngaleyo ndlela sinciphise ubungozi be-thrombosis nezinye izinkinga.
Imiphi imishanguzo ye-hypoglycemic esebenza ngempumelelo kakhulu izotshela uchwepheshe kuvidiyo ekulesi sihloko.
