Umuthi wasekhaya i-Glimepiride (INN) ovela enkampanini yamakhemisi uphungula ngempumelelo izinga le-glycemia ezigulini ezinokuhlolelwa uhlobo lwesifo sikashukela sohlobo 2.
Ikakhulu, i-ejenti yokuphikisana nesifo sikashukela isiza ngokwanele kokulashwa kokudla, ukuzivocavoca umzimba kanye nokunciphisa umzimba. Njengawo wonke umuthi, i-glimepiride inezimpawu ezithile zemithi okufanele udokotela nesiguli bazi ngazo.
Igama lesiLatini laleli thuluzi linguGrimepiride. Isakhi esiyinhloko salo muthi yiqembu le-sulfonylureas. Umenzi futhi unezela inani elincane lezinto ezengeziwe emkhiqizweni: ushukela wobisi (i-lactose), i-microcrystalline cellulose, i-sodium lauryl sulfate, isitashi pregelatinized, i-magnesium stearate namanye amadayi.
I-Pharmstandard ikhiqiza i-ejenti yokuphikisana nesifo sikashukela ngendlela yethebhulethi (1 ithebhulethi iqukethe 1, 2, 3 noma 4 mg ye-glimepiride).
Umuthi uphuzwa ngomlomo, ugezwe ngenani elincane lamanzi. Ngemuva kokungena emzimbeni womuntu, okuqukethwe okuphezulu kakhulu kwento esebenzayo kufinyelelwa emahoreni angaba ngu-2,5. Ukudla cishe akuphazamisi ukumuncwa kwe-glimepiride.
Izici eziphambili zento esebenzayo zivezwa kanjena:
- Ukugqugquzela ukukhiqizwa kwe-hormone enciphisa ushukela kusuka kumaseli we-beta ama-islets weLangerhans.
- Impendulo engcono yamaseli we-beta ekuvuseleleni ngokomzimba kweglucose. Kumele kuqashelwe ukuthi inani le-insulin elikhiqizwayo alilingani kunaphansi kwethonya lezidakamizwa zendabuko - eziphuma ku-sulfonylurea.
- Ukuvinjwa kokukhushulwa koshukela ngesibindi futhi kunciphise ukumuncwa kwe-hormone enciphisa ushukela ngesibindi.
- Ukwanda kokucabanga kwamangqamuzana okuqondisa we-adipose nezicubu zemisipha emiphumeleni ye-insulin.
- I-Glimeperid inyusa okuqukethwe kwe-alpha-tocopherol endo native, umsebenzi we-glutathione peroxidase, catalase, ne-superoxide dismutase. Lokhu kuholela ekunciphiseni ukukhula kwengcindezelo oxidative, okuhlala njalo kunesifo sikashukela sohlobo 2.
- I-inhibition yokukhetha ye-cycloo oxygenase, kanye nokwehla kokuguqulwa kwe-thromboxane A2 kusuka ku-arachidonic acid. Le nqubo inomphumela we-antithrombotic.
- Ukuhlelwa ngokwejwayelekile kwamazinga we-lipid kanye nokwehla kokuhlushwa kwe-malondialdehyde ku-plasma yegazi. Lezi zinqubo ezimbili ziholela kumphumela we-anti-atherogenic womuthi.
Ingxenye yesithathu yama-metabolites e-glimepiride ayakhishwa ngamathumbu, kuthi izingxenye ezimbili kwezintathu zidonswa yizinso.
Ezigulini ezihlushwa yizinso zezinso, ukuqashelwa kwe-glimepiride kuyanda kanye nokuhlungwa kwamanani ayo aphakathi naphakathi ku-serum yegazi kuyehla.
Imiyalo yokusebenzisa amaphilisi
Umuthi ovela kudokotela onguchwepheshe yisimo esiyisisekelo ongathenga kuso umuthi i-Glimepiride. Lapho uthenga umuthi, kuyisiko ukunaka incazelo echazwe kwimiyalo enamathiselwe.
Umthamo wesidakamizwa kanye nesikhathi sokwelashwa kunqunywa yi-endocrinologist, ngokususelwa kuzinga le-glycemia yesiguli nesimo sayo sempilo esijwayelekile. Lapho uthatha i-Glimepiride, imiyalo yokusebenzisa iqukethe imininingwane yokuthi ekuqaleni kufanelekile ukuphuza i-1 mg kanye ngosuku. Ukuthola isenzo esifanelekile semithi, lokhu kungathathwa ukuze kugcinwe ushukela ojwayelekile.
Uma umthamo ophansi kakhulu (1 mg) ungasebenzi, odokotela banquma kancane kancane i-2 mg, 3 mg noma i-4 mg yomuthi ngosuku. Ezimweni ezingavamile, umthamo ungakhushulwa ube ngu-3 mg kabili ngosuku ngaphansi kokuqashwa ngudokotela okuqinile.
Amathebulethi kufanele athathwe ngokuphelele, angahlafunwanga futhi ahlanzwa phansi ngoketshezi. Uma weqa ukuthatha lo muthi, awukwazi ukuwuphinda kabili umthamo.
Ukuhlanganisa i-glimepiride ne-insulin, isilinganiso somuthi okukhulunywa ngaso akudingeki siguqulwe. Ukwelashwa kwe-insulin kunikezwa ngethamo elincane, kancane kancane elikwandisa. Ukusetshenziswa okuhlangene kwezidakamizwa ezimbili kudinga ukunakwa okukhethekile kusuka kudokotela.
Lapho beguqula irejimeni yokwelashwa, ngokwesibonelo, ngenxa yokushintsha kusuka kwelinye i-ejenti ye-antidiabetesic to glimepiride, baqala ngomthamo omncane (1 mg).
Amacala okudlulisela kusuka ku-insulin yokwelashwa nokuthatha i-Glimepiride kungenzeka, lapho isiguli sigcina umsebenzi oyimfihlo wamaseli we-pancreatic beta ngohlobo 2 sikashukela. Ngaphansi kokuqondisa kukadokotela, iziguli zithatha i-1 mg yomuthi kanye ngosuku.
Lapho uthenga i-ejenti yokulwa nesifo sikashukela, kufanele unake usuku lokuphelelwa kwayo. Kwi-glimepiride, yiminyaka emi-2.
Contraindication kanye nemiphumela emibi
Njenganoma yisiphi esinye isidakamizwa, umuthi we-drug glimepiride contraindication kanye nemiphumela emibi kungaba yisizathu sokuthi ukusetshenziswa kwawo kwenqatshelwe kwamanye amaqembu eziguli.
Njengoba ukwakheka kwamathebhulethi kufaka phakathi izinto ezibangela ukusabela kokungezwani komzimba, okunye kokuphambana okuphezulu kwalesi sidakamizwa se-hypoglycemic yi-hypersensitivity kuzakhi ezinjalo.
Ngokwengeziwe, ukutholwa kwemali kunqatshelwe lapho:
- isifo sikashukela sikashukela;
- isifo sikashukela esithembele ku-insulin;
- isifo sikashukela sikashukela, i-precoma;
- ukungasebenzi kwezinso noma kwesibindi;
- uphethe ingane;
- ukuncelisa.
Abathuthukisi balesi sidakamizwa benze izifundo eziningi zemitholampilo kanye nezentengiso. Ngenxa yalokhu, bakwazile ukwenza uhlu lwemiphumela emibi, efaka:
- Ukusabela kwesikhumba (ukulunywa, i-rash, i-urticaria).
- Ukuphazamiseka Kwesisu (ishuqa, ukugabha, isicanucanu, ubuhlungu besisu).
- Umsebenzi wokulimala kwesibindi (i-hepatitis, ukwanda kwama-enzymes wesibindi, i-jaundice, ukwehluleka kwesibindi ne-cholestasis).
- Ukwehla okusheshayo kwezinga likashukela (hypoglycemia).
- Ukusabela kwe-Hypersensitivity (umfutho ophansi wegazi, ukushesha komoya, ukushaqeka).
- Ukunciphisa ukuhlangana kwe-sodium egazini.
- Ukwehla okubonakalayo okwehlisiwe (kuvame ukwenzeka emasontweni okuqala okwelashwa).
- Ukuphazamiseka kohlelo lwe-hematopoietic (ukuthuthukiswa kwe-agranulocytosis, i-leukopenia, i-hemolytic anemia ku-mellitus yesifo sikashukela, i-thrombocytopenia, i-pancytopenia).
Uma kwenzeka kwe-overdose, i-hypoglycemia yenzeka, ihlala amahora angama-12 kuye kwangama-72. Ngenxa yokuthatha umthamo omkhulu, isiguli sinezimpawu ezilandelayo:
- ubuhlungu ohlangothini lwesokunene;
- ukuphefumula kwenhliziyo kanye nokuhlanza;
- injabulo;
- ukuzikhulula kwemisipha ngokuzithandela (ukuthuthumela);
- ukozela;
- ukwethuka kanye nokuntuleka kokuxhumana;
- ukuthuthukiswa kwenhliziyo.
Izimpawu ezingenhla ezimweni eziningi zibangelwa ukumunca umuthi emgodini wokugaya ukudla. Njengendlela yokwelapha, i-gastric lavage noma ukugabha kuyadingeka. Ukuze wenze lokhu, thatha i-carbon noma amanye ama-adsorbents, kanye nama-laxatives. Kungenzeka kube nezimo zokulaliswa esibhedlela zeziguli ne-glucose ye-intravenous.
Ukuxhumana nezinye izidakamizwa
Kwabanesifo sikashukela abaningi, kuphakama umbuzo wokuthi ingabe i-Glimepiride ingathathwa neminye yini imishanguzo ngaphandle kwemijovo ye-insulin. Akulula kangako ukuphendula. Kunohlu olucatshangelwayo lwezidakamizwa olungaba nemiphumela ehlukile ekusebenzeni kwe-glimepiride. Ngakho-ke, abanye bandisa umphumela wayo we-hypoglycemic, kanti abanye, ngokungafani nalokho, banciphisa.
Kulokhu, odokotela bancoma kakhulu ukuthi iziguli zabo zibike lonke ushintsho esimweni sabo sempilo, kanye nanoma yiziphi izifo ezihlangene nesifo sikashukela.
Ithebula libonisa izidakamizwa eziphambili nezinto ezithinta i-glimepiride. Ukusetshenziswa kwabo kanyekanye akufiseleki ngokweqile, kepha kwezinye izimo kungabekwa ngaphansi kokuqashwa okuqinile kochwepheshe okwelapha.
Izidakamizwa ezingakhulisa umphumela we-hypoglycemic yilezi:
- imijovo ye-insulin;
- I-Fenfluramine;
- Izicucu;
- okuphuma ku-coumarin;
- Ama-Disopyramid;
- I-Allopurinol;
- I-Chloramphenicol;
- ICyclophosphamide;
- Feniramidol;
- I-Fluoxetine;
- IGuanethidine;
- AMO inhibitors, PASK;
- I-Phenylbutazone;
- Ama-Sulfonamides;
- Ama-inhibitors e-ACE;
- ama-anabolics;
- I-probenicide;
- Isophosphamides;
- I-Miconazole;
- I-Pentoxifylline;
- I-Azapropazone;
- I-Tetracycline;
- ama-quinolones.
Imithi enciphisa umphumela wokwehlisa ushukela uma uthathwa ndawonye ne-glimepiride:
- Acetazolamide.
- Corticosteroids.
- I-Diazoxide.
- Ama-diuretics.
- I-Sympathomimetics.
- Izibongo
- Ama-Progestogens.
- Phenytoin.
- Ama-hormone egilo.
- Ama-estrogens.
- I-Phenothiazine.
- I-Glucagon.
- I-Rifampicin.
- Ama-Barbiturates
- I-Nicotinic acid
- Adrenaline.
- Okususelwa kuCoumarin.
Kuyadingeka futhi ukuba uqaphele izinto ezinjengotshwala ne-histamine H2 receptor blockers (Clonidine neReserpine).
Ukutholwa kweCoumarin kungakhuphula futhi kunciphise i-glycemia ezigulini.
Izindleko, ukubuyekezwa kanye nokufana kwezidakamizwa
Ungawuthenga lo muthi ekhemisi ejwayelekile nakuwebhusayithi esemthethweni yomenzi, ngemuva kokubona isithombe sephakheji esiyingqayizivele kusengaphambili.
Kungenzeka futhi ukuthola i-glimepiride ngokwemibandela yokukhetha.
Kwa-Glimepiride, intengo iyahluka ngokuya ngefomu lomthamo nenani lamathebulethi amaphakethe.
Ngezansi kunolwazi ngezindleko zomuthi (i-Pharmstandard, Russia):
- I-Glimepiride 1 mg - kusuka kuma-ruble ayi-100 kuye kwangama-145;
- I-Glimepiride 2 mg - kusuka kuma-ruble ayi-115 kuye kwangama-240;
- I-Glimepiride 3 mg - kusuka kuma-ruble ayi-160 kuye kwangama-275;
- I-Glimepepiride 4 mg - kusuka kuma-ruble angama-210 kuya kwangama-330.
Njengoba ukwazi ukubona, intengo yamukeleka kahle esigulini ngasinye, kungakhathalekile ukuthi singenaphi. Kwi-Intanethi ungathola izibuyekezo ezahlukahlukene mayelana nomuthi. Njengomthetho, abanesifo sikashukela banelisekile ngesenzo salo muthi, futhi ngaphandle kwalokho, udinga ukusiphuza kanye ngosuku.
Ngenxa yemiphumela emibi noma i-contraindication, udokotela angabeka inani elithile labambeli. Phakathi kwazo, izidakamizwa ezihambisanayo (eziqukethe into efanayo esebenzayo) nezidakamizwa ze-analog (eziqukethe izakhi ezihlukile, kepha ezinomphumela ofanayo wokwelapha) ziyahlukaniswa.
Imikhiqizo edume kakhulu equkethe isithako esifanayo esebenzayo yile:
- Amaphilisi we-Glimepiride Teva - isidakamizwa esisebenzayo esinciphisa ushukela wegazi. Abakhiqizi abaphambili yi-Israyeli neHungary. E-Glimepiride Teva, ukufundiswa kuqukethe imiyalo ecishe ifane nokusetshenziswa kwayo. Kodwa-ke, imithamo yehlukile kwesidakamizwa sasekhaya. Intengo emaphakathi yepakethe eyi-1 ye-Glimepiride Teva 3 mg No. 30 ingama-ruble angama-250.
- I-Glimepiride Canon ingesinye isidakamizwa esithembekile ekulweni nezimpawu eziphakeme ze-glycemia nezimpawu zesifo sikashukela. Ukukhiqizwa kwe-Glimepiride Canon kuyenzeka naseRussia yinkampani yezokwelapha iCanonfarm Production. I-Glimepiride Canon ayinakho umehluko okhethekile, imiyalo ikhombisa ukungqubuzana okufanayo nokulimala okungase kube khona. Izindleko ezijwayelekile ze-Glimepiride Canon (4 mg No. 30) ngama-ruble angama-260. Umuthi i-Glimepirid Canon unenombolo enkulu yama-analogues futhi ungaba usizo lapho umuthi ungafanele isiguli.
- I-Altar isidakamizwa esidumile phakathi kweziguli. I-Glimepiride, eyingxenye ye-Altar yezidakamizwa, ikhuthaza ukukhishwa kwe-insulin ngamaseli e-beta. I-Altar inezici ezifanayo zohlelo lokusebenza. Umkhiqizi womkhiqizo we-Altar yiBerlin-Chemie. Intengo yepakethe elilodwa le-Altar imaphakathi neziqalo ezingama-250.
Kunezidakamizwa eziningi ezinomphumela ofanayo wokwelapha, isibonelo:
- I-Metformin i-ejenti eyaziwayo ye-hypoglycemic. Isakhi esiyinhloko segama elifanayo (i-metformin), ngobunono sehlisa amazinga kashukela futhi cishe asikaze siholele ku-hypoglycemia. Kodwa-ke, iMetformin inohlu olude lwe-contraindication nemiphumela emibi. Izindleko ezijwayelekile zesidakamizwa iMetformin (500 mg No. 60) ngama-ruble ayi-130. Njengoba le ngxenye iyingxenye yenani elikhulu lezidakamizwa, ungathola izinhlobo ezahlukene zemikhiqizo - Metformin Richter, Canon, Teva, BMS.
- Ezinye izidakamizwa ze-hypoglycemic - Siofor 1000, Vertex, Diabeteson MV, Amaril, njll.
Ngakho-ke, uma ngasizathu simbe i-glimepiride ingalingani, ama-analogues angayibuyisela. Kodwa-ke, leli thuluzi liyasebenza ekuthuthukiseni i-hyperglycemia.
Imininingwane ngezidakamizwa ezisebenza ngokunciphisa ushukela inikezwe kuvidiyo kule ndatshana.
