Ukusetshenziswa kwezidakamizwa ezinjengeManinil noDiabeteson kungabhekana ngokuphumelelayo nesimo se-hyperglycemia, esivuswa emzimbeni wesiguli ngokuqhubeka kwesifo sikashukela sohlobo 2.
Olunye lwale mithi alunazo nje kuphela izinzuzo zalo, kodwa futhi nobunzima.
Kungenxa yalesi sizathu ukuthi umbuzo wokuthi ngabe uManinil noma uDiabeteson, ongcono, uyafaneleka yini esigulini.
Ukukhethwa kwezidakamizwa kuncike ezicini eziningi. Izici ezithinta ukukhetha kwesidakamizwa yilezi:
- ukusebenza kahle kwalo muthi;
- amathuba emiphumela emibi;
- izici zomzimba ngamunye;
- imiphumela yokuhlolwa ushukela wegazi;
- izimbangela zesifo sikashukela i-mellitus zohlobo lwesibili;
- izinga lokuqhubeka kwezifo.
Impendulo yombuzo wokuthi ngabe uDiabeteson noma uManinil kungcono ukuwusebenzisa ekwelashweni inganikezwa kuphela ngudokotela ophethe ukwelashwa ngemuva kokuthola lonke ulwazi oludingekayo mayelana nesimo sesiguli futhi afundele nezimpawu zesifundo esikuye.
Umphumela wesifo sikashukela emzimbeni womuntu
Isifo sikashukela sisetshenziselwa ukwelapha isifo sikashukela sohlobo 2. Lesi sidakamizwa singumenzeli osebenzayo we-hypoglycemic. Okuphuma kwesizukulwane sesibili. Ukwethulwa kwalesi sidakamizwa emzimbeni kuthuthukisa ukusebenza kwamaseli we-pancreatic beta, okuholela ekwandeni kokukhiqizwa kwawo kwe-hormone insulin.
Ithuluzi lithinta ukuzwela kokuthola ama-insulin kuma-membranes weseli wezicubu zomzimba ezibangelwa i-insulin. Lezi izicubu izicubu zomzimba namafutha.
Ukuthatha umuthi kunciphisa ubude besikhathi sesiguli phakathi kokudla nokuqala kokukhishwa kwe-insulin ngamaseli e-pancreatic beta angena egazini.
Ukusetshenziswa kwesifo sikashukela kuthuthukisa noma kuvumele ukuqina kokuqina kwezindonga zesistimu yemithambo yegazi.
Lapho usebenzisa umuthi, kuyehla ukwehla kwezinga le cholesterol yegazi lesiguli. Lo mphumela ugwema ukuthuthukiswa ohlelweni lwe-vascular lwesiguli ehlushwa uhlobo lwe-2 sikashukela mellitus, i-micothrombosis kanye ne-atherosclerosis.
Ngaphansi kwethonya lento esebenzayo yesidakamizwa, inqubo ye-microcirculation yegazi ijwayelekile.
Ngokuphikisana nesizinda sokuthuthukiswa kwe-nephropathy yesifo sikashukela esigulini, ukusetshenziswa kwomuthi kunganciphisa izinga le-proteinuria.
I-Pharmacokinetics, izinkomba kanye ne-contraindication yokusetshenziswa kwe-Diabeteson
Ngemuva kokuphathwa ngomlomo emzimbeni, isidakamizwa siphula ngokushesha okukhulu. Umphumela omkhulu emzimbeni ufinyelelwa emahoreni angama-4 ngemuva kokulawulwa kwomuthi. Umuthi ubopha amaprotheni e-plasma, amaphesenti ekwakheka okuyinkimbinkimbi afinyelela ku-100.
Uma usufika izicubu zesibindi, ingxenye esebenzayo iguqulwa ibe yi-8 metabolites.
Ukuhoxiswa komuthi kwenziwa amahora ayi-12. Ukuhoxiswa kwezidakamizwa emzimbeni wezinso ngohlelo lokukhuphuka.
Cishe i-1% yezidakamizwa ikhishwa emchameni ungashintshiwe.
Isibonakaliso esiyinhloko sokusetshenziswa kwe-Diabeteson ukuba khona komzimba wesiguli sohlobo lwe-2 mellitus, okungancike kwe-insulin. Umuthi ungasetshenziswa njenge-prophylactic ekuboneni ukwephulwa kwezinqubo ze-microcirculation yegazi.
Umuthi ungasetjenziswa zombili ngesikhathi se-monotherapy nanjengengxenye lapho usebenzisa ikhambi eliyinkimbinkimbi lesifo sikashukela i-mellitus.
I-contraindication eyinhloko ekusebenziseni umuthi yile mibandela elandelayo yomzimba:
- ukuba khona komzimba wesifo sikashukela esincike ku-insulin sohlobo lokuqala;
- Isifo sikashukela sikashukela, isimo esithandekayo;
- isiguli sinezimpawu zokukhula kwesifo sikashukela sikashukela;
- ukuphazamiseka emsebenzini wokusebenza kwezinso nesibindi.
Akunconyelwe ukusebenzisa umuthi ngokuhlangana ne-glycosides kanye nemidazole derivatives. Uma kunokuzwela okwengeziwe komzimba wesiguli ku-sulfonamides ne-sulfanilurea, akunconywa ukusebenzisa i-Diabeteson ukwelashwa.
Ukwephulwa kwezincomo zokusetshenziswa kwomuthi kuvusa ukuthuthukiswa kwemiphumela emibi emzimbeni.
Imithamo esetshenzisiwe nemiphumela emibi
Ukusetshenziswa komuthi kunconywa ukuthi uqale ngomthamo ka-80 mg. Umthamo ophelele ovunyelwe nsuku zonke akufanele udlule i-320 mg.
Kunconywa ukuthatha umuthi kabili ngosuku ekuseni nakusihlwa. Inkambo yokwelashwa nge-Diabeteson ingaba yinde. Isinqumo sokusebenzisa nokuyeka ukusebenzisa umuthi senziwa udokotela oholayo ebheka imiphumela yokuhlolwa nezimpawu zomzimba wesiguli ngamunye.
Lapho isetshenziswa ekwelapheni isifo sikashukela i-mellitus Diabeteson, imiphumela elandelayo elandelayo ingavela:
- Izifiso zokuhlanza.
- Ukuvela kwemizwa yesicanucanu.
- Ukubonakala kobuhlungu esiswini.
- Ezimweni ezingavamile, kukhula i-leukopenia noma i-thrombocytopenia.
- Ukuvela komzimba kungenzeka. Okubonakala njengokuqubuka kwesikhumba nokulunywa.
- Uma i-overdose yenzeka emzimbeni wesiguli, kuvela izimpawu ze-hypoglycemia.
Uma udokotela elandayo enquma isifo sikashukela. Ngemuva kwalokho kufanele wenze ukuhlolwa kwegazi njalo nge-glucose.
Akunconyelwe ukusebenzisa umuthi ngokuhlanganiswa nemithi equkethe i-verapamil ne-cimetidine.
Sebenzisa i-Diabeteson, ngokuya ngayo yonke imithetho, kungasithuthukisa kakhulu isimo sesiguli esinohlobo 2 sikashukela.
Izici zokusetshenziswa kweManinil
I-Maninil isidakamizwa se-hypoglycemic esenzelwe ukusetshenziswa komlomo. Isithako esikhulu esisebenzayo ekwakhekeni komuthi yi-glibenclamide. Umkhakha wemithi ukhiqiza umuthi ngendlela yamathebulethi anomthamo ohlukile wengxenye esebenzayo.
Ukulungiselela kusakazwa emaphaketheni epulasitiki. Iphakheji liqukethe amaphilisi ayi-120.
IManinil isuselwa kwisizukulwane sesibili sulfonylurea. Ukusetshenziswa kwomuthi kungasiza amaseli we-beta kusebenze ukukhiqizwa kwe-insulin. Ukukhiqizwa kwe-hormone kuqala kumaseli wamanyikwe ngokushesha ngemuva kokudla. Umphumela we-hypoglycemic wokuthatha umuthi uphikelela amahora angama-24.
Ngaphezu kwengxenye eyinhloko, ukwakheka komkhiqizo kufaka phakathi izithako ezilandelayo:
- i-lactose monohydrate;
- isitashi samazambane;
- i-magnesium stearate;
- i-talc;
- i-gelatin;
- udayi.
Amathebhulethi anombala opinki ngombala, ijamo le-flat-cylindrical line-chamfer ene-notch eseceleni linye lwethebhulethi.
Lapho usiphuza ngomlomo, lesi sidakamizwa sisheshe futhi sicishe sithathwe. Isikhathi sokufika ekuhlushweni okuphezulu emzimbeni ngemuva kokuphathwa umuthi amahora angama-2,5. Ingxenye esebenzayo yesidakamizwa ibopha amaprotheni e-plasma cishe ngokuphelele.
I-Glibenclamide metabolism yenziwa kumaseli wezicubu zesibindi. I-Metabolism ihambisana nokwakhiwa kwama-metabolites amabili angasebenzi. Enye yama-metabolites idalulwa yi-bile, futhi ingxenye yesibili etholwe yi-metabolism ye-glibenclamide iyakhishwa kumchamo.
Ukuphila kwesigamu umuthi okuvela emzimbeni wesiguli cishe amahora angama-7.
Izinkomba kanye ne-contraindication zokusetshenziswa kwemithi kanye nemiphumela emibi
Isibonakaliso esiyinhloko sokusetshenziswa kwomuthi ubukhona besiguli sikashukela i-mellitus kwifomu elizimele le-insulin. Kusetshenziswa ekusetshenzisweni kokubili okuyinkimbinkimbi ne-monotherapy.
Akunconyelwe ukusebenzisa umuthi lapho wenza ukwelashwa okuyinkimbinkimbi kwesifo sikashukela ngokuhlangana noshukela sulfonylurea.
Njenganoma yisiphi isidakamizwa, iManinil inezindlela eziningi zokuphikisana nokusetshenziswa komuthi.
Ukuphambana okuyinhloko ekusebenziseni umuthi yile:
- ukuba khona kwe-hypersensitivity kuzakhi zomuthi.
- Ukuba khona kokukhula okungenhla kokutholwa kwe-sulfonylurea, i-sulfonamides kanye nezinye izidakamizwa eziqukethe iqembu le-sulfonamide, ngoba ukusabela kokuphambana kungenzeka.
- Isiguli sinesifo sikashukela sohlobo 1.
- Isimo se-ketoacidosis ye-thoroma, ukoma kanye nesifo sikashukela.
- Ukuba khona kokwehluleka okukhulu kwezinso.
- Isimo sokuwohloka kwe-carbohydrate metabolism ekwakhiweni kwesifo esithathelwanayo.
- Ukuthuthukiswa kwe-leukopenia.
- Ukuvela kokuvinjwa kwamathumbu kanye ne-paresis yesisu.
- Ukuba khona kwefa lactose ukungabekezelelani noma ukuba khona kwe-glucose ne-lactose malabsorption syndrome.
- Ukuba khona emzimbeni wokuntuleka kwe-glucose-6-phosphate dehydrogenase.
- Isikhathi sokukhulelwa nokukhulelwa.
- Isiguli singaphansi kweminyaka engu-18 ubudala.
Ukuqapha kufanele kusetshenziswe uma kunezifo ze-thyroid ezikhuthaza ukusebenza kwengcindezi yokulimala.
Kufanele futhi uqaphele uma kukhona i-febrile syndrome ye-cerebral atherosulinosis emzimbeni, i-hypofunction ye-anterior pituitary gland kanye nokudakwa kotshwala.
Njengemiphumela emibi evela ekusetshenzisweni kweManinil, ukuphazamiseka kwamathumbu emathunjini, ikhanda, ukuphazamiseka kokukhuluma nokubona, kanye nokukhuphuka okuncane kwesisindo somzimba kungabonakala.
Yini engcono Maninil noma Diabeteson?
Thola ukuthi yiziphi iziguli okufanele zinqume iManinil noma i-Diabeteson okufanele abe udokotela. Ukukhethwa kwezidakamizwa zokwelashwa kwenziwa kuphela udokotela ohambayo ngokuya ngemiphumela yokuhlolwa komzimba futhi ebheka zonke izici zomzimba ngamunye ogulayo ohlushwa isifo sikashukela sohlobo 2.
Ngayinye yale mishanguzo isebenza kakhulu ekusebenziseni. Zombili lezi zidakamizwa zinemiphumela ephezulu emzimbeni futhi zinciphisa ngempumelelo izinga le-hyperglycemia.
Akunampendulo ecacile embuzweni wokuthi yisiphi isidakamizwa esingcono ukuthatha.
Kufanele kukhunjulwe ukuthi akunconywa ukusebenzisa, ngokwesibonelo, isifo sikashukela uma isiguli sinokuhluleka kwe-hepatic noma kwe-renal.
Inzuzo yokusebenzisa iManinil ukuthi lapho uyisebenzisa, isiguli kungenzeka singakhathazeki ngokwanda okungazelelwe koshukela emzimbeni, ngoba isikhathi somuthi usuku lonke.
Ngasikhathi sinye, isiguli akufanele sikhohlwe ngemigomo yokwelashwa kokudla i-mellitus yesifo sikashukela kanye nohlobo lokuphuza imithi iqinisekisa ukuthi amazinga kashukela ayagcinwa ezingeni elamukelekayo.
Ividiyo ekulesi sihloko ihlinzeka ngesibiniso somuthi i-Diabeteson.
