IGliclada iyisidakamizwa ekwelapheni isifo sikashukela sohlobo 2 kwiziguli ezindala. Ithuluzi linconyelwa esimweni lapho umsebenzi ojwayelekile womzimba, ukudla okune-carb ephansi kungabi nomphumela ofanele emzimbeni wesiguli, akunakwenzeka ukulawula amazinga noshukela wegazi.
IGlyclad ayinqunyelwe uhlobo lwe-1 sikashukela mellitus, ukukhulelwa, ukuphuma kwengqondo, ukuqina kwe-hepatic, ukwehluleka kwezinso, i-ketoacidosis, ukungabekezelelani komuntu ngamunye kwisithako esiyisisekelo esisebenzayo, isifo sikashukela nesimo esidlangalaleni.
Kulesi sidakamizwa se-hypoglycemic, intengo ephakathi izoba ngama-ruble angama-290.
Imiyalo yokusebenzisa umuthi
Izibhebhe ze-Glyclad kufanele zithathwe ngesikhathi sasekuseni, zigwazwe ziphelele, hhayi zihlafunwe. Lapho umuntu onesifo sikashukela ephuze ukuthatha ikhambi, umthamo olandelayo awunakunyuswa ngokuzayo.
Kusuka kumathebulethi ayi-1 kuye ku-4 (ama-30 kuye kwangama-120 mg) athathwa ngosuku, umthamo ngqo kufanele ukhethwe ngamunye, ngokusekelwe ekuphenduleni kwe-metabolic yesiguli. Umthamo ojwayelekile wosuku lomuthi ngu-30 mg, uma ukulawulwa kwe-glycemia kusebenza, ama-30 mg wesidakamizwa asetshenziswa njengokwelashwa kokulungiswa.
Lapho ukulawulwa kokuhlushwa kwe-glucose kunganele, inani lemithi liyakhuphuka kancane kancane liye ku-60, 90, noma i-120 mg ngosuku. Ukuvalwa phakathi kokukhuphuka okulandelayo komthamo womuthi kufanele kube okungenani izinsuku ezingama-30, kodwa ngaphandle kokuthi ezimweni lapho amazinga kashukela egazi engabuyelanga emuva emuva kwezinsuku eziyi-12 zokwelashwa. Ezimweni ezinjalo, umthamo wanda ngokushesha kunangemva kwamaviki ama-2. Okuphezulu okuvunyelwe ukuthatha i-120 mg ngosuku.
Uma ungakwazi ukulawula izinga le-glucose namaphilisi we-Glyclazide 80 mg, angashintshwa ngokuphelele nge-Glyclad. Kwezinye izimo, kunezinkomba:
- qala ukwelashwa nge-30 noma 60 mg yesidakamizwa;
- khuphula kancane kancane umthamo kuya ngenhlalonhle yesifo sikashukela.
Amacwecwe angasetshenziswa ngokuhambisana nezinye izidakamizwa ezilwa nesifo sikashukela, lezi zingaba ngama-Biguanides, ama-insulin, ama-alpha glucosidase inhibitors. Kodwa-ke, ukusetshenziswa okuhlanganiswe nemijovo ye-insulin kumele kwenziwe ngaphansi kokuqashwa okuqinile kwezokwelapha.
Iziguli zeminyaka esegugile (ngaphezulu kweminyaka engama-65) ziyanconywa ukuthi ziphuze imishanguzo evamile. Ngakho-ke, abanesifo sikashukela abanokulimala okulinganiselwe, okunempilo nezinso banikezwa ngokwabo ukwelashwa.
Imithamo emincane yansuku zonke yesidakamizwa kufanele ithathwe iziguli ezinalezi zifo kanye nezimo ze-pathological:
- ukungondleki;
- ukungalawulwa kahle, ukwephulwa okunzima kohlelo lwe-endocrine;
- ukwelashwa isikhathi eside ngezidakamizwa ze-corticosteroid;
- izifo ezinzima zenhliziyo, imithambo yegazi.
Ukuphendula okungafuneki komzimba
Ngokusho kokubuyekezwa, ezinye iziguli zingaba nemiphumela emibi yomzimba, ekhonjiswa ukuphazamiseka kwezitho ezahlukahlukene nezinhlelo.
Ngakho-ke, umuntu onesifo sikashukela angaba ne-hypoglycemia, imvamisa lokhu kwenzeka ngemuva kokudla isidakamizwa okungejwayelekile noma ukweqa ukudla. Kulokhu, kunezimpawu: izinhlungu ekhanda, ukugcwala kwenhliziyo, ukuhlanza, ukuphazamiseka kokulala ebusuku, ukukhathala, indlala enkulu.
Ubudlova obungenakufinyeleleka, ukugxilwa okungahambi kahle, ukubambezela ukusabela kwe-psychomotor, umuzwa wokungakwazi ukusiza, kanye nesimo sokudangala asikhishwa. Nge-hyperglycemia, isiyezi, umbono okhubazekile, ukukhuluma, i-paresis, ukuthuthukiswa kwe-aphasia, ukuzwela kuyancipha. Ezinye iziguli zinokuphefumula okungaxutshwe nalutho, zivame ukulahlekelwa ingqondo, okuholela ekukhohlisweni, ukukhohlisa nokufa.
Kukhona futhi kungenzeka kwezimpawu ze-adrenergic ezijoyina:
- umuzwa wokukhathazeka;
- izithukuthuku ezinamathele;
- ukwanda kwengcindezi yegazi;
- Ubuhlungu enhliziyweni;
- arrhythmia.
Okunye ukusabela okuhlukile kuzoba yilokhu: izinhlungu emgodini wesisu, ukwanda okuphindayo kwama-enzyme wesibindi, ukuqubuka kwesikhumba, i-hyponatremia. Ukuphazamiseka okubuyela emuva kuzoba yi-leukopenia, i-anemia, i-pancytopenia. Ukuqunjelwa kungenzeka ngesifo sikashukela.
Ekuqaleni kokulashwa kwezidakamizwa, kuphakama ukuphazamiseka kwesikhashana, ngokwesibonelo, izinkinga zokubuka.
Imininingwane yalokhu ichazwe emiyalweni yokusetshenziswa.
Ukusebenzelana kwezidakamizwa
Ngokusetshenziswa okuhlangene kwesidakamizwa neMiconazole, amathuba okuthuthuka kwe-hypoglycemia ayanda, aze afike ekhefeni. IGlyclad ayinqunyelwe kanye ne-phenylbutazone; izidakamizwa eziqukethe utshwala azikhishwa ngesikhathi sokwelashwa.
Ngenxa yengozi eyandayo ye-hypoglycemia, udokotela kufanele aqaphele kakhulu ngenkathi ebeka amanye amaqembu emithi yesifo sikashukela: ama-biguanides, ama-insulin, ne-acarbose ngenkathi edla izidakamizwa ezilwa nesifo sikashukela. Kuyadingeka futhi ukuthi ugweme ukwelashwa okuhlanganyelwe nabakwa-beta-blockers, ama-sulfonamides, izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala.
Ukuhlanganiswa kwe-gliclazide neDanazole kungakhuphula ushukela wegazi, uma kunesidingo esibi sezidakamizwa ezinjalo kuboniswa ukulawula i-glycemia, esinye isincomo ukuguqula umthamo weGlllada ngesikhathi sokusebenzisa iDanazol nangemva kokwelashwa.
Njengoba kungenzeka ukuthi kube ne-hyperglycemia:
- kubalulekile ukuba uqaphele lapho unquma umuthi nge-chlorpromazine yento;
- kunezinkomba zokulungisa umthamo we-gliclazide.
Ngokusebenzisa okuhleliwe okuhleliwe, okwasekhaya, okulandelanayo, okwenziwe ngendlela ethambile, futhi okunama-glucocorticosteroid, ukwanda kwe-glycemia kungenzeka ngenxa yokwehla kokumelana nama-carbohydrate.
Kunombono wokuthi kuyadingeka ukuhlanganisa ngokucophelela i-glycade nezinto i-salbutamol, i-ritodrin, i-terbutaline ngenxa yengozi ye-hyperglycemia.
Uma kungenzeka, ezimweni ezinjalo, baphendukela ekwelashweni kwe-insulin.
Imiyalo ekhethekile
Ukwelapha kuqala kuphela ngokudla ejwayelekile, kufaka phakathi ibhulakufesi. Kukhona ubungozi be-hypoglycemia ngokungondleki, ngemuva kokuzivocavoca kanzima ngokomzimba, ukuphuza utshwala. Ukuvimbela ushintsho emazingeni kashukela egazini, odokotela batusa futhi ukudla okudla i-carbohydrate.
Njengoba i-hypoglycemia ingahle ikhule ngokuphathwa ngokubambisana okuphathelene nokuphuma kwe-sulfonylurea, isiguli sikashukela singadinga ukulashwa okuphuthumayo esikhungweni sezokwelapha. Esibhedlela, kunesidingo sezinsuku ezimbalwa zokusebenzisa ushukela.
Ukuze unciphise iziqephu ze-hypoglycemia, kufanele usibhekele kahle isimo sakho, uxwayise ngokushayisana kwezihlobo.
Kunezici ezingakhulisa amathuba we-hypoglycemia:
- ukwenqaba inkambo ebekiwe yokwelashwa (kaningi lokhu kwenzeka ezigulini esezikhulile);
- ukwehluleka kwezinso;
- amacala okwehluleka okukhulu kwesibindi;
- ukondliwa okungafanele, ukuzila isikhathi eside, ukweqa ukudla;
- ukuntuleka kokulinganisela okufanele kokudla kwe-carbohydrate kanye nokuzivocavoca komzimba;
- izidakamizwa ezidakwayo.
Akunangozi kangako ngokubuka kokuthuthukiswa kwe-hypoglycemia yohlobo 2 sikashukela yizifo ze-thyroid, izifo ze-adrenal gland kanye nokusetshenziswa kwezidakamizwa ezingahambisani.
Ngokuhluleka kwe-hepatic and reso, i-pharmacokinetic, izakhiwo ze-pharmacodynamic zomuthi zingashintsha. Amacala we-hypoglycemia kuma-diabetesics angaba wesikhashana noma ahlala isikhathi eside, ngakho-ke, ukuqapha okufanele kufanele kwenziwe.
Isifo sikashukela kufanele saziswe ngesikhathi esifanele ngesidingo sokulandela ukudla okuqinile, ukubaluleka kokusebenza ngokomzimba okuhleliwe, nokubhekwa kwezinkomba zeglucose yegazi. Isiguli kanye namalungu omndeni wakhe kufanele bazi ngobungozi be-hypoglycemia, izimpawu zayo, izindlela zokwelashwa nezinto ezibeka engcupheni ukuthuthukiswa kwenkinga enjalo.
Kukhona ukubuyekezwa kodokotela lapho ongafunda khona ngokusebenza kokulawula ushukela uma isiguli sithola ukwelashwa okulwa nesifo sikashukela. Ukusebenza okunjalo kungancishiswa kakhulu lapho:
- izinga lokushisa lomzimba liyenyuka;
- ukwelashwa kokuhlinzwa kwenziwa;
- kwakukhona ukulimala, izifo.
Kwesinye isikhathi kuyadingeka ukunquma imijovo ye-insulin.
Ngokuhamba kwesikhathi, ukusebenza kwe-hypoglycemic kwanoma imuphi umuthi we-antidiabetesic kuyancipha, futhi i-glycazide nayo ihlukile. Ngalesi sizathu, ngemuva kwesikhathi esithile, ukusabela kwesiguli ekwelashweni okwenziwayo kuyancishiswa. Isimo esifanayo sibizwa ngokuthi ukuntuleka kwesibili kokusebenza kwezokwelapha. Isiphetho esinjalo senziwa kuphela uma umthamo ulungiswa kahle, futhi kudingeka ukudla.
Ukuhlola ikhwalithi yokuqapha ama-glycemic indices, ama-glycated hemoglobin indices kufanele alinganiswe; okunye okuhlukile kule nqubo ukuzimisela kokuzila izinga le-glucose ku-plasma yegazi elizalwe.
Uma amalungiselelo e-sulfonylurea emiselwe iziguli ezinesifo sokuphuza kwe-glucose-6-phosphate dehydrogenase, ngenxa yalokho kungenzeka:
- IGliclazide kungcono ukwenqaba;
- khetha izinkomba zesidakamizwa.
Amacwecwe aqukethe i-lactose, uma uhlobo lwesifo sikashukela sesi-2 nawo enesifo sofuzo esihlangene ne-galactose ukungabekezelelani, ukusweleka kwe-lactose, i-glucose-galactose malabsorption, akufanele athathe ukwelashwa okunjalo.
Kubalulekile ukwazi ukuthi umuthi kwezinye izikhathi uthinta kabi ijubane lokuphendula kwengqondo yomuntu, ngenxa yalesi sizathu kubalulekile ukwenqaba noma ukunciphisa umkhawulo ekuphatheni kwezokuhamba kwezimoto, ezinye izindlela zemishini ngesikhathi sokwelashwa.
Amacala okweqa
Uma isiguli sithathe umthamo omkhulu kakhulu womuthi, siba ne-hypoglycemia yobunzima obuhlukahlukene - ukusuka kokulingene kuya kokukhulu. Ukubuyekezwa kweziguli kuthi kulezo zimo zinqunyelwe ukudliwa kwe-carbohydrate, ushintsho noma ukulungiswa kokudla. Isifo sikashukela singaphansi kokulawulwa ngudokotela kuze kube yilapho kuqeda ingozi, isimo singazinzi.
Kwi-hypoglycemia enzima, ehambisana nokuphazamiseka kwemizwa, kubalulekile ukubiza i-ambulensi. Nge-hypoglycemic coma noma izinsolo zokukhula kwayo, i-glucagon noma isixazululo seglue egxilile kufanele siphathwe ngokushesha.
Ngemuva kwalokhu, ukufakwa kwesisombululo se-glucose esingu-10% kuyaqhubeka, lokhu kuzoqinisekisa ukugcinwa kokugcotshwa koshukela egazini. I-Hemodialysis ngeke isebenze. Ividiyo ekulesi sihloko izokutshela ukuthi imiphi eminye imishanguzo yesifo sikashukela ongayisebenzisa.
