I-Diabetesalong inokukhishwa okuqhubekayo (PV) noma ukukhishwa okuguquliwe (MV) okusetshenziswe kusifo sikashukela sohlobo 2. Kungokwesigaba sesibili sulfonylurea group.
Ukusetshenziswa kwaso kubangelwa iqiniso lokuthi kwesinye isikhathi kunzima kakhulu ukulawula i-pathology enjalo ngokudla okukodwa kanye nomsebenzi womzimba. Izikhala ezihlala njalo kushukela nezimpawu ze-hyperglycemia kufanele zilawulwe.
Ukwelashwa okungalungile noma ngokungafanele kwesifo sikashukela kuholela ezinkingeni ezahlukahlukene, okuyingozi kakhulu ama-pathologies ezinhliziyo. Ukuthatha isidakamizwa i-Diabetesalong kunciphisa amathuba okuba nezifo ezincanyana kanye nezifo ezinkulu kakhulu emzimbeni. Lo mbhalo uzokusiza uthole ukuthi ungawuphuza kanjani umuthi ngendlela efanele.
Isenzo se-Pharmacological somuthi
Umphumela wehlisela ushukela wezidakamizwa i-Diabetalong uhlotshaniswa nengxenye yawo esebenzayo - glycoslazide. Ithebhulethi ngayinye iqukethe ama-30 noma ama-60 mg wezinto eziphambili kanye nenani elincane lezingxenye ezengeziwe: i-hypromellose, i-calcium stearate, i-talc, i-lactose monohydrate, kanye ne-colloidal silicon dioxide.
IGliclazide ibizwa ngokuthi yi-sulfonylurea derivatives, njengoba kwashiwo ngaphambili. Lapho isisemzimbeni, lesi sakhi siqala ukukhuthaza ukukhiqizwa kwe-insulin ngamaseli e-beta enza i-islet apparatus.
Kumele kuqashelwe ukuthi ngisho nangemva kweminyaka emibili yokwelashwa nalesi sidakamizwa, ukwanda kokuqukethwe kwe-C-peptide kanye ne-postprandial insulin kuhlala. Futhi-ke, i-gliclazide inemiphumela elandelayo:
- ukulawulwa kwe-carbohydrate metabolism;
- ukukhuthaza ukukhiqizwa kwe-insulin;
- hemovascular.
Lapho isiguli sidla ukudla noma sethula ushukela ngaphakathi, i-gliclazide iqala ukukhipha ukukhiqizwa kwe-hormone. Umphumela we-hemovascular kungenxa yokuthi into inciphisa amathuba okuba ne-thrombosis yemikhumbi emincane. Ukwemukela kwayo njalo kuvimbela ukuthuthukiswa kwe:
- I-Microvascular pathologies - i-retinopathy (ukuvuvukala kwe-retina) nephropathy (umsebenzi wezinso ophazamisekile).
- Imiphumela ye-Macrovascular - imivimbo noma ukumuka kwe-myocardial.
Ngemuva kokungenisa, i-gliclazide idonswa iphelele. Ukuhlushwa kwayo egazini kukhuphuka ngokulinganayo, okuqukethwe kwesiqongo kubhekwe ngemuva kwamahora ayi-6 ngemuva kokusebenzisa umuthi. Isikhathi sokusebenza sisuka emahoreni ayi-6 kuye kwayi-12. Ukudla akuphazamisi ukumuncwa kwento. I-Glyclazide idlulwa kakhulu yizinso, impilo yayo engxenye iyahlukahluka kusuka emahoreni ayi-12 kuye kwangama-20.
Umuthi lo kufanele ugcinwe endaweni lapho kungafinyelelwa khona ukukhanya kwelanga kanye namehlo wengane encane, emazingeni okushisa angeqi ku-25 degrees. Impilo yeshalofu yesidakamizwa yiminyaka emi-3.
Imiyalo yokusebenzisa umuthi
Okokuqala, kufanele kuphawulwe ngaso leso sikhathi ukuthi amaphilisi e-Diabetalong anqunyelwe ukwelashwa kwabantu abadala kuphela. Ngaphambi kokuqala ukwelashwa, kuyadingeka ukubonana nodokotela ozonquma uhlobo lomuthi wokwelashwa futhi akunikeze umthamo womuthi, kucatshangelwa izici zomuntu ngamunye ogulayo.
Ngemuva kokuthenga umuthi i-Diabetesalong, imiyalo yokusetshenziswa nayo kumele ifundwe ngokucophelela. Uma kuphakama imibuzo ethile, badinga ukubuzwa nguchwepheshe ohambelayo.
Ngesikhathi sokuphathwa kwamathebulethi ukuthuthukisa umphumela wawo wokwelashwa, kubalulekile ukunamathela kule mithetho:
- Zithathwa ngomlomo ngesikhathi esisodwa, mhlawumbe ekuseni.
- Umthamo owodwa kufanele ube kusuka kuma-30 kuye ku-120 mg ngosuku.
- Ithebhulethi ayidingi ukuhlafunwa, igwinyiwe iphelele.
- Uma weqa ukuthatha umuthi, awukwazi ukuwuphinda kabili umthamo.
- Umthamo wesidakamizwa ukhethiwe ngokulandelana ubheka izinga likashukela kanye ne-HbAlc.
Umthamo wokuqala onconywayo ngu-30 mg ngosuku, kepha uma isiguli singakwazi ukulawula kahle amazinga kashukela, khona-ke umthamo ungakhuphuka ngokuxhumanisa lokhu nodokotela. Kodwa-ke, ukwandisa umthamo akudingekile ngaphambi kwenyanga yokwelashwa nalesi sidakamizwa. Kepha uma isiguli sehluleka ukunciphisa izinga likashukela amasonto amabili, khona-ke singakhuphula umthamo womuthi.
Kumele kuqashelwe ukuthi i-1 i-tablet yesidakamizwa i-Diabetalong PV iqukethe ama-60 mg we-glyclazide, ehambelana namathebulethi amabili emuthi we-MV nomthamo ka-30 mg.
Lapho ushintsha usuka kwezinye izidakamizwa ezinciphisa ushukela ukwelashwa nge-Diabetalong, ngokuvamile awekho amakhefu adingekayo. Okuwukuphela kokunye ukusetshenziswa kwe-sulfonylurea derivatives. Umthamo wokuqala womuthi ngu-30 mg, yize kungcono ukubonana nodokotela wakho.
I-Diabetesalong ingasetjenziswa ngokufana nezidakamizwa ze-hypoglycemic ezifana nama-biguanides, insulin kanye ne-alpha-glucosidase inhibitors.
Ngokuqapha, kufanele isetshenziswe iziguli ezisengozini ye-hypoglycemia.
Contraindication kanye nomonakalo ongaba khona
Lesi sidakamizwa sinokuphikisana okuningi. Zihlanganiswa kakhulu nomsebenzi wezinso, amanyikwe kanye nesibindi.
Ngaphezu kweqiniso lokuthi i-Diabetalong ayinakuthathwa ngabanesifo sikashukela ngesimo esincike ku-insulin, lesi sidakamizwa sinqatshelwe:
- ukungabekezelelani komuntu ngamunye ku-gliclazide nezinye izinto;
- Isifo sikashukela sikashukela, i-precoma, ukuthuthukiswa kwe-ketoacidosis yesifo sikashukela;
- ukwehluleka kakhulu kwe-renal noma kwesibindi;
- ukusetshenziswa okufanayo kwe-miconazole;
- ukuzala ingane nokukhipha ingane;
- ukungabekezelelani kwe-lactose, i-glucose-galactose malabsorption kanye nokuntuleka kwe-lactase;
- izingane ezingaphansi kweminyaka engu-18.
Umuthi kufanele uphathwe ngokunakekelwa okukhethekile kwabanesifo sikashukela esidala, kanye:
- ukudla okungalinganiseli;
- ukusweleka kwe-glucose-6phosphate dehydrogenase;
- i-hypothyroidism;
- i-hypoituitarism;
- ukungapheleli kwepituational noma adrenal;
- ukuphuza njalo utshwala;
- ukwehluleka kwezinso kanye / noma kwesibindi;
- ukwelashwa isikhathi eside ngama-glucocorticoids.
Isifo sikashukela esinciphisa ushukela kumele sithathwe, sibheka yonke imithamo nezincomo zochwepheshe. Ukweqa amaphilisi, ukudla okungajwayelekile, noma ukweqisa ngokweqile kungabangela ukusabela okuhlukahlukene okungekuhle. Okungaba ukulimala okungase kube:
- Ukuthuthukiswa kwesimo se-hypoglycemic. Kubonakala ngezimpawu eziningi, isibonelo, ikhanda kanye nesiyezi, indlala, ukugayeka, ukudangala, ukudideka, ukwehluleka, ukulahlekelwa ukuzithiba, ukubona okufiphele, ukukhuphuka kwezinga lokuphefumula kanye nesilinganiso senhliziyo.
- Ukuvela kokuphendula kwe-adrenergic. Lokhu kufaka phakathi umjuluko, ukukhathazeka, umfutho wegazi owengeziwe, i-angina pectoris, i-arrhythmia ne-tachycardia.
- Ukuphazamiseka kwendlela yokugaya ukudla, ebonakaliswa wubuhlungu besisu, ukugcwala kwenhliziyo kanye nokuhlanza, isifo sohudo noma ukuqunjelwa.
- Ukushintshwa kwesikhumba okufana ne-pruritus, i-rash, i-edema ye-Quincke, i-urticaria, i-erythema, ukuqubuka kwe-maculopapular, noma ukusabela kwe-bulous.
- I-Hemopoiesis ukusebenza kokulimazeka - i-anemia, i-thrombocytopenia, i-leukopenia ne-granulocytopenia.
- Ukungasebenzi kwesibindi kanye nepheshana elihlanganisiwe, elibonakaliswa yi-hepatitis, ukwanda komsebenzi wama-enzyme wesibindi.
Ngaphezu kwalokho, ukulimala okungaba khona kungabonakala ekubonakala kokungasebenzi kahle kwezitho zomzimba (umbono, ukunambitheka).
Ukusebenzelana Nezidakamizwa Diabetesalong
Uma isiguli sithatha ezinye izidakamizwa ngasikhathi sinye, kufanele sazise udokotela waso ngalokhu. Ukufihla imininingwane enjalo ebalulekile kungaholela emiphumeleni emibi.
Umphumela wezidakamizwa ezahlukahlukene ngomphumela weDiabetesalong uhlukile: kwezinye izimo kuthuthukisa umphumela wazo we-hypoglycemic, kwezinye, kunalokho, uyancipha.
Ukusetshenziswa kwe-miconazole, phenylbutazone ne-ethanol kunomthelela ekwakhiweni kwesimo se-hypoglycemic esigulini esinesifo sikashukela i-mellitus. Futhi i-danazol, i-chlorpromazine, i-GCS, i-terbutaline, i-ritodrin ne-salbutamol kuholela ekunciphiseni komphumela wokwehlisa ushukela kwezidakamizwa. Ngaphezu kwalokho, ukusetshenziswa kwe Diabetesolong kanye nama-anticoagulants kufanele kuhlanganiswe nokuqapha.
Ngokukhula kwe-hypoglycemia ngendlela emnene noma elinganiselayo, lapho isiguli sazi, kufanele sinikezwe umkhiqizo oqukethe ushukela kanye nama-carbohydrate (ucezu kashukela, ushokoledi, ujusi wezithelo omnandi). Ngemuva kwalokho kuzodingeka ukuthi abonane nodokotela ngokulungiswa komthamo noma ngokushintshwa kwezidakamizwa.
Esimweni esibi kakhulu se-hypoglycemic, lapho isiguli singazi lutho futhi sinezimpawu zokugula, kudingeka ukuphuthumiswa esibhedlela okuphuthumayo. Ezimweni ezinjalo, udokotela wethula isiguli isisombululo se-glucose esangaphakathi (20-40%). Ngemuva kokuphaphama, unikezwa ukudla okuqukethe ama-carbohydrate. Ngemuva kokujwayelekile, isifo sikashukela siphethwe ngabodokotela cishe izinsuku ezimbili. Ngemuva kwalokho udokotela uxazulula inkinga yokwelashwa okwengeziwe nge-hypoglycemic.
Kumele kuqashelwe ukuthi inqubo ye-dialysis enezindlela ezinzima ze-hypoglycemia ayisebenzi, ngoba i-gliclazide ivame ukubopha kumaphrotheni ku-plasma yegazi.
Izindleko, ukubuyekezwa kanye nama-analogues
Njengoba umuthi uthengiswa ngomuthi kuphela, onesifo sikashukela ngeke azenzele, uma uqala, funa usizo lukadokotela. Umuthi uthengwa kokubili ekhemisi elijwayelekile nasezingosini ze-Intanethi.
I-Diabetesalong inentengo efanelekile. Isibonelo, izindleko zokupakisha amaphilisi ama-30 mg (izingcezu ezingama-60) zisukela kuma-ruble angama-98 kuya kwayi-127 amaRussia.
Ngokuqondene nemibono yabathengi nodokotela, bebonke, wonke umuntu ujabule ngalesi sidakamizwa. Uma usebenzisa i-Diabetesalong, ukubuyekezwa kusho ukuthi empeleni umuthi osebenzayo ekwelapheni isifo sikashukela sohlobo 2. Ngenxa yamazwana eziguli eziningi ezisebenzisa lo muthi, izinzuzo ezilandelayo zingaqokonyiswa:
- ukwehla okubushelelezi kushukela;
- ukuxhumana okuhle nezinye izidakamizwa;
- intengo engabizi yemithi;
- ukuncipha kwesisindo ngesikhathi sokusetshenziswa kwamathebulethi.
Kodwa-ke, ngesikhathi sokulashwa nomuthi, iziguli eziningi azizange zisithande isidingo sokuhlola njalo ushukela wazo wegazi. Kodwa uma le nuance ingabesabisi abanye, khona-ke i-Diabetalong iyindlela enhle yokuqinisa izinga le-glycemia. Ngaphezu kwalokho, ukusetshenziswa kwayo okuqhubekayo kunciphisa isidingo sokulawulwa kweshukela okunjalo.
Esimweni lapho umuthi ubangela ukusabela okuhlukahlukene esigulini noma kufakwa ku-contraindified ngokuvamile, udokotela umchaza ngokufana naye. Izindlela ezifanayo yilezo eziqukethe izinto ezihlukile, kepha zibe nomphumela ofanayo wokwelapha. Lokhu kufaka phakathi: Amaryl, Glemaz, Glimepiride, Glyurenorm nezinye izidakamizwa.
Futhi, udokotela angagxila ekukhetheni isidakamizwa esifanekisanayo, okungukuthi, i-ejenti equkethe ingxenye efanayo esebenzayo. Umehluko ukhona kuphela kwababukeli, isibonelo, iDiabeteson MV, Glidiab, Gliclada.
I-Diabetesalong umuthi omuhle kakhulu wokunciphisa ushukela olwehlisa kahle ushukela. Ngokusetshenziswa okufanele, isiguli singazinza izinga le-glycemia futhi sivikele izingqinamba ezinzima, ikakhulukazi kuma-pathologies wezinhliziyo.
Uma ngesizathu esithile umuthi ungalungile, zonke izinhlobo zama-analogues zingasibuyisela. Into ebaluleke kakhulu ukubonisana nodokotela wakho bese ulandela zonke izincomo ezibekiwe.
