I-Amaryl iqukethe i-glimepiride, engokwesizukulwane esisha, sesithathu, sulfonylurea derivatives (PSM). Lo muthi ubiza kakhulu kune-glibenclamide (Maninil) ne-glyclazide (Diabeteson), kepha umehluko wentengo uvunyelwa ukusebenza kahle okuphezulu, isenzo esisheshayo, umphumela omnene kuma-pancreas, kanye nengozi ephansi ye-hypoglycemia.
Nge-Amaril, amangqamuzana e-beta ancishiswa kancane kunokuba nezizukulwane ezedlule ze-sulfonylureas, ngakho-ke ukuqhubekela phambili kwesifo sikashukela kuyancipha futhi ukwelashwa kwe-insulin kuzodingeka kamuva.
Ukubuyekezwa okuthatha umuthi kunethemba: kunciphisa ushukela kahle, kufanelekile ukuwusebenzisa, baphuza amaphilisi kanye ngosuku, kungakhathalekile ukuthi muphi umthamo. Ngaphezu kwe-glimepiride emsulwa, ukuhlanganiswa kwayo ne-metformin kukhiqizwa - I-Amaril M.
Umyalo omfishane
| Isenzo | Yehlisa ushukela wegazi, othinta izinga layo ezinhlangothini ezimbili:
Ngaphezu kwalokho, umuthi unciphisa ingozi ye-thrombosis, i-cholesterol ejwayelekile, futhi unciphise ukucindezela kwe-oxidative. I-Amaryl isuswe ngaphandle komchamo, ngokwengxenye yomgudu wokugaya ukudla, ngakho-ke ingasetshenziswa ezigulini ezihluleka ukuqina kwezinso, uma imisebenzi yezinso igcinwe ngokwengxenye. |
| Izinkomba | Isifo sikashukela kuphela izinhlobo ezi-2. Imfuneko yokusetshenziswa kungamaseli we-beta agcinwe ngokwengxenye, ukwakheka okusalayo kwe-insulin yabo. Uma ama-pancreas eseyekile ukukhiqiza ama-hormone, i-Amaril ayinqunyelwe. Ngokwemiyalo, umuthi ungathathwa nge-metformin kanye ne-insulin therapy. |
| Umthamo | I-Amaryl ikhiqizwa ngohlobo lwamacwecwe aqukethe aze afike ku-4 mg we-glimepiride. Ukuze kube lula ukusetshenziswa, umthamo ngamunye unombala wawo. Umthamo wokuqala ngu-1 mg. Kuthathwa izinsuku eziyi-10, emva kwalokho baqale ukukhula kancane kancane kuze kube yilapho ushukela usujwayelekile. Umthamo omkhulu ovunyelwe yi-6 mg. Uma inganikeli isinxephezelo sikashukela, izidakamizwa ezivela kwamanye amaqembu noma i-insulin zengezwa kunhlobo yokwelashwa. |
| Ukweqisa | Ukweqisa umthamo omkhulu kuholela esikhathini eside kwe-hypoglycemia. Ngemuva kokwenza ushukela ngokwejwayelekile, kungawa ezinye izinsuku ezintathu. Sonke lesi sikhathi, isiguli kufanele sibe ngaphansi kokuqashwa kwezihlobo, ngesidakamizwa esinamandla ngokweqile - esibhedlela. |
| Contraindication |
I-Amaryl imiswa okwesikhashana futhi ithathelwe indawo imijovo ye-insulin ngesikhathi sokukhulelwa nokuqunjelwa, izinkinga ezinzima zesifo sikashukela, kusuka ku-ketoacidosis kuya ku-hyperglycemic coma. Ngezifo ezithathelwanayo, ukulimala, ukugcwala ngokweqile kwemizwelo, i-Amaril kungenzeka ingabi yanele ukuguqula ushukela, ngakho-ke ukwelashwa kuhambisana ne-insulin, imvamisa. |
| Ingozi ye-hypoglycemia | Ushukela wegazi wehla uma onesifo sikashukela ekhohlwa ukudla noma engazange alubuyise ushukela owachitha ngesikhathi sokuzivocavoca. Ukulungisa i-glycemia ngokwejwayelekile, udinga ukuthatha ama-carbohydrate asheshayo, imvamisa ucezu kashukela, ingilazi yejusi noma itiye elimnandi kwanele. Uma umthamo we-Amaril udluliwe, i-hypoglycemia ingabuya kaningana ngesikhathi somuthi. Kulokhu, ngemuva kokujwayelekile ushukela, bazama ukususa i-glimepiride emgodini wokugaya ukudla: bavusa ukugabha, baphuze i-adsorbents noma i-laxative. Ukwelashwa ngokweqile kuyabulala; Ukwelashwa kwe-hypoglycemia enzima kufaka i-glucose eyenzelwe ukungena emzimbeni. |
| Imiphumela emibi | Ngaphezu kwe-hypoglycemia, lapho kuthathwa i-Amaril, izinkinga zokugaya zingabonakala (ngaphansi kwe-1% yeziguli), ukungezwani komzimba, kusuka ekuqhekekeni kanye nokuhashazwa kuya ekushisweni kwe-anaphylactic (<1%), ukuvela kwesibindi, ushintsho ekwakhiweni kwegazi (<0.1%) . |
| Ukukhulelwa kanye ne-GV | Ukufundisa ngokuqinile kwenqabela ukwelashwa nge-Amaril ngesikhathi sokukhulelwa kanye ne-HBV. Umuthi udlula kwisithintelo se-placental bese ungena egazini le-fetus, ungena ebisini lesifuba. Uma isiguli esikhulelwe noma eselapheka sikashukela singayeki ukuthatha lo muthi, ingane isengozini enkulu ye-hypoglycemia. |
| Ukusebenzelana kwezidakamizwa | Umphumela we-Amaril ungashintsha ngokusetshenziswa kanyekanye kwezinye izidakamizwa: ama-hormonal, ama-antihypertensive, amanye ama-antibhiksthi nama-ejenti we-antifungal. Uhlu oluphelele luqukethwe emiyalweni yokusetshenziswa. |
| Ukwakheka | Into esebenzayo yi-glimepiride (i-Amaril M ine-glimepiride ne-metformin), izithako ezisekelayo zokwenziwa kwethebhulethi futhi yandise impilo yayo yeshalofu: sodium glycolate, lactose, cellulose, polyvidone, magnesium stearate, udayi. |
| Umkhiqizi | I-Sanofi Corporation, i-glimepiride yenziwa eJalimane, amaphilisi kanye nokufakwa e-Italy. |
| Intengo | I-Amaryl: 335-1220 rub. ngamathebhulethi angama-30, izindleko zincike kumthamo. Iphakethe elikhulu kunawo wonke - amaphilisi angama-90 ama-4 mg lilinye libiza cishe ama-ruble angama-2700. I-Amaril M: 750 rub. ezibhebheni ezingama-30. |
| Isitoreji | Iminyaka emithathu Umuthi kufanele ugcinwe ungatholakali ezinganeni, ngoba ukusetshenziswa kwe-Amaril okungalawulwa kungaba yingozi empilweni. |
Imithetho Yokwamukela
Amatafula e-Amaryl anqunyelwe ezimweni ezimbili:
- Uma isifo sikashukela singapheli unyaka wokuqala, futhi i-metformin ayanele ukusinxephezela.
- Ekuqaleni kokwelashwa, kanye ne-metformin nokudla, uma kutholakala i-glycated hemoglobin ephezulu (> 8%). Ngemuva kokunxephezela lesi sifo, isidingo semithi ye-hypoglycemic siyancipha, futhi i-Amaryl ikhanseliwe.
Umuthi uphuzwa nokudla.. Ithebhulethi ayikwazi ukuchobozekwa, kepha ingahlukaniswa phakathi isengozini. Ukwelashwa kwe-Amaril kudinga ukulungiswa okunempilo:
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
- ukudla lapho bephuza khona amaphilisi kufanele kube kuningi;
- Akunakusho ukuthi weqa ukudla. Uma kwakungeke kwenzeke ukuba ube nesidlo sasekuseni, ukwamukelwa kuka-Amaril kudluliselwa esidlweni sakusihlwa;
- Kuyadingeka ukuhlelela ukuthathwa ngokulinganayo kwama-carbohydrate egazini. Lo mgomo utholwa ngokudla okuvame ukwenziwa (ngemuva kwamahora ama-4), ukwabiwa kwama-carbohydrate kuzo zonke izitsha. I-index ephansi ye-glycemic yokudla, kulula kakhulu ukuthola isinxephezelo sikashukela.
I-Amaril idakiwe iminyaka ngaphandle kokuthatha ikhefu. Uma umthamo omkhulu usuphelile ukunciphisa ushukela, dinga ngokuphuthumayo ushintshele ekwelashweni kwe-insulin.
Isikhathi sokwenza
I-Amaryl ine-bioavailability ephelele, i-100% yezidakamizwa ifinyelela endaweni yokusebenza. Ngokusho kwemiyalo, inani eliphezulu le-glimepiride esegazini lakhiwa ngemuva kwamahora ayi-2,5. Isikhathi sokusebenza esedlule singamahora angama-24, okuphezulu umthamo, amaphilisi we-Amaril asele azosebenza.
Ngenxa yesikhathi sayo eside, umuthi uvunyelwe ukuphuzwa kanye ngosuku. Uma kucatshangelwa ukuthi ama-60% abantu abanesifo sikashukela abanothambekele ekulandeleni ngokuqinile imiyalo kadokotela, umthamo owodwa unganciphisa ukungabikhona kwezidakamizwa ngama-30%, futhi ngenxa yalokho wenze ngcono isifundo sikashukela.
Ukuhambisana notshwala
Utshwala obudakayo buthinta i-Amaryl ngokungalindele, bangawukhulisa futhi bawenze buthaka umphumela wawo. Ingozi ye-hypoglycemia esongela impilo iyanda, kuqala ngezinga eliphansi lokudakwa. Ngokusho kwesifo sikashukela, umthamo ophephile wotshwala ingaphezu kwengilazi ye-vodka noma ingilazi yewayini.
Izithonjana zika-Amaril
Umuthi unezifanekiswana ezimbalwa ezishibhile ezinento efanayo esebenza kanye nomthamo, okuthiwa i-generics. Ngokuyisisekelo, lawa amaphilisi okukhiqizwa kwasekhaya, emikhiqizweni engenisiwe ungathenga kuphela iCroatia Glimepirid-Teva. Ngokusho kokubuyekezwa, ama-analogues aseRussia ababi kangako kune-Amaril engenisiwe.
| Izithonjana zika-Amaril | Izwe lokukhiqiza | Umkhiqizi | Intengo yomthamo omncane, hlikihla. |
| I-Glimepiride | IRussia | Atoll I-Vertex I-Pharmproject I-Pharmstandard-Leksredstva, | 110 |
| I-Glimepiride Canon | Ukukhiqizwa kweCanonfarm. | 155 | |
| I-Diamerid | I-Akrikhin | 180 | |
| I-Glimepiride-teva | ECroatia | UPliva waseKhrvatsk | 135 |
| UGlemaz | I-Argentina | Kimika Montpelfer | ayitholakali emakhemisi |
I-Amaryl noma i-Diabeteson
Njengamanje, i-glimepiride nefomu elide le-glyclazide (Diabeteson MV nama-analogues) zithathwa njenge-PSM yesimanje nephephe kakhulu. Zombili lezi zidakamizwa zincane kakhulu kunababengaphambi kwazo ukubangela i-hypoglycemia enzima.
Futhi-ke, amaphilisi we-Amaryl kashukela awancamela:
- zithinta isisindo seziguli kancane;
- ukungabi nomphumela omubi kangaka ohlelweni lwezinhliziyo;
- abanesifo sikashukela badinga umthamo ophansi wesidakamizwa (umthamo omkhulu we-Diabeteson ucishe ube ngu-3 mg we-Amaril);
- ukwehla kweshukela lapho uthatha i-Amaril kuhambisana nokwenyuka okuphansi kwamazinga e-insulin. KuDiabeteson, lesi silinganiso singu-0.07, kwe-Amaril - 0.03. Kwi-PSM eseleyo, isilinganiso sibi kakhulu: u-0.11 we-glipizide, u-0.16 we-glibenclamide.
I-Amaryl noma i-Glucophage
Ngamafuphi, umbuzo u-Amaril noma i-Glucophage (metformin) akufanele ubuzwe. IGlucophage nezimpawu zayo zesifo sikashukela sohlobo lwe-2 zihlala zichazwa endaweni yokuqala, ngoba zisebenza kahle kakhulu kunezinye izidakamizwa ezenza imbangela enkulu yalesi sifo - ukumelana ne-insulin. Uma udokotela ebeka kuphela amaphilisi e-Amaryl, ikhono layo likufanele ukungabaze.
Naphezu kokuphepha okuqhathaniswayo, lo muthi uthinta ngqo ama-pancreas, okusho ukuthi kunciphisa ukuhlanganiswa kwe-insulin yakho uqobo. I-PSM inqunywe kuphela uma i-metformin ingabekezelelwa kahle noma umthamo wayo omkhulu awanele nge-glycemia ejwayelekile. Njengomthetho, lokhu kungaba ukubola okunzima kwesifo sikashukela, noma ukugula okuhlala isikhathi eside.
I-Amaril neYanumet
I-Yanumet, njengo-Amaryl, ithinta womabili amazinga e-insulin kanye nokumelana ne-insulin. Izidakamizwa ziyehluka ngendlela yokwenza nezakhiwo zamakhemikhali, ngakho-ke zingathathwa ndawonye. I-Yanumet ingumuthi omusha oqhathaniswa, ngakho-ke kubiza kusuka kuma-ruble ayi-1800. kwepakethe elincane kunazo zonke. E-Russia, ama-analogues ayo abhalisiwe: iCombogliz neVelmetia, ezingabizi kakhulu kunasekuqaleni.
Ezimweni eziningi, isinxephezelo sikashukela singatholakala ngokuhlanganiswa kwe-metformin eshibhile, ukudla, ukuvivinya umzimba, kwesinye isikhathi iziguli zidinga i-PSM. IYanumet kufanelekile ukuthenga kuphela uma izindleko zayo zingabalulekile kwisabelomali.
I-Amaril M
Ukungahambisani kwabanesifo sikashukela ngokwelashwa okunqunyiwe yisona sizathu esiyinhloko sokuhoxiswa kwesifo sikashukela. Ukwenza lula i-regimen yokwelashwa kwanoma yisiphi isifo esingamahlalakhona kuthuthukisa imiphumela yayo, ngenxa yalokho, kwiziguli ezikhethekayo, izidakamizwa ezihlanganayo ziyathandwa. I-Amaryl M iqukethe inhlanganisela evame kakhulu yezidakamizwa ezinciphisa ushukela: i-metformin ne-PSM. Ithebhulethi ngayinye iqukethe ama-500 mg we-metformin ne-2 mg ye-glimepiride.
Akunakwenzeka ukulinganisa ngokufanelekile zombili izinto ezisebenzayo kwithebhulethi eyodwa yeziguli ezihlukile. Esigabeni esiphakathi sikashukela, i-metformin engaphezulu, i-glimepiride engaphansi iyadingeka. Akukho ngaphezu kwe-1000 mg ye-metformin evunyelwe ngesikhathi, iziguli ezinesifo esibi kuzodingeka ziphuze i-Amaril M kathathu ngosuku. Ukukhetha umthamo oqondile, kungakuhle ukuthi iziguli eziqondisiwe zithathe i-Amaril ngokwahlukana ekudleni kwasekuseni naseGlucofage kathathu ngosuku.
