Omunye wabamele iqembu elikhulu le-sulfonylurea derivatives (PSM) yi-Glurenorm yomlomo. Umuthi wayo osebenzayo, i-glycidone, onomphumela we-hypoglycemic, uboniswa isifo sikashukela sohlobo 2. Naphezu kokuthandwa kwayo okuncane, i-Glurenorm iyasebenza ngendlela efanayo namaqembu alo weqembu. Umuthi awukacoliswanga yizinso, ngakho-ke isetshenziswa kabanzi kwi-nephropathy yesifo sikashukela ngokwehluleka okuqhubekayo kwezinso. IGlurenorm ikhishwa yingxenye yamaGrikhi yenkampani yezokwelapha yaseJalimane iBeringer Ingelheim.
Umgomo wokusebenza kweglurenorm
IGlurenorm ingeyesizukulwane sesibili sePSM. Umuthi unazo zonke izici zezimpawu zokwelapha zaleli qembu lama-hypoglycemic agents:
- Isenzo esivelele i-pancreatic. I-Glycvidone, into esetshenziswayo yamathebhulethi e-Glurenorm, ibopha kuma-pancreatic cell receptors futhi ivusele ukwakheka kwe-insulin kuzo. Ukwanda kokuhlushwa kwaleli hormone egazini kusiza ukunqoba ukumelana ne-insulin, futhi kusiza ukuqeda ushukela emithanjeni yegazi.
- Isenzo esingeziwe i-extrapancreatic. I-gluluorm ithuthukisa umuzwa we-insulin, inciphisa ukukhishwa kweglucose egazini kusuka esibindini. Isifo sikashukela sohlobo 2 saziwa ngokujwayezwa kuphrofayili ye-lipid yegazi. I-Glurenorm isiza ukuguqula izinkomba lezi ngokwejwayelekile, zivimbela i-thrombosis.
Amathebulethi enza isigaba 2 sokuhlanganiswa kwe-insulin, ngakho-ke okokuqala ngemuva kokudla ushukela kungandiswa. Ngokusho kwemiyalo, umphumela wesidakamizwa uqala ngemuva kwehora, umphumela omkhulu, noma isiqu, ubonwa ngemuva kwamahora ayi-2,5. Isikhathi sonke sesenzo sifinyelela emahoreni ayi-12.
Yonke i-PSM yanamuhla, kufaka phakathi i-Glurenorm, ine -backback ebalulekile: ivuselela ukwakheka kwe-insulin, kungakhathalekile ukuthi ishukela lisemikhunjini yesifo sikashukela, okungukuthi, lisebenza nge-hyperglycemia noshukela ojwayelekile. Uma ushukela omncane wegazi uhanjiswa egazini kunokwejwayelekile, noma uma kuchithwe emsebenzini wemisipha, i-hypoglycemia iqala. Ngokusho kokubuyekezwa kwabanesifo sikashukela, ubungozi bayo buba bukhulu ikakhulukazi ngesikhathi sokuphakama komuthi kanye nokucindezelwa okuhlala isikhathi eside.
I-Pharmacokinetics yesidakamizwa
Isigaba esikhulu kunazo zonke seziguli ezinesifo sikashukela sohlobo 2 asebekhulile. Zibonakaliswa ukwehla komzimba emsebenzini wezinso. Uma isifo sikashukela sinqunyelwe, iziguli zisengozini enkulu ye-nephropathy, bese ukwehluleka kwezinso. Iningi lezinto ze-hypoglycemic zivezwa yizinso, uma zincane, ukugcwala komuthi emzimbeni kuqala, okuholela ku-hypoglycemia enzima.
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%
IGlurenorm ingenye yezidakamizwa eziphephe kakhulu zezinso. Imiyalo yokusebenzisa ikhombisa ukuthi ishesha futhi igxila ngokuphelele emgodini wokugaya ukudla, bese kancane kancane ibhidlizwa yisibindi iye kuma-metabolites angasebenzi noma abuthakathaka. Iningi labo, i-95%, likhishwa kanye nezindunduma. I-akhawunti yezinso i-5% kuphela yama-metabolites. Ukuze uqhathanise, ama-50% we-glibenclamide (Maninil), 65% ye-glyclazide (Diabeteson), 60% ye-glimepiride (Amaryl) akhishwa ngomchamo. Ngenxa yalesi sici, i-Glurenorm ibhekwa njengesidakamizwa sokukhetha sohlobo 2 sikashukela esinekhono lokuncipha le-renal.
Izinkomba zokwamukelwa
Umyalo utusa ukwelashwa nge-Glurenorm kuphela ngesifo sikashukela sohlobo 2 esiqinisekisiwe, kufaka phakathi isifo sikashukela esikhulile kanye neziguli ezineminyaka ephakathi.
Ucwaningo lufakazele ukusebenza kokwehla ushukela okuphezulu komuthi i-Glyurenorm. Lapho kunqunywa ngokushesha ngemuva kokuthola isifo sikashukela kumthamo wansuku zonke ofinyelela kwabangu-120 mg abanesifo sikashukela, ukwehla okujwayelekile kwe-hemoglobin ye-glycated ngaphezu kwamaviki ayi-12 kungu-2.1%. Emaqenjini athatha i-glycidone neqembu layo i-analogue glibenclamide, cishe inani elifanayo leziguli lithole isinxephezelo sikashukela, okukhombisa ukusebenza kahle kwale micimbi.
Lapho i-Glurenorm ayikwazi ukuphuza
Imiyalo esetshenzisiwe yenqabela ukuthatha i-Glurenorm yesifo sikashukela ezimweni ezilandelayo:
- Uma isiguli singenawo amaseli we-beta. Imbangela ingaba yi-resection ye-pancreatic noma uhlobo 1 sikashukela.
- Kwezifo ezinzima zesibindi, i-hepatic porphyria, i-glycidone ingakhiwa kahle ngokungafanele futhi iqongelele emzimbeni, okuholela ekweqisweni ngokweqile.
- Nge-hyperglycemia, isindwa yi-ketoacidosis kanye nezinkinga zayo - ukucacileka kanye nokukhohlisa.
- Uma isiguli sine-hypersensitivity to glycvidone noma enye i-PSM.
- Nge-hypoglycemia, umuthi awunakudakwa kuze kube yilapho ushukela usujwayelekile.
- Ezimweni ezinzima kakhulu (izifo ezingathi sína, ukulimala, ukuhlinzwa), i-glurenorm okwesikhashana ithathelwa ukwelashwa kwe-insulin.
- Ngesikhathi sokukhulelwa nangesikhathi se-hepatitis B, umuthi uvunyelwe ngokuphelele, ngoba i-glycidone ingena egazini lengane futhi ithinte kabi ukukhula kwayo.
Ngesikhathi somkhuhlane, kuphakama ushukela wegazi. Inqubo yokwelapha ivame ukuhambisana ne-hypoglycemia. Ngalesi sikhathi, udinga ukuthatha i-Glurenorm ngokuqapha, imvamisa ukukala i-glycemia.
Funda i-athikili - Ukushisa okuphezulu nokuphansi kushukela
Ukuphazamiseka kweHormonal okubonakalayo kwezifo ze-thyroid kungashintsha umsebenzi we-insulin. Iziguli ezinjalo zikhonjiswa izidakamizwa ezingadali i-hypoglycemia - metformin, glyptins, acarbose.
Ukusetshenziswa kwezidakamizwa i-Glurenorm ekudakweni kotshwala kugcwala ukudakwa kanzima, ukugxuma okungalindeleki ku-glycemia.
Imithetho Yokwamukela
I-Glurenorm itholakala kumthamo ka-30 mg kuphela. Amathebulethi ayingozi, ngakho-ke angahlukaniswa ukuze athole uhhafu womthamo.
Umuthi udakwa mhlawumbe ngaphambi kokudla, noma ekuqaleni kwawo. Kulokhu, lapho kuphela ukudla noma ngokushesha nje ngemuva kwalokho, izinga le-insulin lizonyuka cishe ngama-40%, okuzoholela ekwehlekeni koshukela. Ukwehla okwalandela kwe-insulin lapho usebenzisa i-Glyurenorm kusondelene ngokomzimba, ngakho-ke, ingozi ye-hypoglycemia iphansi. Umyalo uncoma ukuqala ngesigamu sepilisi ngesikhathi sebhulakufesi. Ngemuva kwalokho umthamo wanda kancane kancane kuze kube yilapho isinxephezelo sikashukela sitholakala. Isikhathi esiphakathi kokulungiswa kwamthamo kufanele okungenani sibe yizinsuku ezintathu.
| Umthamo wezidakamizwa | Amaphilisi | mg | Isikhathi sokwamukela |
| Ukuthoma umthamo | 0,5 | 15 | ekuseni |
| Umthamo wokuqala lapho ushintsha usuka kwenye i-PSM | 0,5-1 | 15-30 | ekuseni |
| Umthamo ofanele | 2-4 | 60-120 | I-60 mg ingathathwa kanye ngesikhathi sokudla kwasekuseni, umthamo omkhulu uhlukaniswe izikhathi ezingama-2-3. |
| Umkhawulo wethamo | 6 | 180 | Imithamo emi-3, umthamo ophakeme kunayo yonke ekuseni. Ezigulini eziningi, umphumela wehlise ushukela we-glycidone uyeka ukukhula kumthamo ongaphezulu kuka-120 mg. |
Musa ukweqa ukudla ngemuva kokuthatha umuthi. Imikhiqizo kumele ibe nama-carbohydrate, mhlawumbe nge inkomba ephansi ye-glycemic. Ukusetshenziswa kwe-Glenrenorm akukukhanseli ukudla okudliwe ngaphambili nokuzivocavoca. Ngokusetshenziswa okungalawulwa kwama-carbohydrate kanye nomsebenzi ophansi, umuthi ngeke ukwazi ukunikeza isinxephezelo sikashukela ngobuningi beziguli.
Ukwemukelwa kwe-Glyurenorm nge-nephropathy
Ukulungiswa komthamo weglurenorm wesifo sezinso akudingekile. Njengoba i-glycidone idluliswa isikhathi eside idlula izinso, abanesifo sikashukela nge-nephropathy abayikhulisi ingozi ye-hypoglycemia, njengakwamanye umuthi.
Imininingwane yokuhlola ikhombisa ukuthi ngaphezulu kwamasonto amane ukusetshenziswa komuthi, i-proteinuria iyancipha kanye nokulawulwa okuthuthukile kwesifo sikashukela, futhi ukuphinda umchamo kuyathuthuka. Ngokwezibuyekezo, i-Glurenorm inqunywa ngisho nangemva kokudluliselwa kwezinso.
Sebenzisa izifo zesibindi
Umyalo wenqabela ukuthatha i-Glurenorm ekuhlulekeni kwesibindi okunzima. Kodwa-ke, kunobufakazi bokuthi i-glycidone metabolism ezifweni zesibindi ihlala igcinwa, kuyilapho ukonakala kokusebenza kwesitho kungenzeki, futhi imvamisa yemiphumela emibi ayikhuphuki. Ngakho-ke, ukuqokwa kweGlyurenorm kwiziguli ezinjalo kungenzeka ngemuva kokuhlolwa ngokuphelele.
Ukwelapha okuhlanganayo
Emiyalweni yeGlyurenorm, umuthi uvunyelwe kuphela nge-metformin. Ngokusho kokubuyekezwa, umuthi futhi uhambe kahle nge-acarbose, DPP-4 inhibitors, insulin. Ukuvimbela ukuphuza ngokweqile, i-Glyrenorm yenqatshelwe ukuphuza ngasikhathi sinye nezinye i-PSM.
Imiphumela emibi, imiphumela yehaba
Imvamisa yemiphumela engathandeki lapho uthatha umuthi iGlurenorm:
| Imvamisa% | Indawo Yokwephulwa Kwezimali | Imiphumela emibi |
| ngaphezulu kuka-1 | Amapheshana wesisu | Ukuphazamiseka kokugaya ukudla, Ubuhlungu besisu, ukugabha, ukuncipha kwesifiso. |
| kusuka ku-0.1 kuye ku-1 | Isikhumba | I-allergic itching, i-erythema, i-eczema. |
| Uhlelo lwezinzwa | Ubuhlungu bekhanda, ukudideka kwesikhashana, isiyezi. | |
| kufika ku-0,1 | Igazi | Kwehlisiwe ukubalwa kweplatelet. |
Ezimweni ezingafani, bekukhona ukwephulwa kokuphuma kwe-bile, i-urticaria, ukwehla kwezinga lama-leukocytes nama-granulocytes egazini.
Uma kwenzeka kweqisa ngokweqile, ingozi ye-hypoglycemia iphezulu. Khipha nge-glucose yomlomo noma ye-intravenous. Ngemuva kokujwayelekile ushukela, ungawa kaninginingi kuze kube yilapho umuthi ukhishwa emzimbeni.
Ukusebenzelana kwezidakamizwa
Umphumela weGlenrenorm ungashintsha ngokuphathwa kanyekanye nezinye izidakamizwa:
- izindlela zokuvimbela inzalo ngomlomo, izisusa ze-CNS, ama-hormone e-steroid nama-hormone egilo, i-nicotinic acid, i-chlorpromazine yenza buthaka umphumela wayo;
- amanye ama-NSAIDs, ama-antibalas, ama-antidepressants, ama-antimicrobials, ama-coumarins (acenocoumarol, warfarin), ama-thiazide diuretics, ama-beta-blockers, ama-ethanol athuthukisa umphumela wesidakamizwa.
Imiyalo ekhethekile
Lapho uthatha i-Glyurenorm, ukuhambisana nezincomo zezokwelapha ezijwayelekile ze-carbohydrate metabolism kuyadingeka. Ukulawulwa kwesisindo somzimba, ukubambelela ngokuqinile ekudleni okunqunyiwe, isheke elijwayelekile lomsebenzi wezinso liyadingeka.
Uma kwenzeka imiphumela emibi, udinga ukubonana nodokotela ngokuphuthumayo ukuze uxazulule inkinga yesidingo sokushintsha umuthi.
Emisebenzini edinga ukunakwa okukhulu kokunakwa (ukushayela, ukusebenza ngamasu, ukuphakama, njll.), Kufanele uqaphele kakhulu ukuthi ungaphuthelwa yizimpawu zokuqala ze-hypoglycemia. Ingozi yokwehla ushukela iphakeme ngesikhathi sokuthintela umthamo.
Amanani kanye ne-Glurenorm
Intengo yephakethe enamathebhulethi ayi-60 eGlyurenorm icishe ibe ngama-ruble angama-450. I-glycidon ye-izidakamizwa ayifakwanga ohlwini lwezidakamizwa ezibalulekile, ngakho-ke ngeke kwenzeke ukuthi uyithole mahhala.
I-analogue ephelele enento efanayo esebenzayo eRussia ayikatholakali. Manje inqubo yokubhalisa iyaqhubeka nomuthi i-Yuglin, umenzi we-Pharmasynthesis. Ukufana kwe-Yuglin ne-Glyurenorm sekuvele kuqinisekisiwe, ngakho-ke, kungekudala kulindeleke ukuthi kubonakale kuthengisiwe.
Ngo kwabanesifo sikashukela ezinso ezinempilo, noma iyiphi i-PSM ingathatha isikhundla se-Glurenorm. Banzi, ngakho-ke kulula ukukhetha umuthi ongabizi. Izindleko zokwelashwa ziqala kusuka kuma-ruble angama-200.
Ekuhlulekeni kwezinso, kunconywa i-linagliptin. Le nto esebenzayo iqukethwe kumalungiselelo eTrazhent naseGentadueto. Intengo yamathebulethi ngenyanga yokwelashwa ivela kuma-ruble ayi-1600.
