Kuhlobo lwesifo sikashukela sohlobo 2, kufika isikhathi lapho i-insulin yakho inganele, futhi isiguli sinokukhetha: qala ukwelashwa nge-insulin noma uthathe amaphilisi akhuthaza ukwakheka kwe-hormone yakhe, ngokwesibonelo, Maninil. Lesi sidakamizwa yindala kunayo yonke eqenjini laso, ngenxa yokusebenza kahle kwayo isikhathi eside ibhekwa njengejwayelekile le "golide" ekwelapheni isifo sikashukela.
Njengamanje, ukubuyekezwa mayelana nalo muthi akunathemba kangako, odokotela abaningi bakhetha ukunquma izidakamizwa zesimanje zokwehlisa ushukela kwabanesifo sikashukela. Ukwelashwa kweManinil akuboniswanga kuzo zonke iziguli. Ekuqaleni kwesifo, uzokwenza okubi kakhulu kunokuhle. Ngakho-ke, lesi sidakamizwa sithengiswa ngokuya ngencwadi ebekwe ngudokotela ngemuva kokuthola imiphumela yokuhlolwa eqinisekisa ukuba khona kwezinkomba zokuthatha iManinil.
Ibhuku lokufundisa
Umuthi wokwelapha kumathebulethi eManinyl yi-glibenclamide, okuyi-sulfonylurea esuselwa futhi ingeyesizukulwane sesibili. Ngokokuqala ngqa i-glibenclamide yaqala ukusetshenziswa kwezokwelapha emtholampilo emuva ngo-1969. IGliclazide, glipizide ne-glycidone nakho kungokwesizukulwane esifanayo. Isizukulwane sesithathu glimepiride yesimanje. UManilin ukhiqizwa yinkampani yaseJalimane iBerlin-Chemie. Phakathi kwezakwethu, lesi sidakamizwa sivelele ukusebenza kahle kwaso, intengo ephansi, kepha futhi siyingozi enkulu kuma-pancreas.
| Isenzo | Kuthinta isifo sikashukela kusuka ezinhlangothini ezimbili:
Ngaphezu kokuthinta ukuphazamiseka okusemqoka kwesifo sikashukela, iManinil yehlisa i-lipids yegazi, yi-cardiprotector ebuthakathaka, futhi inomphumela we-antiarrhythmic. Iphrofayli yesenzo evela kwimiyalo esetshenzisiwe: inani elingamahora angama-2,5 kwifomu elijwayelekile, amahora ayi-1.5 omkhiqizo, isikhathi sonke sokusebenza sifinyelela emahoreni angama-24, khona-ke into iphukile esibindini. Imikhiqizo ye-Cleavage ayiqoqeki emzimbeni, kepha isheshe ikhishwe kumchamo ne-bile. |
| Izinkomba zokusetshenziswa | 2 uhlobo lwesifo sikashukela. Umuthi ungahlanganiswa nabenzeli be-hypoglycemic abavela kwamanye amaqembu. Ukutholakala kweSulfonylurea ngeke kuthathwe ukuze kugwenywe ukweqisa. |
| Contraindication |
Ngokuya ngemiyalo yokuthi kwehliswe kanzima isifo sikashukela i-mellitus noma isimo esibuhlungu esingaholela kukho, iManinil ithathelwa indawo okwesikhashana ukwelashwa kwe-insulin. Ukuhambisana notshwala: imithamo emincane yotshwala ngeke ilethe ukulimala, ukudakwa noma ukudakwa ngokweqile kungadala i-hypoglycemia esongela impilo. |
| Umphumela ongemuhle ongaba khona | Umphumela wecala ovame kakhulu yi-hypoglycemia. Kungabangelwa ukweqisa, ukudla okuqinile ngokweqile, ukuvivinya umzimba isikhathi eside. I-insulin ivimbela ukweqiwa kwama-lipids, ngakho-ke lapho uthatha iManinil, isisindo sesiguli singakhuphuka. Ngaphansi kwe-1% yeziguli, ukwelashwa kuhambisana nokuvela komzimba ngendlela yokulunywa nokuqunjelwa, kanye nokuphazamiseka kokugaya ukudla okuhambisana nokuxineka kwenhliziyo, isifo sohudo, usizi noma ubuhlungu esiswini. Ukuphazamiseka kwesibindi, komzimba omkhulu, ushintsho ekwakhekeni kwegazi kuvame kakhulu. Imiyalo esetshenzisiwe ixwayisa ukuthi ukuthatha iManinil kungakhulisa ukuzwela kwesikhumba ekukhanyisweni kwe-ultraviolet, ngakho-ke, iziguli eziphuza umuthi, Ukuvinjwa isikhathi eside elangeni. |
| Ingozi ye-hypoglycemia | Emiyalweni, amathuba okuba wehle ushukela alinganiselwa ku-1-10%. Imvamisa i-hypoglycemia ihambisana nokuthuthumela, indlala, ukujuluka okuthe xaxa, i-tachycardia, ukukhathazeka. Njengoba isimo siba sibi kakhulu, isiguli sehluleka ukulawula okwenziwe, lapho-ke ukwaziwa kuyaphazamiseka. Uma ukwelashwa kungaqalwa ngesikhathi, kuba nehlaya le-hypoglycemic. Ezigulini ezine-hypoglycemia ejwayelekile noma isifo sikashukela, izimpawu ziba eziphikisayo, futhi ngenxa yalokho ziba yingozi. Uma i-hypoglycemia isolwa, kuyenqatshelwa ukuthatha iManinil, ukushayela imoto nokwenza izinto ezidinga ukunakwa okukhethekile. |
| Ukubambisana nezinye izidakamizwa | I-Hormonal, hypoglycemic, hypotensive, antifungal, antitumor drug, antidepressants, antibiotics, NSAIDs nezinye izidakamizwa zingathinta umphumela weManinil. Uhlu oluphelele luqukethwe encazelweni enemininingwane yesidakamizwa esinamathiselwe kwiphakethi ngayinye yamathebulethi. Ngokuphathwa kwabo kanyekanye, ukulungiswa komthamo kweManinil kungadingeka zombili eziqondisweni zokwanda nokwehla. Zonke izidakamizwa ezithathiwe kumele kuvunyelwane nodokotela noma nge-endocrinologist. |
| Khipha ifomu | Izibhebhe ezibomvu zomthamo ohlukahlukene. KuManinil 1.75 kanye ne-glibenclamide eyi-3,5 ifakwe kwifomu yemicronic, okungukuthi, izinhlayiya zento esethebhulethini ziyancishiswa, okuvumela ukusheshisa ukumunca kwayo. IManinil 5 iqukethe ama-5 mg we-glibenclamide ejwayelekile. I-Micronization ye-glibenclamide inyusa i-bioavailability yayo (ukusuka ku-29-69 iye ku-100%), okusho ukuthi ikuvumela ukuthi uthathe umuthi ngomuthi ophansi. |
| Ukwakheka | Glibenclamide 1.75; 3.5; 5 mg Izithako ezingeziwe: udayi, i-lactose, i-silicon dioksidi, i-hydroxyethyl cellulose, isitashi, i-magnesium stearate, i-5 talc ne-gelatin eManinil. |
| Izidingo zokugcina | Ukushisa okufika ku-25 ° C, umuthi ugcina izakhiwo zawo iminyaka emi-3 kusukela ngesikhathi sokukhiqizwa. |
Imithetho Yokwamukela
IManinyl nokunye okususelwa ku-sulfonylurea akufiseleki kubantu abatholakala benesifo sikashukela. Ngalesi sikhathi, ukukhishwa kwe-insulin sekuvele kukhulu, ukuyengeza ngosizo lwamathebulethi kukhulisa ukumelana ne-insulin, ukuqinisa indlala, ukuthola amakhilogremu amasha amafutha. Ngaphezu kwalokho, i-pancreas, egqugquzelwa yi-glibenclamide, izophoqeleka ukuthi isebenzele ukugqoka, ngakho-ke izokuyeka ukusebenza ngaphambilini, futhi isiguli siyophoqeleka ukuthi sishintshe ekwelashweni kwe-insulin.
Ekuqaleni kwalesi sifo, ukudla, ezemidlalo kanye ne-metformin kuvame ukubekwa. Amathebhulethi iManinil aqala ukuthathwa ngemuva kweminyaka yokugula (isilinganiso seminyaka engu-8), lapho i-metformin esezingeni eliphezulu inganikeli isinxephezelo esanele sesifo sikashukela. Ngaphambi kokuthi uqale ukuyithatha, kungakuhle ukuthi uqiniseke ukuthi ukuhlanganiswa kwe-insulin akwanele ngokudlula ekuhlolweni kwe-C-peptide. Kungavela ukuthi ukuntuleka kwe-insulin kunecala kushukela omningi, kepha amaphutha okudla nesisindo ngokweqile.
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%
Abanye odokotela bafuna ukuyeka ngokuphelele ukwelashwa noManinil. Ukuze kwandiswe ukusebenza kwamaseli e-pancreatic, lapho iMetformin ingasebenzi ngokwanele, batusa ukuthi ukwelashwa kwe-insulin kuqalwe ngokushesha.
Ukukhetha kwedosi
Umthamo owuthandayo ukhethwa ngawodwa esigulini ngasinye. Iminyaka yesifo sikashukela, ubulukhuni nobungako besinxephezelo sesi sifo kuyabhekelelwa. Umthamo wokuqala ngokwemiyalo ngu-1.75 mg. Khula kancane kancane ngesonto kuze kufinyelele ezingeni lelitshe le-glycemia. Imithamo emincane (<3.5 mg) ithathwa ngaphambi kokudla kwasekuseni; imithamo emikhulu ihlukaniswe ekuseni nakusihlwa. Ukugwema i-hypoglycemia yasebusuku, umthamo wakusihlwa uphansi izikhathi ezimbili kunethamo lasekuseni. Ukuthola umthamo ofanele, amaphilisi angahlukaniswa ngokuhambisana nobungozi.
| Khipha ifomu | Ukuthoma umthamo amaphilisi | Umthamo omkhulu amaphilisi | Isikhathi sokwamukela |
| Maninil 1.75 | 1-2 | 6 | Ngaphambi nje kokudla |
| Maninil 3.5 | 0,5-1 | 3 | |
| Maninil 5 | 0,5-1 | 3 | Ngemizuzu engama-30 |
Ukunciphisa umthamo, ukukhiqizwa kwe-insulin isikhathi eside kuzohlala. Ukudla okune-carb ephansi, ukunciphisa isisindo ngokujwayelekile, ukuvivinya umzimba njalo kuzosiza ukunciphisa umthamo. Imizamo yokunxephezela i-mellitus yesifo sikashukela ngethamo elwedlula inani eliphakeme, hhayi ukuletha kuphela ukwelashwa kwe-insulin, kodwa futhi kungadala i-hypoglycemia enzima.
I-Metformin Reception
Ukwelashwa kanyekanye nge-metformin (Glucofage, Siofor, njll.) NeManinil kuvunyelwe. Le mishanguzo ihlangana kahle futhi inikeze umphumela oqhubekayo wokunciphisa ushukela. Ukwenza lula ukuphathwa kwamathebhulethi futhi unciphise amathuba okuwalahleka, kukhiqizwa amaphilisi ahlanganisiwe: Ama-Glucovans, Glibomet, Bagomet Plus, Metglib. Ziqukethe i-2,5 noma 5 mg ye-glibenclamide ne-400-500 mg ye-metformin.
Lapho iManinil Ingancishisi Ushukela
IManinil isebenza uma nje amaseli e-pancreatic beta esaphila. Lapho nje ukubhujiswa kwabo kuba okubalulekile (imvamisa> 80%), ukuthatha noma imaphi amaphilisi anciphisa ushukela akunamsebenzi. Kwakungalesi sikhathi lapho isifo sikashukela esinga-insulin siguqukela ku-insulin. Kusukela kulo mzuzu, iziguli ziyadingeka ukuthatha imijovo ye-insulin impilo yonke. Ukuncipha ngokuqala kokwelashwa kwe-insulin kusongela impilo. Uma kungabikho i-hormone yayo, ushukela wegazi uzokwenyuka ngokushesha, bese kuba nesibindi sokukhubazeka kwe-ketoacidotic.
Ukufana kwezidakamizwa
Ngaphezu kweManinil yaseJalimane, ungathola ngokuthengisa i-Russian Glibenclamide. Inkampani yakwa-Atoll iyayithengisa, intengo yephakethe lamathebhulethi angama-50 ngama-ruble ayi-26-50. Ukukhiqizwa nokupakishwa kwamatafula kutholakala esifundeni Samara, kepha into ethengisa amakhambi iyathathwa ibuya eNdiya. Ngokusho kwesifo sikashukela, ukwelashwa ngeManinil kubekezelelwa kangcono futhi kunciphisa ushukela ngempumelelo kakhulu kunomuthi wasekhaya. Uma ubheka ukuthi umuthi wokuqala ungabizi kakhulu (intengo ingama-ruble ayi-120-170 wamathebulethi ayi-120) futhi ikuyo yonke ikhemisi, ukufaka esikhundleni seManinil ngama-analogu akusizi ngalutho.
Maninil noma Diabeteson - okungcono?
Le mishanguzo ingeyeqembu elifanayo nesizukulwane, kepha inezinto ezihlukile ezisebenzayo: Maninil - glibenclamide, Diabeteson - glyclazide.
Ukungafani kwabo:
- I-Diabeteson ayikhuthazi ukukhishwa kwe-insulin isikhathi eside kangako, ngakho-ke ubungozi be-hypoglycemia, ukukhathala kwe-pancreatic, kanye nokuthola isisindo kuphansi.
- Maninil unamandla. Kwezinye izimo, nguyena kuphela ongafinyelela ushukela ojwayelekile.
- I-Diabeteson ibuyisela ukukhiqizwa okusheshayo kwe-insulin ukuphendula ukwanda ushukela, uManinil usebenza esigabeni sesibili. Uma uthatha i-gliclazide, ushukela ngemuva kokudla uzoqala ukuncipha ngokushesha.
- Abanye bathi, isifo sikashukela siphephe kakhulu inhliziyo.
Umehluko ubaluleke kakhulu, ngakho-ke, iziguli zithatha amaphilisi emithanjeni emincane, kunengqondo ukufaka esikhundleni seManinil nge-Diabeteson.
I-athikili yethu enemininingwane ngesidakamizwa i-Diabeteson, ifundwe lapha -//diabetiya.ru/lechimsya/diabeton-mv-60.html
Ukubuyekezwa mayelana nomuthi
Eminyakeni eminingi yokusebenzisa iManinil ukunxephezela isifo sikashukela, kubuye kwaba nokubukeza okuningi okuhle nokubi kodokotela nabanesifo sikashukela.
Iziguli eziningi ziphawula isidingo esikhulu sokondliwa kweManilin nendlela yokuphila. Ukweqa ukudla, ukuntuleka kwama-carbohydrate, ukusatshalaliswa kwawo okungalingani phakathi nosuku, umthwalo omude - zonke lezi zinto ziholela ku-hypoglycemia. Kwezinye izazi zesifo sikashukela, ama-ushukela amaningi abonwa usuku lonke: ukuwa ngemuva kokuphuza iphilisi bese kuphakama okubukhali ngemuva kokudla. Futhi, iziguli zinaka ukwanda kwesifiso sokudla kanye nesisindo somzimba. Njengomthetho, ukwelashwa ngeManinil kubekezeleleka kahle, amacala okucanuzelelwa kwenhliziyo kanye nokuhlanza okuchazwe emiyalweni kungukuthi i-sporadic. Ingxenye enkulu yesifo sikashukela, esikhundleni seManinil, yaqala ukuthatha i-Diabeteson ephephile ne-Amaryl.
Izazi ezingama-Endocrinologists zikhuluma ngeManinil ngokuthi “isiswebhu” esisebenzayo esakaza amanyikwe. Bazama ukunquma umuthi lapho ezinye izindlela zokubuyisa isifo sikashukela zinganele noma zivinjelwe izinkomba ngazinye.
