I-Amaril M umuthi owusizo kubantu abanesifo sikashukela. Inhloso ebalulekile yesidakamizwa ukunciphisa okuqukethwe ushukela emzimbeni. Kwezokwelapha, izidakamizwa ezivela kulesi sigaba zibizwa nge-hypoglycemic.
Izici zokwakheka
Umuthi ukhiqizwa ngendlela yethebhulethi. Ithebhulethi ngayinye iqukethe i-2 mg ye-glimepiride enemicronised kanye ne-500 mg ye-metformin hydrochloride. Futhi lapho kulungiswa kunezakhi ezengeziwe - i-magnesium stearate, i-lactose monohydrate, i-povidone, njll.
Intengo ye-amaryl m incike ezicini eziningi. Izindleko ezijwayelekile zento zingama-ruble angama-600.
Isimiso sokusebenza
Umuthi unomphumela oyinkimbinkimbi we-hypoglycemic. Enye yezinto ezisebenzayo zesidakamizwa - i-glimepiride - isebenzisa ukukhiqizwa nokukhululwa kwe-insulin kumanyikwe. Ngaphezu kwalokho, ithuluzi likhulisa ukuzwela kwezicubu esenzweni se-insulin yangaphakathi.
Enye into esebenzayo yi-metformin. Le ngxenye ingezinto ze-hypoglycemic eziqhamuka esigabeni sama-Biguanides. Umphumela walesi sithako ubonakaliswa ngemuva kwesizinda sokukhiqizwa kwe-insulin.
I-Metformin iyakwazi ukwandisa umsebenzi we-insulin futhi ikhuphule ukuthambekela kwezicubu kule nto. Futhi, ithuluzi liholela ekuncipheni kokuhlanganiswa kwamafutha acid kanye ne-oxidation yamafutha, futhi limisa ne-gluconeogenesis esibindini. Ngaphezu kwalokho, lo muthi uholela ekuncipheni kwesifiso sokudla kanye nokumuncwa kwama-carbohydrate.
Okuqukethwe okuphezulu kwezidakamizwa egazini kwenzeka amahora angama-2,5 ngemuva kokudla umuthi ongu-4 mg ngosuku. Umzimba ubheka i-bioavailability ephelele yesidakamizwa. Ukudla ukudla akunawo umthelela obalulekile ukumunca umuthi - kunganciphisa kancane ijubane le nqubo.
Ingxenye esemqoka yama-metabolites as Umuthi ishiya umzimba ungena ezinso. Izakhi ezisele zikhishwa ngamathumbu. Kunobufakazi bokuthi umuthi uyakwazi ukungena ubisi lwebele futhi weqe umgoqo we-placental.
Izinkomba
Lokhu kubekelwe abantu abanesifo sikashukela sohlobo 2 kumacala alandelayo:
- Kuyadingeka ukufaka esikhundleni sokwelashwa okuyinkimbinkimbi nge-glimepiride ne-metformin;
- I-Monotherapy ene-metformin noma i-glimepiride ayinikezi imiphumela oyifunayo.
Izici zohlelo lokusebenza
Imvamisa, umthamo wento unqunywa ngokuya ngokuqukethwe koshukela emzimbeni. Kubalulekile ukusebenzisa umthamo ophansi kakhulu owanele ukuthola ukulawulwa kwe-metabolic edingekayo.
Ukusetshenziswa kabi kwesidakamizwa, njengokweqa umthamo, akufanele kuxhaswe ukwenyuka kwevolumu ngokuzayo. Izenzo zesiguli ezinamaphutha anjalo kufanele kuxoxwe ngazo nodokotela ngaphambi kwesikhathi.
I-Normalization yokulawulwa kwe-metabolic ihlotshaniswa nokuzwela kwezicubu ezandisiwe ku-insulin. Ngakho-ke, lapho usebenzisa i-amaryl m, isidingo se-glimepiride siyancishiswa. Ukuvimbela ukuvela kwe-hypoglycemia, kubaluleke kakhulu ukunciphisa umthamo ngesikhathi noma uyeke ngokuphelele ukuthatha into.
Umuthi udakwa izikhathi ezi-1-2 ngosuku ngokudla. Umthamo owodwa we-metformin yi-1000 mg. Umthamo wemihla ngemihla we-metformin kufanele ube ngu-2000 ml, glimepiride - 8 mg. Inani elincane kuphela leziguli, ukusetshenziswa kwama-ngaphezu kwe-6 mg we-glimepiride kusebenza kakhulu.
Ukuvimbela ukwenzeka kwe-hypoglycemia, kubalulekile ukuthi uqiniseke ukuthi umthamo wokuqala wesidakamizwa awudluli umthamo wansuku zonke we-metformin ne-glimepiride, osuvele uthathwe ngumuntu.
Uma udokotela emdlulisela umuntu ku-amaryl m, umthamo uyakhethwa kuye ngemithi ephuzwayo. Uma udinga ukwandisa ivolumu, inani lansuku zonke kufanele lithunyelwe kukhuphuka kwengxenye yethebhulethi ngomthamo we-2 mg + 500 mg. Ukwelashwa nalokhu kufanele kube yinde. Isikhathi esithize sikhethwe uchwepheshe.
Kutholakale ukuthi i-metformin ishiya umzimba ngokuyinhloko ngokusebenzisa izinso. Ngakho-ke, amathuba emiphumela emibi kubantu abanesifo sezinso kuphezulu kakhulu. Umuthi unconywa ukuthi usetshenziswe kuphela uma kungekho zinguquko kulolunga.
Imiphumela emibi
Ukufundiswa kwe-amaryl m kukhombisa ukuthi kwesinye isikhathi umuthi uholela emiphumeleni engathandeki. Umuthi uvusa ukwehla kwevolumu glucose, okudala ingozi ye-hypoglycemia.
Lesi simo singabonakala isikhathi eside futhi sihambisane nokuboniswa okunjalo:
- Isimo sokucindezelwa
- Isicanucanu
- Indlala enkulu;
- Ukuqhafaza
- Ubuhlungu bekhanda;
- Ukunakwa kokunakwa;
- Ukulimazeka kwenkulumo;
- Ukulimazeka kokubonakalayo;
- Isiyezi
- Ukwehla kwesibindi;
- Ukungazi kahle;
- Ukulahlekelwa umuzwa;
- I-Convulsive syndrome.
Ezimweni ezinzima, umuntu ulahlekelwa ukuqaphela futhi angahle awele enkingeni. Imvamisa kuba nokuphefumula okungashisi bese kuthi i-bradycardia ivele.
Ngaphezu kwalokho, kunobungozi bezimpawu zokuphikisana nomthetho we-adrenergic. Lesi simo sibonisa ngokujuluka kanzima, ukubonakala kwe-angina pectoris, tachycardia, ukunamathela kwe-dermis, arrhythmia. Ezimweni ezinzima, ukuhlaselwa kwe-hypoglycemia esithombeni somtholampilo kufana nokushaywa unhlangothi. Ngemuva kokujwayelekile, ukubonakaliswa okusohlwini kuvame ukunyamalala.
Ngaphezu kwemiphumela emibi yesidakamizwa faka lokhu okulandelayo:
- Esigabeni sokuqala sokwelashwa, ukuphazamiseka okubonakalayo kwesikhashana kuvame ukuvela kuhlobene nokushintsha kokuqukethwe kweglucose emzimbeni.
- Ngomonakalo ohlelweni lokugaya ukudla, i-nausea nokuhlanza kwenzeka. Imvamisa kuba nobunzima noma umuzwa wokugcwala ku-epigastrium. Kukhona nengozi yobuhlungu besisu nohudo.
- Ngokulimala kwesibindi nepheshana elihlanganisiwe, umsebenzi wama-enzyme wesitho ungakhula. Kukhona nengozi ye-hepatitis, cholestasis. Ezimweni ezinzima, ukwehluleka kwesibindi kuyavela.
- Ngokuphulwa kohlelo lwe-hematopoietic, i-leukopenia ne-thrombocytopenia kuthuthukisa. Kukhona futhi nengozi ye-hemolytic anemia, agranulocytosis, granulocytopenia nezinye izifo. Ngesikhathi sokulashwa, kubalulekile ukubheka isimo sesiguli, ngoba kunosongo lwe-pancytopenia kanye ne-aplastic anemia.
Izimo ezinje ziyisisekelo sokumiswa kokusetshenziswa kwomuthi.
Ngokuzwela okuphezulu kwezithako zento, i-allergies noma i-pseudo-allergic reaction. Lezi zimo zivela njengokuzwa kokulunywa nokuqhuma. Bangaba mnene noma bathuthuke.
Kwezinye izimo, i-vasculitis ye-allergic ingavela. Kunobungozi futhi bokuthi we-photosensitivity kanye nokwehla kwe-sodium egazini.
Contraindication
I-contraindication eyinhloko ekusebenziseni umuthi ifaka okulandelayo:
- Thayipha isifo sikashukela sokuqala
- Ukuzwela okuphezulu kuzakhi zomuthi;
- Ukuba khona kwe-pathologies yesibindi eyinkimbinkimbi noma i-hemodialysis.
- Ukukhulelwa nokukhulelwa;
- Ukuthambekela kokubukeka kwe-lactic acidosis;
- Ukwethulwa kwamalungiselelo wokuqhathanisa ne-iodine. Kulokhu, ukusetshenziswa kwalesi sidakamizwa kufanele kumiswe okwesikhashana, ngoba kunengozi yokulimala kwezinso okukhulu kakhulu;
- Ama-pathologies athelelekayo wokutheleleka;
- Izimo ngaphambi nangemuva kokusebenza;
- Umonakalo omkhulu;
- Kwehliswe umsebenzi we-adrenal noma we-pituitary, cachexia, yindlala yesiguli;
- Umsebenzi wezinso ongasebenzi kahle;
- Ukwehluleka kwenhliziyo okudala kudinga ukusetshenziswa kwezidakamizwa;
- Ukulimala kwesibindi, i-pathologies eyinkimbinkimbi yamaphaphu nokunye ukungahambi kahle okungahle kuhambisane ne-hypoxemia;
- Ukuphuza ngokweqile, ukomisa, ukuphazamiseka kokugaya ukudla, kufaka phakathi ukugabha nohudo;
- Iminyaka yezingane.
Ukwakheka komuthi kuqukethe i-lactose. Ngakho-ke, lesi sidakamizwa sinqatshelwe ukunikeza abantu abangabekezeleli lo muthi. Okunye ukuphikisana nokubakhona kwe-glucose-galactose malabsorption syndrome.
Ukweqisa
Ezimweni ezinjalo, ukwelashwa kukhethwa ngokuya ngobukhali be-hypoglycemia. Ezimweni zobumnene ezingahambelani nokulahlekelwa ukuqaphela kanye nokulimazeleka kwengqondo, kunconywa ukusebenzisa i-dextrose ngaphakathi. Okubaluleke ngokufanayo ukulungiswa kokudla kanye nethamo lemithi.
Isikhathi esithile, kuyadingeka ukubheka isimo sesiguli. Lokhu kuyadingeka ukuqeda ingozi empilweni yabantu nokuphila.
Ezimweni eziyinkimbinkimbi ze-hypoglycemia, ezibonakala ngokuqubuzana, ukoma nokunye ukuphazamiseka kwemizwa, isiguli singaphansi kokulaliswa esibhedlela okuphuthumayo. Ngemuva kwalokho, ukwelashwa kwenziwa esibhedlela. Izinyathelo ezithile zikhethiwe ngokuya ngokuboniswa.
Izici Zokusebenzelana
Ukusetshenziswa kwe-glimepiride nezidakamizwa ezithile kungathinta i-metabolism yayo. Lokhu kusebenza ngokuthatha i-fluconazole, i-rifampicin nezinye izidakamizwa.
Ngaphezu kwalokho, kunezidakamizwa ezithuthukisa umphumela we-hypoglycemic. Lokhu kufaka i-insulin, i-allopurinol, i-anabolic steroids. Ama-salicylates, ama-phenylbutazone, ama-phenenecid nezinye izinto eziningi anomphumela ofanayo.
Ukuhlanganiswa nezinto ezithile kunciphisa imiphumela ye-hypoglycemic. Lokhu kufaka i-barbiturates, i-diuretics, i-acetazolamide, i-laxatives. Izakhiwo ezifanayo zitholakala ngama-estrogens, ama-phenytoins, i-glucagon, njll.
Ukuhlanganiswa kwe-amaryl m nge-clonidide, i-reserpine, noma i-histamine receptor blockers kungadala ukwanda noma ukuncipha komphumela we-hypoglycemic.
Lapho usebenzisa ama-ejenti ahlukile ne-iodine, kunengozi yokuhluleka kwezinso. Lokhu kudala ukunqwabelana ngokweqile kwe-metformin, okwandisa ubungozi be-lactic acidosis. Ezimweni ezinjalo, yeka ukusebenzisa umuthi izinsuku ezimbalwa.
Umphumela ofanayo uyatholakala esimweni lapho kuhlanganiswa ama-amaryl m nama-antibacterial agents anomphumela we-nephrotoxic. Lokhu kufaka i-gentamicin.
Ngakho-ke, ngaphambi kokuqala ukwelashwa nalesi sidakamizwa, udinga ukubonana nodokotela mayelana nezinhlanganisela ezingaba khona. Lokhu kuzosiza ukunciphisa izakhiwo eziyingozi zemithi.
Ukuhlanganiswa kwento neziphuzo ezidakayo kungaholela ekwandeni noma ekunciphiseni komphumela we-hypoglycemic glimepiride. Ngaphezu kwalokho, le nhlanganisela yandisa kakhulu ingozi ye-lactic acidosis. Le ngozi yanda kakhulu ngokuhluleka kwesibindi noma ukweqa ukudla.
Ngakho-ke, kubaluleke kakhulu esigabeni sokulashwa nge-amaryl m ukulahla uphuzo oludakayo nanoma imuphi umuthi oqukethe i-ethanol.
Ama-Analog
Ngokungakubekezeleli kwento, ungakhetha izithasiselo ze-amaryl m. Okusebenzayo kakhulu kufaka izindlela ezinjalo:
- I-Diamerid;
- I-Gluconorm;
- UGlemaz;
- I-Meglimid.
Ukubuyekezwa
Ukubuyekezwa okuningi mayelana ne-amaryl m kuqinisekisa ukusebenza kahle komuthi:
I-Amaryl m - ithuluzi elisebenzayo elinikezela ukwehla kokuqukethwe ushukela emzimbeni. Ibhekelwa kubantu abanesifo sikashukela sohlobo olu-1. Ukuthola imiphumela oyifunayo, kubaluleke kakhulu ukulandela ngokusobala imiyalo nazo zonke izincomo zezokwelapha. Uma kwenzeka ukusabela okubi, kufanele uthintane nochwepheshe.
