I-Glurenorm umuthi onomphumela we-hypoglycemic. Isifo sikashukela sohlobo 2 siyinkinga ebaluleke kakhulu yezokwelapha ngenxa yokuxhaphaka kwayo okuphezulu kanye namathuba aphezulu okulingana okuphakeme. Noma kungaba nokuxhuma okuncane kokuhlushwa kwe-glucose, amathuba we-retinopathy, ukushaya kwenhliziyo noma unhlangothi kukhula kakhulu.
I-Glurenorm ingenye eyingozi kakhulu ngokwemiphumela emibi yama-antiglycemic agents, kepha ayiphansi ekusebenzeni kwezinye izidakamizwa kulesi sigaba.
Ikhemisi
I-Glurenorm yi-ejenti ye-hypoglycemic ethathwe ngomlomo. Lesi sidakamizwa sitholakala sulfonylurea. Ine-pancreatic kanye ne-extrapancreatic action. Kuthuthukisa ukukhiqizwa kwe-insulin ngokuthinta ukwakheka kwe-glucose-Mediated synthesis kule hormone.
Umphumela we-hypoglycemic wenzeka ngemuva kwamahora angu-1.5 ngemuva kokuphathwa kwangaphakathi komuthi, inani eliphakeme lomphumela lenzeka ngemuva kwamahora amabili kuya amathathu, lihlala amahora angama-10.
I-Pharmacokinetics
Ngemuva kokuthatha umthamo owodwa ngaphakathi, i-Glyurenorm imunca ngokushesha futhi icishe ngokuphelele (80-95%) kusuka kugaya lokugaya ngokungenisa.
Umuthi osebenzayo - i-glycidone, unobuhlobo obuphezulu bamaprotheni ku-plasma yegazi (ngaphezulu kwama-99%). Akunamininingwane endimeni noma ukungatholakali kokudlula kwalokhu noma imikhiqizo ye-metabolic ku-BBB noma ku-placenta, kanye nokukhishwa kwe-glycvidone kubisi lukamama okhulisa ngesikhathi sokubeletha.
Imikhiqizo eminingi ye-glycidone metabolism ishiya umzimba, idonswa ngamathumbu. Ingxenyana encane yemikhiqizo yokuqhekeka kwento iphuma ezinso.
Ucwaningo luthole ukuthi ngemuva kokuphathwa kwangaphakathi, cishe i-86% yesidakamizwa esibhalwe ukuthi isotope ikhishwa ngamathumbu. Kungakhathalekile ubukhulu besilinganiso kanye nendlela yokuphatha ngokusebenzisa izinso, cishe i-5% (ngendlela yemikhiqizo ye-metabolic) yomthamo owamukelekayo wesidakamizwa uyakhishwa. Izinga lokukhishwa kwezidakamizwa ngezinso lihlala lincane, noma ngabe lithathwa njalo.
Izinkomba ze-pharmacokinetics ziyahlangana ezigulini nasebegugile abaneminyaka ephakathi.
Ngaphezu kwe-50% ye-glycidone ikhishwa ngamathumbu. Ngokolunye ulwazi, i-metabolism yezidakamizwa ayishintshi nganoma iyiphi indlela uma isiguli sehluleka ngokwe-renal. Njengoba i-glycidone ishiya umzimba ungena ezinso ngezinga elincane kakhulu, ezigulini ezihluleka yizinso, umuthi awunqwabelana emzimbeni.
Izinkomba
Thayipha isifo sikashukela esingu-2 phakathi nasesikhulile.
Contraindication
- Thayipha isifo sikashukela sokuqala
- I-acidosis ehlobene nesifo sikashukela;
- Isifo sikashukela sikashukela
- Ukuntuleka kokusebenza kwesibindi ngokweqile;
- Noma yisiphi isifo esithathelwanayo;
- Iminyaka engaphansi kweminyaka eyi-18 (njengoba kungekho lwazi maqondana nokuphepha kwe-Glyurenorm yalesi sigaba seziguli);
- I-Hypersensitivity yomuntu ngamunye ukuze sulfonamide.
Ukuqapha okwengeziwe kuyadingeka lapho uthatha i-Glyurenorm phambi kwama-pathologies alandelayo:
- Umkhuhlane
- Isifo se-yegilo;
- Uphuzo oludakayo
Imithamo
I-Glurenorm yenzelwe ukusetshenziswa kwangaphakathi. Ukunamathela ngokuqinile ezimweni zokwelashwa maqondana nomthamo nokudla kuyadingeka. Awukwazi ukumisa ukusetshenziswa kwe-Glyurenorm ngaphandle kokubonisana nodokotela wakho kuqala.
Umthamo wokuqala uhhafu wephilisi elithathwe ngebhulakufesi.
I-gluluorm kufanele idliwe esigabeni sokuqala sokudla.
Musa ukweqa ukudla ngemuva kokudla umuthi.
Lapho ukuthatha isigamu sepilisi kungasebenzi, udinga ukubonana nodokotela okuthi, ngokunokwenzeka, azokhulisa umthamo kancane kancane.
Esimweni sokunquma umthamo odlula lemikhawulo engenhla, umphumela ophinyiselwe ngaphezulu ungatholakala esimweni sokwehlukanisa umthamo owodwa wansuku zonke kumithamo emibili noma emithathu. Umthamo omkhulu kuleli cala kufanele udliwe ngesikhathi sasekuseni. Ukungezelela umthamo kumathebulethi amane noma ngaphezulu ngosuku, njengomthetho, akubangeli ukwanda kokusebenza kahle.
Umthamo omkhulu kakhulu ngosuku ngamathebulethi amane.
Ezigulini ezinenkinga yezinso umsebenzi
Cishe amaphesenti ama-5 wemikhiqizo ye-metabolic ye-Glurenorm ishiya umzimba ungena ezinso. Uma isiguli siphazamise umsebenzi wezinso, ukulungiswa komthamo akudingeki.
Ezigulini ezinokukhubazeka kwe-hepatic
Lapho usebenzisa umuthi emithanjeni engaphezu kwama-75 mg ezigulini ezinomsebenzi we-hepatic okhubazekile, kufanele kuqashelwe udokotela ngokucophelela. I-gluluorm akufanele ithathwe ngokulimazeka okukhulu kwe-hepatic, ngoba amaphesenti angama-95 omthamo ucutshungulwa esibindini nangaphandle komzimba ngamathumbu.
Ukwelapha okuhlanganayo
Esimweni sokusebenza okunganele kokusetshenziswa kweGlyurenorm ngaphandle kokuyihlanganisa nezinye izidakamizwa, kuphela ukuphathwa kwe-metmorphine njengoba kuboniswa i-ejenti eyengeziwe.
Imiphumela emibi
- I-Metabolism: hypoglycemia;
- I-CNS: ukwanda kwesifo esibuhlungu, ikhanda elibuhlungu, isifo sokukhathala okungamahlalakhona, i-paresthesia;
- Inhliziyo: hypotension;
- Ipheshana esiswini: ukulahleka kwesifiso, ukugabha, isifo sohudo, ukungaphatheki kahle esiswini, i-cholestasis.
Ukweqisa
Ukubonakaliswa: ukukhuphuka kokujuluka, indlala, ikhanda, ukuqubuka, ukuqwasha, ukukhubazeka.
Ukwelashwa: uma kunezimpawu ze-hypoglycemia, kudingeka ukuthi kuthathwe i-glucose yangaphakathi noma imikhiqizo equkethe inani elikhulu lama-carbohydrate. Kwi-hypoglycemia enzima (ehambisana nokufikelwa amandla noma ukoma), ukuphathwa okuphathelene ne-dextrose kuyadingeka.
Ukusebenzelana kwamakhemikhali
I-Glurenorm ingakhuphula umphumela we-hypoglycemic uma uthathwa ngokufana ne-ACE inhibitors, i-allopurinol, i-painkillers, i-chloramphenicol, i-clofibrate, i-clarithromycin, i-symfanilamides, i-sulfinpyrazone, i-tetracyclines, i-cyclophosphamides ethathwe ngomlomo ngemithi ye-hypoglycemic.
Kungase kube nokuncipha komphumela we-hypoglycemic esimweni sokuphathwa ngokufanayo kwe-glycidone nge-aminoglutethimide, i-sympathomimetics, i-glucagon, i-thiazide diuretics, i-phenothiazine, i-diazoxide, kanye nezidakamizwa eziqukethe i-nicotinic acid.
Imiyalo ekhethekile
Iziguli ezinesifo sikashukela kufanele zilandele ngokuqinile imiyalo kadokotela obonayo. Kuyadingeka kakhulu ukuqapha isimo ngesikhathi sokukhethwa komthamo noma ukuguqukela ku-Glyrenorm kusuka kwelinye i-ejenti elinomphumela we-hypoglycemic.
Izidakamizwa ezinomphumela we-hypoglycemic, ezithathwe ngomlomo, azikwazi ukusebenza njengendawo ephelele yokudla evumela ukuthi wena ulawule isisindo sesiguli. Ngenxa yokweqa ukudla noma ukwephula imiyalo kadokotela, ukwehla okukhulu kweglucose yegazi kungenzeka, okuholele ekudumeni. Uma uthatha iphilisi ngaphambi kokudla, esikhundleni sokulidla ekuqaleni kokudla, umphumela we-Glyrenorm kushukela wegazi unamandla, ngakho-ke, amathuba we-hypoglycemia ayanda.
Uma kukhona ukubonakaliswa kwe-hypoglycemia, kuthathwa ngokushesha umkhiqizo wokudla oqukethe ushukela omningi. Uma i-hypoglycemia iqhubeka, ngisho nangemva kwalokhu kufanele ufune usizo lodokotela ngokushesha.
Ngenxa yokuxineka ngokomzimba, umphumela we-hypoglycemic ungakhuphuka.
Ngenxa yokuphuza utshwala, kungenzeka ukwanda noma ukuncipha komthelela we-hypoglycemic.
Ithebhulethi ye-Glyurenorm iqukethe i-lactose ngesilinganiso se-134.6 mg. Lesi sidakamizwa si-contraindised kubantu abahlushwa i-pathologies ethile yamafa.
I-Glycvidone ithathwe ngokuvela kwe-sulfonylurea, ebonakala ngesenzo esifushane, ngoba isetshenziswa iziguli ezinesifo sikashukela sohlobo 2 futhi sinamathuba akhulayo we-hypoglycemia.
Ukwemukelwa kwe-Glyurenorm yiziguli ezinesifo sikashukela sohlobo 2 nezifo zesibindi ezihambisanayo kuphephile ngokuphelele. Ukuphela kokuqedwa kancane kancane kwemikhiqizo ye-metabolism ye-glycidone engasebenzi ezigulini zalo mkhakha. Kodwa ezigulini ezinomsebenzi we-hepatic okhubazekile, lesi sidakamizwa asithandwa kakhulu ukusithatha.
Uvivinyo selukhombisile ukuthi ukuthatha i-Glyurenorm unyaka owodwa nohhafu nanhlanu akuholeli ekwenyukeni kwesisindo somzimba, noma ukwehla kancane kwesisindo kungenzeka. Ucwaningo oluqhathaniswa lweGlurenorm nezinye izidakamizwa, okuyi-sulfonylureas, luveze ukungabikho koshintsho lwesisindo ezigulini zisebenzisa lo muthi isikhathi esingaphezu konyaka.
Akunamininingwane ngemiphumela ye-Glurenorm ekhonweni lokushayela izimoto. Kepha isiguli kufanele sixwayiswe ngezimpawu ezingenzeka ze-hypoglycemia. Zonke lezi zibonakaliso zingenzeka ngesikhathi sokwelapha ngalesi sidakamizwa. Ukuqapha kuyadingeka lapho ushayela.
Ukukhulelwa, ukuncelisa ibele
Akunamininingwane ngokusetshenziswa kwe-Glenrenorm ngabesifazane ngesikhathi sokukhulelwa nokubeletha.
Akukacaci ukuthi i-glycidone nemikhiqizo yayo ye-metabolic ingena kanjani ebisini lwebele. Abesifazane abakhulelwe abanesifo sikashukela badinga ukuqashwa okusondele kweglucose yabo egazini.
Ukusetshenziswa kwemithi yesifo sikashukela somlomo kwabesifazane abakhulelwe akwenzi ukulawula okufanelekile kwe-carbohydrate metabolism. Ngalesi sizathu, ukuthatha lesi sidakamizwa ngesikhathi sokukhulelwa nokuqunjelwa kuyaphulwa.
Uma ukukhulelwa kwenzeka noma uma ukuhlela ngesikhathi sokulashwa nalomenzeli, kuzodingeka ukhansele i-Glyurenorm bese ushintshela ku-insulin.
Uma kwenzeka ukulimazeka kwezinso
Njengoba ingxenye enkulu yeGlyurenorm idonswa ngamathumbu, kulezi ziguli ezinokulimazeka kwezinso kusebenza, ukuqoqwa kwalesi sidakamizwa akwenzeki. Ngakho-ke, ingabelwa ngaphandle kwemikhawulo kubantu okungenzeka ukuthi bane-nephropathy.
Cishe amaphesenti ama-5 wemikhiqizo ye-metabolic yalesi sidakamizwa ekhishwa ngokusebenzisa izinso.
Ucwaningo olwenziwe ukuqhathanisa iziguli ezinesifo sikashukela kanye nokulimazeka kwezinhlungu kwamazinga ahlukahlukene obunzima, neziguli nazo ezinesifo sikashukela, kodwa zingasebenzi umsebenzi wezinso, zibonisa ukuthi ukusetshenziswa kwe-50 mg yalesi sidakamizwa kunomthelela ofanayo ku-glucose.
Akukho ukubonakaliswa kwe-hypoglycemia okuphawuliwe. Kuyalandela kulokhu ukuthi ezigulini eziphazamise ukusebenza kwe-renal, ukulungiswa komthamo akudingekile.
