Umuthi we-antidiabetesic Maninil

Izidakamizwa ze-oral sulfonylurea ezisiza ukulawula uhlobo 2 sikashukela ziyisigaba esiningi kakhulu semithi ye-hypoglycemic. Futhi, ngaphandle kokuthi isizukulwane esisha semithi esuselwa ku-glimepiride (njenge-Amaryl) sesivele sithuthukisiwe, iManinil (glibenclamide ekwakhiweni kwayo) ayikaze ilahlekelwe ukuhambisana kwayo. Ucwaningo lwamuva nje luveze izici ezintsha zomuthi wakudala.

Amathebulethi e-antidiabetic eqembu le-sulfonylurea lezidakamizwa avusa umsebenzi we-pancreatic futhi akuwona wonke umuntu onesifo sikashukela onesifo sohlobo 2 ofanelekile, ngakho-ke kufanele uqonde kahle izici zawo.

Maninil - ifomu lokukhulula

UManilin, isithombe saso esivezwe kulesi sigaba, siqukethe isakhi esisebenzayo se-glibenclamide nabahlunga:

• Methyl hydroxyethyl cellulose;
• I-Lactose Monohydrate;
• Isitashi samazambane;
• Magnesium stearate;
• I-silicon dioxide;
• I-Dye Ponceau 4R.

Ukuhlonza imikhiqizo yenkampani yezokwelapha yaseJalimane iBerlin-Chemie (Menarini Group) ngokubukeka kulula: amaphilisi ane-pinkish tinge ane-chamfer nomugqa ohlukanisayo ohlangothini olulodwa. Ngokuya ngomthamo, ithebhulethi eyodwa ingaqukatha u-3.5-5 mg wesithako esiyisisekelo esisebenzayo.

Kwinethiwekhi yamakhemisi, umuthi ungathengwa ngokubhaliwe. EManinil, intengo isabelomali impela - kusuka kuma-ruble ayi-140 kuye kwangama-185. Umuthi awudingi izimo ezikhethekile zokugcinwa, kepha ukufinyelela kwezingane nokukhanya kwelanga okuqondile kufanele kube nomkhawulo. Impilo yeshalofu yamathebulethi yiminyaka emi-3, umuthi ophelelwe yisikhathi ungachithwa.

Amathuba wemithi

Umsebenzi oyinhloko we-glibenclamide ukukhuthaza ama-β-cell ama-islets we-Langerhans, anecala lokukhiqiza i-insulin yawo uqobo. Umsebenzi we-Β-cell uhambelana ngqo nezinga le-glycemia nemvelo yayo. Ngemuva kokusetshenziswa, amaphilisi adonswa ngokushesha yizindonga zamathumbu. Izinga lokufakwa kwevolumu lokuqukethwe esiswini nesikhathi sokugcwaliswa kwalo kokudla kalithinteki. Ngamaprotheni e-plasma, isidakamizwa sihlangana ne-98%. Inani eliphakeme lesilinganiso saso ku-serum yegazi libonakala ngemuva kwamahora amabili nesigamu bese lifinyelela inani lama-100 ng / ml. Isigamu sempilo singamahora ama-2, lapho sithathwa nge-os - amahora ayi-7. Ngokuya ngesithombe somtholampilo walesi sifo, kwabanesifo sikashukela lesi sikhathi singathatha amahora angama-8 noma ayi-10.

Umuthi wenziwe ngesibindi ikakhulukazi esibindini, uguqulwa ngosizo lwe-non-pathocyte ezinhlotsheni ezimbili zama-metabolites: i-3-cis-hydroxy-glibenclamide ne-4-trans-hydroxy-glibenclamide.

Kuqinisekiswe ngokokuzama ukuthi ama-metabolites awakhubeki amazwe athi yi-hypoglycemic, aqeda izinso nezinhlayiya ze-bile emzimbeni emzimbeni ezinsukwini ezingama-2-3.

Uma isibindi sinenkinga, umuthi ugcinwa egazini isikhathi eside. Ngama-pathologies wezinso ngomchamo, uqedwa ngokubambezeleka, isikhathi sawo kuncike ekujuleni kokusebenza kokuntuleka kwesitho.

Ikakhulu, ngobumnene obufushane bokulinganisela bokusebenza kwezinso, ukubekelwa phansi akulungisiwe. Ngokucaciswa kwe-creatinine ≤30 ml / min, izinga lokuqedwa kwama-metabolites liyancipha, ngokulandelana likhulisa izinga lomuthi osegazini. Izimo ezifanayo zeManinil zidinga ukunikezwa kwemithamo noma ukuhoxiswa (imvamisa ezimweni ezinjalo, kunqunywa i-insulin insulin).

Maninil ungubani?

Umuthi wenzelwe ukulawula isifo sikashukela sohlobo lwe-2 (ifomu elinganciki i-insulin). Amacwecwe anqunyelwe abanesifo sikashukela ngaphezu kwalokho, lapho kungekho umphumela ohleliwe ngemuva kokuguqulwa kwendlela yokuphila (ukudla okune-carb ephansi, umsebenzi owanele womzimba, ukulungiswa kwesisindo ngokweqile, ukulawulwa kwesimo somzwelo, ukubambelela ekulaleni nasekuphumuleni).

I-endocrinologist ibeka lo muthi, ibala irejimeni yokwelashwa icabanga ngokudla, iminyaka yesiguli, isigaba sesifo, i-pathologies eyingqayizivele, inhlala-kahle nempendulo yomzimba kulo muthi. Umthamo unqunywa ngokususelwa kuphrofayili ye-glycemic yesiguli.

Umthamo wokuqalisa uvame ukubekelwa ubuncane - uhhafu wethebhulethi enesisindo esingu-5 mg noma we-3.5 mg ngosuku. Ukunakwa kakhulu ekushintsheni kwamadosi kunikezwa iziguli ze-asthenic ngokudla okuphansi kwekhalori, emlandweni lapho kunokuhlaselwa khona kwe-hypoglycemic, kanye nakubantu abasebenza kanzima. Isonto lokuqala lokulawulwa kwe-glycemic yansuku zonke liyadingeka. I-dosing titration yenziwa ngokobufakazi bemitha nangokuya kwodokotela.

Ukwelashwa okujwayelekile kweManinil cishe kungama-15 mg / ngosuku, okungamathebhulethi amathathu ama-5 mg noma amaphilisi ama-5 we-3.5 mg.

Lapho iManinil ithatha ezinye izidakamizwa ze-hypoglycemic, ziqondiswa yidosi yokuqalisa. Ngemuva kokukhanselwa kwemithi yangaphambilini, izinkomba ze-glucometer kanye nemiphumela yokuhlaziywa komchamo ngemuva kwemvelo, ngaphandle kokuchayeka kwezidakamizwa, kuyacaciswa. Ukuphendula komzimba kuhlolwa ngethamo elincane - amaphilisi we-0.5 we-3.5 noma 5 mg. Ukuhambisana nokudla kanye nezinye izimo zempilo enempilo kuyimpoqo. Ukugwema imiphumela emibi, umthamo womuthi omusha ukhuphuka kancane kancane. Umuntu onesifo sikashukela kumele azise udokotela oholayo ngalo lonke ushintsho empilweni.

Iziphakamiso zokusetshenziswa

UManinil uncoma ukuyisebenzisa ekuseni, ngaphambi kokudla kwasekuseni, ugeza umthamo wamathebulethi wakho ngengilazi yamanzi angenalutho. Lapho imvelo idlula ama-2 ama-pcs / ngosuku, ihlukaniswe ngemithamo emi-2 isilinganiso 2 2. Ukuthola umphumela omkhulu wokwelapha, kungakuhle ukuphuza umuthi ngamahora afanayo.

Imiphumela emibi

Ngokusho kwezincomo ze-WHO, imvamisa yemiphumela emibi evela emiphumeleni yezidakamizwa ihlolwa ngesilinganiso esikhethekile:

• Kaningi kakhulu - kusuka ku-10%;
• Imvamisa - ukusuka ku-1 kuye ku-10%;
• Kwesinye isikhathi - kusuka ku-0.1 kuye ku-1%;
• Akuvamile, ukusuka ku-0.01% kuya ku-0,1%;
• Kuyaqabukela - kuya ku-0,01% noma amacala awazange abhalwe phansi.

Izibalo zemicimbi emibi ethatha iManinil ifundwe kalula etafuleni.

Ukuphazamiseka okubukwayo kuvame ukubonwa ngesikhathi sokuzivumelanisa nomuthi bese zihamba zodwa, ngaphandle kokungenelela kwezokwelapha. Ukuphazamiseka kwe-dyspeptic ngesimo sokucanuzelelwa kwenhliziyo, ukuhlanza, ukuhudula akudingi ukufaka umuthi esikhundleni futhi kubuye kunyamalale ngaphandle kwesikhathi.

Uma kukhona uhlobo lwe-hyperergic of allergy to glibenclamide, kunengozi ye-cholerasis ye-intracranial enezinkinga ngendlela yokuqina kwesibindi.

Ukuphendula komzimba kwesikhumba kuvame ukuguquguqulwa, kepha ezimweni ezingandile kungavusa ukushaqeka okusongela impilo yesifo sikashukela.

Ukusuka eManinil, i-allergies neminye imiphumela emibi kungabonakala ngokushiswa, umkhuhlane, izimpawu ze-jaundice, kanye nokutholwa kwamaprotheni ezihlolweni zomchamo. Kuzo zonke izimo, ukubonana nodokotela ophuthumayo kuyadingeka.

Kwezinye izimo, ukuncishiswa kwazo zonke izithako zegazi kuqoshwa ngokushesha. Lapho umuthi ukhanseliwe, isimo asidlulisi ngokuzumayo. I-Cross-allergy kungenzeka neminye imithi ekhuthaza i-hypersensitivity esigulini. Ikakhulu, idayi E124, esetshenziswa ekwenziweni kwezidakamizwa, yi-allergen enamandla.

Maninil - contraindication

Umuthi awubekelwe i-hypersensitivity kuzithako zefomula. Futhi, ayikhonjisiwe:

• Okwe-allergies kuma-diuretics kanye nanoma yiziphi izidakamizwa ezenzelwe i-sulfonylurea, amalungiselelo we-sulfonylamide, i-probenecid;
• Isifo sikashukela sohlobo 1 sikashukela, esine-atrophy of β-cell;
• Uma isisulu sine-metabolic acidosis, ikhefu lesifo sikashukela;
• Omama abakhulelwe futhi abancelile;
• Iziguli ezinenkinga yokuqina kwesibindi nezinso (ibanga 3);
• Kwabaphuza utshwala nabahlukumeza utshwala (usongo lwe-hypoglycemia).

Ngokudakwa kotshwala, amandla we-hypoglycemic we-glibenclamide ayathuthukiswa, futhi isimo sokudakwa senza imaskhi yezimpawu zenhlekelele ezayo.

Ngokuhlinzwa kwesisu, ukulimala okukhulu, ukusha okukhulu, ukuthatha noma imaphi amaphilisi we-antidiabetesic akuvunyelwe. Esikhundleni sesikhashana zithathelwa indawo nge-insulin, ekuvumela ukuthi ulungise kalula futhi ngokushesha ushukela ekugcotshweni kweplasma.

Akukho ukwenqatshelwa okuphelele kwezimoto zokushayela neminye imishini eyinkimbinkimbi ngesikhathi sokwelashwa ngeManinil. Kodwa ukuhlaselwa kwe-hypoglycemic kungalimaza izinqubo zokunaka nezokucabanga, ikakhulukazi ekwelashweni okuhlangene nemithi yokwehlisa ushukela. Ngakho-ke, izinga lobungozi lesifo sikashukela ngasinye kufanele sizihlole.

Imiphumela Yokusebenzelana Kwezidakamizwa

Nge-parallel therapy nge-glibenclamide ne-clonidine, kanye ne-β-adrenergic blockers, i-reserpine, i-guanethidine, izimpawu ze-hypoglycemia ezingenayo ziyahlatshwa umxhwele futhi zingakuvumeli ukwenekelwa kwesifo sikashukela okungenayo.

Ukusetshenziswa njalo kwama-laxatives okuvusa ukuphazamiseka kwesitulo kunciphisa i-glucometer futhi kukwenyuse namathuba we-hypoglycemia.

Qinisa amathuba we-glibenclamide aze afike ekuhlaselweni kwe-hypoglycemic, ungasebenzisa ukusetshenziswa okufanayo kwe-insulin, i-ACE inhibitors, amaphilisi anciphisa ushukela, umuthi osuselwa kuma-hormone owesilisa, izidakamizwa ze-steroid, ama-antidepressants, ama-β-blockers, Clofibrate, umuthi osuselwa ku-quinolone, coumarin, phenamine, disaminophen i-miconazole, i-PASK, i-pentoxifylline, i-perhexylin, i-pyrazolone, i-phenenecid, i-salicylates, izidakamizwa ze-sulfonamidamide, ama-antibiotics esigaba se-tetracycline, tritokvalin, cytost tics.

Ivimbela umsebenzi wesidakamizwa, ovusa izimo ze-hyperglycemic, ukusetshenziswa kanyekanye kwama-acetazolamides, ama-β-adrenergic blocking agents, i-diazoxide, i-glucagon, i-barbiturates, i-diuretics, izidakamizwa ze-phenazazine, i-glucocorticosteroids, izidakamizwa zeklasi ze-phenothiazine, izidakamizwa ze-phenytoin, i-nicotinate. indlala yegilo.

Izidakamizwa zeqembu leCoumarin, i-ranitidine, i-g2ric H2 receptor antagonists, pentamidine, reserpine isenzo ngokungalindeleki, zisebenza njengama-catalysts noma ama-inhibitors womsebenzi we-glibenclamide.

Siza ngokweqile

I-overdose ye-glibenclamide (zombili zisesimweni esibuhlungu futhi icasulwe yi-cumulation) ihlinzeka nge-hypoglycemia enzima - nomphumela owenzeka isikhathi eside, izimpawu ezinzima nezisongela impilo yomuntu ohlukunyeziwe. Ukubonakaliswa komtholampilo kokuhlaselwa kwe-hypoglycemic, ngamunye onesifo sikashukela kufanele aqaphele kahle:

• Indlala engalawulwa;
• Ukuqina kwezingalo nemilenze;
• I-Tachycardia;
• Ukwanda kokukhathazeka;
• Isikhumba esimebala nolwelwesi lwama-mucous.

Ngezinye izikhathi kuba nezinkinga zesikhashana zokuqwashisa, i-paresthesia. Uma ohlukunyeziwe enganikezwa usizo oluphuthumayo lwezokwelapha, uwela i-hypoglycemic precoma ne-coma, ebulalayo.

Ukuxilongwa kwemiphumela enjalo kuqala ngokuqoqwa kwemininingwane mayelana nomuntu ohlukunyeziwe ezihlotsheni ezijwayele imishanguzo ethathwe yisifo sikashukela nezifo ezihlobene naso. Kwenziwa ukuhlolwa kwelabhoratri.

Ukuhlolwa kwesisulu kukuvumela ukuthi uhlole isimo sesikhumba (ukubanda, ukugoba, ukumanzi). Ukushisa kungaba okujwayelekile noma okuphansi. Ngokuya ngobukhulu bokuhlaselwa, imisipha yemisipha yohlobo lwe-tonic noma lwe-clonic, ikhalipha okungelona elijwayelekile, kanye nokukhishwa kuyabonakala.

Uma ohlukumezekile esakwazi, angaphuza itiye elinoshukela ejwayelekile, adle noma yiliphi i-carbohydrate asheshayo (amaswidi, amakhukhi). Uma isimo singazinzanga, onesifo sikashukela esibhedlela.
Nge-coma esibhedlela, kuphakama isisombululo sikashukela esingu-40% (40 ml) iv. Ngaphansi kokubhekwa kokuhlolwa kwelebhu, ukwelashwa kwe-infusion ngosizo lwama-carbohydrate asisindo esincane kuyalungiswa.

Kunamacala aziwayo we-hypoglycemic eside futhi abambezele ukubambezeleka, acasulwe amandla ahlanganayo we-glibenclamide. Izimo ezinjalo zidinga ukubonwa kwesisulu esibhedlela izinsuku eziyi-10 noma ngaphezulu ngokuqapha njalo i-glycemia kanye nokwelashwa okubonisa izimpawu.

Uma ohlukumezekile ephuze amanye amaphilisi futhi ngengozi, kwanele ukuhlanza isisu, mnike umuntu amunce kanye nengilazi yetiyi noma ujusi omnandi.

Ukufana kwezidakamizwa

Njengoba kunesithako esifanayo esisebenzayo eGlibenclamide, Glibenclamide naseGlibamide kungathatha isikhundla seManinyl. Izinkomba, ama-contraindication, imiphumela emibi ayifani ncamashi. Ngokwekhodi ye-ATX yezinga le-4 leManinil, iGlidiab, iGlyclazide, iDiabetes, iGlurenorm, enomphumela ofanayo wezokwelapha, ingaba yi-analogues.

Izincomo ezingeziwe

Ezigulini ezivuthiwe, abantu abanokudla okunama-calorie aphansi, ama-asthenics, abanesifo sikashukela abanesibindi kanye ne-pathologies yezinso, izinga lokuqalisa leManinil lincishiswa lincane ngenxa yobungozi be-hypoglycemia. Uma umuntu onesifo sikashukela eseshintshe isisindo, indlela yokuphila, irejimeni yokwelashwa iyabuyekezwa.

Ukunakwa ikakhulukazi kuyadingeka ezigulini ezinokuwohloka komqondo okuyi-senile, ukuphazamiseka kwengqondo kanye nezinye izimo ezixaka ukuxhumana okugcwele kwesiguli nodokotela. Ukuhlolwa kwelabhoratri kwalesi sigaba seziguli kufanele kwenzeke kaningi ngangokunokwenzeka. Ukuhlola zonke izici zomphumela wesidakamizwa emzimbeni, ngaphambili kunqunywe izifanekiswana ngokukhishwa ngokushesha kwezinto ezisebenzayo.

Uma umuntu onesifo sikashukela engathathi i-metformin, unikezwa umuthi we-glitazone njenge-rosiglitazone noma i-pioglitazone. Ngezinkomba ezifanele, amaphilisi eManinil nawo anezelwa neminye imishanguzo ye-antidiabetic ngenqubo ehlukile yokusebenza. IGuarem noma i-Acarbose, okuthi, njengeManinil, ivuse ama-pancreas, asetshenziswa ekwelashweni okuyinkimbinkimbi.

Ukusetshenziswa isikhathi eside kwe-glibenclamide depletes β-cell, kuholela ku-necrosis, futhi kuthuthukisa ukuzwela amandla kuManinil. Ukusekela ama-pancreas, onesifo sikashukela udluliselwa ku-insulin (iphelele noma ingxenye, kuya ngezinga le-atrophy yabo).

Ukuhlolwa kwezokwelapha ngodokotela kanye nabanesifo sikashukela

Mayelana nokubuyekezwa kweManinil kuxuziwe. Odokotela bakubheka njengomuthi wendabuko we-hypoglycemic onobufakazi obunamandla besisekelo sokusebenza nokuphepha. Abantu abanesifo sikashukela abanelisekile ngenzuzo eyengeziwe ecishe iqinisekiswe isisindo kanye neminye imiphumela emibi, kepha okungenani kunobandlululo bokuhlaziya amandla emithi ngokwemiphumela yesiguli esithile.

Izincomo ezikuleli sayithi ziyiinguqulo eguqulwe yemiyalo esemthethweni, ehloselwe ukujwayelwa okujwayelekile, hhayi eyokuzelapha. Ukuzikhethela komuthi kanye nokulungiswa kwerejimeni yokwelashwa kungumsebenzi kadokotela kuphela.