I-mellitus yesifo sikashukela enganciki i-insulin iyindlela ejwayelekile yesifo (90-95% yazo zonke izimo zesifo sikashukela). Ukuphathwa okusebenzayo kwesifo esingelapheki akudingi kuphela ukuguqulwa kwendlela yokuphila, kodwa futhi nokwelashwa okujwayelekile kwezidakamizwa. Ama-Derivatives we-sulfonylureas (SM) nawo afakiwe ohlwini lwezidakamizwa ezibalulekile kwisifo sikashukela - enye yezinketho zokwelashwa ezaziwa kakhulu nganoma iyiphi i-algorithm.
Ukusebenza kahle okuphezulu ngokubekezelela okuhle nokufinyeleleka ngokwezomnotho kuvunyelwe isikhathi eside ukusebenzisa okuphuma ku-SM njengegumbi eliphambili lama-ejenti omlomo we-hypoglycemic, ukuwagcina kuma-regimens ekwelashweni ngisho nalapho eshintshela ku-insulin.
Umuthi ofanelekile we-antidiabetic namuhla kufanele ube lula ukuwuphatha, ngengozi encane yemiphumela emibi (hhayi i-hypoglycemia kuphela), engabizi, esebenza ngokuthembekile futhi ephephile. Ihlangabezana nazo zonke lezi zidingo IGliclazide (ngesiLatini Gliclazide) ingumuthi wokuqala wesigaba seCM.
I-Pharmacology Glycaside
IGliclazide, isithombe sayo esingabonakala kulesi sigaba, umuthi omelela isigaba se-SM yesizukulwane sesibili.
Umphumela omkhulu (kodwa hhayi ukuphela) womuthi yi-hypoglycemic: uthuthukisa ukukhiqizwa kwe-insulin endulini yi-pancreatic b-cell. Ngokuvuselela i-glycogen synthase yemisipha, i-gliclazide ithuthukisa ukusetshenziswa kwe-glucose yemisipha. Umuthi ubuyisela amapharamitha we-glycemic ngokushesha, kufaka phakathi isifo sikashukela se-metabolic.
Kusukela kokutholwa kokudla endaweni yokugaya ukudla kuze kube umzuzu wokukhiqizwa kwe-insulin ngamathebhulethi, isikhathi esincanyana kakhulu sidlula kunokuba ngaphandle kwabo. I-Hyperglycemia, icasulwe wukudla kwama-carbohydrate, nge-gliclazide ayinangozi.
I-Pharmacokinetics yesidakamizwa
Ukusuka emgudwini wokugaya ukudla, umuthi udonswa ngokushesha futhi kugcwele. Izinga eliphakeme liyatholakala ebangeni ukusuka emahoreni amabili kuya kwayi-6, nakumathebulethi onomphumela owude - kusuka emahoreni ayi-6 kuye kwayi-12. Isikhathi sokuvezwa kosuku olujwayelekile. Ngamaprotheni egazi, umuthi uhlotshaniswa nama-85-99%. Umuthi ubunjwe nge-biotransformed esibindini, wakhe ama-metabolites, elinye lawo athinta kahle i-microcirculation.
Ukuqedwa kwesigamu sempilo kuqondiswe kuhla lwamahora angama-8 kuya kwe-12. E-Gliclazide MV - amahora ayi-12-16. Ngaso leso sikhathi, umuthi ongu-65% uqedwa ngohlobo lwama-metabolites umchamo, u-12% emathunjini.
Umuthi ubekwa nini?
Umuthi wenzelwe ukulawula i-glycemic yesifo sikashukela sohlobo 2, kokubili njenge-monotherapy kanye nokwelashwa okuhlangene nezinye izidakamizwa zomlomo zesifo sikashukela noma amalungiselelo e-insulin.
Imiyalo ye-Gliclazide yokusetshenziswa nayo itusa ukusetshenziswa njengengxenye yezakhiwo zokwelapha ukuphazamiseka kwezifo ezincanyana. Ngenhloso yokuvimbela, kunqunywa umuthi ukuvimbela ukuthuthukiswa kwezinkinga zesifo sikashukela - i-retinopathy, i-neuropathy, i-nephropathy, imivimbo kanye nokuhlaselwa yisifo senhliziyo.
Contraindication ye-Gliclazide
Uhlu lwe-contraindication alusebenzi ku-Glyclazide kuphela, kodwa futhi nakuzo zonke izifaniso zalo (ngesici esisebenzayo esivamile).
Phakathi kokuvinqelwa ngokuphelele:
- Uhlobo 1 sikashukela;
- I-Ketoacidosis (ifomu lesifo sikashukela);
- I-Hypersmolar noma isifo sikashukela;
- Hypersensitivity kuzithako zefomula;
- I-Hepatic kanye ne-renal pathologies;
- Ukulimala okungathi sína;
- I-Leukopenia;
- I-Hyper- ne-hypothyroidism;
- Ukuvinjwa kwamathumbu;
- I-Paresis yesisu;
- Ukutheleleka okuhambisana nokumuncwa kwezakhi zomzimba.
Imikhawulo yohlelo lokusebenza
Ukuphela kwemikhawulo yobudala bezingane, ngoba ukuphepha kanye nokusebenza ngempumelelo kwaleli qembu leziguli akuzange kusungulwe.
Kwezinye izimo ze-pathological (ukuhlinzwa okuhleliwe, izifundo ze-radiopaque), ukuguqulwa kwesikhashana kwe-insulin kuyadingeka (imvamisa amahora angama-48 ngaphambi namahora angama-48 ngemuva kwenqubo).
Ukwelapha nomuthi kuyaphulwa ngesikhathi sokukhulelwa, futhi uma ukwelashwa kwenzeka phakathi kokuqunjelwa, ingane idluliselwa komsoco wokufakelwa.
Imiphumela emibi
Muva nje, ukushicilelwa kuye kwavela eYurophu naseMelika mayelana nobudlelwano obumsolwa phakathi kokuthatha okuphuma kwe-SM ngokulungiswa kwe-insulin kanye nethuba le-pancreatitis kanye ne-pancreatic cancer pathologies. Imininingwane engaqinisekisiwe, ngoba i-gliclazide iyisidakamizwa sokuqala, yenze ukuhlolwa ngokuphepha okuqinile.
Uhlu oluphelele lwemiphumela engalindelekile lusetafuleni.
| Yiluphi uhlangothi umphumela | Izinketho zemiphumela engaba khona yeSide |
| Amapheshana wesisu | ukuphazamiseka kwengqondo ngesimo sokucanuzelelwa kwenhliziyo, ukuhlanza, Ubuhlungu besisu |
| Ukukhohlisa umzimba | izimo ze-hypoglycemic |
| Uhlelo lokujikeleza | i-eosinophilia, cytopenia, anemia |
| Isikhumba | Ukungezwani komzimba, ukuzwela izithombe |
| Izitho zomzimba | ukunambitheka kokushintsha, ukuntuleka kokuxhumana, ikhanda, ukuwohloka |
Ngenxa yobungozi bezimo ze-hypoglycemic, ungabeki i-Gliclazide kubantu abadala abanesifo sikashukela abanesondlo esingenele kanye nokuntuleka kokusekelwa komphakathi, ikakhulukazi nge-cardiac ne-renal pathologies.
Ukusebenzelana kwezidakamizwa
I-Gliclazide iyakwazi ukuthuthukisa i-ACE inhibitors, ama-anabolic steroid, ama-β-blockers, i-fluoxidine, i-cimetidine, i-salicylates, i-miconazole, i-MAO inhibitors, i-fluconazole, i-theophylline, i-pentoxifylline, i-tetracyclines.
Umphumela we-glycoside ubuthakathaka ngokusetshenziswa okufanayo kwe-barbiturates, glucocorticoids, sympathomimetics, saluretics, izindlela zokuvimbela inzalo ngomlomo, i-rifampicin, ama-estrogens.
Ungasifaka kanjani isicelo
IGlycloside ithathwa ngomlomo ngokudla. Ithebhulethi ligwinye ligcwele, ngaphandle kokuchotshozwa, ligezwe ngamanzi. Udokotela uzokhetha imithamo ngayinye, acabangele isigaba sesifo kanye nokusabela kwesifo sikashukela emuthini. Imvamisa yokuqalisa imvamisa ayidluli kuma-80 mg, uma ingasebenzi ngokwanele, umthamo uyanda kancane kancane.
Isimo sansuku zonke sisukela ku-30 mg siye ku-120 mg, kucatshangelwa isigaba sesifo sikashukela kanye nemikhawulo yobudala. Kwezinye izimo, angafika ku-320 mg angabekwa.
Uma isikhathi sokwemukelwa siphuthelwe, awukwazi ukuphinda kabili isilinganiso. Umuthi kufanele uphuzwe lapho kuvela ithuba lokuqala.
Ukusetshenziswa kwezinhlanganisela ezingaguquki akunakwenzeka kuphela nge-metformin, esetshenziswa yona kuphela kabanzi kunabamele abakwa-SM, kodwa futhi nangezakhiwo ezihlanganisiwe eziphindwe kathathu.
Ukudla kwasekuseni, okuthatha umuthi, kufanele kube okuphelele, ngobuncane obuphoqelekile bama-carbohydrate. Ukubulawa yindlala phakathi nosuku, ikakhulukazi ukulayisha ngokweqile ngokomzimba, kungabangela i-hypoglycemia. Isimo esifanayo kungenzeka ngemuva kokuphuza utshwala.
Abantu abanesifo sikashukela ebudaleni bayazwela kakhulu i-Glyclazide, ngoba kungenzeka ukuthi bathuthukise i-glycemia. Imithi yesikhathi esifushane efana ne-Glyclazide ejwayelekile ilungele lesi sigaba seziguli.
Amathebulethi wokukhishwa aguquliwe asebenza ngokulinganayo usuku lonke, ngaphezu kwalokho, ukuphathwa kwomuthi onjalo kukodwa. Umthamo we-Gliclazide MV uyingxenye yesilinganiso esisejwayelekile. Umuthi usebenza ngempumelelo iminyaka emi-3-5, khona-ke amathuba wokuphikiswa uyanda - ukungabi nalutho noma okuphelele kokusebenza kwawo. Ezimweni ezinjalo, i-endocrinologist ishintsha irejimeni yokwelashwa.
Umuthi wokuqala, njengama-generics awo, usebenza kuphela ekuguquleni indlela yokuphila - ukudla okunempilo kwe-carbohydrate, ukuzikhandla okwanele nokujwayelekile komzimba, ukuqapha isimo sokomzwelo, ukuqaphela ukulala nokuqabula kabusha.
Okubaluleke ngokufanayo ukuqapha i-glycemia phakathi nosuku ngokuqopha imiphumela kudayari yesifo sikashukela. Ngemuva kokuxineka kakhulu, ukusebenza ngokweqile ngokomzimba, ukungondleki, ukunikezwa isilinganiso sasemithanjeni kungahle kudingekile. Ukuqapha isimo sakho nokuxhumana njalo nodokotela wakho kuzosiza ukugwema imiphumela emibi.
Izindlela zokuvimbela
Ukuvimbela ukuhlaselwa kwe-hypoglycemic, kubalulekile ukuba ube nesidlo sasekuseni esiphelele ngemuva kwepilisi, uvikele ukubulawa yindlala phakathi nosuku, futhi ungafaki utshwala ekudleni. Ukusetshenziswa okufanayo kwe-b-blockers kungavimba izimpawu ze-hypoglycemic. Kubalulekile ukuthi abanesifo sikashukela balandele ukudla okune-carb ephansi.
Siza isisulu nge-overdose
Uma inqubo evunyelwe idlulwa kakhulu, izimpawu zokweqisa zingabonakala:
- Umuzwa wokukhathala;
- Ukwanda kwengcindezi yegazi;
- Ubuhlungu bekhanda;
- Ubunono, ukungaphatheki kahle;
- Ukusabela okungavinjelwe;
- Ukulimazeka okubukwayo okwesikhashana;
- Ukuphazamiseka kwemisebenzi yokukhuluma;
- Ukuqothuka;
- Iyahluleka.
Uma i-glycemia ithathe ifomu elinzima futhi ohlukunyezwayo engasilawuli isimo sakhe, udinga ukulaliswa esibhedlela ngokuphuthumayo. Ukumisa ukuhlaselwa emahoreni okuqala, kuyadingeka ukufaka umjovo ongu-50 mg we-glucose (30% r) emthanjeni kanye ne-Drip - dextrose (10% r) emthanjeni. Kubalulekile ezinsukwini zokuqala ukubheka njalo i-glycemia. Ukuxilongwa nge-overdose ye-gliclazide ayisebenzi.
Ifomu lomthamo nokwakheka kwalo
Ngokuya ngokwanda, amalungiselelo e-SM angokwesibili kuMetformin kuphela. Enye yezinzuzo zomuthi ukutholakala kwawo: kweGliclazide, intengo eketheni likhemisi ayidluli ama-ruble ayi-160. ama-30 ama-PC. Kwinethiwekhi yamakhemisi, kunikezwa imishanguzo ngaphansi kwamagama ahlukahlukene okuhweba: Glyclazide-Akos, Glyclazide Canon, Glidiab-MV. Umuthi ukhiqizwa ngezindlela ezahlukahlukene, kukhona inketho ngokukhululwa okuguquliwe kwengxenye yesisekelo.
Amatafula ane-tint kakhilimu kanye nokugquma kancane. Emangqamuzaneni amapuleti e-aluminium angaba ama-10, 20 noma ama-30 ama-pcs. amaphilisi. Amabhola afakwe emabhokisini amaphilisi ayi-10, 20, 30, 60 ngisho ne-100.
Ithebhulethi ngayinye iqukethe i-gliclazide esetshenziswayo, efakwe ne-cellulose, i-hypromellose, i-colloidal silicon dioxide, i-magnesium stearate.
Ukwehluka okunomphumela wesikhathi eside weGlycaside MV kuthengiswa ngamaphakeji afanayo wamathebulethi ayi-15 noma angama-30 embizeni noma ebhokisini.
Ukubuyiselwa okukhulu kwalesi sigaba sezidakamizwa amathuba okuthi umuntu angakwazi ukumelana nawo: ngokwezibalo, ama-5% abantu abanesifo sikashukela abakade bethatha okususelwa ku-SM isikhathi eside ukushintshela ku-insulin ngokuhamba kwesikhathi.
IGenclazide ejwayelekile
I-Gliclazide - umuthi wokuqala, zonke ezinye izidakamizwa ezinento efanayo esebenzayo noma umphumela we-pharmacological, analogues. UGlidiab unentengo enhle kakhulu nekhwalithi phakathi kwe-Gliclazide analogues ebiza ama-ruble angama-111-137. Ukudunyiswa okuphezulu kunikezwa odokotela ngemithi i-Diabeteson ne-Diabeteson MV. Intengo yezidakamizwa isuka kuma-ruble angama-250 kuya kwangama-320.
Phakathi kwezinye izidakamizwa ezihambisana nekhodi ye-ATX level 4, ezaziwa kakhulu yilezi:
- IGlurenorm;
- I-Glimepiride;
- Lungisa;
- I-Glibenclamide;
- I-Amaryl;
- Maninil.
Uma ngemuva kokucacisa i-Glyclazide entsha, imizwa engaqondakali ivele, bika udokotela wakho ukungakhululeki. Mhlawumbe, ngemuva kokuhlolwa okwengeziwe, uzokwehlisa umthamo noma akhethe i-analogue efanelekile. Ukuzibonela nge-generics ngokwakho kuyingozi empilweni yakho.
I-Gliclazide - ukubuyekezwa kwabanesifo sikashukela nodokotela
Ukwelashwa kwesimanje kwe-hypoglycemic yesifo sikashukela sohlobo 2 kufanele kuguqulwe ngokulandelana, "kuqondaniswe" nezidingo zesiguli esithile, kufanele kubhekwe iminyaka yakhe nezici zomtholampilo ukuze kuncishiswe ukukhubazeka, kuguqulwe ngokufanele imiphumela yesikhathi eside yesifo futhi kwandise impilo yesifo sikashukela.
Impela, i-Glyclazide ayilungele wonke umuntu, kanye nezinye izisebenzi ezinciphisa ushukela, kepha kungaphikiswa ukuthi umuthi kanye nokufana kwawo kuhambisana ngokuphelele namazinga wesimanje ashiwo, uhlale efanelekile futhi uqhubeke nokusiza abanesifo sikashukela ukuphatha ngempumelelo lesi sifo esikhohlisayo.
Mayelana nokwelashwa kwezokwelapha okunesifo sikashukela 2-goth kuvidiyo
