Umenzeli onciphisa ushukela: Glibenclamide

I-Glibenclamide ingumuthi onezakhiwo ze-hypoglycemic eziqhamuka ekilasini lesibili lesizalo se-sulfonylurea. Ibuye ibe nomphumela we-hypolipidemic futhi inciphisa ingozi yokuqunjelwa yi-vascular thrombosis.

Isimilo esivamile

Igama lomuthi iGlibenclamide kwifomethi yamazwe omhlaba ngesiLatini yiGlibenclamide. Ngaphandle, umuthi uyipilisi elincane elikhanyayo ngendlela ye-disc enomugqa ohlukanisayo. Ukuhlanganiswa kungenzeka kube nesakhiwo semabula esinokufakwa okuncane.

Amathebulethi ahlanganisiwe emabhulokini ezincezu eziyi-10 Ebhokisini elilodwa kungafinyelela amapuleti ayi-12 anjalo.

IGlibenclamide ikhishwa ngomuthi, igcinwe ngaphansi kwezimo ezijwayelekile, ngaphandle kokutholwa yizingane. Imiyalo yathi impilo yeshalofu yesidakamizwa - iminyaka emi-5. Umuthi ophelelwe yisikhathi akufanele uthathwe.

Ithebhulethi ngayinye iqukethe ama-5 mg we-glibenclamide nababekhona ngendlela ye-lactose monohydrate, isitashi samazambane, i-magnesium stearate, i-polyvinylpyrrolidone, i-E 124.

Izinkampani zemithi yezasekhaya zikhiqiza i-ejenti eyehlisa ushukela:

• Anti-viral;
• I-Akrikhin HFK;
• I-Bivitech;
• ALSI Pharma;
• I-Biosynthesis

Iqaliswa kanye nenkampani yase-Ukraine Health. KwaGlibenclamide, intengo eketeni likhemisi laseRussia ingama-ruble angama-270-350.

Izici ze-Pharmacological

I-Pharmacodynamics yesidakamizwa

Isidakamizwa se-Oral hypoglycemic. EGlibenclamide, indlela yokusebenza isuselwa ekuvuseleleni kokukhiqizwa kwe-insulin ngamaseli we-pancreatic β-cell. Ngaso leso sikhathi, ukumelana kwe-insulin kwezicubu zomzimba kuyancipha. Umuthi usebenza uma kunamasiseli β-amaseli asebenzayo ngokwanele kumanyikwe. Yehlisa umuthi nokuhlanganiswa kweplatelet.

Izici ze-Pharmacokinetic

Ukusuka kwipheshana lesisu ngemuva kokuphathwa ngomlomo esiswini esingenalutho, umuthi udonswa ngokushesha, ubopha amaprotheni egazi ngamaphesenti angama-95. Ukuguqulwa kwento esebenzayo ibe ngama-metabolites angathathi hlangothi kuyenziwa esibindini. I-Excretion ilawulwa izinso kanye nama-ducts we-bile. Isikhathi sokuphila esisuka egazini sisuka ehoreni elilodwa nohhafu size amahora amathathu nesigamu. Ushukela ulawula umthamo owodwa wesidakamizwa okungenani amahora ayi-12.

Ngama-pathologies e-hepatic, ukumbiwa kwezidakamizwa akuvinjelwe. Uma ukwehluleka kwesibindi kuvezwa ngesimo esibuthakathaka, lokhu akukuthinti inqubo yokukhucululwa kwama-metabolites; ezimweni ezibucayi kakhulu, ukunqwabelana kwabo akubekelwe.

Uboniswa ngubani uGlibenclamide

Kwenziwe i-hypoglycemic kwabanesifo sikashukela ngohlobo lwesibili lwesifo. Nikeza imishanguzo, inqobo nje uma ukondliwa okuphansi kwe-carb kanye nemithwalo ejwayelekile yemisipha akunikezi imiphumela oyifunayo.

Imithamo nokwelashwa

I-Glibenclamide iyanconywa ukuthi isetshenziswe ngokushesha ngemuva kokudla. I-endocrinologist ibala umthamo ngokuya ngemiphumela yokuhlolwa kwegazi ushukela, iminyaka yesiguli, ubukhulu besifo esiyimbangela, i-concomitant pathologies kanye nempilo ejwayelekile.

Esigabeni sokuqala sesi sifo, okujwayelekile kuyinto engu-2,5-5 mg / ngosuku. Thatha umuthi kanye ngemuva kokudla kwasekuseni. Uma isinxephezelo esiphelele se-glycemia singeke sitholwe, udokotela angalungisa umthamo ngokungeza u-2,5 mg wesidakamizwa ngemuva kwesonto. Izinga le-marginal (kufika ku-15 mg / ngosuku) lilingana namathebulethi amathathu. Umthamo ophelele awubekelwa maningi, futhi akukho ukukhuphuka okukhulu kwe-glycemia.

Uma umuntu onesifo sikashukela enesisindo somzimba esingaphansi kwamakhilogremu angama-50, umthamo wokuqala unqunywe ku-2,5 mg, ohambelana nengxenye yepilisi. Uma inqubo yansuku zonke ingeqi izicucu ezimbili, badakwa ngokuphelele ekuseni ngesikhathi sasekuseni, kwezinye izimo, umuthi usatshalaliswa kabili, ekuseni nakusihlwa ngokwesilinganiso 2: 1.

Lapho i-Glibenclamide idluliswa ngemuva kokwelashwa okuphumelelayo ngenye imishanguzo ye-hypoglycemic, umthamo wokuqala uzoba ngu-2,5 mg kanye, ekuseni.

Ngokusebenza kahle, ungaguqula okujwayelekile masonto onke ngokungeza u-2,5 mg.

Uma kwenzeka ukuthi umphumela wokwelashwa neminye imishanguzo yesifo sikashukela awunelisi, umthamo wokuqala uzoba ngu-5 mg ekuseni, ngemuva kokudla. Uma kunesidingo, ukulungiswa kwe-2,5-5 mg njalo ngeviki kuvunyelwe. Isilinganiso esilinganiselwe sihlala sifana - 15 mg / ngosuku.

Uma inani eliphakeme lansuku zonke le-Glibenclamide, ngenkathi libuka ukudla okune-carb ephansi kanye nokuzivocavoca kahle komzimba, linganikeli isinxephezelo sikashukela esingu-100%, isifo sikashukela sidluliselwa kwirejimeni yokwelashwa ephelele. Umuthi oyinhloko unezelwa ngama-biguanides, insulin, namanye ama-hypoglycemic agents.

Uma ukukhiqizwa kwe-insulin okwenziwa i-insulin kuma-diabetics ngohlobo lwesibili lwesifo kucindezelwe ngokuphelele, ukwelashwa okuyinkimbinkimbi akuqinisekisi umphumela ofanayo nangokwe-monotherapy ngamalungiselelo we-insulin.

Uma ngasizathu simbe isikhathi sokuthatha i-Glibenclamide siphuthelwe isikhathi esingaphezu kwehora noma amabili, awukwazi ukuthatha lesi sidakamizwa ngokuzayo. Ngakusasa ekuseni, thatha umthamo ojwayelekile, ungancomi ukukhuphula izinga.

Imiphumela emibi

Nge-overdose yesidakamizwa, izimo ze-hypoglycemic zobunzima obahlukahlukene kungenzeka, kufaka phakathi ukoma. Ngokusebenzisa kabi utshwala kanye nokudla okukodwa noma kabili ngosuku, ukusebenza ngokweqile, izinkinga ngesibindi, indlala yegilo nezinso, imiphumela engathandeki nayo kungenzeka.

Contraindication ukusetshenziswa kwezokwelapha

Umuthi walesi sigaba awumiselwe abanesifo sikashukela ngohlobo lokuqala lwesifo sikashukela, amafomu abizwa ngokuthi yi-ketoacidosis, ikhefana, isifo sikashukela kanye nesimo saso esandulelayo.

Umuthi awukhonjiswa ezigulini ezine-pathologies zesibindi nezinso, uma umsebenzi wezinso uncishiselwa amanani we-creatinine clearance ngezansi ngaphansi kwama-30 ml / min.

Uma umuntu onesifo sikashukela enokugula, i-hypersensitivity to thiazide diuretics ne-sulfonamides, udokotela kufanele futhi akubheke lokhu.

Ngenkathi yezifo ezithathelwanayo, ezinye izidakamizwa, kufaka phakathi i-insulin, zinqunyelwe ukunxephezela isifo sikashukela. Ukwelashwa kwe-insulin kukhonjiswa nasekushiseni okukhulu, ukulimala okuyingozi, nokusebenza kanzima, kufaka phakathi i-pancreatic resection.

Ngokufakwa kabi kwezakhi zomzimba, ama-paresis wesisu, ukuvinjezelwa kwamathumbu, umuthi uyahlanganiswa.

I-Glibenclamine nayo ikhanseliwe ngesikhathi sokukhulelwa nokuncelisa.

Amacala okweqisa kwe-Glibenclamide

Ukusetshenziswa okuhleliwe kwezingxenye ezidliwayo zomuthi kukhuthaza i-hypoglycemia enkulu, okuyingozi empilweni yomuntu ohlukunyeziwe.

Umphumela ofanayo ungatholakala ngokusetshenziswa kwesidakamizwa ngokumelene nesizinda sokungondleki okungajwayelekile, ukusebenza ngokweqile komzimba, ithonya lemithi ethile ethathwe ngokuhlangana neGlibenclamide.

Izimpawu zesimo se-hypoglycemic:

• Indlala engalawulwa;
• Ukwehla kwekhwalithi yokulala;
• Ubunqunu;
• Ukwehlukaniswa;
• Ukwanda kokujuluka;
• Ubuhlungu bekhanda;
• Ukuphazamiseka kwe-dyspeptic;
• I-Hypertonicity;
• Ukuthuthumela kwesandla;
• I-Tachycardia.

Ukuphambuka emsebenzini we-psyche ngezinkinga ze-endocrine kungavezwa ukwazi ukungadideki, ukozela, ukugoba, ukuthinta okubuthakathaka, ukunakwa okungahambi kahle, ukugxila okuphindwe kabili, ukwethuka lapho ushayela imoto noma ulawula izindlela eziqondile, amazwe acindezelayo, ulaka, izinkinga zemithambo yegazi nezitho zokuphefumula, coma.

Kokubili ngokuphelele nangefomu elilinganiselwe le-overdose, i-hypoglycemia izokhulunywa ngaphezulu uma iqhathaniswa ne-overdose yokuphuma kwe-sulfonylurea yesizukulwane sokuqala.

Ukuze unciphise isimo somhlukunyezwa ngokuqina kokuhlaselwa okulinganiselayo, ngokushesha ungathatha ngokushesha i-carbohydrate - amaswidi, isigamu sengilazi yetiyi noshukela noma ujusi (ngaphandle kwama-sweeteners wokufakelwa). Uma lezo zinyathelo zingasanele, i-glucose (40%) noma i-Dextrose (5-10%) ifakwa emthanjeni, i-glucagon (1 mg) ifakwa emisipha. I-Diazoxide ingathathwa ngomlomo. Uma isisulu sasiphuza i-acarbose, i-hypoglycemia yomlomo ingalungiswa kuphela nge-glucose, kepha hhayi ngama-oligosaccharides.

Uma isisulu se-hypoglycemia sisakwazi, ushukela unqunyelwe ukusetshenziswa kwangaphakathi. Uma kwenzeka ulahlekelwe yimizwa, kuphakama i-glucose iv, ushukela - iv, i / m nangaphansi kwesikhumba. Uma ukwazi kubuyile, ukuvikela ukubuyela emuva, isifo sikashukela kufanele sinikezwe ngokudla okunempilo okususelwa kuma-carbohydrate asheshayo.

Ukuqashwa kwe-glycemia, i-pH, i-creatinine, ama-electrolyte, i-nitrogen ye-urea kugadiwe njalo.

Izici zokwelashwa nge-glibenclamide

1. Uma belashwa ngomuthi, abanesifo sikashukela kufanele balandele ukudla okuqinile.
2. Ezimweni zokuphazamiseka kwegazi lokugeleza kwenhliziyo, umkhuhlane, ukudakwa, isidakamizwa sinqunywa ngokuqapha.
3. Umuntu onesifo sikashukela kumele aqhubeke nokuqapha imikhondo yakhe ebalulekile. Imitha ye-glucose kufanele iqoshwe okungenani kabili ngosuku (empeleni, iphrofayili ye-glycemic ihlolwa izikhathi ezi-5 / ngosuku.). Umchamo wansuku zonke kufanele ubhekelwe ubukhona beshukela ne-acetone.
4. Nge-hemodialysis, ukuntuleka kokudla ngemuva kokuthatha umuthi, ukweqisa ngokomzimba, ukucindezela, isibindi kanye nezinso zezinso, ukusetshenziswa kabi kotshwala, ukungapheleli kwesimo se-adrenal, futhi ikakhulukazi ngokuhlanganiswa kwezinto eziningana, ingozi yokuthola i-glycemia enkulu engalawulwa. Ezimweni ezinjalo, ukuqashwa njalo kwezinkomba ze-glucometer ngokulungiswa komthamo okufika ngesikhathi umuthi kuyadingeka.
5. Ama-blockers we-Β-adrenoreceptor, imithi ethinta kabi uhlelo lwezinzwa oluyinkimbinkimbi, angafaka izibonakaliso ze-hypoglycemia.
6. Ebusheni obukhulu, umuthi unconyelwa kumthamo omncane (kusuka ku-1 mg / ngosuku), ngoba amathuba okuthola i-glycemia kulesi sigaba aphakeme ngenxa yemisebenzi yohlelo lobuchwephesha engenamandla.
7. Ezimpawu zokuqala zokungezwani komzimba, umuthi ukhanseliwe futhi nama-antihistamines anqunyelwe. Kuyo yonke inkathi yokwelashwa, imisebe ye-ultraviolet enolaka kufanele igwenywe.
8. Uma kwenzeka umkhuhlane, i-pneumonia, ubuthi, ukwanda kwezifo ezingamahlalakhona (i-cholecystitis, i-pyelonephritis), ukushaya kwenhliziyo kanye nezinye izimo ezinzima ze-vascular, NMC esibi, i-gangrene, kanye nokuhlinzwa okukhulu kwesifo sikashukela, kudluliselwa ku-insulin.
9. Ngokuvamile, i-Glibenclamide ayithinti ukuphathwa kwezimoto, kepha ezimweni ezingejwayelekile (ukusebenza ezimweni ezinzima, ukucindezelwa, ukuphakama, njll.), Ukunakekelwa kufanele kuthathwe, ngoba isimo esivuswa wushintsho oshukela wegazi singathuthuka nganoma yisiphi isikhathi.
10. Ukunakekelwa okuyisisekelo kumele kuthathwe lapho ushintsha umuthi, ukhetha umthamo ophelele kanye nokusetshenziswa okungajwayelekile kwezidakamizwa.

I-glibenclamide analogues

Ngokuhambisana nekhodi ye-ATX yezinga le-4 nomdlalo wezidakamizwa i-Glibenclamide:

• IGlurenorm;
• Lungisa;
• I-Amaryl;
• I-Gliclazide;
• Maninil;
• UGlidiab;
• I-Glimepiride;
• Isifo sikashukela.

Njengokuvumelanisa kwemikhiqizo eyehlukene i-Glibenclamide ifana nemithi i-Glibeks, yeGileyadi, ne-Glibamid, ne-Glidanil.

Imiphumela yokuxhumana kwezidakamizwa ye-Glibenclamide

I-excretion ye-glimenclamide iyabambezeleka, ngenkathi ithuthukisa amandla ayo e-hypoglycemic, azopropanone, miconazole, amalungiselelo e-coumaric acid, i-oxyphenbutazone, izidakamizwa zeqembu le-sulfonamide, phenylbutazone, sulfapyrazonfeniramidol.

Ukwelapha okuhlanganisiwe neminye imishanguzo ehlisa ushukela, ukuqeda ukumelana ne-insulin, kukhombisa imiphumela efanayo.

Ngokusetshenziswa okufanayo kwezidakamizwa ze-anabolic, i-allopurinol, i-cimetidine, i-β-adrenoreceptor blockers, i-cyclophosphamide, i-guanethidine, i-clofibric acid, i-monoamine oxidase inhibitors, i-sulfonamides ngesenzo esisebenza isikhathi eside, ama-salicylates, ama-tetracyclines, utshwala, amandla ayisisekelo we-hypoglycemic.

Uma i-barbiturates, i-chlorpromazine, i-rifampicin, i-diazoxide, i-epinephrine, i-acetazolamide, nezinye izidakamizwa ze-sympathomimetic, i-glucocorticosteroids, i-glucagon, i-indomethacin, i-diuretics, kufaka phakathi i-acetazolamide, i-nicotinates (kumthamo omkhulu), i-phenothiazine ye-phenothiazine. , ama-saluretics, usawoti we-lithium, imithamo emikhulu yotshwala ne-laxative, umphumela we-glimenclamide uyancishiswa.

Imiphumela engalindeleki yokuxhumana nokusetshenziswa okufana nayo kuboniswa ngabaphikisi be-H2 receptor.

Ukubuyekezwa kwe-Glibenclamide

Emaforamu atholakalayo, abanesifo sikashukela nodokotela bavame ukuxoxa ngokusebenza kwezinhlobo ezahlukahlukene zokwelashwa ngezidakamizwa. Labo abanqunywe yi-monotherapy njengomuthi bakhala ngenxephezelo yeshukela engaphelele. Ngokulashwa okuyinkimbinkimbi, abanye baphawula umsebenzi we-Glibenclamide okweqile.

Odokotela bagcizelela ukuthi ukukhetha umthamo ophelele we-Glibenclamide, okuzokuvumela ukuthi ulondoloze inhlala-kahle ejwayelekile isikhathi eside, kudinga indlela yomuntu ngamunye, kudinga isikhathi nokubheka njalo ukufundwa kwemitha ye-glucose ezimweni ezihlukile zesiguli. Ezimweni ezinjalo, ukwelulekwa ngembalelwano kungaba nje kungaphumeleli, kodwa futhi kube yingozi.

Imininingwane emayelana nomuthi osendaweni iyatholakala futhi ibhekisisa, iqoqwe emithonjeni etholakalayo futhi ayisona isisekelo sokuxilongwa nokwelashwa ngokwakho. Ngeke asiphinde esikhundleni sokwelulekwa yi-endocrinologist.