Ukwelashwa kwesifo sikashukela sohlobo 2 kufaka phakathi ukuphathwa kwezidakamizwa ze-hypoglycemic zamaqembu ahlukene.
Lokhu kufaka phakathi ukukhishwa kwe-sulfonylurea.
Omunye wabamele leli qembu yi-chlorpopamide.
Imininingwane ejwayelekile mayelana nomuthi
I-Chlorpropamide iyinto esebenzayo engokwesizukulwane sokuqala sulfonylurea. Iqembu layo le-pharmacological agents abenzalo be-hypoglycemic synthetic agents. I-Chlorpropamide ayixubeki emanzini, kepha, kunalokho, iyanyibilika etshwaleni.
Ngokungafani nezinye izizukulwane ze-sulfonylurea derivatives, i-chlorpropamide isebenza kafushane. Ukufinyelela isilinganiso esifanele se-glycemia, isetshenziswa ngemithamo emikhulu.
Imiphumela emibi yokuphuza lo muthi idalulwa kakhulu uma iqhathaniswa ne-Glibenclamide nabanye abamele isizukulwane sesibili. Isebenza kahle ngokukhiqizwa okunganele kwe-hormone (i-insulin) kanye nokwehla kwezicubu zomzimba kuyo. Ukwelashwa nge-chlorpropamide kunomthelela kwiziguli ezinesifo sikashukela esilinganayo kanye / noma onesifo sikashukela sohlobo 2.
IChlorpropamide yigama elejwayelekile elejwayelekile elenziwa ngomuthi. Kwakha isisekelo somuthi (okuyingxenye esebenzayo). Kutholakala ezibhebheni.
Isenzo se-Pharmacological
Umuthi unomphumela we-hypoglycemic. Umuthi ubopha iziteshi ze-potassium, uvuselela ukucasulwa kwe-insulin. Ezicutshini nasezithobeni ezixakwe yi-insulin, inani lama-receptors e-hormone liyanda.
Lapho kukhona i-insulin endulin, amazinga kashukela anciphisa. Inomsebenzi we-antidiuretic. Ngenxa yokufihlwa kwe-insulin, inzuzo yesisindo iyenzeka.
Ukudambisa i-glycemia kuncike kancane kushukela wegazi. I-Chlorpropamide, njengamanye ama-sulfonylureas, ithwala ubungozi be-hypoglycemia, kepha ngezinga elincane.
Lapho kuhlanganiswa namanye ama-hypoglycemic agents (ama-biguanides, ama-thiazolidinediones, bheka ukusebenzisana nezinye izidakamizwa), umthamo wokugcina uncishiswa kancane.
Indlela yokusebenza yesikhipha sulfonylurea
I-Pharmacokinetics
Ngemuva kokungena emgodini wokugaya ukudla, i-chlorpropamide idonswa kahle. Ngemuva kwehora, umuthi usegazini, ukuqina kwawo uphezulu - ngemuva kwamahora angama-2-4. Amaprotheni e-Plasma abopha> 90%.
Umuthi usebenza usuku lonke uma ungasetshenziswa. Ukuqedwa kwesigamu sempilo kungamahora angama-36. Igcotshwa ikakhulu kumchamo (kuze kufike ku-90%).
Izinkomba kanye ne-contraindication
Izinkomba ezisetshenziswayo zingushukela ongaxekile we-insulin, kanye nesifo sikashukela. I-Chlorpropamide yachazwa ezimweni lapho ukwelashwa kokudla, ukuzivocavoca kwezokwelapha kungalethi umphumela ofanele ngokulungiswa kwezinkomba.
Phakathi kokuphikisana nokusetshenziswa kwomuthi kufaka phakathi:
- hypersensitivity to chlorpropamide;
- Uhlobo 1 sikashukela;
- hypersensitivity kwamanye ama-sulfonylureas;
- imetabolism enesisekelo sokubheka i-acidosis;
- i-pathology yegilo;
- ketoacidosis;
- ukungasebenzi kwesibindi nezinso;
- isifo esithathelwanayo esibuhlungu;
- ukukhulelwa / ukukhulelwa;
- ukhokho ne-coma;
- iminyaka yezingane;
- ukwehluleka okuphindaphindiwe kwe-chlorpropamide therapy;
- izimo ngemuva kokuqalwa kabusha kwe-pancreatic.
Imithamo nokuphatha
Umthamo ubekwa udokotela ngokusekelwe enkambweni yesifo sikashukela kanye nokukhululeka kwe-glycemia. Lapho uthola isinxephezelo esizinzile esigulini, singancishiswa. Njengomthetho, ngesifo sikashukela sohlobo 2, imvelo yansuku zonke ingama-250-500 mg. Ngoshukela i-insipidus - eyi-125 mg ngosuku. Uma kudluliselwa kwezinye izidakamizwa, ukulungiswa komthamo kuyadingeka.
Imiyalo yokusebenzisa i-chlorpropamide ikhombisa ukusetshenziswa komuthi isigamu sehora ngaphambi kokudla. Kubalulekile ukuyisebenzisa ngesikhathi esisodwa. Uma umthamo uhlinzekela amaphilisi angaphansi kwe-2, khona-ke ukwamukela kwenzeka ekuseni.
Ividiyo evela kuchwepheshe mayelana nesifo sikashukela nokuthi ungayiphatha kanjani:
Imiphumela emibi kanye ne-overdose
Imiphumela elandelayo emibi ingahle ivele ngesikhathi sokuphathwa kwe-chlorpropamide:
- isicanucanu, ukugabha, izinhlungu zesisu, izihlalo ezikhathazayo;
- i-hypoglycemia;
- i-hyponatremia;
- ukunambitheka kwensimbi emlonyeni, ukuntuleka kwesifiso sokudla;
- ukungaboni kahle
- imichilo yesikhumba yemvelo ehlukile;
- i-hemolytic anemia;
- ukwanda kwezinkomba zesibindi;
- thrombo-, leuko-, erythro-, granulocytopenia;
- ikhanda kanye nesiyezi;
- ukuncishiswa kwengcindezi;
- ubuthakathaka, ukunganaki, ukozela, ukukhathazeka;
- i-cholestatic jaundice;
- ukugcinwa kwamanzi emzimbeni;
- ukwethuka kwe-anaphylactic.
Nge-degree ethambile / elinganiselwe ye-hypoglycemia, isiguli sithatha amagremu ama-20-30 eglucose. Esikhathini esizayo, umthamo uyalungiswa futhi ukudla kuyabuyekezwa.
Ezimweni ezibucayi, ezihambisana nokuphefumula nokuqubula, ushukela uphethwe ngaphakathi. Ngaphezu kwalokho, i-glucagon ingahle iphathwe ngokuhlinzwa noma nge-intramuscularly. Ngemuva kokumisa i-hypoglycemia kungakapheli izinsuku ezimbili, izinkomba ziqashwa kusetshenziswa i-glucometer.
Izici zohlelo lokusebenza
Ngaphambi kokuhlela ukukhulelwa, kufanele ulahle i-chlorpropamide. Ukulawulwa kwesifo sikashukela sohlobo 2 nge-insulin kubhekwa njengekhambi elilungile. Ngesikhathi sokukhishwa, banamathela ezimisweni ezifanayo.
Ukudlulisela kulo muthi kwenziwa kusuka engxenyeni yethebhulethi ngosuku, bese kubekelwa kuyo ithebhulethi yokuqala. Iziguli ezinokukhubazeka kwe-renal / hepatic function zizodinga ukulungiswa komthamo. Lapho unquma umthamo wezidakamizwa kubantu asebekhulile, iminyaka yabo iyabhekwa.
Lapho kunxephezela lesi sifo, kunciphisa umthamo kuyadingeka. Ukulungiswa kwenziwa futhi nangoshintsho kwesisindo somzimba, imithwalo, kudlulela kwenye indawo yesikhathi.
Ngenxa yokuntuleka kolwazi ngokuphepha kokusetshenziswa, umuthi awubekelwe izingane. Uma kwenzeka ukulimala, ngaphambi / ngemuva kokuhlinzwa, ngesikhathi sezifo ezithathelwanayo, isiguli sidluliselwa okwesikhashana ku-insulin.
Musa ukusebenzisa ne Bozetan. Kunobufakazi bokuthi zithinte kabi iziguli ezithola i-chlorpropamide. Baphawule ukwanda kwama-hepatic indices (ama-enzyme). Ngokuya ngezakhiwo zombili lezi zidakamizwa, indlela yokuphuma kwe-asidi acid evela kumaseli iyancishiswa. Lokhu kufaka ukunqwabelana kwabo, okuholela kumphumela onobuthi.
Ukuxhumana neminye imithi
IBiguanide Metformin
Ngokusebenzisa kanyekanye i-chlorpropamide neminye imithi, umphumela wayo ungancipha noma ukhuphuke. Ukubonisana okuphoqelekile ngaphambi kokuthatha eminye imithi.
Ukwandisa izidakamizwa action kwenzeka uma coadministered nge-insulin, nezinye izidakamizwa hypoglycemic, biguanides, coumarin okunye, Phenylbutazone, izidakamizwa tetracycline, mao inhibitor, fibrates, salicylates, miconazole, streroidami, ama-hormone wesilisa, cytostatics, sulfonamides, quinolone okunye, clofibrate, sulfinpyrazone.
Izidakamizwa ezilandelayo zenza buthaka umphumela we-chlorpropamide: ama-barbiturates, ama-diuretics, ama-adrenostimulants, ama-estrogens, ama-tableet contracepital, imithamo emikhulu ye-nicotinic acid, i-diazoxide, ama-hormone e-thyroid, i-phenytoin, i-glucocorticosteroids, i-sympathomimetics, i-phenothiazine.
I-Chlorpropamide yi-ejenti ye-hypoglycemic ebhekise kokutholwa kwesizukulwane sokuqala se-sulfonylurea. Uma kuqhathaniswa nabalandeli bayo, inezinga eliphansi lokunciphisa ushukela kanye nemiphumela emibi ethe xaxa. Okwamanje, umuthi awusetshenziswa.
