Magunguna don masu ciwon sukari Glimepiride: umarni da sake dubawa na haƙuri

Glimepiride (Glimepiride) - mafi zamani na shirye-shiryen sulfonylurea. Tare da ciwon sukari, yana ƙara ƙaddamar da insulin a cikin jini, yana rage glycemia. A karo na farko, Sanofi ya yi amfani da allunan a Amaryl. Yanzu ana samar da kwayoyi tare da wannan abun a duk duniya.

Hakanan ana iya jure glimepiride na Rasha, yana rage sukari sosai, yana haifar da ofarancin sakamako masu illa, kamar allunan farko. Binciken yana nuna kyakkyawan inganci da ƙarancin magunguna na gida, don haka ba abin mamaki bane cewa masu ciwon sukari Glimepiride galibi sun fi son asalin Siril na asali.

Wanene zai nuna glimepiride

Ana bada shawarar miyagun ƙwayoyi don daidaituwa na ƙwayar cutar glycemia kawai a cikin nau'in ciwon sukari na 2. Koyarwar don amfani ba ta ƙayyade lokacin da magani tare da Glimepiride ya barata ba, tun da zaɓin wani takamammen magani kuma gwargwadon nasa shine ƙwarewar likitan halartar. Bari muyi kokarin gano wanda aka nuna wa kwayar cutar Glimepiride.

Ciwon sukari ya tashi sama saboda dalilai biyu: saboda juriya da insulin da raguwar sakin insulin daga sel beta da ke cikin farji. Jurewar insulin yana tasowa tun kafin halarta na farko na ciwon sukari, ana iya samun shi a cikin marasa lafiya tare da kiba da masu ciwon suga. Dalilin shine ƙarancin abinci mai gina jiki, rashin motsa jiki, kiba. Wannan halin yana haɗuwa da haɓakar insulin, ta wannan hanyar jiki yana ƙoƙarin shawo kan juriya daga sel kuma tsabtace jinin wucewar glucose. A wannan lokacin, hanyar da ta dace shine canza zuwa rayuwa mai kyau da kuma tsara metformin, magani ne wanda ke rage juriya ga insulin.

Higherarin cutar glycemia na haƙuri, mafi yawan ƙwayar cutar sankara na ci gaba. Rashin damuwa na farko yana da alaƙa tare da raguwa cikin ɓoye insulin, kuma hyperglycemia sake faruwa a cikin mai haƙuri. A cewar likitocin, a cikin binciken cutar sankara, ana samun karancin insulin a kusan rabin marasa lafiya. A wannan mataki na cutar, ban da insulin, dole ne a tsara magunguna waɗanda ke motsa aikin aikin ƙwayoyin beta. Mafi inganci da araha daga cikinsu sune abubuwan da ake amfani da su na sulfonylurea, wanda aka rage shi PSM.

Ciwon sukari da hauhawar jini zai zama abin da ya wuce

• Normalization na sukari -95%
• Cirewa kan jijiyoyin mara wuya - 70%
• Cire zuciyar mai karfin zuciya -90%
• Rabu da cutar hawan jini - 92%
• Increasearuwar kuzarin rana, inganta bacci da dare -97%

Nazarin Gwanaye

Arkady Alexandrovich

Endocrinologist tare da gwaninta

Tambaye gwani a tambaya

Glimepiride shine magani mafi inganci na zamani kuma mai lafiya daga ƙungiyar PSM. Ya kasance na sabon zamani kuma an ba da shawarar don amfani da ƙungiyoyin endocrinological a duniya.

Dangane da abubuwan da muka gabata, zamu haskaka alamomi game da nadin maganin Glimepiride:

1. Rashin ingancin abinci, motsa jiki da metformin.
2. An tabbatar da shi ta hanyar nazarin karancin insulin nasu.

Umarni yana ba da damar amfani da miyagun ƙwayoyi Glimepiride tare da insulin da metformin. Dangane da sake dubawa, miyagun ƙwayoyi kuma suna da kyau tare da glitazones, gliptins, incretin mimetics, acarbose.

Hanyar aiwatar da maganin

Addamar da insulin daga ƙwayar cikin ƙwayar jini yana yiwuwa saboda tashoshin KATP na musamman. Suna nan a cikin kowane sel mai rai kuma suna samar da kwararar potassium ta membrane. Lokacin da taro na glucose a cikin tasoshin ya kasance a cikin iyakoki na al'ada, waɗannan tashoshi akan sel na buɗe. Tare da haɓakar ƙwayar cutar glycemia, suna rufe, wanda ke haifar da mamayar adadin kuzari, sannan sakin insulin.

Magungunan Glimepiride da duk sauran tashoshi masu rufe tasirin tasirin tashoshi mai suna PSM, hakan zai kara samarda insulin da kuma rufin asiri. Yawan adadin hormone da aka saki a cikin jini ya dogara ne kawai akan sashi na glimepiride, kuma ba kan matakin glucose ba.

A cikin 'yan shekarun da suka gabata, ƙarni 3, ko sake sabuwa, na PSM an ƙirƙira su kuma an gwada su. Ayyukan ƙwayoyin ƙarni na 1, chlorpropamide da tolbutamide, sun rinjayi wasu kwayoyi masu ciwon sukari, wanda sau da yawa suna haifar da mummunan rashin lafiyar da ake iya faɗi. Tare da zuwan ƙarni na PSM 2, glibenclamide, glyclazide da glipizide, an magance wannan matsalar. Suna hulɗa tare da wasu abubuwa masu rauni sosai fiye da PSM na farko. Amma waɗannan kwayoyi kuma suna da gazawa da yawa: idan akwai wani batun cin mutuncin abinci da abubuwan lodi, suna haifar da hauhawar jini, suna haifar da hauhawar nauyin nauyi, sabili da haka, haɓakar insulin juriya. A cewar wasu nazarin, ƙarni na 2 na PSM na iya yin tasiri ga aikin zuciya.

Lokacin ƙirƙirar ƙwayar Glimepiride, an yi la'akari da tasirin sakamako masu zuwa. Sunyi nasarar rage su a cikin sabon shiri.

Amfanin Glimepiride akan PSM na al'ummomin da suka gabata:

1. Hadarin hypoglycemia lokacin da aka ɗauka yana da ƙasa. Haɗin magungunan tare da masu karɓa ba shi da tabbatuwa kamar na analogues na rukuni, ƙari, jiki yana ɗaukar matakan da ke hana haɗarin insulin tare da ƙarancin glucose. Lokacin kunna wasanni, rashin carbohydrates a cikin abinci, glimepiride yana haifar da hypoglycemia milder fiye da sauran PSM. Abubuwan lura sun nuna cewa sukari yayin shan allunan glimepiride ya faɗi ƙasa da ke al'ada a cikin 0.3% na masu ciwon sukari.
2. Babu tasiri akan nauyi. Yawan wuce haddi a cikin jini yana hana fashewar kitse, yawan kiba a jiki yana kawo yawan ci da kuma yawan caloric. Glimepiride amintacce ne a wannan batun. A cewar marasa lafiya, ba ya haifar da hauhawar nauyi, kuma tare da kiba shi ma yana ba da taimako ga asarar nauyi.
3. Rashin haɗarin cutar zuciya. PSM sun sami damar yin hulɗa tare da tashoshin KATP waɗanda ba kawai a cikin hanji ba, har ma a bango na jijiyoyin jini, suna ƙara haɗarin cututtukan cututtukan su. Magungunan glimepiride yana aiki ne kawai a cikin ƙwayar cuta, saboda haka an ba shi izuwa ga masu ciwon sukari tare da angiopathy da cututtukan zuciya.
4. Umarnin yana nuna iyawar Glimepiride don rage juriya na insulin, ƙara sautin glycogen, da kuma toshe abubuwan glucose. Wannan aikin yana da rauni sosai fiye da metformin, amma ya fi sauran PSM ƙarfi.
5. Magungunan suna aiki da sauri fiye da analogues, zaɓin sashi da cin nasarar rama ga masu ciwon sukari suna ɗaukar lokaci kaɗan.
6. Allunan Glimepiride suna ta da bangarorin insulin guda biyu, saboda haka, suna rage glycemia da sauri bayan cin abinci. Tsofaffin kwayoyi suna aiki da farko a cikin lokaci 2.

Sashi

Matsayi da aka yarda gaba ɗaya na glimepiride, wanda masana'antun ke biye dashi, shine 1, 2, 3, 4 MG na kayan aiki a cikin kwamfutar hannu. Kuna iya zaɓar adadin da ya dace na miyagun ƙwayoyi tare da babban inganci, idan ya cancanta, kashi yana da sauƙin canzawa. A matsayinka na mai mulki, an shirya kwamfutar hannu tare da haɗari, wanda zai baka damar raba shi a rabi.

Tasirin rage ƙwayar sukari na miyagun ƙwayoyi yana ƙaruwa lokaci guda tare da karuwa a kashi daga 1 zuwa 8 MG. A cewar masu ciwon sukari, yawancin mutane suna buƙatar kawai 4 MG ko ofasa da glimepiride don rama don ciwon sukari. Babban sashi mai yiwuwa ne a cikin marasa lafiya da ke fama da cutar sikari da kuma juriya da insulin juriya. Ya kamata su hankali su ragu yayin da jihar ke daidaita - inganta haɓakar insulin, rasa nauyi, da canza salon rayuwa.

Ana sa ran raguwa a cikin glycemia (ƙididdigar matsakaici bisa ga binciken):

Bayani daga umarnin akan jerin zabi na abinda ake so:

1. Maganin farawa shine 1 MG. Yawancin lokaci ya isa ga masu ciwon sukari tare da ɗan ƙaramin glucose mai ɗan ƙaraɗa, da kuma ga marasa lafiya da gazawar koda. Cututtukan hanta ba su shafar girman kashi.
2. Yawan kwamfutoci yana ƙaruwa har sai an cimma maƙasudin sukari. Don hana hypoglycemia, sashi yana karuwa a hankali, a tsakanin tsaran makonni biyu. A wannan lokacin, ana buƙatar ƙarin ma'aunin mitar glycemia fiye da yadda aka saba.
3. Tsarin girma na dige: har zuwa 4 MG, ƙara 1 MG, bayan - 2 MG. Da zarar glucose ya isa al'ada, dakatar da ƙara yawan allunan.
4. Matsakaicin da aka yarda da shi shine 8 MG, an kasu kashi da yawa: 2 zuwa 4 MG ko 3; 3 da 2 MG.

Cikakkun umarnin don amfani

Babban tasirin maganin yana faruwa ne bayan kimanin awanni 2 daga gudanarwarsa. A wannan lokacin, glycemia na iya raguwa kaɗan. Dangane da haka, idan kun sha Glimepiride sau ɗaya a rana, irin wannan ganiya zai zama ɗaya, idan kuka rarraba kashi sau 2, ganiya zai zama biyu, amma zai fi sauƙi. Sanin wannan yanayin na miyagun ƙwayoyi, zaku iya zaɓar lokacin shigarwar. Yana da kyau Peak na aiki ya faɗi akan lokaci bayan cikakken cin abinci wanda ya ƙunshi jinkirin carbohydrates, kuma baya haɗuwa da aikin motsa jiki da aka shirya.

Rashin daidaituwa ko rashin abinci mai gina jiki, babban aiki tare da isasshen amfani da carbohydrates, mummunan cututtuka, rikicewar endocrine, wasu kwayoyi suna kara haɗarin hauhawar jini.

Yin hulɗa da miyagun ƙwayoyi bisa ga umarnin:

Siffofin shan yara da mata masu juna biyu

Lokacin amfani dashi lokacin daukar ciki, ƙwayar Glimepiride tana shiga jinin tayi kuma zai iya haifar da hypoglycemia a ciki. Hakanan, sinadarin ya shiga cikin madarar nono, kuma daga nan ya shiga narkewar jikin jariri. A lokacin daukar ciki da HB, shan Glimepiride an haramta shi sosai. FDA (Gudanar da Magungunan Magungunan Amurka) ta ware Glimepiride a matsayin aji na C. Wannan yana nuna cewa nazarin dabbobi ya nuna cewa wannan abu yana da mummunar tasiri a tayin.

Ba a sanya wa Glimepiride yara ba, koda kuwa sun kamu da ciwon sukari na 2. Magungunan ba su ƙaddamar da gwaje-gwaje masu mahimmanci ba, sakamakonsa akan kwayoyin da ke girma ba a yi nazari ba.

Jerin sakamako masu illa

Babban mummunan tasirin cutar Glimepiride shine hypoglycemia. Dangane da gwaje-gwaje, haɗarinsa ya fi ƙasa da na PSM ƙarfi - glibenclamide. Ruwan sukari, wanda ya haifar da zuwa asibiti kuma ana buƙatar raguwa tare da glucose, a cikin marasa lafiya akan Glimepiride - raka'a 0.86 a cikin shekaru 1000 mutum. Idan aka kwatanta da glibenclamide, wannan alamar ta ninka sau 6.5. Amfani da rashin tabbas na miyagun ƙwayoyi shine ƙananan haɗarin hauhawar jini yayin aiki ko tsawaita aiki.

Sauran mahimman tasirin glimepiride daga umarnin don amfani:

Akwai kuma saƙo game da yiwuwar ruɓewa mai narkewar ƙwayar antidiuretic. Ana gwada gwada wannan sakamako, don haka ba a cikin umarnin ba.

Za a iya samun yawan abin sama da ya kamata

Ko yaya zamani da m magani ne Glimepiride, shi har yanzu ya kasance wani abu wanda yake haifar da maganin saƙar jini, wanda ke nufin cewa yawan ƙarfinsa yana haifar da hauhawar jini. Wannan sakamako na gefen yana da asali a cikin hanyar maganin, ana iya magance shi ta hanyar lura da sashi sosai.

Dokar hana rigakafin hypoglycemia daga umarnin don amfani: idan an rasa kwamfutar hannu ta Glimepiride, ko kuma babu wani tabbaci cewa an bugu da ƙwayoyi, bai kamata a ƙara yawan kashi a kashi na gaba ba, koda kuwa jinin sukari ya tashi.

Za'a iya tsayar da hypoglycemia tare da glucose - ruwan 'ya'yan itace mai zaki, shayi ko sukari. Ba lallai ba ne a jira alamun halayen, isasshen bayanan glycemic. Tun da miyagun ƙwayoyi yana aiki na kusan a rana, sukari da aka mayar da shi al'ada na iya raguwa akai-akai zuwa lambobin haɗari. Duk wannan lokacin da kuke buƙatar saka idanu game da glycemia, kada ku bar mai ciwon sukari shi kadai.

Strongaukar ƙarin maye lokaci ɗaya, tsawaita amfani da manyan allurai na glimepiride suna haɗari ga rayuwa. A cikin haƙuri tare da ciwon sukari, asarar hankali, raunin jijiyoyin jini, yiwuwar cutar hypoglycemic mai yiwuwa. A cikin lokuta masu rauni, saukad da sukari a cikin sukari na iya wuce kwanaki.

Doaukar overdose - lavage na ciki, abubuwan narkewa, maido da normoglycemia ta hanyar shigar da glucose a cikin jijiya.

Contraindications

A wasu halaye, shan maganin Glimepiride na iya zama cutarwa ga lafiyar:

• HS, shekarun yara;
• ciki, ciwon suga na ciki;
• a cikin siffofin mai tsanani na hepatic ko na koda maye. Ba a yi amfani da allunan glimepiride a cikin marasa lafiyar dialysis ba;
• tabbatar da nau'in ciwon sukari na 1. Idan aka gano nau'ikan cututtukan cututtukan cututtukan fata (Modi, latent), alƙawarin da ƙwayar glimepiride yana yiwuwa;
• m rikitarwa na ciwon sukari. Ya kamata a kawar da cututtukan cututtukan jini kafin ɗaukar kwaya ta gaba. Ga kowane nau'in ciwon sukari com da precom, duk shirye-shiryen kwamfutar an soke su;
• idan mai ciwon sukari yana da rashin lafiyan kowane ɗayan sinadarin kwamfutar hannu, halayen anaphylactic zai yiwu tare da ci gaba da amfani;
• saboda gaskiyar cewa abubuwan da ke cikin allunan sun hada da lactose, marasa lafiya zasu iya ɗaukar su ta hanyar rashin lafiyar gado.

Koyarwar ta ba da shawarar kulawa ta musamman a farkon jiyya tare da glimepiride, a matakin zaɓin kashi, lokacin da ake canza abinci ko salon rayuwa. Hyperglycemia na iya haifar da raunin da ya faru, cututtukan da ke haifar da kumburi, musamman waɗanda ke haɗuwa da zazzabi. A cikin lokacin dawo da su, akasin haka, rashin lafiyar hypoglycemia mai yiwuwa ne.

Cututtukan narkewa na iya canza tasirin allunan idan shaye yana da damuwa. Rashin ƙwayar cuta na glucose-6-phosphate dehydrogenase lokacin shan miyagun ƙwayoyi Glimepiride na iya ƙaruwa.

Glimepiride analogues

Akwai analogues a Russia rajista a cikin rajista na magunguna:

Dangane da sake dubawar masu ciwon sukari, analolo masu inganci na Amaril sune Glimepiride-Teva da Glimepiride samar. Sauran abubuwan da aka gano a cikin magunguna suna da ɗanɗano.

Glimepiride ko Diabeton - wanda yafi kyau

Abubuwan da ke aiki a cikin Diabeton shine gliclazide, PSM 2 tsara. Kwamfutar hannu tana da tsari na musamman, wanda ke samar da kwararar ƙwayoyi a hankali a cikin jini. Sakamakon wannan, Diabeton MV ba shi da wataƙila zai iya haifar da hypoglycemia fiye da gliclazide na yau da kullun. Daga cikin dukkanin wadatar PSM, shi ne ingantaccen glyclazide da glimepiride waɗanda endocrinologists suna ba da shawarar a matsayin mafi aminci. Suna da sakamako mai kama da sukari a cikin kwatankwacin digo (1-6 mg don glimepiride, 30-120 mg don gliclazide). Mitar yawan cututtukan jini a cikin wadannan kwayoyi ma yana kusa.

Mai ciwon sukari da Glimepiride suna da ɗan bambance-bambance. Mafi mahimmancin su sune:

1. Glimepiride yana da alamar ƙananan rabo na haɓaka insulin / raguwa a cikin glucose - 0.03. A cikin ciwon sukari, wannan nuni shine 0.07. Saboda gaskiyar cewa lokacin shan allunan glimepiride, ana samar da insulin ƙasa kaɗan, masu ciwon sukari sun rasa nauyi, juriya na insulin ya ragu, kuma ƙwayoyin beta suna aiki tsawon lokaci.
2. Akwai bayanai daga nazarin da ke tabbatar da ci gaba a cikin yanayin marasa lafiya da ke dauke da cututtukan cututtukan zuciya bayan sauyawa daga Diabeton zuwa Glimepiride.
3. A cikin marasa lafiya suna shan metformin tare da glimepiride, mace-mace ta ɗan ƙanƙanta fiye da masu ciwon sukari waɗanda ke wajabta magani tare da gliclazide + metformin.

Glimepiride ko Amaryl - wanda yafi kyau

Amaril wani magani ne na asali wanda ɗayan shugabannin ke cikin kasuwancin magungunan hana ƙwaƙwalwar ƙwayar cuta, damuwa Sanofi. Dukkanin karatun da aka ambata a sama an gudanar dasu tare da halartar wannan magani.

Hakanan, ana samar da shirye-shiryen glimepiride a karkashin sunayen iri guda guda daga kamfanonin Rasha guda biyar. Abubuwan halittar jini ne, ko analogues, suna da tsari iri ɗaya ko kuma irin kamanninsu. Dukkansu sun fi rahusa da Amaril. Bambanci a farashin ya faru ne saboda gaskiyar cewa waɗannan magungunan ba su wuce duk gwaje-gwajen da ake buƙata don yin rajistar sabon magani ba. Hanyar da aka yiwa tsarin halitta, a saukake, ya isa ga mai ƙira ya tabbatar da daidaituwar ƙwaƙwalwar ƙwayoyin kwamfutocinsa zuwa asalin Amaril. Matsayin tsarkakewa, tsofaffi, nau'in kwamfutar hannu na iya bambanta.

Duk da cewa sake dubawa game da Amaril da Glimepirides na Rasha kusan iri ɗaya ne, akwai masu ciwon sukari da suka fi son magunguna na asali kawai. Idan akwai tuhuma cewa jana'izar na iya yin muni, zai fi kyau a sayi Amaril, tunda dogaro ga magani da aka tsara yana da matukar muhimmanci. Tasirin placebo yana shafar kowannenmu kuma yana da tasiri kai tsaye ga rayuwarmu.

Farashi da adanawa

Farashin kayan kwalliya, farashi 4 mg:

Samun Ozone da Pharmproject daga St. Petersburg ne ke haifar da ƙananan ƙoshin analogues. Duk kamfanonin biyu suna siyan magungunan ne daga kamfanonin magunguna na Indiya.

Rayuwar shiryayye na masana'antun daban-daban ya bambanta kuma shine shekaru 2 ko 3. Abubuwan buƙatun don zazzabi ajiya iri ɗaya ne - ba su wuce digiri 25 ba.

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