Glibenclamide - umarnin kan abin da ke da haɗari da kuma waɗanda suke musanyawa

Glibenclamide shine mafi mashahuri kuma wanda aka samo asali na sulfonylurea wanda aka samo asali tare da kaddarorin rage sukari. A shekara ta 2010, an ba shi lambar yabo ta babbar Kreutzfeld, wacce aka bayar don nasarar magunguna. Magungunan sun cika dacewa da tsayayyen ƙa'idodi da kwamitin zaɓin ya sanya, an tabbatar da ingancinsa ta shekaru da yawa na bincike da kuma aikin asibiti.

Kusan magunguna na iya yin alfahari da lura na shekaru 20 da yin cikakken nazari game da jinkirta tasirin amfani da shi. Lowarancin farashin kwayoyin yana rage yawan kuɗaɗe na lura da masu cutar siga. Dangane da ka'idodin farashi mai sauƙi da tasiri, an saka glibenclamide cikin jerin mahimman magungunan da ake amfani da su don ciwon sukari. Bayan shi, Metformin da insulin ne kawai aka basu irin wannan girmamawa.

Alamu don alƙawari

Nau'in nau'in ciwon suga shine cuta mai ci gaba wanda ke buƙatar magani. Ko da a cikin yanayin ingantaccen iko na glycemic, aikin ƙwayoyin beta a hankali suna ƙaruwa a cikin marasa lafiya kuma ƙara yawan haɓakar insulin a cikinsu yana raguwa. Tare da sukari mai ɗorewa koda yaushe, ana lalata matakan lalata sel. Za'a iya gano canje-canje na farko a cikin ɓoye insulin a lokacin ganewar asali. A cikin wasu marasa lafiya, ba su shafar matakin sukari sosai, kuma don rama ciwon sukari, kawai abincin da ya dace, metformin da ilimin jiki sun isa.

Masu ciwon sukari, waɗanda a cikin sel masu ƙoshin lafiya ba su da ikon yin aiki don kansu da kuma ga 'yan uwan ​​matattu, dole ne su tsara bayanan sirri. Suna ƙarfafa aikin insulin, suna sa sel suyi aiki sosai.

Lokacin da aka wajabta glibenclamide:

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%

1. Ana amfani da miyagun ƙwayoyi a matsayin ɗaya daga cikin manyan asirin sirri, saboda haka an nuna shi ga marasa lafiya da masu ciwon sukari tare da rage yawan kwayar cutar kansa, kamar yadda aka tabbatar da wani babban glycemia a lokacin ganewar asali. Tare da deellensus deellensus na decompensated, haɓakawa baya faruwa nan da nan, glucose a hankali yana raguwa game da makonni 2. Masu fama da cutar siga tare da ƙananan ƙwayar cuta ba su ba da magani kai tsaye bayan kamuwa da cutar sankara.
2. An nuna Glibenclamide don ƙaruwa na jiyya ban da wasu jami'ai. An daɗe da tabbatar da cewa magunguna masu rage ƙwayar sukari da yawa waɗanda ke shafar abubuwan sanadin hauhawar jini daga bangarori daban-daban sun fi ƙarfin ɗaya. Don inganta sarrafawa na rayuwa, ana iya haɗe glibenclamide tare da insulin da kowane allunan rage sukari, banda PSM da yumɓu.

Lokacin da ake rubuta magani, ya kamata a haifa da hankali cewa yana haifar da ƙwayoyin beta don aiki tare da ƙaruwa mai ƙarfi. Dangane da bincike, irin wannan motsa jiki yana haifar da karamin ragi a cikin rayuwar su. Tunda glibenclamide shine mafi karfi a cikin rukunin ta, wannan tasirin da ba'a so shine yafi bayyanar dashi fiye da na zamani PSM. Idan mai ciwon sukari yana ƙoƙarin kula da aikin insulin muddin zai yiwu, magani da glibenclamide ya kamata a jinkirta su a daidai lokacin da magungunan da ke da rauni ba za su ƙara samar da maganin masu ciwon sukari ba.

Yadda glibenclamide ke aiki

Hanyar aikin glibenclamide an fahimci shi sosai kuma an bayyana shi dalla-dalla a cikin umarnin magunguna. Abubuwan sun toshe tashoshin KATF waɗanda ke kan membrane na beta sel, wanda ke haifar da dakatar da potassium a cikin sel, yana raunana yaduwar ƙwayar membrane da kuma shiga cikin ƙwayoyin alli. Increasearuwar ƙwayar ƙwayar calcium a cikin sel yana ƙarfafa aiwatar da sakin insulin daga ciki zuwa cikin ruwan intercellular, sannan kuma zuwa jini. Glucose yana raguwa saboda iyawar insulin don ɗaukar shi daga tasoshin jini zuwa kyallen takarda. Glibenclamide ya fi karfi fiye da sauran PSM yana ɗaure wa masu karɓar beta-cell, saboda haka yana da mafi kyawun tasirin sukari.

Ofarfin maganin yana ƙaruwa tare da kara yawan ƙwayoyi. Sakamakon glibenclamide bai dogara da glycemia ba, miyagun ƙwayoyi suna aiki tare da yawan glucose kuma tare da rashin isasshen, don haka lokacin ɗaukar shi, kuna buƙatar yin hankali kamar yadda zai yiwu kuma a auna sukari lokacin da duk wani alamun kama da hypoglycemic ya faru.

Baya ga babban hypoglycemic, ƙarin tasirin yanki shine halayyar duk PSM. Dangane da umarnin, glibenclamide dan kadan rage insulin juriya na ƙwayoyin tsoka da mai, wanda ke ba da gudummawa ga ƙarin raguwar glucose.

An yi nazarin tasirin cututtukan zuciya da magunguna daban. Ya juya cewa glibenclamide yana da ikon toshe tashoshin KATF ba kawai akan sel na beta ba, har ma akan ƙwayoyin zuciya - cardiomyocytes. A akasi, irin wannan aikin na iya lalacewa sakamakon ciwon zuciya a cikin masu ciwon sukari. A cikin gwaji na asibiti, ba a tabbatar da wannan sakamako ba. Haka kuma, an samo tasirin maganin rigakafi a cikin glibenclamide, wanda ke rage mace-mace a lokacin tsananin ischemia. A cewar likitocin, da yawa daga cikinsu suna jin tsoron rubanya maganin Glibenclamide don kowane cuta na cututtukan zuciya, duk da bayanan bincike.

Shirye-shiryen Glibenclamide

Yawancin masu ciwon sukari sun saba da glibenclamide ta miyagun ƙwayoyi Maninil, wanda aka samar a Jamus ta hanyar Berlin-Chemie. Wannan magani na asali ne, tare da halartar sa an gudanar da adadin ɗimbin karatun da suka yi nazari kan inganci da amincin glibenclamide. Maninil yana da zaɓuɓɓukan sashi guda 3. A cikin allunan 1.75 da 3.5 mg, abu mai aiki yana cikin wani nau'in micronized na musamman, wanda ke ba da izinin rage glycemia tare da ƙananan ƙwayar magani. 5 MG maninyl ya ƙunshi glibenclamide na gargajiya.

Analogs a Rasha su ne:

• Statiglin daga Farmasintez-Tyumen da Glibenclamide daga kamfanin Ozon (reg. Takaddun nasa ne Atoll LLC). Wadannan kwayoyi suna da magunguna iri ɗaya, amma masana'antun ba su bayyana kasancewar ƙwayar glibenclamide a cikin kowane zaɓuɓɓuka ba.
• Allunan magani na Glibenclamide da Moskhimpharmpreparaty suka kirkira, Pharmstandard-Leksredstva, Biosynthesis, Valenta Pharmaceuticals suna da magungunan guda daya na 5 MG. Ana iya raba su don samun rabin kashi na 2.5 MG.

Yana da mahimmanci a sani cewa analogues ne kawai na cikin gida, tunda kamfanoni suna siyan glibenclamide a ƙasashen waje, galibi a Indiya. Iyakar abin da banda shi ne Statiglin, rajista a cikin 2017. Glibenclamide don an samar dashi a Rasha a cikin kamfanin BratskKhimSintez.

Dukkanin alamun ana amfani da Maninil analogues ana gwada su don ƙirar halitta kuma suna da abun da ke kama. Nazarin haƙuri ya nuna cewa waɗannan kwayoyi suna da tasiri daidai, amma har yanzu masu ciwon sukari sun fi son siyan magani na ainihi, saboda shaharar da ya shahara da ƙananan farashin.

Yin hukunci da sake dubawa, hadewar glibenclamide da metformin suma sun shahara sosai. Duk abubuwan guda biyu sune ɓangare na magungunan abubuwa guda biyu Glucovans, Glimecomb, Gluconorm. Metglib, Glibomet da sauransu.

Umarnin don amfani

Umarni don amfani yana ba da shawarar ƙayyade buƙatar glibenclamide daban-daban ga kowane mara lafiya:

1. Matsakaicin farawa mai aminci ba zai wuce 2.5 MG ba, tare da ciwo mai tsanani - 5 MG. An ba da izinin fara magani tare da glibenclamide kawai idan akai-akai sarrafa glycemic zai yiwu kuma kawai kamar yadda aka umurce kuma a ƙarƙashin kulawar likita. Dole ne mu manta cewa miyagun ƙwayoyi na iya haifar da hypoglycemia, gami da mai tsanani. Magunguna a cikin mafi ƙaranci shine ya bugu sau ɗaya a rana, mintina 20 kafin karin kumallo. Ana ɗaukar ƙwayar glibenclamide daidai kafin abinci.
2. Idan matakan sukari ba su koma al'ada ba a cikin mako guda, da sannu-sannu ana ƙaruwa sashi, yana ƙara 1.75-2.5 MG sau ɗaya a mako. A cikin adadin har zuwa 10 MG, glibenclamide ya bugu da safe. Idan ana buƙatar babban sashi don rama don ciwon sukari, ƙwayar ta sha kafin karin kumallo da kuma abincin dare. Umarni da shan glibenclamide kafin lokacin bacci ta hanyar umarnin, saboda yana iya haifar da cututtukan cututtukan daji na nocturnal.
3. Matsakaicin adadin shine allunan 3 na 5 MG. Biyu daga cikinsu suna sha da safe, ɗaya kafin abincin dare.

Side effects

Mitar tasirin da ba a ke so a cikin jiyya tare da Glibenclamide yana da ƙasa. Tare da madaidaicin sashi da yarda da umarnin don amfani, ana samun sakamako masu illa a cikin kusan 1% na masu ciwon sukari, wanda ke nuna babban amincin miyagun ƙwayoyi.

Hypoglycemia da nauyi riba sakamakon rashin abinci mai gina jiki da yawaitar glibenclamide. A cewar masu ciwon sukari, idan ka karkada tsarin abincin ka, ka kirga yawan adadin carbohydrates a kowane abinci, kar ka tsallake abinci, ka shirya abun ciye-ciye yayin motsa jiki na tsawaitawa, za a iya rage hadarin wadannan tasirin.

Ga wanda liyafar aka contraindicated

Koyarwar ta gabatar da dokar hana shan Glibenclamide Allunan a wadannan lamura:

• idan miyagun ƙwayoyi ko kwayoyi masu amfani da ita suna da wata alerji;
• lokacin da mai ciwon sukari ya rasa ƙwayoyin beta (nau'in 1 na ciwon sukari, kamannin ciwon huhu);
• a cikin yanayin mummunar lalacewa na ciwon sukari mellitus tare da ketoacidosis ko kuma a cikin haɗari mai tsauri saboda mummunan raunin da cututtuka;
• tare da matsanancin na koda da rashin hepatic;
• idan akwai rashin haƙuri a cikin lactose, wanda yake ƙunshe a cikin magani azaman kayan taimako;
• yayin daukar ciki, lactation;
• a cikin yara masu ciwon sukari.

Tare da matsanancin taka tsantsan, ya zama dole don aiwatar da magani don rikicewar hormonal, giya, cututtukan narkewa, cikin tsufa, a babban zazzabi.

Yawan damuwa

Yawan abin sama da yakamata koyaushe yana haifar da cututtukan jini. A matakin farko, ana iya kawar da shi ta hanyar karin maganin gubar glucose. Idan hypoglycemia ya tsananta, koyarwar tana bada shawarar yin amfani da glucagon. A lokaci guda, masu ciwon sukari suna buƙatar kulawar likita ta gaggawa. Tare da mummunar ƙwayar magunguna Glibenclamide, sukari yakan faɗi sau da yawa yayin rana, saboda haka an allurar da mai tare da maganin glucose a cikin ciki kuma yana kula da yanayin.

Glibenclamide analogs da maye gurbinsu

Abubuwan kusa kusa da analogues na glibenclamide sune sauran abubuwan da ake amfani da su na sulfonylureas. A halin yanzu, ana amfani da glyclazide, glimepiride, glycidone ba sau da yawa.

Mafi yawan araha glibenclamide kwamfutar hannu madadin:

Gliptins, wanda kuma ke haifar da aikin insulin, sunada tsada glibenclamide analogues. Glyptins wani ɓangare ne na Januvii, Ongliza, Xelevia, Galvus, Trazhenty, farashin magani yana akalla 1,500 rubles. da wata. Wadannan kwayoyi kusan ba sa haifar da hypoglycemia, ba su ba da gudummawa ga lalata ƙwayoyin beta, amma kada ku rage sukari da sauri kamar glibenclamide. Dangane da sake dubawa, glyptins yana ba da sakamako mafi kyau tare da farko ba shi da ƙarfi sosai.

Farashi a cikin kantin magani

Maninil wanda ke ɗauke da ƙwayoyin glibenclamide micronized 130-160 rubles. kowace fakiti tare da allunan 120. Maninil 5 MG zai zama mai rahusa, farashin fakitin kusan 120 rubles. Kudin analogues na gida har ma da ƙananan: daga 26 rubles. don 50 Allunan ko 92 rubles. na allunan 120. Don haka, har ma da matsakaicin sashi, farashin magani bai wuce 100 rubles ba. da wata.

Za'a iya samun magani Glibenclamide kyauta a kowane yanki na Rasha, idan mai haƙuri yana da ciwon sukari na mellitus, kuma ya yi rajista tare da endocrinologist.

Nazarin masu ciwon sukari