Wakili mai rage sukari: Glibenclamide

Glibenclamide magani ne tare da kaddarorin hypoglycemic daga aji na ƙarni na biyu na abubuwan samo asali na sulfonylurea. Hakanan yana da tasiri a cikin jini da rage haɗarin ƙwayar jijiyoyin bugun jini.

Babban halayyar mutum

Sunan miyagun ƙwayoyi Glibenclamide a cikin tsarin duniya a Latin shine Glibenclamide. A waje, maganin yana maganin kwayar ruwan hoda mai haske ta hanyar diski tare da layin rabawa. Mai rufin na iya samun tsarin marmara tare da ƙananan inclusions.

Allunan Allunan a blisters na 10 guda. A cikin akwatin guda ɗaya za'a iya samun kusan faranti 12.

Ana fitar da Glibenclamide ta hanyar takardar sayan magani, adana shi a cikin yanayi na al'ada, ba tare da yara ba. Umarnin ya bayyana rayuwar shiryayye na miyagun ƙwayoyi - 5 years. Kada magunguna masu ƙarewa kar a sha.

Kowane kwamfutar hannu ta ƙunshi 5 MG na glibenclamide da tsofaffi a cikin nau'i na lactose monohydrate, sitaci dankalin turawa, stenes magnesium, polyvinylpyrrolidone, E 124.

Kamfanonin magungunan cikin gida sun samar da wakilin rage sukari:

• Anti rigakafi;
• Akrikhin HFK;
• Bivitech;
• AlDA Pharma;
• Biosynthesis

An ƙaddamar da shi da kamfanin na Yukren. Don Glibenclamide, farashin a cikin sarkar kantin magani na Rasha shine 270-350 rubles.

Abubuwan da ke tattare da magunguna

Pharmacodynamics na miyagun ƙwayoyi

Oral hypoglycemic magani. A Glibenclamide, hanyar aiwatar da aiki ya dogara ne akan kuzarin samar da insulin ta hanyar ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin cuta. A lokaci guda, jurewar insulin na kyallen mahaifa yana raguwa. Magungunan suna aiki idan akwai isasshen β-sel a cikin ƙwayar da ke haifar da ƙwayoyin ciki. Yana rage yawan magunguna da tari.

Halayen Pharmacokinetic

Daga cikin jijiyoyin mahaifa bayan sarrafa bakin a kan komai a ciki, ana shan maganin da sauri, yana ɗaukar garkuwar jini da kashi 95%. Canji daga abu mai aiki zuwa tsaka tsaki metabolites ana aiwatar dashi a cikin hanta. Excretion ana sarrafa shi ta hanjin kodan da bututun bile. Rabin-rayuwa daga jinin haila daga karfe daya da rabi zuwa uku da rabi. Sugar yana sarrafa kashi ɗaya na miyagun ƙwayoyi na akalla awanni 12.

Tare da cututtukan cututtukan hepatic, an hana amfani da magungunan ƙwayar cuta. Idan aka bayyana gazawar hanta a wani rauni, wannan ba ya shafar tsarin fitar da metabolites; a cikin mafi tsananin yanayi, ba a cire tarin su ba.

Wanene aka nuna Glibenclamide

An inganta hypoglycemic ga masu ciwon sukari tare da nau'in cuta ta biyu. Bayar da magani, idan aka ba da ƙarancin abinci mai gina jiki da nauyin tsoka ba su bayar da sakamakon da ake so.

Dosages da jiyya

Ana bada shawarar Glibenclamide don amfani dashi nan da nan bayan abinci. A endocrinologist lissafi da kashi dangane da sakamakon gwajin jini ga sukari, da shekaru haƙuri, da tsananin cutar muhimmi, concomitant pathologies da general kiwon lafiya.

A matakin farko na cutar, daidaitaccen ma'aunin shine 2.5-5 mg / rana. Theauki maganin sau ɗaya bayan karin kumallo. Idan ba a iya samun cikakken biyan diyya ga ƙwayar cuta ba, likita na iya daidaita sashi ta hanyar ƙara 2.5 MG na miyagun ƙwayoyi bayan mako guda. Matsakaicin gefe (har zuwa 15 mg / rana) daidai yake da allunan uku. Matsakaicin matsakaici ba a ƙaddara shi ba, kuma babu wani ƙaruwa mai yawa a cikin glycemia.

Idan mai ciwon sukari yana da nauyin jikin ƙasa da kilogiram 50, ana sanya kashi na farko a cikin ƙwayar 2.5, wanda ya dace da rabin kwamfutar hannu. Idan tsarin yau da kullun bai wuce guda biyu ba, sun bugu gaba ɗaya da safe a karin kumallo, a wasu halayen, ana rarraba maganin sau biyu, safe da maraice a cikin rabo na 2: 1.

Lokacin da aka canza Glibenclamide bayan magani mai nasara tare da madadin magungunan hypoglycemic, kashi na farawa zai zama 2.5 MG sau ɗaya, da safe.

Tare da ingantaccen aiki, zaku iya daidaita al'ada kowace mako ta ƙara 2.5 MG.

A cikin taron cewa sakamakon magani tare da wasu magungunan maganin antidiabetic ba su da gamsarwa, yawan farawa zai zama 5 MG da safe, bayan abinci. Idan ya cancanta, ana ba da izinin daidaitawa na 2.5-5 MG kowane mako. Matsakaicin iyaka yana zama iri ɗaya - 15 MG / rana.

Idan matsakaicin matsakaita na yau da kullun na Glibenclamide, yayin lura da karancin abincin abinci da ingantaccen aikin jiki, baya bayar da diyya na kashi 100%, ana tura cutar sankarau zuwa cikakken tsarin kulawa. Babban likitan yana da ƙari tare da biguanides, insulin, da sauran wakilai na hypoglycemic.

Idan endogenous samar da hormone insulin a cikin masu ciwon sukari tare da nau'in cuta ta biyu an shafe shi gaba ɗaya, ƙwaƙƙwarar magani baya bada garantin sakamako guda ɗaya kamar yadda tare da monotherapy tare da shirye-shiryen insulin.

Idan saboda wasu dalilai an rasa lokacin shan Glibenclamide fiye da awa ɗaya ko biyu, ba za ku iya ɗaukar magani a nan gaba ba. Washegari, ɗauki madaidaicin kashi, ba da shawarar kara farashin.

Side effects

Tare da yawan ƙwayar ƙwayar cutar ƙwayar cuta, yanayin hypoglycemic na tsananin wahala mai yiwuwa, gami da coma. Tare da cin zarafin giya da abinci guda ɗaya ko biyu a rana, yawan aiki, matsaloli tare da hanta, glandar thyroid da ƙodan, sakamakon da ba a so shi ma yana yiwuwa.

Contraindications don amfani da magani

Ba a sanya magani na wannan aji ba don masu ciwon sukari tare da nau'in ciwon sukari na farko, har ma da nau'ikan labile, ketoacidosis, coma, ciwon sukari da kuma yanayin da ya gabata.

Ba'a nuna magungunan ga marasa lafiya da cututtukan hanta da kodan ba, idan an rage aikin renal zuwa ƙimar tsarkakewar creatinine a ƙasa 30 ml / min.

Idan mai ciwon sukari yana da tabin hankali, rashin kula da cututtukan thiazide da sulfonamides, likitan yakamata ya yi la’akari da wannan.

A lokacin cututtukan kamuwa da cuta, an sanya wasu kwayoyi, gami da insulin, don rama ciwon suga. Hakanan an nuna cewa maganin insulin don ƙonewa mai yawa, raunin da ya faru, da mummunan aiki, ciki har da kamannin ƙwayar cuta.

Tare da rashin ƙarfi na abubuwan gina jiki, paresis na ciki, toshewar hanji, maganin yana karɓa.

Hakanan an soke Glibenclamine yayin haihuwa da kuma shayarwa.

Cases da yawan abin sama da ya faru na Glibenclamide

Tsarin amfani da sassan magungunan da aka juyar da damuwa yana haifar da mummunan zubar jini, wanda ke da haɗari ga rayuwar wanda aka azabtar.

Ana iya samun sakamako irin wannan tare da yin amfani da miyagun ƙwayoyi dangane da tushen rashin abinci mai gina jiki na yau da kullun, aikin motsa jiki, rinjayar wasu magunguna waɗanda aka ɗauka tare da haɗin Glibenclamide.

Alamun yanayin rashin haila:

• Yunwar da ba a sarrafawa;
• Rage ingancin bacci;
• Rashin tausayi;
• Rushewa;
• Karin gumi;
• Ciwon kai;
• Rashin cutar dyspeptic;
• Rashin hauhawar jini;
• Hannun girgiza;
• Tachycardia.

Bayyanawa a cikin aikin psyche tare da matsalolin endocrine za a iya bayyana su a cikin ruɗani na ruɗani, faɗuwar rana, cramps, alamun rauni, bayyanar da damuwa, bifurcation na mayar da hankali, tsoro yayin tuki da abin hawa ko sarrafa madaidaitan hanyoyin, jihohi masu taƙama, tashin hankali, matsalolin tasoshin jini da gabobin jiki, coma.

Dukansu gabaɗaya kuma a cikin ma'anar kusancin jini, yawan jini zai zama mafi ma'ana idan aka kwatanta da yawan abin da ya sul ya samo asali na sulfanylurea.

Don rage yanayin wanda aka azabtar da shi mai rauni zuwa matsakaici zuwa matsakaici na kai harin, nan da nan za ku iya ɗaukar carbohydrates mai sauri - gumi, rabin gilashin shayi tare da sukari ko ruwan 'ya'yan itace (ba tare da kayan zaki ba). Idan irin waɗannan matakan sun kasa wadatarwa, glucose (40%) ko Dextrose (5-10%) ana allurar cikin jijiya, ana allurar glucagon (1 mg) a cikin tsokoki. Ana iya ɗaukar Diazoxide a baki. Idan wanda aka azabtar ya ɗauki acarbose, za a iya gyara maganin ta da ƙarfi kawai da glucose, amma ba tare da oligosaccharides ba.

Idan wanda aka cutar da hypoglycemia har yanzu yana sane, an wajabta sukari don amfanin ciki. Game da asarar hankali, ana gudanar da glucose iv, glucagon - iv, i / m kuma a karkashin fata. Idan hankali ya dawo, don rigakafin sake dawowa, ya kamata a samar da mai ciwon sukari tare da abinci mai gina jiki dangane da carbohydrates mai sauri.

Ana kulawa da kula da glycemia, pH, creatinine, electrolytes, urea nitrogen a koyaushe.

Siffofin magani tare da glibenclamide

1. Lokacin da aka magance shi da magani, masu ciwon sukari dole ne su bi tsayayyen abinci.
2. A cikin maganganun cututtukan hawan jini, zazzabi, buguwa, an wajabta maganin tare da taka tsantsan.
3. Mai ciwon sukari dole ne ya lura da mahimman sigoginsa koyaushe. Ya kamata a yi rikodin mita na glucose aƙalla sau biyu a rana (mafi dacewa, ana bincika bayanan glycemic 5 sau / rana.). Yakamata a kula da fitsari kullun don kasancewar sugars da acetone.
4. Tare da maganin hemodialysis, rashin abinci bayan shan magani, hauhawar jiki, damuwa, hanta da koda, shan giya, rashin damuwa da rashin ƙarfi, kuma musamman tare da haɗuwa da abubuwan da yawa, haɗarin haɓaka cuta mai yawa wanda ba a sarrafa shi ba yana ƙaruwa. A irin waɗannan yanayi, ana buƙatar saka idanu akai-akai na alamomin glucometer tare da daidaita sikelin na lokaci na maganin.
5. Blo-adrenoreceptor mai hanawa, magunguna waɗanda ke cutar da tsarin juyayi na tsakiya, na iya rufe alamun hypoglycemia.
6. A cikin balagaggen girma, ana bada shawarar maganin a cikin ƙarancin kashi (daga 1 MG / rana), tun da damar samun glycemia a cikin wannan rukunin ya fi hakan saboda raunin ayyukan urinary.
7. A alamomin farko na rashin lafiyan, an soke maganin kuma an tsara maganin antihistamines. A duk tsawon lokacin jiyya, guji zafin zafin rana.
8. Game da mura, huhu, guba, haɓakawa da cututtukan cututtukan fata (cholecystitis, pyelonephritis), bugun zuciya da sauran mummunan yanayin jijiyoyin jiki, NMC, gangrene, da mummunan ayyukan masu ciwon sukari, an canza su zuwa insulin.
9. Gabaɗaya, Glibenclamide baya tasiri kan abin hawa, amma a cikin yanayi na daban (aiki a cikin mawuyacin yanayi, damuwa, tsawo, da dai sauransu), dole ne a kula, tunda yanayin da canje-canje a cikin sukari na jini zai iya ci gaba a kowane lokaci.
10. Dole ne a kula da musamman lokacin da ake canza magunguna, zaɓi mafi kyau duka, da kuma amfani da kwayoyi marasa daidaituwa.

Glibenclamide analogues

A daidai da lambar ATX ta mataki na 4 tare da wasan ƙwayar Glibenclamide wasa:

• Glurenorm;
• Amix;
• Amaryl;
• Gliclazide;
• Maninil;
• Glidiab;
• Glimepiride;
• Mai ciwon sukari.

Kamar yadda ma'anar alamun alamun kasuwanci daban-daban, Glibenclamide ya dace da magungunan Glibex, Gilemal, Glibamide, Glidanil.

Sakamakon Cutar Glibenclamide

Hankalin glimenclamide ya jinkirta, yayin inganta haɓakar ƙarfinsa, azopropanone, miconazole, shirye-shiryen coumaric acid, oxyphenbutazone, magungunan rukuni na sulfonamide, phenylbutazone, sulfapyrazonfeniramidol.

Haɗakarwa da magani tare da madadin magunguna masu rage sukari, kawar da juriya na insulin, yana nuna irin sakamakon.

Tare da amfani da layi daya na amfani da magungunan anabolic, allopurinol, cimetidine, β-adrenergic receptor blockers, cyclophosphamide, guanethidine, clofibric acid, monoamine oxidase inhibitors, sulfonamides tare da tsawaita aiki, salicylates, tetracyclines, barasa, yiwuwar hypoglycemic na asali

Idan barbiturates, chlorpromazine, rifampicin, diazoxide, epinephrine, acetazolamide, sauran magungunan tausayawa, glucocorticosteroids, glucagon, indomethacin, diuretics, gami da acetazolamide, nicotinates (a cikin manyan allurai), phenothiazines, phenytin, the gland contrait , saluretics, gishiri na lithium, babban adadin barasa da laxative, ana rage tasirin glimenclamide.

Sakamakon da ba a iya faɗi ba game da hulɗa tare da amfani da layi daya an nuna su ta hanyar masu adawa da masu karɓar H2.

Nazarin Glibenclamide

A wuraren tattaunawar mahaifa, masu ciwon sukari da likitoci galibi suna tattaunawa kan ingancin hanyoyin magani na magunguna. Wadanda aka wajabta maganin monotherapy a matsayin magani suna koka game da rashin biyan bashin da ke ƙare mai ƙima. Tare da kulawa mai rikitarwa, wasu lura da wuce kima aikin Glibenclamide.

Likitocin sun jaddada cewa zabar mafi kyawun sashi don Glibenclamide, wanda zai ba ka damar kula da lafiyar al'ada na dogon lokaci, yana buƙatar yanayin mutum, yana buƙatar lokaci da kuma lura da karatun ɗakunan glucose na yanayi don yanayi daban-daban na mai haƙuri. A irin waɗannan halayen, ba da shawara na wasiƙa na iya zama ba kawai rashin inganci ba, har ma yana da haɗari.

Bayani game da magani a kan yanar gizon shine don tunani da kuma samarwa, tattara daga hanyoyin da ke akwai kuma ba tushen tushen ganewar asali da magani na kai ba. Ba za ta maye gurbin shawarar likitan dabbobi ba.