Dokokin Amaril na miyagun ƙwayoyi don amfani yana ba da kimantawa azaman magani na sabon ƙarni na magunguna don magance cututtukan type 2. Ofayan abin da ya fi dacewa a yau shine Glibenclamide-HB-419 daga ƙungiyar sulfonylurea. Fiye da rabin masu ciwon sukari tare da nau'in na biyu sun dandana shi.
Halayen magunguna na maganin
Amaryl wani ƙwayar cuta ce ta hypoglycemic wacce ke taimaka wajan sarrafa ƙoshin plasma. Abubuwan da ke aiki mai amfani da ƙwayar cuta shine glimepiride. Kamar wanda ya riga shi, Glibenclamide, Amaril shima ya fito ne daga rukunin sulfonylurea, wanda ke haɓaka aikin insulin daga ƙwayoyin ƙwayoyin ƙwayoyin ƙwayoyin cuta na Langerhans.
Don cimma sakamakon da aka yi niyya, suna toshe tashar potassium na ATP tare da ƙara ji. Lokacin da sulfonylurea ya ɗaura wa masu karɓa waɗanda ke kan membran-b-cell, ayyukan aikin K-AT ya canza. Tarewa da tashoshi na alli tare da haɓakawa a cikin ATP / ADP a cikin cytoplasm yana tsokani membrane depolarization. Wannan yana ba da gudummawa ga sakin hanyoyin kalifa da haɓakar maida hankali akan ƙwayoyin cytosolic.
Sakamakon irin wannan rudani na exocytosis na manyan bayanan sirri, wanda shine hanzarin ƙwayar mahadi zuwa cikin matsakaici tsakanin sel, zai zama sakin insulin cikin jini.
Glimepiride wakili ne na ƙarni na 3 na sulfonylureas. Yana ƙarfafa sakin ƙwayar tsoka da sauri, kuma yana inganta haɓakar insulin na furotin da ƙwayoyin lipid.
Abubuwan kyallen takarda na cikin gida suna amfani da glucose sosai ta amfani da abubuwan kariya daga jigilar kwayar halitta. Tare da nau'in ciwon sukari-mai zaman kanta, sauyawa na canza sukari zuwa kyallen takarda yana raguwa. Glimepiride yana haɓaka ƙaruwar kariyar sunadarai da inganta ayyukan su. Irin wannan sakamako mai tasirin gaske yana taimakawa rage karfin jurewar insulin (rashin hankali) ga kwayar.
Amaryl yana hana ayyukan glucogen ta hanta saboda karuwa a cikin yawan ƙwayar fructose-2,6-bisphosphate tare da antiaggregant (hanawa da haɓakar thrombus), antiatherogenic (raguwa a cikin alamun "mummunan" cholesterol) da maganin antioxidant (farfadowa, tsufa). Hanyoyin hadawan abu da iskar shaka yana raguwa saboda karuwar abubuwan da ke tattare da sinadarin b-tocopherol da kuma aiki na enzymes na antioxidant.
Pharmacokinetics na miyagun ƙwayoyi
A cikin abun da ke ciki na Amaril, babban aikin shine glimepiride daga ƙungiyar sulfonylurea. Ana amfani da povidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose da dyes E172, E132 ana amfani dasu azaman matattara.
Amaryl yana aiwatar da enzymes hanta 100%, don haka ko da tsawan amfani da miyagun ƙwayoyi baya barazanar tara yawan yalwarsa a cikin gabobin da kyallen takarda. Sakamakon aiki, abubuwa biyu na glipemiride an kafa su: hydroxymetabolite da carboxymethabolite. Na farko metabolite yana da ƙimar magunguna waɗanda ke ba da tsayayyen sakamako na hypoglycemic.
A cikin jini, ana lura da matsakaicin abun aiki mai aiki bayan sa'o'i biyu da rabi. Kasancewa cikakkiyar bioavailability, ƙwayar ba ta iyakance mai ciwon sukari a zaɓin kayan abinci wanda zai “sha” maganin ba. Hasashen zai kasance 100%.
Ana lura da haɓaka mahimman abubuwa a cikin abubuwan kwantar da hankali ko da tare da matsalolin aiki tare da hanta, musamman, a cikin balagaggu (sama da shekaru 65) kuma tare da lalacewar hanta, haɗuwa da sashin aiki mai aiki al'ada.
Yadda ake amfani da Amaryl
Ana samar da magani a cikin nau'ikan allunan oval tare da tsinkaye, wanda zai ba ku damar raba kashi cikin sauƙi. Launi na allunan ya dogara da sashi: 1 MG na glimepiride - harsashi mai ruwan hoda, 2 MG - greenish, 3 MG - rawaya.
Ba a zaɓi wannan zane kwatsam ba: idan za'a iya bambanta allunan ta launi, wannan zai iya rage haɗarin yawan haɗari, musamman a cikin tsofaffi marasa lafiya.
Allunan an cakuda a blisters na 15 inji mai kwakwalwa. Kowane akwati na iya samun daga 2 zuwa 6 irin faranti.
Fasali na amfanin Amaril:
- Kwamfutar hannu (ko wani ɓangarenta) an haɗiye ta duka, an yi wanka da ruwa aƙalla 150 ml. Nan da nan bayan shan magani, kuna buƙatar ci.
- Masana ilimin kimiyya na endocrinologist suna zaɓar tsarin kulawa ta hanyar daidai da sakamakon bincike na magudanan ƙwayoyin halitta.
- Fara farawa da karancin allurai na Amaril. Idan yanki na 1 MG bayan wani lokaci bai nuna sakamakon da aka ƙaddara ba, adadin yana ƙaruwa.
- Ana daidaita sashin a hankali, a cikin makonni 1-2, domin jiki ya sami lokaci don daidaitawa da sababbin yanayi. Yau da kullun, zaku iya ƙara yawan adadin da ba fiye da 1 mg ba. Matsakaicin maganin shine 6 mg / rana. An saita iyakar mutum daga likita.
- Wajibi ne a gyara al'ada tare da canji a cikin masu ciwon sukari ko kuma yawan nauyin ƙwayar tsoka, kazalika da haɗarin cututtukan zuciya (tare da matsananciyar yunwa, rashin abinci mai gina jiki, shan giya, matsalar koda da hanta).
- Lokacin amfani da sashi zai dogara ne da yanayin rayuwa da sifofin metabolism. Yawancin lokaci, ana ba da umarnin guda ɗaya na Amaril kowace rana tare da wajabta haɗuwa da abinci. Idan karin kumallo ya cika, zaku iya shan kwaya da safe, idan alama ce - yana da kyau ku hada liyafar da abincin rana.
- Yawan abin sama da ya wuce na tsoratar da tsotsar jini, idan glucose a cikin tsotsewar tayi saukar da 3.5 mol / L ko ƙasa. Yanayin na iya kasancewa na dogon lokaci: daga awanni 12 zuwa 3.
Allunan Amaryl (a cikin kunshin 30 guda) suna samuwa don siyarwa a farashin:
- 260 rub - 1 MG kowane;
- 500 rub - 2 MG kowane;
- 770 rub. - 3 MG kowane;
- 1020 rub. - 4 MG kowane.
Kuna iya samun fakitin 60, 90,120 guda na Allunan.
Sauran karfin jituwa
Masu ciwon sukari, musamman “tare da gogewa”, a matsayinka na mai mulki, suna da cikkaken rikice-rikice: hauhawar jini, zuciya da jijiyoyin bugun jini, damuwa na rayuwa, koda da hanta. Tare da wannan kit ɗin, dole ne ku ɗauki magunguna masu rage sukari kawai.
Don hana abnormalities na jini da zuciya, an wajabta magunguna tare da asfirin. Amaryl ya kawar da ita daga tsarin furotin, amma matakin shi a cikin jini baya canzawa. Gabaɗaya tasirin amfani da hadaddun zai iya inganta.
Ingantaccen aiki AMARE ta Bugu da kari ga insulin, Allopurinu, coumarin Kalam, anabolic steroids, guanethidine, chloramphenicol, fluoxetine, fenfluramine, pentoxifylline, Feniramidolu, fibric acid Kalam, phenylbutazone, miconazole, azapropazone, probenecid, quinolones, oxyphenbutazone, salicylates, tetracycline, sulfinpyrazone, Tritocqualin da sulfonamides.
Amaril ya rage ikon ƙara Epinephrine, glucocorticosteroids Diazoxide, laxatives, Glucagon, barbiturates, Acetazolamide, saluretics, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, da protsinin, da kuma gishiri.
Amaryl da histamine H2 masu hana karɓa, reserpine da clonidine yana ba da sakamakon da ba tsammani tare da saukad da a cikin glucometer ta kowane bangare. Sakamakon makamancin wannan yana ba da yawan barasa da Amaril.
Magungunan ba su da tasiri ga ayyukan ACE inhibitors (Ramipril) da wakilin maganin anticoagulant (Warfarin) ta kowace hanya.
Hypoglycemic karfinsu
Idan kowane magani na hypoglycemic dole ne a musanya shi da Amaril, an tsara mafi ƙarancin magunguna (1 MG), har ma a lokuta inda mai haƙuri ya karɓi maganin da ya gabata a mafi girma. Da farko, ana kula da abin da ke faruwa na kwayoyin cutar sukari na makonni biyu, sannan sai an daidaita sashi.
Idan an yi amfani da wakili na maganin antidi tare da rabin rai a gaban Amaril don guje wa ci gaban hypoglycemia, ya kamata a ɗan dakatar da wasu kwanaki bayan sokewa.
Idan mai ciwon sukari ya sami ikon kula da ƙwayar kumburin ƙwayar ƙwayar ƙwayar cuta don samar da ƙwayar kansa, to, injections na insulin na iya 100% maye gurbin Amaryl. Hakanan karatun yana farawa da 1 MG / day.
Lokacin da tsarin biyan sukari na Metformin na gargajiya bai bada izinin cikakken sarrafa ciwon sukari ba, ana iya ƙara 1 mg na Amaril. Idan sakamakon bai gamsar ba, sannu a hankali ana daidaita tsarin zuwa 6 mg / rana.
Idan tsarin shirin Amaril + Metformin bai yi rayuwa ba har zuwa tsammanin, Insulin ya maye gurbinsa, yayin da yake gudanar da tsarin al'ada na Amaril. Injections na insulin kuma ana farawa da mafi karancin sashi. Idan alamomin glucose ɗin basu da ƙarfafawa, ƙara yawan insulin. Amfani da keɓaɓɓen amfani da kwayoyi har yanzu abin fin so ne, tunda yana ba ka damar rage ciwar hormone da kashi 40% idan aka kwatanta da aikin maganin ƙwaƙwalwar tsafta.
Baya ga Amaril, endocrinologist shima yana da zaɓuɓɓuka don analogues: Amaperid, Glemaz, Diapyrid, Diameprid, Glimepiride, Diagliside, Reclide, Amix, Glibamide, Gllepid, Glayri, Panmicron, Glibenclamide, Gligenclad, Glliblik Dimari, Dimari, Dimari, Dimari, Dimari, Dimari Glimaril, Glyclazide, Manil, Maninil, Glimed, Glioral, Olior, Glynez, Glyrid, Gluktam, Glypomar, Glyrenorm, Diabeton, Diabresid.
Ga wanda aka yi niyya, kuma ga wanda ba a ba da shawarar magani ba
An kirkiro maganin don maganin cututtukan type 2. Ana amfani dashi duka tare da monotherapy kuma a cikin hadaddun jiyya a layi daya tare da Metformin ko Insulin.
Abubuwan da ke aiki na Amaril suna aiki ne da shamaki a cikin mahaifa, haka nan kwayayen sun shiga cikin madarar nono. A saboda wannan dalili, bai dace da mata masu juna biyu da masu shayarwa ba. Idan mace tana so ta zama uwa, tun kafin ta ɗauki yaro, dole ne a tura ta zuwa allurar ta insulin ba tare da Amaril ba. Don lokacin ciyarwa, ana kiyaye irin waɗannan alƙawura, idan kuwa har yanzu akwai buƙatar magani tare da Amaril, an daina shayarwa.
Ba a yarda da amfani da miyagun ƙwayoyi a cikin cutar rashin lafiyar masu cutar ƙwaya da yanayin da ke gaban coma ba. A cikin rikitattun rikice-rikice na ciwon sukari (kamar ketoacidosis), Ba a ƙara Amaryl ba. Hakanan magani bai dace da masu ciwon sukari tare da cutar farko ba.
Tare da rikice-rikicewar aiki na kodan da hanta, Amaril ba shi da amfani, ba a nuna Amaril don cututtukan hemodialysis da masu ciwon sukari ba, har ma da rashin haƙuri ɗaya ga glipemiride ko wasu kwayoyi na aji na sulfonamide da sulfonylurea aji.
Tare da paresis na hanji ko toshewar hanji, shaye-shayen kwayoyi na damun su, don haka Amaril baya tsara irin waɗannan matsalolin yayin tashin hankali. Suna buƙatar canzawa zuwa insulin da raunin da yawa, tiyata, cututtukan zazzabi mai zafi, ƙone mai tsanani.
Amaril zai iya kasancewa tare da halayen maganganu na hypoglycemic. Wasu lokuta marasa lafiya suna koka da tsananin zafin rai, wasu sun dagula ingancin bacci, akwai fargaba, gumi mai yawa, da rikicewar magana. A cikin ciwon sukari, akwai lokuta da yawa akan yunwar da ba a sarrafawa ba, cututtukan dyspeptik, rashin jin daɗi a cikin hanta. Wataƙila rikicewar bugun zuciya, kurji a fata. Hawan jini a wasu lokuta yakan karaya.
Sakamakon yawan yawan zubar jini
Yin amfani da magunguna na dogon lokaci, har da mummunar zubar da ciki, na iya tayar da hankalin mutum, alamun cututtukan da aka bayyana a sashin da ya gabata.
Mai ciwon sukari yakamata ya sami bayanin kula tare da takaitaccen bayanin rashin lafiyar sa da wani abu daga carbohydrates mai sauri (alewa, kukis). Ruwan zaki ko kuma shayi sun dace, kawai ba tare da kayan zaki ba. A cikin mawuyacin hali, dole ne a kwantar da mai haƙuri a cikin gaggawa don lavage na ciki da kuma gudanar da aikin sha (carbon mai aiki, da sauransu).
Side effects
A lokuta da dama, amfanin Amaril yana haɗuwa da sakamako masu illa a cikin nau'i na asarar hangen nesa, matsaloli tare da tsarin wurare dabam dabam, cuta na rayuwa, rikicewar gastrointestinal.
Daga cikin mafi yawan:
- Cutar glycemic, wanda aka nuna shi ta hanyar asarar ƙarfi, raguwa a cikin taro, asarar hangen nesa, arrhythmia, yunwar da ba a sarrafawa ba, yawan gumi.
- Bambanci a cikin alamomin sukari, yana haifar da raunin gani.
- Rashin matsala na dissi, keta haddin lalacewa, ɓacewa lokacin da aka cire maganin.
- Allergies of tsananin bambance-bambancen (fatar fata, itching, amya, vasculitis rashin lafiyan, tashin hankali anaphylactic, saukar karfin jini da gajeriyar numfashi).
Amaraukar Amaril mummunan tasiri yana haifar da saurin halayen psychomotor - tuki mota, kazalika da aikin da ke buƙatar kulawa, musamman a matakin farko na magani, ba su dace da ilimin lafiyar Amaril ba.
Ra'ayoyin likitoci da masu ciwon sukari game da Amaril
Binciken masana game da cututtukan cututtukan cututtukan cututtukan fata wanda ke haɗuwa da kowace rana ta bayyanuwar cutar rashin hankali shine mafi yawan maƙasudin, saboda suna da damar yin nazarin halayen marasa lafiya game da miyagun ƙwayoyi don su yanke shawara game da tasirinsa.
A cewar likitocin, tare da ingantaccen tsarin kulawa da magani daidai, Amaril yana taimakawa wajen daidaita yanayin glycemic indies cikin sauri. Masu ciwon sukari da ke shan miyagun ƙwayoyi suna da koke-koken cututtukan jini yayin da aka zaɓi zaɓin mara kyau. Duk da haka, game da magani na Amaril, sake dubawa na haƙuri suna da kyakkyawan fata.
-Arancin carb, abinci mai ƙoshin ƙarfi, sarrafa nauyi yana da tasiri mai tasiri akan tasirin magani na Amaril. Mai ciwon sukari ya kamata ya sanar da endocrinologist a cikin lokaci game da tasirin sakamako, alamun cututtukan hypo- da hyperglycemia wanda ke haɓaka tare da Amaril.
Hakanan jiyya ya ƙunshi kulawa da kai na yau da kullun game da alamun sukari da kuma lura da ayyukan hanta, gwaje-gwaje na dakin gwaje-gwaje, musamman gwajin gwajin haemoglobin, wanda a yau ake ɗauka mafi mahimmancin ra'ayi don kimanta yanayin mai haƙuri da ciwon sukari. Wannan zai taimaka wajen gano matsayin juriya ga Amaril don gyaran tsarin kulawa.
Kuna iya koya game da ƙarin kayan aikin Amaril daga bidiyon.
