Gliclada yog ib qho tshuaj rau kev kho mob ntshav qab zib hom 2 hauv cov neeg laus. Cov cuab yeej pom zoo nyob rau hauv cov ntaub ntawv thaum kev ua haujlwm lub cev, kev noj zaub mov kom tsawg tsis muaj qhov ua rau lub cev ntawm tus neeg mob, nws tsis tuaj yeem tswj tau qhov hnyav thiab ntshav qab zib.
Glyclad tsis raug tshuaj rau hom 1 mob ntshav qab zib mellitus, cev xeeb tub, lactation, mob nyhav rau lub raum, lub raum tsis ua haujlwm, ketoacidosis, ib tus neeg tsis haum rau lub ntsiab kev noj haus, ntshav qab zib tsis xeev thiab lub xeev qub.
Rau cov tshuaj no hypoglycemic, tus nqi nruab nrab yuav yog txog 290 rubles.
Cov lus qhia rau kev siv tshuaj
Glyclad ntsiav tshuaj yuav tsum tau noj thaum noj tshais, lawv nqos tag nrho, tsis yog zom. Thaum cov mob ntshav qab zib tau plam kev noj tshuaj, tsis tuaj yeem muab tshuaj ntxiv rau lwm zaus.
Los ntawm 1 mus rau 4 ntsiav tshuaj noj ib hnub (los ntawm 30 txog 120 mg), cov pes tsawg kiag yuav tsum tau xaiv ib tus zuj zus, raws li tus neeg mob cov tshuaj tiv thaiv metabolic. Qhov nruab nrab txhua hnub ntawm cov tshuaj yog 30 mg, yog tias kev tswj ntawm glycemia siv tau, 30 mg ntawm cov tshuaj siv los kho kev kho mob.
Thaum cov piam thaj hauv cov ntshav tswj tsis txaus, qhov tshuaj yuav maj mam nce mus rau 60, 90, lossis 120 mg ib hnub twg. Lub sijhawm nruab nrab ntawm qhov nce ntxiv ntawm kev siv tshuaj ntxiv yuav tsum yog tsawg kawg 30 hnub, tab sis tshwj tsis yog qee kis uas cov piam thaj hauv ntshav tsis tau rov qab zoo li qub tom qab 12 hnub ntawm kev kho mob. Nyob rau hauv cov xwm txheej zoo li no, cov tshuaj ntau dua sai dua tom qab 2 asthiv. Qhov siab tshaj plaws tau tso cai siv 120 mg ib hnub twg.
Yog tias koj tuaj yeem tswj cov ntshav qabzib nrog Glyclazide 80 mg ntsiav tshuaj, tuaj yeem hloov tag nrho nrog Glyclad. Qee qhov xwm txheej, nws muaj kev qhia:
- pib txoj kev kho nrog 30 lossis 60 mg ntawm cov tshuaj;
- maj mam ntxiv rau qhov ntau npaum li cas nyob ntawm qhov kev thaj yeeb ntawm cov ntshav qab zib.
Cov tshuaj yuav siv tau rau hauv kev sib xyaw nrog lwm cov tshuaj tiv thaiv ntshav qab zib, cov no tuaj yeem yog biguanides, insulin, alpha glucosidase inhibitors. Txawm li cas los xij, kev siv cov tshuaj tiv thaiv kab mob nrog cov tshuaj insulin yuav tsum tau ua nyob rau hauv kev saib xyuas mob nkeeg nruj.
Cov neeg mob uas muaj hnub nyoog laus dua (ntau dua 65 xyoos) raug nquahu kom kho txoj hauv kev ntau npaum li cas. Yog li, cov neeg mob ntshav qab zib nrog cov mob tsis txaus, mob raum tsis zoo yog kws kho lawv tus kheej.
Cov tshuaj txhua hnub tsawg kawg ntawm cov tshuaj yuav tsum noj los ntawm cov neeg mob uas muaj cov kab mob zoo li no thiab kab mob pathological:
- kev noj haus tsis txaus;
- kev them nyiaj tsis zoo, kev ua txhaum ntawm cov kab mob endocrine;
- kev kho mus sij hawm ntev nrog tshuaj corticosteroid;
- cov kab mob hnyav heev ntawm lub siab, cov hlab ntshav.
Tej zaum tsis haum lub cev
Raws li kev tshuaj xyuas, qee cov neeg mob yuav muaj kev tsis zoo ntawm lub cev, uas tau pom los ntawm kev cuam tshuam ntawm ntau yam plab hnyuv siab raum thiab cov kab ke.
Yog li, tus kab mob ntshav qab zib tuaj yeem tsim lub qog ua ntshav qab zib, feem ntau qhov no tshwm sim tom qab kev noj tshuaj tsis xwm yeem los yog noj zaub mov ntau. Hauv qhov no, muaj cov tsos mob: mob taub hau, txhaws ntswg, xeev ntuav, cuam tshuam kev pw tsaug zog hmo ntuj, qaug zog, mob plab sai.
Kev tsim txom uas tsis tsim nyog, ua rau lub siab tsis hnov qab, ua rau lub hlwb khiav qeeb qeeb, ib qho kev xav zoo li tsis muaj kev cia siab, thiab lub xeev nyuaj siab tsis tau txiav txim. Nrog hyperglycemia, kiv taub hau, hnov tsis pom kev, hais lus, paresis, aphasia nthuav dav, rhiab hloov zuj zus. Qee tus neeg mob tau mob los ntawm kev nqus pa, feem ntau tsis nco qab, uas ua rau delirium, tsis nco qab thiab tuag.
Muaj kuj tseem adrenergic cov cim koom:
- kev xav ntawm kev ntxhov siab;
- nplaum hws;
- nce ntshav siab;
- mob hauv lub plawv;
- arrhythmia.
Lwm txoj kev phiv tshuaj yuav yog: mob mob hauv plab plab, thim rov qab ua rau daim siab daim tawv nqaij, ua pob ua pob rau ntawm daim tawv nqaij, hyponatremia. Kev rov qab mob siab ntsws yuav ua mob leukopenia, anemia, pancytopenia. Cem quav tseem muaj peev xwm ua tau mob ntshav qab zib.
Thaum pib ntawm kev siv tshuaj kho, kev hloov pauv hloov zuj zus, piv txwv, teeb meem tsis pom kev.
Cov ntsiab lus ntawm qhov no tau piav qhia nyob rau hauv cov lus qhia rau siv.
Yeeb tshuaj sib cuam tshuam
Nrog rau kev siv tshuaj ua ke nrog Miconazole, qhov ntxim nyiam ntawm kev txhim kho hypoglycemia nce, nce txog lub cev tsis nco qab lawm. Cov tshuaj Glyclad tsis yog yam tshuaj nrog rau phenylbutazone; cov tshuaj muaj cawv yog tsis suav nrog thaum kho.
Vim tias cov neeg mob ntshav qab zib tsawg dua, tus kws kho mob yuav tsum tau ceev faj heev thaum sau tshuaj rau lwm pawg ntawm cov tshuaj mob ntshav qab zib: biguanides, insulins, thiab acarbose. Nws kuj tseem yuav tsum zam kom tsis txhob muaj kev sib koom tes nrog beta-blockers, sulfonamides, tsis-tshuaj steroidal anti-inflammatory.
Kev sib xyaw ua ke ntawm gliclazide nrog Danazole tuaj yeem ua rau cov ntshav qab zib nce siab, thaum cov neeg xav tau cov tshuaj zoo li no nws tau qhia tswj kev mob glycemia, lwm qhov kev pom zoo yog kho qhov tshuaj ntau dua ntawm Gliklada thaum siv Danazol thiab tom qab kho.
Txij li thaum nws muaj peev xwm ntawm hyperglycemia:
- nws yog ib qho tseem ceeb kom ceev faj thaum sau daim ntawv tshuaj nrog cov tshuaj chlorpromazine;
- muaj cov kev qhia kom kho qhov koob tshuaj gliclazide.
Nrog cov kab ke hauv ib cheeb tsam, hauv zos, lub qhov quav, subcutaneous, txiav thiab ntxiv kev siv tshuaj glucocorticosteroid, kev nce ntxiv ntawm glycemia yuav tshwm sim vim kev txo qis hauv kev tawm tsam cov roj.
Muaj ib lub tswv yim hais tias nws yog qhov yuav tsum ua tib zoo sib xyaw ua ke ntawm cov glycade nrog tshuaj salbutamol, ritodrin, terbutaline vim tias muaj kev pheej hmoo ntawm hyperglycemia.
Yog tias ua tau, nyob rau hauv cov xwm txheej zoo li no, lawv hloov mus rau kev kho tshuaj insulin.
Cov lus qhia tshwj xeeb
Txoj kev kho mob tsuas yog pib noj mov nrog rau noj tshais, nrog rau noj tshais. Nws muaj kev pheej hmoo ntawm hypoglycemia nrog kev noj zaub mov tsis zoo, tom qab ua haujlwm hnyav lub cev, haus cawv. Txhawm rau tiv thaiv cov kev hloov hauv cov piam thaj hauv ntshav, kws kho mob pom zoo ntxiv rau kev noj zaub mov carbohydrate.
Txij li thaum lub qog ntshav qab zib kuj tseem tuaj yeem txhim kho nrog kev kho mob nrog sulfonylurea derivatives, tus neeg mob ntshav qab zib yuav xav tau kev mus pw hauv tsev kho mob sai. Hauv tsev kho mob, xav tau ob peb hnub los tswj hwm cov piam thaj.
Txo cov kev mob ntshav qab zib tsawg, koj yuav tsum ua tib zoo saib xyuas koj tus mob, ceeb toom txog qhov yuav tshwm sim ntawm cov neeg txheeb ze.
Nws muaj ntau yam ua tuaj yeem ua rau muaj qhov txo qis ntawm cov ntshav qog ntshav:
- tsis kam ntawm cov txheej txheem kho mob (feem ntau qhov no tshwm sim hauv cov neeg laus laus);
- lub raum tsis ua haujlwm;
- cov kev mob rau daim siab hnyav;
- cov khoom noj tsis huv, ua kom yoo mov ntev, kom yoo mov;
- tsis muaj qhov sib npaug ntawm kev ua kom tau cov carbohydrate thiab kev siv lub cev;
- noj tshuaj ntau dhau.
Tsis muaj kev phom sij tsawg dua los ntawm qhov pom ntawm kev txhim kho hypoglycemia hauv hom 2 mob ntshav qab zib mellitus yog cov kab mob qog, cov kab mob qog, thiab kev siv cov tshuaj tsis sib xws.
Nrog rau tus mob hepatic thiab lub raum tsis ua haujlwm, pharmacokinetic, pharmacodynamic zog ntawm cov tshuaj yuav hloov pauv. Cov neeg mob ntshav qab zib hauv cov ntshav qab zib tuaj yeem yog ib ntus lossis siv sijhawm ntev, yog li, kev saib xyuas tsim nyog yuav tsum tau nqa tawm.
Tus mob ntshav qab zib yuav tsum tau qhia kom raws sij hawm txog qhov yuav tsum tau ua raws kev noj haus nruj, qhov tseem ceeb ntawm kev ua haujlwm ntawm lub cev, thiab soj ntsuam cov ntshav qabzib. Tus neeg mob thiab nws tsev neeg yuav tsum paub txog qhov txaus ntshai ntawm cov ntshav qog ntshav qab zib, nws cov tsos mob, txoj kev kho thiab yam tseem ceeb uas yuav ua rau muaj kev txhim kho.
Muaj kev tshuaj xyuas cov kws kho mob los ntawm qhov koj tuaj yeem kawm paub txog kev ua haujlwm ntawm kev tswj ntshav qab zib yog tias tus neeg mob tau txais kev kho mob tiv thaiv ntshav qab zib. Cov txiaj ntsig zoo li no tuaj yeem txo kom tsawg thaum:
- lub cev kub nce;
- kev phais mob tau siv;
- muaj muaj kev raug mob, kis mob.
Qee lub sij hawm nws yog qhov tsim nyog los sau tshuaj insulin.
Thaum lub sijhawm dhau los, qhov ua kom muaj txiaj ntsig hypoglycemic ntawm ib qho tshuaj tiv thaiv kab mob hauv lub qhov ncauj tsawg zuj zus, thiab glycazide tsis muaj qhov tshwj xeeb. Vim li no, tom qab qee lub sijhawm, tus neeg mob qhov tshuaj tiv thaiv rau kev kho mob ua haujlwm yog txo. Cov mob zoo sib xws hu ua yam tsis muaj txiaj ntsig ntawm kev kho. Xws li cov lus xaus tsuas yog yog hais tias ntau npaum cov tshuaj kho tau kom yog, thiab kev noj haus yuav tsum muaj.
Txhawm rau ntsuas qhov ua tau zoo ntawm kev saib xyuas glycemic, glycated hemoglobin qhov ntsuas yuav tsum tau ntsuas; lwm qhov txawv ntawm cov txheej txheem yog kev txiav txim siab ntawm kev ceev ceev cov piam thaj hauv plasma cov ntshav txhaws.
Yog tias sulfonylureas raug kho rau cov neeg mob uas muaj ntshav qabzib-6-phosphate dehydrogenase tsis txaus, hemolytic anemia yuav tshwm sim, yog li:
- Gliclazide yog qhov zoo dua rau tsis kam;
- xaiv cov tshuaj analogues ntawm cov tshuaj.
Cov ntsiav tshuaj muaj lactose, yog tias hom ntshav qab zib hom 2 tseem raug kev txom nyem los ntawm cov kab mob caj ces cuam tshuam nrog galactose intolerance, lactose tsis txaus, qabzib-galactose malabsorption, lawv yuav tsum tsis txhob noj tshuaj.
Nws yog ib qho tseem ceeb kom paub tias cov tshuaj hauv qee kis tsis zoo cuam tshuam rau qhov ceev ntawm ib tug neeg lub hlwb kev xav, vim li no nws yuav tsum tsis kam lees lossis txwv kev tswj hwm kev thauj tsheb thiab lwm yam kev siv thaum kho.
Ntau tus neeg mob
Yog hais tias tus neeg mob tau noj ntau dhau lawm ntawm lub koob tshuaj, nws muaj kev txhim kho hypoglycemia ntawm qhov sib txawv - ntawm mob loj tsawv. Kev ntsuas tus neeg mob hais tias nyob rau hauv cov xwm txheej zoo li no lawv tau sau cov khoom noj carbohydrate kom tsawg, hloov lossis hloov kho kom haum. Tus mob ntshav qab zib yog nyob hauv kev tswj hwm ntawm tus kws kho mob kom txog rau thaum cov phom sij raug tshem tawm, qhov xwm txheej tsis tshee.
Hauv cov ntshav qog ntshav hnyav, uas yog nrog mob ntshav siab, nws yog qhov tseem ceeb uas hu rau lub tsheb thauj neeg mob. Nrog lub hypoglycemic coma lossis lub luag haujlwm ntawm nws txoj kev txhim kho, glucagon los yog cov kua nyeem uas muaj qabzib yuav tsum tau muab tshuaj tam sim ntawd.
Tom qab qhov no, Txoj kev lis ntshav ntawm 10% cov kua nplaum nyob mus txuas ntxiv, qhov no yuav ua kom muaj kev saib xyuas ntawm qhov tsim nyog cov piam thaj ntawm cov piam thaj hauv cov ntshav. Hemodialysis yuav siv tsis tau. Daim vis dis aus hauv tsab xov xwm no yuav qhia koj txog lwm yam tshuaj kho ntshav qab zib koj tuaj yeem siv.
