Glibenclamide yog tshuaj noj nrog hypoglycemic thaj chaw ntawm chav kawm ntawm thib ob tiam sulfonylurea derivatives. Nws kuj tseem muaj cov nyhuv hypolipidemic thiab txo qis kev pheej hmoo vascular thrombosis.
Tus yam ntxwv dav
Lub npe ntawm cov tshuaj Glibenclamide hauv cov txheej txheem thoob ntiaj teb hauv Latin yog Glibenclamide. Sab nraud, cov tshuaj yog lub teeb tsom liab ntsiav tshuaj hauv daim ntawv ntawm disc nrog txoj kab sib faib. Cov xim pleev xim tej zaum yuav muaj cov qauv pob zeb nrog kev txiav txim siab me.
Ntim ntim cov tshuaj rau hauv hlwv ntawm 10 daim. Hauv ib lub thawv muaj peev xwm yuav muaj txog 12 daim hlau.
Glibenclamide raug tso tawm los ntawm cov tshuaj noj, muab khaws cia rau hauv ib qho xwm txheej, tsis muaj menyuam nkag los. Cov lus qhia tau hais tias lub txee lub neej ntawm cov tshuaj - 5 xyoo. Cov tshuaj uas tas sij hawm yuav tsum tsis txhob noj.
Txhua lub ntsiav tshuaj muaj 5 mg ntawm glibenclamide thiab excipients nyob rau hauv daim ntawv ntawm lactose monohydrate, qos hmoov txhuv nplej siab, magnesium stearate, polyvinylpyrrolidone, E 124.
Cov chaw tsim tshuaj kho mob tsim cov khoom nyob hauv qab zib:
- Los tiv thaiv kis;
- Akrikhin HFK;
- Bivitech;
- ALSI Pharma;
- Kev siv biosynthesis
Tshaj tawm nws thiab lub tuam txhab Ukrainian Kev Noj Qab Haus Huv. Rau Glibenclamide, tus nqi hauv cov khw muag tshuaj Lavxias yog 270-350 rubles.
Cov yam ntxwv ntawm Pharmacological
Pharmacodynamics ntawm cov tshuaj
Tshuaj qhov ncauj hypoglycemic. Hauv Glibenclamide, qhov kev ua haujlwm ntawm kev ua raws li kev ua kom muaj zog ntawm insulin ntau lawm los ntawm pancreatic β-cells. Tib lub sijhawm, cov kua dej tsis haum ntawm cov ntaub so ntswg feem ntau poob qis. Cov tshuaj ua haujlwm yog tias muaj kev ua haujlwm txaus in-cov hlwb hauv cov txiav ua kab mob rau cov tshuaj endogenous. Txo cov tshuaj thiab cov platelet ua ke.
Cov yam ntxwv ntawm Pharmacokinetic
Los ntawm kev mob plab tom qab qhov ncauj tswj hwm ntawm lub plab khoob, cov tshuaj tau nqus sai sai, nws khi rau cov ntshav protein los ntawm 95%. Kev hloov pauv ntawm cov tshuaj nquag mus rau hauv kev ua kom nruab nrab plab yog nqa tawm hauv daim siab. Kev tshem tawm yog tswj los ntawm lub raum thiab bile ducts. Ib nrab-lub neej los ntawm cov hlab ntsha yog los ntawm ib thiab ib nrab rau peb thiab ib nrab xuaj moos. Cov piam thaj tswj hwm ib qho tshuaj ib zaug rau tsawg kawg 12 teev.
Nrog tus kab mob hepatic pathologies, kev tshem tawm tshuaj tiv thaiv yog inhibited. Yog hais tias daim siab ua haujlwm tau qhia nyob rau hauv daim ntawv tsis muaj zog, qhov no tsis cuam tshuam rau cov txheej txheem ntawm kev nthuav tawm ntawm metabolites; nyob rau hauv ntau qhov xwm txheej hnyav, lawv cov kev txuam nrog tsis suav nrog.
Leej twg tau qhia Glibenclamide
Kev siv tshuaj hypoglycemic tau tsim los rau cov neeg mob ntshav qab zib nrog hom mob thib ob. Cov tshuaj noj, muab cov khoom noj uas tsis muaj carb thiab ua kom cov leeg mob ib ce tsis zoo rau qhov xav tau.
Dosages thiab kev kho mob
Glibenclamide pom zoo rau kev siv tam sim ntawd tom qab noj mov. Tus kws kuaj mob endocrinologist laij cov koob tshuaj raws li cov txiaj ntsig kev kuaj ntshav rau qab zib, lub hnub nyoog ntawm tus neeg mob, qhov mob hnyav ntawm lub hauv paus, kab mob sib deev thiab kev noj qab haus huv feem ntau.
Nyob rau thawj theem ntawm tus kabmob, tus qauv kev cai yog 2.5-5 mg / hnub. Siv cov tshuaj ib zaug tom qab noj tshais. Yog tias kev them nyiaj tiav rau kev mob glycemia tsis tuaj yeem ua tiav, tus kws kho mob tuaj yeem kho qhov tshuaj ntxiv los ntawm kev ntxiv 2.5 mg ntawm cov tshuaj tom qab ib lub lim tiam. Tus nqi txij nkawm (nce txog 15 mg / hnub) yog sib npaug rau peb ntsiav tshuaj. Qhov siab tshaj plaws yog qhov tsis tshua muaj tshuaj, thiab tsis muaj qhov tshwm sim tseem ceeb hauv glycemia.
Yog tias tus mob ntshav qab zib muaj lub cev hnyav dua li 50 kg, thawj koob tau muab rau hauv 2.5 mg, uas sib haum rau ib nrab ntawm cov ntsiav tshuaj. Yog tias qhov kev cai niaj hnub tsis pub dhau ob daim, lawv qaug cawv thaum sawv ntxov thaum noj tshais, lwm qhov, cov tshuaj tau faib ob zaug, thaum sawv ntxov thiab yav tsaus ntuj hauv qhov sib piv ntawm 2: 1.
Thaum Glibenclamide pauv mus rau tom qab tau txais kev kho mob zoo nrog lwm cov tshuaj hypoglycemic, qhov pib noj yuav yog 2.5 mg ib zaug, thaum sawv ntxov.
Nrog rau cov txiaj ntsig tsis zoo, koj tuaj yeem kho cov kev cai txhua lub lim tiam los ntawm kev ntxiv 2.5 mg.
Yog tias qhov tshwm sim ntawm kev kho mob nrog lwm cov tshuaj tiv thaiv kab mob tsis haum, qhov pib yuav yog 5 mg thaum sawv ntxov, tom qab noj mov. Yog tias tsim nyog, yuav tsum kho ua ntej 2.5-5 mg txhua lub lim tiam tau tso cai. Kev txwv tsis pub dhau tseem nyob tib yam - 15 mg / hnub.
Yog tias qhov siab niaj hnub niaj hnub tshaj plaws ntawm Glibenclamide, thaum soj ntsuam cov zaub mov tsis zoo thiab kev ua kom lub cev tsis zoo, tsis muab 100% cov nyiaj qab zib, ntshav qab zib tau pauv mus rau kev kho kom zoo. Cov tshuaj tseem ceeb yog ntxiv nrog biguanides, insulin, thiab lwm yam kab mob hypoglycemic.
Yog tias kev tsim cov tshuaj endogenous ntawm cov tshuaj hormone insulin hauv cov neeg mob ntshav qab zib nrog hom mob thib ob yog kev cuam tshuam tag, kev kho mob tsis tuaj yeem lav tsis tau tib yam li kev kho mob monotherapy nrog kev npaj tshuaj insulin.
Yog tias vim li cas qee lub sijhawm lub sijhawm noj Glibenclamide tau ploj mus ntau dua li ib teev lossis ob teev, koj tsis tuaj yeem noj cov tshuaj no yav tom ntej. Tag kis sawv ntxov, noj ib qho qauv koob tshuaj, tsis pom zoo nce qhov nce qib.
Sab sij huam
Nrog kev siv tshuaj ntau dhau ntawm cov tshuaj, hypoglycemic tej yam kev mob sib txawv muaj peev xwm ua tau, suav nrog coma. Nrog kev haus dej cawv thiab ib lossis ob pluag noj nyob rau ib hnub, ua haujlwm dhau lawm, muaj teeb meem rau daim siab, lub qog thiab lub raum, lub txim tsis muaj qhov xav tau kuj muaj.
| Organs thiab tshuab | Sab sij huam | Zaus qhia |
| CNS | Pom qhov muag tsis pom kev, ntu daim tawv nqaij | Qee zaum |
| Tej ntshav ntws | Thrombocytopenia, erythrocytopenia, leukocytopenia, granulocytopenia, pancytopenia, vasculitis, hemolytic anemia | Tsawg tsawg zaus |
| Kev kho mob txoj hnyuv | Dyspeptic cuam tshuam, saj hloov pauv, ua txhaum ntawm cov lus sib dhos ntawm txoj hnyuv, mob plab, daim siab ua haujlwm, cholestasis, daj ntseg | Cawv |
| Cov kab mob zis | Tsis txaus diuresis | Feem ntau |
| Kev ua xua | Cov tshuaj tiv thaiv kev tsis haum xeeb, Lyell thiab Stevens-Johnson syndromes, kev paub txog duab tawv nqaij, erythroderma, exfoliative dermatitis, exanthema, urticaria | Cawv |
| Lwm yam kev xaiv | Lub qog ua hauj lwm tsis zoo, lub cev hnyav tuaj | Tsuas yog nrog siv ntev |
Cov txheej txheem ua kom tsis haum rau kev siv tshuaj kho mob
Cov tshuaj ntawm cov chav kawm no tsis yog kws kho mob rau cov neeg mob ntshav qab zib nrog thawj hom mob ntshav qab zib, nrog rau cov ntaub ntawv labile, ketoacidosis, coma, mob ntshav qab zib thiab nws cov mob ua ntej.
Cov tshuaj tsis qhia rau cov neeg mob pathologies ntawm lub siab thiab lub raum, yog tias lub raum kev ua haujlwm raug txo qis rau creatinine qhov kev tshem tawm qis dua 30 ml / min.
Yog tias tus mob ntshav qab zib muaj qhov ua xua, txo lub cev kom thiazide diuretics thiab sulfonamides, tus kws kho mob yuav tsum xav txog qhov no.
Nyob rau lub sijhawm cov kab mob kis, lwm yam tshuaj, suav nrog insulin, yog kho los kho ntshav qab zib. Kev kho tshuaj Insulin kuj tseem qhia tau rau kev kub nyhiab, kev raug mob phom sij, thiab kev ua haujlwm hnyav, suav nrog kev rov ua haujlwm rau leeg mob.
Nrog kev tsis zoo ntawm cov khoom noj muaj txiaj ntsig, paresis ntawm lub plab, cov hnyuv tawm tsam, cov tshuaj yog contraindicated.
Glibenclamine tseem raug tso tseg thaum cev xeeb tub thiab pub niam mis.
Cov Ntsej Muag ntawm Overdose ntawm Glibenclamide
Kev siv cov txheej txheem ntawm kev noj ntau dhau ntawm cov tshuaj provokes hypoglycemia loj, uas yog qhov txaus ntshai rau lub neej ntawm tus neeg raug tsim txom.
Cov txiaj ntsig zoo sib xws tuaj yeem tau nrog kev siv cov tshuaj tiv thaiv cov keeb kwm yav dhau los ntawm kev noj zaub mov tsis huv, kev ua haujlwm lub cev, kev cuam tshuam ntawm qee yam tshuaj noj ua ke nrog Glibenclamide.
Cov tsos mob ntawm tus mob hypoglycemic:
- Kev tswj tsis tau tshaib plab;
- Txo tsis zoo ntawm kev pw tsaug zog;
- Kev tsis zoo nkauj;
- Puas;
- Muaj nce hws;
- Mob taub hau;
- Dyspeptic cuam tshuam;
- Hypertonicity;
- Tes kev co;
- Tachycardia.
Kev tsis sib haum xeeb hauv kev ua haujlwm ntawm psyche nrog teeb meem endocrine tuaj yeem ua rau tsis meej pem nco qab, nkees nkees, mob plab tsis muaj zog, tsis muaj peev xwm tuav tau, bifurcation ntawm kev ua kom pom tseeb, ceeb ntshai thaum tsav tsheb lossis tswj cov txheej txheem, cov xeev tsis txaus, txhoj puab heev, teeb meem ntawm cov hlab ntsha thiab lub plab ua pa, coma.
Ob leeg nyob rau hauv meej thiab nyob rau hauv daim ntawv txheeb ze ntawm kev overdose, hypoglycemia yuav muaj kev hais zoo dua piv nrog kev noj ntau tshaj ntawm thawj tiam sulfanylurea derivatives.
Txhawm rau txo tus mob ntawm tus neeg mob nrog mob me me mus rau mob hnyav ntawm kev tawm tsam, koj tuaj yeem nqa khoom sai sai sai - khoom qab zib, ib nrab khob dej qab zib nrog qab zib lossis kua txiv (yam tsis muaj khoom qab zib). Yog tias cov kev ntsuas tsis tau txuas ntxiv, cov piam thaj (40%) lossis Dextrose (5-10%) tau txhaj rau hauv cov leeg ntshav, glucagon (1 mg) txhaj rau hauv cov leeg. Diazoxide tuaj yeem noj ntawm qhov ncauj. Yog tias tus neeg mob tau noj tshuaj acarbose, qhov ncauj ntawm lub ntsej muag tuaj yeem kho kho tsuas yog nrog cov piam thaj, tab sis tsis yog nrog oligosaccharides.
Yog tias tus neeg raug mob ntshav qab zib tseem tseem nco qab, qab zib yog tsim rau sab hauv. Thaum poob ntawm kev nco qab, qabzib yog siv iv, glucagon - iv, i / m thiab hauv qab daim tawv nqaij. Yog tias nco qab tau rov qab los, rau kev tiv thaiv kom rov huam mob, qhov mob ntshav qab zib yuav tsum tau txais kev noj zaub mov zoo raws li kev ua si sai.
Kev tshuaj xyuas ntawm glycemia, pH, creatinine, electrolytes, urea nitrogen yog soj qab txhua zaus.
Cov yam ntxwv ntawm kev kho mob nrog glibenclamide
- Thaum kho nrog tshuaj, ntshav qab zib yuav tsum ua raws li kev noj zaub mov nruj.
- Nyob rau hauv kev kis mob ntawm cov mob hlwb khiav ntshav tsis txaus, ua npaws, dej cawv, cov tshuaj yog kws kho nrog ceev faj.
- Tus kws kho ntshav qab zib yuav tsum tau saib xyuas nws tsis tseem ceeb. Cov ntsuas dej qabzib yuav tsum tau sau tsawg kawg ob zaug hauv ib hnub (qhov tseem ceeb, cov ntaub ntawv glycemic raug tshuaj xyuas 5 zaug / hnub.). Cov zis txhua hnub yuav tsum tau saib xyuas kom muaj cov suab thaj thiab acetone.
- Nrog rau cov mob hemodialysis, tsis muaj zaub mov tom qab noj tshuaj, lub cev ntau dhau, kev ntxhov siab, mob siab thiab lub raum pathologies, kev haus dej cawv, kev ua kom lub siab thiab qog tsis txaus, thiab tshwj xeeb tshaj yog nrog kev sib txuam ntawm ntau yam, qhov kev pheej hmoo ntawm kev loj hlob tsis paub meej glycemia nce. Nyob rau hauv cov xwm txheej zoo li no, kev soj ntsuam tas li ntawm cov ntsuas glucometer nrog kev kho kom haum cov tshuaj raws sij hawm.
- Block-adrenoreceptor blockers, tshuaj kho mob uas cuam tshuam rau lub hauv nruab nrab lub paj hlwb, tuaj yeem npog cov tsos mob ntawm kev mob ntshav qab zib.
- Hauv cov laus, cov tshuaj tau pom zoo hauv qhov tsawg kawg nkaus (los ntawm 1 mg / hnub), txij li qhov muaj feem tau txais glycemia hauv pawg no tau ntau dua vim qhov ua haujlwm ntawm cov kab mob ua haujlwm tsis muaj zog ntawm cov zis.
- Nyob rau ntawm thawj cov tsos mob ntawm kev tsis haum tshuaj, cov tshuaj no raug muab tso tseg thiab antihistamines raug kho. Rau tag nrho lub sijhawm kev kho mob, tiv thaiv kev tshaj tawm hluav taws xob ultraviolet yuav tsum zam.
- Thaum mob khaub thuas, mob ntsws, lom, txhawm rau ua rau muaj cov kab mob sib kis ntev (cholecystitis, pyelonephritis), mob plawv thiab lwm yam mob ntshav khov, mob NMC, mob vwm, thiab ua haujlwm hnyav rau cov neeg mob ntshav qab zib, lawv tau pauv mus rau insulin.
- Feem ntau, Glibenclamide tsis cuam tshuam rau kev tswj hwm lub tsheb, tab sis nyob rau qhov xwm txheej txawv (ua haujlwm nyob rau hauv cov xwm txheej nyuaj, kev ntxhov siab, qhov siab, thiab lwm yam), yuav tsum tau saib xyuas, txij li ib qho xwm txheej los ntawm kev hloov pauv hauv cov ntshav qab zib tuaj yeem hloov thaum twg los tau.
- Tshwj xeeb yuav tsum tau saib xyuas thaum hloov cov tshuaj, xaiv qhov zoo tshaj plaws, thiab kev siv tshuaj tsis xwm yeem.
Glibenclamide analogues
Ua raws li ATX cov cai ntawm Qib 4 nrog cov tshuaj Glibenclamide kev sib tw:
- Khoom Plig Ntsuas;
- Amix;
- Amaryl;
- Gliclazide;
- Maninil;
- Glidiab;
- Glimepiride;
- Lawj xeeb.
Raws li cov lus txhais ntawm ntau cov cim lag luam, Glibenclamide sib raug rau cov tshuaj Glibex, Gilemal, Glibamide, Glidanil.
Kev Tshuaj Ntsuam Xyuas Cov Tshuaj Glibenclamide
Kev tsis pom kev ntawm glimenclamide qeeb, thaum txhim kho nws lub peev xwm hypoglycemic, azopropanone, miconazole, coumaric acid npaj, oxyphenbutazone, sulfonamide pawg tshuaj, phenylbutazone, sulfapyrazonfeniramidol.
Ua ke nrog kev kho mob nrog lwm cov kua qab zib, txo cov tshuaj insulin tsis kam, pom cov txiaj ntsig zoo sib xws.
Nrog rau cov tib neeg siv cov tshuaj anabolic, allopurinol, cimetidine, β-adrenergic receptor blockers, cyclophosphamide, guanethidine, clofibric acid, monoamine oxidase inhibitors, sulfonamides nrog kev ua lub sijhawm ntev, salicylates, tetracyclines, haus cawv, hypoglycemic muaj peev xwm ntawm theem pib.
Yog tias barbiturates, chlorpromazine, rifampicin, diazoxide, epinephrine, acetazolamide, lwm yam tshuaj sympathomimetic, glucocorticosteroids, glucagon, indomethacin, diuretics, suav nrog acetazolamide, nicotinates (hauv koob tshuaj loj), phenothiazines, phenytin, tshuaj tiv thaiv qog muaj nyob rau hauv cov tshuaj. , saluretics, lithium ntsev, loj haus dej cawv thiab laxative, cov nyhuv ntawm glimenclamide tsawg dua.
Cov txiaj ntsig tsis tau tshwm sim ntawm kev sib txuam nrog kev siv loj yog qhia los ntawm H2 receptor antagonists.
Glibenclamide Xyuas
Ntawm cov ncauj lus thematic, cov kab mob ntshav qab zib thiab kws kho mob feem ntau sib tham txog qhov ua tau zoo ntawm ntau cov tshuaj kho mob. Cov uas tau kho tshuaj kho mob monotherapy raws li cov tshuaj yws yws ntawm cov khoom qab zib tsis tiav. Nrog txoj kev kho mob, qee qhov sau tseg ntau dhau ntawm Glibenclamide kev ua haujlwm.
Cov kws kho mob taw qhia tias xaiv cov tshuaj zoo tshaj plaws rau Glibenclamide, uas yuav ua rau koj tswj kev noj qab haus huv kom zoo rau lub sijhawm ntev, yuav tsum muaj tus kheej mus kom ze, yuav tsum muaj sijhawm thiab soj ntsuam tas li ntawm cov ntsuas dej qabzib rau lub sijhawm sib txawv ntawm tus neeg mob. Hauv cov xwm txheej zoo li no, kev sib tham sib tham tsis tuaj yeem tsis yog qhov tsis muaj txiaj ntsig, tab sis kuj tseem txaus ntshai.
Cov ntaub ntawv hais txog kev siv tshuaj rau ntawm qhov chaw yog rau kev siv thiab dav dav, sau los ntawm cov peev txheej muaj thiab tsis yog lub hauv paus rau kev txheeb xyuas thiab kev siv tus kheej. Nws yuav tsis hloov lub tswv yim ntawm tus endocrinologist.
