AMARIL - COV LUS QHIA RAU KEV SIV, NQE, XYUAS THIAB ANALOGUES

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Cov tshuaj Amaril cov lus qhia rau kev siv muab ib qho kev ntsuas ua ib qho tshuaj ntawm lub cim tshiab ntawm cov tshuaj los tiv thaiv kev mob ntshav qab zib hom 2. Ib qho ntawm cov pheej hmoo tshaj plaws niaj hnub no yog Glibenclamide-HB-419 los ntawm sulfonylurea pawg. Ntau tshaj li ib nrab ntawm cov neeg mob ntshav qab zib nrog hom thib ob tau ntsib nws.

Amaril yog kev hloov kho tshiab ntawm Glibenclamide, tsim los ua kom tau raws li cov kev cai tshiab rau kev tswj hwm ntawm "kab mob qab zib."

Pharmacological cov yam ntxwv ntawm cov tshuaj

Amaryl yog cov tshuaj hypoglycemic uas pab tswj cov ntshav qab zib hauv ntshav. Cov tshuaj nquag ua haujlwm ntawm cov tshuaj yog glimepiride. Zoo li nws ua ntej, Glibenclamide, Amaril kuj yog los ntawm pawg sulfonylurea, uas ua kom cov synthesis ntawm insulin los ntawm cov hlwb b ntawm lub pancreatic islets ntawm Langerhans.

Yuav kom ua tiav qhov txiaj ntsig uas tau npaj tseg, lawv thaiv cov channel potassium ntawm ATP nrog lub siab tawv. Thaum sulfonylurea khi rau cov receptors nyob ntawm b-cell daim nyias nyias, cov haujlwm ntawm K-AT qib hloov. Kev thaiv ntawm cov calcium calcium uas muaj qhov nce ntxiv ntawm ATP / ADP piv rau hauv cytoplasm provokes membrane depolarization. Qhov no pab txhawb kev tso tawm cov calcium calcium txoj hauv kev thiab nce qhov kev kub siab ntawm cytosolic calcium.

Qhov tshwm sim ntawm kev txhawb nqa zoo li ntawm exocytosis ntawm secretory granules, uas yog cov txheej txheem ntawm excretion ntawm cov sib txuas rau hauv nruab nrab nruab nrab los ntawm cov hlwb, yuav yog qhov kev tso tawm ntawm cov tshuaj insulin rau hauv cov ntshav.

Glimepiride yog tus sawv cev ntawm tiam 3 ntawm sulfonylureas. Nws txhawb kev tso tawm ntawm pancreatic hormone sai, thiab txhim kho cov insulin rhiab heev ntawm protein thiab lipid hlwb.

Peripheral cov ntaub so ntswg metabolize cov piam thaj siv ntau dua los siv thauj cov protein los ntawm cov qog ntawm tes. Nrog rau hom ntshav qab zib insulin-ywj siab, kev hloov pauv ntawm cov piam thaj rau hauv cov ntaub so ntswg yog qeeb. Glimepiride txhawb nqa kev nce hauv qhov ntim ntawm cov thauj cov protein thiab txhim kho lawv cov haujlwm. Xws li lub cev ua tau zoo uas ua rau pancreatic pab txo kom tsis txhob muaj cov tshuaj insulin tsis kam (qhov tsis zoo) rau cov tshuaj hormones.

Amaryl inhibits cov synthesis ntawm glucogen los ntawm lub siab vim muaj kev nce hauv ntim ntawm fructose-2,6-bisphosphate nrog antiaggregant (inhibition ntawm thrombus tsim), antiatherogenic (txo qis hauv qhov ntsuas ntawm "tsis zoo" cov cholesterol) thiab antioxidant (rov ua dua tshiab, los tiv thaiv kev laus) lub peev xwm. Cov txheej txheem oxidation tau qeeb qeeb vim qhov nce ntawm cov ntsiab lus ntawm endogenous b-tocopherol thiab cov haujlwm ntawm cov antioxidant enzymes.

Txawm tias cov tshuaj me me ntawm Amaril ua rau txhim kho glucometer.

Pharmacokinetics ntawm cov tshuaj

Nyob rau hauv cov muaj pes tsawg leeg ntawm Amaril, lub ntsiab nquag tivthaiv yog glimepiride los ntawm sulfonylurea pab pawg. Povidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose thiab dyes E172, E132 yog siv los ua cov tshuaj ntxaws.

Amaryl ua lub siab ua rau cov leeg mob 100%, yog li txawm tias siv sijhawm ntev ntawm cov tshuaj tsis cuam tshuam qhov kev txuam nrog ntawm nws tshaj hauv cov kabmob thiab cov nqaij. Raws li qhov tshwm sim los ntawm kev ua tiav, ob qho txuas ntxiv ntawm glipemiride yog tsim: hydroxymetabolite thiab carboxymethabolite. Thawj cov tshuaj metabolite yog muaj nrog lub zog pharmacological uas muab cov nyhuv hypoglycemic ruaj khov.

Hauv cov ntshav, cov ntsiab lus siab tshaj plaws ntawm cov nquag nquag tau pom tom qab ob thiab ib nrab teev. Muaj qhov tsis txaus ntseeg tiag tiag, cov tshuaj tsis txwv tus neeg mob ntshav qab zib hauv kev xaiv cov khoom noj uas nws "noj" cov tshuaj. Qhov kev muab assimilation yuav nyob rau hauv txhua rooj plaub yog 100%.

Nws hloov tawm ntawm cov tshuaj yog qeeb heev, tus nqi tso tawm cov ntaub so ntswg thiab kua dej ntawm cov tshuaj (tshem tawm) yog 48 ml / min. Qhov kev tshem tawm ib nrab-lub neej yog los ntawm 5 mus rau 8 teev.

Kev txhim kho tseem ceeb hauv glycemic indices yog pom txawm tias muaj teeb meem ua haujlwm nrog lub siab, tshwj xeeb, hauv kev laus (ntau dua 65 xyoos) thiab nrog daim siab tsis ua hauj lwm, qhov tseem ceeb ntawm cov nquag muaj feem.

Yuav siv Amaryl li cas

Ib qho tshuaj yog tsim nyob rau hauv daim ntawv ntawm oval ntsiav tshuaj nrog sib faib sawb, uas tso cai rau koj kom yooj yim cais qhov koob tshuaj nyob rau hauv halves. Cov xim ntawm cov ntsiav tshuaj nyob ntawm qhov ntau npaum: 1 mg ntawm glimepiride - plhaub liab, 2 mg - greenish, 3 mg - daj.

Qhov kev tsim no tsis raug xaiv los ntawm lub caij nyoog: yog tias cov ntsiav tshuaj tuaj yeem pom qhov txawv txav ntawm cov xim, qhov no txo txoj kev pheej hmoo ntawm kev noj ntau dhau, tshwj xeeb tshaj yog nyob rau cov neeg laus.

Cov ntsiav tshuaj tau ntim rau hauv cov hlwv ntawm 15 pcs. Txhua lub npov tuaj yeem muaj los ntawm 2 txog 6 cov phiaj xwm ntawd.

Lub chav kawm ntawm kev kho nrog cov tshuaj yog ntev, muaj ntau nuances. Piv txwv li, koj tuaj yeem hla tsis dhau cov pluas noj tom ntej thaum noj cov tshuaj.

Cov yam ntxwv ntawm kev siv Amaril:

Cov ntsiav tshuaj (lossis ib feem ntawm qhov ntawd) nqos tag nrho, ntxuav nrog dej tsawg tsawg 150 ml. Tam sim ntawd tom qab noj tshuaj, koj yuav tsum noj.
Tus kws endocrinologist xaiv tus txheej txheem tshuaj kho raws li kev soj ntsuam cov kua nruab nrog cev.
Pib chav kawm nrog tsawg kawg ntawm Amaril. Yog tias ib feem ntawm 1 mg tom qab lub sijhawm tshwj xeeb tsis qhia qhov tshwm sim tau npaj tseg, tus nqi nce.
Cov koob tshuaj tau hloov kho me ntsis, nyob rau hauv 1-2 lub lis piam, kom lub cev muaj sij hawm hloov mus rau cov kev mob tshiab. Txhua hnub, koj tuaj yeem nce tus nqi kom tsis ntau tshaj 1 mg. Qhov ntau kawg ntawm cov tshuaj yog 6 mg / hnub. Tus kws kho mob txwv ib qho zuj zus yog tus kws kho mob tau teeb tsa.
Nws yog ib qho tsim nyog yuav tau kho cov kev cai nrog kev hloov pauv qhov hnyav ntawm lub cev ntshav qab zib lossis lub ntim ntawm cov leeg mob, nrog rau thaum muaj kev pheej hmoo ntawm hypoglycemia (thaum lub sij hawm tshaib plab, noj tsis txaus, haus dej cawv, lub raum thiab mob siab).
Lub sijhawm ntawm kev siv thiab ntau npaum li cas yuav nyob ntawm lub suab ntawm lub neej thiab cov yam ntxwv ntawm cov metabolism. Feem ntau, kev tswj hwm ib leeg ntawm Amaril yog tshuaj rau ib hnub nrog kev sib xyaw ua ke nrog zaub mov. Yog tias noj tshais puv, koj tuaj yeem haus ib qho tshuaj ntsiav thaum sawv ntxov, yog tias muaj lub cim qhia - nws zoo dua los ua ke nrog kev txais tos nrog pluas su.
Kev siv tshuaj ntau dhau ua teeb meem nrog lub qog ntshav qab zib, thaum cov piam thaj hauv cov qog tso ntshav tawm mus rau 3.5 mol / L lossis qis dua. Tus mob yuav nyob ntev heev: txij li 12 teev txog 3 hnub.

Amaryl ntsiav tshuaj (hauv ib pob ntawm 30 daim) muaj muag rau ntawm tus nqi:

260 rub - 1 mg txhua;
500 rub - 2 mg txhua;
770 rub. - 3 mg txhua;
1020 RUB. - 4 mg txhua.

Koj tuaj yeem nrhiav pob ntawm 60, 90,120 pieces ntawm ntsiav tshuaj.

Lub thawv Amaril tau tso rau hauv qhov chaw sov (txog li 30 degrees) tsis ntev tshaj peb xyoos. Cov khoom siv ua ntej yuav tsum tsis pub siv rau cov menyuam yaus.

Lwm yam tshuaj sib txuam

Cov neeg mob ntshav qab zib, tshwj xeeb "nrog kev paub", raws li txoj cai, muaj tag nrho cov teeb meem pheej cuam tshuam: kub siab, mob plawv thiab ntshav, teeb meem metabolic, raum thiab lub siab pathologies. Nrog rau cov khoom siv no, koj yuav tsum tsis txhob siv cov tshuaj muaj suab thaj qis dua.

Rau kev tiv thaiv kev tsis txaus siab ntawm cov hlab ntsha thiab lub siab, cov tshuaj uas muaj aspirin yog tshuaj. Amaryl hloov chaw nws tawm hauv cov qauv protein, tab sis nws qib hauv cov ntshav tseem tsis tau hloov pauv. Cov txiaj ntsig ntawm kev siv ntau ntxiv tuaj yeem txhim kho.

Enhanced ua si AMARE nws ntxiv rau insulin, Allopurinu, coumarin derivatives, anabolic steroids, guanethidine, chloramphenicol, fluoxetine, fenfluramine, pentoxifylline, Feniramidolu, fibric acid derivatives, phenylbutazone, miconazole, azapropazone, probenecid, quinolones, oxyphenbutazone, salicylates, tetracycline, sulfinpyrazone, Tritocqualin thiab sulfonamides.

Amaril txo lub peev xwm ntxiv Epinephrine, glucocorticosteroids Diazoxide, laxatives, Glucagon, barbiturates, Acetazolamide, saluretics, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, thiab progestin, thiab ntsev.

Amaryl ntxiv rau histamine H2 receptor blockers, reserpine thiab clonidine muab qhov kev npaj txhij txog nrog rau dauv hauv glucometer hauv ib qho kev taw qhia. Cov txiaj ntsig zoo sib xws ua kom muaj cawv thiab Amaril ntau ntxiv.

Cov tshuaj tsis cuam tshuam rau cov kev ua ntawm ACE inhibitors (Ramipril) thiab cov tshuaj tiv thaiv kab mob (Warfarin) hauv txhua txoj kev.

Hypoglycemic Sib Piv

Yog tias ib qho tshuaj hypoglycemic yuav tsum tau hloov nrog Amaril, qhov tsawg kawg noj tshuaj (1 mg) yog tau sau tseg, txawm tias muaj mob tus neeg mob tau txais cov tshuaj dhau los hauv qhov ntau tshaj plaws. Ua ntej tshaj, qhov tshuaj tiv thaiv ntawm tus kab mob ntshav qab zib tau soj ntsuam ob lub lis piam, thiab tom qab ntawd ces cov tshuaj kho tau kho.

Yog tias tus neeg sawv cev tiv thaiv kab mob siab nrog lub siab ib nrab-lub neej tau siv ua ntej Amaril kom tsis txhob muaj kev txhim kho ntawm lub qog ntshav qab zib, yuav tsum tau ncua sijhawm ob peb hnub tom qab tshem tawm.

Yog tias cov ntshav qab zib tau tswj hwm muaj peev xwm ntawm cov txiav ua kab mob los tsim nws cov tshuaj hormones, tom qab ntawd cov tshuaj insulin tuaj yeem 100% hloov Amaryl. Chav kawm tseem pib nrog 1 mg / hnub.

Thaum txoj kev them nyiaj ib txwm Metformin cov piam thaj tsis tso cai tswj kev mob ntshav qab zib kom tiav, 1 mg ntawm Amaril yuav raug ntxiv. Yog tias cov txiaj ntsig tsis txaus siab, cov txiaj ntsig maj mam hloov mus rau 6 mg / hnub.

Yog tias Amaril + Metformin cov txheej txheem tsis tau ua raws li qhov kev cia siab, nws raug hloov los ntawm Insulin, thaum tswj hwm qhov Amaril. Cov tshuaj insulin kuj tseem pib nrog kev txhaj tshuaj tsawg kawg nkaus. Yog tias cov ntsuas ntawm glucometer tsis tau txhawb nqa, ua kom cov Insulin ntau ntxiv. Kev sib txuam nrog kev siv tshuaj yog tseem tau zoo, vim nws tso cai rau koj kom txo cov tshuaj hormones los ntawm 40% piv nrog kev kho tshuaj ntshiab.

Ntxiv rau Amaril, tus kws kho mob endocrinologist tseem muaj kev xaiv rau cov 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.

Rau leej twg nws yog npaj, thiab rau cov tshuaj tsis pom zoo

Cov tshuaj tau txhim kho kev kho mob ntshav qab zib hom 2. Nws yog siv ob qho tib si nrog monotherapy thiab hauv txoj kev kho mob hauv kev sib txuam nrog Metformin lossis Insulin.

Cov tshuaj tivthaiv ntawm Amaril kov yeej cov nyom ntawm cov placenta, thiab cov tshuaj kuj dhau mus rau hauv niam mis. Vim li no, nws tsis haum rau leej niam cev xeeb tub thiab lactating. Yog tias tus poj niam xav ua niam, txawm tias ua ntej xeeb menyuam, nws yuav tsum pauv mus rau cov tshuaj insulin uas tsis muaj Amaril. Rau lub sijhawm pub mis, cov sijhawm tau teem sijhawm li no tau tshwj tseg, yog tias txawm li cas los xij yuav tsum tau kho nrog Amaril, kev pub mis niam tau nres.

Kev siv cov tshuaj nyob rau hauv ntshav qab zib coma thiab lub zwj ceeb ua ntej lub tsis nco qab yog tsis tsim nyog. Hauv kev mob hnyav rau ntshav qab zib (xws li ketoacidosis), Amaryl tsis ntxiv. Cov tshuaj tseem tsis haum rau cov neeg mob ntshav qab zib nrog thawj hom mob.

Nrog kev ua haujlwm tsis zoo ntawm lub raum thiab mob siab, Amaril tsis muaj txiaj ntsig, Amaril tsis qhia rau hemodialysis thiab ntshav qab zib, ntxiv rau rau ib tus neeg tsis kam lees rau glipemiride lossis lwm yam tshuaj ntawm sulfonamide thiab sulfonylurea chav kawm.

Nrog lub plab hnyuv paresis lossis mob plab hnyuv, kev nqus ntawm cov tshuaj yog cuam tshuam, yog li Amaril tsis hais txog teeb meem zoo li no thaum exacerbation. Lawv yuav tsum hloov mus rau cov tshuaj insulin thiab ntau qhov kev raug mob, phais mob, ntsuas kub, ua rau kub hnyiab.

Amaril tej zaum yuav nrog los ntawm kev dhau mus hypoglycemic. Qee zaum cov neeg mob yws ntawm kiv taub hau, qee qhov ua rau tsis zoo ntawm kev pw tsaug zog, muaj kev ntxhov siab, tawm hws ntau dhau, thiab hais lus tsis meej. Ntawm cov ntshav qab zib, muaj ntau zaus uas tsis tuaj yeem tswj hwm kev tshaib plab, mob plab tsis haum, tsis xis nyob hauv lub siab. Ua tau malfunction ntawm lub plawv atherosclerosis, tawm pob rau ntawm daim tawv nqaij. Ntshav ntws qee zaum worsens.

Nrog tus mob ntshav qab zib hom 2, nws yog ib qho tseem ceeb uas tswj hwm koj tus mob thaum pib ntawm kev noj tshuaj Amaril, nrog rau kev muaj peev xwm txhim kho hypoglycemia, kev hloov pauv ntawm kev noj zaub mov zoo thiab kev ua si.

Qhov teeb meem ntawm kev overdose

Lub sijhawm ntev ntawm kev siv tshuaj, nrog rau kev haus ib qho loj heev, tuaj yeem ua rau mob ntshav qab zib, cov tsos mob uas tau hais hauv seem yav dhau los.

Tus mob ntshav qab zib yuav tsum muaj daim ntawv qhia nrog qhov qhia qhov luv luv ntawm nws qhov mob thiab ib yam dab tsi los ntawm cov khoom noj ceev uas yog carbohydrates (khaub noom, ncuav qab zib). Cov kua txiv qab zib lossis tshuaj yej kuj tsim nyog, tsuas yog tsis muaj cov khoom ua kua qab zib xwb. Thaum muaj mob hnyav, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob kom sai vim tias mob plab thiab ua haujlwm rau lub zog (nqus cov pa roj carbon, thiab lwm yam).

Sab sij huam

Qee qhov tsis tshua muaj, kev siv Amaril nrog cov kev mob tshwm sim hauv cov qauv ntawm qhov tsis pom kev ib nrab, muaj teeb meem nrog cov ntshav ncig, cov roj ntsha tsis ua haujlwm, lub plab zom mov.

Ntawm cov feem ntau muaj:

Glycemic syndrome, muaj tus cwj pwm tsis muaj zog, ua rau lub siab tsis tuaj yeem, tsis pom kev, tsis pom kev, tsis tuaj yeem tswj tau, muaj kev tshaib plab, tawm hws.
Qhov sib txawv hauv cov ntsuas qhov qab zib, ua rau pom kev pom.
Kev tso zis tsis tuaj yeem, ua txhaum ntawm lub suab ntawm kev tso quav, ploj thaum tso cov tshuaj.
Ua xua ntawm kev ua txhaum sib txawv (ua pob ua pob ua pob, khaus khaus, ua xua, ua xua vasculitis, anaphylactic ceeb, tsis muaj ntshav siab thiab ua tsis taus pa).

Noj Amaril cuam tshuam loj heev rau kev ceev ntawm lub hlwb kev xav - tsav tsheb, nrog rau kev ua haujlwm uas yuav tsum muaj kev kub siab, tshwj xeeb tshaj yog nyob rau theem pib ntawm kev kho, tsis sib haum nrog Amaril txoj kev kho.

Kev xav ntawm cov kws kho mob thiab cov ntshav qab zib txog Amaril

Kev tshuaj xyuas cov neeg mob endocrinologist uas niaj hnub ntsib txhua qhov tshwm sim ntawm tus kab mob insidious yog feem ntau lub hom phiaj, vim tias lawv muaj sijhawm los kawm txog kev cuam tshuam ntawm cov neeg mob rau cov tshuaj nyob rau hauv thiaj li yuav kos cov lus xaus txog nws cov hauj lwm zoo.

Raws li cov kws kho mob, nrog cov txheej txheem kev kho mob kom raug, Amaril pab ua kom normalize glycemic indices sai heev. Tus kws kho mob ntshav qab zib noj cov tshuaj muaj kev tsis txaus siab ntawm lub qog ntshav qab zib thaum txoj kev xaiv tau xaiv tsis zoo. Thiab tsis tau, hais txog cov tshuaj Amaril, kev xyuas neeg mob yog qhov kev xav tau zoo.

Zinchenko A.I. Kuv tau tawm tsam mob ntshav qab zib hom 2 tau 7 xyoo. Nws tau ntsib ntau yam tshuaj - los ntawm Metformin thiab Novonorm mus rau Insulin. Kuv tab tom noj tshuaj 2 mg ntawm Amaril tam sim no. Kom tus kws kho mob tuaj yeem nkag siab tias cov tshuaj puas haum rau kuv, Kuv ntsuas ntshav qab zib ob peb zaug hauv ib hnub. Nrog rau cov ntsiav tshuaj no, qhov tau nyeem ntawm lub taub poob tau nqis mus rau 4.6 mmol / L. Hauv kev sab laj zaum kawg, lawv tau txo qis kuv cov koob tshuaj thiab piav qhia tias cov tshuaj ua haujlwm ua ob txoj kev: nws tswj kev tso tawm ntawm nws cov insulin thiab pab kom daim siab hloov pauv cov piam thaj rau glycogen kom muaj kev nyab xeeb.

Kovaleva Irina. Raws li cov ntshav qab zib nrog kev paub Kuv noj Amaril twb tau ntau npaum li 3 mg. Cov nyiaj them qee zaum no ua rau kuv ua txhaum nrog kev noj zaub mov noj (ib diav ntawm zib ntab lossis dej khov nab kuab ib zaug ib lim tiam). Kuv tsis nyiam qhov qab qab zib li, yog li kuv sim ua kom tsis muaj lawv. Yog tias cov ntsuas tau qhia kuv qhov kev cai ntawm qab zib rau ob peb hnub, kuv tsum tsis haus tshuaj, sim hloov mus rau tshuaj ntsuab thiab zawm kuv cov zaub mov kom zoo. Kuv ntseeg tias cov ntsiav tshuaj tseem pab kuv poob 8 phaus ntxiv.

Kev noj haus qis-carb, kev siv lub cev ua si, tswj lub cev nyhav muaj qhov cuam tshuam rau cov txiaj ntsig ntawm kev siv tshuaj Amaril. Tus mob ntshav qab zib yuav tsum qhia rau tus kws kho qhov mob endocrinologist kom txog sijhawm muaj cov kev mob tshwm sim, cov tsos mob ntawm hypo- thiab hyperglycemia uas tsim nrog Amaril.

Txoj kev kho kuj tseem cuam tshuam kev soj ntsuam tus kheej ntawm cov piam thaj ntsuas thiab kev soj ntsuam ntawm lub siab ua haujlwm, kev sim tshuaj, tshwj xeeb tshaj yog kev kuaj ntshav glycated hemoglobin, uas niaj hnub no suav hais tias yog lub hom phiaj tseem ceeb tshaj plaws rau kev ntsuas tus neeg mob ntshav qab zib. Qhov no yuav pab txhawm rau txheeb xyuas qhov degree ntawm tsis kam ntawm Amaril rau kev kho ntawm kev kho mob kiag li.

Koj tuaj yeem kawm txog cov nta ntxiv ntawm Amaril los ntawm cov yeeb yaj kiab.

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