Kev kho mob ntshav qab zib hom 2 suav nrog kev tswj hwm tshuaj hypoglycemic ntawm ntau pab pawg.
Cov no suav nrog sulfonylurea derivatives.
Ib tus sawv cev ntawm pawg no yog chlorpopamide.
Cov ntaub ntawv dav dav txog cov tshuaj
Chlorpropamide yog cov tshuaj nquag ua haujlwm uas yog los ntawm tiam 1 tiam sulfonylurea derivatives. Nws pharmacological pawg yog hypoglycemic hluavtaws tus neeg sawv cev. Chlorpropamide tsis yog soluble hauv dej, tab sis, ntawm qhov tsis tooj, yog soluble hauv cawv.
Tsis zoo li lwm tiam ntawm sulfonylurea derivatives, chlorpropamide ua yeeb yam luv luv. Yuav kom ua tiav qib siab ntawm glycemia, nws yog siv rau hauv cov tshuaj loj.
Cov kev mob tshwm sim los ntawm kev noj tshuaj muaj ntau dua cov lus piv nrog Glibenclamide thiab lwm tus neeg sawv cev ntawm 2 tiam. Pib siv nrog cov tshuaj hormone (insulin) tsis txaus thiab ua rau cov nqaij mos raug tshem tawm qis. Kev kho mob nrog chlorpropamide muaj cov nyhuv hauv cov neeg mob uas muaj ntshav qab zib ib feem insipidus thiab / lossis muaj ntshav qab zib hom 2.
Chlorpropamide yog cov tshuaj lub npe rau cov tshuaj. Nws ua lub hauv paus ntawm cov tshuaj (yog ib qho kev tiv thaiv). Muaj nyob hauv ntsiav tshuaj.
Pharmacological kev txiav txim
Cov tshuaj muaj cov nyhuv hypoglycemic. Cov tshuaj khi rau cov kab mob potassium, stimulates lub zais cia ntawm insulin. Hauv cov ntaub so ntswg thiab cov plab hnyuv siab raum nqus tau los ntawm cov tshuaj insulin, tus naj npawb ntawm cov receptors rau qhov nce qib.
Nyob rau hauv muaj cov endogenous insulin, cov piam thaj txo qis. Nws muaj cov kev ua haujlwm antidiuretic. Vim kev zais tawm ntawm insulin, qhov hnyav nce tshwm sim.
Tiv thaiv glycemia yog me ntsis tso ntshav qab zib. Chlorpropamide, zoo li lwm yam sulfonylureas, muaj kev pheej hmoo ntawm hypoglycemia, tab sis rau qee yam tsawg dua.
Thaum ua ke nrog lwm tus kab mob hypoglycemic (biguanides, thiazolidinediones, saib kev sib txuam nrog lwm cov tshuaj), qhov ntau npaum ntawm qhov kawg yuav txo qis me ntsis.
Tus txheej txheem ntawm kev txiav txim ntawm sulfonylurea derivatives
Cov Tshuaj Pharmacokinetics
Tom qab nkag mus rau hauv lub plab zom mov, chlorpropamide zoo rau kev nqus. Tom qab ib teev, cov tshuaj muaj nyob rau hauv cov ntshav, nws lub siab tshaj plaws - tom qab 2-4 teev.Qhov khoom siv tshuaj yog metabolized hauv lub siab. Plasma protein khi> 90%.
Cov yeeb tshuaj ua thoob plaws ib hnub nyob rau hauv cov ntaub ntawv ntawm kev siv ib zaug. Qhov kev tshem tawm ib nrab-lub neej yog txog 36 teev. Nws yog tawm hauv feem ntau hauv cov zis (txog li 90%).
Kev taw qhia thiab contraindications
Kev qhia rau kev siv yog tsis muaj ntshav qab zib-insulin-mob ntshav qab zib, thiab ntshav qab zib insipidus. Chlorpropamide tau raug sau tseg rau hauv qhov xwm txheej uas kev noj zaub mov noj, kev tawm dag zog tsis tau coj cov txiaj ntsig tsim nyog hauv kev kho qhov ntsuas.
Ntawm cov contraindications rau kev siv tshuaj muaj xws li:
- kev ua haujlwm tsis haum rau chlorpropamide;
- Ntshav Qab Zib Hom 1;
- cov tshuaj tiv thaiv tsis haum rau lwm cov sulfonylureas;
- metabolism hauv nrog ib qho kev xav tau ntawm acidosis;
- cov thyroid pathology;
- ketoacidosis;
- daim siab thiab lub raum tsis ua hauj lwm;
- mob kis hnyav;
- cev xeeb tub / lactation;
- poj koob yawm txwv thiab coma;
- cov menyuam hnub nyoog;
- rov ua tsis tau zoo ntawm cov tshuaj chlorpropamide;
- tej yam kev mob tom qab rov quav dua.
Tsuas tshuaj thiab tswj hwm
Cov koob tshuaj yog teem los ntawm tus kws kho mob raws li cov chav kawm mob ntshav qab zib thiab kev nyem ntawm glycemia. Thaum ua tiav cov nyiaj raug mob ruaj khov hauv tus neeg mob, nws tuaj yeem txo qis. Raws li txoj cai, nrog hom 2 ntshav qab zib, qhov ib txwm ntsib yog 250-500 mg. Nrog ntshav qab zib insipidus - 125 mg ib hnub twg. Thaum pauv mus rau lwm cov tshuaj, yuav tsum tau kho ntau npaum li cas.
Cov lus qhia rau kev siv chlorpropamide qhia tias kev siv tshuaj li ib nrab ib teev ua ntej noj mov. Nws yog ib qho tseem ceeb kom haus nws ntawm ib zaug. Yog tias qhov tshuaj muab rau tsawg dua 2 ntsiav tshuaj, ces qhov kev txais tos yuav siv sijhawm sawv ntxov.
Video los ntawm cov kws tshaj lij mob ntshav qab zib thiab yuav kho nws li cas:
Phiv thiab haus tshaj
Cov kev mob tshwm sim hauv qab no tej zaum yuav tshwm sim thaum cov tshuaj chlorpropamide:
- xeev siab, ntuav, mob plab, tso quav tsis xis nyob;
- ntshav tshuaj qis;
- tshuaj tiv thaiv hyponatremia;
- nws yog xim hlau hauv lub qhov ncauj, tsis muaj qhov tsis qab los;
- pom kev tsis zoo;
- cov tawv nqaij ua pob ua si sib txawv;
- hemolytic anemia;
- nce hauv cov siab ntsuas;
- thrombo-, leuko-, erythro-, granulocytopenia;
- mob taub hau thiab kiv taub hau;
- siab txo;
- tsis muaj zog, tsis quav ntsej, qaug zog, ntxhov siab;
- cholestatic jaundice;
- kev saib xyuas dej hauv lub cev;
- anaphylactic poob siab.
Nrog rau cov ntshav qog ua kom lub cev kub / nrab ntawm cov ntshav qab zib, tus neeg mob yuav noj 20-30 gram ntawm cov piam thaj. Nyob rau hauv lub neej yav tom ntej, cov ntau npaum hloov thiab cov khoom noj tau hloov kho.
Hauv cov xwm txheej loj, uas nrog los ntawm coma thiab huam, kua nplaum nyob ua ke tso leeg. Tsis tas li ntawd, glucagon tuaj yeem muab tshuaj rau hauv qhov quav tshuaj lossis ib leeg. Tom qab nres kev mob ntshav qab zib hauv ob hnub, ntsuas yuav tsum siv cov glucometer.
Daim ntawv thov nta
Ua ntej npaj kev xeeb tub, koj yuav tsum tso tseg chlorpropamide. Kev tswj ntshav qab zib hom 2 nrog insulin yog suav tias yog kev kho mob zoo tshaj plaws. Thaum lub sij hawm lactation, lawv ua raws li cov ntsiab cai ib yam.
Hloov mus rau cov tshuaj yog tsim los ntawm ib nrab ntsiav tshuaj hauv ib hnub, tom qab ntawd nws yog tshuaj rau thawj lub ntsiav tshuaj. Cov neeg mob uas lub raum / lub cev tsis ua haujlwm zoo yuav tsum tau txhaj koob tshuaj. Thaum sau daim ntawv noj ntau npaum li cas ntawm cov tshuaj rau cov neeg laus, lawv lub hnub nyoog tau coj mus rau hauv tus account.
Thaum them nyiaj rau tus kab mob, yuav tsum tau txo tshuaj ntau ntau. Kev kho kuj tseem ua tiav nrog kev hloov pauv ntawm lub cev nyhav, thauj khoom, hloov mus rau lwm lub sijhawm.
Vim tias tsis muaj cov ntaub ntawv hais txog kev nyab xeeb ntawm kev siv, cov tshuaj tsis tau sau tseg rau cov menyuam yaus. Yog tias muaj kev raug mob, ua ntej / tom qab ua haujlwm, thaum lub sijhawm sib kis cov neeg mob, tus neeg mob hloov mus rau insulin ib ntus.
Tsis txhob siv nrog Bozetan. Muaj cov ntaub ntawv pov thawj tias nws cuam tshuam rau cov neeg mob uas tau txais chlorpropamide. Lawv tau sau tseg tias qhov nce hauv cov kabmob hepatic (enzymes). Raws li cov yam ntxwv ntawm ob qho tshuaj, lub tshuab ntawm kev nthuav dav ntawm cov kua tsib kua qaub los ntawm cov hlwb raug txo kom tsawg. Qhov no entails lawv cov tsub zuj zuj, uas ua rau kom muaj kev phom sij.
Kev cuam tshuam nrog lwm yam tshuaj
Biguanide Metformin
Nrog rau kev siv tib txhij ntawm chlorpropamide thiab lwm yam tshuaj, nws cov nyhuv yuav txo lossis nce ntxiv. Yuav tsum tau sab laj ua ntej yuav noj lwm yam tshuaj.
Ua tshuaj txiav txim tshwm sim thaum coadministered nrog insulin, lwm yam hypoglycemic tshuaj, biguanides, coumarin derivatives, phenylbutazone, tshuaj tetracycline, Mao inhibitors, fibrates, salicylates, miconazole, streroidami, txiv neej cov tshuaj hormones, cytostatics, sulfonamides, quinolone derivatives, clofibrate, sulfinpyrazone.
Cov tshuaj hauv qab no ua rau cov tshuaj chlorpropamide ua kom tsis tshua muaj zog: barbiturates, diuretics, adrenostimulants, estrogens, ntsiav tshuaj tiv thaiv kab mob, koob tshuaj ntau ntawm nicotinic acid, diazoxide, thyroid hormones, phenytoin, glucocorticosteroids, sympathomimetics, phenothiazine derivatives, Acetazolamide.
Chlorpropamide yog ib tus neeg sawv cev hypoglycemic uas yog hais txog tiam 1 tiam sulfonylurea derivatives. Piv nrog rau nws cov thwjtim, nws muaj suab thaj ua rau qis dua thiab muaj cov teebmeem tshwm sim ntau dua. Tam sim no, cov tshuaj yog tsis siv tsis tau.
