Glibenclamide: cov lus qhia rau kev siv tus neeg sawv cev hypoglycemic

Glibenclamide yog qhov ncauj tshuaj hypoglycemic uas hais txog kev thiv thiv los sulfonylureasCov. Cov txheej txheem ntawm kev ua ntawm glibenclamide cuam tshuam nrog kev tsim kom zais kev zais cia tshuaj insulin β cov ntshav hauv txiavlos ntawm kev nce tawm ntawm cov tshuaj insulin. Feem ntau, qhov ua tau zoo yog pom nyob rau theem ob ntawm insulin ntau lawm. Qhov no nce qhov rhiab ntawm peripheral cov ntaub so ntswg mus rau kev ua ntawm insulin, nrog rau nws txoj kev sib txuas nrog cov phiaj hlwb. Tsis tas li, glibenclamide yog tus cwj pwm los ntawm lipid-txo cov nyhuv thiab txo qis hauv cov khoom muaj zog thrombogenic ntshav.

Sab hauv lub cev, kev ceev nrawm thiab kev nqus ntawm cov tshuaj los ntawm cov hnyuv tau sau tseg. Kev sib txuas lus nrog cov protein ntshav sib raug rau yuav luag 95%. Kev zom zaub mov cov tshuaj yog nqa tawm hauv daim siab, uas ua rau tsim muaj qhov tsis muaj zog metabolitesCov. Kev nqhis dej feem ntau tshwm sim hauv cov khoom muaj zis thiab ib feem - bile, nyob rau hauv daim ntawv ntawm metabolites.

Cov Yuav Tsum Muaj

Cov tshuaj tsis pom zoo rau kev siv nrog:

• kev tiv thaiv tsis haumrau Glibenclamide lossis sulfonamides thiab thiazide diuretics,
• uas ua rau mob ntshav qab zib lossis ua rau tsis nco qab,
• ketoacidosis,
• dav kub hnyiab
• kev raug mob thiab phais mob,
• hnyuv ob peb leeg thiab paresis ntawm lub plab,
• ntau hom malabsorption ntawm cov zaub mov,
• kev txhim kho ntshav qab zib,
• lactation, cev xeeb tub,
• mob ntshav qab zib1 hom thiab yog li ntawd.

Sab sij huam

Hauv kev kho nrog Glibenclamide, kev txhim kho ntawm qhov tsis xav pom tshwm sim cuam tshuam rau kev ua haujlwm ntawm endocrine, plab zom mov, poob siab, kab mob ntsws thiab cov hlab ntsha ua haujlwm tau. Yog li ntawd, nws yuav tshwm sim: ntshav qogsib txawv qib ntawm heev xeev siab, raws plablub siab ua tsis taus haujlwm, cholestasis, mob taub hauqaug zog thiab qaug zog kiv taub hau.

Cov kev tshwm sim ntawm kev tsis haum tshuaj thiab tshuaj pleev ib ce nyob rau hauv daim ntawv ntawm: tawv nqaij ua pob, khaus, ua kom lub cev thiab lwm cov tsos mob kuj muaj peev xwm ua tau.

Cov lus qhia rau kev siv Glibenclamide (Txuj ci thiab ntau npaum li cas)

Cov lus qhia rau kev siv Glibenclamide qhia tias cov koob tshuaj ntawm lub tshuaj tau muab cais ua ib tus zuj zus thiab nyob ntawm lub hnub nyoog, qhov mob hnyav ntawm tus kabmob thiab qib txhauvCov. Cov ntsiav tshuaj tau noj ntawm qhov ncauj, ntawm plab lossis 2 teev tom qab noj mov.

Qhov nruab nrab txhua hnub koob tau teem nyob rau hauv thaj tsam ntawm 2.5-15 mg, nrog rau ntau zaus ntawm kev tswj hwm 1-3 zaug hauv ib hnub.

Cov koob tshuaj txhua hnub saum toj no 15 mg yog siv tsis tshua muaj, tsis muaj qhov tseem ceeb nce hauv cov nyhuv hypoglycemic. Cov neeg laus cov neeg mob tau txhaj tshuaj ib hnub ib zaug 1 mg thaum pib kho. Txhua qhov kev hloov pauv ntawm ib qho yeeb tshuaj mus rau lwm qhov, kev tswj hwm koob tshuaj thiab lwm yam, yuav tsum ua nyob rau hauv kev saib xyuas ntawm tus kws tshaj lij.

Noj ntau dhau

Thaum tus neeg haus ntau dhau, txoj kev txhim kho hypoglycemia yog qhov ua tau, uas tuaj yeem nrog kev xav zoo li tsis tshaib plab, tsis muaj zog, kev txhawj xeeb, mob taub hau, kiv taub hau, hws, lub plawv dhiatshee tshee lub hlwb edemahais lus thiab tsis pom kev zoo thiab lwm yam.

Kev kho mob cuam tshuam nrog kev ua kom sai ntawm cov piam thaj, kua txiv, kua kub qab zib, pob kws phoov, zib ntab - hauv qee kis.

Cov teeb meem loj mas yuav tsum daws kom taupiam thaj 50% Txoj kev lis ntshav tas mus li rau txoj kev daws teeb meem Dextrose 5-10%, kev taw qhia Glucagon intramuscularly Diazoxide sab hauv. Tsis tas li ntawd, nws yog qhov tsim nyog los tswj qib ntawm glycemia, txiav txim siab pH, creatinine, urea nitrogen, electrolytes.

Kev sib txuam

Ua ke nrog cov tshuaj tua kab mob uas tsis muaj zog, fluoroquinolones, tetracyclines, chloramphenicol, H2-blockers, beta-blockers, ACE inhibitors thiab MAO,clofibrate, bezafibrate, probenecid, Paracetamol, ethionamide, anabolic steroids, pentoxifylline, allopurinol, cyclophosphamide, Reserpine, sulfonamide thiab Insulin. muaj peev xwm rau hwj chim hypoglycemia.

Concomitant siv nrog barbiturates, phenothiazines, diazoxide, glucocorticoid thiab cov thyroid hormones, estrogens, gestagens, glucagons, tshuaj adrenomimetic, lithium ntsev tawm los ntawm nicotinic acid thiab tshuaj pleev tus nqaij tej zaum yuav ua rau cov nyhuv hypoglycemic tsawg.

Txhais tau tias uas tuaj yeem acidify zis, piv txwv: calcium chloride, ammonium chlorideloj koob tshuaj ascorbic acid tuaj yeem txhim kho cov nyhuv ntawm cov tshuaj. Kev sib txuas nrog Rifampicin nrawm inactivation thiab txo nws cov hauj lwm zoo.

Cov lus qhia tshwj xeeb

Nws raug nquahu kom ua tib zoo kho cov neeg mob kev txom nyem los ntawm kev mob siab rau lub siab thiab lub raum, nrog rau cov teeb meem febrile, kev ua haujlwm ntawm lub qog ua haujlwm rau lub qog adrenal los yog lub qog caj pas, thiab cov cawv cawv ntev.

Rau tag nrho cov txheej txheem kev kho mob kom zoo, kev saib xyuas ntawm qib ntawm cov piam thaj hauv cov ntshav thiab cov kua nplaum tawm yog qhov tsim nyog.

Yog tias hypoglycemia txhim kho hauv cov neeg mob nco ntsoov, tom qab ntawd cov piam thaj lossis ntshav qab zib raug muab ntawm qhov ncauj. Thaum muaj mob tsis nco qab, qabzib yog tswj hwm dej, thiab glucagon - intramuscularly, subcutaneously lossis intravenously.

Thaum lub siab nco qab rov qab, tus neeg mob yog tam sim ntawd muab cov zaub mov nplua nuj nyob hauv cov khoom noj kom hnyav kom tsis txhob rov ua qog ntshav qab zib.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Hauv 1 tab. tshuaj tiv thaiv kab mob muaj 1,75 mg, 3.5 mg lossis 5 mg ntawm cov tshuaj nquag, uas yog glibenclamide.

Kuj tseem nyob hauv cov tshuaj muaj:

• Povidone
• Lactose Monohydrate
• Qos yaj ywm hmoov txhuv nplej siab
• Magnesium stearate
• Ponceau 4R.

Cov ntsiav tshuaj hloov puag ncig, daj ntseg liab xim hauv xim, tej zaum yuav muaj txaws. Cov tshuaj muaj nyob rau hauv lub khob fwj uas muaj 120 ntsiav tshuaj, ib daim ntawv ntxiv ntawm cov neeg siv tau txuas nrog.

Kho thaj chaw

Nws yog tsim nyog sau cia tias kev lag luam lub npe ntawm cov tshuaj txuam nrog lub npe ntawm cov tshuaj nquag. Cov tshuaj muaj cov nyhuv hypoglycemic ob leeg hauv cov tib neeg uas tau los ntawm hom 2 mob ntshav qab zib mellitus, thiab hauv cov neeg muaj kev noj qab haus huv tiag. Lub tshuab kev ua ntawm kev ua raws li kev ua kom insulin ntau ntxiv los ntawm β-hlwb ntawm cov txiav ua tiav los ntawm nws cov kev txhawb nqa. Xws li cov nyhuv nyob ntawm, ua ntej ntawm txhua yam, nyob rau theem ntawm cov piam thaj hauv qhov nruab nrab uas nyob ib puag ncig β-hlwb.

Tom qab noj cov ntsiav tshuaj, cov tshuaj nquag tau nrawm thiab yuav luag nqus. Nrog rau cov pluas noj, tsis muaj ib qho tseem ceeb txo qis hauv tus nqi ntawm kev nqus ntawm glibenclamide. Qhov taw qhia ntawm kev sib txuas lus nrog plasma protein yog 98%. Qhov siab tshaj plaws ntawm ib yam khoom hauv ntshav dej yog saib tom qab 2.5 teev. Ib qho kev poob qis hauv kev cia siab ntawm glibenclamide tau sau cia tom qab 8-10 teev thiab nyob ntawm qhov ntau npaum li cas ntawm cov tshuaj uas tus neeg mob noj. Qhov kev tshem tawm ib nrab-lub neej yog nyob rau nruab nrab 7 teev.

Kev hloov pauv ntawm glibenclamide tshwm sim hauv cov kab mob siab, metabolites yog tsim, uas xyaum tsis koom nrog cov suab thaj txo cov nyhuv ntawm cov tshuaj nquag. Kev nqhis ntawm cov khoom lag luam metabolic yog nqa nrog cov zis, nrog rau cov kua tsib hauv cov khoom sib npaug, qhov kev pom zoo kawg ntawm cov metabolites tau pom tom qab 45-72 teev.

Hauv cov neeg muaj lub siab tsis ua hauj lwm daim siab, ncua kev nthuav tawm ntawm glibenclamide tau sau tseg. Hauv cov neeg mob uas mob raum tsis ua haujlwm, kev nthuav tawm ntawm lub cev tsis ua haujlwm ncaj qha hauv cov zis yuav ntxiv nyiaj ntau.

Cov lus qhia rau kev siv ntsiav tshuaj

Nqe: txij li 56 txog 131 rubles.

Kev noj tshuaj ntau yog txiav txim siab ntawm tus kheej coj mus rau hauv tus account tus neeg mob lub hnub nyoog, glycemia, nrog rau qhov mob hnyav ntawm cov chav kawm ntawm tus kab mob. Nws raug nquahu kom noj tshuaj rau ntawm lub plab khoob lossis tom qab 2 teev tom qab noj mov.

Feem ntau, qhov nruab nrab cov tshuaj txhua hnub nws txawv ntawm 2.5 mg - 15 mg. Qhov ntau zaus ntawm kev siv tshuaj yog 1-3 p. txhua hnub.

Txais tos ntawm ib koob tshuaj txhua hnub ntawm 15 mg thiab saum toj no tau sau tseg tsis tshua muaj txiaj ntsig, qhov no tsis tshua nce cov nyhuv hypoglycemic ntawm cov tshuaj. Cov neeg laus yog qhov pom zoo kom pib kho nrog 1 mg ib hnub twg.

Qhov kev hloov ntawm ib cov tshuaj tiv thaiv kab mob rau lwm tus lossis hloov pauv hauv lawv cov tshuaj yuav tsum muaj nyob rau hauv kev saib xyuas ntawm kws kho mob.

Kev tiv thaiv kev nyab xeeb

Kev siv tshuaj kho mob yuav tsum tau ua nyob rau hauv kev saib xyuas cov ntshav qab zib thiab zis tsis tu ncua.

Thaum kho, koj yuav tsum tsis kam lees haus dej haus cawv, txij li kev txhim kho hypoglycemia, zoo li disulfiram zoo li kev ua yeeb yam, tsis raug cais.

Thaum cov tsos mob ntawm hypoglycemia tshwm sim, nws yuav tsim nyog los them rau qhov tsis muaj cov piam thaj los ntawm kev tswj hwm ntawm dextrose. Yog tias thaum lub xeev tsis nco qab lawm, dextrose yog tswj xyuas qhov quav tshuaj. Txhawm rau kom tsis txhob rov mob dua, nws tsim nyog los ua kom cov pluas noj nrog carbohydrates.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Daim ntawv txiav txim - cov ntsiav tshuaj: tiaj-cylindrical, nrog cov kab sib faib, dawb lossis dawb nrog lub teeb grey lossis daj ntxoov ntxoo ntawm xim (10 pcs. Hauv cov hlwv, hauv daim ntawv thawv ntawm 1, 2, 3 lossis 5 pob, 20, 30 lossis 50 txhua nyob rau hauv cov kaus poom ua los ntawm cov polymer lossis cov iav tsaus, hauv pob ntawv cardboard 1 tuaj yeem).

Cov tshuaj yeeb tshuaj yog glibenclamide, hauv 1 ntsiav tshuaj - 5 mg.

Ntu cov khoom siv: lactose monohydrate (mis nyuj muaj suab thaj), magnesium stearate, povidone (cov roj ntshav hnyav polyvinylpyrrolidone kho mob), cov hmoov txhuv nplej siab.

Cov Tshuaj Pharmacokinetics

Thaum noj ntawm qhov ncauj, glibenclamide yog nqus tau ntawm txoj hnyuv mus li ntawm 48–84%. Qhov siab tshaj plaws ntawm cov tshuaj yeeb dej caw tiav tau tiav 1-2 teev tom qab kev coj noj coj ua. Qhov ntim ntawm kev faib tawm yog 9-10 liv. Glibenclamide khi rau cov ntshav muaj protein li ntawm 95–99%. Nws cov bioavailability yog 100%, yog li cov tshuaj muaj peev xwm noj tam sim ntawd ua ntej noj mov.

Glibenclamide nkag mus rau qhov chaw tsis zoo thiab qhov yuav luag tiav hauv lub siab, ua rau ob lub cev tsis ua haujlwm, ib qho tawm hauv cov kua tsib, thiab lwm qhov hauv cov zis. Qhov kev tshem tawm ib nrab-lub neej txawv ntawm 3 txog 10-16 teev.

Cov lus qhia rau kev siv Glibenclamide: txoj kev thiab ntau npaum li cas

Cov ntsiav tshuaj noj noj ntawm qhov ncauj 20-30 feeb ua ntej lossis 2 teev tom qab noj mov.

Tus kws kho mob tau sau ntawv rau noj ib lub zuj zus, nyob ntawm qhov mob ntshav qab zib ntau npaum li cas, hnub nyoog ntawm tus neeg mob thiab theem ntawm glycemia.

Qhov txiaj ntsig nruab nrab hauv ib hnub ib zaug yog li ntawm 2.5 txog 15 mg, nrog rau kev tswj hwm ntawm 1-3 zaug. Hauv qee qhov tsis tshua muaj tshwm sim, cov tshuaj siv rau hauv ib koob tshuaj ntau dua 15 mg rau ib hnub, qhov no tsis cuam tshuam ntau ntxiv rau qhov nce ntawm cov nyhuv hypoglycemic.

Thawj koob tshuaj rau cov neeg mob laus yog 1 mg ib hnub twg.

Thawj koob tshuaj thaum hloov pauv los ntawm biguanides yog 2.5 mg rau ib hnub.

Txhawm rau kom them nyiaj rau cov kev ua txhaum ntawm cov carbohydrate metabolism tom qab tshem tawm ntawm biguanides, cov koob tshuaj glibenclamide, yog tias tsim nyog, tuaj yeem tau nce ntawm 2.5 mg txhua 5-6 hnub. Txoj kev hloov mus rau kev kho ua ke nrog glibenclamide thiab biguanides yuav tsum npaj ua ntej thaum tsis muaj cov nyiaj them poob haujlwm li ntawm 4-6 lub lim tiam.

Sab sij huam

Kev siv cov tshuaj yuav ua rau cov kev mob tshwm sim hauv qab no:

• Los ntawm cov kab mob endocrine: hypoglycemia txog thaum tsis nco qab (yog daim ntawv qhia tseeb, ua raws li cov tshuaj noj thiab kev noj haus txo qhov ntxim nyiam ntawm nws txoj kev txhim kho),
• Los ntawm cov kab mob hauv lub cev: tsis tshua muaj - mob taub hau, kiv taub hau, qaug zog, paresis, tsis muaj zog, tsis hnov ​​mob,
• Los ntawm lub plab zom mov: zoo nkaus li hnyav rau hauv thaj chaw epigastric, xeev siab, raws plab, tsis tshua muaj - cholestasis, ua haujlwm lub siab ua haujlwm,
• Los ntawm cov kab mob hemopoietic: tsis tshua muaj - hematopoiesis, kev loj hlob ntawm pancytopenia,
• Ua xua: khaus, tawv nqaij ua pob,
• Dermatological tshua: tsis tshua muaj - photosensitivity.

Cov kws kho mob tshuaj xyuas txog glibenclamide

Ntawm ntau cov tshuaj tau tawm rau kev kho mob ntshav qab zib mellitus, raws li txoj cai, ntawm hom 2-1, cov neeg mob tau sau tseg tias kev tsis muaj txiaj ntsig ntawm Glibenclamide. Kuv yuav tsum txuas lwm cov tshuaj.

Tsis meej xwm txog lub tshuaj. Qee tus neeg muaj cov tshuaj no, qee tus tsis kam siv. Txhua tus, koj yuav tsum daws qhov teeb meem no nrog koj tus kws kho mob.

Glibenclamide xyuas neeg mob

Tsis ntev los no, kuv txiv tau mob ntshav qab zib hom 2. Nws tau pw tsev kho mob vim yog muaj hluav taws xob tsis zoo. Muaj ntshav qab zib 14. Tus kws endocrinologist tau sau cov tshuaj metformin thiab glibenclamide (Kuv tsis nco qab cov npe ntawm cov tshuaj). Kuv txiv tau siv tshuaj rau ib lub hlis twb tau txais peb zaug ib hnub. Qhov chaw ib lub lis piam tom qab pib siv cov tshuaj, Kuv pib yws yws tas li ntawm qhov tsis muaj xeev siab, tab sis, raws li nws, qhov no tsis tseem ceeb piv rau qhov tseeb tias cov tshuaj yeej tswj cov piam thaj hauv 6-7 (peb niaj hnub siv cov glucometer), yog li kuv txiv yim zoo siab.

Kuv cov ntshav qab zib muaj 5 xyoos. Thaum xub thawj lawv raug kho nrog metformin, tab sis nws tsis ua haujlwm zoo heev - tsis muaj kev mob tshwm sim, tab sis tsis muaj ib qho kev vam meej hauv kev ua cov suab thaj ib txwm ib yam. Thiab qhov no txawm hais tias qhov tseeb kuv tau tsa lub koob ob zaug. Tom qab 2 lub xyoos dhau los kuv tau kho tus mob glibenclamide, ntxiv rau metformin, thiab txij thaum ntawd txhua yam tau tig los rau qhov zoo dua. Kuj tseem tsis muaj kev mob tshwm sim, tab sis lawv hnov ​​zoo li qub thiab qab zib feem ntau yog qis dua 7.

Tsis ntev dhau los, Kuv tau mob los ntawm tus kab mob no, li 3-4 xyoo, nrhiav tau los ntawm kev tshawb nrhiav tshuaj, Kuv tsis xav tias kuv tuaj yeem mob ntshav qab zib. Tam sim no kuv yog ib tus qhua uas niaj hnub tuaj saib rau lub nroog Essentuki thiab cov txheej txheem kho mob. Tab sis kuv tseem coj Glibenclamide, los ntawm txoj kev, cov tshuaj no tau sau rau kuv ntawm no hauv lub nroog no, lawv tau hais tias nws ua haujlwm zoo dua thiab yuav pab kuv. Kuv tau siv lwm yam tshuaj uas ua rau txo cov ntshav qab zib kom ntau. Thaum xub thawj, Kuv tau muaj kev phiv nyob rau hauv daim ntawv ntawm xeev siab thiab raws plab, tab sis tom qab siv sijhawm ntev, lawv pib ploj, pom meej, kev quav yeeb tshuaj rau cov tshuaj mus. Tab sis qhov tseem ceeb tshaj plaws, cov piam thaj hauv qab zib tau raug txo qis thaum noj cov tshuaj, uas tau sau tseg los ntawm cov kua nplaum thiab noj qab haus huv txhua hnub.

Kuv tau mob ntshav qab zib ntau dua 15 xyoos. Kuv tau sim ntau cov tshuaj uas muaj suab thaj, tab sis Glibenclamide tseem yog qhov haum rau kuv. Cov kev mob tshwm sim hauv daim ntawv ntawm xeev siab thiab tsis qab los noj mov tau nyob hauv thawj lub lis piam, tom qab ntawd txhua yam ua tiav. Nws txo cov piam thaj kom zoo nrog nce zuj zus thiab tso cai rau koj kom nws nyob li qub. Qhov tsis yooj yim xwb - koj yuav tsum ntsuas cov piam thaj tas li. Tab sis rau kuv nws tau ntev dhau los ua cov neeg ib txwm paub.

Cov lus qhia luv luv

Cov suab thaj txo qis tshuaj glibenclamide hauv nws cov qauv tshuaj yog los ntawm tiam 2 ntawm sulfonylurea derivatives. Nrog txhua qhov chaw muag tshuaj "txo qis" ntawm cov tshuaj no (thiab hauv kev coj ua nws tau siv txij li xyoo 1969), nws txoj kev ntseeg tau thiab paub tau tuaj yeem ua kom poob qab. Thiab tsis tas yog nyob ntawm qee qhov chaw txhawm rau, tab sis ua ib qho kev kho mob nrov tshaj plaws rau hom ntshav qab zib hom 2. Hauv kev sim thiab kev sim tshuaj, glibenclamide tseem yog tus qauv rau kev soj ntsuam qhov kev ua tau ntawm cov tshuaj tshiab yam tshuaj lom neeg thiab kev siv tshuaj hauv kev kho mob, thaum ua kom pom cov txiaj ntsig tshiab. Lub tshuab ntawm hypoglycemic kev ua si ntawm glibenclamide, zoo li lwm yam tshuaj ntawm pab pawg no, tau kawm nyob rau hauv txoj kev qhia ntau tshaj plaws tau tawg mus rau hauv cov lwg me me: cov tshuaj txwv cov potassium ua ke ntawm pancreatic cells-hlwb, uas cia li pab txhawb rau kev nkag ntawm calcium ions rau hauv lub cell, uas ua rau kev rhuav tshem cov granules nrog insulin thiab kev tso tawm ntawm tom kawg rau hauv cov ntshav thiab cov kua dej ua haujlwm ncua. Ntawm tag nrho cov sulfonylurea derivatives, glibenclamide tau txais nrog kev lees paub tshaj plaws rau cov khoom sib cuam tshuam ntawm β-hlwb thiab qhov muaj zog tshaj plaws ntawm hypoglycemic ntawm tag nrho cov sulfonylurea derivatives. Qhov kev tso tawm ntawm cov tshuaj insulin yog qhov loj dua, ntau dua qhov tau lees txais ntawm cov tshuaj.Txhua yam tshuaj ntawm cov chav kawm no tseem muaj lub npe hu ua cov kabmob ntxiv, ua rau cov ntaub so ntswg feem ntau nkag siab txog insulin thiab kev txhim kho cov kua nplaum ntxiv los ntawm adipose thiab cov leeg nqaij.

Qhov xwm txheej no ua rau muaj kev nqus ntxiv ntawm cov kua nplaum los ntawm cov ntaub so ntswg (nyeem: txo qis glycemia).

Yog li, glibenclamide, raws li tus lej ntau, tseem muaj kev sib tw. Ua ntej tshaj plaws, nws yog qhov ua tau pov thawj los ntawm kev ua haujlwm ntev hauv kev thov. Cov tshuaj txwv tsis pub ncua sijhawm mob ntshav qab zib, suav nrog myocardial infarction thiab microvascular cov teeb meem. Glibenclamide tau zoo ua ke nrog lwm cov tshuaj, piv txwv li, metformin, thiab yog tias tsis muaj kab mob them nyiaj, cov txiaj ntsig zoo tuaj yeem tau txais los ntawm qhov peb leeg ua ke ntawm metformin + glibenclamide + glitazone. Glibenclamide tau ua tiav tau zoo hauv cov neeg laus cov neeg mob nrog "pob paj" ntawm cov kab mob sib xyaw. Thiab dab tsi yog qhov tseem ceeb (thiab rau ntau ntawm peb cov neeg txawv - qhov tseem ceeb tshaj plaws), cov tshuaj muaj nyob ntawm kev noj kev haus thiab kev xav. Nws yog qhov pheej yig dua ntau ntawm nws cov neeg niaj hnub "ua haujlwm" hauv kev tawm tsam mob ntshav qab zib.

Thaum noj cov tshuaj glibenclamide, nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas qib ntawm cov piam thaj vim muaj qhov pheej hmoo ntawm cov ntshav qog ntshav qab zib. Yog tias hypoglycemia tau "them" rau tus neeg mob uas tau noj cov tshuaj, tom qab ntawd nws yuav tsum tau xyuas tam sim ntawd tias cov piam thaj hauv nws lub cev (qhov ncauj lossis txhaj tshuaj, nyob ntawm nws lub xeev ntawm kev nco qab). Hloov chaw, khaws cov zaub mov nplua nuj nyob hauv cov roj carbohydrates sai rau ntawm tes txhua lub sijhawm.

Kws Tshuaj

Tus neeg sawv cev ntawm tus mob ntshav qab zib ntau ntau, yog sulfonylurea derivative ntawm lub cim thib ob. Tsim kho kev tsim txom cov insulin los ntawm β-hlwb ntawm tus txiav, nce qhov tso tawm ntawm insulin. Feem ntau ua nyob rau theem ob ntawm insulin secretion. Tsub qhov rhiab heev ntawm peripheral cov ntaub so ntswg rau insulin thiab qhov sib ntawm nws khi rau cov phiaj hlwb. Nws muaj cov nyhuv hypolipidemic, txo cov yam ntxwv ua kom ntshav muaj zog.

Hla kev sib txuam yeeb tshuaj

Antimycotic tshuaj ntawm cov kab ke ua haujlwm, ethionamide, fluoroquinolones, MAO thiab ACE inhibitors, H2-blockers, NSAIDs, tetracycline tshuaj, paracetamol, insulin, tshuaj anabolic steroid, cyclophosphamide, β-adrenergic blockers, clofibrate, reserpilamin, proberpilin, pawg. allopurinol, paracetamol, thiab chloramphenicol tuaj yeem nce ntxiv qhov hnyav ntawm cov qog ntshav qab zib.

COCs, barbiturates, glucagon, saluretics, npaj raws li cov ntsev lithium, diazoxide, nicotinic acid derivatives, phenothiazines, thiab cov tshuaj adrenomimetic txo cov nyhuv hypoglycemic ntawm glibenclamide.

Txhais tau hais tias acidify zis nce ntxiv ntawm cov tshuaj.

Rifampicin txhawb nqa qhov ua tsis tiav ntawm cov tshuaj nquag thiab txo nws cov nyhuv kho mob.

Tsuas tshuaj thiab tswj hwm

Cov koob tshuaj yog xaiv tau ib tus zuj zus. Sab hauv, 20-30 feeb ua ntej noj mov, haus dej kom ntau. Qhov hno thawj zaug yog 2.5 mg / hnub. Yog tias tsim nyog, qhov koob tshuaj yog maj mam nce los ntawm 2.5 mg ib lub lis piam kom ua tiav cov nyiaj them rau cov khoom noj metabolism. Kev txij nkawm txhua hnub koob tshuaj yog 5-10 mg, qhov ntau tshaj yog 15 mg. Rau cov neeg mob laus, cov koob tshuaj thawj zaug yog 1 mg / hnub. Qhov ntau zaus ntawm kev tswj hwm yog 1-3 zaug nyob rau ib hnub.

Cov ntsiab lus ntawm nosological pawg

Cov nqi hauv cov khw muag tshuaj hauv Moscow

Tso koj saib

Cov Ntaub Ntawv Tam Sim No Xav Tau Index, ‰

Sau npe Cov Tshuaj Tseem Ceeb thiab Tseem Ceeb

Glibenclamide daim ntawv pov thawj rau npe

• LP-003742

• LP-000933

• FS-000940

• LS-002499

• P N014959 / 01-2003

• LSR-008753/09

• LS-000992

• LS-002056

• LS-001139

• P N002907 / 01

• P N001630 / 01-2002

• P N013959 / 01-2002

• P N012149 / 01-2000

• P N012093 / 01-2000

• P N011705 / 01-2000

• P N011400 / 01-1999

• S-8-242 N011172

• 010027

• 95/370/3

• 82/374/1

Lub vev xaib raug cai ntawm lub tuam txhab RLS ®. Lub encyclopedia tseem ceeb ntawm cov tshuaj thiab cov khoom muag ntawm cov khw muag tshuaj assortment ntawm Lavxias Internet. Daim ntawv teev cov tshuaj Rlsnet.ru muab cov neeg siv kev nkag mus rau cov lus qhia, tus nqi thiab cov lus piav qhia txog tshuaj, khoom noj khoom haus, khoom siv kho mob, khoom siv kho mob thiab lwm yam khoom lag luam. Daim ntawv qhia pharmacological suav nrog cov ntaub ntawv ntawm kev sib xyaw thiab daim ntawv tso tawm, kev nqis tes ua pharmacological, kev taw qhia rau kev siv, contraindications, kev phiv tshuaj, kev cuam tshuam tshuaj, hom kev siv tshuaj, cov tuam txhab tshuaj. Daim ntawv qhia cov tshuaj muaj nqi rau tshuaj thiab cov khoom lag luam tshuaj hauv Moscow thiab lwm lub nroog Lavxias.

Nws yog txwv tsis pub xa, theej, tshaj tawm cov ntaub ntawv yam tsis tau txais kev tso cai los ntawm RLS-Patent LLC.
Thaum hais cov ntaub ntawv xov xwm luam tawm nyob rau ntawm nplooj ntawv ntawm lub xaib www.rlsnet.ru, qhov txuas mus rau qhov chaw ntawm cov ntaub ntawv xav tau.

Ntau ntau yam nthuav

Qoob loo.

Kev ua lag luam siv cov ntaub ntawv tsis raug tso cai.

Cov ntaub ntawv yog npaj rau cov kws kho mob.

Yeeb tshuaj sib cuam tshuam

Kev siv tib lub sijhawm ntev ntawm sulfonamides, beta-blockers, allopurinol, anabolic agents, cimetidine, cyclophosphamide, clofibrate, isobarin, monoamine oxidase inhibitors (MAOs), salicylates, tetracyclines, thiab chloramphenicol tuaj yeem txhim kho hypoglycemic effect ntawm cov tshuaj.

Glibenclamide tuaj yeem txo qis thiab qhov kev pheej hmoo ntawm kev loj hlob hyperglycemia hauv cov neeg mob ib txhij noj chlorpromazine, barbiturates, diazoxide, phenothiazines, phenytoin, acetazolamide, glucocorticoids, glucagon, sympathomimetic tshuaj, indomethacin, tshuaj ntau ntau nicotinates, saluretics, tshuaj tiv thaiv kab mob thiab ntsev , cov thyroid hormones, siab ntawm kev tso quav.

Glibenclamide analogues yog: Glibeks, Glibamid, Gilemal, Glidanil, Betanaz, Antibet, Manin, Maninil, Maniglide.

Cov lus qhia rau kev teem caij

Hom ob ntawm cov ntshav qab zib yog ib tus mob uas yuav tsum tau mus kho txuas ntxiv. Txawm hais tias muaj kev tswj hwm zoo glycemic, txoj haujlwm ntawm beta hlwb maj zuj zus hauv cov neeg mob thiab cov tshuaj insulin ntau ntau hauv lawv txo qis. Nrog tas li kom muaj suab thaj, cov txheej txheem rhuav tshem ntawm tes yog nrawm. Thawj cov kev hloov pauv hauv kev tiv thaiv cov kab mob hauv insulin tuaj yeem pom thaum lub sij hawm kuaj mob. Hauv qee tus neeg mob, lawv tsis cuam tshuam txog cov ntshav qab zib, thiab kom them nyiaj rau ntshav qab zib, tsuas yog kev noj zaub mov kom zoo, metformin thiab kev kawm lub cev muaj txaus.

Cov neeg mob ntshav qab zib, uas cov hlwb hlwb zoo tsis tuaj yeem ua haujlwm rau lawv tus kheej thiab cov kwv tij tuag lawm, yuav tsum tau sau ntawv cia zais cia. Lawv txhawb kev tsim kho cov tshuaj insulin, ua rau lub hlwb ua haujlwm ntau dua.

Thaum glibenclamide sau tseg:

1. Cov tshuaj yog suav hais tias yog ib qho tseem ceeb tshaj plaws zais cia, yog li nws tau qhia rau cov neeg mob ntshav qab zib nrog kev txo qis sib txawv ntawm lawv tus kheej insulin, raws li muaj pov thawj los ntawm kev muaj ntshav ntau heev thaum lub sijhawm kuaj mob. Nrog decompensated ntshav qab zib mellitus, txhim kho tsis tshwm sim tam sim ntawd, cov piam thaj maj mam poob zuj zus li ntawm 2 lub lis piam. Cov neeg mob ntshav qab zib nrog cov me hyperglycemia tsis xaj tshuaj noj tom qab kuaj mob ntshav qab zib.
2. Glibenclamide yog qhia rau cov kev mob hnyav kho ntxiv nrog rau lwm tus neeg sawv cev. Nws tau ntev tau muaj pov thawj tias ntau yam tshuaj qab zib uas muaj feem cuam tshuam rau cov laj thawj ntawm hyperglycemia los ntawm ntau sab muaj ntau txoj hauv kev zoo dua ib. Txhawm rau txhawm rau txhim kho kev zom zaub mov, glibenclamide tuaj yeem ua ke nrog cov tshuaj insulin thiab ib qho qis-txo cov ntsiav tshuaj, tsuas yog PSM thiab av nplaum.

Thaum muab tshuaj rau, nws yuav tsum tau nyob rau hauv lub siab tias nws ntxias lub cev hlwb ua haujlwm nrog kev siv ntau dua. Raws li kev tshawb nrhiav, kev txhawb nqa zoo li no ua rau txo qis me me hauv lawv lub sijhawm. Txij li thaum glibenclamide yog qhov muaj zog tshaj plaws hauv nws pawg, qhov kev xav tsis zoo no tshwm sim rau nws ntau dua rau PSM niaj hnub. Yog tias tus mob ntshav qab zib xav ua kom tswj tau cov tshuaj insulin ntev li ntev tau, kev kho mob nrog glibenclamide yuav tsum tau muab ncua kom txog thaum siv tshuaj tsis muaj zog los tswj cov ntshav qab zib.

Ua li cas glibenclamide ua

Cov txheej txheem ntawm kev ua ntawm glibenclamide tau zoo to taub thiab tau piav qhia hauv kev nthuav dav hauv cov lus qhia rau cov tshuaj. Cov tshuaj thaiv cov kab KATF uas nyob rau ntawm qhov beta-cell membrane, uas ua rau qhov kev tso tseg ntawm cov poov tshuaj rau hauv cov hlwb, ua kom lub zog ntawm cov polarization ntawm daim nyias nyias thiab kev nkag ntawm calcium ions. Kev nce ntxiv ntawm cov concentration ntawm cov calcium hauv lub cell txhawb cov txheej txheem ntawm kev cais tawm ntawm cov kua dej los ntawm nws mus rau hauv cov kua uas ua rau sab hauv, thiab tom qab ntawd mus rau hauv cov ntshav. Cov kua nplaum txo qis vim yog lub peev xwm ntawm insulin thauj nws los ntawm cov hlab ntshav mus rau cov ntaub so ntswg. Glibenclamide ua haujlwm ntau dua li lwm qhov PSM khi rau beta-cell receptors, yog li nws muaj qhov ua tau zoo tshaj plaws hauv qab zib.

Lub zog ntawm cov tshuaj nce ntxiv nrog nce zuj zus. Qhov tshwm sim ntawm glibenclamide tsis yog nyob ntawm glycemia, cov tshuaj ua haujlwm nrog ib qho dhau ntawm cov piam thaj thiab nrog ib qho tsis txaus, yog li thaum noj nws, koj yuav tsum tau ua tib zoo saib thiab ntsuas cov suab thaj thaum muaj cov tsos mob zoo ib yam li hypoglycemic tshwm sim.

Ntxiv nrog rau lub ntsiab hypoglycemic, ib qho ntxig ntxiv txuas ntxiv yog cov yam ntxwv ntawm txhua PSM. Raws li cov lus qhia, glibenclamide me ntsis txo cov insulin tsis kam ntawm cov leeg hlwb thiab rog, uas ua rau txo qis ntxiv hauv qabzib.

Kev mob plawv ntawm cov tshuaj tau kawm cais ua ke. Nws muab tawm tias glibenclamide tuaj yeem thaiv KATF cov chaw tsis yog rau cov hlwb hlwb xwb, tab sis kuj rau lub siab hlwb - cardiomyocytes. Raws li txoj kev xav, qhov kev nqis tes ua no tuaj yeem cuam tshuam txog lub plawv mob ntshav qab zib hauv cov ntshav qab zib. Hauv kev sim tshuaj, qhov tshwm sim no tsis tau lees tias. Ntxiv mus, lub suab tawm los tiv thaiv qhov cuam tshuam tau pom hauv glibenclamide, uas txo cov neeg tuag nyob rau lub sijhawm mob ischemia. Raws li cov kws kho mob, ntau ntawm lawv ntshai tsis kam sau tshuaj rau Glibenclamide rau ib qho kev kuaj mob plawv, txawm hais tias cov ntaub ntawv tshawb fawb.

Glibenclamide npaj

Cov neeg mob ntshav qab zib feem coob tau paub txog glibenclamide los ntawm cov tshuaj Maninil, uas yog tsim nyob rau hauv lub teb chaws Yelemees los ntawm Berlin-Chemie. Cov tshuaj no yog qhov qub, nrog nws koom nrog ntau cov kev tshawb fawb tau ua dhau los uas tau kawm txog qhov ua tau zoo thiab kev nyab xeeb ntawm glibenclamide. Maninil muaj 3 kev xaiv ntau npaum. Hauv cov ntsiav tshuaj ntawm 1.75 thiab 3.5 mg, cov tshuaj nquag muaj nyob rau hauv daim ntawv me me tshwj xeeb, uas tso cai rau kom txo qis glycemia nrog kev noj tshuaj tsawg dua. 5 mg maninyl muaj cov tshuaj glibenclamide classical.

Cov Lus Tshaj Tawm nyob hauv Lavxias yog:

• Statiglyn los ntawm Pharmasintez-Tyumen thiab Glibenclamide los ntawm cov tuam txhab Ozone (sau npe ntawm atoll belongs rau Atoll LLC). Cov tshuaj no muaj tib lub tshuaj siv ntau yam, tab sis cov tuam ntxhab tsis tau hais tias muaj micronized glibenclamide nyob rau hauv ib qho ntawm cov kev xaiv.
• Glibenclamide ntsiav tshuaj tsim los ntawm Moskhimpharmpreparaty, Pharmstandard-Leksredstva, Biosynthesis, Valenta Cov Tshuaj muaj tib lub sijhawm 5 mg. Lawv tuaj yeem faib kom tau ib nrab koob tshuaj 2.5 mg.

Nws yog tsim nyog sau cia tias lawv tsuas yog nyob hauv tsev ib qho muaj hnub nyoog sib npaug, txij li cov neeg lag luam yuav glibenclamide txawv teb chaws, feem ntau hauv Is Nrias teb. Tsuas yog kev zam tsuas yog Statiglin, sau npe hauv xyoo 2017. Glibenclamide rau nws yog tsim nyob rau hauv Russia ntawm BratskKhimSintez enterprise.

Txhua tus Maninil analogues raug sim rau bioequivalence thiab muaj qhov sib xws. Kev tshuaj xyuas tus neeg mob tau qhia tias cov tshuaj no zoo ib yam, tab sis tseem muaj cov neeg mob ntshav qab zib nyiam yuav cov tshuaj qub, vim nws muaj koob meej ntau dua qub thiab tus nqi qis dua.

Kev txiav txim los ntawm kev txheeb xyuas, kev sib xyaw ntawm glibenclamide thiab metformin kuj tseem nrov heev. Ob qho tshuaj yeeb tshuaj yog qee qhov ntawm ob qhov tshuaj tiv thaiv Cov kab mob Glucovans, Glimecomb, Gluconorm. Metglib, Glibomet thiab lwm yam.

Rau leej twg txais tos yog contraindicated

Cov kev qhia ua qhia txog kev txwv rau kev noj cov tshuaj Glibenclamide rau qee yam hauv qab no:

• yog hais tias cov tshuaj lossis cov tshuaj analogues yav dhau los ua xua,
• thaum uas qhov mob ntshav qab zib tsis muaj cov qe ntshav beta (hom 1 mob ntshav qab zib, kev rov ua mob ntshav qab zib),
• nyob rau hauv ib lub xeev ntawm mob sai ua rau mob ntshav qab zib mellitus nrog ketoacidosis lossis muaj kev pheej hmoo siab decompensation vim yog raug mob hnyav thiab kab mob,
• nrog mob raum thiab ntshav siab tsis txaus,
• thaum lactose tsis txaus ntseeg, uas yog muaj nyob hauv cov tshuaj ua ntu pabcuam,
• thaum cev xeeb tub, lactation,
• hauv cov menyuam muaj ntshav qab zib.

Nrog rau kev ceev faj, nws yog ib qho tsim nyog yuav tsum tau coj los kho cov tshuaj hormonal tsis txaus, haus dej cawv, lub plab zom mov, hauv lub hnub nyoog laus, thaum kub.

Glibenclamide analogs thiab hloov chaw

Qhov zoo tshaj plaws analogues ntawm glibenclamide yog lwm yam kev sib txuas ntawm sulfonylureas. Tam sim no, glyclazide, glimepiride yog siv dav, tsawg dua glycidone.

Qhov pheej yig tshaj glibenclamide ntsiav tshuaj hloov chaw:

Gliptins, uas tseem txhawb cov tshuaj insulin, yog cov nqi ntau dua glibenclamide analogues. Glyptins yog ib feem ntawm Januvii, Ongliza, Xelevia, Galvus, Trazhenty, lawv cov nqi kho mob tsawg kawg yog 1,500 rubles. hauv ib hlis. Cov tshuaj no ua rau tsis muaj ntshav qab zib, tsis ua rau kev puas tsuaj ntawm beta hlwb, tab sis tsis txo qis qab zib sai npaum li glibenclamide. Raws li kev txheeb xyuas, glyptins muab cov txiaj ntsig zoo dua nrog kev pib tsis ntau glycemia.

Nqi hauv cov chaw muag tshuaj

Maninil muaj micronized glibenclamide nqi 130-160 rubles. rau ib pob nrog 120 ntsiav tshuaj. Maninil 5 mg yuav pheej yig dua, tus nqi ntawm ib pob yog li 120 rubles. Tus nqi ntawm domestic analogues tseem qis dua: los ntawm 26 rubles. rau 50 ntsiav tshuaj lossis 92 rubles. rau 120 ntsiav tshuaj. Yog li, txawm tias qhov ntau tshaj qhov ntau, tus nqi ntawm kev kho mob tsis tshaj 100 rubles. hauv ib hlis.

Cov tshuaj Glibenclamide tuaj yeem nrhiav dawb nyob hauv txhua cheeb tsam ntawm Russia, yog tias tus neeg mob ntshav qab zib mellitus, thiab nws tau sau npe nrog tus kws kho mob endocrinologist.

Kev txheeb xyuas ntawm Glibenclamide

Feem ntau, kev tshuaj xyuas ntawm Glibenclamide yog kev sib tham txog kev kho mob kho tau siv hauv cov neeg mob ntshav qab zib mellitus. Feem ntau cov neeg mob tau qhia txog kev siv cov tshuaj no ua kev kho mob monotherapy, txawm li cas los xij, qee tus neeg tau sau nws ua ib feem ntawm kev sib xyaw ua ke, uas yog, nrog rau cov tshuaj ntxiv hypoglycemic. Qee zaum cov neeg mob muaj lus nug vim muaj ntau dhau los lossis tsis muaj txiaj ntsig ntawm Glibenclamide.

Cov kws tshaj lij ntseeg tias lub hom phiaj ntawm cov tshuaj no yuav tsum yog tus kheej, thiab cov txheej txheem kev kho yuav tsum raug xaiv nyob rau hauv txhua kis ntawm tus kab mob.Yog li, kev noj cov tshuaj Glibenclamide raws li kev pom zoo ntawm cov neeg tsis tuaj yeem yog qhov nyuaj thiab yuav muaj kev phom sij rau kev noj qab haus huv. Ntau yam yuav tsum tau txiav txim siab, piv txwv li, ntshav qab zib cov ntshav ntawm tus neeg mob nyob hauv ntau yam mob. Tsuas yog hauv qhov no, nws tuaj yeem xav tias kev noj tshuaj yuav txhim kho txoj kev noj qab haus huv ntawm tus neeg mob zoo.