Maninil 5: cov lus qhia rau kev siv, analogues thiab tshuaj xyuas, tus nqi hauv cov khw muag tshuaj ntawm Russia

Cov Tshuaj Hauv Tshuaj Glibenclamide - (1- <4-2- (5-chloro-2-methoxybenzamido) ethylbenzene sulfonyl> -3-cycloxyxylurea) yog ib tus neeg sawv cev hypoglycemic. Nws txo qis cov piam thaj hauv ntshav plasma ob leeg hauv cov neeg mob ntshav qab zib hom II thiab cov neeg tuaj yeem noj qab haus huv vim muaj cov kua dej insulin ntau ntxiv los ntawm pancreatic β-hlwb. Cov nyhuv hypoglycemic ntawm glibenclamide yog nyob ntawm kev saib xyuas cov kua nplaum hauv thaj chaw ib puag ncig the-cov hlwb ntawm pancreatic islets ntawm Langerhans. Nws inhibits kev tso tawm ntawm glucagon los ntawm pancreatic cells-hlwb thiab muaj cov txiaj ntsig tshwj xeeb, tshwj xeeb, tsub kom lub siab ntawm insulin receptors rau insulin hauv peripheral cov ntaub so ntswg, txhim kho kev ua ntawm insulin nyob rau qib tom qab-txais thiab qeeb kev rhuav tshem ntawm receptors, txawm li cas los xij, qhov tseem ceeb ntawm cov kab mob no tseem tsis tau kawm.
Cov Tshuaj Pharmacokinetics Tom qab lub qhov ncauj tswj hwm, nws tau nrawm thiab yuav luag nqus. Kev noj ib txhij ntawm cov zaub mov tsis cuam tshuam loj heev rau kev nqus ntawm glibenclamide, tab sis tuaj yeem ua rau txo qis ntawm cov concentration ntawm glibenclamide hauv cov ntshav ntshav. Kev khi rau ntshav albumin - 98%. Cmax hauv cov ntshav ntshav tom qab noj 1.75 mg ntawm glibenclamide tiav tom qab 1-2 teev thiab yog 100 ng / ml. Tom qab 8-10 teev, cov ntshav plasma tsawg zuj zus, nyob ntawm seb cov koob tshuaj tau siv npaum li cas, los ntawm 5-10 ng / ml. Hauv daim siab, glibenclamide yuav luag hloov pauv mus ua ob qhov tseem ceeb: 4-trans-hydroxy-glibenclamide thiab 3-cis-hydroxy-glibenclamide. Ob lub cev ua tiav tau tawm hauv cov khoom sib npaug nrog cov zis thiab cov kua tsib hauv 45–72 teev .T1 / 2 ntawm glibenclamide yog 2-5 teev, tab sis tuaj yeem txuas ntxiv txog 8-10 teev. Lub sijhawm ua, txawm li cas los xij, tsis sib haum rau T1 / 2. Hauv cov neeg mob uas lub siab ua tsis tau haujlwm, ntshav tawm yog qeeb. Hauv raum tsis ua haujlwm, nyob ntawm qhov neeg poob siab ntawm lub raum kev ua haujlwm, kev nthuav tawm ntawm cov khoom nyob rau hauv cov zis yuav ntxiv tawm. Nrog mob raum tsis ua haujlwm (kev tua neeg tsim neeg muaj peev xwm - 30 ml / min), tag nrho kev tshem tawm tseem tsis tau hloov, nrog rau lub raum ua tsis zoo, kev nruam yog qhov ua tau.

Kev qhia rau kev siv tshuaj Maninil

Cov mob ntshav qab zib uas tsis yog-insulin-hom mob ntshav qab zib hom (hom II), yog tias nws tsis tuaj yeem them taus rau cov teeb meem hauv lub cev los ntawm kev ua raws li kev noj zaub mov kom zoo thiab ua kom lub cev muaj zog ntau dua thiab yog tias tsis xav tau kev kho mob insulin. Nrog rau kev txhim kho ntawm cov kab mob thib ob tsis kam rau glibenclamide, kev sib xyaw ua ke nrog cov tshuaj insulin tuaj yeem nqa tawm, txawm li cas los xij, nws yuav tsis muaj txiaj ntsig zoo tshaj li insulin monotherapy.

Kev siv cov tshuaj Maninil

Cov tshuaj yuav tsum yog tus kws kho mob tau sau tseg thiab nco ntsoov kho cov khoom noj kom zoo. Kev noj tshuaj yog nyob ntawm cov txiaj ntsig tau los ntawm kev kawm txog theem ntawm cov piam thaj hauv ntshav plasma thiab zis.
Ua ntej thiab tom qab teem caij. Qhov kev kho mob tau pib, kom deb li sai tau, nrog kev txhaj tshuaj tsawg kawg, ua ntej txhua yam, nws txhawj txog cov neeg mob uas muaj kev nce siab ntau ntawm cov ntshav siab thiab lub cev hnyav ≤50 kg. Txoj kev kho kom zoo yog xav kom pib nrog kev teem sijhawm 1 / 2-1 ntsiav tshuaj Maninil 3.5 (1.75-3.5 mg glibenclamide) lossis 1/2 ntsiav tshuaj Maninil 5 (2.5 mg glibenclamide) 1 zaug nyob rau ib hnub. Cov koob tshuaj no tuaj yeem maj mam nce nrog qhov luv ntawm ob peb hnub mus rau 1 lub lim tiam, txog thaum siv tshuaj kho kom zoo. Kev siv tshuaj ntau tshaj plaws yog 15 mg / hnub (3 ntsiav tshuaj ntawm Maninil 5) lossis 10.5 mg ntawm micronized glibenclamide (3 ntsiav tshuaj ntawm Maninil 3.5).
Hloov chaw ntawm tus neeg mob nrog siv lwm yam tshuaj tiv thaiv kab mob vwm. Qhov hloov mus rau kev tswj hwm ntawm Maninil 3.5 yog nqa tawm kom zoo zoo thiab pib nrog 1 / 2-1 ntsiav tshuaj ntawm Maninil 3.5 (1.75-3.5 mg ntawm glibenclamide ib hnub).
Xaiv xaiv. Hauv cov neeg mob laus, cov neeg mob ua tsis txaus siab lossis nrog zaub mov tsis txaus, nrog rau lub raum lossis lub cev tsis ua haujlwm zoo, qhov pib thiab saib xyuas yuav tsum raug txo vim muaj kev pheej hmoo ntawm hypoglycemia. Ntxiv rau, nrog qhov kev txo qis ntawm tus neeg mob lub cev qhov hnyav lossis los ntawm kev hloov pauv hauv lub neej, nws yog qhov tsim nyog los daws qhov teeb meem ntawm kev hloov tshuaj.
Ua ke nrog lwm cov tshuaj tiv thaiv kab mob kev nkeeg. Maninil tuaj yeem kho raws li kev kho mob monotherapy lossis hauv kev sib xyaw nrog metformin. Qee qhov xwm txheej, nrog metformin tsis nkag siab, ntxiv rau kev siv cov tshuaj glitazone pawg (rosiglitazone, pioglitazone) yuav raug qhia. Maninil tseem tuaj yeem ua ke nrog cov tshuaj tiv thaiv kab mob hauv lub qhov ncauj uas tsis txhawb kev tso tawm ntawm endulinous insulin los ntawm pancreatic β-cells (guar lossis acarbose). Nrog theem nrab tsis kam mus rau glibenclamide (txo qis ntawm insulin ntau lawm los ntawm kev txo cov of-hlwb ntawm cov islets ntawm Langerhans), kev sib xyaw ua ke nrog cov tshuaj insulin tuaj yeem siv. Txawm li cas los xij, nrog kev ua tiav ntawm kev tsis ua tiav ntawm kev muaj tus kheej cov kua dej hauv lub cev, kev kho mob monotherapy nrog insulin yog qhia.
Txoj kev tswj hwm thiab lub sijhawm kho. Ib koob tshuaj txhua hnub txog li 2 ntsiav tshuaj ntawm Maninil tau noj yam tsis tau ntxo nrog kom muaj kua txaus (1 khob dej) 1 zaug nyob rau ib hnub ua ntej noj tshais. Ntawm qhov siab dua txhua hnub, nws raug nquahu kom faib nws rau 2 koob tshuaj hauv qhov sib piv ntawm 2: 1 thaum sawv ntxov thiab yav tsaus ntuj. Nws yog ib qho tseem ceeb heev uas yuav tsum tau siv cov tshuaj txhua lub sijhawm tib lub sijhawm. Thaum koj hla tawm cov tshuaj, koj tsis tuaj yeem noj nws ob zaug koob tshuaj hloov chaw tsis nco qab. Lub sijhawm kho yog nyob ntawm chav kawm ntawm tus kabmob. Thaum kho, nws yog qhov yuav tsum tau soj ntsuam lub xeev ntawm cov metabolism.

Qhov ua kom pom kev siv tshuaj Maninil

Yog tias xav tau cov tshuaj insulin: insulin-tiv thaiv cov ntshav qab zib mellitus (hom I), metabolic acidosis, hyperglycemic precoma thiab coma, decompensation ntawm metabolic mob nyob rau hauv cov kis kab mob thiab kev ua haujlwm, nrog rau lub xeev tom qab pancreatic resection, ua tiav theem nrab tsis kam mus rau glibenclamide hauv hom II mob ntshav qab zib mellitus.
Lwm qhov kev sib kis muaj xws li: lub siab ua rau lub siab tsis ua haujlwm, lub raum tsis ua haujlwm nrog creatinine tshem tawm ≤30 ml / min, txo qis rau glibenclamide, Ponso 4R zas xim lossis lwm yam tshuaj, nrog rau lwm yam tshuaj sulfonylurea derivatives, sulfonamide, diuretics thiab probenecid, cev xeeb tub thiab pub niam mis.

Kev phiv tshuaj ntawm Maninil

Thaum ntsuas cov kev mob tshwm sim, cov nqi hauv qab no ntawm qhov muaj tshwm sim tau tshwm sim los ua lub hauv paus: ntau heev (≥10%), feem ntau (≤10% thiab ≥1%), qee zaum (≤1% thiab ≥0.1%), tsis tshua muaj (≤0.1) % thiab ≥0.01%), tsis tshua muaj (≤0.01% lossis mob tsis paub):
los ntawm sab ntawm cov metabolism: feem ntau - kev nce hauv lub cev hnyav, cov ntshav qog ntshav, uas tuaj yeem tawm tsam thiab ua rau lub cev ntas ntshav ntws tsis zoo, uas ua rau neeg mob lub neej. Cov laj thawj rau qhov no yuav yog kev noj tshuaj ntau dhau, ua rau lub siab thiab lub raum tsis ua haujlwm, kev quav dej cawv, noj zaub mov tsis xwm yeem (tshwj xeeb yog noj mov), ua haujlwm lub cev tsis zoo, cuam tshuam cov metabolism carbohydrate vim muaj cov kab mob ntawm cov thyroid caj pas, anterior pituitary thiab adrenal cortex. Cov tsos mob adrenergic nrog hypoglycemia tej zaum yuav qhaj ntawv los yog me me nrog maj mam txhim kho hypoglycemia, mob hlab ntsha hlwb, lossis kho kev kho mob nrog sympatholytics (feem ntau β-adrenergic receptor blockers). Cov tsos mob ntawm tus neeg mob qog ntawm hypoglycemia: hyperhidrosis, palpitations, tshee tshee, qhov kev xav zoo ntawm kev tshaib plab, ntxhov siab vim, mob plab tawg ntawm lub qhov ncauj, pallor ntawm daim tawv nqaij, mob taub hau, tsaug zog, dysomnia, kev tsis sib haum ntawm kev txav, hloov chaw ntawm lub cev tsis zoo (hais lus thiab pom lub qhov muag, tsis meej thiab lub cev muaj zog). ) Yog xav paub ntxiv txog lub xeev ntawm hypoglycemia, saib noj ntau dhau. Nrog kev siv lub sijhawm ntev, kev txhim kho ntawm txoj kev ua haujlwm ntawm cov thyroid caj pas yog qhov ua tau,
nyob rau ib feem ntawm kev hloov khoom nruab nrog: tsis tshua muaj heev - pom kev pom thiab qhov chaw nyob, tshwj xeeb thaum pib kho,
los ntawm lub plab zom mov: qee zaum - xeev siab, zoo nkaus li lub siab / puv nteev hauv plab, ntuav, mob hauv plab, raws plab, tso tawv nqaij, tso rau hauv lub qhov ncauj. Cov kev hloov pauv no dhau los thiab tsis tas yuav tsum txiav cov tshuaj,
los ntawm hepatobiliary system: tsis tshua muaj heev - muaj kev hloov pauv ntxiv ntawm ASAT thiab ALAT, alkaline phosphatase, tshuaj tiv thaiv kab mob siab, mob cholestasis, mob tshwm sim los ntawm kev tsis haum tshuaj ntawm hyperergic yam los ntawm hepatocytes. Cov kev tsis zoo no yog rov qab tau tom qab tsis txiav luam yeeb tshuaj, tab sis tuaj yeem ua rau lub neej puas tsuaj rau daim siab,
nyob rau ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: qee zaum khaus, urticaria tawm pob, erythema nodosum, corymboid lossis maculopapular exanthema, purpura, kev paub tab. Cov tshuaj tiv thaiv hypersensitivity no thim rov qab, tab sis tsis tshua muaj neeg tuaj yeem ua rau lub neej muaj sia, nrog rau kev ua pa thiab qhov txo ntshav siab los txo qis, nce mus rau txoj kev loj hlob ntawm kev poob siab. Tsis tshua muaj tshwm sim - muaj qhov tsis haum lub cev tsis haum lub cev, uas nrog ua pob ntawm daim tawv nqaij, mob pob qij txha, ua daus no, proteinuria thiab tawv nqaij, ua xua vasculitis,
nyob rau ib feem ntawm cov ntshav system thiab lymphatic system: tsis tshua muaj - thrombocytopenia, tsis tshua muaj - leukopenia, erythropenia, granulocytopenia (txog kev loj hlob ntawm agranulocytosis), hauv qee kis - pancytopenia, hemolytic anemia. Cov kev pauv hloov hauv cov duab ntshav yog qhov thim rov qab, tab sis tsis tshua muaj neeg tuaj yeem tsim kev hem thawj rau lub neej,
lwm cov kev mob tshwm sim: tsis tshua muaj tshwm sim - cov nyhuv diuretic uas tsis muaj zog, rov qab muaj proteinuria, hyponatremia, disulfiram zoo li cov tshuaj tiv thaiv, hla kev ua xua nrog sulfonamides, sulfonamide derivatives thiab probenecid. Ponso 4R zas tuaj yeem ua rau ua xua.

Cov lus qhia tshwj xeeb rau kev siv tshuaj Maninil

Kev kho mob Maninil yuav tsum tau muaj kev saib xyuas mob tas li. Thaum siv cov tshuaj hauv cov koob tshuaj ntau dua lossis thaum rov ua ntawv thov thaum ncua sijhawm luv luv, nws yuav tsum xav txog lub sijhawm siv sijhawm ntev dua li siv thaum siv tsawg.
Nws yuav tsum nco ntsoov tias nrog kev siv tib lub sijhawm ntawm Maninil nrog clonidine, β-adrenergic blockers, guanethidine thiab reserpine, tus neeg mob txoj kev xav ntawm cov tsos mob ua ntej ntawm hypoglycemia tej zaum yuav muaj kev cuam tshuam.
Yog tias lub raum lossis lub cev tsis ua haujlwm, lub qog ua haujlwm tsawg, lub caj pas pituitary lossis adrenal cortex, yuav tsum tau saib xyuas tshwj xeeb.
Hauv cov neeg mob laus, muaj kev pheej hmoo ntawm lub sijhawm ntev ntawm lub qog ntshav qab zib, yog li ntawd, glibenclamide tau raug tshaj tawm nrog kev ceev faj thiab nyob rau hauv kev saib xyuas tas li thaum pib kho, nws raug nquahu kom ua ntej sulfonylurea npaj nrog lub sijhawm luv dua. Nrog rau kev sib cuag tsis yooj yim nrog tus neeg mob (piv txwv li, nrog mob hlwb atherosclerosis), kev pheej hmoo ntawm kev txhim kho hypoglycemia nce. Lub sijhawm tseem ceeb ntawm kev noj mov, kev noj zaub mov tsis txaus noj tsis txaus, ua kom lub cev txawv txav, zawv plab lossis ntuav tuaj yeem ua rau muaj kev mob ntshav qab zib tsawg. Cawv nrog ib koob nkaus xwb nyob rau hauv ib qho tseem ceeb thiab nrog nws txoj kev noj haus tas li tuaj yeem poob nthav lub zog lossis tsis muaj zog ntawm Maninil. Kev tsim txom tsis tu ncua ntawm kev tso quav tawm tuaj yeem ua rau lub xeev tsis zoo los ntawm cov metabolism. Yog tias kev kho mob ntshav qab zib tsis ua raws, nrog lub cev tsis txaus hypoglycemic cov tshuaj los yog thaum muaj kev ntxhov siab, cov piam thaj hauv ntshav yuav nce ntxiv. Cov tsos mob ntawm hyperglycemia: polydipsia, lub qhov ncauj qhuav, tso zis ntau zaus, khaus thiab tawv nqaij qhuav, fungal lossis kis kab mob ntawm daim tawv nqaij, txo qis kev ua haujlwm. Nyob rau hauv cov kev ntxhov siab hnyav (kev poob plig, phais, mob sib kis, uas nrog los ntawm kev nce hauv lub cev kub), cov metabolism hauv lub cev yuav ua kom tsis zoo, ua rau hyperglycemia, qee zaum thiaj li hais tawm tias nws yuav tsim nyog hloov mus ib ntus rau tus neeg mob rau kev kho mob insulin. Tus neeg mob yuav tsum tau qhia rau nws tias nws yuav tsum qhia rau tus kws kho mob tam sim ntawd txog kev txhim kho ntawm lwm yam kabmob thaum tab tom kho nrog Maninil.
Thaum muaj cov piam thaj-6-phosphate dehydrogenase tsis txaus, kev kho mob nrog sulfonylurea npaj, suav nrog glibenclamide, tuaj yeem ua rau hemolytic anemia, yog li nws yuav tsum txiav txim siab txog kev siv tshuaj sulfonylurea derivatives.
Nrog rau cov keeb kwm kev tsis haum galactose, lactase deficiency lossis impaired glucose / galactose absorption, Maninil yuav tsum tsis txhob siv.
Siv thaum cev xeeb tub thiab lactation. Contraindicated.
Siv rau menyuam yaus. Tsis siv.
Lub peev xwm los cuam tshuam cov tshuaj tiv thaiv tus nqi thaum tsav tsheb lossis ua haujlwm nrog tshuab. Nrog hypoglycemia, lub peev xwm tswj hwm thiab qhov tshuaj tiv thaiv ceev kuj yuav txo, uas yuav tsum tau coj mus rau hauv kev tsav tsheb thaum tsav tsheb thiab ua haujlwm nrog lwm cov txheej txheem. Qhov no yog qhov tshwj xeeb tshaj yog qhov xwm txheej tshwm sim ntawm cov ntshav qoj ib ce lossis tsis muaj kev nkag siab zoo ntawm cov tsos mob ua ntej ntawm hypoglycemia, thaum nws yog qhov yuav tsum tau txiav txim siab qhov kev pom zoo ntawm kev tsav tsheb lossis ua haujlwm nrog cov txheej txheem.

Yeeb tshuaj cuam tshuam Maninil

Nce glibenclamide kev txiav txim (kev loj hlob ntawm hypoglycemic tej yam kev mob yog ua tau) yog ua tau thaum siv ib txhij nrog lwm cov tshuaj tiv thaiv kab mob hauv lub qhov ncauj (metformin thiab acarbose) thiab insulin, ACE inhibitors, anabolic steroids thiab txiv neej pw ua ke, cov tshuaj tiv thaiv kab mob (fluoxetine, MAO inhibitors), phenylbutazone adrenergic thaiv cov neeg sawv cev quinolone, chloramphenicol, clofibrate thiab nws cov lus sib piv, disopyramide, fenfluramine, miconazole, PASK, pentoxifylline (nrog rau kev tswj hwm hauv tsoom hauv pawg siab), p ergexilin, pyrazolone derivatives, probenecid, salicylates, fibrates, sulfonamides, tetracycline tshuaj, tritokvalin, cytostatics (cyclophosphamide, ifosfamide, trophosphamide).
Kev txo qis glibenclamide siv (kev loj hlob ntawm hyperglycemic tej yam kev mob) muaj peev xwm ua tiav nrog kev siv tib txhij nrog acetazolamide, β-adrenoreceptor blockers, barbiturates, diazoxide, chloramphenicol, phenylbutazone, oxyphenbutazone, azopropanone, sulfinpyrazone, miconazole, pheniramidine, phenomotin azimonidonase, glucose, glucoson phenytoin, rifampicin, cov thyroid hormones, tshuaj ntawm poj niam txiv neej cov tshuaj hormones (gestagens, estrogens), sympathomimetics.
H2 receptor antagonists tuaj yeem ua rau ob qho kev ua kom tsis muaj zog thiab txhim kho cov tshuaj hypoglycemic. Kev quav cawv tuaj yeem txhim kho lossis txo cov nyhuv hypoglycemic ntawm glibenclamide.
Muaj qee kis, pentamidine tuaj yeem ua rau mob ntshav qab zib (hypo) lossis hyperglycemia ntau heev. Qhov kev txiav txim ntawm coumarin derivatives tuaj yeem ob leeg nce thiab txo qis.
Cov kab mob sympatolytic, xws li β-adrenergic blockers, reserpine, clonidine thiab guanethidine, nrog kev siv txuas ntxiv, tuaj yeem pab txo qis cov ntshav qab zib thiab npog cov tsos mob ntawm lub ntsej muag.

Kev noj ntau tshaj ntawm cov tshuaj Maninil, cov tsos mob thiab kev kho mob

Mob ntsws ntev thiab mob ntev tshaj ntawm glibenclamide tuaj yeem ua rau kev txhim kho mob ntshav qab zib, lub sijhawm ntev thiab muaj sia nyob. Kev mob ntshav siab ntshav qab zib tuaj yeem tsim muaj vim tias yoo mov noj mov, ua si lub cev ntau ntxiv thiab sib cuam tshuam ntawm cov tshuaj.
Cov tsos mob ntawm tus mob hypoglycemia: kev tshaib nqhis hnyav, xeev siab, ntuav, feem ntau tsis muaj zog, ntxhov siab, hyperhidrosis, tachycardia, tshee, mydriasis, mob nqaij hlav, mob taub hau, pw tsaug zog, pw tsis txaus, endocrine psychologist kev mob siab (chim siab, txhoj puab heev, kev nyuaj siab, kev nyuaj siab ntawm kev saib xyuas, tsis meej pem, kev tsis sib haum xeeb) kev kho lub cev thaum ub - kev npau taws, kev txhoj puab heev, kev npau suav, cramps, cov tsos mob - hemiplegia, aphasia, diplopia, nkees nkees, tsis nco qab, ua txhaum txoj cai ntawm kev cai nruab nrab ntawm kev ua pa thiab lub plawv dhia sudistoy system). Nrog rau kev muaj mob ntawm hypoglycemia, poob ntawm kev nco qab (hypoglycemic coma) yog ua tau, tus yam ntxwv los ntawm daim tawv nqaij ntub thiab txias thaum lub sijhawm palpation, tachycardia, hyperthermia, lub cev muaj zog zoo siab, hyperreflexia, cov tsos ntawm qhov zoo ntawm Babinsky reflex thiab kev txhim kho paresis thiab qaug dab peg.
Kev Kho Mob. Cov ntshav qog ntshav qab zib me me (tsis muaj qhov tsis nco qab), tus neeg mob muaj peev xwm tshem tawm ntawm nws tus kheej, noj kwv yees li 20 g ntawm qabzib, piam thaj lossis zaub mov muaj protein ntau.
Yog tias muaj kev siv tshuaj ntau dhau thiab muaj kev tiv tauj nrog tus neeg mob, nws yog qhov tsim nyog los ua kom ntuav, ua kom mob plab (thaum tsis muaj qhov txawj nyeem ntawv tau), muab tshuaj rau adsorbents thiab muab cov kua roj tov rau qab zib. Thaum mob ntshav nce siab ntau (nrog tsis nco qab lawm), catheterization ntawm txoj leeg yuav tsum tau ua tam sim ntawd. 40-100 ml ntawm 40% kua nplaum tov yog bolus txhaj koob tshuaj, ua raws li kev lis ntshav ntawm 5-10% cov kua nplaum tov, thiab yog tias muaj cov leeg catheterization tsis tau, nws yuav raug muab tshuaj intramuscularly lossis s / c 1-2 mg glucagon. Yog hais tias tus neeg mob tsis rov qab nco qab, cov kev ntsuas saum toj no tau rov ua dua, yog tias tsim nyog, kev kho mob hnyav yog nqa tawm. Txog kev tiv thaiv kom rov mob huam tuaj ntawm hypoglycemia tom qab rov qab nco qab ntawm 24-48 teev tom qab, cov khoom noj carbohydrates yog raug kho sab hauv (20-30 g tam sim ntawd thiab txhua 2-3 teev) lossis txuas ntxiv iv kev lis ntshav ntawm 5-20% kua nplaum tov muab. Koj tuaj yeem nkag rau 48 teev txhua 6 teev rau 1 mg ntawm glucagon / m. Glycemia tau saib xyuas tsis tu ncua tsawg kawg 48 teev tom qab tshem tawm ib qho kev muaj ntshav qab zib tsawg kawg. Yog tias nco qab tsis zoo nrog kev siv ntau tshaj (piv txwv li, nrog kev tua tus kheej), kev tso dej tsis tu ncua ntawm 5-10% cov kua nplaum ua haujlwm, qhov xav tau ntshav ntshav qab zib yog kwv yees li 200 mg / dl. Tom qab 20 feeb, rov tso ib qho tshuaj tsw qab li 40% cov kua nplaum ua tau. Yog hais tias daim duab hauv chaw kho mob tsis hloov pauv, nws yog qhov yuav tsum tau ua qhov kev kuaj xyuas qhov txawv txav ntawm txoj kev tsis nco qab, thiab tib lub sij hawm ua qhov kev kho rau kev puas hlwb (dexamethasone, sorbitol). Glibenclamide tsis raug tawm thaum lub sij hawm hemodialysis.

Cov lus qhia rau kev siv

Noj Maninil, zoo li lwm yam tshuaj noj qab zib, koj yuav tsum ua raws li kev noj haus.

Maninil yog cov tshuaj pheej yig uas tsim los ntawm Berlin-Chemie AG / Menarini Group (Lub Tebchaws Yelemees). Nws cov tshuaj analogue ntawm Glimidstad tsim los ntawm Arzneimittel AG (Lub Tebchaws Yelemees) kuj tau sau npe. Nws yog tsis yooj yim sua kom pom cov tshuaj no hauv cov khw muag tshuaj thaum lub sijhawm sau ntawv.

Pheej yig glibenclamide ntsiav tshuaj yog tsim los ntawm cov chaw tsim khoom hauv thaj chaw CIS, piv txwv li, Atoll LLC (Russia). Cov tshuaj German qub Maninil yog qhov pheej yig heev. Nws tsis muaj qhov taw tes rau kev hloov mus rau cov khoom sib txuas txawm tias pheej yig dua. Thov nco ntsoov tias cov tshuaj no muaj nyob rau ntawm cov npe cov tshuaj phom sij rau cov ntshav qab zib hom 2. Yog li, nws yog qhov zoo dua rau qhov tsis kam noj cov ntsiav tshuaj uas nws muaj tshuaj yog glibenclamide.

Tus Maninil twg zoo dua? Kev noj tshuaj txhua hnub yog 1.75, 3.5 lossis 5 mg?

Qhov no yog yeeb tshuaj tsis zoo, tsis hais qhov ntau npaum li cas ntawm qhov koj yuav tau coj nws. Txawm li cas los xij, ntau dua qhov ntau npaum li cas, kev txiav txim siab ua tiav sai sai ntawm tus txiav yuav tshwm sim, thiab ntshav qab zib hom 2 yuav dhau los ua hom mob ntshav qab zib hom 1 loj dua. Nyeem kab lus “Kab Mob Ntsuas Yam 2 Ntsiav Tshuaj Ntshav Qab Zib: Sau” rau cov lus qhia ntxiv. Pheej yig tshuaj ua nyob rau hauv Russia thiab CIS lub teb chaws tej zaum yuav txawm phem tshaj qhov qub tshuaj siv.

Yuav noj Maninil li cas

Cov lus qhia pom zoo kom noj Maninil 2 zaug hauv ib hnub - sawv ntxov thiab yav tsaus ntuj, ua ntej noj mov, nrog dej. Cov ntsiav tshuaj tuaj yeem muab faib ua ib nrab, tab sis tsis tuaj yeem zom. Ib lub tshuaj uas tsim nyog yog kws kho mob sau tseg. Cov neeg mob ntshav qab zib ua tsis tau nws tus kheej, vim tias koj ua txhaum nrog lub koob tshuaj, nws tuaj yeem muaj kev phiv loj heev. Tom qab noj cov tshuaj, koj yuav tsum tau noj, kom cov ntshav qab zib tsis poob ntau.

Coob tus neeg mob siab xav txog qhov twg yog qhov ntau tshaj ib hnub ntawm glibenclamide. Txawm li cas los xij, kev sim ua kom nce qhov ntau npaum li cas ntawm cov tshuaj no ib txwm nqa tsuas muaj kev phom sij. Yog hais tias glibenclamide hauv ib qho me me lossis nruab nrab koob tau nres qis dua koj cov piam thaj, koj yuav tsum hloov mus rau cov tshuaj insulin. Nyeem ntawm no vim li cas Maninil yog ib qho tshuaj tsis zoo thiab tseg tsis noj nws. Kawm paub txo cov piam thaj hauv ntshav kom tsawg thiab kom nws nyob tus li qub tsis noj tshuaj uas tsim kev puas tsuaj.

Maninil lossis Diabeton: uas yog ib qho zoo dua? Kuv tuaj yeem nqa tib lub sijhawm?

Maninil thiab Diabeton yog cov tshuaj phom sij. Nws zoo dua yog tsis siv ib qho ntawm lawv los kho hom mob ntshav qab zib hom 2. Nyeem cov kab lus no kom ntxaws ntxiv seb lawv coj dab tsi thiab koj tuaj yeem hloov lawv li cas. Maninil thiab Diabeton muaj cov tshuaj sib txawv, tab sis suav nrog tib pawg sulfonylureas. Txhua yam tshuaj uas poob rau hauv pawg no txo ​​qis cov ntshav qab zib kom ntau, tab sis tsis txo qis kev tuag ntawm cov neeg mob, tab sis theej nws ntxiv.

Cov tshuaj noj ntev ntev Diabeton MV, uas tau pom zoo kom noj ib hnub ib zaug, tsis muaj phom sij ntau dua Maninil, uas yuav tsum noj 2 zaug ib hnub. Tab sis qhov no tsis txhais tau tias koj yuav tsum hloov ntawm glibenclamide mus rau Diabeton MV. Siv cov txheej txheem kev kho mob ib qib zuj zus rau kev saib ntshav qab zib hom 2, uas tsis tas yuav muaj ib qho tshuaj phom sij lossis kim.

Maninil lossis Glucophage: uas zoo dua?

Maninil nyob rau hauv cov npe rau cov tshuaj phom sij rau hom ntshav qab zib hom 2. Los ntawm nws qhov kev txais tos yuav tsum tau muab tso tseg sai sai. Glucophage (metformin) - ntawm qhov tsis sib xws, yog ib qho khoom siv uas tseem ceeb thiab txawm siv tsis tau. Nws tsis tsuas yog txo qis ntshav qab zib, tab sis tseem ua rau qis kev txhim kho cov ntshav qab zib muaj teeb meem, thiab txo kev pheej hmoo tuag los ntawm kev mob plawv thiab lwm yam.

Lub vev xaib endocrin-patient.com pom zoo kom noj cov tshuaj tuaj txawv teb chaws Glucofage. Nws yog qhov zoo dua tsis hloov ntawm nws mus rau cov pheej yig tsim hom metformin ntsiav tshuaj. Yog tias koj muaj teeb meem qab zib thaum sawv ntxov nyob rau ntawm lub plab khoob, them sai sai rau cov tshuaj Glucofage Ntev.

Yuav ua li cas noj tshuaj metformin thiab maninil tib lub sijhawm?

Metformin thiab Maninil yuav tsum tsis txhob noj tib lub sijhawm. Metformin yuav tsum tseg rau koj hom kev kho mob ntshav qab zib hom 2, thiab teeb meem glibenclamide yuav tsum tau muab tshem tawm ntawm nws sai. Ntawm kev npaj cov tshuaj metformin, qhov kev xaiv zoo tshaj plaws yog thawj cov tshuaj muaj npe, Glucofage. Siofor ntsiav tshuaj kuj muaj nyob hauv kev thov loj. Feem ntau cov feem ntau, lawv ua qee qhov tsis muaj zog dua li Glucofage, tab sis lawv kuj pab tau zoo. Lub vev xaib endocrin-patient.com tsis pom zoo kom noj cov metformin kev npaj ua hauv tebchaws Russia thiab CIS.

Yuav ua li cas yog tias Maninil tsis pab, tsis txo cov ntshav qab zib? Yuav hloov nws li cas?

Maninil tsis txo cov ntshav qab zib hauv cov kis thaum tus neeg mob lub cev tsis ua haujlwm los tsim cov tshuaj insulin. Qhov no txhais tau hais tias tus kabmob tau hloov mus ua hom kabmob ntshav qab zib hom 1 loj heev. Txais tos ntawm glibenclamide thiab lwm yam tshuaj phem ua rau muaj kev cuam tshuam zoo li no tshwm sim ntawm cov xwm txheej hauv cov neeg mob T2DM. Nyob rau hauv qhov teeb meem nyuaj, tsis muaj tshuaj pab. Koj yuav tsum tau pib txhaj cov tshuaj insulin sai sai, tsis li ntawd tus neeg mob yuav poob mus rau hauv coma thiab tuag. Nws yog qhov nyuaj heev kom nres kev txhim kho ntawm cov kev mob nyhav, txawm tias siv tshuaj insulin.

Rov xyuas cov tshuaj no

Tus thawj muag tshuaj Maninil tsis kim. Yog li, ntau cov neeg mob uas muaj ntshav qab zib hom 2 xaiv cov tshuaj no, thiab tsis yog Diabeton MV thiab Amaryl ntsiav tshuaj sib tw nrog nws. Qhov ntau cov neeg tau noj tshuaj, cov ntaub ntawv qhia txog nws cov nyhuv accumulates lub sijhawm. Hauv Lavxias-lus-hauv lub vev xaib koj tuaj yeem nrhiav ntau cov neeg mob ntshav qab zib txog cov tshuaj Maninil. Feem ntau ntawm lawv, cov neeg mob yws tias tom qab ob peb xyoos ntawm kev noj tshuaj glibenclamide tau nres pab. Thaum pib kho, nws txo qis ntshav qab zib, tab sis tom qab ntawd poob qhov kev ua haujlwm.

Qhov no yog ntuj vim hais tias glibenclamide depletes tus txiav. Hauv qab ntawm cov tshuaj no, T2DM rau 4-10 xyoo dhau mus rau hom ntshav qab zib hom 1 loj. Maninil thiab lwm yam tshuaj tsis pab lawm. Tus neeg mob tsis muaj kev xaiv tab sis mus txhaj tshuaj insulin hauv kev txhaj tshuaj loj. Nws yog qhov tsis yooj yim sua kom txwv qhov kev loj hlob ntawm tus mob ntshav qab zib tsis haum.

Thaum nyeem cov kev txheeb xyuas zoo txog Maninil, tsis txhob ntseeg lawv. Vim tias lawv tau sau los ntawm cov neeg uas nyuam qhuav pib noj cov tshuaj. Tom qab ntau xyoo ntawm kev txais neeg mob, lub tswv yim ntawm cov neeg mob ntshav qab zib txog cov tshuaj glibenclamide feem ntau hloov pauv. Tab sis nws yog lig dhau lawm. Pancreatic kev puas tsuaj yog tsis muaj kev cuam tshuam. Lub vev xaib endocrin-patient.com pom zoo kom siv cov tshuaj kho mob ntshav qab zib hom 2 ntawm cov kauj ruam hloov chaw siv cov tshuaj phem. Nws yog qhov ua tau zoo thiab muaj kev nyab xeeb.

8 lus hais rau Maninil

Nyob zoo Koj muaj qhov haujlwm txawv thiab nthuav. Kuv vam tias yuav muab lus qhia rau kuv mob. Kuv muaj hnub nyoog 59 xyoos, qhov siab 169 cm, hnyav 87 kg, Kuv tau mob ntshav qab zib hom 2 muaj tsawg kawg yog 8 xyoo. Txhua xyoo no nws tau noj Maninil ntawm 3.5 mg 2 zaug ib hnub. Ua tsaug rau cov tshuaj, qab zib yog ib txwm nyob hauv ib txwm muaj kev txwv, tsis siab dua 6.5. Tab sis rau ntau tshaj 3 lub hlis, ntsuas thaum sawv ntxov nyob rau ntawm lub plab khoob nce rau 6.5-7.5. Kuv tau pib tshawb hauv Is Taws Nem, tshawb pom koj lub xaib thiab hloov mus rau kev noj haus cov zaub mov tsis muaj roj ntau ntau. Kuv tseem tuaj yeem thim Maninil, Kuv noj Cov Qos Qab Zib 850 mg 3 zaug hauv ib hnub. Dua li ntawm qhov no, qab zib tsis rov mus nyob li qub. Thaum sawv ntxov nws yog txog 6.8. Tom qab ntawd ib teev tom qab noj mov txog 8,2. Tom qab 2 teev - hauv thaj av ntawm 7.5-8.0. Ntxiv rau ntshav qab zib, kuj tseem kub siab, uas kuv tswj nrog kev pab los ntawm kev siv tshuaj ua ke. Kuv taug kev thaj tsam li 10 km ntawm ib asthiv, ua kev tawm dag zog thaum sawv ntxov. Kuv yuav ua li cas thiaj li nqa suab thaj rov qab los yam tsis muaj insulin? Los yog nws lig dhau lawm?

Kuv tau pib tshawb hauv Is Taws Nem, tshawb pom koj lub xaib thiab hloov mus rau kev noj haus cov zaub mov tsis muaj roj ntau ntau. Kuj tseem tso tseg Maninil,

Nws zoo dua yav dhau los

Kuv yuav ua li cas thiaj li nqa suab thaj rov qab los yog qub tsis muaj insulin? Los yog nws lig dhau lawm?

Koj sau tias koj tau noj Maninil tau 8 xyoo, los ntawm kev ntxiv koj cov txiav ua ke nrog cov tshuaj tsis zoo no.

Lub sijhawm zoo ntawm hnub! Kuv niam, 69 xyoo, yog qhov mob ntshav qab zib thiab mob ntshav siab nrog kev ua haujlwm ntev. Nws qhov siab thiab qhov hnyav kuv tsis paub, tab sis meej meej kom tiav. Nws lees txais mannin rau cov ntshav qab zib, thiab bisoprolol, valsartan, physiotens, amlodipine, kuj cardiomagnyl thiab qee zaum zylt (clopidogrel) rau cov ntshav siab. Txog 10 hnub dhau los, qab zib pib nce mus rau 10-15 thiab tib lub sijhawm kub siab ua teeb meem pib ib qho dhau ib qho. Pom tseeb tias, mannyl tsis ua dab tsi lawm. Lus Nug: Cov teeb meem kub siab puas cuam tshuam txog qhov no ib yam?

Pom tseeb tias maninil tsis ua haujlwm lawm

Nov yog qhov tseeb. Tus kabmob tseem ceeb tau hloov mus ua hom ntshav qab zib 1 vim kev kho mob ntev ntev. Koj tus niam mob sai sai xav pib txhaj cov tshuaj insulin, txwv tsis pub nws tej zaum yuav poob rau hauv lub dag zog tsis mob qab zib.

Lus Nug: Cov teeb meem kub siab puas cuam tshuam txog qhov no ib yam?

Nov yog lus nug tswv yim uas tsis tuaj yeem teb tau meej. Thiab nws tsis cuam tshuam rau txoj kev kho mob. Yuav tswj cov ntshav qab zib hom 2 tau piav li cas ntawm no - http://endocrin-patient.com/lechenie-diabeta-2-tipa/. Qhov no system normalizes tsis tsuas theem ntawm cov piam thaj nyob rau hauv cov ntshav, tab sis kuj ntshav siab.

Nws lees txais mannin rau cov ntshav qab zib, thiab bisoprolol, valsartan, physiotens, amlodipine, kuj cardiomagnyl thiab qee zaum zylt (clopidogrel) rau cov ntshav siab.

Txog koj cov ntaub ntawv, cardiomagnyl thiab lwm cov tshuaj aspirin raug pom zoo kom noj tsuas yog rau kev tiv thaiv ntawm kev rov mob plawv, tab sis tsis yog thawj zaug. Txhawm rau muab cov tshuaj clopidogrel (sylt), yuav tsum muaj laj thawj zoo, kev kuaj ntshav tsis zoo, qhia txog kev pheej hmoo ntshav txhaws. Koj niam puas tau kuaj no? Cov tshuaj seem ntawm koj cov ntawv yuav ntau lossis tsawg dua kev nyab xeeb.

Koj tuaj yeem haus tshuaj ntsiav tes puv tes txhua hnub, tab sis qhov no tsis hloov qhov kev saib xyuas txoj kev noj qab nyob zoo.

Nyob zoo Kuv muaj lus nug tshwj xeeb no. Kuv muaj hom mob ntshav qab zib hom 2 tsis ntev los no. Tus kws endocrinologist tau sau tseg tsuas yog glibenclamide - Maninil lossis qee yam ntawm nws cov analogues. Raug txwv tsis pub noj Siofor lossis Glyukofazh. Nws hais tias qhov kev hais daws no (metformin) hauv kuv rooj plaub tsis tsim nyog vim yog tus neeg tsis muaj hlwb. Qhov tseeb yog tias yam type 2 mob ntshav qab zib tsim tom qab txiav kab mob pancreatitis. Puas yog kws kho mob tau teem sijhawm puas raug?

Puas yog kws kho mob tau teem sijhawm puas raug?

Qhov no yog ib lo lus nug philosophical. Yog tias cov tshuaj metformin tsis haum rau koj, ces glibenclamide tseem ntau dua.

Qhov tseeb yog tias yam type 2 mob ntshav qab zib tsim tom qab txiav kab mob pancreatitis.

Ntawm no yog cov txheej txheem kho mob ntshav qab zib, raws li kev noj zaub mov noj kom tsawg - http://endocrin-patient.com/lechenie-diabeta-2-tipa/. Tus mob pancreatitis tsis yog kev sib deev hauv txoj ntsiab cai! Tus kab mob no tau ua tiav siv los ntawm ntau cov neeg mob uas muaj tus kab mob no. Koj xav tau 100% tsis kam ntawm kib (hlawv) thiab haus zaub mov, nrog rau ua tib zoo zom zaub mov, tsis txhob noj nrawm. Tsis txhob noj cov khoom noj ua tiav txhua qhov, ua noj zaub mov zoo rau koj tus kheej. Raws li rau cawv - nws yog tus kheej.

Nyob zoo, Sergey. Kuv niam muaj 59 xyoos, qhov siab 167 cm, hnyav 79 kg. Nws kuaj mob ntshav qab zib hom 2. Hauv cov tshuaj noj, Maninil 500 mg ob zaug ib hnub. Nws ua raws li kev noj haus, Kuv ua raws qhov no kuv tus kheej. Kev txhawj xeeb txog surges hauv qab zib, feem ntau yog thaum tshee. Tsis yog feem ntau, tab sis nws tshwm sim uas nws nce mus rau 11-12, thiab thaj. Los ntawm cov leaps, raws li kuv nkag siab, tus kws kho mob endocrinologist tau hais Dibicor rau nws. Nws tau haus nws rau ib lub lim tiam, qab zib tam sim no zoo li nyob rau tib theem li, tab sis ib zaug ntxiv nws dhia. Tej zaum nws ua rau kev nkag siab txuas qee yam tshuaj ntxiv?

Tej zaum nws ua rau kev nkag siab txuas qee yam tshuaj ntxiv?

Ua ntej tshaj plaws, koj yuav tsum ua tib zoo kawm cov lus ntawm lub vev xaib no, thiab tom qab ntawd sau cov lus pom, nug cov lus ntse.

tus kws kho mob endocrinologist tau hais Dibicor rau nws

Kev ntsuas rau siv

Dab tsi pab Maninil 5? Raws li cov lus qhia, cov tshuaj yog tshuaj hauv cov kis hauv qab no:

• Hom 2 mob ntshav qab zib mellitus - raws li monotherapy lossis ua ib feem ntawm kev sib xyaw ua ke nrog lwm cov tshuaj tiv thaiv ntshav qab zib hauv qhov ncauj, tshwj tsis yog sulfonylureas thiab clayides.

Analogs Maninil 5, tus nqi hauv cov khw muag tshuaj

Yog tias tsim nyog, koj tuaj yeem hloov Maninil 5 nrog ib qho analogue rau cov tshuaj nquag - cov no yog cov tshuaj:

1. Gilemal
2. Glibamide
3. Glibenclamide,
4. Glidanil
5. Glimidstad
6. Glitisol
7. Glucobene,
8. Daonil
9. Maniglide
10. Euglucon.

Thaum xaiv cov analogues, nws yog ib qho tseem ceeb kom nkag siab tias cov lus qhia rau kev siv Maninil 5, nqe thiab tshuaj xyuas, tsis txhob siv rau cov tshuaj ntawm cov nyhuv zoo sib xws. Nws yog ib qho tseem ceeb kom kws kho mob sab laj thiab tsis txhob hloov pauv cov tshuaj ywj siab.

Tus nqi hauv cov khw muag tshuaj Lavxias: Maninil 5 120 ntsiav tshuaj - los ntawm 77 txog 135 rubles, raws li 683 lub tsev muag tshuaj.

Saib xyuas kom ncav tsis cuag ntawm cov menyuam ntawm qhov kub txog 25 ° C. Txee lub neej yog 3 xyoos.

Qhov xwm txheej ntawm kev faib tawm los ntawm cov khw muag tshuaj yog los ntawm cov tshuaj noj.

Kev txheeb xyuas txog kev siv Maninil 5 feem ntau yog qhov zoo. Cov neeg noj tshuaj thiab cov kws kho mob sau tseg tias qhov tshwm sim tau zoo ntawm cov tshuaj. Hauv kev txheeb xyuas muaj cov ntawv tshaj tawm txog kev txhim kho cov kev mob tshwm sim hauv daim ntawv ntuav thiab kiv taub hau - qhov no tuaj yeem yog vim cov tshuaj tsis yog.