Glibenclamide: lus piav qhia ntawm cov tshuaj, tshuaj xyuas thiab cov lus qhia

Qhov ncauj tshuaj hypoglycemic. Derivatives ntawm sulfonylureas.

ATX code: A10VB01.

Glibenclamide txo qis cov ntsiab lus ntawm cov piam thaj hauv cov ntshav. Kev nce ntxiv ntawm cov ntshav dej insulin concentration thiab txo qis hauv cov piam thaj tshwm sim maj mam tshwm sim. Favorably cuam tshuam rau cov txheej txheem metabolic. Qhov kev txiav txim tsim tawm 2 teev tom qab kev tswj hwm, nce mus txog qhov siab kawg tom qab 7-8 teev thiab kav ntev txog 8-12 teev.

Kev cuam tshuam nrog lwm yam tshuaj

Txhim kho cov txiaj ntsig ntawm kev tsis ncaj ntawm anticoagulants.
Cov kav dej tso zis acidifying agents (ammonium chloride, calcium chloride, ascorbic acid nyob rau hauv cov koob tshuaj loj) txhim kho cov nyhuv ntawm glibenclamide.

Noj mauj txhais tau tias (azole derivatives), fluoroquinolones, tetracyclines, chloramphenicol, H2-blockers, beta-blockers, ACE inhibitors, nonsteroidal antiinflammatory tshuaj, monoamine oxidase inhibitors, clofibrate, bezafibrate, probenecid, acetaminophen, ethionamide, anabolic steroids, pentoxifylline, allopurmnol , cyclophosphamide, reserpine, sulfonamides, cov tshuaj insulin pab txhawb kev txhim kho hypoglycemia.
Barbiturates, phenothiazines, diazoxide, glucocorticoid thiab cov thyroid hormones, estrogens, gestagens, glucagon, adrenomimetic tshuaj, lithium ntsev, nicotinic acid derivatives, rifampicin thiab saluretics ua kom cov nyhuv hypoglycemic tsis muaj zog.

Cov Yuav Tsum Tau Ua

Glibenclamide yog contraindicated nyob rau hauv cov teeb meem hauv qab no:

• mob ntshav qab zib insulin-hom mob ntshav qab zib hom (hom 1), suav nrog cov menyuam yaus thiab cov hluas,
• mob ketoacidosis,
• kuaj cov ntshav qab zib lossis coma,
• txiav tawm
• hyperosmolar coma,
• mob raum lossis lub siab ua haujlwm tsis zoo (creatinine tshem tawm tus nqi tsawg dua 30 ml / min),
• dav kub hnyiab
• raug mob ntau qhov raug mob
• kev pab cuam phais mob
• hnyuv ob tog,
• paresis ntawm lub plab
• malabsorption ntawm cov zaub mov nrog txoj kev txhim kho hypoglycemia,
• leukopenia
• nce ib tug neeg rhiab heev rau cov tshuaj, nrog rau lwm yam tshuaj sulfa thiab sulfonylureas,
• cev xeeb tub thiab lactation
• hnub nyoog txog 14 xyoos.

Cov poj niam npaj ua cev xeeb tub, nrog rau kev muaj menyuam, yuav tsum hloov pauv mus rau insulin lossis txwv tsis pub mis niam.

Tsuas tshuaj thiab tswj hwm

Glibenclamide yuav tsum tau muab ntxuav nrog qhov dej me me. Tus kws kho mob txiav txim siab muab thawj zaug thiab ntau npaum li cas ntawm cov tshuaj rau kev kho kev kho mob rau txhua tus neeg mob ib tus zuj zus, raws li cov ntsiab lus ntawm kev soj ntsuam txog qib ntawm cov piam thaj hauv cov zis thiab ntshav. Nws yog cov lus qhia zoo li no rau kev siv uas Glibenclamide xav tau.

Thawj qhov tshuaj thawj zaug yog ib nrab ntawm ib ntsiav tshuaj (2.5 mg) ib hnub ib zaug. Yog tias tsim nyog, qhov kev niaj hnub tuaj yeem raug nce los ntawm kev saib xyuas cov kua qabzib hauv cov ntshav. Qhov kev txhaj tshuaj nce ntxiv yuav tsum tau nqa tawm maj nrog ib nrab hnub ntawm ob peb hnub los ntawm 2.5 mg, kom txog thaum siv tshuaj kho kom zoo.

Qhov siab tshaj plaws yuav yog 3 ntsiav tshuaj hauv ib hnub (15 mg). Tshaj cov nyiaj dhau los tsis ua kom cov nyhuv qog ntshav qab zib.

Yog tias cov koob tshuaj tau siab txog 2 ntsiav tshuaj hauv ib hnub, tom qab ntawd lawv raug coj mus rau ib lub sijhawm thaum sawv ntxov ua ntej noj mov. Yog tias koj yuav tsum siv tshuaj loj dua, ces nws yog qhov zoo dua rau hauv nws ob zaug, thiab qhov sib piv yuav tsum yog 2: 1 (sawv ntxov thiab yav tsaus ntuj).

Cov neeg laus yuav tsum tau pib kho nrog ib nrab koob ntxiv tom qab ntawd nws nce nrog lub sijhawm ib vas thiv tsis tshaj li 2.5 mg rau ib hnub.

Yog tias tus neeg lub cev qhov hnyav lossis kev hloov hauv lub neej, qhov koob tshuaj yuav tsum tau kho. Tsis tas li, txoj kev kho yuav tsum tau nqa tawm yog tias muaj qee yam uas ua rau muaj kev pheej hmoo ntawm kev mob ntshav qab zib- lossis hypoglycemia.

Nrog kev siv tshuaj ntau dhau ntawm cov tshuaj no, hypoglycemia pib. Nws tus mob:

1. nce hws
2. ntxhov siab
3. tachycardia thiab nce ntshav siab, mob hauv plawv, arrhythmia,
4. mob taub hau
5. qab los noj mov, ntuav, xeev siab,
6. kev qaug zog, tsis quav ntsej,
7. tsim txom thiab ntxhov siab
8. tsis hnov ​​lus,
9. kev nyuaj siab, rov quav niab
10. paresis, tshee hnyo,
11. rhiab hloov
12. convulates ntawm central genesis.

Qee qhov xwm txheej, hauv nws qhov kev pom, hypoglycemia zoo li mob stroke. Lub cev ntaj ntsug yuav loj tuaj.

Ntau tshaj kev kho mob

Nrog rau cov ntshav qabzib mus txog qib nrab ntawm lub qog ntshav qab zib, nws tuaj yeem nres los ntawm kev noj zaub mov sai ntawm carbohydrates (cov piam thaj, cov tshuaj yej qab zib lossis kua txiv txiv). Yog li, cov ntshav qab zib yuav tsum tau ib txwm nqa ib puag ncig 20 g ntawm qabzib (plaub lub suab thaj).

Cov khoom qab zib tsis muaj kev kho mob kho mob ntshav qab zib nrog lub qog ntshav qab zib. Yog tias tus neeg mob lub cev hnyav, nws yuav tsum tau mus pw hauv tsev kho mob. Nco ntsoov sim ua kom qaug dab peg thiab muab tshuaj rau dej (dej los sis kua txiv qaub nrog sodium sulfate thiab ua kom cov pa roj carbon), ntxiv rau cov tshuaj hypoglycemic.

Sab sij huam

Los ntawm sab ntawm cov metabolism tuaj yeem yog:

hypoglycemia, feem ntau nocturnal, nrog los ntawm:

• mob taub hau
• kev tshaib kev nqhis
• xeev siab
• kev ntxhov siab vim pw tsaug zog
• npau suav phem
• ntxhov siab
• tshee
• tso pa tawm hws txias.
• tachycardia
• tsis meej pem pem
• zoo nkaus li nkees
• hais lus thiab tsis pom kev zoo

Qee zaum yuav muaj kev qaug dab peg thiab coma, nrog rau:

1. muaj kev cuam tshuam zoo rau cawv,
2. hnyav
3. dyslipidemia, tsub zuj zuj ntawm adipose nqaij,
4. nrog lub caij nyoog siv, qhov kev loj hlob ntawm hypofunction ntawm lub qog ua haujlwm yog ua tau.

Los ntawm lub plab zom mov:

• xeev siab, ntuav,
• hnyav, tsis xis nyob thiab zoo nkaus li mob plab,
• flatulence, kub siab, raws plab,
• nce lossis txo qhov qab los noj mov,
• Tsis tshua muaj mob, lub siab ua haujlwm tuaj yeem cuam tshuam, kab mob siab, mob siab daj ntseg, mob pob qij txha tuaj yeem loj hlob.

Los ntawm cov kab ke hemopoietic:

1. tsawg kawg tej zaum yuav muaj aplastic lossis hemolytic anemia,
2. leukopenia
3. agranulocytosis,
4. tus mob pancytopenia
5. eosinophilia
6. thrombocytopenia.

• erythema multiforme, photosensitivity lossis exfoliative dermatitis tsis tshua muaj kev loj hlob,
• phiv khaub thuas ua xua rau cov thiazide-xws li cov tshuaj tiv thaiv, sulfonamides lossis sulfonylureas yuav tshwm sim.

Lwm cov kev phiv:

Qhov tsis txaus ntseeg tso tawm ntawm antidiuretic hormone, nrog los ntawm:

• kiv taub hau
• o ntawm lub ntsej muag
• tes thiab pob taws
• kev nyuaj siab
• nkees
• cramps
• neeg ruam
• coma
• kev hloov chaw nyob (chav).

Yog tias muaj ib qho kev xav tsis txaus lossis qhov tshwm sim txawv txawv, tom qab ntawd koj yuav tsum sab laj nrog koj tus kws kho mob txog kev kho ntxiv nrog cov tshuaj no, lub sijhawm no, Glibenclamide yuav tau ncua sijhawm.

Daim ntawv thov nta

Tus kws kho mob yuav tsum nco ntsoov paub txog tus neeg mob kev coj ua yav dhau los rau cov tshuaj hauv pawg no. Glibenclamide yuav tsum tsuas yog siv rau ntawm cov koob tshuaj pom zoo thiab nyob rau lub sij hawm nruj me ntsis ntawm lub hnub. Qhov no yog cov lus qhia meej rau kev siv, thiab txwv tsis pub Glibenclamide tsis pom zoo.

Tus kws kho mob txiav txim siab ntau npaum li cas, kev faib khoom kom yog rau kev nkag thaum nruab hnub thiab lub sijhawm siv, raws li tus neeg mob lub cev txhua hnub.

Txhawm rau kom cov tshuaj ua kom cov ntshav qabzib zoo, nws yuav tsum ua raws li kev noj zaub mov tshwj xeeb nrog kev noj tshuaj, ua kev tawm dag zog thiab txo lub cev qhov hnyav, yog tias tsim nyog. Tag nrho cov no yuav tsum yog cov lus qhia rau kev siv.

Tus neeg mob yuav tsum sim txo lub sijhawm uas siv rau hauv lub hnub thiab txo qhov muaj roj ntau.

Kev ceev faj thiab yuam kev ntawm kev siv tshuaj

Kev teem caij mus ntsib ib txwm yuav tsum yog los ntawm tus kws kho mob sab laj, koj siv tsis tau cov tshuaj kom ntev dua li lub sijhawm pom zoo. Glibenclamide thiab analogues yuav tsum tau siv nrog ceev faj thaum muaj mob febrile syndrome, adrenal tsis txaus, cawv, cov kab mob qog (hyper- lossis hypothyroidism), thaum lub cev ua haujlwm tsis zoo, nrog rau cov neeg laus.

Nrog cov tshuaj tua kab mob rau ntau dua tsib xyoos, kev tawm tsam ntxiv yuav tshwm sim.

Kuaj xyuas

Thaum kho nrog glibenclamide, koj yuav tsum tau saib xyuas qhov kev nkag siab hauv cov ntshav (thaum lub sijhawm tau xaiv, qhov no yuav tsum tau ua ob peb zaug hauv ib lub lis piam), nrog rau qib ntawm glycated hemoglobin (tsawg kawg ib zaug txhua peb lub hlis), qhov chaw nrog qhov no tseem ceeb thiab qabzib hauv cov zis. Qhov no yuav ua rau nws pom tias thawj lossis theem nrab tsis kam nrog cov tshuaj no hauv lub sijhawm.

Koj yuav tsum tau saib xyuas cov ntshav ntawm cov ntshav nruab nrog cev (tshwj xeeb cov ntsiab lus ntawm cov qe ntshav dawb thiab qe ntshav), ntxiv rau lub siab ua haujlwm.

Kev phom sij ntawm hypoglycemia thaum pib ntawm kev siv tshuaj

Hauv cov theem pib ntawm kev kho, qhov pheej hmoo ntawm kev tsim tus mob no nce, tshwj xeeb yog tias cov zaub mov raug hla los yog zaub mov tsis xwm yeem tshwm sim. Qhov tseem ceeb ua rau muaj kev txhim kho hypoglycemia:

1. qhov ua tsis tiav los yog tsis kam ua ntawm cov neeg mob, tshwj xeeb tshaj yog cov neeg laus, kom koom tes nrog tus kws kho mob thiab noj cov tshuaj Glibenclamide lossis nws cov analogues,
2. kev noj zaub mov tsis zoo, kev noj zaub tsis xwm yeem lossis zaub mov ploj lawm,
3. npaus tsis txaus ntawm kev ua kom txaus thiab kev ua kom lub cev,
4. yuam kev hauv kev noj haus
5. haus dej cawv, tshwj xeeb yog hais tias muaj kev tsis haum,
6. lub raum tsis ua hauj lwm zoo,
7. mob siab ua rau lub siab tsis ua haujlwm,
8. noj tshuaj ntau dhau
9. cov kab mob tsis pom kev ntawm cov kab mob endocrine uas cuam tshuam rau cov metabolism hauv kev ua kom yuag, nrog rau kev tiv thaiv cov qog ntshav qab zib, suav nrog kev ua kom tsis muaj zog thiab adrenocortical tsis txaus, ua rau cov thyroid tsis ua haujlwm,
10. kev siv lwm cov tshuaj thooj txhij.

Zoo tshuaj nyob rau hauv cov nyhuv:

• gliclazide (30mg ntsiav tshuaj),
• gliclazide (80 mg txhua),
• gliclazide maxpharma,
• diadeon
• ntshav qab zib MV,
• glurenorm.

Glibenclamide yog koom nrog cov pab pawg neeg hypoglycemic rau kev tswj hwm qhov ncauj. Nws muaj cov txheej txheem ntawm kev txiav txim siab nyuaj, uas muaj nyob rau hauv ib qho ntxiv-txiav npluav thiab txiav txim nyhuv.

Cov Tshuaj Pharmacokinetics

Tom qab lub qhov ncauj tswj hwm, kev ceev nrawm thiab kev ua tiav kev nqus ntawm glibenclamide hauv cov tshuaj ntsuab tshwm sim. Hauv kev soj ntsuam vitro tso tawm pom tias cov khoom xyaw nquag Glibenclamide nthuav tawm kwv yees li 63% ntawm cov tshuaj muaj yees nyob hauv 15 feeb, 72% hauv 60 feeb. Nyob rau tib lub sijhawm, kev noj zaub mov tuaj yeem ua rau poob qis hauv nws qhov kev mob siab hauv cov ntshav ntshav piv nrog kev siv ntawm lub plab khoob. Kev khi ntawm glibenclamide nrog albumin hauv cov ntshav plasma ntau dua li 98%. 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 roj ntsha tau faib rau tib yam li ob lub raum thiab nplooj siab. Qhov nruab nrab ib nrab-lub neej ntawm glibenclamide los ntawm ntshav ntshav yog 1.5-3.5 teev. Lub sijhawm ua li cas, txawm li cas los xij, tsis raug rau lub neej ib nrab los ntawm ntshav ntshav. Hauv cov neeg mob uas lub siab ua haujlwm tsis txaus siab, ntshav tawm los txo qis. Nrog mob raum tsis ua hauj lwm (kev tshem tawm ntawm 30 ml / min), kev nthuav tawm ntawm glibenclamide thiab ob qhov tseem ceeb ntawm cov zaub mov tseem tsis hloov, nrog lub raum tsis ua haujlwm, kev nruam yog qhov ua tau.

Yuav siv li cas: noj ntau thiab hom tshuaj kho

Qhov koob tshuaj nyob ntawm lub hnub nyoog, qhov mob hnyav ntawm cov chav kawm mob ntshav qab zib, qhov tsom ntawm kev yoo ntshav cov piam thaj thiab 2 teev tom qab noj mov. Qhov nruab nrab txhua hnub koob tshuaj nruab nrab ntawm 2.5 txog 15 mg. Qhov ntau zaus ntawm kev tswj hwm yog 1-3 zaug hauv ib hnub rau 20-30 feeb ua ntej noj mov. Cov koob tshuaj ntau dua 15 mg / hnub tsis nce qhov hnyav ntawm cov nyhuv hypoglycemic. Thawj koob tshuaj rau cov neeg laus yog 1 mg / hnub.

Thaum hloov cov tshuaj hypoglycemic nrog ib yam zoo sib xws, lawv raug kho raws li cov txheej txheem tau muab rau saum toj no, thiab cov tshuaj dhau los tam sim ntawd raug muab tso tseg. Thaum hloov los ntawm biguanides, qhov pib siv tshuaj rau txhua hnub yog 2.5 mg, yog tias tsim nyog, qhov koob tshuaj txhua hnub tau nce txhua txhua 5-6 hnub los ntawm 2.5 mg kom txog thaum them nyiaj tiav. Thaum tsis muaj cov nyiaj them poob haujlwm tsis pub dhau 4-6 lub lis piam, nws yog qhov tsim nyog los txiav txim siab txog kev sib koom ua ke.

Sab sij huam

Cov Hypoglycemia (ua txhaum rau txoj kev noj tshuaj ntau thiab noj tsis txaus), ua rau lub cev hnyav, ua npaws, mob caj dab, proteinuria, ua xua (tawv nqaij ua pob khaus, khaus), dyspepsia (xeev siab, zawv plab, ib qho kev xav ntawm hnyav hauv epigastrium), mob hlwb (paresis, mob rhiab heev) , hemopoiesis (hypoplastic lossis hemolytic anemia, leukopenia, agranulocytosis, pancytopenia, eosinophilia, thrombocytopenia), ua rau lub siab ua haujlwm tsis zoo (cholestasis), kev txiav cov leeg ntev, hloov hauv saj, polyuria, yees duab ensibilizatsiya, mob taub hau, qaug zog, tsis muaj zog, kiv taub hau.

Noj ntau dhau. Cov tsos mob: hypoglycemia (tshaib plab, tawm hws, tsis muaj zog txaus, palpitations, tshee tshee, ntxhov siab, mob taub hau, kiv taub hau, pw tsis tsaug zog, txob taus, nyuaj siab, cerebral edema, tsis hnov ​​lus thiab tsis pom kev, tsis nco qab lawm), ua tsis tau pa tsis nco qab.

Kev Kho Mob: yog tias tus neeg mob nco qab, noj qab zib sab hauv, nrog tsis nco qab - hno iv dextrose (iv bolus - 50% dextrose daws, tom qab ntawd ua rau cov kua tshuaj 10%), 1-2 mg glucagon s / c, i / m lossis iv, diazoxide 30 mg iv rau 30 feeb, saib xyuas cov piam thaj cov ntshav siab txhua 15 feeb, nrog rau kev txiav txim siab pH, urea nitrogen, creatinine, thiab electrolytes hauv cov ntshav. Tom qab nws rov qab nco qab, nws yog ib qho tsim nyog yuav tsum muab cov neeg mob cov zaub mov nplua nuj nyob hauv cov khoom noj zom zaub mov kom yooj yim (kom tsis txhob rov qab txhim kho hypoglycemia). Nrog cerebral edema, mannitol thiab dexamethasone.

Cov lus qhia tshwj xeeb

Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam cov ntshav qabzib hauv cov ntshav ntawm lub plab khoob thiab tom qab noj mov, qhov nkhaus niaj hnub ntawm cov ntsiab lus ntawm cov piam thaj hauv cov ntshav thiab zis.

Yog hais tias muaj kev phais mob lossis kev decompensation tiv thaiv ntshav qab zib, kev siv cov tshuaj insulin yuav tsum raug txiav txim siab.

Cov neeg mob yuav tsum tau ceeb toom txog kev pheej hmoo ntawm kev muaj ntshav qab zib tsawg nyob rau hauv rooj plaub ntawm kev noj tshuaj ethanol (suav nrog kev txhim kho disulfiram zoo li cov tshuaj tiv thaiv: mob plab, xeev siab, ntuav, mob taub hau), NSAIDs, thiab tuag tshaib.

Thaum kho, nws tsis pom zoo kom nyob hauv lub hnub ntev.

Ib qho kev hloov kho koob tshuaj yog qhov tsim nyog rau kev tawm dag zog lub cev thiab lub siab, hloov kev noj zaub mov.

Cov chaw txhaj tshuaj tiv thaiv kev mob ntshav qab zib siab tuaj yeem ua npog ntsej muag thaum noj beta-blockers, clonidine, reserpine, guanethidine.

Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab koom nrog lwm yam kev phom sij uas yuav tsum muaj kev mloog zoo thiab ceev ntawm cov kev tiv thaiv psychomotor.

Cov lus nug, lus teb, tshuaj xyuas ntawm Tshuaj Glibenclamide

Cov ntaub ntawv muab yog npaj rau kev kho mob thiab kws tshaj lij. Cov ntaub ntawv muaj tseeb tshaj plaws txog cov tshuaj muaj nyob hauv cov lus qhia uas txuas nrog lub ntim los ntawm cov kws tsim khoom lag luam. Tsis muaj cov ntaub ntawv tso tawm rau ntawm no lossis lwm nplooj ntawv ntawm peb lub xaib tuaj yeem hloov chaw rau qhov tsis txaus siab tus kheej rau tus kws tshaj lij.

Noj ntau dhau

Kev Kho Mob: kev txhaj tshuaj ntawm 40-100 ml ntawm 20% kua nplaum tov thiab / lossis (thiab tej zaum qhov catheterization ntawm txoj leeg tsis tuaj yeem) cov ntshav txhaj los yog subcutaneous txhaj ntawm 1-2 ml ntawm glucagon. Txog kev tiv thaiv kom rov zoo li qub tom qab rov qab nco qab, carbohydrates tau muab qhov ncauj (20-30 carbohydrates tam sim ntawd thiab txhua 2 rau 3 teev) dhau 24 mus rau 48 teev, lossis ntev li ntawm cov piam thaj (5 txog 20%) tau muab. Nws muaj peev xwm los tswj cov tshuaj intramuscularly 1 ml glucagon txhua 48 teev hauv 48 teev.Kev tshuaj xyuas cov ntshav qab zib tas li 48 teev tom qab xaus rau qhov mob ntshav qab zib tsawg kawg. Nyob rau qee kis, nyob ntawm qhov muaj cov neeg muaj ntshav siab txaus (xws li tua tus kheej), tsis nco qab qhov cuam tshuam, qhov kev ncua ntev txog 5-10% piam thaj tau ua tiav, qhov xav tau ntawm cov piam thaj hauv cov ntshav yuav tsum muaj kwv yees li 200 mg / dl. Tom qab 20 feeb, kev rov ua tiav ntawm 40% kua nplaum daws tau. Yog hais tias daim duab hauv chaw kho mob tsis hloov pauv, nws yog qhov yuav tsum tau saib mus rau lwm yam ua rau poob kev nco qab, ntxiv rau kev coj ua kev kho mob rau cerebral edema (dexamethasone, sorbitol), kev tshuaj xyuas ntau ntxiv ntawm tus neeg mob thiab kev kho mob. Hauv kev mob lom hnyav, tuaj yeem nqa nrog ua ke nrog cov kev ntsuas saum toj no, nrog rau kev ntsuas dav dav kom tshem tawm kev lom (mob plab, ua kom mob ntuav), thiab tseem sau ntawv kom siv lub tshuab hluav taws xob. Glibenclamide tsis raug ntiab tawm los ntawm hemodialysis.

Cia rau cov neeg mob

Muab khaws cia rau qhov kub thiab txias tsis tshaj 25 ° C kom ncav tsis cuag cov menyuam.

Daim ntawv tso tawm:
Glibenclamide - ntsiav tshuaj.
30 ntim hauv cov ntim.

1 ntsiav tshuajGlibenclamide muaj glibenclamide 5 mg.
Cov kev zam: lactose monohydrate, qos hmoov txhuv nplej siab, croscarmellose sodium, povidone 25, magnesium stearate, colloidal silicon dioxide, indigo carmine E 132.