Glurenorm: cov lus qhia rau kev siv, tshuaj xyuas, ua haujlwm analogues

Cov Tshuaj Hauv Tshuaj Glurenorm yog ib tus neeg sawv cev ntawm qhov ncauj hypoglycemic, sulfonylurea derivative ntawm lub cim thib ob. Glurenorm stimulates tso pa tawm ntawm endogenous insulin los ntawm pancreatic cells-hlwb, ua kom cov ntshav qabzib siv, inhibits cov txheej txheem ntawm lipolysis.
Glurenorm txo cov tshuaj insulin tsis pub dhau lub siab thiab adipose cov ntaub so ntswg los ntawm kev nce ntawm insulin receptors thiab kev ua kom zoo tom qab txais cov txheej txheem vim qhov kev ua ntawm insulin. Qhov yuav tsum tau kawm uantej rau kev txo qis hypoglycemic ntawm Glyurenorm yog qhov muaj sia nyob ntawm insulin endogenous.
Qhov tshwm sim ntawm kev txo qis cov ntshav qab zib tau pib 60-90 feeb tom qab kev tswj hwm ntawm qhov ncauj thiab nce mus txog qhov siab kawg 2-3 teev tom qab kev tswj hwm.
Lub sijhawm ntawm cov ntshav hypoglycemic ntawm Glurenorm yog 8-10 teev Yog li ntawd, Glurenorm yog suav tias yog tshuaj lom neeg luv luv.
Kev siv cov sulfonylureas, uas yog cov tshuaj tiv thaiv luv luv, raug pom zoo rau kev kho mob ntawm cov neeg mob uas muaj kev pheej hmoo ntawm kev mob ntshav qab zib tsawg, piv txwv li, cov neeg laus thiab cov neeg mob lub raum tsis ua haujlwm.
Txij li thaum lub raum tshem tawm ntawm Glyurenorm yog qhov tsis zoo, cov tshuaj muaj peev xwm kho tau feem ntau yog rau cov neeg mob raum tsis ua haujlwm lossis mob ntshav qab zib nephropathy.
Qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv Glyurenorm rau cov neeg mob ntshav qab zib mellitus tau raug pov thawj, uas yog qhia rau kev kho nrog sulfonylurea kev npaj uas muaj cov kab mob siab ua haujlwm.
Cov Tshuaj Pharmacokinetics 2-3 teev tom qab noj 30 mg ntawm Glurenorm, qhov siab tshaj plaws ntshav plasma tau mus txog (500-700 ng / ml), tom qab ntawd txo qis 2 zaug hauv 1 / 2-1 teev .Txoj kev sib piv ntawm lub siab nkhaus hauv cov ntshav ntshav paub meej tias yuav luag tiav. cov tshuaj.
Glurenorm tau koom ua ke nrog cov ntshav protein (99%).
Glurenorm yog metabolized kiag li, feem ntau los ntawm hydroxylation thiab demethylation. Feem ntau ntawm cov metabolites raug tawm los ntawm qhov biliary system nrog quav. Tsuas yog ib feem me me ntawm cov metabolites tau ua tawm los ntawm lub raum. Tsuas yog 5% ntawm cov koob tshuaj tiv thaiv metabolized tau pom hauv cov zis. Txawm hais tias tom qab qhov rov qab siv dua ntawm Glyrenorm siv, kev kho ntxiv rau lub raum tseem muaj tsawg.
Tsis tas li ntawd, nrog kev tswj hwm tsis tu ncua ntawm Glyrenorm rau cov neeg mob ntshav qab zib mellitus nrog lub raum tsis ua haujlwm, tsis muaj kev hloov pauv hauv txoj kev nthuav dav tau kuaj pom. Tsis muaj kev phom sij ntawm kev txuam nrog cov khoom lossis nws cov khoom nruab nrog.
Cov tshuaj metabolites yog pharmacodynamically ua haujlwm thiab tsis cuam tshuam rau cov ntshav ntshav qabzib.
Pharmacological tests tau ua haujlwm ntawm cov nas tsuag thiab nas tau pom tias Glyrenorm thiab nws cov khoom siv tiv thaiv kab mob tsis hla ntawm BBB lossis lub chaw placental.

Kev siv tshuaj ntawm cov tshuaj Glyurenorm

Kev pib khomob
Feem ntau, thawj koob tshuaj Glenrenorm yog 1/2 ntsiav tshuaj (15 mg). Nws yog coj thaum lub sijhawm noj tshais. Nrog rau qhov tsis muaj zog, qhov tshuaj tau tuaj yeem maj mam nce. Qhia pom tias tsis pub ntau tshaj 2 ntsiav tshuaj (60 mg) yog qhov kev noj tshuaj, koob tshuaj Glyurenorm txhua hnub tuaj yeem noj ib zaug thaum noj tshais. Txawm li cas los xij, thaum siv ntau dua nyob rau hauv cov koob tshuaj ntau dua, kev tswj xyuas zoo tshaj plaws yog muab los ntawm 2-3 zaug ib koob tshuaj txhua hnub. Hauv qhov no, qhov ntau tshaj yuav tsum noj thaum noj tshais thaum sawv ntxov. Glenrenorm ntsiav tshuaj yuav tsum tau noj thaum pib noj mov. Nws yuav tsum raug sau tseg tias nce qhov koob tshuaj rau 4 ntsiav tshuaj (120 mg) ib hnub twg feem ntau tsis ua rau muaj kev nce ntxiv hauv kev kho mob.
Thaum hloov lwm tus neeg sawv cev ntawm qhov ncauj hypoglycemic nrog lub ntsej muag zoo sib xws
Thawj lub koob tshuaj tau txiav txim siab nyob ntawm lub caij ntawm tus kab mob thaum lub sijhawm saib xyuas cov tshuaj. Thaum hloov lwm tus neeg sawv cev tiv thaiv kab mob nrog Glurenorm, nws yuav tsum nco ntsoov tias qhov kev txiav txim ntawm 1 ntsiav tshuaj ntawm Glurenorm yog kwv yees li 1000 mg ntawm tolbutamide.
Kev sib txuas ua ke
Yog tias monotherapy nrog Glurenorm tsis muaj kev tswj hwm txaus hauv cov ntshav cov ntshav hauv lub cev, kev teem caij ntxiv ntawm biguanide yuav tsum raug txiav txim siab.
Lub sijhawm tiv thaiv ntawm cov chav kho yog nyob ntawm qhov xwm ntawm tus kabmob thiab qhov tshwm sim ntawm kev kho.

Cov Txheej Txheem Txuas rau txoj kev siv tshuaj Glurenorm

Insulin-dependent type I diabetes mellitus, mob ntshav qab zib tsis nco qab thiab precomatosis, mob ntshav qab zib mellitus nyuaj los ntawm acidosis thiab ketosis, tom qab txiav tawm kab mob, nyob rau lub sijhawm mob sai sai, ua ntej kev phais mob, mob siab rau lub siab ua haujlwm tsis txaus, mob siab (mob ntshav qab zib) porphyria, hypersensitivity to sulfonylurea npaj.

Phiv los ntawm cov tshuaj Glenrenorm

Raws li txoj cai, Glurenorm muaj kev zam zoo rau cov neeg mob, tab sis qee qhov muaj kev tiv thaiv hypoglycemic, xeev siab, ntuav, cem quav, zawv plab, tsis qab los noj mov, kev tawm tsam: khaus, eczema, mob taub hau, kiv taub hau, cuam tshuam ntawm kev pab, thrombocytopenia tuaj yeem tshwm sim.
Muaj qee kis, mob siab cholestasis, urticaria, Stevens-Johnson syndrome, mob leukopenia, agranulocytosis yuav pib mob.

Cov lus qhia tshwj xeeb rau kev siv tshuaj yeeb tshuaj Glurenorm

Lub sijhawm ntawm cev xeeb tub thiab lactation. Cov kev tshawb fawb txog kev siv Glyurenorm thaum cev xeeb tub thiab lactation tsis tau ua. Yog li, kev siv Glurenorm yuav tsum zam thaum lub sijhawm no. Yog tias cev xeeb tub yog tsim los, nws yog ib qho tsim nyog yuav tsum tsis txhob noj Glyurenorm sai li sai tau.
Hauv kev kho mob ntshav qab zib, kev saib xyuas kev kho mob tsis tu ncua yog qhov tsim nyog. Tshwj xeeb yuav tsum tau saib xyuas thaum xaiv cov tshuaj lossis hloov tshuaj.
Txawm hais tias tsuas yog 5% ntawm Glurenorm raug tso tawm los ntawm lub raum thiab feem ntau zoo rau cov neeg mob raum, kev kho mob ntawm cov neeg mob uas lub raum tsis ua haujlwm zoo yuav tsum tau ua nrog kev saib xyuas zoo.
Cov neeg mob ntshav qab zib yog cov nquag tiv thaiv kab mob plawv. Txoj kev pheej hmoo no tsuas yog txo qis qis los ntawm kev noj zaub mov raws li kws kho mob sau tseg. Kev siv cov tshuaj tiv thaiv kab mob rau qhov ncauj yuav tsum tsis txhob hloov kho cov khoom noj uas tso cai rau koj los tswj tus neeg mob lub cev qhov hnyav thiab yog qhov yuav tsum tau ua txawm hais tias siv tshuaj tiv thaiv hypoglycemic. Txhua tus neeg tso tshuaj tiv thaiv kab mob hauv qhov ncauj nrog rau noj mov tsis raws sijhawm lossis kev ua txhaum ntawm qhov kev pom zoo noj tshuaj tuaj yeem ua rau txo qis ntshav qabzib ntau ntau. Kev siv cov piam thaj, cov khoom qab zib, lossis cov dej qab zib feem ntau pab tiv thaiv qhov pib ntawm qhov mob hypoglycemic.
Cawv ntawm lub peev xwm tsav tsheb thiab ua haujlwm nrog lwm cov txheej txheem.Cov neeg mob yuav tsum tau ceeb toom txog kev ua raws li kev ntsuas kom tiv thaiv kev mob ntshav qab zib thaum tsav tsheb. Qhov no tseem ceeb tshwj xeeb tshaj yog rau cov neeg uas tsis muaj cov tsos mob ntawm lub qog ntshav qab zib (hypoglycemia) lossis txheeb xyuas qee zaus muaj cov ntshav qog ntshav qab zib tsawg. Qhov tsim nyog ntawm kev tsav tsheb yuav tsum raug txiav txim siab raws li cov xwm txheej no.

Kev sib cuam tshuam yeeb tshuaj Glurenorm

Muaj kev cuam tshuam nrog cov tshuaj uas cuam tshuam rau cov metabolism hauv qabzib yuav tsum raug suav nrog.
Cov tshuaj uas tuaj yeem txhim kho hypoglycemic nyhuv ntawm Glurenorm: NSAIDs, MAO inhibitors, oxytetracyclines, ACE inhibitors, clofibrates, cyclophosphamides thiab lawv cov neeg sawv cev, sulfonamides thiab lwm yam tshuaj tua kab mob uas tiv thaiv kom tsis pom kev, lwm yam tshuaj tiv thaiv kab mob, insulin.
Cov tshuaj uas zoo li yuav txhim kho hypoglycemic ntxim ntawm Glurenorm: β-adrenergic receptor blockers, lwm yam tshuaj sympatholytics (piv txwv li clonidine), reserpine, guanethidine. Cov tshuaj no tseem tuaj yeem npog cov tsos mob ntawm kev mob ntshav qab zib.
Cov tshuaj uas tuaj yeem txo qhov kev txo qis hypoglycemic ntawm Glurenorm: GCS, tshuaj tiv thaiv steroid, sympathomimetics, thyroid hormones, glucagon, diuretics (thiazide hom lossis voj diuretics), diazoxide, phenothiazine, nicotinic acid.
Barbiturates, rifampicin, phenytoin thiab cov tshuaj muaj yees zoo sib xws yuav txo qhov hnyav ntawm cov nyhuv ntshav qab zib hauv Glyrenorm los ntawm kev ua kom lub siab enzymes.
Qhov txo qis lossis nce ntxiv hauv qhov mob ntawm cov qog ntshav hypoglycemic ntawm Glurenorm yog sau tseg nrog kev siv ua ke nrog H2 receptor antagonists (cimetidine, ranitidine) thiab dej cawv.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Daim ntawv tshuaj ntawm Glyurenorm yog cov ntsiav tshuaj: puag ncig, du, dawb, nrog beveled npoo, ntawm ib sab muaj kev sau tus kheej ntawm lub tuam txhab logo, sab nraud muaj qhov pheej hmoo, ntawm ob sab muaj qhov txaug "57C" (10 pcs. Hauv cov hlwv, 3, 6 lossis 12 lub hlwv hauv pob ntawv qhwv).

Cov khoom xyaw nquag: glycidone, hauv 1 ntsiav tshuaj - 30 mg.

Cov tshuaj ntxiv: soluble pob kws hmoov txhuv nplej siab, pob kws nplej siab, magnesium starate, lactose monohydrate.

Cov Tshuaj Hauv Tshuaj

Glycvidone pab txhim kho cov tshuaj insulin los ntawm kev ua kom cov piam thaj hauv kev tawm suab rau kev tsim cov khoom no. Kev sim tsiaj ua pov thawj tias cov tshuaj txo cov tshuaj insulin nyob rau hauv adipose cov nqaij mos thiab daim siab los ntawm kev ua haujlwm ntawm insulin receptors, zoo li txhawb lub zog tom qab receptor los ntawm insulin. Cov nyhuv hypoglycemic dhau los 1-1.5 teev tom qab kev tswj hwm qhov ncauj. Qhov siab tshaj plaws tau sau cia 2-3 teev tom qab kev tswj hwm thiab kav ntev li 8-10 teev. Glycvidone yog luv luv ua yeeb yam sulfonylurea derivative, uas ua rau nws siv rau cov neeg mob uas muaj ntshav qab zib hom 2 mob ntshav qab zib uas muaj kev pheej hmoo ntawm lub qog ntshav qab zib, piv txwv li, hauv cov neeg laus lossis cov neeg mob lub raum tsis ua haujlwm.

Txij li glycidone raug tawm los ntawm lub raum hauv cov khoom me, cov tshuaj tuaj yeem raug kho rau cov neeg mob uas muaj ntshav qab zib thiab qog ua haujlwm tsis zoo. Muaj pov thawj qhia tias kev noj Glenrenorm rau cov neeg mob ntshav qab zib hom 2 mob ntshav qab zib mellitus, raug mob los ntawm daim siab ua mob rau lub siab, yog qhov muaj txiaj ntsig thiab nyab xeeb. Txawm li cas los xij, qhov kev nthuav tawm ntawm cov tshuaj yeeb dej caw hauv cov neeg mob zoo li no muaj kev cuam tshuam me ntsis. Hauv qhov no, kev teem sij hawm ntawm glycidone hauv cov neeg mob ntshav qab zib mellitus nyuaj los ntawm kev mob ntshav siab tsis txaus siab tsis pom zoo.

Cov txiaj ntsig ntawm kev tshawb fawb pom tseeb tias kev siv Glyurenorm rau 18 thiab 30 lub hlis tsis ua rau nce hauv lub cev qhov hnyav, thiab hauv qee kis muaj txawm tias qhov txo hauv lub cev hnyav los ntawm 1-2 kg. Cov kev tshawb fawb sib piv hauv lwm qhov sulfonylurea derivatives tau kawm ua pov thawj qhov tsis muaj qhov hloov pauv hauv lub cev hnyav hauv cov neeg mob noj glycidone.

Cov Tshuaj Pharmacokinetics

Nrog kev noj ib zaug ntawm glycidone ntawm ib koob tshuaj 15 lossis 30 mg, cov tshuaj yog nqus tau los ntawm cov hnyuv nrog kev kub ceev thiab yuav luag tiav (80-95%). Qhov siab tshaj plaws hauv cov ntshav ntshav nruab nrab yog 0.65 μg / ml (nws txawv li ntawm 0.12 txog 2.14 μg / ml) thiab tau nce mus txog li 2 teev 15 feeb (kev hloov pauv ntawm 1.25 1.4.75 yog qhov ua tau cov sij hawm). Thaj chaw hauv qab txoj kab nruab nrab-concentration (AUC) yog 5.1 μg × h / ml (qhov hloov ntawm 1.5 thiab 10.1 μg × h / ml yog ua tau).

Tsis muaj qhov sib txawv ntawm pharmacokinetic cov sib txawv ntawm cov tib neeg noj qab haus huv thiab cov neeg mob ntshav qab zib mellitus.

Glycvidone yog tus cwj pwm los ntawm qhov muaj txiaj ntsig zoo rau cov ntshav plasma nqaij tshaj li ntawm 99%. Cov ntaub ntawv hais txog kev nkag mus ntawm ib yam khoom lossis nws cov khoom noj sib txig sib luag los ntawm cov ntshav-hlwb thiab thaj chaw tsis tiav. Tsis muaj pov thawj tau pom tias glycidone tuaj yeem tshwm sim hauv cov kua mis.

Glycvidone yog ua kom tiav hauv lub siab, feem ntau yog los ntawm demethylation thiab hydroxylation. Glycvidone metabolites yog cov tshuaj ua tsis tau zoo, lossis ua yeeb yam me ntsis piv nrog niam txiv cov khoom sib txuas.

Glycvidone metabolites yog ua nrog quav, thiab tsuas yog qee tus lawv tso nyob hauv cov zis. Cov txiaj ntsig kev tshawb fawb qhia tau tias tom qab kev tswj hwm ntawm qhov ncauj, kwv yees li 86% ntawm radiolabelled (14 C) glycidone raug tawm hauv txoj hnyuv. Kwv yees li 5% (nyob rau hauv kev tsim cov tshuaj metabolites) ntawm kev noj tshuaj yog tawm los ntawm ob lub raum, thiab cov txheej txheem no tsis siv tshuaj ntau thiab tsis nyob ntawm txoj kev coj ntawm Glyurenorm. Txawm hais tias siv cov tshuaj tsis tu ncua, nws nyob hauv cov zis hauv qhov ntau tsawg.

Kev tshem tawm ib nrab-lub neej yog 1.2 teev (qhov ntau ntawm txawv yog 0.4–3 teev), thiab lub davhlau ya nyob twg tshem tawm ib nrab-lub neej yog kwv yees li 8 teev (tus nqi tuaj yeem txawv ntawm 5.7 txog 9.4 teev).

Hauv cov neeg mob ntawm kev laus thiab hnub nyoog nruab nrab, cov tsis muaj tshuaj sib luag zoo ib yam. Hauv cov neeg mob uas lub raum thiab hepatic ua rau lub cev tsis ua haujlwm, feem ntau ntawm glycvidone yog cov tawm hauv cov quav. Muaj cov pov thawj tias cov metabolism hauv cov tshuaj tiv thaiv ntawm cov tshuaj tsis tshua hloov pauv hauv cov neeg mob uas lub siab tsis ua haujlwm. Txij li glycidone raug tawm los ntawm ob lub raum hauv cov nyiaj me me, tsis muaj kev nkag mus ntawm cov tshuaj hauv cov neeg mob uas lub raum tsis ua haujlwm.

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

Glurenorm noj qhov ncauj raws li kws kho mob pom zoo txog kev noj tshuaj thiab noj haus.

Thaum pib kho, raws li txoj cai, ½ ntsiav tshuaj tau kho thaum noj tshais (thaum pib noj mov). Yog tias tsis muaj kev txhim kho tau teev tseg, qhov koob tshuaj yog maj mam nce ntxiv.

Yog tias qhov koob tshuaj txhua hnub tsis pub tshaj 2 ntsiav tshuaj, nws yuav tsum noj nyob rau hauv 1 thaum sawv ntxov. Yog tias nws dhau qhov siab, nws yog qhov yuav tsum tau faib los ntawm 2-3 koob tshuaj, tab sis koom nrog qhov loj tshaj plaws thaum sawv ntxov thaum noj tshais.

Qhov siab tshaj plaws pub rau txhua hnub yog 4 ntsiav tshuaj. Kev nce ntxiv ntawm koob tshuaj ntau dua 4 ntsiav tshuaj yog qhov ua tsis tau, vim tias nws tsis ua rau kev nce hauv kev ua haujlwm.

Tsis txhob noj mov tom qab noj Glyurenorm thiab tsum tsis haus tshuaj yam tsis tau sab laj nrog kws kho mob.

Thaum muab tshuaj rau hauv cov tshuaj ntau dua 75 mg (2.5 ntsiav tshuaj), cov neeg mob lub siab ua tsis tau haujlwm yuav tsum ua tib zoo saib xyuas tus mob.

Thaum tsis tshua muaj kev soj ntsuam kev kho mob thaum lub sij hawm monotherapy nrog Glyrenorm, kev kho kev sib txuam ua ke nrog metformin tuaj yeem kho tau.

Sab sij huam

• Hematopoietic system: leukopenia, thrombocytopenia, agranulocytosis,
• Tej leeg hauv lub cev: nkees nkees, mob siab, mob plab, mob taub hau, nkees,
• Kev kho mob ntawm lub plawv: ua kom dhau, mob ntshav siab, mob taub hau, mob leeg ntshav txha ntshav, lub plawv tsis ua haujlwm,
• Lub plab zom mov: xeev siab, tsis qab los, ua lub qhov ncauj qhuav, tsis xis nyob hauv plab, cem quav / raws plab, ntuav, cholestasis,
• Kev tiv thaiv kab mob: hypoglycemia,
• Lub koom haum ntawm lub zeem muag: kev pabcuam txawv,
• Cov tawv nqaij thiab cov nqaij mos subcutaneous: kev tawm tsam cov tshuaj tiv thaiv, urticaria, tawm pob, khaus, tawv nqaij Stevens-Johnson,
• Lwm yam: mob hauv siab.

Noj ntau dhau

Kev noj tshuaj ntau dhau ntawm Glyurenorm tuaj yeem ua rau lub ntsej muag tsis txaus, uas yog txiav txim siab los ntawm cov tsos mob hauv qab no: lub cev muaj zog ntxhov siab, tachycardia, palpitations, hais lus tsis meej thiab tsis pom kev, tawm hws, tshaib plab, txob taus, insomnia, mob taub hau, tshee tshee, thiab tsaus muag. Thaum cov tsos mob ntawm hypoglycemia tshwm sim, nws yog ib qho tsim nyog yuav tau noj zaub mov nplua nuj hauv cov carbohydrates lossis cov piam thaj (dextrose).Thaum muaj mob ntshav qab zib heev, nrog rau kev ploj thiab tsis nco qab lawm, dextrose yog muab tshuaj rau leeg. Tom qab tus neeg mob rov qab nco qab, nws yuav tsum noj cov zaub mov carbohydrates tau yooj yim txhawm rau kom zam dhau qhov rov qab ua rog hypoglycemic.

Cev xeeb tub thiab lactation

Cov ntaub ntawv hais txog kev siv glycidone hauv cov neeg mob thaum cev xeeb tub thiab lactation tsis muaj. Cov poj niam cev xeeb tub uas kuaj tau tias mob ntshav qab zib xav tau kev soj ntsuam ntshav ntau nyob ntawm ntshav qab zib. Kev noj qhov ncauj hypoglycemic hauv cov neeg mob thaum cev xeeb tub tsis tuaj yeem lav tias yuav tsum tau tswj glycemic. Vim li no, noj Glyurenorm thaum cev xeeb tub yog contraindicated.

Yog tias tus neeg mob tau xeeb tub thaum kho nrog cov tshuaj, lossis nws npaj rau nws, glycidone thim thiab hloov mus rau tshuaj insulin.

Nrog lub siab ua haujlwm tsis zoo

Glurenorm tsis pom zoo rau cov neeg mob uas muaj lub siab ua rau lub siab, vim 95% ntawm qhov koob tshuaj noj yog qhov tshwj xeeb hauv daim siab thiab nthuav tawm nrog quav. Cov kev tshawb fawb soj ntsuam nyob rau hauv uas cov neeg mob ntshav qab zib mellitus thiab lub siab ua rau lub siab ua rau muaj qhov txawv txav (suav nrog cov mob ntsws ua rau mob siab, nrog kev tawm tsam ntawm lub qhov ncauj) coj ib feem, pom tias glycvidone tsis ua rau muaj teeb meem txuas ntxiv ntawm lub siab ua haujlwm, kev nce ntxiv ntawm qhov tshwm sim ntawm cov kev mob tshwm sim, thiab hypoglycemic tshua tau tsis tuaj kawm ntawv.

Yeeb tshuaj sib cuam tshuam

Nws yog ua tau los txhim kho cov nyhuv hypoglycemic ntawm Glurenorm nrog kev sib txig sib xyaw ntawm cov tshuaj hauv qab no: monoamine oxidase inhibitors, tshuaj tsis-steroidal anti-inflammatory, analgesics, antifungal agents, tricyclic antidepressants, tetracyclines, insulin, lwm yam tshuaj tiv thaiv kab mob hauv lub cev, angiotensin-cycloformin-converting , sulfonamides, sulfinpyrazone, clofibrate, clarithromycin, chloramphenicol, allopurinol.

Sympatholytics (suav nrog clonidine), beta-blockers, guanethidine thiab reserpine tsis tuaj yeem tsuas yog ua kom cov nyhuv hypoglycemic ntawm Glyrenorm, tab sis tib lub sijhawm npog cov tsos mob ntawm hypoglycemia.

Nws yog qhov muaj peev xwm los txo qis cov nyhuv hypoglycemic ntawm Glyurenorm thaum muab tshuaj rau hauv qab no: sympathomimetics, glucocorticosteroids, thyroid hormones, thiazide thiab voj diuretics, tshuaj tiv thaiv mob qhov ncauj, npaj tshuaj nicotinic acid, aminoglutetimide, phenothiazine, diazoxide, glucagon, rifenitin thiab rifampin.

Nrog tib lub sij hawm siv cov tshuaj ethanol, histamine H blockers₂-receptors (piv txwv li, ranitidine, cimetidine), nws muaj peev xwm ob leeg los txhim kho thiab ua kom lub zog tsis muaj zog hypoglycemic ntawm Glyrenorm.

Glurenorm's analogues yog: Amix, Glair, Glianov, Glibetic, Gliklada.

Kev Sib Sau thiab daim ntawv ntawm tso tawm

Glurenorm muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, puag ncig dawb nrog lub cim "57C" thiab tuam txhab logo nyob tom qab. Txhua lub ntsiav tshuaj muaj 30 mg ntawm cov tshuaj nquag - glycidone, cov khoom siv pabcuam tau nthuav tawm rau hauv daim ntawv: lactose monohydrate, soluble pob kws hmoov txhuv nplej, qhuav, magnesium stearate. Cov ntsiav tshuaj tau ntim rau hauv 10 daim. hauv cov hlwv ntim hauv pob ntawv thawv ntawm 3, 6 lossis 12 pcs.

Tsuas tshuaj thiab tswj hwm

Cov ntsiav tshuaj yog noj ntawm qhov ncauj. Qhov kev tswj hwm ntawm kev noj Glenrenorm thiab kev noj tshuaj ntau yog txiav txim siab ntawm lub hauv paus ntawm carbohydrate metabolism.

Feem ntau, thawj zaug koob tshuaj ntawm ib nrab yog ntsiav tshuaj, nws raug nquahu kom noj thaum noj tshais. Ntxiv mus, yog tias tsim nyog, cov koob tshuaj tau maj mam nce (raws li kws kho mob pom zoo).

Thaum muaj mob uas tus neeg mob tau noj 2 ntsiav tshuaj ib hnub, tuaj yeem siv ib zaug. Cov qib siab dua ntawm Glenrenorm yuav tsum tau muab faib ua ob lossis peb koob.

Cov lus thiab cov xwm txheej ntawm kev cia

Ua raws li cov lus qhia, Glurenorm yuav tsum muab cia rau hauv qhov chaw tsaus, qhuav thiab tawm ntawm qhov chaw ncav cuag ntawm cov menyuam, ntawm chav sov.

Los ntawm cov chaw muag tshuaj, cov tshuaj yog faib tawm los ntawm cov tshuaj. Lub txee lub neej ntawm cov ntsiav tshuaj, raug raws li cov lus pom zoo ntawm cov khw muag khoom, yog tsib xyoos. Glurenorm tsis tuaj yeem siv tom qab hnub tas sij hawm siv.

Pom qhov yuam kev hauv cov ntawv nyeem? Xaiv nws thiab nias Ctrl + Enter.

Pharmacological kev txiav txim

Glurenorm ua rau lub cev ua rau pancreatic thiab extrapancreatic, pab txhawb kev ua kom tsis muaj zog ntawm cov insulin endogenous (qhov tseem ceeb tshaj plaws ntawm kev hloov pauv ntawm carbohydrate metabolism) los ntawm pancreatic beta hlwb, thaum tseem txhim kho kev ua haujlwm ntawm insulin, cuam tshuam rau cov piam thaj los ntawm cov leeg thiab lub siab, thiab inhibits lipolysis hauv adipose nqaij. Qhov siab ntawm cov piam thaj hauv cov ntshav pib txo qis ib teev tom qab noj tshuaj, cov nyhuv siab tshaj plaws tau tiav tom qab 2-3 teev, lub sijhawm ntawm kev ua ntawm Glenrenorm raws li kev soj ntsuam yog 8-10 teev. Glurenorm yog nqus tag nrho los ntawm cov hnyuv hauv plab, metabolized hauv lub siab thiab tso tawm feem ntau los ntawm txoj hnyuv thiab tsuas yog 5% hauv cov zis xwb.

Glurenorm, yog sulfonylurea derivative, yog ib qho yeeb tshuaj luv luv, yog li ntawd nws raug pom zoo rau kev siv los ntawm cov neeg mob kev mob ntshav qab zib hom 2 uas muaj kev pheej hmoo siab ntawm hypoglycemia (muaj hnub nyoog laus lossis muaj lub raum tsis ua haujlwm). Tsis tas li, cov tshuaj yeeb yaj kiab tuaj yeem siv rau hauv cov neeg mob ntshav qab zib nephropathy thiab lub raum tsis ua haujlwm, vim tias glycidone raug tawm los ntawm lub raum hauv qhov tsawg tsawg.

Cov Yuav Tsis Txaus Glenrenorm

Raws li cov lus qhia txuas nrog rau Glurenorm, kev siv cov tshuaj yog contraindicated hauv:

• Kev mob siab rau daim siab,
• Yam 1 ntshav qab zib
• Mob ntshav qab zib tsis xeev thiab precomatous mob,
• Kas tom qab pancreatic resection,
• Kis tau cov kab mob
• Cev xeeb tub thiab lub sijhawm pub mis niam,
• Kev phais mob nrog kev kho mob insulin tsim nyog,
• Galactosemia, lactase deficiency,
• Hnub nyoog qis dua 18 xyoo,
• Hypersensitivity rau cov tshuaj.

Tsis tas li, nrog kev ceev faj, cov tshuaj yog kho rau cov neeg mob uas ua tsis taus cov thyroid, nrog febrile syndrome, thiab tseem cuam tshuam los ntawm kev quav cawv.

Cov tshuaj muaj pes tsawg leeg, nws cov lus piav qhia, ntim khoom, daim ntawv

Nyob rau hauv daim ntawv dab tsi ua Glurenorm npaj tsim? Cov lus qhia rau kev siv qhia tau tias cov khoom no muaj nyob hauv daim ntawv dawb thiab du ntsiav tshuaj ntawm ib puag ncig cov duab, nrog cov nqaj thiab beveled npoo, nrog rau cov ntawv kos "57C" thiab lub logo ntawm tuam txhab.

Cov tshuaj tivthaiv tseem ceeb ntawm cov tshuaj hauv cov lus nug yog glycidone. Nws kuj suav nrog cov hmoov txhuv nplej qhuav, lactose monohydrate, soluble pob kws hmoov txhuv nplej siab thiab magnesium stearate (ntxiv cov tebchaw ntxiv).

Cov tshuaj Glurenorm (ntsiav tshuaj) mus rau ntawm cov muag khoom ntawm 10 daim, uas tau ntim rau hauv pob ntawv ntawm cardboard.

Pharmacological kev txiav txim

Cov tshuaj Glurenorm yog dab tsi? Cov kev qhia rau kev siv qhia tias qhov no yog tus neeg sawv cev hypoglycemic, lub zog los ntawm sulfonylurea (tiam thib ob). Nws yog tsim rau cov thawj coj hauv qhov ncauj nkaus xwb.

Cov tshuaj nyob rau hauv nqe lus nug muaj cov teebmeem ntxiv thiab pancreatic. Nws stimulates tso pa tawm ntawm insulin thiab potentiates qabzib-mediated txoj kev ntawm nws tsim.

Kev sim ntawm cov tsiaj hauv chaw sim pom tau tias cov tshuaj "Glyurenorm", kev qhia ntawm cov uas muaj nyob hauv lub thawv ntawv cardboard, tuaj yeem txo cov tshuaj insulin tsis zoo rau hauv daim ntaub adipose thiab lub siab. Qhov no tshwm sim los ntawm kev tsim kho lub zog ntawm postreceptor mechanism, uas tau sib kho los ntawm insulin, nrog rau kev nce ntxiv hauv nws cov receptors.

Cov nyhuv rau lub ntsejmuag tomqab noj cov tshuaj tomqab 65-95 feeb. Raws li rau qhov siab tshaj plaws ntawm cov tshuaj, nws tshwm sim tom qab li 2-3 teev thiab kav txog 8-10 teev.

Kinetic khoom

Cov lus qhia rau kev siv "Glyurenorm" tau hais tias kev siv ib koob ntawm cov tshuaj no (15-30 mg) ua rau nws sai thiab ua tiav kev nqus los ntawm kev mob hauv plab (li 80-95%). Nws mus txog qhov siab ntawm nws qhov kev xav tom qab 2 teev.

Cov tshuaj uas nquag muaj ntawm cov tshuaj muaj qhov ua kom zoo rau cov ntshav protein.

Tsis muaj cov ntaub ntawv hais txog qhov tshwm sim dhau ntawm glycidon lossis nws cov keeb kwm dhau los ntawm cov placenta lossis BBB. Kuj tseem tsis muaj lus qhia txog kev nkag mus ntawm glycidone rau hauv niam mis.

Cov metabolism hauv cov tshuaj "Glyurenorm" nyob qhov twg? Cov lus qhia rau kev siv hais tias cov tshuaj hauv cov lus nug yog metabolized hauv daim siab los ntawm demethylation thiab hydroxylation.

Feem ntau ntawm glycidone derivatives yog dhau los ntawm txoj hnyuv. Ib nrab-lub neej ntawm cov tshuaj no yog 1-2 teev.

Hauv cov neeg laus thiab cov neeg laus ib nrab, cov cim kev sib deev ntawm Glyurenorm kuj zoo sib xws.

Raws li cov kws tshaj lij, cov metabolism hauv cov tshuaj no tsis hloov pauv hauv cov neeg mob uas lub siab tsis ua haujlwm. Nws tseem yuav tsum tau sau tseg tias hauv cov neeg mob uas lub raum tsis zoo, cov tshuaj tsis txuam nrog.

Nyob rau hauv cov xwm txheej dab tsi yog cov tshuaj "Glurenorm" zoo tshaj? Cov lus qhia rau kev siv, tshuaj xyuas pom tias qhov ntsuas rau nws siv yog hom 2 mob ntshav qab zib mellitus hauv cov neeg laus thiab cov neeg laus (nrog cov tsis muaj txiaj ntsig ntawm kev kho kev noj zaub mov).

Kev txwv tsis pub noj tshuaj

Hauv cov xwm txheej dab tsi nws yog contraindicated los sau tshuaj ntsiav Glurenorm? Cov lus qhia rau kev siv qhia cov contraindications hauv qab no rau cov tshuaj no:

• porphyria hloov ua mob hnyav,
• Yam 1 ntshav qab zib
• mob siab mob siab,
• mob ntshav qab zib acidosis, precoma, ketoacidosis thiab coma,
• lub sij hawm tom qab resection ntawm lub txiav,
• tsis tshua muaj cov kab mob xws li galactosemia, lactose intolerance, tsis muaj lactase thiab glucose-galactose malabsorption,
• mob hnyav ntawm tus neeg mob (piv txwv, kev phais mob hnyav, kab mob sib kis),
• cev xeeb tub lub sijhawm
• muaj hnub nyoog yau (vim yog cov ntaub ntawv tsis txaus ntawm kev nyab xeeb thiab kev siv tshuaj hauv pawg hnub nyoog no),
• lub sijhawm pub niam mis
• hypersensitivity rau sulfonamides.

Cov tshuaj "Glurenorm": cov lus qhia rau kev siv

Glurenorm ntsiav tshuaj tsuas yog kho sab hauv. Thaum noj lawv, koj yuav tsum ua raws txhua tus kws kho mob cov lus qhia txog kev noj tshuaj thiab zaub mov noj. Nws yog txwv tsis pub nres kev noj tshuaj yam tsis tau sab laj nrog cov kws tshaj lij.

Thawj koob tshuaj ntawm cov tshuaj hauv nqe lus nug yog 0.5 ntsiav tshuaj (i.e. 15 mg) thaum thawj noj tshais. Cov tshuaj yuav tsum tau noj thaum pib noj mov. Tom qab noj mov, hla zaub mov raug txwv.

Yog tias kev siv ntawm 1/2 ntsiav tshuaj tsis ua rau muaj kev txhim kho, tom qab tom qab sab laj nrog kws kho mob, qhov ntau npaum li cas yog maj mam nce. Nrog kev noj tshuaj "Glyurenorm" txhua hnub tsis pub ntau tshaj 2 ntsiav tshuaj, nws tuaj yeem noj ib zaug thaum noj tshais.

Yog tias tus kws kho mob tau sau ntawv muab tshuaj ntau dua, tom qab ntawd rau cov txiaj ntsig zoo lawv yuav tsum tau faib ua 2 lossis 3 koob tshuaj.

Kev nce ntxiv ntawm ntau dua 4 ntsiav tshuaj hauv ib hnub feem ntau tsis nce lawv cov hauj lwm zoo. Yog li, kev noj tshuaj "Glyurenorm" tshaj li tus nqi teev tseg tsis pom zoo.

Hauv cov neeg muaj teeb meem lub raum, kev hloov tshuaj ntau dua tsis tas yuav tsum ua.

Kev noj cov tshuaj ntau dua 75 mg rau hauv cov neeg mob uas lub siab tsis ua hauj lwm yuav tsum tau soj ntsuam tas li los ntawm kws kho mob.

Thaum tsis muaj kev kho mob txaus, ua ke nrog "Glurenorm" tus neeg mob yuav tau ntxiv "Metformin".

Ntau tus neeg mob

Kev noj cov tshuaj sulfonylurea ntau ntxiv ua rau tus mob ntshav qab zib tsawg. Tsis tas li ntawd, kev haus ib ce ntau dhau ntawm cov tshuaj no tuaj yeem ua rau cov tsos mob hauv qab no: tawm hws, tachycardia, chim siab, tshaib plab, mob taub hau, palpitations, tshee tshee, insomnia, ntxhov siab vim lub cev, tsis pom kev thiab tsis hais lus, tsis nco qab.

Thaum cov tsos mob ntawm hypoglycemia tshwm sim, koj yuav tsum noj ntshav qabzib lossis zaub mov nplua nuj hauv carbohydrates.

Sab sij huam

Tam sim no koj paub yog vim li cas ib cov tshuaj xws li Glurenorm tau sau tseg. Cov lus qhia rau kev siv cov tshuaj no kuj tau raug saib xyuas saum toj no.

Raws li cov neeg mob, thaum noj cov tshuaj no, koj yuav ntsib kev:

• thrombocytopenia, angina pectoris, agranulocytosis,
• paresthesia, hypoglycemia, kiv taub hau,
• mob leukopenia, mob taub hau, ntxiv ntawm cev, tsaug zog,
• kev cuam tshuam txog kev pab hauv kev ntxhov siab, kev nkees, hypotension,
• hlab plawv tsis ua haujlwm, qhov ncauj qhuav, Stevens-Johnson mob,
• tsis qab los noj mov, tshem tawm qhov tsis haum, xeev siab, tawm pob,
• urticaria, ntuav, mob hauv siab, cholestasis,
• quav tawv, khaus ntawm daim tawv nqaij, raws plab, tsis xis nyob hauv plab.

Kev sib cuam tshuam txog yeeb tshuaj

Nrog rau kev tswj hwm tib lub sijhawm ntawm glycidone nrog Allopurinol, ACE inhibitors, tshuaj tiv thaiv kev ua kom tsis taus, tshuaj loog, tshuaj pleev ib ce, tshuaj tua kab mob NSAIDs thiab lwm tus, cov nyhuv tshuaj tiv thaiv hypoglycemic dhau los yuav kho kom zoo.

Rifampicin, barbiturates, thiab Phenytoin txo qis cov ntshav tsis zoo ntawm Glyurenorm.

Cov lus pom zoo tshwj xeeb

Kev siv tshuaj hypoglycemic rau kev tswj hwm ntawm lub qhov ncauj yuav tsum tsis txhob hloov cov khoom noj kho mob.

Cov neeg mob ntshav qab zib yuav tsum ua raws nraim li txhua tus lus qhia ntawm kws kho mob.

Thaum cov tsos mob hypoglycemia tshwm sim, koj yuav tsum noj cov zaub mov uas muaj suab thaj tam sim ntawd.

Cov kev tawm dag zog lub cev tuaj yeem txhim kho cov nyhuv hypoglycemic ntawm cov tshuaj.

Vim qhov tseeb tias kev tsis pom tseeb ntawm glycidone los ntawm ob lub raum yog qhov tsis txaus ntseeg, cov tshuaj hauv nqe lus nug tuaj yeem ua rau muaj kev nyab xeeb rau cov neeg mob raum, thiab mob ntshav qab zib nephropathy.

Hauv qhov kev tshawb nrhiav tshuaj, nws tau pom tias kev siv yeeb tshuaj hauv nqe lus nug 30 lub hlis tsis pab txhawb kev nce hauv tus neeg mob lub cev. Ntxiv mus, muaj cov xwm txheej ntawm qhov hnyav poob los ntawm 1-2 kg.

Kev ntsuas thiab kev kuaj xyuas

Cov tshuaj hauv qab no xa mus rau Glurenorm analogues: Gliklada, Amiks, Glianov, Glayri, Glibetik.

Kev tshuaj xyuas txog cov tshuaj hauv nqe lus nug tuaj yeem pom sib txawv heev. Raws li cov neeg siv khoom qhia, cov tshuaj no muaj peev xwm ua tau zoo thiab muaj peev xwm nkag tau rau txhua tus. Txawm li cas los xij, nws yuav tsum raug sau tseg tias ntau tus neeg mob txhawj xeeb heev txog daim ntawv teev cov kev tsis zoo ntawm cov tshuaj no. Txawm hais tias cov kws kho mob hais tias lawv tsis tshua muaj thiab tsuas yog muaj qee qhov xwm txheej.