Cov tshuaj Glibenclamide rau cov ntshav qab zib - cov lus qhia rau kev siv

Hom 2 mob ntshav qab zib mellitus yog ib hom kev ua rau ntau tus mob, uas pom los ntawm kev ua txhaum ntawm cov metabolism hauv cov metabolism. Cov qauv tseem ceeb ntawm kev kho mob yog kev siv lub cev, kev kho zaub mov noj, kev siv tshuaj yaj yeeb. Ib qho ntawm cov tshuaj tau muab rau ntshav qab zib hom 2 yog glibenclamide.

Cov ntaub ntawv dav dav txog cov tshuaj

Glibenclamide yog cov tshuaj muaj suab thaj uas paub zoo uas tau siv hauv txawv teb chaws, tshwj xeeb hauv tebchaws Russia, txij thaum pib xyoo 70s. Nws yog tus sawv cev ntawm sulfonylurea derivatives (tiam 2). Cov tshuaj nquag siv kho mob ntshav qab zib hom 2.

Cov tshuaj tau nthuav tawm qhia cov txiaj ntsig ntxiv rau lub cev. Hauv 45 lub xyoos dhau los, txhim kho cov tshuaj tiv thaiv kab mob thiab tshuaj yeeb tshuaj nrog cov txheej txheem sib txawv ntawm kev txiav txim tau tshwm sim rau ntawm lub khw muag tshuaj. Tab sis Glibenclamide tseem tau sau tseg los ntawm kws kho mob thiab tsis plam nws qhov tseeb.

Tsis zoo li nws cov neeg ua ntej, cov tshuaj muaj kev tiv thaiv ntau dua thiab nquag. Nws tau raug xaj nyob rau hauv qhov tsis muaj ntawm cov nyhuv ntawm kev kho tsis siv tshuaj thiab kev tawm tsam rau lwm cov tshuaj.

Cov yam ntxwv pharmacological thiab muaj pes tsawg leeg

Cov nyhuv ntawm cov tshuaj yog hypocholesterolemic, hypoglycemic. Nws tsub kom yuav tsum muaj cov tshuaj insulin ntau ntxiv los ntawm tus txiav, nquag ua haujlwm ntawm beta hlwb ntawm islet apparatus. Cov tshuaj thaiv cov poov tshuaj calcium uas tso rau (ATP channels).

Cov kev txhawb ntawm secretory granules nrog cov tshuaj insulin tshwm sim thiab, vim li ntawd, cov khoom siv roj ntsha tau nkag mus rau cov ntshav thiab cov kua dej intercellular.

Ntxiv nrog rau cov nyhuv tseem ceeb, cov tshuaj muaj cov nyhuv thrombogenic thiab txo cov roj cholesterol. Muab cov kev tshem tawm sai thiab kev nqus ntawm txoj hnyuv. Kev khi rau cov ntshav plasma protein tshwm sim yuav luag tiav (98%). Cov tshuaj yaj yeeb nyob rau hauv lub siab. Qhov siab tshaj plaws hauv cov ntshav tau mus txog hauv 2 teev.

Cov khoom siv tau siv tau rau 12 teev. Ib nrab-lub neej tom qab kev tswj hwm ntawm qhov ncauj yog 7 teev, xaus rau hauv 2-3 hnub. Muaj feem ntau yog tshem tawm nrog cov kua tsib thiab tso zis. Nrog rau kev txo lub siab ua haujlwm ntawm lub siab, kev nthuav dav pom qis dua, thiab nrog lub raum tsis ua haujlwm, ntawm qhov tsis sib xws, nws nce.

Lub npe ntawm cov tshuaj nquag hauv Latin yog glibenclamide. Daim ntawv tso tawm: round ntsiav tshuaj ca. Txhua tus muaj 5 mg ntawm cov tshuaj nquag.

Kev taw qhia thiab contraindications

Qhov qhia rau kev siv: kev mob ntshav qab zib tsis yog-insulin, qhia tias tsis muaj tshwm sim cov ntshav qabzib los ntawm kev siv tshuaj tsis yog tshuaj.

Contraindications rau siv muaj:

intolerance mus rau active tshuaj,
lub siab ua tsis taus haujlwm,
metabolism nrog ib tug nyiam acidify lub cev,
precoma los yog ntshav qab zib coma,
cev xeeb tub
lub raum tsis ua hauj lwm zoo,
kev pub mis
ua tiav kev kho tsis ua tiav
mob ntshav qab zib insulin-hom mob ntshav qab zib (DM 1),
cov hnub nyoog qis dua 18 xyoo.

Cov lus qhia rau kev siv

Qhov kev hloov mus rau glibenclamide yog ua tiav ntseeg nkaws, cov tshuaj yog kho nrog 0.5 ntsiav tshuaj ib hnub. Cov neeg laus uas lub cev tsis ua haujlwm ntawm cov kabmob tau pom zoo kom nce cov tshuaj noj kom qeeb.

Qhov no muaj tseeb tshwj xeeb rau cov tib neeg hnyav txog 50 kg. Hauv ib hnub, qhov ntau npaum li cas yog 2.5-5 mg ntawm qhov tshuaj (nce txog 1 ntsiav tshuaj). Yog tias tsim nyog, nce qhov koob tshuaj kom tsawg. Cov txheej txheem txhua hnub yog nce mus txog 3 ntsiav tshuaj.

Cov tshuaj yog noj ua ntej noj mov. Ntawm koob tshuaj ntau dua 1 ntsiav tshuaj, nws raug pom zoo kom ua raws li qhov sib piv ntawm 2: 1 (thaum sawv ntxov: yav tsaus ntuj). Kev txais tos yog nqa tawm ntawm ib lub sijhawm yam tsis muaj kev tawg ntse. Thaum kho, lub xeev cov metabolism yog saib xyuas.

Nrog faj seeb, cov tshuaj yuav tsum tau siv raws li cov hauv qab no ntawm cov neeg mob:

laus lawm
cov neeg muaj lub siab tsis ua hauj lwm zoo,
cov neeg mob uas txo cov thyroid muaj nuj nqi,
nrog cov cim ntawm cerebral sclerosis.

Cawv thaum kho nyob rau hauv txoj kev tswj hwm tau cuam tshuam rau qhov tsis meej - txhim kho lossis txo cov nyhuv ntawm cov tshuaj. Dye E124 ua rau ua xua rau cov neeg mob yooj yim. Yog tias muaj mob (lossis cov uas twb muaj lawm) tshwm sim, nws yog qhov tsim nyog yuav tau qhia rau tus kws kho mob. Cov neeg mob yuav tsum tsis txhob cia li tsis noj tshuaj los yog kho qhov tshuaj kom tsis txhob sab laj nrog kws kho mob.

Phiv thiab haus tshaj

Ntawm cov kev phiv pom:

hnyav
ntuav, xeev siab, hnyav hauv lub plab zom mov, mob plab zom mov,
khaus tawv nqaij, tawm pob, ua xua,
lub siab ua tsis taus haujlwm,
nce hauv biochemical tsis,
pom kev pom
qog ntshav,
kev fab tshuaj tsis haum
thrombocytopenia, leukocytopenia, erythrocytopenia, granulocytopenia,
tsis muaj zog diuretic nyhuv.

Kev noj tshuaj ntau dhau (ntev me ntsis lossis ib-ncua sij hawm nce siab hauv koob tshuaj) feem ntau ua rau cov ntshav qog ntshav qab zib.

hws
pallor ntawm daim tawv nqaij
tsis hnov lus thiab rhiab,
kev nkees, ua daus no,
nrog lub xeev muaj txiaj ntsig - hypoglycemic coma.

Hauv cov xwm txheej hnyav, nws yog ib qhov tsim nyog yuav tsum tau yaug lub plab thiab txhaj ib qho kua nplaum ntawm qabzib. Yog tias tsim nyog, glucagon raug tswj hwm. Cov ntshav qab zib me me tuaj yeem raug tshem tawm ntawm nws tus kheej los ntawm kev noj cov piam thaj.

Kev cuam tshuam nrog lwm cov tshuaj thiab cov tshuaj analogues

Cov tshuaj uas ua rau muaj kev cuam tshuam ntau dua ntawm Glibenclamide suav nrog: Miconazole, tetracycline tshuaj tua kab mob, anabolic steroids, antidepressants, insulin thiab ntau yam tshuaj mob ntshav qab zib, txiv neej poj niam.

Cov tshuaj uas txo cov kev cuam tshuam muaj xws li: cov thyroid hormones, corticosteroids, nicotinates, glucagon, beta-andrenoblockers, cov poj niam txiv neej pw ua ke, diuretics, barbiturates.

Cov tshuaj tuaj yeem cuam tshuam rau glibenclamide (txhim kho lossis, hloov pauv, qis dua) suav nrog: Clonidine, Reserpine, H2 receptor blockers, pentamidine.

Cov tshuaj ntawm kev ua zoo sib xws:

tus analogue tsis yog Maninil (cov tshuaj ua haujlwm yog qhov zoo ib yam),
pab pawg ntawm cov tshuaj nrog glimepiride - Amapirid, Amaril, Glibetic, Glimax, Diapride,
npaj nrog Gliclazide - Glidia, Glicada, Gliclazide, Diagnizid, Panmicron-MV,
cov nyiaj nrog Glipizidom - Glynez, Minidiab.

Cov khoom siv vis dis aus los ntawm Dr. Malysheva txog cov khoom uas txo cov suab thaj hauv ntshav qab zib thiab tuaj yeem siv ua tshuaj ntxiv rau cov tshuaj:

Tus neeg mob lub tswv yim

Los ntawm kev tshuaj xyuas ntawm cov neeg mob noj Glibenclamide, peb tuaj yeem xaus tias tus nqi ntawm cov tshuaj yog pheej yig heev thiab nws txo qis qab zib zoo, tab sis tom qab nws siv, cov kev mob tshwm sim feem ntau tshwm sim rau hauv daim ntawv ntawm xeev siab thiab tsis qab los noj mov.

Kuv tau mob ntshav qab zib tau 12 xyoos. Cov tshuaj sib txawv tau raug txiav txim, tab sis Glibenclamide tau ua pov thawj rau qhov tsim nyog tshaj plaws. Thaum xub thawj lawv raug kho nrog Metformin - tsis muaj ib qho tshwj xeeb ntawm qhov ib txwm ua ntawm qab zib txawm tias tom qab nce qhov ntau npaum. Tom qab pom zoo Glibenclamide. Cov kev mob tshwm sim hauv daim ntawv uas yuav ua kom tsis qab los thiab xeev siab nyob hauv thawj lub hlis, tom qab ntawd txhua yam rov qab zoo li qub. Qib thaj thaum lub sijhawm siv cov tshuaj txo qis thiab khaws cia tsis pub dhau 6. Thaum nruab hnub Kuv xav zoo li qub, thiab nws thov tau.

Irina, 42 xyoo, Samara

Kuv niam nyuam qhuav nrhiav tau tus mob ntshav qab zib hom 2 no. Tus kws kho mob tuaj koom tam sim ntawd tau muab tshuaj Glibenclamide thiab muab tshuaj rau nws. Kwv yees li ib lub lim tiam tom qab nws siv, Kuv tau pib mob siab thiab tsis qab los noj mov. Tab sis, zoo li nws tau hais, qhov no tsis tseem ceeb piv rau qhov tseeb tias cov piam thaj nyob hauv 6-7. Thaum kho, ntxiv rau cov piam thaj, nws yog ib qho tsim nyog yuav tau soj ntsuam daim siab. Tab sis niam, nrog rau Glibenklemin, hnov zoo.

Sergey, 34 xyoo, Yekaterinburg

Kuv tus mob ntshav qab zib muaj hnub nyoog 6 xyoo. Lawm, kua nplaum tsis tuaj yeem hloov kho. Kuv yuav tsum xaiv ib cov tshuaj. Kuv xav tias cov nyhuv tsuas yog los ntawm Glibenklemin - piam thaj txo mus rau 6.5. (Kuv ib txwm siv lub 'meter'). Ua ntej ntawd, Kuv tsis tuaj yeem ua tiav qhov ntsuas ntawd ntev ntev, hauv qab 7 piam thaj tsis poob. Thaum kawg kuv khaws kuv cov tshuaj. Thaum xub thawj kuv tau nce phaus me ntsis, tab sis tom qab ntawd kuv kho kuv kev noj haus. Ntawm cov kev mob tshwm sim: tsis tseg, qee zaus - raws plab thiab tsis qab los noj mov.

Oksana, 51 xyoo, Nizhny Novgorod

Tus nqi ntawm cov tshuaj xub yog li ntawm 90 txog 120 rubles. Cov tshuaj yuav muab faib tawm los ntawm cov kws kho mob sau.

Glibenclamide yog cov tshuaj zoo rau kev txo qis ntshav qabzib. Nws nquag ua haujlwm los ntawm cov kws kho mob thiab tsis plam nws qhov tseeb, txawm tias muaj cov tshuaj ntawm cov qauv tshiab.

Tso tawm daim ntawv, muaj pes tsawg leeg thiab ntim khoom

Glibenclamide muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj ntawm cov xim dawb, me ntsis daj lossis xim grey, ib lub tiaj tus cylindrical duab nrog lub txav rov qab hauv qhov nruab nrab.

Cov ntsiav tshuaj muaj nyob hauv cov hlwv nrog cov hlwb (10 pcs.), Uas yog nyob hauv cov thawv ntawv thawv. Cov qauv ntawm 20, 30, 50 ntsiav tshuaj tuaj yeem ntim rau hauv cov kaus poom yas lossis cov iav dub.

1 ntsiav tshuaj muaj 5 mg ntawm glibenclamide - cov tshuaj nquag. Raws li cov khoom xyaw ntxiv, mis qab zib (lactose monohydrate), povidone, qos hmoov txhuv nplej siab, magnesium thiab calcium stearate muaj.

Me ntsis soluble hauv dej thiab cawv.

Kev tshuaj xyuas cov kev lag luam kws tshuaj tau qhia tias tus nqi tshuaj ntau nyob ntawm cov chaw tsim khoom thiab thaj chaw muag. Yog li, hauv Moscow, thaj av thiab St. Petersburg, cov khoom lag luam hauv tsev tau nthuav tawm nyob rau hauv thaj tsam ntawm 30-70 rubles, txawv teb (Is Nrias teb) - los ntawm 90 rubles.

Hauv cov cheeb tsam, qhov nqi tshuaj yog siab dua. Yog li, Lavxias-ua Glibenclamide muag los ntawm 96 rubles, thiab txawv teb - 130-140 rubles.

Pharmacological kev txiav txim

Qhov ncauj qhov ncauj ntawm lub cim thib ob ntawm sulfonylurea. Nws muaj hypoglycemic (normalizes ntshav qabzib) thiab hypocholesterolemic (txo qis roj) kev ua.

Zoo li lwm yam kev kho mob ntshav qab zib, Glibenclamide ua rau lub siab ntsws ua kom lub hlwb tsis txaus siab uas tsim cov tshuaj insulin. Tsis zoo li cov tshuaj thawj zaug, nws yog tus cwj pwm los ntawm kev ua haujlwm siab (qhov tshwm sim tau nrawm dua nrog ib koob tshuaj tsawg dua), yog qhov ua tau zoo.

Normalizes rhiab ntawm pancreatic beta hlwb rau kev hloov pauv ntawm cov piam thaj hauv cov ntshav. Nws nce cov kab mob hauv insulin hauv plasma thiab txo qis qis ntawm cov theem tom kawg hauv cov ntshav. Cov txheej txheem normalization yog nqa tawm ntseeg nkaws, yam tsis ua rau cov kev mob hypoglycemic. Nce qhov ntim ntawm zom cov piam thaj hauv cov leeg thiab nplooj siab, cuam tshuam rau kev tsim cov glycogen (ib hom carbohydrate) hauv lawv. Nws txo qhov kev kub siab ntawm lipids, tswj kev lipolysis hauv daim ntaub adipose, muaj cov nyhuv antidiuretic, txo txoj kev pheej hmoo ntawm cov ntshav txhaws.

Nrog lub cev tiv thaiv rau lwm cov tshuaj ntawm pab pawg no, glibenclamide feem ntau ua tau zoo dua. Lub siab tshaj plaws ntawm txoj kev kho mob nthuav dav tom qab 1-2 teev, ncav qhov siab tshaj plaws tom qab 7-8 teev, thiab kav ntev li 8-12 teev.

Cov Tshuaj Pharmacokinetics

Cov tshuaj nquag yuav luag nqus los ntawm txoj hnyuv plab. Yuav luag 100% ua txhua yam rau cov protein plasma. Qhov kev tshem tawm ib nrab-lub neej ua rau 4-11 teev. Hauv lub siab, nws tawg rau hauv ob qhov tshuaj lom neeg: ib qho yog tawm hauv cov zis, thib ob - nrog cov kua tsib los ntawm cov hnyuv.

Cov tshuaj tsis zoo dhau qhov kev tsis sib haum xeeb.

cov neeg mob uas muaj hom ntshav qab zib hom 2 hauv qhov tsis muaj txiaj ntsig kev noj zaub mov zoo,
nrog lub cev tsis kam mus rau lwm cov tshuaj ntawm pawg no,
cov neeg mob siv txog li 30 units ntawm insulin ib hnub,
txuam nrog cov tshuaj insulin.

Cov Yuav Tsum Muaj

ntshav qab zib hom 1
muaj lub cev tsis haum rau lub tshuaj,
ketoacidosis
precomatous thiab coma,
lub raum thiab lub siab ua haujlwm,
leukopenia
pares paresis,
malabsorption nyob rau hauv cov hnyuv,
hnyuv ob tog,
kev pab cuam phais mob
kis kab mob
cev xeeb tub thiab lactation.

Tsuas tshuaj thiab cov ntawv thov

Glibenclamide yuav tsum noj 3 zaug hauv ib hnub 20-30 feeb ua ntej noj mov, haus dej kom ntau.

Thaum pib, qhov muab tshuaj rau txhua hnub yog 2.5 mg rau ib hnub. Thaum tsis muaj qhov tshwm sim tsis zoo thiab kom ua tiav cov txiaj ntsig kho qhov xav tau, qhov ntau dua yog maj mam nce 2 zaug nyob rau ib hlis.

Kev kho cov txij nkawm yuav 5-10 mg ib hnub, tab sis tsis ntau tshaj 15 mg.

Tseem Ceeb! Rau cov neeg mob laus, cov tshuaj ib hnub yog 1 mcg.

Cov lus qhia tshwj xeeb

Cov tshuaj yuav tsum tau noj nyob rau tib lub sijhawm.

Thaum kho, yuav tsum saib xyuas cov piam thaj kom tas mus li. Hauv kev npaj rau kev khiav haujlwm thiab thawj zaug tom qab lawv, nrog rau lub sijhawm cev xeeb tub, nws yog qhov yuav tsum tso tseg Glibenclamide thiab hloov mus rau insulin. Nws yuav tsum tau yug hauv siab tias kev tswj kom tsis txhob muaj menyuam yaus thiab glucocorticosteroids txo qis kev ua haujlwm ntawm cov tshuaj, thiab beta-blockers nce.

Nrog rau kev siv cov tshuaj tsis tu ncua, nws yog ib qho tseem ceeb kom ua raws li kev noj haus thiab hnub. Koj yuav tsum tso tseg dej cawv.

Nrog kev ceev faj, cov tshuaj yog tawm rau cov neeg mob uas muaj lub siab thiab lub raum ua haujlwm.

Piv nrog analogues

Cov tshuaj muaj cov nyhuv zoo sib xws, muaj:

Glyclazide txawv ntawm Glibenclamide nrog tib yam tshuaj muaj yees. Nws yog siv rau hom tshuaj insulin-mob ntshav qab zib. Nws muaj tsawg dua qhov kev sib piv piv rau nws cov neeg sawv cev. Tso cai los ntawm 18 xyoo.

Diabeton yog ib yam tshuaj uas nquag ua haujlwm, ib yam li hauv cov tshuaj dhau los, - gliclazide. Nws yuav luag tsis muaj analogue.

Diadeon. Cov tshuaj nquag siv kuj yog gliclazide. Pab txo cov ntshav qabzib, thiab tseem txo kev pheej hmoo ntawm cov ntshav txhaws hauv cov hlab ntsha me.

Vaj Pov. Nws txawv ntawm cov tshuaj nquag piav qhia saum toj no, uas yog hu ua "glycidone". Nws kuj tseem tau kho tus mob ntshav qab zib hom II.

Glibenclamide, tsis zoo li analogues, ntxiv txo cov cholesterol thiab tiv thaiv kom tsis txhob mob thrombosis.

Kev tshuaj xyuas ntawm kev txheeb xyuas pom tau tias cov tshuaj muaj txiaj ntsig zoo heev, nws yog tus cwj pwm los ntawm kev mob tshwm sim me ntsis. Maj mam muab qis dua cov qib qab zib.

Hauv kev xyuas, cov neeg mob tsuas yog sib tham txog kev noj tshuaj thiab kev cuam tshuam nrog lwm cov tshuaj nyob rau hauv kev kho ua ke.

Cov kws tshaj lij pom zoo hais tias txhua kis yog tshwj xeeb thiab ib leeg, yog li nws tsis muaj peev xwm thiab tsis raug cai los sau tshuaj kho mob hauv kev qhaj ntawv.

Qhov kev xaiv ntawm txoj kev kho zoo thiab kho kom zoo yuav tsum qee lub sijhawm los ua kev tshawb fawb hauv chav kuaj, kom paub meej qhov kev ua haujlwm ntawm tus kabmob. Tsuas yog tom qab qhov no peb tuaj yeem nres ntawm ib lossis lwm qhov kev kho mob ntxiv.