Amaryl ntsiav tshuaj - cov lus qhia, tshuaj xyuas ntawm tus tswv tsev, nqi

Amaryl yog tshuaj hypoglycemic uas pab tswj ntshav qab zib hauv ntshav. Cov tshuaj nquag ua haujlwm ntawm cov tshuaj yog glimepiride. Zoo li nws ua ntej, Glibenclamide, Amaril kuj yog los ntawm pawg sulfonylurea, uas ua kom cov synthesis ntawm insulin los ntawm b hlwb ntawm lub pancreatic islets ntawm Langerhans.

Yuav kom ua tiav qhov txiaj ntsig uas tau npaj tseg, lawv thaiv ATP potassium channel nrog muaj lub siab tawv. Thaum sulfonylurea khi rau cov receptors nyob ntawm b-cell daim nyias nyias, cov haujlwm ntawm K-AT qib hloov. Kev thaiv ntawm cov calcium calcium uas muaj qhov nce ntxiv ntawm ATP / ADP piv rau hauv cytoplasm provokes depolarization ntawm daim nyias nyias. Qhov no pab tso cov calcium calcium txoj hauv kev thiab ua rau kom muaj cov calcium cytosolic ntxiv.

Qhov tshwm sim ntawm kev txhawb nqa ntawm exocytosis ntawm secretory granules, uas yog cov txheej txheem ntawm excretion ntawm cov sib txuas rau hauv nruab nrab nruab nrab los ntawm cov hlwb, yuav yog qhov kev tso tawm ntawm cov tshuaj insulin rau hauv cov ntshav.

Glimepiride yog tus sawv cev ntawm tiam 3 ntawm sulfonylureas. Nws stimulates tso tawm ntawm pancreatic hormone sai, txhim kho insulin rhiab heev ntawm protein thiab lipid hlwb.

Peripheral cov ntaub so ntswg metabolize cov piam thaj siv ntau dua los ntawm cov khoom siv thauj khoom thauj los ntawm cov kab mob cell. Nrog rau hom ntshav qab zib insulin-ywj siab, kev hloov pauv ntawm cov piam thaj rau hauv cov ntaub so ntswg yog qeeb. Glimepiride txhawb nqa kev nce hauv qhov ntim ntawm cov thauj cov protein thiab txhim kho lawv cov haujlwm. Xws li lub cev ua tau zoo ua rau lub cev pab txo qis cov insulin tsis kam (lub cev tsis raug) rau lub cev lawm.

Amaryl inhibits cov synthesis ntawm glucogen los ntawm lub siab vim qhov nce hauv ntim ntawm fructose-2,6-bisphosphate nrog antiaggregant (inhibition ntawm thrombus tsim), antiatherogenic (txo qis hauv qhov ntsuas ntawm "tsis zoo" cov cholesterol) thiab antioxidant (rov ua dua tshiab, tiv thaiv kev laus) cov peev xwm. Cov txheej txheem oxidation tau qeeb qeeb vim qhov nce ntawm cov ntsiab lus ntawm endogenous b-tocopherol thiab cov haujlwm ntawm cov antioxidant enzymes.

Pharmacokinetics ntawm cov tshuaj

Nyob rau hauv cov muaj pes tsawg leeg ntawm Amaril, lub ntsiab nquag tivthaiv yog glimepiride los ntawm sulfonylurea pab pawg. Povidone, lactose monohydrate, magnesium stearate, microcrystalline cellulose thiab dyes E172, E132 yog siv los ua cov tshuaj ntxaws.

Amaryl ua lub siab ua rau cov leeg mob 100%, yog li txawm tias siv sijhawm ntev ntawm cov tshuaj tsis cuam tshuam qhov kev txuam nrog ntawm nws tshaj hauv cov nruab nrog cev thiab cov nqaij. Raws li qhov tshwm sim los ntawm kev ua tiav, ob qho txuas ntxiv ntawm glipemiride yog tsim: hydroxymetabolite thiab carboxymethabolite. Thawj cov tshuaj metabolite yog muaj nrog lub zog pharmacological uas muab cov nyhuv hypoglycemic ruaj khov.

Hauv cov ntshav, cov ntsiab lus siab tshaj plaws ntawm cov nquag nquag tau pom tom qab ob thiab ib nrab teev. Possessing tsis txaus ntseeg tiag tiag, cov tshuaj tsis txwv tus mob ntshav qab zib hauv kev xaiv cov khoom noj cov khoom noj uas nws "seizes" cov tshuaj. Kev tshem tawm yuav yog nyob rau hauv txhua kis 100%.

Kev txhim kho tseem ceeb hauv glycemic indices yog pom txawm tias muaj teeb meem ua haujlwm nrog lub siab, tshwj xeeb, hauv kev laus (ntau dua 65 xyoo) thiab nrog daim siab tsis ua hauj lwm, qhov tseem ceeb ntawm cov nquag muaj feem.

Yuav siv Amaryl li cas

Ib qho tshuaj yog tsim nyob rau hauv daim ntawv ntawm oval ntsiav tshuaj nrog sib faib sawb, uas tso cai rau koj kom yooj yim cais qhov koob tshuaj nyob rau hauv halves. Cov xim ntawm cov ntsiav tshuaj nyob ntawm qhov tsuas tshuaj: 1 mg ntawm glimepiride - plhaub liab, 2 mg - greenish, 3 mg - daj.

Qhov kev tsim no tsis raug xaiv los ntawm lub caij nyoog: yog tias cov ntsiav tshuaj tuaj yeem pom qhov txawv txav ntawm cov xim, qhov no txo ​​txoj kev pheej hmoo ntawm kev noj ntau dhau, tshwj xeeb tshaj yog nyob rau cov neeg laus.

Cov ntsiav tshuaj tau ntim rau hauv cov hlwv ntawm 15 pcs. Txhua lub npov tuaj yeem muaj los ntawm 2 txog 6 li cov paib.

Cov yam ntxwv ntawm kev siv Amaril:

1. Cov ntsiav tshuaj (lossis ib feem ntawm qhov ntawd) nqos tag nrho, ntxuav nrog dej tsawg tsawg 150 ml. Tam sim ntawd tom qab noj tshuaj, koj yuav tsum noj.
2. Tus kws endocrinologist xaiv tus txheej txheem tshuaj kho raws li kev soj ntsuam cov kua nruab nrog cev.
3. Pib chav kawm nrog tsawg kawg ntawm Amaril. Yog tias ib feem ntawm 1 mg tom qab lub sijhawm tshwj xeeb tsis qhia qhov tshwm sim tau npaj tseg, tus nqi nce.
4. Cov koob tshuaj tau hloov kho me ntsis, nyob rau hauv 1-2 lub lis piam, kom lub cev muaj sij hawm hloov mus rau cov kev mob tshiab. Txhua hnub, koj tuaj yeem nce tus nqi kom tsis ntau tshaj 1 mg. Qhov ntau kawg ntawm cov tshuaj yog 6 mg / hnub. Tus kws kho mob txwv ib qho zuj zus yog tus kws kho mob tau teeb tsa.
5. Nws yog ib qho tsim nyog yuav tau kho cov kev cai nrog kev hloov pauv qhov hnyav ntawm lub cev ntshav qab zib lossis lub ntim ntawm cov leeg mob, nrog rau thaum muaj kev pheej hmoo ntawm hypoglycemia (thaum lub sij hawm tshaib plab, noj zaub mov tsis zoo, kev haus cawv, lub raum thiab mob siab).
6. Lub sijhawm ntawm kev siv thiab ntau npaum li cas yuav nyob ntawm lub suab ntawm lub neej thiab cov yam ntxwv ntawm cov metabolism. Feem ntau, kev tswj hwm ib leeg ntawm Amaril yog tshuaj rau ib hnub nrog kev sib xyaw ua ke nrog zaub mov. Yog tias noj tshais puv, koj tuaj yeem haus ib qho tshuaj ntsiav thaum sawv ntxov, yog tias muaj lub cim qhia - nws zoo dua los ua ke nrog kev txais tos nrog pluas su.
7. Kev siv tshuaj ntau dhau ua teeb meem nrog lub qog ntshav qab zib, thaum cov piam thaj hauv cov qog tso ntshav tawm mus rau 3.5 mol / L lossis qis dua. Tus mob no tuaj yeem txuas mus ntev heev: txij li 12 teev txog 3 hnub.

Amaryl ntsiav tshuaj (hauv ib pob ntawm 30 daim) muaj muag ntawm tus nqi ntawm:

• 260 rub - 1 mg,
• 500 rub - 2 mg txhua
• 770 rub - 3 mg txhua
• 1020 RUB. - 4 mg txhua.

Koj tuaj yeem nrhiav pob ntawm 60, 90,120 pieces ntawm ntsiav tshuaj.

Lwm yam tshuaj siv tau

Cov neeg mob ntshav qab zib, tshwj xeeb "nrog kev paub", raws li txoj cai, muaj tag nrho cov teeb meem pheej cuam tshuam: kub siab, mob plawv thiab ntshav, teeb meem metabolic, raum thiab lub siab pathologies. Nrog rau cov khoom siv no, koj yuav tsum tsis txhob siv cov tshuaj muaj suab thaj qis dua.

Rau kev tiv thaiv kev tsis txaus siab ntawm cov hlab ntsha thiab lub siab, cov tshuaj uas muaj aspirin yog tshuaj. Amaryl hloov chaw nws tawm hauv cov qauv protein, tab sis nws qib hauv cov ntshav tseem tsis tau hloov pauv. Cov txiaj ntsig ntawm kev siv ntau ntxiv tuaj yeem txhim kho.

Enhanced ua si AMARE nws ntxiv rau insulin, Allopurinu, coumarin derivatives, anabolic steroids, guanethidine, chloramphenicol, fluoxetine, fenfluramine, pentoxifylline, Feniramidolu, fibric acid derivatives, phenylbutazone, miconazole, azapropazone, probenecid, quinolones, oxyphenbutazone, salicylates, tetracycline, sulfinpyrazone, Tritocqualin thiab sulfonamides.

Amaril txo lub peev xwm ntxiv Epinephrine, glucocorticosteroids Diazoxide, laxatives, Glucagon, barbiturates, Acetazolamide, saluretics, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, thiab progestin, thiab ntsev.

Amaryl ntxiv rau histamine H2 receptor blockers, reserpine thiab clonidine muab qhov kev npaj txhij txog nrog rau dauv hauv glucometer hauv ib qho kev taw qhia. Cov txiaj ntsig zoo sib xws ua kom muaj cawv thiab Amaril ntau ntxiv.

Cov tshuaj tsis cuam tshuam rau cov kev ua ntawm ACE inhibitors (Ramipril) thiab cov tshuaj tiv thaiv anticoagulant (Warfarin) hauv txhua txoj kev.

Hypoglycemic Sib Piv

Yog tias ib qho tshuaj hypoglycemic yuav tsum tau hloov nrog Amaril, qhov kev siv tshuaj tsawg kawg nkaus (1 mg) tau sau tseg, txawm tias muaj xwm txheej tus neeg mob tau txais cov tshuaj dhau los hauv qhov ntau tshaj plaws. Ua ntej tshaj, qhov tshuaj tiv thaiv ntawm tus kab mob ntshav qab zib tau soj ntsuam ob lub lis piam, thiab tom qab ntawd ces cov tshuaj kho tau kho.

Yog tias tus neeg sawv cev tiv thaiv kab mob siab nrog lub siab ib nrab-lub neej tau siv ua ntej Amaril nyob rau hauv kev txiav txim kom tsis txhob muaj kev txhim kho ntawm lub qog ntshav qab zib, yuav tsum tau ncua sijhawm ob peb hnub tom qab tshem tawm.

Yog tias cov ntshav qab zib tau tswj hwm tswj kev muaj peev xwm ntawm cov txiav ua tiav nws cov tshuaj hormones, tom qab ntawd cov tshuaj insulin tuaj yeem 100% hloov Amaryl. Chav kawm tseem pib nrog 1 mg / hnub.

Thaum tsoos cov piam thaj tso ib txwm Metformin tsis tso cai tswj ntshav qab zib kom puv, koj tuaj yeem noj tshuaj Amaril 1 mg ntxiv. Yog tias cov txiaj ntsig tsis txaus siab, cov txiaj ntsig maj mam hloov mus rau 6 mg / hnub.

Yog tias Amaril + Metformin cov txheej txheem tsis tau ua raws li qhov kev cia siab, nws raug hloov pauv nrog Insulin, thaum tswj kev ua raws li Amaril. Cov tshuaj insulin kuj tseem pib nrog kev txhaj tshuaj tsawg kawg nkaus. Yog tias cov ntsuas ntawm glucometer tsis tau txhawb nqa, ua kom cov Insulin ntau ntxiv. Kev sib txig nrog kev siv tshuaj yog tseem tau zoo, vim nws tso cai rau koj txo qis kev noj tshuaj hormone los ntawm 40% piv nrog kev kho tshuaj ntshiab tshuaj.

Ntxiv rau Amaril, tus kws kho mob endocrinologist tseem muaj kev xaiv rau cov analogues: Amaperid, Glemaz, Diapyrid, Diameprid, Glimepiride, Diagliside, Reclid, Amix, Glibamide, Gllepid, Glayri, Panmicron, Glibenclamide, Gligenclad, Glliblik Dimari, Dimari, Dimari, Dimari, Dimari, Dimari Glimaril, Glyclazide, Manil, Maninil, Glimed, Glioral, Olior, Glynez, Glirid, Gluktam, Glypomar, Glyurenorm, Diabeton, Diabresid.

Rau leej twg nws yog npaj, thiab rau cov tshuaj tsis pom zoo

Cov tshuaj tau txhim kho kev kho mob ntshav qab zib hom 2. Nws yog siv ob qho tib si nrog monotherapy thiab hauv txoj kev kho mob hauv kev sib txuam nrog Metformin lossis Insulin.

Cov tshuaj tivthaiv ntawm Amaril kov yeej cov nyom ntawm cov placenta, thiab cov tshuaj kuj dhau mus rau hauv niam mis. Vim li no, nws tsis haum rau leej niam cev xeeb tub thiab lactating. Yog tias tus poj niam xav ua niam, txawm tias ua ntej xeeb menyuam, nws yuav tsum pauv mus rau cov tshuaj insulin uas tsis muaj Amaril. Rau lub sijhawm pub mis, cov sijhawm tau teem sijhawm li no tau tshwj tseg, yog tias txawm li cas los xij yuav tsum muaj kev kho mob nrog Amaril, kev pub mis niam tau tso tseg.

Kev siv cov tshuaj nyob rau hauv ntshav qab zib coma thiab lub zwj ceeb ua ntej lub tsis nco qab yog tsis tsim nyog. Hauv kev mob hnyav rau ntshav qab zib (xws li ketoacidosis), Amaryl tsis ntxiv. Cov tshuaj tseem tsis haum rau cov neeg mob ntshav qab zib nrog thawj hom mob.

Nrog kev ua haujlwm tsis zoo ntawm lub raum thiab mob siab, Amaryl tsis muaj txiaj ntsig, Amaril tsis qhia rau hemodialysis thiab ntshav qab zib, ntxiv rau rau ib tus neeg tsis kam lees rau glipemiride lossis lwm yam tshuaj ntawm sulfonamide thiab sulfonylurea chav kawm.

Nrog lub plab hnyuv paresis lossis mob plab hnyuv, kev nqus ntawm cov tshuaj yog cuam tshuam, yog li Amaril tsis tau hais txog kom tsis zoo rau cov teeb meem no. Lawv xav tau kev hloov pauv rau cov tshuaj insulin thiab cov kev raug mob ntau, ua haujlwm phais, mob kub, thiab kub hnyiab.

Amaril tej zaum yuav nrog los ntawm kev dhau mus hypoglycemic. Qee zaum cov neeg mob yws ntawm kiv taub hau, qee qhov ua rau tsis zoo ntawm kev pw tsaug zog, muaj kev ntxhov siab, tawm hws ntau dhau, thiab hais lus tsis meej. Nrog rau ntshav qab zib, muaj ntau zaus ntawm kev tsis tuaj yeem tswj hwm kev tshaib plab, mob plab tsis haum, tsis xis nyob hauv lub siab. Ua tau malfunction ntawm lub plawv atherosclerosis, tawm pob rau ntawm daim tawv nqaij. Qee lub sij hawm cov ntshav ntws tawm ntau.

Qhov teeb meem ntawm kev overdose

Lub sijhawm ntev ntawm kev siv tshuaj, nrog rau kev haus ib qho loj heev, tuaj yeem ua rau mob ntshav qab zib, cov tsos mob uas tau hais hauv seem yav dhau los.

Tus mob ntshav qab zib yuav tsum muaj daim ntawv qhia nrog qhov qhia qhov luv luv ntawm nws qhov mob thiab ib yam dab tsi los ntawm cov khoom noj ceev uas yog carbohydrates (khaub noom, khaub noom). Cov kua txiv qab zib lossis tshuaj yej kuj tsim nyog, tsuas yog tsis muaj cov khoom ua kua qab zib xwb. Thaum muaj mob hnyav, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob kom sai vim tias mob plab thiab ua haujlwm rau lub zog (nqus cov pa roj carbon, thiab lwm yam).

Sab sij huam

Qee qhov tsis tshua muaj, kev siv Amaril yog nrog kev mob tshwm sim los ntawm cov qauv ntawm qhov tsis pom kev ib nrab, muaj teeb meem nrog cov ntshav ncig, cov roj ntsha tsis ua haujlwm, lub plab zom mov.

Ntawm cov feem ntau muaj:

1. Glycemic syndrome, tus cwj pwm los ntawm kev tawg tsis zoo, cuam tshuam ntawm kev saib xyuas, tsis pom kev, tsis pom kev, tsis tuaj yeem tswj hwm kev tshaib plab, tawm hws.
2. Qhov sib txawv hauv cov ntsuas qhov qab zib, ua rau pom kev pom.
3. Kev tso zis tsis tuaj yeem, ua txhaum ntawm lub suab ntawm kev tso quav, ploj thaum tso cov tshuaj.
4. Ua xua ntawm kev ua txhaum sib txawv (ua pob ua pob ua pob, khaus khaus, ua xua, ua xua vasculitis, anaphylactic ceeb, tsis muaj ntshav siab thiab ua tsis taus pa).

Noj Amaril cuam tshuam loj heev rau kev ceev ntawm lub hlwb kev xav - tsav tsheb, nrog rau kev ua haujlwm xav tau kev saib xyuas, tshwj xeeb tshaj yog nyob rau theem pib ntawm kev kho, tsis sib haum nrog Amaril txoj kev kho.

Amaryl cov nqi hauv cov khw muag tshuaj hauv Moscow

Cov kws kho mob rov tshuaj txog amaryl

Cov tshuaj qub, vim tias muaj ob qhov kev ua haujlwm ntawm kev ua, tso cai rau koj kom zoo tswj theem ntawm cov piam thaj hauv cov ntshav. Qhov zoo tshaj plaws ntawm kev zais cia.

Tus nqi pheej yig rau pawg tshuaj no. Kev pheej hmoo siab ntawm kev mob ntshav siab. Xav tau ntau npaum li cas xaiv.

Qhov ua tau zoo tshaj plaws tau ua tiav nrog kev siv cov metformin.

Kev Ntsuam Xyuas Rau Neeg Mob rau Amaryl

Kuv yog tus mob ntshav qab zib uas tau ua dhau los, hom ntshav qab zib hom 2, tau noj Amaril ntau xyoo ntawm 3 mg rau ib hnub. Yog li, Kuv tsis tshua ua raws kev noj haus, Kuv tseem tuaj yeem them taus qee yam qab zib, piv txwv li, ib rab diav ntawm zib ntab lossis ib feem ntawm cov dej khov ib ob zaug ntawm ib lub lim tiam. Qee zaum kuv hloov qab zib nrog saccharin lossis stevia, Kuv tsis nyiam lawv cov saj, yog li kuv kawm haus txhua yam tsis muaj qab zib. Tawm tsam keeb kwm yav dhau los ntawm kev noj "Amaril" ntshav qab zib yog yuav luag tsis pub dhau ib txwm muaj txwv, Kuv tswj kuv tus kheej nrog glucometer. Kuv tsis xav tias muaj kev phiv tsis zoo tshwj xeeb. Yog tias cov piam thaj tsis zoo rau ib lub sijhawm ntev, Kuv so noj Amaril, tom qab ntawd, ntawm chav kawm, Kuv mus noj zaub mov thiab haus ib yam zaub uas txo cov qab zib, piv txwv li, blueberries.

Kuv niam muaj tus mob ntshav qab zib hom 2, nws tau siv lwm yam tshuaj, tab sis tsis ntev los no nws tsis pab, tus kws kho mob hais kom sim Amaryl, yog tias nws tsis pab, nws yuav tsum txhaj tshuaj insulin. Kuv nkag siab los ntawm tus kws kho mob piav qhia tias muaj 2 yam tshuaj nquag ua nyob rau hauv qhov kev npaj no. 1 - tswj kev tsim tawm ntawm cov tshuaj insulin, 2 lub cev - ua rau lub cev ua kom muaj suab thaj rau glycogen kom muaj kev nyab xeeb rau cov neeg mob ntshav qab zib. Cov tshuaj yuav pab cov niam kom qab zib kom nyob rau theem ntawm yuav luag ib xyoos, siv Amaryl. Tsis tas li, cov tshuaj no tau qhia rau cov neeg mob ntshav qab zib, zoo li kuv niam. Peb cia siab tias cov tshuaj yuav pab ntxiv.

Ob xyoos dhau los, Niam thiaj paub tias mob ntshav qab zib mellitus, thiab yuav luag tam sim ntawd nws tau xaj Amaryl 2 mg. Cov tshuaj yeej pab, maj mam txo cov ntshav hauv cov ntshav hauv cov ntshav. Cov tshuaj los ntawm kev nkag mus rau kev lees paub zoo txhawb nqa cov qib ntawm cov piam thaj hauv cov ntshav. Ntau zaug nws tau yog tias, vim tias muaj ntau ntawm cov tshuaj rau kev mob ntshav siab, nws yog qhov tsim nyog yuav tau nce cov tshuaj, ntawm 2 txog 3 lossis 4 mg. Tab sis tom qab ntawd yooj yim niam rov qab rau nws 2 mg. Cov tshuaj tsis quav yeeb, rau ob xyoos, tsis yog ib sab phiv los ntawm Amaril tau ntsib los ntawm niam.

Kuv tus kheej yeej tsis tau ntsib qhov no, tab sis kuv tus pog uas tas sim neej muaj ntshav qab zib. Tag nrho nws lub neej (Kuv paub, raws li kuv nco qab) nws tau nkaug nws tus kheej hauv caj npab, tom qab ntawd hauv txhais ceg insulin. Cia li nyob tawm ntawm nws. Nws tau hloov pauv cov ntsiav tshuaj uas yuav tsum tau noj tib lub sijhawm uas nws tau txhaj. Qhov tseeb, nws tsis zoo li tias nrog cov kab mob zoo li nws tuaj yeem cia siab kom rov zoo, nws yog qhov kev saib xyuas ntawm lub xeev tam sim no. Yog li ntawd hais tias tsis muaj qhov tsis taus. Amaryl raug tsa ua haujlwm rau nws. Ordinary, zoo li pinkish ntev ntsiav tshuaj, thiab ntau qhov ntshai heev tshwm sim. Thaum xub thawj, tsis muaj leej twg pom qhov hloov pauv, tab sis tom qab ... Nws tau ntsib tus neeg tsaug zog txaus ntshai, nws mob hawb pob tau loj zuj zus. Thiab kuv tsis paub, tej zaum los ntawm cov tshuaj los yog mob ntshav qab zib mellitus nws tus kheej tau ua rau nws tus kheej xav, tab sis nws qhov muag pom meej zuj zus. Kuv tsis xav tias qhov tshuaj no phem heev, nws tsis zoo rau txhua tus.Tus kws kho mob yuav tsum tau coj mus rau hauv tus account txhua qhov kev tiv thaiv, tab sis qhov no yog cov tshuaj Lavxias ...

Cov lus qhia luv luv

Cov tshuaj amaryl (INN - glimepiride) yog ib qho tshuaj tiv thaiv kev tsis haum rau kev siv qhov ncauj los ntawm German ceg ntawm lub koom haum tshuaj thoob ntiaj teb Sanofi Aventis. Amaryl ua rau lub hlwb β-hlwb ntawm tus mob ua kom lub cev ua kom tsis txhob ua haujlwm ntxiv los tsim cov insulin ntau dua, uas txo qis cov piam thaj hauv cov ntshav: cov tshuaj txo qis ntawm qhov tsis zoo ntawm β-hlwb rau qhov kev ua ntawm cov piam thaj rau lawv. Raws li lub koom haum Institute of Statistics hauv kev kho mob hauv ntiaj teb, kwv yees li 20 plhom tus neeg mob ntshav qab zib noj sulfonylurea derivatives - tshuaj uas yog tus qauv hauv kev kho mob ntshav qab zib hom 2 thaum nws tsis tuaj yeem them nyiaj rau tus kab mob los ntawm kev kho kev noj zaub mov kom zoo nrog kev ua si lub cev. Cov khoom siv ntawm sulfonylureas tau muab faib ua cov tshuaj ntawm 1 thiab 2 tiam. Amaril yog ib tus neeg sawv cev ntawm "nthwv dej tshiab" ntawm cov kab mob hypoglycemic. Yog tias peb piv rau amaryl nrog lwm tus neeg sawv cev ntawm tiam 2 ntawm sulfonylurea derivatives nrog glibenclamide (maninil), cov tshuaj insulin uas tso tawm hauv cawv ntawm thawj zaug yog tsawg dua, nrog qhov txo qis hauv qabzib concentration vim yog siv ob qho tshuaj. Qhov no qhia tau tias amaryl muaj qee qhov zoo, tshwj xeeb, nws lub peev xwm rhiab cov ntaub so ntswg tiv thaiv cov insulin thiab muaj cov insulinomimetic kev ua haujlwm. Hauv lwm lo lus, amaryl muaj qhov kev ua tau zoo piv rau glibenclamide thaum siv tshuaj tsawg dua, tsis ua rau cov ntshav tsis haum, thiab tseem muaj cov txiaj ntsig zoo ntawm cov rog metabolism.

Amaryl muaj nyob rau hauv cov ntsiav tshuaj tsuas tshuaj noj. Qhov zaus ntawm nws cov sij hawm teem - 1 zaug hauv ib hnub - nws yooj yim, tshwj xeeb tshaj yog rau cov neeg laus. Vim hais tias kev hloov pauv hauv kev ua hauj lwm hauv cov concentration ntawm cov piam thaj hauv cov ntshav tau txuas rau kev noj zaub mov carbohydrate, lub hauv paus tseem ceeb rau kev noj sulfonylurea derivatives yog nws cuam tshuam nrog kev noj zaub mov noj. Txhawm rau nce cov hauj lwm zoo ntawm amaryl thiab kev mob siab rau cov neeg mob

cov tshuaj tau qhia rau siv ib hnub ib zaug ua ntej noj mov tseem ceeb. Thaum pib theem ntawm kev siv amaryl, cov tshuaj tau tshwm sim hauv ib koob tshuaj 1 mg. Yog tias qhov kev cia siab ua tiav tsis tiav, qhov koob tshuaj tau nce ntxiv mus rau 2, 3, 4, 6 thiab, thaum kawg, 8 mg txog thaum muaj kev them nyiaj meej meej ntawm hyperglycemia. Raws li kev xyaum qhia, qhov zoo tshaj koob tshuaj rau feem coob ntawm cov neeg mob nyob ntawm thaj tsam li 1 txog 6 mg. Lwm qhov kev txhawb nqa los ntawm kev tshawb fawb soj ntsuam yog qhov tsis txheeb ze ntawm kev phiv tsis zoo thaum sib xyaw nrog amaryl nrog calcium antagonists, ACE inhibitors, tsis siv tshuaj tiv thaiv tsis haum tshuaj, sulfonamides. Ib txoj kab cais yuav tsum tau hais txog cov nyhuv tshuaj tiv thaiv atherogenic ntawm amaryl: cov tshuaj normalizes lipid profile, txo cov theem ntawm cov roj (cholesterol) thiab cov lipoproteins tsawg tsawg.

Kws Tshuaj

Ib qho tshuaj hypoglycemic qhov ncauj yog ib qho kev sib txuas ntawm peb tiam sulfonylurea.

Glimepiride txo qis kev ua haujlwm ntawm cov piam thaj hauv cov ntshav, feem ntau vim yog kev tsa ntawm kev tso tawm ntawm insulin los ntawm from-hlwb ntawm cov txiav. Nws cov nyhuv yog feem ntau cuam tshuam nrog kev txhim kho nyob rau hauv lub peev xwm ntawm pancreatic cells-hlwb los teb rau lub cev kev xav nrog lub ntsej muag. Piv nrog rau glibenclamide, qis dua ntawm glimepiride tso tawm cov tshuaj insulin tsawg dua thaum muaj kwv yees li ntawm cov ntshav qab zib tsawg dua. Qhov tseeb no ua tim khawv nyob rau hauv kev pom zoo muaj cov kab mob ntxiv los tiv thaiv hypoglycemic nyob rau hauv glimepiride (nce cov ntaub so ntswg rhiab rau insulin thiab insulinomimetic effect).

Cov tshuaj insulin zais cia. Zoo li txhua lwm yam sulfonylurea derivatives, glimepiride tswj hwm cov kua dej los ntawm kev sib koom tes nrog ATP-nkag siab potassium txuas ntawm β-cell daim nyias nyias. Tsis zoo li lwm yam sulfonylurea derivatives, glimepiride xaiv khi rau cov protein nrog cov roj molecular ntawm 65 kilodaltons uas nyob hauv lub qog ntawm β-hlwb ntawm tus txiav. Qhov no sib cuam tshuam ntawm glimepiride nrog cov protein sib khi ua kom nws tswj qhov qhib lossis kaw ntawm ATP-nkag mus poov tshuaj raws.

Glimepiride kaw cov kab xo potassium. Qhov no ua rau depolarization ntawm β-hlwb thiab ua rau qhib ntawm voltage-rhiab calcium channel thiab qhov khiav ntawm calcium nyob rau hauv lub cell. Raws li qhov tshwm sim, ib qho kev nce ntxiv hauv cov tshuaj calcium uas muaj siab tshaj yuav ua rau cov insulin secretion los ntawm exocytosis.

Glimepiride ua nrawm dua thiab vim li no thiaj li muaj kev sib cuag thiab raug tso tawm los ntawm daim ntawv cog lus nrog cov protein khi rau nws tshaj li glibenclamide. Nws tau kwv yees tias cov cuab yeej no ntawm kev hloov pauv siab ntawm glimepiride nrog cov protein khi rau nws txiav txim siab nws cov lus tshaj tawm ntawm kev txiav txim siab ntawm ose-hlwb rau cov kua nplaum thiab lawv cov kev tiv thaiv tiv thaiv desensitization thiab ntxov ntxov.

Cov nyhuv ntawm nce zuj zus cov ntaub so ntswg mus rau insulin. Glimepiride ua rau kev cuam tshuam zoo ntawm insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg peripheral.

Cov tshuaj Insulinomimetic. Glimepiride muaj cov teebmeem zoo ib yam li cov tshuaj insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg thiab kev tso tawm cov piam thaj los ntawm lub siab.

Peripheral cov ntaub so ntswg qabzib yog nqus tau los ntawm kev thauj nws mus rau hauv cov leeg nqaij thiab adipocytes. Glimepiride ncaj qha nce tus naj npawb ntawm cov lwg me nyuam thauj cov piam thaj hauv plasma cov leeg ntawm cov leeg nqaij thiab adipocytes. Kev nce ntxiv ntawm kev noj cov ntshav qabzib ua rau kev ua haujlwm ntawm glycosylphosphatidylinositol-phospholipase C. Yog li ntawd, cov tshuaj calcium calcium uas tsis txaus siab poob qis, ua rau muaj kev cuam tshuam ntawm cov dej num ntawm protein kinase A, uas ua rau lub ntsej muag ua rau lub zog ntawm cov metabolism glucose.

Glimepiride inhibits kev tso tawm ntawm qabzib los ntawm lub siab los ntawm kev nce lub siab ntawm fructose-2,6-bisphosphate, uas inhibits gluconeogenesis.

Ntxim rau platelet aggregation. Glimepiride txo cov platelet sib sau ua ke hauv vitro thiab hauv vivo. Cov nyhuv no zoo li cuam tshuam nrog kev xaiv inhibition ntawm COX, uas yog lub luag haujlwm rau kev tsim ntawm thromboxane A, ib qho tseem ceeb endogenous platelet aggregation factor.

Antiatherogenic siv. Glimepiride pab txhawb rau kev kho lipid cov ntsiab lus, ua rau txo qis ntawm malonic aldehyde hauv cov ntshav, uas ua rau txo qis tseem ceeb ntawm lipid peroxidation. Hauv cov tsiaj txhu, glimepiride ua rau muaj qhov txo qis hauv kev tsim ntawm atherosclerotic plaques.

Txo cov leeg mob oxidative kev nyuab siab, uas ib txwm muaj rau cov neeg mob ntshav qab zib hom 2. Glimepiride nce rau theem ntawm endogenous to-tocopherol, qhov kev ua ntawm catalase, glutathione peroxidase thiab superoxide dismutase.

Kev mob plawv. Los ntawm ATP-nkag siab poov tshuaj channel, sulfonylurea derivatives kuj cuam tshuam rau cov hlab plawv cov ntshav. Muab piv rau cov tshuaj sulfonylurea derivatives, glimepiride muaj cov txiaj ntsig zoo dua rau cov kev mob plawv, uas yuav piav qhia los ntawm qhov xwm txheej tshwj xeeb ntawm nws cov kev cuam tshuam nrog cov protein txuas ntawm ATP-rhiab poov tshuaj raws.

Hauv cov neeg ua haujlwm noj qab haus huv, cov tshuaj txhaj tsawg kawg ntawm glimepiride yog 0.6 mg. Cov nyhuv ntawm glimepiride yog koob tshuaj thiab rov ua dua tshiab. Lub cev muaj zog teb rau kev ua lub cev (txo qis insulin qis) nrog glimepiride yog tswj.

Tsis muaj qhov sib txawv ntawm cov nyhuv, nyob ntawm seb cov tshuaj tau siv 30 feeb ua ntej noj mov lossis tam sim ntawd ua ntej noj mov. Hauv cov neeg mob ntshav qab zib, kev tswj kev zom zaub mov txaus tuaj yeem ua tiav nyob hauv 24 teev nrog tib lub tshuaj. Ntxiv mus, hauv kev soj ntsuam mob, 12 ntawm 16 cov neeg mob raum tsis ua haujlwm (CC 4-79 ml / min) kuj tau ua tiav kev tswj cov metabolic txaus.

Kev sib xyaw ua ke nrog metformin. Hauv cov neeg mob uas lub cev tsis txaus tswj kev tiv thaiv thaum siv ntau tshaj plaws ntawm glimepiride, kev sib txuas ua ke nrog glimepiride thiab metformin tuaj yeem pib ua. Hauv ob txoj kev tshawb nrhiav, thaum ua cov kev kho mob sib xyaw ua ke, nws tau ua pov thawj tias kev tswj cov metabolism yog qhov zoo dua li ntawm txoj kev kho txhua yam ntawm cov tshuaj cais tawm.

Kev sib xyaw ua ke nrog cov tshuaj insulin. Hauv cov neeg mob uas lub cev tsis txaus tswj kev noj zaub mov zoo thaum noj glimepiride ntawm kev noj tshuaj ntau tshaj plaws, kev kho mob insulin ib txhij tuaj yeem pib. Raws li cov txiaj ntsig ntawm ob txoj kev tshawb nrhiav, thaum siv txoj kev sib xyaw no, tib txoj kev txhim kho hauv kev tswj cov zom zaub mov yog ua tiav thaum siv tsuas yog ib qho insulin. Txawm li cas los xij, kev sib xyaw ua ke yuav tsum tau siv tshuaj insulin tsawg dua.

Daim ntawv tso tawm

Cov ntsiav tshuaj yog xim paj yeeb, oblong, tiaj tus, nrog cov kab sib cais ntawm ob sab, sau nrog "NMK" thiab cov "h" rau ob sab.

Cov zam: lactose monohydrate - 68.975 mg, sodium carboxymethyl hmoov txhuv nplej siab (hom A) - 4 mg, povidone 25 000 - 0.5 mg, microcrystalline cellulose - 10 mg, magnesium stearate - 0.5 mg, hlau oxide liab zas xim (E172) - 0.025 mg.

15 Pcs. - hlwv (2) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (4) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (6) - pob khoom los ntawm cardboard.
15 Pcs. - hlwv (8) - pob khoom los ntawm cardboard.

Raws li txoj cai, koob tshuaj ntawm Amaril ® yog txiav txim los ntawm lub hom phiaj concentration ntawm cov piam thaj hauv cov ntshav. Cov tshuaj yuav tsum tau siv nyob rau hauv qhov tsawg kawg nkaus kom txaus kom ua tiav qhov kev tswj hwm kev hnyav tsim nyog.

Thaum kho nrog Amaril ®, nws yog ib qho tsim nyog yuav tsum tau soj ntsuam tas li theem ntawm cov piam thaj hauv cov ntshav. Tsis tas li ntawd, kev soj ntsuam tas li ntawm glycosylated hemoglobin qib raug pom zoo.

Kev ua txhaum ntawm cov tshuaj, piv txwv li, hla cov koob tshuaj tom ntej, yuav tsum tsis txhob ua los ntawm cov thawj coj hauv tshuaj hauv qhov siab dua.

Tus kws kho mob yuav tsum qhia tus neeg mob ua ntej txog cov kev coj ua thaum muaj qhov yuam kev hauv kev noj Amaril ® (tshwj xeeb, thaum hla cov koob tshuaj tom ntej lossis dhia noj mov), lossis hauv cov xwm txheej uas tsis tuaj yeem siv tshuaj.

Amaril-ntsiav tshuaj yuav tsum noj kom tag nrho yam tsis muaj kev zom, haus dej kom ntau (li 1/2 khob). Yog tias tsim nyog, ntsiav tshuaj ntawm Amaril ® tuaj yeem muab faib raws cov kev pheej hmoo ua ob seem sib luag.

Thawj koob tshuaj Amaril ® yog 1 mg 1 zaug / hnub. Yog tias tsim nyog, koob tshuaj txhua hnub tuaj yeem hloov zuj zus (ntu sijhawm li ntawm 1-2 lub lis piam) raws li kev saib xyuas ntshav qabzib tas li thiab raws li cov cai hauv qab no: 1 mg-2 mg-3 mg-4 mg-6 mg (-8 mg) ib hnub Cov.

Hauv cov neeg mob uas muaj hom mob ntshav qab zib hom 2, tshuaj txhua hnub feem ntau yog 1-4 mg. Kev noj tshuaj txhua hnub ntau dua 6 mg yuav zoo dua hauv qee tus neeg tsawg xwb.

Tus kws kho mob txiav txim siab txog lub sijhawm noj Amaril ® thiab faib cov koob tshuaj nruab hnub, noj mus rau hauv tus neeg mob txoj kev ua neej (lub sijhawm noj mov, tus naj npawb ntawm cov dej num). Cov koob tshuaj txhua hnub tau sau tseg hauv 1 koob tshuaj, feem ntau tam sim ntawd ua ntej noj tshais tag nrho lossis, yog tias qhov tshuaj txhua hnub tsis tau noj, tam sim ntawd ua ntej noj mov thawj. Nws yog ib qho tseem ceeb kom tsis txhob pluas noj tom qab noj Amaril-ntsiav tshuaj.

Vim hais tias kev txhim kho kev zom zaub mov yog txuam nrog kev nkag siab ntau ntxiv rau cov tshuaj insulin; thaum kho, kev xav tau glimepiride yuav raug txo. Txhawm rau kom tsis txhob muaj kev txhim kho hypoglycemia, nws yog ib qho tsim nyog yuav tsum txo kom tsis txhob noj lub sijhawm lossis tsis noj tshuaj Amaril ®.

Cov mob uas yuav tau txhaj tshuaj kho qhov mob glimepiride:

• poob phaus
• kev pauv hloov hauv lub neej (hloov kev noj zaub mov, kev noj zaub mov, ntau yam kev tawm dag zog),
• kev tshwm sim ntawm lwm yam uas ua rau kom muaj kev cuam tshuam ua ntej rau kev kho ntshav nrog lossis hyperglycemia.

Glimepiride kho mob feem ntau yog ua rau lub sijhawm ntev.

Hloov pauv ntawm tus neeg mob los ntawm kev noj lwm qhov ncauj tshuaj hypoglycemic rau kev noj tshuaj Amaril ®

Tsis muaj kev sib txheeb ze ntawm cov koob tshuaj ntawm Amaril ® thiab lwm qhov tshuaj hypoglycemic hauv qhov ncauj. Thaum hloov pauv los ntawm cov tshuaj no rau Amaryl ®, qhov kev xav pom zoo thawj hnub ntawm qhov kawg yog 1 mg (txawm tias tus neeg mob hloov mus rau Amaryl ® nrog qhov siab tshaj plaws ntawm lwm qhov tshuaj hypoglycemic). Qhov koob tshuaj nce ntxiv yuav tsum tau nqa tawm hauv theem, suav txog qhov lus teb rau glimepiride raws li cov lus pom zoo saum toj no. Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv qhov kev siv thiab lub sijhawm ntawm cov nyhuv ntawm yav dhau los hypoglycemic tus neeg sawv cev. Kev cuam tshuam los ntawm kev kho mob tej zaum yuav tsum kom tsis txhob muaj cov txiaj ntsig ntxiv uas ua rau muaj kev pheej hmoo ntawm ntshav qab zib.

Siv ua ke nrog metformin

Hauv cov neeg mob uas tsis muaj peev xwm tswj tau tus mob ntshav qab zib mellitus, thaum noj cov tshuaj glimepiride lossis metformin ntau tshaj plaws hauv txhua hnub, kev kho mob nrog kev sib xyaw ntawm ob hom tshuaj no tuaj yeem pib ua. Hauv qhov no, kev kho yav dhau los nrog rau glimepiride lossis metformin txuas ntxiv ntawm tib lub koob tshuaj, thiab cov koob tshuaj ntxiv ntawm metformin lossis glimepiride pib nrog kev txhaj tshuaj qis, uas yog tom qab ntawv suav nyob ntawm qib hom phiaj ntawm kev tswj metabolic, txog qhov siab tshaj plaws txhua hnub. Txoj kev kho ua ke yuav tsum tau pib los ntawm kev saib xyuas mob nkeeg nruj me ntsis.

Siv ua ke nrog cov tshuaj insulin

Hauv cov neeg mob uas tsis muaj peev xwm tswj tau tus mob ntshav qab zib mellitus, cov tshuaj insulin yuav muab rau tib lub sijhawm thaum noj glimepiride qhov siab tshaj plaws txhua hnub. Hauv qhov no, koob tshuaj kawg ntawm glimepiride qhia rau tus neeg mob tseem tsis hloov pauv. Hauv qhov no, kev kho tshuaj insulin pib nrog kev siv tshuaj tsawg, uas maj mam nce ntxiv ntawm kev tswj hwm qhov kev tswj hwm ntawm cov piam thaj hauv cov ntshav. Txoj kev kho tag nrho yog ua tiav los ntawm kev saib xyuas zoo.

Cov neeg mob ua rau lub raum tsis zoo ua haujlwm yuav ua rau nkag siab qhov teebmeem hypoglycemic ntawm glimepiride. Cov ntaub ntawv hais txog kev siv Amaril ® hauv cov neeg mob raum tsis ua haujlwm yog txwv.

Cov ntaub ntawv hais txog kev siv Amaril ® hauv cov neeg mob siab tsis ua hauj lwm yog muaj tsawg.

Noj ntau dhau

Cov tsos mob: nrog rau noj ntau dhau, nrog rau kev kho mob ntev ntev nrog glimepiride nyob rau hauv ntau dhau heev lawm, ua rau lub neej muaj ntshav siab ntau hypoglycemia yuav tshwm sim.

Kev Kho Mob: Kev mob ntshav qab zib yuav luag txhua lub sijhawm yuav tsum nres sai los ntawm kev noj zaubmov sai (cov piam thaj lossis ib qho qab zib, kua txiv txiv qab zib lossis tshuaj yej). Hauv kev hais txog qhov no, tus neeg mob yuav tsum nco ntsoov nqa tsawg kawg 20 g suab thaj (4 daim ntawm qab zib). Cov khoom qab zib yog qhov tsis muaj txiaj ntsig hauv kev kho mob ntawm hypoglycemia.

Txog thaum tus kws kho mob txiav txim siab tias tus neeg mob tsis muaj kev phom sij, tus neeg mob yuav tsum tau ua tib zoo saib xyuas mob. Nws yuav tsum tau yug los hauv lub siab tias hypoglycemia tuaj yeem rov ua haujlwm tom qab kev pib kho mob ntawm cov concentration ntawm cov piam thaj hauv cov ntshav.

Yog tias ib tug neeg mob uas mob ntshav qab zib tau txais kev kho mob los ntawm cov kws kho mob sib txawv (piv txwv li, thaum nyob hauv tsev kho mob tom qab muaj xwm txheej, nrog rau mob thaum hnub so), nws yuav tsum qhia lawv txog nws tus mob thiab txog kev kho mob dhau los.

Qee lub sij hawm yuav tsum tau pw hauv tsev kho mob ntawm tus neeg mob, txawm tias tsuas yog kev ceev faj ua ntej.Tseem ceeb tshaj plaws yog noj ntau dhau thiab muaj kev tsis haum nrog cov kev ua kom pom kev xws li tsis nco qab lossis lwm tus mob loj ntawm cov mob paj hlwb yog qhov mob sai sai thiab xav tau kev kho mob sai sai thiab mus pw hauv tsev kho mob.

Yog tias tsis nco qab, nws yog qhov yuav tsum tau siv iv kev qhia ntawm cov tshuaj sib tov ntawm dextrose (kua nplaum) (rau cov laus, pib nrog 40 ml ntawm 20% kev daws). Raws li lwm txoj hauv kev rau cov neeg laus, nws muaj peev xwm los tswj hwm iv, sc lossis IM glucagon, piv txwv li ntawm koob tshuaj 0.5-1 mg.

Hauv kev kho mob ntawm hypoglycemia vim los ntawm kev tswj hwm ntawm Amaril accident los ntawm cov menyuam mos lossis menyuam yaus, qhov dextrose yuav tsum ua tib zoo kho kom tsis txhob muaj kev phom sij hyperglycemia, kev qhia txog dextrose yuav tsum tau ua raws kev soj ntsuam tas li ntawm cov ntshav qabzib.

Yog tias muaj kev noj tshuaj ntau dhau ntawm Amaril ®, lub plab zom mov thiab kev nqus cov pa hluav taws muaj qhov xav tau.

Tom qab kev kho kom sai ntawm kev saib xyuas ntawm cov piam thaj hauv cov ntshav, txoj hlab ntshav ntawm dextrose tov ntawm qhov qis qis yog qhov tsim nyog los tiv thaiv kev rov ua haujlwm ntawm hypoglycemia. Cov ntsiab lus ntawm cov piam thaj hauv cov ntshav hauv cov neeg mob ntawd yuav tsum tau soj ntsuam tas li 24 teev. Thaum mob hnyav nrog lub sijhawm ntev ntawm lub qog ntshav qab zib, txoj kev phom sij ntawm cov ntshav qabzib tsawg yuav nyob ntev mus li ob peb hnub

Sai li qhov pom sai dhau hwv lawm, nws maj nrawm qhia rau tus kws kho mob txog qhov no.

Kev sib txuam

Glimepiride yog metabolized nrog kev koom tes ntawm CYP2C9 isoenzyme, uas yuav tsum tau coj mus rau hauv tus account thaum siv cov tshuaj nrog cov inducers (piv txwv li rifampicin) lossis tshuaj tiv thaiv kab mob (xws li fluconazole) CYP2C9.

Lub zog ua haujlwm ntawm hypoglycemic kev ua haujlwm thiab, nyob rau qee kis, kev loj hlob tau ntawm hypoglycemia cuam tshuam nrog qhov no tuaj yeem pom thaum Amaril ® sib xyaw nrog ib qho ntawm cov tshuaj hauv qab no: insulin, lwm yam kab mob hypoglycemic rau kev tswj hwm ntawm qhov ncauj, ACE inhibitors, anabolic steroids thiab txiv neej poj niam txiv neej, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, pheniramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, fluconazole, PASK, pentoxifylline (koob tshuaj ntau ntau) , phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, clarithromycin, sulfanilamides, tetracyclines, tritokvalin, trophosphamide.

Kev txo qis hauv hypoglycemic kev txiav txim siab thiab cuam tshuam ntxiv ntawm cov ntshav qabzib hauv siab yog ua tau thaum ua ke nrog ib qho ntawm cov tshuaj hauv qab no: acetazolamide, barbiturates, glucocorticosteroids, diazoxide, diuretics, sympathomimetic tshuaj (suav nrog epinephrine), glucagon, laxatives (nrog rau siv ntev ), nicotinic acid (hauv qib siab), estrogens thiab progestogens, phenothiazines, phenytoin, rifampicin, iodine-muaj cov thyroid hormones.

Cov tshuaj tiv thaiv histamine H₂receptors, beta-blockers, clonidine thiab reserpine muaj peev xwm ob leeg los txhim kho thiab txo cov nyhuv hypoglycemic ntawm glimepiride.

Hauv qab ntawm cov neeg mob sympatholytic, xws li beta-blockers, clonidine, guanethidine thiab reserpine, cov cim ntawm adrenergic counterregulation nyob rau hauv teb rau hypoglycemia tej zaum yuav raug txo lossis ploj.

Tawm tsam keeb kwm yav dhau los ntawm kev noj glimepiride, kev sib zog los yog ua kom qaug zog ntawm kev nqis tes ua ntawm coumarin derivatives yog ua tau.

Kev haus cawv ib leeg lossis mob ntev tuaj yeem ua rau ob leeg txhim kho thiab tsis muaj zog ntawm cov nyhuv hypoglycemic ntawm glimepiride.

Sequestrants ntawm cov kua tsib cov kua qaub: lub log phau ntawv khi rau glimepiride thiab txo qhov nqus ntawm glimepiride los ntawm kev mob plab. Kev siv ntawm glimepiride, tsawg kawg 4 teev ua ntej yuav haus cov cadelovel, tsis muaj kev cuam tshuam tau pom. Yog li no, glimepiride yuav tsum tau noj tsawg kawg 4 teev ua ntej coj log log.

Sab sij huam

Los ntawm ib sab ntawm cov metabolism: hypoglycemia yog ua tau, uas, xws li nrog kev siv lwm yam sulfonylurea derivatives, tuaj yeem siv sijhawm ntev. Cov tsos mob ntawm tus mob ntshav qab zib - mob taub hau, tshaib plab, xeev siab, ntuav, nkees, tsaug zog, pw tsaug zog, ntxhov siab vim, txhoj puab heev, tsis hnov ​​qab, ceeb toom thiab khiav ceev, ntxhov siab, tsis meej pem, hais lus tsis meej, tsis meej pem, pom kev tsis sib haum, tshee hnyo, paresis , hnov ​​lub siab tsis sib xws, kiv taub hau, plam ntawm qhov yus tus kheej, ua kom lom zem, mob plab hlaub, qaug zog lossis tsis nco qab los txog thaum lub siab tsis nco qab, ua pa nyuaj, bradycardia. Tsis tas li ntawd, tej zaum yuav muaj qhov pom ntawm adrenergic counterregulation nyob rau hauv kev teb rau cov ntshav qog, xws li cov tsos ntawm khaub thuas, nplaum tawm hws, ntxhov siab vim, tachycardia, hlab ntsha tawg, angina pectoris, palpitations, thiab lub plawv atherosclerosis kev ntxhov siab. Cov lus qhia soj ntsuam ntawm tus mob ntshav qab zib siab heev yuav zoo li tus mob stroke. Cov tsos mob ntawm cov ntshav qog ntshav yuav luag ploj tom qab nws tshem tawm.

Los ntawm ob sab ntawm cov khoom hauv nruab nrog ntawm lub zeem muag: thaj chaw muaj kev cuam tshuam pom vim muaj qhov hloov pauv hauv cov concentration ntawm cov piam thaj hauv cov ntshav tau muaj (tshwj xeeb thaum pib kho). Lawv qhov ua rau yog ib ntus hloov ntawm qhov lo ntsiab muag o, nyob ntawm kev mloog ntawm cov piam thaj hauv cov ntshav, thiab vim qhov no, qhov hloov pauv ntawm qhov lo ntsiab muag ntawm lub lo ntsiab muag.

Los ntawm cov txheej txheem hauv plab: tsis tshua muaj - xeev siab, ntuav, hnov ​​qhov hnyav lossis ntws tawm hauv epigastrium, mob plab, mob raws plab, qee qhov - kab mob siab, nce kev ua haujlwm ntawm daim siab enzymes thiab / lossis cholestasis thiab daj ntseg, uas tuaj yeem ua rau lub siab ua rau lub siab ua rau lub siab poob, tab sis yuav yauv mus hla kev txhim kho thaum siv cov tshuaj txiav tawm.

Los ntawm cov kab mob hemopoietic: tsis tshua muaj - thrombocytopenia, qee qhov - leukopenia, hemolytic anemia, erythrocytopenia, granulocytopenia, agranulocytosis thiab pancytopenia. Hauv kev tshaj tawm txog kev siv tshuaj, cov teeb meem loj ntawm thrombocytopenia nrog platelet suav ® tau tshaj tawm tias muaj kev cuam tshuam hauv kev xeeb tub. Kev xeeb menyuam hauv plab lossis thaum pib cev xeeb tub, tus pojniam yuav tsum pauv mus rau kev kho mob insulin.

Nws tau raug tsim muaj tias glimepiride ua tawm hauv cov kua mis. Thaum lub sijhawm pub mis, koj yuav tsum pauv tus poj niam mus rau insulin lossis tsum tsis pub mis niam.

Cov lus qhia tshwj xeeb

Hauv cov chaw muaj kev ntxhov siab tshwj xeeb, xws li kev mob nyhav, kev phais mob, kev kis mob nrog kub taub hau febrile, kev tswj cov teeb meem hauv lub cev yuav ua rau cov neeg mob ntshav qab zib mellitus poob qis, yog li, kev kho ib ntus ntawm cov tshuaj insulin kuj yuav tsum tau tswj kev tswj cov metabolic txaus.

Hauv thawj lub lis piam ntawm kev kho mob, qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia yog ua tau, uas yuav tsum tau saib xyuas tshwj xeeb ntawm cov concentration ntawm cov piam thaj hauv cov ntshav.

Qhov tseem ceeb uas yuav ua rau muaj kev pheej hmoo ntawm lub qog ntshav qab zib muaj xws li:

• kev tsis txaus siab lossis tsis muaj peev xwm ntawm tus neeg mob (feem ntau pom tau hauv cov neeg mob laus) kom koom tes nrog tus kws kho mob,
• khoom noj tsis txaus, tsis noj mov los yog yoo mov noj,
• tsis sib xws ntawm kev qoj ib ce thiab kev ua kom yuag,
• kev noj haus hloov
• haus cawv, tshwj xeeb tshaj yog ua ke nrog kev tshem tawm cov zaub mov,
• mob raum tsis zoo,
• kev mob siab rau daim siab hnyav (hauv cov neeg mob uas muaj mob rau daim siab hnyav, kev kho tshuaj insulin yog qhov qhia, tsawg kawg kom txog thaum kev tswj hwm metabolic tiav),,
• noj tshuaj ntawm glimepiride,
• qee qhov decompensated endocrine cuam tshuam uas cuam tshuam rau cov metabolism hauv lub cev los yog adrenergic counterregulation nyob rau hauv kev teb rau hypoglycemia (piv txwv li, qee qhov kev ua haujlwm ntawm cov thyroid caj pas thiab lub caj pas ua haujlwm pituitary, adrenal cortex tsis txaus),
• siv cov yeeb tshuaj ib txhij
• txais tos ntawm glimepiride thaum tsis muaj kev ntsuas rau nws kev txais tos.

Kev kho mob nrog sulfonylurea derivatives, uas suav nrog glimepiride, tuaj yeem ua rau kev txhim kho hemolytic anemia, yog li ntawd, hauv cov neeg mob uas muaj ntshav qabzib-6-phosphate dehydrogenase tsis txaus, tshwj xeeb yuav tsum tau saib xyuas thaum sau ntawv glimepiride, nws yog qhov zoo dua yog siv cov tshuaj tiv thaiv kab mob ntshav qab zib uas tsis yog sulfonylurea derivatives.

Nyob rau ntawm qhov kev pheej hmoo ntawm cov xwm txheej saum toj no rau kev txhim kho hypoglycemia, zoo li thaum muaj kev cuam tshuam ntawm cov kabmob sib kis thaum kho lossis hloov tus neeg mob lub neej, kev hloov kho koob tshuaj glimepiride lossis kev kho tag nrho tej zaum yuav xav tau.

Cov tsos mob ntawm lub qog ntshav qab zib los ntawm adrenergic counterregulation ntawm lub cev hauv kev teb rau hypoglycemia tej zaum yuav mob me lossis tsis tuaj nrog kev txhim kho maj mam hypoglycemia, hauv cov neeg mob laus, hauv cov neeg mob uas muaj teeb meem ntawm lub hlwb tsis txaus lossis hauv cov neeg mob uas tau txais beta-blockers, clonidine, reserpine , guanethidine thiab lwm tus neeg siv sympatholytic.

Kev mob ntshav qab zib tsawg tuaj yeem raug tshem tawm sai sai nrog kev noj sai ntawm kev zom cov zaub mov sai sai (qabzib lossis sucrose). Ib yam li lwm yam sulfonylurea derivatives, txawm hais tias thawj zaug kev vam meej ntawm kev txo qis ntawm hypoglycemia, hypoglycemia yuav rov pib dua. Yog li, cov neeg mob yuav tsum nyob twj ywm nrog kev saib xyuas tas mus li. Hauv kev mob ntshav nce siab ntau, yuav tsum tau txais kev kho mob sai thiab kev saib xyuas mob, thiab qee kis, yuav tsum tau pw hauv tsev kho mob.

Thaum kho nrog glimepiride, yuav tsum soj ntsuam daim siab ua haujlwm thiab daim duab txhav ntshav (tshwj xeeb cov leukocytes thiab platelets).

Cov kev mob tshwm sim xws li mob ntshav qab zib ntau ntau, hloov pauv hnyav hauv daim duab ntshav, kev tsis haum tshuaj nyhav, thiab lub siab ua rau muaj kev phom sij txog lub neej, yog li, yog tias muaj kev cuam tshuam loj tuaj, tus neeg mob yuav tsum qhia tus kws kho mob tam sim ntawd txog ntawm lawv, tsum tsis noj tshuaj thiab tsis rov noj dua yam tsis muaj tus kws kho mob pom zoo. Cov.

Kev Siv Khomob

Cov ntaub ntawv hais txog kev ua kom tau ntev ntev thiab muaj kev nyab xeeb rau cov tshuaj hauv cov menyuam yaus tsis muaj.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Thaum pib ntawm kev kho mob, tom qab hloov pauv kev kho lossis nrog kev tswj hwm tsis xwm yeem ntawm glimepiride, qhov kev txo qis ntawm kev mloog thiab qhov ceev ntawm psychomotor tshua vim yog hypo- lossis hyperglycemia tuaj yeem sau tseg. Qhov no yuav cuam tshuam tsis zoo rau kev muaj peev xwm tsav tsheb los yog tswj tau ntau lub tshuab thiab tshuab.

Kev xav ntawm cov kws kho mob thiab cov ntshav qab zib txog Amaril

Kev tshuaj xyuas cov neeg mob endocrinologist uas niaj hnub ntsib txhua qhov tshwm sim ntawm tus kab mob insidious yog feem ntau lub hom phiaj, vim tias lawv muaj sijhawm los kawm txog kev cuam tshuam ntawm cov neeg mob rau cov tshuaj nyob rau hauv thiaj li yuav kos cov lus xaus txog nws cov hauj lwm zoo.

Raws li cov kws kho mob, nrog cov txheej txheem kev kho mob kom raug, Amaril pab ua kom cov glycemic indices sai txaus. Tus neeg mob ntshav qab zib noj cov tshuaj muaj kev tsis txaus siab ntawm lub qog ntshav qab zib thaum txoj kev xaiv tau xaiv tsis zoo. Thiab tsis tau, hais txog cov tshuaj Amaril, kev xyuas neeg mob yog qhov kev xav tau zoo.

Kev noj haus qis-carb, kev siv lub cev ua si, tswj lub cev nyhav muaj qhov cuam tshuam rau kev ua haujlwm ntawm Amaril kho mob. Tus mob ntshav qab zib yuav tsum qhia rau tus kws kho qhov mob endocrinologist kom txog sijhawm muaj cov kev mob tshwm sim, cov tsos mob ntawm hypo- thiab hyperglycemia uas tsim nrog Amaril.

Kev kho mob kuj tseem cuam tshuam txog kev saib xyuas tus kheej ntawm cov piam thaj thiab kev soj ntsuam ntawm lub siab ua haujlwm, kev sim tshuaj, tshwj xeeb tshaj yog kuaj ntshav glycated hemoglobin, uas niaj hnub no suav hais tias yog lub hom phiaj tseem ceeb tshaj plaws rau kev ntsuas tus neeg mob ntshav qab zib. Qhov no yuav pab txhawm rau txheeb xyuas qhov degree ntawm tsis kam ntawm Amaril rau kev kho ntawm kev kho mob kiag li.

Koj tuaj yeem kawm txog cov nta ntxiv ntawm Amaril los ntawm cov yeeb yaj kiab.

Cov Lus Cim Amaryl

Qhov sib tw raws cov cim

Nqe txij li 90 rubles. Cov analogue yog pheej yig dua los ntawm 1716 rubles

Qhov sib tw raws cov cim

Nqe txij li 97 rubles. Cov analogue yog pheej yig dua los ntawm 1709 rubles

Qhov sib tw raws cov cim

Nqe txij li 115 rub. Cov analogue yog pheej yig dua los ntawm 1691 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 130 rubles. Cov analogue yog pheej yig los ntawm 1676 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 273 rubles. Cov analogue yog pheej yig dua los ntawm 1533 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 287 rubles. Cov analogue yog pheej yig dua los ntawm 1519 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 288 rubles. Cov analogue yog pheej yig dua los ntawm 1518 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 435 rubles. Cov analogue yog pheej yig dua los ntawm 1371 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 499 rubles. Cov analogue yog pheej yig dua los ntawm 1307 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 735 rubles. Cov analogue yog pheej yig los ntawm 1071 rubles

Qhov sib tw raws cov cim

Nqe txij li 982 rubles. Cov analogue yog pheej yig dua los ntawm 824 rubles

Qhov sib tw raws cov cim

Nqe los ntawm 1060 rubles. Cov analogue yog pheej yig dua los ntawm 746 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 1301 rubles. Cov analogue yog pheej yig dua los ntawm 505 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 1395 rubles. Cov analogue yog pheej yig dua los ntawm 411 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 2128 rubles. Cov analogue muaj nqi ntau dua ntawm 322 rubles

Qhov sib tw raws cov cim

Nqe los ntawm 2569 rubles. Cov kab xev analogue kim dua los ntawm 763 rubles

Qhov sib tw raws cov cim

Tus nqi yog los ntawm 3396 rubles. Cov analogue kim dua los ntawm 1590 rubles

Qhov sib tw raws cov cim

Nqe los ntawm 4919 rubles. Cov analogue kim dua los ntawm 3113 rubles

Qhov sib tw raws cov cim

Nqe txij li 8880 rubles. Cov kab xev analogue kim dua los ntawm 7074 rubles

Pharmacological kev txiav txim

Ib qho tshuaj hypoglycemic qhov ncauj yog ib qho kev sib txuas ntawm peb tiam sulfonylurea.

Glimepiride txo qis kev ua haujlwm ntawm cov piam thaj hauv cov ntshav, feem ntau vim yog kev tsa ntawm kev tso tawm ntawm insulin los ntawm from-hlwb ntawm cov txiav. Nws cov nyhuv yog feem ntau cuam tshuam nrog kev txhim kho nyob rau hauv lub peev xwm ntawm pancreatic cells-hlwb los teb rau lub cev kev xav nrog lub ntsej muag. Piv nrog rau glibenclamide, qis dua ntawm glimepiride tso tawm cov tshuaj insulin tsawg dua thaum muaj kwv yees li ntawm cov ntshav qab zib tsawg dua. Qhov tseeb no ua tim khawv nyob rau hauv kev pom zoo muaj cov kab mob ntxiv los tiv thaiv hypoglycemic nyob rau hauv glimepiride (nce cov ntaub so ntswg rhiab rau insulin thiab insulinomimetic effect).

Cov tshuaj insulin zais cia. Zoo li txhua lwm yam sulfonylurea derivatives, glimepiride tswj hwm cov kua dej los ntawm kev sib koom tes nrog ATP-nkag siab potassium txuas ntawm β-cell daim nyias nyias. Tsis zoo li lwm yam sulfonylurea derivatives, glimepiride xaiv khi rau cov protein nrog cov roj molecular ntawm 65 kilodaltons uas nyob hauv lub qog ntawm β-hlwb ntawm tus txiav. Qhov no sib cuam tshuam ntawm glimepiride nrog cov protein sib khi ua kom nws tswj qhov qhib lossis kaw ntawm ATP-nkag mus poov tshuaj raws.

Glimepiride kaw cov kab xo potassium. Qhov no ua rau depolarization ntawm β-hlwb thiab ua rau qhib ntawm voltage-rhiab calcium channel thiab qhov khiav ntawm calcium nyob rau hauv lub cell. Raws li qhov tshwm sim, ib qho kev nce ntxiv hauv cov tshuaj calcium uas muaj siab tshaj yuav ua rau cov insulin secretion los ntawm exocytosis.

Glimepiride ua nrawm dua thiab vim li no thiaj li muaj kev sib cuag thiab raug tso tawm los ntawm daim ntawv cog lus nrog cov protein khi rau nws tshaj li glibenclamide. Nws tau kwv yees tias cov cuab yeej no ntawm kev hloov pauv siab ntawm glimepiride nrog cov protein khi rau nws txiav txim siab nws cov lus tshaj tawm ntawm kev txiav txim siab ntawm ose-hlwb rau cov kua nplaum thiab lawv cov kev tiv thaiv tiv thaiv desensitization thiab ntxov ntxov.

Cov nyhuv ntawm nce zuj zus cov ntaub so ntswg mus rau insulin. Glimepiride ua rau kev cuam tshuam zoo ntawm insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg peripheral.

Cov tshuaj Insulinomimetic. Glimepiride muaj cov teebmeem zoo ib yam li cov tshuaj insulin rau ntawm qhov nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg thiab kev tso tawm cov piam thaj los ntawm lub siab.

Peripheral cov ntaub so ntswg qabzib yog nqus tau los ntawm kev thauj nws mus rau hauv cov leeg nqaij thiab adipocytes. Glimepiride ncaj qha nce tus naj npawb ntawm cov lwg me nyuam thauj cov piam thaj hauv plasma cov leeg ntawm cov leeg nqaij thiab adipocytes. Kev nce ntxiv ntawm kev noj cov ntshav qabzib ua rau kev ua haujlwm ntawm glycosylphosphatidylinositol-phospholipase C. Yog li ntawd, cov tshuaj calcium calcium uas tsis txaus siab poob qis, ua rau muaj kev cuam tshuam ntawm cov dej num ntawm protein kinase A, uas ua rau lub ntsej muag ua rau lub zog ntawm cov metabolism glucose.

Glimepiride inhibits kev tso tawm ntawm qabzib los ntawm lub siab los ntawm kev nce lub siab ntawm fructose-2,6-bisphosphate, uas inhibits gluconeogenesis.

Ntxim rau platelet aggregation. Glimepiride txo cov platelet sib sau ua ke hauv vitro thiab hauv vivo. Cov nyhuv no zoo li cuam tshuam nrog kev xaiv inhibition ntawm COX, uas yog lub luag haujlwm rau kev tsim ntawm thromboxane A, ib qho tseem ceeb endogenous platelet aggregation factor.

Antiatherogenic siv. Glimepiride pab txhawb rau kev kho lipid cov ntsiab lus, ua rau txo qis ntawm malonic aldehyde hauv cov ntshav, uas ua rau txo qis tseem ceeb ntawm lipid peroxidation. Hauv cov tsiaj txhu, glimepiride ua rau muaj qhov txo qis hauv kev tsim ntawm atherosclerotic plaques.

Txo kev mob nyav ntawm oxidative kev nyuaj siab, uas niaj hnub muaj rau cov neeg mob ntshav qab zib hom 2. Glimepiride nce rau theem ntawm endogenous to-tocopherol, qhov kev ua ntawm catalase, glutathione peroxidase thiab superoxide dismutase.

Kev mob plawv. Los ntawm ATP-nkag siab poov tshuaj channel, sulfonylurea derivatives kuj cuam tshuam rau cov hlab plawv cov ntshav. Muab piv rau cov tshuaj sulfonylurea derivatives, glimepiride muaj cov txiaj ntsig zoo dua rau cov kev mob plawv, uas yuav piav qhia los ntawm qhov xwm txheej tshwj xeeb ntawm nws cov kev cuam tshuam nrog cov protein txuas ntawm ATP-rhiab poov tshuaj raws.

Hauv cov neeg ua haujlwm noj qab haus huv, cov tshuaj txhaj tsawg kawg ntawm glimepiride yog 0.6 mg. Cov nyhuv ntawm glimepiride yog koob tshuaj thiab rov ua dua tshiab. Lub cev muaj zog teb rau kev ua lub cev (txo qis insulin qis) nrog glimepiride yog tswj.

Tsis muaj qhov sib txawv ntawm cov nyhuv, nyob ntawm seb cov tshuaj tau siv 30 feeb ua ntej noj mov lossis tam sim ntawd ua ntej noj mov. Hauv cov neeg mob ntshav qab zib, kev tswj kev zom zaub mov txaus tuaj yeem ua tiav nyob hauv 24 teev nrog tib lub tshuaj. Ntxiv mus, hauv kev soj ntsuam mob, 12 ntawm 16 cov neeg mob raum tsis ua haujlwm (CC 4-79 ml / min) kuj tau ua tiav kev tswj cov metabolic txaus.

Kev sib xyaw ua ke nrog metformin. Hauv cov neeg mob uas lub cev tsis txaus tswj kev tiv thaiv thaum siv ntau tshaj plaws ntawm glimepiride, kev sib txuas ua ke nrog glimepiride thiab metformin tuaj yeem pib ua. Hauv ob txoj kev tshawb nrhiav, thaum ua cov kev kho mob sib xyaw ua ke, nws tau ua pov thawj tias kev tswj cov metabolism yog qhov zoo dua li ntawm txoj kev kho txhua yam ntawm cov tshuaj cais tawm.

Kev sib xyaw ua ke nrog cov tshuaj insulin. Hauv cov neeg mob uas lub cev tsis txaus tswj kev noj zaub mov zoo thaum noj glimepiride ntawm kev noj tshuaj ntau tshaj plaws, kev kho mob insulin ib txhij tuaj yeem pib. Raws li cov txiaj ntsig ntawm ob txoj kev tshawb nrhiav, thaum siv txoj kev sib xyaw no, tib txoj kev txhim kho hauv kev tswj cov zom zaub mov yog ua tiav thaum siv tsuas yog ib qho insulin. Txawm li cas los xij, kev sib xyaw ua ke yuav tsum tau siv tshuaj insulin tsawg dua.

Kev noj tshuaj ntxiv

Raws li txoj cai, koob tshuaj ntawm Amaril ® yog txiav txim los ntawm lub hom phiaj concentration ntawm cov piam thaj hauv cov ntshav. Cov tshuaj yuav tsum tau siv nyob rau hauv qhov tsawg kawg nkaus kom txaus kom ua tiav qhov kev tswj hwm kev hnyav tsim nyog.

Thaum kho nrog Amaril ®, nws yog ib qho tsim nyog yuav tsum tau soj ntsuam tas li theem ntawm cov piam thaj hauv cov ntshav. Tsis tas li ntawd, kev soj ntsuam tas li ntawm glycosylated hemoglobin qib raug pom zoo.

Kev ua txhaum ntawm cov tshuaj, piv txwv li, hla cov koob tshuaj tom ntej, yuav tsum tsis txhob ua los ntawm cov thawj coj hauv tshuaj hauv qhov siab dua.

Tus kws kho mob yuav tsum qhia tus neeg mob ua ntej txog cov kev coj ua thaum muaj qhov yuam kev hauv kev noj Amaril ® (tshwj xeeb, thaum hla cov koob tshuaj tom ntej lossis dhia noj mov), lossis hauv cov xwm txheej uas tsis tuaj yeem siv tshuaj.

Amaril-ntsiav tshuaj yuav tsum noj kom tag nrho yam tsis muaj kev zom, haus dej kom ntau (li 1/2 khob). Yog tias tsim nyog, ntsiav tshuaj ntawm Amaril ® tuaj yeem muab faib raws cov kev pheej hmoo ua ob seem sib luag.

Thawj koob tshuaj Amaril ® yog 1 mg 1 zaug / hnub. Yog tias tsim nyog, koob tshuaj txhua hnub tuaj yeem hloov zuj zus (ntu sijhawm li ntawm 1-2 lub lis piam) raws li kev saib xyuas ntshav qabzib tas li thiab raws li cov cai hauv qab no: 1 mg-2 mg-3 mg-4 mg-6 mg (-8 mg) ib hnub Cov.

Hauv cov neeg mob uas mob ntshav qab zib hom 2 Cov koob tshuaj txhua hnub yog feem ntau 1-4 mg. Kev noj tshuaj txhua hnub ntau dua 6 mg yuav zoo dua hauv qee tus neeg tsawg xwb.

Tus kws kho mob txiav txim siab txog lub sijhawm noj Amaril ® thiab faib cov koob tshuaj nruab hnub, noj mus rau hauv tus neeg mob txoj kev ua neej (lub sijhawm noj mov, tus naj npawb ntawm cov dej num). Cov koob tshuaj txhua hnub tau sau tseg hauv 1 koob tshuaj, feem ntau tam sim ntawd ua ntej noj tshais tag nrho lossis, yog tias qhov tshuaj txhua hnub tsis tau noj, tam sim ntawd ua ntej noj mov thawj. Nws yog ib qho tseem ceeb kom tsis txhob pluas noj tom qab noj Amaril-ntsiav tshuaj.

Vim hais tias kev txhim kho kev zom zaub mov yog txuam nrog kev nkag siab ntau ntxiv rau cov tshuaj insulin; thaum kho, kev xav tau glimepiride yuav raug txo. Txhawm rau kom tsis txhob muaj kev txhim kho hypoglycemia, nws yog ib qho tsim nyog yuav tsum txo kom tsis txhob noj lub sijhawm lossis tsis noj tshuaj Amaril ®.

Cov mob uas yuav tau txhaj tshuaj kho qhov mob glimepiride:

- yuag poob,

- lub neej hloov pauv (hloov hauv kev noj zaub mov, lub sijhawm noj mov, qhov khoom siv lub cev),

- kev tshwm sim ntawm lwm yam uas ua rau muaj kev cuam tshuam ua ntej rau kev txhim kho hypoglycemia lossis hyperglycemia.

Glimepiride kho mob feem ntau yog ua rau lub sijhawm ntev.

Hloov pauv ntawm tus neeg mob los ntawm kev noj lwm qhov ncauj tshuaj hypoglycemic rau kev noj tshuaj Amaril ®

Tsis muaj kev sib txheeb ze ntawm cov koob tshuaj ntawm Amaril ® thiab lwm qhov tshuaj hypoglycemic hauv qhov ncauj. Thaum hloov pauv los ntawm cov tshuaj no rau Amaryl ®, qhov kev xav pom zoo thawj hnub ntawm qhov kawg yog 1 mg (txawm tias tus neeg mob hloov mus rau Amaryl ® nrog qhov siab tshaj plaws ntawm lwm qhov tshuaj hypoglycemic). Qhov koob tshuaj nce ntxiv yuav tsum tau nqa tawm hauv theem, suav txog qhov lus teb rau glimepiride raws li cov lus pom zoo saum toj no. Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv qhov kev siv thiab lub sijhawm ntawm cov nyhuv ntawm yav dhau los hypoglycemic tus neeg sawv cev. Kev cuam tshuam los ntawm kev kho mob tej zaum yuav tsum kom tsis txhob muaj cov txiaj ntsig ntxiv uas ua rau muaj kev pheej hmoo ntawm ntshav qab zib.

Siv ua ke nrog metformin

Hauv cov neeg mob uas tsis muaj peev xwm tswj tau tus mob ntshav qab zib mellitus, thaum noj cov tshuaj glimepiride lossis metformin ntau tshaj plaws hauv txhua hnub, kev kho mob nrog kev sib xyaw ntawm ob hom tshuaj no tuaj yeem pib ua. Hauv qhov no, kev kho yav dhau los nrog rau glimepiride lossis metformin txuas ntxiv ntawm tib lub koob tshuaj, thiab cov koob tshuaj ntxiv ntawm metformin lossis glimepiride pib nrog kev txhaj tshuaj qis, uas yog tom qab ntawv suav nyob ntawm qib hom phiaj ntawm kev tswj metabolic, txog qhov siab tshaj plaws txhua hnub. Txoj kev kho ua ke yuav tsum tau pib los ntawm kev saib xyuas mob nkeeg nruj me ntsis.

Siv ua ke nrog cov tshuaj insulin

Hauv cov neeg mob uas tsis muaj peev xwm tswj tau tus mob ntshav qab zib mellitus, cov tshuaj insulin yuav muab rau tib lub sijhawm thaum noj glimepiride qhov siab tshaj plaws txhua hnub. Hauv qhov no, koob tshuaj kawg ntawm glimepiride qhia rau tus neeg mob tseem tsis hloov pauv. Hauv qhov no, kev kho tshuaj insulin pib nrog kev siv tshuaj tsawg, uas maj mam nce ntxiv ntawm kev tswj hwm qhov kev tswj hwm ntawm cov piam thaj hauv cov ntshav. Txoj kev kho tag nrho yog ua tiav los ntawm kev saib xyuas zoo.

Cov neeg mob uas lub raum tsis ua hauj lwm zoo tej zaum yuav nkag siab zoo rau cov nyhuv hypoglycemic ntawm glimepiride. Cov ntaub ntawv hais txog kev siv Amaril ® hauv cov neeg mob raum tsis ua haujlwm yog txwv.

Cov ntaub ntawv hais txog kev siv Amaril ® cov neeg mob mob siab tsis ua hauj lwm luag.

Sab sij huam

Los ntawm sab ntawm cov metabolism: hypoglycemia yog ua tau, uas, raws li nrog lwm cov sulfonylurea derivatives, tuaj yeem siv sijhawm ntev. Cov tsos mob ntawm tus mob ntshav qab zib - mob taub hau, tshaib plab, xeev siab, ntuav, nkees, tsaug zog, pw tsaug zog, ntxhov siab vim, txhoj puab heev, tsis hnov ​​qab, ceeb toom thiab khiav ceev, ntxhov siab, tsis meej pem, hais lus tsis meej, tsis meej pem, pom kev tsis sib haum, tshee hnyo, paresis , hnov ​​lub siab tsis sib xws, kiv taub hau, plam ntawm qhov yus tus kheej, ua kom lom zem, mob plab hlaub, qaug zog lossis tsis nco qab los txog thaum lub siab tsis nco qab, ua pa nyuaj, bradycardia. Tsis tas li ntawd, tej zaum yuav muaj qhov pom ntawm adrenergic counterregulation nyob rau hauv kev teb rau cov ntshav qog, xws li cov tsos ntawm khaub thuas, nplaum tawm hws, ntxhov siab vim, tachycardia, hlab ntsha tawg, angina pectoris, palpitations, thiab lub plawv atherosclerosis kev ntxhov siab. Cov lus qhia soj ntsuam ntawm tus mob ntshav qab zib siab heev yuav zoo li tus mob stroke. Cov tsos mob ntawm cov ntshav qog ntshav yuav luag ploj tom qab nws tshem tawm.

Los ntawm sab ntawm cov khoom ntawm lub zeem muag: ua tau (tshwj xeeb yog thaum pib kho) Txuag lub sij hawm muaj qhov muag pom vim muaj kev hloov hauv cov concentration ntawm cov piam thaj hauv cov ntshav. Lawv qhov ua rau yog ib ntus hloov ntawm qhov lo ntsiab muag o, nyob ntawm kev mloog ntawm cov piam thaj hauv cov ntshav, thiab vim qhov no, qhov hloov pauv ntawm qhov lo ntsiab muag ntawm lub lo ntsiab muag.

Los ntawm lub plab zom mov: tsis tshua muaj, xeev siab, ntuav, zoo nkaus li mob hnyav lossis phwj rau hauv qhov epigastrium, mob plab, mob raws plab, qee qhov mob siab, muaj kev ua haujlwm ntawm daim siab ua haujlwm siab thiab / lossis cholestasis thiab mob daj ntseg, uas tuaj yeem hloov mus rau lub siab ua rau lub siab ua tsis tau, tab sis yuav muaj kev rov qab tsim kho thaum tsum tsis haus tshuaj.

Los ntawm cov kab ke hemopoietic: tsis tshua muaj thrombocytopenia, nyob rau qee kis - leukopenia, hemolytic anemia, erythrocytopenia, granulocytopenia, agranulocytosis thiab pancytopenia. Hauv kev tshaj tawm txog kev siv tshuaj, cov xwm txheej loj ntawm thrombocytopenia nrog platelet suav tau tshaj tawm

Cov Yuav Tsum Tau Ua

- hom ntshav qab zib 1

- mob ketoacidosis, mob ntshav qab zib thiab ua rau tsis nco qab,

- Kev ua txhaum loj ntawm daim siab ua haujlwm (tsis muaj kev tshawb nrhiav hauv chaw kho mob),

- Mob raum tsis zoo, suav nrog cov neeg mob hemodialysis (tsis muaj kev kuaj mob)

- lactation (pub niam mis),

- menyuam yaus hnub nyoog (tsis muaj kev ntsuam xyuas mob),

- muaj kab mob tsis tshua muaj mob, xws li galactose intolerance, lactase deficiency lossis glucose-galactose malabsorption,

- Cov tshuaj tiv thaiv tsis haum rau cov tshuaj,

- Cov tshuaj tiv thaiv tsis haum rau lwm cov tshuaj sulfonylurea thiab cov tshuaj sulfonamide (kev pheej hmoo ntawm kev tiv thaiv hypersensitivity).

Nrog ceev faj cov tshuaj yuav tsum tau siv hauv thawj lub lis piam ntawm kev kho mob (nce kev pheej hmoo ntawm ntshav siab), yog tias muaj kev pheej hmoo rau kev loj hlob ntawm hypoglycemia (nws yuav tsum tau kho qhov kev kho mob ntawm glimepiride lossis tag nrho txoj kev kho), nrog cov kab mob sib kis thaum kho mob, lossis thaum cov neeg mob hloov lawv txoj kev ua neej (hloov hauv kev noj zaub mov thiab lub sijhawm nkag khoom noj khoom haus, nce lossis txo qis hauv kev siv lub cev), thaum lub cev tsis muaj qabzib-6-phosphate dehydrogenase, nyob rau hauv rooj plaub ntawm malabsorption ntawm cov zaub mov thiab tshuaj los ntawm lub plab zom mov (hnyuv teeb meem, paresis Shechnik).

Cev xeeb tub thiab lactation

Amaril ® yog contraindicated rau hauv lub cev xeeb tub. Kev xeeb menyuam hauv plab lossis thaum pib cev xeeb tub, tus pojniam yuav tsum pauv mus rau kev kho mob insulin.

Nws tau raug tsim muaj tias glimepiride ua tawm hauv cov kua mis. Thaum lub sijhawm pub mis, koj yuav tsum pauv tus poj niam mus rau insulin lossis tsum tsis pub mis niam.

Yeeb tshuaj sib cuam tshuam

Glimepiride yog metabolized nrog kev koom tes ntawm CYP2C9 isoenzyme, uas yuav tsum tau coj mus rau hauv tus account thaum siv cov tshuaj nrog cov inducers (piv txwv li rifampicin) lossis tshuaj tiv thaiv kab mob (xws li fluconazole) CYP2C9.

Lub zog ua haujlwm ntawm hypoglycemic kev ua haujlwm thiab, nyob rau qee kis, kev loj hlob tau ntawm hypoglycemia cuam tshuam nrog qhov no tuaj yeem pom thaum Amaril ® sib xyaw nrog ib qho ntawm cov tshuaj hauv qab no: insulin, lwm yam kab mob hypoglycemic rau kev tswj hwm ntawm qhov ncauj, ACE inhibitors, anabolic steroids thiab txiv neej poj niam txiv neej, chloramphenicol, coumarin derivatives, cyclophosphamide, disopyramide, fenfluramine, pheniramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, fluconazole, PASK, pentoxifylline (koob tshuaj ntau ntau) , phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, clarithromycin, sulfanilamides, tetracyclines, tritokvalin, trophosphamide.

Kev txo qis hauv hypoglycemic kev txiav txim siab thiab cuam tshuam ntxiv ntawm cov ntshav qabzib hauv siab yog ua tau thaum ua ke nrog ib qho ntawm cov tshuaj hauv qab no: acetazolamide, barbiturates, glucocorticosteroids, diazoxide, diuretics, sympathomimetic tshuaj (suav nrog epinephrine), glucagon, laxatives (nrog rau siv ntev ), nicotinic acid (hauv qib siab), estrogens thiab progestogens, phenothiazines, phenytoin, rifampicin, iodine-muaj cov thyroid hormones.

Cov tshuaj tiv thaiv histamine H₂receptors, beta-blockers, clonidine thiab reserpine muaj peev xwm ob leeg los txhim kho thiab txo cov nyhuv hypoglycemic ntawm glimepiride.

Hauv qab ntawm cov neeg mob sympatholytic, xws li beta-blockers, clonidine, guanethidine thiab reserpine, cov cim ntawm adrenergic counterregulation nyob rau hauv teb rau hypoglycemia tej zaum yuav raug txo lossis ploj.

Tawm tsam keeb kwm yav dhau los ntawm kev noj glimepiride, kev sib zog los yog ua kom qaug zog ntawm kev nqis tes ua ntawm coumarin derivatives yog ua tau.

Kev haus cawv ib leeg lossis mob ntev tuaj yeem ua rau ob leeg txhim kho thiab tsis muaj zog ntawm cov nyhuv hypoglycemic ntawm glimepiride.

Sequestrants ntawm cov kua tsib cov kua qaub: lub log phau ntawv khi rau glimepiride thiab txo qhov nqus ntawm glimepiride los ntawm kev mob plab. Kev siv ntawm glimepiride, tsawg kawg 4 teev ua ntej yuav haus cov cadelovel, tsis muaj kev cuam tshuam tau pom. Yog li no, glimepiride yuav tsum tau noj tsawg kawg 4 teev ua ntej coj log log.