Glibenclamide (Glibenclamide)

Glibenclamide
Tshuaj lom neeg cov khoom sib txuas
IUPAC	5-chloro-N-(4-N- (cyclohexylcarbamoyl) sulfamoylphenethyl) -2-methoxybenzamide
Cov piav suav	C23H28Cln3O5Qha
Molar loj	494.004 g / mol
Cas	10238-21-8
PubChem	3488
Tshuajqauj Tshuaj	APRD00233
Kev faib tawm
ATX	A10BB01
Cov Tshuaj Pharmacokinetics
Ntshav Protein losis tswvyim dabtsi	Pheej
Kev zom zaub mov	Daim siab ua paug siab (CYP2C9-mediated)
Ib nrab-lub neej.	10 teev
Kev cais tawm	Raum thiab mob siab
Dosage Cov Ntawv
ntsiav tshuaj
Tus thawj coj kev tswj hwm
sab hauv
Lwm lub npe
Maninil

Glibenclamide (syn. Antibet, Apoglyburide, Noob glib, Gilemal, Glibamide, Glibenclamide Teva, Gliburide, Glucobene, Daonil, Dianti, Maninil, Euglycon) Yog tus sawv cev ntawm lub cim thib ob ntawm sulfonylurea derivatives, ib qho nrov tshaj plaws thiab kawm txog cov tshuaj muaj suab thaj, uas txij li xyoo 1969 tau siv dav hauv ntau lub teb chaws ntawm lub ntiaj teb raws li kev ntseeg siab thiab muaj pov thawj kho rau hom 2 mob ntshav qab zib mellitus nrog qhov tsis muaj txiaj ntsig ntawm kev hloov pauv hauv lub neej.

Txawm hais tias qhov tshwm sim ntawm sulfonylurea tshiab nrog kev txhim kho cov yam ntxwv, nrog rau cov tshuaj tiv thaiv kab mob nrog rau lwm cov txheej txheem ntawm kev ua, nws tseem ntxov dhau los tso qhov keeb kwm ntawm glibenclamide - hauv kev sim tshuaj thiab cov kev tshawb fawb, cov tshuaj no tsis yog tsuas yog ua piv txwv rau kev soj ntsuam qhov kev ua tau zoo ntawm cov qauv tshuaj tshiab thiab kev kho mob, tab sis kuj qhia tau tias muaj peev xwm siv cov khoom muaj zog ntxiv.

Kev ua tau zoo thiab kev nyab xeeb

Lub ntsiab tseem ceeb ntawm kev ua ntawm glibenclamide, zoo li lwm tus neeg sawv cev ntawm sulfonylurea kev npaj, yog kawm tau zoo ntawm qib molecular receptor. Glibenclamide nplov ATP-dependant cov kab mob potassium (K + -ATP-channels), ua rau thaj chaw ntawm lub plasma daim nyias nyias ntawm beta hlwb ntawm cov txiav. Kev txiav tawm ntawm txoj kev tawm los ntawm cov cell potassium ua rau txoj kev puas tsuaj ntawm daim nyias nyias thiab cov dej ntws ntawm Ca 2+ ions los ntawm cov xaim calcium uas muaj kev tiv thaiv raws. Kev nce ntxiv ntawm cov ntsiab lus calcium hauv lub cev los ntawm kev ua kom muaj calcium / calmodulin-protein protein kinase II ua rau lub zog exocytosis ntawm secretory granules nrog insulin, vim li ntawd cov tshuaj hormones nkag mus rau hauv cov kua nruab nrog cev thiab ntshav. Qhov tsis sib xws ntawm kev muaj txiaj ntsig ntawm sulfonylurea npaj rau beta-cell receptors txiav txim siab lawv ntau yam kev ua suab thaj. Glibenclamide muaj kev sib raug zoo tshaj plaws rau sulfonylurea receptors ntawm beta hlwb thiab cov suab thaj txo qis tshaj plaws ntawm sulfonylurea npaj.

Cov nyhuv ntawm cov tshuaj lom insulin secretion ncaj qha nyob ntawm koob tshuaj glibenclamide noj thiab tshwm sim ob qho tib si hauv hyperglycemia thiab hauv normoglycemia lossis hypoglycemia.

Tag nrho cov pab pawg ntawm sulfonylurea kev npaj, mus rau ib theem lossis lwm qhov, muaj kev cuam tshuam peripheral (ntxiv-ua rau lub cev), uas yog txhawm rau nce cov kev xav ntawm cov nqaij mos peripheral, feem ntau cov rog thiab cov leeg, rau qhov kev ua ntawm insulin thiab txhim kho cov piam thaj los ntawm cov hlwb.

Kev ua tau zoo thiab kev nyab xeeb |Cov Yuav Tsum Muaj

Hypersensitivity rau sulfonylurea derivatives thiab sulfonamide tshuaj, hom 1 mob ntshav qab zib mellitus, mob ntshav qab zib ketoacidosis, mob ntshav qab zib precoma thiab coma, mob ntshav qab zib mellitus decompensation rau kev kis kab mob, kev raug mob, kub hnyiab, phais, mob raum thiab lub siab ua haujlwm tsis zoo, cev xeeb tub, pub mis.

Kev Sau thiab tso cov foos

Hauv 1 tab. tshuaj tiv thaiv kab mob muaj 1,75 mg, 3.5 mg lossis 5 mg ntawm cov tshuaj nquag, uas yog glibenclamide.

Kuj tseem nyob hauv cov tshuaj muaj:

• Povidone
• Lactose Monohydrate
• Qos yaj ywm starch
• Magnesium stearate
• Ponceau 4R.

Cov ntsiav tshuaj hloov puag ncig, daj ntseg liab xim hauv xim, tej zaum yuav muaj txaws. Cov tshuaj muaj nyob rau hauv lub khob fwj uas muaj 120 ntsiav tshuaj, ib daim ntawv ntxiv ntawm cov neeg siv tau txuas nrog.

Kho thaj chaw

Nws yog tsim nyog sau cia tias kev lag luam lub npe ntawm cov tshuaj txuam nrog lub npe ntawm cov tshuaj nquag. Cov tshuaj muaj cov nyhuv hypoglycemic ob leeg hauv cov tib neeg uas tau los ntawm hom 2 mob ntshav qab zib mellitus, thiab hauv cov neeg muaj kev noj qab haus huv tiag. Lub tshuab kev ua ntawm kev ua raws li kev ua kom insulin ntau ntxiv los ntawm β-hlwb ntawm cov txiav ua tiav los ntawm nws cov kev txhawb nqa. Xws li cov nyhuv nyob ntawm, ua ntej ntawm txhua yam, nyob rau theem ntawm cov piam thaj hauv qhov nruab nrab uas nyob ib puag ncig β-hlwb.

Tom qab noj cov ntsiav tshuaj, cov tshuaj nquag tau nrawm thiab yuav luag nqus. Nrog rau cov pluas noj, tsis muaj ib qho tseem ceeb txo qis hauv tus nqi ntawm kev nqus ntawm glibenclamide. Qhov taw qhia ntawm kev sib txuas lus nrog plasma protein yog 98%. Qhov siab tshaj plaws ntawm ib yam khoom hauv ntshav dej yog saib tom qab 2.5 teev. Ib qho kev poob qis hauv kev cia siab ntawm glibenclamide tau sau cia tom qab 8-10 teev thiab nyob ntawm qhov ntau npaum li cas ntawm cov tshuaj uas tus neeg mob noj. Qhov kev tshem tawm ib nrab-lub neej yog nyob rau nruab nrab 7 teev.

Kev hloov pauv ntawm glibenclamide tshwm sim hauv cov kab mob siab, metabolites yog tsim, uas xyaum tsis koom nrog cov suab thaj txo cov nyhuv ntawm cov tshuaj nquag. Kev nqhis ntawm cov khoom lag luam metabolic yog nqa nrog cov zis, nrog rau cov kua tsib hauv cov khoom sib npaug, qhov kev pom zoo kawg ntawm cov metabolites tau pom tom qab 45-72 teev.

Hauv cov neeg muaj lub siab tsis ua hauj lwm daim siab, ncua kev nthuav tawm ntawm glibenclamide tau sau tseg. Hauv cov neeg mob uas mob raum tsis ua haujlwm, kev nthuav tawm ntawm lub cev tsis ua haujlwm ncaj qha hauv cov zis yuav ntxiv nyiaj ntau.

Cov lus qhia rau kev siv ntsiav tshuaj

Nqe: txij li 56 txog 131 rubles.

Kev noj tshuaj ntau yog txiav txim siab ntawm tus kheej coj mus rau hauv tus account tus neeg mob lub hnub nyoog, glycemia, nrog rau qhov mob hnyav ntawm cov chav kawm ntawm tus kab mob. Nws raug nquahu kom noj tshuaj rau ntawm lub plab khoob lossis tom qab 2 teev tom qab noj mov.

Feem ntau, qhov nruab nrab cov tshuaj txhua hnub nws txawv ntawm 2.5 mg - 15 mg. Qhov ntau zaus ntawm kev siv tshuaj yog 1-3 p. txhua hnub.

Txais tos ntawm ib koob tshuaj txhua hnub ntawm 15 mg thiab saum toj no tau sau tseg tsis tshua muaj txiaj ntsig, qhov no tsis tshua nce cov nyhuv hypoglycemic ntawm cov tshuaj. Cov neeg laus yog qhov pom zoo kom pib kho nrog 1 mg ib hnub twg.

Qhov kev hloov ntawm ib cov tshuaj tiv thaiv kab mob rau lwm tus lossis hloov pauv hauv lawv cov tshuaj yuav tsum muaj nyob rau hauv kev saib xyuas ntawm kws kho mob.

Kev tiv thaiv kev nyab xeeb

Kev siv tshuaj kho mob yuav tsum tau ua nyob rau hauv kev saib xyuas cov ntshav qab zib thiab zis tsis tu ncua.

Thaum kho, koj yuav tsum tsis kam lees haus dej haus cawv, txij li kev txhim kho hypoglycemia, zoo li disulfiram zoo li kev ua yeeb yam, tsis raug cais.

Thaum cov tsos mob ntawm hypoglycemia tshwm sim, nws yuav tsim nyog los them rau qhov tsis muaj cov piam thaj los ntawm kev tswj hwm ntawm dextrose. Yog tias thaum lub xeev tsis nco qab lawm, dextrose yog tswj xyuas qhov quav tshuaj. Txhawm rau kom tsis txhob rov mob dua, nws tsim nyog los ua kom cov pluas noj nrog carbohydrates.

Hla kev sib txuam yeeb tshuaj

Antimycotic tshuaj ntawm cov kab ke ua haujlwm, ethionamide, fluoroquinolones, MAO thiab ACE inhibitors, H2-blockers, NSAIDs, tetracycline tshuaj, paracetamol, insulin, tshuaj anabolic steroid, cyclophosphamide, β-adrenergic blockers, clofibrate, reserpilamin, proberpilin, pawg. allopurinol, paracetamol, thiab chloramphenicol tuaj yeem nce ntxiv qhov hnyav ntawm cov qog ntshav qab zib.

COCs, barbiturates, glucagon, saluretics, npaj raws li cov ntsev lithium, diazoxide, nicotinic acid derivatives, phenothiazines, nrog rau cov tshuaj adrenomimetic txo cov nyhuv hypoglycemic ntawm glibenclamide.

Txhais tau hais tias acidify zis nce ntxiv ntawm cov tshuaj.

Rifampicin txhawb nqa qhov ua tsis tiav ntawm cov tshuaj nquag thiab txo nws cov nyhuv kho mob.

Sab sij huam

Cov kev mob tshwm sim hauv qab no tej zaum yuav tshwm sim:

• CCC thiab cov kab mob hematopoietic: eosinophilia, erythrocytopenia, thrombocytopenia, leukocytopenia, granulocytopenia, tsis tshua muaj agranulocytosis, qee qhov mob ntshav tsis txaus (hemolytic lossis hypoplastic)
• NS: mob taub hau nrog kiv taub hau
• Hniav cov khoom nruab nrog cev: ua txhaum ntawm saj ntawm nqaij tawv
• Kev tiv thaiv kab mob: txoj kev loj hlob ntawm kev txiav cov kab mob ntshav qab zib ntu, proteinuria, thiab cov ntshav qog ntshav qab zib
• Lub plab zom mov: dyspepsia, lub siab pathology, cholestasis
• Kev ua xua rau: tawv nqaij ua pob
• Lwm tus: ua npaws, mob polyuria, yuag yuag, mob caj dab, nrog rau kev txhim kho ntawm photosensitivity.

Noj ntau dhau

Kev mob ntshav siab yog qhov ua tau, qhov ntawd yog qhov kev xav ntawm kev tshaib plab, qaug zog, tawm hws, nce lub plawv dhia, tshee tshee, hais lus tsis meej, ntxhov siab, mob taub hau nrog kiv taub hau heev, thiab qhov muag puas.

Thaum muaj mob hnyav, yuav tsum muaj 50% piam thaj tov lossis 5-10% dextrose daws yuav tsum tau ua txhaum, kev tso ntshav tawm ntawm glucagon yog ua tau. Hauv qhov no, nws yuav tsim nyog los tswj cov kev qhia glycemia, cov theem ntawm electrolytes, creatinine, thiab tseem urea.

Coob leej tab tom nrhiav rau Glibenclamide cov lus ua kom sib npaug (analogues) uas yuav muaj qhov ua kom zoo ib yam. Ntawm lawv, Maninil yog qhov txawv.

Berlin Chemie, Lub Tebchaws Yelemees

Nqi los ntawm 99 txog 191 rubles.

Cov tshuaj yog cov tshuaj analogue ntawm Glibenclamide, cov tshuaj txuam ua ke sib luag, feem, thiab cov nyhuv ntawm lub cev yog tib yam. Cov tshuaj muaj nyob hauv daim ntawv foos.

• Tus nqi qis
• Txo txoj kev pheej hmoo ntawm kev txhim kho retinopathy thiab nephropathy
• Lub sijhawm ua haujlwm ntev (ntau dua 12 teev).

• Muaj daim ntawv yuav tshuaj
• Contraindicated hauv ketoacidosis
• Ua rau kev txhaum fab tshuaj.

Kev piav qhia ntawm cov tshuaj nquag (INN) Glibenclamide.

Pharmacology: Qhov kev txiav txim ntawm Pharmacological - hypoglycemic, hypocholesterolemic.

Cov Lus Qhia: Hom 2 mob ntshav qab zib mellitus nrog qhov ua tsis tau ntawm kev them nyiaj rau hyperglycemia nrog kev noj zaub mov zoo, poob phaus, ua si lub cev.

Cov Txheej Txheem: Hypersensitivity (suav nrog rau cov tshuaj sulfa, thiazide diuretics), mob ntshav qab zib thiab ua rau nws tsis nco qab, ketoacidosis, kub hnyiab ntev, phais thiab mob, mob plab hnyuv, mob plab paresis, tej yam mob nrog kev tsis tuaj yeem noj zaub mov (kev txhim kho hypoglycemia) kab mob, thiab lwm yam), hypo- lossis hyperthyroidism, ua rau lub siab thiab lub raum tsis ua haujlwm, mob leukopenia, hom ntshav qab zib hom 1, xeeb menyuam, pub niam mis rau menyuam noj.

Cev xeeb tub thiab lactation: Contraindicated. Thaum lub sijhawm kho yuav tsum tsis pub niam mis rau menyuam noj.

Cov kev mob tshwm sim: Los ntawm sab ntawm cov hlab plawv thiab ntshav (hematopoiesis, hemostasis): tsis tshua muaj - thrombocytopenia, granulocytopenia, erythrocytopenia, pancytopenia, eosinophilia, leukocytopenia, agranulocytosis (mob tsawg kawg), muaj qee yam mob ntshav qab zib.

Los ntawm cov leeg hlwb thiab cov haujlwm hauv lub cev: hnov ​​mob taub hau, kiv taub hau, hloov pauv ntawm qhov hnov.

Los ntawm sab ntawm cov metabolism: hypoglycemia, proteinuria, lig cutaneous porphyria.

Los ntawm cov hnyuv: ua rau lub siab ua haujlwm, cholestasis, dyspepsia.

Kev ua xua: ua pob khaus tawv nqaij (erythema, exfoliative dermatitis).

Lwm yam: kub cev, mob pob txaws, mob polyuria, yuag yuag, photosensitivity.

Kev sib cuam tshuam: Systemic antifungals (azole derivatives), fluoroquinolones, tetracyclines, chloramphenicol (inhibits metabolism), H2-blockers, beta-blockers, ACE inhibitors, NSAIDs, MAO inhibitors, clofibrate, bezafibrat, probenecid, paracetamol, anabolic pentoxifylline, allopurinol, cyclophosphamide, reserpine, sulfonamides, insulin - potentiate hypoglycemia. Barbiturates, phenothiazines, diazoxide, glucocorticoid thiab cov thyroid hormones, estrogens, gestagens, glucagon, adrenomimetic tshuaj, lithium ntsev, nicotinic acid derivatives thiab saluretics ua kom cov nyhuv hypoglycemic. Cov chaw tso zis acidifying agents (ammonium chloride, calcium chloride, ascorbic acid nyob rau hauv cov koob tshuaj loj) txhim kho cov nyhuv (txo qis ntawm kev sib cais thiab nce kev rov pab dua). Nws yog tus synergist (ntxiv cov nyhuv) ntawm kev tiv thaiv tsis tau rau lwm tus. Rifampicin ua kom nrawm nrawm thiab txo qis kev ua haujlwm.

Overdose: Cov tsos mob: hypoglycemia (kev tshaib kev nqhis, tsis muaj zog loj, ntxhov siab, mob taub hau, kiv taub hau, tawm hws, mob taub hau, mob tshee, cerebral edema, tsis hnov ​​lus thiab tsis pom kev, tsis nco qab lawm thiab hypoglycemic coma, lub txiaj ntsig tuag).

Kev Kho Mob: hauv qee qhov mob sai sai - kev noj qab zib sai, tshuaj yej qab zib kub, kua txiv hmab txiv ntoo, pob kws phoov, zib ntab, nyob rau hauv rooj plaub loj - kev qhia txog 50% kua nplaum tov (50 ml iv thiab sab hauv), txuas ntxiv iv infusion ntawm 5-10% dextrose kev daws teeb meem, i / m tswj hwm ntawm glucagon 1-2 mg, diazoxide 200 mg qhov ncauj txhua 4 teev lossis 30 mg iv rau 30 feeb, nrog cerebral edema - mannitol thiab dexamethasone, saib xyuas glycemia (txhua 15 feeb), kev txiav txim siab pH, urea nitrogen, creatinine, electrolytes.

Muab thiab tua: Hauv, tsis ntxo, ntxuav nrog me me ntawm cov dej. Cov koob tshuaj txhua hnub yog xaiv ib tus zuj zus, nyob ntawm lub hnub nyoog, qhov hnyav ntawm cov ntshav qab zib, theem ntawm hyperglycemia, thiab feem ntau yog 1.25-20 mg (koob tshuaj thawj zaug yog 2.5-5 mg / hnub, qhov siab tshaj plaws txhua hnub koob tshuaj yog 20-25 mg), uas tau sau tseg rau hauv ib, ob, tsawg zaus - peb koob rau 30-60 feeb (cov ntawv me me rau 10-15 feeb) ua ntej noj mov. Nrog cov nyhuv tsis txaus, kev sib xyaw nrog biguanides thiab insulin yog ua tau.

Qhov ceeb toom: Rau kev tiv thaiv ntawm hypoglycemic tej yam kev mob, kev noj yuav tsum tau ua raws cai. Yuav tsum yog kev siv cov zaub mov tsis pub dhau 1 teev tom qab siv cov tshuaj. Thaum xaiv cov koob tshuaj rau lub hom phiaj pib lossis hloov los ntawm lwm cov tshuaj hypoglycemic, ib qho kev txiav txim siab tsis tu ncua ntawm cov piam thaj profile tau qhia (ntau zaus hauv ib lub lis piam). Hauv cov txheej txheem ntawm kev kho mob, kev tswj hwm ntawm qib ntawm cov piam thaj (glycosylated hemoglobin) hauv cov ntshav cov ntshav yuav tsum muaj (tsawg kawg 1 zaug hauv 3 hlis). Nws yuav tsum tau yug los hauv lub siab tias cov kab mob kev tshwm sim ntawm kev mob ntshav qab zib tuaj yeem muaj ntsej muag thaum noj beta-blockers, clonidine, reserpine, guanethidine. Nyob rau hauv cov ntaub ntawv ntawm hloov mus rau glibenclamide los ntawm cov tshuaj insulin ntawm ib koob ntawm 40 units / hnub lossis ntau dua, nyob rau thawj hnub ib nrab ntawm insulin thiab 5 mg ntawm glibenclamide tau raug kho nrog maj mam hloov kho ntawm cov koob tshuaj tom kawg raws li tsim nyog. Siv nrog kev ceeb toom rau cov neeg mob laus - lawv pib kho nrog ib nrab koob tshuaj, uas tom qab ntawd hloov los ntawm tsis ntau tshaj li 2.5 mg / hnub nrog txhua lim piam, nrog rau cov mob febrile. Kev kho mob nrog glibenclamide yuav tsum tsis kam haus cawv (disulfiram-zoo li ua tau), ncua ntev mus lub hnub thiab kev txwv ntawm cov khoom noj muaj roj. Thaum pib kho, kev ua si uas yuav tsum muaj qhov tshuaj tiv thaiv nce siab tsis pom zoo.

Cov neeg tsim khoom: LLC "Lub tuam txhab Tshuaj" Kev Noj Qab Haus Huv "Ukraine

PBX Code: A10B B01

Daim foos tso tawm: Cov ntaub ntawv muab tshuaj. Ntsiav tshuaj

Cov yam ntxwv dav dav. Muaj pes tsawg leeg:

Lub npe thoob ntiaj teb thiab tshuaj npe: glibenclamide, 5-chloro-N-amino-sulfonylphenylethyl-2-methoxybenzamide,
qhov yooj yim ntawm lub cev thiab tshuaj: cov ntsiav tshuaj dawb, daim ntawv tiaj tus-cylindrical nrog cov bevel,
muaj pes tsawg leeg: 1 ntsiav tshuaj muaj 5 mg glibenclamide,
excipients: mannitol, qos hmoov txhuv nplej siab, povidone, calcium stearate.

Cov yam ntxwv Pharmacological:

Cov Tshuaj Hauv Tshuaj Cov tshuaj tiv thaiv kab mob hypoglycemic, yog tiam thib ob ntawm sulfonylurea derivative. Cov suab thaj txo cov nyhuv ntawm cov tshuaj yog vim qhov ua haujlwm nyuaj ntawm kev txiav txim siab thiab ua haujlwm ntxiv.
Pancreatic kev txiav txim siab muaj nyob rau hauv kev ua kom muaj zog ntawm insulin los ntawm pancreatic b-cells, uas yog nrog los ntawm kev txhim kho thiab nce ntxiv ntawm cov tshuaj insulin endogenous. Cov nyhuv no yog vim muaj kev sib cuam tshuam ntawm glibenclamide nrog receptors sib xyaw ua ke ntawm cov qauv ntawm ATP-dependant K + channels ntawm plasma daim nyias nyias ntawm kev ua haujlwm b-hlwb ntawm tus txiav, txiav tawm ntawm lub xias cell, ua kom voltage-gated Ca2 + channels. Nws inhibits kev tso tawm ntawm glucagon los ntawm pancreatic hlwb.
Cov txiaj ntsig ua ke ntxiv nyob rau hauv kev nce rhiab ntawm peripheral cov ntaub so ntswg mus rau kev ua ntawm endogenous insulin, inhibiting cov synthesis ntawm qabzib thiab glycogen hauv daim siab.
Kev nce hauv cov ntshav insulin thiab txo cov ntshav hauv qabzib tau tshwm sim maj, uas txo txoj kev pheej hmoo ntawm cov ntshav hypoglycemic. Cov nyhuv hypoglycemic tsim tawm 2 teev tom qab kev tswj hwm, nce mus txog qhov siab kawg tom qab 7-8 teev thiab kav ntev txog 8-12 teev.
Glibenclamide ua rau lub ntsej muag ntxig ntawm pancreatic thiab plab hnyuv somatostatin (tab sis tsis yog glucagon), muaj cov nyhuv diuretic muaj txiaj ntsig (vim muaj qhov nce ntxiv ntawm lub raum ua kom tshem cov dej dawb). Txo txoj kev pheej hmoo ntawm kev txhim kho txhua yam mob uas tsis muaj cov tshuaj insulin-mob (vascular, cardiopathy) thiab ntshav qab zib ntsig txog kev tuag. Nws muaj cov hlab plawv thiab ua rau tsis nco qab.

Cov Tshuaj Pharmacokinetics Tom qab lub qhov ncauj tswj hwm, nws tau nrawm thiab yuav luag nqus los ntawm txoj hnyuv hauv lub plab. Noj yooj yim yuav maj mam nqus.
Qhov siab tshaj plaws hauv cov ntshav tom qab noj ib zaug yog ua tiav tom qab 1-2 teev Kev khi rau cov ntshav protein - ntau dua 98%. Nws nkag mus rau qhov tsis zoo los ntawm qhov chaw nres.
Nws yog biotransformed hauv daim siab ua ob lub cev tsis muaj zog (kwv yees li qhov sib npaug), ib tus tau tawm los ntawm lub raum, thiab lwm qhov yog cov kua tsib. Qhov kev tshem tawm ib nrab-lub neej yog 6-10 teev. Lub cev tsis ceev.
Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb. Hauv cov neeg mob uas lub raum lub raum tsis ua haujlwm me me txog qib nrab, tsis muaj qhov sib txawv hauv cov chaw muag tshuaj ntawm cov tshuaj, nrog rau qhov hnyav (creatinine tshem tawm tsawg dua 30 ml / min) kev sib txuam yog tau.

Muab thiab kev coj:

Muab tso rau sab hauv, 20-30 feeb ua ntej noj mov, tsis tas yuav zom, nrog me me ntawm kua (li ½ khob).
Cov koob tshuaj thaum pib thiab txij nkawm, lub sijhawm ntawm kev tswj hwm thiab faib rau cov koob tshuaj txhua hnub tau tsim ib lub zuj zus raws li cov txiaj ntsig tau los ntawm kev txiav txim siab tsis tu ncua ntawm cov piam thaj hauv cov ntshav thiab zis.
Thawj qhov tshuaj thawj zaug yog 2.5 mg (1/2 ntsiav tshuaj) 1 zaug hauv ib hnub. Yog tias tsim nyog, ib qho kev nce ntxiv rau hauv cov tshuaj txhua hnub yog nqa nrog kev saib xyuas tsis tu ncua ntawm cov ntshav qabzib, maj mam nce cov koob tshuaj nrog cov sijhawm nruab nrab ntawm ob peb hnub mus rau 1 lub lim tiam los ntawm 2.5 mg (1/2 ntsiav tshuaj) kom txog thaum txoj kev kho tau txais txiaj ntsig zoo. Qhov ua tau zoo tshaj plaws yog 15 mg (3 ntsiav tshuaj). Cov koob tshuaj saum toj 15 mg / hnub tsis nce qhov hnyav ntawm cov nyhuv hypoglycemic.
Ib koob tshuaj txhua hnub txog 10 mg (2 ntsiav tshuaj) noj 1 zaug hauv ib hnub, ua ntej noj tshais. Ntawm qhov siab dua txhua hnub, nws raug nquahu kom faib nws ua ob zaug hauv qhov sib piv ntawm 2: 1, thaum sawv ntxov thiab yav tsaus ntuj.
Hauv cov neeg mob laus, kev kho mob pib nrog ib nrab ib koob, uas txuas ntxiv nce ntxiv tsis ntau tshaj 2.5 mg / hnub nrog ib lis piam sib nrug.
Nrog rau kev hloov ntawm tus neeg mob lub cev qhov hnyav lossis kev ua neej nyob nrog rau qhov pom ntawm yam uas ua rau muaj kev pheej hmoo ntawm tus mob hypo- lossis hyperglycemia, yuav tsum tau txhaj tshuaj kom haum.
Siv ua ke nrog cov tshuaj insulin. Glibenclamide ua ke nrog cov tshuaj insulin yog sau tseg thaum nws tsis tuaj yeem ua kom tiav cov ntshav qabzib hauv cov ntshav los ntawm kev noj ntau tshaj plaws ntawm glibenclamide hauv kev kho mob monotherapy. Ntxiv mus, tiv thaiv keeb kwm yav dhau los ntawm kev txhaj tshuaj tiv thaiv kab mob glibenclamide kawg rau tus neeg mob, kev kho mob insulin pib nrog nws qhov kev siv tsawg kawg, nrog kev tshwm sim tom qab kev nce qib hauv koob tshuaj insulin nyob rau hauv kev tswj hwm ntawm cov ntshav qabzib concentration. Txoj kev kho mob sib xyaw ua ke yuav tsum muaj kev saib xyuas mob nkeeg tas li. Thaum muab cov tshuaj glibenclamide nrog cov tshuaj insulin, qhov kawg ntawm cov tom kawg tuaj yeem txo los ntawm 25-50%.
Tam sim no tsis muaj ntaub ntawv hais txog kev siv tshuaj yeeb los kho menyuam yaus.

Daim Ntawv Thov Nta:

Cov tshuaj yog siv nrog ceev faj thaum muaj mob febrile syndrome, haus dej cawv, mob qog (hypo- lossis), hauv cov neeg laus thiab cov neeg mob uas lub siab tsis zoo.
Nrog lub sijhawm kho mob hlwb ntev (ntau dua 5 xyoos), kev tiv thaiv kab mob zaum ob tuaj yeem tsim kho.
Saib xyuas cov ntsuas tsis zoo. Hauv kev kho mob nrog cov tshuaj, nws yog ib qho tsim nyog yuav tsum tau saib xyuas kom tsis txhob muaj cov kua nplaum hauv cov ntshav thiab zis (ntau zaus hauv ib lub lis piam thaum lub sijhawm xaiv cov tshuaj), nrog rau cov concentration ntawm glycosylated hemoglobin (tsawg kawg 1 zaug hauv 3 hlis), uas yuav ua rau pom sij hawm tiv thaiv ntawm thawj lossis theem siab tsis kam. rau cov tshuaj. Tsis tas li ntawd, nws yog ib qho tsim nyog los tswj lub siab ua haujlwm thiab daim duab ntawm cov ntshav nruab nrab (tshwj xeeb cov naj npawb ntawm platelets thiab leukocytes).
Cov kev mob uas yuav tsum tau hloov mus rau tus neeg mob los ntawm glibenclamide rau kev kho tshuaj insulin: kev mob nyhav, ntau qhov kev raug mob, kev phais mob ntau ntxiv, malabsorption ntawm cov zaub mov thiab tshuaj nyob rau hauv lub plab zom mov (mob hnyuv, mob plab paresis), ua rau lub siab thiab lub raum tsis ua haujlwm, suav nrog nyob ua hemodialysis. Qhov xav tau hloov chaw mus ib ntus rau insulin tuaj yeem tshwm sim hauv kev ntxhov siab (kev raug mob, kev phais mob, kev kis tus kab mob nrog rau mob npaws).
Kev pheej hmoo ntawm kev loj hlob thaum pib ntawm kev kho mob nrog glibenclamide. Hauv thawj lub lis piam ntawm kev kho mob, kev pheej hmoo ntawm kev txhim kho hypoglycemia tuaj yeem nce (tshwj xeeb yog cov zaub mov tsis xwm yeem lossis hla zaub mov noj). Cov xwm txheej hauv qab no tuaj yeem pab txhawb nws txoj kev txhim kho:
kev tsis txaus siab lossis (tshwj xeeb hauv hnub nyoog laus) tsis muaj peev xwm ntawm tus neeg mob kom koom tes nrog kws kho mob,
noj tsis xwm yeem, noj zaub mov tsis txaus, noj tsis txaus,
tsis sib xws ntawm kev qoj ib ce thiab kev ua kom yuag,
hloov pauv khoom noj
haus dej cawv, tshwj xeeb yog cov zaub mov tsis txaus los yog yoo mov noj,
lub raum tsis ua hauj lwm zoo,
mob siab ua rau daim siab,
haus tshuaj ntau dhau
tsis pom kev cuam tshuam cov kab mob ntawm cov endocrine system uas cuam tshuam rau cov metabolism hauv plhaws los yog kev tiv thaiv hypoglycemia (suav nrog kev ua haujlwm ntawm cov thyroid tsis ua haujlwm, pituitary lossis adrenocortical tsis txaus),
kev siv lwm cov tshuaj (thooj cuam nrog rau lwm cov tshuaj).
Cov tsos mob ntawm tus mob ntshav qab zib tsawg tej zaum yuav ua mob sib khuav los sis tsis tuaj thaum lub sijhawm nws loj hlob zuj zus hauv cov neeg laus, thiab hauv cov neeg mob tsis txaus lossis ib txwm tau txais kev kho mob nrog b-adrenoreceptor blockers, clonidine, reserpine, guanethidine, lossis lwm yam sympatholytics.

Cov tshuaj yuav tsum noj tsuas yog thaum lub sijhawm muab tshuaj thiab lub sijhawm sijhawm ntawm lub hnub.

Lub sijhawm ntawm kev tswj hwm thiab kev faib tawm ntawm cov tshuaj txhua hnub yog txiav txim los ntawm tus kws kho mob, coj mus rau hauv tus account yam ntxwv ntawm tus neeg mob lub hnub.
Yuav tsum tau yog pluas noj tsis pub dhau 1 teev tom qab siv cov tshuaj.
Yuav kom ua tiav qhov zoo tshaj plaws tswj cov qib glycemia thaum sau tshuaj glibenclamide, nws yog ib qho tsim nyog yuav tsum ua raws li kev noj zaub mov zoo, nqa tawm lub cev kev tawm dag zog thiab, yog tias tsim nyog, txo lub cev qhov hnyav. Koj yuav tsum tso tseg lub siab ntev tiv tshav ntuj thiab txwv kev siv cov zaub mov muaj roj.
Cov kev ua yuam kev hauv kev tswj hwm ntawm glibenclamide (tsis nco qab ntawm lub koob tshuaj vim tsis nco qab) tuaj yeem tsis muaj kev txhim kho los ntawm kev tswj hwm txuas ntxiv ntawm qhov siab dua. Tus kws kho mob thiab tus neeg mob yuav tsum xub tham txog cov kev ntsuas uas yuav tsum tau ua thaum muaj qhov yuam kev hauv kev siv tshuaj (hla ib koob, hla zaub mov) lossis hauv cov xwm txheej uas tsis tuaj yeem siv tshuaj thaum lub sijhawm.
Tus neeg mob yuav tsum qhia rau tus kws kho mob tam sim ntawd yog tias muaj qee qhov kev nqus tshuaj ntau dhau los yog muaj tshuaj ntau dhau.
Hloov chaw ntawm tus neeg mob mus rau glibenclamide los ntawm lwm qhov kev npaj sulfonylurea (tshwj tsis yog chlorpramide) thiab tshuaj insulin (koob tshuaj txhua hnub - ntau dua 40 units). Thaum hloov chaw rau tus neeg mob mus rau glibenclamide, nws raug nquahu kom nce cov koob tshuaj zuj zus. Nrog rau cov tshuaj insulin, ib nrab koob ntawm insulin thiab 5 mg ntawm glibenclamide tau sau tseg rau thawj hnub.
Cuam Tshuam rau kev muaj peev xwm tsav tsheb thiab ua haujlwm nrog tshuab. Thaum pib ntawm kev kho mob lossis nrog kev siv tsis xwm yeem ntawm glibenclamide, qhov kev txo qis ntawm kev saib xyuas thiab qhov ceev ntawm tus neeg mob psychomotor tshua vim yog hypo- lossis hyperglycemia tuaj yeem sau tseg. Hauv cov xwm txheej zoo li no, koj yuav tsum tsis txhob koom nrog cov kev ua phom sij uas yuav tsum muaj kev saib xyuas ntau dua thiab nrawm dua cov kev puas hlwb.

Phiv los sis:

Los ntawm ib sab ntawm cov metabolism. Kev mob ntshav qab zib, nrog rau kev ua hmo no (mob taub hau, tshaib plab, nkees, npau suav phem, qaug cawv lub xeev, tshee hnyo, tsis meej pem, hais lus thiab pom kev tsis zoo, tsis tshua muaj siab - coma). Tsis tas li ntawd, vim qhov tshwm sim ntawm adrenergic lub tswv yim kev tiv thaiv, qee zaum cov tsos mob hauv qab no yuav tshwm sim: khaub thuas, nplaum hws,. Kev tsis haum rau cawv, hnyav ntxiv, dyslipidemia, ua haujlwm ntawm adipose cov nqaij mos, tom qab siv ntev - hypothyroidism.
Los ntawm cov mob hauv plab zom mov. Qee zaum - xeev siab, zoo nkaus li hnyav thiab tsis xis nyob hauv lub epigastrium, mob plab, poob lossis nce hauv qab los noj mov, tsawg kawg - kev mob siab rau lub siab ua haujlwm, cholestatic jaundice,.
Los ntawm cov ntshav system. Tsis tshua muaj heev - hemolytic lossis aplastic, pancytopenia,.
Kev ua xua tsis haum. Tsis tshua muaj - erythema multiforme, exfoliative, photosensitivity. Kev phiv khaub thuas nrog lwm cov tshuaj sulfonylurea, tshuaj sulfonamides thiab thiazide zoo li cov tshuaj muaj peev xwm ua tau.
Lwm tus. hypoosmolarity lossis cov tsos mob ntawm qhov tsis muaj qhov tsis txaus ntawm cov tshuaj tiv thaiv antidiuretic (kev nyuaj siab, qaug zog, lub ntsej muag, pob taws thiab tes, cramps, ruam lossis rov qab, tsis nco qab), kev hloov chaw nyob ib ntus.

Kev cuam tshuam nrog lwm cov tshuaj:

Amplification hypoglycemic kev txiav txim ntawm glibenclamide zaum yuav tshwm sim thaum lub sij hawm siv insulin los yog lwm yam hypoglycemic tshuaj, angiotensin converting enzyme inhibitors, allopurinol, anabolic steroids thiab txiv neej nrog txiv neej pw cov tshuaj hormones, chloramphenicol, cimetidine, coumarin derivatives, cyclo-, Trojan thiab ifosfamide, fenfluramine, feniramidolom, fibrates, fluoxetine, guanethidine, MAO inhibitors, miconazole, fluconazole, pentoxifylline, phenylbutazone, oxyphenbutazone, azapropano om, Probenecid, salicylates, sulfinpyrazone, ntev-sawv sulfonamides, tetracyclines, tritokvalinom.
Kev qaug zog ntawm cov nyhuv hypoglycemic ntawm glibenclamide yog ua tau nrog siv tib txhij nrog acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) thiab lwm yam sympathomimetics, glucagon, laxatives (nrog rau siv ntev), thiab nws cov nicotinic acid , estrogens thiab progestogens, phenothiazine, phenytoin, rifampicin, cov thyroid hormones, cov roj ntsha lithium, chlorpromazine.
Ob qho kev ua kom muaj zog thiab ua kom cov ntshav hypoglycemic ntawm glibenclamide tuaj yeem pom nrog tib lub sijhawm siv nrog histamine H2 receptor blockers, clonidine thiab reserpine, ib leeg lossis mob cawv mus ntev.
Tawm tsam keeb kwm yav dhau los ntawm kev noj glibenclamide, ib qho kev nce los yog qaug zog ntawm kev nqis tes ua ntawm coumarin derivatives tuaj yeem pom.

Pharmacodynamics thiab pharmacokinetics

Glibenclamide yog qhov ncauj tshuaj hypoglycemic uas hais txog kev thiv thiv lwm tus neeg sulfonylureasCov. Cov txheej txheem ntawm kev ua ntawm Glibenclamide cuam tshuam nrog kev ua kom muaj kev sib luag ntawm β-cell zais cia hauv txiavlos ntawm kev nce tawm ntawm cov tshuaj insulin. Feem ntau, qhov ua tau zoo yog pom nyob rau theem ob ntawm insulin ntau lawm. Qhov no nce qhov rhiab ntawm peripheral cov ntaub so ntswg mus rau kev ua ntawm insulin, nrog rau nws txoj kev sib txuas nrog cov phiaj hlwb. Tsis tas li ntawd, glibenclamide yog tus cwj pwm los ntawm cov nyhuv hypolipidemic thiab txo qis hauv cov khoom muaj zog thrombogenic.

Sab hauv lub cev, kev ceev nrawm thiab kev nqus ntawm cov tshuaj los ntawm cov hnyuv tau sau tseg. Kev sib txuas lus nrog cov protein ntshav sib raug rau yuav luag 95%. cov tshuaj yog nqa tawm hauv daim siab, uas ua rau tsim muaj qhov tsis muaj zog. Kev nqhis dej feem ntau tshwm sim hauv cov khoom muaj zis thiab ib feem - bile, nyob rau hauv daim ntawv ntawm metabolites.

Cov lus qhia tshwj xeeb

Nws raug nquahu kom ua tib zoo kho cov neeg mob kev txom nyem los ntawm kev mob siab rau lub siab thiab lub raum, nrog rau cov teeb meem febrile, kev ua haujlwm ntawm lub qog ua haujlwm rau lub qog adrenal lossis lub caj pas cov thyroid caj pas, thiab cov cawv cawv ntev.

Rau tag nrho cov txheej txheem kev kho mob kom zoo, kev saib xyuas ntawm qib ntawm cov piam thaj hauv cov ntshav thiab cov kua nplaum tawm yog qhov tsim nyog.

Yog tias hypoglycemia txhim kho hauv cov neeg mob nco ntsoov, tom qab ntawd cov piam thaj lossis ntshav qab zib raug muab ntawm qhov ncauj. Thaum muaj mob tsis nco qab, qabzib yog tswj hwm dej, thiab glucagon - intramuscularly, subcutaneously lossis intravenously.

Thaum lub siab nco qab rov qab, tus neeg mob yog tam sim ntawd muab cov zaub mov nplua nuj nyob hauv cov khoom noj kom hnyav kom tsis txhob rov ua qog ntshav qab zib.

Glibenclamide yog tshuaj noj nrog hypoglycemic thaj chaw ntawm chav kawm ntawm thib ob tiam sulfonylurea derivatives. Nws kuj tseem muaj cov nyhuv hypolipidemic thiab txo qis kev pheej hmoo vascular thrombosis.

Tus yam ntxwv dav

Lub npe ntawm cov tshuaj Glibenclamide hauv cov txheej txheem thoob ntiaj teb hauv Latin yog Glibenclamide. Sab nraud, cov tshuaj yog lub teeb tsom liab ntsiav tshuaj hauv daim ntawv ntawm disc nrog txoj kab sib faib. Cov xim pleev xim tej zaum yuav muaj cov qauv pob zeb nrog kev txiav txim siab me.

Ntim cov ntsiav tshuaj hauv blisters 10 daim. Hauv ib lub thawv muaj peev xwm yuav muaj txog 12 daim hlau.

Glibenclamide raug tso tawm los ntawm cov tshuaj noj, muab khaws cia rau hauv ib qho xwm txheej, tsis muaj menyuam nkag los. Cov lus qhia tau hais tias lub txee lub neej ntawm cov tshuaj - 5 xyoo. Cov tshuaj uas tas sij hawm yuav tsum tsis txhob noj.

Txhua lub ntsiav tshuaj muaj 5 mg ntawm glibenclamide thiab excipients nyob rau hauv daim ntawv ntawm lactose monohydrate, qos hmoov txhuv nplej siab, magnesium stearate, polyvinylpyrrolidone, E 124.

Cov chaw tsim tshuaj kho mob tsim cov khoom nyob hauv qab zib:

Tshaj tawm nws thiab lub tuam txhab Ukrainian Kev Noj Qab Haus Huv. Rau Glibenclamide, tus nqi hauv cov khw muag tshuaj Lavxias yog 270-350 rubles.

Pharmacodynamics ntawm cov tshuaj

Tshuaj qhov ncauj hypoglycemic. Hauv Glibenclamide, qhov kev ua haujlwm ntawm kev txiav txim yog ua raws li kev ua kom muaj zog ntawm insulin ntau lawm los ntawm pancreatic cells-cells. Nyob rau tib lub sijhawm, kev tiv thaiv cov kab mob ntawm cov nqaij peripheral tsawg dua. Cov tshuaj ua haujlwm yog tias muaj kev ua haujlwm txaus in-hlwb hauv cov txiav ua kab mob rau cov tshuaj endogenous. Txo cov tshuaj thiab cov platelet ua ke.

Cov yam ntxwv ntawm Pharmacokinetic

Los ntawm lub plab zom mov tom qab qhov ncauj tswj hwm ntawm lub plab tas, cov tshuaj tau nqus sai sai, nws khi rau cov ntshav protein los ntawm 95%. Kev hloov pauv ntawm cov tshuaj nquag mus rau hauv kev ua kom nruab nrab plab yog nqa tawm hauv daim siab. Kev tshem tawm yog tswj los ntawm lub raum thiab bile ducts. Ib nrab-lub neej los ntawm cov hlab ntsha yog los ntawm ib thiab ib nrab rau peb thiab ib nrab xuaj moos. Cov piam thaj tswj hwm ib qho tshuaj ib zaug rau tsawg kawg 12 teev.

Nrog tus kab mob hepatic pathologies, kev tshem tawm tshuaj tiv thaiv yog inhibited.Yog hais tias daim siab ua haujlwm tau qhia nyob rau hauv daim ntawv tsis muaj zog, qhov no tsis cuam tshuam rau cov txheej txheem ntawm kev nthuav tawm ntawm metabolites;

Cov ntsiab lus ntawm nosological pawg

Cov ntsiav tshuaj dawb los yog dawb nrog lub ntsej muag daj lossis txho, ploskilindris nrog kev pheej hmoo.

Kev siv tshuaj hypoglycemic rau qhov ncauj tswj hwm ntawm sulfonylurea pawg ntawm tiam thib ob.

Glibenclamide muaj cov teebmeem ua pancreatic thiab extrapancreatic. Nws stimulates insulin secretion los ntawm kev txo qis qis ntawm pancreatic beta-cell glucose voos tshaj plaws, nce insulin rhiab heev thiab nws cov lus qhia rau lub hlwb phiaj, nce insulin tso tawm, txhim kho cov nyhuv ntawm insulin rau cov leeg nqaij thiab lub siab ua kom lub ntsej muag, thiab inhibits lipolysis hauv adipose cov ntaub so ntswg (ntxiv cov teebmeem ntawm pancreatic) Cov. Kev ua nyob rau theem ob ntawm insulin secretion. Nws muaj cov nyhuv hypolipidemic, txo cov yam ntxwv ua kom ntshav muaj zog.

Cov nyhuv hypoglycemic tshwm sim tom qab 2 teev, nce mus txog qhov siab kawg tom qab 7-8 teev thiab kav ntev li 12 teev. Cov tshuaj muab kev nce qib hauv cov tshuaj insulin zoo thiab nce qis hauv cov ntshav ntshav qabzib, uas txo cov kev pheej hmoo ntawm cov ntshav qog ntshav qab zib. Cov kev ua ntawm glibenclamide tau tshwm sim nrog kev ua haujlwm ua haujlwm endocrine ntawm lub txiav ua ke los coj cov tshuaj insulin.

Thaum noj ntawm qhov ncauj, nqus tawm ntawm txoj hnyuv plab yog 48-84%. Lub sijhawm kom mus txog qhov siab tshaj plaws yog 1-2 teev, qhov ntim ntawm kev faib tawm yog 9-10 litres. Kev sib txuas lus nrog cov protein ntshav yog 95-99%. Lub bioavailability ntawm glibenclamide yog 100%, uas tso cai rau koj noj cov tshuaj yuav luag ua ntej noj mov. Qhov tsis pub dhau ntawm qhov chaw hla tsis zoo. Yuav luag txhua qhov ua tiav nyob hauv daim siab nrog rau kev tsim ntawm ob lub cev tsis ua haujlwm, ib qho yog tawm los ntawm lub raum, thiab lwm qhov yog cov kua tsib. Qhov kev tshem tawm ib nrab-lub neej yog los ntawm 3 txog 10-16 teev.

Hom 2 mob ntshav qab zib mellitus nrog qhov tsis muaj txiaj ntsig ntawm kev kho mob kev noj haus.

ntshav qab zib hom 1

ketoacidosis, mob ntshav qab zib precoma thiab coma,

mob tom qab kuaj cov nqaij leeg nqaij,

mob siab ua rau daim siab,

mob raum tsis zoo,

hypersensitivity rau glibenclamide thiab / lossis lwm yam sulfonylurea derivatives, sulfonamides, diuretics muaj ib pawg sulfonamide nyob rau hauv cov qauv molecule, thiab probenecide, raws li paub los ntawm anamnesis hla kev rov qab tuaj yeem tshwm sim

decompensation ntawm carbohydrate metabolism hauv kev kis tus kab mob lossis tom qab kev phais mob loj thaum kev kho tshuaj insulin,

hnyuv ob leeg, paresis ntawm lub plab,

mob nrog malabsorption ntawm cov zaub mov thiab cov kev txhim kho ntawm hypoglycemia,

cev xeeb tub thiab lub sijhawm pub mis.

Glibenclamide yuav tsum tau siv rau:

cov kab mob qog (nrog rau lub cev tsis zoo),

hypofunctions ntawm anterior pituitary lossis adrenal cortex,

hauv cov neeg laus cov neeg mob vim tias qhov txaus ntshai ntawm kev txhim kho hypoglycemia.

Qhov cuam tshuam tshwm sim tshaj plaws nyob rau hauv kev kho mob ntawm glibenclamide yog ntshav qog. Tus mob no tuaj yeem coj qhov xwm txheej ntev ntev thiab pab txhawb rau kev txhim kho ntawm cov mob hnyav, mus txog rau comatose, lub neej mob tus neeg mob lossis xaus rau lub cev tuag. Nrog rau cov mob ntshav qab zib polyneuropathy lossis nrog kev kho mob nrog cov tshuaj sympatholytic (saib ntu "Kev cuam tshuam nrog lwm cov tshuaj"), cov xwm txheej ua ntej ntawm hypoglycemia yuav tsis tshua mob los sis tsis tuaj yeem ua rau nws tas li.

Cov laj thawj rau kev txhim kho hypoglycemia tuaj yeem yog: kev noj ntau dhau ntawm cov tshuaj, kev qhia tsis raug, noj mov tsis xwm yeem, cov neeg laus cov neeg mob, ntuav, raws plab, lub cev ntau dhau, cov kab mob uas txo qis qhov xav tau ntawm insulin (kev mob siab rau lub siab thiab lub raum kev ua haujlwm, kev ua haujlwm ntawm adrenal cortex, pituitary lossis thyroid caj pas) , kev haus cawv, nrog rau kev cuam tshuam nrog lwm cov tshuaj (saib Ntu "Kev cuam tshuam nrog lwm cov tshuaj"). Cov tsos mob ntawm tus mob hypoglycemia yog: kev tshaib nqhis heev, tawm hws sai sai, tawm hws, tawv nqaij, tawv nqaij hauv lub qhov ncauj, tshee tshee, kev ntxhov siab, mob taub hau, mob taub hau, pw tsaug zog, ntxhov siab, ntshai tsam, kev sib koom tes ntawm kev txav mus los, ua rau mob hlwb ib ntus (piv txwv li kev pom thiab hais lus tsis meej, kev pom ntawm paresis lossis tuag tes tuag taw lossis hloov qhov kev nkag siab ntawm kev xav). Nrog rau kev nce qib ntawm hypoglycemia, cov neeg mob yuav plam lawv tus kheej kev tswj hwm thiab kev nco qab. Feem ntau xws li tus neeg mob tau ntub, tawv nqaij txias thiab ua kom rov zoo mob.

Ua ke nrog hypoglycemia, cov hauv qab no yog tau:

Digestive System Kev Tsis Txaus Siab: tsis tshua muaj kev xeev siab, ntuav, ntuav, saj "xim hlau" hauv qhov ncauj, zoo nkaus li hnyav thiab puv hauv plab, mob plab thiab raws plab. Qee qhov xwm txheej, kev nce siab ib ntus hauv cov dej num ntawm daim siab "siab" phiv (alkaline phosphatase, glutamine-oxalacetic acetic aminotransferase, glutamine-pyruvic aminotransferase) hauv ntshav cov ntshav, tshuaj tiv thaiv kab mob siab thiab daj ntseg tau piav qhia.

Tsis tshua muaj tshwm sim kev tawv nqaij ua xua: tawm pob khaus, khaus ntawm daim tawv nqaij, urticaria, liab ntawm daim tawv nqaij, Quincke's edema, pom cov ntshav tawm hauv daim tawv, khaus tawm pob rau ntawm qhov chaw loj ntawm cov tawv nqaij thiab nce ntxiv ntawm qhov tawv nqaij. Tsis tshua muaj tshwm sim, cov tawv nqaij ua haujlwm tuaj yeem ua lub hauv paus pib ntawm kev txhim kho ntawm cov mob hnyav, nrog los ntawm kev ua pa luv thiab txo ntshav siab kom txog thaum pib ntawm kev poob siab, uas tsim kev hem thawj rau tus neeg mob lub neej. Tej tus neeg tau piav qhia cov kev tsis haum tshuaj loj nrog daim tawv nqaij ua pob xoo, sib koom tes mob, ua npaws, qhov tshwm sim ntawm cov protein nyob hauv cov zis thiab lub cev daj.

Los ntawm cov kab ke hemopoietic: thrombocytogeny tsis tshua pom muaj los yog muaj feem ntau mob leukocytopeia, agranulocytosis. Hauv cov teeb meem sib cais, hemolytic anemia lossis pancytopenia txhim kho.

Rau lwm cov kev phiv pom nyob rau hauv cov teeb meem raug mob cais tawm muaj xws li: lub zog diuretic tsis zoo, qhov pom tshwm sim ib ntus ntawm cov protein nyob hauv cov zis, qhov pom kev tsis zoo thiab chaw nyob, nrog rau kev cuam tshuam ntawm cov cawv tsis txaus ntseeg tom qab haus cawv, qhia los ntawm cov teeb meem ntawm cov ntshav ncig thiab ua pa ntawm lub cev (disulfira-xws li cov tshuaj tiv thaiv: ntuav, hnov tshav kub hauv lub ntsej muag thiab lub cev sab saud, tachycardia, kiv taub hau, mob taub hau).

Thaum tus neeg noj ntau dhau, txoj kev txhim kho ntawm lub qog ntshav qab zib muaj peev xwm ua tau.

Nrog rau cov ntshav qog ua ntshav lossis ntshav txhaws, ntshav qabzib lossis ntshav qab zib yog noj ntawm qhov ncauj.

Thaum muaj mob ntshav qab zib tsawg (tsis nco qab lawm), ib qho 40% dextrose (qabzib) tshuaj lossis glucagon yog tso tshuaj rau hauv qhov txhab, intramuscularly, subcutaneously.

Tom qab nws rov qab nco qab, tus neeg mob yuav tsum tau muab cov zaub mov nplua nuj nyob hauv cov khoom noj kom hnyav kom tsis txhob muaj kev rov qab txhim kho ntawm hypoglycemia.

Ntxiv dag zog rau cov nyhuv hypoglycemic ntawm Glibenclamide tau pom nrog kev siv tib lub sijhawm ntawm angiotensin-inhibiting enzyme inhibitors, tus neeg sawv cev anabolic.

lwm cov tshuaj tiv thaiv ntawm cov tshuaj hypoglycemic (piv txwv li, acarbose, biguanides) thiab insulin, tshuaj tsis-steroidal anti-inflammatory tshuaj (NSAIDs), beta-blockers, quinine, quinolone derivatives, chloramphenicol, clofibrate, coumarin derivatives, disoyramidine, microfenoxylamine, fenfluon-faminfenfaminos, fenfluzamin, fenfluzamin, fenfluzaminos, fenfluzaminos, fenfen para-aminosalicylic acid, pentoxifylline (hauv kev txhaj tshuaj loj yog muab niam txiv), perhexiline, pyrazolone derivatives, phenylbutazones, phosphamides (e.g. cyclophosphamide, ifos amide, trofosfamide), probenecid, salicylates, sulfinpirazona, sulphonamides, tetracyclines thiab tritokvalina. Zis acidifying agents (ammonium chloride, calcium chloride) txhim kho cov nyhuv ntawm glibenclamide los ntawm kev txo qis hauv nws cov kev cuam tshuam thiab nce o rov kho dua.

Cov tshuaj noj uas ua kom cov leeg hlwb hematopoiesis ua rau muaj kev pheej hmoo ntawm myelosuppression.

Nrog rau kev nce siab ntawm hypoglycemic, beta-blockers, clonilip, guanethidine thiab reserpine, ntxiv rau cov tshuaj nrog qhov nruab nrab ntawm kev ua, yuav ua rau lub zog ntawm qhov ua ntej ntawm hypoglycemia.

Cov nyhuv hypoglycemic ntawm glibenclamide tuaj yeem txo qis nrog kev siv tib lub sijhawm ntawm barbiturates, isoniazid, cyclosporine, diazoxide, glucorticostrosroids, glucagon, nicotinates (hauv siab), phenytoin, phenothiazines, rifampicipi, thiazide diuretics, acetaminophen dimes, cov ua cov thyroid caj pas, cov blockers ntawm "qeeb" calcium channel, cov neeg ua mob sympathomimetic thiab cov ntsev lithium.

Kev siv dej cawv thiab tshuaj yeeb dej cawv ntev dhau los yuav ua rau kev ua txhaum ntawm cov metabolism hauv cov metabolism.

H2 receptor antagonists tuaj yeem ua kom tsis muaj zog, ntawm ib sab tes, thiab txhim kho cov nyhuv hypoglycemic ntawm Glibenclamide ntawm lwm yam. Muaj qee zaus, pentamidine tuaj yeem ua rau muaj zog txo lossis nce ntxiv hauv cov ntshav cov piam thaj. Cov nyhuv ntawm coumarin derivatives yuav nce ntxiv lossis txo qis.

Nrog rau cov tshuaj tiv thaiv hypoglycemic ntau ntxiv ntawm beta-blockers, clonidine, guanethidine thiab reserpine, ntxiv rau cov tshuaj nrog qhov ua haujlwm nruab nrab ntawm kev txiav txim, tuaj yeem ua rau lub zog ntawm qhov ua ntej ntawm hypoglycemia.

Cov tshuaj yuav tsum tau noj tsis tu ncua thiab, yog tias ua tau, tib lub sijhawm. Nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas kev coj ntawm cov tshuaj thiab kev noj haus.

Tus kws kho mob yuav tsum ua tib zoo xav txog kev teem sij hawm ntawm Glibenclamide rau cov neeg mob uas lub siab thiab lub raum tsis ua haujlwm, nrog rau kev ua rau lub qog ua haujlwm rau lub qog ua ntshav, lub plav ntawm lub raum lossis adrenal cortex. Qhov kev hloov kho koob tshuaj Glibenclamide yog qhov tsim nyog nrog lub cev thiab lub siab lub ntsws dhau los, kev hloov pauv ntawm cov zaub mov noj. Kev phais mob thiab kev raug mob loj, kev kub nyhiab, kab mob kis nrog febrile syndrome yuav tsum tsis siv tshuaj txuas ntxiv hauv qhov ncauj thiab ua cov tshuaj insulin.

Cov neeg mob yuav tsum ceeb toom qhia txog kev pheej hmoo yuav txo ntshav qab zib hauv lub cev thaum haus cawv, NSAIDs, thiab kev tshaib plab.

Thaum pib kho, thaum xaiv cov koob tshuaj, cov neeg mob nquag txhim kho hypoglycemia tsis tau hais kom koom nrog cov haujlwm uas xav tau kev saib xyuas ntau ntxiv thiab ceev ntawm cov kev tiv thaiv psychomotor.

Thaum kho cov neeg mob uas tsis muaj lactase, nws yuav tsum tau yug los rau hauv lub siab tias cov tshuaj muaj lactose monohydrate.

Hauv qhov chaw tsaus li ntawm qhov kub thiab txias tsis siab tshaj 25 ° C.

Txhob nyob ze cov me nyuam.

Cov Cai Siv Tshuaj So

Cov tshuaj muaj antithrombotic, lipid-txo qis thiab tshuaj qog ntshavntawv.

Dosages thiab kev kho mob

Glibenclamide pom zoo rau kev siv tam sim ntawd tom qab noj mov. Tus kws kuaj mob endocrinologist laij qhov ntau ntxiv nyob rau ntawm cov txiaj ntsig kev kuaj ntshav rau qab zib, lub hnub nyoog ntawm tus neeg mob, qhov mob hnyav ntawm lub hauv paus, kab mob sib deev thiab kev noj qab haus huv feem ntau.

Nyob rau thawj theem ntawm tus kabmob, tus qauv kev cai yog 2.5-5 mg / hnub. Siv cov tshuaj ib zaug tom qab noj tshais. Yog tias kev them nyiaj tiav rau kev mob glycemia tsis tuaj yeem ua tiav, tus kws kho mob tuaj yeem hloov qhov tshuaj los ntawm kev ntxiv 2.5 mg ntawm cov tshuaj tom qab ib lub lim tiam. Tus nqi txij nkawm (nce txog 15 mg / hnub) yog sib npaug rau peb ntsiav tshuaj. Qhov siab tshaj plaws yog qhov tsis tshua muaj tshuaj, thiab tsis muaj qhov tshwm sim tseem ceeb hauv glycemia.

Yog tias tus mob ntshav qab zib muaj lub cev hnyav dua li 50 kg, thawj koob tau muab rau hauv 2.5 mg, uas sib haum rau ib nrab ntawm cov ntsiav tshuaj. Yog tias qhov kev cai niaj hnub tsis pub dhau ob daim, lawv qaug cawv thaum sawv ntxov thaum noj tshais, lwm qhov, cov tshuaj tau faib ob zaug, thaum sawv ntxov thiab yav tsaus ntuj hauv qhov sib piv ntawm 2: 1.

Thaum Glibenclamide pauv mus rau tom qab tau txais kev kho mob zoo nrog lwm cov tshuaj hypoglycemic, qhov pib noj yuav yog 2.5 mg ib zaug, thaum sawv ntxov.

Nrog rau cov txiaj ntsig tsis zoo, koj tuaj yeem kho cov kev cai txhua lub lim tiam los ntawm kev ntxiv 2.5 mg.

Yog tias qhov tshwm sim ntawm kev kho nrog lwm cov tshuaj tiv thaiv kab mob ua kom tsis haum, qhov pib yuav yog 5 mg thaum sawv ntxov, tom qab noj mov. Yog tias tsim nyog, yuav tsum kho ua ntej 2.5-5 mg txhua lub lim tiam tau tso cai. Kev txwv tsis pub dhau tseem nyob tib yam - 15 mg / hnub.

Yog tias qhov siab niaj hnub niaj hnub tshaj plaws ntawm Glibenclamide, thaum soj ntsuam cov zaub mov tsis zoo thiab kev ua kom lub cev tsis zoo, tsis muab 100% cov nyiaj qab zib, ntshav qab zib tau pauv mus rau kev kho kom zoo. Cov tshuaj tseem ceeb yog ntxiv nrog biguanides, insulin, thiab lwm yam kab mob hypoglycemic.

Yog tias kev tsim cov tshuaj endogenous ntawm cov tshuaj insulin hauv cov neeg mob ntshav qab zib nrog hom mob thib ob yog kev cuam tshuam tag, kev kho mob tsis tuaj yeem lav tsis tau tib yam li kev kho mob monotherapy nrog kev npaj tshuaj insulin.

Yog tias, vim qee qhov laj thawj, lub sijhawm noj Glibenclamide tau ploj mus ntau dua li ib teev lossis ob teev, koj tsis tuaj yeem siv cov tshuaj no yav tom ntej. Tag kis sawv ntxov, noj ib qho qauv koob tshuaj, tsis pom zoo nce qhov nce qib.

Sab sij huam

Nrog kev siv tshuaj ntau dhau ntawm cov tshuaj, hypoglycemic lub xeev ntawm qhov mob sib txawv tau, nrog rau tsis nco qab. Nrog rau kev haus dej cawv thiab ib lossis ob pluas noj nyob rau ib hnub, ua haujlwm dhau lawm, muaj teeb meem rau daim siab, lub qog thiab lub raum, lub txim tsis muaj qhov xav tau kuj muaj.

Cov Ntsej Muag ntawm Overdose ntawm Glibenclamide

Kev siv cov txheej txheem ntawm kev noj ntau dhau ntawm cov tshuaj provokes hypoglycemia loj heev, uas yog qhov txaus ntshai rau lub neej ntawm tus neeg raug tsim txom.

Cov txiaj ntsig zoo sib xws tuaj yeem tau nrog kev siv cov tshuaj tiv thaiv cov keeb kwm yav dhau los ntawm kev noj zaub mov tsis huv, kev ua haujlwm lub cev, kev cuam tshuam ntawm qee yam tshuaj noj ua ke nrog Glibenclamide.

Cov tsos mob ntawm tus mob hypoglycemic:

• Tswj tsis tau kev tshaib plab
• Tsis nqhuag zoo
• Tsom
• Rawg
• Muaj hws ntau
• Mob taub hau
• Dyspeptic mob
• Kev hypertonicity
• Tes tshee
• Tachycardia.

Kev tsis sib haum xeeb hauv kev ua haujlwm ntawm psyche nrog teeb meem endocrine tuaj yeem ua rau tsis meej pem nco qab, nkees nkees, cramps, kev sib tsoo tsis muaj zog, ua tsis taus siab, cais ua kom pom tseeb, ceeb thaum tsav tsheb lossis tswj cov txheej txheem, cov xeev tsis txaus, txhoj puab heev, teeb meem ntawm cov hlab ntsha thiab lub plab ua pa, coma.

Ob leeg nyob rau hauv meej thiab nyob rau hauv daim ntawv txheeb ze ntawm kev overdose, hypoglycemia yuav muaj kev hais zoo dua piv nrog kev noj ntau dhau ntawm thawj tiam sulfanylurea derivatives.

Txhawm rau txo tus mob ntawm tus neeg mob nrog mob me me mus rau mob hnyav ntawm qhov kev tawm tsam, koj tuaj yeem noj cov zaub mov sai sai - khoom qab zib, ib nrab khob dej qab zib nrog qab zib lossis kua txiv (tsis muaj khoom qab zib). Yog tias qhov kev ntsuas tsis tau txuas ntxiv, cov piam thaj (40%) lossis Dextrose (5-10%) tau txhaj rau hauv cov leeg ntshav, glucagon (1 mg) txhaj rau hauv cov leeg. Diazoxide tuaj yeem noj ntawm qhov ncauj. Yog tias tus neeg mob tau coj acarbose, qhov ncauj ntawm qhov ncauj ntshav qab zib tuaj yeem kho kho tsuas yog nrog cov piam thaj, tab sis tsis yog nrog oligosaccharides.

Yog tias tus neeg raug mob ntshav qab zib tseem tseem nco qab, qab zib yog tsim rau sab hauv. Thaum poob ntawm kev nco qab, qabzib yog siv iv, glucagon - iv, iv thiab hauv qab ntawm daim tawv nqaij. Yog tias nco qab tau rov qab los, rau kev tiv thaiv kom rov huam mob, qhov mob ntshav qab zib yuav tsum tau txais kev noj zaub mov zoo raws li kev ua si sai.

Kev tshuaj xyuas ntawm glycemia, pH, creatinine, electrolytes, urea nitrogen yog soj qab txhua zaus.

Kev Tshuaj Ntsuam Xyuas Cov Tshuaj Glibenclamide

Kev nthuav tawm ntawm glimenclamide qeeb, thaum txhim kho nws lub peev xwm hypoglycemic, azopropanone, miconazole, coumaric acid npaj, oxyphenbutazone, sulfonamide pawg tshuaj, phenylbutazone, sulfapyrazonfeniramidol.

Ua ke nrog kev kho mob nrog lwm cov tshuaj qab zib uas txo cov tshuaj insulin kuj ua rau pom cov txiaj ntsig zoo sib xws.

Nrog rau kev siv cov tshuaj anabolic tib lub sijhawm, allopurinol, cimetidine, β-adrenoreceptor blockers, cyclophosphamide, guanethidine, clofibric acid, monoamine oxidase inhibitors, sulfonamides nrog kev ua lub sijhawm ntev, salicylates, tetracyclines, cawv, hypoglycemic cov khoom ntawm theem pib yog ua tau.

Yog tias cov tshuaj kho mob muaj barbiturates, chlorpromazine, rifampicin, diazoxide, adrenaline, acetazolamide, lwm cov tshuaj sympathomimetic, glucocorticosteroids, glucagon, indomethacin, diuretics, suav nrog acetazolamide, nicotinate (hauv koob tshuaj loj), phenothiazines, phenytinoids, caj pas , saluretics, lithium ntsev, loj haus dej cawv thiab laxative, cov nyhuv ntawm glimenclamide tsawg dua.

Cov txiaj ntsig tsis tau tshwm sim ntawm kev sib txuam nrog kev siv loj yog qhia los ntawm H2 receptor antagonists.