MANINIL 3

nyob rau hauv lub khob ntim ntawm 120 pcs., hauv ib pob ntawv los ntawm cov thawv ntawv 1 lub raj mis lossis hauv ib lub hlwv ntim 10 lossis 20 pcs., hauv ib pob khoom ntawm cardboard 3 blisters.

nyob rau hauv lub khob ntim ntawm 120 pcs., hauv ib pob ntawv los ntawm cov thawv ntawv 1 lub raj mis lossis hauv ib lub hlwv ntim 10 lossis 20 pcs., hauv ib pob khoom ntawm cardboard 3 blisters.

nyob rau hauv lub khob ntim ntawm 120 pcs., hauv ib pob ntawv los ntawm 1 lub khob ntawv los yog hauv ib lub hlwv ntim ntawm 20 pcs., hauv ib pob ntawv ntawm cardboard 1, 2, 3, 4 lossis 6 blisters.

Cov Tshuaj Pharmacokinetics

Tom qab noj ntawm Maninil 3.5, kev nqus sai thiab yuav luag tiav los ntawm cov hnyuv tau pom. Tso tawm tag nrho ntawm cov tshuaj microionized nquag tshwm sim hauv 5 feeb.
Plasma protein khi yog ntau tshaj li 98% rau Maninyl 3,5, 95%.
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.
T1 / 2 rau Maninyl 3.5 yog 1.5-3.5 teev.

Txoj kev ntawm daim ntawv thov

Maninil 3.5 noj ntawm qhov ncauj, tag kis sawv ntxov thiab yav tsaus ntuj, ua ntej noj mov, tsis yog ntxo. Cov koob tshuaj tau teeb tsa ib leeg zuj zus, nyob ntawm qhov mob hnyav ntawm tus kab mob.
Thawj qhov tshuaj yog 1 / 2-1 ntsiav tshuaj, qhov nruab nrab yog 1 ntsiav tshuaj. tauj ib hnub, qhov ntau - 3, tshwj tsis yog - 4 ntsiav tshuaj. ib hnub.
Cov koob tshuaj txhua hnub txog li 2 ntsiav tshuaj. feem ntau noj ib zaug (thaum sawv ntxov), siab dua - muab faib ua 2 koob tshuaj (sawv ntxov thiab yav tsaus ntuj).

Sab sij huam

Kev mob ntshav qab zib yog ua tau (nrog cov zaub mov noj qab haus huv, noj tshuaj ntau dhau, nrog rau lub cev ua kom lub cev ntau ntxiv, nrog rau kev haus dej cawv ntau).
Los ntawm cov hnyuv hauv plab: qee zaus - xeev siab, ntuav, qee kis - mob cholestatic daj ntseg, kab mob siab.
Los ntawm cov kab mob hemopoietic: tsis tshua muaj mob - thrombocytopenia, granulocytopenia, erythrocytopenia (txog pancytopenia), qee kis - mob ntshav khov hemolytic.
Ua xua: tsis tshua muaj tshwm sim - xoo pob khaus, ua npaws, mob sib koom tes, proteinuria.
Lwm yam: thaum pib ntawm kev kho mob, kev hloov chaw nyob qhov tsis yooj yim yog qhov ua tau. Nyob rau hauv tsawg zaus, photosensitivity.

Cov Yuav Tsum Tau Ua

Cov tshuaj tiv thaiv kom zoo rau kev siv tshuaj Maninil 3.5 yog: hypersensitivity (suav nrog rau cov tshuaj sulfonamide thiab lwm yam sulfonylurea derivatives), hom 1 mob ntshav qab zib mellitus (insulin-dependant), tshuaj tiv thaiv metabolic decompensation (ketoacidosis, precoma, coma), lub xeev tom qab pancreatic resection, kab mob siab thiab mob raum, qee qhov mob hnyav (piv txwv li, decompensation ntawm carbohydrate metabolism hauv cov kab mob sib kis, kub hnyiab, raug mob lossis tom qab phais mob loj thaum siv tshuaj tua kab mob insulin), mob leukopenia, mob plab hnyuv tawm, paired h mob plab, tej yam kev mob uas cuam tshuam nrog kev tsis taus ntawm kev noj zaub mov thiab kev txhim kho hypoglycemia, cev xeeb tub thiab lub sijhawm pub mis.

Kev cuam tshuam nrog lwm yam tshuaj

Lub zog ua kom cov ntshav txo qis ntawm cov tshuaj Maninil 3.5 ua tau nrog kev siv sib xyaw nrog ACE inhibitors, tus neeg sawv cev anabolic thiab txiv neej poj niam txiv neej cov tshuaj hormones, lwm yam kab mob hypoglycemic hauv qhov ncauj (piv txwv li, acarbose, biguanides) thiab insulin, azapropazone, NSAIDs, beta-blockers, quinolone derivatives, chloramphenicol, clomofiber, disopyramide, fenfluramine, tshuaj tua kab mob (miconazole, fluconazole), fluoxetine, MAO inhibitors, PASK, pentoxifylline (hauv koob tshuaj ntau rau kev tswj hwm ntawm cov niam txiv noj mov), perhexiline, pyrazolone derivatives, phosphamides (e.g. cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfonamides, tetracyclines thiab tritoqualin.
Cov neeg tso zis acidifying agents (ammonium chloride, calcium chloride) txhim kho cov nyhuv ntawm cov tshuaj Maninyl los ntawm kev txo qis hauv nws cov neeg ua haujlwm tsis zoo thiab nce ntxiv kev rov kho dua.
Cov nyhuv hypoglycemic ntawm cov tshuaj Maninil tuaj yeem txo qis nrog kev siv barbiturates tib lub sijhawm, isoniazid, diazoxide, GCS, glucagon, nicotinates (hauv kev txhaj tshuaj ntau), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, tshuaj tiv thaiv qhov ncauj thiab tshuaj tiv thaiv estrogen, tshuaj hormones estrogen, estrogen cov tshuaj hormones, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen, cov tshuaj hormones estrogen. blockers ntawm qeeb calcium calcium, lithium ntsev.
H2 receptor antagonists tuaj yeem ua kom tsis muaj zog, ntawm ib sab tes, thiab, ntawm lwm qhov, txhim kho cov nyhuv hypoglycemic ntawm Maninil.
Muaj qee zaus, pentamidine tuaj yeem ua rau muaj zog txo lossis nce ntxiv hauv cov ntshav cov piam thaj.
Nrog rau kev siv ua ke nrog cov tshuaj, Maninil tuaj yeem txhim kho lossis txo cov nyhuv ntawm coumarin derivatives.
Nrog rau kev nce siab ntawm hypoglycemic, beta-blockers, clonidine, guanethidine thiab reserpine, nrog rau cov tshuaj nrog qhov ua haujlwm nruab nrab ntawm kev txiav txim siab, tuaj yeem ua rau tsis muaj zog ntawm cov tsos mob ntawm hypoglycemia.

Noj ntau dhau

Nrog kev nce kho ntawm hypoglycemia, tus neeg mob tuaj yeem plam tus kheej thiab tus kheej nco qab, qhov kev txhim kho ntawm hypoglycemic coma.
Kev Kho Mob: Yog tias qhov mob ntshav qab zib tsawg, tus neeg mob yuav tsum nqa ib qho qab zib, zaub mov lossis dej qab zib nrog cov piam thaj hauv siab (jam, zib ntab, ib khob dej qab zib) hauv. Yog tias tsis nco qab, nws yog ib qhov tsim nyog yuav tau txhaj iv qabzib - 40-80 ml ntawm 40% dextrose tov (qabzib), tom qab ntawd ua li ntawm 5-10% dextrose tov. Tom qab ntawd koj tuaj yeem txuas ntxiv rau 1 mg ntawm glucagon hauv / hauv, / m lossis s / c. Yog tias tus neeg mob tsis rov qab nco qab, ces qhov kev ntsuas no tuaj yeem rov qab ua dua; ntxiv mus, yuav tsum muaj kev kho mob hnyav ntxiv.

Daim ntawv tso tawm

Maninil 3.5 - ntsiav tshuaj.
Ntim - hauv cov iav fwj ntawm 120 pcs., Hauv ib pob ntawv los ntawm cardboard hauv 30 lossis 60 pcs.

1 ntsiav tshuaj Maninil 3.5 muaj cov tshuaj uas nquag: glibenclamide (hauv micronized form) 3.5 mg.
Cov muaj mob: cov lactose monohydrate, cov hmoov txhuv nplej siab, gimetellosa, colloidal silicon dioxide, magnesium stearate, zas xim liab (Ponceau 4R) (E124)

Pharmacological kev txiav txim

Nws muaj cov teebmeem pancreatic thiab cov teebmeem ntxiv. Pancreatic kev ua haujlwm tau tshwm sim hauv kev tsim tawm ntawm insulin ntau ntau los ntawm pancreatic beta hlwb, thiab cov haujlwm ntawm cov neeg ua haujlwm sab nrauv tau tshwm sim hauv kev nce siab ntawm lub hom phiaj nqaij insulin receptors (vim muaj tyrosine kinase stimulation) rau insulin, thiab kev tawm ntawm gluconeogenesis thiab glycogenolysis hauv daim siab.

Cov Chaw Tshuaj Kho Mob

Micronized cov duab muab cov txiaj ntsig ua ntej dhau los ntawm C_max , Kev sib haum xeeb ntawm cov nyhuv hypoglycemic siv sib haum rau lub ncov ntawm postprandial hyperglycemia, uas ua kom lub cev muaj txiaj ntsig ntawm nws hauv kev sib xyaw nrog T luv_1/2 txo txoj kev pheej hmoo ntawm hypoglycemia. Qhov niaj hnub xav tau rau glibenclamide tuaj yeem txo los ntawm 30-40%.

Kev tiv thaiv kev nyab xeeb

Nws yog siv nrog kev ceev faj thaum muaj mob febrile syndrome, mob qog (nrog rau lub cev tsis zoo), hypofunction ntawm anterior pituitary lossis adrenal cortex, kev quav dej quav cawv, hauv cov neeg laus vim tias muaj feem ntau yuav txhim kho hypoglycemia. Yuav tsum muaj kev saib xyuas mob niaj hnub. Thaum kho, koj yuav tsum nruj kev noj zaub mov kom zoo. Noj Maninil tsis hloov cov khoom noj. Thaum kho, nws tsis pom zoo kom koom rau hauv cov haujlwm uas yuav tsum muaj kev xav thiab qhov nrawm ntawm lub cev kev xav, kom nyob hauv lub hnub ntev. Ib qho kev hloov kho koob tshuaj yog qhov tsim nyog rau kev tawm dag zog lub cev thiab lub siab, hloov kev noj zaub mov.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

Cov koob tshuaj tau teeb tsa ib leeg zuj zus, nyob ntawm hnub nyoog, mob ntshav qab zib ntau yam, yoo mov glycemia thiab 2 teev tom qab noj mov.

Qhov nruab nrab koob yog 2.5-15 mg / hnub, qhov ntau zaus ntawm kev tswj hwm yog 1-3 zaug / hnub. Noj 20-30 feeb ua ntej noj mov. Hauv kev noj ntau dua 15 mg / hnub, nws yog siv rau hauv qee qhov tsis tshua muaj thiab tsis ua rau muaj kev cuam tshuam ntau ntxiv hauv cov nyhuv hypoglycemic.

Rau cov neeg mob laus, cov koob tshuaj thawj zaug yog 1 mg / hnub.

Thaum hloov pauv los ntawm biguanides, thawj koob tshuaj glibenclamide yog 2.5 mg / hnub. Cov tshuaj loj yuav tsum tau muab tshem tawm, thiab cov koob tshuaj glibenclamide, yog tias tsim nyog, tuaj yeem nce tau 2.5 mg txhua 5-6 hnub los txhawm rau kev them nyiaj rau kev ua txhaum ntawm cov metabolism hauv cov metabolism. Thaum tsis muaj kev them nyiaj rau 4-6 lub lis piam, nws yog qhov tsim nyog los npaj kev kho kom sib xyaw nrog glibenclamide thiab biguanides.

Kev phiv los ntawm Maninil 3.5:

Los ntawm cov kab mob endocrine: hypoglycemia mus txog thaum tsis nco qab (qhov zoo li ntawm nws txoj kev txhim kho nce nrog kev ua txhaum ntawm kev noj tshuaj thiab noj tsis txaus).

Ua xua: tawv nqaij ua pob, khaus.

Los ntawm lub plab zom mov: xeev siab, raws plab, qhov kev xav ntawm qhov hnyav hauv thaj av epigastric, tsis tshua muaj - lub siab ua haujlwm tsis zoo, cholestasis.

Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb thiab qhov hluav taws xob ntawm lub paj hlwb: tsis tshua muaj - paresis, mob rhiab, mob taub hau, qaug zog, qaug zog, kiv taub hau.

Los ntawm cov kab mob hematopoietic: tsis tshua muaj - hematopoiesis cuam tshuam txog kev loj hlob ntawm pancytopenia.

Dermatological tshua: tsis tshua muaj - photosensitivity.

Cov lus qhia tshwj xeeb rau kev siv Maninil 3.5.

Nws yog siv nrog kev ceev faj hauv cov neeg mob uas muaj pathology ntawm lub siab thiab lub raum (suav nrog hauv keeb kwm), nrog rau ua npaws, ua tsis taus adrenal ua haujlwm, lub qog ua haujlwm lub caj pas thiab cov cawv cawv ntev.

Thaum kho, kev saib xyuas cov ntshav qabzib txhua hnub thiab kev tso zis tawm ntawm cov ntshav qabzib yog tsim nyog.

Nrog rau kev txhim kho cov ntshav qog ntshav qab zib, yog tias tus neeg mob nco qab, qabzib (lossis kua qab zib) yog tshuaj hauv. Yog tias tsis nco qab, tso ntshav qabzib lossis glucagon sc, intramuscularly lossis intravenously raug tswj hwm. Tom qab nws rov qab nco qab, nws yog ib qho tsim nyog yuav tsum tau muab rau cov neeg mob zaub mov nplua nuj nyob hauv cov khoom noj kom paub zoo kom tsis txhob rov qab txhim kho kev mob hypoglycemia.

Cov neeg mob noj glibenclamide yuav tsum tsis txhob haus cawv. Kev haus cawv, kev txhim kho ntawm disulfiram-zoo li cov tshuaj tiv thaiv kab mob, nrog rau kev mob ntshav qab zib ntau, yog ua tau.

Kev cuam tshuam ntawm Maninil 3.5 nrog rau lwm cov tshuaj.

Ntxiv dag zog rau cov nyhuv hypoglycemic ntawm glibenclamide yog ua tau nrog kev siv beta-blockers, cov neeg sawv cev anabolic, allopurinol, cimetidine, clofibrate, cyclophosphamide, isobarin, MAO inhibitors, ntev sulfonamides, salicylates, chloramphenicol, tetracycline, ethane.

Kev qaug zog ntawm kev ua ntawm glibenclamide thiab kev loj hlob ntawm hyperglycemia yog ua tau nrog kev siv tib lub sijhawm ntawm barbiturates, chlorpromazine, phenothiazines, phenytoin, diazoxide, acetazolamide, glucocorticoids, sympathomimetics, glucagon, indomethacin, siab ntawm nicotinates, tshuaj tiv thaiv kab mob, tshuaj noj ntawm ncauj high dax ntawm laxatives.