Diabetalongzen, nrhiav, yuav

Pauv lub npe ntawm qhov kev npaj: Lawbalong

Lub npe txawv tebchaws tsis raws cai: Gliclazide (Gliclazide)

Daim ntawv noj tshuaj: Hloov Daim Ntawv Qhia Tawm

Yam tshuaj muaj sia: Gliclazide (Gliclazide)

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

Cov yam ntxwv Pharmacological:

Kev siv tshuaj qhov ncauj hypoglycemic, ib qho sulfonylurea derivative ntawm lub cim thib ob.

Nws ua rau lub cev muaj zog ntawm cov insulin los ntawm tus txiav, qis dua qib ntawm cov piam thaj hauv cov ntshav, ua rau cov insulin-secretory zoo li ntawm cov piam thaj thiab ua rau kev nkag siab ntawm cov ntaub so ntswg mus rau insulin. Tom qab 2 xyoo ntawm kev kho mob, feem ntau cov neeg mob tsis txhim kho kev quav yeeb tshuaj (nce qib ntawm cov tshuaj insulin tom qab thiab kev zais ntsiag to ntawm C-peptides tseem nyob).

Txo lub sijhawm ua ntu zus los ntawm lub sijhawm noj mov kom pib lub insulin secretion. Nws rov qab pib lub ncov thaum ntxov ntawm insulin secretion hauv kev teb rau cov piam thaj (tsis zoo li lwm yam sulfonylurea derivatives, uas muaj qhov cuam tshuam tshwj xeeb tshaj yog nyob rau theem thib ob ntawm kev zais cia). Nws tseem ua kom zoo dua theem thib ob ntawm kev tsim cov tshuaj insulin. Txo cov ncov ntawm hyperglycemia tom qab noj mov (txo qis postprandial hyperglycemia).

Glyclazide ntau ntxiv qhov rhiab ntawm peripheral cov ntaub so ntswg rau insulin (i.e., muaj cov lus hais ntxiv ua kom zoo ntxiv). Hauv cov leeg nqaij, cov nyhuv ntawm cov tshuaj insulin rau ntawm cov piam thaj, vim muaj cov ntaub so ntswg hloov pauv mus rau insulin, tau nce ntau (nce txog + 35%), txij li glycazide stimulates cov kev ua ntawm cov leeg glycogen synthetase.

Txo kev tsim cov piam thaj hauv lub siab, ua haujlwm li qub ceev ceev cov piam thaj.

Ntxiv rau kev cuam tshuam rau cov metabolism hauv cov metabolism, gliclazide txhim kho microcirculation. Cov tshuaj txo txoj kev pheej hmoo ntawm cov ntshav me me ntawm cov ntshav thrombosis, cuam tshuam rau ob lub tswv yim uas yuav koom nrog kev txhim kho cov teeb meem hauv cov ntshav qab zib mellitus: ib feem ntawm kev txwv tsis pub platelet thiab kev sib dhos thiab ib qho kev txo qis hauv kev ua kom muaj cov platelet ua kom muaj lwm yam (beta-thromboglobulin, thromboxane B2), nrog rau kev kho rov qab ntawm fibrinolytic. vascular endothelial kev ua si thiab nce kev ua si ntawm cov nqaij mos plasminogen activator.

Glyclazide muaj cov khoom ua antioxidant: nws txo cov ntshav lipid peroxides hauv ntshav, nce qhov kev ua haujlwm ntawm cov ntshav liab ntshav superoxide dismutase.

Vim tias cov yam ntxwv ntawm daim ntawv muab tshuaj, cov tshuaj txhua hnub ntawm Diabetalong 30 mg ntsiav tshuaj muab cov tshuaj kho zoo ntawm gliclazide hauv cov ntshav ntshav rau 24 teev.

Tom qab kev tswj hwm ntawm qhov ncauj, gliclazide yog kiag li nqus los ntawm cov hnyuv. Kev noj tsis cuam tshuam rau kev nqus. Qhov kev kub siab ntawm cov tshuaj nquag hauv cov ntshav plasma nce ntau zuj zus, nce mus txog qhov siab thiab nce mus txog toj siab 6-12 teev tom qab noj cov tshuaj. Kev hloov pauv ntawm tus kheej yog qhov tsawg. Cov kev sib raug zoo ntawm cov koob tshuaj thiab kev saib xyuas ntawm cov tshuaj hauv ntshav ntshav yog txoj kab tso siab raws lub sijhawm.

Kev faib khoom thiab cov metabolism

Plasma protein khi yog kwv yees li 95%.

Nws yog metabolized hauv daim siab thiab feem ntau yog tawm los ntawm lub raum. Tsis muaj cov metabolites hauv lub plasma ntshav.

Kev zam los ntawm ob lub raum yog ua tiav rau feem ntau ntawm kev tsim cov tshuaj metabolites, tsawg dua 1% ntawm cov tshuaj yog tawm tsis pauv.

T1 / 2 yog kwv yees li 16 teev (12 txog 20 teev).

Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb

Hauv cov neeg laus, tsis muaj qhov tshwj xeeb hauv kev kho mob hauv qhov kev hloov pharmacokinetic.

Kev taw qhia rau kev siv:

- Hom 2 mob ntshav qab zib mellitus ua ke nrog kev kho kev noj haus nrog kev noj zaub mov tsis txaus thiab kev tawm dag zog.

Cov Tshuaj Tiv Thaiv:

- hom ntshav qab zib 1

- uas ketoacidosis, mob ntshav qab zib precoma, mob ntshav qab zib coma,

Mob raum thiab / lossis nplooj siab tsis ua haujlwm,

- muaj hnub nyoog txog 18 xyoo

- lub sijhawm pub niam mis (lactation),

- mob plab lactose tsis txaus ntseeg, lactase deficiency lossis glucose-galactose malabsorption,

- Kev ua haujlwm tsis haum rau gliclazide lossis ib qho ntawm cov tsis nyiam ntawm cov tshuaj, mus rau lwm yam sulfonylurea derivatives, rau sulfonamides.

Nws tsis pom zoo kom siv cov tshuaj ib txhij ua ke nrog phenylbutazone lossis danazole.

Nrog ceev faj: cov hnub nyoog laus, tsis meej thiab / los sis tsis noj zaub mov noj tsis txaus, cov kab mob hnyav ntawm cov hlab plawv (suav nrog kev mob plawv, atherosclerosis), hypothyroidism, adrenal lossis pituitary tsis txaus, hypopituitarism, raum thiab / lossis daim siab tsis ua haujlwm, kev kho mob ntev nrog corticosteroids, kev haus cawv, piam thaj-6-phosphate dehydrogenase tsis txaus.

Cev xeeb tub thiab lactation

Tsis muaj kev paub nrog gliclazide thaum cev xeeb tub. Cov ntaub ntawv hais txog kev siv lwm cov sulfonylurea derivatives thaum cev xeeb tub muaj tsawg.

Hauv kev kawm txog cov tsiaj hauv chaw sim, teratogenic cov teebmeem ntawm gliclazide tsis tau txheeb xyuas.

Txhawm rau kom txo cov kev pheej hmoo ntawm lub cev tsis xwm yeem, kev tswj hwm qib siab (kev kho kom haum) ntawm ntshav qab zib mellitus yog qhov tsim nyog.

Qhov ncauj hypoglycemic qhov ncauj thaum cev xeeb tub tsis siv. Cov tshuaj ntawm cov kev xaiv rau kev kho mob ntshav qab zib hauv cov poj niam cev xeeb tub yog cov tshuaj insulin. Nws raug nquahu kom hloov qhov kev noj tshuaj ntawm qhov ncauj hypoglycemic nrog insulin txoj kev kho ob leeg nyob rau hauv rooj plaub ntawm kev npaj cev xeeb tub, thiab yog tias cev xeeb tub tau tshwm sim thaum noj cov tshuaj.

Ua rau hauv kev txiav txim siab tsis muaj cov ntaub ntawv hais txog kev noj cov gliclazide hauv cov kua mis thiab kev pheej hmoo ntawm kev noj qab haus huv neonatal hypoglycemia, kev pub mis niam yog contraindicated thaum kho cov tshuaj.

Siv rau lub siab ua haujlwm tsis zoo

Nrog ceev faj nyob rau hauv daim siab tsis ua hauj lwm.

- Mob raum thiab / lossis daim siab ua haujlwm ntau.

Siv rau lub raum tsis zoo muaj nuj nqi

Hauv cov neeg mob uas mob mentsis mus txog rau lub raum lub raum tsis ua hauj lwm, cov tshuaj no tau sau tseg rau tib lub sijhawm ib yam li cov neeg mob uas lub raum tsis ua haujlwm. Hauv kev mob raum tsis ua haujlwm, Diabetalong yog contraindicated.

Siv rau menyuam yaus

Contraindicated rau cov menyuam yaus hnub nyoog qis dua 18 xyoo.

Siv rau cov neeg mob laus

Rau cov neeg mob uas tsis tau txais kev kho yav tas los (suav nrog rau cov neeg laus dua 65 xyoo), qhov pib tshuaj yog 30 mg. Tom qab ntawd cov koob tshuaj tau xaiv ib tus zuj zus kom txog thaum qhov txiaj ntsig kho tau tiav.

Kev cuam tshuam nrog lwm cov tshuaj:

Glyclazide txhim kho cov nyhuv ntawm cov tshuaj anticoagulants (warfarin); koob tshuaj tiv thaiv cov tshuaj anticoagulant yuav tsum ua.

Miconazole (nrog kev tswj hwm kev tswj hwm thiab thaum siv lub ntsej muag rau ntawm lub qhov ncauj mucosa) txhim kho qhov kev tiv thaiv hypoglycemic ntawm cov tshuaj (hypoglycemia yuav dhau mus txog thaum tsis nco qab).

Phenylbutazone (kev tswj hwm kev tswj hwm) txhim kho cov nyhuv hypoglycemic ntawm cov tshuaj (hloov chaw vim plasma protein thiab / lossis qis tawm ntawm lub cev), ntshav qabzib tswj thiab tshuaj kho glyclazide yog tsim nyog, ob qho tib si thaum phenylbutazone tswj hwm thiab tom qab rho tawm.

Ethanol thiab ethanol-muaj cov tshuaj kho txhim kho kev mob ntshav qab zib, inhibiting qhov kev rov qab ua txhaum, tuaj yeem pab txhawb kev txhim kho hypoglycemic coma.

Thaum noj nrog lwm cov tshuaj hypoglycemic (insulin, acarbose, biguanides), beta-blockers, fluconazole, ACE inhibitors (captopril, enalapril), histamine H2 receptor blockers (cimetidine), MAO inhibitors, hypoglycemic thiab sulfanilamides thiab cim. kev phom sij ntawm hypoglycemia.

Nrog rau kev siv concomitant nrog danazol, ib qho mob ntshav qab zib tau sau tseg. Nws yog qhov tsim nyog los tswj theem ntawm cov ntshav qabzib thiab kho cov koob tshuaj ntawm gliclazide, ob qho tib si thaum lub sijhawm saib xyuas ntawm danazol thiab tom qab nws tshem tawm.

Chlorpromazine hauv kev txhaj tshuaj ntau dua (ntau dua 100 mg / hnub) nce cov piam thaj hauv cov ntshav, txo cov ntshav hauv insulin. Nws yog qhov tsim nyog los tswj cov ntshav qabzib thiab kho cov koob tshuaj ntawm gliclazide, ob qho tib si thaum tswj hwm ntawm chlorpromazine thiab tom qab nws tshem tawm.

GCS (cov kab ke, intraarticular, sab nraud, lub qhov ncauj tswj hwm) nce cov ntshav qabzib nrog txoj kev loj hlob ntawm ketoacidosis (txo qis hauv kam rau ua rau carbohydrates). Nws yog qhov tsim nyog los tswj cov ntshav qabzib thiab kho cov koob tshuaj ntawm gliclazide ob qho tib si thaum tswj hwm GCS thiab tom qab lawv rho tawm.

Ritodrine, salbutamol, terbutaline (iv) nce ntshav ntxiv hauv lub cev. Kev tswj ntshav qabzib tau pom zoo thiab, yog tias tsim nyog, hloov pauv ntawm tus neeg mob mus rau kev kho mob insulin.

Muab thiab kev coj:

Cov tshuaj yog npaj rau kev kho mob ntawm cov neeg laus xwb.

Diabetalong ntsiav tshuaj nrog kev hloov pauv ntawm 30 mg tau noj ntawm ncauj 1 lub sijhawm / hnub thaum noj tshais.

Kev xaiv koob tshuaj yuav tsum tau ua tiav raws li theem ntawm cov piam thaj hauv cov ntshav tom qab pib kev kho mob. Txhua qhov hloov pauv koob tshuaj tom qab tuaj yeem ua tom qab tsawg kawg ob lub lim tiam.

Qhov koob tshuaj txhua hnub tuaj yeem hloov los ntawm 30 mg (1 tab.) Txog 90-120 mg (3-4 tab.). Qhov tshuaj txhua hnub yuav tsum tsis pub ntau tshaj 120 mg (4 ntsiav tshuaj).

Tus kab mob ntshav qab zib tuaj yeem hloov cov tshuaj gliclazide ua ntej (80 mg) hauv 1 zaug rau 4 ntsiav tshuaj / hnub.

Yog tias koj plam ib lossis ntau dua ntawm cov tshuaj, koj tsis tuaj yeem noj ntau dua ntawm qhov koob tshuaj ntxiv (hnub tom qab).

Thaum hloov lwm cov tshuaj hypoglycemic nrog Diabetalong® 30 mg ntsiav tshuaj, tsis muaj lub sijhawm hloov pauv ntawm lub sijhawm. Koj yuav tsum xub tsum tsis txhob noj cov tshuaj ntawm txhua hnub thiab tsuas yog hnub tom qab pib noj cov tshuaj no.

Yog tias tus neeg mob tau txais kev kho mob yav dhau los nrog sulfonylureas nrog ntev dua ib nrab-lub neej, tom qab ntawd ceev faj saib xyuas (saib xyuas ntshav qabzib) rau 1-2 lub lis piam yog qhov tsim nyog kom tsis txhob mob ntshav qab zib ua qhov tsis muaj txiaj ntsig ntawm qhov seem ntawm cov kev kho mob dhau los.

Diabetalong tuaj yeem siv rau hauv kev sib xyaw nrog biguanides, alpha glucosidase inhibitors lossis insulin.

Hauv cov neeg mob uas muaj kev pheej hmoo txhim kho hypoglycemia (kev noj zaub mov tsis txaus lossis tsis txaus noj, cov mob hnyav lossis cov neeg ua haujlwm tsis txaus ua rau cov leeg endocrine - pituitary thiab adrenal tsis txaus, hypothyroidism, tshem tawm cov glucocorticosteroids tom qab siv sijhawm ntev thiab / lossis kev tswj hwm siab ntau ntxiv), cov kab mob hnyav ntawm cov hlab plawv / kev mob ntshav siab hauv lub plawv, mob hnyav carotid arteriosclerosis, mob atherosclerosis /) nws raug nquahu kom siv cov tshuaj tsawg kawg (30 mg 1 teev / hnub) ntawm cov tshuaj Diabetalong.

Cov lus qhia tshwj xeeb:

Txoj kev kho yog nqa tawm tsuas yog ua ke nrog kev noj zaub mov kom muaj calorie tsawg, carb tsawg.

Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam qib ntshav qabzib hauv cov ntshav ntawm lub plab khoob thiab tom qab noj mov, tshwj xeeb tshaj yog nyob rau thawj hnub ntawm kev kho mob nrog tshuaj.

Tus kab mob ntshav qab zib tuaj yeem tsuas yog kho rau cov neeg mob uas tau txais kev noj mov tsis tu ncua, uas suav nrog noj tshais thiab muab cov khoom noj txaus rau hauv kev noj haus.

Thaum sau tshuaj, nws yuav tsum tau yug los rau hauv lub siab tias vim tias kev noj ntawm sulfonylurea derivatives, cov ntshav qab zib tsawg tuaj yeem txhim kho, thiab qee qhov xwm txheej hauv kev mob hnyav thiab lub sijhawm ntev, uas yuav tsum tau pw hauv tsev kho mob thiab ntshav qabzib rau ob peb hnub. Kev mob ntshav qab zib feem ntau pib txhim kho nrog cov zaub mov tsis muaj calorie, tom qab ua haujlwm ntev lossis ua kom ib ce muaj zog, tom qab haus dej haus cawv, lossis thaum noj ntau yam tshuaj hypoglycemic nyob rau tib lub sijhawm.

Txhawm rau kom zam dhau kev txhim kho hypoglycemia, yuav tsum ceev faj thiab xaiv cov koob tshuaj yuav tsum tau, nrog rau kev muab cov neeg mob nrog cov ntaub ntawv tiav ntawm cov kev kho mob uas tau thov.

Nrog rau lub cev thiab lub siab lub ntsws dhau los, thaum hloov mus rau kev noj haus, kev kho qhov ntau ntawm cov tshuaj Diabetalong yog qhov tsim nyog.

Tshwj xeeb tshaj yog nkag siab rau qhov kev txiav txim ntawm cov tshuaj hypoglycemic yog cov neeg laus, cov neeg mob uas tsis tau txais kev noj zaub mov zoo, nrog rau lub xeev tsis muaj zog txaus, cov neeg mob uas muaj lub hlwb pituitary-adrenal tsis txaus.

Beta-blockers, clonidine, reserpine, guanethidine tuaj yeem npog qhov chaw kho mob tshwm sim ntawm hypoglycemia.

Cov neeg mob yuav tsum ceeb toom qhia txog kev pheej hmoo yuav muaj ntshav qab zib tsawg nyob rau hauv muaj ethanol, NSAIDs, thiab tshaib plab.

Hauv kev hais txog cawv cawv (haus cawv), nws kuj tseem muaj peev xwm tsim tau cov disulfiram-syndrome xws li (mob plab, xeev siab, xeev siab, ntuav, mob taub hau).

Kev phais mob thiab kev raug mob loj, kev kub nyhiab, kev kis kab mob nrog febrile syndrome yuav tsum muaj kev tshem tawm ntawm qhov ncauj hypoglycemic tshuaj thiab kev teem sijhawm kho tshuaj insulin.

Kev txhim kho ntawm cov tshuaj tiv thaiv theem nrab yog qhov ua tau (nws yuav tsum tau qhov txawv ntawm thawj qhov, uas qhov tshuaj tsis muab qhov kev cia siab tshwm sim ntawm kev kho mob thaum thawj zaug).

Tawm tsam keeb kwm ntawm kev kho cov tshuaj Diabetalong, tus neeg mob yuav tsum tso tseg kev haus cawv thiab / lossis cov tshuaj cawv thiab muaj tshuaj thiab khoom noj khoom haus.

Thaum kho mob Diabetalong, tus neeg mob yuav tsum tau txiav txim siab tias qib ntshav qabzib thiab glycosylated hemoglobin hauv cov ntshav, thiab cov piam thaj hauv cov zis nyob rau hauv cov zis.

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

Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab koom nrog lwm yam kev phom sij uas yuav tsum muaj kev ntseeg ntau ntxiv thiab ceev ntawm cov kev tiv thaiv psychomotor.

Phiv los sis:

Cov Hypoglycemia (ua txhaum rau txoj kev noj tshuaj ntau thiab noj tsis txaus): mob taub hau, qaug zog ntau, tshaib plab, tawm hws, mob tsis muaj zog, palpitations, arrhythmia, nce ntshav siab, tsaug zog, insomnia, ntxhov siab, ntxhov siab, ntxhov siab, chim siab, tsis hnov qab, tsis tuaj yeem ua kom pom tseeb thiab maj mam tshwm sim, kev nyuaj siab, tsis pom kev, tsis meej pem, tshee tsig, paresis, hnov kev tsis sib haum xeeb, kiv taub hau, zoo li tsis muaj kev cia siab, ploj ntawm kev tswj hwm tus kheej, delirium, convulsions, dag e ua pa, bradycardia, hnovqab, coma.

Los ntawm lub plab zom mov: xeev siab, ntuav, raws plab, mob plab, cem quav (qhov mob ntawm cov tsos mob no tsawg dua thaum noj nrog zaub mov), tsis tshua muaj - lub siab ua haujlwm tsis ua haujlwm (kab mob siab, nce kev ua haujlwm ntawm hepatic transaminases, alkaline phosphatase, cholestatic jaundice - yuav tsum tau tshem tawm tshuaj).

Los ntawm cov ntshav hemopoietic plab hnyuv siab raum: inhibition ntawm pob txha mob hematopoiesis (mob ntshav qab zib, thrombocytopenia, leukopenia, granulocytopenia).

Kev ua xua: ua pob khaus tawv, tso zis, tso pob khaus, ua pob maculopapular thiab bullous), erythema.

Lwm yam: tsis pom kev pom.

Cov kev mob tshwm sim ntawm sulfonylurea derivatives: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, kev tsis haum vasculitis, ua rau lub siab ua rau lub siab tsis ua haujlwm.

Noj ntau dhau

Cov tsos mob: hypoglycemia, hnov lus tsis zoo, mob ntshav qab zib tsis tsaug zog.

Kev Kho Mob: yog tias tus neeg mob nco qab, noj qab zib sab hauv.

Tej zaum qhov kev txhim kho ntawm cov kev mob hypoglycemic hnyav, nrog kev tsis nco qab, ntog lossis lwm yam mob puas siab ntsws. Yog tias cov tsos mob no tshwm sim, yuav tsum tau txais kev kho mob ceev ceev thiab tau mus pw hauv tsev kho mob sai.

Yog tias hypoglycemic coma yog xav paub lossis kuaj mob, tus neeg mob tau nrawm nrawm nrog 50 ml ntawm 40% dextrose (piam thaj) tov. Tom qab ntawd, 5% dextrose (kua nplaum) tov yog txhaj rau cov tshuaj kom tswj qib theem cov piam thaj hauv cov ntshav.

Tom qab rov qab nco qab, nws yog ib qho tsim nyog yuav tsum muab cov neeg mob cov zaub mov nplua nuj nyob hauv cov khoom noj zom tau yooj yim (kom tsis txhob rov qab txhim kho kev mob ntshav qab zib). Kev ua tib zoo soj ntsuam cov ntshav qabzib hauv qib siab thiab soj ntsuam ntawm tus neeg mob yuav tsum tau nqa tawm tsawg kawg 48 teev tom qab. Tom qab lub sijhawm no, nyob ntawm tus neeg mob lub sijhawm, tus kws kho mob txiav txim siab txog qhov xav tau kev tshuaj xyuas ntxiv.

Kev lim ntshav tsis muaj txiaj ntsig vim yog qhov tseeb khi ntawm gliclazide ntxiv rau cov ntshav protein.

Hnub tas sij hawm: 3 xyoos

Kws kho mob tawm li cas: Los ntawm tshuaj.

Chaw tsim tshuaj paus: SYNTHESIS, OJSC (Russia)