Gliclada® (30 mg) Gliclazide > Kev khomob thiab kev tiv thaiv

30 mg hloov kho cov ntsiav tshuaj

Ib ntsiav tshuaj muaj

cov tshuaj nquag - gliclazide 30 mg

tus zam: hypromellose (4000 **), hypromellose (100 **)

calcium carbonate, lactose monohydrate, colloidal silicon dioxide, magnesium stearate

** Tus nqi ntawm cov nominal viscosity rau ib 2% (m / v) aqueous tov ntawm hypromellose

Oval ntsiav tshuaj, los ntawm dawb mus rau yuav luag dawb, me ntsis biconvex

Cov tshuaj pab pawg kho mob

Txhais tau tias kho mob ntshav qab zib. Cov tshuaj muaj piam thaj rau kev tswj hwm qhov ncauj. Derivatives ntawm sulfonylureas. Gliclazide

ATX code A10VB09

Pharmacological kev txiav txim

Cov Tshuaj Pharmacokinetics

Xuas thiab faib khoom

Tom qab noj cov tshuaj hauv, gliclazide yog kiag li nqus los ntawm txoj hnyuv hauv plab. Qhov siab ntawm gliclazide hauv plasma nce ntau zuj zus nyob rau thawj 6 teev tom qab kev tswj hwm thiab nce mus txog toj siab uas tseem pheej ua siab ntev ntev txuas txij 6 mus txog 12 teev. Kev hloov pauv ntawm tus kheej muaj feem tsawg. Kev noj tsis cuam tshuam rau qib kev nqus. Qhov xa tawm yog kwv yees li 30 litres. Plasma protein khi yog kwv yees li 95%. Ib qho tshuaj txhua hnub ntawm cov tshuaj Gliclada® ua rau kev saib xyuas ntawm kev saib xyuas zoo ntawm glyclazide hauv cov ntshav ntshav rau ntau dua 24 teev.

Gliclazide yog metabolized feem ntau hauv lub siab. Qhov ua rau lub cev zom tau tsis muaj tshuaj lom neeg kev ua si. Cov kev sib raug zoo ntawm cov koob tshuaj tau nce mus txog 120 mg thiab qhov tsom ntawm cov tshuaj hauv ntshav yog ib txoj kab tso siab raws lub sijhawm.

Ib nrab-lub neej (T1 / 2) ntawm gliclazide yog 12-20 teev. Nws yog tsuas yog tawm los ntawm lub raum hauv daim ntawv ntawm metabolites, tsawg dua 1% yog tawm hauv cov zis tsis hloov pauv.

Pharmacokinetics hauv cov chaw kuaj mob tshwj xeeb

Hauv cov neeg laus, tsis muaj qhov sib txawv hauv tsev kho mob tau tshawb pom.

Cov Tshuaj Hauv Tshuaj

Gliclada® yog qhov ncauj tshuaj hypoglycemic los ntawm cov pab pawg ntawm sulfonylurea derivatives ntawm lub cim thib ob, uas sib txawv los ntawm cov tshuaj zoo sib xws los ntawm qhov muaj cov N-muaj heterocyclic ntiv nplhaib nrog kev ua kom sib luag endocyclic.

Glyclada ers txo qis ntshav qab zib los ntawm kev ua kom muaj zog hauv insulin secretion los ntawm Langerhans islets nrog R cell. Tom qab ob xyoos ntawm kev kho mob, qhov nce ntawm qib ntawm insulin tom qab thiab kev zais ntsiag to ntawm C-peptides tseem nyob. Hauv hom 2 mob ntshav qab zib mellitus, cov tshuaj rov qab ua rau lub sijhawm thaum kawg ntawm cov kua dej hauv cov kua dej hauv cov lus teb rau cov piam thaj thiab ua rau qib thib ob ntawm insulin secretion. Ib qho tseem ceeb nce ntxiv ntawm insulin secretion tau pom nyob rau hauv teb rau kev tsa ua vim kev noj zaub mov thiab qabzib kev tswj hwm.

Ntxiv rau kev cuam tshuam rau cov metabolism hauv cov metabolism, Glyclada® muaj qhov cuam tshuam rau 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.

Tsuas tshuaj thiab tswj hwm

Cov tshuaj yog npaj rau cov neeg mob laus.

Nws pom zoo kom noj cov ntsiav tshuaj yam tsis tau zom zom thaum noj tshais. Yog tias koj tsis nco qab noj ntxiv nyob rau hnub tom qab, koj tsis tuaj yeem nce ntxiv.

Cov koob tshuaj txhua hnub ntawm Glyclad® yog los ntawm 30 txog 120 mg (1 txog 4 ntsiav tshuaj). Cov koob tshuaj ntawm cov tshuaj yog xaiv nyob ntawm tus neeg cov teeb meem metabolic teb ntawm tus neeg mob.

Qhov pom zoo kom pib noj yog 30 mg rau ib hnub. Nrog rau kev tswj xyuas ntshav qabzib, cov tshuaj no tuaj yeem siv los ua kev kho mob.

Nrog kev tswj tsis tau zoo ntawm cov piam thaj, cov tshuaj txhua hnub tuaj yeem hloov maj mam nce mus txog 60, 90 lossis 120 mg. Lub sijhawm nruab nrab ntawm txhua txoj kev noj tshuaj yuav tsum yog tsawg kawg 1 hlis, tshwj tsis yog cov neeg mob uas cov ntshav qabzib tsis txo tom qab 2 lub lis piam ntawm kev tswj hwm. Hauv cov xwm txheej zoo li no, cov koob tshuaj tuaj yeem nce ntxiv 2 lub lis piam tom qab pib kev kho mob. Qhov koob tshuaj ntau tshaj plaws yog 120 mg rau ib hnub.

Hloov ntawm 80 mg Glyclazide ntsiav tshuaj rau Glyclad Hloov Daim Ntawv Qhia Tawm®

Kev tswj hwm kev ua haujlwm zoo nyob rau hauv cov neeg mob cov ntshav nrog 80 mg glycoslide ntsiav tshuaj, lawv tuaj yeem hloov nrog Glyclada® hauv qhov sib piv ntawm 1 ntsiav tshuaj ntawm glycoslide 80 mg = 1 ntsiav tshuaj ntawm Glyclada®.

Hloov los ntawm lwm qhov kev tso tshuaj hypoglycemic rau Glyclad®

Thaum hloov txoj kev loj hlob, kev noj tshuaj thiab ib nrab-lub neej ntawm cov tshuaj ua ntej yuav tsum raug txiav txim siab. Lub sijhawm hloov kev sib hloov feem ntau tsis xav tau. Txais ntawm cov tshuaj Glyclada® yuav tsum pib nrog 30 mg, tom qab los ntawm kev hloov kho nyob ntawm seb cov tshuaj tiv thaiv metabolic zoo li cas.

Thaum hloov los ntawm lwm cov tshuaj ntawm sulfonylurea pab pawg nrog lub sijhawm ntev ib nrab-lub neej, txhawm rau kom tsis txhob muaj qhov cuam tshuam ntxiv ntawm ob hom tshuaj, lub sijhawm tsis muaj tshuaj nyob rau ob peb hnub yuav raug tsim nyog.

Nyob rau hauv cov xwm txheej zoo li no, kev hloov mus rau Glyclad® ntsiav tshuaj yuav tsum pib nrog kev pom zoo kom pib ntawm 30 mg, tom qab los ntawm kev nce qib hauv koob tshuaj nyob ntawm seb cov tshuaj tiv thaiv metabolism.

Siv ua ke nrog lwm cov tshuaj tiv thaiv kab mob

Gliclada ® tuaj yeem kho nyob rau hauv kev sib xyaw nrog biguanides, alpha-glucosidase inhibitors lossis insulin. Kev tswj hwm tib neeg ntawm kev siv tshuaj insulin yuav tsum tau pib ua haujlwm los ntawm kev saib xyuas nruj ntawm kws kho mob.

Cov neeg laus (laus dua 65 xyoos)

Cov tshuaj yog sau ntawv hauv tib lub tshuaj rau cov neeg mob hnub nyoog qis dua 65 xyoos.

Hauv cov neeg mob uas muaj mob me me los yog mob raum lub raum kev ua haujlwm, cov tshuaj tau raug sau tseg nyob rau hauv txhua lub sijhawm.

Cov neeg mob uas muaj kev pheej hmoo ntawm hypoglycemia: nrog rau kev noj zaub mov tsis txaus, nrog rau cov mob endocrine hnyav lossis tsis zoo (hypopituitarism, hypothyroidism, tsis muaj adrenocorticotropic hormone), tom qab ntev thiab / lossis kev txhaj tshuaj ntau ntau los kho corticosteroid, kev mob plawv hnyav, kev kho mob tau pom zoo kom pib nrog qhov tsawg kawg nkaus koob tshuaj txhua hnub ntawm 30 mg.

Sab sij huam

hypoglycemia (thaum noj tsis qab lossis noj mov): mob taub hau, mob tshaib plab, xeev siab, ntuav, nkees, pw tsaug zog, ntxhov siab, tsis meej pem, txhoj puab heev, tsis xav txog, ua rau cov tshuaj tiv thaiv qeeb qeeb, poob siab, tsis paub pab, pom thiab hais lus tsis meej , kev nyuaj siab, paresis, tshee tshee, tsis hnov qhov muag, kiv taub hau, qaug zog, qaug dab peg, tsis tuaj yeem tswj tus kheej, tsaug zog, ntog pa, tsis nco qab, delirium, ua rau rov qab thiab tuag. Cov tsos mob Adrenergic muaj peev xwm ua tau: nplaum hws, ntxhov siab, tachycardia, nce ntshav siab, mob hauv plawv, arrhythmia

mob plab, xeev siab, ntuav, raws plab, cem quav (tuaj yeem txo los ntawm kev noj tshuaj thaum noj tshais)

thim rov qab nce qib hauv cov qib mob hepatic enzymes (ALT, AST, phosphatase alkaline), kab mob siab (tsis tshua muaj), hyponatremia

daim tawv nqaij ua pob khaus, khaus, urticaria, angioedema, erythema, maculopapular tawv nqaij, tawv nqaij tsis haum (xws li Stevens-Johnson syndrome, tshuaj lom epidermal necrolysis)

anemia, leukopenia, thrombocytopenia, granulocytopenia, pancytopenia (thim rov qab tom qab rho yeeb tshuaj)

kev tsis pom kev pom, tshwj xeeb tshaj yog thaum pib kho mob, vim muaj cov pauv ntshav hauv cov ntshav

Cov Yuav Tsum Tau Ua

paub tias muaj qhov tsis haum lub siab rau gliclazide lossis ib qho ntawm cov tshuaj ntu ntawm cov tshuaj, nrog rau lwm cov tshuaj ntawm sulfonylurea pawg lossis sulfonamides

ntshav qab zib hom 1

cov ketoacidosis uas mob ntshav qab zib, precomatosis thiab mob ntshav qab zib coma

mob raum lossis lub siab ua haujlwm poob

cev xeeb tub thiab lactation

Cov tshuaj sib cuam tshuam

Kev siv ua ke ntawm gliclazide thiab miconazole yog qhov sib txuam nrog kev pheej hmoo ntawm kev mob ntshav qab zib, nce mus txog hypoglycemic coma.

Glyclazide tsis pom zoo rau siv ib txhij nrog phenylbutazone thiab haus dej cawv vim muaj qhov pheej hmoo ntawm kev mob ntshav qab zib tsawg. Thaum lub sijhawm kho nrog tshuaj, nws yog ib qho tsim nyog yuav tsum tsis txhob haus cawv thiab noj tshuaj uas muaj cawv.

Hauv kev sib txuas nrog qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia, ceeb toom yuav tsum tau siv thaum sau tshuaj gliclazide thiab tshuaj tiv thaiv kab mob ntawm lwm pab pawg (insulins, acarbose, biguanides), beta-blockers, fluconazole, angiotensin-hloov enzyme inhibitors (captopril, enalapril), thiab H2 receptor antagonists, (IMAO), sulfonamides thiab tshuaj tsis-steroidal anti-inflammatory tshuaj tiv thaiv.

Tsis pom zoo siv cov tshuaj gliclazide thiab danazol vim tias qhov kev pheej hmoo ntawm cov ntshav qabzib nce ntxiv. Yog tias tsim nyog, kev teem sij hawm ntawm kev sib txuam no yuav tsum ua tib zoo saib xyuas qib ntawm cov piam thaj hauv cov ntshav thiab zis, thiab hauv qee kis, kho qhov koob tshuaj gliclazide thaum kho nrog danazol thiab tom qab nws.

Hauv kev saib xyuas qhov kev pheej hmoo ntawm kev loj hlob hyperglycemia, kev ceev faj yuav tsum tau siv thaum sib txuas nrog gliclazide nrog chlorpromazine (ntawm koob tshuaj> 100 mg rau ib hnub, tom kawg ua rau txo qis hauv cov tshuaj insulin). Rau lub sijhawm ntawm chlorpromazine kev kho mob, kev hloov kho tshuaj ntawm gliclazide tej zaum yuav tsum tau ua.

Glucocorticosteroids (rau kev siv rau hauv qhov chaw thiab hauv zos: intraarticular, sub- lossis subcutaneous, lub qhov quav) thiab tetracosactides, thaum noj ua ke nrog glycoslazide, nce ntxiv hauv cov ntshav cov ntshav thiab, vim qhov txo qis hauv kev ua kom tau cov carbohydrate, tuaj yeem ua rau ketosis. Thaum kho thiab tom qab kho glucocorticoid, koob tshuaj gliclazide yuav tau kho.

Ceev faj yuav tsum tau tawm dag zog hauv kev siv ua ke ntawm gliclazide nrog ritodrine, salbutamol thiab tertbutaline (rau leeg) vim muaj kev pheej hmoo ntawm kev txhim kho hyperglycemia. Yog tias tsim nyog, mus rau tshuaj insulin.

Nrog rau kev siv ua ke ntawm gliclazide nrog anticoagulants (warfarin, thiab lwm yam), kev nce qib hauv cov nyhuv anticoagulant yuav tau pom.

Cov lus qhia tshwj xeeb

Cov tshuaj yuav tsum tau sau tseg tsuas yog nrog cov khoom noj kom tsawg los ntawm tus neeg mob (suav nrog noj tshais).

Txoj kev pheej hmoo ntawm cov ntshav qog ntshav qab zib nce ntxiv nrog cov zaub mov tsis muaj calorie, tom qab ua haujlwm ntev lossis ua kom lub cev ntau dhau, haus dej haus cawv, lossis thaum muaj kev sib xyaw ua ke ntawm ntau cov tshuaj hypoglycemic.

Hauv kev pom ntawm cov kev pheej hmoo ntawm cov ntshav qab zib tsawg, nws pom zoo tias koj yuav tsum noj cov khoom noj carbohydrates tsis tu ncua (yog tias cov zaub mov noj tau qeeb, yog tias zaub mov tsis txaus noj, lossis yog tias cov zaub mov muaj cov zaub mov tsis muaj carbohydrate tsawg).

Kev mob hypoglycemia yuav tshwm sim tom qab siv sulfonylurea derivatives. Qee qhov xwm txheej tuaj yeem ua rau hnyav thiab ntev ntev. Yuav tsum tau mus pw hauv tsev kho mob, thiab kuj yuav qabzib ntev mus ob peb hnub.

Txo qhov kev pheej hmoo ntawm kev mob hypoglycemic phaum ntu, kev qhia yuav tsum tau ua tib zoo ntawm tus neeg mob.

Qhov tseeb uas ua rau muaj kev phom sij ntawm hypoglycemia:

Noj ntau dhau

Plaws thiab lub siab ua haujlwm: Cov chaw muag tshuaj thiab cov tshuaj pharmacodynamic zog ntawm gliclazide tuaj yeem hloov pauv hauv cov neeg mob uas mob rau daim siab lossis mob hlaus tsis zoo. Kev mob ntshav qab zib ntau ntau uas tshwm sim hauv cov neeg mob zoo li no tuaj yeem siv sijhawm ntev, thiab yog li kev saib xyuas tsim nyog yuav tsum tau ua.

Yuav tsum qhia rau tus neeg mob txog qhov tseem ceeb ntawm kev noj haus, qhov xav tau ntawm lub cev ua si thiab soj ntsuam cov ntshav qabzib kom tsis tu ncua. Cov neeg mob thiab lawv tsev neeg yuav tsum piav qhia txog qhov phom sij ntawm lub qog ntshav qab zib, tham txog nws cov tsos mob, cov txheej txheem kho thiab lwm yam uas cuam tshuam rau kev txhim kho ntawm tus mob no.

Kev tswj cov ntshav qab zib tsis zoo

Kev ua tau zoo ntawm kev tswj cov piam thaj hauv cov ntshav ntawm tus neeg mob uas tau txais tshuaj tua kab mob yuav muaj kev cuam tshuam los ntawm cov hauv qab no: ua npaws, mob lub cev, kis mob, lossis kev phais mob. Hauv qee kis, nws yuav tsim nyog sau tshuaj insulin.

Kev ua rau lub ntsej muag hypoglycemic ntawm ib qho tshuaj tiv thaiv kab mob hauv lub qhov ncauj, suav nrog gliclazide, hauv ntau tus neeg mob txo qis lub sijhawm vim qhov kev loj hlob ntawm cov ntshav qab zib lossis txo qis hauv cov tshuaj rau cov tshuaj (theem nrab tsis muaj kev kho mob). Qhov xaus hais txog kev ua haujlwm theem nrab ntawm qhov tshwm sim ntawm kev kho tuaj yeem ua tau tsuas yog tom qab tsim nyog muab tshuaj kho kom haum thiab yog tias tus neeg mob noj cov zaub mov noj.

Thaum ntsuas kev tswj cov ntshav qabzib, nws raug pom zoo tias qib glycated hemoglobin (lossis piam thaj hauv kev yoo ntshav ntawm cov ntshav txha).

Kev noj tshuaj sulfonylurea rau cov neeg mob uas muaj ntshav qabzib-6-phosphate dehydrogenase ua rau cov ntshav tsis txaus siab tuaj yeem ua rau hemolytic tsis txaus. Kev ceev faj yuav tsum tau tawm dag zog thaum sau tshuaj gliclazide hauv cov neeg mob uas muaj ntshav qabzib-6-phosphate dehydrogenase thiab xav txog kev kho mob lwm yam nrog cov tshuaj ntawm lwm chav kawm.

Cov Ntaub Ntawv Tshwj Xeeb ntawm Cov Muaj Nqes

Gliclada® muaj cov lactose. Cov neeg mob uas tsis tshua muaj mob cov kabmob ntawm galactose intolerance, Lapp lactase deficiency lossis glucose-galactose malabsorption yuav tsum tsis txhob noj cov tshuaj no.

Cov yam ntxwv ntawm cov nyhuv ntawm cov tshuaj rau ntawm lub peev xwm tsav tsheb lossis cov phom sij phom sij

Ceev faj yuav tsum tau siv thaum tsav tsheb lossis lwm yam txheej txheem, tshwj xeeb tshaj yog thaum pib kho.

Noj ntau dhau

Cov tsos mob ntshav nce qog rau qhov hnyav.

Kev Kho Mob: cov tsos mob ntawm kev mob ntshav txhav uas tsis muaj kev nco qab lossis lub cim ntawm lub paj hlwb tsis zoo, tshem tawm txoj kev noj zaubmov, kev hloov tshuaj thiab / lossis kev hloov pauv ntawm kev noj zaub mov. Kev tswj hwm kev mob nkeeg yuav tsum tau txuas ntxiv mus kom txog thaum tus kws kho mob paub tseeb tias tus neeg mob nyob ruaj khov thiab tawm ntawm kev txaus ntshai.

Mob hnyav ntxiv ntawm lub ntsej muag hypoglycemia, nrog rau kev tsis nco qab, ntog lossis lwm qhov mob ntawm lub paj hlwb, xav tau kev saib xyuas sai thiab mus pw hauv tsev kho mob sai. Yog tias qhov mob ntshav qab zib tsis hnov qab tshwm sim lossis xav tias tsam tsis haum, glucagon thiab 50 ml ntawm cov tshuaj muaj qabzib (20-30% tso ntshav) yuav tsum tau txhaj tam sim ntawd, thiab tom qab ntawd txuas ntxiv Txoj kev lis ntshav ntawm 10% kua nplaum nyob ntawm tus nqi uas xyuas kom cov ntshav qabzib ntau dua 1 g / l Cov. Tus neeg mob yuav tsum nyob hauv qab kev saib xyuas kho mob nruj. Hemodialysis yuav tsis zoo.

Pharmacological pawg

Cov neeg sawv cev ntawm lub cev hypoglycemic, sulfonamides, urea derivatives. Tus lej ATX A10V B09.

Gliclazide yog ib qho tshuaj hypoglycemic qhov ncauj, sulfonylurea derivative, uas txawv ntawm lwm cov tshuaj los ntawm qhov tshwm sim ntawm lub nplhaib heterocyclic uas muaj cov nitrogen thiab muaj cov kab mob endocyclic.

Gliclazide txo qis ntshav qabzib ntau vim kev ua haujlwm ntawm insulin secretion los ntawm β cov hlwb ntawm pancreatic islets ntawm Langerhans. Kev nce nyob rau theem ntawm cov tshuaj tiv thaiv postprandial thiab ua kom zais ntawm C-peptide mob siab txawm tias tom qab 2 xyoo ntawm kev siv tshuaj. Gliclazide tseem muaj cov khoom muaj hemovascular.

Ntxim rau insulin secretion.

Hauv cov neeg mob uas muaj ntshav qab zib hom II, gliclazide rov qab ua kom tiav thaum kawg ntawm insulin secretion hauv kev teb rau cov piam thaj thiab nce theem ob ntawm insulin secretion. Ib qho kev nce ntxiv hauv insulin secretion tau tshwm sim raws li kev noj zaub mov lossis piam thaj tso.

Glyclazide txo microthrombosis vim ob txoj kev koom tes uas tuaj yeem koom nrog hauv kev txhim kho kev mob ntshav qab zib mellitus:

ib nrab inhibits platelet aggregation thiab adhesion, txo tus naj npawb ntawm platelet ua cim (thr-thromboglobulin, thromboxane B 2)
cuam tshuam rau txoj kev ua haujlwm ntawm fibrinolytic ntawm vascular endothelium (nce tRA kev ua haujlwm).

Lub ntsiab lus kawg muaj qhov tseem ceeb macrovascular (kev mob plawv tuag, tsis tuag-myocardial infarction, tsis mob ntshav tawm) thiab microvascular (mob tshiab lossis mob tsis zoo ntawm nephropathy, retinopathy) cov xwm txheej.

11,140 cov neeg mob tau suav nrog kev kuaj mob hauv tsev kho mob. Lub sijhawm 6 lub lim tiam ntawm lub sijhawm qhia, cov neeg mob txuas ntxiv rau kev noj cov ntshav qab zib. Tom qab ntawd, raws li lub luag haujlwm ntawm randomized, cov neeg mob tau muab cov txheej txheem glycemic tswj hwm kev tswj hwm (n = 5569) los yog kev tswj hwm nrog kev tswj hwm ntawm glycoslide, hloov-tso cov ntsiav tshuaj, raws li cov tswv yim rau kev tswj hwm glycemia (n = 5571). Lub tswv yim rau kev tswj hwm glycemic yog ua raws li kev teem sijhawm ntawm gliclazide, ntsiav tshuaj nrog kev hloov pauv, los ntawm kev kho mob thaum pib, lossis rau kev teem sijhawm ntawm gliclazide, ntsiav tshuaj nrog kev hloov kho tau hloov, hloov cov qauv kev kho mob (kev kho mob uas tus neeg mob tau txais thaum lub sijhawm suav nrog), nrog kev nce ntxiv ntawm qhov koob tshuaj mus rau qhov siab tshaj plaws thiab tom qab ntawd nrog rau lwm cov tshuaj txo cov ntshav qab zib, yog tias tsim nyog, xws li metformin, acarbose, thiazolidinediones lossis insulin. Cov neeg mob tau saib zoo thiab taug qab kev noj zaub mov kom nruj.

Kev soj ntsuam tau ntev li 4.8 xyoo. Qhov tshwm sim ntawm kev kho mob nrog gliclazide, hloov kho cov ntsiav tshuaj tso tawm, uas yog lub hauv paus ntawm lub tswv yim rau kev siv tshuaj tiv thaiv glycemic (qhov nruab nrab ua tiav HbAlc - 6.5%) piv nrog kev tswj glycemia (qhov nruab nrab ua tiav theem ntawm HbAlc - 7.3%), muaj qhov tseem ceeb txo qis tag nrho 10% kev pheej hmoo ntawm kev pheej hmoo loj ntawm loj macro- thiab microvascular teeb meem loj ((HR) 0.90, 95% Cl 0.82, 0.98 p = 0.013, 18.1% ntawm cov neeg mob los ntawm pawg tswj hwm mob sib piv piv rau 20% ntawm cov neeg mob los ntawm pawg txheem tswj). Qhov zoo ntawm cov tswv yim rau kev tswj hwm glycemic nrog kev teem sij hawm ntawm gliclazide, hloov-tso cov ntsiav tshuaj nyob rau hauv lub hauv paus ntawm txoj kev kho yog vim:

qhov tseem ceeb txo qis hauv qhov kev pheej hmoo sib piv ntawm cov teeb meem microvascular loj dua 14% (HR 0.86, 95% Cl 0.77, 0.97, p = 0.014, 9.4% tiv thaiv 10.9%),
qhov tseem ceeb txo qis hauv qhov kev pheej hmoo txheeb ze ntawm cov teeb meem tshiab lossis kev nce qib ntawm nephropathy los ntawm 21% (HR 0.79, 95% Cl 0.66 - 0.93, p = 0.006, 4.1% tiv thaiv 5.2%),
qhov tseem ceeb 8% txo rau hauv kev pheej hmoo sib piv ntawm microalbuminuria uas tshwm sim rau thawj zaug (HR 0.92, 95% Cl 0.85 - 0.99, p = 0.030, 34.9% tiv thaiv 37.9%),
qhov tseem ceeb txo qis hauv kev pheej hmoo ntawm kev raug mob raum los ntawm 11% (HR 0.89, 95% Cl 0.83, 0.96, p = 0.001, 26.5% tiv thaiv.

Thaum kawg ntawm txoj kev tshawb no, 65% thiab 81.1% ntawm cov neeg mob hauv pawg tswj hwm zoo (tiv tiag 28.8% thiab 50.2% ntawm pawg tswj hwm) tau tiav HbAlc ≤ 6.5% thiab ≤ 7%, feem. 90% ntawm cov neeg mob hauv cov pab pawg tswj hwm tau siv gliclazide, cov ntsiav tshuaj nrog kev hloov pauv (qhov nruab nrab ib hnub yog 103 mg), 70% ntawm lawv tau noj ntau tshaj plaws ib hnub ntawm 120 mg. Hauv pawg ntawm kev sib zog glycemic tswj hwm raws li gliclazide, hloov kho ntsiav tshuaj tso tawm, tus neeg mob lub cev hnyav tseem nyob ruaj khov.

Qhov zoo ntawm cov tswv yim rau kev tswj hwm glycemic raws li gliclazide, hloov kho cov ntsiav tshuaj tso tawm, tsis cuam tshuam los txo cov ntshav siab.

Qib ntawm gliclazide nyob rau hauv ntshav ntshav nce siab thaum thawj 6:00, mus txog toj siab uas yog rau mus rau kaum ob teev tom qab kev tswj hwm tshuaj.

Kev txua tus kheej yog qhov tsis zoo.

Glyclazide yog qhov nqus kiag li. Kev noj tsis cuam tshuam rau tus nqi thiab npaum li cas ntawm kev nqus.

Plasma protein khi yog kwv yees li 95%. Cov kev sib raug zoo ntawm cov koob noj hauv ntau npaum li 120 mg thiab thaj chaw hauv qab qhov nkhaus-sijhawm nkhaus yog kab. Qhov xa tawm yog kwv yees li 30 litres.

Gliclazide yog cov tshuaj tiv thaiv hauv lub siab thiab cov zis hauv lub tso zis; tsawg dua 1% ntawm cov tshuaj nquag tso rau hauv cov zis tsis hloov pauv. Tsis muaj cov metabolites hauv lub plasma ntshav.

Ib nrab-lub neej ntawm gliclazide yog 12-20 teev.

Hauv cov neeg laus cov neeg mob, tsis muaj lub luag haujlwm tseem ceeb hauv cov chaw muag tshuaj ntawm cov tshuaj.

Cov koob tshuaj ib leeg Glyclada, cov ntsiav tshuaj nrog rau kev hloov pauv, tswj qhov zoo ntawm glycazide hauv cov ntshav rau 24 teev.

Kab Mob Ntshav Qab Zib Hom II:

txo thiab tswj ntshav qabzib thaum lub cev tsis ua haujlwm rau cov ntshav qabzib feem ntau tsuas yog noj zaub noj mov, ua kom tawm dag zog lossis poob phaus
kev tiv thaiv ntawm cov teeb meem ntawm hom II mob ntshav qab zib mellitus: txo kev pheej hmoo ntawm loj heev- thiab microvascular cov teeb meem, nrog rau cov mob tshiab lossis mob nyhav rau cov neeg mob ntshav qab zib hom II mob ntshav qab zib.

Chaw tsim tshuaj paus

Krka, hnub Novo Mesto, Slovenia

Marješka 6, 8501 Novo Mesto, Slovenia

Lub chaw nyob ntawm cov koomhaum uas lees txais thov nyiaj los ntawm cov neeg siv khoom ntawm cov khoom lag luam zoo (cov khoom lag luam) hauv koom pheej ntawm Kazakhstan

Krka Kazakhstan LLP, Kazakhstan, 050059, Almaty, Al-Farabi Ave. 19, lub tsev 1 b,

Kev sib cuam tshuam nrog lwm yam tshuaj thiab lwm yam kev sib cuam tshuam

Thaum siv tshuaj yeeb tshuaj, kev tswj hwm ib txhij uas yuav ua rau mob ntshav qab zib (hypo- or hyperglycemia), Sidid ceeb toom rau tus neeg mob txog qhov yuav tsum tau ua tib zoo saib xyuas ntshav qabzib hauv cov ntshav thaum kho. Kev siv tshuaj ntau dua ntawm cov tshuaj hypoglycemic tej zaum yuav xav tau lub sijhawm thiab tom qab kho nrog cov tshuaj no.

Cov tshuaj yuav ua rau muaj kev pheej hmoo nyob rau hauv lub raum

Miconazole (rau kev siv thev naus laus zis, oromucous gel) txhim kho cov kev tiv thaiv hypoglycemic nrog kev txhim kho tau ntawm cov tsos mob ntawm tus mob hypoglycemia lossis tseem hnov qab.

Tsis pom zoo kev sib txuas ua ke

Phenylbutazone (rau kev siv systemic) txhim kho cov nyhuv hypoglycemic ntawm sulfonylurea (hloov nws txoj kev sib txuas nrog plasma protein thiab / lossis txo nws cov txiaj ntsig). Nws raug nquahu kom siv lwm cov tshuaj los tiv thaiv thiab kos tus neeg mob lub siab rau qhov xav tau thiab qhov tseem ceeb ntawm kev tswj tus kheej. Yog tias tsim nyog, qhov tshuaj ntawm Glyclad yog tswj hwm thaum lub sijhawm thiab tom qab noj tshuaj tiv thaiv.

Cawv yuav pab tau kom cov tshuaj tiv thaiv ntshav qab zib tsawg tsawg (los ntawm inhibiting qhov kev rov ua txhaum), uas tuaj yeem ua rau qhov pib ntawm hypoglycemic coma. Zam kev haus yeeb tshuaj uas muaj cawv, thiab haus cawv muaj cawv.

Tej kev sib txuam uas xav tau ceev faj

Ntxiv dag zog rau cov tshuaj hypoglycemic ntawm qee yam tshuaj thiab qee kis, hypoglycemia yuav tshwm sim los ntawm cov khoom siv sib luag nrog lwm cov tshuaj tiv thaiv kab mob nrog rau cov tshuaj (insulin, acarbose, metformin, thiazolidinediones, dipeptidyl peptidase 4 inhibitors, glucose-1-phosphate receptor agonists) ACE inhibitors (captopril, enalapril), H 2 receptor antagonists, MAO inhibitors, sulfonamides, clarithromycin, thiab tshuaj tsis-steroidal anti-inflammatory tshuaj.

Cov tshuaj noj uas tuaj yeem ua rau nce ntxiv hauv cov ntshav qab zib

Tsis pom zoo kev sib txuas ua ke

Danazole: Cov nyhuv ntshav qab zib ntawm Danazol.

Yog tias kev siv cov tshuaj nquag no tsis tuaj yeem zam, tus neeg mob yuav tsum raug ceeb toom txog qhov xav tau thiab qhov tseem ceeb ntawm kev saib xyuas nws tus kheej hauv cov piam thaj hauv ntshav thiab ntshav. Nws yuav raug kho los kho lub koob tshuaj tiv thaiv kab mob siab thaum lub sij hawm thiab tom qab kho nrog danazol.

Tej kev sib txuam uas xav tau ceev faj

Chlorpromazine (antipsychotic): kev siv tshuaj ntau ntawm chlorpromazine (> 100 mg rau ib hnub) nce qib ntawm cov piam thaj hauv cov ntshav (vim tias txo qis hauv insulin secretion).

Tus neeg mob yuav tsum tau txais kev ceeb toom txog qhov xav tau thiab qhov tseem ceeb ntawm kev soj ntsuam cov ntshav qabzib kom ntau. Nws yuav yog qhov yuav tsum tau hloov kho lub koob tshuaj tiv thaiv kab mob siab thaum lub sijhawm thiab tom qab kho cov tshuaj tiv thaiv kev puas hlwb.

Glucocorticoids (rau kev siv rau qhov systemic thiab tshuaj pleev: kev tso ntshav, nqaij thiab qhov quav) thiab tetracosactrin ua rau muaj ntshav qabzib ntau ntxiv nrog kev txhim kho ketosis (vim kev txo qis ntawm kev ua kom tau cov carbohydrates los ntawm glucocorticoids).

Tus neeg mob yuav tsum tau txais kev ceeb toom txog qhov xav tau thiab qhov tseem ceeb ntawm kev soj ntsuam cov ntshav qabzib kom qis, tshwj xeeb tshaj yog thaum pib kho. Nws yuav tsim nyog los kho lub koob tshuaj ntawm cov tshuaj tiv thaiv kab mob thaum lub sijhawm thiab tom qab kho glucocorticoid.

Ritodrin, salbutamol, terbutaline (c) nce qib ntawm cov piam thaj hauv cov ntshav vim los ntawm beta-2 agonists.

Nws yuav tsum raug ceeb toom txog qhov xav tau los tswj cov ntshav qabzib kom ntau. Yog tias tsim nyog, tus neeg mob yuav tsum pauv mus rau insulin.

Sib txuas ntxiv mus saib rau

Kev kho nrog anticoagulants (xws li warfarin, thiab lwm yam) sulfonylurea kev npaj tuaj yeem txhim kho cov nyhuv anticoagulant nrog kev kho mob concomitant. Cov tshuaj tiv thaiv Anticoagulant yuav tsum tau kho kom haum.

Daim ntawv thov nta

Txoj kev kho yog raug kho rau cov neeg mob uas tuaj yeem ua raws thiab noj cov zaub mov kom huv thiab tsis tu ncua (suav nrog noj tshais). Nws yog ib qho tseem ceeb uas koj niaj hnub noj cov khoom noj carbohydrates vim qhov muaj feem yuav muaj kev mob ntshav qab zib, uas tshwm sim thaum cov zaub mov noj lig, noj tsis txaus, lossis yog tias cov zaub mov muaj protein tsawg. Txoj kev pheej hmoo ntawm cov ntshav qog ntshav qab zib nce ntxiv nrog cov zaub mov tsis muaj calorie, ua lub cev ntev thiab mob lub cev, nrog cawv lossis nrog cov tshuaj tiv thaiv hypoglycemic.

Kev mob ntshav qab zib hauv lub cev tuaj yeem tshwm sim vim kev siv tib lub sijhawm sulfonylurea npaj thiab (saib "Kev Nyuaj Phem") hauv qee kis tuaj yeem mob hnyav thiab lub sijhawm ntev. Qee zaum yuav tsum tau mus pw hauv tsev kho mob thiab siv cov piam thaj ntev mus ob peb hnub yuav tsum ua.

Kev soj ntsuam kom zoo ntawm cov neeg mob, kev siv qee qhov tshuaj ntawm cov tshuaj thiab ua kom nruj rau kev siv tshuaj thiab cov ntawv thov noj mov yog tsim nyog los txo cov ntshav qog ntshav qab zib.

Qhov tseeb uas ua rau muaj kev phom sij ntawm hypoglycemia:

kev tsis kam lossis (tshwj xeeb yog cov neeg mob laus) cov neeg mob tsis muaj peev xwm koom tes,
Kev noj zaub mov kom tsawg-tsawg lossis ib txwm noj, khoom txom ncauj, ncua sij hawm ntawm kev yoo mov lossis hloov pluas noj,
ua txhaum ntawm qhov sib npaug ntawm qhov kev qoj ib ce thiab theem ntawm kev ua kom muaj carbohydrate,
lub raum tsis ua hauj lwm
mob siab hnyav ua haujlwm
kev noj tshuaj ntawm Glyclad,
qee cov kab mob ntawm cov endocrine: kab mob thyroid, hypopituitarism thiab adrenal tsis txaus,
kev siv lwm cov tshuaj ib txhij (saib ntu "Txawv nrog lwm yam tshuaj thiab lwm hom kev sib cuam tshuam").

Plaws thiab lub siab ua haujlwm

Cov chaw muag tshuaj thiab / lossis pharmacodynamics ntawm gliclazide yuav txawv rau cov neeg mob uas mob rau daim siab lossis mob raum tsis zoo. Kev mob ntshav ntu ntawm hypoglycemia uas tshwm sim hauv cov neeg mob zoo li no tuaj yeem ua rau ntev thiab yuav tsum ua qee yam ntsuas.

Tus Neeg Mob Cov Ntaub Ntawv

Tus neeg mob thiab nws tsev neeg yuav tsum tau ceeb toom txog qhov kev pheej hmoo ntawm lub qog ntshav qab zib, piav qhia txog nws cov tsos mob (saib ntu "Cov Kev Phom Sij"), kho mob, nrog rau qee yam uas ua rau muaj kev pheej hmoo ntawm nws txoj kev txhim kho.

Cov neeg mob yuav tsum paub txog qhov tseem ceeb ntawm kev noj zaub mov zoo, tawm dag zog kom tsis tu ncua, thiab ntsuas ntshav qab zib kom tsis tu ncua.

Kev ua txhaum ntawm cov kev cai ntawm cov ntshav qabzib

Cov xwm txheej hauv qab no tuaj yeem cuam tshuam txog kev tswj kav ntawm cov ntshav qabzib hauv cov neeg mob noj tshuaj tiv thaiv kab mob: ua npaws, mob, mob, lossis phais. Qee qhov xwm txheej, yuav tsum muaj insulin.

Kev ua rau lub ntsej muag ntshav qis dua ntawm kev siv tshuaj tiv thaiv kab mob, nrog rau gliclazide, txo qis lub sijhawm hauv ntau tus neeg mob: qhov no yuav tshwm sim vim qhov kev vam meej ntawm qhov mob ntshav qab zib lossis txo qis hauv kev teb rau kev kho mob. Qhov tshwm sim no yog paub tias yog theem nrab tsis ua haujlwm, uas sib txawv ntawm thawj qhov kev siv thaum cov tshuaj nquag tsis muaj txiaj ntsig hauv kev kho mob nrog thawj-kab yeeb tshuaj. Qhov tsim nyog hloov kho koob tshuaj thiab kev noj haus yuav tsum tau ua ua ntej xa tus neeg mob mus rau cov pab pawg theem nrab tsis ua haujlwm.

Nws raug nquahu los txiav txim siab txog qib glycosylated hemoglobin (lossis qib qab zib hauv kev yoo cov ntshav txhaws). Kev ntsuas tus kheej cov ntshav qab zib kuj tseem tsim nyog.

Kev kho mob ntawm cov neeg mob uas muaj piam thaj-6-phosphate dehydrogenase tsis muaj peev xwm nrog sulfonylurea kev npaj yuav ua rau hemolytic anemia. Txij li thaum gliclazide belongs rau chav kawm tshuaj lom neeg ntawm sulfonylurea kev npaj, cov neeg mob uas muaj piam thaj-6-phosphate dehydrogenase yuav tsum tau ceev faj; lwm txoj kev kho nrog tshuaj uas tsis muaj sulfonylurea yuav tsum tau txiav txim siab.

Kev Ceev Faj Txog Tej Yam

Gliclada muaj lactose. Cov neeg mob uas muaj mob tsis tshua muaj mob lactose tsis txaus ntseeg, nrog galactosemia lossis glucose-galactose malabsorption syndrome yuav tsum tsis txhob noj cov tshuaj no.

Siv thaum cev xeeb tub lossis lactation.

Tsis muaj kev paub dhau los ntawm kev siv gliclazide thaum cev xeeb tub, txawm hais tias muaj qee cov pov thawj ntawm kev siv lwm yam sulfonylureas.

Kev tswj ntshav qab zib yuav tsum ua tiav ua ntej cev xeeb tub txhawm rau txo cov kev pheej hmoo ntawm kev yug menyuam tsis tuaj yeem cuam tshuam txog kev tswj ntshav qab zib tsis tau.

Kev siv cov tshuaj tiv thaiv kab mob hauv qhov ncauj tsis pom zoo, insulin yog qhov tseem ceeb siv rau kev kho mob ntshav qab zib thaum cev xeeb tub. Nws raug nquahu kom hloov tus neeg mob mus rau insulin thaum xeeb menyuam lossis thaum nws tshwm sim.

Cov ntaub ntawv ntawm kev nkag mus ntawm gliclazide lossis nws cov metabolites rau hauv niam mis tsis muaj. Muab qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia hauv menyuam yaus, kev siv cov tshuaj tsis sib haum hauv cov pojniam uas tseem noj niam mis.

Lub peev xwm los cuam tshuam cov tshuaj tiv thaiv tus nqi thaum tsav tsheb lossis ua haujlwm nrog lwm cov txheej txheem.

Gliclada tsis muaj kev paub txog lub peev xwm los tsav lub tsheb lossis ua haujlwm nrog cov tshuab. Txawm li cas los xij, cov neeg mob yuav tsum ceev faj txog qhov pib ntawm cov tsos mob ntawm tus mob ntshav qab zib thiab kom ceev faj thaum tsav tsheb lossis siv tshuab, tshwj xeeb tshaj yog thaum pib kho.

Kev phiv tshuaj

Raws li kev paub nrog gliclazide thiab sulfonylurea derivatives, cov kev mob tshwm sim hauv qab no tau qhia.

Kev noj zaub mov tsis xwm yeem, thiab tshwj xeeb tshaj yog khoom noj txom ncauj thaum lub sij hawm kho nrog sulfonylureas, suav nrog Glyclad, tuaj yeem ua rau muaj kev txhim kho hypoglycemia. Cov tsos mob tshwm sim ntawm kev mob ntshav qab zib: mob taub hau, tshaib plab, xeev siab, ntuav, nkees, pw tsaug zog, ntxhov siab vim, chim siab, tsis hnov qab, tsis nco qab thiab ua rau muaj kev cuam tshuam tsawg, kev nyuaj siab, tsis pom kev thiab tsis hais lus, tsis meej pem, tshee, paresis, tsis hnov mob , kiv taub hau, ploj ntawm kev tswj tus kheej, delirium, ua kom qaug dab peg, ua pa nyuaj, bradycardia, nkees nkees, ploj ntawm kev nco qab thiab txawm tias txoj kev rov qab tsaug zog nrog lub txiaj ntsig tuag.

Tsis tas li ntawd, tej zaum yuav muaj qhov pom ntawm kev tsis sib haum adrenergic: kev tawm hws ntau dhau, daim tawv nqaij nplaum, ntxhov siab, tachycardia, hlab ntsha tawg, lub plawv dhia, lub plawv dhia, angina pectoris thiab arrhythmia.

Feem ntau cov tsos mob ploj tom qab noj carbohydrates (qab zib). Txawm li cas los xij, cov khoom cua dag ua rau tsis muaj kev cuam tshuam. Cov kev paub dhau los nrog lwm cov kev npaj sulfonylurea qhia tau hais tias kev txo ntshav qab zib tuaj yeem tshwm sim ntau zaus, txawm hais tias muaj kev ntsuas tau ua tiav tam sim ntawd.

Yog tias ntu kev kub siab ntawm ntshav qab zib mob hnyav thiab ncua sijhawm ntev dua, txawm tias nws tau raug tswj los ntawm cov piam thaj ntau ib nrab, kev mus pw hauv tsev kho mob sai thiab kev kho mob xwm txheej ceev yog qhov tsim nyog.

Feem ntau ntawm cov ntshav ntawm lub qog ntshav tau pom nyob rau hauv cov neeg mob uas muaj kev kho cov tshuaj insulin.

Lwm yam phiv

Los ntawm lub plab zom mov: mob plab, xeev siab, ntuav, dyspepsia, raws plab thiab cem quav. Cov tsos mob no tuaj yeem tshem tawm lossis txo qis los ntawm kev noj gliclazide thaum noj tshais.

Cov hauv qab no yog cov kev xav tsis zoo uas tsis tshua pom.

Ntawm ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: pob khaus, khaus, urticaria, angioedema, liab, liab mob maculopapular, kev muaj mob voos (xws li Stevens-Johnson syndrome thiab mob lom epidermal necrolysis).

Los ntawm cov roj ntsha ua haujlwm thiab cov kabmob lymphatic: kev hloov pauv ntawm cov ntshav hematological, suav nrog anemia, leukopenia, thrombocytopenia, granulocytopenia. Cov tshwm sim no tsis tshua muaj thiab feem ntau ploj tom qab kev txiav tu ncua yeeb tshuaj.

Ntawm ib sab ntawm daim siab thiab kab mob biliary: nce ntxiv hauv qib ntawm daim siab enzymes (AST, ALAT, alkaline phosphatase), kab mob siab (mob cais tawm). Thaum muaj mob cholestatic daj ntseg, kev siv cov tshuaj yuav tsum tsis ua mus ntxiv.

Los ntawm ob sab ntawm cov khoom hauv lub zeem muag: pom kev tsis pom kev ib ntus, vim muaj qhov hloov ntawm theem ntawm cov piam thaj hauv cov ntshav, kev tsis pom kev ib ntus tshwm sim, tshwj xeeb tshaj yog thaum pib kho.

Qhov cuam tshuam hauv cov khoom sulfonylurea:

Ib yam li lwm yam kev npaj ua sulfonylurea, tau muaj tus mob erythrocytopenia, agranulocytosis, hemolytic anemia, pancytopenia, ua xua vasculitis, hyponatremia, ua rau daim siab mob siab thiab ua rau lub siab ua haujlwm tsis zoo (piv txwv, nrog cholestasis thiab jaundice) thiab mob siab uas ploj tom qab tsis muaj kabmob lossis tus neeg raug ua rau lub siab ua rau lub siab tsis ua haujlwm.

Cov chaw muag tshuaj

Gliclazide txo qis ntshav qabzib ntau vim kev ua haujlwm ntawm insulin secretion los ntawm β-cov hlwb ntawm pancreatic islets ntawm Langerhans. Kev nce nyob rau theem ntawm cov tshuaj tiv thaiv postprandial thiab ua kom zais ntawm C-peptide mob siab txawm tias tom qab 2 xyoo ntawm kev siv tshuaj.

Gliclazide tseem muaj cov khoom muaj hemovascular.

Ntxim rau insulin secretion.

Gliclazide txo cov microthrombosis los ntawm ob lub tshuab uas tuaj yeem koom nrog hauv kev txhim kho kev mob ntshav qab zib mellitus:

ib nrab inhibits platelet aggregation thiab adhesion, txo tus naj npawb ntawm platelet ua cim (thr-thromboglobulin, thromboxane B 2)
cuam tshuam rau txoj kev ua haujlwm ntawm fibrinolytic ntawm vascular endothelium (nce tRA kev ua haujlwm).

Kev tiv thaiv ntawm cov kev mob uas mob ntshav qab zib hom II.

ADVANCE yog tus tseev tsim ntiaj teb multicenter randomized sim nrog bi-factorial tsim, tswj kev txheeb xyuas cov txiaj ntsig ntawm kev siv cov tshuaj tiv thaiv glycemic (HbAlc ≤ 6.5%) raws li tau hloov kho glycoslide ntsiav tshuaj (Gliclazide MR) piv rau cov qauv glycemic tswj thiab cov txiaj ntsig ntawm txo ntshav siab siab siv qhov sib xyaw ua ke ntawm perindopril / indapamide piv nrog cov placebo nyob rau tom qab ntawm cov kev kho mob tam sim no (ob chav dig muag sib piv) raws li cov nyhuv ntawm lub ntsiab kev tshwm sim micro - thiab microvascular rau cov neeg mob uas muaj ntshav qab zib hom II.

Txoj kev tshawb no suav nrog 11 140 cov neeg mob uas muaj hom mob ntshav qab zib hom mellitus (txhais tau tias: hnub nyoog 66 xyoo, BMI (lub cev nyhav) 28 kg / m 2, sijhawm mob ntshav qab zib 8 xyoo, HbAlc theem ntawm 7.5% thiab SBP / DBP (systolic ntshav siab / diastolic ntshav siab) 145/81 mmHg). Ntawm cov neeg mob no, 83% muaj mob ntshav siab, hauv 325 tus neeg mob thiab hauv 10%, kab mob macro- thiab micro-vascular tau sau cia keeb kwm ntawm tus kabmob, ntsig txog, thiab hauv 27%, microalbuminuria (MAU) tau kuaj pom. Feem ntau cov neeg mob tau kho ua ntej mob ntshav qab zib hom II, 90% - los ntawm kev noj tshuaj (47% - kev kho mob monotherapy, 46% - kho ob zaug thiab 7% - kho peb zaug) thiab 1% nrog insulin thaum 9% tsuas yog noj zaub mov noj. Thaum xub thawj, sulfonylurea (72%) thiab metformin (61%) feem ntau tau sau tseg. Kev pom zoo nrog rau 75 feem pua ntawm cov tshuaj uas txo cov ntshav siab (BP), lipid-txo cov tshuaj (35%, feem ntau yog statins - 28%), tshuaj aspirin thiab lwm yam tshuaj antiplatelet (47%). Lub sijhawm 6 lub lim tiam ntawm kev tswj hwm ntawm kev sib xyaw ntawm perindopril / indapamide thiab cov kev kho mob rau cov ntshav qab zib, cov neeg mob uas muaj lub luag haujlwm ua haujlwm tau muab cov qauv glycemic tswj kev tswj hwm (n = 5569), lossis MR glycazide kev tswj hwm raws li lub tswv yim ntawm kev siv tshuaj tiv thaiv glycemia (n = 5571). Lub tswv yim rau kev siv tshuaj glycemic tswj tau zoo yog los ntawm kev sau ntawv tshuaj Gliclazide MR los ntawm kev pib kho lossis los ntawm kev sau ntawv tshuaj Gliclazide MR es tsis txhob siv cov tshuaj kho mob (kev kho mob uas tus neeg mob tau txais thaum lub sijhawm koom nrog) nrog kev nce ntxiv rau hauv koob tshuaj rau qhov ntau thiab tom qab ntawd, yog tias tsim nyog, ntxiv rau lwm cov tshuaj uas muaj suab thaj, xws li: metformin, acarbose, thiazolidinediones lossis tshuaj insulin. Cov neeg mob tau saib zoo thiab taug qab kev noj zaub mov kom nruj.

Kev soj ntsuam tau ntev li 4.8 xyoo. Qhov tshwm sim ntawm Gliclazide MR kho, uas yog lub hauv paus ntawm cov tswv yim rau kev tswj hwm glycemic (qhov nruab nrab ua tiav HbAlc qib yog 6.5%) piv rau kev tswj glycemia (qhov nruab nrab ua tiav HbAlc qib yog 7.3%), qhov tseem ceeb txo qis ntawm 10% tus txheeb ze txoj kev pheej hmoo ntawm cov teeb meem loj heev- thiab microvascular teeb meem ((HR) 0.90, 95% Cl 0.82, 0.98 p = 0.013, 18.1% ntawm cov neeg mob los ntawm pawg tswj hwm mob sib piv piv rau 20% ntawm cov neeg mob los ntawm pab pawg tswj hwm). Qhov zoo ntawm cov tswv yim rau kev tswj hwm glycemic nrog kev teem caij ntawm MR gliclazide hauv lub hauv paus ntawm txoj kev kho yog vim:

qhov tseem ceeb txo qis hauv qhov kev pheej hmoo txheeb ze ntawm cov teeb meem microvascular loj dua 14% (HR 0.86, 95% Cl 0.77, 0.97, p = 0.014, 9.4% vs. 10.9%),
qhov kev txo qis tseem ceeb ntawm cov kev pheej hmoo sib txheeb ntawm cov mob tshiab lossis kev nce qib ntawm nephropathy los ntawm 21% (HR 0.79, 95% Cl 0.66 - 0.93, p = 0.006, 4.1% vs. 5.2%),
qhov tseem ceeb txo qis hauv kev pheej hmoo sib piv ntawm microalbuminuria, uas tshwm sim rau thawj zaug, los ntawm 8% (HR 0.92, 95% Cl 0.85 - 0.99, p = 0.030, 34.9% vs. 37.9%),
qhov tseem ceeb txo qis hauv kev pheej hmoo rau kev txheeb ze raug txo los ntawm 11% (HR 0.89, 95% Cl 0.83, 0.96, p = 0.001, 26.5% vs. 29.4%).

Qhov kawg ntawm txoj kev tshawb no, 65% thiab 81.1% ntawm cov neeg mob hauv pawg tswj hwm zoo (vs 28.8% thiab 50.2% ntawm pawg tswj hwm tus qauv) ua tiav HbAlc lub hom phiaj ≤ 6.5% thiab ≤ 7%, feem.

90% ntawm cov neeg mob hauv cov pab pawg tswj hwm tau siv Gliclazide MR (qhov nruab nrab ib hnub yog 103 mg), 70% ntawm lawv tau noj ntau tshaj plaws ib hnub ntawm 120 mg. Hauv kev siv tshuaj tswj glycemic tswj hwm raws li Gliclazide MR, tus neeg mob lub cev qhov hnyav tseem nyob ruaj khov.

Cov txiaj ntsig ntawm Glycoslazide MR-based glycemic tswj lub tswv yim tsis yog nyob ntawm txo qis ntshav siab.

Qib ntawm gliclazide nyob rau hauv cov ntshav plasma nce siab thaum thawj 6:00, mus txog ib lub toj siab uas txuas ntxiv rau 6-12 teev tom qab kev tswj hwm ntawm cov tshuaj. Gliclazide yog qhov ua kom tiav rau hauv txoj hnyuv plab. Kev noj tsis cuam tshuam rau tus nqi thiab npaum li cas ntawm kev nqus.

Cov kev sib raug zoo ntawm qhov koob nce txog 120 mg thiab thaj chaw hauv qab qhov nkhaus-sijhawm nkhaus yog kab. Kev khi rau cov ntshav plasma protein yog 95%.

Gliclazide yuav luag tag nrho cov zaub mov hauv lub siab thiab ua rau lub tso zis. Tsawg dua li 1% ntawm gliclazide raug nthuav tawm tsis hloov pauv ntawm cov zis. Tsis muaj cov metabolites hauv lub plasma ntshav.

Ib nrab-lub neej ntawm gliclazide los ntawm lub cev yog 12-20 teev. Qhov xa tawm yog kwv yees li 30 litres.

Thaum siv tib lub koob tshuaj ntawm cov tshuaj no, cov ntsiab lus ntawm gliclazide hauv cov ntshav ntshav tau tswj xyuas 24 teev.

Hauv cov neeg laus laus, cov teeb meem pharmacokinetic tsis hloov pauv ntau.

Kev sib hloov ntawm ib leeg-ib leeg yog tsawg.

Kab Mob Ntshav Qab Zib Hom II:

txo thiab tswj ntshav qabzib thaum nws tsis tuaj yeem ua kom tsis muaj ntshav qabzib ntau dhau los ntawm kev noj zaub mov zoo, tawm dag zog lossis poob phaus
kev tiv thaiv ntawm cov teeb meem ntawm hom II mob ntshav qab zib mellitus: txo kev pheej hmoo ntawm loj heev- thiab microvascular cov teeb meem, nrog rau cov mob tshiab lossis mob nyhav rau cov neeg mob ntshav qab zib hom II mob ntshav qab zib.

Cov Menyuam Yaus

Siv thaum cev xeeb tub lossis lactation

Kev siv cov tshuaj tiv thaiv kab mob hauv qhov ncauj tsis pom zoo, insulin yog qhov tseem ceeb siv rau kev kho mob ntshav qab zib thaum cev xeeb tub. Nws raug nquahu kom tus neeg mob hloov mus rau insulin thaum xeeb menyuam lossis thaum nws tshwm sim.