Glibenclamide: nkọwa ọgwụ, nyocha na ntuziaka

Ọgwụ hypoglycemic ọgwụ. Nchịkwa nke sulfonylureas.

Koodu ATX: A10VB01.

Glibenclamide na -ebelata mkpokọ glucose na ọbara. Mmụba na ịba ụba nke insulin plasma na mbelata ọkwa glucose na-ewere nwayọ. N'ụzọ dabara adaba na-emetụta usoro metabolic. Omume ahụ na-etolite awa 2 mgbe nchịkwa, rute ihe kachasị ma elekere asaa ruo elekere 7-8 wee rue awa 8-12.

Mmekọrịta na ọgwụ ndị ọzọ

Na-akwalite nsonaazụ anticoagulants na-apụtaghị ìhè.
Ndị na-ewepụta acidic acid (ammonium chloride, calcium chloride, ascorbic acid na nnukwu usoro) na-eme ka mmetụta glibenclamide nwee ike.

Antifungal systemic n'aka (azole nkwekọrịta), fluoroquinolones, tetracyclines, chloramphenicol, H2-blockers, beta-blockers, Ace inhibitors, ndị so ná ndị antiinflammatory ọgwụ ọjọọ, monoamine oxidase inhibitors, clofibrate, bezafibrate, probenecid, acetaminophen, ethionamide, anabolic Steroid, pentoxifylline, allopurmnol , cyclophosphamide, reserpine, sulfonamides, insulin na-enye aka na mmepe nke hypoglycemia.
Barbiturates, phenothiazines, diazoxide, glucocorticoid na homonụ thyroid, estrogens, gestagens, glucagon, ọgwụ adrenomimetic, nnu nke lithium, nicotinic acid acid, rifampicin na saluretics na-ebelata ike hypoglycemic.

Ihe ngbanwe

A na-egbochi Glibenclamide n'ọnọdụ ndị a:

• Mellitus-shuga na-arịa ọrịa shuga (ụdị 1), gụnyere ụmụaka na ndị nọ n'oge uto,
• ọrịa mamịrị ketoacidosis,
• ọrịa mamịrị acomụrụma
• mwepu pancreas
• hyperosmolar coma,
• oke akụrụ ma ọ bụ imeju akwara (mmacha nke creatinine erughị 30 ml / min),
• oke oku
• nnukwu mmerụ ahụ
• ihe ogwugwo
• eriri afọ,
• paresis nke afo
• malabsorption nke nri na mmepe nke hypoglycemia,
• leukopenia
• ịbawanyewanye na uche onye ọgwụ ahụ yana ọgwụ ọgwụ sulfa ndị ọzọ na sulkalluluas.
• ime na lactation
• gbara afọ 14.

Womenmụ nwanyị na-eme atụmatụ ime, yana ịmụ nwa, kwesịrị ịgbanwe insulin ma ọ bụ kwụsị inye ara kpamkpam.

Usoro onunu ogwu na nhazi

Ekwesịrị iji mmiri dị obere glibenclamide sachaa ya. Dọkịta na-ekpebi ọgwụ mbụ na ọnụọgụ ọgwụ maka ọgwụgwọ mmezi maka onye ọrịa ọ bụla n'otu n'otu, dabere na nsonaazụ nyocha nke ogo glucose na mmamịrị na ọbara. Ọ bụ ntuziaka maka ojiji Glibenclamide chọrọ.

Usoro mbụ nke ọgwụ bụ ọkara mbadamba (2.5 mg) otu ugboro n'ụbọchị. Ọ bụrụ na ọ dị mkpa, enwere ike ịbawanye kwa ụbọchị site na ị na-elele mgbe niile ịba ụba nke glucose na ọbara. Ekwesịrị iji nwayọ were mmụba were bulie ya ruo ọtụtụ ụbọchị site na 2.5 mg, ruo mgbe a ga-enweta ọ̀tụ̀tụ̀ ọgwụgwọ dị mma.

Oke kachasị nwere ike ịbụ mbadamba 3 kwa ụbọchị (15 mg). Amountgafe ego a anaghị ebuli mmetụta hypoglycemic.

Ọ bụrụ na ọgwụ ahụ dị ihe dị ka mbadamba 2 kwa ụbọchị, mgbe ahụ, a na-ewere ha n'otu oge n'ụtụtụ tupu nri. Ọ bụrụ na ịchọrọ iji ọgwụ buru ibu karị, mgbe ahụ ọ ka mma ịme ya na doses abụọ, rashọn ahụ kwesịrị ịbụ 2: 1 (n'ụtụtụ na mgbede).

Ndị ọrịa merela agadi kwesịrị ịmalite ọgwụgwọ site na ọkara nke ọkara ya na mmụba ya na etiti otu izu agaghị karịa 2.5 mg kwa ụbọchị.

Ọ bụrụ n’arụ ahụ mmadụ ma ọ bụ otú o si ebi ndụ gbanwere, a ga-agbanwe ọgwụ ọ ga-arụ. Ọzọkwa, a ga-eme mgbazi ma ọ bụrụ na enwere ihe ndị na - eme ka ịbawanye hyperglycemia ọgụ.

N'ịdoụfe ọgwụ ọgwụ a, hypoglycemia amalite. Aria ya:

1. amata aja aja
2. nchegbu
3. ọbara na ọbara mgbali elu, ihe mgbu n'obi, arrhythmia,
4. isi ọwụwa
5. ubara agụụ, ọgbụgbọ, ọgbụgbọ,
6. iro ụra, enweghị mmasị,
7. iwe na nchekasị
8. ịta ahụhụ,
9. nkụda mmụọ, nsụhọ nzuzo,
10. paresis, shoor,
11. mgbanwe mgbanwe
12. mbufụt nke mkpụrụ ndụ ihe nketa.

N'ọnọdụ ụfọdụ, na ngosipụta ya, hypoglycemia yiri ọrịa strok. Coma nwere ike itolite.

Treatmentụbiga ọgwụ ike ókè

Site na ogo hypoglycemia dị nwayọ ruo obere, enwere ike ịkwụsị ya site na oriri nke carbohydrates (Mpekere shuga, tii dị ụtọ ma ọ bụ ihe ọ fruitụ fruitụ mkpụrụ osisi). Ya mere, ndị na-arịa ọrịa shuga kwesịrị iburu glucose ugboro 20 ghaa (iberibe shuga anọ).

Ndị na-atọ ụtọ anaghị enwe ọgwụgwọ ọgwụgwọ na hypoglycemia. Ọ bụrụ na ọnọdụ onye ọrịa ahụ dị oke njọ, mgbe ahụ ọ ga-achọ ka akpọga ya ụlọ ọgwụ. Gbalịsie ike itinye mgbali ma chekwaa mmiri mmiri (mmiri ma ọ bụ lemonade nwere sodium sulfate na carbon carbon), yana ọgwụ hypoglycemic.

Mmetụta akụkụ

Site n'akụkụ nke metabolism nwere ike ịbụ:

hypoglycemia, oge ehihie, na - eso:

• isi ọwụwa
• agụụ
• ọgbụgbọ
• nsogbu ụra
• n’abali
• nchegbu
• ịma jijiji
• zachapu oyi nke ajirija ajirija,
• tachycardia
• gbagwojuru anya
• ike gwụrụ
• nsogbu ụbụrụ na ahụrụ ụzọ

Mgbe ụfọdụ enwere ike ịnwe nkwarụ na coma, yana:

1. mmanya na-abawanye ókè
2. I nweta ibu
3. dyslipidemia, aru nke aru adi adi,
4. site n'iji ogologo oge, mmepe nke hypofunction nke thyroid gland ga-ekwe omume.

Site na nri digestive:

• ọgbụgbọ, vomiting,
• ike ọgwụgwụ, ahụ erughị ala na mmetụta nke afọ,
• flatulence, obi mgbawa, afọ ọsịsa.
• mụbara ma ọ bụ belata agụụ,
• n'ọnọdụ ndị a na-adịghị ahụkebe, ọrụ imeju nwere ike igbochi, ịba ọcha n'anya, cholestatic jaundice, porphyria nwere ike ịmalite.

Site na sistemụ hemopoietic:

1. ọ dịkarịghị adị enwere ike ịnwe akwara ma ọ bụ ọbara ọgbụgba,
2. leukopenia
3. agranulocytosis,
4. pancytopenia
5. eosinophilia
6. thrombocytopenia.

• ọtụtụ erythema, fotoensitivity ma ọ bụ exfoliative dermatitis adịkarịghị etolite,
• nfụkasị ahụ nye ndị na - eme ka thiazide, sulfonamides ma ọ bụ sulfonylureas nwere ike ime.

Mmetụta ọzọ:

Enweghi omimi nke homonụ antidiuretic, yana:

• anya ntughari
• ọzịza nke ihu
• aka na nkwonkwo ụkwụ
• ịda mba
• iju
• ogwe
• onye nzuzu
• Coma
• nsogbu ọgba obibi (obere oge).

Ọ bụrụ na enwere mmeghachi omume na-adịghị mma ma ọ bụ ihe ọhụụ na-adịghị ahụkebe, mgbe ahụ ị kwesịrị ịkpọtụrụ dọkịta gị gbasara ọgwụgwọ ọzọ na ọgwụ a, ka ọ dị ugbu a, a ga-eyigharịrị Glibenclamide.

Njirimara ngwa

Dọkịta kwesịrị ịmara mgbe niile ihe onye ọrịa mere na ọgwụ ndị otu a. Ekwesịrị iji Glibenclamide mee ihe mgbe ọ bụla naanị na usoro onyonyo a tụrụ aro ya na oge a kapịrị ọnụ n ’ụbọchị. Nke a bụ ezigbo ntuziaka maka ojiji, ma ọ bụghị Glibenclamide akwadoghị.

Dọkịta na-ekpebi usoro ọgwụgwọ ahụ, nkesa nnabata ziri ezi n'oge ụbọchị na oge ojiji, dabere na usoro onye ọrịa kwa ụbọchị.

Iji mee ka ọgwụ nwee ike bute glucose ọbara dị mma, ọ dị mkpa ịgbaso nri pụrụ iche yana ị takingụ ọgwụ, ịme mmega ahụ ma belata oke ahụ, ma ọ bụrụ na ọ dị mkpa. Ihe a niile kwesịrị ịdị ka ntuziaka maka ojiji.

Onye ọrịa ahụ kwesịrị ịgbalị igbochi oge anwụ na-ebelata ma belata nri nke abụba.

Kpachara anya na njehie ị takingụ ọgwụ ahụ

Oge izizi kwesiri ibu ụzọ kwado dọkịta, ị gaghị ejikwa ọgwụ ahụ ogologo oge karịa oge a tụrụ aro. Ekwesịrị iji mgbakwunye Glibenclamide na analogues jiri nlezianya mee ihe banyere ọrịa febrile, adrenal insufficiency, a alcoụrụma, ọrịa thyroid (hyper- ma ọ bụ hypothyroidism), bụrụ na ọ nwere ọrụ imeju na-adịghị mma, yana ndị ọrịa agadi.

Site na monotherapy ihe karịrị afọ ise, nguzo nke abụọ nwere ike ịmalite.

Nnyocha ụlọ nyocha

N'oge ọgwụgwọ glibenclamide, ịkwesịrị ilebara anya n'ọbara mgbe niile (mgbe a na-ahọrọ ọgwụ a, ekwesịrị ịme ya ọtụtụ ugboro n'izu), yana ọkwa nke glycated haemoglobin (ọbụlagodi otu ugboro kwa ọnwa atọ), ebe a nwere ihe dị mkpa yana glucose na mmamịrị. Nke a ga - eme ka ọ kwe omume ịchọpụta ihe bụ isi ma ọ bụ nke abụọ megide ọgwụ a n'oge.

Shouldkwesịrị ka ị nyochaa ọnọdụ ọbara dị n'elu (ọkachasị ọdịnaya nke mkpụrụ ndụ ọbara ọcha na platelet) yana ọrụ imeju.

Nsogbu nke hypoglycemia na mmalite nke ọgwụ ịgwọ ọrịa

N'ime usoro ọgwụgwọ mbụ, ohere ị ga-ebute ọrịa a na-abawanye, ọkachasị ma ọ bụrụ na nri adịghịzị ma ọ bụ iri nri na-adịghị adị. Ihe ndị na-enye aka na mmepe nke hypoglycemia:

1. enweghi ike ma ọ bụ achọghị ime nke ndị ọrịa, ọkachasị ndị agadi, ịgọnyere dọkịta ma were Glibenclamide ma ọ bụ ihe atụ ya,
2. erighị ihe na-edozi, ụdị nri na-eri oge ma ọ bụ nri na-efu,
3. akpachapụghị anya dị n'etiti oriri na ịba n'anya na arụ ọrụ,
4. njehie na nri
5. na-a alcoholụ mmanya, karịsịa ma ọ bụrụ na ị na-adịghị edozi ahụ
6. ọrụ ezughi oke,
7. nnukwu ọrịa imeju,
8. ịdoụ ọgwụ ọdoụ .ụ
9. ọrịa na-enweghị nchịkwa nke usoro endocrine nke na-emetụta metabolism metabolism, yana mgbochi nke hypoglycemia, gụnyere pituitary na adrenocortical insufficiency, ọrụ thyroid na-arụ ọrụ.
10. n'otu oge iji ụfọdụ ọgwụ ndị ọzọ.

Drugsdị ọgwụ ọjọọ a si arụ ọrụ:

• gliclazide (mbadamba 30mg),
• gliclazide (80 mg nke ọ bụla),
• gliclazide maxpharma,
• diadeon
• mamịrị MV,
• glurenorm.

Glibenclamide bụ otu nke ndị ọrụ hypoglycemic nke na-ahụ maka nchịkwa ọnụ. O nwere usoro ihe eji eme ihe di mgbagwoju anya, nke mejuputara na mmezi ya na nke puru iche.

Mlọ ọgwụ

Mgbe nchịkwa ọnụ gasịrị, a na-enweta mmịkọta nke glibenclamide ngwa ngwa ma dịkwa irè n'ọhịa ahụ. Na ule nnabata nke vitro gosipụtara na Glibenclamide ihe na-arụ ọrụ wepụtara ihe dị ka 63% nke ihe na-arụ ọrụ n'ime nkeji iri na ise, 72% n'ime nkeji 60. N'otu oge ahụ, iri nri nwere ike ibute mbelata nke ọbara na plasma ọbara ma e jiri ya tụnye ya na nri afọ. Njikọ nke glibenclamide na albumin na plasma ọbara karịrị 98%. N'ime imeju, a na-agbanwe glibenclamide kpamkpam ka ọ bụrụ metabolites abụọ: 4-trans-hydroxy-glibenclamide na 3-cis-hydroxy-glibenclamide. A na-ekepụta metabolites abụọ n'otu oge site na akụrụ na imeju. Nkezi ọkara ndụ glibenclamide site na plasma ọbara bụ awa 1.5-3.5. Ogologo oge omume a, o kwekọghi na ọkara ndụ site na plasma ọbara. N'ime ndị ọrịa nwere obere ọrụ imeju, a na-ebelata plasma excretion. Na ọdịda akụrụngwa na-agafeghị oke (mwepụ nke creatinine nke 30 ml / min), mwepụ nke glibenclamide na metabolites abụọ ahụ na-agbanwe agbanwe, na nnukwu akwara siri ike, mmụpụta ga-ekwe omume.

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

Ọgwụ a na-adabere na afọ, ogo nke ọrịa shuga, ịta nke glucose ọbara na-ebu ọnụ na awa 2 mgbe ị risịrị nri. Ogologo ubochi ubochi sitere na 2.5 ruo 15 mg. Oge nchịkwa dị ugboro 1-3 kwa ụbọchị maka nkeji 20-30 tupu eri. Usoro onyonye ihe kariri 15 mg / ụbọchị anaghị ebido ogo mmetụta hypoglycemic. Ọgwụ izizi n’ebe ndị ọrịa agadi dị 1 mg / ụbọchị.

Mgbe dochie ọgwụ hypoglycemic nwere ụdị ọrụ a, a na-edepụtara ha dịka atụmatụ enyere dị n'elu, ọgwụ ị gara aga na-akwụsị ozugbo. Mgbe ị na-agbanwe site na biguanides, usoro mbụ kwa ụbọchị bụ 2.5 mg, ọ bụrụ na ọ dị mkpa, a na-amụba kwa ụbọchị kwa ụbọchị 5-6 site na 2.5 mg ruo mgbe a ga-enweta ụgwọ. Na enweghị ụgwọ n'ime izu 4-6, ọ dị mkpa ikpebi na usoro njikọta ọgwụ.

Nsonaazụ

Hypoglycemia (nke megidere usoro ịsingụ ọgwụ na nri ezughị oke), oke ibu, ahụ ọkụ, ọrịa arthralgia, proteinuria, mmeghachi omume nfụkasị (ọnya anụ ahụ, itching), dyspepsia (ọgbụgbọ, afọ ọsịsa, mmetụta nke oke ibu na epigastrium), nsogbu akwara ozi (paresis, ọrịa uche) , hemopoiesis (hypoplastic ma ọ bụ hemolytic anaemia, leukopenia, agranulocytosis, pancytopenia, eosinophilia, thrombocytopenia), arụ ọrụ imeju (cholestasis), mbubreyo cutaneous porphyria, mgbanwe na uto, polyuria, foto ensibilizatsiya, isi ọwụwa, ike ọgwụgwụ, adịghị ike, dizziness.

Dodoụbiga ya ókè. Mgbaàmà: hypoglycemia (agụụ, ọsụsọ, adịghị ike siri ike, palpitations, ịma jijiji, nchekasị, isi ọwụwa, ọgbụgbọ, ehighị ụra, obi mgbawa, ịda mba, ụbụrụ akụkụ, okwu isi na ọhụhụ, mmụọ na-adịghị mma), hypoglycemic coma.

Ọgwụgwọ: ọ bụrụ na onye ọrịa maara, were shuga n'ime, yana mwepụ - inject iv dextrose (iv bolus - 50% dextrose solution, mgbe ahụ infusion nke 10% ngwọta), 1-2 mg glucagon s / c, i / m ma ọ bụ iv, diazoxide 30 mg iv maka minit 30, na-elele glucose ịta 15 nkeji, yana ikpebi pH, urea nitrogen, creatinine, na electrolytes n'ime ọbara. Mgbe ọ nwetasịrị, ọ dị mkpa inye onye ọrịa ahụ nri nwere nnukwu carbohydrates na-adị ngwa ngwa (iji zere ịmalite ịmalite hypoglycemia). Na ọrịa ụbụrụ, mannitol na dexamethasone.

Ntụziaka pụrụ iche

Ọ dị mkpa ilebara ọkwa glucose anya mgbe niile n'ọbara na afọ efu na mgbe ị risịrị nri, usoro ụbọchị niile nke ọdịnaya glucose n'ọbara na mmamịrị.

N'ihe banyere usoro ịwa ahụ ma ọ bụ oria shuga, enwere ike ịtụle iji insulin eme ihe.

E kwesiri ịdọ ndị ọrịa aka na ntị gbasara ịba ụba hypoglycemia n'ihe banyere ethanol oriri (gụnyere mmepe nke mmeghachi omume disulfiram-: mgbu afọ, ọgbụgbọ, ọgbụgbọ, isi ọwụwa), NSAIDs, na agụụ.

N'oge ọgwụgwọ, a naghị atụ aro ka ọ nọrọ n’anyanwụ ogologo oge.

Imeghari otu ọ̀ dị mkpa maka ịghara oke nri anụ ahụ na nke mmetụta uche, mgbanwe nri.

A ga-ekpuchi ngosipụta nke ọrịa hypoglycemia mgbe ị na-ewere beta-blockers, clonidine, reserpine, guanethidine.

N'oge usoro ọgwụgwọ, a ga-akpachara anya mgbe ị na-anya ụgbọ ala ma na-eme ihe ndị ọzọ nwere ike ịdị ize ndụ chọrọ mgbanye uche na ọsọ nke mmeghachi omume psychomotor.

Ajuju, azịza, nyocha banyere ọgwụ Glibenclamide

Ihe omuma a enyere ndi okacha amara n’ulo ogwu. Ihe omuma nke oma banyere ogwu a di na ntuziaka ndi emeputara na nkwakọ. Enweghị ozi edeputara na ibe a ma ọ bụ na saịtị ọ bụla ọzọ nwere ike ịnọchite anya arịrịọ nke onye ọkachamara.

Dodoụbiga ya ókè

Usoro ọgwụgwọ: ogwu ogbugba nke 40 - 100 ml nke 20% ngwọta glucose na / ma ọ bụ (na n'ọnọdụ ebe catheterization nke akwara agaghị ekwe omume) intramuscular ma ọ bụ subcutaneous ọgwụ na 1-2 ml nke glucagon. Maka mgbochi nke nlọghachi azụ mgbe a nwetasịrị mmụọ, a na-ekwu okwu carbohydrates (20-30 carbohydrates ozugbo na oge ọ bụla ruo awa 2 ruo 3) n'ime awa 24 ruo 48 na-esote, ma ọ bụ na-agbatị glucose ogologo oge (5 na 20%). Ọ ga-ekwe omume ịhazi glucagon 1 ml intramuscularly kwa awa iri anọ na anọ ọ bụla n’ime awa iri anọ na anọ ọ bụla.Nyochaa shuga ọbara oge ọ dịkarịa ala awa 48 mgbe njedebe nke nnukwu ọrịa hypoglycemic gasịrị. N'ọnọdụ ebe, n'ihu ọnụnọ nke mmanya oke (dịka nke ebumnuche igbu onwe onye), ọnwụ nke mmụọ na-adịgide, mgbatị gafere ogologo nke 5-10% glucose, n'ọbara nke achọrọ glucose dị n'ọbara kwesịrị ịbụ ihe dịka 200 mg / dl. Mgbe minit 20 gasịrị, ịmaliteghachi ihe ngwọta nke glucose 40% ga-ekwe omume. Ọ bụrụ na ndise adabaghị agbanwe, ọ dị mkpa ịchọ maka ihe ndị ọzọ kpatara mwepu, na mgbakwunye na-eduzi ọgwụgwọ maka ọrịa ụbụrụ (dexamethasone, sorbitol), nlebara anya nke onye ọrịa na ọgwụgwọ. N'ime oke nsi, a ga-ebu ha ọnụ yana usoro ndị dị n'elu, yana usoro izugbe iji kpochapụ nsị (gastric lavage, inweta vomiting), ma chekwazie unyi na-arụ ọrụ. Glibenclamide eweputaghi site na hemodialysis.

Ọnọdụ nchekwa

Chekwaa na nju okpomọkụ kariri 25 Celsius C nke iru ụmụaka.

Mwepụta weputara:
Glibenclamide - mbadamba nkume.
Mbadamba mbadamba 30 n’ime ite.

1 mbadambaGlibenclamide nwere glibenclamide 5 mg.
Ndị na-ahụ maka ihe: lactose monohydrate, stachi nduku, silium croscarmellose, povidone 25, magnesium stearate, silloon silicon dioxide, indigo carmine E 132.