Ntụziaka maka mbadamba mbadamba Amaryl

Otu mbadamba mmanya nke Amarsh 1 mg nwere: ihe na-arụ ọrụ: glimepiride - 1 mg,

ndị na-ahụkarị: lactose monohydrate, sitena sodium carboxymethyl (tndi A), povidone 25000 (E1201), celclosese microcrystalline (E460), magnesium stearate (E470), iron oxide red dye (E172).

Otu mbadamba Amarsh 2 mg nwere: ihe na - arụ ọrụ: glimepiride - 2 mg,

ndị na-ahụkarị: lactose monohydrate, sodium carboxymethyl stachi (ụdị A), povidone 25000 (E1201), microcrystalline cellulose (E460), magnesium stearate (E470), ọla edo na-acha odo odo (E172), indigo carmin aluminom varnish (E132).

Otu mbadamba nke Amarsh 3 mg nwere: ihe na-arụ ọrụ: glimepiride - 3 mg.

ndị na - ahụkarị: lactose monohydrate, sitena sodium carboxymethyl stachi (ụdị A), povidone 25000 (E1201), microcrystalline cellulose (E460), magnesium stearate (E470), ihe nchara na-acha odo odo (E172).

Otu mbadamba nke Amarsh 4 mg nwere: ihe na - arụ ọrụ: glimepiride - 4 mg.

ndị na - ahụkarị: lactose monohydrate, sitena sodium carboxymethyl sitiri (ụdị A), povidone 25000 (E1201), microcrystalline cellulose, magnesium stearate (E460), indigo carmine aluminom varnish (E132).

Amarsh 1 mg: Onyinye mbadamba uhie, pink di larịị na akuku ya na uzo nkewa. Stampụ Top: Aha NMK / Brand. Akara ala: Akara Aha / NMK.

Amarsh 2 mg: Onyinye akwụkwọ ndụ akwụkwọ ndụ dị larịị, nke dị n ’akụkụ abụọ ya na ibelata nkebi na akụkụ abụọ. Stamp nke dị elu: Aha NMM / Brand. Akara ala: Akara Aha / NMM.

Amarsh 3 mg: Onyinye mbadamba n’elu, n’akụkụ abụọ nke agba odo na -acha n ’ụzọ n’ ụzọ abụọ. Stampụ n’elu: Aha NMN / Brand. Akara ala: Akara Aha / NMN.

Amarsh 4 mg: Onyinye mbadamba ihe dị n’elu abụọ nke mbadamba ihe na-acha anụnụ anụnụ na ndagwurugwu ụzọ abụọ. Stampụ n’elu: Aha NMO / Brand. Akara ala: Aha Brand / NMO.

Omume ọgwụ

Glimepiride, ihe na-arụ ọrụ nke Amaril, bụ ọgwụ hypoglycemic (na-ebelata shuga) maka iji ọnụ mee ihe - ihe sitere na sulfonylurea.

Glimepiride na - akpali insulin na ntọhapụ nke insulin site na mkpụrụ ndụ beta nke pancreas (mmetụta a na - eme), na - eme ka ịdị ọcha nke anụ ahụ (akwara na abụba) rụọ ọrụ insulin nke ya (mmetụta extrapancreatic).

Ihe ndị dị na Sulfonylurea na-achịkwa izochi insulin site na imechi ọwa mmiri ọgwụ ATP na-adabere na mkpụrụ ndụ cytoplasmic nke mkpụrụ ndụ beta pancreatic. Na-emechi oghere ndị dị na potassium, ha na-akpata depolarization nke mkpụrụ ndụ beta, nke na-enyere aka mepee ụzọ calcium ma na-abawanye usoro nke calcium n'ime sel. Glimepiride, nwere nnukwu ọnụọgụ mgbakwunye, na-agwakọta ma na-ewepụ protein protein beta-cell (molar mass 65 kD / SURX), nke jikọtara na ọwa mmiri ọgwụ ATP na-adabere, ma dị iche na saịtị nke ọdịbendị ọdịnala mbụ.

sulfonylureas (protein molar mass 140 kD / SUR1). . - X p>

Usoro a na - eduga na mwepụta nke insulin site na exocytosis, na nke a. -ogo nke insulin zoro ezo bu nke di ala n’enweghi nke ihe ndi ozo. Mmetụta kacha nta nke glimepiride na insulin insulin na-enye ntakịrị ihe ize ndụ nke hypoglycemia.

Na mgbakwunye, a gosipụtara mmetụta extrapancreatic nke glimepiride (mbelata insulin iguzogide, mmetụta dị ala na sistem obi, mgbochi-atherogenic, mgbochi mkpali na antioxidant) gosipụtara, nke nwekwara ụdị ọdịbendị sulfonylurea, ma ọ bụ nke obere.

Site na anụ ahụ na - eme ka glucose dị n'ọbara site na akwara anụ ahụ (akwara na abụba) na - apụta site na nchedo mbugharị pụrụ iche (GLUT1 na GLUT4) nke dị na sel sel. Transportbufe glucose na akwara ndị a na ụdị ọrịa shuga 2 bụ ihe na-eme ka a na -eleta ọsọ ọsọ na ojiji nke glucose. Glimepiride na - eme ka ọnụọgụ glucose na - ebugharị ụmụ irighiri (GLUT1 na GLUT4) na - eme ngwa ngwa, na - ebute mmụba nke glucose site na anụ ahụ.

Glimepiride nwere mmetụta mgbochi inhibitory na-esighi ike na K_AỌwa TF nke kadiomyocytes. Mgbe ị na-ewere glimepiride, a na-echekwa ike ịmegharị ikike nke metabolic nke myocardium na ischemia.

Glimepiride na-abawanye ọrụ nke glycosyl phosphatidylinositol-phospholipase kpọmkwem, nke ọgwụ Lipogenesis na glycogenesis nwere ike mezie na akwara dịpụrụ adịpụ na mkpụrụ ndụ abụba.

Glimepiride na-egbochi mmepụta glucose na imeju site na ịbawanye ụba intracellular nke fructose-2,6-bisphosphate, nke n'aka nke na-egbochi gluconeogenesis.

Glimepiride na-egbochi cyclooxygenase ma belata ntụgharị nke arachidonic acid na thromboxane A2, nke na-akwalite nchịkọta platelet, si otú ahụ na-arụ ọrụ antithrombotic.

Glimepiride na - enye aka na nhazi nke ihe dị n'ime mmiri ahụ, na --ebelata ọkwa nke obere aldehyde n'ime ọbara, nke na - eduga n'ịbelata oke nke peroxidation lipid, nke a na - enye aka na ọgwụ mgbochi atherogenic. Glimepiride na-abawanye ọkwa nke a-tocopherol, ọrụ nke catalase, glutathione peroxidase na superoxide dismutase, nke na-enyere aka belata nrụgide oxidative n'ahụ ahụ onye ọrịa, nke na-adị mgbe niile n'ụdị ụdị ọrịa shuga 2 nke ọrịa mellitus.

N’ime ndị ahụ dị mma, ọgwụ glimepiride dịkarịa ala dị ihe dị ka 0.6 mg. Nsonaazụ nke glimepiride bụ dose dabere na ịmụgharị. A na-emeghachi omume mmeghachi omume nke anụ ahụ na mgbatị anụ ahụ dị ukwuu na mbelata insulin na-agbanye mmiri mgbe ị na-ewere glimepiride.

Enweghị nnukwu ọdịiche dị na nsonaazụ ahụ, dabere ma a theụrụ ọgwụ ahụ nkeji iri atọ tupu nri ma ọ bụ ozugbo nri .. N'ime ndị ọrịa nwere ọrịa shuga, enwere ike ịchịkwa metabolic afọ ojuju karịa awa 24 site na ị takingụ otu ọgwụ kwa ụbọchị.

N'agbanyeghị eziokwu ahụ bụ na glimepiride hydroxymetabolite kpatara ntakịrị ntakịrị mbelata ọbara mgbatị ọbara na ndị ọrịa, metabolite a bụ maka naanị obere akụkụ nke mmetụta ọgwụ niile.

Ngwakọta ọgwụ na metformin

N’otu nnyocha ụlọ ọgwụ, emere ka ọ pụta ìhè na n’ime ndị ọrịa nwere nsonaazụ ọgwụgwọ na-adịghị afọ ojuju, n’agbanyeghi oke metformin, ojiji nke glimepiride n’otu oge na metformin na-enye njikwa metabolic ka mma ma e jiri ya tụnyere metotin monotherapy.

Ngwakọta ọgwụ na insulin

Ihe data maka ngwakọta nke glimepiride na insulin dị ụkọ. Ndị ọrịa nwere ọgwụgwọ na-enweghị afọ ojuju na oke nke glimepiride nwere ike ịmalite ọgwụgwọ insulin n'otu oge. N'ime ule abụọ nke ọgwụgwọ, ọgwụgwọ ngwakọta nyere otu nkwalite metabolic ahụ dị ka insulin monotherapy, ma, n'ihe metụtara ọgwụgwọ njikọ, achọrọ obere insulin.

Otu Penti Pụrụ Iche

Childrenmụaka na ndị nọ n'afọ iri na ụma

A na-eme nnwale ụlọ ọgwụ nwere njikwa ike (glimepiride ruo 8 mg kwa ụbọchị ma ọ bụ metformin ruo 2,000 mg kwa ụbọchị) ka ejiri ụmụaka 285 (afọ 8-17 dị afọ 8) nwee ụdị ọrịa shuga na-adịgide adịgide. Ngwakọta abụọ ahụ, glimepiride na metformin, gosipụtara nnukwu mbelata na HbAlc dabere na ọkwa mbu nke glimepiride -0.95 (na ser 0, 41), metformin -1.39 (na ser 0.40). N'agbanyeghi nke a, glimepiride ezughi oke nke onodu “adighi ka nke metformin”, na-ekpe ikpe site na mgbanwe mgbanwe na HbAlc dabere na akara ngosi nke mbu. Ihe dị iche bụ 0.44% kwadoro metformin. Oke dị elu (1.05) ntụkwasị obi 95%

oge nke ọdịiche ahụ dị elu karịa ikike kwere nke opekempe arụmọrụ ruru 0.3%,

Ọgwụ Glimepiride ekpughereghị nchekwa nchekwa maka ụmụaka ma e jiri ya tụnyere ndị okenye nwere ọrịa shuga nke 2. Enweghị data sitere na nrụpụta ogologo oge na ọmụmụ nchekwa maka ndị ọrịa ụmụaka.

Mlọ ọgwụ

Mgbe inwetara glimepiride ya bioavailability zuru ezu. Iri nri adighi enwe mmetuta di iche-iche, ewezuga ihe na adighi ike. Site na iji glimepiride ugboro ugboro na ọgwụ kwa ụbọchị nke 4 mg, ntinye kachasị na ọbara ọbara (C_tah) abatachara ihe dị ka elekere 2.5 na ihe ruru 309 ng / ml, enwere mmekọrịta kwụ ọtọ n’etiti dose na Stax, yana n’etiti dose na AUC (mpaghara dị n’okpuru oge itinye uche).

Ejiri Glimepiride mara oke nkesa nke dị obere (ihe dị ka 8.8 L), ihe ruru nha olu nke nkesa albumin, ogo dị elu na-egbochi protein plasma (ihe karịrị 99%) na mkpochasị dị ala (ihe dịka 48 ml / min).

Biotpansformatssh na mwepụ

Mgbe otu ọgwụ glimepiride na-enwetụ otu ugboro, 58% dị na mmamịrị ebe 35% na feces. Achọpụtaghị ihe dị n’ime mmamịrị. Mwepu ọkara ndụ na plasma nke ọgwụ a serum kwekọrọ na otutu usoro dosing bụ 5-8 awa. Mgbe ị sesụsịrị ọgwụ ọ ,ụ ,ụ dị elu, ọkara ndụ ahụ na-abawanye ntakịrị.

A na-achọpụta metabolites abụọ na - adịghị arụ ọrụ na mmamịrị na feces, nke etolite n'ihi metabolism na imeju, otu n'ime ha bụ ihe na - ewepụta hydroxy, ma nke ọzọ bụ ọgwụ sitere na carbon. Mgbe abatasịrị nke glimepiride, ọkara ndụ nke metabolites ndị a bụ awa 3-5 na awa 5-6, n'otu n'otu.

Glimepiride na-apụ apụ na mmiri ara ara ma na-agafe ihe mgbochi placental. Ọgwụ na-abanye n’adịghị mma site na mgbochi ụbụrụ ọbara.

Tụnyere nke otu na ọtụtụ (otu ugboro kwa ụbọchị) nchịkwa glimepiride ekpugheghị ọdịiche pụtara ìhè na ọgwụ ọgwụ, a hụkwara ngbanwe ha dị oke ala n'etiti ndị ọrịa dị iche iche. Ọ nweghị ọgwụ dị ịrịba ama.

Otu Penti Pụrụ Iche

Pharmacokinetic parampam yiri na ndị ọrịa nke nwoke na nwanyị na ụmụ afọ dị iche iche. N’ebe ndị ọrịa nwere nsogbu gbasara akụrụngwa (ya na iwere ya dị obere), enwere mmụba nke glimepiride ma belata ogo mgbanye ya n’obara ọbara, nke kachasị bụ n’ihi ọgwụ ngwa ngwa n’onwe ya n’ihi obere njikọ ya na protein. N'ihi ya, na ụdị ndị ọrịa a, ọ nweghị ihe ize ndụ ọzọ nke nchịkọta nke ọgwụ.

Nnwale iji mụọ gbasara ọgwụ ọgwụ, nchekwa, na nnagide nke otu 1 mg nke glimepiride na ndị ọrịa 30 (4 ụmụaka gbara afọ 10-12 na ụmụaka 26 dị afọ 12-17) na-arịa ụdị ọrịa shuga 2 gosipụtara na nkezi AUCo -i_{dị ka}t, C_max na X ihe analogueschny ụkpụrụ ekwuru na ndị okenye.

Ihe ngbanwe

Ekwesighi iji glimepiride maka:

• hypersensitivity na glimepiride ma ọ bụ na akụkụ ọ bụla na-adịghị arụ ọrụ nke ọgwụ ahụ, na ihe ndị ọzọ na-ere sulfonylurea ma ọ bụ ọgwụ sulfa (ihe egwu nke mmeghachi omume hypersensitivity),

• ọrịa shuga na-akpata insulin,

• ketoacidosis na-arịa ọrịa shuga, precca shuga na coma,

• nnukwu nsị akwara,

O nwere oke nrụrụ akụrụngwa (ya na ndị ọrịa na -akpata hemodialysis),

• ime na lactation.

Ime na lactation

A na-enyefe ihe dị n’ime ụmụ nwanyị dị ime. N'ihe dị ime tụwara ime ma ọ bụ mmalite nke afọ ime, a ga-agafara nwanyị na insulin ọgwụ.

Ebe ọ bụ na glimepiride, dịka o doro anya, na-abanye na mmiri ara ara, ekwesighi inye ya ụmụ nwanyị n'oge a na-enye ya ara. N'okwu a, ọ dị mkpa ka ị gbanwee gaa na ọgwụ insulin ma ọ bụ ịkwụsị ị breastụ ara.

Usoro onunu ogwu na nhazi

Bu n'obi iji ọnụ.

Ihe ndabere maka njikwa ọrịa shuga na-aga nke ọma bụ nri kwesịrị ekwesị, mmega ahụ usoro, yana ilebara ọbara na mmamịrị anya oge niile. Nri mbido sitere na ndụmọdụ nri, enweghị ike ịkwụ ụgwọ ma ọ bụ mbadamba ma ọ bụ insulin.

Usoro izizi na nhọrọ ịhọrọ ya

A na-ekpebi usoro nke glimepiride site na nyocha nke glucose n'ọbara na mmamịrị.

Ọgwụ nke mbụ bụ 1 mg nke glimepiride kwa ụbọchị, ọ bụrụ n’otu oge ahụ a na-enweta njikwa metabolic na-aga nke ọma - a ga-edobe dose a n’oge ọgwụgwọ.

Maka usoro usoro ọgwụgwọ ndị ọzọ, mbadamba dịnụ na usoro kwesịrị ekwesị.

Ọ bụrụ na ọ dị mkpa, enwere ike ịbawanye ubochi kwa ụbọchị n’ilele nlebara anya glucose na ọbara (yana oge izu 1-2) yana n’usoro: 1 mg - 2 mg - 3 mg - 4 mg glimepiride kwa ụbọchị.

Ọgwụ nke glimepiride karịrị 4 mg kwa ụbọchị na-eduga na nsonaazụ kachasị mma naanị n'ọnọdụ ndị dị egwu. Ihe kachasị akwadoro kwa ụbọchị bụ 6 mg.

Ọ bụ dọkịta ga-ekpebi oge na oge ole ị na-eme kwa ụbọchị, na-eburu n'uche ụdị ndụ onye ọrịa dị. Dịka iwu, nhọpụta kwa ụbọchị na 1 dose ozugbo tupu ma ọ bụ n'oge nri ụtụtụ ma ọ bụ, ma ọ bụrụ na ụbọchị adịghị

Ewere ya ozugbo tupu ma ọ bụ n'oge nri mbụ. Agaghị ewepụchapụrụ ọgwụ a site na nchịkwa na-esote nke ị doseụ ọgwụ dị elu. A na-ewere mbadamba mkpụrụ osisi Amaril, na-enweghị ata, na mmiri nwere ezuru (ihe dị ka iko 0.5). Ọ dị ezigbo mkpa ịhapụ isi nri mgbe ị gachara Amaril.

Jiri na metformin mee ihe

N'ọnọdụ nkwanyeghị afọ nke ike glucose n'ọbara n'ime ndị ọrịa na-ewere metformin, enwere ike ịmalite ọgwụgwọ consolitant with glimepiride. Ka ị na-ejigide dose nke metformin n'otu ọkwa ahụ, ọgwụgwọ glimepiride na-amalite site na obere opekempe, mgbe nke ahụ, ọgwụ ya ji nke nta nke nta na-abawanye dabere na ọkwa glycemic chọrọ. Ekwesịrị ịmalite ọgwụgwọ njikọta n'okpuru nlekọta ahụike.

Jiri yana insulin

N'ọnọdụ ebe ọ na-agaghị ekwe omume ịnweta nhazi nke glucose n'ọbara site na ị takingụ ọgwụ glimepiride kachasị na monotherapy ma ọ bụ na nchịkọta nke oke nke metformin, ngwakọta glimepiride na insulin ga-ekwe omume. N'okwu a, ọgwụ ikpeazụ glimepiride enyere onye ọrịa ahụ agbanwebeghị. N'ọnọdụ a, ọgwụgwọ insulin na-amalite site na obere opekata mpe, jiri mmụba nke insulin na-esote mmụba nke insulin n'okpuru njikwa nke glucose n'ọbara. Ijikọtara ọgwụgwọ chọrọ nlekọta nlekọta ahụike. Ka ị na-ejigide nchịkwa ogologo oge, usoro ọgwụgwọ a na-ejikọ ọnụ nwere ike belata ihe insulin chọrọ ruo 40%.

Nyefee onye ọrịa site na ọgwụ ọgwụ hypoglycemic ọzọ gaa glimepiride Enweghị mmekọrịta ọ bụla dị n'etiti ọgwụ glimepiride na ọgwụ ọgwụ hypoglycemic ọzọ. Mgbe ị na-ebufe site na ọgwụ ndị dị otú ahụ na glimepiride, usoro mbụ nke ụbọchị ikpeazụ ga-abụ 1 mg (ọbụlagodi na a na-ebugharị onye ọrịa na glimepiride na oke ọgwụ nke ọgwụ hypoglycemic ọzọ).Mmụba ọ bụla na dose nke glimepiride kwesịrị ịmalite na nkebi, na-eburu n'uche mmeghachi omume glimepiride dabere na ndụmọdụ ndị dị n'elu. Ọ dị mkpa iburu n'uche usoro ejiri mee ihe na oge nke mmetụta nke onye na-ahụ maka hypoglycemic gara aga. N'ọnọdụ ụfọdụ, ọkachasị mgbe ị na - ewere hypoglycemic ọgwụ na ọkara ndụ ogologo (dịka ọmụmaatụ, chlorpropamide), ọ nwere ike ịdị mkpa nwa oge (n'ime ụbọchị ole na ole) ịkwụsị ọgwụgwọ iji zere mmetụta mmụba nke na-abawanye ohere ịba ụba hypoglycemia.

Nyefee onye ọrịa na insulin gaa glimepiride

N'ọnọdụ ndị pụrụ iche, ọ bụrụ na ndị ọrịa nwere ụdị shuga mellitus nke 2 na-anata ọgwụgwọ insulin, mgbe ahụ site n'ịkwụghachi ọrịa ahụ yana ọrụ echekwara nke mkpụrụ ndụ beta pancreatic, enwere ike igosi ha mbufe na glimepiride. Ekwesịrị ime ntụgharị a n'okpuru nlekọta ahụike dị nso. N'okwu a, nnyefe onye ọrịa na glimepiride na-amalite site na obere glimepiride nke 1 mg.

Ngwa maka akụrụngwa na akụrụ

Enweghi ozi zuru oke banyere iji ọgwụ ahụ eme ihe na ndị ọrịa nwere akụrụ na ọrịa ịba ọcha n'anya (lee ngalaba Contraindications).

Childrenmụaka na ndị nọ n'afọ iri na ụma

Achọpụtaghị data maka ojiji nke glimepiride na ndị ọrịa na-erubeghị afọ 8. Maka ụmụaka dị afọ 8 ruo 17, enwere obere data maka iji glimepiride n'ụdị monotherapy (lee ngalaba ọgwụ na ngalaba Pharmacodynamics). Ihe omuma di ugbu a banyere odi nma na nchekwa ezughi oke maka iji glimepiride na ulo ogwu, ya mere adighi akwado udiri ihe di otua.

Mmetụta akụkụ

Ihe omuma banyere mmeghachi omume ojoo na-akpata site na ị gụ glimepiride na ihe ndị ọzọ na-eme ka sulfonylurea pụta bụ ndị a ka e gosipụtara n'okpuru ikpe ikpe. A na-ekezi mmeghachi omume ọjọọ na klaasị sistem ma kekọta ọnụ iji belata ugboro ole ihe a na - eme (ọtụtụ mgbe:> 1/10, mgbe mgbe:> 1/100, 1/1000, 1/10000,

Dodoụbiga ya ókè

Mgbe abatasịrị nnukwu glimepiride, mmepe nke hypoglycemia ga-ekwe omume, na-adịgide site na awa 12 ruo 72, nke enwere ike ikwugharị mgbe mmalite nke mbido glucose dị n'ọbara. Enwere ike ịkwụsị hypoglycemia oge niile site na nri nke carbohydrates ozugbo (glucose ma ọ bụ shuga, dịka ọmụmaatụ, n'ụdị mpempe shuga, ihe ọ fruitụ fruitụ mkpụrụ osisi ma ọ bụ tii). N'akụkụ a, onye ọrịa ahụ kwesịrị inwe ma ọ dịkarịa ala 20 g glucose (iberibe shuga 4). Ndị na-atọ ụtọ ụtọ anaghị arụ ọrụ na ọgwụgwọ hypoglycemia. N'ọnọdụ ka ukwuu, a na-atụ aro ịlele n'ụlọ ọgwụ. Ọgwụgwọ gụnyere mbido ọgbụgbọ, iwere mmiri (mmiri ma ọ bụ lemonade na unyi na-arụ ọrụ (adsorbent) na sodium sulfate (laxative)) Mgbe ị na-a takingụ nnukwu ọgwụ ahụ, a na-egosi ọnya afọ, na-esote ntinye nke unyi na sodium sulfate. ihe onyonyo onyonyo nke opi, ya mere, o choro ọgwụgwọ ozigbo n’ilebe onye dibia, na onodu ufodu na ime ulo ogwu nke onye oria. Ngwa ngwa o kwere omume, iwebata glucose, ma oburu na odi nkpa. N'ihe iv ogwu ogwu nke 50 ml nke uzo 40%, soso nbanye nke uzo 10% ma jiri nlezianya nyochaa oke nke glucose na ọbara, ọgwụgwọ ozo kwesiri ibu ihe ngosi.

Enwere ike ịrịa ọrịa hypoglycemia ma ọ bụ na-anọghị ya kpamkpam na ndị ọrịa agadi, na ndị ọrịa na-ata ahụhụ site na autonomic neuropathy ma ọ bụ na-anata ọgwụgwọ n'otu oge na p-adrenoblockers, clonidine, reserpine, guanethidine ma ọ bụ ndị ọzọ nwere ọmịiko.

Ọ bụrụ na ndị dọkịta dị iche iche na-agwọ onye ọrịa na-arịa ọrịa shuga (dịka ọmụmaatụ, n'oge ọnụnọ ụlọ ọgwụ mgbe ihe ọghọm, na-arịa ọrịa na ngwụsị izu), ọ ga-agwa ha banyere ọrịa ya na ọgwụgwọ mbụ.

Na ọgwụgwọ hypoglycemia nke malitere site na nchịkwa mberede nke Amaril site na ụmụ aka ma ọ bụ ụmụaka, ekwesịrị ilebara anya nke dextrose (50 ml nke 40% ngwọta) iji zere hyperglycemia dị ize ndụ. N'akụkụ a, ọ dị mkpa ileba anya nke ọma n'ịchịkọta glucose na ọbara.

Mmekọrịta na ọgwụ ndị ọzọ

N'ihe banyere iji ọgwụ glimepiride nke ụfọdụ ọgwụ ndị ọzọ, ma mbelata na-adịghị mma na mmụba a na-achọghị na hypoglycemic mmetụta nke glimepiride nwere ike ime. N'akụkụ a, ọgwụ ọgwụ ndị ọzọ nwere ike ị withụ ya naanị site n'ikike (ma ọ bụ dịka enyere ya).

Glimepiride bụ cytochrome P4502C9, nke a kwesịrị ịtụle ma ejiri ya mee ihe n'otu oge na ntinye (dịka egampampicin) ma ọ bụ inhibitors (dịka ọmụmaatụ fluconazole).

Na mmekọrịta mmekọrịta vivo bipụtara na akwụkwọ ahụ na-egosi na fluconazole, otu n'ime ihe kachasị ike na-egbochi CY32C9, na-abawanye AUC nke glimepiride ihe dị ka ugboro abụọ.

Dabere na ahụmịhe glimepiride na usoro ndị ọzọ na-esi na sulfonylurea, ekwesịrị ịmatu mmekọrịta ndị a.

Enwere ike ịbawanye mmụba hypoglycemic na mmepe nke hypoglycemia metụtara nke a site na ojiji nke glimepiride n'otu oge na ọgwụ ndị a:

- phenylbutazone, azapropazone, oxyphenbutazone,

- insulin na ọgwụ hypoglycemic ndị ọzọ, dị ka metformin,

- salicylates na aminosalicylic acid,

- anabolic steroid na nwoke na nwanyi homonụ nwoke,

- chloramphenicol, ụfọdụ ndị na - arụ ọrụ sulfonamides ogologo oge, tetracyclines, quinolones na clarithromycin,

- angiotensin na - agbanwe enzyme (ACE)

- fluoxetine, monoamine oxidase inhibitors (MAO),

- allopurinol, probenicide, sulfinpyrazone,

- cyclo-, tro- na ifosfamides,

- pentoxifylline (ya na nchịkwa parenteral na nnukwu usoro),

Enwere ike ịhụ mmebi nke ike hypoglycemic na mmụba metụtara njikọta nke glucose n'ọbara site n'otu oge iji glimepiride na ọgwụ ndị a:

- estrogens na progestogens,

- saluretics na thiazide diuretics,

- homonụ thyroid, glucocorticosteroids

- epinephrine na ndị ọzọ na - enye nkwado ọgwụ,

- nicotinic acid (na oke doses) na usoro nke nicotinic acid,

- laxatives (iji ogologo oge),

- glucagon, barbiturates na rifampicin,

Ndị na - ebugharị N₂ndị na-anabata ihe, clonidine na reserpine na-enwe ike ịkwalite ma wedata ike hypoglycemic nke glimepiride.

N'okpuru mmetụta nke ndị na - eme ebere, dị ka beta-igbochi, clonidine, guanethidine na reserpine, akara nke adrenergic counterregulation na nzaghachi hypoglycemia nwere ike belata ma ọ bụ anọghị ya.

Na-agbakwunye nzụlite glimepiride, enwere ike ịhụbawanye ma ọ bụ na-akụda mmụọ nke ihe ndị sitere na coumarin.

Otu ị orụ mmanya na-egbu egbu ma ọ bụ nke na-adịghị ala ala nwere ike ịkwalite ma wedata ike hypoglycemic nke glimepiride.

Njirimara ngwa

Ekwesịrị iji glimepiride ozugbo tupu ma ọ bụ n'oge nri.

Ọ bụrụ na a na-eri nri n’oge oge ụfọdụ ma ọ bụ na-amapụkwa kpam kpam, onye ọrịa na-anara ọgwụgwọ glimepiride nwere ike ịmalite

hypoglycemia. Ihe mgbaàmà puru iche nke hypoglycemia gụnyere: isi ọwụwa, agụụ siri ike, ọgbụgbọ, ọgbụgbọ, ịda mba, ụra, nchekasị ụra, nchekasị, oke iwe, ịta ahụhụ, nlebara anya na mmeghachi omume, ịda mba, ọgba aghara, okwu na nhụsianya anya, aphasia, jijiji, paresis , nsogbu ọgba aghara, nkụda mmụọ, mmetụta nke enweghị enyemaka, ọnwụ nke njide onwe onye, ​​nchekasị, ụbụrụ na-akpata ọgba aghara na enweghị uche, gụnyere coma, iku ume na-emighị emi, bradycardia. Na mgbakwunye, n'ihi nzaghachi adrenergic usoro, mgbaàmà dị ka oyi, ọsụsọ clammy, nchegbu, tachycardia, ọbara mgbali, obi palpitations, angina pectoris, na obi mgbakasị obi nwere ike ime.

Ngosiputa ogwu nke akwara hypoglycemia nke oma yiri nkea nke gosiputara oria aru.

N'ihe fọrọ nke nta ka ọ bụrụ n'ọnọdụ niile, enwere ike ịchịkwa mgbaàmà site na ịnweta hydrocarbons ozugbo (sugar). Ihe na-atọ mmadụ ụtọ adịghị mma n'otu oge.

Dị ka amaara site na ahụmịhe iji usoro ndị ọzọ nke sulfonylurea, na agbanyeghị ọganiihu n'ụzọ mbido, hypoglycemia nwere ike ịmaliteghachi.

Ọrịa hypoglycemia siri ike ma ọ bụ ruo ogologo oge, nke ị amountsụ shuga na-achịkwa naanị nwa oge, chọrọ ọgwụgwọ ozugbo ma ọ bụ ọbụna ụlọ ọgwụ.

Ihe ndi n’enye aka na mmepe nke hypoglycemia gụnyere:

- ịda mba ma ọ bụ (na - eme agadi) ezughị ezu nke ndị ọrịa iji soro dọkịta kwenye, nkwarụ, nri na-ezighi ezi, nri iri nri, ibu ọnụ,

- mgbanwe na nri ị na-emebu.

- ahazighi ahazi n’etiti mmega ahu na oriri ndi ahu,

- ịụ mmanya na-egbu egbu, ọkachasị yana nri nri,

- arụ ọrụ akụrụngwa na-arụ ọrụ, ọrụ imeju na-arụ ọrụ nke ukwuu.

- ụfọdụ ọrịa na - agbakọghị agbanwe agbanwe nke usoro endocrine na - emetụta metabolism metabolism, ma ọ bụ nzaghachi hypoglycemia (dịka ọmụmaatụ, ụfọdụ dysfunctions nke thyroid gland, pituitary insufficiency ma ọ bụ ezughi oke nke adrenal cortex), ojiji nke ọgwụ ụfọdụ ndị ọzọ (lee mmekọrịta na ọgwụ ndị ọzọ. )

Withgwọ glimepiride chọrọ ka a na-enyochakarị glucose na ọbara na mmamịrị. Na mgbakwunye, a na-atụ aro ọkwa hemoglobin glycosylated.

Ọzọkwa, mgbe a na-agwọ glimepiride, ịlele ọrụ imeju na ịgụta mkpụrụ ndụ ọbara (ọkachasị leukocytes na platelet) dị mkpa.

N'ọnọdụ nrụgide (dịka ọmụmaatụ, mgbe ihe ọghọm, arụmọrụ mberede, ọrịa febrile, wdg), enwere ike igosipụta oge mgbanwe insulin.

Enweghị ahụmịhe na glimepiride n'ime ndị ọrịa nwere nnukwu akụrụ okpu ma ọ bụ na ndị ọrịa chọrọ hemodialysis. A na-egosi ndị ọrịa nwere nnukwu akụrụ ma ọ bụ oke ịba ọcha ọkụ ka ha gbanwee insulin.

Iji ọgwụgwọ sulfonylurea mee ihe nwere ike ibute anaemia hemolytic n'ime ndị ọrịa nwere ụkọ glucose-6-phosphate dehydrogenase. Ebe ọ bụ na glimepiride bụ nke otu usoro sulfonylurea, ekwesịrị iji ya kpachara anya na ndị ọrịa nwere ụkọ glucose-b-phosphate dehydrogenase. Na mgbakwunye, a ga-atụle nhọrọ nhọrọ ọgwụgwọ na ndị nnọchi ọzọ na-enweghị ụdị mmanụ sulfonylurea.

Amaryl nwere lactose monohydrate, yabụ ekwesighi iburu ya na ndị ọrịa nwere ọrịa lactose e ketara eketa, ụkọ lactase ma ọ bụ mmịpụta glucose-lactose.

Emebeghị nnyocha nke uto nke glimepiride n'ikike nke ịnya ugbo ala. Enwere ike belata nzaghachi nke onye ọrịa ma ọ bụ ikike itinye uche n'ihi mmepe nke hypoglycemia ma ọ bụ hyperglycemia, ma ọ bụ, dịka ọmụmaatụ, n'ihi nkwarụ anya. Mmetụta ndị a nwere ike ịdị ize ndụ n'ọnọdụ ebe ikike ndị a dị ezigbo mkpa (dịka ọmụmaatụ, mgbe ị na-anya ụgbọ ala ma ọ bụ igwe).

Ekwesịrị ịgwa ndị ọrịa banyere mkpa ị ga-akpachapụ anya iji zere hypoglycemia mgbe ha na-anya ụgbọala. Nke a dị mkpa karịsịa maka ndị ọrịa nwere ọrịa hypoglycemia ugboro ugboro, ma ọ bụ ndị ọrịa na-ezughi ezu ma ọ bụ na-amachaghị ihe ịrịba ama mbụ nke hypoglycemia. N'ụdị ndị a, a ga-atụle ike nke ịnya ụgbọ ala ma ọ bụ igwe eji arụ ọrụ.

Ngwakọta na ụdị ntọhapụ

A na-emepụta Amaryl na mbadamba nwere 1-4 mg, nke a na-etinye ya na mbak. Otu mkpọ ọgwụ ahụ nwere ike ị nweta blisters 2, 4, 6 ma ọ bụ 8.

• Otu mbadamba ọgwụ ahụ gụnyere ihe ndị na - arụ ọrụ - glimepiride - 1-4 mg na ngwa inye aka: lactose monohydrate, povidone, sodium carboxymethyl stachi, microcrystalline cellulose, indigo carmine na magnesium stearate.

Linlọ ọgwụ na ọgwụ ọgwụ: ọgwụ hypoglycemic ọgwụ.

Ntụziaka maka ojiji

Dabere na ntuziaka maka ojiji, usoro ọgwụgwọ nke Amaryl na Amaryl M ka dọkịta depụtara n’otu n’otu maka onye ọrịa ọ bụla, dabere n’otú ọkwa shuga dị n’ọbara nke onye ọrịa dị. Ekwesịrị iji ọgwụ ahụ mee ihe na ntakịrị opekempe iji nweta njikwa metabolic dị mkpa.

Ntụziaka maka ojiji nke Amaril na-akọkwa na ọgwụgwọ chọrọ mkpebi siri ike nke itinye glucose n'ọbara na ọkwa nke hemoglobin glycosylated.

Ekwesịrị iji mbadamba amaryl zuru ezu, na-enweghị ịta ata, na mmiri mmiri zuru ezu (ihe dị ka iko 1/2). Ọ bụrụ na ọ dị mkpa, enwere ike ikewa mbadamba ọgwụ Amaryl ya na nsogbu ya ụzọ abụọ.

• Usoro mbu nke Amaril bụ 1 mg 1 oge / ụbọchị. Ọ bụrụ na ọ dị mkpa, enwere ike ịbawanye ubochi kwa ụbọchị (na oge nke 1-2 izu) n'okpuru nlele glucose ọbara kwa mgbe na usoro a: 1 mg-2 mg-3 mg-4 mg-6 mg (-8 mg) kwa ụbọchị .
• N'ime ndị ọrịa nwere ụdị ọrịa shuga 2 na-achịkwa nke ọma, usoro a na-ahụ kwa ụbọchị na-abụkarị mg mg mg. Aụ ọgwụ kwa ụbọchị nke ihe karịrị 6 mg dị irè karịa naanị ntakịrị ndị ọrịa.

Mmebi nke ị pụ ọgwụ, dịka ọmụmaatụ, na-agafe ọgwụ ọzọ, ekwesighi ịme ya site na iji Amaril na-esote ọgwụ dị elu.

Ọ bụ dọkịta ga-ekpebi oge ị ga-ewere mbadamba mbadamba na ikesa ọgwụ niile kwa ụbọchị. N'otu oge ahụ, ọ na-eburu n'uche ụdị ndụ onye ọrịa nwere (oge ole a na-emega ahụ, oge nri, nri). A na-agbanye ọgwụ kwa ụbọchị na ọgwụ 1, ozugbo nri ụtụtụ zuru oke. Ọ bụrụ na a doseụghị ọgwụ kwa ụbọchị, tupu nri nri mbụ. Ọ dị mkpa ịhapụ isi nri mgbe ị takingụsịrị ọgwụ.

A na-arụkarị ọgwụ glimepiride ogologo oge.