Ma muli o ke kumukūʻai nui o Amaril, hoʻohana pinepine ʻia nā analogues e hoʻomaʻamaʻa i nā glucose koko i ka maʻi maʻi me ka maʻi ʻokoʻa ʻole o ka maʻi o ka insulin. He kūpono kēia lāʻau lapaʻau no ka mālama ʻana i ka glycemia me ka meaʻai kūikawā a me ke ʻano haʻuki.
Eia naʻe, ʻaʻole hiki i nā mea āpau ke kūʻai aku i kēia ʻaila hypoglycemic. No laila, i kēia ʻatikala, e hōʻike ʻia ka hana o ka lāʻau lapaʻau ma Amaril a laila e kapa ʻia kona mau ʻano hoʻohālikelike i hana ʻia ma Lūkia.
ʻO ka hana lāʻau lapaʻau ma ka lāʻau
ʻO Amaryl kahi lāʻau lapaʻau hypoglycemic waha e kōkua ai i ka hoʻokahe o ke koko ma o ka hoʻoulu ʻana i ka hoʻokuʻu a me ka hoʻōla ʻana o ka synthesis o nā insulin e nā cell beta maʻamau i loaʻa i ka kiko pancreatic.
ʻO ka hana nui no ka hoʻoulu ʻana i ke kaʻina hana syntʻI ka hoʻonui ʻana ʻo Amaril i ka pane ʻana o nā ʻōnaehana beta i kahi nui o ke kao o ka glucose i ke kahe koko o kekahi kanaka.
I nā liʻiliʻi liʻiliʻi, ua hāʻawi kēia lāʻau lapaʻa i ka hoʻonui liʻiliʻi i ka hoʻokuʻu ʻana i ka insulin. Loaʻa iā Amaryl ka waiwai e hoʻonui ai i ka manaʻo o ka membrane cell-dependant insulin i ka insulin.
ʻO ka lilo ʻana i ka hopena o ka sulfonylurea, hiki i Amaril ke hoʻomohala i ke kaʻina o ka hana o ka insulin. ʻO kēia ka hōʻoia i ka mea o ka ulu ikaika o ka lāʻau lapaʻau e hoʻopili me nā ala o ATP o nā cell beta. Hoʻopili ʻo Amaryl i nā protein i ka papa o ka membrane selly me ka koho. ʻO kēia waiwai o ka lāʻau lapaʻau e ʻae e hoʻonui i ka naʻau o nā cell cell i ka insulin.
Hoʻomaopopo ka hapanui o ka pōʻaiapili e nā kino o nā ʻili o ke kino.
Eia kekahi, ʻo ka hoʻohana ʻana o ka lāʻau e pale i ka hoʻokuʻu o ka glucose e nā sela o nā kiko o ke ake. ʻO kēia kaʻina hana ma muli o ka hoʻonui o ka ʻike o ka fructose-2,6-biophosphate, ka mea i hāʻawi i ka hana o ka gluconeogenesis.
Hoʻoulu ka hoʻoliʻi ʻana o ka synthesis ma muli o ka mea i hoʻomohala i ka nui o ka hoʻōla o ka paʻakai i ka nui o nā beta, a me ke koena o ka nui o ke kō i loko o ke kōpae alakaʻi i ka hoʻonui nui o ka hormone.
Ke hoʻohana nei i ka lāʻau hoʻohui i hui pū me ka metformin, loaʻa i ka poʻe maʻi ka hoʻomaikaʻi ʻana i ka metabolic control o ka nui o ke kō i loko o ke kino.
Ke hana nei i ka hoʻohui hui ʻana me ka hoʻohui pū ʻana me ka inikini insulin. Hoʻohana ʻia kēia ʻano hana i nā hihia i loaʻa ʻole ka hoʻokele maikaʻi o ka hoʻokūkū metabolic i ka wā e lawe ai i ka lāʻau hoʻokahi. Ke hoʻokō nei ʻo ia i kēia ʻano lāʻau lapaʻau no ka maʻi mellitus no ka maʻi, pono ʻia ka hoʻoponopono ʻana i ka insulin.
ʻO ka nui o nā insulin e hoʻohana ai i kēia ʻano maʻi e hoʻemi ʻia.
ʻO ka Pharmacokinetics o ka lāʻau
Me ka hapa hoʻokahi o ka lāʻau lapaʻau ma kēlā me kēia lā no 4 mg o ka nui, ʻike ʻia kona kiʻekiʻe ma hope o 2 mau hola a i nā nui o 309 ng / ml. ʻO ka bioavailability o ka lāʻau lapaʻau he 100%. ʻAʻohe meaʻai he hopena iki i ke kaʻina o ka heiho ʻana, me ka hoʻēmi ʻole ʻana i ka wikiwiki o ke kaʻina.
ʻO ka hiʻohiʻona ikaika o ka lāʻau lapaʻau e hōʻikeʻia e ka hiki ke komo i ka hoʻokumuʻana o ka waiū umauma a ma o ka pale o placental. ʻO ka mea e kaupalena ai ka hoʻohana ʻana o ka lāʻau lapaʻau i ka wā hapai a me ka umauma.
Ke lawe ʻia nei ka ʻaila o ka hana ikaika i loko o nā kiko o ke akea. ʻO ka isoenzyme nui i hoʻokomo i ka metabolism, ʻo CYP2C9. Ma ke kaʻina o ka hana metabolism o nā papa hana nui, ʻelua mau metabolites i hana, kahi i hoʻoiho ʻia i loko o nā feces a me nā urine.
Lawe ʻia ka hoʻōla ʻana o ka lālani e nā keiki i ka nui o ka 58% a ma kahi o 35% me ke kōkua o ka ʻōpū. ʻAʻole ʻike ʻia ka mea ikaika o ka lāʻau i loko o ka urine.
E like me nā hopena o nā haʻawina, ua ʻike ʻia ʻaʻole i hilinaʻi ʻia ka pharmacokinetics ma ka wahine a me ka pūʻulu o kāna makahiki.
Inā hana ka mea maʻi i ka hana o ka pūpū a me ka ʻōnaehana o ka excretory, he nui ka mea maʻi i ka hoʻomaʻemaʻe o ka glimepiride a me ka hoʻēmi ʻana ma kona kaila o ka hoʻokaʻa i loko o ke kahe koko, i kumu ʻia e ka wikiwiki o ka hoʻohemo ʻana o ka lāʻau lapaʻau ma muli o ka hoʻopiʻi ʻana o ka pūhui ikaika i nā protein
ʻO nā hiʻohiʻona maʻamau o ka lāʻau
ʻO Amaryl i manaʻo ʻia he kolu o ka hanauna hanauna o ka olakoka sulfonylurea. ʻO nā ʻāina e hana ana i ka lāʻau lapaʻau ʻo Kelemela a me Italia. Hana ʻia ka lāʻau i loko o kahi papa papa ma 1, 2, 3 a i ʻole 4 mg. 1 papa o Amaril ka ʻaoʻao nui - glimepiride a me nā mea hana'ē aʻe.
Kuhi nui nā hopena o ka glimepiride i ka hoʻohaʻahaʻa ʻana i ke kaila koko ma o ka hoʻoulu ʻana i ka hana ʻana o ka insulin e nā cell beta. Eia kekahi, ʻo ka mea hana e hana ai i ka hopena insulinomimetic a hoʻonui i ka paʻakaha o nā ʻae ʻana o nā cell i ka hormone hoʻohaʻahaʻa i ka hē.
I ka manawa e lawe maʻamau ai ka mea maʻi iā Amaryl, ʻoi loa ka ʻike kiʻekiʻe loa o ka glimepiride ma hope o 2 mau hola. Hiki ke lawe ʻia ka lāʻau lapaʻau ma muli o ka manawa o ka ʻai ʻana i ka meaʻai. Eia naʻe, ʻai liʻiliʻi ʻia i ka hana o ka glimepiride. Kūkulu, ua hōʻiliʻili ʻia kēia mea ma o nā ʻōpū a me nā ʻili.
Ua kuhikuhi aku i nā loina ʻoi aku i nā papa ʻo Amaril i ka mea maʻi me ka maʻi maʻamau ʻo 2 me ka monotherapy a i hui pū ʻia me nā mea maʻi hypoglycemic.
Akā, ʻaʻole e kāohi i ka lāʻau lapaʻau i ka hana mau ʻana i ka meaʻai kūpono e kāpae ai i nā momona a me ka maʻalahi e hōʻalo ʻia o nā kaola, a me ke ʻano ola.
Nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau
ʻAʻole hiki iā ʻoe ke kūʻai i ka lāʻau lapaʻau me ka loaʻa ʻole o ka kauka kauka. Ma mua o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono ʻoe e kipa i ke kauka a nīnau iā ia i kāu mau nīnau āpau. ʻO ia ka mea e hiki ke hoʻoholo i ka nui o ke ʻano o ka lāʻau lapaʻau a kuhikuhi i kahi hoʻoponopono lāʻau e pili ana i ka pae o ka glucose o ka mea maʻi.
Lawe ʻia nā papa ʻaary amaryl me ka ʻōwili ʻole ʻia, a holoi ʻia me ka wai nui. Inā poina ke mea inu e inu i ka lāʻau lapaʻau, papalua ka laʻa ua pāpā ʻia. I ka wā mālama, pono ʻoe e nānā pinepine i ka pae o ke kō, me ka ʻike ʻana i ka hemoglobin glycosylated.
I ka hoʻomaka, lawe ka mea maʻi i kahi pākahi o 1 mg i kēlā me kēia lā. Noho mālie, ma waena o hoʻokahi a ʻelua mau pule, hiki i ka nui o ke ʻano lāʻau ke piʻi me ka 1 mg. No kahi laʻana, 1 mg, a laila 2 mg, 3 mg, a pēlā aku a hiki i 8 mg i kēlā me kēia lā.
ʻO ka maʻi maʻi maʻi maikaʻi e loaʻa ke kaomi glycemic maikaʻi i kahi lā i kēlā me kēia lā a hiki i 4 mg.
Hoʻomaʻama pinepine, lawe ʻia ka lāʻau i hoʻokahi manawa ma mua o ka pāʻina kakahiaka a i ʻole, i ʻole ke kau ʻana i ka hoʻohana ʻana i nā papa, ma mua o ka papa kai nui. I kēia hihia, pono ke kāhea ʻo ka mea loea i ka nohona o ka maʻi maʻi, ka manawa ʻai a me kāna hana kino. Hoʻoponopono paha kahi dosis nui o ka lāʻau inā ke:
- hōʻemi;
- loli ma ke ʻano o ke ola maʻamau (kauʻai, hoʻouka, ʻai manawa);
- mauʻu ʻē aʻe.
E noʻonoʻo e nīnau aku i ke kauka a hoʻomaka me ka liʻiliʻi liʻiliʻi (1 mg) o Amaril inā pono ka mea maʻi:
- ka hoʻololi ʻana o kekahi lāʻau lapaʻau haʻahaʻa e hoʻohuhū me Amaril;
- kahi hui o ka glimepiride a me ke metformin;
- ʻO ka hui ʻana he glimepiride a me ka insulin.
ʻAʻole pono ia e lawe i ka lāʻau lapaʻau no nā mea maʻi me ka renal dysfunction, me ka mea pūlea a me / a me ke kōpaʻa hemahema.
Nā hiʻohiʻona a me nā hopena maikaʻiʻole
ʻO Amaril glimepiride i loko o ka lāʻau lapaʻau, me nā mea hoʻohui aʻe, ʻaʻole e hoʻopili maikaʻi i ke kino o ka maʻi maʻi.
E like me ke ala ʻē aʻe, loaʻa i ka lāʻau nā contraindications.
ʻAʻole pāpā ʻia e lawe i nā paila i nā mea maʻi i kēia mau kūlana:
- insulin-type like diabetes;
- ka manawa o ka ulu a me ka umauma;
- maʻi ketoacidosis maʻi (hoʻonaninani o ka pelekina i ke kīlohelohe), ke kūlana o ka maʻi precoma a me ka coma;
- nā mea maʻi ma lalo o ka makahiki 18;
- intolerance galactose, nele lactase;
- ka hoʻomohala ʻana o ka malabsorption glucose-galactose;
- nā hana kipi o ka pūpū a me nā ʻōpū, i nā mea maʻi e hele ana i ka hemodialysis;
- ka hoʻomaloka ʻole ʻana i nā mea o ka lāʻau, nā derivatives o ka sulfonylurea, nā mea ʻele o sulfonamide.
ʻO nā ʻōlelo i hoʻopili ʻia e ʻōlelo ai i loko o nā hebedoma mua o ka hoʻolālā ʻana, pono e mālama ʻia ʻo Amaryl me ka mālama aka ʻole i ka hoʻomohala ʻana o kahi kūlana hypoglycemic. Eia kekahi, ma ka hihia o ka malabsorption o ka meaʻai a me nā lālani mai ke kaomi ʻana i ka huehue, hōʻemi iki ka glucose-6-phosphate dehydrogenase, nā maʻi hakakā, a ma mua o kahi hopena e hoʻomau i kahi kūlana hypoglycemic, hoʻohana maikaʻi ʻia ʻo Amaryl.
Me ka hoʻohana pono ʻana o nā papa (no ka laʻana, ka uhai ʻana i ke ʻano), nui nā hopena koʻikoʻi.
- ʻO ke kūlana Hypoglycemic, nā hōʻailona o ke poʻo a me ka maʻi o ka maʻi, nā mea nānā ʻole, ke kaua, ka haunaele, ka nalowale, nāwaliwali, nā wili, nā hōʻuluʻulu a me nā ʻike pupule.
- ʻO Adrenergic counterregulation ma ke ʻano o ka pane i ka hoʻohaʻahaʻa wikiwiki i nā glucose, i hōʻike ʻia e ka hopohopo, palpitations, tachycardia, hanaʻeha o ka puʻuwai a me ka hiʻohiʻona o ka huluhulu maloʻo.
- ʻO nā maʻi heu - ka wili o ka paila, ka luaʻi ʻana, ka lemela, ka ʻeha o ka ʻōpū, ke nānā ʻana, ka hoʻomohala ʻana o ka hepatitis, ʻo ka nui o ke ʻano o nā huina o nā ate, jaundice a cholestasis.
- ʻO ka hoʻonāukiuki o ka ʻōnaehana hematopoietic - leukopenia, thrombocytopenia, granulocytopenia a me kekahi mau ala e ae.
- Allergy, i hōʻike ʻia e nā palahalaha i ke kino, ʻeha, hives, i ka manawa anaphylactic ʻano a me ka vasculitis allergic.
Hiki i nā hopena ʻē aʻe - photosensitization a me hyponatremia.
ʻO ke kumukūʻai, nā loiloi a me nā hoʻohālike
ʻO ke kumukūʻai o ka lāʻau lapaʻau Amaryl kūpaʻa pololei i ke ʻano o kāna hoʻokuʻu. ʻO ka mea e hoʻokomo ʻia ana ka lāʻau lapaʻau, e like me ia, ua kiʻekiʻe ke kumukūʻai. Eia nā kumukūʻai o nā papa ʻaʻa Amaryl e like me kēia.
- 1 mg 30 papa - 370 mau rubles;
- 2 mg 30 papa - 775 mau rubles;
- 3 mg 30 papa - 1098 rubles;
- 4 mg 30 papa - 1540 rubles;
ʻO ka manaʻo o ke maʻi maʻi maʻi e pili ana i ka maikaʻi o ka lāʻau lapaʻau, kūpono lākou. Me ka hoʻohana mau ʻana o ka lāʻau lapaʻau, hoʻi mai ka nui o ka glucose. ʻOiai aia ka papa inoa he nui mau hopena kūpono, ʻo ka hapa liʻiliʻi o kā lākou hoʻomaka. Eia nō naʻe, aia kekahi mau loiloi maikaʻi ʻole o nā poʻe maʻi e pili ana i ka uku kiʻekiʻe o ka lāʻau. He nui nā poʻe o lākou e ʻimi no nā hili ʻo Amaril.
I ka ʻoiaʻiʻo, ua nui nā ʻae a me nā analogue i kēia lāʻau i loko o ka Lūkini Lūkini, no ka laʻana:
- ʻO Glimepiride kahi lāʻau lapaʻau e loaʻa ai nā ʻano hana like, nā contraindications a me nā hopena ʻaoʻao. Aia ka hoʻokoʻa ʻana i nā mea hou aʻe. Ka awelika kumukūʻai o ka lāʻau (2 mg No. 30) no 189 mau rubles.
- ʻO Diagninide kahi lāʻau lapaʻau ka hoʻohaʻahaʻa o nā kōpili, ma kāna pūnaehana like me ka lāiwi i lawe ʻia mai NovoNorm. ʻO ka mea hana ikaika ka repaglinide. ʻO Novonorm (Diagninide) aneane like nā like contraindications a me nā hopena maikaʻiʻole. I mea e hoʻomaopopo pono ai i ka ʻokoʻa ma waena o kēia mau metala ʻelua, pono e hoʻohālikelike i ke kumukūʻai: ke kumukūʻai o Diaglinide (1 mg No. 30) ʻo 209 mau rubles, a ʻo NovoNorm (1 mg No. 30) ʻo 158 mau rubles.
- ʻO Glidiab kahi lāʻau lapaʻau Lūkini, ʻo ia hoʻi kahi mea hoʻohālike o ka diabetes mellitus maʻi maʻamau. ʻO ke kumukūʻai kūpono o nā papa Glidiab (80 mg No. 60) ʻo 130 rubles, a me ke kumukūʻai o ka lāʻau lapaʻau Diabeton (30 mg No. 60) ʻo 290 rubles.
ʻO Amaryl kahi lāʻau lapaʻau kalepa maikaʻi, akā kūʻai ʻia. No laila, hiki ke hoʻololi ʻia e nā mea ʻai ʻemi, ʻo ka ʻĀneka (Diclinid, Glidiab), a hoʻopili ʻia (NovoNorm, Diabeton) mau lāʻau. ʻO ka mea i hoʻohui ʻia i ka glimepiride, a i ʻole nā mea waiwai ʻē aʻe i hāʻawi i ka emi o ka glucose. Hoʻomaopopo i ka aniani, hiki i ke kauka a me ka mea maʻi ke hoʻoholo i ka lāʻau ʻoi aku ka maikaʻi e lawe. Ke hoʻomau nei ke wikiō ma kēia ʻatikala i ke kumumanaʻo Amaril no ka maʻi maʻi.
