ʻO nā lāʻau lapaʻau Oral sulfonylurea e kōkua i ka mālama ʻana i nā maʻi diabetes type 2 he nui ka helu o ka lāʻau hypoglycemic. A, ʻoiai ʻo ka maʻi hou o nā lāʻau lapaʻau hou e pili ana i ka glimepiride (e like me Amaryl) ua hoʻomohala ʻia, ua maikaʻi ke ʻano maikaʻi ʻo Maninil (glibenclamide i loko o kāna mea). Ua hōʻike nā noi hou hou i nā hiʻohiʻona hou o ka lāʻau lapaʻau maʻamau.
ʻO nā papa antidiabetic o ka hui sulfonylurea o nā lāʻau lapaʻau e hoʻoikaika i ka hana pancreatic a ʻaʻole i kēlā me kēia maʻi maʻi āpau me nā maʻi type 2, kūpono nō ʻoe e hoʻomaopopo pono i kā lākou mau hiʻohiʻona.
Maninil - hoʻokuʻu kau
ʻO Manilin, ke kiʻi o ka mea i hōʻike ʻia ma kēia ʻāpana, loaʻa nā mania glibenclamide kumuhana a me nā hoʻopiha:
- Methyl hydroxyethyl cellulose;
- Lactose Monohala;
- Uhu kākele;
- Hoʻolāleʻa Magnesium;
- Kāleka silika;
- Dye Ponceau 4R.
ʻO ka hoʻomaopopo ʻana i nā huahana o ka lāʻau lapaʻau Kelemānia Kelemania-Chemie (Menarini Group) ma ke ʻano he maʻalahi: nā papakū me nā tinge pinkish ka chamfer a me ka laina hoʻokaʻawale ma kekahi ʻaoʻao. Wahi a ka dosage, hoʻokahi papa paha he 3.5-5 mg o ka mea hana maʻamau.
I loko o ka pūnaewele olakino, hiki ke kūʻai ʻia ka lāʻau lapaʻau me kahi papa inoa. Ma Maninil, kūʻai kālā nui ke kumukūʻai - mai ke 140 a 185 mau rubles. ʻAʻole pono ka lāʻau lapaʻau i nā kūlana kūikawā no ka mālama, akā pono e kiʻi i ke kiʻi ʻana o nā keiki a me ka lā maka pololei. ʻO 3 mau makahiki ka noho i ka pale o nā papa ma ka hoʻokaʻa.
Hiki i nā pono Pharmacological
ʻO ka hana nui o ka glibenclamide ka hoʻoweliweli ʻana i nā β-cell o nā mokupuni o Langerhans, kuleana no ka hoʻokumu ʻana o kā lākou ponoʻī. Hoʻololi pololei ka hana cell-cell i ka pae o ka glycemia a me kona wahi. Ma hope o ka hoʻohanaʻana, ua hoʻopili nui ʻia nā papa e nā paia o ka pūpū. ʻO ka helu o ka hoʻopihapiha ʻana o ka nui o nā waihona o ka ʻōpū a me ka manawa o kona hoʻopiha ʻana me ka meaʻai ʻaʻole i kau ʻia. Me nā protein o ka plasma, hiki i ka lāʻau lapaʻau ke hoʻopili e 98%. Hōʻike ʻia ka kiʻekiʻe o kona kaila i loko o ka serum koko ma hope o 2 a me ka hapalua hola a hiki i nā nui o 100 ng / ml. ʻO ka hapalua ola e pili ana i nā hola 2, i ka manawa i lawe ai i kēlā me kēia os - 7 hola. Aia ma ke kiʻi o ka maʻi maʻi o ka maʻi, ma ka maʻi diabetes me kēia manawa ke mau a 8 a 10 mau hola paha.
Ka hoʻoneʻe nui ʻia ka lāʻau ma ka nū, e hoʻololi ana me ke kōkua o ke ala ʻole-pathocytes i ʻelua mau ʻano o nā metabolites: 3-cis-hydroxy-glibenclamide a me 4-trans-hydroxy-glibenclamide.
Ua hōʻike ʻia ua hoʻokolohua ʻole i hoʻonāukiuki nā metabolites i nā ʻōlelo hypoglycemic, e kāpae ana i nā puʻuwai a me nā papa umauma mai ke kino holoʻokoʻa i nā lā 2-3.
Inā pilikia ka ate, mālama ʻia ka lāʻau lapaʻau i loko o ke koko no ka manawa lōʻihi. Me nā ala āpau o nā pūpū me ka urine, e hoʻopau ʻia me ka kali ʻana, ka manawa e hilinaʻi ʻia ana i ka paʻakikī o ka insufficiency o ka huina.
ʻO keʻano kūikawā, me ke ʻano maʻalahi o ke ʻano hana o ka renal disfunction, ʻaʻole i paʻa ʻia ka cumulation. Me kahi cleince clearance ≤30 ml / min, ke emi nei ka nui o ka hoʻopau ʻana i nā metabolites, e hoʻonui ana i ka pae o ka lāʻau lapaʻau i loko o ke koko. Kūloko nā kūlana like no Maninil e loaʻa ai ka titration o ka maʻa a hōʻemi paha (ma mua o ia mau hihia, ua kuhikuhi ʻia ka basal insulin).
ʻO Maninil no wai?
Hoʻolālā ʻia ka lāʻau lapaʻau e mālama i ka maʻi diabetes type 2 (ʻano like ʻole-insulin). Hoʻomaopopo ʻia nā papa i ka maʻi maʻi ma ka hoʻohui, i ka hala ʻole o ka hopena i hoʻolālā ʻia ma hope o ka loli ʻana o ka noho ʻana (kaʻai ʻai haʻahaʻa, ke ʻano kūpono o ke kino, ka hoʻoponopono ʻana i ke kaumaha nui, ka mālama ʻana i ke kūlana o ka naʻau, ka hoʻokau e moe a me ka hoʻomaha).
Ua koho kekahi mea endocrinologist i ka lāʻau lapaʻau, ke helu nei i ka regimen lapaʻau e mālama ana i ka mea ʻai, ke ahonui, ka manawa o ka maʻi, nā ala e hoʻopili ai, ka lehulehu a me ka pane ʻana o ke kino i ka lāʻau lapaʻau. Hoʻoholo ʻia ka Dosage e pili ana i ka ʻike glycemic o ka mea maʻi.
Hoʻololi pinepine ʻia ka lāʻau hoʻomaka ma ke ʻano he hapa haʻahaʻa - hapalua kahi papa pāpaona 5 mg a i ʻole 3.5 mg i kēlā me kēia lā. Hāʻawi ʻia ka ʻike kūikawā i ka hoʻoponopono ʻana i nā maʻi maʻi asthenic me kahi mea ʻai haʻahaʻa, i ka mōʻaukala o ia mau mea ʻo ka hypoglycemic attack, me ka poʻe hoʻi i hana i ka hana kino kaumaha. Pono ʻia ka hebedoma mua o ka mana glycemic maʻamau. Hana ʻia ka titration e like me ka hōʻike o ka mita a ma ke ʻano o ke kauka.
ʻO ka pilina therapeutic o Maninil e pili ana i 15 mg / lā, ʻo ia nā papa 3 o 5 mg a i ʻole nā papa 5 o ka 3,5 mg.
Ke hoʻololi nei ʻo Maninil i nā lāʻau lapaʻau hypoglycemic ʻē aʻe, e alakaʻi ʻia ana e ka maʻi hoʻomaka. Ma hope o ke kāpae ʻia ʻana o nā lāʻau lapaʻau ma mua, e hoʻopili ʻia nā hōʻailona o ka glucometer a me nā hopena o ka nānā ʻana i ka urine ma kahi kūlana kūlohelohe, me ka ʻole o ka ʻike ʻana i nā lāʻau lapaʻau. Kuhi ʻia ke ʻano o ke kino e ka palena liʻiliʻi - 0,5 papa o 3.5 a i ʻole 5 mg. ʻO ka hoʻokō ʻana me ka meaʻai a me nā kūlana ʻē aʻe o ke ola kino e koi. No ka paleʻana i nā hopena o ka hopena, hoʻonui nui ʻia ka lāʻau lapaʻau hou. Pono ka maʻi maʻi maʻi e hōʻike i ke kauka e pili ana i nā loli āpau i ke olakino.
Nā manaʻo e hoʻohana
Maninil ka ʻōlelo ʻana i ka hoʻohana ʻana i ia kakahiaka, ma mua o ka ʻaina kakahiaka, ka holoi ʻana i kou kaomi o nā papa me ke aniani o ka wai mā. I ka manawa ʻaʻole iʻoi aku ka 2 mau pcs / lā, ua mahele ʻia i 2 dosis i kahi māhele o 2: 1. No ka loaʻa o ka hopena therapeutic kiʻekiʻe, pono e inu i ka lāʻau lapaʻau i nā hola like.
Nā hopena hopena
Wahi a nā ʻōmole o ka WHO, ʻo ka hala o nā hopena maikaʻi loa mai nā hopena o nā lāʻau lapaʻau, ua loiloi ʻia ma ka ʻano nui
- Loaʻa pinepine - mai 10%;
- ʻIke pinepine - mai 1 a 10%;
- I kekahi manawa - mai 0.1 a 1%;
- ʻIa pinepine, mai,01% a i 0.1%;
- ʻAʻole paʻa loa - a hiki i 0,01% a i ʻole nā hihia i hoʻopaʻa ʻole ʻia i nā manawa.
ʻO nā helu o nā hanana maikaʻiʻole mai ka lawe ʻana iā Maninil i hoʻopaʻa ʻia maʻalahi i ka papa ʻaina.
| Nā ʻōnaehana a me nā hui | Nā ʻano o nā hopena | Heʻike |
| Hāpai | Hoʻokomo ʻia ʻo hypoglycemic, obesity | pinepine |
| Hōʻike | ka haunaele o ka noho ʻana a me ka ʻike | loa loa |
| ʻŌpala Gastrointestinal | nā kinipōpō dyspeptic, kahi hoʻololi i ke kaʻe o ka neʻe ʻana o ka neʻe i loko o kahi alo | i kekahi manawa |
| Pāʻālua | ka hoʻonui i ka pae (ʻoi ka nui) o ka alkatine phosphatase a me nā transaminases | lawa ʻole |
| ʻO ka ʻili a me ke kōpili | like dermatitis-like rash along with itching | lawa ʻole |
| Kahe koko | ka hōʻemi o ka helu platelet i ka plasma; ʻO ka hōʻemi ʻana o ka erythrocyte me nā sela koko keʻokeʻo | lawa ʻole |
| Nā kino ʻē aʻe | Ka hopena o ka diuretics, ka proteinuria lewa, ka hapa sodium | loa loa |
ʻO nā hana hoʻonā i nā manawa ke nānā ʻia ma ka manawa o ka hoʻololi ʻana i ka lāʻau lapaʻau a haʻalele i kā lākou iho, me ka pale ʻole o ka lāʻau lapaʻau. ʻO ka maʻi Dyspeptic i ke ʻano o ka maʻiila, ka luaʻi ʻana, ka maʻi ʻaʻa ʻole, ʻaʻole pono e koi i ka pono o ka lāʻau lapaʻau a nalowale hoʻi i ka wā o ka manawa.
Inā aia kekahi ʻano hyperergic o allergy i glibenclamide, aia kahi hopena o ka intracranial cholestasis me nā hoʻopiʻi ma ke ʻano o nā maʻi he nui koʻikoʻi.
Hiki i ka hoʻololi hou ʻana o nā maʻi kūlohelohe i nā mea maʻamau, akā ma nā hihia koʻikoʻi hiki ke hoʻonāukiuki i kahi ʻano hoʻoweliweli i ke ola o ka maʻi maʻi.
Mai Maninil, maʻi pākuʻi a me nā hopena ʻē aʻe e hōʻike ʻia e ka wīwī, ke kuni, nā hōʻailona o ka jaundice, a me ka wehe ʻana o ka protein i nā hoʻāʻo ʻana i ka urine. I nā kūlana a pau, pono ke kūkā ʻana o ke kauka hele mai.
I kekahi mau manawa, hoʻopaʻa koke ʻia ka hōʻemi ʻana i nā mea pili koko āpau. Ke hoʻopau ʻia ka lāʻau lapaʻau, ʻaʻole hoʻokuʻu ʻia ke kūlana. Hiki ke cross-allergy me nā lāʻau lapaʻau ʻē aʻe e hoʻonāukiuki i ka hypersensitivity i ka mea maʻi. ʻO keʻano pilikino, ʻo ka make o ka E124, ka mea i hoʻohana ʻia me ka hana ʻana i nā lāʻau, he alerine ikaika.
Maninil - contraindications
ʻAʻole kuhikuhi i ka lāʻau lapaʻau no ka hypersensitivity i nā mea kūpono o ke ʻano. ʻAʻole nō hoʻi ia i hōʻike ʻia:
- No nā mea maʻi i ka diuretics a me nā lāʻau pili i pili i ka sulfonylurea, ka hoʻomākaukau ʻana o ka sulfonylamide, probenecid;
- ʻO ka maʻi maʻi me ka maʻi maʻi type 1, me ka atrophy o β-cell;
- Inā he metabolic acidosis ka mea hōʻeha, ka maʻi maʻi maʻi koma;
- Nā makuahine hāpai a me ka lactating;
- ʻO nā mea maʻi me nā pēpē koʻikoʻi a me kaʻeha o kaʻeha (pae 3);
- I nā mea inu a me nā mea inu kolohe (hoʻoweliweli no ka hypoglycemia).
Me ka inu wai ʻawaʻawa, hoʻonui ʻia ka nui o ka hypoglycemic o ka glibenclamide, a me ke ʻano o ka palaka hoʻohuihui i nā hōʻailona o ka hoʻopiʻi.
Me nā hana o ka ʻōpū, nā hōʻeha koʻikoʻi, ke kākā nui ʻana, ka lawe ʻia ʻana o kekahi papa antidiabetic. Hoʻololi iki lākou ia me ka insulin, kahi e hiki ai iā ʻoe ke hana maʻalahi a hoʻoponopono koke i ka ʻike ʻana o nā kō i nā puna.
ʻAʻohe paʻa kūpono ʻole e hoʻokele i nā kaʻa a me nā mea paʻakikī e ʻoi aku ana i ka wā o ka mālama ʻana me Maninil. Akā hiki i nā hōʻeha hypoglycemic hiki ke hoʻopoina i ka nānāʻana a me nā hana noʻonoʻo, ʻoiai hoʻi i ka hoʻohui pū ʻana me nā lāʻau hoʻohiolo ʻana i ke kō. No laila, pono ke kiʻekiʻe o ka hopena i kēlā me kēia maʻi maʻi maʻi e loiloi iā ia iho.
Nā hopena hoʻopuka lāʻau lapaʻau
Me ka hopena pākuʻi me ka glibenclamide a me ka clonidine, a me nā block-adrenergic blockers, reserpine, guanethidine, nā hōʻailona o ka hopena me ka hypoglycemia e kākuhi ʻia a ʻaʻole e ʻae ʻia ka pale ʻia ʻana o ka coma maʻiʻaila.
ʻO ka hana maʻamau o ka laxatives e hoʻonāukiuki i kahi hōʻeha o ka papaʻa, e hōʻemi ana i ka glucometer a hoʻonui i ka manawa o ka hypoglycemia.
Ke hoʻoikaika i nā hiki o ka glibenclamide a hiki i ka hōʻeuʻeu ʻana i ka hypoglycemic, hiki iā ʻoe ke hoʻohana i ka ʻokoʻa i ka hoʻohana ʻana i ka insulin, ka inhibitions ACE, nā papa ʻana i ke kō, nā lāʻau lapaʻau e pili ana i nā hormones kāne, nā lāʻau lapaʻau steroid, antidepressants, β-blockers, clofibrate, lāʻau lapaʻau e pili ana i ka quinolone, Coumarin, phenamine, disaminophen miconazole, PASK, pentoxifylline, perhexylin, pyrazolone, probenecid, salicylates, sulfonamidamide lāʻau lapaʻau, nā papa lāʻau tetracycline, tritokvalin, cytost tics.
Mālama i ka hana o ka lāʻau lapaʻau, hoʻonāukiuki i nā kūlana hyperglycemic, ka hoʻohana like ʻana o ka acetazolamides, β-adrenergic blocking agents, diazoxide, glucagon, barbiturates, diuretics, tubazide, glucocorticosteroids, phenothiazine class drugs, phenytoin, nicotinates, rifampomin pani ʻia.
ʻO nā lāʻau lapaʻau Coumarin, ranitidine, antagonist H2 receptor antagonist, pentamidine, ka hana o ka reserpine i hana ʻole ʻia, e hana ana me ka catalysts a me nā mea paʻa o ka hana glibenclamide.
Kōkua me ka overdose
ʻO kahi overdose o glibenclamide (ma ka hoʻohālikelike a hoʻonāukiuki ʻia e ka cumulation) hāʻawi i ka hypoglycemia koʻikoʻi - me kahi hopena lōʻihi, koʻikoʻi a me nā hōʻailona hoʻoweliweli o ka mea i hoʻopiʻi ʻia. ʻO nā hōʻike pilikino o nā hōʻeha hypoglycemic, pono e hoʻomaopopo ka mea maʻi i kēlā me kēia maʻi:
- Ka pōloli make;
- Tremor o nā lima a me nā wāwae;
- Tachycardia;
- Hoʻonui i nā hopohopo;
- ʻO ka ʻili pāleʻa a me nā membous memous.
I kekahi manawa aia kahi pōʻino o ka noʻonoʻo ʻana, paresthesia. Inā ʻaʻole hāʻawi ʻia ka mea ʻai me ka mālama mālama olakino, hāʻule ia i loko o kahi precoma hypoglycemic a me kahi coma, kahi mea momona.
Hoʻomaka ka hana maʻi o nā hopena like me ka hōʻiliʻili o ka ʻikepili e pili ana i ka mea pepehi mai nā ʻohana pili i nā lāʻau lapaʻau i lawe ʻia e ka maʻi maʻi a me kāna mau maʻi pili. Ke hoʻokō nei kekahi hōʻike.
ʻO ka nānā ʻana o ka mea ʻeha e hiki iā ʻoe ke nānā i ke ʻano o ka ʻili (cold, clammy, wet). Hiki i ke wela ke ʻano a he haʻahaʻa paha. Mamuli o ka paʻakikī o ka hoʻouka ʻana, ʻike ʻia nā mākia kalamila o ka tonic a i ʻole clonic type, ʻike ʻole ʻia ka maʻamau, a me nā hoʻopaʻapaʻa.
Inā ʻike mau ka mea ʻai, hiki iā ia ke inu i ke kīʻaha ʻoi me ke kō maʻamau, ʻai i nā kīaʻai wikiwiki (nā ʻono, nā kuki). Inā ʻaʻole hoʻomau ke kūlana, hoʻomaha ke haukapila i ka haukapila.
Me ka coma i kahi haukapila, kahi loiloi glucose he 40% (40 ml) e lawelawe ana i ka iv. Ma lalo o ka nānāʻana o nā hoʻokolohua hoʻokolohua, ua hoʻoponopono ʻia ka lāʻau infusion me ke kōkua o nā haʻahaʻa kākoi momona haʻahaʻa.
Aia ke ʻike ʻia nā hihia o ka hypoglycemic lohi a lohi i ka hopu ʻana, hoʻonāukiuki ʻia e nā kumulative kumulima o glibenclamide. Pono kēlā mau kūlana i ka nānā ʻana o ka mea i loko o ka haukapila no 10 a i ʻole nā lā he nui me ka mālama pinepine ʻana i ka glycemia a me ka therapyaticatic therapy.
Inā lawe ʻia ka mea ʻai i nā pōpoki keu hoʻokahi a hiki ʻole me ka make ʻole, ua lawa ia e holoi i ka ʻōpū, hoʻolā i nā mea momona a hoʻokaʻawale i kahi ʻono maikaʻi a i ʻole waiʻa.
Nā hiʻohiʻona o ka lāʻau
Me ka papa hana like ʻole ma Glibenclamide, hiki i Glibenclamide a me Glibamide ke hoʻololi i Maninyl. Nā hōʻailona, contraindications, nā hopena ʻokoʻa like loa. Wahi a ka code ATX o ka pae 4 no Maninil, Glidiab, Glyclazide, Diabeton, Glurenorm, he hopena therapeutic like, hiki ke hoʻohana i nā analogues.
Nā ʻōlelo ʻokoʻa
No nā maʻi maʻi, ka poʻe me kaʻai haʻahaʻa, ʻo ka asthenics, maʻi pākia me nā huakaʻi concomitant a me nā ala e pili ana i ka maʻi, ua hoʻemi ʻia ka hoʻomaka hoʻomaka ʻana o Maninil ma ka liʻiliʻi ma muli o ka hopena o ka hypoglycemia. Inā ua hoʻololi ka mea maʻi i ke kaumaha, ke ʻano hana, ke nānā ʻia nei ka noho hoʻoponopono.
Pono ka ʻike koʻikoʻi e nā maʻi me ka dementia senile, nā maʻi noʻonoʻo a me nā kūlana ʻē aʻe e hoʻopiha i ka hoʻopili piha ʻana i ka mea maʻi me ke kauka. ʻO nā hoʻokolohua Laboratory o kēia mahele o nā mea maʻi e hana pinepine e like me ka hiki. No ka loiloi i nā hiʻohiʻona a pau o ka hopena o ka lāʻau lapaʻau ma ke kino, ua kuhikuhi mua ʻia lākou i nā analogues me nā wikiwiki wikiwiki o nā mea ikaika.
Inā ʻaʻole pā ka mea maʻi maʻi i ka metformin, ua hoʻonoho ʻia ʻo ia i nā lāʻau lapaʻau glitazone e like me rosiglitazone a i ka pioglitazone. Me nā hōʻailona kūpono, hoʻohui pū ʻia nā papa Maninil me nā lāʻau lapaʻau ʻanoma me nā ʻano ʻē aʻe hou o ka hana. Hoʻohana ʻia ka Guarem a i ʻole Acarbose, e like me Maninil, i ka pancreas, i ka hoʻohana ʻana i ka maʻi paʻakikī.
Hoʻohana lōʻihi ka hoʻohana ʻana i nā glibenclamide depletes β-cell, alakaʻi i ka necrosis, a ulu i ka insensitivity iā Maninil. E kākoʻo i ka pancreas, ua hoʻohuli ʻia ka maʻi maʻi i ka insulin (i ka nui a i ʻole ka mahele, e pili ana i ke kiʻekiʻe o kā lākou atrope).
ʻO ka loiloi o ka lāʻau lapaʻau e nā kauka a me nā maʻi maʻi
E pili ana nā loiloi Maninil. Hoʻomaʻamaʻa nā kauka iā ia ma kahi lāʻau lapaʻau hypoglycemic kuʻuna me kahi kumu loiloi ikaika a me ka palekana. ʻAʻole ʻoluʻolu ʻia i ka maʻi maʻi me ka loaʻa ʻana o ke kaupaona hoʻopiʻi a me nā hopena ʻē aʻe, akā aia ka liʻiliʻi i ka loiloi e loiloi i ka hiki o ka lāʻau lapaʻau e like me nā hopena o kahi mea maʻi.
ʻO nā loiloi ma kēia pūnaewele kahi haʻawina kūpono i nā ʻōlelo aʻo, i manaʻo ʻia no ka familiarization aoao, ʻaʻole no ka lāʻau lapaʻau ponoʻī. ʻO ke koho o ka lāʻau lapaʻau a me ka hoʻomākaukau o ka regimen lapaʻau kūʻokoʻa wale nō ke kuleana o ke kauka.
