Ka lebaka la litšenyehelo tse phahameng tsa Amaril, li-analogues li sebelisoa hangata ho fetofisa glucose ea mali ho lefu la tsoekere le mofuta o ikemetseng oa lefu. Setlhare sena se loketse ho boloka glycemia ka lijo tse khethehileng le lipapali.
Leha ho le joalo, ha se motho e mong le e mong ea ka khonang moemeli enoa oa hypoglycemic. Ka hona, sehloohong sena, mohato oa bongaka oa Amaril o tla senoloa mme litšoantšo tsa mantlha tse hlahisitsoeng Russia li tla boleloa.
Ketso ea pharmacological ea moriana
Amaryl ke lithethefatsi tsa molomo tse matlafatsang tse thusang ho fokotsa tsoekere e maling ka ho susumetsa tokollo le ts'ebetso ea "insulin" ka lisele tse ikhethileng tsa beta tse fumanehang lithaneng tsa "pancreatic".
Mokhoa o ka sehloohong oa ho hlasimolla mekhoa ea ho kopanya lintho ke hore Amaril e eketsa karabelo ea lisele tsa beta ho eketseha ha khatello ea mali maling a motho.
Ka litekanyetso tse nyane, setlhare sena se kenya letsoho keketseho e nyane ea ho lokolloa ha insulin. Amaryl e na le thepa ea ho eketsa kutloelo-bohloko ea litho tsa lisele tse itšetlehileng ka insulin ho insulin.
Kaha Amaril o tsoa sulfonylurea, o khona ho susumetsa tlhahiso ea insulin. Sena se netefatsoa ke taba ea hore karolo e sebetsang ea lithethefatsi e kenella le liteishene tsa ATP tsa lisele tsa beta. Amaryl e kopana le liprotheine tse holim 'a membrane ea sele ka boomo. Thepa ena ea lithethefatsi e lumella ho eketsa kutloisiso ea lisele tsa lisele ho insulin.
Glucose e ngata e monya haholo ke lisele tsa mesifa ea 'mele.
Ntle le moo, tšebeliso ea lithethefatsi e thibela ho ntšoa ha tsoekere ke lisele tsa lithane tsa sebete. Ts'ebetso ena e etsahala ka lebaka la keketseho ea litaba tsa fructose-2,6-biophosphate, e tlatsetsang ho sitiseng ha gluconeogeneis.
Ho kenya ts'ebetso ea insulin synthesis ho etsahala ka lebaka la hore ntho e sebetsang ea lithethefatsi e ntlafatsa ho ata ha ions tsa potasiamo liseleng tsa beta, le potasiamo e ngata seleng e lebisa tlhahiso e eketsehileng ea hormone.
Ha u sebelisa phekolo e kopaneng hammoho le metformin, bakuli ba na le ntlafatso taolong ea metabolic ea maemo a tsoekere 'meleng.
Ho etsa kalafo ea ho kopanya hammoho le liente tsa insulin. Mokhoa ona oa taolo o sebelisoa maemong a ha maemo a lekaneng a taolo ea metabolic a sa fihlellehe ha o sebelisa moriana o le mong. Ha o etsa mofuta ona oa phekolo ea lithethefatsi bakeng sa lefu la tsoekere, ho hlokahala hore ho fetisoe tekanyetso ea insulin.
Palo ea "insulin" e sebelisoang mofuta ona oa phekolo e fokotseha haholo.
Pharmacokinetics ea lithethefatsi
Ka tekanyo e le 'ngoe ea moriana ka tekanyo ea letsatsi le letsatsi ea 4 mg, khatello ea eona e phahameng e shejoa kamora lihora tse 2,5 mme e fihla ho 309 ng / ml. Bioavailability ea lithethefatsi ke 100%. Ho ja ha ho na phello e itseng ts'ebetsong ea ho monya, ntle le ho fokotseha hanyane hoa lebelo la ts'ebetso.
Ntho e sebetsang ea lithethefatsi e tšoauoa ka bokhoni ba ho kenella ho hlophisoa ha lebese la matsoele le ka sekhahla sa placental. E fokotsang monyetla oa ho sebelisa lithethefatsi nakong ea kemolo le nakong ea kanyeso.
Metabolism ea ntho e sebetsang e etsoa ka har'a lisele tsa sebete. Leihloenzyme la mantlha le amehang ho metabolism ke CYP2C9. Ts'ebetsong ea metabolism ea motsoako o ka sehloohong o sebetsang, ho thehoa li-metabolites tse peli, tseo ka mor'a moo li kenyellelitsoeng mantle le moroto.
Excretion ea lithethefatsi e etsoa ke liphio ka bophahamo ba 58% le hoo e ka bang 35% ka thuso ea mala. Sesebelisoa se sebetsang sa moroto ha se bonoe se sa fetoha.
Ho latela liphetho tsa liphuputso, ho fumanoe hore pharmacokinetics ha ea itšetleha ka bong ba mokuli le sehlopha sa hae sa lilemo.
Haeba mokuli a sitisitse tšebetso ea liphio le sistimi ea mokokotlo, mokuli o na le keketseho ea ho pepeseha ha glimepiride le phokotso ea karolelano ea khatello ea mali serumeng se bakoang ke ho tlosoa ha moriana o potlakileng haholo ka lebaka la tlamo e tlase ea karolo e sebetsang ea liprotheine.
Litšobotsi tse akaretsang tsa lithethefatsi
Amaryl e nkuoa e le karolo ea boraro ea sulfonylurea. Linaha tse hlahisang moriana ona ke Jeremane le Italy. Setlhare se entsoe ka foromo ea lipilisi ho 1, 2, 3 kapa 4 mg. Letlapa le le leng la Amaril le na le karolo ea mantlha - glimepiride le li-excipients tse ling.
Litlamorao tsa glimepiride li etselitsoe haholo ho theola tsoekere ea mali ka ho khothaletsa tlhahiso ea insulin ke lisele tsa beta. Ntle le moo, ntho e sebetsang e na le phello ea insulinomimetic mme e eketsa tlhaloganyo ea li-receptor tsa sele ho ea lihormone tse fokotsang tsoekere.
Ha mokuli a amohela Amaryl ka molomo, ho ba le khatello e phahameng haholo ea glimepiride ka mor'a lihora tse 2,5. Setlhare se ka nooa ho sa tsotelehe nako ea ho ja lijo. Leha ho le joalo, ho ja hanyane ho ama tšebetso ea glimepiride. Ha e le hantle, motsoako ona o epolloa ka mala le liphio.
Setsebi se phekolang se fana ka matlapa a Amaril ho mokuli ea nang le lefu la tsoekere la mofuta oa 2 e le monotherapy kapa ha a kopantsoe le li-hypoglycemic agents.
Leha ho le joalo, ho sebelisa moriana ona ha ho thibele ho latela phepelo e nepahetseng ea lijo tse sa kenyeng mafura le lik'habohaedreite tse bonolo tsa ho chesoa le bophelo bo mafolofolo.
Litaelo tsa tšebeliso ea lithethefatsi
O ka reka sethethefatsi ntle le taelo ea ngaka. Pele o sebelisa moriana, o lokela ho etela ngaka le ho mo botsa lipotso tsohle tsa hau. Ke eena ea ka khethollang litekanyetso tsa moriana mme a fana ka mofuta oa kalafo o thehiloeng boemong ba tsoekere ea mokuli.
Matlapa a Amaryl a nooa ka molomo ntle le ho hlafuna, 'me a hlatsuoa ka metsi a lekaneng. Haeba mokuli a lebetse ho noa moriana, ho lumelloa habeli tekanyetso ho thibetsoe. Nakong ea kalafo, o lokela ho hlahloba boemo ba tsoekere khafetsa, le khatello ea mali ea glycosylated hemoglobin.
Pele, mokuli o nka tekanyetso e le 'ngoe ea 1 mg ka letsatsi. Butle-butle, ka nako ea libeke tse peli ho isa ho tse peli, litekanyetso tsa moriana li ka eketseha ka 1 mg. Mohlala, 1 mg, ebe 2 mg, 3 mg, joalo-joalo ho fihlela ho 8 mg ka letsatsi.
Litsebi tsa lefu la tsoekere tse nang le taolo e ntle ea glycemic li nka tekanyetso ea letsatsi le letsatsi ea ho 4 mg.
Khafetsa, moriana o nooa hanngoe le pele ho lijo tsa hoseng kapa, haeba o tla tšela tšebeliso ea matlapa pele ho lijo tse kholo. Maemong ana, setsebi se lokela ho nahana ka mokhoa oa bophelo ba lefu la tsoekere, nako ea lijo le ho ikoetlisa. Phetoho ea litekanyetso tsa moriana e ka hlokahala ha:
- ho fokotsa boima ba 'mele;
- phetoho ka tsela e tloaelehileng ea bophelo (phepo e nepahetseng, mojaro, nako ea lijo);
- lintlha tse ling.
Etsa bonnete ba hore o buisana le ngaka 'me u qala ka tekanyetso e fokolang (1 mg) ea Amaril haeba mokuli a hloka:
- phetisetso ea lithethefatsi tse ling tse fokotsang tsoekere le Amaril;
- motsoako oa glimepiride le metformin;
- motsoako ona ke glimepiride le insulin.
Ha ho kgothaletswe ho nka moriana oa bakuli ba nang le bothata ba ho ruruha, hammoho le ho fokola ha lerema le / kapa sebete.
Contraindication le maikutlo a fosahetseng
Amaril glimepiride e fumanehang ka har'a moriana, le likarolo tse ling, ha se kamehla e amang 'mele oa motho ea nang le lefu la tsoekere.
Le mekhoa e meng, lithethefatsi li na le li-contraindication.
Ha hoa lumelloa ho nka lipilisi ho bakuli maemong a latelang:
- mofuta oa lefu la tsoekere o itšetlehileng ka insulin;
- nako ea ho emara le ho anyesa;
- lefu la tsoekere la ketoacidosis (metabolism ea carbohydrate e holofetseng), boemo ba lefu la tsoekere le lefu la tsoekere;
- bakuli ba ka tlase ho lilemo tse 18;
- galactose ho hloka mamello, khaello ea lactase;
- nts'etsopele ea glucose-galactose malabsorption;
- tlolo ea sebete le liphio, haholo-holo bakuli ba ntseng ba tšoaroa ke hemodialysis;
- ho se mamellane ho tse kahare tsa moriana, li-sulfonylurea derivatives, li-sulfonamide agents.
Litaelo tse kentsoeng li re libekeng tsa pele tsa kalafo, Amaryl e lokela ho nkuoa ka hloko e le ho qoba nts'etsopele ea boemo ba hypoglycemic. Ntle le moo, maemong a ha malabsorption ea lijo le lithethefatsi a tsoa phepelong ea lijo, tsoekere ea glucose-6-phosphate dehydrogenase, maloetse a amanang, 'me ho le joalo, ha ho na le monyetla oa ho ba le boemo ba hypoglycemic, Amaryl e sebelisoa ka hloko.
Ka tšebeliso e fosahetseng ea matlapa (ho etsa mohlala, ho se lumele ho tlola), ho ka ba le karabelo e matla:
- Boemo ba Hypoglycemic, matšoao ao e leng hlooho le ho tsitsipana, tlhokomelo e sa lekanyetsoang, mabifi, pherekano, ho otsela, ho akheha, ho thothomela, ho tsitsipana le pono e fifalitsoeng.
- Adrenergic ho hanyetsa e le karabelo ea ho fokotseha ha tsoekere e potlakileng, ho bonahatsoa ke ho tšoenyeha, palpitations, tachycardia, pherekano ea morethetho oa pelo le ponahalo ea mofufutso o batang.
- Mathata a amanang le ho ja ka mpeng - ho nyekeloa ke pelo, ho hlatsa, ho ruruha, bohloko ba ka mpeng, lets'ollo, nts'etsopele ea hepatitis, ts'ebetso e eketsehileng ea li-enzyme tsa sebete, jaundice kapa cholestasis.
- Ho senya tsamaiso ea hematopoietic - leukopenia, thrombocytopenia, granulocytopenia le li-pathologies tse ling.
- Allergy, e bonahatsoa ke makhopho a letlalo, ho hlohlona, likokoana, ka linako tse ling ho tsitsipana ha anaphylactic le alculgic vasculitis.
Lintho tse ling li ka etsahala - photosensitization le hyponatremia.
Litsenyehelo, litekolo le li-analogues
Theko ea lithethefatsi Amaryl ka kotloloho e ipapisitse le mofuta oa tokollo ea eona. Kaha moriana o kentsoe naheng, ho ea ka seo, litšenyehelo tsa sona se phahameng haholo. Litheko tsa litafole tsa Amaryl li tjena.
- Matlapa a 1 mg 30 - li-ruble tse 370;
- Matlapa a 2 mg 30 - li-ruble tse 775;
- Matlapa a 3 mg 30 - li-ruble tse 1098;
- Matlapa a 4 mg 30 - li-ruble tse 1540;
Ha e le maikutlo a batho ba nang le lefu la tsoekere mabapi le katleho ea moriana o motle. Ka tšebeliso ea nako e telele ea lithethefatsi, maemo a tsoekere a khutlela ho tloaelehileng. Leha lenane le na le litlamorao tse ngata tse ka bang teng, liperesente tsa ho qala ha bona li nyane haholo. Leha ho le joalo, ho na le litlhahlobo tse mpe tsa bakuli ba amanang le theko e phahameng ea lithethefatsi. Bongata ba bona ba tlameha ho batla sebaka sa Amaril.
Ebile, moriana ona o na le lipapatso le liemahale tse ngata tse hlahisitsoeng 'Musong oa Russia, mohlala:
- Glimepiride ke setlhare se nang le motsoako o tšoanang o sebetsang, li-contraindication le litlamorao. Phapang e fumaneha feela linthong tse ling. Theko e tloaelehileng ea lithethefatsi (2 mg No. 30) ke li-ruble tse 189.
- Diagninide ke sethethefatsi se theolelang tsoekere, ka sebopeho sa eona se ts'oana le sethethefatsi se tsoang ka ntle NovoNorm. Ntho e sebetsang ke repaglinide. Novonorm (Diagninide) e batla e na le li-contraindication tse tšoanang le maikutlo a fosahetseng. Ho utloisisa phapang lipakeng tsa li-analogues tsena tse peli, ho hlokahala hore u bapise litšenyehelo: theko ea Diaglinide (1 mg No. 30) ke li-ruble tse 209, 'me NovoNorm (1 mg No. 30) ke li-ruble tse 158.
- Glidiab ke sethethefatsi sa Russia, seo hape e leng analogue ea mellitus Diabeteson ea tsebahalang ka lefu la tsoekere. Litsenyehelo tse tloaelehileng tsa matlapa a Glidiab (80 mg No. 60) ke li-ruble tse 130, mme theko ea moriana Diabeteson (30 mg No. 60) ke li-ruble tse 290.
Amaryl ke sethethefatsi se fokotsang tsoekere, empa se theko e boima. Ka hona, e ka nkeloa sebaka ke lithethefatsi tse theko e tlase, tse tsoang malapeng (Diclinid, Glidiab), le tse tsoang kantle ho naha (NovoNorm, Diabeteson). Motsoako ona o na le glimepiride, kapa lintho tse ling tse tlatsetsang ho fokotseheng ha tsoekere. Ka ho tseba ka li-analogues, ngaka le mokuli ba tla tseba ho etsa qeto ea hore na ho sebelisitsoe lithethefatsi life. Video e sehloohong sena e tsoela pele ka sehlooho sa Amaril sa lefu la tsoekere.
