Litaelo tsa Amaril ea lithethefatsi bakeng sa tšebeliso li fana ka tlhahlobo e le setlama sa moloko o mocha oa meriana ho loants'a lefu la tsoekere la mofuta oa 2. E 'ngoe ea tse khothatsang haholo kajeno e ne e le Glibenclamide-HB-419 ho tsoa sehlopheng sa sulfonylurea. Ba fetang halofo ea batho ba nang le lefu la tsoekere ba nang le mofuta oa bobeli ba bo utloile.
Litšoaneleho tsa lithethefatsi tsa lithethefatsi
Amaryl ke lithethefatsi tsa hypoglycemic tse thusang ho laola tsoekere ea plasma. Motsoako o sebetsang oa lithethefatsi ke glimepiride. Joalo ka pele ho eona, Glibenclamide, Amaril le eona e tsoa sehlopheng sa sulfonylurea, e ntlafatsang motsoako oa insulin ho tsoa lisele tsa b tsa lihlekehleke tsa pancreatic tsa Langerhans.
Ho fihlela sephetho se reriloeng, ba thibela mocha oa potasiamo oa ATP ka kutloisiso e eketsehileng. Ha sulfonylurea e tlama ho li-receptor tse fumanehang ho li-membrane tsa b-cell, ts'ebetso ea karolo ea K-AT e fetoha. Ho thibeloa ha liteishene tsa khalsiamo ka keketseho ea karo-karolelano ea ATP / ADP ho cytoplasm ho hlohlelletsa depolarization ea membrane. Sena se kenya letsoho ho lokiseng khalase ea methapo ea methapo le ho eketsa bongata ba calcium ea cytosolic.
Liphetho tsa ho hlohlona ho joalo ha li-granules tsa sekhukhu, e leng mohato oa ho kenyelletsa metsoako ka har'a sele kahare ka lisele, e tla ba ho lokolloa ha insulin maling.
Glimepiride ke moemeli oa moloko oa 3 oa sulfonylureas. E susumetsa ho tsoa ha hormone ea pancreatic kapele, mme e matlafatsa kutloisiso ea insulin ea lisele tsa protheine le lipid.
Litholoana tsa lero le leng le le leng li matlafatsa tsoekere e matla haholo li sebelisa liprotheine tse tsoang liphatong tsa sele. Ka mofuta oa lefu la tsoekere le ikemetseng, phetoho ea tsoekere ho linama e lieha ho fokola. Glimepiride e khothalletsa keketseho ea palo ea liprotheine tsa tsamaiso le ho ntlafatsa ts'ebetso ea bona. Phello e matla joalo ea pancreatic e thusa ho fokotsa ho hanyetsa insulin (insensitivity) ho hormone.
Amaryl e thibela motsoako oa glucogen ke sebete ka lebaka la keketseho ea palo ea fructose-2,6-bisphosphate e nang le antiaggregant (thibelo ea sebopeho sa thrombus), antiatherogenic (ho fokotseha ha matšoao a "cholesterol" e mpe) le matla a antioxidant (regenerative, anti-aging). Ts'ebetso ea oxidation e lieha ho fokotseha ka lebaka la keketseho ea litaba tsa li-b-tocopherol tsa endo native le ts'ebetso ea li-enzyme tsa antioxidant.
Pharmacokinetics ea lithethefatsi
Ka sebopeho sa Amaril, karolo ea mantlha e sebetsang ke glimepiride e tsoang sehlopheng sa sulfonylurea. Povidone, lactose monohydrate, magnesium stearate, cellcose ea microcrystalline le dyes E172, E132 li sebelisoa e le lifilimi.
Amaryl e sebetsa li-enzymes tsa sebete 100%, ka hona, tšebeliso ea nako e telele ea lithethefatsi ha e tšose ho bokelloa ha eona ka bongata litho le liseleng. Ka lebaka la ts'ebetso, ho thehoa likarolo tse peli tsa glipemiride: hydroxymetabolite le carboxymetabolite. Metabolite ea pele e na le thepa ea pharmacological e fanang ka phello e tsitsitseng ea hypoglycemic.
Meleng, litaba tsa mantlha tsa karolo e sebetsang li bonoa ka mor'a lihora tse peli le halofo. Ho ba le bioavailability e felletseng, setlhare ha se felle ho tsoekere ho khetho ea lihlahisoa tsa lijo tseo a "amohelang" moriana ka tsona. Kamohelo e tla ba 100%.
Lintlafatso tsa bohlokoa ho li-indices tsa glycemic li bonoa esita le ka mathata a sebetsang le sebete, haholoholo, ho ba motho e moholo (lilemo tse fetang 65) le ka ho hloleha ha sebete, khatello ea karolo e sebetsang e tloaelehile.
Mokhoa oa ho sebelisa Amaryl
Motsoako o hlahisoa ka mokhoa oa matlapa a oval a nang le mola o arohanang, o u lumellang hore o arole lethal dose habonolo ka halofo. 'Mala oa litafole o ipapisitse le tekanyetso: 1 mg ea glimepiride - khetla e pinki, 2 mg - botala, 3 mg - mosehla.
Moralo ona ha oa khethoa ka tšohanyetso: haeba matlapa a ka khetholloa ka 'mala, sena se fokotsa kotsi ea ho sebelisa overdose ka tšohanyetso, haholo-holo ho bakuli ba tsofetseng.
Matlapa a kenngoe ka har'a lithutsoana tsa 15 likhomphutha. Lebokose le leng le le leng le ka ba le lipakana tse joalo ho isa ho tse tšeletseng.
Likarolo tsa tšebeliso ea Amaril:
- Letlapa (kapa karolo ea lona) le metsitsoe kaofela, e hlatsuoe ka metsi bonyane 150 ml. Hang ka mor'a ho nka meriana, o hloka ho ja.
- The endocrinologist e khetha mofuta oa kalafo ho latela sephetho sa tlhahlobo ea maro a tlhaho.
- Qala thuto ka litekanyetso tse nyane tsa Amaril. Haeba karolo ea 1 mg ka mor'a nako e itseng e sa bonts'a sephetho se reriloeng, sekhahla sea eketseha.
- Tekanyetso e fetoloa butle butle, kamora libeke tse 1-2, 'mele o be le nako ea ho ikamahanya le maemo a macha. Letsatsi le letsatsi, o ka eketsa tekanyo ka ho sa feteng 1 mg. Tekanyo e phahameng ea lithethefatsi ke 6 mg / letsatsi. Meeli e behiloeng ke ngaka.
- Hoa hlokahala ho lokisa tloaelo ka phetoho ea boima ba lefu la tsoekere kapa boholo ba mojaro oa mesifa, hammoho le ha ho na le kotsi ea hypoglycemia (nakong ea tlala, khaello ea phepo e nepahetseng, tšebeliso e mpe ea joala, mathata a liphio le sebete).
- Nako ea ts'ebeliso le litekanyetso li tla latela moralo oa bophelo le litšobotsi tsa metabolism. Hangata, tsamaiso e le 'ngoe ea Amaril e beoa ka letsatsi ka mokhoa o tlamang le lijo. Haeba lijo tsa hoseng li tletse, o ka noela pilisi hoseng, haeba e le sesupo - ho molemo ho kopanya seamo le lijo tsa mots'eare.
- Tekanyetso e fetang tekano e tšosa ka hypoglycemia, ha tsoekere e maling e theohela ho 3.5 mol / L kapa tlase. Boemo bo ka nka nako e telele haholo: ho tloha lihora tse 12 ho isa ho matsatsi a 3.
Matlapa a Amaryl (ka har'a sephutheloana sa likotoana tse 30) a rekisoa ka theko:
- 260 rub - 1 mg ka ngoe;
- 500 rub - 2 mg ka ngoe;
- 770 rub. - 3 mg ka 'ngoe;
- 1020 rub. - 4 mg ka 'ngoe.
U ka fumana lipakete tsa matlapa a 60, 90,120 a matlapa.
Ho tsamaisana le lithethefatsi tse ling
Litsebi tsa lefu la tsoekere, haholoholo “le boiphihlelo”, joalo ka molao, li na le mathata a mangata a kopanang: khatello ea mali, mathata a pelo le pelo, mathata a metabolic, a liphio le a masapo a sebete. Ka lisebelisoa tsena, ha ua lokela ho nka feela lithethefatsi tse theolelang tsoekere.
Bakeng sa thibelo ea litlolo tse mpe tsa methapo ea mali le pelo, ho fanoa ka litlhare tse nang le asipirini. Amaryl e e tlosa mehahong ea liprotheine, empa boemo ba eona maling bo lula bo sa fetohe. Liphello tsohle tsa tšebeliso e rarahaneng li ka ntlafala.
Ntlafatsoa mosebetsi AMARE phaella moo lona ho ka insulin, Allopurinu, coumarin derivatives, anabolic steroid, guanethidine, chloramphenicol, fluoxetine, fenfluramine, pentoxifylline, Feniramidolu, fibric acid e derivatives, phenylbutazone, miconazole, azapropazone, probenecid, quinolones, oxyphenbutazone, salicylates, tetracycline, sulfinpyrazone, Tritocqualin le sulfonamides.
Amaril e fokotsa bokhoni ba ho eketsa Epinephrine, glucocorticosteroids Diazoxide, laxatives, Glucagon, barbiturates, Acetazolamide, saluretics, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, le progestin, le progestin.
Amaryl plus histamine H2 receptor blockers, reserpine le clonidine e fana ka sephetho se sa lebelloang le marotholi a glucometer ka nqa efe kapa efe. Sephetho se tšoanang se fana ka joala le Amaril haholo.
Lithethefatsi ha li ame tšebetso ea ACE inhibitors (Ramipril) le li-anticoagulant agents (Warfarin) ka tsela efe kapa efe.
Tekanyo ea Hypoglycemic
Haeba moriana leha e le ofe oa hypoglycemic o lokela ho nkeloa sebaka ke Amaril, ho behiloe tekanyetso e nyane (1 mg), esita le maemong ao mokuli a ileng a fumana moriana o fetileng ka tekanyetso e kholo. Taba ea pele, ts'ebetso ea sebopuoa sa lefu la tsoekere e hlahlojoa libeke tse peli, 'me joale litekanyetso li ntlafatsoa.
Haeba moemeli oa antidiabetesic ea nang le halofo e phahameng ea bophelo a sebelisitsoe pele Amaril ho qoba nts'etsopele ea hypoglycemia, ho lokela hore ho be le khefu matsatsi a 'maloa ka mor'a ho hlakoloa.
Haeba lefu la tsoekere le khona ho boloka bokhoni ba makhopho a ho hlahisa lihormone tsa lona, joale liente tsa insulin li ka nkela Amaryl 100 sebaka. Thupelo ena e boetse e qala ka 1 mg / ka letsatsi.
Ha morero oa puseletso ea tsoekere ea Metformin o sa lumelle taolo e felletseng ea lefu la tsoekere, 1 mg ea Amaril e kanna ea eketsoa. Haeba liphetho li sa khotsofatse, butle-butle maemo a fetoha 6 mg / letsatsi.
Haeba leano la Amaril + Metformin le sa ka la phela ho latela litebello, le nkeloa sebaka ke Insulin, ha le ntse le boloka tloaelo ea Amaril. Liente tsa insulin le tsona li qala ka tekanyetso e fokolang. Haeba matšoao a glucometer a sa khothatse, eketsa palo ea Insulin. Ts'ebeliso e tšoanang ea lithethefatsi e ntse e rateha, kaha e u lumella ho fokotsa tšebeliso ea li-hormone ka 40% ha e bapisoa le kalafo e ntle ea li-hormone.
Ntle le Amaril, endocrinologist e boetse e na le likhetho tsa li-analogues: Amaperid, Glemaz, Diapyrid, Diameprid, Glimepiride, Diagliside, Reclide, Amix, Glibamide, Gllepid, Glayri, Panmicron, Glibenclamide, Gligenclad, Glliblik Dimimari Glimaril, Glyclazide, Manil, Maninil, Glimed, Glioral, Olior, Glynez, Glyrid, Gluktam, Glypomar, Glyrenorm, Diabeteson, Diabresid.
E etselitsoe mang le mang meriana e sa khothaletsoa?
Moriana ona o ile oa hlahisoa bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2. E sebelisoa ka bobeli ka monotherapy le kalafong e rarahaneng ha e bapisoa le Metformin kapa Insulin.
Karolo e sebetsang ea Amaril e hlola mokoallo oa placenta, 'me moriana o fetela le lebeseng. Ka lebaka lena, ha e tšoanelehe bakeng sa bo-mme baimana le ba anyang. Haeba mosali a batla ho ba 'm'a, le pele ho kemaro ea ngoana, o lokela ho fetisoa ka ente ea insulin ntle le Amaril. Bakeng sa nako ea ho fepa, nako e joalo ea tumello ea bolokoa, leha ho le joalo ho na le tlhoko ea kalafo le Amaril, ho anyesa ho emisitsoe.
Tšebeliso ea lithethefatsi ho komeng ea lefu la tsoekere le boemo bo ka pele ho komello ha e amohelehe. Mathateng a tebileng a lefu la tsoekere (joalo ka ketoacidosis), Amaryl ha e eketsoe. Moriana hape ha o loketse bakuli ba lefu la tsoekere ba nang le mofuta oa lefu la pele.
Ka mathata a sebetsang a liphio le sebete, Amaril ha e na thuso, Amaril ha e bontšoe bakeng sa hemodialysis le lefu la tsoekere, le bakeng sa ho se mamellane ha motho ka mong ho glipemiride kapa lithethefatsi tse ling tsa sehlopha sa sulfonamide le sulfonylurea.
Ka intestinal paresis kapa ho kenella ka mpeng, ho kenngoa hoa lithethefatsi hoa senyeha, kahoo Amaril ha e fane ka litlatsetso tsa mathata a joalo nakong ea exacerbation. Ba hloka ho chencha insulin le likotsi tse ngata, lingaka tse buoang, mafu a mocheso o phahameng, likotsi tse mpe.
Amaril e ka tsamaisana le liphetoho tsa hypoglycemic. Ka linako tse ling bakuli ba tletleba ka ho tsekela, ba bang ba mpefatsa boemo ba ho robala, ho ba le letsoalo, ho fufuleloa ho feteletseng le bothata ba puo. Ho lefu la tsoekere, ho na le maemo a teng khafetsa a tlala e sa laoleheng, mathata a dyspeptic, ho se khotsofale sebakeng sa sebete. Ho se sebetse hantle ha morethetho oa pelo, lekhopho letlalong. Ho phalla ha mali ka linako tse ling ho mpefala.
Liphetho tsa bongoana bo bongata
Tšebeliso ea nako e telele ea moriana, le tšebeliso e ngata ea lithethefatsi, li ka baka hypoglycemia, matšoao a hlalositsoeng karolong e fetileng.
Motho ea nang le lefu la tsoekere o lokela ho ba le lengolo le hlalosang ka botlalo ka bokuli ba hae le ho hong ho tsoang ho lik'habohaedreite tse potlakileng (lipompong, likuku). Jusi kapa tee e tsoekere e boetse e loketse, ha e se feela linoko tse entsoeng ka maiketsetso. Maemong a boima, mokuli o tlameha ho kena sepetlele ka potlako bakeng sa ho lavaha ka mpeng le ho tsamaisoa ha li-drabents (khabone ea carbon, joalo-joalo).
Litlamorao
Maemong a sa tloaelehang, ts'ebeliso ea Amaril e tsamaea le litla-morao ka mokhoa oa ho lahleheloa ke pono, mathata ka tsamaiso ea potoloha, mathata a metabolic, mathata a ka mpeng.
Har'a tse tloaelehileng haholo:
- Glycemic syndrome, e tšoauoang ke ho felloa ke matla, ho putlama ha khatello ea kelello, ho felloa ke pono, ho khora, tlala e sa laoleheng, ho fufuleloa ho feteletseng.
- Phapang lipontšong tsa tsoekere, e etsang hore motho a felloe ke matla.
- Mathata a amanang le tahi, tlolo ea morethetho oa phetheho, a nyamela ha sethethefatsi se tlosoa.
- Lintho tse ling tse fapaneng le ho teba ha letlalo (lekhopho la letlalo, ho hlohlona, likhahla, allergic vasculitis, ho thothomela hoa moea, khatello e tlase ea mali le ho hema ka thata).
Ho nka Amaril hampe ho ama lebelo la karabelo ea psychomotor - ho khanna koloi, hammoho le mosebetsi o hlokang tlhokomelo, haholo-holo mohato oa pele oa kalafo, ha o tsamaisane le kalafo ea Amaril.
Maikutlo a lingaka le lefu la tsoekere ka Amaril
Litlhahlobo tsa lingaka tsa endocrinologists tseo khafetsa li kopanang le lipontšo tsa lefu lena le bolotsana li bohlokoa haholo, hobane li na le monyetla oa ho ithuta karabelo ea bakuli ho moriana ho fihlela liqeto mabapi le katleho ea ona.
Ho latela lingaka, ka moralo oa kalafo o hlophisitsoeng hantle, Amaril e thusa ho etsa hore indices ea glycemic e sebetse hantle kapele. Litsebi tsa lefu la tsoekere tse noang moriana o na le litletlebo tsa hypoglycemia ha litekanyetso li sa khethoe hantle. Mme leha ho le joalo, mabapi le lithethefatsi Amaril, litlhahlobo tsa bakuli li na le tšepo.
Lijo tse nang le phepo ea Carb e fokolang, ho ikoetlisa ka 'mele, ho laola boima ba' mele li na le tšusumetso e kholo katlehong ea kalafo ea Amaril. Lefu la tsoekere le lokela ho tsebisa endocrinologist ka nako ka litla-morao, matšoao a hypo- le hyperglycemia e hlahang le Amaril.
Phekolo e boetse e kenyelletsa ho itlhahloba ho bona matšoao a tsoekere le ho lekola mesebetsi ea sebete, liteko tsa laboratori, haholo-holo tlhahlobo ea hemoglobin ea glycated, eo kajeno e nkoang e le mohlala o ka sehloohong oa ho hlahloba boemo ba mokuli ea nang le lefu la tsoekere. Sena se tla thusa ho tseba tekanyo ea ho hanyetsa Amaril bakeng sa tokiso ea mofuta oa kalafo.
U ka ithuta ka likarolo tse ling tsa Amaril ho tsoa video.
