Matlapa a Amaryl - litaelo, litlhahlobo tsa moamoheli, theko

Amaryl ke lithethefatsi tse 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 fihlella sephetho se reriloeng, ba thibela mocha oa potasiamo oa ATP ka kutloelo-bohloko 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 khopisa depolarization ea membrane. Sena se thusa ho lokolla tsela ea khalsiamo 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 likhakanyo kahare ho li-cellellular medium ka lisele, e tla ba tokollo ea insulin maling.

Glimepiride ke moemeli oa moloko oa 3 oa sulfonylureas. E susumetsa ho lokolloa ha hormone ea pancreatic kapele, 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 ea 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 bokhoni ba 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-enzyme tsa 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 carboxymethabolite. Metabolite ea pele e na le thepa ea pharmacological e fanang ka phello e tsitsitseng ea hypoglycemic.

Meleng, litaba tse kaholimo-limo tsa karolo e sebetsang li bonoa ka mor'a lihora tse peli le halofo. Kaha e na le bioavailability e felletseng, setlhare ha se fane ka lefu la tsoekere boikhethong ba lihlahisoa tsa lijo tseo a "li nkang" moriana. Ho fufuleloa ho tla ba boemong bofe kapa bofe 100%.

Lintlafatso tsa bohlokoa ho li-indices tsa glycemic li bonoa esita le 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 mohala 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 monyetla oa 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:

1. 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.
2. The endocrinologist e khetha mofuta oa kalafo ho latela sephetho sa tlhahlobo ea maro a tlhaho.
3. 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.
4. Tekanyetso e fetoloa butle butle, ka nako ea libeke tse 1-2, hore mmele 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.
5. Hoa hlokahala ho lokisa tloaelo ka phetoho ea boima ba lefu la tsoekere kapa bophahamo 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).
6. 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.
7. Mofuta o mongata oa ts'oaetso o tšosa ka hypoglycemia, ha tsoekere e maling e theohela ho 3.5 mol / L kapa tlase. Boemo bo ka tsoela pele 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 ea:

• 260 rub - 1 mg,
• 500 rub - 2 mg,
• 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, haholo-holo “ka 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 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 se nang le marotholi a glucometer ntlheng efe kapa efe. Sephetho se tšoanang se fana ka joala le Amaril haholo.

Setlhare sena ha se ame ts'ebetso ea li-inhibitors tsa ACE (Ramipril) le li-anticoagulant (Warfarin) ka tsela efe kapa efe.

Tekanyo ea Hypoglycemic

Haeba moriana leha e le ofe oa hypoglycemic o hloka ho nkeloa sebaka ke Amaril, ho beoa tekanyetso e fokolang (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 telele ea bophelo a sebelisitsoe pele Amaril e le ho qoba nts'etsopele ea hypoglycemia, ho lokela ho ba le phomolo 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 moralo oa puseletso ea tsoekere oa setso Metformin e sa lumelle taolo e felletseng ea lefu la tsoekere, ka ho eketsa o ka nka Amaril 1 mg. Haeba sephetho se 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 lihormone.

Ntle le Amaril, endocrinologist e boetse e na le likhetho tsa li-analogues: Amaperid, Glemaz, Diapyrid, Diameprid, Glimepiride, Diagliside, Reclid, Amix, Glibamide, Gllepid, Glayri, Panmicron, Glibenclamide, Gligenclad, Glliblik Dimimari Glimaril, Glyclazide, Manil, Maninil, Glimed, Glioral, Olior, Glynez, Glirid, Gluktam, Glypomar, Glyurenorm, 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.

Ts'ebeliso ea lithethefatsi ho komeng ea lefu la tsoekere le boemo bo ka pele ho komello ha li 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, Amaryl ha e na thuso, Amaril ha e bontšoe bakeng sa hemodialysis le lefu la tsoekere, hammoho le 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 laetsoe ho eketsa mathata a joalo. Ba hloka chenche ea insulin le likotsi tse ngata, lingaka tse buoang, mafu a mocheso a phahameng le ho chesa haholo.

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. Ka lefu la tsoekere, hangata ho na le maemo a ho lapa a 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 feela ntle le 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, tšebeliso ea Amaril e tsamaisana le litla-morao ka mokhoa oa ho lahleheloa ke pono, mathata ka tsamaiso ea potoloha, mathata a metabolic, mathata a tšebeliso ea mala.

Har'a tse tloaelehileng haholo:

1. Glycemic syndrome, e tšoauoang ke ho phatloha, khatello ea maikutlo e sa laoleheng, ho lahleheloa ke pono, ho ferekana, tlala e sa laoleheng, ho fufuleloa ho feteletseng.
2. Phapang lipontšong tsa tsoekere, e etsang hore motho a felloe ke matla.
3. Dyspeptic mafu a, tlolo ea morethetho oa phepelo, ea nyamela ha sethethefatsi se tlosoa.
4. Lintho tse ling tse fapaneng le ho teba ha letlalo (lekhopho la letlalo, ho hlohlona, ​​likhahla, allergic vasculitis, ho makala ha anaphylactic, 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.

Litheko tsa Amaryl lihoebi tsa meriana Moscow

Lingaka li hlahloba mabapi le amaryl

Moriana oa mantlha, ka lebaka la ts'ebetso e habeli ea ts'ebetso, o u lumella ho laola hantle tsoekere e maling. Libaka tse ntle ka ho fetisisa tsa lekunutu.

Ka theko e phahameng haholo bakeng sa sehlopha sena sa lithethefatsi. Kotsi e phahameng haholo ea hypoglycemia. E hloka khetho ea litekanyetso.

Phello e phahameng e fihlelloa hammoho le ts'ebeliso ea metformin.

Tlhahlobo ea Mamello bakeng sa Amaryl

Ke lefu la tsoekere le boiphihlelo, lefu la tsoekere la mofuta oa 2, 'me ke nkile Amaril ka lilemo tse' maloa ho 3 mg ka letsatsi. Ka hona, ha ke latele lijo hantle, ke khona le ho reka ntho e monate, mohlala, khaba ea mahe a linotsi kapa karolo ea ice cream makhetlo a 'maloa ka beke. Ka linako tse ling ke nkela tsoekere ka sesekarin kapa stevia, ha ke rate tatso ea bona, kahoo ke ile ka ithuta ho noa ntho e ngoe le e ngoe ntle le tsoekere. Khahlano le nalane ea ho nka "Amaril" tsoekere ea mali e batla e le ka har'a meeli e tloaelehileng, ke itaola ka glucometer. Ha ke utloe bohloko bo bong bo ikhethang. Haeba tsoekere ke ntho e tloaelehileng ka nako e telele, ke nka khefu ho nka Amaril, ka hona, ke ja lijo ebe ke noa meroho e nkang tsoekere ka mohlala, li-blueberries.

'M'ae o ne a tšoeroe ke lefu la tsoekere la mofuta oa 2, a nka sethethefatsi se seng, empa haufinyane a emisitse ho thusa, ngaka e khothalelitse ho leka Amaryl, haeba a sa thusoe, o tla tlameha ho enta insulin. Ke ile ka utloisisa ho tsoa ho tlhaloso ea ngaka hore ho na le lintho tse peli tse sebetsang tokisetsong ena. 1 - e laola tlhahiso ea insulin, lintho tse 2 - e etsa hore 'mele o fetole tsoekere e bolokehileng ho bakuli ba lefu la tsoekere. Setlhare se thusa 'm'e ho boloka tsoekere e le boemong bo batlang bo lekana le selemo, e nka Amaryl. Hape, moriana ona o bontšoa bakeng sa batho ba nang le lefu la tsoekere le ho feta, joalo ka mme oa ka. Re ts'epahale ruri hore lithethefatsi li tla thusa le ho feta.

Lilemong tse peli tse fetileng, 'M'e o ile a fumanoa a tšoeroe ke lefu la tsoekere,' me hang-hang a fuoa Amaryl 2 mg. Setlhare se hlile sea thusa, ka bonolo se fokotsa sekhahla sa tsoekere maling. Lithethefatsi ho amoheloa hantle li tšehetsa boemo bo tloaelehileng ba tsoekere maling. Ka makhetlo a mangata e ne e le hore, ka lebaka la palo e kholo ea lithethefatsi bakeng sa khatello ea mali ea methapo, ho ile ha hlokahala hore ho eketsoe litekanyetso, ho tloha ho 2 ho isa ho 3 kapa 4 mg. Empa joale mme ea bonolo o khutlela ho eena 2 mg. Moriana ha o lemale, hobane ho na le lilemo tse peli ha ho motho ea nang le litlamorao tse mpe tsa Amaril.

Le 'na ha ke e-so kopane le sena, empa nkhono'a ka ea hlokahetseng o ne a e-na le lefu la tsoekere. Bophelong bohle ba hae (kelello ea ka, ho ea kamoo ke hopolang kateng) o ile a itihela matsohong, eaba o oa ka metsong ea insulin. Ke phetse ntle le eena. O ne a lula a fetola lipilisi tse neng li lokela ho nooa ka nako e tšoanang le eo a neng a e enta ka eona. Ebile, ha ho na monyetla oa hore ka mafu a kang ao a neng a nahanne hore a tla fola, ke ts'ebetso ea mmuso oa hajoale. E le hore ho se be le litšitiso. Amaryl o ile a abeloa mosebetsi oa hae. Matlapa a malelele, a shebahalang eka a pinki, 'me ho bile le tšabo e kholo. Qalong, ha ho motho ea hlokometseng liphetoho, empa kamora hore ... O ile a otsela habohloko, lefu la hae la asthma le ile la mpefala. 'Me ha ke tsebe, mohlomong ho tsoa lipilisi kapa lefu la tsoekere le ile la iponahatsa, empa mahlo a hae a ile a mpefala le ho feta. Ha ke nahane hore sethethefatsi sena se fosahetse, ha se a loketse motho e mong le e mong.Ngaka e lokela hore ebe e nkile likhathatso tsohle, empa sena ke moriana oa Russia ...

Tlhaloso e khutšoane

Drug amaryl (INN - glimepiride) ke setlhare sa antihyperglycemic bakeng sa tšebeliso ea molomo ho tsoa lekaleng la Jeremane la mokhatlo oa machaba oa meriana Sanofi Aventis. Amaryl e hlohlelletsa li-cells-lisele tsa li-pancreatic pancreatic liatlem ho hlahisa insulin e eketsehileng, e theolang boemo ba tsoekere maling maling: lithethefatsi li theola matla a kutlo tsa lisele tsa β-ketso ea tsoekere ho tsona. Ho ea ka Institute of Statistics in Healthcare lefats'eng, batho ba ka bang limilione tse mashome a mabeli ba nang le lefu la tsoekere ba nka lithibelo tsa sulfonylurea - lithethefatsi tseo e leng litekanyetso kalafong ea lefu la tsoekere la 2 ha ho sa khonehe ho lefella lefu lena ka ho lokisa lijo tse tsamaeang le 'mele o lekaneng. Mehloli ea sulfonylureas e arotsoe ka lithethefatsi tsa meloko e le 'ngoe le e' ngoe. Amaril ke moemeli oa "leqhubu le lecha" la li-hypoglycemic agents. Haeba re bapisa amaryl le moemeli e mong oa moloko oa 2 oa sulfonylurea e tsoang ho glibenclamide (maninil), palo ea insulin e ntšoang ka ts'usumetso ea ea pele e nyane, ka phokotseho e lekanang ea khatello ea tsoekere ka lebaka la ho sebelisa lithethefatsi ka bobeli. Sena se fana ka maikutlo a hore amaryl e na le melemo e itseng, haholoholo, bokhoni ba eona ba ho hlasimolla lisele tse khahlanong le insulin le boteng ba ts'ebetso ea insulinomimetic. Ka mantsoe a mang, amaryl e na le katleho e ts'oanang le glibenclamide ha e sebelisa litekanyetso tse tlase, ha e bake karabelo ea hypoglycemic, hape e na le phello e ntle ho metabolism ea mafura.

Amaryl e fumaneha ka foromo ea litekanyetso tsa letlapa. Nako ea ho beoa ha eona - nako e le 'ngoe ka letsatsi - e loketse, haholo-holo ho batho ba baholo. Hobane Ho feto-fetoha ha maemo ha glucose e maling e hokahane le tšebeliso ea lijo tsa nama ea lik'habohaedreite, ntho e bohlokoa bakeng sa ho nka melemo ea sulfonylurea ke kamano ea eona le kemiso ea phepo. Bakeng sa ho eketsa katleho ea amaryl le matšeliso a mokuli

setlhare se bontšoa hore se sebelisoe hang ka letsatsi pele ho lijo tse kholo. Boemong ba pele ba ho sebelisa amaryl, lithethefatsi li nooa ka tekanyetso ea 1 mg. Haeba sephetho se lebelletsoeng se sa fumanehe, tekanyetso e eketseha ka katleho ho 2, 3, 4, 6 mme, qetellong, 8 mg ho fihlela phumants'o e hlakileng ea hyperglycemia e fumaneha. Joalokaha boikoetliso bo bontša, tekanyetso e nepahetseng bakeng sa bakuli ba bangata e lutse ho tloha ho 1 ho isa ho 6 mg. Phello e 'ngoe e khothatsang ea lithuto tsa kliniki ke ho ba sieo ha litlamorao tse mpe ha u kopanya amaryl le bahanyetsi ba calcium, li-inhibitors tsa ACE, lithethefatsi tse seng tsa steroidal tse thibelang mafu, sulfonamides. Ho lokela ho boleloa mola o arohaneng ka phello ea anti-atherogenic ea amaryl: lithethefatsi li etsa hore boemo ba "sepid" bo fokotse boemo ba cholesterol ka botlalo le lipoprotein tse tlaase.

Thutela-litso

Setlhare sa "hypoglycemic" se tsoang molomong oa boraro ke sulfonylurea.

Glimepiride e fokotsa khatello ea "glucose" maling, haholo-holo ka lebaka la tšusumetso ea tokollo ea insulin ho lisele tsa β-cell tsa manyeme. Phello ea eona e amahanngoa haholo le ntlafatso ea bokhoni ba li-pancreatic β-cell ho arabela ho susumetso ea 'mele ka glucose. Ha ho bapisoa le glibenclamide, litekanyetso tse tlase tsa glimepiride li ntša insulin e fokolang ha ho fokotseha ho lekanang le tekanyo ea glucose ea mali. Taba ena e paka molemong oa ho ba teng ha litlamorao tsa extrapancreatic hypoglycemic ho glimepiride (kutloelo-bohloko e eketsehileng ea tishu ho insulin le phello ea insulin-mimetic).

Secretion ea insulin. Joalo ka tse ling tsohle tse tsoang ho sulfonylurea, glimepiride e laola secretion ea insulin ka ho sebelisana le liteishene tsa potasiamo tse nang le maikutlo tsa ATP ho li-membrane tsa β-cell. Ho fapana le lihlahisoa tse ling tsa sulfonylurea, glimepiride e ikhethela protheine e nang le boima ba li-kilodron tse 65 tse fumanehang kahara litho tsa "li-pancreas" tsa "pancreas". Tšebelisano ena ea glimepiride e nang le protheine e tlamang ho eona e laola ho buloa kapa ho koaloa ha lits'ebetso tsa potasiamo tse potang ATP.

Glimepiride e koala likheo tsa potasiamo. Sena se baka ho putlama ha lisele tsa β 'me se lebisa ho buloeng ha liteishene tsa khalsiamo tse amohelang matla le phallo ea khalsiamo ka seleng. Ka lebaka leo, keketseho ea "calcium" ea intracellular calcium e kenya ts'ebetso ea insulin ka exocytosis.

Glimepiride e potlakile haholo ka hona e khona ho kopana 'me e lokolloa tlamahanong le protheine e tsamaeang le eona ho feta glibenclamide. Ho nahanoa hore thepa ena ea theko e phahameng ea phapanyetsano ea glimepiride e nang le protheine e tlamang ho eona e etsa qeto ea phello ea eona ea maikutlo a cells-lisele tsa glucose le ts'ireletso ea bona khahlanong le takatso le tahlehelo ea pele ho nako.

Kameho ea ho eketsa kutloisiso ea lithane ho insulin. Glimepiride e ntlafatsa litlamorao tsa "insulin" ho monngoeng ha tsoekere ke lithane tsa pherekano.

Matla a insulinomimetic. Glimepiride e na le litlamorao tse ts'oanang le litlamorao tsa "insulin" ho kenngoeng ha tsoekere ke li-tishu tsa peripheral le ho lokolloa ha tsoekere maling.

Glucose ea peripheral ea methapo e kenngoa ka ho e tsamaisa liseleng tsa mesifa le li-adipocytes. Glimepiride ka kotloloho e eketsa palo ea limolek'hule tse tsamaisang glucose ho li-membrane tsa plasma tsa lisele tsa mesifa le adipocytes. Keketseho ea tekanyo ea lisele tsa tsoekere e lebisa ts'ebetsong ea phospholipase e ikhethileng ea glycosylphosphatidylinositol C. Ka lebaka leo, khatello ea khalsiamo ea "intracellular" ea calcium e ea fokotseha, 'me e baka ho fokotseha hoa ts'ebetso ea protheine ea kinase A,' me e lebise ho hlohlelleng metabolism ea tsoekere.

Glimepiride e thibela ho ntšoa ha tsoekere ho tsoa sebete ka ho eketsa bongata ba fructose-2,6-bisphosphate, e thibelang gluconeogenesis.

Kameho ka ho kopana ha liplatelete. Glimepiride e fokotsa kopanyo ea liplatelete ka vitro le vivo. Matla ana ho bonahala a amahanngoa le thibelo e ikhethileng ea COX, e ikarabellang bakeng sa ho thehoa ha thromboxane A, ntho ea bohlokoa e kenyelletsang bokahohle.

Matla a antiatherogenic. Glimepiride e kenya letsoho ho thathamiseng litaba tsa lipid, e fokotsa boemo ba aldehyde ba maloneng maling, e lebisang phokotsong e kholo ea lipid peroxidation. Ho liphoofolo, glimepiride e lebisa ho fokotseha ho hoholo ha sebopeho sa li-atherosmithotic plaque.

Fokotsa ho teba ha khatello ea khang ea oxidative, e lulang e le teng ho bakuli ba lefu la tsoekere la mofuta oa 2. Glimepiride e eketsa boemo ba io-tocopherol ea endo native, mosebetsi oa catalase, glutathione peroxidase le superoxide dismutase.

Liphello tsa pelo. Ka liteishene tsa potasiamo tse tebileng tsa ATP, lintho tse tsoang ho sulfonylurea le tsona li ama tsamaiso ea methapo ea pelo. Ha e bapisoa le litlamorao tsa setso tsa sulfonylurea, glimepiride e na le phello e fokolang haholo ts'ebetsong ea pelo, e ka hlalosoang ke mofuta o ikhethileng oa tšebelisano ea hau le protheine e tlamang ea methapo ea potasiamo e nang le matla ea ATP.

Ho baithaopi ba phetseng hantle, tekanyetso e sebetsang ea glimepiride ke 0,6 mg. Kameho ea glimepiride e itšetleha ka lethal dose hape e ka ikatisa. Karabelo ea 'mele ho ts'ebetso ea' mele (ho fokotsa insulin secretion) e nang le glimepiride e lula e le teng.

Ha ho na phapang e kholo ea phello, ho latela hore na moriana o nooa metsotso e 30 pele ho lijo kapa hang pele lijo. Bakeng sa bakuli ba nang le lefu la tsoekere, taolo e lekaneng ea metabolic e ka fihlelleha nakong ea lihora tse 24 ka tekanyetso e le 'ngoe. Ho feta moo, lithutong tsa bongaka, bakuli ba 12 ho ba 16 ba nang le bothata ba ho ruruha (CC 4-79 ml / min) le bona ba fihletse taolo e lekaneng ea metabolic.

Motsoako oa motsoako o kopantsoeng le metformin. Bakeng sa bakuli ba nang le taolo e lekaneng ea metabolic ha ba sebelisa tekanyetso e phahameng ea glimepiride, phekolo e kopaneng le glimepiride le metformin e ka qala. Lithutong tse peli, ha ho etsoa kalafo e kopaneng, ho ile ha netefatsoa hore taolo ea metabolic e molemo ho feta ea kalafo ea e 'ngoe le e ngoe ea lithethefatsi tsena ka thoko.

Motsoako oa ho kopanya le insulin. Bakeng sa bakuli ba nang le taolo e tlase ea metabolic ha ba nka glimepiride ka tekanyo e phahameng, kalafo ea "insulin" e ka qala. Ho latela liphetho tsa lipatlisiso tse peli, ha u sebelisa motsoako ona, ntlafatso e tšoanang taolong ea metabolic e fihlella joalo ka ha ho sebelisoa insulin e le 'ngoe feela. Leha ho le joalo, kalafo ea ho kopanya e hloka tekanyetso e tlase ea insulin.

Fomu ea tokollo

Matlapa ana a pinki, a oblong, a sephara, 'me a na le mola o arolang mahlakore ka bobeli, a ngotsoe ka "NMK" le "h" e entsoe ka mahlakoreng ka bobeli.

Baeti: lactose monohydrate - 68.975 mg, sodium carboxymethyl starch (mofuta A) - 4 mg, povidone 25 000 - 0.5 mg, microcrystalline cellulose - 10 mg, magnesium stearate - 0.5 mg, iron oxide red dae (E172) - 0,025 mg.

Li-pcs tse 15. - Mabokose (2) - lipakete tsa karete.
Li-pcs tse 15. - marangrang (4) - lipakete tsa karete.
Li-pcs tse 15. - lithutsoana (6) - lipakete tsa karete.
Li-pcs tse 15. - marangrang (8) - lipakete tsa karete.

Ha e le molao, tekanyetso ea Amaril ® e khethoa ke sepheo sa "glucose" se lebisitsoeng. Moriana o lokela ho sebelisoa ka tekanyetso e fokolang ho fihlela taolo ea metabolic e hlokahalang.

Nakong ea kalafo le Amaril ®, hoa hlokahala ho tseba khafetsa boemo ba tsoekere maling. Ntle le moo, ho khothalletsoa ho lekola kamehla maemo a hemoglobin ea glycosylated.

Tlolo ea lithethefatsi, ka mohlala, ho tlola tekanyetso e latelang, ha ea lokela ho etsoa ke tsamaiso e latelang ea lithethefatsi ka tekanyetso e phahameng.

Ngaka e lokela ho laela mokuli esale pele ka liketso tse lokelang ho nkuoa haeba ho e-na le liphoso tsa ho nka Amaril ® (haholoholo, ha a tšela tekanyetso e latelang kapa a tlola lijo), kapa maemong ao ho seng bonolo ho a sebelisa.

Matlapa a Amaril ® a lokela ho nkuoa a sa nooa, a noe metsi a mangata (hoo e ka bang senoelo sa 1/2). Ha ho hlokahala, matlapa a Amaril ® a ka aroloa hammoho le likotsi ka likarolo tse peli tse lekanang.

Motsoako oa pele oa Amaril ® ke 1 mg 1 nako / letsatsi. Ha ho hlokahala, tekanyetso ea letsatsi le letsatsi e ka eketsoa butle-butle (ka linako tse ling tsa libeke tse 1-2) ka tlasa tlhahlobo ea tsoekere ea mali le ka tatellano e latelang: 1 mg-2 mg-3 mg-4 mg-4 mg-6 mg (-8 mg) ka letsatsi .

Bakeng sa bakuli ba nang le lefu la tsoekere la mofuta oa 2 le laoloang hantle, tekanyetso ea letsatsi le letsatsi hangata ke 1-4 mg. Pilisi ea letsatsi le letsatsi e fetang 6 mg e sebetsa hantle ho palo e fokolang feela ea bakuli.

Ngaka e beha qeto ea nako ea ho nka Amaril ® le ho ajoa ha litekanyetso motšehare, ho nahanela tsela ea mokuli (nako ea lijo, palo ea mesebetsi ea 'mele). Karolelano ea letsatsi le letsatsi e beoa tekanyetso e le 'ngoe, hangata kapele pele ho lijo tsa hoseng tse phethahetseng kapa, haeba tekanyetso ea letsatsi le letsatsi ha e-so nkuoe, kapele pele ho lijo tsa pele tse kholo. Ho bohlokoa haholo hore u se ke oa tlola lijo ka mor'a ho nka matlapa a Amaril ®.

Hobane taolo e ntlafalitsoeng ea metabolic e amahanngoa le ho eketseha ha maikutlo ho insulin; nakong ea kalafo, tlhoko ea glimepiride e ka fokotsoa. Bakeng sa ho qoba nts'etsopele ea hypoglycemia, hoa hlokahala ho fokotsa tekanyetso ka nako kapa ho khaotsa ho nka Amaril ®.

Maemo ao ho ka 'nang ha hlokahala tokiso ea lethal dose ea glimepiride:

• ho theola boima ba 'mele
• Liphetoho Mokhoa oa bophelo (Phetoho ea lijo, ja lijo, palo ea tšebetso ea 'mele),
• ho hlaha hoa lintlha tse ling tse lebisang ho holofatsong ea kholo ea hypoglycemia kapa hyperglycemia.

Phekolo ea Glimepiride hangata e etsoa ka nako e telele.

Phetisetso ea mokuli ho nka lithethefatsi tse ling tsa molomo tsa hypoglycemic ho isa Amaril ®

Ha ho na kamano e nepahetseng lipakeng tsa litekanyetso tsa Amaril ® le lithethefatsi tse ling tsa molomo tsa hypoglycemic. Ha ho fetisoa ho tloha lithethefatsing tse joalo ho ea Amaryl ®, litekanyetso tsa pele tse khothalelitsoeng tsa letsatsi le letsatsi tsa morao-rao ke 1 mg (le haeba mokuli a fetisetsoa Amaryl ® ka tekanyo e phahameng ea lithethefatsi tse ling tsa molomo tsa hypoglycemic). Keketseho efe kapa efe ea litekanyetso e lokela ho etsoa ka mekhahlelo, ho nka karabelo ho glimepiride ho latela likhothaletso tse kaholimo. Hoa hlokahala ho ela hloko botebo le nako ea phello ea moemeli oa hypoglycemic ea nakong e fetileng. Ho kenella kalafo ho ka hlokahala bakeng sa ho qoba sephetho se eketsang kotsi ea hypoglycemia.

Sebelisa hammoho le metformin

Ho bakuli ba nang le lefu la tsoekere le sa laoleheng le sa laoleheng, ha ba nka glimepiride kapa metformin ka tekanyetso e phahameng ea letsatsi le letsatsi, kalafo e nang le litlhare tsena tse peli e ka qala. Maemong ana, kalafo ea nakong e fetileng e nang le glimepiride kapa metformin e tsoela pele ka tekanyetso e le 'ngoe,' me tekanyetso e eketsehileng ea metformin kapa glimepiride e qala ka tekanyetso e tlase, e ntan'o kenngoa ka palo ho latela tekanyetso ea taolo ea metabolic, ho fihlela tekanyo e phahameng ea letsatsi le letsatsi. Phekolo ea ho kopanya e lokela ho qaloa ka tlasa tlhokomelo ea bongaka e matla.

Sebelisa hammoho le insulin

Ho bakuli ba nang le lefu la tsoekere le laolehileng le sa laoleheng, insulin e ka fanoa ka nako e ts'oanang ha u nka glimepiride ka tekanyo e kholo ea letsatsi le letsatsi. Tabeng ena, tekanyetso ea ho qetela ea glimepiride e fuoeng mokuli e lula e sa fetoha. Tabeng ena, kalafo ea insulin e qala ka tekanyetso e tlase, eo butle-butle e eketsehang tlasa taolo ea khatello ea "glucose" maling. Phekolo e kopaneng e etsoa ka tlasa tlhokomelo ea bongaka e haufi.

Bakuli ba nang le ts'ebetso ea renal e sa sebetseng hantle ba ka ameha haholo ka phello ea hypoglycemic ea glimepiride. Lintlha tse mabapi le tšebeliso ea Amaril ® ho bakuli ba nang le bothata ba ho phekola ba le methapo li lekanyelitsoe.

Lintlha tse mabapi le tšebeliso ea Amaril ® ho bakuli ba nang le bothata ba sebete li haelloa.

Bongata

Matšoao: haeba ho na le lithethefatsi tse ngata tse feteletseng, hammoho le kalafo ea nako e telele le glimepiride litekanyetso tse phahameng haholo, hypoglycemia e ka behang bophelo kotsing.

Phekolo: hypoglycemia e kanna ea emisoa ka potlako ke ho kenella ha lik'habohaedreite (tsoekere kapa sengoathoana sa tsoekere, lero la litholoana tse monate kapa tee). Tabeng ena, mokuli o lokela ho lula a na le bonyane 20 g ea tsoekere (likotoana tse 4 tsa tsoekere). Li-sweeteners ha li na thuso kalafong ea hypoglycemia.

Ho fihlela ngaka e etsa qeto ea hore mokuli o kotsing, mokuli o hloka ho hlahlojoa ka hloko ke lingaka. Re lokela ho hopola hore hypoglycemia e ka boela ea qala kamora ho khutlisetsoa ha khatello ea tsoekere maling.

Haeba mokuli ea nang le lefu la tsoekere a phekoloa ke lingaka tse fapaneng (mohlala, nakong ea ho lula sepetlele kamora kotsi, a kula ka beke), o lokela ho ba tsebisa ka bokuli ba hae le kalafo e fetileng.

Ka linako tse ling ho hlokahala mokuli ho kena sepetlele, le haeba ho hlokahala feela hore a be hlokolosi.Ts'ebeliso e kholo ea ts'ebeliso e feteletseng le karabelo e matla e nang le lipontšo tse joalo ka ho lahleheloa ke kelello kapa mathata a mang a tebileng a methapo ea kutlo ke maemo a potlakileng a bongaka mme a hloka kalafo ea potlako le ho kena sepetlele.

Maemong a tahleheloang ke kelello, ho hlokahala hore iv ho hlahisoe tharollo ea methapo ea methapo (tsoekere) (ho batho ba baholo, ho qala ka 40 ml ea tharollo ea 20%). E le mokhoa o mong ho batho ba baholo, ho ka khoneha ho tsamaisa iv, sc kapa glucagon, ka mohlala, ka tekanyo ea 0.5-1 mg.

Ha ho phekoloa hypoglycemia ka lebaka la tsamaiso e sa lebelloang ea Amaril ® ke masea kapa bana ba banyenyane, tekanyetso ea dextrose e lokela ho fetoloa ka hloko ho qoba monyetla oa hyperglycemia e kotsi, tsamaiso ea dextrose e lokela ho etsoa tlhatlhobo e sa khaotseng ea mahloriso a tsoekere ea mali.

Haeba ho na le tlhokahalo e fetelletseng ea Amaril ®, ho phatloha ha sefuba le tšohanyetso ea mashala a entsoeng ka matla ho ka hlokahala.

Kamora ho khutlisetsa khatello ea tsoekere ea mali kapele, ho kenella ka mokhoa o kenang ka tharollo ea dextrose sebakeng se tlase sa khatello ho hloka ho thibela ho qala ha hypoglycemia. Ho bokellana ha tsoekere maling maling ho bakuli ba joalo ho lokela ho lula ho beiloe leihlo bakeng sa lihora tse 24. Maemong a matla a nang le thupelo ea nako e telele ea hypoglycemia, monyetla oa ho fokotseha ha litekanyetso tsa tsoekere ea mali o ka phehella matsatsi a mangata

Hang ha ho fumanoa lithethefatsi tse ngata, ho potlakile ho tsebisa ngaka ka sena.

Tšebelisano

Glimepiride e tšelisoa le ho nka karolo ha CYP2C9 isoenzyme, e lokelang ho tsotelloa ha lithethefatsi li sebelisoa le inducers (e.g. rifampicin) kapa li-inhibitors (mohlala, fluconazole) CYP2C9.

Monyetla oa ts'ebetso ea hypoglycemic mme, maemong a mang, nts'etsopele ea mohlomong ea hypoglycemia e amanang le sena e ka bonoa ha Amaril ® e kopantsoe le e 'ngoe ea lithethefatsi tse latelang: li-insulin, li-agents tsa hypoglycemic bakeng sa tsamaiso ea molomo, li-inhibitors tsa ACE, li-anabolic steroid le lihormone tsa banna tsa thobalano, chloramphenicol, li-coumarin. cyclophosphamide, disopyramide, fenfluramine, pheniramidol, fibrate, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, fluconazole, PASK, pentoxifylline (litekanyetso tse phahameng tsa parenteral) , phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, clarithromycin, sulfanilamides, tetracyclines, tritokvalin, trophosphamide.

Ho fokotseha ha ts'ebetso ea hypoglycemic le keketseho e amanang le tsoekere ea mali ho ka khoneha ha e kopantsoe le e 'ngoe ea lithethefatsi tse latelang: acetazolamide, barbiturates, glucocorticosteroids, diazoxide, diuretics, lithethefatsi tsa sympathomimetic (ho kenyeletsa epinephrine), tsoekere, litlatsetso (ka tšebeliso e telele ), nicotinic acid (ka tekanyetso e phahameng), estrogens le progestogens, phenothiazines, phenytoin, rifampicin, lihomone tsa qoqotho tsa iodine.

Histamine H blockers₂li-receptors, beta-blockers, clonidine le reserpine li khona ho ntlafatsa le ho fokotsa phello ea hypoglycemic ea glimepiride.

Tlas'a tšusumetso ea baemeli ba nang le kutloelo-bohloko, joalo ka beta-blockers, clonidine, guanethidine le reserpine, matšoao a ho hanyetsa ha adrenergic ha a arabela hypoglycemia a ka fokotsoa kapa a ba sieo.

Khahlano le semelo sa ho nka glimepiride, ho matlafatsa kapa ho fokolisa ketso ea melemo ea coumarin ho ka etsahala.

Tšebeliso e le 'ngoe ea joala kapa e sa foleng e ka matlafatsa le ho fokolisa phello ea hypoglycemic ea glimepiride.

Li -ququirerate tsa bile acid: lebili la loreketso le tlama ho glimepiride mme le fokotsa ho monya ha glimepiride ho tsoa pampiring ea gastrointestinal. Tabeng ea ts'ebeliso ea glimepiride, bonyane lihora tse 4 pele a kenella cadelovel, ha ho na tšebelisano. Ka hona, glimepiride e lokela ho nkuoa bonyane lihora tse 4 pele u nka wheelchair.

Litlamorao

Ho tloha ka lehlakoreng la metabolism: hypoglycemia e ka etsahala, eo, joalo ka ts'ebeliso ea tse ling tse tsoang ho sulfonylurea, li ka tšoarelleha. Matšoao a hypoglycemia - hlooho, tlala, ho nyekeloa, ho hlatsa, mokhathala, ho otsela, ho tsitsinyeha ha boroko, ho tšoenyeha, ho ba mabifi, ho tsepamisa mohopolo, ho falimeha le ho potlakela ho arabela, ho tepella maikutlo, pherekano, mathata a puo, aphasia, likhathatso tsa pono, ho thothomela, ho haroha letsoalo , likhathatso tsa kelello, ho tsekela, ho felloa ke boitšoaro, ho ferekana, ho tsitsipana, ho otsela kapa ho akheha ho fihlela ho akheha, ho hema ka mokhoa o sa tsitsitseng, bradycardia. Ntle le moo, lipontšo tsa taolo ea khatello ea adrenergic li ka ba teng ka lebaka la hypoglycemia, joalo ka ponahalo ea ho bata, ho fufuleloa ka tieo, matšoenyeho, tachycardia, khatello ea mali ea methapo, pherekano ea methapo, le phallo ea pelo. Tlhahiso ea kliniki ea hypoglycemia e matla e ka tšoana le ho otloa. Matšoao a hypoglycemia a lula a nyamela kamora ho felisoa.

Ho tloha lehlakoreng la setho sa pono: Ho ferekana ha nakoana ka lebaka la phetoho ea phallo ea tsoekere maling e ea khonahala (haholo-holo qalong ea kalafo). Lebaka la tsona ke phetoho ea nakoana ea ho ruruha ha lilense, ho ipapisitse le phallo ea tsoekere maling, 'me ka lebaka la sena, ke phetoho lenaneng la lilense tse hlakileng.

Ho tsoa ho ts'ebetso ea tšilo ea lijo: ka seoelo - ho nyekeloa, ho hlatsa, ho utloa bohloko kapa ho tšoloha epigastrium, bohloko ba ka mpeng, lets'ollo, maemong a mang - hepatitis, ts'ebetso e eketsehileng ea li-enzyme tsa sebete le / kapa cholestasis le jaundice, tse ka tsoelang pele ho se atlehe ha sebete, empa o ka fetoha tlhabollo ha sethethefatsi se khaotsa.

Ho tsoa ho sistimi ea hemopoietic: ka seoelo - thrombocytopenia, maemong a mang - leukopenia, hemolytic anemia, erythrocytopenia, granulocytopenia, agranulocytosis le pancytopenia. Ts'ebelisong ea moriana ea morao-rao, linyeoe tse matla tsa "thrombocytopenia" tse nang le lipalo tsa liplateleme li tlalehiloe li tšoaetsitsoe nakong ea kemaro. Tabeng ea kemolo e reriloeng kapa qalong ea kemaro, mosali o lokela ho fetisetsoa kalafo ea insulin.

Ho fumanoe hore glimepiride e pepesetsoa lebeseng la matsoele. Nakong ea kemaro, o lokela ho fetisetsa mosali ho insulin kapa ho emisa ho anyesa.

Litaelo tse khethehileng

Maemong a khethehileng a sithabetsang a kliniki, joalo ka khatello ea maikutlo, ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso, tšoaetso ea feberu ea febrile, taolo ea metabolic e ka kenella ho bakuli ba nang le lefu la tsoekere, ka hona, tlhokomelo ea nakoana ea kalafo ea insulin e ka hlokahala ho boloka taolo ea metabolic e lekaneng.

Libekeng tsa pele tsa kalafo, ho na le monyetla oa hore hypoglycemia e be teng, 'me ho hlokahala hore ho be le tlhokomelo e hlokolosi ea khatello ea mali maling.

Liphetoho tse bakang kotsi ea hypoglycemia li kenyeletsa:

• ho se batle kapa ho se khone ha mokuli (hangata ho bonoang ho bakuli ba tsofetseng) ho sebelisana le ngaka,
• khaello ea phepo e nepahetseng, ho ja ka tsela e sa tloaelehang kapa ho tlōla lijo,
• ho se leka-lekane pakeng tsa ho ikoetlisa le ho ja lijo tse nang le lik'habohaedreite,
• phetoho ea lijo
• tšebeliso ea joala, haholo hammoho le lijo tse sieo.
• Ho senyeha ha real,
• ho senyeha haholo hoa hepatic (ho bakuli ba nang le ho senyeha ho matla ha hepatic, ho bontšoa kalafo ea insulin, bonyane ho fihlela taolo ea metabolic e fihlella).
• overdose of glimepiride,
• mafu a mang a senyehileng a "endocrine" a sitisang carbohydrate metabolism kapa adrenergic counterregulation ha a araba hypoglycemia (mohlala, dysfunctions tse ling tsa gland ea thyme le gland ea anterior, ho hloka tsebo ea adrenal);
• tšebeliso e tšoanang ea lithethefatsi tse ling
• kamohelo ea glimepiride ho se na matšoao a kamohelo ea eona.

Phekolo ka litlamorao tsa sulfonylurea, tse kenyelletsang glimepiride, e ka lebisa ho nts'etsopele ea hemolytic anemia, ka hona, ho bakuli ba nang le khaello ea glucose-6-phosphate dehydrogenase, tlhokomelo e khethehileng e lokela ho nkuoa ha ho laeloa glimepiride, ho molemo ho sebelisa li-hypoglycemic agents tse sa hlahisoeng ke sulfonylurea.

Ka boteng ba lintlha tse ka holimo tsa kotsi bakeng sa nts'etsopele ea hypoglycemia, hammoho le maemong a tšoaetsanoang nakong ea kalafo kapa phetoho tseleng ea bophelo ba mokuli, ho ka hlokahala hore ho fetoloe tekanyo ea glimepiride kapa phekolo kaofela.

Matšoao a hypoglycemia a hlahisoang ke ho hanyetsa 'mele ha adrenergic e ka ba bonolo kapa a ba sieo ka nts'etsopele ea butle-butle ea hypoglycemia, ho bakuli ba tsofetseng, ho bakuli ba nang le mathata a tsamaiso ea methapo ea kutlo kapa ho bakuli ba fumanang beta-blockers, clonidine, reserpine , guanethidine le baemeli ba bang ba nang le kutloelo-bohloko.

Hypoglycemia e ka felisoa kapele ka takatso ea hang-hang ea lik'habohaedreite tse potlakileng tsa tsoekere (glucose kapa sucrose). Joalo ka liphihlelo tse ling tsa sulfonylurea, leha ho bile le katleho ea mantlha ea hypoglycemia, hypoglycemia e ka boela ea qala. Ka hona, bakuli ba lokela ho lula ba behiloe leihlo khafetsa. Ho hypoglycemia e matla, ho hlokahala kalafo ea hang-hang le tlhokomelo ea bongaka, 'me maemong a mang, ho kena sepetlele ho mokuli.

Nakong ea kalafo e nang le glimepiride, ho hlahlojoa ha ts'ebetso ea sebete le setšoantšo sa mali sa pheriferale (haholoholo palo ea leukocytes le liplatelete) hoa hlokahala.

Litla-morao tse kang hypoglycemia e matla, liphetoho tse mpe setšoantšong sa mali, litla-morao tse matla le lefu la sebete li ka beha bophelo kotsing, ka lebaka leo, haeba maemo a joalo a hlaha, mokuli o lokela ho tsebisa ngaka eo hang-hang ka bona, a khaotse ho sebelisa lithethefatsi mme a se ke a qalella ho nka ntle le tlhahiso ea ngaka .

Ts'ebeliso ea Lingaka

Boitsebiso bo mabapi le tšebeliso ea lithethefatsi ka nako e telele ho bana ha bo fumanehe.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Qalong ea kalafo, kamora ho fetola kalafo kapa ka tsamaiso e sa laoleheng ea glimepiride, ho fokotseha hoa maikutlo le lebelo la karabelo ea psychomotor ka lebaka la hypo- kapa hyperglycemia e kanna ea hlokomeleha. Sena se ka ama hampe bokgoni ba ho khanna makoloi kapa ho laola metjeko le metjhene e fapaneng.

Maikutlo a lingaka le lefu la tsoekere ka Amaril

Tlhahlobo ea lingaka tsa endocrinologists tseo khafetsa li kopanang le lipontšo tsa lefu le ipatileng letsatsi le leng le le leng ke sepheo sa tsona, 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 fokotsa likotsi tsa glycemic kapele ka ho lekana. Litsebi tsa 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.

Analogs Amaryl

Match ho ea ka lipontšo

Theko e tsoang ho li-ruble tse 90. Analogue e theko e tlaase ka li-ruble tsa 1716

Match ho ea ka lipontšo

Theko e tsoang ho li-ruble tse 97. Analogue e theko e tlaase ka li-ruble tse 1709

Match ho ea ka lipontšo

Theko e tsoang ho li-ruble tse 115. Analogue e theko e tlaase ka li-ruble tse 1691

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 130. Analogue e theko e tlaase ka li-ruble tse 1676

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 273. Analogue e theko e tlaase ka li-ruble tse 1533

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 287. Analogue e theko e tlaase ka li-ruble tse 1519

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 288. Analogue e theko e tlaase ka li-ruble tse 1518

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 435. Analogue e theko e tlaase ka li-ruble tse 1371

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 499. Analogue e theko e tlaase ka li-ruble tse 1307

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 735. Analogue e theko e tlaase ka li-ruble tse 1071

Match ho ea ka lipontšo

Theko e tsoang ho li-ruble tse 982. Analogue e theko e tlaase ka li-ruble tse 824

Match ho ea ka lipontšo

Theko e tsoang ho li-ruble tse 1060. Analogue e theko e tlaase ka li-ruble tse 746

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 1301. Analogue e theko e tlaase ka li-ruble tse 505

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 1395. Analogue e theko e tlaase ka li-ruble tse 411

Match ho ea ka lipontšo

Theko e tsoa ho li-ruble tse 2128. Analogue e theko e phahameng haholo ho li-ruble tse 322

Match ho ea ka lipontšo

Theko e tsoang ho li-ruble tse 2569. Analogue e theko e phahameng haholo ke li-ruble tse 763

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Theko e tsoa ho li-ruble tse 3396. Analogue e theko e phahameng haholo ke li-ruble tse 1590

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Theko e tsoang ho li-ruble tse 4919. Analogue e theko e phahameng haholo ke li-ruble tse 3113

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Theko e tsoang ho li-ruble tse 8880. Analogue e theko e phahameng haholo ke li-ruble tse 7074

Ketso ea pharmacological

Setlhare sa "hypoglycemic" se tsoang molomong oa boraro ke sulfonylurea.

Glimepiride e fokotsa khatello ea "glucose" maling, haholo-holo ka lebaka la tšusumetso ea tokollo ea insulin ho lisele tsa β-cell tsa manyeme. Phello ea eona e amahanngoa haholo le ntlafatso ea bokhoni ba li-pancreatic β-cell ho arabela ho susumetso ea 'mele ka glucose. Ha ho bapisoa le glibenclamide, litekanyetso tse tlase tsa glimepiride li ntša insulin e fokolang ha ho fokotseha ho lekanang le tekanyo ea glucose ea mali. Taba ena e paka molemong oa ho ba teng ha litlamorao tsa extrapancreatic hypoglycemic ho glimepiride (kutloelo-bohloko e eketsehileng ea tishu ho insulin le phello ea insulin-mimetic).

Secretion ea insulin. Joalo ka tse ling tsohle tse tsoang ho sulfonylurea, glimepiride e laola secretion ea insulin ka ho sebelisana le liteishene tsa potasiamo tse nang le maikutlo tsa ATP ho li-membrane tsa β-cell. Ho fapana le lihlahisoa tse ling tsa sulfonylurea, glimepiride e ikhethela protheine e nang le boima ba li-kilodron tse 65 tse fumanehang kahara litho tsa "li-pancreas" tsa "pancreas". Tšebelisano ena ea glimepiride e nang le protheine e tlamang ho eona e laola ho buloa kapa ho koaloa ha lits'ebetso tsa potasiamo tse potang ATP.

Glimepiride e koala likheo tsa potasiamo. Sena se baka ho putlama ha lisele tsa β 'me se lebisa ho buloeng ha liteishene tsa khalsiamo tse amohelang matla le phallo ea khalsiamo ka seleng. Ka lebaka leo, keketseho ea "calcium" ea intracellular calcium e kenya ts'ebetso ea insulin ka exocytosis.

Glimepiride e potlakile haholo ka hona e khona ho kopana 'me e lokolloa tlamahanong le protheine e tsamaeang le eona ho feta glibenclamide. Ho nahanoa hore thepa ena ea theko e phahameng ea phapanyetsano ea glimepiride e nang le protheine e tlamang ho eona e etsa qeto ea phello ea eona ea maikutlo a cells-lisele tsa glucose le ts'ireletso ea bona khahlanong le takatso le tahlehelo ea pele ho nako.

Kameho ea ho eketsa kutloisiso ea lithane ho insulin. Glimepiride e ntlafatsa litlamorao tsa "insulin" ho monngoeng ha tsoekere ke lithane tsa pherekano.

Matla a insulinomimetic. Glimepiride e na le litlamorao tse ts'oanang le litlamorao tsa "insulin" ho kenngoeng ha tsoekere ke li-tishu tsa peripheral le ho lokolloa ha tsoekere maling.

Glucose ea peripheral ea methapo e kenngoa ka ho e tsamaisa liseleng tsa mesifa le li-adipocytes. Glimepiride ka kotloloho e eketsa palo ea limolek'hule tse tsamaisang glucose ho li-membrane tsa plasma tsa lisele tsa mesifa le adipocytes. Keketseho ea tekanyo ea lisele tsa tsoekere e lebisa ts'ebetsong ea phospholipase e ikhethileng ea glycosylphosphatidylinositol C. Ka lebaka leo, khatello ea khalsiamo ea "intracellular" ea calcium e ea fokotseha, 'me e baka ho fokotseha hoa ts'ebetso ea protheine ea kinase A,' me e lebise ho hlohlelleng metabolism ea tsoekere.

Glimepiride e thibela ho ntšoa ha tsoekere ho tsoa sebete ka ho eketsa bongata ba fructose-2,6-bisphosphate, e thibelang gluconeogenesis.

Kameho ka ho kopana ha liplatelete. Glimepiride e fokotsa kopanyo ea liplatelete ka vitro le vivo. Matla ana ho bonahala a amahanngoa le thibelo e ikhethileng ea COX, e ikarabellang bakeng sa ho thehoa ha thromboxane A, ntho ea bohlokoa e kenyelletsang bokahohle.

Matla a antiatherogenic. Glimepiride e kenya letsoho ho thathamiseng litaba tsa lipid, e fokotsa boemo ba aldehyde ba maloneng maling, e lebisang phokotsong e kholo ea lipid peroxidation. Ho liphoofolo, glimepiride e lebisa ho fokotseha ho hoholo ha sebopeho sa li-atherosmithotic plaque.

Fokotsa ho teba ha khatello ea maikutlo a nang le ts'oaetso, e lulang e le teng ho bakuli ba nang le lefu la tsoekere la mofuta oa 2. Glimepiride e eketsa boemo ba io-tocopherol ea endo native, mosebetsi oa catalase, glutathione peroxidase le superoxide dismutase.

Liphello tsa pelo. Ka liteishene tsa potasiamo tse tebileng tsa ATP, lintho tse tsoang ho sulfonylurea le tsona li ama tsamaiso ea methapo ea pelo. Ha e bapisoa le litlamorao tsa setso tsa sulfonylurea, glimepiride e na le phello e fokolang haholo ts'ebetsong ea pelo, e ka hlalosoang ke mofuta o ikhethileng oa tšebelisano ea hau le protheine e tlamang ea methapo ea potasiamo e nang le matla ea ATP.

Ho baithaopi ba phetseng hantle, tekanyetso e sebetsang ea glimepiride ke 0,6 mg. Kameho ea glimepiride e itšetleha ka lethal dose hape e ka ikatisa. Karabelo ea 'mele ho ts'ebetso ea' mele (ho fokotsa insulin secretion) e nang le glimepiride e lula e le teng.

Ha ho na phapang e kholo ea phello, ho latela hore na moriana o nooa metsotso e 30 pele ho lijo kapa hang pele lijo. Bakeng sa bakuli ba nang le lefu la tsoekere, taolo e lekaneng ea metabolic e ka fihlelleha nakong ea lihora tse 24 ka tekanyetso e le 'ngoe. Ho feta moo, lithutong tsa bongaka, bakuli ba 12 ho ba 16 ba nang le bothata ba ho ruruha (CC 4-79 ml / min) le bona ba fihletse taolo e lekaneng ea metabolic.

Motsoako oa motsoako o kopantsoeng le metformin. Bakeng sa bakuli ba nang le taolo e lekaneng ea metabolic ha ba sebelisa tekanyetso e phahameng ea glimepiride, phekolo e kopaneng le glimepiride le metformin e ka qala. Lithutong tse peli, ha ho etsoa kalafo e kopaneng, ho ile ha netefatsoa hore taolo ea metabolic e molemo ho feta ea kalafo ea e 'ngoe le e ngoe ea lithethefatsi tsena ka thoko.

Motsoako oa ho kopanya le insulin. Bakeng sa bakuli ba nang le taolo e tlase ea metabolic ha ba nka glimepiride ka tekanyo e phahameng, kalafo ea "insulin" e ka qala. Ho latela liphetho tsa lipatlisiso tse peli, ha u sebelisa motsoako ona, ntlafatso e tšoanang taolong ea metabolic e fihlella joalo ka ha ho sebelisoa insulin e le 'ngoe feela. Leha ho le joalo, kalafo ea ho kopanya e hloka tekanyetso e tlase ea insulin.

Melemo ea litekanyetso

Ha e le molao, tekanyetso ea Amaril ® e khethoa ke sepheo sa "glucose" se lebisitsoeng. Moriana o lokela ho sebelisoa ka tekanyetso e fokolang ho fihlela taolo ea metabolic e hlokahalang.

Nakong ea kalafo le Amaril ®, hoa hlokahala ho tseba khafetsa boemo ba tsoekere maling. Ntle le moo, ho khothalletsoa ho lekola kamehla maemo a hemoglobin ea glycosylated.

Tlolo ea lithethefatsi, ka mohlala, ho tlola tekanyetso e latelang, ha ea lokela ho etsoa ke tsamaiso e latelang ea lithethefatsi ka tekanyetso e phahameng.

Ngaka e lokela ho laela mokuli esale pele ka liketso tse lokelang ho nkuoa haeba ho e-na le liphoso tsa ho nka Amaril ® (haholoholo, ha a tšela tekanyetso e latelang kapa a tlola lijo), kapa maemong ao ho seng bonolo ho a sebelisa.

Matlapa a Amaril ® a lokela ho nkuoa a sa nooa, a noe metsi a mangata (hoo e ka bang senoelo sa 1/2). Ha ho hlokahala, matlapa a Amaril ® a ka aroloa hammoho le likotsi ka likarolo tse peli tse lekanang.

Motsoako oa pele oa Amaril ® ke 1 mg 1 nako / letsatsi. Ha ho hlokahala, tekanyetso ea letsatsi le letsatsi e ka eketsoa butle-butle (ka linako tse ling tsa libeke tse 1-2) ka tlasa tlhahlobo ea tsoekere ea mali le ka tatellano e latelang: 1 mg-2 mg-3 mg-4 mg-4 mg-6 mg (-8 mg) ka letsatsi .

Ho bakuli ba nang le lefu la tsoekere la mofuta oa 2 le laolehileng hantle Tekanyetso ea letsatsi le letsatsi ea lithethefatsi hangata e le 1-4 mg. Pilisi ea letsatsi le letsatsi e fetang 6 mg e sebetsa hantle ho palo e fokolang feela ea bakuli.

Ngaka e beha qeto ea nako ea ho nka Amaril ® le ho ajoa ha litekanyetso motšehare, ho nahanela tsela ea mokuli (nako ea lijo, palo ea mesebetsi ea 'mele). Karolelano ea letsatsi le letsatsi e beoa tekanyetso e le 'ngoe, hangata kapele pele ho lijo tsa hoseng tse phethahetseng kapa, haeba tekanyetso ea letsatsi le letsatsi ha e-so nkuoe, kapele pele ho lijo tsa pele tse kholo. Ho bohlokoa haholo hore u se ke oa tlola lijo ka mor'a ho nka matlapa a Amaril ®.

Hobane taolo e ntlafalitsoeng ea metabolic e amahanngoa le ho eketseha ha maikutlo ho insulin; nakong ea kalafo, tlhoko ea glimepiride e ka fokotsoa. Bakeng sa ho qoba nts'etsopele ea hypoglycemia, hoa hlokahala ho fokotsa tekanyetso ka nako kapa ho khaotsa ho nka Amaril ®.

Maemo ao ho ka 'nang ha hlokahala tokiso ea lethal dose ea glimepiride:

- boima ba 'mele,

- Liphetoho tsa mokhoa oa bophelo (Phetoho ea lijo, nako ea lijo, palo ea tšebetso ea 'mele),

- ho hlaha hoa lintlha tse ling tse lebisang ho holofatsong ea kholo ea hypoglycemia kapa hyperglycemia.

Phekolo ea Glimepiride hangata e etsoa ka nako e telele.

Phetisetso ea mokuli ho nka lithethefatsi tse ling tsa molomo tsa hypoglycemic ho isa Amaril ®

Ha ho na kamano e nepahetseng lipakeng tsa litekanyetso tsa Amaril ® le lithethefatsi tse ling tsa molomo tsa hypoglycemic. Ha ho fetisoa ho tloha lithethefatsing tse joalo ho ea Amaryl ®, litekanyetso tsa pele tse khothalelitsoeng tsa letsatsi le letsatsi tsa morao-rao ke 1 mg (le haeba mokuli a fetisetsoa Amaryl ® ka tekanyo e phahameng ea lithethefatsi tse ling tsa molomo tsa hypoglycemic). Keketseho efe kapa efe ea litekanyetso e lokela ho etsoa ka mekhahlelo, ho nka karabelo ho glimepiride ho latela likhothaletso tse kaholimo. Hoa hlokahala ho ela hloko botebo le nako ea phello ea moemeli oa hypoglycemic ea nakong e fetileng. Ho kenella kalafo ho ka hlokahala bakeng sa ho qoba sephetho se eketsang kotsi ea hypoglycemia.

Sebelisa hammoho le metformin

Ho bakuli ba nang le lefu la tsoekere le sa laoleheng le sa laoleheng, ha ba nka glimepiride kapa metformin ka tekanyetso e phahameng ea letsatsi le letsatsi, kalafo e nang le litlhare tsena tse peli e ka qala. Maemong ana, kalafo ea nakong e fetileng e nang le glimepiride kapa metformin e tsoela pele ka tekanyetso e le 'ngoe,' me tekanyetso e eketsehileng ea metformin kapa glimepiride e qala ka tekanyetso e tlase, e ntan'o kenngoa ka palo ho latela tekanyetso ea taolo ea metabolic, ho fihlela tekanyo e phahameng ea letsatsi le letsatsi. Phekolo ea ho kopanya e lokela ho qaloa ka tlasa tlhokomelo ea bongaka e matla.

Sebelisa hammoho le insulin

Ho bakuli ba nang le lefu la tsoekere le laolehileng le sa laoleheng, insulin e ka fanoa ka nako e ts'oanang ha u nka glimepiride ka tekanyo e kholo ea letsatsi le letsatsi. Tabeng ena, tekanyetso ea ho qetela ea glimepiride e fuoeng mokuli e lula e sa fetoha. Tabeng ena, kalafo ea insulin e qala ka tekanyetso e tlase, eo butle-butle e eketsehang tlasa taolo ea khatello ea "glucose" maling. Phekolo e kopaneng e etsoa ka tlasa tlhokomelo ea bongaka e haufi.

Bakuli ba nang le ts'oaetso ea renal e kanna ea tsotella haholoanyane phello ea hypoglycemic ea glimepiride. Lintlha tse mabapi le tšebeliso ea Amaril ® ho bakuli ba nang le bothata ba ho phekola ba le methapo li lekanyelitsoe.

Lintlha mabapi le ts'ebeliso ea Amaril ® bakuli ba nang le bothata ba sebete limited.

Litla-morao

Ka lehlakoreng la metabolism: hypoglycemia ea khonahala, eo, joalo ka lintho tse ling tsa sulfonylurea, li ka tsoeloang nako e telele. Matšoao a hypoglycemia - hlooho, tlala, ho nyekeloa, ho hlatsa, mokhathala, ho otsela, ho tsitsinyeha ha boroko, ho tšoenyeha, ho ba mabifi, ho tsepamisa mohopolo, ho falimeha le ho potlakela ho arabela, ho tepella maikutlo, pherekano, mathata a puo, aphasia, likhathatso tsa pono, ho thothomela, ho haroha letsoalo , likhathatso tsa kelello, ho tsekela, ho felloa ke boitšoaro, ho ferekana, ho tsitsipana, ho otsela kapa ho akheha ho fihlela ho akheha, ho hema ka mokhoa o sa tsitsitseng, bradycardia. Ntle le moo, lipontšo tsa taolo ea khatello ea adrenergic li ka ba teng ka lebaka la hypoglycemia, joalo ka ponahalo ea ho bata, ho fufuleloa ka tieo, matšoenyeho, tachycardia, khatello ea mali ea methapo, pherekano ea methapo, le phallo ea pelo. Tlhahiso ea kliniki ea hypoglycemia e matla e ka tšoana le ho otloa. Matšoao a hypoglycemia a lula a nyamela kamora ho felisoa.

Ka lehlakoreng la setho sa pono: ho khoneha (haholo-holo qalong ea kalafo) ho senyeha ha nakoana ka lebaka la liphetoho tse bang teng tsoekere e maling. Lebaka la tsona ke phetoho ea nakoana ea ho ruruha ha lilense, ho ipapisitse le phallo ea tsoekere maling, 'me ka lebaka la sena, ke phetoho lenaneng la lilense tse hlakileng.

Ho tsoa ts'ebetsong ea tšilo ea lijo: ka seoelo, ho nyekeloa ke pelo, ho hlatsa, ho utloa bohloko kapa ho aparela epigastrium, bohloko ba ka mpeng, lets'ollo, maemong a mang a hepatitis, ts'ebetso e atileng ea li-enzyme tsa sebete le / kapa cholestasis le jaundice, tse ka tsoelang pele ho fokoliseng lefu la sebete, empa li ka fetela pele ntlafatsong ha o tlohela lithethefatsi.

Ho tsoa ho sheropoietic system: thrombocytopenia, maemong a mang - leukopenia, hemolytic anemia, erythrocytopenia, granulocytopenia, agranulocytosis le pancytopenia. Tšebelisong ea lithethefatsi kamora ho bapatsa, ho boleloa linyeoe tse matla tsa thrombocytopenia e nang le lipalo tsa liplatelete

Contraindication

- mofuta oa 1 lefu la tsoekere

- lefu la tsoekere ketoacidosis, lefu la tsoekere, le komisi,

- tlhekefetso e matla ea ts'ebetso ea sebete (ho hloka tsebo ea bongaka),

- Ts'oaetso e tebileng ea a renal, ho kenyeletsa bakuli ba hemodialysis (ho hloka tsebo ea bongaka)

- ho anyesa (matsoele),

- lilemo tsa bana (ho hloka tsebo ea bongaka),

- mafu a lefutsoang a fumanehang ka bongata, a joalo ka ho se mamellane ha galactose, khaello ea lactase kapa lefu la glucose-galactose malabsorption,

- Hypersensitivity ho likarolo tsa moriana,

- Hypersensitivity ho tse ling tse tsoang ho sulfonylurea derivatives le lithethefatsi tsa sulfonamide (kotsi ea karabelo ea hypersensitivity).

Le tlhokomeliso lithethefatsi li lokela ho sebelisoa libekeng tsa pele tsa kalafo (kotsi e eketsehang ea ho ba le hypoglycemia), haeba ho na le mabaka a kotsi bakeng sa nts'etsopele ea hypoglycemia (ho ka hlokahala hore u fetole lethal dose ea glimepiride kapa phekolo eohle), ka mafu a kopaneng nakong ea kalafo, kapa ha bakuli ba fetola tsela eo ba phelang ka eona (ho fetola lijo le nako ea ho amoheloa. lijo, keketseho kapa ho fokotseha hoa ts'ebetso ea 'mele), ha ho na le khaello ea glucose-6-phosphate dehydrogenase, maemong a ha malabsorption ea lijo le lithethefatsi tse tsoang pampiring ea gastrointestinal (intestinal obstruction, paresis Shechnik).

Bokhachane le pelehi

Amaril ® e kopantsoe le kemaro. Tabeng ea kemolo e reriloeng kapa qalong ea kemaro, mosali o lokela ho fetisetsoa kalafo ea insulin.

Ho fumanoe hore glimepiride e pepesetsoa lebeseng la matsoele. Nakong ea kemaro, o lokela ho fetisetsa mosali ho insulin kapa ho emisa ho anyesa.

Ho sebelisana le lithethefatsi

Glimepiride e tšelisoa le ho nka karolo ha CYP2C9 isoenzyme, e lokelang ho tsotelloa ha lithethefatsi li sebelisoa le inducers (e.g. rifampicin) kapa li-inhibitors (mohlala, fluconazole) CYP2C9.

Monyetla oa ts'ebetso ea hypoglycemic mme, maemong a mang, nts'etsopele ea mohlomong ea hypoglycemia e amanang le sena e ka bonoa ha Amaril ® e kopantsoe le e 'ngoe ea lithethefatsi tse latelang: li-insulin, li-agents tsa hypoglycemic bakeng sa tsamaiso ea molomo, li-inhibitors tsa ACE, li-anabolic steroid le lihormone tsa banna tsa thobalano, chloramphenicol, li-coumarin. cyclophosphamide, disopyramide, fenfluramine, pheniramidol, fibrate, fluoxetine, guanethidine, ifosfamide, MAO inhibitors, fluconazole, PASK, pentoxifylline (litekanyetso tse phahameng tsa parenteral) , phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, clarithromycin, sulfanilamides, tetracyclines, tritokvalin, trophosphamide.

Ho fokotseha ha ts'ebetso ea hypoglycemic le keketseho e amanang le tsoekere ea mali ho ka khoneha ha e kopantsoe le e 'ngoe ea lithethefatsi tse latelang: acetazolamide, barbiturates, glucocorticosteroids, diazoxide, diuretics, lithethefatsi tsa sympathomimetic (ho kenyeletsa epinephrine), tsoekere, litlatsetso (ka tšebeliso e telele ), nicotinic acid (ka tekanyetso e phahameng), estrogens le progestogens, phenothiazines, phenytoin, rifampicin, lihomone tsa qoqotho tsa iodine.

Histamine H blockers₂li-receptors, beta-blockers, clonidine le reserpine li khona ho ntlafatsa le ho fokotsa phello ea hypoglycemic ea glimepiride.

Tlas'a tšusumetso ea baemeli ba nang le kutloelo-bohloko, joalo ka beta-blockers, clonidine, guanethidine le reserpine, matšoao a ho hanyetsa ha adrenergic ha a arabela hypoglycemia a ka fokotsoa kapa a ba sieo.

Khahlano le semelo sa ho nka glimepiride, ho matlafatsa kapa ho fokolisa ketso ea melemo ea coumarin ho ka etsahala.

Tšebeliso e le 'ngoe ea joala kapa e sa foleng e ka matlafatsa le ho fokolisa phello ea hypoglycemic ea glimepiride.

Li -ququirerate tsa bile acid: lebili la loreketso le tlama ho glimepiride mme le fokotsa ho monya ha glimepiride ho tsoa pampiring ea gastrointestinal. Tabeng ea ts'ebeliso ea glimepiride, bonyane lihora tse 4 pele a kenella cadelovel, ha ho na tšebelisano. Ka hona, glimepiride e lokela ho nkuoa bonyane lihora tse 4 pele u nka wheelchair.