Diapiride ea lithethefatsi: litaelo tsa tšebeliso

Moemeli oa hypoglycemic, sulfonylurea ea moloko oa boraro e nkiloeng ketsong e telele. Phello ea hypoglycemic ea lithethefatsi e bakoa ke mokhoa o rarahaneng oa ts'ebetso ea pancreatic le extrapancreatic.

Ketso ea pancreatic e kenyelletsa secretion ea "insulin" e ntlafatsang ke lisele tsa "pancreatic", tse tsamaeang le ts'usumetso le keketseho e kholo ea "insulin" ea "insulin". Ts'ebetso ena e bakoa ke taba ea hore glimepiride, e nang le tekanyo e phahameng ea sebaka, e kopanya le ho khaola ho tsoa ho protheine ea cells-lisele tsa manyeme, e amanang le mekhoa ea potasiamo e itšetlehileng ka ATP, empa e fapana le sebaka se tloaelehileng sa ho tlama sa soponylureas ea 1st le 2nd. Ka lebaka leo, insulin e ntšoa ke exocytosis, ha bongata ba "insulin" bo bolokiloeng bo tlase haholo tlasa ts'ebetso ea litekanyetso tsa setso tsa sulfonylurea. Tšusumetso e nyane joalo e fokotsang glimepiride ho secretion ea insulin le eona e fana ka kotsi e tlase ea hypoglycemia.

Phello ea extrapancreatic ea glimepiride e bontšoa ke litlamorao, tse lebisang ho tsona ke keketseho ea kutloelo-bohloko ea methapo ea mesifa (mesifa le mafura) ho ts'oarella insulin ka keketseho ea palo le ts'ebetso ea liprotheine tse tsamaisang tsoekere ka har'a li-membrane tsa sele, le tšitiso ea motsoako oa glucose sebeteng ka keketseho ea methapo ea methapo-kholo ea 2.6. β-phosphate e thibelang gluconeogeneis. Litholoana tse ling tsa extrapancreatic tsa glimepiride li kenyelletsa: ho fokotseha ha pokello ea liplatelete ka lebaka la thibelo e khethollang ea COX le phetoho ea arachidonic acid ho thromboxane A2, activation plateletation, keketseho ea boemo ba endogenous α-tocopherol le ts'ebetso ea li-enzyme tsa antioxidant oxidase, glutaseidase. khatello ea maikutlo, e lulang e bonoa ho lefu la tsoekere, ho loants'oa ha atherogenic ka lebaka la ts'ebetso e khethehileng C. phospholipase C.

Glimepiride ha e thibele liphetoho tsa metabolism ea myocardium ho ischemia (ho fapana le glibenclamide).

Phello e phahameng ea hypoglycemic ea moriana e hlaha lihora tse 2-3 kamora ho tsamaisoa, ho nka nako e fetang lihora tse 24 mme e its'ere litekanyetso.

Ka litekanyetso tse ngata tsa glimepiride ka tekanyetso ea letsatsi le letsatsi ea 4 mg, karolelano e phahameng ea serum ea mali e fihlelloa kamora lihora tse 2,5 mme e fihla ho 309 ng / ml, ho na le kamano ea mola pakeng tsa lethal dose le palo e phahameng ea glimepiride maling, hammoho le lipakeng tsa tekanyetso le sebaka se ka tlasa "curl" - Nako. ” Glimepiride e na le bioavailability e felletseng. Ho ja ha ho na phello ea bohlokoa ho amohengng, ntle le ho fokotseha hanyane ka tekanyo ea ho amoheloa.

Glimepiride e tsebahala ka palo e nyane ea kabo (hoo e ka bang 8,8 L), e batlang e lekana le bophahamo ba karolelano ea albin, tekanyo e phahameng ea ho tlama liprotheine tsa plasma tsa mali (ho feta 99%) le tumello e tlase ea creatinine (hoo e ka bang 48 ml / min). Glimepiride e kenella kahara lebese la matsoele le ka hematoplacental barriers, e kenella hantle BBB. Glimepiride e entsoe ka biotransformed 'meleng hore e be li-metabolites tse peli, tse bōpiloeng ka lebaka la metabolism ea glimepiride ka har'a sebete mme ke hydroxyl le carboxyl e tsoang ho glimepiride. Nako ea halofo ea bophelo ba glimepiride maemong a eona a plasma ka hara serum ea mali e tsamaisanang le mofuta o mengata oa dosing ke lihora tse 5 Kamora ho nka glimepiride ka tekanyo e phahameng, halofo ea bophelo e eketsehile. Kamora tekanyetso e le 'ngoe ea molomo ea radiolabeled glimepiride, 58% e ile ea fumanoa mochineng le 35% ho mantle. Ntho e sa fetoheng e sebetsang ka har'a moroto ha ea ka ea fumanoa. Bophelo ba halofo ea hydroxyl le carboxyl metabolite ea glimepiride e ne e ka ba lihora tse 3-6 le lihora tse 5 ka tatellano.

Ho bakuli ba nang le ts'ebetso ea renal e senyehileng (tumello e tlase ea creatinine), ho ne ho na le tšekamelo ea ho eketsa ho hlaka ha glimepiride le ho fokotseha ha karolo ea eona ea karolelano maling, e kanna ea hlahisoa ka potlako ke lithethefatsi ka lebaka la ho tlama protheine e tlase. Ka hona, mokhahlelong ona oa bakuli ha ho na kotsi ea ho eketseha ha glimepiride.

Litekanyetso tsa pharmacokinetic glimepiride lia tšoana ho bakuli ba bong bo fapaneng le ba lilemo tse fapaneng.

Type II lefu la tsoekere mellitus (e sa itšetlehang ka insulin) ho batho ba baholo e le monotherapy kapa hammoho le metformin kapa insulin.

Contraindication diapiride matlapa

hypersensitivity e tsebahalang ea likarolo tsa lithethefatsi le ho tsoa ho sulfonylurea kapa litokisetso tse ling tsa sulfonylamide

mofuta oa lefu la tsoekere

lefu la tsoekere ketoacidosis, lefu la tsoekere

a matla a renal le hepatic

ho ima le ho nyekeloa

bana ba ka tlase ho lilemo tse 18

drug componentterine zhne sulfonylurea tuyndylaryna nemese basқa sulfonylamidtik litokiso tarғa belgilі zhoғary sezmtaldy

insulin tәuдldi Ke thaepa lefu la tsoekere

lefu la tsoekere ketoacidosis, lefu la tsoekere

bauyr zhne bүyrek mesebetsi ea son ң auyr bұzylulary

zhktіlіk zhne lactation

18 jasқa deyingі balalarғa

Litla-morao tsa matlapa a diapiride

hypersensitivity liphetoho - ho hlohlona, lekhopho le urticaria

allergy e allergy e nang le sulfonylurea, sulfonamides kapa metsoako e amanang

maemo a eketsehang a li-enzyme tsa sebete

liphetoho tsa nakoana ponong li ka hlaha ka lebaka la liphetoho maemong a tsoekere ea mali, haholo qalong ea kalafo

ka ho leka-lekana ho fihlela thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, hemolytic anemia le pancytopenia, eo hangata e nyamelang kamora ho khaotsa kalafo

Litlamorao tsa hypoglycemic tse etsahalang hangata maemong a mangata, li ka nka sebopeho se matla mme ha ho bonolo ho khalemeloa habonolo. Ho hlaha hoa liphetoho tsena ho latela, joalo ka nakong ea mefuta e meng ea kalafo ea hypoglycemic, ka maemo a latelang a phepo e nepahetseng, joalo ka phepo e nepahetseng le litekanyetso.

allergic vasculitis, hypersensitivity reactions ho tloha ho e monyane ho ea ho tebileng ka nts'etsopele ea dyspnea, ho fokotseha ha khatello ea mali, ka linako tse ling ho ts'oha

ho nyekeloa ke pelo, ho hlatsa, lets'ollo, khatello kapa ho ikutloa u tletse ka mpeng, bohloko ba ka mpeng, boo ka linako tse ling bo ka hlokang ho khaotsa kalafo

ho se sebetse hantle ha sebete (ka mohlala, ho thekesela ha bile le lefu la sethoathoa), hepatitis, e ka tsoelang pele ho fokola ha sebete

hypersensitivity ho khanya

ho fokotseha ha palo ea sodium ho serum ea mali

Zhoғary sezimtaldyқ reaktylary - қysynu bөrtpe zhene esekzhem

sulphonylurea, sulphonamidetermen nemese tekte

bauyr Fermentteri deңgejіnің zhoғarylauy

gluандағы glucose deңgejііnің өzgeruіne bailanysty, әсіресеемдеудің басында көрудің уақытша бұзылалары туындауы мүмкін

orthashadan auyr derezhey denging thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, hemolytic anemia, pancytopenia ea basali, olar етdette emdeoudi totatannanne kejin zhoala

kөp zhadaylarda birden tuyndaytyn hypoglycemiaқ reactionar auyr tүrhe haoі zhne tүzetuge үnemi kөne bermeuі mүmkіn. Ho bile le karohano ea karabelo ы tuyndauy hypoglycemia қ emdeudіқ basқa tүrlerі kesіne de, tamқtanu zhne demoalau khanyang ектив subjective і sharttarғa le bailanysty

allergalsқ vasculitis, eleusenden dyspnea, damuymen, arterialsқ қrysymnyң tөmendeuіmen kүrdelіlerіne deіngі zhғғary sezmtaldyқ reaktylary, keide - makala

Zhurek Ainuy, құsu, lets'ollo, asқazandaғy қysyme nemese matšoele a ketu sezimі, іштің ауыруы, keide emdeudі toқtatudy қazet etuim mүmkіn

Bauyr қyzmetіnің bұzylouy (menahano өт ірікілісі және сарғағ), hepatitis, ol bauyr zhetkіlіksіzdіgіne deіn үdeuі mүmkіn

жарыққа жоғары сеімталдық

қан sarysuyndaғy sodium mөlsherіnің tөmendeuі

Litaelo tse khethehileng bakeng sa tšebeliso

Phekolo e atlehang ea lefu la tsoekere e itšetleha ka hore mokuli a latele lijo tse loketseng, ho ikoetlisa khafetsa le ho lekola litekanyetso tsa tsoekere ea mali le moroto kamehla. Ho se shebe lijo ka bongata ke bakuli ho ke ke ha lefshoa ka ho sebelisa lipilisi kapa insulin.

Diapiride e tlameha ho nooa nakoana pele kapa ka lijo. Haeba lijo li hlaha nako le nako ka nako e fapaneng kapa li ts'oaroe ka ho felletseng, ho li sebelisa ho ka baka hypoglycemia. Matšoao a ka lula a felisoa ka potlako haeba lik'habohaedreite (tsoekere) li nkuoa hang-hang.

Lisebelisoa tse tsoekere tsa maiketsetso li ke ke tsa fana ka phello.

Boiphihlelo le liphihlelo tse ling tsa sulfonylurea li bonts'a hore nts'etsopele ea hypoglycemia e ka etsahala, leha ho bile le katleho ea pele ea mehato e nkuoeng.

Hypoglycemia e matla kapa e telele, e ka fokolisoang ke nakoana ka lebaka la ho noa tsoekere e tloaelehileng, e hloka kalafo hanghang, 'me ka linako tse ling e kenngoe sepetlele.

Lintlha tse tlatsetsang ho hlaha hoa hypoglycemia ke: ho tsilatsila kapa (hangata ho bakuli ba tsofetseng) ho se khone ho sebelisana le ngaka, khaello ea phepo e nepahetseng, ho ja ka tsela e sa tloaelehang kapa ho tlola lijo, ho itima lijo, ho fetola lijo, ho leka-lekana pakeng tsa ts'ebetso ea 'mele le ho ja lijo tse nang le lik'habohaedreite, tšebeliso ea lino tse tahang. hammoho le lijo tse qhekelletsoeng, ho hlaphoheloa ka mokhoa o itekanetseng le ho senyeha hoa mmele, ho fetella ho Diapirid, mafu a mang a sa sebetseng a endocrine a amang ba kentse letsoho ho "carbohydrate metabolism" kapa "regoglycemia" (mohlala, dysfunctions tse ling tsa tšoelesa ea qoqotho, ho se lekane hoa ts'ebetso ea anterior pituitary kapa adrenal cortex), tšebeliso e tšoanang ea lithethefatsi tse ling (bona karolo ea "Drug Interaction").

Phekolo ka Diapiride e hloka ho hlahlojoa khafetsa ha mali le glucose ea morine. Ntle le moo, ho khothalletsoa ho laola boholo ba hemoglobin ea glycosylated.

Nakong ea ts'ebeliso ea lithethefatsi, ho hlahlojoa ha ts'ebetso ea sebete le tlhaiso ea setšoantšo sa mali (ke haholo-holo palo ea leukocytes le liplatelete).

Maemong a sithabetsang (mohlala, likotsi, ts'ebetso e potlakileng, ts'oaetso e tsamaeang le feberu), phetoho ea nakoana ea mokuli ho insulin e kanna ea bontšoa.

Ha ho na datha ea ts'ebeliso ea Diapiride ho bakuli ba nang le ts'ebetso ea sebete e matla kapa ba bontšitsoeng ho ts'oaroa ha lets'oao. Bakuli ba nang le bothata ba ho renal kapa hepatic e haellang ba lokela ho fetisetsoa ho insulin.

Ho lokela ho hopoloa hore matšoao a hypoglycemia a ka patoa kapa a ba sieo ho bakuli ba tsofetseng ba nang le autonomic neuropathy kapa ho bao ka nako e tšoanang ba fumanang kalafo ka β-adrenergic receptor blockers, reserpine, clonidine, guanethidine kapa mofuta o mong oa kutloelo-bohloko. Haeba phello e sa lekana kapa phello e fokotsehile, maemong a kalafo ea nako e telele, ho khothalletsoa ho kopantsoe le metformin kapa insulin.

Tabeng ea matšeliso a lefu la tsoekere, maikutlo a insulin a eketseha, ka hona, tlhoko ea lithethefatsi e ka fokotseha nakong ea ts'ebetso ea kalafo. Ho qoba nts'etsopele ea hypoglycemia, ho hlokahala hore o theole litekanyetso ka nako e loketseng kapa oa hlakola lithethefatsi. Phetoho ea tekanyetso le eona e lokela ho etsoa ha ho fetoloa boima ba 'mele oa mokuli kapa tsela eo a phelang ka eona, kapa maemong a mang a tlatsetsang ho hypo- kapa hyperglycemia.

Bakuli ba nang le lefutso la galactose le fumanehang ka seoelo, khaello ea lactase kapa ho kenngoa ha glucose-galactose, ha baa lokela ho nka Diapiride.

Қant diabetіn emdeudің sәttіlіgі emdelushіnің sәykesіnshe tamaқtanu ratsionyn saқtauyna, ұdayy Dene belsendіlіgіne, Sondalo-AK қan fetohile neseptegі tsoekere deңgeyіnің tұraқty baқylanuyna baylanysty. Nauқastardyң emdәm saқtamauynyң ornyn matlapa a pakeng nemese insulinind қabyldau argyly toltyru mүmkіn еес.

Diapiridti joalo ka isherden bіraz bұryn nemese joalo ka isu kesіnde қabyldau Jaeger as іshu ретr rette әr tүrlі uaқytta oryn alsa nemese mүldem zhyberilip alsa, litokisetso қabyldau hypoglycemia tuғyzuy mүmkіn. Eger bіrden kөmіrsular (қant) қabyldasa, matšoao a daryn үnemі derlіk tez ңіlddetugu boladi.

Zhasandy tәttіlendіrgіshter Yeshanday әser Bermaidi.

Basқa sulfonylurea tuyndylaryn қoldanu tәzhіribesі, tіrele қabyldanғan sharalardyң bastapқydғy sәttіlіgіne қарамастан, hypoglycemiaң Kayta damuy mүmkіnеkendі.

Қanttyң әdettegi mәlsherin paydalanyp tek uaқytsha ғana basu болa bolatyn auyr nemese ұza созa kopanetsweng hypoglycemia dereu dәrі-dәrmekpen emdeoudі, al keide - auruhanaғa zhatyyutudyut.

Gipoglikemiyanyң tuyndauyna yқpal etetіn faktorlar mynalar bolyp tabylady: dәrіgermen yntymaқtasudy қalamau Nemesu (kөbіnese egde zhastaғy emdelushіlerde) mүmkіndіgі bolmau, toyyp tamaқ іshpeu, zhүyelі tamaқtanbau Nemesu lenaihana іshudі zhіberіp alu, ashyғu kezeңі, tamaқtanu rezhimіnің өzgeruі, Dene zhүktemelerі fetohile kөmіrsulardy paydalanu arasyndaғy teңgerіmnің bұzyluy, joala, әsіresе іshudі jіberіp alumen bіrge paydalanu, bүyrek әne bauyr mesebetsi ea mora ң Ortash bұzylulary, Diapiridtің artyқ dzozalanuy, endocrindyk үенyenің kөmіrsulardy lizmіne әser etetіn keybіr kompensatsiyalanbaytyn bұzylystary, Nemes gipoglikemiyanyң kerі regulyatsiyasy (mysaly, қalқansha ntle funktsiyasynyң keybіr bұzylulary, gipofizdің aldyңғy bөlіgіnің Nemesu bүyrek үstі bezі қyrtystarynyң zhetkіlіksіzdіgі) keybіr dәrіlіk zattardy bir mezgіlde қabyldau ( "Dәrіlermen өzara әrekettesuі" bөlіmіn қaraңyz).

Diapiridpen emdeu қan banna nonseptegly glucose deңgeyіn tұraқty tүrde baқılap oteruda ezhet ety. Bұdan өzge, glycosyldengen hemoglobin mөlsherin baқylauғa alu ұsynilady.

Lithethefatsi ғoldanғan kezhe bauyr worksya әәne shetkergi қan kөrіnіsіn (әsіrese leukocytter men thrombocytosis sanyn) ұdayy bakylap otyu қyazht.

Khatello ea maikutlo jaғdailarinda (mehopolo, jazatayim jaғdaylarda, mafura a ts'ebetso a potlakileng, қyzbamen қatar zүretіn ұқұқpalarda) nauқasty uaқytsha insulating ayustyru kөrsetiluu mіmkіn.

Mesebetsi ea Bauyr ea mora ң auyr bұzylulary bar nemes dialysis kөrsetilgen emdelushіlerge Diapiridti қoldanuғa қatysty mәlіmetter zhoқ. Bүyrektің nemese bauyrdy kүrdeli zhetkіlіksіzdіgі bareki nauқastardy insulinіd қabyldauғa ayystru kerek.

Vegetative neuropathy bar nemesis β-adrenergic receptor neuromuscular blocker, reserpinmen, clonidinmen, guanethidinmen nemesse basa sympatholytictermen biology meningitis mesog hypoglycaemia hypoglycaemia Jaeger әseri zhitkіlіksіz nemese іserі tөmendegen bolsa, қzaқ emdeu zhadayynda, metforminmen nemese insulinman bіrіktіru ұsynylady.

Диабant diabetіnің indemnation сез zhaydayynda insulin sezіmtaldyқ artada, soғan bailanisty emdeu үderіsіnde drugқa қazhettіlіk tөmendeuі mүmkіn. Hypoglycemiaң damuyn boldyrmau үshіn dozasyn der kesіnde tөmenddetu nemesa meriana toқtatu kerek. Dozasyn tүzetudі emdelushіnің dene salmaғy өzgergen nemese onyң өmir sүru tәsili өzgergen kездеde de, Sondai-aқ basқa hypothesis ea hyperglycemia tuғyzuy mүmіkіnar jaғе paydaғ.

Sirek tұқym алаualaytyn galaktosany kөter almaushyly, lactase zhetkіlіksіzdіgі bareng nemesa tsoekere-galactose sіңuі bұzylғan emdelushіlerge Diapiridtі қabyldauva bolmaida.

Tekanyetso le tsela ea tsamaiso

Setlhare sena se sebelisoa ho batho ba baholo.The litekanyetso li itšetleha ka diphetho tsa tlhahlobo ea mali le moroto. Ka tloaelo, diapiride e sebelisoa nako e le 'ngoe ka letsatsi. Setlhare se khothalletsoa ho nooa nakoana pele kapa nakong ea lijo tsa hoseng tse monate kapa, haeba ho se na lijo tsa hoseng, nakoana pele kapa nakong ea lijo tsa pele tse kholo. Letlapa le lokela ho monngoa ntle le ho hlafuna, ho hlatsuoa ka metsi, haeba lethal dose le latelang la moriana le hlotsoe, lethal dose ha le a lokela ho eketsoa tekong e latelang.

Tekanyetso ea pele ke 1 mg ea glimepiride ka letsatsi. Haeba tekanyo e joalo e u lumella ho laola tsoekere hantle, e sebelisoa e le phepelo. Haeba taolo ea glycemic e sa sebetse hantle, litekanyetso li lokela ho eketsoa ho 2, 3 kapa 4 mg ea glimepiride ka letsatsi ka mekhahlelo (ka linako tse ling tsa libeke tse 1-2). Haeba mokuli a e-na le karabelo ea hypoglycemic ea ho nka moriana ka tekanyetso ea 1 mg ka letsatsi, sena se bolela hore lefu lena le ka laoloa feela ke ho latela lijo. Tekanyetso e kaholimo ho 4 mg ka letsatsi e fana ka litholoana tse ntle feela maemong a le mong. Tekanyo e phahameng e khothalletsoang ke 6 mg ea diapiride ka letsatsi.

Haeba tekanyetso e phahameng ea letsatsi le letsatsi ea metformin e sa fane ka taolo e lekaneng ea glycemic, kalafo e tšoanang e nang le glimepiride e ka qala. Ho latela tekanyetso e fetileng ea metformin, moriana o lokela ho qala ka tekanyetso e tlase, e ka eketsoang hanyane ka hanyane ho ea holimo tekanyetso ea letsatsi le letsatsi, o shebane le boemo bo lakatsehang ba taolo ea metabolic. Phekolo ea ho kopanya e lokela ho etsoa ka tlasa tlhokomelo ea bongaka e haufi.

Haeba tekanyetso e phahameng ea letsatsi le letsatsi ea Diapiride ha e fane ka taolo e lekaneng ea glycemic, haeba ho hlokahala, kalafo ea insulin e ka qala. Ho latela tekanyetso e fetileng ea glimepiride, kalafo ea "insulin" e lokela ho qala ka tekanyetso e tlase, e ka eketsoang, e tsepamisitse maikutlo holima boemo bo lakatsehang ba taolo ea metabolic. Phekolo ea ho kopanya e lokela ho etsoa ka tlasa tlhokomelo ea bongaka e haufi. Ho ntlafatsa taolo ea lefu la tsoekere ho tsamaisana le maikutlo a eketsehileng a insulin, kahoo tlhoko ea glimepiride e ka fokotseha nakong ea kalafo. Bakeng sa ho thibela hypoglycemia, lethalinyana le lokela ho fokotsoa butle-butle kapa phekolo e lokela ho kenella ka ho felletseng. Tlhahlobo ea litekanyetso e kanna ea hlokahala haeba boima ba 'mele oa mokuli kapa tsela eo a phelang ka eona e fetoha kapa maemo a mang a ama kotsi ea hypo- kapa hyperglycemia.

Lisebelisoa tse ling tsa molomo tsa hypoglycemic hangata li ka fetoleloa ho diapiride. Nakong ea phetoho e joalo, matla le halofo ea bophelo ba moemeli ea fetileng e lokela ho tsotelloa. Maemong a mang, haholo-holo haeba sethethefatsi sa antidiabetesic se na le nako e telele ea bophelo (mohlala, chlorpropamide), ho kgothaletsoa ho ema matsatsi a 'maloa pele o nka Diapiride. Sena se tla fokotsa kotsi ea karabelo ea hypoglycemic ka lebaka la tlatsetso ea liakhente tse peli. Tekanyetso ea pele e khothalletsoang ke 1 mg ea glimepiride ka letsatsi. Tekanyetso e ka eketseha butle-butle ho nahanela karabelo ea moriana.

Litokisetso tsa Heresectergoldanada. Dozasa Kan banna neseptegі glucose құramyn taldau әtyzhelerіne baylanysty. 1dette Diapiridti tәuligine 1 ret қoldanady. Lithethefatsi tsa toyymdy taңғy astan bіraz bұryn nemese taңғy joalo kesіnde nemese, jäger taңғy joalo ka bolmas, alғashқy negіzgі ha іsherden bіraz bұryn nemese joalo ka іshu kesіnde қabyldau ұsynylady. Letlapa shaynamay, sұyyқtyқpen іshіp zhtu kerek. Litokisetso tsa Jäger kesekti қabyldau zhіberіlіp alsa, kelesі қabyldaғan keshe dozasyn arttyrmau kerek.

Litekanyetso tsa bastapy tuligine 1 mg glimepiridtіradydy. Jäger Mundai dosasy қant deңgejіn talapқa sa baқylauғa mүmkіndіk berse, ony demeusiem retіnda Koldanady. Eger glykemiyalyқ baқylau ңtayly bolyp tabylmasa, dozasyn tәulіgіne 2, 3 nemese 4 mg glimepiridke deyn satylap (1-2 apta aralıtarman) e tla fuoa arttyru. Litokisetso tsa Jaeger nauқasta әuligine 1 mg lethal dose ea қabyldauғa hypoglycemia қ karabelo ea ba, als, bұl auruda tech emdәm ұstanudyң kөmegimen ғana baқylauғa bolatynyn kөrsetedі. Tәulіgіne 4 mg asatyn doses tek jekelegen zhadaylarda ғana үzdіk nәtyzhe pele. Litekanyetso tsa Ең жоғарғы ұсынылатин - тәулігіне 6 mg Diapiride.

Eger metforminnін еі жңңарңңы тәуліктік tekanyetso ea bophelo bo le bong glycemia қ baқylauda қamtamasyz etpese, glimepiridpen қatarlas emdi bastauғa bolyady. Metforminnіd aldyңғy dozasyn ea otyryp ea naha, litokisetso tsa қabyldaudy tөmen dozasynan bastau kerek, ony keyin ика baқylaudyң қazhetti deңgeyyn baғdarғa ala otyryp arttyruғa bolyda. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek.

Jaeger Diapiridtің еғ жoғарәы тәуліктік tekanyo ea likhase tse ngata tsa tsoekere ea mali tsa baқylaudy қamtamasyz etpes, қ insulinman қatarlas emdeoudi bastauғa bolydy. Glimepiridtің aldyңғy dozasyn syүyene otyryp, insulin emdeudі tөmen dozasynan bastau kerek, ony keyin ика baқylaudyң қazhetti deңgeyin baғdarғa ala otyryp artyruғa. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek. Diabetesty baқylaudy jaқsartu insulin sezmtaldyқtyң artuymen қatar zhredі, sondyқtan emdeu lithuto kazіnde glimepiridke қazhettіlіk azayuy mүmkіn. Hypoglycemia boldyrmau masatynda dozasyn birtіndep azaytu nemese emdeudі mүlddem totatu kerek. Dozasyn қayta қarau қazhettіlіgі Eger emdelushіde Dene salmaғy Nemes Omir sүru tәsіlі өzgerse Nemes Nemes hyperglycemia hypo қaupіn arttyratyn basқa e zhaғdaylar әser etse, tuyndauy mүmkіn.

Ishu agyly қabyldanatyn basқa hypoglycemia agentterden әdette Diapiridke kөshugu bolada. Mundai auysu kesіnde aldyңғy dәrіnің kүshі banna zhartylai shyғarylu keseңіn esker kerek. Kay zhadaylarda, іsіrese jäger lefu la tsoekere сыars litokisetso ң zhartylı shyғarylu keseңi ұzaқ bolsa (menahano, chlorpropamide), Diapiridtі қabyldauda bastardyң aldynda bіrneshe kүn tүru. Бұл ікі agentт additivetik ісerіnің saldarynan hypoglycemiaуп reactionar іаупін азайтуға мүмкіндік береді. Litekanyetso tsa Ұsynylatyn bastapқ - tәuligine 1 mg glimepiride. Dozasyn lithethefatsi ke e sebetsang eskere otyryp, satylap arttyruғa bolyady.

Ho sebelisana le lithethefatsi

Tsamaiso e tšoanang ea Diapiride ka lithethefatsi tse ling e ka baka ho fokolisa le ho eketseha ha phello ea hypoglycemic ea glimepiride. Ka hona, lithethefatsi tse ling li lokela ho nooa feela ka tumello (kapa joalo ka taelo ea ngaka). Glimepiride e entsoe ka metaboliki e sebelisa cytochrome P450 2C9 (CYPC9). Hoa tsebahala hore ka lebaka la tsamaiso e le 'ngoe ea inducers (e.g. rifampicin) kapa li-inhibitors tsa CYPC9 (mohlala fluconazole), metabolism ena e ka fetoha. Phuputso e mabapi le ts'ebetso ea vivo e bontšitse hore fluconazole, e 'ngoe ea li-inhibitors tse matla ka ho fetisisa tsa CYPC9, e eketsa AUC ea glimepiride ka halofo.

Matlafatsa phello ea glimepiride ka ts'ebeliso e tšoanang: phenylbutazone, azapropazone le oxyphenbutazone, sulfinpyrazone, insulin le lithethefatsi tse tsoang ka molomo, li-sulfonamides tse ngata, metformin, tetracyclines, salicylates le p-aminosalicylic acid, li-inhibitors tsa MAO, li-anabolic steroids le li-hormone tsa banna tsa thobalano. , miconazole, fenfluramine, pentoxifyline (tekanyetso e phahameng ea batsoali ka bongata), li-fibrate, tritokvalin, li-inhibitors tsa ACE, fluconazole, fluoxetine, allopurinol, kutloelo-bohloko, cyclophosph ID, disopyramide, feniramidol, guanethidine, ifosfamide Lebakeng.

Fokotsa phello ea hypoglycemic ea glimepiride ha u ntse u sebelisa: estrogens le progestogens, saluretics, thiazide diuretics, lihormone tsa qoqotho le lithethefatsi tse khothalletsang ts'ebetso ea qoqotho, corticosteroids le glucocorticoids, melemo ea phenothiazine, chlorpromazine, epinephrine le ideathomimetics, nicotinic acid (litekanyetso tse phahameng) le lihlahisoa tsa eona, glucagon kopo), phenytoin, diazoxide, glucagon, barbiturates le rifampicin, acetazolamide.

H2 receptor antagonists, beta-blockers, clonidine le reserpine ka bobeli li ka ba le monyetla oa ho fokotsa phello ea hypoglycemic. Tlas'a tšusumetso ea kutloelo-bohloko, joalo ka beta-blockers, clonidine, guanethidine le reserpine, pontšo ea adrenergic reverse regulation ea hypoglycemia e ka fokotseha kapa ea nyamela. Ho nwa joala ho ka ntlafatsa kapa ho fokolisa phello ea hypoglycemic ea glimepiride.

Diapiridti belgіlі bіr dәrіlіk zattarmen bіr mezgіlde қabyldau glimepiridtің hypoglycemia қсерінің әлсіреуін де, күшеюін де туғызуы мүмк. Sondyқtan basқa litokisetso tsa theknoloji ea lithethefatsi dәrіgerdің kelіsіmіmen (nemese taayyndauymen) ғana Koldanu kerek. Glimepiride P450 2C9 (CYPC9) cytochromes ң kmegimen metabolizdenedі. СYPC9 inductorlaryn (mehopolo ea rifampicind) nemez tezhegіshterіn (menahano ea fluconazold) bir mezgilda kabyldaudyң saldarynan metabolism өzgeruі mүmkіn kenen belgіlі. Vn vivo раzara әrekettesulerin sertteu әtyzheleri, СYPC9 ң күшті тежегіштерінің бірі fluconazole, glimepiridtі AUC екі есеге жуық арттыратыннөө.

Bіr mezgіlde қoldanғanda glimepiridtің әсerіn kүsheytedі: Phenylbutazone, azapropazone zhane oxyphenbutazone, sulfinpyrazone, ka insulin zhane іshіletіn diabetke қarsy preparattar, ұzaқ әser etetіn keybіr sulfonamidter, metformin, tetratsiklinder, salitsilattar zhane leq-aminosalitsil қyshқyly Mao tezhegіshterі, anabolikalyқ steroidtar zhane erlerdің zhynystyқ gormondary, hinolondyқ antibiotikter, chloramphenicol, probenecid, coumarindek anticoagulantar, miconazole, fenfluramine, pentoxifyline (batsoali ba batsoali), fiberrattar, tritokvalin, AӨF tezhegіshterі, fluconazole, fluoxetine, allopurinol, kutloelo-bohloko itikter, cyclophosphamide, disopyramide, feniramidol, guanethidine, ifosfamide PASҚ.

Bіr mezgіlde қoldanғanda glimepiridtің hypoglycemiaқ әсерін төмендетеді: Estrogender zhane progestagender, saluretikter, tiazidtіk diuretikter, қalқansha ntle gormondary zhane қalқansha ntle қyzmetіn kөtermeleytіn preparattar, kortikosteroidtar zhane glyukokortikoidtar, phenothiazine tuyndylaryn, chlorpromazine, epinephrine zhane simpatomimetikter, bokoali қyshқyly (zhoғary dozalary) zhane onyң tuyndylary, glucagon, іsh zhүrgіzgіsh dәrіler (ұzaқ Uayyt Koldanu), phenytoin, diazoxide, glucagon, barbiturattar zhene rifampicin, acetazolamide.

Hob2-receptor lardң antagonists, beta-blocker, banna ba limela tsa resonpine hypoglycemia әserin әleuettendіruі de, tөmendueti de mүmkіn. Beta-blocker, clonidine, guanethidine, basali ba sallpine, e khanyang sympatholyticterdin әserinen hypoglycemia ң adrenergic қ Keri regulation ea bara ң kңrіnіsі azayu nemese zhғaluy mүmkіn. Alcohol Paidalanu glimepiridtің hypoglycemiaқ әсerіn kтуshaituі nemese әlsіretuі mүmkіn.

Ketso ea pharmacological

Moemeli oa hypoglycemic, e nkiloeng ka sulfonylurea molokong oa boraro oa ketso e telele. Phello e fokotsang tsoekere ea lithethefatsi e bakoa ke mokhoa o rarahaneng oa ketso ea pancreatic le extrapancreatic. Ketso ea pancreatic e kenyelletsa secretion ea "insulin" e ntlafatsang ke lisele tsa "pancreatic", tse tsamaeang le ts'usumetso le keketseho e kholo ea "insulin" ea "insulin". Ts'ebetso ena e bakoa ke taba ea hore glimepiride, e nang le tekanyo e phahameng ea sebaka, e hokahanya le ho khaola ho tsoa ho protheine ea cells-lisele tsa manyeme, e amanang le lits'ebetso tsa potasiamo tse atamelaneng tsa ATP, empa e fapana le sebaka se tloaelehileng sa ho tlama sa sstanylureas sa 1 le sa bobeli. Ka lebaka leo, insulin e ntšoa ke exocytosis, ha bongata ba "insulin" bo bolokiloeng bo tlase haholo tlasa ts'ebetso ea lits'oaetso tsa setso tsa sulfanylurea. Tšusumetso e joalo e batlang e le bonolo haholo ea glimepiride ho secretion ea insulin e fana ka kotsi e tlase ea hypoglycemia. Phello ea extrapancreatic ea glimepiride e tšoauoa ka liketso tse fapaneng, e lebisang ho eona ke keketseho ea kutloelo-bohloko ea methapo ea mesifa (mesifa le mafura) ho insulin ka keketseho ea palo le ts'ebetso ea liprotheine tse tsamaisang glucose ka li-membrane tsa sele, le tšitiso ea motsoako oa glucose sebeteng ka keketseho ea 26 ea intracellular. β-phosphate e thibelang gluconeogeneis. Litholoana tse ling tsa extrapancreatic tsa glimepiride li kenyelletsa: ho fokotseha ha bongata ba liplatelese ka lebaka la khetho e thibelang cycloo oxygenase le phetoho ea arachidonic acid ho ea thromboxane A2, e sebetsang ka bongata ba mokokotlo, keketseho ea boemo ba endo native α-tocopherol le ts'ebetso ea li-antioxidant diquisease. khatello ea maikutlo, e lulang e le teng khaellong ea lefu la tsoekere, anti-atherogenic effect ka lebaka la tivatsii itseng phospholipase C. glimepiride ha thibela metsoako ea tlwaetsa tshilong ya dijo ka ho myocardial ischemia (ho fapana le glibenclamide). Phello e phahameng ea hypoglycemic ea moriana e hlaha lihora tse 2-3 kamora ho tsamaisoa, ho nka nako e fetang lihora tse 24 mme e its'ere litekanyetso.
Mofumahali
Ka litekanyetso tse ngata tsa glimepiride ka tekanyetso ea letsatsi le letsatsi ea 4 mg, karolelano e phahameng ea serum ea mali e fihlelloa kamora lihora tse 2,5 mme ke 309 ng / ml, ho na le kamano ea mola pakeng tsa lethal dose le palo e phahameng ea glimepiride maling, hammoho le lipakeng tsa lethal dose le sebaka se ka tlasa "curl" Nako. " Glimepiride e na le bioavailability e felletseng. Ho ja ha ho na phello ea bohlokoa ho amohengng, ntle le ho fokotseha hanyane ka tekanyo ea ho amoheloa. Glimepiride e tšoauoa ka palo e tlase haholo ea phetiso (e ka bang 8.8 L), e batlang e lekana le bophahamo ba karolelano ea albin, tekanyo e phahameng ea ho tlama liprotheine tsa plasma (ho feta 99%) le tumello e tlase (hoo e ka bang 48 ml / min). Glimepiride e hloekisoa lebeseng la matsoele mme e tšela sethopo sa placental. E kenella hampe ka har'a mokoallo oa mali le bokong. Glimepiride e entsoe ka biotransformed 'meleng hore e be metabolites tse peli, e hlahisoa ke metabolism ea glimepiride e leng ka har'a sebete mme e emetse likhakanyo tsa hydroxylated le carboxylated tsa glimepiride. Nako ea halofo ea bophelo ba glimepiride maemong a eona a plasma ho serum e lumellanang le regimen e mengata ea dosing ke lihora tse 5-8. Kamora ho nka glimepiride ka tekanyetso e phahameng, halofo ea bophelo e eketsehile. Kamora tekanyetso e le 'ngoe ea molomo ea glimepiride e ngotsoeng ka label ea radioactive, 58% e fumanoe ka har'a moroto le 35% ho mekoti. Ntho e sa fetoheng e sebetsang ka har'a moroto ha ea ka ea fumanoa. Bophelo ba halofo ea hydroxylated le carboxylated glimepiride metabolite e ne e ka ba lihora tse 3-6 le lihora tse 5-6, ka ho latellana. Bakeng sa bakuli ba nang le bothata ba ho ruruha ho sa sebetse hantle (tumello e tlase ea creatinine), ho ne ho na le tšekamelo ea ho eketsa ho hlaka ha glimepiride le ho fokotseha ha karolelano ea eona ea mali maling, eo ka monyetla o mong le o mong o bakoang ke tšilafalo ea moriana ka potlako ka lebaka la ho tlama protheine e tlase. Kahoo, sehlopheng sena sa bakuli ha ho na kotsi e eketsehileng ea ho eketseha ha glimepiride. Litekanyetso tsa pharmacokinetic glimepiride lia tšoana ho bakuli ba bong bo fapaneng le ba lilemo tse fapaneng.

Mokhoa oa kopo

Bakeng sa batho ba baholo: Abela kahare pele ho lijo tsa hoseng tse futhumetseng kapa lijo tsa mots'eare. Matlapa a metsitsoe ntle le ho hlafuna, a hlatsuoa ka metsi a lekaneng (hoo e ka bang senoelo sa 1/2). Ho bohlokoa haholo hore o se ke oa tlola lijo ka mor'a ho nka Diapiride. Tekanyetso ea pele le ea tlhokomelo, nako ea tsamaiso le kabo ea tekanyetso ea letsatsi le letsatsi e beoa ka mokhoa o fapaneng ho latela sephetho sa khafetsa ea boemo ba tsoekere maling le moriring.Tekanyetso ea pele ea Diapiride ke 1 mg ka nako e le 'ngoe ka letsatsi. Haeba ho hlokahala, keketseho ea tekanyetso ea letsatsi le letsatsi e etsoa ka ho lekola maemo a tsoekere ea mali butle-butle, butle-butle ho eketsa tekanyetso libeke tse ling le tse ling tse 1-2 ho latela morero: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg. Maemong a mang, tekanyetso ea letsatsi le letsatsi ea Diapiride e ka eketsoa ho 8 mg. Ka tloaelo lethal dose la letsatsi le letsatsi le sebelisoa hanngoe. Bakeng sa bakuli ba nang le lefu la tsoekere le tlatsitsoeng hantle, lethal dose ea letsatsi le letsatsi hangata e le 1-4 mg ea glimepiride, feela ho bakuli ba bang phello e hlokahalang e fumanoa ha ba nka tekanyetso ea letsatsi le letsatsi ea 6 mg kapa ho feta. Tekanyo e phahameng ea letsatsi le letsatsi ke 6 mg, maemong a mang - 8 mg. Setlhare sena se sebelisoa nako e telele. Tabeng ea matšeliso bakeng sa lefu la tsoekere, kutloelo-bohloko ea lisele tse ho insulin lia eketseha, ka hona tlhoko ea glimepiride e ka fokotseha, e hlokang ho fokotsoa ha tekanyo ea nakoana ea litekanyetso kapa ho tlosoa hoa lithethefatsi (ho ipapisitsoe le liphetho tsa tlhahlobo ea mali le moroto oa tsoekere). Ka phetoho boima ba 'mele oa mokuli kapa mokhoa oa hae oa bophelo, hammoho le ponahalo ea mabaka a tlatsetsang kotsing e kholo ea ho ba le hypo- kapa hyperglycemia, ho hlokahala phetoho ea litekanyetso.
Sebelisa hammoho le metformin. Diapiride e kopantsoeng le metformin e laetsoa haeba phallo ea tsoekere e maling e sa tsitsa ho bakuli ba tšoaroang ke monotherapy ea metformin. Ha u ntse u boloka tekanyo ea metformin ka tekanyo e le 'ngoe, kalafo e nang le Diapiride e qala ka tekanyetso e fokolang ea 1 mg, butle-butle e eketsa tekanyetso ho latela boemo bo lakatsehang ba taolo ea glycemic, ho fihlela tekanyo e phahameng ea letsatsi le letsatsi ea 6 mg.
Sebelisa hammoho le insulin. Diapiride hammoho le insulin e laetsoe haeba ho ke ke ha khoneha ho fihlella maemo a tloaelehileng a khatello ea tsoekere ea mali ka ho nka tekanyetso e phahameng ea Diapiride e le monotherapy kapa hammoho le tekanyetso e phahameng ea metformin. Ho feta moo, khahlano le semelo sa lethalinyana la ho qetela la Diapirid se fuoeng mokuli, kalafo ea insulin e qala ka tekanyetso ea eona e tlase, ka keketseho e tlang butle-butle ea lethal dose la insulin tlasa taolo ea khatello ea mali maling. Phekolo e kopaneng e hloka tlhokomelo e tlamang ea bongaka. Ha e ntse e boloka taolo ea glycemic ea nako e telele, kalafo ena e kopaneng e ka fokotsa tlhoko ea insulin ka 40%.
Phetisetso ea mokuli ho Diapiride ho tsoa ho moemeli e mong oa molomo oa hypoglycemic. Ha ho na kamano e teng lipakeng tsa litekanyetso tsa glimepiride le lithethefatsi tse ling tsa molomo tsa hypoglycemic. Ha o fetisoa ho tsoa lithethefatsing tse joalo (ho kenyeletsa le litekanyetso tsa tsona tse phahameng) ho Diapiride, tekanyetso ea pele ea glimepiride e lokela ho ba 1 mg. Keketseho efe kapa efe ea tekanyetso ea Diapiride e lokela ho etsoa ka mekhahlelo, ho nka karabelo ea 'mele ho moemeli enoa oa phekolo. Tekanyetso e sebelisitsoeng le nako ea phello ea moemeli oa hypoglycemic ea nakong e fetileng e lokela ho tsotelloa. Maemong a mang, haholo-holo ka taolo e fetileng ea lithethefatsi tsa hypoglycemic tse nang le nako e telele ea bophelo (mohlala, chlorpropamide), ho ka hlokahala hore ka nakoana (matsatsi a 'maloa) u khaotse ho phekoloa e le ho qoba tšusumetso e eketsang kotsi ea hypoglycemia.

Phetisetso ea mokuli ho tsoa ho insulin ho ea ho Diapiride. Maemong a ikhethang, ha bakuli ba nang le lefu la tsoekere le sa itšetleheng ka insulin (mofuta oa II) ba fumana kalafo ea insulin, ha ba ntse ba lefella lefu lena le ho boloka tšebetso ea lekunutu la lisele tsa "pancreatic", ba ka bontšoa phetiso ho tsoa ho insulin ho ea Diapiride. Phetisetso ho Diapiride e lokela ho tsamaisoa tlasa tlhokomelo ea bongaka e haufi. Tabeng ena, tekanyetso ea pele ea Diapiride ke 1 mg. Nako ea kalafo boemong ka bomong e khethiloe ke ngaka. Ha ho na boiphihlelo ka tšebeliso ea lithethefatsi bakeng sa kalafo ea bana.

- Mofuta oa lefu la tsoekere la mofuta oa II mellitus (o sa itšetleheng ka insulin) ho batho ba baholo e le monotherapy kapa hammoho le metformin kapa insulin.

Fomu ea tokollo

Lipilisi
Letlapa le le leng le na le 2 mg, kapa 3 mg, kapa 4 mg ea glimepiride, li-excipients: lactose monohydrate, microcrystalline cellulose (102), sodium starch glycolate, povidone (25), magnesium stearate. Letlapa la Diapiride 2 mg ka ho eketsehileng li na le oxide e tshehla e tšehla, indigo carmine, Diapiride 3 mg - iron oxide e mosehla, Diapiride 4 mg - Indigo carmine.

Tlhahisoleseling e leqepheng le o e shebileng e entsoe ka sepheo sa tlhahisoleseling feela 'me ha e phatlalatse mokhoa oa ho iphekola. Sesebelisoa se reretsoe ho tloaela litsebi tsa tlhokomelo ea bophelo bo botle ka tlhaiso-leseling e tlatselletsang mabapi le meriana e itseng, ka ho etsa joalo e eketse maemo a bona a bosebeletsi. Ts'ebeliso ea lithethefatsi "Karoline" joang kapa joang e fana ka tumellano le setsebi, hammoho le litlhahiso tsa hae mabapi le mokhoa oa tšebeliso le litekanyetso tsa moriana o khethiloeng.

Lokolla liforomo le sebopeho

Setlhare se etsoa ka mokhoa oa litafole tse nang le litekanyetso tse fapaneng tsa ntho e sebetsang. Ka har'a pakete ea karete ho na le matlapa a 30 ka lithutsoana. Letlapa le le leng le na le 2, 3 kapa 4 mg ea glimepiride (ntho e sebetsang). Matlapa a nang le litekanyetso tsa 2 mg a le botala bo bobebe, 3 mg ke mosehla o bobebe, 4 mg ke bouu bo bobebe.

Meetso ea matlapa e kenyelletsa lethathamo le joalo:

lactose monohydrate,
phospholle cellulose,
sodium starch glycolate,
povidone
oxide ea tšepe e mosehla
magnesium stearate,
indigo carmine.

Mofumahali

Kamora ho kenella, glimepiride e kenella ka potlako mochesong oa lijo mme e kena maling. Ho ja ha ho fokotse ho amoheloa ha moriana. Ntho ena e fihla sehlohlolong se phahameng ka ho fetisisa maling a plasma nakong ea lihora tse 2-2,5.

Kamora ho kenella, glimepiride e kenella ka potlako mochesong oa lijo mme e kena maling.

Glimepiride e tšoauoa ka ho tlama liprotheine tse ngata tsa mali (99%). Metabolism ea lithethefatsi e etsoa ka har'a sebete. Motsoako ona o hlahisoang ke liphio le mala. Setlhare sena se hlakotsoe ho tsoa 'meleng nakong ea lihora tse 10-16. Ha o ntse o nka Diapiride, ho bokellana ha dintho mmeleng ha ho shebelwe (leha e le ka tšebeliso e telele).

Ka tlhokomelo

Tlas'a taolo e tiileng ea ngaka, moriana o sebelisoa bakeng sa ts'ebetso e potlakileng, botaoa ba feberu, feberu, ho hlohlona ha qoqotho, khaello ea adrenal le ts'oaetso e matla.

Kamora ho kenella ka matla kalafong, ho lemala, ho chesa, bakuli ba eletsoa hore ba fetole kalafo ea insulin.

U ka nka diapiride joang?

Setlhare se nooa ka molomo ka metsi a fokolang. Ho bohlokoa ho kopanya tsamaiso ea litafole le lijo bakeng sa thibelo ea li-pathologies tsa gastrointestinal.

Le lefu la tsoekere

Bakeng sa kalafo ea mofuta oa tsoekere e sa itšetleheng ka insulin II, sethethefatsi sena se nooa habeli ka letsatsi. Qalong ea lethalinyana, lethal dose ke 1 mg ho latela glimepiride. Haeba ho lekane ho etsa tsoekere e maling maling, joale lethal dose ha le eketsehe.

Ka phello e sa lekaneng, lethalinyana le eketseha butle ho isa ho 2, 3 kapa 4 mg. Nako pakeng tsa liphetoho tsa litekanyetso li lokela ho ba bonyane matsatsi a 7. Ka linako tse ling bakuli ba fuoa 6 mg ea glimepiride ka letsatsi (tekanyetso e lumellehang ea letsatsi le letsatsi).

Lingaka li ka fana ka taolo ea tšebelisano ea lithethefatsi ka metformin kapa insulin ho fihlela katleho e kholo. Ho nwa meriana ena ho ka lebisa ho eketseheng ho sa feleng ha insulin susceptibility. Tabeng ena, tekanyo e fokotsehile kapa e hlakotsoe ka botlalo.

Karolong ea setho sa pono

Nakong ea kalafo, ho ka ba le tšitiso ea nakoana ea pono (ho senyeha hoa nakoana). Sesosa sa phello ena ke phetoho ea tsoekere ea mali.

Bakeng sa kalafo ea mofuta oa tsoekere e sa itšetleheng ka insulin II, sethethefatsi sena se nooa habeli ka letsatsi.

Hematopoietic litho tsa ka hare

Litlamorao ho tsoa ho hematopoietic system:

thrombocytopenia
leukopenia
phokolo ea mali
granulocytopenia,
erythrocytopenia,
agranulocytosis,
pancytopenia.

Tsamaiso ea methapo e bohareng

Ho tsoa tsamaisong ea methapo e bohareng e bonoe:

hlooho e bohloko
ho tsekela
pherekano,
ho hloka boroko
mokhathala,
maemo a sithabetsang
fokotseha ha maikutlo a psychomotor,
ho sitisoa ke puo
Ho thothomela ka maoto
cramps.

Ho tloha ka lehlakoreng la metabolism

Tšusumetso e mpe ho metabolism e bontšoa ke hypoglycemia.

Nakong ea tsamaiso, ho hlaseloa ke lintho tse kulang ho ka etsahala:

letlalo la letlalo le boreleli
urticaria
makhopho
allergic vasculitis.

Sebelisa botsofaling

Sesebelisoa se lumelloa ho sebelisoa bakeng sa bakuli ba mefuta e fapaneng ea lilemo, ntle le bana. Empa batho ba baholo ba nang le tšebeliso e telele ea lipilisi ba ka ba le hypoglycemia. Ho qoba ts'oaetso ea lefu lena, lingaka li fa bakuli ba tsofetseng lijo tse khethehileng le litekanyetso tse tlase tsa meriana (haeba ho khoneha).

Bongata ba diapiride

Ho ata ha lithethefatsi ho lebisa ponahalong ea maikutlo a hypoglycemic (lerotholi le matla la tsoekere ea mali). Maemong ana, mokuli o ikutloa a tepelletse, otsela, ho tsekela. Ho lahleheloa ke kelello. Ho felisa matšoao a bosholu ba boitšoaro bo feteletseng, ba sebelisa phekolo e nang le matšoao.

Ho ata ha lithethefatsi ho lebisa ponahalong ea maikutlo a hypoglycemic (lerotholi le matla la tsoekere ea mali).

Ho sebelisana le lithethefatsi tse ling

Moriana o lokela ho nooa ka hloko hammoho le meriana e kang:

Fluconazole
Phenylbutazone.
Azapropazone.
Sulfinpyrazone.
Oxyphenbutazone.
Pentoxifylline.
Tritokvalin.
Disopyramides.
Fenfluramine.
Propenecid.
Li-anticoagulants tse tsoang sehlopheng sa coumarin.
Salicylates.
Li-antidepressants tse ling (MAO inhibitors).
Fibrate.
Fluoxetine.
Cyclophosphamide.
Feniramidol.
Ifosfamide.
Miconazole
Tetracycline le lithibela-mafu tsa quinolone.
Lithethefatsi tse ling tsa hypoglycemic.
Li-steroid tsa anabolic.
Li-inhibitors tsa ACE.
PASK (para-aminosalicylic acid).

Ka tšebeliso e tšoanang ea chelete ena, phello ea hypoglycemic ea Diapiride e matlafatsoa. Ho fokotseha hoa phello ea lithethefatsi ho bonoa ha ho nkuoa hammoho le Phenothiazine le lintho tse tsoang ho eona, li-estrogens le progestogens, glucagon, nicotinic acid, corticosteroids, barbiturates, Phenytoin, Acetazolamide, diuretics le lithethefatsi bakeng sa kalafo ea tšoelesa ea qoqotho.

Boimana

Se ke ua sebelisa lithethefatsi Diapiride nakong ea kemolo. Haeba mokuli ea nkang glimepiride a rera ho ima kapa a le moimana, o lokela ho fetisetsoa kalafo ea insulin kapele kamoo ho ka khonehang.
Kaha lihlahisoa tse ling tsa sulfonylurea li ikemiselitsoe lebeseng, ho khothalletsoa hore kalafo e nang le glimepiride e khaotse ka lebaka la kotsi ea hypoglycemia ho masea a sa tsoa hlaha.

Foromo ea litekanyetso

2 mg, 3 mg, le matlapa a 4 mg

Letlapa le leng le na le

ntho e sebetsang: glimepiride (micronized) ho latela 100% ntho - 2 mg, 3 mg le 4 mg,

Matlapa a 2 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (mofuta A), povidone (25), iron (III) oxide mose (E 172), indigo carmine (E 132), magnesium stearate,

Matlapa a 3 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (mofuta A), povidone (25), iron (III) oxide e (E 172), magnesium stearate,

Matlapa a 4 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (mofuta A), povidone (25), indigo carmine (E 132), magnesium stearate.

Matlapa a nang le sebopeho se chitja se nang le 'mala o sephara, ho tloha botala bo botala ho ea ho botala (bakeng sa tekanyetso ea 2 mg), ho tloha botala bo botala ho isa ho mosehla (bakeng sa tekanyetso ea 3 mg), ho tloha botala bo boputsoa ho putsoa (bakeng sa tekanyetso ea 4 mg), e mathotsoeng ka kotloloho le notch. Holim'a matlapa a ne a kenelletse kahare

Diapiride e feta tekete matlapeng

Ho sebelisa overdose ho ka lebisa ho hypoglycemia, e nkang lihora tse 12 ho isa ho tse 72, mme kamora ntlafatso ea pele e ka hlaha hape. Matšoao a ka hlaha lihora tse 24 kamora ho amoheloa ha moriana. E le molao, bakuli ba joalo ba lokela ho ba sepetlele.

Matšoao a hypoglycemia: ho nyekeloa ke pelo, ho hlatsa le ho opeloa ke mpeng, ho thothomela, ho ferekana kelellong, ho senyeha hantle, ho otsela, ho robala, ho tšoenyeha, ho ba mabifi, ho tsepamisa maikutlo le nako ea ho arabela, khatello ea maikutlo, ho ferekana kelellong, puo le pono ea pono, aphasia, paresis, maikutlo a senyehileng, ho tsekela, ho hloka thuso, ho felloa ke boitšoaro, ho nyekeloa, ho nyekeloa ke likhoele, ho felloa ke kelello ho fihlela nts'etsopele ea ho akheha, ho phefumoloha ho sa tebang le bradycardia. Ntle le moo, matšoao a ho feto-fetoha ha maemo a adrenergic joalo ka ho fufuleloa, ho tšoenyeha, tachycardia, khatello ea mali ea methapo, ho phahamisa mahlo, angina pectoris le pelo ea pelo li ka bonoa. Setšoantšo sa tleliniking sa tlhaselo e matla ea hypoglycemic se ka tšoana le setorouku.

Artyқ dosalanuy hypoglycemiaғa alyp keluy mүmkіn, ol 12-den 72 saғatқa dejin sozulyuy, mosali alәashқy zhқsaruynan keyіn қaita bіlіnu mүmkіn. Meriana ea matšoao ң sіңuіnen keyin 24 saғattan soң bіlіnuі mіmkіn. Hospitaldette, mұndai emdelušіler sepetlele sa bolu tiis.

Limpho tsa Matšoao a Hypoglycemia: Zhurek Ainu құsu zhane asқazan tұsynyң auyruy, tremor, kөru bұzylystary, қimyl-қozғalys үylesіmіnің bұzyluy, ұyқyshyldyқ, ұyқynyң bұzyluy, mazasyzdyқ, ozbyrlyқ, zeyіn shoғyrlandyru zhane itšoara joang uaқyttarynyң bұzyluy, ho tepella maikutlo, baғdarsyzdyқ, sөyleu zhane kөru bұzylystary, aphasia, paresis, sezmtaldyқtyң bұzyluy, bass ainaluy, sharasyzdyқ, өзін-өзі baқylai almau, delirium, cerebral құrysular, coma damuyna deyngі esten tanu, үstіrtіn tynys alu jane bradik. Bұdan өzge, terleu, үreilenu, tachycardia, arterialsқ khatello ea mali, үurek қaқuyn sezinu, angina pectoris әәerek arrhythmias shining keri adrenergialқ regulation of Belgler baiқaluy mүmkіn. Auyr hypoglycemiaқ ұstamanyң tlelinikingқ kөrіnіsі stroke іske saluy mүmkіn.

Ho sebelisana le lithethefatsi

Li ntlafatsa phello ea glimepiride le ts'ebeliso e ts'oanang ea: phenylbutazone, azapropazone le oxyphenbutazone, sulfinpyrazone, insulin le lithethefatsi tsa molomo tsa antidiabetic, sulfonamide tse ling tse nkang nako e telele, metformin, tetracyclines, salicylates le p-aminosalicylic acid, drugic anticionid acidic chloramphenicol, probenecid, coumarin anticoagulants, miconazole, phenfluramine, pentoxifyline (tekanyetso e phahameng ea kholo ka kholo), fibrate, tritokvalin, ACE inhibitors, Fl uconazole, fluoxetine, allopurinol, kutloelo-bohloko, cyclophosphamide, disopyramide, pheniramidol, guanethidine, isophosphamide, PASK.

Fokotsa phello ea hypoglycemic ea glimepiride ka ts'ebeliso e le 'ngoe: estrogens le progestogens, saluretics, thiazide diuretics, lihomone tsa qoqotho le lithethefatsi tse khothalletsang ts'ebetso ea qoqotho, li-corticosteroids le glucocorticoids, li-phenothiazine tse tsoang ho eona, chlorpromazine, epinephrine le dicotometics. , glucagon, laxatives (tšebeliso ea nako e telele), phenytoin, diazoxide, glucagon, barbiturates le rifampicin, acetazolamide.

H2 receptor antagonists, beta-blockers, clonidine le reserpine ka bobeli li ka ba le monyetla oa ho fokotsa phello ea hypoglycemic.Tlas'a tšusumetso ea kutloelo-bohloko, joalo ka beta-blockers, clonidine, guanethidine le reserpine, pontšo ea adrenergic reverse regulation ea hypoglycemia e ka fokotseha kapa ea nyamela. Ho nwa joala ho ka ntlafatsa kapa ho fokolisa phello ea hypoglycemic ea glimepiride.

Glimepiride e khona ho eketsa le ho fokotsa phello ea litlamorao tsa coumarin.

Litlamorao

Ka lehlakoreng la metabolism: hypoglycemia (hlooho ea hlooho, tlala, ho nyekeloa, ho hlatsa). Khafetsa - maikutlo a ho khathala, ho otsela, ho tšoenyeha ka boroko, ho tšoenyeha, ho ba mabifi, ho tsepamisa maikutlo le ho arabela, khatello ea maikutlo, pherekano, puo le maikutlo a ferekanyang, aphasia, ho thothomela, ho ferekana ha maikutlo, ho tsekela, ho hokahana ka tsela e sa laoleheng. Ke ka seoelo - delirium, likhoele tsa mokokotlo, ho se tsebe, komisi, ho hema ka mokhoa o sa tsitsang, bradycardia. Ntle le moo, ka lebaka la mochine oa karabo ea adrenergic, ka linako tse ling matšoao a joalo a ka ba teng: mofufutso, mofufutso o thellisang, tachycardia, khatello ea mali, angina pectoris, likhathatso tsa morethetho oa pelo.

Ho tsoa pampiring ea ka mpeng: ho nyekeloa ke pelo, ho hlatsa, ho utloa bohloko kapa ho hlonama ho bohloko ba pelo ka mpeng, ho opeloa ke mpa, maemong a sa tloaelehang, keketseho ea tšebetso ea liprotheine tsa hepatic, ho sitisoa ha tšebetso ea sebete (cholestasis le jaundice), hepatitis le ho hloleha ha sebete.

Ho tsoa tsamaisong ea mali: thrombocytopenia (e lekanang ho isa ho e matla), hangata leukopenia, hemolytic kapa aplastic anemia, erythrocytopenia, granulocytopenia, agranulocytosis le pancytopenia (ka lebaka la myelosuppression).

Ho tloha lehlakoreng la setho sa pono: ho senyeha ha nakoana hoa pono ka lebaka la phetoho ea khatello ea tsoekere maling (haholo-holo qalong ea kalafo).

Litla-morao: pruritus, urticaria, rash, hangata dyspnea, li fokotse khatello ea mali, allergic vasculitis, photosensitivity. Liphetoho tsa mmele ka kakaretso le tsa pseudo-allergic, joalo ka molao, li leka-lekane, empa li ka tsoela pele, li tsamaisana le dyspnea le ho fokotseha ha khatello ea mali, ho fihlela ho makala. Cross-allergy e ka etsahala ka tse ling tse tsoang ho sulfonylurea, sulfonamides.

Haeba litla-morao tse mpe li hlaha, moriana o hlakotsoe mme kalafo ea matšoao e ea etsoa.

Litšebelisano

Ho matlafatsa phello ea hypoglycemic ea glimepiride e ka hlokomeloa ka ts'ebeliso e le 'ngoe ka insulin kapa lithethefatsi tse ling tsa hypoglycemic, li-inhibitors tsa ACE, allopurinol, li-anabolic steroids le li-hormone tsa botona tsa banna, ka chloramphenicol, li-coumarin derivatives, cyclo-, tro- and isophosphamide, phenfluramine, pheniramidol, fibetraminum, fibetinum , miconazole, pentoxifylline (ka tsamaiso ea batsoali ka tekanyetso e phahameng), e nang le phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, su lfanilamides tse telele, li-tetracyclines, tritocqualin.

Ho fokola ha phello ea hypoglycemic ea glimepiride khoneha ka ts'ebeliso e le 'ngoe le acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) le tse ling tse ling tsa kutlo tsa maikutlo, glucagon, li-laxatives (ka tšebeliso e telele), nicotinic acid (ka tekanyetso e phahameng), le li-antijeni tsa eona. , phenothiazine, phenytoin, rifampicin, lihormone tsa qoqotho, letsoai la lithium, chlorpromazine.

Ho matlafatsa le ho fokolisa phello ea hypoglycemic ea glimepiride e ka hlokomeloa ka ts'ebeliso e le 'ngoe le histamine H blockers₂li-receptors, clonidine le reserpine, e nang le ts'ebeliso e le 'ngoe ea joala kapa e sa foleng.

Khahlano le nalane ea ts'ebeliso ea glimepiride, keketseho kapa ho fokola hoa ts'ebetso ea litokollo tsa coumarin e ka hlokomeloa.

Pharadodynamics

Ishke қabyldaғan kemede glimepiride tolyғymen sіңedі, joalo ka іshu sіңuіne eleeleul dәrezhede әser etpeydi. Concentrationан sarysuyndaғy ezhoғar концентрацияy mahloriso a mora oa ішке қыabyldaannan keyin 2,5 saғattan soңethedі. Taralu kөlemi tөmen (8.8 ml), clearance - 48 ml / min, plasma aқuyzdarymen bailanysuy - 99% -dan astam, zhartyly shygarylu keseeni - 5-8 saғatқa zhuyқ. Litokisetso tsa Zhoosalary dosalard қabyldaылannan keyin zhartylai shygarylu keseni artady.

Bauyrda glimepiridtің hydroxyldengen tuyndylaryna deіn metabolizdenedі, olar nesepte de (lithethefatsi ң bir rettіk dozasynyң 58% ғa zhuyғy), nәzhiste de (35-40%) anyқtalady. Litokisetso bir ret қabyldaғanda zhne birneshe kүn қatarynan tәulіginі 1 ret қoldanғanda pharmacokinetics sinda aytarlyқtai ayyrmashylyқ bayalmaғan. Lithethefatsi zhinaқtalmaydy. Zhas shamalarymen zhynystary әр түрлі еделушілердегі Pharmacokinetics қ Parlueler ұқсас.

Mesebetsi ea Bүyrek ea sonң bұzylouy bar edelushіlerde glimepiride clearance artumen men onyң ortasha mahloriso a moraң tөmendeuіne beyimdіlіk bajalada.