Glibenclamide (Glibenclamide)

Glibenclamide
Khemik'hale ea lik'hemik'hale
IUPAC	5-chloro-N-(4-N- (cyclohexylcarbamoyl) sulfamoylphenethyl) -2-methoxybenzamide
Foromo e akaretsang	C23H28Cln3O5S
Boima ba Molar	494.004 g / mol
Cas	10238-21-8
PubChem	3488
Drugbank	APRD00233
Tlhomamiso
ATX	A10BB01
Mofumahali
Ho Kopanya Liprotheine tsa Plasma	E atile
Metabolism	Hydroxylation ea sebete (CYP2C9-mediated)
Half-life.	Lihora tse 10
Mofuta	Liphio le sebete
Mefuta ea Litekanyetso
lipilisi
Tsela ea tsamaiso
kahare
Mabitso a mang
Maninil

Glibenclamide (sy. Antibet, Apoglyburide, Gene glib, Gilemal, Glibamide, Glibenclamide Teva, Gliburide, Glucobene, Daonil, Dianti, Maninil, Euglycon) Ke moemeli oa moloko oa bobeli oa litlamorao tsa sulfonylurea, e leng e 'ngoe ea lithethefatsi tse theolelang tsoekere ka ho fetesisa, tseo ho tloha ka 1969 esale li sebelisoa linaheng tse ngata tsa lefats'e e le kalafo e tšepahalang le e netefalitsoeng ea mofuta oa lefu la tsoekere la mofuta oa 2 ka ho se sebetse hantle hoa liphetoho tsa mokhoa oa bophelo.

Leha ho hlaha litokisetso tse ncha tsa sulfonylurea tse nang le litšobotsi tse ntlafalitsoeng, le lithethefatsi tsa antidiabetic tse nang le mekhoa e meng ea ts'ebetso, e sa le qalong haholo ho felisa nalane ea glibenclamide - lithutong tsa liteko le tsa bongaka, setlhare sena ha se feela mohlala oa ho hlahloba katleho ea limolek'hule tse ncha le mekhoa ea phekolo, empa hape e bonts'a mekhoa e metle. thepa ea bohlokoa e eketsehileng.

Ho sebetsa hantle le polokeho

Mochine o ka sehloohong oa ts'ebetso ea glibenclamide, joalo ka baemeli ba bang ba litokisetso tsa sulfonylurea, o ithutoa hantle sehlopheng sa limolek'hule. Glibenclamide e thibela likotara tsa potasiamo tse itšetlehileng ka ATP (K + -ATP-channels), tse fumanehang kahara membrane ea plasma ea lisele tsa pancreatic beta. Ho felisoa ha monyetla oa ho tsoa ka seleng ea potasiamo ho lebisa ho putlama ha membrane le tšubuhlellano ea Ca 2+ ions ka liteishene tsa khalsiamo tse itšetlehileng ka matla. Keketseho ea dikahare tsa calcium tse kenang kahare ho ts'ebetso ea ts'ebetso ea calcium / utulivu ea protheine e thehiloeng ho protheine e phahamisa exocytosis ea li-granules tsa sephiri tse nang le insulin, ka lebaka leo ka lona lihormone li kenang ka har'a mokelikeli oa mali le mali. Ho se leka-lekane ha litokisetso tsa sulfonylurea bakeng sa li-receptor tsa beta ke tsona tse rerang tšebetso ea bona e fapaneng ea ho theola tsoekere. Glibenclamide e na le tumellano e phahameng ka ho fetisisa ea li-sulfonylurea receptors liseleng tsa beta le phello e tsejoang haholo e fokotsang tsoekere har'a litokisetso tsa sulfonylurea.

Matla a ho hlohlelletsa insulin secretion ka kotloloho a ipapisitse le tekanyetso ea glibenclamide e nkuoeng mme e bonahatsoa ka bobeli ho hyperglycemia le ho standardoglycemia kapa hypoglycemia.

Sehlopha sohle sa litokisetso tsa sulfonylurea, ho isa boholeng bo bong kapa bo bong, se na le litlamorao (tse eketsang pancreatic) tse ngata haholo, tse eketsang maikutlo a litho tsa kahare, haholo mafura le mesifa, ketsong ea insulin le ho ntlafatsa tsoekere ea glucose ka lisele.

Ts'ebetso le polokeho ea polokeho |Contraindication

Hypersensitivity to sulfonylurea derivatives le lithethefatsi tsa sulfonamide, mofuta oa 1 lefu la tsoekere, lefu la tsoekere la ketoacidosis, lefu la tsoekere le lefu la ho fokotseha, pheko ea lefu la tsoekere bakeng sa mafu a tšoaetsanoang, likotsi, ho chesoa, ho buoa, ts'ebetso e matla ea liphio le ho senyeha ha sebete, ho ima, ho anyesa.

Mefuta le sebopeho sa tokollo

Ho 1 tab. lithethefatsi tsa antidiabetesic li na le 1,75 mg, 3.5 mg kapa 5 mg ea motsoako o sebetsang, e leng glibenclamide.

Hape ho tsa bongaka ho teng:

• Povidone
• Lactose Monohydrate
• Litapole tsa litapole
• Magnesium stearate
• Ponceau 4R.

Matlapa a chitja ka 'mala o mosehla, o mopinki ka' mala, ho kanna ha ba le Splash. Setlhare sena se fumaneha ka botlolong ea khalase e nang le matlapa a 120, ho ts'oaroa bukana ea tataiso ea mosebelisi.

Pholiso ea thepa

Ho bohlokoa ho hlokomela hore lebitso la khoebo la lithethefatsi le tsamaisana le lebitso la karolo e sebetsang. Lithethefatsi li na le phello ea hypoglycemic ka bobeli ho batho ba nang le lefu la tsoekere la mofuta oa 2, le bathong ba phetseng hantle. Mochine oa ts'ebetso o ipapisitse le secretion e eketsehileng ea insulin ke lisele tsa β-li-pancreas ka lebaka la ts'usumetso ea eona e sebetsang. Phello e joalo, pele ho tsohle, e ea boemong ba tsoekere e bohareng e potileng lisele tsa β.

Kamora ho sebelisa pilisi, ntho e sebetsang e potlakile ebile e batla e ananeloa ka botlalo. Ka lijo, ha ho na phokotseho e kholo ea tekanyo ea ho kenngoa ha glibenclamide. Letšoao la puisano le liprotheine tsa plasma ke 98%. Khokahano e phahameng ka ho fetisisa ea ntho e serumeng e bonoa ka mor'a lihora tse 2,5. Ho fokotseha ha khatello ea glibenclamide ho tlalehiloe kamora lihora tse 8-10 mme ho latela tekanyo ea lithethefatsi tse nkuoeng ke mokuli. Ho felisoa ha halofo ea bophelo ke bolelele ba lihora tse 7.

Phetoho ea metabolism ea glibenclamide e etsahala liseleng tsa sebete, ho thehoa metabolites, tseo ha li sa nke karolo ho fokotseng tsoekere ea ntho e sebetsang. Excretion ea lihlahisoa tsa metabolic e etsoa ka moroto, hammoho le bile ka bongata bo lekanang, tlhahiso ea ho qetela ea metabolites e bonoa ka mor'a lihora tse 45-72.

Ho batho ba nang le bothata ba ho se sebetse hantle ha sebete, ho rekotoa mantle a glibenclamide. Ho bakuli ba nang le bothata ba ho phekoloa ke lipholisa, ho pepesetsoa ha metabolite e sa sebetseng ka kotloloho mokokotlong ho eketsa pompo ea bona.

Litaelo tsa ho sebelisoa ha matlapa

Theko: Ho tloha ho 56 ho isa ho 131 li-ruble.

Litekanyetso tsa lithethefatsi li khethoa ka bonngoe ho nahanela lilemo tsa mokuli, glycemia, le boima ba lefu lena. Ho kgothaletswa ho nwa dipilisi ka mpeng e se nang letho kapa kamora dihora tse 2 kamora ho ja.

Ka tloaelo, tekanyetso ea letsatsi le letsatsi e fapana pakeng tsa 2,5 mg - 15 mg. Khafetsa ea tšebeliso ea lipilisi ke 1-3 leq. letsatsi lohle.

Ho amoheloa ka tekanyetso ea letsatsi le letsatsi ea 15 mg mme ho ka holimo ho boletsoe hanyane haholo, sena ha se eke haholo phello ea moriana. Batho ba baholo ba khothalletsoa ho qala kalafo ka 1 mg ka letsatsi.

Phetoho ho tsoa ho setheo se le seng sa meriana e loantšang lefu la tsoekere ho ea ho se seng kapa phetoho ea litekanyetso tsa bona e lokela ho ba tlasa taolo ea ngaka.

Litlhokahalo tsa polokeho

Phekolo ea kalafo e lokela ho etsoa ka tlasa tlhahlobo ea kamehla ea tsoekere ea mali le moroto.

Nakong ea kalafo, o lokela ho hana ho noa lino tse tahang, hobane nts'etsopele ea hypoglycemia, hammoho le lipontšo tse kang disulfiram, ha e qheleloe ka thoko.

Ha matšoao a hypoglycemia a hlaha, ho tla hlokahala ho etsa tefo bakeng sa khaello ea tsoekere ka tsamaiso ea molomo ea dextrose. Sebakeng sa boemo ba ho se tsebe letho, dextrose e tsamaisoa ka matla. Ho qoba ho oela hape, ho bohlokoa ho ruisa lijo le lik'habohaedreite.

Tšebelisano ea lithethefatsi

Lithethefatsi tsa antimycotic tsa systemic action, ethionamide, fluoroquinolones, MAO le ACE inhibitors, H2-blockers, NSAIDs, lithethefatsi tsa tetracycline, paracetamol, insulin, li-anabolic steroid drug, cyclophosphamide, β-adrenergic blockers, clofibrate, reserpilamin, prober allopurinol, paracetamol, hammoho le chloramphenicol li ka eketsa ho teba ha hypoglycemia.

Li-COC, barbiturates, glucagon, saluretics, litokisetso tse thehiloeng ho letsoai la lithium, diazoxide, li-nicotinic acid derivatives, phenothiazines, hammoho le lithethefatsi tsa adrenomimetic li fokotsa phello ea hypoglycemic ea glibenclamide.

Mefuta e reng acidine ea moroto e eketsa katleho ea moriana.

Rifampicin e khothalletsa ho inactivation ea ntho e sebetsang le ho fokotsa phello ea eona ea kalafo.

Litlamorao

Maikutlo a latelang a ka hlaha:

• CCC le hematopoietic system: eosinophilia, erythrocytopenia, thrombocytopenia, leukocytopenia, granulocytopenia, ka seoelo agranulocytosis, maemong a mang anemia (hemolytic kapa mofuta oa hypoplastic)
• NS: hlooho e tsamaeang le ho tsekela
• Litho tsa kutlo: tlolo ea maikutlo a tatso
• Metabolism: nts'etsopele ea li-porphyria tsa cutaneous tsa morao-rao, proteinuria, hammoho le hypoglycemia
• Phekolo ea ka mpeng: dyspepsia, lefu la sebete, cholestasis
• Liponahatso tsa ho kula: lekhopho la letlalo
• Ba bang: feberu, polyuria, boima ba 'mele, arthralgia, hammoho le nts'etsopele ea photosensitivity.

Bongata

Hypoglycemia ea khonahala, eo ho eona ho nang le maikutlo a tlala, mokoka, ho fufuleloa ka sekhahla, ho eketseha ha pelo, ho thothomela ha mesifa, ho fokola ha puo, ho tšoenyeha, ho opeloa ke hlooho le ho tsekela ho tebileng.

Maemong a tebileng, tharollo ea glucose ea 50% kapa 5-10% dextrose tharollo e lokela ho kenngoa, tsamaiso ea methapo ea glucagon e ka khonahala. Maemong ana, ho tla hlokahala ho laola matšoao a glycemia, boemo ba li-electrolyte, creatinine, hape le urea.

Batho ba bangata ba batla li-synonyms tsa Glibenclamide (analogues) tse tla ba le phello e tšoanang ea kalafo. Har'a bona, Maninil oa khetholoha.

Berlin Chemie, Jeremane

Theko ho tloha ho li-ruble tse 99 ho isa ho 191.

Sesebelisoa ke analogue ea Glibenclamide, lintho tse sebetsang li tsamaellana, ka ho latellana, 'me phello ea' mele e joalo. Setlhare se fumaneha ka foromo ea lipilisi.

• Theko e tlase
• Fokotsa monyetla oa ho holisa retinopathy le nephropathy
• Ketso ea nako e telele (lihora tse fetang 12).

• Ngoliso e ea fumaneha
• E kopantsoe le ketoacidosis
• E kanna ea baka tsitiso ea mefuta eohle ea lintho tse ling.

Tlhaloso ea ntho e sebetsang (INN) Glibenclamide.

Pharmacology: Ketso ea Pharmacological - hypoglycemic, hypocholesterolemic.

Matšoao: Mofuta oa lefu la tsoekere la mofuta oa 2 ka monyetla oa ho lefella hyperglycemia ka lijo, ho theola boima ba 'mele, ho ikoetlisa.

Contraindication: Hypersensitivity (ho kenyelletsa le lithethefatsi tsa sulfa, thiazide diuretics), lefu la tsoekere le ho akheha, ketoacidosis, ho chesoa haholo, ts'ebetso ea khatello ea maikutlo le khatello ea maikutlo, ho kenella ka mpeng, boemo ba mpa, maemo a tsamaeang le ho kenella ha lijo ka botlalo (nts'etsopele ea hypoglycemia) maloetse, jj.), hypo- kapa hyperthyroidism, ts'ebetso ea sebete le ts'ebetso ea liphio, leukopenia, mofuta oa 1 lefu la tsoekere, ho ima, ho anyesa.

Bokhachane le pelehi: e tsoetse pele. Ka nako ea kalafo o lokela ho emisa ho anyesa.

Litla-morao: Ho tloha lehlakoreng la methapo ea pelo le mali (hematopoiesis, hemostasis): ka seoelo - thrombocytopenia, granulocytopenia, erythrocytopenia, pancytopenia, eosinophilia, leukocytopenia, agranulocytosis (hangata haholo), maemong a mang.

Ho tsoa ho tsamaiso ea methapo ea kutlo le litho tsa kutlo: hlooho ea hlooho, ho tsekela, phetoho ea maikutlo a monate.

Ho tloha lehlakoreng la metabolism: hypoglycemia, proteinuria, porphyria ea cutaneous.

Ho tsoa ho tšilo ea lijo: ts'ebetso ea sebete e senyehileng, cholestasis, dyspepsia.

Litla-morao: Lintho tse etsahalang letlalo (erythema, dermatitis ea letlalo).

Tse ling: feberu, arthralgia, polyuria, boima ba 'mele, photosensitivity.

Tšebelisano: Systemic antifungals (azole derivatives), fluoroquinolones, tetracyclines, chloramphenicol (inhibits metabolism), H2-blockers, beta-blockers, ACE inhibitors, NSAIDs, MAO inhibitors, clofibrate, bezafibrat, probenecid, paracetamol, anabolic pentoxifylline, allopurinol, cyclophosphamide, reserpine, sulfonamides, insulin - potentiate hypoglycemia. Li-Barbiturates, phenothiazines, diazoxide, glucocorticoid le lihomone tsa qoqotho, li-estrogens, gestagens, glucagon, lithethefatsi tsa adrenomimetic, salate ea lithium, li-nicotinic acid tse tsoang le saluretics li fokolisa phello ea hypoglycemic. Li-urine acidifying agents (ammonium chloride, calcium chloride, ascorbic acid e tekanyetso e kholo) ntlafatsa sephetho (fokotsa tekanyo ea ho ikarola le ho eketsa reabsorption). Ke synergist (matla a eketsang) a li-anticoagulants tse sa tobang. Rifampicin e potlakisa ts'ebetso ea inactivation mme e fokotsa ts'ebetso.

Matšoao a mangata: Matšoao: hypoglycemia (tlala, bofokoli bo matla, ho hloka phomolo, ho opeloa ke hlooho, ho tsekela, ho fufuleloa, ho akheha, ho thothomela hoa mesifa, mokokotlo oa mokokotlo, puo le pono e sa bonahaleng, letsoalo le sa bonahaleng le komello ea hypoglycemic).

Phekolo: maemong a bonolo - ho ja tsoekere hang-hang, tee e chesang e tsoekere, lero la litholoana, sirapo ea poone, mahe a linotsi maemong a tebileng - ho hlahisoa ha tharollo ea glucose ea 50% (50 ml iv le ka hare), infusion e tsoelang pele ea iv Tharollo ea dextrose, i / m tsamaiso ea glucagon 1-2 mg, diazoxide 200 mg ka molomo nako le nako lihora tse 4 kapa 30 mg iv ka metsotso e 30, ka edema ea methapo - mannitol le dexamethasone, ho shebella glycemia (metsotso e meng le e meng e 15), boikemisetso pH, naetrojene ea urea, creatinine, li-electrolyte.

Tekanyetso le tsamaiso: Kahare ntle le ho hlafuna, e hlatsoitsoe ka metsi a manyane. Tekanyetso ea letsatsi le letsatsi e khethoa ka bonngoe, ho latela lilemo, ho teba ha lefu la tsoekere, boemo ba hyperglycemia, 'me hangata ke 1.25-20 mg (lethalinyana la litekanyetso ke 2,5-5 mg / ka letsatsi, tekanyetso e kholo ea letsatsi le letsatsi ke 20-25 mg), e boletsoeng ka e le 'ngoe, tse peli, hangata ha ho bonolo - litekanyetso tse tharo tsa metsotso e 30-60 (liforomo tsa micronised bakeng sa metsotso e 10-15) pele ho lijo. Ka phello e sa lekaneng, ho kopantsoe le li-biguanides le insulin hoa khoneha.

Litlhoko-hloko: Bakeng sa thibelo ea maemo a hypoglycemic, ho ja kamehla ho lokela ho bolokoe ka hloko. Ho tlama ke ts'ebeliso ea lijo pele ho hora e le 'ngoe ka mor'a ho sebelisa lithethefatsi. Nakong ea khetho ea tekanyetso bakeng sa sepheo sa pele kapa phetisetso ho tsoa ho sethethefatsi se seng sa hypoglycemic, boikemisetso bo tloaelehileng ba profil ea tsoekere bo bontšoa (makhetlo a 'maloa ka beke). Ts'ebetsong ea kalafo, taolo e matla ea boemo ba glucose (glycosylated hemoglobin) serum ea mali e hlokahala (bonyane nako e le 'ngoe ho likhoeli tse 3). Re lokela ho hopola hore lipontšo tsa kliniki tsa hypoglycemia li ka koaloa ha ho nkuoa li-beta-blockers, clonidine, reserpine, guanethidine. Tabeng ea phetisetso ea glibenclamide ho tsoa ho insulin ka tekanyo ea li-unit tsa 40 / ka letsatsi kapa ho feta, ka letsatsi la pele tekanyetso ea halofo ea insulin le 5 mg ea glibenclamide e fanoa ka phetoho ea butle-butle ea lethal dose ea ho qetela kamoo ho hlokahalang. E sebelisoa ka tlhokomeliso ho bakuli ba tsofetseng - ba qala kalafo ka litekanyetso tsa halofo, tse fetotsoeng kamora nako e sa feteng 2,5 mg / letsatsi ka karohano ea beke le beke, le maemo a febrile. letsatsi le thibelo ea lijo tse mafura. Qalong ea kalafo, ha ho khothaletsoe mesebetsi e hlokang sekhahla sa karabelo.

Mohlahisi: LLC "Khamphani ea litlhare" Health "Ukraine

Khoutu ea PBX: A10B B01

Foromo ea ho lokolloa: Liforomo tsa litekanyetso tse matla. Lipilisi

Litšobotsi tse akaretsang. Moetso:

Mabitso a machabeng le a lik'hemik'hale: glibenclamide, 5-chloro-N-amino-sulfonylphenylethyl-2-methoxybenzamide,
thepa ea mantlha ea 'mele le ea lik'hemik'hale: matlapa a masoeu, sebopeho se sephara sa sefahleho se nang le bevel,
Letlapa: 1 Letlapa le na le 5 mg glibenclamide,
li-excipients: mannitol, starch ea litapole, povidone, calcium stearate.

Sebopeho sa pharmacological:

Mofumahali Hypoglycemic agent, moloko oa bobeli oa sulfonylurea o tsoa. Phello e fokotsang tsoekere ea lithethefatsi e bakoa ke mokhoa o rarahaneng oa ts'ebetso ea pancreatic le extrapancreatic.
Ketso ea pancreatic e kenyelletsa ho hlohlelletsa secretion ea insulin ke lisele tsa "pancreatic b", tse tsamaeang le ts'usumetso le keketseho e kholo ea insulin. Phello ena e bakoa ke ho sebelisana ha glibenclamide le li-receptors tse kopantsoeng ka sebopeho sa liteishenara tse itšetlehileng ka KP tsa KP tsa li-membrane tsa plasma tsa ts'ebetso ea b-lisele tsa manyeme, depolarization ea membrane ea sele, ts'ebetso ea liteishene tse itšetlehileng ka matla a Ca2 +. E thibela ho ntšoa ha tsoekere ke lisele tsa pancreatic.
Phello ea extrapancreatic e kenyelletsa ho matlafatsoa ha kutloisiso ea litho tsa thipa ho ts'ebetso ea li-insulin tsa nako e telele, ho thibela tlhahiso ea tsoekere le glycogen ka har'a sebete.
Keketseho ea maemo a insulin ea mali le ho fokotseha ha maemo a glucose ho etsahala butle, e leng ho fokotsang kotsi ea ho fetoha ha li-hypoglycemic. Phello ea hypoglycemic e hlaha lihora tse 2 kamora tsamaiso, e fihla hofihlella kamora lihora tse 7-8 mme e nka lihora tse 8-12.
Glibenclamide e ntlafatsa secretion ea pancreatic le gastric somatostatin (empa eseng glucagon), e na le phello e ntle ea diuretic (ka lebaka la keketseho ea renal clearance ea metsi a mahala). Fokotsa kotsi ea ho holisa mathata ohle a lefu le sa ts'epeng le "insulin" le amanang le lefu la tsoekere. E na le phello ea pelo le antiarrhythmic.

Mofumahali Kamora ho tsamaisoa ka molomo, e kenella ka potlako le ka mokhoa o felletseng ho tsoa mpeng ea mpa. Ho ja ka mokhoa o khahlisang ho ka liehisa ho monya.
Khokahano e phahameng maling maling kamora ho sebelisa tekanyetso e le 'ngoe ka mor'a lihora tse 1-2. Ho ikopanya le liprotheine tsa mali - ho feta 98%. E kenella hampe kahara sethopo sa placental.
E kenelletse ka har'a sebete ka har'a metabolite tse peli tse sa sebetseng (hoo e batlang e le tse lekanang), e 'ngoe e supetsoeng ke liphio, e ngoe ka bile. Ho felisoa ha halofo ea bophelo ke lihora tse 6-10. Mmele ha o kopane.
Pharmacokinetics maemong a khethehileng a kliniki. Bakeng sa bakuli ba nang le bothata ba ho renal bo sa sebetseng hantle ka tekanyo e lekanang, ha ho na phapang e kholo litabeng tsa meriana ea lithethefatsi, ka ho eketseha ho matla ka tlase ho 30 ml / min) ho ka etsahala.

Tekanyetso le tsamaiso:

Abela ka hare, metsotso e 20-30 pele ho lijo, ntle le ho hlafuna, ka mokelikeli o monyane (hoo e ka bang senoelo sa ½).
Litekanyetso tsa pele le tsa tlhokomelo, nako ea tsamaiso le kabo ea tekanyetso ea letsatsi le letsatsi e beoa ka bonngoe ho ipapisitse le liphetho tsa khafetsa ea boemo ba tsoekere maling le moriring.
Tekanyetso ea pele ea lithethefatsi ke 2,5 mg (1/2 pilisi) nako e le 1 ka letsatsi. Haeba ho hlokahala, keketseho ea tekanyetso ea letsatsi le letsatsi e etsoa ka ho lekola litekanyetso tsa tsoekere ea mali butle-butle, butle-butle e eketsa tekanyetso ka nako ea matsatsi a 'maloa ho isa ho beke 1 ke pilisi e le 1/2 ho fihlela tekanyetso e sebetsang e fumanehang. Tekanyetso e sebetsang haholo ke 15 mg (matlapa a 3). Metharo e kaholimo ho 15 mg / ka letsatsi ha e ekeole ho teba ha phello ea hypoglycemic.
Pilisi ea letsatsi le letsatsi ea ho fihlela ho 10 mg (matlapa a mabeli) e nooa nako e le ngoe ka letsatsi, pele ho lijo tsa hoseng. Ka tekanyo e phahameng ea letsatsi le letsatsi, ho khothalletsoa ho e arola ka litekanyetso tse peli ka tekanyo ea 2: 1, hoseng le ka shoalane.
Ho bakuli ba tsofetseng, kalafo e qala ka tekanyetso ea halofo, e ntseng e eketseha ka ho fetisa ha ho feta 2,5 mg / ka letsatsi le karohanyo ea beke le beke.
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 insulin. Glibenclamide hammoho le insulin e fanoe ha ho sa khonehe ho fihlela boemo ba "glucose" bo bongata maling ka ho nka tekanyetso e phahameng ea glibenclamide ho monotherapy. Ntle le moo, khahlanong le semelo sa lethal dose ea ho qetela ea glibenclamide e fuoeng mokuli, kalafo ea insulin e qala ka tekanyetso ea eona e tlase, ka keketseho e tlang ea 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 o kopanya glibenclamide le insulin, tekanyo ea ho qetela e ka fokotsoa ka 25-50%.
Hajoale, ha ho na tlhahisoleseling mabapi le tšebeliso ea lithethefatsi bakeng sa kalafo ea bana.

Lintlha tsa kopo:

Setlhare sena se sebelisoa ka hlokolosi ha ho na le lefu la febrile, joala, mafu a qoqotho (hypo- kapa), ho bakuli ba tsofetseng le ho bakuli ba nang le ts'ebetso ea sebete.
Ka monotherapy ea nako e telele (ho feta lilemo tse 5), khanyetso ea bobeli e ka hlaha.
Ho lekola li-paramente tsa laboratori. Mo kalafong ka sethethefatsi, ho hlokahala hore ho shebelle khafetsa boemo ba tsoekere maling le moroto (makhetlo a 'maloa ka beke nakong ea khetho ea lethal dose), le khatello ea methapo ea glycosylated hemoglobin (bonyane nako e le ngoe ho likhoeli tse 3), e tla lumella ho bonoa ka nako ka nako ea ho hanyetsa mantlha kapa ea bobeli. ho sethethefatsi. Ntle le moo, ho hlokahala ho laola ts'ebetso ea sebete le setšoantšo sa mali a potoloho (haholo-holo palo ea liplatelese le leukocytes).
Maemo a hlokang ho fetisoa ha mokuli ho tloha glibenclamide ho ea kalafong ea insulin: ts'oaetso e ngata, e matla haholo, ts'ebetso e ngata, malabsorption ea lijo le lithethefatsi ka mpeng ea mpa ea mpa (ho emella ka popelong, mala a ka mpeng), ts'ebetso e matla ea sebete le ts'ebetso ea liphio. Ho ba le hemodialysis. Tlhokahalo ea phetisetso ea insulin ea nakoana e ka hlaha maemong a sithabetsang (likotsi, ts'ebetso ea ts'ebetso ea ts'ebetso, mafu a tšoaetsanoang a tsamaeang le feberu).
Kotsi ea nts'etsopele qalong ea kalafo ka glibenclamide. Libekeng tsa pele tsa kalafo, menyetla ea ho ba le hypoglycemia e ka eketseha (haholo-holo ka lijo tse sa tloaelehang kapa lijo tse se nang letho). Lintho tse latelang li ka kenya letsoho kholisong ea eona:
ho se batle kapa (haholoholo botsofaling) bokhoni bo sa lekaneng ba mokuli ba ho sebelisana le ngaka,
ho ja ka tsela e sa tloaelehang, ho tlōla lijo, khaello ea phepo e nepahetseng,
ho se leka-lekane pakeng tsa ho ikoetlisa le ho ja lijo tse nang le lik'habohaedreite,
Liphetoho lijong
ho nwa jwala, haholoholo ka phepo e sa lekanang kapa ho ja lijo tse bobebe.
mosebetsi o sa sebetseng oa renal,
ho hloka matla ha sebete,
lithethefatsi tse ngata
mafu a sa kopaneng a tsamaiso ea endocrine a amang metabolism ea carbohydrate kapa antiregation ea hypoglycemia (ho kenyelletsa mosebetsi o sa sebetseng oa qoqotho, pituitary kapa adrenocortical insufficiency).
tšebeliso e tšoanang ea lithethefatsi tse ling (bona Ho sebelisana le lithethefatsi tse ling).
Matšoao a hypoglycemia a kanna a ba bonolo kapa a ba sieo nakong ea nts'etsopele ea 'ona butle-butle ho bakuli ba tsofetseng, hammoho le ho bakuli ba nang le khatello ea kelello kapa ka nako e tšoanang ba amohela kalafo ka li-b-adrenoreceptor blockers, clonidine, reserpine, guanethidine, kapa kutloelo-bohloko e' ngoe.

Moriana o lokela ho nooa feela ka tekanyetso e boletsoeng le ka nako e itseng ea letsatsi.

Nako ea tsamaiso le kabo ea tekanyetso ea letsatsi le letsatsi ea moriana e khethoa ke ngaka, ho nahanela litšobotsi tsa regimen ea letsatsi la mokuli.
Bo tlameha ke lijo ha ho e-so fete hora ea 1 kamora ho sebelisa moriana.
Bakeng sa ho fihlela taolo e nepahetseng ea boemo ba glycemia ha u fana ka glibenclamide, ho bohlokoa ho latela mokhoa o nepahetseng oa ho ja, ho ikoetlisa 'meleng, mme ha ho hlokahala, fokotsa boima ba' mele. U lokela ho tlohela ho pepesetsoa ke letsatsi nako e telele le ho fokotsa ts'ebeliso ea lijo tse mafura.
Liphoso tsamaisong ea glibenclamide (ho siuoa hoa lethal dose ka lebaka la ho lebala) ho ke ke ha lokisoa ke ts'ebetso e latelang ea tekanyetso e phahameng. Ngaka le mokuli ba lokela ho buisana pele ka mehato e lokelang ho nkuoa haeba ho na le liphoso tšebelisong ea lithethefatsi (ho tlola tekanyetso, ho tlola lijo) kapa maemong ao ho ke keng ha khoneha ho a nooa ka nako e behiloeng.
Mokuli o lokela ho tsebisa ngaka hang-hang haeba a ka ja lithethefatsi ka tšohanyetso kapa ka litekanyetso tse ngata haholo.
Phetisetso ea mokuli ho glibenclamide ho tloha litokisetsong tse ling tsa sulfonylurea (ntle le chlorpramide) le insulin (tekanyetso ea letsatsi le letsatsi - likarolo tse fetang 40). Ha u fetisetsa mokuli ho glibenclamide, ho kgothaletsoa ho eketsa tekanyetso butle-butle. Ka kalafo ea insulin, tekanyetso ea halofo ea insulin le 5 mg ea glibenclamide li fanoa ka letsatsi la pele.
Tšusumetso ho bokhoni ba ho khanna makoloi le ho sebetsa ka mekhoa. Qalong ea kalafo kapa ka tšebeliso e sa tloaelehang ea glibenclamide, ho fokotseha hoa khatello ea maikutlo le ho potlaka ha maikutlo a mokuli ka lebaka la hypo- kapa hyperglycemia ho ka hlokomeloa. Maemong a joalo, o lokela ho hana ho etsa lintho tse kotsi tse hlokang tlhokomelo e eketsehileng le lebelo la karabelo ea psychomotor.

Litlamorao:

Ho tloha ka lehlakoreng la metabolism. Hypoglycemia, ho kenyelletsa mantsiboea (hlooho e opang, tlala, mokhathala, ho robala bosiu, boemo ba tahi, ho thothomela, pherekano, puo le lits'oants'o tsa pono, ka seoelo - coma). Ntle le moo, ka lebaka la mochine oa karabo ea adrenergic, ka linako tse ling ho ka hlaha matšoao a latelang: mofufutso o batang, o thetsang. Hypersensitivity ho joala, ho nona haholo, dyslipidemia, ho beoa ha lithane tsa adipose, kamora ts'ebeliso ea nako e telele - hypothyroidism.
Ho tsoa pampiring ea ka mpeng. Ka linako tse ling - ho nyekeloa ke pelo, ho utloa bohloko kapa ho hlonepha ho epigastrium, bohloko ba ka mpeng, ho fokotseha kapa ho eketseha ha takatso ea lijo, ka seoelo - ts'ebetso ea sebete e senyehileng, jaundice ea cholestatic ,.
Ho tsoa tsamaisong ea mali. Ke ka seoelo - hemolytic kapa aplastic, pancytopenia,.
Litla-morao. Khafetsa - erythema multiforme, exfoliative, photosensitivity. Ho kopanya lintho tse ling le lithethefatsi tse ling tsa sulfonylurea, sulfonamide le lithethefatsi tse kang thiazide hoa khoneha.
Ba bang. hypoosmolarity kapa lefu la ho se sebetse hantle ha leino la antidiuretic (khatello ea maikutlo, mokhathala, sefahleho, maqaqailana le matsoho, makhopho, stupor, coma), lefu la nakoana la bolulo.

Ho sebelisana le lithethefatsi tse ling:

Kholiso hypoglycemic bohato ba glibenclamide ka 'na la hlaha ha ho sebelisoa ha ka insulin kapa lithethefatsi tse ling hypoglycemic, inhibitors angiotensin fetola potlakisang tsebetso ea lik'hemik'hale, allopurinol, anabolic steroid le li-hormone ho kopanela liphate e motona, chloramphenicol, cimetidine, coumarin derivatives, cyclo-, Trojan le ifosfamide, fenfluramine, feniramidolom, fibrates, fluoxetine, guanethidine, MAO inhibitors, miconazole, fluconazole, pentoxifylline, phenylbutazone, oxyphenbutazone, azapropano shuhalo, Probenecid, salicylates, sulfinpyrazone, nako e telele-a sebetsa ho sulfonamides, tetracyclines, tritokvalinom.
Ho fokola ha phello ea hypoglycemic ea glibenclamide ho ka khoneha ka tšebeliso e tšoanang le acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) le ling tse ling tsa kutlo tsa maiketsetso (acid) le prolonged. , estrogens le progestogens, phenothiazine, phenytoin, rifampicin, lihormone tsa qoqotho, letsoai la lithium, chlorpromazine.
Ho matlafatsa le ho fokolisa phello ea hypoglycemic ea glibenclamide ho ka bonoa ka tšebeliso e tšoanang le histamine H2 receptor blockers, clonidine le reserpine, joala bo le bong kapa bo sa foleng.
Khahlano le semelo sa ho nka glibenclamide, keketseho kapa ho fokola hoa ts'ebetso ea melemo ea coumarin e ka bonoa.

Pharmacodynamics le pharmacokinetics

Glibenclamide ke lithethefatsi tse tsoang ka molomo tse amanang le "derivatives" sulfonylureas. Mochine oa ts'ebetso oa Glibenclamide o kenyelletsa ho hlohlelletsa secretion ea β-cell ho manyemeka ho eketsa ho lokolloa ha insulin. Haholo, ho sebetsa hantle ho bonahala mohatong oa bobeli oa tlhahiso ea insulin. Sena se eketsa kutloisiso ea lisele tsa pherite ho ea ketsong ea insulin, hammoho le khokahano ea eona le lisele tsa sepheo. Ho feta moo, glibenclamide e tšoauoa ka phello ea hypolipidemic le ho fokotseha ha thepa ea thrombogenic.

Ka hare ho mmele, ho monya ntho ka potlako le ho tsoa ka botlalo ho tsoa ho tšilo ea lijo ho ile ha hlokomeloa. Puisano le liprotheine tsa plasma li tšoana le hoo e ka bang 95%. sethethefatsi se etsoa ka har'a sebete, ho etsa hore ho se sebetse letho. Excretion e etsahala haholo ha ho etsoa moroto le karolo - bile, ka sebopeho sa metabolites.

Litaelo tse khethehileng

Ho khothalletsoa ho phekola ka hloko bakuli ba nang le bothata ba sebete le liphio, tse nang le maemo a mabe, ts'ebetso ea ts'ebetso ea methapo ea methapo kapa adlandal gland, le joala bo sa foleng.

Bakeng sa ts'ebetso ea bongaka e felletseng, ho lekola ka hloko boemo ba tsoekere maling le bokong ba tsoekere bo hlokahala.

Haeba hypoglycemia e hlaha ho bakuli ba hlokofetseng, joale tsoekere kapa tsoekere e fanoa ka molomo. Maemong a ho lahleheloa ke kelello, tsoekere e fanoa ka methapo, 'me glucagon - ka methati, ka kotlolloho kapa ka methati.

Ha kelello e hlaphoheloa, ka potlako mokuli o fuoa lijo tse nang le lik'habohaedreite ho qoba ho pheta-pheta hypoglycemia khafetsa.

Glibenclamide ke moriana o nang le thepa ea hypoglycemic ho tsoa sehlopheng sa lihlahisoa tsa bobeli tsa sulfonylurea. E boetse e na le phello ea hypolipidemic hape e fokotsa monyetla oa ho tšoaroa ke vascular thrombosis.

Tloaelo e akaretsang

Lebitso la lithethefatsi Glibenclamide ka sebopeho sa machabeng ka Selatine ke Glibenclamide. Ntle le moo, moriana ke pilisi e pinki e bobebe ka tsela ea disc e nang le mola o arolang. Ho koahela ho ka ba le sebopeho sa 'mabole se nang le litšekamelo tse nyane.

Matlapa a pakiloeng ka mekotla ea likotoana tse 10. Ka lebokoseng le le leng ho ka ba le lipolanete tse joalo tse 12.

Glibenclamide e lokolloa ka lengolo la ngaka, e bolokiloe tlasa maemo a tloaelehileng, ntle le phihlello ea bana. Litaelo li boletse bophelo ba sethethefatsi - lilemo tse 5. Motsoako o felletseng ha oa lokela ho nkoa.

Letlapa le leng le le leng le na le 5 mg ea glibenclamide le li-excipients ka mokhoa oa lactose monohydrate, starch ea litapole, magnesium stearate, polyvinylpyrrolidone, E 124.

Likhamphani tsa meriana ea lapeng li hlahisa moemeli ea theolelang tsoekere:

E qala le k'hamphani ea Seukraine Health. Bakeng sa Glibenclamide, theko ka sekontiri sa litlama tsa Russia ke li-ruble tse 270-350.

Pharmacodynamics ea lithethefatsi

Setlhare sa molomo sa hypoglycemic. Ho Glibenclamide, mochine oa ts'ebetso o ipapisitse le ts'usumetso ea tlhahiso ea insulin ke lisele tsa "pancreatic". Ka ho bapisa, insulin ea ho hanyetsa litho tsa tharollo ea fokotseha ea fokotseha. Moriana ona oa sebetsa haeba ho na le lisele tse sebetsang tsa β-li-pancreas tse kopantseng lihormone tsa mofuta oa tlhaho. Fokotsa litlhare le litlatsetso tsa mokokotlo.

Litšoaneleho tsa Pharmacokinetic

Ho tloha pampiring ea mala ka mor'a ho tsamaisoa ka molomo ka mpeng e se nang letho, sethethefatsi se kenngoa ka potlako, se kenella ho liprotheine tsa mali ka 95%. Phetoho ea ntho e sebetsang ho metabolites e sa sebetseng e etsoa ka har'a sebete. Excretion e laoloa ke liphio le li-ducts tsa bile. Bophelo ba halofo ho tloha maling bo tsoa ho hora le halofo ho isa ho tse tharo le halofo. Tsoekere e laola tekanyetso e le 'ngoe ea moriana bonyane lihora tse 12.

Ka hepatic pathologies, litheko tsa lithethefatsi li thibetsoe.Haeba ho hloleha ha sebete ho hlahisoa ka mokhoa o fokolang, sena ha se ame ts'ebetso ea excretion ea metabolites; maemong a matla le ho feta, ho bokella ha bona ha ho qheleloe ka thoko.

Polelo ea lihlopha tsa nosological

Matlapa a na le 'mala o mosoeu kapa o mosoeu ka' mala o moputsoa kapa 'mala o moputsoa, ​​ploskilindris e nang le kotsi.

Hypoglycemic moemeli oa tsamaiso ea molomo oa sehlopha sa bobeli sa sulfonylurea.

Glibenclamide e na le litlamorao tsa pancreatic le extrapancreatic. E matlafatsa secretion ea insulin ka ho theola monyako oa pancreatic beta-cell glucose, e eketsa kutloisiso ea insulin le ho tlama ha eona ho lisele tse nang le sepheo, e eketsa tlhahiso ea insulin, e ntlafatsa phello ea insulin mesifa le mokokotlong oa "glucose", 'me e thibela lipolysis litekeng tsa adipose (litlamorao tse ling tsa pancreatic). . E sebetsa mohatong oa bobeli oa insulin secretion. E na le phello ea hypolipidemic, e fokotsa mali a mali a "thrombogenic".

Phello ea hypoglycemic e hlaha kamora lihora tse peli, e fihla hofihlella ka mor'a lihora tse 7-8 mme e nka lihora tse 12. Moriana o fana ka keketseho e ntle ea khatello ea insulin le phokotseho e ntle ea tsoekere ea plasma, e fokotsang kotsi ea maemo a hypoglycemic. Ketsahalo ea glibenclamide e bonahatsoa le ts'ebetso e bolokiloeng ea endocrine ea manyeme ho kopanya insulin.

Ha ho nkuoa ka molomo, ho kenngoa ka har'a pampitšana ea ka mpeng ke 48-84%. Nako ea ho fihlela mahloriso a phahameng ke lihora tse 1-2, bophahamo ba thomello ke lilitha tse 9-10. Puisano le liprotheine tsa plasma ke 95-99%. Bioavailability ea glibenclamide ke 100%, e u lumellang ho nka moriana ona hoo e ka bang pele ho lijo. Tšitiso ea placental e feta hampe. E batla e na le metabolism e felletseng ka har'a sebete ka ho theha metsoako e 'meli e sa sebetseng, e' ngoe e supuoa ke liphio, e 'ngoe ka bile. Ho felisoa ha halofo ea bophelo ke lihora tse 3 ho isa ho tse 10-16.

Type 2 lefu la tsoekere le ho se sebetse hantle hoa kalafo ea ho ja.

mofuta oa 1 lefu la tsoekere

lefu la tsoekere la ketoacidosis, lefu la tsoekere le leta,

boemo kamora ho pancreatic resection,

ho hloka matla ha sebete,

Ho senyeha ha real,

hypersensitivity ho glibenclamide le / kapa lintho tse ling tse tsoang ho sulfonylurea, sulfonamides, diuretics tse nang le sehlopha sa sulfonamide molek'huleng, le probenecide, joalo ka ha ho tsejoa ho tsoa ho anamnesis karabelo ea sefapano e ka hlaha

ho buseletsoa ha metabolism ea carbohydrate ho mafu a tšoaetsanoang kapa ka mor'a ts'ebetso e kholo ea ts'ebetso ha ho bontšoa kalafo ea insulin,

mala, mala, mala a ka mpeng,

maemo a tsamaeang le malabsorption ea lijo le nts'etsopele ea hypoglycemia,

boimana le nako ea ho anyesa.

Glibenclamide e lokela ho sebelisoa bakeng sa:

maloetse a qoqotho (a nang le ts'oaetso),

hyp hypoquise ea anterior pituitary kapa adrenal cortex,

ho bakuli ba tsofetseng ka lebaka la kotsi ea ho ba le hypoglycemia.

Phello e mpe e atileng haholo kalafong ea glibenclamide ke hypoglycemia Boemo bona bo ka nka sebopeho se tsoetseng pele 'me ba kenya letsoho kholisong ea maemo a boima, ho fihlela ho mokuli ea comatose, ea sokelang bophelo kapa ea qetella a bolaile. Ka lefu la tsoekere la polyneuropathy kapa kalafo e kopanetsoeng le lithethefatsi tse nang le kutloelo-bohloko (bona karolo "Ho sebelisana le lithethefatsi tse ling"), li-hypoglycemia tse tloaelehileng li ka ba bonolo kapa tsa ba sieo ka ho felletseng.

Mabaka a nts'etsopele ea hypoglycemia e ka ba: tšebeliso e feteletseng ea lithethefatsi, sesupo se fosahetseng, lijo tse sa hlakoheng, bakuli ba tsofetseng, ho hlatsa, lets'ollo, ho ikoetlisa ka matla 'meleng, mafu a fokotsang tlhoko ea insulin (ts'ebetso ea sebete le ts'ebetso ea liphio, hypofunction ea adrenal cortex, pituitary kapa gland ea tšoelesa) , tšebeliso e mpe ea joala, hammoho le ho sebelisana le lithethefatsi tse ling (bona karolo "Ho sebelisana le lithethefatsi tse ling"). Matšoao a hypoglycemia ke: tlala e matla, ho fufuleloa ka tšohanyetso, ho phahamisa mahlo, pallor ea letlalo, paresthesia molomong, ho thothomela, ho tšoenyeha ka kakaretso, ho opa ha hlooho, ho tšoha ha boroko, maikutlo a tšabo, ho hokahana ha metsamao, mathata a nakoana a methapo ea kutlo (jk. mathata a pono le a puo, lipontšo tsa paresis kapa ho holofala kapa maikutlo a fetotsoeng a maikutlo. Ha tsoelo-pele ea hypoglycemia e ntse e tsoela pele, bakuli ba ka 'na ba lahleheloa ke boitšoaro le ho hlaphoheloa kelellong. Hangata mokuli ea joalo o na le metsi a batang a letlalo le bata ebile a le makhopho.

Hammoho le hypoglycemia, ho ka etsahala lintho tse latelang:

Mathata a Tsamaiso ea Dijo: seoelo se bakoang ke ho nyekeloa ke pelo, ho lapa, ho hlatsa, tatso ea "tšepe" molomong, ho utloa bohloko le ho tlala ka mpeng, bohloko ba ka mpeng le lets'ollo. Maemong a mang, keketseho ea nakoana ea ts'ebetso ea li-enzymes tsa "sebete" (alkaline phosphatase, glutamine-oxalacetic acetic aminotransferase, glutamine-pyruvic aminotransferase) ka serum ea mali, hepatitis e hlahisitsoeng ke lithethefatsi le jaundice e hlalositsoe.

Ha hlaha hangata ho kula ha letlalo: lekhopho, ho hlohlona letlalong, uritisaria, bofubelu ba letlalo, edema ea Quincke, letheba lekhopho letlalong, le bilikang matlalong a maholo a letlalo le ho eketsa khanya ea mahlo. Ka seoelo, karabelo ea letlalo e ka sebetsa e le qalo ea kholo ea maemo a matla, e tsamaisana le ho hema hanyane le phokotso ea khatello ea mali ho fihlela tshimolohong, e leng se sokelang bophelo ba mokuli. Ho hlalositsoe linyeoe tsa motho ka mong e matla e akaretsang karabelo ya ketso lekhopho la letlalo, bohloko bo kopaneng, feberu, ponahalo ea protheine ka har'a moroto le jaundice.

Ho tsoa ho sheropoietic system: thrombocytogeny ha e bonoe ka seoelo kapa e fumaneha ka seoelo leukocytopeia, agranulocytosis. Maemong a ikhethileng, ho hlaha hemolytic anemia kapa pancytopenia.

Litlamorao tse ling tse hlokometsoeng maemong a ikhethileng li kenyelletsa: phello e fokolang ea ho hlohlona, ​​ponahalo ea nakoana ea protheine ka har'a moroto, ho senyeha hoa pono le bolulo, hammoho le karabelo e mpe ea ho se mamelle joala kamora ho noa, e hlahisoang ke mathata a litho tsa mmele tse potang le tsa ho hema (ho se sebetse joalo ka moea: ho hlatsa, maikutlo mocheso sefahlehong le 'mele o kaholimo, tachycardia, kizunguzungu, hlooho ea hlooho).

Haeba ho na le bongoana bo bongata, nts'etsopele ea hypoglycemia e ka etsahala.

Ka hypoglycemia e bonolo kapa e itekanetseng, glucose kapa tharollo ea tsoekere e nkuoa ka molomo.

Haeba ho na le hypoglycemia e matla (ho lahleheloa ke ho tseba lintho), tharollo ea 40% ea dextrose (glucose) kapa glucagon e tsamaisoa ka methati, intramuscularly, subcutaneally.

Kamora ho hlaphoheloa kelellong, mokuli o lokela ho fuoa lijo tse nang le lik'habohaedreite ho qoba tsoelopele ea hypoglycemia.

Ho matlafatsa phello ea hypoglycemic ea Glibenclamide e bonoa ka ts'ebeliso e ts'oanang ea li-angiotensin-inhibiting enzyme inhibitors, li-anabolic agents.

li-inhibitors tse ling tsa lithethefatsi tsa hypoglycemic (mohlala, acarbose, biguanides) le insulin, lithethefatsi tse seng khahlanong le ts'oaetso tsa kokoana-hloko (NSAIDs), beta-blockers, quinine, quinolone derivatives, chloramphenicol, clofibrate, coumarin derivatives, obeyyramidine, microfenoxaminefaminfaminefulifenfululinfamin, ferrinfulifenfululinulamin, trupibrate, microfenoxaminefulifenfululinusulinfinfululin, trufibrate, mammeliculini, microfenoxulifenfululinusulinfululin, trufibrate para-aminosalicylic acid, pentoxifylline (ka tekanyetso e kholo e laetsoeng motsoali), perhexiline, li-derivatives tsa pyrazolone, phenylbutazones, phosphamides (mohlala, cyclophosphamide, ifos amide, trofosfamide), probenecid, salicylates, sulfinpirazona, sulphonamides, tetracyclines le tritokvalina. Li-urine acidifying agents (ammonium chloride, calcium chloride) li ntlafatsa phello ea glibenclamide ka ho fokotsa sekhahla sa ho ikarola le ho eketsa ho ikhula.

Meriana e thibelang hematopoiesis ea masapo e eketsa kotsi ea myelosuppression.

Hammoho le phello e eketsehang ea hypoglycemic, beta-blockers, clonilip, guanethidine le reserpine, hammoho le lithethefatsi tse nang le mochine o bohareng ba ts'ebetso, li ka fokolisa maikutlo a li-precursors tsa hypoglycemia.

Phello ea hypoglycemic ea glibenclamide e ka fokotsoa ka tšebeliso ea nako e le 'ngoe ea barbiturates, isoniazid, cyclosporine, diazoxide, glucorticostrosroids, glucagon, nicotinates (ka tekanyetso e phahameng), phenytoin, phenothiazines, rifampicip, thiazide diuretics. gland ea qoqotho, li-blockers tsa liteishene tsa calcium tse "liehang", li-antimometer tsa maiketsetso le letsoai la lithium.

Ts'ebeliso e mpe ea tahi le lino tse tahang li ka mpefatsa tlolo ea molao ea "carbohydrate metabolism".

Bahanyetsi ba H2 receptor ba ka fokolisa, ka lehlakoreng le leng, le ho ntlafatsa phello ea hypoglycemic ea Glibenclamide ka lehlakoreng le leng. Maemong a sa tloaelehang, pentamidine e ka baka ho fokotseha ho matla kapa keketseho ea khatello ea tsoekere ea mali. Litlamorao tsa tse tsoang ho coumarin li ka eketseha kapa tsa fokotseha.

Hammoho le phello e eketsehang ea hypoglycemic ea beta-blockers, clonidine, guanethidine le reserpine, hammoho le lithethefatsi tse nang le mochine o bohareng oa ts'ebetso, li ka fokolisa maikutlo a li-precursors tsa hypoglycemia.

Moriana o lokela ho nooa khafetsa, 'me haeba ho khoneha, ka nako e ts'oanang. Hoa hlokahala ho hlokomela ka hloko mofuta oa lithethefatsi le lijo.

Ngaka e lokela ho nahanisisa ka hloko ho khethoa ha Glibenclamide ho bakuli ba nang le ts'ebetso ea sebete le ea liphio, hammoho le hypofunction ea tšoelesa ea qoqotho, anterior pituitary kapa adrenal cortex. Phetoho ea khalase ea Glibenclamide e ea hlokahala ho feta tekano mmeleng le maikutlong, phetoho ea lijo. Lits'oaetso tse kholo tsa ho buoa le ho lemala, ho chesa haholo, mafu a tšoaetsanoang a nang le febrile syndrome ho ka hloka hore a khaoloe lithethefatsi tsa molomo tsa hypoglycemic le tsamaiso ea insulin.

Bakuli ba lokela ho lemosoa ka kotsi e eketsehang ea hypoglycemia maemong a tšebeliso ea lino tse tahang, NSAIDs le tlala.

Qalong ea kalafo, nakong ea khetho ea lethal dose, bakuli ba tloaetseng ho nts'etsapele hypoglycemia ha ba khothaletsoe ho etsa lintho tse hlokang tlhokomelo e potlakileng le lebelo la karabelo ea psychomotor.

Ha u phekola bakuli ba nang le khaello ea lactase, ho lokela ho hopoloa hore moriana o na le lactose monohydrate.

Sebakeng se lefifi ka mocheso o sa feteng 25 ° C.

Qoba hole le bana.

Lipehelo tsa Maemo a Phomolo ea meriana

Setlhare se na antithrombotic, lipid-lowing le hypoglycemicketso.

Melemo le kalafo

Glibenclamide e khothalletsoa hore e sebelisoe hang ka mor'a lijo. The endocrinologist e bala lethal dose ho latela litholoana tsa liteko tsa mali bakeng sa tsoekere, lilemo tsa mokuli, ho teba ha lefu le ka tlas'a lona, ​​methapo ea bophelo bo botle le bophelo ka kakaretso.

Boemong ba pele ba lefu lena, maemo a tloaelehileng ke 2,5-5 mg / ka letsatsi. Nka moriana hang ka mor'a lijo tsa hoseng. Haeba matšeliso a felletseng bakeng sa glycemia a ke ke a fumaneha, ngaka e ka ntlafatsa lethal dose ka ho eketsa 2,5 mg ea moriana kamora beke. Sekhahla sa 'maraka (ho fihlela 15 mg / letsatsi) se lekana le matlapa a mararo. Tekanyetso e phahameng ha e fuoe hangata, 'me ha ho na keketseho e kholo ea glycemia.

Haeba motho ea nang le lefu la tsoekere a na le boima ba 'mele bo ka tlase ho 50, tekanyo ea pele e fanoa ho 2,5 mg, e lekanang le halofo ea letlapa. Haeba tloaelo ea letsatsi le letsatsi e sa feta likotoana tse peli, ba taoa ka ho felletseng hoseng lijo tsa hoseng, maemong a mang, moriana o tsamaisoa habeli, hoseng le mantsiboea ka karolelano ea 2: 1.

Ha Glibenclamide e fetisetsoa kamora kalafo e atlehileng ka lithethefatsi tse ling tsa hypoglycemic, litekanyetso li tla ba 2,5 mg hang, hoseng.

Ka ho se sebetse hantle, o ka fetola maemo a tloaelehileng beke le beke ka ho eketsa 2,5 mg.

Ketsahalong eo sephetho sa kalafo ka meriana e meng e khahlanong le lefu la tsoekere se sa khotsofatseng, tekanyetso ea ho qala e tla ba 5 mg hoseng, kamora lijo. Haeba ho hlokahala, phetoho ea 2,5-5 mg ka beke e ea lumelloa. Tloaelo ea moeli e lula e tšoana - 15 mg / letsatsi.

Haeba tekanyetso e phahameng ea letsatsi le letsatsi ea Glibenclamide, ha u ntse u shebile lijo tse tlase tsa carb le ho ikoetlisa hantle, ha e fane ka matšeliso a tsoekere a 100%, lefu la tsoekere le fetisetsoa ho regimen e phethahetseng ea kalafo. Setlhare se ka sehloohong se tlatselletsoa ka li-biguanides, insulin le li-agents tse ling tsa hypoglycemic.

Haeba tlhahiso ea tsoelo-pele ea "insulin" ea tsoekere ho batho ba nang le lefu la tsoekere e hatelletsoe ka botlalo, kalafo e rarahaneng ha e tiise sephetho se ts'oanang le sa monotherapy ka litokisetso tsa insulin.

Haeba, ka lebaka le itseng, nako ea ho nka Glibenclamide e hlotsoe nako e fetang hora kapa tse peli, u ke ke ua nka moriana nakong e tlang. Hoseng ho latelang, nka tekanyetso e tloaelehileng, u se ke ua khothaletsa ho eketsa sekhahla.

Litlamorao

Ka moriana o feteletseng oa lithethefatsi, linaha tse nang le khatello e matla ea kelello li ka khoneha, ho kenyelletsa le ho ferekana. Ka tšebeliso e mpe ea lino tse tahang le ho ja habeli ka letsatsi, ho sebetsa ka thata, mathata le sebete, tšoelesa ea qoqotho le liphio, ho ka ba le litlamorao tse sa rateheng.

Lintlha tsa overdose ea Glibenclamide

Ts'ebeliso e hlophisehileng ea likarolo tse ling tsa lithethefatsi li baka hypoglycemia e matla, e leng kotsi ho bophelo ba motho ea hlasetsoeng.

Sephetho se ts'oanang se ka fumanoa ka ts'ebeliso ea lithethefatsi khahlanong le semelo sa khaello e sa lekanyetsoang, ho ikoetlisa ka ho feteletseng, tšusumetso ea meriana e meng e nkiloeng hammoho le Glibenclamide.

Matšoao a boemo ba hypoglycemic:

• Tlala e sa laoloeng
• Motsoako o theohileng oa boroko
• Mongobo
• Karohano
• Ho eketsa mofufutso
• Ho opeloa ke hlooho
• Mathata a amanang le dyspeptic
• Hypertonicity
• Ho thothomela ka letsoho
• Tachycardia.

Ho kheloha mosebetsing oa psyche e nang le mathata a endocrine ho ka hlahisoa ka ho ferekana kelellong, ho otsela, ho tsitsipana, ho ts'oara ho fokolang, ho ts'oara tlhokomelo, ho tsepamisa maikutlo habeli, ho tšoha ha ho khanna koloi kapa ho laola mekhoa e nepahetseng, linaha tse sithabetsang, mabifi, mathata a methapo ea mali le litho tsa phefumoloho. coma.

Ka botlalo le ka mokhoa o fetelletseng oa litso tse ngata, hypoglycemia e tla phatlalatsoa haholoanyane ha e bapisoa le lithethefatsi tse tsoang molokong oa pele oa sulfanylurea.

Ho fokotsa boemo ba motho ea hlokofalitsoeng ka bonolo ba ho hlasela ka mokhoa o leka-lekaneng, ka potlako o ka nka lik'habohaedreite tse potlakileng - liswisi, halofo ea khalase ea tee le tsoekere kapa lero (ntle le li-sweeteners tsa maiketsetso). Haeba mehato e joalo ha e sa lekana, tsoekere (40%) kapa Dextrose (5-10%) e kenngoa methapong, glucagon (1 mg) e kenngoa mesifa. Diazoxide e ka nooa ka molomo. Haeba motho ea hlokahalitsoeng a nkile acarbose, hypoglycemia ea molomo e ka lokisoa feela ka tsoekere, empa eseng ka oligosaccharides.

Haeba motho ea hlokofalitsoeng ke hypoglycemia a ntse a tseba, ho na le tsoekere e sebelisoang kahare. Maemong a ho lahleheloa ke kelello, tsoekere e fanoa iv, tsoekere - iv, i / m le ka tlasa letlalo. Haeba kelello e khutlile, bakeng sa thibelo ea ho khutlela morao, lefu la tsoekere le lokela ho fuoa phepo e nepahetseng e thehiloeng lik'habohlokoedreite tse potlakileng.

Tlhokomelo ea glycemia, pH, creatinine, electrolyte, urea nitrogen e lula e beiloe leihlo.

Liphetoho tsa ts'ebeliso ea lithethefatsi tsa Glibenclamide

Tlhahiso ea glimenclamide e liehile, ha e ntse e ntlafatsa bokhoni ba eona ba hypoglycemic, azopropanone, miconazole, litokisetso tsa coumaric acid, oxyphenbutazone, lithethefatsi tsa sehlopha sa sulfonamide, phenylbutazone, sulfapyrazonfeniramidol.

Phekolo e kopaneng le litlhare tse ling tse fokotsang tsoekere tse kokobetsang ho hanyetsa insulin li bontša litholoana tse tšoanang.

Ka tšebeliso e le 'ngoe ea lithethefatsi tsa anabolic, allopurinol, cimetidine, β-adrenoreceptor blockers, cyclophosphamide, guanethidine, clofibrinic acid, monoamine oxidase inhibitors, sulfonamides e nang le ts'ebetso ea nako e telele, salicylates, tetracyclines, joala, thepa ea mantlha ea motheo.

Haeba kalafo ea kalafo e na le barbiturates, chlorpromazine, rifampicin, diazoxide, adrenaline, acetazolamide, lithethefatsi tse ling tsa sympathomimetic, glucocorticosteroids, glucagon, indomethacin, diuretics, ho kenyelletsa acetazolamide, nicotrate (doses tse kholo, tse doses tse ngata, tse ngata tse ngata tse fetotsoeng) , saluretics, lithium salate, litekanyetso tse kholo tsa joala le laxative, phello ea glimenclamide e ea fokotsoa.

Liphetho tse sa lebelloang tsa ho sebelisana le tšebeliso ea papali li bonts'oa ke bahanyetsi ba H2 receptor.