MANINIL 3

ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea karete e le 'ngoe ea 1 kapa ka har'a pakete e lutlang ea li-pcs tse 10 kapa tse 20, ka paketeng ea likarete tse tharo.

ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea karete e le 'ngoe ea 1 kapa ka har'a pakete e lutlang ea li-pcs tse 10 kapa tse 20, ka paketeng ea likarete tse tharo.

ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea karete e le 'ngoe ea 1 kapa ka har'a sutuk'hehetso ea mekotla e 20, ka har'a pakete ea likarete 1, 2, 3, 4 kapa 6.

Mofumahali

Kamora ho ts'oaroa ha Maninil 3.5, ho chechisoa ka potlako le ka mokhoa o felletseng ho tsoa pampiring ea mala. Ho lokolloa ka botlalo ha ntho e sebetsang ea microionised ho etsahala nakong ea metsotso e 5.
Plasma e tlamang protheine e feta 98% bakeng sa Maninyl 3,5, 95%.
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.
T1 / 2 bakeng sa Maninyl 3.5 ke lihora tse 1.5-3,5.

Mokhoa oa kopo

Maninil 3.5 ho nooa ka molomo, hoseng le mantsiboea pele ho lijo, u sa hlafuna. Tekanyetso e beoa ka bonngoe, ho latela boteng ba lefu lena.
Motsoako oa pele ke matlapa a 1 / 2-1, karolelano ke letlapa le le leng. ka letsatsi, boholo - 3, maemong a ikhethang - matlapa a 4. ka letsatsi.
Litekanyetso tsa letsatsi le letsatsi ho isa ho matlapa a mabeli. hangata e nkuoa hang (hoseng), e phahameng - e arotsoe ka litekanyetso tse peli (hoseng le mantsiboea).

Litlamorao

Hypoglycemia ea khonahala (ka ho tlōla lijo, ho ja sethethefatsi ka mokhoa o feteletseng, le ho ikoetlisa ka matla le ho sebelisa joala haholo).
Ho tsoa ho tšilo ea lijo: ka linako tse ling - ho nyekeloa, ho hlatsa, maemong a mang - cholestatic jaundice, hepatitis.
Ho tsoa ho sistimi ea hemopoietic: ka seoelo - thrombocytopenia, granulocytopenia, erythrocytopenia (ho fihlela pancytopenia), maemong a mang - hemolytic anemia.
Litla-morao: Ke ka seoelo - rash ea letlalo, feberu, bohloko bo kopaneng, proteinuria.
Tse ling: qalong ea kalafo, lefu la nakoana la bolulo le ka khonahala. Maemong a sa tloaelehang, photosensitivity.

Contraindication

Contraindication mabapi le ts'ebeliso ea lithethefatsi Maninil 3.5 ke: hypersensitivity (ho kenyelletsa le lithethefatsi tsa sulfonamide le tse ling tse tsoang ho sulfonylurea), mofuta oa 1 lefu la tsoekere (ho itšetleha ka insulin), tšenyo ea metabolic (ketoacidosis, precoma, coma), mmuso ka mor'a ho pencreatic resection, mafu a matla a sebete le a liphio. maemo a hlobaetsang (mohlala, ho phuhlama ha metabolism ea carbohydrate ho mafu a tšoaetsanoang, ho cha, likotsi kapa kamora ho buuoa ho hoholo ha ho bontšoa kalafo ea insulin), leukopenia, ho thijoa ka mala h mala, maemo a tsamaeang le ho monya lijo tse ngata le nts'etsopele ea hypoglycemia, ho ima le nako ea ho anyesa.

Ho sebelisana le lithethefatsi tse ling

Ho matlafatsa phello ea moriana Maninil 3.5 ka khoneha ka tšebeliso e kopanetsoeng le li-inhibitors tsa ACE, li-anabolic agents le lihormone tsa banna tsa thobalano, li-agents tse ling tsa molomo (e leng mohlala, acarbose, biguanides) le insulin, li-azapropazone, li-NSAIDs, beta-blockers, li-quinolone derivatives, chloramphenicol, Clomofiber, disopyramide, fenfluramine, lithethefatsi tsa antifungal (miconazole, fluconazole), fluoxetine, MAO inhibitors, PASK, pentoxifylline (lethal dose le phahameng la tsamaiso ea batsoali ho ja), perhexiline, li-derivatives tsa pyrazolone, phosphamides (mohlala, cyclophosphamide, ifosfamide, trophosphamide), probenecid, salicylates, sulfonamides, tetracyclines le tritoqualin.
Li-urine acidifying agents (ammonium chloride, calcium chloride) li ntlafatsa phello ea lithethefatsi Maninyl ka ho fokotsa sekhahla sa ho ikarola le ho eketsa botjha ba eona.
Phello ea hypoglycemic ea lithethefatsi Maninil e ka fokotseha ka tšebeliso e tšoanang ea li-barbiturates, isoniazid, diazoxide, GCS, glucagon, nicotinates (litekanyetso tse phahameng), phenytoin, phenothiazines, rifampicin, thiazide diuretics, lihormone lihormone, lihormone lihormone, lihormone lihormone, lihormone tsa lihormone, lihormone lihormone, lihormone lihormone, lihormone lihormone, lihormone lihormone, lihormone tsa lihormone, lihormone lihormone. li-blockers tsa liteishene tsa calcium tse liehang, letsoai la lithium.
Bahanyetsi ba H2 receptor ba ka fokolisa, ka lehlakoreng le leng, 'me ka lehlakoreng le leng, ba ka ntlafatsa phello ea hypoglycemic ea Maninil.
Maemong a sa tloaelehang, pentamidine e ka baka ho fokotseha ho matla kapa keketseho ea khatello ea tsoekere ea mali.
Ka tšebeliso e le 'ngoe le lithethefatsi, Maninil a ka ntlafatsa kapa a fokolisa phello ea lihlahisoa tsa coumarin.
Hammoho le ts'ebetso e eketsehileng ea hypoglycemic, beta-blockers, clonidine, guanethidine le reserpine, hammoho le lithethefatsi tse nang le mochine o bohareng oa ts'ebetso, li ka fokolisa maikutlo a matšoao a hypoglycemia.

Bongata

Ha tsoelo-pele ea hypoglycemia e ntse e eketseha, mokuli a ka lahleheloa ke boitšoaro le tsebo, nts'etsopele ea hypoglycemic coma.
Phekolo: haeba ho na le hypoglycemia e bonolo, mokuli o lokela ho nka sengoathoana, lijo kapa lino tse nang le tsoekere e ngata (jeme, mahe a linotsi, khalase ea tee e tsoekere) kahare. Maemong a ho felloa ke kelello, ho hlokahala hore ho kenngoe glucose ea iv - 40-80 ml ea tharollo ea glucose ea 40%, ebe ho kenella ka tharollo ea 5-10% dextrose. Joale o ka kenya 1 mg ea glucagon ka / ka, / m kapa s / c. Haeba mokuli a sa hlaphoheloe, mohato ona o ka phetoa; ho ea pele, kalafo e matla e ka hlokahala.

Fomu ea tokollo

Maninil 3.5 - matlapa.
Ho paka - ka libotlolong tsa khalase tsa li-pcs tse 120., Ka paketeng ea karete ea likarete ka 30 kapa 60 likhomphutha.

Letlapa le le leng la Maninil 3.5 e na le lintho tse sebetsang: glibenclamide (ka sebopeho sa micronised) 3.5 mg.
Baeti: lactose monohydrate, starch ea litapole, gimetellosa, colloidal silicon dioxide, magnesium stearate, krimsson dae (Ponso 4R) (E124)

Ketso ea pharmacological

E na le litlamorao tsa pancreatic le extrapancreatic. Ts'ebetso ea pancreatic e bonahatsoa ke ts'usumetso ea tlhahiso ea insulin ke lisele tsa pancreatic beta, mme ts'ebetso ea extrapancreatic e bontšoa ka keketseho ea kutloelo-hloko ea li-insulin receptors tsa tharollo (ka lebaka la ts'usumetso ea tyrosine kinase) ho insulin, le khatello ea gluconeogenesis le glycogenolysis ho sebete.

Clinical Pharmacology

Sebopeho se nang le khanya se fana ka katleho ea pejana ea C_max , mangolo a phello ea hypoglycemic e lumellana hantle le tlhoro ea "postprandial hyperglycemia", e netefatsang phello ea 'mele ea eona hammoho le T e khutsufalitsoeng_1/2 e fokotsa kotsi ea hypoglycemia. Tlhokahalo ea letsatsi le letsatsi ea glibenclamide e kanna ea fokotseha ka 30-40%.

Litlhokahalo tsa polokeho

E sebelisoa ka hloko ha ho na le febrile syndrome, lefu la qoqotho (le nang le ts'ebetso e holofetseng), hypofunction ea anterior pituitary kapa adrenal cortex, botahoa, ho bakuli ba tsofetseng ka lebaka la menyetla ea ho ba le hypoglycemia. Ho hlokahala tlhokomelo ea khafetsa ea bongaka. Nakong ea kalafo, o lokela ho latela lijo ka tieo. Ho nka Maninil ha ho nkeloe sebaka sa lijo. Nakong ea kalafo, ha ho khothalletsoe ho etsa lintho tse hlokang ho tsepamisa mohopolo le lebelo la maikutlo a psychomotor, ho lula le letsatsi nako e telele. Phetoho ea tekanyetso ea hlokahala bakeng sa ho fetella hoa mmele le maikutlo, phetoho ea lijo.

Tekanyetso le tsela ea tsamaiso ea moriana.

Tekanyetso e beoa ka bonngoe, ho latela lilemo, botebo ba lefu la tsoekere, glycemia e potlakileng le lihora tse peli ka mor'a ho ja.

Tekanyetso e tloaelehileng ke 2,5-5 mg / ka letsatsi, khafetsa ea tsamaiso ke linako tse 1-3 / ka letsatsi. Nka metsotso e 20-30 pele ho lijo. Bakeng sa litekanyetso tse fetang 15 mg / ka letsatsi, e sebelisoa maemong a sa tloaelehang mme ha e hlahise keketseho e kholo ea phello ea hypoglycemic.

Bakeng sa bakuli ba tsofetseng, tekanyetso ea pele ke 1 mg / letsatsi.

Ha o fetoha ho tloha ho Biguanides, tekanyetso ea pele ea glibenclamide ke 2,5 mg / ka letsatsi. Biguanides e lokela ho felisoa, 'me tekanyo ea glibenclamide, haeba ho hlokahala, e ka eketseha ka 2,5 mg ka matsatsi ohle a 5-6 ho lefella tlolo ea metabolism ea carbohydrate. Ha ho se na matseliso bakeng sa libeke tse 4-6, ho hlokahala hore u rale motsoako oa ho kopanya le glibenclamide le biguanides.

Litla-morao tsa Maninil 3.5:

Ho tloha ts'ebetsong ea endocrine: hypoglycemia ho fihlela ho coma (menyetla ea nts'etsopele ea eona e eketseha ka tlolo ea mofuta oa dosing le lijo tse sa lekaneng).

Boitšoaro bo kulisang: lekhopho la letlalo, ho hlohlona.

Ho tsoa ho tsamaiso ea tšilo ea lijo: ho nyekeloa ke pelo, lets'ollo, maikutlo a boima sebakeng sa epigastric, ka seoelo - ts'ebetso ea sebete e senyehileng, cholestasis.

Ho tloha lehlakoreng la tsamaiso ea methapo e bohareng le tsamaiso ea methapo ea methapo: ka seoelo - paresis, mathata a ho utloa bohloko, hlooho e bohloko, mokhathala, bofokoli, ho tsekela.

Ho tsoa kemisong ea hematopoietic: ka seoelo - mathata a hematopoiesis ho fihlela nts'etsopele ea pancytopenia.

Boitšoaro ba methapo ea methapo: ka seoelo - photosensitivity.

Litaelo tse ikhethang bakeng sa ts'ebeliso ea Maninil 3.5.

E sebelisoa ka hloko ho bakuli ba nang le lefu la methapo ea sebete le liphio (ho kenyeletsoa nalane), hammoho le feberu, ts'ebetso e mpe ea adrenal, tšoelesa ea qoqotho le joala bo sa foleng.

Nakong ea phekolo, ho hlokahala hore ho lekantsoe tsoekere ea mali le tsoekere ea moriana letsatsi le letsatsi hore ua hlokahala.

Ka nts'etsopele ea hypoglycemia, haeba mokuli a le teng, ho na le glucose (kapa tharollo ea tsoekere) kahare. Bakeng sa tahlehelo ea kelello, glucose e kenang kapa glucagon sc, intramuscularly kapa intravenous e tsamaisoa. Kamora ho hlaphoheloa kelellong, ho bohlokoa ho fa mokuli lijo tse nang le lik'habohaedreite e le ho qoba tsoelopele ea hypoglycemia.

Bakuli ba nkang glibenclamide ba lokela ho hana ho noa joala. Tabeng ea ts'ebeliso ea lino tse tahang, nts'etsopele ea maikutlo a kang a disulfiram, hammoho le hypoglycemia e ka etsahala.

Ho sebelisana ha Maninil 3.5 le lithethefatsi tse ling.

Ho matlafatsa phello ea hypoglycemic ea glibenclamide ho khoneha ka ts'ebeliso e ts'oanang ea beta-blockers, li-anabolic agents, allopurinol, cimetidine, clofibrate, cyclophosphamide, isobarin, MAO inhibitors, sulfonamide ea nako e telele, salicylates, chloramphenicol, ethane.

The attenuation bohato ba glibenclamide le ntshetsopele ya hyperglycemia khoneha ha ho sebelisoa ha barbiturates, chlorpromazine, phenothiazines, phenytoin, diazoxide, acetazolamide, glucocorticoids, sympathomimetic mahlahana, glucagon, indomethacin, tekanyetso e phahameng nicotinate, lithibela-pelehi bakeng sa-ja le estrogens, saluretics, thyroid li-hormone, matsoai tsa lithium tekanyetso e phahameng ea laxatives.