Diabetesalongzen, fumana, reka

Lebitso la Khoebo la tokiso: Diabetesalong

Lebitso la machabeng le sa sebetseng: Gliclazide (Gliclazide)

Foromo ea boholo: Litafole tsa tokollo tse fetotsoeng

Lintho tse sebetsang: Gliclazide (Gliclazide)

Sehlopha sa Pharmacotherapeutic: Hypoglycemic moemeli oa tsamaiso ea molomo oa sehlopha sa bobeli sa sulfonylurea.

Sebopeho sa pharmacological:

Oral hypoglycemic drug, e fumanoang molomong oa bobeli.

E hlohlelletsa secretion ea insulin ke manyeme, e theola boemo ba tsoekere maling, e matlafatsa sephetho sa "glucose" le ho boloka kutloelo-bohloko ea lisele tsa pherekano ho insulin. Kamora kalafo ea lilemo tse peli, bakuli ba bangata ha ba hlahise lithethefatsi (litekanyetso tse eketsehileng tsa insulin ea postprandial le secretion ea C-peptides li sala).

Fokotsa nako ea ho qalella ho tloha motsotso oa ho ja ho isa ho qala ho secretion. E khutlisetsa tlhoro ea pele ea "insulin secretion" ho arabela tekanyo ea tsoekere (ho fapana le lintho tse ling tse tsoang ho sulfonylurea, tse nang le phello e kholo nakong ea bobeli ea secretion). E boetse e ntlafatsa karolo ea bobeli ea seculin ea insulin. Fokotsa tlhoro ea hyperglycemia kamora ho ja (e fokotsa "hypprousial hyperglycemia").

Glyclazide e eketsa kutloisiso ea lithane tsa peripheral ho insulin (i.e., e na le phello e boletsoeng ea extrapancreatic). Ho mesifa ea mesifa, phello ea insulin mabapi le tsoekere ea tsoekere, ka lebaka la kutloisiso e ntlafalitsoeng ea lisele ho insulin, e eketseha haholo (ho fihla ho + 35%), hobane glycazide e phahamisa tšebetso ea mesifa ea glycogen synthetase.

Fokotsa sebopeho sa tsoekere maling, ho etsa hore boleng ba tsoekere bo potlakileng.

Ntle le ho ama metabolism ea carbohydrate, gliclazide e ntlafatsa microcirculation. Setlhare se fokotsa kotsi ea "thrombosis" e nyane ea mali, e ama mekhoa e mmedi e ka amehang ho nts'etsopele ea mathata a lefu la tsoekere: ho thibela likarolo tsa methapo le ho khomarela le ho fokotseha ha lintho tse ngata tse amanang le mokokotlo oa mokokotlo (beta-thromboglobulin, thromboxane B2) vascular endothelial shughuli le tšebetso e eketsehang ea activator ea plasminogen.

Glyclazide e na le thepa ea antioxidant: e fokotsa sekhahla sa lipid peroxides ho plasma, e eketsa ts'ebetso ea diselutase ea mali a khubelu ea mali.

Ka lebaka la litšobotsi tsa foromo ea litekanyetso, lethal dose ea letsatsi le letsatsi ea matlapa a Diabetalong 30 mg e fana ka phekolo e sebetsang ea "gliclazide" plasma ea mali ka lihora tse 24.

Kamora ho tsamaisoa ka molomo, gliclazide e kenella ka botlalo ho tsoa ho tšilo ea lijo. Ho ja ha ho ame ho monya. Ho bokellana ha ntho e sebetsang plasma ea mali butle-butle ho eketseha butle-butle, ho fihla bonyenyaneng ebe ho fihla setsing sa lihora tse 6 ho isa ho tse tšeletseng ka mor'a ho nka moriana. Phapang ea motho ka mong e tlaase haholo. Kamano lipakeng tsa lethal dose le mokokotlo oa moriana ho plasma ea mali ke ho itšetleha ka nako ka nako.

Tsamaiso le metabolism

Plasma protein e tlamang ke hoo e ka bang 95%.

E tšeloa ka har'a sebete 'me e hloekisoa haholo ke liphio. Ha ho na metabolites e sebetsang ho plasma.

Excretion ke liphio e etsoa haholo ka sebopeho sa metabolites, ka tlase ho 1% ea lithethefatsi ha li sa fetoloa.

T1 / 2 ke lihora tse ka bang 16 (lihora tse 12 ho isa ho tse 20).

Pharmacokinetics maemong a khethehileng a kliniki

Bathong ba tsofetseng, ha ho liphetoho tse bohlokoa tsa kliniki maemong a pharmacokinetic li bonoang.

Matšoao a sebeliso:

- Type 2 lefu la tsoekere le kopantsoe le kalafo ea ho ja le ho ja lijo tse sa lekaneng le boikoetliso.

Contraindication:

- mofuta oa 1 lefu la tsoekere

- lefu la tsoekere ketoacidosis, lefu la tsoekere, lefu la tsoekere,

Ho hloleha ho matla ha masapo le / kapa ho se sebetse hantle ha sebete,

- lilemo ho isa ho 18

- Nako ea ho anyesa (ho anyesa),

- congenital lactose ts'oarello, khaello ea lactase kapa lefu la glucose-galactose malabsorption,

- Hypersensitivity ho gliclazide kapa mang kapa mang ea fumanang lithethefatsi, ho tse ling tse tsoang ho sulfonylurea, ho sulfonamides.

Ha ho khothalletsoe ho sebelisa lithethefatsi ka nako e le 'ngoe hammoho le phenylbutazone kapa danazole.

Ka tlhokomeliso: botsofe, khaello e sa tloaelehang le / kapa e sa leka-lekanang, mafu a matla a tsamaiso ea pelo (ho kenyeletsa le lefu la pelo, atherosclerosis), hypothyroidism, ho hlaka kapa ho hloleha hoa setho, hypopituitarism, renal le / kapa ho hloleha ha sebete, kalafo ea nako e telele le corticosteroids, joala, tsoekere ea glucose-6-phosphate dehydrogenase.

Bokhachane le pelehi

Ha ho na boiphihlelo ka gliclazide nakong ea kemolo. Lintlha tse mabapi le tšebeliso ea tse ling tse tsoang sulfonylurea nakong ea kemaro li na le moeli.

Boithutong ba liphoofolo tse sebelisoang ka laboratoring, litla-morao tsa "gliclazide" ha li so tsejoe.

Ho fokotsa kotsi ea tšoaetso ea tlhaho ea tlhaho, ho hlokahala hore ho laoloe hantle (kalafo e nepahetseng) ea lefu la tsoekere.

Lithethefatsi tsa molomo tsa molomo nakong ea kemolo ha li sebelisoe. Moriana oa khetho bakeng sa kalafo ea lefu la tsoekere ho basali baimana ke insulin. Ho khothalletsoa ho nka sebaka sa ts'ebeliso ea lithethefatsi tsa molomo tsa hypoglycemic ka kalafo ea insulin ka bobeli nakong ea kemaro e reriloeng, le hore na ho ima ho etsahetse ha u ntse u sebelisa moriana.

Ka ho nahana ka ho haella ha tlhaiso-leseling mabapi le tšebeliso ea gliclazide ka lebese la matsoele le kotsi ea ho ba le neonatal hypoglycemia, letsoele le hanyetsoa nakong ea kalafo ea lithethefatsi.

Sebelisa bakeng sa ts'ebetso ea sebete e sa sebetseng

Ka temoso mabapi le ho hloleha ha sebete.

- Ho ba le bothata bo matla ba renal le / kapa ho senyeha ha sebete.

Sebelisa bakeng sa ts'ebetso ea renal e senyehileng

Bakeng sa bakuli ba nang le bothata ba ho hlaphoheloa ke liphekolo tse bonolo le tse itekanetseng, moriana o laoloa ka tekanyetso e lekanang le ea bakuli ba nang le ts'ebetso e tloaelehileng ea fig. A ho hloleha ka matla ha a liphio, lefu la tsoekere le tšoaetsanoa.

Sebelisa ho bana

E kopantsoe le bana ba ka tlase ho lilemo tse 18.

Sebelisa ho bakuli ba tsofetseng

Bakeng sa bakuli ba sa kang ba fumana kalafo (ho kenyelletsa le bakeng sa batho ba baholo ho feta lilemo tse 65), tekanyetso ea pele ke 30 mg. Ebe mokelikeli o khethoa ka bonngoe ho fihlela phello ea kalafo e lakatsehang e fihlelle.

Ho sebelisana le lithethefatsi tse ling:

Glyclazide e ntlafatsa phello ea li-anticoagulants (warfarin); tokiso ea li-anticoagulant e ka hlokahala.

Miconazole (e nang le tsamaiso ea methapo le ha o sebelisa li-gel ho mucosa ea molomo) e ntlafatsa phello ea hypoglycemic ea lithethefatsi (hypoglycemia e ka ba ho fihla ho komisi).

Phenylbutazone (tsamaiso ea methapo) e ntlafatsa phello ea hypoglycemic ea lithethefatsi (maqhubu ka lebaka la liprotheine tsa plasma le / kapa e liehisa ho tsoa 'meleng), taolo ea tsoekere ea mali le tokiso ea litekanyetso tsa glyclazide lia hlokahala, ka bobeli nakong ea tsamaiso ea phenylbutazone le ka mor'a ho tlohela.

Lithethefatsi tse nang le ethanol le ethanol li ntlafatsa hypoglycemia, tse thibelang karabelo e lumellanang, li ka kenya letsoho kholisong ea komello ea hypoglycemic.

Ha e nkuoa ka mokhoa o ts'oanang le lithethefatsi tse ling tsa hypoglycemic (insulin, acarbose, biguanides), beta-blockers, fluconazole, ACE inhibitors (Captopril, enalapril), histamine H2 receptor blockers (cimetidine), MAO inhibitors, hypoglycemic le sulfanilamides mme e tšoailoe kotsi ea hypoglycemia.

Ka tšebeliso e kopanang le danazol, phello ea lefu la tsoekere e hlokomeleha. Hoa hlokahala ho laola boemo ba tsoekere ea mali le ho ntlafatsa tekanyetso ea gliclazide, ka bobeli nakong ea tsamaiso ea danazol le ka mor'a ho tlohela.

Chlorpromazine ka tekanyetso e phahameng (ho feta 100 mg / ka letsatsi) e eketsa sethala sa glucose maling, e fokotsa sekhahla sa insulin. Hoa hlokahala ho laola tsoekere ea mali le ho ntlafatsa tekanyetso ea gliclazide, ka bobeli nakong ea tsamaiso ea chlorpromazine le ka mor'a ho tlohela.

GCS (systemic, intraarticular, external, rectal management) e eketsa tsoekere ea mali ka nts'etsopele ea ketoacidosis (ho fokotseha ha mamello ho lik'habohaedreite). Hoa hlokahala ho laola tsoekere ea mali le ho ntlafatsa tekanyetso ea gliclazide ka bobeli nakong ea tsamaiso ea GCS le kamora ho itokolla.

Ritodrine, salbutamol, terbutaline (iv) e eketsa tsoekere ea mali. Ho khothalletsoa taolo ea tsoekere ea mali 'me, haeba ho hlokahala, phetisetso ea mokuli ho ea kalafo ea insulin.

Tekanyetso le tsamaiso:

Setlhare se etselitsoe feela kalafo ea batho ba baholo.

Litafole tsa Diabetesalong tse nang le tlhahiso e fetotsoeng ea 30 mg li nkuoa ka molomo nako e le ngoe / letsatsi nakong ea lijo tsa hoseng.

Khetho ea moriana e lokela ho etsoa ho latela boemo ba tsoekere maling maling ka mor'a ho qala kalafo. Phetoho e 'ngoe le e' ngoe ea kokoana-hloko e latelang e ka etsoa kamora bonyane libeke tse peli.

Tekanyetso ea letsatsi le letsatsi ea lithethefatsi e ka fapana ho tloha ho 30 mg (1 tab.) Ho 90-120 mg (3-4 tab.). Tekanyetso ea letsatsi le letsatsi ha ea lokela ho feta 120 mg (matlapa a 4).

Diabetesalong e ka nkela matlapa a tloaelehileng a gliclazide (80 mg) litekanyetso tsa matlapa a 1 ho isa ho a 4.

Haeba u fetoa ke tekanyetso e le 'ngoe kapa tse' maloa tsa moriana, u ke ke ua nka tekanyetso e phahameng ka tekanyetso e latelang (ka le hlahlamang).

Ha u nkela lithethefatsi tse ling tsa hypoglycemic lipilisi tsa Diabetalong® 30 mg, ha ho hlokahale nako ea phetoho. U lokela ho qala ka ho khaotsa ho sebelisa tekanyetso ea letsatsi le letsatsi ea lithethefatsi tse ling ebe ka letsatsi le hlahlamang qala ho sebelisa moriana ona.

Haeba mokuli a kile a fumana kalafo ka sulfonylureas e nang le bophelo bo bolelele ba bophelo, ho hlokahala hore ho be le tlhokomelo ka hloko (ho lekola tsoekere ea mali) bakeng sa libeke tse 1-2 ho latela sephetho sa litlamorao tsa kalafo e fetileng.

Diabetesalong e ka sebelisoa hammoho le biguanides, alpha glucosidase inhibitors kapa insulin.

Ho bakuli ba kotsing ea ho ba le hypoglycemia (phepo e sa lekaneng kapa e sa leka-lekanang, mathata a endocrine a tebileng kapa a sa sebetseng hantle - ho hloka khaello ea phepo le adrenal, hypothyroidism, ho hlakoloa ha glucocorticosteroids kamora ho tsamaisoa ha nako e telele le / kapa tekanyetso e phahameng, mafu a matla a tsamaiso ea methapo ea pelo / lefu la pelo le matla la coronary, carotid arteriossteosis e atileng, atherosulinosis /) ho kgothaletswa ho sebelisa tekanyetso e fokolang (30 mg 1 nako / letsatsi) ea moriana Diabetalong.

Litaelo tse ikhethang:

Phekolo e etsoa feela hammoho le lijo tse nang le khalori e tlase e tlaase.

Hoa hlokahala hore kamehla u lekole boemo ba tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja, haholo-holo matsatsing a pele a kalafo le moriana.

Diabetesalong e ka fuoa feela bakuli ba fumanang lijo tse tloaelehileng, tse hlokang ho kenyelletsa lijo tsa hoseng 'me li fana ka phepo e lekaneng ea lik'habohaedreite.

Ha u fana ka litlhare, ho lokela ho hopoloa hore ka lebaka la tšebeliso ea likhakanyo tsa sulfonylurea, hypoglycemia e ka ba teng, 'me maemong a mang e le ka mokhoa o thata le o tšoarellang, o hlokang ho kenngoa sepetlele le taolo ea tsoekere ka matsatsi a' maloa. Hypoglycemia hangata e hlaha ka ho ja lijo tse nang le khalori e tlase, ka mor'a ho ikoetlisa nako e telele kapa ho ikoetlisa ka mor'a ho noa joala kapa ka ho sebelisa lithethefatsi tse 'maloa tsa hypoglycemic ka nako e le' ngoe.

Bakeng sa ho qoba nts'etsopele ea hypoglycemia, ho hlokahala hore ho khethoe litekanyetso ka hloko le ka bomong, hammoho le ho fa mokuli tlhaiso-leseling e phethahetseng ka kalafo e boletsoeng.

Ka ho fetella 'meleng le maikutlong, ha u fetola lijo, ho hlokahala hore u fetole litekanyetso tsa meriana.

Haholo-holo a amehang ka ketso ea lithethefatsi tsa hypoglycemic ke batho ba tsofetseng, bakuli ba sa fumaneng lijo tse nang le phepo e nepahetseng, ba nang le boemo bo fokolang ba 'mele, bakuli ba nang le pituitary-adrenal insuffanele.

Beta-blockers, clonidine, reserpine, guanethidine e ka pata lipontšo tsa kliniki tsa hypoglycemia.

Bakuli ba lokela ho lemosoa ka kotsi e eketsehang ea hypoglycemia maemong a ethanol, NSAIDs, le tlala.

Tabeng ea ethanol (joala), ho boetse ho khonahala ho ba le discriram-syndrome (bohloko ba ka mpeng, ho nyekeloa ke pelo, ho hlatsa, hlooho).

Ho kenella ka matla le ho lemala ho hoholo, ho chesa haholo, mafu a tšoaetsanoang a nang le febrile syndrome ho ka hloka ho felisoa ha litlhare tsa hypoglycemic tsa molomo le tumellano ea kalafo ea insulin.

Nts'etsopele ea khatello ea bobeli ea lithethefatsi e ka etsahala (e tlameha ho khetholloa ho ea mantlha, moo moriana o sa feng phello e lebelletsoeng ea kliniki nakong ea kopano ea pele).

Khahlano le semelo sa kalafo sa lithethefatsi Diabetalong, mokuli o tlameha ho tlohela tšebeliso ea lithethefatsi le / kapa lithethefatsi tse nang le ethanol le lihlahisoa tsa lijo.

Nakong ea kalafo le Diabetalong, mokuli o lokela ho tseba khafetsa litekanyetso tsa tsoekere le glycosylated hemoglobin maling, le litlatsetso tsa "glucose" ka har'a moroto.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Nakong ea kalafo, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea psychomotor.

Litlamorao:

Hypoglycemia (e khahlanong le regimen ea litekanyetso le lijo tse sa lekaneng): hlooho ea hlooho, mokhathala o eketsehileng, tlala, ho eketsa ho fufuleloa, bofokoli bo matla, ho akheha, ho tepella maikutlo, khatello ea mali, ho otsela, ho hloka boroko, ho ruruha, ho teneha, ho teneha, ho hloka kelello, ho hloka tlhokomelo e tlase, ho se khonehe tsepamisa maikutlo le ho nka bohato butle, khatello ea maikutlo, pono e sa sebetseng, ho ferekana, ho thothomela, paresis, ho ferekana ha maikutlo, ho tsekela, ho ikutloa u se na thuso, ho lahleheloa ke boitaolo, ho hlasimoloha, ho tsitsipana, ho se tsitse ea e respiration, bradycardia, utloe letho, coma.

Ho tsoa ho ts'ilo ea lijo: ho nyekeloa ke pelo, ho hlatsa, lets'ollo, bohloko ba ka mpeng, ho sokela (ho teba ha matšoao ana ho fokotseha ha ho nooa ka lijo), ka seoelo - ts'oaetso ea sebete (hepatitis, mosebetsi o eketsehileng oa hepatic transaminase, alkaline phosphatase, cholestatic jaundice - e hloka ho tlosoa hoa lithethefatsi).

Ho tsoa lithong tsa hemopoietic: thibelo ea masapo a hematopoiesis (anemia, thrombocytopenia, leukopenia, granulocytopenia).

Litla-morao tsa ho nyekeloa: ho hlohlona ha letlalo, urticaria, lekhopho la letlalo, ho kenyeletsoa maculopapular and bullous), erythema.

Tse ling: ho sitisoa ha pono.

Litla-morao tse tloaelehileng tsa derivatives ea sulfonylurea: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, allergic vasculitis, ho se sebetse hantle hoa sebete.

Bongata

Matšoao: hypoglycemia, ho akheha ka letsoalo, ho ferekana kelellong.

Phekolo: haeba mokuli a hlokahalletse, nka tsoekere kahare.

Mohlomong nts'etsopele ea maemo a matla a hypoglycemic, e tsamaeang le komisi, ho akheha kapa mathata a mang a methapo ea methapo. Haeba matšoao a joalo a hlaha, ho hlokahala tlhokomelo ea tšohanyetso ea bongaka le ho kena sepetlele hang-hang.

Haeba hypoglycemic coma e belaelloa kapa e fumanoa, mokuli o kenngoa ka potlako ka 50 ml ea tharollo ea 40% ea dextrose (glucose). Ebe tharollo ea 5% ea dextrose (glucose) e kenngoa kahare ho boloka sekhahla se hlokahalang sa tsoekere maling.

Kamora ho hlaphoheloa kelellong, ho bohlokoa ho fa mokuli lijo tse nang le lik'habohaedreite tse bonolo tse tsoang habonolo (e le ho qoba tsoelopele ea hypoglycemia). Ho lekola ka hloko maemo a tsoekere ea mali le ho hlahloba mokuli ho lokela ho etsoa bonyane lihora tse 48 tse latelang. Kamora nako ena ea nako, ho latela boemo ba mokuli, ngaka e eang e nka qeto ea tlhoko ea tlhahlobo e ngoe hape.

Ho buoa ka methapo ha ho na thuso ka lebaka la ho tlangoa ha gliclazide liprotheine tsa plasma.

Letsatsi la ho felloa ke nako: Lilemo tse 3

Maemo a ho abjoa ho tsoa litlolong tsa litlama: Ka lengolo la ngaka.

Moetsi: SYNTHESIS, OJSC (Russia)