Hypoglycemic drug Maninil le lingoloa tsa eona

TLOTLISO
ts'ebeliso ea lithethefatsi
Maninil

Fomu ea tokollo
Lipilisi

Sebopeho
Letlapa le le leng le na le:
Lintho tse sebetsang: glibenclamide (ka sebopeho sa micronised) 1,75 mg.
Baeti: lactose monohydrate, starch ea litapole, gimetellosa, colloidal silicon dioxide, magnesium stearate, krimsson dae (Ponceau 4R) (E124)

Ho paka
ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea likarete tsa 30 kapa 60 likhomphutha.

Ketso ea pharmacological
Mofumahali
Oral hypoglycemic drug ho tsoa sehlopheng sa sulfonylurea e tsoang molokong oa bobeli.
E hlohlelletsa secretion ka ho tlama ho li-receptor tse khethehileng tsa "pancreatic β-cell", e fokotsa monyako oa pancreatic β-cell glucose, e eketsa kutloisiso ea insulin le ho tlama ha eona ho lisele tsa sepheo, e eketsa ts'ebetso ea insulin, e ntlafatsa phello ea insulin mabapi le tsoekere ea glucose le sebete, ka tsela eo li fokotsa phallo ea glucose maling. E sebetsa mohatong oa bobeli oa insulin secretion. E thibela lipolysis ka har'a lithane tsa adipose. E na le phello ea ho fokotsa lipid, e fokotsa mali a mali.
Maninil® 1.5 le Maninil® 3.5 ka sebopeho sa micronized ke theknoloji e phahameng haholo, haholo fatše ea glibenclamide, e lumellang sethethefatsi hore se kenngoe kahare ho tšilo ea lijo kapele. Mabapi le phihlello ea pejana ea Cmax ea glibenclamide ho plasma, phello ea hypoglycemic e batla e lekana le keketseho ea khatello ea tsoekere maling maling ka mor'a ho ja, e etsang hore litlamorao tsa sethethefatsi li nolofale 'meleng. Nako ea ketso ea hypoglycemic ke lihora tse 20-25.
Phello ea hypoglycemic ea lithethefatsi Maninil® 5 e hlaha kamora lihora tse peli 'me e nka lihora tse 12.

Mofumahali
Suction
Kamora ho ts'oaroa ha Maninil 1.75 le Maninil 3.5, ho amoheloa ka potlako le ka mokhoa o felletseng ho tsoa pampiring ea mpa ho bonahala. Ho lokolloa ka botlalo ha ntho e sebetsang ea microionised ho etsahala nakong ea metsotso e 5.
Kamora ho ts'oaroa ha Maninil 5, ho amoheloa mokhoeng oa mpa ke 48-84%. Tmax - lihora tse 1-2. Bioavailability e felletseng - 49-59%.
Tsamaiso
Ho kopanya protheine ea Plasma ho feta 98% bakeng sa Maninil 1.75 le Maninil 3.5, 95% bakeng sa Maninil 5.
Metabolism le excretion
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 Maninil 1.75 le Maninil 3.5 ke lihora tse 1.5-3,5, bakeng sa Maninil 5 - 3-16 lihora.

Maninil, matšoao a sebelisoa
Type 2 lefu la tsoekere la mellitus (le sa itšetlehang ka insulin) ka ho se sebetse hantle kalafong ea ho ja, ho theola boima ba 'mele ka botenya le ho ikoetlisa ka ho lekaneng.

Contraindication
Hypersensitivity (ho kenyelletsa le lithethefatsi tsa sulfonamide le tse ling tse tsoang sulfonylurea), mofuta oa 1 lefu la tsoekere mellitus (le itšetlehileng ka insulin), metaboliki decompensation (ketoacidosis, precoma, komisi), pancreatic resection, sebete se matla le mafu a liphio, maemo a mang a hlobaetsang (mohlala, ho bolaoa ha metabolism ea carbohydrate mefuteng ea mafu a tšoaetsanoang, ho cha, likotsi kapa kamora ho buuoa ho hoholo ha ho bontšoa kalafo ea insulin), leukopenia, ho thijoa ke mala, paresis ea mala. maemo a tsamaeang le malabsorption ea lijo le nts'etsopele ea hypoglycemia, ho ima le nako ea ho anyesa.

Tekanyetso le tsamaiso
Maninyl 1.75 e nooa ka molomo, hoseng le mantsiboea, pele ho lijo, ntle le ho hlafuna. Tekanyetso e beoa ka bonngoe, ho latela boteng ba lefu lena.
Tekanyetso ea pele ke Letlhare la 1/2, karolelano ke matlapa a mabeli. ka letsatsi, boholo - 3, maemong a ikhethang - matlapa a 4. ka letsatsi. Haeba ho hlokahala ho nka tekanyetso e phahameng ea lithethefatsi (ho fihlela ho 14 mg / ka letsatsi), ba fetohela maninil ea 3.5 mg.

Bokhachane le pelehi
Setlhare sena se kopantsoe hore se sebelisoe nakong ea kemaro le nakong ea kanyeso.
Ha ho ima ho etsahala, moriana o lokela ho emisoa.

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.

Litaelo tse khethehileng
Nakong ea kalafo le Maninil®, ho bohlokoa ho latela ka hloko litlhahiso tsa ngaka mabapi le ho ja le ho itlhahloba ha khatello ea tsoekere ea mali.
Ho itima lijo nako e telele, ho haella ha lik'habohaedreite, ho ikoetlisa ka matla, ho ts'oaroa ke lets'ollo kapa ho hlatsa ho ka beha kotsi ea hypoglycemia.
Tšebeliso e tšoanang ea lithethefatsi ka sepheo sa tsamaiso ea methapo e kholo, ho theola khatello ea mali (ho kenyelletsa le beta-blockers), le neuropathy ea peripheral, e ka koala matšoao a hypoglycemia.
Ho bakuli ba tsofetseng, menyetla ea ho ba le hypoglycemia e phahame hanyane, ka hona, ho khethoa ka hloko ha tekanyetso ea lithethefatsi le ho lekola kamehla khatello ea tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja, haholo-holo qalong ea kalafo.
Joala bo ka tsosa nts'etsopele ea hypoglycemia, le nts'etsopele ea karabelo e kang ea disulfiram (ho nyekeloa ke pelo, ho hlatsa, bohloko ba ka mpeng, ho utloa mocheso sefahlehong le bokaholimo ba tachycardia, ho tsekela hlooho, hlooho), ka hona, o lokela ho hana ho noa joala nakong ea kalafo le Maninil®.
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.
Nakong ea kalafo, ho pepesetsoa letsatsi nako e telele ha ho khothalletsoe.

Ho susumetsa bokhoni ba ho khanna makoloi le mekhoa e meng e hlokang tlhokomelo e matla
Nakong ea kalafo, bakuli ba lokela ho ba hlokolosi ha ba khanna makoloi le lintho tse ling tse ka bang kotsi tse hlokang tlhokomelo e eketsehileng le lebelo la karabelo ea psychomotor.

Ho sebelisana le lithethefatsi
Ho ntlafatsa phello ea hypoglycemic ea Maninil ® hoa khoneha ha u ntse u nka li-inhibitors tsa ACE, li-anabolic agents le lihormone tsa banna tsa botona le botšehali, li-agent tse ling tsa molomo tsa hypoglycemic (mohlala, acarbose, biguanides) le li-insulin, azapropazone, NSAIDs, beta-adrenergic blockers, chlorofibrinol derivatives, chinofenoliviv analogues, coumarin derivatives, disopyramide, fenfluramine, lithethefatsi tsa antifungal (miconazole, fluconazole), fluoxetine, MAO inhibitors, PA SC, pentoxifylline (ka tekanyetso e phahameng ea tsamaiso ea batsoali), perhexylin, 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 Maninil® ka ho fokotsa tekanyo ea ho ikarola ha eona le ho eketsa botjha ba eona.
Phello ea hypoglycemic ea Maninil® e ka fokotseha ka tšebeliso ea nako e le 'ngoe ea barbiturates, isoniazid, diazoxide, GCS, glucagon, nicotinates (ka tekanyetso e phahameng), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, li-hormone tsa estrogen le estrogen. , li-blockers tsa liteishene tsa calcium tse liehang, letsoai la lithium.
Bahanyetsi ba H2 receptor ba ka fokolisa, ka lehlakoreng le leng, le ho ntlafatsa phello ea hypoglycemic ea Maninil® ka lehlakoreng le leng.
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®, phello ea melemo ea coumarin e ka eketseha kapa ea fokotseha.
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
Matšoao: hypoglycemia (tlala, hyperthermia, tachycardia, ho otsela, bofokoli, mongobo letlalong, tšebelisano e mpe ea ho sisinyeha, ho thothomela, ho tšoenyeha ka kakaretso, tšabo, ho opeloa ke hlooho, mathata a amanang le methapo ea kelello (seh., Mathata a pono le a puo, paresis kapa ho holofala kapa maikutlo a fetotsoeng a maikutlo.) Ka ho eketseha ha hypoglycemia, bakuli ba ka lahleheloa ke boitšoaro le nts'etsopele, kholo ea kholo 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.

Maemo a polokelo
Boloka sebakeng se lefifi ka mocheso o sa feteng 25 ° C.

Letsatsi la ho felloa ke nako
Lilemo tse 3

Feature

Ho sebetsa e le taolo ea metabolism ea glucose, Manin, ha e kenella, e eketsa tlhoko ea insulin-receptors, e tsosa ho lokolloa ha insulin ea insulin ke manyeme.

Ntle le moo, e hatella gluconeogenesis ea hepatic le glycogenolysis, e thibela glucose lipolysis, 'me e fokotsa mali a "thrombogenicity". Nako ea phello ea hypoglycemic e hlahisoang ke moriana lihora tse 2 kamora ts'ebetso ke lihora tse ka bang 12.

Letlapa Glibenclamide Maninyl 3.5 mg

Karolo e sebetsang ea tsoekere ea tsoekere ea Maninil - glibenclamide, e hlahisitsoeng ka sebopeho sa micron, e na le phello e bobebe ea 'mele, e kenang ka potlako ka mpeng ka 48-84%. Kamora ho sebelisa moriana, ho lokolloa ka botlalo ha glibenclamide ho hlaha ka nako ea metsotso e 5. Motsoako o sebetsang o robehile ka botlalo ka har'a sebete 'me o supe ke liphio le bile.

Setlhare sena se hlahisoa ka sebopeho sa likhalase tsa mohala o nang le likhakanyo tsa hau tsa 1 tse sebetsang:

Matlapa a sephara-cylindrical a le sebopeho, a na le chamfer le letšoao le sebelisitsoeng ho o mong oa mabala, 'mala ke pinki.

Moetsi oa sethepu ke FC Berlin-Chemie; ka har'a meriana ho fanoa ka litlatsetso feela. Setlhare sena se kentsoe ka libotlolong tsa khalase e bonaletsang, li-pcs tse lekholo tse 120 ka 'ngoe. ka ho le leng, libotlolo ka botsona li tlatsitsoe ka lebokoseng la karete. Tsela ea Latin ea Maninil ke e latelang: Maninil.

Ho latela liphuputso, ho latela tekanyetso e lekaneng ha u sebelisa moriana ona kannete ho fokotsa monyetla oa ho ba le pelo le mathata a mang a bakoang ke lefu la tsoekere le sa ts'epeng insulin, ho kenyeletsa le lefu le amanang le lefu lena.

Li-analog mabapi le sebopeho le pontšo ea ts'ebeliso

SehloohoTheko ho la RussiaTheko Ukraine
Glibenclamide Glibenclamide30 rub7 UAH
Glibenclamide-Health Glibenclamide--12 UAH

Lethathamo le ka holimo la li-analogues tsa lithethefatsi, tse bontshang Maninil ea nkang sebaka, e loketse haholo hobane e na le sebopeho se tšoanang sa lintho tse sebetsang ebile e lumellana ho latela sesupo sa tšebeliso

Li-analoggs ka pontšo le mokhoa oa ts'ebeliso

SehloohoTheko ho la RussiaTheko Ukraine
Glyurenorm glycidone94 rub43 UAH
Bisogamma Glyclazide91 rub182 UAH
Glidiab Glyclazide100 rub170 UAH
Diabeteson MR --92 UAH
Diagnizide mr Gliclazide--15 UAH
Glidia MV Gliclazide----
Glykinorm Gliclazide----
Gliclazide Gliclazide231 rub57 UAH
Glyclazide 30 MV-Indar Glyclazide----
Glyclazide-Health Gliclazide--36 UAH
Glioral Glyclazide----
Lekola Gliclazide--14 UAH
Diazide MV Gliclazide--46 UAH
Osliklid Gliclazide--68 UAH
Diadeon gliclazide----
Glyclazide MV Gliclazide4 rub--
Amaril 27 rub4 UAH
Glemaz glimepiride----
Glian glimepiride--77 UAH
Glimepiride Glyride--149 UAH
Glimepiride diapiride--23 UAH
Aletare --12 UAH
Glimax glimepiride--35 UAH
Glimepiride-Lugal glimepiride--69 UAH
Clay Glimepiride--66 UAH
Diabrex glimepiride--142 UAH
Meglimide glimepiride----
Melpamide Glimepiride--84 UAH
Perinel glimepiride----
Glempid ----
Ke thabo ----
Glimepiride glimepiride27 rub42 UAH
Glimepiride-teva glimepiride--57 UAH
Glimepiride Canon glimepiride50 rub--
Glimepiride Pharmacyard glimepiride----
Dimaril glimepiride--21 UAH
Glamepiride diamerid2 rub--

Moetso o fapaneng o kanna oa lumellana ho bonts'a mokhoa le mokhoa oa ts'ebeliso

SehloohoTheko ho la RussiaTheko Ukraine
Rosiglitazone e sebetsang, metformin hydrochloride----
Bagomet Metformin--30 UAH
Glucofage metformin12 rub15 UAH
Glucophage xr metformin--50 UAH
Reduxin Met Metformin, Sibutramine20 rub--
Dianormet --19 UAH
Diaformin metformin--5 UAH
Metformin metformin13 rub12 UAH
Metformin sandoz metformin--13 UAH
Siofor 208 rub27 UAH
Foromo Metformin Hydrochloride----
Emnorm EP Metformin----
Megifort Metformin--15 UAH
Metamine Metformin--20 UAH
Metamine SR Metformin--20 UAH
Metfogamma metformin256 rub17 UAH
Tefor metformin----
Glycometer ----
Glycomet SR ----
Forthine 37 rub--
Metformin Canon metformin, ovidone K 90, starch ea poone, crospovidone, magnesium stearate, talc26 rub--
Insuffor metformin hydrochloride--25 UAH
Metformin-teva metformin43 rub22 UAH
Diaformin SR metformin--18 UAH
Mepharmil Metformin--13 UAH
Metformin Farmland Metformin----
Amaryl M Limepiride Micronized, Metformin Hydrochloride856 rub40 UAH
Glibomet glibenclamide, metformin257 rub101 UAH
Glucovans glibenclamide, metformin34 rub8 UAH
Dianorm-m Glyclazide, Metformin--115 UAH
Dibizid-m glipizide, metformin--30 UAH
Douglimax glimepiride, metformin--44 UAH
Duotrol glibenclamide, metformin----
Gluconorm 45 rub--
Glibofor metformin hydrochloride, glibenclamide--16 UAH
Avandamet ----
Avandaglim ----
Janumet metformin, sitagliptin9 rub1 UAH
Velmetia metformin, sitagliptin6026 rub--
Galvus Met vildagliptin, metformin259 rub1195 UAH
Tripride glimepiride, metformin, pioglitazone--83 UAH
Comboglize XR metformin, saxagliptin--424 UAH
Comboglyz Prolong metformin, saxagliptin130 rub--
Gentadueto linagliptin, metformin----
Vipdomet metformin, alogliptin55 rub1750 UAH
Sinjardi empagliflozin, metformin hydrochloride240 rub--
Voglibose Oxide--21 UAH
Glutazone pioglitazone--66 UAH
Dropia Sanovel pioglitazone----
Januvia sitagliptin1369 rub277 UAH
Galvus vildagliptin245 rub895 UAH
Onglisa saxagliptin1472 rub48 UAH
Nesina alogliptin----
Vipidia alogliptin350 rub1250 UAH
Trazhenta linagliptin89 rub1434 UAH
Lixumia lixisenatide--2498 UAH
Sebaka sa Guarem Guar9950 rub24 UAH
Insvada repaglinide----
Novonorm Repaglinide30 rub90 UAH
Repodiab Repaglinide----
Baeta Exenatide150 rub4600 UAH
Baeta Long Exenatide10248 rub--
Viktoza liraglutide8823 rub2900 UAH
Saxenda liraglutide1374 rub13773 UAH
Forksiga Dapagliflozin--18 UAH
Forsiga Dapagliflozin12 rub3200 UAH
Invocana canagliflozin13 rub3200 UAH
Jardins Empagliflozin222 rub566 UAH
Trulicity Dulaglutide115 rub--

U ka fumana analogue e theko e tlaase ea moriana o theko e phahameng?

Ho fumana analogue e theko e phahameng ea moriana, mofuta oa generic kapa lebitso, pele ho tsohle re khothaletsa ho ela hloko sebopeho, e leng lintho le lipontšo tse tšoanang tse sebetsang. Metsoako e tšoanang ea lithethefatsi e tla bonts'a hore lithethefatsi li tsamaisana le lithethefatsi, li ka lekana meriana kapa li ka etsa meriana. Leha ho le joalo, u se ke oa lebala ka likarolo tse sa sebetseng tsa lithethefatsi tse tšoanang, tse ka amang polokeho le ts'ebetso. Se ke la lebala ka litaelo tsa lingaka, ho itlama ho ka lematsa bophelo ba hau, ka hona, etela ngaka ea hau kamehla pele u sebelisa meriana leha e le efe.

Matšoao a ho sebelisoa

Tsamaiso ea Manilin e bontšoa bakeng sa ho khetholla mofuta o ikemetseng oa insulin oa lefu la tsoekere mellitus (ea mofuta oa bobeli). E ka hlalosoa e le tekanyetso e ikemetseng kapa hammoho le meriana e meng ea hypoglycemic. Phapang ke tsamaiso e kopaneng ea li-glinides le tse tsoang ho sulfonylurea.

Likarolo tsa litekanyetso le tsamaiso

Ho kenella Maninil pele ho buelloa pele lijo, ho hlatsuoa ho sa hlakeloe.

Tekanyetso ea letsatsi le letsatsi e khethoa ke setsebi sa ts'ebetso ea endocrinologist ka bonngoe:

  1. haeba e sa fetise matlapa a mabeli ka letsatsi, moriana o nooa hang, ka ho khetheha hoseng - pele ho lijo tsa hoseng.
  2. ha u fana ka tekanyetso e phahameng, tšebeliso ea moriana e etsoa ho litekanyetso tse 2 - hoseng - pele ho lijo tsa hoseng le mantsiboea - pele ho lijo tsa mantsiboea.

Mabaka a khethollang ho khethoa mokhoa oa kalafo ke palo ea lilemo, boteng ba lefu lena, le khatello ea mali maling ka mpeng e se nang letho le kamora ho ja ka mor'a lihora tse peli.

Tabeng ea ts'ebeliso e tlase ea moriana o boletsoeng ke ngaka, ho ka etsoa qeto ea ho e eketsa. Ts'ebetso ea ho eketsa litekanyetso ho ea boemong bo nepahetseng e etsoa butle-butle - ho tloha matsatsing a mabeli ho isa ho a supileng, kamehla e le tlasa taolo ea ngaka.

Tabeng ea ho fetohela Maninil ho tloha litokisetsong tse ling tsa kalafo ka phello ea hypoglycemic, tsamaiso ea eona e laetsoe ka tekanyetso e tloaelehileng ea tekanyetso, haeba ho hlokahala, e eketseha, e etsoa hantle ntle le taolo ea bongaka.

Tekanyetso ea mantlha ea mantlha ea Maninil:

  • e nang le 1,75 mg ea motsoako o sebetsang - ke matlapa a 1-2 hang ka letsatsi. Tekanyetso e phahameng ha e fetisetse matlapa a 6 ka letsatsi,
  • e nang le 3.5 mg ea ntho e sebetsang - Letlapa la 1 / 2-1 hang ka letsatsi. Tekanyetso e kholo ke matlapa a 3 ka letsatsi,
  • e nang le 5 mg ea motsoako o sebetsang - Letlapa le le 1 la 1 ka letsatsi. Tekanyetso e kholo e lumelletsoeng ho pholletsa le letsatsi ke matlapa a 3.

Batho ba baholo (ba kaholimo ho lilemo tse 70), ba latela lithibelo tsa lijo, hammoho le ba nang le bothata ba ho fokola ka mpeng kapa ka lebaka la tšokelo ea hypoglycemia, ho khothaletsoa ho sebelisa litekanyetso tse theotsoeng tsa moriana.

Haeba u fetoa ke tekanyetso e le 'ngoe, tekanyetso e latelang ea Maninil e etsoa ka tekanyetso e tloaelehileng (ntle le keketseho) ka nako e tloaelehileng.

Litlamorao

Lefu la tsoekere le tšaba pheko ena, joalo ka mollo!

U hloka ho kenya kopo ...

Ponahalo ea ho ferekana ha ts'ebetso ea litsamaiso tse ling ha e ntse e nka Maninil e bonoa seoelo. Lipontšo tsa bona tse sa tloaelehang lia khoneha:

  • ho tsoa mokokotlong oa mpa - ka mokhoa oa ho nyekeloa, ho beoa, ho utloa bohloko ka mpeng, ho bonahala eka tatso ea tšepe e ka molomong, lets'ollo,
  • ho tsoa ho sebete - ka mokhoa oa ts'ebetso ea nakoana ea li-enzyme tsa sebete, nts'etsopele ea intrahepatic cholestasis kapa hepatitis,
  • lehlakoreng la metabolism - ka mokhoa oa ho phahamisa boima ba 'mele kapa hypoglycemia e nang le matšoao a eona - ho thothomela, ho fufuleloa ho eketsehileng, ho tšoenyeha ha boroko, ho tšoenyeha, migraine, pono kapa puo e sa sebetseng.
  • ka lehlakoreng la boits'ireletso - ka mokhoa o fapaneng oa ho ama letlalo ka lera - petechiae, ho hlohlona, ​​hyperthermia, photosensitivity le ba bang,
  • ho tsoa ho hematopoietic system - ka mokhoa oa thrombocytopenia, hemolytic anemia, erythrocytopenia,
  • karolong ea litho tse bonoang - ka mokhoa oa tlolo ea bolulo.

Ntlha ea bohlokoa ha u ntse u nka Maninil ke ho latela ditaelo tsa bongaka ka botlalo mabapi le ho ja le ho itlhokomela lero la plasma. Haeba ho na le bongoana bo bongata, hypoglycemia e ka hlaha le matšoao a eona.

Ha ho na le matšoao a bobebe a bosholu ba joala, ho kgothaletswa ho ja tsoekere e nyane kapa lijo tse nang le lik'habohaedreite tse bonolo tse jang lijo. Mabapi le mefuta e matla ea overdose, iv ente ea glucose tharollo e laetsoe. Sebakeng sa glucose, ente ea glucagon ea IM kapa subcutaneous ea glucagon e amoheleha.


Kotsi ea hypoglycemia e eketseha haeba:

  • joala
  • khaello ea lik'habohaedreite
  • nako e telele pakeng tsa lijo,
  • ho hlatsa kapa ho nyekeloa,
  • ho ikoetlisa ka matla.

Matšoao a hypoglycemia a ka koaheloa ha a ntse a nka Maninil ka meriana e amang methapo ea kutlo kapa e ka fokotsang khatello ea mali.

Matla a Maninil a ka fokotsoa ha a ntse a sebelisoa ka li-barbiturates, taolo ea bokhachane le lithethefatsi tse ling tse thehiloeng ho li-hormone. Ho fapana le hoo, tšebeliso e tšoanang ea li-anticoagulants, reserpine, tetracyclines, anabolic steroids e khona ho matlafatsa ketso ea eona.

Meeli le likhaello

Ha o sebetsana le Maninil, ho kgothaletswa ho qoba ho pepesetsoa nako e telele, le ho ba hlokolosi ha o khanna koloi, o etsa ba bang ba hlokang ho tsotelloa, ho tsepamisa mohopolo le mesebetsi e potlakileng ea karabelo.

Setlhare sa hypoglycemic se loants'oa ketsahalong ea ho ba teng:

  • lefu la tsoekere le itšetlehileng ka insulin
  • ho hloleha ha sebete
  • mala,
  • lefu la tsoekere ketoacidosis,
  • lefu la tsoekere kapa letšollo,
  • paresis ea mala
  • leukopenia
  • lactose ho hloka mamello le ho haella ha lactase,
  • tlatsetso habonolo ho karolo e sebetsang - glibenclamide kapa likarolo tse ling tse teng sebopeho sa moriana,
  • hypersensitivity ho PSM, hammoho le sulfonamides le diuretics tse nang le lintlha tse tsoang ho sehlopha sa sulfonamide,
  • ho tlosoa ha manyeme.

Ho hlakoloa ha Maninil le ho nkeloa sebaka sa insulin ho etsoa haeba:

  • mafu a tšoaetsanoang a tsamaeang le lipontšo tsa febrile,
  • lits'ebetso tse hlaselang
  • ho chesa haholo,
  • likotsi
  • boimana kapa tlhoko ea letsoele.

Ka hlokolosi, sethethefatsi sena se lokela ho nkuoa ha ho e-na le mathata a tšoelesa ea qoqotho.

Moriana oa hypoglycemic o tšoaelitsoe bana.

Mokhoa oa ho khutlisa Maninil: analogues le theko

Joalo ka lithethefatsi tse ngata, Maninil o na le lipono le li-analogues. Ketso e ts'oanang e na le meriana e fokotsang tsoekere, motsoako o sebetsang oa eona e leng glibenclamide.

Maninyl 3,5 analogue e na le tse latelang:

  • Glibomet - ho tloha li-ruble tse 339,
  • Glibenclamide - ho tloha li-ruble tse 46,
  • Maninil 5 - ho tloha ho li-ruble tse 125.

Bakuli mabapi le analogues ba na le lipotso tse 'maloa, mohlala, ke eng e betere - Maninil kapa Glibenclamide? Tabeng ena, tsohle li bonolo. Glibenclamide ke Maninil. Karolo ea bobeli feela ke mofuta oa theknoloji e phahameng ea boleng bo phahameng e ikhethang.

Mme ke eng e betere - Maninil kapa Glidiab? Tabeng ena, ha ho na karabo e tobileng, hobane ho hongata ho latela litšobotsi tsa motho ka mong.

Analogues ea Maninil bakeng sa lefu la tsoekere la mofuta oa 2 ka phello ea kalafo:


  • Amaril - ho tloha li-ruble tse 350,
  • Vazoton - ho tloha li-ruble tse 246,
  • Arfazetin - ho tloha li-ruble tse 55,
  • Glucophage - ho tloha ho li-ruble tse 127,
  • Listata - ho tloha li-ruble tse 860,
  • Diabetes - ho tloha ho li-ruble tse 278,
  • Xenical - ho tloha li-ruble tse 800,
  • le ba bang.

Ha ba khetha analogue ea Maninil, litsebi li khothaletsa ho fana ka lithethefatsi tse entsoeng ke likhamphani tsa meriana tsa Majapane, tsa Amerika le tsa Bophirimela: Gideon Richter, Krka, Zentiv, Hexal le ba bang.

Taeo ea Maninil

TLOTLISO
ts'ebeliso ea lithethefatsi
Maninil

Fomu ea tokollo
Lipilisi

Sebopeho
Letlapa le le leng le na le:
Lintho tse sebetsang: glibenclamide (ka sebopeho sa micronised) 1,75 mg.
Baeti: lactose monohydrate, starch ea litapole, gimetellosa, colloidal silicon dioxide, magnesium stearate, krimsson dae (Ponceau 4R) (E124)

Ho paka
ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea likarete tsa 30 kapa 60 likhomphutha.

Ketso ea pharmacological
Mofumahali
Oral hypoglycemic drug ho tsoa sehlopheng sa sulfonylurea e tsoang molokong oa bobeli.
E hlohlelletsa secretion ka ho tlama ho li-receptor tse khethehileng tsa "pancreatic β-cell", e fokotsa monyako oa pancreatic β-cell glucose, e eketsa kutloisiso ea insulin le ho tlama ha eona ho lisele tsa sepheo, e eketsa ts'ebetso ea insulin, e ntlafatsa phello ea insulin mabapi le tsoekere ea glucose le sebete, ka tsela eo li fokotsa phallo ea glucose maling. E sebetsa mohatong oa bobeli oa insulin secretion. E thibela lipolysis ka har'a lithane tsa adipose. E na le phello ea ho fokotsa lipid, e fokotsa mali a mali.
Maninil® 1.5 le Maninil® 3.5 ka sebopeho sa micronized ke theknoloji e phahameng haholo, haholo fatše ea glibenclamide, e lumellang sethethefatsi hore se kenngoe kahare ho tšilo ea lijo kapele. Mabapi le phihlello ea pejana ea Cmax ea glibenclamide ho plasma, phello ea hypoglycemic e batla e lekana le keketseho ea khatello ea tsoekere maling maling ka mor'a ho ja, e etsang hore litlamorao tsa sethethefatsi li nolofale 'meleng. Nako ea ketso ea hypoglycemic ke lihora tse 20-25.
Phello ea hypoglycemic ea lithethefatsi Maninil® 5 e hlaha kamora lihora tse peli 'me e nka lihora tse 12.

Mofumahali
Suction
Kamora ho ts'oaroa ha Maninil 1.75 le Maninil 3.5, ho amoheloa ka potlako le ka mokhoa o felletseng ho tsoa pampiring ea mpa ho bonahala. Ho lokolloa ka botlalo ha ntho e sebetsang ea microionised ho etsahala nakong ea metsotso e 5.
Kamora ho ts'oaroa ha Maninil 5, ho amoheloa mokhoeng oa mpa ke 48-84%. Tmax - lihora tse 1-2. Bioavailability e felletseng - 49-59%.
Tsamaiso
Ho kopanya protheine ea Plasma ho feta 98% bakeng sa Maninil 1.75 le Maninil 3.5, 95% bakeng sa Maninil 5.
Metabolism le excretion
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 Maninil 1.75 le Maninil 3.5 ke lihora tse 1.5-3,5, bakeng sa Maninil 5 - 3-16 lihora.

Maninil, matšoao a sebelisoa
Type 2 lefu la tsoekere la mellitus (le sa itšetlehang ka insulin) ka ho se sebetse hantle kalafong ea ho ja, ho theola boima ba 'mele ka botenya le ho ikoetlisa ka ho lekaneng.

Contraindication
Hypersensitivity (ho kenyelletsa le lithethefatsi tsa sulfonamide le tse ling tse tsoang sulfonylurea), mofuta oa 1 lefu la tsoekere mellitus (le itšetlehileng ka insulin), metaboliki decompensation (ketoacidosis, precoma, komisi), pancreatic resection, sebete se matla le mafu a liphio, maemo a mang a hlobaetsang (mohlala, ho bolaoa ha metabolism ea carbohydrate mefuteng ea mafu a tšoaetsanoang, ho cha, likotsi kapa kamora ho buuoa ho hoholo ha ho bontšoa kalafo ea insulin), leukopenia, ho thijoa ke mala, paresis ea mala. maemo a tsamaeang le malabsorption ea lijo le nts'etsopele ea hypoglycemia, ho ima le nako ea ho anyesa.

Tekanyetso le tsamaiso
Maninyl 1.75 e nooa ka molomo, hoseng le mantsiboea, pele ho lijo, ntle le ho hlafuna. Tekanyetso e beoa ka bonngoe, ho latela boteng ba lefu lena.
Tekanyetso ea pele ke Letlhare la 1/2, karolelano ke matlapa a mabeli. ka letsatsi, boholo - 3, maemong a ikhethang - matlapa a 4. ka letsatsi. Haeba ho hlokahala ho nka tekanyetso e phahameng ea lithethefatsi (ho fihlela ho 14 mg / ka letsatsi), ba fetohela maninil ea 3.5 mg.

Bokhachane le pelehi
Setlhare sena se kopantsoe hore se sebelisoe nakong ea kemaro le nakong ea kanyeso.
Ha ho ima ho etsahala, moriana o lokela ho emisoa.

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.

Litaelo tse khethehileng
Nakong ea kalafo le Maninil®, ho bohlokoa ho latela ka hloko litlhahiso tsa ngaka mabapi le ho ja le ho itlhahloba ha khatello ea tsoekere ea mali.
Ho itima lijo nako e telele, ho haella ha lik'habohaedreite, ho ikoetlisa ka matla, ho ts'oaroa ke lets'ollo kapa ho hlatsa ho ka beha kotsi ea hypoglycemia.
Tšebeliso e tšoanang ea lithethefatsi ka sepheo sa tsamaiso ea methapo e kholo, ho theola khatello ea mali (ho kenyelletsa le beta-blockers), le neuropathy ea peripheral, e ka koala matšoao a hypoglycemia.
Ho bakuli ba tsofetseng, menyetla ea ho ba le hypoglycemia e phahame hanyane, ka hona, ho khethoa ka hloko ha tekanyetso ea lithethefatsi le ho lekola kamehla khatello ea tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja, haholo-holo qalong ea kalafo.
Joala bo ka tsosa nts'etsopele ea hypoglycemia, le nts'etsopele ea karabelo e kang ea disulfiram (ho nyekeloa ke pelo, ho hlatsa, bohloko ba ka mpeng, ho utloa mocheso sefahlehong le bokaholimo ba tachycardia, ho tsekela hlooho, hlooho), ka hona, o lokela ho hana ho noa joala nakong ea kalafo le Maninil®.
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.
Nakong ea kalafo, ho pepesetsoa letsatsi nako e telele ha ho khothalletsoe.

Ho susumetsa bokhoni ba ho khanna makoloi le mekhoa e meng e hlokang tlhokomelo e matla
Nakong ea kalafo, bakuli ba lokela ho ba hlokolosi ha ba khanna makoloi le lintho tse ling tse ka bang kotsi tse hlokang tlhokomelo e eketsehileng le lebelo la karabelo ea psychomotor.

Ho sebelisana le lithethefatsi
Ho ntlafatsa phello ea hypoglycemic ea Maninil ® hoa khoneha ha u ntse u nka li-inhibitors tsa ACE, li-anabolic agents le lihormone tsa banna tsa botona le botšehali, li-agent tse ling tsa molomo tsa hypoglycemic (mohlala, acarbose, biguanides) le li-insulin, azapropazone, NSAIDs, beta-adrenergic blockers, chlorofibrinol derivatives, chinofenoliviv analogues, coumarin derivatives, disopyramide, fenfluramine, lithethefatsi tsa antifungal (miconazole, fluconazole), fluoxetine, MAO inhibitors, PA SC, pentoxifylline (ka tekanyetso e phahameng ea tsamaiso ea batsoali), perhexylin, 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 Maninil® ka ho fokotsa tekanyo ea ho ikarola ha eona le ho eketsa botjha ba eona.
Phello ea hypoglycemic ea Maninil® e ka fokotseha ka tšebeliso ea nako e le 'ngoe ea barbiturates, isoniazid, diazoxide, GCS, glucagon, nicotinates (ka tekanyetso e phahameng), phenytoin, phenothiazines, rifampicin, thiazide diuretics, acetazolamide, li-hormone tsa estrogen le estrogen. , li-blockers tsa liteishene tsa calcium tse liehang, letsoai la lithium.
Bahanyetsi ba H2 receptor ba ka fokolisa, ka lehlakoreng le leng, le ho ntlafatsa phello ea hypoglycemic ea Maninil® ka lehlakoreng le leng.
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®, phello ea melemo ea coumarin e ka eketseha kapa ea fokotseha.
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
Matšoao: hypoglycemia (tlala, hyperthermia, tachycardia, ho otsela, bofokoli, mongobo letlalong, tšebelisano e mpe ea ho sisinyeha, ho thothomela, ho tšoenyeha ka kakaretso, tšabo, ho opeloa ke hlooho, mathata a amanang le methapo ea kelello (seh., Mathata a pono le a puo, paresis kapa ho holofala kapa maikutlo a fetotsoeng a maikutlo.) Ka ho eketseha ha hypoglycemia, bakuli ba ka lahleheloa ke boitšoaro le nts'etsopele, kholo ea kholo 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.

Maemo a polokelo
Boloka sebakeng se lefifi ka mocheso o sa feteng 25 ° C.

Letsatsi la ho felloa ke nako
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