Hypoglycemic drug Maninil le lingoloa tsa eona
TLOTLISO Fomu ea tokollo Sebopeho Ho paka Ketso ea pharmacological Mofumahali Maninil, matšoao a sebelisoa Contraindication Tekanyetso le tsamaiso Bokhachane le pelehi Litlamorao Litaelo tse khethehileng Ho susumetsa bokhoni ba ho khanna makoloi le mekhoa e meng e hlokang tlhokomelo e matla Ho sebelisana le lithethefatsi Bongata Maemo a polokelo Letsatsi la ho felloa ke nako 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. 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 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. 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. 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:
ts'ebeliso ea lithethefatsi
Maninil
Lipilisi
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)
ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea likarete tsa 30 kapa 60 likhomphutha.
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.
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.
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.
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.
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.
Setlhare sena se kopantsoe hore se sebelisoe nakong ea kemaro le nakong ea kanyeso.
Ha ho ima ho etsahala, moriana o lokela ho emisoa.
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.
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.
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 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.
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.
Boloka sebakeng se lefifi ka mocheso o sa feteng 25 ° C.
Lilemo tse 3Feature
Li-analog mabapi le sebopeho le pontšo ea ts'ebeliso
Sehlooho Theko ho la Russia Theko Ukraine Glibenclamide Glibenclamide 30 rub 7 UAH Glibenclamide-Health Glibenclamide -- 12 UAH Li-analoggs ka pontšo le mokhoa oa ts'ebeliso
Sehlooho Theko ho la Russia Theko Ukraine Glyurenorm glycidone 94 rub 43 UAH Bisogamma Glyclazide 91 rub 182 UAH Glidiab Glyclazide 100 rub 170 UAH Diabeteson MR -- 92 UAH Diagnizide mr Gliclazide -- 15 UAH Glidia MV Gliclazide -- -- Glykinorm Gliclazide -- -- Gliclazide Gliclazide 231 rub 57 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 Gliclazide 4 rub -- Amaril 27 rub 4 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 glimepiride 27 rub 42 UAH Glimepiride-teva glimepiride -- 57 UAH Glimepiride Canon glimepiride 50 rub -- Glimepiride Pharmacyard glimepiride -- -- Dimaril glimepiride -- 21 UAH Glamepiride diamerid 2 rub -- Moetso o fapaneng o kanna oa lumellana ho bonts'a mokhoa le mokhoa oa ts'ebeliso
Sehlooho Theko ho la Russia Theko Ukraine Rosiglitazone e sebetsang, metformin hydrochloride -- -- Bagomet Metformin -- 30 UAH Glucofage metformin 12 rub 15 UAH Glucophage xr metformin -- 50 UAH Reduxin Met Metformin, Sibutramine 20 rub -- Dianormet -- 19 UAH Diaformin metformin -- 5 UAH Metformin metformin 13 rub 12 UAH Metformin sandoz metformin -- 13 UAH Siofor 208 rub 27 UAH Foromo Metformin Hydrochloride -- -- Emnorm EP Metformin -- -- Megifort Metformin -- 15 UAH Metamine Metformin -- 20 UAH Metamine SR Metformin -- 20 UAH Metfogamma metformin 256 rub 17 UAH Tefor metformin -- -- Glycometer -- -- Glycomet SR -- -- Forthine 37 rub -- Metformin Canon metformin, ovidone K 90, starch ea poone, crospovidone, magnesium stearate, talc 26 rub -- Insuffor metformin hydrochloride -- 25 UAH Metformin-teva metformin 43 rub 22 UAH Diaformin SR metformin -- 18 UAH Mepharmil Metformin -- 13 UAH Metformin Farmland Metformin -- -- Amaryl M Limepiride Micronized, Metformin Hydrochloride 856 rub 40 UAH Glibomet glibenclamide, metformin 257 rub 101 UAH Glucovans glibenclamide, metformin 34 rub 8 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, sitagliptin 9 rub 1 UAH Velmetia metformin, sitagliptin 6026 rub -- Galvus Met vildagliptin, metformin 259 rub 1195 UAH Tripride glimepiride, metformin, pioglitazone -- 83 UAH Comboglize XR metformin, saxagliptin -- 424 UAH Comboglyz Prolong metformin, saxagliptin 130 rub -- Gentadueto linagliptin, metformin -- -- Vipdomet metformin, alogliptin 55 rub 1750 UAH Sinjardi empagliflozin, metformin hydrochloride 240 rub -- Voglibose Oxide -- 21 UAH Glutazone pioglitazone -- 66 UAH Dropia Sanovel pioglitazone -- -- Januvia sitagliptin 1369 rub 277 UAH Galvus vildagliptin 245 rub 895 UAH Onglisa saxagliptin 1472 rub 48 UAH Nesina alogliptin -- -- Vipidia alogliptin 350 rub 1250 UAH Trazhenta linagliptin 89 rub 1434 UAH Lixumia lixisenatide -- 2498 UAH Sebaka sa Guarem Guar 9950 rub 24 UAH Insvada repaglinide -- -- Novonorm Repaglinide 30 rub 90 UAH Repodiab Repaglinide -- -- Baeta Exenatide 150 rub 4600 UAH Baeta Long Exenatide 10248 rub -- Viktoza liraglutide 8823 rub 2900 UAH Saxenda liraglutide 1374 rub 13773 UAH Forksiga Dapagliflozin -- 18 UAH Forsiga Dapagliflozin 12 rub 3200 UAH Invocana canagliflozin 13 rub 3200 UAH Jardins Empagliflozin 222 rub 566 UAH Trulicity Dulaglutide 115 rub -- U ka fumana analogue e theko e tlaase ea moriana o theko e phahameng?
Matšoao a ho sebelisoa
Likarolo tsa litekanyetso le tsamaiso
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 Fomu ea tokollo Sebopeho Ho paka Ketso ea pharmacological Mofumahali Maninil, matšoao a sebelisoa Contraindication Tekanyetso le tsamaiso Bokhachane le pelehi Litlamorao Litaelo tse khethehileng Ho susumetsa bokhoni ba ho khanna makoloi le mekhoa e meng e hlokang tlhokomelo e matla Ho sebelisana le lithethefatsi Bongata Maemo a polokelo Letsatsi la ho felloa ke nako
ts'ebeliso ea lithethefatsi
Maninil
Lipilisi
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)
ka botlolong ea likhalase tsa likhomphutha tse 120., ka paketeng ea likarete tsa 30 kapa 60 likhomphutha.
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.
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.
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.
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.
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.
Setlhare sena se kopantsoe hore se sebelisoe nakong ea kemaro le nakong ea kanyeso.
Ha ho ima ho etsahala, moriana o lokela ho emisoa.
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.
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.
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 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.
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.
Boloka sebakeng se lefifi ka mocheso o sa feteng 25 ° C.
Lilemo tse 3