Ko te raina Diapiride: he tohutohu hei whakamahi

He kaihoko hypoglycemic, he kohinga whanui-tuatoru-whakatipuranga o te mahi roa. Ko te pānga hypoglycemic o te tarukino na te tikanga uaua o te pancreatic me te mahi extrapancreatic.

Ko te mahi pancreatic kei roto i te whakaongaonga i te huna o te insulin e te pancreatic β-cell, me te whakaohooho me te whakapiki i te haumanu endogenous. Ko tenei paanga na te mea ko te glimepiride, me te nui o te whakakapi, ka whakakotahi me te aukati mai i te pūmua o te cells-pūtau o te pancreas, e hono ana ki nga paoma pāhono tiihi ATP, engari he rereke mai i te papaa o mua mo te sulfonylureas tuatahi me te 2. I te mutunga, ka tukuna te insulin e te exocytosis, engari ko te nui o te insulin huna e tino iti iho ana i raro i nga mahi a te konukawata a sulfonylurea tuku iho. Ko te tino ngawari o te whakaongaonga o te glimepiride i te whakamaoritanga o te insulin, e whakaratohia ana hoki te mate o te hypoglycemia.

Ko te hua o te extrapancreatic o te glimepiride e whakaatuhia ana e nga whaainga, ko te kaiarahi o te mea he piki ake o te maarama o nga kopa paitini (uaua me te ngako) ki te insulin me te piki haere o te tau me te mahi o te pūmua e kawe ana i te huka na roto i nga membrane pūtau, me te aukati i te whakahiatotanga o te huka i roto i te ate me te piki haere o te kukume o te fractose-2.6 β-phosphate te aukati i te gluconeogenesis. Ko etahi atu hua o te extrapancreatic o te glimepiride kei roto: te whakaheke o te whakahiatotanga o te platelet hei hua o te aukati o te COX me te hurihanga o te waikawa arachidonic ki te thromboxane A2, te whakahohe i te roopu harakeke, he piki ake i te taumata o te au-tocopherol endogenous me te mahi o te whakatipu antioxidant (catalase, glutathione peroxidase, ahotea, Kei te mau tonu i te mate huka mellitus, te painga anti-atherogen hei hua o te whakangao C. phospholipase C.

Kaore te Glimepiride e aukati i te taapiri hiko o te myocardium ki te ischemia (kaore i rite ki te glibenclamide).

Ko te hua hypoglycemic nui o te tarukino ka kitea e 2-3 haora i muri i te whakahaere, ka roa ake i te 24 haora ka whakawhirinaki te horopeta.

Na nga paatai maha o te glimepiride i te horopeta o ia ra ki te 4 mg, ko te kukume nui i roto i te serum toto e tae atu ana i muri ake i te 2.5 haora me te 309 ng / ml, he hononga hononga i waenga i te horopeta me te kukume nui o te glimepiride i roto i te toto, tae atu ki waenga i te horopeta me te rohe i raro o te kuru " - te wā. " Glimepiride he bioavailability tino. Kaore e pa ana te kai ki te hiawhiotanga, me te kore o te ngoikore o te huringa o te tere o te whakauru.

Ko te Glimepiride e whakaahuahia ana e te rahinga iti o te tohatoha (tata ki te 8,8 L), he rite ki te rōrahi o te tohatoha o te albumin, he tohu nui ki te hono ki te pūmua hinu toto (neke atu i te 99%) me te waatea iti o te auaha (mo te 48 ml / min). Ka uru te Glimepiride ki te miraka miraka a ma te arai hematoplacental, ka uru te BBB. Ko te Glimepiride te biotransformed i roto i te tinana ki te 2 metabolites, i hangaia hei hua o te pākia o te glimepiride i roto i te ate ko te hydroxyl me te carboxyl hauhautanga o te glimepiride. Ko te hawhe-ora o te glimepiride i tana kukū plasma i roto i te serum toto e pa ana ki te tikanga penehi maha ko te 5-8 haora. Ka mutu te tango i te glimepiride i te horopeta nui, ka piki te hawhe-ora. I muri i te horopeta waha kotahi o te glimepiride radiolabeled, 58% i kitea i te urine me te 35% i roto i te kaiha. Kaore i kitea te peke kaha ki te mimi ka kitea. Ko te hawhe-ora o te hydroxyl me te karawaka whakarereke o te glimepiride tata ki te 3-6 haora me te 5-6 haora, aua.

I roto i nga turoro o te ngoikoretanga o te mahi renal (iti te aukati i te aukati), ka kaha te whakapiki ake i te aukati o te glimepiride me te whakaheke i te toharite toharite o te toto, tera pea e kaha ana ki te tere ake o te raau taero na te kore o te aukati. Na, i tenei waahanga o nga turoro kaore he mate o te whakahekenga o te glimepiride.

Ko nga momo pharmacokinetic o te glimepiride he rite i roto i nga turoro o nga ira tangata me nga roopu reanga rereke.

Mellitus momo II mate mellitus (kore-insulin-e whakawhirinaki ana) ki nga pakeke he monotherapy ranei i te whakakotahi me te metformin, he insulin ranei.

Panui papa pararau

e mohiotia ana te hypersensitivity ki nga waahanga o te tarukino me nga turukuka sulfonylurea tetahi atu whakaritenga whakarite sulfonylamide ranei

momo mate mellitus m

ketoacidosis huka, mate komi huka

nui whakaharahara me te raru hepatic

hapūtanga me te kōtaha

tamariki kei raro iho i te 18 tau

tarukino sangkapterine zhne sulfonylurea tuyndylaryna nemese basқa sulfonylamidtik te whakarite tarғa belgilі zhoғary sezmtaldy

insulin tәuдldi Ahau te momo mate huka

ketoacidosis huka, mate komi huka

bauyr zhne bүyrek mahi a te tama ң auyr bұzylulary

zhktіlіk zhne lactation

18 jasқa deyingі balalarғa

Nga paanga o nga papa whakapae

tauhohenga hypersensitivity - kauhau, te whiu me te urticaria

whakawhiti mate pāwera ki te sulfonylurea, sulfonamides he pūhui whai kiko ranei

nui haere nga taumata o nga piripiri ate

Ko nga huringa poto o te tirohanga ka puta mai na nga huringa o te taumata huka toto, ina koa i te tiimata o te maimoatanga

ngawari ki te thrombocytopenia kino, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, anemia hemolytic me te pancytopenia, e ngaro ana i muri i te whakakorenga o te maimoatanga

tauhohenga hypoglycemic e tupu ana i te nuinga o nga keehi ka taea te tango i tetahi ahua kino, kaore i te wa ngawari ki te whakatika. Ko te puta o enei tauhohenga ka whakawhirinaki, penei i etahi atu momo maimoatanga hypoglycemic, i runga i nga ahuatanga o te kaupapa, penei i te kai me te inenga

vasculitis mate pāwera, tauhohenga hypersensitivity mai i te iti ki te tino taumaha ki te whanaketanga o te dyspnea, he whakaheke toto toto, i etahi wa ka ohorere

te mura, te ruaki, te taatai, te taawewe, te manawa ranei i te kopu, te mamae o te puku, me etahi wa ka whakakorea te maimoatanga

te ngoikoretanga o te ate ate (hei tauira, te aukati i te aukati me te jaundice), hepatitis, ka taea te ahu whakamua ki te ate ate

hypersensitivity ki te marama

heke te maha o te konutai ki te serum toto

Zhoғary sezimtaldyқ reaktylary - қysynu bөrtpe zhene esekzhem

sulphonylurea, sulphonamidetermen nemese tektes

bauyr fermentteri deңgejіnің zhoғarylauy

қандағы glucose de glucosegejііnің өzgeruіne bailanysty, әсіресеемдеудің басында көрудің уақытша бұзылалары туындауы мүмкін

orthashadan auyr derezhey denging thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, anemia hemolytic, pancytopenia wahine, olar етdette emdeoudi totatannanne kejin zhoala

kөp zhadaylarda birden tuyndaytyn hypoglycemiaқ reactionar auyr tүrhe enuі zhne tүzetuge үnemi kөne bermeuі mүmkіn. I puta he ariki tauhohenga ы tuyndauy hypoglycemia қ emdeudіқ basқa tүrlerі kesіne de, tamқtanu zhne dosisalau whana ектив kaupapa marau i te sharttarғa me bailanysty

allergalsқ vasculitis, eleusenden dyspnoeus damuymen, arterialsқ қrysymnyң tөmendeuіmen kүrdelіlerіne deyngі zhғғary sezmtaldyқ reaktylary, keide - ohorere

Zhurek Ainuy, құsu, te mate tupapaku, asқazandaғy қysym nemese nga tangata tini o te ketu sezimі, іштің ауыруы, keide emdeudі toқtatudy қazet etuim mүmkіn

bauyr қyzmetіnің bұzyluy (whakaaroaro өт ірікілісі және сарғаю), hepatitis, ol bauyr zhetkіlіksіzdіgіne deіn үdeuі mүmkіn

жарыққа жоғары сеімталдық

қан photosuyndaғy konutai mөlsherіnің tөmendeuі

Nga tohutohu motuhake hei whakamahi

Ko te maimoatanga angitu o te mate huka e pa ana ki te ngoikoretanga o te manawanui ki te kai e tika ana, te mahi a te tinana i ia wa, tae atu ki te tirotiro tonu i nga taumata o te toto me te toto urine. Ko te kore tirotiro i nga kai e nga turoro kaore e taea te utu ma te tango penihana, i te waipiro ranei.

Me tango te Diapiride i te wa poto i mua i te kai ranei. Mena ka kai te kai i nga wa katoa i te wa rereke ka hurihia ranei, ko te tango i te tarukino ka mate pea te hypoglycemia. Ko nga tohu ka tata tonu ka mawhiti tonu mena ka mau tonu nga warowaihā (huka).

Ko nga mea reka kaore e whai mana.

Ko te wheako me etahi atu derivatives sulfonylurea e whakaatu ana ka taea ano te whakawhanake i te hypoglycemia, ahakoa ko te angitu o nga mahi i mahia.

Ko te hypoglycemia kino te roa tonu ranei, ka taea ai te ngoikore o te waa ma te inu i te rahinga o te huka, e hiahia ana ki te rongoa i nga wa tonu, me etahi wa ka hohipera.

Ko nga tohu e whai take ana ki te takenga o te hypoglycemia ko: te aukati i te waa ranei (he maha tonu te nui o nga taangata pakeke) te koretake ki te mahi tahi ki te taote, ki te kai kino, ki te kai koretake, ki te pupuri i te wa kai, te wa nohopuku, te whakarereke o te kai, te koretake i waenga i nga mahi tinana me te taarua o te warowaihono, te waipiro i roto i te taha ki nga kai paarua, te koretake o te renal me nga ngoikoretanga hepatic, te kaha o te Diapirid, etahi mate whakarakei mutunga kore e pa ana kei te whakauru atu ratou ki te pākia pākawa, ki te whakarereke ranei o te hypoglycemia (hei tauira, ko etahi taarua o te repe thyroid, kaore i te kaha te mahi o te pituitary orort adortal cortex), te whakamahi i etahi raau taero (tirohia te waahanga "Whakawao Haurangi").

Te maimoatanga me te Diapiride me aro turuki tonu i nga taumata toto me te taumata toto urine. I tua atu, ka tūtohutia kia whakahaerehia te rahinga o te hemoglobin glycosylated.

I te wa e whakamahia ana te tarukino, me te tirotiro tonu i nga mahi a te ate me te tātari o te pikitia toto peripheral (ina koa ko te maha o nga leukocytes me nga platelets) e tika ana.

I nga ahuatanga e pouri ana (hei tauira, i nga aitua, te whakahaere ohorere, nga mate e haere tahi ana e te kirika), ka tohu tetahi wa poto mo te manawanui ki te insulin.

Kaore he raraunga e pa ana ki te whakamahi i te Diapiride i nga turoro e whai ana i te raru o te ate e tino kino ana ki te hunga mate ranei. Ko nga kaihoko e mate ana ki te renal kino ranei te mate hepatic ranei me whakawhiti ki te insulin.

Me mahara te tohu ka huna pea nga tohu o te hypoglycemia kei te ngaro ranei i nga taangata o te taangata me te neuropathy autonomic, i roto ranei i te wa e whiwhi rongoa ana me nga kaiwhaiwhai receptor β-adrenergic, reserpine, clonidine, guanethidine me etahi atu tohu tohu-tohu ranei. Mena kaore i te tino koretake te heke mai ranei, ka whakahekehia te paatai, i roto i te keehi o te rongoa roa, ka tūtohutia he ranunga ki te metformin, he insulin ranei.

I roto i nga keehi o te utu mate huka, ka piki ake te hinengaro o te karaka, na reira, ka heke iho te hiahia mo te tarukino i te wa o te waahi maimoatanga. Hei karo i te whakawhanaketanga o te hypoglycemia, he mea tika ki te whakaheke i te wa, te whakakore ranei i te raau taero. Ko te whakariterite i te horopeta me whakahaere i te waa e huri ana i te taumaha o te tinana o te manawanui, tona momo noho ranei, i etahi atu waahanga ranei e whai waahi ana ki te hyp- or hyperglycemia.

Ko nga taangata he raupatu o te galactose turi kore, he ngoikoretanga o te lactase, he ngoikore o te haukawa-galactose ranei, kaua e tango i te Diapiride.

Қant diabetіn emdeudің sәttіlіgі emdelushіnің sәykesіnshe tamaқtanu ratsionyn saқtauyna, ұdayy Dene belsendіlіgіne, ke қan Sondalo-ak neseptegі kūhuka deңgeyіnің tұraқty baқylanuyna baylanysty. Nauқastardyң emdәm saқtamauynyң ornyn tabletlardes nemese insulinind қabyldau argyly toltyru mүmkіn еес.

Diapiridti as isherden bіraz bұryn nemese rite take kesіnde қabyldau Jaeger as іshu ретr rette әr tүrlі uaқytta oryn alsa nemese mүldem zhyberilip alsa, faaineineraa қabyldau hypoglycemia tuғyzuy mүmkіn. Jaeger bіrden kөmіrsular (қant) қabyldasa, tohu o te daryn үnemі derlіk tez ңіlddetuge boladi.

Zhasandy tәttіlendіrgіshter Yeshanday әser Bermaidi.

Basқa sulfonylurea tuyndylaryn қoldanu tәzhіribesі, tіpti қabyldanғan sharalardyң bastapқydғy sәttіlіgіne қaramastan, hypoglycemiaң Kayta damuy mүmkіnekendі.

Қanttyң әdettegi mәlsherin paydalanyp tek uaқytsha ғana basu болa bolatyn auyr nemese ұza созa i huihuia te hypoglycemia dereu dәrі-dәrmekpen emdeoudі, al keide - auruhanaғa zhatyyutudyut.

Gipoglikemiyanyң tuyndauyna yқpal etetіn faktorlar mynalar bolyp tabylady: dәrіgermen yntymaқtasudy қalamau Nemesu (kөbіnese egde zhastaғy emdelushіlerde) mүmkіndіgі bolmau, toyyp tamaқ іshpeu, zhүyelі tamaқtanbau Nemesu ac іshudі zhіberіp alu, ashyғu kezeңі, tamaқtanu rezhimіnің өzgeruі, Dene zhүktemelerі ke kөmіrsulardy paydalanu arasyndaғy teңgerіmnің bұzyluy, waipiro, әsіresе іshudі jіberіp alumen bіrge paydalanu, bүyrek әne bauyr mahi o te tama ң Ortash bұzylulary, Diapiridtің artyқ dzozalanuy, endocrindyk үенyenің kөmіrsulardy lizmіne әser etetіn keybіr kompensatsiyalanbaytyn bұzylystary, Nemes gipoglikemiyanyң kerі regulyatsiyasy (mysaly, қalқansha kahore funktsiyasynyң keybіr bұzylulary, gipofizdің aldyңғy bөlіgіnің Nemesu bүyrek үstі bezі қyrtystarynyң zhetkіlіksіzdіgі) keybіr dәrіlіk zattardy bir mezgіlde қabyldau ( "Dәrіlermen өzara әrekettesuі" bөlіmіn қaraңyz).

Diapiridpen emdeu қan men neseptegi waikawa deейgeyіn tұraқty tүrde baқılap oteruda ezhet ety. Bұdan өzge, glycosyldengen hemoglobin mөlsherin baқylauғa alu ұsynilady.

Nga raau taero ғoldanғan kezhe bauyr functionya әәne shetkergi қan kөrіnіsіn (әsіrese leukocytter men thrombocytosis sanyn) ұdayy bakylap otyu қyazht.

Stress jaғdailarinda (whakaaro, jazatayim jaғdaylarda, he hinu poaka whakahaere, қyzbamen қatar zүretіn ұқұқpalarda) nauқasty uaқytsha insulating ayustyru kөrsetiluu mіmkіn.

Ko nga mahi a Bauyr o te tama ң auyr bұzylulary bar nemes dialysis kөrsetilgen edelushіlerge Diapiridti қoldanuғa қatyty mәlіmetter zh ж. Bүyrektің nemese bauyrdy kүrdeli zhetkіlіksіzdіgі bar nauқastardy insulindy қabyldauғa ayystru kerek.

Ko nga kaitohu neuroporo rongoa hu nemesis β-adrenergic reseptor neuromuscular blocker, reserpinmen, clonidinmen, guanethidinmen nemesse basa simpatholytictermen koiora meningitis muscular hypoglycaemia hypoglycaemia Jäger әseri zhitkіlіksіz nemese әseri tөmendegen bolsa, ұзақемдеу жғғдайында, metforminmen nemese insulinman bіrіktіru ұsynylad.

Диабant diabetesіnің indemnification ғ zhaydayynda insulin sezіmtaldyқ artada, soғan bailanisty emdeu үderіsіnde drugқa қazhettіlіk tөmendeuі mүmkіn. Hypoglycemiaң damuyn boldyrmau үshіn dozasyn der kezіnde tөmenddetu nemesa rongoā toқtatu kerek. Dozasyn tүzetudі emdelushіnің dene salmaғy өzgergen nemese onyң өmir sүru tәsili өzgergen kездеde de, Sondai-aқ basқa tohu hinengaro o te hyperglycemia tuғyzuy mүmіkіnar jaғе paydaғ.

Sirek tұқym алаualaytyn galaktosany kөter almaushyly, lactase zhetkіlіksіzdіgі bar nemesa glucose-galactose sіңuі bұzylғan emdelushіlerge Diapiridtі қabyldauva bolmaida.

Te inenga me te huarahi whakahaere

Ko te tarukino ka whakamahia i roto i nga pakeke.Ko te horopeta e pa ana ki nga hua o te toto me te haumanu o te mimi. Ko te tikanga, ka whakamahia te diapiride 1 wa ia ra. E taunaki ana te rongoa kia tangohia i mua i te wa ranei i te parakuihi ngakau ranei, ki te mea kaore he parakuihi, i mua noa atu i te wa ranei o te kai tuatahi tuatahi. Me horomia te papaa kaore he ngote, horoia ki te wai. Mena kua ngaro te horopeta o muri o te tarukino, me neke atu te horopeta ki te horopeta o muri.

Ko te horopeta tuatahi ko te 1 mg o te glimepiride ia ra. Mena ka taea e tenei horopeta te whakahaere tika i te taumata o te huka, kei te whakamahia hei peehi. Mena kaore e pai te mana o te mate glycemic, me nui ake te horopeta ki te 2, 3, ki te 4 mg ranei o te glimepiride ia ra i nga waahanga (i nga waa o te 1-2 wiki). Mena kei te rongoa te manawanui ki te tango i te tarukino i te horopeta o te 1 mg i ia ra, ko te tikanga ka taea te whakahaere mate ma te whai i te kai. Ko te horopeta i runga ake i te 4 mg i ia ra ka puta nga hua pai rawa atu i nga keehi takitahi. Ko te horopeta nui e tohuhia ana ko te 6 mg o te diapiride ia ra.

Ki te kore te rongoa o te metformin i te ra e kore e whai kiko ana te mate glycemic, ka taea te tiimata te haangai me te glimepiride. Ko te piri ki te horopeta o te metformin o mua, me tiimata te tiimata me te iti o te horopeta, ka taea ka piki haere te nuinga ki te horopeta o ia ra, me te aro ki te kaha o te mana ki te taatai. Ko te tikanga whakakotahitanga me whakahaere i raro i te tirotiro hauora.

Mena kaore i te rongoa o te Diapiride te nui o te ra ki te kore e whai kiko ana te mate glycemic, ki te mea e tika ana, ka taea te tiimata o te haumanu. Ko te piri ki te inenga o te glimepiride o mua, me tiimata te maimoatanga o te insulin ki te horopeta iti, ka taea te piki ake, e aro ana ki te kaha o te whakatau-a-mate. Ko te tikanga whakakotahitanga me whakahaere i raro i te tirotiro hauora. Ko te whakatikatika o te mana o te mate huka kei te haere tahi me te kaha o te hinengaro ki te insulin, no reira ka heke iho te hiahia mo te glimepiride i te wa o te maimoatanga. Hei aukati i te hypoglycemia, me ata heke te horopeta, me haukotia ranei te rongoa. Tērā pea ka arotakehia te reanga mēnā ka huri te tinana o te manawanui, te whakarereketanga o te noho a te tangata, i etahi atu ahuatanga ranei e pa ana ki te mate o te hyp- or hyperglycemia.

Ko etahi atu kaihoko taakahu hypoglycemic ka taea te huri ki te diapiride. I roto i te waa whakawhiti, me kaha te whakahaere me te hawhe-ora o te kaihoko o mua. I etahi keehi, ina koa mena he roa te ora-roa o te raau taero antidiabetic (hei tauira, ko te chlorpropamide), ka tatari kia ruarua nei nga ra i mua i te tango i te Diapiride. Ma tenei ka whakaiti i te mate o nga urupare hypoglycemic e tika ana ki te taapiri o nga kaihoko e rua. Ko te horopeta tuatahi e tohua ana ko te 1 mg o te glimepiride ia ra. Ka taea te piki haere o te horopeta ki te tango i te tauhohenga ki te tarukino.

Te whakarite mo te heresectergoldanada. Dozasa Kan men neseptegі karukaru құramyn taldau әtyzhelerіne baylanysty. Әdette Diapiridti tәuligine 1 ret қoldanady. Nga raau taero o toyymdy taңғy astan bіraz bұryn nemese taңғy as kesіnde nemese, jäger taңғy as bolmas, alғashқy negіzgі as іsherden bіraz bұryn nemese as іshu kesіnde қabyldau ұsynylady. Papa raka shaynamay, sұyyқtyқpen іshіp zhtu kerek. Ko nga whakaritenga a Jäger kesekti қabyldau zhіberіlіp alsa, kelesі қabyldaғan keshe dozasyn arttyrmau kerek.

Ko te paukena kirikiri te paukena 1 mg glimepiridtіradydy. Jäger Mundai dosasy ыant deңgeyіn talapқa sa baқylauғa mүmkіndіk berse, ony demeusiem retіnda Koldanady. Eger glykemiyalyқ baқylau ңtayly bolyp tabylmasa, dozasyn tәulіgіne 2, 3 nemese 4 mg glimepiridke deyn satylap (1-2 apta akorangaıtarman) ka hoatu ki arttyru. Jaeger nauқasta whakaritenga әuligine 1 mg inenga o ofabyldauғa hypoglycemia қ tauhohenga o ba, als, bұl auruda hangarau emdәm ұstanudyң kөmegimen ғana baқylauғa bolatynyn kөrsetedі. Tәulіgіne 4 mg asatyn doses tek jekelegen zhadaylarda ғana үzdіk nәtyzhe i mua. Ең ғоғарғы ұсынылатин doses - тәулігіне 6 mg Diapiride.

Jäger metforminnің eң zhoғarғy tәulіktіk ngao o te rite ki te glycemia glycemia bamylauda қamtamasyz etpese, glimepiridpen қatarlas emdi bastauғa bolyady. Metforminnіd aldyңғy dozasyn o te whenua otyryp, faaineineraa қabyldaudy, tymen dozasynan bastau kerek, ony keyin ика baқylaudyң қazhetti deңgeyyn baғdarғa ala otyryp arttyruғa bolyda. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek.

Jaeger Diapiridtің еғ жoғарәы тәуліктік pota o te nui o nga taumata o te toto toto o baқylaudy қamtamasyz etpes, қ insulinman қatarlas emdeoudi bastauғa bolydy. Glimepiridtің aldyңғy dozasyn syүyene otyryp, te insulin emdeudі tөmen dozasynan bastau kerek, oney keyin ика baқylaudyң қazhetti deңgeyin baғdarғa ala otyryp artyruғa. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek. Diabetty baқylauda jaқsartu insulin sezmtaldyқtyң artuymen қatar zhredі, sondyқtan emdeu akoranga kazіnde glimepiridke қazhettіlіk azayuy mүmkіn. Hypoglycemia boldyrmau masatynda dozasyn birtіndep azaytu nemese emdeudі mүlddem totatu kerek. Dozasyn Kayta қarau қazhettіlіgі äger emdelushіde dené salmaғ nemese өmіr sүru tәsіlі өzgerse nemesa hypomemes hyperglycemia упaupіn arttyratyn basқa da zhaydaylaryt ү у uyusaynuyurnuyetuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyuyeu

Ishu agyly қabyldanatyn basқa hypoglycemia agentterden әdette Diapiridke kөshugu bolada. Mұndai auysu kesіnde aldyңғy dәrіnің kүshі men zhartylai shyғarylu hiriwaңіn esker kerek. Kay zhadaylarda, іsіrese jäger mate huka preparationsars faaineineraa ң zhartylı shyғarylu hiriwaңi ұzaқ bolsa (whakaaro, chlorpropamide), Diapiridti қabyldauda bastardy nd aldynda bіrneshe kүn kүte tұru. Бұл екі agentт additivetik әсerіnің saldarynan hypoglycemiaқ reactionar упаупін азайтуға мүмкіндік береді. Ұsynylatyn bastapқ inenga - tәuligine 1 mg glimepiride. Ko te raau taero Dozasyn he react eskere otyryp, satylap arttyruғa bolyady.

Taunekeneke

Ko te whakahaere waatea o Diapiride me etahi raau taero ka taea te ngoikore e rua, me te piki ake o te kaha o te hypoglycemic o te glimepiride. No reira, ko etahi atu raau taero me tangohia anake me te whakaae (me whakaatu ranei) na te taakuta. Ko te Glimepiride te whakariterite ma te whakamahi i te cytochrome P450 2C9 (CYPC9). Kei te mohiohia na te mea ko te whakahaere tonutanga o te inducers (e.g. rifampicin) me nga kaitautoko CYPC9 ranei (e.g. fluconazole), ka huri pea tenei kaiao. I roto i nga rangahau taunekeneke vivo i whakaatu ko te fluconazole, tetahi o nga kaitoha CYPC9 tino kaha, ka whakapiki i te AUC o te glimepiride i te hawhe.

Me whakapakari i te painga o te glimepiride me te whakamahi i te wa ano: phenylbutazone, azapropazone me te oxyphenbutazone, sulfinpyrazone, insulin me nga rongoa antidiabetic waha, etahi sulfonamides roa, e mahi ana ki te miihini, tetracyclines, salicylates, me te waikawa p-aminosalicylic, haukoti MAO, anabolic anabolic me nga tane taane tane, cholinergicokolinolinek, , miconazole, fenfluramine, pentoxifyline (nui nga papa i runga i te maatua), fibrates, tritokvalin, ACE inhibitors, fluconazole, fluoxetine, allopurinol, sympatholytics, cyclophosph id, disopyramide, feniramidol, guanethidine, pa ifosfamide.

Whakaitihia te hua hypoglycemic o te glimepiride i te wa e whakamahia ana: estrogens me progestogens, saluretics, thiazide diuretics, hormones thyroid me nga raau taero e whakaohooho ana i te mahi thyroid, corticosteroids me nga glucocorticoids, derivatives phenothiazine, chlorpromazine, epinephrine me te sympathomimetics, waikawa nikotinic (nui te pona) me ona huringa, glucagon, la tono), phenytoin, diazoxide, glucagon, barbiturates me rifampicin, acetazolamide.

Ko nga antagonis tohutoro H2, nga beta-aukati, te clonidine me te reserpine e rua pea te potentiate me te whakaiti i te hua hypoglycemic. I raro i te mana o te sympatholytics, pēnei i te beta-aukati, te clonidine, guanethidine me te haurangi, ko te whakakitenga mai o te ture whakarereke adrenergic o te hypoglycemia ka heke, ka ngaro ranei. Ko te inu waipiro ka kaha ki te whakanui, ki te whakaiti ranei i te hua hypoglycemic o te glimepiride.

Diapiridti belgіlі bіr dәrіlіk zattarmen bіr mezgіlde қabyldau glimepiridtің hypoglycemia қсерінің әлсіреуін де, күшеюін де туғызуы мүмкін. Sondyқtan basқa te whakarite mo te hangarau raau taero dәrіgerdің kelіsіmіmen (nemese taayyndauymen) ғana Koldanu kerek. Glimepiride P450 2C9 (CYPC9) cytochromes ң kmegimen metabolizdenedі. СYPC9 inductorlaryn (whakaaro kino) nemez tezhegіshterіn (whakaaro fluconazold) bir mezgilda kabyldaudyң saldarynan metabolism өzgeruі mүmkіn kenen belgіlі. Vn vivo раzara әrekettesulerin sertteu әtyzheleri, СYPC9 ң күшті тежегіштерінің бірі fluconazole, glimepiridtі AUC екі есеге жуық арттыратыннөөрсет

Bіr mezgіlde қoldanғanda glimepiridtің әсerіn kүsheytedі: Phenylbutazone, azapropazone zhane oxyphenbutazone, sulfinpyrazone, taiāki zhane іshіletіn diabetke қarsy preparattar, ұzaқ әser etetіn keybіr sulfonamidter, metformin, tetratsiklinder, salitsilattar zhane p-aminosalitsil қyshқyly tezhegіshterі Mao, anabolikalyқ steroidtar zhane erlerdің zhynystyқ gormondary, antibiotikter hinolondyқ, chloramphenicol, probenecid, Coumarindek anticoagulantar, miconazole, fenfluramine, pentoxifyline (maatua tuatua), fibrattar, tritokvalin, AӨF tezhegіshterі, fluconazole, fluoxetine, allopurinol, sympatho itikter, cyclophosphamide, disopyramide, feniramidol, guanethidine, PASҚ ifosfamide.

Bіr mezgіlde қoldanғanda glimepiridtің hypoglycemiaқ әсерін төмендетеді: Estrogender zhane progestagender, saluretikter, tiazidtіk diuretikter, қalқansha kahore gormondary zhane қalқansha kahore қyzmetіn kөtermeleytіn preparattar, kortikosteroidtar zhane glyukokortikoidtar, phenothiazine tuyndylaryn, chlorpromazine, epinephrine zhane simpatomimetikter, nikotīni қyshқyly (dozalary zhoғary) zhane onyң tuyndylary, glucagon, іsh zhүrgіzgіsh dәrіler (ұzaқ Uayyt Koldanu), phenytoin, diazoxide, glucagon, barbiturattar zhene rifampicin, acetazolamide.

Н2-receptor lardң antagonists, beta-aukati, he taakaro clonidine he urupara hypoglycemia әserin әleuettendіruі de, tөmendueti de mүmkіn. Beta-blocker, clonidine, guanethidine, wahine reserpine, whiti ana te raupaparumarakitanga әserinen hypoglycemia ң adrenergic қ Keri ture o nga tama ң kңrіnіsі azayu nemese zhғaluy mүmkіn. Te waipiro Paidalanu glimepiridtің hypoglycemiaқ әсerіn kтуshaituі nemese әlsіretuі mүmkіn.

Te mahi rongoā

He kaihoko hypoglycemic, he ahu mai i te sulfonylurea o te tuatoru o nga whakatipuranga o te mahi roa. Ko te paitini whakaheke huka o te tarukino na te mahi uaua o te pancreatic me te mahi extrapancreatic. Ko te mahi pancreatic kei roto i te whakaongaonga i te huna o te insulin e te pancreatic β-cell, me te whakaohooho me te whakapiki i te haumanu endogenous. Ko tenei whaainga na te mea ko te glimepiride, me te nui o te whakakapi, te hono me te aukati mai i te pūmua o te ß-pūtau o te pancreas, e hono ana ki nga paoma pāhono tiihi ATP, engari he rereke mai i te waahi o te waahi o te whanariki tuatahi me te 2-whanariki. I te mutunga, ka tukuna te insulin e te exocytosis, engari ko te nui o te insulin huna e tino iti iho ana i raro i nga mahi a te taangata whanariki o te sulfanylurea. Ko te tino ngawari o te whakaongaonga o te glimepiride i te whakamaoritanga o te insulin, e whakararu ana i te mate hypoglycemia. Ko te mahinga extrapancreatic o te glimepiride e whakaatuhia ana e te tini o nga mahi, ko te arahi ko te piki haere o te maarama o nga kopa paitini (te uaua me te ngako) ki te insulin me te piki haere o te tau me te mahi o te pūmua e kawe ana i te whaikorero na roto i nga membrane, me te aukati i te whakahiatotanga o te huka i roto i te ate me te piki haere o te kukume o te fractose-2.6 β-phosphate te aukati i te gluconeogenesis. Ko etahi atu hua o te extrapancreatic o te glimepiride kei roto: te whakaheke o te whakahiato pareparenga hei hua o te aukati pai o te cyclooxygenase me te hurihanga o te waikawa arachidonic ki te thromboxane A2, e whakahohe ana i te roopu o te roopu, he whakapiki i te taumata o te auora-tocopherol, me te mahi o te ngota antiioxidant (catalasease, glutage ahotea, te mea e tu tonu ana i roto i te mate mellitus, mate anti-atherogenic hei hua o e kore e motuhake tivatsii phospholipase C. glimepiride tautāwhi i te urutaunga pūkoro ki te ischemia myocardial (pērā glibenclamide). Ko te hua hypoglycemic nui o te tarukino ka kitea e 2-3 haora i muri i te whakahaere, ka roa ake i te 24 haora ka whakawhirinaki te horopeta.
Takaroa
Na nga paatai maha o te glimepiride i roto i te totika o te ra ki te 4 mg, ko te kukume nui i roto i te serum toto e tae atu ana i muri ake i te 2,5 haora ka 309 ng / ml, he hononga hononga i waenga i te horopeta me te kukume nui o te glimepiride i roto i te toto, tae atu ki waenga i te horopeta me te rohe i raro o te kuru " -pune. " Glimepiride he bioavailability tino. Kaore e pa ana te kai ki te hiawhiotanga, me te kore o te ngoikore o te huringa o te tere o te whakauru. Ko te Glimepiride e whakaatuhia ana e te rita tino iti o te tohatoha (tata ki te 8,8 L), he rite ki te rōrahi o te tohatoha o te albumin, he tohu tiketike mo te pūmua plasma (neke atu i te 99%) me te whakaheke iti (mo te 48 ml / min). Ko Glimepiride te kopu i te miraka miraka me te whakawhiti i te arai papa. Ka uru raanei ki te arai toto-roro. Ko te Glimepiride te biotransformed i roto i te tinana ki te 2 metabolites, i puta mai i te punga o te glimepiride i roto i te ate e tohu ana i te whakahuihui waipiro me te karawaka o te glimepiride. Ko te hawhe-ora o te glimepiride i ona kukume plasma i roto i te serum e pa ana ki te reimenima tikanga maha he 5-8 haora. I muri i te rongoa o te waha o te glimepiride e tapaina ana ki te tapanga radioactive, i kitea te 58% i roto i te urine me te 35% i roto i te kaiha. Kaore i kitea te peke kaha ki te mimi ka kitea. Ko te hawhe-ora o te waihiko waihoki waihoki me te karawaka glimepiride tata ki te 3-6 haora me te 5-6 haora. I roto i nga turoro o te ngoikoretanga o te mahi renal (iti te aukati i te aukati), ka kaha te whakapiki ake i te aukati o te glimepiride me te whakaheke i te toharite toharite o te toto, i te mea hoki, na te tere o te tere o te tarukino na te ngoikore o te rongoa. Na, i tenei waahanga o nga turoro kaore he taapiri atu mo te whakahiatotanga o te glimepiride. Ko nga momo pharmacokinetic o te glimepiride he rite i roto i nga turoro o nga ira tangata me nga roopu reanga rereke.

Tikanga tono

Mo nga pakeke: Tuhia ki roto o mua o te parakuihi tino tina mo te tina raanei. Ka horomia nga papa kaore he ngau, ka horoia ki te nui o te wai (tata ki te 1/2 kapu). He mea nui kia kaua e peke i te kai i muri i te tango i te Diapiride. Ko te horopeta tuatahi me te tiaki, te wa whakahaere me te tohatoha o te horopeta o ia ra ka whakaritea takitahi i runga i nga hua o te whakatau tonu i te taumata o te huka o roto o te toto me te urine.Ko te horopeta tuatahi o te Diapiride ko te 1 mg kia 1 nga wa ia ra. Mena e tika ana, ka whakahaerehia he pikinga nui o ia ra me te tirotiro tonu i nga taumata o te huka toto, ka piki haere te horopeta ia 1-2 wiki ki te kaupapa: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg. I etahi waahanga, ko te horopeta o te ra o Diapiride ka kaha te piki ki te 8 mg. I te nuinga o te waa ka whakamahia he horopeta o ia ra. Mo nga turoro e pa ana ki te mate huka, ko te awhe horopeta ia ra te nuinga o te 1-4 mg o te glimepiride, ko etahi noa o nga turoro ka pa te mate e tika ana ka tangohia nga ra e 6 mg, neke atu ranei. Ko te horopeta nui o ia ra ko te 6 mg, i etahi waahanga - 8 mg. Whakamahia ai te rongoa mo te wa roa. I roto i nga keehi o te utu mo te mate huka, ka kaha ake te taangata o te kopa ki te insulin, na reira ka heke iho te hiahia ki te glimepiride, e hiahia ana kia whakaiti te waatea, te tangohanga raau taero ranei (i runga i nga hua o te tātaritanga o te toto me te taumata toto urine). Ma te whakarereketanga o te taumaha o te tinana o te manawanui, ki te ahua ranei o nga ahuatanga e whai wāhi atu ana ki te nui o te tupono ki te whakawhanake i te hypo-, ko te hyperglycemia ranei, he tika te whakatikatika i te horopeta.
Whakamahia i roto i te taha ki te metformin. Ko te Diapiride hei honohono me te metformin kua tohutohutia ki te kore e tino kaha te whakapakaritanga o te huka i roto i te toto ki nga turoro e pa ana ki te miimeta metformin. I te wa e mau ana te rongoa o te metformin i te taumata kotahi, ka timata te maimoatanga me te Diapiride me te horopeta iti o te 1 mg, ka whakapiki i te horopeta ki te taumata e hiahiatia ana o te mana glycemic, tae atu ki te horopeta mo te ra 6 mg nui.
Whakamahia i te taha ki te insulin. Ko te Diapiride e whakauruhia ana ki te insulin, ki te kore e taea te whakatutukitanga o te kukume toto toto ma te tango i te horopeta o te Diapiride hei monotherapy, i te whakakotahitanga ranei me te horopeta o te metformin. Ano, ki te papamuri o te horopeta whakamutunga o Diapirid kua tohua ki te manawanui, ka tiimata te maimoatanga o te insulin me tona reanga iti, ka taea te piki haere o te inenga o te insulin i raro i te mana o te kukume toto toto. Ko te maimoatanga whakahoahoa e hiahiatia ana hei tirotiro i te tirotiro hauora. I te wa e mau ana te mana glycemic wā roa, ko tenei rongoa whakakotahi ka taea te whakaiti i te hiahia insulin mo te 40%.
Ko te whakawhiti i te manawanui ki Diapiride mai i tetahi atu kaihoko hypoglycemic waha. Kaore he hononga tika i waenga i nga horopeta o te glimepiride me etahi atu raau taero hypoglycemic waha. I te wa e whakawhiti ana i taua raau taero (tae atu ki o raatau mea totika nui) ki Diapiride, ko te 1 mg te horopeta tuatahi o te glimepiride. Ko nga hua i runga i te horopeta o Diapiride me whakahaere i nga waahanga, ma te whakautu i te urupare o te tinana ki tenei kaitohutohu haumanu. Ko te horopeta e whakamahia ana me te roanga o te painga o te kaimene hypoglycemic waha o mua me whai whakaaro. I etahi waahanga, ina koa me nga whakahaere o te raau taero hypoglycemic me te roa o te hawhe-ora (hei tauira, chlorpropamide), he mea tika kia waatea (mo etahi ra) ki te aukati i te maimoatanga kia kore ai e whai hua te taapiri ka piki ake te mate o te hypoglycemia.

Ko te whakawhiti i te manawanui mai i te insulin ki Diapiride. I nga keehi rereke, ka whiwhi nga turoro i te mate huka-kore-insulin-mellitus (momo II) te haumanu hau, me te utu i te mate me te pupuri i te mahi muna o te pancreatic β-cell, ka whakaatuhia mai he whakawhitinga mai i te insulin ki Diapiride. Ko te whakawhiti ki te Diapiride me whakahaerehia i raro i te tirotiro hauora. I tenei keehi, ko te horopeta tuatahi o te Diapiride te 1 mg. Ko te roanga o te maimoatanga i ia keehi takitahi ka whakatauhia e te taote. Kaore he wheako o te whakamahinga o te tarukino mo te maimoatanga o nga tamariki.

- Tomo II mate mellitus mote (kore-insulin-whakawhirinaki) i roto i nga pakeke hei monotherapy ranei i te whakakotahitanga me te metformin he insulin ranei.

Puka puka

Pire
Kei roto i te papa 1 te 2 mg, i te 3 mg ranei, te 4 mg ranei o te glimepiride, nga kaihaa: te monotehe lactose, te cellulose microcrystalline (102), te konutai starch glycolate, povidone (25), te konupora konupora. Papa Diapiride 2 mg taapiri kei roto i te hāora waro whero, te karawhiu indigo, Diapiride 3 mg - te kowiri waro kowhai, Diapiride 4 mg - Ko te Indigo carmine.

Ko nga korero kei te whaarangi e tirohia ana e koe mo nga kaupapa korero anake, engari kaore i te whakatairanga i te rongoa ki a koe ano. Ko te rauemi he mea kia waia ai te maakuta hauora ngaio me etahi atu korero mo etahi rongoa, na reira ka piki ake te taumata ngaiotanga. Te whakamahi tarukino "Diapyrid" me te kore e whai waahi ki te whakawhiti korero me tetahi tohunga, me ona whakaaro mo te tikanga whakamahinga me te horopeta o to rongoa i whiriwhiria.

Te tuku puka me te hanga

Ko te rongoa ka hangaia i te ahua o nga papa me nga inenga rereke o te taonga hohe. I roto i te kete kaata he 30 nga papa i roto i te pupuhi. 1 papa to 2, 3, 4 ranei o te glimepiride (tohe kaha). Ko nga papa me te inenga he 2 mg he maama matomato, 3 mg he maama te kara, 4 mg he kikorangi te marama.

Kei roto i te hanganga o nga papa nga mea taangata:

te waipiro hinu lactose,
cellulose microcrystalline,
konutai māngaro glycolate,
povidone
te hāhi karaka kowhai
konupora konupora,
ko Indigo carmine.

Takaroa

I muri i te whakauru, ka whakauruhia te glimepiride ki roto i te taatai ka keri ka uru ki te kaiti toto. Ko te kai e kore e whakaiti i te kapenga o te tarukino. Ka tutuki tenei matū ki tona tino kukume i te hinu toto i roto i te 2-2,5 haora.

I muri i te whakauru, ka whakauruhia te glimepiride ki roto i te taatai ka keri ka uru ki te kaiti toto.

Ko te Glimepiride e tohua ana e te pai o te here ki te pūmua toto (99%). Ko te kaera o te rongoa ka kawea i roto i te ate. Ko nga huakita ka puta mai na nga whatukuhu me nga hakihaki. Kua tapahia te tarukino mai i te tinana i roto i nga haora 10-16. I a koe e tango ana i te Diapiride, ko te kohi o nga taonga o te tinana kaore e kitea (ahakoa me te whakamahi roa).

Ma te manukanuka

I raro i te tino tirotiro a te taote, ka whakamahia te rongoa hei whakahaere tere, te haurangi, te kirikaa, te mate thyroid, te ngoikore o te adrenal me nga mate kino.

I muri i nga wawaotanga whakangaromanga kino, nga whara, nga tahu, ka tohutohungia nga turoro ki te huri ki te haumanu hau.

Me pehea te tango i te diapiride?

Ko te rongoa ka tangohia i te waha ki te wai iti. He pai te whakaaro ki te whakakotahi i te whakahaeretanga o nga papa me te kai hei aukati i nga ara o te wahi o te gastrointestinal.

Ki te mate huka

Mo te maimoatanga o te mate huka-kore-inapi-kore II-momo mate, ka tangohia tenei tarukino 1-2 wa ia ra. I te tiimata o te horopeta, ko te horopeta te 1 mg ki te kupu glimepiride. Mena ka nui te whakareri i te toto i roto i te toto, na kua piki te horopeta.

Ki te kore e tino kaha, ka piki haere te horopeta ki te 2, 3, ki te 4 mg ranei. Ko te wehenga i waenga i nga huringa whakakahoretanga kia iti ake i te 7 nga ra. I etahi wa ka tohutohuhia nga turoro 6 mg o te glimepiride ia ra (te horopeta mo te ra ka whakaaetia).

Ka taea e nga taakuta te whakarite paarua te tarukino me te metformin, te insulin ranei kia tutuki ai te painga. Ko te tango i enei raau taero ka arahi ki te kaha tonu o te haumanutanga o te insulin. I tenei keehi, kua whakahekehia, ka whakakorea ranei te horopeta.

I runga i te waahanga o te tinana o te tirohanga

I te wa e rongoa ana, ka raru te tirotiro a-kanohi (ka ngoikore noa iho). Ko te take o tenei paanga he huringa i te huka toto.

Mo te maimoatanga o te mate huka-kore-inapi-kore II-momo mate, ka tangohia tenei tarukino 1-2 wa ia ra.

Nga hakora Hematopoietic

Nga putanga taha mai i te punaha hematopoietic:

thrombocytopenia
leukopenia
huaketo
granulocytopenia,
erythrocytopenia,
Agranulocytosis,
pancytopenia.

Pūnaha io

Mai i te punaha pokapū pokapū e kitea ana:

tokomona
ngoikore
whakama,
korokoro
ngenge,
whakapouri
te whakaheke i te tauhohenga psychomotor,
ngoikoretanga korero
rorirori
kirikiri.

Mai i te taha o te pākia

Kei te whakaatuhia tetahi pa kino ki te pākia e te hypoglycemia.

I te wa o te whakahaere tari, ka taea nga urupare mate mate:

kiri kiri
urutaria
kātuhi
mate vasculitis mate.

Whakamahia i roto i nga tawhito

Ka taea te whakamahi i te taputapu mo nga turoro o nga waahanga reanga, me te kore tamariki. Engari ko nga taangata pakeke me te whakamahi roa o nga penihana ka whakawhanake i te hypoglycemia. Hei karo i tenei huarahi patai, ka tohua e nga taakuta nga turoro he kai motuhake me nga waahanga iti o te tarukino (mena ka taea).

Tuhinga o mua

Ko te kohinga nui o te tarukino ka arahi ki te ahua o nga tauhohenga hypoglycemic (he maturuturu kaha o te huka toto). I tenei keehi, ka raru te manawanui, te ngenge, te ngoikoretanga. Te mate koretake o te mahara. Hei whakakore i nga tohu o te taapiri nui, ka uru ratou ki te maimoatanga tohu.

Ko te kohinga nui o te tarukino ka arahi ki te ahua o nga tauhohenga hypoglycemic (he maturuturu kaha o te huka toto).

Te taunekeneke me etahi atu raau taero

Me tango te raau taero me te tupato me nga rongoā penei:

Fluconazole
Phenylbutazone
Azapropazone.
Sulfinpyrazone.
Te Oxyphenbutazone.
Pentoxifylline.
Tritokvalin.
Disopyramides.
Fenfluramine.
Parani.
Anticoagulants mai i te roopu Coumarin.
Nga Taarua.
Ko etahi kaitautoko antidepressants (MAO inhibitors).
Karauna.
Te Foxoxetine.
Cyclophosphamide.
Feniramidol.
Ifosfamide.
Miconazole
Nga Tauhokohoko Tetracycline me te quinolone.
Ko etahi atu raau taero hypoglycemic.
He steroids anabolic.
Whakaheke ACE.
PASK (para-aminosalicylic waikawa).

Na te whakamahi i nga moni o te moni, ka whakareihia te hua hypoglycemic Diapiride. Ko te whakaheke o te paanga o te tarukino ka kitea i te wa e tangohia tahi ana me Phenothiazine me ona takawaa, estrogens me progestogens, glucagon, waikawa nikotinic, corticosteroids, barbiturates, Phenytoin, Acetazolamide, diuretics me nga raau taero mo te maimoatanga o te repe thyroid.

Pepeini

Kaua e whakamahi i te tarukino Diapiride i te wa e hapu ana. Mena kei te whakamahere te tangata e whakapae ana te glimepiride kei te hapu ranei ia e hapu ana, me tere tonu te neke ki te haumanu mo te insulin.
I te mea ko etahi atu derivatives sulfonylurea e whakatauhia ana ki te miraka miraka, ka whakaarohia kia mutu te maimoatanga me te glimepiride na te mea he mate o te hypoglycemia ki nga tamariki hou.

Puka inenga

2 mg, 3 mg, me te papa e 4

He papa kotahi

taonga kaha: glimepiride (micronized) i roto i nga waahanga 100% matū - 2 mg, 3 mg me 4 mg,

Nga papa rongoa 2: te taatai karawawa lactose, cellulose microcrystalline 102, konutai starch glycolate (momo A), povidone (25), te rino (III) waikuriki kowhai (E 172), indigo carmine (E 132), te konupora magnesium (

Paatete 3 mg: te taatai karawawa lactose, cellulose microcrystalline 102, konutai starch glycolate (momo A), povidone (25), te rino (III) waikuriki kowhai (E 172), te konupora magnesium,

Ko nga papa rongoa 4: te taatai karawawa lactose, cellulose microcrystalline 102, te konutai konupuna glycolate (momo A), povidone (25), indigo carmine (E 132), magnesium stearate.

Nga papaa tuawha me te papa papatahi, mai i te papanga matomato ki te matomato (mo te horopeta o te 2 mg), mai i te kowhai kowhai ki te kowhai (mo te dosage 3 mg), mai i te puru kikorangi ki te kikorangi (mo te dosage o te 4 mg). me nga taha beveled me te kakariki. I runga i te papa o nga papa, ka whakauruhia

Ko te taatai Diapiride i roto i nga papa

Ko te overdose ka taea te mate ki te hypoglycemia, ka roa i te 12 ki te 72 haora, a, i muri mai ka puta ano te whakapainga tuatahi. Ka kitea pea nga tohu mo te 24 haora i muri i te tohaina o te tarukino. Hei tikanga, ko nga turoro penei ki te hohipera.

Nga tohu o te hypoglycemia: taikaha, te ruaki me te mamae i roto i te kopu, nga ru, nga kitenga whakaheke, te whakahiango ngoikore, te moe, te ohorere moe, te manukanuka, te taikaha, te aro turai me te wa o te tauhohenga, te pouri, te pouri, te korero me te mate whakakitenga, aphasia, paresis, ngoikore te ngoikoretanga, ngoikoretanga, ngoikore, he ngoikore ki te whakahaere whaiaro, whakangawari, kerekere tuuturu, ngaro o te maarama tae noa ki te whakawhanaketanga o te piko, te manawa ngongo me te bradycardia. Hei taapiri ano, ka kitea pea nga tohu o te whakarereke adrenergic penei i te werawera, te awangawanga, te tachycardia, te haangai arterial, palpitations, angina pectoris me te miihiniatanga o te ngakau. Ko te pikitia haumanu o te whakaeke hypoglycemic kino ka rite ki te whiu.

Artyқ dosalanuy hypoglycemiaғa alyp keluy mүmkіn, ol 12-den 72 saғatқa dejin sozulyuy, wahine alәashқy zhқsaruynan keyіn қaita bіlіnu mүmkіn. Nga rongoa whakamate ң sіңuіnen keyin 24 saғattan soң bіlіnuі mүmkіn. Әdette, mұndai emdelušіler hōhipera o te bolu tiis.

Nga Tohu Tohungatanga Homo: Zhurek Ainu құsu zhane asқazan tұsynyң auyruy, faaati, kөru bұzylystary, қimyl-қozғalys үylesіmіnің bұzyluy, ұyқyshyldyқ, bұzyluy ұyқynyң, mazasyzdyқ, ozbyrlyқ, zeyіn shoғyrlandyru zhane tauhohenga uaқyttarynyң bұzyluy, korekore, baғdarsyzdyқ, sөyleu zhane kөru bұzylystary, aphasia, paresis, sezmtaldyқtyң bұzyluy, bass ainaluy, sharasyzdyқ, өзін-өзі baқylai almau, delirium, cerebral құrysular, coma damuyna deyngі esten tanu, үstіrtіn tynys alu jane bradik. Bұdan өzge, terleu, үreilenu, tachycardia, arterialsқ hypertension, үurek қaқuyn sezinu, angina pectoris әәerek arrhythmias whiti ana keri adrenergialқ ture a Belgler baiқaluy mүmkіn. Auyr hypoglycemiaқ ұstamanyң Clinicsқ kөrіnіsі stroke іske saluy mүmkіn.

Te taunekeneke tarukino

Ka whakanuihia e ratou te paanga o te glimepiride me te whakamahi i te waa: phenylbutazone, azapropazone me te oxyphenbutazone, sulfinpyrazone, he insulin, he rongoa antidiabetic o-waha, etahi sulfonamides roa, e mahi ana ki te metformin, tetracyclines, salicylates me te waikawa p-aminosalicylic, taero antioabetic a-taero, etahi taero mo te roa o te mahi, etahi sulfonamides roa, chloramphenicol, probenecid, antikoagulants Coumarin, miconazole, fenfluramine, pentoxifyline (he nui te nui o nga kaitautoko), he hakarahi, he tritokvalin, he haukoti ACE, fl uconazole, fluoxetine, allopurinol, sympatholytics, cyclophosphamide, disopyramide, feniramidol, guanethidine, isophosphamide, PASK.

Whakaitihia te hua hypoglycemic o te glimepiride me te whakamahi i nga wa katoa: estrogens me progestogens, saluretics, thiazide diuretics, hormones thyroid me nga raau taero e whakaohooho ana i te mahi thyroid, corticosteroids me te glucocorticoids, derivatives phenothiazine, chlorpromazine, epinephrine me ona sympathomimetics ( , glucagon, laxatives (whakamahi roa), phenytoin, diazoxide, glucagon, barbiturates me rifampicin, acetazolamide.

Ko nga antagonis tohutoro H2, nga beta-aukati, te clonidine me te reserpine e rua pea te potentiate me te whakaiti i te hua hypoglycemic.I raro i te mana o te sympatholytics, pēnei i te beta-aukati, te clonidine, guanethidine me te haurangi, ko te whakakitenga mai o te ture whakarereke adrenergic o te hypoglycemia ka heke, ka ngaro ranei. Ko te inu waipiro ka kaha ki te whakanui, ki te whakaiti ranei i te hua hypoglycemic o te glimepiride.

Ka taea e Glimepiride te whakanui ake me te whakaheke i te paanga o nga turunga takirua.

Nga mate taha

Mai i te taha o te pākia: hypoglycemia (mamae, hiakai, whakapairuaki, ruaki). He maamaa - he tihi ngenge, te moe, te moe korikori, te awangawanga, te whakahirahira, te aro ki te aro, me te tauhohenga, te pouri, te puhipuhitanga, te korero, me nga raru a te kanohi, te aphasia, te ru, te raru, te ngoikoretanga, te taangata, te aukati. He tino uaua - te momoho, te hiiti cerebral, te ngaro o te maarama, te koma, te manawa paku, te bradycardia. I tua atu, ko te hua o te umanga urupare a te adrenergic, i etahi wa ka puta ake nga tohu penei: makariri, maru kaukau, tachycardia, haangaiangai, angina pectoris, nga raru ohorere o te ngakau.

Mai i te taatai puku: taiaki, ruaki, te ngakau pouri ranei te ngoikoretanga o te epigastrium, mamae o te puku, te mate, te mate keehi, ka piki ake te ngohe o te hepatic transaminases, he ngoikore o te ate (cholestasis me jaundice), hepatitis, me te ngoikoretanga o te ate.

Mai i te punaha toto: thrombocytopenia (iti ki te taumaha), onge te leukopenia, hemolytic ranei anemia aplastic, erythrocytopenia, granulocytopenia, agranulocytosis me te pancytopenia (mai i te myelosuppression).

Mai i te taha o te roopu o te matakite: te ngoikore o te tirohanga kanohi na te huringa o te kukume o te huka kei roto i te toto (ina koa i te tiimata o te maimoatanga).

Hohenga tauhohenga: pruritus, urticaria, ruamata, onge dyspnea, he whakaheke toto toto, vasculitis mate pāwera, photosensitivity. Ko nga tauhohenga haumanu me te pseudo-mate pāwera, hei tikanga, he ngawari, engari ka taea te ahunga whakamua, me te dyspnea me te whakaheke toto toto, tae noa ki te wiri. Ka taea te ripeka-mate pāwera me etahi atu derivatives sulfonylurea, sulfonamides.

Mena ka pa ki nga paanga kino, ka aukati te tarukino, ka whakahaerehia te rongoa tohu.

Te taunekeneke

Te whakapakari i te hua hypoglycemic o te glimepiride Ka taea te tohuhia me te whakamahi i te wa ano ki te insulin me etahi atu raau taero hypoglycemic, ACE inhibitors, allopurinol, anabolic anabolic and male sex hormones, with chloramphenicol, Coumarin derivatives, cyclo-, tropa- and isophosphamide, fenfluramine, feniramidol, fibetraminum, fibetinum, fibratetin, , miconazole, pentoxifylline (me te whakahaere matua i nga horopeta tiketike), me te phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, su lfanilamides roa-mahi, tetracyclines, tritocqualin.

Ko te ngoikore o te mate hypoglycemic o te glimepiride taea ki te whakamahi i nga wa katoa ki te acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) me etahi atu tohu-a-waihomotiki, glucagon, laxatives (me te roa o te whakamahinga), te waikawa nikotiniki (i te horopeta teitei) me ona takawaenga, estrogest , fenothiazine, phenytoin, rifampicin, homoni thyroid, hinu lithium, chlorpromazine.

Ka kaha te whakapakari me te ngoikore o te mate hypoglycemic o te glimepiride ka kitea pea me te whakamahi i te waatea me te histamine H blockers₂nga kaiwhakauru, clonidine me te reserpine, me te whakamahi waipiro nui ranei.

Ki te papamuri o te whakamahinga o te glimepiride, ka kaha ake te whakatipu, te ngoikore ranei o te mahi a nga derivatives Coumarin.

Takaroa

I roto i te rangatira o te mate o te ao, a ko te hunga e mate ana ki ahau. Қан sarysuyndaғy ezhoғar концентрацияy te kukume o te tama o ішке қыabyldaannan keyin 2,5 saғattan soңethedі. Taralu kөlemi tөmen (8.8 ml), whakawhiwhi - 48 ml / min, a plasma aқuyzdarymen bailanysuy - 99% -dan astam, zhartyly shygarylu hiriwaeni - 5-8 saғatқa zhuyқ. Nga Whakariterite a Zhoғary dosalard қabyldaылannan keyin zhartylai shygarylu keseni artady.

Bauyrda glimepiridtің hydroxyldengen tuyndylaryna deіn metabolizdenedі, olar nesepte de (te raau taero ң bir rettіk dozasynyң 58% ғa zhuyғy), nәzhiste de (35-40%) anyқtalady. Te faaineinaraa bir ret қabyldaғanda zhne birneshe kүn қatarynan tәulіgіne 1 ret қoldanғanda pharmacokinetics sinda aytarlyқtay ayyrmashylyқ bayalmaғan. Ko te zhinaқtalmaydy te tarukino. Zhas shamalarymen zhynystary әр түрлі еделушілердегі Pharmacokinetics қ Parameterler ұқсас.

Mahi Bүyrek o te tamaң bұzylouy bar edelushіlerde glimepiride clearance artumen men onyң ortasha kukume o te tamaң tөmendeuіne beyimdіlіk bajalada.