Ke lāʻau lapaʻau Diapiride: nā ʻōlelo i hoʻohana no ka hoʻohana

ʻO kahi mākaʻi hypoglycemic, kahi kolu o ka wā o ka sulfonylurea ʻano derivative o ka hana lōʻihi. ʻO ka hopena hypoglycemic o ka lāʻau ma muli o ke kaomi paʻakikī o ka pancreatic a me ka extrapancreatic hana.

Hoʻokomo ka hana pancreatic i ka hoʻoulu ʻana i ka mea huna insulin e ka pancreatic β-cells, ka mea i hui pū ʻia e ka hoʻoweliweli ʻana a me ka hoʻonui ʻana o ka insulin endogenous. ʻO kēia hopena ma muli o ka glimepiride, me kahi uku nui, ua hui pū a kāpae i ka pilina o ka protein o cells-cells o ka pancreas, ka mea pili me nā pā pālola e pili ana i ka ATP, akā, ʻokoʻa ia mai kahi kahua paʻa maʻamau o ka 1st a me ka 2 o ka sulfonylureas. A ʻo kahi hopena, hoʻokuʻu ʻia ka insulin e ka exocytosis, aʻo ka nui o ka insulin huna ʻia i mea ʻokoʻa ma lalo o ka hana a nā ʻano haʻaluna o ka sulfonylurea. Kēia hopena e hoʻowalewale ʻia ai ka hopena o ka glimepiride i ka huna ʻana i ka insulin e hāʻawi pū ana i ka liʻiliʻi o ka hypoglycemia.

Hōʻike ka hopena o ka extrapancreatic o ka glimepiride i nā hopena, ke alakaʻi nei ka nui o ka hoʻonui ʻana i ka naʻau o nā ʻolua peripheral (pūpū a me ka momona) i ka insulin me ka hoʻonui ʻana i ka helu a me ka hana o nā protein e lawe ana i ka glucose ma o ka membranes, a me ka pale ʻana i ka synthesis o ka glucose i loko o ke akea me ka hoʻonui ʻana i ka ʻike o ka intracellular i loko o ka fructose-2.6 β-phosphate e hoʻopili ana i ka gluconeogenesis. ʻO nā hopena ʻē aʻe o ka extrapancreatic o ka glimepiride ka hopena: ka hoʻohaʻahaʻa ʻana i ka hui platelet me ka hoʻokaʻawale ʻana a me ka hoʻololi ʻana o ka acid arachidonic i ka thromboxane A2, e hoʻoulu hou ana i ka platelet aggregation, ka hoʻonui ʻana i ke kiʻekiʻe o ka endogenous α-tocopherol a me ka hana o nā antiioxidant enzymes (catalase, glutathione peroxidase i ke kaumaha, hōʻikeʻike nui ʻia nei i ka diabetes mellitus, anti-atherogenic effect ma ke kumu o ka hoʻopono ʻana i kahi kikoʻī C. phospholipase C.

ʻAʻole ʻo Glimepiride ke kāohi i ka hana hoʻokalakupua o ka myocardium i ischemia (ʻaʻole like glibenclamide).

ʻO ka hopena hypoglycemic loa o ka lāʻau lapaʻau e ʻike ʻia i nā hola 2-3 ma hope o ka hoʻokele ʻana, eʻoi aku ma mua o 24 mau hola a hilinaʻi ʻia ka dosis.

Me nā helu he nui o ka glimepiride i loko o kēlā me kēia lā he 4 mg, ka lōʻihi o ka ʻike nui ʻana ma ka serum koko ma hope o kahi o 2.5 mau hola a i ka nui o 309 ng / ml, aia kahi pilina ma waena o ka nui a me ka pae kiʻekiʻe o ka glimepiride i loko o ke koko, a me ka hopena ma waena o ka hopena a me ka wahi ma lalo o ka piko "i hoʻopaʻa ʻia ai. - wā. " Loaʻa iā Glimepiride ka bioavailability piha. ʻAʻole ʻai iki ka ʻai i ka absorption, me ka hoʻokaʻawale ʻana me kahi lohi i kahi iki o ka absorption.

Hōʻike ʻia ka Glimepiride e kahi puʻupuʻu liʻiliʻi o ka hoʻolaha (ma kahi o 8,8 L), e like me ka nui o ka māhele o ka hoʻokaʻawale ʻana o albumin, kahi kiʻekiʻe o ka hoʻopaʻa ʻana i nā protein plasma koko (ma mua o 99%) a me kahi haʻahaʻa manamana haʻahaʻa (ma kahi o 48 ml / min). Hoʻopili ʻo Glimepiride i loko o ka waiū umauma a ma o ka pale hematoplacental, ʻaʻole komo i ka BBB. ʻO Glimepiride ka biotransformed i ke kino i loko o ka 2 mau metabolites, i hoʻolālā ʻia e like me ka hopena o ka metabolism o ka glimepiride i loko o ka ate a he hydroxyl a me kahi mea kuli o ka carboxyl o ka glimepiride. Kahi hapalua o ka glimepiride ma kona kaila plasma i loko o ka serum koko e pili ana i ka regimen dote ʻana i nā lā he 5.8 mau hola. Ma hope o hoʻokahi kaʻe o ka waha o kahi glimepiride radiolabeled, ua ʻike ʻia ka 58% i ka urine a me 35% i nā moena. ʻAʻole i ʻike ʻia nā mea ikaika e hoʻololi ʻia ai i ka urine. ʻO ka hapalua o ka hē o ka hydroxyl a me ka pahu kalaka o ka glimepiride ma kahi o 3-6 mau hola a me 5-6 mau hola, kēlā

I ka poʻe maʻi me ka hana renal impaired (haʻahaʻa hana hōʻemi), aia kahi manaʻo e hoʻonui i ka clearance o glimepiride a me kahi hoʻēmi ʻana i ka hoʻokaʻawale ʻana o ka neʻe i loko o ke koko, ʻo ia paha ka wikiwiki o ka wikiwiki o ka lāʻau lapaʻau ma muli o ka hoʻopiʻi ʻana i ka protein. No laila, i kēia ʻāpana o nā maʻi ʻaʻohe pilikia o ka cumulation of glimepiride.

ʻO nā hiʻohiʻona pharmacokinetic o ka glimepiride e like i nā mea maʻi o nā kāne like ʻole a me nā hui like ʻole.

ʻO ka maʻi diabetes mellitus type II (non-insulin-depend) i nā pākeke me he monotherapy a i hui pū ʻia me metformin a i ʻole insulin.

Nā papa ʻaina diapiride

kaulana hypersensitivity i nā mea o ka lāʻau a me ka derivatives sulfonylurea a i ʻole ka hoʻomākaukau ʻana o ka waiony sulfonylamide

type like diabetes mellitus

maʻi ketoacidosis maʻi maʻi maʻi, maʻi koma maʻi

pilikia koʻikoʻi a me ka hoʻonāukiuki hepatic

hapai a lactation

keiki malalo o 18 makahiki

drug sangkapterine zhune sulfonylurea tuyndylaryna nemese basқa sulfonylamidtik hoʻomākaukau tarғa belgilі zhoғary sezmtaldy

ʻO insulin tәuдldi ʻO kaʻu ʻāpana ʻāpana ʻokoʻa

maʻi ketoacidosis maʻi maʻi maʻi, maʻi koma maʻi

bauyr zhne bүyrek hana o ke keiki ң auyr bұzylulary

zhktіlіk zhne lactation

18 jasқa deyingі balalarғa

Nā hopena ʻāpana o nā papa diapiride

valersensitivity hopena - itching, rash a me urticaria

cross allergy me sulfonylurea, sulfonamides a i ʻole nā mea pili e pili ana

i hoʻonui nui aʻe o nā enzymes ati

hiki ke loli paha nā pōkole ma ka nānā ʻana ma muli o nā loli o ke kaʻe o ka glucose o ke koko, kaomi ma mua o ka hoʻomaka ʻana o ka mālama ʻana

nā maʻi i ke thrombocytopenia koʻikoʻi, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, hemolytic anemia a me pancytopenia, kahi e nalo aku nei ma hope o ka hoʻokuʻu ʻana o ka hoʻōla

ʻO nā hopena hypoglycemic e puka mai ana i ka hapa nui o nā hihia koke, hiki ke hana i kahi ʻano koʻikoʻi a ʻaʻole hoʻi e maʻalahi ka maʻalahi i ka hoʻoponopono ʻana. ʻO ka loaʻa ʻana o kēia mau pane, e like me nā ʻano ʻē aʻe o ka maʻi hypoglycemic, ma nā ʻano kumuhana, e like me ka mea kūpono a me ka pau

vasculitis allergic, kūlike o ka hypersensitivity mai ke keiki liʻiliʻi i ka koʻikoʻi me ka hoʻomohala ʻana o ka dyspnea, he hoʻemi i ke koko, ke mau ʻia kekahi manawa

nausea, luaʻi, ke kuʻi ʻana, ka manaʻo a i ʻole ka ʻōpū i loko o ka ʻōpū, ka ʻōpū o ka ʻōpū, e koi ʻia ai i kekahi manawa

hana aho akea (no ka laʻana, stagnation o ka bile a me ka jaundice), hepatitis, i hiki ke holomua i ka ate ate

ke kaumaha i ka māmā

hoʻemi i ka nui o ka sodium i loko o kahi serum koko

Zhoғary sezimtaldyқ reaktylary - қysynu bөrtpe zhene esekzhem

sulphonylurea, sulphonamidetermen nemese tektes

bauyr fermentteri deңgejіnің zhoғarylauy

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

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

kөp zhadaylarda birden tuyndaytyn hypoglycemiaқ reaksiar auyr tүrhe enuі zhne tүzetuge үnemi kөne bermeuі mүmkіn. I was control lords ы tuyndauy hypoglycemia қ emdeudіқ basқa tүrlerі kesіne de, tamқtanu zhne dosisalau kilina ектив subjective і sharttarғa and bailanysty

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

Zhurek Ainuy, құsu, ʻ ,lelo, asқazandaғy қysym nemese lehulehu o ketu sezimі, іштің ауыруы, keide emdeudі toқtatudy қazet etuim mүmkіn

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

жарыққа жоғары сеімталдық

қан sarysuyndaғy sodium mөlsherіnің tөmendeuі

Nā ʻōlelo kikoʻī kūikawā e hoʻohana ai

Ma muli o ka mālama maikaʻi ʻana i ka maʻi hānai e pili ana i ka mākaukau o ka mea maʻi me kahi meaʻai kūpono, ka hana kino maʻamau, a me ka mālama mau ʻana i nā pae o ke koko a me ka hoʻoholomua. ʻAʻole hiki ke uku ʻia ka nānā ʻole ʻana i ka meaʻai e nā mea maʻi e ka lawe ʻana i nā pōpoki a i ʻole i ka insulin.

Pono koke ʻia ka Diapiride i mua o ʻole a me ka ʻai ʻana. Inā hele ʻia kahi pāʻawa i kēlā me kēia manawa a i ʻole ke kala ʻia ʻana, lawe ka lāʻau lapaʻau hiki ke hana i ka hypoglycemia. Hiki i nā ʻōmaʻomaʻo ke hoʻokaʻawale koke me ka wikiwiki inā lawe koke ka ʻaiā (kōpala).

ʻAʻole e hāʻawi ʻia kahi mea aloha i ka mea ulu.

ʻO ka ʻike me nā derivatives sulfonylurea e hōʻike ana he hiki ke hoʻomohala hou i ka hypoglycemia, ʻoiai me ka pōmaikaʻi mua o nā hana i hāpai ʻia.

ʻO ka hypoglycemia koʻikoʻi a lōʻihi paha, hiki ke hōʻemi wale ʻia i ka manawa pōkole ma ka inu ʻana i ka nui o ke kō, e pono ai ka lāʻau lapaʻau koke, a i kekahi manawa nā hale hoʻokipa.

ʻO nā mea i manaʻo i ka hanana o ka hypoglycemia ka: hoʻomaha a i ʻole (pinepine i ka poʻe maʻi makua) ʻo ka hiki ʻole ke hana pū me ke kauka, ka maʻi ʻole, nā meaʻai ʻōpō a i ʻole ka inu ʻana i ka meaʻai, ka wā ʻai, hoʻololi i ka ʻai, ka hoʻokaʻawale ʻana ma waena o ka hana kino a me ka intake o ka kalaiwa, ka inu ʻona. i ka hui pū ʻana me nā meaʻai skiple, hōʻemi a me ka hoʻohiolo o ka maʻi hepatic, overdose o Diapirid, kekahi mau hopena endocrine uncompensated e hoʻopilikia ai pili lākou i ka metabolism momololi, a i ʻole ke hoʻoponopono i ka hoʻoponopono ʻana o ka hypoglycemia (no ka laʻana, kekahi mau kuhi o ka glandida thyroid, ka lawa ʻana o ka hana o ka pituitary anterior a cortex adrenal), ka hoʻohana ʻana i kekahi mau lāʻau lapaʻau (e nānā i ka ʻāpana "Nā Pāʻina Kūleʻa").

Pono ka hoʻomaʻamaʻa ʻana me Diapiride i ka mālama mau ʻana i ke koko a me nā pae o ka wai paʻila. Eia kekahi, e ʻōlelo pono e hoʻomalu i ka nui o ka hemoglobin glycosylated.

I ka wā o ka lāʻau lapaʻau, mālama pono ka mālama ʻana i ka hana o ka ate a me ka nānā ʻana o ke kiʻi koko peripheral (ʻoi aku ka nui o ka leukocytes a me nā platelets) pono.

Ma nā kūlana koʻikoʻi (no ka laʻana, i nā ulia pōpilikia, nā hana wikiwiki, nā maʻi e hele pū ʻia e ke kuni), hiki ke kuhikuhi ʻia kahi manawa iki o ka maʻi.

ʻAʻohe ʻikepili e pili ana i ka hoʻohana ʻana o Diapiride i nā mea maʻi me ka maʻi puʻupaʻa ikaika loa a i ʻole nā mea e hōʻike ʻia o ka dialysis. ʻO nā maʻi me ka maʻi palaualelo a i ʻole hepatic insufficiency e hoʻoneʻe i ka insulin.

Pono e noʻonoʻo ʻia ka hūnā ʻia a i ʻole mau i nā hōʻailona o ka hypoglycemia i nā poʻe maʻi me nā neuropathy autonomic a i ʻole i ka poʻe i loaʻa i ka hopena me ka blockers β-adrenergic receptor, reserpine, clonidine, guanethidine a i ʻole sympatholytics. Inā lawa ʻole ka hopena a i hōʻemi ʻia ka hopena, ma ke keola o ka hoʻomanawanui ʻana, e hui pū ʻia me ka metformin a i ʻole insulin.

I ka hihia o ka maʻi diabetes, hoʻonui ka naʻau o ka insulin, a no laila, e emi ka pono o ka lāʻau lapaʻau i ka wā o ke kaʻina hana. I mea e hōʻalo ai i ka hoʻomohala ʻana o ka hypoglycemia, pono ia e hoʻemi i ka wā kūpono a hōʻoki paha i ka lāʻau lapaʻau. Pono e hoʻoponopono ʻia nā ʻano hoʻohālikelike i ke hoʻololi ʻana i ke kaumaha o ke kino o ka mea maʻi a i ʻole kona ʻano, a i ʻole ia i nā mea ʻē aʻe e loaʻa ai ka hypo- a i ka hyperglycemia.

ʻO ka poʻe maʻi i loaʻa i ka intolerance galactose luhua i loaʻa ʻole, ka hemahema o ka lactase a i ʻole he mea hoʻoluhinu o ka glucose-galactose e hopu ai, ʻaʻole pono e lawe i Diapiride.

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

Diapiridti as isherden bіraz bұryn nemese as isu kesіnde қabyldau Jaeger as іshu ретr rette әr tүrlі uaқytta oryn alsa nemese mүldem zhyberilip alsa, hoʻomākaukau қabyldau hypoglycemia tuғyzuy mүmkіn. Eger bіrden kөmіrsular (қant) қabyldasa, hōʻailona o ka daryn үnemі derlіk tez ңіlddetugu boladi.

Zhasandy tәttіlendіrgіshter Aehanday әser Bermaidi.

Basқa sulfonylurea tuyndylaryn қoldanu tәzhіribesі, tіpti қabyldanғan sharalardyң bastapқydғy sәttіlіgіne қарамастан, hypoglycemiaң Kayta damuy mүmkіnеkendі.

Қanttyң әdettegi mәlsherin paydalanyp tek uaқytsha ғana basu болa bolatyn auyr nemese ұza созa i hoʻopaʻa ʻia 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 e Alu, ashyғu kezeңі, tamaқtanu rezhimіnің өzgeruі, Dene zhүktemelerі hoʻololi kөmіrsulardy paydalanu arasyndaғy teңgerіmnің bұzyluy, inu waiu, әsіresе іshudі jіberіp alumen bіrge paydalanu, bүyrek әne bauyr hana o ke keiki ң Ortash bұzylulary, Diapiridtің artyқ dzozalanuy, endocrindyk үенyenің kөmіrsulardy lizmіne әser etetіn keybіr kompensatsiyalanbaytyn bұzylystary, Nemes gipoglikemiyanyң kerі regulyatsiyasy (mysaly, қalқansha ole 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 nonseptegly glucose deңgeyіn tұraқty tүrde baқılap oteruda ezhet ety. Bұdan өzge, glycosyldengen hemoglobin mөlsherin baқylauғa alu ұsynilady.

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

Stress jaғdailarinda (mau manaʻo, jazatayim jaғdaylarda, hana hoʻomalu lard, қyzbamen қatar zүretіn ұқұқpalarda) nauқasty uaқytsha insulating ayustyru kөrsetiluu mіmkіn.

Bauyr hana o ke keiki ң auyr bұzylulary bar nemes dialysis kөrsetilgen emdelushіlerge Diapiridti қoldanuғa қatysty mәlіmetter zhoқ. Bүyrektің nemese bauyrdy kүrdeli zhetkіlіksіzdіgі bar nauқastardy insulinіd қabyldauғa ayystru kerek.

ʻO nā mea neuropathy baropathy bar nemesis β-adrenergic receptor neuromuscular blocker, reserpinmen, clonidinmen, guanethidinmen nemesse basa sympatholytictermen biology meningitis muscular hypoglycaemia hypoglycaemia Jaeger әseri zhitkіlіksіz nemese іserі tөmendegen bolsa, қzaқ emdeu zhadayynda, metforminmen nemese insulinman bіrіktіru ұsynylady.

Diabetesиабant diabetes Hypoglycemiaң damuyn boldyrmau үshіn dozasyn der kesіnde tөmenddetu nemesa lāʻau lapaʻau toқtatu kerek. Dozasyn tүzetudі emdelushіnің dene salmaғy өzgergen nemese onyң өmir sүru tәsili өzgergen kездеde de, Sondai-aқ basқa hypothesis o ka hyperglycemia tuғyzuy mүmіkіnar jaғе paydaғ.

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

Dosis a me ke ala o ka hoʻokele ʻana

Hoʻohana ʻia ka lāʻau lapaʻau i nā pākeke.Hoʻokumu ka dosage i nā hopena o ke koko a me nā hoʻokaʻina o ka glucose o ka urine. Hoʻohana pinepine ʻia ka diapiride i ka manawa 1 i ka lā. Manaʻo ʻia ka lāʻau e lawe koke i ka wā ma mua a i ka wā o ka ʻaina kakahiaka a i ʻole, ināʻaʻohe kakahiaka kakahiaka, ma mua o ka manawa a i ʻole ma ka papa ʻaina mua. Puhi ka papa ʻula ʻole me ka hoʻomāeʻe ʻole ʻia, holoi ʻia me ka wai. Inā ua pau ka make aʻe o ka lā mai, ʻaʻole e hoʻonui ʻia ka hopena i loko o ka hopena hou.

ʻO ka maʻa mua loa he 1 mg o ka glimepiride i kēlā me kēia lā. Inā hiki i kahi ʻano maʻi ia oe e hoʻokele kūpono i ke kiʻekiʻe o ke kō, hoʻohana ʻia ia ma ke ʻano he mālama mālama. Inā ʻaʻole maikaʻi loa ka mana o ka glycemic, pono ke hoʻonui ʻia ka nui o ka nui i ka 2, 3 a i ʻole 4 mg o ka glimepiride i kēlā me kēia lā i nā manawa (ma waena o 1-2 mau pule). Inā loaʻa i ka mea maʻi ka hopena hypoglycemic lawe i ka lāʻau lapaʻau ma kahi o 1 mg o ka pākēneka i kēlā me kēia lā, ʻo ia ka mea e hiki ke hoʻomake wale ʻia ka maʻi mai ka hahai ʻana i kahi meaʻai. ʻO kahi dosis ma mua o 4 mg i kēlā me kēia lā e hāʻawi i nā hopena maikaʻi loa i nā hihia pilikino wale nō. ʻO ka mahuʻumau ʻoi loa e pili ana i ka 6 mg o ka diapiride i kēlā me kēia lā.

Inā ʻaʻole i hāʻawi ʻia ka nui o ka laiki o ka metformin i ka mana glycemic control, hiki ke hoʻomaka i ka lāʻau concomitant me glimepiride. Hoʻohui ʻia i ka wai o mua o ka metformin, pono e hoʻomaka ʻia ka lāʻau me ka haʻahaʻa haʻahaʻa, a laila hiki ke hoʻonui ʻia i ka nui i kēlā me kēia lā, e noʻonoʻo ana i ka pae o ka mana o ka hoʻokalakupua. ʻO ka hoʻokūkū hui pono e hoʻokō ʻia ma lalo o ka nānā mālama olakino.

Inā ʻaʻole ʻo ka wai nui o ka lā maʻamau o Diapiride e hāʻawi i ka mana glycemic lawa, inā pono, hiki ke hoʻomaka i ka hoʻomehana insulin concomitant. Hoʻopau i nā kaʻi mua o ka glimepiride, pono e hoʻomaka ka mālama ʻana i ka insulin me ka haʻahaʻa haʻahaʻa, a laila e hoʻonui ʻia, e nānā ana i ke kiʻekiʻe o ka hoʻokele metabolic. ʻO ka hoʻokūkū hui pono e hoʻokō ʻia ma lalo o ka nānā mālama olakino. ʻO ka hoʻomaikaʻi ʻana i ka hoʻomake ʻana o ka maʻi diabetes me ka piʻi aʻe o ka naʻau o ka insulin, no laila e emi ka nui o ka glimepiride i ka wā o ka mālama ʻana. I mea e pale ai i ka hypoglycemia, pono e hoʻemi iki ʻia ka lula a i ʻole hoʻopau ʻia ke ʻano holoʻokoʻa. Pono paha paha kahi loiloi maʻi pono inā he koʻikoʻi ke kino o ke kino a i ʻole e loli ana ke ola a i nā kūlana ʻē aʻe e pili ana i ka hopena o ka hopena o ka hypo- a hyperglycemia.

Hiki ke hoʻololi ʻia nā lawepiko hypoglycemic waha hou i ka diapiride. I ka wā o kēlā ke hoʻololi ʻana, pono e noʻonoʻo ʻia ka ikaika a me ka hapalua o ka luna ma mua. I kekahi mau hihia, ʻoiai inā he lōʻihi loa ka hapa o ka lāʻau antidiabetic (no ka laʻana, ʻo ka chlorpropamide), ʻoi ʻia ke kali i kekahi mau lā ma mua o ka lawe ʻana i Diapiride. Hoʻemi kēia i ka hopena o ka hopena hypoglycemic ma muli o ka hopena hoʻohui o nā mea ʻelua. ʻO ka lā inā i ʻōlelo ʻia ʻo 1 mg o glimepiride i kēlā me kēia lā. Hiki ke hoʻonui ikaika ʻia ka nui o ka hopena e noʻonoʻo i ka hopena i ka lāʻau lapaʻau.

Hoʻomoe ʻana i ka heresectergoldanada. Dozasa Kan men neseptegі glucose құramyn taldau әtyzhelerіne baylanysty. Retdette Diapiridti tәuligine 1 ret қoldanady. Lawa i maemeni taymy astan bіraz bұryn nemese taңғy as kesіnde nemese, jäger taңғy as bolmas, alғashқy negіzgі as іsherden bіraz bұryn nemese as іshu kesіnde қabyldau ұsynylady. Nā ʻ shlana papaʻa, sұyyқtyқpen іshіp zhtu kerek. Jäger hoʻomākaukau kesekti қabyldau zhіberіlіp alsa, kelesі қabyldaғan keshe dozasyn arttyrmau kerek.

Bastapy dosages tuligine 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 aralıtarman) e hāʻawi ʻia i arttyru. Hoʻomoe ʻo Jaeger nauқasta әuligine 1 mg dosis o қabyldauғa hypoglycemia қ reaksi o ba, als, bұl auruda tech emdәm ұstanudyң kөmegimen ғana baқylauғa bolatynyn kөrsetedі. Tәulіgіne 4 mg asatyn doses tek jekelegen zhadaylarda ғana үzdіk nәtyzhe mua. D жоғарғы ұсынылатин dosis - тәулігіне 6 mg Diapiride.

Eger metforminnін ең жңңарғы тәуліктік mau waihona o ka glycemia like-life қ baқylauda қamtamasyz etpese, glimepiridpen қatarlas emdi bastauғa bolyady. Metforminnіd aldyңғy dozasyn o ka ʻāina otyryp, hoʻomākaukau 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 eңoғarғy tәulіktіk dosages zhetkіlіktі glykemiyalyқ baқylauda қamtamasyz etpese, қ insulinman қatarlas emdeudi bastauғa bolydy. Glimepiridtің aldyңғy dozasyn syүyene otyryp, insulin emdeudі tөmen dozasynan bastau kerek, oney keyin ика baқylaudyң қazhetti deңgeyin baғdarғa ala otyryp artyruғa. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek. Diabetty baқylaudy jaқsartu insulin sezmtaldyқtyң artuymen қatar zhredі, sondyқtan emdeu papa kazіnde glimepiridke қazhettіlіk azayuy mүmkіn. Hypoglycemia boldyrmau masatynda dozasyn birtіndep azaytu nemese emdeudі mүlddem totatu kerek. ʻO Dozasyn Kayta қarau қazhettіlіgі äger emdelushіde dené salmaғ nemese өmіr sүru tәsіlі өzgerse nemesa hypomemes hyperglycemia упaupіn arttyratyn basқa da zhaydaylaryt ү у uyusaynuyurnuyetuyuy

Ishu agyly қabyldanatyn basқa hypoglycemia agentterden әdette Diapiridke kөshugu bolada. Mұndai auysu kesіnde aldyңғy dәrіnің kүshі men zhartylai maluғarylu hiriwaңіn esker kerek. Kay zhadaylarda, іsіrese jäger diabetes қars hoʻomākaukau ң zhartylı shyғarylu hiriwaңi ұzaқ bolsa (manaʻo, chlorpropamide), Diapiridti қabyldauda bastardy ң aldynda bіrneshe kүn kүte tұru. Бұл екі agentт additivetik әсerіnің saldarynan hypoglycemiaқ reaksiar упаупін азайтуға мүмкіндік береді. Ұsynylatyn bastapқ dosages - tәuligine 1 mg glimepiride. ʻO Dozasyn drug is reactive eskere otyryp, satylap arttyruғa bolyady.

Nā Hoʻohui Kūʻai

ʻO ka lawelawe like ʻana o Diapiride me kekahi mau lāʻau hiki ke hoʻolōʻihi i ka nawaliwali a me ka hoʻonui ʻana o ka hopena hypoglycemic of glimepiride. No laila, lawe ʻia nā lāʻau lapaʻau wale nō me ka ʻae ʻana (a i ʻole e kuhikuhi ʻia) e ke kauka. Hoʻopili ʻia ka Glimepiride me ka hoʻohana ʻana i ka cytochrome P450 2C9 (CYPC9). Ua ʻike ʻia ma muli o ka hoʻokahuli ʻana o nā inducers (e.g. rifampicin) a i ʻole CYPC9 inhibitors (e.g. fluconazole), i ʻole kēia loli. Ua hōʻike ʻia kahi haʻawina ma vivo e pili ana i ka fluconazole, ʻo ia kekahi o nā mea paʻa nui CYPC9, hoʻonui i ka AUC o ka glimepiride e pili ana i ka hapalua.

E hoʻoikaika i ka hopena o ka glimepiride me ka hoʻohana pū: phenylbutazone, azapropazone and oxyphenbutazone, sulfinpyrazone, insulin a me nā lāʻau antidiabetic waha, kekahi sulfonamides lōʻihi, metformin, tetracyclines, salicylates a me ka waikiki p-aminosalicylic, inhibitor MAO, anabolic anabids a male sex hormones, cholinergicinololekekekekekekekekekek, , ka miconazole, fenfluramine, pentoxifyline (nui nā wai makua), nā fibrates, tritokvalin, ACE inhibitors, fluconazole, fluoxetine, allopurinol, sympatholytics, cyclophosph ka memo a, disopyramide, feniramidol, guanethidine, ifosfamide Pas.

Hoʻemi i ka hopena hypoglycemic o ka glimepiride i ka wā e hoʻohana ana: estrogens a progestogens, saluretics, thiazide diuretics, thyroid hormone a me nā lāʻau hoʻōla e hoʻoikaika i ka hana thyroid, corticosteroids a me glucocorticoids, phenothiazine derivatives, chlorpromazine, epinephrine a me sympathomimetics, nicotinic acid (kiʻekiʻe nā wai) a me nā kumulāʻau, glucagon, laʻa noi), phenytoin, diazoxide, glucagon, barbiturates a me rifampicin, acetazolamide.

Nā Hagon receptor Hime, nā beta-blockers, clonidine a me ka reserpine hiki i ka lua me ka hoʻōla a hoʻemi i ka hopena hypoglycemic. Ma lalo o ka hopena o ka sympatholytics, e like me beta-blockers, clonidine, guanethidine a me ka reserpine, ka hōʻike ʻana o ka hoʻoponopono o ka adrenergic reverse o ka haʻaogogogogia e hoʻoneʻe a ʻalo paha. Hiki i ka inu ʻona ke hoʻoikaika a hoʻonāwaliwali i ka hopena hypoglycemic o ka glimepiride.

Diapiridti belgіlі bіr dәrіlіk zattarmen bіr mezgіlde қabyldau glimepiridtің hypoglycemia қсерінің әлсіреуін де, күшеюін де туғызуы мүмкін. Sondyқtan basқa ka hoʻomākaukau ʻana i ka lāʻau lapaʻau dәrіgerdің kelіsіmіmen (nemese taayyndauymen) ғana Koldanu kerek. Glimepiride P450 2C9 (CYPC9) nā cytochromes ң kmegimen metabolizdenedі. СYPC9 inductorlaryn (manaʻo noʻonoʻo rifampicind) nemez tezhegіshterіn (manaʻo 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, insulina zhane іshіletіn diabetke қarsy preparattar, ұzaқ әser etetіn keybіr sulfonamidter, metformin, tetratsiklinder, salitsilattar zhane pa-aminosalitsil қyshқyly Mao tezhegіshterі, anabolikalyқ steroidtar zhane erlerdің zhynystyқ gormondary, hinolondyқ antibiotikter, chloramphenicol, probenecid, Coumarindek anticoagulantar, miconazole, fenfluramine, pentoxifyline (makua makua), fibrattar, tritokvalin, AӨF tezhegіshterі, fluconazole, fluoxetine, allopurinol, sympatho itikter, cyclophosphamide, disopyramide, feniramidol, guanethidine, ifosfamide PASҚ.

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

Agon2-receptor lardң antagonist, beta-blocker, clonidine men reserpine hypoglycemia әserin әleuettendіruі de, tөmendueti de mүmkіn. Beta-blocker, clonidine, guanethidine, wahine kūlohelohe, ka ʻohuihilima sympatholyticterdin ә serineen hypoglycemia ң adrenergic ия Keri nā rula o nā keiki ң kңrіnіsі azayu nemese zhғaluy mүmkіn. Alika Paidalanu glimepiridtің hypoglycemiaқ әсerіn kтуshaituі nemese әlsіretuі mүmkіn.

Ka hana lāʻau lapaʻau

ʻO kahi ʻaihue hypoglycemic, kahi hua o ka sulfonylurea o ke kolu o ka hanauna o ka hana lōʻihi. ʻO ka hopena o ke kōmākaha o ka hilo o ka lāʻau ma muli o ka hoʻopulapula o ka pancreatic a me ka hana extrapancreatic. Hoʻokomo ka hana pancreatic i ka hoʻoulu ʻana i ka mea huna insulin e ka pancreatic β-cells, ka mea i hui pū ʻia e ka hoʻoweliweli ʻana a me ka hoʻonui ʻana o ka insulin endogenous. ʻO kēia hopena ma muli o ka glimepiride, me ka nui o ka nui o ka substitution, ke hoʻopili a me ke kāohi ʻana mai ka protein o ka ß-cells o ka pancreas, ka mea pili me nā pā pālima e hilinaʻi ana i ka ATP, akā, ʻokoʻa ia mai nā kahua paʻa maʻamau o ka 1st a me ka 2 o ka sulfanylureas. A ʻo kahi hopena, hoʻokuʻu ʻia ka insulin e ka exocytosis, aʻo ka nui o ka insulin huna ʻia i mea ʻokoʻa ma lalo o ka hana a nā ʻano kuʻuna o ka sulfanylurea. Kēia hopena hoʻonāukiuki i ka hopena o ka glimepiride i ka huna ʻana o ka insulin e hāʻawi i kahi haʻahaʻa o ka haʻahaʻa o ka hypoglycemia. Hōʻike ka hopena o ka extrapancreatic o ka glimepiride e kekahi mau hana, ʻo ke alakaʻi no ia ka mea i hoʻonui ʻia i ka naʻau o nā ʻiʻo peripheral (pūʻai a me ka momona) i ka insulin me ka hoʻonui ʻana i ka helu a me ka hana o nā protein e lawe ana i ka glucose ma o ka membranes, a me ka pale ʻana i ka synthesis o ka glucose i loko o ke ate me ka hoʻonui ʻana i ka hoʻololi ʻana o ka fractose-2.6 β-phosphate e hoʻopili ana i ka gluconeogenesis. ʻO nā hopena ʻē aʻe o ka extrapancreatic o ka glimepiride ka hopena: ka hoʻohaʻahaʻa ʻana i ka platelet aggregation ma muli o ka hoʻokaʻa selektif o ka cyclooxygenase a me ka hoʻololi ʻana o ka waikawa arachidonic e ka thromboxane A2, e hoʻōla ana i ka hui platelet, ka nui o ke kiʻekiʻe o ka endogenous α-tocopherol a me ka hana o nā antiioxidant enzymes (catalasease, glutathath, glutathathath) i ke kaumaha, ke kū nei mau i ka diabetes mellitus, anti-atherogenic effect ma ke kumu o tivatsii i ho'ākāka 'phospholipase C. glimepiride' aʻole i inhibit i ka metabolic ka hoʻololiʻana i myocardial ischemia (like glibenclamide). ʻO ka hopena hypoglycemic loa o ka lāʻau lapaʻau e ʻike ʻia i nā hola 2-3 ma hope o ka hoʻokele ʻana, eʻoi aku ma mua o 24 mau hola a hilinaʻi ʻia ka dosis.
Lapaʻau lāʻau
Me nā helu he nui o ka glimepiride i loko o kēlā me kēia lā he 4 mg, ka lōʻihi o ka ʻike nui ʻana ma ka serum koko ma hope o kahi o 2.5 mau hola a 309 ng / ml, aia kahi pilina laina ma waena o ka pāhono a me ka paeʻikepili nui o ka glimepiride i loko o ke koko, a me ka hopena ma waena o ka hopena a me nā wahi ma lalo o ka piko. -iko. " Loaʻa iā Glimepiride ka bioavailability piha. ʻAʻole ʻai iki ka ʻai i ka absorption, me ka hoʻokaʻawale ʻana me kahi lohi i kahi iki o ka absorption. Kuhi ʻia ka Glimepiride e kahi haʻahaʻa o ka hoʻoili ʻana (ma kahi o 8,8 L), aneane like me ka nui o ka māhele ʻana o ka albumin, kahi kiʻekiʻe o ka hoʻopaʻa ʻana i nā protein plasma (ma mua o 99%) a me ka haʻahaʻa haʻahaʻa (ma kahi o 48 ml / min). Hoʻopili ʻia ʻo Glimepiride i ka waiū umauma a kau i ka pāpaʻi placental. E komo i loko me ka palaka o ke kahe koko-lolo. ʻO Glimepiride ka biotransformed i ke kino i loko o ka 2 mau metabolites, ka hopena mai ka metabolism o ka glimepiride i loko o ka ate a e hōʻike ana i kahi kahi hydroxylated a me kahi mea i hana ʻia o ka glimepiride. ʻO ka hapalua hapalua o ka glimepiride i kāna mālama plasma i loko o ka serum e pili ana i ka regimen dote ʻana i nā manawa he 5-8 mau hola ma hope o ka lawe ʻana i ka glimepiride i nā wai kala kiʻekiʻe, hoʻonui ʻia ka hapalua-ola. Ma hope o kahi kahe o hoʻokahi waha o glimepiride i kāʻei ʻia me ka leki leo, 58% i loaʻa i loko o ka urine a me 35% i nā feces. ʻAʻole i ʻike ʻia ka mea i hoʻololi ʻia i loko o ka urine. ʻO ka hapalua o ka manawa o ka hydroxylated a me ka carboxylated metabolite o glimepiride ma kahi o 3-6 hola a me 5-6 hola, kēlā me kēia. I ka poʻe maʻi me ka hana renal impaired (haʻahaʻa hana hōʻemi), aia ka manaʻo e hoʻonui i ka clearance o glimepiride a me ke kaohi ʻana o ka hoʻokaʻawale ʻana o ka neʻe i loko o ke koko, a inā paha, ʻoi aku ka wikiwiki o ka wikiwiki o ka lāʻau ma muli o ka hoʻopiʻi ʻana i ka protein. No laila, ma kēia ʻāpana o nā maʻi ʻaʻohe mea hou aku i ka nui o ka hoʻohui o ka glimepiride. ʻO nā hiʻohiʻona pharmacokinetic o ka glimepiride e like i nā mea maʻi o nā kāne like ʻole a me nā hui like ʻole.

Ke ʻano o ka noi

No nā pākeke: E hāʻawi i loko o mua o ka ʻaina kakahiaka a i ʻole ʻaina awakea. Pōmaikaʻi ʻia nā papa me ka ʻole o ka minamina, holoi ʻia me ka nui o ka wai (e pili ana i ka 1/2 kī). He mea nui ia e hoʻōki i ka papaʻaina ma hope o ka lawe ʻana i Diapiride. ʻO ka pākuʻi mua a me ka mālama mālama ʻana, ka manawa o ka hoʻokele a me ka hāʻawi ʻana i ka ʻikepili i kēlā me kēia lā e kau hoʻokahi ma muli o nā hopena o ka hoʻoholo maʻamau o ka pae o ka glucose i ke koko a me ka urine.ʻO ka maʻa mua loa o Diapiride ka 1 mg hoʻopaʻa ma 1 mau manawa i kēlā me kēia lā. Inā pono, e hoʻokau ʻia ka hoʻonui ʻia o ka pākana i kēlā me kēia lā me ka mālama pinepine ʻana i nā pae glucose koko, e hoʻonui mālie i ka nui ma kēlā me kēia mau hebedoma 1-2 e like me ke kumu: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg. I kekahi mau hihia, hiki ke hoʻonui ʻia ka nui o ka lā ma Diapiride i 8 mg. Hoʻohana ʻia ka nui o nā lā i kēlā me kēia lā. No nā mea maʻi me ka maʻi 'aʻai, e laʻa ka nui o ka lā i kēlā me kēia lā he 1-4 mg o ka glimepiride, aia wale nō i kekahi mau mea maʻi ka hopena pono i ka wā e lawe ai i nā kēpana i kēlā me kēia lā o 6 mg a keu aʻe. ʻO ka 6 mg nui ka laila e 6 mg, ma kekahi mau hihia - 8 mg. Ke hoʻohana ʻia ka lāʻau lapaʻau i ka wā lōʻihi. Ma ka hihia o ka maʻi diabetes, hoʻonui ʻia ka ʻike ʻana i nā kao i ka insulin, a no laila e emi iho ka pono o ka glimepiride, e koi ai i kahi hōʻemi iki ʻana a i ʻole hoʻoneʻe ʻia o ka lāʻau (e pili ana i nā hopena o ka loiloi o ke ʻano o ke koko a me ka hoʻoliʻi wai ʻai). Me kahi loli o ke kaumaha o ke kino a me ke ʻano o ke ola, a me ka ke ʻano o nā mea i hāʻawi ʻia i ka nui o ka ulu ʻana o ka ulu ʻana o ka hypo- a hyperglycemia, pono kahi hoʻoponopono lāʻau e pono ai.
Hoʻohana me ka hui pū me ka metformin. Ua hoʻohālikelike ʻia ʻo Diapiride me ka metformin inā ʻaʻole i lawa ka paʻa o ka glucose i ke koko i nā poʻe maʻi e hoʻomaʻamaʻa ana i ka metformin monotherapy. ʻOiai e mālama pono ana i ka hāmeʻa o ka metformin ma ka pae like, hoʻomaka ka mālama ʻana me Diapiride me ka liʻiliʻi haʻahaʻa o 1 mg, e hoʻonui mālie i ka nui o ka make ʻana ma ke ʻano o ka makemake glycemic control, a hiki i ka nui o kēlā me kēia lā o 6 mg.
Hoʻohana me ka insulin. Hoʻohui ʻia ʻo Diapiride me ka insulin i ka wā i hiki ʻole ai ke hoʻokō ʻia ka maʻamau normalization o ke kaila glucose ma o ka lawe ʻana i ka nui loa o ka Diapiride ma ke ʻano monotherapy a i hui pū paha me ka nui o ka metformin. Eia kekahi, e kū i ke kiʻi o ka hopena o Diapirid i kuhikuhi ʻia i ka mea maʻi, hoʻomaka ka mālamaʻana i ka insulin me ka hōʻemi haʻahaʻa loa, me ka nui o ka hiki o ka nui o ka nui o ka insulin i lalo o ka kaohi o ke kaohi glucose o ke koko. Hoʻohālikelike ka hoʻomaʻamaʻa ʻana i ka lāʻau lapaʻau kauoha paʻa. ʻOiai e mālama nei i ka mālama glycemic wā lōʻihi, hiki i kēia hoʻohui hoʻohui ke hōʻemi i ka noiʻana o ka insulin ma ka 40%.
Ka hoʻouna i ka mea maʻi i Diapiride mai kahi mālamalama hypoglycemic waha. ʻAʻohe pilina kūpono ma waena o nā pona o ka glimepiride a me nā lāʻau lapaʻau hypoglycemic waha. Ke lawe nei i kēlā mau lāʻau lapaʻau (me ka nui o ko lākou mau kiʻekiʻe) i Diapiride, pono ka lāʻau mua o ka glimepiride. Pono e hoʻonui ʻia i kēlā me kēia pane o Diapiride ma ke ʻano, e noʻonoʻo ana i ka pane o ke kino i kēia loea therapeutic. ʻO ka hopena i hoʻohana ʻia a me ka lōʻihi o ka hopena o ka hopena ma mua o ka waha hypoglycemic waha pono e mālama ʻia. I kekahi mau hihia, ʻoi aku me nā hoʻokele mua o ka lāʻau hypoglycemic me ka hapalua ola (ʻo ka laʻana, ʻo chlorpropamide) pono ia no ka manawa iki (no kekahi mau lā) ke kāpae nei i ka mālama ʻana i mea e pale ai i ka hopena hoʻohui e hoʻonui i ka hōʻeha o ka hypoglycemia.

Ka hoʻololi i ka mea maʻi mai ka insulin i Diapiride. I nā hanana kūʻokoʻa loa, i ka wā i loaʻa ai ka poʻe maʻi me ka diabetes-mellitus non-insulin mellitus (type II) e hoʻohana i ka terapi insulin, ʻoiai e uku nei no ka maʻi a me ka mālama ʻana i ka hana huna o nā maʻi o ka pancreatic,-cell, hiki iā lākou ke hōʻike ʻia kahi hoʻololi mai ka insulin i Diapiride. Pono e hoʻoneʻe aku i Diapiride ma lalo o ka mālama mālama olakino. I kēia hihia, ʻo ka maʻi mua o ka Diapiride ka 1 mg. ʻO ka lōʻihi o ka mālama ʻana i kēlā me kēia hihia i hoʻoholo ʻia e ke kauka. ʻAʻoheʻike me ka hoʻohana o ka lāʻau lapaʻau no ka mālama ʻana o nā keiki.

- Kahi II mellitus maʻi '(non-insulin-depend) i nā pākeke me he monotherapy a i hui pū ʻia me metformin a i ʻole insulin.

E hoʻokuʻu i ke ʻano

Nā Palaki
ʻO ka papa 1 he 2 mg, a he 3 mg paha, a i ʻole 4 mg o ka glimepiride, nā mea hoʻonani: lactose monohala, microcrystalline cellulose (102), sodium starch glycolate, povidone (25), magnesium stearate. Nā papa papa i Diapiride 2 mg hoʻohui pū i ka hao oxide yellow, indigo carmine, Diapiride 3 mg - ka hao i ka oxide yellow, Diapiride 4 mg - Indigo carmine.

Hoʻokumu ʻia ka ʻikepili ma ka ʻaoʻao āu e nānā nei no nā pahuhopu ʻike a ʻaʻole ia e hoʻolaha i ka lāʻau lapaʻau ponoʻī ma kekahi ʻano. Pono ka punaewele e hoʻomaʻamaʻa i nā limahana mālama olakino me nā ʻike hou e pili ana i kekahi mau lāʻau lapaʻau, e hoʻonui ai i ko lākou pae kiʻekiʻe. Ke hoʻohana nei i ka lāʻau "Diapyrid" me ka nele o ka hoʻolako ʻana i kamaʻilio kūkākūkā me kahi loea, a me kāna mau ʻōlelo aʻoaʻo e pili ana i ke ʻano o ka hoʻohana a me ke ʻano o kāu lāʻau i koho ʻia.

E hoʻokuʻu i nā palapala a me ka ʻano

Hana ʻia ka lāʻau lapaʻau i ke ʻano o nā papa me nā ʻano like ʻole o ka mea ikaika. I loko o kahi pahu kāleka he 30 mau papa i nā palaka. 1 papa pili iā 2, 3 a i ʻole 4 mg o ka glimepiride (mea ikaika). ʻO nā papa ʻaina me kahi dosage o 2 mg mau kukui he'ōmaʻomaʻo, 3 mg kukui ke kukui, 4 mg ʻolika ka aniani.

ʻO ka hoʻonohonoho ʻana o nā papa i loaʻa nā mea like loa.

laktosa lactose,
mikuleka
sodium starch glycolate,
povidone
hāleʻa hao hao ʻona
konekena stearate,
indigo carmine.

Lapaʻau lāʻau

Ma hope o ke kauā ʻana, ua hoʻopili koke ʻia ka glimepiride i ke kaomi kūwili ʻana a komo i ke kahe wai. ʻO ka ʻai ʻana, ʻaʻole i hōʻemi i ka lawe ʻana o ka lāʻau. Ua hiki i kēia mea hoʻonaʻeha loa i kona kaila koko i loko o nā hola 2-2.5.

Ma hope o ke kauā ʻana, ua hoʻopili koke ʻia ka glimepiride i ke kaomi kūwili ʻana a komo i ke kahe wai.

Hōʻike ʻia ka Glimepiride e ka hoʻopiʻi maikaʻi ʻana i nā protein koko (99%). Lawe ʻia ka metabolism o ka lāʻauʻala ma ka nuku. ʻO nā metabolite ka hopena e hōʻike ʻia e nā pōpoki a me nā lau. Hoʻokuʻu ʻia ka lāʻau lapaʻau mai ke kino ma loko o nā hola 10-16. ʻOiai e lawe ana iā Diapiride, ʻaʻole i ʻike ʻia ka hōʻiliʻili o nā mea i loko o ke kino (ʻoiai me ka hoʻohana mau ʻana).

Me ka mālama pono

Ma lalo o ka mākaʻikaʻi paʻa ʻana o kahi kauka, hoʻohana ʻia ka lāʻau lapaʻau no ka hana wikiwiki, ka wai ʻawa, ke kuni, ke kanulau o ka thyroid, ka maʻi adrenal a me ka maʻi ʻino.

Ma hope o ka hoʻoili kino o ka hōʻeha ʻana, nā mea hōʻeha, ke kau ʻana, ʻōlelo ʻia nā mea maʻi e hoʻohuli i ka hoʻomehana insulin.

Pehea e lawe ai i ka diapiride?

Lawe ʻia ka lāʻau ma ke ʻano me ka liʻiliʻi o ka wai. Hoʻomaopopo ia e hoʻohui i ka hana o nā papa me ka meaʻai no ka pale ʻana o nā pono gastrointestinal.

Me ka maʻi diabetes

No ka mālamaʻana i ka non-insulin-depend type type II mellitus, lawe ʻia kēia lāʻau lapaʻau i 1-2 mau manawa i ka lā. I ka hoʻomaka o ka hopena, ʻo ka nui o nā lemona he 1 mg ma kahi o ka glimepiride. Inā lawa ka hana maʻamau i ka glucose i ke koko, a laila ʻaʻole hoʻonui ka nui o ka make.

Me ka loaʻa ʻole o ka hopena, hoʻonui ka lohi i ka 2, 3 a i ʻole 4 mg. ʻO ka palena ma waena o nā loli dosage e liʻiliʻi ma kahi o 7 mau lā. No kekahi manawa ua kuhikuhi ʻia nā mea maʻi 6 mg o ka glimepiride i kēlā me kēia lā (ʻokoʻa loa ka ʻele loa i kēlā me kēia lā).

Hiki i nā kauka ke kuhikuhi i ka hoʻokele ʻana o ka lāʻau lapaʻau me ka metformin a i ʻole insulin e hoʻokō i ka hopena kiʻekiʻe. ʻO ka lawe ʻana i kēia mau lāʻau hiki ke piʻi i ka hoʻonui mau ʻana o ka hiki ʻana i nā insulin. I kēia hihia, hoʻemi a hoʻopau ʻia ka huakaʻi ʻana.

Ma ka ʻāpana o ka io o ka hihiʻo

I ka wā mālama, hiki ke hele i ka hana ʻōwili ākea (hōʻeha waʻa). ʻO ke kumu o kēia hopena hopena he hoʻololi i ke kō koko.

No ka mālamaʻana i ka non-insulin-depend type type II mellitus, lawe ʻia kēia lāʻau lapaʻau i 1-2 mau manawa i ka lā.

Hematopoietic mau hui

ʻO nā hopena ʻaoʻao mai ka ʻōnaehana hematopoietic:

thrombocytopenia
leukopenia
anemia
halekulaolia,
erythroclopiaia,
huokupaʻa,
pancytopenia.

Pūnaehana pīhoihoi waena

Mai ka pūnaehana neʻe o ka mea i ʻike ʻia:

lie kanikela
āhāhuʻe
hilahila
ʻōpala
luhi, luhi
nā kūlana kaumaha
ho'ēmi i ka hopena psychomotor,
hoʻonā wahaʻōlelo
limu lima,
nahoa.

Mai ka ʻaoʻao o ka metabolism

Hōʻike ka hopena maikaʻi ʻole i ka hana metabolism e ka hypoglycemia.

I ka wā o ka hoʻokele ʻana, hiki i nā hopena maʻi:

kaʻiliʻili
urticaria
ʻohiʻala
maʻi vasculitis.

Hoʻohana i ka wā kahiko

Hāʻawi ʻia ka mea hana no ka poʻe maʻi o nā ʻokoʻa makahiki, me kaʻole o nā keiki. Akā hiki i nā poʻe kahiko me ka hoʻohana mau loa i nā lāʻau hoʻomohala e ulu i ka hypoglycemia. I mea e pale aku ai i kēia kulekele, kuhikuhi ke kauka i nā mea maʻi maʻi makua i ka meaʻai kūikawā a me nā helu haʻahaʻa o ka lāʻau (inā hiki).

Ka huhū o Diapiride

ʻO kahi overdose o ka lāʻau lapaʻau e alakaʻi i ke ʻano o nā hopena hypoglycemic (kahi pākeke ikaika i ke kōhi koko). I kēia hihia, hōʻeha ka mea maʻi i ka palupalu, ke kaumaha, mau maʻi kaumaha. Hiki paha ke nalowale. No ka hoʻopau ʻana i nā hōʻailona o kahi overdose, hele lākou i ka maʻi hōʻailona.

ʻO kahi overdose o ka lāʻau lapaʻau e alakaʻi i ke ʻano o nā hopena hypoglycemic (kahi pākeke ikaika i ke kōhi koko).

Hoʻopili pū me nā lāʻau ʻē aʻe

Pono ka lāʻau e hoʻokaʻawale me ka makaʻala e hui pū ai me nā lāʻau lapaʻau e like me:

Fluconazole
Phenylbutazone.
ʻAzapropazone.
Sulfinpyrazone.
Oxyphenbutazone.
Pentoxifylline.
Tritokvalin.
Nā Disopyramides.
Fenfluramine.
Probenecid.
Anticoagulants mai ka hui pūʻulu.
Nā Salicylates.
Kekahi antidepressants (MAO inhibitors).
Hoʻopuka ʻana.
Hoʻolālā.
Cyclophosphamide.
Feniramidol.
Ifosfamide.
ʻO Miconazole
Nā lāʻau Tetracycline a me quinolone.
ʻO nā lāʻau lapaʻau hypoglycemic ʻē aʻe.
ʻO nā mea maʻi anabolic.
ACE paleai.
PASK (para-aminosalicylic acid).

Me ka hoʻohana like ʻana o kēia mau kālā, ua hoʻonui ʻia ka hopena hypoglycemic Diapiride. ʻO ka hoʻohaʻahaʻa ʻana i ka hopena o ka lāʻau lapaʻau e nānā ana i ka wā e lawe pū pū me ka Phenothiazine a me nā mea waiwai, estrogens a me progestogens, glucagon, acid acid nicotinic, corticosteroids, barbiturates, Phenytoin, Acetazolamide, diuretics a me nā lāʻau lapaʻau no ka mālama ʻana i ka gland thyroid.

Kahawai

Mai hoʻohana i ka lāʻau Diapiride i ka wā hāpai. Inā hoʻoholo ka mea maʻi i ka glimepiride i kahi hāpai a i ka manawa hāpai paha, pono ia e neʻe i ka hoʻōla kino ma ka wikiwiki.
No ka mea ua hoʻoholo ʻia nā kumuhana sulfonylurea i ka waiū umauma, ua hōʻike ʻia e hoʻolōʻihi ʻia ka mālama ʻana me ka glimepiride no ka hopena o ka hopena o ka hypoglycemia i nā keiki hou.

Pākuʻi helu

2 mg, 3 mg, a me nā papa 4 mg

Aia ma ka papa papa

mea hoʻonaʻauao: glimepiride (micronized) ma kahi o ka 100% mea - 2 mg, 3 mg a me 4 mg,

Nā papa 2 mg: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (type A), povidone (25), hao (III) oxide melemele (E 172), indigo carmine (E 132), magnesium stearate,

3 papa papa: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (type A), povidone (25), hao (III) ka pōkole melemele (E 172), magnesium stearate,

4 papa papa: lactose monohydrate, microcrystalline cellulose 102, sodium starch glycolate (type A), povidone (25), indigo carmine (E 132), magnesium stearate.

Nā papa papa lapalapa me kahi papa pālahalaha, mai ke aniani nāala a hiki i ke ʻōmaʻomaʻo (no ka dosage o 2 mg), mai ke aniani a ʻulaʻula a i ka melemele (no ke ʻano he 3 mg), mai i ka uliuli i ka uliuli (no ka dosage o 4 mg). me nā kihi he beveled a notch. Ma ka papa o nā papa, interspersed

Hoʻokomo ʻia ka diapiride i nā papa

Hiki i ke overdose ke alakaʻi i ka hypoglycemia, kahi e hala ana mai 12 a 72 mau hola, a ma hope o ka hoʻomaʻamaʻa hou ʻana o ka hoʻomaʻamaʻa mua ʻana. Hiki ke hōʻola ʻia nā ʻōhumu 24 mau hola ma hope o ke lilo ʻana o ka lāʻau. Ma ke kānāwai, pono nā mea maʻi i loko o ka haukapila.

Nā hōʻailona o ka hypoglycemia: ka nausea, ka luaʻi a me ka ʻeha i loko o ka ʻōpū, nā haʻalulu, nā pilikia ākea, nā lūlū loea, nā lūlū, ke hiamoe ʻana i ka hiamoe, nā hopohopo, hoʻāliʻi, hoʻonaninani, a me ke ʻano he manawa, me ka hopohopo, hoʻomālamalama, ka ʻōlelo a me ka hoʻopiʻi ʻia, nā aphasia, paresis, hoʻonanea dizziness, helplessness, nalowale o ke kiaʻi ponoʻī, delirium, cerebral cramps, ka nalowale o ka ʻike ma ka hoʻomohala ʻana i ka coma, hāwaʻe hāpili a me ka bradycardia. Eia kekahi, pono e nānā ʻia nā hōʻailona o ke hoʻoponopono adrenergic e like me ka holoi ʻana, ka hopohopo, tachycardia, hypertension arterial, palpitations, angina pectoris a me cardiac arrhythmia. ʻO ke kiʻi o ka maʻi lapaʻau o ka hōʻeha hypoglycemic koʻikoʻi e like me kahi hōʻeha.

Artyқ dosalanuy hypoglycemia ғ alyp keluy mүmkіn, ol 12-den 72 saғatқa dejin sozulyuy, әne alғashқy zhқsaruynan keyіn қaita bіlіnі mүmkіn. Nā lāʻau mālama maʻi ң sіңuіnen keyin 24 saғattan soң bіlіnuі mүmkіn. Әdette, mұndai emdelušіler hospital of the bolu tiis.

Nā Hypoglycemia Symptom Gift: Zhurek Ainu құsu zhane asқazan tұsynyң auyruy, tremor, kөru bұzylystary, қimyl-қozғalys үylesіmіnің bұzyluy, ұyқyshyldyқ, ұyқynyң bұzyluy, mazasyzdyқ, ozbyrlyқ, zeyіn shoғyrlandyru zhane naoh uaқyttarynyң bұzyluy, kaumaha, 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 shining keri adrenergialқ regulation of Belgler baiқaluy mүmkіn. Auyr hypoglycemiaқ ұstamanyң clinicsқ kөrіnіsі stroke іske saluy mүmkіn.

Hoʻopili i nā lāʻau lapaʻau

Hoʻonui lākou i ka hopena o ka glimepiride me ka hoʻohana pū ʻana i: phenylbutazone, azapropazone a me ka oxyphenbutazone, sulfinpyrazone, insulin a me nā lāʻau antidiabetic waha, kekahi sulfonamides lōʻihi o ka hana, metformin, tetracyclines, salicylates a me nā waila p-aminosalicylic, nā waiʻoniʻoniʻoniʻoniʻoniʻoniʻona, nā waiʻākina antialabetic, ʻaihākena anionic chloramphenicol, probenecid, Coumarin anticoagulants, miconazole, fenfluramine, pentoxifyline (nā kuʻi wai nui), nā huaʻai, tritokvalin, ACE inhibitors, fl uconazole, fluoxetine, allopurinol, sympatholytics, cyclophosphamide, disopyramide, pheniramidol, guanethidine, isophosphamide, PASK.

Hoʻemi i ka hopena hypoglycemic o ka glimepiride me ka hoʻohana like ʻana: ka estrogens a me ka progestogens, saluretics, thiazide diuretics, nā hormone thyroid a me nā lāʻau e hoʻoulu ana i ka hana thyroid, corticosteroids a me glucocorticoids, derothiazine derivatives, chlorpromazine, epinephrine a me nā sympathomimetics kiʻekiʻe ( , glucagon, laxatives (hoʻohana lōʻihi), phenytoin, diazoxide, glucagon, barbiturates a me rifampicin, acetazolamide.

Nā Hagon receptor Hime, nā beta-blockers, clonidine a me ka reserpine hiki i ka lua me ka hoʻōla a hoʻemi i ka hopena hypoglycemic.Ma lalo o ka hopena o ka sympatholytics, e like me beta-blockers, clonidine, guanethidine a me ka reserpine, ka hōʻike ʻana o ka hoʻoponopono o ka adrenergic reverse o ka haʻaogogogogia e hoʻoneʻe a ʻalo paha. Hiki i ka inu ʻona ke hoʻoikaika a hoʻonāwaliwali i ka hopena hypoglycemic o ka glimepiride.

Hiki i ke Glimepiride ke hoʻonui a hoʻonui i ka hopena o nā derivatives Coumarin.

Nā hopena hopena

Mai ka ʻaoʻao o ka metabolism: hypoglycemia (hōʻeha o ka pōpilikia, ka pōloli, ka ʻōpū, ka luaʻi). Kēia - ka manaʻo o ka luhi, ke hiamoe nei, ke kaumaha hoʻoluhi, ka hopohopo, hoʻonaninani, hoʻihoʻi ʻole i ka manaʻo a me ka hopena, ke kaumaha, ka hilahila, ka ʻōlelo a me ka pilikia e pili ana, aphasia, haʻalulu, hoʻonaninani kuʻuna, hoʻonaninani, hoʻopuka hoʻoluhi, ka lilo ʻana o ka pale ponoʻī. Kēia loa - delirium, cerebral cramps, nalowale o ka ʻike, coma, papalihi hāmama, bradycardia. Eia kekahi, ma muli o ka hana hoʻonaninani adrenergic, i kekahi manawa hiki ke loaʻa nā hōʻailona like ʻole: ke anuanu, nā mea hōʻiliʻili i ka nui, tachycardia, hypertension, angina pectoris, nā hōʻehaʻeha o ka puʻuwai.

Mai ka palaki kuʻekuʻe: nūpepa, ka luaʻi ʻana, ka ʻeha o ka ʻeha a i ʻole ka ʻāʻī o ka epigastrium, ʻeha o ka ʻōpū, ka ʻōpū ʻana, a me nā hihia loaʻa ʻole, ka nui o ka hana o nā transaminases hepatic, hana kīnā huina (cholestasis a me nā jaundice), hepatitis, a me ka hōʻōwili ʻana.

Mai ke koko koko: thrombocytopenia (i ke kaumaha loa i ka maʻi), ʻaʻole leukopenia, hemolytic a i ʻole anemia aplastic, erythrocytopenia, granulocytopenia, agranulocytosis a pancytopenia (ma muli o myelosuppression).

Mai ka ʻaoʻao o ke kino o ka hihiʻo. ka pilikia o ka ʻike transientment ma muli o kahi loli o ka neʻe o ka glucose i ke koko (ʻoi aku hoʻi i ka hoʻomaka ʻana o ka mālama ʻana).

Nā maʻi kūwaha: pruritus, urticaria, manuahi, hoʻēmi i dyspnea, hoʻēmi i ke koko, alehu vasculitis, photosensitivity. ʻO ke ʻano kuʻuna a pakanika a pseudo-alerine ka maʻa maʻamau, akā hiki ke holomua, hele pū ʻia e ka dyspnea a me ka hoʻolohi ʻana i ke koko, hiki i ka pīhoihoi. Hiki ke cross-allergy i nā derivatives sulfonylurea, sulfonamides.

Inā hele mai nā hopena koʻikoʻi, hana hoʻopau ʻia ka lāʻau lapaʻau a lawe ʻia ka lāʻau lapaʻau.

Hoʻopuka

Ke hoʻoikaika nei i ka hopena hypoglycemic o ka glimepiride hiki ke hoʻomaopopo ʻia me ka hoʻohana pū ʻana me ka manuahi a i nā ʻano lāʻau hypoglycemic ʻē aʻe, nā ACE inhibitors, allopurinol, anabolic steroids a male male sex hormones, me chloramphenicol, Coumarin derivatives, cyclo-, tro- and isophosphamide, fenfluramine, feniramidol, fibetraminum, fibetinum, fibratetin, , ka miconazole, pentoxifylline (me ka hoʻokele makua i nā kao kiʻekiʻe), me ka phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, su lohiilamides lōʻihi-lōʻihi, tetracyclines, tritocqualin.

ʻO ka nāwaliwali o ka hopena hypoglycemic glimepiride hiki ke hoʻohana pū me ka acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) a me nā puʻuwaiʻōmaʻomaʻo, glucagon, laxatives (me ka hoʻohana ʻana i ka manawa), ka waikawa nikotinic (ma ke kiʻekiʻe kiʻekiʻe) a me ka derivatives, estrogest , fenothiazine, phenytoin, rifampicin, nā thyroid hormones, lithium salts, chlorpromazine.

ʻO ka hoʻoikaika ʻana a me ka nāwaliwali o ka hopena hypoglycemic of glimepiride Kakau ʻia paha me ka hoʻohana pū ʻana me ka histamine H blockers₂nā mea hoʻonaninani, nā clonidine a me ka reserpine, me ka hoʻohana kū hoʻokahi a me ka hoʻohana ʻana paha i ka waiʻona.

E kūlike i ke ʻano o ka hoʻohana ʻana i ka glimepiride, hiki ke hoʻomaopopo ʻia ka hoʻonui a nawaliwali paha i ka hana a ka derivatives Coumarin.

Lapaʻau lāʻau

Ikeekee қabylda keman kemede glimepiride tolyғymen sіңedі, as іshu sіңuіne puleul durezhde әser etpeydi. Қан sarysuyndaғy ezhoғar концентрацияy konsentrate o ke keiki a ішке қыabyldaannan keyin 2,5 saғattan soңethedі. Taralu kөlemi tөmen (8.8 ml), clearance - 48 ml / min, plasma aқuyzdarymen bailanysuy - 99% -dan astam, zhartyly shygarylu hiriwaeni - 5-8 saғatқa zhuyқ. Hoʻomākaukau o Zhoғary dozalard қabyldaғannan kein жарırtylai shyғarylu kezңңi artady.

Bauyrda glimepiridtің hydroxyldengen tuyndylaryna deіn metabolizdenedі, olar nesepte de (nā lāʻau lapaʻau ң bir rettіk dozasynyң 58% ғa zhuyғy), nәzhiste de (35-40%) anyқtalady. Hoʻomoe bir ret қabyldaғanda zhne birneshe kүn қatarynan tәulіgіne 1 ret қoldanғanda pharmacokinetics sinda aytarlyқtay ayyrmashylyқ bayalmaғan. ʻO ka lāʻau zinaқtalmaydy. Zhas shamalarymen zhynystary әр түрлі еделушілердегі Pharmacokinetics қ Parameterler ұқсас.

Bүyrek hana o ka sonң bұzylouy bar edelushіlerde glimepiride clearance artumen men onyң ortasha konshile o ka sonң tөmendeuіne beyimdіlіk bajalada.