Hoʻolaunuʻi (Glibenclamide)

ʻO Glibenclamide
Hoʻohui kūlohelohe
IUPAC	5-chloro-N-(4-N- (cyclohexylcarbamoyl) sulfamoylphenethyl) -2-methoxybenzamide
Hōʻuluʻulu kālā	C23H28Cln3O5S
Papale ʻaʻa	494.004 g / mol
Kēlā	10238-21-8
PubChem	3488
Kāleka	APRD00233
Kahi helu
ATX	A10BB01
Lapaʻau lāʻau
Palapala ʻaila Plasma	Hoʻopili
Hāpai	Hae aku ka honi hau (CYP2C9-hapai)
Ka hapalua ola.	10 mau hola
ʻĀina	ʻ Kidlelo a me nā pēpē
Nā Kūlana Moho
ʻO nā pōpō
Kahi alanui hoʻokele
i loko
Nā inoa ʻē aʻe
Maninil

ʻO Glibenclamide (ʻāpana. Antibet, Apoglyburide, Hoʻolālā Gene, ʻO Gilemal, Hoʻolālā, ʻO Glibenclamide Teva, Hoʻolālā, Hoʻolaha, Daonil, Dianti, Maninil, Kawaihope) He lālā o ka lua o ka huaʻawa o ka hua palapala sulfonylurea, ʻo ia kekahi o nā mea kaulana loa a hoʻopaʻa ʻia i nā lāʻau hoʻohaʻahaʻa i ka gula, mai ka makahiki 1969 ua hoʻohana nui ʻia i nā ʻāina o ka honua he mea e hōʻoiaʻiʻo a hōʻoia ʻia no ka maʻi diabetes mellitus type 2 me ka maikaʻi ʻole o nā loli ʻano.

ʻOiai ka puka ʻana o ka hoʻomākaukau o ka sulfonylurea hou me ka maikaʻi o nā hiʻohiʻona, a me nā lāʻau antidiabetic me nā hana ʻē aʻe o ka hana, ke ala koke ke hoʻopau i ka mōʻaukala o ka glibenclamide - i ka hoʻokolohua a me nā haʻawina hoʻokolohua, ʻaʻole wale kēia lāʻau lapaʻau i ka loiloi no ka loiloi ʻana i ka hopena o nā molekele hou a me nā hoʻokolohua therapeutic, akā hōʻike pū kekahi waiwai waiwai hou aʻe.

Ka maikaʻi a me ka palekana

ʻO ka papa hana maʻamau o ka hana o ka glibenclamide, e like me nā luna ʻē aʻe o ka hoʻomākaukau ʻana o ka sulfonylurea, ua aʻo ʻia i ka pae molekui ʻokoʻa. Hoʻopili ke Glibenclamide i nā kahe pālala e hilinaʻi ʻia o ATP (K + -ATP-saluran), i hoʻopaʻa ʻia ma ka membrane plasma o nā hua beta o ka pancreas. ʻO ka hoʻopau ʻana i ke kao mai ka papa pālea e alakaʻi i ka depolarization o ke membrane a i ka pā ʻana o ka wai o Ca 2+ ma o nā kaila kūlohelohe kūlike. Ke hoʻonui i ka ʻike o ka calcium intacellular ma o ka hoʻoweliweli ʻana i ka protein kinase-kalebona i ka kinase II e hoʻoulu ai i ka exocytosis o ka mau mea huna a me ka insulin, ma muli o ke ʻano o ka hormone i loko o ka wai hoʻoneʻe intercellular a me ke koko. ʻO ka like ʻole o ka pilina hoʻoliʻi o ka sulfonylurea no ka beta-cell receptors e hoʻoholo i kā lākou mau hana like me ka hoʻokaʻa ʻana i ke kō. ʻO Glibenclamide ka pilina kiʻekiʻe loa no nā mea hoʻokipa sulfonylurea ma nā pū beta a me ka hopena e hoʻākāka nui ʻia ana e like me nā haʻalulu.

ʻO ka hopena o ka hoʻoulu ʻana i ka mea huna insulin e kū pololei i ka maʻa o ka glibenclamide i lawe ʻia a hōʻike ʻia i ka hyperglycemia a me i normoglycemia a i ʻole hypoglycemia.

ʻO ka hui āpau o ka hoʻomākaukau ʻana o ka sulfonylurea, i kahi pae a i ʻole, ua loaʻa nā hopena peripheral (extra-pancreatic), kahi e hoʻonui ai i ka ʻike ʻana o nā ʻili o peripheral, ma mua loa ka momona a me ka ʻōpū, i ka hana o ka insulin a hoʻomaikaʻi i ka hoʻoliʻi glucose i nā kō.

Pono a me ka hoʻoponopono palekana |Nā Hoʻohui

Hypersensitivity to dergatives sulfonylurea a me nā huina sulfonamide, type 1 diabetes mellitus, ketoacidosis maʻi, maʻi precoma a coma, diabetes mellitus decompensation no nā maʻi maʻi, nā hōʻeha, nā ʻomaʻi, nā hana hōʻeha, ka ʻeha a me nā hana lawelawe o ka ʻōpū, hapai, hoʻōho.

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

I 1 kōpō. nā lāʻau antidiabetic nona ka 1.75 mg, 3,5 mg a i ka 5 mg o ka mea hana ikaika, ʻo ia ka glibenclamide.

Eia nō hoʻi i ka lāʻau lapaʻau ka ʻānō:

• ʻO Povidone
• Lawaʻawa Lactose
• ʻOki kalato
• ʻO ka lāʻau ʻo Magnesium
• Ponceau 4R.

Ua poepoe nā papa papa, ʻulaʻula a i ke kala, kū mai paha. Loaʻa ka lāʻau lapaʻau i loko o kahi pahu aniani i loaʻa nā papa ʻelua 120, ua hoʻopili ʻia kahi manual hoʻohana hou.

Hoʻomaopopo i nā waiwai

He mea koʻikoʻi ia e ʻike i ka inoa ʻo ke kālepa o ka lāʻau lapaʻau me ka inoa o ka mea hana. Ke loaʻa nei ka lāʻau i ka hopena hypoglycemic ʻelua i ka poʻe i loaʻa i ka maʻi mellitus type 2, a i nā poʻe olakino maikaʻi loa. Kuhi ʻia ka hana o ka hana i ka neʻe ʻana i ka inikini insulin e nā β-cell o ka pancreas ma muli o kona hoʻoikaika. Kēia hopena pēlā, e ʻoluʻolu, i ka pae o ka glucose i ka waʻa e hoʻopuni ana i nā β-cell.

Ma hope o ka lawe ʻana i ka pōʻai, ua wikiwiki koke ka mea hoʻowalewale a ke hoʻopili maoli nei. Me kahi papaʻai, ʻaʻohe nui nui o ka emi ʻana o ka helu o ka absorption o glibenclamide. ʻO kahi hōʻailona o ka kamaʻilio pū me nā protein plasma he 98%. Kuhi ʻia ka ʻai kiʻekiʻe loa o kahi mea i loko o ka serum ma hope o nā hola 2.5. ʻO ka emi ʻana o ke kaʻe o ka glibenclamide i hoʻopaʻa ʻia ma hope o 8-10 mau hola a hilinaʻi paha i ka ʻano o ka lāʻau lapaʻau i lawe ʻia e ka mea maʻi. ʻO ka hoʻopau hapa hapalua-ola ma ka manawa 7 mau hola.

Ka hoʻohuli ʻana o ka metabolic o nā glibenclamide i loko o nā wahī o ka naʻau, hana ʻia nā metabolites, ka mea pono ʻole ia e komo i ka hopena o ke kōmike o ka hoʻōla o ka mea hana. Kuhi ʻia nā huahana o ka metabola me ka urine, a me ka bile ma nā mea like, ʻo ka hana hope o ka metabolites e nānā ma hope o 45-72 hola.

I ka poʻe me ka hana o ka puʻuwai lēwa, ua hoʻopaʻa ʻia ka excretion o glibenclamide. I loko o nā mea maʻi e loaʻa ʻole ana ka maikaʻi o ka renal, ʻo ka hoʻopihapiha o nā metabolite kaila i ka nui i ka urine e hoʻonui i ka uku.

Nā ʻōkuhi no ka hoʻohana ʻana i nā papa

Kumukūʻai: mai 56 a 131 mau rubles.

Hoʻoholo ka hewa o nā lāʻau lapaʻau hoʻokahi e noʻonoʻo i ka makahiki o ka mea maʻi, glycemia, a me ka paʻakikī o ka papa o ka maʻi. Hoʻonohonoho ʻia e lawe i nā paila ma kahi ʻōpū ʻole a i ʻole ma hope o 2 mau hola ma hope o ka ʻai ʻana.

ʻO ka maʻamau, ʻokoʻa ka maʻamau o kēlā me kēia lā ma waena o 2,5 mg - 15 mg. ʻO ka hoʻohana pinepine ʻana o nā ʻūpī he 1-3 p. i ke ao a pau.

Hoʻomaopopo ka ʻike i kēlā me kēia lā he 15 mg a ma luna aʻe, ʻaʻole iki e hoʻonui i ka hopena hypoglycemic o ka lāʻau. Hoʻomaopopo ʻia nā poʻe ʻelemakule e hoʻomaka i ka mālama ʻana me 1 mg i kēlā me kēia lā.

ʻO ka hūnā mai kekahi lāʻau lapaʻau antidiabetic i kekahi a i ʻole kahi loli i kā lākou dosages e hana ma lalo o ka mākaʻi o kekahi kauka.

ʻO nā mea mālama palekana

Pono e hoʻomaʻemaʻe i nā lāʻau lapaʻau ma lalo o ka mālama mau ʻana i ke kō o ke koko a me ka wai.

I ka wā mālama, pono ʻoe e hōʻole i ka inu ʻawaʻī, ʻoiai ke kūkulu ʻia ʻana o ka hypoglycemia, me nā hōʻike like ʻole a disulfiram.

Ke hele mai nā hōʻailona o ka hypoglycemia, pono e hoʻoponopono iā ia no ka nele o ka glucose i o ka hoʻokalakū waha o dextrose. Ma kahi o kahi kūlana ʻole maopopo, e lawelawe ʻia ka dextrose i loko o ka lā. I mea e hōʻalo hou ai, ʻoi aku ka waiwai o ka hoʻopili ʻana i ka mea ʻai me nā mea laʻa.

Nā pili kūleʻa lāʻau

Nā lāʻau lapaʻau antimycotic o nā hana systemic, ka ethionamide, fluoroquinolones, MAO a me ACE inhibitors, H2-blockers, NSAIDs, tetracycline drug, paracetamol, insulin, anabolic drug drug, cyclophosphamide, β-adrenergic blockers, clofibrate, reserpilamin, proberpilin, p allopurinol, paracetamol, a me ka chloramphenicol hiki ke hoʻonui i ka nui o ka hypoglycemia.

ʻO nā COC, barbiturates, glucagon, saluretics, hoʻomākaukau e pili ana i nā paʻakai lithium, diazoxide, derivatives acid nicotinic, phenothiazines, a me nā lāʻau adrenomimetic e hōʻemi i ka hopena hypoglycemic o glibenclamide.

ʻO nā manaʻo e hoʻonui ai i ka urine e hoʻonui i ka pono o ka lāʻau.

Hoʻokomo ʻo Rifampicin i ka hana ʻole o ka mea hoʻoikaika a hoʻemi i kāna hopena therapeutic.

Nā hopena hopena

Hiki i kēia nā hopena ʻano:

• CCC me ka ʻōnaehana hematopoietic: eosinophilia, erythrocytopenia, thrombocytopenia, leukocytopenia, granulocytopenia, luhi pinepine ʻo agranulocytosis, i kekahi mau hihia anemia (hemolytic a hypoplastic type)
• NS: nā kuʻuna i hele pū ʻia e ka maʻi manawaleʻa
• ʻO nā hui ʻala: hoʻopau i nā manaʻo o ka manaʻo
• Metabolism: ke hoʻomohala ʻana o ka polphyria hope cutaneous, proteinuria, a me ka hypoglycemia hoʻi
• Paleka Gastrointestinal: dyspepsia, pathology ate, cholestasis
• Hōʻike Allergic: ʻili kino
• ʻO kekahi: hiʻona, polyuria, loaʻa ke kaumaha, arthralgia, a me ka hoʻomohala ʻana i ka photosensitivity.

Ke keu

Hiki ke ʻano o ka hypoglycemia, kahi i ka manaʻo o ka pōloli, ka lethargy, hoʻonui nui aʻe, hoʻonui ʻia ka nui o ka naʻau, nā puʻuwaha o ka naʻau, ka hoʻopuka ʻana o ka ʻōlelo, ka hopohopo, nā ʻeha me ka ʻeha nui, a me ka pohō.

I nā pilikia koʻikoʻi, he 50% ka hopena o ka glucose a i ʻole 5-10% e hoʻopau ai i ka hopena o ka maʻi e hoʻopili ʻia, hiki i ka hoʻokō ʻāwili o ka ʻaihā. I kēia hihia, pono ia e kāohi i nā mea hoʻohālikelike glycemia, ka pae o nā electrolytes, creatinine, a me ka urea hoʻi.

Ke nānā nei ka poʻe he nui i ka like pū o Glibenclamide (analogues) e loaʻa kahi hopena therapeutic like. I waena o lākou, hoʻokaʻawale ʻia ʻo Maninil.

Berlin Chemie, Kelemānia

Kūʻai mai 99 a 191 mau rubles.

ʻO ka lāʻau lapaʻau kahi mea hoʻohālike o Glibenclamide, nā mea ikaika e hakakā nei, kū hoʻokahi, a me ke ʻano i ke kino. Loaʻa ka lāʻau lapaʻau i kahi palapala papa.

• ʻO ke kumu kūʻai haʻahaʻa
• Hoʻemi i ka hopena o ka hoʻomohala ʻana i ka retinopathy a me ka nephropathy
• Nā hana i lōʻihi (ʻoi aku ma mua o 12 mau hola).

• Loaʻa ka ʻaha kauoha
• Contraindicated i ka ketoacidosis
• Hiki ke hoʻonāukiuki i nā hopena kūlohelohe.

ʻO ka wehewehe ʻana i nā mea ikaika (INN) Glibenclamide.

Pharmacology: hana Pharmacological - hypoglycemic, hypocholesterolemic.

Nā maʻi maʻi: Kaʻi ʻia o ka maʻi diabetes mellitus me ka impossability o ka hoʻopiʻi ʻana no ka hyperglycemia me kahi meaʻai, ke kaupaona ʻana, ke ʻano kino.

Nā Contraindications: Hypersensitivity (e pili ana i nā lāʻau sulfa, thiazide diuretics), precomatous diabetes a me kahi coma, ketoacidosis, keʻena nui, ka hōʻoki ʻana a me nā trauma, ka hana o ka ʻōpū, ka paresis o ka ʻōpū, nā kūlana i hoʻopili ʻia e ka maʻi o ka ʻaina (hoʻomohala i ka hypoglycemia) maʻi, etc.), hyp- a i ʻole hyperthyroidism, nele i ka naʻau a me ka hana kidney, leukopenia, type 1 diabetes mellitus, hapai, mālama keiki.

ʻLelo a me ka lactation: Contraindicated. I ka manawa mālama e ho'ōki i ka umauma.

Nā hopena ʻaoʻao: Mai ka ʻaoʻao o ka ʻōnaehana cardiovascular a me ke koko (hematopoiesis, hemostasis): jarang - thrombocytopenia, granulocytopenia, erythrocytopenia, pancytopenia, eosinophilia, leukocytopenia, agranulocytosis (loaʻa pinepine), i kekahi mau hihia - hypoplastic a ʻoliolytic.

Mai ka pūnao o ka pīpī a me ka hoʻonaninani: nā poʻo, ke kaumaha, ka hoʻololi i nā ʻonoʻono.

Mai ka ʻaoʻao o ka hana metabolism: hypoglycemia, proteinuria, late cutaneous porphyria.

Mai ka hana pānaʻi ʻana: hana o nā aʻalolo hemahema, cholestasis, dyspepsia.

Nā hui kūloko: rashes ʻiliʻu (erythema, dermatitis exfoliative).

Nā mea'ē aʻe: ka hika, ka arthralgia, polyuria, ka loaʻa ʻana o ka paona, photosensitivity.

Hoʻohui: Pūnaehana antifungals (azole derivatives), fluoroquinolones, tetracyclines, chloramphenicol (ʻae ʻana i ka metabolism), H2-blockers, beta-blockers, ACE inhibitors, NSAIDs, MAO inhibitors, clofibrate, bezafibrat, probenecid, paracetamol, anabolic pentoxifylline, allopurinol, cyclophosphamide, reserpine, sulfonamides, insulin - potentiate hypoglycemia. ʻO nā Barbiturates, phenothiazines, diazoxide, glucocorticoid a me nā hormone thyroid, estrogens, gestagens, glucagon, nā lāʻau lapaʻau adrenomimetic, salith lithium, derivatives waikawa a me ka saluretics e hoʻonāwaliwali i ka hopena hypoglycemic. Kālā i hoʻohuihui ʻia nā paʻakai (ammonium chloride, calcium chloride, ascorbic acid ma nā wai he nui) e hoʻomaikaʻi i ka hopena (hoʻemi i ka pae o nā kipi a hoʻonui i ka reabsorption). He synergist (hoʻohui i nā hana) o nā anticoagulants kūlike. Hoʻopili ke Rifampicin i ka hana ʻole a hoʻemi i ka hana pono.

Ka nānā: Kaʻeha: hypoglycemia (pōloli, nāwaliwali koʻikoʻi, hopohopo, hōʻeha, hōʻeha, luhi, palpitations, pīhoihoi o ka musema, edema cerebral, wahaheʻe a me ka ʻike, naʻaupō o ka naʻau a me ka hypoglycemic coma, hopena hopena).

Mea mālama: i nā hihia kūpaʻa - lawe koke i ka kō, ka wai wela momona, ka hua wai, ke kōkōniki, ka meli, ma nā hihia koʻikoʻi - ʻo ka hoʻolaha ʻana o kahi ʻōmole 50% kūloko (50 ml iv a i loko), mau ka iv infusion o 5-10% ʻO ka hopena dextrose, i / m ka hoʻokele o ka glucagon 1-2 mg, diazoxide 200 mg orally i kēlā me kēia 4 hola a 30 mg iv paha no 30 mau minuke, me ka cerebral edema - mannitol a me dexamethasone, mālama i ka glycemia (i kēlā me kēia 15 mau minuke), hoʻoholo. pH, urea ʻenekena, mea hana, nā electrolytes.

Pākuʻi a me ka ʻoihana: loko, me ka ʻaʻa ʻole ʻana, holoi ʻia me ka wai liʻiliʻi. Koho ʻia ka helu o kēlā me kēia lā, e pili ana i ka makahiki, he aʻeha o ka maʻi maʻi, ka pae o ka hyperglycemia, a ʻoi ka 1.25-20 mg (ʻo ka dosis mua he 2.5-5 mg / lā, ʻo ka nui o ka nui o kēlā me kēia lā he 20-25 mg), kahi i kuhikuhi ʻia i loko hoʻokahi, ʻelua, emi iki - ʻekolu mau palena no 30-60 mau minuke (micronized form no 10-15 mau minuke) ma mua o ka papaʻaina. Me ka hopena ʻole, hiki ke hui pū me nā biguanides a me ka insulin.

No ka mālama ʻana: no ka pale ʻana i nā kūlana hypoglycemic, pono e mālama pono ʻia ka paʻa ʻana. ʻO Mandatory ka hoʻohana ʻana o ka meaʻai iʻoi aku ma mua o 1 mau hola ma hope o ka hoʻohana ʻana i ka lāʻau. I ka wā o ke koho ʻana i kahi kao no ka kumu kumu a i ʻole ka hoʻoneʻe ʻana mai kekahi lāʻau lapaʻau hypoglycemic ʻē aʻe, hōʻike ʻia ka hoʻonā maʻamau o ka paukū haki (i kekahi mau manawa i ka pule). Ma ke kaʻina o ka mālama ʻana, ka hoʻomohala ʻia o ka pae o ka glucose (glycosylated hemoglobin) i loko o kahi serum koko e koi ʻia (ma kahi o ka manawa 1 i ka 3 mau mahina). Pono e noʻonoʻo i ka hōʻike hoʻomohala o ka hypoglycemia hiki ke hoʻohui ʻia i ka wā e lawe ai i nā beta-blockers, clonidine, reserpine, guanethidine. I ka hihia o ka hoʻololi i glibenclamide mai insulin i kahi maʻa o 40 mau unahi / lā a i ʻole, ʻoi aku ka lā ma ka lā mua i hoʻokahi hapalua wai o ka insulin a me ka 5 mg o ka glibenclamide e kuhikuhi ʻia me ka hoʻololi lohi ʻana i ka maʻi o ka poʻe hope inā pono. Hoʻohana ʻia me ka makaʻala i nā poʻe maʻi ʻelemakule - hoʻomaka lākou i ka mālama ʻana me nā hapalua hapalua, kahi e hoʻololi ʻia nei ma hope o 2,5 mg / lā me kahi pule hebedoma, me nā kūlana o ka hūpī. lā a me ke kāohi ʻana i nā meaʻai momona. I ka hoʻomaka ʻana o ka mālama ʻana, ʻaʻole i ʻōlelo ʻia nā hana e loaʻa ai ka piʻi ʻana o ka hopena.

Mea hana: LLC "ʻOihana lāʻau lapaʻau" Health "Ukraine

Kauoha PBX: A10B B01

Kūpono i nā puka: nā palapala hoʻohālikelike. Nā Palaki

Nā hiʻohiʻona maʻamau. Kūkulu:

Nā inoa ākea a me nā huahana: glibenclamide, 5-chloro-N-amino-sulfonylphenylethyl-2-methoxybenzamide,
nā waiwai pilikino a me nā mea ʻalike: nā papa keʻokeʻo, pāwili piha-cylindrical me kahi bevel,
hui: 1 papa he 5 mg glibenclamide,
nā mea waiwai: mannitol, māka māka, povidone, calcium stearate.

Lapaʻa lāʻau:

Lapaʻau lāʻau ʻO ka maʻi hypoglycemic, kahi lua o ka hui o ka sulfonylurea. 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 o ka insulin e ka pancreatic b-cells, ka mea i hui pū ʻia e ka hoʻoneʻe ʻana a me ka hoʻonui ʻana o ka insulin endogenous. ʻO kēia hopena ma muli o ka hoʻopili ʻana o ka glibenclamide me nā mea komo i hoʻohui ʻia i loko o ke kaola o ke kanawai o ka KP-hilinaʻi K + o nā membran plasma e hana ana i nā b-cell o ka pancreas, depolarization o ka membrane cell, hoʻōla i nā kaila ʻikea o ka lālani Ca2 + gated. Mālama i ka hoʻokuʻu ʻana o ka glucagon e nā pihi pancreatic.
Hoʻonui ka hopena extrapancreatic i ka hoʻonui ʻana i ka ʻike ʻana i nā kinipōpeka peripheral i ka hana o ka insulin endogenous, ke kāohi nei i ka synthesis o ka glucose a me ka glycogen i loko o ka ate.
Ke hoʻonui nei i nā pae o ka insulin koko a me kahi hoʻohaʻahaʻa i nā pae o ka glucose e hele lohi, e hōʻemi ana i ka hopena o ka hopena hypoglycemic. Hoʻopilikia ka hopena hypoglycemic i nā hola 2 ma hope o ka hoʻokele ʻana, hiki i ka nui ma hope o 7-8 mau hola a lōʻihi ʻo 8-12 mau hola.
Hoʻonui ka Glibenclamide i ka mea huna o ka pancreatic a me ka gastric somatostatin (akā naʻe ʻaʻole ʻo glucagon), he hopena diuretic iki (no ka hoʻonui ʻana i ka hoʻomaʻemaʻe kino o ka wai manuʻa). Hoʻololi i ka hopena o ka hoʻomohala ʻana o nā hoʻopiʻi kūʻokoʻa o ka insulin-dependant (vascular, cardiopathy) a me ka maʻi maʻamau e pili ana i ka maʻi diabetes. Loaʻa iā ia kahi hopena cardioprotective a me nā antiarrhythmic.

Lapaʻau lāʻau Ma hope o ka lawelawe waha, ua wikiwiki a paʻa loa ia mai ke kumu ʻeha o ka gastrointestinal. ʻO ka ʻai ʻaina hiki ke hoʻolohi i ka hoʻopili ʻana.
ʻO ka pae kiʻekiʻe loa i ke koko ma hope o hoʻokahi mau hopena i loaʻa ma hope o nā hola he 1-2. Hoʻakeʻa i nā protein koko - ʻoi aku ma mua o 98%. E komo palaka maikaʻi ʻia ma o ka paepae placental.
Hoʻopili ia i loko o ka ate i loko o nā metabolites ʻaʻole hana (like i ke kumukūʻai like ʻole), ka mea i hoʻopiʻi ʻia e nā ʻili, a me kekahi me ka ʻoi. ʻO ka pau hoʻopau hapa-ola he 6-10 mau hola. ʻAʻole hoʻohālikelike ke kino.
ʻO ka pharmacokinetics i nā hihia lapaʻau kūikawā. I nā mea maʻi me ka hana renal maʻi ʻole i ke ʻano maʻalahi, ʻaʻohe ʻokoʻa o nā ʻoihana ʻē aʻe i loko o ka pharmacokinetics o ka lāʻau lapaʻau, me ka hōʻemi nui loa (clearanine clearance ma mua o 30 ml / min) hiki i ka cumulation.

Nā ʻoslelo a me ke hoʻoponopono:

Hāʻawi i loko, 20-30 mau minuke ma mua o kaʻai, me ka ʻaʻa ʻole ʻole, me ka liʻiliʻi e loaʻa nā wai (e pili ana i ka ½ kī).
ʻO nā helu mua a me ka mālama mālama ʻia, ka manawa o ka hoʻokele a me ka hāʻawi ʻana i ka nui o 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 inikua mua o ka lāʻau lapaʻau ʻo 2.5 mg (1/2 papa) 1 ka manawa i kēlā me kēia lā. Inā kūpono, hoʻonui ʻia ke kaila o kēlā me kēia lā me ka nānā pinepine ʻana i nā pae glucose i ke koko, e hoʻonui lōlō i ka nui me ka manawa o kekahi mau lā i 1 wiki e 2.5 mg (1/2 papa) a hiki i ka hopena lapaʻau hopena. ʻO ka mau momona kūpono loa he 15 mg (3 mau papa). ʻO nā wai ma luna o 15 mg / lā ʻaʻole e hoʻonui i ka nui o ka hopena hypoglycemic.
Hoʻopau ʻia ka wai i kēlā me kēia lā i kahi 10 mg (2 mau papa) i ka manawa 1 i ka lā, ma mua o ka ʻaina kakahiaka. Ma kahi lāʻau kiʻekiʻe i kēlā me kēia lā, e pono ai e hoʻokaʻawale iā ia i ʻelua mau puʻupaʻa ma kahi o 2: 1, i ke kakahiaka a i ke ahiahi.
I nā poʻe maʻi ʻelemakule, hoʻomaka ka mālama ʻana i ka hapalua hapai, kahi e hoʻonui nui ʻia ma mua o 2.5 mg / lā me ka awina hebedoma.
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 insulin. Hoʻololi ʻia ka Glibenclamide me ka insulin i ka hiki ʻole ke hoʻokō me ka hoʻomaʻamaʻa ʻana i ka hoʻohuihui o ka glucose i ke koko ma o ka lawe ʻana i ka nui o ka lilo o ka glibenclamide i monotherapy. Eia hou, ke kū'ē i ka hope o ka hopena o ka glibenclamide i kauoha ʻia i ka mea maʻi, hoʻomaka ka mālamaʻana i ka insulin me ka hōʻemi haʻahaʻa loa, me ka hiki ʻana o ka hoʻonui hou aʻe i ka hopena o ka insulin ma lalo o ka kaohi o ke kaohi glucose o ke koko. Hoʻohālikelike ka hoʻomaʻamaʻa ʻana i ka lāʻau lapaʻau kauoha paʻa. Ke hoʻohui i ka glibenclamide me ka insulin, hiki ke hoʻemi ʻia ka nui o ka hopena o ka hopena ma o 25-50%.
I kēia manawa, ʻaʻohe ʻike o ka hoʻohana ʻana i ka lāʻau lapaʻau no ka mālamaʻana i nā keiki.

Nā hiʻohiʻona noi:

Hoʻohana ʻia ka lāʻau lapaʻau me ka mālama ʻana i ka hihia o ka febrile syndrome, ka waipakena, nā maʻi thyroid (hypo- ko), i nā mea maʻi a me nā mea maʻi me nā hana pūpū.
Me ka monotherapy lōʻihi (ʻoi aku ma mua o 5 mau makahiki), hiki i ke kūleʻa kekona ke ulu.
Ka nānā ʻana aku i nā ʻāpana kauka. Ma ka hoʻomaʻamaʻa ʻana me ka lāʻau lapaʻau, pono ia e nānā pono i nā pae o ka glucose i ke koko a me ka wai (i kekahi mau manawa i ka hebedoma i ka manawa koho o ke ʻano), me ke kuʻi ʻana o ka hemoglobin glycosylated (ma kahi o ka liʻiliʻi 1 ka manawa i 3 mau mahina), e ʻae nō i ka ʻike manawa i ka pae mua ʻana o ke kūleʻa mua ʻana a i ʻole kūmole. i ka lāʻau lapaʻau. Eia kekahi, pono e kāohi i ka hana o ka ate a me ke kiʻi o ke koko peripheral (ʻoi aku hoʻi ka nui o nā platelets a me leukocytes).
Nā ʻōiwi e koi ai i ka hoʻololi ʻana o ka mea maʻi mai ka glibenclamide i ka hoʻonaninani ʻana i ka insulin: i ka nui, ka nui o ka trauma, ka nui o ka hōʻeha ʻana, ka malabsorption o ka meaʻai a me nā lāʻau hōʻeha i ka ʻeha gastrointestinal (ʻeha o ka ʻawaʻawa, paresis intestinal), puʻuwai koʻikoʻi a me ka hana o ka kidney E noho ana i ka hemodialysis. Pono ka liuliu iki ʻana i ka insulin e hiki mai i loko o nā kūlana koʻikoʻi (ʻoi ʻia, hōʻeha ʻana o ke kaupaʻi, nā maʻi pūpili me ka maʻi maʻi).
ʻO ka pilikia o ka hoʻolālāʻana i ka hoʻomaka ʻana o ka mālama ʻana me ka glibenclamide. I nā hebedoma mua o ka mālama ʻana, hoʻonui ʻia ka hopena o ka hoʻomohala ʻana i ka hypoglycemia (ʻoi aku paha me nā kīʻaha e ʻole a i ʻole nā ​​kuke ʻai). Hiki i kēia mau mea ke kōkua i kona hoʻomohala ʻana:
ka makemake ʻole a i ʻole (ʻoi paha ʻo ia i ka ʻelemakule) lawa ʻole o ka hiki i ka mea maʻi e hana pū me kahi kauka.
ʻai ʻaina, ʻai ʻaʻai, ʻai pōkole,
ka hoʻemi ʻana ma waena o ka hana kino a me ka hoʻowalewale o ka kalaiʻe,
loli i kaʻai
inu wai ʻona, keu me ka lawa ʻole o ka meaʻai a i ʻole ke kala ʻana i ka ʻai,
huakaʻi renal function,
lima hana hoʻopili hewa,
ʻOke lāʻau
nā maʻi concomitant concomitant o ka hopena o ka endocrine e pili ana i ka puhaka o ka puhaka o ka metabolism a i ʻole counterregulation o hypoglycemia (e komo pū ana i ka hana thyroid paʻa, pituitary a i ʻole adrenocortical insufficiency).
ka hana like ʻana o kekahi mau lāʻau ʻē aʻe (e ʻike i ka Hoʻohui ʻana me nā lāʻau lapaʻau ʻē aʻe).
ʻO nā ʻōmaʻomaʻo o ka hypoglycemia e hōʻoluʻolu a maʻalahi paha i ka wā o ka hoʻomohala ʻana i ka wā i nā mea maʻi maʻi, a me nā poʻe maʻi me ka autonomic dysfunction a i ʻole ia e loaʻa ka mālama ʻana me nā bers-adrenoreceptor blockers, clonidine, reserpine, guanethidine, a i ʻole nā ​​sympatholytics ʻē aʻe.

ʻO ka lā lāʻau e lawe wale ʻia ma nā ʻano i kauoha ʻia a i kekahi manawa o ka lā.

Hoʻoholo ka manawa o ka hoʻokele ʻana a me ka hāʻawi ʻana i ka ʻokoʻa o kēlā me kēia lā ka lāʻau lapaʻau, e noʻonoʻo ana i nā hiʻohiʻona o ka noho aliʻi o ka lā maʻi.
ʻO ka mandatory kahi papaʻaina ʻole ma mua o kahi hola 1 ma hope o ka lawe ʻana i ka lāʻau lapaʻau.
I mea e hoʻokō ai i ka mālama pono o ka pae glycemia i ka wā i kuhikuhi ai i ka glibenclamide, pono ia e hahai i kahi meaʻai kūpono, hoʻokō i nā hana pilikino a, inā pono, e hōʻemi i ke kaumaha o ke kino. Pono ʻoe e haʻalele i ka hōʻike lōʻihi ʻana i ka lā a kaupalena i ka hoʻohana ʻana i nā meaʻai momona.
ʻO nā hewa i ka mālama ʻana o ka glibenclamide (kahi o ka paukū ma muli o ka poina) e hiki ʻole ke hoʻoponopono ʻia e ka hoʻokō hou ʻana o kahi mahele kiʻekiʻe. Pono e kūkā mua ke kauka a me ka mea maʻi i nā kaʻina e pono ai e mālama i ka hōʻemi ma ka hoʻohana ʻana i ka lāʻau lapaʻau (ʻūhā ʻia i kahi maʻa, ʻaina i nā meaʻai) a i nā kūlana i hiki ʻole ke inu i ka lāʻau lapaʻau i ka manawa i ʻōlelo ʻia.
Pono i ka mea maʻi e hoʻomaopopo koke i ke kauka i ka loaʻa ʻole o kahi mea i hiki ʻole ke hana a keu i ka nui o ka nui o ka lāʻau.
Ka hoʻololi i ka mea maʻi i ka glibenclamide mai nā hoʻomākaukau ʻē aʻe sulfonylurea (me ka ʻike ʻole o ka chlorpramide) a me ka insulin (i kēlā me kēia lā - ʻoi aku ma mua o 40 mau ʻāpana). Ke hoʻihoʻi nei i ka mea maʻi i glibenclamide, hoʻolauna ʻia e hoʻonui mālie i ka maʻi. Me ka haukapila insulin, ka hapalua o ka nui o ka insulin a me 5 mg o ka glibenclamide e kuhikuhi i ka lā mua.
Hoʻokomo i ka hiki ke alakaʻi i nā kaʻa a hana me nā mīkini. I ka hoʻomaka ʻana o ka hoʻōla a me ka hana ʻole ʻana o ka glibenclamide, kahi hōʻemi o ka neʻe ʻana o ka nānā nui a me ka wikiwiki o ka hopena psychomotor o ka mea maʻi ma muli o ka hypo- a i ka hyperglycemia e ʻike ʻia. I kēlā mau kūlana, pono ʻoe e hōʻole i ka hana ʻana i nā hana e pili ana i ka mea e pono ai ka mālama ʻana a me ka wikiwiki o nā hopena psychomotor.

Nā hopena ʻaoʻao:

Mai ka ʻaoʻao o ka metabolism. ʻO ka hypoglycemia, me ka nocturnal (kaʻeha, ka pōloli, ka luhi, ka ʻāina poʻo, nā ʻona, ʻūhū, hoʻohālikelike, ʻōlelo ana a me nā haunaele, ʻike nui loa - coma). Eia kekahi, ma muli o ka mīkini hoʻonaninani adrenergic, i kekahi manawa hiki i nā hōʻailona like ʻole e loaʻa: ke anuanu, kaomi maʻa,. ʻO ka hypersensitivity i ka waiʻona, lilo ka paona, dyslipidemia, ka waiho ʻana o ke kiko adipose, ma hope o ka hoʻohana lōʻihi - hypothyroidism.
Mai ka gastrointestinal tract. I kekahi manawa - nausea, ka manaʻo o kaʻeha a i ʻole ka palupalu i ka epigastrium, ʻeha ʻeha, hōʻeha a hoʻonui paha i ka momona, ʻokoʻa loa - hana i nā aʻalopona hana luhi, jaundice cholestatic,.
Mai ka pūnaehana koko. Nui loa - hemolytic a aplastic paha, pancytopenia,.
Allergic hopena pili. Kēia - erythema multiforme, exfoliative, photosensitivity. Hiki i nā cross-allergy me nā kumukia sulfonylurea, sulfonamides a me nā lāʻau like-thiazide-like.
ʻO ka poʻe ʻē aʻe. hypoosmolarity a i ʻole hōʻeleu no ka neʻe huna ʻana o ka hormone antidiuretic (ke kaumaha, ka lethargy, helehelena, nā kuʻekuʻe, a me nā lima, nā kīwaha, stupor, coma), ka huakaʻi hoʻomaha wāwahi.

Hoʻohui pili me nā lāʻau ʻē aʻe:

Amplification hypoglycemic hana o ka glibenclamide ke'ākoʻakoʻa ana i ka hana o ka insulina 'ole' ē aʻe hypoglycemic ai ', angiotensin hoʻololi''ūhū nā mea kūpale, allopurinol, anabolic steroid a me kane ke keka hormones, chloramphenicol, cimetidine, coumarin nā mea loaʻa, cyclo-, Trojan a me ifosfamide, fenfluramine, feniramidolom, fibrates, fluoxetine, guanethidine, paleO MAO, miconazole, fluconazole, pentoxifylline, phenylbutazone, oxyphenbutazone, azapropano Om, Probenecid, salicylates, sulfinpyrazone, lōʻihi-e hana sulfonamides, tetracyclines, tritokvalinom.
ʻO ka palupalu i ka hopena hypoglycemic o glibenclamide hiki ke hoʻohana pū me ka acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, epinephrine (adrenaline) a me nā sympathomimetics, glucagon, laxatives (me ka hoʻohana ʻana i ka manawa lōʻihi), , estrogens a me progestogens, fenothiazine, phenytoin, rifampicin, nā thyroid hormones, lithium salts, chlorpromazine.
ʻO ka hoʻoikaika ʻana a me ka nāwaliwali o ka hopena hypoglycemic of glibenclamide hiki ke nānā ʻia me ka hoʻohana pū ʻana me ka blockamine H2 receptor blockers, clonidine a me ka reserpine, ka lāʻau ʻokoʻa a ʻokoʻa ʻole hoʻi.
E kūlike i ke ʻano o ka lawe ʻana i ka glibenclamide, hiki ke ʻike ʻia kahi hoʻonui a nawaliwali paha i ka hana a ka derivatives Coumarin.

Pharmacodynamics a me ka pharmacokinetics

ʻO Glibenclamide kahi lāʻau lapaʻau hypoglycemic waha e pili ana i ka derivatives huikaʻi. ^ E Ha yM. Ka hana o ka hana a Glibenclamide e pili ana i ka hoʻoulu ʻana o ka huna secret-cell i loko pancreasma ka hoʻonui ʻana i ka hoʻokuʻu i ka insulin. ʻO ka pinepine, hōʻike ʻia ka hoʻokōʻana i ka lua o ka hana o ka hana ʻana i ka insulin. Hoʻonui kēia i ka naʻau o ka pili peripheral i ka hana o ka insulin, a me kona pili pū ʻana me nā cell target. Eia kekahi, hoʻohālikelike ʻia ka glibenclamide e kahi hopena hypolipidemic a me ka hoʻohaʻahaʻa ʻana i nā waiwai thrombogenic.

I loko o ke kino, ka wikiwiki a me ka piha o ka hoʻonaina o ka waiwai mai ke kaʻi ʻana o ka digestive. ʻO nā kamaʻilio me nā protein plasma e pili pono ana i ka kokoke o 95%. lawe ʻia ka lāʻau lapaʻau i ka puʻu, ka hopena ma ke ʻano he hana ʻole. Hoʻoulu nui ka excretion i ka pūpū o ka urine a me nā ʻāpana - bile, i ke ʻano o nā metabolites.

Nā ʻōlelo kikoʻī

Hoʻomaopopo ʻia e mālama pono i nā poʻe maʻi e hōʻeha nei i ka pōpoki a me nā puʻuwai, me nā kūlana febrile, ka hana pathological o nā kelepa adrenal a i ʻole ka thyroid gland, a me nā palaka kūʻole.

No ka papa o kahi kaʻina hana lapaʻau piha piha, pono ka mālama ponoʻana i ka pae o ka glucose i loko o ke koko a me ka hoʻoliʻi glucose.

Inā ulu ka hypoglycemia i ka poʻe maʻi ma ka hoʻomaopopo ʻana, a laila e lawelawe ʻia ai ke kōkō a i ʻole ka glucose. I na hihia o ka nalowale o ka ike, e lawelaweia ana ka glucose i ka intravenously, a nāonaona - intramuscularly, subcutaneously a i ʻole intravenously.

Ke hoʻihoʻi ka naʻau, hāʻawi koke ka mea maʻi i ka meaʻai i nā mea momona i mea e pale ai i ka hypoglycemia hou.

ʻO Glibenclamide kahi lāʻau lapaʻau me nā waiwai hypoglycemic mai ka papa o ka lua o ka hopena o nā kōmia sulfonylurea. Loaʻa iā ia kekahi hopena hypolipidemic a hōʻemi i ka hopena o ka vascular thrombosis.

ʻO keʻano maʻamau

ʻO ka inoa o ka lāʻau lapaʻau Glibenclamide i loko o ka hoʻokūkū o ka honua ma ka Latin ʻo Glibenclamide. ʻO waho, kahi lāʻau lapaʻau he penikala mālamalama mālamalama ma ke ʻano o ka disc me ka laina hoʻokaʻawale. Hiki i ke kaina ke ʻano he ʻaukā me ka inclusions liʻiliʻi.

Hoʻopili i nā papa ma nā poli o nā ʻāpana he 10. I loko o kahi pahu e hiki ai a hiki i ka 12 mau papa.

Hoʻokuʻu ʻia ka Glibenclamide ma o ke kumu kūʻai, i mālama ʻia ma lalo o nā kūlana maʻamau, me ka loaʻa ʻole o nā keiki. Nā ʻōlelo i hōʻike ʻia i ke ola o ke ola - 5 mau makahiki. ʻAʻole pono ke lawe ʻia i ka lāʻau lapaʻau.

Aia kēlā me kēlā me kēia papa āpau he 5 mg o ka glibenclamide a me nā mea hanu ma ke ʻano o ka lōmole lactose, kālaiʻai, kāʻai magnesium, polyvinylpyrrolidone, E 124.

ʻO nā ʻoihana kūʻai olakino kūʻai e hana i kahi kōlā hoʻohiolo kālā.

Hoʻokumu ʻia ia a me ke olakino Ola Ola. No Glibenclamide, ʻo ke kumukūʻai ma ke kaulahao Lūkini Russian 270-350 rubles.

ʻO ka Pharmacodynamics o ka lāʻau

ʻO ka lāʻau lapaʻau hypoglycemic oral. Ma Glibenclamide, ua kau ʻia ke ʻano o ka hana i ka hoʻoulu ʻia ʻana o ka hana insulin e ka pancreatic β-cells. Ma ka ʻokoʻa, hoʻemi ʻia ka pale ʻana o ka ʻolua peripheral. E hana ana ka lāʻau lapaʻau inā loaʻa nā ikaika cells-cells i ka pancreas e synthesize i ka hormone endogenous. Hoʻemi i ka lāʻau lapaʻau a me ka hoʻohui platelet.

Nā hiʻohiʻona Pharmacokinetic

Mai ka wahi gastrointestinal ma hope o ke kaʻina waha ma luna o kahi ʻōpū ʻole, hoʻopili koke ʻia ka lāʻau lapaʻau, nakinaki ia i nā protein koko i ka 95%. Ke hoʻohuli ʻia ka loli o ka waiwai ikaika i loko o nā hana kūlohelohe o ke kūpaʻa. E kāohi ʻia ka ʻōpala e nā keiki a me nā kumu bile. ʻO ka hapalua kēia mai ke kahe koko mai a hoʻokahi a i ka hapa a ʻekolu a me ka hapa. Mālama ke kō i hoʻokahi wai o ka lāʻau no ka liʻiliʻi loa 12 mau hola.

Me nā ala hepatic, ua pale ʻia ka hoʻohana ʻana i ka lāʻau lapaʻau.Inā hōʻike ʻia ka hina ʻole ma kahi palupalu, ʻaʻole pili kēia i ke kaʻina o ka hana o nā metabolites; i nā kūlana koʻikoʻi loa, ʻaʻole i hoʻokaʻawale ʻia kā lākou hōʻuluʻulu.

Nā hui like ʻana o nā hui nosological

Ke keʻokeʻo a keʻokeʻo paha nā papa me kahi hāhai melemele a hina hina paha, ploskilindris me ka ikehu.

Hoʻopuka Hypoglycemic no ka mālama waha waha o ka hui sulfonylurea o ka lua o ka hanauna.

He hopena pancreatic a me ka extrapancreatic i loko o Glibenclamide. Hoʻonohonoho ia i ka hoʻonaʻauao insulin ma ka hoʻohaʻahaʻa ʻana i ka paepae hoʻonāukiuki a ka pancreatic beta-cell glucose irritation, hoʻonui i ka ʻike ʻana i ka insulin a me kona paa ʻana i nā cell target, hoʻonui i ka hoʻokuʻu ʻana i ka insulin, e hoʻonui ana i ka hopena o ka insulin ma ka ʻāʻī a me ka puʻuwai a ka puhaluhi, a pale i ka lipolysis ma ka ʻaoʻao adipose (extra-pancreatic) . ^ E Ha yM. Nā hana i ka lua o ka hana ʻana o ka inikini insulin. Loaʻa iā ia kahi hopena hypolipidemic, e hōʻemi i nā waiwai thrombogenic o ke koko.

Hoʻopilikia ka hopena hypoglycemic ma hope o 2 mau hola, hiki i kahi lōʻihi ma hope o 7-8 mau hola a lōʻihi nā hola 12. Hāʻawi ka lāʻau lapaʻau i ka hoʻonui maikaʻi ʻana i ka hoʻoliʻiliʻi o ka insulin a me kahi hoʻohaʻahaʻa kūpono i ka glucose o ka plasma, e hōʻemi ana i ka hopena o nā kūlana o ka hypoglycemic. Hōʻike ʻia ka hana o glibenclamide me ka hana endocrine i mālama ʻia o ka pancreas e synthesize i ka insulin.

I ka wā e lawe kolohe ai, ʻo ke kō ʻana mai ka gastrointestinal tract he 48-84%. ʻO ka manawa e hiki ai i ka lōʻihi o ke kau ʻana he 1-2 mau hola, ʻo ka nui o ka hoʻoili ʻana he 9-10 lita. ʻO ka kamaʻilio pū me nā protein plasma he 95-99%. ʻO ka bioavailability o glibenclamide he 100%, kahi e hiki ai iā ʻoe ke lawe i ka lāʻau lapaʻau ma mua o kaʻai ʻana. ʻAno ʻino ʻole ka mea hoʻonoho. Ua aneane pau loa i ke kāʻei o ka ate me ka hoʻokumu ʻana o nā metabolites ʻelua i hana ʻia, kekahi o nā mea i hoʻopili ʻia e nā palaka, a me nā ʻē aʻe. ʻO ka hoʻopau hapa hapalua-ola mai 3 a 10-16 mau hola.

ʻO ka maʻi mellitus type 2 me ka hikiʻole o ka mālama ʻana i ka lāʻau.

maʻi diabetes type 1

maʻi ketoacidosis maʻi, maʻi kanesa precoma a me ka coma,

kūlana ma hope o ka haʻalele ʻana o ka pancreatic,

lima hana hoʻopili hewa,

pilikia hanalei,

hypersensitivity i glibenclamide a / ai ʻole i nā derivatives sulfonylurea, sulfonamides, diuretics e pili ana i ka hui sulfonamide i ka molola, a me ka probenecide, e like me ka ʻike ʻia mai ka anamnesis neʻe paha ke ʻano he kūlia

decompensation o nā pakanalua kaʻeʻeha i nā maʻi hopuna a ma hope o nā hana ʻoihana nui ke hōʻike ʻia ka maʻi insulin.

ʻala, ka ʻōpū o ka ʻōpū,

nā kūlana i hele pū me ka malabsorption o ka meaʻai a me ka hoʻomohala ʻana o ka hypoglycemia,

hapai a me ka wā o ka umauma.

Hoʻohana ʻia ʻo Glibenclamide no:

mai nā maʻi thyroid (me ka hana ʻole o ke kanaka).

hypofunctions o ka pituitary anterior a cortex adrenal paha,

i nā poʻe maʻi maʻi ma muli o ka pilikia o ka hoʻomohala ʻana i ka hypoglycemia.

ʻO ka hopena ākea ka hopena maʻamau o ka mālamaʻana i ka glibenclamide hypoglycemia. Hiki i kēia ʻano ke hana i kahi ʻano protracted a kōkua i ka hoʻomohala ʻana i nā kūlana koʻikoʻi, a hiki i kahi mea hoʻomehana, hoʻoweliweli a ola a hoʻopau paha. Me ka polyneuropathy diabetic a i ʻole ai me ka launa pū me nā mea maʻi lapaʻau (ʻike i ka ʻāpana "Hoʻohālikelike me nā lāʻau ʻē aʻe"), nā hana maʻamau o ka hypoglycemia e maʻalahi a i ʻole ka ʻole.

ʻO nā kumu no ka hoʻomohala ʻana i ka hypoglycemia hiki i: ka overdose o ka lāʻau, hōʻino maikaʻi ʻole, ʻaiʻai ʻole, nā mea maʻi, hele aʻokiʻoki, ʻeha, hoʻōkuhi kūlohelohe kino, nā maʻi e hōʻemi ai i ka pono o ka insulin (pehu a me ka hana o ka ʻōpū, hypofunction o adrenal cortex, pituitary or thyroid gland) , ka hōʻemi kino ʻana, a me ke hoʻopili ʻana me nā lāʻau lapaʻau ʻē aʻe (e ʻike i ka ʻāpana "Hoʻohālikelike me nā hua lāʻau ʻē aʻe"). ʻO nā hōʻailona o ka hypoglycemia: ka pōloli loa, ka hoʻoheheʻe ʻana me ka palu, nā palpitations, pallor o ka ʻili, paresthesia i loko o ka waha, haʻalulu, hopohopo laulā, hōʻea, ka puʻuwai holo, nā hiamoe hiamoe, nā manaʻo hopohopo, hoʻākoʻa ʻana me ka hoʻowalewale o nā neʻe, nā maʻi neurological pōkole (e.g. ʻike ʻia a nānā ʻia i ka maʻi, nā hōʻike kuʻuna o ka paresis a i ʻole paralysis a i ʻole nā ​​hoʻololi ʻana i ka manaʻo o nā sensations). Me ka hoʻomohala ʻana o ka hypoglycemia, hiki i nā mea maʻi ke nalowale i kā lākou iho a me ka ʻike. ʻO ka maʻi pinepine o kēlā mea maʻi i ka ʻili, ke anuanu a me ka predisposition no ka pulupulu.

Me nā hypoglycemia, hiki ke loaʻa nā mea penei:

Nā Hoʻolaha Digestive: kaʻai pinepine ʻana i ka ʻōpū, ka belching, ka luaʻi, he ʻomo "ʻōpio" i loko o ka waha, ka manaʻo o ke kaumaha a me ka piha i loko o ka ʻōpū, ʻeha a me nā ʻōpū. I kekahi mau hanana, kahi manawa iki o ka hana o nā enzymes "ate" (phosphatase alkaline, glutamine-oxalacetic acetic aminotransferase, glutamine-pyruvic aminotransferase) i loko o ka serum koko, ua hoʻākāka ʻia ka maʻi hepatitis a me nā hana hoʻomau.

Kūkulu ʻia nā hanana hui kūlohelohe: lapalapa, hōʻeha o ka ʻili, urticaria, ʻulaʻulaʻula o ka ʻili, ka edema o Quincke, ʻike hemorrhages i ka ʻili, ka pīkī ʻana i ka ʻōwili nui o nā ʻāpana nui o ka ʻili a hoʻonui ʻia photosensitivity. Maʻalahi loa, hiki i nā hopena ʻili ke mālama i ka hoʻomaka ʻana o ka hoʻomohala ʻana i nā kūlana koʻikoʻi, hele pū me ka pōkole o ka hanu a me ka emi ʻana o ke kahe koko a hiki i ka hoʻomaka ʻana o ka pīhoihoi, ka hoʻoweliweli ʻana i ke ola o ka mea maʻi. ʻO nā hihia pilikino i wehewehe ʻia ʻano maʻi maʻamau āpau me ka ʻokiʻoki i ke kino, ʻeha kuʻuna, ka maʻi, ke ʻano o ka protein i ka urine a me ka jaundice.

Mai ka ʻōnaehana hemopoietic: maʻa pinepine ʻia nā thrombocytogeny a ʻike ʻole paha i ka leukocytopeia, agranulocytosis. I nā hihia hoʻokaʻawale, ulu ka hemolytic anemia a i ʻole pancytopenia.

I nā hopena ʻē aʻe nānā i nā hanana kaawale i: nā hopena diuretic nāwaliwali, ka manawa hoʻonaninua ka protein i loko o ka pāʻai, ka hoʻonaninani ʻana a me ka noho ʻana, a me ka hopena o ka hoʻonaninua ʻana o ka ʻona ma hope o ka inu ʻana, i haʻi ʻia e nā ʻōuli o ke kaila a me nā mea hanu (ka hopena like ʻole disulfira: huʻi, hoʻonaninani ka wela i ke alo a me ke kino o luna, tachycardia, dizziness, headache).

Inā loaʻa kahi overdose, hiki i ka uluʻana o ka hypoglycemia.

Me ka hypoglycemia maʻalahi a hōʻoluʻolu paha, ua lawe ʻia ka glucose a i ʻole ka wai momona.

Ma ka hihia o ka hypoglycemia koʻikoʻi (ka nalowale o ka ʻike ʻana), kahi hopena 40% dextrose (glucose) a i ʻole glucagon e mālama ʻia i loko o intravenously, intramuscularly, subcutaneously.

Ma hope o ka hāpai hou ʻana, pono e hāʻawi ka mea maʻi i nā meaʻai momona-momona e pale ai i ka hoʻomohala hou ʻana o ka hypoglycemia.

Ke hoʻoikaika nei i ka hopena hypoglycemic o Glibenclamide e nānā me ka hoʻohana pinepine ʻana o ka angiotensin-hoʻomālamalama huakaʻi i nā ʻenehana, ʻĀpiha anabolic.

nā mea hoʻohālikelike o ka lāʻau hypoglycemic (no ka laʻana, acarbose, biguanides) a me ka insulin, nā lāʻau anti-inflammatory non-steroidal (NSAIDs), beta-blockers, quinine, quinolone derivatives, chloramphenicol, clofibrate, Coumarin derivatives, disoyramidine, microfenoxylamine, fenfludamine, fenflamono, fenflamono, fenflamono para-aminosalicylic acid, pentoxifylline (i nā kaila nui i mālama ʻia ma ka makua), perhexiline, derivoli pyrazolone, phenylbutazones, ka phosphamides (e.g. cyclophosphamide, ifos amide, trofosfamide), probenecid, salicylates, sulfinpirazona, sulphonamides, tetracyclines a me tritokvalina. Hoʻokomo ʻia nā ʻaihini e hoʻohuihui i ka urine (ammonium chloride, calcium chloride) i ka hopena o ka glibenclamide ma ka hoʻemi ʻana i ka pae o kona ʻāwili a me ka hoʻonui ʻana o nā reabsorption.

ʻO nā lāʻau lapaʻau e pale i ka hematopoiesis pumehana o ka iwi e hoʻonui i ka hopena o ka myelosuppression.

Me ka hopena o ka hopena hypoglycemic hoʻonui, beta-blockers, clonilip, guanethidine a me ka reserpine, a me nā lāʻau lapaʻau me ke ʻano kumu o nā hana, hiki ke hoʻonāwaliwali i ka manaʻo o nā mea no ka hypoglycemia.

Hiki ke hōʻemi ʻia ka hopena hypoglycemic glibenclamide me ka hoʻohana ʻana i ka barbiturates, isoniazid, cyclosporine, diazoxide, glucorticostrosroids, glucagon, nicotinates (ma nā helu koʻikoʻi), phenytoin, phenothiazines, rifampicip, thiazide diuretics, acetaminophen nā maʻi thyroid, nā mea hoʻowalewale o nā kahawai calcium "lohi", nā aelike me ka lithium a me nā paʻakai lithium.

ʻO ka hōʻeha kino a me ka laxatives e hoʻonāukiuki i ka hōʻino o ka aila i ka hana 'ana.

Hiki ke hoʻonāwaliwali i ka ʻāpana o ka receptor H2, ma kekahi lima, a hoʻonui i ka hopena hypoglycemic o Glibenclamide ma ka ʻaoʻao. I nā hihia pilikia, hiki i ka pentamidine ke hōʻeha i kahi hoʻonui nui a hoʻonui paha i ka kaila glucose wai. Hiki ke hoʻonui a emi paha ka hopena o nā derivatives Coumarin.

Me ka hopena o ka hopena hypoglycemic hoʻonui o nā beta-blockers, clonidine, guanethidine a me ka reserpine, a me nā lāʻau lapaʻau me ke ʻano kumu o nā hana, hiki ke hoʻonāwaliwali i ka manaʻo o nā mea no ka hypoglycemia.

Pono ʻia ka lāʻau i nā manawa maʻamau a, inā hiki, i ka manawa like. Pono e nānā pono i ka nohona o ka lāʻau a me ka meaʻai.

E pono e noʻonoʻo pono ke kauka i ke koho ʻana o Glibenclamide i nā mea maʻi me ka maʻi aho a me ka hana ʻana o ka pūpū, a me ka hypofunction o ka lolo thyroid, pituitary anterior a cortex adrenal. Pono ʻia ke hoʻoponopono ʻia o Glibenclamide me ka overstrain kino a me ke ʻano, he loli i ka meaʻai. ʻO nā hōʻiliʻili nui a me nā hōʻeha, nā wela ākea, nā maʻi maʻi me ka febrile syndrome e koi ai i ka hoʻopau ʻana i nā lāʻau hypoglycemic waha a me ka hoʻokele ʻana o ka insulin.

Hoʻomaʻamaʻa ʻia nā mea maʻi e pili ana i ka hoʻonui nui o ka hypoglycemia i nā hihia o ka inuʻana i ka waiʻona, nā NSAID, a me ka pōloli.

I ka hoʻomaka ʻana o ka mālama ʻana, i ka wā e koho ai i ka nui o nā maʻi, ʻike ʻia nā mea maʻi i ka hoʻomohala ʻana o ka hypoglycemia, ʻaʻole i ʻōlelo ʻia e hana i nā hana e koi ai i ka piʻi nui a me ka wikiwiki o ka hopena psychomotor.

Ke mālama nei i nā mea maʻi me ka nele o ka lactase, pono e noʻonoʻo ʻia i ka lāʻau i loaʻa ka lactose monohydrate.

Ma kahi wahiʻeleʻele i kahi mahana o kaʻoki ʻole eʻoi aʻe ma mua o 25 ° C.

Mai mālama i nā keiki.

Hoʻohui Kūʻai Kūʻai

Loaʻa ka lāʻau lapaʻau antithrombotic, lipid-ʻohi a hypoglycemichana.

Nā ʻoka a me nā hoʻōla

Hoʻomaopopo ʻia ka Glibenclamide no ka hoʻohana koke ma hope o ka ʻaina. Hoʻopili ka endocrinologist i nā hopena ma muli o nā hopena o nā hoʻokolohua o ke koko no ka kō, ka makahiki o ka mea maʻi, ka nui o ka maʻi ma lalo o nā maʻi, nā kuʻuna concomitant a me ke olakino ākea.

I ka hoʻomaka mua o ka maʻi, ka maʻamau maʻamau ʻo 2.5-5 mg / lā. Lawe i ka lāʻau lapaʻau hoʻokahi manawa ma hope o ka ʻaina kakahiaka. Inā loaʻa ʻole ka uku piha no ka glycemia hiki ke hoʻokō, hiki i ke kauka ke hoʻoponopono i ka nui ma o ka hoʻohui ʻana i ka 2.5 mg o ka lāʻau ma hope o hoʻokahi hebedoma. ʻO ka helu marginal (a hiki i ka 15 mg / lā) ka like me nā papa ʻekolu. ʻAʻole lawa ka ʻāpaʻa nui loa, ʻaʻohe hua nui i hoʻonui ʻia i ka glycemia.

Inā loaʻa ka maʻi diabetes i ke kaumaha o ke kino e emi iho ma mua o 50 kg, ua kuhikuhi mua ʻia ke kaha lāʻau mua ma 2.5 mg, e pili ana i ka hapalua o ka papaʻaina. Inā ʻaʻole iʻoi aku ka maʻamau o kēlā me kēia lā i ʻelua mau ʻāpana, inu ʻokoʻa i ke kakahiaka i ka kakahiaka kakahiaka, ma ka ʻaoʻao ʻē aʻe, ua hoʻohele ʻia ka lāʻau lapaʻau ʻelua, i ke kakahiaka a me ke ahiahi ma ka pālahalaha o 2: 1.

Ke neʻe nei ʻo Glibenclamide ma hope o ka mālama ʻana i ka mālama ʻia me nā lāʻau lapaʻau hypoglycemic hou, e hoʻolōʻihi ʻia ka pomo hoʻomaka ʻana i ka 2,5 mg i hoʻokahi, i ke kakahiaka.

Me ka hanaʻole maikaʻi, hiki iā ʻoe ke hoʻoponopono i ke ʻano maʻamau i kēlā me kēia pule me ka hoʻonui ʻana i ka 2.5 mg.

Ma ka hanana ʻana o ka hopena o ka mālama ʻana me nā lāʻau lapaʻau antidiabetic maikaʻi loa, ʻaʻole me ka maikaʻi, ʻo ka hoʻomaka hoʻomaka ʻana ma 5 mg i ke kakahiaka, ma hope o ka papaʻaina. Inā loaʻa, kahi ʻae ʻia o ka 2.5-5 mg i kēlā me kēia pule. Ke mau nei ka palena palena - 15 mg / lā.

Inā ʻaʻole ka lāono o Glibenclamide i kēlā me kēia lā, aʻo ka nānā ʻana i kahi ʻai haʻahaʻa-kālima a me ka hana kūlohelohe kūloko, ʻaʻole ia e hāʻawi i ka uku o ka 100% gula, ua hoʻoneʻe ʻia ka maʻi diabetes i kahi papa hana lapaʻau piha. Hoʻohui ʻia ka lāʻau nui me nā biguanides, insulin, a me nā mea ʻokoʻa hypoglycemic ʻē aʻe.

Inā hoʻopau ka ʻono endogenous i ka nui o ka insulin i ka maʻi maʻi maʻi me ka lua o ka maʻi e pani ʻia loa, ʻaʻole hoʻopiʻi ka mālama ʻana i nā hopena like me ka monotherapy me ka hoʻomākaukau ʻana o ka insulin.

Inā, no kekahi kumu, ua hala ka manawa e lawe ai iā Glibenclamide no hoʻokahi manawa a ʻelua paha mau makahiki, ʻaʻole hiki iā ʻoe ke lawe i ka lāʻau lapaʻau i ka wā e hiki mai ana. I ke kakahiaka aʻe, e lawe i kahi laʻa maʻamau, mai ʻōlelo i ka hoʻonui ʻana i ka helu.

Nā hopena hopena

Me kahi overdose o ka lāʻau lapaʻau, hiki i nā kūlana hypoglycemic o kēlā me ke ʻano o ka hōʻeha he nui, me ka coma. Me ka hoʻowahāwahā ʻia o ka waiʻona a i ʻole hoʻokahi a ʻelua paha i ka lā i ka lā, ma luna o ka hana, nā pilikia me ka ʻāʻā, nā kelepa thyroid a me nā ʻōpū, he hopena hiki ʻole nō hoʻi.

Nā hihia o ka Overdose o Glibenclamide

Hoʻohana ka lawelawe ʻōnaehana o ka mahele hāpana o ka lāʻau lapaʻau i hoʻonāukiuki i ka hypoglycemia koʻikoʻi, kahi mea weliweli no ke ola o ka mea nāna.

Hiki ke loaʻa ka hopena like me ka hoʻohana ʻana i ka lāʻau lapaʻau e pili ana i ke kūmole o ke kīnā o ke ʻano kūʻai, ka hana ʻana o ke kino, ka mana o kekahi mau lāʻau lapaʻau i lawe pū ʻia me Glibenclamide.

Nā hōʻailona o kahi kūlana hypoglycemic:

• Ka pololi hiki ʻole paʻa
• Hoʻemi ka maikaʻi o ka hiamoe
• Kaipo keiki
• Waha haole
• Hoʻonui kaho
• Laumapa
• Nā maʻi Dyspeptic
• Hypertonicity
• Hālau nui
• Tachycardia.

ʻO nā mea haehae i ka hana o ka psyche me nā pilikia endocrine hiki ke hōʻike ʻia i ke kaheʻe ʻana i ka hopohopo, ke kaumaha nei, nā puʻupuʻu, nāwaliwali nāwaliwali, ʻike ʻole ʻia, hoʻāla hopohopo, panikō ke lawe ʻana i kahi kaʻa a mālama i nā ʻōnaehana pololei, nā wahi kaumaha, ka huhū, nā pilikia o nā moku koko a me nā ʻōpū hanu, koma.

E kūlike aʻe ana i ke ʻano kaulike a me ka hoalohui o kahi overdose, hypoglycemia e hoʻohiki ʻia a hoʻohālikelike ʻia me kahi overdose o nā derivatives sulfanylurea ulu mua.

No ka hōʻoluʻolu o ke ʻano o ka mea i hoʻopiʻi ʻia me kahi hōʻoluʻolu o ke ʻano o ka hoʻouka ʻana, hiki koke ʻoe iā ʻoe iho koke i nā kāloli wikiwiki loa - nā ʻuʻuku, hapalua kīʻaha o ke kīʻaha me ke kō a i ʻole ka wai (me ka mea aloha kūlohelohe). Inā ʻaʻole lawa kēia mau kaʻina, hoʻopili ʻia ka glucose (40%) a i ʻole Dextrose (5-10%) i loko o kahi uaua, a laila hopu ʻia ke kīmona (1 mg) i loko o nā ʻōpū. Hiki ke kiʻi ʻia ka Diazoxide. Inā ua lawe ka mea pepehi i ka acarbose, hiki ke hoʻoponopono ʻia i ka hypoglycemia waha ma ka glucose wale nō, akā ʻaʻole me ka oligosaccharides.

Inā ʻike ka mea pepehi i ka hypoglycemia, hoʻolaʻa ʻia ke kōpaʻa no ka hana o loko. I ka hihia o ka nalowale o ka ʻike, mālama ʻia ka glucose i ka iv, glucagon - iv, iv a ma lalo o ka ʻili. Inā hoʻihoʻi ka naʻau, no ka pale ʻana i ka hoʻihoʻi, pono e hāʻawi ʻia kahi mea maʻi me kaʻai e pili ana i ka paʻakai wikiwiki.

Ka nānā kiaʻi ʻana i ka glycemia, pH, creatinine, electrolytes, urea nitrogen ka ʻike ʻia.

ʻO nā hopena Hoʻohui Kūleʻa ʻO Glibenclamide

Hoʻololi ka hoʻopuka ʻia ʻana o ka glimenclamide, ʻoiai e hoʻonui ana i kona mana hypoglycemic, azopropanone, miconazole, hoʻomākaukau i ka waikawa Coumaric, oxyphenbutazone, sulfonamide hui lāʻau, phenylbutazone, sulfapyrazonfeniramidol.

ʻO ka hui pū ʻia me nā laila e hoʻohaʻahaʻa i nā lāʻau lapaʻau e hoʻoneʻe ana i ka pale ʻana i ka insulin e hōʻike i nā hopena like.

Me ka hana like o nā lāʻau anabolic, allopurinol, cimetidine, β-adrenoreceptor blockers, cyclophosphamide, guanethidine, clofibric acid, monoamine oxidase inhibitors, sulfonamides me ka hana lōʻihi, salicylates, tetracyclines, waiʻona, hypoglycemic waiwai o nā mea maʻamau.

Inā loaʻa i ka regimen therapeutic barbiturates, chlorpromazine, rifampicin, diazoxide, adrenaline, acetazolamide, nā waiwaʻina aikathomimetic, glucocorticosteroids, glucagon, indomethacin, diuretics, me ka acetazolamide, nicotinate (ma nā nui) , ʻona saluretics, nā paʻakai lithium, nui nā wai momona a me ka laxative, ua hoʻemi ʻia ka hopena o ka glimenclamide.

Hōʻike ʻia nā hopena he kumu ʻole o ka launa pū me ka hoʻohana pākuʻi e nā H2 receptor antagonist.