Nā ʻōkuhi no ka hoʻohana ʻana i nā papa Amaryl

Hoʻokahi papa papa o ʻAmesa 1 mg: ka waiwai ikaika: glimepiride - 1 mg,

nā mea hoʻopuka: lactose monohydrate, sodium carboxymethyl starch (tun A), povidone 25000 (E1201), cellulose microcrystalline (E460), magnesium stearate (E470), nā waipuna momona oxide (E172).

Hoʻokahi papa papa o Amarsh 2 mg: mau mea ikaika: glimepiride - 2 mg,

nā mea waiwai: ka momona o ka lactose, sodium carboxymethyl starch (type A), povidone 25000 (E1201), microcrystalline cellulose (E460), magnesium stearate (E470), kaila hao kaila puaʻa (E172), indigo carmine aluminium (E132).

Hoʻokahi papa papa o Amarsh 3 mg i loaʻa: ka waiwai ikaika: glimepiride - 3 mg.

nā mea waiwai: kaʻaila o ka lactose, sodium carboxymethyl starch (type A), povidone 25000 (E1201), cellulose microcrystalline (E460), magnesium stearate (E470), kaila hao melemele (E172).

Hoʻokahi papa papa o Amarsh 4 mg: mau mea ikaika: glimepiride - 4 mg.

nā mea waiwai: kaʻaila lactose, sodium carboxymethyl starch (type A), povidone 25000 (E1201), cellulose microcrystalline, magnesium stearate (E460), indigo carmine aluminum varnish (E132).

Amarsh 1 mg: Oblong, papa ʻeleʻele papa ma nā ʻaoʻao ʻelua me kahi kahelehele ma nā ʻaoʻao ʻelua. Leka Kiʻi Kiʻi: NMK / Kūlana inoa. Aia kākuhi: Palapala inoa / NMK.

Amras 2 mg: Oblong, papa ʻeleʻele papa ma nā ʻaoʻao ʻelua me kahi puʻupuʻu e hoʻokaʻawale i nā ʻaoʻao ʻelua. Leka Kiʻi Kiʻi: NMM / Kūlana inoa. Aia kāwaha inoa: Kau inoa inoa / NMM.

Amarsh 3 mg: ʻAkela, nā papa ʻ onlelo ma nā ʻaoʻao ʻelua he kukui melemele kukui me ka ʻāpana kuʻuna ma nā ʻaoʻao ʻelua. Leka Kiʻi Kiʻi: NMN / inoa inoa. Aia kākuhi: Palapala inoa / NMN.

Amarsh 4 mg: Oblong, papa ʻ flatlelo ma nā ʻaoʻao ʻelua o ka papa polū me kahi alaloa hoʻokaʻawale i nā ʻaoʻao ʻelua. Leka Kiʻi Kiʻi: NMO / inoa inoa. Kahiki hōʻailona: Huaʻī inoa / NMO.

Ka hana lāʻau lapaʻau

ʻO Glimepiride, ka mea hana a Amaril, kahi lāʻau lapaʻau hypoglycemic (hoʻohaʻahaʻa i ke kōpaʻa) no ka hoʻohana ʻana i ka waha - he derphative sulfonylurea.

Ke hoʻoikaika nei ʻo Glimepiride i ka hana huna a hoʻokuʻu i ka insulin mai nā beta beta o ka pancreas (hopena i ka pancreatic), hoʻomaikaʻi i ka ʻike ʻana o nā ʻiʻo peripheral (musina a me ka momona) i ka hana o kāna iho (i ka hopena extrapancreatic).

ʻO nā kumulepala Sulfonylurea e hoʻoponopono i ka huna ʻana i ka insulin ma o ka pani ʻana i nā hāmeʻa pālio hilinaʻi ATP i loaʻa i ka membioma cytoplasmic o nā sela beta pancreatic. Ke pani nei i nā kahe pākia, hana lākou i ka depolarization o nā beta beta, e kōkua ana e wehe i nā kahikina kalaleka a hoʻonui i ka kahe o ka calcium ma nā puna. ʻO Glimepiride, me kahi uku nui, ka hoʻohui a me ka neʻe ʻana mai ka protein beta-cell protein pancreatic (molar mass 65 kD / SURX), ka mea i hui pū ʻia me ka pā pālola e hilinaʻi ana i ka ATP, akā, ʻokoʻa ia mai kahi kahua paʻa maʻamau o nā derivatives maʻamau.

sulfonylureas (protein molar mass 140 kD / SUR1). . ^ E Ha yM. - X p>

Ke alakaʻi nei kēia kaʻina i ka hoʻokuʻu ʻana i ka insulin e ka exocytosis, i kēia hihia. - ʻO ka maikaʻi o ka insulin huna ʻia ka liʻiliʻi ma mua o nā sulfonylureas maʻamau. ʻO ka hopena liʻiliʻi loa e pili ana i ka glimepiride i ka huna ʻana o ka insulin e hāʻawi i kahi haʻahaʻa o ka haʻahaʻa o ka hypoglycemia.

Eia kekahi, ua hōʻike ʻia nā hopena extrapancreatic o glimepiride (kahi hoʻohaʻahaʻa i ka kū ʻana o ka insulin, he hopena hōʻemi i ka ʻōnaehana cardiovascular, anti-atherogenic, anti-aggregation a me nā hopena antioxidant) i hōʻike ʻia, nā mea like me nā derivatives sulfonylurea, akā i kahi mea hōʻemi.

Hoʻonui ka hoʻohana ʻana i nā glucose mai ka koko ma o nā io hope peripheral (pūpū a me nā momona) e hoʻohana ana i nā ʻōnaehana hoʻouka kūikawā (GLUT1 a me GLUT4) e loaʻa ana i nā membrane cell. ʻO ka halihali o ka glucose i kēia mau kiko ma ke ʻano type diabetes 2 he hana wikiwiki i ka hoʻohana ʻana i nā glucose. Hoʻonui nui ʻo Glimepiride i ka nui a me nā hana o nā molekikua o ka lawe ʻana i nā glucose (GLUT1 a me GLUT4), e alakaʻi ana i ka hoʻonuiʻu glucose i nā kipi peripheral.

ʻO Glimepiride ka hopena palupalu ikaika i ke K_ANā kaʻa TF o cardiomyocytes. Ke lawe nei i ka glimepiride, mālama ʻia ka hiki i ka metabolic adaptation o myocardium i ka ischemia.

Hoʻonui ʻo Glimepiride i ka hana o ka glycosyl phosphatidylinositol-spocolpase C kūikawā, me ka lipogenesis a nā huahana a me nā glycogenesis hiki ke hoʻoponopono i nā pūlima a me nā momona momona.

Hoʻopili ʻo Glimepiride i ka hana glucose i loko o ka puʻuwai ma o ka hoʻonui ʻana i ka hoʻoulu ʻana o intracellular o ka fructose-2,6-bisphosphate, a ma ia ʻano e pale aku ai i ka glucoseoneogenesis.

Hoʻopili ka Glimepiride selly i ka cyclooxygenase a hōʻemi i ka hoʻololi ʻana o ka waikawa arachidonic i ka thromboxane A2, e hāpai ana i ka hoʻohui platelet, a laila e hana ai i kahi hopena antithrombotic.

Hāʻawi ʻo Glimepiride i ka maʻamau o ka ʻike lipid, hōʻemi i ka pae o ka aldehyde liʻiliʻi i loko o ke koko, e alakaʻi ai i kahi hōʻemi nui i ka peroxidation lipid, ua kōkua kēia i ka hopena anti-atherogenic o ka lāʻau. Hoʻonui ka Glimepiride i ka pae o ka endogenous a-tocopherol, ka hana o ka catalase, glutathione peroxidase a me ka superoxide dismutase, e kōkua ana i ka hōʻemi o ka paʻakikī o ke kaumaha oxidative i loko o ke kino o ka mea maʻi, ka mea mau i ka type 2 diabetes mellitus.

I nā poʻe olakino, ʻoi aku ka liʻiliʻi o ka hopena o ka waha o ka glimepiride ma kahi o 0.6 mg. ʻO ka hopena o ka glimepiride ke kūpaʻa a me ka hoʻohuli. ʻO ka pane ʻana o ka physiological i ka hoʻoikaika kino nui a me ka hoʻēmi ʻana i ka mea huna insulin i ka wā e mālama ana i ka glimepiride.

ʻAʻole ʻokoʻa nā hopena ʻē aʻe ma muli o ka hopena, ma muli o ka lawe ʻia ʻana o nā lāʻau 30 mau minuke ma mua o kaʻai ʻana a ma mua o kaʻai ʻana. Ma nā mea maʻi me ka maʻi maʻi, hiki ke loaʻa ka hoʻonaninani metabolinola ʻo 24 mau manawa e hiki i ka hopena hoʻokahi ʻona.

ʻOiai ke kumu o ka glimepiride hydroxymetabolite e hōʻemi ana i ka liʻiliʻi o ka nui o ke kaila o ka glucose i loko o nā maʻi olakino, ʻo kēia metabolite ke kuleana wale no ka mea liʻiliʻi o ka hopena o ka hopena.

ʻO ka hoʻohui lāʻau me Metformin

I loko o kahi noiʻi haukapila, ua hōʻike ʻia no ka mea i loko o nā mea maʻi me ka hopena maikaʻi ʻole o ka hopena, ʻoiai me ka nui o ke koena o ka metformin, ka hoʻohana pinepine ʻana o ka glimepiride me ka metformin e hoʻomaikaʻi ana i ka hana hoʻokūkū maikaʻi ʻoi aku me ka metformin monotherapy.

Hoʻohui hui me ka insulin

Aʻo ka ʻikepili ma ka hui ʻana o ka glimepiride me ka insulin. ʻO nā maʻi me nā hopena hoʻomaʻamaʻa ʻana ʻole maikaʻi ʻole me nā inika nui loa o ka glimepiride hiki ke hoʻomaka i ka like me ka insulin. I loko o nā ʻelua mau ho'āʻo koʻikoʻi, ua hāʻawi ʻo ka hui hui like i ka holomua metabolic e like me ka monotherapy insulin, akā naʻe, ma ka hui hui pū ʻana, e koi ʻia nā dosis haʻahaʻa.

Nā hui kelepona kūikawā

Na keiki a ʻōpio

ʻO ka hoʻokolohua lapaʻau me ka kāohi ikaika (glimepiride a 8 mg i ka lā a i ʻole ka metformin a hiki i ka 2,000 mg i kēlā me kēia lā mau loa he 24 mau keiki me 285 mau keiki (8-17 mau makahiki) me ke ʻano maʻi type 2. ʻO nā pūhui ʻelua, glimepiride a me metformin, hōʻike i ka hoʻemi nui o HbAlc me ka mahalo i ka pae mua o ka glimepiride -0.95 (i loko o kahi serum 0, 41), metformin -1.39 (i ka serum 0.40). ʻOiai naʻe, ʻaʻole i hoʻokō ka glimepiride i nā kūlana o ke kūlana "ʻoi aku ka maikaʻi ma mua o ka metformin", i ka hoʻokolokolo ʻia e ka loli awelika o HbAlc e pili ana i ka ʻōlelo kuhikuhi. ʻO ka ʻokoʻa he 0.44% i makemake i ka metformin. Palena palena kiʻekiʻe (1.05) 95% hilinaʻi

o ke kikowaena no ka ʻokoʻa he ʻoi aku ma mua o ka mea i ʻae ʻia e ka liʻiliʻi ʻae loa me 0.3%.

ʻAʻole i hōʻike i ka maʻi Glimepiride e pili ana i nā mea i palekana no ka palekana i nā keiki i hoʻohālikelike ʻia i nā mea maʻi pākē me nā maʻi maʻi 2. ʻAʻohe ʻikepili mai ka lōʻihi a me nā hoʻopaʻa ʻana palekana no ka maʻi pediatric.

Lapaʻau lāʻau

Ke hoʻopau ʻia ka glimepiride pau ʻana o ka bioavailability. ʻAʻole ʻai iki ka ʻai i kaʻai ʻana, me ka hoʻokaʻawale ʻana me kahi lohi o nā ʻano haʻahaʻa. Me ka hoʻohana mau ʻana o ka glimepiride i kēlā me kēia lā no 4 mg, ka nui o ka paila o ka sima o ke koko (C_tah) ke kiʻi ma hope o nā hola he 2 mau hola a he 309 ng / ml, aia kahi pilina ma waena o ka hopena a me Stax, ma ke ʻano o ka ʻāʻī a me AUC (ʻo ka wahi ma lalo o ka pihi-nā manawa paʻa).

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).

ʻO Biotpansformatssh a kāpae

Ma hope o hoʻokahi pākahi waha o ka glimepiride, 58% e hoʻopiʻi ʻia i loko o ka pāʻai a me 35% me nā feces. ʻAʻole i ʻike ʻia ka waiwai i hoʻololi ʻia i loko o ka urine. ʻO ka wehe ʻana o ka hapa-ola i ka plasma o ka lāʻau i ka serum e pili ana i ka regimen doses ʻana he 5-8 mau hola. Ma hope o ka laweʻana i nāosa kiʻekiʻe, hoʻonui ʻia ka hapalua ola.

ʻIke ʻia nā lua o nā metabolites i ka uea a me nā mea hoʻopiʻi, i hoʻokumu ʻia ma muli o ka huina o ka puhipuhi i loko o ka ate, ka mea hoʻokahi o ko lākou iho, kahi derivative a me ka mea ʻē aʻe, kahi ko ka huamo carboxy. Ma hope o ka nānāʻana i ka glimepiride, ʻo ka hapalua hapalua o kēia mau metabolites he 3-5 mau hola a me nā hola 5-6, kēlā me kēia.

Hoʻopili ʻia ʻo Glimepiride i ka waiū umauma a kau i ka pāpaʻi placental. Hoʻokomo ka lāʻau i ka palaka ma o ka pale koko-lolo.

ʻO ka hoʻohālikelike o ka hoʻokahi a me ka helu (hoʻokahi hoʻokahi lā) ʻo ka hoʻokele glimepiride ʻaʻole i hōʻike i nāʻokoʻa nui i nā pālākiō pharmacokinetic, a ʻo kā lākou ʻano haʻahaʻa haʻahaʻa i ʻike ʻia ma waena o nā mea maʻi. Nui ka hōʻiliʻili ʻana o ka lāʻau lapaʻau.

Nā hui kelepona kūikawā

ʻO nā hiʻohiʻona Pharmacokinetic e like me i nā mea maʻi o nā kāne like ʻole a me nā hui like ʻole. I loko o nā mea maʻi me ka hana renal lēʻaila (me ka hana ʻana ma lalo o ka creatinine) i ke ʻano o ka hoʻonui ʻana i ka hoʻomaʻamaʻa ʻana o ka glimepiride a me ka hoʻēmi ʻana ʻana i ka hoʻoliʻiliʻi ʻana i loko o ka serum koko, ʻo ia ka mea nui loa ma muli o ka wikiwiki o ka lāʻau lapaʻau ma muli o kona paʻa ʻana i ka protein. Pēlā, i kēia mahele o nā mea maʻi ʻaʻohe pilikia ʻē aʻe o ka hoʻopili ʻana o ka lāʻau lapaʻau.

ʻO kahi hoʻokolohua e hoʻopaʻa i ka pharmacokinetics, palekana, a me ka hoʻomanawanui o ka pākaʻi o 1 1 mg o glimepiride ma nā maʻi maʻi pediatric 30 (4 mau keiki he mau makahiki 10-12 a ʻo 26 mau keiki nona 12-17 mau makahiki) e hōʻeha ana i ka maʻi maʻamau ʻo 2 -i_{e like me}t, C_max a X a hui huichny mau waiwai i nānā ʻia ma nā pākeke.

Nā Hoʻohui

ʻAʻole pono e hoʻohana ʻo Glimepiride no:

• ke hypersensitivity i ka glimepiride a i ʻole kekahi mea i ka hana o ka lāʻau lapaʻau, i nā derivatives sulfonylurea a i nā huamo sulfa paha (ka hopena o ka hopena hypersensitivity),

• nā mellitus kū'ē i ka insulin,

• ka maʻi ketoacidosis maʻi, maʻi diabetes precoma a me ka coma,

• palupalu palalaki palu,

• hōʻeha nui o ka lua (ʻo ka poʻe maʻi ma ka hemodialysis),

• hāpai a me ka lactation.

ʻŌpū a me ka lactation

Contlimicated ʻo Glimepiride i nā wahine hāpai. I ka hihia o kahi hapai i hoʻolālā ʻia a i ka hoʻomaka ʻana o ka hāpai ʻana, pono i kahi wahine e hoʻoneʻe i ka ʻomo insulin.

No ka mea he glimepiride, ʻike ʻia i loko o ka waiū umauma, ʻaʻole pono e kuhikuhi ʻia i nā wahine i ka wā lactation. I kēia hihia, pono ia e hoʻololi i ka hoʻololi ʻana i ka insulin a i ʻole e pau i ka ʻōpū.

ʻLoe a me ke kākele

Kuhi ʻia no ka hoʻohana waha.

ʻO ke kumu no ka hoʻokūkala o ka maʻi hānai kūpono heʻai kūpono, hoʻomaʻamaʻa ʻōnaehana, a me ka mālama pinepine ʻana i nā helu koko a me nā ʻihi. ʻAʻole hiki ke hoʻopaʻi ʻia nā papa ʻaina mai nā papa ʻaina meaʻai e nā papa a i ʻole insulin.

Hoʻomoe a me ke koho kūloko

Hoʻoholo ʻia ka nui o ka glimepiride e ka ʻike ʻana o ka glucose i loko o ke koko a me ka ʻai.

ʻO ka ʻōlelo mua ma kahi o 1 mg o ka glimepiride i kēlā me kēia lā, inā i ka manawa like i hoʻokō ʻia ka hoʻokō metabola kūlohelohe - pono e mālama ʻia kēia ʻauʻau i ka wā o ka mālama ʻana.

No nā regimen ʻē aʻe ʻē aʻe, aia nā papa i nā kūpono kūpono.

Inā kūpono, hiki ke hoʻonui iki ʻia ka lā i lalo ma lalo o ka mālama pinepine ʻana o ka neʻe o ka glucose i ke koko (me nā manawaleʻa o 1-2 mau pule) a i kēia ʻano: 1 mg - 2 mg - 3 mg - 4 mg glimepiride i kēlā me kēia lā.

ʻO kahi maʻi o ka glimepiride ma mua o 4 mg i kēlā me kēia lā e alakaʻi i nā hopena maikaʻi wale nō i nā hihia kūikawā. ʻO ka mahuʻumau ʻoiila no kēlā me kēia lā he 6 mg.

ʻO ka manawa a me ka manawa o ka lawe ʻana i ka ʻāpana i kēlā me kēia lā e hoʻoholo ʻia e ke kauka, i ka noʻonoʻo ʻana i ke ʻano o ke kanaka maʻi. Ma ke ʻano he kānāwai, ʻo ke koho ʻana i kahi huakaʻi i kēlā me kēia lā i 1 mau manawa koke ma mua a i ʻole i ka wā o ka ʻaina kakahiaka a i ʻole, inā ʻaʻole ia ka hopena o kēlā me kēia lā

ua lawe koke ʻia ma mua a i ʻole ma o ka ʻai kau mua. ʻAʻole hōʻoki ʻia ka pau ʻana o ka lāʻau lapaʻau e ka neʻe ʻana ma kahi ʻoina i kiʻekiʻe aku ai. Lawe ʻia nā papa ʻaia amaril, me ka ʻole o ka huki ʻana, me ka nui o ka wai (ma kahi o 0,5 mau kī). He mea nui ia e skip i ka papa meaʻai ma hope o ka lawe ʻana iā Amaril.

Hoʻohana me ka hui pū me ka metformin

I ka hihia o ka lawa ʻole o ka hoʻomau ʻana o ka ʻaila o ka glucose i ke koko i loko o nā mea maʻi e lawe ana i ka metformin, concomitant therapy me glimepiride e hoʻomaka. ʻOiai e mālama pono ana i ka nui o ka metformin ma ka pae like, hoʻomaka ka mālama ʻana me ka glimepiride me ka liʻiliʻi haʻahaʻa, a laila e hoʻonui pinepine ʻia kona momona e hilinaʻi ana i ka pae o ka mana glycemic makemake, a hiki i ka nui o nā lā he nui o 6 mg. ʻO ka hoʻokūkū hui pono e hoʻokō ʻia ma lalo o ka nānā mālama olakino.

Hoʻohana me ka insulin

I nā hihia he hiki ʻole ke hoʻokō i ka normalization o ka hoʻohuihui o ka glucose i ke koko ma o ka lawe ʻana i ka nui o ka nui o ka glimepiride i loko o ka monotherapy a i hui pū ʻia paha me ka nui o ka metformin, ka hui pū ʻana o ka glimepiride me ka insulin. I kēia hihia, ʻaʻole i loli iki ka hopena hope o ka glimepiride i ʻōlelo ʻia i ka mea maʻi. Ma kēia hihia, hoʻomaka ka hana ʻana o ka insulin me ka liʻiliʻi ʻatikala, me kahi hoʻolōʻihi ʻia o ka hoʻonui ʻia ʻana o ka dosis o ka insulin ma lalo o ke kāohi ʻana o ka kaʻe o ka glucose i loko 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 hoʻemi i nā koi o ka insulin a hiki i 40%.

Ka hoʻololi ʻana o ka mea maʻi mai kekahi lāʻau lapaʻau hypoglycemic waha i ka glimepiride ʻAʻohe pilina kūpono ma waena o nā ʻano o ka hua ʻōlelo glimepiride a me nā lāʻau lapaʻau hypoglycemic waha. Ke hoʻoneʻe nei mai ia mau lāʻau i ka glimepiride, pono ka nui o ka lā o ka lā ma mua o 1 mg (ʻoiai ke neʻe ʻia ka mea maʻi i ka glimepiride me ka nui o kekahi o ka lāʻau hypoglycemic waha).ʻO kēlā me ke hoʻonui o ka maʻa o ka glimepiride e pono e hana i nā hana ma hope, e noʻonoʻo ana i ka pane i ka glimepiride e like me nā ʻōlelo aʻoaʻo ma luna. Pono e nānā i ka pāpaʻa i hoʻohana ʻia a me ka lōʻihi o ka hopena o ka ʻaihue hypoglycemic ma mua. I kekahi mau hihia, ʻoi aku ka wā e lawe ai i ka lāʻau hypoglycemic me ka hapalua hapalua (no ka laʻana, ka chlorpropamide) pono ia i kahi manawa iki (i loko o kekahi mau lā) e hoʻohuli i ka mālama ʻana e pale i ka hopena hoʻohui e hoʻonui i ka hōʻeha o ka hypoglycemia.

Ka hoʻololi i kahi maʻi mai ka insulin i ka glimepiride

I nā hanana kūʻokoʻa loa, inā loaʻa nā maʻi me ka diabetes type 2 mellitus i ka maʻi insulin, a laila me ka uku o ka maʻi a me ka hana huna i mālama ʻia nā mea hoʻoliʻi pancreatic beta, e hōʻike ʻia ana lākou i kahi mea hoʻololi i glimepiride. Pono e lawe ʻia ka unuhi ma lalo o ka nānā mālama olakino. I kēia hihia, hoʻomaka ka hoʻololi ʻana o ka mea maʻi i glimepiride me kahi hōʻemi haʻahaʻa o glimepiride o 1 mg.

Ke noi no ka pilikia a me ka hana ʻole o ka ate

Loaʻa nā ʻike ʻikepili i ka hoʻohana ʻana o ka lāʻau lapaʻau i ka poʻe maʻi me ka maʻi hakahaka a me ka maʻi hepatic (e ʻike i nā māhele Contraindications).

Na keiki a ʻōpio

ʻAʻole ʻike nā ʻikepili ma ka hoʻohana ʻana o ka glimepiride i nā mea maʻi ma lalo o 8 mau makahiki o ka makahiki. No nā keiki he 8 a 17 mau makahiki, he palena palena ʻikepili i ka hoʻohana ʻana o ka glimepiride i ke ʻano o ka monotherapy (e nānā i ka māhele ʻo Pharmacokinetics a me ka Pharmacodynamics). ʻAʻole lawa nā ʻikepili i loaʻa no ka pono a me ka palekana no ka hoʻohana ʻana o ka glimepiride i ka pediatrics, a no laila ʻaʻole ke aʻo ʻia ka hoʻohana ʻana.

Loaʻa ka hopena

Hōʻike ʻia nā ʻikepili e pili ana i ka hopena ʻino ma muli o ka lawe glimepiride a me nā derivatives sulfonylurea i hōʻike ʻia ma lalo nei i ka wā e hoʻokolokolo ai. Hoʻokaʻawale ʻia nā hopena ʻino i loko o nā papa o nā ʻōnaehana o ka hui a hui pū ʻia i ka hōʻemi ʻana i ka pinepine o nā hanana (pinepine:> 1/10, pinepine:> 1/100, 1/1000, 1/10000,

Ke keu

Ma hope o ka nānā ʻana i ka wai nui o ka glimepiride, hiki ke hoʻomohala ʻia ka hypoglycemia, e mau ana mai 12 a 72 mau hola, hiki ke haʻi hou ʻia ma hope o ka hoʻihoʻi mua ʻana o ka glucose i loko o ke koko. Hiki i ka hypoglycemia aneʻi ke pani koke e ka ʻai o ka ʻai o ka ʻaiā (glucose a me ke kō, inā like, ma ke ʻano o kahi ʻāpana wai, aʻa wai momona a iʻa paha paha). I kēia mea, pono i ka mea maʻi e loaʻa ma ka 20 g o ka glucose (4 mau mea momona o ke kō). Ka maikaʻi ʻole nā ​​mea momona i ka mālama ʻana i ka hypoglycemia. I ka hapa nui, ua kuhikuhi ʻia ke kiaʻi ʻana ma ka hale mālama hau. Hoʻomaʻaʻa i ka hopena me ka hoʻoulu ʻana i ka luaʻi, lawe i nā wai (wai a i ʻole lemonade me ka ulala i hoʻolaʻa ʻia (adsorbent) a me ka sodium sulfate (laxative) Ka lawe ʻana i ka nui o ka lāʻau, hōʻike ʻia ke ʻano o ka palu, a ukali ʻia e ka hoʻomaka ʻana o ke kaola a me ka sodium sulfate. ke kiʻi o ke kino o ka manawa, no laila, pono ia i ka mālama koke ma lalo o ka mākaʻi o ke kauka, a i kekahi mau kūlana a me ka hoʻokipa ʻana o ka mea maʻi. Ua hiki koke, ka hoʻomaka ʻana o ka glucose, inā pono Ma ke ʻano o ka inikua iv o 50 ml o kahi hopena o 40%, ukali ʻia e ka infusion o kahi hopena o 10% me ka mālama pono ʻana i ka neʻe o ka glucose i loko o ke koko, e ʻike hou i ka hana maʻi.

Hoʻohālikelike ʻia nā hōʻailona o ka hypoglycemia i ʻole a i ʻole i loko o ka poʻe ʻōpiopio, i nā mea maʻi e loaʻa ana i ka neuropathy autonomic a e loaʻa ana ka hoʻomaʻamaʻa manawa me ka p-adrenoblockers, clonidine, reserpine, guanethidine a i ʻole nā ​​mea hoʻohui aathatholytic.

Inā mālama ʻia ka mea maʻi ma ka maʻi maʻi e nā kauka like ʻole (no ka laʻana, ma ka wā o kahi haukapila ma hope o kahi ulia, me ka maʻi i ka hopena pule), pono ʻo ia e hoʻomaopopo iā lākou e pili ana i kāna maʻi a me ka mālama ʻana ma mua.

Ma ka mālama ʻana i ka hypoglycemia i kūkulu ʻia ma muli o ka hiki ʻole ʻana o ka hoʻokele ʻana ʻo Amaril i nā pēpē a i ʻole nā ​​keiki ʻōpio, nā ʻano kuhikuhi o dextrose (50 ml o kahi hopena o 40%) e nānā pono ʻia e pale i ka hyperglycemia pōʻino. I kēia mea, pono ka hoʻomau a hoʻomau pono ʻana i ka ʻike o ka glucose i ke koko.

Hoʻopili pū me nā lāʻau ʻē aʻe

Ma ka hihia o ka hoʻohana ʻana me ka glimepiride o kekahi mau lāʻau ʻē aʻe, ʻelua hōʻemi ʻokoʻa a me ka piʻi ʻole ʻana o ka hopena hypoglycemic of glimepiride hiki mai. Ma kēiaʻano, hiki ke kiʻi wale ʻia nā lāʻau lapaʻau me ka ʻae ʻia (a i ʻole e kuhikuhi ʻia) e ke kauka.

Hoʻopili ʻia ka Glimepiride e ka cytochrome P4502C9, pono e noʻonoʻo ʻia i ka wā e hoʻohana pū ʻia ai me ka inducers (e ..gif rifampicin) a i ʻole nā ​​inhibitor (e.g. fluconazole).

I nā pilina o vivo i paʻi ʻia i ka puke e hōʻike ana i ka fluconazole, kekahi o nā mea pale nui o CY32C9, e hoʻonui i ka AUC o ka glimepiride e pili ana i 2 mau manawa.

Hoʻokumu ʻia i ka ʻike me ka glimepiride a me nā derivatives sulfonylurea, pono e ʻike ʻia nā pilina pili.

ʻO ka hoʻonui ʻia o ka hopena hypoglycemic a me ka hiki ke hoʻomohala ʻia o ka hypoglycemia pili me kēia, hiki ke ʻike ʻia me ka hoʻohana ʻana o ka glimepiride me nā huaʻala i lalo iho nei:

- phenylbutazone, azapropazone, oxyphenbutazone,

- - nā ʻaihue a me nā lāʻau hypoglycemic ʻē aʻe, e like me ka metformin,

- ka paʻakai a me ka waona aminosalicylic,

- nā mea anabolic a me nā kāne kāne kāne,

- chloramphenicol, kekahi mau sulfonamides lōʻihi, tetracyclines, quinolones a me clarithromycin,

- ka hoʻololi ʻana o ka angiotensin i ka lula o ka enzyme (ACE),

- fluoxetine, monoamine oxidase inhibitors (MAO),

- allopurinol, probenicide, sulfinpyrazone,

- cyclo-, tro- a ifosfamides,

- pentoxifylline (me ka hoʻokele makua i nā wai kiʻekiʻe),

ʻO ka nāwaliwali o ka hopena hypoglycemic a me ka hoʻonui e pili ana i ka kao o ka glucose i loko o ke koko hiki ke mālama ʻia me ka hoʻohana ʻana o ka glimepiride me nā lāʻau e like me kēia:

- nā estrogens a me nā progestogens,

- saluretics and thiazide diuretics,

- nā hormones thyroid, glucocorticosteroids

- epinephrine a me nā mea hou e pili ana i ka sympathomimetic,

- ka paʻikū nikotinic (ma nā helu koʻikoʻi) a me nā mea waiwai o ka waikeka nikotinic,

- ka laxatives (me ka hoʻohana lōʻihi),

- glucagon, barbiturates a me nā rifampicin,

Na Palapala N₂nā mea paʻi, clonidine a me ka reserpine hiki iā lākou ke hoʻoikaika a hoʻonāwaliwali i ka hopena hypoglycemic o ka glimepiride.

Ma lalo o ka hopena o nā aihini sympatholytic, e like me beta-blockers, clonidine, guanethidine a reserpine, nā hōʻailona hōʻailona o ka adrenergic counterregulation i pane aku ai i ka hypoglycemia e hoʻemi a ʻokoʻa paha.

Ma muli o ke kua ʻana o ka glimepiride, hiki ke ʻike ʻia kahi hoʻonui a nawaliwali paha i ka hana a ka derivatives Coumarin.

Hiki i ka hoʻohana kū hoʻokahi a ʻano hoʻonaninani paha i ka waiʻona e hoʻoikaika a hoʻonāwaliwali i ka hopena hypoglycemic o ka glimepiride.

Nā hiʻohiʻona noi

Pono lawe ʻia ʻo Glimepiride ma mua o a i ʻole wā ʻaina.

Inā lawe ʻia nā ʻai ma nā manawa kūpono a i ʻole holo ʻia ʻole, e hoʻomohala ʻia ka mea maʻi e loaʻa ana i ka lāʻau glimepiride

hypoglycemia. ʻO nā ʻōmaʻomanaʻo paha o ka hypoglycemia e pili ana: ka ʻeha, ka pōloli nui, ka hoʻomaha, ka luaʻi, ka makaʻu, ka luhi, ka hiamoe, ke hopohopo, ka pīhoihoi, ka pīhoihoi, a me ka hopohopo, ke kaumaha, ka pīhoihoi, ka ʻōlelo a me ka pilikia, , nā piʻi hopohopo, dizziness, ka manaʻo o ke kōkua ʻole, ka nalowale o ka pale ʻana i ka naʻau, delirium, spebms spebms, kahi hilahila a me ka nalowale o ka hoʻomaopopo ʻana, e pili ana i ka coma, ka lau aniani, bradycardia. Eia kekahi, ma muli o ka hopena adrenergic hoʻomaʻomaʻo, nā hōʻailona like me ke anuanu, ka pipi clammy, ke hopohopo, tachycardia, hypertension arterial, palpitations puʻuwai, angina pectoris, a me nā hōʻeha o ka puʻuwai e hiki mai.

ʻO ka hōʻike hoʻohālikelike o ka hypoglycemia koʻikoʻi e like me ka hōʻike ʻana o ke kauka ma kahi maʻi.

I ka aneane āpau, hiki ke hoʻokuʻi koke ʻia nā hōʻailona e ka hoʻokomo koke o ka hydrocarbons (gula). ʻAʻole maikaʻi kēlā me nā mea aloha mai ka manawa like.

E like me ka ʻike ʻia mai ka ʻike o ka hoʻohana ʻana i nā derivatives sulfonylurea, ʻoiai ke kūleʻa o ka hoʻohana ʻana i nā countermeasures ma ka hoʻomaka, a laila hiki mai ke ʻano hypoglycemia.

ʻO ka hypoglycemia koʻikoʻi a lōʻihi paha, ka manawa i mālama ʻia i ka manawa maʻamau e ka nui o ke kō, e koi koke i ka lāʻau lapaʻau a i ʻole ka hale hoʻokipa.

Hoʻokomo i nā mea hōʻike i ka hoʻomohala ʻana o ka hypoglycemia:

- kahea a i ʻole (ma ke ʻano ʻelemakule) lawa ʻole o ka hiki i ka poʻe maʻi e hana pū me ke kauka, pale ʻole, ʻohi maʻamau, ʻoki ʻole i ka ʻai, ka hookeʻa,

- nā loli i ka meaʻai maʻamau,

- ka pale kaulike ma waena o ka hana kino a me ka hoʻowalewale paʻakai,

- inu wai ʻona, keu me ka hui pū me nā kīlipī ʻai ʻana,

- hana huehue lēwa

- kekahi mau maʻi o ka hanana o ka endocrine e pili ana i ka metabolism, a i ʻole ka pane hypoglycemia (no ka laʻana, kekahi mau kuhi o ka nui o ka thyroid gland, insufficiency pituitary a i ʻole lawa o ka adrenal cortex), ka hoʻohana 'ana i kekahi mau lāʻau lapaʻau (e pili ana i ke kikowaena me nā lāʻau ʻē aʻe. )

Pono ka hoʻomaʻamaʻa ʻana me ka glimepiride i ka mālama pinepine ʻana o ka neʻe o ka glucose i ke koko a me ka wai. Eia kekahi, ua hāʻawi ʻia nā pae hemoglobin glycosylated.

Eia nō hoʻi, i ka wā e mālama ai me ka glimepiride, nā loiloi maʻamau o ka hana ʻana o ka ate a me ka helu ʻana o nā ʻolihe koko (ʻoi aku nā leukocytes a me nā platelets) pono.

I nā kūlana koʻikoʻi (no ka laʻana, ma hope o nā ulia, ka ʻoihana ʻāpulipiki, nā maʻi puhipuhi, a me kekahi mea).

ʻAʻoheʻike i ka glimepiride i nā mea maʻi me ka maikaʻi ʻole o ka renal i ʻole nā ​​mea maʻi e koi ana i ka hemodialysis. ʻO nā mea maʻi me ka pūniki koʻikoʻi a i ʻole ka maʻi hepatic e hōʻike ʻia e hoʻololi i ka insulin.

Hiki i nā hopena me nā derivatives sulfonylurea hiki ke alakaʻi i ka anemia hemolytic i nā mea maʻi me ka nele o ka glucose-6-phosphate. No ka mea ʻo ka glimepiride pili i ka papa derivatives sulfonylurea, pono e hoʻohana me ka akahele me ka poʻe maʻi me ka glucose-b-phosphate dehydrogenase. Eia kekahi, pono e noʻonoʻo pono i nā koho lapaʻau me nā mea hoʻohana ʻē aʻe i loaʻa ʻole i ka deralona sulfonylurea.

Amaryl i loko o ka lactose monohydrate, no laila ʻaʻole pono e lawe ʻia i nā mea maʻi me ka hoʻomehana lactose hereditary, pōkole lactase a i ʻole nā ​​mea hoʻokuʻi līwona o lactose.

ʻAʻole i mālama ʻia kahi hōʻike o ka hopena o ka glimepiride e hiki ai ke hoʻokele i nā kaʻa a me nā ʻenehana. ʻO ka pane a ka mea maʻi e hōʻemi ai i hiki ke hoʻemi ʻia ma muli o ka hoʻomohala ʻana o ka hypoglycemia a i ʻole hyperglycemia, a i ʻole, no ka hoʻopiʻi ʻana. Hiki i kēia mau hopena ke weliweli i ke kūlana i mea koʻikoʻi kēia mau mana (no ka laʻana, i ka wā e holo ai i ke kaʻa a i ʻole nā ​​mīkini).

Pono e ʻike ʻia nā mea maʻi e pono ai ka mālama mua ʻole e pale aku i ka hypoglycemia i ka wā e holo ana. He mea koʻikoʻi loa kēia no nā maʻi me nā manawa pinepine o ka hypoglycemia, a i ʻole nā ​​mea maʻi ʻaʻole lawa a maopopo ʻole paha i nā hōʻailona mua o ka hypoglycemia. I kēia mau hihia, pono ke noʻonoʻo ʻia ka hiki ʻana o nā kaʻa kaʻa a i ʻole me ka mīkini hana.

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

Hana ʻia ʻo Amaryl i loko o nā papa i loaʻa iā 1-4 mg, e ʻoki ʻia i nā ʻāpana he 15 i kēlā me kēia blister. Hoʻokahi i hoʻokahi pahu o ka lāʻau lapaʻau ke komo pū me nā blus 2, 4, 6 a 8 paha.

• Hoʻokahi papa papa o ka lāʻau lapaʻau ka waiwai o ka mea ikaika - glimepiride - 1-4 mg a me nā mea kōkua: lactose monohydrate, povidone, sodium carboxymethyl starch, microcrystalline cellulose, indigo carmine a magnesium stearate.

Nā lāʻau lapaʻau a me ka lāʻau lapaʻau: ka hopena hypoglycemic oral.

Nā ʻōkuhi no ka hoʻohana

Wahi a nā ʻōlelo pili no ka hoʻohana ʻana, e kuhikuhi ʻia ana ka nui o ka hoʻomākaukau ʻana o Amaryl a me Amaryl M e ke kauka ponoʻī no kēlā me kēia maʻi, e pili ana i ke kiʻekiʻe o ke kōpaʻa koko o ka maʻi. Pono ka hoʻohanaʻana i ka lāʻau i ka liʻiliʻi maʻa mau e hoʻokō ai i ka hoʻomālamalama mau pono.

Ke hōʻike pū nei nā ʻōkuhi no ka hoʻohana ʻana iā Amaril e pono ka mālama ʻana i ka kaila o ka neʻe o ka glucose i ke koko a me ka pae o ka hemoglobin glycosylated.

Pono nā lālani Amaryl e lawe holoʻokoʻa, me ka ʻole o ka huki ʻana, me ka nui o ka wai (e pili ana i ka 1/2 kī). Inā kūpono, hiki ke hoʻokaʻawale i nā papa o ka lāʻau lapaʻau Amaryl ma o nā wahi'ē aʻe i ʻelua mau wahi like.

• ʻO ka maʻa mua loa o Amaril ka 1 mg 1 manawa / lā. Inā kūpono, hiki ke hoʻonui iki ʻia ka lā maʻamau (ma waena o 1-2 mau pule) ma lalo o ka mālama pinepine ʻana i ka glucose koko a me ka papa ʻōlelo aʻe: 1 mg-2 mg-3 mg-4 mg-6 mg (-8 mg) i kēlā me kēia lā . ^ E Ha yM.
• I ka poʻe maʻi me ka maʻi maʻamau kīnā 2, ʻo ka nui o ka lā ma mua o 1-4 mg. ʻOi aku ka momona o kahi lā ma mua o 6 mg ʻoi aku ka maikaʻi ma loko o kahi helu liʻiliʻi o nā maʻi.

ʻO ka hana hōʻino ʻana i nā pōpoki, no ka laʻana, ke kāpae nei i ka dosis hou aʻe, ʻaʻohe pono ke hana ʻia e ka hoʻohana ʻana iā Amaril i kahi kiʻekiʻe aʻe.

ʻO ka manawa no ka lawe ʻana i nā papa a me ke kaomi ʻana o nā papa i ka lā a pau e hoʻoholo ʻia e ke kauka. I ka manawa like, pono ia i kahi o ke ʻano o ka mea maʻi (ka nui o ka hana pilikino, ka manawa ʻai, ka meaʻai). Kuhi ʻia ka lā helu i kēlā me kēia lā ma mua o 1, ma mua o ka ʻaina kakahiaka piha. Inā ʻaʻole i lawe ʻia ka dosis ia lā, ma mua o ka ʻai mua. He mea nui ia e hoʻokaʻawale i ka ʻai ma hope o ka lawe ʻana i ka lāʻau.

Lā ʻia kahi maʻi Glimepiride e lōʻihi.