Diapiride oogun naa: awọn ilana fun lilo

Aṣoju hypoglycemic kan, itọsi-irandiṣon alailowaya sulfystlurea ti ẹnikẹta ti igbese gigun. Ipa hypoglycemic ti oogun naa jẹ nitori ẹrọ iṣelọpọ ti iṣan ati igbese extrapancreatic.

Iwa pancreatic jẹ ninu safikun yomi insulin nipasẹ awọn sẹẹli reat-ẹyin, eyiti o jẹ pẹlu ifọra ati idasilẹ itusilẹ ti hisulini endogenous. Ipa yii jẹ nitori otitọ pe glimepiride, pẹlu iwọn aropo giga, papọ ati ge asopọ lati amuaradagba ti awọn β-ẹyin ti awọn ti oronro, eyiti o ni nkan ṣe pẹlu awọn ikanni potasiomu ATP ti o gbẹkẹle, ṣugbọn o yatọ si aaye didipọ iṣaju ti 1st ati 2nd iran sulfonylureas. Gẹgẹbi abajade, hisulini ni itusilẹ nipasẹ exocytosis, lakoko ti iye ti hisulini ti o ni ifipamo dinku ni o kere si labẹ iṣe ti awọn itọsẹ ti aṣa ti ipilẹṣẹ. Iru ipa safikun kekere ti glimepiride lori tito hisulini tun pese eewu kekere ti hypoglycemia.

Ipa extrapancreatic ti glimepiride ni a fi agbara han nipasẹ awọn ipa, oludari eyiti o jẹ ilosoke ninu ifamọ ti awọn sẹẹli ara (iṣan ati ọra) si insulin pẹlu ilosoke ninu nọmba ati iṣẹ ti awọn ọlọjẹ gbigbe glukosi nipasẹ awọn sẹẹli, ati idiwọ ti iṣelọpọ glucose ninu ẹdọ pẹlu ilosoke ninu ifọkansi intracellular ti fructose 2.6 β-fosifeti lilu gluconeogenesis. Awọn ipa extrapancreatic miiran ti glimepiride pẹlu: idinku ninu akojọpọ platelet bi abajade ti inhibition COX ati iyipada ti arachidonic acid si thromboxane A2, ṣiṣi ipele ti platelet α-tocopherol ati iṣẹ ti enzymes enzymes oxidase aapọn, eyiti a ṣe akiyesi nigbagbogbo ni mellitus àtọgbẹ, ipa egboogi-atherogenic bi abajade ti imuṣiṣẹ ti pato C. phospholipase C.

Glimepiride ko ṣe idiwọ ifunmọ iṣelọpọ ti myocardium si ischemia (ko dabi glibenclamide).

Ipa hypoglycemic ti o pọju ti oogun naa han awọn wakati 2-3 lẹhin ti iṣakoso, o ju wakati 24 lọ ati pe o gbẹkẹle-iwọn lilo.

Pẹlu ọpọlọpọ awọn iṣọn glimepiride ni iwọn lilo ojoojumọ ti 4 miligiramu, ifọkansi ti o pọ julọ ninu omi ara ẹjẹ ti de lẹhin awọn wakati 2.5 ati iye si 309 ng / milimita, ibatan kan wa laarin iwọn lilo ati ifọkansi ti o pọ julọ ti glimepiride ninu ẹjẹ, bakanna laarin iwọn lilo ati agbegbe labẹ iṣupọ “ifọkansi - akoko. ” Glimepiride ni iye bioav wiwa pipe. Ounjẹ ko ni ipa pataki lori gbigba, pẹlu ayafi ti idinku iyara diẹ ninu oṣuwọn gbigba.

Glimepiride jẹ ijuwe nipasẹ iwọn didun pipin pinpin (nipa 8,8 L), iwọn deede si iwọn ti pinpin albumin, iwọn giga ti didi si awọn ọlọjẹ ẹjẹ pilasima (diẹ sii ju 99%) ati iyọkuro creatinine kekere (nipa 48 milimita / min). Glimepiride si sinu wara ọmu ati nipasẹ idankan ọran-ọta hematoplacental, ni ibi ti o wọ inu BBB. Glimepiride jẹ biotransformed ninu ara sinu awọn metabolites 2, eyiti a ṣe agbekalẹ bii abajade ti iṣelọpọ ti glimepiride ninu ẹdọ ati pe o jẹ itọsi hydroxyl ati itọsi hydroxyl ti glimepiride. Igbesi-aye idaji ti glimepiride ni fifo plasma rẹ ninu omi ara ti o baamu si ilana itọju dosing pupọ jẹ awọn wakati 5-8. Lẹhin mu glimepiride ni iwọn giga, igbesi aye idaji pọ. Lẹhin iwọn lilo ẹnu kan ti glimepiride redio ti a n yan, 58% ni a ti rii ninu ito ati 35% ni awọn feces. Nkan ti nṣiṣe lọwọ iyipada ninu ito ko rii. Igbesi aye idaji ti hydroxyl ati metabolites ti glimepiride jẹ nipa awọn wakati 3-6 ati wakati 5-6, ni atele.

Ninu awọn alaisan ti o ni iṣẹ kidirin ti ko nira (aṣeyọri creatinine kekere), ifarahan kan lati mu imukuro glimepiride pọ si ati idinku ninu ifọkansi apapọ rẹ ninu ẹjẹ, eyiti o ṣee ṣe nitori iyọkuro iyara ti oogun nitori didasilẹ amuaradagba kekere. Nitorinaa, ni ẹya yii ti awọn alaisan ko si eewu ti ikojọpọ ti glimepiride.

Awọn afiwe ti ile elegbogi oogun ti glimepiride jẹ iru kanna ni awọn alaisan ti o yatọ si awọn ẹgbẹ ati awọn ẹgbẹ ori oriṣiriṣi.

Iru II suga mellitus (ti kii-insulin-igbẹkẹle) ninu awọn agbalagba bi monotherapy tabi ni apapo pẹlu metformin tabi hisulini.

Awọn tabulẹti diapiride Contraindications

ibajẹ ti a mọ si awọn paati ti oogun ati si awọn nkan pataki ti sulfonylurea tabi awọn igbaradi sulfonylamide miiran

Iru Mo àtọgbẹ mellitus

dayabetik ketoacidosis, coma dayabetik

to jọmọ kidirin ati aarun alaapọn

oyun ati lactation

Awọn ọmọde labẹ ọdun 18

oogun paati oogun zhne sulfonylurea tuyndylaryna nemese basқa sulfonylamidtik igbaradi tarғa belgilі zhoғary sezmtaldy

hisulini tәuдldi ni mo tẹ diabetesan àtọgbẹ

dayabetik ketoacidosis, coma dayabetik

bauyr zhne bүyrek awọn iṣẹ ti ọmọ ң auyr bұzylulary

zhktіlіk zhne lactation

18 jasқa deyingі balalarғa

Awọn ipa ẹgbẹ ti awọn tabulẹti diapiride

aati ifunilara - nyún, ara ati urticaria

Ẹhun apọju pẹlu sulfonylurea, sulfonamides tabi awọn iṣọn ti o ni ibatan

alekun awọn ipele ti awọn enzymu ẹdọ

awọn ayipada igba diẹ ninu iran le waye nitori awọn ayipada ninu awọn ipele glukosi ẹjẹ, ni pataki ni ibẹrẹ itọju

iwọntunwọnsi si thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythrocytopenia, hemolytic anemia ati pancytopenia, eyiti o parẹ nigbagbogbo lẹhin ifasilẹ itọju

aati hypoglycemic ti o waye ninu ọpọlọpọ awọn ọran lẹsẹkẹsẹ, le gba fọọmu ti o lagbara ati pe kii ṣe irọrun nigbagbogbo ni atunse. Iṣẹlẹ ti awọn aati wọnyi da lori, bi lakoko awọn oriṣi miiran ti itọju ailera hypoglycemic, lori awọn ipo ti o tẹri, bii ounjẹ ati iwọn lilo

vasculitis inira, awọn ifun hypersensitivity lati kekere si pataki pẹlu idagbasoke dyspnea, idinku ninu titẹ ẹjẹ, nigbami riru-mọnamọna

inu riru, ìgbagbogbo, igbe gbuuru, titẹ tabi rilara ti kikun ninu ikun, irora inu, eyiti o le nilo itusalẹ itọju nigba miiran

iṣẹ ẹdọ ti ko ni ọwọ (fun apẹẹrẹ, ipoju bile ati jaundice), jedojedo, eyiti o le ni ilọsiwaju si ikuna ẹdọ

hypersensitivity si ina

dinku ni iye ti iṣuu soda ninu omi ara

Zhoғary sezimtaldyқ reaktylary - қysynu bөrtpe zhene esekzhem

sulphonylurea, sulphonamidetermen nemese tektes

bauyr fermentteri deңgejіnің zhoғarylauy

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

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

kөp zhadaylarda birden tuyndaytyn hypoglycemiaқ reactionar auyr tүrhe enuі zhne tүzetuge үnemi kөne bermeuі mүmkіn. Awọn ọkunrin iṣe ifinufindo waye ы tuyndauy hypoglycemia қ emdeudіқ basқa tүrlerі kesіne de, tamқtanu zhne dosealau shine sharttarғa ati bailanysty

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

Zhurek Ainuy, құsu, gbuuru, asқazandaғy қysym nemese ti ketu sezimі, іштің ауыруы, keide emdeudі toқtatudy қazet etuim mүmkіn

bauyr қyzmetіnің bұzyluy (awọn ero өт ірікілісі және сарғаю), jedojedo, ol bauyr zhetkіlіksіzdіgіne deіn үdeuі mүmkіn

арыққа жоғары сеімталдық

қан sarysuyndaғy sodium mumlsherіnің tөmendeuі

Awọn ilana pataki fun lilo

Itọju aṣeyọri ti àtọgbẹ da lori ibamu alaisan pẹlu ounjẹ ti o yẹ, iṣẹ ṣiṣe ti ara nigbagbogbo, ati abojuto nigbagbogbo igbagbogbo ti ẹjẹ ati awọn ipele glukosi ito. Akiyesi-ounjẹ ti awọn alaisan ko le san owo fun nipasẹ awọn oogun tabi hisulini.

Diapiride gbọdọ mu laipẹ ṣaaju tabi pẹlu ounjẹ. Ti ounjẹ kan ba waye ni gbogbo igba ni akoko ti o yatọ tabi ti a fo ni lapapọ, gbigbe oogun naa le fa hypoglycemia. Awọn aami aisan le fẹrẹ rọra nigbagbogbo nigbati o ba mu awọn carbohydrates (suga) lẹsẹkẹsẹ.

Awọn ologe ti atọwọda ko ni fun eyikeyi ipa.

Iriri pẹlu awọn itọsẹ imi-ọjọ miiran fihan pe iṣi-idagbasoke ti hypoglycemia jẹ ṣeeṣe, paapaa ti aṣeyọri akọkọ ti awọn igbese ti o ya.

Arun ti ko nira tabi pẹ, eyiti o le jẹ alailagbara fun igba diẹ nipasẹ mimu iye gaari tẹlẹ, nilo itọju tootọ lẹsẹkẹsẹ, ati nigbakọọkan ile-iwosan.

Awọn okunfa ti o ṣe alabapin si iṣẹlẹ ti hypoglycemia jẹ: ifura tabi (diẹ sii nigbagbogbo ninu awọn alaisan agbalagba) ailagbara lati ni ifọwọsowọpọ pẹlu dokita kan, aito, ounjẹ alaibamu tabi gbigbemi ounjẹ ti o padanu, akoko ãwẹ, iyipada ninu ounjẹ, aidogba laarin iṣẹ ṣiṣe ti ara ati gbigbemi carbohydrate, mimu oti, pataki ni apapo pẹlu ounjẹ ti o fo, iṣupọ ọmọ wẹwẹ ati ailagbara iṣan, idapọju ti Diapirid, diẹ ninu awọn ipọnju endocrine ailopin ti ko ni ipa wọn kopa ninu iṣelọpọ agbara carbohydrate, tabi ilana iyipada ti hypoglycemia (fun apẹẹrẹ, diẹ ninu awọn aila-ara ti tairodu ẹṣẹ, ailagbara ti iṣẹ ti iwaju pituitary tabi cortex adrenal), lilo ilopọ ti awọn oogun kan (wo apakan “Awọn Ibaṣepọ Awọn oogun”).

Itọju pẹlu Diapiride nilo abojuto nigbagbogbo ti ẹjẹ ati awọn ipele glukosi ito. Ni afikun, o niyanju lati ṣakoso iye iṣọn-ẹjẹ glycosylated.

Lakoko lilo oogun naa, ibojuwo deede ti iṣẹ ẹdọ ati itupalẹ ti aworan ẹjẹ agbeegbe (pataki nọmba awọn leukocytes ati awọn platelets) jẹ pataki.

Ni awọn ipo ti o ni aifọkanbalẹ (fun apẹẹrẹ, ninu awọn ijamba, awọn iṣẹ pajawiri, awọn akoran ti o wa pẹlu iba), gbigbe alaisan kan si insulin le jẹ itọkasi.

Ko si data lori lilo Diapiride ninu awọn alaisan ti o ni iṣẹ ẹdọ ti o nira pupọ tabi awọn ti o han ifasẹyin. Awọn alaisan ti o ni to jọmọ kidirin tabi aini itun hepatic yẹ ki o gbe si insulin.

O yẹ ki o jẹri ni lokan pe awọn aami aiṣan ti hypoglycemia le farapamọ tabi ṣi wa ni awọn alaisan agbalagba pẹlu neuropathy tabi ni awọn ti o ngba itọju nigbakanna pẹlu awọn bulọki pt-adrenergic receipor, awọn ifiomipamo, clonidine, guanethidine tabi awọn miiran ti o ni ibatan. Ti ipa naa ko ba tabi pe a dinku ipa naa, ni ọran ti itọju ailera gigun, a ṣe iṣeduro apapo pẹlu metformin tabi hisulini.

Ninu ọran ti isanwo akọ-aisan, ifamọ insulin pọ si, ati nitorinaa, iwulo fun oogun naa le dinku lakoko ilana itọju. Lati yago fun idagbasoke ti hypoglycemia, o jẹ dandan lati dinku iwọn lilo tabi fagile oogun naa. Atunṣe Iwọn tun yẹ ki o gbe jade nigbati yiyipada iwuwo ara alaisan tabi igbesi aye rẹ, tabi ni ọran ti awọn ifosiwewe miiran ti o ṣe alabapin si hypo- tabi hyperglycemia.

Awọn alaisan ti o ni ailoriwọ galactose hereditary ti ko ni arokan, aipe lactase tabi gbigba mimu gluko-galactose ti ko ni ailera, ko yẹ ki o gba Diapiride.

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

Diapiridti bi isherden bіraz bұryn nemese bi isu kesіnde қabyldau Jaeger bi іshu ретr rette әr tүrlі uaқytta oryn alsa nemese mүldem zhyberilip alsa, awọn igbaradi қabyldau hypoglycemia tuғyzuy mүmkіn. Jaeger bіrden kөmіrsular (қant) қabyldasa, aisan ti daryn үnemі derlіk tez ңіlddetuge boladi.

Zhasandy tәttіlendіrgіshter Yeshanday әser Bermaidi.

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

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

Gipoglikemiyanyң tuyndauyna yқpal etetіn faktorlar mynalar bolyp tabylady: dәrіgermen yntymaқtasudy қalamau Nemesu (kөbіnese egde zhastaғy emdelushіlerde) mүmkіndіgі bolmau, toyyp tamaқ іshpeu, zhүyelі tamaқtanbau Nemesu ac іshudі zhіberіp alu, ashyғu kezeңі, tamaқtanu rezhimіnің өzgeruі, Dene zhүktemelerі yi pada kөmіrsulardy paydalanu arasyndaғy teңgerіmnің bұzyluy, oti, әsіresе іshudі jіberіp alumen bіrge paydalanu, bүyrek әne bauyr awọn ọmọ ң Ortash bұzylulary, Diapiridtің artyқ dzozalanuy, endocrindyk үенyenің kөmіrsulardy lizmіne әser etetіn keybіr kompensatsiyalanbaytyn bұzylystary, Nemes gipoglikemiyanyң kerі regulyatsiyasy (mysaly, қalқansha lai 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 awọn ọkunrin neseptegi glukosi deейgeyіn tұraқty tүrde baқılap oteruda ezhet ety. Bұdan өzge, glycosyldengen haemoglobin mөlsherin baқylauғa alu ұsynilady.

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

Jaғdailarinda Wahala (awọn ero, jazatayim jaғdaylarda, lard isẹ ṣiṣe, қyzbamen қatar zүretіn ұқұқpalarda) nauқasty uaқytsha insulating ayustyru kөrsetiluu mіmkіn.

Awọn iṣẹ Bauyr ti ọmọ ң auyr bұzylulary bar nemes dialysis kөrsetilgen edelushіlerge Diapiridti қoldanuғa қatyty mәlіmetter zh ж. Bүyrektің nemese bauyrdy kүrdeli zhetkіlіksіzdіgі bar nauқastardy insulindy қabyldauғa ayystru kerek.

Ewebe neuropathy bar nemesis β-adrenergic receptor neuromuscular blocker, reserpinmen, clonidinmen, guanethidinmen nemesse basa sympatholytictermen biology meningitis isan hypoglycaemia hypoglycaemia Jäger әseri zhitkіlіksіz nemese әseri tөmendegen bolsa, ұзақемдеу жғғдайында, metforminmen nemese insulinman bіrіktіru ұsynylad.

Диабant diabetіnің indemnification ғ zhaydayynda hisulini sezіmtaldyқ artada, soғan bailanisty emdeu үderіsіnde oogunқa қazhettіlіk tөmendeuі mүmkіn. Hypoglycemiaң damuyn boldyrmau үshіn dozasyn der kezіnde tөmenddetu nemesa oogun toқtatu kerek. Dozasyn tүzetudі emdelushіnің dene salmaғy өzgergen nemese onyң өmir sүru tәsili өzgergen kездеde de, Sondai-aқ basқa aleebu ti hyperglycemia tuғyzuy mүmіkіnar jaғе paydaғ.

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

Doseji ati ipa ti iṣakoso

Lo oogun naa ni awọn agbalagba.Iwọn lilo da lori awọn abajade ti ẹjẹ ati itupalẹ glukosi ito. Ni deede, a lo 1 dia fun ọjọ kan fun ọjọ kan. O gba oogun naa lati mu laipẹ ṣaaju tabi nigba ounjẹ aarọ tabi ti inu, ti ko ba ni ounjẹ aarọ, ni kete ṣaaju tabi lakoko ounjẹ akọkọ. O yẹ ki o gbe tabili tabulẹti naa laisi ijẹjẹ, wẹ pẹlu omi Bi o ba ti padanu iwọn lilo atẹle ti oogun naa, iwọn lilo ko yẹ ki o pọ si ni iwọn-atẹle.

Iwọn akọkọ ni miligiramu 1 ti glimepiride fun ọjọ kan. Ti iru iwọn lilo yii ba gba ọ laaye lati ṣakoso ipele ti suga daradara, o lo bi itọju. Ti iṣakoso glycemic ko dara julọ, iwọn lilo yẹ ki o pọ si 2, 3 tabi 4 miligiramu ti glimepiride fun ọjọ kan ni awọn ipele (ni awọn aaye arin ti awọn ọsẹ 1-2). Ti alaisan naa ba ni ihuwasi hypoglycemic si mu oogun naa ni iwọn lilo 1 miligiramu fun ọjọ kan, eyi tumọ si pe a le dari arun na nipa atẹle ounjẹ. Iwọn lilo loke 4 miligiramu fun ọjọ kan fun awọn esi to dara julọ nikan ni ọran kọọkan. Iwọn iṣeduro ti o pọ julọ jẹ 6 miligiramu ti diapiride fun ọjọ kan.

Ti iwọn lilo ojoojumọ ti metformin ko pese iṣakoso glycemic to, itọju ailera consolit pẹlu glimepiride le bẹrẹ. Ni ibamu si iwọn iṣaaju ti metformin, oogun naa yẹ ki o bẹrẹ pẹlu iwọn kekere, eyi ti a le ṣe alekun lẹhinna diẹ si iwọn lilo ojoojumọ ti o pọju, ni idojukọ ipele ti o fẹ ti iṣakoso ti iṣelọpọ. Itọju adapo yẹ ki o ṣee ṣe labẹ abojuto iṣoogun sunmọ.

Ti iwọn lilo ojoojumọ ti Diapiride ti o ga julọ ko pese iṣakoso glycemic to, ti o ba jẹ dandan, itọju ailera isulini concomitant le bẹrẹ. Ni ibamu si iwọn lilo iṣaaju ti glimepiride, itọju isulini yẹ ki o bẹrẹ pẹlu iwọn kekere, eyiti o le pọ si, ni idojukọ ipele ti o fẹ ti iṣakoso ti iṣelọpọ. Itọju adapo yẹ ki o ṣee ṣe labẹ abojuto iṣoogun sunmọ. Imudara iṣakoso iṣakoso tairodu wa pẹlu ifamọra pọ si insulin, nitorinaa iwulo fun glimepiride le dinku lakoko itọju. Lati ṣe idiwọ hypoglycemia, iwọn lilo naa yẹ ki o dinku tabi itọju ailera yẹ ki o ni idilọwọ lapapọ. Atunwo iwọn lilo tun le jẹ pataki ti iwuwo ara ti alaisan tabi awọn ayipada igbesi aye tabi awọn ipo miiran ni ipa lori ewu hypog- tabi hyperglycemia.

Awọn oṣiṣẹ iṣọn hypoglycemic miiran le jẹ igbagbogbo yipada si diapiride. Lakoko iru iyipada kan, agbara ati igbesi aye idaji ti oluranlowo ti tẹlẹ yẹ ki o gba sinu ero. Ni awọn ọrọ kan, ni pataki ti oogun antidiabetic ba ni igbesi aye idaji pipẹ (fun apẹẹrẹ, chlorpropamide), a gba ọ niyanju lati duro ni awọn ọjọ diẹ ṣaaju ki o to mu Diapiride. Eyi yoo dinku eewu ti awọn aati hypoglycemic nitori ipa afikun ti awọn aṣoju meji. Iwọn lilo akọkọ ti a ṣe iṣeduro jẹ 1 miligiramu ti glimepiride fun ọjọ kan. Iwọn naa le pọ si mu ni laiyara mu sinu ifura si oogun naa.

Awọn ipalemo ti heresectergoldanada. Dozasa Kan awọn ọkunrin neseptegі glukosi құramyn taldau әtyzhelerіne baylanysty. Әdette Diapiridti tәuligine 1 ret қoldanady. Awọn oogun ti toyymdy taңғy astan bіraz bұryn nemese taңғy bi kesіnde nemese, jäger taңғy bi bolmas, alғashқy negіzgі bi іsherden bіraz bұryn nemese bi іshu kesіnde қabyldau ұsynylady. Awọn tabulẹti shaynamay, sұyyқtyқpen іshіp zhtu kerek. Awọn igbaradi Jäger kesekti қabyldau zhіberіlіp alsa, kelesі қabyldaғan keshe dozasyn arttyrmau kerek.

Bastapy dosages tuligine 1 mg glimepiridtіradydy. Jäger Mundai dosasy қant deңgejіn 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) ni yoo fun arttyru. Awọn igbaradi Jaeger iruәasta әuligine 1 miligiramu ti ofabyldauғa hypoglycemia қ lenu ti ba, als, bұl auruda tech emdәm ұstanudyң kөmegimen ғana baқylauғa bolatynyn kөrsetedі. Tәulіgіne 4 mg asatyn abere tek jekelegen zhadaylarda ғana үzdіk nәtyzhe iwaju. Do жоғарғы ұсынылатин abere - әулігіәулігіне 6 mg Diapiride.

Jäger metforminnің eң zhoғarғy tәulіktіk awọn egbo ti kanna bi glycemia glycemia bamylauda қamtamasyz etpese, glimepiridpen қatarlas emdi bastauғa bolyady. Metforminnіd aldyңғy dozasyn ti orilẹ-ede otyryp, awọn igbaradi қabyldaudy tөmen dozasynan bastau kerek, ony keyin ика baқylaudyң қazhetti deңgeyyn baғdarғa ala otyryp arttyruғa bolyda. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek.

Jaeger Diapiridtің еғ жoғарәы тәуліктік awọn iwọn lilo ti ọpọlọpọ awọn ipele glukosi ẹjẹ ti baқylaudy қamtamasyz etpes, қ insulinman қatarlas emdeoudi bastauғa bolydy. Glimepiridtің aldyңғy dozasyn syүyene otyryp, insulin emdeudі tөmen dozasynan bastau kerek, ony keyin ика baқylaudyң қazhetti deңgeyin baғdarғa ala otyryp artyruғa. Bіrіktіrіlgen emdi dәrіgerdің қataң baқylauymen zhrgizu kerek. Diabetry baқylauda jaқsartu insulin sezmtaldyқtyң artuymen қatar zhredі, sondyқtan emdeu courses kazіnde glimepiridke қazhettіlіk azayuy mүmkіn. Hypoglycemia boldyrmau masatynda dozasyn birtіndep azaytu nemese emdeudі mүlddem totatu kerek. Dozasyn Kayta қarau қazhettіlіgі äger emdelushіde dené salmaғ nemese өmіr sүru tәsіlі өzgerse nemesa hypomemes hyperglycemia упaupіn arttyratyn basқa da zhaydaylaryt ү у uwayteyinyin

Ishu agyly қabyldanatyn basқa hypoglycemia agentterden әdette Diapiridke kөshugu bolada. Mұndai auysu kesіnde aldyңғy dәrіnің kүshі men zhartylai shyғarylu keseңіn esker kerek. Kay zhadaylarda, diabetessіrese jäger àtọgbẹ preparationsars awọn igbaradi ң zhartylı shyғarylu keseңi ұzaқ bolsa (awọn ero, chlorpropamide), Diapiridti қabyldauda bastardy ң aldynda bіrneshe kүte kұte tұru. Ікі aṣojuт additivetik ісerіnің saldarynan hypoglycemiaуп reactionar іаупін азайтуға мүмкіндік береді. Қsynylatyn bastapқ awọn iwọn lilo - tәuligine 1 glimepiride. Dozasyn oogun jẹ ifesi eskere otyryp, satylap arttyruғa bolyady.

Awọn isopọ Oògùn

Isakoso igbakọọkan ti Diapiride pẹlu awọn oogun kan le fa mejeeji jẹ irẹwẹsi ati ilosoke ninu ipa hypoglycemic ti glimepiride. Nitorinaa, awọn oogun miiran yẹ ki o mu nikan pẹlu ifohunsi (tabi bi a ti paṣẹ) ti dokita. Glimepiride jẹ metabolized nipa lilo cytochrome P450 2C9 (CYPC9). O ti wa ni a mọ pe nitori si igbakana iṣakoso ti awọn inducers (fun apẹẹrẹ rifampicin) tabi awọn inhibitors CYPC9 (fun apẹẹrẹ fluconazole), iṣelọpọ agbara yii le yipada. Iwadi ibaraenisọrọ vivo fihan pe fluconazole, ọkan ninu awọn oludaniloju CYPC9 ti o ni agbara julọ, mu AUC ti glimepiride pọ nipa idaji.

Ṣe ipa ipa ti glimepiride pẹlu lilo igbakana: phenylbutazone, azapropazone ati oxyphenbutazone, sulfinpyrazone, awọn oogun oogun antidiabetic, diẹ ninu awọn sulfonamides gigun, metformin, tetracyclines, salicylates ati p-aminosalicylic acid, MAO inhibitors, anabolic sitẹriodu ati awọn homonu ibalopọ , miconazole, fenfluramine, pentoxifyline (iwọn lilo giga parenterally), fibrates, tritokvalin, awọn inhibitors ACE, fluconazole, fluoxetine, allopurinol, sympatholytics, cyclophosph id, disopyramide, feniramidol, guanethidine, ifosfamide pas.

Din ipa ti hypoglycemic ti glimepiride ṣiṣẹ lakoko lilo: estrogens ati progestogens, saluretics, turezide diuretics, awọn homonu tairodu ati awọn oogun ti o mu iṣẹ tairodu ṣiṣẹ, awọn corticosteroids ati glucocorticoids, awọn itọsi phenothiazine, chlorpromazine, epinephrine ati sympathomimetics, nicotinic acid (awọn abere to gaju) ati awọn ọna abayọ rẹ, awọn ipoidojuu, ohun elo), phenytoin, diazoxide, glucagon, barbiturates ati rifampicin, acetazolamide.

Awọn antagonists olugba H2, awọn bulọki beta, clonidine ati reserpine le jẹ mejeeji ni agbara ati dinku ipa hypoglycemic. Labẹ ipa ti sympatholytics, bii beta-blockers, clonidine, guanethidine ati reserpine, iṣafihan ilana ilana adrenergic ti hypoglycemia le dinku tabi parun. Mimu ọti mimu le mu tabi mu irẹwẹsi ipa hypoglycemic ti glimepiride ṣiṣẹ.

Diapiridti belgіlі bіr dәrіlіk zattarmen bіr mezgіlde қabyldau glimepiridtің hypoglycemiaқ әсерінің әлсіреуін де, күшеюін де туғызуы мүмкін. Sondyқtan basқa igbaradi ti imọ-ẹrọ oogun dәrіgerdің kelіsіmіmen (nemese taayyndauymen) ғana Koldanu kerek. Glimepiride P450 2C9 (CYPC9) cytochromes ң kmegimen metabolizdenedі. СYPC9 inductorlaryn (awọn ero ti dabampicind) nemez tezhegіshterіn (awọn ero fluconazold) bir mezgilda kabyldaudyң saldarynan ti iṣelọpọ өzgeruі mүmkіn kenen belgіlі. IN vivo өzara әrekettesulierin sertteu уtyzheleri, СYPC9 ң күшті тежегіштерінің бірі fluconazole, glimepiridtі AUC екі есеге жуық арттыратыннөөрсетті.

Bіr mezgіlde қoldanғanda glimepiridtің әсerіn kүsheytedі: Phenylbutazone, azapropazone zhane oxyphenbutazone, sulfinpyrazone, hisulini zhane іshіletіn diabetke қarsy preparattar, ұzaқ әser etetіn keybіr sulfonamidter, metformin, tetratsiklinder, salitsilattar zhane p-aminosalitsil қyshқyly Mao tezhegіshterі, anabolikalyқ steroidtar zhane erlerdің zhynystyқ gormondary, hinolondyқ antibiotikter, chloramphenicol, probenecid, coumarindek anticoagulantar, miconazole, fenfluramine, pentoxifyline (parenteral parenterals), 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 lai gormondary zhane қalқansha lai қyzmetіn kөtermeleytіn preparattar, kortikosteroidtar zhane glyukokortikoidtar, phenothiazine tuyndylaryn, chlorpromazine, efinifirini zhane simpatomimetikter, eroja taba қyshқyly (zhoғary dozalary) zhane onyң tuyndylary, glukagoni, іsh zhүrgіzgіsh dәrіler (ұzaқ Uayyt Koldanu), phenytoin, diazoxide, glucagon, barbiturattar zhene rifampicin, acetazolamide.

Ң2-receptor lardң antagonists, beta-blocker, clonidine men reserpine hypoglycemia әserin әleuettendіruі de, tөmendueti de mүmkіn. Beta-blocker, clonidine, guanethidine, awọn obinrin ni reserpine, ti nmọlẹ jinlẹ ti inu didamu ofin ң adrenergic қ Ilana ti awọn ọmọ ң kңrіnіsі azayu nemese zhғaluy mүmkіn. Ọti Paidalanu glimepiridtің hypoglycemiaқ әсerіn kтуshaituі nemese әlsіretuі mүmkіn.

Iṣe oogun elegbogi

Aṣoju hypoglycemic kan, itọsẹ ti sulfonylurea ti iran kẹta ti igbese pẹ. Ipa ti o ni iyọdajẹ ti oogun jẹ nitori iṣelọpọ eka ti iṣan ati igbese extrapancreatic. Iwa pancreatic jẹ ninu safikun yomi insulin nipasẹ awọn sẹẹli reat-ẹyin, eyiti o jẹ pẹlu ifọra ati idasilẹ itusilẹ ti hisulini endogenous. Ipa yii jẹ nitori otitọ pe glimepiride, pẹlu iwọn aropo giga, sopọ ati ge asopọ lati inu amuaradagba ti awọn ß-ẹyin ti awọn ti oronro, eyiti o ni nkan ṣe pẹlu awọn ikanni potasiomu ATP-ti o gbẹkẹle, ṣugbọn o yatọ si aaye didipọ deede ti 1st ati keji iran sulfanylureas. Gẹgẹbi abajade, hisulini ni itusilẹ nipasẹ exocytosis, lakoko ti iye ti hisulini ti o ni ifipamo dinku pupọ ju labẹ iṣẹ ti awọn itọsẹ ti aṣa ti sulfanylurea. Iru ipa safikun kekere ti glimepiride lori tito hisulini pese eewu kekere ti hypoglycemia. Ipa extrapancreatic ti glimepiride jẹ eyiti o ṣe afihan nipasẹ awọn iṣe lọpọlọpọ, oludari eyiti o jẹ ilosoke ninu ifamọ ti awọn sẹẹli ara (iṣan ati ọra) si insulin pẹlu ilosoke ninu nọmba ati iṣẹ ti awọn ọlọjẹ gbigbe glukosi nipasẹ awọn sẹẹli, ati inhibition ti iṣelọpọ glimepiride ninu ẹdọ pẹlu ilosoke ninu ifọkanbalẹ iṣan-ara β-fosifeti lilu gluconeogenesis. Awọn ipa extrapancreatic miiran ti glimepiride pẹlu: idinku ninu apapọ platelet bi abajade ti inhibition ti cyclooxygenase ati iyipada ti arachidonic acid si thromboxane A2, eyiti o mu ki iṣako platelet pọ, ilosoke ninu ipele ti endogenous to-tocopherol ati iṣẹ-ṣiṣe ti epo-ara-ohun-elo atẹyinyin aapọn, eyiti o wa nigbagbogbo ni àtọgbẹ, ipa egboogi-atherogenic bi abajade ti tivatsii kan pato phospholipase C. glimepiride ko ni dojuti awọn ijẹ-aṣamubadọgba si myocardial ischemia (ko glibenclamide). Ipa hypoglycemic ti o pọju ti oogun naa han awọn wakati 2-3 lẹhin ti iṣakoso, o ju wakati 24 lọ ati pe o gbẹkẹle-iwọn lilo.
Elegbogi
Pẹlu ọpọlọpọ awọn iṣọn glimepiride ni iwọn lilo ojoojumọ ti 4 miligiramu, ifọkansi ti o pọ julọ ninu omi ara ẹjẹ ti de lẹhin awọn wakati 2.5 ati pe o jẹ 309 ng / milimita, ibatan kan wa laarin iwọn lilo ati ifọkansi ti o pọ julọ ti glimepiride ninu ẹjẹ, bakanna laarin iwọn lilo ati agbegbe labẹ iṣupọ "fifo -awon. ” Glimepiride ni iye bioav wiwa pipe. Ounjẹ ko ni ipa pataki lori gbigba, pẹlu ayafi ti idinku iyara diẹ ninu oṣuwọn gbigba. A ṣe afihan Glimepiride nipasẹ iwọn didun pinpin pupọ (pinpin 8,8 L), o fẹrẹ dọgba si iwọn ti pinpin albumin, iwọn giga ti didi si awọn ọlọjẹ pilasima (diẹ sii ju 99%) ati imukuro kekere (nipa 48 milimita / min). Glimepiride ti yọ si wara ọmu o si rekọja idena ibi-ọmọ. O si lọ ni ibi nipasẹ ohun idena ẹjẹ-ọpọlọ. Glimepiride jẹ biotransformed ninu ara sinu awọn metabolites 2, Abajade lati iṣelọpọ ti glimepiride ninu ẹdọ ati aṣoju aṣoju ati itọsi hydroxylated ti glimepiride. Igbesi-aye idaji ti glimepiride ni awọn ifọkansi pilasima rẹ ni omi ara ti o baamu si ilana itọju dosinni pupọ jẹ awọn wakati 5-8. Lẹhin mu glimepiride ni awọn iwuwo giga, igbesi aye idaji pọ. Lẹhin iwọn lilo ọpọlọ kan ti glimepiride ti o ni aami pẹlu aami ipanilara, 58% ni a ri ninu ito ati 35% ni awọn feces. Nkan ti nṣiṣe lọwọ iyipada ninu ito ko rii. Igbesi aye idaji ti hydroxylated ati metabolites ti glimepiride jẹ to wakati 3-6 ati wakati 5-6, ni atele. Ninu awọn alaisan pẹlu iṣẹ kidirin ti ko nira (aṣeyọri kekere ti creatinine), ifarahan kan lati mu imukuro glimepiride pọ si ati idinku ninu ifọkansi apapọ rẹ ninu ẹjẹ, eyiti, ni gbogbo o ṣeeṣe, jẹ nitori iyọkuro iyara ti oogun nitori didasilẹ amuaradagba kekere. Nitorinaa, ni ẹya yii ti awọn alaisan ko si afikun eewu ti ikojọpọ ti glimepiride. Awọn afiwe ti ile elegbogi oogun ti glimepiride jẹ iru kanna ni awọn alaisan ti o yatọ si awọn ẹgbẹ ati awọn ẹgbẹ ori oriṣiriṣi.

Ọna ti ohun elo

Fun awọn agbalagba: Seto inu ṣaaju ounjẹ aarọ tabi ounjẹ ọsan. A gbe awọn tabulẹti naa laisi ajẹkẹjẹ, a wẹ wọn pẹlu iye to bi omi (nipa 1/2 ago). O ṣe pataki pupọ lati maṣe jẹ ounjẹ lẹhin ti o mu Diapiride. Ibẹrẹ ati iwọn lilo itọju, akoko ti iṣakoso ati pinpin iwọn lilo ojoojumọ ni a ṣeto ni ọkọọkan ti o da lori awọn abajade ti ipinnu deede ti ipele ti glukosi ninu ẹjẹ ati ito.Iwọn akọkọ ti Diapiride jẹ 1 miligiramu orally 1 akoko fun ọjọ kan. Ti o ba jẹ dandan, ilosoke ninu iwọn lilo ojoojumọ ni a ṣe pẹlu abojuto deede ti awọn ipele glucose ẹjẹ, ni alekun jijẹ iwọn lilo ni gbogbo awọn ọsẹ 1-2 ni ibamu si ero naa: 1 mg - 2 mg - 3 mg - 4 mg - 6 mg. Ni awọn ọrọ kan, iwọn lilo ojoojumọ ti Diapiride le pọ si 8 miligiramu. Nigbagbogbo a lo iwọn lilo ojoojumọ lo lẹẹkan. Fun awọn alaisan ti o ni itọ-aisan to ni isanwo daradara, iwọn lilo ojoojumọ jẹ igbagbogbo 1-4 mg ti glimepiride, nikan ni diẹ ninu awọn alaisan ipa ti o yẹ ki o waye nigbati mu awọn iwọn ojoojumọ lo ti 6 miligiramu tabi diẹ sii. Iwọn ojoojumọ ti o pọju jẹ 6 miligiramu, ni awọn ọran - 8 miligiramu. Ti lo oogun naa fun igba pipẹ. Ninu ọran ti isanpada àtọgbẹ, ifamọ ti awọn ara si hisulini pọ si, ati nitori naa iwulo fun glimepiride le dinku, eyiti o nilo idinku iwọn lilo igba diẹ tabi yiyọkuro oogun (da lori awọn abajade ti igbekale ẹjẹ ati awọn ipele ito ito). Pẹlu iyipada ninu iwuwo ara ti alaisan tabi igbesi aye rẹ, bi daradara pẹlu ifarahan ti awọn okunfa ti o ṣe alabapin si alekun ewu ti hypoglycemia, atunṣe iwọn lilo jẹ pataki.
Lo ni apapo pẹlu metformin. Diapiride ni apapo pẹlu metformin ni a fun ni ti o ba jẹ pe ifọkansi ti glukosi ninu ẹjẹ ko ni iduroṣinṣin ni awọn alaisan ti o wa pẹlu abojuto monotherapy metformin. Lakoko ti o n ṣetọju iwọn lilo ti metformin ni ipele kanna, itọju pẹlu Diapiride bẹrẹ pẹlu iwọn lilo ti o kere ju 1 miligiramu, laiyara jijẹ iwọn lilo ti o da lori ipele ti o fẹ ti iṣakoso glycemic, to iwọn lilo ojoojumọ ti o pọju 6 mg.
Lo ni apapo pẹlu hisulini. Diapiride ni idapo pẹlu hisulini ni a paṣẹ fun nigba ti ko ṣee ṣe lati ṣe aṣeyọri iwulo ti ifọkansi glukosi ẹjẹ nipa gbigbe iwọn lilo Diapiride ti o pọ julọ bi monotherapy tabi ni idapo pẹlu iwọn lilo ti o pọju ti metformin. Pẹlupẹlu, lodi si ipilẹ ti iwọn lilo ikẹhin ti Diapirid ti a paṣẹ fun alaisan, itọju insulini bẹrẹ pẹlu iwọn lilo rẹ ti o kere julọ, pẹlu ilosoke atẹle ti o ṣee ṣe ni iwọn lilo hisulini labẹ iṣakoso ti ifọkansi glucose ẹjẹ. Itọju apapọ ti nbeere abojuto iṣoogun dandan. Lakoko ti o ṣetọju iṣakoso glycemic pipẹ, itọju apapọ yii le dinku ibeere insulin nipasẹ 40%.
Gbigbe ti alaisan si Diapiride lati ọdọ aṣoju hypoglycemic miiran. Ko si ibatan kan pato laarin awọn abere ti glimepiride ati awọn oogun ọpọlọ hypoglycemic miiran. Nigbati gbigbe lati iru awọn oogun (pẹlu iwọn lilo to pọ wọn) si Diapiride, iwọn lilo akọkọ ti glimepiride yẹ ki o jẹ 1 miligiramu. Eyikeyi ilosoke ninu iwọn lilo Diapiride yẹ ki o gbe ni awọn ipele, mu akiyesi idahun ti ara si oluranlọwọ itọju ailera yii. Iwọn lilo ti o lo ati iye akoko ti oṣiṣẹ iṣọn hypoglycemic ti iṣaaju gbọdọ wa ni akiyesi. Ni awọn ọrọ kan, ni pataki pẹlu iṣakoso iṣaaju ti awọn oogun hypoglycemic pẹlu igbesi aye idaji pipẹ (fun apẹẹrẹ, chlorpropamide), o le jẹ dandan lati igba diẹ (fun ọpọlọpọ awọn ọjọ) dawọ itọju duro ni ibere lati yago fun ipa afẹsodi ti o mu eegun ti hypoglycemia pọ.

Gbigbe ti alaisan lati hisulini si Diapiride. Ni awọn iṣẹlẹ ọranyan, nigbati awọn alaisan ti o ni alaisan mellitus ti o gbẹkẹle-insulin-igbẹgbẹ (iru II) gba itọju isulini, lakoko ti o san idiyele fun arun naa ati mimu iṣẹ ṣiṣe aṣiri ti awọn sẹẹli reat-sẹẹli naa, wọn le ṣafihan gbigbe lati insulin si Diapiride. Gbigbe si Diapiride yẹ ki o gbe jade labẹ abojuto iṣoogun to sunmọ. Ni ọran yii, iwọn lilo akọkọ ti Diapiride jẹ 1 miligiramu. Iye akoko ti itọju ni ọran kọọkan kọọkan ni ṣiṣe nipasẹ dokita. Ko si iriri pẹlu lilo oogun naa fun itọju awọn ọmọde.

- Iru II suga mellitus (ti kii-insulin-igbẹkẹle) ninu awọn agbalagba bi monotherapy tabi ni apapo pẹlu metformin tabi hisulini.

Fọọmu Tu silẹ

Awọn ìillsọmọbí
Tabulẹti 1 ni 2 miligiramu, tabi 3 miligiramu, tabi 4 miligiramu ti glimepiride, awọn aṣeyọri: lactose monohydrate, celclostse microcrystalline (102), iṣuu soda sitashi glycolate, povidone (25), iṣuu magnẹsia stearate. Awọn tabulẹti Diapiride 2 miligiramu ni afikun ohun elo alawọ ofeefee ohun elo afẹfẹ, indigo carmine, Diapiride 3 miligiramu - ofeefee ohun elo afẹfẹ, Diapiride 4 mg - Indigo carmine.

Alaye ti o wa ni oju-iwe ti o nwo ni a ṣẹda fun awọn idi alaye nikan ati kii ṣe igbelaruge oogun funrararẹ ni eyikeyi ọna. Orisun naa ni ipinnu lati mọ awọn akosemose ilera pẹlu alaye afikun nipa awọn oogun kan, nitorinaa jijẹ ipele ti ọjọgbọn wọn. Lilo Oògùn "Diapyrid" laisi ikuna pese fun ijumọsọrọ pẹlu ogbontarigi, gẹgẹbi awọn iṣeduro rẹ lori ọna lilo ati iwọn lilo ti oogun ti o yan.

Awọn ifilọlẹ ati kikọ silẹ

A ṣe oogun naa ni irisi awọn tabulẹti pẹlu awọn iwọn oriṣiriṣi ti nkan ti nṣiṣe lọwọ. Ninu apoti paali jẹ awọn tabulẹti 30 ni awọn roro. Tabulẹti 1 ni 2, 3 tabi 4 miligiramu ti glimepiride (nkan ti nṣiṣe lọwọ). Awọn tabulẹti pẹlu iwọn lilo ti 2 miligiramu jẹ alawọ ewe ina, 3 mg jẹ ofeefee ina, 4 miligiramu jẹ buluu ina.

Ẹtọ ti awọn tabulẹti pẹlu iru awọn aṣaaju-ọna:

lactose monohydrate,
microcrystalline cellulose,
iṣuu soda sitẹmu
povidone
ohun elo pupa irin
iṣuu magnẹsia
indigo carmine.

Elegbogi

Lẹhin ingestion, glimepiride ti wa ni gbigba iyara ni tito nkan lẹsẹsẹ ati wọ inu ẹjẹ. Jijẹ ko dinku gbigba ti oogun naa. Ẹrọ yii de ifọkansi rẹ ti o ga julọ ni pilasima ẹjẹ laarin awọn wakati 2-2.5.

Lẹhin ingestion, glimepiride ti wa ni gbigba iyara ni tito nkan lẹsẹsẹ ati wọ inu ẹjẹ.

Glimepiride jẹ ijuwe nipasẹ abuda to dara si awọn ọlọjẹ ẹjẹ (99%). Ti iṣelọpọ ti oogun naa ni a ṣe ni ẹdọ. Awọn iyọrisi ti o wa ni iyọdajẹ ti yọ jade nipasẹ awọn kidinrin ati awọn ifun. Oogun naa ti yọ si ara laarin awọn wakati 10-16. Lakoko ti o mu Diapiride, ikojọpọ ti awọn oludoti ninu ara ko ṣe akiyesi (paapaa pẹlu lilo pẹ).

Pẹlu abojuto

Labẹ abojuto ti o lagbara ti dokita kan, a lo oogun naa fun awọn iṣiṣẹ pajawiri, ọti mimu, iba, isun tairodu, ailagbara ati aarun inu.

Lẹhin awọn ilowosi iṣẹ abẹ ti o nira, awọn ipalara, ijona, a gba awọn alaisan niyanju lati yipada si itọju ailera insulini.

Bawo ni lati mu diapiride?

Ti mu oogun naa pẹlu oral pẹlu omi kekere ti omi. O ni ṣiṣe lati darapo iṣakoso ti awọn tabulẹti pẹlu ounjẹ fun idena ti awọn iwe inu.

Pẹlu àtọgbẹ

Fun itọju ti kii ṣe insulin-ti o gbẹkẹle iru aarun suga mellitus II, a mu oogun yii ni igba 1-2 ni ọjọ kan. Ni ibẹrẹ iwọn lilo, iwọn lilo jẹ 1 miligiramu ni awọn ofin ti glimepiride. Ti o ba to lati ṣe deede glukosi ninu ẹjẹ, lẹhinna iwọn lilo naa ko pọ si.

Pẹlu ipa ti ko to, iwọn lilo naa pọ si 2, 3 tabi 4 miligiramu. Aarin laarin awọn iyipada doseji yẹ ki o wa ni o kere ju 7 ọjọ. Nigba miiran awọn alaisan ni a fun ni miligiramu 6 ti glimepiride fun ọjọ kan (iwọn lilo ti o pọju fun ojoojumọ lojumọ).

Awọn oniwosan le ṣe ilana iṣakoso ijọba ti oogun pẹlu metformin tabi hisulini lati ṣe aṣeyọri ipa ti o pọju. Mu awọn oogun wọnyi le ja si alekun ibisi ni ifaragba insulin. Ni ọran yii, iwọn lilo dinku tabi paarẹ patapata.

Lori apakan ti eto ara iran

Lakoko itọju, idamu oju akoko (ailagbara igba diẹ) le waye. Idi ti ipa ẹgbẹ yii jẹ iyipada ninu suga ẹjẹ.

Fun itọju ti kii ṣe insulin-ti o gbẹkẹle iru aarun suga mellitus II, a mu oogun yii ni igba 1-2 ni ọjọ kan.

Awọn ara ti Hematopoietic

Awọn ipa ẹgbẹ lati eto eto idaamu:

thrombocytopenia
leukopenia
ẹjẹ
ololufẹ,
erythrocytopenia,
agranulocytosis,
pancytopenia.

Aringbungbun aifọkanbalẹ eto

Lati aringbungbun aifọkanbalẹ eto ti wa ni šakiyesi:

orififo
iwara
rudurudu,
airorunsun
rirẹ,
awọn ipo ti ibanujẹ
dinku ninu awọn aati psychomotor,
ailera ọrọ
ọwọ sisẹ,
cramps.

Lati ẹgbẹ ti iṣelọpọ

Ipa ti ko dara lori iṣelọpọ agbara jẹ eyiti a fihan nipasẹ hypoglycemia.

Lakoko iṣakoso, awọn aati inira ṣee ṣe:

awọ ara
urticaria
sisu
vasculitis inira

Lo ni ọjọ ogbó

A gba Ọpa laaye lati lo fun awọn alaisan ti o yatọ si awọn ẹka ori, pẹlu ayafi awọn ọmọde. Ṣugbọn awọn agbalagba ti o lo awọn oogun ti pẹ ni idagbasoke le dagbasoke hypoglycemia. Lati yago fun iwe-ẹkọ aisan yii, awọn onisegun ṣalaye awọn alaisan agbalagba ounjẹ pataki kan ati awọn iwọn kekere ti oogun (ti o ba ṣeeṣe).

Ilọju ti Diapiride

Ijẹ iṣuju ti oogun naa nyorisi hihan ti awọn aati hypoglycemic (ju idinku suga suga lọ). Ni ọran yii, alaisan kan lara rirẹ, idaamu, dizziness. O ṣeeṣe ipadanu ẹmi mimọ. Lati yọ awọn aami aisan ti iṣuju kuro, wọn lo si itọju symptomatic.

Ijẹ iṣuju ti oogun naa nyorisi hihan ti awọn aati hypoglycemic (ju idinku suga suga lọ).

Ibaraṣepọ pẹlu awọn oogun miiran

O yẹ ki o mu oogun naa pẹlu iṣọra ni apapo pẹlu awọn oogun bii:

Fluconazole
Phenylbutazone
Azapropazone.
Sulfinpyrazone.
Oxyphenbutazone.
Pentoxifylline.
Tritokvalin.
Awọn aṣebiakọ.
Fenfluramine.
Probenecid.
Anticoagulants lati ẹgbẹ coumarin.
Salicylates.
Diẹ ninu awọn antidepressants (awọn idiwọ MAO).
Fibrates.
Fluoxetine.
Cyclophosphamide.
Feniramidol.
Ifosfamide.
Miconazole
Tetracycline ati awọn oogun ajẹsara ti quinolone.
Awọn oogun hypoglycemic miiran.
Awọn sitẹriọdu amúṣantóbi.
AC inhibitors.
PASK (para-aminosalicylic acid).

Pẹlu lilo igbakọọkan awọn owo wọnyi, ipa hypoglycemic ti Diapiride ti ni ilọsiwaju. A ṣe akiyesi idinku ipa ti oogun naa nigbati a ba mu papọ pẹlu Phenothiazine ati awọn itọsẹ rẹ, estrogens ati progestogens, glucagon, nicotinic acid, corticosteroids, barbiturates, Phenytoin, Acetazolamide, awọn diuretics ati awọn oogun fun itọju ti ẹṣẹ tairodu.

Oyun

Maṣe lo oogun naa Diapiride lakoko oyun. Ti alaisan kan ti o mu glimepiride n gbero oyun tabi ti loyun, o yẹ ki o gbe lọ si itọju isulini ni kete bi o ti ṣee.
Niwọn igba ti awọn ipilẹṣẹ sulfonylurea miiran ti pinnu ninu wara-ọmu, o niyanju pe itọju pẹlu glimepiride yoo dawọ duro nitori ewu iṣọn-ẹjẹ ninu awọn ọmọ-ọwọ.

Fọọmu doseji

2 mg, 3 mg, ati awọn tabulẹti 4 mg

Tabulẹti kan ni

nkan ti nṣiṣe lọwọ: glimepiride (micronized) ni awọn ofin ti nkan 100% - 2 mg, 3 mg ati 4 mg,

Awọn tabulẹti 2 miligiramu: lactose monohydrate, celclolose microcrystalline 102, iṣuu soda iṣuu soda (iru A), povidone (25), iron (III) ofeefee ohun elo afẹfẹ (E 172), indigo carmine (E 132), iṣuu magnẹsia iṣuu,

Awọn tabulẹti 3 miligiramu: lactose monohydrate, celclolose microcrystalline 102, iṣuu soda iṣuu soda (iru A), povidone (25), iron (III) ohun elo alawọ ofeefee (E 172), iṣuu magnẹsia stearate,

Awọn tabulẹti 4 miligiramu: lactose monohydrate, celclolose microcrystalline 102, iṣuu soda iṣuu soda (iru A), povidone (25), indigo carmine (E 132), iṣuu magnẹsia stearate.

Awọn tabulẹti iyika-yika pẹlu dada pẹlẹbẹ, lati alawọ alawọ bia si alawọ ewe (fun iwọn lilo ti 2 miligiramu), lati ofeefee bia si ofeefee (fun iwọn lilo 3 miligiramu), lati bulu bia si buluu (fun iwọn lilo ti 4 miligiramu), pẹlu awọn igun didan ati ogbontarigi. Lori ori awọn tabulẹti, pin kakiri

Diapiride overdose ninu awọn tabulẹti

Ijẹ iṣupọ le ja si hypoglycemia, eyiti o to lati wakati 12 si 72, ati lẹhin ilọsiwaju akọkọ le han lẹẹkansi. Awọn aami aisan le waye lẹhin awọn wakati 24 lẹhin gbigba oogun naa. Gẹgẹbi ofin, iru awọn alaisan yẹ ki o wa ni ile-iwosan.

Awọn aami aisan ti hypoglycemia: ríru, ìgbagbogbo ati irora ninu ikun, awọn iwariri, awọn idamu wiwo, iṣakojọpọ ti ko dara, idaamu, idamu oorun, aibalẹ, ibinu, akiyesi akoko ati akoko ifarakanra, ibanujẹ, disorientation, ọrọ ati riru iran, aphasia, paresis, ailagbara ifarakan, iwariri, ainiagbara, pipadanu iṣakoso ara-ẹni, delirium, awọn ohun-mimu ọra, pipadanu aiji titi de idagbasoke ti ẹlẹma, mimi aijinile ati bradycardia. Ni afikun, awọn ami ti iyipada adrenergic ilana bii sweating, aibalẹ, tachycardia, haipatensonu iṣan, palpitations, angina pectoris ati arrhythmia ti aisan le jẹ akiyesi. Aworan ile-iwosan ti ikọlu hypoglycemic ti o muna le dabi igun-ara ọpọlọ.

Artyқ dosalanuy hypoglycemia ғ alyp keluy mүmkіn, ol 12-den 72 saғatқa dejin sozulyuy, әne alғashқy zhқsaruynan keyіn қaita bіlіnі mүmkіn. Awọn oogun Symptomatic ң sіңuіnen keyin 24 saғattan soң bіlіnuі mүmkіn. Әdette, mұndai emdelušіler ile iwosan ti bolu tiis.

Awọn ẹbun Aisan Hypoglycemia: Zhurek Ainu құsu zhane asқazan tұsynyң auyruy, tremor, kөru bұzylystary, қimyl-қozғalys үylesіmіnің bұzyluy, ұyқyshyldyқ, ұyқynyң bұzyluy, mazasyzdyқ, ozbyrlyқ, zeyіn shoғyrlandyru zhane lenu uaқyttarynyң bұzyluy, şuga, baғdarsyzdyқ, sөyleu zhane kөru bұzylystary, aphasia, paresis, sezmtaldyқtyң bұzyluy, baasi 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 haipatensonu, үurek қaқuyn sezinu, angina pectoris әәerek arrhythmias ti n tan keri adrenergialқ ilana ti Belgler baiқaluy mүmkіn. Auyr hypoglycemiaқ амstamanyң ile iwosanқ kөrіnіsі ọgbẹ ida іske saluy mүmkіn.

Awọn ibaraenisepo Oògùn

Wọn ṣe igbelaruge ipa ti glimepiride pẹlu lilo igbakanna: phenylbutazone, azapropazone ati oxyphenbutazone, sulfinpyrazone, insulin ati awọn oogun antidiabetic oral, diẹ ninu awọn sulfonamides pipẹ, metformin, tetracyclines, salicylates ati p-aminosalicylic acid, antiic anicic antiids, chloramphenicol, probenecid, colinarin anticoagulants, miconazole, phenfluramine, pentoxifyline (iwọn lilo giga), fibrates, tritokvalin, AC inhibitors, fl uconazole, fluoxetine, allopurinol, sympatholytics, cyclophosphamide, obeypyramide, pheniramidol, guanethidine, isophosphamide, PASK.

Din ipa ti hypoglycemic ti glimepiride pẹlu lilo igbakan: estrogens ati progestogens, saluretics, thiazide diuretics, awọn homonu tairodu ati awọn oogun ti o mu iṣẹ tairodu ṣiṣẹ, awọn corticosteroids ati glucocorticoids, awọn itọsi phenothiazine, chlorpromazine, epinephrine ati awọn ọmọnikeji rẹ) , glucagon, awọn laxatives (lilo igba pipẹ), phenytoin, diazoxide, glucagon, barbiturates ati rifampicin, acetazolamide.

Awọn antagonists olugba H2, awọn bulọki beta, clonidine ati reserpine le jẹ mejeeji ni agbara ati dinku ipa hypoglycemic.Labẹ ipa ti sympatholytics, bii beta-blockers, clonidine, guanethidine ati reserpine, iṣafihan ilana ilana adrenergic ti hypoglycemia le dinku tabi parun. Mimu ọti mimu le mu tabi mu irẹwẹsi ipa hypoglycemic ti glimepiride ṣiṣẹ.

Glimepiride ni anfani lati pọsi ati dinku ipa ti awọn itọsẹ ti coumarin.

Awọn ipa ẹgbẹ

Lati ẹgbẹ ti iṣelọpọ: hypoglycemia (orififo, ebi, ríru, ìgbagbogbo). O ni aiṣedede - ikunsinu ti rirẹ, idaamu, idamu oorun, aibalẹ, ibinu, akiyesi ti ko dara ati iṣe, ibanujẹ, rudurudu, ọrọ ati idamu wiwo, aphasia, warìri, idaru ọpọlọ, dizziness, iṣakoso ailagbara, isonu iṣakoso. Pupọ pupọ - delirium, awọn ọgbun iṣan, pipadanu mimọ, coma, mimi isimi, bradycardia. Ni afikun, gẹgẹbi abajade ti ẹrọ adrenergic esi, nigbakan iru awọn aami aisan le waye: otutu, lagun alalepo, tachycardia, haipatensonu, angina pectoris, rudurudu rudurudu.

Lati inu iṣan ara: inu rirun, ìgbagbogbo, rilara ti iṣan-ara tabi ibanujẹ ninu efinigun, irora inu, iba gbuuru, ni awọn iṣẹlẹ ti o ṣọwọn, ilosoke ninu iṣẹ ti awọn iṣọn iṣan ẹdọfu, iṣẹ ẹdọ ti ko ni ailera (cholestasis ati jaundice), jedojedo, ati ikuna ẹdọ ṣee ṣe.

Lati inu ẹjẹ eto: thrombocytopenia (dede si àìdá), ṣọwọn leukopenia, hemolytic tabi aplastic anaemia, erythrocytopenia, granulocytopenia, agranulocytosis ati pancytopenia (nitori myelosuppression).

Lati ẹgbẹ ti ẹya ara ti iran: ailagbara wiwo ni asiko nitori ayipada kan ni ifọkansi ti glukosi ninu ẹjẹ (pataki ni ibẹrẹ itọju).

Awọn aati aleji: pruritus, urticaria, sisu, dyspnea ṣọwọn, titẹ ẹjẹ ti o dinku, ẹdọforo inira, fọtoensitivity. Ẹhun aleji ati awọn nkan ti ara korira jẹ nigbagbogbo rirẹ, ṣugbọn le ni ilọsiwaju, pẹlu dyspnea ati idinku ninu riru ẹjẹ, titi di mọnamọna. Ẹhun aleji ṣee ṣe pẹlu awọn itọsẹ sulfonylurea miiran, sulfonamides.

Ti awọn igbelaruge ẹgbẹ to ba waye, oogun naa ti fagile ati pe itọju ailera ni a ti ṣe.

Awọn ibaraenisepo

Okun ipa ti hypoglycemic ti glimepiride o le ṣe akiyesi pẹlu lilo nigbakan pẹlu insulin tabi awọn oogun hypoglycemic miiran, awọn oludena ACE, allopurinol, awọn sitẹriọdu anabolic ati awọn homonu ibalopo ti akọ, pẹlu chloramphenicol, awọn itọsi coumarin, cyclo-, tro- ati isophosphamide, phenfluramine, pheniramidol, fibin, fibetin, fibetin, fibetin , miconazole, pentoxifylline (pẹlu iṣakoso parenteral ni awọn abere giga), pẹlu phenylbutazone, azapropazone, oxyphenbutazone, probenecid, quinolones, salicylates, sulfinpyrazone, su lfanilamides ti n ṣiṣẹ ṣiṣe gigun, awọn tetracyclines, tritocqualin.

Ikun ailera ipa hypoglycemic ti glimepiride ṣee ṣe pẹlu lilo igbakana pẹlu acetazolamide, barbiturates, glucocorticosteroids, diazoxide, saluretics, thiazide diuretics, efinifirini (adrenaline) ati awọn miiran ti o ni ibatan, glucagon, awọn iṣẹ aṣiwere (pẹlu lilo pẹ), nicotinic acid (ni iwọn giga) ati awọn ohun elo eleyi , phenothiazine, phenytoin, rifampicin, awọn homonu tairodu, iyọ litiumu, chlorpromazine.

Mejeeji okun ati irẹwẹsi ipa hypoglycemic ti glimepiride ni a le ṣe akiyesi pẹlu lilo nigbakanna pẹlu awọn olutọpa hisamini H₂awọn olugba, clonidine ati reserpine, pẹlu lilo ẹyọkan tabi onibaje oti.

Lodi si ipilẹ ti lilo glimepiride, ilosoke tabi irẹwẹsi iṣẹ ti awọn itọsẹ ti coumarin ni a le ṣe akiyesi.

Elegbogi

Ishke қabyldaғan kemede glimepiride tolyғymen sіңedі, bi іshu sіңuіne eleeleul durezhde әser etpeydi. Қан sarysuyndaғy ezhoғar концентрацияy fojusi ọmọ ішке қыabyldaannan keyin 2,5 saғattan soңethedі. Taralu kөlemi tөmen (8,8 milimita), kiliaransi - 48 milimita / min, pilasima aқuyzdarymen bailanysuy - 99% -dan astam, zhartyly shygarylu keseeni - 5-8 saғatқa zhuyқ. Awọn igbaradi ti Zhoғary dozalard қabyldaғannan kein жарırtylai shyғarylu kezңңi artady.

Bauyrda glimepiridtің hydroxyldengen tuyndylaryna deіn metabolizdenedі, olar nesepte de (awọn oogun ң bir rettіk dozasynyң 58% za zhuyғy), nәzhiste de (35-40%) anyқtalady. Awọn ipalemo bir ret қabyldaғanda zhne birneshe kүn қatarynan tәulіgіne 1 ret қoldanғanda pharmacokinetics sinda aytarlyқtay ayyrmashylyқ bayalmaғan. Oògùn zhinaқtalmaydy. Zhas shamalarymen zhynystary әр түрлі еделушілердегі Pharmacokinetics қ Parameterler ұқсас.

Awọn iṣẹ Bүyrek ti sonң bұzylouy bar edelushіlerde glimepiride kiliani artumen awọn ọkunrin onyң ortasha fojusi ti sonң tөmendeuіne beyimdіlіk bajalada.