Miyagun ƙwayoyi Glemaz: umarnin don amfani

Form sashi - Allunan: rectangular, lebur, light kore a launi, tare da 3 layi daya notches amfani a fadin nisa daga cikin kwamfutar hannu a garesu da kuma rarraba shi zuwa 4 daidai sassa (5 ko 10 guda a cikin blisters, a cikin fakitin kwali 3 ko 6 blisters )

Sinadaran aiki: glimepiride, a cikin kwamfutar hannu 1 - 4 MG.

Componentsarin abubuwan da aka haɗa: microcrystalline cellulose, magnesium stearate, cellulose, croscarmellose sodium, shuɗi mai haske mai shuɗi, quinoline mai ruwan shuɗi.

Contraindications

Type 1 ciwon sukari
Leukopenia
Cutar rashin lafiyar koda (ciki har da contraindicated ga marasa lafiya a kan hemodialysis),
Mai tsananin rashin hanta,
Precoma na ciwon sukari da coma, masu ciwon sukari ketoacidosis,
Yanayin tare da cutar malassorption na abinci da haɓakar haɓakawar jini (gami da cututtukan cututtukan),
Shekaru 18 a duniya
Haihuwa da lactation
Hypersensitivity ga abubuwan da ke cikin miyagun ƙwayoyi ko wasu abubuwan da suka samo asali na sulfonylurea da magungunan sulfonamide.

Ya kamata a yi amfani da Glemaz tare da taka tsantsan a cikin yanayin da ake buƙatar canja wurin mai haƙuri zuwa maganin insulin, kamar malabsorption abinci da kwayoyi a cikin jijiyoyin ciki (ciki har da paresis na ciki da toshewar hanji), manyan hanyoyin aikin tiyata, raunin rauni mai yawa, ƙonewa mai yawa.

Sashi da gudanarwa

Glemaz ya yi magana da baki. Ya kamata a sha kashi na yau da kullun a cikin kashi ɗaya kafin ko lokacin karin kumallo mai ban sha'awa ko babban abincin farko. Allunan za a hadiye su ba tare da taunawa ba, a wanke su da isasshen ruwan sha (kamar ½ kofin). Bayan shan kwaya, ba da shawarar tsallake abincin ba.

An ƙaddara matakin farko da tabbatarwa gwargwado gwargwadon sakamakon ƙuduri na yau da kullun na tattarawar glucose a cikin jini.

A farkon farawa, ana amfani da 1 mg na glimepiride (1 /₄ Allunan) lokaci 1 a rana. Idan yana yiwuwa a cimma sakamako mafi kyau na warkewa, ana ci gaba da shan ƙwayar a cikin kashi ɗaya (a matsayin maganin tabbatarwa).

A cikin rashi na sarrafa glycemic, ana amfani da ƙimar yau da kullun a hankali, ana saka idanu akai-akai game da yawan glucose a cikin jini: kowane mako 1-2, na farko har zuwa 2 MG, to har zuwa 3 MG, to har zuwa 4 MG (wani kashi akan 4 MG yana tasiri kawai a lokuta na musamman ) Matsakaicin izini na yau da kullun shine 8 MG.

Lokaci da mitar shan miyagun ƙwayoyi ya ƙaddara ta likita dangane da salon haƙuri. Jiyya yana da tsawo, yana aiki da glucose jini.

Yi amfani dashi a hade tare da metformin

Idan ba'a iya samun ikon sarrafa glycemic a cikin marasa lafiya suna shan metformin, ana iya tsara maganin haɗin gwiwa tare da Glemaz. A wannan yanayin, ana kiyaye kashi na metformin a daidai matakin, kuma an wajabta glimepiride a cikin mafi ƙarancin kashi, bayan haka a hankali yana ƙaruwa har zuwa matsakaicin adadin yau da kullun (dangane da maida hankali na glucose a cikin jini). Ana aiwatar da aikin haɗin gwiwa a ƙarƙashin kulawa ta lafiya.

Yi amfani da haɗin tare da insulin

Idan marasa lafiya suna karɓar Glemaz a matsakaicin adadin azaman ƙwayoyi guda ɗaya ko a haɗe tare da matsakaicin ƙwayar metformin bazai iya samun ikon sarrafa glycemic ba, ana iya tsara maganin haɗin gwiwa tare da insulin. A wannan yanayin, kashi na ƙarshe da aka ƙayyade na glimepiride ya ragu ba a canza shi ba, an kuma tsara insulin a cikin mafi ƙarancin kashi kuma, idan ya cancanta, sannu a hankali ƙara shi a ƙarƙashin kulawar taro na glucose a cikin jini. Ana aiwatar da magani gaba ɗaya a ƙarƙashin kulawa ta lafiya.

Canja wurin haƙuri zuwa Glemaz daga wani magani na baka hypoglycemic magani

Lokacin canja wurin mai haƙuri daga wani wakili na hypoglycemic na bakin, farkon kashi na glimepiride ya kamata ya zama 1 MG, koda kuwa an dauki wani magani a matsakaicin adadin. Idan ya cancanta, a nan gaba, kashi na Glemaz yana ƙaruwa mataki-daidai gwargwadon shawarwarin gaba ɗaya da aka bayyana a sama da yin la'akari da tasiri, kashi da tsawon lokacin aiwatar da magungunan cutar ta hypoglycemic. A wasu halaye, musamman lokacin amfani da wakili na hypoglycemic tare da tsawon rabin rayuwa, yana iya zama dole a dakatar da jinya na ɗan lokaci (na kwanaki da yawa) don guje wa tasirin ƙari wanda ke kara haɗarin cutar rashin ƙarfi na hypoglycemia.

Canza haƙuri daga insulin zuwa glimepiride

A cikin lokuta na musamman, lokacin gudanar da aikin insulin a cikin marasa lafiya da ke dauke da nau'in ciwon sukari na 2 na 2, yayin da ake biyan cutar da aikin adana sirrin β-sel, ana iya maye gurbin insulin tare da glimepiride. Amincewa da Glemaz yana farawa da mafi ƙarancin kashi na 1 MG, canja wurin ana aiwatar da shi a karkashin kulawa ta kusa da likita.

Side effects

Hanyar metabolism: halayen hypoglycemic wanda ke faruwa ba da daɗewa ba bayan shan miyagun ƙwayoyi (suna iya samun nau'i mai tsauri kuma hanya, ba koyaushe za a iya dakatar da su cikin sauƙi ba),
Tsarin narkewa: ciwon ciki, jin nauyi ko rashin jin daɗi a cikin jijiyoyin jiki, tashin zuciya, amai, gudawa, zazzabin cizon sauro, ƙwaƙwalwa, haɓaka ayyukan hepatic transaminases, hepatitis (har zuwa gaɓar hanta),
Tsarin hawan jini: aplastic or hemolytic anemia, erythrocytopenia, leukopenia, granulocytopenia, pancytopenia, agranulocytosis, thrombocytopenia (matsakaici zuwa mai tsanani),
Organ na hangen nesa: mafi sau da yawa a farkon farji - rashi mara gani na gani,
Allergic halayen: urticaria, fatar fata, itching (yawanci m, amma na iya ci gaba, tare da shortness na numfashi da saukar karfin jini, kai ga anaphylactic gigicewa), giciye-alerji tare da sulfonamides da sauran sulfonylureas ko abubuwa masu kama, rashin lafiyar vasculitis,
Sauran: a wasu halaye - hyponatremia, asthenia, photoensitivity, ciwon kai, ƙarshen fata fata.

Umarni na musamman

Ya kamata a dauki Glemaz sosai daidai da shawarar likita. Kurakuran karɓar karɓa (alal misali, tsallake kashi na gaba) ba za'a taɓa kawar da shi ta gaba na ƙarin kashi na gaba ba. Mai haƙuri ya kamata ya tattauna tare da likita a gaba matakan da ya kamata a ɗauka idan akwai irin waɗannan kurakurai ko a cikin yanayi lokacin da kashi na gaba ba zai yiwu ba a lokacin da aka zaɓa. Ya kamata mai haƙuri ya sanar da likita nan da nan idan ya sha ƙwalla.

Haɓaka hypoglycemia bayan shan Glemaz a cikin kashi na yau da kullun na 1 MG yana nufin cewa ana iya sarrafa glycemia kawai ta abinci.

Da zarar an biya diyya ga masu ciwon sukari na 2, ƙwayar insulin tana ƙaruwa, don haka ana iya buƙatar rage kashi na glimepiride. Don hana haɓakar hypoglycemia, ya kamata ka rage kashi kaɗan na ɗan lokaci ko kuma a soke Glemaz gaba ɗaya. Hakanan za'a iya aiwatar da gyaran gyare-gyare tare da canji a cikin nauyin jikin mai haƙuri, salon rayuwa, ko wasu abubuwan da zasu iya haifar da ci gaban hypo- ko hyperglycemia.

Musamman lura da mai haƙuri ya zama dole a farkon makonni na jiyya, saboda Yana cikin wannan lokacin ne haɗarin haɓakar haɓakar jini yana ƙaruwa. Irin wannan yanayin yana faruwa lokacin tsallake abinci ko cin abinci kullun.

Ya kamata a ɗauka a hankali cewa cututtukan hypoglycemia na iya sauƙaƙewa ko ɓacewa gaba ɗaya a cikin tsofaffi, marasa lafiya tare da neuropathy marasa lafiya da marasa lafiya da ke karɓar beta-blockers, reserpine, clonidine, guanethidine. Abunda ke motsa jini kusan koyaushe ana iya tsayar da shi ta hanzarin shan carbohydrates (sukari ko glucose, alal misali, a cikin wani yanki na sukari, shayi mai zaki ko ruwan 'ya'yan itace). Don wannan, ana ba da shawarar cewa marasa lafiya koyaushe suna da akalla g 20 na glucose (guda 4 na sukari mai ladabi) tare da su. Masu zaki cikin jiyya na rashin lafiya na rashin inganci.

Duk tsawon lokacin kulawa tare da Glemaz, ya zama dole don saka idanu akai-akai game da yawaitar glucose a cikin jini, matakin glycosylated haemoglobin, aikin hanta, da hoton hoton farji (musamman yawan platelet da leukocytes).

A cikin yanayi mai damuwa (alal misali, tare da cututtukan da ke kama da zazzabi, tiyata ko rauni), ana buƙatar buƙatar canja wurin haƙuri na ɗan lokaci zuwa insulin.

Yayin aikin jiyya, ya kamata a yi taka tsantsan yayin shiga cikin abubuwan haɗari, aiwatarwa wanda ke buƙatar ƙimar amsawa da ƙara kulawa (ciki har da tuki.

Hulɗa da ƙwayoyi

Tare da yin amfani da Glemaz a lokaci guda tare da wasu kwayoyi, canji a cikin aikinsa yana yiwuwa - ƙarfafa ko raunana. Sabili da haka, yiwuwar shan kowane magani ya kamata a yarda da likitanka.

Thearfafa aikin hypoglycemic na Glemaz kuma, a sakamakon haka, haɓakar hypoglycemia na iya haifar da haɗuwa tare da kwayoyi masu zuwa: insulin, metformin, sauran magungunan maganganu na baka, magungunan angiotensin da ke canza masu inzyme, anabolic steroids da kwayoyin jima'i na maza, kwayoyin nan na oxidase inhibitors acid), wakilai na rigakafi - abubuwan quinolone, abubuwan tetracyclines, mai juyayi (ciki har da guanethidine), wasu sulfonamides masu aiki da sauransu, da sauransu. coumarin Kalam, fibrates, allopurinol, trofosfamide, fenfluramine, ifosfamide, fluoxetine, miconazole, cyclophosphamide, chloramphenicol, oxyphenbutazone, tritokvalin, azapropazone, fluconazole, sulfinpyrazone, phenylbutazone, pentoxifylline (gudanar parenterally a high allurai).

Rage rauni na aikin hypoglycemic na Glemaz kuma, a sakamakon hakan, haɓaka taro na glucose a cikin jini, na iya haifar da haɗin gwiwa tare da kwayoyi masu zuwa: glucocorticosteroids, thiazide diuretics, laxatives (tare da amfani na dogon lokaci), estrogens da progestogens, barbiturates, epinephrine da sauransu, nicotinic acid (a cikin manyan allurai) da ire-irensa, glucagon, diazoxide, acetazolamide, abubuwan asali, ciki har da chlorpromazine, rifampicin, phenytoin, saltsin lithium, hormones thyroid.

Reserpine, clonidine, antiam masu hutu₂masu karɓa zasu iya yin rauni da kuma ƙarfin tasirin hypoglycemic na glimepiride. A ƙarƙashin tasirin waɗannan kwayoyi da guanethidine, rauni ko cikakkiyar rashi alamun alamun cutar rashin lafiya na yiwuwa.

Glimepiride na iya yin rauni ko haɓaka sakamakon abubuwan tushe na coumarin.

Game da amfani da kwayoyi na lokaci guda da ke hana jini toshewar jini, hadarin haɓaka myelosuppression yana ƙaruwa.

Amfani guda na giya ko na yau da kullun zai iya haɓakawa da raunana tasirin glemaz.

Misalan magungunan Glemaz sune: Amaryl, Glimepiride, Canyon Glimepiride, Diamerid.

Umarnin don amfani da Glemaz (hanya da sashi)

Ana ɗaukar allunan Glemaz a baki a cikin guda ɗaya kai tsaye kafin ko yayin karin kumallo mai bugun zuciya, ko babban abincin farko. Takeauki allunan gaba daya, kada a tauna, sha ruwa mai yawa (kimanin kofuna waɗanda 0.5). An saita sashin ne akayi daban-daban bisa sakamakon saka idanu na yau da kullun game da tattarawar glucose na jini.

Maganin farko: 1 mg 1 sau ɗaya kowace rana. Lokacin samun babban tasiri na warkewa, ana bada shawara don ɗaukar wannan kashi azaman maganin kiyayewa.

Idan babu kulawar glycemic, haɓakar hankali a cikin adadin yau da kullun yana yiwuwa (tare da saka idanu na yau da kullun na yawan haɗuwar glucose na jini a cikin tsaka-tsakin 1 zuwa 2 makonni) zuwa 2 mg, 3 mg ko 4 mg kowace rana. Allurai akan 4 MG a rana za'a iya wajabta shi kawai a lokuta na musamman.

Matsakaicin shawarar da aka bayar na yau da kullun: 8 MG.

Harshen magani: na dogon lokaci, a ƙarƙashin kulawar glucose jini.

Yi amfani dashi a hade tare da metformin

Idan babu kulawar glycemic a cikin marasa lafiya suna shan metformin, maganin concomitant tare da glimepiride yana yiwuwa.

Yayinda yake riƙe da kashi na metformin a daidai matakin, jiyya tare da glimepiride yana farawa da mafi ƙarancin kashi, sannan kashi a hankali yana ƙaruwa dangane da abin da ake so a cikin glucose a cikin jini, har zuwa iyakar adadin yau da kullun.

Ya kamata a gudanar da aikin kwantar da hankali a karkashin kulawa ta fuskar lafiya.

Yi amfani da haɗin tare da insulin

A wasu halaye, maganin monotherapy tare da Glemaz, har ma da haɗuwa da metformin, ba ya ba da sakamakon da ake so: glycemic control ba zai iya cimma ba. A cikin irin wannan yanayin, haɗuwa da glimepiride tare da insulin yana yiwuwa. A wannan yanayin, kashi na ƙarshe na glimepiride da aka wajabta wa mai haƙuri ya kasance ba a canzawa ba, kuma maganin insulin yana farawa da mafi ƙarancin kashi, tare da yiwuwar ƙarin ci gaba na digiri a cikin adadinsa a ƙarƙashin kulawar tattarawar glucose jini.

Daidaita magani yana buƙatar kulawa da likita na tilas.

Canja wuri daga wani magani na baka hypoglycemic magani zuwa glimepiride

Maganin farko na yau da kullun: 1 MG (koda kuwa an canja mai haƙuri zuwa glimepiride tare da matsakaicin kashi na wani maganin ƙwaƙwalwar ƙwayar cuta).

Duk wani ƙaruwa a cikin kashi na Glemaz ya kamata a aiwatar dashi a matakai, gwargwadon tasiri na jiyya, kashi da tsawon lokacin aikin wakili na hypoglycemic da aka yi amfani dashi.

A wasu halaye, musamman lokacin shan magungunan hypoglycemic tare da tsawon rabin rayuwar, yana iya zama dole don ɗan lokaci (a cikin fewan kwanaki) dakatar da magani don guje wa tasirin ƙari wanda ke kara haɗarin cutar rashin jini.

Fassara daga insulin zuwa glimepiride

A cikin lokuta na musamman, lokacin gudanar da aikin insulin a cikin marasa lafiya da ke dauke da nau'in ciwon sukari na 2 na 2, yayin da suke raunin cutar da kuma riƙe ayyukan asirin ƙwayoyin cuta na huhu, yana yiwuwa a maye gurbin insulin tare da glimepiride.

Ana aiwatar da fassara a ƙarƙashin kulawa ta likita.

Kashi na farko: 1 MG kowace rana.

Side effects

Yin amfani da miyagun ƙwayoyi na iya haifar da sakamako masu illa:

Hanyar metabolism: jim kadan bayan shan miyagun ƙwayoyi, bayyanar cututtukan hypoglycemic mai yiwuwa ne, wanda zai iya samun tsauraran hanya da tsari kuma ba koyaushe za'a iya tsayar da su ba.
Umarni na hangen nesa: yayin jiyya (musamman a farkonta), ana iya lura da rikicewar gani na yau da kullun da ke da alaƙa da canji a cikin glucose jini.
Tsarin hematopoietic: leukopenia, aplastic or hemolytic anemia, matsakaici zuwa babban thrombocytopenia, pancytopenia, agranulocytosis, erythrocytopenia da granulocytopenia.
Tsarin narkewa: hare-hare na tashin zuciya, amai, ciwon ciki, rashin jin daɗi ko nauyi a cikin hanji, zawo, haɓaka ayyukan hanta, hanji, cholestasis, hepatitis (haɗe da haɓaka hanta).
Bayyanar bayyanar cututtuka: fatar fata, itching, urticaria na iya faruwa. Yawanci, ana gabatar da irin waɗannan halayen na ɗan lokaci, amma wani lokacin za su iya ci gaba, tare da breatharancin numfashi (har zuwa haɓakar girgiza ƙwayar anaphylactic), raguwar hauhawar jini. Reactionwayar rashin lafiyar giciye tare da wasu abubuwan da aka samo na sulfonylurea, sulfonamides ko sulfonamides mai yiwuwa ne, kazalika da haɓakar rashin lafiyar ƙwayar cuta.
Sauran: a wasu halaye, ci gaban marigayi cutaneous porphyria, daukar hoto, hyponatremia, asthenia, da ciwon kai yana yiwuwa.

Aikin magunguna

Glemaz magani ne na baka. Babban sinadaran da ke aiki da maganin shine glimepiride, wanda ke tayar da ruɗani da sakin insulin daga ƙwayoyin cells-pancreatic ((tasirin ƙwayar cuta), yana inganta yanayin jijiyoyin jiki (tsoka da mai) zuwa aikin insulin nasa (ƙari-pancreatic sakamako).

Tare da yin shigar guda guda, kodan sun wuce zuwa kashi 60% na kashin da aka dauka, ragowar 40% suna shiga cikin hanji. Ba'a gano abu mai canzawa a cikin fitsari ba. T_1/2 a plasma maida hankali ne na miyagun ƙwayoyi a cikin magani daidai da yawancin allurai allurai, shine 5 - 8. sa'o'i a cikin T zai yiwu_1/2 bayan shan magunguna a allurai.

Yawan abin sama da ya kamata

Dangane da sake duba Glemaz, bayan shan magunguna masu yawa, hypoglycemia na iya haɓaka, yana ɗaukar awanni 12-72, wanda za'a sake maimaitawa bayan dawo da matakan glucose na al'ada.

Hypoglycemia yana bayyana ta: ƙara yawan shaye-shaye, tachycardia, damuwa, bugun zuciya, haɓaka jini da ci, tashin zuciya, ciwon kai, arrhythmia, tsananin farin ciki, amai, tashin zuciya, tashin zuciya, damuwa, rashin tsoro, tashin hankali, rage yawan damuwa, rikicewa, , paresis, rawar jiki, rashi, rashin nutsuwa, laima.

Domin bi da yawan abin sama da ya kamata, ya zama dole ne a sanya amai a cikin mara lafiyar. Hakanan ana nuna babban abin sha tare da sodium picosulfate da gawayi mai aiki.

Idan aka yi amfani da magunguna masu yawa, to ana yin lavage na ciki, sannan an gabatar da sodium picosulfate da gawayi, bayan an gabatar da dextrose. Treatmentarin magani yana nuna alama.

Yin hulɗa tare da wasu kwayoyi

Tare da amfani da maganin a lokaci daya tare da:

Metformin, insulin, sauran baka hypoglycemic jamiái, allopurinol, ACE hanawa, ɗa namiji hormones, anabolic steroids, chloramphenicol, cyclophosphamide, coumarin Kalam, ifosfamide, trofosfamide, fibrates, fenfluramine, sympatholytic, fluoxetine, Mao hanawa, pentoxifylline, miconazole, probenecid, phenylbutazone , oxyphenbutazone, azapropazone, salicylates, abubuwan quinolone, tetracyclines, sulfinpyrazone, fluconazole, tritokvalin - yana faruwa da lethality na hypoglycemic sakamako,
Acetazolamide, diazoxide, barbiturates, saluretics, glucocorticosteroids, thiazide diuretics, epinephrine, glucagon, nicotinic acid da abubuwan da yake dashi, abubuwan da ke haifar da kwayoyin halittar sitothiazine, estrogens da progestogens, kwayoyin hormones thyroid - sakamakon tasirinsa mai rauni,
Tarihin H bloams₂-receptors, clonidine, barasa - zasu iya raunanawa da haɓaka tasirin hypoglycemic,
Ta hanyar kwayoyi waɗanda ke hana haɓakar ƙwaƙwalwar kashi, haɗarin myelosuppression yana ƙaruwa.