Golda MV

Ana samun magungunan a cikin nau'ikan Allunan tare da sakewa mai saki: farar fata ko fari tare da tint mai launin rawaya, zagaye, lebur-sililin, tare da bevel, akan allunan tare da sashi na 60 MG akwai haɗarin rabuwa (don sashi na 30 MG: 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 120, 150, 180, 200 ko 300 inji a cikin gwangwani, a cikin kwali na kwali 1 na iya, pcs guda 10. A cikin fakitin bokaye, a cikin kwali na fakiti 1-10 fakitoci, don sashi 60 mg: 10, 20, 25, 30, 40, 50, 60, 70, 75, 80, 84, 90, 100, 120, 125, 140, 150, 180, 250, ko 300 a cikin gwangwani, a cikin kwali 1 zai iya, cikin fakiti mai laushi: 10 inji mai kwakwalwa., Per fakiti fakiti 1-10, 7 inji mai kwakwalwa,, a cikin fakitin fakiti 2, 4, 6, 8 ko fakitoci 10. Kowace fakitin kuma yana da umarnin don amfani da Golda MV).

Kwamfutar hannu 1 ya ƙunshi:

• abu mai aiki: gliclazide - 30 ko 60 mg,
• abubuwan taimako: lactose monohydrate, sitaci carboxymethyl sitaci (nau'in C), hypromellose 2208, silloon silicon dioxide, magnesium stearate.

Pharmacodynamics

Golda MV magani ne na baki na hypoglycemic. Gliclazide, abu ne mai aiki, tushen juyi ne na fitarwa na sulfonylurea na ƙarni na biyu. An bambanta ta da irin waɗannan kwayoyi ta gaban ƙarar heterocyclic ringi na N-tare da haɗin endocyclic. Glyclazide yana ƙarfafa ƙwayar insulin ta ƙwayoyin beta na tsibirin na Langerhans, yana rage haɗuwar glucose a cikin jini. Bayan shekaru biyu na jiyya, sakamakon ƙara yawan taro na postprandial insulin da C-peptide ya ci gaba.

Tare da tasirin metabolism na metabolism, yana da tasirin jini. A cikin nau'in 2 na ciwon sukari na mellitus, gliclazide yana taimakawa wajen dawo da farkon farkon ƙwayar insulin a cikin martani ga ciwan glucose da haɓaka kashi na biyu na ɓoye insulin. Insulin ƙwayar insulin yana ƙaruwa sosai akan yanayin ƙarfafa saboda yawan abinci da gudanarwar glucose.

Sakamakon hemovascular na gliclazide an nuna shi ta hanyar rage haɗarin ƙananan ƙwayar thrombosis. A wani ɓangare na hana haɗuwar platelet da adhesion, rage matakin maida hankali akan abubuwan kunna faranti (thromboxane B2, beta-thromboglobulin). Yana taimakawa haɓaka ayyukan ƙwayar plasminogen mai kunnawa, yana da tasirin sakamako kan maido da aikin fibrinolytic na ƙwayar jijiyoyin bugun jini.

A cikin marasa lafiya tare da glycemic haemoglobin (Hb_A1c) kasa da 6.5%, yin amfani da gliclazide yana ba da izinin sarrafa glycemic m, yana rage mahimmancin rikice-rikice na micro-da macro-vascular of type 2.

Dalilin gliclazide don mahimmancin sarrafa glycemic mai ƙarfi ya haɗa da ƙara yawan ƙwayar ta a hade tare da daidaitaccen aikin likita (ko kuma a maimakon sa) kafin ƙara metformin, wani abu mai mahimmanci na thiazolidinedione, inhibitor na alpha-glucosidase, insulin ko wasu wakili na hypoglycemic a ciki. Sakamakon bincike na asibiti ya nuna cewa a kan bangon asali na amfani da gliclazide a cikin matsakaita na yau da kullun na 103 mg (matsakaicin kashi - 120 mg) idan aka kwatanta da daidaitaccen kulawa na kulawa, haɗarin haɗari na haɗakar mitar macro-da rikitarwa na microvascular an rage shi da 10%.

Abubuwan da ke tattare da kulawar glycemic mai ƙarfi yayin ɗaukar Golda MV sun haɗa da raguwa na asibiti a cikin abubuwanda suka haifar da rikice-rikice kamar manyan rikicewar microvascular (ta hanyar 14%), nephropathy (ta hanyar 21%), rikice-rikice na koda (11%), microalbuminuria (ta 9%) , macroalbuminuria (30%).

Pharmacokinetics

Bayan an dauki Golda MV a baki, glycazide ya sha duka, matakin plasma dinsa zai tashi a hankali kuma ya kai ga a cikin filayen cikin awa 6-12. Abincin abinci na lokaci daya baya shafar matakin sha, bambance bambancen mutum ya zama sakaci. Gliclazide a cikin adadin har zuwa 120 MG ana bayyanar da shi ta hanyar alaƙar laushi tsakanin takaddara da aka karɓa da AUC (yanki a ƙarƙashin ɓarna-lokaci na kantin magani).

Haɗawa ga furotin jini na jini - 95%.

Ofimar rarraba shine kusan lita 30. Singleaya daga cikin kashi na gliclazide yana tabbatar da cewa ingantaccen taro a cikin jini yana kiyaye fiye da sa'o'i 24.

Gliclazide yana cikin metabolized a cikin hanta. Babu metabolites mai aiki a cikin jini na jini.

Cire rabin rayuwar shine 12-20 hours.

An cire shi a cikin mafi yawa ta hanyar kodan a cikin hanyar metabolites, canzawa - kasa da 1%.

A cikin tsofaffi marasa lafiya, ba a tsammanin canje-canje masu mahimmanci a cikin sigogin kantin magani.

Alamu don amfani

• lura da nau'in ciwon sukari na 2 na rashin lafiya - in babu isasshen tasirin maganin abinci, aikin jiki da asarar nauyi,
• rigakafin rikice-rikice a cikin marasa lafiya da ke fama da ciwon sukari na 2 na cuta - rage hadarin microvascular (retinopathy, nephropathy) da macrovascular (myocardial infarction, bugun jini) pathologies ta hanzarta sarrafa glycemic.

Contraindications

• nau'in ciwon sukari guda 1
• karin sukari, kamuwa da cutar sankara,
• mai ciwon sukari ketoacidosis,
• mai rauni na koda
• mai tsanani hanta,
• concomitant far tare da miconazole,
• Haɗa tare da danazol ko phenylbutazone,
• rashin daidaituwa tsakanin lactose, galactosemia, glucose-galactose malabsorption,
• lokacin haihuwa
• nono
• shekaru zuwa shekaru 18
• rashin jituwa ga asalin abubuwan da suka samo asali daga sulfonylurea, sulfonamides,
• rashin hankali ga abubuwan da ke cikin miyagun ƙwayoyi.

Ya kamata a yi amfani da allunan zinare na Zinare tare da taka tsantsan a cikin tsofaffi marasa lafiya da rashin daidaituwa da / ko abinci mai daidaitawa, mummunan cututtuka na tsarin zuciya da jijiyoyin jini (cututtukan zuciya mai tsauri, atherosclerosis, cututtukan carotid arteriosclerosis), glucose-6-phosphate dehydrogenase rashi, renal da / ko gazawar hanta, adrenal ko pituitary insufficiency, hypothyroidism, jinya mai tsawo tare da glucocorticosteroids (GCS), shan giya.

Golda MV, umarnin don amfani: hanyar da sashi

Ana ɗaukar allunan zinari na MV a baki, suna haɗiye duka (ba tare da taunawa ba), zai fi dacewa yayin karin kumallo.

Ana ɗaukar maganin yau da kullun sau ɗaya kuma ya kamata ya kasance cikin kewayon daga 30 zuwa 120 MG.

Ba za ku iya sake maye gurbin kwatankwacin kashi na gaba ba a cikin kashi na gaba, ɗaukar ƙarin ƙaruwa.

An zaɓi kashi na gliclazide daban-daban, yin la'akari da matakin daidaituwa na glucose a cikin jini da kuma bayanan Hb_A1c.

Sanarwa da aka ba da shawarar: kashi na farko shine 30 MG (1 kwamfutar hannu kwalajin MG 30 na zinari ko Gold kwamfutar hannu M Gold MV 60 MG 60). Idan adadin da aka nuna yana ba da isasshen ikon sarrafawa, to ana iya amfani dashi azaman maganin kiyayewa. A cikin rashin isasshen sakamako na asibiti bayan kwanaki 30 na maganin, ana fara samun kashi na farko a cikin yawan adadin 30 MG (har zuwa 60, 90, 120 MG). A cikin lokuta na musamman, idan matakin glucose na mai haƙuri bai ragu ba bayan kwanakin 14 na maganin, zaku iya ci gaba don ƙara yawan kashi 14 bayan farawar gudanarwa.

Matsakaicin adadin yau da kullun shine 120 MG.

Idan kun canza daga ɗaukar allunan glyclazide na kwatsam a kan 80 MG, ya kamata ku fara ɗaukar allunan sakin bayanai tare da kashi 30 MG, tare da magani tare da kulawa da hankali glycemic.

Lokacin canzawa zuwa Golda MV tare da wasu magungunan hypoglycemic, ba a buƙatar lokacin juyawa. Kashi na farko na gliclazide a cikin allunan kwaskwarimar da aka sake wanda yakamata yakamata ya zama 30 MG, yakasance yakamata ya dogara da yawan glucose a cikin jini.

Lokacin yin fassarar, yakamata yayi la'akari da kashi da rabin rayuwar maganin da ya gabata na hypoglycemic. Idan abubuwan maye gurbin sulfonylurea tare da tsawon rayuwar rabin, to, za a iya dakatar da dukkanin wakilan hypoglycemic na kwanaki da yawa. Wannan zai guje wa hypoglycemia saboda ƙari sakamakon tasirin glycoslazide da kuma abubuwan da aka samo asali na sulfonylurea.

Amfani da Golda MV a hade tare da inhibitors na alpha-glucosidase, biguanides ko insulin ya nuna.

Marasa lafiya tsofaffi (sama da 65) ba sa buƙatar gyaran kashi.

A cikin lalacewa mai sauƙi zuwa gazawar ƙididdigar matsakaici, ba a buƙatar daidaita sashi ba.

An ba da shawarar yin amfani da mafi ƙarancin kashi (30 MG) na gliclazide na tsawon lokaci don kula da marasa lafiya a cikin haɗarin haɓaka haɓaka, rashin daidaituwa ko abinci mara daidaituwa, mummunan rashi ko ƙarancin raunin endocrine, hypothyroidism, mummunan cututtuka na tsarin zuciya, lokacin bayan tsawaita amfani da / ko gudanarwa a babban allurai. glucocorticosteroids (GCS).

Yin amfani da Golda MV ban da abinci da motsa jiki don hana rikice-rikice na nau'in ciwon sukari na 2 ya kamata a fara tare da kashi 30 MG. Don cimma mummunar sarrafawa mai ƙarfi da manufa matakan Hb_A1c kashi na farko za a iya ƙara hankali zuwa matsakaicin adadin na 120 MG kowace rana. Dalilin miyagun ƙwayoyi don manufar sarrafa glycemic mai ƙarfi yana nunawa a hade tare da metformin, inhibitor na alpha-glucosidase, mai thiazolidinedione, insulin da sauran wakilai na hypoglycemic.

Side effects

Tare da watsi da abinci na gaba ko rashin daidaitaccen abinci na yau da kullun, alamu masu zuwa na hypoglycemia na iya bayyana: karuwar gajiya, matsananciyar yunwar, ciwon kai, jinkirta lokaci, tashin zuciya, matsananciyar damuwa, rage yawan damuwa, tsananin farin ciki, rauni, tashin hankalin barci, tashin hankali, tashin hankali, rikicewa, ciki, gurguwar hangen nesa da magana, paresis, aphasia, rawar jiki, asarar iko da kai, tsinkaye mara kyau, jin rashin taimako, rashi, numfashi mara nauyi, bradycardia, rashi, nutsuwa, matsi. st, asarar sani, coma (ciki har da m), adrenergic martani - ƙara sweating, juyayi, clammy fata na jiki, tachycardia, ta ƙara jini (jini), arrhythmia, palpitations, angina pectoris. Sakamakon binciken asibiti ya nuna cewa lokacin amfani da miyagun ƙwayoyi don manufar sarrafa glycemic m, hypoglycemia yana faruwa sau da yawa fiye da daidaitaccen sarrafa glycemic. Yawancin lokuta na hypoglycemia a cikin ƙwayar glycemic mai ƙarfi ya faru a kan asalin maganin kwantar da hankali na insulin.

Kari akan haka, akasin amfani da Golda MV, tasirin sakamako masu zuwa na iya haɓaka:

• daga jijiyoyin ciki: zafin ciki, tashin zuciya, amai, gudawa, zawo,
• daga jijiyoyin jini da jijiyoyin jini: da wuya - thrombocytopenia, anaemia, leukopenia, granulocytopenia,
• daga tsarin hepatobiliary: karuwar ayyukan alkaline phosphatase, ACT (aspartate aminotransferase), ALT (alanine aminotransferase), hepatitis, cholestatic jaundice,
• a bangare na hangen nesa: na yau da kullun rikicewar gani (mafi yawa a farkon farji),
• halayen cututtukan cututtukan fata: itching, kurji, maculopapular rash, urticaria, erythema, Quincke's edema, mummunan halayen (ciki har da ciwo na Stevens-Johnson, guba mai guba)
• sauran (sakamako masu illa na abubuwan da suka samo asali na maganin sulfonylurea): haemolytic anemia, erythrocytopenia, agranulocytosis, vasculitis rashin lafiyan, pancytopenia, hyponatremia, jaundice, gajiya hanta.

Yawan abin sama da ya kamata

Bayyanar cututtuka: tare da yawan wuce gona da iri, alamomin halayyar ƙwayar cuta na haɓaka.

Jiyya: don dakatar da alamu na matsakaici na hypoglycemia (ba tare da alamun cututtukan zuciya da ƙwarewar hankali ba), ya zama dole a ƙara yawan ƙwayar carbohydrate, rage yawan adadin Golda MV da / ko canza abincin. Ana nuna kulawa sosai game da yanayin likita game da yanayin haƙuri.

Tare da bayyanar mummunan yanayin hypoglycemic (coma, convulsions da sauran rikicewar asali na asali), ana buƙatar asibiti nan da nan.

Kulawa ta gaggawa na likita don rashin lafiyar hypoglycemic ko tuhumarta ta ƙunshi allurar ciki (iv) na maganin 20-30% na dextrose (glucose) a cikin kashi 50 ml, na biye da iv drip na maganin 10% na dextrose, wanda ke kula da matakin yawan glucose a cikin jini sama da 1 g / l. Ya kamata a ci gaba da sanya ido sosai game da yanayin mai haƙuri da saka idanu akan tattarawar glucose na jini don awanni 48 masu zuwa.

Rashin daidaituwa ba shi da tasiri.

Umarni na musamman

Golda MV ya kamata a tsara shi kawai idan abincin mai haƙuri ya haɗa da karin kumallo, kuma abinci mai gina jiki na yau da kullun ne. Wannan yana da alaƙa da babban haɗarin haɓakar haɓaka, ciki har da siffofi masu tsauri da tsawan gaske da ke buƙatar asibiti da gudanar da iv na maganin dextrose na kwanaki da yawa. Yayin cinikin Golda MV, yana da matukar muhimmanci a tabbatar da isasshen wadataccen carbohydrates a jiki tare da abinci. Abinci na yau da kullun, rashin wadataccen abinci, ko abinci mara kyau na carbohydrate na iya haifar da cututtukan jini. Mafi sau da yawa, ana ganin ci gaban hypoglycemia a cikin marasa lafiya waɗanda ke bin abincin mai ƙarancin kalori, bayan matsanancin motsa jiki ko tsawan jiki, shan giya ko lokacin da ake hulɗa tare da wakilai na hypoglycemic da yawa a lokaci guda. Yawancin lokaci, abinci mai gina jiki na carbohydrate (gami da sukari) zai iya taimakawa rage alamun cututtukan hypoglycemia. A wannan yanayin, maye gurbin sukari ba su da tasiri. Ya kamata a ɗauka a hankali cewa hypoglycemia na iya sake komawa. Sabili da haka, idan hypoglycemia yana da alamun bayyanar cututtuka ko yanayin tsawanta, duk da tasirin shan abinci mai wadataccen abinci na carbohydrate, kuna buƙatar neman taimakon likita na gaggawa.

Lokacin zartar da Golda MV, likita ya kamata ya sanar da mai haƙuri dalla-dalla game da ilmin likitancin da kuma buƙatar tsananin bin tsarin kulawa, daidaitaccen abinci da aikin jiki.

Dalilin ci gaban hypoglycemia shine rashin ƙarfi na mara haƙuri ko rashin yarda (musamman a cikin tsufa) don bin shawarwarin likita da kuma sarrafa matakan sukari na jini, isasshen abinci mai gina jiki, canji a abinci, abincin tsallake abinci ko yunwar, rashin daidaituwa tsakanin aikin jiki da adadin carbohydrates da aka ɗauka, rashin ƙarfi na hanta. , gazawar koda, ƙwayar ƙwayar cuta, ƙwayar ƙwayar cuta da ƙarancin ƙwayar cuta da / ko cutar thyroid.

Bugu da kari, hypoglycemia na iya yin ma'amala da gliclazide tare da magungunan kwantar da hankali. Sabili da haka, mai haƙuri ya kamata ya yarda da kowane likita game da shan kowane magani.

Lokacin zartar da Golda MV, likita ya kamata ya sanar da mara lafiya da membobin gidansa dalla-dalla game da haɗarin da ke tattare da haɗari da fa'idar jiyya mai zuwa, mahimmancin bin abincin da aka ba da shawarar da saiti na motsa jiki, da yiwuwar sa ido na yau da kullun na matakan glucose jini.

Don kimanta ikon sarrafa glycemic, Hb ya kamata a auna a kai a kai._Alc.

Ya kamata a ɗauka a cikin zuciya cewa tare da hepatic mai ɗorewa da / ko lalacewar ƙoshin na koda, yanayin hypoglycemia na iya tsawaita tsawon lokaci kuma yana buƙatar magani da ya dace nan da nan.

Thearjin da ake samu na motsa jiki na iya yin rauni ta hanyar kamuwa da zazzabi, cututtuka, raunin da ya shafi jijiyoyi. A cikin waɗannan yanayin, yana da kyau don canja wurin mai haƙuri zuwa insulin far.

Rashin tasiri na gliclazide bayan dogon lokacin magani na iya zama saboda juriya na magungunan sakandare, wanda shine sakamakon ci gaba da cutar ko raguwa a cikin martani na asibiti game da miyagun ƙwayoyi. Lokacin da ake bincika juriya na magani na sakandare, ya zama dole don tabbatar da cewa mai haƙuri ya bi abin da aka tsara da kuma tantance cancantar da adadin Golda MV da aka ɗauka.

Tare da rashi na glucose-6-phosphate dehydrogenase, yin amfani da abubuwan ƙira na sulfonylurea yana ƙara haɗarin cutar haemolytic. Saboda haka, don kula da marasa lafiya da raunin glucose-6-phosphate dehydrogenase, yakamata a fifita wakilan hypoglycemic na wata ƙungiyar.

Hulɗa da ƙwayoyi

• miconazole: tsari na miconazole ko amfani dashi a cikin nau'i na gel a kan mucosa na haifar da haɓaka sakamako na hypoglycemic na gliclazide, wanda zai iya haifar da haɓakar cutar hauhawar jini har zuwa hauhawar jini,
• phenylbutazone: haɗuwa tare da nau'ikan nau'ikan phenylbutazone yana haɓaka sakamako na hypoglycemic na Golda MV, sabili da haka, idan ba zai yiwu a tsara wani maganin anti-mai kumburi ba, ya zama dole don daidaita sashin glyclazide duka biyu yayin gudanar da phenylbutazone da bayan cirewa,
• ethanol: yawan shan giya ko kwayoyi masu dauke da kwayoyi na ethanol suna hana sakamako diyya, wanda kan iya haifar da hauhawar hauhawar jini ko haɓakar ƙwayar cuta,
• sauran wakilai na hypoglycemic (insulin, acarbose, metformin, thiazolidinediones, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists), beta-blockers, fluconazole, angiotensin suna canza enzyme inhibitors (masu toshe hanzari, da sauransu).₂Masu karɓar -histamine, monoamine oxidase inhibitors, sulfonamides, clarithromycin, magungunan anti-steroidal anti-inflammatory: haɗuwa da waɗannan kwayoyi tare da glycazide yana haɗuwa tare da karuwa a cikin aikin Golda MV da haɓakar haɗarin hypoglycemia,
• danazol: sakamakon diabetogenic danazol yana taimaka wajan rage tasirin gliclazide,
• chlorpromazine: allurai na yau da kullun (sama da 100 akan mg) na chlorpromazine suna rage insulin, suna ba da gudummawa ga haɓakar taro na jini. Saboda haka, tare da concomitant antipsychotic far, zaɓi na kashi na gliclazide da hankali glycemic iko, gami da bayan dakatar da chlorpromazine, ana buƙatar,
• tetracosactide, GCS don amfani da tsari da amfani da karfi: rage haɓakar carbohydrate, ba da gudummawa ga karuwar cutar glycemia da haɗarin haɓaka ketoacidosis. Ana buƙatar kulawa da hankali game da matakan glucose na jini, musamman a farkon aikin haɗin gwiwa, idan ya cancanta, daidaita kashi na gliclazide,
• ritodrin, salbutamol, terbutaline (iv): ya kamata a lura da cewa beta₂-adrenomimetics yana haɓaka matakin glucose a cikin jini, sabili da haka, idan aka haɗu da su, marasa lafiya suna buƙatar sarrafa kansa na glycemic na yau da kullun, yana yiwuwa don canja wurin mai haƙuri zuwa maganin insulin,
• warfarin da sauran magungunan anticoagulants: gliclazide na iya ba da gudummawa ga gagarumar karuwa a cikin tasirin maganin rashin ƙarfi na anticoagulants.

Analogs na Golda MV sune: Diabetalong, Glidiab, Gliclada, Gliclazide Canon, Gliclazide MV, Gliclazide-SZ, Gliclazide-Akos, Diabeton MB, Diabinax, Diabefarm, Diabefarm MV, da dai sauransu.

Ra'ayoyi game da Gold MV

Reviews game da Gold MV mai rikitarwa ne. Marasa lafiya (ko danginsu) suna nuna saurin cimma nasarar isasshen sakamako na rage sukari yayin ɗaukar ƙwayoyi, yayin da akwai haɗarin haɗarin hauhawar jini da sauran tasirin sakamako. Bugu da ƙari, kasancewar contraindications ana ɗaukarsa a matsayin hasara.

A lokacin gudanar da Golda MV, ana bada shawara don tsayar da ƙayyadadden tsarin rage cin abinci da abinci, sarrafa kullun na sukari na jini.