Diabetalongzen, nemo, siyan

Sunan kasuwanci na shirye-shiryen: Diabetalong

Sunan kasa da kasa mai zaman kansa: Gliclazide (Gliclazide)

Tsari sashi: Allunan sakewa Allunan

Aiki mai aiki: Gliclazide (Gliclazide)

Rukunin Magunguna: Hypoglycemic wakili don baka na sarrafa na sulfonylurea rukuni na biyu.

Propertiesungiyoyin magunguna:

Oral hypoglycemic magani, mai sulfonylurea mai asali na ƙarni na biyu.

Yana karfafa rufin insulin ta hanyar farji, yana rage matakin glucose a cikin jini, yana inganta tasirin insulin-siririn glucose kuma yana kara karfin jijiyoyin jiki zuwa insulin. Bayan shekaru 2 na jiyya, yawancin marasa lafiya ba sa ci gaba da jaraba ga ƙwayoyi (ƙara yawan matakan insprandial insulin da ɓoye na C-peptides ya kasance).

Yana rage tazara daga lokacin cin abinci har zuwa farkon insulin insulin. Yana dawo da farkon farkon kwayar insulin a cikin martani ga karuwar glucose (sabanin sauran abubuwanda suka samo asali, wadanda suke da tasirin gaske a yayin mataki na biyu na rayuwa). Hakanan yana haɓaka kashi na biyu na ɓoye insulin. Yana rage kololuwar hyperglycemia bayan cin abinci (yana rage hyperglycemia postprandial).

Glyclazide yana ƙaruwa da hankalin jijiyoyin ƙwararrun ƙwayoyin zuwa insulin (i.e., yana da tasirin sakamako na extrapancreatic). A cikin ƙwayar tsoka, sakamakon insulin akan tasirin glucose, saboda haɓakar jijiyar nama zuwa insulin, yana ƙaruwa sosai (har zuwa + 35%), tunda glycazide yana ƙarfafa ayyukan tsoka glycogen synthetase.

Yana rage samuwar glucose a cikin hanta, yana daidaita dabi'ar glucose mai azumi.

Baya ga shafar metabolism, gliclazide yana inganta microcirculation. Magungunan yana rage haɗarin ƙananan ƙwayar jini na jini, yana haifar da hanyoyin guda biyu waɗanda zasu iya shiga cikin ci gaba da rikice-rikice a cikin ciwon sukari mellitus: hanawa da tarawar platelet da adhesion da raguwa a cikin abubuwanda ke haifar da abubuwa na faranti (beta-thromboglobulin, thromboxane B2), kazalika da sake dawo da fibrinolytic Aiki na jijiyoyin bugun zuciya da haɓaka aikin ƙwaƙwalwar ƙwayar jini.

Glyclazide yana da kaddarorin antioxidant: yana rage matakin liro peroxides a cikin plasma, yana ƙara yawan ayyukan ƙwayar sel jini superoxide dismutase.

Sakamakon sifofin nau'in sashi, yawan kwayoyi na Diabetalong 30 allunan kwayoyi suna ba da ingantaccen maida hankali ne game da gliclazide a cikin jini a cikin awowi 24.

Bayan gudanar da baki, gliclazide yana cikin komai daga narkewa. Cin abinci baya tasiri sha. Yawan maida hankali akan abu mai aiki a cikin jini jini sannu a hankali yana ƙaruwa a hankali, ya kai iyawa har ya kai ga awo a cikin awoyi 6-12 bayan shan maganin. Musamman daidaiku yana da ɗan ƙanƙantar da hankali. Dangantaka tsakanin kashi da maida hankali ga miyagun ƙwayoyi a cikin jini shine dogarawar kan layi akan lokaci.

Rarraba da metabolism

Shafaffen furotin na Plasma kusan 95%.

Yana cikin metabolized a cikin hanta kuma an cire shi gaba ɗaya ta kodan. Babu ƙwayoyin metabolites mai aiki a cikin jini.

Shaƙatawa da kodan yana gudana ne a cikin hanyar metabolites, ƙasa da 1% na miyagun ƙwayoyi an keɓance shi ba a canzawa.

T1 / 2 kimanin awa 16 ne (awanni 12 zuwa 20).

Pharmacokinetics a cikin lokuta na musamman na asibiti

A cikin tsofaffi, babu canje-canje mai mahimmanci a cikin sigogi na pharmacokinetic.

Alamu don amfani:

- Nau'in mellitus na ciwon siga na 2 a haɗe tare da maganin rage cin abinci tare da rashin isasshen abinci da motsa jiki.

Yarjejeniyar:

- nau'in ciwon sukari na 1

- mai ciwon sukari ketoacidosis, mai ciwon sukari, mai ciwon sukari,

Mai tsananin cutar koda da / ko hanta,

- shekaru har zuwa shekaru 18

- lokacin shayarwa (noctation),

- rashin daidaituwa na lactose, karancin lactase ko gubar glucose-galactose malabsorption,

- Hypersensitivity to gliclazide ko wani daga cikin magabata na miyagun ƙwayoyi, zuwa wasu abubuwan da suka samo asali na sulfonylurea, zuwa ga sulfonamides.

Ba'a ba da shawarar yin amfani da miyagun ƙwayoyi a lokaci ɗaya a hade tare da phenylbutazone ko danazole.

Tare da taka tsantsan: tsufa, rashin daidaituwa da / ko abinci mai daidaitawa, cututtukan cuta masu rauni na zuciya (ciki har da cututtukan zuciya da jijiyoyin zuciya, atherosclerosis), cututtukan zuciya, rashin haihuwa ko rashin wadatar zuciya, rashin ƙarfi a cikin jiki, rashin ƙarfi a cikin hanji, / koda kuma gazawar hanta, tsawaitawa tare da corticosteroids, barasa, gubar glucose-6-phosphate dehydrogenase.

Haihuwa da lactation

Babu gwaninta tare da gliclazide yayin daukar ciki. Bayanai game da amfani da wasu abubuwan da ake amfani da su na sulfonylurea yayin daukar ciki suna iyakatacce.

A cikin bincike a kan dabbobi na dakin gwaje-gwaje, ba a gano tasirin teratogenic na gliclazide ba.

Don rage haɗarin rikice-rikice na haihuwar haihuwa, ingantaccen iko (magani mai dacewa) na ciwon sukari mellitus ya zama dole.

Ba'a amfani da magungunan maganin ƙwayar cuta na baka a lokacin daukar ciki. Magungunan zabi don magance cututtukan cututtukan ƙwayar cuta a cikin mata masu ciki shine insulin. An bada shawara don maye gurbin ci na maganin ƙwayoyin cuta hypoglycemic na baki tare da maganin insulin duka a cikin yanayin da aka shirya yin ciki, kuma idan ciki ya faru yayin shan maganin.

Yin la'akari da rashin bayanai game da cin gliclazide a cikin madara da kuma hadarin haɓaka ƙarancin ƙwayar cuta, an shayar da jarirai nono yayin maganin ƙwayoyi.

Yi amfani da shi don aikin hanta mai rauni

Tare da taka tsantsan a cikin hanta gazawar.

- mai girma renal da / ko hanta gazawar.

Yi amfani da shi don aikin keɓaɓɓiyar aiki

A cikin marasa lafiya tare da gazawar matsakaici na matsakaici zuwa matsakaici, an sanya maganin a daidai gwargwado kamar yadda a cikin marasa lafiya da keɓaɓɓen aikin na koda. A cikin gazawar rashin aiki mai girma, Diabetalong yana contraindicated.

Yi amfani da yara

Contraindicated a cikin yara a karkashin 18 shekara.

Yi amfani a cikin marasa lafiya tsofaffi

Ga marasa lafiya waɗanda ba su karɓi magani a baya ba (ciki har da ga waɗanda suka girmi shekaru 65), kashi na farko shine 30 MG. Sannan an zabi kashi daban daban har sai an sami sakamako mai warkewa.

Yin hulɗa tare da wasu kwayoyi:

Glyclazide yana haɓaka tasirin maganin anticoagulants (warfarin); ana iya buƙatar daidaita kashi na maganin anticoagulant.

Miconazole (tare da gudanarwa na tsari da kuma lokacin amfani da gel a kan mucosa na bakin) yana haɓaka tasirin maganin ƙwaƙwalwar ƙwayar cuta (hypoglycemia na iya haɓaka har zuwa coma).

Phenylbutazone (gudanarwa na tsari) yana haɓaka tasirin maganin ƙwaƙwalwar ƙwayar cuta (ƙauracewar saboda kariyar plasma da / ko jinkirin cirewa daga jiki), sarrafa glucose na jini da daidaita sakin glyclazide ya zama dole, duka yayin gudanar da phenylbutazone da bayan cirewa.

Ethanol da ethanol-dauke da kwayoyi suna haɓaka maganin hypoglycemia, yana hana halayen ramuwar gayya, na iya ba da gudummawa ga ci gaban ƙwaƙwalwar ƙwayar cuta.

Yayin shan tare da wasu magungunan hypoglycemic (insulin, acarbose, biguanides), beta-blockers, fluconazole, ACE inhibitors (captopril, enalapril), bloam ɗin masu karɓar maganin Hipambo (cimetidine), MAO inhibitors, hypoglycemic da sulfanilamides da alama hadarin kamuwa da cututtukan jini.

Tare da amfani da concoitant tare da danazol, an lura da sakamako masu ciwon sukari. Wajibi ne don kula da matakin glucose na jini da daidaita sashin gliclazide, duka a lokacin mulkin danazol da kuma bayan an cire shi.

Chlorpromazine a cikin allurai masu yawa (fiye da 100 mg / rana) yana ƙara yawan abubuwan glucose a cikin jini, yana rage ɓoye insulin. Wajibi ne don sarrafa glucose na jini da daidaita kashi na gliclazide, duka a lokacin gudanar da chlorpromazine da bayan cirewa.

GCS (na tsari, intraarticular, waje, gudanarwa na rectal) yana ƙara yawan glucose na jini tare da yiwuwar ci gaban ketoacidosis (raguwa cikin haƙuri ga carbohydrates). Wajibi ne don sarrafa glucose na jini da daidaita sashin gliclazide duka biyu yayin gudanar da GCS da kuma bayan an cire su.

Ritodrine, salbutamol, terbutaline (iv) suna ƙara yawan glucose na jini. Ana ba da shawarar sarrafa glucose na jini kuma, idan ya cancanta, canja mai haƙuri zuwa insulin far.

Sashi da gudanarwa:

Magungunan an yi shi ne kawai don maganin manya.

Allunan kwalaben tare da ingantaccen sakin na 30 MG ana shan su a baki sau 1 / rana yayin karin kumallo.

Dole a aiwatar da zaɓin gwargwado daidai da matakin glucose a cikin jini bayan farawar magani. Kowane kashi na iya canzawa bayan akalla sati biyu.

Yawan maganin yau da kullun na iya bambanta daga MG 30 (1 tab.) Zuwa 90-120 mg (3-4 shafin.). Maganin yau da kullun yakamata ya wuce 120 MG (4 Allunan).

Diabetalong na iya maye gurbin allunan gliclazide waɗanda aka saba (80 MG) a allurai na 1 zuwa 4 Allunan / rana.

Idan ka rasa magunguna ɗaya ko sama da ɗaya, baza ku iya ɗaukar babban magani ba a kashi na gaba (gobe).

Lokacin maye gurbin wani magani na hypoglycemic tare da Allunan 30 na Diabetalong® 30 mg, babu lokacin canzawa da ake buƙata. Dole ne a fara dakatar da shan kullun na wani magani kuma gobe kawai za a fara shan wannan magani.

Idan mara lafiya ya taɓa karɓar magani tare da sulfonylureas tare da tsawon rabin rayuwa, to, saka idanu a hankali (saka idanu akan glucose na jini) don makonni 1-2 ya zama dole don guje wa hypoglycemia sakamakon sakamakon tasirin maganin da ya gabata.

Ana iya amfani da Diabetalong a hade tare da biguanides, alpha glucosidase inhibitors ko insulin.

A cikin marasa lafiya da ke cikin haɗarin haɓakar hypoglycemia (isasshen abinci mai gina jiki ko rashin daidaituwa, mummunan cuta ko raunin endocrine - damuwa da rashin ƙarfi, hypothyroidism, sakewa na glucocorticosteroids bayan tsawanta da / ko gudanarwa mai yawa, mummunan cututtuka na tsarin zuciya da jijiyoyin jini / mummunan ciwon zuciya, mummunan carotid arteriosclerosis, atherosclerosis /) ana bada shawara don amfani da mafi ƙarancin (30 MG 1 lokaci / rana) na miyagun ƙwayoyi Diabetalong.

Umarnin na musamman:

Ana gudanar da jiyya ne kawai a hade tare da ƙarancin kalori, ƙarancin carb.

Wajibi ne a kula da matakin glucose a cikin jini akai-akai a cikin komai a ciki kuma bayan cin abinci, musamman a farkon kwanakin magani tare da miyagun ƙwayoyi.

Ana iya ba da umarnin Diabetalong kawai ga marasa lafiya da ke karbar abinci na yau da kullun, wanda dole ya haɗa da karin kumallo da kuma samar da isasshen abincin carbohydrates.

Lokacin da ake rubuta magani, ya kamata a haifa a hankali cewa saboda yawan abubuwan da ake samu na maganin sulfonylurea, hypoglycemia na iya haɓakawa, kuma a wasu yanayi a cikin mummunan yanayi da tsawan lokaci, yana buƙatar asibiti da gudanarwar glucose na kwanaki. Hypoglycemia sau da yawa yana haɓaka tare da rage cin abinci mai kalori, bayan tsawanta ko motsa jiki mai ƙarfi, bayan shan giya, ko yayin shan magunguna masu yawa da yawa a lokaci guda.

Don guje wa ci gaban hypoglycemia, ana buƙatar zaɓin hankali da mutum na musamman, kazalika da samar wa mai haƙuri cikakken bayani game da maganin da aka ƙaddamar.

Tare da wuce gona da iri na jiki, da canza yanayin abinci, sauƙaƙe sashi na maganin Diabetalong ya zama dole.

Musamman kula da aikin hypoglycemic kwayoyi tsofaffi mutane ne, marasa lafiya waɗanda ba su karɓar abinci mai daidaitawa, tare da yanayin ƙasa mai rauni, marasa lafiya tare da rashin isasshen ƙwayar cuta ta pituitary-adrenal.

Beta-blockers, clonidine, reserpine, guanethidine na iya rufe alamun bayyanar cututtuka na hypoglycemia.

Ya kamata a faɗakar da marasa lafiya game da haɗarin haɗarin hauhawar jini a cikin yanayin ethanol, NSAIDs, da kuma matsananciyar yunwa.

Dangane da batun ethanol (barasa), kuma yana yiwuwa a haɓaka wata cuta ta disulfiram kamar (ciwon ciki, tashin zuciya, amai, ciwon kai).

Manyan hanyoyin tiyata da raunin da ya faru, konewa mai yawa, cututtuka masu yaduwa tare da cututtukan febrile na iya buƙatar dakatar da magungunan ƙwayar cuta na baki da kuma alƙawarin maganin insulin.

Haɓaka juriya na magungunan sakandare yana yiwuwa (dole ne a bambanta shi da na farko, wanda magani bai ba da sakamako na asibiti da ake tsammanin ba a wa’adin farko).

A kan asalin aikin maganin miyagun ƙwayoyi na Diabetalong, dole ne mai haƙuri ya yi watsi da amfani da barasa da / ko ethanol da ke ɗauke da kwayoyi da kayayyakin abinci.

A yayin jiyya tare da Diabetalong, mara lafiya dole ne a kai a kai ƙayyadadden matakan glucose da gemocosylated haemoglobin a cikin jini, da abubuwan glucose a cikin fitsari.

Tasiri kan ikon tuka motoci da hanyoyin sarrafa abubuwa

A lokacin jiyya, dole ne a kula sosai lokacin tuki motoci da shiga wasu ayyukan masu haɗari waɗanda ke buƙatar haɓakar jawo hankali da saurin halayen psychomotor.

Sakamako masu illa:

Hypoglycemia (take hakkin tsarin allurar rigakafi da rashin isasshen abinci): ciwon kai, kara gajiya, yunwa, karuwar gumi, rauni mai yawa, ciwon jiki, tashin hankali, hauhawar jini, rashin bacci, rashin bacci, tashin hankali, tashin hankali, damuwa, rashin damuwa, rashin kulawa, rashin yiwuwar hakan mai da hankali da jinkirtawa, bacin rai, hangen nesa mara kyau, aphasia, rawar jiki, paresis, tashin hankali, rashi, jin kai na rashin nasara, rashin kamun kai, rashi, rikice rikice, na sama, na sama. e numfasawa, bradycardia, unconsciousness, coma.

Daga tsarin narkewa: tashin zuciya, amai, gudawa, ciwon ciki, maƙarƙashiya (ƙarancin waɗannan alamun yana raguwa lokacin ɗauka tare da abinci), da wuya - ƙarancin aikin hanta (hepatitis, ƙara yawan aikin hepatic transaminases, alkaline phosphatase, cholestatic jaundice - yana buƙatar cire magunguna).

Daga gabobin hemopoietic: hanawa ƙwaƙwalwar ƙwayar jini (anemia, thrombocytopenia, leukopenia, granulocytopenia).

Allergic halayen: pruritus, urticaria, fatar fata, ciki har da maculopapular da tsoro), erythema.

Sauran: raunin gani.

Sakamakon sakamako na yau da kullun na abubuwan da ke haifar da maganin sulfonylurea: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, vasculitis rashin lafiyan, gazawar hanta na barazanar rayuwa.

Yawan abin sama da ya kamata

Bayyanar cututtuka: hypoglycemia, ƙarancin ƙwaƙwalwar hankali, cutar rashin ƙarfi na hypoglycemic.

Jiyya: idan mai haƙuri yana da hankali, ɗauki sukari a ciki.

Wataƙila haɓaka yanayi mai rauni, tare da coma, tarko ko wasu rikicewar jijiyoyin jiki. Idan irin waɗannan bayyanar cututtuka sun bayyana, kulawar likita ta gaggawa da asibiti a cikin gaggawa suna da mahimmanci.

Idan ana zargin ko cutar ta haihuwar hypoglycemic, ana saurin haƙuri da allurar 50 ml na 40% na dextrose (glucose). Sannan, maganin 5% na dextrose (glucose) ana allurar dashi a ciki don kula da matakin glucose din da ake bukata a cikin jini.

Bayan maido da tunani, ya wajaba a baiwa mai haƙuri abincin da ke cikin wadataccen abinci mai narkewa a cikin jiki (don kauce wa sake haɓakar ƙwanƙwasa jini). Dole ne a yi taka tsantsan da lura da matakan glucose na jini da saka idanu akan mara lafiya aƙalla awanni 48 masu zuwa. Bayan wannan lokacin, dangane da yanayin haƙuri, likitan halartar ya yanke shawara game da buƙatar ƙarin sa ido.

Dialysis ba shi da tasiri saboda ƙayyadadden ikon ɗaukar nauyin gliclazide zuwa ƙwayoyin plasma.

Ranar cikawa: Shekaru 3

Yanayin harhada magunguna: Da takardar sayan magani.

Mai masana'anta: SYNTHESIS, OJSC (Russia)