Maganin Glucose da Gudanarwa

Chlorpropamide (Chlorpropamidum)

N- (para-Chlorobenzenesulfonyl) -N - propylurea.
Farin lu'ulu'u mai farin fata; kamshi da rashin iyawa. A zahiri ba shi da illa a cikin giya, benzene, acetone.
Tsarin yana kusa da butamide, a kimiyyance ya bambanta da na ƙarshen a cikin cewa a cikin para wuri na benzene nucleus ya ƙunshi Cl atom a maimakon ƙungiyar CH3 kuma a maimakon rukunin butyl (C 4 H 9) a N 'ya ƙunshi rukunin propyl (C 3 H 7).

Side effects

Allergic halayen, leukopenia (raguwa a matakin leukocytes a cikin jini), thrombocytopenia (raguwa a cikin adadin platelet a cikin jini), agranulocytosis (raguwa mai yawa a cikin adadin granulocytes a cikin jini), zawo (zawo), cholestatic jaundice (yellowing na fata da mucous membranes na yiwuwar) stagnation na bile a cikin biliary fili).

Contraindications

Precomatous (cikakken asarar sani - matakin farko na ci gaba na ƙwayoyin cuta, wanda ya ƙunshi kiyaye jin daɗi da amsawar motsa jiki) da kuma ƙimma (cikakkiyar asarar hankali, halin da cikakkiyar halayen jiki ke haifar da motsawar waje) yanayi, ketoacidosis (acidation saboda yawan wuce kima na jikin ketone a cikin jini - matsakaici samfurori na rayuwa), yara da matasa, ciki da lactation, cututtukan cututtuka masu yaduwa, aikin nakasa na yara, leukopenia, thrombocyte da granulocytopenia (hankali raguwa a cikin adadin platelet da granulocytes a cikin jini), abubuwan da suka shafi tiyata, halayen rashin lafiyan da ke haifar da sulfonamides.
Cikakken contraindications sune jaundice da aikin hanta mai rauni.

Chlorpropamide - halaye da fasali na aikace-aikace

Don lura da gidajen abinci, masu karatunmu sunyi nasarar amfani da DiabeNot. Ganin shahararrun kayan wannan samfurin, mun yanke shawarar ba da shi ga hankalin ku.

Hanyar warkewa don cututtukan type 2 na ciwon sukari wanda ya ƙunshi gudanar da rage ƙwayar sukari na ƙungiyoyi daban-daban.

Waɗannan sun haɗa da abubuwan samo asali na sulfonylurea.

Daya daga cikin wakilan wannan rukunin shine chlorpopamide.

Babban bayani game da miyagun ƙwayoyi

Chlorpropamide shine abu mai aiki wanda ya kasance na asalin ƙarni na abubuwan da suka samo asali na sulfonylurea. Groupungiyar rukunin magungunan ƙwayoyin cuta shine jami'ai na roba. Chlorpropamide ba mai narkewa bane a cikin ruwa, amma, akasin haka, yana narkewa a cikin giya.

Ba kamar sauran tsararraki na abubuwan da suka samo asali na sulfonylurea ba, kwayar chlorpropamide ba da jimawa ba. Don cimma daidaitaccen matakin glycemia, ana amfani dashi a cikin manyan allurai.

Abubuwan da ke haifar da shan magani sun kasance mafi ma'ana idan aka kwatanta da Glibenclamide da sauran wakilan ƙarni na 2. Inganci tare da isasshen samar da kwayoyin halittar (insulin) da raguwar saukin kamuwa da shi. Jiyya tare da chlorpropamide yana da tasiri a cikin marasa lafiya da ciwon insipidus masu ciwon sukari da / ko tare da ciwon sukari na 2.

Chlorpropamide shine asalin halittar sunan magani. Yana samar da tushen maganin (sashi mai aiki ne). Akwai shi a allunan.

Aikin magunguna

Magungunan suna da tasirin hypoglycemic. Abin yana ɗaure zuwa tashoshi na potassium, yana ƙarfafa ɓoye insulin. A cikin kyallen takarda da gabobin da insamura ke dauke da su, yawan masu karuwar horon yana karuwa.

A gaban insulin kwayoyin halitta, matakan glucose ya ragu. Yana da maganin antidiuretic. Saboda ruɓewar insulin, yawan nauyi yana faruwa.

Taimakawa da cutar ta glycemia ba ta dogara da sukarin jini ba. Chlorpropamide, kamar sauran maganin zaki, yana ɗaukar hatsarori na hypoglycemia, amma zuwa ƙaranƙanci.

Lokacin da aka haɗu tare da sauran wakilai na hypoglycemic (biguanides, thiazolidinediones, duba hulɗa tare da wasu kwayoyi), sashi na ƙarshen yana ɗan ƙaramin abu.

Pharmacokinetics

Bayan an shiga cikin narkewar abinci, ana amfani da sinadarin chlorpropamide sosai. Bayan awa daya, abu yana cikin jini, mafi girman fifikonsa - bayan sa'oin 2-4. Abubuwan yana lalata cikin hanta. Shafa furotin na Plasma> 90%.

A miyagun ƙwayoyi ke aiki a ko'ina cikin yini idan akwai wani amfani guda ɗaya. Kawar rabin rayuwa kusan awa 36 kenan. An cire shi a cikin fitsari (90%).

Manuniya da contraindications

Abubuwan da ke nuna alama don amfani sune cututtukan da ba su da insulin-insulin ba, har ma da ciwon sukari insipidus. An ba da Chlorpropamide a cikin lokuta inda maganin rage cin abinci, motsa jiki na warkewa bai kawo sakamakon da ya dace ba game da gyaran alamu.

Daga cikin abubuwanda suka sabawa amfani da maganin sun hada da:

• maganin rashin ƙarfi ga maganin ƙwaƙwalwa,
• Type 1 ciwon sukari
• rashin ƙarfi ga sauran sulfonylureas,
• metabolism tare da nuna bambanci ga acidosis,
• ilimin cututtukan mahaifa,
• ketoacidosis
• hanta da koda.
• m cutar
• ciki / lactation,
• magabaci kuma ga wa
• shekarun yara
• maimaita faduwar chlorpropamide far,
• yanayi bayan kamanceceniya.

Sashi da gudanarwa

An saita maganin ne ta hanyar likita dangane da cutar siga da kuma taimakon glycemia. Lokacin samun biyan bashi tabbatacce a cikin haƙuri, ana iya rage shi. A matsayinka na mai mulki, tare da nau'in ciwon sukari na 2, tsarin yau da kullun shine 250-500 MG. Tare da ciwon sukari insipidus - 125 MG kowace rana. Lokacin da aka canza shi zuwa wasu kwayoyi, ana buƙatar daidaita sashi.

Umarnin don amfani da chlorpropamide yana nuna amfanin shan miyagun ƙwayoyi rabin awa kafin abinci. Yana da mahimmanci a cinye shi lokaci ɗaya. Idan sashi ya samar da kasa da allunan 2, to liyafar ta yi da safe.

Bidiyo daga kwararre game da ciwon sukari da yadda za a bi da shi:

Siffofin aikace-aikace

Kafin shirin daukar ciki, kuna buƙatar barin chlorpropamide. Gudanar da nau'in ciwon sukari na 2 tare da insulin ana ɗauka mafi kyawun maganin. A lokacin shayarwa, suna yin aiki da wannan ka'idodi.

Canja wurin magunguna ana yin shi ne daga rabin kwamfutar hannu a kowace rana, sannan an wajabta shi don kwamfutar hannu ta farko. Marasa lafiya waɗanda ke da rauni na koda / aikin hepatic zai buƙaci daidaitawa na kashi. Lokacin da aka tsara yawan sashi na miyagun ƙwayoyi ga tsofaffi, shekarunsu suna cikin la'akari.

Lokacin da ake rama cutar, ana buƙatar raguwar sashi. Hakanan ana yin gyara tare da canje-canje a cikin nauyin jiki, kayan lodi, motsi zuwa wani lokaci.

Saboda rashin bayanai game da amincin amfani, ba a ba da magani ga yara. Game da raunin da ya faru, kafin / bayan ayyukan, a lokacin cututtukan cututtuka, ana tura mai haƙuri zuwa ɗan lokaci zuwa insulin.

Karka yi amfani da Bozetan. Akwai shaidun cewa mummunar cutar ta shafi marasa lafiyar da suka karbi chlorpropamide. Sun lura da karuwa a cikin cututtukan hepatic (enzymes). Dangane da kaddarorin magungunan guda biyu, hanyoyin rage ƙwayar bile acid daga sel yana raguwa. Wannan yana haɗuwa da tarawarsu, wanda ke haifar da sakamako mai guba.

Yin hulɗa tare da wasu magunguna

Ta yin amfani da chlorpropamide tare da sauran magunguna lokaci guda, tasirin sa na iya raguwa ko ƙaruwa. Shawarwari mai mahimmanci kafin ɗaukar wasu magunguna.

Kara miyagun ƙwayoyi mataki faruwa a lokacin coadministered da insulin, sauran hypoglycemic kwayoyi, biguanides, coumarin Kalam, phenylbutazone, kwayoyi tetracycline, Mao hanawa, fibrates, salicylates, miconazole, streroidami, namiji hormones, cytostatics, sulfonamides, quinolone Kalam, clofibrate, sulfinpyrazone.

Kwayoyi masu zuwa suna raunana tasirin chlorpropamide: barbiturates, diuretics, adrenostimulants, estrogens, tableted contraves, manyan allurai na nicotinic acid, diazoxide, hormones na thyroid, phenytoin, glucocorticosteroids, sympathomimetics, phenothiazine derivide, Acetazolam.

Chlorpropamide wakili ne na jini wanda ke nufin ƙarni na 1 na abubuwan da suka samo asali na maganin sulfonylurea. Idan aka kwatanta shi da mabiyan sa, yana da ƙananan rage ƙarfin sukari da ƙarin sakamako masu illa. A yanzu, ba a amfani da miyagun ƙwayoyi.

Kwayoyin hana haihuwa don kamuwa da cutar siga

Wasu hanyoyi na iya yin tasiri ga sukarin jini. Koyi game da zaɓuɓɓukan sarrafawar haihuwa ga mata masu ciwon sukari.

Mace da ke da ciwon sukari dole ne ta fuskanci irin wannan matsalolin da galibin mata ke fuskanta, kamar zabar hanyar hana haihuwa. Koyaya, ba kamar matan da ba su da ciwon sukari ba, dole ne ta yi la’akari da yadda nau’in hana haihuwa da ta zaɓa za ta shafi sukarin jininta.

Ciwon sukari da magungunan hana haihuwa

A da, ba a ba da shawarar kwayoyin hana daukar ciki ba ga mata masu fama da cutar sankara saboda canje-canje na hormonal da magani zai iya haifar. Manyan allurai na kwayoyin halittar jiki na iya yin tasiri ga sukarin jini, wanda hakan ke sanya ya zama da wahala mata su iya sarrafa ciwon su. Koyaya, bincike a cikin sabon tsari ya haifar da saurin haɗarin hormone. Sabbin kwayoyin hana daukar ciki, irin su Jess na shiri, amintattu ne ga mata da yawa, ba wai kawai da masu ciwon suga ba. Idan baku da gogewa ta amfani da wannan rigakafin, karanta karatun likita game da allunan. Matan da ke da ciwon sukari waɗanda suka yanke shawarar yin amfani da kwayoyin hana haihuwa, ya kamata su ɗauki mafi ƙarancin yiwuwar su iyakance tasirin maganin a kan cutar sankara.

Amma, mata masu shan kwayoyin hana daukar ciki ya kamata su tuna cewa har yanzu akwai karuwar hatsarin amai ko rauni a cikin mata ta amfani da wannan hanyar maganin hana haihuwa. Tun da mutane masu ciwon sukari suna da haɗarin haɓakar cututtukan zuciya, mata ya kamata su nemi likita.

Ciwon sukari da sauran hanyoyin hana haihuwa

Maganin hana daukar ciki ba shine kawai hanyar yin amfani da kwayoyin ba don hana daukar ciki. Hakanan akwai allura, abubuwan fashewa, zoben da faci.

Inje shine ya zama sanannen zabi domin allura guda daya na depot medroxyprogesterone acetate (Depo-Provera) na iya hana daukar ciki har zuwa watanni uku. Yin amfani da wannan hanyar, mata ya kamata suyi tunani game da hana haihuwa sau hudu a shekara. Koyaya, tunda allurar tana amfani da progestin na hormone, ana iya samun sakamako masu illa kamar ƙimin nauyi, hauhawar gashi, mara nauyi, ciwon kai, da damuwa.

Idan bakya son allurar kowane wata uku, zaku iya kokarin dasa maganin hana haihuwa. Wannan itace ƙaramin filastik wanda ya dace da fata na ƙashin hannu. Lokacin da abin ya shigo, sai ya fitar da progestin, hormone daya azaman allura.

Wata sabuwar na'ura da aka haɗa a cikin rukunin hana haihuwa ita ce zobe ta farji, wacce aka sa wa kwana 21. Ana sanya wannan zobe a cikin babba na farjin, lokacin da yake wurin, baku jin shi. Hannun zobe yana ba kawai progestin, amma har ma da estrogen, wanda ke nufin cewa matan da ke amfani da shi na iya fuskantar tasirin sakamako waɗanda suka yi kama da maganin ƙwaƙwalwar ƙwayar cuta.

A ƙarshe, akwai facin hanawa. Kamar sauran filayen magunguna, alal misali, wanda ke taimaka muku daina shan sigari, ƙwayoyin hana haihuwa suna aiki ne idan an shafa fata. Facin ya saki estrogen da progestin a cikin sati daya, sannan kuma aka sake shi da wani sabo, ana yin wannan ne na duka sati uku a jere. Ba a saka facin na sati na hudu (a lokacin haila), sannan sake zagayowar. Hakanan, tasirin sakamako na iya zama kama da maganin hana haihuwa ko zoben farji, da akwai wasu hangula a yankin fatar inda kake amfani da facin.

Kamar kwayoyin hana daukar ciki, wasu nau'ikan hana daukar ciki na iya shafar sukarin jininka. Idan ka yanke shawarar amfani da ɗayan waɗannan hanyoyin, ƙila kuna buƙatar daidaita sashi na maganin ciwon sukari.

Ciwon sukari da na’urar cikin ciki

Na'urar Intrauterine (IUDs) sune na'urorin da aka shigar cikin mahaifa. IUD tana kasancewa a cikin wani ɗan lokaci na lokaci har sai likitan ya cire shi. Don dalilai waɗanda likitoci ba su fahimta sosai ba, IUD ta hana kwai daga ciki ya shiga cikin bangon mahaifa don haka yana taimakawa hana juna biyu. Kodayake robar mahaifa hanya ce mai kyau ta hana haihuwa, ɗayan haɗarin amfani da na'urar shine kamuwa da cuta a cikin mahaifa.

Matan da ke da ciwon sukari sun riga sun kasance cikin haɗari mafi girma na kamuwa da cuta saboda rashin lafiya, don haka wannan nau'in hana haihuwa na iya kasancewa ba zaɓi mafi kyau ba idan kuna da ciwon sukari.

Ciwon sukari da hanyoyin shawo kan hana haihuwa

Tare da damuwa game da cututtukan da ake ɗauka ta hanyar jima'i, hanyoyin hanawa suna karuwa sosai tsakanin mata. Ta hana maniyyi kaiwa ga mahaifa, rage hadarin ciki, da kuma yaduwar cuta.

Ga yawancin mata, hanyoyin shamaki na iya zama ingantacciyar hanyar hana haihuwa, kuma kwaroron roba da diaphragms na farji baya shafar sukarin jini. Yana da mahimmanci, duk da haka, fahimtar cewa hanyoyin hana shinge suna da tsananin lalacewa sama da Allunan kuma ya kamata a yi amfani dasu da kyau, tare da kowace ma'amala ta jima'i. Bugu da kari, mata masu fama da ciwon sukari na iya samun hadarin kamuwa da kamuwa da cuta mai yisti yayin amfani da diaphragm.

Ciwon sukari da Hauka

A ƙarshe, wataƙila mafi amincin hanyar hana haihuwa, shine haifuwa ta amfani da hanyar tiyata da ake kira jijiyoyin mahaifa. Wannan, koyaushe, hanya ce ta hana haihuwa idan mace tana cikin tiyata. Dogaro da wannan hanyar yana da girma Pro, kuma gaskiyar cewa kullun na iya zama "a kan" idan ba ku da kashi 100 cikin 100 tabbata cewa ba ku son yara.

Wani batun kuma da yake yarda da wannan hanyar ga mata masu fama da cutar siga shine cewa sanya maye ba ya tasiri ga matakin jini na mace. Koyaya, aikin ba shi da haɗari, gami da kamuwa da cuta da sauran rikitarwa.

Duk abin da kuka zaɓa, ingantacciyar hanyar hana haihuwa tana da mahimmanci ga mata masu fama da cutar sankara, kamar yadda ba a tsara haihuwa cikin haɗari ga lafiyar uwa da ɗa. Shan alhaki don lafiyar haihuwar ku shine ya sanya ku cikin kujerar direba.

Don lura da gidajen abinci, masu karatunmu sunyi nasarar amfani da DiabeNot. Ganin shahararrun kayan wannan samfurin, mun yanke shawarar ba da shi ga hankalin ku.

Aikace-aikacen

An saita kashi ɗaya akayi daban-daban, yin la'akari da alamun glycemia da glucosuria. Maganin farko shine 250 MG / rana, ga marasa lafiya tsofaffi - 100-125 mg / rana, tsawon lokacin amfani shine kwanaki 3-5. Sannan, dangane da tasirin, ana rage rage girman ko an karu da kashi 50-125 tare da tazara tsakanin kwanaki 3-5. Matsakaicin adadin yau da kullun shine 500 MG.

Matsakaicin matsakaiciyar kulawa shine 100-500 mg / rana, gwargwadon yanayin mai haƙuri, mitar gudanarwa ita ce 1 r / rana yayin karin kumallo. Lokacin maye gurbin sauran ma'aikatan hypoglycemic tare da chlorpropamide, ya kamata a dakatar da magungunan da aka yi amfani dasu a baya kuma ya kamata a tsara maganin chlorpropamide a cikin kashi 250 mg / rana.

Yin amfani da miyagun ƙwayoyi na dogon lokaci na iya haifar da raguwa cikin ƙimar jiyya ga wakilai na bakin jini.Lokacin da aka ƙara chlorpropamide a cikin wani aikin insulin na baya (a lokuta inda kashi na yau da kullun na insulin bai wuce raka'a 40 ba), yawan insulin yawanci ana rage shi da 50%.

Side sakamako

- hauhawar jini mai wahala wanda ya sha bamban, har zuwa damuna,
- rikicewar dyspeptic (tashin zuciya, tashin zuciya, jin cikakken ciki a ciki),
- fata AR (redness, urticaria),
- wani lokacin - leukopenia, agranulocytosis,
- da wuya - jaundice mai hana tashin zuciya, thrombocytopenia, cutar rashin jini.

Yadda ake amfani: sashi da hanya na jiyya

A ciki. A cikin masu cutar sukari na matsakaici tare da mummunan hyperglycemia da glucosuria, suna farawa da 0.5 g sau ɗaya a rana, da safe, minti 30 kafin cin abinci.

A cikin nau'ikan cututtukan cututtukan sukari - daga kashi na 0.25 g, a cikin rashin sakamako a cikin mako 1, an kara yawan zuwa 0,5 g, kuma a wasu yanayi zuwa 0.75 g. Tare da daidaituwa na glycemia da kawar da glucosuria, ana rage rage yawan kashi ta 0.125 g kowane mako 2. Idan babu sakamakon kwayar 0.75 g, ƙarin gudanarwa ba shi da tasiri.

Tare da ciwon sukari insipidus - 0.1-0.15 g / rana.

Umarni na musamman

Kulawa na yau da kullun na glucose jini mai jini kuma bayan abinci, glycosylated Hb, ana buƙatar glycemia yau da kullun da glucosuria.

Don raunin da ya faru, ayyukan tiyata, cututtukan cututtuka, a lokacin daukar ciki, an nuna jigilar haƙuri na ɗan lokaci zuwa insulin.

Yakamata a gargadi marassa lafiya game da yuwuwar cutarwar mahaifa, musamman yayin kamuwa da cuta ko lokacin rashin abinci mai gina jiki.

Kwayar cutar hypoglycemia na iya zama mai da hankali ko rashinsa cikin tsofaffi marasa lafiya tare da neuropathy na autonomic ko a lokaci guda suna karɓar beta-blockers, clonidine, reserpine, guanethidine ko wasu masu juyayi.

Idan ya zama dole don canja wurin mai haƙuri daga insulin faris zuwa maganin baka na chlorpropamide, to, ana iya dakatar da allurar insulin cikin gaggawa, kuma idan mara lafiya ya sami fiye da 40 PIECES / rana, to ana iya fara magani da chlorpropamide tare da raguwa 50% a cikin yawan insulin a cikin kwanakin farko.

Lokacin biyan dila mellitus na ciwon sukari, ƙwaƙwalwar insulin yana ƙaruwa (mai yiwuwa yana buƙatar buƙatar maganin).

Ana aiwatar da gyaran juyi ne tare da canji a jikin mai haƙuri, salon rayuwa, saboda riskarin hadarin hauhawar jini.

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

Tambayoyi, amsoshi, sake dubawa game da magungunan Chlorpropamide

Bayanin da aka bayar an yi shi ne don ƙwararrun likitoci da magunguna. Cikakken bayani game da magani yana kunshe ne a cikin umarnin da aka haɗe zuwa marufin da mai masana'anta. Babu wani bayani da aka sanya akan wannan ko wani shafin yanar gizon mu wanda zai iya canza matsayin roko na musamman ga kwararrun.

Pharmacology

Yana ƙarfafa sakin insulin daga ƙwayoyin beta na pancreatic kuma yana ƙaruwa da yawan masu karɓar insulin a cikin gabobin da aka yi niyya. Yana da maganin antidiuretic.

Yayi kyau sosai daga narkewa, ana gano shi cikin jini a cikin awa na farko bayan gudanarwa. C_max an cimma cikin sa'o'i 2-4. T_1/2 - sa'o'i 36. Kodan ya keɓe shi (80-90% na kashi) na awanni 96, gami da 20-30% ba canzawa. Tasirin hypoglycemic bayan kashi daya na awa 24.

Yawan abin sama da ya kamata

Jiyya: tare da matsakaici hypoglycemia - shigo da glucose a ciki, daidaitawa ko rage cin abinci. A cikin nau'i mai tsanani (mara wuya sosai) tare da coma da rudewa - gabatarwar 50% na glucose bayani da haɓaka maganin glucose na 10% (don kula da matakan glucose na jini sama da 100 mg / dl), saka idanu a hankali game da matakan glucose na jini na 24- 48 a

Sunayen kasuwanci

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