Edit the efficacy of this paragraph. By increasing the level of insulin in portal vein or directly acting on liver, glycogen decomposition and gluconeogenesis in liver are inhibited, and the production and output of glucose in liver are reduced; It may also increase the sensitivity of extrapancreatic tissue to insulin and the utilization of sugar (probably mainly through post-receptor action). Therefore, the overall effect is to reduce fasting blood glucose and postprandial blood glucose. It is absorbed quickly, and the blood concentration reaches the peak 2 ~ 6 hours after oral administration, and the duration can reach 24 hours. T1/2 is 1 ~ 12 hours, and it loses its activity mainly through liver metabolism, and it can be excreted by 98% the next day. The oral absorption of this product is rapid, the peak time of blood drug concentration is 2 ~ 4 hours, the binding rate of plasma protein is 85% ~ 87%, the action maintenance time is 2～4h hours, and the serum half reduction period is 1 ~ 12 hours. Most of this product is metabolized into inactive metabolites by the liver in vivo. 59% of it is excreted in urine within 1 day after administration, a small amount is excreted in feces, and 95% is excreted in kidney within 5 days.
edit the pharmacological effects of this paragraph
this product is the second generation of sulfonylurea oral hypoglycemic agents, which have hypoglycemic effects on both normal people and diabetic patients. Its hypoglycemic intensity is between metsulfuron and glibenclamide. This product mainly acts directly on pancreas, promoting the transport of Ca++ to islet β cells, and stimulating insulin secretion. At the same time, it can also improve the metabolism of glucose in surrounding tissues, thus reducing blood sugar. ?
in addition, this product can inhibit the release of arachidonic acid from phospholipids in platelets, thus reducing the synthesis of thromboxane (TXA3), inhibiting various coagulation factors (such as ⅴ, ⅷ, ?), increasing the level of plasminogen activator and promoting the dissolution of fibrin. Animal experiments also found that this product can reduce the levels of plasma cholesterol, triglycerides and fatty acids.
edit the indications of this paragraph
It is suitable for mild and moderate non-insulin-dependent diabetes mellitus with unsatisfactory effect of diet control alone. The islet B cells of patients have certain insulin secretion function of β cells
, and there are no serious complications. It is mainly used for mild and medium-sized diabetes with ineffective diet control and no ketosis tendency after adulthood. It can also improve the fundus lesions and the disorder of metabolism and vascular function in diabetic patients. It can be used with biguanide oral hypoglycemic agents for patients who cannot be controlled by single use, and it can be used with insulin to treat insulin-dependent diabetes mellitus, which can reduce the dosage of insulin.
edit this paragraph of adverse reactions and treatment
Occasionally, there are mild nausea, vomiting, epigastric pain, constipation, diarrhea, erythema, urticaria, thrombocytopenia, granulocytopenia, anemia, etc., and most of them disappear after stopping taking the drug. Severe liver and renal insufficiency is prohibited. It is forbidden for those who are allergic to sulfonylureas. Patients with type ⅱ diabetes should be treated with insulin under stress conditions such as infection, trauma and operation, and when ketoacidosis and nonketotic hyperosmolar diabetes coma occur. Not suitable for patients with type I diabetes. When combined with non-steroidal anti-inflammatory drugs (especially salicylates), sulfonamides, dicoumarin anticoagulants, monoamine oxidase inhibitors, receptor blockers, benzodiazepines, tetracycline, chloramphenicol, dicyclohexylpiperidine, clofibrate, ethanol and other drugs, the dosage should be reduced to avoid hypoglycemia. When combined with anticoagulant drugs, we should often make relevant coagulation tests. When the dosage of this medicine is too large, eating too little or exercising vigorously, attention should be paid to prevent hypoglycemia reaction.
editing drug interactions in this paragraph
The combination with thiazide diuretics, adrenocortical hormones and estrogen preparations may weaken the hypoglycemic effect of this product. With chloramphenicol, dicoumarin, ethanol
butazone, hydroxybutazone, clofibrate and sulfadiazine, it can inhibit the metabolism of this product and enhance the hypoglycemic effect, and may even cause hypoglycemia reaction. Aspirin, phenylbutazone and sulfadiazine can compete with this product for binding with plasma protein, thus enhancing the hypoglycemic effect of this product. When combined with non-steroidal anti-inflammatory drugs (especially salicylates), sulfonamides, coumarin anticoagulants, monoamine oxidase inhibitors, b- receptor blockers, benzodiazepines, tetracycline, chloramphenicol, dicyclohexylpiperidine, clofibrate, ethanol and other drugs, the dosage should be reduced.
Edit the usage and dosage of this paragraph
Take 8mg orally at the beginning, once before breakfast or before breakfast and before lunch, or 4mg, three times a day, before meals, and if necessary, increase the daily amount of ethanol by 8mg after 7 days
. Generally, the daily dose is 8 ~ 24 mg, and the maximum dose is not more than 32mg per day. Preparation and specifications: gliclazide tablets 8mg. Oral administration, 8mg once, twice a day at first, for 2-3 weeks, and then increase or decrease the dosage according to the condition, with a daily dosage range of 8-24mg. It can change the blood picture. Check the blood picture regularly during medication. Juvenile diabetes, diabetes with ketosis, diabetic coma, etc. all need insulin injection, and this product cannot be used alone. After oral administration, 16mg per day, generally 8 ~ 16 mg per day at first, and then it can be increased to 24 ~ 32 mg per day according to the condition, and taken in 2 ~ 3 times. If the insulin is changed to this product, if the original dose is large (about 2 ~ 3IU), the insulin will be halved on the first day, and this product will be added, and then it will be gradually reduced according to the condition. Blood sugar and urine sugar should be checked regularly during taking medicine so as to adjust the treatment plan.
editing the function and use of this paragraph
It is the second generation of oral sulfonylgills hypoglycemic drugs, which reach high bees 2-6 hours after oral administration, and t1/2 is about 1-12 hours, mainly excreted by the kidney. It has hypoglycemic effect on adult diabetic patients, can reduce platelet adhesion, reduce plasma specific viscosity, reduce ADP-induced platelet aggregation and improve nail fold microcirculation. Platelets < P > In addition, experiments have proved that this product can reduce cholesterol accumulation and reduce the plasma concentrations of glycerol triphosphate and fatty acids in aorta. Therefore, the combination of the two can not only treat diabetic metabolic disorder, but also prevent vascular diseases and improve retinopathy and renal function. It can be used for adult diabetes, diabetes with obesity or vascular diseases.
Notes for editing this paragraph
1. Pregnant women are prohibited; 2. Gliclazide should be checked frequently during taking this medicine
3. People with renal dysfunction should use it with caution; 4. Juvenile diabetes, diabetes with ketosis, diabetic coma, etc. all need insulin injection, and this product cannot be used alone.