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Глибенкламид профиль эффективности и безопасности

Глибенкламид профиль эффективности и безопасности

Abstract

В арсенале пероральных сахароснижающих препаратов глибенкламид сохраняет лидирующие позиции как наиболее эффективное по своей гипогликемизирующей активности средство. Эффективность препарата обусловлена его уникальной химической структурой, содержащей не только сульфонилмочевинное кольцо, но и бензамидную группировку в боковой цепи, что обеспечивает максимальное сродство к SUR 1 на ƒ-клетке и возможность связывания с SUR 2А на клетках периферических тканей, таких как кардиомиоциты, гладкомышечные клетки сосудистой стенки и адипоциты. Вместе с тем данная особенность может повышать риск гипогликемических состояний и оказывать негативный эффект на сердечно-сосудистую систему. Рассматриваются данные клинических исследований, доказывающих эффективность и безопасность препарата, получившего в 2010 году Премию Лекарственных Средств Г.Г. Крейтцфельдта, на основе доказательной базы долгосрочных наблюдений, продемонстрировавших снижение риска сосудистых осложнений сахарного диабета, возможность легко комбинироваться с препаратами других групп, назначения пожилым и мультиморбидным пациентам. Глибенкламид единственный из препаратов сульфонилмочевины внесен в список Жизненно Важных Лекарственных Средств Всемирной Организации Здравоохранения.

Glibenclemide is the most effective drug among oral hypoglycemic ones. The efficacy of this drug is determined by its unique chemical structure that contains sulfonylurea, not only ring, but also benzamid group in the side chain. This provides the maximum affinity for SUR 1 on the beta-cell ATP‑dependent K+ channels and ability to associate with SUR 2A cells in the peripheral tissues such as cardiomyocytes, smooth muscle cells of the vascular wall and adipocytes. However, this feature can increase the risk of hypoglycemic states and have a negative effect on the cardiovascular system. We consider data from clinical studies proving the efficacy and safety of the drug, which were based on evidence of long-term observations, and which demonstrated reduced risk of vascular complications of diabetes, compatibility with drugs of other groups, and possibility to use in elderand multimorbid patients. Glibenclamide was evaluated by prestigious H.G. Creutzfeldt Drug Prize in 2010. It is the only SCI listed essential medicine of the World Health Organization.

Keywords

ТЕРАПИЯ САХАРНОГО ДИАБЕТА 2 ТИПА, СЕКРЕЦИЯ ИНСУЛИНА, РЕЦЕПТОР СУЛЬФОНИЛМОЧЕВИНЫ SUR, АТФ ЗАВИСИМЫЕ К+-КАНАЛЫ, ИШЕМИЧЕСКОЕ ПРЕКОНДИЦИОНИРОВАНИЕ, ГИПОГЛИКЕМИЧЕСКИЕ СОСТОЯНИЯ, K + ATP CHANNELS

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold