Glucovans ndi mankhwala ophatikiza a hypoglycemic, omwe amapangidwa pamaziko a metformin ndi glibenclamide.

Monga zimadziwika, metformin ndi ya gulu la Biguanides. Kugwiritsa ntchito kwake kumathandizira kuchepetsa kuchuluka kwa glucose pakuphatikizika. magazi a m'magazi. Pankhaniyi, palibe kukondoweza kwa kubisala insulinchifukwa chake sizikula hypoglycemia.

Mwambiri, njira zitatu zoyenera kuchitira ndi mawonekedwe a metformin, awa:

• kuchepa kwa kupanga kwa shuga kwa chiwindi poletsa glycogenolysis ndi gluconeogeneis,
• zotumphukira zolandilira insulin, kutulutsa shuga ndi kugwiritsidwa ntchito ndi minofu ya minofu,
• Kuchedwa kuyamwa kwa shuga m'matumbo.

Kuphatikiza apo, mankhwalawa ali ndi phindu pamapangidwe magaziotsika kwambiri cholesterolmzere triglyceridesndi zina zotero.

Glibenclamide, zotumphukira za sulfonylurea, amatha kutsitsa shuga poyambitsa chinsinsi cha insulin ndi ma cell a β-penancreas.

Ngakhale metformin ndi glibenclamide zimadziwika ndi machitidwe osiyanasiyana, zimathandizira mphamvu ya hypoglycemic. Kuphatikiza apo, othandizira awa amawonetsa ntchito za synergistic pochepetsa zomwe zili shuga.

Ndi makonzedwe amkati a glibenclamide, mayamwidwe ake m'matumbo am'mimba pafupifupi 95%. Izi zimapangidwa ma micron. Kukwaniritsidwa kwa ndende yayikulu mu plasma kumatheka mkati mwa maola 4. Kumangiriza mapuloteni a plasma kumafanana 99%. Zotsatira zake kagayidwe 2 yosagwira amapangidwa m'chiwindi metabolitechotsitsidwa ndi impso ndi bile.

Metformin imadziwika ndi kuyamwa kwathunthu kuchokera m'matumbo am'mimba, mpaka kufika pazovuta zambiri pambuyo pa maola 2,5. Nthawi yomweyo, gawo lake limapukusidwa mosasinthika mothandizidwa ndi impso.

Kuphatikiza kwa metformin ndi glibenclamide kumakhala ndi bioavailability womwewo monga zinthu padera. Kudya sikumakhudzanso bioavailability wa metformin, koma kumawonjezera kuchuluka kwa mayamwidwe a glibenclamide.

Zizindikiro zogwiritsidwa ntchito

Chizindikiro cha kumwa mapiritsi ndi mtundu 2 shuga odwala akulu:

• osagwira ntchito chakudya, zolimbitsa thupi ndi chithandizo cham'mbuyomu ndi metformin,
• kuti m'malo mwamankhwala omwe mudalandira odwala omwe mulingo wa glycemia umawongoleredwa.

Contraindication

Mankhwala osavomerezeka:

• zomumvera iye ndi kapangidwe kake,
• lembani matenda ashuga
• kulephera kwa aimpso ndi matenda a impso,
• matenda ashuga ketoacidosis, precomndi chikomokere
• zovuta pachimake zomwe zimabweretsa kusintha kwa ntchito ya impso: kuchepa kwamadzi, matenda opatsirana, kugwedezeka ndi zina,
• matenda pachimake kapena aakulu limodzi ndi minofu hypoxia: mtima kapena kupuma kulephera, m'mbuyomu myocardial infarationdziko lodzidzimutsa
• ubwana
• kulephera kwa chiwindi
• porphyria
• kuyamwa, kutenga pakati,
• opaleshoni yayikulu
• uchidakwa wambiri kapena mowa wambiri kuledzera,
• lactic acidosis,
• kutsatira zakudya zochepa zopatsa mphamvu.

Kuphatikiza apo, mankhwalawa sakuvomerezeka kwa odwala azaka zopitilira 60, anthu omwe amagwira ntchito molimbika komanso amakhala ndi matenda osowa kwa makolo omwe amapezeka ndi galactose tsankho, shuga-galactose malabsorption komanso kuchepa kwa lactase.

Chenjezo liyenera kuchitidwa pochiza odwala omwe ali ndi vuto la lebrile, adrenal insuffence, hypofunction ya anterior pituitary gland, matenda a chithokomiro, ndi mavuto ena.

Zotsatira zoyipa

Pochiza ndi ma Glucovans, zotsatira zoyipa zimakhudza ziwalo zosiyanasiyana za thupi.

Matenda a metabolism amatha kutsagana ndi hypoglycemia, kuukira kwa hepatic kapena cutaneous porphyria, lactic acidosis, ndi zina zambiri.

Dongosolo lamagazi ndi ma lymphatic limatha kuchita leukopenia, thrombocytopenia, agranulocytosiszomwe nthawi zambiri zimadutsa kusiya mankhwala.

Zotsatira zoyipa zomwe zimagwira ntchito yamanjenje ndikuphwanya kukoma. Kutembenuka mu ziwalo zamasomphenya, m'mimba, pakhungu ndi minyewa yolowerera sikunathere kunja.

Matenda a immunological, mavuto a hepatobiliary ndi kusintha kwa magawo a labotale, mwachitsanzo, kuchuluka kwa kuchuluka, nthawi zina kumachitika urea creatininechitukukohyponatremia.

Malangizo ogwiritsira ntchito Glucovans (Njira ndi Mlingo)

Wothandizirawa wa hypoglycemic amapangidwira kukonzekera pakamwa. Pankhaniyi, malangizo ogwiritsira ntchito a Glucovans akuti mlingo wa mankhwalawa umaperekedwa pamlandu uliwonse payekhapayekha ndipo zimatengera mulingo wa glycemia.

Yambirani chithandizo ndi piritsi limodzi la kumwa limodzi tsiku lililonse. Pofuna kupewa kukula kwa hypoglycemia, ndikofunikira kuti mlingo woyambirira usapitirire kuchuluka kwa tsiku ndi tsiku la glibenclamide kapena metformin, yomwe idagwiritsidwa ntchito kale. Chifukwa chake, muthanso kuwonjezera kuchuluka kwa 5 mg + 500 mg tsiku lililonse pakapita masabata awiri kapena kuposa. Njira imeneyi imakuthandizani kuti muzitha kuyendetsa bwino magazi m'magazi a shuga.

Kubwezeretsa chithandizo cham'mbuyomu chophatikizira ndi metformin ndi glibenclamide, mlingo woyambirira umakhazikitsidwa malinga ndi mlingo womwe unalandiridwa kale. Pakadutsa milungu iwiri kapena isanu ndi umodzi kuyambira pa chiyambi cha mankhwalawa, kusintha kwa mankhwalawa kumatheka malinga ndi kuchuluka kwa glycemia.

Pankhaniyi, muyeso waukulu tsiku lililonse ndi mapiritsi 4 a Glucovans 5 + 500 mg kapena 6 pa 2.5 + 500 mg. Mankhwala othandizira amatengera munthu payekha malinga ndi katswiri.

Mapiritsi ayenera kumwedwa ndi chakudya. Ndikofunika kuti aliyense wogwiritsa ntchito mankhwalawa limodzi ndi zakudya zamafuta ambiri, zomwe zimathandiza kupewa kupezeka kwa hypoglycemia.

Bongo

Pankhani ya bongo, hypoglycemia imayamba. Pakuwonetsera pang'ono pang'ono, kuphatikiza kwamtunduwu kumatheka kudzera pakumwa shuga msanga. Koma mukufunikanso kusintha mlingo ndi zakudya.

Kusintha kwakukulu kwa hypoglycemic, limodzi ndi chikomokere, paroxysm, matenda ena amitsempha, amafunikira chithandizo chamankhwala mwadzidzidzi.

Chithandizo chofunikira chimaphatikizira kubaya yankho mu mtsempha. Dextrosendi mankhwala ena ochiritsira. Chikumbumtima chikadzabwezeretsa, wodwalayo ayenera kudyetsedwa chakudya chamafuta ambiri, zomwe zimapewe kuyambiranso kwa hypoglycemia.

Kuphatikiza apo, chitukuko cha lactic acidosis, chithandizo chomwe chimachitidwa kuchipatala sichimachotsedwa. Mankhwala othandizira omwe amathandizira kuchotsa metformin ndi lactate ndi hemodialysis.

Kuchita

Kutenga mankhwalawa Miconazole zingayambitse kukula kwa hypoglycemia chifukwa cha zomwe zili mu glibenclamide mmenemo. Kugwiritsa ntchito nthawi yomweyo ndi mankhwala okhala ndi ayodini sikuloledwa.

Phenylbutazone kuonjezera kuchuluka kwa Hypoglycemic. Kuphatikiza ndi Bosentan.

Pogwiritsa ntchito chida ichi, tikulimbikitsidwa kuti musamale mosamala Chlorpromazine, Tetracosactide, Danazole,β2-adrenergic agonists, okodzetsa, zoletsa zina za ACE zomwe zimatha kusintha zomwe zili m'magazi ndikupangitsa kukula kwa zotsatira zosafunikira. Chifukwa chake, kumwa mankhwala aliwonse kumafuna kuvomerezedwa ndi katswiri.

Glucovans analogues

Zofanizira zazikulu:Glybomet, Glucofast, Metformin ndi Siofor.

Kugwiritsa ntchito nthawi yomweyo mowa kumatha kubweretsa kukula kwa lactic acidosis, komwe kumatha kukula ndi kuledzera kwambiri. Vutoli limakulirakulira chifukwa cha njala kapena kuperewera kwa chakudya, komanso kulephera kwa chiwindi. Kuphatikiza apo, mowa nthawi zambiri umayambitsa hypoglycemia. Chifukwa chake, kugwiritsa ntchito zakumwa zoledzeretsa ndi zinthu zina zokhala ndi zakumwa siziyenera kuletsedwa.

Ndemanga za Glucovans

Zokambirana za chida ichi nthawi zambiri zimapezeka pamaforamu okhudzana ndi matenda ashuga. Odwala omwe amapatsidwa mankhwalawa nthawi zambiri amakambirana mafunso pakusankhidwa kwa chiwembu ndi Mlingo, komanso kuphatikiza pamodzi ndi mankhwala osiyanasiyana. Nthawi yomweyo, kuwerengetsa za Glucovans 5 + 500 mg ndi 2.5 + 500 mg ndizotsutsana kwambiri. Nthawi zambiri, kuti mukwaniritse bwino, ndikofunikira kuwona kuchuluka kwa zopatsa mphamvu zomwe zimagwiritsidwa ntchito ndi ma carbohydrate ndipo, inde, kuchuluka kwa mankhwala.

Tsoka ilo, nthawi zina pamakhala ndemanga kuti kumwa mankhwalawa sikubweretsa mpumulo. Mwachitsanzo, mwa odwala ena, pamakhala vuto lina la shuga m'magazi, ndiko kuti, hypoglycemia. Odwala ena amati kuti akhale athanzi, amafunikira kusintha kwakanthawi kwakanthawi kachitidwe kawo ka mankhwala.

Komabe, mankhwala amtundu uwu ndiofunikira kwambiri pakuchita zamankhwala, chifukwa amathandizira odwala omwe ali ndi matenda ashuga. Kuzindikira koteroko kumawonetsa kuti thanzi la wodwalayo nthawi zonse limafuna kuwongoleredwa komanso chithandizo chapadera. Izi ndizotheka kokha chifukwa cha kuyanjana kwa dokotala ndi wodwala, zomwe zimapangitsa kuti zinthu zikhale bwino.

Kuphatikizika, mfundo zoyenera kuchitira ndi zomwe zikugwiritsidwa ntchito

Glucovans ndi mankhwala omwe zosakaniza zake zazikulu ndi metformin ndi glibenclamide. Ndi a gulu la mankhwala ophatikizika a hypoglycemic omwe adapangidwa kuti agwiritsidwe ntchito ngati gawo la zovuta kuchiza kwa anthu omwe ali ndi matenda osokoneza bongo a mtundu wachiwiri (matenda osagwirizana ndi insulin). Tulutsani mafomu - mapiritsi a pakamwa. Phukusili lili ndi matuza awiri kapena anayi, lililonse lili ndi mapiritsi 10 kapena 15. Kutengera kuchuluka kwa mapiritsi omwe ali phukusili, mtengo wake umasiyana kuchokera pa 280 mpaka 400 rubles.

Mfundo za machitidwe a mankhwalawa zimatha kufotokozedwa m'mawu osavuta: mukamamwa ndi chakudya, zimathandizira kuchepetsa kapena kuyamwa pang'ono pang'onopang'ono, chifukwa chomwe kupsinjika kwa mahomoni m'magazi kungapewe. Gawo lalikulu la mankhwala a metformin limaphatikizidwa mu gulu la pharmacological la biguanides, monga zikuwonetsedwa ndi malangizo ogwiritsira ntchito. Ma analogi a Glucovans amagwira ntchito chifukwa cha zinthu zomwezo. Chifukwa chake, ndizomveka kuyesa kusankha kwanu mankhwala oyenera kuchokera pagulu la mitengo yotsika mtengo, koma ndi zigawo zomwezo.

Kwa metformin (chomwe ndi chophatikizira chachikulu chophatikizanso ndi mitundu yambiri ya Glucovans), mfundo zitatu zowonetsera thupi ndizikhalidwe:

• kuchepa kwa shuga wama chiwindi poletsa glycogenolysis ndi gluconeogeneis,
• zotumphukira zolandilira insulin, kutulutsa shuga ndi kugwiritsidwa ntchito ndi minofu ya minofu,
• Kuchedwa kuyamwa kwa shuga m'matumbo.

Chifukwa cha zovuta izi, mankhwalawo adziwonetsa okha pochiza matenda a shuga 2 - onse monga chida chodziyimira pawokha komanso chothandizira othandizira (ndizotheka kugwiritsa ntchito limodzi ndi mankhwala ena, mavitamini komanso zowonjezera pakudya pambuyo povomerezedwa ndi maphunziro a endocrinologist).

Type 1 ndi Type 2 shuga

Matenda a shuga ndi "mliri" weniweni wamasiku athu ano. Endocrinologists akuwonetsa alarm: m'zaka zaposachedwa, milandu yodwala matenda a shuga omwe amadalira insulin ayamba kuchuluka pakati pa achinyamata. Pafupifupi zaka makumi asanu zapitazo, matendawa adapezeka, ngati lamulo, mwa anthu (makamaka azimayi) achikulire kuposa zaka 50. Nthawi zambiri, zomwe zimayambitsa kukula kwake ndizosagwirizana ndi zakudya kwa zaka zambiri, kusagwira bwino ntchito kwa kapamba, mantha akulu amanjenje ndi kupsinjika kwanthawi yayitali.

Ndizomveka kugwiritsa ntchito mankhwalawa ngati wodwala salandira insulin ndi jakisoni. Zilibe kanthu kuti munthu wodwala matenda ashuga azitsatira zakudya zapadera za carb kapena ayi, a Glucovans 5500 ndi ma analoge omwe ali ndi kuchuluka komweko kwa metformin pakuphatikizika ndi kudya pafupipafupi kumathandizira kuti azitha kuyamwa pang'ono zam'thupi. Zachidziwikire, kumwa mankhwalawa sikutanthauza kuti uchotsere zakudya zopanda pake. Ngakhale motsutsana ndi maziko a mankhwala a pharmacological, wodwalayo ayenera kutsatira malamulo a zakudya zosafunikira. Komabe, ma endocrinologists nthawi zambiri amachenjeza odwala awo kuti ma fanizo a Glucovans omwe ali ndi metformin mu kapangidwe amapangitsa kuti asatsatire zakudya mosamalitsa, osawopa zotsatira za thanzi labwino komanso kuwonjezeka kwadzidzidzi mu shuga. Koma osadalira kwambiri momwe mankhwalawo amathandizira - kuchuluka kwa mafuta omwe amaperekedwa ndi chakudya kuyenera kuchepetsedwa mulimonse.

Contraindication ndi mlingo woyenera

Malangizo ogwiritsira ntchito akuti pali zotsatirazi zotsutsana za kumwa mapiritsi a Glucovans:

• mtundu 1 shuga
• aakulu aimpso kulephera ndi zina za impso (nephrologist kufunsa),
• Mimba, kuyamwa,
• kuchira pambuyo opaleshoni,
• uchidakwa wambiri, nthawi yomwe uchotse mowa,
• kusowa kwamadzi, nthawi yamatenda owopsa.
• matenda osachiritsika a chiwindi (phwando limatheka atakambirana ndi a hepatologist).

Glucovans 500 ndi fanizo la mankhwalawa zimakhudza mayamwidwe amthupi, chifukwa chake, ngakhale ndi limodzi mlingo, amatha kupweteketsa mtima odwala omwe ali ndi matenda a chiwindi ndi impso. Kudzisankhira nokha mankhwalawa ndikosatheka - ngakhale kuti ikugulitsidwa popanda mankhwala ndipo aliyense angagule, muyenera kuunika ziwalo zamkati musanayambe ndikutsimikiza kuti mufunsane ndi endocrinologist. Nthawi zambiri zimakhala zovuta kupeza kuti mulingo woyenera wodwala - piritsi limodzi patsiku limakwanira wina, ndipo atatu sangakwanire munthu. Mlingo woyenera kwambiri umatengera umunthu wa thupi - kulemera, jenda, zaka, kuyezetsa magazi.

Mndandanda wazofananira ndi mfundo yogwira ntchito

Mendulo ndi zina zotchulidwa za "Glucovans", zomwe zilinso ndi metformin monga chinthu chachikulu chogwira ntchito:

• Galvus Met,
• Siofor
• Chikwanje,
• Glibomet,
• Gluconorm,
• Amaril M

Mankhwalawa onse ali ndi mfundo zofananirazi - amachepetsa kuyamwa kwa mafuta, kotero kuti wodwalayo amayamba kumva bwino, kulakalaka zakudya zosavuta zamafuta zimachepa, zimakhala zosavuta kusunga zakudya, komanso kuchuluka kwa shuga m'magazi.

Analogue yotsika mtengo ya mapiritsi a Glucovans ndi Metformin. Komabe, m'mafakitala ndizovuta kupeza. Ngakhale ilipo, akatswiri azamankhwala amakonda kugulitsa ma analogu okwera mtengo kwambiri.

Galvus Met: malangizo ogwiritsira ntchito ndi kuwunika pa analogi ya Glucovans

Mtengo wa mankhwalawo ndi pafupifupi ma ruble 1300 pa paketi iliyonse. Galvus Met ndiokwera mtengo kwambiri chifukwa, kuwonjezera pa metformin, vildagliptin imaphatikizidwanso. Izi ndi zigawo ziwiri za hypoglycemic zomwe zimakhala ndi zosiyana pang'ono. Makamaka, vildagliptin ndi dipeptidyl peptidase-4 inhibitor. Pamodzi ndi metformin, chinthuchi chimayambitsa kutsika kwa glucose kosakhalitsa. Odwala ambiri omwe ali ndi matenda a shuga a 2 amafunika kumwa piritsi limodzi patsiku, pomwe a Glucovans amayenera kumwa kangapo patsiku.

Chifukwa chake, mtengo wokwera ndi wolungamitsidwa: chifukwa chake, njira ya Galvus Met nthawi zambiri imakhala yachuma kuposa njira ya Glucovans. Ndemanga za chida "Galvus Met" ndizosiyana. Zambiri zimatengera momwe munthu amadyera zakudya. Ndemanga zambiri zidakalipobe: odwala akugogomezera kuti, chifukwa chodya pafupipafupi mankhwala, adatha kubwezeretsa kuchuluka kwa shuga m'magazi. Ndizachidziwikire, nthawi zambiri zimakhala zokwezeka, koma zokhazikika, chifukwa chomwe odwala amakhala osangalala, ogwira ntchito ndipo samadwala chizungulire, nseru ndi zina zowonetsa matendawa.

Kufotokozera za mtundu wa kipimo

Mlingo wa 2.5 mg +500 mg: mapiritsi okhala ndi biconvex wopangidwa ndi kapisozi, wokutidwa ndi utoto wamafilimu amtundu wowala wa lalanje, wokhala ndi "2,5" mbali imodzi.

Mlingo 5 mg +500 mg: mapiritsi okhala ndi biconvex wopangidwa ndi kapisozi, wokutidwa ndi utoto wakanema wachikasu, wolemba "5" mbali imodzi.

Pharmacokinetics

Glibenclamide. Mukaperekedwa, kuyamwa kuchokera m'matumbo am'mimba ndizoposa 95%. Glibenclamide, yomwe ndi gawo la mankhwala Glucovans ®, imakhala micron. C_max mu plasma imafikira pafupifupi maola 4, V_d - pafupifupi malita 10. Kuyankhulana ndi mapuloteni a plasma ndi 99%. Imakhala ngati imaphatikizidwa kwathunthu m'chiwindi ndikupanga ma metabolites awiri osagwira, omwe amatsitsidwa ndi impso (40%) komanso bile (60%). T_1/2 - kuyambira 4 mpaka 11 maola

Metformin. Pambuyo pakukonzekera pakamwa, imatengedwa kuchokera m'matumbo am'mimba kwathunthu, C_max mu plasma zimatheka mkati maola 2,5. Pafupifupi 20-30% ya metformin imachotsedwa kudzera m'matumbo amtundu wosasinthika. Mtheradi bioavailability kuchokera 50 mpaka 60%. Metformin imagawidwa mwachangu mu minofu, sikuti imagwira mapuloteni a plasma. Amapangidwira pamlingo wofooka kwambiri ndikuwonetsa impso. T_1/2 pafupifupi 6.5 mawola. Ngati vuto laimpso lisokonezeka, chilolezo cha impso chimachepa, monga momwe chilengedwe chimapangidwira,_1/2 ukuwonjezeka, komwe kumabweretsa kuwonjezeka kwa kuchuluka kwa metformin m'madzi a m'magazi.

Kuphatikiza kwa metformin ndi glibenclamide mu mtundu womwewo wa mapangidwewo kuli ndi bioavailability yomweyo ngati mukumwa mapiritsi okhala ndi metformin kapena glibenclamide patokha. The bioavailability ya metformin kuphatikiza ndi glibenclamide sichikhudzidwa ndi chakudya, komanso bioavailability wa glibenclamide. Komabe, kuchuluka kwa mayamwa a glibenclamide kumawonjezera ndi chakudya.

Zisonyezero za mankhwala Glukovans ®

Type 2 shuga mwa akulu:

- ndi kusachita bwino kwa mankhwala othandizira kudya, kuchita masewera olimbitsa thupi komanso chithandizo cham'mbuyomu chokhala ndi metformin kapena zotumphukira za sulfonylurea,

- kusintha chithandizo chamankhwala am'mbuyomu ndimankhwala awiri (metformin ndi zotumphukira za sulfonylurea) mwa odwala omwe ali ndi khola komanso glycemia yoyendetsedwa bwino.

Mimba komanso kuyamwa

Kugwiritsa ntchito mankhwalawa kumapangidwa pakakhala pakati. Wodwalayo ayenera kuchenjezedwa kuti munthawi ya chithandizo ndi mankhwalawa Glucovans ® ndikofunikira kudziwitsa dokotala za mimba yomwe yakonzekereratu komanso nthawi yomwe mayi adzakhale ndi pakati. Mukakonzekera kutenga pakati, komanso ngati muli ndi pakati pa nthawi yomwe mukumwa Glucovans ®, mankhwalawa ayenera kuthetsedwa ndi chithandizo cha insulin.

Glucovans ® imaphatikizidwa pakamayamwa, popeza palibe umboni wa kuthekera kwake kudutsa mkaka wa m'mawere.

Zotsatira zoyipa

Zotsatira zoyipa izi zitha kuchitika pakumwa mankhwala a Glucovans ®: pafupipafupi zotsatira zoyipa za mankhwalawa zimawerengeredwa motere: pafupipafupi - ≥1 / 10, pafupipafupi - ≥1 / 100, thirakiti la m'mimba: Nthawi zambiri - nseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba komanso kusowa kudya. Zizindikirozi ndizofala kumayambiriro kwa chithandizo ndipo nthawi zambiri zimadutsa zokha. Popewa kukula kwa zizindikirozi, tikulimbikitsidwa kumwa mankhwalawa mu 2 kapena 3, kuwonjezeka kwapang'onopang'ono kwa mlingo wa mankhwalawa kumathandizanso kulolerana kwake.

Pa khungu ndi subcutaneous minofu: kawirikawiri, zimachitika pakhungu, monga kuyabwa, urticaria, zotupa za maculopapular, kawirikawiri, khungu kapena visceral matupi a vasculitis, erythema ya polymorphic, exoresative dermatitis, photosensitivity.

Zokhudza matenda: kawirikawiri - kugwedezeka kwa anaphylactic. Mtanda-hypersensitivity zimachitika sulfonamides ndipo zotumphukira zawo zimachitika.

Mavuto a Hepatobiliary: kawirikawiri - kuwonongeka kwa chiwindi ntchito kapena chiwindi, kufuna kusiya kwa mankhwalawa.

Malangizo apadera

Potengera momwe mankhwalawo amathandizira ndi Glucovans ®, ndikofunikira kuyang'anira kuchuluka kwa glycemia pamimba yopanda kanthu ndikatha kudya.

Lactic acidosis ndizosowa kwambiri koma zowopsa (kufa kwakukulu pakalibe chithandizo chamankhwala mwadzidzidzi) zomwe zitha kuchitika chifukwa cha kuchuluka kwa metformin. Milandu ya lactic acidosis mwa odwala omwe amachitidwa ndi metformin imachitika makamaka mwa odwala omwe ali ndi matenda osokoneza bongo omwe amalephera kwambiri aimpso.

Zina zokhudzana ndi chiwopsezo ziyenera kuganiziridwanso, monga matenda osokoneza bongo osagwiritsidwa bwino ntchito, ketosis, kusala kudya kwa nthawi yayitali, kumwa kwambiri mowa, kulephera kwa chiwindi, komanso vuto lililonse lomwe lingakhale ndi hypoxia yayikulu.

Muyenera kuganizira za chiopsezo cha lactic acidosis ndi mawonekedwe a zosakhazikika, monga kukokana kwa minofu, limodzi ndi vuto la dyspeptic, kupweteka kwam'mimba komanso kupweteka kwambiri. Woopsa milandu, kufupika kwa acidotic, hypoxia, hypothermia, ndi chikomokere zimachitika.

Diagnostic labotale magawo ndi: ochepa magazi pH, plasma lactate ndende pamwamba 5 mmol / l, kuchuluka anionic imeneyi ndi lactate / pyruvate chiŵerengero.

Popeza Glucovans ® imakhala ndi glibenclamide, kumwa mankhwalawo kumayendera limodzi ndi chiopsezo cha hypoglycemia wodwala. Kuchepetsa pang'onopang'ono kwa mankhwala atangoyamba chithandizo kungalepheretse kupezeka kwa hypoglycemia. Chithandizo ichi chitha kuperekedwa kwa wodwala yemwe amatsatira chakudya chokhazikika (kuphatikizapo chakudya cham'mawa). Ndikofunikira kuti kudya zakudya zamafuta nthawi zonse, chifukwa chiopsezo cha kukhala ndi hypoglycemia chikuwonjezeka ndikudya mochedwa, kudya kosakwanira kapena koperewera kwa chakudya. Kukula kwa hypoglycemia nthawi zambiri kumatha kukhala ndi chakudya cha hypocaloric, mutachita masewera olimbitsa thupi kwambiri kapena nthawi yayitali, ndi mowa kapena kuphatikiza othandizira a hypoglycemic.

Chifukwa cha kubweza komwe kumachitika chifukwa cha hypoglycemia, thukuta, mantha, tachycardia, matenda oopsa, kutsekemera, angina pectoris ndi arrhythmia. Zizindikiro zomalizirazi zitha kupezeka ngati hypoglycemia imayamba pang'onopang'ono, pankhani ya kuchepa kwa magazi kapena kuperekera pamodzi kwa β-blockers, clonidine, reserpine, guanethidine kapena sympathomimetics.

Zizindikiro zina za hypoglycemia mwa odwala omwe ali ndi matenda ashuga zimatha kuphatikizira mutu, njala, nseru, kusanza, kutopa kwambiri, kusokonezeka kwa tulo, kukwiya, kusokonezeka kwa chidwi ndi zochitika zama psychomotor, kupsinjika, chisokonezo, kusokonekera kwa mawu, kusawona bwino, kunjenjemera, kudwala ziwalo. ndi paresthesia, chizungulire, kupuma, kukoka, kukayikira, kusazindikira, kupuma kosakhazikika, ndi bradycardia.

Kuwapatsa mankhwala mosamala, kusankha kwa mankhwala, ndi malangizo oyenera kwa wodwala ndikofunikira kuti achepetse vuto la hypoglycemia. Ngati wodwala wayambiranso vuto la hypoglycemia, lomwe lili loopsa kapena logwirizana ndi kusazindikira zizindikirazo, ayenera kuthandizanso pochira odwala ena.

Zomwe zimathandizira pakupanga hypoglycemia:

- kumwa nthawi yomweyo, makamaka pakusala kudya,

- kukana kapena (makamaka kwa odwala okalamba) kulephera kwa wodwalayo kulumikizana ndi adokotala ndikutsatira malangizo omwe afotokozedwa mu malangizo ogwiritsira ntchito,

- Zakudya zoperewera, kusadya zakudya zachilendo, njala kapena kusintha zakudya,

- Kusiyana pakati pa zochitika zolimbitsa thupi ndi kudya thupi,

kulephera kwambiri kwa chiwindi

- mankhwala osokoneza bongo a Glukovans ®,

- Matenda amtundu wa endocrine: kuchepa kwa chithokomiro,

- munthawi yomweyo mankhwala.

Kulephera kwamkati ndi chiwindi

Pharmacokinetics ndi / kapena pharmacodynamics amatha kusiyanasiyana kwa odwala omwe ali ndi chiwindi cha hepatic kapena kuwonongeka kwambiri kwaimpso. Hypoglycemia yomwe imapezeka mwa odwalawa imatha kupitilira, momwemo chithandizo choyenera chiyenera kuyamba.

Magazi a Magazi

Pakachitika opaleshoni kapena chifukwa china chobowola matenda a shuga, tikulimbikitsidwa kuti kusinthidwa kwakanthawi kochepa ka mankhwala a insulin kuganiziridwe. Zizindikiro za hyperglycemia ndi kukodza pafupipafupi, ludzu lalikulu, khungu louma.

Maola 48 asanafike kuchitidwe opaleshoni kapena jekeseni wa iodine wokhala ndi ayodini, mankhwala a Glucovans ® ayenera kusiyidwa. Chithandizo chikulimbikitsidwa kuti chithandizidwenso pambuyo pa maola 48 ndipo pambuyo poti ntchito yaimpso yafufuzidwa ndikuzindikira kuti ndi zabwinobwino.

Popeza impformin imachotsedwa impso, musanayambe chithandizo komanso nthawi zambiri pambuyo pake, ndikofunikira kudziwa Cl creatinine ndi / kapena serum creatinine: osachepera pachaka kwa odwala omwe ali ndi vuto la impso, komanso kawiri pachaka kwa odwala okalamba, ndipo komanso odwala Cl Clinine pa VGN.

Ndikulimbikitsidwa kusamala mosamala ngati vuto la impso lingakhale lolephera, mwachitsanzo, odwala okalamba kapena poyambitsidwa ndi antihypertensive chithandizo, okodzetsa kapena NSAIDs.

Njira zina zopewera

Wodwalayo ayenera kudziwitsa dokotala za mawonekedwe a matenda a bronchopulmonary kapena matenda opatsirana.

Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu. Odwala ayenera kudziwitsidwa za chiopsezo cha hypoglycemia ndikuwonetsetsa mosamala poyendetsa ndikugwira ntchito ndi zida zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Wopanga

Adilesi yazamalamulo: 37, rue Saint-Romaine, 69379, LION SEDEX, 08, France.

Adilesi ya malo opangira: Center de Prodion CEMOIS, 2, rue du Pressoir Ver, 45400, CEMOIS, France.

Zogwirizana ndi makasitomala ndi zidziwitso pazinthu zovuta ziyenera kutumizidwa ku adilesi ya LLC Merk: 115054, Moscow, ul. Zokwanira, 35.

Tele: (495) 937-33-04, (495) 937-33-05.

Mankhwala osakanikirana a hypoglycemic ophatikizika: mtengo, analogi ndi malangizo ogwiritsira ntchito

Glucovans ndi mankhwala ophatikiza a hypoglycemic.

Amapangidwa kuti azigwiritsa ntchito mkati.

Mankhwala ali ndi phindu pazomwe zimapangidwa ndi lipid ya magazi, atatha kugwiritsa ntchito, kutsitsa cholesterol yonse.

Kutulutsa Fomu

Mapiritsi a Glucovans amaphatikizidwa ndi utoto wamtundu wamtundu wa kuwala kwamalanje a lalanje, wokhala ndi mawonekedwe apamwamba (biconvex).

Mapiritsi a Glucovans 500 mg

Kumbali imodzi ya piritsi lililonse mutha kujambula "2,5" kapena "5" (zomwe zili mu glibenclamide mg mg piritsi limodzi). Paketi imodzi ili ndi mapiritsi awiri kapena anayi. Kalatayo "M (yofunikira kutetezedwa kuti isasokonekere) yalembedwa pamakatoni ndi chithuza cha pulasitiki.

Kufotokozera za mankhwalawa

Glucovans - Mankhwala ophatikiza a hypoglycemic ophatikizidwa pakamwa.

Glucovans ® ndi kuphatikiza kosakanikirana kwa othandizira awiri am'magazi a hypoglycemic pamagulu osiyanasiyana a pharmacological: metformin ndi glibenclamide.

Metformin ndi ya gulu la Biguanides ndipo amachepetsa zomwe zimakhala ndi basal ndi postprandial glucose m'magazi a m'magazi. Metformin simalimbikitsa kubisirana kwa insulin chifukwa chake siyambitsa hypoglycemia. Ili ndi njira zitatu:

- amachepetsa kupanga shuga ndi chiwindi poletsa gluconeogeneis ndi glycogenolysis,

- kumawonjezera kukhudzika kwa zotumphukira zolandilira ku insulin, kumwa ndi kugwiritsa ntchito shuga m'maselo a m'mitsempha,

- Imachedwetsa mayamwidwe amkati kuchokera m'mimba.

Zimakhalanso ndi phindu pamapangidwe amtundu wa lipid m'magazi, kuchepetsa kuchuluka kwa cholesterol yathunthu, LDL ndi TG.

Metformin ndi glibenclamide zimakhala ndi njira zosiyanasiyana zochitira zinthu, koma zimathandizana wina ndi mnzake pogwira ntchito. Kuphatikizidwa kwa ma othandizira awiri a hypoglycemic kumathandizira pakuchepetsa shuga.

Alendo 23 adanenanso za kuchuluka kwa chakudya tsiku lililonse