Mapiritsi a Metformin 1000 mg, 60 ma PC.

Chonde, musanagule Metformin, mapiritsi 1000 mg, 60 ma PC., Onani zambiri za nkhaniyi ndi zomwe zili patsamba lawebusayiti la wopanga kapena tchulani mtundu wina ndiomwe amayang'anira kampani yathu!

Zomwe zikuwonetsedwa patsamba lino sizoperekedwa pagulu. Wopangayo ali ndi ufulu wosintha kapangidwe kake, kapangidwe kake ndi katengedwe ka katundu. Zithunzi zamalonda pazithunzi zomwe zaperekedwa pamndandanda wazomwe zili patsamba lino zimasiyana ndi zomwe zidachokera.

Zambiri pamutengo wa zinthu zomwe zawonetsedwa pamndandanda wa masamba tsambalo zingasiyane ndi zenizeni panthawiyo yokhazikitsa dongosolo la zomwe zikugwirizana.

Zotsatira za pharmacological

Metformin imalepheretsa gluconeogenesis m'chiwindi, amachepetsa kuyamwa kwa m'matumbo, imakulitsa kugwiritsidwa ntchito kwa glucose, komanso kumakulitsa chidwi cha minofu kulowa insulin. Sichikukhudzana ndi kubisika kwa insulini ndi ma cell a beta, sikuti kumayambitsa kutengeka kwa hypoglycemic. Amachepetsa mulingo wa ma triglycerides ndi ma linoprotein otsika m'magazi. Imakhazikika kapena kuchepetsa thupi. Ili ndi fibrinolytic mwina chifukwa chokakamira minofu ya plasminogen activator inhibitor.

Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera m'mimba. Bioavailability mutatenga muyezo mlingo 50-60%. Cmax mu madzi a m'magazi amafikira maola 2,5 atatha kumwa. Sizikugwirizana ndi mapuloteni a plasma. Amadziunjikira tiziwalo tating'ono, minofu, chiwindi ndi impso. Imayatsidwa osasinthika ndi impso. T1 / 2 ndi maola 9-12. Ndi vuto laimpso, kuwonongeka kwa mankhwalawa ndikotheka.

Type 2 shuga mellitus popanda chizolowezi cha ketoacidosis (makamaka odwala kunenepa kwambiri) ndi mankhwala ochizira, osakanikirana ndi insulin, mtundu 2 shuga mellitus, makamaka ndi kutchulidwa kwa kunenepa kwambiri, limodzi ndi insulin kukana.

Contraindication

• matenda ashuga ketoacidosis, matenda a shuga, chikomokere,
• kuwonongeka kwaimpso,
• matenda pachimake ndi chiwopsezo cha matenda aimpso: kuchepa magazi (ndi m'mimba, kusanza), kutentha thupi, matenda opatsirana, hypoxia (mantha, sepsis, matenda a impso, bronchopulmonary matenda).
• mwaukadaulo wawonetsera matenda owopsa komanso osachiritsika omwe angayambitse kukula kwa minofu hypoxia (mtima kapena kupuma, kulephera kwamtima),
• opaleshoni yayikulu ndi zoopsa (pamene chithandizo cha insulin chikusonyeza),
• chiwindi ntchito,
• uchidakwa wambiri, chakumwa chakumwa choledzeretsa,
• gwiritsani ntchito kwa masiku osachepera a 2 musanayambe ndi masiku awiri mutapanga maphunziro a radioisotope kapena x-ray ndikumayambitsa ayodini wokhala ndi zosiyana pakati,
• lactic acidosis (kuphatikizapo mbiri),
• kutsatira zakudya zochepa zama calori (zosakwana 1000 calories / tsiku),
• mimba
• kuyamwa
• Hypersensitivity mankhwala.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa mwa anthu opitirira zaka 60 omwe amagwira ntchito zolimbitsa thupi, zomwe zimagwirizanitsidwa ndi chiwopsezo chokhala ndi lactic acidosis mwa iwo.

Zotsatira zoyipa

Kuchokera pamimba: kukhumudwa, kusanza, kulawa kwazitsulo mkamwa, kusowa chilakolako cha chakudya, kutsegula m'mimba, kuwawa, kupweteka kwam'mimba. Zizindikirozi ndizofala kumayambiriro kwa chithandizo ndipo nthawi zambiri zimakhala zokha. Zizindikiro izi zitha kuchepetsa kuikidwa kwa anthocides, zotumphukira za atropine kapena antispasmodics.

Kuchokera kumbali ya kagayidwe: kawirikawiri - lactic acidosis (imafuna kuleka kwa chithandizo), ndi chithandizo cha nthawi yayitali - hypovitaminosis B12 (malabsorption).

Kuchokera ku ziwalo za hemopoietic: Nthawi zina - megaloblastic anemia.

Kuchokera ku endocrine system: hypoglycemia.

Thupi lawo siligwirizana: zotupa pakhungu.

Kuchita

Kugwiritsa ntchito nthawi yomweyo danazol osavomerezeka kuti apewe hyperglycemic zotsatira za chomaliza. Ngati mankhwala a danazol akufunika komanso atasiya kuyimitsa, kusintha kwa metformin ndi ayodini kuyenera kuyendetsa glycemia.

Kuphatikiza komwe kumafunikira chisamaliro chapadera: chlorpromazine - pamene imwedwa mu milingo yayikulu (100 mg / tsiku) kumakulitsa glycemia, kuchepetsa kutulutsa kwa insulin.

Mankhwalawa antipsychotic ndipo atasiya kuyimilira, kusintha kwa metformin kumafunika muulamuliro wa glycemia.

Pogwiritsa ntchito munthawi yomweyo ndimomwe zimachokera ku sulfonylurea, acarbose, insulin, NSAIDs, ma inhibitors a MAO, oxytetracycline, ACE inhibitors, clofibrate zotumphukira, cyclophosphamide, β-blockers, ndizotheka kuwonjezera mphamvu ya hypoglycemic ya metformin.

Pogwiritsa ntchito munthawi yomweyo ndi GCS, kulera pakamwa, epinephrine, sympathomimetics, glucagon, mahomoni a chithokomiro, thiazide ndi loop diuretics, zotumphukira zochokera mu mtima, zotuluka za nicotinic acid, kuchepa kwa mphamvu ya hypoglycemic ya metformin ndikotheka.

Cimetidine amachepetsa kuchotsedwa kwa metformin, yomwe imawonjezera chiopsezo cha lactic acidosis.

Metformin itha kufooketsa mphamvu ya ma anticoagulants (zotumphukira za coumarin).

Kumwa mowa mwauchidakwa kumawonjezera mwayi wokhala ndi lactic acidosis panthawi yoledzera ya pachimake, makamaka ngati akusala kudya kapena kutsatira zakudya zochepa zopatsa mphamvu, komanso ngati chiwindi chikulephera.

Momwe mungatenge, njira ya makonzedwe ndi kumwa

Mlingo wa mankhwalawa umakhazikitsidwa ndi adokotala payekha, kutengera kuchuluka kwa shuga m'magazi.

Mlingo woyambirira ndi 500-1000 mg patsiku (mapiritsi a 1-2). Pambuyo masiku 10-15, kuwonjezereka kwapang'onopang'ono kwa mlingo kumatheka kutengera mtundu wa shuga.

Mankhwala okonza mankhwalawa nthawi zambiri amakhala 1500-2000 mg patsiku. (Mapiritsi 3-4) Mulingo woyenera kwambiri ndi 3000 mg patsiku (mapiritsi 6).

Odwala okalamba, tsiku lililonse mapiritsi ake osavomerezeka sayenera kupitirira 1 mapiritsi 2.

Mapiritsi a Metformin amayenera kumwa nthawi zonse mukatha kudya ndi madzi pang'ono (kapu yamadzi). Kuti muchepetse mavuto kuchokera m'matumbo am'mimba, mlingo wa tsiku ndi tsiku uyenera kugawidwa mu Mlingo wa 2-3.

Chifukwa chowonjezera chiopsezo cha lactic acidosis, mlingo uyenera kuchepetsedwa ngati mavuto azovuta a metabolic.

Bongo

Ndi bongo wa Metformin, lactic acidosis yokhala ndi zotsatira zakupha ndiyotheka. Zomwe zimayambitsa kukula kwa lactic acidosis amathanso kukhala cumulation wa mankhwalawa chifukwa cha kuwonongeka kwa impso.

Zizindikiro za lactic acidosis: nseru, kusanza, kutsegula m'mimba, kutsitsa kutentha kwa thupi, kupweteka kwam'mimba, kupweteka kwa minofu, mtsogolomo pakhoza kuwonjezeka kupuma, chizungulire, chikumbumtima chodwala komanso kukula kwa chikomokere.

Chithandizo: ngati zizindikiro za lactic acidosis, chithandizo ndi Metformin ziyenera kuyimitsidwa nthawi yomweyo, wodwalayo ayenera kuchipatala mwachangu ndipo atatsimikiza kuti ali ndi lactate, atsimikizireni matendawa. Njira yothandiza kwambiri yochotsa lactate ndi metformin kuchokera mthupi ndi hemodialysis. Chithandizo cha Zizindikiro zimachitidwanso.

Mankhwala ophatikizidwa ndi Metformin ndi sulfonylureas, hypoglycemia imayamba.

Malangizo apadera

Pa chithandizo, ndikofunikira kuwunika ntchito yaimpso. Osachepera 2 pachaka, komanso maonekedwe a myalgia, zomwe zimakhala mu plasma ziyenera kutsimikiziridwa. Kuphatikiza apo, kamodzi pa miyezi isanu ndi umodzi ndikofunikira kuti muwongolere kuchuluka kwa creatinine mu seramu yamagazi (makamaka mwa odwala okalamba). Metformin sayenera kufotokozedwa ngati mulingo wa creatinine m'magazi ndiwoposa 135 μmol / L mwa amuna ndi 110 μmol / L mwa akazi.

Mwinanso kugwiritsa ntchito mankhwala a Metformin osakanikirana ndi mankhwala a sulfonylurea. Potere, makamaka kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira.

Maola 48 isanakwane komanso mkati mwa maola 48 mutatha radiopaque (urography, iv angiography), muyenera kusiya kutenga Metformin.

Ngati wodwala ali ndi matenda a bronchopulmonary kapena matenda opatsirana a genitourinary, adokotala ayenera kudziwitsidwa nthawi yomweyo.

Pa chithandizo, muyenera kupewa kumwa mowa ndi mankhwala okhala ndi Mowa. .

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kugwiritsa ntchito mankhwalawa monotherapy sikukhudza kuyendetsa magalimoto ndikugwira ntchito ndi njira.

Metformin ikaphatikizidwa ndi ma othandizira ena a hypoglycemic (sulfonylurea, insulin), mikhalidwe ya hypoglycemic imatha kukhala ndi mwayi wokhoza kuyendetsa magalimoto ndi kuchita zina zomwe zingakhale zowopsa zomwe zimafunikira chidwi chochulukirapo komanso kusintha kwa ma psychomotor.