Glyformin wa matenda ashuga

Dzina ladziko lonse la mankhwalawa ndi Metformin. Mapiritsi a Glyformin amatha kutulutsa shuga m'magazi.

Mankhwalawa amalimbikitsidwa pochiza matenda osokoneza bongo omwe amadalira matenda a shuga (mtundu II matenda ashuga) ngati mankhwala othandizira amadya sawonekeratu. Monga mankhwala othandizira, Glyformin amagwiritsidwanso ntchito ngati mtundu 1 wa shuga (wodalira insulin).

Mphamvu ya Glformin pa thupi la munthu imawonetsedwa m'njira ziwiri: mbali inayo, imalepheretsa kupangika kwa shuga mu chiwindi, mbali inayo, imalepheretsa kuyamwa kwa zinthu m'mimba. Nthawi yomweyo, njira yogwiritsira ntchito glucose mu minofu imakulitsidwa, ndipo kumva kwa minyewa yokhudzana ndi insulin kumakulitsidwa.

Gwiritsani ntchito paubwana

Kugwiritsa ntchito mankhwalawa mankhwalawa kumatheka pokhapokha ngati odwala ali ndi zaka zopitilira 10 ali mu mawonekedwe a monotherapy komanso osakanikirana ndi insulin. Zomwe zimagwira sizikhudza kukula ndi kukula kwa wodwala wochepa. Chifukwa cha kusowa kwa deta mukamatha msanga, kuwunika mosamala mlingo wa mankhwalawa ndikofunikira. Makamaka ana azaka 10 mpaka 10.

Mlingo woyambirira (masiku atatu oyamba) samapitilira 500/8 mg / tsiku. Pakupita milungu iwiri, adotolo amasintha nthawi yoikidwiratu, kutengera zotsatira zakufufuza kwa kuchuluka kwa shuga m'magazi. Mlingo wambiri suli woposa 2000 mg.

Kuti muchepetse mavuto obwera chifukwa cha metformin pamimba, chakudya chatsiku ndi tsiku chimagawidwa pawiri kapena kawiri pachakudya.

Mimba komanso kuyamwa

Pobweza pang'ono mtundu wa matenda ashuga a 2, mimbayo imapitirira ndi ma pathologies: kusokonezeka kwa kubadwa, kuphatikizanso kufa kwa pathupi, ndizotheka. Malinga ndi malipoti ena, kugwiritsa ntchito metformin sikuti kumayambitsa kusintha kwa kubereka mwa mwana wosabadwa.

Komabe, pa gawo lokonzekera kubereka, ndikofunika kusintha kuti mukhale ndi insulin. Pofuna kupewa kupatuka kwa mwana, ndikofunikira kuti amayi apakati azilamulira glycemia ndi 100%.

Amayi oyembekezera komanso othamangitsa azimayi munthawi yodyetsa zachilengedwe, kugwiritsa ntchito Glformin ndizoletsedwa. Kafukufuku wokhudza kukhalapo kwa metformin mkaka wa m'mawere sanachitike.

Mukakonzekera kutenga pakati, kutenga Glyformin kumalowedwa ndi insulin.

Kuphatikiza kophatikizidwa

Zizindikiro zosiyanitsa ndi X-ray, zomwe zimakhala ndi ayodini, zimatha kuyambitsa lactic acidosis mu matenda ashuga omwe amakhala ndi vuto la impso. M'mayeso ogwiritsa ntchito mankhwalawa, wodwalayo amamuika insulin masiku awiri. Ngati impso ili yokhutiritsa, patatha masiku awiri mutawerengedwa, mutha kubwerera ku regimen yapita.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwala Glformin Prolong, kampani yaku Russia ya mankhwala Akrikhin, amatulutsa mapiritsi okhala ndi mafilimu okhala ndi mphamvu yotulutsa.

Piritsi lililonse la chikasu la biconvex limakhala ndi 750 mg yogwira ntchito ya metformin hydrochloride ndi zotulukazo: silicon dioxide, hypromellose, cellcrystalline cellulose, magnesium stearate.

Mapiritsi okhala ndi 30 kapena 60 ma PC. mu pensulo yonyamula pulasitiki yokhala ndi cholembera ndi kuteteza chitetezo pakutsegulira koyamba. Pulasitiki yonyamula imayikidwa mu katoni. Alumali moyo wa mankhwalawa pamalo owuma, amdima firiji ndi zaka 2. Kwa Gliformin Prolong 1000, mtengo pa intaneti umachokera ku ma ruble 477.

Ngati mukufuna m'malo mankhwalawa, adokotala amatha kugwiritsa ntchito fanizo ndi mankhwala omwewo:

Fomu
Metformin
Glucofage,
Metformin Zentiva
Glformin.

Ngati munthu wodwala matenda ashuga atenga kale mankhwala opangidwa ndi Metformin omwe ali ndi mphamvu yotulutsidwa, ndiye kuti mukawachotsa ndi Glformin Prolong, wina ayenera kuganizira za kumwa kwa tsiku lililonse. Ngati wodwala amatenga metformin pafupipafupi muyezo wa 2000 mg, kusintha kwa glyformin kwakanthawi sikokwanira.

Ngati wodwalayo adagwiritsa ntchito othandizira ena a hypoglycemic, ndiye kuti mukachotsa mankhwalawo ndi Glformin Pronge amawongoleredwa ndi muyezo.

Metformin yamtundu wa 2 shuga imagwiritsidwanso ntchito limodzi ndi insulin. Mlingo woyambira wa Glyformin Prolong ndi zovuta mankhwala ndi 750 mg / tsiku. (phwando limodzi lophatikizidwa ndi chakudya chamadzulo). Mlingo wa insulin amasankhidwa poganizira zomwe amawerengera a glucometer.

Mlingo wovomerezeka wazomwe zimakhala ndi nthawi yayitali ndi 2250 mg (3 ma PC.). Ngati matenda ashuga sangakwanitse kuwongolera kwathunthu matendawa, amawasinthira mtundu wamankhwala ndikumasulidwa kwachizolowezi. Mwa njira iyi, mlingo waukulu ndi 3000 mg / tsiku.

Ngati nthawi yakumapeto yakusowa, muyenera kumwa mankhwalawo nthawi yoyamba. Ndikosatheka kuwirikiza kawiri pankhani iyi: mankhwalawa amafunika nthawi kuti thupi lizitha kuyamwa.

Gliformin sayenera kutumikiridwa chifukwa cha ketoacidosis, matenda osatha a chiwindi, chikomokere, mtima, kuperewera kwa m'mapapo, panthawi yapakati, yoyamwitsa, myocardial infarction, kumva kwambiri magawo a mankhwalawa.

Tengani mosamalitsa mankhwala othandizira matenda a etiology, musanachite opareshoni yayikulu.

Imawonjezera mphamvu ya kugwiritsidwa ntchito kwa metformin limodzi ndi zotumphukira:

sulfonylureas,
insulin
acarbose,
mankhwala osapweteka a antiidal
ma inhibitors a FAD amadalira aminoxidase ndi angiotensin kusintha enzyme,
cyclophosphamide
oxytetracycline.

Mankhwalawa, zotsatira zoyipa ziyenera kukumbukiridwa pophatikiza mankhwala ndi mankhwala ena:

Mapiritsi a Glformin Prolong sayenera kumwedwa ndi odwala omwe ali ndi X-ray yomwe ili ndi ayodini.
Sizoletsedwa kuphatikiza mankhwala ndi zakumwa zoledzeretsa kapena zakumwa zoledzeretsa.
Kutalika kwa Glyformin ndikosayenera kuphatikiza ndi GCS, tetracosactide, β-2-adrenergic agonists, Cloprozamine ndi mankhwala ena osokoneza bongo monga hyperglycemic. Ngati ndi kotheka, kuphatikiza koteroko kumafunikira kusintha kwa mlingo.
Kugwiritsira ntchito limodzi ndi okodzetsa kumakwiyitsa lactic acidosis.
Kuphatikizidwa kwa metformin ndi salicylates, insulin, sulfonylurea kumalimbikitsa hypoglycemia.

Ngati munthawi ya chithandizo ndi Glformin Prolong wodwalayo adalandira mankhwala aliwonse, ndikofunikira kufotokozera zomwe zikugwirizana.

Glformin imalimbikitsidwa kuti igwiritsidwe ntchito kaya ndi chakudya, kapena mutatha kumwa, kumwa mapiritsi okhala ndi madzi ambiri omveka.

M'milungu iwiri yoyambirira ya chithandizo (gawo loyambirira la mankhwala), mulingo wa tsiku ndi tsiku womwe umagwiritsidwa ntchito sayenera kupitirira 1 g. Mlingo umachulukana pang'onopang'ono, koma kuletsa kumawerengedwa - mankhwala akukonzanso sayenera kupitirira 2 g patsiku, logawidwa kawiri kapena katatu pa tsiku.

Ngati wodwala ali ndi zaka zopitilira 60, ndiye kuti mlingo woyenera wa mankhwalawa si wopitilira 1 g patsiku.

Momwe mungagwiritsire ntchito moyenera

Kutalika kwa Glyformin kumapangidwira ntchito zamkati. Piritsi imatengedwa kamodzi - madzulo, ndi chakudya chamadzulo, popanda kutafuna. Mlingo wa mankhwalawa amatsimikiziridwa ndi dotolo, poganizira zotsatira za mayeso, gawo la matenda ashuga, zomwe zimayenderana ndi zomwe zimachitika, zomwe zimachitika komanso momwe munthu amvera mankhwalawo.

Monga mankhwala oyambira, ngati munthu wodwala matenda ashuga sanamwe mankhwala a metformin, tikulimbikitsidwa kuti mlingo woyambirira uyenera kudulidwa mkati mwa 750 mg / tsiku. kuphatikiza mankhwala ndi chakudya.

M'masabata awiri ndizotheka kuwerengera bwino momwe mankhwalawo adasankhidwira ndipo ngati ndi kotheka, musinthe. Kuchepetsa kucheperachepera kwa muyezo kumathandizira kuti thupi lizisintha mosavutikira komanso kuchepetsa kuchuluka kwa zovuta.

Mulingo wamba wamankhwala ndi 1500 mg (mapiritsi 2), omwe amamwa kamodzi. Ngati simungathe kukwaniritsa momwe mungafunikire, mukulitse mapiritsi kuti akhale 3 (iyi ndi mlingo waukulu). Amatengedwa nthawi yomweyo.

Gliformin amagwiritsidwa ntchito mosamalitsa monga momwe dokotala wamulembera pamankhwala omwe amalumikizidwa kwambiri ndi momwe wodwalayo alili komanso kuchuluka kwake kwa shuga.

Zofunika! Kuphwanya Mlingo wa mankhwalawa kungayambitse zotsatira zoyipa ndikuchepetsa kuchiritsa kwa mankhwalawa.

Gliformin imayamba ndi Mlingo wochepa, pakapita nthawi kuchuluka kwa mankhwalawa kumachulukitsa, pang'onopang'ono kubwera pamlingo wokonza.

Mapiritsi ayenera kumwedwa kwathunthu, osaphwanya ndi kutafuna, ndi chakudya kapena mukangodya. Mankhwalawa ayenera kutsukidwa ndi kapu ya madzi. Kuti muchepetse zotsatira zoyipa za mankhwalawa m'matumbo, muyezo wa tsiku ndi tsiku umagawika katatu (kutengera mtundu wa mankhwalawo).

Zizindikiro za matenda ashuga - kanema

Zisonyezero zogwiritsira ntchito mankhwalawa ndi mtundu wachiwiri wa matenda osokoneza bongo a shuga, pamene kudya mosamalitsa ndi mankhwala a gulu la sulfonylurea alibe phindu. Glyformin imalembedwanso mtundu wa shuga 1 ngati adjunct wa jakisoni wa insulin.

Panthawi yamankhwala, kugwira ntchito kwa impso kuyenera kuyang'aniridwa, pafupifupi miyezi isanu ndi umodzi ndikulimbikitsidwa kuti mupange kusanthula kuti muwone mkaka wa m'magazi.

Mapiritsi amatha kuledzera pakudya kapena mutatha kudya, mlingo woyenera uyenera kutumikiridwa ndi dokotala, poganizira zotsatira za kuyesedwa kwa magazi:

kumayambiriro kwa mankhwala, mankhwalawa si oposa gramu imodzi patsiku,
pambuyo masiku 15, kuchuluka kwa ndalama kumachulukitsidwa.

Mulingo woyenera wokonza sayenera kupitilira magalamu awiri patsiku, uyenera kugawidwa moyenera pazigawo zingapo. Anthu odwala matenda ashuga okalamba tsiku lililonse amalimbikitsidwa kuti amwe mankhwala ambiri a gramu imodzi.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa odwala omwe ali ndi zaka zopitilira 60 omwe amagwira ntchito yolemetsa, yomwe imalumikizidwa ndi chiwopsezo chokhala ndi lactic acidosis mwa iwo. Odwala okalamba, tsiku lililonse mankhwala sayenera kupitirira 1 g.

Dokotala wodziwikiratu ndi amene amadziwa kuchuluka kwa mankhwalawo malinga ndi maphunziro a misempha ya m'magazi.

Mlingo woyambirira kumayambiriro kwa mankhwala ndi 500-1000 mg / tsiku. Pakatha milungu iwiri, imatha kukula kutengera mtundu wa glycemia. Mlingo wabwinobwino ndi 1.5-2 g / tsiku, ndipo 3000 mg. Pofuna kuchepetsa zovuta zomwe zimapangitsa kuti mankhwalawo apakidwe m'matumbo, mu gawoli limagawidwa pawiri.

Mapiritsi a Glyformin amatenga malangizo ogwiritsira ntchito kudya - makamaka madzulo. Mapiritsi saloledwa kuluma, kuphwanya - ayenera kuwameza kwathunthu. Mlingo ndi kutalika kwa njira yothandizira achire zimatsimikiziridwa padera kwa wodwala aliyense mogwirizana ndi zizindikiro za shuga m'magazi.

Mlingo woyambirira wa mlingo umodzi ndi 500 mg, kuchuluka kwake kumatsimikiziridwa payekhapayekha (amaloledwa kumwa mpaka katatu pa tsiku kapena kumwa Glformin 1000 mg mu kumwa limodzi). Amaloledwa kuwonjezera mlingo mpaka 850 mg x 1-2 p./d. Ngati dokotala akuwona kuti ndizofunikira, ndiye kuti mankhwalawa amawonjezedwa pang'onopang'ono mpaka kufika pazambiri - 2-3 g patsiku.

Monotherapy ya ana

Mankhwalawa ndi osayenera kwa ana osakwana zaka 18. Ngati mukusankhidwa, mlingo ungakhale wa ana opitirira zaka 10-50-8 mg mg wa tsiku limodzi.

Ndizothekanso kuikidwa kwa 500 mg x 2 p. / d

Ngati ndi kotheka, kuwonjezeka kwapang'onopang'ono kwa mlingo ndikotheka. Masiku 10-15 pambuyo pa kuyamba kwa makonzedwe, kukonza kwa kuchuluka kwa mankhwalawa kumachitidwa molingana ndi kuwerengedwa kwa kuchuluka kwa shuga m'magazi.

Ndi zovuta mankhwala, limodzi ndi insulin, mlingo woyambirira wa Glformin ndi 500-850 mg ndi pafupipafupi wa 2-3 r / s. Kuchuluka kwa insulin kumayendetsedwa ndi kuwerengera kwa glucose.

Pa nthawi yoyembekezera komanso yoyamwitsa

Amadziwika kuti decompensated shuga mellitus nthawi ya gestation imawopseza kukula kwa zovuta zokhudzana ndi kubereka komanso matenda a fetus, mwana akamwalira.

Mankhwalawa adapangira kuti azilamulira matenda a shuga a mtundu wa 2, makamaka kwa anthu okalamba onenepa kwambiri, ngati kusintha kwa moyo kulibe kubwezera 100% glycemic.

Mankhwalawa amagwiritsidwa ntchito onse mu monotherapy komanso panjira yovuta kutsata ndi mapiritsi ena a antidiabetes kapena insulin nthawi iliyonse yamatendawa.

Zoyipa zamagwiritsidwe ntchito a Glformin zitha kukhala:

mavuto mu chiwindi ndi impso,
kupezeka kwa matenda a shuga, lactic acidosis kapena ketoacidosis (kuphatikizapo mbiri)
kulephera kwa mtima kapena kupuma,
pachimake myocardial infaration,

Kutsutsana ndi kugwiritsa ntchito Glformin ndikuphwanya kwambiri magazi

Chithandizo cha mankhwala sichingachitike ngati wodwala wapezeka ndi matenda otsatirawa:

kulephera kwa mtima, ngozi ya mtima, kulephera kupuma komanso kulowetsedwa kwa mtima,
matenda a shuga
lactic acidosis
matenda ashuga ketoacidosis,
kwambiri matenda opatsirana, kuchepa kwamadzi ndi hypoxia.

Wodwala sayenera kuthandizidwa ndimankhwala ngati pali chida china chowonjezereka. Kugwiritsa ntchito mankhwalawa panthawi yopanga opaleshoni ndikulimbikitsidwa kwa insulin.

- lembani matenda ashuga a 2 a shuga ndi kusachita bwino kwa mankhwala akudya (makamaka odwala omwe ali ndi kunenepa kwambiri) monga monotherapy kapena kuphatikiza mankhwala ena a hypoglycemic.

Mankhwalawa ali ndi zotsutsana zotsatirazi:

Ketoacidosis ndi chiopsezo chomwe chimayamba ndi insulin yathunthu,
Matenda a shuga - kulephera kuzindikira komanso kusamva,
Lactic acidosis ndi kuchuluka kwambiri kwa lactic acid,
Matenda ndi matenda a impso, chiwindi,
Mtima, kulephera m'mapapo,
Myocardial minofu infaration,
Kuchepetsa ndi pakati
Matenda opatsirana, kuvulala kwambiri,
Ntchito zazikulu zomwe zakonzedwa posachedwa.

Ndi mphamvu yochepa, chithandizo chamankhwala chimaperekedwa kwa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri. Gliformin adadzitsimikizira polimbana ndi kunenepa kwambiri. Ndikotheka kugwiritsa ntchito mankhwalawa ngati monotherapy, komanso kuphatikiza ndi mankhwala ena omwe amachepetsa shuga ya plasma.

matenda a shuga, wodwala,
matenda ashuga ketoacidosis,
matenda oyambitsa minofu hypoxia (pachimake myocardial infarction, mapapo amalephera),
aimpso ndi chiwindi ntchito,
Njira zochizira zomwe zimapangidwira insulin,
kuvulala kwambiri
uchidakwa chifukwa choledzera.
mimba ndi mkaka wa m`mawere
kutsatira zakudya zochepa zama calori (zosakwana 1000 kcal / tsiku),
kuchuluka kwa magawo a mankhwala.

Maola 48 asanafike pofufuza wama radiology ogwiritsa ntchito othandizira (iv), mankhwalawa amayimitsidwa. Imayambiranso masiku awiri pambuyo pa njirayi molingana ndi zotsatira za kuchuluka kwa shuga m'magazi.

Mankhwala saloledwa kupereka kwa odwala omwe ali ndi:

Mulingo wapamwamba wokhudzidwa ndi zigawo za mankhwala
Mavuto a matenda ashuga (ketoacidosis, precoma, chikomokere)
Chiwindi ndi / kapena kulephera kwa impso
Zovuta zomwe zimayambitsa matenda a impso, zovuta matenda opatsirana
Kuchulukitsa kwa matenda komwe kumakhala chiwopsezo cha minofu hypoxia (kuphatikizapo kupweteka kwamkati wamtima, kuperewera kwa mtima, ndi zina zambiri)
Pamaso pa opaleshoni ntchito ndi kuvulala komwe insulin mankhwala zotchulidwa
Kuperewera kwa chiwindi
Uchidakwa, chakumwa choledzeretsa chachikulu
Mimba
Lactic acidosis yomwe ilipo pa nthawi yoyendetsa kapena mbiri
Kugwiritsa ntchito mankhwala osiyana ndi ayodini chifukwa makonzedwe a mtima
Asanakwanitse zaka 18 (chifukwa chosadziwa zambiri zamankhwala omwe amachitika m'gululi).

Kugwiritsa ntchito kwa Gliformin kumadziwikiratu pamaso pa wodwala:

machitidwe a hypoglycemic, n. wodwala matenda ashuga
ketoacidosis yolumikizana ndi hypoglycemia,
kudziwa magawo a mankhwala,
mimba ndi kuyamwitsa.

Pamaso pa matenda a somatic komanso opatsirana mu gawo lazowawa, chidwi chochuluka chimayenera kulipidwa posankha mtundu wofunikira.

Zotsatira zoyipa

Metformin ndi imodzi mwamankhwala otetezeka kwambiri omwe amayesedwa nthawi ndi maphunziro ambiri. Kapangidwe ka zotsatira zake sikulimbikitsa kupanga kwa insulin yake, chifukwa chake, hypoglycemia pa nthawi ya monotherapy sichimapangitsa kutalika kwa glyformin.

Chochitika chovuta kwambiri ndizovuta zam'mimba zam'mimba, zomwe zimatengera umunthu wa thupi ndikupita pambuyo pozolowera popanda chithandizo chamankhwala. Kukula kwa zoyambitsa kumawunikidwa malinga ndi kuchuluka kwa WHO: