Glucovans - malangizo, m'malo ndi kuwunika kwa wodwala

Mankhwala osiyanasiyana amagwiritsidwa ntchito kutengera mtundu wa shuga.

Pa mtundu 1, ma insulin ndi omwe amafunsidwa, ndipo a 2, makamaka amapangira mapiritsi.

Mankhwala ochepetsa shuga akuphatikizanso a Glucovans.

Zambiri pazamankhwala

Glucovans (glucovance) - mankhwala ovuta omwe ali ndi vuto la hypoglycemic. Chachilendo chake ndi kuphatikiza magawo awiri omwe amagwira ntchito zamagulu osiyanasiyana a mankhwala a metformin ndi glibenclamide. Kuphatikiza uku kumawonjezera zotsatira.

Glibenclamide ndi nthumwi ya m'badwo wachiwiri wa zotumphukira za sulfonylurea. Imadziwika ngati mankhwala othandiza kwambiri m'gululi.

Metformin amatengedwa ngati mankhwala a mzere woyamba, womwe umagwiritsidwa ntchito pokhapokha ngati pali chithandizo chamankhwala. Mankhwala, poyerekeza ndi glibenclamide, ali ndi chiopsezo chochepa cha hypoglycemia. Kuphatikizidwa kwazinthu ziwirizi kumakupatsani mwayi wopeza zotsatira zowoneka bwino ndikuwonjezera luso la mankhwala.

Kuchita kwa mankhwalawa kumachitika chifukwa cha magawo awiri omwe amagwira ntchito - glibenclamide / metformin. Monga zowonjezera, magnesium stearate, povidone K30, MCC, sodium croscarmellose amagwiritsidwa ntchito.

Wopezeka mu mawonekedwe a piritsi m'milingo iwiri: 2.5 mg (glibenclamide) +500 mg (metformin) ndi 5 mg (glibenclamide) +500 mg (metformin).

Zotsatira za pharmacological

Glibenclamide - imaletsa njira za potaziyamu ndikuwonjezera maselo a pancreatic. Zotsatira zake, katulutsidwe ka timadzi tambiri timachulukana, timalowa m'magazi ndi m'madzi am'magazi.

Mphamvu ya kukondoweza kwa katulutsidwe ka mahomoni imatengera mlingo womwe umatenge. Amachepetsa shuga onse odwala matenda ashuga komanso anthu athanzi.

Metformin - amalepheretsa kupanga kwa glucose m'chiwindi, kumawonjezera chidwi cha zimakhala ndi mahomoni, amalepheretsa mayamwidwe am'magazi m'magazi.

Mosiyana ndi glibenclamide, sichikulimbikitsa kaphatikizidwe ka insulin. Kuphatikiza apo, ili ndi phindu pa mbiri ya lipid - cholesterol yathunthu, LDL, triglycerides. Sizimachepetsa kuchuluka koyamba kwa shuga mwa anthu athanzi.

Pharmacokinetics

Glibenclamide imatengeka mwachangu mosasamala kanthu za kudya. Pambuyo maola 2,5, kuchuluka kwake kwa magazi m'magazi kumafikiridwa, pambuyo pa maola 8 amayamba kuchepa. Hafu ya moyo ndi maola 10, ndipo kuchotsedwa kwathunthu ndi masiku 2-3. Pafupifupi zimapukusidwa kwathunthu mu chiwindi. Thupi limapukusidwa mu mkodzo ndi bile. Kumangiriza kwa mapuloteni a plasma sikupitirira 98%.

Pambuyo pakukonzekera pakamwa, metformin imangokhala yodzaza kwathunthu. Kudya kumakhudza mayamwidwe a metformin. Pambuyo maora 2,5, kuchuluka kwambiri kwa chinthu kumafikiridwa, m'magazi kumakhala kocheperachepera m'madzi a m'magazi. Siphathamatidwa ndipo singasinthe. Kutha kwa theka-moyo ndi maola 6.2. Amaperekedwa makamaka ndi mkodzo. Kulumikizana ndi mapuloteni ndikosathandiza.

The bioavailability wa mankhwala ndi chimodzimodzi ndi osiyana gawo lililonse yogwira pophika.

Zizindikiro ndi contraindication

Mwa zina mwa zomwe mukumwa mapiritsi a Glucovans:

• Matenda a shuga a Mtundu 2 pakalibe mphamvu ya mankhwalawa pakudya, zolimbitsa thupi,
• Mtundu wa shuga wachiwiri mukusowa kwamphamvu panthawi ya monotherapy ndi Metformin ndi Glibenclamide,
• Posintha mankhwala odwala omwe amalamulidwa ndi glycemia.

Contraindication kuti agwiritse ntchito ndi:

• Mtundu woyamba wa shuga
• Hypersensitivity kuti amachokera ku sulfonylurea, metformin,
• Hypersensitivity pazinthu zina za mankhwala,
• kukanika kwa impso
• mimba / mkaka wa m`mawere
• matenda ashuga ketoacidosis,
• othandizira opaleshoni
• lactic acidosis,
• kuledzera
• Zakudya zama hypocaloric
• zaka za ana
• kulephera kwa mtima
• kulephera kupuma
• matenda opatsirana opatsirana
• vuto la mtima
• porphyria
• matenda aimpso.

Malangizo ogwiritsira ntchito

Mlingo wakhazikitsidwa ndi adokotala, poganizira kuchuluka kwa glycemia ndi machitidwe a thupi. Pafupifupi, muyezo wazithandizo zimagwirizana ndi zomwe zimaperekedwa. Chiyambireni cha chithandizo cha mankhwala chimakhala chimodzi patsiku. Popewa hypoglycemia, sayenera kupitilira muyeso womwe unakhazikitsidwa wa metformin ndi glibenclamide padera. Kuchulukitsa, ngati pakufunika, kumachitika milungu iwiri iliyonse kapena kupitilira apo.

Pankhani ya kusintha kuchokera ku mankhwalawa kupita ku Glucovans, chithandizo chamankhwala chimayikidwa poganizira zam'mbuyomu Mlingo uliwonse wogwira ntchito. Kutalika kokhazikika kwa tsiku ndi tsiku ndi magawo anayi a 5 + 500 mg kapena 6 magawo a 2,5 + 500 mg.

Mapiritsi amagwiritsidwa ntchito molumikizana ndi chakudya. Pofuna kupewa shuga wambiri m'magazi, pangani chakudya chamafuta nthawi zonse mukamwa mankhwala anu.

Kanema kochokera kwa Dr. Malysheva:

Odwala apadera

Mankhwalawa sanatchulidwe pokonzekera komanso panthawi yoyembekezera. Zikatero, wodwalayo amapatsidwa insulin. Mukakonzekera kutenga pakati, muyenera kudziwitsa dokotala. Chifukwa cha kusowa kwa kafukufuku wofufuza, ndi mkaka wa m'mawere, Glucovans sigwiritsidwa ntchito.

Odwala okalamba (> azaka 60) sanapatsidwe mankhwala. Anthu omwe akuchita ntchito yayikulu salimbikitsidwa kumwa mankhwalawo. Izi zimagwirizanitsidwa ndi chiwopsezo chachikulu cha lactic acidosis. Ndi megoblastic anemia, ndikofunikira kuganizira kuti mankhwalawa amachepetsa kuyamwa kwa B 12.

Malangizo apadera

Gwiritsani ntchito mosamala matenda a chithokomiro, zotupa, kutalika kwa adrenal. Palibe mankhwala omwe amalembera ana. Glucovans saloledwa kuphatikiza mowa.

Mankhwalawa amayenera kutsagana ndi muyeso wa shuga musanadye kapena mutatha kudya. Ndikulimbikitsanso kuyang'ana ndende ya creatinine. Ngati vuto la impso mwa okalamba, kuyang'anira kumachitika katatu pachaka. Ndi magwiridwe antchito a ziwalo, ndikokwanira kuti muwunike kamodzi pachaka.

Maola 48 asanafike / atachitidwa opaleshoni, mankhwalawa amathetsedwa. Maola 48 isanachitike / atatha kuyesedwa kwa X-ray ndi chinthu cha radiopaque, Glucovans sigwiritsidwa ntchito.

Anthu omwe ali ndi vuto la mtima ali ndi chiopsezo chowonjezeka cha matenda a impso ndi hypoxia. Kuyang'anira kwambiri mtima ndi ntchito ya impso ndikulimbikitsidwa.

Zotsatira zoyipa ndi bongo

Zina mwazotsatira zoyipa zakumwa zimawonekera:

• chofala kwambiri ndi hypoglycemia,
• lactic acidosis, ketoacidosis,
• kuphwanya kukoma
• thrombocytopenia, leukopenia,
• kuchuluka kwa creatinine ndi urea m'magazi,
• kusowa kwa chakudya komanso mavuto ena am'mimba,
• urticaria ndi kuyabwa kwa khungu,
• kuwonongeka kwa ntchito ya chiwindi,
• chiwindi
• hyponatremia,
• vasculitis, erythema, dermatitis,
• zosokoneza zowoneka zakanthawi.

Ndi bongo wa Glucovans, hypoglycemia imatha kukhazikika chifukwa cha kukhalapo kwa glibenclamide. Kumwa 20 g shuga kumathandiza kuti mapapu azikhala mwamphamvu. Kupitilira apo, kusintha kwa mlingo kumachitika, chakudyacho chimawunikanso. Hypoglycemia yayikulu imafuna chisamaliro chadzidzidzi komanso kugonekedwa kuchipatala. Mankhwala ochulukirapo amatha kutulutsa ketoacidosis chifukwa cha kukhalapo kwa metformin. Zofananazo zimathandizidwa kuchipatala. Njira yothandiza kwambiri ndi hemodialysis.

Kuchita ndi mankhwala ena

Osaphatikiza mankhwalawa ndi phenylbutazone kapena danazole. Ngati ndi kotheka, wodwalayo amayang'anira momwe zimachitikira. ACE zoletsa amachepetsa shuga. Kuchulukitsa - corticosteroids, chlorpromazine.

Glibenclamide siyikulimbikitsidwa kuti iphatikizidwe ndi miconazole - kuyanjana uku kumawonjezera zovuta za hypoglycemia. Kulimbitsa machitidwe a chinthucho ndikotheka mutatenga Fluconazole, anabolic steroids, clofibrate, antidepressants, sulfalamides, mahomoni achimuna, zotumphukira za coumarin, cytostatics. Mahomoni achikazi, mahomoni a chithokomiro, glucagon, barbiturates, diuretics, sympathomimetics, corticosteroids amachepetsa mphamvu ya glibenclamide.

Ndi munthawi yomweyo makonzedwe a metformin okhala ndi okodzetsa, mwayi wokhala lactic acidosis ukuwonjezeka. Zinthu za Radiopaque zikaphatikizidwa zimatha kupangitsa kulephera kwa impso. Pewani kugwiritsa ntchito mowa basi, komanso mankhwala osokoneza bongo omwe ali ndi zomwe zili.

Zambiri, ma analogu

Mtengo wa mankhwala Glucovans ndi 270 rubles. Sichifuna malo osungirako. Yoperekedwa ndi mankhwala. Moyo wa alumali ndi zaka zitatu.

Kupanga - Merck Sante, France.

Analogue mtheradi (zigawo zomwe zimagwirizana) ndi Glybomet, Glybofor, Duotrol, Glunored.

Palinso mitundu ina yophatikizira yogwira (metformin ndi glycoslide) - Dianorm-M, metformin ndi glipizide - Dibizid-M, metformin ndi glimeperide - Amaryl-M, Douglimax.

M'malo mwake mutha kukhala mankhwala okhala ndi chinthu chimodzi chogwira ntchito. Glucophage, Bagomet, Glycomet, Insufort, Meglifort (metformin). Glibomet, Maninil (glibenclamide).

Maganizo a odwala matenda ashuga

Ndemanga za odwala zimawonetsa kugwira ntchito kwa Glucovans komanso za mtengo wovomerezeka. Amadziwikanso kuti muyezo wa shuga mukamamwa mankhwalawa uyenera kuchitika pafupipafupi.

Poyamba adatenga Glucophage, atalembedwa Glucovans. Dokotala adaganiza kuti zitha kukhala zothandiza kwambiri. Mankhwalawa amachepetsa shuga bwino. Pokhapokha tiyenera kuchita zambiri kuti tipewe hypoglycemia. Adotolo adandiuza izi. Kusiyana pakati pa Glucovans ndi Glucophage: mankhwala oyamba ali ndi glibenclamide ndi metformin, ndipo chachiwiri chimakhala ndi metformin.

Salamatina Svetlana, wazaka 49, Novosibirsk

Ndakhala ndikuvutika ndi matenda ashuga kwa zaka 7. Posachedwa ndidasankhidwa kukhala mankhwala osakanikirana a Glucovans. Pompopompo pazabwino: kukonzekera, kugwiritsa ntchito, chitetezo. Mtengo ulibe kuluma - pakukhazikitsa zonse ndimangopatsa 265 r, zokwanira theka la mwezi. Mwa zolakwa: pali zotsutsana, koma sindili m'gulu lino.

Lidia Borisovna, wazaka 56, Yekaterinburg

Mankhwalawa adalembera amayi anga, ali ndi matenda ashuga. Amatenga Glucovans pafupifupi zaka 2, akumva bwino, ndikumuwona akuchita bwino komanso wokondwa. Poyamba, mayi anga anali ndi vuto lakumimba - nseru komanso kutaya mtima, mwezi ukatha zonse zimatha. Ndidazindikira kuti mankhwalawa ndi othandiza komanso amathandiza.

Sergeeva Tamara, wazaka 33, Ulyanovsk

Ndinatenga Maninil m'mbuyomu, shuga adakhala pafupifupi 7.2. Adasinthira ku Glucovans, mu sabata la shuga shuga adatsikira ku 5.3. Ndikuphatikiza chithandizo ndi masewera olimbitsa thupi komanso zakudya zosankhidwa mwapadera. Ndimayetsa shuga pafupipafupi ndipo sindimalola kuti zinthu ziziwayendera kwambiri. M'pofunika kusinthira ku mankhwalawa pokhapokha mukaonana ndi dokotala, onani kuti mwatsatanetsatane.

Alexander Savelyev, wazaka 38, St. Petersburg

Zomwe zimayikidwa poika glucovans

Kuchepetsa kukula kwa zovuta za anthu odwala matenda ashuga kumatheka pokhapokha kuwongolera matenda ashuga. Chiwerengero chobwezeretsera ndalama chakhala chovuta m'zaka makumi angapo zapitazi. Izi ndichifukwa choti madokotala anasiya kulingalira za mtundu wachiwiri wa matenda ashuga mtundu wochepera matenda kuposa mtundu 1. Zakhazikitsidwa kuti uwu ndi matenda ovuta, aukali, opita patsogolo omwe amafunikira chithandizo chanthawi zonse.

Kuti mukwaniritse glycemia wabwinobwino, nthawi zambiri pamafunika mankhwala ochulukirapo a shuga. Njira yovuta yochizira ndichinthu chodziwika bwino kwa ambiri odwala matenda ashuga omwe akudziwa. Monga lamulo wamba, mapiritsi atsopano amawonjezeredwa atangomaliza omwe sakupatsanso kuchuluka kwa hemoglobin ya glycated. Mankhwala oyambira ku maiko onse padziko lapansi ndi metformin. Zomwe zimachokera ku sulfonylureas nthawi zambiri zimawonjezeredwa kwa icho, chotchuka kwambiri chomwe ndi glibenclamide. Glucovans ndi kuphatikiza kwa zinthu ziwiri izi, zimakupatsani mwayi wochepetsera chiwembu cha matenda a shuga, osachepetsa mphamvu yake.

Glucovans yemwe ali ndi matenda ashuga amalembedwa:

1. Ngati mwazindikira mochedwa matenda ake kapena mwachangu, mwamwano. Chizindikiro chakuti metformin yokhayo siyokwanira kuthana ndi matenda ashuga komanso kuti Glucovans ndiyofunika - glucose yofulumira ya oposa 9.3.
2. Ngati pa gawo loyamba la matenda a shuga musamadye chakudya chopatsa mphamvu, kulimbitsa thupi ndi metformin musamachepetse glycated hemoglobin pansipa 8%.
3. Ndi kuchepa pakupanga insulin. Izi mwina mwina labotale zimatsimikiziridwa kapena kunenedwa potengera kukula kwa glycemia.
4. Ndi kulekerera bwino kwa metformin, komwe kumawonjezera nthawi yomweyo ndi kuwonjezeka kwa mlingo wake.
5. Ngati metformin yapamwamba Mlingo wambiri.
6. Pamene wodwalayo kale adatenga metformin ndi glibenclamide ndipo akufuna kuchepetsa kuchuluka kwa mapiritsi.

Momwe mungamwe mankhwalawa pakumwa

Mankhwala a Glukovans amapangidwa m'mitundu iwiri, kotero mutha kusankha mosavuta mlingo woyenera pachiyambi ndikuwonjezera mtsogolo. Chowonetsera pa paketi ya 2,5 mg + 500 mg chikuwonetsa kuti glibenclamide ya microformated ya 2,5 imayikidwa piritsi, 500 mg metformin. Mankhwalawa akuwonetsedwa koyambirira kwamankhwala pogwiritsa ntchito PSM. Njira 5 mg + 500 mg ndiyofunikira kuti mulimbitse mankhwala. Kwa odwala omwe ali ndi hyperglycemia amalandira mlingo woyenera wa metformin (2000 mg patsiku), kuchuluka kwa glibenclamide kukuwonetsedwa pakuwongolera matenda osokoneza bongo.

Malangizo othandizira odwala ndi ma Glucovans pazomwe angagwiritse ntchito:

1. Mlingo woyambira nthawi zambiri ndi 2.5 mg + 500 mg. Mankhwalawa amatengedwa ndi chakudya, chomwe chimayenera kukhala chakudya.
2. Ngati m'mbuyomu mtundu wachiwiri wa matenda ashuga atenga zonse zodwala muyezo waukulu, mulingo woyambira ungakhale wokwera: kawiri 2.5 mg / 500 mg. Malinga ndi odwala matenda ashuga, glibenclamide monga gawo la Glucovans imakhala yothandiza kwambiri kuposa masiku onse, chifukwa chake, mlingo wapitawu ungayambitse hypoglycemia.
3. Sinthani mlingo pambuyo masabata awiri. Choyipa chomwe wodwala amene ali ndi matenda ashuga amaloleza kulandira ndi mankhwala a metformin, nthawi yayitali malangizowo amawalimbikitsa kusiya kuti azolowere mankhwala. Kukula msanga kwa mankhwalawa kumangobweretsera mavuto ndi m'mimba, komanso kutsika kwamphamvu kwa magazi.
4. Mlingo wapamwamba ndi 20 mg ya micronized glibenclamide, 3000 mg ya metformin. Pankhani ya mapiritsi: 2.5 mg / 500 mg - 6 zidutswa, 5 mg / 500 mg - 4 zidutswa.

Malangizo pa malangizo omwe mungamwe mapiritsi:

Zotsatira zoyipa

Zambiri kuchokera ku malangizo ogwiritsira ntchito pafupipafupi zotsatira zoyipa:

Malinga ndi ndemanga, zovuta zazikulu za odwala omwe amamwa mankhwalawa Glukovans, zimayambitsa kusapeza bwino m'mimba. Amatha kupewedwa pochulukitsa pang'onopang'ono komanso kugwiritsa ntchito mapiritsi ndi chakudya basi.

Mu odwala matenda ashuga, makamaka hypoglycemia imachitika. Amachotsedwa msanga ndi shuga atangoyamba kumene zizindikiro. Kwa odwala omwe samva kuchepa kwa shuga, malangizowo salimbikitsa kumwa mapiritsi a Glucovans ndi magulu awo am'magulu. Amawonetsa kuphatikiza kwa metformin ndi glyptins: Galvus Met kapena Yanumet.

Contraindication

Kugwiritsa ntchito Glucovans ndizowopsa kwa odwala matenda ashuga omwe ali ndi zotsutsana ndi metformin kapena glibenclamide:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

• matupi awo sagwirizana ndi metformin kapena PSM iliyonse,
• Mtundu woyamba wa shuga
• matenda a impso, ngati creatinine> 110 mmol / L mwa akazi,> 135 mwa amuna,
• pa matenda owopsa, kufunsa kwa mwayi wogwiritsa ntchito mankhwalawa wodwala kumasankhidwa ndi adokotala.
• Mimba, kuyamwa,
• ketoacidosis, lactic acidosis,
• chizolowezi cha lactic acidosis, chiopsezo chake chachikulu,
• zakudya zopatsa mphamvu zamafuta ochepa ( Sofia akukumbukira . Ndinayamba kumwa Glucovans ndimapiritsi 1 m'mawa, sabata lomwe shuga amatsika kuchokera 12 mpaka 8. Tsopano ndimamwa mapiritsi awiri, shuga ndi abwinobwino, koma nthawi zina hypoglycemia imachitika. Ndizosangalatsa kwambiri kuti mlingo wocheperako umagwira. Zitsamba ndi zakudya zomwe dokotala adapereka sizinathandize. Ndizachisoni kuti mtengo wa mankhwalawo wakwera, ndipo sikuti umapezeka nthawi zonse kuchipatala.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Kupanga ndi mawonekedwe a kumasulidwa

Glibenclamide ndi metformin hydrochloride adagwiritsidwa ntchito ngati zosakaniza zogwira ntchito.

Munthawi ya zida zothandizika:

• croscarmellose sodium
• cellcrystalline mapadi,
• magnesium wakuba,
• povidone K30,
• Opadry OY-L-24808 wokhala ndi pinki kulocha.

Fomu yotulutsira - mapiritsi, pamwamba pake omwe amajambula filimu. Chombochi chimapangidwa ndi kuchuluka kwa zosakaniza 500 mg ndi 5 mg, kapena 500 ndi 2.5. Mapiritsi ali ndi matumba a contour a 15 zidutswa, bokosi lililonse lili ndi 2 kapena 4 mwa maphukusili.

Malangizo ogwiritsira ntchito

Mankhwalawa akuwonetsedwa kuti agwiritsidwe ntchito ndi odwala achikulire omwe ali ndi matenda a shuga a 2 muzochitika zotsatirazi:

• ngati zakudya, zolimbitsa thupi ndi mankhwala a metformin, zomwe zidachitika kale, sizothandiza,
• m'malo mwa chithandizo choyambirira cha odwala omwe ali ndi index ya glycemic yoyendetsedwa.

Mapiritsi amatengedwa pakamwa pakumwa chakudya, ndipo zakudya zimayenera kuphatikizidwa ndi chakudya.

Mlingo wa mankhwalawa amasankhidwa ndi dokotala payekhapayekha, yemwe ayenera kukumbukira index.

Zofunika! Poyamba, muyenera kumwa Glucovans 500 mg + 2,5 mg kapena Glucovans 500 +5, piritsi limodzi kamodzi patsiku.

Nthawi zina wodwala amachotsedwa kuphatikiza kapena kudzichiritsa nokha ndi mankhwala okhala ndi sulfonylurea ndi metformin kupita ku Glucovans. Pankhaniyi, pofuna kupewa mapangidwe a glycemia, mlingo woyambirira umayikidwa muyezo wofanana ndi kuchuluka kwa mankhwalawa tsiku lililonse omwe amwe mankhwala omwe adalandiridwa kale.

Kuti mukwaniritse zowongolera zoyenera pa glycemic index, mlingo umawonjezeka pakapita nthawi, kuchuluka kwa 500 mg + 5 mg patsiku lililonse masiku 14 kapena kuchepera. Yendetsani kuchuluka kwa mankhwalawa kuyenera kupatsidwa index ya glycemic.

Mlingo wa tsiku ndi tsiku wa Glucovans ndiwofika pazidutswa zinayi ndi mlingo wa 500 mg ndi 5 mg wa zosakaniza, kapena 6 zokhala ndi zosakaniza zolimbitsa 500 ndi 2.5. Pafupipafupi kugwiritsa ntchito mankhwalawa amasankhidwa ndi dokotala payekhapayekha, zimatsimikiziridwa ndi mlingo wa tsiku ndi tsiku wa mankhwalawa.

• Chidutswa chimodzi chokhala ndi zinthu zilizonse zofunikira - kamodzi patsiku,
• 2 kapena 4 zidutswa zilizonse zokhala ndi zosakaniza - kawiri pa tsiku, pa chakudya cham'mawa komanso chamadzulo,
• 3, 5 kapena 6 zidutswa 500 mg + 2.5 mg kapena 3 zidutswa 500 + 5 - katatu patsiku, phwando limachitika pakudya kwam'mawa, masana komanso chakudya chamadzulo.

Akuluakulu amafunika kumwa mapiritsi ambiri a 1 pc. Ndi yogwira mankhwala mu 500 mg + 2,5 mg. Glucovans imalembedwa ndikugwiritsidwa ntchito poyang'anira kayendedwe ka impso.

Musanayambe kulandira chithandizo ndi mapiritsi awa, ndikofunikira kupatula kukhalapo kwa zotsutsana zilizonse. Simungatenge Glucovans ndi:

• Hypersensitivity pazinthu monga metformin, glibenclamide kapena zotumphukira zina za sulfonylurea, komanso zina zowonjezera,
• Mtundu woyamba wa matenda a shuga
• matenda ashuga ketoacidosis,
• matenda ashuga kapena precom odwala matenda ashuga,
• Kulephera kwa impso kapena kufooka kwa ziwalo (creatinine chilolezo choposa 60 ml pa mphindi imodzi.),
• pachimake zinthu zomwe zingayambitse kusintha kwa impso: kuphwanya mphamvu yamagetsi am'madzi mthupi, matenda opatsirana, mantha, makina osokoneza bongo a othandizira omwe ali ndi ayodini,
• matenda a pachimake kapena matenda Inde limodzi ndi mpweya kufa mu minofu: chosakwanira mu mtima ndi mapapu, myocardial infarction, mantha,
• kulephera kwa chiwindi
• matenda a porphyrin,
• wokhala ndi mwana ndi nthawi yobereka;
• munthawi yomweyo kugwiritsa ntchito miconazole,
• opaleshoni yayikulu
• kudalira mowa kwambiri, kumwa poyizoni ndi mawonekedwe owopsa,
• lactic acidosis, kuphatikiza pa zambiri zamakono,
• Kutsatira zakudya zochepa zama calori (zosakwana calories 1000 patsiku).

Mankhwala osavomerezeka kuti agwiritsidwe ntchito ndi odwala matenda ashuga omwe ali ndi zaka zopitilira 60, akuchita ntchito yayikulu, popeza motsutsana ndi maziko a chithandizo chotere, chiopsezo chotenga matenda monga lactic acidosis chikuwonjezeka.

Glucovans imakhala ndi lactose, pachifukwa ichi sichiyenera kutengedwa ngati matenda amtundu wa cholowa atapezeka motsutsana ndi maziko a shuga, momwe galactose tsankho, kuperewera kwa lactase kapena glucose-galactose malabsorption.

Chenjezo liyenera kumwedwa ndi Glucovans ndi:

• febrile syndrome
• kuperewera kwa adrenal,
• makina obisika mu anterolateral pituitary dera,
• Matenda a chithokomiro limodzi ndi kusintha kosasintha kwa ntchito ya thupi.

Popewa kupangika kwa zovuta zilizonse, ndikofunikira kufunsa dokotala musanagwiritse ntchito mankhwalawa.

Panthawi yomwe Glucovans pazifukwa zina sizigwirizana ndi wodwalayo, amodzi a fanizo adayikidwa:

• mwaogwira: Glibomet, Glyconorm, Metglib, Gluconorm kuphatikiza,
• malinga ndi momwe thupi limakhudzira: Glucobaia, Maninila, Humaloga, Glformina, Glyurenorma.

Mulimonsemo, ndikofunikira kukaonana ndi katswiri, chifukwa mankhwala aliwonse ali ndi zotsutsana zina zomwe angagwiritse ntchito ndipo zimapangitsa kuti pakhale zovuta zina.

Kuganizira za mankhwalawa kumatha kupezeka m'malo ambiri momwe anthu amalankhulirana za matenda ashuga. Odwala omwe adalandira mankhwalawa akukambirana za kusankha kwa regimen ndi mlingo wa mankhwalawo, komanso kugwiritsa ntchito limodzi ndi mankhwala ena. Ndemanga za chithandizo ndi Glucovans ndizotsutsana. Monga lamulo, kuti mukwaniritse zomwe mukufuna, ndikofunikira kuyang'anira kuchuluka kwa chakudya chamafuta, zomwe zili ndi zopatsa mphamvu ndi kuchuluka kwa mankhwalawa.

Koma odwala ena amalankhula molakwika za mankhwalawo. Nthawi zina, glitches mu index ya glycemic imayamba, i.e. mapangidwe a hypoglycemia. Nthawi zina, odwala amati: pofuna kukhazikika bwino, amayenera kusintha mosamala moyo wawo komanso njira zina zochiritsira.

Komabe, mankhwala omwe ali ndi matendawa mthupi ndi gawo lofunikira la mankhwalawa odwala omwe amapezeka ndi matenda osokoneza bongo, chifukwa amathandiza kusintha moyo wawo. Ndi matendawa, odwala amafunikira kuwunikira pafupipafupi komanso chithandizo chapadera. Izi zitha kuchitika pokhapokha ngati mgwirizano ndi dokotala ndi wodwalayo, zomwe zingathandize kwambiri thanzi la womaliza.

Ndemanga Zahudwala

• Valentine, wazaka 41. Anandipeza ndi matenda a shuga a mtundu wachiŵiri. Adotolo alemba kuti azikhala ndi ma glucovans. Nthawi zina, poiwalika, ndimadumphira kumwa mankhwalawo, ngakhale kuchuluka kwa shuga m'magazi kumakhalabe kozungulira. Ndimatsatira malangizo onse azachipatala okhudzana ndi zakudya komanso masewera olimbitsa thupi. Amamva bwino, shuga adachepetsedwa ndikuwunikira, koma osati kwambiri.
• Antonina, wazaka 60. Anathandizidwa ndi Metformin, koma zotsatira zake zidachepa atagwiritsidwa ntchito kwa nthawi yayitali, chifukwa chomwe Glucovans adamulembera. Mulingo wa shuga watsika ndi theka, chizindikiro pa mita sichidutsa 7. Mapiritsi amathandizira kwambiri, ndikumva bwino. Sindikukayika kuti bokosi latsopano lamankhwala lidzakhala ndi zotsatira zofananazo, chifukwa zofanana ndi zomwe adachitapo kuchipatala.

Glucovans ikhoza kugulidwa m'malo opangira mankhwala mukamapereka mankhwala. Mtengo wa mankhwalawa muyezo wa 500 mg +2.5 mg - rubles 210-310, wokhala ndi zinthu zofunikira mu 500 mg + 5 mg - 280-340 rubles.

Zizindikiro zogwiritsidwa ntchito

Mankhwala ndi zina zotere:

• mtundu 2 shuga
• Zakudya zabwino komanso chithandizo chamankhwala,
• m'malo mwa chithandizo cham'mbuyomu odwala omwe amakhala ndi glycemia.

Mankhwalawa ali ndi vuto la hypoglycemic.

Kutulutsa Fomu

Glucovans imapangidwa ndi zinthu zofunikira za 5 + 500 mg ndi 2.5 + 500 mg. Mankhwala amadzaza matuza a mapiritsi 15. Phukusili limaphatikizapo matuza awiri kapena anayi.

Mapiritsi 30 a Glucovans 2.5 + 500 mg amatenga ma ruble a 220-320, 5 + 500 mg amatenga ma ruble 250-350.

• glibenclamide,
• metformin hydrochloride,
• sodium croscarmellose,
• MCC
• Povidone K30.

Zowonjezera: Opadry OY-L-24808 pinki.

Zolemba zogwiritsira ntchito

Glucovans imakhudza ziwalo zonse, kotero mutha kuzigwiritsa ntchito pokhapokha ngati mwalandira dokotala. Matenda a shuga a Type 1 sayenera kugwiritsa ntchito mankhwalawa. Odwala muubwana kapena okalamba omwe ali ndi zaka zopitilira 60 amaletsedwanso ku Glucovans.

Anthu omwe amakhala ndi nkhawa nthawi zonse amakhala ndi mankhwala ena. Zomwe zimapanga ma Glucovans zimayambitsa lactic acidosis. Lactose imakhudza thanzi la odwala omwe ali ndi matenda osalolera.

Mavuto a impso ndi ma contraindication. M'madera ena odwala matenda ashuga, mapiritsi atatha kulowa mthupi amayambitsa matenda osiyanasiyana, mavuto akulu a chiwindi ngakhale ndi michere yaying'ono.

Pamaso pa opareshoni, mankhwalawo amasokonezedwa kwa masiku awiri, kuchuluka komwekukuyenera kudikirira musanayambenso. Pachimake kapena matenda a kupuma dongosolo, mtima amakula pambuyo kumwa mankhwalawo. Simungamwe mapiritsi ndi mowa.

Kuchita ndi mankhwala ena

Glucovans amatanthauza contraindication mankhwala munthawi yomweyo ndi miconazole ndi kugwiritsa ntchito zosiyana madzi okhala ayodini.

Sikoyenera kumwa mapiritsi nthawi yomweyo:

• Phenylbutazone complies kukula kwa hypoglycemia,
• Bozentan ali ndi poizoni, akumayambitsa chiwindi.
• Mowa umakwiyitsa lactic acidosis.

Ndi kuyesedwa kwa X-ray, kugwiritsa ntchito Glucovans ndizochepa. Potenga chithandizo, ndikofunikira kuphunzira kuchuluka kwa shuga. Glibenclamide pa kuchuluka kwa mankhwalawa kumakwiyitsa maonekedwe a hypoglycemia. Wodwalayo ali ndi mwayi uliwonse wakupezeka ndi vuto lakudya ndi mafuta ochepa.

Zotsatira zoyipa

Tilembapo mavuto:

• kusadya bwino
• akukumbutsa
• kulemera m'mimba
• kutsegula m'mimba
• kulawa kwazitsulo pamimba yopanda kanthu
• kupweteka m'mimba
• kudzimbidwa
• kusokonekera kwamatumbo,
• m'malo mwake khungu limayatsidwa
• kuvulala kumawonjezeka
• zotupa, redness,
• kupweteka kwa minofu
• kuvutika kupuma.

Ngati lactic acidosis ikachitika, muyenera kulumikizana ndi katswiri kuti akuthandizeni. Kuwonjezeka pang'ono kwa ndende ya urea ndi creatinine kumatsimikiziridwa pambuyo pakupenda, zizindikiro sizimachitika.

Palibe zizindikiritso zilizonse ndi kusowa kwa vitamini B12 chifukwa cha zovuta zomwe zimayamwa ndikugwiritsa ntchito metformin kwanthawi yayitali. Nthawi zina odwala amakhala ndi lilime lowawa, kumeza kumakhala kovuta, ndipo chiwindi chimakula kukula.

Ndi kugundana kwa anaphylactic, kuthamanga kwa magazi kumachepa, kutupa kumachitika, ndipo mavuto apuma amayamba. Hypoglycemia imachitika pamene mankhwalawa agwiritsidwa ntchito molakwika, wodwalayo amafuna kudya, kupweteka kumamveka, manja akunjenjemera, mantha akumakulirakulira, mtima ukugunda pafupipafupi.

Matenda am'mimba amachititsa zovuta zambiri. Adzatha kuwaletsa atangowonjezera pang'ono muyezo ndikugwiritsa ntchito mankhwalawo ndi chakudya. Anthu odwala matenda ashuga amapanga mtundu wofatsa wa hypoglycemia, womwe umachotsedwa posachedwa pambuyo poyambira zizindikiro zoyambirira. Odwala omwe samva kuti kuchepa kwa shuga ali osavomerezeka kuti atenge mankhwala a Glucovans ndi analogue.

Bongo

Hypoglycemia imachitika ndi mankhwala osokoneza bongo. Ngati mumadya shuga pang'ono, mutha kuthana ndi mawonekedwe owonda kwambiri. Onetsetsani kuti musinthe mlingo komanso zakudya.

Zochitika zovuta za hypoglycemic, zomwe zimayendetsedwa ndi chikomokere, paroxysm, ndi minyewa yamitsempha, zimafunikira chithandizo cha odwala komanso thandizo la akatswiri oyenerera.

Dextrose amawayikira odwala kudzera m'mitsempha ndikupatsidwa chithandizo chofunikira. Pambuyo pozindikira, wodwalayo amapatsidwa chakudya chochepa chamafuta. Izi zimathandiza kupewa mobwerezabwereza hypoglycemia.

Nthawi zonse pamakhala mwayi wa lactic acidosis, kulimbana komwe kumachitika mchipatala. Hemodialysis imakuthandizani kuti muchotse lactate ndi metformin kuchokera mthupi mwachangu.

Tili ndi mndandanda waukulu:

Ndalamazi zimasiyana pakapangidwe kake ndi cholinga chachikulu, koma zimatha kusintha china chilichonse.

Zomwe zili bwino - Glucofage kapena Glucovans

Metformin ndiye chinthu chofunikira kwambiri pa mankhwalawa.

Kuti mudziwe chomwe chiri bwino, ndikofunikira kuphunzira zamankhwala:

• shuga
• kugwiritsa ntchito bwino glycemic,
• kuchepa thupi mwa kusintha kwa kagayidwe kazinthu,
• Mavuto a matenda akuluakulu samachitika nthawi zambiri poyerekeza ndi mankhwala ena.

Mwina munthawi yomweyo kugwiritsa ntchito mankhwalawo ndi mankhwala ena. Glucophage ndi Glucovans amalimbikitsidwa kuti agwiritsidwe ntchito ndi odwala matenda ashuga omwe ali onenepa kwambiri.Mukamasankha, muyenera kuyang'ana mtengo wa mankhwalawo komanso upangiri wa akatswiri.

Ndili ndi matenda ashuga a 2, madokotala amamulembera Glucovans. Nthawi zina ndimayiwala kumwa mapiritsi, komabe ndimatha kukhalabe ndi shuga. Nthawi zonse ndimatsatira upangiri wa madotolo pazakudya ndikuchita masewera olimbitsa thupi.

Metformin sagwiranso ntchito, adotolo adapereka ma Glucovans. Glucose yafupika nthawi 2, chipangizocho sichikuwonetsa kupitirira 7. Mankhwala amathandiza nthawi zonse, amapereka chitsimikizo. Sindikukayikira kuti ndikagula phukusi latsopano ndidzalandira zotsatira zofananira popanda kusintha.

Zotsatira za mankhwala

Kuphatikizidwa kwa wothandizila wa hypoglycemic kuphatikiza zinthu ziwiri zogwira: Metformin ndi Glibenclamide. Chiwerengero chawo mwa makapisozi zimasiyanasiyana:

Mankhwala, mumapezekanso zotupa: croscarmellose sodium, magnesium stearate, selulosi, povidone K 30.

Mankhwalawa amasulidwa ngati mapiritsi. Chipolopolo cha kapisozi chimatha kukhala chachikasu kapena lalanje. Mu mtundu woyamba, nambala ya "5" yalembedwa mbali yakutsogolo, lachiwiri - "2,5".

Zotsatira za pharmacological

Metformin ndi woimira gulu la ma biagudins. Cholinga chake chachikulu ndikuchepetsa kuchuluka kwa shuga a basal ndi postprandial m'magazi. Thupi silimbikitsa kupangika kwa ambulensi amkati, chifukwa chake sikuti limayambitsa hypoglycemia. Njira zikuluzikulu zake:

• Kuchepetsa kapangidwe ka glycogen m'chiwindi poletsa njira za gluconeogeneis,
• Kuthetsa "khungu" la zotumphukira timadzi timene timatulutsa,
• Kuchuluka kwa magwiritsidwe ntchito a glucose m'maselo,
• Kuletsa kwa shuga.

Metformin imakhudzanso kagayidwe ka lipid: kuchuluka kwa mafuta a triglycerol ndi "oyipa" amachepetsa kwambiri.

Glibenclamide ndi woimira gulu lachiwiri la mankhwala a sulfonylurea. Gulu la glycemia limathandizira kusintha chifukwa cha kukhudzika kwa maselo a β-cell omwe amapanga insulin.

Kupanga kwamachitidwe a zigawo za formula ndikosiyana, koma amakwanitsa kuthana ndi vuto la chilichonse, ndikupanga mgwirizano. Pogwiritsa ntchito mosiyanasiyana, Mlingo wa mankhwala aliwonse pazotsatira zofananazo udzakhala wokwera kwambiri.

Mphamvu ya Pharmacokinetic

Glibenclamide ikamilowetsa m'mimba m'matumbo imalowetsedwa ndi 95%. Monga gawo la mankhwala Glucovans® imapangidwa micron. Kuchuluka kwa ndende m'magazi kumatha kufikira maola 4, kuchuluka kwa magawo athunthu mpaka 10 malita. Glibenclamide imamangiriza mapuloteni 99%. Kagayidwe kachakudya zimachitika m'chiwindi, komwe amasinthidwa kukhala ma inert metabolites awiri. Amatuluka m'thupi kudzera mu impso (mpaka 40%) komanso kudzera munjira ya biliary (mpaka 60%). Njira ya theka-moyo imachokera ku maola 4-11.

Pakaperekedwa pakamwa, metformin imalowetsedwa kwathunthu, thunthu limafikira m'magazi awiri ndi theka. Popanda kusintha kwakukulu, 20-30% ya chinthucho imapukusa matumbo. The bioavailability wa metformin ndi 50-60%. M'matipi, mankhwalawo amafalikira pafupifupi nthawi yomweyo ndipo samamangirira mapuloteni am magazi konse. Katunduyu sakhala pafupi ndi kagayidwe, ambiri a iwo amatsitsidwa ndi impso. Hafu ya moyo imatenga pafupifupi maola 6 ndi theka.

Mu matenda a impso a impso, kuvomerezeka kwa creatinine kumachepetsedwa. T1 / 2 ndi chiwalo chomwe mukufuna sichichedwa, mankhwalawa amadziunjikira m'magazi. Glucovans bioavailability ndi ofanana ndi amitundu iliyonse. Kudya sikukhudza gawo ili, koma kuchuluka kwa mayamwa a glibenclamide motsatana ndi chakudya kumakhala kwakukulu.

Ndani akuwonetsedwa mankhwalawo

Ovuta amapangidwira kuchiza matenda amtundu wa 2 shuga. Zimasankhidwa ngati kusintha kwamakhalidwe ndi chithandizo cham'mbuyomu ndi metformin kapena mankhwala ena osagwiritsa ntchito zotsatira zomwe zikuyembekezeka.

Mankhwala amalimbikitsidwa kwa odwala matenda ashuga omwe ali ndi shuga yokwanira kubwezeretsanso njira yapitayo yoyambira ndi mankhwala awiri osiyana - Metformin ndi oyimira gulu la sulfonylurea.

Momwe mungagwiritsire ntchito

Kutengera ndi mankhwalawa omwe amachitika chifukwa cha matenda a matenda ashuga, endocrinologist imakonzekera chiwembu. Pazomwe wopanga akupanga, miyambo yonse yamtundu woyambira imaperekedwa: kapisozi imodzi yamtundu uliwonse wa Glucovans.

Ngati mulingo wosankhidwa sakulipirira mokwanira glycemia munthawi ya kusintha kwa moyo, mutha kusintha, koma osapitilira sabata ziwiri, 5 mg ya glibenclamide + 500 mg ya metformin tsiku lililonse.

Posintha chithandizo chamankhwala cham'mbuyomu ndi a Glucovans, mlingo woyambira uyenera kukhala wofanana ndi wa tsiku ndi tsiku wa glibenclamide kapena mankhwala ofananawo kuchokera ku gulu la sulfonylurea, komanso metformin, yomwe idafotokozedwera gawo lomaliza la chithandizo.

Malinga ndi kuwerenga kwa mita pambuyo masabata awiri, mutha kusintha kuchuluka kwa glucovans.

Mapiritsi ambiri omwe angafotokozedwe kwa odwala matenda ashuga ndi zidutswa 4 pamiyeso ya 5 mg / 500 mg kapena 6 zidutswa za Glucovans ®, zosungika mu 2.5 mg / 500 mg.

Njira yogwiritsira ntchito zimatengera chiwembu chomwe adokotala adasankha. Kwa mapiritsi a 2,5 mg / 500 mg ndi 5 mg / 500 mg pali malingaliro oyenera.

1. Ngati piritsi limodzi / tsiku lakonzeka, amamwa m'mawa ndi chakudya,
2. Ngati chizolowezi cha tsiku lililonse chimakhala mapiritsi awiri kapena anayi, zimagawidwa m'mawa ndi madzulo, kukhalabe zimodzimodzi.
3. Ngati ndi kotheka, tengani mapiritsi a 3.5 kapena 6 / tsiku. pa kumwa kwa 2,5 mg / 500 mg, amamwa ndi chakudya cham'mawa, nthawi ya nkhomaliro komanso chakudya chamadzulo.
4. Pa mlingo wa 5 mg / 500 mg, mapiritsi atatu / tsiku ndi omwe amapatsidwa. ndikugawa m'magawo atatu: kadzutsa, nkhomaliro komanso chakudya chamadzulo.

Ndikofunikira kwambiri kulanda mapiritsi ndi chakudya chokwanira. Kutenga ma Glucovans pamimba yopanda kanthu kumayambitsa hypoglycemia.

Kwa odwala matenda ashuga okalamba, popanga mankhwala a algorithm, amayang'ana kwambiri momwe magwiridwe antchito.

Mlingo woyambira mulimonsemo mulibe piritsi limodzi la 2,5 mg / 500 mg. Pankhaniyi, momwe impso ziyenera kuyang'aniridwa mosalekeza.

Palibe deta yodalirika pamagetsi a Glucovans® pa ana, kugwira ntchito kwake ndi chitetezo chake, chifukwa chake, kugwiritsa ntchito sikulimbikitsidwa kwa ana.

Lactic acidosis

Vutoli ndi losowa, koma lalikulu kwambiri kotero kuti aliyense wodwala matenda ashuga ayenera kudziwa za izi. Popanda chithandizo chamankhwala chofulumira, wozunzidwayo akhoza kufa. Mkhalidwe wowopsa umayamba kuphatikizika ndi metformin. Kusazindikira mosavomerezeka komweko kumalumikizidwa ndi kulephera kwa impso, motero, ndi pyelonephritis ndi zina komanso zovuta pachimake aimpso, mankhwalawa ayenera kumwedwa mosamala.

Zina zomwe zimayambitsa ngozi zimaphatikizira kuwongolera matenda ashuga a mtundu 2, ketosis, kusala kudya kwa nthawi yayitali kapena kuperewera kwa zakudya m'thupi, kuledzera, komanso kukanika kwa chiwindi.

Kuopsa kwa lactic acidosis kumawonjezeka ndi kukokana kwa minofu, kukanika kwa dyspeptic, kupweteka m'dera la epigastric, kufooka kwakukulu.

Pamafunika kuchipatala mwachangu, kufupika kwa acidotic, kuperewera kwa oksijeni, hypothermia, chikomokere.

Hypoglycemia

Glibenclamide ilipo mu mtundu wa Glucovans ®, zomwe zikutanthauza kuti mwayi wa hypoglycemia mukamagwiritsa ntchito mapiritsi sungathetsedwe. Chidwi chosinthika cha mankhwalawa chingathandize kupewa kusintha kwadzidzidzi kwa mashuga a plasma. Ndikofunika kudziwitsa wodwalayo za Zakudya zofunikira panthawi yake, popeza chakudya cham'mawa kapena chakudya cham'mawa chambiri, chopanda mafuta, chakudya chamadzulo chomwe chimayambitsa nthawi chimatha kuyambitsa hypoglycemia. Ndi katundu wowonjezereka wa minofu (masewera olimbitsa thupi, zolimbitsa thupi zolimbitsa thupi), mutatha phwando lochulukirapo, zakudya za hypocaloric kapena kugwiritsa ntchito mankhwala osokoneza bongo a antidiabetes, mwayi wa hypoglycemia ndiwokwera kwambiri.

Kusintha kwatsankho komwe izi zimayambitsa zimawonetsedwa mu thukuta lakuchulukirachulukira, mantha, kuchuluka thukuta, kusokonezeka kwa mtima, matenda oopsa, matenda a mtima.

Ngati hypoglycemia imakula pang'onopang'ono, matenda a mtima samakhazikika nthawi zonse, makamaka ndi neuropathy kapena chithandizo chanthawi zonse ndi β-blockers, reserpine, clonidine, guanethidine.

Zizindikiro zina za hypoglycemia zimaphatikizapo:

• Chilango chosalamulirika
• Mutu
• Zovuta,
• Kutha
• Kusagona bwino
• Mantha
• Kukonda
• Zosokoneza
• Kubweza
• Zowonongeka
• Mavuto olankhula
• Kutentha
• Kutaya kulumikizana
• Kupukuta
• Kuyenda pang'onopang'ono
• Kukhumudwitsa.

Kusankha mosamala mankhwala, kuwerengetsa mulingo woyenera, komanso kudziwitsa odwala zotsatira zake ndizofunikira kwambiri kupewa. Ngati munthu wodwala matenda ashuga kale ali ndi vuto la hypoglycemia, ndikofunikira kubwereza njira yochiritsira.

Glycemia wosakhazikika

Ngati ndi kotheka, chithandizo chosasamala kapena chifukwa china chomwe chimayambitsa kuwonongeka kwa matenda ashuga, wodwalayo amasamutsidwa kwakanthawi ndi insulin. Zizindikiro za hyperglycemia zimatha kukodza pafupipafupi, ludzu losatha, kugona, kufooka, khungu lowuma lam'munsi chifukwa chakuyenda bwino. Masiku awiri asanayambe opareshoni kapena jekeseni wamitsempha ya wothandizira wosiyana ndi maphunziro a X-ray, Glucovans® imathetsedwa, chithandizo chimayambitsidwanso pasanathe masiku awiri pambuyo pa opareshoni ndi njira zoyeserera ndi ntchito yokwanira impso.

Mavuto a impso

Impso zimagwira nawo ntchito yochotsa metformin, motero, isanayambike maphunzirowa komanso mwadongosolo mukamagwiritsa ntchito mankhwalawa, kuyimitsidwa kwa creatinine kuyenera kuwunikiridwa. Anthu odwala matenda ashuga okhala ndi impso zathanzi amayenera kuyesedwa osachepera 1 r. / Chaka, kwa anthu akulu msinkhu, komanso odwala omwe ali ndi chilolezo cha creatinine pamwambapa mwachizolowezi - 2-4 r. / Chaka.

Kuchepetsa kwamkati kumawonedwa mwa odwala oopsa omwe amatenga diuretics ndi NSAIDs, kotero gulu ili la odwala matenda ashuga liyenera kuperekedwa mwachidwi.

Zotsatira zoyipa

Pafupipafupi pazotsatira zosagwiritsidwa ntchito bwino ndi Glucovans zimawerengeredwa malinga ndi kuchuluka kwapadera kwa WHO:

• Nthawi zambiri: ≥ 0.1,
• Nthawi zambiri: ≥ 0.01, Zotsatira za Mankhwala

Wodwala matenda ashuga amakakamizidwa kuti auze dokotala za mankhwala onse omwe atengedwe kuti athe kuganizira momwe angakwaniritsire polemba zakumwa za algorithm komanso kuzindikira zizindikiro zosafunikira munthawi yake.

• Wolemba: Minazole yokhala ndi glibenclamide (yambitsa hypoglycemia), metformin ndi mankhwala okhala ndi ayodini (Glucovans adachotsedwa patatha maola 48).
• Zizindikiro za bongo ndi contraindication

Mankhwala osokoneza bongo ndi owopsa ndi hypoglycemia yamitundu yosiyanasiyana. Ndi mawonekedwe ofatsa, zizindikirazi zimathanso kuchotsedwa ndi shuga, ndipo kuthandizira kwambiri kutsegula kuchipatala ndikofunikira, chifukwa pali chiwopsezo cha lactic acidosis ndi chikomokere, makamaka chokhala ndi hypoglycemia. Ndi dokotala, muyenera kusintha mlingo ndi kugwirizanitsa zakudya.

• Hypersensitivity pazofunikira ndi zotulukirapo,
• Mtundu woyamba wa shuga
• Ketoacidosis, chikomokere ndi matendawo
• Matenda a renal (chilolezo cha creatinine - mpaka 60 ml / min),
• Zinthu zomwe zimayambitsa matenda, mantha, kusowa kwamadzi,
• Pathologies omwe amayambitsa minofu hypoxia,
• Matenda a mtima ndi kupuma,
• Kukanika kwa hepatatic,
• Mimba ndi kuyamwitsa,
• Chithandizo chachikulu cha opaleshoni,
• Kugwiritsa ntchito miconazole munthawi yomweyo,
• Mowa
• Lactic acidosis (mbiri),
• Kuperewera kwa thupi m'thupi

Mtengo ndi malo osungira

Mapiritsi amayikidwa m'matumba. Bokosi lililonse - 2 mbale. Kalata "M" yakhazikika pa ma CD - kutetezedwa ndi zabodza. Gulitsani mankhwala omwe mumalandira.

Ku Glucovans, mtengo wamtengo muma pharmace amatengera dera, mtundu wa mankhwala ndi kipimo. Pafupipafupi, phukusi la 2.5 mg / 500 mg lingagulidwe kwa ma ruble 220., 5 mg / 500 mg - kwa ma ruble a 320.

Sungani mankhwalawo mchipinda popanda ana. Moyo wa alumali ndi zaka zitatu.

Glucovans: malingaliro a madokotala ndi ogwiritsa ntchito

About Glucovans, ndemanga za anthu odwala matenda ashuga amasakanikirana. Anthu azaka zakubadwa amalankhula za kugwiritsidwa ntchito kosavuta: palibe chifukwa chokumbukira mapiritsi omwe ndidamwa ndi omwe ndayiwala. Kwa ena, mankhwalawa asinthana bwino ndi insulin, chifukwa palibe amene amakonda jakisoni. Ena amadandaula za chizungulire, kupweteka kwam'mimba, kusowa kudya kosalekeza.

Madotolo mu ndemanga amati zovuta zoyambira koyamba kwa chithandizo chamankhwala ndi Glucovans ndizabwinobwino. Popita nthawi, thupi limasinthasintha. Simuyenera kuopa insulini, nthawi zina imakhala yokakamiza kwakanthawi. Mulimonsemo, kusankha kwa mankhwala nthawi zonse kumakhala kwa dokotala. Ambiri amazindikira kupezeka kwa mankhwalawo, ngakhale kuti ndi koyenera.

Zolemba za mankhwala

Ngati timalankhula mwatsatanetsatane za momwe mungamwere ma Glucovans, ndiye kuti, choyambirira, muyenera kulabadira kuti sulfonylurea, yomwe ndi gawo lophatikizika, komanso zinthu zina, zimachepetsa kukula kwa glucose yemwe amapangidwa ndi maselo a beta a thupi, makamaka makamaka kapamba. Ndiye chifukwa chake, mankhwalawa amayenera kumwedwa pokhapokha ngati adokotala adauza komanso muyezo womwe amapereka.

Komanso, munthu sayenera kuyiwala kuti metformin ndi glibenclamide zomwe ndi gawo limodzi la mankhwalawa zimakhala ndi mphamvu yofanana ya glycemic, ngakhale amachita mosiyana ndi thupi.

Pakakhala ndalama zamkati mwazomwe zimapezedwa, ndiye kuti zomwe zili m'makina ogaya zimakhala 95%. Koma zomwe zili mu gawo limodzi la zigawo za m'magazi zimafikira maola anayi mutatha kutenga Glucovans 5 mg kapena 2.5 mg. Pakadali pano, metformin m'mimba yogaya imasungunuka kwathunthu mkati mwa maola awiri ndi theka.

Anthu ambiri ali ndi chidwi ndi funso loti amwe mapiritsi angati kuti amwe. Pankhaniyi, zonse zimatengera kuzindikira kwazomwe zikuchitika. Tiyerekeze kuti ndikofunikira kuganizira zaka za wodwalayo, jenda ndi mawonekedwe ena a thupi la wodwalayo. Mlingo weniweniwo ungathe kutumizidwa ndi adokotala, atapimidwa mozama.

Nthawi zambiri pamabuka mafunso ngati Metformin ndi Glibenclamide atha kutengedwa nthawi yomweyo, pamenepo, yankho lake lingakhale inde. Zotsatira zabwino zakugwiritsa ntchito nthawi imodzizi mwa zinthu izi zitha kuwoneka chifukwa cha mankhwala omwe ali pamwambawa.

Ndikofunikanso kuti kudya mwamtheradi sikumakhudza metformin, koma nthawi yomweyo imathandizira zotsatira za glibenclamide.

Kodi zotsutsana ndimankhwala ndizotani?

Ma Glucovans ali ndi ma analogi omwe amapangidwa pamaziko a zomwe zimagwira ntchito zomwezo, kotero mankhwalawa amayenera kumwedwa mosamala komanso kutsatira mankhwalawa.

Mukamamwa mankhwala, contraindication onse ayenera kuganiziridwa.

Akatswiri odziwa ntchito amalimbikitsa kuti musayambe chithandizo ndi mankhwalawa ngati wodwala ali ndi zoletsa zina pazogwiritsa ntchito.

Main contraindication ndi:

• chidwi chamunthu pazinthu zomwe zimapanga mankhwala,
• kukhalapo kwa matenda a shuga a mtundu woyamba,
• Kulephera kwa impso, kulephera kwa izi.
• kuchuluka kwa matupi amtundu wa ketoacidosis, komanso momwe mulili pang'onopang'ono,
• mkhalidwe waumoyo womwe umayendetsedwa ndi chizindikiro monga minofu hypoxia (mtima kapena kupuma kwa dongosolo, kusakhazikika kwa myocardial, mkhalidwe wakunjenjemera),
• zaka zoyambirira za mwana
• kulephera kwa impso
• nthawi yoyamwitsa azimayi, komanso nthawi yakakhanda.
• Ndikulowerera kwakukulu
• pa zakumwa zoledzeretsa, zomwe zili pamlingo wa kukula kwamatenda.

Komanso, ndikofunikira mosamala kumwa mankhwalawa kwa anthu omwe ali ndi zaka zopitilira 60, komanso kwa iwo omwe amagwira ntchito zolimbitsa thupi.

Nthawi zina, madokotala amalimbikitsa kuti musagwiritse ntchito mankhwalawo, mwachitsanzo, amatha kukhala opweteka kapena osakwanira.Kuchepa kwa chithokomiro kungathenso kuchitika mndandandandawo. Kuti mumvetsetse ndendende zomwe anthu omwe amatenga Glurenorm kapena Glucovans, komanso Glucofage, amafunikira kuti apimidwe bwino, ayenera kufufuza kaye ndi katswiri wodziwa bwino yemwe angadziwe ngati ali ndi vutoli komanso asavomereze kapena osavomereza kumwa mankhwalawa.

Nditenge mankhwala liti?

Wopanga amalimbikitsa kutenga glucovans kuti azindikire mtundu wachiwiri wa shuga mwa okalamba. Makamaka, muzochitika ziti zomwe madokotala amapereka mankhwala kwa wodwala wawo, chinthu choyamba chomwe tikulankhula ndi pamene zakudya zomwe wodwala amatsatira sizipereka zomwe akufuna. Milandu yokhudzana ndi mankhwala osokoneza bongo imadziwikanso kwambiri pomwe wodwala woyamba adatenga metformin mwa mawonekedwe ake enieni, koma mankhwalawo sanapereke zotsatira zomwe akufunazo.

Tiyenera kudziwa kuti mapiritsi a Glucovans 500 ali ndi maubwino angapo poyerekeza ndi mankhwala ena omwe amachitanso chimodzimodzi. Ngakhale mankhwala omwe ali pakadali pano amakupatsani mwayi wowongolera shuga m'magazi, koma amapereka zotsatira zoyipa. Mtengo wa mankhwalawo ndiwovomerezeka, ndi ma ruble mazana atatu phukusi la zidutswa makumi atatu.

Ngakhale ndikofunikira kukumbukira kuti Glucovans 500mg 5mg, monga mankhwala ena aliwonse, amatha kukhala ndi zotsatirapo zina.

Mwachitsanzo, imatha kukhala machitidwe a thupi monga:

1. Hepatic kapena khungu porphyria, lomwe limakhala chifukwa cha zovuta za metabolic za wodwalayo.
2. Lactic acidosis.
3. Pali milandu yomwe imadziwika kuti ikuwonjezera kufalikira kwa magazi.

Odwala ena amadandaula kuti chifukwa chotenga masamba a Glucovans 500 kusintha kwawo kumasintha.

Koma musachite mantha nthawi yomweyo, ngati mutamwa Glurenorm kapena mankhwala ena ali ndi vuto lofananalo, ndiye kuti mankhwalawo sangayende limodzi ndi zovuta zambiri.

Zowona, zitha kukhalapo nthawi zina pomwe wodwalayo amatha kudana ndi zovuta za mankhwalawo.

Umboni wa odwala omwe amamwa mankhwalawo

Zachidziwikire, pafupifupi aliyense amene anayenera kudwala matenda ashuga amayesabe kudziwa zambiri mwatsatanetsatane za momwe kugwiritsa ntchito mankhwalawa kwatithandizira. Amakondanso kudziwa tanthauzo la mankhwalawa. Tiyenera kudziwa kuti Glyrenorm amadziwika kuti ndiwodziwika bwino wa mankhwala. Mankhwalawa nthawi zambiri amawerengedwa ndi madokotala kuti azichiza matenda a shuga a 2.

Ponena za kuwunika kwa wodwala, ndizovuta. Wina akuti chithandizo cha mankhwalawa ndichapamwamba kwambiri. Kwa ena, mmalo mwake, zikuwoneka kuti kugwiritsa ntchito mankhwalawa pafupipafupi sikumapereka zotsatira zoyenera, ndipo nthawi zina ngakhale zimapweteketsa mankhwalawo.

Zomwe, momwe Glucovans imasiyanirana ndi Mankhwala a Glurenorm, ndiye kuti koyambirira titha kuzindikira mlingo waukulu wa zigawo zikuluzikulu ndi zinthu zosiyanasiyana zomwe zimagwira ntchito zothandiza. Mlingo weniweni kapena kufunikira kwa kusintha kwa mankhwalawa kungathe kutsimikiziridwa ndi katswiri wodziwa bwino pambuyo pofufuza bwino wodwalayo.

Ngati tikuyankhula za mankhwala ati omwe ali ndi mankhwala ofanana ndi a Glucovans, choyambirira, awa ndi Glucofast ndi Glybomet.

Ndemanga ina ya odwala ambiri imati kuti pakufunika kwa mankhwalawo muyenera kutsatira zakudya zoyenera nthawi zonse. Mwachitsanzo, muyenera kuyesetsa kusiya kugwiritsa ntchito zakumwa zoledzeretsa, kuwongolera kuchuluka kwa chakudya chamafuta, komanso kuchepetsa kudya komwe kumakulitsa shuga m'magazi a anthu.

Kodi ndikofunika kukumbukira chiyani mukamagwiritsa ntchito?

Odwala ena amawopa kwambiri kuti ayambe kulandira mankhwala atatha kuwerengera kuti mankhwalawa sanagwirizane ndi wina. Kapena malingaliro omwe anthu amalemba amati, ndimamwa mankhwalawa, ndipo samapereka kufunika.

Ndikufuna kudziwa kuti simungathe kuchita mantha nthawi yomweyo komanso kukana chithandizo chamankhwala. Nthawi zina izi zimachitika chifukwa chakuti kuchuluka kwa mankhwala omwe amwedwa sikugwirizana ndi kupezeka kwa wodwalayo kapena kuopsa kwa matenda omwewo.

Kuti mumvetsetse bwino mankhwala omwe mukufuna kugula, mutha kuwona zithunzi zam'mapiritsiwo pa intaneti.

Ndipo, ndithudi, ndikofunikira kukumbukira tsiku lomwe munapanga mankhwalawo. Kumwa mapiritsi omwe atha ntchito kumatha kuvulaza wodwala.

Zakhala zanenedwa kale kuti ndizinthu ziti zomwe ndizigawo lamankhwala. Tiyeneranso kudziwa kuti mankhwalawa a INN ali ndi dzina liti, pamenepa amatchedwa metformin.

Inde, mankhwala aliwonse amapereka zabwino zokhazokha pokhapokha ngati wodwala yemwe akuwagwiritsa ntchito akutsatira momveka bwino muyezo komanso atsogoza moyo wabwino. Pankhaniyi, ndikofunikira kutsatira zakudya zoyenera, komanso kuti musanyalanyaze zochitika zolimbitsa thupi mu shuga. Nthawi yomweyo, katundu wambiri thupi samalimbikitsidwa.

Zachidziwikire, simungathe kunyalanyaza malamulo owongolera shuga. Ngati chizindikiro ichi sichikuwunikidwa mu nthawi, ndiye kuti kumwa mankhwalawa kungavulaze thanzi.

Ndi mankhwala ati othandiza kwambiri a hypoglycemic omwe afotokozedwa muvidiyoyi.