Glucophage Kutalika

Kufotokozera kogwirizana ndi 15.12.2014

Dzina lachi Latin: Glucophage kutalika
Code ya ATX: A10BA02
Chithandizo: Metformin (Metformin)
Wopanga: 1. MERC SANTE SAAS, France. 2. Merck KGaA, Germany.

Mapiritsi okhala ndi nthawi yayitali amakhala ndi 500 kapena 750 mg yogwira ntchito - metformin hydrochloride.

Zowonjezera: sodium carmellose, hypromellose 2910 ndi 2208, MCC, magnesium stearate.

Pharmacodynamics ndi pharmacokinetics

Metformin ndi biguanidendi hypoglycemiczotsatiraamatha kuchepetsa ndendeshuga m'magazi amwazi. Komabe, sizimalimbikitsa kupanga insulinchifukwa chake sizoyambitsa hypoglycemia. Mankhwala, zotumphukira zimakhudzidwa kwambiri ndi insulin, ndipo kugwiritsidwa ntchito kwa glucose ndi maselo kumawonjezeka. Chiwopsezo cha shuga chiwindi chimachepetsedwa chifukwa chopinga glycogenolysis ndi gluconeogeneis. Kuchedwa kuyamwa kwa shuga m'mimba.

Yogwira pophika mankhwala imapangitsa kuti glycogen pochita pa glycogen synthase. Zimawonjezera kuthekera kwa mayendedwe a glucose aliwonse.

Mankhwalawa metformin Odwala amasunga thupi kapena kuwona kuchepa kwapakati. Thupi limakhala ndi phindu pa kagayidwe ka lipid: kutsitsa kuchuluka kwathunthu cholesterol triglycerides ndi LDL.

Mapiritsi okhala ndi nthawi yayitali amakhala ndi kuchepetsedwa kwa mayamwa. Chifukwa chake, chithandizo chamankhwala chimapitirira kwa maola osachepera 7. Kuyamwa kwa mankhwalawa sikudalira chakudya ndipo sikuyambitsa kukondweretsedwa. Zofunikira zomanga mapuloteni a plasma zimadziwika. Metabolism imachitika popanda kupangika kwa metabolites. Kuchotsa zigawo zikuluzikulu kumachitika m'njira yosasinthika mothandizidwa ndi impso.

Zizindikiro zogwiritsidwa ntchito

Glucophage Long amalembedwa kuti mtundu 2 shuga odwala akulu omwe ali ndi kunenepa kwambiri pa vuto la kudya mosakwanira ndi zolimbitsa thupi monga:

monotherapy
kuphatikiza mankhwala ndi mankhwala ena a hypoglycemic kapena insulin.

Contraindication

Mankhwala sakhazikitsidwa:

zomverametformin ndi zinthu zina,
matenda ashuga ketoacidosis, precoma chikomokere
kuphwanya kapena kusakwanira kwa impso kapena chiwindi,
pachimake mitundu matenda osiyanasiyana,
kuvulala kwakukulu ndi ntchito,
aakulu uchidakwakuledzera
mimba
lactic acidosis,
gwiritsani ntchito maola 48 isanayambe kapena itatha maphunziro a radioisotope kapena x-ray yokhudzana ndi kuyambitsa kwa sing'anga wokhala ndi ayodini
Zakudya zama hypocaloric,
osakwana zaka 18.

Chenjerani popereka mankhwala awa uyenera kugwiritsidwa ntchito poyerekeza ndi odwala okalamba, anthu omwe akuchita masewera olimbitsa thupi, chifukwa izi zingapangitse chitukuko lactic acidosismankhwalawa akazi mkaka.

Zotsatira zoyipa

Pa mankhwala, mankhwala amatha lactic acidosis, kuchepa kwa magazi m'thupi, idachepetsa mayamwidwe a vitamini B12.

Komanso, kusokonezeka komwe kumagwira ntchito kwamanjenje sikumayikidwa pambali - kusintha kwa kakomedwe, ntchito yam'mimba thirakiti - nseru, kusanza, kupweteka, kutsegula m'mimba, kusowa chilimbikitso. Nthawi zambiri, zizindikirazi zimasokoneza kumayambiriro kwa chithandizo ndikupita pang'onopang'ono. Popewa kukula kwawo, odwala amalangizidwa kuti azitenga metformin limodzi kapena atangodya.

Nthawi zina, zamiseche mu ntchito ya chiwindi ndi bile, chiwonetsero cha khungu thupi lawo siligwirizana.

Bongo

Phwando metformin pa mlingo wochepera 85 ga sizimapangitsa kukula kwa hypoglycemia. Koma mwayi wachitukuko udakalipo lactic acidosis.
Zizindikiro za lactic acidosis zikawonetsedwa, ndikofunikira kusiya kumwa mankhwalawo, kuchipatala, kudziwa kuchuluka kwa lactate, ndikumveketsa bwino matendawa. Kuchita bwino kwa njira yochotsera lactate ndi metformin kuchokera mthupi pogwiritsa ntchito hemodialysis kumadziwika. Concomitatic Symbalatic mankhwala amachitidwanso.

Kuchita

Kukula lactic acidosis Zitha kuyambitsa kuphatikiza kwa mankhwalawa ndi ayodini wokhala ndi ma radiopaque othandizira. Chifukwa chake, kwa maola 48 isanachitike komanso atatha kuyesedwa kwa radiology pogwiritsa ntchito ayodini wokhala ndi radiopaque, kuthetsedwa kwa Glucophage Long ndikulimbikitsidwa.

Kugwiritsa ntchito munthawi yomweyo mankhwala osakhudzana ndi hyperglycemic zotsatira - mankhwala a mahomoni kapena tetracosactidekomanso β2-adrenergic agonists, danazol, chlorpromazine ndi okodzetsazingakhudze kuchuluka kwa shuga m'magazi. Chifukwa chake, ndikofunikira kuwongolera zomwe zikuwonetsa, ndipo ngati ndi kotheka, chitani kusintha kwa mlingo.

Kuphatikiza apo, pamaso pa kulephera kwa aimpsookodzetsakulimbikitsa chitukuko lactic acidosis. Kuphatikiza ndi sulfonylureas, acarbose, insulin, salicylates nthawi zambiri zimayambitsa hypoglycemia.

Kuphatikiza ndi amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprimndi vancomycin, omwe amasungidwa mu aimpso tubules, amalowa mpikisano ndi metformin yoyendetsa ma tubular, yomwe imakulitsa chidwi chake.

Tsiku lotha ntchito

Zofananira zazikulu za mankhwalawa: Bagomet, Glycon, Glyformin, Glyminfor, Langerine, Metospanin, Metadiene, Metformin, Siafor ndi ena.

Kuledzeretsa kumawonjezera mwayi wokhala ndi vuto lactic acidosis pachimake kuledzera. Mphamvu yolimbitsa imawonedwa pakusala kudya, kutsatira zakudya zamafuta ochepa, komanso kupezeka kwa kulephera kwa chiwindi. Chifukwa chake, kumwa mowa pa mankhwalawa kuyenera kutayidwa.

Ndemanga za Glucophage

Nthawi zambiri, odwala amasiya ndemanga za Glucofage Long 750 mg, popeza mlingo womwewo umaperekedwa panthawi ya chithandizo mtundu 2 shuga pakati pake. Potere, odwala ambiri amawona kuchuluka kwa mankhwalawa. Nthawi zambiri pamakhala malipoti oti mankhwalawa atamwa ndi anthu odwala matenda ashuga omwe ali ndi kulemera kwambiri, ndiye kuti pambuyo pake adazindikira kuchepa kwakukulu pamankhwala kuzizindikiro zovomerezeka.

Ponena za Glucofage xr 500, ndiye kuti mankhwalawa atha kuperekedwa pa nthawi yake ya mankhwalawa. M'tsogolomu, kuwonjezeka kwapang'onopang'ono kwa mlingo kumaloledwa mpaka kusankha kumakhala kothandiza kwambiri.

Tiyenera kudziwa kuti ndi katswiri yekha yemwe angafotokozere mankhwala aliwonse a hypoglycemic. Kuphatikiza pa chithandizo chamankhwala chokwanira, dokotala amalimbikitsa kusintha kwa zakudya, zolimbitsa thupi, zomwe ziyenera kukhala gawo lofunikira m'miyoyo ya anthu omwe akudwala matenda ashuga. Njira yokhayo ndi yomwe ingatsimikizire kukhala ndi moyo wabwino komanso osamva kwambiri zisonyezo zonse zoyipazi.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mapiritsi okhala ndi nthawi yayitali amakhala ndi 500, 750 kapena 1,000 mg ya yogwira mankhwala metformin hydrochloride.

Piritsi 1:

yogwira mankhwala: metformin hydrochloride - 500, 750 kapena 1000 mg,
othandizira (500/750/1000 mg): sodium carmellose - 50 / 37.5 / 50 mg, cellcrystalline cellulose - 102 //0 mg, hypromellose 2208 - 358 / 294.24 / 392.3 mg, hypromellose 2910 - 10/0/0 mg, magnesium stearate - 3.5 / 5.3 / 7 mg.

Mankhwala

Mankhwala a metformin amathandizira kutsitsa shuga wamagazi, omwe amatha kuwonjezeka kuchokera pakudya. Kwa thupi la munthu, njirayi ndiyachilengedwe, ndipo kapamba, yemwe amachititsa kuti pakhale insulin, amathandizidwanso. Ntchito ya chinthu ichi ndi kufalikira kwa glucose kumaselo amafuta.

Monga mankhwala othana ndi matenda osokoneza bongo komanso kuwumba thupi, Glucophage Long amagwira ntchito zingapo zofunika:

Imakhazikika kagayidwe ka lipid.
Imawongolera zomwe zimachitika pakuwonongeka kwa chakudya chamthupi ndi kusintha kwawo kukhala mafuta m'thupi.
Imasintha mtundu wa glucose ndi cholesterol, yomwe imakhala yowopsa mthupi.
Imakhazikitsa kupanga kwachilengedwe kwa insulini, komwe kumachepetsa chilakolako chogwiritsa ntchito maswiti.

Magazi a glucose akatsika, mamolekyulu a shuga amatumizidwa mwachindunji kwa minofu. Popeza tapeza pothawirapo, shuga amawotcha, mafuta acids amaphatikizidwa, machitidwe a mayamwidwe amthupi amapita pang'onopang'ono. Zotsatira zake, chilakolako cha kudya chimakhala chochepa, ndipo ma cell a mafuta samadzichulukitsa kapena kusungidwa m'zigawo zosiyanasiyana za thupi.

Malangizo ogwiritsira ntchito

Malangizo ogwiritsira ntchito akuwonetsa kuti Glucofage Long imatengedwa pakumwa 1 nthawi / tsiku, pakudya kwamadzulo. Mapiritsiwo amameza lonse, osafuna kutafuna, ndimadzi okwanira.

Mlingo wa mankhwalawa amayenera kusankhidwa payekha kwa wodwala aliyense potengera zotsatira za kuyeza kuchuluka kwa shuga m'magazi. Glucophage Kutalika kuyenera kumwedwa tsiku lililonse, popanda kusokonezedwa. Ngati atasiya kulandira chithandizo, wodwalayo ayenera kudziwitsa dokotala za izi. Mukadumpha mlingo wotsatira, mlingo wotsatira uyenera kumwedwa nthawi yokhazikika. Musachulukitse mlingo wa Glucofage Long.

Monotherapy ndi kuphatikiza mankhwalawa kuphatikiza ena othandizira a hypoglycemic:

Kwa odwala omwe sanatenge metformin, mlingo woyambira wa Glucofage Long ndi 1 tabu. 1 nthawi / tsiku
Pakadutsa masiku 10-15 aliwonse, mlingo umalimbikitsidwa kuti usinthidwe kutengera zotsatira za kuyeza ndende yamagazi. Kukula pang'onopang'ono kwa mankhwalawa kumathandizira kuchepetsa zoyipa kuchokera m'mimba.
Mlingo woyenera wa Glucofage Long ndi 1500 mg (mapiritsi 2) 1 nthawi / tsiku. Ngati, mukumwa mlingo womwe mwalangizidwa, sikungatheke kuti muzitha kuyendetsa bwino glycemic, ndizotheka kuwonjezera mlingo wa mankhwala mpaka 2250 mg (mapiritsi atatu) 1 nthawi / tsiku.
Ngati mokwanira glycemic control siyikupezeka ndi mapiritsi atatu. 750 mg 1 nthawi / tsiku, ndikotheka kuti musinthe ndikukonzekera metformin ndikumasulidwa kwazomwe zimagwira (mwachitsanzo, Glucofage, mapiritsi okhala ndi filimu) okhala ndi 3000 mg yayikulu tsiku lililonse.
Kwa odwala omwe amalandila chithandizo ndi mapiritsi a metformin, muyezo wa Glucofage Long uyenera kukhala wofanana ndi mlingo wa mapiritsi a tsiku ndi tsiku ndikamasulidwa mwachizolowezi. Odwala omwe amatenga metformin mu mawonekedwe a mapiritsi omwe amatulutsidwa pakadutsa 2000 mg osavomerezeka amasinthidwa kupita ku Glucofage Long.
Pofuna kukonza kusintha kuchokera kwa wothandizila wina wa hypoglycemic: ndikofunikira kusiya kumwa mankhwala ena ndikuyamba kumwa Glucofage Long pa mlingo womwe ukunenedwa pamwambapa.

Kuphatikiza ndi insulin:

Kuti mupeze kuwongolera kwakukhazikika kwa shuga wamagazi, metformin ndi insulin zitha kugwiritsidwa ntchito ngati mankhwala ophatikiza. Mulingo woyamba wa Glucofage Long ndi 1 tabu. 750 mg 1 nthawi / tsiku pakudya, pamene mlingo wa insulin umasankhidwa potengera kuchuluka kwa shuga m'magazi.

Malangizo apadera

Asanayambe chithandizo komanso mtsogolomo mtsogolo, kuvomerezedwa kwa creatinine kuyenera kutsimikiziridwa: pakalibe kusokonezeka, osachepera 1 pachaka, odwala okalamba, komanso odwala omwe amapezeka ndi creatinine chilolezo chotsika, kuyambira 2 mpaka 4 pachaka. Ndi creatinine chilolezo chochepera 45 ml / min, kugwiritsa ntchito Glucofage Long ndizotsutsana.
Odwala akulangizidwa kuti apitirize kudya zakudya zomwe zimapezeka mu chakudya tsiku lonse.
Matenda opatsirana aliwonse (matenda a kwamkodzo ndi matenda amtundu wa kupuma) ndi chithandizo ziyenera kudziwitsidwa kwa dokotala.
M'pofunika kuganizira mwayi wa lactic acidosis ndi maonekedwe a minofu kukokana, omwe amakhala ndi ululu wam'mimba, dyspepsia, malaise wamphamvu ndi kufooka wamba.
Mankhwala ayenera kusokonezedwa maola 48 asanafike pokonzekera opareshoni. Kuyambiranso kwa mankhwalawa kumatha kuchitika patatha maola 48, pokhapokha pakuwunikira, ntchito yaimpso inadziwika kuti ndi yachilendo.
Lactic acidosis imadziwika ndi kupweteka kwam'mimba, kusanza, kuperewera kwa acidotic, hypothermia ndi minofu kukokana kumatsatiridwa ndi chikomokere. Diagnostic labotale magawo - kuchepa kwa magazi pH (5 mmol / l, kuchuluka kwa lactate / pyruvate ndikuwonjezera kusiyana kwa anionic. Ngati lactic acidosis ikukayikiridwa, Glucofage Long imathetsedwa nthawi yomweyo.
Pamaso pa vuto la impso lomwe lingayambike motsutsana ndi maziko ophatikizira ndi antihypertensive mankhwala, okodzetsa kapena osagwiritsa ntchito mankhwala a anti-kutupa odwala okalamba, chisamaliro chapadera chikuyenera kuthandizidwa.
Chiwopsezo chachikulu cha hypoxia ndi kulephera kwaimpso chimawonedwa mwa odwala omwe ali ndi vuto la mtima. Gulu ili la odwala likufunika kuwunika mtima ndi ntchito ya impso.
Ndi onenepa kwambiri, muyenera kupitiriza kutsatira zakudya zama hypocaloric (koma osachepera 1000 kcal patsiku). Komanso, odwala ayenera kuchita masewera olimbitsa thupi pafupipafupi.
Kuti muthane ndi matenda ashuga, kuyeserera kwa ma labotale kumayenera kuchitidwa pafupipafupi.
Ndi monotherapy, Glucophage Long siyimayambitsa hypoglycemia, koma kusamala kumalimbikitsidwa akagwiritsidwa ntchito limodzi ndi insulin kapena othandizira ena pakamwa. Zizindikiro zazikulu za hypoglycemia: kuchuluka thukuta, kufooka, chizungulire, kupweteka mutu, palpitations, kusokonezeka kwa chidwi kapena masomphenya.
Chifukwa cha kupukutidwa kwa metformin, kusowa kosowa koma koopsa ndikotheka - lactic acidosis, yomwe imadziwika ndi kufa kwakukulu pakalibe chithandizo chamankhwala mwadzidzidzi. Makamaka panthawi yogwiritsa ntchito Glucofage Long, milandu yotereyi imachitika m'mayendedwe a shuga motsutsana ndi kumbuyo kwa kulephera kwaimpso. Zina zokhudzana ndi chiopsezo ziyeneranso kuganiziridwa: ketosis, matenda osokoneza bongo osayendetsedwa bwino, kusala kudya kwanthawi yayitali, kulephera kwa chiwindi, kumwa kwambiri mowa ndi zina zilizonse zokhudzana ndi hypoxia yayikulu.
Zosagwira ntchito za Glucofage Long zitha kupukusidwa kudzera m'matumbo osasinthika, zomwe sizikhudza kuchiritsa kwa mankhwala.

Kuyanjana kwa mankhwala osokoneza bongo

Kugwiritsa ntchito munthawi yomweyo mankhwala osagwirizana ndi hyperglycemic - mankhwala a mahomoni kapena tetracosactide, komanso β2-adrenergic agonists, danazol, chlorpromazine ndi diuretics kungakhudze kuchuluka kwa shuga m'magazi. Chifukwa chake, ndikofunikira kuwongolera zomwe zikuwonetsa, ndipo ngati ndi kotheka, chitani kusintha kwa mlingo.

Kuphatikiza apo, pakakhala kulephera kwa aimpso, okodzetsa amathandizira kukulitsa lactic acidosis. Kuphatikizidwa ndi mankhwala a sulfonylurea, acarbose, insulin, salicylates nthawi zambiri kumayambitsa hypoglycemia.

Kukula kwa lactic acidosis kungayambitse kuphatikiza kwa mankhwalawa ndi ayodini okhala ndi ma radiopaque othandizira. Chifukwa chake, kwa maola 48 isanachitike komanso atatha kuyesedwa kwa radiology pogwiritsa ntchito ayodini wokhala ndi radiopaque, kuthetsedwa kwa Glucophage Long ndikulimbikitsidwa.

Kuphatikiza ndi amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim ndi vancomycin, omwe amasungidwa mu aimpso tubules, kupikisana ndi metformin pa tubular transport, yomwe imakulitsa kuchuluka kwake.

Tidatenga ndemanga zakuchepetsa thupi pazokhudza mankhwala Glucofage motalika:

Basil. Ndikumwa mankhwala oti ndichepetse shuga. Piritsi limodzi linakhazikitsidwa pa 750 mg kamodzi patsiku. Asanamwe mankhwalawa, shuga anali 7.9. Pambuyo pa milungu iwiri, adatsikira mpaka 6.6 pamimba yopanda kanthu. Koma kuwunika kwanga sikungabwino.Poyamba, m'mimba mwanga mudadwala, m'mimba mudayamba. Patatha sabata limodzi, kuyabwa kunayamba. Ngakhale izi zikuwonetsedwa ndi malangizo, adotolo ayenera kupita.
Marina Pambuyo pobereka, adapatsidwa insulin ndipo adati izi zimachitika kawirikawiri ndi anthu onenepa kwambiri. Anapemphedwa kuti atenge Glucofage Long 500. Anatenga ndikusintha pang'ono pang'ono zakudyazo. Kugwetsedwa pafupifupi 20 kg. Pali, zambiri, zoyipa, koma akuyenera kuwapeza chifukwa. Kenako timadya pang'onopang'ono titamwa mapiritsi, ndiye kuti ndatopa kwambiri - kenako mutu wanga umandipweteka. Ndipo kotero - mapiritsi ndi odabwitsa.
Irina Ndinaganiza z kumwa Glucofage Long 500 kuti muchepetse thupi. Pamaso pake, panali zoyeserera zambiri: mitundu iwiri yamagetsi osiyanasiyana, komanso masewera olimbitsa thupi. Zotsatira zake zinali zosakhutiritsa, kunenepa kwambiri kunangobwerera chakudya chotsatira chikangomira. Zotsatira zake chifukwa mankhwalawo adadabwitsa: Ndataya 3 kg pamwezi. Ndipitilirabe kumwa, ndipo zimawononga ndalama zambiri.
Svetlana Amayi anga ali ndi matenda ashuga a 2. Mankhwala ndi othandiza. Milingo ya shuga yatsika kwambiri. Amayi anapezeka kuti anali ndi kunenepa kwambiri. Ndi mankhwalawa, ndinatha kuchepa pang'ono, zomwe zimavuta pakukalamba. Panopa akumva bwino kwambiri tsopano. Zomwe ndizosavuta - Glucophage Kutalika kumayenera kutengedwa kamodzi patsiku. Ndipo izi zisanachitike panali mapiritsi omwe amayenera kumwa kawiri - osavomerezeka nthawi zonse.

Malinga ndi ndemanga, Glucofage Long ndi mankhwala othandiza pakugwiritsidwa ntchito kwa nthawi yayitali. Kukula kwa zoyipa kumanenedweratu pafupipafupi. Ndionda kwambiri, kuchepa pang'onopang'ono kumadziwika.

Mankhwala otsatirawa ndi fanizo la mankhwalawa: