Momwe mungagwiritsire ntchito mankhwala Glybomet?

Mankhwala Glybomet ali ndi hypoglycemic ndi hypolipidemic. Malinga ndi malangizo a Glibomet, mankhwalawa amathandizira kubisalira kwa insulin, yomwe imapangidwa ndi kapamba wamunthu, kumawonjezera chidwi cha insulin ya tiziwalo timene timatulutsa thupi. Mankhwala amapanga kutulutsa insulin, pomwe akuletsa lipolysis mu minofu. Kupondera glycogenolysis mu chiwindi, Glybomet imachepetsa mapangidwe am magazi, ndikupanga antiarrhythmic. Kapangidwe kovuta ka Glibomet kamene kamaphatikizapo glibenclamide ndi metformin, kamakhudzanso thupi la wodwalayo, pomwe glibenclamide imayang'anira kupanga insulin, ndipo metformin imachepetsa mayamwidwe a glucose komanso imapangitsa matenda a lipid metabolism.

Zowonetsera Glibometa

Glibomet imagwiritsidwa ntchito pochiza matenda amishuga a 2 shuga, monga lamulo, pambuyo poti adwala azitha kudya. Glybomet imayambanso kugwiritsidwa ntchito mutatha kumwa mankhwala am'mlomo a hypoglycemic omwe analibe achire. Poyerekeza ndi ndemanga ya Glibomet, mankhwalawa ndi othandiza kwambiri ngati wodwala amatsata chithandizo ndi zakudya.

Njira zakugwiritsira ntchito Glybomet ndi Mlingo

Kutsatira malangizo a Glibomet, mankhwalawa amatengedwa pakamwa pakudya. Kutengera mtundu womwe umapezeka kagayidwe kazakudya komanso kuchuluka kwa shuga m'magazi, mulingo umayikidwa, zonsezi zimachitika payekhapayekha, poganizira momwe munthu alili. Amayamba kumwa Glybomet ndi mapiritsi 1, 2 kapena 3, pang'onopang'ono amabwera pa mlingo wofanana ndi matendawa. Kudya kwambiri mankhwala Glibomet, mogwirizana ndi malangizo, kawiri pa tsiku - m'mawa ndi madzulo. Sitikulimbikitsidwa kuwonjezera kuchuluka kwa kumwa mankhwalawa patsiku kwa mapiritsi oposa asanu.

Contraindication pakugwiritsa ntchito Glibomet

Choyimira chachikulu chomwa mankhwalawa, malinga ndi malangizo a Glibomet, ndiko kukhudzika kwa magawo omwe mankhwalawa amapezeka. Mankhwala sangathe kugwiritsidwanso ntchito pa matenda otsatirawa: chikomokere matenda a shuga, matenda ashuga, hypoglycemia, mtundu 1 wa matenda a shuga. Kugwiritsa ntchito mankhwala Glybomet koletsedwa panthawi ya pakati komanso yoyamwitsa.

Zotsatira zoyipa za Glybomet

Kutenga Glybomet kumatha kuyambitsa nseru komanso kusanza kwambiri. Ndemanga za Glybomet zikuwonetsa kuti kuyanjana kwa thupi ndikotheka, zotsatira za hypoglycemic, zomwe zimayambitsa kuchepa kwa zomwe zili m'maselo ofiira a m'magazi, mapulateleti ndi ma granulocytes m'magazi. Nthawi yomweyo, hemolytic anemia, hepatitis ndi cholestatic jaundice akupanga. Nthawi zina kumwa mankhwala Glibomet, arthralgia ndi hyperthermia zimawonedwa. Ndemanga pa Glybomet zimatsimikizira izi pakukweza kwa mapuloteni mumkodzo ndikuwonetsa kwa photosensitivity.

Ma analogi a Glybomet

Nthawi zina, ngati muli ndi matenda, Glibomet imatha kusinthidwa ndi analogues. Zofanizira zotere za Glibomet ndi mankhwala a Glyukovans ndi Glyurenorm. Kumwa mankhwala awiri a Glibenclamide ndi Metformin osagwiritsa ntchito mankhwala ena atha kugwiritsidwa ntchito ngati analogue ya Glibomet, koma zotsatira zake zimakhala zoipa kwambiri mukamamwa mankhwala ovuta.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mapiritsi a Glibomet amapangidwa ali ndi zosakaniza:

Metformin hydrochloride - 400 mg,
Glibenclamide - 2,5 mg.

Zinthu zothandiza za Glibomet ndi michere yotentha, microcrystalline cellulose, colloidal silicon dioxide, glycerol, gelatin, wowuma chimanga, talc.

M'matumba a mapiritsi 20.

Mankhwala

Glibomet ndi mankhwala ophatikizika a hypoglycemic omwe amagwirizana ndi zotumphukira za biguanide ndi sulfonylurea a m'badwo wachiwiri. Amadziwika ndi pancreatic ndi extrapancreatic zochita.

Glibenclamide ndi membala wa gulu la sulfonylurea zotumphukira za mbadwo wa II ndipo amathandizira kapangidwe ka insulin pochepetsa njira yolumikizira khungu la glucose pancreatic. Thupi limakulitsa chidwi cha insulin komanso kuchuluka kwake komwe kumangiriza ma cell, kumapangitsa kuti insulini itulutsidwe, kumawonjezera mphamvu yake pakuwonjezera shuga ndi chiwindi ndi minofu, ndikuletsa lipolysis mu minofu ya adipose. Zotsatira zake zimawonedwa mu gawo lachiwiri la insulin katulutsidwe.

Metformin ili m'gulu la Biguanides. Zimapangitsa chidwi cha kuphatikizika kwa minofu kuzinthu za insulin (kumawonjezera kuchuluka kwa kumanga kwa insulin ku ma receptor, kumakulitsa zovuta za insulin pamatumbo a postreceptor), kumalepheretsa kuyamwa kwa glucose m'matumbo, kumalepheretsa gluconeogeneis komanso kukhudza thupi mozama m'mitsempha ya odwala. Komanso ili ndi vuto la fibrinolytic chifukwa chopewera minofu ya mtundu wa plasminogen activator inhibitor.

Hypoglycemic zotsatira za Glibomet zimawonedwa patatha maola awiri pambuyo pa kukhazikitsa ndipo zimatha kwa maola 12. Kuphatikizika kwa mitundu iwiri yogwira mankhwala, yomwe imapangitsa mphamvu ya sulfonylurea kuti ipange endo native insulin (pancreatic athari) ndi mphamvu yodziwika ya greatuanide pa adipose ndi minofu minofu (kuchuluka kwakukulu kwa glucose - kuwonjezera-pancreatic athari), komanso minyewa ya chiwindi (kuchepetsa gluconeogenesis) Mlingo wochepetsera kuchuluka kwa magawo onse. Izi zimalepheretsa kukondweretsedwa kwambiri kwa maselo a pancreatic beta ndikuchepetsa chiopsezo cha kufooka kwa chiwalochi, komanso zimathandizira kutetezeka kwa kumwa mankhwala a hypoglycemic komanso kumachepetsa zovuta zoyipa.

Pharmacokinetics

Glibenclamide yothamanga kwambiri komanso kwathunthu (84%) imalowetsedwa m'mimba. Kuzindikira kwakukulu kumakwaniritsidwa patatha maola awiri atatha kukhazikitsa. Thupi limalumikiza mapuloteni a plasma ndi 97% ndipo limapangidwa pafupifupi lonse m'chiwindi, ndikupanga metabolites. Glibenclamide imachotsedwa 50% kudzera mu impso ndi 50% ndi bile. Hafu ya moyo ndi 5-10 maola.

Mlingo wa mayamwidwe a metformin m'matumbo am'mimba kwambiri. Pulogalamuyo imagawidwa mwachangu kuzinthu zonse ndipo sikugwirizana ndi mapuloteni a plasma. Metformin siimapukusidwa mthupi ndipo imatulidwa kudzera mu impso komanso matumbo pang'ono. Kuchotsa theka-moyo pafupifupi maola 7.

Malangizo ogwiritsira ntchito Glibomet: njira ndi mlingo

Mapiritsi amatengedwa pakamwa ndi zakudya.

Dokotala amamulembera kuchuluka ndi nthawi ya mankhwalawa payekhapayekha malinga ndi momwe matenda akuwunikira, poganizira kuchuluka kwa shuga m'magazi ndi mkhalidwe wa metabolism ya carbohydrate.

Mlingo woyambirira nthawi zambiri amapezeka mapiritsi atatu patsiku. Mankhwala, wodwalayo amasankha mlingo wothandiza kuti matenda a shuga azikhazikika.

Mlingo wapamwamba wa tsiku lililonse wa Glybomet sayenera kupitilira mapiritsi 6.

Bongo

Ndi bongo wa Glibomet, n`zotheka kukulitsa lactic acidosis yoyambitsidwa ndi zochita za metformin, ndi hypoglycemia yoyambitsidwa ndi zochita za glibenclamide.

Zizindikiro za lactic acidosis ndi kufooka kwakukulu, kuchepa kwa magazi, Reflex bradyarrhythmia, kugona, kusokonezeka ndi kutayika kwa chikumbumtima, hypothermia, vuto la kupuma, kupweteka kwa minofu, kutsegula m'mimba, kusanza, komanso kusanza.

Zizindikiro za hypoglycemia zimaphatikizira kupweteka kwa mutu, kumva mantha, kusokonezeka kwa mitsempha, kusokonezeka kwa kayendedwe ka kayendedwe, kugona, kugona tulo, kuda nkhawa, kunjenjemera, kupweteka kwa pakamwa, kufooka, kufooka kwa khungu, kuchuluka thukuta, kugona. Progression hypoglycemia imatha kubweretsa kulephera kudziletsa komanso kukomoka.

Ngati mukukayikira kukhazikika kwa lactic acidosis, Glibomet iyenera kuchotsedwa mwachangu ndipo wodwala amatumizidwa kuchipatala. Chithandizo chothandiza kwambiri cha bongo ndi hemodialysis.

Hypoglycemia yofatsa imatha kuthana ndi kumeza shuga, zakumwa kapena zakudya zomwe zimakhala ndi mafuta ambiri (kapu ya tiyi wokoma, jamu, uchi).

Ngati musataye chikumbumtima, ndikulimbikitsidwa kubayidwa 40-80 ml ya glucose 40% yankho (dextrose) kudzera mu mtsempha, kenako ndikumapaka 510% dextrose solution. Zowonjezera makonzedwe a 1 mg a glucagon subcutaneously, intramuscularly kapena kudzera m'mitsempha amaloledwa. Wodwala akapanda kuchira, ndikofunikira kubwereza zomwe wachita. Pakusowa chithandizo chachikulu, pitani kuchipatala kwambiri.

Malangizo apadera

Ndikofunikira kusiya kumwa Glibomet ngati zizindikiro za lactic acidosis zikuwoneka ngati kufooka kwathunthu, kusanza, kupweteka kwam'mimba, kukokana kwa minofu, ndikuwonana ndi dokotala nthawi yomweyo.

Ndikulimbikitsidwa kuti mumwa mankhwalawa pang'onopang'ono poyerekeza mulingo wa creatinine m'magazi: kwa odwala omwe ali ndi vuto la impso - osachepera 1 pachaka, kwa odwala omwe ali ndi ndende ya creatinine m'magazi pafupi ndi malire apafupipafupi komanso okalamba - kawiri pachaka.

Glybomet iyenera kuyimitsidwa masiku awiri asanachitike opaleshoni yopanga opaleshoni yomwe imagwiritsidwa ntchito pogwiritsira ntchito opaleshoni ya msana kapena ya cellular. Pitilizani kumwa mankhwalawa ndikuyambiranso kwa zakudya zapakamwa, koma osapitirira masiku awiri mutachitidwa opaleshoni, ngati ntchito yokhazikika ya impso itsimikizirika.

Munthawi ya mankhwalawa, kusamala kumalangizidwa mukamachita ntchito zoopsa ndikuyendetsa, chifukwa pali mwayi wopanga hypoglycemia ndipo, chifukwa chake, kutsika kwa kuthamanga kwa zochitika zama psychomotor komanso kuthekera kwambiri.

Kuchita bwino kwa mankhwalawa kumadalira kutsatira malangizo a dotolo, malingaliro ake okhudzana ndi machitidwe olimbitsa thupi ndi zakudya, komanso kuwunika pafupipafupi kuchuluka kwa shuga m'magazi.

Mukamagwiritsa ntchito Glibomet, muyenera kupewa kumwa mowa, chifukwa Mowa umatha kuyambitsa matenda a hypoglycemia komanso / kapena kusamva bwino (kupweteka kwam'mimba, kusanza, nseru, kumva kutentha pamatumbo ndi nkhope, chizungulire, kupweteka kwa mutu, tachycardia) .

Kuyanjana kwa mankhwala osokoneza bongo

Zotsatira za Glybomet zimachulukitsidwa limodzi ndi kayendetsedwe ka beta-blockers, coumarin derivatives (warfarin, syncumar), allopurinol, cimetidine, monoamine oxidase inhibitors (MAO), oxytetracycline, sulfanilamides, chloramphenicol, phenylbutazide amilefayidiide. , sulfinpyrazone, miconazole (akatengedwa pakamwa), ethanol.

Mphamvu ya hypoglycemic ya mankhwalawa imachepetsa kuphatikiza kwa glucocorticosteroids, adrenaline, njira zakulera zamkati, thiazide diuretics ndi barbiturates, kukonzekera kwa mahomoni a chithokomiro.

Kukhazikika kwa beta-blockers kumatha kumasula zizindikiro za hypoglycemia, kuwonjezera pa thukuta kwambiri.

Pogwiritsa ntchito munthawi yomweyo Glibomet ndi cimetidine, chiopsezo chokhala ndi lactic acidosis imawonjezeka, ma anticoagulants, zotsatira zawo zimakulirakulira.

Chiwopsezo cha wodwala kukulitsa lactic acidosis chimawonjezeka ndi maphunziro a x-ray omwe amagwiritsa ntchito ayodini.

Mafanizo a Glibomet ndi awa: Amaril, Avandamet, Avandaglim, Gluconorm, Glukovans, Glimecomb, Galvus Met, Glyukofast, Bagomet Plus, Combogliz, Metglib, Yanumet.

Ndemanga ya Glibomet

Mwa odwala omwe amamwa mankhwalawa pafupipafupi, nthawi zambiri pamakhala kuwerengetsa zolimbikitsa za Glibomet, komabe, pamakhala zonena za zoyipa zazing'ono. Odwala ambiri omwe amapezeka ndi mtundu wachiwiri wa matenda a shuga amaphatikizira kumwa Glibomet ndi mankhwala ena, chifukwa sangathe kutsimikiza molondola momwe mankhwalawo amathandizira. Anthu ena sanakhutire ndi zoyipa za mankhwalawa, ndipo m'kupita kwa nthawi anasinthana ndi ma Glibomet analogues, omwe amafotokozera kuti pakufunika kothandizirana ndi munthu wina popereka chithandizo.

Kukhalapo kwa magawo awiri omwe amagwira ntchito ku Glibomet nthawi zina kumatha kupangitsa munthu kuti azindikire mankhwala. Tiyenera kukumbukira kuti ngati pali matenda a shuga, ndi dokotala yekha amene angadziwitse kuti apatsidwe mankhwalawa, apange dongosolo la mankhwala ndikusintha mankhwalawo.

Mlingo ndi makonzedwe

Glybomet imatengedwa pakamwa pakudya.

Mlingo ndi kutalika kwa mankhwala zimatsimikiziridwa ndi kupezeka kwa dokotala aliyense payekha, kutengera kuchuluka kwa shuga m'magazi ndi kuchuluka kwa kagayidwe kazakudya.

Mlingo woyambirira wa Glibomet ndi mapiritsi atatu patsiku, ndikusintha pambuyo pake kuti mupeze mulingo wokwanira wamagazi m'magazi. Mapiritsi oposa 6 a mankhwalawa sayenera kugwiritsidwa ntchito patsiku.