Glibomet ndi kuphatikiza pakamwa (pakugwiritsira ntchito mkati) hypoglycemiczotengera bitanide ndi sulfonylureasM'badwo wachiwiri womwe umawonetsedwa extrapancreaticndi kapambamachitidwe.

Kuchokera sulfonylureasM'badwo wachiwiri - glibenclamideimakhala ndi chidwi insulin katulutsidwepochepetsa shuga ndi chopunthwitsa cha khungu la beta kapamba.

Glibenclamideimapangitsa chiwopsezo ku insulinndi kulimbika kwa zomangira zake ndi maselo ojambulidwa kumakulitsa kumasulidwa insulin, imawonjezera kukonzekera kwake kuyamwa kwa shuga chiwindi ndi minofu mu adipose minofu imabweza lipolysis. Zotsatira za mankhwalawa zimawonekera mu gawo lachiwiri la kupanga insulin.

Kuchokera biguanide– metforminchikuwonetsa chotsitsimutsa pokhudzana ndi kupindika kwa ziwopsezo za minofu pazotsatira insulin(imakulitsa chomangira cholandirira insulinndikuwonjezera zotsatira zake pamlingo wa postreceptor).

M'matumbo amachepetsa kuyamwa kwa shugakukhumudwa gluconeogenesis komanso zimakhudza lipid kagayidwe amathandiza kuchepetsa kunenepa kwambiri mwa odwala matenda ashuga. Ili ndi mphamvu ya fibrinolytic chifukwa cha kuletsa kwa minyewa yothandizira plasminogen.

Hypoglycemic zotsatira za Glibomet zimayamba pambuyo pa maola awiri ndipo zimawonedwa kwa maola 12.

Kuphatikizika kwa mitundu iwiri yogwira popanga mankhwala - mphamvu yolimbikitsira imachokera sulfonylureaskupanga insulin yanu (kapambachochita) ndikukhudza mwachindunji biguanidepa adipose ndi minofu yamatumbo (extrapancreatickuchitapo - kuwonjezeka kwakukulu kwa kutsimikizika shuga) ndi minyewa ya chiwindi (kuchepa gluconeogenesis), imalola kuchuluka kwa Mlingo kuti muchepetse zomwe zili chilichonse.

Izi zimathandiza kupewetsa kuchita zambiri. maselo a beta mu kapamba, motero kuchepetsa chiopsezo cha kusayenda bwino kwa ntchito, komanso kuwonjezera chitetezo cha othandizira a hypoglycemic ndikuchepetsa pafupipafupi zovuta zoyipa.

Mafuta glibenclamidemumimba mumapezeka msanga komanso pamalo okwera kwambiri (84%). Kuzindikira kwakukulu kumawonedwa pambuyo pa maola 1-2. Kuyankhulana ndi mapuloteni a plasma pamlingo wa 97%. Pafupifupi zimapukusidwa kwathunthu (kuma metabolites osagwira) m'chiwindi. Amapukusidwa ndi bile ndi mkodzo mogwirizana ndi 50/50%, ndi theka la moyo wa maola 5 mpaka 10.

Mayamwidwe m'mimba metforminkwathunthu kwathunthu. Mankhwala pafupifupi samamangirira mapuloteni a plasma ndipo amafalikira mofulumira. Thupi silimapukusidwa. Amayamwa kwambiri ndi impso komanso pang'ono m'matumbo, ndi theka la moyo pafupifupi maola 7.

Zizindikiro zogwiritsidwa ntchito

Mankhwala Glybomet akuwonetsedwa kuti azitha kugwiritsa ntchito mankhwalawa mtundu 2 shugapa vuto la kusakwanira zakudya mankhwalandi chithandizo cham'mbuyomu khwawandi zotumphukira sulfonylureaskomanso mankhwala ena a pakamwa a hypoglycemic.

Contraindication

• Hypersensitivity kuti glibenclamide(kuphatikizapo zochokera sulfonylureas), metforminkapena zosakaniza zina za mankhwala,
• matenda ashuga
• mtundu 1 shuga,
• lactic acidosis(kuphatikiza mbiri),
• choyambirira ketoacidosischikomokere (matenda ashuga)
• zinthu yodziwika ndi kulowetsedwa kwa chakudya ndi mapangidwe a hypoglycemia,
• zinthu pachimake pachiwopsezo kuwonongeka kwa aimpsomatenda oopsa kusowa kwamadzi, kugwedeza, kuyambitsa kwa zinthu zophatikizana ndi ayodini (zamkati),
• kuphwanya kwa chiwindi ntchito,
• matenda a impso ( creatinine kwa amuna oposa 135 mmol / l ndi azimayi oposa 110 mmol / l),
• zinthu zogwirizana ndi hypoxia(kupuma kapena kulephera kwa mtimakudabwitsidwapo myocardial infarationzovuta zopweteka zam'mapapo thirakiti
• zigawenga, matenda opatsirana, ochulukirapoothandizira opaleshonikutaya magazi kwambiri, kuvulalachachikulu amayakandi zina zofunika mankhwala a insulin,
• Maola 48 isanachitike komanso itatha opaleshoni kuchitapo kanthukapena kugwira radiologykapena radioisotopekuyesa ndi kuyambitsa chinthu chomwe chili ndi ayodini
• leukopenia,
• kusintha kwa dystrophic (lipodystrophy, myotonic dystrophy),
• porphyria,
• kusamalira Zakudya zama hypocaloric (mpaka 1000 kcal patsiku),
• zokometsera kuledzeramowa uchidakwa wosatha,
• shuga-6-phosphodehydrogenase akusowa,
• zaka mpaka 18
• mimbandi kuyamwitsa.

Musalimbikitse kutenga Glybomet kwa odwala okulirapo wazaka zopitilira 60 omwe achita zolimbitsa thupi chifukwa cha kuchuluka kwawoko lactic acidosis.

• kulimbitsa thupi kwambiri (ngozi ya lactic acidosis),
• matenda chithokomiro,
• febrile syndrome,
• mwachidulekhungwa gren adrenalndi / kapena lobe lakunja zodabwisa.

Zotsatira zoyipa

• kusowa kwa chakudya,
• nseru,
• zilonda zam'mimba
• kusanza,
• kukoma kwachitsulo pamkamwa,
• kutsegula m'mimba,
• kutsegula kwa chiwindi michere.

• kuchepa magazi m'thupi,
• leukopenia
• erythrocytopenia,
• thrombocytopenia
• anemia yam'magazi,
• agranulocytosis,
• pancytopenia.

Ngati mawonetseredwe apezeka lactic acidosis(kufooka kwathunthu, kupweteka pamimba, kusanza, kukokana minofu), muyenera kusiya kumwa mapiritsi a Glibomet ndi kufunsa dokotala.

• disulfiram ngati anachitakuwonetsedwa atatengedwa za mowakomanso wodziwika rednesschifuwa chapamwamba ndi khungu la nkhope, mutukumverera kugunda kwa mtima, nserundi kusanza kuchuluka kwa kuthamanga kwa magazi.

Mapiritsi a Glybomet, malangizo ogwiritsira ntchito

Malangizo ogwiritsira ntchito Glibomet amalimbikitsa kumwa mapiritsi a pakamwa pakamwa (mkati), makamaka ndi zakudya.

Mlingo ndi nthawi ya mankhwalawa amasankhidwa ndi adotolo potengera momwe alili chakudya kagayidwe kachakudya odwala komanso magazi shuga.

Monga lamulo, mlingo woyambirira wa tsiku ndi tsiku ndi mapiritsi atatu, ndikusintha pang'onopang'ono kuti musankhe mlingo wogwira bwino kwambiri, womwe ungatsimikizire kuti zonse zili muntchito shuga m'magazi.

Mlingo wovomerezeka tsiku lililonse ndi mapiritsi 6.

Bongo

Ndi bongo, chitukuko chinadziwika hypoglycemia(glibenclamide) ndi lactic acidosis(metformin).

At hypoglycemia anati: kufookakuchuluka thukutamatenda amitsempha (osakhalitsa) kugunda kwa mtima, paresthesia pamkamwa womverakhungu mawonekedwe kunjenjemera, mutukumverera nkhawazamatsenga kugonakumverera kwa mantha mavuto atulo, kusowa kwa mgwirizano. Ndi kupitilira kwa izi zadziwika kulephera kudziletsa ndi za kuzindikira.

M'malo mwa hypoglycemiaZakudya zopepuka zimalimbikitsa shuga, zakumwa kapena zakudya zomwe zimakhala ndi zochuluka chakudya(uchi, jamu, tiyi wokoma). Ngati hypoglycemialimodzi ndi kulephera kudziwa, iv adalowetsa 40% yankho dextrose(shuga) voliyumu ya 40-80 ml, kenako kulowetsedwa kwa 5-10% yankho dextrose. Pambuyo pake, makonzedwe owonjezera a 1 mg ndi otheka. glucagon.

Ngati wodwalayo amakhalabe kusazindikira njira zomwe zili pamwambazi zimabwerezedwa. Kuperewera kwa izi pamenepa, kumabweretsa chisamaliro chachikulu.

At lactic acidosiszadziwika: kutchulidwa kufookakupuma matenda kupweteka kwa minofu, kugona, nseru, kupweteka m'mimba, masanziReflex bradyarrhythmia, kutsegula m'mimbakutsitsa magazi, hypothermiachisokonezo ndikulephera kudziwa.

Pankhani yokayikiridwa lactic acidosissiyani yomweyo mankhwala. hospitalizewoleza mtima ndikuchita njirayi hemodialysis.

Kuchita

Zotsatira za hypoglycemic za Glybomet zimalimbikitsidwa zikaphatikizidwa zotumphukira za coumarin (Sinkumar, Warfarin), beta-blockers, salicylates, Oxytetracycline, Cimetidine, Allopurinol, sulfonamides, Mao zoletsa, Khalid, Phenylbutazonendi zotuluka zake, chloramphenicol, Sulfonamide, cyclophosphamide, Pergexilin, Miconazole (mkamwa) Feniramidol, Sulfinpyrazonendi Mowa.

Glucocorticoids, adrenalinepamlomo kulerabarbiturates thiazide okodzetsa ndipo mahomoni a chithokomiro amachepetsa mphamvu ya hypoglycemic ya Glybomet.

Poyerekeza ndi kumbuyo kwa kutenga Glibomet, kulimbitsa mphamvu ndizotheka anticoagulants.

Kulandila Cimetidinekuonjezera ngozi ya lactic acidosis.

Beta blockers zimatha kuwonetsedwa hypoglycemia(kupatula kutuluka thukuta kwambiri).

Kugwiritsa radiopaqueMuli mankhwala okhala ndi ayodini (pamakina opanga misempha) angayambitse matenda aimpso ndipo kuwerengetsa kwa metformin (chiopsezo cha kuchitika lactic acidosis).

Malangizo apadera

Mankhwala, odwala amafunika kutsatira mosamalitsa malangizo onse a dokotala pokhudzana ndi Mlingo ndi njira yogwiritsira ntchito mankhwalawa, mankhwala zolimbitsa thupikutsatira Zakudyandi kudziletsa kuchuluka kwa shugam'magazi.

Lactic acidosis- chowopsa, koma mwamwayi njira yachilendo yowonekera yomwe imadziwulula yokha kuchuluka kwa lactic acid m'magazi chifukwa chodzikundikira metformin. Milandu Yoyang'aniridwa lactic acidosisOdwala akutenga Metforminnthawi zambiri zimawonedwa mwa odwalamatenda ashuga yofanana ndi mawu aimpsondi kulephera kwa mtima.

Pofuna kupewa lactic acidosiszinthu zonse zokhudzana ndi chiopsezo ziyenera kudziwika, monga: ketosisshuga wowonjezera, yemwe amakhala nthawi yayitali Njala, kulephera kwa chiwindikuchuluka zakumwa zoledzeretsa ndi chikhalidwe chilichonse chotsogolera hypoxia.

Mukadwala Glybomet, serum creatinine iyenera kuyang'aniridwa nthawi zonse, osachepera nthawi 1 m'miyezi 12 yokhala ndi vuto la impso komanso osachepera 2-4 m'miyezi 12 yaukalamba komanso creatininepafupi ndi VGN.

Chisamaliro chapadera chikuyenera kutengedwa pangozi. matenda aimpso (kuyamba kwa chithandizo NSAIDs, antihypertensivemankhwala okodzetsaamatanthauza).

Mankhwala a Glybomet ayenera kusokonezedwa maola 48 isanakwane kuyesa kwa x-ray ndi iv jekeseni wosiyana zinthu zokhala ndi ayodini(munthawi imeneyi, mankhwala ena a hypoglycemic ayenera kumwa).

Komanso, kusokonezeka kwa mankhwala kwa maola 48 kumafuna kuchitapo kanthu pokonzekera opaleshonindi zamatsenga kapena opaleshoni ya msana.

Kuyambiranso kwa mankhwalawa ndikotheka pambuyo poti wodwala ayamba kudya zakudya zapakamwa kapena maola 48 atachitidwa opaleshoni, malinga ndi momwe impso imagwirira ntchito.

Chenjezo liyenera kuchitidwa poyendetsa galimoto kapena kugwira ntchito yolondola komanso yowopsa.

Ma analogi a Glybomet

Zofananira zapafupifupi za Glibomet malinga ndi zomwe zimachitika zimayimiriridwa ndi mankhwala:

• Bagomet Plus,
• Glucovans,
• Glucofast,
• Gluconorm,
• Metglib.

Kugwiritsa ntchito Glibomet kumatsutsana mpaka zaka 18 zakubadwa.

Ndi mowa

Ethanoli, monga zakumwa zoledzeretsa, zimatha kuyambitsa mkwiyo hypoglycemiakomanso chifukwa disulfiram ngati anachita (m'mimba, chizungulire, nserukumva kutentha m'matumbo ndi pakhungu la nkhope, kusanza, tachycardia, mutu,, pazomwe, muyenera kusiya kumwa mowa mwa mitundu yonse.

Ndemanga ya Glibomet

Mwa odwala omwe pakumwa mankhwalawa pano, ndemanga za Glibomet zimakhala zabwino kwambiri, ngakhale ndizolumikizana zingapo, zovuta zingapo.

Anthu ambiri akuvutika mtundu 2 shugaimwani mapiritsi a Glibomet kuphatikiza ena wothandizira wa hypoglycemic Chifukwa chake, sangatsimikizire motsimikiza kuti mankhwalawa ali ndi mphamvu.

Odwala ena omwe adapangidwira Glibomet m'mbuyomu sanakhutire ndi zovuta zake ndipo pamapeto pake amasinthana ndi mankhwala ena a izi. Zonsezi zikusonyeza kuti kuchiritsamatenda ashuga muyenera kuyandikira payekhapayekha, ndipo palibe chitsimikizo kuti mankhwalawo ndiofanana kwa odwala onse.

Vuto linanso la mankhwala ophatikizika ndizophatikizira zomwe zimapangidwa, zomwe sizoyenera kwa wodwala aliyense.

Titha kunena kuti ngati Glybomet ndi yoyenera kwa wodwalayo m'njira zonse, kugwira ntchito kwake kumakhalabe pamlingo wokwera, ndipo mosemphana ndi kanthu, poyankha mosagwirizana ndi thupi pazinthu zomwe zimaphatikizidwa ndi mankhwalawa, ndibwino kusinthana ndi mankhwala ena.

Ndikofunika kukumbukira kuti matenda ashuga ndi dokotala yekhayo amene angakulangireni chithandizo, kusintha Mlingo ndi ma regimens.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Metglib imapangidwa ngati mapiritsi okhala ndi mbali zonse ziwiri, m'chigoba cha lalanje, komanso yoyera m'gawolo.

• 500 metformin hydrochloride,
• 2,5 glibenclamide,
• 12 croscarmellose sodium,
• 45 wowuma chimanga,
• 50 calcium hydrogen phosphate dihydrate,
• 52 povidone
• 3 sodium stearyl fumarate,
• 35,5 microcrystalline cellulose.

Mankhwala amabwera m'mitundu iwiri:

• 2.5 mg glibenclamide, 500 mg metformin,
• 5 glibenclamide, 500 metformin.

Zilonda zimayikidwa pakatoni, ndipo ma CD ake amatha kukhala 30 kapena 40.

Opanga INN

Dzina ladziko lonse lamankhwala ndi Glibenclamide ndi Metformin.

Imakhazikitsa kampani yake Canonfarm, Russia. Adilesi: Dera la Moscow, Shchelkovo, st. Zarechnaya, 105, index 141100.

Mtengo wapakati wamankhwala ndi ma ruble 140 pa paketi iliyonse pazinthu 30. Mwambiri, chida chotsika mtengo, makamaka ngati chalamulidwa pa intaneti.

Zotsatira za pharmacological

Awa ndi mankhwala ophatikiza omwe ali ndi metformin ndi glibenclamide. Cholinga chake chachikulu ndikuchepetsa magazi. Chifukwa cha kuphatikiza kwa zinthu pamwambapa, izi zimachitika.

Metformin imachepetsa kuchuluka kwa shuga m'magazi, sichimapangitsa kutulutsa kwa insulin, kumawonjezera chidwi cha maselo ku glucose, imathandizira kuchedwa kuyamwa kwake m'matumbo ndikuyendetsa thupi la wodwala.

Glibenclamide ndi mtundu wa 2-sulfonylurea wochokera. Zimatsikiranso shuga chifukwa zimapangitsa kuti pakhale insulin. Nthawi yomweyo, kuphatikiza kwake kumaselo kumakhala bwino, lipolysis mu adipose minofu imaletseka.

Zinthu izi zimathandizana wina ndi mnzake, ndipo monga chotulukapo chake pakuwonjezereka kwa zotsatira za hypoglycemic ya mankhwala m'thupi. Poyerekeza ndi zakumwa zake, glucose amalowetsedwa bwino komanso mwachangu.

Pharmacokinetics

Kuwonekera kumawonekera patatha maola awiri mutatenga Metglib, nthawi ya mapiritsi amakhala pafupifupi theka la tsiku.Nthawi yomweyo, glibenclamide imagwidwa ndi maselo am'mimba, imagundidwa m'chiwindi kupita ku metabolites osagwira ndikuthira impso ndi bile, ndi metformin, yomwe imalowetsedwanso m'matumbo am'mimba, imasefa kwambiri ndi impso. Makonzedwe a glibenclamide ndi maola 4-11, metformin - 6.5.

Kwa anthu odwala matenda ashuga amtundu wa 2, ngati chithandizo chopanda mankhwala (zakudya ndi zolimbitsa thupi) sichingalipiridwe.

Malangizo ogwiritsira ntchito (mlingo)

Kulandila kumayikidwa ndi dokotala aliyense payekhapayekha, kutengera zotsatira za mayeso. Mankhwala amatengedwa pakamwa ndi chakudya. Poterepa, zakudya zokwanira ziyenera kutsatiridwa kuti zinthuzo zizichita bwino.

Chithandizo chimayamba ndi 1 unit (2.5 mg ndi 500 mg), kenako sabata iliyonse ndikuwunika kuchuluka kwa shuga, mlingo umasinthidwa.

Ngati zigawo za Metglib zomwe zidagwiritsidwa ntchito kale ndi omwe adagwiritsidwa ntchito ndi odwala pakukonzekera mosiyana, ndikofunikira kulingalira izi popereka mankhwalawa, tsopano kuphatikiza zonse zomwe zimagwira nthawi imodzi.

Chenjezo: Chiwerengero chachikulu cha mapiritsi patsiku ndi 4 (2,5 mg kapena 5 mg ndi 500 mg). Kuchulukitsa chiwerengerochi kumatha kuyambitsa bongo.

Kuyanjana kwa mankhwala osokoneza bongo

Simungatenge miconazole ndi Metglib. Izi zimatha kudzetsa nkhawa.

Mothandizidwa ndi ayodini omwe ali ndi ayodini kuti athane ndi vuto laimpso, phwando limayimitsidwa pakadutsa masiku awiri njirayo isanayambike pokhapokha patatha maola 48.

Kuchita ndi ethanol, phenylbutazone, bosentan osavomerezeka. Zimasokoneza zotsatira za Metglib ndipo zimatha kubweretsa zosafunikira.

Komanso, salangizidwa kuti azigwiritsa ntchito limodzi ndi chithandizo chachikulu:

• beta adrenostimulants,
• chlorpromazine
• glucocorticosteroids,
• okodzetsa
• ACE zoletsa ndi Mao,
• anticoagulants
• danazol
• desmopressin ndi mankhwala ena.

Mwakuyanjana, zimatha kuyambitsa hypo- kapena hyperglycemia ndikuchepetsa mphamvu ya mzake.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwalawa amapangidwa ngati mapiritsi okhala ndi filimu: ozungulira, biconvex, lalanje-lalanje, utoto, wopingasa, (10 iliyonse m'matumba a chithuza, pamatumba a 1, 2, 3, 4, 6, kapena 9 mapaketi) , Ma pc 15. mumapulasitiki otchinga, pamatoni a 2, 4 kapena 6, paketi iliyonse ilinso ndi malangizo ogwiritsira ntchito Metglib).

Piritsi limodzi lili:

• zinthu zogwira: metformin hydrochloride - 400 mg, glibenclamide - 2,5 mg,
• zina zowonjezera: wowuma wa chimanga, macrogol (polyethylene glycol 6000), calcium hydrogen phosphate dihydrate, sodium stearyl fumarate, croscarmellose sodium, microcrystalline cellulose, povidone,
• filimu sheath: Opadry orange hyprolose (hydroxypropyl cellulose), hypromellose (hydroxypropyl methyl cellulose), titanium dioxide, talc, utoto wa ironide wachikasu ndi ofiira wa oxide.

Metglib, malangizo ogwiritsira ntchito: njira ndi mlingo

Mapiritsi a Metglib amatengedwa pakamwa.

Mlingo wa mankhwala, momwe amagwiritsidwira ntchito komanso nthawi yayitali ya mankhwala amatsimikiziridwa ndi dokotala yemwe amalingalira za kagayidwe kazachilengedwe komanso kuchuluka kwa shuga m'magazi.

Nthawi zambiri, Metglib amatengedwa koyamba mapiritsi a tsiku ndi tsiku a 1-2, ndikudya kwakukulu. M'tsogolomu, kusintha kwapang'onopang'ono kwa mlingo kumachitika kuti zitheke bwino kwambiri, komwe kungapatsitse matenda a shuga m'magazi. Pankhaniyi, mlingo woyenera wololeza tsiku lililonse sayenera kupitirira mapiritsi 6, ogawidwa patatu.

Mimba komanso kuyamwa

Amayi oyembekezera saloledwa kutenga Metglib. Panthawi yamankhwala, dokotala wopezekapo amayenera kudziwitsidwa za pakati pathupi kapena nthawi yomwe akukonzekera, popeza muzochitika izi ndikofunikira kusiya kumwa mankhwalawo ndikusamutsa insulin.

Mukamayamwa, kugwiritsa ntchito Metglib kumatsutsana, chifukwa chosadziwa zambiri zakukwaniritsidwa kwake mkaka wa munthu. Ngati mukufunika kumwa mankhwalawa pakadwala, muyenera kusiya kuyamwitsa kapena kusinthira insulin.

Kuphatikiza kwa Metglib kwa odwala matenda ashuga

Metglib ndi mankhwala ophatikizika omwe ali ndi vuto la hypoglycemic, lopangidwa kuti azilamulira matenda a shuga a 2. Kuthekera kwa antiidiabetes kwamankhwala osankhidwa koyamba kumadziwika ndi mitundu iwiri ya mankhwala oyambira omwe ali ndi makina othandizira, omwe amalola mwamphamvu mphamvu ya metabolism ya insulin ndi glucagon. Mankhwalawa ndioyeneranso kwa odwala matenda ashuga omwe amaphatikiza kumwa mapiritsi ndi insulin: amachepetsa mlingo ndi kuchuluka kwa jakisoni wa mahomoni.

Zachidziwikire, kugwiritsidwa ntchito kwake sikuvomerezeka pamilandu yonse (monga mankhwala ena aliwonse a hypoglycemic), koma Metglib imagwirizana kwathunthu ndi miyezo yamakono yofunikira komanso yabwino.

The zikuchokera mankhwala

Njira yolingaliridwa bwino komanso yoyesedwa mwanzeru pazinthu ziwiri zogwira ntchito - metformin (400-500 mg) ndi glibenclamide (2,5 mg) simalola kokha komanso kuwongolera kwathunthu mbiri ya glycemic, komanso zimapangitsa kuchepetsa kuchuluka kwa zosakaniza.

Mankhwala aliwonse omwe amagwiritsidwa ntchito mu monotherapy, Mlingo wawo umasiyana kwambiri. Kuphatikiza pazinthu zoyambira, palinso mafilimu amtundu wa cellulose, wowuma, gelatin, glycerin, talc ndi zina zowonjezera. Mapiritsi a Metglib Force amapezekanso muyeso wa 5 mg glibenclamide ndi 500 mg metformin.

Mankhwala ovuta amatha kuzindikiridwa ndi zizindikiro izi: mapiritsi ozungulira mu chipolopolo choteteza cha terracotta kapena mtundu woyera wokhala ndi mzere wogawika umayikidwa m'maselo a contour a 10 - 90. Malipenga okhala ndi malangizo amadzaza pabokosi la makatoni. Pamtengo wotsika mtengo wa Metglib: ma ruble 240-360. kunyamula.

Pharmacology Metglib

Gawo loyambirira la njira yomwe odwala matenda ashuga ambiri omwe ali ndi matenda amtundu wa 2 amadziwa bwino ndi metformin, mankhwala okhawo amtundu wake pagulu la Biguanide omwe amachepetsa kukana kwa maselo owonongeka a cell insulin. Matenda amtundu wamtundu ndikofunikira kwambiri kuposa kukondweretsa kwa kupanga kwawo, chifukwa mu mtundu 2 wa shuga, ma cell a β-amapereka zomwe amapanga.

Kuphatikiza pakuphatikiza inshuwaransi ya insulin, gawo limakhalanso ndi ntchito zina:

• Kuletsa kuyamwa kwa glucose m'matumbo a matumbo, kukondoweza kugwiritsidwa ntchito kwake ndi minofu,
• Kuletsa kwa gluconeogeneis,
• Chitetezo cha Β-cell kuteteza apaptosis asanakwane ndi necrosis,
• Kupewa kwamitundu yonse ya acidosis komanso matenda oopsa,
• Kukondoweza kwa michere ya michere yazachilengedwe, endothelial ntchito ndi lipid metabolism,
• Kutsika kwa magazi kunenepa kwambiri, kutsekeka kwa kukhathamiritsa kwa oxidative, kukonza lipid.

Mkhalidwe wofunikira pakudziwika kwa mawonekedwe a lipid mu mtundu 2 shuga ndikuwongolera thupi. Metformin Imathandizira Kulimbana ndi Matenda Aakulu A shuga. Matenda opatsirana amawonjezera mwayi wa zovuta za khansa ndi 40%. Biagunide imalepheretsa kusintha koipa. Ngakhale kwa anthu athanzi opitirira 40, WHO imalimbikitsa kuti mutenge Metformin mu gawo lochepetsetsa kwambiri kupewa matenda okalamba ndi mtima.

Chofunikira chachiwiri, glibenclamide, ndikuyimira m'badwo watsopano wa mankhwala a sulfonylurea.

Mankhwalawa akuphatikizidwa pamndandanda wamankhwala ofunikira omwe ali ndi pancreatic ndi extrapancreatic zotsatira.

Mwa kusunthira kapamba, pawiriyo umachulukitsa kupanga kwake kwa insulin. Pogwirizana ndi β-maselo omwe amayendetsa chitukuko cha matenda a shuga a 2, glibenclamide satenga nawo mbali ndipo amasungabe zochitika zawo polimbikitsa zolandilira maselo omwe akutsutsana ndi insulin.

Mankhwala ovuta ndi othandiza pamagawo onse a chitukuko, chifukwa amapereka multivariate momwe:

• Pancreatic - imakulitsa chidwi cha maselo olimbana, imateteza maselo a β-cell ku glucose aukali, amalimbikitsa kaphatikizidwe ka insulin,
• Owonjezera-pancreatic - metabolite imagwira ntchito mwachindunji ndi minyewa komanso mafuta, imalepheretsa glucogenesis, ndipo imalola kuti glucose imidwe kwathunthu.

Kuchuluka kwa zosakaniza zamapangidwe amtunduwu kumakupatsani mwayi wosinthira pang'ono, ndikuwonjezera chitetezo cha mankhwalawa, kuchepetsa chiopsezo cha zovuta komanso zovuta zamagulu.

Mlingo ndi makonzedwe

Posankha mlingo, dokotala amayang'ana pazotsatira za mayeso, gawo la matendawa, zomwe zimagwirizana ndi matenda, zaka za odwala matenda ashuga komanso momwe thupi limayankhira pazigawo za mankhwala.

Kwa Metglib Force, malinga ndi malangizo ogwiritsira ntchito, mlingo woyambira tsiku ndi tsiku ungakhale 2.5 / 500 mg kapena 5/500 mg kamodzi. Ngati chimodzi mwazigawo za Metglib kapena zofanizira zina za sulfonylurea zitha kugwiritsidwa ntchito ngati mankhwala a mzere woyamba, ndiye kuti mukasintha mankhwala ndi mtundu wophatikizika, amawongoleredwa ndi kuchuluka kwa mapiritsiwo.

Mlingo wa kuchepa kwa mankhwalawa uyenera kukhala pang'onopang'ono: pakatha masabata awiri, mphamvu ya mankhwalawa yoyambira ingawunikenso ndikukonzanso 5/500 mg. Pakadutsa theka la mwezi, ngati pakufunika kutero, mankhwalawa amatha kuwonjezeredwa ku mapiritsi 4 pa mlingo wa 5/500 mg kapena mapiritsi 6 okhala ndi mlingo wa 2,5 / 500 mg. Kwa Metglib ndi mlingo wa 2,5 / 500 mg, mlingo waukulu ndi 2 mg ya mankhwalawa.

Mlingo wothandizirana umawonetsedwa bwino patebulo.

Kwa odwala matenda ashuga okalamba omwe ali ndi mphamvu yochepa ya impso, mulingo woyambira wa Metglib Force umakhazikitsidwa nthawi zambiri 2.5 / 500 mg. Pankhaniyi, mawonekedwe a impso amayenera kuyang'aniridwa pafupipafupi, chifukwa kuchuluka kwa metformin panthawi yomwe sichitha kutsirizika sikowopsa, koma zovuta - lactic acidosis. Mwa kulimbikira thupi komanso kudya mokwanira, zoperewera zimafanana.

Zosafunika zotsatira, bongo

Zotsatira zoyipa sizomwe zimapangitsa kukana chithandizo: thupi litasintha, zizindikilo zambiri zimapita zokha, ndipo kuvulazidwa kwa matenda osokoneza bongo kumakhala kwakukulu kwambiri kuposa chiopsezo chochokera ku Metglib. Chachikulu ndikuwerengera moyenera mankhwalawa: ndi mankhwala osokoneza bongo omwe mwangozi kapena wakonzedwa, wodwala matenda ashuga amakula ndi nkhandwe, amataya mphamvu, amakhala ndi mantha, manja ake amanjenjemera. Khungu limakhala lonyowa komanso lonyowa, kugunda kwa mtima kwachangu, wogwidwa ali pafupi kukomoka. Kupeza hypoglycemia kumakhala kotheka kwa okalamba komanso ofooka ndi matenda ndi hypocaloric zakudya za odwala matenda ashuga.

Ngati mankhwala osokoneza bongo, zotsatirazi zimachitika:

• Kupweteka kwam'mimba
• Migraines
• Matenda a Dyspeptic
• Mitundu yosiyanasiyana yokhudza thupi lawo siligwirizana.

Kusakhalitsa kochepa kwakanthawi kumathetsedwa ndi chithandizo chamankhwala, kulimbikira kuwonekera kwa zizindikiritso kumafuna kusintha kwa Metglib analogues – Diabeteson, Dimaril, Gluconorm, Bagomet Plus, Glukovans, Glibenclamide osakanikirana ndi Metformin, Glucofast (mogwirizana ndi lingaliro la adokotala).

Anthu odwala matenda ashuga okhudza Metglieb

Pamabwalo azotheka pa Metglib, kuwunika kwa anthu odwala matenda ashuga ndi madotolo kumasakanizika, chifukwa odwala ambiri akumalandira chithandizo chovuta, ndipo zimawavuta kuwunika momwe mankhwalawo amathandizira. Zambiri zimakhudzana ndi njira ya chithandizo: iwo omwe mankhwalawa amasankhidwa samadandaula za zotsatira zoyipa. Koma kuyesera zomwe takumana nazo odwala matenda ashuga sikotheka komanso koopsa.

Pofotokozera malingaliro onse, titha kunena kuti Metglib ya monotherapy ya matenda a shuga a 2 ndi njira yabwino: chitetezo chachikulu komanso chothandiza, mtengo wotsika mtengo, phindu labwino pamlingo wa wodwalayo, kupewa mavuto amtima komanso a oncological kumaika mankhwala mzere wolemekezeka wa mankhwala osankha oyamba.

Yerekezerani ndi mankhwala ofanana

Metglib ili ndi ma analogi angapo omwe ndi othandiza kuzidziwitsa.

Glucovans. Zomwe zimagwira ndi metformin ndi glibenclamide.

Mtengo - ma ruble 250 pa paketi iliyonse.

Wopanga - Merck Sante SAAS, France.

Ubwino: momwe mankhwalawo amathandizira ndi Metglib, kotero amalembedwa ngati mankhwalawa sagwirizana ndi wodwalayo.

Mtengo wotsikirapo, zotsutsana zomwezo ndi zoyipa zake.

Gluconorm. Zogwira ntchito: zofanana.

Mtengo - avareji ma ruble 240 pamtundu wa 30.

Wopanga - MJ Biofarm, India.

Kuchita - kutsitsa shuga.

Ubwino: Wofunika kwa odwala ambiri, ogwira mtima.

Zambiri: Pali zambiri zotsutsana, zimawononga ndalama zambiri.

Kusintha kulikonse kwa mankhwala ndi kwina kumachitika monga momwe adanenera dokotala. Kudzipatsa nokha koletsedwa!

Pali malingaliro osiyanasiyana okhudza mapiritsi awa. Kwa ena, mankhwalawa ndi oyenera, kwa ena - ayi, ena amawona mavuto ambiri. Pazonse, ndemanga zabwino zimaposa zoyipa.

Vera: “Poyamba adagwiritsa ntchito Glibomet, koma tsopano mitengo yakwera. Ndidafunsa adotolo kuti alembe china chake chotsika mtengo, koma chimodzimodzi. Chifukwa chake ndidapeza Chinsinsi cha Metglib. Zimatenga ndalama zochepa, zimachepetsa shuga ndikutsatira zakudya. Koma ndiyenera kuyitanitsa mu mankhwalawa pasadakhale - pazifukwa zina, sizolembedwa bwino. Chachikulu ndichakuti palibe zotsatilapo zake, ndipo zotsalazo ndi zovuta. ”

Dmitry: “Dokotalayo adandiuza kuti ndipange Metglib akapezeka ndi matenda a shuga a 2. Nditenga mankhwalawa kwa mwezi umodzi, ndipo sindinawone zotsatira zapadera. Shuga adachepetsedwa bwino, motero adasinthidwira ku mankhwala ena. Koma ndinamva anzanga kuti akuthandiza munthu wina bwino. ”

Denis: "Ndinkamwa Metglib kwa milungu iwiri, kupuma movutikira kunayamba. Ndinapita kwa dotolo, adanditumizira mayeso. Zotsatira zake, tinasintha mlingo ndi zakudya. Tsopano zonse zili bwino. Shuga wakhala wabwinobwino kwa miyezi iwiri, motero ndikusangalala ndi mankhwalawo. ”

Mu vuto laimpso

Odwala omwe ali ndi vuto la impso, chiwonetsero cha imphatikizo chimachepetsedwa, monga QC, T, T_1/2 imachulukana, zomwe zimapangitsa kuti mulingo wa metformin uwonjezeke m'magazi. Makina a Metglib ndi oponderezedwa odwala omwe amalephera kupweteka kwa impso, kapena kuwonongeka kwa impso, CC mgawo lomwe limatsika 60 ml / min.

Chifukwa chakuti metformin imafukusidwa ndi impso, isanayambike maphunziro a mankhwalawa komanso nthawi zonse mukamalandira chithandizo ndi Metglib, akuyenera kukhazikitsa QC ndi / kapena serum creatinine m'magazi. Odwala omwe ali ndi vuto laimpso, mayeso oterewa amalimbikitsidwa osachepera kamodzi pachaka. Okalamba kapena odwala ndi CC, kufikira malire apamwamba abwinobwino - kawiri pachaka. Kusamalidwa kwapadera kuyenera kuthandizidwa pokhapokha ngati chiwopsezo cha matenda aimpso chitha, mwachitsanzo, mwa odwala okalamba kapena koyambirira kwa antihypertensive tiba, komanso mukamagwiritsa ntchito mankhwala okodzetsa kapena osapweteka a antiidal (NSAIDs).

Ndemanga za Metglieb

Pamasamba azachipatala, odwala amasiya ndemanga zabwino ndi zoyipa zokhudzana ndi Metglib. Ambiri aiwo amawona kuti ndi mulingo woyenera kwambiri wowerengeka, zotsatira zabwino zamankhwala zimakwaniritsidwa. Komabe, chifukwa chakuti odwala matenda a shuga amakhala ndi mankhwalawa nthawi zambiri amamwa mankhwalawa limodzi ndi mankhwala ena a hypoglycemic, sangadziwike bwino momwe Metglib amagwirira ntchito. Odwala onse omwe ali ndi matenda a shuga amakhala ogwirizana mu chinthu chimodzi - pa chithandizo cha matendawa, dokotala amayenera kukulemberani mankhwala, ndi madokotala okhawo omwe ayenera kulandira mlingo ndi mankhwalawa.

Zoyipa zake nthawi zambiri zimatchulidwa mndandanda wambiri wa zotsutsana komanso zoyipa zomwe zimachitika. Mtengo wa Metglib umatchedwa wotchipa.