Momwe mungagwiritsire ntchito mankhwala Gluconorm?

Mayina apadziko lonse lapansi - gluconorm

Kupanga ndi mawonekedwe a kumasulidwa

Mapiritsi okhala ndi mafilimu yoyera, yozungulira, ya biconvex. Piritsi 1 ili ndi glibenclamide 2.5 mg, metformin hydrochloride 400 mg.

Othandizira: cellcrystalline cellulose - 100 mg, wowuma chimanga - 20 mg, colloidal silicon dioxide - 20 mg, gelatin - 10 mg, glycerol - 10 mg, magnesium stearate - 7 mg, kuyeretsedwa kwa talcum ufa - 15 mg, croscarmellose sodium - 30 mg, sodium carboxymethyl - 183 mg, cellacephate - 2 mg, diethyl phthalate - 0,2 mg.

Ma PC 10 - matuza (1, 2, 3, 4) - mapaketi a makatoni.
20 ma PC. - matuza (1, 2, 3, 4) - mapaketi a makatoni.
30 ma PC - matuza (1, 2, 3, 4) - mapaketi a makatoni.

Zachipatala ndi gulu la mankhwala

Oral hypoglycemic mankhwala.

Gulu la Pharmacotherapeutic

Hypoglycemic wothandizila kukonzekera pakamwa (sulfonylurea ya m'badwo wa II + biguanide).

Zotsatira za pharmacological

Gluconorm ndi kuphatikiza kokhazikika kwa othandizira awiri am'magazi a hypoglycemic a magulu osiyanasiyana a pharmacological: metformin ndi glibenclamide.

Metformin A gulu la Biguanides ndipo amachepetsa kuchuluka kwa shuga mu seramu yamagazi pakuwonjezera mphamvu ya zotumphukira mu zochitika za insulini ndikuthandizira kukoka kwa glucose. Amachepetsa kuyamwa kwa chakudya m'mimba ndipo amalepheretsa gluconeogeneis m'chiwindi. Mankhwalawa alinso ndi phindu pa mbiri ya lipid ya magazi, kutsitsa cholesterol yathunthu. LDL ndi triglycerides. Sichimayambitsa kukhudzana kwa hypoglycemic.

Glibenclamide ndi wa gulu la sulfonylurea zotumphukira za m'badwo wachiwiri. Zimapangitsa secretion ya insulini pochepetsa kutsika kwa shuga wa glucose, kumakulitsa chidwi cha insulin komanso kumangika kwa ma cell omwe mukufuna, kumawonjezera kutulutsidwa kwa insulini, ndikuwonjezera mphamvu ya insulini pakukoka minofu ndi chiwindi cha glucose, ndikuletsa lipolysis mu minofu ya adipose. Machitidwe mu gawo lachiwiri la insulin katulutsidwe.

Pharmacokinetics a Gluconorm

Mukaperekedwa, kuyamwa kuchokera m'matumbo am'mimba ndi 48-84%. Nthawi yoti mufikire C_max - Maora 1-2 V_d - 9-10 malita. Kuyankhulana ndi mapuloteni a plasma ndi 95%.

Imakhala ngati imaphatikizidwa kwathunthu m'chiwindi ndikupanga ma metabolites awiri osagwira ntchito, amodzi omwe amatsitsidwa ndi impso, ndipo ena ndi matumbo. T_1/2 - kuyambira 3 mpaka 10-16 maola

Pambuyo pakukonzekera pakamwa, imatengedwa kuchokera m'matumbo am'mimba mokwanira, 20-30% ya mankhwalawa imapezeka mu ndowe. Mtheradi bioavailability kuchokera 50 mpaka 60%. Ndi kuyamwa kwa munthawi yomweyo, kuyamwa kwa metformin kumachepetsedwa ndikuchedwa. Imagawidwa mwachangu mu minofu, sikuti imagwirizana ndi mapuloteni a plasma.

Amapangidwira pamlingo wofooka kwambiri ndikuwonetsa impso. T_1/2 pafupifupi maola 9-12

Type 2 shuga mwa akulu:

- ndi kusakhazikika kwa mankhwala othandizira pakudya, masewera olimbitsa thupi komanso mankhwala am'mbuyomu omwe anali ndi metformin kapena glibenclamide,

- kusintha chithandizo chamankhwala am'mbuyomu ndi mankhwala awiri (metformin ndi glibenclamide) mwa odwala omwe ali ndi khansa ya magazi.

Mlingo komanso njira yogwiritsira ntchito Gluconorm

Mankhwalawa amagwiritsidwa ntchito pakamwa, komanso zakudya. Mlingo wa mankhwalawa umatsimikiziridwa ndi dokotala aliyense payekha kwa wodwala aliyense, kutengera kuchuluka kwa shuga.

Nthawi zambiri mlingo woyambirira ndi 1 tabu. (400 mg / 2.5 mg) / tsiku. Pakadutsa milungu iwiri ndi inayi atayamba kumwa mankhwalawa, mankhwalawa amathandizidwa malinga ndi kuchuluka kwa shuga m'magazi. Mukamachotsa mankhwala ophatikizira am'mbuyomu ndi metformin ndi glybeklamide, mapiritsi 1-2 amapatsidwa. Gluconorm kutengera mtundu wapitawo wa chilichonse.

Pazipita tsiku lililonse mapiritsi 5.

Zotsatira zoyipa

Thupi lawo siligwirizana ndi immunopathological: kawirikawiri - urticaria, erythema, kuyabwa pakhungu, malungo, arthralgia, proteinuria.

Kuchokera kumbali ya kagayidwe kazakudya: hypoglycemia ndizotheka.

Kuchokera ku hemopoietic system: kawirikawiri - leukopenia, thrombocytopenia, erythrocytopenia, kawirikawiri - agranulocytosis, hemolytic kapena megaloblastic anemia, pancytopenia.

Kuchokera kumbali yamanjenje yapakati: mutu, chizungulire, kufooka, kutopa, kawirikawiri - paresis, zovuta zam'maganizo.

Dermatological zimachitika: kawirikawiri - photosensitivity.

Kuchokera m'mimba ndi chiwindi: kawirikawiri - nseru, kusanza, kupweteka kwam'mimba, kusowa kwa chakudya, "zachitsulo" zamkamwa, nthawi zina - cholestatic jaundice, kuchuluka kwa michere ya chiwindi, hepatitis.

Kuchokera kumbali ya kagayidwe: lactic acidosis.

Zina: pachimake kukomoka mowa pambuyo kumwa, zikuwonetsa zovuta za kuzungulira ndi kupuma ziwalo (disulfiram ngati anachita: kusanza, kumva kutentha mu nkhope ndi chapamwamba thupi, tachycardia, chizungulire, mutu).

Contraindication Gluconorm

- lembani matenda ashuga 1

- matenda opatsirana, chithandizo chachikulu chopangira opaleshoni, kuvulala, kuwotcha kwakukulu ndi zina zomwe zimafuna chithandizo cha insulin,

- matenda ashuga ketoacidosis, matenda a shuga, matenda a shuga,

- pachimake zinthu zomwe zingayambitse kusintha kwa impso (kuchepa madzi, matenda akulu, mantha),

- matenda owopsa kapena osakhazikika omwe amatsatana ndi minyewa hypoxia (mtima kapena kupuma, kutulutsa kwa myocardial kwaposachedwa, mantha),

- gwiritsani ntchito maola osachepera 48 isanachitike komanso mkati mwa maola 48 mutapanga maphunziro a radioisotope kapena X-ray ndikukhazikitsa ma iodine okhala ndi zosiyana pakati,

- kutsatira zakudya zochepa zopatsa mphamvu (zosakwana 1000 calories / tsiku),

- kwambiri aimpso kuwonongeka,

- munthawi yomweyo miconazole,

- uchidakwa wambiri, kuledzera kwambiri,

- lactic acidosis (kuphatikizapo mbiri),

- nthawi yoyamwitsa,

- Hypersensitivity to metformin, glibenclamide kapena zinthu zina za sulfonylurea, komanso zinthu zothandiza.

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa mwa anthu opitirira zaka 60 omwe amagwira ntchito zolimbitsa thupi, zomwe zimagwirizanitsidwa ndi chiwopsezo chokhala ndi lactic acidosis mwa iwo.

Ndi kusamala: febrile syndrome, adrenal insufficiency, hypofunction ya anterior pituitary, matenda a chithokomiro omwe ali ndi vuto la chithokomiro.

Mimba komanso kuyamwa

Pa nthawi ya pakati, kugwiritsa ntchito gluconorm kumapangidwa. Mukakonzekera kutenga pakati, komanso ngati muli ndi pakati pa nthawi yomwe mukumwa Gluconorm, mankhwalawa ayenera kusiyidwa ndipo mankhwala a insulin ayenera kuyikidwa.

Gluconorm imapangidwa mu kuyamwitsa, pamene metformin imadutsa mkaka wa m'mawere. Pankhaniyi, muyenera kusinthana ndi insulin kapena kusiya kuyamwitsa.

Gwiritsani ntchito ntchito yolakwika ya chiwindi

Otsimikizika mu chiwindi kulephera.

Gwiritsani ntchito ntchito yolakwika yaimpso

Chogwiritsidwachi chimaphatikizidwa kwambiri kuwonongeka kwa aimpso ndi zovuta zomwe zimapangitsa kuti masinthidwe a impso (kuchepa magazi, matenda akulu, mantha),

Gwiritsani ntchito odwala okalamba

Sitikulimbikitsidwa kugwiritsa ntchito mankhwalawa mwa anthu opitirira zaka 60 omwe amagwira ntchito zolimbitsa thupi, zomwe zimagwirizanitsidwa ndi chiwopsezo chokhala ndi lactic acidosis mwa iwo.

Malangizo apadera olembetsa

Kuchitapo kwakukulu kwa maopareshoni ndi kuvulala, kuwotcha kwakukulu, matenda opatsirana omwe ali ndi febrile syndrome kungafune kuleka kwa mankhwalawo ndi kuikidwa kwa mankhwala a insulin.

Ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi pamimba yopanda kanthu ndikatha kudya.

Odwala ayenera kuchenjezedwa za chiwopsezo chowonjezereka cha hypoglycemia milandu ya ethanol, NSAIDs, ndi njala.

Kusintha kwa mlingo ndikofunikira pakulimbitsa thupi ndi malingaliro, kusintha kwa zakudya.

Pa mankhwala, osavomerezeka kumwa mowa.

Maola 48 asanafike opaleshoni kapena iv. Yoyamwa yokhala ndi ayodini wokhala ndi radiopaque, makonzedwe a gluconorm ayenera kusiyidwa. Chithandizo cha gluconorm chikulimbikitsidwa kuti chibwezeretsedwe pambuyo pa maola 48.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Munthawi ya chithandizo, chisamaliro chikuyenera kuchitika poyendetsa magalimoto ndi kuchita zina zomwe zingakhale zoopsa zomwe zimafuna kuti anthu azisamalira komanso azithamanga kwambiri.

Bongo

Mankhwala osokoneza bongo kapena kupezeka kwa zinthu zomwe zingachitike pachiwopsezo kungayambitse kukula kwa lactic acidosis, monga Metforminum ndi gawo lokonzekera. Zizindikiro za lactic acidosis zikawoneka (kusanza, kupweteka pamimba, kufooka, minofu kukokana), muyenera kusiya kumwa mankhwalawo. Lactic acidosis ndi vuto lofunika kuchipatala msanga, mankhwalawa a lactic acidosis ayenera kuchitika kuchipatala. Chithandizo chothandiza kwambiri ndi hemodialysis.

Mankhwala osokoneza bongo amathanso kukulitsa kukula kwa hypoglycemia chifukwa cha glibenclamide pokonzekera. Zizindikiro za hypoglycemia: anjala, thukuta kwambiri, kufooka, khungu, kutsekeka kwa pakamwa, kugwedezeka, nkhawa, kupweteka mutu, kugona. Ndi kupita patsogolo kwa hypoglycemia, odwala amatha kulephera kudziletsa komanso kuzindikira.

Ndi hypoglycemia yofatsa kapena yolimbitsa thupi, shuga kapena njira ya shuga imatengedwa pakamwa. Pakachitika vuto lalikulu la hypoglycemia (kusowa kwa chikumbumtima), yankho la 40% dextrose (glucose) kapena glucagon wamkati, v / m, s / c amaperekedwa iv. Pambuyo pozindikira, wodwalayo ayenera kupatsidwa chakudya chamagulu owonjezera chakudya kuti asayambenso kukonzekera hypoglycemia.

Kuchita ndi Mankhwala Ena

Barbiturates, corticosteroids, adrenostimulants (epinephrine, clonidine), antiepileptic mankhwala (phenytoin), wosakwiya calcium njira blockers, carbonic anhydrase inhibitors (acetazolamide), thiazide diuretics, chlortalidone, furosemide, diazanazide , morphine, ritodrine, salbutamol, terbutaline, glucagon, rifampicin, mahomoni okhala ndi chithokomiro, mchere wa lithiamu, muyezo waukulu - nicotinic acid, chlorpromazine, kulera kwapakamwa komanso estrojeni.

ACE inhibitors (Captopril, enalapril), histamine H blockers amalimbikitsa mphamvu ya hypoglycemic₂receptors (cimetidine), antifungal agents (miconazole, fluconazole), NSAIDs (phenylbutazone, azapropazone, oxyphenbutazone), fibrate (clofibrate, bezafibrat), anti-tuberculosis mankhwala (ethionamide), salicytates, anticoagulant antagonists Mao, sulfonamides wa nthawi yayitali, cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, ena hypoglycemic mankhwala (acarbose, biguanides, insulin), allopurinol.

Mankhwala a urine acidifying (ammonium chloride, calcium chloride, ascorbic acid mumadontho akuluakulu) amalimbikitsa zotsatira zake pochepetsa kusiyana kwake ndikuwonjezera kubwezeretsanso kwa glibenclamide.

Ethanol imawonjezera mwayi wa lactic acidosis.

Metformin Imachepetsa C_max ndi T_1/2 furosemide ndi 31% ndi 42.3%, motero.

Furosemide imachulukitsa C_max metformin ndi 22%.

Nifedipine imachulukitsa mayamwidwe, C_max Imachepetsa kuchotsedwa kwa metformin.

Mankhwala a Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren ndi vancomycin) omwe amatulutsidwa mu tubules kupikisanirana kachitidwe ka mayendedwe a tubular ndipo amatha kuonjezera C ndi chithandizo cha nthawi yayitali_max 60% metformin.

Mankhwala Okhala Pamalo a Pharmacy

Mankhwala ndi mankhwala.

Migwirizano ndi magwiritsidwe akusungidwa

Mankhwalawa amayenera kusungidwa pouma, kutetezedwa ndi kuwala, kufikira kwa ana pa kutentha osaposa 25 ° C. Moyo wa alumali ndi zaka zitatu.

Kugwiritsa ntchito mankhwala Gluconorm pokhapokha ngati adokotala adalembera, malangizo ndi omwe angakuthandizeni!

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapangidwa monga mapiritsi. Piritsi limodzi lili ndi 2.5 mg ya glibenclamide ndi 400 mg ya metformin hydrochloride ngati zinthu zofunikira. Zazungulira mawonekedwe. Mtundu - kuchokera oyera mpaka oyera.

Gluconorm ndi yofunika kuthandizira kuthana ndi matenda ashuga.

Zotsatira za pharmacological

Metformin ndi m'gulu la zinthu zomwe zimatchedwa Biguanides. Mlingo wa shuga m'magazi akamwedwa umachepa chifukwa chakuti chiwopsezo cha zotumphukira kuzinthu za insulin chikukula. Kutenga kwa glucose kumakhala kotakataka. Zakudya zomanga thupi sizimalowa kwambiri m'mimba. Mapangidwe a shuga m'chiwindi amachepetsa. Kuchuluka kwa cholesterol m'mwazi kumachepa. Hypoglycemia siitha kuyambitsa.

Ponena za glibenclamide, zimadziwika kuti ndizachokera ku sulfonylurea m'badwo wachiwiri. Imayambitsa kupanga insulin, kumasulidwa kwake, kumachepetsa ntchito ya lipolysis mu minofu ya adipose.

Kuchuluka kwa shuga m'magazi mukamatenga Gluconorm kumachepa chifukwa chakuti chidwi cha zotumphukira kuzinthu za insulin zimachulukana.

Pharmacokinetics

Chiwopsezo chachikulu kwambiri cha glibenclamide m'magazi chimalembedwa maola awiri atatha kumwa mapiritsi. 95% yophatikizidwa ndi mapuloteni am'madzi am'magazi. Kuola pafupifupi 100% kumachitika m'chiwindi. Hafu yocheperako ya moyo ndi maola atatu, okwera amatha kufika maola 16.

Metformin ndi 50-60% bioavava. Kulumikizana ndi mapuloteni am'madzi am'magazi ndi kochepa, kugawa minofu kumatha kufotokozedwa kuti ndi yunifolomu. Zofooka zofooka. Hafu ya moyo ndi maola 9-12.

Chiwopsezo chachikulu kwambiri cha glibenclamide m'magazi chimalembedwa maola awiri atatha kumwa mapiritsi.

Contraindication

Kuchiza ndi mankhwalawa sikungachitike pamene wodwala ali ndi zinthu zotsatirazi:

• achina,
• pathologies ogwirizana ndi minofu hypoxia: myocardial infaration, mtima ndi kupuma matenda, mantha,
• matenda ashuga ketoacidosis,
• mtundu 1 shuga
• lactic acidosis ndi porphyria,
• kuwotcha kwakukulu kapena njira zopatsirana zomwe zimafunikira chithandizo cha insulin mwachangu,
• kuchuluka kwa zomwe zimapangitsa kuti pakhale mankhwala osokoneza bongo.

Kuchiza ndi mankhwalawa sikungachitike pamene wodwala wayamba kutengeka ndi zida zazikulu za mankhwala.
Kuchiza ndi mankhwalawa sikungachitike pamene wodwala ali ndi matenda a shuga 1.
Kuchiza ndi mankhwalawa sikungachitike pamene wodwalayo apangika ndi myocardial infarction.

Ndi matenda ashuga

Asanamwe mapiritsi, wodwala aliyense ayenera kuphunzira malangizowo kuti asavulaze thanzi lawo. Mlingo uyenera kutumizidwa ndi dokotala yemwe akupatseni mankhwala. Amaganiza za mulingo woyenera kwambiri malinga ndi kuchuluka kwa shuga m'magazi omwe amalembedwa mwa wodwala panthawi yodziwika. Nthawi zambiri, zakudya zimaganiziridwa.

Mlingo wapamwamba kwambiri patsiku sungakhale mapiritsi oposa 5. Kwenikweni, ndi piritsi limodzi patsiku (400 mg / 2.5 mg). Kuyambira pachiyambipo chamankhwala, masabata onse a 1-2 njira yochizira imatha kukhala yowongoleredwa, monga momwe dokotala amayang'anira kusintha kwa shuga m'magazi. Ngati igwera, ndiye, molondola, mlingo uyenera kuchepetsedwa.

Mlingo uyenera kutumizidwa ndi dokotala yemwe akupatseni mankhwala.

Hematopoietic ziwalo

Monga kawirikawiri chovuta kuchokera ku hematopoietic dongosolo, kukula kwa leukopenia, thrombocytopenia kumachitika. Pafupipafupi, kutsika kwa kuchuluka kwa leukocytes, kuchepa kwa magazi m'thupi kumayamba.

Monga zina zomwe zimachitika kawirikawiri kuchokera ku hematopoietic dongosolo, leukopenia imachitika.

Zokhudza mphamvu pakuwongolera njira

Chifukwa cha zizindikiritso zamkati wamanjenje, ndikofunikira kukana kuwongolera mawunikidwe.

Chifukwa cha zizindikiritso zamkati wamanjenje, ndikofunikira kukana kuwongolera mawunikidwe.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mankhwalawa sayenera kumwa pakhungu. Ngati pakufunika matenda a shuga, izi ziyenera kuchitidwa ndi insulin.

Metformin imapangidwa mkaka wa m'mawere. Izi zikutanthauza kuti mukamachiza, muyenera kusiya kumwa mankhwalawo kapena kusiya kuyamwitsa ndi kusamutsa mwanayo kuti akumbukire.

Gluconorm Overdose

Ngati mulingo wovomerezeka ndi dokotala uchulukira kwambiri, wodwala amatha kukumana ndi lactacide, chithandizo chomwe chiyenera kuchitika mokhazikika ndi hemodialysis. Hypoglycemia ikhoza kuchitika, yomwe imadziwonetsa mwa maonekedwe akumanjenje, kunjenjemera, mavuto ogona kwakanthawi ndi zovuta zamitsempha.

Makhalidwe

Gluconorm ndi mankhwala ophatikiza omwe amaphatikiza mankhwala am'magulu osiyanasiyana a pharmacological malinga ndi momwe amathandizira.

Gawo loyambirira la fomuloli ndi metformin, woimira biguanides, yemwe amatithandizanso kuzindikira glycemic pokonzanso kukana kwa maselo kukhala ndi insulin yawo ndikuthandizira kugwiritsa ntchito shuga ndi minofu. Kuphatikiza apo, biguanide imalepheretsa kuyamwa kwa mafuta amthupi ndipo imalepheretsa kupanga shuga m'magazi. Amasintha metformin ndi mafuta osamala, kukhalabe ndende zabwino zamitundu yonse ya cholesterol ndi triglycerol.

Glibenclamide, wachiwiri wogwira popereka mankhwala, ngati woimira gulu lachiwiri la sulfonylurea, amalimbikitsa kupanga kwa insulin mothandizidwa ndi ma cell a β-cell a kapamba omwe amachititsa izi. Imawateteza ku glucose aukali, amasintha kukana kwa insulini komanso mtundu wa ligaments wokhala ndi maselo. Kutulutsidwa kwa insulin kumakhudzana ndi mayamwidwe a glucose ndi chiwindi ndi minofu, chifukwa chake, malo ake samapangidwa mumafuta. Thupi limachita gawo lachiwiri la kupanga insulin.

Zambiri za pharmacokinetics

Pambuyo polowa m'mimba, glibenclamide imalowetsedwa ndi 84%. Cmax (pachimake cha msinkhu wake) amafika pambuyo pa maola 1-2. Kugawa ndi voliyumu (Vd) ndi malita 9-10. Thupi limamangiriza mapuloteni amwazi ndi 95%.

Chomwe chili m'chiwindi chimasinthidwa ndikutulutsa ma metabolite awiri osagwirizana. Mmodzi waiwo amachotsa matumbo, chachiwiri - impso. Hafu ya moyo wa T1 / 2 ili mkati mwa maola 3-16.

Pambuyo polowa m'matumbo, metformin imatanganidwa mwachangu, osapitilira 30% ya mlingo omwe amakhalabe mgonero. The bioavailability wa greatuanide sichidutsa 60%. Ndi kufanana kwa michere, kuyamwa kwa mankhwalawo kumachepetsa. Imagawidwa mwachangu, samalowa mu kulumikizana ndi mapuloteni a plasma.

Mlingo wa Gluconorm ndi mawonekedwe ake

Gluconorm, chithunzi chake chomwe chitha kuwonekera m'ndimeyi, amalowa pamaneti ngati mawonekedwe a mapiritsi ozungulira okhala ndi chipolopolo choyera. Pakuswa, mthunzi wa mankhwalawo ndi imvi. Piritsi limodzi pali zinthu ziwiri zofunika pazogawana izi: metformin - 400 mg, glibenclamide - 2,5 g.) Onjezerani formula ndi mafilimu: talc, cellulose, wowuma, glycerol, cellacephate, gelatin, stearate ya magnesium, croscarmellose sodium, sodium carboxymethyl starch, sodium diodium. diethyl phthalate.

Mankhwalawa amadzaza mu ma PC 10 kapena 20. m'maselo omwe amapangidwa ndi zojambulazo. Mu makatoni ma CD atha kukhala awiri kapena anayi. Kwa Gluconorm, mtengo wake umakhala ndi bajeti yonse: kuchokera ku ma ruble 230, amatulutsa mankhwala omwe amapereka. Alumali moyo wa mapiritsi ndi zaka zitatu. Mankhwala safuna mikhalidwe yapadera kuti asungidwe.

Momwe mungagwiritsire ntchito Gluconorm

Kwa Gluconorm, malangizo a ntchito angalembedwe kumwa mapiritsi mkati ndi chakudya. Dokotalayo amawerengera mlingo payekhapayekha, poganizira momwe matendawo amayendera, zomwe zimayenderana ndi matenda, zaka ndi momwe akudwala matenda ashuga, komanso momwe thupi limachitikira ndi mankhwalawo. Monga lamulo, yambani ndi piritsi 1 / tsiku. Pakatha sabata limodzi kapena awiri, mutha kuwunika zotsatira, komanso osakwanira, sinthani zofananira.

Ngati Gluconorm sinali mankhwala oyambira, mukasinthira njira yothandizira yamankhwala am'mbuyomu, mapiritsi 1-2 amatchulidwa poganizira momwe mankhwalawo alili kale. Chiwerengero chachikulu cha mapiritsi omwe angatengedwe patsiku ndi 5 zidutswa.

Kuthandiza ndi bongo

Kukhalapo kwa metformin pamapangidwe kumakhumudwitsa matumbo, ndipo nthawi zina lactic acidosis. Ndi zizindikiro za zovuta (minofu kukokana, kufooka, kupweteka kwa epigastric dera, kusanza), mankhwalawa ayimitsidwa. Ndi lactic acidosis, wozunzidwayo amafunika kuchipatala mwachangu. Bwezeretsani ndi hemodialysis.

Kupezeka kwa glibenclamide mu formula sikumapatula chitukuko cha hypoglycemia. Ndikotheka kuzindikira mkhalidwe wowopsa chifukwa chosafuna kudya, thukuta, tachycardia, kunjenjemera, khungu lotuwa, isomnia, paresthesia, chizungulire komanso mutu, nkhawa. Ndi mtundu wofatsa wa hypoclycemia, ngati wozunzidwayo sanadziwe, amapatsidwa shuga kapena shuga. Ndi kukomoka, shuga, dextrose, glucagon (40% rd) jekeseni iv, pakhungu kapena pakhungu. Wodwalayo akayambanso kuzindikira, amapatsidwa chakudya ndimadzi othamanga, chifukwa nthawi zambiri zimayambiranso.

Zotsatira Zogwiritsa Ntchito Mankhwala

Kuphatikiza ndi ACE inhibitors, NSAIDs, antifungal mankhwala, ma fibrate, salicitates, anti-tuberculosis, β-adrenergic blockers, guanethidine, MAO inhibitors, sulfonamides, chloramphenicol, tetracycopyridinum, tetracycodiaminophenide, tetracycodiaminochenide. .

Ntchito ya hypoglycemic ya Gluconorm imachepetsedwa kuchokera ku zotsatira za adrenostimulant barbiturates, corticosteroids, anti-epilepsy mankhwala, diuretics (thiazide mankhwala), furosemide, chlortalidone, triamteren, morphine, ritodrin, glucagon, mahomoni a chithokomiro io.

Mankhwala othandizira mkodzo acid amathandizira kuti azichita bwino popewa kudzipatula komanso kupititsa mphamvu yogwirizananso ndi gluconorm resorption. Ethanol imawonjezera mwayi wa lactic acidosis. Metformin imakhudza kwambiri pharmacokinetics ya furosemide.

Zotsatira zoyipa

Metformin ndi imodzi mwamankhwala otetezeka kwambiri a hypoglycemic, koma, monga mankhwala aliwonse opangidwa, ali ndi zotsatirapo zake. Zina mwazovuta kwambiri ndi vuto la kukomoka, lomwe limapezeka m'mishuga yambiri odwala matenda ashuga atatha nthawi yosinthira okha. Glibenclamide ndiwophatikizanso nthawi yayitali wokhala ndi umboni waukulu wothandiza ndi chitetezo. Zomwe zalembedwa patebulopo ndizosowa, koma malangizo amayenera kuphunzira musanayambe chithandizo.

Ndani akuwonetsedwa ndikutsutsana ndi Gluconorm

Mapiritsi amalembedwa kwa odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda, ngati kusintha kwa moyo ndi chithandizo cham'mbuyomu sikunapatse 100% glycemic control. Ngati kugwiritsa ntchito mankhwala awiri osiyana (Metformin ndi Glibenclamide) ndikulola kubwezeredwa kwa shuga, ndikofunikanso kuti m'malo mwake muthane ndi mankhwala amodzi - Glucanorm.

Osagwiritsa ntchito Gluconorm ndi:

• Mtundu woyamba wa shuga
• Hypoglycemia,
• Matenda a shuga a ketoacidosis, chikomokere ndi matendawa,
• Zosagwira ntchito zamagalimoto ndi zovuta zawo,
• Matenda a chiwindi,
• Zomwe zimapweteketsedwa ndi njala ya minofu ya minyewa (yokhala ndi vuto la mtima, matenda a mtima, mantha, kulephera kupuma),
• Porphyria
• Kugwiritsa ntchito miconazole munthawi yomweyo,
• Zochitika zomwe zikuwonetsa kusintha kwakanthawi kwa insulini (panthawi ya opareshoni, kuvulala, matenda, mayeso ena ogwiritsa ntchito zilembo zochokera ku ayodini),
• Mowa,
• Lactic acidosis, kuphatikizapo mbiri yachipatala,
• Mimba komanso kuyamwa
• Hypocaloric (mpaka 1000 kcal) zakudya,
• Hypersensitivity pazigawo za formula.

Kugwiritsa ntchito Gluconorm ndi Amayi Oyembekezera ndi Olera

Ngakhale pa nthawi yomwe mwana akukonzekera, Gluconorm iyenera m'malo mwa insulin, popeza mankhwalawa amaphatikizidwa motere. Mkaka wa m'mawere ukadyetsedwa, zoletsa zimakhalabe zonse, popeza mankhwalawo amalowerera osati mwa placenta ya mwana wosabadwayo, komanso mkaka wa m'mawere. Kusankha pakati pa insulini ndikusintha kwa mwana kuti akwanitse kudya kuyenera kuganizira za kuchuluka kwa chiwopsezo kwa mayiyo komanso kuopsa kwa mwana.

Malangizo apadera

Kuvulala kwambiri komanso maopaleshoni akuluakulu, matenda opatsirana omwe amayatsidwa ndi malungo, akusonyeza kuti wodwalayo amasinthana kwakanthawi.

Anthu odwala matenda ashuga ayenera kuchenjezedwa za kuopsa kwa kukhala ndi hypoglycemia pogwiritsa ntchito NSAIDs, mowa, mankhwala opatsirana ndi ethanol, komanso kuperewera kwa zakudya m'thupi nthawi zonse.

Ndi kusintha kwa moyo, kadyedwe, nkhawa komanso thupi, kusintha kwa mankhwalawa ndikofunikira.

Ngati wodwalayo akufufuzidwa pogwiritsa ntchito ayodini, gluconorm imathetsedwa m'masiku awiri, ndikuisintha ndi insulin. Mutha kubwereranso kumalo am'mbuyomu chithandizo musanaphunzire maola 48 mutatha kafukufukuyu.

Kuchita bwino kwa Gluconorm kumachepetsedwa kwambiri ngati wodwala satsata zakudya zama carb ochepa, amatsogolera moyo wongokhala, osawongolera shuga tsiku ndi tsiku.

Gluconorm - analogues

Malinga ndi code ya ATX ya 4th, amagwirizana ndi Gluconorm:

Kusankhidwa ndi kusintha kwa mankhwalawa kumangotengera luso la katswiri. Kudzipenda nokha komanso kudzichitira nokha mankhwala osaganizira mawonekedwe onse a chiwalo china kumatha kukhala zotsatirapo zomvetsa chisoni.

Ndemanga Zahudwala

Zokhudza ndemanga za anthu odwala matenda ashuga a Gluconorm nthawi zambiri zimakhala zotsutsana. Ena amati mankhwalawa samathandiza, pali zodabwitsa zambiri, kuphatikiza kunenepa. Ena amati chovuta chachikulu pothana ndi mankhwalawa chinali kusankha mankhwalawo, kenako shugayo nkubwerera mwakale. Za tiyi wazitsamba "Altai 11 Gluconorm ndi blueberries" ndemanga zabwino: zimathandiza kukhalabe ndi masomphenya, kukhala ndi thanzi labwino.

Gluconorm ndi mankhwala osavuta kugwiritsa ntchito omwe adatsimikiziridwa ndikuchita kafukufuku wazinthu zazikulu. Bivanides ndi sulfanilurea zotumphukira zakhala zikugwiritsidwa ntchito pochizira matenda a shuga 2 kwazopitilira theka la zaka, ndipo mitundu yatsopano ya mankhwala othandizira odwala matenda ashuga sananenebe ulamuliro wawo.

Kuchita ndi mankhwala ena

Osavomerezeka kuti agwiritsidwe ntchito munthawi yomweyo limodzi ndi mankhwala a fenfluramine, cyclophosphamide, ACE inhibitors, mankhwala antifungal, chifukwa amathandizira mphamvu ya mankhwalawa.

Liazone diuretics yokhala ndi mahomoni a chithokomiro cha Iodine imatha kufooketsa ntchito yake.

Osavomerezeka kuti agwiritsidwe ntchito ndi fenfluramine.

Ndemanga za Gluconorm

Madokotala komanso odwala omwe amathandizidwa ndi mankhwalawa amasiya kuwunikira bwino.

D.E. Tikhonov, GP, Ryazan: "Mankhwalawa akuwonetsa zotsatira zabwino pochiza matenda a shuga a mtundu wachiwiri. Odwala akumva bwino. ”

O.D. Ivanova, wa endocrinologist, ku Moscow: "Ndimaona kuti mankhwalawo ndi abwino kwambiri pochiza matenda amtundu wa 2, chifukwa amathandiza msanga komanso moona mtima samachititsa kuti anthu azidana ndi mavuto. Ndimusankha nthawi zambiri zokwanira. "

Gluconorm Type 1 ndi 2 shuga

Alina, wazaka 29, Bryansk: “Ndinkayenera kulandira chithandizo chachikulu chazovuta monga matenda ashuga. Mankhwalawa anali aatali, koma matendawo anali bwino. Chifukwa chake, nditha kuvomereza izi. ”

Ivan, wazaka 49, Ufa: “Anandipeza kuchipatala. Ndinali wokhutira ndi chilichonse, kuphatikizapo chisamaliro cha madotolo ndi ukadaulo wawo. Anandifufuza, ndipo potengera zotsatira zake, anandipatsa mlingo wa mankhwalawo. Nditha kunena kuti mankhwalawa ndi othandiza ndipo ndimalimbikitsa onse odwala matenda ashuga. ”