Gluconorm - mankhwala a matenda a shuga a 2

Mankhwala amapezeka mu mawonekedwe a mapiritsi oyera ozungulira, onunkhira mbali zonse ziwiri. Mankhwala amaphatikizidwa mumatumba a chithuza cha zidutswa 10 chimodzi. Katoniyo amakhala ndi matuza 4. Palinso mapaketi okhala ndi matuza awiri a mapiritsi 20.

Piritsi la Gluconorm lili ndi zinthu zothandiza:

• metformin hydrochloride - 400 mg,
• glibenclamide - 2,5 mg.

Kuonjezera bioavailability, kaphatikizidwe kamaphatikizira othandizira: gelatin, glycerol, diethyl phthalate, croscarmellose sodium, chimanga wowuma, tcefter wa talc, magnesium stearate, colloidal silicon dioxide, cellcrystalline cellcose.

Zotsatira za pharmacological

Ndiwophatikiza ndimankhwala a hypoglycemic ochokera kuma gulu opanga zamankhwala ophatikizika: metformin ndi glibenclamide. Omalizirawa akutanthauza zochokera ku sulfonylurea zochokera m'badwo wachiwiri. Kuchulukitsa kuchuluka kwa shuga kumapangitsa maselo a pancreatic beta, ndikupangitsa secretion ya insulin gawo lachiwiri. Imayendetsa chidwi cha insulin komanso kutalika kwa kumangika kwake kuloza ma cell. Glibenclamide imathandizira kuyamwa kwa shuga ndi minyewa ndi maselo a chiwindi, pomwe nthawi yomweyo imaletsa kuwonongeka kwa mafuta ndi pulase enzyme.

Metformin imachokera ku gulu la Biguanides. Amapangidwa kuti azitha kukhudzidwa ndikuwonjezera kukoka kwa glucose pogwiritsa ntchito zotumphukira. The yogwira mankhwala amachepetsa kuchuluka otsika kachulukidwe lipoproteins ndi triglycerides, kukhala ndi phindu pa lipid mbiri m'magazi. Zimalepheretsa mapangidwe a cholesterol malo popanda kuchita hypoglycemic.

Glibenclamide

Pambuyo pakukonzekera pakamwa, adsorption ya glibenclamide m'matumbo ang'ono ndi 50-85%. Vutoli limafika ndende yake yambiri m'magazi pambuyo pa maola 1.5-2. Amamangidwa ndi mapuloteni a plasma ndi 95%.

Glibenclamide pafupifupi imasinthika kwathunthu m'chiwindi ndikupanga ma metabolites awiri omwe sagwira ntchito. Adapukutidwa payokha kudzera impso ndi m'mimba thirakiti. Hafu ya moyo imatenga maola atatu mpaka 16.

Ikalowa m'matumbo, mayamwidwe athunthu amapezeka. Bioavailability ukufika 50-60%. The kuyamwa kwa zinthu amachepetsa ndi chakudya chimodzi. 30% ya metformin imachotsedwa mu ndowe. Zotsalazo zimagawidwa mwachangu mthupi lonse popanda kumanga mapuloteni a plasma.

Hafu ya moyo imafika maola 9-12. Pafupifupi osakhudzidwa ndi metabolism. Kutulutsa kwa metformin m'thupi kumachitika ndi impso.

Gluconorm imagwiritsidwa ntchito ndi odwala omwe ali ndi matenda amtundu wa 2:

• kudya pang'ono komanso kuchita masewera olimbitsa thupi,
• ndi kulephera kwa mankhwala am'mbuyomu a metformin mwa anthu omwe ali ndi shuga.

Ndikulimbikitsidwa kugwiritsa ntchito kwa anthu opitilira zaka 18.

Contraindication

Gluconorm ndi yoletsedwa kugwiritsidwa ntchito:

• Odwala a shuga a Type I
• azimayi pa nthawi yoyembekezera komanso pakubala,
• Ndi muyezo umodzi wa miconazole,
• Pamaso kukanika kwa impso,
• anthu omwe ali ndi shuga ochepa
• odwala matenda a porphyrin omwe akhudzidwa ndi matenda opatsirana,
• mu ntchito pambuyo opaleshoni kuti muchepetse kuyaka kwa dera lalikulu,
• ndi kulephera kwa chiwindi ndi impso, komanso ndi mikhalidwe yomwe imawatsogolera (kuphwanya mulingo wamadzi wamchere, kutopa kwakutali, kulowerera kwa myocardial ndi kulephera kwa m'mapapo),
• ndi poyizoni thupi
• masiku awiri isanachitike komanso itatha radiology pogwiritsa ntchito njira yothandizira, yomwe imaphatikizapo ayodini,
• ndi lactic acidosis yayikulu,
• kudya zakudya zamagulu ochepa, zomwe munthu amadya zosakwana 1000 kcal / tsiku,
• pamaso pa sayanjana zimachitika metformin ndi othandizira zigawo.

Chenjezo limalimbikitsidwanso kutentha thupi, kugona komanso kuwonongeka kwa ma adrenal glands, ngati vuto la chithokomiro cha m'thupi ndi chithokomiro.

Malangizo ogwiritsira ntchito (mlingo)

Gluconorm lakonzedwa kuti pakhale pakamwa. Mlingo wa mankhwalawa amasankhidwa payekha ndi dokotala wopita. Maziko a kukhazikitsidwa kwa chizolowezi cha tsiku ndi tsiku ndi zotsatira za kusanthula.

Kumayambiriro kwa mankhwala, wodwala amapatsidwa piritsi limodzi patsiku. Pambuyo masiku 7 mpaka 14, mlingo wa mankhwalawa umasinthidwa malinga ndi zotsatira za kusanthula kwa glucose m'magazi. Mulingo waukulu sayenera kupitirira mapiritsi 5 patsiku.

Pothana ndi kuphatikiza kwaposakaniza metformin ndi glibenclamide, mapiritsi 1-2 a Gluconorm amaperekedwa kwa wodwala, malingana ndi mlingo wakale wa chinthu chilichonse.

Zotsatira zoyipa

Kuchokera kumbali ya kagayidwe kazakudya, nthawi zina, hypoglycemia imayamba.

Zotsatira zoyipa m'mimba ndi chiwindi, wodwalayo amatha kumva mseru, kusanza, kupweteka m'dera la epigastric, kusowa kwa chilimbikitso, "chitsulo" pakamwa. Nthawi zina, jaundice amawonekera, ntchito ya chiwindi michere imachulukana, hepatitis imayamba.

Leukopenia, thrombocytopenia, erythrocytopenia, agranulocytosis, hemolytic kapena megaloblastic anemia, pancytopenia imayamba pamene zotsatira zoyipa za hematopoietic zimawonekera.

Mitsempha yapakati imatha kuthana ndi mutu, chizungulire, kufooka, komanso kutopa kwambiri. Mwakamodzikamodzi, paresis, zovuta zam'maganizo zimawonedwa.

Ziwengo zimawonekera mu mawonekedwe a zovuta zamkati:

• urticaria
• erythema
• Khungu
• malungo
• arthralgia,
• proteinuria.

Kuchokera kumbali ya metabolism, lactic acidosis ndiyotheka.

Zina: pachimake kukomoka mowa pambuyo kumwa, zikuwonetsa zovuta za kuzungulira thupi ndi kupuma ziwalo (disulfiram-like: kusanza, kumva kutentha mu nkhope ndi thupi lakumaso, tachycardia, chizungulire, kupweteka kwa mutu).

Bongo

Ndi mankhwala osokoneza bongo ambiri, zizindikiro zotsatirazi zimawoneka motsatana:

• njala
• thukuta kwambiri
• kukomoka mtima,
• kunjenjemera ndi miyendo.
• nkhawa komanso kukhumudwa
• mutu
• kusowa tulo
• kusakhazikika
• chithunziensitivity, kuwonongeka kwa mawonekedwe owoneka ndi kuyankhula.

Ngati wodwala akudziwa, shuga amafunika. Osazindikira, 1-2 ml ya glucagon kapena dextrose wamkati amayenera kuperekedwa. Mukamabwezeretsa nkhawa, wodwalayo ayenera kudya zakudya zopatsa mphamvu.

Chifukwa cha kukhalapo kwa metformin mu "Gluconorm", wodwalayo amatha kuyamba lactic acidosis. Izi zimafuna chithandizo chamankhwala mwadzidzidzi komanso chithandizo chamankhwala kudzera mu hemodialysis.

Kuyanjana kwa mankhwala osokoneza bongo

Wonjezerani zochita zitha:

• allopurinol,
• mankhwala ena a hypoglycemic (magulu a Biguanide, insulin, acarbose),
• calcium tubule blockers,
• monoamine oxidase zoletsa
• coumarin anticoagulants,
• salicylates,
• anabolic steroids
• sulfonamides ochulukirapo,
• cyclophosphamide,
• machez
• fenfluramine,
• fluoxetine
• pyridoxine
• ganethidine,
• pentoxifylline
• ACE zoletsa (enalapril, Captopril),
• histamine H2 receptor blockers (cimetidine),
• antifungal (miconazole, fluconazole) ndi anti-TB,
• chloramphenicol.

Glucocorticosteroids, barbiturates, antiepileptics (phenytoin), acetazolamide, thiazides, chlorthalidone, furosemide, triamterene, asparaginase, baclofen, danazol, diazoxide, isoniazid, morphine, ritodrine, salbutamol, terbutaline, glucagon, rifampicin, mahomoni a chithokomiro, lifiyamu salt amatha kufooketsa mphamvu ya mankhwalawa.

Kulera, nicotinic acid, estrogens ndi chlorpromazine amachepetsa mphamvu ya mankhwalawa.

Poona kuchepa kwa kudziyanasiyana ndikuwonjezeranso kubwezeretsanso kwa glibenclamide, ammonium chloride, calcium chloride, ascorbic acid (pa mlingo waukulu) zimathandizira kuchitapo kanthu kwa mankhwalawa.

"Furosemide" imachulukitsa kuchuluka kwa metformin ndi 22%. "Nifedipine" imathandizira kuyamwa, koma kuphatikiza kwakukulu kumachepetsa kuchoka kwa zinthu zomwe zimagwira.

Amyloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren ndi vancomycin kuchokera munthambo ya cationic yolimbana ndi machitidwe oyendera ma tubular, ndikugwiritsa ntchito nthawi yayitali ndikuonjezera kuchuluka kwa metformin ndi 60%.

Malangizo apadera

Kuchotsa mankhwala osokoneza bongo ndikusinthanitsa ndi insulin mankhwala amafunika kutopa kwambiri pambuyo pakuchita opaleshoni, kuvulala, kuwotcha dera lalikulu, komanso matenda a thupi, limodzi ndi malungo.

Panthawi yamankhwala, kuyang'anira glucose nthawi zonse kumafunika.

Ndi kusala kudya kwanthawi yayitali, komanso kumwa mowa, chiopsezo chothazikika m'magazi a glucose chimakulirakulira. Kutengera ndi kafukufuku, munthawi yamankhwala, mowa saloledwa. Ndi kupsinjika kwakuthupi ndi kwamalingaliro, mlingo wa mankhwalawa umasinthidwa, zakudya zimasintha.

Pakatha masiku awiri opaleshoni kapena opaleshoni ya ayodini yokhala ndi ayodini yomwe imafunikira pa radiology, mankhwalawa adatha. Yambitsaninso patatha maola 48 maphunzirowa atatha.

Panthawi yamankhwala, ndikofunikira kupewa zinthu zosiyanasiyana zomwe zimafuna kuti anthu azitsatira komanso kuthamanga kwa magalimoto. Kuyendetsa galimoto sikulimbikitsidwa.

Mimba komanso kuyamwa

Mankhwalawa amaletsedwa kugwiritsidwa ntchito panthawi yomwe muli ndi pakati. Kwa nthawi yakukonzekera ndi kubala, yathetsedwa. Gluconorm imalowa m'malo mwa insulin.

Amayi panthawi yotseka nawonso saloledwa kumwa mankhwalawa chifukwa cholowera metformin mkaka wa m'mawere. Amayi ayenera kusinthana ndi insulin. Ngati izi sizingatheke, siyani kuyamwitsa.

Fananizani ndi fanizo

Zofunika! Ndi zoletsedwa kotheratu kuchita kulowetsa mwa Gluconorm ndi mankhwala ena popanda kufunsa dokotala.

1. Glibomet. Muli zinthu zofananira zofananira: metformin ndi glibenclamide. Mukamamwa mankhwalawa, katulutsidwe ka mahomoni ndi maselo a kapamba kumawonjezereka ndipo chiwopsezo cha minyewa chichitike cha insulin.

Koma mosiyana ndi Gluconorm, mawonekedwe ogwiritsira ntchito amasiyana:

• "Glibomet" imagwiritsidwa ntchito pamene thupi siligwirizana ndi zotumphukira za sulfonylurea chifukwa chogwiritsa ntchito nthawi yayitali,
• ndi matenda a shuga a insulin.

Nthawi yamankhwala ndi kuchuluka kwa tsiku ndi tsiku la "Glibomet" zimangodalira kuchuluka kwa shuga m'magazi, komanso kutengera kagayidwe kazakudya.

Kusiyanako kumadziwonekeranso mu zovuta zina:

• dontho la magazi oyera,
• thupi lawo siligwirizana limawoneka ngati zimachitika pakhungu (kuyabwa, redness),
• Mlingo woyenera amasankhidwa ndikuwonetsetsa wodwala nthawi zonse.

Mtengo wake ndi 90-100 rubles okwera.

Metglib. Zomwe zimapangidwira zikufanana. Kusiyana kuli mu kapangidwe ka othira, komwe kumapangitsa kuchepa kwa shuga m'matumbo aang'ono, komanso kupewa gluconeogeneis ndi glycogenolysis m'chiwindi.

"Metglib" imachepetsa thupi la wodwalayo poletsa kupangika kwa cholesterol ndi lipoproteins yotsika. Sizoletsedwa kumwa mankhwalawa ndi Bozentan chifukwa chowopsa cha kuledzera kwa hepatic.

Mtengo siwotsika ku Gluconorm.

Pharmacodynamics ndi pharmacokinetics

Gluconorm imakhala ndi kuphatikiza kwapawiri kwa zinthu ziwiri za hypoglycemic zamagulu osiyanasiyana a pharmacological: metforminndi glibenclamide.

Nthawi yomweyo, metformin ndi biguanide yomwe imatha kutsitsa shuga m'magawo a seramu magazi. Izi zimatheka ndikuwonjezera chidwi cha zotumphukira kuti insulini ichitepo kanthu ndikuwonjezera kugwidwa shuga. Komanso kuyamwa kwa chakudya cham'mimba m'mimba kumachepetsa ndipo kumalepheretsa gluconeogenesis m'malo a chiwindi. Zotsatira zabwino za mankhwalawa, zomwe zimayang'ana pakhungu la lipid m'magazi, zidadziwika, zikuwonetsa zonse cholesterol nditriglycerides. Hypoglycemic zochita sizimachitika.

Glibenclamide ndi mtundu wa 2 m'badwo wa sulfonylurea. Gawoli limadziwika ndi kukondoweza kwa insulin katulutsidwe chifukwa cha kuchepa kwa kukhumudwitsa kwa glucose β-cell mu kapamba, chidwi cha insulin, komanso kuchuluka kwake polumikizana ndi maselo ojambulidwa. Kuphatikiza apo, kutulutsidwa kwa insulin kumawonjezera, mphamvu ya insulini pakulowetsedwa kwa glucose ndi minofu minofu ndi chiwindi imalimbikitsidwa, ndipo lipolysis mu adipose zimakhala. Zochita za chinthuchi zimawonetsedwa mu gawo la 2 la secretion insulin

Mankhwala amaphatikizidwa bwino kuchokera kugaya chakudya. Kuzindikira kwakukulu kumatheka mkati mwa maola 1.5. Zotsatira zake kagayidwe angapo metabolites. Mankhwalawa amachotsedwa m'thupi mothandizidwa ndi impso ndi matumbo.

Zizindikiro zogwiritsidwa ntchito

Ntchito ya Gluconorm imapangidwira mtundu 2 shuga kwa odwala akulu omwe ali ndi:

• chakudya chokwanira, kugwiritsa ntchito thupi ndi chithandizo cham'mbuyomu ndi glibenclamide kapena metformin,
• kufunika kwa kubwezeretsa chithandizo cham'mbuyomu ndi mankhwalawa kwa odwala omwe ali ndi chiwonetsero champhamvu chamagazi.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi okhala ndi filimu: ozungulira, onunkhira mbali zonse, pafupifupi oyera kapena oyera, pakhungu - kuchokera loyera mpaka loyera loyera (ma 10 ma PC pachimake, matuza 4 m'bokosi lamatoni, ma 20 ma PC pachimake. , Matuza awiri mu mtolo wa makatoni).

Zinthu zomwe zimagwira piritsi limodzi:

• metformin hydrochloride - 400 mg,
• glibenclamide - 2,5 mg.

Zowonjezerapo: diethyl phthalate, croscarmellose sodium, glycerol, gelatin, starch ya chimanga, cellulosefate, talc, colloidal silicon dioxide, sodium carboxymethyl starch, cellcrystalline cellulose, magnesium stearate.

Zotsatira zoyipa

Mukamamwa Gluconorm, zotsatira zoyipa zimatha kukhala zimakhudza kagayidwe kazakudya, chiwindi ndi m'mimba, hematopoiesis ndi dongosolo lamanjenje. Izi zitha kutsatiridwa ndi: hypoglycemia, lactic acidosis, nseru, kusanza, kupweteka pamimba, kutayika kulakalaka, leukopenia, thrombocytopenia, erythrocytopenia, mutu, chizungulirekufooka, kutopa kwambiri ndi zina zotero.

Gluconorm, malangizo ogwiritsira ntchito (Njira ndi Mlingo)

Mankhwalawa amapangidwira pakamwa pakamwa nthawi yomweyo ndi chakudya. Pankhaniyi, mlingo wa mankhwalawa umakhazikitsidwa ndi adokotala, mukuganizira zomwe munthu aliyense wodwala amatengera ndi glucose wamagazi.

Monga lamulo, chithandizo chimayamba ndi mlingo wa tsiku ndi tsiku - 1 piritsi. Pakupita milungu iwiri, mlingo umasinthidwa molingana ndi kuchuluka kwa shuga m'magazi. Mukamachotsa chithandizo cham'mbuyomu ndi metformin ndi glybeklamide, mapiritsi 1-2 amaperekedwa kwa odwala. Potere, mlingo wa tsiku ndi tsiku sungakhale wopitirira mapiritsi 5.

Zizindikiro za gluconorm

Odwala ambiri omwe ali ndi matenda a shuga, mankhwalawo amalephera kukhazikika kwa glucose, chifukwa madokotala nthawi zambiri amathandizanso palimodzi. Chizindikiro cha kupatsidwa kwake ndi glycated hemoglobin pamtunda wa 6.5-7%.Maganizo abwino kwambiri omwe amaphatikizidwa ndi metformin ndi sulfonylurea derivatives (PSM), gliptins ndi incretin mimetics. Kuphatikiza konseku kumakhudza insulini kukana ndi kuchuluka kwa insulini pompopompo, chifukwa chake zimapereka zotsatira zabwino.

Kuphatikiza kwa metformin + sulfonylurea ndizofala kwambiri. Zinthu sizitha kuyanjana wina ndi mnzake, musachepetse kugwira ntchito bwino. Glibenclamide ndiyamphamvu kwambiri komanso wophunziridwa kuposa PSM yonse. Ili ndi mtengo wotsika kwambiri ndipo imagulitsidwa ku pharmacy iliyonse, chifukwa chake, kuphatikiza ndi metformin, glibenclamide imalembedwa nthawi zambiri kuposa mankhwala ena. Kuti mugwiritse ntchito mosavuta, mapiritsi a magawo awiri amapangidwa ndi zinthu ziwiri izi - Gluconorm ndi analogies.

Malinga ndi malangizowo, Gluconorm imagwiritsidwa ntchito kokha mtundu wa 2 shuga, ngati kuwongolera zakudya, masewera, ndi metformin sikupereka dontho la glucose kuti akwaniritse zofunika. Mlingo wa metformin suyenera kukhala wocheperako (2000 mg) kapena wololera odwala matenda ashuga. Komanso, gluconorm imatha kutengedwa ndi odwala omwe kale ankamwa glibenclamide ndi metformin payokha.

Kafukufuku wapezeka: mapiritsi ochepa omwe wodwala amatenga patsiku, amakonda kutsatira malangizo onse a dotolo, zomwe zikutanthauza kuti munthu amatha kugwiritsa ntchito bwino mankhwalawa. Ndiye kuti, kutenga Gluconorm m'malo mwa miyala iwiri ndi gawo laling'ono lopita kubwezeretsedwe kwabwino kwa matenda ashuga.

Kuphatikiza apo, kuwirikiza kawiri mu kuchuluka kwa mapiritsi ochepetsa shuga sikuthandizanso kuchepetsa shuga. Ndiye kuti, mankhwalawa awiri ocheperako amagwira ntchito moyenera ndikuwapatsa zotsatira zoyipa zochepa kuposa mankhwala amodzi mu muyeso wokwanira.

The zikuchokera ndi tanthauzo la mankhwala

Gluconorm imapangidwa ndi kampani yaku Russia ya Chemstandard mogwirizana ndi Indian Biopharm. Mankhwala amapezeka m'mitundu iwiri:

1. Mapiritsi a Gluconorm amapangidwa ku India, opakidwa ku Russia. Mankhwalawa ali ndi Mlingo wapamwamba wa 2.5-400, ndiye kuti, piritsi lililonse la metformin limakhala ndi 400 mg, glibenclamide 2.5 mg.
2. Mapiritsi a Gluconorm Plus amapangidwa ku Russia kuchokera ku mankhwala omwe agulidwa ku India ndi China. Amakhala ndi ma 2 Mlingo: 2,5-500 kwa odwala matenda ashuga omwe ali ndi insulin yambiri komanso 5-500 kwa odwala popanda kulemera kwambiri, koma ali ndi vuto la insulin lokwanira.

Chifukwa cha njira zingapo za muyezo, mutha kusankha mulingo woyenera wa wodwala aliyense yemwe ali ndi matenda a shuga a 2.

Tiyeni tiwone mwatsatanetsatane momwe zigawo za mankhwala Gluconorm zimagwirira ntchito. Metformin imachepetsa glycemia ya postprandial komanso kusala makamaka chifukwa kuchepa kwa insulin. Glucose amasiya zotengera mwachangu, momwe chidwi cha insulin chikuchulukira. Metformin imachepetsa kupangika kwa glucose m'thupi kuchokera kuzinthu zopanda mafuta, imachepetsa kulowa kwake m'magazi kuchokera m'mimba.

Kwa odwala matenda ashuga, zina zowonjezera za metformin zomwe sizikugwirizana ndi kuchepa kwa glycemia ndizofunikanso. Mankhwalawa amalepheretsa kukula kwa angiopathy mwa kuphatikiza ndi lipids yamagazi, kumathandizira minofu yazakudya. Malinga ndi malipoti ena, metformin imatha kuletsa ma neoplasms. Malinga ndi odwala, amachepetsa kudya, amathandizira kuti azikhala wathanzi, amathandizira kuchepetsa thupi, komanso amathandizira kudya.

Glibenclamide ndi m'badwo wa PSM 2. Imagwira mwachindunji maselo a pancreatic beta: imatsitsa gawo lawo la chidwi chawo m'magazi a glucose, potero limakulitsa kupanga insulini. Glibenclamide imathandizanso glycogenogeneis - njira yosungirako shuga m'misempha ndi chiwindi. Mosiyana ndi metformin, mankhwalawa amatha kuyambitsa hypoglycemia, ovuta kwambiri kuposa oimira ena a gulu la PSM - glimepiride ndi glyclazide. Glibenclamide imawonedwa ngati yamphamvu kwambiri, komanso yoopsa kwambiri ya PSM. Sikulimbikitsidwa kwa odwala matenda ashuga omwe ali pachiwopsezo cha hypoglycemia.

Momwe mungatengere mankhwala a Gluconorm

Zotsatira zoyipa kwambiri za metformin ndi kugaya, glibenclamide - hypoglycemia. Mutha kuchepetsa kwambiri zovuta zotsatila za mankhwala ndi gluconorm, kumwa mapiritsi nthawi yomweyo ndi chakudya ndipo pang'onopang'ono kukulitsa mlingo, kuyambira ndi ochepera.

Mlingo wa mankhwala Gluconorm mogwirizana ndi malangizo:

Ndi kukana kwamphamvu kwa insulin, komwe kumadziwika ndi anthu onenepa kwambiri omwe ali ndi matenda ashuga, metformin yowonjezera ikhoza kutumizidwa. Nthawi zambiri pamenepa amamwa asanagone. Mulingo woyenera tsiku lililonse wa metformin amatengedwa kuti ndi 2000 mg, pazipita - 3000 mg. Kuchulukanso kwina kwa mankhwalawa ndi kowopsa ndi lactic acidosis.

Ndikusowa kwa chakudya chamagulu, Gluconorm imayambitsa hypoglycemia. Kuti mupewe, mapiritsiwa aledzera ndi zakudya zazikulu. Zogulitsa ziyenera kukhala ndi chakudya chamagulu, makamaka pang'onopang'ono. Simungathe kuloleza nthawi yayitali pakati pa chakudya, choncho odwala amalimbikitsidwa kuti azikhala ndi zakudya zazing'ono. Ndemanga ya odwala matenda ashuga akuwonetsa kuti ngati ndichita masewera olimbitsa thupi kwambiri, shuga amatha kugwa pakapita mphindi. Pakadali pano, muyenera kukhala osamala kwambiri thanzi lanu.

Analogs ndi choloweza

Ma analogues athunthu, komanso metformin ndi glibenclamide payokha, atha kumwa moyenera muyezo womwewo wa Gluconorm. Ngati mukufuna kusintha chithandizo kuchokera ku mankhwala ena a sulfonylurea, Mlingo uyenera kusankhidwanso. Madokotala amalimbikitsa kusintha kuchokera ku Gluconorm kupita ku Amaryl kapena Glimecomb kwa odwala matenda ashuga omwe ali ndi matenda amtundu wa 2, omwe nthawi zambiri amakhala ndi hypoglycemia.

Malinga ndi ndemanga, mphamvu ya Gluconorm ndi fanizo lake ili pafupi, koma anthu odwala matenda ashuga amakonda mtundu wa Glybomet wa ku Germany, poganiza kuti ndi mankhwala abwino kwambiri.

Malamulo osungira ndi mtengo

Gluconorm imagwira ntchito kwa zaka 3 kuyambira tsiku lopangidwa. Gluconorm Plus imaloledwa kusunga zosaposa zaka 2. Malangizowo alibe zofunikira pakusungira, ndikukwanira kuti muwone ngati boma lili ndi mafuta osaposa 25 digiri.

Anthu odwala matenda ashuga ku Russia amatha kulandira onse mankhwalawa malinga ndi mankhwala aulere omwe amalembedwa ndi katswiri kapena endocrinologist. Kugula pawokha kumawononga ndalama zotsika mtengo: mtengo wa mapiritsi 40 a Gluconorm ndi pafupifupi ma ruble 230, Gluconorm Plus imayambira 155 mpaka 215 rubles. mapiritsi 30. Poyerekeza, mtengo wa Glibomet yoyambirira uli pafupifupi ma ruble 320.

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 >>

Zolemba zogwiritsira ntchito

M'pofunika kuletsa chithandizo ndi mankhwalawa chifukwa cha matenda opatsirana omwe ali ndi malungo, ndi kuvulala kwambiri komanso kulowererapo. Chiwopsezo chochepetsera kuchuluka kwa shuga panthawi yanjala, kugwiritsa ntchito NSAIDs, Mowa umachulukitsidwa. Kusintha kwa Mlingo kumachitika posintha zakudya, mphamvu zamakhalidwe ndi kutopa.

Malangizo omwe Gluconorm amafotokozera sakulimbikitsidwa kumwa mowa panthawi yamankhwala. Mapiritsi amatha kuthana ndi kuthamanga kwa zochitika zama psychomotor ndikuchepetsa chidwi. Chifukwa chake, muyenera kusamala mukamayendetsa magalimoto owopsa ndi magalimoto.

Sizoletsedwa kumwa mapiritsi ali mwana, panthawi yoyembekezera, poyamwitsa, chifukwa zinthu zikuluzikulu zimalowa mkaka wa mayi. Mankhwalawa amadziwikiratu anthu omwe ali ndi matenda a impso ndi chiwindi. Kugwiritsa ntchito mapiritsi okalamba sikulimbikitsidwa pamodzi ndi kuchita masewera olimbitsa thupi.

Kuchita ndi mankhwala ena

Musanayambe chithandizo, muyenera kuphunzira momwe Gluconorm imalumikizirana ndi mankhwala ena:

• phatikizani katundu wa hypoglycemic: ACE inhibitors, MAO, NSAIDs, ma fibrate, allopurinol, anabolic steroids, anti-TB mankhwala, mapiritsi a mkodzo acidifying,
• kufooketsa izi: mahomoni oletsa kubereka, mahomoni okhala ndi chithokomiro, barbiturates, adrenostimulants, corticosteroids, kuchuluka kwa nicotinic acid, glucagon, furosemide, thiazide diuretics, antiepileptic mankhwala,
• kuchuluka kwa metformin: mankhwala a cationic, furosemide,
• kuchuluka kwa furosemide: metformin,
• Kuchedwa kuchotsedwa kwa metformin: nifedipine.

Mlingo ndi makonzedwe

Gluconorm imawonetsedwa pakamwa. Mapiritsi ayenera kumwedwa ndi zakudya.

Mlingo wokwanira wodwala aliyense amasankhidwa payekhapayekha potengera kuchuluka kwa shuga m'magazi.

Mlingo woyamba nthawi zambiri piritsi limodzi 1 nthawi patsiku. Ngati ndi kotheka, onjezani mlingo uliwonse pakadutsa masabata awiri mpaka awiri mpaka momwe mukufunira.

Pankhani ya makonzedwe a Gluconorm m'malo osakanikirana ndi mankhwala awiri - metformin ndi glibenclamide - mlingo umatsimikiziridwa kutengera mtundu waukulu wamitundu iliyonse, mapiritsi 1-2 amadziwika.

Mlingo wovomerezeka wopezeka ndi mapiritsi 5 patsiku.

Zambiri, kapangidwe ndi mitundu ya kumasulidwa

Gluconorm ndi mankhwala osokoneza bongo a hypoglycemic opangidwa ku India. Kuphatikiza pa kutsitsa shuga, mankhwalawo amathandizira kuchepetsa kuchuluka kwa mafuta m'thupi m'magazi a wodwala.

Amaloledwa kugawa ndalama molingana ndi zomwe katswiriyu amapita. Mankhwalawa amagwiritsidwa ntchito kwa zaka zitatu kuyambira tsiku lomwe adapanga.

Ndikofunikira kuti muzisunga mosamala mankhwalawa. Amasungidwa m'malo amdima osapeza ana. Kutentha kwambiri kosungira ndiko 20-23 0 C.

Kuphatikiza apo, Gluconorm yokhala ndi mabulosi amtundu wa tiyi wopangidwa ndi mankhwala azitsamba, omwe si mankhwala, koma amatengedwa ngati chakumwa chotsitsa shuga.

Mwa zina mwa mankhwala, sodium carboxymethyl starch, magnesium stearate ndi cellacephate zimadziwika. M'malingaliro ena, talc yokhala ndi wowuma wa chimanga ndi gelatin imakhalapo pakuphatikizidwa kwa mankhwalawa.

Phukusi limodzi lamapulogalamu muli matuza 1-4. Mkati mwa chithuza mungakhale mapiritsi 10, 20, 30 a mankhwalawa. Mapiritsi a mankhwalawa ndi oyera ndipo amakhala ndi mawonekedwe a biconvex. Pakuphwanya, mapiritsiwa amatha kukhala pang'ono.

Tiyi ya Gluconorm Blueberry ilibe zinthu zomwe zimapezeka pamapiritsi. Amapangidwa kuchokera ku zitsamba zachilengedwe ndikugulitsa ngati matumba a tiyi. Njira yovomerezeka idapangidwa kwa masabata atatu.

Pharmacology ndi pharmacokinetics

Gluconorm ili ndi zigawo ziwiri zazikulu: Glibenclamide ndi Metformin. Zinthu zonsezi zimagwira ntchito yophatikiza, ndikuwonjezera mphamvu ya mankhwalawa.

Glibenclamide ndi mtundu wa 2 m'badwo wa sulfonylurea. Chifukwa cha zomwe amachita, insulin secretion imakhudzidwa, komanso insulin chiwopsezo chimakulanso kwambiri mu maselo olimbana.

Glibenclamide imalimbikitsa kutulutsa insulin mwachangu ndikuwonjezera mphamvu yake pakuphatikizidwa kwa shuga ndi chiwindi, komanso minofu. Mothandizidwa ndi chinthu, njira yogawa mafuta mu minofu ya adipose imayamba kuchepa.

Metformin ndi chinthu chachikulu. Chifukwa cha zomwe anachita, kuchuluka kwa shuga m'magazi a munthu wodwala kumachepetsedwa, pali kuwonjezereka kwa glucose ndi zotumphukira zimakhala.

Thupi limapangitsa kuchepa kwa kuchuluka kwa cholesterol m'magazi. Chifukwa cha ntchito ya Metformin, mayamwidwe am'mimba m'mimba ndipo matumbo amachepa. Vutoli limalepheretsa kupangika kwa shuga mkati mwa chiwindi.

Glibenclamide ndi Metformin, omwe ndi gawo la mankhwalawo, ali ndi ma pharmacokinetics osiyanasiyana.

The mayamwidwe glibenclamide pambuyo kumeza kuchokera m'mimba ndipo matumbo ukufika 84%. Kuzindikira kwakukulu kwa chinthu kumatha kufikira ola limodzi kapena awiri. Thupi limalumikizidwa bwino ndi mapuloteni amwazi. Mtengo ndi 95%. Hafu yocheperako ya moyo ndi maola atatu, okwera ndi maola 16. Thupi limachotsedwa pang'ono ndi impso, pang'ono ndi matumbo.

The bioavailability okwanira wa Metformin si oposa 60%. Kudya kwambiri kumachepetsa kuyamwa kwa metformin. Zinthu zomwe zimatengedwa pamimba yopanda kanthu zimatengedwa bwino kuchokera m'mimba ndi matumbo.

Mosiyana ndi Glibenclamide, imakhala ndi mgwirizano wotsika ndi mapuloteni amwazi. Amachotsa impso. 30% ya mankhalawo atha kukhalapo mu ndowe za wodwala. Kutha kwa theka moyo kumafika maola 12.

Zizindikiro ndi contraindication

Chizindikiro chachikulu chakumwa mankhwalawa ndicho kupezeka kwa mtundu wachiwiri wa shuga wodwala. Komanso, mankhwalawa amadziwitsidwa pokhapokha pakufunika kwa chithandizo cha mankhwala, zakudya, masewera olimbitsa thupi komanso mankhwala othandizira kutenga Metformin ndi Glibenclamide.

Mankhwalawa akuwonetsedwanso kwa odwala omwe ali ndi shuga wabwinobwino komanso wodala wamagazi, koma akuyenera kusintha mankhwalawo ndi Glibenclamide ndi Metformin.

Chiwerengero chambiri chotsutsana ndi mawonekedwe a mankhwalawa:

• kulephera kwa chiwindi
• shuga wamagazi ochepa (hypoglycemia),
• chidwi chachikulu cha zigawo za mankhwala,
• lembani matenda ashuga
• uchidakwa wambiri,
• mimba
• aimpso kuwonongeka chifukwa cha matenda, mantha,
• ketoacidosis
• kugwiritsa ntchito miconazole,
• kupezeka kwa kuwotcha thupi,
• kulephera kwa mtima
• yoyamwitsa
• matenda osiyanasiyana
• wodwala matenda ashuga
• kulephera kwa aimpso
• myocardial infaration
• othandizira opaleshoni
• lactic acidosis,
• poyizoni wa mowa
• kulephera kupuma
• matenda a shuga
• matenda a porphyrin.

Odwala Apadera ndi Mayendedwe

Mankhwalawa amaletsedwa kwa amayi apakati. Ndizosavomerezeka kumwa mankhwalawa pokonzekera kutenga pakati.

Gluconorm sayenera kumwedwa ndi azimayi amiyala, popeza Metformin imalowa mkaka wa m'mawere ndipo imatha kusokoneza thanzi la wakhanda. Milandu imeneyi, kusintha kwa mankhwala ndi insulin mankhwala ndikofunikira.

Mankhwala osavomerezeka kwa odwala okalamba omwe ali ndi zaka zopitilira 60. Kuphatikiza ndi katundu wolemera, Gluconorm ikhoza kuyambitsa lactic acidosis m'gulu ili la anthu.

Mankhwalawa amafunika kuthandizidwa mosamala ndi odwala omwe ali ndi:

• kuperewera kwa adrenal,
• malungo
• matenda a chithokomiro.

Kwa mankhwala, malangizo apadera angapo amaperekedwa:

• Pa mankhwala, kuyang'anira kuchuluka kwa shuga m'magazi ndikofunikira pamimba yopanda kanthu ndikatha kudya,
• mankhwala oledzera ndi mowa amaletsedwa,
• ndikofunikira kusintha mankhwalawo ndi mankhwala a insulin ngati wodwala wavulala, matenda, kutentha thupi, kutentha, ntchito zakale,
• Masiku awiri asanayambitse mankhwala a radiopaque okhala ndi ayodini m'thupi la wodwalayo, ndikofunikira kusiya kumwa mankhwalawa (pambuyo masiku 2, kudya kumayambidwanso),
• Kuphatikiza kwa Gluconorm ndi ethanol kumakwiyitsa hypoglycemia, kumachitika komanso kusala komanso kumwa mankhwala oletsa kutupa a mtundu wina wopanda mankhwala.
• mankhwalawa amakhudza kuthekera kwa wodwala kuyendetsa galimoto (muyenera kupewa kuyenda pagalimoto panthawi ya mankhwala).

Maganizo a odwala

Ndemanga zingapo za anthu odwala matenda ashuga za mankhwala a Gluconorm ali ndi zotsatira zabwino za kumwa mankhwalawa, komabe, mavuto amatchulidwa, omwe nthawi zambiri kunyansidwa ndi mutu kumachitika, omwe amathetsedwa ndikusintha kwa mlingo.

Mankhwalawa ndi abwino, amatsitsa shuga bwino. Modabwitsa, sindinapeze zovuta zili zonse zomwe zimalembedwa nthawi zambiri. Mtengo wokwanira. Ndikuyitanitsa Gluconorm mosalekeza.

Ndakhala ndikuvutika ndi matenda ashuga a 2 kwazaka zambiri. Dokotala wodziwikiratu ndi Gluconorm. Poyamba, panali mavuto: odwala ambiri, anali ndi chizungulire. Koma mtsogolomo tinasintha mlingo, ndipo zonse zinadutsa. Chida chake ndichothandiza ngati muphatikiza kudya kwake ndi zakudya.

Gluconorm ndiyodalirika kwathunthu. M'malo mwanga, ndinathandizanso kusintha kulemerako. Mankhwala amachepetsa kudya. Mwa mphindi, ndikuwonetsa zovuta. Pali ambiri a iwo. Nthawi ina, mutu wanga udadwala komanso kudwala.

Osati kale kwambiri, endocrinologist adapeza matenda osakondweretsa - matenda a shuga a 2. Gluconorm idayikidwa kuti iwongole shuga. Kwambiri okondwa ndi mankhwalawa. Ndi shuga wambiri, mankhwalawa amatha kuchepetsa kiwango chake mpaka 6 mmol / L. Pali zovuta zina, koma zimathetsedwa. Pamafunika chakudya.

Mtengo wa gluconorm m'magawo osiyanasiyana mdzikolo uli ndi zosiyana. Mtengo wapakati mdzikolo ndi ma ruble 212. Mtengo wa mankhwalawo ndi ma ruble a 130-294.