24 November, 2024
    Mankhwala

    Mphamvu ya Metglib: malangizo ogwiritsira ntchito, zikuchokera, mtengo, ndemanga za anthu odwala matenda ashuga, analogues

    Pakadali pano, mankhwala osiyanasiyana angagwiritsidwe ntchito pochiza wodwala yemwe wapezeka ndi matenda a shuga a 2. Chimodzi mwa mankhwalawa ndi Metglib Force.

    Metglib ndi mankhwala omwe amapezeka mu mawonekedwe apiritsi. Kuphatikizidwa kwa mankhwalawo nthawi yomweyo kumakhala ndi magawo awiri omwe amagwira ntchito - metformin ndi glibenclamide, zomwe zimaloleza kuti ziwonekere gulu la zophatikiza zamankhwala zomwe zimagwiritsidwa ntchito pochiza matenda a shuga mellitus. Chifukwa cha kuphatikiza kwazinthuzi, Metglib ndi imodzi mwamankhwala othandiza kwambiri, monga zikuwonera ndikuwunika kwa odwala ndi madokotala.

    Yogwira ntchito ya metformin imathandizira kuchepetsa shuga m'magazi kuti ikhale yachilengedwe. Kuphatikiza apo, katundu wake akuphatikiza ma analgesic ndi ma antiviral zotsatira, kuchepa kwa thupi ndi chakudya chokwanira.

    The yogwira mankhwala glibenclamine imakhazikitsidwa ngati mankhwala omwe amachepetsa shuga.

    Mankhwalawa amagwiritsidwa ntchito kwambiri pochiza matenda amtundu wa 2 osagwirizana ndi insulin. Kuphatikiza apo, kugwiritsidwa ntchito kwake kumakhala koyenera pambuyo pa chithandizo chamankhwala chosagwiritsidwa ntchito ndi zinthu ziwiri zamankhwala - metformin ndi urea sulfonyl zotumphukira, pokhapokha ngati wodwala ali ndi glycemia wokhazikika.

    Mapiritsi a Metglib ndi ena mwa mankhwala otsika mtengo. Mtengo wawo umatengera zinthu izi:

    • kampani yopanga mankhwala.
    • wogulitsa.
    • malo omwe wogulitsa (mankhwala).

    Pafupifupi, mtengo wamankhwala otere ungasiyane ndi ma ruble 190 mpaka 250 pa paketi (mapiritsi 10).

    Malangizo ogwiritsira ntchito mankhwalawa

    Phukusi lililonse la mankhwalawa lili ndi malangizo ogwiritsa ntchito. Musanayambe njira yothandizira achire, muyenera kudziwa bwino zomwe zili mkati mwake, mulingo woyenera, kuchuluka kwa zovuta ndi contraindication.

    Dokotala wokhayo ndiye woyenera kupereka chithandizo ndi mankhwalawa.

    Mpaka pano, mapiritsi amapezeka mu mitundu yosiyanasiyana, yomwe imasankhidwa kwa wodwala aliyense payekhapayekha. Kutengera kuchuluka kwa zinthu zomwe zingagwiritsidwe ntchito, mankhwalawa angagwiritsidwe ntchito pazotsatira zake:

    1. Kuphatikizikako kumakhala ndi 500 mg ya metformin ndi 2.5 (5) mg wa glibenclamine - chiyambi cha mankhwala chimakhala ndi kumwa piritsi limodzi patsiku m'mawa. Ngati kuli kofunika kuwonjezera mlingo kukhala mapiritsi awiri kapena anayi patsiku, kuchuluka kwa mankhwalawa kumachulukitsidwa ndipo mankhwalawa amatengedwa m'mawa ndi madzulo. Kuphatikiza apo, adokotala amatha kukupatsani mankhwala katatu (mapiritsi atatu, asanu kapena asanu ndi limodzi patsiku).
    2. Kwa anthu achikulire, ndikofunikira kusankha mosamala mlingo wa mankhwalawo ndikuwunikira kuwonekera kwa zovuta, zomwe zimachitika kuchokera ku impso. Mlingo woyambirira sayenera kukhala piritsi limodzi patsiku.

    Dziwani kuti mankhwalawa sanapangidwe kuti athandize odwala matenda ashuga ana.

    Ndi ziti zotsutsana zomwe zimagwiritsidwa ntchito?

    Kuchiza ndi mankhwalawa kuyenera kuyang'aniridwa ndi katswiri wazachipatala.

    Ngakhale zili ndi zabwino zambiri za mankhwalawo, pali mndandanda wathunthu wazotsatira zosiyanasiyana zoyipa ndi zoletsa kugwiritsa ntchito kwake.

    Atsikana oyembekezera komanso azimayi oyembekezera panthawi yotsala sangathe kugwiritsa ntchito mankhwalawa, kuti asavulaze kukula kwa mwana.

    Sizoletsedwa kugwiritsa ntchito chachipatala pazinthu zotsatirazi:

    • ndi kukula kwa wodwala ndi matenda a shuga 1.
    • ngati pali chidwi chochulukirapo kapena kusalolera kwa chinthu chimodzi kapena zingapo za mankhwalawa.
    • odwala opitilira zaka makumi asanu ndi limodzi, makamaka pakakhala kulimbitsa thupi kwambiri.
    • pochitira ana aang'ono.
    • Pamaso pa matenda a impso, ziwalo zamkati pamtima kapena kulephera kwa chiwindi, ndizoletsedwa kumwa mapiritsi a anthu omwe adakumana ndi vuto la myocardial infarction, ali ndi mtima kapena kupuma.
    • kumwa mankhwala kutengera mycnalosis.
    • posachedwa omwe amachitidwa opaleshoni kapena kuvulala ndilimodzi mwazinthu zotsutsana ndi kumwa mankhwalawa.
    • uchidakwa kapena kugwiritsa ntchito mitundu ingapo ya zakumwa zoledzeretsa panthawi ya mankhwala a Metglib.
    • mawonetseredwe a lactic acidosis.
    • mukumamatira pachakudya chokhazikika chama calorie, chomwe sichidutsa kilocalories chikwi patsiku.

    Kuphatikiza apo, chisamaliro chikuyenera kuthandizidwa pochiza wodwala ngati:

    1. febrile syndrome.
    2. mavuto ndi yachibadwa magwiridwe antchito a adrenal.
    3. osakwanira magwiridwe antchire.
    4. matenda a chithokomiro.

    Kusamala mu chithandizo kumafunikira mukamagwira ntchito ndi odwala patatha zaka 70, chifukwa hypoglycemia imatha kuchitika.

    Ndi zovuta zoyipa ziti zomwe zimagwiritsidwa ntchito ndi mankhwalawa zomwe zingachitike?

    Nthawi zina, madokotala amatha kuwona kuwonetsa kwa zoyipa zosiyanasiyana zomwe zimachitika chifukwa chotenga mankhwalawa komanso kusankha kosayenera kwa Mlingo.

    Ngati pali zizindikiro zilizonse zolakwika m'thupi, muyenera kudziwitsa dokotala wanu za momwe akukula.

    Kuphatikiza apo, ndemanga za odwala zimawonetsa zotsatirapo zoipa za mankhwalawa.

    Mawonekedwe olakwika omwe akupezekapo akuphatikizapo:

    1. Matenda osiyanasiyana omwe amachokera ku dongosolo la lymphatic. Zotsatira zoyipa zoterezi ndizosowa kwambiri ndipo, monga lamulo, zimatha mukangomwa mankhwalawo.
    2. Matenda oyamba a chitetezo chamthupi amatha. Mwazovuta kwambiri, kuwopsa kwa anaphylactic kumawonedwa. Hypersensitivity reaction ku sulfonamides kapena zotumphukira zawo zimapezekanso nthawi zina.
    3. Kukula kwa matenda am'mimba ndi ziwalo zam'mimba thirakiti. Zotsatira zoyipa zoterezi zimawonetsedwa m'miseru ndi kusanza, kutsegula m'mimba ndi kupweteka m'mimba. Monga lamulo, zizindikilo zotere ndi zotsatira za kuyamba kumwa mankhwalawo ndikudziwonjezera pazokha masiku ochepa. Kuti mulekerera bwino mankhwalawa, madokotala amalimbikitsa kuti agawe mankhwalawo muzilingo zingapo kuti thupi lizitha kuzolowera.
    4. Kukula kwa zoyipa zomwe zimawonetsedwa ndi kagayidwe kachakudya mthupi. Chimodzi mwazizindikiro zakuwonekera kwawo ndi hypoglycemia.
    5. Zotsatira zoyipa zomwe zimatha kuchitika kumbali yamanjenje zimafotokozedwa ngati mawonekedwe amtundu wamchere wamkamwa.
    6. Mavuto ndi khungu limawoneka ngati kuyabwa, redness, ming'oma, ndi totupa zosiyanasiyana.

    Pharmacology yamakono imapereka mitundu yambiri yazinthu zamankhwala osiyanasiyana zomwe ndi Metglib analogues.

    Kodi mankhwala amatha kusinthidwa ndi mankhwala okhala ndi katundu wofanana?

    Monga lamulo, mankhwalawa ali ndi chinthu chofanana pakapangidwe kake, koma amatha kusiyanasiyana ndi kuchuluka kwa mlingo, mtundu wa kumasulidwa, kampani yopanga ndi ndondomeko yamtengo. Dziwani kuti ogula ambiri amawona kuti mankhwala omwe atumizidwa kunja ndi othandiza kwambiri, omwe amakhala okwera mtengo, koma atha kukhala chimodzimodzi ndi mankhwalawo. Kusankhidwa kapena kusinthana kwa mankhwalawa kuyenera kuchitidwa kokha ndi adokotala.

    Mankhwala omwe amaphatikiza metformin yogwira ndi glibenclamine ndi awa:

    1. Bagomet Plus ndi mapiritsi akukonzekera omwe amapezeka mu 500 mg ya metformin ndi 5 mg ya glibenclamine. Ndiwotsimikizira kwathunthu wa mapiritsi a Metglib. Mtengo wapakati mumasitolo am'mizinda ndi pafupifupi ma ruble 215.
    2. Glibomet - mapiritsi okhala ndi 400 mg a metformin ndi 2,5 mg wa glibenclamine, omwe nthawi zambiri amagwiritsidwa ntchito pochiza matenda a shuga a 2. Mwa zomwe zili pazinthu zomwe zikugwira, zimateteza kwambiri (zimakhala ndi zotsika) poyerekeza ndi Metglib. Mtengo wapakati pama pharmacies umasiyana mkati mwa ma ruble 315.
    3. Gluconorm - mapiritsi, omwe kapangidwe kake ndi katundu amakhala ndi zofanana ndi Metglib. Mtengo wapakati ndi pafupifupi ma ruble 230.

    Mankhwala onse omwe ali pamwambawa ali ndi zigawo ziwiri zogwira ntchito pakuphatikizika kwawo ndipo amaphatikizidwa pagulu la mankhwala osakanikirana omwe amagwiritsidwa ntchito popanga shuga m'magazi.

    Mu kanema munkhaniyi, adotolo apereka malingaliro othandizira odwala matenda a shuga popanda mankhwala.

    Zisonyezero zogwiritsira ntchito Metformin

    Metformin inachita kupangidwa ndi mankhwala a mbuzi, chofala wamba chomwe chimatchedwa kuti shuga. Kuchepetsa kawopsedwe ndikupititsa patsogolo hypoglycemic mbuzi, ntchito inayambika pakugawidwa kwa zinthu zomwe zimapangidwa kuchokera pamenepo. Adadzakhala agogo. Pakadali pano, Metformin ndi mankhwala okhawo m'gululi omwe adakwanitsa kuthana ndi chitetezo, ena onsewo adadzakhala ovulaza chiwindi ndipo adawonjezera kwambiri chiopsezo cha lactic acidosis.

    Chifukwa chogwira ntchito bwino komanso ndi zovuta zochepa, ndi mankhwala a mzere woyamba wochizira matenda amtundu wa 2, ndiye kuti, adakhazikitsidwa koyamba. Metformin sikukula insulin. M'malo mwake, chifukwa cha kuchepa kwa shuga m'magazi, timadzi timatha kupangika mu kuchuluka, komwe kumachitika kawirikawiri mtundu wa 2 wodwala ukayamba.

    Kulandila kwake kumakupatsani mwayi:

    1. Limbikitsani kuyankhidwa kwa maselo ku insulin, ndiye kuti, kuchepetsa kukana kwa insulini - chomwe chimayambitsa kusokonezeka kwa chakudya chamagulu mwa anthu onenepa kwambiri. Metformin kuphatikiza zakudya komanso kupsinjika kungathe kulipiritsa matenda a shuga a 2, ndikotheka kuchiritsa matenda a prediabetes ndikuthandizira kuthetsa metabolic syndrome.
    2. Kuchepetsa mayamwidwe am'mimba m'matumbo, omwe amachepetsa shuga m'magazi.
    3. Kuchepetsa kapangidwe ka shuga m'chiwindi, chifukwa cha momwe mulingo wake m'magazi umatsikira pamimba yopanda kanthu.
    4. Tsitsani magazi lipid: onjezani zomwe zili ndi milomo yambiri ya m'mimba mwake, kuchepetsa cholesterol ndi triglycerides, zomwe zimakhala zovulaza m'mitsempha yamagazi. Izi zimachepetsa chiopsezo cha zovuta zamatenda a shuga.
    5. Sinthani njira za resorption zatsopano zamagazi m'mitsempha, kufooketsa kudziphatika kwa leukocytes, ndiko kuti, kuchepetsa chiopsezo cha atherosulinosis.
    6. Kuchepetsa thupi, makamaka chifukwa chowopsa cha kagayidwe ka mafuta a visceral. Pambuyo pakugwiritsa ntchito zaka 2, kulemera kwa odwala kumatsika ndi 5%. Ndi kuchepa kwa caloric kudya, zotsatira za kuchepa thupi zimayenda bwino.
    7. Yambitsani kuyenda kwa magazi mu zotumphukira zimakhala, ndiko kuti, kukonza zakudya zawo.
    8. Kupangitsa ovulation kukhala ndi polycystic ovary, motero, imatha kutengedwa pokonzekera kutenga pakati.
    9. Tetezani ku khansa. Izi zatsegulidwa posachedwa. Kafukufuku awonetsa kutulutsa katundu wa antitumor mu mankhwalawa; chiopsezo chokhala ndi oncology mwa odwala chatsika ndi 31%. Ntchito yowonjezereka ikuchitika kuti iphunzire ndikutsimikizira izi.
    10. Chepetsani kukalamba. Uwu ndiye mphamvu yopanda tanthauzo ya Metformin, zoyeserera zimachitika kokha pa nyama, zimawonetsa kuwonjezeka kwa nthawi yomwe moyo ungayesedwe makoswe. Palibe zotsatira za kuyesedwa kwathunthu kwachipatala ndi kutenga nawo gawo kwa anthu, kotero ndizoyambiranso kunena kuti Metformin imachulukitsa moyo. Pakadali pano, izi ndizowona kwa odwala omwe ali ndi matenda ashuga okha.

    Chifukwa cha kuchuluka kwa thupi m'thupi, zikuwonetsa kugwiritsidwa ntchito kwa Metformin sikuti kungochiritsa matenda a shuga 2. Itha kuthandizidwa bwino kupewa matenda osokoneza bongo, kuwongolera kuonda. Kafukufuku wasonyeza kuti mwa anthu omwe ali ndi prediabetes (kulolera shuga, kulephera kunenepa, matenda oopsa, insulin yowonjezera) ndi Metformin kokha, matenda a shuga anali ochepa 31%. Powonjezera zakudya ndi maphunziro akuthupi ku chiwembucho kunakwaniritsa bwino zotsatira: 58% ya odwala anatha kupewa matenda ashuga.

    Metformin imachepetsa chiwopsezo cha zovuta zonse za shuga ndi 32%. Mankhwalawa akuwonetsa zotsatira zochititsa chidwi popewa macroangiopathies: mwayi wokhala ndi vuto la mtima komanso sitiroko umachepetsedwa ndi 40%. Izi zimafananizidwa ndi zotsatira za cardiprotectors - mankhwala opsinjika ndi ma statins.

    Mtundu wa kumasulidwa kwa mankhwala ndi kumwa

    Mankhwala oyamba omwe ali ndi Metformin amatchedwa Glucofage, chizindikiro cha kampani ya ku France Merck. Chifukwa chakuti zaka zopitilira 10 zapita kuchokera pamene mankhwalawa adayamba kupanga ndikupeza patent yake, kupanga mankhwala omwe ali ndi mawonekedwe omwewo - majenito, ndizololedwa.

    Malinga ndi ndemanga za madotolo, otchuka komanso apamwamba kwambiri:

    • Germany Siofor ndi Metfogamma,
    • Israeli Metformin-Teva,
    • Russian Glyfomin, Novoformin, Formmetin, Metformin-Richter.

    Ma genetic ali ndi mwayi wotsimikizika: ndi wotsika mtengo kuposa mankhwala oyambirirawo. Sipangokhala zovutirapo: chifukwa cha mawonekedwe opangira, mphamvu zawo zitha kukhala zochepa, ndikuyeretsa. Popanga mapiritsi, opanga amatha kugwiritsa ntchito zinthu zina, zomwe zimatha kubweretsanso zina.

    Mankhwala amapangidwa mwanjira ya mapiritsi amkamwa, Mlingo wa 500, 850, 1000 mg. Kuchepetsa shuga mu zovuta zamatumbo a metabolism kumawonedwa kuyambira 500 mg. Kwa odwala matenda ashuga, mulingo woyenera kwambiri ndi 2000 mg. Ndi kuwonjezeka kwa iye mpaka 3000 mg, zotsatira za hypoglycemic zimakula pang'onopang'ono kuposa chiwopsezo cha mavuto. Kuchulukanso kwa mlingo sikuti kungokhala kopindulitsa, komanso koopsa. Ngati mapiritsi awiri a 1000 mg sanakwaniritse kuchepa kwa glycemia, wodwalayo amamulembera mankhwala ochepetsa shuga a magulu ena.

    Kuphatikiza pa Metformin yoyera, kukonzekera kophatikizidwa kwa matenda ashuga kumapangidwa, mwachitsanzo, Glibomet (yokhala ndi glibenclamide), Amaryl (yokhala ndi glimepiride), Yanumet (ndi sitagliptin). Cholinga chawo chimakhala cholondola mu shuga wa nthawi yayitali, pomwe ntchito za pancreatic zimayamba kuwonongeka.

    Palinso mankhwala ogwiritsira ntchito nthawi yayitali - Glucofage Long (mlingo 500, 750, 1000 mg), fanizo la Metformin Long, Glformin Prolong, Formin Long. Chifukwa cha kapangidwe kapadera ka piritsi, kuyamwa kwa mankhwalawa kumachepetsedwa, zomwe zimayambitsa kuchepa kwapawiri kawiri kwa zovuta zoyambira m'mimba. Mphamvu ya hypoglycemic imasungidwa bwino. Metformin ikamwezedwa, gawo lolembamo kanthulo limatulutsidwa mu ndowe. Chokhacho chingabwezeretse mawonekedwe awa ndiwowonjezeka pang'ono pamlingo wa triglycerides. Kupanda kutero, zotsatira zabwino pa lipid mbiri yamagazi zimatsalira.

    Momwe mungatenge metformin

    Yambani kutenga Metformin ndi piritsi limodzi la 500 mg. Ngati mankhwalawa amalekeredwa bwino, mlingo umawonjezereka mpaka 1000 mg. Kutsitsa kwa shuga kumayamba pang'onopang'ono, kutsika kwamphamvu kwa glycemia kumawonedwa pambuyo pa milungu iwiri yoyendetsa. Chifukwa chake, mlingo umakulitsidwa ndi 500 mg mu sabata kapena awiri, mpaka matenda a shuga amalipiridwe. Kuti muchepetse mavuto obwera chifukwa chimbudzi, mlingo wa tsiku ndi tsiku umagawidwa pawiri.

    Kutulutsa pang'onopang'ono metformin kumayamba kumwa ndi piritsi limodzi, nthawi yoyamba yomwe mankhwalawa amasinthidwa pambuyo masiku 10-15. Kuchuluka kwakuloledwa ndi mapiritsi atatu a 750 mg, mapiritsi 4 a 500 mg. Voliyumu yonse ya mankhwalawa amamwa nthawi yomweyo, nthawi yamadzulo. Mapiritsi sangathe kuphwanyidwa ndikugawika magawo, chifukwa kuphwanya kapangidwe kake kumayambitsa kutayika kwa nthawi yayitali.

    Mutha kutenga Metformin kwa nthawi yayitali, kupuma kwa chithandizo sikofunikira. Ngakhale kudya zakudya zamafuta ochepa komanso kuchita masewera olimbitsa thupi sikulephera. Pamaso pa kunenepa kwambiri, amachepetsa kudya kwa calorie.

    Kugwiritsa ntchito nthawi yayitali kumatha kubweretsa kusowa kwa vitamini B12, chifukwa chake odwala matenda ashuga omwe amatenga Metformin ayenera kudya zakudya zamtundu tsiku lililonse, makamaka chiwindi, impso ndi ng'ombe, ndikuyesedwa pachaka chifukwa cha kuchepa kwa magazi m'thupi la B12.

    Kuphatikiza kwa metformin ndi mankhwala ena:

    Kugawana zoletsaKukonzekeraZosafunika
    Zoletsedwa kotheratuKukonzekera kosiyanitsa ndi X-ray ndi ayodiniMungamupangitse lactic acidosis. Metformin imachotsedwa masiku 2 asanayambe kuphunzira kapena kugwira ntchito, ndikuyambiranso masiku awiri pambuyo pawo.
    Opaleshoni
    ZosafunikaMowa, zakudya zonse ndi mankhwala okhala nazoAmawonjezera chiopsezo cha lactic acidosis, makamaka odwala matenda ashuga pazakudya zama carb ochepa.
    Kuwongolera kowonjezera kumafunikiraGlucocorticosteroids, chlorpromazine, beta2-adrenergic agonistsKukula kwa shuga
    Mankhwala opanikiza kupatula ACE zoletsaKuopsa kwa hypoglycemia
    ZodzikongoletseraKuthekera kwa lactic acidosis

    Zotsatira zoyipa ndi contraindication

    Zotsatira zoyipa za kutenga Metformin ndi pafupipafupi zomwe zimachitika:

    Zochitika ZosiyanasiyanaZizindikiroPafupipafupi
    Mavuto a chimbudziKuchepetsa mphuno, kusowa kwa chilakiko, chimbudzi chamasamba, kusanza.≥ 10%
    KukhumudwaKulawa kwazitsulo mkamwa, nthawi zambiri pamimba yopanda kanthu.≥ 1%
    Thupi lawo siligwirizanaKutupa, redness, kuyabwa.> Phunzirani Zambiri ZOKHUDZA MALO OGULITSA

    Ma analogi a Metformin - momwe mungasinthire?

    Ngati Metformin ilibe kulekerera bwino, itha kubwezeredwa ndi mankhwala omwe atenga nthawi yayitali kapena chithunzi chonse cha wopanga wina.

    Kukonzekera kwa MetforminChizindikiroMtengo wa piritsi limodzi ndi 1000 mg, ma ruble.
    Mankhwala enieniGlucophage4,5
    Glucophage Kutalika11,6
    Analogue yathunthu yanthawi zonseSiofor5,7
    Glyformin4,8
    Metformin teva4,3
    Metfogamma4,7
    Forethine4,1
    Malizitsani kukwaniritsa kwanthawi yayitaliMtundu wautali8,1
    Kutalika kwa Glformin7,9

    Pamaso pa contraindication, mankhwala amasankhidwa ndimayendedwe ofanana ndi ntchito, koma mawonekedwe osiyana:

    Gulu la mankhwala osokoneza bongoDzinaloMtengo pa paketi iliyonse, pakani.
    DPP4 Ma InhibitorsJanuvia1400
    Galvus738
    GPP1 agonistsVictoza9500
    Baeta4950

    Kusintha kwa mankhwalawa kuyenera kuchitika pokhapokha ngati adokotala akuwunikira komanso moyang'aniridwa.

    Kutulutsa mawonekedwe ndi kapangidwe kake

    Mankhwala amapezeka mu mawonekedwe a mapiritsi okhala ndi mafilimu: ozungulira, ma convex mbali zonse, bulauni-lalanje mu utoto (mulingo wa 2,5 mg + 500 mg) kapena pafupifupi yoyera (utoto wa 5 mg + 500 mg), umatha kuwoneka pamtanda pakati ndi pafupi ndi koyera (mulingo wa 2,5 mg + 500 mg: pamakadi okhala ndi mapiritsi 3, 4, 6 kapena 9 mapiritsi 10, kapena 1 polima yokhala ndi mapiritsi 30, 40, 60 kapena 90, muyezo 5 mg + 500 mg: pamakatoni a 3, 4, 6 kapena 9 mapiritsi okhala ndi mapiritsi 10, kapena 2, 4 kapena 6 ma cell contour akovok mapiritsi 15 kapena polima Bank 1 chikukhudza 30, 40, 60 kapena 90 mapiritsi. Aliyense paketi mulinso malangizo ntchito Metgliba Force).

    Piritsi 1:

    • ntchito yogwira: glibenclamide - 2,5 kapena 5 mg, metformin hydrochloride - 500 mg,
    • othandizira: sodium stearyl fumarate, calcium hydrogen phosphate dihydrate, wowonda wa chimanga, microcrystalline cellulose, croscarmellose sodium, povidone K-30, macrogol (polyethylene glycol 6000),
    • Chovala chovomerezeka: mapiritsi a 2.5 mg + 500 mg - lalanje la Opadray, kuphatikiza hyprolose (hydroxypropyl cellulose), titanium dioksidi, talc, hypromellose (hydroxypropyl methyl cellulose), utoto wofiirira wachitsulo, utoto wachikasu wachitsulo, mapiritsi a 5 mg + 500 mg - Opadray yoyera, kuphatikiza hyprolose (hydroxypropyl cellulose), titanium dioxide, talc, hypromellose (hydroxypropyl methylcellulose).

    Zolemba zogwiritsira ntchito

    Anthu odwala matenda ashuga amafunika kulowetsedwa kwa mankhwala opatsirana odwala matenda ashuga omwe ali ndi jakisoni wa insulin motere:

    • opaleshoni yayikulu kapena kuvulala,
    • malo akulu ayaka,
    • malungo a matenda opatsirana.

    Pamafunika kuyang'anitsitsa kuchuluka kwa shuga tsiku lililonse, komanso pamimba yopanda kanthu ndikatha kudya.

    Wodwala ayenera kudziwitsidwa za chiopsezo cha hypoglycemia pakusala, kutenga ethanol.

    Poyerekeza ndi kuchuluka kwa kugwira ntchito kwakuthupi ndi kwamalingaliro, ndikusintha kwa zakudya, ndikofunikira kusintha mlingo wa mankhwalawa.

    Gwiritsani ntchito mankhwalawa mosamala ngati odwala a beta alipo?

    Hypoglycemia ikachitika, wodwalayo amapatsidwa chakudya (shuga), wozunzika kwambiri, wothandizidwa ndi njira ya dextrose yofunika.

    Maphunziro a angiographic kapena urographic a odwala omwe atenga Metlib amafunikira kuti kusiyedwe kwa mankhwalawa masiku awiri isanachitike ndondomeko ndi kuyambanso kuvomerezeka pambuyo pa maola 48.

    Zinthu zomwe zimakhala ndi ethanol, pamodzi ndi kugwiritsa ntchito mankhwalawa, zimathandizira kuwoneka ngati kupweteka pachifuwa, tachycardia, redness pakhungu, kusanza.

    Kubereka ana, kuyamwitsa kumafuna kuletsa mankhwalawo. Wodwalayo ayenera kuchenjeza adokotala za mimba yomwe yakonzekera.

    Mankhwalawa amatha kuthana ndi chidwi komanso kuthamanga kwa magwiridwe antchito, chifukwa chake muyenera kusamala poyendetsa galimoto ndi zochitika zina zowopsa.

    Chiyambireni cha mankhwala ndi mankhwalawa chimatha kutsagana ndi kusintha kwam'mimba thirakiti. Kuti muchepetse mawonetseredwe, ndikofunikira kumwa mankhwalawa mu 2 kapena 3 Mlingo, kuwonjezeka pang'onopang'ono kwa mankhwalawa kungathandize kuchepetsa tsankho.

    Musanayambe chithandizo, muyenera kuwerengera malangizo a Metglib.

    Kuchita ndi mankhwala ena

    Kukhalapo kwa miconazole mu mankhwala kungapangitse kuti shuga achepe kwambiri.

    Muyenera kusiya kumwa mankhwalawa kwa masiku awiri musanayambe kapena pambuyo pokonzekera kulowetsedwa kwa osiyanitsa ndi ayodini.

    Kugwiritsa ntchito pamodzi nthawi yomweyo ndi ethanol ndi Metglib kumawonjezera kutsitsa kwa shuga kwa mankhwalawo ndipo kungayambitse chikomokere. Chifukwa chake, pakumwa, mowa ndi mankhwala osokoneza bongo omwe ali ndi Mowa sayenera kuperekedwa. Lactic acid coma imatha kukhala chifukwa cha poyizoni wa mowa, makamaka ngati wodwala sakudya bwino kapena ngati chiwindi chikulephera.

    Kuphatikiza ndi Bozentan kumabweretsa chiwopsezo pakukula kwa zovuta za impso, komanso kumachepetsa kuchepa kwa shuga kwa Metglib.

    Contraindication

    Mankhwala osokoneza bongo saloledwa motere:

    • shuga wodalira insulin
    • matenda ashuga komanso ketoacidosis,
    • matenda a impso,
    • zinthu zomwe zimakhudza ntchito ya impso,
    • matenda omwe mpweya wofa ndi minofu umachitika.
    • chiwindi ntchito,
    • poyizoni wa mowa
    • nthawi yomwe insulin imafunikira
    • Zakudya zochepa zopatsa mphamvu
    • wazaka 18.

    Mankhwala amatchulidwa mosamala mu milandu:

    • malungo
    • matenda amisempha ya adrenal,
    • kuchuluka kwa anterior pituitary,
    • chithokomiro chosakwanira
    • mwa odwala okalamba omwe ali pachiwopsezo chodontha ndi shuga.

    Bongo

    Kugwiritsa ntchito molakwika mankhwala kumayambitsa lactic acid chikomokere kapena shuga.

    Ndi kuchepa kwa shuga, wodwalayo amalangizidwa kuti azidya zakudya zokhala ndi michere kapena shuga wambiri.

    M'mikhalidwe yovuta, wodwala akayamba kuzindikira, dextrose kapena 1-2 ml ya glucagon imathandizidwa kudzera m'mitsempha. Wodwala akayambanso kuzindikira, amapatsidwa chakudya ndi chakudya chopepuka.

    Mankhwala a antidiabetic amaimiriridwa pamsika wazaka za Russia.

    Amagwiritsidwa ntchito pochiza matenda a shuga 2, omwe ali ndi ziwonetsero zingapo komanso ma contraindication, monga malangizo a Metglib:

    • Glibomet,
    • Glucovans,
    • Gluconorm,
    • Bagomet Plus,
    • Glibenfage ndi ena.

    Mphamvu ya mankhwala othana ndi matenda a shuga zimatengera mphamvu yomwe ili mwa iwo. Ena amachulukitsa chinsinsi cha kapamba, pomwe ena amachulukitsa kumva kwa minyewa kupita ku insulin.

    Kuphatikizika kwa zinthu ziwiri zogwira ntchito ku Metglib kumabweretsa zotsatira zonse ziwiri.

    Mtengo wotsika wa mankhwalawa umapangitsa kuti apikisane pamsika wamankhwala. Mankhwalawa amayenera kumwedwa pokhapokha ngati adokotala adanenanso ndi shuga.

    Amayi ali ndi matenda ashuga a 2. Dokotala adamuuza Glibomet. Koma mtengo wake utachuluka, ndimayenera kuyang'ana m'malo. Njira ina, adotolo adalangiza Metlib Force, mtengo wake ndiwowirikiza kawiri. Shuga amachepetsa bwino, koma zakudya ndizofunikira. Zotsatira zoyipa zambiri, koma amayi alibe.

    Ndakhala ndikutenga Metglib kwa miyezi yambiri. Mkhalidwe m'masiku oyambira sanali abwino kwenikweni. Zosokoneza bongo, chizungulire, koma zonse zidapita mwachangu. Mukungofunika kuthana ndi mlingo waukulu. Ndipo kotero, mwambiri, ndakhutira ndi mankhwalawa ndi momwe amachitidwira. Shuga amachepetsa, akugwira.

    Mankhwala

    Metglib Force ndi njira yophatikiza yomwe imakhala ndi othandizira awiri amlomo a hypoglycemic ochokera kuma gulu osiyanasiyana a pharmacological:

    • glibenclamide ndichotengera mtundu wa sulfonylurea wa m'badwo wachiwiri. Limagwirira ntchito ndi chifukwa kukondoweza kwa insulin katulutsidwe ndi maselo a beta, zomwe zimapangitsa kutsika kwa shuga. Mankhwala kumawonjezera sensulin, ndipo kumawonjezera ake kumangirira maselo, kumawonjezera mphamvu ya insulin pa mayamwidwe ndi minofu ndi chiwindi, ndipo amalepheretsa lipolysis mu minofu ya adipose,
    • metformin - mankhwala ochokera ku gulu la Biguanide, omwe amachepetsa zomwe zili ndi shuga ndi postprandial glucose m'magazi am'magazi. Amadziwika ndi njira zitatu zochitira: I - kuchepa kwa kupanga shuga ndi chiwindi chifukwa cha kuletsa kwa gluconeogeneis ndi glycogenolysis, II - kuwonjezeka kwa mphamvu ya zotumphukira zolandilira ku insulin, kuwonjezeka kwa kugwiritsidwa ntchito ndi kugwiritsidwa ntchito kwa glucose ndi maselo am'matumbo, III - kutsika kwa mayamwidwe m'giriki. Simalimbikitsa kubisalira kwa insulin, chifukwa chake, siyambitsa hypoglycemia. Imakhazikika kapena kuchepetsa thupi. Imakhala ndi phindu pamapangidwe amtundu wa lipid m'magazi, kuchepetsa kuchuluka kwa cholesterol yathunthu, triglycerides ndi otsika kachulukidwe lipoproteins (LDL).

    Glibenclamide ndi metformin amagwiritsa ntchito njira zosiyanasiyana ndipo amathandizirana wina ndi mnzake.

    Chifukwa cha kuphatikiza kwa zinthu zomwe zimagwira, Metglib Force ili ndi ntchito yothandizana pochepetsa kuchuluka kwa shuga.

    Pharmacokinetics

    Glibenclamide, kulowa mgonero, amakamizidwa kuchuluka kwa kuchuluka kwa 95% ya mankhwalawa. Kuzindikira ndende (Cmax) chimafika patadutsa maola 4. Kugawira voliyumu (Vd) pafupifupi malita 10. Pafupifupi 99% imamangilira mapuloteni a plasma. Pafupifupi zimapukusidwa kwathunthu m'chiwindi, zomwe zimachitika kuti ma metabolites awiri osagwira, omwe amapangidwira matumbo (60%) ndi impso (40%). Hafu ya moyo (T½) - 4-11 maola

    Metformin, kulowa mgonero, imamweka bwino. Kudya munthawi yomweyo kumachepetsa komanso kuchedwetsa kuyamwa kwa mankhwalawo. Nthawi yoti mufikire Cmax - pafupifupi maola 2.5. Mtheradi bioavailability ndi 50-60%. Imagawidwa mwachangu mu minofu, pafupifupi sigwirizana ndi mapuloteni a plasma. Amapangidwira pamlingo wofooka kwambiri. Mwa odzipereka athanzi, chilolezo cha metformin ndi 400 ml / min, zomwe zimawonetsa kukhalapo kwa secretion ya tubular yogwira. Imapukutidwa makamaka ndi impso. Mwanjira yosasinthika, pafupifupi 20-30% ya mlingo imatuluka kudzera m'matumbo. T½ - pafupifupi maola 6.5. Ndi kuwonongeka kwa impso, kutsekeka kwa impso kumachepa motsatira kuchuluka kwa chilolezo cha creatinine (CC), pomwe T ikuwonjezeka½ Zotsatira zake, kuchuluka kwa plasma ya metformin.

    The bioavailability ya chilichonse mwa zinthu zomwe zimaphatikizidwa piritsi limodzi ndizofanana ndi zomwe mumagwiritsa ntchito mankhwala okhala ndi metformin kapena glibenclamide padera. Mukamadya, bioavailability wa Metglib Force sasintha, koma kuchuluka kwa mayeso a glibenclamide kumawonjezeka.

    Mphamvu ya Metglib, malangizo ogwiritsira ntchito: njira ndi mlingo

    Mapiritsi a Metglib Force amatengedwa pakamwa. Mulingo woyenera kwambiri umadziwika ndi dokotala kutengera mlingo wa glycemia.

    Mlingo woyambirira ndi 1 nthawi patsiku, piritsi limodzi mu 2,5 mg + 500 mg kapena muyezo wa 5 mg + 500 mg. Ngati wodwala amatenga mankhwala a sulfonylurea kapena a metformin ngati mankhwala a mzere woyamba, pofotokoza za Metglib Force, mlingo woyambirira wa mankhwala omwe ali mgulu lomweli sayenera kupitirira muyeso wa tsiku ndi tsiku wa mankhwala omwe adalandilidwa kale (kupewa kupewa hypoglycemia).

    Ngati ndi kotheka, onjezani mlingo wa Metglib Force, koma osapitirira 5 mg glibenclamide + 500 mg metformin, pakadutsa milungu iwiri. Izi zimathandiza kuti magazi azikhala ndi shuga wokwanira.

    Zikachitika kuti chithandizo cham'mbuyomu chimasinthidwa ndi othandizira awiri, mankhwalawa sayenera kupitirira mlingo wa metformin ndi glibenclamide (kapena mankhwala ena a sulfonylurea) omwe adatengedwa kale.

    Ngati ndi kotheka, pakadutsa pafupifupi milungu iwiri, mlingo wa Metglib Force umasinthidwa kutengera mtundu wa glycemia.

    Mulingo wovomerezeka tsiku lililonse ndi mapiritsi 4 pa mlingo wa 5 mg + 500 mg kapena mapiritsi 6 pa mlingo wa 2,5 mg + 500 mg.

    Nthawi zoyendetsera makonzedwe, kutengera cholinga cha aliyense:

    • Mlingo wa 2,5 mg + 500 mg ndi 5 mg + 500 mg: pofotokoza piritsi limodzi patsiku - nthawi 1 patsiku (m'mawa nthawi ya chakudya cham'mawa), mukamapereka mapiritsi 2 kapena 4 patsiku - 2 kawiri pa tsiku (m'mawa ndi madzulo ),
    • Mlingo wa 2,5 mg + 500 mg: ndi mapiritsi 3, 5 kapena 6 patsiku - katatu pa tsiku (m'mawa, masana ndi madzulo).
    • Mlingo wa 5 mg + 500 mg: ndi mapiritsi atatu patsiku - katatu pa tsiku (m'mawa, masana ndi madzulo).

    Poletsa kukula kwa hypoglycemia, Metglib Force iyenera kumwedwa ndi zakudya zomwe zimakhala ndi chakudya chamagulu ambiri.

    Kwa odwala okalamba, mlingo wa Metglib Force umatsimikiziridwa poganizira momwe ntchito yaimpso imachitikira. Mlingo woyambitsidwa woyamba ndi piritsi limodzi pa mlingo wa 2,5 mg + 500 mg. Ntchito yeniyeni iyenera kuyesedwa pafupipafupi pakumwa mankhwala.

    Kusiya Ndemanga Yanu

    https://pobedidijabetes.org

    Kusankha Mkonzi

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