Glucophage® (Glucophage®)

Mankhwalawa amapezeka pamapiritsi okhala ndi mafilimu a 500, 850 ndi 1000 mg. Mapiritsi a Glucophage pamiyeso ya 500 ndi 850 mg ali ndi kuzungulira, mawonekedwe a biconvex ndi mtundu woyera, mawonekedwe oyera a homogenible amawoneka pamtanda, ndipo mawonekedwe ozungulira, mawonekedwe a biconvex ndi chiwopsezo kumbali zonse pamtanda wa 1000 mg, oyera oyera homogenible pamtanda.

Yogwira ntchito ya mankhwalawa ndi metformin hydrochloride, othandizira pazinthu - povidone ndi magnesium stearate. Utoto wamafilimu a mapiritsi a Glucofage a 500 ndi 850 mg umaphatikizapo hypromellose, 1000 mg ya opadry koyera (macrogol 400 + hypromellose).

Kuchuluka kwa mapiritsi a chithuza ndi matuza mu bokosi la katoni kumadalira kuchuluka kwa mankhwalawa:

• Mapiritsi a Glucofage 500 mg - m'matumba a aluminium zojambulazo kapena PVC, zidutswa 10 kapena 20, pamatumba atatu a matuza atatu kapena 5 ndi zidutswa 15 mu chithuza, pamatayala okhala ndi matuza awiri amtundu wa 2 kapena 4,
• Mapiritsi a Glucofage 850 mg - m'matumba a aluminium zojambulazo kapena PVC, 15 zidutswa zilizonse, pakatoni ka matuza 2 kapena 4 ndi zidutswa 20 zonyamula paketi, pakatoni ka matuza atatu kapena 5,
• Mapiritsi a Glucophage 1000 mg - matuza a aluminium zojambulazo kapena PVC, zidutswa 10 chilichonse, pamatumba okhala ndi matuza 3, 5, 6 kapena 12 ndi zidutswa 15 mu chithuza, m'matumba okhala ndi matuza a 2, 3 kapena 4.

Zizindikiro zogwiritsidwa ntchito

Malinga ndi malangizo, Glucophage imagwiritsidwa ntchito ngati mtundu wachiwiri wa shuga, makamaka kwa anthu onenepa kwambiri, osakwanira kapena osakwanira kuchita masewera olimbitsa thupi komanso kudya.

Mwa odwala achikulire, mankhwalawa amagwiritsidwa ntchito onse limodzi ndi insulin kapena mankhwala ena amkamwa a hypoglycemic, komanso monga monotherapy.

Mwa ana a zaka zosaposa 10, Glucofage amagwiritsidwa ntchito molumikizana ndi insulin kapena ngati yekhayo wothandizira.

Contraindication

Mankhwala sinafotokozeredwe matenda ndi zinthu zotsatirazi:

• Kulephera kwamkati ndi / kapena kuwonongeka kwa impso,
• Kulephera kwa chiwindi ndi / kapena kuwonongeka kwa chiwindi,
• Matenda a shuga ndi precomatosis
• Ketoacidosis
• Matenda akufotokozera za matenda owopsa komanso osachiritsika omwe amathandizira kuti minyewa ikuluzikulu (kufooka kwa myocardial infarction, mtima ndi kupuma, etc.),
• Kuvulala kowonjezereka ndi maopaleshoni momwe chithandizo cha insulin chimasonyezedwera,
• Matenda opatsirana ambiri, kuchepa magazi, mantha,
• Lactic acidosis
• Uchidakwa wambiri ndi poyizoni wa ethanol,
• Hypersensitivity pamagawo a mankhwala,
• Mimba
• Kutsatira ndi zakudya zochepa zopatsa mphamvu.

Kugwiritsa ntchito Glucophage mwa amayi panthawi yoyamwitsa, odwala opitilira zaka 60 ndi anthu omwe akuchita ntchito yayikulu (izi zimagwirizanitsidwa ndi mwayi wokhala ndi lactic acidosis) amafunika kusamala.

Mlingo ndi makonzedwe

Mankhwalawa amapangidwira pakamwa.

Ngati mankhwala kwa akulu ngati monotherapeutic wothandizila komanso kuphatikiza mankhwala ena a hypoglycemic, mlingo wa Glucofage, malinga ndi malangizo, ndi 500 kapena 850 mg kuchokera kawiri mpaka katatu pakudya kapena mutatha kudya. Kutengera ndi kuchuluka kwa shuga m'magazi, kuwonjezeka kwapang'onopang'ono kwa mlingo kumatha mtsogolo.

Mlingo wokonza, monga lamulo, kuchokera pa 1500 mpaka 2000 mg patsiku. Kuchepetsa chiwopsezo cha mavuto kuchokera m'matumbo am'mimba ndikotheka ndikugawa mlingo wa tsiku lililonse ndi 2-3 Mlingo. Mulingo wovomerezeka wa Glucofage patsiku ndi 3000 mg.

Kuwonjezeka pang'onopang'ono kwa mlingo kumathandizira kulolerana kwa mankhwalawa ndi m'mimba thirakiti.

Mukamagwiritsa ntchito Glucofage osakanikirana ndi insulin, mlingo woyambirira wa mankhwalawa ndi 500 kapena 850 mg katatu patsiku, ndipo mlingo wa insulin umasankhidwa payekha, potengera kuchuluka kwa shuga m'magazi.

Achinyamata ndi ana opitirira zaka 10 amapatsidwa mankhwalawa 500 kapena 850 mg kamodzi patsiku akudya kapena atatha kudya. Kusintha kwa Mlingo kumachitika palibe kale kuposa masiku 10-15 chithandizo ndipo zimatengera kuchuluka kwa shuga m'magazi. Mlingo wovomerezeka wa ana tsiku lililonse ndi 2000 mg, umagawidwa pawiri.

Kwa odwala okalamba, mlingo wa metformin umasankhidwa payekhapayekha, kuwunika ntchito yaimpso.

Ndimamwa glucophage tsiku lililonse, popanda zosokoneza. Kutha kwa chithandizo kuyenera kudziwitsidwa kwa dokotala.

Zotsatira zoyipa

Mukamagwiritsa ntchito Glucofage, mavuto monga:

• Kuperewera kwa chakudya, mseru ndi kusanza, kutsekemera kwazitsulo mkamwa, kutsekemera, kutsekula m'mimba, kupweteka kwam'mimba (nthawi zambiri kumachitika poyambira chithandizo ndikudziwonjezera),
• Lactic adidosis (kusiya mankhwala pamafunika), kuchepa kwa vitamini B12 chifukwa cha kupweteka kwa malabsorption (ndimankhwala osakhalitsa),
• Megaloblastic anemia,
• Zotupa pakhungu.

Malangizo apadera

Ndikotheka kuchepetsa kuwonetsa kwa mavuto kuchokera m'mimba thirakiti ndi munthawi yomweyo yoyendetsera ma antacid, antispasmodics, kapena atropine. Ngati zizindikiro za dyspeptic panthawi yogwiritsa ntchito glucophage zimachitika pafupipafupi, mankhwalawo ayenera kusiyidwa.

Panthawi ya chithandizo, muyenera kusiya mowa osamwa mankhwala okhala ndi Mowa.

Zofanana ndi mapangidwe ake a mankhwala ndi Siofor 500, Siofor 850, Metfogamma 850, Metfogamma 500, Gliminfor, Bagomet, Glformin, Metformin Richter, Vero-Metformin, Siofor 1000, Dianormet, Metospanin, Formmetin, Metformin, Glucofage Long, Metfogin 1000, Novoformin Pliva, Metadiene, Diaformin OD, Nova Met, Langerin, Metformin-Teva ndi Sofamet.

Migwirizano ndi magwiritsidwe akusungidwa

Malinga ndi malangizowo, Glucofage ikulimbikitsidwa kuti isungidwe m'malo ozizira, otetezeka ku chinyezi ndi dzuwa lowala.

Alumali moyo wa Glucofage 500 ndi 850 mg ndi zaka 5 kuyambira tsiku lopanga, Glucofage 1000 ndi XR - zaka 3.

Kodi mwapeza cholakwika m'mawuwo? Sankhani ndikusindikiza Ctrl + Lowani.

Zithunzi za 3D

Kufotokozera za mtundu wa kipimo

500 ndi 850 mg mapiritsi: yoyera, yozungulira, ya biconvex, yokhala ndi mafilimu, pamtanda - yopanda choyera.

Mapiritsi a 1000 mg: yoyera, chowulungika, biconvex, yokutidwa ndi chithunzi cha filimu, yopanga notch mbali zonse ziwiri ndikujambula "1000" mbali imodzi, pamtanda wamtanda - misa yoyera yayikulu.

Mankhwala

Metformin imachepetsa hyperglycemia popanda kutsogola kukula kwa hypoglycemia. Mosiyana ndi zotumphukira za sulfonylurea, sizimalimbikitsa kutulutsa insulin ndipo sizikhala ndi vuto loti munthu azikhala wathanzi. Zimawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikugwiritsa ntchito shuga ndi maselo. Imachepetsa kupanga shuga kwa chiwindi poletsa gluconeogeneis ndi glycogenolysis. Kuchepetsa mayamwidwe m'matumbo. Metformin imalimbikitsa kapangidwe ka glycogen pochita glycogen synthetase.

Kuchulukitsa kuchuluka kwa mayendedwe amtundu uliwonse wa ma membrane glucose. Kuphatikiza apo, imakhala ndi phindu pa metabolidi ya lipid: imachepetsa zomwe zimakhala ndi cholesterol yonse, LDL ndi triglycerides. Ngakhale mutamwa metformin, thupi la wodwalayo limakhalabe lolimba kapena limatsika pang'ono. Kafukufuku wachipatala awonetsanso kugwira bwino ntchito kwa mankhwalawa Glucofage ® popewa matenda ashuga odwala omwe ali ndi prediabetes omwe ali ndi chiopsezo chowonjezereka pakukula kwa mtundu wachiwiri wa matenda ashuga, momwe kusintha kwasinthidwe sikunalole kuti chiwonetsero chokwanira cha glycemic chikwaniritsidwe.

Pharmacokinetics

Madzi ndi kugawa. Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera m'mimba. Mtheradi bioavailability ndi 50-60%. C_max (pafupifupi 2 μg / L kapena 15 μmol) mu plasma imatheka pambuyo maola 2,5.Ndibwino kuti muziyamwa chakudya nthawi yomweyo, kuyamwa kwa metformin kumachepetsedwa ndikuchedwa.

Metformin imagawidwa mwachangu mu minofu, sikuti imagwira mapuloteni a plasma.

Kutetemera ndi chimbudzi. Amapangidwira pamlingo wofooka kwambiri ndikuwonetsa impso. Kuwonekera kwa metformin m'maphunziro abwino ndi 400 ml / mphindi (kuchulukitsa kanayi kuposa Cl creatinine), zomwe zikuwonetsa kukhalapo kwa katulutsidwe ka tubular. T_1/2 pafupifupi maola 6.5. Kulephera kwa aimpso, T_1/2 ukuwonjezeka, pamakhala chiwopsezo cha kukopeka kwa mankhwalawa.

Zisonyezero za mankhwala Glucofage ®

lembani matenda a shuga 2, makamaka odwala kunenepa kwambiri, komanso kulephera kwamankhwala olimbitsa thupi komanso kuchita masewera olimbitsa thupi:

- akuluakulu, monga monotherapy kapena kuphatikiza ena othandizira pakamwa kapena ma insulin,

- mwa ana kuyambira zaka 10 monga monotherapy kapena kuphatikiza insulin,

kupewa matenda a shuga a mtundu wachiwiri kwa odwala omwe ali ndi prediabetes omwe ali ndi chiopsezo chowonjezereka cha mtundu 2 wa shuga, momwe kusintha kwasinthidwe sikunalole kuti chiwopsezo cha glycemic chikwaniritsidwe.

Mimba komanso kuyamwa

Matenda a shuga omwe sanakulipiridwe panthawi ya kubereka amalumikizidwa ndi chiwopsezo chowonjezeka cha zilema zakubadwa ndi kufa kwa perinatal. Zambiri zomwe zikusonyeza kuti kutenga metformin mwa amayi apakati sikuti kumawonjezera mwayi wokhala ndi vuto la kubala mwa ana.

Pokonzekera kutenga pakati, komanso ngati mayi ali ndi pakati pam'mbuyo pa kutenga matenda a metformin omwe ali ndi prediabetes ndi mtundu wachiwiri wa shuga, mankhwalawo ayenera kusiyidwa, ngati vuto la matenda ashuga a mtundu wa 2, limaperekedwa. Ndikofunikira kusungitsa glucose omwe ali m'madzi am'magazi pamlingo woyandikira kwambiri kuti achepetse vuto la fetus.

Metformin imadutsa mkaka wa m'mawere. Zotsatira zoyipa za akhanda pa nthawi yoyamwitsa pamene mukumwa metformin sizinawoneke. Komabe, chifukwa cha kuchuluka kwa deta, kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa sikulimbikitsidwa. Lingaliro loletsa kuyamwitsa liyenera kuganiziridwanso zabwino za kuyamwitsa ndi chiopsezo cha zotsatira zoyipa mwa khanda.

Kuchita

Iodini wokhala ndi radiopaque wothandizira: motsutsana ndi kaimidwe ka ntchito yaimpso kwa odwala omwe ali ndi matenda ashuga, kuwunika kwa X-ray pogwiritsa ntchito ma ayodini okhala ndi ayodini kungayambitse kukula kwa lactic acidosis. Kuchiza ndi Glucofage ® kuyenera kuyimitsidwa maola 48 isanachitike kapena pakuwunika kwa X-ray pogwiritsa ntchito ma iodine okhala ndi ma radiopaque othandizira ndipo sayenera kuyambiranso patadutsa maola 48 atatha, ngati ntchito ya impso idadziwika ngati yovomerezeka pakubwereza.

Mowa: ndi kuledzera kwa pachimake, chiopsezo chokhala ndi lactic acidosis imachulukirachulukira, makamaka vuto la kuperewera kwa zakudya m'thupi, kutsatira zakudya zochepa za calorie, komanso kulephera kwa chiwindi. Mukamwa mankhwalawa, mowa ndi mankhwala okhala ndi Mowa zimayenera kupewedwa.

Kuphatikiza komwe kumafunikira kusamala

Danazole: munthawi yomweyo makonzedwe a danazol ali osavomerezeka kuti apewe hyperglycemic zotsatira zomaliza. Ngati mankhwala a danazol akufunika ndipo atayimitsa koyamba, kusintha kwa mankhwala Glucofage ® kumafunika motsogozedwa ndi kuchuluka kwa shuga m'magazi.

Chlorpromazine: Pamene kumwedwa mu waukulu Mlingo (100 mg / tsiku) kumawonjezera kuchuluka kwa shuga m'magazi, kuchepetsa kutulutsidwa kwa insulin. Mankhwalawa antipsychotic ndipo atayimitsa chomaliza, kusintha kwa mankhwalawa kumafunikira motsogozedwa ndimagazi a shuga.

GKS mwatsatanetsatane komanso kwawoko kuchepetsa kulolera kwa shuga, kuwonjezera kuchuluka kwa shuga m'magazi, nthawi zina kumapangitsa ketosis. Mankhwalawa corticosteroids ndipo atayimitsa kudya kwa chakumapeto, kusintha kwa mankhwala Glucofage ® kumafunika motsogozedwa ndi kuchuluka kwa shuga m'magazi.

Zotsatira: munthawi yomweyo kugwiritsa ntchito malupu okodzetsa kungayambitse kukulitsa kwa lactic acidosis chifukwa chotheka kugwira ntchito kwaimpso. Glucofage ® sayenera kulembedwa ngati Cl creatinine ali pansi pa 60 ml / min.

Yovuta β₂-adrenomimetics: kuonjezera kuchuluka kwa shuga m'magazi chifukwa cha kukondoweza kwa β₂-makampani. Poterepa, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi. Ngati ndi kotheka, insulin ikulimbikitsidwa.

Ndi kugwiritsa ntchito mankhwala omwe ali pamwambawa, kuwunika pafupipafupi magazi a shuga kungafunike, makamaka kumayambiriro kwa chithandizo. Ngati ndi kotheka, mlingo wa metformin ungasinthidwe munthawi yamankhwala ndikatha.

Mankhwala a antihypertensive, kupatula AID zoletsa, kumachepetsa shuga. Ngati ndi kotheka, mlingo wa metformin uyenera kusinthidwa.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala Glucofage ® ndi sulfonylurea zotumphukira, insulin, acarbose, salicylates, kukula kwa hypoglycemia ndikotheka.

Nifedipine kumawonjezera mayamwidwe ndi C_max metformin.

Mankhwala a Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim ndi vancomycin) omwe amatulutsidwa mu renal tubules kupikisana ndi metformin kwa machitidwe oyendetsa ma tubular ndipo angayambitse kuchuluka kwa C_max .

Mlingo ndi makonzedwe

Monotherapy ndi kuphatikiza mankhwalawa kuphatikiza othandizira ena am'mlomo a hypoglycemic othandizira a 2 matenda a shuga. Mulingo woyambira woyamba ndi 500 kapena 850 mg katatu patsiku mukatha kudya.

Pakadutsa masiku 10 mpaka 10, tikulimbikitsidwa kusintha mlingo woyambira pazotsatira za kuyeza kuchuluka kwa shuga m'magazi am'magazi. Kukula pang'onopang'ono kwa mankhwalawa kumathandizira kuchepetsa zoyipa kuchokera m'mimba.

Mankhwala okonza mankhwalawa nthawi zambiri amakhala 1500-2000 mg / tsiku. Kuti muchepetse mavuto kuchokera m'matumbo am'mimba, mlingo wa tsiku ndi tsiku uyenera kugawidwa mu Mlingo wa 2-3. Mlingo wapamwamba kwambiri ndi 3000 mg / tsiku, wogawidwa mu 3 waukulu.

Odwala omwe atenga metformin mu Mlingo wa 2000-3000 mg / tsiku amatha kusamutsidwa ku mankhwala Glucofage ® 1000 mg. Mlingo woyenera kwambiri ndi 3000 mg / tsiku, womwe umagawidwa pazigawo zitatu.

Pofuna kukonza kusinthaku kuti mugwire wothandizila wina wa hypoglycemic: muyenera kusiya kumwa mankhwalawa ndikuyamba kumwa Glucofage ® mu mlingo womwe ukunenedwa pamwambapa.

Kuphatikiza ndi insulin. Kukwaniritsa bwino shuga wamagazi, metformin ndi insulin mwa odwala omwe ali ndi matenda a shuga a 2 angagwiritsidwe ntchito ngati mankhwala osakanikirana. Mlingo woyamba wa Glucofage ® ndi 500 kapena 850 mg kawiri pa tsiku, pomwe mlingo wa insulin umasankhidwa potengera kuchuluka kwa shuga m'magazi.

Monotherapy ya prediabetes. Mlingo wamba ndi 1000-1700 mg / patatha masiku kapena nthawi ya chakudya, yogawika awiri.

Ndikulimbikitsidwa kumayendetsa glycemic pafupipafupi kuti muwone kufunika kogwiritsira ntchito mankhwalawa.

Kulephera kwina. Metformin itha kugwiritsidwa ntchito kwa odwala omwe amalephera kupweteka aimpso (Cl creatinine 45-59 ml / min) pokhapokha ngati pali zinthu zomwe zingakulitse chiopsezo cha lactic acidosis.

Odwala a Cl creatinine 45-55 ml / mphindi. Mlingo woyambirira ndi 500 kapena 850 mg kamodzi patsiku.Mlingo wapamwamba ndi 1000 mg / tsiku, logawidwa mu 2 waukulu.

Ntchito yeniyeni iyenera kuyang'aniridwa mosamala (miyezi itatu iliyonse).

Ngati Cl creatinine ali pansi pa 45 ml / min, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo.

Ukalamba. Chifukwa cha kuchepa kwa ntchito yaimpso, mlingo wa metformin uyenera kusankhidwa poyang'anitsitsa mawonetseredwe aimpso (kudziwa kuchuluka kwa creatinine mu seramu osachepera 2-5 pachaka).

Ana ndi achinyamata

Mwa ana kuyambira zaka 10, Glucofage ® ikhoza kugwiritsidwa ntchito limodzi mu monotherapy komanso kuphatikizidwa ndi insulin. Mulingo woyambira woyamba ndi 500 kapena 850 mg 1 nthawi patsiku mutatha kudya kapena. Pambuyo masiku 10-15, mlingo uyenera kusinthidwa potengera kuchuluka kwa magazi. Mulingo wambiri watsiku ndi tsiku ndi 2000 mg, wogawidwa pamitundu iwiri.

Glucofage ® iyenera kumwedwa tsiku lililonse, osasokoneza. Ngati chithandizo chalekeka, wodwalayo ayenera kudziwitsa dokotala.

Bongo

Metformin itagwiritsidwa ntchito muyezo wa 85 g (nthawi zochulukirapo 42,5), kukula kwa hypoglycemia sikunachitike. Komabe, pankhaniyi, kukula kwa lactic acidosis kunawonedwa. Zambiri zokhudzana ndi bongo kapena zovuta zomwe zingagwirizane nazo zimatha kubweretsa kukula kwa lactic acidosis (onani "Malangizo apadera").

Chithandizo: ngati zizindikiro za lactic acidosis, chithandizo ndi mankhwala ziyenera kuyimitsidwa nthawi yomweyo, wodwalayo amayenera kugonekedwa kuchipatala mwachangu ndipo atatsimikiza kuchuluka kwa lactate, kufotokozera kuyenera kumveka bwino. Njira yothandiza kwambiri yochotsa lactate ndi metformin kuchokera mthupi ndi hemodialysis. Chithandizo cha Zizindikiro zimachitidwanso.

Wopanga

Magawo onse opanga, kuphatikiza kuwongolera bwino. Merck Sante SAAS, France.

Production siteji ya Production: Center de Prodion Semois, 2, rue du Pressoir Ver, 45400, Semois, France.

Kapena ngati mutayika mankhwala a LLC Nanolek:

Kupanga kwa fomu yomalizira ya Mlingo ndi ma CD (ma CD oyambira) Merck Santé SAAS, France. Center de Production Semois, 2 rue du Pressoire Ver, 45400 Semois, France.

Sekondale (ma CD a ogula) ndikupereka kuwongolera kwapamwamba: Nanolek LLC, Russia.

612079, dera la Kirov, chigawo cha Orichevsky, Levintsy tawuni, Biomedical zovuta "NANOLEK"

Magawo onse opanga, kuphatikiza kuwongolera bwino. Merck S.L., Spain.

Adilesi ya malo opanga: Polygon Merck, 08100 Mollet Del Valles, Barcelona, ​​Spain.

Wogwirizira satifiketi yakulembetsa: Merck Santé SAAS, France.

Zogwirizana ndi makasitomala ndi zidziwitso pazinthu zovuta ziyenera kutumizidwa ku adilesi ya LLC Merk: 115054, Moscow, ul. Zokwanira, 35.

Tele: (495) 937-33-04, (495) 937-33-05.

Alumali moyo wa mankhwala Glucofage ®

500 mg mapiritsi okhala ndi mafilimu - zaka 5.

500 mg mapiritsi okhala ndi mafilimu - zaka 5.

mapiritsi wokutidwa ndi filimu wokutira wa 850 mg - zaka 5.

mapiritsi wokutidwa ndi filimu wokutira wa 850 mg - zaka 5.

filimu TACHIMATA mapiritsi 1000 mg - zaka 3.

filimu TACHIMATA mapiritsi 1000 mg - zaka 3.

Osagwiritsa ntchito tsiku lotha ntchito likusonyezedwa pa phukusi.

Glucophage. Mlingo

Mapiritsi oyendetsera pakamwa (pakamwa).

Amagwiritsidwa ntchito ngati monotherapy kapena mankhwala ophatikiza (poika ena othandizira a hypoglycemic).

Gawo loyamba ndi 500 mg ya mankhwalawa, nthawi zina - 850 mg (m'mawa, masana, ndi madzulo pamimba yonse.

M'tsogolomu, mlingo umakulitsidwa (monga momwe amafunikira komanso pokhapokha mukaonana ndi dokotala).

Kuti mukhalebe achire mothandizidwa ndi mankhwalawa, tsiku lililonse mlingo umafunikira - kuyambira 1500 mpaka 2000 mg. Mlingo woletsedwa kupitirira 3000 mg ndi pamwamba!

Kuchuluka kwa tsiku ndi tsiku kumagawika katatu kapena kanayi, komwe ndikofunikira kuti muchepetse zovuta.

Zindikirani Ndikofunikira kuwonjezera kuchuluka kwa tsiku lililonse kwa sabata, pang'onopang'ono, kuti mupewe zoipa. Kwa odwala omwe adamwa kale mankhwala ophatikizika ndi Metformin ochulukirapo kuyambira 2000 mpaka 3000 mg, mapiritsi a Glucofage ayenera kumwedwa pa mlingo wa 1000 mg patsiku.

Ngati mukufuna kukana kumwa mankhwalawa omwe amakhudza mafupa a hypoglycemic, muyenera kuyamba kumwa mapiritsi a Glucofage muyezo wochepetsedwa, mwa mtundu wa monotherapy.

Glucophage ndi insulin

Ngati mukufunikira insulin yowonjezera, yotsirizayo imagwiritsidwa ntchito kokha pa mlingo womwe adotolo adatenga.

Mankhwala othandizira omwe ali ndi metamorphine ndi insulin amafunika kuti akwaniritse kuchuluka kwa shuga m'magazi. Algorithm yokhazikika ndi piritsi ya 500 mg (nthawi zambiri imakhala 850 mg) kawiri kapena katatu patsiku.

Mlingo wa ana ndi achinyamata

Kuyambira azaka khumi ndi akulu - ngati mankhwala odziyimira pawokha, kapena ngati gawo limodzi la mankhwala (pamodzi ndi insulin).

Mlingo woyenera (woyamba) wosakwatiwa tsiku lililonse ndi piritsi limodzi (500 kapena 850 mg.), Lomwe limatengedwa ndi zakudya. Amaloledwa kumwa mankhwalawa kwa theka la ola mutatha kudya.

Kutengera kuchuluka kwa shuga m'magazi, mlingo wa mankhwalawo umasinthidwa pang'onopang'ono (mizere - osachepera sabata imodzi kapena ziwiri). Mlingo wa ana waletsedwa kuchuluka (kupitirira 2000 mg). Mankhwalawa agawidwe m'magawo atatu, osachepera awiri.

Kuphatikiza komwe sikuloledwa mwanjira iliyonse

Othandizira kusiyanitsa ndi X-ray (yokhala ndi ayodini). Kuunika kwa radiology kumatha kukhala chothandizira pakukula kwa lactic acidosis kwa wodwala yemwe ali ndi matenda a shuga.

Glucophage amasiya kutengedwa masiku atatu maphunziro asanatenge ndipo sanatenge masiku ena atatu atatha (kwathunthu, limodzi ndi tsiku la kafukufuku - sabata). Ngati ntchito yaimpso molingana ndi zotsatira zake sizinakhutire, nthawi imeneyi imawonjezeka - mpaka thupi litabwezeretseka kwathunthu.

Chingakhale chanzeru kukana kugwiritsa ntchito mankhwalawa ngati pali kuchuluka kwa ethanol mthupi (kuledzera kwakumwa). Kuphatikiza uku kumayambitsa mapangidwe a machitidwe kuti awonetsere zizindikiro za lactic acidosis. Zakudya zama calorie otsika kapena vuto la kuperewera kwa zakudya m'thupi, makamaka motsutsana ndi maziko a kulephera kwa chiwindi, zimakulitsa chiwopsezo ichi.

Pomaliza Ngati wodwala amwa mankhwalawa, ayenera kusiyiratu kumwa mowa uliwonse, kuphatikizapo mankhwala omwe amaphatikizapo ethanol.

Kuphatikiza komwe kumafuna kusamala

Danazole Kugwiritsa ntchito nthawi yomweyo kwa Glucofage ndi Danazole sikofunikira. Danazole ndi wowopsa ndi hyperglycemic effect. Ngati ndizosatheka kukana pazifukwa zosiyanasiyana, kusintha kwapadera kwa glucofage ndikuwunika pafupipafupi kuchuluka kwa shuga pamafunika.

Chlorpromazine mu mlingo waukulu wa tsiku ndi tsiku (woposa 100 mg), womwe umathandiza kuwonjezera kuchuluka kwa shuga m'magazi ndipo umachepetsa mwayi wokhala ndi insulini. Kusintha kwa mlingo kuyenera.

Ma antipsychotic. Chithandizo cha odwala omwe ali ndi antipsychotic chiyenera kuvomerezedwa ndi dokotala. Kusintha kwa mlingo wa Glucofage ndikofunikira malinga ndi kuchuluka kwa shuga m'magazi.

GCS (glucocorticosteroids) imasokoneza kulekerera kwa glucose - kuchuluka kwa glucose m'magazi kumakwera, komwe kungayambitse ketosis. Zikatero, Glucophage imayenera kutengedwa kutengera kuchuluka kwa shuga m'magazi.

Zopitsa za m'mimba mwa loopt zimatengera nthawi yomweyo ndi glucophage zimabweretsa chiopsezo cha lactic acidosis. Ndi CC kuchokera pa 60 ml / mphindi ndi pansi, glucophage sinafotokozedwe.

Adrenomimetics. Mukamamwa ma Beta 2-adrenergic agonists, kuchuluka kwa shuga m'thupi kumawukanso, komwe nthawi zina kumafunanso Mlingo wa insulin wina wodwala.

Ma inhibitors a ACE ndi mankhwala onse a antihypertensive amafuna kusintha kwa mlingo wa metformin.

Sulfonylurea, insulin, acarbose ndi salicylates akaphatikizidwa pamodzi ndi glucophage angayambitse hypoglycemia.

Mimba komanso kuyamwa. Zinthu Zakutha

Glucophage sayenera kumwedwa panthawi yomwe ali ndi pakati.

Matenda akulu a shuga amatha kubadwa kwatsopano kwa mwana wosabadwayo. Pakapita nthawi - umunthu wangozi. Ngati mayi akufuna kubereka kapena ali m'magawo oyamba a kubereka, ndikofunikira kukana kumwa mankhwala Glucofage. M'malo mwake, chithandizo cha insulin chimayikidwa kuti chikhale ndi kuchuluka kwa shuga.

Zotsatira zoyipa

Peresenti yaying'ono ya lactic acidosis. Kugwiritsa ntchito shuga kwa nthawi yayitali kungayambitse kuchepa kwa mayamwidwe a vitamini B12. Vutoli liyenera kuganiziridwa mwa odwala omwe ali ndi vuto la kuchepa kwa magazi m'thupi.

Kuphwanya kukoma.

• Kuukira mseru ndi kusanza.
• Kutsegula m'mimba
• Kupweteka kwam'mimba.
• Chilala.

Yang'anani! Zizindikiro zoterezi zimadziwika m'masiku ochepa ndi milungu yoyamba kumwa mankhwalawa. Pambuyo pake, mavuto amabwera pazokha.

Zizindikiro za erythema, kuyabwa pang'ono, nthawi zina zotupa za pakhungu.

Chiwindi ndi matenda a biliary

Pafupipapo pomwe pali vuto la chiwindi ntchito, ngakhale kawirikawiri - mawonetseredwe a chiwindi. M'pofunika kuthetseratu metformin, yomwe imatha kutengera zotsatira zoyipa.

Kwa odwala. Chidziwitso Chofunikira cha Lacticosis

Lactic acidosis si matenda wamba. Komabe, njira zonse zofunikira ziyenera kuchitidwa kuti athetse chiwonetsero chake, popeza matenda amtunduwu amadziwika ndi zovuta zambiri komanso kufa kwakukulu.

Lactic acidosis nthawi zambiri imawonekera mu odwala omwe amatenga metamorphine omwe anali ndi vuto lalikulu laimpso chifukwa cha matenda a shuga.

Zina zomwe zimayambitsa ngozi ndi izi:

• Zizindikiro za matenda ashuga.
• Mawonekedwe a ketosis.
• Kutalika kwa vuto la kuperewera kwa thupi.
• Magawo owopsa a chidakwa.
• Zizindikiro za hypoxia.

Ndikofunikira. Ndikofunika kulabadira zizindikiro za gawo loyambirira la lactic acidosis. Ichi ndi chizindikiro cha kuwonekera, kuwonekera minofu kukokana, kukomoka, kupweteka kwam'mimba komanso asthenia yayikulu. Acidotic dyspnea ndi hypothermia, ngati zizindikiro isanachitike chikomokere, amasonyezanso matendawa. Zizindikiro zilizonse za metabolic acidosis ndizomwe zimapangitsa kuti mankhwalawo athe kaye komanso kufunafuna chithandizo chamankhwala mwachangu.

Glucophage pa opareshoni

Ngati wodwala wakonzekera kuchitidwa opaleshoni, metformin iyenera kuthetsedwa masiku atatu lisanachitike tsiku la opareshoni. Kuyambiranso kwa mankhwalawa kumachitika pokhapokha atatha kuphunzira za impso, ntchito yomwe idapezeka kuti ikukhutiritsa. Pankhaniyi, Glucofage imatha kutengedwa tsiku lachinayi atachitidwa opaleshoni.

Kuyesa kwa impso

Metformin imakumbidwa ndi impso, kotero kuyamba kwa chithandizo kumagwirizanitsidwa nthawi zonse ndi kuyesedwa kwa labotale (kuwerengera kwa creatinine). Kwa iwo omwe ntchito ya impso yake siili ndi vuto, ndizokwanira kuchititsa maphunziro azachipatala kamodzi pachaka. Kwa anthu omwe ali pachiwopsezo, komanso odwala okalamba, kutsimikiza kwa QC (kuchuluka kwa creatinine) kuyenera kuchitidwa kangapo pachaka.

Ngati ma diuretics ndi mankhwala a antihypertensive amaperekedwa kwa anthu okalamba, kuwonongeka kwa impso kumatha kuchitika, zomwe zimangotanthauza kufunikira kokawunika mosamala madokotala.

Glucophage mwa ana

Kwa ana, mankhwalawa amadziwitsidwa pokhapokha ngati mayesowo awatsimikizira pakutsimikizira kwawo.

Maphunziro azachipatala ayeneranso kutsimikizira chitetezo cha mwana (kukula ndi kutha msinkhu). Kuyang'aniridwa kwachipatala pafupipafupi pochiza ana ndi achinyamata kumafunika.

Njira zopewera kupewa ngozi

Muziwongolera zakudya zomwe zakudya zimayenera kudyedwa mokwanira komanso moyenera.

Ngati ndinu onenepa kwambiri, mutha kupitiliza kudya kwa hypocaloric, koma pokhapokha pazoyambira 1000 - 1500 kcal tsiku lililonse.

Ndikofunikira. Kuyeserera pafupipafupi kwa maulamuliro kuyenera kukhala lamulo lovomerezeka kwa onse omwe amamwa mankhwalawa Glucofage.

Glucophage ndi kuyendetsa

Kugwiritsa ntchito mankhwalawa nthawi zambiri sikugwirizana ndi vuto loyendetsa kapena magwiridwe antchito. Koma chithandizo chovuta kwambiri chimatha kukhala pachiwopsezo cha hypoglycemia. Pankhaniyi, muyenera kufunsa dokotala.

Mankhwala omwe ali ndi vuto la hypoglycemic amatha kusokoneza thupi.

Chimodzi mwazo mankhwalawa ndi, contraindication ndi zotsatira zoyipa zomwe sizingafanane ndi zabwino zake.

Ichi ndi mankhwala ofunikira, omwe amatha kukonza bwino matenda a matenda ashuga.

Glucophage ndi mankhwala ochepetsa shuga omwe amadzipatsa kukana insulin. Kapangidwe ka mankhwalawa ndi hydrochloride.

Glucophage mapiritsi 750 mg

Chifukwa cha kuponderezedwa kwa gluconeogenesis m'chiwindi, zinthu zimachepetsa shuga m'magazi, zimathandizira lipolysis, ndipo zimasokoneza mayamwidwe a glucose m'mimba.

Chifukwa cha malo okhala ndi hypoglycemic, mankhwalawa amapatsidwa mankhwala otsatirawa:

Kodi ndingatengere masewera ndikumwa mapiritsi?

Malinga ndi kafukufuku waposachedwa, munthawi yomwe amamwa mankhwalawa siwoponderezedwa. Kumapeto kwa zaka zana zapitazi, panali malingaliro osiyana. Hypoglycemic wothandizila ndi kuchuluka kwazinthu zimayambitsa lactic acidosis.

Zogwiritsa ntchito Metformin komanso zofananira zinaletsedwa.

Mankhwala a hypoglycemic a mibadwo yoyamba adayambitsa zovuta zina, kuphatikizapo chiwopsezo cha kupangika. Ichi ndi chiopsezo cha moyo momwe lactic acid m'thupi imafikira kwambiri.

Kuchuluka kwa lactate kumalumikizidwa ndi kuphwanya acid-base metabolism mu minofu ndi kusowa kwa insulini m'thupi, ntchito yomwe ndiyo kuphwanya shuga. Popanda chithandizo chamankhwala mwachangu, munthu yemwe ali ndi vutoli. Ndi kukula kwa tekinoloje ya pharmacological, zoyipa zamagwiritsidwe ntchito ka hypoglycemic zidachepetsedwa.

• Osaloletsa kusowa kwamadzi,
• muyenera kuyang'anira kupumira koyenera nthawi yophunzirira,
• kuphunzitsa kuyenera kukhala kwadongosolo, kopumula koyenera kuti uchiritse,
• kuchuluka kwamphamvu kumachuluka pang'onopang'ono,
• ngati mukumva kutentha m'misempha, muyenera kuchepetsa kulimbitsa thupi.
• ziyenera kukhala zogwirizana ndi mavitamini ndi michere yambiri, kuphatikizapo mavitamini a magnesium, B,
• Zakudya ziyenera kuphatikizapo kuchuluka kwa mafuta acids athanzi. Amathandizira kugwetsa lactic acid.

Glucophage ndi zomanga thupi

Thupi la munthu limagwiritsa ntchito mafuta komanso ngati mphamvu.

Mapuloteni ndi ofanana ndi zomanga chifukwa ndi gawo lofunikira pomanga minofu.

Pakakhala kuti pakhale chakudya chamafuta, thupi limagwiritsa ntchito mafuta mphamvu, zomwe zimapangitsa kuchepa kwamafuta amthupi ndikupanga minofu yotsitsimutsa. Chifukwa chake, omanga thupi amatsata pakuumitsa thupi.

Makina a Glucophage ntchito ndikulepheretsa dongosolo la gluconeogeneis, lomwe kudzera mu glucose limapangidwa m'thupi.

Mankhwalawa amasokoneza kuyamwa kwa zakudya zamafuta, zomwe zimakwaniritsa ntchito zomwe womanga thupi amachita. Kuphatikiza pa kupondereza gluconeogeneis, mankhwalawa amawonjezera kukana kwa insulin, kutsitsa cholesterol, triglycerides, lipoproteins.

Omanga a thupi anali ena mwa oyamba kugwiritsa ntchito mankhwala a hypoglycemic kuti atenthe mafuta. Zochita zamankhwala zimafanana ndi zochita za wothamanga. Thupi la hypoglycemic lingathandize kukhalabe ndi zakudya zama carb ochepa komanso kukwaniritsa masewera munthawi yochepa.

Zotsatira pa impso

Mankhwala a hypoglycemic amakhudza mwachindunji impso. Gawo lolimbikira silimapukusidwa ndikufotokozedwa ndi impso osasinthika.

Ndi osakwanira aimpso ntchito, chinthu yogwira bwino ntchito sanachotse, chilolezo aimpso amachepetsa, zomwe zimathandiza kuti kudzikundikira kwake zimakhala.

Pa mankhwala, kuyang'anira kusinthasintha kwa glomerular ndi kuchuluka kwa shuga m'magazi ndikofunikira. Chifukwa cha momwe zinthu zimagwirira ntchito pa impso, sizikulimbikitsidwa kumwa mankhwalawa chifukwa cha kulephera kwa impso.

Zotsatira pa kusamba

Glucophage si mankhwala a mahomoni ndipo samakhudza mwachindunji magazi akusamba. Kufikira pamlingo wina, imatha kukhala ndi vuto pa thumba losunga mazira.

Mankhwalawa amawonjezera kukana kwa insulini ndipo amakhudza zovuta za metabolic, zomwe zimadziwika ndi polycystic.

Mankhwala a Hypoglycemic nthawi zambiri amaperekedwa kwa odwala omwe amafotokozera, kuvutika ndi hirsutism. Kubwezeretsa kwa insulin sensitivity kwagwiritsira ntchito bwino ntchito mankhwalawa osabereka omwe amayamba chifukwa cha zovuta za ovulation.

Chifukwa cha momwe amachitira pancreas, kugwiritsa ntchito kwadongosolo komanso kwa nthawi yayitali mankhwala osokoneza bongo kumakhudza ntchito yamchiberekero. Msambo ungasinthe.

Kodi amayamba kuuma pamankhwala?

Wothandizira hypoglycemic, wokhala ndi zakudya zoyenera, samatha kuyambitsa kunenepa kwambiri, chifukwa amatchinga kuphwanya kwa chakudya chamafuta m'thupi. Mankhwala amatha kusintha kagayidwe kake ka thupi.

Glucophage imathandizira kubwezeretsa mapuloteni ndi mafuta, zomwe zimabweretsa kuwonda.

Kuphatikiza pa zotsatira za hypoglycemic, mankhwalawa amalepheretsa kuchepa kwamafuta ndi kuchuluka kwake kwa chiwindi. Nthawi zambiri, mukamagwiritsa ntchito mankhwalawa, chilakolako chochepa thupi chimachepa, zomwe zimapangitsa kuti azitha kudya mosavuta.

Mankhwalawa alibe mphamvu iliyonse pa minofu ya adipose. Zimangosokoneza mayamwidwe azakudya zokhala ndi zomanga thupi, kuchepetsa shuga m'magazi ndikuwonjezera kuyankha kwa insulin.

Kugwiritsa ntchito glucophage sikuti ndi vuto laku kunenepa kwambiri, muyenera kuwona zoletsa kugwiritsa ntchito mafuta osavuta komanso kukhala olimba. Popeza chinthu chogwira ntchito chimakhudza ntchito ya impso, kutsatira ndikofunikira.