21 November, 2024
    Chithandizo ndi kupewa

    Metformin Canon: malangizo ogwiritsira ntchito ndi chifukwa chake akufunika

    Metformin Canon: malangizo ogwiritsira ntchito ndi kuwunikira

    Dzina lachi Latin: Metformin-Canon

    Code ya ATX: A10BA02

    Chothandizira: Metformin (Metformin)

    Wopanga: KANONFARMA PRODUCTION, CJSC (Russia), NPO FarmVILAR, OOO (Russia)

    Sinthani mafotokozedwe ndi chithunzi: 10.24.2018

    Mitengo muma pharmacies: kuchokera 85 ma ruble.

    Metformin Canon ndi mankhwala osokoneza bongo a hypoglycemic.

    Kutulutsa mawonekedwe ndi kapangidwe kake

    Mlingo wa kutulutsidwa kwa Metformin Canon - mapiritsi okhala ndi filimu:

    • Metformin Canon 500 mg: biconvex, kuzungulira, pafupifupi yoyera kapena yoyera (m'matumba otumbululuka a ma 10 kapena 15 ma PC., Pamakatoni okhala ndi 3, 5, 6, 10 kapena 12 mapaketi 10 ma PC. 2, 4 kapena 8 mapaketi a 10 ma PC. Ma PC 15.)
    • Metformin Canon 850 mg ndi 1000 mg: biconvex, oval, pafupifupi yoyera kapena yoyera (m'matumba otupa a ma PC 10., Pamatumba olembetsedwa a 3, 5, 6, 10 kapena 12).

    Mapiritsi 1 a Metformin Canon 500 mg, 850 mg ndi 1000 mg, motero:

    • yogwira mankhwala: metformin hydrochloride - 0,5, 0,85 kapena 1 g,
    • othandizira zigawo: macrogol (polyethylene glycol 6000) - 0.012, 0.020 4 kapena 0.024 g, talc - 0.003, 0.005 1 kapena 0.006 g, povidone - 0,047, 0,079 9 kapena 0,094 g, sodium stearyl fumarate - 0,003, 0,005 1 kapena 0,006 g, sodium carbo. - 0,008, 0.013 6 kapena 0,016 g, wowuma pregelatinized - 0,027, 0,045 9 kapena 0.054 g,
    • zokutira filimu: Opadry II yoyera - 0.018, 0.03 kapena 0,036 g, kuphatikiza talc - 0.003 132, 0.005 22 kapena 0.006 264 g, titanium dioxide - 0.002 178, 0.003 63 kapena 0.004 356 g, macrogol (polyethylene glycol) - 0.004 248, 0.007 08 kapena 0.008 496 g, mowa wa polyvinyl 0.008 442, 0.014 07 kapena 0.016 884 g.

    Mankhwala

    Chithandizo chogwira mankhwalawa, metformin, ndimagulu am'magazi a hypoglycemic omwe ali mgulu la Biguanide.

    Zochita za Metformin Canon, chifukwa cha zomwe zimapangidwa ndizomwe zimapangidwa:

    • Kuchepa kwa kuchuluka kwa shuga m'magazi ndikuwonjezera kugwiritsidwa ntchito kwake mu minofu ndikukulitsa chidwi chake ku insulin (makamaka minofu yolimba, mpaka minofu yaying'ono ya adipose), kuchepetsa kuyamwa kwake kuchokera m'matumbo am'mimba komanso kuletsa chiwindi cha gluconeogeneis odwala omwe ali ndi matenda osokoneza bongo ,
    • kukondoweza kwa intracellular glycogeneis kudzera mwa kutsegula kwa glycogen synthase,
    • kupanda kukondoweza kwa insulin katulutsidwe ndi zochita za hypoglycemic mwa anthu athanzi (Mosiyana ndi zotumphukira za sulfonylurea),
    • kuchepa kwa ndende mu magazi seramu otsika kachulukidwe lipoproteins, cholesterol ndi triglycerides,
    • kukhazikika kapena kuwonda,
    • fibrinolytic zotsatira mwa kupondeleza minofu mtundu wa plasminogen activator inhibitor.

    Pharmacokinetics

    • mayamwidwe: mayamwidwe ake am'mimba thirakiti ikamamwa ndi 48-52%, kuchepa kwa nthawi yomweyo ndikuchepetsa mayamwidwe, phindu la bioavailability limasiyana kuchokera pa 50 mpaka 60%, Cmax (kuchuluka kwa ndende m'magazi) ndi 2 mcg pa 1 ml, TSmax (nthawi yoti mufikire pazambiri) - 1.81-2.69 h,
    • kufalitsa: kugawidwa mwachangu mu minofu, kumalowa m'magazi ofiira, kudziunjikira impso, chiwindi ndi ma cell a salivary, kuchuluka kwake (kwa mlingo wa 0.85 g) ndi 296-1012 l, kulumikizana pang'ono ndi mapuloteni a plasma,
    • kagayidwe:
    • chimbudzi: chakumaso mosasinthika kudzera mu impso, chilolezo chake mwa anthu athanzi ndi 0,4 l 1 min, T1/2 (theka-moyo) ndi maola 6.2 (koyamba kumasiyana pakati pa maola 1.7-3, malo osungirako - maola 9 mpaka 17), mu vuto la aimpso T1/2 ukuwonjezeka ndipo pamakhala chiwopsezo cha kukopeka kwa mankhwalawo.

    Zizindikiro zogwiritsidwa ntchito

    • Akuluakulu (makamaka onenepa): monotherapy kapena kuphatikiza mankhwalawa ndi insulin kapena mankhwala ena amkamwa a hypoglycemic omwe ali ndi vuto lachiwiri la 2 matenda osokoneza bongo pamene mankhwala olimbitsa thupi samagwira
    • Ana a zaka zopitilira 10: monotherapy kapena kuphatikiza mankhwalawa ndi mtundu wa insulin 2 matenda a shuga.

    Ndani amasankhidwa mankhwalawo

    Pakadali pano, mndandanda wazomwe zikuwonetsa kutenga Metformin Canon umangokhala mtundu wa 2 wa matenda ashuga ndi mikhalidwe yake yapitayi. Posachedwa, kuchuluka kwa mankhwalawa kukukulira. Kuthekera kwa kugwiritsidwa ntchito kwake mwa anthu omwe ali ndi kunenepa kwambiri, matenda am'mimba, dyslipidemia akuganiziridwa.

    Zisonyezero zosankhidwa pa malangizo:

    • Malipiro a shuga kwa akulu ndi ana azaka 10. Mankhwala ayenera kuthandizidwa ndi zakudya komanso maphunziro akuthupi. Gwiritsani ntchito mapiritsi ena a hypoglycemic ndipo insulin imaloledwa. Zotsatira zabwino zamankhwala zimawonedwa mwa onenepa kwambiri.
    • Pofuna kupewa kukula kwa matenda ashuga mwa anthu omwe ali ndi vuto lodana ndi kagayidwe kazakudya. Mankhwala amatchulidwa ngati wodwala sangathe kukwaniritsa matenda a glycemia ndi zakudya ndi masewera, ndipo chiwopsezo cha matenda ashuga chimayesedwa chambiri. Metformin imalimbikitsidwa makamaka kwa anthu opitirira 60 onenepa kwambiri, chibadwa chovuta (matenda a shuga m'modzi wa makolo), vuto la lipid metabolism, matenda oopsa, komanso mbiri yodwala matenda ashuga.

    Mosiyana ndi Metformin

    Kuti tiwonetse malo omwe mankhwalawo anali Metformin Canon pakati pa mapiritsi ena ambiri otchedwa Metformin, titembenukira ku mbiriyakale. Biguanides akhala akugwiritsidwa ntchito ngati mankhwala kwazaka zambiri. Ngakhale ku Middle Ages, kukodza kopusitsa kunathandizidwa ndi infusions kuchokera ku chomera cha Galega officinalis. Ku Europe, adadziwika m'mazina osiyanasiyana - French lilac, profesa udzu, mbuzi (amawerenga za mbuzi yamankhwala), ku Russia nthawi zambiri amatcha kakombo wa ku France.

    Chinsinsi cha mbewuyi chinavumbulutsidwa kumayambiriro kwa zaka za m'ma 1900. Mankhwala, omwe amachepetsa shuga, adapatsidwa dzina loti guanidine. Kutali ndi chomera, guanidine mu matenda a shuga amawonetsa ofooka, koma oopsa. Kusaka chinthu chabwino chotsitsa shuga sikunathe. Mu 1950s, asayansi adakhazikika pa chitetezo chokha cha Biguanides - metformin. Mankhwalawo anapatsidwa dzina lakuti Glucophage - wokonda shuga.

    Pakutha kwa zaka za 1980s, zidadziwika kuti chimodzi mwazomwe zimayambitsa matenda a shuga chinali kukana insulini. Pambuyo pofalitsa zomwe zapezedwa ndi asayansi, chidwi ndi glucophage chakwera kwambiri. Kafukufuku wofunikadi, chitetezo, njira za mankhwalawo, maphunziro ambiri azachipatala achitidwa. Kuyambira 1999, mapiritsi okhala ndi metformin adakhala oyamba m'ndandanda wazomwe zimalimbikitsidwa kuti azikhala ndi matenda ashuga. Akhalabe oyamba mpaka lero.

    Chifukwa chakuti Glucofage idapangidwa zaka zambiri zapitazo, malingaliro a chitetezo cha patent popeza adatha. Mwalamulo, kampani iliyonse yamankhwala ikhoza kupanga metformin. Mazana a Glucophage jenereta tsopano akutulutsidwa padziko lonse lapansi, ambiri a iwo atchedwa Metformin. Ku Russia, kuli opanga mapiritsi oposa khumi ndi awiri okhala ndi metformin. Makampani omwe akhulupirira kudalirika kwa odwala nthawi zambiri amawonjezera chizindikiro cha wopanga dzina la mankhwalawo. Metformin Canon ndi chipangizo cha Canonfarm Production. Kampaniyi yakhala ikutulutsa mankhwala kwa zaka 20. Amakwaniritsa zofunikira zapadziko lonse lapansi komanso miyezo yapamwamba. Kukonzekera kwa Canonfarm kumayang'aniridwa pamagawo angapo, kuyambira pazipangizo zomwe zimagwiritsidwa ntchito, kutha ndi mapiritsi okonzedwa kale. Malinga ndi akatswiri a matenda ashuga, Metformin Canon ali pafupi kwambiri ndi Glucophage yoyambilira pogwira ntchito bwino.

    Canonpharma imatulutsa metformin mu milingo ingapo:

    MankhwalaMlingoMtengo woyandikira, rub.
    30 tabu.60 tabu.
    Metformin Canon500103195
    850105190
    1000125220
    Metformin Long Canon500111164
    750182354
    1000243520

    Malangizo a kumwa mankhwala

    Malangizo agogomezera kukakamizidwa kwa zakudya panthawi yonse ya mankhwala. Wodwala amafunika kuchepetsa kudya kwa chakudya chambiri (dokotala amadziwitsa kuchuluka kwa kuchepa poganizira zovuta za matendawa), ndikugawa magawo aunifolomu tsiku lonse. Ngati onenepa kwambiri, chakudya chochepetsetsa cha kalori chimalimbikitsidwa. Zakudya zochepa za calorie mukatenga Metformin Canon ndi 1000 kcal. Chakudya cholimba chimawonjezera chiopsezo cha mavuto.

    Ngati wodwalayo sanalandire metformin m'mbuyomu, chithandizo chimayamba ndi kuchuluka kwa 500-850 mg, piritsi limamwa pamatumbo athunthu asanagone. Poyamba, chiwopsezo cha zovuta zina chimakhala chachikulu, kotero kuti mankhwalawa sawonjezereka kwa masabata awiri. Pambuyo pa nthawi ino, werengetsani kuchuluka kwa kuchepetsedwa kwa glycemia ndipo ngati kuli koyenera, kuwonjezera kuchuluka kwake. Masabata awiri aliwonse, mutha kuwonjezera kuchokera ku 500 mpaka 850 mg.

    Kuchulukana kwa kuvomereza - katatu patsiku, pomwe chimodzi mwa madyerero ayenera kukhala madzulo. Malinga ndi ndemanga, kwa odwala ambiri, matenda a glycemia ndi okwanira 1500-2000 mg patsiku (3x500 mg kapena 2x850 mg). Mlingo wapamwamba womwe umayikidwa ndi malangizowo ndi 3000 mg (3x1000 mg) kwa akuluakulu, 2000 mg kwa ana, 1000 mg kwa odwala omwe amalephera aimpso.

    Wodwala akatsatira zakudya, amatenga metformin pamlingo wambiri, koma osakwanitsa kukwaniritsa chipukutiro cha matenda a shuga, dokotala anganene kuti kuchepa kwa insulin. Ngati kuchepa kwa insulin kwatsimikiziridwa, mankhwala a hypoglycemic omwe amathandizira kapamba amapangidwanso.

    Zotsatira zoyipa zingakhale ndi

    M'matumbo, kupezeka kwa metformin kumakhala kambiri poyerekeza ndi magazi, chiwindi ndi impso. Zotsatira zoyipa zomwe zimapezeka ndi mankhwala zimayenderana ndi izi. Pafupifupi 20% ya odwala kumayambiriro kwa kutenga Metformin Canon ali ndi vuto logaya m'mimba: nseru ndi m'mimba. Nthawi zambiri, thupi limatha kuzolowera mankhwalawo, ndipo zizindikirozi zimazimiririka pazokha pakatha milungu iwiri. Kuti muchepetse kuwonongeka kwa mavuto, malangizo omwe angagwiritsidwe ntchito amalimbikitsa kumwa mankhwalawa ndi chakudya, yambani kulandira chithandizo chochepa.

    Polekerera bwino, madokotala amalangizidwa kuti asinthane ndi mapiritsi a metformin omwe amapangidwa pogwiritsa ntchito ukadaulo waposachedwa. Amakhala ndi kapangidwe kapadera, chifukwa chake zomwe zimagwira zimalowa m'magazi molingana m'magawo ang'onoang'ono. Pankhaniyi, kulekerera kwa mankhwalawa kumasintha kwambiri. Mapiritsi a Canonfarm omwe amakhala ndi mphamvu yayitali amatchedwa Metformin Long Canon. Malinga ndi ndemanga, ndiwofunika kwambiri kuposa mankhwala Metformin Canon osalolera.

    Zambiri zamafupipafupi pazotsatira:

    Zotsatira zoyipa za MetforminPafupipafupi zochitika,%
    Lactic acidosis1
    Matenda am'mimba> 10
    Thupi lawo siligwirizanaKwa ma ruble 147 okha!

    Contraindication

    Contraindication ambiri mu malangizo ntchito ndi kuyesa kwa wopanga kuletsa lactic acidosis. Metformin sangathe kulembedwa:

    • ngati wodwala walephera komanso a GFR ndi ochepera 45,
    • ndi hypoxia yayikulu, yomwe imayambitsidwa ndi matenda am'mapapo, kulephera kwa mtima, kugunda kwa mtima, kuchepa magazi,
    • ndi vuto la chiwindi,
    • Mowa
    • ngati munthu wodwala matenda ashuga kale anali ndi lactic acidosis, ngakhale kuti sanapangidwe ndi metformin,
    • pa mimba, insulin yokha imaloledwa ku mankhwala a hypoglycemic panthawiyi.

    Mankhwalawa amathetsedwa ndi ketoacidosis, panthawi yochizira matenda opweteka kwambiri, kuvulala kwambiri, kuthetseratu madzi m'thupi, musanachitike opareshoni. Metformin imachotsedwa masiku 2 asanafike pa X-ray yothandizira, ndipo chithandizo chikuyambiridwanso patatha masiku awiri atatha kafukufukuyu.

    Matenda a shuga osakhalitsa omwe amakhala ndi mavuto ambiri nthawi zambiri amakhala ndi vuto la mtima. Mu malangizo, matendawa amatanthauza contraindication chithandizo ndi metformin, koma machitidwe, madokotala amayenera kupereka mankhwala kwa odwala. Malinga ndi kafukufuku woyambirira, metformin mwa odwala omwe ali ndi matenda a mtima samangongolera kubwezeretsedwera kwa shuga, komanso amachepetsa kufa ndikuchepetsa zomwe zimachitika. Chiwopsezo cha lactic acidosis pamenepa chimawonjezeka moperewera. Ngati izi zikutsimikizika, kulephera kwa mtima sikudzaperekedwa mndandanda wazotsutsa.

    Tulutsani mtundu

    Mankhwalawa amapangidwa mosiyanasiyana, ndipo imodzi mwa izo ndi 850 mg. Malangizo a "Metformin Canon" amapezeka paketi iliyonse. Chidacho chimapangidwa ngati mapiritsi a biconvex oval, omwe ali ndi mtundu woyera.

    Zotsatira zamatsenga

    Mankhwala omwe amafunsidwa ndi othandizira a hypoglycemic, omwe amatchedwa Biguanides. Itha kudzikundikira m'chiwindi, impso ndi chisautso chachikulu. Kugwiritsa ntchito bwino kwa mankhwalawa kumagwirizana mwachindunji ndi luso lolepheretsa gluconeogeneis. Kuchita kwake kumachitika chifukwa cha kupangika kwa ma asidi acid ndi kuphatikiza kwa mafutawa, zomwe zimakhudza mphamvu ya mankhwalawa:

    • Kutsitsa shuga.
    • Kuchuluka kwa chidwi cha insulin receptor limodzi ndi kuyamwa kwa shuga, acid oxidation ndi kugwiritsidwa ntchito kwa glucose.
    • Kuchepetsa mayamwidwe a chithokomiro cholimbikitsa chithokomiro komanso shuga m'magazi am'mimba.
    • Lowstersterol, triglyceride ndi otsika kachulukidwe lipoprotein.
    • Njira yoperekera magazi kuundana komanso kukonza kayendedwe ka magazi, zomwe zimachepetsa chiopsezo cha magazi.
    • Kuchepetsa thupi ngati gawo la mankhwala a kunenepa kwambiri.

    Malangizo apadera

    Malinga ndi malangizo a Metformin Canon, 850 mg, mukamagwiritsa ntchito mankhwalawa, kuwongolera shuga pambuyo pakudya komanso pamimba yopanda kanthu ndikofunikira kwambiri, komanso kuwunika pafupipafupi ndende ya creatinine (yogwira ntchito ya impso kamodzi pachaka, komanso kwa anthu achikulire ochepetsedwa nthawi zinayi m'miyezi khumi ndi iwiri). Ngati muli ndi ululu m'matumbo ndi m'mimba, kusanza ndi kufooka m'thupi, motsutsana ndi maziko a malaise (zizindikiro za lactic acidosis), komanso, komanso, ndi zizindikiro za matenda amtundu wamatenda kapena matenda am'mapapo, muyenera kusiya kumwa mapiritsi, kenako kukaonana ndi dokotala.

    Mukamagwiritsa ntchito mankhwalawa ndi othandizira ena a hypoglycemic, kuthekera mofulumira kwa psychomotor reaction kumachepa. Munthawi ya mankhwala, munthu ayenera kupewa kumwa mowa kuti apewe kuchitika kwa lactic acidosis. Mankhwalawa amatsutsana pakubala, motsutsana ndi maziko a mkaka wa m'mawere, kudyetsa kwachilengedwe kuyimitsidwa ngati pakufunika kugwiritsa ntchito "Metformin Canon". Kuchepetsa thupi, mankhwalawa amagwiritsidwa ntchito nthawi zambiri.

    Kuchotsa ma kilogalamu okhala ndi kulemera kambiri ndi ntchito yovuta mu malingaliro ndi thupi, popeza zimafunikira kulimbikira kwakukulu ndi kusintha kwakukulu munthawi yamoyo. Pankhani imeneyi, osati akatswiri azakudya zokha, komanso mwachindunji omwe akufuna kuchepetsa thupi, amakhala akusaka njira zosavuta kwambiri zolembetsera thupi. Zaka zaposachedwa, kwakhala kotchuka kugwiritsa ntchito mankhwala ochepetsera kulemera kwa mankhwalawa omwe sanapangidwe kuti muchepetse thupi, koma onetsani zotere mu chithandizo cha matenda oyambitsidwa.

    Chimodzi mwa mankhwalawa ndi Metformin Canon. Mapiritsiwa amathandizidwa ndi madokotala kuti achepetse kuchuluka kwa shuga pamaso pa shuga. Ochita masewera komanso omanga thupi anali oyamba kugwiritsa ntchito Metformin Canon kuti achepetse thupi. Komanso, atalandira ndemanga zambiri zabwino, mankhwalawa adayamba kupitilira masewera komanso azachipatala.

    Chifukwa chake, polimbana ndi kunenepa kwambiri ndi matenda ashuga, mankhwalawa amachepetsa shuga, omwe amachotsa chilakolako chambiri ndi kulakalaka maswiti. Osewera ndi atsikana pachakudya chomwe alibe shuga amamugwiritsa ntchito mankhwala katatu patsiku kwa mamiligalamu 500 kwa masiku makumi awiri ndi awiri (pambuyo pake muyenera kupuma kwa mwezi umodzi).Mukamamwa, zolimbitsa thupi zimafunikira limodzi ndi kuphatikizidwa kwa chakudya chamafuta ndi mafuta azakudya.

    Kuyanjana kwa mankhwala osokoneza bongo

    Malinga ndi malangizo a Metformin Canon, 850 mg, amalephera kugwiritsa ntchito mapiritsiwa masiku awiri lisanachitike komanso pambuyo phunziroli pogwiritsa ntchito mankhwala a radiopaque. Pali mankhwala omwe ayenera kugwiritsidwa ntchito ndi mankhwala omwe timawafotokozera mosamala:

    • Izi ndiye, choyambirira, Danazol, zomwe zimawonjezera mwayi wa chidziwitso cha hyperglycemic.
    • "Chlorpromazine" Mlingo wambiri (ma milligram 100 patsiku) komanso mankhwala a antihypertensive amathandizira kuchuluka kwa shuga m'magazi. "Chlorpromazine" amachepetsa kutulutsidwa kwa insulin.
    • Mu zitsanzo zina, ketosis imayambitsidwa ndi glucocorticosteroids, kulolera kwa glucose kumachepa ndipo kuphatikiza kwake kumawonjezeka.
    • Loop diuretics imawonjezera mwayi wokhala ndi zizindikiro za lactic acidosis.
    • Jekeseni wa adrenomimetics amachepetsa mphamvu ya hypoglycemic.
    • Zomwe zimaphatikizira insulin, sulfonylurea, acarbose ndi salicylate zimawonjezera kwambiri hypoglycemic.
    • "Nifedipine" imawonjezera mayamwidwe a metformin.

    Zisonyezero zakudikirira

    Mankhwala "Metformin Canon" amaperekedwa kwa odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda ngati njira yosinthira (kudya pang'ono kwamoto komanso masewera olimbitsa thupi, kuwongolera kwam'maganizo) sikunaperekenso chiwonetsero chonse cha glycemic.

    Kwa odwala omwe onenepa kwambiri, Metformin ndiye chisankho chabwino kwambiri. Mankhwalawa amatha kuphatikizidwa ndi mankhwala a hypoglycemic a magulu ena am'magulu ena, momwe mawonekedwe amachitidwe amasiyana ndi biguanides. Kuphatikiza mankhwala ndi insulin ndikothekanso.

    Mankhwalawa adapangidwanso kuti athandizire odwala a mtundu wa II matenda osokoneza bongo omwe ali ndi zaka zopitilira khumi. Amagwiritsidwa ntchito ngati mankhwala a mzere woyamba kapena kuphatikiza ndi insulin. Omanga a thupi amagwiritsa ntchito mankhwalawa kuti aume minofu, ndipo atsikana omwe ali ndi kuchepa thupi akuyesera, koma kugwiritsa ntchito koteroko kumakhala koyenera pokhapokha zovuta zamafuta zikamakhudzana ndi insulin komanso kulephera pama metabolic process.

    Zotsatira zoyipa

    Malinga ndi malangizo ndi malingaliro a Metformin Canon, 850 mg, mwa akulu ndi ana, zotsatila za kumwa mankhwalawa ndizofanana. Pali kulawa kwazitsulo mkamwa komanso kugaya chakudya m'njira yoperewera, kusanza, kupweteka m'mimba, kutsegula m'mimba komanso kusanza. Chizindikiro cha chiwindi chimaphwanyidwa, chiwindi chimachitika. Zotsatira monga B12 hypovitaminosis yokhala ndi mawonekedwe a khungu (kuyabwa kwa khungu, zidzolo, erythema, urticaria) kwa mankhwala ndizosowa kwambiri.

    Bongo

    Mankhwala ayenera kumwedwa pokhapokha pokhapokha pokhapokha pakhoza kukhala chiopsezo cha bongo. Kudya kwa Metformin, kofanana ndi magalamu 85, kumatha kubweretsa kukulitsa kwa lactic acidosis, komwe kumayendetsedwa ndi kupweteka kwa minofu, komanso, kusapeza bwino pamimba, kusanza ndi kusanza. Ngati thandizo siliperekedwa munthawi yake, ndiye kuti mankhwala osokoneza bongo omwe atenga mankhwalawa angayambitse chizungulire, kusokonezeka kwa chikumbumtima komanso chikomokere sichitha. Tsopano timatembenukira ku contraindication ndikupeza pomwe odwala sayenera kumwa mankhwalawa kuti athandizidwe.

    Zotsatira za mankhwala

    Kuphatikizidwa kwa wothandizira antidiabetesic Metformin Canon kumaphatikizapo metformin hydrochloride, chinthu chodziwika bwino mdziko lapansi chomwe chitha kuchepetsa kuchuluka kwa shuga mukudwala matenda ashuga.

    Kuphatikiza pa chinthu ichi, kukonzekera kumakhala ndi sodium stearyl fumarate, wowuma, titanium dioxide, talc, macrogol ndi zinthu zina.

    Wopanga hypoglycemic wothandizira ndi kampani yopanga zamankhwala Canonfarm Production.

    Kampaniyo imatulutsa mankhwala ofanana ndi mapiritsi (oyera, biconvex) mu mitundu yosiyanasiyana:

    1. Metformin Canon 500 mg.
    2. Metformin Canon 850 mg.
    3. Metformin Canon 1000 mg.

    Mankhwalawa amaloledwa kumwa kuchokera zaka 10, osati monotherapy, komanso jekeseni wa insulin. Pakumeza, metformin imalowetsedwa m'matumbo, ndipo kuphatikiza kwakukulu kumachitika pafupifupi maola 2-2,5 pambuyo pakulowetsa. Machitidwe a hypoglycemic amawonetsedwa:

    • kuletsa kupanga kwa shuga m'magulu osagwiritsa ntchito chakudya mu chiwindi,
    • kufooketsa mayamwidwe am'magazi m'mimba,
    • Kuonjezera chiwopsezo cha minofu yolimbana ndi kuchepetsa mphamvu ya shuga,
    • kuchotsa shuga m'matumbo,
    • kulimbikitsa intracellular glycogeneis,
    • pa kutsegula kwa glycogen synthase,
    • kukhazikitsa lipid kagayidwe.

    Kuphatikiza apo, mankhwalawa ali ndi mtundu wina wa fibrinolytic. Metformin Canon imatha kukhazikika ndikuchepetsa thupi. Zimasiyana ndi kukonzekera kwa zotumphukira za sulfonylurea chifukwa sizimapangitsa kupanganso insulin ndipo sikuti zimayambitsa kuthamanga kwa shuga mwa anthu athanzi.

    Gawo lolimbikira limafalikira mokwanira mu minofu. Itha kudzikundikira m'chiwindi, kumaso ndi impso.

    Metformin siimapukusidwa, chifukwa chake imagwiridwa ndi impso mu mawonekedwe osasinthika.

    Malangizo ogwiritsira ntchito mapiritsi

    Ngakhale mutakambirana ndi adokotala mutagula mankhwalawo, malangizo ogwiritsira ntchito ayenera kuphunziridwa mosamala. Ngati muli ndi mafunso ndi wodwala, muyenera kufunsa uphungu.

    Mapiritsi amalimbikitsidwa kwambiri kugwiritsa ntchito nthawi ya chakudya kapena itatha. Samasenda, koma kumeza ndi kapu yamadzi. Kufotokozera kwa mankhwalawa akuti mlingo woyambirira wa anthu akuluakulu ndi 1000-1500 mg patsiku. Pankhaniyi, ndikofunikira kugawa mlingo kangapo patsiku. Malangizowa akuchitika chifukwa chakuti pakusintha kwa thupi ndi zochita za metformin, zotsatira zoyipa zimachitika, makamaka zogwirizana ndi kugaya. Wodwala matenda a shuga amatha kudandaula za kusanza, kutsegula m'mimba, kusintha kwa kakomedwe, kupweteka m'mimba, komanso kugona. Komabe, patatha masiku 10 mpaka 14, izi zimangochitika zokha.

    Thupi likazolowera metformin, dokotala amatha kuwonjezera kuchuluka kwa wothandizila wa hypoglycemic malinga ndi kuchuluka kwa shuga kwa wodwalayo. Mlingo wokonza umaganiziridwa kuti kuyambira 1500 mpaka 2000 mg patsiku. Mulingo wovomerezeka tsiku lililonse ndi 3000 mg.

    Wodwalayo akatembenukira ku Metformin Canon ndi antipyretic ina, ayenera kusiya kuchita izi. Mukaphatikiza mankhwalawa ndi mankhwala a insulin, tikulimbikitsidwa kumayambiriro kwa mankhwalawa kumwa 500 kapena 850 mg kawiri kapena katatu patsiku. Metformin 1000 mg imatengedwa kamodzi patsiku.

    Ana omwe afika zaka 10 akhoza kuyamba kulandira mankhwala ndi 500 mg ya mankhwalawa. Ndikofunika kuti muzidya nthawi yamadzulo mukamadya. Pambuyo masiku 10-14, adokotala amatha kuwonjezera kuchuluka kwa tsiku lililonse mpaka 1000-1500 mg. Mwanayo amaloledwa kutenga zosaposa 2000 mg patsiku.

    Anthu odwala matenda ashuga ayenera kusamalidwa mwapadera. Mlingo ndi nthawi yayitali ya mankhwala amasankhidwa ndi dokotala payekhapayekha. Pazaka zopitilira 60, mankhwala a hypoglycemic angayambitse kusokonezeka kwa impso.

    Dziwani kuti mankhwalawo sangagulidwe popanda mankhwala a dokotala. Ma CD a Metformin Canon amayenera kusungidwa ndi dzuwa kapena chinyezi. Kutentha kosungira sikuyenera kupitirira 25 digiri Celsius.

    Pambuyo pa kumaliza ntchito kwake, zomwe ndi zaka 2, kuyendetsa mankhwala a antidiabetesic ndi koletsedwa.

    Zochita zina zamankhwala

    Monga mukudziwa, mankhwala ena amatha kukhala ndi vuto la Metformin Canon, kuchepetsa kapena kukulitsa mphamvu ya hypoglycemic.

    Malangizowo akuti kuphatikiza komwe kumatsutsana ndikugwiritsa ntchito ayodini omwe ali ndi ayodini.

    Potengera maziko a kulephera kwa impso kwa odwala, amatha kutsogolera kukula kwa lactic acidosis. Sipangonso kuphatikiza zakumwa zoledzeretsa, zozungulira komanso kukonzekera komwe kumakhala ndi ethanol ndikugwiritsa ntchito metformin.

    Kuchenjera kwapadera kumafunika ndi mankhwala omwe amatha kufooketsa zochita za metformin ndikutsogolera ku hyperglycemia. Izi zikuphatikiza:

    1. Danazole
    2. Chlorpromazine.
    3. Ma antipsychotic.
    4. Glucocortecosteroids.
    5. Beta2-adrenergic agonists.

    Angiotensin-akatembenuza enzyme zoletsa, ma insulin, ma salicylates, ma acarbose ndi zotumphukira za sulfonylureas zitha kupititsa patsogolo mphamvu ya hypoglycemic ya metformin.

    Iyenera kukumbukiridwa kuti ndi munthawi yomweyo nifedipine ndi metformin, hypoglycemia ikhoza kuchitika m'mankhwala a shuga. Pofuna kupewa kufalikira kwa impso, ndikofunikira kugwiritsa ntchito NSAIDs mosamala.

    Mulimonsemo, posankha kugwiritsa ntchito mankhwala aliwonse, choyambirira, ndikofunikira kufunsa dokotala. Kubisika kwa ma pathologies kuchokera kwa dokotala kungayambitse zotsatira zosasintha.

    Ndemanga ndi mitengo yamankhwala

    Wodwala aliyense amapatsidwa mwayi wogula mankhwalawo ku pharmacy kapena kudzaza fomu yogula kudzera pa tsamba lovomerezeka la wopanga.

    Wogula angathe kungoyang'ana pa chithandizo cha mankhwalawo, komanso mtengo wake. Tiyenera kudziwa kuti Metformin Canon ali ndi mtengo wotsika.

    Chifukwa chake, wodwala aliyense amatha kugula mankhwala.

    Mtengo wake umatengera mtundu wa kumasulidwa ndi kuchuluka kwa mapiritsi omwe ali phukusi:

    • Metformin Canon 500 mg (mapiritsi 30) - kuchokera ku 94 mpaka 110 ma ruble,
    • Metformin Canon 850 mg (mapiritsi 30) - 112 mpaka 116 zikwangwani,
    • Metformin Canon 1000 mg (mapiritsi 30) - kuchokera ku 117 mpaka 165 rubles.

    Pakati pa madokotala ndi odwala, mutha kupeza ndemanga zambiri zabwino pakugwiritsa ntchito mankhwalawa. Chifukwa chake, akatswiri a matenda ashuga akuti Metformin Canon amalimbitsa shuga popanda kuchititsa hypoglycemia. Ndemanga zimasonyezanso kuchepa kwa anthu onenepa. Chifukwa chake, pakati pazabwino za mankhwalawa zimadziwika kuti ndizothandiza, kugwiritsa ntchito mosavuta komanso mtengo wotsika.

    Mbali zoyipa zogwiritsa ntchito mankhwalawa zimawerengedwa kuti ndi zoyipa zomwe zimachitika chifukwa cha metformin - kugaya chakudya. Koma pogawa Mlingo watsiku ndi tsiku Mlingo wangati womwewo, zizindikiro zotere zimachepa kwambiri.

    Odwala ambiri omwe amamwa Metformin Canon amakumbukiranso kuti chithandizo cha mankhwalawa "chimakhala chopanda ntchito" ngati simutsatira mankhwala, musamachite masewera olimbitsa thupi komanso osayang'anira shuga tsiku lililonse.

    Mankhwala ofanana

    Nthawi zina kugwiritsa ntchito mankhwalawa kumakhala kosatheka pazifukwa zosiyanasiyana, kaya ndi contraindication kapena zovuta zimachitika.

    Zikatero, udindo wonse umakhala ndi dokotala, yemwe wasankha kusintha mankhwalawo. Nthawi yomweyo, ayenera kuganizira kuchuluka kwa shuga m'magazi a wodwalayo komanso mkhalidwe wake wathanzi.

    Mankhwala omwewo ali ndi njira yofanana yothandizira, koma amasiyana pakapangidwe kake.

    Metformin ndi mankhwala otchuka kwambiri omwe amagwiritsidwa ntchito polimbitsa shuga. Pankhaniyi, imagwiritsidwa ntchito ngati gawo logwira ntchito la othandizira ambiri a hypoglycemic.

    Mwa ena odziwika a Metformin Canon kusiyanitsa:

    1. Gliformin ndi mankhwala othandizira odwala matenda ashuga omwe amagwiritsidwa ntchito poyambitsa sulfonylureas. Chifukwa cha metformin yomwe ilipo, imathandizira kuchepetsa kulemera kwa anthu omwe ali onenepa kwambiri. Mtengo wake wapakati umatengera mtundu wa kumasulidwa: ma ruble 500 mg -106, 850 mg -186 ndi 1000 mg - 368 rubles.
    2. Glucophage ndi njira ina yothanirana ndi gulu la Biguanide. Imakhalapo mwanjira yokhala ngati ikuchita zinthu motalika (Glucophage Long). Amagwiritsidwanso ntchito pa matenda a shuga omwe amadalira insulin. Mtengo wapakati wa phukusi limodzi umachokera ku 107 mpaka 315 rubles.
    3. Siofor 1000 ndi mankhwala omwe amagwiritsidwa ntchito kupewa komanso kuchiza matenda ashuga, komanso kuchepetsa kunenepa. Pafupipafupi, mtengo wake umasiyana ndi ma ruble 246 mpaka 420, chifukwa chake sungatchedwa analogue wotsika mtengo kwambiri.
    4. Metformin-Teva ndi mankhwala omwe amagwiritsidwa ntchito pa matenda a shuga a 2, pamene kudya ndi kuchita masewera olimbitsa thupi sizingathandize. Monga Metformin Canon, imakhazikika ndi glycemia, lipid metabolism ndi thupi la wodwalayo. Mtengo wapakati wamankhwala amachokera ku ruble 125 mpaka 260.

    Pali mankhwala ena ambiri omwe ali ndi vuto lofanana ndi Metformin Canon. Zambiri zokhudzana ndi izi zimapezeka pogwiritsa ntchito intaneti kapena kufunsa dokotala.

    Metformin Canon ndi mankhwala othandizira odwala matenda ashuga. Pogwiritsa ntchito moyenera, mutha kuchotsa zizindikiritso za "matenda okoma" ndikukhala ndi moyo wathanzi ndi anthu athanzi. Komabe, mukamagwiritsa ntchito mankhwalawa, muyenera kutsatira malangizo onse a dokotala, kuti musadzivulaze.

    Katswiri kuchokera pa kanema munkhaniyi akamba za Metformin.

    Kodi Metformin ndi chiyani?

    Omwe akutsogolera pakuwongolera matenda a shuga 2 amatenga Metformin. Ndi ya pagogo. Izi ndi zinthu zomwe zimachepetsa shuga. Kugwiritsa ntchito bwino kwa mankhwalawa kumatsimikiziridwa ndi nthawi, machitidwe ogwiritsa ntchito, monga zikuwonekera ndi kuwunika kwa odwala. Awa ndiwo mankhwala okhawo omwe amagwiritsidwa ntchito pochiza matenda a shuga kwa ana. Metformin ili ndi mayina angapo, imagulitsidwa ngati Glucofage, Siofor, Glformin. Zimatengera wopanga komanso kapangidwe kazomwe amapangira mankhwala.

    Kupanga ndi mawonekedwe a kumasulidwa

    Metformin imapezeka mu piritsi. Amakhala ozungulira, biconvex, wokutidwa ndi chipika cha enteric choyera. Mankhwalawa amadzaza m'matumba a zidutswa 10 kapena 15. Katemera wa Carton adzagwira mapiritsi 30. Gome likuwonetsa kapangidwe ka kapisozi kamodzi kamankhwala:

    Yogwira pophika

    Metformin hydrochloride (kapena dimethylbiguanide)

    Wowuma chimanga (kapena mbatata)

    Momwe angatenge

    Mapiritsiwo amameza lonse, kutsukidwa ndi madzi ambiri. Mlingo woyambira osachepera 500 mg kamodzi patsiku, upamwamba wake ndi 2,5-3 g.Amalimbikitsidwa kumwa mapiritsi a metformin mukatha kudya kapena nthawi yomweyo musanakagone. Mlingo wa mankhwalawa ndibwino kuwonjezera pang'onopang'ono. Mlingo woyamba wa dimethylbiguanide umayambitsa kusokonezeka m'mimba ndipo umasokoneza chimbudzi. Kulawa kwazitsulo, nseru ndizizindikiro za mankhwala osokoneza bongo oyamba amagwiritsidwa ntchito ngati mankhwala.

    Ndi monotherapy ndi mankhwala, ndikwabwino kutsatira zomwe zatsimikiziridwa:

    1. Sabata yoyamba, mankhwala ambiri a 500 mg amatengedwa 1 nthawi.
    2. Kenako, tsiku ndi tsiku mlingo ukuwonjezeka mpaka 850-1000 mg ndikugawidwa pawiri.
    3. Ngati njira za metabolic sizikhutira pamlingo waukulu wa 2000 mg, sulfonylureas iyenera kuwonjezeredwa ndi metformin kapena insulin iyenera kugwiritsidwa ntchito.
    4. Kukula kwa mlingo kumatengera shuga wowerengera. Mlingo wamtundu amasankhidwa payekha ndi dokotala.
    5. Odwala okalamba, pazipita tsiku lililonse ndi 1000 mg.

    Kusunga ndi kugulitsa

    Mankhwala amangotulutsidwa ndi mankhwala okha. Moyo wa alumali wa chinthu ichi ndi zaka ziwiri, pamapeto pake ndizoletsedwa kugwiritsa ntchito mankhwalawa. Mankhwalawa amayenera kusungidwa pamalo otetezedwa ndi kuwala, omwe ayenera kukhala owuma, kutentha osapitirira madigiri makumi awiri.

    Mtengo wa mapiritsi 60 a "Metformin Canon" 850 mg - pafupifupi ruble 200.

    Chotsatira, tikupeza zomwe anthu amalemba za mankhwalawa, ndipo, kuwonjezera apo, tidzadziwa malingaliro a madotolo pakuyenda bwino kwa mankhwalawa.

    Choyamba, lingalirani za ndemanga za "Metformin Canon" 850 mg kuchokera kwa odwala.

    Ndemanga za Odwala

    Mu ndemanga, odwala amatsimikizira kuyenera kwa mankhwalawa omwe amafunsidwa pochiza matenda ashuga komanso ngati njira yotaya ma kilogalamu osafunikira.Malinga ndi kuwunika kwa ogula, Metformin Canon ndi mankhwala okwera mtengo komanso othandiza, makamaka pokhudzana ndi kuwongolera kuchuluka kwa glucose komanso kulemera kwa thupi. Pakati pazovuta zazikulu, mawonekedwe a zovuta kuchokera kugaya chakudya amatchulidwa nthawi zambiri.

    Madokotala amafufuza

    M'mawunika awo a "Metformin Canon" 850 mg, akatswiri amatsimikiziranso kuthekera kwa mankhwalawa. Koma akuchenjeza kuti pa mankhwala akuyenera kuchitika pafupipafupi kuyang'anira shuga.

    Ndikwabwino kuti muzidziwitsa za malingaliro a madokotala za Metformin Canon pasadakhale.

    Madokotala alemba kuti ngakhale mukumwa mankhwalawa, kuuma kwambiri, kufooka, kupweteka m'misempha kapena m'mimba komanso kusanza kumatha kuchitika. Muzochitika zonsezi, odwala ayenera kufunsa dokotala, chifukwa zizindikiro zotere zingasonyeze kukula kwa lactic acidosis.

    Kuphatikiza apo, madokotala pakuwunika kwa Metformin Canon amalangiza kuchenjeza pakavulidwe ka impso, mwachitsanzo, kumayambiriro kwa mankhwala omwe ali ndi anti-yotupa-non-steroid mankhwala. Akatswiri amalimbikitsa odwala omwe ali ndi dokotala motsutsana ndi kumbuyo kwa chitukuko cha mawonekedwe a matenda opatsirana a genitourinary dongosolo kapena matenda a bronchopulmonary.

    Metformin Long Canon

    Mankhwalawa amagwira ntchito ngati othandizira pakamwa kuchokera m'gulu la Biguanides. Kupanga kwamachitidwe kumalumikizidwa ndi kuthekera kwa mankhwalawa kuponderezera gluconeogeneis limodzi ndikupanga ma free acid acid. Mankhwala kumawonjezera zotumphukira zolandilira insulin. Ndizofunikira kudziwa kuti Metformin Long Canon siyimakhudzanso kuchuluka kwa insulin m'magazi, koma imasintha ma pharmacodynamics.

    Mankhwala amathandizira kapangidwe ka glycogen. Kuthekera kwamitundu yonse yamatenda a glucose oyenda kumawonjezeka. Mankhwalawa, mwa zina, amachedwa kuyamwa kwa glucose m'matumbo, amachepetsa kuchuluka kwa triglycerides, komanso amathandizira magazi a fibrinolytic. Poyerekeza ndi momwe ntchito mankhwalawa imagwiritsidwira ntchito, thupi la wodwalayo limakhalabe lolimba kapena mwina limachepera.

    Zisonyezero zogwiritsidwa ntchito ngati mankhwala osakhalitsa

    Chizindikiro chachikulu ndi mtundu wachiwiri wa matenda ashuga mwa achikulire (makamaka pakati pa odwala omwe ali ndi kunenepa kwambiri), bola ngati masewera olimbitsa thupi ndi zakudya sizothandiza. Mu milandu iyi, mankhwalawa amatchulidwa ngati gawo la monotherapy komanso kuphatikiza ena othandizira pakamwa kapena insulin.

    Njira ya makonzedwe ndi kumwa mankhwala kwa nthawi yayitali

    Mankhwalawa amayenera kumwa ndi odwala mkati. Mapiritsiwo amameza, osatafuna ndikusambitsidwa pansi ndimadzi okwanira. Amatha kuledzera kamodzi kapena nthawi yamadzulo. Dokotala amasankha mlingo wa mankhwalawo payekhapayekha kwa wodwala winawake malinga ndi zomwe zimapangitsa kuti azikhala ndi glucose.

    Kwa odwala omwe sanamwe kale metformin, muyezo woyenera wa mankhwalawa ndi 500 mamililita kamodzi patsiku chakudya. Masiku onse khumi kapena khumi ndi asanu, ndikofunikira kuti musinthe kuchuluka kwa mankhwalawa chifukwa cha kuyeza kuchuluka kwa shuga m'magazi am'magazi. Kuwonjezeka pang'onopang'ono kwa mlingo kumathandizira kulolerana kwapakati pamimba.

    Chifukwa chake, mankhwalawa Metformin Canon, omwe adaganiziridwa m'nkhaniyi, adapangira zochizira matenda amtundu wa 2 odwala mwa akulu. Koma, monga tawonera kale nthawi zambiri, pakadali pano zikuchulukirachulukira munjira ya njira yokwaniritsira kunenepa kwambiri ndipo nthawi zina amasankhidwa ndi anthu ngati azakudya.

    Tinawunikiranso malangizo a "Metformin Canon" 850 mg.

    Zotsatira za pharmacological

    Mankhwala Metformin ndi wothandizirana ndi hypoglycemic wokhudzana ndi biguanides ndipo amadziunjikira m'chiwindi, zotupa ndi ma impso. Kugwiritsa ntchito bwino kwa mankhwalawa kumagwirizanitsidwa ndi mphamvu yoletsa gluconeogeneis, mapangidwe a mafuta achilengedwe omasuka ndi makutidwe ndi okosijeni amafutazomwe zimakhudza zotsatira zamankhwala;

    • kuchepetsa shuga
    • kuchuluka kwa insulin receptors, kusintha shuga, mafuta acid oxidation ndi zotumphukira shuga.
    • kuchepa kwamphamvu kwa glucose m'mimba, chithokomiro cha magazi cha chithokomiro.
    • kutsitsa cholesterol, triglycerides ndi ochepa kachulukidwe lipoproteins,
    • normalization wa magazi coagulability, kusintha kwake rheological, amene amachepetsa chiopsezo cha thrombosis,
    • Kuchepetsa mankhwalawa kunenepa.

    Kugwiritsa

    Metformin imalembedwa kwa anthu omwe ali ndi mtundu wa 2 matenda a shuga (osagwirizana ndi insulin). Kuchiza ndi mankhwalawa kumalimbikitsidwa ngati wodwala akuvutika ndi kunenepa kwambiri, kapena ngati kuli koyenera, kuwunika ma glucose. Mankhwalawa amalembedwa ngati monotherapy kapena ngati mankhwala ena a insulin kapena mankhwala ena odana ndi matenda a shuga.

    Mlingo ndi makonzedwe

    Mankhwalawa amakamwa pakumwa pakudya kapena akangomaliza kudya. Mapiritsi amayenera kumezedwa kwathunthu popanda kutafuna. Pafupipafupi kayendetsedwe ndi Metformin zimadalira mtundu wa chithandizo:

    Akuluakulu Metformin monotherapy ndi kuphatikiza mankhwalawa ndimankhwala ena amkamwa a hypoglycemic

    1000-1500 mg / tsiku. - mlingo woyambirira wa mankhwalawa. Ndikotheka kuchepetsa mavuto kuchokera m'matumbo am'mimba (thirakiti la m'mimba) mwakugawa kudya ndi katatu. Pakakhala zovuta m'matumbo am'mimba, patatha masiku 10-15, mlingo umatha kuwonjezeka pang'onopang'ono (kutengera glucose).

    Kukonzanso tsiku lililonse - 1500-2000 mg. Pazipita patsiku - 3000 mg, ogaŵikana 3 waukulu.

    Kusintha kuchokera ku mankhwala ena amkamwa kukhala mankhwala a shuga Metformin

    Yambani kumwa mankhwalawa (pamtunda waukulu) mutasiya kugwiritsa ntchito mankhwala ena oopsa.

    Kuphatikiza mankhwala ndi insulin

    Pa mlingo woyambirira wa 500 mg ndi 850 mg, piritsi limodzi katatu / tsiku., Pa 1000 mg - piritsi 1 nthawi 1 / tsiku. Mlingo wa insulin umasankhidwa potengera shuga.

    Ana kuyambira zaka 10 mpaka 16. Mankhwalawa amagwiritsidwa ntchito monotherapy komanso pophatikiza ndi insulin.

    Mlingo woyambirira ndi 500 mg 1 nthawi patsiku, kumwa madzulo ndi chakudya. Pambuyo masiku 10-15, gawo limasinthidwa kutengera mtundu wa glucose. 1000-1500 mg / tsiku., Wogawidwa nthawi 2-3 - mlingo wokonza. 2000 mg mu 3 Mlingo wogawika - pazipita.

    Anthu okalamba

    Mlingo umasankhidwa chifukwa chowunikira pafupipafupi zizindikiro za impso (osachepera 2-4 pachaka).
    Dokotala amawona kutalika kwa mankhwalawa.

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