Matenda a shuga

Mankhwala othandizira odwala matenda a shuga 2 samangokhala pa zakudya zapadera, komanso othandizira kudya zopangidwa zoyenera matendawa.

Ndizofunikira kukwaniritsa chikhalidwe chamtundu wa glycemic.

Mwa mankhwala ambiri omwe amaperekedwa ndi msika wogulitsa mankhwala, odwala nthawi zambiri amapatsidwa mapiritsi a Glibomet.

Zambiri pazamankhwala, mawonekedwe a mawonekedwe ndi mawonekedwe

Glibomet ndi m'gulu la mankhwala a hypoglycemic omwe amatengedwa pakamwa. Mankhwalawa amapangidwa ndi kampani yaku Germany ya BERLIN-CHEMIE / MENARINI. Kuphatikiza pa Glibomet, ku Russia mankhwala opitilira 100 a kampaniyi adalembetsedwa, omwe amagwiritsidwa ntchito mwachangu pochiza matenda ambiri ndipo adakwanitsa kuti wodalirika azikukhulupirira.

Mankhwala amagulitsidwa mwanjira ya mapiritsi ophimbidwa ndi chipolopolo choyera. Iliyonse mwa iyo ili ndi magawo awiri othandizira komanso kuchuluka kwa zinthu zothandizira.

Piritsi la mankhwalawa lili:

• Glibenclamide (2.5 mg) ndi Metformin Hydrochloride (400 mg) ndi zinthu zazikulu,
• wowuma chimanga (michere) - 57,5 ​​mg,
• cellulose (chomera polysaccharide) - 65 mg,
• silicon dioxide (chakudya E551) - 20 mg,
• gelatin - 40 mg
• Glycerol - 17.5 mg,
• talc (mchere) - 15 mg,
• Diethyl phthalate (0.5 mg) ndi 2 mg Acetylphthalyl cellulose - yomwe ili mgulu la mapiritsi.

Phukusili limatha kukhala mapiritsi 40, 60 kapena 100.

Pharmacology ndi pharmacokinetics

Chifukwa cha zomwe zimapangidwa pokonzekera, mankhwalawa amachepetsa chizindikiritso cha magazi m'magazi a wodwala.

Mankhwala Glibenclamide:

• imathandizira kubisalira kwa insulin, komanso imakulitsa kutulutsa kwa mahomoni,
• zimapangitsa chiwopsezo chowonjezeka cha insulin yomwe ilipo mthupi,
• timapitiriza mphamvu ya insulin pa shuga,
• Imachepetsa njira ya lipolysis.

Pharmacological zochita za Metformin:

• imathandizira kukulitsa chidwi cha insulin, komanso imathandizira zotsatira zake,
• amachepetsa mayamwidwe a shuga m'matumbo, amasintha mayamwidwe ndi ziwalo zina,
• amathandiza kuponderesa gluconeogeneis,
• zimakhudza metabolid ya lipid, yomwe imabweretsa kuwonda.

Ndikotheka kukwaniritsa kuchepa kwa glycemia pambuyo piritsi patatha maola 2 ndikusungira kwa maola 12.

Mankhwala amakhudzana ndi mankhwalawa amadziwika ndi mawonekedwe a mayamwidwe, kugawa, kagayidwe ndi kutulutsa kwa zigawo zikuluzikulu.

1. Ntchito ndi kugawa. Pazitali kwambiri pazinthu zimafikiridwa maola awiri pambuyo pokhazikitsa. Gawo lake limatengeka mwachangu kuchokera kumimba yodyetsera (m'mimba). Kulumikizidwa kwa zinthu ndi mapuloteni a plasma kumafika pa 97%.
2. Metabolism imachitika pafupifupi m'chiwindi.
3. Kuswana. Kuongolera izi kumachitika ndi impso. Kukula kwa chinthu kumachitika limodzi ndi mkodzo ndi bile kudzera mkodzo. Hafu ya moyo imatenga maola 10.

1. The mayamwidwe ndi kufalitsa mu zimakhala za chigawocho chimachitika mwachangu komanso mosavuta.
2. Kukula kwa chinthu kuchokera mthupi kumachitika mosasinthika kudzera mu impso ndi matumbo. Kuchotsa hafu ya moyo kumatenga maola 7.

Zizindikiro ndi contraindication kuti mugwiritse ntchito

Mankhwala tikulimbikitsidwa kuti mugwiritse ntchito ndi matenda a shuga a 2, mukamadya zakudya komanso kugwiritsa ntchito mankhwala ena osathandiza.

• Hypersensitivity ku zilizonse za mankhwala,
• mtundu 1 shuga
• matenda ashuga
• lactic acidosis,
• ketoacidosis
• chikomokere (hypoglycemic kapena hyperglycemic),
• kuvulala kwambiri aimpso,
• matenda a chiwindi, impso,
• zigawenga
• kukhalapo kwa matenda opatsirana,
• kuchitapo kanthu kwa opaleshoni, limodzi ndi kutayika kwambiri kwa magazi,
• kuvulala kapena kuwotcha
• chilichonse chikufuna kugwiritsa ntchito mankhwala a insulin,
• leukopenia
• porphyria
• kusintha kwa dystrophic
• kuledzera
• nthawi yoyamwitsa,
• Ana, achinyamata osakwana zaka 18,
• mimba

Malangizo ogwiritsira ntchito ndi malangizo apadera

Mapiritsi amatengedwa pakamwa ndi zakudya. Mlingo wa mankhwalawa ayenera kusankhidwa ndi dokotala, poganizira momwe kagayidwe kazinthu kamene kamayambira ndi glycemia wodwala.

Kumwa mankhwala nthawi zambiri kumayamba ndi piritsi limodzi. Kutengera ndi zotsatira za mankhwala, mankhwalawa amatha kusiyanasiyana. Chiwerengero chokwanira cha mapiritsi ololedwa patsiku ndi 6, chifukwa ndiwowopsa kumwa nawo. Kuchita bwino kwa mitundu yosankhidwa ya mankhwala kumatsimikiziridwa ndi phindu la glucose.

Ndikofunika kuti odwala azitsatira malangizo a dokotala pazakudya, njira yoyendetsera ndi kumwa mankhwala. Ndi shuga wowola, kufa ndi njala, kuledzera, chiwindi chokwanira, komanso chiwonetsero chilichonse cha hypoxia, mapiritsi amayenera kumwedwa mosamala chifukwa cha ngozi yomwe ilipo ya lactic acidosis. Izi zimachitika chifukwa cha kudzikundikira kwa metformin, chifukwa chomwe lactate imapezeka m'magazi.

Kulandila ndalama kumakhudzanso kuyesedwa kwa mayesedwe a magazi a creatinine:

• Kamodzi pachaka pantchito yachilendo ya impso (odwala matenda a shuga),
• zopitilira 2 pachaka mwa anthu omwe ali ndi HBV (kobadwa nako adrenal hyperplasia) kapena odwala okalamba.

• gwiritsani ntchito ndi diuretics mosamala
• musamwe mankhwalawa masiku awiri musanayambe kupimidwa X-ray kapena opaleshoni pogwiritsa ntchito opaleshoni, m'malo mwake ndi insulin kapena mankhwala ena,
• pitilizani kuthandizira pokhapokha maola 48 kuchokera nthawi yomwe opaleshoni iliyonse ingafunike komanso ngati zikugwira bwino impso,
• musamwe mowa limodzi ndi mankhwalawo kuti mupewe hypoglycemia kapena kupezeka kosiyanasiyana chifukwa chomwa mowa,
• mankhwalawa amachepetsa kuchuluka kwa ma psychomotor, omwe angayambitse kuyendetsa galimoto molakwika.

Matenda a shuga nthawi zambiri amakhala amodzi mwa matenda omwe wodwala amakhala nawo. Pamaso pa pathologies ena, ndikofunikira kumwa mankhwalawa mosamala kwambiri.

Gulu lapadera la odwala ndi:

• amayi oyembekezera kapena oyembekezera (mankhwalawa akuphwanya),
• Odwala omwe ali ndi vuto la chiwindi (mankhwala aletsedwa kugwiritsa ntchito),
• anthu omwe ali ndi mavuto a impso (okhala ndi creatinine ochokera ku 135 mmol / l mwa amuna ndipo opitilira 100 mmol / l mwa akazi, mankhwala othandizira amaletsedwa).

Mankhwalawa saloledwa kuti agwiritsidwe ntchito ndi odwala omwe ali ndi zaka zopitilira 60, chifukwa akamagwira ntchito zolimbitsa thupi amatha kuyamba lactic acidosis.

Zotsatira zoyipa ndi bongo

Kumwa mankhwalawa kumatha kuyambitsa zotsatirazi:

• mokhudzana ndi chakudya cham'mimba - kugwidwa ndi mseru komanso kusanza, kutaya kapena kuwonongeka kwathunthu, chilala chopanda pake,
• Kuchokera kuzungulira kwa magazi - leukopenia, komanso magazi m'thupi ndi pancytopenia,
• mogwirizana ndi mitsempha - mutu,
• kuyabwa, urticaria, erythema,
• hypoglycemia kapena lactic acidosis,
• zokonda mtima.

Ndi mankhwala osokoneza bongo ambiri, thanzi la wodwalayo limakulirakulira, hypoglycemia imayamba. Pankhaniyi, muyenera kudya michere. Kupita patsogolo kwa hypoglycemia kungayambitse kulephera kudziletsa komanso kuzindikira. Munthawi imeneyi, wodwalayo sangathenso kudya, motero shuga wamagalamu ndi chithandizo chamankhwala chofunikira.

Kuchita ndi mankhwala ena ndi analogi

Hypoglycemic zotsatira za mankhwala zimatheka mothandizidwa ndi othandizira monga:

• Coumarin zotumphukira,
• Salicylates,
• Mao zoletsa
• Phenylbutazone zotumphukira
• Sulfonamides,
• Miconazole
• Feniramidol
• Ethanoli

Kuchepetsa mphamvu ya kugwiritsa ntchito mankhwalawa zimakhudza:

• Glucocorticoids,
• Thiazide okodzetsa,
• njira zakulera (pamlomo),
• mahomoni kuti ateteze chithokomiro cha chithokomiro,
• Adrenaline.

Ngati Glibomet pazifukwa zina sizikwanira, pali zambiri zake, zomwe zimasiyana pakapangidwe ndi mtengo wake.

Zofanizira zazikulu:

Ndikofunikira kumvetsetsa kuti adokotala okha ndi omwe ayenera kupanga chisankho chokhudza kusintha kwa Glibomet ndi mankhwala ena.

Kanema pazanjira zisanu ndi ziwiri zochepetsera shuga kunyumba:

Maganizo a odwala komanso mitengo ya mankhwala

Kuchokera pakuwunika kwa odwala, titha kunena kuti mankhwalawa amayenera kumwedwa mosamala, popeza ali ndi zovuta zambiri, ndikofunikira kufunsa katswiri musanamwe mankhwalawo.

Ndinayamba kumwa mankhwalawo monga adanenera dokotala. Patsiku loyamba la chithandizo, adamva kawiri Zizindikiro za hypoglycemia, ngakhale kuti zakudya sizinasinthe. Sindinathe kupita kwa dokotala nthawi yomweyo, kotero ndinasankha ndekha kuti ndisayesenso ndipo ndinabwereranso kumwa mapiritsi akale.

Ndimakondwera kwambiri ndi Glibomet. Ndi chithandizo chake, zinali zotheka kusinthitsa shuga. Atawerenga malangizowo, poyamba anali ndi mantha ndi mndandanda waukulu wazotsatira zoyipa, koma adaganiza zokhulupirira dokotala. Zotsatira zake zidakondwera.

Chaka chatha ndidamwa mapiritsi awa. Mankhwalawa sanandigwirizire, chifukwa kulawa kwazitsulo mkamwa mwanga kunalipo nthawi zonse ndipo nthawi zina ndimakhala wosangalala.

Nikita Alexandrovich, wa zaka 65

Chidacho chimachepetsa shuga bwino, koma pakudya kwake simungathe kudumphanso ngakhale osakudya, osati monga zakudya zazikulu. Glybomet imafuna kudya pafupipafupi kuti pasakhale hypoglycemia.

Mtengo wa mankhwalawa ndi pafupifupi ma ruble 350 pamapiritsi 40.

Glybomet - kapangidwe

Kuphatikizidwa mu piritsi lililonse la mankhwala awiri omwe amagwira ntchito - metformin hydrochloride (400 mg) ndi glibenclamide (2.5 mg) zimapangitsa kuti azitha kupewa glycemia, komanso kuchepetsa mlingo wa magawo. Ngati aliyense wa iwo atagwiritsidwa ntchito ngati monotherapy, mlingo wake umakhala wokwera kwambiri.

Ili ndi chilinganizo ndi maipi mu mawonekedwe a cellulose, wowuma chimanga, colloidal silicon dioksidi, gelatin, glycerin, talc, magnesium stearate, acetylphthalyl cellulose, diethyl phthalate.

Zotsatira za pharmacological

Chimodzi mwazinthu zazikulu zomwe zimagwira, glibenclamide, ndi mankhwala a kalasi yamakono ya sulfonylurea, yomwe imaphatikizidwa mndandanda wa mankhwala ofunikira okhala ndi pancreatic ndi zowonjezera pancreatic.

Sizimangoyambitsa ntchito ya kapamba konse, komanso zimathandizira kupanga insulin. Limagwirira ntchito yawo imakhazikika poteteza ma pancreatic β-cell owonongeka ndi glucose ankhanza, omwe amawonetsa kupitilira kwa shuga, komanso kukondoweza kwa insulini kumva kwa maselo aku chandamale.

Kutenga Glibomet mogwirizana ndi glycemic control kumachepetsa kagayidwe ka lipid komanso kumachepetsa chiopsezo cha magazi. Ntchito ya insulin imawonjezeka, ndipo limodzi nawo mayamwidwe a glucose ndim minofu ndi chiwindi. Mankhwala amagwira gawo lachiwiri ndikupanga insulin.

Metformin ndi ya biguanides - kalasi ya zinthu zopatsa mphamvu zomwe zimachepetsa kusagwirizana kwa maselo akhungu kupita ku insulin yawoyawo. Kubwezeretsa kumva sikulinso kofunikira kuposa kupititsa patsogolo katulutsidwe ka timadzi tambiri, chifukwa ndi matenda amtundu wa 2, kapamba amatulutsa ngakhale ochulukirapo.

Metformin imathandizira kulumikizana kwa ma receptors ndi insulin, imawonjezera mphamvu ya postreceptor. Pakakhala insulin m'magazi, zozizwitsa zimawonetsedwa.

Metformin ili ndi mawonekedwe apadera:

Kuunikiridwa mozama kwa odwala matenda ashuga a 5800 omwe ali ndi matenda a shuga a 2 adachitika ku China. Otenga nawo mbali pachiyeso adalandira metformin kuphatikizira ndi kusintha kwa moyo. Gulu lolamulira, odzipereka anangosintha moyo wawo. Kwa miyezi isanu ndi umodzi, mgulu loyamba, kufa anali anthu 7.5 pa anthu 1000 / zaka, chachiwiri - kwa miyezi 45, anthu 11, motsatana.

Mwambiri, pagululi lomwe limalandira metformin ,imfa inali yotsika ndi 29,5% kuposa momwe amawongolera, ndipo pafupipafupi zochitika zamtima zinali 30-35%.

Mankhwalawa amayamba kugwira ntchito maola awiri atalowa m'mphepete, mphamvu yake imapangidwa kwa maola 12. Metformin siziwopseza hypoglycemic. Mankhwala okhala ndi umboni wokwanira, wadutsa mayeso okhazikika a nthawi ndipo amafunikira matenda ashuga pamilingo yonse yolimbikitsira mankhwala.

Masiku ano, msika wogulitsa mankhwala umapereka magawo 10 a mankhwala antidiabetes, koma metformin akadali mankhwala odziwika kwambiri ochizira matenda a shuga 2 pachimake chilichonse cha matendawa.

Kuphatikiza kwa synergistic pazinthu ziwiri zomwe zikugwira ntchito ku Glibomet kumatha kusintha thupi.

Mlingo woyenera wa kuchuluka kwa zinthu zomwe zimagwira ntchito zimatha kusintha mlingo wa mankhwala. Kwa ma b-cell, kusunthika kotereku ndikofunikira kwambiri: kumawonjezera chitetezo cha mankhwalawa, kuchepetsa chiopsezo cha kuwonongeka kwa magwiridwe antchito, ndikuchepetsa mwayi wokhala ndi zotsatirapo zoyipa.

Mphamvu ya Pharmacokinetic

Glybenclamide kuchokera m'matumbo am'mimba amatengedwa ndikugawidwa bwino - ndi 84%, kuchuluka kwa mankhwalawa kumatha kuwonedwa pambuyo pa maola 1-2. Gawo lomwe limapangidwa ndimapuloteni a magazi ndi 97%.

Metabolism ya Glibenclamide imachitika m'chiwindi, pomwe imasinthidwa kwathunthu kukhala metabolites yogwira. Hafu ya zinthu zomwe zawonongeka imadutsa impso, theka linalo kudzera m'miyendo ya bile. Hafu ya moyo amakhala pafupifupi maola 10.

Metformin imalowa kwathunthu m'matumbo am'mimba, imagawidwa nthawi yomweyo ku ziwalo ndi minofu, sikugwirizana ndi mapuloteni amwazi konse. The bioavailability wa chigawo chimachokera 50-60%.

Mu thupi, pafupifupi simapukusidwa; momwe limapangidwira, limapukusidwa ndi impso ndi matumbo. Kuchotsa theka moyo ndi pafupifupi maola 10.

Pazonse, kuchuluka kwakukulu kwa zosakaniza zamkati mwa magazi kumachitika ola limodzi kapena awiri mutamwa mapiritsi.

Zisonyezero zochizira ndi Glybomet

Malangizo akuwonetsa kuti mankhwalawa ndi omwe amaperekedwa kwa odwala matenda ashuga amtundu wa 2, kuphatikizapo odwala matenda a shuga omwe amadalira odwala matenda ashuga, ngati zakudya zapadera, zomwe zimapangitsa kuti azichita masewera olimbitsa thupi komanso zina mwa njira zina za hypoglycemic sizinapereke zotsatira zake.

Mankhwala ambiri amakhala ndi zotsatira zowonjezera, ngati thupi siliyankha moyenera mankhwala, amasintha algorithm ya mankhwala polemba Glibomet pamapiritsi.

Momwe mungatenge Glibomet

Poona ndemanga za ma endocrinologists, kuti mupewe lactic acidosis, odwala matenda ashuga kuposa zaka 60, olimbitsa thupi tsiku lililonse, muyenera kumwa mosamala, kujambula glucometer pafupipafupi.

Pali zoletsa kutenga Glibomet:

Mlingowo umatsimikiziridwa ndi endocrinologist malinga ndi zaka za wodwala komanso mawonekedwe azachipatala, koma wopanga akuwonetsa kuti akuyamba ndi mapiritsi awiri tsiku lililonse, akumagwiritsa ntchito mankhwalawo. Mulingo waukulu wa mankhwalawa ndi 2 g / tsiku. Ndikofunika kugawa phwandoli nthawi zonse. Ngati chiwerengerochi sichikuyembekezeredwa, chithandizo chovuta chimayikidwa ndi kuwonjezera kwa mankhwala amphamvu.

Zotsatira zoyipa ndi bongo

Pali zotsatira zoyipa zambiri zomwe zimachitika mutatha kumwa Glibomet, koma izi siziyenera kukhala chifukwa chokana mankhwalawa, chifukwa kuvulaza komwe thupi sakulipirira matenda ashuga kumakhala kwakukulu kwambiri kuposa kuwopsa kwa zotsatira zoyipa.

Kuti mupewe zoterezi, ndikofunikira kuwerengera mlingo wake. Ngati chizolowezichi chachulukira, odwala matendawa amadzutsa njala yosatha, mphamvu zake, mantha, kugwedezeka kwa dzanja.

Zizindikiro za mankhwala osokoneza bongo amathanso kukhala tachycardia, khungu pakhungu, kuchuluka thukuta, kukomoka.

Zotsatira zoyipa kwambiri mutatha kutenga Glibomed, hypoglycemia imakhala yangozi kwambiri pamtunduwu kwa odwala omwe afooka chifukwa cha matenda omwe atenga nthawi yayitali, odwala matenda ashuga okalamba omwe ali ndi matenda osokoneza bongo a nthawi yayitali, zidakwa, anthu omwe amagwira ntchito zolimbitsa thupi, komanso aliyense amene amakhala ndi theka-nthawi yanjala ( zosakwana 1000 kcal / tsiku.) zakudya.

Mwa Zizindikiro zodziwika bwino, ambiri ndi:

Ngati kusakhalitsa kwakanthawi kumachitika mutamwa mapiritsi, kumatha kuthetseratu chithandizo chamankhwala. Ngati zizindikiro zili zolimba kapena zizindikiro za ziwonetsero zimawonekera, ndiye kuti muyenera kusankha mtundu wa Glibomet.

Zotsatira Zogwiritsa Ntchito Mankhwala

Kuwonjezeka kwa hypoglycemic zotsatira za Glybomet kumawonedwa panthawi yofanana ndi zotumphukira za decumarol, phenylbutamazone, β-blockers, oxytetracycline, allopurinol, cimetidine, ethanol, sulfinpyrazone mu Mlingo wofunikira, phenenecid, chloramphenicol, prophylonocole wamkulu, .

Mankhwala ophatikizidwa ndi mahomoni a chithokomiro, zoteteza pakamwa, barbiturates, mankhwala a thiazide diuretic amalepheretsa Glibomet.

Nawo, zomwe zimagwira mu Glibomet zimathandizira ngati anticoagulants.

Malangizo apadera

Kugwiritsa ntchito Glibomet kumayimitsidwa nthawi yomweyo ngati pali zizindikiro za lactic acidosis: kufooka kwambiri, kusanza, kuphipha kwa minofu, kupweteka pamimba. Wovutitsidwayo amafunikira kuchipatala mwachangu.

Malangizowo akuwalimbikitsa kuti azilandira chithandizo ndi Glybomet kuti aperekeze kuwunika kwa creatinine poyesa magazi. Kwa odwala matenda ashuga omwe ali ndi impso wathanzi, kuwunika koteroko ndikofunikira kamodzi pachaka, odwala omwe mtundu wawo wa creatinine ali pafupi kwambiri ndi malire, ndipo odwala okhwima ayenera kuyesedwa kawiri pachaka.

Masiku awiri asanachitike opaleshoni yokonzekera, momwe kugwiritsa ntchito mankhwala owononga a msana kapena obalalitsa, kutenga Glibomet kwathetsedwa ndipo odwala matenda ashuga asinthika kukhala a insulin . Mutha kubwezeretsa njira ya mankhwalawa ndi Glybomet pambuyo poti wodwala waloledwa kudya mkamwa. Ngakhale ndi impso zomwe zimagwira ntchito pafupipafupi, adotolo samapanga chisankhochi pasanathe masiku awiri opareshoni.

Kumwa mapiritsi pamafunika kusamala mukamagwira ntchito yomwe ingakhale yoopsa ku moyo komanso thanzi, komanso poyendetsa magalimoto. Izi zimaphatikizidwa ndi chiopsezo cha hypoglycemia, kuchepa kwa kuchuluka kwa zochitika zama psychomotor komanso kuthekera kwakuya kwambiri.

Zotsatira za chithandizo chamankhwala ndi Glybomet zimadalira kwambiri kulondola kwa kutsatira malangizo ndi malangizo a endocrinologist: kudya ndi kugona ndikupumula, kuchita masewera olimbitsa thupi pafupipafupi, kuwongolera glycemic mwadongosolo, kuphatikizapo kunyumba.

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuchepetsa kumwa kwambiri momwe mungathere (chizolowezi chimakhala kapu ya vinyo wofiyira kamodzi pa sabata), popeza ethanol imayambitsa chitukuko cha glycemia, komanso mavuto a disulfiram - ululu m'chigawo cha epigastric, mavuto a dyspeptic, kutentha kwa thupi ndi mutu, kutayika. kulumikizana, kupweteka mutu, palpitations.

Pakulephera kwa impso, Glybomet imalephera kupezeka pomwe amawunika KK apamwamba kuposa 135 mmol / l, ngati wodwala ndi wamwamuna, ndipo pamwamba pa 110 mmol / l, ngati wodwala matenda ashuga ndi mkazi.

Mtengo wa mankhwala ndi malamulo osungira

Kodi Glybomet ndi yotsika mtengo ku malo ogulitsa mankhwala? Kutengera ndi dera, mankhwalawo amatha kugulitsidwa ma ruble 200-350. Phukusi lililonse la Glibomet, chithunzi chake chomwe chikuwoneka m'gawoli, chili ndi miyala 40.
Kuti mankhwalawa asathenso kugwira ntchito, ayenera kutetezedwa kuchokera ku dzuwa lowala komanso chinyezi chachikulu.

Mankhwala ofanana

Ngati Glibomed ngakhale mu zovuta mankhwala samapereka kufunika, chifuwa kapena zina zoyipa zawoneka, mankhwalawo amaloŵedwa ndi analogues ndi chinthu choyenera chogwira ntchito.

Kwa Glibomed, mankhwalawa amatha kukhala mapiritsi a Diabeteson, gawo lalikulu lomwe limagwira ndi glyclazide, kapena Dimaril, momwe gulu lothandizira limafanana ndi imodzi mwazinthu za Glibomed, glimepiride.

Mankhwala ena othandizira odwala omwe ali ndi vuto lofananalo, Gluconorm, Bagomet Plus, Glucovans, Glibenclamide osakanikirana ndi Metformin, Glyukofast adalembedwa.
The endocrinologist amapanga m'malo, awerengeranso mlingo. Kusintha kwa regimen ya chithandizo ndikotheka: ma analogu amafotokozedwa onse muzovuta kuchipatala komanso mawonekedwe a monotherapy, kuwonjezera pa zakudya zosachepera carb komanso zolimbitsa thupi.

Ndizosatheka kulosera momwe thupi lingachitire mankhwala atsopano, nthawi yoyamba ndikofunikira mverani zonse zomwe mukuwuza ndikuwuzeni adotolo za kusintha kwamwadzidzidzi kulemera kwake, kuchepa mphamvu kwa thupi, Zotsatira za kuyesedwa kwa glycemia ndi glucometer ndi zina zofunika panthawi yankhani.

Dzina lachi Latin: Glibomet
Code ya ATX: A10B D02
Chithandizo: Glibenclamide
ndi metformin hydrochloride
Wopanga: Berlin Chemie, Germany
Matchuthi ku pharmacy: Ndi mankhwala
Malo osungirako: mpaka 25 C
Tsiku lotha ntchito: Zaka zitatu

Glibomet amatanthauza mankhwala a hypoglycemic, omwe amalembera mtundu II matenda a shuga.

Mankhwala a Glibomet amasonyezedwa ngati pali matenda a shuga a 2 (insulin safunika), pamene mankhwala omwe amagwiritsidwa ntchito munthawi yomweyo amagwiritsa ntchito mankhwala akulu kapena sulfonylurea sanali othandiza.

Kupanga ndi mawonekedwe a kumasulidwa

Kapangidwe ka piritsi ya Glibomet kumaphatikizapo magawo awiri ogwira ntchito, omwe ndi glibenclamide, komanso metformin hydrochloride, gawo lalikulu la zinthu izi ndi 2.5 mg ndi 400 mg, motsatana. Zowonjezera zomwe zilipo:

• Glycerol dibehenate
• Povidone
• Colloidal silicon dioxide
• Magnesium wakuba
• Croscarmellose sodium
• Macrogol.

Mapiritsi ndi ozungulira, oyera kwamiyala, pali chiopsezo mbali imodzi. Mapiritsi amayikidwa mu chithuza chamtundu wa ma PC 20, M'kati mwa matuza awiri.

Kuchiritsa katundu

Glibomet ndi ya nambala ya mankhwalawa a hypoglycemic omwe ali ndi kuphatikiza, zomwe zimagwira ndi zotumphukira za sulfonylurea, komanso genuanideide yachiwiri. Mankhwala amathandizira kaphatikizidwe ka insulin mu kapamba chifukwa chochepetsa kupindika kwa β-cell mwa glucose yokha. Thupi limakulitsa chiwopsezo cha insulin, pomwe kumangiriza ma cell enieniwo kumawonjezeka, ndipo kutulutsidwa kwa insulin kumakhala bwino. Pa mankhwala antidiabetesic, njira ya mayamwidwe a glucose ndi maselo a chiwindi ndi minofu imakhala yofanana, imalepheretsa lipolysis yomwe imapezeka mu minofu ya adipose. Kuwonetsedwa kwa glibenclamide kwalembedwa gawo lachiwiri la insulin secretion.

Metformin ndi membala wa gulu la Biguanide. Imakhala ndi mphamvu yolimbikitsira kuzizira kwa minofu kuti ipangire insulin, imachepetsa kuyamwa kwa glucose mwachindunji m'matumbo, imalepheretsa gluconeogeneis, komanso imakhudza bwino njira ya metabolid ya lipid. Potengera momwe izi zakhudzidwira, ndizotheka kuchepetsa msanga thupi mwa anthu omwe akudwala matenda ashuga.

Zotsatira za hypoglycemic za mankhwala Glibomet zimalembedwa patatha maola awiri pambuyo poti atenge mapiritsi ndipo maola 12 otsatira apulumutsidwa. Chifukwa cha kuphatikiza kwa zinthu ziwiri zogwira ntchito, kaphatikizidwe ka insulin yomwe imatchedwa kuti endo native, imakhudzanso mwachangu osati minofu ndi adipose, komanso minofu ya chiwindi (chifukwa cha kuchepa kwa gluconeogenesis). Pankhaniyi, kukondoweza mwamphamvu kwa β-cell ya kapamba sikunalembedwe, komwe kumachepetsa mwayi wa ziwalo zam'magazi komanso kukula kwa zizindikiro zingapo zammbali.

Mlingo wa mayamwidwe a glibenclamide ndi mucosa wam'mimba uli pafupifupi 84%. Mlingo wapamwamba kwambiri wa chinthuchi m'magazi amalembedwa mkati mwa maola 1-2 atatha kugwiritsa ntchito mankhwala. Kuyankhulana ndi mapuloteni a plasma - 97%. Kusintha kwa metabolism kwa chinthuchi kumachitika m'maselo a chiwindi; zotsatira zake, ma metabolites angapo osagwira amapangidwa. Mukamachotsa zinthu za metabolic, matumbo am'mimba komanso dongosolo la impso zimakhudzidwa. Kutha kwa theka la moyo nthawi zambiri sikuyenera kupitirira maola 5-10.

Kuyamwa kwa metformin ndi mucosa wam'mimba kwambiri. Ikafika mu kayendedwe ka systemic, kugawa kwake mwachangu mu minofu kumawonedwa, pafupifupi sikulowa muubwenzi ndi mapuloteni a plasma. Izi zimapangidwa pang'ono, zotulutsidwa ndi aimpso ndi matumbo. Hafu ya moyo wa metformin ndi maola 7.

Glibomet: malangizo onse ogwiritsira ntchito

Mankhwala adapangira pakamwa. Tengani Glybomet ndi zakudya. Mlingo ndi njira ya chithandizo zimasankhidwa payekha poganizira zomwe zikupezeka m'thupi, kuchuluka kwa shuga m'magazi, komanso chithunzi chonse cha metabolism ya carbohydrate.

Nthawi zambiri, muyeso woyamba wa mankhwala Glibomet ndi mapiritsi atatu. Munthawi ya antiidiabetesic mankhwala, mlingo wogwira bwino kwambiri umasankhidwa, womwe umachepetsa kuchuluka kwa shuga pamikhalidwe yokhazikika. Ndizofunikira kudziwa kuti mulingo wapamwamba kwambiri wa mankhwala tsiku lililonse ndi mapiritsi 6.

Contraindication ndi Kusamala

• Kutengeka kwambiri kwa zinthu zoyambira komanso zowonjezera
• Insellinus wodwala matenda a shuga
• Khalani mu matenda a shuga kapena odwala
• Zambiri hypoglycemia
• Ketoacidosis
• Kuphwanya chiwindi ndi impso
• Mimba, GV
• Lactic acidosis.

Muyenera kuthetseratu chithandizo chamankhwala a Glibomet ndi zizindikiro zoyambirira za lactic acidosis (mawonekedwe a kupweteka kwa kupweteka, kupweteka kwa epigastric, ulesi, kulimbikitsa kusanza) ndi kufunsa uphungu wa dokotala.

Pa mankhwala othandizira odwala matenda ashuga, ndikofunikira kuyang'ananso creatine m'magazi: pakalibe matenda a impso - 1 p. chaka chonse, ndi chidziwitso chowonjezeka cha creatine ndi odwala okalamba - 2-4 p. kwa miyezi 12

Mankhwalawa adzafunika kumalizidwa maola 48 asanafike opaleshoni yomuchitira opaleshoni. Mutha kupitiliza maphunzirowa mukatha kubwezeretsanso zakudya zamagulu onse, koma osapitirira maola 48 mutatha kugwira ntchito ndi chitsimikiziro cha impso yonse.

Mankhwala othandizira odwala matenda ashuga, chisamaliro chikuyenera kuchitika mukamagwira ntchito moyenera ndi kuyendetsa galimoto, chifukwa vuto la hypoglycemia, kuthamanga kwa malingaliro ndi zochitika zama psychomotor zimatha kuchepa kwambiri.

Kuchita bwino kwa mankhwalawa kumatengera kutsatira malangizo a dokotala pokhudzana ndi kuchuluka kwa zakudya, zakudya, zochita zolimbitsa thupi komanso kuyang'anira shuga.

Ndikofunikira kupatula zakumwa zoledzeretsa, chifukwa pamakhala chiopsezo cha hypoglycemia kapena zotchulidwa zofanana ndi disulfiram.

Kuchita mankhwala osokoneza bongo

Mphamvu ya hypoglycemic ya mankhwala imatha kupitilizidwa ndi munthawi yomweyo kugwiritsa ntchito β-blockers, zotumphukira za zinthu monga coumarin ndi phenylbutazone, ma inhibitors a MAO, salicylates, miconazole, cimetidine, sulfanilamides ndi sulfonamides, oxytetracycline, phenenlidenoniden, pheneneciden, phenenliden. komanso perhexiline.

Ma COC, mankhwala ozikidwa ndi mahomoni a chithokomiro, adrenaline, corticosteroids, okodzetsa a gulu la thiazide limodzi ndi barbiturates amachepetsa mphamvu ya Glogometic ya Glibomet.

Pogwiritsa ntchito anticoagulants, kuwonjezeka kwa zotsatira zawo kungawonedwe.

Ngakhale kumwa cimetidine, kuwonjezereka kwa mwayi wa lactic acidosis ndikotheka.

Mukamamwa ma β-blockers, zizindikiro zofatsa za hypoglycemia ndizotheka.

Mukamagwiritsa ntchito mankhwala a iodine okhala ndi ayodini, pamakhala chiwopsezo cha ntchito yaimpso, komanso kuwerengera kwachiwiri kwa yogwira mankhwala - metformin, yomwe pambuyo pake imayambitsa lactic acidosis.

Zotsatira zoyipa ndi bongo

Omwera mankhwalawa amatha kukumana ndi zovuta zingapo:

• M`mimba thirakiti: nseru kwambiri ndi chidwi kusanza, kusowa chilolezo, kupweteka kwa m'mimba, kutsegula m'mimba, kutsekemera kwazitsulo kwamkamwa, osowa kwambiri - ntchito zowonjezera za transaminases
• Dongosolo la hematopoietic: kupezeka kwa thrombocytopenia, leukopenia, komanso erythrocytopenia, kawirikawiri - anemia (meWIblastic kapena hemolytic mtundu), pancytopenia, agranulocytosis
• CNS: mutu wambiri
• Khungu: zotupa za urticaria, pruritus, erythema, Zizindikiro zam'maso
• Metabolism: kupezeka kwa hypokalemia, nthawi zina - lactic acidosis.

Ngati ndi kotheka, dokotala amatha kusankha mtundu wa mankhwala Glybomet (mwachitsanzo, Diabetes). Zomwe zili bwino Glibomet kapena Diabeteson, ndikofunikira kuyang'ana ndi dokotala.

Mwina kukula kwa lactic acidosis (kumakhudzidwa ndi kukhudzana ndi metformin) ndi hypoglycemia (yokhala ndi glibenclamide).

Mankhwala othandizira: okhala ndi zizindikiro za lactic acidosis, muyenera kuletsa mankhwalawo mwachangu ndikupempha thandizo lachipatala. Pankhaniyi, hemodialysis imawerengedwa kuti ndi njira yothandiza yoletsa zizindikiro za matendawa.

Wodwala akakhala kuti alibe chikumbumtima, ndiye kuti 40% ya dextrose yovomerezeka imalowetsedwa mu mtsempha (pafupifupi pafupifupi 80 ml), ndiye kuti 10% dextrose solution iyenera kupatsidwa. Chithandizo chotsatira chimaphatikizidwa ndi makonzedwe a glucagan (1 ml). Ngati, atachita mankhwalawa, wodwalayo sangadziwe, zomwe akufotokozedwazo zibwerezedwa. Palibe achire zotsatira, njira yochotseredwa yolimba imayikidwa.

Ogwira Ntchito Zogwira Ntchito, France

Mtengo kuyambira 269 mpaka 366 rubles.

Diabetes - mankhwala omwe amadziwika ndi zotsatira za hypoglycemic. Amasankha mtundu wachiwiri wa matenda osokoneza bongo kuti athe kuwongolera kaphatikizidwe ka insulin. Zogwira ntchito za Diabeteson ndi gliclazide. Amapezeka piritsi.

• Mtengo wololera
• Zimathandizira kuwonda
• Amachepetsa kuopsa kwa matenda ashuga.

• Zosagwiritsidwa ntchito panthawi yoyembekezera
• Panthawi ya makonzedwe, kusokonezeka m'mimba kumatha
• Siwothandiza aliyense.

Malangizo omaliza opanga 18.07.2005

Zotsatira za pharmacological

Glibenclamide - Imalimbitsa katemera wa insulin pochepetsa kutsika kwa shuga wa khungu la cell wa glucose, imakulitsa chidwi cha insulin komanso kumangika kwa maselo ojambulidwa, imawonjezera kutulutsidwa kwa insulini, ndikuwonjezera mphamvu ya insulini pakukoka minofu ndi chiwindi. Machitidwe mu gawo lachiwiri la insulin katulutsidwe.
Metformin - amalepheretsa gluconeogeneis m'chiwindi, amachepetsa mayamwidwe am'mimba kuchokera m'matumbo am'mimba ndikuwonjezera kugwiritsidwa ntchito kwake mu minofu, amachepetsa zomwe zimachitika mu triglycerides ndi cholesterol mu seramu yamagazi. Amawonjezera kumangiriza kwa insulin ku ma receptors (pakalibe insulini m'magazi, chithandizo cha mankhwala sichikuwonetsedwa). Sichimayambitsa kukhudzana kwa hypoglycemic.

Pharmacokinetics

Glibenclamide mwachangu komanso mwachilungamo (84%) imalowa mu mgodi. Nthawi yofikira C max - maola 7-8. Kumangiriza mapuloteni a plasma - 97%. Imakhala ngati imapukusidwa kwathunthu m'chiwindi kuti metabolites osagwira. 50% imachotseredwa impso ndi 50% ndi bile. T 1/2 - 10-16 h.
Metformin pambuyo mayamwidwe m'mimba thirakiti (mayamwidwe - 48-52%) ndi impso (makamaka osasinthika), pang'ono ndi matumbo. T 1/2 - 9-12 h.

Mlingo ndi makonzedwe

Mkati ndikudya. Mlingo umayikidwa payekha, kutengera mtundu wa metabolism wa chakudya ndi shuga m'magazi. Nthawi zambiri mlingo woyambirira ndi mapiritsi 1-3. patsiku ndi kusankha pang'onopang'ono kwa mankhwalawo kufikira chindapusa chokhazikika cha matendawa. Malangizo oyenera amamwa mankhwalawa katatu patsiku (m'mawa ndi madzulo). Sitikulimbikitsidwa kumwa mapiritsi oposa 5. Glibometa patsiku.

Mafotokozedwe a magulu a nosological

Nthawi zina zimakhala zofunika, makamaka pankhani ya odwala matenda ashuga omwe amafunikira mankhwala ena kuti azitha kupereka shuga m'magazi. Inde, pamsika wamakono wamankhwala pali mankhwala ambiri otere. Koma akatswiri nthawi zambiri amalimbikitsa mankhwalawa "Glibomet." Kuunikira kwa odwala matenda ashuga komanso madokotala akuwonetsa kuti mankhwalawa amakulolani kupirira mavuto.

Kufotokozera kwa kapangidwe kake. Fomu Yotulutsira Mankhwala

Mankhwala "Glibomet" amapezeka mu mawonekedwe a mapiritsi ozungulira oyera okhala ndi chipolopolo cholimba. Amayikidwa m'matumba oyenera a zidutswa 20. Mu pharmacy mutha kugula phukusi lokhala ndi matuza awiri.

Ichi ndi chida chophatikizidwa, motero, kapangidwe kake kamakhala ndi magawo awiri othandizira - glibenclamide (2,5 ml piritsi limodzi) ndi metformin mu mawonekedwe a hydrochloride. Inde, kukonzekera kumakhalanso ndi zinthu zothandiza, makamaka, wowuma wa chimanga, silicon dioxide, cellcrystalline cellulose, talc, diethyl phthalate, glycerin, cellulose acetate phthalate, gelatin.

Kodi mankhwalawa amakhudza bwanji thupi?

Inde, poyambira, ndikofunikira kumvetsetsa zomwe mankhwalawo ali. Zotsatira za hypoglycemic pokonzekera Glibomet zimatsimikiziridwa ndi zomwe zili ndi zigawo ziwiri nthawi imodzi.

Chida ichi chimagwira pa kapamba, monga madera omwe amayang'anira thupi. Nthawi yomweyo, mankhwalawa amathandizira chidwi cha maselo olimbana ndi mahomoni awa. Chifukwa chake, Glibomet imathandizira kutsitsa shuga wamagazi popanda kugwiritsa ntchito insulin yopanga, yofunikira kwambiri kwa matenda ashuga a 2.

Mankhwala amakhalanso ndi milomo yotsitsa lipid. Mothandizidwa ndi iye, kuchuluka kwa mafuta m'magazi kumatsika, komwe kumachepetsa mwayi wamagazi m'magazi (ma magazi). Metformin ndi m'gulu la Biguanides. Izi zimayambitsa njira zamagwiritsidwe ntchito a glucose ndi minofu, zimalepheretsa gluconeogeneis mu chiwindi, ndipo zimalepheretsa adsorption yama chakudya ndi makhoma a m'mimba.

Glibenclamide imatengedwa mwachangu ndi makhoma a matumbo ndipo imakhala pafupi kwathunthu (97%) yomanga mapuloteni a plasma. Mu chiwindi, limasweka, ndikupanga metabolites osagwira, omwe amachotsedwa m'thupi limodzi ndi ndowe ndi mkodzo. Hafu ya moyo ndi maola 5. Metformin imadziwikanso mwachangu mthupi, koma sikugwirizana ndi mapuloteni a plasma. Izi sizimaphatikizidwa m'thupi. wofanana ndi maola awiri.

Kodi mankhwalawo amagwiritsidwa ntchito bwanji?

Anthu ambiri ali ndi matenda onga matenda ashuga 2. Zakudya ndi chithandizo pankhaniyi ndizofunikira kwambiri. Monga lamulo, kwa odwala amapanga zakudya zoyenera. Mutha kusintha shuga yanu yamagazi ndi sulfonylureas.

Mankhwala "Glibomet" amawonetsedwa ngati chithandizo chamankhwala ndikudya ndalama zomwe zili pamwambazi sizimapereka mphamvu yofunikira.

Momwe mungamwe mankhwalawa "Glibomet"? Mlingo umatsimikiziridwa payekhapayekha. Monga lamulo, mlingo woyambirira ndi mapiritsi awiri. Amatengedwa ndi chakudya. Komanso, kuchuluka kwa mankhwalawa kumawonjezereka kuti akwaniritse kwambiri. Mlingo wa tsiku ndi tsiku sayenera kupitirira 2 g ya metformin. Kenako, mlingo umachepetsedwa.

Mankhwala "Glibomet": contraindication pa mankhwala

Uwu ndi mankhwala amphamvu komanso amphamvu, kulandiridwa kwake komwe kumatheka kokha ndi chilolezo cha dokotala. Mankhwala ali ndi mndandanda wosangalatsa wa zotsutsana, zomwe muyenera kuzidziwa musanayambe chithandizo:

• Hypersensitivity magawo othandizira komanso othandiza pamapiritsi,
• Matupi a sulfonylurea zotumphukira zina, komanso sulfamide, probenecid kapena sulfamide diuretics,
• Mankhwala omwe amapezeka mwa amayi panthawi yoyembekezera,
• kuchepa kwa mphamvu kuchokera ku mankhwala,
• matenda ashuga komanso ovuta
• kukhumudwa kwa aimpso, kulephera kwa impso,
• kusowa kwamadzi
• matenda opatsirana
• matenda otupa omwe angayambitse kukula kwa minofu hypoxia,
• kwambiri pathologies a mtima dongosolo, kuphatikizapo mavuto kufalikira, kuchepa kwa mtima, kuchepa kwa matenda oopsa ndi mtima.
• matenda oopsa a kupuma kwamthupi,
• myocardial infaration kapena nthawi yokonzanso pambuyo pake,
• kugwiritsa ntchito munthawi yomweyo mankhwala okodzetsa ndi mankhwala a kuthamanga kwa magazi,
• acidosis kapena chiwopsezo cha chitukuko chake,
• kukhalapo kwa mbiri ya wodwalayo pamilandu ya lactic acidosis,
• matenda oopsa a chiwindi
• mavuto a kupuma,
• kukonzanso pambuyo pang'ono pang'ono kapamba,
• dystrophic pathologies,
• uchidakwa wambiri, mkhalidwe woledzera pachimake,
• magazi akutuluka
• zigawenga
• kuyamwa
• kusala kudya kapena kutsatira zakudya zokhwima.

Ngati muli ndi zilizonse zotsutsana pamwambapa, ndiye chifukwa chake muyenera kuuza a endocrinologist.

Kodi njira zochizira zoopsa zomwe zimabweretsa ndi ziti?

Kodi nthawi zonse kumakhala kotetezeka kumwa mapiritsi a Glibomet? Zotsatira zoyipa zakumbuyo zamankhwala ndizotheka. Milandu yakuchitika kwawo, komabe, sikujambulidwa nthawi zambiri, koma chithandizo chimakhudza magulu osiyanasiyana.

• Dongosolo la Lymphatic ndi magazi . Hemolytic anemia, leukopenia, thrombocytopenia, pancytopenia, erythrocytopenia.
• CNS . Nthawi ndi nthawi kupweteka kwa mutu, kusokonezeka kwa kamvekedwe ka malingaliro.
• Zowongolera masomphenya. Kusokonezeka kwa malo okhala, kuchepa kwa maonedwe acuity, komwe kumalumikizidwa ndi kusintha kwa shuga m'magazi.
• Kupenda . Kuwonjezeka kwambiri kwa thupi, hypoglycemia, lactic acidosis. Kuchiza kwa nthawi yayitali nthawi zina kumabweretsa kuyamwa kwa vitamini B12 m'matumbo, omwe pambuyo pake amathandizira kukulitsa kuchepa kwa magazi m'thupi.
• Matumbo oyenda . Kusanza, kusanza, kutulutsa, kupweteka m'zigawo za epigastric, kugona pafupipafupi, kusowa chilakolako chakufa, mawonekedwe akumaso amkamwa, kumverera kwadzadza m'mimba.
• Khungu komanso minyewa yofinya . Khungu loyenda, erythema, mitundu yosiyanasiyana ya exanthema, limakulitsa khungu lathu kuti lisinthe, khungu lawo siligwirizana.
• Thupi lawo siligwirizana . Kuwala pakhungu, kutupa, jaundice, kuchepa kwakukulu kwa kuthamanga kwa magazi, kupuma, zochitika zadzidzidzi.
• Chiwindi . Intrahepatic cholestasis, mankhwala a chiwindi.
• Mavuto ena amatha kuwonekera, makamaka, kuchuluka kwamkodzo tsiku lililonse, kuwonongeka kwa mapuloteni ndi sodium ndi thupi chifukwa cha kusokonezeka kwa impso.

Ndikofunika kudziwa kuti ambiri mwamavutikawa safuna kuti athetse chithandizo chokwanira - ndikokwanira kuti muchepetse mulingo wake ndipo zotsatirapo zake zimasiyana lokha. Kuchuluka kwa tsiku lililonse kwa mankhwalawa kuyenera kuwonjezeka pang'onopang'ono komanso pang'onopang'ono.

Zambiri pazokhudzana ndi mankhwala ena

Mankhwala "Glibomet" (metformin) sangatengedwe ndi ethyl mowa, chifukwa izi zimawonjezera mwayi wokhala ndi lactic acidosis. Pa chithandizo, zakumwa zoledzeretsa komanso zakumwa zoledzeretsa ziyenera kutayidwa.

Kugwiritsa ntchito mankhwalawa kumayimitsidwa maola 48 njira zisanagwiritsidwe ntchito poyerekeza ndi ayodini. Kugwiritsa ntchito munthawi yomweyo mankhwalawa kungayambitse kulephera kwa impso.

Ngati mutenga "Glibomet" limodzi ndi insulin, anabolic steroids, beta-adrenergic blockers, mankhwala a tetracycline, ndiye kuti chiopsezo chokhala ndi hypoglycemia chikuwonjezeka. Anthu odwala matenda ashuga nthawi zonse amafunika kudziwitsa dokotala za mankhwala omwe amamwa.

Mtengo ndi fanizo

Mankhwala amakono, mankhwala "Glibomet" amagwiritsidwa ntchito nthawi zambiri. Ndemanga ya anthu odwala matenda ashuga, zikuwonetsa ndi zotsutsana ndi, zinthu zofunika. Koma chosasiyananso ndi mtengo wake. Zachidziwikire, ndizovuta kutchula nambala yeniyeni, koma mwatsatanetsatane mtengo wa mapiritsi 40 umachokera ku 340 mpaka 380 rubles, womwe kwenikweni siwambiri.

Inde, mankhwalawa sakhala oyenera nthawi zonse kwa odwala. Pali zolowa m'malo zokwanira pamsika wamakono wamankhwala. Mwachitsanzo, ndi matenda ashuga amtundu wachiwiri, njira monga Avandamet, Vokanamet, Glukovans amagwiritsidwa ntchito nthawi zambiri. Osatinso kawirikawiri, odwala amapatsidwa Dibizid, Dianorm kapena Sinjarji. Zachidziwikire, ndiopezeka pa endocrinologist okha omwe angasankhe analogue yothandiza.

Mankhwala "Glibomet": ndemanga za odwala matenda ashuga ndi madokotala

Mankhwalawa amagwiritsidwa ntchito kwambiri ngati mankhwala amakono. Koma kodi chithandizo ndi Glibomet chimawoneka bwanji? Ndemanga ya anthu odwala matenda ashuga, komanso akatswiri, amatsimikizira kuti mankhwalawa amathana bwino ndi zotsatira za matenda osokoneza bongo omwe amadalira shuga.

Malinga ndi kafukufuku, mankhwalawa amayambitsa gawo la kapamba yemwe amayambitsa kuphatikizira kwa insulin. Izi ndizomwe zimafunikira kwa matenda monga matenda a shuga 2. Zakudya ndi chithandizo pankhaniyi ndizofunikira kwambiri.

Mavuto azotsatira zamankhwala samachitika kawirikawiri. Mankhwalawa amalekeredwa bwino, ndipo mtengo wake ndi wovomerezeka.

Gulu lazachipatala komanso zamankhwala: & nbsp

Kuphatikizidwa ndi mankhwala osokoneza bongo

A.10.B.D.02 Metformin ndi sulfonamides

Wophatikiza antiglycemic wothandizira.

Kutenga kwa sulfonylurea kwa m'badwo wachiwiri, pochepetsa njira yolimbikitsira ma pancreatic β-cell ndi glucose, kumalimbikitsa kubisirana kwa insulin, kumawonjezera kutulutsidwa kwake komanso kuchuluka kwa zomangika kuti zigwire maselo. Zotsatira za hypoglycemic zimatengera kuchuluka kwa magwiritsidwe a β-cell.

Imaphatikizira kuphatikiza kwa maselo a m'magazi, imakhala ndi fibrinolytic, hypolipidemic ndi mphamvu yofooka.

Amachepetsa kuyamwa kwa glucose kuchokera m'matumbo ndikuwonjezera kugwiritsidwa ntchito kwake, kukulitsa chidwi cha minyewa kupita ku insulin, ndikuletsa gluconeogenesis m'chiwindi. Amachepetsa mulingo wochepetsetsa wa lipoprotein ndi triglycerides m'madzi a m'magazi. Sichimayambitsa kukhudzana kwa hypoglycemic, sikukhudzana ndi katulutsidwe ka insulin ndi β-cell ya kapamba. Mwa kupondereza zoletsa wa activator, minofu ya plasminogen imakhala ndi fibrinolytic. Imakhazikika kapena kuchepetsa thupi.

Pambuyo pakukonzekera pakamwa, imalowa mu matumbo a 90%. Kuzindikira kwakukulu mu plasma ya magazi kumachitika pambuyo pa maola awiri. Kuyankhulana ndi mapuloteni a plasma ndi 95%.

Pazipita achire zotsatira zimachitika pambuyo pa maola 7-8. Kutalika kwa kuchitapo kanthu ndi maola 12. Kutupa kwa chiwindi.

Kutha kwa theka-moyo kumapangitsa maola 2-10. Kuchotsa impso ndi ndowe.

Pambuyo pakamwa, mpaka 50-60% imalowetsedwa m'mimba. Kuzindikira kwakukulu mu plasma ya magazi kumachitika pambuyo pa maola 2,5. Sizimanga mapuloteni a plasma.

Amadziunjikira mu minofu ya minofu, tiziwalo tamadontho, impso ndi chiwindi.

Hafu ya moyo ndi maola 6. Kutha kwa impso sikunasinthe.

Amagwiritsidwa ntchito pochiza matenda osokoneza bongo omwe amadalira shuga.

IV.E10-E14.E11 Mellitus wosadalira insulin

Type I shuga mellitus (wodalira insulin), chikomokere, ketoacidosis, tsankho la munthu aliyense.

Chenjezo: Matenda oyamba a dongosolo la endocrine okhudza kagayidwe kazakudya: adenohypophysial ndi adrenocortical insuffence, chithokomiro cha chithokomiro. Mimba komanso kuyamwa: Mlingo ndi makonzedwe:

Momwe munaperekera chithandizo chotsatira ndi metformin ndi glibenclamide: mlingo woyambayo sayenera kupitirira mlingo wa tsiku ndi tsiku wa glibenclamide (kapena mlingo wofanana wa sulfonylurea wina) ndi metformin yomwe idatengedwa kale. Pakatha masabata awiri kapena angapo atayamba kumwa mankhwalawa, mankhwalawa amasinthidwa malinga ndi glycemia.

Mkati, pakudya, muyeso wa 2,5 mg wa glibenclamide ndi 500 mg ya metformin (piritsi 1) kawiri pa tsiku. Kuchuluka kapena kutsika kwa mlingo (kutengera kuchuluka kwa glucose m'magazi).

Mlingo wapamwamba kwambiri watsiku ndi tsiku (2,5 kapena 5 mg ya glibenclamide ndi 500 mg ya metformin): mapiritsi 4.

Mulingo wapamwamba kwambiri (2,5 mg glibenclamide ndi 500 mg metformin): piritsi limodzi.

Hematopoietic dongosolo : kawirikawiri - thrombocytopenia, erythrocytopenia, granulocytopenia, hemolytic anemia.

Matumbo oyenda : dyspepsia, nseru, kusanza, kutsegula m'mimba, chiwindi, cholestatic jaundice.

Dongosolo laumiseche : arthralgia.

Dermatological zimachitika zotupa.

Njira yamikodzo : proteinuria.

Pakati ndi zotumphukira mantha dongosolo : kusowa tulo, paresthesia, kutopa mtima.

Mtima wamtima : tachycardia.

Matumbo oyenda Kuchepa kwa chilimbikitso, kudzimbidwa, nthawi zina - kuchuluka kwa zotupa m'mimba.

Makina a minofu ndi mafupa: Zizindikiro za lactic acidosis ndimasamba a minofu ya ng'ombe.

Chithandizo: shuga mkatikati, mukukayika - kulowetsedwa kwa 40% dextrose solution.

Zoletsa za plasma ndende ya mankhwala zimawonjezera isoenzyme 3A4 cytochrome P450 zoletsa:.

Mlingo wa glycemia umachepetsedwa ndikugwiritsa ntchito mankhwala omwe ali ndi thiazide diuretics, blockers pang'onopang'ono calcium calcium, kukonzekera kwa lithiamu, glucocorticoids, isoniazid, sympathomimetics, nicotinic acid, phenytoin, phenothiazines, mahomoni a chithokomiro.

Pogwiritsa ntchito munthawi yomweyo ndi furosemide, kuchepetsa mlingo ndikofunikira.

Kumwa mowa (makamaka pamimba yopanda kanthu) pamankhwala kumayambitsa mawonekedwe osagwirizana, kumawonjezera kuchuluka kwa lactic acid m'madzi am'magazi komanso chiopsezo cha hypoglycemia.

Pa mimba ndi mkaka wa m`mawere, komanso muzochitika pambuyo kuvulala ndi ntchito yayikulu, mankhwalawa amasiya, mankhwalawa amapitilira jakisoni wa insulin.