Kufotokozera kwa mankhwala Metformin potengera zomwe zapezeka mu malangizo ake ogwiritsira ntchito.
Dzinalo Losayenerana
Metformin.
ATX
Zimatanthauzira gulu la pharmacological: othandizira pakamwa.
Code (ATC): A10BA02 (Metformin).
Kutulutsa mafomu ndi kapangidwe kake
Chithandizo chogwira ntchito: metformin hydrochloride.
Mapiritsiwo ndi oyera, owola, ndipo ali ndi chiopsezo pakatikati, makina ophatikizidwa ndi filimu, ali ndi nthenga, matumba, talc ndi 500 kapena 850 mg yogwira ntchito ngati zina zowonjezera.
Zotsatira za pharmacological
Hypoglycemic mankhwala amatanthauza biguanides - mankhwala ogwiritsira ntchito shuga. Amachepetsa kuchuluka kwa insulin (ndi mapuloteni am magazi), omwe amakwezedwa mu shuga. M'magazi, chiŵerengero cha insulin kuti proinsulin chiwonjezeke, chifukwa chomwe kusakhulupirika kwa insulini kumachepa. Mothandizidwa ndi mankhwalawa, palibe kuchuluka kwa kupanga kwa insulin kapena kukhudzidwa kwa kapamba.
Hypoglycemic mankhwala amatanthauza biguanides - mankhwala ogwiritsira ntchito shuga.
Mothandizidwa ndi mankhwalawa, kuchuluka kwa shuga m'magazi am'magazi kumachepetsa ngakhale zakudya.
The achire zotsatira za mankhwala amaperekedwa ndi:
- kutsika kwa kupanga kwa chiwindi ndi chiwindi chifukwa cha kulepheretsa kwa kagayidwe kazakudya ka glucose kosakanikirana ndi kapangidwe kazakudya zomanga thupi komanso kuphwanya kwa glycogen kupita ku glucose;
- kukonza mayankho a minofu minofu insulin ndi magwiritsidwe ake a shuga;
- chopinga wa matumbo mayamwidwe shuga.
Mankhwala amasintha kagayidwe kake ka mafuta, amachepetsa cholesterol yonse pochepetsa mafuta. Kuchuluka magazi fibrinolytic ntchito ndipo zimakhudza hemostasis. Imalimbikitsa mapangidwe a glycogen mkati mwa selo mwakuchita pa enzyme glycogen synthetase. Kuchulukitsa kuthekera kwakunyamula glucose ndi mitundu yosiyanasiyana ya onyamula michere.
Pochita mankhwala ndi mankhwalawa, kulemera kwa wodwalayo kumatha kuchepa.
Pharmacokinetics
Mankhwala amatengeka ndi 50-60%, kufikira ndende kwambiri patatha maola 2,5 pambuyo pa kukhazikitsa. Kulumikizana ndi mapuloteni amwazi sikungatheke. Minyewa yokhazikika yogwira ntchito m'magazi (<1 μg / ml) imalembedwa patatha maola 24-48 mutamwa mankhwalawa mogwirizana ndi mlingo woyenera. Kuchulukitsa kwakukulu kwa yogwira ntchito ndi mlingo waukulu sikupitirira 5 μg / ml. Mafuta amatha kuchepa pang'ono podya.
Mankhwala Metformin bwino kagayidwe mafuta, amachepetsa cholesterol yonse pochepetsa magazi.
The yogwira thunthu si zimapukusidwa, amachotsa mu mawonekedwe ake amkati ndi mkodzo. Kuchotsa hafu ya moyo ndi maola 6-7. Kuchuluka kwa mankhwala a impso ndi impso pafupifupi 400 ml / min. Kuwonongeka kwaimpso kumayendetsedwa ndi kuchepetsedwa kwa chinthu chogwira ntchito (molingana ndi chilolezo cha creatinine), chomwe chimapangitsa kuwonjezeka kwa theka la moyo komanso kuwonjezereka kwa plasma ndende yogwira ntchito.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa amagwiritsidwa ntchito ngati mtundu wachiwiri wa matenda a shuga, pomwe zakudya ndi zolimbitsa thupi sizikhala ndi zotsatira zabwino kwa odwala omwe ali ndi kunenepa kwambiri. Mankhwalawa amalembera achikulire ndi ana opitirira zaka 10 monga monotherapy kapena gawo limodzi la zovuta zotsutsana ndi hyperglycemia.
Ndi mankhwala osankha kwa odwala akuluakulu omwe ali ndi mtundu wachiwiri wa shuga wambiri, ngati zakudya sizigwira ntchito mokwanira.
Contraindication
- ziwengo ku zinthu zomwe zimagwira kapena chilichonse chothandiza;
- zinthu zomwe zimawonjezera chiopsezo cha lactic acidosis, kuphatikiza impso ntchito ndi indexinine yoposa 150 μmol / l, matenda a chiwindi ndi matenda am'mapapo;
- Kulephera kwaimpso ndi kupezeka kwa creatinine <45 ml / min. kapena GFR <45 ml / min. / 1.73 m²;
- kulephera kwa chiwindi;
- ketoacidosis ndi matenda ashuga, chikomokere ndi matenda ashuga;
- pachimake congestive mtima kulephera (koma vuto lililonse kulephera kwa mtima);
- pachimake gawo la infrction;
- mimba ndi mkaka wa m`mawere;
- poyizoni woledzera.
- nthawi ya opaleshoni (masiku awiri), maphunziro a radiopaque.
Ndi chisamaliro
- ana kuyambira azaka 10 mpaka 12;
- okalamba (atatha zaka 65);
- anthu omwe amagwira ntchito yolemetsa, yomwe imawonjezera chiopsezo cha lactic acidosis.
Momwe mungatenge metformin hydrochloride?
Asanadye kapena pambuyo chakudya?
Nthawi yakumwa mankhwalawa imakhala ndi chakudya kapena mukatha kudya.
Ndi matenda ashuga
Mlingo wa akulu poyamba umachokera pa 500 mpaka 850 mg kawiri kapena katatu pa tsiku. Pambuyo pa masabata awiri, mulingo umapangidwanso malinga ndi kuchuluka kwa shuga m'magazi. Kuwonjezeka kwapang'onopang'ono kwa tsiku ndi tsiku kumapewetsa mavuto osagwirizana ndi kugaya chakudya. Mlingo wa tsiku ndi tsiku sayenera kupitirira 3000 mg mu 3 mgawidwe.
Mlingo wa tsiku ndi tsiku wa ana opitirira zaka 10 ndi achinyamata ndi 500-850 mg mu 1 mlingo. Pambuyo pa masabata awiri, mlingo wa tsiku ndi tsiku wa mankhwalawa umawunikanso mogwirizana ndi kuchuluka kwa shuga m'magazi. Mlingo wa tsiku ndi tsiku wa ana, womwe umagawidwa mu Mlingo wa 2-3, sayenera kupitirira 2000 mg yonse.
Musanakonze mankhwala kwa odwala okalamba, komanso munthawi ya chithandizo. Mwa omwe ali ndi kulephera kwapakati aimpso (creatinine chilolezo cha 45-59 ml / mphindi kapena GFR ya 45-59 ml / min), kugwiritsa ntchito mankhwalawa kumaloledwa (Mlingo watsiku ndi tsiku wa 500-850 kamodzi) popanda ngozi yowonjezera ya lactic acidosis. Mlingo wa tsiku ndi tsiku sapitilira 1000 mg ndipo umagawidwa pawiri. Kuzindikira matenda aimpso ndizovomerezeka osachepera miyezi isanu ndi umodzi.
Kuchepetsa thupi
Mlingo woyambirira monga mankhwala ochepetsa thupi ndi 500 mg 1 nthawi patsiku ndi kuwonjezeka pang'onopang'ono kwa mlingo ndi 500 mg sabata lililonse. Mlingo wovomerezeka tsiku lililonse sayenera kupitirira 2000 mg. Njira yovomerezeka ndi milungu itatu ndikupuma pafupifupi miyezi iwiri. Pamaso pa zovuta zoyipa, tsiku ndi tsiku mlingo umachepa.
Zotsatira zoyipa za Metformin hydrochloride
Kuchiza ndi mankhwalawa nthawi zambiri kumayenderana ndi mavuto. Mu milandu iyi, kuchepetsedwa kwa mankhwalawa kapena kuchotsedwa kwathunthu kwa mankhwalawo kumasonyezedwa kutengera kuopsa kwa vutolo.
Matumbo
Kumayambiriro kwa chithandizo chamankhwala komanso kuwonjezereka kwa mankhwala, zosafunikira monga zofala:
- Zizindikiro za dyspeptic (nseru, kusanza, kugona, kukhumudwa);
- kupweteka kwam'mimba
- kusowa kwa chakudya
- kulumikizira kwazitsulo.
Zizindikiro izi zimayambitsa pafupipafupi mawonetsedwe panthawi ya mankhwala. Izi pang'onopang'ono zimatha pazokha. Kuti muchepetse kapena kuwaletsa, kuwonjezeka kosavuta kwa Mlingo watsiku ndi tsiku komanso kuwononga mitundu ingapo. Ndi chithandizo chazitali, vuto la m'mimba limayamba kuchepa.
Pa khungu
Osasinthika thupi lawo siligwirizana, kuphatikizapo redness ndi kutupa kwa pakhungu, kuyabwa, urticaria.
Kuchokera kumbali ya kagayidwe
Kuchiza kwa nthawi yayitali kumatha kuyambitsa kuchuluka kwa homocysteine, komwe kumalumikizidwa ndi kuperewera kwa vitamini B12 ndi kuchepa kwake, ndipo izi zimatha kusokoneza kupangika kwa magazi ndipo (kawirikawiri) zimayambitsa kuchepa kwa magazi m'thupi.
Kukula kwa lactic acidosis (lactic acidosis) chifukwa cha kudzikundikira kwa lactic acid m'mwazi ndizovuta kwambiri chifukwa chogwiritsa ntchito Biguanides.
Dongosolo la Endocrine
Ndi hypothyroidism, mankhwalawa amachepetsa kuchuluka kwa mahomoni olimbitsa chithokomiro mu seramu yamagazi. Mankhwala amachepetsa kupanga testosterone mwa amuna. Nthawi zina, vuto la kuchepa kwa magazi m'thupi limayamba.
Matupi omaliza
Zotupa za pakhungu.
Zokhudza mphamvu pakuwongolera njira
Mankhwalawa samakhudza kuthekera kwa kugwira ntchito ndi ma kayendedwe ovuta, kuphatikiza magalimoto. Kuphatikiza mankhwala ndi othandizira ena a antihyperglycemic (insulin, meglitinides), kukula kwa zochitika za hypoglycemic zomwe sizigwirizana ndi kuyendetsa ndi njira zina zovuta zomwe zimafunikira chidwi chochulukirapo sichimayikidwa.
Mankhwalawa samakhudza kuthekera kwa kugwira ntchito ndi ma kayendedwe ovuta, kuphatikizapo magalimoto.
Malangizo apadera
Pa mankhwala, muyenera kupanga zakudya zanu kuti chakudya chamagulu azigawika tsiku lonse. Pamaso pa kunenepa kwambiri kwa thupi, ndikofunikira kutsatira chakudya chokhala ndi zopatsa mphamvu zochepa. Zizindikiro za kagayidwe kazakudya ziyenera kuyang'aniridwa pafupipafupi.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Imavomerezedwa kuti igwiritsidwe ntchito panthawi yobala mwana, kuphatikizapo matenda a shuga. Mankhwala, malinga ndi kafukufuku wa zamankhwala, samakhudza mkhalidwe wa mayiyo kapena kukula kwa mwana wosabadwayo. Kukumana kwa zinthu zomwe zimagwiritsidwa ntchito zimapezeka mkaka wa m'mawere, motero ndikulimbikitsidwa kusokoneza yoyamwitsa panthawi ya mankhwala chifukwa chosakwanira deta kuchokera ku maphunziro pa chitetezo cha mankhwala kwa ana.
Kupangira Metformin hydrochloride kwa ana
Kugwiritsa ntchito ana kumaloledwa kuchokera zaka 10 pokhapokha akatsimikizire mtundu wa matenda ashuga a 2. Palibe vuto lililonse la mankhwalawa pa kutha kapena kukula kwa mwana. Koma nkhaniyi sinaphunziridwe mokwanira, chifukwa chake kuyang'anira mosamala magawo awa kwa ana panthawi yayitali mankhwala akulimbikitsidwa.
Gwiritsani ntchito mu ukalamba
Pamafunika kuwunika ntchito ya aimpso, chifukwa amatha kuchepa kwa zaka.
The ntchito aimpso kuwonongeka
Musanayambe komanso pafupipafupi pakumwa (pafupifupi kawiri pachaka), impso ziyenera kuyang'aniridwa, chifukwa metformin imachotsedwa pamkodzo. Ngati creatinine chilolezo chimakhala <45 ml / min., Mankhwala osokoneza bongo amatsutsana.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Nthawi zina, mankhwalawa angayambitse kuwonongeka kwa chiwindi (monga mbali yotsatira). Zotsatira zosafunika zimatha atasiya kumwa mankhwala.
Mankhwala ochulukirapo a Metformin Hydrochloride
Zizindikiro zake zimaphatikizana ndi mseru, kusanza, kutsegula m'mimba, tachycardia, kugona, kawirikawiri hypo- kapena hyperglycemia. Vuto lowopsa lomwe limafunikira kuchipatala mwachangu ndi lactic acidosis, yodziwika ndi zizindikiro za kuledzera, kusokonezeka kwa chikumbumtima. Kukhazikitsidwa kwa sodium bicarbonate kumawonetsedwa, ndi kusakhazikika kwa hemodialysis kumafunika. Imfa zinajambulidwa pambuyo pa kupha kwachuluka kwa anthu opitilira 63 g.
Kuchita ndi mankhwala ena
Kugwiritsa ntchito nthawi yomweyo kwa ayodini wokhala ndi zinthu za radiopaque kumatsutsana. Pankhaniyi, chiwopsezo cha matenda a impso kulephera, kudzikundikira kwa mankhwala osokoneza bongo, lactic acidosis imachulukitsidwa.
Kumwa mankhwalawo limodzi ndi zotumphukira za sulfonylurea, NSAIDs, Acarbose, Insulin kumatha kukometsa vuto la hypoglycemic.
Kutsika kwa zotsatira za hypoglycemic kumachitika pakagwiritsidwa ntchito limodzi:
- glucocorticosteroids;
- mahomoni a chithokomiro;
- zida zodulira;
- zotumphukira za phenothiazine;
- amphanomachul.
Nthawi zina, kugwiritsa ntchito munthawi yomweyo ndi indomethacin (suppositories) kungayambitse metabolic acidosis.
Kuyenderana ndi mowa
Kuyanjana ndi zakumwa zoledzeretsa kapena mankhwala omwe ali ndi zakumwa zoledzeretsa ndikosalimbikitsa. Zowopsa zakumwa zoledzeretsa, makamaka poyerekeza ndi zakudya zama calorie ochepa kapena kuwonongeka kwa chiwindi, zimagwirizanitsidwa ndi mwayi wokhala ndi lactic acidosis.
Analogi
- Glucophage;
- Bagomet;
- Metformin Richter;
- Metformin-Canon;
- Metformin-Akrikhin;
- Metformin Kutalika;
- Siofor.
Kupita kwina mankhwala
Amatanthauzanso mankhwala omwe mumamwa. Adokotala amatha kulowa dzinalo mu Latin Metforminum pafomu.
Kodi ndingagule popanda kulandira mankhwala?
Ayi.
Mtengo wa Metformin Hydrochloride
Mtengo wa mankhwalawa:
- 500 mg mapiritsi, 60 ma PC. - pafupifupi ma ruble 132;
- Mapiritsi a 850 mg, ma 30 ma PC. - pafupifupi ma ruble 109.
Zosungidwa zamankhwala
Sichifuna mikhalidwe yapadera. Amasungidwa mumayendedwe oyamba. Musayandikire ana!
Analogue ya mankhwala akhoza kukhala mankhwala Glucophage.
Tsiku lotha ntchito
Zaka 3 kuyambira tsiku lomwe lasonyezedwa pa phukusi.
Wopanga
Zentiva S.A. (Bucharest, Romania).
Ndemanga pa metformin hydrochloride
Madokotala
Vasiliev R.V., wothandizapo: "Mankhwalawa ndi oyenera kuthandizira komanso kuphatikiza mankhwala othandizira. Ndi othandizika komanso otetezeka kutsatira malangizo omwe amagwiritsidwa ntchito. Amathandizanso kugwiritsira ntchito kagayidwe kake ka thupi, zomwe zimapangitsa kuti kulemera kwake kuonekere. ntchito pochiza khansa yamitundu ina. "
Tereshchenko E. V., wa endocrinologist: "Kwa zaka zambiri ndakhala ndikukufotokozerani mankhwala awa matenda okhudzana ndi kagayidwe kazakudya, makamaka kwa anthu onenepa kwambiri. Amaloledwa kugwiritsa ntchito mankhwalawa panthawi yapakati."
Odwala
Olga, wazaka 56, Yalta: "Ndakhala ndikumwa mankhwalawa mtundu wa 2 matenda ashuga kwa miyezi 5.Kumayambiriro kwenikweni kwa chakudyacho, zimatenga ma kilogalamu angapo a kulemera. "
Kuchepetsa thupi
Tamara, wazaka 28, ku Moscow: "Zaka zingapo zapitazi ndapeza 20 kg chifukwa chovutikira komanso kudya kwambiri. Ndakhala ndikumwa mankhwalawa kwa miyezi isanu ndi umodzi molingana ndi malangizo komanso moyo wabwino. Ndatha kutaya 13 kg."
Taisiya, wazaka 34, Bryansk: "Mankhwalawa amathandizira kuchepetsa thupi, koma pokhapokha mutadya zakudya zoyenera. Popanda kudya, mankhwalawa sagwira ntchito."
