Glimecomb ndi othandizira a hypoglycemic ofuna mtundu wachiwiri wa matenda a shuga. Mankhwala limodzi zimasintha boma mafuta mafuta kagayidwe, kuchepetsa chiopsezo cha atheroscrotic zolengeza pa mtima makoma, kuchepetsa thupi kunenepa kwambiri. Mankhwala ndi mankhwala pokhapokha pokhapokha ngati kudya ndi zolimbitsa thupi.
Dzinalo Losayenerana
Glyclazide + Metformin.
Glimecomb ndi othandizira a hypoglycemic ofuna mtundu wachiwiri wa matenda a shuga.
ATX
A10BD02.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapangidwa mwanjira ya mapiritsi oyera ogwiritsira ntchito pakamwa, amadziwika ndi chikasu kapena kirimu wa kirimu komanso mawonekedwe osalala. Chigawo cha mankhwala chimaphatikizira mankhwala awiri omwe amagwira ntchito: 40 mg ya gliclazide ndi 500 mg ya metformin hydrochloride. Povidone, magnesium stearate, sorbitol ndi croscarmellose sodium amachita zinthu zothandiza. Mapiritsi ali m'magawo 10 m'matumba a blister. Pa katoni kamatabwa pali matuza 6.
Zotsatira za pharmacological
Mankhwala amatanthauza ophatikiza a hypoglycemic opaka pakamwa. Mankhwalawa ali ndi pancreatic komanso extrapancreatic.
Glyclazide ndimachokera ku sulfonylurea. Limagwirira a zochita za wapawiri mankhwala zachokera kukondoweza wa chinsinsi ntchito pancreatic beta maselo. Zotsatira zake za hypoglycemic, chiwopsezo cha maselo amthupi kupita ku insulini chikuwonjezeka, kupanga kwa mahomoni kumawonjezeka. Chithandizo chogwira ntchito chimabwezeretsa ntchito zoyambirira za zisumbu za Langerhans ndikufupikitsa nthawi kuyambira pakudya mpaka chinsinsi cha insulin.
Glimecomb amalimbikitsa kuchepa thupi pomwe akutsatira zakudya pamsana wamafuta onenepa.
Kuphatikiza pa kutenga kagayidwe kazachilengedwe, mankhwalawa amathandizanso kupukusa kwa cellular, kumachepetsa kuphatikizika kwa maselo a cell, motero kupewa chitukuko cha mtima. Poyerekeza ndi kumbuyo kwa kutenga Glimecomb, kupezeka kwa khoma la mtima kumapangidwira, microsrombosis ndi atherosulinosis imayimitsidwa, ndipo parietal fibrinolysis yachilengedwe imabwezeretseka. Mankhwala osokoneza bongo a kuchuluka kwamphamvu kuyankha kwa adrenaline mu microangiopathies. Chimalimbikitsa kuchepa thupi mukamatsatila chakudya pamankhwala onenepa.
Metformin hydrochloride ndi gulu lalikulu. Yogwira pophika imachepetsa kuchuluka kwa shuga mwa kupondereza gluconeogeneis mu hepatocytes ndikuchepetsa kuchuluka kwa kuyamwa kwa glucose m'matumbo ang'ono. Mankhwala amatenga gawo la lipid metabolism, kutsitsa milingo yokhala ochepa osachulukitsa lipoproteins, triglycerides ndi cholesterol m'magazi. Zimathandizira kuchepetsa kulemera kwa thupi, koma pakalibe insulin mu seramu, zochizira sizimatheka. Pa maphunziro azachipatala, palibe zomwe zimachitika mu hypoglycemic zomwe zinajambulidwa.
Pharmacokinetics
| Gliclazide | Metformin |
| Ndi makonzedwe apakamwa, kuthamanga kwamphamvu kumawonedwa. Mukamagwiritsa ntchito 40 mg, pazinthu zambiri zomwe zimakhala mu plasma zimakhazikika pambuyo pa maola awiri ndi atatu. Kuyankhulana ndi mapuloteni a plasma ndikwambiri - 85-97%. Chifukwa cha mapangidwe a protein protein, mankhwalawa amagawidwa mwachangu mthupi lonse. Zimasinthidwa mu hepatocytes. Kutha kwa theka la moyo kumapangitsa maola 8-20. Yogwira pophika imathira mkodzo ndi 70%, ndowe ndi 12%. | Amatengeredwa mwachangu ndi microvilli m'mimba yaying'ono ndi 48-52%. The bioavailability akamagwira chopanda kanthu 50-60%. Kuzindikira kwakukulu kumakwaniritsidwa patatha maola awiri atatha kukhazikitsa. Kumanga mapuloteni a plasma kumakhala kotsika. Kuphatikizika kwa maselo ofiira kumawonedwa. Hafu ya moyo ndi maola 6.2. Mankhwalawa amachotsedwa kudzera mu impso mu mawonekedwe awo oyambira 30% kudzera m'matumbo. |
Mankhwalawa amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa amagwiritsidwa ntchito pochiza matenda amishuga amtundu wa 2, pakakhala chithandizo chochepa chamankhwala, zochitika zolimbitsa thupi ndi mankhwala a Metformin ndi Gliclazide.
Wothandizira wa hypoglycemic amagwiritsidwa ntchito ngati m'malo mwa mankhwala osokoneza bongo omwe ali ndi mankhwala 2 mwa odwala omwe samadalira insulini amadalira matenda a shuga, malinga ngati shuga ya magazi imayang'aniridwa bwino.
Contraindication
Mankhwala ali osavomerezeka kuti mugwiritse ntchito potsatira:
- mtundu 1 matenda a shuga;
- lactic acidosis;
- otsika a plasma potaziyamu;
- matenda a shuga;
- matenda ashuga ketoacidosis;
- kwambiri pathological njira mu impso ndi matenda omwe amasokoneza kugwira ntchito kwa ziwalo (kuchepa magazi, matenda opatsirana kwambiri ndi kutupa, kugwedezeka);
- porphyria;
- kutenga miconazole;
- ntchito yolakwika ya chiwindi;
- kugunda kwa mtima, kuperewera kwa mpweya, kulephera kupuma, kulowerera kwam'mnyewa;
- kuledzera, kuledzera;
- zinthu zomwe insulin chithandizo ndiyofunika (kuvulala kwadzidzidzi, kuvulala kwakanthawi pambuyo pakuchita opaleshoni yayikulu, kuwotcha);
- osachepera maola 48 ndipo mkati mwa masiku awiri atatha radiology yogwiritsa ntchito ayodini;
- Zakudya zamafuta ochepa komanso pamene zimamwa wochepera 1000 kcal patsiku;
- kuchuluka kwa thupi la wodwalayo kumagwiritsa ntchito mankhwala.
Kuphatikiza apo, mankhwalawa ali osavomerezeka kwa anthu okalamba omwe amagwira ntchito pazovuta kwambiri chifukwa chokhala ndi lactic acidosis.
Muyenera kusamala ngati mukutentha, kukomoka kwa chithokomiro cha adrenal, kusagwira kolakwika kwa chithokomiro chamkati, chithokomiro cha chithokomiro.
Momwe mungatengere glimecomb
Mankhwalawa amagwiritsidwa ntchito pakumwa pakamwa pakudya kapena akangomaliza kudya. Mlingo ndi kutalika kwa mankhwala zimatsimikiziridwa ndi dokotala, kukhazikitsa mtundu wa mankhwala malinga ndi kuchuluka kwa shuga m'magazi.
Ndi matenda ashuga
Mlingo umodzi kumayambiriro kwa mankhwalawa ndi mapiritsi a 540 a mapiritsi amodzi pafupipafupi mpaka katatu. Nthawi zambiri, mankhwalawa amatengedwa 2 pa tsiku - m'mawa komanso asanagone. Mlingo watsiku ndi tsiku umasankhidwa pang'onopang'ono mpaka kubwezerera kwamomwe amapangira matenda.
Zotsatira zoyipa za glimecomb
Zotsatira zoyipa m'thupi la wodwalayo zimayamba ndi mankhwalawo mosayenera kapena motsutsana ndi matenda am'mbuyomu.
Mankhwalawa amagwiritsidwa ntchito pakumwa pakamwa pakudya kapena akangomaliza kudya.
Matumbo
Zotsatira zoyipa zamagetsi zimapezeka monga:
- dyspepsia, vuto la chimbudzi;
- kumverera kolemetsa m'mimba;
- kusanza, kusanza;
- kupweteka kwa epigastric;
- kuwoneka kwa kulawa kwachitsulo pamizu ya lilime;
- kuchepa kwamtima.
Nthawi zina, ntchito ya hepatocytic aminotransferases, alkaline phosphatase imatheka. Mwina chitukuko cha hyperbilirubinemia mpaka mwadzidzidzi mankhwala a cholestatic jaundice, omwe amafuna kuti amwe mankhwala.
Hematopoietic ziwalo
Mankhwala angalepheretse kugwira ntchito kwa mafupa ofiira, chifukwa chake kuchuluka kwa mawonekedwe amwazi amachepetsa, agranulocytosis, hemolytic anemia.
Pakati mantha dongosolo
Mwina kuchepa kwa maonedwe acuity, mutu.
Kuchokera pamtima
Arrhasmia, kumverera kwa magazi.
Dongosolo la Endocrine
Ngati dosing regimen ikuphwanyidwa ndipo zakudya sizikutsatiridwa, chiopsezo cha hypoglycemia chimakulirakulira, chomwe chimakhala ndi kufooka kwakukulu, kusinthika kwakanthawi kwamitsempha, kuchepa kwa thukuta, kutayika kwa malingaliro, chisokonezo ndi kusokonezeka kwa mgwirizano.
Kuchokera kumbali ya kagayidwe
Poyerekeza ndi zovuta za metabolic, lactic acidosis imatha kuoneka. Njira ya pathological imadziwika ndi kufooka, kupweteka kwambiri m'matumbo, kulephera kupuma, kupweteka m'mimba, kuchepa kwa kutentha ndi kutsika kwa kuthamanga kwa magazi, ndi bradycardia.
Matupi omaliza
Zochita za anaphylactoid pazomwe zimapezeka mu sulfonylurea zimawonekera mwa mawonekedwe a vasculitis, urticaria, macula, zidzolo ndi pruritus, edema ya Quincke, anaphylactic.
Zokhudza mphamvu pakuwongolera njira
Pa chithandizo ndi Glimecomb, chisamaliro chimayenera kuchitika mukamayendetsa, ndikugwiritsa ntchito njira zovuta komanso zochitika zina zomwe zimafuna kuyang'aniridwa ndi wodwala.
Malangizo apadera
Mukamamwa mankhwala a sulfonylurea, pamakhala chiopsezo chokhala ndi hypoglycemia yayitali komanso yotalikirapo, yomwe imafunikira chithandizo chapadera pakukonzekera komanso kutsekeka kwa njira ya 5% ya shuga masiku 4-5.
Chiwopsezo cha kukhala ndi matenda ammimba chikuwonjezeka ndi kudya kosakwanira, kuchita masewera olimbitsa thupi kwa nthawi yayitali kapena kugwiritsa ntchito mankhwala osiyanasiyana a hypoglycemic. Kuti achepetse njira yodutsitsa, ayenera kutsatira malangizo omwe aperekedwa kwa mankhwalawo ndikuti adziwe zonse pakukambirana ndi adokotala.
Mlingo wofunikira umafunika pakuwonjezera thupi kapena kutengeka kwambiri kapena kusintha zakudya.
Gwiritsani ntchito mu ukalamba
Anthu opitilira zaka zopitilira 60 sayenera kumwa mankhwalawa chifukwa chakuchita zolimbitsa thupi chifukwa chowonjezera chiopsezo cha lactic acidosis.
Kupatsa ana
Mankhwala osavomerezeka amatengedwa kuti azikafika zaka 18.
Mankhwala osavomerezeka amatengedwa kuti azikafika zaka 18.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mimba ikachitika, makonzedwe a Glimecomb amayenera kulowetsedwa ndi mankhwala a insulin, chifukwa kulowetsedwa kwa zinthu zomwe zimachitika kudzera mu chotchinga cha placental ndikotheka. Palibe deta pa teratogenic mphamvu zonse ziwiri zomwe zimagwira ntchito.
Glyclazide ndi metformin imatha kupukusidwa mkaka wa amayi, chifukwa chake, pakumwa ndi hypoglycemic wothandizira, mkaka wa mkaka uyenera kuthetsedwa.
The ntchito aimpso kuwonongeka
Mankhwala ndi contraindicated ngati vuto lolakwika la impso ndi matenda a shuga.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Mankhwalawa amaletsedwa ndi ntchito yolakwika ya chiwindi.
Mankhwala osokoneza bongo a Glimecomb
Ndi mankhwala osokoneza bongo, lactic acidosis ndi chikhalidwe cha hypoglycemia zimayamba. Ngati pali zizindikiro za lactic acid oxidation wa zimakhala, muyenera kuyimbira ambulansi yomweyo. M'malo okhazikika, hemodialysis imagwira.
Pofuna kutaya chikumbumtima, kulowetsedwa kwamphamvu kwa shuga 40% ndikofunikira mu mnofu kapena m'magazi.
Pofuna kutaya chikumbumtima, kulowetsedwa mwamphamvu kwa 40% shuga, glucagon, intramuscularly kapena subcutaneally, ndikofunikira. Pambuyo kukhazikika, wodwalayo amafunikira chakudya chamafuta ambiri.
Kuchita ndi mankhwala ena
Mukamamwa mankhwala ena ofanana ndi Glimecomb, zimachitika motere:
- Kupititsa patsogolo njira yothandizira achire palimodzi ndi capopril, coumarin anticoagulants, beta-blockers, bromocriptine, antifungal agents, salicylates, fibrate, MAO zoletsa, antipatitiscline, mankhwala osapinga a antiidal ndi anti-tuberculosis.
- Glucocorticosteroids, barbiturates, antiepileptic mankhwala, calcium tubule inhibitors, thiazide, okodzetsa, Terbutaline, Glucagon, Morphine amathandizira kuchepa kwa hypoglycemic action.
- Cardiac glycosides amachulukitsa mwayi wamitsempha yamagazi, pomwe kupondereza m'matumbo a hematopoiesis, kumakulitsa chiopsezo cha myelosuppression.
Mankhwala amachepetsa plasma ndende ya Furosemide ndi 31% ndi theka la moyo wawo ndi 42%. Nifedipine imawonjezera mayamwidwe a metformin.
Mankhwala amachepetsa plasma ndende ya Furosemide ndi 31% ndi theka la moyo wawo ndi 42%.
Kuyenderana ndi mowa
Ndi zoletsedwa kumwa mowa nthawi yamankhwala. Ethanol imabweretsa chiopsezo cha kuledzera kwambiri ndi kukula kwa lactic acidosis. Ethanol imawonjezera mwayi wokhala ndi hypoglycemia.
Zoyenera kusintha
The fanizo la mankhwala, ofanana ndi kapangidwe kake ka mankhwala ndi mankhwala.
- Diabefarm;
- Glyformin;
- Gliclazide MV.
Kusinthira ku mankhwala ena ndikotheka chifukwa chotsalira popanda kutenga Glimecomb komanso moyang'aniridwa ndi adokotala.
Kupita kwina mankhwala
Mankhwalawo amagulitsidwa ndi mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Kugulitsa kwaulere kwa mankhwalawo ndizoletsedwa chifukwa chowonjezera chiopsezo cha hypoglycemia mukamamwa mlingo wolakwika.
Mtengo wa Glimecomb
Mtengo wapakati wamapiritsi ndi ma ruble 567.
Zosungidwa zamankhwala
Mankhwalawa amayenera kusungidwa kuti ana asawafikire, m'malo owuma, osadetsedwa ndi kutentha osaposa + 25 ° C.
Tsiku lotha ntchito
Zaka 2
Wopanga
Chomera ndi mankhwala "AKRIKHIN", Russia.
Kugulitsa kwaulere kwa mankhwalawo ndizoletsedwa chifukwa chowonjezera chiopsezo cha hypoglycemia mukamamwa mlingo wolakwika.
Ndemanga ya Matenda a shuga ku Glimecomb
Arthur Kovalev, wazaka 40, Moscow
Kwa matenda a shuga a 2, ndakhala ndikumwa mapiritsi a Glimecomb pafupifupi chaka chimodzi. Kulemera kwa thupi sikunachepe, chifukwa mutatha kumwa mankhwalawa mukufuna kudya. Koma nditamwa mapiritsiwo madzulo asanagone, matendawo amakhazikika. M'mawa, shuga amasiyanasiyana kuyambira 6 mpaka 7.2 mutamwa piritsi ndi kadzutsa.
Kirill Gordeev, wazaka 29, Kazan
Mankhwala amachepetsa shuga. Ndimalola kwa miyezi 8. Ndinaikanso jakisoni wa insulin. Pambuyo pakusokoneza kuperekera kwa mahomoni, ndinayenera kumwa mapiritsi kwakanthawi, koma adawonetsa kuchita bwino kwambiri. Shuga adakhalabe chimodzimodzi.
Madokotala amafufuza
Marina Shevchuk, endocrinologist, wazaka 56, Astrakhan
Mankhwala motsutsana ndi maziko a matenda a shuga a 2 amafunika glycemia bwino. Kutulutsidwa kosinthidwa kumachepetsa chiopsezo chokhala ndi hypoglycemic syndrome, chifukwa chake okalamba ndi anthu omwe akudwala matenda amtima amatha kumwa mankhwalawo. Nthawi zonse ndimagwiritsa ntchito mankhwalawa kuchipatala ndikusankha munthu payekha. Mtengo wotsika kwambiri.
Evgenia Shishkina, endocrinologist wazaka 45, St. Petersburg
Mankhwala amakhala ochepetsetsa komanso ogwira mtima. Zimathandizira kuchepetsa shuga. Pa chithandizo, ndikofunikira kutsatira zakudya, koma idyani pafupipafupi, komanso masewera olimbitsa thupi. Zotsatira zoyipa ndikutsatira kwambiri muyezo wa dosing sizinawoneke. Kuchita kwa mankhwalawa kumayamba posachedwa. Mankhwalawa adziyambitsa okha pamsika wa matenda ashuga.
