Mankhwalawa ndi gawo la gulu la mankhwala omwe amayang'anira kuchuluka kwa shuga m'magazi. Kutumizidwa kwa odwala matenda ashuga. Mankhwalawa amathandiza kupewa zovuta zomwe zimayamba chifukwa cha kunenepa.
Mankhwalawa ali ndi magawo awiri omwe amagwira ntchito ndipo amadziwika ndi mfundo zingapo zoyeserera, zomwe zimakhudza machitidwe osiyana siyana komanso zamankhwala am'thupi mthupi.
Dzinalo Losayenerana
Glibenclamide + Metformin (Glibenclamide + Metformin)
Mankhwala amaphatikizidwa m'gulu la mankhwala omwe amawongolera kuchuluka kwa shuga m'magazi.
ATX
A10BD02. Metformin osakanikirana ndi sulfonamides
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa ali ngati mapiritsi. Monga zida zazikulu zogwiritsidwa ntchito, metformin hydrochloride ndi glibenclamide amagwiritsidwa ntchito. Kuphatikizika kwawo piritsi limodzi: 400 mg ndi 2.5 mg. Zina zomwe sizikuwonetsa zochitika za hypoglycemic:
- calcium hydrogen phosphate dihydrate;
- wowuma chimanga;
- croscarmellose sodium;
- sodium stearyl fumarate;
- povidone;
- microcrystalline mapadi.
Chogulikacho chimapezeka m'mapaketi amtundu wa 40 ma PC.
Mankhwalawa ali ngati mapiritsi.
Zotsatira za pharmacological
Mphamvu ya Hypoglycemic ya mankhwalawa imachitika chifukwa cha kukoka kwa glucose kupanga chiwindi (mphamvuyo imachepa). Kuphatikiza apo, pali kuwonjezeka kwa chidwi cha receptors ku insulin. Nthawi yomweyo, kuwonjezeka kwa minofu ya glucose. Nthawi yomweyo, kuchuluka kwa kugwiritsira ntchito kwa zinthuzi kumawonjezeka. Kutsika kwa mayamwidwe a glucose m'makoma am'mimba, kumapangitsa chidwi cha lipolysis mu minofu ya adipose. Zotsatira zake ndi kuchepa kwa thupi.
Kuphatikiza apo, munthawi ya mankhwala ndi mankhwala omwe mukufunsidwa, kuchuluka kwa lipoproteins ochepa, cholesterol, triglycerides kumachepetsedwa. Mankhwala ndi sulfonylurea derivative (II m'badwo). Mphamvu ya hypoglycemic imachitikanso chifukwa cha kuchuluka kwa insulin yopanga ma cell a pancreatic. Zinthu zomwe zimapangidwa pakupanga kwazinthu zimathandizana wina ndi mnzake, zomwe zimathandiza kukwaniritsa milingo yambiri ya shuga.
Pharmacokinetics
Mafuta a glibenclamide akalowa m'mimba am'mimba ndi 95%. Kwa maola 4, chizindikiritso chapamwamba kwambiri cha chinthucho chimakwaniritsidwa. Ubwino wa panganoli ndikugwirizana kwathunthu ndi mapuloteni a plasma (mpaka 99%). Gawo lofunika la glibenclamide limasinthidwa m'chiwindi, chifukwa cha zomwe ma metabolites awiri amapangidwa, omwe samawonetsa ntchito ndipo amachotsedwa m'matumbo, komanso impso. Izi zimatenga nthawi ya maola 4 mpaka 11; Zomwe zimatsimikiziridwa ndi boma la thupi, kuchuluka kwa yogwira ntchito, kupezeka kwa ma pathologies ena.
Metformin imatengeka pang'ono ponse, bioavailability sichidutsa 60%. Katunduyu amayamba kugwira ntchito mwachangu kuposa glibenclamide.
Pulogalamuyi ili ndi drawback - kuchepa kwakukulu kwa kuthamanga kwa zochita mukamadya chakudya. Metformin ilibe mphamvu yomangiriza mapuloteni amwazi. Thupi limachotsedwa osasinthika, monga pang'onopang'ono zimasintha. Impso ndizomwe zimayambitsa kuphipha kwake.
Metformin ilibe mphamvu yomangiriza mapuloteni amwazi.
Zizindikiro zogwiritsidwa ntchito
Cholinga chachikulu ndikusintha momwe matenda ashupi a 2 amasinthira.
Ntchito zotsatirazi zimachitika:
- m'malo mankhwala a yapita regimen odwala omwe amawongolera shuga;
- kupereka zotsatira motsutsana ndi maziko otsika ogwira zakudya mankhwala, zolimbitsa thupi zochizira odwala onenepa kwambiri.
Contraindication
Zoyipa zamankhwala zimaphatikizapo kuchuluka kwakukulu zoletsa. Kuphatikiza apo, ma contraindication amagawika m'magulu awiri: Mtheradi komanso wachibale.
Gulu loyamba limaphatikizapo:
- mtundu 1 matenda a shuga;
- kusakhudzidwa komwe kumapangitsa munthu pazinthu zilizonse za mankhwala;
- angapo pathological zinthu chifukwa cha matenda a shuga: ketoacidosis, isanayambike precoma, chikomokere;
- aimpso kuwonongeka;
- zingapo zoyipa zomwe zimathandizira kukulitsa matenda a impso, pakati pawo kuchepa kwamadzi, zotupa zopatsirana, zochitika zododometsa, ndi zina zambiri;
- kuwonongeka kwa mtima dongosolo chifukwa hypoxia;
- kukanika kwambiri kwa chiwindi;
- porphyria;
- poizoni wa thupi chifukwa chomwa mowa kwambiri;
- matenda omwe amafunikira chithandizo cha insulin, mwachitsanzo, ndi njira zambiri zopangira opaleshoni, kutentha, kuvulala;
- lactic acidosis;
- Zakudya zopatsa mphamvu zochepa, pomwe mlingo wa zopatsa mphamvu wa tsiku ndi tsiku sukapitirira 1000 kcal.
Ndi chisamaliro
Zowerengeka zingapo zachinyengo zimadziwika kuti zimafuna kugwiritsa ntchito mosamala mankhwala:
- malungo
- kuchepa kwa ntchito ya anterior pituitary gland;
- Matenda a m'magazi a matenda a chithokomiro;
- adrenal kusowa.
Momwe mungatenge Metglib
Malangizo a mankhwalawa amasankhidwa chifukwa cha zinthu izi: kuchuluka kwa shuga m'magazi, mkhalidwe wa kagayidwe kazachilengedwe. Kuchuluka kwa mankhwalawa tsiku lililonse kumasiyana. Mapiritsi amatengedwa pakamwa.
Ndi matenda ashuga
Malangizo ogwiritsira ntchito Metglib:
- pa gawo loyambirira la mankhwalawa, tikulimbikitsidwa kumwa mapiritsi 1-2 patsiku;
- Pambuyo pake, mlingo wa tsiku ndi tsiku umasintha, zimatengera kuchuluka kwa shuga m'magazi, ndikofunikira kuti zitheke.
koyambirira kwa chithandizo, ndikofunikira kumwa mapiritsi a 1-2 patsiku.
Mulingo wovomerezeka wamankhwala patsiku la mtundu wa 2 matenda a shuga ndi mapiritsi 6. Ndipo simungathe kuzitenga nthawi yomweyo. Ndikofunikira kugawa kuchuluka kwa mitundu yayikulu kapena zitatu mosiyanasiyana.
Kuchepetsa thupi
Amadziwika kuti kugwiritsa ntchito zinthu (metformin ndi glibenclamide), zomwe ndi gawo la Metglib, kumapangitsa kuchepa kwa mafuta. Mlingo womwe umalimbikitsa patsiku ndi mapiritsi atatu. Zovomerezeka mosiyanasiyana. Njira ya mankhwala ndi masiku 20. Pofuna kupewa kuwonda kwambiri, mlingo umachepetsedwa mpaka 200 mg kamodzi, kuchuluka kwa tsiku ndi tsiku ndi 600 mg.
Mankhwalawa samapereka chifukwa chofunira popanda thandizo. Zinthu zomwe zimapangidwa zimangopangitsa kuti pakhale kusintha kwa mphamvu kuti ikhale mafuta.
Pofuna kupewa kuwonjezeka kwa mafuta ambiri, amafunika kuwonjezera masewera olimbitsa thupi ndikusintha zakudya zamagulu komanso kugwiritsa ntchito mankhwalawa.
Zotsatira zoyipa
Popeza chida chomwe chikufunsidwachi chimakhudza ntchito ya ziwalo zambiri zamkati ndi machitidwe, komanso chimagwira nawo mbali pazinthu zamtunduwu, kuwonetsa kosayenera kumachitika nthawi zambiri, pakati pawo:
- Matenda a hematopoietic dongosolo: thrombocytopenia, leukopenia, kupezeka kwa matenda monga agranulocytosis, kuchepa magazi, mapiritsi a pancytopenia ndi mafupa aplasy sikuchepa;
- hypoglycemia, zosachulukirapo: lactic acidosis ndi porphyria amtundu wina (wokhala ndi mawonekedwe pakhungu ndi chiwindi);
- anaphylactic anachita tsankho la zikuchokera Metglib ndi sulfonamides;
- Kuchulukana kwa vitamini B12;
- mukumwa mankhwalawo, kulawa kwa "zitsulo" kumatuluka;
- kukhumudwa kowoneka, komwe ndi njira yosinthira;
- kukanika kwa chiwindi, pamene chiwindi nthawi zina chimayamba;
- thupi lawo siligwirizana ndi mawonekedwe: pakhungu, vasculitis, ndi ena;
- matenda am'mimba, ambiri amakhala ndi ululu wam'mimba, kusowa kwa chakudya, nseru ndi kusanza;
- Nthawi zina kumawonjezera ndende ya creatinine ndi urea m'magazi a m'magazi.
Muyenera kudziwa kuti zambiri mwazizindikirozi ndizosakhalitsa ndipo nthawi yomweyo zimazimiririka atachotsedwa kwa Metglib. Ngati phindu logwiritsa ntchito mankhwalawo mukuposa kuvulaza, ndikololedwa kugawa Mlingo muyezo waukulu popanda kusokoneza njira yochiritsira. Pankhaniyi, lamuloli limagwira ntchito: kuwonjezeka pang'onopang'ono tsiku lililonse kumapangitsa kuti pakhale magawo othandizira popanga mankhwala.
Zokhudza mphamvu pakuwongolera njira
Kuyendetsa magalimoto panthawi yamankhwala osokoneza bongo sikuletsedwa. Komabe, chiwopsezo cha kukhala ndi hypoglycemia, kusinthika kwa mawonekedwe owonekeranso, komanso zochitika zina zoipa, ndikuyenera kusamala ziyenera kukumbukiridwa.
Malangizo apadera
Ndikofunika kulandira chithandizo ndikuyang'aniridwa ndi dokotala. Muyenera kuwunika pafupipafupi glucose komanso mukatha kudya.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwalawa amaletsedwa kugwiritsidwa ntchito poyambira ndi kuyamwa. Zinthu zogwira zimalowa mkaka wa mayi. Ngati pakufunika kugwiritsa ntchito mankhwalawa panthawi yachuma ndi kukonzekera, njira ya insulin imachitika.
Mankhwalawa amaletsedwa kugwiritsidwa ntchito poyambira ndi kuyamwa.
Kupangira Metglib kwa Ana
Mankhwalawa amatsutsana ndi odwala omwe sanafike pazaka zambiri.
Gwiritsani ntchito mu ukalamba
Kugwiritsa ntchito Metglib kuyenera kupewedwa ngati wodwala akuchita ntchito yayikulu. Pankhaniyi, pali chiopsezo cha lactic acidosis. Zoletsa zoterezi zimakhudzanso odwala opitilira zaka 60. Kuphatikiza apo, kusamala kuyenera kuchitika pochiza odwala okalamba kuyambira zaka 70 kapena kupitirira. Izi zingayambitse kukula kwa hypoglycemia.
The ntchito aimpso kuwonongeka
Mankhwala sanatchulidwe kulephera kwa aimpso.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Mankhwala amaletsedwa kuti agwiritsidwe ntchito ngati thupi lanu limaperewera. Ganizirani mulingo wa creatinine (malire a chizindikiro ichi mwa amuna ndi 135 mmol / l; mwa akazi - 110 mmol / l).
Mankhwala ndi oletsedwa kugwiritsidwa ntchito ngati chiwindi chikulephera.
Bongo
Ngati kuchuluka kwa mankhwalawa kumawonjezeka pafupipafupi, hypoglycemia imayamba. Mawonekedwe ofooka amachotsedwa ngati mumagwiritsa ntchito shuga. Woopsa milandu, chikomokere, mitsempha imatha kuyamba. Pankhaniyi, thandizo ladzidzidzi liyenera kuyitanidwa.
Mawonekedwe owopsa a pathological mkhalidwe amachotsedwa pakukhazikitsa njira ya dextrose. Ndi bongo, lactic acidosis imayamba. Izi zimafunanso chisamaliro chodzidzimutsa.
Kuchita ndi mankhwala ena
Amakanizidwa kuti agwiritse ntchito mankhwala awa ndi mankhwala ena ndi Metglib:
- Miconazole;
- Othandizira a ayodini omwe amagwiritsidwa ntchito polemba mayeso a Hardware.
Chenjezo liyenera kuchitika mukamagwiritsa ntchito mankhwala ndi mankhwalawa:
- Phenylbutazone;
- Ethanoli;
- Bosentan;
- Chlorpromazine;
- glucocorticosteroid mankhwala;
- Danazole;
- okodzetsa;
- beta 2-adrenergic agonists;
- ACE zoletsa;
- Fluconazole;
- Desmopressin;
- Chloramphenicol;
- Pentoxifylline;
- Mao zoletsa;
- ma coumarin-anticoagulants;
- sulfonamides;
- fluoroquinolones;
- Kutulutsa mawu.
Kuyenderana ndi mowa
Mankhwala omwe akufunsidwa amathandizira kuti thupi lawo lizigwira ntchito molakwika mothandizidwa ndi Mowa. Kuphatikiza apo, pali kuwonjezeka kwa mphamvu ya Metglib motsutsana ndi zakumwa zoledzeretsa, zomwe zimatha kubweretsa zovuta.
Analogi
Mafotokozedwe ogwira mtima omwe ali ndi mawonekedwe omwewo:
- Gluconorm;
- Glibomet;
- Glucovans, koma pankhaniyi, Mlingo wa metformin ndiwokwera - 500 mg;
- Mphamvu ya Metglib (kuchuluka kwa metformin - 500 mg).
Migwirizano ya tchuthi Metglib kuchokera ku pharmacy
Mankhwala amapezeka ndi mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Palibe zotheka.
Mtengo wa Metglib
Mtengo wapakati ku Russia ndi ma ruble 240.
Zosungidwa zamankhwala
Kutentha kovomerezeka kwa mpweya m'chipinda chomwe mankhwalawo amasungidwa: + 25 ° C.
Tsiku lotha ntchito
Chipangizocho chimasunga zinthu zaka 2 kuchokera tsiku lotuluka.
Wopanga Metglib
Canonfarm Production, Russia.
Ndemanga za Metglieb
Kuwunika kwa ogula ndi akatswiri ndi njira yofunikira posankha chida.
Madokotala
Galina Rykova (wochiritsa), wazaka 54, Kirov
Mankhwala okhala ndi zinthu zotsutsana. Mbali imodzi, imadziwika ndi kukwera kwambiri, Komano, kayendetsedwe kake kamayendetsedwa ndi zovuta zingapo.
Andrey Ilin (endocrinologist), wazaka 45, Ufa
Ngati mumatsatira dongosolo la mankhwalawo ndikuwongolera kuchuluka kwa shuga m'magazi tsiku lililonse, kupewa kugwiritsa ntchito mankhwala ena, zotsatira zoyipa sizimachitika.
Odwala
Vladimir, wazaka 39, mzinda wa St.
Chidacho chikuyenererana ndi zochita zake. Mtengo umakhala wokwera pang'ono, kupatsidwa kuti nthawi zambiri ndikofunikira kumwa mankhwalawa kwa nthawi yayitali. Koma sindigwiritsanso ntchito mankhwala ena pano. Sindimakumana ndi zovuta za Metglib. Tiyenera kukumbukira kuti pali analogue yokhala ndi mlingo wapamwamba, Mphamvu imawonjezeredwa mu dzina (Osasokoneza ndi Forte), koma ndi kuzindikira kwanga, Metglib yosavuta ndikwanira.
Valentina, wazaka 38, Penza
Ndimathandizira ndi chithandizo chake kulemera ndikwabwinobwino. Ndiyenera kumangokhalira kudya zakudya zama calorie otsika, koma pakadali pano ndakwanitsa kusunga thupi langa pamlingo womwewo, womwe uli kale ndi metabolism yanga yochepa. Ndayesa zakudya zamagulu osiyanasiyana, koma pakali pano ndimakonda kugwiritsa ntchito Metglib. Kuphatikiza apo, mapiritsi ndi abwino kutenga. Mutha kupita nawo panjira, monga sikofunikira kutsatira malamulo a ukhondo kapena kukonza yankho, monga momwe zimakhalira ndi mankhwala ena.
