Metglib ndi mankhwala ophatikizika ophatikizidwa ndi hypoglycemic effect, omwe amapangidwa kuti azilamulira matenda a shuga a 2. Kuthekera kwa antiidiabetes kwamankhwala osankhidwa koyamba kumadziwika ndi mitundu iwiri ya mankhwala oyambira omwe ali ndi makina othandizira, omwe amalola mwamphamvu mphamvu ya metabolism ya insulin ndi glucagon. Mankhwalawa ndioyeneranso kwa odwala matenda ashuga omwe amaphatikiza kumwa mapiritsi ndi insulin: amachepetsa mlingo ndi kuchuluka kwa jakisoni wa mahomoni.
Zachidziwikire, kugwiritsidwa ntchito kwake sikuvomerezeka pamilandu yonse (monga mankhwala ena aliwonse a hypoglycemic), koma Metglib imagwirizana kwathunthu ndi miyezo yamakono yofunikira ndikuwoneka bwino.
The zikuchokera mankhwala
Njira yolingaliridwa bwino komanso yoyesedwa mwanzeru pazinthu ziwiri zogwira ntchito - metformin (400-500 mg) ndi glibenclamide (2,5 mg) simalola kokha komanso kuwongolera kwathunthu mbiri ya glycemic, komanso zimapangitsa kuchepetsa kuchuluka kwa zosakaniza.
Mankhwala aliwonse omwe amagwiritsidwa ntchito mu monotherapy, Mlingo wawo umasiyana kwambiri. Kuphatikiza pazinthu zoyambira, palinso mafilimu amtundu wa cellulose, wowuma, gelatin, glycerin, talc ndi zina zowonjezera. Mapiritsi a Metglib Force amapangidwa mu kipimo cha 5 mg glibenclamide ndi 500 mg metformin.
Mankhwala okwanira amatha kuzindikiridwa ndi zizindikiro izi: mapiritsi ozungulira mu chipolopolo choteteza cha terracotta kapena mtundu woyera wokhala ndi mzere wogawika umayikidwa m'maselo a contour a 10 - 90 zidutswa. Matumba okhala ndi malangizo amadzaza pabokosi la makatoni. Pamtengo wotsika mtengo wa Metglib: ma ruble 240-360. kunyamula.
Pharmacology Metglib
Gawo loyambirira la njira yomwe odwala matenda ashuga ambiri omwe ali ndi matenda amtundu wa 2 amadziwa bwino ndi metformin, mankhwala okhawo amtundu wake pagulu la Biguanide omwe amachepetsa kukana kwa maselo owonongeka a cell insulin. Matenda amtundu wamtundu ndikofunikira kwambiri kuposa kukondoweza kwa kupanga kwawo, chifukwa cha matenda amtundu wa 2 shuga, maselo a β-masenti amapereka.
Kuphatikiza pakuphatikiza inshuwaransi ya insulin, gawo limakhalanso ndi ntchito zina:
- Kuletsa mayamwidwe a shuga m'matumbo a matumbo, kukondoweza kwa kugwiritsidwa ntchito kwake ndi minofu;
- Kuletsa kwa gluconeogeneis;
- Kuteteza ma β-cell ku apaptosis asanakwane ndi necrosis;
- Kupewa kwamitundu yonse ya acidosis komanso matenda oopsa;
- Kukondoweza kwa microcirculation ya zinthu zachilengedwe, endothelial ntchito ndi lipid metabolism;
- Kutsika kwa magazi kunenepa kwambiri, kutsekeka kwa kukhathamiritsa kwa oxidative, kusintha kwa lipid.
Mkhalidwe wofunikira pakudziwika kwa mawonekedwe a lipid mu mtundu 2 shuga ndikuwongolera thupi. Metformin Imathandizira Matenda Akulimbana ndi Matenda Aakulu. Matenda opatsirana amawonjezera mwayi wa zovuta za khansa ndi 40%. Biagunide imalepheretsa kusintha koyipa. Ngakhale anthu athanzi opitirira zaka 40, WHO imalimbikitsa kugwiritsa ntchito Metformin muyezo wochepetsetsa kuti muchepetse kukalamba ndi zochitika zam'mtima.
Chofunikira chachiwiri, glibenclamide, ndikuyimira m'badwo watsopano wa mankhwala a sulfonylurea.
Mankhwalawa amaphatikizidwa ndi mndandanda wa mankhwala ofunikira omwe ali ndi pancreatic ndi extrapancreatic zotsatira.
Mwa kukweza kapamba, pawiriyo umachulukitsa kupanga kwake kwa insulin. Pokhudzana ndi β-maselo omwe amachititsa kuti matenda ashuga amtundu wa 2 athe, glibenclamide salowerera ndale ndipo amakhalabe ndi zochitika zawo polimbikitsa maselo osafunikira a insulin.
Mankhwala ovuta ndi othandiza pamagawo onse a chitukuko, chifukwa amapereka multivariate momwe:
- Pancreatic - imachulukitsa kuzindikira kwa maselo ojambulidwa, imateteza maselo a β-cell ku glucose aukali, amathandizira kaphatikizidwe ka insulin;
- Zowonjezera-pancreatic - metabolite imagwira ntchito mwachindunji ndi minyewa komanso mafuta, imalepheretsa glucogenesis, ndipo imalola kuti glucose imidwe kwathunthu.
Kuchuluka kwa zosakaniza zamapangidwe amtunduwu kumakupatsani mwayi wosinthira pang'ono, ndikuwonjezera chitetezo cha mankhwalawa, kuchepetsa chiopsezo cha zovuta komanso zovuta zamagulu.
Pharmacokinetics wa mankhwala
Metformin m'mimba yogaya imagwiritsa ntchito kwambiri, imagawidwa ndi kuthamanga thupi lonse, sikumakumana ndi mapuloteni am magazi. Yake bioavailability pafupifupi 50-60%.
Metformin metabolites sanapezeke m'thupi; osasinthika, amachotsedwa impso ndi matumbo. Hafu ya moyo ndi pafupifupi maola 10, mulingo wamagazi ambiri umawonedwa patatha maola 1-2 mutatha kumwa mankhwala.
Glybenclamide kuchokera m'matumbo am'mimba amatengedwa ndikugawidwa ndi 84%, nsonga ya kutsekeka kwake ndiyofanana ndi metformin. Mapuloteni ammagazi amamangiriza mankhwalawo ndi 97%.
Kusintha kwa glibenclamide kukhala ma inert metabolites kumachitika m'chiwindi. Pafupifupi theka la zinthu zowola zomwe zatsitsidwa ndi impso, zina zonse ndi zimbudzi za bile. Kutha kwa theka-moyo ndikofala ndi metformin.
Zizindikiro
Metglib ndi Metglib Force amalembera mtundu wachiwiri wa matenda ashuga, ngati kusintha kwa njira ndi chithandizo cham'mbuyomu ndi metformin kapena sulfonylurea gulu lokhazikika silikuwongolera glycemia kotheratu. Ndikulimbikitsidwa kuti muthane ndi mankhwalawa ndi mankhwala a metformin ndi sulfonylurea ndi mankhwala ovuta komanso ngati muli ndi zikhazikitso za glycemic kuti muchepetse mulingo wa mankhwala ndi katundu m'thupi. Mapiritsi ndi odwala matenda a shuga omwe amadalira insulin omwe ali ndi matenda amtundu wa 2 nawonso ndi oyenera.
Contraindication
Kuphatikiza komwe kumapangitsa kuchuluka kwa ma contraindication, ngakhale ambiri pazosakaniza za chida chachitetezo ndikuwonetsetsa kuyesedwa ndi nthawi. Osatipatsa Metglib:
- Odwala omwe ali ndi hypersensitivity ku gawo lililonse la formula;
- Anthu omwe ali ndi gestational ndi 1st matenda a shuga;
- Amakhudzidwa ndi matenda a shuga kapena matenda am'malire;
- Odwala ndi mbiri ya magwiridwe antchito a impso kapena chiwindi;
- Ngati mu kusanthula kwa creatinine ukuwonjezeka mpaka 110 mmol / l mwa akazi ndi 135 mmol / l mwa amuna;
- Ndi hypoxia yamavuto osiyanasiyana;
- Odwala omwe adapezeka ndi lactic ndi ketoacidosis;
- Anthu odwala matenda ashuga omwe ali ndi hypoglycemia yoyambitsidwa ndi vuto la metabolic;
- Kwakanthawi - munthawi yovulala kwambiri, matenda, kuwotcha kwakukulu, gangrene;
- Panthawi yodzikakamiza mankhwala;
- Ndi leukopenia, porphyria;
- Ngati wodwala ali ndi chakudya chamagulu, chakudya, chomwe sichidutsa 100 kcal / tsiku.;
- Ndi kuledzera (osakwatiwa kapena aakulu).
Kwa ana, amayi oyembekezera komanso oyembekezera, palibe umboni uliwonse wonena za kuthandizira komanso chitetezo cha mankhwalawa, chifukwa chake Metglib imaphatikizidwanso mu gulu ili la odwala.
Mlingo ndi makonzedwe
Mukamasankha mlingo, dokotala amayang'ana pazotsatira za mayeso, gawo la matendawa, zomwe zimagwirizana ndi matenda, zaka za odwala matenda ashuga komanso momwe thupi limayankhira pazigawo za mankhwala.
Kwa Metglib Force, malinga ndi malangizo ogwiritsira ntchito, mlingo woyambira tsiku ndi tsiku ungakhale 2,5 / 500 mg kapena 5/500 mg kamodzi. Ngati chimodzi mwazigawo za Metglib kapena zofanizira zina za sulfonylurea zitha kugwiritsidwa ntchito ngati mankhwala oyambira, ndiye kuti mukalowetsa mankhwalawo ndi mtundu wophatikizika, amawongoleredwa ndi kuchuluka kwa mapiritsi.
Mlingo wa kuchepa kwa mankhwalawa uyenera kukhala pang'onopang'ono: pakatha masabata awiri, mutha kuwunika momwe mankhwalawo amathandizira poyambira ndikuwasintha kukhala 5/500 mg. Pakadutsa theka la mwezi, ngati pakufunika kutero, mankhwalawa amatha kuwonjezeredwa ku mapiritsi 4 pa mlingo wa 5/500 mg kapena mapiritsi 6 omwe ali ndi 2,5 / 500 mg. Kwa Metglib ndi mlingo wa 2,5 / 500 mg, mlingo waukulu ndi 2 mg ya mankhwalawa.
Mlingo wothandizirana umawonetsedwa bwino patebulo.
| Mtundu Wofikira | Chiwerengero cha mapiritsi | Mawonekedwe a phwando |
| 2,5 / 500 mg ndi 5/500 mg | 1 pc 2-4 ma PC. | m'mawa ndi chakudya cham'mawa; m'mawa ndi madzulo, ndi chakudya |
| 2,5 / 500 mg | 3,5,6 ma PC | Ma ruble atatu patsiku, chakudya cham'mawa, nkhomaliro, chakudya chamadzulo |
| 5/500 mg | 3 ma PC | Ma ruble atatu patsiku, chakudya cham'mawa, nkhomaliro, chakudya chamadzulo |
| 2,5 / 400 mg | kuchokera 2 ma PC. | m'mawa ndi madzulo, nthawi imodzi |
Kwa odwala matenda ashuga okalamba omwe ali ndi mphamvu yochepa ya impso, mulingo woyambira wa Metglib Force umakhazikitsidwa nthawi zambiri 2.5 / 500 mg. Pankhaniyi, mawonekedwe a impso amayenera kuyang'aniridwa pafupipafupi, chifukwa kuchuluka kwa metformin panthawi yomwe sichingamalize kuchotsedwa sikowopsa, koma zovuta - lactic acidosis. Mwa kulimbikira thupi komanso kudya mokwanira, zoperewera zimafanana.
Zosafunika zotsatira, bongo
Zotsatira zoyipa sizomwe zimapangitsa kukana chithandizo: thupi litatha kusintha, zizindikiro zambiri zimachoka pazokha, ndipo kuvulazidwa kwa matenda osachiritsika a shuga kumakhala kwakukulu kwambiri kuposa ngozi yomwe ingachitike kuchokera ku Metglib. Chachikulu ndikuwerengera moyenera mankhwalawa: pogwiritsa ntchito mankhwala osokoneza bongo mwangozi kapena wodwala, wodwala matenda ashuga amakhala ndi chidwi ndi nkhandwe, amataya mphamvu, amakhala ndi mantha, manja ake amanjenjemera. Khungu limakhala lonyowa komanso lonyowa, kugunda kwa mtima kwachangu, wogwidwa ali pafupi kukomoka. Kupeza hypoglycemia kumakhala kotheka kwa okalamba komanso ofooka ndi matenda ndi hypocaloric zakudya za odwala matenda ashuga.
Ngati mankhwala osokoneza bongo, zotsatirazi zimachitika:
- Kupweteka kwam'mimba
- Migraines
- Matenda a Dyspeptic;
- Mitundu yosiyanasiyana yokhudza thupi lawo siligwirizana.
Kusakhalitsa kwakanthawi kwakanthawi kumathetsedwa ndi chithandizo chamankhwala, kulimbikira kuwonekera kwa zizindikiritso kumafuna kusintha kwa Metglib analogues - Diabeteson, Dimaril, Gluconorm, Bagomet Plus, Glukovans, Glibenclamide kuphatikiza ndi Metformin, Glucofast (mwakufuna kwa dotolo).
Anthu odwala matenda ashuga okhudza Metglieb
Pamabwalo azotheka pa Metglib, kuwunika kwa anthu odwala matenda ashuga ndi madotolo kumasakanizika, chifukwa odwala ambiri akumalandira chithandizo chovuta, ndipo zimawavuta kuwunika momwe mankhwalawo amathandizira. Zambiri zimakhudzana ndi njira yodziwira chithandizo: iwo omwe mankhwalawo amasankhidwa samadandaula za zotsatira zoyipa. Koma kuyesera zomwe takumana nazo odwala matenda ashuga sikotheka komanso koopsa.
Pofotokozera malingaliro onse, titha kunena kuti Metglib yolemba monotherapy yamtundu wa 2 shuga ndiye chida chabwino kwambiri: chitetezo chachikulu komanso chothandiza, mtengo wotsika mtengo, phindu labwino pamlingo wa wodwalayo, kupewa matenda amtima ndi a oncological kumaika mankhwala mzere wolemekezeka wa mankhwala osankha oyamba.
