Gluconorm ya matenda ashuga

Masiku ano, anthu miliyoni 350 padziko lonse lapansi ali ndi matenda a shuga mellitus (DM). Izi ndi 5% ya anthu padziko lapansi. Ku Russia, kuli odwala ngati 12 miliyoni. Ndipo osati zakuti awa ndi deta yolondola. Anthu omwe ali ndi matenda ashuga omwe ali ndi mtundu wobisika wa shuga amapitilira katatu kuposa momwe awalembetsa. Malinga ndi kuneneratu kwa boma (ndipo osati kopanda chiyembekezo kwambiri), pofika chaka cha 2030, matenda ashuga adzakhala atalanda kale anthu 80% padziko lapansi.

Kukhazikika kwa kasamalidwe ka matenda opatsika ndi njira yofunika kwambiri yolipirira glycemia. Pachikhalidwe, mankhwala a metformin kapena sulfonylurea amagwiritsidwa ntchito ngati mankhwala oyamba a antiidiabetes. Ngati njira zotere sizikwanira (DM - matenda osachiritsika, opita patsogolo), insulin ndi mitundu ina ya mankhwala ochepetsa shuga alumikizidwa.

Kuphatikiza kotchuka kwambiri pakati pa endocrinologists ndi metformin yokhala ndi glibenclamide. Gluconorm - iyi ndi mankhwala azigawo ziwiri zomwe zimachepetsa kuchuluka kwa shuga m'magazi. Kodi mankhwalawa ndi othandizira bwanji, ndipo akuyenera kuwagwiritsa ntchito motani?

Makhalidwe a pharmacological

Gluconorm ndi mankhwala ophatikiza omwe amaphatikiza mankhwala am'magulu osiyanasiyana a pharmacological malinga ndi momwe amathandizira.

Gawo loyambirira la fomuloli ndi metformin, woimira biguanides, yemwe amatithandizanso kuzindikira glycemic pokonzanso kukana kwa maselo kukhala ndi insulin yawo ndikuthandizira kugwiritsa ntchito shuga ndi minofu. Kuphatikiza apo, biguanide imalepheretsa kuyamwa kwa mafuta amthupi ndipo imalepheretsa kupanga shuga m'magazi. Amasintha metformin ndi mafuta osamala, kukhalabe ndende zabwino za mitundu yonse ya cholesterol ndi triglycerol.

Glibenclamide, wachiwiri wogwira popereka mankhwala, ngati woimira gulu lachiwiri la sulfonylurea, amalimbikitsa kupanga kwa insulin mothandizidwa ndi ma cell a β-cell a kapamba omwe amachititsa izi. Imawateteza ku glucose aukali, amasintha kukana kwa insulini komanso mtundu wa ligaments wokhala ndi maselo. Kutulutsidwa kwa insulin kumakhudzana ndi mayamwidwe a shuga ndi chiwindi ndi minofu, chifukwa chake, malo ake samapangidwa mu mafutawo. Thupi limachita gawo lachiwiri la kupanga insulin.

Zambiri za pharmacokinetics

Pambuyo polowa m'mimba, glibenclamide imalowetsedwa ndi 84%. Cmax (pachimake cha msinkhu wake) amafika pambuyo pa maola 1-2. Kugawa ndi voliyumu (Vd) ndi malita 9-10. Thupi limalumikizana ndi mapuloteni amwazi ndi 95%.

Chomwe chili m'chiwindi chimasinthidwa ndikutulutsa ma metabolite awiri osagwirizana. Mmodzi waiwo amachotsa matumbo, chachiwiri - impso. Hafu ya moyo wa T1 / 2 ili mkati mwa maola 3-16.

Pambuyo polowa m'matumbo, metformin imatanganidwa mwachangu, osapitilira 30% ya mankhwala omwe amakhalamo. The bioavailability wa greatuanide sizidutsa 60%. Ndi kufanana kwa michere, kuyamwa kwa mankhwalawo kumachepetsa. Imagawidwa mwachangu, samalowa mu kulumikizana ndi mapuloteni a plasma.

Mlingo wa Gluconorm ndi mawonekedwe ake

Gluconorm, chithunzi chake chomwe chitha kuwonekera m'ndimeyi, amalowa pamaneti ngati mawonekedwe a mapiritsi ozungulira okhala ndi chipolopolo choyera. Pakupuma, mthunzi wa mankhwalawa ndi imvi. Piritsi limodzi pali zinthu ziwiri zofunika pazotsatira izi: metformin - 400 mg, glibenclamide - 2,5 g.) Onjezerani mkondowo ndi zotuluka: talc, cellulose, wowuma, glycerol, cellacephate, gelatin, stearate wa magnesium, croscarmellose sodium, sodium carboxymethyl starch, silicon diodium. diethyl phthalate.

Mankhwalawa amadzaza mu ma PC 10 kapena 20. m'maselo omwe amapangidwa ndi zojambulazo. Mu makatoni ma CD atha kukhala awiri kapena anayi. Kwa Gluconorm, mtengo wake ndi bajeti: kuchokera ku ma ruble 230, amatulutsa mankhwala omwe mumalandira. Alumali moyo wa mapiritsi ndi zaka zitatu. Mankhwala safuna mikhalidwe yapadera kuti asungidwe.

Momwe mungagwiritsire ntchito Gluconorm

Kwa Gluconorm, malangizo a ntchito angalembedwe kumwa mapiritsi mkati ndi chakudya. Dokotalayo amawerengera mlingo payekhapayekha, poganizira momwe matendawo amayendera, zomwe zimachitika ndi matenda amisinkhu, odwala komanso omwe amadwala matenda ashuga, komanso momwe thupi limachitikira ndi mankhwalawo. Monga lamulo, yambani ndi piritsi 1 / tsiku. Pakatha sabata limodzi kapena awiri, mutha kuwunika zotsatira, komanso osakwanira, sinthani zofananira.

Ngati Gluconorm sinali mankhwala oyambira, mukasinthira njira yothandizira yamankhwala am'mbuyomu, mapiritsi 1-2 amatchulidwa poganizira momwe mankhwalawo alili. Chiwerengero chachikulu cha mapiritsi omwe angatengedwe patsiku ndi 5 zidutswa.

Kuthandiza ndi bongo

Kukhalapo kwa metformin pamapangidwe kumakhumudwitsa matumbo, ndipo nthawi zina lactic acidosis. Ndi zizindikiro za zovuta (minofu kukokana, kufooka, kupweteka kwa epigastric dera, kusanza), mankhwalawa ayimitsidwa. Ndi lactic acidosis, wozunzidwayo amafunika kuchipatala mwachangu. Bwezeretsani ndi hemodialysis.

Kupezeka kwa glibenclamide mu formula sikumapatula chitukuko cha hypoglycemia. Ndikotheka kuzindikira mkhalidwe wowopsa chifukwa chosafuna kusamala, thukuta, tachycardia, kunjenjemera, khungu lotuwa, isomnia, paresthesia, chizungulire komanso mutu, nkhawa. Ndi mtundu wofatsa wa hypoclycemia, ngati wozunzidwayo sanadziwe, amapatsidwa shuga kapena shuga. Ndi kukomoka, shuga, dextrose, glucagon (40% rr) jekeseni iv, pakhungu kapena pakhungu. Wodwalayo akayambanso kuzindikira, amapatsidwa chakudya ndimadzi othamanga, chifukwa nthawi zambiri zimayambiranso.

Zotsatira Zogwiritsa Ntchito Mankhwala

Kuphatikiza ndi ACE zoletsa, NSAIDs, antifungal mankhwala, ma fibrate, salicitates, anti-tuberculosis mankhwala, β-adrenergic blockers, guanethidine, MAO inhibitors, sulfonamides, chloramphenicol, tetracyrindiamine, tetracycodiaminophenide, tetrazining theline. .

Ntchito ya hypoglycemic ya Gluconorm imachepetsedwa kuchokera ku zotsatira za adrenostimulant barbiturates, corticosteroids, anti-epilepsy mankhwala, diuretics (thiazide mankhwala), furosemide, chlortalidone, triamteren, morphine, ritodrin, glucagon, mahomoni a chithokomiro.

Mankhwala othandizira mkodzo acid amathandizira kuti azichita bwino popewa kudzipatula komanso kupititsa mphamvu yogwirizananso ndi gluconorm resorption. Ethanol imawonjezera mwayi wa lactic acidosis. Metformin imakhudza kwambiri pharmacokinetics ya furosemide.

Zotsatira zoyipa

Metformin ndi imodzi mwamankhwala otetezeka kwambiri a hypoglycemic, koma, monga mankhwala aliwonse opangidwa, ali ndi zotsatirapo zake. Zina mwazovuta kwambiri ndi vuto la kukomoka, lomwe limapezeka m'mishuga yambiri odwala matenda ashuga atatha nthawi yosinthira okha. Glibenclamide ndiyophatikizanso nthawi yayitali yokhala ndi umboni waukulu wothandiza ndi chitetezo. Zomwe zalembedwa patebulopo ndizosowa, koma malangizo amayenera kuphunzira musanayambe chithandizo.

Ndani akuwonetsedwa ndikutsutsana ndi Gluconorm

Mapiritsi amalembedwa kwa odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda, ngati kusintha kwa moyo ndi chithandizo cham'mbuyomu sikunapatse 100% glycemic control. Ngati kugwiritsa ntchito mankhwala awiri osiyana (Metformin ndi Glibenclamide) ndikulola kubwezerera shuga kwa nthawi yayitali, ndikofunikanso kuti m'malo mwake muthane ndi mankhwala amtundu umodzi - Glucanorm.

Osagwiritsa ntchito Gluconorm ndi:

• Mtundu woyamba wa shuga;
• Hypoglycemia;
• Matenda a shuga a ketoacidosis, chikomokere ndi chidziwitso;
• Zosagwira ntchito zamkati ndi mawonekedwe awo okondweretsa;
• Matenda a chiwindi;
• Mikhalidwe yopweteketsedwa ndi njala ya minofu ya minofu (yokhala ndi vuto la mtima, matenda a mtima, mantha, kulephera kupuma);
• Porphyria;
• Kugwiritsa ntchito miconazole munthawi yomweyo;
• Zomwe zimaphatikizapo kusintha kwakanthawi kwa insulini (panthawi ya opaleshoni, kuvulala, matenda, mayeso ena ogwiritsa ntchito zilembo zochokera ku ayodini);
• Kuledzera;
• Lactic acidosis, kuphatikizapo mbiri;
• Mimba ndi mkaka wa m`mawere;
• Hypocaloric (mpaka 1000 kcal) zakudya;
• Hypersensitivity pazigawo za formula.

Malangizo owonjezera

Kugwiritsa ntchito Gluconorm ndi Amayi Oyembekezera ndi Olera

Ngakhale pa nthawi yomwe mwana akukonzekera, Gluconorm iyenera m'malo mwa insulin, popeza mankhwalawa amaphatikizidwa motere. Mkaka wa m'mawere ukadyetsedwa, zoletsa zimakhalabe zonse, popeza mankhwalawo amalowerera osati mwa placenta ya mwana wosabadwayo, komanso mkaka wa m'mawere. Kusankha pakati pa insulin ndi kusamutsa mwana kuti ayamwitse kudyetsa mwana kuyenera kuganiziranso kuchuluka kwa chiwopsezo kwa mayiyo komanso kuopsa kwa mwana.

Kugwiritsa ntchito mankhwala a chiwindi ndi impso

Pankhani ya kulephera kwa chiwindi (pachimake, mawonekedwe osagwiritsika ntchito) Gluconorm siikusankhidwa. Ndi matenda a impso, komanso m'malo omwe angawakhumudwitse (ndi matenda opatsirana, kugwedezeka, kuchepa kwa madzi), mankhwalawo sawonetsedwa.

Malangizo apadera

Kuvulala kwambiri komanso maopaleshoni akuluakulu, matenda opatsirana omwe amayatsidwa ndi kutentha thupi, akusonyeza kuti wodwalayo amasinthana kwakanthawi.

Anthu odwala matenda ashuga ayenera kuchenjezedwa za kuopsa kwa kukhala ndi hypoglycemia pogwiritsa ntchito NSAIDs, mowa, mankhwala opatsirana ndi ethanol, komanso kuperewera kwa zakudya m'thupi nthawi zonse.

Ngati musintha momwe mumakhalira, zakudya, nkhawa komanso thupi, muyenera kusintha kuchuluka kwa mankhwalawa.

Ngati wodwalayo akufufuzidwa pogwiritsa ntchito ayodini, Gluconorm imathetsedwa masiku awiri, ndikuisintha ndi insulin. Mutha kubwereranso kumalo am'mbuyomu chithandizo musanaphunzire maola 48 mutatha kafukufukuyu.

Kuchita bwino kwa Gluconorm kumachepetsedwa kwambiri ngati wodwala satsata zakudya zama carb ochepa, amatsogolera moyo wongokhala, osawongolera shuga tsiku ndi tsiku.

Zovuta za Gluconorm pa kuthekera kwa kayendedwe ka mayendedwe

Popeza pakati pazotsatira zoyipa zomwe zimagwiritsidwa ntchito ndi Gluconorm palinso zazikulu monga hypoglycemia ndi lactic acidosis, wodwala matenda ashuga ayenera kusamala makamaka poyendetsa komanso ku malo oopsa oopsa (akamagwira ntchito pamalo okwera kapena maginito ovuta).

Gluconorm - analogues

Malinga ndi code ya ATX ya 4th, amagwirizana ndi Gluconorm:

• Glucovans;
• Janumet;
• Glibomet;
• Galvus Met;
• Amaril.

Kusankhidwa ndi kusintha kwa mankhwalawa kumangokhala mwa luso la katswiri. Kudzipenda nokha komanso kudzichitira nokha mankhwala osaganizira mawonekedwe onse a chiwalo china kumatha kukhala zotsatirapo zomvetsa chisoni.

Ndemanga Zahudwala

Zokhudza ndemanga za anthu odwala matenda ashuga a Gluconorm nthawi zambiri zimakhala zotsutsana. Ena amati mankhwalawa samathandiza, pali zodabwitsa zambiri, kuphatikiza kunenepa. Ena amati chovuta chachikulu pothana ndi mankhwalawa chinali kusankha mankhwalawo, kenako shugayo nkubwerera mwakale. Za tiyi wazitsamba "Altai 11 Gluconorm yokhala ndi blueberries" ndemanga zabwino: zimathandiza kukhalabe ndi masomphenya, ndikukhala bwino.

Gluconorm ndi mankhwala osavuta kugwiritsa ntchito omwe adatsimikiziridwa ndikuchita kafukufuku wazinthu zazikulu. Zotsatira za Biguanides ndi sulfanilurea zakhala zikugwiritsidwa ntchito pochizira matenda a shuga 2 kwazopitilira theka la zaka, ndipo mitundu yatsopano ya mankhwala othandizira odwala matenda ashuga sananenebe ulamuliro wawo.