Kuchulukana kwa mtundu wa matenda a shuga a 2

Malinga ndi ziwerengero, mankhwalawa opangidwa ndi metformin amaperekedwa ndi 43% ya anthu odwala matenda ashuga omwe ali ndi mtundu wachiwiri wa matenda omwe awonekera koyamba, ngati kusintha kwa moyo sikupereka chiwonetsero chonse cha glycemic. Chimodzi mwa izo ndi mtundu waku Russia wa mankhwala othandizira odwala matenda ashuga Glucofage wokhala ndi dzina la malonda la Gliformin.

Pali mitundu iwiri ya mankhwala: ndi kutulutsidwa mwachizolowezi komanso ndi mphamvu yayitali. Glformin Prolong imagwiritsidwa ntchito kamodzi, ndipo imagwira ntchito kwa tsiku limodzi. Kugwiritsa ntchito bwino, kuchita bwino komanso chitetezo amayamikiridwa ndi onse odwala matenda ashuga komanso madokotala omwe amagwiritsa ntchito mapiritsi a monotherapy komanso ovuta.

The zikuchokera, mlingo mawonekedwe, analogues

Mankhwala Glformin Prolong, kampani yaku Russia ya mankhwala Akrikhin, amatulutsa mapiritsi okhala ndi mafilimu okhala ndi mphamvu yotulutsa.

Piritsi lililonse la chikasu la biconvex limakhala ndi 750 mg yogwira ntchito ya metformin hydrochloride ndi zotuluka: silicon dioxide, hypromellose, cellcrystalline cellulose, magnesium stearate.

Mapiritsi okhala ndi 30 kapena 60 ma PC. mu cholembera pensulo ya pulasitiki yokhala ndi cholembera ndi chivundikiro chowongolera pakutsegulira koyamba. Pulasitiki yonyamula imayikidwa mu katoni. Alumali moyo wa mankhwalawa pamalo owuma, amdima firiji ndi zaka 2. Kwa Gliformin Prolong 1000, mtengo pa intaneti umachokera ku ma ruble 477.

Ngati mukufuna m'malo mankhwalawa, adokotala amatha kugwiritsa ntchito fanizo ndi mankhwala omwewo:

• Fomu;
• Metformin;
• Glucophage;
• Metformin Zentiva;
• Glformin.

Zamankhwala a Glformin

Mankhwala Glformin Prolong amawerengedwa kuti amachepetsa shuga mu gulu la Biguanide. Dimethylbiguanide bwino basal ndi postprandial glycemia. Amayendedwe a metformin, chinthu chofunikira cha formula, ndikuthandizira chidwi cha zotumphukira za maselo a cell kuti azigwiritsa ntchito insulin ndikufulumizitsa kugwiritsidwa ntchito kwa glucose mu minofu minofu.

Mankhwalawa sakukhudza kupanga kwa amkati a insulin, motero palibe hypoglycemia pakati pazovuta zake. Kuletsa gluconeogeneis, metformin imalepheretsa kuphatikiza kwa shuga m'chiwindi ndikulepheretsa mayamwidwe ake m'matumbo. Pogwiritsa ntchito glycogen synthase mwachangu, mankhwalawa amathandizira kupanga glycogen, imapangitsa luso la mayendedwe amtundu uliwonse wamtundu wa shuga.

Pharmacokinetics

Mutatha kugwiritsa ntchito mapiritsi awiri a Glformin Prolong (1500 mg), kuchuluka kwakukulu m'magazi kumafika patatha pafupifupi maola asanu. Ngati tikufanizira kuchuluka kwa mankhwalawa pakapita nthawi, ndiye kuti mlingo umodzi wa 2000 mg wa metformin wokhala ndi mphamvu yayitali ikufanana pakukwaniritsidwa kawiri kugwiritsa ntchito metformin ndikumasulidwa kwabwinobwino, komwe kumachitika kawiri patsiku kwa 1000 mg.

Kapangidwe ka chakudya, komwe kamatengedwa limodzi, sikukhudza kuyamwa kwa mankhwala Glyformin Prolong. Pogwiritsa ntchito mapiritsi kawiri kawiri pa 2000 mg, kuchuluka kwake sikumakhazikika.

Mankhwalawa amamangirira pang'ono pamapuloteni amwazi. Kugawa voliyumu - mkati mwa 63-276 l. Metformin ilibe ma metabolites.

Mankhwalawa amachotsedwa mu mawonekedwe ake oyambirira m'njira yachilengedwe mothandizidwa ndi impso. Pambuyo polowa m'matumbo, theka la moyo silidutsa maola 7. Ndi kukanika kwa aimpso, theka la moyo limatha kukula ndikuthandizira kuti pakhale kuchuluka kwa metformin m'magazi.

Zizindikiro za gliformin yotalikilapo

Mankhwalawa adapangira kuti azilamulira matenda a shuga a mtundu wa 2, makamaka kwa achikulire onenepa kwambiri, ngati kusintha kwa moyo kulibe kupereka 100% glycemic chiphuphu.

Mankhwalawa amagwiritsidwa ntchito onse mu monotherapy komanso panjira yovuta kutsata ndi mapiritsi ena a antidiabetes kapena insulin nthawi iliyonse yamatendawa.

Contraindication

Osakupatsani mankhwala omwe ali ndi metformin ya:

• Hypersensitivity ku zigawo za formula;
• Matenda ashuga ketoacidosis, precoma ndi chikomokere;
• Zosavomerezeka pamakina pomwe creatinine chilolezo chili pansi pa 45 ml / min.;
• Kutulutsa madzi m'thupi, limodzi ndi kutsegula m'mimba kwambiri komanso kusanza, matenda amtundu wamkati ndi kupuma, kugwedezeka ndi zina zina zomwe zimayambitsa kukula kwa impso;
• Kuchitapo kwakukulu kwa opaleshoni, kuvulala komwe kumakhudzanso kwakanthawi ndimankhwala ndi insulin;
• Kulephera kwa mtima ndi kupuma, myocardial infarction ndi matenda ena osachiritsika komanso owopsa omwe amathandizira minofu hypoxia;
• Matenda a chiwindi;
• Kuledzera kosatha, poyizoni wakumwa;
• Mimba ndi mkaka wa m`mawere;
• Lactic acidosis, kuphatikizapo mbiri;
• Maphunziro osiyanitsa ndi X-ray (kwakanthawi);
• Zakudya za Hypocaloric (mpaka kcal / tsiku limodzi.);
• Zaka za ana chifukwa chosowa umboni wokwanira wogwira ntchito komanso chitetezo.

Makamaka chidwi chake chikuyenera kuperekedwa ku gulu la odwala matenda ashuga okhwima, makamaka omwe akuchita ntchito yayikulu, popeza ali pachiwopsezo cha lactic acidosis.

Glyformin pa mimba

Pobweza pang'ono mtundu wa matenda ashuga a 2, mimbayo imapitirira ndi ma pathologies: kusokonezeka kwa kubadwa, kuphatikizanso kufa kwa pathupi, ndizotheka. Malinga ndi malipoti ena, kugwiritsa ntchito metformin sikuti kumayambitsa kusintha kwa kubereka mwa mwana wosabadwa.

Komabe, pa gawo lokonzekera kubereka, ndikofunika kusintha kuti mukhale ndi insulin. Pofuna kupewa zovuta zapakhomo pakukula kwa mwana, ndikofunikira kuti amayi apakati azilamulira glycemia pa 100%.

Mankhwala amatha kulowa mkaka wa m'mawere. Ndipo ngakhale kuti palibe zoyipa zomwe zimayambitsa makanda omwe akuyamwitsa, Glformin Pronge silipangira malangizo kuti agwiritse ntchito panthawi yoyamwa. Lingaliro la kusinthana ndi kudya kwachilendo limapangidwa poganizira zovuta zomwe zingavulaze mwana ndi mapangidwe ake mkaka wa m'mawere.

Momwe mungagwiritsire ntchito moyenera

Kutalika kwa Glyformin kumapangidwira ntchito zamkati. Piritsi imatengedwa kamodzi - madzulo, ndi chakudya chamadzulo, popanda kutafuna. Mlingo wa mankhwalawa amatsimikiziridwa ndi dokotala, poganizira zotsatira za mayeso, gawo la matenda ashuga, zomwe zimayenderana ndi zomwe zimachitika, zomwe zimachitika komanso momwe munthu amamuchitira mankhwalawo.

Monga mankhwala oyambira, ngati munthu wodwala matenda ashuga sanamwe mankhwala a metformin, tikulimbikitsidwa kuti muyezo woyamba wa mankhwalawa udalowe mkati mwa 750 mg / tsiku, kuphatikiza kumwa mankhwalawo ndi chakudya. M'masabata awiri ndizotheka kuwerengera bwino momwe mankhwalawo adasankhidwira ndipo ngati ndi kotheka, musinthe. Kuchepetsa kucheperachepera kwa muyezo kumathandizira kuti thupi lizisintha mosavutikira komanso kuchepetsa kuchuluka kwa zovuta.

Mulingo wamba wamankhwala ndi 1500 mg (mapiritsi 2), omwe amamwa kamodzi. Ngati sizotheka kukwaniritsa kufunika komwe mukufunako, mutha kuwonjezera kuchuluka kwa mapiritsi mpaka 3 (iyi ndi mlingo waukulu). Amatengedwa nthawi yomweyo.

Kulowa m'malo mwa othandizira ena a hypoglycemic omwe ali ndi Glformin Pronge

Ngati munthu wodwala matenda ashuga atenga kale mankhwala opangidwa ndi Metformin omwe ali ndi vuto lotulutsidwa, ndiye kuti mukawachotsa ndi Glformin Prolong, wina ayenera kuganizira za kumwa kwa tsiku lililonse. Wodwala akalandira metformin wamba muyezo wa 2000 mg, kusintha kwa glyformin kwakanthawi sikungathandize.

Ngati wodwala agwiritsa ntchito othandizira ena a hypoglycemic, ndiye kuti mukamachotsa mankhwalawo ndi Glformin Pronge amawongoleredwa ndi muyezo wokhazikika.

Metformin yamtundu wa 2 shuga imagwiritsidwanso ntchito limodzi ndi insulin. Mlingo woyambira wa Glyformin Prolong ndi zovuta mankhwala ndi 750 mg / tsiku. (phwando limodzi lophatikizidwa ndi chakudya chamadzulo). Mlingo wa insulin amasankhidwa poganizira zomwe amawerengera a glucometer.

Mlingo wovomerezeka wazomwe zimakhala ndi nthawi yayitali ndi 2250 mg (3 ma PC.). Ngati matenda ashuga sangakwanitse kuwongolera kwathunthu matendawa, amawasinthira mtundu wamankhwala ndikumasulidwa kwachizolowezi. Mwa njira iyi, mlingo waukulu ndi 3000 mg / tsiku.

Kutalika kwa maphunziridwe kumatengera ndi matendawa: ngati ma polycystic ovary omwe ali ndi metformin nthawi zina amatha kuchiritsidwa mwezi umodzi, ndiye kuti odwala matenda ashuga omwe ali ndi matenda a 2 amatha kutenga moyo wonse, kuwonjezera njira yothandizira mankhwalawa pogwiritsa ntchito mankhwala ena ngati kuli kofunikira. Ndikofunika kumwa mankhwalawo nthawi yomweyo, tsiku ndi tsiku, osasokoneza, osayiwala zakuwongolera kwa shuga, Zakudya zama carb ochepa, zolimbitsa thupi, komanso zochitika zam'maganizo.

Malangizo a magulu enieni a ashuga

Pa zovuta za impso, mtundu wautaliwu sulembedwera mitundu yokhayo yamatenda, pomwe creatinine chilolezo chotsika kuposa 45 ml / min.

Mlingo woyambira wa odwala matenda ashuga omwe ali ndi impso ndi 750 mg / tsiku, malirewo ali mpaka 1000 mg / tsiku.

Kuchita kwa impso kuyenera kuwunikidwa pafupipafupi kwa miyezi 3-6. Ngati chilengedwe cha creatinine chatsika pansi pa 45 ml / min., Mankhwalawo amachotsedwa mwachangu.

Mu ukalamba, pamene mphamvu ya impso yafupika, kuchepetsedwa kwa gawo la Glformin Prolong kumachitika potsatira mayeso a creatinine.

Zotsatira zoyipa

Metformin ndi imodzi mwamankhwala otetezeka, kuyezetsa nthawi komanso maphunziro ambiri. Kapangidwe ka zotsatira zake sikulimbikitsa kupanga kwa insulin yake, chifukwa chake, hypoglycemia yokhala ndi monotherapy sichimapangitsa kutalika kwa glyformin. Chochitika chovuta kwambiri ndizovuta zam'mimba, zomwe zimatengera umunthu wa thupi ndikupita pambuyo pozolowera popanda chithandizo chamankhwala. Kukula kwa zoyambitsa kumawunikidwa mogwirizana ndi kuchuluka kwa WHO:

• Nthawi zambiri - ≥ 0.1;
• Nthawi zambiri - kuyambira 0.1 mpaka 0.01;
• Kanthawi kochepa - kuchokera pa 0.01 mpaka 0.001;
• Nthawi zambiri, kuyambira 0.001 mpaka 0.0001;
• Osowa kwambiri - <0.0001;
• Sizikudziwika - ngati kuchuluka kwa zomwe zikupezeka sizingadziwike.

Zotsatira zakuwonera zikuwonetsedwa pagome.

Kukonzedwa kwa nthawi yayitali kwa Glyformin Prolong kungayambitse kuwonongeka kwa vitamini B12. Ngati matenda am'madzi a megaloblastic atapezeka, ayenera kulumikizidwa ku etiology yomwe ingatheke.

Kuti muchepetse kuwonetseredwa kwa vuto la dyspeptic, piritsi limatengedwa bwino ndi chakudya.

Hepatic insuffuffence, yomwe imakwiya ndikugwiritsa ntchito Glformin, imangodzilola yokha pambuyo pothana ndi mankhwalawo.

Ngati izi zasintha muumoyo mwapezeka mutatha Glformin Pronge, wodwala matendawa ayenera kuchenjeza adokotala omwe amapezekapo.

Zizindikiro zosokoneza bongo

Mukamagwiritsa ntchito 85 g ya metformin (mlingo umapitirira wowonjezera nthawi 42,5), hypoglycemia sizinachitike. Zikakhala choncho, lactic acidosis inayamba. Ngati wozunzidwayo akuwonetsa zofanana ndi zomwe zikuchitika, kugwiritsa ntchito Glformin Prolong kumatha, wodwala matenda ashuga amapititsidwa kuchipatala, mulingo wa lactate ndikuwunikira kumveka. Metformin yowonjezera ndi lactate zimachotsedwa ndi dialysis. Mofananamo, chithandizo chamankhwala chimachitika.

Zotsatira Zogwiritsa Ntchito Mankhwala

Kuphatikiza kophatikizidwa

Zizindikiro zosiyanitsa ndi X-ray, zomwe zimakhala ndi ayodini, zimatha kuyambitsa lactic acidosis mu matenda ashuga omwe amakhala ndi vuto laimpso. M'mayeso ogwiritsa ntchito mankhwalawa, wodwalayo amapatsidwa insulin kwa masiku awiri. Ngati mawonekedwe a impso ndiwokhutiritsa, patatha masiku awiri mutawerengedwa, mutha kubwerera ku njira yachipatala yapitayi.

Maofesi olimbikitsidwa

Ndi poyizoni wa mowa, mwayi wa lactic acidosis ukuwonjezeka. Amawonjezera mwayi wokhala ndi zakudya zochepa zopatsa mphamvu, kuperewera kwa chiwindi. Mankhwala ofanana ndi Ethanol amakhumudwitsanso chimodzimodzi.

Zosankha kukhala osamala

Mukamagwiritsa ntchito mankhwala osokoneza bongo a hyperglycemic effect (glucocorticosteroids, tetracosactide, β-adrenergic agonists, danazole, okodzetsa), kuyang'anira kuchuluka kwa magazi ndikofunikira. Malinga ndi zotsatira za glucometer, mlingo wa Glyformin Prolong umasinthidwanso. Ma diuretics amayambitsa mavuto a impso, ndipo, chifukwa chake, lactic acidosis.

Mankhwala a antihypertgency amatha kusintha zizindikiro za hypoglycemic. Pogwiritsa ntchito munthawi yomweyo, kupereka gawo la mankhwala a metformin ndikofunikira.

Mankhwala ofanana ndi insulin, acarbose, mankhwala a sulfonylurea, salicylates, Glyformin Prolong angayambitse hypoglycemia.

Imathandizira mayamwidwe a metformin nifedipine.

Mankhwala a Cationic, amenenso amasungidwa mu ngalande za impso, amachedwetsa kuyamwa kwa metformin.

Zotsatira za kuyang'aniridwa

Ndi chithandizo chovuta ndi mankhwala ena osakanikirana, makamaka osakanikirana ndi gulu la sulfonylurea, repaglinide, insulin, hypoglycemia ndizotheka, motero, zochitika zokhudzana ndi chiopsezo chaumoyo ziyenera kutayidwa.

Ndemanga za Glformin Prolong

Ngakhale kuti aliyense ali ndi matenda awo a shuga ndipo amapita mosiyanasiyana, momwe algorithm amachitidwira zinthu zimafala, makamaka kwa mtundu wachiwiri wa matenda ashuga. About Gliformin Prolong mu matenda a shuga, ndemanga zake ndizosadabwitsa, koma nkovuta kuyesa kuchuluka kwa mankhwalawa posakhalapo osaganizira zovuta zonse za matendawa komanso moyo wawo.

Madokotala amayang'ana kwambiri kuti Glyformin Pronge SD imalipira, koma amafunika thandizo. Ndani amamvetsetsa kuti zakudya ndi maphunziro akuthupi ndizosatha, zidzakhala zachilendo ndi Glformin. Kulemera kuyenera kuyendetsedwa ndi njira iliyonse, izi ndizofunikira kwambiri. Ndi chakudya chamagulu, zoletsa ndizosavuta kunyamula ndipo zotsatira zake zimakhala zachangu.

Ngati kulibe kukopa kokwanira, lingalirani za phazi lakudulidwa, mavuto ammaso ndi mavuto a impso, osatchula vuto la mtima kapena kugunda kwam'mimba, komwe kumachitika nthawi iliyonse komanso zaka zilizonse. Ndipo awa sangokhala upangiri wa nyuzipepala ya banja Lamlungu - awa ndi malamulo achitetezo, omwe, monga mukudziwa, olembedwa m'magazi.