Hypoglycemic m`kamwa mankhwala a gulu lachiwiri Glybomet

Pafupifupi 6% ya anthu padziko lapansi masiku ano ali ndi matenda a shuga - matenda omwe chizindikiro chawo chachikulu ndi kuchuluka kwa shuga m'magazi. Zinthu zakunja zimathandizira kukula kwa matendawa; genetics imathandizanso.

Chithandizo chabwino cha matenda ashuga ndichakudya chamafuta ochepa: ngati munthu wabwinobwino amatha kudya mpaka 400 g wamafuta ochepa patsiku, ndiye kuti shuga ndiwosakwana 85 g.

Koma ngakhale kukanidwa kwa chimanga, mbatata, makeke, masamba ambiri ndi zipatso ndikuzisintha ndi mafuta a nyama omwe samakulitsa glucometer, si aliyense angalipire glycemia kwathunthu. Izi zimachitika makamaka kwa odwala matenda ashuga omwe ali ndi matenda amtundu wina, omwe mbiri yakale ya kulephera.

Pochiza matenda a shuga, mitundu inayi ya mankhwala yapangidwa, yomwe imasiyanitsidwa ndi kapangidwe ndi njira yothandizira vutoli.

1. Mankhwala omwe amachepetsa kuchuluka kwa insulin kukokana ndi maselo ndi biguanides (Metformin, Glucofage) ndi thiazolidinediones (Pioglitazone, Rosiglitazone).
2. Pancreatic synthesis zokuthandizira amkati insulin ndi zotumphukira za sulfanylureas (Diabetes, Maninil) ndi dongo.
3. Mankhwala okhala ndi mndandanda wambiri wa incretin, wowongolera kulemera ndi chidwi - Galvus, Januvia, Onglisa, Viktoza, Bayeta.
4. Mankhwala omwe amatchinga kunyamula shuga m'matumbo ndi Acarbose, Glucobay.

Glybomet imatchulidwanso kukonzekera kwa pakamwa kwa gulu lachiwiri, malangizo ogwiritsira ntchito omwe aperekedwenso kuti awunikenso. Chidziwitso chonse chimatengedwa kuchokera kumagulu omwe amapezeka pagulu, kotero si chida chodzipezera tokha komanso kudzithandiza nokha.

Glybomet - kapangidwe

Kuphatikizidwa mu piritsi lililonse la mankhwala awiri omwe amagwira ntchito - metformin hydrochloride (400 mg) ndi glibenclamide (2.5 mg) zimapangitsa kuti azitha kupewa glycemia, komanso kuchepetsa mlingo wa magawo. Ngati aliyense wa iwo atagwiritsidwa ntchito ngati monotherapy, mlingo wake umakhala wokwera kwambiri.

Ili ndi chilinganizo ndi maipi mu mawonekedwe a cellulose, wowuma chimanga, colloidal silicon dioksidi, gelatin, glycerin, talc, magnesium stearate, acetylphthalyl cellulose, diethyl phthalate.

Zotsatira za pharmacological

Chimodzi mwazinthu zazikulu zomwe zimagwira, glibenclamide, ndi m'badwo watsopano wa mankhwala a sulfonylurea omwe amaphatikizidwa pamndandanda wazofunikira zamankhwala okhala ndi pancreatic ndi mphamvu zowonjezera pancreatic.

Sizimangoyambitsa ntchito ya kapamba konse, komanso zimathandizira kupanga insulin. Limagwirira ntchito yawo amatengera chitetezo cha kapamba damaged-maselo owonongeka ndi glucose wamakani, omwe amawonetsa kupitilira kwa shuga, komanso kukondoweza kwa insulini yamatsenga a maselo.

Kutenga Glibomet mogwirizana ndi glycemic control kumachepetsa kagayidwe ka lipid komanso kumachepetsa chiopsezo cha magazi. Ntchito ya insulin imawonjezeka, ndipo limodzi nawo mayamwidwe a glucose ndim minofu ndi chiwindi. Mankhwala amagwira gawo lachiwiri ndikupanga insulin.

Metformin ndi ya biguanides - kalasi ya zinthu zolimbikitsa zomwe zimachepetsa kusazindikira kwa maselo akhungu kupita ku insulin yawo. Kubwezeretsa kumva sikulinso kofunikira kuposa kupititsa patsogolo katulutsidwe ka timadzi tating'onoting'ono, chifukwa ndi matenda amtundu wa 2 shuga, kapamba amatulutsa ngakhale ochulukirapo.

Metformin imathandizira kulumikizana kwa ma receptor ndi insulin, imawonjezera mphamvu ya postreceptor. Pakakhala insulin m'magazi, zozizwitsa zimawonetsedwa.

Metformin ili ndi mawonekedwe apadera:

• Imachepetsa mayamwidwe a glucose m'matumbo amatumbo ndikuthandizira kugwiritsidwa ntchito kwake mu minofu;
• Zoletsa gluconeogeneis;
• Kuteteza b-cell ku apoptosis yothamanga;
• Amachepetsa chiopsezo cha mtundu uliwonse wa acidosis komanso matenda oopsa;
• Amasintha kukoka kwamadzi m'magazi, endothelial ntchito ndi metabolism yamafuta (amachepetsa kuchuluka kwa cholesterol "yoyipa" ndi triglycerol m'magazi);
• Amathandizira kuchepetsa kulemera - chikhalidwe chofunikira pakulamulira kwa glycemic kwa odwala omwe ali ndi mtundu wa 2 DS;
• Amachepetsa magazi kuwirira ndi oxidative nkhawa;
• Iwo ali ndi fibrinolytic zotsatira poletsa minofu plasminogen activator;
• Imalepheretsa njira za oncological (kwakukulu, matenda a shuga amawonjezera chiopsezo cha oncology ndi 40%);
• Amachepetsa chiopsezo cha imfa kuchokera ku zochitika zamtima.

Kuunikiridwa mozama kwa odwala matenda ashuga 5800 omwe ali ndi matenda a shuga a 2 adachitidwa ku China. Otenga nawo mbali pachiyeso adalandira metformin kuphatikizira ndi kusintha kwa moyo. Gulu lolamulira, odzipereka anangosintha moyo wawo. Kwa miyezi 63 mgulu loyamba, kufa anali anthu 7.5 pa anthu 1000 / zaka ziwiri, wachiwiri - kwa miyezi 45, motero anthu 11.

Mankhwalawa amayamba kugwira ntchito maola awiri atalowa m'mphepete, mphamvu yake imapangidwa kwa maola 12. Metformin siziwopseza hypoglycemic. Mankhwala okhala ndi umboni wokwanira, wadutsa mayeso okhazikika a nthawi ndipo amafunikira matenda ashuga pamilingo yonse yolimbikitsira mankhwala.

Masiku ano, msika wogulitsa mankhwala umapereka magawo 10 a mankhwala antidiabetes, koma metformin akadali mankhwala odziwika kwambiri ochizira matenda a shuga 2 pachimake chilichonse cha matendawa.

Kuphatikizika kwa synergistic pazinthu ziwiri zomwe zikugwira ntchito ku Glibomet kumatha kusintha thupi.

1. Mphamvu ya pancreatic - mankhwalawa amachepetsa "khungu" la maselo, amathandizira kubisala kwa insulin yake, amateteza maselo a b.
2. Zowonjezera-pancreatic zotsatira - biagudin zimakhudza mwachindunji minofu ndi mafuta am'mafuta, zimachepetsa gluconeogeneis, zimakulitsa kuchuluka kwa kuthamanga kwa shuga.

Mulingo woyenera kwambiri wa kuchuluka kwa zinthu zomwe zimagwira ntchito zimatha kusintha mlingo wa mankhwala. Kwa ma b-cell, kukondoweza mofatsa kotero ndikofunikira kwambiri: kumawonjezera chitetezo cha mankhwalawa, kumachepetsa chiopsezo cha zovuta zawo, komanso kumachepetsa zovuta.

Mphamvu ya Pharmacokinetic

Glybenclamide kuchokera m'matumbo am'mimba amatengedwa ndikugawidwa bwino - ndi 84%, kuchuluka kwa mankhwalawa kumatha kuwonedwa pambuyo pa maola 1-2. Gawo lomwe limapangidwa ndimapuloteni a magazi ndi 97%.

Metabolism ya Glibenclamide imachitika m'chiwindi, pomwe imasinthidwa kwathunthu kukhala metabolites yogwira. Hafu ya zinthu zomwe zawonongeka imatuluka kudzera mu impso, theka linalo kudzera m'miyendo ya bile. Hafu ya moyo wawo pafupifupi maola 10.

Metformin imalowerera kwathunthu m'matumbo am'mimba, imagawidwa nthawi yomweyo ku ziwalo ndi minofu, sikugwirizana ndi mapuloteni amwazi konse. The bioavailability wa chigawo chimachokera 50-60%.

Pazonse, kuchuluka kwakukulu kwa zosakaniza zamkati mwa magazi kumachitika ola limodzi kapena awiri mutamwa mapiritsi.

Zisonyezero zochizira ndi Glybomet

Malangizo akuwonetsa kuti mankhwalawa ndi omwe amaperekedwa kwa odwala matenda ashuga amtundu wa 2, kuphatikizapo odwala matenda a shuga omwe amadalira odwala matenda ashuga, ngati zakudya zapadera, zomwe zimapangitsa kuti azichita masewera olimbitsa thupi komanso zina mwa njira zina za hypoglycemic sizinapereke zotsatira zake.

Mankhwala ambiri amakhala ndi zotsatira zowonjezera, ngati thupi siliyankha moyenera mankhwala, amasintha algorithm ya mankhwala polemba Glibomet pamapiritsi.

Kwa yemwe mankhwala amatsutsana

Popeza mankhwalawa ali ndi zovuta pavuto, sizodabwitsa kuti ali ndi zoletsa zokwanira kuvomereza.

Mankhwala atha kukhala owopsa:

• Ndi matenda ashuga;
• Ngati wodwala amakhala ndi chidwi chachikulu ndi zosakaniza za formula;
• Anthu odwala matenda ashuga ndi mtundu woyamba wa matenda;
• Ndi matenda ashuga komanso mawonekedwe amalire;
• Ngati mbiri ya chiwindi ndi impso;
• Pamene creatinine imakwera mpaka 110 mmol / l mwa akazi ndi 135 mmol / l mwa amuna;
• Odwala omwe ali ndi lactic acidosis kapena ketoacidosis;
• Ngati wodwala matenda ashuga ali ndi hypoglycemia wopsinjika ndi matenda a metabolic;
• Ndi hypoxia yamitundu yosiyanasiyana;
• Pambuyo pakuvulala, gangrene, matenda, kutentha kwambiri;
• Ndiwofatsa;
• Odwala omwe amapezeka ndi leukopenia, porphyria;
• Ndi zakudya zanjala ndi zopatsa mphamvu zosakwana 1000 kcal / tsiku.;
• Ndi zakumwa zoledzeretsa ndi zakumwa zoledzeretsa;
• Ana aang'ono;
• Amayi oyembekezera komanso oyembekezera.

Momwe mungatenge Glibomet

Pali zoletsa kutenga Glibomet:

1. Ndi matenda a chithokomiro;
2. Ngati wodwala akudwala malungo;
3. Ngati mbiri ya hypofunction ya pituitary cortex ndi adrenal gland.

Mlingowo umatsimikiziridwa ndi endocrinologist malinga ndi zaka za wodwalayo komanso mawonekedwe azachipatala, koma wopanga akuwonetsa kuti akuyamba ndi mapiritsi awiri tsiku lililonse, akumagwiritsa ntchito mankhwalawo. Mulingo waukulu wa mankhwalawa ndi 2 g / tsiku. Ndikofunika kugawa phwandoli nthawi zonse. Ngati chiwerengerochi sichikuyembekezeredwa, chithandizo chovuta chikulembedwera ndikuphatikiza mankhwala amphamvu.

Zotsatira zoyipa ndi bongo

Pali zotsatira zoyipa zambiri zomwe zimachitika mutatha kumwa Glibomet, koma izi siziyenera kukhala chifukwa chokana mankhwalawa, chifukwa kuvulaza komwe thupi sakulipirira matenda ashuga kumakhala kwakukulu kwambiri kuposa kuwopsa kwa zotsatira zoyipa.

Kuti mupewe zoterezi, ndikofunikira kuwerengera mlingo wake. Ngati chizolowezichi chachulukira, odwala matendawa amadzutsa njala yosatha, mphamvu, mantha, kugwedezeka kwa dzanja.

Zizindikiro za mankhwala osokoneza bongo amathanso kukhala tachycardia, khungu pakhungu, kuchuluka thukuta, kukomoka.

Zotsatira zoyipa kwambiri mutatha kutenga Glibomed, hypoglycemia imakhala yangozi kwambiri pamtunduwu kwa odwala omwe afooka chifukwa cha matenda omwe atenga nthawi yayitali, odwala matenda ashuga okalamba omwe ali ndi matenda ashuga, oledzera, anthu omwe amagwira ntchito zolimbitsa thupi, komanso aliyense amene amakhala ndi njala yochepa ( zosakwana 1000 kcal / tsiku.) zakudya.

Mwa Zizindikiro zodziwika bwino, ambiri ndi:

• Mutu;
• Zovuta mu epigastrium;
• Matenda a Dyspeptic;
• Mitundu yosiyanasiyana yokhudza thupi lawo siligwirizana.

Ngati kusakhalitsa kwakanthawi kumachitika mutamwa mapiritsi, kumatha kuthetseratu ndi chithandizo chamankhwala. Ngati zizindikiro zimatchulidwa kapena ngati zizindikiro za ziwonetsero zikuwoneka, ndiye kuti muyenera kusankha mtundu wa Glibomet.

Zotsatira Zogwiritsa Ntchito Mankhwala

Kuwonjezeka kwa hypoglycemic zotsatira za Glybomet kumawonedwa panthawi yofanana ndi zotumphukira za decumarol, phenylbutamazone, β-blockers, oxytetracycline, allopurinol, cimetidine, ethanol, sulfinpyrazone mu Mlingo wofunikira, phenenecid, chloramphenicol, mainampulin .

Mankhwala ophatikizidwa ndi mahomoni a chithokomiro, zoteteza pakamwa, barbiturates, thiazide diuretics amalepheretsa kuthekera kwa Glibomet.

Malangizo apadera

Kugwiritsa ntchito Glibomet kumayimitsidwa nthawi yomweyo ngati pali zizindikiro za lactic acidosis: kufooka lakuthwa, kusanza, kuphipha kwa minofu, kupweteka pamimba. Wovutitsidwayo amafunikira kuchipatala mwachangu.

Malangizowo akuwalimbikitsa kulandira chithandizo ndi Glybomet kuti aperekeze kuwunika kwa creatinine poyesa magazi. Kwa odwala matenda ashuga omwe ali ndi impso wathanzi, kuwunika koteroko ndikofunikira kamodzi pachaka, odwala omwe mtundu wawo wa creatinine ali pafupi kwambiri ndi malire, ndipo odwala okhwima ayenera kuyesedwa kawiri pachaka.

Masiku awiri asanachitike opaleshoni yokonzekera, momwe kugwiritsa ntchito mankhwala owononga a msana kapena obalalitsa, kutenga Glibomet kwathetsedwa ndipo odwala matenda ashuga asinthika kukhala a insulin. Mutha kubwezeretsa njira ya mankhwalawa ndi Glybomet pambuyo poti wodwala waloledwa kudya mkamwa. Ngakhale ndi impso zomwe zimagwira ntchito pafupipafupi, adotolo samapanga chisankhochi pasanadutse masiku awiri opareshoni.

Kumwa mapiritsi pamafunika kusamala mukamagwira ntchito yomwe ingakhale yoopsa ku moyo komanso thanzi, komanso poyendetsa magalimoto. Izi zimagwirizanitsidwa ndi chiopsezo cha hypoglycemia, kuchepa kwa kuchuluka kwa zochitika zama psychomotor komanso kuthekera kwakuya kwambiri.

Zotsatira za chithandizo ndi Glibomet zimadalira kwambiri kulondola kwa kutsatira malangizo ndi malangizo a endocrinologist: kudya ndi kugona ndi kupumula, kuchita masewera olimbitsa thupi nthawi zonse, kuwongolera glycemic mwadongosolo, kuphatikizapo kunyumba.

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuchepetsa kumwa kwambiri momwe mungathere (chizolowezi chimakhala kapu ya vinyo wofiyira kamodzi pa sabata), popeza ethanol imayambitsa chitukuko cha glycemia, komanso mavuto a disulfiram - ululu m'chigawo cha epigastric, mavuto a dyspeptic, kutentha kwa thupi ndi mutu, kutayika. kulumikizana, kupweteka mutu, palpitations.

Mtengo wa mankhwala ndi malamulo osungira

Kodi Glybomet ndi yotsika mtengo ku malo ogulitsa mankhwala? Kutengera ndi dera, mankhwalawo amatha kugulitsidwa ma ruble 200-350. Phukusi lililonse la Glibomet, chithunzi chake chomwe chikuwoneka m'gawoli, chili ndi miyala 40.
Kuti mankhwalawa asathenso kugwira ntchito, ayenera kutetezedwa kuchokera ku dzuwa lowala komanso chinyezi chachikulu.

Mankhwala ofanana

Ngati Glibomed ngakhale mu zovuta mankhwala samapereka kufunika, chifuwa kapena zina zoyipa zawoneka, mankhwalawo amaloŵedwa ndi analogues ndi chinthu choyenera chogwira ntchito.

Kwa Glibomed, mankhwalawa amatha kukhala mapiritsi a Diabeteson, gawo lalikulu lomwe limagwira ndi glyclazide, kapena Dimaril, momwe gawo lothandizira ndilofanana ndi imodzi mwazigawo za Glibomed, glimepiride.

Mankhwala ena othandizira odwala omwe ali ndi vuto lofananalo, Gluconorm, Bagomet Plus, Glucovans, Glibenclamide osakanikirana ndi Metformin, Glucofast ndi mankhwala.The endocrinologist amapanga m'malo, awerengeranso mlingo. Kusintha kwa regimen ya chithandizo ndikotheka: ma analogu amafotokozedwa onse muzovuta kuchipatala komanso mawonekedwe a monotherapy, kuwonjezera pa zakudya zosachepera carb komanso zolimbitsa thupi.

Ndizosatheka kulosera momwe thupi liyankhira ndi mankhwala atsopano, ndiye nthawi yoyamba mverani zizindikiro zonse ndikuwuzani adotolo za kusintha kwamwadzidzidzi kulemera kwake, kuchepa mphamvu kwa thupi, Zotsatira zakuwunika glycemia ndi glucometer ndi zina zofunika panthawi yanthawi yosinthira njira zina.

Ndemanga pa mawonekedwe a Glibomet

Pankhani ya mankhwala a Glycomet omwe amawaonetsa odwala matenda ashuga amakhudzidwa kwambiri ndi momwe matimu ake amagwiritsidwira ntchito kuposa momwe amagwirira ntchito.

Ngati mulingo woyenera wasankhidwa molondola, mayankho ake amakhala abwino, nthawi zina pamakhala zonena za zovuta zina. Koma popeza kuwerengera kumeneku ndi kwamunthu payekha, kutengera maphunziro azachipatala ndi mawonekedwe a matendawa mwa wodwala wina, kusinthana kwa zochitika pankhaniyi kulibe ntchito, ndipo mpaka kumakhala koopsa.

Pfotokozera mwachidule malingaliro onse, titha kunena kuti Glibomed ndiye mankhwala oyenera a mtundu woyamba wa 2 a matenda ashuga: mtengo wotsika mtengo, chitetezo chokwanira, kusaloŵerera m'ndondomeko yokhudza kulemera kwa thupi, zotsatira zopindulitsa pazotsatira zamtima komanso zamankhwala.

Zachidziwikire, kugwiritsa ntchito kwake sikungatheke kwa aliyense (monga mankhwala ena a hypoglycemic), koma mankhwalawa amagwirizana ndi zamakono zamakhalidwe abwino ndikugwirizana.