Mankhwala osiyanasiyana amagwiritsidwa ntchito kutengera mtundu wa shuga.
Pa mtundu 1, ma insulin ndi omwe amafunsidwa, ndipo a 2, makamaka amapangira mapiritsi.
Mankhwala ochepetsa shuga akuphatikizanso a Glucovans.
Zambiri pazamankhwala
Fomula ya Metformin
Glucovans (glucovance) - mankhwala ovuta omwe ali ndi vuto la hypoglycemic. Chachilendo chake ndi kuphatikiza magawo awiri omwe amagwira ntchito zamagulu osiyanasiyana a mankhwala a metformin ndi glibenclamide. Kuphatikiza uku kumawonjezera zotsatira.
Glibenclamide ndi woimira m'badwo wachiwiri wa zotumphukira za sulfonylurea. Amadziwika ngati mankhwala othandiza kwambiri m'gululi.
Metformin amatengedwa ngati mankhwala a mzere woyamba, womwe umagwiritsidwa ntchito pakadalibe zotsatira za mankhwala. Mankhwala, poyerekeza ndi glibenclamide, ali ndi chiopsezo chochepa cha hypoglycemia. Kuphatikizidwa kwazinthu ziwirizi kumakupatsani mwayi wopeza zotsatira zowoneka bwino ndikuwonjezera luso la mankhwala.
Kuchita kwa mankhwalawa kumachitika chifukwa cha magawo awiri omwe amagwira ntchito - glibenclamide / metformin. Monga zowonjezera, magnesium stearate, povidone K30, MCC, croscarmellose sodium imagwiritsidwa ntchito.
Wopezeka mu mawonekedwe a piritsi m'mitundu iwiri: 2,5 mg (glibenclamide) +500 mg (metformin) ndi 5 mg (glibenclamide) +500 mg (metformin).
Zotsatira za pharmacological
Fomula ya Glibenclamide
Glibenclamide - imaletsa njira za potaziyamu ndikuwonjezera maselo a pancreatic. Zotsatira zake, katulutsidwe ka timadzi tambiri timachulukana, timalowa m'magazi ndipo timadzi timinyewa tambiri.
Mphamvu ya kukondoweza kwa katulutsidwe ka hormone imatengera mlingo womwe umatenge. Amachepetsa shuga kwa onse odwala matenda ashuga komanso anthu athanzi.
Metformin - amalepheretsa mapangidwe a shuga m'chiwindi, amalimbikitsa chidwi cha zimakhala ndi mahomoni, timalepheretsa mayamwidwe am'magazi m'magazi.
Mosiyana ndi glibenclamide, sichimalimbikitsa kaphatikizidwe ka insulin. Kuphatikiza apo, ili ndi phindu pa mbiri ya lipid - cholesterol yathunthu, LDL, triglycerides. Sizimachepetsa kuchuluka koyamba kwa shuga mwa anthu athanzi.
Pharmacokinetics
Glibenclamide imatengeka mwachangu mosasamala kanthu za kudya. Pambuyo maola 2,5, kuchuluka kwake kwa magazi m'magazi kumafikiridwa, pambuyo pa maola 8 amayamba kuchepa. Hafu ya moyo ndi maola 10, ndipo kuchotsedwa kwathunthu ndi masiku 2-3. Pafupifupi zimapukusidwa kwathunthu mu chiwindi. Thupi limapukusidwa mu mkodzo ndi bile. Kumangiriza kwa mapuloteni a plasma sikupitirira 98%.
Pambuyo pakukonzekera pakamwa, metformin imangokhala yodzaza kwathunthu. Kudya kumakhudza mayamwidwe a metformin. Pambuyo maola 2,5, kuchuluka kwambiri kwa chinthu kumafikiridwa; kumachepera m'mwazi kuposa m'madzi am'magazi. Siphathamatidwa ndipo singasinthe. Kutha kwa theka-moyo ndi maola 6.2. Amaperekedwa makamaka ndi mkodzo. Kulumikizana ndi mapuloteni ndikosathandiza.
The bioavailability wa mankhwalawa ndi chimodzimodzi kupatula osiyana aliyense yogwira pophika.
Zizindikiro ndi contraindication
Mwa zina mwa zomwe mukumwa mapiritsi a Glucovans:
- Mtundu wachiwiri wa matenda a shuga osagwira ntchito monga chithandizo cha zakudya, zolimbitsa thupi;
- Mtundu wa 2 wodwala matenda a shuga osagwira ntchito panthawi ya monotherapy ndi Metformin ndi Glibenclamide;
- Posintha mankhwala odwala omwe amalamulidwa ndi glycemia.
Contraindication kuti agwiritse ntchito ndi:
- Mtundu 1 wa shuga;
- Hypersensitivity kuti sulfonylureas, metformin;
- Hypersensitivity ku magawo ena a mankhwala;
- kukanika kwa impso;
- mimba / mkaka wa m`mawere;
- matenda ashuga ketoacidosis;
- othandizira opaleshoni;
- lactic acidosis;
- kuledzera;
- chakudya chama hypocaloric;
- zaka za ana;
- kulephera kwa mtima;
- kulephera kupuma;
- matenda opatsirana opatsirana;
- vuto la mtima;
- porphyria;
- matenda aimpso.
Malangizo ogwiritsira ntchito
Mlingo wakhazikitsidwa ndi adokotala, poganizira kuchuluka kwa glycemia ndi machitidwe a thupi. Pafupifupi, muyezo wazithandizo zimagwirizana ndi zomwe zimaperekedwa. Chiyambireni cha mankhwala ndi chimodzi patsiku. Popewa hypoglycemia, sayenera kupitilira muyeso womwe unakhazikitsidwa wa metformin ndi glibenclamide padera. Kuchulukitsa, ngati pakufunika, kumachitika milungu iwiri iliyonse kapena kupitilira apo.
Milandu yosamutsidwa kuchokera ku mankhwala kupita ku Glucovans, chithandizo chamankhwala chimayikidwa poganizira zam'mbuyomu Mlingo uliwonse wogwira ntchito. Kutalika kokhazikika kwa tsiku ndi tsiku ndi magawo anayi a 5 + 500 mg kapena 6 magawo a 2,5 + 500 mg.
Mapiritsi amagwiritsidwa ntchito molumikizana ndi chakudya. Pofuna kupewa shuga wambiri m'magazi, tengani chakudya chamagulu nthawi iliyonse mukamamwa mankhwalawa.
Kanema kochokera kwa Dr. Malysheva:
Odwala apadera
Mankhwalawa sanatchulidwe pokonzekera komanso panthawi yoyembekezera. Zikatero, wodwalayo amapatsidwa insulin. Mukakonzekera kutenga pakati, muyenera kudziwitsa dokotala. Chifukwa cha kusowa kwa kafukufuku wofufuza, ndi mkaka wa m'mawere, Glucovans sigwiritsidwa ntchito.
Odwala okalamba (> azaka 60) sanapatsidwe mankhwala. Anthu omwe akuchita ntchito yayikulu salimbikitsidwa kumwa mankhwalawo. Izi zimagwirizanitsidwa ndi chiwopsezo chachikulu cha lactic acidosis. Ndi megoblastic anemia, ziyenera kukumbukiridwa kuti mankhwalawa amachepetsa kuyamwa kwa B 12.
Malangizo apadera
Gwiritsani ntchito mosamala matenda a chithokomiro, zotupa, kutalika kwa adrenal. Palibe mankhwala omwe amafunsira ana. Glucovans saloledwa kuphatikiza mowa.
Mankhwalawa amayenera kutsatiridwa ndi njira yoyezera shuga musanadye. Ndikulimbikitsanso kuyang'ana ndende ya creatinine. Ngati matenda aimpso okalamba, kuwunika kumachitika katatu pachaka. Ndi magwiridwe antchito a ziwalo, ndikokwanira kudzipenda kamodzi pachaka.
Maola 48 asanafike / atachitidwa opaleshoni, mankhwalawa amathetsedwa. Maola 48 isanachitike / atatha kuyesedwa kwa X-ray ndi chinthu cha radiopaque, Glucovans sigwiritsidwa ntchito.
Anthu omwe ali ndi vuto la mtima ali ndi chiopsezo chowonjezeka cha matenda a impso ndi hypoxia. Kuyang'anira kwambiri mtima ndi ntchito ya impso ndikulimbikitsidwa.
Zotsatira zoyipa ndi bongo
Zina mwazotsatira zoyipa zakumwa zimawonekera:
- chofala kwambiri ndi hypoglycemia;
- lactic acidosis, ketoacidosis;
- kuphwanya kukoma;
- thrombocytopenia, leukopenia;
- kuchuluka kwa creatinine ndi urea m'magazi;
- kusowa kwa chakudya ndi mavuto ena am'mimba;
- urticaria ndi kuyabwa kwa khungu;
- kuwonongeka kwa chiwindi ntchito;
- hepatitis;
- hyponatremia;
- vasculitis, erythema, dermatitis;
- zosokoneza zowoneka zakanthawi.
Ngati bongo wa Glucovans, hypoglycemia imayamba chifukwa cha kukhalapo kwa glibenclamide. Kumwa 20 g shuga kumathandiza kuti mapapu azikhala mwamphamvu. Kupitilira apo, kusintha kwa mlingo kumachitika, chakudyacho chimawunikanso. Hypoglycemia yayikulu imafuna chisamaliro chadzidzidzi ndikugonekedwa kuchipatala. Mankhwala ochulukirapo amatha kutulutsa ketoacidosis chifukwa cha kukhalapo kwa metformin. Zofananazo zimathandizidwa kuchipatala. Njira yothandiza kwambiri ndi hemodialysis.
Kuchita ndi mankhwala ena
Osaphatikiza mankhwalawa ndi phenylbutazone kapena danazole. Ngati ndi kotheka, wodwalayo amayang'anira momwe zimachitikira. ACE zoletsa amachepetsa shuga. Kuchulukitsa - corticosteroids, chlorpromazine.
Glibenclamide sikulimbikitsidwa kuti iphatikizidwe ndi miconazole - kuyanjana kotereku kumawonjezera zovuta za hypoglycemia. Kulimbitsa machitidwe a chinthucho ndikotheka mutatenga Fluconazole, anabolic steroids, clofibrate, antidepressants, sulfalamides, mahomoni achimuna, zotumphukira za coumarin, cytostatics. Mahomoni achikazi, mahomoni a chithokomiro, glucagon, barbiturates, diuretics, sympathomimetics, corticosteroids amachepetsa mphamvu ya glibenclamide.
Ndi munthawi yomweyo makonzedwe a metformin okhala ndi okodzetsa, mwayi wokhala lactic acidosis ukuwonjezeka. Zinthu za Radiopaque zikaphatikizidwa zimatha kupangitsa kulephera kwa impso. Pewani kugwiritsa ntchito mowa basi, komanso mankhwala osokoneza bongo omwe ali ndi zomwe ali nazo.
Zambiri, ma analogu
Mtengo wa mankhwalawa Glukovans ndi ma ruble 270. Sifunika malo osungirako ena. Yoperekedwa ndi mankhwala. Moyo wa alumali ndi zaka zitatu.
Kupanga - Merck Sante, France.
Analogue mtheradi (zigawo zogwira ntchito) ndi Glybomet, Glybofor, Duotrol, Glunored.
Palinso mitundu ina yophatikizira yogwira (metformin ndi glycoslide) - Dianorm-M, metformin ndi glipizide - Dibizid-M, metformin ndi glimeperide - Amaryl-M, Douglimax.
M'malo amatha kukhala mankhwala okhala ndi chinthu chimodzi chogwira ntchito. Glucofage, Bagomet, Glycomet, Insufort, Meglifort (metformin). Glibomet, Maninil (glibenclamide).
Maganizo a odwala matenda ashuga
Ndemanga za odwala zimawonetsa kugwira ntchito kwa Glucovans komanso za mtengo wovomerezeka. Amadziwikanso kuti muyezo wa shuga mukamamwa mankhwalawa uyenera kuchitika pafupipafupi.
Choyamba adatenga Glucophage, atalembedwa kuti akhale Glucovans. Dokotala adaganiza kuti zitha kukhala zothandiza kwambiri. Mankhwalawa amachepetsa shuga bwino. Pokhapokha tiyenera kuchita zinthu zambiri pafupipafupi kuti tipewe hypoglycemia. Adotolo adandiuza izi. Kusiyana pakati pa Glucovans ndi Glucophage: mankhwala oyamba ali ndi glibenclamide ndi metformin, ndipo chachiwiri chimakhala ndi metformin.
Salamatina Svetlana, wazaka 49, Novosibirsk
Ndakhala ndikuvutika ndi matenda ashuga kwa zaka 7. Posachedwa ndidasankhidwa kukhala mankhwala osakanikirana a Glucovans. Pompopompo pazabwino: kukonzekera, kugwiritsa ntchito, chitetezo. Mtengo ulibe kuluma - phukusi lomwe ndimangopereka 265 r, lokwanira theka la mwezi. Mwa zoperewera: pali zotsutsana, koma sindine wa gulu ili.
Lidia Borisovna, wazaka 56, Yekaterinburg
Mankhwalawa adalembera amayi anga, ali ndi matenda ashuga. Amatenga Glucovans pafupifupi zaka 2, akumva bwino, ndikumuwona akuchita bwino komanso wokondwa. Poyamba, mayi anga anali ndi vuto lakumimba - nseru komanso kutaya mtima, mwezi ukatha zonse zimatha. Ndidazindikira kuti mankhwalawa ndi othandiza komanso amathandiza.
Sergeeva Tamara, wazaka 33, Ulyanovsk
Ndinatenga Maninil m'mbuyomu, shuga adakhala pafupifupi 7.2. Adasinthira ku Glucovans, mu sabata la shuga shuga adatsikira ku 5.3. Ndikuphatikiza chithandizo ndi masewera olimbitsa thupi komanso zakudya zosankhidwa mwapadera. Ndimayeza shuga pafupipafupi ndipo sindimalola kuti zinthu ziziwayendera kwambiri. M'pofunika kusinthira ku mankhwalawa pokhapokha mukaonana ndi dokotala, onani kuti mwatsatanetsatane.
Alexander Savelyev, wazaka 38, St. Petersburg
