I-Glimecomb yezidakamizwa: imiyalelo yokusetshenziswa

I-Glimecomb yi-ejenti ye-hypoglycemic efunwa ngohlobo 2 lwesifo sikashukela. Umuthi ngokufana uthuthukisa isimo se-fat metabolism, unciphisa ubungozi be-atherosulinotic plaque ezindongeni ze-vascular, ukunciphisa isisindo somzimba ngokukhuluphala. Umuthi unqunywa kuphela lapho ungekho umphumela wokudla nokuzivocavoca.

Igama Lezwe elingafanele

I-Glyclazide + Metformin.

I-Glimecomb yi-ejenti ye-hypoglycemic efunwa ngohlobo 2 lwesifo sikashukela.

I-ATX

A10BD02.

Khipha amafomu nokwakheka

Umuthi wenziwa ngesimo samathebhule amhlophe wokusetshenziswa komlomo, abonakala nge-tint ophuzi noma ukhilimu kanye nokubukeka okuyisicaba. Iyunithi yokwelapha ihlanganisa amakhompiyutha ama-2 asebenzayo: 40 mg we-gliclazide no-500 mg we-metformin hydrochloride. I-Povidone, i-magnesium stearate, i-sorbitol ne-croscarmellose sodium njengezinto ezisizayo. Amacwecwe aqukethe amayunithi ayi-10 emaphepheni ama-blister. Esiqeshini sekhadibhodi kukhona amanxeba ayi-6.

Isenzo se-Pharmacological

Umuthi ubhekisela kuma-ejenti ahlanganisiwe we-hypoglycemic ekuphathweni komlomo. Umuthi unomphumela we-pancreatic ne-extrapancreatic.

I-Glyclazide itholakala sulfonylurea. Indlela yokusebenza yesimo samakhemikhali isuselwa ekuvuseleleni umsebenzi wezimfihlo wamaseli we-pancreatic beta. Njengomphumela wethonya le-hypoglycemic, ukwanda kwamaseli omzimba ukungena kuma-insulin, ukukhiqizwa kwe-hormone kuyanda. Umuthi osebenzayo ubuyisela umsebenzi wokuqala weziqhingi zeLangerhans futhi ufinyeze isikhathi kusukela ngesikhathi sokudla kuya ekusithekeni kwe-insulin.

I-Glimecomb ikhuthaza ukunciphisa umzimba ngenkathi ilandela ukudla ngemuva kokukhuluphala.

Ngaphezu kokubamba iqhaza ku-carbohydrate metabolism, isidakamizwa sithuthukisa i-capillary microcirculation, sinciphisa ukuhlanganiswa kweplatelet, ngaleyo ndlela kuvimbele ukukhula kwe-vascular thrombosis. Ngokuphikisana nesizinda sokuthatha i-Glimecomb, ukuqina kodonga lwe-vascular kutholakala ngokujwayelekile, i-micothrombosis kanye ne-atherosulinosis kuyamiswa, bese ubuyiselwa kwemvelo parietal fibrinolysis. Umuthi uwukuphikisana nokwanda kokuphendula kwemithambo ku-adrenaline ku-microangiopathies. Kukhuthaza ukwehliswa kwesisindo ngenkathi ulandela ukudla ngemuva kokukhuluphala.

I-Metformin hydrochloride yiqembu le-Biguanide. Isakhi esisebenzayo sinciphisa ukugcwala koshukela ngokuncindezela i-gluconeogeneis kuma-hepatocytes futhi kwehlise izinga lokufakwa kweglucose emathunjini amancane. Amakhemikhali abamba iqhaza ku-lipid metabolism, ehlisa izinga lamazinga aphansi we-lipoproteins, triglycerides ne-cholesterol egazini. Kuyasiza ukwehlisa isisindo somzimba, kepha uma kungekho i-insulin e-serum, umphumela wokwelapha awutholakali. Ngesikhathi sokufunda kwemitholampilo, akukho kusabela kwe-hypoglycemic okurekhodiwe.

I-Pharmacokinetics

Umuthi usetshenziselwa ukwelapha isifo sikashukela sohlobo 2.

Izinkomba zokusetshenziswa

Umuthi usetshenziselwa ukwelapha isifo sikashukela sohlobo lwe-2, lapho kuba nokusebenza okuncane kokulashwa kokudla, ukusebenza ngokomzimba nokwelashwa kwezidakamizwa ngeMetformin ne-Gliclazide.

I-ejog ye-hypoglycemic isetshenziswa njengendawo yokubambela ekwelashweni kwezidakamizwa nezidakamizwa ezi-2 ezigulini ezinesifo sikashukela esingavikelekile nge-insulin, inqobo nje uma ushukela wegazi ulawulwa kahle.

Contraindication

Umuthi awunconyelwe ukusetshenziswa ezimweni ezilandelayo:

• thayipha i-1 isifo sikashukela;
• i-lactic acidosis;
• amazinga e-potassium aphansi;
• isifo sikashukela sikashukela, i-precoma;
• isifo sikashukela sikashukela;
• inqubo ebabazekayo ye-pathological ezinso nasezigulini eziphazamisa ukusebenza kwezitho zomzimba (ukuphuma komzimba, inqubo yokutheleleka okunzima nokuvuvukala, ukushaqeka);
• i-porphyria;
• ukuthatha i-miconazole;
• umsebenzi wesibindi ongalungile;
• ukushaqeka kwe-cardiogenic, ukubulawa yindlala komoya-mpilo, ukwehluleka kokuphefumula, ukufakwa kwe-myocardial;
• ukudakwa kotshwala, izimpawu zokuhoxa;
• izimo lapho ukwelashwa kwe-insulin kudingekile (ukulimala kwangemva kokuhlukumezeka, isikhathi sokuvuselelwa ngemuva kokuhlinzwa kakhulu, ukusha);
• ngaphansi kwamahora angama-48 futhi kungakapheli izinsuku ezingama-2 ngemuva kokusebenzisa i-radiography usebenzisa umehluko oqukethe iodine;
• Ukudla okunama-kilojoule aphansi futhi uma kuthathwa ngaphansi kwama-kcal ayi-1000 ngosuku;
• hypersensitivity of the body's isiguli emzimbeni wezakhi zomuthi.

Ukuthatha isiguli i-Miconazole isidakamizwa kuwukuphikisana nokusetshenziswa kwe-Glimecomb.

I-Precoma ithathwa njengento ephula umthetho ukusetshenziswa komuthi.

Umuthi akufanele ubekelwe i-porphyria.

Ukuphikisana ngokusetshenziswa kwe-Glimecomb ukusebenza okungalungile kwesibindi.

I-Myocardial infarction ithathwa njenge-contraindication ukuthatha i-Glimecomb.

Ukuvumelanisa ukusetshenziswa kwe-Avandamet ukwehluleka komsebenzi wezinso.

Ngaphezu kwalokho, lesi sidakamizwa asinconywa kubantu asebekhulile abasebenza ezimeni zokuzikhandla kakhulu ngokomzimba, ngenxa yokuthuthuka okungenzeka kwe-lactic acidosis.

Kufanele kuqashelwe uma kunomkhuhlane, ukungasebenzi kahle kwe-adrenal gland dysfunction, ukusebenza okungalungile kwe-anterior pituitary, gland yegilo.

Ungayithatha kanjani i-glimecomb

Umuthi wenzelwe ukuphathwa ngomlomo ngesikhathi sokudla noma ngokushesha ngemuva kokudla. Uhlobo lwesilinganiso kanye nesikhathi sokwelashwa kunqunywa udokotela ohambelayo, ebeka imodeli yokwelashwa yomuntu ngamunye ngokuya ngoshukela oshukela egazini.

Ngoshukela

Umthamo owodwa ngesikhathi sokuqala sokwelashwa ngu-540 mg wamathebulethi anemvamisa yokuphatha ngosuku kuze kube izikhathi ezingama-1-3. Ezimweni eziningi, lesi sidakamizwa sithathwa izikhathi ezi-2 ngosuku - ekuseni nangaphambi kokulala. Izinga lansuku zonke likhethwa kancane kancane kuze kube yilapho isinxephezelo esiphikelelayo senqubo ye-pathological.

Imiphumela emibi ye-glimecomb

Ukusabela okungalungile emzimbeni wesiguli kukhula ngokuphathwa ngendlela efanele komuthi noma ngokumelene nesizinda sezifo zesibili.

Umuthi wenzelwe ukuphathwa ngomlomo ngesikhathi sokudla noma ngokushesha ngemuva kokudla.

Amapheshana wesisu

Imiphumela emibi ohlelweni lokugaya ivela njenge:

• i-dyspepsia, ukuphazamiseka kokugaya ukudla;
• imizwa yokusinda esiswini;
• isicanucanu, ukuhlanza;
• Ubuhlungu be-epigastric;
• ukubonakala nokunambitheka kwensimbi ezimpandeni zolimi;
• ukwehla kwesifiso sokudla.

Ezimweni ezingavamile, umsebenzi we-hepatocytic aminotransferases, i-alkaline phosphatase uyathuthukiswa. Mhlawumbe ukuthuthukiswa kwe-hyperbilirubinemia kuze kufike kwe-cholestatic jaundice, edinga ukuyekwa komuthi.

Izitho zeHematopoietic

Umuthi ungadala ukuvimbela ukusebenza komnkantsha obomvu, ngenxa yokuthi inani lezakhi zegazi elibunjiwe liyancipha, i-agranulocytosis, i-hemolytic anemia eba.

Isistimu yezinzwa ephakathi

Mhlawumbe ukwehla kwe-acuity ebonakalayo, ikhanda.

Kusuka ohlelweni lwezinhliziyo

I-Arrhythmia, umuzwa wokugeleza kwegazi.

I-Dyspepsia imiphumela emibi yesidakamizwa.

I-glimecomb ingadala isicanucanu, ukuhlanza.

I-Glimecomb inyusa ukubonakala kobuhlungu esifundeni se-epigastric.

I-Glimecomb ingavusa ukuhla kwesifiso sokudla.

Uhlelo lwe-Endocrine

Uma i-dosing regimen yephulwa futhi ukudla kungalandelwa, ubungozi be-hypoglycemia bukhuphuka, obuhambisana nobuthakathaka obukhulu, ukuphazamiseka kwengqondo okubuyela emuva okwesikhashana, ukujuluka okwandayo, ukulahleka kokulawulwa kwemizwelo, ukudideka nokuxhumeka okuhlelekile.

Ngasohlangothini lwe-metabolism

Ngokuphikisana nesizinda sokuphazamiseka kwe-metabolic, i-lactic acidosis ingavela. Inqubo ye-pathological ibonakala ngobuthakathaka, ubuhlungu obukhulu emisipha, ukwehluleka kokuphefumula, izinhlungu esiswini, ukwehla kwezinga lokushisa kanye nokwehla komfutho wegazi, kanye ne-bradycardia.

Allergies

Ukuphendula kwe-anaphylactoid kokuphuma kwe-sulfonylurea kubonakala ngesimo se-alculgic vasculitis, urticaria, macula, ukushesha kanye ne-pruritus, i-edema ka-Quincke, ukushaqeka kwe-anaphylactic.

Umthelela ekhonweni lokulawula izindlela

Ngesikhathi sokulashwa nge-Glimecomb, ukunakekelwa kufanele kuthathwe lapho ushayela, usebenza ngamasu ayinkimbinkimbi neminye imisebenzi edinga ukugxilwa esigulini.

I-edema kaQuincke ingemiphumela emibi yokuthatha umuthi.

I-Glimecomb ingadala ukulunywa, ukuqubuka.

I-Urticaria isebenza njengomthelela oseceleni womuthi

Umuthi ungavusa ukwehla kwe-visual acuity.

Ubuhlungu bekhanda buthathwa njengomphumela oseceleni wesidakamizwa Glimecomb.

I-Glimecomb ingadala ukujuluka ngokweqile.

Umuthi ungadala ukwehla kwengcindezi yegazi.

Imiyalo ekhethekile

Lapho uthatha izinto ezithathwa yi-sulfonylurea, kunobungozi bokuqhamuka ne-hypoglycemia eyingozi futhi eqhubeka isikhathi eside, edinga ukwelashwa okukhethekile ezimeni zokuma kanye nokuphathwa kwe-glucose yesi-5% kwezinsuku ezingama-4-5.

Ingozi yokwakha i-pathology inyuka ngokudla okunganele, ukudla ngokomzimba okuqhubekayo noma ngokuphathwa kanyekanye kwezidakamizwa eziningana ze-hypoglycemic. Ukunciphisa amathuba wenqubo ye-pathological, umuntu kufanele alandele ngokuqinile izincomo zemiyalo efakwe kulo muthi futhi athole imininingwane ephelele enemininingwane ngesikhathi sokubonisana nodokotela ohambele lo msebenzi.

Ukulungiswa kwedosi kuyadingeka ngokweqile ngokomzimba nangokomzwelo noma ngoshintsho ekudleni.

Sebenzisa ebudaleni

Abantu abaneminyaka engaphezu kwengama-60 ubudala akufanele baphuze lesi sidakamizwa lapho bekhona khona ubunzima bomzimba obukhulu ngenxa yengozi ekhuphukayo ye-lactic acidosis.

Isabelo sezingane

Umuthi awunconywa ukuba uphuzwe kuze kube yilapho uneminyaka eyi-18.

Umuthi awunconywa ukuba uphuzwe kuze kube yilapho uneminyaka eyi-18.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Lapho ukukhulelwa kwenzeka, ukuphathwa kwe-Glimecomb kufanele kuthathelwe indawo nge-insulin Therapy, ngoba ukungena ngokweqile kwezinto ezisebenzayo ngomgoqo we-placental kungenzeka. Akukho datha emomphumela we-teratogenic yazo zombili izinhlanganisela ezisebenzayo.

I-Glyclazide ne-metformin ingadalulwa ubisi lukamama, ngakho-ke, ngesikhathi sokulashwa nge-ejenti ye-hypoglycemic, i-lactation kumele ikhanseliwe.

Isicelo sokusebenza kokulimala kwezinso

Umuthi ubekwa ngemithi uma kwenzeka kungasebenzi kahle izinso kanye nephropathy yesifo sikashukela.

Sebenzisa umsebenzi wesibindi okhubazekile

Umuthi uvinjelwe ukusebenza kwesibindi okungafanele.

I-Glimecomb overdose

Ngokuhlukumezeka kwalo muthi, i-lactic acidosis kanye nesimo se-hypoglycemia kungaqhamuka. Uma kunezimpawu ze-lactic acid oxidation yezicubu, kufanele ngokushesha ushayele i-ambulensi kulowo ohlukunyeziwe. Ezimweni zokuma, i-hemodialysis iyasebenza.

Uma kwenzeka ulahlekelwe ukwazi, ukumfakelwa kwangaphakathi kwe-40% yesisombululo sikashukela kudingekile ngokuxhunywa noma ngokungabonakali.

Uma kwenzeka ulahlekelwe yimizwa, ukufakwa kwe-intravenous kwesisombululo se-glucose sama-40%, i-glucagon, intramuscularly noma ngokufakelwa, kuyadingeka. Ngemuva kokuzinza, isiguli sidinga ukudla okune-carbohydrate eningi.

Ukuxhumana nezinye izidakamizwa

Lapho uthatha ezinye izidakamizwa ngokufana ne-Glimecomb, ukusabela okulandelayo kuyabonakala:

1. Ukuqinisa umphumela wezokwelapha uhlanganiswe ne-Captopril, i-coumarin anticoagulants, i-beta-blockers, i-bromocriptine, ama-antifungal agents, ama-salicylates, imicu, ama-inhibitors we-MAO, ama-tetracycline antibiotic, izidakamizwa ezingezona izidakamizwa ezivimbela ukuvuvukala kanye ne-anti-tuberculosis.
2. I-Glucocorticosteroids, i-barbiturates, izidakamizwa ze-antiepileptic, i-calcium tubule inhibitors, i-thiazide, i-diuretics, i-Terbutaline, i-Glucagon, i-Morphine ineqhaza ekunciphiseni kwesenzo se-hypoglycemic.
3. Ama-glycosides e-Cardiac akhulisa amathuba e-extricas extricas we-cyricular, ngenkathi ecindezela i-hematopoiesis yamathambo, andisa ingozi ye-myelosuppression.

Umuthi unciphisa ukugcwala kwe-plasma yeFurosemide ngama-31% nengxenye yayo yokuphila ngamaphesenti angama-42. I-Nifedipine inyusa izinga lokufakwa kwe-metformin.

Umuthi unciphisa ukugcwala kwe-plasma yeFurosemide ngama-31% nengxenye yayo yokuphila ngamaphesenti angama-42.

Ukuhambisana notshwala

Kuyenqatshelwe ngokuphelele ukuphuza utshwala ngesikhathi sokwelashwa. I-Ethanol ikhipha ubungozi bokudakwa kakhulu kanye nokuthuthukiswa kwe-lactic acidosis. I-Ethanol ikhulisa amathuba okukhula kwe-hypoglycemia.

Yini okufanele uyisuse

Izifanekiso zomuthi, ezifanayo ekwakhekeni kwamakhemikhali nasezakhi zekhemisi, zifaka:

• I-Diabefarm;
• Glyformin;
• IGliclazide MV.

Ukushintshela komunye umuthi kungenzeka uma ungekho umphumela wokwelapha kusuka ekuthatheni i-Glimecomb nangaphansi kokuqashwa okuqinile kodokotela ohambelayo.

Imibandela yekhefu lekhemisi

Umuthi uyathengiswa ngomuthi onikezwe wona.

Ngingakwazi ukuthenga ngaphandle kadokotela

Ukuthengiswa kwamahhala kwalo muthi akuvunyelwe ngenxa yengozi eyandayo ye-hypoglycemia lapho uthatha umthamo ongalungile.

Intengo ye-Glimecomb

Izindleko ezijwayelekile zamathebulethi angama-ruble angama-567.

Izimo zokugcina zomuthi

Umuthi kufanele ugcinwe ngaphandle kokutholwa yizingane, endaweni eyomile, emnyama emazingeni okushisa angeqi ku-25 ° C.

Isikhathi sokuphelelwa yisikhathi

Iminyaka emi-2

Umkhiqizi

Isitshalo samakhemikhali nezemithi "AKRIKHIN", Russia.

Ukuthengiswa kwamahhala kwalo muthi akuvunyelwe ngenxa yengozi eyandayo ye-hypoglycemia lapho uthatha umthamo ongalungile.

Ukubuyekezwa kwesifo sikashukela kwe-Glimecomb

U-Arthur Kovalev, oneminyaka engama-40 ubudala, eMoscow

Ngokwesifo sikashukela sohlobo 2, bengilokhu ngithatha amaphilisi we-Glimecomb cishe unyaka. Isisindo somzimba sehla, ngoba ngemuva kokuthatha umuthi ofuna ukusidla. Kepha ngemuva kokuthi ngiphuze iphilisi kusihlwa ngaphambi kokulala, lesi simo siyejwayelekile. Ekuseni, ushukela uyahlukahluka kusuka ku-6 kuye ku-7.2 ngemuva kokudla iphilisi ngebhulakufesi.

UKirill Gordeev, oneminyaka engama-29 ubudala, Kazan

Umuthi kahle wehlisela ushukela wegazi. Ngiyavuma izinyanga eziyi-8. Ngifaka nemijovo ye-insulin. Ngemuva kokuphazamiseka ekunikezelweni kwe-hormone, kwadingeka ngiphuze amaphilisi isikhashana, kodwa bakhombisa ukusebenza kahle kakhulu. Ushukela wasala kwelinye izinga, yize umsebenzi wesibindi wawungasebenzi kahle kimi.

Ukubuyekezwa kodokotela

UMarina Shevchuk, i-endocrinologist, iminyaka engu-56, u-Astrakhan

Umuthi obhekene nesizinda sohlobo 2 sikashukela unxephezela kahle i-glycemia. Ukukhishwa okuguquliwe kunganciphisa ingozi yokuthola i-hypoglycemic syndrome, yingakho iziguli nabantu asebekhulile abahlushwa yizifo zohlelo lwethambo lwenhliziyo bangawuthatha umuthi. Ngivame ukusisebenzisa lesi sidakamizwa emikhubeni yami yemitholampilo ngokukhetha umthamo ngamunye. Intengo ephansi esebenza kahle kakhulu.

U-Evgenia Shishkina, i-endocrinologist, eneminyaka engama-45 ubudala, iSt

Umuthi unomphumela omnene futhi osebenzayo. Kuyasiza ukwehlisa ushukela wegazi. Ngesikhathi sokulashwa, kubalulekile ukulandela indlela odla ngayo, kepha yidla njalo, kanye nokuzivocavoca. Imiphumela emibi nokunamathela ngokuqinile kwirejimeni yodoti ayizange ibonwe. Isenzo somuthi siqala esikhathini esifushane. Umuthi ususungule ngokwawo emakethe yesifo sikashukela.