I-Avandamet ilungiselelo elihlanganisiwe lesenzo se-hypoglycemic.
Igama Lezwe elingafanele
I-Metformin ihlanganiswe ne-rosiglitazone.
I-Avandamet ilungiselelo elihlanganisiwe lesenzo se-hypoglycemic.
I-ATX
Izimali ze-ATX - A10BD03.
Khipha amafomu nokwakheka
Umuthi uyatholakala ngesimo sethebulethi. Amacwecwe aqukethe izinto ezi-2 ezisebenzayo - i-metformin ne-rosiglitazone. Owokuqala usesimweni se-hydrochloride, owesibili yi-maleate.
Inani le-metformin kuthebhulethi engu-1 ngu-500 mg. Okuqukethwe kwe-rosiglitazone yi-1 mg.
Umuthi uyatholakala emaphepheni amakhadibhodi, ngalinye lawo liqukethe ama-1, 2, 4 noma 8. Elinye lazo lifaka amathebhulethi ayi-14, afakwe kumafilimu.
Kuyathengiswa i-Avandamet enokuqukethwe kwe-rosiglitazone 2 mg.
Isenzo se-Pharmacological
Umuthi usho izidakamizwa zokwehlisa ushukela zomlomo zohlobo oluhlanganisiwe. Kuhlanganisa izinto ezi-2 ezisebenzayo, isenzo saso esivumela ukulawulwa okuphezulu kwamazinga kashukela ezigulini ezinesifo sikashukela esingaxhamli nge-insulin.
I-Rosiglitazone ingeyeqembu le-thiazolidinediones, i-metformin yinto eqhamuka eqenjini le-Biguanide. Zigcwalisana, zisebenza kanyekanye kumaseli wezicubu ezithinta kanye ne-gluconeogenesis esibindini.
Ngokusebenzisa i-rosiglitazone, ukwanda kwamaseli we-pancreatic kuyaphawulwa.
I-Rosiglitazone inyusa ukuzwela kwezicubu ze-peripheral to insulin. Ngenxa yalokhu, kwenzeka ukusebenzisa ushukela omningi egazini.
Umuthi usebenza kwesinye sezixhumanisi eziphambili kwi-pathogenesis ye-mellitus yesifo sikashukela esingaxhamli kakhulu. Ukumelana nezicubu kwe-insulin akuvumeli i-hormone ukuba ilawule ngokwanele amazinga kashukela. Ngaphansi kwethonya le-rosiglitazone, okuqukethwe kwe-insulin, ushukela kanye namafutha acid egazini kuyancipha.
Ngokusetshenziswa kwayo, ukwanda kwamaseli we-pancreatic abhekene nokuhlanganiswa kwe-insulin kuyaphawulwa. Iphinde ivimbele ukuvela kwezinkinga ezithweni ezitholwayo. Umuthi awuthinti isilinganiso sokukhishwa kwe-insulin emangqamuzaneni futhi akuholeli ekwehlelweni okungajwayelekile kwamazinga kashukela.
Ngesikhathi sokufunda, kuye kwancipha ukwehla kwezinga le-insulin nezimbangela zalo ezisegazini. Kunobufakazi bokuthi lezi zihlanganisela ngamanani amakhulu zithinta kabi uhlelo lwenhliziyo.
I-Metformin inciphisa umsebenzi we-glucose synthesis ngamaseli wesibindi. Ngaphansi kwethonya lazo, zombili i-basal concentration ye-glucose nezinga layo ngemuva kokudla zijwayelekile Umuthi awusebenzi ukukhiqizwa kwe-insulin amaseli ama-islets ama-Langerhans.
Ngaphezu kokuvimbela i-gluconeogenesis esibindini, into esebenzayo ikhulisa ukuzwela kwezicubu zomzimba kuyi-insulin, isheshise ukusetshenziswa koshukela wamahhala, futhi yehlise ukumuncwa kwe-glucose nge-mucosa yephepha lesisu.
I-Metformin inciphisa umsebenzi we-glucose synthesis ngamaseli wesibindi.
I-Metformin isiza ukusheshisa ukukhiqizwa kwe-glycogen kumaseli. Isebenzisa iziteshi zokuhambisa i-glucose transporter ezitholakala kuma-membranes weseli. Ilawula ukusebenza kwe-metabolism yamafutha acid, inciphisa inani le-cholesterol namanye ama-lipids ayingozi.
Ukuhlanganiswa kwe-rosiglitazone ne-metformin kusiza ekuzuzeni ukusebenza kahle kokulashwa. Izinto zithinta zonke izingxenye ze-pathogenesis ze-mellitus ezingavikelekile nge-insulin, ngaleyo ndlela zinikeze ukulawulwa okuhle kwamazinga we-glucose.
I-Pharmacokinetics
Ukuthatha umuthi ngokudla kunciphisa ukugcwala okusebenzayo okusebenzayo kwezinto zombili ezisebenzayo. Ukuphila kwabo kwengxenye nakho kuyanda.
Lapho ithathwa ngomlomo, i-rosiglitazone idonswa ngamandla yi-mucosa yamathumbu. I-acidity yesisu ayithinti izinga lokufakwa. I-Bioavailability icishe ifinyelele ku-100%. Umuthi ubopha cishe ngokuphelele ukuthutha ama-peptide. Akuhlanganisi. Ukugxila okusebenzayo okuphezulu kuyabonakala egazini imizuzu engama-60 ngemuva kokuphathwa.
Izinguquko ekuhlakazweni kwento ngokuya ngokutholwa kokudla azibalulekile kakhulu emtholampilo. Leli qiniso likuvumela ukuthi uthathe umuthi, kungakhathalekile isikhathi sokudla.
I-Rosiglitazone ibhekana nokuguqulwa komzimba phansi kwethonya lama-enzyme wesibindi. I-isoenzyme eyinhloko ebhekele ukuguqulwa kwamakhemikhali kwento yi-CYP2C8. Ama-Metabolites akhiwa ngenxa yokusabela awasebenzi.
I-acidity yesisu ayithinti izinga lokufakwa.
Ukuphila kwengxenye kwengxenye kuze kufike emahoreni ayi-130 ngokusebenza okujwayelekile kwezinso. Ama-75% omthamo othathwe afakwa emkhakheni womchamo, cishe ama-25% ashiya umzimba njengengxenye yezinduku. I-Excretion yenzeka ngesimo sama-metabolites angasebenzi, ngenxa yalokho, isikhathi eside sempilo-ayiholeli ekwenyukeni kwemiphumela emibi njengomphumela wokutholwa kwesisindo.
I-metformin ephezulu esebenza ngempumelelo ibonwa ku-plasma emahoreni angama-2-3 ngemuva kokuthatha iphilisi. I-bioavailability yale nto ayidluli kuma-60%. Kufika ku-1/3 komthamo othathwe ukhishwe ungashintshiwe emathunjini. Ingxenye esebenzayo empeleni ayibophele ukuthutha ama-peptides. Kungangena ngaphakathi kwamangqamuzana egazi abomvu.
Izici ze-pharmacokinetic zokushintsha kwe-metformin ngaphansi kwethonya lokudla. Ukubaluleka komtholampilo kwalezi zinguquko akuqondakali ngokuphelele.
Ukwembiwa kwale nto esebenzayo kwenzeka ngesimo sayo sokuqala. Ukuqedwa kwesigamu sempilo kungamahora angama-6-7. Kuthuliswa izinso.
Izinkomba zokusetshenziswa
Umuthi ubekelwe ukwelashwa kwe-mellitus engavikelekile i-insulin, kokubili njenge-monotherapy kanye nokuhlanganiswa neminye izidakamizwa ye-hypoglycemic.
Umuthi ubekelwe ukwelashwa kwe-mellitus engavikelekile nge-insulin.
Contraindication
Ukuxhumana ngokusetshenziswa kwe-Avandamet yile:
- hypersensitivity yomuntu ngamunye ezingxenyeni ezisebenzayo noma ezinye izinto ezakha ukwakheka;
- ukwehluleka kwenhliziyo okungapheli;
- ukwehluleka ukuphefumula;
- izimo zokuthuthumela;
- ukusetshenziswa kabi kotshwala
- ketoacidosis;
- i-precoma;
- ukwehluleka kwezinso nge-creatinine imvume engaphansi kuka-70 ml / min.;
- ukomisa kungenzeka kokuhlakuzeka kwehluleke kakhulu kwe-renal;
- ukusetshenziswa kwama-ejenti ahlukile aqukethe iodine;
- kanyekanye insulin ukwelashwa.
Ngokunakekela
Ngokuqapha, umuthi usetshenziswa ngokuhambisana nama-diuretics nama-beta-adrenergic agonists. Ukuhlanganiswa okunjalo kungaholela ekuthuthukisweni kwe-hyperglycemia. Lokhu kungagwenywa ngokubheka ushukela wegazi kaningi.
Ungayithatha kanjani i-Avandamet
Ngoshukela
Kungcono ukuthatha umuthi ngesikhathi noma ngemuva kokudla. Lokhu kunciphisa ubungozi bemiphumela emibi evela emgodini wesisu. Umthamo ukhethiwe ngamunye.
I-Avandamet ibekiwe uma ukwelashwa kokudla kanye nokuzivocavoca komzimba kungakuvumeli ukulawulwa okwanele kwamazinga kashukela egazi.
Umthamo wokuqala wansuku zonke yi-4 mg ye-rosiglitazone ne-1000 mg ye-metformin. Kamuva ingashintshwa ukuze isebenze kahle. Isilinganiso esiphezulu sansuku zonke yi-8 mg / 2000 mg.
Kunconywa ukwandisa umthamo kancane, okuzovumela umzimba ukuzivumelanisa nomuthi. Ukulindela ushintsho kumiphumela yokwelapha okungenani amaviki ama-2 ngemuva kokulungiswa komthamo.
Imiphumela emibi ye-Avandamet
Engxenyeni yesitho sombono
I-edema ye-Macular ingahle ibonwe.
Kusuka ezicutshini zemisipha
Ukuthatha umuthi kungahle kuhambisane nokwanda kwamathambo brittle, pain mus.
Amapheshana wesisu
Imiphumela elandelayo emibi ingahle ivele:
- ukwephulwa kwesitulo;
- anda umsebenzi we-enzyme wesibindi.
Izitho zeHematopoietic
Kungavela:
- i-anemia
- ukwehla kwesibalo seplatlem;
- ukunciphisa kwe-granulocyte count;
- i-leukopenia.
Isistimu yezinzwa ephakathi
Ukuphendula okulandelayo okungenzekayo kungenzeka:
- Isiyezi
- ikhanda.
Kusuka ohlelweni lwezinhliziyo
Imiphumela elandelayo emibi ingahle ivele:
- ukwehluleka kwenhliziyo okungapheli;
- i-myocardial ischemia.
Allergies
Mhlawumbe ukubonakala kokuphendula kwe-anaphylactic, i-angioedema, i-rashes, ukulunywa, i-urticaria, i-pulmonary edema.
Umthelela ekhonweni lokulawula izindlela
I-Avandamet ayithinti ukunakwa kwejubane lokunaka nokuphendula, ngakho-ke asikho isizathu sokwenqaba ukulawula izindlela noma ukushayela imoto.
Imiyalo ekhethekile
Sebenzisa ebudaleni
Lapho unquma umuthi kubantu asebekhulile, kuyadingeka ukubheka ukuthi kungenzeka yini ukuthi kuncishiswe ukusebenza kwe-renal. Kufanele kugadwe ngesikhathi sokwelashwa. Umthamo kufanele futhi ukhethwe kucatshangelwa ukuvela kwe-renal kwe-creatinine. Lokhu kuzosiza ukugwema imiphumela ethile engafuneki.
Isabelo sezingane
Imininingwane yokusetshenziswa kwe-Avandamet yokwelapha iziguli ezikulesi sigaba ayanele ukuqokwa okuphephile. Kunconywe ukukhetha okunye esikhundleni esanele sethuluzi.
Imininingwane yokusetshenziswa kwe-Avandamet ekwelashweni kwezingane ayanele ekuqeshweni okuphephile.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ubufakazi bokuthi umuthi ungangena emgoqweni we-placental awuvumeli abesifazane ukuthi banikeze ngokukhululekile ngesikhathi sokukhulelwa. Lesi sigaba seziguli sivame ukunqunyelwa i-insulin, sibabeke endaweni ethile okwesikhashana ngama-hypoglycemic agents.
Lapho ukuncelisa ibele, ukuqokwa kwe-Avandamet akunconywa. Ukubuyiselwa okwanele kungaba ukwelashwa kwe-insulin. Uma ukwelashwa ngalesi sidakamizwa kudingekile kowesifazane onkulisayo, kungakuhle ukuthi udlulisele ingane ekuondleni okungelona iqiniso.
Sebenzisa umsebenzi wesibindi okhubazekile
Ukwehla okuncane komsebenzi we-hepatic akudingi ukulungiswa komthamo. Ngokungasebenzi kahle kwamapheshana e-hepatobiliary, kunconywa ukuthi ukwelashwa kwenziwe ngaphansi kokuqondisa kukadokotela. Lokhu kuzosiza ukuvikela i-lactic acidosis. Kungenzeka ukhethe enye indlela yokulawula i-glycemia.
Isicelo sokusebenza kokulimala kwezinso
Ukungasebenzi kahle kwe-renal kudinga ukubhekwa njalo kwesimo sesiguli ngudokotela. Ngaphambi kokuqokwa kwe-Avandamet, zonke izinto ezinobungozi kufanele zibhekwe. Uma idatha yokuqapha ikhombisa ukuba khona kwe-lactic acidosis, ukwelashwa kufanele kuqedwe futhi isiguli silaliswe esibhedlela.
Uma ukuhlushwa kwe-serum creatinine kungaphezu kwe-135 μmol / L (amadoda) kanye ne-110 μmol / L (abesifazane), kufanele wenqabe ukunquma umuthi.
Ukweqisa kwe-Avandamet
I-overdose yesidakamizwa ihambisana nokukhula kwe-lactic acidosis ngenxa yomsebenzi wamakhemikhali we-metformin. Le pathology idinga ukulaliswa esibhedlela kwesiguli ngokunakekelwa okuphuthumayo.
I-Lactate kanye nengxenye esebenzayo kudlulwa yi-hemodialysis. Kuyadingeka ukunikeza isiguli ukwelashwa okubonakalayo, ngoba i-rosiglitazone ihlala isemzimbeni ngenxa yezinga layo eliphezulu lokubopha ukuthutha ama-peptides.
Ukuxhumana nezinye izidakamizwa
I-Avandamet isidakamizwa esihlanganisiwe, akukho datha ekusebenzisaneni kwayo nezidakamizwa. Izifundo zokusebenzelana kwezidakamizwa kwezinto ezisebenzayo zenziwa zodwa.
Ukunakekelwa okukhethekile kufanele kuthathwe ngenkathi usebenzisa i-glucocorticosteroids.
Ukunakekelwa okukhethekile kufanele kuthathwe ngokusetshenziswa kanyekanye kwezidakamizwa ngama-glucocorticosteroids, ama-diuretics, ama-beta2-agonists. Ukuhlanganiswa okunjalo kungadala ukwanda ushukela we-serum.
Ukusetshenziswa okuhlangene kwesidakamizwa ngama-nitrate akunconywa. Lokhu kungadala ukwanda kwezimpawu ze-myocardial ischemia.
Inhlanganisela ene-sulfonylurea ingadala ukwehla kwe-pathological ushukela we-plasma. Ezimweni ezinjalo, kunconywa ukuqapha ngokucophelela ukugxila kweglue glucose.
Ukuhambisana notshwala
Ukuphuza utshwala ngesikhathi sokwelashwa nge-Avandamet kukhulisa ubungozi be-lactic acidosis. Lesi simo se-pathological ukuphulwa okukhulu kwe-homeostasis, okungaholela ku-coma.
Uphuzo oludakayo oluhlanganiswe naleli khambi futhi lukhulisa ubungozi bokuqhamuka neminye imiphumela emibi ebonakala kulo muthi.
Ama-Analog
Izichasiso zalo muthi yilezi:
- IGlucophage;
- Ama-Glucovans;
- I-Subetta.
Imibandela yekhefu lekhemisi
Umuthi kadokotela.
Intengo
Kuya ngendawo yokuthenga.
Izimo zokugcina zomuthi
Kufanele igcinwe emazingeni okushisa angeqi ku-25 ° C.
Isikhathi sokuphelelwa yisikhathi
Umkhiqizo ulungele ukusetshenziswa kungakapheli iminyaka emi-3 kusukela ngosuku lokukhishwa. Ukusetshenziswa okwengeziwe akunconywa.
Umkhiqizi
Umuthi wenziwa nguGlaxo Wellcom S.A., Spain.
Ukubuyekezwa
IGenady Bulkin, i-endocrinologist, Yekaterinburg
Lesi sidakamizwa akuyona i-placebo elula, kepha siyithuluzi elisebenzayo lokulwa ne-mellitus engavikelekile nge-insulin. Ukuhlanganiswa kwezinto ezi-2 ezisebenzayo kuvumela ukulawulwa okusebenzayo kwe-glycemic. Ithuluzi lisebenza kokubili kwezicubu ze-pancreatic nakumaseli wezitho zangasese. Lokhu kunikeza ukuzwela kwe-insulin okwandayo.
Ngincoma lesi sidakamizwa kubantu abanesifo sikashukela sohlobo 2 abangakwazi ukugcina amazinga eglucose ejwayelekile ngokwelashwa kokudla, ukuvivinya umzimba neminye imithi. Ithuluzi linamandla, ngakho-ke ukunakekelwa kufanele kuthathwe ngesikhathi sokwelashwa.
U-Alisa Chekhova, i-endocrinologist, eMoscow
I-Avandamet ingenye yezidakamizwa eziphumelela kakhulu zokulawula i-glycemic. Imvamisa ngiyabela iziguli ezinzima. Ukuhlanganiswa kwezithako ezisebenzayo kungafinyelela ukuphuculwa kwamacala angenathemba kakhulu.
Kukhona nokubi. Ukwelashwa kudinga ukubhekwa ngokucophelela ngudokotela. Umthamo okhethwe kahle kanye nokuqapha njalo kwamazinga kashukela kuzosiza ukugwema imiphumela emibi.
ULeonid, oneminyaka engama-32, eSt
Sekuphele unyaka ngithatha i-Avandamet. Ngaphambi kwalokho ngazama izindlela eziningi, kepha zonke zayeka ukusebenza ngokuqhubeka kwesikhathi. Isifo sikashukela yisifo esiyingozi okuthi uma singalashwa sithinte wonke umzimba.
Ukuze ngilondoloze impilo, ngaya kudokotela we-endocrinologist onolwazi. Intengo yokwamukela yayiluma, kepha ngathola engangikufuna. Udokotela wanquma leli khambi. Ngemuva kwesonto, izinga likashukela lehle. Ngemuva kwenyanga, waqala ukuhlala ezingeni elijwayelekile. Ngibonga udokotela no-Avandamet ngokungibuyisela okujwayelekile.
UVictoria, oneminyaka engama-45, eMoscow
Udokotela uxwayise ukuthi leli thuluzi linomphumela oqinile. Bengingeke ngikwamukele uma ngazi ukuthi yini engizohlangana nayo ngesikhathi sokwelashwa. Endaweni ethile amasonto amabili ngemuva kokuthi ngiqale ukuthatha i-Avandamet, kwavela ukusabela okungathandeki. Isicanucanu, ukuqunjelwa kwaqala ukuphazamiseka. Isiyezi, impilo iwohlokile. Kwakufanele ngibone udokotela. Uthole okunye esikhundleni, ngemuva kwalokho yonke imiphumela emibi yanyamalala.
