Umuthi uyingxenye yeqembu lezidakamizwa elilawula amazinga kashukela egazini. Inikezwe abanesifo sikashukela. Leli khambi lisiza ukuvimbela izinkinga ezibangelwa ukuzuza kwesisindo.
Umuthi uqukethe izingxenye ezi-2 ezisebenzayo futhi ubonakala ngomgomo wezinyathelo eziningi, onomphumela omuhle ezinhlelweni ezihlukile nezinqubo ze-biochemical emzimbeni.
Igama Lezwe elingafanele
I-Glibenclamide + Metformin (Glibenclamide + Metformin)
Umuthi ufakwa eqenjini lezidakamizwa elilawula izinga likashukela egazini.
I-ATX
A10BD02. I-Metformin ihlanganiswe ne-sulfonamides
Khipha amafomu nokwakheka
Umuthi usesimweni samacwecwe. Njengezithako eziphambili ezisebenzayo, i-metformin hydrochloride ne-glibenclamide ziyasetshenziswa. Ukuhlushwa kwabo kuthebhulethi engu-1: 400 mg no-2,5 mg. Ezinye izinto ezingabonisi umsebenzi we-hypoglycemic:
- i-calcium hydrogen phosphate dihydrate;
- isitashi sommbila;
- i-croscarmellose sodium;
- i-sodium stearyl fumarate;
- i-povidone;
- i-microcrystalline cellulose.
Umkhiqizo uyatholakala emaphaketheni amaseli ama-40 ama-pcs.
Umuthi usesimweni samacwecwe.
Isenzo se-Pharmacological
Umphumela we-hypoglycemic wesidakamizwa kungenxa yethonya enqubweni yokukhiqizwa kwe-glucose yisibindi (ukuqina kwehla). Ngaphezu kwalokho, kukhona ukwanda kokuzwela kwama-receptors ku-insulin. Ngasikhathi sinye, kukhuphuka umthamo wokudla izicubu zeglue. Ngasikhathi sinye, isilinganiso sokusetshenziswa kwalesi sihloko siyenyuka. Ukwehla kokufakwa kweglucose ezindongeni zendlela yokugaya ukudla, kuyaphawuleka ukutholakala kwenqubo ye-lipolysis kwezicubu ze-adipose. Umphumela uba ukwehla kwesisindo somzimba.
Ngaphezu kwalokho, ngesikhathi sokwelashwa nomuthi okukhulunywa ngawo, ukuhlushwa kwe-lipoproteins ephansi kakhulu, i-cholesterol, i-triglycerides iyancishiswa. Umuthi umuthi uvela ku-sulfonylurea (Isizukulwane sesi-II). Umphumela we-hypoglycemic ubuye wanda ngokukhiqizwa kwe-insulin ngamaseli e-pancreatic. Izinto ezisebenzayo ekwakhiweni komkhiqizo zigcwalisana, okusiza ukufeza amazinga weglucose efanele.
I-Pharmacokinetics
Ukufakwa kwe-glibenclamide lapho kungena umgodi wokugaya kungama-95%. Emahoreni angama-4, izinkomba zomsebenzi eziphezulu kakhulu zento ziyatholakala. Inzuzo yaleli khompiyutha ukubopha kwayo cishe ngokuphelele amaprotheni e-plasma (afika kuma-99%). Ingxenye ebalulekile ye-glibenclamide iguqulwa esibindini, ngenxa yokuthi kwakheka ama-metabolites ama-2, angakhombisi ukusebenza futhi akhishwa ngamathumbu, kanye nangezinso. Le nqubo ithatha isikhathi esingamahora amane kuya kwayi-11; okunqunywa yisimo somzimba, umthamo wento esebenzayo, ukuba khona kwamanye ama-pathologies.
I-Metformin ibanjelwa ngandlela thile ngokuphelele, ukusebenza kwayo nge-bioavailability akudluli kuma-60%. Le nto ifinyelela umsebenzi wayo omkhulu kakhulu ngokushesha kune-glibenclamide. Ngakho-ke, ukusebenza kwe-metformin okuphezulu kakhulu kuqinisekiswa amahora angama-2,5 ngemuva kokuthatha umuthi.
Le khompiyutha ine-Drawback - ukwehla okukhulu ngesivinini sokusebenza ngenkathi kudliwa ukudla. IMetformin ayinawo amandla okubopha kumaprotheni egazi. Into ikhishwe ingashintshiwe, njengoba buthaka kancane. Izinso zinesibopho sokuphuma kwazo.
IMetformin ayinawo amandla okubopha kumaprotheni egazi.
Izinkomba zokusetshenziswa
Inhloso enkulu ukuguqulela isimo kusimo sohlobo 2 sikashukela.
Imisebenzi elandelayo iyenziwa:
- ukwelashwa okubuyisela esikhundleni kwerejimeni yangaphambilini ezigulini ezinamazinga we-glucose alawulwayo;
- ukuhlinzeka ngemiphumela ephikisana nesizinda sokusebenza okuphansi kokwelashwa kokudla, ukuzivocavoca ekwelashweni kweziguli ezikhuluphele.
Contraindication
Okubi kwomuthi kufaka inani elikhulu lemikhawulo. Ngaphezu kwalokho, ama-contraindication ahlukaniswe ngamaqembu ama-2: ngokuphelele futhi isihlobo.
Iqembu lokuqala lifaka:
- thayipha i-1 isifo sikashukela;
- ukusabela okungekuhle komuntu ngamunye kunoma yiziphi izingxenye zomuthi;
- izimo eziningana ze-pathological ezibangelwa isifo sikashukela i-mellitus: ketoacidosis, ukuqala kwe-precoma, ikoma;
- umsebenzi wezinso ongonakalisiwe;
- izici ezimbalwa ezingezinhle ezifaka isandla ekuthuthukisweni kwezifo zezinso, phakathi kwawo ukomisa, izilonda ezithathelwanayo, izimo zokushaqeka, njll;
- ukonakala kwesistimu yenhliziyo ebangelwa yi-hypoxia;
- ukungasebenzi kahle kwesibindi;
- i-porphyria;
- ubuthi bomzimba obubangelwa ukweqisa utshwala;
- izimo ze-pathological ezidinga ukwelashwa kwe-insulin, ngokwesibonelo, ngokungenelela okubanzi kokuhlinzwa, ukushiswa, ukulimala;
- i-lactic acidosis;
- Ukudla kilojoule ephansi, kuyilapho umthamo wekhalori wansuku zonke ungeqi ku-1000 kcal.
Ngokunakekela
Inani lokuphulwa okuhlobene kuyabonakala ukuthi kudinga ukusetshenziswa kahle kwesidakamizwa:
- umkhuhlane
- ukuncipha kokusebenza kwe-anterior pituitary gland;
- izimo ze-pathological ezihambisana nokuphulwa okungakhokhwanga kwe-gland yegilo;
- ukungapheleli kwe-adrenal.
Ungayithatha kanjani iMetglib
Uhlobo lokwelashwa lukhethiwe kucatshangelwa izici ezinjengalezi: izinga leshukela egazini, isimo se-carbohydrate metabolism. Inani lemithi yansuku zonke ingahluka. Izibhebhe zithathwa ngomlomo.
Ngoshukela
Imiyalo yokusebenzisa iMetglib:
- esigabeni sokuqala sokwelashwa, kunconywa ukuthatha amaphilisi angu-1-2 ngosuku;
- emva kwalokho, umthamo wansuku zonke uyaguquka, kuya ngeveli likashukela egazini, futhi kubalulekile ukufeza umphumela ozinzile.
esigabeni sokuqala sokwelashwa, kunconywa ukuthatha amaphilisi angu-1-2 ngosuku.
Isilinganiso esivumelekile somuthi ngosuku soshukela sohlobo 2 ngamathebhulethi ayi-6. Futhi awukwazi ukuzithatha ngasikhathi sinye. Kuyadingeka ukuhlukanisa inani elicacisiwe libe yimithamo emi-3 ngezikhala ezilinganayo.
Ukwehla kwesisindo
Kuyaphawuleka ukuthi ukusetshenziswa kwezinto (metformin kanye ne-glibenclamide), okuyingxenye yeMetglib, kunomthelela ekwehlekeni kwenani lamafutha. Umthamo onconywayo ngosuku ngamathebulethi ayi-3. Kwamukelwa ngezikhathi ezithile. Inkambo yokwelapha izinsuku ezingama-20. Ukuvimbela ukubukeka kwesisindo ngokweqile, umthamo wehliselwa ku-200 mg kanye, inani lansuku zonke lingama-600 mg.
Umuthi awunikeli ngomphumela oyifunayo ngaphandle kwezindlela ezisizayo. Izinto ekwakhekeni kwazo zinomthelela kuphela ekuvimbeleni ukuguqulwa kwamandla kube ngamafutha omzimba.
Ukuze ugweme ukwanda kwesisindo esinamafutha, kuyadingeka ukwandisa ukusebenza komzimba nokulungisa izondlamzimba kanye nokusetshenziswa komuthi.
Imiphumela emibi
Ngokunikezwe ukuthi ithuluzi okukhulunywa ngalo lithinta umsebenzi wezitho eziningi zangaphakathi nezinhlelo, futhi futhi libambe iqhaza ezinqubweni ze-biochemical, ukubonakaliswa okungalungile kuvame ukwenzeka, phakathi kwabo:
- ukuphazamiseka kohlelo lwe-hematopoietic: i-thrombocytopenia, i-leukopenia, ukwenzeka kwezimo ezinjenge-agranulocytosis, i-anemia, i-pancytopenia kanye ne-apole yethambo kuncane kakhulu;
- i-hypoglycemia, okungaphansi kakhulu: i-lactic acidosis ne-porphyria yohlobo oluhlukile (nokubonakaliswa esikhunjeni nasesibindi);
- ukusabela kwe-anaphylactic ukungabekezelelani kwezakhi ezakhiweni zeMetglib ne-sulfonamides;
- ukumuncwa okwandayo kwe-vithamini B12;
- ngenkathi uphuza umuthi, ukunambitheka “okusansimbi” kuvela emlonyeni;
- ukungaboni kahle okubonakalayo, okuyinqubo eguqukayo;
- ukungasebenzi kwesibindi, kanti kwesinye isikhathi i-hepatitis iyanda;
- ukungahambi kahle komzimba ngokubonakala esikhunjeni: i-urticaria, vasculitis, njll .;
- ukuphazamiseka komgudu wokugaya ukudla, imvamisa kunobuhlungu besisu, ukulahleka kokudla, isicanucanu nokuhlanza;
- kwesinye isikhathi kwandisa ukuqina kwe-creatinine ne-urea ku-plasma yegazi.
Kufanele wazi ukuthi eziningi zalezi zimpawu zingezesikhashana futhi ngokushesha zinyamalale ngemuva kokuqedwa kweMetglib. Uma inzuzo yokusebenzisa umuthi okukhulunywa ngayo idlula ukulimala, kuvunyelwe ukuhlukanisa umthamo ube inani elikhudlwana lama-doses ngaphandle kokuphazamisa inkambo yokwelashwa. Kulokhu, umthetho uyasebenza: ukukhuphuka kancane kwenani lansuku zonke kuthuthukisa ukubekezelelwa kwezinhlaka ezisebenzayo ekwakhekeni komuthi.
Umthelela ekhonweni lokulawula izindlela
Ukushayela izimoto ngesikhathi sokwelashwa kwezidakamizwa akuvunyelwe. Kodwa-ke, ingozi yokuthola i-hypoglycemia, ukuphazamiseka okubukwayo okuguqukayo, kanye nokuvela kwezinye izimpawu ezingezinhle, nokuqapha kufanele kubhekwe.
Imiyalo ekhethekile
Kubalulekile ukuthola ukwelashwa ngaphansi kokuqondisa udokotela. Kufanele ubheke njalo ushukela wokuzila ukudla nangemva kokudla.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi awuvunyelwe ukusetshenziswa ngesikhathi sokukhulelwa nokuncelisa ibele. Izinto ezisebenzayo zingena obisini lukamama. Uma kunesidingo esiphuthumayo sokusebenzisa lo muthi ngesikhathi sokukhulelwa nokuhlela ukukhulelwa, kwenziwa inkambo yokwelashwa kwe-insulin.
Umuthi awuvunyelwe ukusetshenziswa ngesikhathi sokukhulelwa nokuncelisa ibele.
Ukunquma iMetglib ezinganeni
Umuthi uphethwe i-contraindware ezigulini ezingakafiki eminyakeni yobuningi.
Sebenzisa ebudaleni
Ukusetshenziswa kweMetglib kufanele kugwenywe uma isiguli sisebenza kanzima ngokomzimba. Kulokhu, kunobungozi be-lactic acidosis. Imikhawulo enjalo isebenza kwiziguli ezingaphezulu kweminyaka engama-60. Ngaphezu kwalokho, kufanele kuqashelwe ekwelashweni kweziguli esezikhulile kusuka eminyakeni engama-70 noma ngaphezulu. Lokhu kungaholela ekukhuleni kwe-hypoglycemia.
Isicelo sokusebenza kokulimala kwezinso
Umuthi awubekelwe ukwehluleka kwezinso.
Sebenzisa umsebenzi wesibindi okhubazekile
Umuthi awuvunyelwe ukusetshenziswa uma kwenzeka kushoda umsebenzi walo mzimba. Thatha inani le-creatinine (umkhawulo wokunquma kwalesi sikhombisi emadodeni ngu-135 mmol / l; kwabesifazane - 110 mmol / l).
Umuthi uvunyelwe ukusetshenziswa uma kwenzeka ukwehluleka kwesibindi.
Ukweqisa
Uma inani lomuthi landa njalo, i-hypoglycemia ingakhula. Ukubonakaliswa okubuthakathaka kuyasuswa uma usebenzisa ushukela. Ezimweni ezinzima kakhulu, ukoma, ukuphazamiseka kwemizwa kungakhula. Kulokhu, usizo oluphuthumayo kufanele lubizwe.
Ukubonakaliswa okunamandla kwesimo se-pathological kuqedwa ngokufakwa kwekhambi le-dextrose. Nge-overdose, i-lactic acidosis ingakhula. Lesi simo sidinga nokunakekelwa okuphuthumayo.
Ukuxhumana nezinye izidakamizwa
Kufakwe ku-contraindised ukusebenzisa le mithi elandelayo nokuhlanganiswa ne-Metglib:
- I-Miconazole;
- ama-ejenti asuselwa ku-iodine asetshenziselwa ukuhlolwa kwehadi.
Kufanele kuqashelwe lapho kusetshenziswa izidakamizwa nezidakamizwa ezinjengalezi:
- I-Phenylbutazone;
- I-Ethanol;
- IBosentan;
- I-Chlorpromazine;
- izidakamizwa ze-glucocorticosteroid;
- UDanazole;
- okokugcobisa;
- i-beta 2-adrenergic agonists;
- Ama-inhibitors e-ACE;
- I-Fluconazole;
- Desmopressin;
- I-Chloramphenicol;
- I-Pentoxifylline;
- Mao inhibitors;
- ama-anticoagulants asuselwa ku-coumarin;
- ama-sulfonamides;
- i-fluoroquinolones;
- Ama-Disopyramides.
Ukuhambisana notshwala
Umuthi okukhulunywa ngawo unesiza ekubonakala kokuphendula okungekuhle ngaphansi kwethonya le-ethanol eliqukethwe iziphuzo ezidakayo. Ngaphezu kwalokho, kukhona ukwanda kokusebenza kweMetglib ngokumelene nesizinda sokuphuza utshwala, okungaholela ezinkingeni.
Ama-Analog
Ukuvumelanisa okusebenzayo nokwakhiwa okufanayo:
- I-Gluconorm;
- I-Glibomet;
- Ama-Glucovans, kepha kulokhu, umthamo we-metformin uphakeme - 500 mg;
- Amandla we-Metglib (inani le-metformin - 500 mg).
Imibandela yeholide Metglib kusuka ekhemisi
Umuthi uyatholakala ngencwadi kadokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela
Akunakwenzeka lokho.
Intengo yeMetglib
Izindleko ezijwayelekile eRussia ngama-ruble angama-240.
Izimo zokugcina zomuthi
Ukushisa komoya okuvumelekile okuphezulu egumbini okugcinwa kulo umuthi: + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Ithuluzi ligcina izakhiwo zeminyaka engu-2 kusukela ngosuku lokukhishwa.
Umkhiqizi Metglib
ICanonfarm Production, eRussia.
Ukubuyekezwa mayelana neMetglieb
Ukuhlolwa kwabathengi nabachwepheshe kuyindlela ebalulekile lapho ukhetha ithuluzi.
Odokotela
UGalina Rykova (owelaphi), oneminyaka engama-54, uKirov
Umuthi onezinto ezingqubuzanayo. Ngakolunye uhlangothi, libonakala ngokusebenza okuphezulu kakhulu, ngakolunye uhlangothi, ukuphathwa kwayo kuhambisana nezimpawu eziningi ezingezinhle.
U-Andrey Ilin (i-endocrinologist), oneminyaka engama-45, u-Ufa
Uma unamathela ohlelweni lokwelashwa futhi ulawula izinga likashukela egazini nsuku zonke, ukugwema ukusetshenziswa kwezinye izidakamizwa, imiphumela emibi ayenzeki.
Iziguli
UVladimir, oneminyaka engama-39, eSt
Ithuluzi lifanela isenzo salo. Intengo iphakeme kancane, inikezwe ukuthi kuvame ukuthatha umuthi isikhathi eside. Kepha angikabheki eminye imithi okwamanje. Anginayo imiphumela emibi nge-Metglib therapy. Kufanele kukhunjulwe ukuthi kusekhona i-analogue ngedosi ephezulu, i-Force yengezwa egameni (Ungadideki noForte), kepha ngokuxilongwa kwami, iMetglib elula yanele.
UValentina, oneminyaka engama-38, uPenza
Ngiyameseka ngosizo lwakhe ukuthi isisindo sijwayelekile. Kufanele ngihambisane njalo nokudla okunama-kilojoule aphansi, kepha kuze kube manje ngikwazile ukugcina isisindo somzimba wami ngisezingeni elifanayo, elivele lilungile ngomzimba wami odonsa kancane. Ngizame izithasiselo zokudla ezahlukile, kepha kuze kube manje ngithanda umphumela wokusebenzisa iMetglib ngaphezulu. Futhi, amaphilisi alula ukuthatha. Ungabathatha uhambe nabo endleleni, njengoba akudingekile ukulandela imithetho yokuhlanzeka noma ukulungiselela isixazululo, njengoba kunjalo nangeminye imithi.
