I-Metglib 400 iyinhlangano esebenza ngempumelelo yesizukulwane esisha ye-hypoglycemic ekwelapheni iziguli zikashukela zabantu abadala. Akubangeli i-hypoglycemia, ayithinti ukucasulwa kwe-insulin emzimbeni. Ukuphuza umuthi kunikeza imiphumela emihle ekwelashweni nasekulawulweni kwesifo sikashukela.
Igama Lezwe elingafanele
INN - Glibenclamide + Metformin.
I-ATX
Ikhodi ngokuya ngezigaba ze-ATX yi-A10BD02.
Khipha amafomu nokwakheka
Ithebhulethi eyi-1 ifaka i-400 mg ye-metformin hydrochloride ne-glibenclamide 2,5 mg. Izibhebhe zihlanganiswe ne-soluble yefilimu emgodini wamathumbu. Ngokwengeziwe kuqukethe i-calcium hydrogenphosphate dihydrate, i-sodium stearyl fumarate, i-povidone, i-microcrystalline cellulose.
I-Metglib 400 iyinhlangano esebenza ngempumelelo yesizukulwane esisha ye-hypoglycemic ekwelapheni iziguli zikashukela zabantu abadala.
Isenzo se-Pharmacological
Ithuluzi liqukethe inhlanganisela yezidakamizwa ze-hypoglycemic zamaqembu ahlukene wemithi - metformin, glibenclamide. Ngokuphathelene nama-Biguanides, iMetformin yehlisa inani le-glucose ephelele. Inezindlela ezilandelayo zokusebenzisa umzimba:
- ukwehla kwezinga lokukhiqizwa koshukela kwezicubu zesibindi;
- ukuzwela okwandayo kwama-cell receptors ku-insulin;
- ukwandisa izinqubo zokusetshenziswa kanye nokusebenza kwe-glucose kumaseli emisipha;
- ukubambezeleka kokufaka ushukela ezinhlwini zokugaya;
- ukuzinza noma ukunciphisa umzimba kuma-diabetes.
I-Metformin inomphumela omuhle ekulinganisweni kwama-lipids egazi. Yehlisa ukuqoqwa kwe-cholesterol ephelele, ngokuyinhloko ngenxa yezinga eliphansi lokuqina kwe-lipoprotein. Ama-triglycerides aphansi.
I-Glibenclamide iyinhlangano eyakhelwe esigabeni sesibili sulfonylurea.
Ngokusetshenziswa kwayo, inani loshukela wegazi liyehla, ngoba livusa inqubo yokuhlanganiswa kwe-insulin ngamaseli we-beta wamanyikwe. Lokhu kuhambelana nomphumela wehlisela ushukela weMetformin. Ngakho-ke, ukwehla ngokuhleleka kwe-glucose yegazi, okuvimbela ukuthuthukiswa kweziqalo ze-hyperglycemia futhi kuvimbele ukuthuthukiswa kwezimo ze-hyperglycemic acute.
I-Metformin inomphumela omuhle ekulinganisweni kwama-lipids egazi.
I-Pharmacokinetics
Ngemuva kokusetshenziswa kwangaphakathi, i-glibenclamide igxilwe ngokuphelele kusuka ekugayeni kokugaya. Ukuhlushwa kwayo okuphezulu kunqunywa ngemuva kwamahora ama-4. Cishe zibopha ngokuphelele amaprotheni ku-plasma. It is eyenziwe futhi isuswe nge bile, indle.
I-Metformin ayibophele amaprotheni e-plasma. Ngokwesilinganiso esibuthakathaka, kuba nokuwohloka, okucishwe umchamo. Ingxenye yezidakamizwa iphuma nezindunduma.
Ngama-pathologies wezinso, inani le-metformin esegazini likhuphuka ngandlela thile, ngoba izinso azinaso isikhathi sokulenza. Ukudla akukuphazamisi ukutholakala kwezidakamizwa kusuka kuma-Biguanides amaningi.
Izinkomba zokusetshenziswa
Kunconyelwa ukuthi kusetshenziswe ekuhlolweni kwesifo sikashukela esinga-insulin esingaphansi kwe-insulin, inqobo nje uma ukwelashwa kokudla nemfundo yomzimba kungasebenzi noma ngemuva kokusetshenziswa kokutholwa kwe-sulfonylurea. Kungabuye kunqunywe ukuthi kuthathe indawo yokwelashwa okwedlule nge-Metformin ne-sulfonylurea derivatives, inqobo nje uma isifo sikashukela silawulwa kahle futhi kungekho zimo zezimo ze-hyperglycemic acute.
Kunconyelwe ukuthi kusetshenziswe ekuhlolweni kwesifo sikashukela sohlobo lwe-2 esinganciphisi insulin.
Contraindication
Umuthi unezimpawu zokuphambana:
- Thayipha isifo sikashukela sokuqala.
- Ukuzwela okuphezulu komzimba ku-metformin, glibenclamide nezinye izinto ezihlobene ne- sulfonylcarbamides.
- Izimo ezibucayi ezinomthelela ekuguqukeni kokusebenza kwezinso: ukomisa, ukutheleleka kanzima, ukushaqeka.
- I-ketoacidosis, i-precoma nekhotha.
- I-Hypersensitivity kwezinye izithako ezakha iMetglib.
- Ukwehluleka kwangempela kanye nokunye ukuphazamiseka kwezemvelo okubangela ukwehla kwesibalo se-creatinine ngaphansi kwe-60 ml / min.
- Ukulawulwa okungaphakathi kwemikhiqizo ye-x-ray equkethe iodine.
- Izimo ezihambisana nokubulawa yindlala komoya ophuma izicubu: ukungapheleli kwenhliziyo, amaphaphu, ukushaya kwenhliziyo.
- Ukwehluleka kwesibindi, kufaka phakathi i-hepatitis.
- I-Porphyria (ukwephulwa kwezinqubo ze-pigment metabolism, ehambisana nokuqukethwe okwandisiwe kwama-porphyrins egazi, kubonakaliswa ukuzwela okwandisiwe kwesikhumba ukukhanya kwelanga, nokuphazamiseka kwemizwa noma kwengqondo).
- Ukuthatha uMiconazole.
- Ukuhlinzwa, ukulimala nokushiswa okuningi.
- Izimo ezidinga ukwelashwa kwe-insulin.
- Ubuthi obunobungozi obukhulu.
- I-Lactic acidosis (kufaka phakathi umlando).
- Ukuhambisana nokudla kwesiguli sekhalori ephansi ngomkhawulo wokudla nsuku zonke kwe-caloric ongaphansi kwe-1000 kcal.
- Isiguli esingaphansi kweminyaka engu-18.
Ngokunakekela
Umuthi unikezwa ngokuqapha ezimweni ezilandelayo:
- umkhuhlane;
- utshwala;
- ukuntuleka kwe-adrenal;
- ukungasebenzi kahle kwesikhumba se-anterior pituitary;
- ama-pathologies we-thyroid abolile;
- iminyaka engaphezu kweminyaka engama-70 (kukhona ingozi ye-hypoglycemia enzima).
Ungayithatha kanjani iMetglib 400?
Umyalo ukhombisa ukuthi umuthi uphuza ngomlomo. Ithebhulethi ayikwazi ukuhlafunwa, ukuhlafunwa, ukuchobozwa kube yiphutha noma ukumiswa. Kumele igwenywe iphelele futhi igezwe ngenani elanele lokuhlanzekile futhi kusenamanzi. Ukusetshenziswa kwezinye iziphuzo ngalezi zinhloso akuvunyelwe ngenxa yoshintsho olunokwenzeka esenzakalweni se-hypoglycemic seMetglib.
Umyalo ukhombisa ukuthi umuthi uphuza ngomlomo, ithebhulethi ayinakuhlafunwa, ihlafunwe, ifafazwe ibe yiphutha noma yenziwe ngokumiswa okwesikhashana.
Ngoshukela
Umthamo wezidakamizwa zesifo sikashukela unqunywa udokotela, ngokuya ngesimo sesiguli, i-carbohydrate metabolism. Ngokuqokwa komthamo, inkomba ye-glycemic inomphumela onqumayo.
Imvamisa umthamo wokuqala ngamathebhulethi ama-1 noma amabili ngosuku. Kumele aphuzwe nokudla okuyinhloko. Esikhathini esizayo, umthamo ungakhuphuka ube nokuqina okujwayelekile kokuqukethwe ushukela.
Umthamo omkhulu ngamathebhulethi ayi-6. Kulokhu, ahlukaniswe ngemithamo emithathu.
Imiphumela emibi yeMetglib 400
Imiphumela emibi elandelayo ingenzeka ngesikhathi sokwelashwa:
- Kukhona ushintsho ekwakhekeni kwegazi kanye nesimo sohlelo lwe-lymphatic, olukhonjiswe ku-agranulocytosis, leukopenia kanye ne-thrombocytopenia. Lokhu kuphazamiseka kuyivelakancane futhi kunyamalale ngemuva kokuhoxiswa kwezidakamizwa. I-hememic anemia, i-aplasia yomongo wethambo (ukungapheleli kwemisebenzi yesitho), i-pancytopenia (ukuntuleka kwazo zonke izakhi zegazi ezakheke kakhulu) kuyivelakancane kakhulu.
- Kwesinye isikhathi kungaqhamuke ukushaqeka kwe-anaphylactic. Kukhona ukusabela kokuzwela okubukhali kokutholwa kwe-sulfonylurea.
- Ngokwengxenye ye-metabolism, i-hypoglycemia, i-porphyria, ukuncipha kokufakwa kwe-vitamin B12, okuhambisana nokusetshenziswa isikhathi eside kwemithi ye-Metformin, kungenzeka. Kukhona ubungozi be-megaloblastic anemia.
- Ukunambitheka okungathandeki emgodini womlomo kungenzeka. Ekuqaleni kokwelashwa, ukuphuma kwesikhashana kwesitho sokubona kwenzeka ngenxa yokwehla kokuxineka kweglucose.
- Imvamisa kungaba khona isicanucanu, isifo sohudo, ukugabha, izinhlungu esiswini kanye nokwehla (kwesinye isikhathi ukuntuleka okuphelele) kwesifiso sokudla. Lokhu kubonakaliswa kwenzeka ekuqaleni kokwelashwa futhi kudlule ngokushesha. Ukusetshenziswa kwesidakamizwa emithanjeni eminingana kanye nokwanda kancane komthamo kunciphisa amathuba okuba nezimpawu ezinjalo.
- Akuvamile, ukungasebenzi kahle kwesibindi nomsebenzi owengeziwe wama-enzyme wesibindi kungenzeka. Kulokhu, udinga ukuyeka ukuthatha.
- Ukuphendula kwesikhumba akuvamile ukuvela - ukulunywa, ukuqubuka, i-urticaria. I-vasculitis ye-allergic, i-erythema, ne-dermatitis kwesinye isikhathi ingaqala ukukhula. Kube nezimo zokuzwela okwengeziwe kwesikhumba ukukhanya kwelanga.
- Kwesinye isikhathi kungenzeka ukwandisa ukuqoqwa kwe-urea ne-creatinine ku-serum.
- Kuyaqabukela, iziqephu zamazinga we-sodium wegazi anciphile.
Umthelela ekhonweni lokulawula izindlela
Ngenxa yobungozi bokubangela i-hypoglycemia esigabeni sokuqala sokwelashwa, kuyadingeka ukwenqaba umsebenzi ohlobene nokushayela nokulawula imishini. Kanye nengozi ye-hypoglycemia, ukwazi ukwazi kungathikamezeka.
Imiyalo ekhethekile
Ukwelashwa kufanele kwenziwe kuphela ngaphansi kokuqashwa kukachwepheshe. Ngesikhathi sokufundela ukwelashwa, yonke imiyalo kadokotela kufanele ibhekwe ngokucophelela: ukondliwa okufanele, ukuqashwa njalo kwe-glucose yokuzila ukudla nangemva kokudla.
Kwenqatshelwe ukuthatha izithasiselo zokudla ezinoshukela.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ngesikhathi sokukhulelwa, ukuqokwa kubekwe kungqubuzana ngokuphelele. Isiguli kufanele sazise udokotela ukuthi uhlela ukukhulelwa noma ukuthi usefikile. Uma ukukhulelwa kwenzeka ngenkathi uthatha umuthi, umuthi kufanele uhoxiswe ngokushesha. Ngemuva kokukhanselwa kweMetglib, isiguli sinqunyelwe ukwelashwa kwe-insulin (ukwethulwa kwemijovo ye-insulin ukuze sinciphise ukuhlushwa ushukela).
Kuphikisana ngokuqinile ne-Metglib ngesikhathi sokuncelisa ibele. Lokhu kungenxa yokuntuleka kwedatha ekhonweni lezinto ezisebenzayo zomuthi ukungena ubisi lwebele. Uma kuba nesidingo sokusebenzisa umuthi ngesikhathi sokuqunjelwa, isiguli sinqunywe imijovo ye-insulin noma ingane idluliselwa kwindlela yokuphaka eyokufakelwa.
Umuthi weMetglib Wezingane ezingama-400
Ayabelwe.
Sebenzisa ebudaleni
Ukunakekelwa okukhethekile kufanele kuthathwe ngabantu asebekhulile. Kukhona ubungozi be-hypoglycemia enzima.
Isicelo sokusebenza kokulimala kwezinso
Ngokungasebenzi kahle kwezinso, umuthi kufanele usetshenziswe ngokuqapha, ngoba ukukhuphuka kwamazinga wegazi wezakhi zayo ezisebenzayo kungenzeka. Ekwehlulekeni kwezinso esibulalayo akusetshenziswa.
Ngokungasebenzi kwezinso, umuthi kufanele usetshenziswe ngokuqapha.
Sebenzisa umsebenzi wesibindi okhubazekile
Akunakubekelwa ukulimala kwesibindi esibulalayo
I-overdose yeMetglib 400
Nge-overdose, i-hypoglycemia iyakhula. I-hypoglycemia emnene ngokulinganisela imiswa ukusetshenziswa ngokushesha kwamaswidi. Kufanele ushintshe umthamo wesidakamizwa bese ulungisa ukudla.
Kwi-hypoglycemia enzima, ukulahleka kwengqondo kwenzeka, i-paroxysm, ukuphazamiseka kwemizwa okudinga ukwelashwa okuphuthumayo. Ukukhululeka kwesimo esibi kudinga ukwethulwa okuphuthumayo kwe-Dextrose emzimbeni.
I-hyperglycemia esolwayo iyinkomba yokuthi umuntu angeniswe esibhedlela ngokushesha. Ukuze ugweme ukubuyela emuva, umuntu udinga ukunikezwa ukudla okuqukethe kalula ama-carbohydrate angcolile.
Kulesi sifo sesibindi sikashukela, isilinganiso se-glibenclamide clearance siyanda. Ngakho-ke, iziguli ezinjalo zidinga ukuqapha ngokucophelela umthamo womuthi. Uma usebenzisa imithamo ephezulu ye-Metglib, i-dialysis ayisebenzi.
Njengoba iMetformin isesakhiweni, ukusetshenziswa njalo kweMetglib ngamanani amakhulu kungavusa i-lactic acidosis. Lesi yisimo esiyingozi esidinga ukunakekelwa okuphuthumayo. I-lactate ne-metformin ingaqedwa nge-dialysis.
I-lactate ne-metformin ingaqedwa nge-dialysis.
Ukuxhumana nezinye izidakamizwa
Ngesikhathi sokulashwa, ukusetshenziswa kanyekanye kwe-phenylbutazone akuvunyelwe ngokuphelele. Kwandisa umsebenzi we-hypoglycemic weMetglib. Kungcono ukusebenzisa ezinye izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala ekwelapheni izinhlungu nokuvuvukala.
Musa ukusebenzisa ezinye izinto nge-sulfonylurea uma isiguli sesivele sithatha iMetglib. Ngaphandle kwalokho, i-hypoglycemia enzima ingahle ikhule.
Ukusetshenziswa kweBosentan kukhulisa kakhulu ingozi yemiphumela enobuthi yesidakamizwa esibindini. Umphumela we-glibenclamide ungancishiswa kakhulu.
Ukuhambisana notshwala
Ngesikhathi sokwelashwa, ukusabela okufana ne-discriram kungenzeka (okufana nalokho okuvezwa ukusabela kwe-ethanol ne-Antabus). Umuthi lo awuhambelani ne-ethanol.
Utshwala bungakhulisa amathuba okuba nesibindi sokuqina kwe-hypoglycemia ne-hypoglycemic coma. Ngakho-ke, ngokwelashwa kweMetglib, ama-tinctures aqukethe utshwala awavunyelwe.
Ama-Analog
Izinhlu zethuluzi yilezi:
- I-Glibenfage;
- I-Glibomet;
- Ama-Glucovans;
- I-Gluconorm;
- IGluconorm Plus;
- Amandla we-Metglib.
Imibandela yekhefu lekhemisi
Ikhishwe ngumbhalo.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Amanye amakhemisi avumela ukuthengiswa kweMetglib ngaphandle kwemiyalelo kadokotela. Iziguli ezithenga umuthi ngaphandle kokuqokwa uchwepheshe zisengozini ngoba zingase zibe ne-hypoglycemia enzima.
Intengo yeMetglib 400
Izindleko ezijwayelekile zokupakisha (amaphilisi angu-40) zingama-ruble angama-300.
Izimo zokugcina zomuthi
Gcina endaweni eyomile enomoya omncane ongafinyeleleki lapho kukhanya khona ilanga. Izinga lokushisa lomuthi akufanele lidlule + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Umuthi ungagcinwa iminyaka emi-3 kusukela ngosuku lokukhiqizwa.
Umkhiqizi
Ikhiqizwe eCanonfarm Production, eRussia.
Ukubuyekezwa mayelana neMetglib 400
Odokotela
U-Irina, oneminyaka engama-38, i-endocrinologist, u-Obninsk: "Nginikeza i-Metglib ezigulini ezinefomu eligciniwe lesifo sikashukela 2. Emavikini okuqala, iziguli zithatha amaphilisi ama-2 ngosuku, bese umthamo ukhuphuka uye kumathebhulethi angama-3-4. Ngenxa yalokhu, kungenzeka ukugcina amanani eglucose ejwayelekile futhi ungazidluli. "
USvetlana, oneminyaka engama-45 ubudala, i-endocrinologist, eMoscow: "I-Metglib iyithuluzi elisebenzayo lokulawula isifo sikashukela nokuvimbela i-hyperglycemia. Ikhuthazelelwa kahle yiziguli, amacala e-hypoglycemia neminye imiphumela emibi ibonwa kakhulu."
Iziguli
U-Ivan, oneminyaka engama-50, uPetrozavodsk: "Umuthi ophumelelayo wesifo sikashukela ongabangeli isiyezi, impilo engeyinhle futhi ngasikhathi sinye ukuvumela ukuthi ugcine ushukela wegazi ujwayelekile. Eminye imithi ayizange ibe nalomphumela. Wellness yathuthuka kakhulu ngemuva kokuqala ukwelashwa."
U-Olga, oneminyaka engama-42, uVologda: "Ngemuva kokuthatha iMetglib, impilo yami yathuthuka.
UPolina, oneminyaka engama-39, uKirov: "Umuthi ongabizi futhi osebenzayo uthuthuka kahle, wehlisa amazinga kashukela. Umphumela ushesha ukwedlula eminye imithi. Akunamiphumela emibi ngemuva kokuqala kokwelashwa."
