I-Glucophage xr 500 isetshenziswa ngenkuthalo ekwelapheni i-mellitus yesifo sikashukela esingavikelekile i-insulin. I-Metformin isebenza njengento esemqoka esebenzayo, enomphumela ofanele ezingeni le-glycemia.
Namuhla, kutholakala izakhiwo ezintsha zalo msebenzi futhi ukusetshenziswa kwawo kukhula ngokwenele, kusetshenziswa umuthi hhayi kuphela ekwelapheni okuyinkimbinkimbi ngokwakhiwa kwe-pathology.
Yimiphi imithi esetshenziselwa ukwelapha i-pathology?
Uhlobo lwesifo sikashukela sohlobo 2 yisifo se-endocrine lapho amaseli omzimba enqaba i-insulin ekhiqizwa khona amanyikwe.
Ngenxa yale nqubo, amangqamuzana alahlekelwa ukuzwela kwawo ku-hormone, ushukela awukwazi ukungena ngaphakathi kwezicubu, uqwabelana emzimbeni.
Futhi, ukwenyuka kwamazinga e-insulin kuyabonakala futhi, ngoba amanyikwe aqala ukukhiqiza inani laleli hormone ngevolumu ekhuphukayo.
Kuze kube manje, ukwelashwa kohlobo lwesifo sikashukela sohlobo 2 kungukusetshenziswa kwamaqembu alandelayo amadivayisi wezokwelapha:
- Izidakamizwa ezitholakala sulfonylurea. Umphumela we-pharmacological ukukhuthaza ukucasulwa kwe-insulin ye-insulin. Inzuzo enkulu yaleli qembu lemithi ukubekezelela kalula umuthi yiziguli eziningi.
- Imikhiqizo yezokwelapha eqenjini le-Biguanide. Umphumela wazo uhlose ukunciphisa isidingo soku secretion se-insulin.
- Imithi etholakala ku-thiazolidinol isiza ukwehlisa ushukela wegazi futhi ibe nomphumela omuhle ekuvumelaneni kwephrofayili ye-lipid.
- Ama -retretins.
Enhliziyweni yazo zonke izidakamizwa ezivela eqenjini le-Biguanide kuyinto esebenzayo efana ne-metformin. Uhlobo lwesifo sikashukela sohlobo 2 luvame ukubonakaliswa ngokuhambisana nokumelana ne-insulin - ukungakwazi kwamaseli ukubona ngokujwayelekile i-hormone ekhiqizwa amanyikwe.
Imiphumela emqoka yamakhemikhali yezidakamizwa eqenjini le-Biguanide yile:
- ukunciphisa kahle ushukela wegazi;
- ukulawulwa kokukhiqizwa kwe-insulin yi-pancreas, evumela ukunciphisa inani layo ngokweqile emzimbeni;
- akunikeleli ekuthuthukisweni kwe-hypoglycemia.
Ngaphezu kwalokho, izidakamizwa kanye nokwelashwa okufanele kokudla zingakwazi ukukhulisa isisindo futhi zibhekane nokukhuluphala, okubaluleke kakhulu kwiziguli ezinalokhu kutholwa.
I-Metformin isetshenziswa ekwelapheni i-mellitus yesifo sikashukela ngaphandle kokulashwa kwe-insulin. Ibambezela ukumuncwa kwe-glucose emathunjini amancane futhi ivimbela ukukhiqizwa kwayo ngamaseli wesibindi.
Inani lemithamo yomuthi incike kumthamo wayo. Kuze kube manje, amaphilisi anjalo ayatholakala ngo-400, 500, 850 noma 100 mg wesithako esisebenzayo kwiphilisi elilodwa.
Yiziphi izidakamizwa zaleli qembu ezilethwa emakethe yemithi? Okokuqala, le mishanguzo ifaka ama-ejenti omlomo alandelayo:
- Siofor.
- I-Glucophage.
- UGlatiniin.
- I-Metpho-gamma.
- I-Dianormet.
Ukwakheka kwale mishanguzo kunento esemqoka esebenzayo - i-metformin, engafakwa kumithamo ehlukile futhi, ngenxa yalokho, iba nomphumela ohlukile. Leyo mithi isatshalaliswa emakhemisi asedolobheni kuphela uma unikezwa incwadi kadokotela ebekiwe.
Izinkomba eziphambili zokusebenzisa umuthi
I-Glucophage wumuthi ovame ukunikezwa iziguli ezinenkinga yesifo sikashukela.
Amathebulethi asiza ukunciphisa ushukela wegazi, futhi abe nomphumela omuhle ekunciphiseni isisindo ngokweqile.
Isidakamizwa siyasetshenziswa uma isiguli sinezinkomba ezithile zokuzisebenzisa.
Izinkomba eziphambili zokusetshenziswa kwomuthi yilezi:
- i-mellitus yesifo sikashukela enganciki i-insulin kubantu abadala njengesidakamizwa esiyinhloko noma inkambo yokwelashwa ephelele;
- ebuntwaneni (emva kweminyaka eyishumi).
Umuthi onqunywe udokotela oholayo ngemuva kokudla nokuzivocavoca ngokulinganisela awukhombisanga umphumela omuhle.
Ngaphezu kwalokho, imiphumela ezuzisayo yamathebulethi eGlucophage imi ngalendlela elandelayo:
- Isiza ukuvikela ubuchopho ekuguga, okukuvumela ukuthi kusetshenziselwe izinjongo ze-prophylactic emelana nesifo i-Alzheimer's.
- Sithinta kahle isimo semithambo yegazi nemithambo yegazi. Ngakho-ke, ngosizo lweMetformin, ukuthuthukiswa kwe-vasher atermososisosis, ukuhluleka kwenhliziyo, umfutho wegazi ophakeme, kanye nokubalwa kwemithambo kungavinjelwa.
- Yehlisa amathuba womdlavuza.
- Ithinta kakhulu ukuthuthukiswa kwe-potency emadodeni, okwakhubazeka ngenxa yezifo ezihlukahlukene ze-senile.
- Ikunciphisa ukuthuthukiswa kwamathambo kwabanesifo sikashukela. Ikakhulu kaningi, abesifazane bahlushwa amathambo ama-brittle ngemuva kokunqamuka kokuya esikhathini, ngoba kukhona ukwehla okukhulu kwama-hormone - estrogen.
- Kuthinta kahle ukusebenza kwe-gland yegilo.
- Inomsebenzi wokuzivikela maqondana nohlelo lokuphefumula.
Umehluko omkhulu weGlucophage ukubonakaliswa kwemiphumela efana:
- kukhona inqubo yokwenza kusebenze kanye ne-oxidation yamafutha omzimba;
- ama-carbohydrate angena emzimbeni kanye nokudla amuncwa odongeni lwepheshana lesisu ngesilinganiso esincane;
- kukhona okuvusa amandla kanye nokwenza kusebenze ukucubungula i-glucose ngama-izicubu zemisipha;
- izinga lekholesterol embi emzimbeni iyancishiswa;
- sibonga yonke imiphumela engenhla, isisindo esithe xaxa sishiya kancane.
Kungakho i-Glucophage isetshenziswa kaningi ngabanesifo sikashukela, ikakhulukazi uma ukunamathela ngokucophelela ekwelashweni kokudla kungalethi umphumela ofanele.
Izici zamakhemikhali zomkhiqizo wezokwelapha
Isithako esikhulu esisebenzayo somuthi iGlucofage XP yi-metformin hydrochloride, i-silicon dioxide, i-povidone, i-magnesium stearate, ne-macrogol asetshenziswa njengezakhi ezisizayo.
I-Metformin iyinto eqenjini le-Biguanides elinomthelela wokwehlisa ushukela.
Kumele kuqashelwe ukuthi ukulungiswa kwethebhulethi kusiza ekulinganiseni izinga le-glucose kuplasma wegazi, futhi futhi kulawula ukweqa ushukela ngemuva kokudla.
Ukusebenza kahle kwalo muthi kuwukubonakaliswa kwezici ezintathu eziphambili zento esebenzayo:
- Isiza ukunciphisa ukukhiqizwa kwe-glucose yesibindi ngokuvimbela i-gluconeogenesis ne-glycogenolysis.
- Kwandisa ukuzwela kwamangqamuzana nezicubu kwi-insulin ye-hormone, okuthinta kahle ukubanjwa nokuphuma kweglucose egazini.
- Ibambezela ukumuncwa kwe-glucose emathunjini.
Ngemuva kokuthatha amaphilisi, isakhi esiyinhloko esisebenzayo sisatshalaliswa ngokushesha phezu kwezicubu zomzimba, kanti empeleni akuboshelwa kumaprotheni egazi.
Njengoba kufakazelwa yimiyalo ye-Glucofage XP 500, umuthi ukhishwa emzimbeni ungashintshiwe.
Inzuzo enkulu yensiza enjalo yezokwelapha ukuthi ukuthatha lo muthi akuvimbi ukuthuthukiswa kwe-hypoglycemia, njengoba kuvame ukwenzeka ngokutholwa kwesulfonylurea.
Imiyalo yokusebenzisa umuthi
Indlela yokuphatha, inani nomthamo wesidakamizwa kuchazwa ngudokotela ohambelayo.
Imithamo incike ebukhali be-pathology, iminyaka yesiguli nesithombe sayo sonke sezempilo.
Kufanele kukhunjulwe ukuthi namuhla kunezinhlobo eziningana zalo muthi, ezahluka ngokuya ngenani lezinto ezisebenzayo:
Izinhlobo ezilandelayo zemishini yezokwelapha:
- I-Glucophage xr 500 (iqukethe amakhulu amahlanu mg wezinto ezisebenzayo);
- IGlucophage xr 850;
- IGlucophage xr 1000.
Ukulungiswa kwethebhulethi kumele kusetshenziswe njengomuthi ozimele noma ngokubambisana nezinye izidakamizwa ezinciphisa ushukela, ngokuya ngezincomo zikadokotela.
Ukuqala inkambo yokwelashwa nge-Glucofage xr, umthamo wokuqala usethwe ku-500 mg wesithako esisebenzayo. Umuthi uphuzwa kusihlwa ngemuva kwesidlo sakusihlwa. Ngemuva kwezinsuku eziyishumi kuya kweziyishumi nane, umthamo wokuqala ungashintshwa uma kunesidingo, kuya ngemiphumela yokuhlolwa kwegazi. Ukwanda okuhamba kancane futhi okuhamba kancane kwemithamo okwehlisa ubungozi bokusabela okungekuhle. Umthamo omkhulu ongatholwa ukuthatha amaphilisi amane ngosuku, okungukuthi, kungabi ngaphezu kwamamitha ayisigidi wengxenye esebenzayo. Kunconywe ukwandisa umthamo wokuthi ungasaphathwa kanye ngesonto ngamamayela angamakhulu amahlanu.
Ngaphezu kwalokho, kwezinye izimo, udokotela ohambelayo angancoma ukuthatha umuthi kabili ngosuku - ekuseni nakusihlwa. Kulokhu, indlela ejwayelekile yansuku zonke ihlukaniswe kabili.
Kwesinye isikhathi, ukuthola umphumela ongcono, amaphilisi we-Glucofage anikezwa ngokuhambisana nokwelashwa kwe-insulin. Le nhlanganisela ikuvumela ukuthi ulawule kangcono izinga le-glucose egazini.
Ukuboniswa kokusiphi isimo esibi okufanele siqaphele?
Ukusetshenziswa okungalungile kwesidakamizwa noma ukwehluleka ukuhambisana nemithamo enconyiwe kungaholela ekwakhiweni kwemiphumela emibi.
Uma kwenzeka kweqisa umuthi, isiguli kufanele silaliswe esibhedlela ngokushesha ukuze sinikeze usizo oludingekayo. Njengomthetho, ukwelashwa okubonakalayo kwenziwa. Ukususa ngokushesha umuthi emzimbeni, kusetshenziswa into efana ne-hemodiliasis.
Imiphumela emibi engahle ivele phakathi nenkambo yokwelapha ngalo muthi iboniswa ngesimo:
- Ukuqala ukwelashwa kungahle kuhambisane nokubonisa isicanucanu, kwesinye isikhathi nokuhlanza. Isiguli singakhononda ngokunambitheka kwensimbi emgodleni womlomo, ubuhlungu esiswini, ukukhuphuka okuthe xaxa, isifo sohudo kanye nokuphelelwa yisifiso sokudla.
- Ngesikhathi sokusetshenziswa umuthi isikhathi eside, i-acidosis ingaqhamuka, njengoba kukhona ukwehla kwesilinganiso samavithamini we-B kuseramu yegazi. Kulokhu, udokotela wenza isinqumo maqondana nokuqedwa kwomuthi.
- ukungasebenzi kahle kwesibindi kanye ne-hepatitis yezidakamizwa.
- Mhlawumbe ukubonakala kokuqhuma noma ukulunywa esikhunjeni, ukuthuthukiswa kwe-urticaria, isifo sikashukela sikashukela.
Lapho kuhlanganiswa nemithi ethile, iziguli kudingeka ziqaphele ikakhulukazi, njengoba ingozi yemiphumela emibi nempilo engemihle iyanda. Kungakho udokotela oholayo kufanele aziswe ngazo zonke izifo ezihlangene, kanye nokuthatha eminye umuthi. Ukuphathwa kanyekanye kweGlucofage xr ene-diuretics kuvame ukudala i-lactic acidosis.
Ukuthatha i-Glucofage xr ne-chlorpromazine ngasikhathi sinye, kukhona ukwanda okubukhali koshukela wegazi nokukhishwa kwe-insulin ye-hormone kuyancipha.
Ingabe ikhona imikhawulo ekusebenziseni umuthi?
I-Glucophage xr, okubandakanya i-metformin enkulu yezithako, ayihambelani nokuphuza kanyekanye iziphuzo ezinotshwala.
Ngaphezu kwalokho, namuhla kunemikhawulo ethile ekusetshenzisweni kwamathebhulethi anjalo, okudingeka wazi ngawo.
I-contraindication eyinhloko ukusetshenziswa komuthi:
- Lapho kukhona inani elikhulayo lokuzwela kwento eyodwa noma eziningi eziyingxenye yomuthi.
- Isimo se-ketoacidosis yesifo sikashukela noma ukhokho onesifo sikashukela siyabonakala.
- Ukulimazeka kwamalunga kuyabonakala. Ukuxilonga kukhombisa imiphumela ye-creatine clearance engaphansi kuka-60 ml / min.
- Izifo ezithathelanayo ezihlasela kakhulu.
- Ukomisa
- Ukuthuthukiswa kwe-pathologies in amafomu acute noma okungamahlalakhona okungadala izicubu hypoxia.
- I-Lactic acidosis.
- Isifo esikhulu sesibindi.
- Akunconyelwe ukusebenzisa umuthi ngesikhathi sokukhulelwa nokukhishwa komzimba.
- Ebuntwaneni, kuze kube iminyaka eyishumi.
Ukuze ugweme ubungozi bokuthola isimo se-hyperglycemic coma, lesi sidakamizwa asinconywa ukuba sithathwe kanyekanye ne-danazol.
Isazi sevidiyo esikulesi sihloko sizositshela kabanzi ngemiphumela ye-hypoglycemic ye-Glucofage.
