Isidakamizwa iBagomet plus siyinhlanganisela ehleliwe yezidakamizwa ezimbili zomlomo ze-hypoglycemic ngasikhathi sinye, ezingamaqembu ehlukene emithi: Metformin, Glibenclamide.
I-Metformin ingumuthi weqembu le-Biguanide, yehlisa ngokuphelele i-glycemia ngenxa yokuzwela okukhulayo kwezicubu zepherishi ku-insulin ye-hormone, ukuthathwa kweglucose okuthuthukisiwe.
Izinto ezisebenzayo zomuthi zinciphisa ukumuncwa kwama-carbohydrate ngumgudu wokugaya ukudla, zivimbela i-gluconeogenesis esibindini sesiguli, futhi zibe nomthelela omuhle ekwakhekeni kwamafutha egazini, kwehlise ama-triglycerides ne-cholesterol ephelele.
I-Glibenclamide iyi-sulfonylurea yesizukulwane sesibili, ukugxila kwe-glucose ngemuva kokusetshenziswa kwento kunciphisa ngenxa yokugcinwa okusebenzayo kwe-insulin ye-hormone ngamaseli we-pancreas.
Ngemuva kokusebenzisa umuthi, umphumela we-hypoglycemic ukhula ngemuva kwamahora ama-2, futhi ungahlala kuze kube ngamahora ayi-12. Isibonakaliso esiyinhloko sokusetshenziswa uhlobo lwe-2 sikashukela mellitus ngokumelene nesizinda sokuntuleka kwemiphumela yokwelashwa kokudla noma ukwelashwa ngemithi ye-hypoglycemic yomlomo.
Intengo yeBagomet Plus (umthamo we-500 mg) icishe ibe ngama-ruble angama-200. Ama-analoggs womuthi: Glybomet, Glukovans, Gluconorm.
I-contraindication eyinhloko, ukusabela okubi komzimba
Umuthi awunakubekelwa uhlobo lwe-1 yesifo sikashukela, ukhokho onesifo sikashukela, i-ketoacidosis yesifo sikashukela, isifo sezinso kanye nokuntuleka kwe-hepatic, i-lactic acidosis, ukudakwa kakhulu kwezidakamizwa. IBagomet nayo ayinconyelwanga ngenxa yezimo ezimbi kakhulu ze-pathological ezidinga ukwethulwa kwama-iodine aqukethe i-iodine agents.
Ikhambi lihlukaniswe ngaphansi kwezimo ezingamahlalakhona nezesimweni esibi, ezihambisana nokubulawa yindlala komoya-mpilo, okuwukuthi: isimo sokwethuka, ukufakwa kwe-myocardial, ukomisa. Kukhona nemikhawulo ekusetshenzisweni kwalesi sidakamizwa se-porphyria, ukusetshenziswa okufanayo ne-miconazole, ukukhulelwa kanye nokuncelisa ibele.
Kungenzeka ukuthi ngesikhathi sokwelashwa isiguli esinesifo sikashukela siyozwa ukusabela okungathandeki komzimba: ukuhlaselwa wokuhlanza, isicanucanu, isisu esibuhlungu, isifiso sokudla esinciphile, ukunambitheka kwensimbi emlonyeni, ne-erythema. I-Metformin ekwakhiweni kwalesi sidakamizwa kwesinye isikhathi ivusa ukwehla kokufakwa, i-lactate acidosis.
Enye ingxenye yesidakamizwa iBagomet - Glibenclamide - iyakwazi ukubangela lezo zimo:
- ukuqubuka kwesikhumba, ukulunywa, i-urticaria;
- ukugabha, isicanucanu, ubuhlungu besisu;
- umsebenzi ngokweqile we-hepatic transaminases;
- i-leukopenia, i-hemolytic anemia, i-thrombocytopenia.
Ukwanda okungenzeka kokuhlushwa kwe-urea kwegazi, i-aplasia yomongo wethambo, i-pancytopenia, i-hyponatremia, ukusabela okungathi-disulfiram.
Imiyalo yokusebenzisa umuthi
I-Bagomet Plus ithathwa ngokudla, uhlobo oluqondile lomthamo kufanele lukhethwe ngokuhlukile, ngokuya ngesimo sezinqubo ze-metabolic. Njengomthetho, umthamo wokuqala uyithebhulethi eyi-1, kancane kancane inani lemithi lenyuswa, lisuselwa kuzinkomba ze-glycemic. Imvamisa kuthatha amasonto ayi-1-2.
Lapho kunesidingo esiphuthumayo sokufaka esikhundleni sokwelashwa okuhlanganisiwe kwangaphambilini, udokotela unquma amaphilisi angu-1-2 (umthamo uncike kumthamo wangaphambilini womuthi). Amaphilisi amakhulu ama-4 avumelekile ngosuku, ngokususelwa kwizithako ezisebenzayo eziphambili - lokhu ngu-500 mg we-metformin no-5 mg we-glibenclamide.
Uma umuntu onesifo sikashukela eselwenzile ukuhlinzwa, washisa, walimala noma izifo ezithathelwanayo nge-febrile syndrome, kungadingeka ukuthi uyeke ukuthatha imishanguzo ye-hypoglycemic yomlomo nokunquma imijovo ye-insulin.
Ngesikhathi sokulashwa, kuyadingeka ukulawula ngaphansi kokulawulwa:
- i-glycemia esheshayo, ngemuva kokudla;
- ijika nsuku zonke ushukela wegazi.
Udinga ukwazi ngamathuba akhulayo okuthuthukisa i-hypoglycemia uma umuntu onesifo sikashukela, kanye neBagomet Plus, ephuza utshwala, nezidakamizwa ezingezona ezokulwa nezifo ezingekho emthethweni futhi ebulawa yindlala.
Ukulungiswa komthamo wesidakamizwa kuhlinzekelwa ubunzima obungokomzwelo, bomzimba, ushintsho olubucayi ekudleni. Ngokuqapha ngokweqile, umuthi kufanele uphuzwe ngokungemuva kokwelashwa nge-beta-blockers.
Uma kuvela izimpawu ze-hypoglycemia, kukhonjisiwe:
- udle inani elincane lokudla kwe-carbohydrate;
- phatha i-glucose noma isixazululo se-dextrose ngaphakathi.
Lapho kudingeka ucwaningo lwe-urographic noma lwe-angiographic, iBagomet Plus ikhanseliwe ezinsukwini ezi-2 ngaphambi kwenqubo futhi iphinde iqale ngemuva kwamahora angama-48.
Ngokusetshenziswa okufanayo kwezinto eziqukethe i-ethanol, kunethuba lokuthuthukisa ukusabela okufana nokuvela kwe-disulfiram.
Isikhathi sokuthola ukwelashwa, onesifo sikashukela kuyadingeka ukuba aqaphele kakhulu lapho eshayela izinhlobo ezahlukahlukene zokuhamba, esebenza ngezindlela ezinobungozi ezifaka ukunakwa okukhulu kokunaka, kanye nesivinini sokuphendula kwengqondo.
Ukusebenzelana kwezidakamizwa
Ukusetshenziswa okuhlanganyelwe nge-miconazole kungadala ukukhula kwe-hypoglycemia yobukhulu obuhlukahlukene, kuze kufinyelele kuhlutha. Uma iBagomet isetshenziswa ndawonye neFluconazole, kungenzeka ukuthi kube khona i-hypoglycemia, ngoba izinga lokuphuma kwe-sulfonylurea landa.
Umuthi i-Phenylbutazone uyakwazi ukufaka izinto eziphuma ku-sulfonylurea, ngaleyo ndlela ubangele ukwanda kwenani labo emgodini wegazi, ingozi ye-hypoglycemia.
Ukusetshenziswa kwezidakamizwa eziqukethe iodine iodine kungadala ukuthuthukiswa kokulimala kwezintso zomsebenzi wethambo, ukunqwabelana kwe-metformin. Kulokhu, ukuthuthukiswa kwe-lactic acidosis akubekelwe eceleni. Ukwelapha ngomuthi kukhonjiswa ukuthi kufanele kuqashelwe ezinsukwini ezimbili ngaphambi kokusetshenziswa kwemithi enjalo, futhi kungaqala kabusha ngemuva kwamahora angama-48.
Ukwelashwa kweBagomet nokusetshenziswa kwezidakamizwa eziqukethe i-ethanol kwezinye izigaba zeziguli ezinesifo sikashukela kungavusa ukusabela okufana nokwenzeka kwe-disulfiram.
Okulingana neBagomet Plus yiMetformin 850 noma i-1000.
Ngokusetshenziswa okufanayo kwezidakamizwa ze-glucocorticosteroid, ama-diuretics nama-beta2-blockers:
- kukhona ukwehla okukhulu ekusebenzeni kwezokwelapha;
- kunezinkomba zokulungisa umthamo wezidakamizwa.
Ngokuphikisana nesizinda sokwelashwa nge-ACE inhibitors, amathuba we-hypoglycemia avela, abahlaseli be-beta bazokwandisa imvamisa nobunzima balesi simo se-pathological.
Uma kusetshenziswa izidakamizwa ze-antibacterial, ukwehla ngokushesha kwamazinga kashukela kungaqala, le mithi ifaka phakathi:
- ama-sulfonamides;
- Mao inhibitors;
- I-Pentoxifylline;
- I-Chloramphenicol;
- Ama-Disopyramides.
Ukusabela okufanayo kungenzeka lapho usebenzisa izidakamizwa ezokwehlisa i-lipid eqenjini lama-fibrate.
Amacala okweqa
Uma kwenzeka kweqa ngokweqile, i-hypoglycemia yenzeka, kubangelwa ukuba khona kwe-glibenclamide kulokho.
Ngakho-ke i-hypoglycemia kwisifo sikashukela ingadala indlala, ukujuluka ngokweqile, ubuthakathaka bemisipha, isikhumba esiphaphathekile, ukuthuthumela emzimbeni, ikhanda.
Lapho i-hypoglycemia ithuthuka, kuba nengozi yokulahlekelwa ukuzithiba nokwazi okufiphele. Kulokhu, kuyadingeka ngokuphuthumayo ukuthatha inani elincane lokudla kwe-carbohydrate, ukujova ushukela emzimbeni. Kodwa-ke, le ndlela izosiza kuphela ngobumnene nobukhulu bokulinganisela kwe-hypoglycemia.
Ezinye izibonakaliso kufanele zibizwe:
- isifo sokulala;
- ukwesaba okungenasisekelo;
- ukungasebenzi kahle, ukuhlangana kokunyakaza;
- ukuphazamiseka kwemizwa ngezikhathi ezithile;
- isiyezi.
Ezimpawu ezibucayi ze-hypoglycemia, uma onesifo sikashukela encipha, udinga ukujova isisombululo se-40% se-dextrose noma i-glucagon ngokunqenqemeni, ngaphakathi emithanjeni noma emzimbeni. Intengo yale maniplication kungukugcinwa kwempilo yabantu.
Ikhodi izobuyisela ukwazi, isiguli kufanele sidle ukudla okuqukethe ama-carbohydrate amaningi, lokhu kuzovimbela ukwenziwa kabusha kwe-hypoglycemia.
Imiyalo yokusebenzisa iBagomet Plus ixwayisa ukuthi ukwelashwa isikhathi eside kungadala ukukhula kwezinkinga ezifana ne-lactic acidosis, ngoba umuthi uqukethe i-met metin ye-drug.
I-Lactic acidosis - isimo esidinga ukunakekelwa okuphuthumayo kwezokwelapha, ukwelashwa kwenziwa kuphela esibhedlela. Indlela ephumelela kakhulu yokususa i-hemodialysis.
Ividiyo ekulesi sihloko ikhuluma ngemiphumela ye-met metin yesifo sikashukela.
