Ukubuyekezwa kweziguli ezisebenzisa i-Glimecomb kuhlobo lwesibili lwe -abetes mellitus therapy kukhombisa ukusebenza kahle kwesidakamizwa. Lesi sidakamizwa sikuvumela ukuthi ulawule ngempumelelo izinga loshukela emzimbeni womuntu ogulayo.
I-Glimecomb ingumkhiqizo wezokwelapha, otholakala ngendlela yamathebulethi amhlophe noma akhilimu amhlophe ane-tint kirimu. Ithebhulethi ngayinye ihlukaniswe phakathi nengxenye ngobungozi obusebusweni futhi ine-bevel. Ekwenzeni komkhiqizo okwelapha, ukuba khona kokumangalisa ngaphezulu kwamathebulethi kuvunyelwe.
Ukwakheka kwalesi sidakamizwa kufaka i-metformin ngesimo se-hydrochloride njengesakhiwo esisebenzayo maqondana nezinto ezihlanzekile kumthamo we-500 mg kanye ne-glycoslide ngokuya ngento emsulwa emthamo ka-40 mg.
Izici ezisizayo zomuthi yi-sorbitol, i-povidone, i-croscarmellose sodium ne-magnesium stearate.
Ithuluzi lisetshenziselwa ukuphathwa ngomlomo njengesidakamizwa se-hypoglycemic. Lo muthi uhlanganisiwe, ngoba uhlanganisa amakhambi wamakhemikhali ahlobene nama-Biguanides ne-sulfonylureas.
I-Pharmacokinetics yomkhiqizo okwelapha
Umuthi ubonakala ngokuba khona kwe-pancreatic kanye ne-extrapancreatic effect.
I-Gliclazide ivuselela inqubo yokwenziwa kwe-insulin ngamaseli we-pancreatic beta futhi isiza ukwandisa ukuzwela kwamaseli we-insulin ancike kwi-insulin. Ngaphezu kwalokho, i-compact iyasiza ukuvusa i-enzyme ye-intracellular - synthetase yemisipha ye-glycogen. Ukusetshenziswa kwe-gliclazide kusiza ukubuyisela inani eliphakeme lokuqala le-insulin secretion futhi kunciphise i-postpradial hyperglycemia.
Ngaphezu kokuthonya izinqubo ze-carbohydrate metabolism, ukusetshenziswa kwaleli khompiyutha kuthinta i-microcirculation yegazi, kunciphisa izinga lokunamathela nokuhlanganiswa kwamaplatelet, kunciphisa ukuqhubeka kwe-parietal thrombosis, kubuyisela ukuvunyelwa okuvamile kwezindonga ze-vascular, kunciphisa impendulo yezindonga ze-vascular ku-adrenaline uma kwenzeka i-microangiopathy.
Ukusetshenziswa kwe-gliclazide kusiza ukunciphisa ukuthuthukiswa kwe-retinopathy yesifo sikashukela; ngaphezu kwalokho, lapho kukhona i-nephropathy, ukwehla kwe-proteinuria kuyabonakala.
I-Metformin iyinhlangano yamakhemikhali eyeqembu le-Biguanide. Le khompiyutha isiza ukunciphisa okuqukethwe ushukela ku-plasma yegazi. Umphumela utholakala ngokuvimbela inqubo ye-gluconeogenesis kumaseli wesibindi, kanye nokwehlisa izinga lokufakwa kweglucose kusuka ekukhanyisweni kwephepha lesisu, futhi ngokuthuthukisa ukufakwa kweglucose ngamaseli wezicubu zomzimba. Ukusetshenziswa kwe-metformin kusiza ukunciphisa i-serum triglycerides, cholesterol kanye ne-low density lipoprotein. Ukwethulwa kwe-metformin emzimbeni kunikeza ukwehla nokuqina kwesisindo somzimba.
Ukusetshenziswa kwe-metformin lapho kungekho i-insulin egazini akuholeli ekubonakalisweni komphumela wokwelapha futhi ukuvela kokuvela kwe-hypoglycemic akubonwa. Ukusetshenziswa kwe-metformin kuthuthukisa izakhiwo zegazi ze-fibrinolytic.
Lokhu kutholakala ngokucindezela i-inhibitor activation inhibitor.
Izinkomba kanye ne-contraindication yokusebenzisa umuthi
Izinkomba zokusetshenziswa kwe-Glimecomb zihlobo lwe-2 yesifo sikashukela ngokungabikho kokusebenza kahle kokusetshenziswa kokulashwa kokudla kanye nokuzivocavoca komzimba, futhi lapho ungekho umphumela womphumela owenziwe ngaphambilini wokwelashwa ngosizo lwe-metaformine ne-glycazide.
I-Glimecomb isetshenziselwa ukufaka esikhundleni sokwelashwa okuyinkimbinkimbi okwenziwe ngaphambili ngemithi emibili ye-Metformin ne-Glycoside, inqobo nje uma izinga likashukela wegazi liqinile futhi lilawulwa kahle.
I-Glimecomb inobubanzi obuhlukahlukene bokuphikisana nokusetshenziswa komuthi.
Okubaluleke kakhulu phakathi kwe-contraindication yile elandelayo:
- I-Hypersensitivity yomzimba wesiguli emiphumeleni ye-metformin, gliclazide noma amanye ama-sulfonylureas. Ngaphezu kwalokho, lesi sidakamizwa akufanele sisetshenziswe lapho kukhona i-hypersensitivity kwezinye izingxenye zemithi.
- Ukuba khona kohlobo 1 sikashukela.
- Ukuba khona kwe-ketoacidosis yesifo sikashukela, isifo sikashukela kanye nemicimbi ye-coma hypoglycemic.
- Ukuthuthukiswa kokulimazeka okukhulu kwe-renal.
- Ukuthuthukiswa kwezimo ezibucayi ezingaholela ekushintsheni kokusebenza kwezinso, ukuthuthukiswa kokuphelelwa ngamanzi emzimbeni, ukutheleleka kanzima kanye nokushaqeka.
- Ukuthuthukiswa kwezifo ezingamahlalakhona futhi ezinzima, kuhambisana nokuvela kwezicubu hypoxia.
- Ukuvela kokwehluleka kwezinso.
- Porphyria.
- Isikhathi sokukhulelwa nesikhathi sokuncelisa.
- Ukuphathwa kanyekanye kwe-miconazole.
- Izifo ezithelelekile kanye nokungenelela kokuhlinzwa, ukusha okukhulu nokulimala okukhulu, okuthi ngesikhathi sekwelashwa kudinga ukusetshenziswa kwe-insulin therapy.
- Ukuba khona kwezidakwa ezingalapheki nokudakwa ngokweqile kwezidakamizwa.
- Ukuthuthukiswa kwe-lactic acidosis.
- Ukulandela ukudla okune-carb ephansi.
Ngaphezu kwalezi zimo, umuthi awunqunyelwe ukusisebenzisa lapho usetshenziselwa ukuhlolwa kwe-iodine equkethe i-iodine emzimbeni.
Ungasisebenzisi lesi sidakamizwa ekwelapheni isifo sikashukela ezigulini ezifika eminyakeni engu-60, ezithola kanzima ukuzivocavoca. Lokhu kungenxa yamathuba aphezulu okuthuthukisa i-lactic acidosis kulezi ziguli.
Ukuqashelwa ikakhulukazi kufanele kusetshenziswe lapho kuthathwa umuthi uma isiguli sinezimpawu ezibuthakathaka, ukungasebenzi kahle ekusebenzeni kwezindlala ze-adrenal, ukuba khona kwe-hypofunction ye-anterior pituitary, isifo se-thyroid, esidala ukwephula ukusebenza kwaso.
Ukusetshenziswa kwezidakamizwa
Imiyalo yokusebenzisa i-Glimecomba ilawula futhi ichaze ngokuningiliziwe zonke izimo lapho kunconywa ukuthatha umuthi nalapho ukusetshenziswa komuthi kwenqatshelwe. Imininingwane yemiyalo yonke imiphumela emibi eyenzeka lapho usebenzisa umkhiqizo kanye nomthamo onconyelwe ukusetshenziswa.
Umuthi usetshenziswa ngomlomo ngesikhathi sokudla noma ngokushesha emva kwawo. Umthamo odingekayo wokwamukelwa unqunywa udokotela ohambayo ngokuya ngemiphumela yokuhlolwa kanye nezimpawu zomzimba womuntu ngamunye. Umthamo wesidakamizwa unqunywa ngokuhambisana nezinga le-glucose emzimbeni wesiguli.
Imvamisa, umthamo wokuqala wesidakamizwa onconywa udokotela iziguli ngamaphilisi ayi-1-3 ngosuku ngokukhethwa kancane kancane komthamo wokuqinisekisa ukunxeshezelwa okuzinzile kwesifo sikashukela i-mellitus. Uma ungazilandeli izincomo, kuzosungulwa ushukela ohlubekile.
Ngokuvamile, umuthi kufanele uphuzwe kabili ngosuku ekuseni nakusihlwa. Futhi umthamo omkhulu wesidakamizwa ungaba amathebulethi ayi-5.
Kunemiyalo ekhethekile okufanele ilandelwe lapho wenza ukwelashwa kweGrimecomb:
- ukwelashwa kufanele kwenziwe kuphela ngokuhlanganiswa nokudla okunama-kilojoule amancane aqukethe inani elincane lama-carbohydrate;
- iziguli kufanele zithole ukudla okunempilo okujwayelekile, okufanele kufake phakathi ibhulakufesi;
- ukugwema ukuthuthukiswa kwezimpawu ze-hypoglycemia, kufanele kukhethwe umthamo ngamunye;
- lapho ukucindezelwa okuphezulu komzimba nangokomzwelo kufakwa emzimbeni, ukulungiswa kwamthamo womuthi ozothathwa kuyadingeka;
Lapho wenza ukwelashwa ngomuthi onjengeGlifecomb, kufanele wenqabe ukuphuza utshwala nokudla okuqukethe i-ethanol.
Ukuqashelwa ikakhulukazi kufanele kusetshenziswe lapho usebenzisa umuthi lapho wenza lezo zinhlobo zomsebenzi ezidinga ukunakwa okukhulayo kokubhekisisa nokushesha kokuphendula.
Imiphumela emibi engenzeka
Lapho uthatha umuthi, isiguli singathola imiphumela emibi eminingana.
Izinqubo ze-metabolic, ukwephula imithamo noma lapho usebenzisa ukudla okunganele, ukuphazamiseka kungakhula okuholela ku-hypoglycemia. Lesi simo somzimba sihambisana nobuhlungu bekhanda, ukubonakala kokukhathala, umuzwa onamandla wendlala, ukukhuphuka kwenhliziyo, ukubukeka kwesiyezi, kanye nokuhlangana okungahambi kahle kokunyakaza.
Ngaphezu kwalokho, uma kwenzeka ukwephulwa komthamo esigulini, kungaqhamuka isimo se-lactic acidosis, esibonakaliswa buthakathaka i-myalgia, ukudonsa okwandayo, izinhlungu esiswini kanye nokwehla komfutho wegazi.
Ukuphazamiseka okulandelayo kungenzeka ohlelweni lokugaya ukudla:
- ukubonakala komzwa wokucanuzelelwa kwenhliziyo;
- ukuthuthukiswa kwesifo sohudo;
- ukubonakala kokuzwa kwesisindo ku-epigastrium;
- ukubonakala nokunambitheka kwensimbi emlonyeni;
- ukwehla kwesifiso sokudla;
- ezimweni ezingavamile, ukulimala kwesibindi njenge-hepatitis, i-cholestatic jaundice nabanye bayakhula.
Uma kunokungahambi kahle esibindini, umuthi kufanele umiswe ngokushesha.
Ngokuphula imithamo kanye nemigomo yokwelashwa, ukuthuthukiswa kokuvinjwa komsebenzi we-hematopoietic kungenzeka.
Njengemiphumela emibi, isiguli singakhula ukusabela komzimba, okubonakaliswe ngohlobo lokulunywa, i-urticaria kanye nokuqhuma kwe-maculopapular.
Uma isiguli sakha imiphumela emibi ekuphuzeni umuthi, kufanele wehlise umthamo ngokushesha noma uyeke ukusebenzisa umuthi.
Ukukhishwa ifomu, imibandela yokubeka kanye nemigomo, ukuqondana nezindleko
Umuthi uyatholakala ngesimo samathebulethi emabhodleleni epulasitiki. Ibhodlela elilodwa liqukethe, kuya ngokufakwa, amaphilisi angama-30,60 noma angama-120. Ngaphezu kwalokho, umuthi uyatholakala ngesimo samathebulethi abekwe uphawu kwiphakheji yensimbi. Ngale ndlela yokukhishwa, iphakethe ngalinye liqukethe amaphilisi ayi-10 noma angama-20.
Ibhodlela ngalinye lifakwa ebhokisini lekhadibhodi, lapho kufakwe khona imiyalo yokusebenzisa umuthi. Amaphakeji weselula nawo agcwele emaphaketheni amakhadibhodi. Kuya ngokuthi mangaki amaphilisi asephaketheni lamaselula, inani lokugcina kwiphakethe liyahluka. Inani lamathebhulethi yizicucu ezingama-60 noma eziyi-100.
Umuthi ungowalolo hlu B. Umkhiqizo kufanele ugcinwe endaweni eyomile neyomnyama ngamazinga okushisa angabi ngaphezu kwama-25 degrees Celsius.
Imiyalo ye-Glimecomb idinga ukugcinwa endaweni engafinyeleleki ezinganeni. Impilo yeshalofu yesidakamizwa yiminyaka emi-2.
Umuthi usatshalaliswa ekhemisi ngokuqinile ngokwemiyalelo kadokotela.
Umkhiqizi endaweni yeRussian Federation nguJSC Chemical and Pharmaceutical Combine AKRIKHIN.
Izifanekiselo zasemakhaya zesidakamizwa nguGlidiab, uGlidiab MV, uGliklazid MV, uGlatformin, uGliformin Prolong noDiabefarm nabanye.
Intengo yeGrimecomb emakhemisi ahlukahlukene isukela kuma-ruble angama-232 kuya kwangama-600, kuye ngesifunda seRussia Federation nomhlinzeki. Intengo ye-analogues yesidakamizwa ekhiqizwa eRussia Federation, ngokuya ngesifunda, isuka kuma-ruble ayi-158 kuya kuma-300. Ngokusho kweziguli, ukufana kwemithi akuwona ophansi kwaso ekusebenzeni kokuchayeka esigulini ngesifo sikashukela. Ividiyo ekulesi sihloko izogxila ekwelashweni kwesifo sikashukela.
