I-Glibomet ingenye yezinhlanganisela ezidume kakhulu ze-metformin kanye ne-sulfonylurea derivative, glibenclamide. Lezi zinto zinendlela ehlukile yokusebenza, ngakho-ke ukuhlanganiswa kwazo kwithebhulethi eyodwa kukuvumela ukuthi ube nomthelela ngokwengeziwe egazini likashukela wegazi, ukuvikela izinkinga zesifo sikashukela.
IBerlin-Chemie Glibomet kwakuyinhlanganisela yokuqala yezidakamizwa ezimbili ezisela ushukela ezibhalisiwe eRussia. Eminyakeni engu-15 edlule, umuthi awuphulukanga ukuthandwa kwawo, ngenxa yokusebenza kwawo okuphezulu, ikhwalithi enhle, intengo ephansi. Ngokunxeshezelwa okunganele kwesifo sikashukela, i-Glibomet ingezwe kwezidakamizwa ezivela kwamanye amaqembu kwirejimeni yokwelashwa.
Izinkomba zokusetshenziswa kwe-Glibomet
Enye yezenzo zesidakamizwa ukuvusa ukukhiqizwa kwe-insulin yayo uqobo. Lokhu kungenzeka kuphela uma isiguli sinamaseli we-beta bukhoma kuma-pancreas, ngakho-ke amaphilisi we-Glibomet anqunywe kuphela onesifo sikashukela sohlobo 2. Ngesifo sohlobo 1, lo muthi awusebenzi.
Izinkomba ezisetshenziswayo:
- Iziguli ezikhonjiswa ukwelashwa zinenkimbinkimbi yezinhlobo ezimbili (ezine-glycated hemoglobin edlula ama-8%) noma ezintathu (HH> 9%) ama-hypoglycemic agents.
- Iziguli ezinokudla, imidlalo, kanye ne-metformin noma i-glibenclamide ebekiwe ngaphambili azinikezi ukuncishiswa kweshukela okudingekayo.
- Abanesifo sikashukela ngokubekezelela imithamo ephezulu ye-metformin.
- Esikhundleni semithi emibili nelinye ezigulini ezinesifo sikashukela esinxephezelwe isikhathi eside.
Wonke amaphilisi we-sulfonylurea antidiabetesic angadala i-hypoglycemia. I-Glibomet iyahlukile. IGlibenclamide, eyingxenye yayo, isidakamizwa esinamandla kakhulu kuleli qembu, okusho ukuthi nayo iyingozi kakhulu ngokuya nge-hypoglycemia.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Iziguli ezinesifiso sokuthi sehlise ushukela ngokushesha noma zinezimpawu ezibucayi uGlybomet akazami ukunquma. I-diabetesics entsha ilungele kakhulu kulabo abanesifo sikashukela.
Ukwakheka kanye nomphumela wesidakamizwa
Umphumela wesidakamizwa kungenxa yezinto ezisebenzayo ezakha ukwakheka kwazo. Ithebhulethi eyodwa ye-Glibomet iqukethe i-400 mg ye-metformin, 2,5 mg ye-glibenclamide.
I-Metformin isebenza kuma-carbohydrate metabolism ngezindlela eziningana. Akukho neyodwa yazo ethinta ngqo i-pancreas. I-Metformin inciphisa ukuphuma kweglucose egazini ngesibindi, esisiza ngokwejwayelekile ushukela wokuzila ukudla. Kuthuthukisa ukuphendula kwamaseli ku-insulin, ethuthukisa ukusetshenziswa kwe-glucose yizicubu ezibucayi ze-insulin - izicubu, amafutha nesibindi. Njengoba i-metformin ingathinti amaseli we-beta, ayikwazi ukuholela kwi-hypoglycemia.
Ezenzweni ezengeziwe zalo muthi, okubaluleke kakhulu kushukela we-mellitus umphumela we-metformin ekhonweni legazi lokuqothula izingcezu zegazi ezisanda kuqala ukwakha. Njengamanje lesi kuphela isidakamizwa sokulwa nesifo sikashukela esifakazelwe ukunciphisa ingozi yezinkinga ezinkulu ze-macrovascular in diabetesics. IMetformin yehlisa ukufa ngama-42%, ukuhlaselwa yinhliziyo ngama-39%.
Umsebenzi wengxenye yesibili yeGlibomet, glibenclamide, ukuthuthukisa ukugcinwa kwe-insulin yayo. Ukwenza lokhu, kunamathela kuma-beta-cell receptors futhi, njengeglucose, kuvusa umsebenzi wawo. Eqenjini lawo, i-glibenclamide ingumuthi onamandla kakhulu wethonya le-hypoglycemic. Iyakwazi nokwandisa izitolo ze-glycogen ezicutshini zemisipha. Ngokusho kodokotela, ukuthatha i-glibenclamide ezigulini ezingenayo i-insulin enganele kungathuthukisa inkambo yesifo sikashukela futhi kunciphise isibalo sezinkinga ezincane ezinama-25%.
Ngakho-ke, umuthi i-Glybomet uthinta izimbangela eziphambili ze-hyperglycemia: ibuyisela ukukhiqizwa okunganele kwe-insulin futhi yehlisa ukumelana ne-insulin.
Izinzuzo ze-Glibomet:
- ukusetshenziswa kalula. Esikhundleni samathebhulethi ayi-6, amathathu anele;
- ukunciphisa ushukela ngaphambi nangemva kokudla;
- amandla okunciphisa umthamo kuya kumathebula ama-1-2 uma isinxephezelo sikashukela sitholwa;
- isenzo esengeziwe - ukuthuthukisa iphrofayili ye-lipid yegazi, ukunciphisa isisindo, ukunciphisa umfutho;
- yehlisa indlala. Ngokusho kwabanesifo sikashukela, lo mphumela ukuvumela ukuthi unamathele ngempumelelo ekudleni;
- ukutholakala - I-Glybomet ingathengwa cishe kuwo wonke amakhemisi ngentengo engabizi. Ukwelashwa ngezidakamizwa ezimbili ezinesakhiwo esifanayo, isibonelo uManinil noSiofor, kuzodla ngaphezulu kokuthatha i-Glibomet ehlanganisiwe.
Ungayithatha kanjani
Ukunciphisa ushukela ngemuva kokuthatha i-Glibomet kuqala emahoreni ama-2 bese kuthatha amahora angama-12, ngakho-ke imiyalo yokusebenzisa itusa ukuthatha umuthi kabili ngosuku. Phuza iphilisi ngokudla.
Umthamo wesidakamizwa unqunywa yi-endocrinologist. Kulokhu, izinga le-glucose, ubudala, isisindo sesiguli, ukudla kwakhe, ukuthambekela kwe-hypoglycemia kufanele kubhekwe nakho.
Ungayikhetha kanjani imithamo efanele:
- Ukuqala umthamo amaphilisi angu-1-3. Lapho iphakeme i-glycemia, kudingeka amaphilisi amaningi. Uma isiguli singakaze siphuze umuthi ngezithako ezifanayo ezisebenzayo, kuphephile ukuqala ngethebhulethi eyi-1. Isifo sikashukela esingakaze siphuze i-metformin siphuza nethebhulethi eyi-1 emasontweni amabili okuqala. Le nto ivame ukudala ukungahambi kahle emgodini wokugaya ukudla. Ukujwayela, umzimba kuthatha isikhathi esincane.
- Ukungezelela umthamo ngesinxephezelo esanele sesifo sikashukela kungaba njalo ezinsukwini ezi-3. Ngokungabekezeleli kahle i-metformin - njalo emavikini ama-2.
- Umthamo omkhulu wansuku zonke ngokuya ngemiyalo ngamathebulethi ayi-5. Ukudlula lapho kungaholela ekutheni kube ne-overdose ne-hypoglycemia enzima. Uma amaphilisi ama-5 enganele ukunxephezela isifo sikashukela, ukwelashwa kuhambisana nezidakamizwa ezivela kwamanye amaqembu.
Umthamo we-metformin eGlibomet incane. Ngomthamo ojwayelekile wansuku zonke wamathebulethi ayi-4, abanesifo sikashukela bathola i-1600 mg ye-metformin, kuyilapho umthamo wabo ophelele ungu-2000 kanti umthamo omkhulu ngu-3000 mg. Uma isiguli esinesifo sikashukela sibonakaliswa ukukhuluphala esiswini, ukungakwazi noma ukubekezelela okungekuhle kokuzivocavoca ngokomzimba, ukumelana ngokuqinile kwe-insulin, ushukela wegazi ophakeme, kunconywa ukuthatha izithasiselo ze-metformin ngaphambi kokulala.
Imiphumela emibi kanye ne-overdose
Phakathi kwemiphumela emibi yesidakamizwa i-Glibomet, okuvame kakhulu yi-hypoglycemia, engakhuphuka ibe yi-hypoglycemic coma. Ingxenye eyinhloko ye-hypoglycemia ngamaphaphu, edinga ukungenelela okuncane kweziguli ezinesifo sikashukela. Imbangela yokwehla ushukela kungaba ukweqisa kwethamo le-Glibomet, ukwephulwa kokudla, ukusebenza ngokweqile komzimba noma okungakahlelwanga.
I-overdose ingahle iholele ekubandakanyekeni okukhulu kwesifo sikashukela - i-lactic acidosis. Imvamisa, izici ezihlangene ziyadingeka ekuthuthukisweni kwayo: izifo zezinso, isibindi, izitho zokuphefumula, i-anemia, njll.
Uhlu lwemiphumela emibi engenzeka ngokuya ngemiyalo:
| Ukwephula umthetho | Izimpawu | Imininingwane eyengeziwe |
| I-Hypoglycemia | Ukuthukuthela, ikhanda, indlala ebabazekayo, ukuzindla. | Ukuqeda isidingo sokuphathwa ngomlomo kwe-15 g ye-glucose (ujusi, ikhiyamu kashukela, itiye elimnandi). |
| Izinkinga zokugaya | Isicanucanu, ukulahlekelwa yinhliziyo, ukunambitha emlonyeni, isifo sohudo. | Lezi zimpawu zidalwa yi-metformin. Zingagwenywa ngokwandisa kancane kancane umthamo, njengoba kuchazwe ngenhla. Ngokusho kokubuyekezwa, kubantu abaningi abanesifo sikashukela, izifo zokugaya ziyanyamalala ngemuva kwamasonto amabili kokuthatha i-Glibomet. |
| Umsebenzi wesibindi ongasebenzi kahle | IHepatitis, umsebenzi owandisiwe wama-enzyme ALT, AST. | Ukuvela kwemiphumela emibi enjalo kungadinga ukuyekiswa komuthi. Kulokhu, ushintsho lwe-pathological luyanyamalala ngokwabo, imvamisa abadingi ukwelashwa. |
| Shintsha ekwakhekeni kwegazi | Abekho. Ekuhlolweni kwegazi - ukwehla kwenani lama-leukocytes namaplatelet, i-anemia. | |
| Ukungezwani komzimba kanye ne-hypersensitivity ezingxenyeni zesidakamizwa i-Glibomet | Isikhumba esishisayo, ukuqhuma, umkhuhlane, izinhlungu ezihlangene. | Allergies kungadala osebenzayo futhi abathola ithebhulethi. Uma ukusabela kwe-anaphylactic kwenzeka, umuthi uyakhanselwa. |
| I-Lactic acidosis | Ubuthakathaka, izinhlungu ku-sternum, izicubu, ukuqina kwemisipha, ukugabha, Ubuhlungu besisu. | Lesi simo siyingozi nge-lactic acidotic coma, sidinga ukuqedwa kweGlibomet kanye nesikhalazo esiphuthumayo kudokotela. |
| Ukudakwa kotshwala | Izimpawu eziphindaphindwe kaningi zokudakwa: ukuhlanza, ikhanda, ukugcwala, umfutho wegazi ophakeme. | Kungenzeka kwenzeke ngenkathi uthatha i-Glibomet notshwala. Kwabanesifo sikashukela abasebenzisa umuthi, imiyalo incoma ukuyeka utshwala. |
Ubungozi bemiphumela engathandeki, ngaphezu kwe-hypoglycemia, kuhlolwa ngemiyalo yokusetshenziswa njengengamanani (ngaphansi kuka-0,1%) futhi kuyivelakancane kakhulu (ngaphansi kuka-0.01%).
Contraindication
Ukwemukelwa kweGlybomet kwenqatshelwe ngumyalo ngamacala alandelayo:
- hypoglycemia Ithebhulethi akufanele idakwe kuze kube ushukela wegazi ubuyela kokujwayelekile;
- i-ketoacidotic coma nezimo zayo zangaphambili;
- hypersensitivity kunoma yiziphi izingxenye zesidakamizwa i-Glibomet;
- 1 uhlobo lwesifo sikashukela. Uma ukwelashwa kwe-insulin kubekelwe isifo sohlobo 2, kungahlanganiswa ne-Glybomet;
- abakhuthele abasebenza kanzima sikashukela, njengoba baba nengozi ephezulu ye-lactic acidosis;
- ukudla okuqukethe amakhalori angaphansi kuka-1000;
- ukukhulelwa kanye ne-hepatitis B I-Glibenclamide idlulela kubisi lwebele, ngomgoqo we-placental, futhi ingadala i-hypoglycemia enganeni;
- utshwala, ukudakwa.
Uma kwenzeka izifo ezinkulu zesibindi nezinso, izifo ezithathelwanayo ezingathí sina, ukungenelela kokuhlinzwa, amanxeba amaningi nokushiswa, ukuphefumula nokuhluleka kwenhliziyo, ukufakwa kwe-myocardial, umbuzo wokuvuma ukuthatha i-Glibomet unqunywa udokotela ohambelayo. Umsebenzi wesifo sikashukela nezihlobo zakhe ukwazisa abasebenzi bezokwelapha ngobukhona besifo sikashukela esigulini nakwimithi ayiphuzayo.
Esimweni sokushisa esiphakeme kanye ne-endocrine ukuphazamiseka, i-Glybomet ingadala i-hypoglycemia engalindeleki, ngakho-ke umyalo ululeka ukuyisebenzisa ngokuqapha.
Ama-analog namagama
Ama-analog we-Glibomet anomthamo ofanayo wezinto ezisebenzayo (2,5 + 400) - i-Indian Gluconorm ne-Russian Metglib. Yonke enye inhlanganisela ye-glibenclamide ene-metformin inemithamo engu-2,5 + 500 no-5 + 500, ngakho-ke lapho ushintshela kule mishanguzo, ushukela wegazi ojwayelekile ungashintsha. Kungenzeka kakhulu, ukulungiswa komthamo kuzodingeka.
Ama-Analogues eRussia akhiqizwa yizinkampani ezinkulu zemithi ezi-4 - i-Pharmasintez, Pharmstandart, Kanonfarma neValeant. Ngokusho kokubuyekezwa, izidakamizwa zabo zisebenza njengeGlibomet.
| Iqembu lezidakamizwa | Igama | Izwe lokukhiqiza | Umkhiqizi |
| I-analogues ephelele, inhlanganisela ye-metformin ne-glibenclamide | I-Glibenfage | IRussia | I-Pharmasynthesis |
| IGluconorm Plus | I-Pharmstandard | ||
| Amandla we-Metglib | I-Canonpharma | ||
| I-Metglib | I-Canonpharma | ||
| I-Bagomet Plus | I-Valeant | ||
| Ama-Glucovans | EFrance | Merk | |
| I-Gluconorm | India | MJ Biopharm | |
| I-Glibenclamide Tablets | IStiglin | IRussia | I-Pharmasynthesis |
| I-Glibenclamide | I-Atoll, Moskhimpharmprep-t, Pharmstandard, Biosynthesis | ||
| Maninil | EJalimane | Berlin Chemie | |
| I-Glimidstad | Isiqu | ||
| Ukulungiselela kweMetformin | I-Metformin | IRussia | UGideon Richter, uMedisorb, uCanon Pharma |
| Merifatin | I-Pharmasynthesis | ||
| Ifomu elide | I-Pharmstandard | ||
| I-Glucophage | EFrance | Merk | |
| Siofor | EJalimane | Berlin Chemie | |
| Ama-analoggs emigomo yokusebenza, metformin + sulfonylurea | I-Glimecomb, Gliclazide + Metformin | IRussia | Ahrikhin |
| I-Amaryl, glimepiride + metformin | EFrance | Sanofi |
Uma umuthi wokuhlanganisa ungekho ekhemisi, ungathathelwa indawo nge-metformin ne-glibenclamide kumathebhulethi ahlukile. Uma uthatha umthamo ofanayo, isinxephezelo sikashukela ngeke sikhule.
I-Glimecomb ne-Amaril basondele eGlibomet ngomshini wesenzo. Izinto ezisebenzayo ezifakiwe ekwakhekeni kwazo, i-gliclazide ne-glimepiride, ziyizithasiselo zeqembu le-glibenclamide. Banciphisa ushukela kancane kancane kahle, kepha baphephile amaseli we-beta.
Imithetho Yokugcina Nezindleko
I-Glybomet ilondolozela ukusebenza kweminyaka emi-3, okuwukuphela kwesidingo sesitoreji izinga lokushisa lingaphansi kwama-30 ° C.
Ukupakisha Glibomet kusuka kumathebhulethi angama-40 kubiza ama-ruble angama-280-350. Ama-analogues we-Cheaper yiGluconorm Plus (intengo ama-ruble angama-150 amaphilisi angama-30), iGluconorm (ama-ruble angama-220 emathebhulethi angama-40), iMetglib (ama-ruble angama-210 wamathebulethi angama-40).
