I-Gluconorm isidakamizwa esishibhile, esisebenzayo, esifunde kahle, kepha asihlali sivikelekile njalo. Kunqunyelwe uhlobo 2 sikashukela ukwehlisa ushukela wegazi. Izinto ezimbili zinikeza umphumela wokwehlisa ushukela - i-glibenclamide ne-metformin. Ngokusho kocwaningo, ukusetshenziswa kwale mishanguzo kungahle kwehlise i-hemoglobin ye-glycated nge-1% uma kuqhathaniswa nokuthatha enye yazo. Kwabanesifo sikashukela esiningi, lokhu kungumphumela omuhle kakhulu, owenza ukuthi kunxephezelwe isifo sikashukela, ngakho-ke, ukugwema izinkinga zaso zakamuva.
Okudonsela emuva kwe-Gluconorm yengozi ye-hypoglycemia, ngakho-ke bazama ukungabeki umuthi ezigulini ezivame ukwehla ngokushesha kushukela.
Izinkomba zokuqokwa kwe-gluconorm
Ezigulini eziningi ezinesifo sikashukela i-mellitus, umuthi owodwa awukwazi ukugcina ushukela ojwayelekile, ngakho odokotela bavame ukusebenzisa ukwelashwa okuhlangene. Inkomba yokuqokwa kwayo yi-hemoglobin ye-glycated ngenhla kuka-6.5-7%. Ukucabanga okuhle kunakho konke okubheka inhlanganisela ye-metformin ene-sulfonylurea derivatives (PSM), ama-gliptins nama-incretin mimetics. Zonke lezi zinhlanganisela zithinta ukumelana ne-insulin kanye nevolumu lokukhiqizwa kwe-insulin, futhi ngenxa yalokho zinikeza umphumela omuhle kakhulu.
Ukuhlanganiswa kwe-metformin + sulfonylurea yikhona okuvame kakhulu. Izimo azikwazi ukusebenzelana, unganciphisi ukusebenza kahle. IGlibenclamide inamandla futhi ifundwe kakhulu kuyo yonke i-PSM. Inentengo ephansi futhi ithengiswa kuwo wonke amakhemisi, ngakho-ke, ngokuhlanganiswa ne-metformin, i-glibenclamide inqunywe kaningi kunezinye izidakamizwa. Ukuze kube lula ukusetshenziswa, kudaleke amaphilisi ezinxenye ezimbili ngalezi zithako ezimbili ezisebenzayo - i-Gluconorm nezimpawu zayo.
Ngokwemiyalo, i-Gluconorm isetshenziselwa kuphela isifo sikashukela sohlobo 2, uma ukulungiswa kokudla okunempilo, ezemidlalo, ne-metformin kunganikeli amaconsi egalofu ukubheka amanani. Umthamo we-metformin akufanele ube ngaphansi kakhulu (2000 mg) noma uvunyelwe ngesifo sikashukela. Futhi, i-gluconorm ingathathwa yiziguli ezake zaphuza i-glibenclamide ne-metformin ngokwehlukana.
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%
Ucwaningo olutholakele: amaphilisi ambalwa isiguli asithatha ngosuku, yilapho ethambekele kakhulu ekuthobeleni yonke imiyalo kadokotela, okusho ukuthi okuphezulu kokusebenza kokulashwa. Okusho ukuthi, ukuthatha i-Gluconorm esikhundleni samathebulethi amabili kuyisinyathelo esincane esiya ekuncepheni kangcono sikashukela.
Ngaphezu kwalokho, ukwanda okuphindwe kabili komthamo wamaphilisi anciphisa ushukela akunikezi ukuncishiswa okufanayo ushukela. Okusho ukuthi, izidakamizwa ezimbili zomuthi omncane zizosebenza kahle futhi zinikeze imiphumela emibi emincane kunomuthi owodwa ku-dosage ephezulu.
Ukwakheka kanye nomphumela wesidakamizwa
IGluconorm ikhiqizwa yinkampani yaseRussia i-Pharmstandard ngokubambisana ne-Indian Biopharm. Umuthi uyatholakala ezinguqulweni ezi-2:
- Amacwecwe e-Gluconorm enziwa eNdiya, ahlanganiswe eRussia. Umuthi une-dosage ekhethekile ye-2,5-400, okungukuthi, ithebhulethi ngayinye ye-metformin iqukethe ama-400 mg, glibenclamide 2.5 mg.
- Kukhiqizwa amaphilisi we-Gluconorm Plus eRussia avela kwinto ethengiswayo eyathengwa eNdiya nase China. Zine-dosages ezi-2: i-2,5-500 yabanesifo sikashukela esine-high insulin ukumelana kanye ne-5-500 yeziguli ngaphandle kwesisindo ngokweqile, kepha ngokuswela okucacile kwe-insulin.
Ngenxa yezinketho ezahlukene zemithamo, ungakhetha isilinganiso esifanele kunoma yisiphi isiguli esinohlobo 2 sikashukela.
Ake sibheke ngemininingwane ethe xaxa ukuthi izingxenye zomuthi iGluconorm zisebenza kanjani. I-Metformin yehlisa kokubili i-postprandial and glycemia ikakhulukazi ngenxa yokuncipha kokumelana ne-insulin. IGlucose ishiya imikhumbi ngokushesha njengoba ukuzwela kwezicubu kukhuphuka nge-insulin. I-Metformin futhi inciphisa ukwakheka kwe-glucose emzimbeni kusuka ezintweni ezingeyona i-carbohydrate, yehlisa ukungena kwayo egazini kusuka emgudwini wokugaya ukudla.
Kuma-diabetes, izakhiwo ezingeziwe ze-metformin ezingahambisani nokuncipha kwe-glycemia nazo zibaluleke kakhulu. Umuthi uvimbela ukuthuthukiswa kwe-angiopathy ngokufaka ama-lipids egazi ngokwejwayelekile, uthuthukisa umsoco wezicubu. Ngokweminye imibiko, i-metformin iyakwazi ukuvimba ukuvela kwama-neoplasms. Ngokusho kweziguli, kunciphisa isifiso sokudla, kusiza ukugcina isisindo esijwayelekile, kuvuselele ukunciphisa umzimba, futhi kukwenyuse ukusebenza kokudla.
IGlibenclamide isizukulwane sePSM 2. Isebenza ngokuqondile kumaseli we-pancreatic beta: kwehlisela umkhawulo wokuzwela kwabo emazingeni kashukela egazini, ngaleyo ndlela andise ukukhiqizwa kwe-insulin. I-Glibenclamide iphinde ithuthukise i-glycogenogeneis, inqubo yokugcina ushukela emisipha kanye nesibindi. Ngokungafani ne-metformin, lo muthi ungadala i-hypoglycemia, kakhulu kunabanye abamele iqembu le-PSM - glimepiride ne-glyclazide. IGlibenclamide ithathwa njengeyona enamandla kakhulu, kepha futhi iyingozi kakhulu yePSM. Akunconywa kwabanesifo sikashukela ngengozi enkulu ye-hypoglycemia.
Ungawuthatha kanjani umuthi we-Gluconorm
Umphumela ojwayelekile kakhulu we-metformin ukugaya, glibenclamide - hypoglycemia. Unganciphisa kakhulu ingozi yemiphumela emibi yokwelashwa nge-gluconorm, ukuphuza amaphilisi ngasikhathi sinye nokudla futhi kancane kancane ngikhulise umthamo, kuqala ngobuncane.
Umthamo wezidakamizwa iGluconorm ngokwemiyalo:
| Izici zokwamukela | I-Gluconorm | IGluconorm Plus | |
| 2,5-500 | 5-500 | ||
| Ukuqala umthamo, ithebhu. | 1-2 | 1 | 1 |
| Umthamo wokunciphisa, ithebhu. | 5 | 6 | 4 |
| I-oda yesilinganiso esandayo | Sandisa umthamo ngethebhulethi eyi-1 njalo ezinsukwini ezi-3 uma isiguli sike sathatha ngempumelelo i-metformin. Uma i-metformin yayingabekelwe lowo onesifo sikashukela, noma engasibekezeleli kahle, engeza isibhebhe sesibili kungakapheli amasonto amabili kamuva. | ||
| Ukuvinjelwa kwabanesifo sikashukela ngesifo sezinso nesibindi | Ukuze kususwe i-gluconorm emzimbeni, kudingeka isibindi nokusebenza kwezinso. Uma kwenzeka ukunganele kwalezi zitho ezinamazinga aphansi, imiyalo incoma ukukhawulelwa kumthamo omncane. Ukuqala ngeveli elisezingeni lokwehluleka, umuthi wenqatshelwe. | ||
| Imodi yesicelo | Phuza ithebhulethi engu-1 esidlweni sasekuseni, 2 noma 4 ekudleni kwasekuseni nakusihlwa. 3, 5, 6 ithebhu. ihlukaniswe ngemithamo emithathu. | ||
Ngokuphikiswa okuqinile kwe-insulin, okuyisimo sabantu abakhuluphele abanesifo sikashukela, kungenzeka kunikezwe i-metformin eyengeziwe. Imvamisa kuleli cala bayaliphuza ngaphambi kokulala. Umthamo ofanele we-metformin nsuku zonke uthathwa njenge-2000 mg, okuphezulu - 3000 mg. Ukwanda okuthe xaxa komthamo kuyingozi nge-lactic acidosis.
Ngokuntuleka kwama-carbohydrate ekudleni, i-Gluconorm ibangela i-hypoglycemia. Ukuyivimbela, amaphilisi adakiwe ngokudla okuyinhloko. Imikhiqizo kumele ibe nama-carbohydrate, ikakhulukazi kancane. Awukwazi ukuvumela izikhawu ezinde phakathi kokudla, ngakho-ke iziguli zinconyelwa ukudla okulula. Ukubuyekezwa kwabanesifo sikashukela kubonisa ukuthi ngokuzikhandla okukhulu, ushukela ungawa endabeni yemizuzu. Ngalesi sikhathi, udinga ukulalelisisa impilo yakho.
Imiphumela emibi kanye ne-overdose
Imiphi imiphumela emibi isiguli sikashukela engahlangabezana nayo lapho isebenzisa i-Gluconorm noma i-analogues yayo:
- i-hypoglycemia ngenxa ye-PSM;
- imiphumela evela emgudwini wokugaya ukudla, imbangela yawo yi-metformin. Ngokusho kokubuyekezwa, abantu abaningi abanesifo sikashukela bavame ukuhuda kanye nokugula kwasekuseni. Imiyalo yokusebenzisa ixwayisa ukuthi ubuhlungu besisu nokuhlanza kuyenzeka. Uma kuphakama izinkinga ezinjalo, ungayilahli ngokushesha i-Gluconorm, imvamisa ngesonto umzimba uvumelana futhi uyeke ukuphendula umuthi onjalo;
- ukwephulwa kwenqubo yokwakheka kwegazi. Inani lezakhi zamaselula egazini lingase lehle. Lapho kuqedwa ukwelashwa nge-gluconorm yokwakheka kwegazi kuyabuyiselwa;
- I-lactic acidosis iyinkimbinkimbi yesifo sikashukela, isimilo sohlobo 2. Ngaphandle kosizo lwezokwelapha, kuholela ekhefeni;
- ukungabekezeleli notshwala ngesimo esibuhlungu;
- isistimu yezinzwa ephakathi nendawo ingaphendula ukusetshenziswa kwe-gluconorm enekhanda nobuthakathaka;
- imiphumela yokungezwani komzimba kungenzeka, kuze kufike ku-anaphylactic.
Imiphumela emibi efana ne-hypoglycemia ne-lactic acidosis ingumphumela we-overdose ye-Gluconorm. Kungaba:
- Okuqondile: onesifo sikashukela uphuze kakhulu kunomuthi obekiwe.
- Ngqo. I-Hypoglycemia ingenzeka uma kunokuntuleka kwamakhakhithamini ekudleni noma kushukela kudliwe ngokushesha ngesikhathi sokuzivocavoca komzimba kanye nokuxineka kakhulu, kokubili ngokwengqondo nangokomzimba. Ukwakheka kwama-lactate kukhuphuka ezimweni zokudakwa kotshwala, ukwehluleka kwezitho okuholela ku-hypoxia, nokulimala kanzima nezifo ezithathelanayo.
Izenzo ze-overdose ngokuya ngemiyalo: i-hypoglycemia emnene imiswa yi-glucose noma imikhiqizo enokuqukethwe kwayo okuphezulu. I-Lactic acidosis kanye ne-hypoglycemia, ehambisana nokungazi kahle, idinga ukulaliswa esibhedlela ngokuphuthumayo.
Contraindication
Lapho i-Gluconorm yesifo sikashukela ingenakusetshenziswa:
- nokuzwela okwengeziwe kwezingxenye zethebhulethi. Lokhu kuphulwa kubandakanya ukusabela komzimba, futhi kwasho izenzo ezingafuneki ezidinga ukuyekwa komuthi;
- uma kutholakala uhlobo 1 lwesifo sikashukela;
- ngesikhathi sokwelashwa kwezinkinga ezinzima zesifo sikashukela, izifo ezinzima nokulimala. Isinqumo sokushintshwa kwesikhashana kokwelashwa kwe-insulin senziwa udokotela oholayo;
- ngomonakalo omkhulu wezinso noma ubungozi obukhulu bokulimazeka okunjalo;
- ngesikhathi sokukhulelwa kanye ne-HB. Imikhawulo yokusetshenziswa kwe-Gluconorm iqinile, ngoba i-PSM ekwakhiweni kwethebhulethi ingaphazamisa ukukhula kwesibeletho, iholele ku-hypoglycemia enganeni;
- ngenkathi uthatha ama-antifungal agents. Ukuhlanganiswa kweGluconorm nge-miconazole noma i-fluconazole kugcwele i-hypoglycemia enzima. Uhlu lwezidakamizwa ezithinta isenzo seGluconorm lukhonjisiwe kwimiyalo yokusebenzisa;
- uma ngabe isifo sikashukela sesivele sathola i-lactic acidosis noma sisengozini enkulu yokukuthuthukisa.
Ama-analog namagama
| Abangaphansi | Umkhiqizi | Uphawu lwentengiso |
| Qeda i-gluconorm analogues | I-Canonpharma | I-Metglib |
| Berlin-Chemie, Guidotti Laborator | I-Glibomet | |
| I-Gluconorm Plus Analogs | I-Pharmasynthesis | I-Glibenfage |
| I-Canopharma | Amandla we-Metglib | |
| Merck Sante | Ama-Glucovans | |
| I-Valeant | I-Bagomet Plus | |
| Ukulungiselela kweMetformin | I-Vertex, uGideon Richter, iMedisorb, IzvarinoFarma, njll. | I-Metformin |
| I-Pharmasynthesis | Merifatin | |
| Merk | I-Glucophage | |
| Amalungiselelo we-Glibenclamide | I-Pharmasynthesis | IStiglin |
| I-Pharmstandard, Atoll, Moskhimpharmpreparaty, njll. | I-Glibenclamide | |
| Berlin Chemie | Maninil | |
| Izidakamizwa ezinezingxenye ezimbili: metformin + PSM | Sanofi | I-Amaryl, njengengxenye ye-PSM glimepiride |
| I-Akrikhin | I-Glimecomb, iqukethe i-PSM Gliclazide |
Ama-analogues aphelele, kanye ne-metformin ne-glibenclamide ngokwehlukana, angadakwa ngokuphepha kumthamo ofanayo ne-Gluconorm. Uma uhlela ukushintshela ekwelashweni ngesinye isusonyonylurea derivative, umthamo kuzodingeka ukuthi ukhethwe futhi. Odokotela batusa ukuthi kususwe i-Gluconorm iye e-Amaryl noma i-Glimecomb iye kwabanesifo sikashukela abanesifo sohlobo lwe-carbohydrate 2, esivame ukuba ne-hypoglycemia.
Ngokusho kokubuyekezwa, ukusebenza kwe-Gluconorm kanye nokufana kwayo kusondele, kepha abanesifo sikashukela basayikhetha iGlybomet yaseGerman, beyithatha njengeyona izidakamizwa ezisezingeni eliphakeme kakhulu.
Imithetho yokubeka kanye nentengo
IGluconorm isebenza iminyaka emi-3 kusukela ngosuku lokukhiqizwa. IGluconorm Plus ivumelekile ukugcina isikhathi esingaphezu kweminyaka emi-2. Umyalo awunazo izidingo ezikhethekile zezimo zokugcina, kwanele ukugcina ukubusa okushisayo okungekho ngaphansi kwama-25 degrees.
Izazi zesifo sikashukela saseRussia zingathola zombili lezi zidakamizwa ngokusho incwadi yamahhala enqunywe udokotela ojwayelekile noma i-endocrinologist. Ukuthengwa okuzimele kuzobiza okungabizi kakhulu: intengo yephakethe lamathebhulethi angama-40 eGluconorm icishe ibe ngama-ruble angama-230, iGluconorm Plus ibiza kusuka kuma-ruble ayi-155 kuya kwangama-215. ezibhebheni ezingama-30. Ukuze uqhathanise, intengo ye-Glibomet yasekuqaleni icishe ibe ngama-ruble angama-320.
