I-Glimecomb ingeyeqembu lezidakamizwa ezihlangene ze-antidiabetes. Ihlukaniswa yinhlanganisela eyingqayizivele, engafani neRussia yezakhi ezisebenzayo. Umuthi uqukethe i-metformin ne-gliclazide. Umphumela ophelele walezi zinto uvumela ukunciphisa ukushesha kanye ne-postprandial glycemia ngo-3 mmol / l, ngaphandle kokuthinta isisindo sikashukela
Inzuzo ebalulekile ye-Glimecomb ngaphezulu kwamalungiselelo wokuhlanganiswa athandwa kakhulu aqukethe i-metformin ne-glibenclamide ubungozi obuncishisiwe be-hypoglycemia. I-Glimecomb ikhiqizwa ibhizinisi le-Akrikhin eduze kwaseMoscow.
Izinkomba zokuqokwa
Ama-Sulfonylurea derivatives (PSM) umuthi 2 onqunyelwe kunazo zonke wabanesifo sikashukela ngemuva kwe-metformin. Inhlanganisela ye-PSM ne-metformin iyadingeka kulabo abaguli lapho ukudla okune-carb ephansi, ezemidlalo, ne-metformin kunganikeli ukuncishiswa okudingayo koshukela. Lezi zinto zisebenza ekuxhumaniseni okuyinhloko kwe-pathogenesis yohlobo 2 lwesifo sikashukela: ukumelana ne-insulin ephezulu nokuntuleka kwe-insulin, ngenxa yalokho banikeza imiphumela emihle kakhulu ngokuhlanganiswa. I-Glyclazide, eyingxenye yezidakamizwa i-Glimecomb, iyi-PSM yezizukulwane ezi-2 futhi ibhekwa njengenye yezinto eziphephe kakhulu eqenjini layo.
Amacwecwe we-Glimecomb angabekwa:
- Lapho ukwelashwa kwangaphambilini kuyekile ukunikeza isinxephezelo esihle sesifo sikashukela.
- Masinyane ngemuva kokutholakala kwesifo sikashukela, uma izinga le-glycemia liphezulu kakhulu.
- Uma isifo sikashukela singabekezeleli i-metformin kumthamo omkhulu.
- Ukunciphisa inani lamathebulethi ezigulini ezithatha i-gliclazide ne-metformin.
- Isifo sikashukela i-glibenclamide (Maninil ne-analogues) noma inhlanganisela yaso ne-metformin (Glibomet et al.) Sibangela ukuvama okukhulu kwe-hypoglycemia.
- Iziguli zokwehluleka kwezinso okwenqatshelwe zona i-glibenclamide.
- Isifo sikashukela esiyinkimbinkimbi yisifo senhliziyo. Kufakazelwe ukuthi i-gliclazide ayithinti kabi i-myocardium.
Ngokusho kocwaningo, osuvele izinyanga zokwelashwa nge-Glimecomb, ushukela we-glucose osheshayo uyancipha ngokwesilinganiso esingu-1,8 mmol / L. Ngokuqhubeka kokusebenzisa umuthi, umphumela wawo uyaqina, ngemuva kwezinyanga ezi-3 ukwehla sekuvele kungu-2.9. Ukwelashwa izinyanga ezintathu ngokwejwayelekile ushukela esigabeni seziguli ezine-mellitus ebolile, kuyilapho umthamo awudlanga amaphilisi ama-4 ngosuku. Ukuqina kwesisindo kanye ne-hypoglycemia enkulu, edinga ukulaliswa esibhedlela, akuzange kubhalwe phansi ngalo muthi.
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%
I-Pharmacology Glimecomb
Ukuhlanganiswa kwe-PSM ne-metformin kubhekwa njengokujwayelekile. Ngaphandle kokuvela kwama-ejenti amasha we-hypoglycemic, izinhlangano zamazwe omhlaba ezinesifo sikashukela kanye noMnyango Wezempilo waseRussia Federation bayaqhubeka nokuncoma lokhu kuhlanganiswa njengokunengqondo kunabo bonke. I-Glimecomb ilula ukuyisebenzisa futhi ingabizi. Izakhi zalo ziyasebenza futhi ziphephile.
IGlyclazide enesifo sikashukela sohlobo 2 ivuselela ukukhiqizwa kwe-insulin yayo uqobo, futhi iqala ukusebenza esigabeni sokuqala secretion yayo, lapho ushukela usanda kungena egazini. Lesi senzo sikuvumela ukuthi wehlise ngokushesha i-glycemia ngemuva kokudla, udlulisele ushukela ezicutshini ezingapheli. I-Glyclazide ivimbela ukukhula kwe-angiopathy: kuvimbela i-thrombosis, ithuthukise i-microcirculation kanye nesimo sezindonga zemithambo yegazi. Umphumela omuhle we-gliclazide enkambisweni ye-retinopathy neph ne-nephropathy sekufakazelwe. Izibhebhe ze-Glimecomb empeleni aziholeli ekuthini i-insulin ibe yigazi, ngakho-ke azibangeli ukukhuluphala kwesisindo. Imiyalo ibuye yaphawula nekhono le-gliclazide yokuthuthukisa ukuzwela kwe-insulin, kepha kulokhu yena ukude ne-metformin, umholi owaziwayo ekulweni nokulwa ne-insulin.
IMetformin yiyona kuphela izidakamizwa ezinconyelwe bonke abanesifo sikashukela sohlobo 2 ngaphandle kokunye. Ivuselela ukuguquguquka kwe-glucose kusuka emithanjeni yegazi iye emangqamuzaneni, kuvimbela ukwakheka koshukela isibindi, ukubambezela ukuphuma kwayo emathunjini. Umuthi ulwa ngempumelelo nokukhubazeka kwe-lipid metabolism, okuyisimo sohlobo 2 lwalesi sifo. Ngenxa yokubuyekezwa okuningi okuhle kwesifo sikashukela, i-metformin isetshenziselwa ukunciphisa umzimba. Akubangeli i-hypoglycemia, uma isetshenziswa ngokuya ngemiyalo iphephile ngokuphelele. Ukungathandeki kwalesi sakhi se-Glimecomb imvamisa ephezulu yemiphumela engathandeki ethambekeni lokugaya ukudla.
I-Pharmacokinetics yezakhi zomuthi:
| Amapharamitha | gliclazide | metformin | |
| I-Bioavailability,% | kufika ku-97 | 40-60 | |
| Amahora okusebenza aphezulu ngemuva kokuphatha | Amahora angu-2-3 | 2 amahora lapho kufakwa esiswini esingenalutho; Amahora angama-2,5 uma uphuza umuthi ngasikhathi sinye ngokudla, njengoba iziyalo ziyala. | |
| Half-life, amahora | 8-20 | 6,2 | |
| Indlela yokuhoxisa,% | izinso | 70 | 70 |
| amathumbu | 12 | kufika ku-30 | |
Umthamo
I-Glimecomb yezidakamizwa inenketho eyodwa yomthamo - 40 + 500, kuthebhulethi 40 mg ye-glyclazide, 500 mg ye-metformin. Ukuthola umthamo owodwa, ithebhulethi ingahlukaniswa, kukhona ubungozi kuyo.
Uma umuntu onesifo sikashukela engakaze athathe i-metformin ngaphambili, ithebhulethi engu-1 ibhekwa njengedosi yokuqala. Emavikini la-2 lalandzelako kungafiseleki kukwenyusa, ngako-ke unganciphisa ingozi yekungakhululeki eluhlelweni lwekugaya. Iziguli ezijwayele i-metformin futhi zikubekezelela kahle zingabekwa ngokushesha kuze kube namaphilisi ama-3 Glimecomb. Umthamo owuthandayo unqunywa udokotela, kucatshangelwa izinga le-glycemia yesiguli neminye imithi ayiphuzayo.
Uma umthamo wokuqalisa unganikeli umphumela oyifunayo, uyakhula kancane kancane. Ukuvimbela i-hypoglycemia, isikhathi esiphakathi kokulungiswa kwamthamo kufanele okungenani sibe yisonto. Okuphezulu kuvunyelwe ngamathebhulethi ayi-5. Uma kuleli dosi, i-Glimecomb inganikeli isinxephezelo sikashukela i-mellitus, esinye isidakamizwa esinciphisa ushukela sinqunyelwe isiguli.
Uma isiguli sinokumelana okukhulu kwe-insulin, i-Glimecomb kwisifo sikashukela ingadakwa nge-metformin. Inani lamathebulethi kuleli cala libalwa ukuze umthamo ophelele we-metformin ungeqi kuma-3000 mg.
Imithetho yokuphuza umuthi i-Glimecomb
Ukwenza ngcono ukubekezelelwa kwe-metformin nokuvimbela ukwehla okubukhali koshukela, amaphilisi we-Glimecomb aphuzwa kanyekanye ngokudla noma ngokushesha emva kwawo. Ukudla kufanele kube nokulinganisela kahle futhi kufanele kuqukathe ama-carbohydrate, okungcono kunzima ukugaya. Uma kuqhathaniswa nokubuyekezwa, abafinyelela ku-15% abanesifo sikashukela bakholelwa ukuthi ukuthatha i-Glimecomb nezinye izidakamizwa ezinciphisa ushukela kususa isidingo sabo sokulandela ukudla. Ngenxa yalokhu, baphuza imithamo ephakeme yezidakamizwa, ekhulisa imiphumela emibi yabo kanye nezindleko zokwelashwa, bekhononda ushukela omatasatasa, futhi ngaphambili babhekane nezinkinga zesifo sikashukela.
Manje asikho isidakamizwa sethebhulethi esisodwa sikashukela esingangena esikhundleni sokudla. Ngesifo sohlobo 2, ukondliwa kukhonjiswa ngaphandle kwama-carbohydrate asheshayo, ngomkhawulo wama-carbohydrate ashubile, futhi ngokujwayelekile kuncishiswa nokuqukethwe kwekhalori - ukudla kohlobo 2 sikashukela. Uhlobo lokwelashwa lubandakanya ukwenziwa ngokweqile kwesisindo kanye nomsebenzi owandayo.
Ukuqinisekisa umphumela ofanayo we-Glimecomb phakathi nosuku, umthamo obekiwe uhlukaniswe ngemithamo emi-2 - ekuseni nakusihlwa. Ngokusho kokubuyekezwa, imiphumela emihle yokwelashwa ibonwa ezigulini eziphuza umuthi kathathu (ngemuva kokudla ngakunye), ngaphandle kokuthi imiyalo yokusebenzisa ayihlinzeki ngalolo khetho.
Imiphumela emibi
Iningi lemiphumela emibi ingancipha uma ulandela imithetho yokuthatha nokwandisa umthamo ovela emiyalweni. Ukukhanselwa kwe-Glimecomb ngenxa yokungabekezeleli akudingeki kakhulu.
| Imiphumela engathandeki yomuthi | Imbangela yemiphumela emibi, okufanele uyenze uma ivela |
| I-Hypoglycemia | Kuvela ngomthamo okhethwe ngokungafanele noma ukudla okunganele. Ukuvimbela, ukudla kusatshalaliswa ngokulinganayo usuku lonke, ama-carbohydrate kumele abekhona kuwo ngamunye wabo. Uma i-hypoglycemia yenzeka ngokuqagela ngasikhathi sinye, isidlo esincane sizosiza ukugwema lokho. Amaconsi avama ushukela - ithuba lokunciphisa umthamo we-Glimecomb. |
| I-Lactic acidosis | I-complication engathandeki kakhulu, imbangela i-overdose ye-metformin noma ukuthatha i-Glimecomb ezigulini eziphathiselwe zona. Ezigulini zezinso, ukuqapha njalo ukusebenza kwabo kuyadingeka. Lokhu kuyadingeka ukuze ukhansele umuthi ngesikhathi uma kutholwa izinga elikhulu lokuntuleka kwesimo. |
| Izinzwa ezingemnandi emgodini wokugaya ukudla, ukugabha, isifo sohudo, ukunambitheka kwensimbi. | Le miphumela emibi ivame ukuhambisana nokuqala kwe-metformin. Ezigulini eziningi, ziyanyamalala zodwa emavikini angama-1-2. Ukuze uthuthukise ukubekezelelana kwe-Glimecomb, udinga ukwandisa kancane umthamo wayo, kusukela kowokuqala. |
| Ukulimala kwesibindi, ushintsho ekwakhekeni kwegazi | Isidingo sokukhansela umuthi, ngemuva kokuthi lokhu kwephulwa kunyamalale ngokwawo, ukwelashwa akuvunyelwe kakhulu. |
| Ukulimazeka kokubonakalayo | Zingezesikhashana, ziqashelwa kwabanesifo sikashukela ekuqaleni ushukela ophezulu. Ukuze uzigweme, umthamo we-Glimecomb kumele wengezwe kancane ukuze uvikele ukwehla okubukhali kwe-glycemia. |
| Ukungezwani komzimba | Qhubekeka kakhulu. Lapho zivela, kungakuhle ukuthi ungene esikhundleni se-Glimecomb nge-analog. Isifo sikashukela esine-allergy to gliclazide sisengozini enkulu yokusabela okufanayo kwenye i-PSM, ngakho-ke sikhonjiswa inhlanganisela ye-metformin enama-glisitins, isibonelo, i-Yanumet noma i-Galvus Met. |
Contraindication
Lapho ungakwazi ukuphuza i-Glimecomb:
- Uhlobo 1 sikashukela;
- hypoglycemia Umuthi awukwazi ukudakwa kuze kukhuphuke ushukela wegazi ube uvamile;
- ubunzima bezinkinga zesifo sikashukela, ukugula okungathi sína nokulimala okudinga ukwelashwa kwe-insulin. Icala le-lactic acidosis esikhathini esidlule;
- ukukhulelwa, ukuncelisa;
- I-X-ray enezinto ezihlukile eziqukethe iodine;
- ukungabekezeleli kunoma yiziphi izingxenye zomuthi;
- i-reso, ukwehluleka kwesibindi, i-hypoxia, nezifo okungenzeka zibangele lokhu kuphazamiseka;
- uphuzo oludakayo, imithamo ephezulu yotshwala obukhulu.
Ezigulini ezinezifo ezingama-hormone, abanesifo sikashukela asebekhulile ngokuzikhandla isikhathi eside, ubungozi bemiphumela emibi buyanda, ngakho-ke uma uthatha i-Glimecomb, kufanele banake kakhulu impilo yabo.
Ukuhambisana nezinye izidakamizwa
Umphumela we-Glimecomb ungathuthukiswa noma ube buthaka lapho uthathwa nezinye izidakamizwa. Uhlu lokusebenzelana kwezidakamizwa lukhulu impela, kepha imvamisa ushintsho ekusebenzeni kwalo alubucayi futhi lungalungiswa kalula ngokuguqula umthamo.
| Umthelela kumthelela we-glimecomb | Ukulungiselela |
| Yehlisa ukusebenza kahle, i-hyperglycemia engenzeka. | Ama-Glucocorticoids, ama-hormone amaningi, kufaka phakathi izindlela zokuvimbela inzalo; ama-adrenostimulants, imithi yesifo sokuwa, i-diuretics, i-nicotinic acid. |
| Banomphumela we-hypoglycemic, ukunciphisa umthamo we-Glimecomb kungadingeka. | Ama-inhibitors e-ACE, ama-sympatholytics, izidakamizwa ezihlasela i-anti-tuberculosis, ama-NSAIDs, ama-fibrate, ama-sulfonamides, ama-salicylates, ama-steroid, ama-microcirculation stimulants, amavithamini B6. |
| Khulisa amathuba e-lactic acidosis. | Noma ibuphi utshwala. Kwenziwa i-metformin esegazini lapho kuthathwa i-furosemide, i-nifedipine, i-glycosides ye-cardiac. |
Yini ukuqondanisa okumelwe ungene esikhundleni
IGrimecomb ayinazo izinkomba ezigcwele ezibhalisiwe eRussia Federation. Uma umuthi ungekho ekhemisi, izidakamizwa ezimbili ezinezinto ezifanayo ezisebenzayo zingasibuyisela:
- IMetformin iqukethe i-Glucofage yasekuqaleni ekhiqizwe eFrance, iSiofor yaseGerman, iMetformin yaseRussia, iMerifatin, iGlatiniin. Zonke zinomthamo we-500 mg. Kwabanesifo sikashukela ngokubekezelela kabi i-metformin, kufakwe uhlobo oluthile lomuthi, oluqinisekisa ukungena kokufana kwento egazini futhi kunciphise kakhulu ingozi yemiphumela emibi. Lezi izidakamizwa iMetformin Long Canon, Metformin MV, IFomin Long nezinye.
- IGliclazide nayo iyi-hypoglycemic ethandwa kakhulu. Umuthi uyingxenye yeRussia Glidiab neDiabefarm. IGliclazide Eguquliwe njengamanje ibhekwa njengefomu elithandwayo. Ukusetshenziswa kwayo kunganciphisa imvamisa nobukhali be-hypoglycemia. I-gliclazide eshintshiwe iqukethwe kumalungiselelo Diabefarm MV, Diabeteson MV, Gliclazide MV, Diabetalong, njll. Lapho uthenga, udinga ukunaka umthamo, ungadinga ukuhlukanisa ithebhulethi ngesigamu.
Kunamagama amaningi weqembu le-Glimecomb emakethe yaseRussia. Iningi lazo ziyinhlanganisela ye-metformin ene-glibenclamide. Le mishanguzo iphephe kakhulu kune-glimecomb, ngoba imvamisa ibangela i-hypoglycemia. Ukubuyiselwa okuhle kwe-Glimecomb Amaril (metformin + glimepiride). Njengamanje, lesi isidakamizwa sezinhluthulelo ezimbili eziphambili kakhulu esine-PSM.
Intengo
Intengo yephakethe lamathebhulethi angama-60 eGlimecomb isuka kuma-ruble angama-459 kuya kwangama-543. IGliclazide ne-metformin kusuka kumkhiqizi ofanayo kuzobiza ama-ruble ayi-187. komthamo ofanayo (amaphilisi angama-60 weGlidiab 80 mg abiza ama-ruble ayi-130, amaphilisi angama-60. I-Gliformin 500 mg - ama-ruble ayi-122). Intengo yenhlanganisela yamalungiselelo okuqala we-gliclazide ne-metformin (Glucofage + Diabeteson) icishe ibe ngama-ruble angama-750, womabili asefomu elilungisiwe.
