IGlucovans ilungiselelo elinezakhi ezimbili elenza izidakamizwa zokunciphisa ushukela ezimbili kakhulu, i-glibenclamide ne-metformin. Zombili izinto zikhombise ukuphepha nokusebenza kwazo ezifundweni eziningi. Kuyafakazelwa ukuthi abagcini nje ngokweqile ukwenza ushukela, kepha futhi banciphisa ingozi yezinkinga ze-angiopathic futhi bandise impilo yesiguli sikashukela.
Inhlanganisela ye-metformin ne-glibenclamide yande. Noma kunjalo, ama-Glucovans angakwazi, ngaphandle kwehaba, abizwe ngokuthi umuthi oyingqayizivele ongenazo i-analogues, ngoba i-glibenclamide isefomini elikhethekile, elinemicrosoft kulo, elinciphisa kakhulu ubungozi be-hypoglycemia. Kwenziwa amaphilisi eGlucovans eFrance yiMerck Sante.
Izizathu zokuqokwa kwama-glucovans
Ukunciphisa ukuqhubekela phambili kwezinkinga kubashukela kungenzeka kuphela ngokulawulwa isikhathi eside sikashukela. Izibalo zesinxephezelo sezingqongqo emashumini eminyaka amuva. Lokhu kungenxa yokuthi odokotela bayekile ukubheka isifo sikashukela sohlobo 2 uhlobo lwesifo esinciphile kunalesi hlobo lokuqala. Kusungulwe ukuthi lesi yisifo esinamandla, esinolaka, esithuthukayo esidinga ukwelashwa njalo.
Ukufeza i-glycemia ejwayelekile, imvamisa kudinga umuthi ongaphezu kokukodwa ushukela. Uhlobo lokwelashwa oluyinkimbinkimbi luyinto evamile kubantu abaningi abanesifo sikashukela abanolwazi. Njengomthetho ojwayelekile, kufakwa amaphilisi amasha lapho nje lawo angaphambilini engasanikeli iphesenti eliqondiwe le-hemoglobin ye-glycated. Umuthi wolayini wokuqala kuwo wonke amazwe omhlaba yi-metformin. Ama-Derivatives we-sulfonylureas ajwayele ukungezelelwa kukho, ithandwa kakhulu yi-glibenclamide. I-Glucovans iyinhlanganisela yalezi zinto ezimbili, ikuvumela ukuba wenze lula irekhodi lokwelashwa likashukela, ngaphandle kokunciphisa ukusebenza kwalo.
Ama-Glucovans anesifo sikashukela anqunyelwe:
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%
- Uma kwenzeka kutholakala ukuthi usheshe wasithola lesi sifo noma inkambo yaso esheshayo, enolaka. Inkomba yokuthi i-metformin iyodwa ngeke yanele ukulawula isifo sikashukela nokuthi i-Glucovans iyadingeka - glucose esheshayo engaphezu kwe-9.3.
- Uma esigabeni sokuqala sokwelashwa kwesifo sikashukela ukudla okungasebenzi kahle kwe-carbohydrate, ukuzivocavoca kanye ne-metformin akukunciphisi i-glycated hemoglobin ngaphansi kwe-8%.
- Ngokuncipha kokukhiqizwa kwe-insulin uqobo. Lokhu kuqondiswa kungenzeka ukuthi kuelebhu noma kuphakanyiswe kususelwa ekwandeni kwe-glycemia.
- Ngokungabekezeleli kahle i-metformin, ekhuphuka ngasikhathi sinye ngokwanda komthamo wayo.
- Uma i-metformin kwimithamo ephezulu ifakwa ku-contraindication.
- Lapho isiguli sithathe ngempumelelo i-metformin ne-glibenclamide futhi sifuna ukunciphisa inani lamaphilisi.
Isenzo se-Pharmacological
Umuthi we-Glucovans uyinhlanganisela engaguquki yama-ejenti amabili we-hypoglycemic anemiphumela eminingi.
I-Metformin yehlisa ushukela wegazi ngokwandisa ukuzwela kwezicubu, amafutha nesibindi ku-insulin ekhiqizwayo. Ithinta izinga lokuhlanganiswa kwe-hormone kuphela ngokungaqondile: umsebenzi wamangqamuzana we-beta athuthuka ngokwenziwa okujwayelekile kokuhlanganiswa kwegazi. Futhi, amaphilisi we-metformin ama-Glucovans anciphisa inani lokukhiqizwa kwe-glucose ngesibindi (ngohlobo 2 lwesifo sikashukela liphakeme izikhathi eziphindwe izikhathi ezingama-2 kabili kunokujwayelekile), lehlisa izinga likashukela kusuka emgudwini we-gastrointestinal lingene egazini, lijwayeze i-lipids yegazi, futhi libe nomthelela ekunciphiseni isisindo.
I-Glibenclamide, njengawo wonke ama-sulfonylurea derivatives (i-PSM), inomphumela oqondile wokuqashelwa kwe-insulin ngokubopha kuma-beta-cell receptors. Umphumela wethonya lomuthi mncane: ngenxa yokwanda kokuxineka kwe-insulin egazini kanye nokwehla komphumela onobuthi we-glucose kwezicubu, ukusetshenziswa kweglucose kuyathuthuka, futhi ukukhiqizwa kwawo kuvinjelwe isibindi. I-Glibenclamide isidakamizwa esinamandla kunazo zonke eqenjini le-PSM; isetshenziswe emtholampilo iminyaka engaphezu kwengu-40. Odokotela manje bakhetha uhlobo olusha lwe-glibenclamide, oluyingxenye yamaGlucovans.
Izinzuzo zako:
- usebenza ngempumelelo kakhulu kunokujwayelekile, okuvumela ukunciphisa umthamo womuthi;
- izinhlayiya ze-glibenclamide ku-matrix yethebhulethi zinosayizi aba-4 abahlukahlukene. Ziyancibilika ngezikhathi ezahlukahlukene, ngaleyo ndlela zikwenza kube lula ukuhamba komuthi ungene egazini futhi kunciphise ingozi ye-hypoglycemia;
- izinhlayiya ezincane kakhulu ze-glibenclamide ezivela eGlucovans zidonswa ngokushesha zingene egazini futhi zinciphise ngenkuthalo i-glycemia emahoreni okuqala emva kokudla.
Ukuhlanganiswa kwezinto ezimbili kwithebhulethi eyodwa akukuphazamisi ukusebenza kwazo. Ngokuphambene nalokho, lolu cwaningo lwathola idatha evuna amaGlucovans. Ngemuva kokudluliselwa kwabanesifo sikashukela ukuthatha i-metformin ne-glibenclamide kuyiwa eGlucovans, i-hemoglobin ye-glycated yehle ngesilinganiso esingu-0.6% izinyanga eziyisithupha zokwelashwa.
Ngokusho komkhiqizi, iGlucovans iyisidakamizwa esidumile esinezakhi ezimbili emhlabeni, ukusetshenziswa kwayo kuvunyelwe emazweni angama-87.
Ungawuthatha kanjani umuthi ngesikhathi sokwelashwa
I-Glukovans yezidakamizwa ikhiqizwa ngezinguqulo ezimbili, ngakho-ke ungakwazi ukukhetha kalula umthamo ofanele ekuqaleni bese uyandisa esikhathini esizayo. Isibonakaliso esephepheni le-2,5 mg + 500 mg sibonisa ukuthi i-glibenclamide eyi-2,5 microformated ibekwe kwithebhulethi, i-500 mg metformin. Lo muthi ukhonjiswa ekuqaleni kokwelashwa usebenzisa i-PSM. Inketho 5 mg + 500 mg iyadingeka ukuqinisa ukwelashwa. Ezigulini ezine-hyperglycemia ethola umthamo ophelele we-metformin (2000 mg ngosuku), ukwandiswa komthamo we-glibenclamide kukhonjelwe ukulawula isifo sikashukela i-mellitus.
Iziphakamiso zokwelapha ze-Glucovans ezivela emiyalweni yokusetshenziswa:
- Umthamo wokuqalisa ezimweni eziningi ngu-2,5 mg + 500 mg. Umuthi uthathwa ngokudla, okufanele kube ama-carbohydrate.
- Uma ngaphambilini uhlobo lweswekile 2 sithathe zombili izithako ezisebenzayo kumthamo omkhulu, umthamo wokuqala ungahle ube ngaphezulu: kabili nge-2,5 mg / 500 mg. Ngokusho kwesifo sikashukela, i-glibenclamide njengengxenye yeGlucovans isebenza kahle kakhulu kunokujwayelekile, ngakho-ke umthamo owedlule ungadala i-hypoglycemia.
- Lungisa umthamo ngemuva kwamaviki ama-2. Isiguli esiba nesifo sikashukela esibi sibekezelela ukwelashwa nge-metformin, isikhathi eside lapho lo myalezo uncoma ukuwuyeka ukuze ujwayele umuthi. Ukwanda komthamo okusheshayo kungaholeli ezinkingeni nge-gastrointestinal kuphela, kepha futhi nokwehla ngokweqile kweglucose yegazi.
- Umthamo omkhulu ngu-20 mg we-glibenclamide enemicrosoft, 3000 mg ye-metformin. Ngokuya ezibhebheni: 2.5 mg / 500 mg - 6 izingcezu, 5 mg / 500 mg - izingcezu ezi-4.
Iziphakamiso ezivela emiyalweni yokuthatha amaphilisi:
| Babelwe etafuleni. | 2,5 mg / 500 mg | 5 mg / 500 mg |
| 1 pc | ekuseni | |
| 2 ama-PC | 1 pc. ekuseni nakusihlwa | |
| 3 pc | usuku lwantambama ntambama | |
| 4 pc | ekuseni 2 ama-PC., kusihlwa 2 ama-PC. | |
| 5 pc | ekuseni 2 pc., kwasemini 1 pc. kusihlwa 2 pc. | - |
| Ama-6 ama-PC | ekuseni, isidlo sasemini, kusihlwa, ama-2 ama-pcs. | - |
Imiphumela emibi
Imininingwane evela emiyalweni esetshenziselwa imvamisa yemiphumela emibi:
| Imvamisa% | Imiphumela emibi | Izimpawu |
| ngaphezu kwe-10% | Ukuphendula okuvela endaweni yokugaya ukudla. | Ukwehla kwesifiso sokudla, isicanucanu, usizi ku-epigastrium, uhudo. Ngokusho kokubuyekezwa, lezi zibonakaliso ziyimpawu yokuqala ukwelashwa, khona-ke ezinsukwini eziningi zesifo sikashukela ziyanyamalala. |
| ngaphansi kuka-10% | Ukwephula ukunambitheka. | Ukunambitheka kwensimbi emlonyeni, kuvame esiswini esingenalutho. |
| ngaphansi kuka-1% | Ukukhula kancane kwe-urea ne-creatinine egazini. | Azikho izimpawu, kunqunywa ukuhlolwa kwegazi. |
| ngaphansi kuka-0,1% | I-hephatic noma i-cutphous porphyria. | Ubuhlungu besisu, ukungasebenzi kahle kwamathumbu, ukuqunjelwa. Ukuvuvukala kwesikhumba, kwandisa usizi lwalo. |
| Ukwehla kwezinga lamangqamuzana amhlophe egazi noma amapuleti egazini. | Ukuphazamiseka kwesikhashana kuyanyamalala ngokuhoxiswa kwezidakamizwa iGlucovans. Kutholakala kuphela ngesisekelo sokuhlolwa kwegazi. | |
| Ukusabela komzimba kwesikhumba. | Ukulunywa, ukuqunjelwa, ubomvu kwesikhumba. | |
| ngaphansi kuka-0,01% | I-Lactic acidosis. | Ubuhlungu emithanjeni nangemuva kwe-sternum, ukwehluleka ukuphefumula, ubuthakathaka. Abantu abanesifo sikashukela badinga ukunakekelwa kwezokwelashwa ngokushesha. |
| Ukushoda kwe-B12 ngenxa yokufakwa emzimbeni lapho kutholakala isikhathi eside ukusetshenziswa kwe-metformin. | Azikho izimpawu ezithile, Ubuhlungu obunokwenzeka olimini, ukugwinya okungasebenzi, nesibindi esandisiwe. | |
| Ukudakwa okuqinile lapho uphuza utshwala. | Ukuqhephuka, ukucindezela kwegiya, ikhanda elibuhlungu. | |
| Ukushoda kwama-ion e-sodium ku-plasma yegazi. | Ukwephula okwesikhashana, ukwelashwa akudingekile. Izimpawu azikho. | |
| Ukushoda kwamangqamuzana abomvu egazi, amaseli amhlophe egazi, ukucindezelwa komsebenzi we-hematopoietic of marow. | ||
| Ukwethuka kwe-Anaphylactic. | I-Edema, ukwehla kwengcindezi, ukwehluleka kokuphefumula okungenzeka. | |
| imvamisa ayisethiwe | I-Hypoglycemia ingumphumela we-overdose yesidakamizwa. | Indlala, ikhanda, ukwethuka, ukwesaba, ukukhuphuka kwenhliziyo. |
Ngokusho kokubuyekezwa, izinkinga ezinkulu zeziguli ezithatha umuthi i-Glukovans, zidala ukungahambi kahle emgodini wokugaya ukudla. Zingavinjelwa kuphela ukwanda okuncane kakhulu komthamo nokusetshenziswa kwamathebulethi ngokudla kuphela.
Ku-diabetesics, i-hypoglycemia ebabazekayo kakhulu yenzeka. Iqedwa ngokushesha yi-glucose ngemuva kokuqala kwezimpawu. Ezigulini ezingazizwa zinokwehla kushukela, ukufundiswa akukhuthazi ukuthatha amaphilisi eGlucovans kanye namagama ezinto zawo. Ubonisa ukuhlanganiswa kwe-metformin ngama-glissins: Galvus Met noma iYanumet.
Contraindication
Ukusetshenziswa kwe-Glucovans kuyingozi kwabanesifo sikashukela abanokuphambana ne-metformin noma i-glibenclamide:
- ukungahambi kahle kwe-metformin noma iyiphi i-PSM;
- Uhlobo 1 isifo sikashukela;
- isifo sezinso, uma i-creatinine> 110 mmol / l kwabesifazane,> 135 emadodeni;
- esimweni sezifo ezinzima, umbuzo wokuthi kungenzeka usebenzise umuthi ogulini unqunywa udokotela;
- ukukhulelwa, ukukhulelwa;
- i-ketoacidosis, i-lactic acidosis;
- ukuthambekela kwe-lactic acidosis, ingozi yayo ephezulu;
- umsoco wesikhathi eside wekhalori ephansi (<1000 kcal / ngosuku);
- ukuthatha imishanguzo ethi, ihlangene ne-Glucovans, ifake isandla ekuthuthukisweni kwe-hypoglycemia. Ama-ejenti ayingozi kakhulu antifungal. Imithi ethinta kancane i-glycemia (uhlu oluphelele emiyalweni yamaphepha) ingasetshenziswa ngasikhathi sinye nabakwaGlucovans ngemuva kokulungiswa kwamthamo.
Yini engavalwa
Ama-Glucovans awanayo i-analogues ephelele, ngoba zonke ezinye izidakamizwa ezibhalisiwe eRussia ngesakhiwo esifanayo ziqukethe i-glibenclamide ejwayelekile, futhi hhayi micronized. Ngokucabanga okukhulu bazosebenza kancane kuneGlucovans, ngakho-ke umthamo wabo kuzodingeka ukuthi unyuswe.
Izidakamizwa ezihlanganisiwe i-metformin + i-glibenclamide ejwayelekile yi-Glibenfage; IGluconorm neGluconorm Plus; I-Metglib kanye ne-Metglib Force; I-Glibomet; I-Bagomet Plus.
Ama-analogues eqembu le-Glucovans yi-Amaril M no-Glimecomb. Babhekwa njengabanamuhla kakhulu kunemithi engenhla futhi mancane amathuba okubangela i-hypoglycemia.
Namuhla, ama-DPP4 inhibitors (ama-glyptins) nezinhlanganisela zawo ne-metformin - uYanuviya noJanumet, uGalvus noGalvus Met, u-Ongliza noCombogliz Prolong, iTrazhenta neGentadueto - ziya ngokuya zithandwa. Bona, njengamaGlucovans, bakhuthaza ukuhlanganiswa kwe-insulin, kodwa musa ukubangela i-hypoglycemia. Le mishanguzo ayidumile njengamaGlucovans ngenxa yentengo ephezulu. Izindleko zokufaka zanyanga zonke zivela kuma-ruble ayi-1,500.
Ama-Glucovans noma ama-Glucophage - okungcono
I-Glucofage yezidakamizwa iqukethe i-metformin kuphela, ngakho-ke, lo muthi uzosebenza kuphela esigabeni sokuqala sikashukela, lapho ukuhlanganiswa kwe-insulin kusenele ukwenza i-glycemia ibe yodwa. Umuthi awukwazi ukuvimba ukubhujiswa kwama-beta cell ngohlobo 2 sikashukela. Ku-diabetes, le nqubo ithatha isikhathi esihlukile, isuka eminyakeni engu-5 iye kumashumi eminyaka. Lapho nje ukusweleka kwe-insulin kuba nzima, i-Glucophage iyodwa ayikwazi ukusatshalaliswa nayo, noma ngabe ithathwe ngethamo elikhulu. Njengamanje, kunconyelwa ukuqala ukuthatha amaGlucovans lapho i-2000 mg yeGlucophage inganikezi ushukela ojwayelekile.
Izimo zesitoreji nentengo
Intengo yomthamo ophansi wamaGlucovans - kusuka kuma-ruble angama-215., Ephakeme - kusuka kuma-ruble angama-300., Kwiphakethe lamathebulethi angama-30. Amalungiselelo aseRussia ahlanganisiwe ne-glibenclamide abiza cishe ama-ruble angama-200. Intengo ye-Amaril icishe ibe ngu-800, iGlifecomb - cishe ama-ruble angama-500.
I-Glucovans igcinwe iminyaka emi-3. Ngokusho kwemiyalo, amaphilisi kufanele agcinwe emazingeni okushisa angaphansi kuka-30 ° C.
