Isifo sikashukela i-mellitus, ngenxa yokukhula kwayo ngokushesha kanye nokushona okukhulu, sibeka engcupheni enkulu ubuntu. Eminyakeni engama-20 edlule, isifo sikashukela singene kwizimbangela ezintathu eziphambili zokufa kwabantu. Akumangazi ukuthi lesi sifo sifakwa ezinhlosweni eziningi ezibekwe kuqala odokotela emhlabeni jikelele.
Uhlobo lomthamo wokwelapha
Isidakamizwa iMetformin-richter enesithako esiyisisekelo esisebenzayo se-metformin hydrochloride siveliswa ngumenzi wasekhaya ngemithamo emibili: 500 mg noma i-850 mg lilinye. Ngaphezu kwengxenye eyisisekelo, kukhona nababekhona kokuqanjwa: I-Opadry II, i-silicon dioxide, i-magnesium stearate, i-copovidone, i-cellulose, i-polyvidone.
Umuthi ungakhonjwa yizimpawu zomlingiswa: amaphilisi ayindilinga ama-round (500 mg) noma ama-oval (850 mg) egobolondweni agcwele amaseli ama-blister izingcezu eziyi-10. Ebhokisini ungathola kusuka ku-1 kuya ku-6 amapuleti anjalo. Umuthi ungawuthola kuphela ngokubhaliwe.. KuMetformin Richter, intengo yamathebulethi angama-60 ama-500 mg noma ama-850 mg ngama-ruble angama-200 noma angama-250. ngokufanele. Umenzi unqunyelwe usuku lokuphelelwa yisikhathi phakathi kweminyaka emithathu.
Indlela yokusebenza yesidakamizwa
IMetformin Richter ingeyesigaba se-Biguanides. Isithako saso esiyisisekelo, i-metformin, ihlisa i-glycemia ngaphandle kokuvuselela i-pancreas, ngakho-ke akukho-hypoglycemia phakathi kwemiphumela yayo emibi.
I-Metformin-richter inendlela ephindwe kathathu yemiphumela yokulwa nesifo sikashukela.
- Umuthi ngo-30% uvimbela ukukhiqizwa kwe-glucogen esibindini ngokuvimbela i-glucogeneis ne-glycogenolysis.
- Umuthi uvimba ukumunca ushukela yizindonga zamathumbu, ngakho-ke ama-carbohydrate ngokwengxenye angena egazini. Ukuphuza amaphilisi akufanele kube yisizathu sokwenqaba ukudla okune-carb ephansi.
- IBiguanide inciphisa ukumelana kwamaseli eglucose, isheshise ukusetshenziswa kwayo (ngezinga elikhulu emisipha, ngaphansi kongqimba lwamafutha).
Umuthi uthuthukisa kakhulu ukwakheka kwe-lipid kwegazi: ngokusheshisa ukusabela kwe-redox, kuvimbela ukukhiqizwa kwe-triglycerol, kanye nezinhlobo ezijwayelekile nezimbi "ezimbi" (eziphansi kakhulu) futhi kunciphisa ukumelana ne-insulin kwama-receptors.
Njengoba amaseli we-β-cell we-islet apparatus abhekene nokukhiqizwa kwe-insulin endulin awathinteki yi-metformin, lokhu akuholeli ekulimaleni kwawo ngaphambi kwesikhathi kanye necrosis.
Ngokungafani nezinye izidakamizwa ze-hypoglycemic, ukusetshenziswa njalo kwesidakamizwa kunikeza ukuqina kwesisindo. Leli qiniso libalulekile kubantu abaningi abanesifo sikashukela, ngoba isifo sikashukela sohlobo 2 sivame ukuhambisana nokukhuluphala, okuqinisa kakhulu ukulawulwa kwe-glycemia.
Inomphumela we-biguanide ne-fibrinolytic, osuselwa ekuvinjelweni kwe-plasminogen izicubu inhibitor.
Kusukela kwipheshana lesisu, i-ejenti yomlomo igxile ngokuphelele nge-bioavailability efinyelela ku-60%. Inani eliphakeme lokugcotshwa kwalo libonakala ngemuva kwamahora acishe abe ngu-2,5. Umuthi usatshalaliswa ngokungalingani ngaphezulu kwezitho nezinhlelo: iningi lazo linqwabelana esibindini, ku-renal parenchyma, emisipha nasezintanjeni ze-salivary.
Izinsalela ze-metabolite ziqedwa izinso (70%) namathumbu (30%), isigamu-sokuphila esisusa ngokuhlukahluka sisuka emahoreni ayi-1.5 kuye kwayi-4,5.
Uboniswa ngubani lo muthi
I-Metformin-richter ibekelwe ukuphathwa kwesifo sikashukela sohlobo 2, kokubili njengesidakamizwa sohlanga sokuqala nakwezinye izigaba zesifo, uma ukuguqulwa kwendlela yokuphila (umsoco ophansi we-carbohydrate, ukulawulwa kwesimo ngokomzwelo nokusebenza ngokomzimba) akusasinikezi i-glycemic control ephelele. Umuthi ulungele i-monotherapy, usetshenziswa futhi ekwelapheni okuyinkimbinkimbi.
Ukulimala okungase kube okuvela kulo muthi
Amathebulethi ancishiselwa abantu abane-hypersensitivity kuzithako zefomula. Ngaphezu kwalokho, iMetformin Richter ayinqunyelwe:
- Ngomsebenzi obolile wezinso kanye nesibindi;
- Abantu abanesifo sikashukela abanenhliziyo enamandla nokuhluleka kokuphefumula;
- Omama abakhulelwe futhi abancelile;
- Izidakwa kanye nezisulu zobuthi obunobungozi obukhulu;
- Iziguli zisesimweni se-lactic acidosis;
- Ngesikhathi sokuhlinzwa, ukwelashwa kokulimala, ukushiswa;
- Ngesikhathi se-radioisotope kanye ne-radiopaque izifundo;
- Esikhathini sokuvuselelwa ngemuva kokuqothuka kwe-myocardial;
- Ngokudla kwe-hypocaloric kanye nokuzikhandla komzimba osindayo.
Iziphakamiso zokusetshenziswa
Udokotela uthola uhlobo lokwelashwa lomuntu ngamunye onesifo sikashukela ngawodwana, kucatshangelwa imininingwane yaselabhorathri, isigaba sokuthuthuka kwalesi sifo, izinkinga ezihlangene, ubudala, indlela umuntu asabela ngayo kulo muthi.
KuMetformin Richter, imiyalo yokusebenzisa itusa ukuthi uqale izifundo ngenani elilinganiselwe le-500 mg ngokunikezwa okulinganiselwe kwesilinganiso somuthi ngokusebenza kwawo okunganele njalo emavikini ama-2. Isilinganiso esiphezulu somuthi ngu-2,5 g / ngosuku. Kwabanesifo sikashukela abavuthiwe, abavame ukuba nezinkinga zezinso, umthamo omkhulu kungu-1 g / ngosuku.
Lapho ushintshela kuMetformin Richter kwamanye amaphilisi anciphisa ushukela, umthamo wokuqala ojwayelekile ngu-500 mg / ngosuku. Lapho wenza uhlelo olusha, aqondiswa nomthamo ophelele wezidakamizwa ezedlule.
Inkambo yokwelashwa inqunywa ngudokotela, ngokuphendula okujwayelekile komzimba, labo abaphuza izidakamizwa bathathelwa impilo yonke.
Ukuhlolwa komuthi odokotela kanye nabanesifo sikashukela
Mayelana ne-Metformin Richter, izibuyekezo zixubekile. Odokotela nabanesifo sikashukela baphawula ukusebenza kahle komuthi: kuyasiza ukulawula ushukela kanye nokuthambekela, akunamphumela umlutha, imiphumela emincane esezingeni eliphansi, ukuvikela okuhle kwezifo zenhliziyo nezinye izinkinga.
Abantu abaphilile abazama umuthi ukwehlisa umzimba bangakwazi ukukhononda ngemiphumela engafuneki. Iziphakamiso zokulungisa inani lalesi sigaba seziguli kufanele zenziwe nongondli, hhayi abangeneleli kwi-Intanethi.
Hhayi nje kuphela ama-endocrinologists asebenza nge-metformin, kepha futhi nabezenhliziyo, abelaphi, ama-oncologists, ama-gynecologists, kanye nokubuyekezwa okulandelayo kungobunye ubufakazi balokhu.
U-Irina, oneminyaka engama-27 ubudala, eSt. Emaforamu anezingqikithi, iMetformin Richter ihlala ixoxwa kakhulu ngabanesifo sikashukela noma abasubathi, futhi ngiyiphuzile ukukhulelwa. Kade ngiphatha i-ovary yami ye-polycystic, odokotela ababeyibiza ngokuthi imbangela yokungazali, iminyaka engaba ngu-5. Amaphilisi weProgesterone (imijovo) noma amaphilisi e-hormonal awasizanga ukuhambisa le nkinga, aze anikela nange-laparoscopy yokwakha amaqanda. Ngenkathi ngilungiselela izivivinyo futhi ngilapha i-asthma yami - isithiyo esikhulu ekusebenzeni, omunye udokotela wezengqondo onengqondo wangeluleka ukuba ngizame iMetformin Richter. Kancane kancane, umjikelezo waqala ukululama, futhi lapho izinyanga eziyisithupha kamuva kunezimpawu zokukhulelwa, angizange ngikholwe ukuthi uvivinyo noma odokotela! Ngikholwa ukuthi lawa maphilisi angisindisile, ngokufisa ngikweluleka ukuthi nakanjani uzame, uvumelana kuphela no-gynecologist wesikhathi sokudla.
Ukweqisa komzimba nemiphumela emibi
Ngisho nokunyuka okuphindwe kabili kwesilinganiso semithamo ye-metformin amavolontiya awathola ekuvivinyweni kwemitholampilo akuzange kubangele i-hypoglycemia Esikhundleni salokho, i-lactic acidosis yathuthuka. Ungasibona isimo esiyingozi ngobuhlungu bemisipha nokugunda, ukwehlisa izinga lokushisa lomzimba, ukuphazamiseka komzimba, ukulahleka kokuxhumana, inyama yokwehla emzimbeni.
Isisulu sidinga ukulaliswa esibhedlela ngokushesha. Esibhedlela, izinsalela ze-metabolite zisuswa yi-hemodialysis, kanti ukwelashwa okubonakalayo kwenziwa ngokubheka imisebenzi yazo zonke izitho ezibalulekile.
Ingxenye esebenzayo ye-metformin hydrochloride inesisekelo sobufakazi esiqinile sokuphepha. Kepha lokhu kuyasebenza, okokuqala, kwi-Glucophage yasekuqaleni. IGeneriksi ihluke ngandlela-thile ekubumbeni, izifundo ezinkulu ezenziwa ngokusebenza kwazo azange zenziwe, futhi ngenxa yalokho imiphumela ingahle ivezwe.
Cishe isigamu sabanesifo sikashukela sikhononda ngokuphazamiseka kwe-dyspeptic, ikakhulukazi ngesikhathi sokuzivumelanisa nezimo. Uma ulungisa kancane kancane umthamo, thatha umuthi ngokudla, isicanucanu, ukunambitheka kwensimbi nezitulo ezithukuthele kungagwenywa. Ukwenziwa kokudla nakho kudlala indima ebalulekile: ukusabela kwe-metformin nomzimba kujwayelekile kwimikhiqizo yamaprotheni (inyama, inhlanzi, ubisi, amaqanda, amakhowe, imifino eluhlaza).
Ngingangena kanjani esikhundleni seMetformin-richter
Kwisidakamizwa iMetformin Richter, ama-analogues angaba amaphilisi anezakhi ezifanayo eziyisisekelo metformin hydrochloride, noma ezinye izidakamizwa ze-hypoglycemic ezinomphumela ofanayo:
- IGlucophage;
- Glyformin;
- Metfogamm;
- I-NovoFormin;
- Metformin-Teva;
- I-Bagomet;
- I-Diaformin OD;
- Metformin Zentiva;
- IFomu Pliva;
- Metformin-Canon;
- Glyminfor;
- Siofor;
- Methadiene.
Ngokungeziwe kuma-analogues ngokukhishwa okusheshayo, kukhona amaphilisi anomphumela wesikhathi eside, kanye nokuhlanganiswa kwezithako eziningana ezisebenzayo kwifomula eyodwa. Ukukhetha izidakamizwa okuningana, ngisho nakodokotela, akuhlali kukuvumela ukuthi ukhethe ngokunembile okunye esikhundleni nomthamo, futhi ukuzama impilo yakho ngokwakho uhlelo lokuzibulala.
Umsebenzi wesifo sikashukela ukusiza umsebenzi wezidakamizwa ngamandla akhe amakhulu, ngoba ngaphandle kokuguqulwa kwendlela yokuphila, zonke izincomo ziphelelwa amandla.
Iseluleko sikaProfessor E. Malysheva kubo bonke labo udokotela abebekhethelwe i-metformin, kwi-roller
