I-GLUCONORM - IMIYALO ESETSHENZISWAYO, INTENGO, UKUBUYEKEZWA KANYE NAMA-ANALOGUES

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Namuhla, abantu abayizigidi ezingama-350 emhlabeni wonke banesifo sikashukela i-mellitus (DM). Lokhu kungu-5% wabantu emhlabeni. E-Russia, kuneziguli ezingaba yizigidi eziyi-12. Futhi hhayi iqiniso lokuthi le yimininingwane eyiqiniso. Abantu abanesifo sikashukela abanefomu elifihlekile likashukela bangaphezulu kwezikhathi ezi-2 kabili kunalokho ababhalisiwe. Ngokuqagela okusemthethweni (hhayi okuthembela kunazo zonke!), Ngo-2030, isifo sikashukela sesizobe sesithathe izakhamuzi ezingama-80% emhlabeni.

Ukuqiniswa kokuphathwa kwesifo esifihlekile kuyisimo esiyisisekelo sokubuyiswa okuthembekile kwe-glycemia. Ngokwesiko, noma i-metformin noma i-sulfonylurea derivatives isetshenziswa njengezidakamizwa zokuqala ze-antidiabetes. Uma izinyathelo ezinjalo zinganele (i-DM - isifo esingapheli, esiqhubekayo), i-insulin nezinye izinhlanganisela zezidakamizwa ezinciphisa ushukela zixhunyiwe.

Inhlanganisela ethandwa kakhulu phakathi kwe-endocrinologists yi-metformin ene-glibenclamide. I-Gluconorm - lesi isidakamizwa esinezakhi ezimbili esinciphisa ukugcwala koshukela egazini. Ngabe isebenza kangakanani le ndlela yokwelapha, kufanele isetshenziswe kubani futhi kufanele isetshenziswe kanjani?

Izici ze-Pharmacological

I-Gluconorm umuthi ohlanganisiwe ohlanganisa izidakamizwa zamakilasi e-pharmacological ahlukene ngokwendlela yokusebenza.

Ingxenye yokuqala eyisisekelo yefomula yi-metformin, ummeleli wama-Biguanides, ojamisa indices ze-glycemic ngokuthuthukisa ukumelana kwamangqamuzana kuma-insulin awo futhi kusheshiswe ukusetshenziswa kwe-glucose ngezicubu. Ngaphezu kwalokho, i-Biguanide ivimbela ukufakwa kwama-carbohydrate futhi ivimbele ukukhiqizwa kwe-glucose esibindini. Kuthuthukisa i-metformin kanye nokulinganisa kwamafutha, kugcina ukugcwala okufanele kwazo zonke izinhlobo ze-cholesterol ne-triglycerol.

I-Glibenclamide, isithako sesibili esisebenzayo embhalweni, njengommeleli wesigaba sesibili se-sulfonylurea, sithuthukisa ukukhiqizwa kwe-insulin ngosizo lwe-β-cell of pancreas elibhekele le nqubo. Ibavikela eglucose enolaka, ithuthukisa ukumelana ne-insulin kanye nekhwalithi yama-ligaments enamaseli. Ukukhishwa kwe-insulin kuthinta ngokuphelele ukufakwa kwe-glucose yisibindi kanye nemisipha, ngakho-ke, isitoko sayo asakhiwa kulwahla lwamafutha. Umuthi usebenza esigabeni sesi-2 sokukhiqizwa kwe-insulin.

Izici ze-pharmacokinetics

Ngemuva kokungena esiswini, i-glibenclamide idonswa yi-84%. I-Cmax (inani eliphakeme lesilinganiso sakhe) ifinyelela ngemuva kwamahora we-1-2. Ukusatshalaliswa ngevolumu (Vd) kungama-9-10 amalitha. Umuthi ubopha amaprotheni egazi ngamaphesenti angama-95.

Ingxenye yesibindi iguqulwa ngokukhishwa kwama-metabolites ayi-2 angathathi hlangothi. Omunye wabo uqeda amathumbu, owesibili - izinso. Ukuphila kwengxenye kwe-T1 / 2 kungakapheli amahora angama-3-16.

Ngemuva kokungena ohlelweni lokugaya, i-metformin igxiliwe ngentshiseko, akukho ngaphezu kwe-30% yomthamo osasele esihlalweni. I-bioavailability ye-Biguanide ayidluli kuma-60%. Ngokudla okufanayo kwezakhi zomzimba, ukumunca umuthi kuyancipha. Kusatshalaliswa ngokushesha, kungangeni ekuxhumaneni ngamaprotheni e-plasma.

Umuthi empeleni awutheleleki, uqeda imfucuza yezinso imfucuza, impilo yesigamu se-T1 / 2 - kusuka emahoreni ayi-9 kuye kwayi-12.

Ifomu lomthamo we-Gluconorm nokwakheka kwalo

IGluconorm, isithombe sayo esingabonakala kulesi sigaba, ingena kwinethiwekhi ekhemisi ngesimo samaphilisi e-convex eyindilinga ngegobolondo elimhlophe. Ekuqhekekeni, umthunzi wesidakamizwa ungwevu. Kwithebhulethi linye kunezithako ezimbili eziyisisekelo kulezi zilinganiso ezilandelayo: i-metformin - 400 mg, glibenclamide - 2,5 g .. Faka ifomula nge-excipients: talc, cellulose, starch, glycerol, cellacephate, i-gelatin, i-magnesium stearate, i-croscarmellose sodium, i-sodium carboxymethyl starch, i-silicon diodium diethyl phthalate.

Umuthi ufakwa kuma-10 noma angama-20 ama-pcs. kumaseli enziwe nge-aluminium foil. Ekufakweni kwamakhadibhodi kungaba kusuka kumapulethi amabili kuya kwayi-4. Kwi-Gluconorm, intengo isabelomali impela: kusuka kuma-ruble angama-230, bakhipha umuthi obhalwe phansi. Impilo yeshalofu yamathebulethi yiminyaka emi-3. Umuthi awudingi izimo ezikhethekile zokugcinwa.

Ungayisebenzisa kanjani iGluconorm

Ye-Gluconorm, imiyalo yokusebenzisa ukunquma ukuthatha amaphilisi ngaphakathi nokudla. Udokotela ubala umthamo ngamunye, ecabanga ngezimpawu zaso lesi sifo, izifo ezilandelanayo, ubudala kanye nesimo sikashukela, kanye nendlela umzimba osabela ngayo kulo muthi. Njengomthetho, qala ngethebhulethi eyi-1 / ngosuku. Ngemuva kweviki elilodwa noma amabili, ungalinganisa umphumela, futhi ngokusebenza ngokunganele, ulungise okujwayelekile.

Uma i-Gluconorm ingewona umuthi wokuqalisa, lapho kuthatha indawo yendlela yokwelashwa edlule, kubekwa amaphilisi ama-1-2 kucatshangelwa isimo esejwayelekile sezidakamizwa. Inani elikhulu kakhulu lamathebhulethi angathathwa ngosuku yizicucu ezi-5.

Uma isifo sikashukela singathathi nje kuphela izidakamizwa ze-hypoglycemic, udokotela we-endocrinologist kufanele akwazi lokhu. Nganoma yiluphi ushintsho enhlalakahleni, ikakhulukazi ngesikhathi sokuzivumelanisa ne-Gluconorm, kufanele wazise udokotela ngokushesha.

Siza ngokweqile

Ukuba khona kwe-metformin ekwakhiweni kuvame ukuvusa ukuphazamiseka kwamathumbu, futhi kwesinye isikhathi i-lactic acidosis. Ngezimpawu zokuphazamiseka (imisipha yokulimala, ubuthakathaka, ubuhlungu esifundeni se-epigastric, ukuhlanza), umuthi uyamiswa. Nge-lactic acidosis, isisulu sidinga ukulashwa ngokuphuthumayo esibhedlela. Yibuyisele nge-hemodialysis.

Ukuba khona kwe-glibenclamide kwifomula akubeki eceleni ukuthuthukiswa kwe-hypoglycemia. Kungenzeka ukuthi uqaphele isimo esiyingozi ngokudla okungalawulwa, ukukhukhula okwandayo, i-tachycardia, ukwethuka, isikhumba esidabukile, isomnia, i-paresthesia, isiyezi nekhanda, ukukhathazeka. Ngendlela emnene ye-hypoclycemia, uma ohlukunyezwa engazi, unikezwa ushukela noma ushukela. Ngokwehluleka, ushukela, i-dextrose, i-glucagon (40% rr) inj inj iv, im noma ngaphansi kwesikhumba. Ngemuva kokuthi isiguli siphinde siqaphele, sinikwa ngemikhiqizo enama-carbohydrate asheshayo, ngoba ukubuyela emuva kulesi simo kuvame ukwenzeka.

Imiphumela Yokusebenzelana Kwezidakamizwa

Inhlanganisela ne-ACE inhibitors, ama-NSAIDs, izidakamizwa ze-antifungal, i-fibrate, ama-salicitates, izidakamizwa ezilwa nesifo sofuba, β-adrenergic blockers, i-guanethidine, i-MAO inhibitors, i-sulfonamides, i-chloramphenicol, i-tetracyrindiamine, i-tetracycodiaminophenide, i-tetrazin thepatline. .

Umsebenzi we-hypoglycemic we-Gluconorm uyancipha emiphumeleni yezidakamizwa ze-adrenostimulant barbiturates, izidakamizwa ze-corticosteroids, izidakamizwa zokulwa nokuqina, i-diuretics (izidakamizwa ze-thiazide), i-furosemide, i-chlortalidone, i-triamteren, i-morphine, i-ritodrin, i-glucagon, i-hormone ye-thyroid.

Izidakamizwa ze-urine acid-boosting zisebenza njengegalelo lokusebenza ngempumelelo ngokunciphisa ukuhlukaniswa futhi kuthuthukise ukuqalwa kabusha kwe-gluconorm. I-Ethanol ikhulisa amathuba we-lactic acidosis. I-Metformin ithinta kabi i-pharmacokinetics ye-furosemide.

Imiphumela engathandeki

I-Metformin ingenye yezidakamizwa eziphephe kakhulu ze-hypoglycemic, kepha, njenganoma yimuphi umuthi wokwenziwa, unemiphumela emibi. Ezinye zezinto ezivame kakhulu ukuphazamiseka kwesifo sokuqaqamba kwamazinyo, okunyamalala kubantu abaningi abanesifo sikashukela ngemuva kokuphela kwesikhathi sokuzijwayeza. I-Glibenclamide futhi isithako esivivinywa isikhathi eside esinezibonakaliso ezinkulu zesisekelo sokusebenza nokuphepha. Izimo ezifakwe kuhlu etafuleni azivamile, kepha imiyalo kumele ifundwe ngaphambi kokuqala ukwelashwa.

Ama-Organs nezinhlelo	Imiphumela engalindelekile	Imvamisa
Ukukhohlisa umzimba	hypoglycemia	kaningi
Amapheshana wesisu	ukuphazamiseka kwe-dyspeptic, ukungahambi kahle kwe-epigastric, ukunambitheka kwensimbi; jaundice, i-hepatitis	kaningi kuyaqabukela
Uhlelo lokujikeleza	i-leukopenia, erythrocytopenia, thrombocytopenia; i-agranulocytosis, i-pancytopenia, i-anemia	kaningi ngesinye isikhathi
CNS	ikhanda, ukuhlangana okungahambi kahle, ukukhathala okusheshayo nokungabi namandla; paresis	kaningi kaningi
Ukungavikeleki	i-urticaria, i-erythema, ukulunywa kwesikhumba, ukwanda kwe-photosensitivity; umkhuhlane, i-arthralgia, i-proteinuria	kaningi kaningi
Izinqubo ze-Metabolic	i-lactic acidosis	kuyaqabukela
Okunye	Ukudakwa kotshwala obunezinkinga: ukugabha, i-arrhythmias yenhliziyo, isiyezi, i-hyperemia	ngotshwala

Ngubani okhonjiswayo futhi ophule umthetho we-Gluconorm

Amacwecwe anqunyelwe abanesifo sikashukela ngohlobo lwesibili lwesifo, uma ukuguqulwa kwendlela yokuphila nokwelashwa okwedlule kungazange kunikeze i-100% glycemic control. Uma ukusetshenziswa kwezidakamizwa ezimbili ezihlukile (i-Metformin ne-Glibenclamide) kuvumela ukunxephezelwa okuqinile koshukela, kuyalulekwa futhi ukuthi esikhundleni salokho kube yinkimbinkimbi ngomuthi owodwa - i-Glucanorm.

Ungasebenzisi i-Gluconorm nge:

Uhlobo 1 sikashukela;
I-Hypoglycemia;
I-ketoacidosis yesifo sikashukela, ikoma kanye ne-precoma;
Ukungasebenzi kahle kwe-renal kanye nezimo zabo ezicasulayo;
Ukungasebenzi kwesibindi;
Izimo ezidonswa yindlala yokuphefumula kwezicubu (ngokuhlaselwa yisifo senhliziyo, i-inhliziyo pathologies, ukushaqeka, ukwehluleka ukuphefumula);
Porphyria;
Ukusetshenziswa okufanayo kwe-miconazole;
Izimo ezibandakanya ukushintshwa kwesikhashana kwe-insulin (ngesikhathi sokuhlinzwa, ukulimala, izifo, ezinye izivivinyo zisebenzisa amaki asuselwa ku-iodine);
Ukusetshenziswa kabi kotshwala;
I-Lactic acidosis, kufaka phakathi umlando;
Ukukhulelwa nokukhulelwa;
I-Hypocaloric (kuze kufike ku-1000 kcal) umsoco;
Hypersensitivity ezingxenyeni zefomula.

Ukuqokwa kwe-gluconorm ebudaleni kubashukela abanesifo sikashukela abasebenza kanzima ngokomzimba kuyingozi ngoba kungenzeka ukuthi kukhule i-lactic acidosis.

Ukugxila kakhulu lapho kulungiswa irejimithi yokwelashwa kufanele kunikezwe iziguli ezinesifo sokuqina kwezinhlungu, ukungasebenzi kahle emzimbeni (adrenal dysfunction), i-pituitary hypofunction, i-pathologies yegland gland.

Izincomo ezingeziwe

Ukusetshenziswa kwe-Gluconorm ngabamama abakhulelwe nabahlengikazi

Noma esesigabeni sokuhlela kwengane, i-Gluconorm kumele ithathelwe indawo nge-insulin, ngoba umuthi uboshwe ngalesi simo. Lapho ubisi lwebele londlisiwe, imikhawulo ihlala igcwele, ngoba umuthi ungena hhayi kuphela kuyi-placenta ye-fetus, kodwa futhi ubisi lwebele. Ukukhetha phakathi kwe-insulin nokudlulisela ingane ekuondleni okufakwayo kufanele kucabangele izinga lobungozi kumama kanye nokulimaza okungaba khona enganeni.

Ukusetshenziswa kwomuthi ukuphathwa kabi kwesibindi nezinso

Uma kwenzeka ukwehluleka kwesibindi (ifomu elinamandla, elingamahlalakhona) iGluconorm ayinqunyelwe. Ngama-pathologies ezinso, futhi ezimweni ezingazicasulayo (ngezifo ezithathelwanayo, ukushaqeka, ukuphuma komzimba), umuthi awukhonjisiwe.

Imiyalo ekhethekile

Ukulimala okukhulu nokuhlinzwa okungathi sína, izifo ezithathelwanayo ezihambisana nomkhuhlane, kuphakamisa ukudluliswa kwesikhashana kwesiguli ku-insulin.

Isifo sikashukela kufanele sixwayiswe ngengozi yokuthola i-hypoglycemia nokusetshenziswa kwama-NSAIDs, utshwala, izidakamizwa ezenzelwe i-ethanol kanye nokungondleki njalo.

Uma ushintsha indlela yakho yokuphila, ukudla, imizwa ngokweqile nangokomzimba, kufanele uguqule umthamo womuthi.

Uma isiguli siyohlolwa sisebenzisa okokumaka okuqukethe i-iodine, i-Gluconorm ikhanseliwe ngezinsuku ezimbili, isisuse i-insulin. Ungbuyela kwirejimeni yokwelashwa edlule ngaphambi kwamahora angama-48 ngemuva kocwaningo.

Ukusebenza kwe-Gluconorm kuzoncishiswa kakhulu uma isiguli singakulandeli ukudla okune-carb ephansi, kuholela endleleni yokuphila yokuhlala, singalawulwa ushukela wakhe nsuku zonke.

Umphumela weGluconorm ekuthengeni kokuphathwa kwezokuthutha

Njengoba phakathi kwemiphumela emibi evela ekusetshenzisweni kwe-Gluconorm kukhona futhi okubi kakhulu njenge-hypoglycemia ne-lactic acidosis, umuntu onesifo sikashukela kufanele aqaphele ikakhulukazi lapho eshayela nasendaweni enobungozi emsebenzini (lapho esebenza ezindaweni eziphakeme noma ngamasu ayinkimbinkimbi).

I-Gluconorm - i-analogues

Ngokwekhodi ye-ATX yezinga 4, bahlangana ne-Gluconorm:

Ama-Glucovans;
UJanumet;
I-Glibomet;
UGalvus Met;
Amaril.

Ukukhetha nokukhipha umuthi kulelikhono lochwepheshe. Ukuzihlola kanye nokuzelapha ngaphandle kokubheka zonke izici zesitho esithile kungaphenduka imiphumela ebuhlungu.

Ukubuyekezwa kwesifo sikashukela

Mayelana nokubuyekezwa kwe-Gluconorm Diabetesic kuvame ukuphikisana. Abanye bathi umuthi awusizi, kunezimanga eziningi eziseceleni, kufaka phakathi isisindo somzimba. Abanye bathi ubunzima obukhulu ekwelapheni lo muthi kwakungukukhethwa komthamo, bese ushukela ubuyela kokujwayelekile. Mayelana netiye le-herbal "I-Altai 11 Gluconorm enama-blueberries" ukubuyekeza okuhle: kusiza ukugcina umbono, kuthuthukisa inhlala-kahle.

U-Evgenia Fedorovna, eVoskresensk “Sekuphele iminyaka engu-7 ngigula nginesifo sikashukela, ngizihlolele yona imishanguzo eminingi. Phakathi kwabo bekukhona iGluconorm. Ngiphuze amaphilisi ama-2, ekuseni nakusihlwa. Ushukela ubamba, kepha ukhathele ukulwa nemiphumela emibi. Ngizama ukulandela lokhu kudla, kepha isisu esikhathazekile nobuhlungu bekhanda kungapheli inyanga akuphelanga. Udokotela wathi lezi yizici zobudala bami nomzimba wami, futhi washo umuthi wokuqala iGlucofage. Ngiphuza amaphilisi ama-2 ngosuku futhi ngizwe umphumela useviki lokuqala. Kuvele amandla, asikho isifiso sokudla esinamandla futhi akukho ukwesaba ukuphuma. "

UVladimir, uSaratov “Ngesikhathi ngihlolwa ngokomzimba, ngiveze ngengozi ushukela ekuhlaziyeni, futhi muva nje sesithole isisindo. Ngingumshayeli, umsebenzi wami uhlala phansi, futhi umgwaqo namuhla ucindezelekile njalo. U-Therapist wabiza lesi simo ngokuthi yi-prediabetes futhi wabeka i-Gluconorm ithebhulethi eyodwa ngosuku, engiyiphuza nokudla. Ngemuva kwamaviki ama-2 ngiphinda ngiye kwi-reception futhi nginethemba lokuthi konke kuzophela, yize udokotela ethi uma ngangehlulwa isisindo futhi angigcinanga ukudla, ngakho-ke alikho ithuba ushukela ojwayelekile. Kunzima ukujwayela izimo ezintsha, kepha ithemba lokukhubazeka likwenza ucabange. ”

I-Gluconorm iyisidakamizwa esisebenziseka kalula ocwaningweni olufakazelwe kanye nokwenza izinto eziyisisekelo kwezomtholampilo. Ama-Biguanides kanye ne-sulfanilurea derivatives asetshenziselwe ekwelapheni isifo sikashukela sohlobo 2 isikhathi esingaphezu kwengxenye yekhulu, futhi izinhlobo ezintsha zemithi ye-antidiabetes azikaze zithi igunya lazo.

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