I-Gliformin inweba isifo sikashukela sohlobo 2

Ngokwezibalo, izidakamizwa ezenziwa nge-metformin zinqunywa ama-43% abantu abanesifo sikashukela ngohlobo lwesibili lwesifo esitholwe okokuqala, uma ukuguqulwa kwendlela yokuphila kunganikeli ngokuphelele ukulawulwa kwe-glycemic. Enye yazo i-Russian generic of the Original French anti-diabetesic drug Glucofage enegama lokuhweba elithi Gliformin.

Kunezinhlobo ezimbili zemithi: ngokukhishwa okujwayelekile nangomphumela owenziwe isikhathi eside. I-Gliformin Prolong isetshenziswa kanye, futhi isebenza usuku. Ukusebenziseka kalula, ukusebenza kahle kanye nokuphepha kwakwaziswa yibo bobabili abanesifo sikashukela nodokotela abasebenzisa amaphilisi we-monotherapy nokwelashwa okuyinkimbinkimbi.

Ukwakheka, ifomu lomthamo, ama-analogues

Isidakamizwa uGliformin Prolong, inkampani yezokwelapha yaseRussia u-Akrikhin, ikhiqiza ngendlela amaphilisi afakwe ngawo ifilimu ngomthelela oqinile wokukhishwa.

Ithebhulethi ngayinye ephuzi ye-biconvex iqukethe i-750 mg yesakhi esisebenzayo se-metformin hydrochloride nababekhona: i-silicon dioxide, i-hypromellose, i-microcrystalline cellulose, i-magnesium stearate.

Amaphilisi atholwe ama-30 noma angama-60 ama-PC. ibe ipeni lepensela lepulasitiki eline-screw cap kanye nesembozo sokulawula sokuvula kokuqala. Ukufakwa kwepulasitiki kufakwa ebhokisini lekhadibhodi. Impilo yeshalofu yesidakamizwa endaweni eyomile, emnyama ekushiseni kwegumbi iminyaka emi-2. Kwi-Gliformin Prolong 1000, intengo ku-Intanethi isuka kuma-ruble angama-477.

Uma udinga ukufaka esikhundleni somuthi, udokotela angasebenzisa izifaniso ngento efanayo eyisisekelo:

• IFommetin;
• I-Metformin;
• IGlucophage;
• Metformin Zentiva;
• UGlatiniin.

Izici ze-Pharmacological zeGliformin

Isidakamizwa i-Gliformin Prolong sithathwa njenge-ejenti ekwehlisa ushukela eqenjini le-Biguanide. I-Dimethylbiguanide ithuthukisa i-basal ne-postprandial glycemia. Indlela yokusebenza ye-metformin, isakhi esiyisisekelo sefomula, ukuvusa umuzwa wokutholwa kwamaseli we-peripheral cell receptors kwi-insulin yawo futhi kusheshise isilinganiso sokusetshenziswa kwe-glucose kwezicubu zemisipha.

Umuthi awuthinti ukukhiqizwa kwe-insulin endulin, ngakho-ke akukho-hypoglycemia phakathi kwemiphumela yayo engathandeki. Ivimbela i-gluconeogenesis, i-metformin ivimba ukwakheka kwe-glucose esibindini futhi ivimbele ukungena kwayo emathunjini. Ngokuvuselela amandla i-glycogen synthase, isidakamizwa sandisa ukukhiqizwa kwe-glycogen, sithuthukisa amandla okuhamba azo zonke izinhlobo zabathutha beglue.

I-Pharmacokinetics

Ngemuva kokusebenzisa amaphilisi amabili we-Gliformin Prolong (1500 mg), ukuqina okukhulu egazini kufinyelela ngemuva kwamahora amahlanu. Uma siqhathanisa ukuhlangana komuthi ngokuhamba kwesikhathi, khona-ke umthamo owodwa ka-2000 mg we-metformin onamandla okuhlala isikhathi eside uyafana ekusebenzeni kabili kwe-metformin ngokukhululwa okujwayelekile, okuthathwa kabili ngosuku nge-1000 mg.

Ukwakheka kokudla, okuthathwa ngokufana, akuphazamisi ukufakwa kwesidakamizwa iGlyformin Prolong. Ngokusetshenziswa okuphindaphindiwe kwamathebulethi ngethamo lika-2000 mg, ukubekelwa phansi akulungisiwe.

Umuthi ubopha kancane amaprotheni egazi. Ivolumu yokusabalalisa - ngaphakathi kwe-63-276 l. I-Metformin ayinawo ama-metabolites.

Umuthi uqedwa ngohlobo lwawo lwangempela ngendlela yemvelo ngosizo lwezinso. Ngemuva kokungena emgodini wokugaya ukudla, impilo eyihafu ayidluli amahora angama-7. Ngokusebenza kwe-renal, i-half-life ingakhuphuka futhi inikele ekuqongeleleni kwe-metformin eyeqile egazini.

Izinkomba ze-gliformin ende

Umuthi wenzelwe ukulawula isifo sikashukela sohlobo 2, ikakhulukazi kwiziguli ezikhuluphele, uma ukuguqulwa kwendlela kunganikeli isinxephezelo se-100% glycemic.

Umuthi usetshenziswa zombili kwi-monotherapy nasekwelapheni okuyinkimbinkimbi namanye amaphilisi e-antidiabetic noma i-insulin kunoma yisiphi isigaba salesi sifo.

Contraindication

Ungabeki izidakamizwa nge-metformin ye:

• Hypersensitivity ezingxenyeni zefomula;
• I-ketoacidosis yesifo sikashukela, i-precoma ne-coma;
• Ukungasebenzi kahle lapho i-creatinine imvume ingaphansi kwe-45 ml / min.;
• Ukwelashwa komzimba, okuhambisana nokushayeka okunamandla nokuhlanza, ukutheleleka kwezinhlelo zokuphefumula nezokuzala, ukushaqeka kanye nezinye izimo ezisesikhathini ezidala ukukhula kokwehluleka kwezinso;
• Ukungenelela okubucayi kokulimala, ukulimala okubandakanya ukumiselela umuthi okwesikhashana nge-insulin;
• Ukwehluleka kwenhliziyo nokuphefumula, ukufakwa kwe-myocardial kanye nezinye izifo ezingamahlalakhona nezishukumisayo ezifaka umfutho kwi-izicubu hypoxia;
• Ukungasebenzi kwesibindi;
• Ukusetshenziswa kabi kotshwala okungapheli, ubuthi obunobungozi obukhulu;
• Ukukhulelwa nokukhulelwa;
• I-Lactic acidosis, kufaka phakathi umlando;
• Izifundo zokuqhathanisa i-X-ray (okwesikhashana);
• Ukudla kwe-Hypocaloric (kuze kufike kwinkulungwane kcal / ngosuku.);
• Iminyaka yezingane ngenxa yokuntuleka kobufakazi obanele bokusebenza nokuphepha.

Kufanele kubhekwe ikakhulukazi isigaba sabanesifo sikashukela esivuthiwe, ikakhulukazi labo abasebenza kanzima ngokomzimba, ngoba basengozini yokuthuthukiswa kwe-lactic acidosis.

I-Glyformin ngesikhathi sokukhulelwa

Ngokunxeshezelwa kwengxenye yesifo sikashukela sohlobo 2, ukukhulelwa kuyaqhubeka nge-pathologies: ukungasebenzi kahle, okubandakanya ukufa kwe-perinatal. Ngokusho kweminye imibiko, ukusetshenziswa kwe-metformin akubonisi ukuthuthuka kokukhubazeka kwezingane ezisanda kuzalwa.

Noma kunjalo, esigabeni sokuhlela ukukhulelwa, kuyalulekwa ukushintshela ku-insulin. Ukuvimbela ukukhubazeka ekukhuleni kwengane, kubalulekile kwabesifazane abakhulelwe ukulawula i-glycemia ku-100%.

Umuthi uyakwazi ukungena ubisi lwebele. Futhi yize ingekho imiphumela emibi ezinganeni ezinceliswa ibele, uGlformin Prolong akancomi ukuthatha imiyalo yokusebenzisa ngesikhathi sokuqunjelwa. Isinqumo sokushintshela kokudla okungezelelwe senziwa kucatshangelwa ukulimala okungaba khona enganeni nezinzuzo zobisi lwebele ngayo.

Ungasisebenzisa kanjani ngempumelelo

I-Glyformin Prolong yenzelwe ukusetshenziswa kwangaphakathi. Iphilisi lithathwa kanye kuphela - kusihlwa, ngesidlo sakusihlwa, ngaphandle kokuhlafuna. Umthamo womuthi unqunywa ngudokotela, kucatshangelwa imiphumela yokuhlolwa, isigaba sesifo sikashukela, i-concomitant pathologies, isimo esijwayelekile kanye nokusabela komuntu ngamunye kulo muthi.

Njengokwelashwa kokuqala, uma umuntu onesifo sikashukela engakaze athathe izidakamizwa ezakhiwe nge-metformin, kunconywa ukuthi umthamo wokuqala unqunywe kungakapheli u-750 mg / ngosuku, ohlanganisa ukuthatha umuthi nokudla. Emavikini amabili sekuvele kungenzeka ukuthi kuhlolwe ukusebenza ngempumelelo komthamo okhethiwe futhi, uma kunesidingo, wenze ushintsho. Ukwehla kancane komthamo kusiza umzimba ukuzivumelanisa nobuhlungu futhi kwehlise inani lemiphumela emibi.

Isimo esijwayelekile somuthi yi-1500 mg (amaphilisi ama-2), athathwa kanye. Uma kungenzeki ukufeza ukusebenza okudingayo, ungangeza inani lamathebulethi libe u-3 (lo umthamo omkhulu). Nazo zithathwa ngasikhathi sinye.

Ukufakwa esikhundleni kwamanye ama-ejenti we-hypoglycemic nge-Gliformin Prolong

Uma umuntu onesifo sikashukela esevele ethathe izidakamizwa ezenzelwe iMetformin ezinomphumela wokukhishwa okujwayelekile, lapho-ke uzibuyisela ngeGlformin Prolong, umuntu kufanele agxile kudosi losuku langaphambilini. Uma isiguli sithatha i-metformin ejwayelekile ngethamo elingaphezu kuka-2000 mg, ukuguqukela kwi-glyformin ende akusebenzi.

Uma isiguli sisebenzisa amanye ama-hypoglycemic agents, lapho-ke sibuyisela umuthi nge-Gliformin Prolong baqondiswa umthamo ojwayelekile.

I-Metformin yohlobo 2 sikashukela nayo isetshenziswa ihlanganiswa ne-insulin. Umthamo wokuqala we-Glyformin Prolong onokulashwa okunjalo okuyinkimbinkimbi ngu-750 mg / ngosuku. (ukwamukelwa okukodwa kuhlanganiswe nesidlo sakusihlwa). Imithamo ye-insulin ikhethiwe kucatshangelwa ukufundwa kwe-glucometer.

Umthamo omkhulu ovunyelwe wokuhluka okuhlala isikhathi eside ngu-2250 mg (ama-3 ama-PC.). Uma isifo sikashukela singenele ukulawula ngokuphelele kwalesi sifo, sidluliselwa kuhlobo lomuthi ngokukhululwa okuvamile. Ngale ndlela, umthamo omkhulu ngu-3000 mg / ngosuku.

Isikhathi sesifundo sincike ekuxilongeni: uma i-polycystic ovary nge-metformin ngesinye isikhathi singalashwa enyangeni, khona-ke isifo sikashukela esinesifo sohlobo 2 singakuthatha impilo yonke, sinikeze irekhodi lokwelashwa ngemithi ehlukile uma kunesidingo. Kubalulekile ukuphuza umuthi ngasikhathi sinye, nsuku zonke, ngaphandle kweziphazamiso, ngenkathi ungakhohlwa ngokulawulwa koshukela, ukudla okune-carb ephansi, ukusebenza komzimba kanye nesimo somzwelo.

Iziphakamiso zamaqembu athile wesifo sikashukela

Ngezinkinga zezinso, inguqulo ende ayinqunyelwe kuphela izinhlobo ezinzima zesifo, lapho imvume ye-creatinine ingaphansi kuka-45 ml / min.

Umthamo wokuqala kwabanesifo sikashukela nge-renal pathologies ngu-750 mg / ngosuku, umkhawulo ufinyelela ku-1000 mg / ngosuku.

Ukusebenza kwezinso kufanele kuhlolwe kaningi izinyanga eziyi-3-6. Uma imvume ye-creatinine iwele ngaphansi kuka-45 ml / min., Umuthi ukhanselwa ngokuphuthumayo.

Ebusheni obukhulu, lapho amandla ezinso esevele ancishisiwe, ukufakwa kwesithamo somthamo we-Gliformin Prolong kwenziwa ngesisekelo sokuhlolwa kwe-creatinine.

Imiphumela emibi

I-Metformin ingenye yezidakamizwa eziphephe kakhulu, ezihlolwa isikhathi nesikhathi nezifundo eziningi. Indlela esebenza ngayo ayivuseleli ukukhiqizwa kwe-insulin yayo, ngakho-ke, i-hypoglycemia ene-monotherapy ayibangeli isikhathi eside ukwanda kwe-glyformin. Umcimbi obuhlungu kakhulu uvame ukuphazamiseka emathunjini, okuncike ezimeni zomzimba ngamunye bese kudlula ngemuva kokuzijwayeza ngaphandle kokungenelela kwezokwelashwa. Imvamisa yemiphumela emibi ihlolwa ngokuya ngesilinganiso se-WHO:

• Imvamisa kakhulu - ≥ 0.1;
• Imvamisa - kusuka ku-0.1 kuye ku-0,01;
• Ngokujwayelekile - kusuka ku-0,01 kuya ku-0.001;
• Kuyaqabukela, kusuka ku-0.001 kuya ku-0.0001;
• Akuvamile kakhulu - <0.0001;
• Akwaziwa - uma imvamisa yolwazi olutholakalayo ingenakunqunywa.

Imiphumela yokubonwa kwezibalo yethulwe etafuleni.

Ukulawulwa kwesikhathi eside kwe-Glyformin Prolong kungadala ukonakala kokufakwa kwe-vitamin B12. Uma kutholakala ukuthi une-megaloblastic anemia, ukunakwa kufanele kukhokhwe ku-etiology engaba khona.

Ukunciphisa ukubonakaliswa kokuphazamiseka kwe-dyspeptic, ithebhulethi ithathwa kangcono ngokudla.

Ukuswelakala kwe-Hepatic, okucasulwe ukusetshenziswa kweGliformin, kudlula ngokwayo ngemuva kokubuyisela umuthi.

Uma lezi zinguquko empilweni zitholwa ngemuva kokuthatha i-Gliformin Prolong, onesifo sikashukela kufanele axwayise udokotela ozobe ekhona.

Izimpawu ze-overdose

Lapho usebenzisa ama-85 g we-metformin (umthamo wedlula lowo owelaphayo izikhathi ezingama-42,5), i-hypoglycemia ayenzekanga. Esimweni esinjalo, i-lactic acidosis yathuthuka. Uma ohlukunyeziwe ekhombisa izimpawu zesimo esifanayo, ukusetshenziswa kweGliformin Prolong kukhanseliwe, onesifo sikashukela esibhedlela, izinga le-lactate nokuxilongwa kuyacaciswa. I-metformin eyeqile ne-lactate ziqedwa yi-dialysis. Ngokuhambisana, ukwelashwa okubonakalayo kuyenziwa.

Imiphumela Yokusebenzelana Kwezidakamizwa

Inhlanganisela ehlanganisiwe

Ama-X-ray umehluko umehluko, aqukethe iodine, ayakwazi ukukhuthaza i-lactic acidosis kwisifo sikashukela esinokuphazamiseka kwengqondo. Ezivivinyweni zisebenzisa izidakamizwa ezinjalo, isiguli sidluliselwa ku-insulin izinsuku ezimbili. Uma isimo sezinso siyanelisa, ezinsukwini ezimbili ngemuva kokuhlolwa, ungaphindela kwirejimeni yokwelashwa edlule.

Izinhlobo ezinconyiwe

Ngobuthi botshwala, amathuba we-lactic acidosis ayanda. Bandisa amathuba wokudla okuphansi kilojoule, ukungasebenzi kahle kwesibindi. Izidakamizwa ezenziwa nge-Ethanol zivusa umphumela ofanayo.

Izinketho zokuqaphela

Lapho usebenzisa izidakamizwa ezinomphumela oqondile we-hyperglycemic (glucocorticosteroids, tetracosactide, β-adrenergic agonists, danazole, diuretics), ukuqapha njalo ukwakheka kwegazi kuyadingeka. Ngokwemiphumela ye-glucometer, umthamo we-Glyformin Prolong nawo uyalungiswa. Ama-diuretics adala izinkinga zezinso, futhi ngenxa yalokho, amathuba we-lactic acidosis.

Izidakamizwa ze-antihypertensive zingashintsha izinkomba ze-hypoglycemic. Ngokusebenzisa kanyekanye, ukunikezwa kwesilinganiso somuthi we-metformin kuphoqelekile.

Ngokulashwa okuhambisana ne-insulin, i-acarbose, izidakamizwa ze-sulfonylurea, amasalicylates, i-Glyformin Prolong kungadala i-hypoglycemia.

Igqamisa ukufakwa kwe-metformin nifedipine.

Izidakamizwa ze-cationic, ezibuye zigcinwe emiseleni yezinso, zinciphisa ukumuncwa kwe-metformin.

Umphumela wokuhlushwa

Ngokulashwa okuyinkimbinkimbi ngemithi ehlukile, ikakhulukazi ehlanganiswa neqembu le-sulfonylurea, i-repaglinide, i-insulin, i-hypoglycemia kungenzeka, ngenxa yalokho, imisebenzi ehambisana nezingozi ezingaba khona zempilo kufanele ilahlwe.

Ukubuyekezwa mayelana nokunwebeka kwe-Gliformin

Naphezu kweqiniso lokuthi wonke umuntu unesifo sakhe sikashukela futhi uqhubeka ngokuhlukile, i-algorithm yezenzo ijwayelekile, ikakhulukazi ngohlobo lwesibili lwesifo sikashukela. Mayelana ne-Gliformin Prolong ku-mellitus yesifo sikashukela, ukubuyekezwa kuyamangaza, kepha kunzima ukuhlola ukusebenza komuthi lapho ungekho khona ngaphandle kokubheka wonke ama-nuances esi sifo nendlela yokuphila.

Odokotela bagxile ekutheni iGlyformin Prolong SD iyalinxephezela, kepha udinga usizo. Ngubani oqonda ukuthi ukudla nokudla ngokomzimba kungunaphakade, kuzoba okujwayelekile ngeGlformin. Isisindo kufanele silawulwe nganoma yiziphi izindlela, lokhu kuyinto eza kuqala. Ngokudla okune-fractional, imikhawulo kulula ukuyithwala futhi umphumela ushesha.

Uma kungenaso isikhuthazo esanele, cabanga ngonyawo olunqunyiwe, izinkinga zokubuka nezinkinga zezinso, ingasaphathwa eyokuhlaselwa yisifo senhliziyo noma unhlangothi, okungenzeka ngasiphi isikhathi nanganoma iyiphi iminyaka. Futhi lezi akuyona nje izeluleko zephephandaba lomndeni wangeSonto - le yimithetho yezokuphepha, okuthi, njengoba wazi, ebhalwe egazini.