I-Hypoglycemic drug drug yeqembu lesibili iGlybomet

Cishe i-6% yabantu bomhlaba namuhla banesifo sikashukela i-mellitus - isifo uphawu lwaso oluphambili ukwanda koshukela wegazi. Izici zangaphandle zithonya ukukhula kwesifo; izakhi zofuzo nazo zidlala indima.

Ukwelashwa okungcono kakhulu kwesifo sikashukela ekudleni okune-carb ephansi: uma umuntu ojwayelekile engadla aze afike ku-400 g wama-carbohydrate ngosuku, khona-ke isifo sikashukela singaphansi kwama-85 g.

Kepha noma senqatshwa okusanhlamvu, amazambane, amakhekhe, imifino eningi nezithelo futhi esikhundleni sawo namafutha ezilwane angayikhulisi i-glucometer, akuwona wonke umuntu ongayinxephezela ngokuphelele i-glycemia. Lokhu kuyiqiniso ikakhulukazi kwabanesifo sikashukela ngohlobo lwesibili lwesifo, okuthi umlando wokuhluleka kwezinso.

Ukwelashwa kwesifo sikashukela, izinhlobo ezi-4 zezidakamizwa sezakhiwe, ezihlukaniswa ukwakheka nendlela yokuthonya kule nkinga.

1. Ukulungiselela okwehlisa izinga lokuphikisana ne-insulin kwamangqamuzana yi-Biguanides (Metformin, Glucofage) ne-thiazolidinediones (Pioglitazone, Rosiglitazone).
2. Izithambisi ze-pancreatic synthesis ze-insulin endo native zitholakala kwe-sulfanylureas (Diabeteson, Maninil) nobumba.
3. Imithi yochungechunge lwama-incretin, elawula isisindo nokudla - Galvus, Januvia, Onglisa, Viktoza, Bayeta.
4. Imithi evimba ukumuncwa kwe-glucose emathunjini yi-Acarbose, Glucobay.

IGlybomet iphinde futhi ibhekiswe kumalungiselelo omlomo we-hypoglycemic womlomo weqembu lesibili, imiyalo yokusebenzisa lapho izokwethulwa ukuthi ibuyekezwe. Yonke imininingwane ithathwa emithonjeni etholakala emphakathini, ngakho-ke akusona ithuluzi lokuzihlola nokuzelapha.

I-Glybomet - ukwakheka

Ukuhlanganiswa kwithebhulethi ngayinye yezakhi ezimbili ezisebenzayo - i-metformin hydrochloride (400 mg) ne-glibenclamide (2,5 mg) kwenza ukuthi kungagcini ngokulawula i-glycemia, kodwa futhi nokunciphisa umthamo walezi zinto. Ukube ngamunye wabo ubesetshenziselwa i-monotherapy, umthamo ubungaphezulu kakhulu.

Iqukethe ifomula nababambi ngendlela yeselula, isitashi sommbila, i-colloidal silicon dioxide, i-gelatin, i-glycerin, i-talc, i-magnesium stearate, i-acetylphthalyl cellulose, i-diethyl phthalate.

Izici ze-Pharmacological

Enye yezithako ezisebenzayo eziyinhloko, i-glibenclamide, isizukulwane esisha sezidakamizwa zekilasi le-sulfonylurea ezifakwe ohlwini lwezidakamizwa ezibalulekile ezinamandla we-pancreatic kanye ne-extra-pancreatic.

Akukhulisi kuphela ukusebenza kwama-pancreas wonke, kepha futhi kuthuthukisa ukwenziwa kwe-insulin endulin. Indlela yokusebenza yabo isuselwe ekuvikelweni kwama-pancreatic β-cell alimale yi-glucose enolaka, enquma ukuqhubekela phambili kwesifo sikashukela, kanye nokukhuthaza ukuzwela kwe-insulin kwamaseli kwelitshe.

Ukuthatha i-Glibomet ngokuhambisana nokulawulwa kwe-glycemic kuthuthukisa i-lipid metabolism futhi kunciphise ingozi yokuqhekeka kwegazi. Umsebenzi we-insulin uyakhuphuka, futhi ngalo ukumuncwa kwe-glucose izicubu zemisipha nesibindi. Umuthi uyasebenza esigabeni sesibili sokukhiqizwa kwe-insulin.

I-Metformin ingeyama-Biguanides - isigaba sezinto ezivuselelayo ezinciphisa ukungazwisiseki kwamaseli ayizimpumputhe kuye kwe-insulin yazo. Ukubuyisela ukuzwela akubalulekile kangako njengokuthuthukisa ukugcinwa kwe-hormone, ngoba ngesifo sikashukela sohlobo 2, ama-pancreas akhiqiza ngisho nangokweqile.

I-Metformin ithuthukisa ukuxhumana kwama-receptors ne-insulin, inyusa ukusebenza kwe-postreceptor kwehormone. Uma kungekho i-insulin egazini, umphumela wokwelapha awuboniswa.

I-Metformin inezici ezihlukile:

• Yehlisa ukufakwa kweglucose yizindonga zamathumbu futhi isize ukusetshenziswa kwayo kwezicubu;
• Inhibits gluconeogeneis;
• Ivikela i-b-cell kusuka ku-apoptosis esheshayo;
• Yehlisa ingozi yanoma yiluphi uhlobo lwe-acidosis kanye nezifo ezimbi;
• Kuthuthukisa i-microcirculation of fluid, ukusebenza kwe-endothelial kanye ne-metabolism yamafutha (kunciphisa ukugcwala kwe-cholesterol "embi" ne-triglycerol egazini);
• Ilungiselela ukunciphisa umzimba - isimo esibalulekile sokulawulwa ngempumelelo kwe-glycemic ezigulini zohlobo 2 DS;
• Yehlisa ukusweleka kwegazi nengubo yokuxineka;
• Inomphumela we-fibrinolytic ngokuvimbela i-activ plasminogen activator;
• Ivimbela izinqubo ze-oncological (ngokuvamile, isifo sikashukela sandisa ubungozi be-oncology ngama-40%);
• Yehlisa ubungozi bokufa ezenzakalweni zenhliziyo.

Kuhlolwa okwenziwe kabusha kwabanesifo sikashukela abangama-5800 abanesifo sikashukela sohlobo 2 kwenziwa eChina. Abahlanganyeli kulingo bathole i-metformin ehambisana nokuguqulwa kwendlela yokuphila. Eqenjini elilawulayo, izisebenzi zokuzithandela zimane zalungisa indlela yazo yokuphila. Ezinyangeni ezingama-63 eqenjini lokuqala, ukufa kwaba ngabantu abayi-7.5 kubantu abayi-1000 / iminyaka, kwesibili - izinyanga ezingama-45, ngokulandelana abantu abayi-11.

Umuthi uqala ukusebenza amahora amabili ngemuva kokungena esophagus, ukusebenza kwawo kuklanyelwe amahora angama-12. I-Metformin ayibeki usongo lwe-hypoglycemic. Umuthi onobufakazi obukhulu, udlulise isivivinyo esiqinile sesikhathi futhi udinga ushukela kuzo zonke izigaba zokuqinisa ukwelashwa.

Namuhla, imakethe yezemithi inikeza amakilasi ayi-10 emithi yokwelapha isifo sikashukela, kepha i-metformin iseyisidakamizwa esithandwa kakhulu ekwelapheni isifo sikashukela sohlobo 2 kunoma yisiphi isigaba salesi sifo.

Ukuhlanganiswa kwe-synergistic kwezithako ezimbili ezisebenzayo ze-Glibomet kunomthelela oyinkimbinkimbi emzimbeni.

1. Umphumela we-pancreatic - umuthi unciphisa "ubumpumputhe" bamaseli, uvuselela ukugcinwa kwe-insulin yayo uqobo, kuvikela ama-b-cell.
2. Umphumela owengeziwe-we-pancreatic - i-biagudin ithinta ngqo izicubu zemisipha kanye namafutha, inciphisa i-gluconeogeneis, inyuse iphesenti lokuthathwa kwe-glucose ephelele.

Isilinganiso esifanele sezilinganiso sezinto ezisebenzayo singalungisa kakhulu umthamo womuthi. Kumaseli e-b, ukukhuthaza okunomusa okunjalo kubaluleke kakhulu: kwandisa ukuphepha komuthi, kunciphisa ingozi yokuphazamiseka kokusebenza kwawo, futhi kunciphisa amathuba emiphumela emibi.

Amandla we-Pharmacokinetic

I-Glybenclamide evela emgodini wesisu iyabanjwa futhi isatshalaliswa kahle - ngama-84%, umphumela omkhulu wesidakamizwa ungabonakala ngemuva kwamahora we-1-2. Ingxenye ibopha amaprotheni egazi ngamaphesenti angama-97.

I-Glibenclamide metabolism iyenzeka esibindini, lapho iguqulwa ngokuphelele ibe yi-metabolites engasebenzi. Ingxenye yento esetshenzisiwe iphumela ezinso, enye ingxenye idlule emiseleni ye-bile. Ingxenye yempilo imaphakathi namahora ayi-10.

I-Metformin igxilwe ngokuphelele ohlelweni lokugaya ukudla, isatshalaliswa ngokushesha kwizitho nezicubu, ayibophele amaprotheni egazi nakancane. Ukuqina kwe-bioavailability kwengxenye kusuka ku-50-60%.

Ngokuvamile, ukugcotshwa okuphezulu kwezithako zefomula esegazini kwenzeka ihora noma amabili ngemuva kokuthatha iphilisi.

Izinkomba zokwelashwa nge-Glybomet

Imiyalo esemthethweni ikhombisa ukuthi umuthi unqunyelwe isifo sikashukela sohlobo 2, kufaka phakathi isifo sikashukela esincike ku-insulin, uma ukondliwa okhethekile, ukusebenza komzimba kanye nezinye izidakamizwa ze-hypoglycemic zingazange zinikeze umphumela obuhleliwe.

Izidakamizwa eziningi zinomphumela wokulutha, uma umzimba ungaphenduli ekwelashweni kahle, ziguqula i-algorithm yokwelapha ngokunquma i-Glibomet kumathebulethi.

Kuqondiswe kubani ikhambi?

Njengoba umuthi unomphumela onzima enkingeni, akumangazi ukuthi unemikhawulo eyanele yokwamukelwa.

Umuthi ungaba yingozi:

• Isifo sikashukela sokukhulelwa;
• Uma isiguli sinokuzwela okukhulu kwezithako zefomula;
• Isifo sikashukela sohlobo lwesifo sokuqala;
• Njengoba unesifo sikashukela sikashukela nezimpawu zomngcele;
• Uma umlando wesibindi nokungasebenzi kwezinso;
• Lapho i-creatinine ikhuphuka ibe ngu-110 mmol / l kwabesifazane kanye no-135 mmol / l emadodeni;
• Iziguli ezine-lactic acidosis noma i-ketoacidosis;
• Uma isifo sikashukela sine-hypoglycemia eshukunyiswa ukuphazamiseka kwe-metabolic;
• Nge-hypoxia ye-genesis ehlukile;
• Ngemuva kokulimala, i-gangrene, ukutheleleka, ukushiswa okukhulu;
• Ngokulashwa okungathi sína;
• Iziguli zitholwe i-leukopenia, porphyria;
• Ngokudla okulambile okunama-kilojoule angaphansi kuka-1000 kcal / usuku .;
• Ngotshwala notshwala obunobuthi;
• Izingane ezincane;
• Omama abakhulelwe futhi ababelethayo.

Ungayithatha kanjani i-Glibomet

Kunemikhawulo yokuthatha i-Glibomet:

1. Ngama-pathologies we-gland yegilo;
2. Uma isiguli sinomkhuhlane;
3. Lapho umlando we-hypofunction we-cortex yesifo sezinhlwathi kanye ne-adrenal gland.

Umthamo unqunywa yi-endocrinologist ngokuya ngeminyaka yesiguli nangezici zomtholampilo, kepha umenzi uphakamisa ukuthi kuqalwe ngamathebhulethi amabili nsuku zonke, ahlala ewuthatha umuthi. Umthamo omkhulu wesidakamizwa ngu-2 g / ngosuku. Kungcono ukusabalalisa ukwamukela ngezikhathi ezithile. Uma le mali ingenamphumela olindelekile, ukwelashwa okuyinkimbinkimbi kunqunyelwe ngokungezwa kwemithi enamandla.

Imiphumela emibi kanye ne-overdose

Kunemiphumela eminingi engathandeki engaba khona ngemuva kokuphuza i-Glibomet, kepha lokhu akufanele kube yisizathu sokwenqaba umuthi, ngoba ukulimala okubangelwe emzimbeni yisifo sikashukela esingafakwanga sikhulu kakhulu kunengozi engaba khona yemiphumela emibi.

Ukuze ugweme izimo ezinjalo, kubalulekile ukubala isilinganiso sakho. Uma okwejwayelekile sekudliwe ngaphezulu, isifo sikashukela sivusa indlala engapheli, ukulahlekelwa amandla, ukwesaba, ukwethuka kwesandla.

Izimpawu zokweqisa ngokweqile nazo zingaba yi-tachycardia, blancing kwesikhumba, ukukhuphuka kokujuluka, ukufoka.

Emiphumeleni emibi kakhulu ngemuva kokuthatha i-Glibomed, i-hypoglycemia iyingozi enkulu kulesi simo ezigulini ezibuthakathaka ngenxa yokugula isikhathi eside, abanesifo sikashukela sebanga elivuthiwe abanesifo sikashukela, abadakwa utshwala, abantu abasebenza kanzima ngokomzimba, kanye nawo wonke umuntu ohlezi onesigamu sendlala ( ukudla okungaphansi kuka-1000 kcal / usuku.) Ukudla.

Kwezimpawu ezijwayelekile, ezivame kakhulu yilezi:

• Ubuhlungu bekhanda;
• Ukungakhululeki epigastrium;
• Ukuphazamiseka kwe-dyspeptic;
• Izinhlobo ezahlukene zokuphendula komzimba.

Uma kwenzeka ukungaphatheki kahle kwesikhashana ngemuva kokuthatha amaphilisi, kungaqedwa ngokwelashwa okubonakalayo. Uma izimpawu zivezwa noma kuvela izimpawu zokungezwani komzimba, kuzofanela ukhethe izichasiso ze-Glibomet.

Imiphumela Yokusebenzelana Kwezidakamizwa

Ukwanda komphumela we-hypoglycemic we-Glybomet ubonwa ngesikhathi sokwelashwa okufana nalokhu okutholwe ku-decumarol, phenylbutamazone, β-blockers, oxytetracycline, allopurinol, cimetidine, ethanol, sulfinpyrazone kumthamo obalulekile, i-probenecid, chloramphenicol, i-mainamporizone. .

Ukwelashwa okuhlangene nama-hormone we-yegland yegland, izindlela zokuvimbela inzalo ngomlomo, i-barbiturates, i-thiazide diuretics kuvimbela amandla e-Glibomet.

Imiyalo ekhethekile

Ukusetshenziswa kwe-Glibomet kumiswa ngokushesha lapho kunezimpawu ze-lactic acidosis: ubuthakathaka obukhali, ukugabha, ukuqina kwemisipha, izinhlungu emgodini wesisu. Isisulu sidinga ukulashwa ngokuphuthumayo esibhedlela.

Umyalo utusa ukwelashwa nge-Glybomet ukuze ihambisane nokuqapha i-creatinine ekuhlolweni kwegazi. Kwabanesifo sikashukela ezinso ezinempilo, ukuhlolwa okunjalo kudingekile okungenani kanye ngonyaka, iziguli ezinamazinga e-creatinine asondele emkhawulweni ophakeme wesikhathi esijwayelekile, futhi iziguli ezivuthiwe kufanele zivivinywe izikhathi ezi-2-4 ngonyaka.

Izinsuku ezimbili ngaphambi kokungenelela kokuhlinzwa okuhleliwe, lapho usebenzisa i-anesthesia yomgogodla noma ye-epidural, ukuthatha i-Glibomet kukhanseliwe futhi isifo sikashukela sishintshwa ku-insulin. Ungayibuyisela inkambo yokwelashwa nge-Glybomet ngemuva kokuba isiguli sivunyelwe ukudla okwenziwe ngomlomo. Ngisho nezinso ezisebenza ngokujwayelekile, udokotela wenza lesi sinqumo kungakapheli izinsuku ezimbili kuqedwe ukuhlinzwa.

Ukuphuza amaphilisi kudinga ukuqaphela lapho wenza umsebenzi ongaba yingozi empilweni nasempilweni, nalapho ushayela izimoto. Lokhu kuhlotshaniswa nengozi ye-hypoglycemia, ukwehla kwezinga lokuphendula kwengqondo kanye namandla okugxila.

Imiphumela yokwelashwa nge-Glybomet izoncika kakhulu ekunembeni kokulandela izincomo ezibekwe kwimiyalo nemiyalo ye-endocrinologist: ukunamathela ekudleni nasekulaleni nasekuphumuleni, ukuvivinya umzimba njalo, ukulawula i-glycemic ehlelekile.

Lapho usebenzisa umuthi, kuyadingeka ukukhawulela ukusetshenziswa kotshwala ngangokunokwenzeka (okujwayelekile ingilazi yewayini elibomvu elomile kanye ngeviki), ngoba i-ethanol ivusa ukuthuthukiswa kwe-glycemia, kanye nokuphazamiseka kofana ne-disulfiram - Ubuhlungu esifundeni se-epigastric, ukuphazamiseka komzimba, ukushisa okuvuthayo emzimbeni ophezulu nasekhanda, ukulahleka ukuxhumanisa, ukukhanda ikhanda, i-palpitations.

Izindleko zemithi nemithetho yokugcina

Ngabe iGlybomet iyabiza emaketangeni ekhemisi? Ngokuya esifundeni, umuthi ungathengwa ngama-ruble angama-200 ukuya kwangama-200. Iphakethe ngalinye le-Glibomet, isithombe salo esingabonakala kulesi sigaba, sinamathebhulethi angama-40.
Ukuze umuthi ungalahlekelwa ukusebenza kwawo, kufanele uvikeleke elangeni eliqondile kanye nomswakama ophezulu.

Izidakamizwa ezifanayo

Uma Glibomed noma ekwelashweni okuyinkimbinkimbi kunganikeli umphumela oyifunayo, kuye kwavela ukungezwani komzimba noma eminye imiphumela emibi, umuthi uthathelwa indawo ngomuthi ohambelana nomuthi ofanelekile osebenzayo.

Kwa-Glibomed, izidakamizwa ezinjalo zingaba amaphilisi we-Diabeteson, isakhi esiyinhloko esisebenzayo lapho kukhona i-glyclazide, noma i-Dimaril, lapho isakhi esisebenzayo siyefana nenye yezakhi ze-Glibomed - glimepiride.

Kwezinye izidakamizwa ezingama-antidiabetic ezinomphumela ofanayo, iGluconorm, iBagomet Plus, iGlucovans, iGlibenclamide ngokuhlanganiswa neMetformin, iGlucofast kubekiwe.I-endocrinologist yenza okunye, izobala nomthamo. Ushintsho kwirejimeni yokwelashwa kungenzeka: ama-analogues anqunywa ekwelashweni okuyinkimbinkimbi nangendlela ye-monotherapy, njengesengezo sokudla okune-carb ephansi kanye nokuzivocavoca umzimba.

Kuyinto 100% engenakwenzeka ukubikezela impendulo yomzimba emithini emisha, ngakho-ke isikhathi sokuqala lalela zonke izinkomba futhi wazise udokotela ngokushintsha kwesisindo okungazelelwe, imalavese evamile, imiphumela yokuhlola i-glycemia nge-glucometer nabanye ebalulekile ngesikhathi sokuzivumelanisa nezinye izindlela zemicimbi.

Ukubuyekezwa kwizici ze-Glibomet

Mayelana nokubuyekezwa kwezidakamizwa kweGlycomet kwabanesifo sikashukela bakhathazeka kakhulu nge-algorithm yokusebenzisa kwayo ukwedlula ukusebenza.

Uma umthamo ukhethwe kahle, izimpendulo ziba zimbi, kwesinye isikhathi kukhona izinkomba zemiphumela emincane emincane. Kepha njengoba lezi zibalo zingabantu ngazinye, ngokusekelwe kwizifundo zomtholampilo kanye nezimpawu zenkinga yesifo esigulini esithile, ukushintshaniswa okuhlangenwe nakho kulokhu akunamsebenzi, futhi ngezinga elithile kuyingozi.

Ukufingqa zonke izinkolelo, singaphetha ngokuthi I-Glibomed umuthi ofanele wokukhetha wokuqala wohlobo 2 lwesifo sikashukela i-monotherapy: izindleko ezingabizi, iphrofayli yokuphepha ephezulu, ukungathathi hlangothi mayelana nesisindo somzimba, umphumela onenzuzo emiphumeleni yenhliziyo nemiphumela ye-oncological.

Vele, ukusetshenziswa kwayo akwenzeki kuwo wonke umuntu (njengazo ezinye izidakamizwa ze-hypoglycemic), kepha umuthi uyahambisana namazinga wesimanje wekhwalithi nokuhambisana.