I-Galvus Met - imiyalo ephelele yokusetshenziswa, ukubuyekezwa kwabanesifo sikashukela nodokotela

IGalvus Honey ingumuthi wokudidiyela odidiyelwe onamakhono we-hypoglycemic pharmacological. Kwenzelwe ukujwayeza i-glycemia ku-diabetics ngohlobo lwesibili lwesifo. Umuthi ulawula ngamandla amandla we-insulin ne-glucagon.

I-European Medical Association ikholelwa ukuthi uGalvus Honey uphumelela kakhulu ukwedlula owandulelayo, uGalvus, okululekwa ukuthi usebenzise kuphela ukungabekezelelani komuntu nomuntu nge-metformin.

Incazelo yefomu lomthamo

Kwinethiwekhi yamakhemisi, umuthi unikezwa ngendlela yamathebulethi ehlanganisiwe; ngalinye lazo liqukethe izithako ezimbili ezisebenzayo: 50 mg we-vildagliptin no-500, 850 noma u-1000 mg we-metformin. I-Magnesium stearate, hyprolose, hypromellose, talc, titanium dioxide, macrogol 4000 ne-iron oxide asetshenziswa njengamafilitha.

Ihlamvu ngalinye liqukethe amaphilisi ayi-10. Amapuleti afakwe emabhokisini ezincezu ezi-3, iphakethe ngalinye i-Galvus Met inemiyalo.

• 50/500 mg - amaphilisi okusaqanda onqenqemeni obukhali egobolondweni le-hue ephuzi-epinki. I-LLO ifingqiwe ohlangothini olulodwa ne-NVR emuva.
• 50/8 mg - Ukwakheka kwethebhulethi efanayo, igobolondo kuphela eliphuzi futhi ukumaka kufanelekile: SEH ngakolunye uhlangothi ne-NVR kolunye.
• 50/1000 mg - Izibhebhe ezihlukile kohlobo lwangaphambilini emthunzini ophuzi kakhudlwana ngokufakwa okumpunga nokufinyezwa: I-NVR - ngaphambili futhi uFLO - ngemuva.

Amathuba wemithi

Amandla we-hypoglycemic yesidakamizwa atholakala ngezinhlobo ezimbili zezakhi eziyisisekelo, ngayinye yazo inendlela yayo yokwenza. Amandla abo ayinkimbinkimbi akuvumela ukuthi ulawule ngokuthembekile i-glycemia phakathi nosuku.

1. I-Vildagliptin - inhibitor ye-dipeptidyl peptidase-4 (DPP-4) - ithuthukisa ukuzwela kwamangqamuzana ukuya ku-insulin, ikhulisa ukukhiqizwa kwayo. Lo mphumela unikezwa ukukhuthaza kwezinhlobo ze-glyptin zokukhiqizwa kwamaprotheni abalulekile kuma-pancreas - uhlobo lwe-glucagon-like peptide 1 (GLP-1) ne-glucose-insulinotropic polypeptide (HIP).
2. I-Metformin, okuyinhlanganisela yeqembu le-hydrochloride biguanide, yenza indices ye-glycemic yehlise isilinganiso sokufakwa kwe-carbohydrate emathunjini amancane, inciphise ukukhiqizwa kwe-glycogen esibindini futhi ithuthukise ukusetshenziswa kwayo kwezicubu ezithambile. Isakhiwo singadala i-hypoglycemia.

Ngokusetshenziswa komuthi umuthi, i-vildagliptin ne-metformin zingena egazini ngokusebenzisa udonga lwamathumbu, zifinyelela esimweni sezokwelapha ngemizuzu engama-25 kuya kwengama-30 futhi zisatshalaliswe ngokulinganayo ngaphezulu kwezitho nezicubu. Izinqubo ze-metabolic ze-metabolite zeGalvus Met zenzeka esibindini. Bola imikhiqizo emihle yezinso ngomchamo. Isikhathi sokuphumula lapho kukhonjiswe khona uhhafu wesimo esetshenzisiwe cishe amahora amathathu.

Ngesikhathi sokwelashwa okuyinkimbinkimbi ngezidakamizwa ezimbili ngesilinganiso semihla ngemihla se-metformin 1500-3000 mg ne-vildagliptin 50 mg, kusatshalaliswe ngaphezulu kwezicelo ezi-2, ukwehla okukhulu koshukela begazi kwabhalwa ngaphezulu konyaka. Ngesikhathi esifanayo, indices ye-glycosylated hemoglobin yehle ngo-0.7%, uma uyiqhathanisa neqembu lokulawula, elithole kuphela i-metformin.

Kwabanesifo sikashukela abebesezokwelapha eziyinkimbinkimbi zeGalvus Metom, ukulungiswa kwesisindo esibalulekile akuzange kubhalwe phansi. Ngaphezu kwamaviki angama-24 ukusetshenziswa kwezidakamizwa, ukwehla okukhulu komfutho wegazi kuvezwe ezigulini ezinesifo sikashukela sohlobo 2 sikashukela. Amacala we-Hypoglycemic aqopha inombolo encane.

Lapho uGalvus Meta enqunywe ngesikhathi sokwelashwa nge-insulin (umthamo wamayunithi angama-41) ezindaweni zokuzithandela ezinesifo sikashukela ezibamba iqhaza ocwaningweni, izinga le-glycosylated hemoglobin lehle ngo-0.72%. I-Hypoglycemia eqenjini elingaphansi lokuhlola naseqenjini le-placebo lalingafani nokuvama kwamacala.

Ngokusebenzisa okufanayo kwe-glimepiride (kusuka ku-4 mg / ngosuku) neGalvus Met, ukwehla okukhulu kwe-hemoglobin ye-glycosylated nakho kwaqoshwa - ngo-0.76%.

Izici ze-pharmacokinetics

I-Vildagliptin

Uma uthatha amaphilisi ngaphambi kokudla, isithako esisebenzayo simunwa ngokushesha, sifinyelela esiphezulu ngemuva kwemizuzu engu-105 ngemuva kokungenwa. Lapho usebenzisa umuthi ngokudla, isilinganiso sokumunca sincipha kancane.

I-bioavailability ephelele yesidakamizwa iphakeme impela - 85%. Ukusatshalaliswa kwe-metabolite phakathi kwe-plasma ne-erythrocyte kuyafana, kubopha ngokungatheni iprotheni yegazi - kuphela ama-9.3%.

Indlela eyinhloko yokuqedwa kwezidakamizwa yi-biotransformation, i-69% yomthamo emzimbeni uphenduka ube yi-metabolite engasebenzi ye-chemacologic. Ukuphuma kwe-vildagliptin kwenzeka ngokusebenzisa izinso (85%) namathumbu (23%).

Abamele izinhlanga ezahlukahlukene, owesilisa noma owesifazana, wezisindo ezahlukene zomzimba bakhombisa cishe i-pharmacokinetics efanayo yomuthi.

Ngokuntuleka kwe-hepatic kwifomu emnene noma elinganiselayo, i-bioavailability ye-vildagliptin yehlela ku-20%, ifomu elinamandla ikhuphuka ngo-22%.

Nge-pathology ye-renal, izinhlobo ezimnene, ezilinganiselayo neziqinile ze-AUC, i-vildagliptin ikhula amahlandla ayi-1,4 kuye kwayi-2.

Imiphumela ye-vildagliptin kuma-pharmacokinetics wezingane ayifundwanga.

I-Metformin

Kumthamo we-500 mg, i-bioavailability ye-metformin ingu-50-60% uma uthathwe ngaphambi kokudla. Ngomthamo owandayo, inkomba inyuka ngokulinganayo. Uma uthatha umuthi ngokufana nokudla, i-bioavailability iyancipha.

Ngomthamo owodwa, i-metabolite cishe ayibophele amaprotheni e-plasma (uma uqhathanisa, amalungiselelo e-sulfonylurea abopha ukuya ku-90%). Ngokusetshenziswa isikhathi eside, umuthi ungena kancane kancane emangqamuzaneni abomvu egazi.

Ukufakwa imijovo okulingene emzimbeni kwesivolontiya esinempilo kubonise ukumbiwa okujwayelekile kwezinso ekwakhekeni okufanayo. Awekho ama-metabolites atholakala esibindini. Ku-diabetes, kuze kufike ku-90% wemishanguzo esetshenzisiwe ikhishwa yizinso kungakapheli amahora angama-24.

Ukwehluka kobulili akuthinti ama-pharmacokinetics omuthi. Ama-diabetesics ezinhlanga ezahlukahlukene aqopha ukusebenza okufanayo kwe-metformin.

Izici zokufakwa, ukusatshalaliswa kanye nokuqedwa komuthi ezigulini ezine-pathologies zesibindi azifundiswanga. Nge-pathology ye-renal, i-Half-life iyanda. Ngenxa yokwehla kwezinga lezinso ezigulini ezivuthiwe, imiphumela efanayo iyabonakala. Akukho datha emiphumeleni yesidakamizwa emiphumeleni yokwelashwa ezinganeni.

Uboniswa ngubani umuthi

Inhlanganisela yakhelwe ukwelapha abanesifo sikashukela ngohlobo 2 sikashukela. Ngokusekelwe kwi-Galvus Meta, kunezindlela ezahlukahlukene zokwelapha.

1. I-Monotherapy - ukulungisa ushukela ngokwejwayelekile, basebenzisa umuthi owodwa - uGalvus Met.
2. Ukusetshenziswa okuhlukile kwezakhi ezisebenzayo zeMetformin neVildagliptin njengezidakamizwa ezizimele.
3. Ukwelapha okuhlanganayo ngokuhambisana nokutholakala kwe-sulfanylurea.
4. Isikimu esiphindwe kabili ngokufakwa kwe-insulin ku-Galvus Meta.
5. Njengomuthi wolayini wokuqala osetshenziswa ekuqaleni kokwelashwa kwezidakamizwa, lapho ukudla okune-carb ephansi nemithambo yemisipha ekhanyayo kungaholeli kumphumela oyifunayo.

Ukwelashwa kwe-Galvus metome komama abakhulelwe futhi abakhulelwe

Ukuhlolwa kwezilwane ezikhulelwe, ezaziphiwa imithamo ye-vildagliptin ephindwe izikhathi ezingama-200 kunokwejwayelekile, kukhombisile ukuthi umuthi awephuli ukuthuthukiswa kombungu futhi awunamphumela we-teratogenic. Ukusetshenziswa kukaGalvus Meta kumthamo ka 1/10 kubonise imiphumela efanayo.

Umphumela wesidakamizwa esibelethweni somuntu awukafundiswanga ngokwanele, ngakho-ke, abesifazane abakhulelwe ababekiwe. I-Metformin idlulela kubisi lwebele; akukho datha ekungeneni kwe-vildagliptin.

Ngokuvamile, iGalvus Met ayisetshenziselwa ukuncelisa ibele.

Kuqondiswe kubani kuye i-ejenti ye-hypoglycemic

Ama-pathologies lapho i-metabolite ingabekiwe khona:

• Ukungatheleleki komuntu ngamunye, i-hypersensitivity kunoma yiziphi izingxenye zemithi;
• Uhlobo 1 sikashukela - onesifo esincike e-insulin yaleli fomu, i-insulin iyadingeka;
• Izinsuku ezimbalwa ngaphambi kokuhlinzwa, i-X-ray kanye nokuhlolwa kwe-radioisotropic, ukuxilongwa okuhlaselayo;
• I-acetonemia ingukuphazamiseka kwemetaboliki okubonakala ngokubonakala kwezidumbu ze-ketone kuketshezi lwezinto eziphilayo, ikakhulukazi lokhu kwenzeka nge-hyperglycemia;
• I-Renal pathologies (kwifomu elibi noma elingamahlalakhona), izinqubo ezikhuthaza ukomisa - ukopha okucashile komzimba ngenxa yohudo noma ukugabha kaningi, umkhuhlane, ukutheleleka (sepsis, izifo zesistimu yokuphefumula);
• Ukudonswa kwesibindi okuhambisana nezimo ezinciphisa ukusebenza kwawo (cirrhosis, hepatitis);
• Isifo senhliziyo, ukushaya kwenhliziyo, ukuphefumula komoya;
• I-Alcoholism njengesifo noma ukudakwa okukodwa;
• Isondlo se-Hypocaloric, lapho kufika ku-1000 kcal / usuku olungena emzimbeni .;
• Noma yisiphi isikhathi sokukhulelwa nokuqunjelwa;
• Izingane - ukuphepha kanye nemithi yokwelashwa akukasungulwa.

Ungawusebenzisa kanjani umuthi

Ithebhulethi kufanele igwenywe ngokuphelele, ngaphandle kokuhlafuna noma ukuncibilikisa, igezwe ngenani elanele lamanzi emazingeni okushisa athambile. Uma uphuza iphilisi ngokudla, ubungozi bemiphumela emibi buyancishiswa.

Imithamo ka-Galvus Meta incike kubungako isinxephezelo sikashukela, imiphumela yokwelashwa kwangaphambilini nge-analogues, kanye nobude besifo. Kunoma ikuphi, uhlelo lokwelashwa udokotela.

Uma umuthi unqunyelwe okokuqala, njengesengezo ekudleni okungasebenzi kahle nokuzivocavoca umzimba, ukujwayelekile kwawo kuzoba ngu-50/500 mg (inkomba yokuqala yi-vildagliptin, owesibili yi-metformin). Ngokuzayo, ngokungasebenzi okwanele kokulapha, okunqunywa izindlela zelebhu, umthamo ungalungiswa.

Lapho isiguli sesivele sazi imishanguzo (wasiphuza ngokwehlukana noma kwesinye inhlanganisela), batusa enye yezinketho - 50/8 mg noma 50/1000 mg.

Eminyakeni yokuvuthwa noma nge-pathologies yezinso ekhulayo, umthamo omncane uvame ukunconywa.

Ukuhlola umphumela wokwelashwa kweGalvus Metom, kuyadingeka ukuthi uhlole izinga loshukela (kokubili ekhaya, nge-glucometer, nelabhorethri) njalo.

Imiphumela emibi

Imiphumela engathandeki ayirekhodwa kaningi, kepha kuyadingeka ukutadisha uhlu ngaphambi kokusebenzisa ushukela.

1. Ipheshana esiswini - ukuphazamiseka kwe-dyspeptic, ukushisa kwenhliziyo, i-pancreatitis, ukunambitheka kwensimbi emlonyeni, ukumuncwa kabi kwe-vithamini B12.
2. I-CNS - ukulahleka kokuxhumana, ikhanda, izandla eziqhaqhazelayo.
3. Isibindi ne-bile ducts - ukuvuvukala kwesibindi nokuqina kwesibindi.
4. Uhlelo lwe-musculoskeletal - Ubuhlungu obuhlangene nomsipha.
5. Isikhumba - amabhulukwe, ukuvuvukala, isikhumba esomile.
6. I-Metabolism - i-lactic acidosis (ukukhuphuka kokuhlushwa kwe-uric acid, ukusabela kwe-acidic kwemvelo).
7. Ukungezwani komzimba - ukuqubuka kwesikhumba, ukulunywa, i-urticaria; ekuphendukeni okukhulu - i-edema ye-angioedema Quincke (ukuvuvukala kobuso nezitho zangasese) kanye nokuqhaqha kwe-anaphylactic (ukwehla okubukhali kwengcindezi yegazi, okuxhaswa ukwehluleka kwezitho eziningi).

   
   

Kwesinye isikhathi i-hypoglycemia iba nemiphumela yokujuluka kwamakhaza, izandla eziqhaqhazelayo. Ezimpawu zokuqala, udinga ukuphuza uhhafu wengilazi yetiye noma ujusi, udle uswidi.

Imiyalo ekhethekile

Lapho enquma umuthi, isifo sikashukela kudingeka sifunde imiyalo uqobo. Imiyalo ekhethekile izosiza ukugwema imiphumela emibi.

• IGalvus Met akuyona i-analogue ye-insulin, kubalulekile, okokuqala, kubantu abanesifo sikashukela abanesifo sikashukela esincike ku-insulin.
• Ekwelashweni nomuthi, kudingeka ukuthi kuqashelwe njalo ushukela wegazi (elebhu kanye nelomuntu ngamunye, kusetshenziswa i-glucometer).
• Inyanga ngayinye, izindlela zaselabhorethi zihlola isimo sezinso, isibindi kanye nokuxineka kwe-lactic acid.
• Ngesikhathi sokulashwa, iGalvus Metom ayemukeleki ukuphuza utshwala - lokhu kungaba nomthelela ekwakheni i-lactic acidosis.
• Ukutholwa kabi kwe-Vitamin B12, okubangelwa ukusetshenziswa komuthi, kungavusa i-anemia ne-neuropathy.
• Izingane, omama abakhulelwe nabakhanyayo uGalvus Met abemukeli.
• Izakhi ezisebenzayo ze-metabolite zisebenzisana nezidakamizwa eziningi, lapho wenza irejista yokwelashwa, udokotela kufanele aziswe ngayo yonke imishanguzo ethathiwe.
• Umphumela we-Galvus Meta ekuphendukeni kwe-psychomotor kanye nezinga lokugxilisa ukunakwa alifundwanga. Lapho usebenza ngemishini nemishini ngesikhathi sokwelashwa nomuthi, umuntu kufanele aqaphele kakhulu.

Ukweqisa

Uma umthamo onconyiwe udlulwa kaningi, i-myalgia, hypoglycemia, ukuphazamiseka kwengqondo, i-edema yamaphethelo, i-lactic acidosis (kusuka ngokweqile kwe-metformin). Izimpawu ze-overdose ziyanyamalala ngemuva kokuyeka ukwelashwa.

Ngezimpawu ezinjalo, umuthi uyakhanselwa, ugezwe ngepheshana lesisu futhi ukwelashwa okubonakalayo kuyenziwa. Usebenzisa i-hemodialysis, yi-metformin kuphela engadedelwa ngokuphelele, i-vildagliptin isuswe ngokwengxenye.

UGalvus Met - izazi

Uma siqhathanisa ukwakheka nemiphumela yokwelashwa, khona-ke ngokwezinto ezisebenzayo kanye nokusebenza kahle kokulapha, ama-analogues angaba:

• I-Nova Met;
• I-Sofamet;
• Trazenta;
• Methadiene;
• IFomu Pliva.

Izincomo zokugcina nezindleko zemithi

Ngokwemiyalo, iGalvus Met ilungele ukusetshenziswa kungakapheli izinyanga eziyi-18 kusukela ngosuku lokukhishwa, ngokuya ngesitoreji esifanele. Umuthi ophelelwe yisikhathi kumele ulahlwe. Indawo emnyama neyomile engenakufinyeleleka ekunakekelweni yizingane kufanelekile ukugcinwa, ngezimo zokushisa zifinyelela ku-30 ​​° C.

Uyakhishwa umuthi onikezwa umuthi. Kwi-Galvus Met, umthamo unqunywa umthamo:

1. I-50/500 mg - isilinganiso sama-ruble ayi-1457;
2. I-50/8 mg mg - isilinganiso sama-ruble ayi-1469;
3. 50/1000 mg - isilinganiso sama-ruble ayi-1465.

Noma kusetshenziswa kanye usuku nosuku, akubona bonke abanesifo sikashukela abanelisekile ngale ndleko, iningi labo elikhononda kubahola impesheni ngemholo elincane. Kodwa-ke, imikhiqizo yenkampani yaseSwitzerland i-Novartis Pharma ihlala ihlukaniswa ngekhwalithi yabo enhle, futhi ayiyona ingxenye yesabelomali sabenzeli be-hypoglycemic.

UGalvus Met - ukubuyekezwa kwabanesifo sikashukela nodokotela

Emaforamu atholakalayo, ama-endocrinologists aphendula kahle ngemiphumela yokwelashwa kweGalvus Metom. Akunconywa ukuyinikeza ezinkingeni ze-oncological, ngoba i-DPP-4, i-enzyme ecindezela ukuthuthukiswa kwe-neoplasms, ivinjelwe nguGalvus Metom. Kumdlavuza we-pancreatic, i-insulin ivame ukunqunywa. Ukubuyekezwa kweziguli ngeGalvus Mete kuxutshwe, isihloko esikhulu sengxabano yikhwalithi yentengo.

Imininingwane mayelana nomuthi i-Galvus Met ehlanganiswe nemiphumela ye-hypoglycemic ku-insulin ne-glycogen emzimbeni isuselwe kwimiyalo esemthethweni, kepha ihlinzekelwe imininingwane kuphela futhi ayinakuba yinkomba yokuxilongwa noma ukuzelapha.