I-Glimecomb isho izidakamizwa ezisetshenziselwa isifo sikashukela sohlobo 2.
Ithuluzi linempahla ehlangene ye-hypoglycemic.
Ngemuva kokuphuza umuthi, kubukeka njengokujwayelekile kweleveli yeglucose egazini lesiguli.
Imininingwane ejwayelekile, ukwakheka kanye nendlela yokukhululwa
Umuthi ochaziwe ubhekisela kuma-hypoglycemic agents athathwe ngomlomo. Ithuluzi linomphumela ohlanganisiwe. Ngaphezu komphumela wokwehlisa ushukela, i-Glimecomb inomphumela we-pancreatic. Kwezinye izimo, umuthi unomphumela we-extrapancreatic.
Ukulungiselela kuqukethe i-Metformin hydrochloride ngesilinganiso esingu-500 mg no-Gliclazide - 40 mg, kanye ne-excipients sorbitol ne-croscarmellose sodium. Inani elincane, i-magnesium stearate ne-povidone zikhona emithini.
Umuthi uyatholakala ngesimo samaphilisi we-cylindrical in white, cream noma aphuzi shades. Ngamathebhulethi, ukushaywa kolulu kwamukelekile. Amaphilisi anobungozi kanye ne-bevel.
I-Glimecomb ithengiswa kumathebhulethi ayi-10 emaphepheni ama-blister. Iphakethe elilodwa liqukethe amaphakethe ayi-6.
I-Pharmacology ne-pharmacokinetics
I-Glimecomb isidakamizwa sokuhlanganisa esihlanganisa ama-hypoglycemic agents eqembu le-Biguanide ne-sulfonylurea.
Umenzeli ubonakala ngemiphumela ye-pancreatic ne-extrapancreatic.
IGliclazide ingenye yezinto eziphambili zomuthi. Kuyisiqalo sulfonylurea.
Umuthi unomthelela ku:
- ukukhiqizwa kwe-insulin okusebenzayo;
- ukwehla kokuxineka kwegazi glucose;
- ukunciphisa ukunamathela kwe-platelet, okuvimbela ukwakheka kweziqalo zegazi emithanjeni;
- ukulungiswa kwemvelo kwemvume.
I-Gliclazide ivimbela ukuvela kwe-micothrombosis. Ngesikhathi sokusebenza isikhathi eside somuthi ezigulini ezine-nephropathy yesifo sikashukela, kuyabonakala ukwehla kwe-proteinuria (ukuba khona kwamaprotheni kumchamo).
IGliclazide ithinta isisindo sesiguli esithatha umuthi. Ngokudla okufanele ezigulini ezinesifo sikashukela ezithatha i-Glimecomb, ukulahleka kwesisindo kuyaphawulwa.
I-Metformin, eyingxenye yesidakamizwa, ibhekisa eqenjini le-Biguanide. Umuthi wehlisa inani loshukela egazini, usiza ukwenza buthaka inqubo yokufakwa kweglue esiswini namathumbu. I-Metformin isiza ukusheshisa inqubo yokusebenzisa ushukela kusuka izicubu zomzimba.
Umuthi wehlisa i-cholesterol, ama-lipoproteins aphansi. Kulokhu, i-Metformin ayithinti izinga lama-lipoprotein a kwabantu abahlukile. NjengoGlyclazide, wehlisa isisindo sesiguli. Akunamphumela lapho ukungabikho kwe-insulin egazini. Akufaki iqhaza ekubukekeni kokuphendula kwe-hypoglycemic. I-Gliclazide ne-metformin zifakwa ngenye indlela futhi zidonswa esigulini. IGliclazide ibonakala ngokufakwa okuphezulu kakhulu kunokweMetformin.
Inani eliphakeme le-Gliclazide esegazini lifinyelelwa ngemuva kwamahora ama-3 kusukela ngesikhathi sokufakwa komuthi. Umuthi ukhishwa ezinso (70%) kanye namathumbu (12%). Ukuqedwa kwesigamu sempilo kufinyelela emahoreni angama-20.
I-bioavailability yeMetformin ingama-60%. Umuthi uhlangana ngokuphelele kumaseli abomvu egazi. Isigamu sempilo singamahora ayi-6. Ukukhishwa emzimbeni kwenzeka ngezinso, kanye namathumbu (30%).
Izinkomba kanye ne-contraindication
Umuthi uyanconywa kwabanesifo sikashukela abanesifo sikashukela sohlobo 2 uma:
- ukwelashwa kwangaphambilini ngokudla nokuzivocavoca kwakungenampumelelo efanele;
- kunesidingo sokubuyisa ukwelashwa okuhlanganisiwe okwenziwe ngaphambili kusetshenziswa i-Gliclazide ne-Metformin ezigulini ezinamazinga kashukela egazi.
Umuthi ubonakala ngohlu olubanzi lwe-contraindication, phakathi kwalo:
- ukuba khona kwesifo sikashukela sohlobo 1;
- ukungabekezelelani komuntu siqu ezingxenyeni zomuthi;
- umsebenzi wokuphazamiseka kwezinso;
- ukukhulelwa
- ukwehluleka kwesibindi;
- i-lactic acidosis;
- ukwehluleka kwenhliziyo;
- isifo sikashukela;
- ukucaphuka
- izifo ezahlukahlukene;
- infarction myocardial;
- isifo se-porphyrin;
- isifo sikashukela;
- Ukungenelela kokuhlinzwa kwangaphambilini;
- isikhathi sesiguli esenziwa ezifundweni ze-x-ray kanye nezivivinyo sisebenzisa imisakazo ngokwazisa ngezinto ezihlukanisa i-iodine emzimbeni (kwenqatshelwe ukuthatha izinsuku ezi-2 ngaphambi nangemva kwalezi zifundo);
- ukulimala okungathi sína;
- izimo zokushaqeka ngemuva kwesizinda sezifo zenhliziyo nezinso;
- ukwehluleka ukuphefumula;
- ukudakwa kotshwala;
- ushukela wegazi ophansi (hypoglycemia);
- ukutheleleka kwezinso okunzima;
- uphuzo oludakayo;
- ukusha okukhulu emzimbeni;
- ukunamathela ezigulini ngokudla kwe-hypocaloric;
- ukuthatha i-miconazole;
- isifo sikashukela sikashukela.
Imiyalo yokusebenzisa nemiyalo ekhethekile
Umthamo wesidakamizwa ungowomuntu ngamunye esigulini ngasinye. Kunconywa ukuthatha amaphilisi ama-1-3 ngosuku. Ezinsukwini ezilandelayo zokwelashwa, ukwanda komthamo kungenzeka, kususelwa kuzinkomba zikashukela egazini lesiguli kanye nasezingeni lokubonakaliswa kwesifo sakhe. Kwa-Glimecomb, umthamo omkhulu ngamathebhulethi ayi-5 ngosuku.
Umuthi unconywa ukuthi uphuzwe ekuseni nakusihlwa. Umuthi uthathwa ngesikhathi sokudla noma ngemuva kokudla.
Ithuluzi alinconywa kwiziguli ezingaphezu kweminyaka engama-60, zisebenza ezimeni ezinzima zomzimba. Ngokusebenza kanzima nokuthatha i-Glimecomb asebekhulile, i-lactic acidosis ingahle ikhule.
Ukukhulelwa kungenye yezimpawu zokuphuza ukuthatha lo muthi. Lapho ukukhulelwa kwenzeka, kanye nangaphambi kokuhlela kwayo, kuyadingeka ukufaka umuthi esikhundleni sokwelashwa kwe-insulin.
Ukuncelisa amabele kubuye kube ne-contraindication ngenxa yokufakwa okuphezulu kwezakhi zomuthi obisini lwebele. Kuyadingeka ukukhansela okuphakelayo isikhathi sokuthatha i-Glimecomb ngumama noma ukuyeka ukuthatha umuthi uqobo ngesikhathi sokuxunjelwa.
Ngokuqapha, kuyadingeka ukuthatha lo muthi ezigulini ezine:
- umkhuhlane;
- izinkinga ze-yegilo;
- ukungapheleli kwe-adrenal.
Umuthi awuvunyelwe ezigulini ezinezifo zesibindi, kanye nokusebenza kokulimala kwethambo, okuhambisana nokuthuthumela, ukomisa kanye nezinye izehlakalo ezinzima.
Umuthi uthathwa kuphela ngokudla okune-khalori ephansi nokudla okune-carbohydrate ongaphansi. Ezinsukwini zokuqala zokwelashwa, ukulawula ushukela wegazi kuyadingeka. Ukwelapha nomuthi kwenziwa kuphela kulezo ziguli ezithola umsoco njalo.
ISulfonylureas, okuyingxenye yesidakamizwa, ingavusa i-hypoglycemia. Kwenzeka ngokudla okuphansi kwekhalori kanye nokusebenza ngokomzimba. Kuyadingeka ukulungisa njalo umthamo womuthi, ikakhulukazi ezigulini esezikhulile.
I-Hypoglycemia inokwenzeka ezigulini lapho uthatha:
- i-ethyl alcohol;
- izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala.
Ukuzila futhi futhi kwandisa ingozi ye-hypoglycemia ezigulini, nezidakamizwa ezinjenge-reserpine nge-clonidine ziyawugcina.
Ezimweni lapho iziguli zihlinzwa khona, uma zinokushiswa, ukulimala, ukutheleleka ngomkhuhlane kanye ne-myalgia, i-lactic acidosis, ukuyekiswa ngokushesha komuthi kuyadingeka.
Umuthi ungathinta ukushayela. Ukunakekelwa kumele kuthathwe.
Kuyadingeka ukuyeka ukuthatha i-Glimecomb ezinsukwini ezi-2 ngaphambi nangemva kokungena emzimbeni wesiguli i-ejenti ye-radiopaque ene-iodine.
Imiphumela emibi kanye ne-overdose
Phakathi kwemiphumela emibi eyenzeka ngenxa yokusebenzisa umuthi kungenzeka:
- i-hypoglycemia ngokujuluka okukhulu, ubuthakathaka, isiyezi, indlala, nokufelwa;
- i-lactic acidosis nokudinwa, umfutho ophansi wegazi, ubuthakathaka, ubuhlungu besisu, i-myalgia;
- isicanucanu
- i-anemia
- Izinkinga zokubuka;
- i-urticaria;
- i-vasculitis ye-allergic;
- isifo sohudo
- ukulunywa
- i-hemolytic anemia;
- ukulunywa
- i-erythropenia;
- ezimweni ezingavamile, i-hepatitis;
- ukwehluleka kwesibindi.
Izimpawu ezivame kakhulu ze-overdose yi-hypoglycemia kanye ne-lactic acidosis. Zombili lezi zimpawu zidinga ukwelashwa ngokushesha esibhedlela. Kuzona zozimbili lezi zinhlobo, umuthi uyamiswa. Esimweni sokuqala, isiguli sithola ukunakekelwa kwezokwelapha, kwenziwa i-hemodialysis.
Nge-hypoglycemia emnene futhi elinganiselayo, kwanele ukuthi iziguli zithathe isisombululo sikashukela ngaphakathi. Kwisimo esibuhlungu, i-glucose ihanjiswa ngaphakathi kweziguli (40%). Enye indlela ingaba i-glucagon, elawulwa zombili ngokungakhethi nangokuzitholela. Ukwelashwa okuqhubekayo kwenzeka isiguli sidla ukudla okune-carbohydrate eningi.
Ukusebenzisana kwezidakamizwa kanye nama-analog
Umuthi uxhumana neminye imithi kanjena:
- umphumela we-hypoglycemic uyathuthukiswa lapho uthathwa ndawonye ne-enalapril, cimetidine, miconazole, clofibrate, ethionamide, anabolic steroids, cyclophosphamide, tetracycline, reserpine namanye ama-ejenti anomphumela we-hypoglycemic;
- ukunciphisa umphumela we-hypoglycemic lapho kuthathwa ndawonye neClonidine, iPhenytoin, i-Acetazolamide, iFurosemide, iDanazole, iMorphine, iGlucagon, iRifampicin, i-nicotinic acid edamini enkulu, i-estrogen, usawoti we-lithium, izindlela zokuvimbela inzalo ngomlomo;
- ukusetshenziswa okufanayo ne-nifedipine kubambezela ukuhoxiswa kwe-metformin;
- ukusebenzisana ngokubambisana nezidakamizwa ze-cationic kwandisa ukukhuphuka okuphezulu kwe-metformin egazini ngamaphesenti angama-60;
- kwandisa ukugcwala kokubambisana kwe-metformin umuthi nge-furosemide.
I-Glimecomb ine-analogues kanye namagama womqondo owodwa:
- UGlidiab;
- Glyformin;
- I-Glidiab MB;
- Ukwanda kwesikhathi;
- I-Metglib;
- IFommetin;
- Glyclazide MB;
- Diabetesalong;
- I-Gliclazide-Akos.
Iphilisi levidiyo likhombisa izimpawu nokwelashwa kwesifo sikashukela:
Imibono yongoti neziguli
Ukusuka kwezibuyekezo zeziguli, singaphetha ngokuthi i-Glimecomb yehlisa kahle ushukela wegazi futhi ibekezelelwa kahle, nokho, odokotela bayaphikelela ekuqapheliseni kwayo ngenxa yemiphumela emibi eminingana.
I-Glimecomb iyindlela ephumelelayo yokwelapha isifo sikashukela sohlobo 2. Kepha uma unikezwe leyo mibiko eminingi, kuyanconywa ukuthi kunqunyelwe ngokuqapha ezigulini eziningi. Ikakhulu asebekhulile.
U-Anna Zheleznova, oneminyaka engama-45 ubudala, udokotela wobuchopho
Umuthi omuhle wokulawula ushukela wegazi. Ngayithatha inyanga eyodwa, kwakungekho miphumela emibi, noma ngabe miningi yayo emiyalweni. Kujabuliswe ngentengo.
Uthando, iminyaka engama-57
Sekuphele isikhathi eside ngihlaselwa isifo sikashukela sohlobo 2. Ngiyayamukela i-Glimecomb. Umuthi muhle futhi awubizi kakhulu. Yehlisa ushukela kahle. Into esemqoka ukuthi udle kahle futhi udle ngendlela efanele.
U-Alexandra, oneminyaka engama-51
Umuthi ochaziwe usatshalaliswa ngumbhalo. Izindleko zayo zisukela kuma-ruble angama-440-580. Intengo yabanye ozakwabo basekhaya isuka kuma-ruble angama-82 kuye kwangama-423.
