Ukwelapha uhlobo lwe-2 yesifo sikashukela asikho ekudla okondlayo kuphela, kepha futhi ekudleni okuphoqelekile kwemikhiqizo yokwenziwa efanelekile ngalesi sifo.
Ziyadingeka ukufezekisa amanani ajwayelekile we-glycemia.
Phakathi kwezidakamizwa eziningi ezinikezwa yimakethe yemithi, iziguli zivame ukubekwa amaphilisi eGlibomet.
Imininingwane ejwayelekile mayelana nomuthi, ifomu lokukhipha nokwakhiwa
I-Glibomet ingeyeqembu lezidakamizwa ze-hypoglycemic ezithathwe ngomlomo. Umuthi wenziwa yinkampani yaseJalimane iBERLIN-CHEMIE / MENARINI. Ngaphandle kweGlibomet eRussia, kunemithi engaphezulu kwe-100 yale nkampani ebhalisiwe, esetshenziswa ngenkuthalo ekwelapheni izifo eziningi futhi esivele ikwazile ukuthola ukwethenjwa kweziguli.
Umuthi uthengiswa ngendlela yamathebulethi afakwe ngegobolondo elimhlophe. Ngayinye yazo iqukethe izinto ezi-2 ezisebenzayo nenani elikhulu lezinto ezisizayo.
Ithebhulethi yesidakamizwa iqukethe:
- I-Glibenclamide (2,5 mg) ne-Metformin Hydrochloride (400 mg) yizinto ezibalulekile;
- isitashi sommbila (umsoco) - 57,5 mg;
- i-cellulose (i-polysaccharide) - 65 mg;
- i-silicon dioxide (isengezo sokudla i-E551) - 20 mg;
- i-gelatin - 40 mg;
- I-Glycerol - 17.5 mg;
- i-talc (amaminerali) - 15 mg;
- I-Diethyl phthalate (0.5 mg) ne-2 mg Acetylphthalyl cellulose - equkethe igobolondo yamathebulethi.
Iphakethe lingaba amaphilisi angama-40, 60 noma ayi-100.
I-Pharmacology ne-pharmacokinetics
Ngenxa yezakhi eziqukethwe lapho kulungiswa, umuthi wehlisa inkomba ye-glucose egazini lesiguli.
Isenzo se-pharmacological yento i-Glibenclamide:
- ivusa ukukhululeka kwe-insulin, futhi futhi yenyusa ukukhishwa kwehomoni;
- kunomthelela ekwandeni kokuthambekele kokuthola insulin ekhona emzimbeni;
- kuthuthukisa umphumela we-insulin ngokumelene ne-glucose;
- kubambezela inqubo ye-lipolysis.
Isenzo se-Pharmacological seMetformin:
- kusiza ukwandisa ukuzwela ku-insulin, futhi futhi kuthuthukisa umphumela wayo;
- kwehlisa ukufakwa kwe-glucose emathunjini, ithuthukisa ukumuncwa kwayo ngezinye izitho;
- kunomthelela ekucindezelweni kwe-gluconeogeneis;
- ithinta kahle i-lipid metabolism, okuholela ekunciphiseni isisindo.
Kungenzeka ukufezekisa ukwehliswa kwe-glycemia ngemuva kwepilisi ngemuva kwamahora ama-2 bese ugcine amahora angama-12.
Umphumela we-pharmacological wesidakamizwa ubonakala ngezimpawu zokufakwa, ukusatshalaliswa, i-metabolism kanye nokukhishwa kwezakhi eziphambili.
I-Glibenclamide:
- Inqubo yokwenziwa nokusatshalaliswa. Ukuqoqwa okukhulu kwento kufinyelelwa emahoreni ama-2 ngemuva kokuphathwa. Ingxenye idonswa ngokushesha kusuka emgudwini wokugaya ukudla (ipheshana lesisu). Ukuxhumeka kwento namaprotheni e-plasma kufinyelela kuma-97%.
- Metabolism kwenzeka cishe ngokuphelele esibindini.
- Ukuzala. Ukulawulwa kwalesi senzo kwenziwa izinso. Ukwembiwa kwengxenye kwenziwa kanye nomchamo ne-bile ngomchamo. Ukuqedwa kwesigamu sempilo kuthatha amahora angama-10.
I-Metformin:
- Ukufakwa kanye nokusatshalaliswa kwezicubu zento kwenzeka ngokushesha okukhulu futhi kalula.
- Ukwembiwa kwengxenye emzimbeni kuvela kungashintshiwe ngokusebenzisa izinso namathumbu. Ukuqedwa kwesigamu sempilo kuthatha amahora angama-7.
Izinkomba kanye ne-contraindication ukuze zisetshenziswe
Isidakamizwa sinconywa ukuthi sisetshenziswe isifo sikashukela sohlobo 2, lapho sidla futhi sisebenzisa nezinye izidakamizwa singasebenzi.
Contraindication:
- hypersensitivity kunoma yiziphi izingxenye zomuthi;
- Uhlobo 1 sikashukela;
- indlela yesifo sikashukela;
- i-lactic acidosis;
- ketoacidosis;
- i-coma (hypoglycemic noma hyperglycemic);
- ukulimazeka okukhulu kwezinso;
- i-pathology yesibindi, izinso;
- gangren
- ukuba khona kwezifo ezithathelwanayo;
- ukungenelela kokuhlinzwa, okuhambisana nokulahleka kwegazi okukhulu;
- ukulimala noma ukushiswa;
- noma yisiphi isimo esidinga ukusetshenziswa kokulashwa kwe-insulin;
- i-leukopenia;
- i-porphyria;
- Izinguquko ze-dystrophic;
- ukudakwa kotshwala;
- isikhathi sokuncelisa;
- izingane, intsha engaphansi kweminyaka eyi-18;
- ukukhulelwa
Imiyalo yokusebenzisa nemiyalo ekhethekile
Izibhebhe ziphuza ngomlomo ngokudla. Umthamo wesidakamizwa kufanele ukhethwe udokotela, kucatshangelwa inqubo ye-metabolism yama-carbohydrate kanye ne-glycemia esigulini.
Ukuphuza umuthi uvame ukuqala ngethebhulethi elilodwa. Ngokuya ngemiphumela yokwelashwa, umthamo ungahluka. Inani eliphezulu lamathebulethi avumelekile ngosuku ayi-6, ngoba kuyingozi ukuwaphuza ngomthamo ophakeme. Ukusebenza kahle kwerejimeni yokwelashwa ekhethiwe kunqunywa yinani le-glucose elitholile.
Kubalulekile ukuthi iziguli zilandele izincomo zikadokotela ngokudla okunempilo, indlela yokuphatha kanye nomthamo womuthi. Isifo sikashukela esibolile, indlala, ukusetshenziswa kabi kotshwala, ukungasebenzi kahle kwesibindi, kanye nanoma yikuphi ukuboniswa kwe-hypoxia, amaphilisi kufanele athathwe ngokucophelela ngenxa yengozi ekhona ye-lactic acidosis. Lesi simo singumphumela wokuqongelelwa kwe-metformin, ngenxa yalokho kutholakala i-lactate egazini.
Ukwemukelwa kwemali kubandakanya ukusebenza okuphoqelekile kokuhlolwa kwegazi kwe-creatinine:
- Kanye ngonyaka ngesikhathi somsebenzi wezinso ojwayelekile (ezigulini ezinesifo sikashukela);
- izikhathi ezingaphezu kwezingu-2 ngonyaka kubantu abane-HBV (congenital adrenal hyperplasia) noma ezigulini esezikhulile.
Imiyalo ekhethekile:
- sebenzisa ngokuqapha nge-diuretics;
- Ungawuthathi umuthi ezinsukwini ezimbili ngaphambi kokuhlolwa noma kokuhlinzwa kwe-X-ray okuhleliwe usebenzisa i-anesthesia, ukuyibuyisela esikhundleni se-insulin noma eminye imithi;
- phinda usebenzise ukwelashwa kuphela ngemuva kwamahora angama-48 kusukela esikhathini sokungenelela kokuhlinzwa nangaphansi kwesimo sokusebenza okujwayelekile kwezinso;
- ungaphuzi utshwala kanye nomuthi ukuze ugweme i-hypoglycemia noma ukuvela kokuhlukahluka okumelana nemvelaphi yokudakwa kotshwala;
- umuthi wehlisela izinga lokuphendula kwe-psychomotor, okungathinta kabi ukushayela.
Isifo sikashukela i-mellitus kwesinye sezifo isiguli sinaso. Lapho kukhona amanye ama-pathologies, kubalulekile ukuthatha umuthi ngokucophelela okukhulu.
Iqembu leziguli elikhethekile yile:
- omama abakhulelwe noma abancelayo (umuthi uyaphulwa);
- iziguli ezinenkinga yokusebenza kwesibindi (umuthi uvunyelwe ukusetshenziswa);
- abantu abanezinkinga zezinso (nge-creatinine kusuka ku-135 mmol / l kubantu besilisa nangaphezulu kwe-100 mmol / l kwabesifazane, ukwelashwa kwezidakamizwa akuvunyelwe).
Umuthi awukhuthazwanga ukuthi usetshenziswe yiziguli ezingaphezu kweminyaka engama-60, ngoba lapho zisebenza kanzima, zingakha i-lactic acidosis.
Imiphumela emibi kanye ne-overdose
Ukuthatha umuthi kungadala imiphumela emibi elandelayo:
- maqondana nohlelo lokugaya - ukuhlaselwa isicanucanu nokuhlanza, ukulahleka noma ukulahlekelwa ngokuphelele kwesifiso sokudla, isihlalo sokucasulwa;
- kusuka ohlelweni lokujikeleza kwegazi - i-leukopenia, kanye ne-anemia ne-pancytopenia;
- maqondana nohlelo lwezinzwa, ikhanda;
- ukulunywa, i-urticaria, i-erythema;
- i-hypoglycemia noma i-lactic acidosis;
- ukuzindla kwenhliziyo.
Ngokweqile komuthi, inhlalakahle yesiguli iya ngokuya ikhula, i-hypoglycemia iyakhula. Kulokhu, kufanele udle ama-carbohydrate. Ukuqhubeka kwe-hypoglycemia kungadala ukulahleka kokuzithiba nokwazi. Kulesi simo, isiguli asisakwazi ukudla, ngakho-ke i-glucose ye-intravenous nokunakwa kwezokwelashwa kuyodingeka.
Ukuxhumana neminye imithi kanye nama-analogues
Umphumela we-hypoglycemic wesidakamizwa uyathuthukiswa ngaphansi kwethonya labenzeleli abanjengo:
- Okususelwa kuCoumarin;
- Ama-salicylates;
- Mao inhibitors;
- i-phenylbutazone derivatives;
- Ama-Sulfonamides;
- I-Miconazole;
- Feniramidol;
- I-Ethanol
Ukunciphisa umphumela wokusetshenziswa kwomuthi othinta:
- Glucocorticoids;
- I-Thiazide diuretics;
- izindlela zokuvimbela inzalo (ngomlomo);
- ama-hormone wokugcina indlala yegilo;
- Adrenaline.
Uma i-Glibomet ngesizathu esithile ibingalingani, ziningi izifaniso zayo, ezahlukahlukene ngokwakhiwa nezindleko.
Ama-analogues amakhulu:
- UGalvus Met;
- I-Glimecomb;
- Avandaglim;
- UJanumet;
- Avandamet;
- I-Combogliz.
Kubalulekile ukuqonda ukuthi udokotela kuphela okufanele enze isinqumo mayelana nokufakwa esikhundleni kweGlibomet neminye imithi.
Ividiyo ngezindlela eziyisikhombisa zokunciphisa ushukela wegazi ekhaya:
Imibono yeziguli kanye nezintengo zezidakamizwa
Ukusuka ekubuyekezweni kweziguli, kungaphethwa ngokuthi umuthi kufanele uphuzwe ngokucophelela, ngoba unemiphumela emibi eminingi, kubalulekile futhi ukubonana nochwepheshe ngaphambi kokuthatha umuthi.
Ngiqale ukuphuza umuthi njengokuyalelwa udokotela. Ngosuku lokuqala lokwelashwa, wezwa kabili izimpawu ze-hypoglycemia, yize ukudla kwakhe kungashintshile. Angikwazanga ukuya kudokotela khona lapho, ngakho-ke nganquma ukuthi ngeke ngisaphinda ngayihlola futhi ngabuya nokuthatha amaphilisi angaphambilini.
USvetlana, oneminyaka engama-33
Ngijabule kakhulu ngeGlibomet. Ngosizo lwayo, kungenzeka ukuba kubuyiswe izinga leshukela. Ngemuva kokufunda imiyalo, ekuqaleni wesaba uhlu olukhulu lwemiphumela emibi, kepha wanquma ukwethemba udokotela. Umphumela wajabulisa.
U-Egor, oneminyaka engama-46
Ngonyaka odlule ngithathe la maphilisi. Lo muthi awuzange ungifanele, ngoba ukunambitheka kwensimbi emlonyeni wami kwakukhona ngaso sonke isikhathi futhi kwesinye isikhathi ngangizizwa ngicashile.
UNikita Alexandrovich, oneminyaka engama-65
Ithuluzi lehlisa ushukela kahle, kepha ngesikhathi sokudla kwalo awukwazi ukweqa ngisho nokudla, hhayi njengokudla okuyinhloko. I-Glybomet idinga ukondleka okujwayelekile ukuze kungabikho i-hypoglycemia.
U-Irina, oneminyaka engama-48
Izindleko zomuthi cishe zizi-ruble ezingama-350 zamathebulethi angama-40.
