Hypoglycemic tablets Glybomet: cov lus qhia rau kev siv

Qhov tshuaj pleev ntshav pleev rau qhov muag tshuaj no yog tsim nyob rau hauv daim ntawv puag ncig dragees ntawm ib qho ntxoov ntxoo dawb. Txhua lub ntsiav tshuaj Glibomet muaj cov tshuaj metformin hydrochloride thiab glibenclamide, uas ua haujlwm ua haujlwm. Ntu cov khoom xyaw yog gelatin, MCC, sib xyaw ua kua silica, pob kws hmoov txhuv nplej siab, magnesium starate, glycerin, diethyl phthalate, cellulose acetate phthalate thiab talc.

Txhawm rau noj tshuaj hypoglycemic Glybomet, cov lus qhia rau kev siv qhia tshwj xeeb yog tias monotherapy nrog tshuaj noj ntawm qhov ncauj lossis kev noj zaub mov kom tsis muaj txiaj ntsig rau kev kho mob tsis muaj tshuaj insulin-tiv thaiv hom 2 mob ntshav qab zib mellitus. Ntxiv rau, cov chaw tsim khoom lag luam pom zoo muab tshuaj rau cov ntsiav tshuaj no nrog kev txo qis rhiab rau sulfonylureas vim yog lawv siv sijhawm ntev.

Raws li rau qhov tsis xav tau thiab cov mob tshwm sim, cov tsos mob uas feem ntau tuaj yeem tshwm sim los ntawm kev noj Glybomet ntsiav tshuaj, qhov kev pheej hmoo ntawm hypoglycemia, cholestatic jaundice lossis kab mob siab yuav tsum tau hais qhia ntawm no ua ntej. Ib qho ntxiv, qee tus neeg siv cov cuab yeej no yuav muaj kev mob xws li ntuav, mob taub hau, tsis muaj zog, tsis hnov mob, khaus, paresis, mob leeg, mob megaloblastic lossis hemolytic anemia, mob pob qij txha.

Glybomet - muaj pes tsawg leeg

Kev sib xyaw ua ke hauv txhua cov ntsiav tshuaj ntawm ob lub tebchaw sib xyaw - metformin hydrochloride (400 mg) thiab glibenclamide (2.5 mg) ua rau nws tsis tsuas yog tswj tau glycemia, tab sis kuj tseem txo cov koob tshuaj ntawm cov feem no. Yog tias txhua tus ntawm lawv tau siv rau kev kho mob monotherapy, txoj kev noj tshuaj yuav ntau dua.

Nws muaj cov mis thiab cov neeg tsis paub nyob rau hauv daim ntawv ntawm cellulose, pob kws hmoov txhuv, colloidal silicon dioxide, gelatin, glycerin, talc, magnesium stearate, acetylphthalyl cellulose, diethyl phthalate.

Cov yam ntxwv ntawm Pharmacological

Ib qho ntawm cov khoom xyaw tseem ceeb, glibenclamide, yog tshuaj ntawm cov tub ntxhais tshiab tiam sulfonylurea, suav nrog hauv cov npe ntawm cov tshuaj tseem ceeb nrog pancreatic thiab muaj peev xwm ntxiv.

Nws tsis tsuas yog txhawb cov kev ua haujlwm ntawm tus txiav ua kab plaub hau tag nrho, tab sis kuj txhim kho kev tsim cov tshuaj insulin endogenous. Lub tshuab ntawm lawv cov haujlwm yog ua raws li kev tiv thaiv ntawm pancreatic cells-cov hlwb puas los ntawm kev ua rau cov ntshav qabzib, uas txiav txim qhov kev nce qib ntawm cov ntshav qab zib, thiab kev ua kom muaj zog ntawm insulin rhiab heev ntawm cov phiaj hlwb.

Noj Glibomet hauv parallel nrog glycemic tswj txhim kho lipid metabolism thiab txo kev pheej hmoo ntawm cov ntshav txhaws. Cov kev ua ub no ntawm insulin nce, thiab nrog nws nqus ntawm cov piam thaj los ntawm cov leeg nqaij thiab lub siab. Cov tshuaj yog nquag nyob rau theem ob ntawm insulin ntau lawm.

Metformin belongs rau biguanides - chav kawm ntawm cov tshuaj lom uas ua rau txo lub cev tsis muaj zog ntawm qhov muag dig muag rau lawv tus kheej insulin. Rov qab rhiab heev tsis muaj qhov tseem ceeb tshaj qhov txhim kho kev zais cia ntawm lub cev, vim tias muaj ntshav qab zib hom 2, cov txiav ua nws txawm tias dhau mus.

Metformin pab txhim kho ntxiv rau txoj kev sib cuag ntawm receptors thiab insulin, ua rau kom cov kab mob postreceptor zoo dua. Thaum tsis muaj cov tshuaj insulin hauv cov hlab ntshav, kev kho mob tsis ua rau pom tseeb.

Metformin muaj qhov tshwj xeeb:

Nws ua rau qeeb qis nqus ntawm cov piam thaj los ntawm lub plab hnyuv phab ntsa thiab pab nws siv nyob rau hauv cov ntaub so ntswg,
Txwv tsis pub gluconeogenesis,
Tiv thaiv cov b-cell los ntawm kev ua kom sai apoptosis,
Txo qhov kev pheej hmoo ntawm ib hom acidosis thiab mob hnyav,
Txhim kho microcirculation ntawm kua, ua haujlwm ntawm endothelial thiab cov roj metabolism (txo qhov kev xav ntawm cov "teeb meem" cov roj cholesterol thiab triglycerol hauv cov ntshav),
Cov hnyav ua rau yuag yuag - ib qho tseem ceeb rau kev tswj tau zoo glycemic hauv hom 2 DS,
Txo ntshav txhaws thiab oxidative kev nyuaj siab,
Nws muaj cov nyhuv fibrinolytic los ntawm kev ua kom cov nqaij plasminogen activator,
Nws inhibits oncological cov txheej txheem (feem ntau, ntshav qab zib nce qhov kev pheej hmoo ntawm oncology los ntawm 40%),
Txo txo txoj kev pheej hmoo ntawm kev tuag los ntawm cov kab mob plawv.

Kev rov qab tshuaj xyuas txog 5800 tus neeg mob ntshav qab zib nrog hom ntshav qab zib hom 2 tau ua hauv Suav teb. Cov neeg koom nrog sim tau txais metformin hauv kev sib xyaw ua ke nrog kev ua neej hloov kho. Hauv pawg tswj hwm, cov neeg ua haujlwm pab dawb tsuas hloov lawv txoj kev ua neej. Rau 63 lub hlis, hauv thawj pab pawg, kev tuag yog 7,5 tus neeg hauv 1000 tus neeg / xyoo, hauv ob - rau 45 lub hlis, ntsig txog 11 tus neeg.

Cov tshuaj pib ua haujlwm ob teev tom qab nkag mus rau txoj hlab pas, nws txoj kev ua haujlwm yog tsim rau 12 teev. Metformin tsis ua rau kev hem thawj qhov tsis zoo. Cov tshuaj nrog cov pov thawj loj, tau dhau qhov kev sim ntawm lub sijhawm thiab yuav tsum muaj ntshav qab zib nyob rau txhua theem ntawm kev siv tshuaj kho ntau ntxiv.

Niaj hnub no, lub khw muag tshuaj muaj 10 cov tshuaj tiv thaiv kab mob siab, tab sis metformin tseem yog qhov tseem nrov tshaj plaws rau kev kho mob ntshav qab zib hom 2 ntawm txhua theem ntawm tus kab mob.

Kev sib xyaw ua ke ntawm ob qho kev nquag ua ke ntawm Glibomet muaj qhov cuam tshuam txog lub cev.

Cov nyhuv txiav nyhuv - cov tshuaj txo qhov "dig muag" ntawm cov hlwb, txhawb kev zais ntawm nws tus kheej insulin, thiab tiv thaiv b cell.
Cov nyhuv tshwj xeeb-txiav txim siab - biagudin cuam tshuam ncaj qha rau cov leeg nqaij thiab cov nqaij rog, txo qis gluconeogenesis, nce qhov feem pua ntawm cov piam thaj tag nrho.

Cov qib siab zoo ntawm qhov sib piv ntawm cov sib npaug ntawm cov tshuaj nquag yuav hloov kho ntau npaum ntawm cov tshuaj. Rau cov b-cell, xws li kev txhawb nqa sparing yog qhov tseem ceeb heev: nws nce kev nyab xeeb ntawm cov tshuaj, txo qhov kev pheej hmoo ntawm kev ua haujlwm tsis zoo, thiab txo qhov muaj feem ntawm cov kev mob tshwm sim.

Muaj peev xwm ntawm Pharmacokinetic

Glybenclamide los ntawm kev mob plab hnyuv tau nqus thiab muab faib tau zoo heev - los ntawm 84%, cov nyhuv siab tshaj plaws ntawm cov tshuaj tuaj yeem pom tom qab 1-2 teev. Kev tivthaiv khi ua kom cov ntshav tawm los ntawm 97%.

Glibenclamide metabolism tshwm sim hauv daim siab, qhov uas nws hloov pauv kiag rau hauv kev siv tshuaj tiv thaiv kab mob. Ib nrab ntawm cov khoom uas tau siv mus rau hauv lub raum, lwm qhov ib nrab los ntawm cov kua tsib. Ib nrab-lub neej nyob rau nruab nrab 10 teev.

Metformin yog qhov ua tiav rau lub plab zom mov, yog muab faib sai sai rau cov plab hnyuv siab raum thiab cov ntaub so ntswg, tsis khi rau cov ntshav protein txhua. Lub bioavailability ntawm lub feem tiv thaiv li ntawm 50-60%.

Feem ntau, qhov siab tshaj plaws ntawm cov khoom xyaw ntawm cov qauv hauv cov ntshav tshwm sim ib teev lossis ob teev tom qab noj cov ntsiav tshuaj.

Kev qhia rau kev kho mob nrog Glybomet

Cov lus qhia tseem ceeb tau qhia tias cov tshuaj tau tawm rau cov ntshav qab zib hom 2, suav nrog cov tshuaj ntshav qab zib-insulin, yog tias muaj kev noj zaub mov tshwj xeeb, kev siv lub cev ua si thiab lwm cov tshuaj hypoglycemic tsis muab qhov tshwm sim los.

Ntau cov tshuaj muaj cov txiaj ntsig ntxiv, yog tias lub cev tsis teb rau kev kho kom zoo, lawv hloov cov kev kho tus mob los ntawm kev sau ntawv ntawm Glibomet hauv cov ntsiav tshuaj.

Rau leej twg cov kev kho yog contraindicated

Txij li thaum cov tshuaj muaj qhov cuam tshuam rau qhov teeb meem, nws tsis yog qhov ceeb uas nws muaj kev txwv txaus rau kev nkag mus.

Cov tshuaj tuaj yeem ua rau txaus ntshai:

Nrog tus mob ntshav qab zib gestational,
Yog tias tus neeg mob tau mob siab rau cov khoom sib xyaw ntawm cov qauv,
Tus mob ntshav qab zib nrog rau thawj hom mob,
Nrog mob ntshav qab zib coma thiab ciam teb teeb meem, Yuav noj li cas Glibomet

Muaj cov kev txwv ntawm kev noj cov Glibomet:

Nrog pathologies ntawm lub qog gland,
Yog hais tias tus neeg mob tau kub taub hau,
Thaum muaj keeb kwm los ntawm hypofunction ntawm lub pituitary cortex thiab qog adrenal.

Qhov ntau thiab tsawg yog txiav txim los ntawm tus kws endocrinologist raws li tus neeg mob lub hnub nyoog thiab cov kws kho mob, tab sis cov neeg tsim khoom lag luam pom zoo pib nrog ob ntsiav tshuaj txhua hnub, ib txwm txeeb cov tshuaj. Qhov ntau kawg ntawm cov tshuaj yog 2 g / hnub. Nws raug nquahu kom faib txoj kev txais tos nyob rau ntawm qhov tsis tu ncua. Yog tias qhov nyiaj no tsis muaj qhov xav pom tshwm sim, kev kho mob nyuaj tau hais nrog kev sib ntxiv ntawm cov tshuaj muaj zog.

Phiv thiab haus tshaj

Muaj ntau yam tsis xav tau qhov tshwm sim tuaj yeem tshwm sim tom qab noj Glibomet, tab sis qhov no yuav tsum tsis yog lub laj thawj tsis kam noj tshuaj, vim tias cov kev mob tshwm sim rau lub cev los ntawm cov ntshav qab zib uas tsis tau txais yog ntau dua li kev pheej hmoo ntawm kev phiv.

Txhawm rau kom tsis txhob muaj cov xwm txheej zoo li no, nws yog ib qho tseem ceeb kom koj ntsuas koj cov tshuaj noj kom ntau npaum li cas. Yog hais tias qhov kev txwv yog overestimated, mob ntshav qab zib awakens indomitable kev tshaib kev nqhis, poob ntawm lub zog, poob siab, tes tshee hnyo.

Cov tsos mob ntawm kev siv ntau dhau kuj tuaj yeem ua tachycardia, blanching ntawm daim tawv nqaij, nce tawm hws, tsaus muag.

Ntawm cov kev mob tshwm sim ntau tshaj plaws tom qab noj Glibomed, mob ntshav qab zib qis yog qhov pheej hmoo tshaj plaws nyob rau hauv cov xwm txheej no rau cov neeg mob uas tsis muaj zog los ntawm kev mob ntev, mob ntshav qab zib ntawm lub hnub nyoog laus nrog cov ntshav qab zib ntev, dej cawv, cov neeg koom ua haujlwm lub cev hnyav, zoo li txhua tus neeg zaum ib nrab ntawm cov neeg mob plab ( tsawg dua 1000 kcal / hnub.) kev noj haus.

Ntawm cov qauv kev mob tshwm sim, feem ntau yog:

Mob taub Hau
Epigastric tsis xis nyob,
Dyspeptic mob
Txawv ntau hom kev tsis haum tshuaj.

Yog tias qhov tsis xis nyob me ntsis tshwm sim tom qab noj cov ntsiav tshuaj, nws tuaj yeem tshem tawm los ntawm kev kho tus mob. Yog tias cov tsos mob hnyav lossis cov tsos mob ua xua tshwm sim, tom qab ntawd koj yuav tsum xaiv cov tshuaj analogues rau Glibomet.

Qhia Txog Tshuaj Yeeb

Kev nce ntawm hypoglycemic nyhuv ntawm Glybomet yog pom thaum lub sijhawm kev kho mob tib si nrog kev pabcuam ntawm decumarol, phenylbutamazone, β-blockers, oxytetracycline, allopurinol, cimetidine, ethanol, sulfinpyrazone hauv cov koob tshuaj tseem ceeb, probenecid, chloramphenicol, cov tshuaj tseem ceeb, inhibiton, micon. Cov.

Cov kev sib txuas ua ke nrog cov tshuaj hormones rau cov thyroid caj pas, tshuaj noj hauv qhov ncauj, barbiturates, thiazide diuretic tshuaj inhibits lub peev xwm ntawm Glibomet.

Cov lus qhia tshwj xeeb

Kev siv ntawm Glibomet yog nres tam sim ntawd thaum muaj cov cim ntawm lactic acidosis: kev ua kom tsis muaj zog, ntuav, mob leeg, mob lub plab. Tus neeg mob xav tau kev mus pw hauv tuam tsev kho mob sai.

Cov kev qhia tau pom zoo kev kho mob nrog Glybomet kom nrog kev saib xyuas ntawm creatinine hauv kev kuaj ntshav. Rau cov neeg mob ntshav qab zib nrog lub raum kom noj qab haus huv, xws li kev kuaj mob yog qhov yuav tsum tau tsawg kawg ib xyoos ib zaug, cov neeg mob uas muaj creatinine nyob ze rau qhov kev txwv siab tshaj, thiab cov neeg mob paub tab yuav tsum kuaj 2-4 zaug hauv ib lub xyoo.

Ob hnub ua ntej npaj kev cuam tshuam txog kev phais, nyob rau hauv uas siv tus mob hnoos lossis txha caj qaum, noj Glibomet yog raug tso tseg thiab cov ntshav qab zib tau hloov mus rau hauv dej insulinCov. Koj tuaj yeem rov kho qhov chav kawm ntawm kev kho mob nrog Glybomet tom qab tus neeg mob tau tso cai rau lub qhov ncauj noj haus. Txawm hais tias ib txwm ua haujlwm hauv lub raum, tus kws kho mob ua qhov kev txiav txim siab no tsis pub dhau ob hnub tom qab kev phais.

Kev noj tshuaj yog qhov yuav tsum ceev faj thaum ua haujlwm uas yuav muaj kev phom sij rau lub neej thiab kev noj qab haus huv, zoo li thaum tsav tsheb. Qhov no yog cuam tshuam nrog kev pheej hmoo ntawm lub qog ntshav qab zib, qhov kev txo qis hauv kev puas siab puas ntsws psychomotor thiab muaj peev xwm mloog zoo.

Cov txiaj ntsig ntawm kev kho nrog Glibomet feem ntau yuav yog nyob ntawm qhov tseeb ntawm kev ua raws li cov lus pom zoo hauv cov lus qhia thiab cov lus qhia ntawm tus kws kho mob endocrinologist: ua raws li kev noj zaub mov noj thiab kev noj haus ntawm kev pw tsaug zog thiab so kom txaus, kev tawm dag zog ib txwm, kev tswj kab mob glycemic, suav nrog hauv tsev.

Thaum siv cov tshuaj, nws yuav tsum txwv txoj kev haus dej haus cawv kom ntau li ntau tau (qhov kev cai yog ib khob ntawm liab liab caw ib zaug ib lub lim tiam), txij li thaum ethanol ua rau kev loj hlob ntawm glycemia, nrog rau disulfiram-zoo li cuam tshuam - mob hauv thaj av epigastric, muaj mob dyspeptic, kub kub hauv lub cev thiab lub taub hau, ploj. ua kom sib haum, mob taub hau, palpitations.

Tus nqi ntawm cov tshuaj thiab cov cai khaws cia

Puas yog Glybomet pheej yig tau ntawm lub chaw muag tshuaj? Nyob ntawm thaj av ntawd, cov tshuaj yuav tuaj yeem yuav rau 200-350 rubles. Txhua pob ntawm Glibomet, daim duab uas tuaj yeem pom hauv ntu no, muaj 40 ntsiav tshuaj.
Yog li hais tias cov tshuaj tsis poob nws cov hauj lwm zoo, nws yuav tsum muaj kev tiv thaiv los ntawm tshav ntuj ncaj qha thiab av noo.

Cov tshuaj zoo sib xws

Yog hais tias Glibomed txawm nyob rau hauv txoj kev kho tsis tau muab cov txiaj ntsig uas xav tau, qhov kev fab tshuaj lossis lwm qhov kev phom sij loj tau tshwm sim, cov tshuaj tau hloov nrog cov tshuaj analogues nrog cov tshuaj uas tsim nyog.

Rau Glibomed, cov tshuaj no tuaj yeem yog Ntshav qab zib cov ntsiav tshuaj, lub ntsiab lus nquag nyob hauv uas yog glyclazide, lossis Dimaril, uas cov nquag sib xyaw ua ke yog tib yam ntawm ib qho ntawm cov khoom ntawm Glibomed, glimepiride.

Ntawm lwm cov tshuaj tiv thaiv kab mob uas muaj cov txiaj ntsig zoo ib yam, Gluconorm, Bagomet Plus, Glucovans, Glibenclamide nrog Metformin, Glyukofast raug kho.Tus endocrinologist hloov kho, nws tseem yuav suav cov ntau npaum li cas. Ib qho kev hloov pauv ntawm txoj kev kho mob yog qhov ua tau: cov tshuaj tiv thaiv kab mob tau muab ob qho tib si hauv kev kho mob nyuaj thiab hauv kev kho mob monotherapy, ntxiv rau qhov noj cov zaub mov tsis muaj carb tsawg thiab kev siv lub cev.

Nws yog 100% tsis tuaj yeem kwv yees kev tawm tsam ntawm lub cev rau cov tshuaj tshiab, yog li thawj zaug tsim nyog mloog tag nrho cov tsos mob thiab qhia tus kws kho mob txog kev hloov sai sai ntawm kev hnyav, kev ua kom tsis zoo, cov txiaj ntsig ntawm kev kuaj ntshav glycemia nrog glucometer thiab lwm tus tseem ceeb thaum lub sijhawm hloov mus rau lwm txoj hauv kev.

Xyuas rau ntawm cov yam ntxwv ntawm Glibomet

Txog cov tshuaj Glycomet kev tshuaj xyuas cov neeg mob ntshav qab zib muaj feem xyuam rau cov teeb meem ntawm nws daim ntawv thov dua li cov hauj lwm zoo.

Yog tias ntau npaum li cas xaiv qhov raug, cov lus teb tau zoo, qee zaum muaj kev xa mus rau cov kev mob tshwm sim me. Tab sis txij li cov kev suav no yog tus kheej, raws li kev tshawb fawb soj ntsuam thiab tus yam ntxwv ntawm cov chav kawm ntawm tus kab mob hauv ib tus neeg mob tshwj xeeb, kev sib pauv ntawm qhov kev paub hauv qhov no tsis muaj txiaj ntsig, thiab qee yam tseem muaj kev phom sij.

Kev qhia tag nrho cov lus qhia, peb tuaj yeem xaus tias Glibomed yog thawj qhov kev xaiv tshuaj rau hom 2 mob ntshav qab zib monotherapy: tus nqi pheej yig, cov ntaub ntawv muaj kev nyab xeeb ntau, kev tsis tuaj yeem nrog hwm lub cev qhov hnyav, muaj txiaj ntsig zoo ntawm kev mob plawv thiab oncological.

Tau kawg, nws txoj kev siv tsis tau rau txhua tus neeg (zoo li lwm yam tshuaj hypoglycemic), tab sis cov tshuaj muaj raws li cov qauv niaj hnub zoo thiab muaj txiaj ntsig.

Kws Tshuaj

Kev sib xyaw ua ke ntawm ob lub qhov ncauj hypoglycemic ntawm ntau yam pharmacological pawg: glibenclamide thiab metformin.

Metformin belongs rau cov pab pawg ntawm biguanides thiab txo cov ntsiab lus ntawm ob qho tib si basal thiab postprandial qab zib hauv ntshav ntshav. Metformin tsis txhawb cov tshuaj insulin secretion thiab vim li ntawd nws tsis ua rau cov ntshav qog ntshav qab zib.Nws muaj 3 lub zog ntawm kev ua: nws txo cov khoom nyob rau hauv qabzib los ntawm daim siab los ntawm inhibiting gluconeogenesis thiab glycogenolysis, nce qhov kev nkag siab ntawm peripheral insulin receptors, kev noj thiab siv cov piam thaj los ntawm cov hlwb hauv cov leeg, thiab qeeb lub cev kev nqus ntawm cov ntshav hauv lub plab. Ua kom muaj zog txav lossis txo lub cev qhov hnyav hauv cov neeg mob ntshav qab zib.

Nws kuj tseem muaj txiaj ntsig zoo li kev txuam ntawm lipid cov ntshav, txo cov roj cholesterol tag nrho, LDL thiab triglycerides.

Metformin thiab glibenclamide muaj cov txheej txheem sib txawv ntawm cov yeeb yam, tab sis ob leeg ua tiav ib leeg ntawm kev ua kom lub cev tsis muaj zog. Kev sib xyaw ntawm ob tus kab mob hypoglycemic muaj qhov ua tau los txo cov ntshav qabzib.

Glibenclamide. Thaum muab tshuaj, nqus tau los ntawm txoj hnyuv hauv plab ntau dua 95%. T max - 4 teev, V d - txog 10 litres. Kev sib txuas lus nrog cov protein ntshav yog 99%. Yuav luag txhua qhov ua tiav hauv lub siab nrog kev tsim ntawm ob lub cev tsis ua haujlwm, uas yog tawm los ntawm lub raum (40%) thiab los ntawm cov hnyuv (60%). T 1/2 - los ntawm 4 txog 11 teev

Metformin tom qab kev tswj hwm ntawm qhov ncauj, nws yog nqus tau los ntawm txoj hnyuv plab kom txaus, C max hauv plasma tau mus txog hauv 2.5 teev. Kev nqus dej ntawm lub cev yog li ntawm 50 txog 60%. Nrog kev noj ib txhij, kev nqus ntawm metformin yog txo thiab qeeb. Metformin tau faib sai sai hauv cov ntaub so ntswg, kev xyaum tsis khi rau cov ntshav protein. Nws yog metabolized mus rau ib tug kawm ntawv uas tsis muaj zog thiab tawm los ntawm ob lub raum. Kev tshem tawm ntawm metformin hauv cov ntsiab lus noj qab haus huv yog 400 ml / min, uas qhia tias muaj cov tubular muaj kev zais cia. Kwv yees li 20-30% ntawm metformin raug ntog tawm los ntawm txoj hnyuv tsis hloov pauv. T 1/2 yog qhov nruab nrab li ntawm 6,5 teev .Txoj kev mob tsis zoo, ua kom lub raum tsis zoo, ua kom tsis pom kev zoo, thaum T 1/2 nce ntxiv, uas ua rau muaj qhov nce ntshav plasma metformin ntau ntxiv. Metformin thiab glibenclamide muaj nyob hauv ib ntsiav tshuaj muaj tib lub cev muaj zog zoo ib yam li hauv cov ntsiav tshuaj uas muaj metformin lossis glibenclamide hauv kev rho tawm. Lub bioavailability ntawm metformin nyob rau hauv kev sib xyaw nrog glibenclamide tsis cuam tshuam los ntawm kev noj zaub mov, nrog rau lub bioavailability ntawm glibenclamide. Txawm li cas los xij, qhov kev nqus ntawm glibenclamide nce nrog kev noj zaub mov.

Kev siv cov tshuaj Glibenclamide + Metformin

Hom 2 mob ntshav qab zib mellitus hauv cov neeg laus uas tsis muaj txiaj ntsig ntawm kev noj zaub mov zoo, kev tawm dag zog lub cev thiab cov kev kho mob yav dhau los nrog tshuaj metformin lossis sulfonylurea derivatives, hloov kho kev kho mob yav dhau los nrog ob yam tshuaj (metformin thiab sulfonylurea derivative) hauv cov neeg mob uas ruaj khov thiab tswj tau glycemia.

Cov Yuav Tsum Tau Ua

Kev tsis haum xeeb rau metformin, glibenclamide lossis lwm yam sulfonylurea derivatives, hom 1 mob ntshav qab zib mellitus, mob ntshav qab zib ketoacidosis, mob ntshav qab zib precoma, mob ntshav qab zib tsis ua hauj lwm, lub raum tsis ua haujlwm lossis xiam oob qhab raum ua haujlwm (creatinine Cl tsawg dua 60 ml / min), mob hnyav uas tuaj yeem ua rau muaj kev hloov pauv hauv kev ua haujlwm ob lub raum: lub cev qhuav dej, mob hnyav, ua rau poob siab, tswj hwm ntawm cov tshuaj iodine uas muaj cov tshuaj tiv thaiv kab mob (saib "Kev Ceeb Toom"), mob hnyav los yog mob ntev uas nrog hypoxia cov ntaub so ntswg: lub siab lossis ua pa tsis ua haujlwm, tsis ntev los no myocardial infarction, mob siab ua haujlwm, porphyria, siv cov tshuaj miconazole, cov kab mob sib kis, kev phais mob loj, kev raug mob, kev kub nyhiab thiab lwm yam mob uas xav tau kev kho mob insulin, ntev cawv, dej cawv ua kom qaug tshuaj, lactic acidosis ( suav nrog kev ntsuas hauv plab), ua raws li kev noj zaub mov kom tsawg (tsawg dua 1000 kcal / hnub), cev xeeb tub, lub sijhawm pub mis niam, menyuam muaj hnub nyoog qis dua 18 xyoo.

Cev xeeb tub thiab lactation

Thaum cev xeeb tub, kev siv yog contraindicated. Tus neeg mob yuav tsum tau ceeb toom tias thaum kho nrog tshuaj glibenclamide + metformin, nws yuav tsum tau qhia tus kws kho mob txog qhov kev npaj xeeb tub thiab kev pib ntawm kev xeeb tub. Thaum npaj kev cev xeeb tub, nrog rau kev xeeb tub thaum lub sijhawm noj cov tshuaj, nws yuav tsum tso tseg, thiab kev kho tshuaj insulin yuav tsum yog tus kws kho mob.

Nws yog qhov cuam tshuam thaum lub sijhawm pub niam mis, txij li tsis muaj ntaub ntawv hais txog lub peev xwm ntawm kev sib xyaw glibenclamide + metformin txhawm rau nkag mus rau niam mis. Yog tias tsim nyog, siv thaum lub sijhawm pub niam mis yuav tsum hloov mus rau kev kho mob insulin lossis tsum tsis pub mis niam.

Kev ntsuas phoo thiab nthuav tawm

Yuav luag txhua qhov teeb meem hauv lub siab. Thawj ib nrab ntawm cov quav tawm los nrog zis, thiab thib ob 50% tawm nrog cov kua tsib. T1 / 2 - 3-16 teev.

Kev nqus thiab faib khoom

Raug rho tawm ntawm lub plab hnyuv tawm yuav luag 50%. Tag nrho bioavailability yog 50-60%. Tam sim ntawd tawg hauv cov ntaub so ntswg, yuav luag tsis cuam tshuam nrog cov protein ntshav.

Kev ntsuas phoo thiab nthuav tawm

Kev mob plab yog qhov tsis muaj zog, tawm hauv lub cev nrog rau cov zis (yuav luag hauv nws daim tseem) thiab ib nrab nrog quav. T1 / 2 - 9-12 teev.

Kev ntsuas rau siv

Ib lub glibomet yog tshuaj los ntawm tus kws kho mob rau tus neeg mob uas mob ntshav qab zib hom 2 nyob rau hauv rooj plaub thaum kev noj zaub mov, kis las thiab kho yav dhau los nrog glibenclamide lossis metformin tsis muaj txiaj ntsig. Tsis tas li, cov tshuaj tau qhia rau kev siv ua kev hloov kho rau cov neeg mob uas muaj kev tswj hwm thiab tsis hloov pauv ntawm glycemia.

Qhov ntau npaum li cas thiab kev kho mob ntev npaum li cas tau muab rau tus kheej, tus kws kho mob tso siab rau lub xeev ntawm tus neeg mob cov metabolism hauv lub cev thiab cov degree ntawm cov piam thaj hauv cov ntshav.

Qhov tsawg kawg cov tshuaj feem ntau yog 1 txog 3 ntsiav tshuaj hauv ib hnub. Tom qab ntawd cov koob tshuaj yog xaiv maj mam kom txog thaum lub siab tshaj tawm.

Raws li txoj cai, ntsiav tshuaj tau noj ob zaug ib hnub nyob rau yav tsaus ntuj thiab thaum sawv ntxov thaum lub sijhawm noj mov.

Qhov siab tshaj plaws ntawm cov tshuaj glybomet yog qhov ntau kawg ntawm 5 ntsiav tshuaj hauv ib hnub.

Sab sij huam

Hais txog cov txheej txheem hauv lub cev zom zaub mov, kev txhim kho hypoglycemia thiab nce ntshav hauv lactate yog qhov yuav tshwm sim. Hais txog ntawm txoj hnyuv hauv plab, kev txheeb xyuas pom tias nws yuav muaj qhov saj ntawm "hlau" hauv lub qhov ncauj kab noj hniav, ntuav, xeev siab thiab tsis qab los noj mov.

Qee qhov xwm txheej, kev siv cov tshuaj glibometa ua rau mob siab, cholestatic jaundice thiab hyperreactivity ntawm daim siab enzymes. Cov tshuaj kuj tseem tuaj yeem ua rau ua xua, tshwm sim nyob rau hauv daim ntawv ntawm urticaria, ua rau pom qhov tshwm sim ntawm cov protein nyob hauv cov zis, ua rau mob hauv cov pob qij txha thiab ua rau kub taub hau.

Tseem, kev tshuaj xyuas cov neeg mob ntshav qab zib tom qab noj cov tshuaj qhia pom muaj cov kev mob dermatological (ua kom lub ntsej muag), lub cev tsis zoo, mob taub hau, paresis, kiv taub hau thiab malaise.

Qee zaum, tom qab haus cawv, kev siv cov tshuaj ua rau "antabuse siv."

Nta

Kev siv tshuaj kho glybomet thiab muab tshuaj yuav tsum tau ua raws li kev saib xyuas nruj ntawm ib tus kws tshaj lij.

Thaum muaj teeb meem ntawm cov kab mob lactic acidosis (ua kom mob, ua kom mob, ntuav), nws yog qhov yuav tsum tau tsum tsis txhob siv cov tshuaj thiab nqa tawm kev kho mob tsim nyog.

Tsis tas li, tus neeg mob yuav tsum ua raws li qee qhov kev noj haus, tswj cov piam thaj hauv qab thiab, yog tias pom tias muaj cov kab mob lactic acid, pom tus kws kho mob tam sim ntawd.

Tseem Ceeb! Thaum siv glibomet, koj yuav tsum tsis txhob haus dej cawv.

Cov lus qhia txuas nrog rau cov tshuaj ceeb toom: nyob rau hauv tus txheej txheem ntawm tsav tsheb, lub ntsej muag glibomet tuaj yeem cuam tshuam, vim tias kev txhim kho ntawm hypoglycemia tsis yog tsis suav.

Noj ntau dhau

Yog tias cov tshuaj ua rau noj ntau dhau, tom qab ntawd cov tsos mob tshwm sim xws li lactic acidosis los ntawm kev ua ntawm metformin thiab hypoglycemia los ntawm kev ua ntawm glibenclamide yog ua tau.

kev tshaib kev nqhis
malaise
cov leeg mob hlwb
nce hws
kev ua haujlwm tsis zoo ntawm kev txav
palpitations
kev pw tsaug zog tas li
daj ntseg tawv nqaij
kev ntshai ntawm kev ntshai
paresthesia nyob rau hauv lub qhov ncauj kab noj hniav,
kev ntxhov siab vim pw tsaug zog
tshee hnyo
mob taub hau
kev txhawj xeeb.

Yog tias hypoglycemia hloov zuj zus, tom qab ntawd kev poob siab thiab kev tswj hwm tus kheej yog ua tau.

Lactic acidosis xav tau kev kho mob sai sai hauv qhov chaw pw. Txoj hauv kev kho mob siab tshaj plaws yog kho mob hemodialysis.

Thaum mob me los sis mob ntshav nce hlwb ntau ntau, yuav tsum tau noj kua qab zib lossis qabzib. Hauv cov ntshav qog ntshav qab zib hnyav, kev txhaj tshuaj rau cov ntshav qabzib (40%) lossis glucagon tau muab.

Tseem Ceeb! Thaum tus neeg mob rov qab nco qab, nws yuav tsum noj zaub mov carbohydrate kom tiv thaiv kom tsis txhob muaj ntshav qab zib dua.

Kev cuam tshuam nrog lwm yam tshuaj

Cov tshuaj muaj peev xwm nce cov nyhuv hypoglycemic nyob rau hauv rooj plaub ntawm kev sib txig siv dicumarol, oxytetracycline, beta-blockers, sulfonamides, salicylates, chloramphenicol, ethanol, allopurinol, sulfinpyrazone, miconazole, MAO inhibitors, probenecid thiab cimetidine.

Cov nyhuv ntawm kev noj gibomet tuaj yeem txo los ntawm cov thyroid hormones thiab, yog tias cov tshuaj no tau noj nrog epinephrine, barbiturates, glucocorticosteroids, thiazide diuretics, tshuaj tiv thaiv (ntsiav tshuaj).

Tsis tas li, cov tshuaj muaj peev xwm txhim kho cov txiaj ntsig ntawm kev noj tshuaj antioagulants, thiab thaum sib cuam tshuam nrog cimetidine, qhov kev pheej hmoo ntawm lactic acidosis nce.

Cov tsos mob ntawm tus mob ntshav qab zib tsis tuaj yeem pom tshwm sim vim yog beta-adrenolocators.

Qauv Khoos Kas-Kho Mob Tshooj 1

Ua liaj ua teb. Qhov ncauj xyaw hypoglycemic tus neeg sawv cev, sulfonylurea derivative ntawm lub cim thib ob. Nws muaj cov teebmeem pancreatic thiab cov teebmeem ntxiv. Glibenclamide stimulates insulin secretion los ntawm kev txo qis rau kev txiav txim siab rau pancreatic beta-cell glucose voos, nce insulin rhiab heev thiab nws cov lus cog rau lub hom phiaj hlwb, nce insulin tso tawm, txhim kho cov nyhuv ntawm insulin rau cov leeg nqaij thiab lub siab ua haujlwm, thiab inhibits lipolysis hauv adipose nqaij. Kev ua nyob rau theem ob ntawm insulin secretion. Metformin inhibits gluconeogenesis nyob rau hauv daim siab, txo qis kev nqus ntawm cov piam thaj los ntawm kev mob plab thiab nce nws txoj kev siv hauv cov ntaub so ntswg, txo cov ntsiab lus ntawm TG thiab cov cholesterol nyob rau hauv cov ntshav ntshav. Nce kev khi ntawm insulin rau kev txais (nyob rau hauv qhov tsis muaj tshuaj insulin hauv cov ntshav, cov kev kho mob tsis pom tshwm). Tsis ua rau muaj kev tsis haum ntshav. Cov nyhuv hypoglycemic tshwm sim tom qab 2 teev thiab kav ntev li 12 teev.

Cov Tshuaj Pharmacokinetics Glibenclamide ua haujlwm sai thiab ncaj ncees (84%) nqus tau rau hauv lub plab zom zaub mov, TC max - 7-8 teev. Kev sib txuas lus nrog plasma protein - 97%. Nws yuav luag txhua yam hauv lub siab ua rau lub cev tsis ua haujlwm. 50% raug tawm los ntawm lub raum, 50% - nrog bile. T 1/2 - 10-16 teev. Tom qab kev nqus ntawm txoj hnyuv (nqus - 48-52%), Metformin raug cais tawm los ntawm lub raum (feem ntau tsis hloov), qee qhov ntawm cov hnyuv. T 1/2 - 9-12 h.

Cov Khoom Qhia. Hom 2 mob ntshav qab zib mellitus (nrog rau qhov tsis muaj txiaj ntsig ntawm kev noj zaub mov noj lossis tshuaj monotherapy nrog qhov ncauj tshuaj hypoglycemic).

Cov Yuav Tsum Muaj Cov kab mob ntshav siab, hom 1 mob ntshav qab zib mellitus, mob ntshav qab zib ketoacidosis, mob ntshav qab zib ua ntej thiab tsis nco qab, mob caj dab (mob keeb kwm), mob raum tsis ua hauj lwm (creatinine ntau tshaj 135 mmol / l hauv cov txiv neej thiab ntau dua 110 mmol / l hauv cov poj niam), mob hnyav , uas tuaj yeem ua rau lub raum ua haujlwm tsis zoo (nrog rau lub cev qhuav dej, mob hnyav, poob siab, kev tswj hwm ntawm iodine uas muaj cov tshuaj tiv thaiv tsis zoo), muaj cov kab mob siab thiab mob mus nrog cov nqaij mos hypoxia (suav nrog lub plawv tsis ua haujlwm, ua pa tsis ua haujlwm, lub plawv nres tsis ntev los no myoca Yog, qhov poob siab), hepatic insufficiency, mob cawv qaug cawv, porphyria, concomitant siv miconazole, cev xeeb tub, lactation.

Nrog ceev faj. Kev quav dej cawv, adrenal tsis txaus, hypofunction ntawm anterior pituitary, mob qog nrog lub cev tsis ua haujlwm.

Tsuas tshuaj Sab hauv, thaum noj mov. Cov tshuaj noj rau tshuaj yog xaiv ib qho zuj zus, nyob ntawm lub xeev cov metabolism. Feem ntau, qhov pib hloov zuj zus yog 1 ntsiav tshuaj (2.5 mg glibenclamide thiab 500 mg metformin), nrog rau qhov tshuaj tiv thaiv maj mam xaiv txhua 1-2 lis piam nyob ntawm glycemic index.

Thaum hloov cov kev kho ua ke yav dhau los nrog metformin thiab glibenclamide (raws li cov khoom sib cais), 1-2 ntsiav tshuaj (2,5 mg ntawm glibenclamide thiab 500 mg ntawm metformin) raug kho, nyob ntawm qhov koob tshuaj dhau los ntawm txhua feem.

Qhov siab tshaj plaws niaj hnub noj yog 4 ntsiav tshuaj (2.5 lossis 5 mg ntawm glibenclamide thiab 500 mg ntawm metformin).

Sab sij huam. Metformin: xeev siab, ntuav, mob plab, poob qab los noj mov, "nws yog xim hlau" saj hauv lub qhov ncauj, erythema (raws li lub cev tsis nco qab lawm), kev nqus qis thiab, vim li ntawd, kev saib xyuas ntawm cyanocobalamin nyob rau hauv cov ntshav ntshav (nrog siv ntev), lactic acidosis.

Glibenclamide: hypoglycemia, maculopapular tawm pob (nrog rau ntawm cov qog ua paug), tawv nqaij khaus, urticaria, photosensitivity, xeev siab, ntuav, tsis xis nyob hauv thaj chaw epigastric, muaj kev ua haujlwm ntau ntawm hepatic transaminases, kab mob siab, mob leukopenia, thrombocytosis, thrombocytopenia, thrombocytopenia , cov pob txha mob pob txha aplasia, pancytopenia, hlais pob txha thiab mob ntshav qab zib, mob ntshav qab zib, mob ntshav qab zib, mob siab urea hauv ntshav plasma, disulfiram zoo li cov tshuaj tiv thaiv (nrog rau siv thaum siv nrog ethanol).

Noj ntau dhau. Cov tsos mob: hypoglycemia thiab lactic acidosis.

Kev Kho Mob: nrog hypoglycemia (yog tias tus neeg mob nco qab) - qab zib sab hauv, nrog tsis nco qab - iv dextrose lossis 1-2 ml ntawm glucagon. Tom qab nws rov qab nco qab, nws yog ib qho tsim nyog yuav tsum muab cov neeg mob cov zaub mov nplua nuj nyob hauv cov khoom noj zom zaub mov kom yooj yim (kom tsis txhob rov qab txhim kho hypoglycemia).

Kev sib txuam. Miconazole yog qhov pheej hmoo ntawm lub qog ntshav qab zib (nce txog coma).

Fluconazole - qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia (nce T 1/2 sulfonylurea derivatives).

Phenylbutazone tuaj yeem tshem tawm sulfonylureas (glibenclamide) derivatives los ntawm kev sib txuas nrog cov protein, uas tuaj yeem ua rau muaj kev nce ntxiv hauv lawv cov kev mob siab hauv ntshav ntshav thiab qhov kev pheej hmoo ntawm hypoglycemia.

Kev siv ntawm iodine-muaj cov tshuaj radiopaque (rau kev tswj hwm intravascular) tuaj yeem ua rau txoj kev txhim kho ntawm lub raum ua haujlwm tsis zoo thiab kev txuam nrog metformin, uas ua rau muaj kev pheej hmoo ntawm lactic acidosis. Kev kho nrog cov tshuaj no raug muab tso tseg 48 teev ua ntej lawv tswj hwm thiab tau rov pib dua tsis pub dhau 48 teev tom qab.

Kev siv cov tshuaj tiv thaiv uas muaj cov tshuaj pleev nyob rau tom qab ntawm glibenclamide tuaj yeem ua rau kev txhim kho ntawm disulfiram zoo li cov tshuaj tiv thaiv.

GCS, beta 2 -adrenostimulants, diuretics tuaj yeem ua rau txo qis hauv qhov kev siv tshuaj, kev hloov kho tshuaj kuj yuav tsum tau ua.

ACE inhibitors - qhov phom sij ntawm cov ntshav qog ntshav nrog kev siv sulfonylureas (glibenclamide).

Beta-blockers nce qhov tshwm sim thiab qhov hnyav ntawm cov ntshav qog ntshav qab zib.

Cov tshuaj tua kab mob los ntawm pab pawg ntawm sulfanilamides, fluoroquinolones, anticoagulants (coumarin derivatives), MAO inhibitors, chloramphenicol, pentoxifylline, lipid-txo cov tshuaj los ntawm cov pab pawg ntawm cov fibrates, disopyramides - qhov kev pheej hmoo ntawm hypoglycemia nrog kev siv glibenclamide.

Cov lus qhia tshwj xeeb. Kev phais mob thiab kev raug mob loj, kev kub nyhiab, kab mob kis nrog febrile syndrome yuav tsum muaj kev tshem tawm cov tshuaj glypoglycemic hauv qhov ncauj thiab kev tswj hwm cov tshuaj insulin.

Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam cov ntshav qabzib hauv cov ntshav ntawm lub plab khoob thiab tom qab noj mov, qhov nkhaus niaj hnub ntawm cov ntsiab lus ntawm cov piam thaj hauv cov ntshav thiab zis.

Cov neeg mob yuav tsum ceeb toom qhia txog kev pheej hmoo yuav muaj ntshav qab zib tsawg nyob rau hauv muaj ethanol, NSAIDs, thiab tshaib plab.

Ib qho kev hloov kho koob tshuaj yog qhov tsim nyog rau kev tawm dag zog lub cev thiab lub siab, hloov kev noj zaub mov.

Cov kev ceev faj yog tau kho thaum kho nrog beta-blockers.

Nrog rau cov tsos mob ntawm tus mob ntshav qab zib, carbohydrates (qab zib) tau siv, nyob rau hauv cov mob hnyav, kev daws teeb meem dextrose yog maj mam muab iv.Rau kev raug mob, raug mob, phais mob, kis kab mob thiab febrile syndrome, hloov mus rau insulin.

Nws yog ib qho tsim nyog yuav tsum thim cov tshuaj 2 hnub ua ntej kev kuaj mob angiographic lossis urographic (kev kho yog rov qab 48 teev tom qab tshuaj ntsuam).

Tawm tsam keeb kwm yav dhau los ntawm kev siv ethanol uas muaj cov tshuaj yeeb dej caw, kev txhim kho ntawm disulfiram-zoo li cov tshuaj tiv thaiv yog tau.

Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab koom nrog lwm yam kev phom sij uas yuav tsum muaj kev mloog zoo thiab ceev ntawm cov kev tiv thaiv psychomotor.

Lub xeev tso npe ntawm cov tshuaj. Daim ntawv tshaj tawm raug cai: hauv 2 ntim. M: Medical Council, 2009. - Feem 2, ntu 1 - 568 s., Tshooj 2 - 560 s.

Muaj kev cuam tshuam nrog lwm cov tshuaj phiv

Acarbose ua rau kom cov ntshav hypoglycemic ua ke ntawm kev sib xyaw ntawm glibenclamide + metformin.

Allopurinol *

Allopurinol ua rau cov hypoglycemic ua tau zoo ntawm kev sib xyaw ntawm glibenclamide + metformin.

Ascorbic acid *

Hauv kev txhaj tshuaj ntau, ascorbic acid (acidifying zis ntawm cov tshuaj) ua rau muaj kev cuam tshuam ntawm kev sib xyaw ntawm glibenclamide + metformin los ntawm kev txo cov neeg ua haujlwm ntawm kev sib cais thiab nce rov qab kho cov glibenclamide.

Asparaginase

Asparaginase ua kom cov nyhuv ntawm kev sib xyaw ntawm glibenclamide + metformin.

Acetazolamide *

Acetazolamide tsis muaj zog cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Baclofen attenuates cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Bezafibrat *

Bezafibrat ua rau cov ntshav hypoglycemic ua ke ntawm kev sib xyaw ntawm glibenclamide + metformin.

Bromocriptine *

Bromocriptine ua rau kev kho mob hypoglycemic ntxiv ntawm kev sib xyaw ntawm glibenclamide + metformin.

Vancomycin *

Glucagon qaug zog cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Yog tias tsim nyog, tib lub sijhawm teem nrog kev sib xyaw ntawm glibenclamide + metformin danazole thiab thaum koj tsum tsis noj lub tom kawg, koj yuav tsum kho qhov koob tshuaj ntawm kev sib xyaw ua ke nyob rau hauv kev tswj hwm qib glycemia (danazol muaj cov nyhuv hyperglycemic thiab ua rau lub zog tsis muaj zog).

Disopyramides *

Disopyramide ua rau kev kho mob hypoglycemic ntau dua ntawm kev sib txuas ntawm glibenclamide + metformin.

Isoniazid attenuates cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Cov tshuaj calcium chloride

Calcium chloride (acidifying zis ntawm cov tshuaj) ua rau muaj kev cuam tshuam ntawm kev sib xyaw ntawm glibenclamide + metformin los ntawm kev txo qis hauv kev sib cais thiab nce kev rov kho dua ntawm glibenclamide.

Captopril ua rau cov hypoglycemic ua rau cov txiaj ntsig ntawm kev sib xyaw ntawm glibenclamide + metformin thiab ua rau kom muaj kev txhim kho hypoglycemic ntau dua los ntawm kev txhim kho cov kua nplaum ua kom haum siab thiab txo qhov xav tau ntawm insulin.

Miconazole ua rau muaj txiaj ntsig ntawm kev sib xyaw ntawm glibenclamide + metformin, tuaj yeem ua rau qhov txhim kho ntawm cov ntshav qog nqaij hlav (nce txog kev tsis nco qab).

Niacin *

Nicotinic acid (nyob rau hauv cov koob tshuaj siab) tsis muaj zog cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Nifedipine tsub kom qhov nqus ntxiv thiab C max ntawm metformin thiab ua rau nws cov zuaj qis qeeb.

Pentoxifylline *

Pentoxifylline ua rau cov ntshav hypoglycemic sib xyaw ua ke ntawm glibenclamide + metformin.

Pyridoxine *

Pyridoxine ua rau txhim kho kev mob hypoglycemic ntawm kev sib xyaw ntawm glibenclamide + metformin.

Procainamide *

Reserpine ua rau cov ntshav hypoglycemic ua ke ntawm kev sib xyaw ntawm glibenclamide + metformin.

Rifampicin *

Rifampicin tsis muaj zog cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Salbutamol *

Salbutamol ua kom cov nyhuv ntawm kev sib xyaw ntawm glibenclamide + metformin.

Theophylline ua kom cov ntshav qog ua kom zoo ntawm kev sib xyaw ntawm glibenclamide + metformin.

Terbutaline *

Terbutaline ua rau tsis muaj zog ntawm kev sib txuam ntawm glibenclamide + metformin.

Tetracycline *

Tetracycline ua rau kom muaj qhov ua kom ntshav qab zib tsawg dua ntawm kev sib txuam ntawm glibenclamide + metformin.

Furosemide nce C max metformin los ntawm 22% thiab AUC los ntawm 15% (tsis muaj qhov hloov pauv tseem ceeb hauv lub raum. Metformin txo C max furosemide los ntawm 31%, AUC los ntawm 12% thiab T 1/2 los ntawm 32% (tsis muaj qhov hloov pauv tseem ceeb hauv kev kho lub raum).

Chloramphenicol *

Chloramphenicol ua rau cov hypoglycemic ua ke ntawm kev sib xyaw ntawm glibenclamide + metformin.

Chlorpromazine *

Chlorpromazine hauv kev txhaj tshuaj ntau (100 mg / hnub) tsis muaj zog cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin, vim tias ua rau muaj glycemia ntau ntxiv.

Chlortalidone *

Chlortalidone attenuates cov nyhuv ntawm kev sib txuam ntawm glibenclamide + metformin.

Cimetidine (ib qho tshuaj cationic) zais cia hauv cov tubules sib tw rau cov tshuab thauj tubular thiab nce C max metformin los ntawm 60% thiab AUC los ntawm 40%.

Enalapril ua rau cov ntshav hypoglycemic nce ntxiv ntawm kev sib xyaw ntawm glibenclamide + metformin thiab ua rau kom muaj kev txhim kho hypoglycemic ntau dua los ntawm kev txhim kho cov kua nplaum ua haujlwm thiab txo qhov xav tau ntawm insulin.

Epinephrine ua rau tsis muaj zog ntawm kev sib txuam ntawm glibenclamide + metformin.

Nrog rau kev tswj hwm tib lub sij hawm ntawm kev sib xyaw ntawm glibenclamide + metformin thiab cawv, qhov kev pheej hmoo ntawm kev txhim kho hypoglycemic, nrog rau cov mob tsis nco qab, thiab lactic acidosis nce ntxiv, yog li kev tswj hwm yuav tsum tau zam.

Ethionamide ua rau kom muaj cov nyhuv ntshav qab zib ntau dua ntawm kev sib txuas ntawm glibenclamide + metformin.

Feem ntau hauv kev kho mob hom 2 mob ntshav qab zib mellitus, nws tsis txaus siv tsuas yog ib qho ntawm ob qho kev taw qhia ntawm cov piam thaj txo cov ntsiav tshuaj. Biguanides thiab hloov siab dua yuav tsum tau ntxiv rau kev kho mob nrog sulfonylurea derivatives.

Cov kws muag tshuaj tau tsim los tsim cov tshuaj Glibomet, uas yog kev sib koom ua ke zoo ntawm ob pawg thiab muaj kev nkag siab, ua tsaug rau cov kev sib txawv ntawm kev sib kis, daws cov teeb meem ntawm cov neeg mob los ntawm kev mob nkeeg no.

Cov tshuaj Glibomet los ua rau cov qib qab zib hauv ib txwm muaj rau cov neeg mob ntshav qab zib hom 2, rau kev sim coj qab zib kom ib txwm muaj nrog kev noj zaub mov noj, noj sulfonylurea derivatives lossis biguanides tau ua tsis tiav.

Cov tshuaj muaj pes tsawg leeg suav nrog 2 yam tshuaj:

glibenclamide 2.5 mg - tus sawv cev ntawm lub cim thib ob sulfonylurea derivatives,
Metformin 400 mg yog ib qho kev sib txuas ntawm lub zog loj.

Tsim cov ntsiav tshuaj loj yog sawv cev los ntawm cov txheej txheem ntawm cov tsis suav.

Sab saum toj ntawm cov ntsiav tshuaj yog coated nrog talc txheej nrog qhov sib ntxiv ntawm ib qho ntawm ntau hom cellulose thiab diethyl phthalate.

Pharmacological kev txiav txim

Los ntawm kev noj cov tshuaj Glibomet, ob lub hom phiaj ua tiav:

txo cov suab thaj theem mus rau qhov tsis muaj,
cov kev cai ntawm cov rog metabolism.

Dab tsi ua rau cov haujlwm no? Txhua ntawm lub Cheebtsam ua lub luag haujlwm:

Glibenclamide tsub kom lub zais ntawm cov tshuaj insulin nyob rau hauv lub txiav (mob nyhuv nyhuv) thiab txhim kho qhov rhiab ntawm cov ntaub so ntswg mus rau nws ntawm periphery (ntxiv cov nyhuv ntxiv). Nyob rau hauv nws lub hwj chim, qabzib los ntawm lub txaj vascular mus rau hauv hepatocytes thiab mus rau hauv cov leeg nqaij, qhov twg glycogen depot tau tsim.
Metformin tsub kom qhov kev xav tau ntawm cov ntaub so ntswg txuas ntxiv rau insulin, inhibits qhov nqus ntawm cov piam thaj hauv cov plab hnyuv plab hnyuv, ua kom nws cov lus mos thaum lub sij hawm gluconeogenesis, thiab txhim kho cov roj metabolism.

Cov nyhuv synergistic ntawm ob lub ntsiab lus tso cai los txo cov feem ntau ntawm ib leeg yam tsis muaj kev txiav txim siab rau cov nyhuv kho, uas tshwm sim 2 teev tom qab kev tswj hwm thiab kav 12 teev. Ntxiv rau, qhov no txo qhov kev pheej hmoo ntawm phiv.

Hauv lub cev, glibenclamide thiab metformin coj tus cwj pwm sib txawv. Glibenclamide nquag khi rau cov ntshav plasma protein thiab metabolized hauv daim siab, tom qab ntawd nws raug tawm los ntawm cov kua tsib thiab cov zis ua rau hom tsis muaj zog. Metformin tsis nkag rau hauv qhov sib txuas nrog cov protein, nws nkag mus rau hauv cov ntaub so ntswg, qhov chaw nws ua haujlwm yam tsis muaj metabolized. Nws yog tawm hauv feem ntau nrog tso zis, me ntsis los ntawm txoj hnyuv.

Cov lus qhia rau kev siv

Cov lus qhia ntawm cov txheej txheem ntawm kev tswj hwm thiab koob tshuaj tau piav qhia nyob rau hauv cov lus qhia rau kev siv Glibomet.

Tsuas muaj ib txoj hauv kev rau kev muab tshuaj - cov ntsiav tshuaj noj nrog qhov ncauj nrog zaub mov. Thawj qhov tshuaj muaj ntau txog 1 txog 3 ntsiav tshuaj hauv ib hnub. Hauv lub neej yav tom ntej, tus kws kho mob endocrinologist xaiv ib qho tshuaj ntau npaum li cas, noj mus rau hauv tus neeg mob qhov mob thiab qab zib theem. Qhov siab tshaj plaws niaj hnub noj yuav tsum tsis pub tshaj 6 ntsiav tshuaj.

Cov ntau npaum xaiv los ntawm tus kws kho mob yog yuav tau yoog thaum lub sijhawm kho thiab tswj cov piam thaj. Lub hom phiaj ntawm kev xaiv koob tshuaj yog xav kom muaj ປົກ ກະ ຕິ cov ntshav qab zib.

Kev saib xyuas yuav tsum tau coj thaum tsav tsheb thiab ua haujlwm nrog kev txav txav tshuab.

Kev cuam tshuam nrog lwm yam tshuaj

Kev sib cuam tshuam nrog tus naj npawb ntawm cov tshuaj ua rau kev nce hauv cov nyhuv hypoglycemic. Cov no suav nrog:

npaj Marmarin,
muaj ntsev,
beta blockers
sulfonamides,
MAO inhibitors
miconazole
ethyl haus cawv.

Glibomet tsub kom cov nyhuv ntawm anticoagulants.

Qhov fab ntxeev ntawm hypoglycemia yog:

glucocorticoids,
tshuaj tiv thaiv qhov ncauj
diuretics ntawm thiazine series,
barbiturates
adrenaline
cov thyroid hormones.

Beta blockers ntub cov chaw kuaj ntshav txhaws, uas tuaj yeem tsim kev phom sij rau ntshav qab zib.

Iodine-contrast agents ua rau txhaj rau hauv txoj hlab ntsha pab txhawb kev txuam nrog metformin, thiab yog li muaj kev hem thawj ntawm lactic acidosis.

Muaj cov analogues ntawm Glibamet hauv kev ua thiab kev muaj pes tsawg leeg.

Glucovans yog kev npaj ua ke ntawm hypoglycemic kev txiav txim siab, tsim los ntawm Merck, Fabkis. Cov ntsiav tshuaj muaj xws li glibenclamide thiab metformin hauv cov hlwv pob ntawm 15 ntsiav tshuaj. Hauv pob ntawv 2 lossis 4 blisters.
Metglib - muaj qhov sib txuam zoo sib xws, ntsiav tshuaj ntawm 40 daim ib pob.
Bagomet-plus - tib 2 cov tshuaj nquag, tab sis qhov tsuas tshuaj yog txawv me ntsis. Hauv ib pob ntawm 30 ntsiav tshuaj. Chaw tsim tshuaj paus Argentina.
Gluconorm - kev sib txuas ntawm tib qho tshuaj, 40 pieces txhua, yog muab los ntawm Is Nrias teb.
Glibomet analogues uas txawv hauv muaj pes tsawg leeg tab sis zoo sib xws hauv kev ua xws li:
Amaryl raws li glimepiride 1.2.3.4 mg rau cov hlwv ntawm 15 daim, hauv ib pob ntawm 2, 4, 6 lossis 8 blisters. Muaj nyob hauv lub teb chaws Yelemees.
Maninil thiab Diabeton - raws li glibenclamide, yog derivatives ntawm 2nd tiam sulfonurea.
Maninil - ntsiav tshuaj ntawm 1.75 mg, 3.5 mg thiab 5 mg ntawm 120 pieces. Chaw Tsim Tshuaj - Berlin-Chemie, Lub Tebchaws Yelemees.
Diabeton MV - 30 lossis 60 mg ntsiav tshuaj ntawm 60 lossis 30 ntsiav tshuaj, ntsig txog. Servier Laboratory, Fabkis cov chaw muag tshuaj.

Hauv kev sib piv, Maninil - Diabeton yuav tsum tau muab kev nyiam rau Diabeton, raws li cov tshuaj tsawg dua.

Ntawm tus nqi, Glybomet thiab nws cov analogues muaj nyob rau kwv yees li qhov qub.

Tus nqi nruab nrab rau Glibomed yog los ntawm 200 txog 300 rubles.
Glucovans - tus nqi yog nyob rau hauv thaj tsam ntawm 250 - 350 rubles.
Bagomet-plus tau muag rau 225 -235 rubles.
Metglib tuaj yeem muas tau hauv nruab nrab rau 230 rubles.
Maninil tus nqi 130 -170 rubles.
Tus mob ntshav qab zib nyob hauv qhov kev txwv ntawm 159 - 202 rubles.
Tus nqi ntawm Amaryl nyob nruab nrab ntawm 150 txog 3400 rubles. Amaryl yog muag hauv tus nqi siab tshaj plaws hauv kev haus tshuaj ntau tshaj 4 mg ntawm 90 ntsiav tshuaj.

Tsev »Cholecystitis» Glibomet - cov lus qhia txog kev siv tshuaj, tshuaj xyuas. Kev siv tshuaj hypoglycemic qhov ncauj ntawm pab pawg neeg thib ob glybomet

Yuav ua li cas noj Glibomet

Kev txiav txim los ntawm kev tshuaj xyuas cov kws kho mob endocrinologist, txhawm rau kom tsis txhob muaj cov kab mob lactic acidosis, cov neeg mob ntshav qab zib hnub nyoog laus dua 60 xyoo, nrog rau kev siv lub cev hnyav txhua hnub, koj yuav tsum siv cov tshuaj nrog ceev faj, sau cov xwm txheej glucometer hauv phau ntawv sau cia.

Muaj cov kev txwv ntawm kev noj cov Glibomet:

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Cov tshuaj sib xyaw ntawm Glibomet ntsiav tshuaj suav nrog ob qho kev ua haujlwm, uas yog glibenclamide, zoo li metformin hydrochloride, feem ntau ntawm cov tshuaj no yog 2.5 mg thiab 400 mg, feem. Txuas ntxiv:

Glycerol dibehenate
Povidone
Colloidal silicon dioxide
Magnesium stearate
Croscarmellose sodium
Macrogol.

Cov ntsiav tshuaj puag ncig, milky dawb, muaj qhov pheej hmoo ntawm ib sab. Cov ntsiav tshuaj muab tso rau hauv lub hlwv ntim ntawm 20 pcs., Sab hauv pob ib 2 lub hlwv.

Kho thaj chaw

Glibomet belongs rau tus naj npawb ntawm cov tshuaj hypoglycemic nrog cov tshuaj sib xyaw ua ke, cov tshuaj ua kom nquag plias yog sulfonylurea derivatives, raws li zoo li thib ob tiam lojuanide. Cov tshuaj ua kom muaj zog ntawm cov tshuaj insulin hauv cov txiav ua qab vim txo qis qhov pib ntawm β-cell mob los ntawm cov piam thaj nws tus kheej. Cov tshuaj tsub kom insulin ua rau muaj kev cuam tshuam ntau ntxiv, thaum khi rau lub hlwb sib kis tau nce, thiab insulin tso tawm zoo dua tuaj. Thaum lub sij hawm kho cov tshuaj tiv thaiv kab mob, cov txheej txheem ntawm kev nqus nqus dej los ntawm lub siab ua rau lub siab thiab cov leeg nqaij yog qhov ib txwm ua, nws inhibits lipolysis uas tshwm sim hauv cov ntaub so ntswg adipose. Tawm rau glibenclamide kaw nyob rau theem ob ntawm insulin zais cia.

Metformin yog tus tswv cuab ntawm pab pawg neeg biguanide. Nws muaj qhov ua rau lub zog tsis tseem ceeb ntawm cov ntaub so ntswg mus rau insulin, txo cov txheej txheem ntawm cov piam thaj nqus ncaj qha rau hauv txoj hnyuv, inhibits gluconeogenesis, thiab kuj zoo cuam tshuam rau chav kawm ntawm lipid metabolism. Tawm tsam keeb kwm ntawm cov txiaj ntsig tshwj xeeb no, nws muaj peev xwm ua kom sai sai txo lub cev qhov hnyav hauv cov neeg muaj kev mob ntshav qab zib.

Cov nyhuv hypoglycemic ntawm cov tshuaj Glibomet tau sau cia 2 teev tom qab lub sijhawm ntawm kev noj cov ntsiav tshuaj thiab 12 teev tom ntej tau txais kev cawmdim. Vim tias kev sib xyaw ntawm ob yam tshuaj lom neeg, qhov kev sib txuas ntawm lub npe hu ua endogenous insulin yog ua kom tiav, biguanide muaj qhov cuam tshuam ncaj qha tsis yog rau cov leeg nqaij thiab adipose, tab sis kuj ua rau daim siab mob (vim yog txo qis hauv gluconeogenesis). Hauv qhov xwm txheej no, kev tsim kho muaj zog ntawm cell-cell ntawm tus txiav tsis tuaj yeem kaw, uas txo txoj kev muaj peev xwm ntawm cov kab mob hloov khoom nruab nrog thiab kev txhim kho ntawm ntau sab tsos mob

Qib ntawm kev nqus ntawm glibenclamide los ntawm kev mob ncauj plab yog li 84%. Qhov siab tshaj plaws ntawm cov tshuaj no hauv cov ntshav tau sau tseg hauv 1-2 teev tom qab siv tshuaj. Kev sib txuas lus nrog cov ntshav plasma protein - 97%. Kev hloov pauv hauv kev zom zaub mov ntawm cov khoom no tshwm sim hauv lub siab ua haujlwm, vim li ntawd, ntau lub cev tsis ua haujlwm tau tsim. Hauv kev ua haujlwm ntawm kev tshem tawm cov khoom siv metabolic, lub plab zom mov thiab lub raum ua haujlwm koom nrog. Qhov kev tshem tawm ib nrab-lub neej feem ntau tsis pub tshaj 5-10 teev.

Qhov nqus ntawm metformin los ntawm qhov hnyuv plab hnyuv muaj ntau heev. Thaum nkag mus rau hauv qhov nruab nrab ntawm txoj kev ncig, nws txoj kev faib tawm sai hauv cov ntaub so ntswg yog pom, nws yuav luag tsis nkag rau hauv kev sib raug zoo nrog cov plasma protein. Qhov tshuaj no yog qee qhov ua kom tiav, raug tshem tawm los ntawm cov hlaus thiab cov hnyuv. Ib nrab-lub neej ntawm metformin yog 7 teev.

Glibomet: cov lus qhia ua tiav rau kev siv

Cov tshuaj yog npaj rau hauv lub qhov ncauj. Siv Glybomet nrog cov pluas noj. Kev noj tshuaj thiab kev kho mob yog xaiv tau ntawm tus kheej coj mus rau hauv cov lus qhia txog cov chaw kho mob uas muaj, qib cov piam thaj hauv cov ntshav, nrog rau daim duab tag nrho ntawm cov metabolism hauv kev noj haus.

Feem ntau, cov khoom tso ua ntej ntau npaum ntawm cov tshuaj Glibomet yog 1-3 ntsiav tshuaj. Twb tau thaum lub sij hawm kho cov tshuaj tiv thaiv kab mob, cov tshuaj uas zoo tshaj plaws yog raug xaiv, uas txo cov piam thaj hauv qab mus rau qhov tseem ceeb. Nws tsim nyog sau cia tias kev siv tshuaj ntau tshaj txhua hnub yog 6 ntsiav tshuaj.

Kev piav qhia ntawm cov muaj pes tsawg leeg. Daim Ntawv Tso Tawm Yeeb Tshuaj

Cov tshuaj "Glibomet" muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj dawb puag ncig nrog lub plhaub tawv. Lawv muab tso rau hauv cov hlwv uas yooj yim ntawm 20 daim. Hauv tsev muag tshuaj koj tuaj yeem yuav ib pob uas muaj ob lub hlwv.

Qhov no yog cov khoom siv sib xyaw ua ke, yog li ntawd, qhov muaj pes tsawg leeg muaj ob qho kev ua haujlwm - glibenclamide (2,5 ml hauv ib ntsiav tshuaj) thiab metformin ua hom hydrochloride.Ntawm chav kawm, kev npaj kuj tseem muaj cov tshuaj pab, tshwj xeeb, pob kws hmoov txhuv nplej siab, silicon dioxide, microcrystalline cellulose, talc, diethyl phthalate, glycerin, cellulose acetate phthalate, gelatin.

Cov tshuaj ua rau lub cev hloov li cas?

Yog lawm, kom pib nrog, nws tsim nyog nkag siab txog cov yam ntxwv ntawm cov tshuaj. Cov nyhuv hypoglycemic ntawm Kev Npaj Glibomet yog txiav txim siab los ntawm cov ntsiab lus ntawm ob lub cev ua haujlwm ib zaug.

Cov cuab yeej no ua haujlwm ntawm tus txiav, xws li thaj chaw uas muaj lub luag haujlwm hauv lub cev. Tib lub sijhawm, cov tshuaj pab txoj kev xav ntawm cov phiaj hlwb mus rau cov tshuaj no. Yog li, Glibomet pab txhawm rau txo cov ntshav qab zib yam tsis siv cov tshuaj insulin, uas yog qhov tseem ceeb heev rau ntshav qab zib hom 2.

Cov tshuaj tseem muaj cov lipid-txo cov khoom. Raws li nws cov cawv, cov theem ntawm cov rog hauv cov ntshav yuav txo qis, uas yog qhov ua kom cov ntshav txhaws nyob hauv cov ntshav (ntshav txhaws). Metformin belongs rau cov pab pawg ntawm cov loj loj. Cov tshuaj no ua rau cov txheej txheem ntawm kev ua kom siv cov kua nplaum los ntawm cov leeg nqaij, inhibits gluconeogenesis nyob rau hauv daim siab, thiab inhibits adsorption ntawm carbohydrates los ntawm cov hnyuv phab ntsa.

Glibenclamide nrawm nrawm rau ntawm phab ntsa ntawm txoj hnyuv thiab yuav luag tiav (97%) ua rau cov protein plasma. Hauv daim siab, nws tawg, ua rau lub cev tsis muaj zog, uas tom qab ntawd tau tawm hauv lub cev nrog rau quav thiab tso zis. Ib nrab-lub neej yog 5 teev. Metformin kuj tseem nrawm rau hauv lub cev, tab sis tsis khi rau cov protein ntshav. Qhov khoom siv no tsis yog metabolized hauv lub cev. sib npaug li ob teev.

Thaum twg yog cov tshuaj siv?

Coob leej ntau tus neeg muaj tus mob xws li ntshav qab zib hom 2. Kev noj haus thiab kev kho mob hauv qhov no tseem ceeb heev. Raws li txoj cai, rau cov neeg mob ua rau noj zaub mov kom tsim nyog. Koj tuaj yeem kho koj cov ntshav qab zib nrog sulfonylureas.

Cov tshuaj "Glibomet" yog kev kho mob yog tias kev noj zaub mov noj thiab noj cov nyiaj saum toj no tsis muab cov nyhuv tsim nyog.

Yuav noj cov tshuaj "Glibomet" li cas? Tsuas tshuaj yog txiav txim siab ib tus zuj zus. Raws li txoj cai, thawj koob tshuaj yog ob ntsiav tshuaj. Lawv coj mus nrog noj. Ntxiv mus, qhov nyiaj ntawm cov tshuaj muaj zog nce ua tiav cov nyhuv ntau. Cov koob tshuaj txhua hnub yuav tsum tsis pub ntau tshaj 2 g ntawm metformin. Tom ntej no, lub koob tshuaj yog maj mam txo.

Cov tshuaj "Glibomet": contraindications rau kev kho mob

Qhov no yog qhov muaj zog sib luag, cov tshuaj kho mob hnyav, txais tos kev ua tau yog tsuas yog kev tso cai los ntawm tus kws kho mob. Cov tshuaj muaj ib daim ntawv teev zoo tshaj ntawm contraindications, uas koj yuav tsum paub koj tus kheej nrog ua ntej pib kev kho mob:

cov tshuaj tiv thaiv kom haum rau cov nquag thiab pabcuam ntawm cov ntsiav tshuaj,
ua xua rau lwm cov tshuaj sulfonylurea, thiab sulfamide, probenecid lossis sulfamide diuretics,
cov tshuaj no yog contraindicated rau hauv cov poj niam thaum cev xeeb tub,
tsis muaj kev cuam tshuam los ntawm kev kho,
mob ntshav qab zib coma thiab predomatous mob
mob raum tsis zoo, lub raum tsis ua haujlwm,
lub cev qhuav dej
kis kab mob
mob ailments uas tuaj yeem ua rau kev tsim cov nqaij hypoxia,
cov kab mob loj ntawm cov hlab plawv, nrog rau cov teeb meem kev mob peripheral, myocardial tsis txaus, kis tshuaj lom thiab mob plawv,
yav dhau los mob hnyav ntawm cov kab mob ua pa,
myocardial infarction lossis kev kho kom rov zoo lub sijhawm tom qab nws,
tib lub sijhawm siv tshuaj diuretics thiab tshuaj rau ntshav siab,
acidosis lossis txoj kev pheej hmoo ntawm nws txoj kev loj hlob,
muaj nyob rau hauv tus neeg mob li keeb kwm ntawm cov mob ntawm cov kab mob lactic acidosis,
mob rau daim siab hnyav
kev ua tsis taus ntawm lub nruab pa,
kev rov ua kom tiav lub sijhawm tom qab kho tau qee feem ntawm tus txiav,
dystrophic pathologies,
haus cawv qaug cawv, lub xeev qaug cawv qaug cawv,
mob ntshav khov
poj laib
kev pub mis
yoo mov los yog ua raws cov zaub mov nruj.

Yog tias koj muaj ib qho ntawm cov lus saum toj saud sib txuas ntxiv, tom qab ntawd nws tsim nyog hais qhia rau tus kws kho endocrinologist.

Kev phiv tshuaj dab tsi tuaj yeem kho tau?

Puas yog ib txwm xav tias nws muaj kev nyab xeeb los noj cov ntsiav tshuaj Glibomet? Kev mob tshwm sim rau keeb kwm ntawm kev kho yog qhov ua tau. Cov xwm txheej ntawm lawv qhov tshwm sim, txawm li cas los xij, tsis raug sau cia ntau zaus, tab sis kev kho mob tuaj yeem cuam tshuam cov kab ke hauv lub cev.

Lymphatic system thiab ntshav Cov. Hemolytic anemia, leukopenia, thrombocytopenia, pancytopenia, erythrocytopenia.
CNS Cov. Qee zaus mob taub hau, hnov qhov txawv saj.
Organs ntawm lub zeem muag. Kev cuam tshuam ntawm kev pab, poob qis pom kev, uas cuam tshuam nrog kev hloov pauv hauv cov ntshav qab zib.
Kev zom zaub mov Cov. Kev nce ntxiv hauv lub cev hnyav, cov ntshav qog ntshav qab zib, lactic acidosis. Kev kho mus sij hawm ntev qee zaum ua rau kev tsis hnov qab nqus ntawm cov vitamin B12 nyob rau hauv cov hnyuv, uas tom qab ntawd pab txhawb kev txhim kho megaloblastic anemia.
Lub plab zom mov Cov. Xeev siab, ntuav, tsam plab, mob nyob rau thaj chaw epigastric, nquag plam, tsis qab los noj mov, qhov zoo li lub ntsej muag me me hauv lub qhov ncauj, zoo nkaus li lub plab tag nrho.
Daim tawv nqaij thiab cov nqaij mos Cov. Cov tawv nqaij khaus, erythema, ntau yam exanthema, nce rhiab heev ntawm cov tawv nqaij ua kom pom kev, ua pob khaus tawv nqaij, ua pob ua zas.
Kev ua xua tsis haum Cov. Cov pob khaus ntawm daim tawv nqaij, o, ua daj, ua kom ntshav siab, txo qis, ua pa nyuaj, poob siab.
Lub siab Cov. Kab mob cholestasis, tshuaj tiv thaiv kab mob siab.
Qee qhov teeb meem ntxiv tuaj yeem tshwm sim, tshwj xeeb, qhov nce ntxiv rau hauv lub hnub cov zis, poob ntawm cov protein thiab sodium los ntawm lub cev yog qhov tshwm sim ntawm qhov tsis pom zoo hauv lub raum.

Nws tsim nyog sau cia tias feem ntau ntawm cov teeb meem saum toj no tsis tas yuav tsum tsis tsum kev kho mob - nws txaus los txo qhov koob tshuaj thiab cov kev mob tsis zoo mus rau lawv tus kheej. Qhov ntau npaum li cas ntawm cov tshuaj yuav tsum tau nce ntxiv qeeb thiab maj mam.

Cov ntaub ntawv hais txog kev sib txuam nrog lwm cov tshuaj

Cov tshuaj "Glibomet" (metformin) tsis tuaj yeem nqa nrog ethyl cawv, vim tias qhov no yuav ua rau muaj kev lactic acidosis ntau. Thaum kho, cawv thiab dej cawv uas muaj cawv yuav tsum muab pov tseg.

Kev siv cov tshuaj no tau nres 48 teev ua ntej cov txheej txheem nyob rau hauv uas muaj cov tshuaj tiv thaiv iodine uas muaj cov neeg sawv cev siv tau los siv. Kev siv cov tshuaj no ib txhij tuaj yeem ua rau txoj kev txhim kho lub raum tsis ua haujlwm.

Yog tias koj noj "Glybomet" nrog rau cov tshuaj insulin, anabolic steroids, beta-adrenergic blockers, tetracycline tshuaj, ces qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia nce. Tus mob ntshav qab zib ib txwm xav qhia rau lawv tus kws kho mob txog txhua yam tshuaj uas lawv noj.

Nqi thiab analogues

Hauv cov tshuaj niaj hnub, cov tshuaj "Glibomet" feem ntau siv. Kev txheeb xyuas cov ntshav qab zib, cim thiab contraindications yog, tau kawg, cov ntsiab lus tseem ceeb. Tab sis tsis muaj tsawg tshaj qhov tseem ceeb yog nws tus nqi. Yog lawm, nws yog qhov nyuaj rau npe tus naj npawb, tab sis nyob rau nruab nrab tus nqi ntawm ib pob ntawm 40 ntsiav tshuaj nyob ntawm 340 txog 380 rubles, uas yog qhov tseeb tsis ntau.

Yog lawm, cov tshuaj no tsis zoo rau cov neeg mob. Muaj kev hloov txaus nyob rau hauv kev lag luam tshuaj niaj hnub no. Piv txwv li, nrog ntshav qab zib ntawm hom ob, xws li txhais tau tias Avandamet, Vokanamet, Glukovans feem ntau siv. Tsis muaj tsawg dua, cov neeg mob tau raug txiav txim Dibizid, Dianorm lossis Sinjarji. Tau kawg, tsuas yog tus koom nrog endocrinologist tuaj yeem xaiv qhov sib piv zoo.