Cov kua nplaum: analogues, muaj pes tsawg leeg, cov lus qhia rau kev siv thiab tshuaj xyuas
Glucovans yog cov tshuaj hypoglycemic ua ke, tsim ntawm metformin thiab glibenclamide.
Raws li paub, metformin belongs rau cov pab pawg ntawm biguanides. Nws siv nws pab txo cov piam thaj hauv cov lus muaj pes tsawg leeg. ntshav ntshavCov. Hauv qhov no, tsis muaj qhov tshwj xeeb zais kev zais tshuaj insulinyog li tsis txhim kho ntshav qog.
Feem ntau, 3 kev ua haujlwm ntawm kev coj ua yog yam ntxwv ntawm metformin, uas yog:
- txo cov piam thaj hauv kev ua haujlwm hauv lub siab los ntawm kev zom cov glycogenolysis thiab gluconeogenesis,
- peripheral receptor insulin rhiab heev, qabzib tau thiab siv los ntawm cov leeg hlwb,
- ncua kev nqus ntawm cov piam thaj hauv cov hnyuv.
Tsis tas li ntawd, cov tshuaj muaj cov txiaj ntsig zoo rau muaj pes tsawg leeg ntshavlowers theem rojkab triglyceridesthiab yog li ntawd.
Glibenclamide, sulfonylurea derivative, muaj peev xwm txo qis piam thaj los ntawm kev ua kom muaj zog ntawm cov kua dej los ntawm β-cov hlwb hauv cov txiav ua ke.
Txawm hais tias metformin thiab glibenclamide yog cov yam ntxwv los ntawm cov kev sib txawv ntawm kev nqis tes ua, lawv ua kom tiav rau ib leeg cov nyhuv hypoglycemic. Hauv kev sib koom ua ke, cov neeg sawv cev no ua rau muaj kev sib txuam hauv kev txo cov ntsiab lus ntawm piam thaj.
Nrog kev tswj hwm sab hauv ntawm glibenclamide, nws txoj kev nqus hauv txoj hnyuv plab yog tsawg kawg 95%. Qhov tshuaj no yog micronized. Kev ua tiav ntawm qhov kev xav tau ntau tshaj plaws hauv lub ntshav tau tiav hauv 4 teev Kev khi rau cov protein ntshav sib raug rau 99%. Raws li qhov tshwm sim metabolism hauv 2 lub cev tsis ua haujlwm yog tsim hauv lub siab metaboliteexcreted los ntawm ob lub raum thiab bile.
Metformin yog tus cwj pwm los ntawm kev nqus tau tag nrho los ntawm txoj hnyuv hauv plab, kom ncav cuag qhov siab tshaj plaws tom qab 2.5 teev Cov khoom tsis zoo. Nyob rau tib lub sijhawm, nws feem yog ua rau tsis hloov nrog kev pab ntawm lub raum.
Kev sib xyaw ua ke ntawm metformin thiab glibenclamide muaj tib lub bioavailability raws li cov tshuaj cais. Kev noj tsis cuam tshuam rau kev noj qab haus huv ntawm metformin, tab sis nce tus nqi ntawm kev nqus ntawm glibenclamide.
Kev ntsuas rau siv
Qhov qhia txog kev noj tshuaj yog ntshav qab zib hom 2 hauv cov neeg laus cov neeg mob:
- nrog kev ua tsis tau zoo kev noj haus, kev tawm dag zog lub cev thiab kev kho mob yav dhau los nrog metformin,
- txhawm rau los hloov kev kho mob yav dhau los rau cov neeg mob nyob rau hauv uas theem ntawm glycemia yog tswj tau.
Cov Yuav Tsum Muaj
Cov tshuaj tsis pom zoo rau:
- rhiab rau nws thiab nws muaj pes tsawg leeg,
- yam kuv mob ntshav qab zib
- lub raum tsis ua hauj lwm thiab mob raum,
- cov kab mob hauv plab ketoacidosis, precomthiab coma
- mob uas ua rau lub raum hloov pauv: lub cev qhuav dej, mob hnyav, ntaus poob siab thiab lwm yam,
- mob los yog mob ua ke nrog cov nqaij mos hypoxia: lub plawv lossis txoj hlab ua pa tsis ua hauj lwm, yav dhau los myocardial infarctionpoob siab lub xeev
- thaum yau
- daim siab ua hauj lwm
- porphyria
- lactation, cev xeeb tub,
- dav hlais tawm
- haus cawv ntev ntev los sis qaug cawv qaug cawv,
- lactic acidosis,
- adhering kom tsawg-cov zaub mov tsis muaj calorie.
Ntxiv rau, cov tshuaj tsis pom zoo rau cov neeg mob hnub nyoog 60 xyoo, cov neeg ua haujlwm hnyav thiab muaj cov kab mob tsis tshua muaj kab mob txuam nrog galactose intolerance, glucose-galactose malabsorption syndrome thiab lactase deficiency.
Kev ceev faj yuav tsum tau siv rau kev kho mob los ntawm cov neeg mob febrile syndrome, adrenal tsis txaus, kev ua haujlwm ntawm lub caj pas anterior pituitary, lub qog ua haujlwm thiab lwm yam kev cuam tshuam.
Sab sij huam
Thaum kho nrog Glucovans, kev mob tshwm sim feem ntau cuam tshuam rau ntau yam plab hnyuv siab raum thiab cov kab ke ntawm lub cev.
Kev mob plab zom mov tuaj yeem nrog kev mob ntshav qab zib, kev tawm tsam ntawm cov hlab pob txha lossis mob hlais ntshav, lactic acidosis, thiab lwm yam.
Kev mob ncig thiab lymphatic system tuaj yeem hnov mob leukopenia, thrombocytopenia, agranulocytosisuas feem ntau dhau mus tom qab thim yeeb tshuaj.
Ib qhov kev cuam tshuam cuam tshuam rau kev ua haujlwm ntawm lub paj hlwb yog kev ua txhaum ntawm saj. Kev ua tsis zoo rau cov kev ua haujlwm ntawm cov plab hnyuv siab raum ntawm lub zeem muag, lub plab zom mov, tawv nqaij thiab cov nqaij mos subcutaneous kuj tsis raug cais tawm.
Kev txhaj tshuaj tiv thaiv kev tiv thaiv kab mob, kab mob siab hepatobiliary thiab hloov pauv hauv qhov ntsuas, piv txwv li, kev nce siab hauv qee qhov, qee zaum kuj yuav tshwm sim urea creatininekev txhim khotshuaj mob siab ntsws.
Cov lus qhia rau kev siv ntawm Glucovans (Txujci thiab ntau npaum li cas)
Tus neeg sawv cev hypoglycemic no yog npaj rau kev tswj hwm ntawm qhov ncauj. Hauv qhov no, kev qhia rau kev siv ntawm Glucovans tau tshaj tawm tias cov koob tshuaj tau txiav txim siab tus kheej rau qee kis thiab nyob ntawm qib glycemia.
Pib kho nrog ib ntsiav tshuaj rau ib koob tshuaj txhua hnub. Txhawm rau tiv thaiv kev txhim kho hypoglycemia, nws yog qhov tsim nyog tias thawj koob tshuaj tiv thaiv tsis tshaj li qhov niaj hnub noj tshuaj ntawm glibenclamide lossis metformin, uas tau siv ua ntej. Yog li, koj tuaj yeem nce koob tshuaj ntau npaum li 5 mg + 500 mg txhua hnub txhua 2 lossis ntau lub lis piam. Txoj hau kev no tso cai rau koj kom ua tiav kev tswj cov ntshav qabzib kom txaus.
Txhawm rau hloov cov kev kho ua ke yav dhau los nrog metformin thiab glibenclamide, cov koob tshuaj thawj zaug tau tsim raws li cov tshuaj uas tau txais yav tas los. Txhua txhua 2 lossis ntau lub lim tiam txij li hnub pib los kho, ib koob tshuaj yuav tau kho nyob ntawm qib glycemia.
Hauv qhov no, qhov ntau tshaj txhua hnub ntau npaum li cas yog 4 ntsiav tshuaj Glucovans 5 + 500 mg lossis 6 ntawm 2.5 + 500 mg. Kev siv tshuaj kho kom haum raws tus kheej qhov kev pom zoo ntawm cov kws tshaj lij.
Cov ntsiav tshuaj yuav tsum noj nrog zaub mov. Nws yog ib qho tseem ceeb uas txhua txoj kev siv tshuaj yog nrog los ntawm kev siv cov zaub mov muaj protein ntau, uas yuav pab tiv thaiv qhov tshwm sim ntawm kev mob ntshav qab zib.
Noj ntau dhau
Nyob rau hauv cov ntaub ntawv ntawm overdose, hypoglycemia yuav tsim. Rau cov tsos mob me mus rau sim, qhov ib txwm ua tau tiav los ntawm kev noj qab haus huv tam sim ntawd. Tab sis koj kuj tseem yuav tsum tau kho qhov ntau thiab cov zaub mov noj kom ntau.
Kev mob ntshav qis heev, nrog rau kev tsis nco qab, paroxysm, qee qhov kev mob puas siab ntsws, xav tau kev kho mob sai.
Qhov kev kho mob tseem ceeb suav nrog txhaj cov tshuaj mus rau txoj hlab ntshav. Dextrosethiab lwm yam kev kho mob. Thaum lub siab nco qab rov qab, tus neeg mob yuav tsum tau noj zaub mov nplua nuj nyob hauv cov khoom noj zom tau yooj yim, uas yuav zam tau qhov rov qab txhim kho kev mob ntshav qab zib.
Ib qho ntxiv, kev txhim kho ntawm cov kab mob lactic acidosis, kev kho mob uas tau ua nyob hauv tsev kho mob, tsis suav nrog. Ib txoj hauv kev kho kom zoo uas pab tshem tawm metformin thiab lactate yog hemodialysis.
Kev sib txuam
Noj cov tshuaj no nrog Miconazole tej zaum yuav ua rau kev txhim kho hypoglycemia vim yog cov ntsiab lus ntawm glibenclamide hauv nws. Txwv tsis pub siv tib si nrog cov tshuaj iodine uas muaj cov tshuaj zoo sib xws tsis tso cai.
Phenylbutazone muaj peev xwm nce cov hypoglycemic nyhuv ntawm cov tshuaj. Kev sib xyaw nrog Bosentan.
Thaum siv cov cuab yeej no, nws raug nquahu kom xyuam xim Chlorpromazine, Tetracosactide, Danazole,on2-adrenergic agonists, tshuaj kho mob, qee qhov ACE inhibitors tuaj yeem hloov pauv cov piam thaj hauv cov ntshav thiab ua rau txoj kev txhim kho tsis zoo. Yog li, kev noj tshuaj ib qho twg yuav tsum tau sab laj kev sab laj ntawm tus kws kho mob tshwj xeeb.
Glucovans analogues
Lub ntsiab analogues:Glybomet, Glucofast, Metformin thiab Siofor.
Kev siv dej cawv ib txhij yuav ua rau kev txhim kho ntawm cov kab mob lactic acidosis, tuaj yeem nce nrog kev haus dej cawv ua ke. Tus mob yog aggravated los ntawm kev tshaib plab lossis zaub mov tsis zoo, nrog rau daim siab tsis ua haujlwm. Ntxiv rau, cawv feem ntau ua rau cov ntshav qabzib. Yog li, kev haus dej cawv thiab lwm yam khoom muaj cawv yuav tsum yoo nqhis.
Cov Kev Ntsuam Xyuas Ntawm Glucovans
Cov lus sib tham ntawm cov cuab yeej no feem ntau pom ntawm cov rooj sib tham txog ntshav qab zib. Cov neeg mob uas tau sau cov tshuaj no feem ntau tham txog cov lus nug txog kev xaiv ntawm lub tswvyim thiab ntau npaum li cas, nrog rau kev sib koom tes nrog ntau yam tshuaj. Tib lub sijhawm, kev tshuaj xyuas hais txog Cov Kab Tsib 5 + 500 mg thiab 2.5 + 500 mg yog qhov muaj teeb meem tshaj plaws. Feem ntau, txhawm rau kom ua tiav qhov kev ua tau zoo, nws yog qhov yuav tsum tau soj ntsuam cov calories ntau ntawm cov khoom noj carbohydrates thiab, ntawm chav kawm, ntau npaum li cas ntawm cov tshuaj.
Hmoov tsis zoo, qee zaum muaj kev tshuaj xyuas tias kev noj cov tshuaj no tsis ua rau muaj kev ntxhov siab. Piv txwv, hauv qee cov neeg mob, muaj kev ua tsis zoo ntawm cov suab thaj hauv cov ntshav, uas yog, hypoglycemia. Lwm tus neeg mob tau qhia tias txhawm rau ua kom lawv txoj kev noj qab haus huv zoo, lawv yuav tsum tau kho lub neej ntev thiab kho lub neej ntev.
Txawm li cas los xij, cov tshuaj ntawm hom no yog qhov tseem ceeb tshwj xeeb rau kev kho mob, vim lawv txhim kho lub neej zoo ntawm cov neeg mob ntshav qab zib. Cov kev kuaj pom no qhia tau tias tus neeg mob lub cev yuav tsum tswj hwm thiab kho mob tshwj xeeb. Qhov no tsuas yog ua tau ua tsaug rau kev sib koom tes ntawm tus kws kho mob thiab tus neeg mob, uas ua rau kev txhim kho tseem ceeb hauv tus mob.
Kev Sau Ua ke, cov ntsiab cai ntawm kev nqis tes ua thiab taw qhia rau kev siv
Glucovans yog ib hom tshuaj uas cov tshuaj ua kom muaj zog yog metformin thiab glibenclamide. Nws yog rau cov chav kawm ntawm cov tshuaj sib xyaw ua ke hypoglycemic uas tau tsim los siv ua ib feem ntawm txoj kev kho mob rau cov neeg mob ntshav qab zib mellitus ntawm daim ntawv thib ob (hom tsis muaj insulin-tiv thaiv hom mob). Daim ntawv tso tawm - ntsiav tshuaj rau lub qhov ncauj tswj hwm. Cov pob ntawv muaj ob lossis plaub lub hlwv, txhua tus muaj 10 lossis 15 ntsiav tshuaj. Nyob ntawm seb muaj pes tsawg leej hauv cov pob, tus nqi sib txawv ntawm 280 txog 400 rubles.
Lub hauv paus ntsiab lus ntawm kev ua yeeb tshuaj tuaj yeem piav qhia hauv cov lus yooj yooj yim: thaum noj nrog zaub mov, nws pab ua kom qeeb lossis qee qhov nqus cov carbohydrates, vim qhov kev cuam tshuam ntawm cov tshuaj hormones hauv ntshav yuav zam tau. Lub hauv paus tseem ceeb ntawm cov tshuaj metformin yog suav nrog hauv pawg pharmacological ntawm biguanides, raws li muaj pov thawj los ntawm cov lus qhia rau kev siv. Glucovans analogues ua haujlwm tau zoo vim yog tib cov tshuaj. Yog li ntawd, nws ua rau kev nkag siab rau kev sim nrog kev xaiv rau koj tus kheej ntawm cov tshuaj uas tsim nyog los ntawm cov nqi pheej yig dua, tab sis nrog cov khoom sib xws hauv cov muaj pes tsawg leeg.
Rau metformin (uas yog lub tseem ceeb muaj kuj rau ntau Glucovans analogues), peb lub hauv paus ntawm kev raug rau lub cev yog yam ntxwv:
- lub siab ua cov piam thaj ntau ntau los ntawm inhibiting glycogenolysis thiab gluconeogenesis,
- peripheral receptor insulin rhiab heev, qabzib tau thiab siv los ntawm cov leeg hlwb,
- ncua kev nqus ntawm cov piam thaj hauv cov hnyuv.
Vim tias cov teebmeem no dhau los, cov tshuaj tau ua pov thawj nws tus kheej hauv kev kho mob hom 2 mob ntshav qab zib mellitus - ob qho tib si los ua cov cuab yeej ywj pheej thiab kev txhawb nqa kev kho mob (nws muaj peev xwm siv nws nrog rau lwm cov tshuaj, vitamins thiab zaub mov noj tom qab kev pom zoo ntawm chav kawm ntawm kev kho mob los ntawm koom nrog endocrinologist).
Mob ntshav qab zib Hom 1 thiab Hom 2
Ntshav qab zib mellitus yog qhov "mob plague" tiag ntawm peb lub sijhawm. Endocrinologist ua rau lub tswb nrov: hauv xyoo tsis ntev los no, cov neeg mob ntshav qab zib hom mob ntshav qab zib tau dhau los hauv cov neeg hluas. Kwv yees li tsib caug xyoo dhau los, tus kabmob no tau kuaj pom, raws li txoj cai, tsuas yog hauv cov neeg (feem ntau yog cov pojniam) laus dua 50 xyoo. Feem ntau, cov ua rau nws txoj kev txhim kho tsis zoo rau kev noj haus tsis zoo rau ntau xyoo, ua haujlwm tsis zoo ntawm tus txiav, mob hnyav poob siab thiab mob siab ntev.
Nws pom tau tias yuav siv cov tshuaj yog tias tus neeg mob tsis tau txais insulin los ntawm kev txhaj tshuaj. Nws tsis muaj teeb meem tias tus neeg mob ntshav qab zib ua raws li cov zaub mov tshwj xeeb uas tsis muaj carb lossis tsis haus, Cov Glucovans 5500 thiab cov tshuaj analogues nrog tib cov tshuaj metformin nyob rau hauv cov muaj pes tsawg leeg nrog kev noj haus tsis tu ncua yuav ua kom muaj kev nqus tsawg ntawm cov khoom noj. Yog lawm, noj cov tshuaj no tsis yog indulgence rau licentiousness hauv cov zaub mov. Txawm hais tias tawm tsam keeb kwm ntawm txoj kev kho tshuaj, tus neeg mob yuav tsum ua raws li cov kev cai ntawm kev noj zaub mov tsis muaj carb tsawg. Txawm li cas los xij, endocrinologist feem ntau ceeb toom lawv cov neeg mob tias cov analogues ntawm Glucovans nrog metformin hauv kev sib xyaw ua rau nws tsis tuaj yeem ua raws li kev noj zaub mov noj kom nruj me ntsis, tsis muaj kev ntshai txog qhov tshwm sim ntawm kev noj qab haus huv tsis zoo thiab tshwm sim sai sai hauv qab zib. Tab sis tsis txhob cia siab ntau dhau rau cov nyhuv ntawm cov tshuaj - qhov ntau ntawm cov carbohydrates noj nrog zaub mov yuav tau raug txo kom nyob hauv txhua kis.
Cov tshuaj tiv thaiv thiab kev pom zoo kom ntau npaum li cas
Cov kev qhia rau kev siv xov xwm qhia tias muaj cov nram qab no contraindications rau noj Glucovans ntsiav tshuaj:
- ntshav qab zib hom 1
- mob raum tsis ua hauj lwm thiab lwm txoj kev ua haujlwm ntawm lub raum (sab laj kev sab laj nephrologist yuav tsum tau),
- cev xeeb tub, lactation,
- rov qab lub sijhawm tom qab phais,
- haus cawv qaug cawv, lub sij hawm haus cawv,
- lub cev qhuav dej, lub sijhawm uas muaj mob hnyav,
- kab mob siab mob siab (txais tos yog muaj peev xwm tom qab sab laj nrog tus kws kho kab mob siab).
Glucovans 500 thiab cov tshuaj analogues ntawm cov tshuaj no cuam tshuam rau kev nqus ntawm carbohydrates, yog li ntawd, txawm tias nrog ib koob tshuaj, lawv tuaj yeem ua rau tsis zoo rau cov neeg mob uas muaj kab mob siab thiab raum. Kev tswj hwm tus kheej ntawm cov tshuaj yog tsis yooj yim sua - txawm hais tias nws muag tau yam tsis muaj daim ntawv xaj thiab leej twg tuaj yeem yuav nws, koj yuav tsum yauv mus kuaj hauv cov nruab nrog cev ua ntej noj nws thiab nco ntsoov sab laj nrog tus kws kho mob endocrinologist. Nws feem ntau tsis yooj yim kom nrhiav tau qhov ntau npaum haum rau tus neeg mob - ib ntsiav tshuaj ib hnub yog txaus rau ib tug neeg, thiab peb yuav tsis txaus rau ib tug neeg. Cov khoom noj zoo tshaj nyob ntawm tus yam ntxwv ntawm lub cev - qhov hnyav, poj niam txiv neej, hnub nyoog, cov ntshav kuaj tau.
Sau cov analogues los ntawm cov ntsiab cai ntawm kev ua haujlwm
Kev ntsuas tshuaj thiab hloov chaw rau cov tshuaj "Glucovans", uas tseem muaj cov metformin ua cov tshuaj tseem ceeb:
- Galvus Met,
- Siofor
- Glucophage,
- Glibomet,
- Gluconorm,
- Awb M
Tag nrho cov tshuaj no muaj tib lub ntsiab cai ntawm kev nqis tes ua - lawv txo qhov nqus ntawm carbohydrates, kom tus neeg mob pib zoo zuj zus ntxiv, nqhis rau cov carbohydrates yooj yim poob qis, nws yuav yooj yim rau kev noj zaub mov, thiab ntshav qab zib cov ntshav yuav rov qab ua haujlwm.
Cov Pheej Yig Tshaj Qhov Pauv ntawm Glucovans ntsiav tshuaj yog Metformin. Txawm li cas los xij, hauv cov chaw muag tshuaj nws yog qhov nyuaj heev kom nrhiav tau. Txawm hais tias nws muaj nyob, cov kws muag tshuaj nyiam rau cov khoom sib npaug ntau dua.
Galvus Met: cov lus qhia rau kev siv thiab tshuaj xyuas cov analogue ntawm Glucovans
Tus nqi ntawm cov tshuaj yog li 1300 rubles rau ib pob. Galvus Met kim dua vim tias, ntxiv rau metformin, vildagliptin tseem suav nrog. Cov no yog ob qho hypoglycemic cheebtsam uas muaj cov nyhuv sib txawv. Hauv tshwj xeeb, vildagliptin yog dipeptidyl peptidase-4 inhibitor. Ua ke nrog metformin, cov tshuaj no ua rau txo qis hauv cov ntshav qabzib ntau. Feem ntau ntawm cov neeg mob uas muaj ntshav qab zib hom 2 xav tau tsuas yog noj ib ntsiav ib hnub, thaum Glucovans yuav tsum noj ob peb zaug hauv ib hnub.
Yog li no, tus nqi siab raug txiav txim: qhov tshwm sim, Galvus Met txoj kev feem ntau raug nqi ntau dua li ntawm Glucovans txuj ci. Kev txheeb xyuas cov cuab yeej "Galvus Met" yog qhov txawv. Feem ntau nyob ntawm ntau npaum li cas ib tug neeg ua raws kev noj haus. Feem ntau ntawm kev tshuaj xyuas tseem yog qhov zoo: cov neeg mob taw qhia tias, ua tsaug rau kev noj tshuaj tsis tu ncua, lawv muaj peev xwm rov qab ua cov ntshav qabzib hauv lub cev. Nws yog, ntawm chav kawm, feem ntau, nce siab, tab sis ruaj khov, qhov txiaj ntsig ntawm qhov uas cov neeg mob hnov zoo siab, ua haujlwm zoo thiab tsis raug kev txom nyem los ntawm kiv taub hau, xeev siab thiab lwm yam kev tshwm sim ntawm tus kab mob.
Kev piav qhia ntawm daim ntawv tshuaj
Muab koob tshuaj 2.5 mg +500 mg: cov ntsiav tshuaj zoo li tus ua nrog tshuaj ntsiav, coated nrog zaj duab xis ntuag ntawm lub teeb txiv kab ntxwv xim, nrog kev sau ua "2.5" ntawm ib sab.
Muab koob tshuaj 5 mg +500 mg: cov ntsiav tshuaj zoo li tus ua npuas roj vov, txau nrog txheej daj zaj duab xis txheej, nrog pob ntawv "5" ntawm ib sab.
Cov Tshuaj Pharmacokinetics
Glibenclamide. Thaum muab tshuaj, nqus tau los ntawm txoj hnyuv hauv plab ntau dua 95%. Glibenclamide, uas yog ib feem ntawm cov tshuaj Glucovans is, yog micronized. Cmax hauv ntshav ntxiv mus txog li 4 teev, Vd - txog 10 litres. Kev sib txuas lus nrog cov protein ntshav yog 99%. Yuav luag txhua qhov ua tiav nyob hauv daim siab nrog rau kev tsim ntawm ob lub cev tsis muaj zog, uas tau tawm los ntawm lub raum (40%) thiab nrog cov kua tsib (60%). T1/2 - txij 4 txog 11 teev
Metformin. Tom qab lub qhov ncauj tswj hwm, nws yog nqus tau los ntawm cov hnyuv zoo tag nrho, Cmax nyob rau hauv cov ntshav ntshav tau tiav hauv 2.5 teev. Kwv yees li 20-30% ntawm metformin raug ntaws tawm los ntawm txoj hnyuv plab hauv daim ntawv tsis hloov. Kev tsis raug cai txog kev nyab xeeb yog los ntawm 50 txog 60%. 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. T1/2 qhov nruab nrab li ntawm 6,5 teev .Txoj kev ua haujlwm tsis zoo rau lub raum, lub raum kev pom zoo tsawg zuj zus, ib yam li kev tua neeg tsis muaj kev phom sij, thaum T1/2 nce ntxiv, uas ua rau muaj kev nce ntxiv ntawm cov metformin hauv cov ntshav ntshav.
Kev sib xyaw ntawm metformin thiab glibenclamide nyob rau hauv tib daim ntawv tshuaj muaj tib lub bioavailability zoo li thaum noj 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 taw qhia ntawm cov tshuaj Glukovans ®
Ntshav qab zib Hom 2 rau cov neeg laus:
- nrog qhov tsis muaj txiaj ntsig ntawm kev kho kev noj haus, kev tawm dag zog thiab kev kho mob yav dhau los nrog metformin lossis sulfonylurea derivatives,
- los hloov cov kev kho mob yav dhau los nrog ob yam tshuaj (metformin thiab sulfonylurea derivative) hauv cov neeg mob uas muaj lub qog thiab tswj tau zoo ntawm glycemia.
Cev xeeb tub thiab lactation
Kev siv cov tshuaj yog contraindicated thaum cev xeeb tub. Tus neeg mob yuav tsum tau ceeb toom tias thaum lub sijhawm kho nrog tshuaj Glucovans ® nws yog qhov yuav tsum tau qhia rau tus kws kho mob txog qhov kev npaj cev xeeb tub thiab kev pib ntawm kev xeeb tub. Thaum npaj lub cev xeeb tub, nrog rau kev muaj cev xeeb tub thaum lub sijhawm noj cov tshuaj Glucovans ®, cov tshuaj yuav tsum tau tshem tawm thiab kho cov tshuaj insulin.
Glucovans ® sib kis hauv kev pub niam mis, vim tias tsis muaj ib qho pov thawj ntawm nws qhov peev xwm mus rau hauv niam mis.
Sab sij huam
Cov kev mob tshwm sim hauv qab no tuaj yeem tshwm sim thaum kho nrog Glucovans ®: ntau zaus cov kev mob tshwm sim ntawm cov tshuaj yog kwv yees li nram no: ntau heev - /1 / 10, heev heev - ≥1 / 100, mob plab hnyuv: heev heev - xeev siab, ntuav, raws plab, mob plab thiab tsis qab los noj mov. Cov tsos mob no tshwm sim ntau dua thaum pib kho thiab feem ntau kis ntawm lawv tus kheej. Txhawm rau tiv thaiv kev txhim kho ntawm cov tsos mob no, nws raug nquahu kom noj cov tshuaj nyob rau hauv 2 lossis 3 koob tshuaj, ib qho kev nce qeeb ntawm cov tshuaj ntawm cov tshuaj kuj tseem txhim kho nws lub siab.
Ntawm ib feem ntawm daim tawv nqaij thiab cov nqaij mos subcutaneous: tsis tshua muaj tshwm sim, cov tawv nqaij ua xua, xws li khaus, urticaria, maculopapular pob, tsis tshua muaj heev, tawv nqaij lossis visceral ua xua vasculitis, polymorphic erythema, exfoliative dermatitis, photosensitivity.
Kev Txhaj Tshuaj Tiv Thaiv: tsawg tsawg - anaphylactic ceeb. Tus mob khaub thuas sib deev tsis haum rau cov tshuaj sulfonamides thiab lawv lub zog sib deev tuaj yeem tshwm sim.
Hepatobiliary mob: muaj tsawg kawg - kev ua haujlwm ntawm daim siab ua haujlwm tsis zoo los yog mob rau daim siab, yuav tsum tsis ua haujlwm kho ntxiv.
Cov lus qhia tshwj xeeb
Tawm tsam tom qab ntawm kev kho mob nrog Glucovans ®, nws yog qhov yuav tsum tau saib xyuas qib ntawm glycemia ntawm lub plab khoob thiab tom qab noj mov.
Cov kab mob lactic acid yog ib yam mob uas tsis tshua pom muaj tab sis mob hnyav (tuag thaum lub sijhawm tsis muaj kev kho mob sai) ua rau cov nyom uas tshwm sim vim kev txuam nrog metformin. Cov mob uas cov kab mob lactic acid nyob rau hauv cov neeg mob kho nrog metformin tshwm sim feem ntau hauv cov neeg mob ntshav qab zib mellitus uas mob raum tsis ua haujlwm.
Lwm yam kev pheej hmoo cuam tshuam yuav tsum txiav txim siab, xws li tswj ntshav qab zib tsis zoo, ketosis, kev yoo mov ntev, kev haus cawv ntau dhau, kab mob siab, thiab lwm yam kev mob cuam tshuam nrog hypoxia hnyav.
Koj yuav tsum coj mus rau hauv qhov kev pheej hmoo ntawm cov kab mob lactic acidosis nrog cov tsos mob ntawm qhov tsis muaj qhov cim, xws li mob leeg, nrog cov mob plab tsis ua hauj lwm, mob plab thiab mob hnyav. Thaum mob hnyav, ua pa acidotic txog siav, hypoxia, mob hypothermia, thiab coma yuav tshwm sim.
Kev kuaj pom tseeb yog: ntshav pH qis, ntshav lactate siab siab tshaj 5 mmol / l, nce siv anionic interval thiab lactate / pyruvate piv.
Txij li thaum Glucovans ® muaj cov tshuaj glibenclamide, kev noj cov tshuaj nrog cov phom sij hauv lub cev. Kev maj mam dhau ntawm kev txhaj tshuaj tom qab pib txoj kev kho mob tuaj yeem tiv thaiv qhov tshwm sim ntawm kev mob ntshav qab zib. Txoj kev kho no tsuas yog kho tau rau tus neeg mob uas ua raws li txoj kev noj mov tsis tu ncua (suav nrog noj tshais). Nws yog ib qho tseem ceeb tias cov khoom noj ua kom muaj carbohydrate yog tsis tu ncua, vim qhov kev pheej hmoo ntawm kev txhim kho hypoglycemia nce nrog cov pluas mov lig, tsis txaus los yog tsis noj zaub mov carbohydrate. Kev txhim kho cov ntshav qog ntshav qab zib feem ntau yuav nrog kev noj zaub mov hypocaloric, tom qab kev ua haujlwm lub cev lossis lub sijhawm ntev, nrog haus cawv lossis nrog cov tshuaj tiv thaiv hypoglycemic.
Vim tias cov tshuaj tiv thaiv yog tshwm sim los ntawm kev mob ntshav qab zib, tawm hws, ntshai, tachycardia, tawg, palpitations, angina pectoris thiab arrhythmia tuaj yeem tshwm sim. Cov tsos mob tom kawg tej zaum yuav tsis tuaj yeem yog tias hypoglycemia tsim qeeb qeeb, nyob rau hauv cov ntaub ntawv ntawm autonomic neuropathy lossis thaum noj β-blockers, clonidine, reserpine, guanethidine lossis sympathomimetics.
Lwm cov tsos mob ntawm tus mob ntshav qab zib tsawg nyob rau hauv cov neeg mob ntshav qab zib tuaj yeem suav nrog mob taub hau, tshaib plab, xeev siab, ntuav, qaug zog heev, cuam tshuam pw tsaug zog, ntxhov siab, ntxhov siab, tsis hnov qab thiab muaj lub siab xav, kev nyuaj siab, tsis meej pem, hais lus tsis meej, pom kev tsis meej, tshee tshee, tuag tes tuag taw thiab paresthesia, kiv taub hau, delirium, convulsions, tsis ntseeg, tsis nco qab lawm, ua pa nyuaj, thiab bradycardia.
Txoj kev kho mob kom zoo, kev xaiv koob tshuaj, thiab cov lus qhia kom zoo rau tus neeg mob yog qhov tseem ceeb uas yuav txo tau kev mob ntshav siab. Yog hais tias tus neeg mob rov qab ua rau muaj kev mob ntshav qab zib, uas yog mob hnyav lossis cuam tshuam nrog kev tsis quav ntsej ntawm cov tsos mob, yuav tsum xav txog kev kho mob nrog lwm tus neeg mob ntshav qab zib.
Qhov tseem ceeb ua rau muaj kev txhim kho hypoglycemia:
- kev siv cawv ib txhij, tshwj xeeb yog thaum yoo mov,
- kev tsis kam lossis (tshwj xeeb tshaj yog rau cov neeg laus laus) tus neeg mob tsis muaj peev xwm sib txuas lus nrog tus kws kho mob thiab ua raws li cov lus pom zoo tau teev tseg hauv cov lus qhia rau kev siv,
- kev noj zaub mov tsis zoo, kev noj zaub mov tsis xwm yeem, tshaib plab lossis hloov noj zaub mov,
- kev tsis txaus ntawm lub cev kev ua si thiab kev ua kom yuag,
mob siab hnyav ua haujlwm
- kev siv ntau dhau ntawm cov tshuaj Glukovans ®,
- cov mob endocrine: tsis txaus ntawm cov thyroid caj pas, pituitary caj pas thiab qog adrenal,
- kev tswj hwm ua ke nrog cov tshuaj ib leeg.
Plaws thiab lub siab ua haujlwm
Pharmacokinetics thiab / lossis pharmacodynamics yuav sib txawv hauv cov neeg mob uas muaj mob rau daim siab lossis mob rau lub raum tsis zoo. Kev mob ntshav khov uas tshwm sim hauv cov neeg mob zoo li no yuav ua kom ntev, nyob rau hauv rooj plaub twg kev kho mob tsim nyog yuav tsum tau pib.
Ntshav Qab Zib Muaj Feem
Thaum muaj kev phais mob lossis lwm qhov ua rau mob ntshav qab zib decompensation, nws raug pom zoo tias yuav tsum tau hloov mus ib ntus rau kev kho mob insulin. Cov tsos mob ntawm tus mob hyperglycemia yog tso zis heev, nqhis dej heev, ua kom tawv nqaij qhuav.
48 teev ua ntej npaj kev phais mob lossis iv txhaj tshuaj tiv thaiv cov pa tshuaj iodine muaj radiopaque, cov tshuaj Glucovans ® yuav tsum tsis ua hauj lwm. Txoj kev kho yog pom zoo kom rov ua dua tom qab 48 teev thiab tsuas yog tom qab lub raum rov qab tau raug ntsuas thiab paub zoo li qub.
Txij li metformin raug tawm los ntawm lub raum, ua ntej pib kev kho mob thiab tsis tu ncua tom qab ntawd, nws yuav tsum txiav txim siab Cl creatinine thiab / lossis cov ntshav creatinine: tsawg kawg ib xyoos ib zaug hauv cov neeg mob uas muaj lub raum zoo li qub, thiab 2 times4 zaug hauv ib xyoos hauv cov neeg laus, thiab kuj rau cov neeg mob nrog Cl creatinine ntawm VGN.
Nws raug nquahu kom yuav tsum tau saib xyuas tshwj xeeb ntxiv rau hauv cov teeb meem uas lub raum kev ua haujlwm tsis zoo, piv txwv, hauv cov neeg mob laus lossis thaum muaj mob los kho tus mob, diuretics lossis NSAIDs.
Lwm qhov ceev faj
Tus neeg mob yuav tsum qhia tus kws kho mob txog qhov pom tshwm ntawm tus mob bronchopulmonary los yog tus kab mob sib kis ntawm cov kab mob genitourinary.
Cawv rau ntawm kev muaj peev xwm tsav lub tsheb thiab ua haujlwm nrog cov tshuab. Cov neeg mob yuav tsum paub txog kev pheej hmoo ntawm lub qog ntshav qab zib thiab saib xyuas qhov yuav tsum tau ceev faj thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem uas yuav tsum muaj kev nce siab ntxiv thiab ceev ntawm cov kev tiv thaiv psychomotor.
Chaw tsim tshuaj paus
Chaw nyob raug cai: 37, rue Saint-Romaine, 69379, LION SEDEX, 08, Fab Kis teb.
Chaw nyob ntawm thaj chaw tsim khoom: Center de Producion CEMOIS, 2, rue du Pressoir Ver, 45400, CEMOIS, Fab Kis.
Cov neeg siv khoom thov thiab cov ntaub ntawv ntawm cov xwm txheej tsis zoo yuav tsum raug xa mus rau qhov chaw nyob ntawm LLC Merk: 115054, Moscow, ul. Tag nrho, 35.
Xov Tooj: (495) 937-33-04, (495) 937-33-05.
Ua ke nrog cov tshuaj hypoglycemic Glucovans: nqe, analogues thiab cov lus qhia rau kev siv
Glucovans yog ib hom tshuaj hypoglycemic ua ke.
Nws yog npaj rau kev siv sab hauv.
Cov tshuaj muaj cov txiaj ntsig zoo ntawm kev sib xyaw lipid hauv cov ntshav, tom qab thov, txo qis tag nrho cov roj (cholesterol).
Daim ntawv tso tawm
Glucovans ntsiav tshuaj yog coated nrog zaj duab xis-hom membrane ntawm lub teeb txiv kab ntxwv, muaj cov duab ntxoo-puab (biconvex).
Glucovans ntsiav tshuaj 500 mg
Ntawm ib sab ntawm txhua cov ntsiav tshuaj koj tuaj yeem pom cov ntawv sau "2.5" lossis "5" (cov ntsiab lus ntawm glibenclamide hauv mg hauv ib ntsiav tshuaj). Ib pob muaj 2 lossis 4 ntsiav tshuaj. Tsab ntawv “M (tsim nyog rau kev tiv thaiv tiv thaiv kev ua phem) yog cim rau cov thawv ntawv thawv thiab cov hlwv yas.
Qhia txog ntawm cov tshuaj
Glucovans - Ua ke nrog tshuaj hypoglycemic rau kev siv lub qhov ncauj.
Glucovans ® yog kev sib xyaw ua ke ntawm ob lub qhov ncauj hypoglycemic ntawm ntau yam pharmacological pawg: metformin thiab glibenclamide.
Metformin zwm rau cov pab pawg ntawm biguanides thiab txo cov ntsiab lus ntawm ob qho tib si basal thiab postprandial qab zib hauv cov 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 kev ua haujlwm ntawm kev ua:
- txo qis tsim cov piam thaj los ntawm daim siab los ntawm inhibiting gluconeogenesis thiab glycogenolysis,
- nce rhiab heev ntawm peripheral receptors rau insulin, kev noj thiab siv cov piam thaj los ntawm cov leeg hauv cov leeg nqaij,
- ncua kev nqus ntawm cov piam thaj ntawm lub plab zom mov.
Nws kuj muaj cov txiaj ntsig zoo ntawm cov lipid muaj pes tsawg leeg ntawm cov ntshav, txo cov ntshav ntawm cov roj (cholesterol) tag nrho, LDL thiab TG.
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.
23 tus qhua tau tshaj tawm qhia cov nqi nce txhua hnub
Kuv yuav tsum tau haus ntshav ntau npaum li cas rau glucovans?Cov neeg teb feem ntau yuav tau haus cov tshuaj no 2 zaug ib hnub. Daim ntawv tshaj tawm qhia tias pes tsawg tus neeg teb ntxiv siv cov tshuaj no.
Cov Tswv Cuab | % | ||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
2 zaug ib hnub | 15 | 65.2% | |||||||||||||||||||||||||||||||||
3 zaug ib hnub | 4 | 17.4% | |||||||||||||||||||||||||||||||||
Ib hnub | 3 | 13.0% | |||||||||||||||||||||||||||||||||
4 zaug ib hnub | 1 | Xya qhua qhua qhia pes koob
| 57.1% | ||||||||||||||||||||||||||||||||
101-200mg | 2 | 28.6% | |||||||||||||||||||||||||||||||||
6-10mg | 1 | Peb tus qhua tshaj tawm cov hnub tas sij hawmNtev npaum li cas nws yuav tsum tau siv sijhawm Glucovans paub txog kev txhim kho hauv tus neeg mob lub sijhawm?Cov neeg tuaj koom kev soj ntsuam feem ntau tom qab 1 hnub hnov qhov kev txhim kho. Tab sis qhov no yuav tsis raug rau lub sijhawm uas koj yuav txhim kho. Nrog koj tus kws kho mob xav ntev li cas koj yuav tsum tau noj cov tshuaj no. Cov lus hauv qab no qhia cov kev tshwm sim ntawm kev tshawb fawb txog kev pib ua haujlwm zoo.
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