Cov tshuaj Metformin 1000 mg, 60 pcs.

Thov, ua ntej koj yuav Metformin, ntsiav tshuaj 1000 mg, 60 pcs., Txheeb xyuas cov ntaub ntawv hais txog nws nrog cov ntaub ntawv ntawm lub vev xaib raug cai ntawm cov chaw tsim khoom lossis hais kom meej cov qauv tshwj xeeb nrog tus thawj tswj haujlwm ntawm peb lub tuam txhab!

Cov ntaub ntawv qhia ntawm lub xaib tsis yog pej xeem kev pom zoo. Lub chaw tsim khoom muaj txoj cai los hloov cov qauv tsim, tsim qauv thiab ntim khoom. Cov duab ntawm cov khoom hauv cov duab tau tshaj tawm hauv phau ntawv teev npe rau ntawm lub xaib yuav txawv ntawm cov qauv.

Cov ntaub ntawv ntawm tus nqi ntawm cov khoom tau hais hauv phau ntawv qhia rau ntawm lub xaib yuav txawv qhov tseeb ntawm ib tus neeg thaum lub sijhawm tso daim ntawv txiav txim rau cov khoom lag luam.

Pharmacological kev txiav txim

Metformin inhibits gluconeogenesis nyob rau hauv daim siab, txo qhov nqus ntawm cov piam thaj los ntawm cov hnyuv, txhim kho kev siv ntu ntawm cov piam thaj, thiab tseem ua rau kev nkag siab ntawm cov ntaub so ntswg mus rau insulin. Nws tsis cuam tshuam qhov zais cia ntawm insulin los ntawm beta hlwb ntawm tus txiav, tsis ua rau kev tsis tuaj yeem tshwm sim. Txo cov theem ntawm triglycerides thiab qis linoproteins hauv cov ntshav. Stabilizes lossis txo qhov hnyav lub cev. Nws muaj cov nyhuv fibrinolytic vim yog kev tsuj tawm ntawm cov nqaij plasminogen activator inhibitor.

Tom qab lub qhov ncauj tswj hwm, metformin yog nqus los ntawm cov hnyuv. Bioavailability tom qab noj cov qauv tshuaj yog 50-60%. Cmax hauv cov ntshav plasma tau mus txog 2.5 teev tom qab noj. Nws xyaum tsis khi rau cov plasma protein. Nws accumulates nyob rau hauv salivary qog, nqaij, mob siab thiab ob lub raum. Nws yog tawm tawm tsis hloov pauv los ntawm ob lub raum. T1 / 2 yog 9-12 teev. Nrog kev ua haujlwm tsis zoo hauv lub raum, kom cov tshuaj ntau tau.

Hom 2 mob ntshav qab zib mellitus yam tsis muaj ketoacidosis (tshwj xeeb tshaj yog nyob rau cov neeg mob rog) nrog kev kho mob tsis muaj txiaj ntsig, nrog rau cov tshuaj insulin, nyob rau hom 2 mob ntshav qab zib mellitus, tshwj xeeb tshaj yog muaj kev paub txog kev rog, nrog rau kev tiv thaiv kab mob insulin.

Cov Yuav Tsum Tau Ua

• ketoacidosis, mob ntshav qab zib precoma, coma,
• lub raum tsis ua hauj lwm zoo,
• cov kab mob siab heev nrog kev pheej hmoo ntawm kev tsim muaj lub raum ua haujlwm: lub cev qhuav dej (nrog rau mob raws plab, ntuav), kub taub hau, mob hnyav kis, hypoxia (poob siab, sepsis, mob raum, kab mob ntsws).
• cov kab mob hais tawm los ntawm cov mob huam thiab mob ntev tuaj yeem ua rau kev loj hlob ntawm cov nqaij mos hypoxia (lub plawv lossis ua pa tsis ua haujlwm, mob myocardial infarction),
• mob hnyav thiab raug mob (thaum insulin kho yog qhia),
• lub siab ua tsis taus haujlwm,
• haus cawv qaug cawv, qaug cawv lom,
• siv tsawg kawg 2 hnub ua ntej thiab tom qab 2 hnub tom qab ua kev tshawb fawb radioisotope lossis xoo hluav taws xob nrog kev qhia ntawm iodine-contrast contrast medium,
• lactic acidosis (suav nrog keeb kwm),
• ua raws li kev noj haus kom tsis txhob muaj calories ntau tsawg (tsawg dua 1000 calories / hnub),
• cev xeeb tub
• kev pub mis
• hypersensitivity rau cov tshuaj.

Nws tsis pom zoo kom siv cov tshuaj rau cov neeg laus dua 60 xyoo uas ua haujlwm lub cev hnyav, uas cuam tshuam nrog kev pheej hmoo ntawm kev tsim mob lactic acidosis hauv lawv.

Sab sij huam

Los ntawm lub plab zom mov: xeev siab, ntuav, nws yog xim hlau hauv lub qhov ncauj, tsis muaj qab los noj mov, raws plab, plhaw, mob plab. Cov tsos mob no tshwj xeeb tshaj yog thaum pib kho thiab feem ntau yuav ploj mus ntawm lawv tus kheej. Cov tsos mob no tuaj yeem txo qis lub sijhawm ntawm anthocides, derivatives ntawm atropine lossis antispasmodics.

Los ntawm ib sab ntawm cov metabolism: hauv qee qhov tsis tshua muaj tshwm sim - lactic acidosis (yuav tsum muaj kev kho mob ncua ntev), nrog kev kho mob ntev - hypovitaminosis B12 (malabsorption).

Los ntawm cov kabmob hemopoietic: qee kis - megaloblastic anemia.

Los ntawm cov kab ke endocrine: hypoglycemia.

Kev ua xua rau: xoo pob khaus.

Kev sib txuam

Kev siv tib lub sijhawm sib xyaw ntawm danazol tsis pom zoo nyob rau hauv kev txiav txim kom tsis txhob muaj cov nyhuv hyperglycemic ntawm tom kawg. Yog tias kev kho mob nrog danazol yog qhov tsim nyog thiab tom qab txiav tom kawg, kev kho tshuaj metformin thiab iodine yuav tsum tswj hwm theem ntawm glycemia.

Kev sib xyaw ua ke xav tau kev saib xyuas tshwj xeeb: chlorpromazine - thaum noj ntau dua (100 mg / hnub) nce glycemia, txo qis kev tsim tawm ntawm insulin.

Hauv kev kho tshuaj tiv thaiv kev tiv thaiv thiab tom qab tso tseg kev noj cov tom kawg, koob tshuaj metformin raug kho raws li kev tswj hwm ntawm qib glycemia.

Nrog rau kev siv tib lub sijhawm nrog sulfonylurea derivatives, acarbose, insulin, NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide, β-blockers, nws yog qhov ua tau kom nce cov nyhuv hypoglycemic ntawm metformin.

Nrog rau kev siv tib lub sijhawm nrog GCS, qhov ncauj tawm tsam, epinephrine, sympathomimetics, glucagon, cov thyroid hormones, thiazide thiab voj diuretics, phenothiazine derivatives, nicotinic acid derivatives, txo qis hauv cov nyhuv hypoglycemic ntawm metformin yog ua tau.

Cimetidine qeeb kev tshem tawm ntawm metformin, uas ua rau muaj kev pheej hmoo ntawm lactic acidosis.

Metformin tej zaum yuav ua rau cov tshuaj anticoagulants tsis muaj zog (coumarin derivatives).

Cawv kev haus dej cawv ua rau muaj kev pheej hmoo ntawm kev tsim cov kab mob lactic acid thaum haus dej cawv ua rau qaug cawv, tshwj xeeb tshaj yog thaum muaj kev yoo mov lossis ua raws li cov zaub mov tsis zoo, nrog rau lub siab ua tsis tau.

Yuav ua li cas coj, chav kawm ntawm kev tswj hwm thiab ntau npaum li cas

Cov koob tshuaj ntawm lub tshuaj yog teem los ntawm tus kws kho mob ib leeg zuj zus, nyob ntawm seb muaj qib ntshav qabzib hauv cov ntshav.

Thawj koob tshuaj yog 500-1000 mg ib hnub twg (1-2 ntsiav tshuaj). Tom qab 10-15 hnub, nce ntxiv hauv koob tshuaj ntau dua yog ua tau raws cov qib ntshav qabzib.

Kev saib xyuas cov tshuaj ntawm cov tshuaj feem ntau yog 1500-2000 mg ib hnub. (3-4 ntsiav tshuaj) Qhov ntau kawg yog 3000 mg ib hnub (6 ntsiav tshuaj).

Hauv cov neeg mob laus, cov koob tshuaj pom zoo txhua hnub yuav tsum tsis pub ntau dua 1 g (2 ntsiav tshuaj).

Metformin ntsiav tshuaj yuav tsum noj tag nrho thaum lossis noj mov tom qab noj mov nrog ib qho kua tsawg (ib khob dej). Txhawm rau kom txo cov kev mob tshwm sim los ntawm txoj hnyuv plab, qhov tshuaj txhua hnub yuav tsum tau muab faib ua 2-3 zaug.

Vim tias muaj qhov pheej hmoo ntxiv ntawm cov kab mob lactic acidosis, cov koob tshuaj yuav tsum raug txo qis yog tias muaj kev cuam tshuam loj ntawm cov metabolism hauv lub cev.

Noj ntau dhau

Nrog kev siv tshuaj ntau dhau ntawm Metformin, ib qho kab mob lactic acidosis nrog rau kev ua rau neeg tuag taus yog ua tau. Qhov ua rau kev txhim kho ntawm cov kab mob lactic acid tuaj yeem tseem yog kev ruaj khov ntawm cov tshuaj vim tias lub zog ua haujlwm tsis zoo.

Cov tsos mob ntawm tus kab mob lactic acidosis: xeev siab, ntuav, raws plab, txo qis lub cev kub, mob plab, mob nqaij, yav tom ntej yuav muaj kev ua pa ntau ntxiv, kiv taub hau, tsis hnov ​​qab thiab ua rau tsis nco qab lawm.

Kev Kho Mob: Yog tias pom tias lactic acidosis, kev kho mob nrog Metformin yuav tsum nres tam sim ntawd, tus neeg mob yuav tsum tau mus tom tsev kho mob sai thiab, tau txiav txim siab qhov hnoos ntawm lactate, paub meej tias txoj kev kuaj mob. Qhov ua tau zoo tshaj plaws rau kev tshem tawm lactate thiab metformin los ntawm lub cev yog hemodialysis. Cov kev mob tshwm sim kuj yog nqa tawm.

Nrog kev kho ua ke nrog Metformin thiab sulfonylureas, cov ntshav qog ntshav qog ntshav tuaj yeem txhim kho.

Cov lus qhia tshwj xeeb

Thaum kho, nws yog qhov yuav tsum tau saib xyuas lub raum ua haujlwm. Tsawg kawg 2 zaug hauv ib xyoos, nrog rau qhov pom ntawm myalgia, lub lactate cov ntsiab lus hauv cov ntshav yuav tsum txiav txim siab. Ntxiv rau, ib zaug txhua 6 lub hlis nws yog qhov tsim nyog los tswj theem ntawm creatinine hauv cov ntshav cov ntshav (tshwj xeeb tshaj yog nyob rau hauv cov neeg mob ntawm lub hnub nyoog qib siab). Tshuaj Metformin yuav tsum tsis txhob raug tshuaj yog tias qib creatinine hauv cov ntshav siab tshaj 135 μmol / L hauv cov txiv neej thiab 110 μmol / L hauv cov poj niam.

Tej zaum kev siv cov tshuaj Metformin txuam nrog sulfonylurea derivatives. Hauv qhov no, tshwj xeeb tshaj yog saib xyuas cov ntshav ntshav qab zib kom tsim nyog.

48 teev ua ntej thiab nyob hauv 48 teev tom qab radiopaque (urography, iv angiography), koj yuav tsum tsis txhob noj Metformin.

Yog tias tus neeg mob tau mob bronchopulmonary los yog tus kab mob sib kis ntawm cov kab mob genitourinary, cov kws kho mob uas koom nrog yuav tsum qhia tam sim.

Thaum kho, koj yuav tsum caiv tsis txhob haus cawv thiab tshuaj muaj ethanol. Cov.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Kev siv cov tshuaj rau hauv monotherapy tsis cuam tshuam rau lub peev xwm tsav tsheb thiab ua haujlwm nrog cov txheej txheem.

Thaum Metformin koom ua ke nrog lwm cov kab mob hypoglycemic (sulfonylurea derivatives, insulin), cov kev mob ntshav qab zib tsawg tuaj yeem txhim kho qhov uas lub peev xwm tsav tsheb thiab koom nrog lwm cov kev phom sij uas xav tau kev nce siab ntxiv thiab cov teeb meem psychomotor sai sai yog qhov tsis hnov ​​lus.