Glucovans: cov lus qhia rau kev siv

1 lub ntim zaj duab xis-txheej muaj:

Muab koob tshuaj 2.5 mg + 500 mg:

Lub Cheebtsam nquag: glibenclamide - 2.5 mg, metformin hydrochloride - 500 mg.

Lub hauv paus: croscarmellose sodium - 14.0 mg, povidone K 30 - 20.0 mg, cellulose

microcrystalline - 56,5 mg, magnesium stearate - 7.0 mg.

Plhaub: opadry OY-L-24808 liab dawb - 12.0 mg: lactose monohydrate - 36.0%,

15cP hypromellose - 28.0%, titanium dioxide - 24.39%, macrogol - 10.00%, oxide hlau daj - 1.30%, liab hlau oxide - 0.3%, dub hlau oxide - 0.010%, dej huv - qs

Koob tshuaj 5 mg + 500 mg:

Lub Cheebtsam nquag: glibenclamide - 5 mg, metformin hydrochloride - 500 mg.

Nucleus: croscarmellose sodium - 14.0 mg, povidone K 30 - 20.0 mg, microcrystalline cellulose - 54.0 mg, magnesium stearate - 7.0 mg.

Plhaub: Opadry 31-F-22700 daj - 12.0 mg: lactose monohydrate - 36.0%, hypromellose 15 cP - 28.0%, titanium dioxide - 20.42%, macrogol - 10.00%, zas quinoline daj - 3.00%, hlau oxide daj - 2.50%, hlau oxide liab - 0.08%, dej huv - qs.

Dosage 2.5 mg + 500 mg: tshuaj ntsiav zoo li biconvex ntsiav tshuaj, zaj duab xis-coated nrog lub teeb xim txiv kab ntxwv, sau nrog "2.5" ntawm ib sab.

5 mg + 500 mg muab tshuaj: noj tshuaj ntsiav zoo li biconvex zaj duab xis-ntsiav tshuaj
lub plhaub daj, sau nrog "5" ntawm ib sab.

Pharmacological kev txiav txim

Glucovans® yog kev sib txuam 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 hauv lub plab zom mov.

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.

Cov Tshuaj Pharmacokinetics

Glibenclamide. Thaum noj ntawm qhov ncauj, nqus tawm ntawm txoj hnyuv plab ntau dua 95%. Glibenclamide, uas yog ib feem ntawm cov tshuaj Glucovans® yog micronized. Qhov siab tshaj plaws nyob hauv cov ntshav plasma tau mus txog 4 teev, qhov ntim ntawm kev faib tawm yog li 10 litres. Kev sib txuas lus nrog cov protein ntshav yog 99%. Nws yuav luag tag nrho cov kabmob hauv lub siab nrog kev tsim ntawm ob lub cev tsis ua haujlwm, uas

ua rau lub raum (40%) thiab nrog cov kua tsib (60%). Qhov kev tshem tawm ib nrab-lub neej yog los ntawm 4 txog 11 teev. Tom qab kev tswj hwm ntawm qhov ncauj, metformin tau nqus tawm ntawm txoj hnyuv plab mus tag nrho, qhov siab tshaj plaws nyob rau hauv ntshav tau txog li ntawm 2.5 teev. Kwv yees li 20-30% ntawm cov tshuaj metformin raug tso tawm los ntawm txoj hnyuv huam hloov pauv. 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. Qhov kev tshem tawm ib nrab-lub neej yog qhov nruab nrab ntawm 6,5 teev. Yog tias lub raum ua haujlwm tsis zoo, kev ua kom lub raum txo qis, ib yam li kev tsim lub peev xwm tshem tawm, thaum kev tshem tawm ib nrab ntawm lub neej nce, uas ua rau muaj kev nce ntxiv ntawm cov tshuaj 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 ntsuas rau siv

Ntshav qab zib Hom 2 rau cov neeg laus:

nrog rau qhov tsis muaj txiaj ntsig ntawm kev kho kev noj haus, kev tawm dag zog lub cev thiab cov 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.

Cov Yuav Tsum Tau Ua

cov tshuaj tiv thaiv kab mob rau metformin, glibenclamide lossis lwm yam sulfonylurea derivatives, thiab cov koom tes pabcuam, hom 1 ntshav qab zib mellitus,

mob ntshav qab zib ketoacidosis, mob ntshav qab zib precoma, mob ntshav qab zib tsis nco qab, lub raum tsis ua hauj lwm los yog lub raum tsis zoo ua haujlwm (creatinine tshem tawm tsawg dua 60 ml / min),

mob hnyav uas tuaj yeem ua rau lub raum hloov pauv: lub cev qhuav dej, mob hnyav, ceeb, lub cev ntawm cov tshuaj iodine uas muaj cov tshuaj tiv thaiv tsis zoo (saib "Cov Lus Qhia Tshwj Xeeb"),

mob los yog mob mus ntev nrog cov nqaij mos hypoxia: mob plawv lossis ua pa tsis ua haujlwm, tsis ntev los no myocardial infarction, poob siab, mob siab, tsis ua haujlwm, porphyria,

cev xeeb tub, lub sijhawm ntawm kev pub mis niam, kev siv miconazole tib lub sijhawm, kev phais loj,

cawv ntev, mob qaug cawv qaug cawv, lactic acidosis (suav nrog rau keeb kwm ntawm)

ua raws li kev noj haus kom tsis txhob muaj calories ntau tsawg (tsawg dua 1000 calories / hnub),

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.

Glucovans® muaj cov lactose, yog li ntawd nws txoj kev siv tsis pom zoo rau cov neeg mob uas tsis tshua muaj mob muaj feem cuam tshuam nrog kev tsis haum galactose, lactase tsis txaus lossis cov ntshav qabzib-galactose malabsorption syndrome.

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 kho nrog 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 muaj xwm txheej hauv cev xeeb tub thaum lub sijhawm noj cov tshuaj Glucovans®, cov tshuaj yuav tsum tau txiav thiab tshuaj kho cov tshuaj insulin. Glucovans® yog qhov sib txuam hauv kev pub niam mis, vim tias tsis muaj ib qho pov thawj ntawm nws qhov peev xwm mus rau hauv niam mis.

Tsuas tshuaj thiab tswj hwm

Cov koob tshuaj ntawm cov tshuaj tau txiav txim siab los ntawm tus kws kho mob tshwj xeeb rau txhua tus neeg mob, nyob ntawm seb muaj qib glycemia.

Thawj koob tshuaj yog 1 ntsiav tshuaj ntawm cov tshuaj Glucovans® 2.5 mg + 500 mg lossis Glucovans® 5 mg + 500 mg ib hnub ib zaug. Txhawm rau kom tsis txhob mob ntshav qab zib, thawj koob tshuaj yuav tsum tsis pub tshaj li qhov niaj hnub noj tshuaj glibenclamide (lossis qhov sib npaug ntawm lwm yam tshuaj sulfonylurea yav dhau los) lossis metformin, yog tias lawv tau siv los ua kev kho thawj. Nws raug nquahu tias cov koob tshuaj tau nce ntxiv los ntawm tsis pub ntau dua 5 mg ntawm glibenclamide + 500 mg ntawm metformin ib hnub ib zaug txhua 2 lossis ntau lub lis piam txhawm kom ua tiav cov ntshav tswj ntshav qabzib.

Hloov chaw ntawm cov kev sib txuas ua ke dhau los nrog metformin thiab glibenclamide: koob tshuaj thawj zaug yuav tsum tsis pub tshaj qhov kev txhaj tshuaj glibenclamide (lossis koob tshuaj sib npaug ntawm lwm qhov kev npaj sulfonylurea) thiab metformin noj yav tas los. Txhua txhua 2 lossis ntau lub lim tiam tom qab pib kev kho mob, cov koob tshuaj raug kho nyob ntawm qib glycemia.

Qhov siab tshaj plaws txhua hnub yog 4 ntsiav tshuaj ntawm cov tshuaj Glucovans® 5 mg + 500 mg lossis 6 ntsiav tshuaj ntawm yeeb tshuaj Glucovans® 2.5 mg + 500 mg.

Kev muab tshuaj yog nyob ntawm tus kheej lub hom phiaj:

Rau kev muab tshuaj ntawm 2.5 mg + 500 mg thiab 5 mg + 500 mg

• Ib hnub ib zaug, thaum sawv ntxov thaum noj tshais, nrog rau kev teem 1 ntsiav tshuaj ib hnub.

• Ib hnub ob zaug, thaum sawv ntxov thiab yav tsaus ntuj, nrog rau kev teem sijhawm 2 lossis 4 ntsiav tshuaj hauv ib hnub.

Rau qhov ntau npaum ntawm 2.5 mg + 500 mg

• Peb zaug ib hnub, thaum sawv ntxov, tav su thiab yav tsaus ntuj, nrog kev teem sijhawm 3, 5 lossis 6 ntsiav tshuaj hauv ib hnub.

Rau qhov ntau npaum ntawm 5 mg + 500 mg

• Peb zaug ib hnub, thaum sawv ntxov, tav su thiab yav tsaus ntuj, nrog rau kev teem muaj 3 ntsiav tshuaj rau ib hnub.

Cov ntsiav tshuaj yuav tsum noj nrog zaub mov. Txhua pluas noj yuav tsum tau noj mov nrog cov pluas mov uas muaj carbohydrate ntau txaus kom tiv thaiv qhov tshwm sim ntawm kev mob ntshav qab zib.

Cov koob tshuaj ntawm cov tshuaj raug xaiv raws li lub xeev ntawm lub raum ua haujlwm. Thawj koob tshuaj yuav tsum tsis pub ntau tshaj 1 ntsiav tshuaj ntawm yeeb tshuaj Glucovans® 2.5 mg + 500 mg. Yuav tsum tau ntsuas kev ntsuas lub raum tsis tu ncua.

Glucovans® tsis pom zoo siv rau menyuam yaus.

Noj ntau dhau

Yog tias dhau ntawm kev noj tshuaj ntau dhau lawm, ntshav qog ntshav yuav tuaj yeem tsim vim muaj cov tshuaj sulfonylurea derivative nyob rau hauv kev sib xyaw ntawm cov tshuaj (saib "Cov Lus Qhia Tshwj Xeeb").

Me me mus rau mob mentsis mus txog rau cov tsos mob ntawm lub cev tsis muaj kev tsis nco qab thiab tsis pom qhov mob hlwb tau kho tau sai los ntawm kev noj qab zib. Nws yog qhov tsim nyog los ua kom tau txais kev hloov kho koob tshuaj thiab / lossis hloov cov khoom noj. Qhov tshwm sim ntawm kev cuam tshuam hypoglycemic heev nyob rau hauv cov neeg mob ntshav qab zib, nrog rau kev ua kom tsis nco qab, paroxysm, lossis lwm qhov kev mob puas siab ntsws, yuav tsum tau txais kev kho mob xwm txheej ceev. Kev tswj hwm ntawm kev daws qhov mob dextrose yog tsim nyog tam sim ntawd tom qab kuaj mob los yog xav tias qhov ua kom tsis txhob mob, ua ntej mus pw hauv tsev kho mob ntawm tus neeg mob. 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 haus ntev ntev lossis muaj cov txuam nrog uas yuav muaj feem cuam tshuam rau kev txhim kho ntawm cov kab mob lactic acidosis, vim tias metformin yog ib feem ntawm cov tshuaj

Cov kab mob lactic acidosis yog qhov mob uas yuav tsum tau txais kev kho mob xwm txheej ceev, kev kho mob ntawm cov kab mob lactic acidosis yuav tsum tau nqa tawm hauv chaw kho mob. Qhov kev kho mob ua tau zoo tshaj plaws rau kev tshem tawm lactate thiab metformin yog hemodialysis.

Plasma glibenclamide tshem tawm tuaj yeem nce ntxiv hauv cov neeg mob mob siab. Txij li thaum glibenclamide tab tom khi rau cov ntshav cov ntshav, cov tshuaj tsis tawm thaum raug lim ntshav.

Kev cuam tshuam nrog lwm yam tshuaj

Cov kab mob lactic acidosis yog qhov mob uas yuav tsum tau txais kev kho mob xwm txheej ceev, kev kho mob ntawm cov kab mob lactic acidosis yuav tsum tau nqa tawm hauv chaw kho mob. Qhov kev kho mob ua tau zoo tshaj plaws rau kev tshem tawm lactate thiab metformin yog hemodialysis.

Plasma glibenclamide tshem tawm tuaj yeem nce ntxiv hauv cov neeg mob mob siab. Txij li thaum glibenclamide tab tom khi rau cov ntshav cov ntshav, cov tshuaj tsis tawm thaum raug lim ntshav.

Bozentan hauv kev sib xyaw nrog glibenclamide ua rau muaj kev pheej hmoo ntawm hepatotoxicity. Nws raug nquahu kom tsis txhob siv cov tshuaj no ib txhij. Cov nyhuv hypoglycemic ntawm glibenclamide kuj tseem yuav poob qis.

Metformin-cuam tshuam

Cawv: Txoj kev pheej hmoo ntawm kev txhim kho cov kab mob lactic acid nce nrog rau kev haus dej cawv sai, tshwj xeeb tshaj yog thaum muaj kev tshaib plab, lossis khoom noj tsis zoo, lossis lub siab tsis ua haujlwm. Lub sijhawm kho nrog Glucovans®, haus dej cawv thiab tshuaj noj muaj cawv yuav tsum zam.

Txuam nrog kev siv ntawm txhua tus neeg sawv cev hypoglycemic

Chlorpromazine: hauv siab (100 mg / hnub) ua rau muaj glycemia ntau ntxiv (txo qis tshaj tawm cov tshuaj insulin).

Cov kev ceeb toom: koj yuav tsum ceeb toom rau tus neeg mob txog qhov xav tau ntawm kev saib xyuas ntshav qab zib kom tsis txhob muaj, yog tias tsim nyog,

kho qhov koob tshuaj ntawm tus neeg sawv cev hypoglycemic thaum lub sijhawm sib xyaw ua ke siv cov tshuaj tiv thaiv kev tiv thaiv thiab tom qab tsis cuam tshuam ntawm nws siv.

Glucocorticosteroids (GCS) thiab tetracosactide: kev nce ntxiv ntawm cov ntshav qabzib, qee zaum nrog ketosis (GCS ua rau muaj kev txo qis hauv qabzib).

Cov kev ceeb toom: tus neeg mob yuav tsum tau ceeb toom txog qhov yuav tsum tau soj ntsuam kev ywj pheej ntawm cov ntshav qabzib, yog tias tsim nyog, cov koob tshuaj hypoglycemic tus neeg sawv cev yuav tsum tau hloov kho thaum kev siv GCS ib txhij thiab tom qab txiav kev siv.

Danazole muaj cov nyhuv hyperglycemic. Yog tias kev kho mob nrog danazol yog qhov tsim nyog thiab thaum kawg tau tso tseg, kev kho tshuaj ntawm cov tshuaj Glucovans® yuav tsum muaj kev tswj hwm ntawm qib glycemia.

Zr-adrenergic agonists: vim qhov kev txhawb nqa ntawm Pr-adrenergic receptors nce cov concentration ntawm cov piam thaj hauv cov ntshav.

Qhov ceeb toom: nws yog qhov yuav tsum ceeb toom rau tus neeg mob thiab teeb tsa kev tswj hwm cov ntshav qab zib cov ntsiab lus, hloov mus rau kev kho mob insulin yog ua tau.

Diuretics: nce ntxiv hauv cov ntshav qabzib.

Cov kev ceeb toom: tus neeg mob yuav tsum tau ceeb toom txog qhov yuav tsum tau soj ntsuam kev ywj pheej ntawm cov ntshav qabzib, kev kho lub ntsej muag ntawm tus neeg sawv cev hypoglycemic thaum lub sijhawm sib xyaw nrog cov tshuaj diuretics thiab tom qab txiav siv lawv yuav tsum tau.

Angiotensin-hloov enzyme (ACE) inhibitors (captopril, enalapril): kev siv ACE inhibitors pab txo cov ntshav qabzib. Yog tias tsim nyog, cov koob tshuaj Glucovans® yuav tsum tau kho thaum siv qhov sib txig nrog ACE inhibitors thiab tom qab siv tag nrho.

Metformin-cuam tshuam

Diuretics: Lactic acidosis uas tshwm sim thaum Metformin noj nrog lub raum tsis ua haujlwm los ntawm diuretics, tshwj xeeb tshaj yog voj diuretics.

Txuam nrog kev siv ntawm glibenclamide

Z-adrenergic blockers, clonidine, reserpine, guanethidine thiab sympathomimetics npog qee cov tsos mob ntawm tus mob hypoglycemia: palpitations thiab tachycardia, feem ntau tsis xaiv-beta-blockers nce qhov tshwm sim thiab qhov mob ntawm hypoglycemia. Tus neeg mob yuav tsum tau ceeb toom txog qhov yuav tsum tau ua kom muaj kev ywj pheej soj ntsuam ntshav qabzib, tshwj xeeb tshaj yog thaum pib kho.

Fluconazole: Ib qho kev nce ntxiv ntawm ib nrab ntawm lub neej ntawm glibenclamide nrog qhov tshwm sim tshwm sim ntawm cov tsos mob ntawm hypoglycemia. Tus neeg mob yuav tsum tau ceeb toom txog qhov yuav tsum tau muaj kev ywj pheej soj ntsuam cov piam thaj hauv cov ntshav, nws yuav tsim nyog los kho lub koob tshuaj hypoglycemic thaum lub sijhawm kho mob nrog fluconazole thiab tom qab siv nws cov kev siv.

Txuam nrog kev siv ntawm glibenclamide

Desmopressin: Glucovans® yuav txo qhov antidiuretic nyhuv ntawm desmopressin.

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

Daim ntawv thov nta

Tawm tsam tom qab ntawm kev kho mob nrog Glucovans®, nws yog ib qho tsim nyog yuav tsum soj ntsuam theem ntawm cov kua nplaum ceev tom qab noj mov.

Cov kab mob lactic acidosis yog ib qho mob uas tsis tshua pom muaj, tab sis mob hnyav (kev tuag nyob rau qhov tsis muaj kev kho mob sai) cov kev mob uas yuav 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.

Txoj kev pheej hmoo ntawm kev tsim cov kab mob lactic acidosis yuav tsum tau txiav txim siab thaum tsis muaj cov cim tshwj xeeb xws li mob leeg nrog cov mob dyspeptic, mob plab thiab mob hnyav tshwm sim. 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 tshuaj nrog cov kev phom sij hauv hypoglycemia hauv tus neeg mob. 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 ntawm cov ntshav qab zib yog feem ntau yuav nrog hypocaloric noj cov zaub mov, tom qab khaus lossis lub sijhawm ntev dhau ntawm lub cev, nrog 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 beta-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, pw tsaug zog, ntxhov siab, cuam tshuam, tsis nco 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 haus dej cawv ib txhij, tshwj xeeb tshaj yog thaum yoo mov,

• Tsis kam lossis (tshwj xeeb 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 qhia pom zoo siv hauv cov lus qhia rau kev siv,

• Khoom noj tsis zoo, noj zaub tsis xwm yeem, tshaib plab lossis hloov noj zaub mov txawv,

• Qhov tsis txaus ntawm kev qoj ib ce thiab kev ua kom yuag,

• Mob rau daim siab mob hnyav,

• Ntau dhau ntawm cov tshuaj Glucovans®,

• Xaiv cov teeb meem hauv endocrine: lub qog ua haujlwm tsis muaj peev xwm,

cov qog pituitary thiab qog,

• Kev tswj hwm ib leeg cov tshuaj.

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 txoj kev npaj phais mob lossis kev tswj hwm cov tshuaj tiv thaiv tus kabmob iodine uas muaj cov kab mob radiopaque, cov tshuaj Glucovans® yuav tsum tsis ua mus ntxiv. Txoj kev kho yog pom zoo kom rov ua dua tom qab 48 teev, thiab tsuas yog tom qab lub raum kev ua haujlwm tau raug tshuaj thiab tau pom zoo li qub.

Txij li metformin raug tawm los ntawm lub raum, thiab tsis tu ncua tom qab ntawd, nws yog qhov yuav tsum tau txiav txim siab creatinine kev tshem tawm thiab / lossis cov ntshiab cov ntsiab lus creatinine: tsawg kawg ib xyoos ib zaug hauv cov neeg mob uas muaj lub raum zoo li qub, thiab 2-4 zaug hauv ib xyoos hauv cov neeg laus , thiab nyob rau hauv cov neeg mob nrog creatinine tshem ntawm qhov txwv sab sauv ntawm qhov ib txwm muaj.

Kev ceev faj yog pom zoo nyob rau hauv cov mob uas lub raum kev ua haujlwm tuaj yeem ua tsis tiav, piv txwv li, hauv cov neeg mob laus, lossis thaum muaj kev pib kho mob, kev siv tshuaj diuretics lossis non-steroidal anti-inflammatory tshuaj (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 ceeb toom txog qhov kev pheej hmoo ntawm lub qog ntshav qab zib thiab yuav tsum tau saib xyuas kev tiv thaiv kev nyab xeeb thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem uas yuav tsum muaj kev xav ntau ntxiv thiab ceev ntawm cov kev tiv thaiv psychomotor.