Yuav ua li cas siv tshuaj yeeb Gluconorm?

Lub npe thoob ntiaj teb - gluconorm

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Zaj duab xis-coated ntsiav tshuaj dawb, puag ncig, biconvex. 1 ntsiav tshuaj muaj glibenclamide 2.5 mg, metformin hydrochloride 400 mg.

Tshwjxeeb: microcrystalline cellulose - 100 mg, hmoov nplej pob kws - 20 mg, colloidal silicon dioxide - 20 mg, gelatin - 10 mg, glycerol - 10 mg, magnesium stearate - 7 mg, purified talcum hmoov - 15 mg, croscarmellose sodium - 30 mg, sodium carboxymethyl starch - 18.3 mg, cellacephate - 2 mg, diethyl phthalate - 0.2 mg.

10 Pcs. - hlwv (1, 2, 3, 4) - pob khoom los ntawm cardboard.
20 Pcs. - hlwv (1, 2, 3, 4) - pob khoom los ntawm cardboard.
30 pcs - hlwv (1, 2, 3, 4) - pob khoom los ntawm cardboard.

Cov chaw soj ntsuam thiab chaw muag tshuaj

Tshuaj qhov ncauj hypoglycemic.

Cov tshuaj pab pawg kho mob

Kev siv tshuaj hypoglycemic rau kev tswj hwm qhov ncauj (sulfonylurea ntawm II tiam + biguanide).

Pharmacological kev txiav txim

Gluconorm yog kev sib koom ua ke ntawm ob lub qhov ncauj hypoglycemic ntawm ntau yam pharmacological pawg: metformin thiab glibenclamide.

Metformin belongs rau cov pab pawg ntawm biguanides thiab txo qib ntawm cov piam thaj hauv ntshav cov ntshav los ntawm kev nce qhov kev hnov ​​mob ntawm cov ntaub so ntswg txuas mus rau qhov kev ua ntawm insulin thiab txhim kho kev qabzib zoo. Txo kev nqus ntawm carbohydrates nyob rau hauv lub plab zom mov thiab inhibits gluconeogenesis nyob rau hauv daim siab. Cov tshuaj kuj tseem muaj txiaj ntsig zoo rau cov lipid profile ntawm cov ntshav, txo qis theem ntawm cov roj (cholesterol) tag nrho. LDL thiab triglycerides. Tsis ua rau muaj kev tsis haum ntshav.

Glibenclamide zwm rau cov pab pawg ntawm sulfonylurea derivatives ntawm lub cim thib ob. Nws stimulates insulin secretion los ntawm kev txo qis ntawm qhov pib ntawm pancreatic cell-cell glucose voos, nce insulin rhiab heev thiab nws cov lus qhia rau lub hlwb phiaj, nce insulin tso tawm, txhim kho cov nyhuv ntawm insulin rau cov leeg thiab lub siab ua kom lub cev, thiab inhibits lipolysis hauv adipose nqaij. Kev ua nyob rau theem ob ntawm insulin secretion.

Pharmacokinetics ntawm Gluconorm

Thaum muab tshuaj, nqus ntawm lub plab zom mov yog 48-84%. Lub sijhawm mus txog C_max - 1-2 teev V_d - 9-10 litres. Kev sib txuas lus nrog cov protein ntshav yog 95%.

Yuav luag txhua qhov ua tiav nyob hauv daim siab nrog rau kev tsim ntawm ob lub cev tsis ua haujlwm, ib qho yog tawm los ntawm lub raum, thiab lwm qhov los ntawm txoj hnyuv. T_1/2 - txij 3 txog 10-16 teev

Tom qab lub qhov ncauj tswj hwm, nws yog nqus tau los ntawm lub plab zom mov kom txaus, 20-30% ntawm qhov koob tshuaj yog pom hauv cov quav. Kev tsis raug cai txog kev nyab xeeb yog los ntawm 50 txog 60%. Nrog kev noj ib txhij, kev nqus ntawm metformin yog txo thiab qeeb. Nws 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. T_1/2 kwv yees li 9-12 teev

Ntshav qab zib Hom 2 rau cov neeg laus:

- nrog rau qhov tsis muaj txiaj ntsig ntawm kev noj haus kev kho mob, kev tawm dag zog thiab kev kho mob yav dhau los nrog metformin lossis glibenclamide,

- txhawm rau los hloov cov kev kho mob yav dhau los nrog ob yam tshuaj (metformin thiab glibenclamide) hauv cov neeg mob uas muaj ntshav khov thiab tswj tau ntshav qabzib.

Dosage regimen thiab txoj kev ntawm daim ntawv thov ntawm Gluconorm

Cov tshuaj siv yog noj ntawm qhov ncauj, nrog noj mov. Qhov ntau thiab tsawg ntawm cov tshuaj tau txiav txim los ntawm tus kws kho mob tshwj xeeb rau txhua tus neeg mob, nyob ntawm seb cov ntshav nyob ntawm seb ntau npaum li cas.

Feem ntau cov tshuaj pib yog 1 tab. (400 mg / 2.5 mg) / hnub. Txhua 1-2 lub lis piam tom qab pib kho, qhov tshuaj ntawm cov tshuaj tau kho raws li qib ntshav cov ntshav nyob hauv lub cev. Thaum hloov cov kev sib txuas ua ke dhau los nrog metformin thiab glybeklamide, 1-2 ntsiav tshuaj yog kws kho. Gluconorm nyob ntawm seb koob tshuaj dhau los ntawm txhua qhov.

Qhov siab tshaj plaws niaj hnub noj yog 5 ntsiav tshuaj.

Sab sij huam

Kev ua xua thiab immunopathological: tsis tshua muaj - urticaria, erythema, tawv nqaij ua pob khaus, kub ib ce, mob caj pas, mob caj dab.

Los ntawm sab ntawm carbohydrate metabolism: hypoglycemia yog ua tau.

Los ntawm cov kab ke hemopoietic: tsis tshua muaj - leukopenia, thrombocytopenia, erythrocytopenia, muaj tsawg - agranulocytosis, hemolytic lossis megaloblastic anemia, pancytopenia.

Los ntawm sab ntawm lub hauv nruab nrab hauv lub paj hlwb: mob taub hau, kiv taub hau, tsis muaj zog, qaug zog, tsis tshua muaj - paresis, mob rhiab.

Kev kho kom haum Dermatological: tsawg tsawg - photosensitivity.

Los ntawm lub plab zom mov thiab lub siab: tsis tshua muaj - xeev siab, ntuav, mob plab, poob qab los noj mov, "nws yog xim hlau" saj ntawm lub qhov ncauj, qee qhov - mob siab daj ntseg, muaj kev ua si ntawm daim siab ua paug, mob siab.

Los ntawm sab ntawm cov metabolism: lactic acidosis.

Lwm yam: mob hnyav haus cawv tsis txaus ntseeg tom qab haus cawv, qhia los ntawm cov teeb meem ntawm cov ntshav ncig thiab ua pa ntawm lub cev (disulfiram zoo li cov tshuaj tiv thaiv: ntuav, hnov ​​qhov kub ntawm lub ntsej muag thiab lub cev sab saud, tachycardia, kiv taub hau, mob taub hau).

Cov Txheej Txheem Kab Mob Gluconorm

- hom ntshav qab zib 1

- cov kab mob kis, kev cuam tshuam loj ntawm kev phais mob, kev raug mob, kev kub nyhiab thiab lwm yam mob uas yuav tsum muaj tshuaj tua kab mob,

- uas ketoacidosis, mob ntshav qab zib precoma, mob ntshav qab zib coma,

- mob hnyav uas tuaj yeem ua rau lub raum hloov pauv (lub cev qhuav dej, ua mob hnyav, ua rau poob siab),

- mob ceev los yog mob ntev nrog cov nqaij mos hypoxia (mob plawv lossis ua pa tsis ua haujlwm, tsis ntev los no myocardial infarction, poob siab),

- siv tsawg kawg 48 teev ua ntej thiab nyob rau hauv 48 teev tom qab ua kev tshawb fawb radioisotope lossis X-ray nrog kev qhia ntawm iodine-contrast contrast medium,

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

- Lub raum khiav tsis zoo,

- tib lub sijhawm tswj hwm ntawm miconazole,

- ntev kev haus cawv, qaug cawv kom qaug,

- lactic acidosis (suav nrog keeb kwm),

- lub sijhawm pub niam mis,

- Ua haujlwm kom muaj qhov cuam tshuam rau metformin, glibenclamide lossis lwm yam sulfonylurea derivatives, thiab ntxiv rau cov tshuaj pab tsis haum.

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.

Nrog ceev faj: mob ntsws febrile, adrenal tsis txaus, hypofunction ntawm anterior pituitary, mob qog nrog kev ua haujlwm tsis taus.

Cev xeeb tub thiab lactation

Thaum cev xeeb tub, kev siv ntawm gluconorm yog contraindicated. Thaum npaj lub cev xeeb tub, nrog rau kev muaj cev xeeb tub thaum lub sijhawm noj cov tshuaj Gluconorm, cov tshuaj yuav tsum tau txiav tawm thiab kev kho mob insulin yuav tsum tau kho.

Gluconorm yog contraindicated rau kev pub mis niam, raws li metformin kis mus rau hauv niam mis. Hauv qhov no, koj yuav tsum hloov mus rau kev siv tshuaj insulin lossis txwv kev pub niam mis.

Siv rau lub siab ua haujlwm tsis zoo

Contraindicated nyob rau hauv daim siab tsis ua hauj lwm.

Siv rau lub raum tsis zoo muaj nuj nqi

Kev siv yog contraindicated nyob rau hauv kev mob raum tsis zoo thiab mob hnyav uas tuaj yeem ua rau muaj kev hloov pauv ntawm lub raum (lub cev qhuav dej, mob hnyav, poob siab),

Siv rau cov neeg mob laus

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.

Cov lus qhia tshwj xeeb rau kev txais neeg kawm

Kev phais mob thiab kev raug mob loj, kev kub nyhiab, kev kis mob nrog febrile syndrome yuav tsum tsis siv tshuaj ntxiv thiab teem caij rau tshuaj insulin.

Nws yog ib qho tsim nyog yuav tau soj ntsuam cov qib ntawm cov piam thaj hauv cov ntshav ntawm lub plab khoob thiab tom qab noj mov.

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.

Thaum kho, nws tsis pom zoo kom haus cawv.

48 teev ua ntej kev phais lossis iv kev tswj hwm ntawm iodine-muaj radiopaque tus neeg sawv cev, gluconorm tswj hwm yuav tsum tsis ua haujlwm ntxiv. Gluconorm kev kho mob yog pom zoo kom rov ua dua tom qab 48 teev.

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

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.

Noj ntau dhau

Kev noj tshuaj ntau dhau lossis muaj qhov muaj pheej hmoo tuaj yeem cuam tshuam kev loj hlob ntawm cov kab mob lactic acidosis, zoo li Metforminum yog ib feem ntawm kev npaj. Thaum cov tsos mob ntawm tus kab mob lactic acid tshwm sim (ntuav, mob plab, feem ntau tsis muaj zog, mob leeg), koj yuav tsum tsum tsis txhob noj cov tshuaj no. Lactic acidosis yog kev mob uas yuav tsum tau txais kev kho mob xwm txheej ceev, kev kho mob ntawm cov kab mob lactic acidosis yuav tsum tau ua nyob hauv tsev kho mob. Qhov kev kho mob uas zoo tshaj plaws yog hemodialysis.

Kev noj tshuaj ntau dhau kuj tuaj yeem ua rau kev txhim kho ntawm cov ntshav qog nqaij hlav vim muaj cov glibenclamide hauv kev npaj. Cov tsos mob ntawm tus mob hypoglycemia: kev tshaib kev nqhis, tawm hws ntau dhau, tsis muaj zog, kab mob pob ntseg, pallor ntawm daim tawv nqaij, nqaij tawv nqaij ntawm lub qhov ncauj qhov ntswg, tshee tshee, kev ntxhov siab, kev mob taub hau, mob taub hau, mob taub hau, pw tsaug zog, pw tsaug zog, muaj kev ntshai, ua kom sib haum ntawm taw, ib ntus ntawm cov leeg mob. Nrog rau kev nce qib ntawm hypoglycemia, cov neeg mob yuav plam lawv tus kheej kev tswj hwm thiab kev nco qab.

Nrog cov ntshav qog ntshav qab zib tsawg lossis mob ntshav qab zib, dextrose (piam thaj) lossis kua qab zib yog noj ntawm qhov ncauj. Thaum muaj mob ntshav nce hlwb ntau (qhov tsis nco qab lawm), 40% dextrose (qabzib) tov lossis tso ntshav qabzib, v / m, s / c raug siv iv. Tom qab nws rov qab nco qab, tus neeg mob yuav tsum tau muab cov zaub mov nplua nuj nyob hauv cov khoom noj kom hnyav kom tsis txhob muaj kev rov qab txhim kho ntawm hypoglycemia.

Kev sib cuam tshuam nrog Lwm Yam Tshuaj

Barbiturates, corticosteroids, adrenostimulants (epinephrine, clonidine), cov tshuaj tiv thaiv kab mob (phenytoin), qeeb calcium calcium blockers, carbonic anhydrase inhibitors (acetazolamide), thiazide diuretics, chlortalidone, furosemide, diazanazide, triazene diazenterine , morphine, ritodrine, salbutamol, terbutaline, glucagon, rifampicin, iodine-muaj cov thyroid hormones, lithium ntsev, hauv kev txhaj tshuaj ntau - nicotinic acid, chlorpromazine, tshuaj tiv thaiv qhov ncauj thiab estrogens.

ACE inhibitors (captopril, enalapril), histamine H blockers txhim kho cov nyhuv hypoglycemic ntawm cov tshuaj₂receptors (cimetidine), antifungal agents (miconazole, fluconazole), NSAIDs (phenylbutazone, azapropazone, oxyphenbutazone), fibrates (clofibrate, bezafibrat), tshuaj tiv thaiv kab mob ntsws (ethionamide), salicytates, anticoagulant antagon MAO, sulfonamides ntev ntev, cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, lwm tus cov tshuaj hypoglycemic (acarbose, biguanides, insulin), allopurinol.

Zis acidifying tshuaj (ammonium chloride, calcium chloride, ascorbic acid nyob rau hauv cov koob tshuaj loj) txhim kho cov nyhuv los ntawm kev txo qis ntawm kev sib cais thiab nce kev rov kho dua ntawm glibenclamide.

Ethanol tsub kom muaj feem ntau ntawm cov kab mob lactic acidosis.

Metformin Txo C_max thiab T_1/2 furosemide los ntawm 31% thiab 42.3%, feem.

Furosemide nce C_max metformin los ntawm 22%.

Nifedipine nce ntxiv kev nqus, C_max ua kom qis qis dua ntawm kev siv tshuaj metformin.

Cov tshuaj Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren thiab vancomycin) zais cia hauv cov tubules sib tw rau cov tshuab thauj tubular thiab tuaj yeem nce C nrog kev kho mob ntev_max 60% metformin.

Cov Cai Siv Tshuaj So

Cov tshuaj yog ntawv yuav tshuaj.

Cov lus thiab cov xwm txheej ntawm kev cia

Cov tshuaj yuav tsum tau muab cia rau hauv qhov chaw qhuav, tiv thaiv los ntawm lub teeb, tawm ntawm cov menyuam yaus ntawm qhov kub tsis tshaj 25 ° C. Txee lub neej yog 3 xyoos.

Kev siv ntawm cov tshuaj Gluconorm tsuas yog raws li kws kho mob tau sau tseg, cov lus qhia yog rau siv!

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov tshuaj yeeb yaj kiab yog tsim nyob hauv daim ntawv ntawm cov ntsiav tshuaj. 1 ntsiav tshuaj muaj 2.5 mg ntawm glibenclamide thiab 400 mg ntawm metformin hydrochloride ua cov tshuaj muaj zog. Lawv muaj puag ncig zoo li hauv. Xim - los ntawm dawb mus rau yuav luag dawb.

Gluconorm xav tau hauv kev kho mob los tiv thaiv mob ntshav qab zib.

Pharmacological kev txiav txim

Metformin belongs rau ib pawg ntawm cov tshuaj hu ua biguanides. Cov theem ntawm cov piam thaj hauv cov ntshav thaum nws noj raug txo vim qhov tseeb tias qhov ua rau raug mob ntawm cov ntaub so ntswg mus rau insulin kev ua si nce. Glucose uptake ua haujlwm dua. Cov roj carbohydrates tsis nrawm rau hauv cov hnyuv. Qhov tsim tsa suab thaj hauv lub siab ua rau koj lub cev poob qis. Cov concentration ntawm cov roj (cholesterol) hauv cov ntshav txo qis. Kev mob ntshav qis yog tsis muaj peev xwm ua rau muaj mob.

Hais txog glibenclamide, nws tau sau tseg tias nws yog neeg siv tshuaj sulfonylurea ntawm lub cim thib ob. Nws ua kom lub zog tsim cov tshuaj insulin, nws tso tawm, ua rau qeeb ntawm cov txheej txheem ntawm lipolysis nyob rau hauv cov ntaub so ntswg adipose.

Cov ntshav qab zib theem thaum noj Gluconorm poob qis vim qhov tseeb ntawm qhov rhiab ntawm peripheral cov ntaub so ntswg rau insulin kev ua si nce.

Cov Tshuaj Pharmacokinetics

Qhov siab tshaj plaws ntawm glibenclamide hauv cov ntshav tau sau tseg 1-2 teev tom qab noj tshuaj. 95% sib xyaw nrog cov ntshav plasma protein. Yuav luag lwj 100% tshwm sim hauv lub siab. Qhov tsawg kawg nkaus ib nrab-lub neej yog 3 teev, qhov siab tshaj plaws yuav ncav cuag 16 teev.

Metformin yog 50-60% bioavailable. Kev sib txuas lus nrog cov ntshav plasma protein yog qhov tsawg heev, kev faib tawm ntawm cov ntaub so ntswg tuaj yeem piav qhia tau zoo ib yam. Kev ua tsis tau zoo, ua kom yws tawm ntawm lub raum. Qhov kev tshem tawm ib nrab-lub neej yog 9-12 teev.

Qhov siab tshaj plaws ntawm glibenclamide hauv cov ntshav tau sau tseg 1-2 teev tom qab noj tshuaj.

Cov Yuav Tsum Muaj

Kev kho nrog tshuaj tsis tuaj yeem nqa tawm thaum tus neeg mob muaj cov mob no:

• ntshav qab zib,
• pathologies txuam nrog cov nqaij mos hypoxia: myocardial infarction, mob plawv ntev thiab ua pa tsis haum, poob siab,
• mob ketoacidosis,
• ntshav qab zib hom 1
• lactic acidosis thiab porphyria,
• cov mob kub nyhiab lossis cov txheej txheem sib kis uas xav tau kev kho mob sai sai,
• Muaj kev cuam tshuam ntau ntxiv rau cov ntsiab lus tseem ceeb ntawm cov tshuaj.

Txoj kev kho nrog rau cov tshuaj tsis tuaj yeem nqa tawm thaum tus neeg mob tau muaj kev cuam tshuam ntau ntxiv rau cov khoom tseem ceeb ntawm cov tshuaj.
Kev kho nrog tshuaj tsis tuaj yeem nqa tawm thaum tus neeg mob ntshav qab zib hom 1.
Kev kho nrog tshuaj tsis tuaj yeem nqa tawm thaum tus neeg mob tau myocardial infarction.

Nrog ntshav qab zib

Ua ntej noj cov tshuaj, txhua tus neeg mob yuav tsum kawm cov lus qhia thiaj li tsis ua mob rau lawv tus kheej kev noj qab haus huv. Qhov ntau npaum yuav tsum yog tus kws kho mob sau ntawv yuav tshuaj. Nws txiav txim siab qhov zoo ntawm lub koob tshuaj raws li theem dab tsi hauv cov piam thaj hauv cov ntshav tau sau cia hauv tus neeg mob nyob rau lub sijhawm tau teev tseg. Feem ntau, cov zaub mov raug coj mus rau hauv tus account.

Qhov kev txhaj tshuaj ntau tshaj hauv ib hnub yuav tsum tsis pub ntau tshaj 5 ntsiav tshuaj. Yeej, nws yog 1 ntsiav tshuaj hauv ib hnub (400 mg / 2.5 mg). Txij thaum pib ntawm txoj kev kho, txhua 1-2 lub lis piam chav kawm ntawm txoj kev kho tuaj yeem raug kho, raws li kws kho mob soj ntsuam kev hloov pauv hauv cov ntshav hauv cov ntshav qabzib. Yog tias nws poob, tom qab ntawd, raws li, qhov koob tshuaj yuav tsum raug txo kom tsawg.

Qhov ntau npaum yuav tsum yog tus kws kho mob sau ntawv yuav tshuaj.

Hematopoietic plab hnyuv siab raum

Thaum muaj qhov tshwm sim tsis tshua muaj tshwm sim los ntawm cov kab mob hematopoietic, kev txhim kho ntawm leukopenia, thrombocytopenia tshwm sim. Tsawg tsawg zaus, muaj qhov txo qis ntawm cov leukocytes, megaloblastic anemia kev loj hlob.

Thaum muaj qhov tshwm sim tsis tshua muaj tshwm sim los ntawm cov kab mob hematopoietic, kev txhim kho ntawm leukopenia tshwm sim.

Cuam tshuam rau lub peev xwm los tswj cov tshuab

Vim yog cov tsos mob ntawm lub hauv nruab nrab hauv lub cev, nws yog qhov zoo dua kom thim ntawm kev tswj hwm cov txheej txheem.

Vim yog cov tsos mob ntawm lub hauv nruab nrab hauv lub cev, nws yog qhov zoo dua kom thim ntawm kev tswj hwm cov txheej txheem.

Siv thaum cev xeeb tub thiab lactation

Cov tshuaj yuav tsum tsis txhob noj thaum lub sijhawm yoj tes. Yog tias xav tau cov ntshav qab zib, qhov no yuav tsum tau ua nrog kev kho mob insulin.

Metformin ntau ntau nyob hauv leej niam cov kua mis. Qhov no txhais tau tias thaum kho, koj yuav tsum tso tseg kev kho mob nrog cov tshuaj lossis tso tseg kev pub mis niam thiab hloov tus menyuam mus rau qhov cuav.

Gluconorm Overdose

Yog tias cov koob tshuaj pom zoo los ntawm tus kws kho mob ua rau pom zoo dhau lawm, tus neeg mob tuaj yeem ntsib lactacide, kev kho mob uas yuav tsum tau ua nyob rau hauv chaw mob nrog hemodialysis. Kev muaj ntshav qab zib tsawg yuav tshwm sim, uas yuav tshwm sim nws tus kheej los ntawm qhov zoo li ntawm qhov kev xav ntawm kev tshaib plab, tshee tshee, teeb meem pw tsaug zog ib ntus thiab cov leeg ntshaus siab.

Cov yam ntxwv ntawm Pharmacological

Gluconorm yog kev sib xyaw ua ke tshuaj uas sib xyaw cov tshuaj ntawm cov chav kawm sib txawv raws li kev siv tshuab.

Thawj qhov pib ntawm cov mis yog metformin, tus sawv cev ntawm biguanides, uas normalizes glycemic indices los ntawm kev txhim kho qhov tsis kam ntawm cov hlwb rau lawv tus kheej insulin thiab ua kom nrawm rau kev siv cov kua nplaum los ntawm cov ntaub so ntswg. Ntxiv rau, biguanide inhibits qhov nqus ntawm carbohydrates thiab cuam tshuam qhov tsim tawm ntawm cov piam thaj hauv lub siab. Txhim kho cov tshuaj metformin thiab cov rog sib npaug, tswj qhov kev pom zoo ntawm txhua hom roj cholesterol thiab triglycerol.

Glibenclamide, qhov tshuaj lom neeg thib ob hauv tshuaj, ua tus sawv cev ntawm chav kawm sulfonylurea thib ob, ua kom cov tshuaj insulin ntau ntxiv nrog kev pab ntawm β-hlwb ntawm cov txiav ua lub luag haujlwm rau cov txheej txheem no. Nws tiv thaiv lawv los ntawm cov kua nplaum hnyav, txhim kho insulin tsis kam thiab qhov zoo ntawm ligaments nrog cov hlwb. Tso tawm cov tshuaj insulin cuam tshuam qhov kev nqus ntawm cov piam thaj los ntawm daim siab thiab cov leeg, yog li ntawd, nws cov khoom lag luam tsis yog tsim hauv cov rog txheej. Cov tshuaj ua haujlwm ua ntu 2 ntawm kev tsim tshuaj insulin.

Cov yam ntxwv ntawm pharmacokinetics

Tom qab nkag rau hauv plab, glibenclamide yog nqus los ntawm 84%. Cmax (qib siab ntawm nws qib) nws nce mus txog tom qab 1-2 teev. Qhov faib tawm los ntawm ntim (Vd) yog 9-10 litres. Cov tshuaj khi rau cov ntshav protein ntawm 95%.

Qhov kev tivthaiv hauv lub siab yog hloov nrog kev tso tawm ntawm 2 nruab nrab lub cev. Ib ntawm lawv tshem tawm cov hnyuv, thib ob - lub raum. Ib nrab-lub neej ntawm T1 / 2 yog nyob hauv 3-16 teev.

Tom qab nkag mus rau hauv lub plab zom mov, metformin nquag nqus, tsis pub ntau tshaj 30% ntawm cov koob tshuaj tseem nyob hauv cov quav. Lub bioavailability ntawm biguanide tsis tshaj 60%. Nrog rau kev sib txig sib xyaw nrog cov as-ham, kev nqus ntawm cov tshuaj nqus qeeb. Nws tau faib tawm sai sai, tsis nkag rau hauv kev sib txuas lus nrog cov ntshav protein.

Gluconorm tsuas tshuaj thiab muaj pes tsawg leeg

Gluconorm, ib daim duab uas tuaj yeem pom hauv tshooj no, nkag mus hauv lub khw muag tshuaj hauv daim ntawv ntawm cov kab mob convex puag ncig nrog lub plhaub dawb. Ntawm qhov tawg, qhov ntxoov ntxoo ntawm cov tshuaj yog greyish. Hauv ib ntsiav tshuaj muaj ob qho yooj yim hauv cov lus hauv qab no: metformin - 400 mg, glibenclamide - 2.5 g Ntxiv rau cov mis uas muaj cov ntsaws: talc, cellulose, hmoov txhuv nplej siab, glycerol, cellacephate, gelatin, magnesium stearate, croscarmellose sodium, sodium carboxymethyl hmoov txhuv nplej siab, silicon dioxide, sodium dioxide kev noj haus kev noj haus phthalate.

Cov tshuaj ntim rau hauv 10 lossis 20 pcs. hauv cov hlwb ua los ntawm cov ntawv nyiaj txhuas. Hauv cov thawv ntawv ntim tuaj yeem yog los ntawm 2 txog 4 daim hlau. Rau Gluconorm, tus nqi yog qhov peev nyiaj ntau: los ntawm 230 rubles, lawv tso tshuaj rau cov tshuaj. Lub txee lub neej ntawm cov ntsiav tshuaj yog 3 xyoos. Cov tshuaj tsis tas yuav tshwj xeeb rau kev cia khoom.

Yuav siv Gluconorm li cas

Rau Gluconorm, cov lus qhia rau kev siv tshuaj noj cov tshuaj noj sab hauv nrog zaub mov. Tus kws kho mob suav qhov ntau npaum li cas ntawm tus kheej, noj mus rau hauv tus account cov yam ntxwv ntawm chav kawm ntawm tus kab mob, concomitant pathologies, hnub nyoog thiab cov mob ntawm cov ntshav qab zib, thiab lub cev cov tshuaj tiv thaiv yeeb tshuaj. Raws li txoj cai, pib nrog 1 ntsiav tshuaj / hnub. Tom qab ib lossis ob lub lim tiam, koj tuaj yeem ntsuas qhov tshwm sim, thiab nrog kev ua haujlwm tsis txaus, kho cov qauv.

Yog hais tias Gluconorm tsis yog kev pib noj tshuaj, thaum hloov cov kev kho mob yav dhau los, 1-2 ntsiav tshuaj tau sau tseg rau hauv tus account yav dhau los cov tshuaj. Qhov ntau tshaj plaws ntawm cov ntsiav tshuaj uas tuaj yeem noj ib hnub yog 5 daim.

Pab nrog overdose

Lub xub ntiag ntawm cov metformin hauv kev tsim qauv feem ntau ua rau mob plab hnyuv, thiab qee zaum lactic acidosis. Nrog cov tsos mob ntawm tus mob (mob leeg, tsis muaj zog, mob nyob hauv thaj av epigastric, ntuav), cov tshuaj tau txiav. Nrog tus mob lactic acidosis, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob sai. Rov qab kho nws nrog hemodialysis.

Qhov pom muaj glibenclamide nyob rau hauv cov mis tsis cais qhov kev loj hlob ntawm hypoglycemia. Nws yog qhov ua tau kom paub txog kev muaj xwm txheej txaus ntshai los ntawm kev tswj tsis tau, kev tawm hws, tachycardia, tshee tshee, tawv nqaij daj, isomnia, paresthesia, kiv taub hau thiab mob taub hau, ntxhov siab. Nrog rau ib daim ntawv me me ntawm hypoclycemia, yog tias tus neeg mob tsis nco qab, lawv tau muab cov piam thaj lossis qab zib. Nrog kev tsaus muag, piam thaj, dextrose, glucagon (40% ntxiv) yog hno iv, txhij lossis hauv qab tawv nqaij. Tom qab tus neeg mob rov qab nco qab, nws tau pub nrog cov khoom nrog ceev carbohydrates, txij li cov mob rov qab hauv lub xeev no feem ntau tshwm sim.

Qhia Txog Tshuaj Yeeb

Kev sib xyaw nrog ACE inhibitors, NSAIDs, tshuaj tua kab mob, fibrates, salicitates, tshuaj tiv thaiv tuberculosis, β-adrenergic blockers, guanethidine, MAO inhibitors, sulfonamides, chloramphenicol, tetracycopyridinum, tetracycodiaminophenide, tetrazinopyridinin, tetrazinopyridinin, tshuaj tiv thaiv tetrazinopyridin, ntxiv rau tetrazinopyridin Cov.

Cov kev ua haujlwm hypoglycemic ntawm Gluconorm yog txo los ntawm cov teebmeem ntawm adrenostimulant barbiturates, corticosteroids, tshuaj tiv thaiv epilepsy, diuretics (thiazide tshuaj), furosemide, chlortalidone, triamteren, morphine, ritodrin, glucagon, thyroid hormones (nyob rau hauv uas oestra, iodine, thiab lwm yam).

Zis acid-boosting tshuaj ua cov tshuaj txhawb rau kev ua tau zoo los ntawm kev txo kev cuam tshuam thiab ua kom zoo dua qub gluconorm resorption. Ethanol tsub kom muaj feem ntau ntawm cov kab mob lactic acidosis. Metformin cuam tshuam tsis zoo rau lub pharmacokinetics ntawm furosemide.

Yam tsis tau xav txog

Metformin yog ib qho tshuaj zoo tshaj plaws ntawm hypoglycemic, tab sis, zoo li ib yam tshuaj hluavtaws, nws muaj kev phiv. Ntawm cov nquag muaj dyspeptic cuam tshuam, uas ploj hauv feem ntau ntawm cov ntshav qab zib tom qab qhov kawg ntawm lub sijhawm hloov kho lawv tus kheej. Glibenclamide tseem yog lub sijhawm ntsuas cov khoom pov thawj nrog lub pov thawj loj hauv kev ua haujlwm thiab kev nyab xeeb. Cov xwm txheej tau teev nyob rau hauv lub rooj yog qhov tsawg, tab sis cov lus qhia yuav tsum tau kawm ua ntej pib kev kho mob.

Leej twg tau qhia thiab contraindicated Gluconorm

Cov ntsiav tshuaj tau muab rau cov neeg mob ntshav qab zib nrog tus mob thib 2, yog tias txoj kev hloov kho hauv lub neej thiab kev kho mob yav dhau los tsis muab 100% glycemic tswj. Yog tias kev siv ob yam tshuaj cais (Metformin thiab Glibenclamide) tso cai rau kom muaj kev noj qab zib nyob ntev, nws kuj tseem xav kom hloov lub complex nrog ib cov tshuaj - Glucanorm.

Tsis txhob siv Gluconorm nrog:

• Yam 1 ntshav qab zib
• Kev Ntshav Qab Zib,
• Tus kab mob ntshav qab zib ketoacidosis, coma thiab precoma,
• Cov raum tsis ua haujlwm thiab lawv cov kev mob,
• Daim siab ua hauj lwm
• Cov xwm txheej ua rau muaj pa oxygen tshaib plab ntawm cov nqaij mos (nrog rau lub plawv nres, plhaw plawv, kev poob siab, ua pa tsis ua haujlwm),
• Porphyria
• Concurrent siv ntawm miconazole,
• Cov xwm txheej qhia txog qhov hloov mus ib ntus rau insulin (thaum ua haujlwm, raug mob, kis mob, qee qhov kev kuaj mob uas siv cov cim raws li iodine),
• Cawv kev tsim txom,
• Cov kab mob lactic acidosis, suav nrog kev kho mob yav dhau los,
• Cev xeeb tub thiab lactation
• Hypocaloric (txog 1000 kcal) khoom noj khoom haus,
• Kev ua haujlwm tsis txaus siab rau cov txheej txheem ntawm cov mis.

Kev Siv Cov Gluconorm los ntawm Cev xeeb Tub thiab Mob Niam

Txawm tias nyob rau theem npaj ntawm tus me nyuam, Gluconorm yuav tsum tau hloov nrog cov tshuaj insulin, vim tias cov tshuaj tau cuam tshuam hauv cov mob no. Thaum pub niam mis rau noj, cov kev txwv muaj nyob rau hauv tag nrho, txij li cov tshuaj nkag mus rau hauv tsis yog los ntawm tus me nyuam lub cev xwb, tab sis kuj mus rau niam mis. Kev xaiv ntawm cov tshuaj insulin thiab kev hloov pauv ntawm tus menyuam mus rau kev pub mis rau noj yuav tsum xav txog qhov kev pheej hmoo rau leej niam thiab muaj peev xwm muaj kev phom sij rau tus menyuam.

Cov lus qhia tshwj xeeb

Kev raug mob hnyav thiab kev ua haujlwm hnyav, kis kab mob sib kis nrog kub taub hau, qhia tus neeg mob hloov mus ib ntus.

Cov neeg mob ntshav qab zib yuav tsum tau ceeb toom txog qhov phom sij ntawm kev txhim kho hypoglycemia nrog kev siv cov NSAIDs, haus dej cawv, tshuaj tsis haum xeeb, thiab tsis muaj teeb meem ntawm lub cev tsis tu ncua.

Nrog rau kev hloov pauv ntawm txoj kev ua neej, kev noj zaub mov, kev xav thiab lub cev ntau dhau, kev hloov pauv ntawm cov tshuaj yog tsim nyog.

Yog tias tus neeg mob yuav tsum tau kuaj xyuas siv cov cim iodine uas muaj cov cim ntsuas, gluconorm tau muab tso tseg ob hnub, hloov nws nrog insulin. Koj tuaj yeem rov qab mus rau kev tswj kev kho mob yav dhau los tsis pub dhau 48 teev tom qab kev kawm.

Kev ua haujlwm ntawm Gluconorm yuav raug txo qis yog tias tus neeg mob tsis ua raws li cov zaub mov qis, ua rau lub neej tsis ua pa, tsis tswj nws cov suab thaj txhua hnub.

Gluconorm - analogues

Raws li ATX code ntawm qib 4, lawv ua ke nrog Gluconorm:

Kev xaiv thiab hloov cov tshuaj yog tshwj rau kev paub ntawm tus kws tshwj xeeb. Kev kuaj tus kheej thiab kev noj tshuaj tus kheej tsis suav nrog txhua tus yam ntxwv ntawm tus kab mob tshwj xeeb tuaj yeem hloov mus rau qhov muaj kev tu siab.

Kev Ntsuas Xyuas Mob Ntshav Qab Zib

Txog Gluconorm Kev kuaj ntshav qab zib feem ntau muaj kev sib cav. Qee tus neeg sib cav hais tias cov tshuaj tsis pab, muaj ntau sab txaus ntshai, suav nrog qhov hnyav ntxiv. Lwm tus hais tias lub ntsiab nyuaj hauv kev kho mob nrog cov tshuaj yog nyob rau hauv kev xaiv ntawm cov tshuaj, thiab tom qab ntawd cov suab thaj rov qab zoo li qub. Txog cov tshuaj ntsuab tshuaj ntsuab "Altai 11 Gluconorm nrog blueberries" cov kev tshuaj xyuas zoo: pab tswj kev pom kev, txhim kho kev noj qab haus huv.

Gluconorm yog ib qho yooj yim-rau-siv tshuaj nrog cov pov thawj tshawb fawb thiab kev soj ntsuam kev siv yooj yim. Biguanides thiab sulfanilurea derivatives tau siv rau kev kho mob ntshav qab zib hom 2 rau ntau tshaj li ib nrab xyoo, thiab cov tshuaj tiv thaiv kev kho mob tshiab tsis tau lees tias lawv txoj cai.

Kev cuam tshuam nrog lwm yam tshuaj

Tsis pom zoo rau kev siv tib lub sijhawm nrog cov tshuaj fenfluramine, cyclophosphamide, ACE inhibitors, tshuaj tua kab mob, vim tias lawv txhim kho cov nyhuv ntawm cov tshuaj.

Thiazide diuretics uas muaj iodine thyroid cov tshuaj hormones tuaj yeem ua rau nws tsis muaj zog.

Tsis pom zoo rau kev siv sib txuas nrog fenfluramine.

Gluconorm xyuas

Ob tus kws kho mob thiab cov neeg mob uas tau kho nrog cov tshuaj tawm hauv kev txheeb xyuas zoo.

D.E. Tikhonov, GP, Ryazan: “Cov tshuaj pom tau tias zoo tshaj plaws hauv kev kho mob ntshav qab zib hom 2. Cov neeg mob yuav zoo me ntsis. ”

O.D. Ivanova, endocrinologist, Moscow: “Kuv xav txog cov tshuaj yog qhov zoo tshaj plaws rau kev kho mob ntshav qab zib hom 2, vim tias nws pab sai sai thiab ua rau tsis ua rau pom kev tshwm sim tsis zoo. Kuv yuav tsa nws kom ntau txaus. "

Gluconorm Hom 1 thiab 2 mob ntshav qab zib

Alina, 29 xyoo, Bryansk: “Kuv yuav tsum raug kho mob hnyav li ntshav qab zib. Txoj kev kho tau ntev, tab sis cov xwm txheej tau zoo dua tuaj. Yog li, Kuv tuaj yeem pom zoo cov tshuaj no. "

Ivan, 49 xyoo, Ufa: “Kuv tau raug kho nrog cov tshuaj hauv tsev kho mob. Kuv tau txaus siab rau txhua yam, suav nrog kev saib xyuas ntawm cov kws kho mob thiab lawv tus kws tshaj lij. Lawv tau tshuaj xyuas kuv thiab, raws li cov txiaj ntsig tau, kws kho tshuaj tau ntau npaum li cas. Kuv tuaj yeem hu cov tshuaj no zoo thiab qhia nws rau txhua tus neeg mob ntshav qab zib. "