Ntshav qab zib mellitus ntsiav tshuaj

Kev kho mob rau cov ntshav qab zib hom 2 mob ntshav qab zib tsis yog los ntawm kev noj haus tshwj xeeb xwb, tab sis kuj yog los ntawm kev tsim cov khoom hluavtaws uas tsim nyog rau tus kabmob.

Lawv tsim nyog kom ua tiav glycemia muaj nuj nqis.

Ntawm cov ntau cov tshuaj muaj los ntawm cov khw muag tshuaj, cov neeg mob feem ntau tau sau npe rau Glibomet ntsiav tshuaj.

Cov ntaub ntawv dav dav txog cov tshuaj, daim ntawv tso tawm thiab cov qauv

Glibomet belongs rau cov pab pawg neeg hauv cov tshuaj hypoglycemic coj noj ntawm qhov ncauj. Cov tshuaj yog tsim los ntawm lub tuam txhab German BERLIN-CHEMIE / MENARINI. Ntxiv rau Glibomet, hauv Lavxias ntau tshaj li 100 cov tshuaj ntawm lub tuam txhab no tau sau npe, uas tau siv kev kho mob ntau yam kab mob thiab twb tau tswj hwm kom tau txais kev ntseeg siab ntawm cov neeg mob.

Cov tshuaj tau muag hauv daim ntawv ntawm cov ntsiav tshuaj coated nrog lub plhaub dawb. Txhua ntawm lawv muaj 2 lub zog ua haujlwm thiab cov lej ntawm cov khoom pabcuam tsawg.

Cov ntsiav tshuaj ntawm cov tshuaj muaj:

• Glibenclamide (2.5 mg) thiab Metformin Hydrochloride (400 mg) yog cov khoom tseem ceeb,
• cov hmoov txhuv nplej siab pob kws (mis) - 57,5 ​​mg,
• cellulose (tsob nroj polysaccharide) - 65 mg,
• silicon dioxide (zaub mov ntxiv E551) - 20 mg,
• gelatin - 40 mg
• Glycerol - 17,5 mg,
• talc (ntxhia) - 15 mg,
• Diethyl phthalate (0.5 mg) thiab 2 mg Acetylphthalyl cellulose - muaj nyob hauv cov plhaub ntawm cov ntsiav tshuaj.

Cov pob tuaj yeem yog 40, 60 lossis 100 ntsiav tshuaj.

Cov chaw muag tshuaj thiab tshuaj pharmacokinetics

Ua tsaug rau cov feem uas muaj nyob hauv kev npaj, cov tshuaj txo cov ntshav qabzib nyob hauv tus neeg mob cov ntshav.

Pharmacological kev txiav txim ntawm cov tshuaj Glibenclamide:

• txhawb kev ua haujlwm ntawm cov kua dej hauv kev zais, thiab tseem nce qhov kev tso tawm ntawm cov tshuaj hormones,
• ua rau muaj kev cuam tshuam ntau ntxiv rau cov tshuaj insulin hauv lub cev,
• txhim kho cov nyhuv ntawm cov tshuaj insulin rau cov piam thaj,
• ua rau qeeb ntawm cov txheej txheem ntawm lipolysis.

Pharmacological kev txiav txim ntawm Metformin:

• pab txhawm rau nce rhiab rau insulin, thiab tseem txhim kho nws cov nyhuv,
• txo qis dua qhov nqus ntawm cov piam thaj hauv txoj hnyuv, txhim kho nws txoj kev nqus los ntawm lwm lub nruab nrog cev,
• pab txhawb gluconeogenesis,
• favorably cuam tshuam lipid metabolism, uas ua rau kom poob phaus.

Nws muaj peev xwm ua tiav kom txo qis glycemia tom qab ntsiav tshuaj tom qab 2 teev thiab txuag rau 12 teev.

Cov nyhuv pharmacological ntawm cov tshuaj yog cov yam ntxwv ntawm kev nqus, kev faib tawm, cov metabolism thiab ua kom zoo ntawm cov khoom tseem ceeb.

1. Kev nqus thiab xa cov txheej txheem. Qhov siab tshaj plaws ntawm cov khoom siv tau mus txog 2 teev tom qab kev tswj hwm. Qhov feem cuam yog nqus nrawm ntawm cov hnyuv (mob plab zom mov). Kev sib txuas ntawm cov tshuaj nrog cov plasma protein nce mus txog 97%.
2. Kev mob plab tshwm sim yuav luag tag nrho lub siab.
3. Chaw Sau Ntawv. Kev cai ntawm kev ua no yog ua los ntawm lub raum. Kev nthuav tawm ntawm qhov txuam yog ua ke nrog zis thiab tso tawm tso tawm los ntawm tso zis. Ib nrab-lub neej yuav siv 10 teev.

1. Qhov nqus thiab xa tawm hauv cov ntaub so ntswg ntawm cov khoom sib txuas ua ke tshwm sim sai thiab yooj yim.
2. Kev nthuav tawm ntawm cov feem los ntawm lub cev tshwm sim tsis hloov pauv ntawm lub raum thiab hnyuv. Kev tshem tawm ib nrab-lub neej yuav siv 7 teev.

Kev taw qhia thiab contraindications rau siv

Cov tshuaj raug pom zoo rau kev siv nrog mob ntshav qab zib hom 2, thaum kev noj haus thiab kev kho mob nrog lwm cov tshuaj muaj txiaj ntsig.

• ua kom lub cev tsis haum rau ib qho twg ntawm cov tshuaj,
• ntshav qab zib hom 1
• mob ntshav qab zib gestational
• lactic acidosis,
• ketoacidosis
• coma (hypoglycemic los yog hyperglycemic),
• mob raum tsis zoo,
• pathology ntawm lub siab, ob lub raum,
• poj laib
• muaj cov kis kab mob,
• kev phais mob ntxiv, nrog rau ntshav ntshav ntau,
• kev raug mob lossis hlawv roj
• tej yam mob uas yuav tsum tau siv tshuaj kho mob,
• leukopenia
• porphyria
• dystrophic hloov pauv
• cawv intoxication,
• lub sij hawm pub niam mis,
• cov menyuam yaus, cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo,
• cev xeeb tub

Cov lus qhia rau kev siv thiab cov lus qhia tshwj xeeb

Cov ntsiav tshuaj noj ntawm ncauj nrog noj mov. Qhov ntau npaum ntawm cov tshuaj yuav tsum tau xaiv los ntawm tus kws kho mob, coj mus rau hauv tus txheej txheem cov txheej txheem ntawm cov metabolism ntawm carbohydrates thiab glycemia hauv tus neeg mob.

Kev noj tshuaj ntau zaus pib nrog ib ntsiav tshuaj. Nyob ntawm cov txiaj ntsig ntawm kev kho, qhov ntau npaum li cas yuav sib txawv. Qhov siab tshaj plaws ntawm kev tso cai cov ntsiav tshuaj hauv ib hnub yog 6, vim tias nws yog qhov txaus ntshai yuav tsum coj lawv ntawm qhov muab ntau dua. Cov txiaj ntsig ntawm kev xaiv cov tshuaj kho tau txiav txim siab yog txiav txim siab los ntawm cov txiaj ntsig cov piam thaj tau.

Nws yog ib qho tseem ceeb rau cov neeg mob kom ua raws li kws kho mob cov lus pom zoo txog khoom noj khoom haus, txoj kev ntawm kev coj thiab kev siv tshuaj. Nrog rau cov ntshav qab zib decompensated, tshaib plab, haus dej cawv, tsis txaus siab rau lub siab ua haujlwm, nrog rau txhua qhov kev qhia tawm ntawm hypoxia, ntsiav tshuaj yuav tsum tau noj nrog ceev faj vim muaj kev pheej hmoo ntawm lactic acidosis. Tus mob no yog ib qho ua tau los ntawm kev sib txuam ntawm metformin, vim cov txiaj ntsig ntawm lactate raug kuaj hauv cov ntshav.

Kev lees txais cov nyiaj cuam tshuam nrog qhov kev ua tiav uas yuav tsum kuaj ntshav rau creatinine:

• Ib xyoos ib zaug thaum lub raum kev ua haujlwm (hauv cov neeg mob ntshav qab zib),
• ntau dua 2 zaug hauv ib xyoos hauv cov neeg muaj HBV (mob qog nqaij hlav ntshav hauv ntshav) lossis cov neeg laus.

• siv nrog diuretics nrog ceev faj
• tsis txhob noj cov tshuaj ob hnub ua ntej kev teem sijhawm xoo hluav taws xob los yog phais mob siv tshuaj loog, hloov nrog insulin lossis lwm yam tshuaj,
• rov pib kho txoj kev kho mob tsuas yog tom qab 48 teev los ntawm lub sijhawm ntawm kev phais mob thiab nyob rau hauv qhov xwm txheej ntawm kev ua haujlwm ntawm lub raum,
• tsis txhob haus cawv ua ke nrog cov tshuaj txhawm rau kom tsis txhob mob ntshav qab zib lossis qhov tshwm sim ntawm ntau yam tshuaj tshwm sim vim haus cawv tsis txaus ntseeg,
• cov tshuaj txo tus nqi ntawm cov kev xav psychomotor, uas tuaj yeem cuam tshuam rau kev tsav tsheb.

Ntshav qab zib mellitus feem ntau yog ib qho ntawm cov kab mob uas tus neeg mob tau muaj. Nyob rau hauv muaj lwm cov pathologies, nws yog ib qho tseem ceeb uas yuav tsum tau siv cov tshuaj nrog ceev faj.

Ib pab pawg neeg tshwj xeeb ntawm cov neeg mob yog:

• Cov niam cev xeeb tub lossis lactating (cov tshuaj yog contraindicated),
• cov neeg mob uas muaj lub siab tsis ua hauj lwm zoo (tshuaj txwv tsis pub siv),
• cov neeg mob raum (nrog creatinine los ntawm 135 mmol / l hauv cov txiv neej thiab siab dua 100 mmol / l hauv cov poj niam, kev kho tshuaj tsis raug cai).

Cov tshuaj tsis raug pom zoo rau kev siv los ntawm cov neeg mob hnub nyoog tshaj 60 xyoo, txij li thaum ua haujlwm hnyav lub cev lawv yuav tsim muaj cov kab mob lactic acidosis.

Phiv thiab haus tshaj

Kev noj tshuaj yuav ua rau cov kev mob tshwm sim hauv qab no:

• nyob rau hauv kev cuam tshuam nrog lub plab zom mov - tawm tsam xeev siab thiab ntuav, poob lossis ua kom tsis qab los noj mov, tso quav,
• los ntawm kev mob ncig - leukopenia, as Well as anemia thiab pancytopenia,
• muaj feem rau kev mob hlwb - mob taub hau,
• khaus, urticaria, erythema,
• hypoglycemia lossis lactic acidosis,
• lub plawv dhia.

Nrog kev noj tshuaj ntau dhau, tus neeg mob tsis muaj qhov mob tshwm sim zoo li cas, mob ntshav qab zib tsawg zuj zus. Hauv qhov no, koj yuav tsum noj carbohydrates. Qhov kev nce qib ntawm hypoglycemia tuaj yeem ua rau poob ntawm kev tswj tus kheej thiab kev nco qab. Hauv cov xwm txheej no, tus neeg mob tsis tuaj yeem noj mov, yog li cov ntshav dej qab zib thiab kev kho mob yuav tsum tau ua.

Kev cuam tshuam nrog lwm cov tshuaj thiab cov tshuaj analogues

Cov nyhuv hypoglycemic ntawm cov tshuaj yog txhim kho nyob rau hauv tus ntawm cov neeg sawv cev xws li:

• Txuj kev sib cav sib yuav,
• Cov ntsev,
• MAO inhibitors
• phenylbutazone derivatives,
• Sulfonamides,
• Miconazole
• Feniramidol
• Ethanol

Txhawm rau kom txo cov txiaj ntsig ntawm kev siv cov tshuaj cuam tshuam rau:

• Glucocorticoids,
• Thiazide diuretics,
• tshuaj tiv thaiv (qhov ncauj),
• cov tshuaj hormones los tswj cov thyroid caj pas,
• Adrenaline.

Yog hais tias Glibomet rau qee qhov laj thawj tsis haum, muaj ntau ntawm nws cov analogues, sib txawv hauv cov muaj pes tsawg leeg thiab nqi.

Lub ntsiab analogues:

Nws yog ib qho tseem ceeb kom nkag siab tias tsuas yog tus kws kho mob yuav tsum txiav txim siab txog kev hloov Glibomet nrog lwm yam tshuaj.

Yees duab ntawm xya txoj hauv kev los txo cov ntshav qab zib hauv tsev:

Tus neeg mob lub tswv yim thiab tus nqi tshuaj

Los ntawm kev tshuaj xyuas cov neeg mob, nws tuaj yeem xaus lus tias cov tshuaj yuav tsum tau ua nrog ceev faj, vim nws muaj ntau yam tshwm sim, nws tseem yuav tsum tau sab laj tus kws kho mob tshwj xeeb ua ntej noj cov tshuaj.

Kuv pib noj cov tshuaj raws li kws kho mob hais. Nyob rau thawj hnub ntawm kev kho mob, nws tau hnov ​​ob zaug cov tsos mob ntawm kev mob ntshav qab zib, txawm hais tias nws kev noj zaub mov tsis hloov. Kuv tsis tuaj yeem mus ntsib kws kho mob tam sim ntawd, yog li kuv tus kheej txiav txim siab tsis txhob sim ntxiv lawm thiab rov qab mus noj cov tshuaj uas dhau los.

Kuv zoo siab nrog Glibomet. Nrog nws cov kev pab, nws ua tau rau normalize qib ntawm cov piam thaj. Tom qab nyeem cov lus qhia, thaum xub thawj nws tau ntshai ntawm cov npe loj ntawm cov kev mob tshwm sim, tab sis txiav txim siab los ntseeg tus kws kho mob. Cov tshwm sim txaus siab.

Xyoo tas los kuv coj cov tshuaj no. Cov tshuaj no tsis haum rau kuv, vim yog xim hlau me me hauv kuv lub qhov ncauj tau pom txhua lub sijhawm thiab qee zaum ua rau kuv xav xeev siab.

Nikita Alexandrovich, 65 xyoo

Cov cuab yeej txo cov suab thaj kom zoo, tab sis thaum lub sijhawm nws nkag mus koj tsis tuaj yeem hla txawm tias ib qho khoom noj txom ncauj, tsis zoo li cov zaub mov tseem ceeb. Glybomet yuav tsum noj zaub mov kom tsis tu ncua kom tsis muaj qog ntshav qab zib.

Tus nqi ntawm cov tshuaj yog kwv yees li 350 rubles rau 40 ntsiav tshuaj.

Glybomet - muaj pes tsawg leeg

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

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

Cov yam ntxwv ntawm Pharmacological

Ib qho ntawm cov khoom xyaw tseem ceeb, glibenclamide, yog qhov tshuaj ntawm cov tub ntxhais tshiab tiam sulfonylurea, uas tau muaj nyob hauv daim ntawv teev cov tshuaj tseem ceeb nrog pancreatic thiab ntxiv-pancreatic muaj peev xwm.

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

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

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

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

Metformin muaj qhov tshwj xeeb:

Kev rov qab tshuaj xyuas txog 5800 tus neeg mob ntshav qab zib nrog hom ntshav qab zib hom 2 tau ua hauv Suav teb. Cov neeg koom nrog sim tau txais metformin hauv kev sib xyaw ua ke nrog kev ua neej hloov kho. Hauv pawg tswj hwm, cov neeg ua haujlwm pab dawb tsuas hloov lawv txoj kev ua neej. Rau 63 lub hlis, hauv thawj pab pawg, kev tuag yog 7.5 tus neeg rau 1000 tus neeg / xyoo, hauv ob - rau 45 lub hlis, ntsig txog 11 tus neeg.

Feem ntau, hauv cov pab pawg uas tau txais cov tshuaj metformin, qhov kev tuag yog qhov tsawg dua 29.5% dua li ntawm kev tswj hwm, thiab qhov zaus ntawm cov kev mob plawv yog 30-35%.

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

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

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

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

Muaj peev xwm ntawm Pharmacokinetic

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

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

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

Hauv lub cev, yuav luag tsis cuam tshuam; nyob rau hauv nws thawj daim ntawv, nws raug tawm los ntawm lub raum thiab cov hnyuv. Qhov kev tshem tawm ib nrab-lub neej yog kwv yees li 10 teev.

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

Kev qhia rau kev kho mob nrog Glybomet

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

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

Yuav ua li cas noj Glibomet

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

Muaj cov kev txwv ntawm kev noj cov Glibomet:

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

Phiv thiab haus tshaj

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

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

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

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

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

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

Qhia Txog Tshuaj Yeeb

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

Cov kev sib xyaw ua ke nrog cov tshuaj hormones rau cov thyroid caj pas, tshuaj noj hauv qhov ncauj, barbiturates, thiazide diuretic tshuaj kho qhov tsis zoo ntawm Glibomet.

Nyeg, cov khoom siv nquag ua ke ntawm Glibomet ua haujlwm pab txhawb nqa kev tawm tsam.

Cov lus qhia tshwj xeeb

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

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

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

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

Cov txiaj ntsig ntawm kev kho nrog Glybomet yuav feem ntau nyob ntawm qhov tseeb ntawm kev ua raws li cov lus pom zoo hauv cov lus qhia thiab cov lus qhia ntawm tus kws kho mob endocrinologist: noj zaub mov thiab pw tsaug zog thiab so, ua haujlwm lub cev, tswj kev ua haujlwm glycemic, suav nrog hauv tsev.

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

Hauv kev mob raum tsis ua haujlwm, Glybomet yog contraindicated thaum nyob rau hauv kev tshuaj ntsuam KK siab dua 135 mmol / l, yog tias tus neeg mob yog tus txiv neej, thiab siab dua 110 mmol / l, yog tias tus mob ntshav qab zib yog poj niam.

Tus nqi ntawm cov tshuaj thiab cov cai khaws cia

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

Cov tshuaj zoo sib xws

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

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

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

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

Lub npe Latin: Glibomet
ATX Code: A10B D02
Yam tshuaj muaj sia: Glibenclamide
thiab metformin hydrochloride
Chaw tsim tshuaj paus: Berlin Chemie, Lub Tebchaws Yelemees
Hnub so los ntawm cov tsev muag tshuaj: Los ntawm tshuaj
Cia rau cov neeg mob: t txog 25 C
Hnub tas sij hawm: 3 xyoos

Glibomet yog hais txog kev siv tshuaj hypoglycemic, uas yog kho rau hom II mob ntshav qab zib mellitus.

Kev kho cov tshuaj Glibomet yog qhia thaum muaj mob ntshav qab zib hom 2 (insulin tsis tas yuav ua li cas), thaum kev noj zaub mov noj nrog kev siv ntau dua ib zaug ntawm biguanides lossis sulfonylurea tsis tau txais txiaj ntsig zoo.

Kev Sau thiab tso cov foos

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

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

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

Kho thaj chaw

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

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

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

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

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

Glibomet: cov lus qhia ua tiav rau kev siv

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

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

Cov Kev Tsis Txaus Ntseeg thiab Kev Ceev Faj

• Ntau qhov nkag tau yooj yim rau cov pib thiab cov tshuaj ntxiv
• Ntshav qab zib mob ntshav Insulin-tiv thaiv (thawj hom)
• Nyob hauv cov neeg mob ntshav qab zib ua tsis nco qab lossis precoma
• Mob ntshav qab zib tsawg
• Ketoacidosis
• Kev ua txhaum ntawm daim siab thiab lub raum
• Cev xeeb tub, GV
• Lactic acidosis.

Koj yuav tsum tau txiav tawm tam sim ntawd Kev Kho Mob Glibomet nrog thawj cov tsos mob ntawm cov kab mob lactic acidosis (cov tsos mob ntawm tus mob chua mob, mob epigastric, qaug zog, txhaws ntuav) thiab nrhiav tswv yim ntawm koj tus kws kho mob.

Thaum lub sij hawm tshuaj tiv thaiv kab mob, nws yuav tsum tau soj ntsuam cov creatine hauv cov ntshav: thaum tsis muaj lub raum pathologies - 1 p. thoob plaws hauv lub xyoo, nrog nce kev siv creatine Performance index thiab cov neeg laus laus - 2-4 p. tau 12 lub hlis

Cov tshuaj yuav tau ua kom tiav 48 teev ua ntej kev iab liam kev phais mob nrog tshuaj loog. Koj tuaj yeem txuas ntxiv chav kawm tom qab kev hloov kho tag nrho ntawm kev noj zaub mov ib txwm, tab sis tsis tau ntxov dua 48 teev tom qab kev ua haujlwm nrog kev paub tseeb ntawm tag nrho kev ua haujlwm ntawm lub raum.

Thaum lub sij hawm kho cov tshuaj tiv thaiv kab mob, kev saib xyuas yuav tsum tau ua thaum ua haujlwm nrog cov txheej txheem meej thiab tsav tsheb, txij li thaum lub cev tsis muaj ntshav qab zib, qhov ceev ntawm kev nkag siab thiab psychomotor tshua tuaj yeem txo qis.

Qhov ua tau zoo ntawm kev kho mob yuav yog nyob ntawm kev ua raws nrog tus kws kho mob cov lus qhia hais txog kev siv tshuaj, khoom noj khoom haus, kev tawm dag zog thiab kuaj xyuas qabzib.

Nws yog ib qho tsim nyog kom tshem tawm cov kev haus cawv, vim tias muaj kev pheej hmoo siab ntawm hypoglycemia lossis cov lus hais tawm disulfiram zoo li.

Hla kev sib txuam yeeb tshuaj

Cov nyhuv rau hypoglycemic tuaj yeem ua kom zoo dua nrog kev siv tib lub sijhawm ntawm β-blockers, derivatives ntawm xws li cov khoom xws li coumarin thiab phenylbutazone, MAO inhibitors, salicylates, miconazole, cimetidine, sulfanilamides thiab sulfonamides, oxytetracycline, probenecid, pheniramidol, ethanol, etiol ntxiv rau perhexiline.

COCs, tshuaj raws li cov thyroid hormones, adrenaline, corticosteroids, diuretics ntawm thiazide pawg ua ke nrog barbiturates txo cov nyhuv hypoglycemic ntawm Glibomet.

Nrog rau kev siv tshuaj tiv thaiv ua ke, kev nce siab hauv lawv cov txiaj ntsig yuav raug pom.

Thaum noj cov tshuaj cimididine, kev nce ntxiv hauv kev ntxim siab ntawm cov kab mob lactic acidosis muaj peev xwm ua tau.

Thaum noj β-blockers, cov tsos mob me me ntawm hypoglycemia yog ua tau.

Thaum siv cov tshuaj iodine-muaj radiopaque, muaj kev pheej hmoo siab ntawm lub raum ua kom lub cev ua haujlwm, nrog rau kev ua kom ruaj khov ntawm cov tshuaj thib ob ntawm cov tshuaj - metformin, uas tuaj yeem tom qab lactic acidosis.

Phiv thiab haus tshaj

Cov uas noj cov tshuaj no tuaj yeem ntsib teebmeem ntau yam:

• Lub plab zom mov: xeev siab ua rau muaj qhov ntuav kom ntuav, tsis qab los noj mov, mob plab, mob plab zawv plab, ib qho xim hlau tshwj xeeb hauv lub qhov ncauj tsis tshua zoo, tsis tshua muaj - kev ua si ntau dua ntawm transaminases
• Cov kab mob hematopoietic: qhov tshwm sim ntawm thrombocytopenia, leukopenia, nrog rau erythrocytopenia, tsis tshua muaj tshwm sim - muaj ntshav tsis txaus (megaloblastic lossis hemolytic type), pancytopenia, agranulocytosis
• CNS: mob taub hau heev
• Daim tawv nqaij: pob khaus urticaria, mob pruritus, erythema, cov tsos mob ntawm daim tawv nqaij
• Kev tiv thaiv kab mob: qhov tshwm sim ntawm hypokalemia, nyob rau qee kis - lactic acidosis.

Yog tias tsim nyog, tus kws kho mob tuaj yeem xaiv analogues rau cov tshuaj Glybomet (piv txwv li, Diabeton). Dab tsi zoo dua rau Glibomet lossis Diabeton, nws tsim nyog kuaj nrog koj tus kws kho mob.

Tej zaum muaj kev txhim kho ntawm cov kab mob lactic acidosis (ua rau muaj kev sib xyaw nrog metformin) thiab cov ntshav qog ntshav (nrog glibenclamide).

Kev kho mob kom zoo: nrog cov cim ntawm cov kab mob lactic acidosis, koj yuav tsum tshem tawm cov tshuaj tam sim ntawd thiab nrhiav kev pab kho mob. Hauv qhov xwm txheej no, hemodialysis suav hais tias yog txoj hauv kev zoo los nres tus tsos mob ntawm tus kab mob.

Yog tias tus neeg mob nyob rau hauv lub xeev tsis nco qab lawm, tom qab ntawd 40% kev daws teeb meem yog txhaj rau hauv txoj hlab ntshav (kwv yees ntau npaum li cas txog 80 ml), tom qab ntawv kho 10% dextrose yuav tsum tau siv tshuaj. Tom qab kho nrog kev tswj hwm ntawm glucagan (1 ml). Yog tias, tom qab ua txoj kev ua kom tiav, tus neeg mob tseem tsis nco qab, cov kev piav qhia tau rov ua dua. Thaum tsis muaj kev kho mob kom zoo, ib qho kev saib xyuas mob hnyav yog tau kho.

Servier Lub chaw soj nstuam, Fabkis

Nqi los ntawm 269 txog 366 rubles.

Diabeton - cov tshuaj uas pom los ntawm lub suab hypoglycemic nyhuv. Nws yog tshuaj rau hom 2 mob ntshav qab zib mellitus thiaj li tswj tau cov tshuaj insulin. Cov nquag ua haujlwm ntawm Diabeton yog gliclazide. Muaj nyob hauv ntsiav tshuaj daim ntawv.

• Tsim nyog tus nqi
• Pab txhawb kev poob phaus
• Txo txoj kev pheej hmoo ntawm cov teeb meem ntshav qab zib.

• Tsis tau teev tseg thaum cev xeeb tub
• Lub sijhawm tswjhwm, kev mob plab hnyuv muaj peev xwm ua tau
• Tsis haum rau txhua tus.

Lub xeem hloov tshiab los ntawm chaw tsim tshuaj paus 18.07.2005

Pharmacological kev txiav txim

Glibenclamide - nws stimulates insulin secretion los ntawm kev txo qis ntawm kev pib ntawm pancreatic beta-cell glucose voos, nce insulin rhiab heev thiab nws cov lus qhia rau lub hlwb cov phiaj xwm, nce insulin tso tawm, txhim kho cov nyhuv ntawm insulin rau cov leeg nqaij thiab lub siab ua kom lub ntsej muag, thiab inhibits lipolysis hauv adipose nqaij. Kev ua nyob rau theem ob ntawm insulin secretion.
Metformin - inhibits gluconeogenesis nyob rau hauv daim siab, txo qhov nqus ntawm cov piam thaj ntawm lub plab zom mov thiab nce nws txoj kev siv hauv cov nqaij mos, txo cov ntsiab lus ntawm triglycerides thiab cov roj cholesterol hauv cov ntshav ntshav. Nce kev khi ntawm insulin rau kev txais (nyob rau hauv qhov tsis muaj tshuaj insulin hauv cov ntshav, cov kev kho mob tsis pom tshwm). Tsis ua rau muaj kev tsis haum ntshav.

Cov Tshuaj Pharmacokinetics

Glibenclamide nrawm nrawm thiab ncaj ncees (84%) nqus tau ntawm cov hnyuv. Lub sijhawm kom mus txog C max yog 7-8 teev .Tus khi rau cov ntshav plasma yog 97%. Nws yuav luag txhua yam hauv lub siab ua rau lub cev tsis ua haujlwm. 50% yog tawm los ntawm lub raum thiab 50% nrog bile. T 1/2 - 10-16 h.
Metformin tom qab kev nqus hauv cov hnyuv (nqus - 48-52%) yog tawm los ntawm lub raum (feem ntau tsis hloov), qee qhov ntawm cov hnyuv. T 1/2 - 9-12 h.

Tsuas tshuaj thiab tswj hwm

Sab hauv thaum noj mov. Qhov ntau npaum li cas tau teem rau ib leeg zuj zus, nyob ntawm lub xeev ntawm cov khoom noj metabolism thiab cov ntshav qab zib. Feem ntau cov tshuaj thawj zaug yog 1-3 ntsiav tshuaj. ib hnub nrog kev maj mam xaiv cov koob tshuaj kom txog thaum them nyiaj ruaj khov kho ntawm tus mob. Cov qib siab noj tshuaj yog noj tshuaj 2 zaug hauv ib hnub (sawv ntxov thiab yav tsaus ntuj). Nws tsis pom zoo kom noj ntau dua 5 ntsiav tshuaj. Glibometa ib hnub.

Cov ntsiab lus ntawm nosological pawg

Qee lub sijhawm nws tsim nyog, tshwj xeeb tshaj yog thaum nws los rau cov neeg mob ntshav qab zib xav tau qee yam tshuaj los tswj cov ntshav qab zib. Yog lawm, hauv kev lag luam pharmacological niaj hnub no muaj ntau ntau yam tshuaj. Tab sis cov kws tshaj lij feem ntau pom zoo cov tshuaj "Glibomet." Kev tshuaj xyuas ntawm cov ntshav qab zib thiab cov kws kho mob qhia tias qhov kev daws teeb meem no ua rau koj daws cov teeb meem kev kub ntxhov.

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

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

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

Cov tshuaj ua rau lub cev hloov li cas?

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

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

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

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

Thaum twg yog cov tshuaj siv?

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

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

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

Cov tshuaj "Glibomet": contraindications rau kev kho mob

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

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

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

Kev phiv tshuaj dab tsi tuaj yeem kho tau?

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

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

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

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

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

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

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

Nqi thiab analogues

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

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

Cov tshuaj "Glibomet": tshuaj xyuas cov neeg mob ntshav qab zib thiab kws kho mob

Cov tshuaj no yog siv dav hauv cov tshuaj niaj hnub. Tab sis kev kho mob nrog Glibomet zoo li cas? Kev tshuaj xyuas cov neeg mob ntshav qab zib, nrog rau cov kws tshaj lij, paub meej tias cov tshuaj kho tau zoo nrog rau cov kev rau txim rau cov mob ntshav qab zib tsis yog insulin-tiv thaiv kev mob ntshav qab zib.

Raws li kev tshawb nrhiav, cov tshuaj ua rau muaj feem ntawm cov txiav ua lub luag haujlwm rau lub zog ntawm cov tshuaj insulin. Qhov no yog kiag li qhov uas yuav tsum tau muaj rau tus mob xws li mob ntshav qab zib hom 2. Kev noj haus thiab kev kho mob hauv qhov no tseem ceeb heev.

Cov xwm txheej tsis zoo hauv kev kho mob tsis tshua tau teev tseg. Cov tshuaj yog qhov ua tau zoo, thiab nws tus nqi yog qhov tsim nyog heev.

Cov pab pawg kho mob thiab chaw muab tshuaj: & nbsp

Hauv tshuaj

A.10.B.D.02 Metformin thiab sulfonamides

Ua ke nrog tus sawv cev antiglycemic.

Ib qho sulfonylurea derivative ntawm lub cim thib ob, los ntawm kev txo qis qis dua rau kev txhawb nqa ntawm pancreatic cells-hlwb nrog cov piam thaj, txhawb kev tso pa tawm ntawm insulin, nce nws tso tawm thiab qib ntawm khi rau cov hlwb hom. Kev siv lub ntsej muag hypoglycemic nyob ntawm tus naj npawb ntawm kev ua haujlwm β-hlwb.

Txhawb nqa platelet kev sib sau, muaj fibrinolytic, hypolipidemic thiab tsis muaj zog diuretic zoo.

Nws txo qhov kev nqus ntawm cov piam thaj los ntawm txoj hnyuv thiab txhim kho nws cov kev siv hluav taws xob ntau ntxiv, ua kom muaj kev cuam tshuam ntawm cov ntaub so ntswg mus rau insulin, thiab inhibits gluconeogenesis hauv daim siab. Txo cov theem ntawm qis lipoproteins tsawg thiab triglycerides hauv ntshav ntshav. Tsis ua rau lub cev tsis haum ntshav, tsis muaj kev cuam tshuam rau cov kua dej los ntawm β-hlwb ntawm cov txiav. Los ntawm kev txwv ib qho inhibitor ntawm ib tug activator, nqaij plasminogen muaj cov nyhuv fibrinolytic. Stabilizes lossis txo qhov hnyav lub cev.

Tom qab kev tswj hwm ntawm qhov ncauj, nws tau nqus rau hauv lub plab zom mov 90%. Qhov siab tshaj plaws hauv cov ntshav ntshav tau mus txog tom qab 2 teev. Kev sib txuas lus nrog cov protein ntshav yog 95%.

Qhov ua tau siab tshaj plaws kho tau 7-8 teev tom qab kev tswj hwm. Lub sijhawm tiv thaiv yog 12 teev. Cov kab mob ntshav siab nyob hauv nplooj siab.

Qhov kev tshem tawm ib nrab-lub neej ua rau 2-10 teev. Kev tshem tawm ntawm ob lub raum thiab cov quav.

Tom qab lub qhov ncauj tswj hwm, txog li 50-60% yog nqus rau hauv lub plab zom mov. Qhov siab tshaj plaws hauv cov ntshav ntshav tau mus txog tom qab 2.5 teev. Tsis khi rau ntshav protein.

Nws accumulates nyob rau hauv cov leeg nqaij, salivary qog, ob lub raum thiab mob siab.

Ib nrab-lub neej yog 6 teev. Kev tshem tawm los ntawm ob lub raum tsis hloov.

Nws raug siv los kho mob ntshav qab zib uas tsis yog insulin-mellitus.

IV.E10-E14.E11 Tsis muaj ntshav qab zib tsis yog insulin-tiv thaiv ntshav qab zib mellitus

Hom I mob ntshav qab zib mellitus (insulin-dependant), tsis nco qab, ketoacidosis, tus neeg tsis kam txais.

Cov ntaub ntawv ceeb toom: Cov kab mob tsis txaus ntseeg ntawm cov endocrine system cuam tshuam rau cov metabolism hauv kev ua kom yuag: adenohypophysial thiab adrenocortical tsis txaus, muaj cov thyroid tsis ua haujlwm. Cev xeeb tub thiab lactation: Chaw Tos Kev thiab cov thawj coj:

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

Sab hauv, thaum noj mov, hauv thawj koob tshuaj 2.5 mg ntawm glibenclamide thiab 500 mg ntawm metformin (1 ntsiav tshuaj) 2 zaug hauv ib hnub. Kev nce lossis txo qis hauv koob (nyob ntawm seb qib piam thaj hauv ntshav).

Qhov tshuaj txhua hnub ntau tshaj plaws (2.5 lossis 5 mg ntawm glibenclamide thiab 500 mg ntawm metformin): 4 ntsiav tshuaj.

Qhov siab tshaj plaws ib koob tshuaj (2.5 mg glibenclamide thiab 500 mg metformin): 1 ntsiav tshuaj.

Hematopoietic system : tsis tshua muaj - thrombocytopenia, erythrocytopenia, granulocytopenia, hemolytic anemia.

Lub plab zom mov : dyspepsia, xeev siab, ntuav, raws plab, mob siab, mob cholestatic jaundice.

Musculoskeletal system : arthralgia.

Kev kho kom haum Dermatological ua pob.

Cov kab mob zis : proteinuria.

Cov hlab ntsha nruab nrab thiab ntu : insomnia, paresthesia, siab ntsws lability.

Kev kho plawv : tachycardia.

Lub plab zom mov : poob ntawm qab los, cem quav, qee zaum - exacerbation ntawm hemorrhoids.

Musculoskeletal system: Cov tsos mob ntawm lactic acidosis yog spasms ntawm cov leeg plab.

Kev Kho Mob: muaj piam thaj sab hauv, nrog ploj los ntawm kev nco qab - kev tswj hwm ntawm 40% kev daws teeb meem.

Cov tshuaj nyob hauv cov ntshav plasma concentration ntawm cov tshuaj nce isoenzyme 3A4 cytochrome P450 inhibitors:,.

Cov qib glycemia raug txo qis thaum siv cov tshuaj nrog thiazide diuretics, qeeb calcium calcium blockers, lithium npaj, glucocorticoids, isoniazid, sympathomimetics, nicotinic acid, phenytoin, phenothiazines, cov thyroid hormones.

Nrog rau kev siv ua ke nrog furosemide, yuav tsum tau txo koob tshuaj.

Kev haus dej haus cawv (tshwj xeeb tshaj yog nyob rau ntawm lub plab khoob) thaum kho mob ua rau muaj kev cuam tshuam zoo li disulfiram, ua rau cov tshuaj lactic acid nyob rau hauv cov ntshav plasma thiab muaj kev pheej hmoo ntawm hypoglycemia.

Thaum cev xeeb tub thiab lactation, nrog rau cov xwm txheej tom qab raug mob thiab ua haujlwm ntau, cov tshuaj txuas ntxiv, kev kho mob ntshav qab zib txuas ntxiv nrog kev txhaj tshuaj insulin.