Glimecomb ke moemeli oa li-hypoglycemic tse batloang ho mofuta oa lefu la tsoekere la 2 lefu la tsoekere. Moriana ka tsela e tšoanang o ntlafatsa boemo ba metabolism ea mafura, o fokotsa kotsi ea liathomo tsa atherosselotic marakong a methapo, o fokotsa boima ba 'mele ka botenya. Setlhare se fanoa feela ha ho sena phello ea ho ja le ho ikoetlisa.
Lebitso la Machaba le sa Tšoanelehang
Glyclazide + Metformin.
Glimecomb ke moemeli oa li-hypoglycemic tse batloang ho mofuta oa lefu la tsoekere la 2 lefu la tsoekere.
ATX
A10BD02.
Lokolla liforomo le sebopeho
Setlhare se entsoe ka mokhoa oa matlapa a masoeu bakeng sa ts'ebeliso ea molomo, e khetholloang ka 'mala o mosehla kapa oa tranelate le sebopeho se sephara-cylindrical. Setsi sa meriana se kopanya metsoako e 2 e sebetsang: 40 mg ea gliclazide le 500 mg ea metformin hydrochloride. Povidone, magnesium stearate, sorbitol le croscarmellose sodium li sebetsa e le lintho tse thusang. Matlapa a fumaneha ka likarolo tse 10 ka har'a mekotla ea blister. Ka lebokoseng la karete ho na le lithutsoana tse 6.
Ketso ea pharmacological
Setlhare sena se bolela lits'oants'o tse kopaneng tsa hypoglycemic bakeng sa tsamaiso ea molomo. Moriana o na le pancreatic le extrapancreatic.
Glyclazide ke sulfonylurea e tsoang ho eona. Mohato oa ts'ebetso oa motsoako oa lik'hemik'hale o ipapisitse le ts'usumetso ea ts'ebetso ea lekunutu ea lisele tsa pancreatic beta. Ka lebaka la phello ea hypoglycemic, ts'ebetso ea lisele tsa 'mele ho kenella ka insulin, tlhahiso ea li-hormone ea eketseha. Ntho e sebetsang e khutlisetsa tšebetso ea pele lihlekehlekeng tsa Langerhans mme e khutsufatsa nako ho tloha motsotso oa ho ja ho fihlela secretion ea insulin.
Glimecomb e khothalletsa ho theola boima ba 'mele ha u ntse u latela lijo ka mokokotlong oa botenya.
Ntle le ho nka karolo ho metabolism ea carbohydrate, moriana o ntlafatsa li-microcirculation tsa capillary, o fokotsa ho kopana ha liplatelete, ka ho etsa joalo o thibela nts'etsopele ea vascular thrombosis. Khahlano le semelo sa ho nka Glimecomb, permeability ea lebota la vascular e tloaelehile, microthrombosis le atherosulinosis lia emisoa, mme parietal fibrinolysis ea tlhaho e khutlisoa. Lithethefatsi ke mohanyetsi oa karabelo e eketsehang ea vascular ho adrenaline ho microangiopathies. E khothalletsa ho theola boima ba 'mele ha u ntse u latela lijo ka mokokotlong oa botenya.
Metformin hydrochloride ke sehlopha sa Biguanide. Karolo e sebetsang e fokotsa bongata ba plasma ea tsoekere ka ho hatella tsoekere ho hepatocytes le ho fokotsa sekhahla sa ho kenngoa ha glucose ka mpeng e nyane. Khemik'hale e nka karolo ho li-metabolism tsa lipid, e theola boemo ba lipoprotein tse fokolang, triglycerides le cholesterol maling. E thusa ho fokotsa boima ba 'mele, empa ha ho na le insulin ka serum, phello ea kalafo ha e fihlelle. Nakong ea lithuto tsa tliliniki, ha ho litla-morao tsa hypoglycemic tse tlalehiloeng.
Mofumahali
| Gliclazide | Metformin |
| Ka tsamaiso ea molomo, sekhahla se phahameng sa ho amoheloa se bonoa. Ha o sebelisa 40 mg, palo e phahameng ea ntho e ho plasma e ts'oaroa kamora lihora tse 2-3. Puisano le liprotheine tsa plasma e phahame - 85-97%. Ka lebaka la sebopeho sa li-protein tsa protheine, moriana o phatlalatsoa ka potlako lithong tsohle. E fetoha phetoho ho hepatocytes. Ho felisoa ha halofo ea bophelo ho etsa lihora tse 8-20. Karolo e sebetsang e epolloa ka har'a moroto ke 70%, e nang le mantle ka 12%. | E kenella ka potlako ke microvilli ka mpeng e nyane ka 48-52%. Boaoavailability ha e nkeloa ka mpeng e se nang letho ke 50-60%. Ts'oarello e kholo e fihlella ka mor'a lihora tse 1-2 ka mor'a tsamaiso. Plasma e tlamang protheine e tlase. Cumulation e khubelu ea sele ea mali e bonoa. Bophelo ba halofo ke lihora tse 6.2. Setlhare sena se qhekelloa ho fihlela liphio ka sebopeho sa tsona sa pele le 30% ho ea ka mala. |
Setlhare se sebelisetsoa ho phekola lefu la tsoekere la mofuta oa 2.
Matšoao a ho sebelisoa
Setlama se sebelisetsoa ho phekola lefu la tsoekere la mofuta oa 2, ha ho e-na le katleho e fokolang ea kalafo ea ho ja, ho ikoetlisa 'meleng le kalafo ea lithethefatsi ka Metformin le Gliclazide.
Moemeli oa hypoglycemic o sebelisoa e le sebaka sa kalafo ea lithethefatsi ka lithethefatsi tse peli ho bakuli ba nang le lefu la tsoekere le sa ts'epeng insulin, ha feela tsoekere ea mali e laoloa hantle.
Contraindication
Moriana ha oa khothalletsoa hore o sebelisoe maemong a latelang:
- mofuta oa 1 lefu la tsoekere;
- lactic acidosis;
- maemo a potasiamo e tlase;
- lefu la tsoekere, precoma;
- lefu la tsoekere la ketoacidosis;
- ts'ebetso e matla ea methapo methapo le mafu a sitisang ts'ebetso ea litho (ho omella, ts'ebetso e matla ea ts'oaetso le ho ruruha, tšabo);
- porphyria;
- ho nka miconazole;
- ts'ebetso e fosahetseng ea sebete;
- ho thothomela ha pelo le moea, tlala ea oksijene, ho se atlehe phefumong, infarction ea myocardial;
- lino tse tahang, matšoao a bang teng ha motho a khaotsa ho tsuba;
- maemo ao ho hlokahalang kalafo ea "insulin" (likotsi tsa ka morao ho kotsi, nako ea ho hlaphoheloa kamora ho buuoa ka bongata, ho chesa);
- nako e ka tlase ho lihora tse 48 le ka nako ea matsatsi a mabeli ka mor'a hore radiograph e sebelise phapang e nang le iodine;
- Lijo tse nang le khalori e tlase le ha li nooa ka tlase ho 1000 kcal ka letsatsi;
- hypersensitivity ea 'mele oa mokuli ho likarolo tsa moriana.
Ntle le moo, setlhare sena ha se khothaletsoe batho ba tsofetseng ba sebetsang maemong a thata a mangata a mmele, ka lebaka la nts'etsopele ea lactic acidosis.
Ho lokela hore ho sebelisoe tlhokomeliso haeba ho e-na le feberu, ho se sebetse hantle ha lets'ollo (adrenal gland dysfunction), ts'ebetso e fosahetseng ea "pituitary" ea anterior, gland.
Mokhoa oa ho nka glimecomb
Setlhare se etselitsoe ho tsamaisoa ka molomo nakong ea lijo kapa hang ka mor'a lijo. Mokhoa oa kalafo ea litekanyetso le nako ea kalafo li khethoa ke ngaka e eang, ho beha mohlala oa kalafo ho latela ho ts'oaroa ha tsoekere maling.
Le lefu la tsoekere
Tekanyetso e le 'ngoe qalong ea kalafo ke 540 mg ea matlapa a nang le khafetsa ea tsamaiso ka letsatsi ho fihlela makhetlo a 1-3. Maemong a mangata, moriana o nooa habeli ka letsatsi - hoseng le pele u robala. Sekhahla sa letsatsi le letsatsi se khethoa butle butle ho fihlela phumants'o e tsitsitseng ea ts'ebetso ea pathological.
Litlamorao tsa glimecomb
Boitšoaro bo bobe 'meleng oa mokuli bo qala ka tsamaiso e fosahetseng ea lithethefatsi kapa khahlano le mafu a morao.
Setlhare se etselitsoe ho tsamaisoa ka molomo nakong ea lijo kapa hang ka mor'a lijo.
Phekolo ea ka mpeng
Litlamorao tsamaisong ea tšilo ea lijo li bonahala e le:
- dyspepsia, bothata ba tšilo ea lijo;
- maikutlo a boima ka mpeng;
- ho nyekeloa ke pelo, ho hlatsa;
- bohloko ba epigastric;
- ponahalo ea tatso ea tšepe ka motso oa leleme;
- takatso e fokotsehileng.
Maemong a sa tloaelehang, ts'ebetso ea hepatocytic aminotransferase, alkaline phosphatase ea matlafatsoa. Mohlomong nts'etsopele ea hyperbilirubinemia ho fihlela ho hlaha ha cholestatic jaundice, e hlokang ho khaotsa lithethefatsi.
Hematopoietic litho tsa ka hare
Moriana o ka baka tšitiso ea ts'ebetso ea 'moko o mofubelu, ka lebaka leo palo ea likarolo tsa mali tse bopehileng e fokotsehang, agranulocytosis, anemia ea hemolytic.
Tsamaiso ea methapo e bohareng
Mohlomong ho fokotseha ha pono ea mahlo, hlooho ea hlooho.
Ho tsoa ho tsamaiso ea methapo ea pelo
Arrhythmia, maikutlo a phallo ea mali.
Sistimi ea Endocrine
Haeba mokhoa oa dosing o tlotsoa 'me lijo li sa lateloe, menyetla ea ho ba le hypoglycemia ea eketseha, e tsamaeang le bofokoli bo matla, khatello ea methapo ea nakoana ea mokokotlo, ho fufuleloa ho eketsehileng, tahlehelo ea taolo ea maikutlo, pherekano le ho hokahana ha litho tsa' mele.
Ho tloha ka lehlakoreng la metabolism
Khahlano le semelo sa mathata a metabolic, lactic acidosis e ka hlaha. Ts'ebetso ea methapo ea methapo e tšoauoa ka bofokoli, bohloko bo boholo mesifa, ho se khone ho hema, ho utloa bohloko ka mpeng, ho theoha hoa mocheso le ho theoha ha khatello ea mali le bradycardia.
Allergie
Boitšoaro ba anaphylactoid ho li-derivatives tsa sulfonylurea bo bonahatsoa ka sebopeho sa allergic vasculitis, urticaria, macula, rash le pruritus, edema ea Quincke, anaphylactic.
Tšusumetso ho bokhoni ba taolo ea methapo
Nakong ea kalafo le Glimecomb, tlhokomelo e lokela ho nkoa ha u khanna, u sebetsa ka mekhoa e rarahaneng le mesebetsi e meng e hlokang ho tsepamisoa ke mokuli.
Litaelo tse khethehileng
Ha u nka li-derivatives tsa sulfonylurea, ho na le monyetla oa ho ba le hypoglycemia e matla le e telele, e hlokang phekolo e khethehileng maemong a ho ema le tsamaiso e matla ea tharollo ea glucose ea 5% bakeng sa matsatsi a 4-5.
Kotsi ea ho ba le lefu la tsoekere e eketseha ka ho ja lijo tse sa lekanang, ho ikoetlisa ka nako e telele kapa ka tsamaiso e le 'ngoe ea lithethefatsi tse' maloa tsa hypoglycemic. Ho fokotsa menyetla ea ts'ebetso ea ts'ebetso ea methapo, motho o lokela ho latela ka hloko litlhahiso tsa litaelo tse fanoeng morianeng mme a fumane tlhaiso-leseling e felletseng nakong ea tlhahlobo le ngaka e eang.
Phetoho ea moriana e hlokahala bakeng sa ho fetella hoa mmele le maikutlong kapa phetoho ea lijo.
Sebelisa botsofaling
Batho ba kaholimo ho lilemo tse 60 ha baa lokela ho nka moriana o le teng ka lebaka la ts'ebetso e matla ea 'mele ka lebaka la kotsi e eketsehang ea lactic acidosis.
Mosebetsi ho bana
Moriana ha o khothalletsoe ho nooa ho fihlela o le lilemo li 18.
Moriana ha o khothalletsoe ho nooa ho fihlela o le lilemo li 18.
Sebelisa nakong ea bokhachane le pelehi
Ha bokhachane bo etsahala, tsamaiso ea Glimecomb e lokela ho nkeloa sebaka ke kalafo ea "insulin", hobane ho kenella ka hare ho lintho tse sebetsang ka sekhahla sa placental hoa khoneha. Ha ho na data mabapi le phello ea teratogenic ea likhomphutha tsena ka bobeli tse sebetsang.
Glyclazide le metformin li ka pepesoa ka lebese la mme, ka hona, nakong ea kalafo le moemeli oa hypoglycemic, lactation e lokela ho hlakoloa.
Kopo ea ts'ebetso ea renal e senyehileng
Setlhare sena se kopantsoe le maemo a fosahetseng a ts'ebetso ea liphio le lefu la tsoekere.
Sebelisa bakeng sa ts'ebetso ea sebete e sa sebetseng
Setlhare se thibetsoe ka ho se sebetse hantle ha sebete.
Mofuta o mongata oa Glimecomb
Ka tlhekefetso ea lithethefatsi, lactic acidosis le boemo ba hypoglycemia li ka hlaha. Haeba ho na le matšoao a oxidation ea lactic acid ea lisele, o lokela ho letsetsa ambulense hanghang. Maemong a ho ema, hemodialysis e sebetsa.
Ha motho a lahleheloa ke tsebo ea hae, ho kenella kahare ho tharollo ea tsoekere ea 40% ho hlokahala ka mokhoa o ts'oanang kapa ka thipa.
Boemong ba ho felloa ke kelello, ho kenella kahare ho tharollo ea tsoekere ea 40%, glucagon, intramuscularly kapa subcutaneally, ho hlokahala. Kamora ho tsitsa, mokuli o hloka lijo tse nang le lik'habohaedreite tse ngata.
Ho sebelisana le lithethefatsi tse ling
Ha o sebelisa lithethefatsi tse ling hammoho le Glimecomb, maikutlo a latelang a bonoa:
- Ho matlafatsa phello ea kalafo e kopantsoeng le Captopril, li-anticoagulants tsa coumarin, beta-blockers, bromocriptine, li-antifungal agents, salicylates, fibrate, MAO inhibitors, lithibela-mafu tsa tetracycline, lithethefatsi tse seng tsa antiidal le anti-lefuba.
- Glucocorticosteroids, barbiturates, lithethefatsi tsa antiepileptic, calcium tubule inhibitors, thiazide, diuretics, Terbutaline, Glucagon, Morphine li kenya letsoho ho fokotseha ha ketso ea hypoglycemic.
- Cardiac glycosides e eketsa menyetla ea ventricular extrasystole, ha e ntse e hatella moko oa masapo hematopoiesis, e eketsa kotsi ea myelosuppression.
Lithethefatsi li fokotsa khatello ea plasma ea Furosemide ka 31% le halofo ea bophelo ba eona ka 42%. Nifedipine e eketsa sekhahla sa ho amoheloa ha metformin.
Lithethefatsi li fokotsa khatello ea plasma ea Furosemide ka 31% le halofo ea bophelo ba eona ka 42%.
Tekanyo ea joala
Ho thibetsoe ka thata ho noa joala nakong ea kalafo. Ethanol e baka kotsi ea ho tahoa haholo le nts'etsopele ea lactic acidosis. Ethanol e eketsa monyetla oa ho ba le hypoglycemia.
Seo u ka se nkang
Papiso ea lithethefatsi, tse tšoanang ka sebopeho sa lik'hemik'hale le thepa ea meriana, li kenyeletsa:
- Diabefarm;
- Glyformin;
- Gliclazide MV.
Ho fetohela moriana o mong ho ka etsahala ha ho se na phello ea kalafo e tsoang ho ho nka Glimecomb le tlasa taolo e tiileng ea ngaka e eang.
Lipehelo tsa khefu ea khemisi
Setlhare se rekisoa ka taelo ea ngaka.
A na nka reka ntle le lengolo la ngaka?
Ho rekisa mahala lithethefatsi ho thibetsoe ka lebaka la kotsi e eketsehang ea hypoglycemia ha u nka litekanyetso tse fosahetseng.
Theko ea Glimecomb
Litsenyehelo tse tloaelehileng tsa matlapa ke li-ruble tse 567.
Maemo a polokelo ea moriana
Moriana o lokela ho bolokoa o le hole le bana, sebakeng se ommeng le se lefifi ka mocheso o sa feteng 25 + C.
Letsatsi la ho felloa ke nako
Lilemo tse 2
Moqapi
Semela sa lik'hemik'hale le litlhare "AKRIKHIN", Russia.
Ho rekisa mahala lithethefatsi ho thibetsoe ka lebaka la kotsi e eketsehang ea hypoglycemia ha u nka litekanyetso tse fosahetseng.
Litlhahlobo tsa lefu la tsoekere bakeng sa Glimecomb
Arthur Kovalev, ea lilemo li 40, Moscow
Bakeng sa lefu la tsoekere la mofuta oa 2, ke ntse ke nka matlapa a Glimecomb hoo e ka bang selemo. Boima ba 'mele ha boa fokotseha, hobane ka mor'a ho nka moriana o batla ho ja. Empa kamora hore ke noe pilisi mantsiboea pele ke robala, boemo bo fetoha hantle. Hoseng, tsoekere e fapana ho tloha ho 6 ho isa ho 7.2 ka mor'a ho nka pilisi ka lijo tsa hoseng.
Kirill Gordeev, ea lilemo li 29, Kazan
Setlhare sena se fokotsa tsoekere ea mali. Ke amohela bakeng sa likhoeli tse 8. Ke boetse ke kenya liente tsa insulin. Kamora ho kena-kenana le phepelo ea lihormone, ke ile ka tlameha ho nka lipilisi nakoana, empa li ile tsa bonala li sebetsa hantle haholo. Letsoai le ile la lula le le boemong bo tšoanang, leha 'mele oa ka o ile oa senyeha.
Tlhahlobo ea lingaka
Marina Shevchuk, setsebi sa endocrinologist, ea lilemo li 56, Astrakhan
Sesebelisoa se khahlanong le semelo sa lefu la tsoekere la mofuta oa 2 se koahela glycemia hantle. Ho lokolloa ho fetotsoeng ho ka fokotsa kotsi ea ho ba le hypoglycemic syndrome, ke ka lebaka leo bakuli ba tsofetseng le batho ba nang le mafu a tsamaiso ea methapo ea pelo ba ka noang moriana. Ke sebelisa lithethefatsi khafetsa tloaelong ea ka ea bongaka le khetho ea motho ka mong. Theko e tlase e nang le ts'ebetso e phahameng.
Evgenia Shishkina, setsebi sa endocrinologist, ea lilemo tse 45, St. Petersburg
Moriana o na le phello e bonolo le e sebetsang. E thusa ho theola tsoekere ea mali. Nakong ea kalafo, ho bohlokoa ho latela mokhoa oa ho ja, empa ho ja khafetsa, hammoho le boikoetliso. Litlamorao tse tlatselletsang ho kalafo ea dosing ha lia ka tsa bonoa. Ketso ea moriana e qala ka nako e khuts'oane. Moriana o itlhomme 'marakeng bakeng sa lefu la tsoekere.
