Kajeno, batho ba limilione tse 350 lefatšeng ka bophara ba tšoeroe ke lefu la tsoekere mellitus (DM). Ena ke karolo ea 5% ea baahi ba lefatše. Naheng ea Russia, ho na le bakuli ba joalo ba ka bang limilione tse 12. Mme eseng taba ea hore tsena ke data e nepahetseng. Batho ba nang le lefu la tsoekere ba nang le mofuta o sa patiloeng oa lefu la tsoekere ba makhetlo a 2-3 ho feta ho ngolisoa. Ho latela bolepi ba semmuso (mme eseng bo se nang tšepo ka ho fetesisa!), Ka 2030, lefu la tsoekere le tla be le se le hapile baahi ba lefatše ba 80%.
Matlafatso ea taolo ea lefu le ipatileng ke boemo ba mantlha bakeng sa puseletso e tšepahalang ea glycemia. Ka setso, litlamorao tsa metformin kapa sulfonylurea li sebelisoa e le lithethefatsi tsa pele tsa antidiabetes. Haeba mehato e joalo e sa lekana (DM - lefu le sa foleng, le tsoelang pele), insulin le metsoako e meng ea lithethefatsi tse fokotsang tsoekere li hokahane.
Motsoako o tsebahalang haholo har'a li-endocrinologists ke metformin e nang le glibenclamide. Gluconorm - sena ke setlhare se nang le likarolo tse peli se fokotsang khatello ea tsoekere maling. Phekolo ee e sebetsa hakae, hona ho e lokela ho sebelisoa ho mang?
Litšoaneleho tsa pharmacological
Gluconorm ke setlhare se kopaneng se kopantseng lithethefatsi tsa lihlopha tse fapaneng tsa pharmacological ho ea ka mochini oa ts'ebetso.
Karolo ea pele ea foromo ke metformin, moemeli oa li-biguanides tse thatafatsang likhahla tsa glycemic ka ho ntlafatsa ho hanyetsa ha lisele ho insulin ea tsona le ho potlakisa ts'ebeliso ea tsoekere ke lisele. Ntle le moo, biguanide e thibela ho kenngoa ha lik'habohaedreite hape e thibela tlhahiso ea tsoekere maling. E ntlafatsa metformin le tekanyo ea mafura, ho boloka khokahano e nepahetseng ea mefuta eohle ea cholesterol le triglycerol.
Glibenclamide, motsoako oa bobeli o sebetsang oa ngakeng, e le moemeli oa sehlopha sa bobeli sa sulfonylurea, o ntlafatsa tlhahiso ea insulin ka thuso ea cells-cell ea li-pancreas tse ikarabellang ts'ebetsong ena. E e sireletsa ho tsoa ho glucose e mabifi, e ntlafatsa ho hanyetsa ha insulin le boleng ba ligaments tse nang le lisele. Ho tsoa insulin ho ama ka botlalo ho kenngoa ha glucose ke sebete le mesifa, ka hona, setoko sa eona ha se thehe ka karolo ea mafura. Ntho ena e sebetsa mohato oa bobeli oa tlhahiso ea insulin.
Litšobotsi tsa pharmacokinetics
Kamora ho kena ka mpeng, glibenclamide e kenngoa ke 84%. Cmax (tlhoro ea boemo ba hae) o fihla ka mor'a lihora tse 1-2. Ho ajoa ka boholo (Vd) ke lilithara tse 9-10. Ntho ena e tlama liprotheine tsa mali ka 95%.
Karolo e leng ka har'a sebete e fetoloa ka ho lokisoa ha metabolites e 'meli. E 'ngoe ea tsona e tlosa mala, ea bobeli - liphio. Bophelo ba halofo ea T1 / 2 bo kahare ho lihora tse 3-16.
Kamora ho kenella ts'ebetsong ea tšilo ea lijo, metformin e kenella ka mafolofolo, ha ho feta 30% ea lethal dose e setseng setulong. The bioavailability ea biguanide ha e fetang 60%. Ka mokhoa o tšoanang oa limatlafatsi, ho amoheloa ha moriana ho ea butle. E ajoa ka potlako, ha e kenelle puisanong le liprotheine tsa plasma.
Sebopeho sa litekanyetso tsa Gluconorm le sebopeho
Gluconorm, e leng foto ea eona e ka bonoang karolong ena, e kena marang-rang a meriana ka mokhoa oa matlapa a potolohileng a nang le khetla e tšoeu. Ha le robeha, moriti oa moriana o putsoa. Letlapeng le leng ho na le metsoako e 'meli ea mantlha ka litekanyetso tse latelang: metformin - 400 mg, glibenclamide - 2,5 g. Tlatsetsa foromo ka li-excipients: talc, cellulose, starch, glycerol, cellacephate, gelatin, magnesium stearate, croscarmellose sodium, sodium carboxymethyl starch, silicon diodium diethyl phthalate.
Setlhare sena se kenngoe ka likhomphutha tse 10 kapa 20. ka lisele tse entsoeng ka foil ea aluminium. Ka ho paka ka karete e ka ba ho tloha lipapaling tse peli ho isa ho tse 'ne. Bakeng sa Gluconorm, theko ke tekanyetso haholo: ho tloha li-ruble tse 230, ba lokolla moriana o fanoeng ke ngaka. Bophelo ba lishelefo tsa matlapa ke lilemo tse 3. Setlhare ha se hloke maemo a khethehileng bakeng sa polokelo.
Mokhoa oa ho sebelisa Gluconorm
Bakeng sa Gluconorm, litaelo tsa tšebeliso li fana ka ho nka litafole kahare ka lijo. Ngaka e lekanya lethal dose ka bonngoe, e nahanela litšobotsi tsa lefu leo, methapo e ts'oanang, lilemo le boemo ba lefu la tsoekere, le karabelo ea 'mele ea moriana. E le molao, qala ka 1 letlapa / letsatsi. Kamora beke kapa tse peli, o ka lekola sephetho, 'me ka ho se sebetse hantle, lokisa maemo.
Haeba Gluconorm ha se moriana oa ho qala, ha u nka mofuta oa kalafo e fetileng, matlapa a 1-2 a beoa ho latela tloaelo e fetileng ea lithethefatsi. Palo e kholo ka ho fetisisa ea matlapa a ka noang ka letsatsi ke likotoana tse 5.
Thuso ka overdose
Ho ba teng ha metformin ka sebopeho hangata ho halefisa mathata a mala, mme ka linako tse ling lactic acidosis. Ka matšoao a mathata (mesifa ea mokokotlo, bofokoli, bohloko sebakeng sa epigastric, ho hlatsa), lithethefatsi li emisitsoe. Ka lactic acidosis, motho ea hlokahalitsoeng o hloka ho kena sepetlele ka potlako. E khutlisetse ka hemodialysis.
Ho ba teng ha glibenclamide ka foromo ha ho khelle nts'etsopele ea hypoglycemia. Ho a khonahala ho lemoha boemo bo kotsi ka takatso e sa laoleheng, ho fufuleloa ho eketsehileng, tachycardia, ho thothomela, letlalo le pherese, isomnia, paresthesia, kizungu le hlooho, ho tšoenyeha. Ka mofuta o bobebe oa hypoclycemia, haeba motho ea hlokahalitsoeng a sa tsebe letho, o fuoa tsoekere kapa tsoekere. Ka ho akheha, glucose, dextrose, glucagon (40% rr) e kentsoe iv, ka tlas'a letlalo. Kamora hore mokuli a hlaphoheloe, o feptjoa lihlahisoa tse nang le lik'habohaedreite tse potlakileng, kaha ho khutlela mokhoeng ona hangata ho ba teng.
Liphetoho tsa ho sebelisana le lithethefatsi
Motsoako o nang le li-inhibitors tsa ACE, li-NSAIDs, lithethefatsi tsa antifungal, li-fibrate, salicitates, lithethefatsi tse khahlanong le lefuba, β-adrenergic blockers, guanethidine, MAO inhibitors, sulfonamides, chloramphenicol, tetracyrindiamine, tetracycodiaminophenide, tetrazing -etriping. .
Ts'ebetso ea hypoglycemic ea Gluconorm e fokotsehile ho tsoa litlamorao tsa adrenostimulant barbiturates, corticosteroids, lithethefatsi tse khahlanong le lefu la sethoathoa, diuretics (lithethefatsi tsa thiazide), furosemide, chlortalidone, triamteren, morphine, ritodrin, glucagon, lihomone tsa qoqotho, joalo-joalo.
Litlhare tse matlafatsang Urine acid li sebetsa e le sesupo sa ho sebetsa hantle ka ho fokotsa ho ikarola le ho ntlafatsa ho sutumetsoa ha gluconorm. Ethanol e eketsa menyetla ea lactic acidosis. Metformin e ama hampe pharmacokinetics ea furosemide.
Liphetho tse sa rateheng
Metformin ke e 'ngoe ea lithethefatsi tse sireletsehileng ka ho fetisisa tsa hypoglycemic, empa joalo ka moriana o mong le o mong oa maiketsetso o na le litlamorao. Har'a tse atileng haholo ke mafu a dyspeptic, a nyamelang ho batho ba bangata ba lefu la tsoekere ka mor'a hore nako ea ho ikamahanya le maemo e be bona. Glibenclamide le eona ke motsoako o lekiloeng nako le nako o nang le bopaki bo bongata ba ts'ebetso le polokeho. Maemo a thathamisitsoeng tafoleng a fumaneha seoelo, empa litaelo li tlameha ho ithutoa pele ho qala kalafo.
| Organs le litsamaiso | Litlamorao tse sa lebelloang | Khafetsa |
| Metabolism | hypoglycemia | khafetsa |
| Phekolo ea ka mpeng | mathata a dyspeptic, ho hloka botsitso ha epigastric, tatso ea tšepe; jaundice, hepatitis | khafetsa ka seoelo |
| Tsamaiso ea potoloha | leukopenia, erythrocytopenia, thrombocytopenia; agranulocytosis, pancytopenia, anemia | khafetsa ka linako tse ling |
| CNS | hlooho e bohloko, khokahano e senyehileng, mokhathala o potlakileng le ho hloka matla; paresis | khafetsa khafetsa |
| Ts'ireletso | urticaria, erythema, ho hlohlona ha letlalo, ho eketsa photosensitivity; feberu, arthralgia, proteinuria | khafetsa khafetsa |
| Mekhoa ea Metabolic | lactic acidosis | ka seoelo |
| Tse ling | Ho lemalla joala le mathata a mang: ho hlatsa, pelo le methapo ea pelo, letsoalo, hyperemia | ka joala |
Ke mang ea bontsitsoeng le contraindified Gluconorm
Matlapa a ngolloa batho ba lefu la tsoekere ka mofuta oa 2 oa lefu lena, haeba phetoho ea bophelo le kalafo e fetileng e sa fane ka taolo ea 100% glycemic. Haeba ts'ebeliso ea lithethefatsi tse peli tse arohaneng (Metformin le Glibenclamide) e lumella puseletso e tsoekere ea tsoekere, ho boetse ho bohlokoa hore u tlose motsoako ona ka setlhare se le seng - Glucanorm.
Se ke oa sebelisa Gluconorm ka:
- Mofuta oa 1 lefu la tsoekere;
- Hypoglycemia;
- Lefu la tsoekere la ketoacidosis, komisi le precoma;
- Mathata a renang le maemo a ho teneha;
- Mathata a sebete;
- Maemo a susumetsoang ke tlala ea oksijene ea li-tishu (tse nang le ho nyekeloa ke pelo, methapo ea pelo, tšabo, ho hloleha ho phefumoloha);
- Porphyria;
- Tšebeliso e tšoanang ea miconazole;
- Maemo a kenyelletsang phetoho ea nakoana ho insulin (nakong ea ts'ebetso, likotsi, tšoaetso, litlhahlobo tse ling li sebelisa matšoao a thehiloeng ho iodine);
- Tšebeliso e mpe ea tahi;
- Lactic acidosis, ho kenyelletsa le nalane;
- Bokhachane le pelehi;
- Hypocaloric (ho fihlela ho 1000 kcal) phepo e nepahetseng;
- Hypersensitivity ho likarolo tsa formula.
Litlhahiso tse ling
Ts'ebeliso ea Gluconorm ke Baimana ba baimana le baoki
Leha sethaleng sa ngoana se hlophisoa, Gluconorm e tlameha ho nkeloa sebaka ke insulin, kaha sethethefatsi sena se kopantsoe le sena. Ha lebese la matsoele le feptjoa, lithibelo li lula li tletse, kaha sethethefatsi se kenella eseng feela ka placenta ea lesea, empa hape le ka lebese la matsoele. Khetho pakeng tsa insulin le ho fetisetsa lesea phepelong ea maiketsetso e lokela ho nka tekanyo ea kotsi ho mme le kotsi e ka bang teng ho lesea.
Tšebeliso ea lithethefatsi bakeng sa khatello ea methapo
Tabeng ea ho hloleha ha sebete (foromo e mpe, e sa foleng) Gluconorm ha e khethoe. Ka li-pathologies tsa liphio, hammoho le maemong a ka li khopisang (ka mafu a tšoaetsanoang, tšabo, ho omella), moriana ha o bontšoa.
Litaelo tse ikhethang
Ho tsoa likotsi tse mpe le ts'ebetso e tebileng, mafu a tšoaetsanoang a tsamaeang le feberu, a fana ka maikutlo a phetisetso ea nakoana ea mokuli ho insulin.
Litsebi tsa lefu la tsoekere li lokela ho lemosoa ka kotsi ea ho ba le hypoglycemia ka tšebeliso ea li-NSAIDs, joala, lithethefatsi tse nang le ethanol, le khaello ea phepo e nepahetseng khafetsa.
Haeba u fetola mokhoa oa hau oa bophelo, ja, lijo tse ngata tsa maikutlo le tsa mmele, o lokela ho fetola litekanyetso tsa lithethefatsi.
Haeba mokuli a lokela ho hlahlojoa a sebelisa matšoao a nang le iodineine, Gluconorm e hlakotsoe ka matsatsi a mabeli, ebe e nka insulin. O ka khutlela kalafong ea kalafo e fetileng pejana ho feta lihora tse 48 kamora thuto.
Ts'ebetso ea Gluconorm e tla fokotsoa haholo haeba mokuli a sa latele lijo tse tlase tsa carb, a phela bophelo ba ho lula fatše, a sa laole tsoekere ea hae letsatsi le letsatsi.
Kameho ea Gluconorm mabapi le monyetla oa taolo ea lipalangwang
Kaha hara litla-morao tsa ts'ebeliso ea Gluconorm ho boetse ho na le tse tebileng tse kang hypoglycemia le lactic acidosis, lefu la tsoekere le lokela ho ba hlokolosi haholo ha o khanna le sebakeng se ka bang kotsi (ha o sebetsa libakeng tse phahameng kapa ka mekhoa e rarahaneng).
Gluconorm - analogues
Ho latela khoutu ea ATX ea boemo ba 4, ba tsamaisana le Gluconorm:
- Glucovans;
- Janumet;
- Glibomet;
- Galvus Met;
- Amaril.
Khetho le ho khutlisetsa lithethefatsi ka mokhoa o ikhethileng ke bokhoni ba setsebi. Ho itlhahloba le ho iphekola ntle le ho nahana ka litšobotsi tsohle tsa setho se itseng ho ka fetoha litlamorao tse bohloko.
Litlhahlobo tsa lefu la tsoekere
Mabapi le litlhahlobo tsa lefu la tsoekere la Gluconorm hangata li baka likhang. Ba bang ba pheha khang ea hore moriana ha o na thuso, ho na le menyetla e mengata e mebe, e kenyeletsang ho nona. Ba bang ba re bothata bo boholo ba ho phekola le lithethefatsi e ne e le ho khethoeng ha litekanyetso, ebe tsoekere e khutlela ho tloaelehileng. Mabapi le tee ea limela "Altai 11 Gluconorm e nang le li-blueberries" litlhahlobo tse ntle: e thusa ho boloka pono, ho ntlafatsa bophelo bo botle.
Gluconorm ke lithethefatsi tse fumanehang habonolo ka lipatlisiso tse netefalitsoeng le lithuto tsa mantlha tsa kliniki. Li-derivatives tsa Biguanides le sulfanilurea li sebelisitsoe bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2 bakeng sa nako e fetang halofo ea lekholo, mme mefuta e mecha ea lithethefatsi tsa antidiabetes ha e so ka e batla bolaoli ba eona.
