Cov tshuaj Bagomet ntxiv yog kev sib txuam ua ke ntawm ob qhov ncauj tshuaj hypoglycemic hauv ib zaug, uas zwm rau txawv txawv pharmacological pawg: Metformin, Glibenclamide.
Metformin yog cov tshuaj ntawm cov pab pawg biguanide, nws txig txo glycemia vim muaj qhov cuam tshuam ntau ntxiv ntawm cov ntaub so ntswg mus rau lub cev lawm cov tshuaj insulin, txhim kho cov piam thaj tseem ceeb.
Cov tshuaj phiv tshuaj lom neeg txo qis kev nqus ntawm carbohydrates los ntawm kev zom zaub mov, inhibit gluconeogenesis nyob rau hauv tus neeg mob lub siab, thiab muaj lub txiaj ntsig zoo ntawm cov roj sib xyaw ua ke ntawm cov ntshav, txo qis triglycerides thiab roj cholesterol tag nrho.
Glibenclamide yog sulfonylurea thib ob, lub ntsej muag nyob tom qab siv cov tshuaj txo qis vim tias muaj kev cuam tshuam cov tshuaj tua kabmob ntawm cov tshuaj insulin los ntawm lub hlwb ntawm cov txiav.
Tom qab thov cov tshuaj, cov nyhuv hypoglycemic tshwm sim tom qab 2 teev, thiab tuaj yeem ntev txog 12 teev. Lub ntsiab tseem ceeb rau kev siv yog hom 2 mob ntshav qab zib mellitus tawm tsam keeb kwm ntawm ib qho kev tsis muaj txiaj ntsig los ntawm kev noj zaub mov noj lossis kev kho mob nrog qhov ncauj tshuaj hypoglycemic.
Tus nqi ntawm Bagomet Plus (noj tshuaj ntawm 500 mg) yog kwv yees li 200 rubles. Cov tshuaj ntawm cov tshuaj: Glybomet, Glukovans, Gluconorm.
Lub ntsiab contraindications, phiv tshuaj tiv thaiv ntawm lub cev
Cov tshuaj tsis tuaj yeem raug sau rau hom 1 mob ntshav qab zib mellitus, ntshav qab zib poj koob yawm txwv, coma, mob ntshav qab zib ketoacidosis, mob raum thiab mob hepatic tsis txaus, lactic acidosis, mob ntshav qab zib kom qaug cawv. Bagomet kuj tseem tsis pom zoo rau cov mob voos xwm txheej uas yuav tsum tau qhia txog cov tshuaj iodine uas muaj cov kab mob sib xyaw.
Cov kev daws yog contraindicated nyob rau hauv ntev thiab mob mob, uas nrog ua pa oxygen tshaib plab, uas yog: lub xeev poob siab, myocardial infarction, lub cev qhuav dej. Nws kuj tseem muaj kev txwv rau kev siv cov tshuaj rau porphyria, concomitant siv nrog miconazole, cev xeeb tub, thiab pub niam mis.
Nws ua tau tias thaum kho cov neeg mob ntshav qab zib yuav muaj lub cev tsis txaus siab: tawm tsam ntuav, xeev siab, mob plab, tsis qab los noj mov, saj ntawm hlau hauv lub qhov ncauj, erythema. Metformin hauv tshuaj muaj pes tsawg leeg qee zaus provokes txo qis hauv kev nqus, lactate acidosis.
Lwm qhov sib xyaw ntawm cov tshuaj Bagomet - Glibenclamide - muaj peev xwm ua rau muaj tej yam kev mob zoo li no:
- tawv nqaij ua pob, khaus, urticaria;
- ntuav, xeev siab, mob plab;
- ntau dhau ntawm kev ua haujlwm ntawm hepatic transaminases;
- leukopenia, mob ntshav qab zib hemolytic, thrombocytopenia.
Muaj peev xwm nce ntxiv nyob rau hauv cov ntshav urea concentration, hlwb pob txha aplasia, pancytopenia, hyponatremia, disulfiram zoo li cov tshuaj tiv thaiv.
Cov lus qhia rau kev siv tshuaj
Bagomet Plus tau noj nrog zaub mov noj, qhov ntau npaum cov tshuaj kiag yuav tsum tau xaiv ib tus zuj zus, nyob ntawm lub xeev cov txheej txheem hauv kev zom zaub mov. Raws li txoj cai, kev muab tshuaj thawj zaug yog 1 ntsiav tshuaj, maj mam cov tshuaj tau nce, raws li cov cim glycemic. Feem ntau nws siv sijhawm 1-2 asthiv.
Thaum muaj qhov xav tau ceev nrawm los hloov cov kev sib txuas ua ke dhau los, tus kws kho mob tau sau ntawv 1-2 ntsiav tshuaj (qhov ntau npaum li cas yog nyob ntawm qhov siv tshuaj dhau los). Ntau kawg 4 ntsiav tshuaj pub rau ib hnub, raws li cov khoom tseem ceeb - no yog 500 mg ntawm metformin thiab 5 mg ntawm glibenclamide.
Yog tias tus mob ntshav qab zib tau raug phais, nws muaj mob kub hnyiab, raug mob lossis kis tus kab mob nrog rau tus mob febrile syndrome, koj yuav tsum tau tsum tsis txhob noj tshuaj qhov ncauj ntshav thiab noj tshuaj insulin.
Thaum lub sijhawm kho mob, nws yuav tsum tswj hwm:
- yoo mov glycemia, tom qab noj mov;
- txhua hnub nkhaus ntawm cov ntshav qab zib.
Koj yuav tsum paub txog qhov muaj feem yuav ua rau muaj tus mob ntshav qab zib tsawg yog tias tus mob ntshav qab zib, nrog rau Bagomet Plus ntxiv, haus cawv, tsis siv tshuaj tsis haum tshuaj, thiab yog ua rau nws tuag tshaib.
Qhov ntau thiab tsawg ntawm cov tshuaj tau muab rau kev mob siab ntsws, ua kom lub cev nruj nreem, qhov hloov pauv ntawm kev noj zaub mov noj. Nrog kev ceev faj, cov tshuaj yuav tsum noj tawm tsam ntawm keeb kwm ntawm kev kho mob nrog beta-blockers.
Yog tias cov tsos mob ntawm tus mob hypoglycemia tshwm sim, nws yog qhia:
- noj ib qho me me ntawm cov khoom noj carbohydrate;
- tswj cov piam thaj lossis dextrose kev daws teeb meem.
Thaum qhov kev tshawb fawb urographic lossis angiographic xav tau, Bagomet Plus tau muab tso tseg 2 hnub ua ntej qhov txheej txheem thiab rov qab ua dua tom qab 48 teev.
Nrog rau txoj kev sib txig ntawm kev siv cov tshuaj uas muaj ethanol, muaj qhov ntxim nyiam ntawm kev txhim kho disulfiram-zoo li cov tshuaj tiv thaiv.
Rau lub sijhawm ntawm kev kho mob, tus mob ntshav qab zib yuav tsum ua kom ceev faj heev thaum tsav tsheb ntau yam kev thauj mus los, ua haujlwm nrog cov phom sij phom sij uas suav nrog kev saib xyuas ntau ntxiv, thiab qhov ceev ntawm psychomotor tshua.
Yeeb tshuaj sib cuam tshuam
Kev siv sib xyaw nrog miconazole tuaj yeem ua rau kev txhim kho hypoglycemia ntawm kev ua mob hnyav, mus txog rau lub cev tsis xeev (coma). Yog hais tias Bagomet siv nrog ua ke nrog Fluconazole, muaj qhov ua tau ntawm hypoglycemia, txij li theem ntawm sulfonylurea derivatives nce.
Cov tshuaj Phenylbutazone tuaj yeem txav mus rau sulfonylurea derivatives, yog li ua rau muaj kev nce ntxiv hauv lawv cov lej hauv cov hlab ntshav, qhov kev pheej hmoo ntawm hypoglycemia.
Kev siv cov tshuaj radiopaque iodine tuaj yeem ua rau kev txhim kho ntawm lub raum kev ua haujlwm, kev tsub zuj zuj ntawm metformin. Hauv qhov no, kev txhim kho ntawm cov kab mob lactic acidosis tsis suav nrog. Kev kho nrog cov tshuaj yog qhia kom pom tias sau tseg ob hnub ua ntej siv cov tshuaj, thiab nws tuaj yeem rov pib dua tom qab 48 teev.
Kev kho mob Bagomet nrog kev siv cov tshuaj ethanol uas muaj nyob hauv qee pawg ntawm cov neeg mob ntshav qab zib tuaj yeem ua rau muaj kev cuam tshuam zoo li disulfiram.
Qhov sib npaug ntawm Bagomet Plus yog Metformin 850 lossis 1000.
Nrog rau cov kev sib txig siv cov tshuaj glucocorticosteroid, diuretics thiab beta2-blockers:
- muaj qhov kev txo qis ntawm cov txiaj ntsig ntawm kev kho;
- muaj qhov qhia tias yuav kho cov tshuaj ntau npaum li cas.
Tawm tsam keeb kwm ntawm kev kho mob nrog ACE inhibitors, qhov yuav ua rau muaj ntshav qab zib tsawg tshwm, beta-blockers yuav ua rau kom muaj ntau zaus thiab mob hnyav ntawm cov kab mob no.
Yog siv cov tshuaj tua kab mob tua kab mob, txo qis hauv qab zib cov ntshav yuav pib, cov tshuaj no suav nrog:
- sulfonamides;
- MAO inhibitors;
- Pentoxifylline;
- Chloramphenicol;
- Disopyramides.
Cov tshuaj tiv thaiv zoo ib yam li no tuaj yeem tshwm sim thaum siv cov tshuaj lipid-txo cov tshuaj los ntawm cov pab pawg ntawm fibrates.
Ntau tus neeg mob
Thaum noj tshuaj ntau dhau, mob ntshav qab zib ntau tshwm sim, nws tshwm sim los ntawm qhov pom ntawm glibenclamide nyob rau hauv cov tshuaj yeeb dej caw.
Yog li hypoglycemia hauv ntshav qab zib tuaj yeem ua rau tshaib plab, tawm hws ntau dhau, ua rau cov leeg tsis muaj zog, tawv nqaij daj ntseg, tshee tshee hauv lub cev, mob taub hau.
Thaum hypoglycemia zuj zus, muaj qhov pheej hmoo ntawm qhov ua tau ntawm kev tswj hwm tus kheej thiab qhov muag plooj plooj nco qab. Hauv qhov no, nws yog qhov yuav tsum tau maj mam noj me me ntawm cov khoom noj carbohydrate, txhaj cov kua nplaum hauv lub cev. Txawm li cas los xij, cov kauj ruam no yuav muaj txiaj ntsig tsuas yog qhov hnyav mus rau mob hnyav ntawm cov ntshav qog ntshav qab zib.
Lwm qhov kev qhia yuav tsum raug hu ua:
- pw tsis tsaug zog;
- kev ntshai tsis muaj dab tsi;
- tsis hnov qab zoo, kev sib koom tes ntawm taw;
- mob tsis tu ncua;
- kiv taub hau.
Hauv cov tsos mob hnyav ntawm hypoglycemia, yog tias qhov mob ntshav qab zib tsis txaus siab, nws yuav tsum tau txhaj tshuaj 40% dextrose daws teeb meem lossis glucagon subcutaneously, tso ntshav los yog intramuscularly. Tus nqi ntawm kev tswj hwm no yog kev tiv thaiv ntawm tib neeg lub neej.
Txoj cai yuav rov qab nco qab, tus neeg mob yuav tsum noj zaub mov uas muaj cov carbohydrates ntau, qhov no yuav tiv thaiv qhov kev rov txhim kho hypoglycemia.
Cov lus qhia rau kev siv Bagomet Plus ceeb toom tias kev kho mob mus ntev yuav ua rau muaj kev txhim kho ntawm cov teeb meem xws li lactic acidosis, vim tias cov tshuaj muaj cov tshuaj metformin.
Lactic acidosis - qhov mob uas yuav tsum tau kho sai, kev kho yog nqa tshwj xeeb hauv tsev kho mob. Txoj hauv kev zoo tshaj plaws kom tshem tawm nws yog hemodialysis.
Daim vis dis aus hauv tsab xov xwm no tham txog kev cuam tshuam ntawm cov quav tshuaj metformin rau cov ntshav qab zib.
