Niaj hnub no, 350 lab tus tib neeg thoob ntiaj teb muaj kev mob ntshav qab zib mellitus (DM). Nov yog 5% ntawm lub ntiaj teb cov pej xeem. Hauv tebchaws Lavxias, muaj txog 12 plhom tus neeg mob no. Thiab tsis qhov tseeb tias cov no yog cov ntaub ntawv raug. Tus mob ntshav qab zib nrog cov zais zais hauv cov ntshav qab zib yog 2-3 zaug ntau dua li sau npe. Raws li cov kev kwv yees tau kwv yees (thiab tsis yog qhov xav tau ntau tshaj plaws!), Los ntawm 2030, ntshav qab zib yuav tau xa txog 80% ntawm lub ntiaj teb cov neeg nyob.
Kev mob siab rau kev tswj hwm ntawm tus kab mob insidious yog ib qho mob tseem ceeb rau kev them nqi txhim kho ntawm glycemia. Kev lig kev cai, txawm tias metformin lossis sulfonylurea derivatives yog siv los ua thawj cov tshuaj tiv thaiv kab mob. Yog tias cov kev ntsuas zoo li no tsis txaus (DM - mob ntev, mob nyuaj zuj zus), tshuaj insulin thiab lwm yam kev sib xyaw ntawm cov tshuaj txo cov ntshav qab zib tau txuas nrog.
Kev sib txuam nrov tshaj plaws ntawm cov neeg endocrinologist yog metformin nrog glibenclamide. Gluconorm - qhov no yog xws li ob qho tshuaj tiv thaiv uas txo cov tshuaj ntsiab lus ntawm cov suab thaj hauv cov ntshav. Qhov kev khomob no ua tau zoo npaum li cas, rau leej twg thiab nws yuav siv nws li cas?
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 lub 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. Tsis tas li ntawd, 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%.
Kev tivthaiv hauv lub siab yog hloov nrog kev tso tawm ntawm 2 lub cev tsis ua haujlwm. 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, qhov 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 cov mis nrog cov neeg zam: talc, cellulose, hmoov txhuv nplej siab, glycerol, cellacephate, gelatin, magnesium stearate, croscarmellose sodium, sodium carboxymethyl starch, 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 heev: 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 peculiarities ntawm cov chav kawm ntawm tus kab mob, cuam tshuam 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 ib qho kev pib kho mob, thaum hloov cov kev kho mob yav dhau los, 1-2 ntsiav tshuaj yog tshuaj noj rau hauv tus account yav dhau los cov tshuaj. Qhov loj tshaj plaws ntawm cov ntsiav tshuaj uas tuaj yeem noj nyob hauv ib hnub yog 5 daim.
Pab nrog overdose
Lub xub ntiag ntawm cov metformin hauv kev tsim cov tshuaj feem ntau ua rau mob plab hnyuv, thiab qee zaum lactic acidosis. Nrog cov tsos mob tshwm sim ntawm cov leeg (mob leeg, tsis muaj zog, mob hauv thaj tsam epigastric, ntuav), cov tshuaj tau tso tseg. Nrog tus mob lactic acidosis, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob sai. Rov qab kho nws nrog hemodialysis.
Lub xub ntiag ntawm glibenclamide nyob rau hauv cov mis tsis cais qhov kev loj hlob ntawm hypoglycemia. Nws muaj peev xwm paub txog qhov 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 daim ntawv me hauv hypoclycemia, yog hais tias tus neeg mob tsis nco qab, nws tau muab cov piam thaj lossis qab zib. Nrog kev tsaus muag, piam thaj, dextrose, glucagon (40% rr) yog txhaj rau iv, txhij lossis hauv qab daim 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 rau hauv tus mob no feem ntau tshwm sim.
Qhia Txog Kev Sib Koom Tes Nrog Tshuaj
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, tetracyrindiamine, tetracycodiaminophenide, tetrazinopyridinum, txo tus mob tetrazinopyridinum, txo tus mob tetrazinopyridinum, txo tus mob tetrazinopyridinum 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 (uas muaj cov tshuaj estrogen, 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 ntau yam rau 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.
| Organs thiab tshuab | Qhov tsis pom txog yam yuav tshwm sim | Zaus |
| Kev zom zaub mov | ntshav qog | pheej xav |
| Kev kho mob txoj hnyuv | mob dyspeptic, epigastric tsis xis nyob, saj ntawm hlau; daj daj ntseg, kab mob siab | pheej xav tsis tshua muaj |
| Kev kaw lus hauv lub cev | leukopenia, erythrocytopenia, thrombocytopenia; agranulocytosis, pancytopenia, anemia | pheej xav qee zaum |
| CNS | mob taub hau, ua kom tsis muaj kev sib koom tes, nkees sai thiab tsis muaj zog; paresis | feem ntau pheej xav |
| Kev tiv thaiv kab mob | urticaria, erythema, khaus ntawm daim tawv nqaij, nce photosensitivity; kub taub hau, mob caj dab, mob caj dab | pheej xav pheej xav |
| Kev paub kev zom zaub mov | lactic acidosis | tsis tshua muaj neeg pom |
| Lwm yam | Cawv dej cawv ua rau muaj teeb meem: ntuav, mob plawv dhia tsis xwm yeem, kiv taub hau, hyperemia | nrog dej cawv |
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 kev them nyiaj ntawm cov suab thaj zoo, nws kuj tseem xav kom hloov lub complex nrog ib cov tshuaj - Glucanorm.
Tsis txhob siv Gluconorm nrog:
- Ntshav Qab Zib Hom 1;
- Kev Hypoglycemia;
- Cov kab mob ntshav qab zib ketoacidosis, coma thiab precoma;
- Cov raum tsis ua haujlwm thiab lawv cov kev mob;
- Daim siab ua haujlwm siab;
- Cov xwm txheej provoked los ntawm oxygen oxygen kev tshaib plab ntawm cov nqaij mos (nrog rau lub plawv nres, plhaw plhaw, poob siab, ua tsis taus pa);
- Porphyria;
- Txhawb kev siv miconazole;
- Cov xwm txheej uas cuam tshuam nrog kev hloov mus ib ntus rau insulin (thaum lub sijhawm ua haujlwm, raug mob, kis mob, qee qhov kev kuaj mob uas siv cov cim raws li iodine);
- Siv dej cawv;
- Lactic acidosis, suav nrog keeb kwm;
- 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.
Cov lus pom zoo ntxiv
Kev Siv 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 tawm hauv qhov 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 hloov mus rau ib tus menyuam rau kev pub mis noj yuav tsum coj mus rau hauv qhov ntau ntawm qhov kev pheej hmoo rau leej niam thiab muaj peev xwm muaj kev phom sij rau tus menyuam.
Kev siv cov tshuaj rau daim siab thiab lub raum ua rau lub cev tsis ua haujlwm
Yog tias daim siab ua haujlwm (daim siab mob, mob ntev) Gluconorm tsis raug kho. Nrog lub raum pathologies, zoo li nyob rau hauv cov xwm txheej uas tuaj yeem ua rau lawv (nrog cov kab mob kis, poob siab, lub cev qhuav dej), cov tshuaj tsis qhia.
Cov lus qhia tshwj xeeb
Kev raug mob hnyav thiab kev ua haujlwm hnyav, kis kab mob sib kis nrog kub taub hau, qhia kom hloov tus neeg mob mus ib ntus rau insulin.
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 tsis zoo.
Yog tias koj hloov koj txoj kev ua neej, kev noj zaub mov, kev xav thiab lub cev ntau dhau, koj yuav tsum hloov chaw noj tshuaj.
Yog tias tus neeg mob yuav tsum tau kuaj xyuas siv cov cim iodine uas muaj cov cim, 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 lub cev noj zaub mov kom tsawg, ua rau lub neej nyob ntsiag to, tsis tswj nws qab zib txhua hnub.
Qhov Cuam Tshuam ntawm Gluconorm ntawm kev tuaj yeem tswj hwm kev thauj mus los
Txij li ntawm ntawm cov kev mob tshwm sim los ntawm kev siv Gluconorm kuj tseem muaj cov teeb meem loj xws li ntshav qab zib thiab mob lactic acidosis, tus mob ntshav qab zib yuav tsum tau ceev faj tshwj xeeb thaum tsav tsheb thiab hauv thaj chaw muaj kev phom sij (thaum ua haujlwm ntawm qhov siab lossis nrog txoj haujlwm nyuaj).
Gluconorm - analogues
Raws li ATX code ntawm qib 4, lawv ua ke nrog Gluconorm:
- Glucovans;
- Janumet;
- Glibomet;
- Galvus Met;
- Amaril.
Kev xaiv thiab hloov cov tshuaj yog tshwj rau kev paub ntawm tus kws tshwj xeeb. Kev kuaj tus kheej thiab kev noj tshuaj rau tus kheej tsis tas coj mus rau 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. Hais txog 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.
