ʻO nā papa metformin 1000 mg, 60 pcs.

Eʻoluʻolu, ma mua o kou kūʻai ʻana i ka Metformin, nā papa kai 1000 mg, 60 pcs., E nānā i ka ʻikepili e pili ana iā ia me ka ʻikepili ma ka pūnaewele mana o ka mea hana a kuhikuhi i kahi kikoʻī o kahi ʻano kikoʻī me ka luna o kā mākou hui!

ʻO ka ʻike i hōʻike ʻia ma ka pūnaewele ʻaʻole i hāʻawi i ka lehulehu. Mālama ka mea hana i nā kuleana e hana i nā loli i ka hoʻolālā, hoʻolālā ʻana a me ka hoʻopili ʻana i nā huahana. Hiki i nā kiʻi o nā huahana i nā kiʻi i hōʻike ʻia i loko o ke kākuhi ma ka pūnaewele ke ʻokoʻa i nā kumu kumu.

ʻOkoʻa ka ʻike ma ke kumukūʻai o nā huahana i hōʻike ʻia i loko o ka katala ma ka pūnaewele ma mua o ka manawa e waiho i ke kauoha no ka huahana like.

Ka hana lāʻau lapaʻau

Hoʻopili ka Metformin i ka glucoseoneogenesis i loko o ka puhiluhi, e hōʻemi ana i ka lilo ʻana o ka glucose i loko o nā lau, hoʻomaikaʻi ai i ka hoʻohana ʻana i peripheral i nā glucose, a hoʻonui pū hoʻi i ka ʻike ʻana o nā io i ka insulin. ʻAʻole pili i ka huna ʻana o ka insulin e nā cell beta o ka pancreas, ʻaʻole ia i ka hopena hypoglycemic. Hoʻemi i ka pae o ka triglycerides a me ka linoproteins haʻahaʻa haʻahaʻa ma ke koko. Mālama a hoʻoikaika paha i ke kaumaha o ke kino. Loaʻa ia he hopena fibrinolytic ma muli o ke kaohi ʻana o kahi kaila plasminogen activator inhibitor.

Ma hope o ka hoʻopale ʻana i ka waha, hoʻohuihui ʻia ka metformin mai ka digestive tract. Bioavailability ma hope o ka lawe ʻana i kahi maʻa maʻamau he 50-60%. Loaʻa ka Cmax i loko o ke koko koko 2.5 mau hola ma hope o ke kau ʻana. ʻAʻole hiki ke hoʻopaʻaʻia i nā protein plasma. Hoʻomili ia i nā mea kuʻi salivary, nā mākala, nā ʻōpū a me nā puʻupuʻu. Hoʻokuʻu ʻia ia i nā loli a ke keiki. ʻO T1 / 2 he mau hola 9-12. Me ka hana nona kahi paʻa ʻole, hiki i ka cumulation o ka lāʻau.

ʻO ka maʻi mellitus type 2 me ka ʻole o ka ketoacidosis (ka mea nui i ka poʻe maʻi me ka huʻihune) me ka maikaʻi ʻole o ka mālama ʻana i ka papa, i hui pū ʻia me insulin, i ka maʻi mellitus type 2, ka mea nui me ka pae o ka momona, i hui pū ʻia e ka pale kino insulin.

Nā Hoʻohui

• maʻi ketoacidosis maʻi, maʻi kanesa precoma, coma,
• huakaʻi renal function,
• nā maʻi maʻi me ka pilikia o ka hoʻomohala ʻana i ka hana renal: dehydration (me ka maʻi ʻaʻa, ka luaʻi), ke ʻano, ka maʻi huakino, nā maʻi maʻi maʻi, hypoxia (haʻalulu, sepsis, maʻi maʻi, nā maʻi bronchopulmonary).
• nā hōʻike olakino i hōʻike ʻia aʻe o nā maʻi a me nā maʻi a hiki ke alakaʻi i ka hoʻomohala ʻana o ka kiko hypoxia (puʻuwai a i ʻole ka hāʻule ʻana o ka maʻi, aʻule myocardial infarction),
• hōʻeha koʻikoʻi a me nā trauma (i ka wā e hōʻike ʻia ana ka maʻi insulin),
• lawelawe aho ʻaia,
• humuhinu maoli, huakino makehewa,
• hoʻohana no ka liʻiliʻi he 2 mau lā ma mua a i loko o 2 mau lā ma hope o ka lawe ʻana i nā haʻawina radioisotope a i ʻole x-ray me ka hoʻomaka ʻana o ka iodine-medium medium,
• lactic acidosis (me ka mōʻaukala),
• ka adherence i ka meaʻai haʻahaʻa-emi (emi iho ma mua o 1000 kaleka / lā),
• hapai
• lactation
• hypersensitivity i ka lāʻau.

ʻAʻole ia e hoʻohana i ka lāʻau i loko o nā kānaka ma mua o 60 mau makahiki o ka mea e hana i ka hana kino kino, a pili pū me ka piʻi nui o ka hoʻomohala ʻana i ka acidact lactic i loko o lākou.

Nā hopena hopena

Mai ka pūnaehana hana ʻana: nausea, luaʻi, metallic ʻono i loko o ka waha, ka nele ʻana i ka momona, ka ʻōpū ʻana, ka lemela, ka ʻeha o ka ʻōpū. Hoʻohana maʻamau kēia mau hōʻailona i ka hoʻomaka ʻana o ka mālama ʻana a maʻamau e hele ma o lākou iho. Hiki i kēia mau hōʻailona ke hōʻemi i ka koho ʻana o nā anthocides, derivatives o ka atropine a i nā antispasmodics.

Mai ka ʻaoʻao o ka hana o ka metabolism: i nā hihia maʻamau - lactic acidosis (koi i ka hoʻokuʻu ʻana o ka mālama ʻana), me ka mālama lōʻihi ʻana - hypovitaminosis B12 (malabsorption).

Mai nā hemopoietic organitions: i kekahi mau hihia - megaloblastic anemia.

Mai ka pūnaehana endocrine: hypoglycemia.

Nā maʻi kūlou: hāpau ka ʻili.

Hoʻohui

ʻAʻole kōkua ʻia ka hoʻohana pinepine ʻana o danazolea e pale ai i ka hopena hyperglycemic o ka mea hope. Inā pono ke mālama ʻana me ka danazol a ma hope o ka hoʻokuʻu ʻana i ka hopena, pono ka hoʻoponopono ʻana o ke metformin a me ka iodine e hoʻomalu i ka glycemia.

ʻO nā hui e koi ana i ka mālama kūikawā: chlorpromazine - i ka wā e lawe ai i nā dosis he nui (100 mg / lā) e hoʻonui i ka glycemia, e hoʻoneʻe ana i ka hoʻokuʻu ʻana i ka insulin.

I ka mālamaʻana i nā antipsychotics a ma hope o ka pau ʻana i ka lawe ʻana i ka hopena, pono ka hoʻoponopono ʻana o ka metformin i lalo o ka kaohi o ka pae glycemia.

Me ka hoʻohana like ʻana me nā derivatives sulfonylurea, acarbose, insulin, NSAIDs, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate derivatives, cyclophosphamide, β-blockers, hiki ke hoʻonui i ka hopena hypoglycemic o ka metformin.

Me ka hana like me ka GCS, ka poʻe i hoʻohālikelike i ka waha, epinephrine, sympathomimetics, glucagon, hormon tiroid, thiazide a me diuretics loop, derivatives phenothiazine, ka hopena hoʻōla o ka nikotinic, hiki ke hōʻemi i ka hopena hypoglycemic o metformin.

Hoʻololi ʻo Cimetidine i ke kāpae ʻana o ka metformin, e hoʻonui ai i ka hopena o ka lactic acidosis.

Hiki i ka metformin ke hoʻonāwaliwali i ka hopena o nā anticoagulants (dermaratives Coumarin).

Hoʻonui ka ʻōpū i ka waiʻona i ka hopena o ka hoʻomohala ʻana i ka waikaʻi lactic i ka wā o ka hoʻohuʻawaʻawa ʻawa o ka waiʻona, ka mea nui a i nā hihia ʻaina ʻole e hele nei ma kaʻai haʻahaʻa, a me ka puʻuwai hemahema.

Pehea e hana ai, papa o ka hoʻokele a me ka helu ʻana

Hoʻonohonoho ʻia ka hopena o ka lāʻau e kēlā me kēia kauka, i ka pae o ka glucose i loko o ke koko.

ʻO ka ma mua mua he 500-1000 mg i kēlā me kēia lā (1-2 papa). Ma hope o nā lā 10-15, hiki ke hoʻonui hou ʻia ka nui o ka wai ma muli o ka pae o ke kaila o ke koko.

ʻO ka mālama mālamaʻana o ka lāʻau no ka 1500-2000 mg i ka lā. (3-4 papa) ʻO ka nui loa ka nui o ka 3000 mg i kēlā me kēia lā (6 papa).

I nā poʻe maʻi maʻi, ʻaʻole eʻoi aku ka nui o ka lāʻau i kēlā me kēia lā i 1 g (2 mau papa).

Pono e lawe ʻia nā papa metformin i ka wā āpau a ma hope paha o ka ʻaina me ka liʻiliʻi o ka wai (kahi kīʻaha wai). No ka hōʻemi i nā hopena ʻaoʻao mai ka gastrointestinal tract, pono e hoʻokaʻawale ʻia ka nui o ka lā i 2-3 mau pona.

Ma muli o ka hoʻonui nui o ka acidosis lactic, pono e hoʻemi ʻia ka nui o ka maʻi ma ka hopena o ka hōʻoluʻolu metabolic.

Ke keu

Me kahi overdose o Metformin, kahi hopena lactic acidosis me kahi hopena momona. ʻO ke kumu o ka hoʻomohala ʻana o ka acidosis lactic hiki ke lilo i ka hoʻohui ʻia o ka lāʻau ma muli o ka hana renal impaired.

Nā hōʻailona o ka lactic acidosis: nausea, luaʻi, hōʻeha ke hoʻohaʻahaʻa, hoʻohaʻahaʻa i ke ʻano kino o ke kino, ʻeha o ka ʻōpū, ka ʻeha o ka naʻau, i ka wā e hiki mai ana ka nui o ka hanu, ka ʻōpū, ka naʻau a me ka hoʻomohala ʻana i ka piko.

Hoʻomaʻamaʻa: ma ke ʻano o nā hōʻailona o ka lactic acidosis, pono e hoʻokaʻawale ke mālama me Metformin, pono e mālama koke ʻia i ka mea maʻi a me ka hoʻoholo ʻana i ke ʻano o ka lactate, e hōʻoia i ka maʻi maʻi. ʻO ka ʻoi aku ka hopena e hiki ai ke hoʻopau i ka lactate a me ke metformin mai ke kino he hemodialysis. Hoʻopili ʻia hoʻi ka hana maʻi Symptomatic.

I ka hui pū ʻana me Metformin a me sulfonylureas, hiki i ka hypoglycemia ke ulu.

Nā ʻōlelo kikoʻī

I ka wā mālama, pono ia e nānā i nā hana renal. Ma kahi o 2 mau manawa i ka makahiki, e like me ka nānā ʻana me myalgia, pono ka hoʻoholoʻana o ka lactate ma ka plasma. Eia kekahi, hoʻokahi i kēlā me kēia 6 mau mahina, pono ia e kaohi i ka pae o ka creatinine i loko o kahi serum koko (maʻa mau i nā maʻi o nā makahiki holomua). ʻAʻole pono ke kuhikuhi ʻo Metformin inā he kiʻekiʻe loa ka pae ma ka koko ma mua o 135 mol / L i nā kāne a me 110 mol / L i nā wahine.

Malia paha o ka hoʻohanaʻana i ka lāʻau Metformin i hui pū me ka huaʻala sulfonylurea. I kēia hihia, pono e mālama pono ana i ka pae o ka glucose koko.

ʻO 48 mau hola ma mua a i loko o nā hola 48 ma hope o ka radiopaque (urography, iv angiography), pono e ho'ōki i ka lawe ʻana iā Metformin.

Inā loaʻa i ka mea maʻi ka maʻi bronchopulmonary a i ʻole kahi maʻi hopohopo o nā hanana genitourinary, pono e hoʻomaopopo koke ʻia ke kauka hele mai.

I ka wā mālama, pono ʻoe e pale i ka inu ʻana i ka waiʻona a me nā lāʻau ʻai e pili ana i ka ethanol. . ^ E Ha yM.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini

ʻAʻole pili ka hoʻohana ʻana i ka lāʻau lapaʻau ma ka monotherapy i ka hiki ke hoʻokau i nā kaʻa a hana me nā mīkini.

I ka manawa e hui pū ai ʻo Metformin me nā māmala hypoglycemic ʻē aʻe (sulfonylurea derivatives, insulin), ulu paha nā kūlana hypoglycemic kahi e hiki ai i ka hoʻokae i nā kaʻa ke komo i nā hana ʻē aʻe ʻē aʻe e koi ai i ka nānā nui a wikiwiki ʻia ka hopena psychomotor.