Pehea e hoʻohana ai i ka lāʻau lapaʻau Gluconorm?

Inoa inoa honua - hanaʻai

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

Nā papa hana ʻulaʻī keʻokeʻo, pōʻai, biconvex. 1 papa e loaʻa ai ka glibenclamide 2.5 mg, metformin hydrochloride 400 mg.

Nā mea kūʻai: cellulose microcrystalline - 100 mg, kōpio palaoa - 20 mg, silikone koloila colloidal - 20 mg, gelatin - 10 mg, glycerol - 10 mg, magnesium stearate - 7 mg, paukiki talcum hoʻomaʻemaʻe - 15 mg, sodium croscarmellose - 30 mg, sodium carboxymethyl starch - 18.3 mg, cellacephate - 2 mg, diethyl phthalate - 0.2 mg.

10 kamepiula - blisters (1, 2, 3, 4) - nā ʻeke pepa.
20 mau kāleka. - blisters (1, 2, 3, 4) - nā ʻeke pepa.
30 kiʻi - blisters (1, 2, 3, 4) - nā ʻeke pepa.

Nā ʻoihana ʻoihana ʻo ka ʻoihana kāohi me ka lāʻau lapaʻau

ʻO ka lāʻau lapaʻau hypoglycemic oral.

ʻĀpana Pharmacotherapeutic

Hoʻoponopono ka hypoglycemic no ka hoʻokō waha (sulfonylurea o ka hanauna II + biguanide).

Ka hana lāʻau lapaʻau

ʻO Gluconorm kahi hui pūpū o ʻelua mau loiloi hypoglycemic waha o nā hui lāʻau lapaʻau like ʻole: metformin a me glibenclamide.

Metformin nona ka pūʻulu o ka biguanides a hōʻemi i ka pae o ka glucose i ka serum o ke koko ma o ka hoʻonui ʻana i ka ʻike ʻana o nā ʻiʻo peripheral i ka hana o ka insulin a me ka hoʻomaikaʻi ʻana i ka uptake glucose. Hoʻēmi i ka komo ʻana o nā huapalapala i loko o ka digestive tract a hoʻopaʻa i ka gluconeogenesis ma loko o ka ate. He hopena maikaʻi hoʻi ka lāʻau lapaʻau i ka ʻike lipid o ke koko, e hoʻohaʻahaʻa i ka pae o ka nui o ka cholesterol. LDL a me triglycerides. ʻAʻole ia e kumu i ka pane hypoglycemic.

ʻO Glibenclamide nona nā pūʻulu o nā kōmani sulfonylurea o ka lua o ka hanauna. Hoʻonohonoho ia i ka hana huna insulin ma ka hoʻohaʻahaʻa ʻana i ka paepae pancreatic β-cell glucose, hoʻonui i ka ʻike ʻana i ka insulin a me kona paa ʻana i nā cell target, hoʻonui i ka hoʻokuʻu ʻana i ka insulin, e hoʻonui ana i ka hopena o ka insulin ma ka ʻāʻī a me ka puʻuwai glucose uptake, a pale i ka lipolysis ma ka adipose tissue. Nā hana i ka lua o ka hana ʻana o ka inikini insulin.

ʻO nā Pharmacokinetics o Gluconorm

Ke hoʻokau ʻia, mālamaʻia mai ka gastrointestinal tract ʻo 48-84%. He manawa e hiki ai i C_max - 1-2 hola V_{e d} - 9-10 lita. ʻO ka kamaʻilio pū me nā protein plasma he 95%.

Ua aneane ʻokoʻa loa i ka ate a me ka hoʻokumu ʻana o ʻelua mau metabolite hana, ʻo kekahi kekahi a hoʻopiʻi ʻia e nā ʻeha, a ʻo kekahi i nā ʻāpana o nā ʻāpana. T_1/2 - mai 3 a hiki i ka 10-16 hola

Ma hope o ka lawelawe waha, ua hoʻoiho ʻia mai ka gastrointestinal tract piha loa, 20-30% o ka nui i loaʻa i ka feces. ʻO ka bioavailability kūpono mai 50 a 60%. Me nā ingestion like ʻole, ua hoʻemi ʻia a emi aʻe ke ʻano o ka hoʻopili ʻana o ka metformin. Hāʻawi koke ʻia ia i ka kiko, hoʻomaʻamaʻa ʻole ia i nā protein plasma.

Hoʻomili ʻia ia i kahi pae palupalu loa a hoʻopā ʻia e nā keiki. T_1/2 aneane 9-12 hola

Pākuʻi type 2 i nā pākeke:

- me ka loaʻa ʻole o ka hoʻoikaika kino o ka meaʻai, ka hoʻomaʻamaʻa a me ka lāʻau i mua me ka metformin a i ʻole glibenclamide,

- e hoʻololi i ka terapi i hala me nā lāʻau ʻelua (metformin a me glibenclamide) i nā mea maʻi me ka nui o ka pae ʻana i ke kaila glucose a maikaʻi.

Ka hoʻoponopono ʻana o ka helu ai a me ke ʻano hana o Gluconorm

Hoʻohana pinepine ʻia ka lāʻau lapaʻau, me ka papaʻaina. Hoʻoholo ʻia ka nui o ka lāʻau e ke kauka ponoʻī no kēlā me kēia maʻi, e pili ana i ke kiʻekiʻe o ka glucose koko.

ʻO ka maʻamau maʻamau ka pae ʻono. (400 mg / 2,5 mg) / lā. I kēlā me kēia 1-2 mau pule ma hope o ka hoʻomaka ʻana o ka hoʻomaʻamaʻa, hoʻoponopono ʻia ke ʻano o ka lāʻau lapaʻau ma muli o ke kau o ka glucose koko. Ke hoʻohālikelike nei i ka lāʻau hui mua me ka metformin a me ka glybeklamide, ua kuhikuhi ʻia nā papa 1-2. Kūpono ʻia ka Gluconorm ma mua o ka hopena o mua o kēlā

ʻO ka papa helu ʻehā loa no 5 mau papa.

Loaʻa ka hopena

Allergic a me immunopathological ʻano: jarang - urticaria, erythema, hōʻeha o ka ʻili, ke kuni, ka arthralgia, proteinuria.

Mai ka ʻaoʻao o ka mea laʻa kalapule: hiki ke hypoglycemia.

Mai ka ʻōnaehana hemopoietic: līpoki - leukopenia, thrombocytopenia, erythrocytopenia, loa loa - agranulocytosis, hemolytic a megaloblastic anemia, pancytopenia.

Mai ka ʻaoʻao o ka pīkī laha waena: hōʻeha, hōʻeha, nā nāwaliwali, luhi, lohi - paresis, nā maʻi paʻakikī.

Nā hopena dermatological: mākaʻaka - photosensitivity.

Mai ka palaki a me ka pepeha: maʻa - ʻuwelele, luaʻi, hōʻeha o ka ʻōpū, ka nalo o ka ʻono, ʻono ʻono "ʻōpio" i loko o ka waha, i kekahi mau hihia - jaundice cholestatic, hoʻonui i ka hana o nā enzyme o ka ate, hepatitis.

Mai ka ʻaoʻao o ka metabolism: lactic acidosis.

Nā ʻili: ka hopena o ka hoʻōho ʻana o ka waipona ma hope o ka inu ʻana, i hōʻike ʻia e ka hoʻopiʻi o nā kaila o ka kaʻe a me ka hanu (disulfiram-like ʻano: hoʻohuihui, hoʻāhu ʻia ka wela i ka maka a me ke kino o luna, tachycardia, huki, hōʻeha).

Nā ʻōhala Gluconorm

- momo type diabetes

- nā maʻi maʻi pāpaʻi, nā hōʻiliʻili nui, nā hōʻeha, nā kuniahi a me nā kūlana ʻē aʻe e koi ai i ka ʻomo ʻana o ka insulin.

- ka maʻi ketoacidosis maʻi, diabetes precoma, diabetes coma,

- nā maʻi koʻikoʻi e hiki ke alakaʻi i kahi loli i ka hana o ka aʻalilima (kūmole, hōʻeha nui, kūhae)

- nā maʻi akamai a i ʻole ke hele pū me ka maʻi hypoxia (puʻuwai a i ʻole ka hanu, hou ʻana o ka myocardial infarction, weliweli),

- hoʻohana no ka liʻiliʻi he 48 mau hola ma mua a i loko o nā hola 48 ma hope o ka hoʻopaʻa ʻana i nā haʻawina radioisotope a i ʻole X-ray me ka hoʻomaka ʻana o ka iodine-medium medium,

- ka mālamaʻana i kahi pāʻina haʻahaʻa-haʻahaʻa (emi iho ma mua o 1000 kaleka / lā),

- pilikia hania

- ka hui pūʻana o ka miconazole,

- nāu kūlohelohe, huakino make kūlike,

- ka acidosis lactic (me ka mōʻaukala),

- wā waiū,

- Hypersensitivity i ka metformin, glibenclamide a i ʻole nā ​​mea pōpilikia sulfonylurea, a me nā mea waiwai.

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.

Me ka akahele: syndrome febrile, adrenal insufficiency, hypofunction o ka pituitary anterior, maʻi thyroid me ka hana lēwa.

ʻŌpū a me ka lactation

I ka wā hāpai, ua contraindicated ka hoʻohana ʻana o ka gluconorm. Ke hoʻolālā nei i ka hapai, me ka mālama ʻana i ka wā hāpai i ka wā e lawe ai iā Gluconorm, pono e haʻalele ʻia ka lāʻau lapaʻau a pono hoʻi e kuhikuhi ʻia ka lāʻau lapaʻau.

Kūkākūkā ʻia ʻo Gluconorm ma ka umauma maʻi, ma ke ʻano o ka metformin i loko o ka waiū umauma. I kēia hihia, pono ʻoe e hoʻololi i ka hoʻololi ʻana i ka insulin a i ʻole hoʻokū ʻaʻa.

Hoʻohana no ka hana lawelawe lēwa

Contraindicated i ka hāʻule ʻole o ka ate.

Hoʻohana no ka hana renal impaired

Hoʻopili ʻia ka hoʻohana ʻana i nā hana hōʻeha o ka renal a me nā kūlana kūpono e hiki ai ke alakaʻi i ka hoʻololi ʻana i ka hana o ka renal (dehydration, maʻiʻeha, weliweli),

Hoʻohana i nā mea maʻi maʻi

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 ʻōlelo kikoʻī kūikawā no ke komo ʻana

ʻO nā hōʻiliʻili o nā maʻi a me nā hōʻeha, ʻoi loa ke kīwī, nā maʻi ʻeha me ka febrile syndrome e koi i ka hoʻokuʻu ʻana i ka lāʻau a me ka koho ʻana i ka hana maʻi insulin.

Pono e kiaʻi pinepine i ka pae glucose i loko o ke koko ma kahi ʻōpū ʻole a ma hope o ka ʻai.

Hoʻomaʻamaʻa ʻia nā mea maʻi e pili ana i ka hoʻonui nui o ka hypoglycemia i nā hihia o ka ethanol, NSAID, a me ka pōloli.

Pono kahi hoʻoponopono hoʻoponopono ʻia no ke ʻano kūlohelohe a me ke kaumaha, kahi hoʻololi i ka ʻai.

I ka wā mālama, ʻaʻole pono e inu i ka waiʻona.

ʻO 48 mau hola ma mua o ka ʻoi a i ʻole ka hoʻōho ʻana o ka mana o ka radiopaque iodine i loaʻa, e hoʻokaʻawale ke keʻena gluconorm. Hoʻomaopopo ʻia ka hana hoʻōla ʻia o Gluconorm ma hope o 48 mau hola.

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

I ka wā o ka mālama ʻana, pono e mālama ʻia i ka wā e alakaʻi ana i nā kaʻa a hana i nā hana ʻē aʻe paha e koi ai i ka piʻi ʻana o ka nānā a me ka wikiwiki o ka hopena psychomotor.

Ke keu

ʻO kahi overdose a i ʻole ka heleʻana o nā mea pili i hiki ke hoʻowalewale i ka hoʻomohala ʻana o ka acidosis lactic, ʻoiai ʻO ka metforminum kahi papa i ka hoʻomākaukau. Ke hele nei nā hōʻailona o ka lactic acidosis (ka luaʻi, ka ʻōpū o ka ʻōpū, nā nāwaliwali ākea, nā ʻōpūʻī o ka naʻau), pono ʻoe e hoʻōki i ka lawe ʻana i ka lāʻau. Lactic acidosis kahi kūlana e koi ai i ka mālama maʻi olakino, mālama pono i ka lactic acidosis e lawe ʻia i loko o ka haukapila. ʻO ka hopena kūpono e pili ana i ka hemodialysis.

Hiki i kahi overdose ke alakaʻi i ka uluʻana o ka hypoglycemia ma muli o ka loaʻaʻana o glibenclamide i ka hoʻomākaukau. Nā hōʻailona o ka hypoglycemia: ka pōloli, momona nui, nāwaliwali, palpitations, pallor o ka ʻili, paresthesia o ka wahaosa waha, nā mea haʻalulu, ka hopohopo nui, ke poʻo, ka hiamoe o ka pathological, nā hana hiamoe, ka naʻau hopohopo, nā mākaukau ʻana o nā neʻe, ka maʻi neurological pōkole. Me ka hoʻomohala ʻana o ka hypoglycemia, hiki i nā mea maʻi ke nalowale i kā lākou iho a me ka ʻike.

Me ka hypoglycemia maʻalahi a hōʻoluʻolu paha, lawe i ka dextrose (glucose) a i ʻole ka hilo i ke kō. Ma ka hihia o ka hypoglycemia koʻikoʻi (ka nalowale o ka ʻike) ʻole, kahi hopena o 40% dextrose (glucose) a i ʻole glucagon intravenous, v / m, s / c e lawelawe ʻia iv. Ma hope o ka hāpai hou ʻana, pono e hāʻawi ka mea maʻi i ka meaʻai i ka momona o ka pale i ke pale ʻana i ka hoʻomohala hou ʻana o ka hypoglycemia.

Nā pilina pili me nā lāʻau lapaʻau ʻē aʻe

Barbiturates, corticosteroids, adrenostimulants (epinephrine, clonidine), nā lāʻau antiepileptic (phenytoin), nā blockers kahalulu kalepa, nā mālamuku anhydrase carbonic (acetazolamide), thiazide diuretics, chlortalidone, furosemide, diazanazide, triaakenene , morphine, ritodrine, salbutamol, terbutaline, glucagon, rifampicin, iodine-i pili ana i nā huaola tiroid, nā paʻakai lithium, ma nā wai haʻahaʻa - nā waikele nikotiniki, chlorpromazine, nā ʻōpala a me nā estrogens.

ACE inhibitors (captopril, enalapril), histamine H blockers hoʻomaikaʻi i ka hopena hypoglycemic o ka lāʻau.₂nā mea kūmole (cimetidine), nā antifungal agents (miconazole, fluconazole), NSAIDs (phenylbutazone, azapropazone, oxyphenbutazone), fibrates (clofibrate, bezafibrat), anti-tuberculosis drug (ethionamide), salicytates, anticoagulant MAO, ka lōʻihi o ka manawa sulfonamides, cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, me nā mea ʻē aʻe ʻO ka lāʻau hypoglycemic (acarbose, biguanides, insulin), allopurinol.

Kāohi i ka hoʻohuihui ʻana i ka wai (ammonium chloride, calcium chloride, ascorbic acid ma nā wai he nui) hoʻonui i ka hopena ma ka hoʻemi ʻana i ka pae o ke kipi a hoʻonui i ka reabsorption o glibenclamide.

Hoʻonui ka Ethanol i ka nui o ka acidact lactic.

Hoʻohālikelike ka Metformin C_max a T_1/2 furosemide e 31% a me 42.3%, loaʻa.

Hoʻonui ka Furosemide C_max metformin e 22%.

Hoʻonui ka Nifedipine i ka hoʻopili ʻana, C_max hoʻoluhi i ka hoʻopauʻana o ka metformin.

ʻO nā lāʻau lapaʻau cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren a me vancomycin) i hūnā ʻia i loko o nā tubule e hoʻokūkū ana no nā ʻōnaehana o ka tubular a hiki ke hoʻonui i ka C me ka lōʻihi o ka hoʻokō_max 60% metformin.

Hoʻohui Kūʻai Kūʻai

Ke kūleʻa nei ka lāʻau lapaʻau.

Nā kuleana a me nā kūlana e waiho ai

E mālama ʻia ka lāʻau lapaʻau i kahi maloo, pale ʻia mai ka mālamalama, ʻaʻole hiki i nā keiki ke ana i kahi wela ʻaʻole iʻoi aku ma mua o 25 ° C. ʻO 3 mau makahiki kahi ola i nā pale.

ʻO ka hoʻohana ʻana i ka lālani Gluconorm wale nō e like me ka mea i kuhikuhi ʻia e ke kauka, ʻo nā ʻōkuhi no ke kuhikuhi!

E hoʻokuʻu i nā palapala a me ka ʻano

Hoʻohana ʻia ka lāʻau lapaʻau i ke ʻano o nā papa. 1 ka papaʻu he 2.5 mg o ka glibenclamide a me 400 mg o ka metformin hydrochloride me nā mea ikaika. Ua puni lākou i ka helehelena. ʻAno - mai ke keʻokeʻo a hiki i ka keʻokeʻo.

Pono ʻia ka Gluconorm i ka mālama ʻana e hakakā i ka maʻi maʻi.

Ka hana lāʻau lapaʻau

Aia ʻo Metformin i kahi pūʻulu o nā mea i kapa ʻia ʻo biguanides. ʻO ka pae o ke kō i loko o ke koko i ka wā e lawe ʻia ai ma muli o ka loaʻaʻana o ka paʻakikī o nā jaringan peripheral i ka hana o ka insulin. ʻOi aku ka hopena o Glucose. ʻAʻole kalai koke ʻia nā kalaiwa i ka ʻōnaehana ʻana. Hoʻopau i ke ʻano o ka glucose i ka ate. Hoʻomaʻemau ka ʻano o ke kolamu ma ka koko. ʻAʻole hiki i nā hypoglycemia ke kumu.

E pili ana i ka glibenclamide, ua hoʻomaopopo ʻia he hua derivative o ka sulfonylurea o ka lua o ka hanauna. Hoʻonui ia i ka hana o ka insulin, kona hoʻokuʻu, e hoʻolohi ana i ka hana o lipolysis i ka hoʻopili adipose.

ʻO ka pae o ke kō koko i ka wā e lawe ai ʻo Gluconorm ma muli o ka hana i ka hoʻololiʻana i nā koli peripheral i ka hana o ka insulin.

Lapaʻau lāʻau

ʻO ka kauka nui loa o ka glibenclamide i loko o ke koko ka hoʻopaʻa ʻia 1-2 mau hola ma hope o ka lawe ʻana i ka paila. 95% hui pū ʻia me nā protein plasma koko. E hoʻoneʻe loa a kokoke 100% nā pehu. ʻO ka hapalua -ʻo ka hapalua o nā ola he 3 mau hola, ʻo ka nui loa hiki ke loaʻa ka 16 hola.

ʻO ka Metformin he 50-60% bioavailable. ʻO ka launa pū me nā protein plasma koko he mea liʻiliʻi loa, hiki ke wehewehe ʻia ke kahakaha ma luna o nā ʻili. Hoʻopau palupalu, hoʻopili ʻia ma o nā keiki. ʻO ka hapalua-ola he 9-12 hola.

ʻO ka kauka nui loa o ka glibenclamide i loko o ke koko ka hoʻopaʻa ʻia 1-2 mau hola ma hope o ka lawe ʻana i ka paila.

Nā Hoʻohui

ʻAʻole hiki ke hoʻokō ʻia ka lāʻau me ka lāʻau lapaʻau inā loaʻa ka maʻi i nā ʻano aʻe:

• huahuʻi,
• nā ala i pili ai me ka hypoxia tissue: myocardial infarction, maʻi cardiac a me nā hanu maʻi, nā weliweli,
• maʻi maʻamau ketoacidosis,
• maʻi diabetes type 1
• lactic acidosis a me ka porphyria,
• mau ʻoi ʻana a koʻikoʻi paha nā kaʻina hana e koi i ka therapy insulin,
• hoʻonui mahuahua i nā mea ikaika o ka lāʻau.

ʻAʻole hiki ke hoʻokō ʻia ka mālama ʻia me ka lāʻau lapaʻau inā loaʻa ka mea maʻi i ka hiki ke hoʻonui i nā mea hoʻoikaika nui o ka lāʻau.
ʻAʻole hiki ke hoʻokō ʻia ka lāʻau me ka lāʻau lapaʻau inā loaʻa nā maʻi maʻi 1 i ka maʻi diabetes.
ʻAʻole hiki ke hoʻokō ʻia ka lāʻau lapaʻau me ka lāʻau lapaʻau inā loaʻa ka maʻi maʻi myocardial infarction.

Me ka maʻi diabetes

Ma mua o ka lawe ʻana i nā panila, pono e hoʻopaʻa ʻia kēlā me kēia maʻi i nā ʻōkuhi i ʻole e hōʻino i ko lākou olakino. Pono ka papa ʻōlelo e kuhikuhi ʻia e ke kauka nāna i kuhikuhi i ka lāʻau lapaʻau. Ke hoʻoholo nei ʻo ia ma ka hopena mākau loa e pili ana i ka pae o ka glucose i ke koko ua kākau ʻia ma ka mea maʻi i ka manawa i koho ʻia. I ka manawa pinepine, ua lawe ʻia nā pāʻina i ka moʻo ʻana.

ʻAʻole hiki i nā mea hou loa ka lā ma mua o 5 mau papa. Pōlele ia, he 1 papa o ka lā (400 mg / 2.5 mg). Mai ka hoʻomaka o ka hoʻomaʻamaʻa, ʻo kēlā me kēia mau hebedoma 1-2 e hiki ke hoʻoponopono ʻia i ke ʻano o ka mālama ʻana, ʻoiai ke nānā nei ke kauka i ka loli i nā pae o ka glucose koko. Inā hāʻule ka hāʻule, a laila, e like me ka mea, e hoʻemi ʻia ka ʻona.

Pono ka papa ʻōlelo e kuhikuhi ʻia e ke kauka nāna i kuhikuhi i ka lāʻau lapaʻau.

Hematopoietic mau hui

E like me ka loaʻa ʻole o nā hopena ʻino mai ka ʻōnaehana hematopoietic, hiki i ka hoʻomohala ʻana o ka leukopenia, thrombocytopenia ʻOi aku ka liʻiliʻi, ʻo ka hoʻohaʻahaʻa ʻana i ka nui o nā leukocytes, ulu ka megaloblastic anemia.

E like me ka loaʻa pinepine ʻana mai ka ʻōnaehana hematopoietic, hele mai ka hoʻomohala ʻana o ka leukopenia.

Hoʻopilikia i ka hiki ke mālama i nā mīkini

Ma muli o nā hōʻailona o ka pūnaehana neʻe o ka mea ma mua, ʻoi aku ka maikaʻi o ka hōʻole ʻana i ka mālama ʻana i nā hana.

Ma muli o nā hōʻailona o ka pūnaehana neʻe o ka mea ma mua, ʻoi aku ka maikaʻi o ka hōʻole ʻana i ka mālama ʻana i nā hana.

Hoʻohana i ka wā hāpai a me ka lactation

ʻAʻole pono ke lawe i ka lāʻau lapaʻau i ka wā gestation. Inā makemake kekahi o ka maʻi maʻi, pono e hoʻomaʻamaʻa ʻia me ka ʻomo ʻana o ka insulin.

ʻĀpili ʻia ka metformin i ka waiū umauma. ʻO kēia ka mea i ka wā o ka lāʻau lapaʻau, pono ʻoe e hoʻōki i ka mālama ʻana me ka lāʻau lapaʻau a haʻalele paha i ka umauma a hoʻolilo i ke keiki i nā mea like.

ʻO ka hoʻonāukiuki o Gluconorm

Inā nui ka nui o ka lāʻau i manaʻo ʻia e ke kauka, hiki i ka mea maʻi ke hālāwai me ka lactacide, kahi pono o ka mea e pono ai ka hana ma ke ʻano me ka hemodialysis. Hiki mai paha ʻo hypoglycemia, ka mea e hōʻike iā ia iho e ke ʻano o ka manaʻo o ka pōloli, haʻalulu, nā pilikia hiamoe pōkole a me nā pilikia neʻe.

ʻO nā hiʻohiʻona Pharmacological

ʻO Gluconorm kahi lāʻau lapaʻau i hui pū ʻia e hoʻohui i nā lāʻau lapaʻau o nā papa lāʻau lapaʻau like ʻole e like me ke ʻano o ka hana.

ʻO ka mea kumu mua o ka pôpeku ka metformin, he mākaʻikaʻi o ka biguanides, nāna e hoʻokaʻawale i nā hanana glycemic ma o ka hoʻomaikaʻi ʻana i ke kū'ē o nā cell i ko lākou iho ponoʻī a me ka wikiwiki o ka hoʻohana ʻana i ka glucose i nā kiko. Eia kekahi, ke pale aku nei ka biguanide i ka hoʻopili ʻana o nā mea kalaiʻa a hoʻokaʻawale i ka hana o nā glucose i loko o ka ate. Hoʻomaikaʻi i ka metformin a me ka momona momona, mālama i kahi paʻa o ke ʻano o nā kolamu a me ka triglycerol.

ʻO Glibenclamide, ka lua o ka hana ikaika i loko o ka papa kuhikuhi, e like me ke kuana o ka papa o ka hui o ka ʻāwina o ka lua o nā makahiki, ke hoʻonui nei i ka hana hana me ka kōkua o β-cells of the pancreas e pili ana i kēia kaʻina. Mālama ʻo ia iā lākou mai ka maʻi kūlohelohe, hoʻomaikaʻi i ka pale ʻana i ka insulin a me ka maikaʻi o nā ligelet me nā cell. Hoʻopau ka ikaika o ka insulin i ka hoʻopili ʻana o ka glucose e nā ʻōpū a me nā ʻāʻī, no laila, ʻaʻole i hoʻokumu ʻia kāna stock i ke papena momona. Hana ka hana i ka 2 kau o ka hana hana insulin.

Nā hiʻohiʻona o nā pharmacokinetics

Ma hope o ke komo ʻana i ka ʻōpū, hoʻopili ʻia ka glibenclamide e 84%. Cmax (ka pae o kona pae) i hōʻea ia ma hope o 1-2 mau hola. ʻO ka hoʻoili ʻana ma nā helu (Vd) he 9-10 lita. Hoʻopili ka mea i nā protein koko ma ka 95%.

Hoʻololi ka mea i loko o ka ate i ka hoʻokuʻu ʻana o 2 i nā metabolites kūleʻa. ʻO kekahi o lākou e hoʻopau i nā wahi palupalu, ʻo ka lua - ʻo nā keiki. ʻO ka hapalua ola o T1 / 2 i loko o 3-16 hola.

Ma hope o ke komo ʻana i ka ʻōnaehana kūwili, ʻike ʻia ka metformin, ʻaʻole iʻoi aku ma mua o 30% o ka pauku e waiho mau ana i loko o ka papa. ʻAʻoleʻoi aku ka bioavailability o ka biguanide ma kahi o 60%. Me kahi pākuʻina kūpono like o nā mea kanu, e wālolo ana ka lilo o ka lāʻau. Hoʻouna ʻia ia me ka wikiwiki, ʻaʻole ia e komo i ka launa me nā protein plasma.

Hoʻomoe dosis a me ka hoʻopili ʻana o Gluconorm

ʻO Gluconorm, kahi kiʻi kiʻi e hiki ke ʻike ʻia ma kēia ʻāpana, komo i ka pānaʻi lapaʻau i loko o ke ʻano o nā papa convex pōkole me kahi pūpū keʻokeʻo. I ka heleʻana, he hina ka hina o ka lāʻau. I loko o ka papa pākahi, ʻelua mau mea hoʻohālikelike e pili ana i ka helu ʻana: metformin - 400 mg, glibenclamide - 2,5 g. Hoʻohui i ka ʻano me nā fillers: talc, cellulose, starch, glycerol, cellacephate, gelatin, magnesium stearate, croscarmellose sodium, sodium carboxymethyl starch, silium dioxide, sodium hoʻohelena phthalate.

Hoʻopaʻa ka lāʻau i ka 10 a i ʻole 20 pcs. i loko o nā hale i loaʻa i ka alumini foil. I ka pepa pahu hopu mai ka 2 a 4 mau papa. Na Gluconorm, kūʻai kālā nui ke kumukūʻai: mai ka 230 rubles, hoʻokuʻu lākou i ka lāʻau lapaʻau hoʻolālā. ʻO 3 mau makahiki ka lōʻihi o ke ola o nā papa. ʻAʻole pono ka lāʻau lapaʻau i nā kūlana kūikawā no ka mālama.

Pehea e hoʻohana ai iā Gluconorm

No Gluconorm, ʻo nā ʻōlelo aʻo e hoʻohana ai i ke kau ʻana i nā papa papa i loko me ka meaʻai. Hoʻolilo ke kauka i ka nui ma ka helu, me ka noʻonoʻo ʻana i nā hiʻohiʻona o ke ʻano o ka maʻi, nā pathologies concomitant, ka makahiki a me ke ʻano o ka maʻi maʻi, a me ke ʻano o ke kino i ka lāʻau lapaʻau. E like me ke kānāwai, e hoʻomaka me 1 papa / lā. Ma hope o hoʻokahi a ʻelua paha pule, hiki iā ʻoe ke loiloi i ka hopena, a me ka lawa ʻole, hiki iā ʻoe ke hoʻoponopono i ke ʻano.

Inā ʻaʻole Gluconorm he lāʻau lapaʻau e hoʻomaka ana, ke hoʻohuli nei i ka hoʻoponopono lāʻau lapaʻau ma mua, ua kau ʻia nā papa papa 1-2 e pili ana i ke ʻano o nā lāʻau lapaʻau ma mua. ʻO ka helu nui loa o nā papa i hiki ke lawe ʻia i kēlā me kēia lā he 5 mau ʻāpana.

Kōkua me ka overdose

ʻO ka heleʻana o ka metformin i ka hoʻopiʻi pinepine e hoʻonāukiuki i nā pilikia o ka ʻōpū, a i kekahi manawa o ka acidosis lactic. Me nā hōʻailona o nā hoʻopiʻi (nā ʻehaʻeha o ka naʻau, nāwaliwali, ke hōʻeha ma ka wahi o ka epigastric, holo kino), ua pau ka lāʻau lapaʻau. Me ka lactic acidosis, pono ka mea maʻi e mālama i ka hoʻokipa. E hoʻihoʻi hou me ka hemodialysis.

ʻO ka heleʻana o glibenclamide ma ka hopena ka mea e hoʻokaʻawale ai i ka hoʻomohala ʻana o ka hypoglycemia. Hiki ke hoʻomaopopo i kahi kūlana pōpilikia ma o ka makemake ʻole i hoʻomohi ʻia, hoʻonui nui ʻia, ka tachycardia, tremor, ʻulaʻula, isomnia, paresthesia, huki a me ke poʻo, hopohopo. Me kahi ʻano moho o ka hypoclycemia, inā ʻaʻole ʻike ʻole ka mea ʻai, ua hāʻawi ʻia i ka glucose a me ke kō. Me ka nāwaliwali, glucose, dextrose, glucagon (40% rd) e paʻi iv, im a i ʻole o ka ʻili. Ma hope o ka loaʻa ʻana o ka mea maʻi i ka ʻike, ua hānai ʻia ʻo ia me nā huahana me nā momona kākāwa nui, no ka mea e hā pinepine ʻia ana i kēia kūlana.

Nā hopena hoʻopuka lāʻau lapaʻau

A ho'ākea hypoglycemic hiki lāʻau me ka hui pu ana me ACE nā mea kūpale, NSAIDs, Anati-fungal ai ', fibrates, salitsitatami, ai' ku tuberculosis, β-blockers, guanethidine, Mao nā mea kūpale, sulfonamides, chloramphenicol, fluoxetine, tetracycline, reserpine, theophylline, disopyramide, pyridoxine, kahi antidiabetic konohiki . ^ E Ha yM.

Hoʻololi ʻia ka hana hypoglycemic of Gluconorm mai nā hopena o ka barbiturates adrenostimulant, corticosteroids, nā lāʻau anti-epilepsy, diuretics (thiazide lāʻau lapaʻau), furosemide, chlortalidone, triamteren, morphine, ritodrin, glucagon, hormone thyroid (ma laila oestra, iodine, etc.

Hoʻokomo ʻia nā hana hoʻonāukiuki i ka waikika e hana ai i ka hoʻomaʻamaʻa ʻana ma o ka hōʻemi ʻana i ka hoʻokaʻawale ʻana a me ka hoʻomaikaʻi ʻana i ka hoʻonui ʻana o ka gluconorm. Hoʻonui ka Ethanol i ka nui o ka acidact lactic. Hoʻopilikia maoli ka Metformin i ka pharmacokinetics o furosemide.

Nā hopena hopena

ʻO Metformin kekahi o nā lāʻau lapaʻau hypoglycemic palekana loa, akā, e like me kekahi lāʻau lapaʻau synthetic, he hopena pūpū. Ma waena o nā maʻi maʻamau ka dyspeptic, e nalowale i ka hapa nui o nā maʻi maʻi ma hope o ka hopena o ka manawa adaptation ma luna o lākou. ʻO Glibenclamide kahi mea i hōʻike ʻia i ka manawa me ka waihona hōʻike e hōʻike ai ka maikaʻi a me ka palekana. ʻAʻole loaʻa nā kūlana i hōʻike ʻia i ka papaʻaina, akā pono e aʻo ʻia nā ʻōlelo aʻo ma mua o ka hoʻomaka ʻana i ka mālama ʻana.

ʻO wai e hōʻike ʻia ana a contraindicated Gluconorm

Ua kuhikuhi ʻia nā papa no nā maʻi maʻi me ka maʻi 2 o ka maʻi like ʻole, inā ʻaʻole i hāʻawi ʻia ka mana o ka maʻi glycemic 100%. Inā hiki ke hoʻohana i nā lāʻauʻokoʻa ʻokoʻa ʻelua (Metformin a me Glibenclamide) e uku ʻia no ka hoʻōla kōlele ʻana, e hāmama ʻia hoʻi e hoʻololi i ka paʻakikī i kahi lāʻau hoʻokahi - Glucanorm.

Mai hoʻohana iā Gluconorm me:

• ʻAno maʻi type 1
• Hypoglycemia,
• ʻO ka maʻi ketoacidosis Diabetic, coma a me ka precoma,
• Nā hana Renal a me nā kūlana hoʻonāukiuki,
• Nāheʻe luhi,
• ʻO nā maʻi i hoʻonāukiuki ʻia e ka pololi oxygen o nā ʻōpala (me ka puʻuwai puʻuwai, nā ala palaualela, ʻāʻī, hana ʻole i ka hanu),
• Porphyria
• ʻO ka hoʻohana ʻana i ka miconazole,
• Ke hōʻike nei i kahi kaʻawale manawa i ka insulin (i ka wā o nā hana, nā hōʻeha, nā maʻi maʻi, kekahi mau hoʻokolokolo e hoʻohana ana i nā māka e pili ana i ka iodine),
• Hōʻino maikaʻi ʻana i ka waiʻona,
• Lactic acidosis, me ka mōʻaukala olakino,
• ʻŌpū a me ka lactation
• Hypocaloric (a hiki i ka 1000 kcal) kaʻai,
• Hypersensitivity i nā ʻāpana o ke ʻano.

Hoʻohana ʻia e Gluconorm e nā ʻōpio a me nā makuahine hānai

ʻOiai i ka papa hoʻolālā ʻana o ke keiki, pono e hoʻololi ʻia ʻo Gluconorm i ka insulin, no ka mea ua hoʻonoho ʻia nā lāʻau lapaʻau ma kēia ʻano. Ke hānai ʻia ka waiū umauma, mau nō nā kīpē, no ka mea ua komo ka lāʻau lapaʻau ʻaʻole wale ma o ka plasenta o ka kuʻi ʻana, akā i loko hoʻi o ka waiū wai. ʻO ka koho ma waena o ka insulin a me ka hoʻoneʻe ʻana o ke keiki i ka hānai hana no ka mālama ʻana i ka nui o ka pohō i ka makuahine a me ka hopena e hōʻino ai i ka pēpē.

Nā ʻōlelo kikoʻī

ʻO nā hōʻeha hōʻeha a me nā hana koʻikoʻi, nā maʻi maʻi pūpū i hele pū ʻia e ke kuni, e hōʻike ʻana i kahi manawa iki o ka mea maʻi i ka insulin.

Hoʻomaʻamaʻa ʻia ka maʻi maʻi e pili ana i ka pilikia o ka hoʻomohala ʻana i ka hypoglycemia me ka hoʻohana ʻana i nā NSAIDs, ka waiʻona, nā mea e pili ana i ka ethanol, a me ka mālama mau ʻana.

Me kahi loli o ka nohona, kaʻai ʻana, ka luhi a me ke kaumaha, kūpono ke loli ma ke ʻano o ka lāʻau lapaʻau.

Inā hoʻokolokolo ʻia ka mea maʻi me ka hoʻohana ʻana i nā hōʻailona iodine, i hoʻopau ʻia ka gluconorm i ʻelua mau lā, e hoʻohuli iā ia me insulin. Hiki iā ʻoe ke hoʻi i ka regimen lapaʻau mua ma mua o nā hola 48 ma hope o ka hoʻopaʻa ʻana.

E hōʻemi nui ʻia ka hopena o Gluconorm inā ʻaʻole e hahai ka mea maʻi i kaʻai haʻahaʻa-pahu, ke alakaʻi nei i kahi ʻano maʻalahi, ʻaʻole i kaomi i kāna kōkō i kēlā me kēia lā.

Kūkākūkā - analog

Wahi a ka ʻōlelo ATX o ka pae 4, ua pili pū lākou me ka Gluconorm:

Kahi a me ka koho o ka lāʻau lapaʻau i kūʻokoʻa wale nō i ka hoʻokūkū o ka loea loea. Ka hoʻopaʻa ʻana a me ka hoʻāʻo ʻana iā ʻoe iho me ka ʻole e noʻonoʻo pono i nā hiʻohiʻona a pau o ke ʻano mea hiki ke hoʻololi i nā hopena kaumaha.

Nā Hōʻike Kokua

E pili ana i nā loiloi maʻi Diabetic pinepine a hoʻopaʻapaʻa pinepine ʻia. Kūʻē kekahi ʻo ia ʻaʻole ka kōkua i ka lāʻau lapaʻau, aia nā mea kupanaha he nui, e komo pū ana ka paona. Wahi a kekahi, ʻo ka paʻakikī nui i ka mālama ʻana i ka lāʻau lapaʻau ke koho ʻana i ke ʻano, a laila hoʻi mai ke kō. E pili ana i kaʻaila lāʻau "Altai 11 Gluconorm me blueberries" i nā loiloi kūpono: e kōkua i ka mālama ʻana i ka hihiʻo, hoʻomaikaʻi maikaʻi i ka maikaʻi.

ʻO ka Gluconorm kahi lāʻau maʻalahi maʻalahi me ka noiʻi a me ka hoʻomaʻamaʻa ʻana i nā mahele i nā mea pono. Ua hoʻohana ʻia ʻo Biguanides a me sulfanilurea derivatives no ka mālama ʻana i ka maʻi type 2 no ka hapalua o hoʻokahi hapa mau makahiki, a ʻaʻole i hoʻopiʻi nā ʻano hou o ka lāʻau antidiabetic i ko lākou mana.

Hoʻopili pū me nā lāʻau ʻē aʻe

ʻAʻole i makemake ʻia no ka hoʻohana like ʻana me ka lāʻau fenfluramine, cyclophosphamide, ACE inhibitors, antifungal lāʻau lapaʻau, ke hoʻonui nei i ka hopena o ka lāʻau.

Thaizide diuretics e loaʻa ana nā iodine thyroid hormones e hoʻonāwaliwali i kāna hana.

ʻAʻole ia i koi ʻia no ka hoʻohana concomitant me ka fenfluramine.

Nā kūkākūkā Gluconorm

ʻO nā kauka a me nā mea maʻi i mālama ʻia me ka lāʻau lapaʻau e waiho i nā loiloi maikaʻi.

D.E. Tikhonov, GP, Ryazan: "Ke hōʻike nei ka lāʻau lapaʻau i nā hopena maikaʻi loa i ka mālama ʻana i ka maʻi maʻi 2. ʻIke maikaʻi ka poʻe maʻi. "

O.D. Ivanova, endocrinologist, Moscow: "Ke manaʻo nei au i ka lāʻau lapaʻau ka mea maikaʻi loa no ka mālama ʻana i ka maʻi type 2, no ka mea e kōkua wikiwiki a hana ʻole e hoʻonāukiuki i ka ʻano o nā hopena ʻino. E koho pinepine nō wau iā ia. "

Kūkākūkā Gluconorm Type 1 a me 2

ʻO Alina, 29 makahiki, ʻo Bryansk: "Ua pono wau e mālama ʻia i kēlā maʻi maʻi e like me ka maʻi maʻi. Ua lōʻihi ka lōʻihi o ka lāʻau, akā i hoʻonui maikaʻi ʻia ke ʻano. No laila, hiki iaʻu ke kāpae i kēia lāʻau lapaʻau. ”

Ivan, 49 makahiki, Ufa: “Ua mālama ʻia au me ka lāʻau lapaʻau i ka haukapila. Ua ʻoluʻolu wau i nā mea āpau, me ka mālama o nā kauka a me kā lākou ʻano hana. Ua nānā lākou iaʻu a, ma muli o nā hopena, i kuhikuhi ʻia ka nui o ka lāʻau lapaʻau. Hiki iaʻu ke kāhea i kēia lāʻau lapaʻau me ka ʻōlelo ikaika i nā maʻi āpau me ka maʻi maʻi. "