ʻO nā ʻōlelo aʻoaʻo Glucovans no ka hoʻohana ʻana, contraindications, nā hopena pili, nā loiloi

ʻO nā ʻanoosa o nā Glucovans - nā papa: nā biconvex i kālai ʻia i loko o kahi kiʻi ʻoniʻoni o ka ʻulaʻula kukui me ka kiʻi ʻana i kahi ʻaoʻao o "2.5" a i ʻole ka melemele a me ke kālai ʻia o "5" (15 pcs.

• Glibenclamide - 2,5 mg a i ka 5 mg paha,
• Metformin hydrochloride - 500 mg.

Nā mea kūʻokoʻa: povidone K30, sodium croscarmellose, magnesium stearate, microcrystalline cellulose.

ʻO ka hui o ka pūpū ka mea ʻalani ʻulaʻula / ʻeleʻele: opadry OY-L-24808 ʻulaʻula / ʻulaʻula 31-F-22700 ʻulaʻula (hypromellose 15cP, lōpose lactose, titanium dioxide, hao oksida ʻulaʻula, pōpoki ʻeleʻele / ʻeleʻele quinoline melemele, macrogol, iron oxide ʻālana), ka wai maʻemaʻe.

Lapaʻau lāʻau

ʻO Glucovans kahi hui paʻa o nā lawelawe ʻelua hypoglycemic waha, nona nā kulana kākāʻā like ʻole: glibenclamide a me metformin.

ʻO Metformin ka māhele o ka pūʻulu biguanide a hōʻemi i ka pae kiʻekiʻe o nā puna postprandial a me basal glucose i loko o ke koko koko. ʻAʻole ia he mea hoʻoikaika i ka hana insulin, kahi mea e hōʻemi ai i ka liʻiliʻi o ka hypoglycemia. ʻEkolu mau ʻano hana o ke ʻano he ʻano mea:

• pale ʻana o ka hoohohena ʻana o ka glucose i loko o ke kaomi hanā,
• hoʻonui i ka manaʻo o ka receptors insulin peripheral, e hoʻonui ana i ka ʻai a me ka hoʻohana ʻana i ka glucose i nā ʻōpū mālamalama,
• Ka hoʻohemo ʻana i ka hoʻohuihui glucose i ka ate ma ka pale ʻana i ka glycogenolysis a me ka gluconeogenesis.

Hoʻohana maikaʻi ʻia ka Metformin i ka hana lipid o ke koko, hoʻēmi i ka paʻa ʻana o ka triglycerides, haʻahaʻa lipoproteins haʻahaʻa (LDL) a me ka nui o ka cholesterol.

ʻO Glibenclamide kahi lua o ka ʻoniʻoni sulfonylurea. Hōʻemi ka pae glucose i ka wā o ka mālama ʻia o kēia ʻano ikaika ma muli o ka hoʻōla ʻana i ka hana o ka insulin e nā cell beta i loaʻa i ka pancreas.

He ʻokoʻa nā mīkini o ke ʻano o ka metformin a me nā glibenclamide, akā he mau ʻano synergistic nā mea a hiki ke hoʻōla i ka hana hypoglycemic a kēlā me kēia.

Lapaʻau lāʻau

Hoʻopau i ka ea glibenclamide mai ka gastrointestinal tract ma hope o ka hoʻokūkū waha ma mua o 95%. ʻO kēia māhele ikaika o Glucovans i micronized. Loaʻa ka lōʻihi loa o kahi mea i loko o ka plasma i kahi mau hola 4, a ʻo ka nui o ke kahe ana he 10 mau lita. Hoʻopili ka Glibenclamide i nā protein plasma e 99%. Ma aneane 100% metabolized ma loko o ke akea, hana ʻia ʻelua mau metabolites ʻaʻole i hana, ka mea i hoʻopiʻi ʻia me ka bile (60% o nā kiʻi i hoʻokoʻa ʻia) a me nā urine (40% o nā kiʻi i lawe ʻia). Hoʻololi ʻia ka hapalua hapa ola mai 4 a 11 mau hola.

Ma hope o ka lawelawe waha, ua hopu ʻia ka metformin mai ka gastrointestinal tract piha loa, a hiki i kona pae kiʻekiʻe plasma ke loaʻa i loko o nā hola 2 mau hola. Ma kahi o 20-30% o ka waiwai e hoʻopihapiha ʻia mai ka hana o ka digestive i loli ʻole. ʻO ka bioavailability piha kūpono he 50-60%.

Kuhi ʻia ka metformin i loko o nā ʻili me ka wikiwiki kiʻekiʻe, a me kona ʻano o ka pilina ʻana i ka protein plasma heʻuʻuku. Hoʻopili iki ʻia ia mea a hoʻomāhele ʻia ma o nā keiki. ʻO ka hoʻopau hapa hapalua-ola ma ka manawa 6.5 mau hola. I ka poʻe maʻi me ka renal dysfunction, aia ke emi ʻana o ka hoʻomaʻemaʻe renal a me ka hoʻonui ʻana i ka hapalua-ola, ke alakaʻi nei i ka hoʻonui o ka manaʻo o ka metformin i ka plasma koko.

ʻO ka hui pū ʻana o ka glibenclamide a me ke metformin i loko o kahi lāʻau i hōʻike ʻia e ka bioavailability like like me ka lawe ʻana i nā palapala papa i loaʻa i kēia mau mea kaha. ʻAʻole make ka ʻai i ka bioavailability o Glucovans, ʻo ia kahi hui o glibenclamide a me nā metformin. Eia naʻe, hiki i ka nui o ke kaila o ka glibenclamide ke lawe ʻia me ka piʻi ʻana o ka meaʻai.

Nā hōʻailona no ka hoʻohana ʻana

E like me nā ʻōkuhi, ua kuhikuhi ʻia ʻo Glucovans no nā pākeke me ka maʻi ʻōmaʻomaʻo type 2 inā:

• ʻO ka monotherapy o mua me ka sulfonylureas a i like me ka metformin, pono i kaʻai ʻana a me ka hoʻoikaika kino.
• ʻO ka hana hui pū me nā metformin a me nā derivatives o sulfonylurea i loko o nā mea maʻi me ka glycemia paʻa pono a paʻa i ka maʻi maʻi e pono ke hoʻololi i ka monotherapy.

Nā Hoʻohui

• ʻAno maʻi type 1
• ʻO ka precoma Diabetic a me ka coma
• Maʻi molaʻi
• Lactic acidosis, me ka mōʻaukala o
• ʻO Renal a me / a i ʻole ka palupalu oʻe,
• Renal hoʻokaumaha hana (clearance hana (QC)
• Nā hopena o nā hopena e hana ai i nā loli
• Porphyria
• Tissue hypoxia ma mua o nā huaʻeha a me nā hopena o ke ea a i ʻole ka huhū ʻana o ka ʻōpū a me nā puʻuwai, nā neʻe, ka wā kokoke i ka myocardial infarction,
• ʻO ka wā hapai a me ka umauma,
• ʻO ka hoʻohana mua ʻana o ka miconazole,
• ʻO ka maʻi nui
• Ka make wai hoʻowahāwahā, hoʻonāukiuki i ke ʻano waiona,
• ʻO ka hoʻokō me ka meaʻai hypocaloric (ʻoi aku ma mua o 1000 kcal i kēlā me kēia lā),
• Glucose-galactose malabsorption syndrome, galactose intolerance, lactase nele,
• Ke lalo o 18 mau makahiki
• He mau makahiki i luna o 60 mau makahiki, i ka wā e hoʻokō ai i ka kaumaha kino kino (me ka hopena o ka lactic acidosis),
• ʻO ka hypersensitivity i nā māhele o ka lāʻau lapaʻau a i nā derivatives sulfonylurea ʻē aʻe.

Me ka mālama aka, ua ʻōlelo ʻia nā Glucovans no: nā maʻi o ka momona thyroid me ka hoʻopiʻi ʻole ʻia ʻana o kāna hana, adrenal insufficiency, febrile syndrome, hypofunction o ka aniani pituitary gland.

Nā ʻōkuhi no ka hoʻohana ʻana o Glucovans: ke ʻano a me ka helu ʻana

Noi ʻia nā papa ʻaʻa Glucovans e lawe pū me nā meaʻai, a me nā mea he nui o ka mauʻu i mea e pono ai i loko o kaʻai.

Kūkulu ke kauka i ke kū hoʻokahi i ka helu ʻana, me ka noʻonoʻo ʻana i ke kiʻekiʻe o ka glycemia.

ʻO ka ʻōlelo mua he 1 papa Glucovans 2.5 mg / 500 mg a i ʻole Glucovans 5 mg / 500 mg hoʻokahi i ka lā.

Ke hoʻoneʻe nei i ka mea maʻi me ka hui pū a i ʻole monotherapy me sulfonylurea a me ka metformin i ka hoʻōla ʻana o Glucovans, i mea e pale ai i ka hypoglycemia, ʻaʻole pono ka nui o ka hopena mua ma mua o ka hopena i kēlā me kēia lā i mua o ka lāʻau i lawe ʻia ma mua. No ka hoʻokō ʻana i ke kaona kūpono o ke koko, e hoʻonui pono ʻia ka nui o nā lewa, ʻaʻole iʻoi aʻe ma mua o 5 mg / 500 mg i kēlā me kēia lā i ʻelua mau pule a i ʻole ka liʻiliʻi. Pono e hoʻoponopono ʻia ka dosis ma muli o ka pae o ka glycemia.

ʻO ka nui loa o nā lā i kēlā me kēia lā he 4 papa Glucovans 5 mg / 500 mg a i nā papa 6,5 ​​2.5 mg / 500 mg. Hoʻoholo ka ʻāhewa o nā papa ma ke kanaka hoʻokahi, kau ʻia ia i kēlā me kēia lā o ka lāʻau lapaʻau.

• 1 papa (ʻo kekahi ʻano lau) - 1 mau lā i ka lā, i ke kakahiaka
• 2 a i ʻole ʻehā mau papa (me kekahi manaʻo hou) - 2 mau manawa i ka lā, kakahiaka a i ke ahiahi
• 3, 5 a 6 paha mau papa o 2.5 mg / 500 mg a i ʻole 3 mau papa o ka 5 mg / 500 mg - 3 mau manawa i ka lā, pono ʻia i ke kakahiaka, ahiahi a me ke ahiahi.

No nā poʻe maʻi ʻelemakule, ʻaʻole eʻoi aku ka make o ka mua ma mua o ka 1 papa 2.5 mg / 500 mg. ʻO ke kumu o ka ʻikepili a me ka hoʻohana ʻana o Glucovans e nānā pono ʻia no ka hana ʻole.

Nā hopena hopena

• Mai ka pūnaehana ʻana: pinepine pinepine - ka nele o ka makemake, ka ʻōpū, ka ʻeha o ka ʻōpū, ka luaʻi, ke kuʻi ʻana. Hōʻike mau nā hōʻailona ma ka hoʻomaka ʻana o ka ʻoihana a me ka wā pōkole. Kuhi loa ʻole - nā maʻi hana o ka ate, hepatitis,
• Mai nā unuhi sensory: pinepine - he ʻono o ke kala i loko o ka waha. I ka hoʻomaka ʻana o ka ho'ōla, hiki i kahi hiʻona pōkole ke manawa.
• Mai ka ʻaoʻao o ka hana metabolism: hypoglycemia, ʻokoʻa - ka hoʻouka ʻana i ka porphyria ʻili a me nā puʻu porphyria, aneane loa - ka lactic acidosis. Me ka hoʻomohala lōʻihi - kahi emi o ka pae o ka neʻe o ka vitamin B12 i ka serum koko (hiki i ka meemia megaloblastic). E kūʻē i ke kūmole i ka inu ʻona, kahi ʻano like ʻole o disulfiram.
• Hematopoietic i nā ʻōpio: līpoki - thrombocytopenia a me leukopenia, loa loa - pancytopenia, hemolytic anemia, iwi molowela aplasia, agranulocytosis,
• Ma ka ʻāpana o ka ʻili: maʻamau - ʻaina, kānalua-like like ʻole, nui loa - derfitis exfoliative, erythema multiforme, photosensitivity,
• He maʻi kūloko: ʻaʻohe - urticaria, aneane ʻole - visceral a i ʻole pakania vasculitis aʻokiʻoki, kūlohelohe anaphylactic. Me ka hoʻokūkū pinepine, hiki i ka cross-hypersensitivity ka sulfonamides a me kā lākou mea i pae ʻia,
• Nā hōʻailona o ka Laboratory: pinepine - hoʻonui i ka neʻe o ka creatinine a me urea i ka serum o ke koko i ke kiʻekiʻe o ke ʻano, ka liʻiliʻi loa - hyponatremia.

Ke keu

Hiki i kahi overdose o Glucovans ke hoʻonāukiuki i ka hoʻomohala ʻana o ka hypoglycemia, no ka mea, he māhele o ka sulfonylurea.

ʻO nā hōʻailona o ka palekane i ke hypoglycemia maʻalahi i ke kaawale ʻole o nā pilikia o ka pūnao a me ka syncope maʻamau e hoʻoponopono ʻia e ka koke o ke kō. Pono ʻoe e hoʻoponopono i nā haʻahaʻa o nā Glucovans a me / a hoʻololi i ka ʻai. Inā ʻike ka poʻe maʻi me ka maʻi mellitus i ke ʻano maʻi hypoglycemic kino, i hele pū ʻia me nā paroxysm, coma a i ʻole nā ​​pilikia neurological, pono ke hoʻolako ʻia ka mālama maʻi olakino. Ma hope koke iho o kahi hana maʻi a i ʻole ma ka hoʻohaʻahaʻa iki ʻana o ka hypoglycemia, hoʻākāka koke ʻia ʻo kahi hopena dextrose ma mua o ke kau ʻia ʻana o ka mea maʻi i loko o ka haukapila. Ma hope o ka loaʻa hou ʻana o ka mea maʻi, pono e hāʻawi ʻia ʻo ia i ka ʻai i nā momona momona, nā mea maʻalahi i ka maʻalahi, e pale aku i ka hoʻomohala ʻana o ka hypoglycemia.

ʻO ka hoʻokele lōʻihi o ka poʻe Glucovans i nā kiʻekiʻe kiʻekiʻe a i ʻole nā ​​hopena pākuʻi conjugate i hiki ke alakaʻi i ka hoʻomohalaʻana o ka acidosis lactic, no ka mea, ʻo ka metformin he ʻāpana o ka lāʻau. Manaʻo ʻia ka acidact lactic i kahi kūlana e koi ai i ka mālama mālama olakino, a pono e mālama ʻia kona ʻano ma ka haukapila. ʻO nā ala e ʻoi aʻe ana o ka hopena o ka maʻi e hoʻolaha i ka excretion o ka lactate a me ka metformin e pili ana i ka hemodialysis.

I ka poʻe maʻi me nā maʻi o ka ate, hiki ke hoʻonui i ka kaila o ka glibenclamide i loko o ke koko koko. No ka mea ikaika loa kēia waiwai i nā protein plasma koko, ʻo kona kinai ʻana i ka wā o hemodialysis, ʻaʻole paha.

Nā ʻōlelo kikoʻī

Hoʻomaopopo ʻia ka hoʻomaʻamaʻa ʻia me ka nānā ʻana me ka mālama pinepine ʻana o ka ʻaihue koko hoʻoliʻiliʻi a ma hope o ka ʻai ʻana.

I ka wā o ka hoʻokele ʻana o Glucovans, pono ia e noʻonoʻo i ka hiki ke hoʻomohala ʻana i ka acidosis lactic, ʻo nā hōʻailona o ka maʻi ka mea e like me ka ʻeha o ka ʻōpū, nā hōʻeha kino, nā ʻōpū māiwi a me nā mea hoʻoweliweli dyspeptic.

Ke kau nei iā Glucovans, aia kahi pilikia o ka hoʻomohala ʻana i ka hypoglycemia, ʻoiai nui ka mea i loaʻa i ka poʻe maʻi ma ka haʻahaʻa haʻahaʻa o ka laikini haʻahaʻa, ke hele nei ma ka inu ʻana i ka ʻai, inu ka wai, loaʻa ka nui o ke kino me ka ʻai hypocaloric. ʻO ka mālamaʻana i ka kuhikuhi ʻana, mālama pono o ka maʻi a me ke kāpae ʻana i nā ʻōlelo manaʻo o ke kauka e hōʻemi i ka maʻi o ka maʻi.

Lā ʻia ka inu ʻawaʻī i ka wā o ke ʻano.

Ma mua o ka manawa e koho ʻia ai ʻo Glucovans a ma ka manawa o ka hoʻokele ʻana, pono e mālama ʻia nā haʻawina maʻamau e hoʻoholo i ka pae o ka serum creatinine concentrations. Pono e hana ʻia ka loiloi i nā maʻi me ka hana maʻamau ka liʻiliʻi o ka manawa 1 ma ka makahiki, me ka hoʻomaʻamaʻa ʻana o nā pēpē a me nā mea maʻi makua - ʻo 2 mau manawa i kēlā me kēia makahiki.

Inā loaʻa nā maʻi lēʻeha o ka bronchi, māmā, a i ʻole nā ​​ʻāpana urogenital, e kūkā koke i kahi kauka.

ʻŌpū a me ka lactation

ʻO ka hoʻomaka ʻana o ka hāpai ʻana he contraindication i ka hoʻohana ʻana o nā glucovans. Pono e hoʻomaopopo ʻia nā mea maʻi i ka wā o ka mālama ʻana me ka lāʻau lapaʻau e pono lākou e hoʻomaopopo i ke kauka e pili ana i ka hoʻolālā o ka hāpai ʻana a i kona hoʻomaka. I kēia mau pilikia ʻelua, hoʻokaʻawale koke ʻia ʻo Glucovans a ua kuhikuhi ʻia kahi papa o ka hana maʻi insulin.

ʻAʻohe ʻike e pili ana i ka hiki ke metformin i hui pū me ka glibenclamide e hoʻoheheʻe i ka waiū umauma, no laila, ʻaʻole kūpono ke koho pono ʻana i ka lāʻau i ka wā lactation.

Hoʻohana i ka wā kahiko

Hoʻokumu ʻia ka hopena no nā poʻe maʻi maʻi e mālama i ke ʻano o ka hana ʻana, kahi mea e loiloi pinepine ʻia. ʻO ka ʻōmua mua ma nā mea maʻi o kēia ʻāpana he 1 papa 2.5 mg / 500 mg.

ʻAʻole ia e ʻōlelo i hoʻohana i ko Glucovans i nā maʻi me ko lākou makahiki ma mua o 60 mau makahiki a ʻo kāna kino e hoʻopilikia i ka hoʻoikaika kino kino, i wehewehe ʻia e ka piʻi nui o ka hoʻomohala lactic acidosis i loko o lākou.

Hoʻohui nūhou

Pono e mālama ʻia ka hoʻokele ʻana o Glucovans i 2 mau lā ma mua a hoʻolaʻa i 2 mau lā ma hope o ka hoʻokele ʻana i loko o nā ʻāpana ʻokoʻa i loko o ka iodine.

Hoʻololi ʻia ka hoʻohana ʻana i ka hoʻohana ʻana i ka miconazole, ma muli o ka hiki ke hoʻonui i ka hypoglycemia, a hiki i kahi coma.

ʻAʻole i hui pū ʻia ka hui ʻana me ka lāʻau e loaʻa ana me nā eʻemika e pili ana i ka etanol a me ka phenylbutazone, no ka mea, hoʻonui lākou i ka hopena hypoglycemic o Glucovans.

Me ka hoʻohana pū ʻana me ka bosentan, hoʻonui i ka nui o ka hana hepatotoxic, e emi ana ka hopena o ka glibenclamide.

Hoʻemi iki ka nui o ka chlorpromazine i ka hoʻokuʻuʻana i ka insulin, e hāʻawi ana i ka hoʻonui i ka glycemia.

Ka hopena o ka hypoglycemic o Glucovans i ka wā i hui pū ʻia me glucocorticosteroids, tetracosactide, diuretics, danazol a me beta2-adrenergic agonists.

ʻOiai e lawe me ka angiotensin-hoʻohuli i ka enzyme (ACE) inhibitors, me ka enalapril a me ka captopril, aia kekahi i ka emi o ka glucose koko.

Pono ka hui pū me ka metformin i ka mālama pono i ka poʻe maʻi me ka hana ʻole o ka renal o ka hana, ʻoiai ke kiʻekiʻe ka ulu ʻana o ka acidosis lactic me ka hoʻohana ʻana o ka "diuretics" loop.

ʻO ka hui pū ʻana o Glucovans me sympathomimetics, beta-blockers, reserpine, clonidine, guanethidine hūnā i nā hōʻailona o ka hypoglycemia.

Pono ka hoʻoponopono ʻana i ka dosis i ka wā e lawe ai i ka fluconazole, aia kahi hewa o ka hypoglycemia.

Hoʻololi ʻo Glibenclamide i ka hopena antidiuretic o ka desmopressin.

Hoʻonui ka hopena hypoglycemic of Glucovans me ka hoʻohana like ʻana me ka monoamine oxidase inhibitors (MAOs), sulfonamides, anticoagulants (Coumarin derivatives), fluoroquinolones, chloramphenicol, pentoxifylline, lipid-hoʻemi iho i nā lāʻau lapaʻau mai ka pūʻulu o nā fibrates, disopyramide.

ʻO nā mea hoʻohālikelike Glucovans o: Glybomet, Glukonorm, Glyukofast, Bagomet Plus, Metformin, Siofor.

Nā Hōʻike Kūkulu

Hoʻomaʻi pinepine nā mea maʻi me ka maʻi maʻi i ka loiloi o Glucovans ma ka pūnaewele. Pili pinepine lākou i nā pilikia e pili ana i ke koho koho a me nā regimens o ka mālama ʻana, a me kona hoʻokele pū ʻana me nā lāʻau ʻē aʻe. Eia naʻe, kūlike loa nā loiloi lākou iho. Ke ʻōlelo nei nā hōʻike i mea e hoʻokō ai i ka hopena kiʻekiʻe loa i ka wā e pono ai ka mālama ʻana, pono ia e helu i ka helu o nā kaloli a me ke kō o ka kalaka, me ke kāʻei ʻana i ka akahele akahele pono o ka ʻimi ʻana o nā lāʻau.

Eia nō naʻe, aia kekahi mau manaʻo e pili ana i ka lapuwale o Glucovans. Hoʻopiʻi ka poʻe maʻi i ka nele o ka hoʻomaikaʻi ʻana i ka maikaʻi a me nā manaʻo koʻikoʻi mai ka neʻe maʻamau o ka honi ma ke koko (hypoglycemia). Ua hōʻike kekahi mau maʻi ʻē aʻe i ka hoʻomaʻamaʻa i ko lākou olakino ke hele aku lākou i ka hoʻoponopono lōʻihi a me ka hoʻoponopono pono o ka hoʻoponopono regimen a me ke ʻano.

Hoʻokuʻu ka poʻe Glucovans i ka hoʻopihapiha, hoʻopihapiha hoʻopihapiha a me ka hoʻonohonohoʻana.

Hoʻopili ʻia nā papa me ke aniani ʻulaʻula māmā, nā ʻano capsule, biconvex, me kahi kālai ʻia o "2.5" ma kahi ʻaoʻao.

1 kōpō
metformin hydrochloride
500 mg
glibenclamide
2,5 mg

Nā mea kūʻokoʻa: povidone K30, magnesium stearate, sodium croscarmellose, microcrystalline cellulose, Opadry (Opadri) OY-L-24808, wai maʻemaʻe.

15 ʻona. - blisters (2) - nā pahu pahu.
20 mau kāleka. - blisters (3) - nā pahu pahu.

ʻO nā papa i uhi ʻia he mau kapa ke ʻano, he biconvex, me kahi kālai "5" ma hoʻokahi ʻaoʻao.

1 kōpō
metformin hydrochloride
500 mg
glibenclamide
5 mg

Nā mea kū'ē: povidone K30, magnesium stearate, sodium croscarmellose, microcrystalline cellulose, Opadry (Opadri) 31F22700, wai maʻemaʻe.

15 ʻona. - blisters (2) - nā pahu pahu.
20 mau kāleka. - blisters (3) - nā pahu pahu.

Kahi ʻia ka wehewehe ʻana o ka lāʻau lapaʻau ma luna o nā kuhikuhi i pili i ka hoʻohana.

ʻO ka hana lāʻau Līpika

Hoʻohui ʻia nā lāʻau hypoglycemic no ka hoʻohana waha.

ʻO Glucovans kahi hui paʻa i nā lawelawe ʻelua o ka hypoglycemic waha o nā hui lāʻau lapaʻau like ʻole.

Aia ʻo Metformin i ka hui o ka biguanides a hōʻemi i ka hoʻoliʻi serum ma o ka hoʻonui ʻana i ka ʻike ʻana o nā ʻiʻo peripheral i ka hana o ka insulin a hoʻonui i ka uptake glucose. Hoʻopili ʻo Metformin i ka lawe ʻana mai o nā kapoʻai mai ka papa hana ʻole a ke pale aku i ka gluconeogenesis ma loko o ka ate. Loaʻa iā ia kekahi hopena maikaʻi na ka lipid komposisyon o ke koko, e hoʻemi i ka pae o ka kolamu, ka LDL a me TG.

ʻO Glibenclamide e pili ana i nā derivatives o ka sulfonylurea o ka lua o ka hanauna. ʻO ka pae o ka glucose i ka wā e lawe ai i ka glibenclamide e hōʻemi ma muli o ka hoʻouluʻana o ka insulin huna i nā ʻāpana pancreatic.

ʻO ka dosis a me ke ala o ka hoʻokele lāʻau.

Hoʻoholo ʻia ka nui o ka lāʻau e ke kauka ponoʻī no kēlā me kēia maʻi, e pili ana i ka pae o ka glycemia.

ʻO ka maʻamau, ʻo ka pākaukau mua o Glucovans he 1 mau papa. 500 mg / 2,5 mg i kēlā me kēia lā. Ke hoʻohālikelike nei i ka lāʻau hui mua me ka metformin a me ka glibenclamide, ua kau ʻia nā papa 1-2. ʻO Glucovansa 500 mg / 2.5 mg hilinaʻi ma mua o ka pae o ka pae ma mua. I kēlā me kēia 1-2 mau pule ma hope o ka hoʻomaka ʻana o ka hoʻōla, hoʻoponopono ʻia ke ʻano ma muli o ke ʻano o ka glycemia.

Pono e lawe ʻia nā papa me nā meaʻai.

ʻO ka palena nui loa i kēlā me kēia lā he 4 papa. ʻO Glucovansa 500 mg / 2.5 mg a i ʻole 2 mau pālaha. Glucovansa 500 mg / 5 mg.

Hoʻopuka ʻaoʻao Glucovans:

Mai ka pūnaehana ʻana: ma ka hoʻomaka ʻana o ka mālama ʻana, ka nausea, ka luaʻi, ka ʻōpū o ka ʻōpū, hiki ke hōʻemi ʻia ka momona (i ka hapa nui, hele a kūʻokoʻa ʻole i ke ʻano o ka hoʻouka ʻana, e pale i ka hoʻomohala ʻana i kēia mau ʻōmole, ua ʻōlelo ʻia e lawe i ka lāʻau lapaʻau i ka 2 a i ʻole 3 nā helu ʻana, hoʻolōʻihi ka hoʻonui ʻana i ka wai o ka lāʻau hoʻomaikaʻi hou i kona ʻae ʻia), hiki i kahi ʻono "metallic" i loko o ka waha.

ʻO kekahi: erythema, anemia megaloblastic, lactic acidosis.

Mai ka pūnaehana hana ʻana: ka nausea, luaʻi, ʻeha o ka epigastric, hoʻonui i ka hana o nā enzyme o ka ate.

Mai ka pūnaehana hemopoietic: leukopenia, thrombocytopenia, ʻaʻole hanana - agranulocytosis, hemolytic anemia, pancytopenia.

He maʻi kūloko: - urticaria, rash, skin itching.

Nā kumuhana hou: hypoglycemia, disulfiram-like reaksi i ka wā e lawe ana i ka waiʻona.

ʻO nā ʻōlelo kūikawā no ka hoʻohana ʻana iā Glucovans.

I ka wā o ka mālama ʻana me Glucovans, pono ia e kiaʻi pono i ka pae o ka glucose i loko o ke koko ma ka ʻōpū ʻole a ma hope o ka ʻai ʻana.

Hoʻomaʻamaʻa ʻia ka mea maʻi inā inā i ka uʻi a me ka ʻeha o ka ʻōpū e hele pū ai me nā ʻehaʻeha o ka hooweliweli a me ka ʻānū maʻamau e hele mai i ka wā ʻo Glucovans e hoʻomaʻamaʻa, a laila pono e hoʻokaʻawale ʻia nā lāʻau a pono e kūkā koke i kahi kauka, no ka mea, ʻo kēia mau hōʻailona paha nā hōʻailona o ka lactic acidosis.

Pono ka mea maʻi e hoʻomaopopo i ke kauka e pili ana i ke ʻano o kahi maʻi bronchopulmonary a i ʻole he maʻi urinary tract.

ʻO 48 mau hola ma mua o ka ʻoi a i ʻole ka hoʻomalu iv ka ʻaina i ʻike ʻia e nā radiopaque iodine. Noi ʻia ke ʻano o Glucovans e hoʻomau ʻia ma hope o 48 mau hola.

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

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

I ka wā o ka mālama ʻana me Glucovans, ʻaʻole pono kahi e hana i nā hana i koi ʻia ka nui o ka nānā a me ka wikiwiki o ka hopena psychomotor.

Hoʻopili ke Glucovans me nā lāʻau lapaʻau ʻē aʻe.

Nā huahana Glucovans-hoʻomaikaʻi (hoʻonui i ka nui o ka hypoglycemia)

Me ka hoʻohana like ʻana me Glucovans, hiki i ka miconazole ke hoʻonāukiuki i ka hoʻokumu ʻana o ka hypoglycemia (a hiki i ke kūkulu houʻana o ka coma).

Hoʻonui ka Fluconazole i ka T1 / 2 o nā derebatives sulfonylurea a hoʻonui i ka pilikia o ka hopena hypoglycemic.

Hoʻonui ka hoʻonuiʻaila o ka waiʻona i ka hopena o ka hopena hypoglycemic (a hiki i ke kūkulu houʻana i ka coma). I ka wā o ka mālama ʻana me Glucovans, inu wai a me nā lāʻau lapaʻau e loaʻa ana i ka ethanol (waiʻona) pono e pale ʻia.

ʻO ka hoʻohana ʻana o ka inhibitor ACE (captopril, enalapril) e hoʻonui i ka hiki ke hoʻomohala ʻana i nā hopena hypoglycemic i ka poʻe maʻi me ka maʻi mellitus i ka mālama ʻana i nā derivatives o ka sulfonylurea ma ka hoʻomaikaʻi ʻana i ke kūmole glucose a hōʻemi i ka pono o ka insulin.

Hoʻonui ka poʻe Beta-blockers i ka ulu a me ka koʻikoʻi o ka hypoglycemia. Nā hōʻailona Beta-blockers mask o hypoglycemia e like me ka palpitations a me ka tachycardia.

ʻO nā lāʻau lapaʻau e hoʻonāwaliwali i ka hopena o nā glucovans

Loaʻa iā Danazole kahi hopena hyperglycemic. Inā makemake ʻia ka mālama ʻana me ka danazol a i ka manawa e hoʻoneʻe ʻia ai kahi hopena, pono ʻia kahi hoʻoponopono hoʻoponopono o nā Glucovans ma lalo o ka hoʻomalu ʻana o ka pae glycemia.

ʻO Chlorpromazine ma nā kuʻekuʻe kiʻekiʻe (100 mg / lā) e hoʻonui ai i ka glycemia.

Hoʻonui ka GCS i ka glycemia a hiki i ke alakaʻi i ka uluʻana o ka ketoacidosis.

Hoʻonui ka Beta2-adrenostimulants i ke kiʻekiʻe o ka glycemia ma muli o ka hoʻouluʻana o ka mea hoʻokele 2-adrenergic.

Hoʻopilikia ka diuretics (ʻoi aku ka "loopbacks") i ka hoʻomohala ʻana o ka ketoacidosis ma muli o ka hiki ʻana o ka hana hoʻopaleha hana.

I / i ka hoʻomaka ʻana o nā mea hoʻonaninani iodine e hiki ai i ka hoʻomohala ʻana o ka hana renal, e huli ai i ka cumulation o ka lāʻau i loko o ke kino a me ka hoʻomohala ʻana i ka acidosis lactic.

Nā hōʻailona Beta-blockers mask o hypoglycemia, e like me ka palpitations a me ka tachycardia.

ʻLoe a me ke kākele

Kuhi ʻia nā papa Glucovans no ka hoʻoponopono waha. Lawe ʻia nā papaʻaina i ka wā ʻai, pono e loaʻa ka nui o nā mea laʻa i mea e pale ai i ka hypoglycemia.

Koho ʻia ka nui o ka lāʻau e ke kanaka e hele ana i ke kauka.

ʻO ka papa helu mua o Glucovans he 1 papa (2.5 mg + 500 mg a i ʻole 5 mg + 500 mg) hoʻokahi i ka lā. Manaʻo ʻia e hoʻonui i ka maʻi i kēlā me kēia 2 a i ʻole mau hebedoma eʻoi aʻe ma mua o 500 mg o ka metformin a me 5 mg o ka glibenclamide i kēlā me kēia lā i mea e hoʻomaʻamaʻa maikaʻi ai i nā pae kahe o ke koko.

Ke hoʻololi nei i ka mālama ʻia ʻana o ka hoʻomaʻamaʻa ʻana me ka glibenclamide a me ka metformin, ʻaʻole eʻoi aku ka nui o ka hopena mua ma mua o ke ʻano o ka lā o glibenclamide a me nā metformin i lawe ʻia ma mua. I kēlā me kēia mau pule ʻelua ma hope o ka hoʻomaka ʻana o ka hoʻōla, hoʻoponopono ʻia nā ʻano o ka lāʻau.

ʻO ka nui loa o ka lā ma Glucovans ka nui he 4 papa 5 mg + 500 mg a i ʻole 6 papa 2,5 mg + 500 mg.

Ka hoʻonui ʻia ʻana o ka lāʻau.

• I ke koho ʻana i kahi papa pākahi i kēlā me kēia lā - i ke kakahiaka, i ka ʻaina kakahiaka.
• Me ka koho o 2, 4 papa i kēlā me kēia lā - kakahiaka a me ke ahiahi
• Me ka koho ʻana o 3, 5, 6 papa i kēlā me kēia lā - i ke kakahiaka, kakahiaka a me ke ahiahi.

Pākuʻi helu

500 mg / 2.5 mg a me 500 mg / 5 mg nā papa ʻoniʻoni ʻoniʻoni

Chaʻalele

Ka helu 500 mg / 2.5 mg

Aia ma ka papa papa

mea waiwai: metformin hydrochloride 500 mg

kaomi 2,5 mg,

nā mea hoʻowalewale: sodium croscarmellose, povidone K 30, cellulose microcrystalline, magnesium stearate

ka hui ʻana o ka ʻani film Opadry OY-L-24808 he pink: ka lactose monohidate, hypromellose 15cP, macrogol, titanium dioxide E 171, ka mea hao kaole i ka meli E 172, ka mea hoʻoneʻeke pōpole ʻula E 172, ka mea ʻona pōpoki ʻeleʻele E 172.

Dosisage 500 mg / 5 mg

Aia ma ka papa papa

mea waiwai: metformin hydrochloride 500 mg

huʻaoleʻa 5 mg,

nā mea hoʻowalewale: sodium croscarmellose, povidone K 30, cellulose microcrystalline, magnesium stearate

ka hui ʻana o ka ʻoni kiʻi ʻoniʻoni Opadry 31-F-22700 ʻalani: melactose monohilate, hypromellose 15 cP, macrogol, quinoline ʻāmole varnish E 104, titanium dioxide E 171, hao ʻōpala hoʻoneʻe ʻeleʻele E 172, hao ʻeleʻio ʻulaʻula E 172.

Ka helu 500 mg / 2.5 mg: nā papa i hoʻohui ʻia me ke membrane kiʻi o ke kala kala ʻulaʻula, i kālai ʻia me kahi papa biconvex a me ke kahakaha "2.5" ma kahi ʻaoʻao.

Dosisage 500 mg / 5 mg: nā pihi i ulana ʻia me kahi ʻāpana kiʻi ʻoniʻoni, ulana ʻia me ka papa biconvex a me ke kahakaha "5" ma kahi ʻaoʻao.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO Metformin a me Glibenclamide

ʻO ka bioavailability o ka metformin a me glibenclamide e hui pū ai me ka bioavailability o ka metformin a me ka glibenclamide ke lawe like ʻia i ka hana o ka hoʻomākaukau monocomponent. ʻAʻole pili ka ʻai i ka bioavailability o ka metformin i hui pū me ka glibenclamide, a me ka bioavailability o glibenclamide i hui pū me ka metformin. Eia nō naʻe, piʻi ka nui o ka emi ʻana o ka glibenclamide me ka ʻaina meaʻai.

Ma hope o ka hoʻoponopono waha ʻana i nā papa metformin, hiki ke piʻi ka nui o ke kaila plasma (Cmax) ma hope o nā hola 2.5 (Tmax). ʻO ka bioavailability pololei ma nā kānaka olakino he 50-60%. Ma hope o ka lawelawe waha, 20-30% o metformin e hoʻopiʻi ʻia ma o ka gastrointestinal tract (GIT) i loli ʻole.

Ke hoʻohana nei i ka metformin ma nā māmā a me nā ʻano o ka hoʻokele ʻana, ʻike ʻia kahi kōla plasma mau i loko o 24-48 mau hola a ʻoi aku ka liʻiliʻi ma mua o 1 μg / ml.

ʻO ka palena o ke hāpili ʻana o ka metformin i nā protein o ka plasma he lapuwale. Kahi ʻia ka metformin ma loko o nā ʻāpana koko ʻula. ʻO ka pae kiʻekiʻe loa i ke koko ka haʻahaʻa ma lalo o ka plasma a ua hōʻea ma kahi o ka manawa. ʻO ka nui nui o ka hoʻoili ʻana (Vd) he 63-276 lita.

Hoʻopili ʻia ʻo Metformin i loko o ka urine. ʻAʻole i hōʻike ʻia ka metformin metabolites i nā kānaka.

ʻO ka hoʻomaʻemaʻe ʻana o ka metformin i ʻoi aku ma mua o 400 ml / min, e hōʻike ana i ke kāpae ʻana o ka metformin e hoʻohana ana i ka filomation glomerular a me ka hilo tubular. Ma hope o ka lawelawe waha, ua kokoke ka hapalua o nā ola he 6.5 hola.

I ka hihia o ka hana renal maʻi ʻole, hōʻemi ka pale ʻana i ka hapa i ka hoʻomaikaʻi ʻana i ka hana o ka creatinine, a no laila e pau ka hapalua o ke ola he nui, e alakaʻi ana i ka nui o ka pae metformin plasma.

Ke hoʻokau ʻia, mālamaʻia mai ka gastrointestinal tract ma mua o 95%. Loaʻa ʻia nā kīpī plasma kiʻekiʻe ma hope o ka 4 mau hola. ʻO ke kamaʻilio me nā protein plasma he 99%.

Hoʻololiau ka Glibenclamide i loko o ka pēpē e hana i ka metabolites ʻelua.

Hoʻololi piha ʻia ʻo Glibenclamide mai ke kino ma hope o nā hola 45-72 i ke ʻano o ka metabolites: me ka hua bile (60%) a me ka urine (40%). ʻO ka hapa hope o ka ola he 4-11 hola.

ʻO ka haʻahaʻa o ka Hepatic e hōʻemi i ka hana o ka glibenclamide a hoʻohaʻahaʻa nui i kona excretion.

Hoʻonui ka biliary o nā metabolites i ka hihia o ka hana ʻole o ka renal (ma muli o ka paʻakikī o ka hana o ka renal) i ka pae o ka hoʻomaʻamaʻa creinine o 30 ml / min. No laila, ʻaʻole pili ka hopena o ka renal i ka excretion o glibenclamide, aʻo ka clearance clearance e noho ma kahi pae ma luna o 30 ml / min.

Pharmacokinetics i loko o nā hui hoʻomanawanui kūikawā.

ʻO nā maʻi maʻi Pediatric

ʻAʻohe ʻokoʻa ʻole i ka pharmacokinetics o metformin a me glibenclamide i nā keiki a me nā mākua olakino.

Lapaʻau lāʻau

ʻO ka metformin kahi biguanide me ka hopena antihyperglycemic, kahi e hoʻemi ai i nā pae glucose a me ka postprandial plasma kiʻekiʻe. ʻAʻole ia e hoʻoulu i ka huna huna o ka insulin a no laila ʻaʻole e kumu i ka hypoglycemia.

Loaʻa iā Metformin 3 mau hana:

hōʻemi i ka hana glucose glucose ma ka pale ʻana i ka glucoseoneogenesis a me ka glycogenolysis,

hoʻomaikaʻi i ka hoʻomaʻamaʻa ʻana a me ka hoʻohana ʻana i ka glucose o peripheral i loko o nā ʻōpū ma ka hoʻonui ʻana i ka naʻau o ka insulin,

lolo i ka lilo ʻana o ka glucose i loko o nā ʻāpana.

Hoʻonohonoho ka Metformin i ka hoʻopili ʻana o ka glycogen intracellular ma o ka hana ʻana ma ka synthase glycogen. Hoʻonui pū ia i ka hiki ke ʻano o nā ʻano mea ʻehā o ka membrane glucose transport (GLUT).

ʻO kaʻoluʻolu o kona hopena ma ka glycemia, he hopena maikaʻi ka metformin ma ka lipid metabolism. I ka wā i hoʻopaʻa ʻia ai nā hoʻokolohua paʻa i ka hoʻohana ʻana i nā kūmole therapeutic, ua loaʻa i ka metformin e hōʻemi ana i ka nui kolamu, nā lipoproteins haʻahaʻa haʻahaʻa a me nā triglycerides. ʻAʻole i ʻike ʻia kēlā mau hopena i ka lipid metabolism i ka wā o nā hoʻokolohua lapaʻau me ka hoʻohana ʻana i ka lāʻau hoʻohui me metformin a me glibenclamide.

ʻO Glibenclamide e pili ana i ka hui o nā luaʻoniʻu lua-me ke aniani o ka lua-ola. ʻO Glibenclamide e hoʻoulu i ka hoʻokaʻina o ke koko, e hoʻoikaika i ka hana o ka insulin e ka pancreas. Pili kēia hana i ka neʻe ʻana o ka hana β-cell o nā mokupuni o Langerhans.

He mea nui ka hana ʻana o ka ʻaihue insulin e ka glibenclamide i ka pane ʻana i ka ʻai i ka meaʻai.

ʻO ka hoʻohana ʻana o ka glibenclamide i nā maʻi me ka maʻi diabetes e hoʻoulu i ka pane i ka postprandial insulin-hoʻoikaika i ka maʻi. ʻO ka hoʻonui ʻana i ka hana postprandial i ke ʻano o ka huna ʻana i ka insulin a me C-peptide e hoʻomau nei no ka liʻiliʻi o 6 mau mahina ma hope o ka mālama ʻana.

He hana pono ka metformin me ka glibenclamide hana like, akā hoʻohui pū kekahi i ka hana antihyperglycemic kekahi. Hoʻolako ʻo Glibenclamide i ka hana ʻana o ka insulin e ka pancreas, a me ka metformin ka hōʻemi ʻana i ka pale ʻana o nā ʻoli i ka insulin ma o ka hana ʻana i kēlā me ke ʻano peripheral (skeletal muscle) a me ka ʻike ʻole ʻana i ka insulin.

ʻLoe a me ke kākele

E lawe ʻia ʻo Glucovans® ma ke alo me ka meaʻai. Hoʻoponopono ʻia ka regimen o ke lāʻau e pili ana i ka meaʻai ʻai pilikino. Pono ka papa ʻaina e hui me ka papa me ka nui o ka haʻalulu ai ka nui o ka puʻukū e pale i ka loaʻa ʻana o ka hypoglycemia.

Pono ke hoʻoponopono o ka lāʻau lapaʻau ma muli o ka pane ʻana i ka metabola kū hoʻokahi (pae kiʻekiʻe o ka glycemia, HbA1c).

Hiki ke hoʻohana nui ʻia nā Glucovans 500 mg / 5 mg ma nā mea maʻi ʻaʻole i loaʻa ka mana kūpono i ka wā e lawe ai i ka Glucovans 500 mg / 2.5 mg.

Hoʻomaka ka hoʻomaʻamaʻa ʻana me kahi mahele o ka lāʻau i hui ʻia e like me nā koina o ka metformin a me nā glibenclamide. Pono e hoʻonui pinepine ʻia ka pākēneka e pono i ka pae o nā hoʻohālikelike glycemic.

Hoʻoponopono ʻia ke ʻano i kēlā me kēia 2 a i ʻole mau hebedoma he hoʻonui me 1 papa, e pili ana i ke kiʻekiʻe o ka glycemia.

ʻO ke hoʻonui hoʻonui i ka maʻi nui e hiki ke kōkua i ka hoʻohaʻahaʻa ʻana i ka ʻaihue gastrointestinal a pale i ka hoʻomohala ʻana o ka hypoglycemia.

ʻO ka palena kiʻekiʻe loa no kēlā me kēia lā no Glucovans® 500 / 2.5 he 6 papa.

ʻO ka nui loa o ka lāʻau no kēlā me kēia lā no Glucovans® 500/5 mg he 3 papa.

I nā hihia kūʻokoʻa loa, hiki ke hoʻonui ʻia kahi nui e piʻi me 4 mau papa o ka lāʻau Glucovans® 500 mg / 5 mg i kēlā me kēia lā.

No ka helu ʻana i ka lāʻau Glucovans® 500 mg / 2.5 mg

I ka lā hoʻokahi: i ke kakahiaka i ka ʻaina kakahiaka, me ke koho ʻana o ka papa 1 papa i ka lā.

ʻElua lā i hoʻokahi lā: ke kakahiaka a me ke ahiahi, me ke koho ʻana o 2 a 4 mau papa i ka lā.

ʻEkolu lā i kahi lā: kakahiaka, ahiahi a me ke ahiahi, me ke koho ʻana o 3, 5 a 6 mau papa i ka lā.

No ka helu ʻana i ka lāʻau Glucovans® 500 mg / 5 mg

I ka lā hoʻokahi: i ke kakahiaka i ka ʻaina kakahiaka, me ke koho ʻana o ka papa 1 papa i ka lā.

ʻElua lā i hoʻokahi lā: ke kakahiaka a me ke ahiahi, me ke koho ʻana o 2 a 4 mau papa i ka lā.

ʻEkolu lā i kahi lā: kakahiaka, ahiahi a me ke ahiahi, me ke koho ʻana o 3 papa i ka lā.

ʻAʻohe ʻikepili i ka hoʻohana ʻana o ka lāʻau lapaʻau me ka insulin.

ʻOiai e lawe ana i ka Glucovans® a me ka chelator bile, ua manaʻo ʻia e lawe ʻoe i ka Glucovans® ma ka liʻiliʻi he 4 mau hola ma mua o kou bile chelator e hōʻemi ai i ka hopena o ka hōʻemi o ka lilo ʻana.

ʻO nā kauoha kikoʻī kūikawā no nā pūʻulu maʻi maʻi

ʻO nā mea maʻi a me nā senile

Pono e hoʻoponopono ʻia ke ʻano o ka Glucovans® ma muli o nā ana o ka hana hana. ʻO ka ʻōlelo mua he 1 papa o Glucovans® 500 mg / 2.5 mg. Pono ʻia ka loiloi maʻamau o ka hana hoka.