Matlapeng a Metformin 1000 mg, 60 li-pcs.

Ka kopo, pele u reka Metformin, matlapa a 1000 mg, li-pc tse 60. Lekola tlhaiso-leseling e mabapi le eona le tlhahisoleseling ho websaeteng ea semmuso ea moetsi kapa hlakisa mofuta o ikhethang oa mofuta o itseng le molaoli oa k'hamphani ea rona!

Tlhahisoleseling e bontšitsoeng sebakeng sena sa marang-rang hase tlhahiso ea sechaba. Moetsi o na le tokelo ea ho etsa liphetoho moralo, moralo le liphutheloana tsa thepa. Litšoantšo tsa thepa tse lifoto tse hlahisitsoeng lethathamong la sebaka sa marang-rang li ka fapana le tsa pele.

Tlhahisoleseling mabapi le theko ea thepa e bontšitsoeng lethathamong la sebaka sa marang-rang e kanna ea fapana ka nako ea ho beha odara bakeng sa sehlahisoa se tsamaellanang.

Ketso ea pharmacological

Metformin e thibela tsoekere e maling, e fokotsa ho kenella ha tsoekere maling, e ntlafatsa tšebeliso ea tsoekere, hape e eketsa kutloisiso ea lithane ho insulin. Ha e ame secretion ea insulin ke lisele tsa beta tsa manyeme, ha e bake karabelo ea hypoglycemic. Fokotsa boemo ba triglycerides le lioprotein tse tlaase maling. E tsitsisa kapa e theola boima ba 'mele. E na le phello ea fibrinolytic ka lebaka la khatello ea inhibitor ea tisy ea plasminogen activator.

Kamora ho tsamaisoa ka molomo, metformin e nkuoa ho tsoa mokokotlong oa lijo. Bioavailability kamora ho nka tekanyetso e tloaelehileng ke 50-60%. Cmax e plasma ea mali e fihlella lihora tse 2,5 ka mor'a ho kenella. Ha e lumellane le liprotheine tsa plasma. E bokellana ka har'a litsoelesa tse qhekellang, mesifa, sebete le liphio. E hloekisoa e sa fetoloe ke liphio. T1 / 2 ke lihora tse 9-12. Ka ts'ebetso ea renal e sa foleng, ho fumaneha ha lithethefatsi hoa khoneha.

Type 2abetes mellitus ntle le tloaelo ea ketoacidosis (haholoholo ho bakuli ba nang le botenya) le kalafo ea ho se sebetse hantle, hammoho le insulin, mofuta oa 2 lefu la tsoekere, haholoholo le bonyane ba botenya, bo tsamaeang le ho hanyetsa insulin.

Contraindication

• lefu la tsoekere ketoacidosis, lefu la tsoekere, leta,
• mosebetsi o sa sebetseng oa renal,
• Maloetse a hlobaetsang le kotsi ea ho ba le bothata ba ho hlaphoheloa kelellong: ho omella (ka lets'ollo, ho hlatsa), feberu, mafu a matla a tšoaetsanoang, hypoxia (tšabo, sepsis, tšoaetso ea liphio, mafu a bronchopulmonary),
• Tlhahlobo e phatlalalitsoeng ka mafu a hlobaetsang le a sa foleng a ka lebisang ho ntlafatso ea tishu hypoxia (pelo kapa ho hloleha ho phefumoloha, infarction e mpe ea myocardial)
• ho buuoa ho hoholo le ho sithabela maikutlo (ha ho bontšoa kalafo ea insulin),
• ho se sebetse hantle ha sebete,
• nako e telele ea joala, chefo e mpe ea joala
• sebelisa bonyane matsatsi a 2 pele le ka nako ea matsatsi a mabeli kamora ho etsa lithuto tsa radioisotope kapa x-ray ka tlhahiso ea iodine e nang le phapang e mahareng.
• lactic acidosis (ho kenyeletsoa le nalane),
• ho khomarela lijo tse nang le khalori e tlase (ka tlase ho likhalori tse ka tlase ho 1000 / letsatsi),
• boimana
• lebone
• hypersensitivity ho lithethefatsi.

Ha ho khothalletsoe ho sebelisa lithethefatsi ho batho ba lilemo tse fetang 60 ba etsang mosebetsi o boima oa 'mele, o amanang le kotsi e kholo ea ho ba le lactic acidosis ho bona.

Litlamorao

Ho tsoa ho tsamaiso ea tšilo ea lijo: ho nyekeloa ke pelo, ho hlatsa, ho latsoa ka tšepe ka hanong, ho hloka takatso ea lijo, lets'ollo, lefutso, bohloko ba ka mpeng. Matšoao ana a tloaelehile haholo qalong ea kalafo 'me hangata a itsamaela a le mong. Matšoao ana a ka fokotsa ho khethoa ha anthocides, li-derivatives tsa atropine kapa antispasmodics.

Ho tloha lehlakoreng la metabolism: maemong a sa tloaelehang - lactic acidosis (e hloka khaello ea kalafo), ka kalafo ea nako e telele - hypovitaminosis B12 (malabsorption).

Ho tsoa lithong tsa hemopoietic: maemong a mang - anemia ea megaloblastic.

Ho tsoa tsamaisong ea endocrine: hypoglycemia.

Litla-morao:

Tšebelisano

Tšebeliso e tšoanang ea danazol ha e khothalletsoe ho qoba sephetho sa hyperglycemic ea ho qetela. Haeba kalafo e nang le danazol e hlokahala mme kamora ho emisa ho qetela, ho lokisoa tekanyetso ea metformin le iodine ho hlokahala ho laola boemo ba glycemia.

Motsoako o hlokang tlhokomelo e khethehileng: chlorpromazine - ha e nooa ka tekanyetso e kholo (100 mg / ka letsatsi) e eketsa glycemia, e fokotsa ho lokolloa ha insulin.

Ka kalafo ea li-antipsychotic le ka mor'a ho khaotsa ho nka mokhoa oa ho qetela, ho fetola litekanyetso tsa metformin ho hlokahala tlasa taolo ea boemo ba glycemia.

Ka ts'ebeliso e ts'oanang le sulfonylurea derivatives, acarbose, insulin, NSAIDs, li-inhibitors tsa MAO, oxetetracycline, li-inhibitors tsa ACE, li-derofatives tse tsoang ka hare, cyclophosphamide, li-blockers tsa qoqotho, li ka khona ho eketsa phello ea hypoglycemic ea metformin.

Ka tšebeliso e tšoanang le GCS, lithibela-pelehi tsa molomo, epinephrine, sympathomimetics, glucagon, lihomone tsa qoqotho, li-thiazide le loop diuretics, li-derothi tsa phenothiazine, li-derivatives tsa nicotinic acid, ho fokotseha hoa phello ea hypoglycemic ea metformin ho ka etsahala.

Cimetidine e liehisa ho felisoa ha metformin, e eketsang kotsi ea lactic acidosis.

Metformin e ka fokolisa phello ea li-anticoagulants (tse tsoang ho coumarin).

Ho itlopa joala ho eketsa kotsi ea ho ba le lactic acidosis nakong ea tahi e matla, haholo litabeng tsa ho itima lijo kapa ho latela lijo tse nang le khalori e tlase, hammoho le ho hloleha ha sebete.

Mokhoa oa ho nka, oa tsamaiso le litekanyetso

Tekanyo ea lithethefatsi e beoa ke ngaka ka bonngoe, ho latela boemo ba tsoekere maling.

Motsoako oa pele ke 500-1000 mg ka letsatsi (matlapa a 1-2). Kamora matsatsi a 10-15, keketseho e tsoelang pele ea butle-butle ea tekanyetso e ka etsahala ho latela boemo ba tsoekere ea mali.

Tekanyo ea tlhokomelo ea moriana hangata e 1500-2000 mg ka letsatsi. (Matlapa a 3-4) Tekanyetso e phahameng ke 3000 mg ka letsatsi (matlapa a 6).

Bakeng sa bakuli ba tsofetseng, tekanyetso ea letsatsi le letsatsi e khothalletsoang ha ea lokela ho feta 1 g (matlapa a 2).

Matlapa a Metformin a lokela ho nooa a felletse nakong ea lijo kapa hang ka mor'a lijo le metsi a mangata (khalase ea metsi). Ho fokotsa litla-morao tse tsoang mpeng ea gastrointestinal, tekanyetso ea letsatsi le letsatsi e lokela ho aroloa ka litekanyetso tse peli.

Ka lebaka la kotsi e eketsehileng ea lactic acidosis, lethal dose le lokela ho fokotsoa haeba ho na le mathata a tebileng a metabolic.

Bongata

Ka overdose ea Metformin, lactic acidosis e nang le sephetho se bolaeang e ka etsahala. Sesosa sa nts'etsopele ea lactic acidosis le eona e ka ba ho lutla ha moriana ka lebaka la ts'ebetso ea renal e sa sebetseng.

Matšoao a lactic acidosis: ho nyekeloa ke pelo, ho hlatsa, lets'ollo, ho fokotsa mocheso oa 'mele, bohloko ba ka mpeng, bohloko ba mesifa, nakong e tlang ho kanna ha eketsoa ho hema, ho tsekela, ho hloka kelello le ho holofala.

Phekolo: haeba ho na le matšoao a lactic acidosis, kalafo e nang le Metformin e lokela ho emisoa hang-hang, mokuli o lokela ho kena sepetlele ka potlako mme ha a se a lemohile hore o na le lactate, o netefatsa tlhahlobo eo. Mohato o sebetsang ka ho fetisisa oa ho tlosa lactate le metformin 'meleng ke hemodialysis. Phekolo ea matšoao le eona ea etsoa.

Ka kalafo e kopaneng le Metformin le sulfonylureas, hypoglycemia e ka hlaha.

Litaelo tse ikhethang

Nakong ea kalafo, ho hlokahala hore ho hlahlojoe ts'ebetso ea renal. Bonyane makhetlo a mabeli ka selemo, hammoho le ponahalo ea myalgia, litaba tsa lactate tse ho plasma li lokela ho ikemisoa. Ntle le moo, hang ka mor'a likhoeli tse ling le tse ling tse tšeletseng ho hlokahala hore ho laoloe boemo ba "metabolinine" serum ea mali (haholoholo ho bakuli ba botsofaling). Metformin ha ea lokela ho khethoa haeba boemo ba "creatinine" maling bo phahame ho feta 135 μmol / L ho banna le 110 μmol / L ho basali.

Mohlomong ts'ebeliso ea lithethefatsi Metformin hammoho le litlamorao tsa sulfonylurea. Maemong ana, ho hlokahala haholo ho lekola maemo a tsoekere ea mali.

Lihora tse 48 pele le ka hare ho lihora tse 48 ka mor'a hore radiopaque (urography, iv angiography), o lokela ho emisa ho nka Metformin.

Haeba mokuli a na le ts'oaetso ea bronchopulmonary kapa lefu le tšoaetsanoang la litho tsa genitourinary, ngaka e tlang e lokela ho tsebisoa hanghang.

Nakong ea kalafo, o lokela ho khaotsa ho nka joala le lithethefatsi tse nang le ethanol. .

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Tšebeliso ea moriana ona ho monotherapy ha e ame bokhoni ba ho khanna makoloi le ho sebetsa ka methapo.

Ha Metformin e kopantsoe le baemeli ba bang ba hypoglycemic (li-sulfonylurea derivatives, insulin), maemo a hypoglycemic a ka hlaha moo bokhoni ba ho khanna makoloi le ho etsa lintho tse ling tse kotsi tse hlokang tlhokomelo e eketsehileng le karabelo e potlakileng ea psychomotor e senyehileng.