Mokhoa oa ho sebelisa lithethefatsi Glybomet?

Glybomet ea lithethefatsi e na le phello ea hypoglycemic le hypolipidemic. Ho ea ka litaelo tsa Glibomet, sethethefatsi sena se phahamisa sephiri sa insulin, se hlahisoang ke makhopho a batho, se eketsa kutloisiso ea "insulin" ea lithane tsohle tsa mmele. Setlhare se baka ho lokolloa ha insulin, ha e ntse e thibela lipolysis ka har'a lithane. E hatella glycogenolysis ka har'a sebete, Glybomet e fokotsa ho theha methapo ea mali, e fana ka phello ea antiarrhythmic. Sebopeho se rarahaneng sa Glibomet, se kenyeletsang glibenclamide le metformin, se na le phello e kopaneng 'meleng oa mokuli, ha glibenclamide e ikarabella bakeng sa tlhahiso ea insulin, mme metformin e fokotsa ho kenella ha glucose le ho thatafatsa metabolid metabolism.

Matšoao bakeng sa ts'ebeliso ea Glibomet

Glibomet e sebelisetsoa ho phekola lefu la tsoekere la mofuta oa 2, e le molao, kamora kalafo ea ho ja molemong oa ho se sebetse hantle. Glybomet le eona e qala ho sebelisoa kamora ho sebelisa lithethefatsi tsa molomo tsa hypoglycemic tse neng li se na phello ea kalafo. Ha ho nahanoa ka litlhahlobo tsa Glibomet, moriana o sebetsa hantle haholo haeba mokuli a latela kalafo le lijo.

Mekhoa ea ho sebelisa Glibomet le litekanyetso

Ka mor'a litaelo tsa Glibomet, moriana o nooa ka molomo nakong ea lijo. Ho latela boemo boo metabolism ea carbohydrate e leng ho eona le boemo ba tsoekere ea mali ho mokuli, litekanyetso li behiloe, tsena tsohle li etsoa ka bonngoe, ho latela boemo ba motho. Ba qala ho nka Glybomet ka matlapa a 1, 2 kapa a 3, hanyane ka hanyane ba fumana lethal e lekanang le lefu lena. Tekanyo e lekaneng ea lithethefatsi Glibomet, ho latela litaelo, habeli ka letsatsi - hoseng le mantsiboea. Ha ho kgothaletswe ho eketsa tekanyetso ea ho sebelisa moriana ka letsatsi bakeng sa matlapa a fetang a mahlano.

Contraindication ka ts'ebeliso ea Glibomet

Pheko e ka sehloohong ea ho noha moriana, ho ea ka litaelo tsa Glibomet, ke hypersensitivity ho likarolo tseo mori o nang le tsona. Setlhare se ke ke sa sebelisoa le bakeng sa maloetse a latelang: lefu la tsoekere, lefu la tsoekere, hypoglycemia, mofuta oa 1 lefu la tsoekere. Ts'ebeliso ea lithethefatsi Glybomet e thibetsoe nakong ea kemaro le kanyeso.

Litla-morao tsa Glybomet

Ho nka Glybomet ho ka baka ho nyekeloa le pelo le ho hlatsa haholo. Tlhahlobo ea Glybomet e bonts'a hore ho ka ba le lintho tse ngata tse ka etsang hore e mpefatse, ho baka phallo ea hypoglycemic, e lebisang ho fokotseheng ha litaba tsa lisele tse khubelu tsa mali, liplatelete le granulocytes maling. Ka nako e ts'oanang, anemia ea hemolytic, hepatitis le cholestatic jaundice lia nts'etsapele. Maemong a mang a ho sebelisa lithethefatsi Glibomet, arthralgia le hyperthermia li ile tsa bonoa. Litlhahlobo ho Glybomet li netefatsa lintlha ka ho phahama ha protheine ka har'a moroto le ponahatso ea photosensitivity.

Litlhaku tsa Glybomet

Maemong a mang, ka bokuli, Glibomet ea lithethefatsi e ka nkeloa sebaka ke li-analogues. Liphetoho tse joalo tsa Glibomet ke lithethefatsi Glyukovans le Glyurenorm. Ho nka lithethefatsi tse peli tsa Glibenclamide le Metformin ha ho se na lithethefatsi tse ling ho ka sebelisoa e le analog ea Glibomet, empa phello e tla ba mpe ho feta ha o sebelisa moriana o le mong o thata.

Sokolla foromo le sebopeho

Matlapa a Glybomet a entsoe ka lisebelisoa tse sebetsang.

Metformin hydrochloride - 400 mg,
Glibenclamide - 2,5 mg.

Lintho tse thusang tsa Glibomet ke lintho tse fofang tse nang le "magnesium" cellulose, colloidal silicon dioxide, glycerol, gelatin, starch ea poone, talc.

Ka marang-rang bakeng sa matlapa a 20.

Pharadodynamics

Glibomet ke setlhare se kopaneng sa "hypoglycemic" se amanang le litlamorao tsa "Biguanide" le "sulfonylurea" ea moloko oa bobeli. E tšoauoa ka ketso ea pancreatic le extrapancreatic.

Glibenclamide ke setho sa sehlopha sa II sulfonylureas ea sesole mme e tsosa motsoako oa insulin ka ho theola monyako oa pancreatic beta-cell glucose. Ntho ena e eketsa kutloisiso ea insulin le boholo ba ho tlama ha eona ho lebisa lisele, li kenya letsoho ho lokolloa ha insulin, e eketsa phello ea eona ho amoeng tsoekere ke sebete le mesifa, hape e thibela lipolysis ho lithane tsa adipose. Phello ea eona e bonoa mohatong oa bobeli oa insulin secretion.

Metformin ke ea mofuta oa "Biguanides". E tsosa kutloisiso ea pherekano ea tishu ho litlamorao tsa insulin (e eketsa tekanyo ea ho tlama ha insulin ho li-receptor, e matlafatsa litlamorao tsa insulin maemong a postreceptor), e thibela ho kenngoa ha glucose ka popelong, e thibela gluconeogeneis 'me e ama hantle metabolism ea metabolism, e thusa ho fokotsa boima ba' mele ho bakuli ba nang le lefu la tsoekere. hape e na le phello ea fibrinolytic ka lebaka la thibelo ea inhibitor ea tisy-mofuta oa plasminogen activator.

Phello ea hypoglycemic ea Glibomet e bonoa lihora tse 2 kamora tsamaiso mme e nka lihora tse 12. Khokahano ea synergistic ea metsoako e 'meli e sebetsang ea lithethefatsi, e kenyelletsang ho tsoala sulfonylurea e tsoang ho synthesize endo native insulin (pancreatic athari) le phello e tobileng ea "greatuanide" mabapi le adipose le mesifa ea mesifa (keketseho e kholo ea tsoekere ea glucose - phello e eketsehileng ea "pancreatic)" tekanyo e itseng ea lethal dose ho fokotsa khatello ea karolo ka 'ngoe. Sena se thibela ts'usumetso e fetelletseng ea lisele tsa pancreatic beta le ho fokotsa kotsi ea ho senyeha ha setho sena, hape e kenya letsoho polokelong ea ho sebelisa lithethefatsi tsa hypoglycemic hape e fokotsa likotsi tsa litlamorao.

Mofumahali

Glibenclamide e nang le lebelo le phahameng haholo 'me e felletse (84%) e kenella ka har'a tšilo ea lijo. Ts'oarello e kholo e fihlella ka mor'a lihora tse 1-2 ka mor'a tsamaiso. Ntho ena e kopana le liprotheine tsa plasma ka 97% mme e batla e na le metabolism e felletseng ka har'a sebete, e etsa metabolites e sa sebetseng. Glibenclamide e epolloa ka 50% ka liphio le 50% ka bile. B halofo ea bophelo ke lihora tse 5-10.

Tekanyo ea ho monngoa ha metformin ka mpeng ea tšilo ea lijo e phahame haholo. Seketsoana sena se ajoa ka potlako likarolong tsohle tsa 'mele' me ha se lumellane le liprotheine tsa plasma. Metformin ha e sebelisoe 'meleng' me e bonoa ka liphio le karolo e itseng ea mpa. Ho felisoa ha halofo ea bophelo ke lihora tse ka bang 7.

Litaelo tsa ho sebelisoa Glibomet: mokhoa le litekanyetso

Matlapa a nooa ka molomo le lijo.

Ngaka e fana ka litlhare le nako ea kalafo ka mokhoa o fapaneng ho latela lipontšo tsa kliniki, ho latela tlhokomelo ea glucose maling le boemo ba metabolism ea carbohydrate.

Tekanyetso ea pele hangata hangata ke matlapa a 1-3 ka letsatsi. Nakong ea kalafo, mokuli o khetha tekanyetso e sebetsang ho fihlela boemo bo tloaelehileng ba tsoekere ea mali.

Tekanyo e phahameng ea letsatsi le letsatsi ea Glybomet ha ea lokela ho feta matlapa a 6.

Bongata

Ka overdose ea Glibomet, hoa khoneha ho ntshetsa pele lactic acidosis e bakoang ke ketso ea metformin, le hypoglycemia e hlahisoang ke ketso ea glibenclamide.

Matšoao a lactic acidosis ke bofokoli bo matla, ho fokotseha ha khatello ea mali, reflex bradyarrhythmia, ho otsela, ho ferekana le ho felloa ke letsoalo, hypothermia, mathata a ho hema, bohloko ba mesifa, lets'ollo, ho nyekeloa le pelo le ho hlatsa.

Matšoao a hypoglycemia a kenyelletsa hlooho ea hlooho, letsoalo, mathata a nakoana a ts'ebetso ea mokokotlo, tšebelisano e tsitsitseng ea ho sisinyeha ha methapo ea methapo, ho otsela, ho tšoenyeha ka kakaretso, ho thothomela, ho phahloha ha lesapo la molomo, bofokoli, pallor ea letlalo, ho fufuleloa ho hoholo, ho phahamisa mahlo, tlala. Hypoglycemia e tsoelang pele e ka lebisa ho lahleheloeng ke boitšoaro le ho tepella.

Haeba ho na le lipelaelo tsa nts'etsopele ea lactic acidosis, Glibomet e lokela ho tlosoa hang-hang 'me mokuli a romeloe sepetlele ka potlako. Phekolo e sebetsang ka ho fetisisa bakeng sa overdose ke hemodialysis.

Hypoglycemia e bonolo e ka sebetsanoa le ho kenya sengoathoana sa tsoekere, lino kapa lijo tse nang le lik'habohaedreite tse ngata (khalase ea tee e tsoekere, jeme, mahe a linotsi).

Ha motho a lahleheloa ke letsoalo, ho kgothaletsoa ho kenella ka 40-80 ml ea tharollo ea tsoekere ea 40% (dextrose) kahare, ebe o kenya tharollo ea 510% dextrose. Tsamaiso e eketsehileng ea 1 mg ea glucagon e lumelloa ka mokhoa o ts'oanang, ka methapo kapa kahare. Haeba mokuli a sa fole, ho hlokahala hore a phete tatellano ea liketso. Ha ho e-na le phello e kholo ea bokuli, fetohela tlhokomelo e matla.

Litaelo tse khethehileng

Hoa hlokahala ho emisa ho nka Glibomet ha matšoao a lactic acidosis a hlaha ka sebopeho sa bofokoli bo akaretsang, ho hlatsa, bohloko ba ka mpeng, mesifa ea mesifa, le ho ea ngakeng hang-hang le ngaka.

Ho khothalletsoa hore o noe lithethefatsi ka ho lekola khafetsa boemo ba "metabolin" maling: bakeng sa bakuli ba nang le ts'ebetso e tloaelehileng ea renal - bonyane nako e le 'ngoe ka selemo, bakeng sa bakuli ba nang le tekanyo ea "creatinine" maling e haufi le moeli o kaholimo o tloaelehileng le oa batho ba baholo - makhetlo a 2-4 ka selemo.

Glybomet e lokela ho emisoa matsatsi a mabeli pele ho ts'ebetso e reriloeng ea ho buuoa e sebelisang anesthesia (spinal kapa anesthesia ea mokokotlo). Tsoela pele ho nka moriana ka ts'ebetso ea phepo e nepahetseng ea molomo, empa eseng pele ho matsatsi a mabeli kamora ho buuoa, haeba ts'ebetso e tloaelehileng ea menoana e tiisitsoe.

Nakong ea kalafo, tlhokomeliso e eletsoa ha ho etsoa lintho tse kotsi le ho khanna, kaha ho na le monyetla oa ho ntšetsa pele hypoglycemia mme ka lebaka leo, ho fokotseha ha lebelo la karabelo ea psychomotor le bokhoni ba ho tsepamisa mohopolo.

Ho sebetsa hantle ha kalafo ho latela ho latela litaelo tsa ngaka ka botlalo, litlhahiso tsa hae mabapi le mokhoa oa ho ikoetlisa le ho ja, le ho lekola maemo a tsoekere ea mali kamehla.

Ha u sebelisa Glibomet, u lokela ho hana ho noa joala, hobane ethanol e ka baka hypoglycemia le / kapa karabelo e kang ea discriram (bohloko ba ka mpeng, ho hlatsa, ho nyekeloa ke pelo, maikutlo a mocheso holim'a 'mele o ka holimo le sefahlehong, ho tsekela, ho opeloa ke hlooho, tachycardia) .

Ho sebelisana le lithethefatsi

Kameho ea Glybomet e eketseha ka tsamaiso e ts'oanang ea beta-blockers, li-coumarin derivatives (warfarin, syncumar), allopurinol, cimetidine, monoamine oxidase inhibitors (MAO), oxytetracycline, slefanilamides, chloramphenicol, phenylbutazide amilefrideamide, amylamutideamane amilefrideide. , sulfinpyrazone, miconazole (ha e nkuoa ka molomo), ethanol.

Phello ea hypoglycemic ea lithethefatsi e fokotsa ho kopana le glucocorticosteroids, adrenaline, lithibela-pelehi tsa molomo, thiazide diuretics le barbiturates, litokisetso tsa lihomone tsa qoqotho.

Tsamaiso e ts'oanang ea beta-blockers e kanna ea pata matšoao a hypoglycemia, ntle le ho fufuleloa ho feteletseng.

Ka tšebeliso e tšoanang ea Glibomet e nang le cimetidine, menyetla ea ho ba le lactic acidosis e eketseha, ka li-anticoagulants, phello ea bona ea eketseha.

Kotsi ea mokuli ea ho ba le lactic acidosis e eketseha ka lithuto tsa x-ray ka tšebeliso ea methapo ea methapo ea li-iodine tse nang le phapang.

Litšoantšiso tsa Glibomet ke: Amaril, Avandamet, Avandaglim, Gluconorm, Glukovans, Glimecomb, Galvus Met, Glyukofast, Bagomet Plus, Combogliz, Metglib, Yanumet.

Tlhahlobo ea Glibomet

Har'a bakuli ba noang moriana ona khafetsa, hangata ho na le litlhahlobo tse ntle ka Glibomet, leha ho le joalo, ho na le litšupiso ka litlamorao tse nyane. Bakuli ba bangata ba fumanoang ba na le lefu la tsoekere la mofuta oa 2 ba kopana ho nka Glibomet le lithethefatsi tse ling, ka hona ba ke ke ba netefatsa katleho ea kalafo le sethethefatsi. Batho ba bang ba ne ba sa khotsofalla litlamorao tsa kalafo ena, 'me qetellong ba fetohela ho Glibomet analogues, e fanang ka maikutlo a tlhokeho ea mokhoa oa motho ka mong ha a laela kalafo.

Ho ba teng ha likarolo tse peli tse sebetsang Glibomet maemong a mang ho ka etsa hore motho a mamelle lithethefatsi ka nako e 'ngoe. Ho lokela ho hopoloa hore maemong a lefu la tsoekere, ke ngaka feela e ka khethang malebela a ho fana ka moriana ona, ho theha mofuta oa kalafo le ho fetola tekanyetso.

Tekanyetso le tsamaiso

Glybomet e nooa ka molomo nakong ea lijo.

Tekanyetso le nako ea kalafo e khethoa ke ngaka e eang ka bonngoe, ho latela boemo ba tsoekere maling le boemo ba metabolism ea carbohydrate.

Tekanyetso ea pele ea Glibomet ke matlapa a 1-3 ka letsatsi, le phetoho e latelang ho fihlela boemo bo phahameng ba tsoekere maling. Matlapa a fetang 6 a moriana ona ha a lokela ho sebelisoa ka letsatsi.