Glibomet ke motsoako o kopaneng (bakeng sa tšebeliso ea kahare) hypoglycemicderivative bitanide le sulfonylureasMoloko oa II o bonts'ang extrapancreaticle pancreaticketso.

E thehiloe sulfonylureasMoloko oa II - glibenclamidee na le tšusumetso ho secretion ea insulinka ho theola tsoekere ka monyako o halefisang oa beta manyeme.

Glibenclamidee ntlafatsa ts'ebetso ea insulinle matla a litlamo tsa eona tse nang le lisele tse shebiloeng li eketsa tokollo insulin, e eketsa matla a eona ts'ebetsong ho monya glucose sebete le mesifa ea lithane tsa adipose lia thiba lipolysis. Matla a sethethefatsi a bonahala mohatong oa bobeli oa tlhahiso insulin.

E thehiloe biguanide– metformine bonts'a phello e matlafatsang kamanong le kutloelo-bohloko ea methapo ea lisele ho ea ho litlamorao insulin(e matlafatsa tlamo ea receptor insulinmme e eketsa litlamorao tsa eona maemong a postreceptor).

Ka mala a fokotseha ho monya glucoseho sithabela maikutlo gluconeogeneis mme e ama hantle lipid metabolism e thusa ho fokotsa boima ba 'mele ho bakuli lefu la tsoekere. E na le katleho ea fibrinolytic ka lebaka la inhibition ea li-activator inhibitor plasminogen.

Phello ea hypoglycemic ea Glibomet e hlaha kamora lihora tse peli mme e bonoa lihora tse 12.

Khokahano ea synergistic ea metsoako e 'meli e sebetsang ea lithethefatsi - phello e susumetsang ea tse tlisoang sulfonylureasho hlahisa insulin ea hau (pancreaticketso) le tshusumetso e tobileng biguanideho adipose le mesifa ea mesifa (extrapancreaticketso - keketseho e kholo ea tlhasimollo tsoekere) le lisele tsa sebete (ho fokotseha gluconeogeneis), e lumella karolo e itseng ea litekanyetso ho fokotsa litaba tsa karolo ka 'ngoe.

Boemo bona bo thusa ho qoba ts'ebetso e ngata. lisele tsa beta manyeme, 'me ka hona, fokotsa kotsi ea ts'ebetso e sa sebetseng, hammoho le ho eketsa ts'ireletseho ea li-agents tsa hypoglycemic le ho fokotsa khafetsa ea litlamorao tse ka bang teng.

Ho fufuleloa glibenclamideka har'a tšilo ea lijo ho etsahala kapele le ka tekanyo e phahameng (84%). Khatello e kholo e bonoa kamora lihora tse 1-2. Puisano le liprotheine tsa plasma maemong a 97%. Hoo e batlang e le metabolite e felletseng (ho li-metabolites tse sa sebetseng) ka har'a sebete. E pepisoa ka bile le moroto ka karolo ea 50/50%, ka bophelo ba halofo ea lihora tse 5 ho isa ho tse 10.

Ho kenella ka har'a tšilo ea lijo metforminhape e felletse. Setlhare se batla se sa kopane le liprotheine tsa plasma mme se hasana kapele ho linama. 'Mele ha o na' mele. E hloekisoa haholo ke liphio le karolo e nyane ke mala, ka bophelo ba halofo ea lihora tse 7.

Matšoao a ho sebelisoa

Lithethefatsi Glybomet e bontšoa bakeng sa kalafo mofuta oa lefu la tsoekeremolemong oa ho se sebetse hantle kalafo ya ho jale kalafo e fetileng biguanidesle tse tsoang sulfonylureashammoho le lithethefatsi tse ling tsa molomo tsa hypoglycemic.

Contraindication

• hypersensitivity ho glibenclamide(ho kenyelletsa le tse tsoang sulfonylureas), metforminkapa metsoako e meng ea lithethefatsi,
• lefu la tsoekere
• mofuta oa 1 lefu la tsoekere,
• lactic acidosis(ho kenyeletsa nalane),
• precoma ketoacidosiscoma (lefu la tsoekere)
• maemo a khetholloang ke ho koaloa ha lijo le ho theoa ha hypoglycemia,
• maemo a hlobaetsang a kotsing ho senyeha ha boitšoaetso e matla ho omella, ho thothomela, kenyelletso ea lintho tse nang le iodine litareng (intravascular),
• mosebetsi o senyehileng oa hepatic,
• lefu la liphio (ka moeinine bakeng sa banna ba fetang 135 mmol / l le bakeng sa basali ba fetang 110 mmol / l),
• maemo a amanang le hypoxia(phefumoloho kapa ho nyekeloa ke pelotšoso e fetileng myocardial infarctionmaemo a bohloko a methapo ea phefumoloho)
• bohlasoa, mafu a tšoaetsanoang, a atilemehato ea ho buoalahleheloa ke mali haholo likotsie kholo chesale maemo a mang a hlokang kalafo ea insulin,
• Lihora tse 48 pele le ka mor'a ts'ebetso ea bongakakapa ho ts'oara radiologykapa radioisotopeho etsa liteko ka ho hlahisoa ha ntho e nang le iodine litareng e fapaneng,
• leukopenia,
• Liphetoho tsa dystrophic (lipodystrophy, myotonic dystrophy),
• porphyria,
• hlokomela hypocaloric ja lijo (ho fihlela ho 1000 kcal ka letsatsi),
• dinoko botaoajoala joala bo sa feleng,
• glucose-6-phosphodehydrogenase,
• lilemo tse ho fihlela 18
• boimanale ho anyesa.

Se ke oa khothaletsa ho isa Glybomet ho bakuli ba lilemo tse kaholimo ho 60 ba etsang mosebetsi o boima oa 'mele, ka lebaka la kotsi e kholo ea lactic acidosis.

• ho ikoetlisa ka matla (kotsi ea lactic acidosis),
• pathology tšoelesa ea qoqotho,
• febrile syndrome,
• hypofunctionbark adrenal gustle / kapa lobe ea ka ntle gland.

Litlamorao

• takatso ea takatso ea lijo,
• ho nyekeloa,
• mala a bohloko
• ho hlatsa,
• tatso ea tšepe ka molomong oa molomo,
• lets'ollo,
• ts'ebetso ea li-enzyme tsa sebete.

• anemia hemolytic
• leukopenia
• erythrocytopenia,
• thrombocytopenia
• megaloblastic anemia,
• agranulocytosis,
• pancytopenia.

Haeba lipontšo li fumanoe lactic acidosis(bofokoli bo akaretsang, bohloko ba ka mpeng, ho hlatsa, mesifa ea mokokotlo), o lokela ho emisa hang hang ho nka matlapa a Glibomet mme o botse ngaka.

• Disulfiram-karabeloho bonahatsoa ha e nkuoa ea joalamme e supe rednessletlalo le holimo, hlooho e bohlokomaikutlo ho otla hoa pelo, ho nyekeloale ho hlatsa keketseho ea khatello ea mali.

Matlapa a Glybomet, litaelo tsa tšebeliso

Litaelo tsa tšebeliso Glibomet e khothaletsa ho nka matlapa a lithethefatsi ka molomo (kahare), ka ho khetheha ka lijo.

Tekanyetso le nako ea kalafo e khethoa ke ngaka e eang ho latela maemo carbohydrate metabolism mamello le palo ea mali tsoekere.

Ha e le molao, tekanyetso ea pele ea letsatsi le letsatsi ke matlapa a 1-3, le liphetoho butle-butle molemong oa ho khetha litekanyetso tse sebetsang hantle, tse tla netefatsa boemo bo tsitsitseng ba litaba tsoekere mading.

Tekanyetso e kholo ea letsatsi le letsatsi e lekaneng ke matlapa a 6.

Bongata

Ka overdose, nts'etsopele e ile ea bonoa hypoglycemia(glibenclamide) le lactic acidosis(metformin).

Ho hypoglycemia o bone: tlala, bofokolieketsehile mofufutsomathata a methapo ea kutlo (a nakoana) ho otla ha pelo, paresthesia molomong oa molomo pallorletlalo le hlakileng thothomela, hlooho e bohlokomaikutlo matshwenyehopathological ho otselaboikutlo ba ho tshoha mathata a ho robala, ho hloka tšebelisano. Ka tsoelo-pele ea boemo bona bo bonoe tahlehelo ea boitšoaro le ya letsoalo.

Boemong ba hypoglycemiaLijo tse bobebe li khothaletsa tsoekere, lino kapa lijo tse nang le bongata bo bongata lik'habohaedreite(mahe a linotsi, jeme, tee e tsoekere). Haeba hypoglycemiatsamaisoa ke ho lahleheloa ke kelello, iv e jere tharollo ea 40% dextrose(tsoekere) ka bophahamo ba 40-80 di ml, ka mora moo ho kenngoe tharollo ea 5-10% tharollo dextrose. Kamora nako, ts'ebetso e eketsehileng ea 1 mg e khonahala. glucagon.

Haeba mokuli a lula ho eona ho hloka tsebo Tsamaiso e kaholimo ea phetoa. Ho haella ha matla ho sena, ho hlahisa tlhokomelo e matla.

Ho lactic acidosise ngotsoe: e hlahisitsoe bofokolimathata a ho hema bohloko ba mesifa, ho otselaho nyekeloa ke pelo, bohloko ba ka mpeng, hlatsaReflex bradyarrhythmia, lets'olloho fokotsa khatello ea mali, hypothermiapherekano leho lahleheloa ke kelello.

Haeba ho belaelloa ka lactic acidosislahla lithethefatsi hanghang, sepetleleka mamello le ho etsa ts'ebetso hemodialysis.

Tšebelisano

Litlamorao tsa hypoglycemic tsa Glybomet li ntlafatsoa ha li kopantsoe le tse tsoang ho coumarin (Sinkumar, Warfarin), beta-blockers, salicylates, Oxytetracycline, Cimetidine, Allopurinol, sulfonamides, MAO inhibitors, Propenecid, Phenylbutazonele lihlahisoa tsa eona, chloramphenicol, Sulfonamide, cyclophosphamide, Pergexilin, Miconazole (ka molomo) Feniramidol, Sulfinpyrazonele ethanol.

Glucocorticoids, adrenalineka molomo lithibela-pelehibarbiturates thiazide diuretics le lihormone tsa qoqotho li fokotsa ho sebetsa ha Glybomet.

Khahlano le nalane ea ho nka Glybomet, ho matlafatsa litlamorao anticoagulants.

Amohela kamohelo e tšoanang Cimetidinee kanna ea eketsa kotsi ea lactic acidosis.

Beta blockers e kanna ea bonts'a lipontšo hypoglycemia(mokhelo ke ho ruruha ho feteletseng).

Kopo radiopaqueLi-iodine tse nang le iodine (bakeng sa tsamaiso ea methapo ea methapo) li ka lebisa ho ts'ebetsong e sa sebetseng ea renal le cumulation of metformin (kotsi ea ho hlaha lactic acidosis).

Litaelo tse khethehileng

Nakong ea kalafo, bakuli ba hlokoa hore ba latele litlhahiso tsohle tsa ngaka ka botlalo mabapi le litekanyetso le mokhoa oa ts'ebeliso ea moriana, regimen ho ikoetlisalatela lijole boitaolo boemo ba tsoekeremading.

Lactic acidosis- e kotsi, empa ka lehlohonolo boemo bo sa tloaelehang ba pathological bo iponahatsang cumulation ea lactic acid maling ka lebaka la ho bokellana metformin. Lintlha tse shebiloeng lactic acidosisho bakuli ba nkang Metforminhangata ho bonoa ho bakulilefu la tsoekere e tšoanang e boletsoe renalle ho nyekeloa ke pelo.

Bakeng sa ho thibela ho khoneha lactic acidosislintlha tsohle tse amanang le kotsi li tlameha ho tsejoa, tse kang: ketosistsoekere e bolileng, e telele tlala, ho hloleha ha sebetehlohlelletsa lino tse tahang le boemo bofe kapa bofe bo lebisang ho hypoxia.

Ha o etsoa ka kalafo ea Glybomet, serum creatinine e lokela ho lula e beiloe leihlo, bonyane nako e le 'ngoe ho likhoeli tse 12 ka ts'ebetso e tloaelehileng ea menoana le bonyane makhetlo a 2-4 ho likhoeli tse 12 le botsofaling. moeininehaufi le VGN.

Tlhokomelo e khethehileng e lokela ho nkuoa maemong a kotsi. mosebetsi o sa sebetseng oa renal (qalo ea kalafo NSAIDs, antihypertensivelithethefatsi diuretice bolela).

Phekolo ea Glybomet e lokela ho kena-kenana le lihora tse 48 pele tlhahlobo ea x-ray le iv kenyelletso ea phapang Lintho tse nang le iodine litareng(nakong ena ea nako, lithethefatsi tse ling tsa hypoglycemic li lokela ho nooa).

Hape, ho sitisoa ha kalafo bakeng sa lihora tse 48 ho hloka ts'ebetso e reriloeng ea ho buoa tlasa anesthesiale lefutso kapa opereishene ea lesapo la mokokotlo.

Ho qala kalafo ho ka etsahala kamora hore mokuli a fetohe phepo e nepahetseng ea molomo kapa lihora tse 48 ka mor'a ts'ebetso, ho latela ts'ebetso e tloaelehileng ea liphio.

Ho hlokahala hore u be hlokolosi ha u khanna koloi kapa u etsa mosebetsi o nepahetseng le o seng kotsi.

Litlhaku tsa Glybomet

Litšoantšo tse haufi-ufi tsa Glibomet mabapi le litlamorao tsa tsona li hlahisoa ke lithethefatsi:

• Bagomet Plus,
• Glucovans,
• Glucofast,
• Gluconorm,
• Metglib.

Ts'ebeliso ea Glibomet e hanyetsanoe ho fihlela lilemo tse 18.

Ka joala

Ethanol, joalo ka lino tse tahang, li ka baka hypoglycemiahammoho le sesosa Disulfiram-karabelo (bohloko ba ka mpeng, ho tsekela, ho nyekeloaho utloa mocheso ka 'mele o ka holimo le letlalo la sefahleho, ho hlatsa, tachycardia, hlooho e bohloko), mabapi le hore na, o lokela ho tlohela tšebeliso ea joala ka mefuta eohle.

Tlhahlobo ea Glibomet

Har'a bakuli ba seng ba ntse ba sebelisa lithethefatsi tsena, litlhahlobo tsa Glibomet li ntle haholo, le ha li e-na le lihokela tse ling tsa litlamorao tse fapaneng hangata.

Batho ba bangata ba utloa bohloko mofuta oa lefu la tsoekerenka matlapa a Glibomet hammoho le a mang hypoglycemic agents ka hona, ba ke ke ba netefatsa ka botlalo hore sethethefatsi sena se na le katleho.

Bakuli ba bang ba neng ba laetsoe Glibomet nakong e fetileng ba ne ba sa khotsofalla litlamorao tsa eona mme qetellong ba fetohela lithethefatsing tse ling tsa sena. Sena sohle se fana ka maikutlo a hore ho phekololefu la tsoekere u hloka ho e atamela ka bonngoe, 'me ha ho na tiiso ea hore moriana o le mong o lekane bakuli bohle.

Bothata bo bong ba meriana e kopaneng ke litlatsetso tse boima tsa linoko tse sebetsang, tse seng li loketse bakuli bohle.

Re ka fihlela qeto ea hore haeba Glybomet e loketse mokuli ka mekhoa eohle, ts'ebetso ea eona e tla lula e le boemong bo phahameng ka ho lekana, 'me ho fapana le moo, ha ho arabeloa ka tsela e sa khotsofatseng ea' mele ho motsoako oa lithethefatsi, ho molemo ho fetohela setlhare se seng.

Ho bohlokoa ho hopola hore ka lefu la tsoekere Ke ngaka feela e ka fanang ka kalafo, fetola litekanyetso le li-regimens tsa litekanyetso.

Fomu ea tokollo, sebopeho le sephutheloana

Metglib e entsoe ka mofuta oa matlapa a khanyetsang mahlakore ka bobeli, ka khetla e 'mala oa lamunu,' me e tšoeu karolong eo.

• 500 metformin hydrochloride,
• 2,5 glibenclamide,
• Sodium limae 1
• 45 starch,
• Khemikhale ea 50 ea hydrogen phosphate,
• 52 povidone
• 3 sodium stearyl fumarate,
• 35,5 microcrystalline cellulose.

Moriba o tla ka mekhoa e 'meli:

• 2,5 mg glibenclamide, 500 mg metformin,
• 5 glibenclamide, 500 metformin.

Metsoako e tšeloa ka har'a pakete ea karete, 'me eona e ka ba matlapa a 30 kapa 40.

Baetsi ba INN

Lebitso la machaba la lithethefatsi ke Glibenclamide le Metformin.

Ho qala k'hamphani ea hae e Canonfarm, Russia. Aterese: Sebaka sa Moscow, Shchelkovo, st. Zarechnaya, 105, index 141100.

Theko e tloaelehileng ea moriana ke li-ruble tse 140 ka pakete e ngoe le e ngoe likotoana tse 30. Ka kakaretso, sesebelisoa se theko e tlaase, haholo-holo haeba se laeloa inthaneteng.

Ketso ea pharmacological

Ena ke setlhare se kopantsoeng se nang le metformin le glibenclamide. Morero oa eona o ka sehloohong ke ho theola tsoekere e maling. Ka lebaka la ho kopantsoe ha lintho tse kaholimo, phello ena e matla le ho feta.

Metformin e fokotsa bongata ba tsoekere maling, ha e bake ho tsoa ha insulin, e eketsa kutloisiso ea lisele ho glucose, e thusa ho liehisa ho kenngoa ha eona ka mala le ho tiisa boima ba 'mele ba mokuli.

Glibenclamide ke mofuta oa meloko e 2 ea sulfonylurea. E boetse e theola tsoekere ka lebaka la hore e tsosa secretion e sebetsang ea insulin manyetsong. Ka nako e ts'oanang, ho tlama ha eona liseleng ho ntlafala, lipolysis ho lisele tsa adipose e thibetsoe.

Lintho tsena li lumellana ka botlalo, 'me ka lebaka leo, ho na le keketseho ea phello ea hypoglycemic ea lithethefatsi' meleng. Khahlano le semelo sa tšebeliso ea eona, tsoekere e monya hamolemo ebile e potlakile.

Mofumahali

Phello e bonahalang e etsahala nakong ea lihora tse peli kamora ho nka Metglib, nako ea litafole e ka halofo ea letsatsi.Ka nako e ts'oanang, glibenclamide e haptjoa ke lisele tse ka mpeng ea gastrointestinal, e sebetsoa ka har'a sebete ho fihlela metabolism e sa sebetseng mme e hlahisoa ke liphio le bile, le metformin, e kenngoeng hape ka har'a pampitšana ea gastrointestinal, e hloekisoa haholo ke liphio ka ponahalo e sa khaotseng. Nako ea ts'ebetso ea glibenclamide ke lihora tse 4-11, metformin - 6.5.

Bakeng sa batho ba nang le lefu la tsoekere la mofuta oa 2, ha feela kalafo e se nang meriana (lijo le boikoetliso) e sa lefelloe.

Litaelo tsa ho sebelisoa (litekanyetso)

Ho amoheloa ho fanoa ke ngaka ka bonngoe, ho ipapisitse le liphetho tsa liteko. Setlhare se nooa ka molomo le lijo. Tabeng ena, phepo e felletseng e lokela ho lateloa e le hore lintho li ka sebetsa hantle.

Phekolo e qala ka yuniti e le 'ngoe (2,5 mg le 500 mg), ebe beke e' ngoe le e 'ngoe ka leihlo la maemo a tsoekere, litekanyetso li fetoha.

Haeba likarolo tsa pele tsa Metglib li ne li sebelisoa ke bakuli ka mokhoa oa litokisetso tse arohaneng, ho bohlokoa haholo ho nahana ka sena ha u fana ka litlhare tsena tse rarahaneng, tseo hona joale li kenyelletsang lintho ka bobeli tse sebetsang ka nako e le ngoe.

Tlhokomeliso: Palo e phahameng ea matlapa ka letsatsi ke 4 (2,5 mg kapa 5 mg le 500 mg). Ho eketseha ha nomoro ena ho ka lebisa ho overdid.

Ho sebelisana le lithethefatsi

U ke ke ua nka miconazole ka Metglib. Sena se ka lebisa ho komeng.

Ka kenyelletso ea li-arhente tse nang le iodine e nang le iodine e le ho qoba mathata a ts'ebetso ea renal e sa sebetseng, kamohelo e emisoa matsatsi a mabeli pele ho ts'ebetso mme e qala hape ka mor'a tlhahlobo kamora lihora tse 48.

Ho sebelisana le ethanol, phenylbutazone, bosentan ha ho kgothaletswe. Li senya phello ea Metglib mme li ka lebisa ho karohano e sa batleheng.

Hape, ha ba eletsoe ho etsa kopo e tsamaellanang le kalafo ea mantlha:

• beta adrenostimulants,
• chlorpromazine
• glucocorticosteroids,
• diuretics
• Li-inhibitors tsa ACE le MAO,
• anticoagulants
• danazol
• desmopressin le lithethefatsi tse ling.

Tšebelisanong, li ka baka hypo- kapa hyperglycemia mme tsa fokotsa ts'ebetso ea e mong.

Sokolla foromo le sebopeho

Setlhare sena se hlahisoa ka mofuta oa matlapa a koahetsoeng ka filimi: pota, biconvex, 'mala oa lamunu ka' mala, hoo e batlang e le bosoeu sefapanong (10 e ngoe le e 'ngoe e le lipaketeng tse blokileng, ka mekotleng ea karete ea 1, 2, 3, 4, 6, kapa 9. , Li-pcs tse 15. ka har'a blouse strip package, ka pakete ea likarete tse 2, 4 kapa 6, pakete ka 'ngoe e na le litaelo tsa ts'ebeliso ea Metglib).

Letlapa le le leng le na le:

• Lintho tse sebetsang: Metformin hydrochloride - 400 mg, glibenclamide - 2,5 mg,
• lisebelisoa tse ling: starch ea poone, macrogol (polyethylene glycol 6000), calcium hydrogen phosphate dihydrate, sodium stearyl fumarate, croscarmellose sodium, microcrystalline cellulose, povidone,
• film sheath: Opadry orange hyprolose (hydroxypropyl cellulose), hypromellose (hydroxypropyl methyl cellulose), titanium dioxide, talc, dae oxide e sootho le khubelu ea oxide.

Metglib, litaelo tsa tšebeliso: mokhoa le litekanyetso

Matlapa a Metglib a nooa ka molomo.

Tekanyo ea lithethefatsi, mokhoa oa ts'ebeliso le nako ea kalafo li khethoa ke ngaka e nahanang ka boemo ba metabolism ea carbohydrate le mahlaseli a plasma a glucose maling.

Maemong a mangata, Metglib e nooa ka tekanyetso ea pele ea matlapa a 1-2 letsatsi le leng le le leng. Nakong e tlang, ho etsoa phetoho ea tekanyetso ea butle-butle e le hore e atlehe ka ho fetisisa, e ka fanang ka maemo a tsitsitseng a maemo a tsoekere ea mali. Maemong ana, tekanyetso e kholo ea letsatsi le letsatsi ha ea lokela ho feta matlapa a 6, e arotsoe ka litekanyetso tse tharo.

Bokhachane le pelehi

Basali ba baimana ha ba khothalletsoe ho nka Metglib. Nakong ea kalafo, ngaka e eang e tlameha ho tsebisoa ka moimana o reriloeng kapa ho qala ha eona, hobane maemong ana ho bohlokoa ho emisa ho sebelisa moriana le ho fetisetsa mokuli ho insulin.

Nakong ea kanyeso, ts'ebeliso ea Metglib e tšoaelitsoe, ka lebaka la ho haella ha tlhahisoleseling mabapi le bokhoni ba eona ba ho pepesetsoa lebese la motho. Haeba u hloka ho sebelisa moriana nakong ea lebone, o lokela ho emisa ho anyesa kapa ho fetohela kalafo ea insulin.

Lithethefatsi tse kopantsoeng tsa Metglib

Metglib ke setlhare se kopantsoeng se nang le phello ea hypoglycemic, e etselitsoeng ho laola lefu la tsoekere la mofuta oa 2. Monyetla oa antidiabetesic oa lithethefatsi tsa khetho ea pele o lemohuoa ka mefuta e 'meli ea lithethefatsi tsa mantlha tse nang le ts'ebetso e lumellanang ea ts'ebetso, e lumellang taolo e matla ea metabolism ea insulin le glucagon. Motsoako o boetse o loketse bakuli ba lefu la tsoekere ba kopanang ho nka lipilisi le insulin: ba fokotsa tekanyo le palo ea ente ea lihormone.

Ho joalo, ts'ebeliso ea eona ha e na mabaka maemong ohle (joalo ka moriana ofe kapa ofe oa hypoglycemic), empa Metglib e lumellana ka botlalo le litekanyetso tsa sejoale-joale tse amanang le boleng.

Sebopeho sa moriana

Foromo e nahannoeng hantle le e lekiloeng ka bongaka ea likarolo tse peli tse sebetsang - metformin (400-500 mg) le glibenclamide (2,5 mg) ha e lumelle feela ho laola ka botlalo profil ea glycemic, empa hape e etsa hore e khonehe ho fokotsa tekanyo ea metsoako.

Ha e 'ngoe le e' ngoe ea lithethefatsi tsa setso e sebelisoa ho monotherapy, litekanyetso tsa tsona li fapane haholo. Ntle le likarolo tsa mantlha, ho boetse ho na le lifilimi ka sebopeho sa cellulose, starch, gelatin, glycerin, talc le lisebelisoa tse ling tsa tlatsetso. Matlapa a Metglib Force a fumaneha hape ka tekanyetso ea gligenclamide ea 5 mg le 500 mg metformin.

Moriana o rarahaneng o ka khetholloa ke matšoao a latelang: matlapa a oval ka har'a khetla e sirelelitsoeng ea "terracotta" kapa 'mala o mosoeu o nang le mola o arohanang, li kenngoa ka har'a lisele tsa contour tsa likarolo tse 10 - 90. Marang-rang a nang le litaelo a pakiloe ka lebokoseng la karete. Ka theko e theko e phahameng ea Metglib: li-ruble tse 240-360. bakeng sa ho paka.

Pharmacology Metglib

Karolo ea pele ea fomula eo batho ba bangata ba lefu la tsoekere ba nang le lefu la mofuta oa 2 ba e tloaetseng ke metformin, e leng eona feela setlhare sa mofuta oa sona sehlopheng sa "Biguanide" se fokotsang ho hanyetsoa hoa li-cell receptors tse senyehileng ho latela insulin. Tsamaiso e tloaelehileng ea kutloelo-bohloko ke ea bohlokoa ho feta ho susumetsa tlhahiso ea eona, hobane ka lefu la tsoekere la mofuta oa 2, lisele tsa cells li fana ka tlhahiso ea tsona e feteletseng.

Ntle le ho ntlafatsa katleho ea insulin, karolo eo e na le mesebetsi e meng:

• Ho thibela ho kenngoa ha glucose marakong a mala, ho hlohlelletsa ts'ebeliso ea eona ka lithane,
• Thibelo ea gluconeogenesis,
• Tšireletso ea Β-cell khahlanong le apaptosis le pele ho nako,
• Thibelo ea mefuta eohle ea acidosis le ts'oaetso e matla,
• Ho hlohlelletsa microcirculation ea metsi a tlhaho, endothelial functional le lipid metabolism,
• Ho theoha ha methapo ea mali e fokotsehileng, ho thibela khatello ea oxidative, ho ntlafatsa sebopeho sa mali.

Boemo ba bohlokoa ba ho tsebahala ha profid ea lipid ka mofuta oa 2 lefu la tsoekere ke taolo ea boima ba 'mele. Metformin E Thusa Lefu la Ts'oaetso ea Letsoai. Boloetse bo ipatileng bo eketsa menyetla ea mathata a mofets'e ka 40%. Biagunide e thibela liphetoho tse mpe. Le bakeng sa batho ba phetseng hantle ba kaholimo ho 40, WHO e khothaletsa ho nka Metformin ka litekanyetso tse tlase haholo bakeng sa thibelo ea liketsahalo tsa botsofaling le tsa pelo.

Motsoako oa bobeli oa mantlha, glibenclamide, ke moemeli oa moloko o mocha oa lithethefatsi tsa sulfonylurea.

Setlhare se kenyelelitsoe lethathamong la meriana ea bohlokoa ka bobeli le litlamorao tsa pancreatic le extrapancreatic.

Ka ho susumetsa manyeme, komporo e eketsa tlhahiso ea insulin ea eona. Mabapi le β-lisele tse ikarabellang bakeng sa tsoelo-pele ea lefu la tsoekere la mofuta oa 2, glibenclamide ha e nke lehlakore ebile e boloka ts'ebetso ea eona ka ho susumetsa li-receptor tsa lisele tse shebiloeng tse sa insulin.

Moriana o rarahaneng o bohlokoa maemong ohle a nts'etsopele ea lefu lena, kaha a fana ka phello ea likokoana-hloko:

• Pancreatic - e matlafatsa kutloisiso ea lisele tse hlaseloang, e sirelletsa cells-lisele tse tsoang ho tsoekere e bohale, e susumetsa mantsoe a insulin,
• Extra-pancreatic - metabolite ka ho toba e sebetsa ka mesifa le mafura, e thibela glucogenesis, 'me e lumella tsoekere ho kenella ka botlalo.

Tekanyo e nepahetseng ea metsoako ea foromo e u lumella ho fetola litekanyetso ka bonyane, ho eketsa polokeho ea lithethefatsi, ho fokotsa kotsi ea litla-morao le mathata a ts'ebetso.

Tekanyetso le tsamaiso

Ha u khetha tekanyetso, ngaka e tsepamisa maikutlo ho litholoana tsa liteko, sethala sa lefu lena, li-pathologies tse amanang, lilemo tsa lefu la tsoekere le karabelo ea 'mele likarolong tsa moriana.

Bakeng sa Metglib Force, ho ea ka litaelo tsa tšebeliso, tekanyetso ea pele ea letsatsi le letsatsi e ka ba 2,5 / 500 mg kapa 5/500 mg hang. Haeba e 'ngoe ea likarolo tsa Metglib kapa li-analogues tse ling tsa sulfonylurea e sebelisitsoe e le moriana oa mola oa pele, joale ha ho khutlisoa lithethefatsi ka mofuta o kopaneng, li tataisoa ke tekanyetso e fetileng ea matlapa.

Dosing titration e lokela ho etsahala butle - kamora libeke tse peli, katleho ea tekanyetso ea kalafo ea pele e ka hlahlojoa le ho fetoloa ho 5/500 mg. Nako le nako ea halofo ea khoeli, haeba ho hlokahala, moetlo o ka eketsoa ho lipilisi tse 4 ka moriana oa 5/500 mg kapa lipilisi tse 6 ka lethal dose ea 2,5 / 500 mg. Bakeng sa Metglib le litekanyetso tsa 2,5 / 500 mg, tekanyetso e kholo ke 2 mg ea moriana.

Mokhoa oa ho fokotsa litekanyetso o hlahisoa habonolo tafoleng.

Bakeng sa batho ba tsofetseng ba nang le lefu la tsoekere le bokhoni ba liphio bo fokolang, litekanyetso tsa pele tsa Metglib Force li behiloe ka mokhoa o tloaelehileng oa 2,5 / 500 mg. Maemong ana, boemo ba liphio bo tlameha ho lula bo beiloe leihlo, kaha ho bokelloa ha metformin nakong ea ho felisoa ho sa lekanyetsoang ho fumaneha ka mokhoa o seng kotsi, empa ho ba le mathata a tebileng - lactic acidosis. Ka ho ikoetlisa ka matla le ho ja lijo tse nang le phepo e lekaneng, mefokolo e tšoana.

Litlamorao tse sa lakatseheng

Ditlamorao ha se lebaka la ho hana kalafo: kamora hore mmele o fetohe, matshwao a mangata a itsamaela a le mong, mme kotsi ya lefu la tswekere e sa laoleheng e phahame haholo ho feta kotsi e ka bang teng ho Metglib. Ntho ea bohlokoa ke ho bala litekanyetso ka nepo: ka lefu le kotsi kapa le reriloeng, motho ea nang le lefu la tsoekere o ntshetsa takatso ea lijo ea phiri, o felloa ke matla, oa tšoha, matsoho a hae a thothomela. Letlalo le boreleli ebile le le mongobo, ho otla ha pelo ho potlakile, lehlasoa le haufi le ho akheha. Ho fumana hypoglycemia ho na le monyetla o moholo ho ba tsofetseng le o fokolisitsoeng ke lefu le hypocaloric phepo e nepahetseng ea lefu la tsoekere.

Haeba ho na le overdose, ho latela tse latelang:

• Bohloko ba ka mpeng
• Migraines
• Mathata a amanang le dyspeptic
• Mefuta e fapaneng ea karabelo ea mafu.

Ho se khotsofale ho fokolang ka nakoana ho tlosoa ke kalafo ea matšoao, lipontšo tse phehellang tsa matšoao li hloka ho nkeloa sebaka Metglib analogues – Diabetes, Dimaril, Gluconorm, Bagomet Plus, Glukovans, Glibenclamide hammoho le Metformin, Glucofast (ka maikutlo a ngaka).

Litsebi tsa lefu la tsoekere Mabapi le Metglieb

Li-forum tsa litema ho Metglib, litlhahlobo tsa batho ba nang le lefu la tsoekere le lingaka li tsoakiloe, hobane bakuli ba bangata ba na le kalafo e rarahaneng, 'me ho ba thata ho bona ho lekola katleho ea moriana o le mong. Tlhahisoleseling e eketsehileng e amana le mofuta oa kalafo: bao moriana o khethiloeng hantle ha ba tletlebe ka litla-morao. Empa ho leka ka boiphihlelo ba lefu la tsoekere e itseng ha ho na kelello ebile ho kotsi.

Ha re akaretsa maikutlo ohle, re ka fihlela qeto ea hore Metglib bakeng sa monotherapy ea lefu la tsoekere la mofuta oa 2 ke mekhoa e nepahetseng: ts'ireletso e phahameng le ts'ebetso e sebetsang, theko e theko e tlaase, phello e ntle ho boima ba mokuli, thibelo ea mathata a pelo le a oncological a beha lithethefatsi moleng o motle oa lithethefatsi tse ikhethileng pele.

Ho bapisoa le meriana e tšoanang

Metglib e na le li-analogues tse 'maloa tse bohlokoa hore u ithute.

Glucovans. Ntho e sebetsang ke metformin le glibenclamide.

Litšenyehelo - li-ruble tse 250 ka pakete e le 'ngoe.

Mohlahisi - Merck Sante SAAS, France.

Melemo: litlamorao tsa kalafo li tšoana le Metglib, ka hona e beoa haeba moriana ona o sa tšoanele mokuli.

Chelete e theko e phahameng haholoanyane, li-contraindication le litlamorao tse tšoanang.

Gluconorm. Ntho e sebetsang: Hoa tšoana.

Theko - karolelano ea li-ruble tse 240 ka likotoana tse 30.

Mohlahisi - MJ Biofarm, India.

Ketso - e fokotsa tsoekere e maling.

Melemo: e loketse bakuli ba bangata, ba sebetsang.

Cons: Ho boetse ho na le li-contraindication tse ngata, ho hloka chelete e ngata.

Mofuta ofe kapa ofe oa lithethefatsi o etsoa ka mokhoa o laetsoeng ke ngaka. Ho ikoetlisa ho thibetsoe!

Ho na le maikutlo a fapaneng ka lipilisi tsena. Bakeng sa ba bang, lithethefatsi li hlile li loketse, ho ba bang - che, ba bang ba hlokomela litlamorao tse ngata. Empa ka kakaretso, litlhahlobo tse ntle li feta tse mpe.

Vera: “Pele ba ne ba sebelisa Glibomet, empa joale theko e se e nyoloha. Ke kopile ngaka ho ngola ntho e theko e tlase, empa e tšoanang ka ts'ebetsong. Kahoo ke fumane risepe ea Metglib. E theko e tlase haholo, e fokotsa tsoekere hantle ha u ntse u latela lijo. Empa ke tlameha ho e odara khemising pele ho nako - ka lebaka le itseng, ha e kenngoe hantle. Taba ea bohlokoa ke hore ha ho na litla-morao, 'me tse ling ke litakatso. ”

Dmitry: “Ngaka e ile ea mpolella Metglib ha ba fumana mofuta oa lefu la tsoekere. Ke nkile pheko ena nako e ka etsang khoeli, 'me ha kea ka ka hlokomela phello e ngata. Tsoekere e ne e sa fokotsehe hantle, ka hona e fetiselitsoe ho sethethefatsi se seng. Empa ke utloile ke metsoalle ea ka hore o thusa motho e mong hantle. ”

Denis: “Ke noetse Metglib libeke tse peli, ke ile ka phefumoloha ka thata. Ke ile ngakeng, o ile a romella tlhahlobo. Ka lebaka leo, re ile ra fetola litekanyetso le lijo. Joale tsohle li hantle. Tsoekere e bile ntho e tloaelehileng ka likhoeli tse peli, ka hona ke thabile ka moriana. ”

Ka mosebetsi o sa sebetseng oa renal

Ho bakuli ba nang le ts'ebetso ea renal e sa sebetseng hantle, tumello ea renal ea metformin e fokotsehile, joalo ka QC, leha ho le joalo, T_1/2 ea eketseha, e lebisang hoketsong ea plasma ea metformin maling. Tsamaiso ea Metglib e tšoaetsanoa ho bakuli ba nang le bothata ba ho phekoloa ka liphio kapa ho senyeha ha liphio, CC e lumellanang le eona e ka tlase ho 60 ml / min.

Ka lebaka la hore metformin e epollotsoe ke liphio, pele ho qaleho ea thupelo ea kalafo le khafetsa nakong ea kalafo le Metglib, ho hlokahala hore e thehe boemo ba QC le / kapa serum creatinine maling. Bakeng sa bakuli ba nang le ts'ebetso e tloaelehileng ea renal, liteko tse joalo li khothalletsoa bonyane nako e le 'ngoe ka selemo. Ho batho ba tsofetseng kapa ho bakuli ba nang le CC, ho fihlela moeli o holimo oa tloaelehileng - makhetlo a 2-4 ka selemo. Tlhokomelo e khethehileng e lokela ho nkuoa haeba ho ka ba le kotsi ea ho ba le ts'ebetso ea renal e sa sebetseng hantle, ka mohlala, ho bakuli ba tsofetseng kapa qalong ea kalafo ea kalafo ea antihypertensive, hammoho le ha u sebelisa meriana ea diuretics kapa e seng steroidal anti-inflammatory (NSAIDs).

Litlhahlobo mabapi le Metglieb

Litsing tse ikhethang tsa bongaka, bakuli ba siea litlhahlobo tse ntle le tse mpe ka Metglib. Boholo ba bona ba hlokometse hore ka litekanyetso tse nepahetseng tsa kalafo, ho fumaneha litholoana tse ntle tsa kalafo. Leha ho le joalo, ka lebaka la hore bakuli ba nang le lefu la tsoekere hangata ba nka moriana ona hammoho le lithethefatsi tse ling tsa hypoglycemic, ba ke ke ba fana ka tlhahlobo ea sepheo sa ts'ebetso ea Metglib. Bakuli bohle ba nang le lefu la tsoekere ha ba lumellane nthong e le 'ngoe - nakong ea kalafo ea lefu lena, ngaka e lokela ho fana ka tekanyetso, ke ngaka feela e lokelang ho beha lethal dose le regimen.

Litsietsi hangata li fetisoa lethathamong le pharaletseng la li-contraindication le karabelo e mpe. Litšenyehelo tsa Metglib hangata li bitsoa tse theko e tlaase.