Glimecomb - litaelo tsa tšebeliso, litekolo, li-analogues le liforomo tsa tokollo (matlapa a 40 mg 500 mg) a moriana bakeng sa kalafo ea mofuta oa "lefu la tsoekere" o sa ts'epheng insulin ho batho ba baholo, bana le boimana.

Sehloohong sena, o ka bala litaelo tsa ho sebelisa lithethefatsi Glimecomb. E fana ka maikutlo a tsoang ho baeti sebakeng sena - bareki ba meriana ena, hammoho le maikutlo a litsebi tsa bongaka mabapi le tšebeliso ea Glimecomb ts'ebetsong ea bona. Kopo e kholo ke ho kenyelletsa maikutlo a hau ka sethethefatsi sena: moriana o thusitseng kapa o sa thusa ho felisa lefu lena, hore na ho bile le mathata afe kapa afe, mme mohlomong a sa phatlalatsoe ke moetsi ho phatlalatso. Li-analogues tsa Glimecomb moo ho nang le li-analogues tsa sebopeho tse fumanehang. Sebelisa bakeng sa kalafo ea lefu la tsoekere le sa itšetleheng ka insulin ho batho ba baholo, bana, esita le nakong ea kemaro le ho beleha. Sebopeho le tšebelisano ea lithethefatsi ka joala.

Glimecomb - sethethefatsi se kopaneng sa hypoglycemic bakeng sa tšebeliso ea molomo. Glimecomb ke motsoako o tsitsitseng oa mahlahana a mabeli a molomo oa hypoglycemic ea sehlopha sa Biguanide le sehlopha sa sulfonylurea sa derivatives. E na le liketso tsa pancreatic le extrapancreatic.

Glyclazide (ntho ea pele e sebetsang ea lithethefatsi Glimecomb) e tsoa ho sulfonylurea. E hlohlelletsa secretion ea insulin ke manyeme, e phahamisa maikutlo a litharollo tsa insulin. E susumetsa ts'ebetso ea li-enzyme tse ka hare, ho kenyeletsa le mesifa ea glycogen synthetase. E khutlisa tlhoro ea pele ea insulin secretion, e fokotsa sekhahla sa nako ho tloha motsotso oa ho ja ho fihlela ho qala ha insulin secretion, mme e fokotsa postprandial (kamora ho ja) hyperglycemia. Ntle le ho ama metabolism ea carbohydrate, e ama microcirculation, e fokotsa mokokotlo oa liplatelete le ho kopana, e liehisa nts'etsopele ea "parietal thrombosis", e tsebahala ka matla a vascular mme e thibela nts'etsopele ea micothrombosis le atherosclerosis, e khutlisetsa ts'ebetso ea physiological parietal fibrinolysis, 'me e hanyetsane le karabelo ea methapo ea methapo. E fokotsa nts'etsopele ea lefu la tsoekere le lefu la tsoekere sethaleng se sa eketseheng, le lefu la tsoekere le nang le tšebeliso ea nako e telele, ho bonahala ho fokotseha ho hoholo ha proteinuria. Ha e lebise keketseho ea boima ba 'mele, kaha e na le tšusumetso e phahameng tlhōrōng ea insulin secretion mme ha e bake hyperinsulinemia, e thusa ho fokotsa boima ba' mele ho bakuli ba batenya, ka mor'a lijo tse nepahetseng.

Metformin (ntho ea bobeli e sebetsang ea lithethefatsi Glimecomb) ke ea sehlopha sa Biguanides. E fokotsa khatello ea "glucose" maling ka ho thibela gluconeogeneis ka har'a sebete, e fokotse ho monya ha tsoekere maling ho tsoa liphatseng tsa gastrointestinal (GIT) le ho eketsa ts'ebeliso ea eona lithong. E fokotsa khatello ea mali ka serum ea mali ea li-triglycerides, cholesterol le li-density lipoprotein (LDL) tse ikemiselitsoeng ka mpeng e se nang letho, 'me ha e fetole khatello ea lipoprotein ea letsoalo le fapaneng. E thusa ho tsitsisa kapa ho theola boima ba 'mele. Ha ho na le insulin maling, phello ea kalafo ha e bonahatsoe. Boitšoaro ba Hypoglycemic ha bo bake. E ntlafatsa thepa ea mali ea fibrinolytic ka lebaka la khatello ea inhibitor ea activator profibrinolysin (plasminogen).

Sebopeho

Glyclazide + Metformin + baamohelang.

Mofumahali

Kamora ho tsamaisoa ka molomo, ho monya gliclazide ho phahame. Plasma protein e tlamang ke 85-97%. E etselitsoe sebeteng. E pepesoa haholo ka sebopeho sa metabolites ke liphio - 70%, ka mala.

Kamora ho tsamaisoa ha molomo, ho kenngoa ha metformin ke 48-52%. E kenelle ka potlako ho tsoa mokokotlong oa lijo. Absolute bioavailability (ka mpeng e se nang letho) ke 50-60%. Plasma protein e tlamang e ke ke ea qojoa. Metformin e khona ho bokellana liseleng tse khubelu tsa mali. E pepesoa ke liphio, haholo-holo ka sebopeho se sa fetoheng (glomerular filtration le secretion ea tubular) le ka mpeng (ho fihlela 30%).

Matšoao

thaepa lefu la tsoekere la 2 lefu la tsoekere (le sa itšetlehang ka insulin) ka ho se sebetse hantle kalafo ea ho ja, boikoetliso le kalafo e fetileng ka metformin kapa gliclazide,
phetisetso ea kalafo ea nakong e fetileng ka lithethefatsi tse peli (metformin le gliclazide) ho bakuli ba nang le mofuta oa lefu la tsoekere la mofuta oa 2 mellitus (o sa itšetleheng ka insulin) o nang le boemo ba tsoekere ea mali le bo laoloang hantle.

Lokolla liforomo

Matlapa a 40 mg + 500 mg.

Litaelo tsa mokhoa oa ho sebelisoa le oa litekanyetso

Glimecomb e nooa ka molomo nakong ea lijo kapa hang ka mor'a lijo. Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe ho mokuli ka mong, ho latela boemo ba tsoekere ea mali.

Tekanyetso ea pele hangata hangata ke matlapa a 1-3 ka letsatsi le khetho ea butle-butle ho fihlela puseletso e tiileng ea lefu lena e fihlella. Sekhahla se phahameng sa letsatsi le letsatsi ke matlapa a 5.

Ka tloaelo moriana o nooa habeli ka letsatsi (hoseng le mantsiboea).

Litla-morao

hypoglycemia (e khahlanong le regimen ea litekanyetso le lijo tse sa lekaneng) - hlooho ea hlooho, ho ikutloa a khathetse, tlala, ho fufuleloa ho eketsehileng, bofokoli bo matla, ho akheha ka letsoalo, ho tsekela, ho hokahana ha metsamao, mathata a nakoana a methapo ea kutlo,
ka tsoelo-pele ea hypoglycemia, ho felloa ke boitšoaro, ho felloa ke tsebo,
lactic acidosis - bofokoli, myalgia, mathata a ho hema, ho otsela, bohloko ba ka mpeng, hypothermia, ho fokotseha ha khatello ea mali (BP), bradyarrhythmia,
dyspepsia - ho nyekeloa, lets'ollo, maikutlo a boima ho epigastrium, tatso ea "tšepe" molomong, ho felloa ke takatso ea lijo,
hepatitis, cholestatic jaundice (ho tlosoa hoa lithethefatsi hoa hlokahala),
mosebetsi o eketsehileng oa hepatic transaminases, alkaline phosphatase (ALP),
inhibition of marrow hematopoiesis - anemia, thrombocytopenia, leukopenia,
pruritus, urticaria, makhopho a maculopapular,
ho sitisoa hoa pono
anemia hemolytic
allergic vasculitis,
bophelo bo behang sebete ho hloleha.

Contraindication

mofuta oa 1 lefu la tsoekere (ho itšetleha ka insulin),
lefu la tsoekere ketoacidosis,
lefu la tsoekere, lefu la tsoekere,
hypoglycemia,
Ho senyeha ha real,
maemo a hlobaetsang a ka lebisang phetohong ea ts'ebetso ea liphio: ho omella, ts'oaetso e matla, ho tsitsipana,
maloetse a hlobaetsang kapa a sa foleng a tsamaeang le "hypoxia" ea methapo: ho nyekeloa ke pelo, ho se khone ho phefumoloha, le ho fifala hoa myocardial, ho ts'oaroa,
ho hloleha ha sebete
porphyria
boimana
lactation (matsoele),
Tšebeliso e tšoanang ea miconazole,
maemo a hlokang kalafo ea insulin, ho kenyelletsa le mafu a tšoaetsanoang, ts'ebetso e kholo ea ts'ebetso ea ho buoa, likotsi, ho chesa haholo,
joala bo sa feleng
joala bo bongata haholo
lactic acidosis (ho kenyeletsoa le nalane ea)
sebelisa bonyane lihora tse 48 pele le ka hare ho lihora tse 48 kamora ho etsa lithuto tsa radioisotope kapa x-ray ka kenyelletso ea li-iodine tse nang le phapang e mahareng,
ho khomarela lijo tse nang le khalori e tlase (ka tlase ho likhalori tse ka tlase ho 1000 ka letsatsi),
hypersensitivity ho likarolo tsa moriana,
hypersensitivity ho tse ling tse sulfonylurea derivatives.

Bokhachane le pelehi

Ts'ebeliso ea moriana o bitsoang Glimecomb nakong ea kemolo e tiisitsoe. Ha u rera ho ima, hammoho le moimana nakong ea ho sebelisa moriana Glimecomb, e lokela ho felisoa mme kalafo ea insulin e lokela ho fanoa.

Glimecomb e kopantsoe le ho anyesa, hobane lintho tse sebetsang li ka pepesetsoa lebese la matsoele. Maemong ana, o tlameha ho fetoha kalafo ea insulin kapa ho emisa ho anyesa.

Sebelisa ho bana

Sebelisa ho bakuli ba tsofetseng

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

Litaelo tse khethehileng

Phekolo ea Glimecomb e etsoa feela hammoho le lijo tse nang le khalori e tlase e tlaase. Hoa hlokahala hore kamehla u lekole boemo ba tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja, haholo-holo matsatsing a pele a kalafo le moriana.

Glimecomb e ka fuoa feela bakuli ba fumanang lijo khafetsa, tseo hangata li kenyelletsang lijo tsa hoseng 'me li fana ka phepo e lekaneng ea lik'habohaedreite.

Ha o fana ka litlhare, ho lokela ho hopoloa hore ka lebaka la tšebeliso ea litekanyetso tsa sulfonylurea, hypoglycemia e ka ba teng, 'me maemong a mang e le ka mokhoa o thata le o tšoarellang, o hlokang ho kenngoa sepetlele le taolo ea tsoekere ka matsatsi a' maloa. Hypoglycemia hangata e hlaha ka ho ja lijo tse nang le khalori e tlase, ka mor'a ho ikoetlisa nako e telele kapa ho ikoetlisa ka mor'a ho noa joala kapa ka ho sebelisa lithethefatsi tse 'maloa tsa hypoglycemic ka nako e le' ngoe. Bakeng sa ho qoba nts'etsopele ea hypoglycemia, ho hlokahala hore ho khethoe litekanyetso ka hloko le ka bomong, hammoho le ho fa mokuli tlhaiso-leseling e phethahetseng ka kalafo e boletsoeng. Ka ho ikoetlisa ho feta tekano mmeleng le maikutlong, ha u fetola lijo, ho hlokahala hore u fetole litekanyetso tsa moriana oa mofuta oa Glimecomb.

Haholo-holo a amehang ka ketso ea lithethefatsi tsa hypoglycemic ke batho ba tsofetseng, bakuli ba sa fumaneng lijo tse nang le phepo e nepahetseng, ba nang le boemo bo fokolang ba 'mele, bakuli ba nang le bothata ba ho hloka pituitary-adrenal.

Beta-blockers, clonidine, reserpine, guanethidine e khona ho pata lipontšo tsa bongaka tsa hypoglycemia.

Bakuli ba lokela ho lemosoa ka kotsi e eketsehang ea hypoglycemia maemong a ho nka ethanol (joala), lithethefatsi tse seng tsa antiidalidal (NSAIDs), le tlala.

Ka ts'ebetso e kholo ea ts'ebetso ea opereishene le likotsi, ho chesa haholo, mafu a tšoaetsanoang a nang le febrile syndrome, ho ka hlokahala hore ho hlakoloe lithethefatsi tsa molomo le ho fana ka kalafo ea insulin.

Ka kalafo, ho lekola ts'ebetso ea liphio hoa hlokahala. Boikemisetso ba lactate ho plasma bo lokela ho etsoa bonyane makhetlo a 2 ka selemo, hammoho le ponahalo ea myalgia. Ka nts'etsopele ea lactic acidosis, ho khaotsa kalafo hoa hlokahala.

Lihora tse 48 pele ho ts'ebetso ea opereishene kapa tsamaiso ea methapo ea enjine e nang le iodineine e sebelisang iodine, e lokelang ho khaotsa ho sebelisoa Glimecomb. Kalafo e khothalletsoa hore e qale hape ka mor'a lihora tse 48.

Khahlano le semelo sa kalafo le Glimecomb, mokuli o tlameha ho tlohela tšebeliso ea joala le / kapa lithethefatsi tse nang le ethanol.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Nakong ea kalafo le Glimecomb, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea psychomotor.

Ho sebelisana le lithethefatsi

Kholiso hypoglycemic lithethefatsi bohato Glimekomb hlokomelwe ha tšebeliso ea inhibitors tsa angiotensin fetola potlakisang tsebetso ea lik'hemik'hale (Ace) inhibitors (captopril, enalapril), blockers tsa histamine H2 receptor (cimetidine), antifungal mahlahana (miconazole, fluconazole), NSAIDs (phenylbutazone, azapropazone, oxyphenbutazone), le fibrates (clofibrate, bezafibrat), lithethefatsi tse felisang lefuba (ethionamide), salicylates, coumarin anticoagulants, anabolic steroids, beta-blockers, monoahibhibili inoxidase (MAO), sulfonamide e sebetsang nako e telele, e na le cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, disopyramide, pompimidideam, pompimidideam, pompimidideam, pompimidideam, disopyramide, disopyrideide, disopyramide, disopyrideide, disopyramide, disopyramide, disopyramide insulin), allopurinol, oxytetracycline.

Ho fokotseha hoa phello ea hypoglycemic ea lithethefatsi Glimecomb ho bonoa ka ts'ebeliso e ts'oanang le barbiturates, glucocorticosteroids (GCS), li-adrenergic agonists (epinephrine, clonidine), lithethefatsi tsa antiepileptic (phenytoin), li-antiepileptic, li-antiepileptic (phenytoin), li-antiepileptic, li-antiepileptic (phenytoin). asparaginase, e nang le baclofen, danazole, diazoxide, isoniazid, e nang le morphine, rhytodrine, salbutamol, terbutaline, e nang le glucagon, rifampicin, e nang le g rmonami thyroid, lithium matsoai, le tekanyetso e phahameng ea acid e nicotinic, chlorpromazine, lithibela-pelehi molomo le estrogens.

E eketsa kotsi ea ho ba le li-ventricular extrasystole bokong ba pelo le pelo.

Meriana e thibelang hematopoiesis ea masapo e eketsa kotsi ea myelosuppression.

Ethanol (joala) e eketsa menyetla ea lactic acidosis.

Metformin e fokotsa khatello e phahameng ea plasma le halofo ea bophelo ba furosemide ka 31 le 42.3%, ka ho latellana.

Furosemide e eketsa boholo ba metformin ka 22%.

Nifedipine e eketsa ho monya, e liehisa tlhahiso ea metformin.

Lithethefatsi tsa cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren le vancomycin) tse fumanehang moqoqong oa tlholisano ea litsamaiso tsa tsamaiso ea methapo, mme ka kalafo ea nako e telele, li ka eketsa bongata bo boholo ba metformin ho plasma ea mali ka 60%.

Li-analog tsa sethethefatsi Glimecomb

Glimecomb ha e na li-analogues tsa sebopeho sa ntho e sebetsang.

Analogs bakeng sa phello ea kalafo (lithethefatsi bakeng sa kalafo ea mellitus e sa itšetleheng ka insulin):

Avandamet
Avandia
Adebite
Amaril
Anvistat
Antidiab
Arfazetin,
Bagomet,
Betanase
Biosulin P,
Vazoton
Victoza
Vipidia,
Galvus
Glemaz
Glibamide
Glibenez
Glibomet,
Glidiab
Glucophage,
Glurenorm,
Daonil
Lefu la tsoekere
Diastabol,
Dibikor
Insulin s
Lenaneng
Metfogamma,
Metformin
Mikstard Penfill,
Monotard MC,
Neovitel
NovoMix Penfill,
Noliprel A
Orsoten
Pankragen,
Pensulin,
Peoglar
Predian
Presartan
Pheta hape
Saxenda
Silubin Letel,
Siofor
Starlix
Telzap
Telsartan
Tricor
Foromo,
Chitosan
Chlorpropamide
Humalog,
Humulin
Cigapan
Endur-B,
Erbisol
Euglucon,
Januvius
Yanumet Nako e telele.

Maikutlo a Endocrinologist

Glimecomb ea antidiabetic drug e na le lethathamo le tšesaane la matšoao le litlolo tse fapaneng ka ho lekana. Ka hona, ha ho hlokahale ho e khetha hangata. Tekanyetso ho mokuli e mong le e mong ea nang le lefu la tsoekere la mofuta oa 2 ke mo khetha ka bonngoe. Ho bakuli ba bolokang melao ea ho nka Glimecomb ka tieo, maikutlo a mabe a hlaha hangata haholo ho feta ho bakuli ba sa lumellaneng le litlhahiso. Le liketsahalo tsa "hypoglycemia" tse matla tsa ho lahleheloa ke kelello li etsahetse ketsong ea ka ha bakuli ba tlameha ho kena sepetlele. Empa ka kakaretso, nka re moriana o lumelloa hantle ke bakuli.

Matšoao a ho sebelisoa

- thaepa lefu la tsoekere la 2 lefu la tsoekere (le sa itšetlehang ka insulin) ka ho se sebetse hantle kalafo ea ho ja, boikoetliso le kalafo ea nakong e fetileng ka metformin kapa gliclazide,

- phetisetso ea kalafo ea nakong e fetileng ka lithethefatsi tse peli (metformin le gliclazide) ho bakuli ba nang le mofuta oa lefu la tsoekere la mofuta oa 2 mellitus (o sa itšetleheng ka insulin) o nang le boemo ba tsoekere ea mali le bo laoloang hantle.

Contraindication

- mofuta oa 1 lefu la tsoekere (ho itšetleha ka insulin),

- Ho lemala hampe renal,

- maemo a hlobaetsang a ka lebisang phetohong ea ts'ebetso ea liphio: ho omella, ts'oaetso e matla, tšabo,

- maloetse a hlobaetsang kapa a sa foleng a tsamaeang le "hypoxia" ea methapo: ho nyekeloa ke pelo, ho se khone ho phefumoloha, infarction ea myocardial ea morao-rao, ho ts'oha,

- ho anyesa (matsoele),

- maemo a hlokang kalafo ea insulin, ho kenyelletsa mafu a tšoaetsanoang, ts'ebetso e kholo ea ts'ebetso ea ho buoa, likotsi, ho chesa haholo,

- lino tse tahang haholo

- lactic acidosis (ho kenyeletsoa le nalane),

- Sebelisa bonyane lihora tse 48 pele le ka hare ho lihora tse 48 kamora ho etsa lithuto tsa radioisotope kapa X-ray ka ho hlahisoa ha iodine e nang le phapang e mahareng.

- ho latela mokhoa oa ho ja lijo tse nang le khalori e tlase (ka tlase ho 1000 cal / ka letsatsi),

- Hypersensitivity ho likarolo tsa moriana,

- Hypersensitivity ho tse ling tse tsoang ho sulfonylurea.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

Moriana o nooa ka molomo nakong ea lijo kapa hang ka mor'a lijo. Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe ho mokuli ka mong, ho latela boemo ba tsoekere ea mali.

Tekanyetso ea pele ke hangata matlapa a 1-3 / letsatsi le khetho ea butle-butle ho fihlela puseletso e tiileng ea lefu lena e fihlella. Sekhahla se phahameng sa letsatsi le letsatsi ke matlapa a 5.

Ka tloaelo moriana o nooa habeli / ka letsatsi (hoseng le mantsiboea).

Litlamorao

Ho tloha tsamaisong ea endocrine: hypoglycemia (e khahlanong le mofuta oa dosing le lijo tse sa lekaneng) - hlooho ea hlooho, ho ikutloa a khathetse, tlala, ho eketsa ho fufuleloa, bofokoli bo matla, ho omella, ho tsejoa, ho hokahana ha metsamao, mathata a nakoana a ts'ebetso ea methapo, ho tsoela pele ha hypoglycemia, tahlehelo ea boitšoaro e ka ba teng, ho lahleheloa ke kelello.

Ho tloha ka lehlakoreng la metabolism: maemong a mang - lactic acidosis (bofokoli, myalgia, mathata a ho hema, ho otsela, bohloko ba ka mpeng, hypothermia, ho fokotseha ha khatello ea mali, bradyarrhythmia).

Ho tsoa ho ts'ebetso ea tšilo ea lijo: dyspepsia (ho nyekeloa, lets'ollo, maikutlo a boima ho epigastrium, tatso ea "metallic" molomong), ea fokotseha takatso ea lijo (ho teba ha maikutlo ana a fokotseha ka moriana o ntse o ja), ka seoelo hepatitis, cholestatic jaundice (ho tlosoa hoa lithethefatsi hoa hlokahala) , mosebetsi o eketsehileng oa hepatic transaminases, alkaline phosphatase.

Ho tsoa ho tsamaiso ea hemopoietic: ka seoelo - thibelo ea masapo a hematopoiesis (anemia, thrombocytopenia, leukopenia).

Litla-morao: Ho otla, urticaria, lekhopho la maculopapular.

Tse ling: ho sitisoa ha pono.

Litaelo tse khethehileng

Glimecomb e ka fuoa feela bakuli ba fumanang lijo khafetsa, tseo hangata li kenyelletsang lijo tsa hoseng 'me li fana ka phepo e lekaneng ea lik'habohaedreite.

Tšebelisano

Ho matlafatsa phello ea hypoglycemic ea lithethefatsi Glimecomb e bonoa ka ts'ebeliso e ts'oanang le ACE inhibitors (Captopril, enalapril), histamine H2-receptor blockers (cimetidine), lithethefatsi tsa antifungal (miconazole, fluconazole), NSAIDs (phenylbutazone, azapropenbazone ), lithethefatsi tse khahlanong le lefuba (ethionamide), salicylates, coumarin anticoagulants, anabolic steroids, beta-blockers, li-inhibitors tsa MAO, sulfonamides tse telele , ka cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, le lithethefatsi tse ling tsa hypoglycemic, t. .

Ho fokotseha hoa phello ea hypoglycemic ea lithethefatsi Glimecomb ho bonoa ka ts'ebeliso e ts'oanang le barbiturates, GCS, adrenergic agonists (epinephrine, clonidine), lithethefatsi tsa antiepileptic (phenytoin), ka li-blockers tse liehang tsa calcium, li-metabolic anhydrase inhibitors, acetazolamide diamide diide diide diode. le baclofen, danazole, diazoxide, isoniazid, le morphine, ritodrin, salbutamol, terbutaline, e nang le glucagon, rifampicin, e nang le lihormone tsa qoqotho. s, lithaelese tsa lithium, tse nang le litekanyetso tse phahameng tsa nicotinic acid, chlorpromazine, lithibela-pelehi tsa molomo le estrogens.

E eketsa kotsi ea ho ba le li-ventricular extrasystole bokong ba pelo le pelo.

Meriana e thibelang hematopoiesis ea masapo e eketsa kotsi ea myelosuppression.

Ethanol e eketsa menyetla ea lactic acidosis.

Lipotso, likarabo, litlhahlobo mabapi le lithethefatsi Glimecomb

Tlhahisoleseling e fanoeng e reretsoe litsebi tsa bongaka le tsa meriana. Tlhahisoleseling e nepahetseng ka ho fetelletseng ka lithethefatsi e fumaneha litaelong tse tlamelletsoeng ke moqapi. Ha ho na tlhahisoleseling e thathamisitsoeng leqepheng lena kapa leha e le efe ea sebaka sa rona sa marang-rang e ka sebeletsang e le sebaka sa boipiletso ba motho ho setsebi.

Buka ea litaelo

Mong'a setifikeiti sa ho ngolisa: Chemical and Pharmaceutical Combine Akrikhin, OJSC (Russia)
Moemeli: Akrikhin OJSC (Russia)

Fomu ea tokollo
Matlapa a 40 mg + 500 mg: 60 li-pcs.

Motsoako o kopantsoeng oa hypoglycemic bakeng sa tšebeliso ea molomo. Glimecomb® ke motsoako o kopantsoeng oa li-agents tse peli tsa molomo tsa hypoglycemic tsa sehlopha sa Biguanide le sehlopha sa sulfonylurea.

E na le liketso tsa pancreatic le extrapancreatic.

Glyclazide ke mofuta oa sulfonylurea. E hlohlelletsa secretion ea insulin ke manyeme, e phahamisa maikutlo a litharollo tsa insulin. E susumetsa ts'ebetso ea li-enzymes tse kenang ka hare - mesifa ea glycogen synthetase. E khutlisa tlhoro ea pele ea insulin secretion, e fokotsa nako ea ho qaleha ho tloha motsotso oa ho ja ho fihlela ho qala ts'ebetso ea "insulin" hape e fokotsa hyperglycemia ea postprandial. Ntle le ho ama metabolism ea carbohydrate, e ama microcirculation, e fokotsa mokokotlo oa liplatelete le ho kopana, e liehisa nts'etsopele ea "parietal thrombosis", e tsebahala ka matla a vascular mme e thibela nts'etsopele ea micothrombosis le atherosclerosis, e khutlisetsa ts'ebetso ea physiological parietal fibrinolysis, 'me e hanyetsane le karabelo ea methapo ea methapo. E fokotsa nts'etsopele ea lefu la tsoekere le lefu la tsoekere sethaleng se sa eketseheng, le lefu la tsoekere le nang le tšebeliso ea nako e telele, ho bonahala ho fokotseha ho hoholo ha proteinuria. Ha e lebise keketseho ea boima ba 'mele, hobane e na le tšusumetso e kholo tlhorong ea pele ea insulin secretion mme ha e bake hyperinsulinemia, e thusa ho fokotsa boima ba 'mele ho bakuli ba batenya, ka mor'a lijo tse nepahetseng.

Metformin ke ea sehlopha sa Biguanides. E fokotsa tsitsipano ea tsoekere maling le ho thibela gluconeogenesis ka har'a sebete, e fokotsa ho monya ha tsoekere maling ho tsoa phepelong ea lijo le ho eketsa ts'ebeliso ea eona lithong. E fokotsa mokokotlo oa triglycerides, cholesterol le LDL (e behiloeng ka mpeng e se nang letho) ka serumeng sa mali mme ha e fetole bongata ba lipoprotein tsa methapo e fapaneng. E thusa ho tsitsisa kapa ho theola boima ba 'mele. Ha ho na le insulin maling, phello ea kalafo ha e bonahatsoe. Boitšoaro ba Hypoglycemic ha bo bake. E ntlafatsa thepa ea mali ea fibrinolytic ka lebaka la khatello ea inhibitor ea activator profibrinolysin (plasminogen).

Tlhahiso le kabo

Kamora ho tsamaisoa ka molomo, ho monya ho phahame. Ha o nooa ka tekanyetso ea 40 mg C max ho plasma ea mali e fihlelloa kamora lihora tse 2-3 mme e fihla ho 2-3 μg / ml. Plasma protein e tlamang ke 85-97%.

Metabolism le excretion

E etselitsoe sebeteng. T 1/1 - lihora tse 8 - 20 - E qotsitsoe haholo ka sebopeho sa metabolites ke liphio - 70%, ka mala.

Ho bakuli ba tsofetseng, liphetoho tse bohlokoa tsa kliniki maemong a pharmacokinetic ha li bonoe.

Tlhahiso le kabo

Kamora ho tsamaisoa ka molomo, ho monya ke 48-52%. E kenelle ka potlako ho tsoa mokokotlong oa lijo. Absolute bioavailability (ka mpeng e se nang letho) ke 50-60%. C max ho plasma ea mali e fihlelloa kamora 1.81-2.69 h mme ha e fetele 1 μg / ml. Ho amoheloa ka lijo ho fokotsa C max ho plasma ka 40% mme e liehise katleho ea eona ka metsotso e 35. Plasma protein e tlamang e ke ke ea qojoa. Metformin e khona ho bokellana liseleng tse khubelu tsa mali.

T 1/2 ke lihora tse 6.2. E pepesitsoe ke liphio, haholo-holo tse sa fetoheng (glomerular filtration le secretion ea tubular) le ka mala (ho fihlela 30%).

- thaepa lefu la tsoekere la 2 lefu la tsoekere (le sa itšetlehang ka insulin) ka ho se sebetse hantle kalafo ea ho ja, boikoetliso le kalafo ea nakong e fetileng ka metformin kapa gliclazide,

- phetisetso ea kalafo e fetileng ka lithethefatsi tse peli (metformin le gliclazide) ho bakuli ba nang le mofuta oa lefu la tsoekere la 2 lefu la mellitus (le sa ts'epeng le insulin) le boemo ba tsoekere ea mali le bo laoloang hantle.

Moriana o nooa ka molomo nakong ea lijo kapa hang ka mor'a lijo. Tekanyetso ea lithethefatsi e khethoa ke ngaka ka bonngoe ho mokuli ka mong, ho latela boemo ba tsoekere ea mali.

Tekanyetso ea pele ke hangata matlapa a 1-3 / letsatsi le khetho ea butle-butle ho fihlela puseletso e tiileng ea lefu lena e fihlella. Sekhahla se phahameng sa letsatsi le letsatsi ke matlapa a 5.

Ka tloaelo moriana o nooa habeli / ka letsatsi (hoseng le mantsiboea).

Ho tsoa ho tsamaiso ea hemopoietic: ka seoelo - thibelo ea masapo a hematopoiesis (anemia, thrombocytopenia, leukopenia).

Litla-morao: Ho otla, urticaria, lekhopho la maculopapular.

Tse ling: ho sitisoa ha pono.

Maemong a litla-morao, lethalinyana le lokela ho fokotsoa kapa sethethefatsi se emisoe ka nakoana.

Litla-morao tse tloaelehileng tsa derivatives ea sulfonylurea: erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, allergic vasculitis, ho se sebetse hantle hoa sebete.

- mofuta oa 1 lefu la tsoekere (ho itšetleha ka insulin),

- lefu la tsoekere, lefu la tsoekere,

- Ho lemala hampe renal,

- maemo a hlobaetsang a ka lebisang phetohong ea ts'ebetso ea liphio: ho omella, ts'oaetso e matla, tšabo,

- maloetse a hlobaetsang kapa a sa foleng a tsamaeang le "hypoxia" ea methapo: ho nyekeloa ke pelo, ho se khone ho phefumoloha, infarction ea myocardial ea morao-rao, ho ts'oha,

- ho anyesa (matsoele),

- tsamaiso e tšoanang ea miconazole,

- maemo a hlokang kalafo ea insulin, ho kenyelletsa mafu a tšoaetsanoang, ts'ebetso e kholo ea ho buoa

- lino tse tahang haholo

- lactic acidosis (ho kenyeletsoa le nalane),

- Sebelisa bonyane lihora tse 48 pele le ka hare ho lihora tse 48 kamora ho etsa lithuto tsa radioisotope kapa X-ray ka ho hlahisoa ha iodine e nang le phapang e mahareng.

- ho latela mokhoa oa ho ja lijo tse nang le khalori e tlase (ka tlase ho 1000 cal / ka letsatsi),

- Hypersensitivity ho likarolo tsa moriana,

- Hypersensitivity ho tse ling tse tsoang ho sulfonylurea.

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

Ka hlokolosi, setlhare se lokela ho sebelisoa maemong a febrile syndrome, ho haella ha adrenal, hypofunction ea anterior pituitary, mafu a tšoelesa ea tšoelesa ea qoqotho.

Ts'ebeliso ea lithethefatsi Glimecomb ® nakong ea bokhachane e tiisitsoe. Ha u rera ho ima, hammoho le moimana nakong ea ho sebelisa moriana Glimecomb ®, e lokela ho felisoa mme kalafo ea insulin e lokela ho fanoa.

Glimecomb ® e kopantsoe le ho anyesa, hobane lintho tse sebetsang li ka pepesoa lebese la matsoele. Maemong ana, o tlameha ho fetoha kalafo ea insulin kapa ho emisa ho anyesa.

Matšoao: lactic acidosis e khonahala (hobane metformin ke karolo ea lithethefatsi), hypoglycemia.

Phekolo: ha matšoao a lactic acidosis a hlaha, o lokela ho khaotsa ho sebelisa moriana. Lactic acidosis ke boemo bo hlokang tlhokomelo ea bongaka ea tšohanyetso, kalafo e etsoa sepetlele. Phekolo e sebetsang ka ho fetisisa ke hemodialysis.

Ka hypoglycemia e bonolo kapa e itekanetseng, tsoekere (dextrose) kapa tharollo ea tsoekere e nkuoa ka molomo. Maemong a hypoglycemia e matla (ho lahleheloa ke kelello), 40% dextrose (glucose) kapa iv glucagon, i / m kapa s / c e kentsoe iv. Kamora ho hlaphoheloa kelellong, mokuli o lokela ho fuoa lijo tse nang le lik'habohaedreite ho qoba tsoelopele ea hypoglycemia.

Ho matlafatsa phello ea hypoglycemic ea lithethefatsi Glimecomb ® e bonoa ka ts'ebeliso e ts'oanang le ACE inhibitors (Captopril, enalapril), histamine H 2 receptor blockers (cimetidine), lithethefatsi tsa antifungal (miconazole, fluconazole), NSAIDs (phenylbutazone, oxapropibone , bezafibrat), lithethefatsi tse khahlanong le lefuba (ethionamide), salicylates, coumarin anticoagulants, anabolic steroids, beta-blockers, li-inhibitors tsa MAO, sulfonamides tse telele vii, e nang le cyclophosphamide, chloramphenicol, fenfluramine, fluoxetine, guanethidine, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, le lithethefatsi tse ling tsa hypoglycemic, oxytetracycline.

Ho fokotseha hoa phello ea hypoglycemic ea lithethefatsi Glimecomb ® e bonoa ka ts'ebeliso e ts'oanang le barbiturates, GCS, adrenergic agonists (epinephrine, clonidine), lithibela-mafu tsa antiepileptic (phenytoin), le li-antiepileptic, li-antiepileptic (phenytoin), le li-antiepileptic drug (phenytoin), tse nang le "calcium" block "cell", "li-antiepileptic" (phenytoin). , le baclofen, danazole, diazoxide, isoniazid, morphine, ritodrin, salbutamol, terbutaline, e nang le glucagon, rifampicin, e nang le lihormone tsa qoqotho zy, lithium matsoai, le tekanyetso e phahameng ea acid e nicotinic, chlorpromazine, lithibela-pelehi molomo le estrogens.

E eketsa kotsi ea ho ba le li-ventricular extrasystole bokong ba pelo le pelo.

Meriana e thibelang hematopoiesis ea masapo e eketsa kotsi ea myelosuppression.

Ethanol e eketsa menyetla ea lactic acidosis.

Metformin e fokotsa C max ho plasma le T 1/2 ea furosemide ka 31 le 42.3%, ka ho latellana.

Furosemide e eketsa C max metformin ka 22%.

Nifedipine e eketsa ho monya, e eketsa C max ho plasma ea mali, mme e liehisa tlhahiso ea metformin.

Lithethefatsi tsa Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren le vancomycin) tse fumanehang molemong oa tlholisano ea lits'ebetso tsa lefutso tsa lefutso mme, ka kalafo ea nako e telele, li ka eketsa C metxini ea C ho plasma ea mali ka 60%.

E amana le ho hloleha ha sebete.

Ho kenella kahare ho ts'enyo e matla ea renal, maemo a hlobaetsang a ka lebisang phetohong ea ts'ebetso ea renal: ho omella, ts'oaetso e matla, ho makala.

Phekolo le Glimecomb ® e etsoa feela hammoho le lijo tse nang le khalori e tlase e tlaase. Hoa hlokahala hore kamehla u lekole boemo ba tsoekere maling maling ka mpeng e se nang letho le ka mor'a ho ja, haholo-holo matsatsing a pele a kalafo le moriana.

Glimecomb ® e ka laeloa feela ho bakuli ba fumanang lijo tse tloaelehileng, tseo hangata li kenyelletsang lijo tsa hoseng 'me li fana ka phepo e lekaneng ea lik'habohaedreite.

Ha o fana ka litlhare, ho lokela ho hopoloa hore ka lebaka la tšebeliso ea litekanyetso tsa sulfonylurea, hypoglycemia e ka ba teng, 'me maemong a mang e le ka mokhoa o thata le o tšoarellang, o hlokang ho kenngoa sepetlele le taolo ea tsoekere ka matsatsi a' maloa. Hypoglycemia hangata e hlaha ka ho ja lijo tse nang le khalori e tlase, ka mor'a ho ikoetlisa nako e telele kapa ho ikoetlisa ka mor'a ho noa joala kapa ka ho sebelisa lithethefatsi tse 'maloa tsa hypoglycemic ka nako e le' ngoe. Bakeng sa ho qoba nts'etsopele ea hypoglycemia, ho hlokahala hore ho khethoe litekanyetso ka hloko le ka bomong, hammoho le ho fa mokuli tlhaiso-leseling e phethahetseng ka kalafo e boletsoeng. Ka ho ikoetlisa ho feta tekano mmeleng le maikutlong, ha u fetola mokhoa oa ho ja, ho hlokahala hore u fetole litekanyetso tsa lithethefatsi Glimecomb ®

Beta-blockers, clonidine, reserpine, guanethidine e khona ho pata lipontšo tsa bongaka tsa hypoglycemia.

Bakuli ba lokela ho lemosoa ka kotsi e eketsehang ea hypoglycemia maemong a ethanol, NSAIDs, le tlala.

Lihora tse 48 pele a buuoa kapa a / ho kenngoeng ha moemeli ea nang le iodineine e nang le iodineine, lithethefatsi Glimecomb ® e lokela ho khaotsa. Kalafo e khothalletsoa hore e qale hape ka mor'a lihora tse 48.

Khahlano le semelo sa kalafo le Glimecomb ®, mokuli o tlameha ho tlohela tšebeliso ea lino tse tahang le / kapa lithethefatsi tse nang le ethanol.

Tšusumetso ho bokhoni ba ho khanna makoloi le litsamaiso tsa taolo

Nakong ea kalafo, tlhokomelo e lokela ho nkuoa ha ho khannoa likoloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang ho tsepamisa mohopolo le ho potlakisa karabelo ea psychomotor.

Fomu ea tokollo, sebopeho le sephutheloana

Lipilisi ho tloha ho o mosoeu ho ea ho o mosoeu o nang le tranelate e bolila kapa e bosehla, e boreleli, e nang le chamfer le notch, marbling e lumelloa.

1 tab
gliclazide	40 mg
metformin hydrochloride	500 mg

Baeti: sorbitol, povidone, sodium ea croscarmellose, magnesium stearate.

Li-pcs tse 10 - liphutheloana tsa lithutsoana (6) - lipakete tsa karete.

Ketso ea pharmacological

E na le liketso tsa pancreatic le extrapancreatic.

Glyclazide - sulfonylurea derivative. E hlohlelletsa secretion ea insulin ke manyeme, e phahamisa maikutlo a litharollo tsa insulin. E susumetsa ts'ebetso ea li-enzymes tse kenang ka hare - mesifa ea glycogen synthetase.

E khutlisa tlhoro ea pele ea insulin secretion, e fokotsa nako ea ho qaleha ho tloha motsotso oa ho ja ho fihlela ho qala ts'ebetso ea "insulin" hape e fokotsa hyperglycemia ea postprandial.

Ntle le ho ama metabolism ea carbohydrate, e ama microcirculation, e fokotsa mokokotlo oa liplatelete le ho kopana, e liehisa nts'etsopele ea "parietal thrombosis", e tsebahala ka matla a vascular mme e thibela nts'etsopele ea micothrombosis le atherosclerosis, e khutlisetsa ts'ebetso ea physiological parietal fibrinolysis, 'me e hanyetsane le karabelo ea methapo ea methapo. E fokotsa nts'etsopele ea lefu la tsoekere le lefu la tsoekere sethaleng se sa eketseheng, le lefu la tsoekere le nang le tšebeliso ea nako e telele, ho bonahala ho fokotseha ho hoholo ha proteinuria. Ha e lebise keketseho ea boima ba 'mele, hobane e na le tšusumetso e kholo tlhorong ea pele ea insulin secretion mme ha e bake hyperinsulinemia, e thusa ho fokotsa boima ba 'mele ho bakuli ba batenya, ka mor'a lijo tse nepahetseng.

Metformin ke oa sehlopha sa Biguanides. E fokotsa tsitsipano ea tsoekere maling le ho thibela gluconeogenesis ka har'a sebete, e fokotsa ho monya ha tsoekere maling ho tsoa phepelong ea lijo le ho eketsa ts'ebeliso ea eona lithong.

E fokotsa mokokotlo oa triglycerides, cholesterol le LDL (e behiloeng ka mpeng e se nang letho) ka serumeng sa mali mme ha e fetole bongata ba lipoprotein tsa methapo e fapaneng. E thusa ho tsitsisa kapa ho theola boima ba 'mele. Ha ho na le insulin maling, phello ea kalafo ha e bonahatsoe. Boitšoaro ba Hypoglycemic ha bo bake.

E ntlafatsa thepa ea mali ea fibrinolytic ka lebaka la khatello ea inhibitor ea activator profibrinolysin (plasminogen).

Mofumahali

Tlhahiso le kabo

Kamora ho tsamaisoa ka molomo, ho monya ho phahame. Ha o nooa ka tekanyetso ea 40 mg Cmax ho plasma e fihlella ka mor'a lihora tse 2-3 mme e lekana le 2-3 μg / ml. Plasma protein e tlamang ke 85-97%.

Metabolism le excretion

E etselitsoe sebeteng. T1 / 2 - lihora tse 8 - 20 - E qotsitsoe haholo ka sebopeho sa metabolites ke liphio - 70%, ka mala.

Ho bakuli ba tsofetseng, liphetoho tse bohlokoa tsa kliniki maemong a pharmacokinetic ha li bonoe.

Tlhahiso le kabo

Kamora ho tsamaisoa ka molomo, ho monya ke 48-52%. E kenelle ka potlako ho tsoa mokokotlong oa lijo. Absolute bioavailability (ka mpeng e se nang letho) ke 50-60%. Cmax ho plasma ea mali e fihlelloa kamora 1.81-2.69 h mme ha e fetele 1 μg / ml. Ho amoheloa ka lijo ho fokotsa Cmax ho plasma ka 40% mme e liehise katleho ea eona ka 35 min. Plasma protein e tlamang e ke ke ea qojoa. Metformin e khona ho bokellana liseleng tse khubelu tsa mali.

T1 / 2 ke lihora tse 6.2. E pepesoa ke liphio, haholo-holo tse sa fetoheng (filtration glomerular le secretion ea tubular) le ka mala (ho fihlela 30%).

- thaepa lefu la tsoekere la 2 lefu la tsoekere (le sa itšetlehang ka insulin) ka ho se sebetse hantle kalafo ea ho ja, boikoetliso le kalafo ea nakong e fetileng ka metformin kapa gliclazide,

Bongata

Matšoao lactic acidosis e khonahala (kaha metformin ke karolo ea lithethefatsi), hypoglycemia.

Phekolo: haeba matšoao a lactic acidosis a hlaha, khaotsa ho sebelisa lithethefatsi. Lactic acidosis ke boemo bo hlokang tlhokomelo ea bongaka ea tšohanyetso, kalafo e etsoa sepetlele. Phekolo e sebetsang ka ho fetisisa ke hemodialysis.

Ho sebelisana le lithethefatsi

E eketsa kotsi ea ho ba le li-ventricular extrasystole bokong ba pelo le pelo.

Meriana e thibelang hematopoiesis ea masapo e eketsa kotsi ea myelosuppression.

Ethanol e eketsa menyetla ea lactic acidosis.

Metformin e fokotsa Cmax ho plasma le T1 / 2 ea furosemide ka 31 le 42.3%, ka ho latellana.

Furosemide e eketsa Cmax ea metformin ka 22%.

Nifedipine e eketsa ho monya, e eketsa Cmax ho plasma ea mali, e liehisa tlhahiso ea metformin.

Lithethefatsi tsa cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren le vancomycin) tse fumanehang ka har'a marang-rang li qothisana le litsamaiso tsa tsamaiso ea methapo, mme ka kalafo ea nako e telele, li ka eketsa Cmax ea metformin ho plasma ea mali ka 60%.

Bokhachane le pelehi

Glimecomb e kopantsoe le ho anyesa, hobane lintho tse sebetsang li ka pepesetsoa lebese la matsoele. Maemong ana, o tlameha ho fetoha kalafo ea insulin kapa ho emisa ho anyesa.

Lipehelo le maemo a polokelo

Lethathamo B. Setlhare se lokela ho bolokoa se sa fihlella bana, se omelle, se sirelelitsoe ke khanya, ka mocheso o sa feteng 25 ° C. Bophelo ba Shelf ke lilemo tse 2.

Tlhaloso ea lithethefatsi GLIMECOMB e ipapisitse le litaelo tse lumelletsoeng ka molao bakeng sa tšebeliso le tumello ke moetsi.

O fumane bug? Khetha eona ebe o tobetsa Ctrl + Enter.

Melao ea ho nka lithethefatsi Glimecomb le lithethefatsi tsa analog

Glimecomb e bua ka lithethefatsi tse sebelisoang ho lefu la tsoekere la mofuta oa 2.

Sesebelisoa se na le thepa e kopaneng ea hypoglycemic.

Kamora ho sebelisa moriana, ho tloaela boemo ba tsoekere maling maling a mokuli hoa hlokomeleha.

Tlhahisoleseling ka kakaretso, sebopeho le mofuta oa tokollo

Setlhare se boletsoeng se bolela li-agents tsa hypoglycemic tse nkuoeng ka molomo. Sesebelisoa se na le phello e kopaneng. Ntle le phello e fokotsang tsoekere, Glimecomb e na le pancreatic effect. Maemong a mang, moriana o na le phello ea extrapancreatic.

Sebopeho sa moriana se na le Metformin hydrochloride ka bongata ba 500 mg le Gliclazide - 40 mg, hammoho le li-sorbitol le sodium ea croscarmellose. Ka tekanyo e nyane, magnesium stearate le povidone li teng kalafong.

Setlhare se fumaneha ka mokhoa oa matlapa a cylindrical ka bosoeu, tranelate kapa 'mala o mosehla. Bakeng sa litafole, ho sesa hoa amoheleha. Lipilisi li na le kotsi le bevel.

Glimecomb e rekisoa ka matlapa a 10 ka har'a mekotla ea blister. Pakete e le 'ngoe e na le liphutheloana tse 6.

Pharmacology le pharmacokinetics

Glimecomb ke lithethefatsi tse kopanyang tse kopanyang li-hypoglycemic agents tsa sehlopha sa Biguanide le lihlahisoa tsa sulfonylurea.

Moemeli o bontšoa ke litlamorao tsa pancreatic le extrapancreatic.

Gliclazide ke e 'ngoe ea likarolo tsa mantlha tsa moriana. Ke tšibollo ea sulfonylurea.

tlhahiso ea insulin e sebetsang
tsoekere e nyane ea mali
fokotseha ho khabeloa hoa liplatelete, e thibelang ho etsoa ha methapo ea mali methapong ea mali,
normalization ea vascular permeability.

Gliclazide e thibela ho hlaha ha microthrombosis. Nakong ea tšebeliso ea nako e telele ea lithethefatsi ho bakuli ba nang le lefu la tsoekere, ho fokotseha ha protheine (boteng ba protheine ho moroto).

Gliclazide e ama boima ba mokuli ea sebelisang moriana. Ka lijo tse nepahetseng ho bakuli ba nang le lefu la tsoekere ba nkang Glimecomb, ho fokotsa boima ba 'mele hoa tsebahala.

Metformin, e leng karolo ea lithethefatsi, e bua ka sehlopha sa Biguanide. Ntho ena e fokotsa bongata ba tsoekere maling, e thusa ho fokolisa tšebetso ea ho monya lero la tsoekere ka mpeng le mala. Metformin e thusa ho potlakisa ts'ebetso ea ho sebelisa tsoekere ho linama tsa 'mele.

Ntho ena e theola cholesterol, litekanyetso tse phahameng tsa letsoalo. Tabeng ena, Metformin ha e ame boemo ba lipoprotein ba methapo e fapaneng. Joalo ka Gliclazide, e fokotsa boima ba mokuli.

Ha e na phello ho ba teng ha insulin maling. Ha e kenye letsoho ponahalong ea karabelo ea hypoglycemic. Gliclazide le metformin ka mokhoa o fapaneng li ananeloa ka mokhoa o fapaneng le ho tsoa ho mokuli.

Gliclazide e tšoauoa ka monko o phahameng ho feta oa Metformin.

Palo e phahameng ea Gliclazide maling e fihlella ka mor'a lihora tse 3 ho tloha nakong ea ho kenella ha moriana. Ntho ena e hloekisoa ka liphio (70%) le mala (12%). Ho felisoa ha halofo ea bophelo ho fihla lihora tse 20.

Bioavailability ea Metformin ke 60%. Ntho ena e bokellana ka matla liseleng tse khubelu tsa mali. Bophelo ba halofo ke lihora tse 6. Ho tlosoa mmeleng ho etsahala ka liphio, hammoho le mala (30%).

Matšoao le contraindication

Moriana ona o khothalletsoa bakeng sa batho ba lefu la tsoekere ba nang le lefu la tsoekere la mofuta oa 2 haeba:

kalafo ea nakong e fetileng hammoho le ho ja le ho ikoetlisa e ne e se na katleho e nepahetseng,
Ho na le tlhoko ea ho khutlisetsa kalafo e kopaneng e neng e entsoe pele ka Gliclazide le Metformin ho bakuli ba nang le maemo a tsitsitseng a glucose.

Moriana o tšoauoa ka lenane le pharaletseng la li-contraindication, tseo ho tsona:

boteng ba lefu la tsoekere la mofuta oa 1,
ho hloka mamello ho likarolo tsa moriana,
ts'ebetso ea menoana e sa sebetseng,
boimana
ho hloleha ha sebete
lactic acidosis,
ho nyekeloa ke pelo
lefu la tsoekere
lebone
tšoaetso e fapaneng
myocardial infarction
lefu la porphyrin
lefu la tsoekere
mehato ea pele ea ho buoa,
nako ea mokuli ea etsang lithuto tsa x-ray le litlhahlobo a sebelisa radioisotope ka ho hlahisoa ha li-iodine-phapanyetsano ea li-iodine (ho thibetsoe ho nka matsatsi a 2 pele le kamora lithuto tsena),
likotsi tse mpe
maemo a makatsang a amanang le mafu a pelo le a liphio,
ho hloleha ho phefumoloha
botaoa,
tsoekere e fokolang ea mali (hypoglycemia),
tšoaetso e matla ea liphio
joala bo sa foleng,
Ho chesa haholo 'meleng,
khomarela bakuli ba nang le phepo ea hypocaloric,
ho nka miconazole,
lefu la tsoekere la ketoacidosis.

Maikutlo a litsebi le bakuli

Ho tsoa ho litlhahlobo tsa bakuli, ho ka fihlela qeto ea hore Glimecomb e fokotsa tsoekere ea mali hantle mme e mamelloa hantle, leha ho le joalo, lingaka li tsitlella tlhokomeliso ea eona ka lebaka la litla-morao tse 'maloa.

Setlhare se boletsoeng se fanoa ka taelo ea ngaka. Litsenyehelo tsa eona li tsoa ho li-ruble tse 440-580. Theko ea balekane ba bang ba lapeng e tsoa ho li-ruble tse 82 ho isa ho tse 423.

E khothalelitsoe Lingoloa Tse Ling Tse Amanang

Glimecomb: litaelo tsa tšebeliso, theko, litekolo, li-analogues

Setlhare se sebetsa ka molomo, se reretsoe ho laola boemo ba tsoekere maling maling a mokuli ea nang le lefu la tsoekere la mofuta oa 2.

Ho kopanya Metformin le Glyclazide ka bobeli, Glimecomb ke tharollo e ntle bothateng ba tsoekere ea mali, taolo eo ho lokelang ho ba bonolo ho e laola.

Ntle le moo, sesebelisoa sena ha se na matla, ka hona ha se tšoanele bakuli ba sa tsitsang le ba maemo a tsoekere a phahameng haholo. Tse latelang ke litlhokahalo tse lokelang ho lateloa ha o sebelisa moriana ona.

Kopo

Glimecomb e khothalletsoa hore e sebelisoe ho bakuli ba nang le lefu la tsoekere la mofuta oa 2.

Ho bohlokoa hore sethethefatsi sena se etselitsoe mofuta o joalo oa lefu lena ha ts'ebetso ea 'mele le' mapa oa lijo o hlophisitsoeng ka kotloloho o sa tlise sephetho se nepahetseng.

Sena se bolela hore sethethefatsi sena se laetsoe haeba ho sa sebetsanoe hantle le kalafo e rarahaneng, e kopantseng lithethefatsi tse peli (hangata e arotsoe metformin le gliclazide) hammoho le ts'ebetso ea mmele le lijo.

Nakong ea kalafo le Glimecomb, ho lekola khafetsa boemo ba tsoekere ba mokuli pele le ka mor'a lijo ho hlokahala (tlhokomelo e khethehileng e lokela ho lefuoa bekeng ea pele ea kamohelo).

Lokolla liforomo

Glimecomb e na le foromo e le 'ngoe ea ho lokolla ka mokhoa oa matlapa. Moriana o arotsoe ka mokhoa oa ho paka ka lihlopha tse latelang:

ka libotlolong tsa polasetiki ka liphutheloana tsa karete. Vial e le 'ngoe e kanna ea ba le matlapa a 30, 60 kapa 120,
ka lebokoseng la karete e nang le lithupa tsa matlapa a 10 ho e le 'ngoe. Pakete e le 'ngoe e na le lilakane tse 6,
ka lebokoseng la karete le nang le lithupa tsa matlapa a 20 ho e le 'ngoe. Sephutheloana se le seng se na le lilakane tse 5.

Matlapa ka boyona a ka sebopeho sa silinda e sephara, hangata e tšoeu (beige, 'mabole kapa e mosehla e loketse). Lipilisi li na le kotsi le bevel. Sebopeho sa Glimecomb se kenyelletsa metformin le hydrochloride ka bongata ba 500 mg, hammoho le glycoslide 40 mg. Ntle le moo, sodium ea povidone, magnesium stearate, sorbitol le croscarmellose e teng ka bongata.

Matlapa a fumaneha feela ho ngaka.

Litlamorao

Litlamorao tse sa rateheng tse ka sebetsanoang le ho etsoa ha Glimecomb hangata li bakoa ke ho fetella kapa ho se lumellane ha hae le 'mele oa mokuli o amehang ka ho khetheha.

Mme litaba tse tsoang ho sulfonylurea derivatives li eketsa kotsi ea palo e kholo ea litla-morao.

Khetho ea lethal e sa sebetseng bakeng sa mokuli e aparetsoe ke kholo ea lactic acidosis, e tsamaeang le migraines, bofokoli bo sa khaotseng, ho otsela ho tebileng, hammoho le bohloko bo otlang ka mpeng le ho fokotseha ha khatello ea methapo ea methapo.

Tse latelang ke litlamorao tse sa batleheng ha o nka Glimecomb:

nts'etsopele ea hypoglycemia le lactocidosis e nang le matšoao ohle a bohloko,
ponahalo ea lets'ollo le ho hlasimoloha,
maikutlo a lulang a sa thabise ka mpeng ea mpa,
fokotseha takatso ea tloaelo,
khafetsa khafetsa, tatso ea mali molomong le 'metso,
Nts'etsopele ea maloetse a tebileng a sebete (hepatitis, jj.) ha e fumanehe
allergic reaction on the dikarolo tsa sebopeho (urticaria, ho hlohlona, lihlahala,
bokhubelu, mefuta e fapaneng ea mehoma),
ho na le maemo a ho senyeha hoa pono ha u ntse u nka Glimecomb.

Haeba u na le matšoao a ka holimo, u lokela ho etela setsebi hang-hang.

Ho latela boholo ba litla-morao, ngaka e lokela ho fokotsa tekanyetso ea moriana kapa e e nkele sebaka ka khetho e amohelehang (tlohela ka botlalo ts'ebeliso ea Glimecomb).

Lifekthering tse etellang pele tsa Russia, theko ea Glimecomb e fapana ho tloha ho li-ruble tse 200 ho isa ho tse 600, ho latela sephutheloana le palo ea litafole tse ho sona, hammoho le ho mofani oa thepa le sebaka sa thekiso.

Litsenyehelo tsena tsa lithethefatsi li etsa hore e be theko e tlase bakeng sa karolo e pharalletseng ea baahi, ka hona e hlokoa 'marakeng oa meriana. Kahoo theko e tloaelehileng mabenkeleng a marang-rang bakeng sa matlapa a Glimecomb ke li-ruble tse 40 mg + 500 mg 450 ka sephutheloana, tse nang le matlapa a 60.

Lifekthering tsa marang-rang, theko ea lithethefatsi bakeng sa matlapa a 60 e tla ba li-ruble tse 500-550.

Li-analogu tsa Glimecomb ke litlhare tse latelang:

Gliformin (li-ruble tse ka bang 250 bakeng sa matlapa a 60), mookotaba oa ts'ebetso o ts'oana le oa Glimecomb, sebopeho se tšoana, empa ho ba teng ha insulin ho etsa hore lithethefatsi tsena li se ke tsa rateha,
Diabefarm (bakeng sa matlapa a 60, u tla tlameha ho lefa li-ruble tse ka bang 150). E na le khatello e matla ea glyclazide - 80 mg, e etselitsoeng ho felisa mathata a tšoanang le Glimecomb.
Gliclazide MV (theko e tloaelehileng ea matlapa a 60 ke li-ruble tse 200). E na le sebopeho se fapaneng le Glimecomb, e na le 30 mg feela ea glycoslazide. Matšoao a sebelisoang a tšoana le a moriana oa mantlha.

Glimecomb: litaelo tsa tšebeliso, theko, litekolo le li-analogues

Ka linako tse ling bakuli ba nang le lefu la tsoekere ba tlameha ho sebelisa lithethefatsi tse ngata hang. Empa ho na le lisebelisoa tse hlahisoang li kopanya likarolo tse hlokahalang. Li u lumella ho etsa ka pilisi e le 'ngoe. "Glimecomb" ke setlhare se nang le thepa e joalo. Nahana ka litaelo tsa tšebeliso ea eona ka botlalo.

Ho bapisoa le li-analogues

Setlhare sena se na le li-analogues tse 'maloa ka sebopeho le ka thepa. A re hlahlobisiseng hore na ngaka ea Glimecomb e ka nkela sebaka sa eng.

Gliformin. Theko - ho tloha li-ruble tse 250 ka sephutheloana (likotoana tse 60). Mohlahisi oa JSC Akrikhin, Russia. E na le metformin. Mefuta ea matlapa a tšoana, empa eseng ho motho e mong le e mong. E sebelisoa ho tsitsisa boima ba 'mele.

Diabefarm. Litšenyehelo - li-ruble tse 160 (matlapa a 60). E hlahisa k'hamphani "Pharmacor", Russia. E na le gliclazide e eketsehileng (80 mg), thepa e meng kaofela e tšoana.

Gliclazide. Ho tloha li-ruble tse 200 ka pakete (likotoana tse 60) Moqapi - Canonfarm, Russia. E na le "gliclazide" e fokolang sebopeho. E thusa ho boloka boima ba mmele bo nepahetse. Ho kenyelletsoa hape ke theko e tlase.

Amaril. Matlapa a joalo a theko e boima ho tloha li-ruble tse 800 ka pakete e ngoe le e ngoe. E entsoe ke Handoc Inc., Korea. Hape ke kalafo e kopaneng bakeng sa lefu la tsoekere (glimepiride + metformin). Contraindication e tšoana. Methapo e theko e phahameng haholo.

Galvus. Theko e qala ho tloha li-ruble tse 1600. Moqapi ke Novartis Pharma, Jeremane. Motsoako oa motsoako (vildagliptin + metformin). E na le litlamorao tse tšoanang le lithibelo tsa ho amoheloa joalo ka Glimecomb. E hloka chelete e ngata, empa ka linako tse ling e ba e sebetsang ho feta molekane oa eona.

Ka kakaretso, batho ba nang le lefu la tsoekere ba nang le boiphihlelo ba arabela hantle ho sethethefatsi sena. Monate oa kalafo e kopaneng o oa tsebahala ha lintho tse peli tse sebetsang li le ka har'a letlapa le le leng. Ka linako tse ling ba ngola hore pheko e ne e sa tšoanele. Litlamorao ha li na seoelo.

Victor: “Ke na le lefu la tsoekere la mofuta oa 2. Ke ne ke tloaetse ho nka metformin le gliclazide ka thoko. E ne e se bonolo ebile e theko e boima. Ngaka e ile ea fetisetsoa Glimecomb. Ntle le taba ea hore hona joale ke noella Letlapa le le leng sebakeng sa tse peli, ke ikutloa ke le betere haholo. Ha kea fumana litla-morao, ke khotsofetse ke lithethefatsi. "

Valeria: “Ntate o lilemo li 63, o ile a fumanoa lilemo tse 'maloa tse fetileng. Lintho tse ngata li se li phekotsoe, ntho e 'ngoe le e' ngoe e khaotsa ho sebetsa. Ngaka e ile ea nkopa hore ke leke Glimecobm, empa ea lemosa hore ke tla latela mokhoa o thata oa ho ja le ho hlokomela bophelo ba ka bo botle. E se e nka likhoeli tse tharo joale, matšoao a tsoekere a hlophisehile, 'me boima ba eona bo felile. Ntate o thabile. ”

Lerato: "Ke khale ke nkile kalafo ena. Ke rata tekanyo ea theko e tlase haholo le boleng bo holimo. Tsoekere ha e eketsehe, ke ikutloa ke le monate, ho ne ho se na litla-morao ebile che. ”

Gregory: “Ngaka e ile ea laela Glimecomb. Kamora khoeli ea ho amoheloa, ke ile ka tlameha ho fetola risepe. Ka molao ke ne ke sa tšoane. Mathata a amanang le ho ja a ile a qala, 'me hlooho le hlooho e ntse e eketseha. Ngaka e re ha se motho e mong le e mong ea lumelang. Empa seo ha sea ntekanela. ”

Alla: “Ba ile ba khetha Glimecomb. O ile a phekoloa libeke tse peli, empa a tlameha ho fetohela pheko e ngoe. Boemo ba tsoekere ha boa fetoha, ho fapana le moo, bo bile bo nyolohile hanyane. Empa ka theko e joalo ha e khopise hoo e sa kang ea lekana. ”

Glimecomb e kopantsoe le lithethefatsi tse fokotsang tsoekere bakeng sa lefu la tsoekere

Lefu la tsoekere ka har'a naha ke e 'ngoe ea mafu a mahlano a bohlokoa ao batho ba habo rona ba holofetseng le ho shoa. Leha ho le ka lipalo tse hakanyetsoang, batho ba ka bang likete tse mashome a mararo ba nang le lefu la tsoekere ba shoa selemo se seng le se seng ka lebaka la lefu la tsoekere naheng. Boholo ba tsona ha li khone ho laola boemo ba tsona ntle le meriana ea boleng.

Lithethefatsi tse tsebahalang haholo tse fokotsang tsoekere ka nako e telele li tsoa sehlopheng sa li-biagunides le sulfonylureas. Li ithutoa haholo lithupelong tsa bongaka le lithutong tse ngata, li sebelisoa maemong ohle a lefu la tsoekere la mofuta oa 2.

Motsoako o kopaneng oa Glimecomb (ka sebopeho sa machaba Glimekomb) o thehiloe motheong oa biagunide le tokiso ea sulfonylurea, ho kopanya bokhoni ba metformin le glycazide, e lumellang glycemia ho laoloa ka nepo le ka mokhoa o sireletsehileng.

Pharmacology Glimecomb

Mokhoa oa ts'ebetso ea litokisetso tsa mantlha tsa ramatiki o fapana haholo, sena se etsa hore ho be le tšusumetso ea bothata ho tsoa liaparong tse fapaneng.

Karolo ea pele ea lithethefatsi ke moemeli oa moloko o mocha oa sulfonylureas. Monyetla o theolelang tsoekere oa lithethefatsi o kenyelletsa ntlafatsong ea tlhahiso ea "insulin" ea insulin ka li-β-cell tsa manyeme.

Ka lebaka la ts'usumetso ea mesifa ea glycogen synthase, ts'ebeliso ea tsoekere ke mesifa e ntlafalitsoe, ho bolelang hore ha e fetoloe ka mafolofolo joalo ka mafura.

Normalise profil ea glycemic ea gliclazide ka matsatsi a seng makae, ho kenyelletsa le lefu la tsoekere la metabolic.

Ho tloha motsotso oa ho amohela limatlafatsi ka har'a tšilo ea lijo ho fihlela qalong ea motsoako oa insulin ka sethethefatsi, ho hlokahala nako e fokolang haholo ho feta kantle ho eona.

Hyperglycemia, eo hangata e iponahatsang ka mor'a ho ja lijo tse nang le lik'habohaedreite, ha e kotsi ka mor'a ts'ebeliso ea gliclazide. Phatlalatso ea liplatelese, fiblinolytic le heparin li eketseha le lithethefatsi.

Mamello e eketsehileng ea heparin, e na le moriana le thepa ea antioxidant.

Mochine oa mosebetsi oa metformin, e leng karolo ea bobeli ea motheo ea Glimecomb, o thehiloe ho fokotseha ha maemo a tsoekere a basel ka lebaka la taolo ea glycogen e lokollotsoeng sebeteng.

Ho matlafatsa kutloisiso ea li-receptor, lithethefatsi li fokotsa ho hanyetsa ha lisele ho insulin.

Ka ho thibela tlhahiso ea tsoekere ho liprotheine le mafura, e potlakisa ho tsamaisoa ha eona ho ea ho mesifa ea mesifa bakeng sa tšebeliso e sebetsang.

Ka mala, metformin e thibela ho kenngoa ha tsoekere ka har'a mabota. Motsoako oa mali oa ntlafala: cholesterol e akaretsang, triglycerol le LDL ("mpe" cholesterol) ea fokotseha, boemo ba cholesterol ea "good" Metformin ha e ame li-β-cell tse ikarabellang bakeng sa tlhahiso ea tsona ea insulin. Ka lehlakoreng lena, ts'ebetso e laola gliclazide.

Ke mang ea sa lumellaneng le Glimecomb

Moriana o kopaneng ha o fuoe:

Batho ba nang le lefu la tsoekere ba nang le lefu la 1,
Ka ketoacidosis (mofuta oa tsoekere),
Ka lefu la tsoekere le letlalong,
Bakuli ba nang le mathata a matla a ho re hlaba
Ka hypoglycemia,
Haeba maemo a tebileng (tšoaetso, ho fokolloa ke metsi, ho tsitsipana) a ka baka ho se sebetse hantle ha liphio kapa sebete,
Ha li-pathologies li tsamaisana le tlala ea tlala ea tishu (ho nyekeloa ke pelo, pelo kapa ho se khone ho hema),
Baimana le baimana
Ka ts'ebeliso e tšoanang ea miconazole,
Maemong a kenyeletsang ho khutlisoa ha litafole ka insulin (ts'oaetso, ts'ebetso, likotsi tse mpe),
Ka mokhoa oa hypocaloric (ho fihlela ho 1000 kcal / letsatsi),
Bakeng sa ba sebelisang joala hampe ka chefo e mpe ea joala,
Haeba u na le nalane ea lactic acidosis,
Ka hypersensitivity ho metsoako ea foromo ea lithethefatsi.