Diaformin od

Na-ezo aka ndị ọrịa hypoglycemic maka onu. Lowers ịta glucosen'ọbara, mana ọ naghị emetụta nzuzo insulinya mere enweghi ike ibute ihe hypoglycemia na ahụ ike.

Mlọ ọgwụ

Diaformin metụtara usoro metabolic nke ahụ mmadụ n'ọtụtụ ụzọ. Mgbe ị theụsịrị ọgwụ ahụ:

• na-abawanye uche nke ndị na - anabata ya na homonụ insulin,
• mkpụrụ ndụ na-abawanye glucose,
• ike nke hecatic gluconeogenesis mgbanwe
• na carbohydrate na -ari nri.
• ọnụego nke lipid metabolism na-abawanye, ebe ndị gosipụtara ihe dịka LDL, TG na cholesterol.

Mlọ ọgwụ

Site na mbadamba mbadamba mbụ, ihe na-arụ ọrụ na-etinye obi gị dum na eriri afọ. Ọzọkwa, bioavailability ya bụ 50-60%. Ma na iwepuga ihe oriri n'otu oge, oriri na-ebelata ma na-ewere nwayọ karịa.

Ozugbo ahụ, akụkụ ahụ na-agbakọta na anụ ahụ ma na -akwụsị akụkụ ya n'ụdị mmamịrị na ahụ. Iwepu ọkara ndụ site na anụ ahụ dị awa 9-12. Ma ọ bụrụ na ọrụ akụrụ anaghị arụ ọrụ, ọ ga-adịgide karịa. N'okwu a, enwere ihe ize ndụ na ọgwụ ahụ ga-agbakọ n'ime ahụ ma mee ka ịdoụbiga mmanya ókè.

Ihe ngosi maka ojiji

Egosiputa Diaformin maka:

• insulin nọọrọ onwe yaọrịa shugan’ebe ndị toro eto nọ, mgbe ike gwụrụ ya na usoro ọgwụgwọ nri, ọ bụ nke na-adịghị arụ ọrụ.
• insulin dabereọrịa shuga (ejikọtara ya na Diaformin na insulin) Ekwesịrị iji Diaformin mee ihe maka ndị ọrịa nwere oke oke ibu, mgbe a na-achọpụta nguzobe nke ọgwụ insulin nke abụọ.

Ihe ngbanwe

Amachibidoro ọgwụ a iji:

• ọrịa mamịrịma obu nna nna,
• dibeto ketoacidosis,
• imebi ikike nhichapụ nke akụrụ,
• ọnụnọ n'ime ahụ usoro na pathologies nke enwere ihe ize ndụ nke imebi oke na ọrụ nke akụrụ,
• akpịrị ịkpọ nkụ
• siri ike ahu ọkụ,
• sepsis,
• akpata oyi,
• udiri oria ojoo,
• obina okuku ume iku ume,
• nkọ infarction myocardial,
• dysfunction imeju
• ala ala alisụrụma,
• nsị mmanya na-egbu egbu,
• nnweta lactic acidosis na anamnesis,
• anụ ahụ (n'ihi nri nwere obere kalori, mgbatị ahụ dị ukwuu na nká),
• n’oge na-adịbeghị anya ịwa ahụ
• tụụrụ ime.

Nsonaazụ

N'oge ọgwụgwọ, mmeghachi omume na-adịghị mma maka ọgwụ sitere na sistemu niile nke ahụ mmadụ nwere ike ịpụta.

Site na nri digestive:

• uto ígwè n’ọnụ
• ọgbụgbọ na vomiting,
• enweghị agụụ
• ọrịa dyspeptik
• mgbu n'ime afọ
• flatulence.

Iji kpochapụ ma ọ bụ belata mgbaàmà ndị a, ị nwere ike ị takeụ ọgwụ antispasmodic ma ọ bụ otu ọgwụ atropine ma malite ị drinkingụ mbadamba mmanya mgbe nri 2 ma ọ bụ ugboro atọ n'ụbọchị. Ọ bụrụ na usoro ndị a ewetaghị enyemaka, a na-akagbu nchịkwa Diaformin.

Site n'akụkụ nke usoro metabolic:

• lactic acid diathesis - Nke a bụ ihe ngosipụta maka iwepụ ọgwụ ngwa ngwa,
• hypovitaminosis B12 (naanị iji ọgwụ ogologo oge).

Nwere ike ịmalite nke ahu anataghi n'ụdị itching na akpukpo aru. O siri ike, a na-ahụta mmeghachi omume na-adịghị mma site na sistemu hematopoietic - mmepe nke anaemiala megaloblastic.

Diaformin, Ntụziaka itinye n'ọrụ

Ekwesịrị ịhọrọ usoro onunu ogwu na oge ọgwụgwọ ọ bụla maka ndị ọrịa n’otu n’otu. Nke a na-eburu n'uche ogo ọrịa ahụ na ọkwa glucose dị n'ọbara.

Ọ dị mkpa ịmalite iji ọgwụgwọ kwa ụbọchị nke 500-1000 mg. Nwere ike iwelie onunu ogwu naanị mgbe ụbọchị 10-15 gachara, na-eburu n’uche nyocha nke glucose ọbara. Ọtụtụ mgbe, site na ọgwụgwọ mmezi, were 1500-2000 mg nke ọgwụ kwa ụbọchị. Ogo ị na-anabata kwa ụbọchị bụ 3000 mg.

Maka umuaka site na afo iri, apuru inye ọgwụ ogwu dika nke nbido 500 ma obu 850 ml kwa ubochi. Ihe kachasị ike ị nweta ike ịrịa ya bụ 2000 mg / ụbọchị, ebe e kewara dose ahụ ụzọ abụọ ma ọ bụ atọ.

Gbafu mbadamba nkume na-ata ata. Emere nke a na mgbe nri gasịrị. Iji belata nsonaazụ na-adịghị mma nke afọ na afọ, ọ bụ ihe amamihe dị na ya imebi ọgwụ kwa ụbọchị n'ọtụtụ usoro.

Dodoụbiga ya ókè

Overdoụbiga mmanya ókè na-amalite lactic acidosis. Enwere ike ịnabata ya site na akara ndị a:

• afọ ọsịsa,
• mmetụta ọgbụgbọ,
• vomiting,
• aru di elu
• mọzụlụ
• mgbu afọ
• akụkụ okuku ume na ụdị nke mkpụkpu ume,
• anya ntugharinke nwere ike ibute gị ọnwụ nke mmụọ,
• Coma(na oke siri ikelactic acidosis).

Ozugbo ihe ịrịba ama ndị mbụ pụtara lactic acidosis, ọ dị mkpa ka a kwụsị ị takingụ ọgwụ wee kpọrọ onye ahụ metụtara n'ụlọ ọgwụ. Enwere ike inye enyemaka Symptomatic. N'ụlọ ọgwụ, a gha eme onye ọrịa ahụ ịba ọcha n'anyaiwepu ogwu n’ahu.

Nyochaa ndị ọrịa gbasara diaformin od

Ana m azụta mbadamba nkume Diaformin 850 mgbe niile. Nke a bụ ọgwụ ndị na-arịa ọrịa shuga na-a .ụ. A na - ewere ya na ọgwụ ndị ọzọ mgbe shuga ọbara dị n'okpuru ebe 8-10 mmol / l. Ikwesiri ị drinkụ Diaformin kwa ụbọchị na nri ugboro atọ n'ụbọchị. Ọgwụ na-ere shuga nke ọma. Amaara m ọtụtụ ndị na-a Dụ ọgwụ Diaformin na Glucovans ruo ọtụtụ afọ. Ha kwuru na ọgwụ na enyere ha aka nke ọma. Mgbe ewere ya, agụụ nwere ike ịka mma. Ihe mgbu obi belatara, ndị ọrịa na-arịa ọbara mgbali gbagotere na nrụgide nkịtị. Ọnụ ahịa ya adịghịkwa elu. Ọ bụrụ na ọ dị mkpa, enwere ike iwere ya.

Enyi na-ewere "Diaformin." Anụrụ m na-ekwu na nke a bụ ọgwụ ọgwụ maka ọrịa shuga. Ma enyi m enweghi oria. Mgbe m malitere ịjụ ya ihe mere Diaformin ji dee, ọ tụgharịrị na ọgwụ a nwere ike ị drunkụbiga mmanya oke. Ndị nwere oke ibu na-enwekarị nnabata glucose (ọrịa shuga), na Diaformin na-etinyekwa abụba n'ọkụ, ọ bụghịkwa na-ebelata glucose ọbara. Na ijikọ ya na nri, ọ na-ekwukarị nsonaazụ ya karịa. N’ime otu ọnwa ị theụ ọgwụ ahụ, a hụrụ ihe dị n’ahụ ibu, mmega ahụ na-abawanye, ike adịghịzi.

Ọgwụ Farmacology

Onye na-ahụ maka hypoglycemic nke sitere na ìgwè nke biguanides (dimethylbiguanide). Usoro nke metformin na-ejikọta ya na ikike ya iji mee ka gluconeogenesis kwụsị, yana imepụta abụba na-enweghị ihe na nsị nke abụba. Na-eme ka mmata nke ndị na-anabata ihe na insulin na itinye glucose site na sel. Metformin anaghị emetụta oke insulin n'ime ọbara, mana ọ na-agbanwe ọgwụ ọgwụ ya site na ibelata ogo insulin na-ejedebe ma na-abawanye oke nke insulin na proinsulin.

Metformin na-akpali njikọ nke glycogen site na ime ihe na glycogen synthetase. Na-eme ka ikike ibuwanye nke ndị na-ebuga glucose ụdị ọ bụla. Na-egbu oge itinye glucose umeji.

Belata ogo triglycerides, LDL, VLDL. Metformin na - eme ka akwara fibrinolytic dị n'ọbara site na - egbochi ihe mgbochi plasminogen onye na - eme ka anụ ahụ nwee ọrụ.

Mgbe ị na-ewere metformin, ịdị arọ nke onye ọrịa ahụ ọ na-adịgide ma ọ bụ na-ebelata obere oge.

Mpempe mwepụta

30 PC - ngwugwu ọnya (1) - ngwugwu nke kaadiboodu.
30 PC - ngwugwu mkpọ (2) - ngwugwu nke kaadiboodu.
30 PC - ngwugwu ọnya (3) - ngwugwu nke kaadiboodu.

A na-ewere ya ọnụ, n'oge nri ma ọ bụ mgbe nri gasịrị.

Ọdịdị yana oge nchịkwa na-adabere n'ụdị usoro eji eme ihe.

Site na monotherapy, usoro mbụ nke ndị okenye bụ 500 mg, dabere n'ụdị usoro eji eme ihe, ugboro nchịkwa ya bụ ugboro 1-3 / ụbọchị. O kwere omume iji 850 mg 1-2 ugboro / ụbọchị. Ọ bụrụ na ọ dị mkpa, a na-eji nwayọ were ọgwụ ahụ were otu nkeji n’izu. ruo 2-3 g / ụbọchị.

Site na monotherapy maka ụmụaka dị afọ 10 na karịa, ọgwụ mbụ bụ 500 mg ma ọ bụ 850 1 oge / ụbọchị ma ọ bụ 500 mg ugboro 2 / ụbọchị. Ọ bụrụ na ọ dị mkpa, na oge dịkarịa ala izu 1, enwere ike ịbawanye dose ahụ ruo ogo 2 g / ụbọchị na usoro 2-3.

Mgbe ụbọchị 10-15 gachara, aga-emegharị ọgwụ ahụ dabere na nsonaazụ nke mkpebi glucose na ọbara.

Na njikọta ọgwụ na insulin, ọgwụ mbụ nke metformin bụ 500-850 mg ugboro abụọ / ụbọchị. A na-ahọrọ ọ̀gwụ insulin dabere na nsonaazụ nke mkpebi glucose na ọbara.

Mmekorita

Iji otu ihe eji eme ihe na usoro sulfonylurea, acarbose, insulin, salicylates, MAO inhibitors, oxytetracycline, ACE inhibitors, yana clofibrate, cyclophosphamide, hypoglycemic mmetụta nke metformin nwere ike ịkwalite.

Site na iji GCS eme ihe n'otu oge, mgbochi nke homonụ maka nchịkwa ọnụ, danazol, epinephrine, glucagon, homonụ phenothiazine, thiazide diuretics, nicotinic acid ọgwụ, mbelata mmetụta hypoglycemic nke metformin ga-ekwe omume.

N'ime ndị ọrịa na-anata metformin, ojiji nke iodine nwere ihe dị iche maka ndị na-ahụ maka nnwale nyocha (gụnyere urography intravenous, cholangiography, angiography, CT) na-abawanye ohere nke nnukwu ọrịa gbasara akụrụ na lactic acidosis. Ndị a na - agakọ ọnụ.

Beta₂-adrenomimetik n'ụdị nke injections na-eme ka ịbawanye ụba nke glucose n'ọbara n'ihi mkpali nke β₂-adrenoreceptors. N'okwu a, ọ dị mkpa ịchịkwa mkpokọta glucose na ọbara. Ọ bụrụ na ọ dị mkpa, a na-atụ aro ịkọ ọgwụ insulin.

Iji cimetidine na-ejikọ ọnụ nwere ike ịbawanye ohere nke lactic acidosis.

Ojiji a na - eme "akaghị ihe" diuretics nwere ike ibute mmepe nke lactic acidosis n'ihi ọdịda akụrụngwa nke arụ ọrụ ga-eduga.

Njikwa oge na ethanol na-abawanye ohere nke lactic acidosis.

Nifedipine na-abawanye mmụba na C_max metformin.

Ọgwụ cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, trimethoprim na vancomycin) zoro ezo na akwara renal na-asọ mpi na metformin maka sistemụ ebu ibu, ọ nwekwara ike ibute mmụba na C_max.

Ntụziaka pụrụ iche

N'agbanyeghị ma onye ọrịa ahụ nwere ọrịa akụrụ, ekwesịrị ikpebi ọkwa lactate ọ dịkarịa ala ugboro abụọ n'afọ n'oge ọgwụgwọ Diaformin. Otu ihe ahụ kwesịrị ime ma ọ bụrụ na ọnya ahụ na-apụta.

Ọ bụrụ na n'oge ọgwụgwọ ọ dị mkpa iji nyocha radioisotope ma ọ bụ X-ray, nke ga-ewebata ọdịiche dị na ọgwụ ọjọọ ayodiin, ịkwesịrị ịkwụsị ị theụ ọgwụ ahụ ụbọchị abụọ tupu usoro nyocha ahụ. Daysbọchị abụọ ka ọ gachara, enwere ike ịga n’ihu ịgwọ ọrịa.

Enweghi nnyocha zuru ezu iji kwubie na ọgwụ ahụ adịghị mma ma dị irè n'ịgwọ ụmụaka, yabụ, edeghị ya maka ụmụaka na-erubeghị afọ 10.

N'oge ime na lactation

Anabataghi itinye ngwa n'ọrụ n’oge ndị a. Enweghị mmetụta teratogenic ahụ, mana a maara nke ahụ metformin na - abanye na mgbochi nke plasta. N'ihi ya, ọ bara uru ịkọ ọgwụ naanị dị ka ebe ikpeazụ, mgbe ihe ize ndụ maka ahụike nne karịrị ihe nwatakịrị ahụ nwere ike ịdaba.

Analogs gụnyere:

Ọnụ ọnụ Diaformin ebe ị ga-azụ

Nwere ike ịzụta Diaformin n'ụlọ ahịa ọgwụ mgbe niile, mana ọ ka mma ịlele nnweta tupu oge eruo. Erere na-eri site na 60 rubles (na ngwugwu nke mbadamba 30 nke 500 mg nke ọ bụla) na 300 rubles (na ngwugwu nke mbadamba 60 nke 1000 mg ọ bụla).

Ọnụ ego mbadamba mkpụrụ osisi na Ukraine sitere na 50 hryvnias (iberibe 500 nke 500 mg nke ọ bụla) ruo 180 hryvnias (60 iberibe 1000 mg 1000).

Mpempe usoro onunu ogwu

500 mg na mbadamba 850 mg

Otu mbadamba ihe nwere:

ihe na-arụ ọrụ: metformin hydrochloride - 500 mg na 850 mg

ndị mgbe ochie: mbadamba 500 mg: stachi nduku, microcrystalline cellulose, povidone, polyethylene glycol (macrogol 4000), magnesium stearate,

Mbadamba mbadamba 850: stachi nduku, lactose monohydrate, cellulose microcrystalline, povidone, polyethylene glycol (macrogol 4000), stearate calcium.

Mbadamba ụrọ nke okirikiri, ya na mbara ala cylindrical, ma ọ bụ nke na-acha ọcha, yana bevel na notch (maka onunu ogwu nke 500 mg)

Mbadamba mbadamba ụrọ, ya na biconvex n’elu, na-acha ọcha ma ọ bụ nke fọrọ nke nta ka ọ bụrụ na-acha ọcha, nwere ma ọ bụ n’etinyeghị aka na ihe egwu (maka usoro onunu ogwu nke 850

Ofzọ nke ngwa

Monotherapy ma ọ bụ ọgwụgwọ njikọta yana njikọta ọnụ nke hypoglycemic nke ọzọ.
Ugboro ugboro ọgwụ mbụ Diaformin bụ 500 mg ma ọ bụ 850 mg 2-3 ugboro n'ụbọchị n'oge ma ọ bụ mgbe nri gasịrị.
Mgbe ụbọchị 10-15 gasịrị, a ga-akụrịrị dose ahụ dabere na nha nke nha ọkwa glucose dị n'ọbara ọbara.
Mmụba na-adịghị ala ala na -ebelata nsonaazụ site na mgbari nri.
N'ime ọgwụgwọ nke oke doses, a na-eji Diaformin, mbadamba ihe mkpuchi, 1000 mg nke ọ bụla.
Ọgwụ kachasị atụ aro ya bụ 3000 mg kwa ụbọchị, kewara n'ime usoro 3.
N'ihe banyere ịgbanwere ọgwụ ọgwụ antidiabet ọzọ, ọ dị mkpa ịkwụsị ị thisụ ọgwụ a wee depụta Diaformin, dị ka akọwara n’elu.
Ngwakọta ọgwụ na insulin.
Iji nweta nchịkwa kachasị mma nke ọkwa glucose ọbara, a pụrụ iji metformin na insulin mee ihe maka njikọta ọgwụgwọ. Dị ka ọ dị, usoro izizi bụ 500 mg ma ọ bụ 850 mg nke Diaformin ugboro atọ n'ụbọchị, ebe a ga-ahọpụta dose nke insulin dabere na nsonaazụ nke glucose ọbara.
Childrenmụaka.
Monotherapy ma ọ bụ ọgwụgwọ njikọ na insulin.
A na-eji Diaformin mee ụmụaka n'ime afọ 10. Dịka ọ dị, usoro izizi bụ 500 mg ma ọ bụ 850 mg nke Diaformin 1 oge kwa ụbọchị n'oge ma ọ bụ mgbe nri gasịrị. Mgbe ụbọchị 10-15 gasịrị, a ga-akụrịrị dose ahụ dabere na nha nke nha ọkwa glucose n'ọbara.
Mmụba na-adịghị ala ala na -ebelata nsonaazụ site na mgbari nri.
Ogo kachasị akwadoro bụ 2000 mg kwa ụbọchị, kewara 2-3 usoro.
N'ime ndị ọrịa agadi, mbelata ọrụ ọrụ akụrụ ga-ekwe omume, ya mere, a ga-ahọrọ dose nke metformin dabere na ntule nke ọrụ gbasara akụrụ, nke a ga-arụrịrị oge niile (lee mpaghara “Peculiarities of use”).
Ọrịa daa ọrịa gbasara akụrụ. Enwere ike iji Diaformin mee ihe na ndị ọrịa nwere obere akwara afọ, ọkwa IIIa (mwepu creatinine 45-59 ml / min ma ọ bụ GFR 45-59 ml / min / 1.73 m2) naanị na enweghị ọnọdụ ndị ọzọ nke nwere ike ịbawanye ohere nke lactic acidosis, sochiri nhazi ndozi: ọgwụ izizi bụ 500 mg ma ọ bụ 850 mg 1 oge kwa ụbọchị. Oke kachasị bụ 1000 mg kwa ụbọchị, kewara abụọ. Ekwesịrị iji nlezianya na-arụ ọrụ gbasara akụrụngwa ọ bụla 3-6 ọnwa.
Ọ bụrụ na mwepu nke creatinine ma ọ bụ GFR gbadata na 45 ml / min ma ọ bụ 45-59 ml / min / 1.73 m2, Diaformin kwesịrị ịkwụsị ozugbo.
Childrenmụaka. Enwere ike iji Diaformin mee ihe na ụmụaka gbara afọ 10.

Ngwongwo ogwu

Mlọ ọgwụ

Mgbe ịwesịrị, a na-agbatị metformin na eriri afọ bụ ihe fọrọ nke nta ka ọ bụrụ kpamkpam, a na-ekpebi 20-30% nke dose ahụ na feces. Ezigbo bioavailability sitere na 50 ruo 60%. Site na ntinye n'otu oge, nnabata nke metformin na-ebelata ma belata.

A na-ekesa Metformin ngwa ngwa na anụ ahụ, ihe fọrọ nke nta ka ọ bụrụ na ọ nweghị ihe nchebe protein.

Metformin nwere obere metabolized ma kpụrụ akụrụ ya.Nwepu ya n'ime ndị nwere ahụike bụ 440 ml / min (ugboro 4 karịa nke creatinine), nke na-egosi itinye nsị nke tubular. Ọkara ọkara bụ ihe dịka awa 9-12. Na ọdịda akụrụngwa, ọ na-abawanye, enwere ihe ize ndụ nke nchịkọta ọgwụ.

Mlọ ọgwụ

Metformin na-ebelata hyperglycemia, adịghị eduga ná mmepe nke hypoglycemia. N'adịghị ka sulfonylurea, ọ naghị akpali insulin n'ahụ ma ọ dịghị eme ka mmetụta hypoglycemic dị iche iche n'ahụ ndị mmadụ n'otu n'otu. Metformin na --ekwupụta uche nke ndị na - anabata ihe na - eme insulin na itinye glucose site na mkpụrụ ndụ akwara. Ọ na - egbochi gluconeogenesis na imeju. Na-egbu oge itinye carbohydrates na eriri afọ. Ọ nwere mmetụta dị mma na metabolism lipid: na-ebelata ọdịnaya nke cholesterol mkpokọta, obere lipoproteins dị ala na triglycerides.

Mkparịta ụka ọgwụ ọjọọ

Site n’otu oge iji ọgwụ Diaformin na danazole, mmepe nke mmetụta hyperglycemic ga-ekwe omume. Ọ bụrụ na ọgwụgwọ na danazol dị mkpa ma kwụsịchaa ya, ọ dị mkpa ịgbanwe ndozi nke Diaformin n'okpuru njikwa glycemia.

Site n'iji ọgwụ Diaformin na ọgwụ mmanya na ọgwụ ethanol nwere, n'otu oge ahụ ihe egwu nke ị developingụ lactic acidosis n'oge ị alcoholụbiga mmanya oke na-abawanye, ọkachasị mgbe ị na-ebu ọnụ ma ọ bụ na-eso obere nri kalori, yana ọrịa imeju.

Chlorpromazine na usoro onyonyo dị elu (100 mg / ụbọchị) na-ebelata ntọhapụ nke insulin ma mee ka ọkwa glucose dị n'ọbara. Iji otu oge iji antipsychotics na mgbe ịkwụsị njikwa ha, a chọrọ ndozi nke Diaformin n'okpuru njikwa glycemia. Glucocorticosteroids (maka usoro na usoro eji) belata nnabata glucose ma mee ka ọkwa glucose ọbara dị n'ọbara, n'ọnọdụ ụfọdụ na-akpata ketosis. Ọ bụrụ na ọ dị mkpa iji nchikota dị otú ahụ ọbụlagodi ịkwụsị nke nchịkwa glucocorticosteroid, a chọrọ ndozi nke Diaformin n'okpuru nchịkwa ọkwa glucose ọbara.

N'iji otu akwara "akaghị" diuretics na Diaformin, enwere ihe ọghọm nke lactic acidosis n'ihi ọdịdị enwere ike ịrụ ọrụ na ụlọ na-ada ada. Ekwesighi inye Diaformin iwu ma oburu na iweputara ya

Njirimara ngwa

Lactic acidosis dịkarịsịrị njọ, mana nnukwu metabolic siri ike (ọnụọgụ ọnwụ na-enweghị ọgwụgwọ mberede), nke nwere ike ibute nsonaazụ nke metformin. A kọọla ọrịa lactic acidosis na ndị ọrịa nwere ọrịa mellitus nwere ọrịa gbasara akụrụ ma ọ bụ na-akawanye njọ na ọrụ gbasara akụrụ.

Ekwesịrị ịtụle ihe ndị ọzọ dị ize ndụ iji zere mmepe nke lactic acidosis: ọrịa mellitus na-achịkwa nke ọma, ketosis, ibu ọnụ ogologo oge, ị alcoholụbiga mmanya ókè, ọdịda imeju, ma ọ bụ ọnọdụ ọ bụla metụtara hypoxia (decompensated obi ọdịda, nnukwu myocardial infarction) (lee "Contraindications").

Lactic acidosis nwere ike gosipụta dịka nkwarụ akwara, mgbu afọ, mgbu afọ na oke asthenia. Ndị ọrịa kwesịrị ịgwa dọkịta ozugbo ozugbo banyere ihe omume ndị dị otú ahụ, karịsịa ma ọ bụrụ na ndị ọrịa anabatachara iji metformin eme ihe. N'ụdị ndị a, ọ dị mkpa ịkwụsị iji metformin nwa oge ruo mgbe a ga-akọwapụta ọnọdụ ahụ. Ekwesịrị ịmaliteghachi usoro ọgwụgwọ Metformin mgbe ị tụlechara uru / elele ihe dị na nha ahụ na ịtụle ọrụ akụrụ.

Diagnostics . Ejiri lactic acidosis bụ obere iku ume iku ume, afọ mgbu na hypothermia, inwekwu mmepe nke coma ga-ekwe omume. Ndị na-egosi nchọpụta nchọpụta gụnyere mbelata ụlọ nyocha na pH ọbara, mmụba nke mkpokọta lactate na ọbara ọbara karịa 5 mmol / l, mmụba nke oghere anion na nha nke lactate / pyruvate. N'ihe banyere mmepe nke lactic acidosis, ọ dị mkpa iji gaa ụlọ ọgwụ ozugbo (lee mpaghara "dohụta oke"). Dọkịta ahụ kwesịrị ịdọ ndị ọrịa aka na ntị gbasara ihe ọghọm nke ịmalite ịrịa ọrịa lactic acidosis.

Odida ntaramahụhụ . Ebe ọ bụ na akụrụ na - ekepụta metformin, tupu oge na mgbe a na - ahụ ya na Diaformin ®, ọ dị mkpa inyocha ọkwa nke creatinine (enwere ike ịtụle ọkwa Plasma creatinine site na iji usoro Cockcroft-Gault) ma ọ bụ GFR:

• ndị ọrịa nwere ọrụ mkpokọta nkịtị ọ dịkarịa ala 1 oge kwa afọ,
• ndị ọrịa nwere ikike iji aka ya mee ihe na njedebe dị ala nke ndị ọrịa nkịtị na ndị agadi ọ dịkarịa ala ugboro 2-4 kwa afọ.

Ọ bụrụ n ’nkọcha nke creatinine bụ 2), a na-egbochi metformin (lee mpaghara“ Contraindications ”).

Mbelata ọrụ gbasara akụrụngwa na ọrịa ndị agadi bụ ihe a na-ahụkarị na asymptomatic. Ekwesịrị iji nlezianya mee ihe n'ọnọdụ ọrụ ọrụ akụrụ nwere ike ịnwe, dịka ọmụmaatụ, n'ihe gbasara akpịrị ịkpọ nkụ ma ọ bụ na mmalite ọgwụgwọ nke ọgwụ antihypertensive, diuretics, na mmalite ọgwụgwọ NSAID. N'ụdị ndị a, a na-atụ aro ka nyochaa ọrụ ezumike tupu ịmalite ọgwụgwọ na metformin.

Obi obi . Ndị ọrịa nwere nkụda obi nwere nnukwu ihe ize ndụ nke ịmalite hypoxia na ọdịda akụrụ. N'ime ndị ọrịa nwere ọrịa obi na-adịghị ala ala, enwere ike iji metformin mee ihe na nlele oge niile gbasara ọrụ gbasara akwara na akụrụ. A na - egbochi Metformin na ndị ọrịa nwere ọrịa obi obi na-enweghị mgbagha (lee mpaghara "Contraindications").

Iodine nwere ihe ndị na-enye rediopaque . Ojiji nke ndị na-ahụ maka rediopapa maka ọmụmụ ihe gbasara redio nwere ike ibute ọdịda akwara, ma, n'ihi ya, iduga nchịkọta nke metformin na nnukwu ihe ize ndụ nke lactic acidosis. Ndị ọrịa nwere GFR> 60 ml / min / 1.73 m 2, a ga-akwụsị iji ojiji nke metformin tupu ma ọ bụ n'oge ọmụmụ ihe ahụ ma ọ bụghị ịmaliteghachi tupu oge awa 48 ka ọmụmụ ihe ahụ gasịrị ma ọ bụ naanị mgbe ị tụlechara ọrụ akụrụ ma gosipụta enweghị mwepu ọzọ gbasara akụrụngwa (lee. Ngalaba “Nmekorita ya na ngwaahịa ogwu ndi ozo na nmekorita ya”.

Ndị ọrịa nwere ọdịda akụrụngwa na-agafeghị oke (GFR 45-60 ml / min / 1.73 m 2) kwesịrị ịkwụsị iji Metformin 48 awa tupu nchịkwa nke ihe na-enwe ineineine iodine, ekwesighi ịmaliteghachi ya tupu elekere 48 mgbe ọmụmụ ihe ahụ gasịrị ma ọ bụ mgbe ha tụleghachiri ọrụ gbasara akụrụ. na nkwenye nke enweghi nsogbu mmerụ ọzọ (lee “Mmekọrịta na ọgwụ ndị ọzọ na ụdị mmekọrịta ndị ọzọ”).

Gerywa ahụ . Ọ dị mkpa ịkwụsị ojiji nke Diaformin hours 48 awa tupu oge ịwa ahụ a na-eme atụmatụ, nke a na-arụ n'okpuru ọgwụ mgbochi azụ, azụ azụ ma ọ bụ epidural ma ghara ịmaliteghachi tupu awa 48 ka a gbasịrị ahụ ma ọ bụ iweghachi nri na-egbu egbu ma ọ bụ naanị ma ọ bụrụ na-arụ ọrụ ezumike nkịtị.

Childrenmụaka . Tupu ịmalite ọgwụgwọ metformin, a ga-enyocha nchọpụta nke ụdị shuga 2. Site na nsonaazụ nke ọmụmụ otu afọ, ọ nweghị mmetụta metformin na uto na uto ya na ụmụaka ekpughere. Agbanyeghị, enweghị data na nsonaazụ uto metformin na oge uto na iji Diaformin longer mee ihe, ya mere, iji nlezianya na-elele paramita ndị a n’ebe ụmụaka na-agwọ ọrịa metformin, ọkachasị n’oge agbọghọbịa.

Agedmụaka gbara afọ 10 ruo 12. Dabere na nsonaazụ nke ọmụmụ ọgwụ, ịdị irè na nchekwa nke otu ndị ọrịa a adịghị iche na nke ụmụaka okenye. Ekwesịrị iji nlezianya depụta ọgwụ ụmụaka ahụ n’afọ 10 ruo 12.

Usoro ndị ọzọ . Ọrịa dị mkpa iji soro usoro nri, oriri nke carbohydrates na-eri ogologo ụbọchị. Ndị ọrịa nwere oke ibu kwesịrị ịnọgide na-agbaso nri obere kalori. Ọ dị mkpa ileba anya mgbe niile n'ihe ndị na - egosi carbohydrate metabolism nke ndị ọrịa.

Monotherapy na metformin anaghị akpata hypoglycemia, mana a ga-akpachara anya mgbe a na-eji Diaformin ® na insulin ma ọ bụ ndị nnọchianya hypoglycemic nke ọnụ (dịka ọmụmaatụ, sulfonylureas ma ọ bụ meglitinide) nwere ike iwelie mmetụta hypoglycemic.

Jiri n’oge ime ma ọ bụ n’ịra.

Ime Ọrịa shuga na-achịkwaghị achịkwa n'oge afọ ime (mmeme ahụ ma ọ bụ ịnọgidesi ike) na-ebulite ohere nke ịmalite imebi ọrịa na-emetụta afọ na ọnwụ nke afọ.

Ara. A na-apịpụta Metformin na mmiri ara ara, mana enweghị mmetụta ọ bụla achọpụtara n'akụkụ ụmụ ọhụrụ / ụmụ ọhụrụ na-enye nwa ara. Agbanyeghị, ebe enwere data ezughi oke maka nchekwa ọgwụ a, a naghị akwado inye ara ara n'oge ọgwụgwọ na Diaformin ®. Ekwesịrị ime mkpebi ịkwụsị inye ara, na-eburu n'uche uru ị benefitsụ ara na ihe ọghọm nke nsonaazụ nwatakịrị nwere.

Ọmụmụ . Metformin emetụtaghị ọmụmụ anụmanụ mgbe ejiri ya na 600 mg / kg / ụbọchị, nke fọrọ nke nta ka okpukpu atọ karịa nke kachasị atụ aro kwa ụbọchị maka ụmụ mmadụ dabere na mpaghara ahụ.

Ikike iji metụta ọnụego mmeghachi omume mgbe ị na-anya ụgbọala ma ọ bụ usoro ndị ọzọ.

Diaformin ® anaghị emetụta ọnụego mmeghachi omume mgbe ị na-anya ma ọ bụ na-arụ ọrụ na usoro ndị ọzọ, ebe monotherapy na ọgwụ ahụ anaghị akpata hypoglycemia.

Agbanyeghị, ekwesịrị iji metformin kpachara anya na njikọta hypoglycemic ndị ọzọ (sulfonylureas, insulin, ma ọ bụ meglitinides) n'ihi ihe ize ndụ nke hypoglycemia.

Mmeghachi omume ọjọọ

Metabolism: lactic acidosis.

Site na iji ọgwụ ogologo oge, ịmịpụta vitamin B nwere ike ibelata ₁₂ , nke na-esonyere mbelata nke ọkwa ya n’ọbara. A na-atụ aro ka ụdị echiche hypovitaminosis B bụrụ nke a ga-atụle. ₁₂ ọ bụrụ na onye ọrịa nwere megaloblastic anaemia.

Si ụjọ usoro: imebi uto.

Site na ngwara: nsogbu nke usoro nri, dị ka ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, afọ na-egbu nri, enweghị agụụ. Ọtụtụ mgbe, mmetụta ndị a na-apụta na mmalite nke ọgwụgwọ ma n'ọtụtụ ọnọdụ na-apụ n'anya n'otu oge. Iji gbochie omume nke nsonaazụ na nsị nri, a na-atụ aro ka ị jiri nwayọ bulie usoro ị useụ ọgwụ na ojiji nke ọgwụ ahụ n’usoro 2-3 mgbe oge nri ma ọ bụ mgbe nri gasịrị.

Site na nri digestive: imebi ihe ngosipụta nke ọrụ imeju ma ọ bụ ịba ọcha n'anya, nke na-apụ n'anya kpamkpam mgbe ọ kwụsịrị metformin.

Na akpụkpọ anụ ahụ mmeghachi omume anụ ahụ, gụnyere erythema, pruritus, urticaria.