Ọgwụ Dianormet: ntuziaka maka ojiji

Mlọ ọgwụ Dianormet (metformin -1 na-arụ ọrụ na-arụ ọrụ) bụ ihe nnọchianya hypoglycemic maka nchịkwa ọnụ nke njikwa biguanide. Na-ebelata glucose ọbara dị elu n’ebe ndị ọrịa nwere ọrịa shuga nọ. Ọgwụ na-etinye nsonaazụ ya n'agbanyeghị ọrụ nzuzo nke pancreas. Usoro ihe omume nke Dianormet bụ n'ihi ihe mgbochi nke mbugharị elektrọn nke ọkpọka n'olu membrane nke mitochondria, nke na-eduga n'ịbelata mkpokọta intracellular ATP na mmeju nke anaerobic glycolysis, n'ihi nke glucose na-abanye mkpụrụ ndụ site na oghere extracellular, glycogen depotate na-abawanye na akwara na-abawanye na akwara imeju na akwara imeju na akụrụngwa na akụrụngụ na akwara na-abawanye na akwara na-abawanye na akwara na-abawanye na akwara imeju na akụrụngwa na akwara na-abawanye na akwara na-abawanye na akwara na-abawanye na akwara na-abawanye na akwara na-abawanye na akwara na-abawanye na akwara na-abawanye uru ahụ. dịka eriri afọ, imeju, yana akwara na adipose anụ ahụ.
Ihe Dianormet gbasara rue:

• Ọkpụkpụ afọ - na - egbochi nnabata nke glucose na eriri afọ, na - ebelata motility nke afọ na eriri afọ,
• imeju - na - egbochi gluconeogenesis na usoro nke glucose n'ime ọbara, na - eme ka ikuku glycolysis anaerobic,
• anụ ahụ na-akpụ akpụ - na - eme ka nnabata glucose dị na anụ ahụ, nke a bụ n'ihi ịba ụba nke ihe insulin na - ebute mmụba na ọnụọgụ nke ndị na - anabata ya, yana mmekorita nke ndị na - anabata sistem - na - ebunye sistem nke na - ebuga glucose na sel. N’ihi nke a, Dianormet anaghị akpali ntọhapụ nke insulin site na sel nke islet ngwa nke pancreas, ọ na - enyere aka wepu hyperinsulinemia, nke bụ otu n’ime ihe na - akpata ọganihu nke nsogbu vaskụla na oke ibu na ọrịa shuga II.

Na mgbakwunye, Dianormet nwere mmetụta metabolic dị mma na:

• ọbara lipids - belata ogo nke cholesterol zuru ezu site na 10-20% na ụmụ irighiri ya: LDL na VLDL, nke ejikọtara ya na mgbochi nke biosynthesis ya na mgbidi eriri afọ ma nwekwuo oghere site na eriri afọ. Ọ na - abawanye HDL site na 10-20% ma belata TG site na 10-20% (ọbụlagodi ma ọ bụrụ na 50% na-abawanye ọkwa ha) site na igbochi nsị nke acid abụba, iwetulata insulin, yana igbochi nnabata nke glucose na eriri afọ.
• coagulation na sistem fibrinolysis - na - ebelata nghọta nke platelet na ihe nchịkọta, na - akpali fibrinolysis endogenous site na ịbawanye ọrụ nke t-PA (plasminogen activator), wedata ọkwa PAI-1 (plasminogen activates inhibitor) na belata fibrinogen,
• mgbidi arịa ọbara - na - egbochi mmụba nke akwara nke akwara.

Mmetụta metabolic ndị ọzọ nke ọgwụ na-ekpebi mmetụta dị mma ya na sistemụ ọbara, na-egbochi mmepe nke ọrịa angiopathy na mgbochi nke nsogbu ndị dị ka ọbara mgbali elu (ọbara mgbali akwara) na ọrịa obi obi. N'ime ndị ọrịa buru ibu, ọ nwere ike belata oke ahụ, karịchaa mmalite nke ọgwụgwọ.
Mlọ ọgwụ A na-etinye ya na duodenum na obere eriri afọ. Bioavailability bụ 50-60%. Ọgwụ ahụ ejikọghị protein na ọbara, a na-ekesa ngwa ngwa na akwara dị iche iche, na-agbakọta tumadi na eriri afọ (afọ, duodenum na obere eriri afọ), imeju, akwara, akụrụ, gland ọ na-anyụ. A na-enweta ntinye kachasị na ọbara ka elekere abụọ gachara. Ọkara ndụ bụ awa 1.5-6. N’adịghị ka phenformin, Dianormet abụghị metabolized n’ahụ. Ọgwụ ahụ agbanweghị na mmamịrị ya (ihe dị ka 90% n'ime awa iri na abụọ). N'ime ndị ọrịa agadi na arụ ọrụ na-arụ ọrụ na-arụ ọrụ ezumike nká, ọgwụ ọgwụ nke metformin na-agbanwe nke ukwuu. Mkpokọta na mkpochapu mkpochaara ndị ọrịa agadi site na 35-40%, n'ime ndị ọrịa nwere nnukwu obere akwara na-ada ada - site na 74-78%. Ọ bụrụ na arụ ọrụ ezumike ezumike, ịnwe ọgwụ ọgwụ ga-ekwe omume.

Ojiji ọgwụ Dianormet

N'ime oge ma ọ bụ ozugbo nri.
Dianormet 500: ọgwụ mbido 500 mg kwa ụbọchị. Ekwesịrị ịbawanye dose ahụ iji nweta mmetụta kachasị mma. Ọtụtụ mgbe, were 500 mg (1 mbadamba) 2-3 ugboro n'ụbọchị. Oke kachasị kwa ụbọchị bụ 2500 mg.
Dianormet 850: mbido 850 mg / ụbọchị. Ekwesịrị ịbawanye dose ahụ iji nweta mmetụta kachasị mma. Na-ewere 1 mbadamba mbido 2-3 ugboro n'ụbọchị. Oke kachasị bụ 2500 mg / ụbọchị.
Mmetụta ọgwụgwọ kachasị elu nwere ike ịmalite mgbe ụbọchị iri nke 14-14 gachara, yabụ ekwesighi ịbawanye dose ahụ ngwa ngwa.
Mgbe ị na-eji Dianormet n'otu oge na insulin n'ime ụbọchị mbụ nke 4-6, a naghị agbanwe ntụtụ nke insulin, n'ọdịniihu, a ga-eji nwayọ belata ọgwụ insulin (site na 4-5 IU ruo ọtụtụ ụbọchị).

Ihe mgbochi iji ọgwụ Dianormet

Hypersensitivity na ọgwụ, ọrịa shuga, metabolic acidosis, lactic acidosis, steeti hypoxia (n'ihi hypoxemia, ujo, wdg), gbasara akụrụ, ọrịa imeju, ọdịda ọbara na hypoxia anụ ahụ, infarction myocardial, mmebi iku ume, oke ọkụ, arụmọrụ, ọrịa na-efe efe. , ojiji nke ayodiin nwere ihe ndi ozo di iche, mmanya, oge ime ya na inye ya ara.

Nsonaazụ nke ọgwụ Dianormet

Agụụ nri, ọnụ dị ụtọ n'ọnụ, ọgbụgbọ, ọgbụgbọ, mgbu afọ, afọ ọsịsa. A na-enweta mbelata ogo ihe ịtụnanya ndị a site n'iji nri mee nri ma ọ bụ ịmalite usoro ọgwụgwọ na obere ọgwụ ụbọchị. Ọ bụrụ na dyspeptip phenomena anaghị agafe onwe ha ogologo oge, o kwesịrị ịkwụsị ọgwụ a.
O siri ike, isi ọwụwa na nkụ, ike ọgwụgwụ, mmeghachi omume nfụkasị anụ ahụ.
Site na iji ọgwụgwọ ogologo oge n'ọnọdụ ndị adịghị ike, megaloblastic anaemia nwere ike ịmalite n'ihi ịba ụba nke vitamin B12 na folic acid. Mgbe ị na-eji ọgwụ ahụ, ọ ga-ekwe omume ịmalite lactic acidosis, ihe omume nke a na-akwalite hypoxia anụ ahụ, akụrụ, imeju ma ọ bụ akụkụ okuku ume, ọdịda okirikiri, hypoxia anụ ahụ, ọrịa na oncological, hypovitaminosis, mmanya mmanya, anesthesia, ịka nká. N'ụdị ndị ahụ, a na-egosipụta ntụgharị ọwụwa ụkwụ. N'oge ọgwụgwọ Dianormet jikọtara ya na ihe ndị na-eme ka sulfonylurea na / ma ọ bụ insulin hypoglycemia nwere ike ịmalite, n'ụdị ndị a, ndozi nke ọgwụ ndị ejiri dị mkpa.

Ntụziaka pụrụ iche maka iji ọgwụ Dianormet

N'oge ọgwụgwọ Dianormet, ekwesịrị ilebara ọkwa glucose na ọbara na mmamịrị oge ụfọdụ. Ọ bụrụ na ọ dị mkpa, usoro ịwa ahụ, ntinye nke ndị na-achọpụta ihe nchọpụta Dianormet obere oge ịkagbu. Alcohol Dụ mmanya na-abawanye n'ihe ize ndụ nke lactic acidosis na ọgwụgwọ Dianormet. Site na iji Dianormet jikọtara na ihe dị na sulfonylurea na insulin, na-ezighi ezi nri, mgbe mgbatị ahụ dị ukwuu ma ọ bụ bụrụ nnukwu mmanya mmerụ ahụ, ọnọdụ hypoglycemic nwere ike ịmalite, nke a ga-eburu n'uche mgbe ị na-anya ụgbọ ala ma na-arụ ọrụ na usoro ndị dị ize ndụ.
Tupu na mgbe a na-agwọ Dianormet, ọ dị mkpa iji nyochaa oge ọrụ na-egosi ọrụ imeju na akụrụ. Site na iji ọgwụ ogologo oge, a ga-eme nnwale ọbara maka ọrịa otu ugboro n'afọ, ebe ọ bụ na enwere ike itinye metformin n'ime sel ọbara.

Mkparịta ụka ọgwụ ọjọọ Dianormet

Dianormet na-eme site na njikọta sulfonylurea (glibenclamide, glipizide), insulin na acarbose. Amiloride, digoxin, quinidine, morphine, procainamide, triamteren, trimethoprim, cimetidine, ranitidine, famotidine, ndị na-egbochi calcium (karịsịa nifedipine) na-egbochi ntụgharị nke tubular na akụrụ ma nwee ike ịbawanye ụba nke Dianormet na ọbara ọbara. Furosemide na-eme ka itinye uche n'ihe Dianormet n'ọbara ọbara, Dianormet na-ebelata ịta na ọkara ndụ nke furosemide.
Mgbe ejiri ọgwụ ndị nwere ike ibute hypoglycemia (clofibrate, probenecid, propranalol, rifampicin, sulfonamides, salicylates), a na-ebelata ọgwụ Dianormet.
Ọgwụ ndị nwere ike ibute ọrịa hyperglycemia (ọgwụ mgbochi estrogen nwere ọnụ, corticosteroids, diuretics, isoniazid, nicotinic acid, phenytoin, chlorpromazine, homonụ thyroid, sympathomimetik) nwere ike belata arụmọrụ nke Dianormet. N'ihe banyere iji ọgwụ ndị a jikọtara ọnụ, a ga-enyocha ọdịnaya glucose ọbara na ọ bụrụ na ọ dị mkpa, mmụba kwekọrọ na dose nke Dianormet. Mmanya ethyl na-abawanye ohere nke lactic acidosis. Colestyramine na guar na-ebelata nnabata nke Dianormet, na -ebelata nsonaazụ ya. Ekwesịrị iji ego ndị a were ọtụtụ awa mgbe ịghasịrị Dianormet. Ọgwụ a na - eme ka mmetụta nke ọgwụ anticoagulants nke mkpụrụ ọgwụ coumarin na-akwalite mmetụta.

Doụbiga ọgwụ ike Dianormet, ihe mgbaàmà na ọgwụgwọ

Ọ bụrụ na ịdoụbiga ihe ókè dị ukwuu anaghị eme ka ọ bụrụ ọrịa hypoglycemia, mana enwere iyi egwu lactic acidosis: ọ na-akawanye ahụike, adịghị ike, mgbu akwara, ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, mgbu afọ, afọ iku ume. Ọgwụgwọ lactic acidosis - ịba ọcha n'anya.
Ọrịa nnyefere dị nro: iro ụra, ọhụhụ ọhụụ, akpụkpọ anụ mucous akọrọ nke oghere ọnya. Mgbe mgbaàmà ndị a pụtara, onye ọrịa kwesịrị ịnọ n'okpuru nlekọta nke dọkịta. Ọgwụgwọ symptomatic.
Na oke ịdoụbiga mmanya ókè, mbelata ma ọ bụ ịrị elu ọbara ọgbụgba, ụmụ akwụkwọ gbakọrọ agbagọ, tachy ma ọ bụ bradycardia, ischuria (n'ihi ụkwara nke ọkpọ ahụ), hypokinesia eriri afọ, hypo- ma ọ bụ ọbara mgbali elu, mgbatị ụbụrụ na-arịwanye elu, ọdịda okuku ume, nkwarụ, ụkwara, enwere ike. Ọgwụgwọ - mwepu ọgwụ, mgbatị afọ, akwara ọhụụ, mweghachi nke ọbara pH, iwepụ hypoxia, ọgwụgwọ anticonvulsant, mmezi nke ọrụ nke akwara obi na sistem iku ume.

Ntụziaka maka iji Dianormet

Metformin 500 mg, 850 mg ma ọ bụ 100 mg.

Ihe ndi ozo: povidone, talc, magnesium stearate.

ụdị 2 ọrịa shuga mellitus (nke na-abụghị insulin) na ọgwụgwọ adịghị eri nri, karịsịa na ndị ọrịa nwere oke ibu: dị ka monotherapy ma ọ bụ usoro ọgwụgwọ na njikọta na ọgwụ ndị ọzọ na-arịa hypoglycemic ma ọ bụ na njikọta insulin maka ọgwụgwọ nke ndị okenye, dị ka monotherapy ma ọ bụ njikọta ọgwụ na insulin. maka ọgwụgwọ ụmụaka site na afọ 10.

Mbelata ịdị njọ nke ọrịa shuga na ndị okenye nwere ụdị ọrịa shuga 2 nke oke ibu na oke ibu bụ onye ji metformin dịka ọgwụ nke mbụ na enweghị ọgwụ ịgwọ nri.

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

N'ime, n'oge ma ọ bụ ozugbo nri gasịrị, maka ndị ọrịa anaghị enweta insulin, 1 g (mbadamba abụọ) ugboro 2 n'ụbọchị n'ụbọchị 3 mbụ ma ọ bụ 500 mg ugboro atọ n'ụbọchị, mgbe ahụ site na ụbọchị anọ ruo ụbọchị iri na anọ - 1 g ugboro atọ n’ụbọchị, mgbe ụbọchị iri na ise gachara, a ga-belata usoro ihe omimi n’iburu ọdịnaya glucose dị n’ọbara na mmamịrị. Mmezi kwa ụbọchị - 1-2 g.

A na-ewere mbadamba azụ (850 mg) 1 n'ụtụtụ na mgbede. Oke kachasị kwa ụbọchị bụ 3 g.

N'iji insulin emeghari onodu ya na oge erughi 40 nkeji / ubochi, usoro onunu ogwu nke metformin bu otu, ebe enwere ike wedata uzo insulin jiri nwayọ belata (site na nkeji 4-8 kwa ubochi obula). N'ihe banyere insulin karịrị 40 nkeji / ụbọchị, iji metformin yana mbelata nke insulin chọrọ nlekọta dị ukwuu ma eme ya n'ụlọ ọgwụ.

Omume ọgwụ

Biguanide, onye na-ahụ maka hypoglycemic maka nchịkwa ọnụ. N'ime ndị ọrịa nwere ọrịa shuga, ọ na-ebelata mkpụkọ nke glucose n'ọbara site na igbochi gluconeogenesis na imeju, na-ebelata nnabata nke glucose na eriri afọ ma na-abawanye ojiji nke anụ ahụ, ọ na-ebelata mkpokọta nke TG, cholesterol na LDL (na-ekpebisi na ihe efu) na ọbara ma ghara ịgbanwe njupụta nke njupụta ndị ọzọ. Na-emekwa ka ahụ sie ike.

Na enweghị insulin n'ime ọbara, a naghị egosipụta mmetụta ọgwụgwọ. Ọkpụkpụ hypoglycemic anaghị akpata. Ọ na - eme ka akwara fibrinolytic dị n'ọbara n'ihi nnabata nke onye na - egbochi nnabata profibrinolysin (plasminogen) ụdị anụ ahụ.

Nsonaazụ

Site na usoro digestive: ọgbụgbọ, ọgbụgbọ, ụtọ "ọla" n'ọnụ, mbelata agụụ, dyspepsia, flatulence, mgbu nke afọ.

Site n'akụkụ nke metabolism: n'ọnọdụ ụfọdụ - lactic acidosis (adịghị ike, myalgia, nsogbu nke akụkụ iku ume, oke ụra, mgbu afọ, hypothermia, mgbada ọbara, mgbatị refdyarrhythmia), na ọgwụgwọ ogologo oge - hypovitaminosis B12 (malabsorption).

Site na akwara hemopoietic: n'ụzọ ụfọdụ - megaloblastic anaemia.

Mmeghachi omume nfụkasị ahụ: ọnya anụ ahụ.

Ọ bụrụ na nsonaazụ ndị ọzọ, a ga-belata dose ahụ ma ọ bụ kagbuo nwa oge. Ọrịa: lactic acidosis.

Mmekorita

Mbelata Cmax na T1 / 2 nke furosemide site na 31 na 42.3%, n'otu n'otu.

Kwekọrọ na ethanol (lactic acidosis).

Jiri mkpachara anya na njikọta ọgwụ na-adịghị mma na cimetidine.

Ngwurugwu nke sulfonylureas, insulin, acarbose, MAO inhibitors, oxytetracycline, ACE inhibitors, clofibrate, cyclophosphamide na salicylates na-eme ka mmelite ahụ dịkwuo mma.

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

Furosemide na-abawanye Cmax site na 22%.

Nifedipine na-abawanye mmịpụta, Cmax, na-eji nwayọ nwayọ ala.

Ọgwụ cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren na vancomycin) zoro ezo na tubules na-asọrịta mpi nke usoro tubular ma nwee ike ịbawanye Cmax site na 60% na ọgwụgwọ ogologo.