Cutar sankarau a cikin ƙasa tana ɗaya daga cikin manyan cututtukan al'umma guda biyar waɗanda waɗanda nakasassu suka mutu kuma suka mutu. Ko da bisa ga ƙididdigar marassa adadi, kusan masu ciwon sukari dubu 230 ke mutuwa kowace shekara daga kamuwa da cutar siga a cikin ƙasa. Yawancinsu ba sa iya sarrafa yanayin su ba tare da magunguna masu inganci ba.
Shahararrun magunguna da aka gwada-rage gwajin sukari suna daga ƙungiyar biagunides da sulfonylureas. Ana nazarin su sosai a cikin aikin asibiti da kuma karatu da yawa, ana amfani dasu a dukkan matakai na nau'in ciwon sukari na 2.
Haɗin maganin Glimecomb (a cikin tsarin ƙasa Glimekomb) an ƙirƙira shi ne akan biagunide da shirye-shiryen sulfonylurea, haɗuwa da ƙarfin metformin da glycazide, waɗanda ke ba da izinin sarrafa glycemia yadda ya kamata kuma cikin aminci.
Pharmacology Glimecomb
Hanyar aiwatar da shirye-shiryen asali na hadaddun ya bambanta sosai, wannan yana ba da damar tasiri tasiri daga kusurwoyi daban-daban.
Gliclazide
Abubuwan farko na miyagun ƙwayoyi sune wakilan sabon ƙarni na sulfonylureas. Thearancin sukari na rage ƙwayar ƙwayar cuta ya ƙunshi haɓaka aikin samar da insulin ruwa mai ƙwanƙwasawa ta hanyar ƙwayoyin ƙwayoyin jiki. Godiya ga ƙarfafa glycogen synthase, yin amfani da glucose ta tsokoki yana inganta, wanda ke nufin cewa ba a canza shi sosai cikin mai ba. Normalizes da glycemic bayanin martaba na gliclazide a cikin 'yan kwanaki, ciki har da na rayuwa sukari latent.
Hyperglycemia, wanda yawanci ke bayyana kanta bayan cin abinci na carbohydrates, ba shi da haɗari bayan cinye gliclazide. Haɗin Platelet, fiblinolytic da aikin heparin sun haɓaka tare da miyagun ƙwayoyi. Asedara haƙuri ga heparin, yana da magani da kaddarorin antioxidant.
Metformin
Hanyar aikin metformin, sashi na biyu na Glimecomb, ya dogara ne da raguwar matakan sukari saboda sarrafa glycogen da aka saki daga hanta. Ta hanyar haɓaka hankalin masu karɓa, ƙwayar ta rage juriya daga sel zuwa insulin. Ta hanyar hana samar da glucose daga sunadarai da mai, yana kara jigilar kayayyaki zuwa jijiyoyin tsoka don yawan aiki.
A cikin hanji, metformin yana hana shan glucose ta cikin bango. Abun da ke cikin jini yana haɓakawa: rage yawan ƙwayoyin cholesterol, triglycerol da LDL ("mummunan" cholesterol) yana raguwa, matakin HDL (cholesterol) mai kyau yana ƙaruwa. Metformin baya tasiri β-sel wadanda ke da alhakin samar da insulin nasu. A wannan gefen, aiwatar yana sarrafa gliclazide.
Pharmacokinetics na miyagun ƙwayoyi
Gliclazide
Bayan shiga cikin narkewa, ana amfani da maganin a cikin sauri: a kashi 40 na MG, an lura da mafi girman darajar Cmax (2-3 μg / ml) a cikin jini bayan sa'o'i 2-6. Glyclazide ya ɗaura nauyin sunadaran ta kashi 85-98%. Biotransformation na miyagun ƙwayoyi yana faruwa a cikin hanta. Daga cikin metabolites da aka kafa, mutum yana da tasiri mai aiki akan microcirculation.
Rabin rayuwar T1 / 2 daga 8 zuwa 20 hours. Abubuwan da ke lalata lalata galibi suna kawar da kodan (har 70%), a wani ɓangare (har zuwa 12%) suna cire hanji. Magungunan suna aiki da rana. A cikin masu ciwon sukari na tsufa, ba a rubutattun siffofin pharmacokinetic na sarrafa Glyclazide. Ana fitar da samfuran sihiri ta asali: 65% - tare da fitsari, 12% - tare da feces.
Metformin
A cikin narkewa, ana amfani da maganin ta hanyar 48-52%. Yin azumi bioavailability bai wuce 60% ba. Ana lura da mafi girman hankali (1 μg / ml) a cikin jini bayan sa'o'i 1.8-2.7. Amfani da miyagun ƙwayoyi tare da abinci yana rage Cmax da 40% kuma rage ƙimar babban nasara ta minti 35. Metformin kusan baya daure wa garkuwar jini, amma yana tarawa cikin sel jini.
Rabin rayuwar T1 / 2 shine sa'o'i 6.2. Ana cire ƙwayoyin metabolites galibi ta ƙodan da kuma a wasu ɓangarorin (kusan na uku) ta hanjin hanji.
Wanda bai dace da Glimecomb ba
Ba a kuma hada magunguna masu hade ba:
- Masu fama da cutar siga da nau'in cuta ta 1;
- Tare da ketoacidosis (nau'in ciwon sukari);
- Tare da precca mai ciwon sukari da coma;
- Marasa lafiya tare da tsananin lalata koda
- Tare da hypoglycemia;
- Idan yanayi mai tsanani (kamuwa da cuta, bushewa, rawar jiki) na iya haifar da ƙoshin koda ko hanta;
- Lokacin da ake haɗuwa da cututtukan jijiyoyin cuta tare da matsananciyar ƙwayar oxygen na kasusuwa (bugun zuciya, zuciya ko gazawar numfashi);
- Iyaye masu juna biyu da masu shayarwa;
- Tare da amfani da layi daya na miconazole;
- A cikin yanayin da ya shafi maye gurbin allunan na ɗan lokaci tare da insulin (kamuwa da cuta, aiki, mummunan raunin da ya faru);
- Tare da hypocaloric (har zuwa 1000 kcal / rana) rage cin abinci;
- Mutanen da ke shan giya, tare da mummunan guba;
- Idan tarihin lactic acidosis;
- Tare da hypersensitivity ga abubuwan da ke cikin ƙwayar maganin.
An soke Glimecomb kwana biyu kafin kuma zuwa daidai wannan lokacin bayan mai haƙuri dole ne ya gwada gwajin rediyotope ko X-ray ta amfani da alamun bambanci na aidin.
Kada a rubuta magunguna ga masu ciwon sukari na balaga (bayan shekaru 60), idan an tilasta musu yin aiki da jiki, wanda hakan ke haifar da faruwar cutar lactic acidosis.
Side effects
Duk magungunan roba, har ma da mafi aminci, suna da sakamako mara amfani. Shirye-shiryen sulfonylurea na ƙarni na biyu - erythropenia, agranulocytosis, hemolytic anemia, pancytopenia, vasculitis rashin lafiyan, mummunar cutar hepatic.
Metformin ƙarni na uku shine magani mafi aminci.
A lokacin daidaitawa, masu ciwon sukari suna korafi kawai na rikicewar dyspeptic: matsi mai ɗaci, saukar da ci, canjin dandano (fitowar ɗanɗano mai ƙarfe).
Baya ga tasirin gaba ɗaya, Glimecomb ya rubuta takamaiman abubuwan. Abubuwan fasalin su suna nuna a cikin tebur.
| Sunayen gabobi da tsarin | Nau'in Sakamakon Cutar da ba a so |
| Tsarin Endocrin | Yanayin hypoglycemic (tare da yawan wuce gona da iri da rashin bin ka'idodin abincin) - ciwon kai, gajiya, yunwar da ba ta kulawa, gumi, asarar ƙarfi, daidaituwa ta haɓaka, ƙarancin zuciya, neurosis, asarar iko da kai, ɓacin rai (idan yanayin ya ci gaba). |
| Hanyoyin tafiyar matakai | A cikin matsanancin yanayi - lactic acidosis, wanda aka bayyana ta hanyar jin tsoka, rauni gaba ɗaya, rashin lafiya, ciwon ciki, jin zafi, saukarwar hawan jini, da bradycardia. |
| Gastrointestinal fili | Rashin daidaituwa a cikin nau'in gudawa, tashin zuciya, nauyi a cikin ciki, canje-canje a cikin dandano, asarar ci (lokacin amfani da Allunan tare da abinci), wani lokacin hepatitis da cholestatic jaundice, suna buƙatar maye gurbin miyagun ƙwayoyi, haɓaka aikin transaminase hanta mai yiwuwa ne. |
| Zubewar jini | A cikin halayen da ba a sani ba, an hana tsarin kewaya, sakamakon cutar leukopenia, anemia, thrombocytopenia. |
| Cutar Al'aura | Ana nuna halayen fata ta hanyar urticaria, itching, maculopapular rashes. |
Ba kasafai ake samun wahalar gani ba, ana buƙatar gyaran kwaskwarima ko cikakkiyar maye gurbin Glimecomb tare da maimaitawa.
Glimecomb sashi nau'i da abun da ke ciki
Kamfanin AKRIKHIN na Rasha ya samar da Glimecomb a cikin nau'ikan allunan silili a cikin farin tare da launin shuɗi, tare da layin raba. Tsarin marmara yana yiwuwa.
Kowace kwamfutar hannu ta ƙunshi 40 MG na gliclazide da 500 MG na metformin. Plementara kayan haɗin yau da kullun tare da filler: sorbitol, sodium croscarmellose, povidone, steneste magnesium. A cikin kowane farantin a cikin sel na abinci, an shirya allunan 10. Akwatin kwali na iya samun blisters da yawa. Zai yuwu a shirya magungunan a lokuta masu filastik tare da dunƙule dunƙule.
An sake bayar da magani. Magungunan ba ya buƙatar yanayi na musamman don ajiya (bushe, mara amfani ga yara da wuri mai aiki na ultraviolet, zazzabi ɗakin). Maƙerin ya ƙayyade rayuwar shiryayye na Glimecomb har zuwa shekaru 2. Dole ne a zubar da maganin da ya ƙare.
Yadda ake nema
Don Glimecomb, umarnin don amfani sun bada shawarar shan maganin tare da abinci ko kuma bayan shi. An zabi sashi ne ta hanyar likita, la'akari da nazarin da aka yi, yanayin mai haƙuri, tsananin cutar, maganganun haɗin kai, ɗaukar mutum zuwa maganin.
Ka'idar farawa baya wuce kwalabe ɗaya zuwa uku a kowace rana tare da ƙaddamar da ƙarancin digiri har zuwa iyakar 5 Allunan / rana. har sai kun sami sakamako mafi kyau. Yawancin kullun ana rarraba shi sau biyu - da safe da maraice.
Taimaka tare da yawan wuce haddi
Kasancewar metformin a cikin gwaje-gwajen tare da kashi na iya haifar da lactic acidosis, da kuma kasancewar gliclazide - zuwa hypoglycemia.
Idan akwai alamun lactic acidosis (rashin tausayi, saurin numfashi, ƙarancin bacci, raunin ƙwayar tsoka, raunin dyspepti), an soke maganin, kuma mai haƙuri yana asibiti cikin gaggawa, tunda wanda aka azabtar za a iya dawo da shi a asibiti ta amfani da hemodialysis.
Idan yanayin hypoglycemic ba shi da ƙarfi, ya isa ya ba wa wanda aka cutar glucose ko sukari na yau da kullun. Idan bai san komai ba, kwayoyi (40% glucose, glucagon, dextrose) suna allura ne ko ja ruwa. Lokacin da mai haƙuri ya murmure, ana ba su abinci mai ƙayyadadden carbohydrate don hana komawa ci gaba.
Umarni na musamman
A cikin farkon kwanakin, yana da mahimmanci don sa ido kan matakan azumi da postprandial (2 sa'o'i bayan cin) sukari. Duk sakamakon aunawa yakamata a yi rikodin shi a cikin littafin diabetic na masu ciwon sukari.
Glimecomb ya dace da masu ciwon sukari da aka tanada tare da cikakken abinci. Idan babu isasshen ƙwayar carbohydrate, mai haƙuri yayi watsi da karin kumallo ko yana tsunduma cikin wasanni, saboda kasancewar gliclazide, haɓakar yanayi mai rauni yana yiwuwa. Hypoglycemia kuma yana haifar da yawan aiki a cikin jiki yayin ƙarancin abinci mai gina jiki, shan giya, shan magunguna masu rage sukari da yawa a layi daya. Sabili da haka, yana da mahimmanci ga masu ciwon sukari su bi duk shawarwarin likita game da sashi da jadawalin magani.
Idan salon rayuwar mai haƙuri ya canza (yawan motsin rai, yawan cin abinci, yawan aiki na jiki), likita zai iya sauya tsarin kulawa kuma ya daidaita sashi na magungunan ƙwayar cuta.
Musamman hankali a cikin nadin Glimecomb ya kamata a bai wa mutanen da suka manyanta tare da ƙarancin lafiya da rashin abinci mai gina jiki, fama da cututtukan pituitary-adrenal.
Bayyanar cututtuka na cututtukan hypoglycemia na iya maye gurbin ckers-blockers, reserpine, clonidine, guanethidine.
Yin jiyya tare da miyagun ƙwayoyi yana buƙatar saka idanu akai-akai game da yanayin kodan, tunda miyagun ƙwayoyi suna haifar da ƙarin nauyi a kansu. Ana bincika matakin lactate sau ɗaya a kowane watanni shida, tare da raunin ƙwayar tsoka.
Yayin gudanar da aikin Glimecomb, yana da mahimmanci a mai da hankali yayin tuki, a tsayi, da kuma a wasu ayyukan masu haɗari. Wannan zai taimaka wajen kawar da mummunan sakamako idan akwai masu illa.
Neman Masu haƙuri
Samun inganci da tasiri na hada magunguna sun ba shi shahararren yabo: sake dubawar masu ciwon sukari da likitoci galibi abokantaka ne game da maganin Glimecomb.
Elizaveta Olegovna, therapist. A cikin tsufa, hanyoyin metabolism suna rage aiki don kada kayayyakin lalata su shiga cikin jiki, ya kamata a tsara maganin tare da taka tsantsan. Abin farin ciki, rikitarwa mai mahimmanci bayan magani tare da Glimecomb da wuya ya faru, don haka ina ba da shawarar cewa marasa lafiya na "tare da ƙwarewar masu ciwon sukari" gwada haɗarin magani. Abubuwan haɗin jikinsa (metformin da gliclazide) sun riga sun saba da yawancin, saboda haka jiki yana ɗaukar sabon magani a hankali. Zai dace a lura da sauƙin amfani, kamar yadda yake tare da shekaru, mutane da yawa sun manta da shan maganin akan lokaci.
Dmitry. Gaskiyar cewa sakamako masu illa suna faruwa a cikin makon farko rashin hankali ne: Ina shan Glimecomb tsawon wata daya yanzu, kuma kamar ranar farko da kaina ya ji rauni, na sami tashin zuciya, hanjin aikina ba su yi tsayi ba. Don Allunan Glimecomb, farashin akan Intanet na al'ada ne (na inji 60. - 450 rubles), maganin yana taimakawa, don haka na sha wahala duk waɗannan rikice-rikice. Amma wataƙila kuna buƙatar tuntuɓi likita - watakila sashi ko magani zai canza.
Taya zan iya maye gurbin Glimecomb
A cikin sarkar kantin magani, magungunan kwayar asali za su kashe ƙarin ɗari, idan ya cancanta, koyaushe kuna iya ɗaukar matakan tsufa analogues na Glimecomb.
- Gliformin - 250 rubles. don inji mai kwakwalwa 60 ;; Hanyar aiwatar da miyagun ƙwayoyi daidai ne, amma kasancewar insulin bai dace da kowa ba.
- Diabefarm - 150 rubles. don inji mai kwakwalwa 60 ;; maida hankali na gliclazide a cikin waɗannan allunan ya fi girma (80 MG), amma gabaɗaya yana magance matsaloli guda ɗaya kamar na asali.
- Gliclazide MV - 200 rubles. don inji mai kwakwalwa 60 ;; gliclazide a ciki shine 30 MG kawai, alamu don amfani suna kama.
Likitoci ba su musun abubuwan da ke haifar da ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta ta "sanyin cuta" ba. Hanyar da ba a saba da ita ba don magance nau'in ciwon sukari na 2 ana bayar da shi ta hanyar masanin ilimin abinci da kuma endocrinologist na mafi girman nau'ikan A. Nikitina a wannan bidiyon:
