Tam sim no muaj ntau tus neeg mob ntshav qab zib thiab mob hnyav hom rog. Muaj ntau yam tshuaj rau kev kho mob ntawm cov mob no. Ib tug ntawm lawv yog cov tshuaj "Formetin". Nws cov yam ntxwv nta yuav tau tham hauv kab lus no.
Tshuaj qeb
Formetin, cov lus qhia rau kev siv uas tau muab rau hauv kab lus no, yog cov tshuaj hypoglycemic ntawm pawg biguanide.
Kev piav qhia ntawm kev sau thiab tso tawm daim ntawv
Ib ntsiav tshuaj muaj:
| m, r | m, r | m, r | |
| khoom muaj nqis | |||
| Metformin hydrochloride | 0,500 | 0, 850 | 1,000 |
| pab tshuaj | |||
| nruab nrab molecular hom povidone | 0, 017 | 0,029 | 0,034 |
| croscarmellose sodium | 0,008 | 0, 0136 | 0,016 |
| Ymagnesium stearate | 0,005 | 0,0084 | 0,010 |
Formetin yog tsim nyob rau hauv cov hlwv ntawm 100, 60 lossis 30 ntsiav tshuaj. Cov xim ntawm cov ntsiav tshuaj yog xim dawb, thiab daim ntawv nyob ntawm qhov ntau npaum li cas ntawm cov tshuaj tseem ceeb. Ntawm 500 mg, lawv muaj lub tiaj tiaj-cylindrical puag ncig nrog kev pheej hmoo thiab chamfer. Tsis tas li ntawd, Formetin muaj ntau npaum li cas ntawm 1000 mg thiab 850 mg. Cov ntsiav tshuaj nyob rau hauv cov ntaub ntawv no yog convex thiab oval. Lawv yog ib leeg pheej hmoo.
Pharmacodynamics
Metformin ("Formetin") qeeb qeeb ntawm gluconeogenesis tshwm sim hauv daim siab, thiab tib lub sijhawm muaj qhov txo qis hauv glycogen khw hauv nws. Cov cuab yeej no txhawb nqa qhov nyuaj ntawm kev nqus cov piam thaj los ntawm txoj hnyuv, ua rau kom cov piam thaj tawm ntawm lub cev. Nyob rau tib lub sijhawm, cov lus teb ntawm cov ntaub so ntswg rau insulin nce, yam tsis muaj kev cuam tshuam rau kev tsim tawm ntawm nws cov endocrine ib feem los ntawm pancreas los ntawm B-hlwb, hla cov tshuaj tiv thaiv hypoglycemic, vim tias cov khoom siv no tsis ua haujlwm.
Cov tshuaj "Formetin", tshuaj xyuas uas hais txog nws cov txiaj ntsig, txo qis cov roj cholesterol thiab triglycerides hauv cov ntshav. Cov ntsiab lus ntawm high-density lipoproteins nce 20-30%. Nrog kev noj zaub mov tsis zoo, cov tshuaj "Formetin", cov lus qhia rau kev siv uas tau piav qhia hauv tsab xov xwm no, pab txo qis thiab / lossis ua kom tus neeg mob qhov hnyav. Qhov no tshwm sim vim oxidation ntawm qabzib nrog oxygen-dawblos ntawm, nrog rau txo qis qab los noj mov. Cov txheej txheem ntawm kev ua kom cov ntaub so ntswg plasminogen tseem blunted los ntawm kev ua ntawm nws cov inhibitor, thaum nws muaj cov nyhuv hemostatic.
YPharmacokinetics
Metformin nqus tau pib hauv plab hnyuv. Qhov siab tshaj plaws cov ntsiab lus ntawm cov tshuaj no nyob rau hauv cov ntshav yog mus txog kwv yees li 2.5 teev tom qab daim ntawv thov ntawm qhov nqus ntawm tus qauv koob tshuaj - 50-60%. Qhov zoo ntawm kev nqus tshuaj hauv lub cev yog cuam tshuam los ntawm kev sib raug zoo ntawm cov tshuaj nquag thiab cov plasma proteins. Cov ntsiav tshuaj Formetin tsis muaj kev sib txuas nrog cov plasma proteins. Qhov no hais txog nws cov txiaj ntsig. Txij li qhov qis dua qhov sib txuas coefficient, qhov zoo dua cov tshuaj yog absorbed. Deposition tshwm sim nyob rau hauv ob lub raum, siab, cov leeg nqaij, cov qog ua kua qaub. Hauv lub cev, metformin tsis hloov pauv. Tom qab ntawd nws yog excreted los ntawm lub raum. Yog li ntawd, nyob rau hauv cov ntaub ntawv ntawm kev ua txhaum ntawm lawv cov hauj lwm, cumulation yog pom. Lub neej ib nrab yog 1.5-4.5 teev.
Purpose
Cov tshuaj "Formetin" yog siv los kho qee yam kab mob. Namely, nyob rau hauv lub xub ntiag ntawm hom 2 mob ntshav qab zib mellitus, nyob rau hauv cov ntaub ntawv ntawm complex rog rog, thaum noj zaub mov tsis pab kom cov suab thaj ib txwm, txawm nyob rau hauv ua ke nrog ib tug sulfonylurea. Kuj tseem zoo yog "Formetin" rau kev poob phaus.
Yuav ua li cas?
koob tshuaj no yog xaiv los ntawm tus kws kho mob, raws li cov piam thaj hauv cov ntshav. Kev noj qhov ncauj yuav tsum tau noj tom qab noj mov nrog ib khob dej.ib tug ntau npaum li cas ntawm cov kua thiab tsis ua rau lub ntsiav tshuaj mus rau mechanical processing. Raws li tau hais los saum no, qhov ntau npaum li cas yog nyob ntawm cov ntsiab lus ntawm cov piam thaj hauv cov ntshav. Nws pib nrog qhov tsawg kawg nkaus - 0.5 g lossis 0.85 g ib hnub. Ob hnub tom qab pib kev kho mob nrog cov tshuaj no, qhov ntsuas tsis tu ncua ntawm metformin hauv cov ntshav tau pom. Yog tias tsim nyog, koj tuaj yeem maj mam nce cov koob tshuaj mus rau qhov siab tshaj plaws. Nws sib npaug rau 3 grams.
Vim tias kev loj hlob ntawm lactic acidosis feem ntau pom nyob rau hauv cov neeg laus, rau lawv cov qib siab tshaj plaws txhua hnub yog 1 g. kev tshwm sim yuav tsum tau tham hauv qab no.
YContraindications
Muaj ntau yam nuances hauv txoj kev npaj no. Cov tshuaj "Formetin", cov lus qhia rau kev siv uas tau muab rau hauv cov ntawv no, yog contraindicated nyob rau hauv lub xub ntiag ntawm:
- Y mob ntshav qab zib ketoacidosis, precoma, coma.
- mob raum ua haujlwm tsis zoo.
- Lub plawv thiab ua pa tsis ua haujlwm.
- mob theem ntawm myocardial infarction.
- Dehydration.
- Kev haus dej cawv ntev ntev thiab lwm yam mob uas tuaj yeem ua rau muaj qhov tshwm sim ntawm lactic acidosis.
- Kev mob cerebrovascular.
- cev xeeb tub thiab pub niam mis.
- Nyob zoo rau cov tshuaj no.
- Kev phais loj thiabKev raug mob thaum kho cov tshuaj insulin.
- Kab mob hnyav.
- Impaired siab ua haujlwm.
- Acute alcohol poisoning.
- Lactic acidosis (nrog rau keeb kwm).
- Kev noj zaub mov hypocaloric (tsawg dua 1000 kcal ib hnub).
- X-ray lossis adioisotope kev tshawb fawb nrog kev qhia txog cov tshuaj muaj iodine.
Nws tseem tsis tau pom zoo siv cov tshuaj "Formetin" rau cov neeg muaj hnub nyoog tshaj rau caum xyoo uas ua haujlwm hnyav rau lub cev. Txij li thaum nyob rau hauv rooj plaub no lawv muaj kev pheej hmoo ntawm kev tsim lactic acidosis.
Side effect
Qhov tshwm sim ntawm cov tsos mob tsis zoo li "hlau" saj nyob rau hauv lub qhov ncauj, ntuav, xeev siab, raws plab, tsim roj, tsis qab los noj mov yuav tsum tau txwv tsis pub siv cov kev kho mob thiab hu rau tus kws kho mob tam sim ntawd. Kev siv cov tshuaj mus ntev ua rau muaj kev ua txhaum lossis ua tiav qhov kev nqus ntawm cov vitamin B 12, uas ua rau muaj kev txuam nrog tom kawg hauv lub cev, ua rau hypovitaminosis. Nyob rau hauv tsawg zaus, qhov sib txawv tsim - megaloblastic В12-deficiency anemia. Yog tias qhov koob tshuaj tsis raug cai, hypoglycemia tuaj yeem ua tau. Kev tsis haum tshuaj nyob rau hauv daim ntawv ntawm daim tawv nqaij pob kuj tshwm sim. Yog li ntawd, cov tshuaj "Formetin", kev tshuaj xyuas ntawm nws qhov kev siv tau zoo sib txawv, yuav tsum tau muab los ntawm tus kws kho mob nkaus xwb.
Cov lus qhia tshwj xeeb
Cov txheej txheem tseem ceeb yog txiav txim siab los ntawm qhov peculiarity ntawm tsub zuj zuj ntawm cov ntsiab lus tseem ceeb "Formetin" hauv lub cev thiabqhov tshwm sim ntawm qhov no.
Txhawm rau tiv thaiv kev sib sau ntawm metformin thiab tiv thaiv lactic acidosis, nws yog ib qho tsim nyog yuav tsum tau saib xyuas cov ntsuas ntawm lub raum ua haujlwm thiab kuaj xyuas seb cov lactic acid hauv lub cev tsawg kawg 2 zaug hauv ib xyoos. Tsis tas li, yog tias mob nqaij hlav, yuav tsum rov kuaj dua.
Qhov cuam tshuam ntawm cov tshuaj no ntawm lub peev xwm tswj cov txheej txheem thiab tsav tsheb
Hauv qhov no, kuj tseem muaj qee qhov nuances. Qhov cuam tshuam ntawm "Formetin" ntawm lub peev xwm los tswj cov txheej txheem thiab kev thauj mus los tsuas yog siv ua ke nrog cov tshuaj uas cuam tshuam rau cov txheej txheem ua haujlwm, xav tau cov lus teb ceev thiab nce siab. Qhov no tseem ceeb kom paub.
Siv thaum pub niam mis thiab cev xeeb tub
Cov tshuaj "Formetin", cov lus qhia rau kev siv uas tau teev tseg hauv cov ntawv no, muaj cov kab mob hauv plab "B" raws li FDA. Thaum cev xeeb tub, koj tuaj yeem noj cov tshuaj no. Txawm li cas los xij, nws siv tsuas yog nyob rau qee kis. Namely, thaum qhov kev xav tau los ntawm qhov kev kho no yuav dhau qhov muaj feem cuam tshuam rau tus menyuam hauv plab. Qee cov kev tshawb fawb thiab kev tshawb fawb tshwj xeeb ntawm kev siv cov tshuaj xws li tshuaj "Formetin" tsis tau ua thaum lub sijhawm cev xeeb tub. Thaum lub sij hawm kho yuav tsum tsis txhob pub niam mis. Txawm li cas los xij, koj yuav tsum nrhiav kev qhia ntawm tus kws kho mob uas tsim nyog.
Kev Sib Tham Tshuaj
Metformin nce qib suab thaj hauvntshav. Qhov no yog qhov tseeb tshwj xeeb tshaj yog thaum noj ib txhij nrog cov tshuaj uas tsis yog-steroidal anti-inflammatory, sulfonylurea thiab clofibrate derivatives, monoamine oxidase inhibitors, acarbose, insulin, oxytetracycline, cyclophosphamide, adrenoblockers thiab angiotensin-hloov enzyme inhibitors..
Y Thaum siv ua ke nrog cov tshuaj endocrine (cov tshuaj tiv thaiv qhov ncauj, glucocorticosteroids, sympathomimetics, epinephrine, thyroid hormones, glucagon, thiazide thiab voj diuretics, phenothiazine derivatives, nicotinic acid derivatives), metformin tuaj yeem cuam tshuam cov txheej txheem hypoglycemic.
Thaum cov tshuaj xws li Formetin tau ua ke nrog Cymidine, Nifedipine, qhov kev pheej hmoo ntawm lactic acidosis tsim, uas inhibits excretion ntawm metformin los ntawm lub cev. Qhov no tau pom thaum noj cov khoom uas muaj cawv, suav nrog ua ib feem ntawm cov tshuaj.
Cationic agents (quinidine, amiloride, digoxin, procainamide, morphine, quinine, vancomycin, ranitidine, triamterene) tsim nyob rau hauv cov tubules sib tw rau kev thauj mus los thiab tuaj yeem nce qib tshuaj mus txog 60% hauv kev kho mob mus ntev.
Ntau tshaj
Kev noj tshuaj ntau dhau ntawm "Formetin" tau pom thaum noj 0.85 grams tauj ib hnub thiab ua rau muaj lactic acidosis. Tsis tas li, cov ntsiab lus siab ntawm metformin yog vim kev ua haujlwm tsis zoo ntawm lub raum.
Cov tsos mob ntxov ntawm lactic acidosis yog qhov tsis muaj zog ntawm tag nrho lub cev, tsam plab, lub cev kub, mob plab thiabcov leeg, txo cov ntshav siab, reflex bradyarrhythmia. Qee zaum, muaj qhov tshwm sim ntawm kev ua pa nquag, tsis nco qab, kiv taub hau thiab, vim li ntawd, coma tshwm sim.
Thaum qhov tshwm sim me ntsis ntawm cov tsos mob ntawm kev siv tshuaj ntau dhau, tsis txhob siv cov tshuaj thiab sab laj nrog kws kho mob kom paub meej tias kev kuaj mob lactic acidosis. Txhawm rau tshem tawm cov khoom nquag ntawm tus neeg sawv cev qhia thiab lactic acid los ntawm lub cev, hemodialysis nrog cov tsos mob sib npaug yuav pab tau.
"Formetin": analogues
Muaj ntau cov nyiaj ntawm hom no. Analogues ntawm "Formetin" yog cov tshuaj uas muaj metformin hydrochloride ua lub ntsiab tivthaiv. Ib qho piv txwv yog cov tshuaj ntawm Lavxias teb sab manufacturers: Vero-Metformin, Gliformin, Metformin, Metformin-Richter, thiab txawv teb chaws - Glucophage, Glucophage thiab Glucophage Ntev (Fabkis), Langerin "(Slovakia), "Metfogamma" nrog ntau npaum li cas ntawm cov nquag. tshuaj 0.100, 0.500 thiab 0.850 g (Lub teb chaws Yelemees).
Cov Cai thiab cov cai ntawm kev cia
Muaj qee yam xwm txheej hauv txoj kev npaj no. Cov tshuaj "Formetin" muaj zog, yog li nws tsuas yog tso tawm los ntawm cov tshuaj thiab yuav tsum tau khaws cia ntawm chav tsev kub, tawm ntawm qhov ncav cuag ntawm cov menyuam yaus thiab hnub ci. Nws lub neej txee yog 2 xyoos.
Tus nqi
Tus nqi nruab nrab rau cov tshuaj "Formetin" yog teem nyob ntawmnqi: los ntawm 59 rubles. rau hlwv 0.5 g, 133 rubles. rau 0.85 g thiab 232 rubles. rau 1 xyoos
Zoo kawg
Txhua yam saum toj no muaj ntau cov ntaub ntawv tseem ceeb. Tom qab nyeem tsab xov xwm no, txhua tus yuav tuaj yeem nrhiav cov lus teb rau lo lus nug ntawm yuav ua li cas noj "Formetin" thiab nws muaj dab tsi.
