I-Siofor yokulahlekelwa isisindo, ukwelashwa kwesifo sikashukela sohlobo 2 nokuvikelwa kwaso

ISiofor umuthi owaziwa kakhulu emhlabeni jikelele wokuvimbela kanye nokwelashwa kwesifo sikashukela sohlobo 2. I-Siofor yigama lokuhweba lesidakamizwa osisithako esisebenzayo yi-metformin. Umuthi lo ukhulisa ukuzwela kwamaseli esenzweni se-insulin, i.e., kunciphisa ukumelana ne-insulin.

Lo muthi uthuthukisa i-cholesterol kanye ne-triglycerides egazini, wehlisa ubungozi besifo senhliziyo, futhi okubaluleke kakhulu - usiza ukunciphisa umzimba.

Izigidi zeziguli ezinesifo sikashukela sohlobo 2 emhlabeni wonke zithatha iSiofor. Lokhu kuyabasiza ukuba balondoloze ushukela omuhle wegazi, ngaphezu kokulandela indlela yokudla. Uma isifo sikashukela sohlobo 2 siqala ukwelashwa ngesikhathi, uSiofor (Glucophage) angasiza ukwenza ngaphandle kwemijovo ye-insulin nokudla amanye amaphilisi anciphisa ushukela wegazi.

Imiyalo yomuthi uSiofor (metformin)

Le ndatshana iqukethe "ingxube" yemiyalo esemthethweni yeSiofor, imininingwane evela kumaphephabhuku wezokwelapha kanye nokubuyekezwa kweziguli ezisebenzisa umuthi. Uma ufuna imiyalo yeSiofor, uzothola lonke ulwazi oludingekayo nathi. Siyethemba ukuthi sikwazile ukuhambisa imininingwane mayelana nalezi zibhebhe ezidumile ezifanele ifomu elikufanele kakhulu.

ISiofor, iGlucofage kanye nezimpawu zabo

IGlucophage isidakamizwa sokuqala. Ikhishwa yinkampani eyasungula i- metformin njengekhambi lesifo sikashukela sohlobo 2. ISiofor iyi-analogue yenkampani yaseJalimane iMenarini-Berlin Chemie. Lawa amaphilisi e-metformin athandwa kakhulu emazweni akhuluma isiRussia naseYurophu. Ziyakwazi ezingabizi futhi zisebenza kahle. IGlucophage ende - umuthi osebenza isikhathi eside. Kubangela ukuphazamiseka kokugaya amahlandla amabili ngaphansi kwe-metformin ejwayelekile. IGlucophage ende nayo ikholelwa ukuthi yehlisa ushukela kangcono kushukela. Kepha lesi sidakamizwa naso sibiza kakhulu. Zonke ezinye izinketho zethebhulethi le-metformin ezibalwe ngenhla etafuleni azisetshenziswa kakhulu. Ayikho idatha enganele ekusebenzeni kwayo.

Izinkomba zokusetshenziswa

Thayipha isifo sikashukela sohlobo 2 (esingathembela ku-insulin), ukuze uthole ukwelashwa nokuvimbela. Ikakhulu ngokuhlanganiswa nokukhuluphala, uma ukwelashwa kokudla nemfundo yomzimba ngaphandle kwamaphilisi kungasebenzi.

Ukwelashwa kwesifo sikashukela, iSiofor singasetshenziswa njenge-monotherapy (okuwukuphela umuthi), kanye nokuhlanganiswa namanye amaphilisi okwehlisa ushukela noma i-insulin.

Contraindication

Ukuxhumana ngokuqokwa kwe-siofor:

• thayipha isifo sikashukela esingu-1 mellitus (*** ngaphandle kwezimo zokukhuluphala. Uma une-Type 1 sikashukela kanye nokukhuluphala - ukuthatha uSiofor kungaba lusizo, thintana nodokotela wakho);
• ukunqanyulwa ngokuphelele kokugodlwa kwe-insulin okwenziwa ngamanyikwe ngohlobo 2 lwesifo sikashukela;
• isifo sikashukela sikashukela, ikhefu lesifo sikashukela;
• ukwehluleka kwe-renal ngamazinga we-creatinine angenhla kwe-136 μmol / l emadodeni futhi ngaphezulu kwe-110 μmol / l kwabesifazane noma izinga lokuhlunga kwe-glomerular (GFR) elingaphansi kwama-60 ml / min;
• umsebenzi wesibindi okhubazekile
• ukwehluleka kwenhliziyo, ukufakwa kwe-myocardial;
• ukwehluleka ukuphefumula;
• i-anemia
• izimo ezimbi kakhulu ezingaba nomthelela emsebenzini we-renal okhubazekile (ukomisa, ukutheleleka komzimba, ukushaqeka, ukwethulwa kwezinto ezihlukile ze-iodine);
• Izifundo ze-X-ray ezinomehluko oqukethe iodine - zidinga ukukhanselwa kwesikhashana kwe-siophore;
• ukusebenza, ukulimala;
• izimo ze-catabolic (izimo ezinenqubo yokubola ethuthukisiwe, ngokwesibonelo, uma kwenzeka izifo zesimila);
• uphuzo oludakayo;
• i-lactic acidosis (kufaka phakathi idluliselwe ngaphambili);
• ukukhulelwa ne-lactation (ukuncelisa ibele) - ungathathi uSiofor ngesikhathi sokukhulelwa;
• ukudla ngomkhawulo obalulekile wokudla kwe-caloric (ngaphansi kuka-1000 kcal / ngosuku);
• iminyaka yezingane;
• hypersensitivity kuzakhi zomuthi.

Umyalo utusa ukuthi amaphilisi we-metformin anqunywe ngokuqapha kubantu abaneminyaka engaphezu kwengu-60 uma benza umsebenzi onzima womzimba. Ngoba lesi sigaba seziguli sinengozi eyandayo ye-lactic acidosis. Ngokwenzekayo, amathuba ale nkinga kubantu abanesibindi esinempilo asondele ku-zero.

I-Siofor yokunciphisa umzimba

Kwi-Intanethi, ungathola izibuyekezo eziningi ezinhle ezivela kubantu abathatha iSiofor yokunciphisa isisindo. Imiyalo esemthethweni yalesi sidakamizwa ayisho ukuthi umuthi ungasetshenziswa hhayi kuphela ekuvimbeleni noma ekwelapheni isifo sikashukela, kodwa ukumane wehlise isisindo.

Kodwa-ke, la maphilisi anciphisa isifiso sokudla futhi athuthukisa i-metabolism ukuze iningi labantu likwazi "ukulahlekelwa" amakhilogremu ambalwa. Umphumela we-Siofor wokulahlekelwa isisindo uyaqhubeka kuze kube yilapho umuntu ekuthatha, kepha ke amafutha asheshe abuye.

Kuyavunywa, iSiofor yokunciphisa isisindo ingenye yezinketho eziphephe kakhulu phakathi kwawo wonke amaphilisi okunciphisa umzimba. Imiphumela emibi (ngaphandle kokuqhakaza, isifo sohudo kanye ne-flatulence) akuvamile kakhulu. Ngaphezu kwalokho, futhi Umuthi ongabizi.

Ama-Siofor okwehlisa isisindo - amaphilisi asebenzayo okwehlisa isisindo, aphephile

Uma ufuna ukusebenzisa uSiofor ukwehlisa isisindo, sicela ufunde isigaba se- “Contraindication” kuqala. Futhi kuzolunga ukubonana nodokotela. Uma kungenjalo nge-endocrinologist, khona-ke nge-gynecologist - bavame ukunquma lo muthi nge-polycystic ovary syndrome. Thatha ukuhlolwa kwegazi nomchamo ukuhlola ukusebenza kwezinso zakho nokuthi kusebenza kanjani isibindi sakho.

Lapho uphuza amaphilisi ukwehlisa isisindo somzimba - ngasikhathi sinye udinga ukunamathela ekudleni. Ngokusemthethweni, ezimeni ezinjalo, kunconyelwa ukudla “okulambile” okunama-kilojoule amancane. Kepha isiza Diabetes-Med.Com ukuthola umphumela ongcono bancoma ukusebenzisa iSiofor yokunciphisa isisindo kanye nokudla okuvinjelwe ama-carbohydrate ekudleni. Lokhu kungaba yindlela yokudla kaDukan, Atkins noma yokudla okuphansi kwe-carbohydrate ka-Diabetes. Zonke lezi zinto zokudla zinempilo, zinempilo futhi zisebenza ngokunciphisa umzimba.

Uyacelwa ukuthi ungeqi umthamo otusiwe ukuze i-lactic acidosis ingakhuli. Le yinkimbinkimbi engandile, kodwa ebulalayo. Uma weqa umthamo ophakanyisiwe, ngeke wehlise isisindo ngokushesha, futhi uzozwa imiphumela emibi yepheshana lesisu ngokugcwele. Khumbula ukuthi ukuthatha uSiofor kukhulisa amathuba okukhulelwa okungakahlelwanga.

Kwi-Intanethi yolimi lwaseRussia, ungathola izibuyekezo eziningi zabesifazane abathatha iSiofor yokunciphisa isisindo. Izilinganiso zalo muthi zihluke kakhulu - kusuka kumdlandla kuya kokubi kakhulu.

Umuntu ngamunye une-metabolism yakhe eyodwa, engafani nawo wonke umuntu. Lokhu kusho ukuthi ukusabela komzimba kuSiofor nakho kuzoba kukodwa. Uma ungahleleli ukuphuza amaphilisi ngasikhathi sinye sokudla okune-carbohydrate ephansi, khona-ke ungalindeli ukuthi uzokwehla ngokweqile isisindo esinjengombhali wesibuyekezo esingenhla. Gxila kokususa 2-4 kg.

Mhlawumbe, uNatalia walandela ukudla okunekhalori ephansi, okungasizi ukunciphisa umzimba, kodwa kunalokho kuvimbela ukwehla kwesisindo. Uma esebenzisa isidlo esisezingeni eliphansi kwe-carbohydrate, umphumela ubuyohluka ngokuphelele. Ukudla kwamaprotheni eSiofor + kushesha futhi kulula ukunciphisa isisindo, ngesimo esihle somoya futhi ngaphandle kwendlala engapheli.

Imbangela ye-Valentina yobuhlungu obuhlangene indlela yokuphila yokuhlala, futhi isifo sikashukela asinakwenza lutho. Umuntu wazalwa ngenhloso yokuhamba. Ukuzivocavoca umzimba kubalulekile kithi. Uma uphila impilo yokuhlala lapho-ke, ngemuva kweminyaka engama-40, izifo ezihlangene eziwohlokayo, kufaka phakathi i-arthritis ne-osteochondrosis, zizokwenzeka nakanjani. Ukuphela kwendlela yokubenza banciphise ijubane ukufunda ukuthi ungazivocavoca kanjani ngentokozo, bese uqala ukukwenza. Ngaphandle kokunyakaza, awekho amaphilisi azosiza, kufaka phakathi i-glucosamine ne-chondroitin. Futhi uSiofor akanalutho lokuthuka. Wenza umsebenzi wakhe ngokwethembeka, esiza ukwehlisa isisindo nokulawula isifo sikashukela.

Esinye isisulu sokudla okuphansi kwekhalori, i-carbohydrate-dense odokotela abakunikeza bonke abanesifo sikashukela. Kepha u-Elena wehla kalula. Uyakwazi ngisho nokunciphisa umzimba. Kepha ngenxa yokudla okungalungile, bekungekho mqondo nhlobo wokuthatha uSiofor, noma ukunciphisa isisindo, noma ukuguqula ushukela wegazi ngokujwayelekile.

UNatyaya kahle walinyusa kancane leli thuba futhi ngenxa yalokhu wakwazi ukugwema imiphumela emibi ngokuphelele. Qhubeka nokudla okune-carbohydrate ephansi - futhi isisindo sakho ngeke siguqeke, kepha undize, wehle.

I-Siofor yokuvimbela isifo sikashukela sohlobo 2

Indlela engcono yokuvimbela isifo sikashukela sohlobo 2 ukushintshela empilweni enempilo. Ikakhulu, ukukhulisa ukusebenza komzimba kanye noshintsho kwisitayela sokudla. Ngeshwa, iningi leziguli empilweni yansuku zonke alilandeli izincomo zokuguqula indlela yazo yokuphila.

Ngakho-ke, umbuzo uphakame ngokuphuthumayo wokuthuthukisa isu lokuvimbela isifo sikashukela sohlobo 2 usebenzisa umuthi. Kusukela ngonyaka we-2007, ochwepheshe be-American Diabetes Association bakhiphe ngokusemthethweni izincomo ngokusetshenziswa kweSiofor ekuvimbeleni isifo sikashukela.

Ucwaningo oluthathe iminyaka emi-3 luveze ukuthi ukusetshenziswa kweSiofor noma iGlucofage kunciphisa ingozi yokuthola ushukela ngo-31%. Ukuqhathanisa: uma ushintsha indlela yokuphila enempilo, khona-ke le ngozi izokwehla ngo-58%.

Ukusetshenziswa kwamacwecwe e-metformin ukuvimbela kunconyelwa kuphela kwiziguli ezinobungozi obukhulu besifo sikashukela. Leli qembu lifaka abantu abangaphansi kweminyaka yobudala engama-60 abanokukhuluphala abanesici esisodwa noma esingaphezulu salezi zingozi ezilandelayo:

• izinga le-hemoglobin ye-glycated - ngaphezulu kuka-6%:
• i-arterial hypertension;
• amazinga aphansi we-cholesterol “enhle” (isilinganiso esiphakeme) egazini;
• ukuphakama kwegazi triglycerides;
• kwakukhona uhlobo 2 lwesifo sikashukela ezihlotsheni eziseduze.
• inkomba yomzimba enkulu kunale noma ilingana ne-35.

Ezigulini ezinjalo, ukuqokwa kweSiofor ekuvinjelweni kwesifo sikashukela emthamo ka-250-850 mg izikhathi ezi-2 ngosuku kungaxoxwa ngaso. Namuhla, iSiofor noma i-Glucophage yayo ehlukahlukene wukuphela kwesidakamizwa esithathwa njengendlela yokuvimbela isifo sikashukela.

Imiyalo ekhethekile

Udinga ukuqapha ukusebenza kwesibindi nezinso ngaphambi kokunquma amaphilisi we-metformin bese kuthi njalo ezinyangeni ezi-6. Kufanele futhi uhlole izinga le-lactate egazini izikhathi ezi-2 ngonyaka noma ngaphezulu.

Ekwelashweni kwesifo sikashukela, inhlanganisela ye-siofor ne-sulfonylurea derivatives iyingozi enkulu ye-hypoglycemia. Ngakho-ke, ukuqapha ngokucophelela amazinga kashukela egazini kuyadingeka kaningana ngosuku.

Ngenxa yobungozi be-hypoglycemia, iziguli ezithatha i-siofor noma i-glucophage azikukhuthazwanga ukuthi zibandakanyeke emisebenzini edinga ukunakwa nokusabela okusheshayo kwe-psychomotor.

Imiphumela emibi

I-10-25% yeziguli ezithatha iSiofor inezikhalazo zemiphumela emibi evela ohlelweni lokugaya ukudla, ikakhulukazi ekuqaleni kokwelashwa. Lokhu ukunambitheka “metallic” emlonyeni, ukulahleka kwesifiso, isifo sohudo, ukuqhakaza negesi, izinhlungu zesisu, isicanucanu ngisho nokuhlanza.

Ukuze wehlise imvamisa nobuningi bale miphumela emibi, udinga ukuthatha i-siofor ngesikhathi noma ngemuva kokudla, futhi wandise umthamo kancane kancane womuthi. Imiphumela emibi evela emgodini wesisu ayisona isizathu sokukhansela ukwelashwa kwe-Siofor. Ngoba ngemuva kwesikhashana bavame ukuhamba, noma nomthamo ofanayo.

Ukuphazamiseka kwemetabolic: kuyivelakancane (ngokweqile komuthi, lapho kunezifo ezikhona, lapho ukusetshenziswa kweSiofor kuphambene khona, notshwala), i-lactic acidosis ingakhula. Lokhu kudinga ukunqamuka ngokushesha kwemithi.

Ukusuka ohlelweni lwe-hematopoietic: kwezinye izimo - i-anemia ye-anemiablastic anemia. Ngokulashwa isikhathi eside nge-siophore, ukuthuthukiswa kwe-B12 hypovitaminosis kungenzeka (ukumuncwa kokulimala). Akuvamile ukuthi kube khona ukusabela komzimba - ukuqubuka kwesikhumba.

Kusuka ohlelweni lwe-endocrine: hypoglycemia (ene-overdose yesidakamizwa).

I-Pharmacokinetics

Ngemuva kokuphathwa ngomlomo, inani eliphakeme le-metformin (lokhu kuyinto esebenzayo yeSiofor) ku-plasma yegazi ifinyelelwa ngemuva kwamahora angaba ngu-2,5. Uma uphuza amaphilisi ngokudla, ukumunca kancane kwehlisa ijubane futhi kunciphe. I-metformin ephezulu ye-plasma, noma umthamo omkhulu, ayidluli ku-4 μg / ml.

Imiyalo ithi i-bioavailability yayo ephelele ezigulini ezinempilo icishe ibe yi-50-60%. Umuthi empeleni awubophele amaprotheni e-plasma. Umuthi osebenzayo uthululiwe emchameni ngokuphelele (100%) ungashintshiwe. Yingakho umuthi ungabekelwe iziguli ezinamazinga wokuhlunga we-renal glomerular lungaphansi kwama-60 ml / min.

Ukucaciswa kwezinso nge-metformin kungaphezu kwama-400 ml / min. Yeqa isilinganiso sokuhlunga kwe-glomerular. Lokhu kusho ukuthi i-siofor ikhishwa emzimbeni hhayi kuphela ngokuhlunga okucwebezelayo, kodwa futhi nangokufihla okusebenzayo kuma-proximal rebu tubules.

Ngemuva kokuphathwa ngomlomo, impilo yesigamu imayelana namahora ayi-6.5. Ngokuhluleka kwezinso, izinga lokukhuphuka kwe-siofor lehla ngokulingana nokuncipha kokuvunyelwa kwe-creatinine. Ngakho-ke, impilo yesigamu ihlala isikhathi eside futhi ukuhlushwa kwe-metformin ku-plasma yegazi kuyenyuka.

Ngabe iSiofor isusa i-calcium ne-magnesium emzimbeni?

Ingabe ukuthatha uSiofor kubhebhethekisa ukushoda kwe-magnesium, i-calcium, i-zinc ne-zethusi emzimbeni? Ochwepheshe baseRomania banquma ukuthola lokho. Ucwaningo lwabo lubandakanya abantu abangama-30 abaneminyaka engama-30-60, abasanda kutholwa ukuthi banesifo sikashukela sohlobo 2 futhi abangazange baselashwa ngaphambili. Bonke babebekwe uSiofor 500 mg izikhathi ezi-2 ngosuku. NguSiofor kuphela owayenqunywe ezibhebheni ukulandelela ukusebenza kwawo. Odokotela baqikelela ukuthi imikhiqizo edliwayo yomhlanganyeli ngamunye yayinama-320 mg we-magnesium ngosuku. Izibhebhe ze-Magnesium-B6 bezingabekelwe muntu.

Iqembu elilawulayo labantu abaphilile, ngaphandle kwesifo sikashukela, nalo lakhiwa. Benze izivivinyo ezifanayo ukuqhathanisa imiphumela yabo naleyo yabanesifo sikashukela.
Iziguli zesifo sikashukela sohlobo 2 ezazinokwehluleka kwe-renal, i-cirrhosis yesibindi, i-psychosis, ukukhulelwa, isifo sohudo esingamahlalakhona, noma abadla izidakamizwa ze-diuretic abavunyelwe ukuhlanganyela ocwaningweni.

Izinga le-magnesium egazini leziguli ezinesifo sikashukela sohlobo 2 liphansi, uma liqhathaniswa nabantu abaphilile. Ukushoda kwe-Magnesium emzimbeni kungenye yezimbangela zesifo sikashukela. Lapho ushukela usuvele ukhulile, izinso zisusa ushukela omningi kumchamo, futhi ngenxa yalokhu, ukulahleka kwe-magnesium kuyanda. Ezigulini ezinesifo sikashukela eziye zaba nezinkinga, kunokuntuleka okungathi sína kwe-magnesium kunalabo abanesifo sikashukela ngaphandle kwezinkinga. I-Magnesium iyingxenye yama-enzyme angaphezu kwama-300 alawula ukusebenza kwe-metabolism yamaprotheni, amafutha nama-carbohydrate. Kufakazelwe ukuthi ukuntuleka kwe-magnesium kuthuthukisa ukumelana ne-insulin ezigulini ezine-metabolic syndrome noma isifo sikashukela. Futhi ukuthatha izithasiselo ze-magnesium, yize kunjalo, kepha nokho kukhulisa ukuzwela kwamangqamuzana ku-insulin. Yize indlela ebaluleke kunazo zonke yokwelapha ukumelana ne-insulin iwukudla okune-carbohydrate ephansi, bonke abanye bayibekela umva womugqa omkhulu.

I-Zinc ngenye yezinto ezibaluleke kakhulu zokulandela emzimbeni womuntu. Kuyadingeka ngezinqubo ezingaphezu kwezingu-300 ezihlukile kumaseli - umsebenzi we-enzyme, ukwakheka kwamaprotheni, ukusayina. I-Zinc iyadingeka ukuze amasosha omzimba asebenze, alondoloze ibhalansi yemvelo, enze ama-radicals mahhala, anciphise ukuguga futhi avikele umdlavuza.

I-Copper nayo iyinto ebalulekile yomkhondo, ingxenye yama-enzyme amaningi. Kodwa-ke, ama-ion ethusi ayabandakanyeka ekwenziweni kwezinhlobo eziyingozi ze-oxygen ezisebenzayo (ama-radicals mahhala), ngakho-ke, ziyi-oxidants. Kokubili ukusweleka kanye nethusi ngokweqile emzimbeni kubangela izifo ezahlukahlukene. Kulokhu, ukweqisa kuvame kakhulu. Isifo sikashukela sohlobo 2 inkinga yokugula engalapheki ekhiqiza amaza amaningi wamahhala, ebangela ukucindezela kwe-oxidative kulimaze amaseli nemithambo yegazi. Ukuhlaziya kukhombisa ukuthi umzimba wesifo sikashukela uvame ukugcwala ngethusi.

Kunamaphilisi amaningi ahlukene abelwe uhlobo 2 sikashukela. Umuthi owaziwa kakhulu yi-metformin, othengiswa ngaphansi kwamagama uSiofor ne-Glucofage. Kuyafakazelwa ukuthi akuholeli ekuzuzeni isisindo, kepha kunalokho kusiza ukwehlisa isisindo, kuthuthukisa i-cholesterol yegazi, nakho konke lokhu ngaphandle kwemiphumela emibi eyingozi. I-Siofor noma i-glucophage enwetshiwe inconywa ukuba inikezwe ngokushesha, lapho nje isiguli sitholakala sine-Type 2 sikashukela noma i-metabolic syndrome.

Odokotela baseRomania banquma ukuphendula imibuzo elandelayo:

• Iliphi izinga elijwayelekile lamaminerali nezakhi zomkhondo emzimbeni weziguli ezisanda kutholakala zinesifo sikashukela sohlobo 2? Kuphezulu, kuphansi noma kuyinto evamile?
• Ukusetshenziswa kwe-metformin kuthinta kanjani amazinga omzimba we-magnesium, i-calcium, i-zinc ne-zethusi?

Ukwenza lokhu, bakala ezigulini zabo ezinesifo sikashukela:

• ukuqoqwa kwe-magnesium, i-calcium, i-zinc ne-zethusi ku-plasma yegazi;
• okuqukethwe i-magnesium, i-calcium, i-zinc ne-zethusi ekusebenzeni komchamo amahora angama-24;
• izinga le-magnesium kumaseli abomvu egazi (!);
• kanye ne-cholesterol "enhle" ne "embi", i-triglycerides, ushukela wegazi osheshayo, i-glycated hemoglobin HbA1C.

Iziguli ezinesifo sikashukela sohlobo 2 ziye zahlolwa igazi nomchamo:

• ekuqaleni kwesifundo;
• bese futhi - ngemuva kwezinyanga ezi-3 zokuthatha i-metformin.

Okuqukethwe kwezinto zomkhondo emzimbeni weziguli ezinesifo sikashukela sohlobo 2 nakubantu abaphilile

Siyabona ukuthi ezigulini ezinesifo sikashukela okuqukethwe kwe-magnesium ne-zinc kusegazini kuncishisiwe, uma kuqhathaniswa nabantu abanempilo. Kunenqwaba yezindatshana kumagazini wezokwelapha olimini lwesiNgisi afakazela ukuthi ukuntuleka kwe-magnesium ne-zinc kungenye yezimbangela zesifo sikashukela sohlobo 2. Yethusi eliningi lifana. Ngolwazi lwakho, uma uthatha i-zinc kumathebhulethi noma emaphaketheni, igcwala umzimba nge-zinc futhi ngasikhathi sinye ithusi eleqile kuyo. Bambalwa abantu abazi ukuthi izithasiselo ze-zinc zinomphumela ophindwe kabili onjalo. Kepha awudingi ukuthathwa kakhulu ukuze kungabikho ukushoda kwethusi. Thatha i-zinc ezigabeni ezi-2 kabili ngonyaka.

Imiphumela yokuhlaziya iveze ukuthi ukuthatha i-metformin akukukhulisi ukuntuleka kwezinto ezilandelwayo namaminerali emzimbeni. Ngoba ukumbiwa kwe-magnesium, i-zinc, ithusi kanye ne-calcium emchini ezigulini ezinesifo sikashukela sohlobo 2 akuzange kukhuphuke ngemuva kwezinyanga ezintathu. Ngokuphikisana nesizinda sokwelashwa ngamathebulethi eSiofor, abanesifo sikashukela bakhuphula okuqukethwe yi-magnesium emzimbeni. Ababhali bocwaningo bathi lokhu ngesenzo sikaSiofor. Ngiyakholelwa nakanjani ukuthi amaphilisi kashukela awasizi ngalutho, kepha ukuthi abahlanganyeli ocwaningweni badle ukudla okunempilo ngenkathi odokotela bebabukela.

Kwakukhona ithusi eliningi egazini lalabo abanesifo sikashukela kunabantu abaphilile, kepha umehluko neqembu lokulawula ubungewona obalulekile. Kodwa-ke, odokotela baseRomania babona ukuthi uma ithusi eliningi ku-plasma yegazi, kuba nzima kakhulu isifo sikashukela. Khumbula ukuthi lolu cwaningo belubandakanya iziguli ezingama-30 ezinesifo sikashukela sohlobo 2. Ngemuva kwezinyanga ezintathu zokwelashwa, banqume ukushiya abangama-22 kubo eSiofor, kwanezelwa amanye amaphilisi angama-8 - okuphuma ku-sulfonylurea. Ngoba uSiofor akazange ehlise ushukela wabo ngokwanele. Labo abaqhubeka nokwelashwa ngoSiofor babene-103.85 ± 12.43 mg / dl yethusi ku-plasma yegazi, futhi labo okwakumelwe banqume okuphuma ku-sulfonylurea kwadingeka abangu-127.22 ± 22.64 mg / dl.

Ababhali balolu cwaningo basungula futhi babonisa ngokwezibalo lobu budlelwano obulandelayo:

• Ukuthatha i-Siofor ngo-1000 mg ngosuku akukhuphulisi ukuphuma kwe-calcium, i-magnesium, i-zinc ne-zethusi kusuka emzimbeni.
• I-magnesium ethe xaxa egazini, ngcono ukufundwa kwe-glucose.
• I-magnesium engaphezulu kumaseli ebomvu egazini, iba ngcono ukusebenza koshukela kanye ne-glycated hemoglobin.
• Lapho ithusi eliningi, kuba nzima ngokwengeziwe ukusebenza ushukela, i-glycated hemoglobin, i-cholesterol ne-triglycerides.
• Lapho likhuphuka izinga le-hemoglobin ene-glycated, i-zinc engaphezulu iyakhishwa kumchamo.
• Izinga le-calcium egazini alihlukile ezigulini ezinesifo sikashukela sohlobo 2 nabantu abanempilo.

Ngidonsela ukunaka kwakho ukuthi ukuhlolwa kwegazi kwe-plasma magnesium akuthembekile, akubonisi ukushoda kwalesi simaminerali. Qiniseka ukwenza ukuhlaziya kokuqukethwe kwe-magnesium kumaseli abomvu egazi. Uma lokhu kungenzeki, futhi uzizwa izimpawu zokushoda kwe-magnesium emzimbeni, khona-ke vele uthathe amaphilisi e-magnesium ane-vithamini B6. Kuphephile ngaphandle kokuthi unesifo sezinso esinzima. Ngasikhathi sinye, i-calcium ayinawo nomthelela kushukela. Ukuthatha amaphilisi e-magnesium nge-vithamini B6 ne-zinc amaphilisi kubaluleke izikhathi eziningi ukwedlula i-calcium.

Isenzo se-Pharmacological

I-Siofor - amaphilisi okwehlisa ushukela wegazi eqenjini le-Biguanide. Umuthi unikeza ukwehla kokuxineka kwe-glucose egazini kokubili esiswini esingenalutho nangemva kokudla. Akubangeli i-hypoglycemia, ngoba ayivusi ukugcinwa kwe-insulin. Isenzo se-metformin kungenzeka sisekelwe kuzindlela ezilandelayo:

• ukucindezelwa kokukhiqiza ushukela ngokweqile esibindini ngokucindezela i-gluconeogeneis ne-glycogenolysis, okungukuthi, i-siofor kuvimbela ukwakheka kwe-glucose kusuka kuma-amino acid nakwezinye "izinto zokusetshenziswa", futhi kuvimbela nokukhipha kwayo ezitolo ze-glycogen;
• ukwenza ngcono ukuthathwa kwe-glucose kumaseli wethambo nokusetshenziswa kwayo lapho ngokunciphisa ukumelana kwe-insulin kwamangqamuzana, okungukuthi, izicubu zomzimba ziba nezwela kakhulu esenzweni se-insulin, futhi ngenxa yalokho amaseli “angangenisa” ushukela ngokwawo ngaphakathi kuwo;
• kwehlisa ukufakwa kweglue emathunjini.

Kungakhathalekile ukuthi kuthini umthelela wokuxhuma kwe-glucose egazini, i-siofor kanye ne-metformin yayo esebenzayo yezinto kuthuthukisa i-lipid metabolism, kunciphisa okuqukethwe kwe-triglycerides egazini, kukhuphula okuqukethwe kwe-cholesterol "enhle" (high density) futhi kwehlise ukuqina kwe-cholesterol ephansi "embi".

I-metformin molecule ifakwa kalula kwi-lipid bilayer yolwelwesi lweseli. ISiofor ithinta ulwelwesi lweseli, kufaka phakathi:

• ukucindezelwa kweketeni lokuphefumula le-mitochondrial;
• umsebenzi owengeziwe we-tyrosine kinase we-insulin receptor;
• ukugqugquzela kokudluliselwa kwe-glucose transporter i-GLUT-4 kulwelwesi lweplasma;
• kusebenze kwe-activation ye-protein ye-AMP eyenziwe isebenze.

Ukusebenza komzimba we-membrane yeseli kuncike emandleni wezinto zamaprotheni zokuhamba ngokukhululeka ku-lipid bilayer. Ukunyuka kokuqina kwe-membrane kuyisici esijwayelekile sesifo sikashukela, esibangela izinkinga zesifo.

Ucwaningo luye lwabonisa ukuthi i-metformin inyusa ukugeleza kolwelwesi lwama-plasma amangqamuzana abantu. Okubaluleke kakhulu umphumela womuthi kulwelwesi lwe-mitochondrial.

I-Siofor ne-Glucofage yandisa ukuzwela kwe-insulin ikakhulukazi kwamaseli wamathambo wamathambo, futhi ngezinga elincane - izicubu ze-adipose. Imiyalelo esemthethweni ithi umuthi unciphisa ukumuncwa kwe-glucose emathunjini ngo-12%. Izigidi zeziguli ziye zaqiniseka ukuthi lesi sidakamizwa sinciphisa isifiso sokudla. Ngokuphikisana nesizinda sokuphuza amaphilisi, igazi liba hhayi obukhulu kangako, kungenzeka ukwakheka kwezigaxa zegazi eziyingozi kuyehla.

I-Glucophage noma i-siofor: okufanele ukhethe?

I-Glucophage ende iyindlela entsha yemithamo ye-metformin. Ihluka nge-siofor ngoba inomphumela owohlala isikhathi eside. Umuthi ovela kwithebhulethi awunakwa ngokushesha, kodwa kancane kancane. Kwi-Siofor ejwayelekile, ama-90% e-metformin akhishwa kwithebhulethi kungakapheli imizuzu engama-30, naku-glucophage isikhathi eside - kancane kancane, ngaphezulu kwamahora ayi-10.

IGlucophage ifana ne-siophore, kepha yesenzo eside. Imiphumela emincane engaphansi futhi kulula kakhulu ukuyithatha, kepha kubiza okuningi.

Uma isiguli singathathi i-siofor, kepha sibe ne-glucophage isikhathi eside, khona-ke ukufinyelela inani eliphakeme le-metformin ku-plasma yegazi kuhamba kancane.

Izinzuzo ze-glucophage isikhathi eside kune-siofor evamile

• kwanele ukuyithatha kanye ngosuku;
• imiphumela emibi evela emapheshana emathunjini ngomthamo ofanayo we-metformin ikhula kaningi izikhathi ezi-2;
• ilawula kangcono ushukela wegazi ebusuku nasekuseni ngesisu esingenalutho;
• Umphumela wehlise amazinga kashukela egazi awubi mkhulu kunalesioror “evamile”.

Yini okufanele uyikhethe - i-siofor noma i-glucophage ende? Impendulo: uma ungabekezeleli i-siofor ngenxa yokuqhakaza, ukuthopha noma uhudo, zama i-glucophage. Uma konke kuhamba kahle nge-Siofor, qhubeka nokuthatha, ngoba amaphilisi amade we-glucophage abiza kakhulu. Unyango lokwelapha isifo sikashukela uDkt Bernstein ukholelwa ukuthi i-glucophage isebenza kakhulu kunamaphilisi okushesha e-metformin. Kepha amakhulukhulu ezinkulungwane zeziguli ayeqiniseka ukuthi i-siofor evamile isebenza ngamandla. Ngakho-ke, ukukhokha okungeziwe kwe-glucophage kunengqondo, kuphela ukuze kunciphise ukugaya okucasulayo.

Imithamo yamathebulethi eSiofor

Umthamo womuthi ubekwa isikhathi ngasinye ngawodwana, kuye ngezinga le-glucose esegazini nokuthi isiguli sikubekezelela kanjani ukwelashwa. Iziguli eziningi ziyayeka ukwelashwa kweSiofor ngenxa yokugcwala, isisu, nobuhlungu besisu. Imvamisa, le miphumela emibi ibangelwa ukukhethwa komthamo okungafanele.

Indlela engcono yokuthatha iSiofor ukukhuphuka komthamo kancane kancane. Udinga ukuqala ngomthamo ophansi - kungabi ngaphezu kwe-0.5-1 g ngosuku. Lawa amaphilisi angu-1-2 omuthi ka-500 mg noma ngethebhulethi elilodwa likaSiofor 850. Uma kungekho miphumela emibi evela emgodini we-gastrointestinal, khona-ke ngemuva kwezinsuku ezingama-4-7 ungakhulisa umthamo usuka ku-500 uye ku-1000 mg noma usuka ku-850 mg uye ku-1700 mg ngosuku, i.e. ngethebhulethi elilodwa ngosuku kuya kwababili.

Uma kulesi sigaba kunemiphumela emibi evela emgudwini wesisu, khona-ke kufanele "ulibuyisele" leli phutha liye kwelaphambilini, bese uphinde uzame ukuyikhulisa. Ukusuka kwimiyalo yeSiofor, ungathola ukuthi umthamo wayo osebenzayo ngu-2 mg ngosuku, 1000 mg ngamunye. Kepha kaningi kwanele ukuthatha izikhathi ezingama-850 mg kabili ngosuku. Ezigulini zomzimba omkhulu, umthamo ofanele ungaba ngu-2500 mg / ngosuku.

Umthamo omkhulu wansuku zonke weSiofor 500 yi-3 g (amaphilisi ayi-6), iSiofor 850 ingu-2.55 g (amaphilisi ama-3). Umthamo omaphakathi nsuku zonke weSiofor® 1000 ngu-2 g (amaphilisi ama-2). Umthamo omkhulu wansuku zonke yi-3 g (amaphilisi ama-3).

Amathebhulethi e-Metformin kunoma imuphi umthamo kufanele aphuzwe ngokudla, ngaphandle kokuhlafuna, ngenani elilinganayo loketshezi. Uma umthamo wansuku zonke obekiwe ungaphezu kwethebhulethi eli-1, lihlukanise kube yimithamo engu-2-3. Uma uphuthelwe ukuphuza iphilisi, khona-ke akufanele unxephezele lokhu ngokuthatha amaphilisi amaningi kanye ngokuzayo.

Isikhathi esingakanani sokuthatha uSiofor - lokhu kunqunywa ngudokotela.

Ukweqisa

Nge-overdose ye-Siofor, i-lactate acidosis ingakhula. Izimpawu zayo: ubuthakathaka obukhulu, ukwehluleka ukuphefumula, ukozela, isicanucanu, ukuhlanza, isifo sohudo, ubuhlungu besisu, ukuqina okubandayo, ukwehla kwengcindezi yegazi, i-Reflex bradyarrhythmia.

Kungenzeka kube nezikhalazo zesineke zobuhlungu bemisipha, ukudideka nokulahlekelwa ukwazi, ukuphefumula ngokushesha. Ukwelashwa kwe-lactic acidosis kuwuphawu. Le yingxaki eyingozi engaholela ekufeni. Kodwa uma ungeqi umthamo futhi ngezinso zakho konke kuhamba kahle, kungenzeka ukuthi kungenzeka ukuthi zero.

Ukusebenzelana kwezidakamizwa

Lesi sidakamizwa sinempahla eyingqayizivele. Leli yithuba lokuyihlanganisa nezinye izindlela zokunciphisa ukugcwala kweglucose egazini. I-Siofor ingabekwa ngokuhlangana nanoma yiluphi olunye uhlobo lwe-2 yesifo sikashukela noma i-insulin.

I-Siofor ingasetjenziswa ihlangana nemithi elandelayo:

• onobhala (ama-sulfonylurea derivatives, meglitinides);
• ama-thiazolinediones (glitazones);
• izidakamizwa ze-incretin (i-analogues / agonists ze-GLP-1, inhibitors of DPP-4);
• izidakamizwa ezinciphisa ukumuncwa kwama-carbohydrate (acarbose);
• i-insulin kanye ne-analogues yayo.

Kunamaqembu ezidakamizwa angakhulisa umphumela we-metformin ekwehliseni ushukela wegazi, uma usetshenziswa ngasikhathi sinye. Lokhu kuthathwe kwe-sulfonylurea, acarbose, insulin, NSAIDs, ama-inhibitors we-MAO, ama-oxetetracycline, ama-inhibitors e-ACE, okuphuma ku-clofibrate, i-cyclophosphamide, i-beta-blockers.

Imiyalo kaSiofor ithi amanye amaqembu ezinye izidakamizwa angawenza buthaka umthelela wazo ekwehliseni ushukela wegazi uma izidakamizwa zisetshenziswa kanyekanye. Lezi ngama-GCS, izindlela zokuvimbela inzalo ngomlomo, i-epinephrine, i-sympathomimetics, i-glucagon, ama-hormone e-thyroid, ama-phenothiazine avela kokunye okuvela ku-nicotinic acid.

Ama-Siofor angawenza buthaka umphumela we-anticoagulants engaqondile. I-Cimetidine ibambezela ukuqedwa kwe-metformin, okwandisa ubungozi be-lactic acidosis.

Ungabuphuzi utshwala ngenkathi uthatha iSiofor! Ngokusetshenziswa kanyekanye ne-ethanol (utshwala), ubungozi bokuthola inkinga eliyingozi - i-lactic acidosis iyanda.

I-Furosemide inyusa izinga lokuqina le-metformin ku-plasma yegazi. Kulokhu, i-metformin inciphisa inani eliphezulu kakhulu le-furosemide ku-plasma yegazi kanye nengxenye yokuphila kwayo.

I-Nifedipine inyusa ukumunca namandla amaningi we-metformin ku-plasma yegazi, ibambezela ukuphuma kwayo.

Izidakamizwa zeCationic (amiloride, digoxin, morphine, procainamide, quinidine, i-quinine, i-ranitidine, i-triamteren, i-vancomycin), ezigcotshwe kuma-tubules, zincintisana nezinhlelo zokuhambisa amashubhu. Ngakho-ke, ngokwelashwa okuhlala isikhathi eside, bangandisa ukwanda kwe-metformin ku-plasma yegazi.

Esihlokweni, sixoxe kabanzi ngezihloko ezilandelayo:

• I-Siofor yokunciphisa umzimba;
• Izibhebhe zeMetformin zokuvimbela kanye nokwelashwa kwesifo sikashukela sohlobo 2;
• Kulezo zimo lapho kufanelekile ukuthatha lo muthi ngesifo sikashukela sohlobo 1;
• Ungayikhetha kanjani imithamo ukuze kungabikho okugayisayo kuphakama.

Ngokwesifo sikashukela sohlobo 2, ungazikhawuleli ekuthatheni iSiofor namanye amaphilisi, kepha landela uhlelo lwethu lwesifo sikashukela sohlobo 2. Ukufa ngokushesha ngenxa yokuhlaselwa yisifo senhliziyo noma unhlangothi kuyingxenye yezinkinga. Futhi ukuba umuntu okhubazekile embhedeni ngenxa yezinkinga zesifo sikashukela kuyethusa ngempela. Funda kithi ukuthi ungasilawula kanjani isifo sikashukela ngaphandle kokudla “okulambile”, imfundo yezomzimba eqeda kanye namacala angama-90-95% ngaphandle kwemijovo ye-insulin.

Uma unemibuzo mayelana nomuthi uSiofor (Glucofage), ungawabuza kumazwana, abaphathi besayithi baphendula ngokushesha.