Imithi yokwelapha isifo sikashukela sohlobo 2 ingafaka i-monotherapy ngomuthi owodwa noma umuthi oyinkimbinkimbi.
I-Yanumet, njenge-ejenti ye-antidiabetesic, umuthi onezithako ezimbili ezisebenzayo, ngakho-ke ukuthatha ithebhulethi eyodwa kungasusa isidingo sokusebenzisa izidakamizwa eziningana.
Kuze kube manje, imithi ehlangene ekhemisi eRussia inezindleko eziphakeme impela. Kepha, ngokusho kochwepheshe bezokwelapha, ukusebenza kwabo kuvumela intengo enjalo.
Yini i-ejenti ye-hypoglycemic?
I-Yanumet yezidakamizwa ifakiwe eqenjini lezidakamizwa elinomphumela we-hypoglycemic. Kungakho, kuvame ukubekelwa ifomu elizimele lesifo sikashukela.
Ukusebenza kwayo kuqiniswa izithako eziningana ezisebenzayo eziyingxenye yemithi.
Izwe okuvela kulo iYanumet yi-United States of America, echaza izindleko eziphakeme zomuthi (kuze kufike kuma-ruble ayizinkulungwane ezintathu, kuya ngomthamo).
Kusetshenziswa amaphilisi weJanumet ezimweni ezilandelayo:
- ukwehlisa amazinga eglucose egazini, ikakhulukazi uma ukudla ngokweqile kanye nokuzivocavoca okulinganiselayo kubonise umphumela ongemuhle;
- uma i-monotherapy isebenzisa isithako esisodwa kuphela esisebenzayo esingalethi umphumela oyifunayo;
- Ingasetshenziswa njengendlela eyinkimbinkimbi yokwelapha ngokuhlangana kwe-sulfrnylurea, i-insulin therapy noma ngabaphikisi bePPAR-gamma.
Umuthi ukwakheka kwawo okungenani izingxenye ezimbili ezisebenzayo ezinomphumela we-hypoglycemic:
- I-Sitaglipin imele iqembu le-enhibme inhibitor ye-DPP-4, okuthi, ngokukhuphuka kashukela wegazi, kuvuse ukuvela nokuqashelwa kwe-insulin ngamaseli we-pancreatic beta. Njengomphumela wale nqubo, kukhona ukwehla kokuvela koshukela esibindini.
- I-Metformin hydrochloride imele iqembu lesizukulwane sesithathu, elinomthelela ekuvinjelweni kwe-gluconeogeneis. Ukusetshenziswa kwezidakamizwa okusekwe kuzo kuvuselela i-glycolysis, okuholela ekuphuculeni kangcono ushukela ngamangqamuzana nezicubu zomzimba. Ngaphezu kwalokho kunokwehla kokufakwa kweglue amaseli wamathumbu. Inzuzo enkulu ye-metformin ukuthi akubangeli ukwehla okukhulu kwamazinga kashukela (ngaphansi kwamazinga ajwayelekile) futhi akuholeli ekuthuthukisweni kwe-hypoglycemia.
Umthamo wesidakamizwa ungahlukahluka kusuka kumamayela wamakhulu amahlanu kuya kwenkulungwane wenye yezinto ezisebenzayo - metformin hydrochloride. Kungakho, ikhemisi lwanamuhla linikeza iziguli izinhlobo ezilandelayo zamathebulethi:
- UJanumet 50/50.
- Janumet 50/850.
- Janumet 50/1000.
Isibalo sokuqala ekwakhiweni kwemithi sikhombisa inani le-sitaglipin esebenzayo, elesibili libonisa amandla e-metformin. Njengoba kusetshenziswa izinto ezisizayo:
- I-Microcrystalline cellulose.
- IPovidone.
- I-Sodium stearyl fumarate.
- I-sodium lauryl sulfate.
- I-Polyvinyl alcohol, i-titanium dioxide, i-macrogol, i-talc, i-iron oxide (igobolondo lokulungiselela kwethebhulethi liqukethe).
Ngenxa yethuluzi lezokwelapha iYanumet (i-Yanomed), kungenzeka ukufezekisa ukuvimbela i-glucagon ngokweqile, okuthi, ngokunyuka kwamazinga e-insulin, kuholele ekujwayelweni kwe-glucose egazini.
Imiyalo yokusebenzisa amaphilisi
Udokotela ohamba yedwa oqapha inqubo yenqubo ye-pathological kuphela onquma ukwelashwa nendlela yokuphuza umuthi ezigulini.
Njengomthetho, amalungiselelo weYanumet kufanele athathwe kabili ngosuku ngesikhathi sokudla (ekuseni nakusihlwa), aphuze amanzi amaningi.
Imiyalo esetshenzisiwe izokhombisa ukuthi ukwelashwa kokuqalisa ngu-500 mg metformin hydrochloride no-50 mg sitaglipin kabili ngosuku (ithebhulethi elilodwa elinomthamo omncane).
Ukwelashwa okwengeziwe kungadinga ukulungiswa ngethamo eliphindwe kabili le-metformin.
Uma ngaphambili isiguli sathatha inkambo yokwelapha sisebenzisa imishanguzo esekwe metformin kuphela, futhi ukwelashwa okunjalo akuzange kulethe umphumela odingekile, ukusetshenziswa kwalesi sidakamizwa kuzoba ngale ndlela elandelayo:
- umthamo we-metformin hydrochloride osebenza ngaphambi kokwelashwa
- ukudla nsuku zonke kwe-sitaglipin kufanele okungenani kube yi-100 mgꓼ
- isibalo samaphilisi ngosuku sibili.
Isigaba seziguli esake sasebenzisa ukwelashwa okusekelwe kwizidakamizwa ezine-sitaglipin kuphela kufanele sithole ukwelashwa okusha ngokuya ngohlelo olulandelayo:
- Kabili ngosuku, umuthi uthathwa ngesilinganiso sama-50 mg we-sitaglipin no-500 mg we-metformin hydrochloride.
- Kamuva, kungenzeka ukwandisa imithamo eyingxenye yepilisi eyodwa kaJanumet 1000.
Uma kusetshenziswa indlela yokwelapha eyinkimbinkimbi yokwelapha nge-sulfonylurea, lezi zinto ezilandelayo zizonquma uhlobo lomuthi:
- umthamo we-metformin hydrochloride unqunywa ngokuya ngezinga lokuthuthuka kwe-pathology esiguliniꓼ
- ukudla nsuku zonke kwe-sitaglipin kungu-100 mg, kuhlukaniswe kabili
- inani lento esetshenziswayo ye-sulfonylurea derivatives inqunywa ngudokotela ohambisanayo ngokususelwa esithombeni somtholampilo wesiguli.
Noma yiziphi izindlela zokwelashwa kufanele zingafaki ukusetshenziswa kotshwala, ngoba utshwala buhlukaniswa ngokwezigaba. Ukuvumelana nezinye izidakamizwa kufanele kuvunyelwane nabachwepheshe bezokwelapha.
Uma kwenzeka kuba ne-overdose, i-lactic acidosis ingahle ikhule.
Ukuyiqeda, iziguli zilaliswa esibhedlela futhi zenza lezi zinhlobo ezilandelayo zokwelashwa - ukwelashwa okusobala, i-hemodialysis.
Kukuziphi izimo lapho kwenqatshelwe ukusebenzisa i-hypoglycemic agent?
Ngaphambi kokuqala ukwelashwa okwelashwa, kufanele ufunde ngokucophelela inani le-contraindication eboniswe emiyalweni esemthethweni.
Ngaphezu kwalokho, kubalulekile ukubonisana nodokotela wakho ngokusetshenziswa kwomuthi.
Njengemithi eminingi, iYanumet ayikwazi ukusetshenziswa ezimweni ezithile.
Okokuqala, kuyenqatshelwa ukuthatha amalungiselelo wethebhulethi uma kunezimpawu ezinjalo:
- Kunezinga elithile lokuzwela esigulini kuya kwengxenye eyodwa noma eziningi zomuthi.
- Izinkinga ngokusebenza okujwayelekile kwezinso, kanye nokuvela kwezimo ezingathinta ukuwohloka kwaso. Lokhu kufaka phakathi ukomisa, inkambo yama-pathologies ashubile wokutheleleka kanye nesimo sokushaqeka.
- Izimo ezingase zibangele i-izicubu hypoxia.
- Isifo sesibindi esibucayi noma ukungapheleli kwayo.
- Ngesikhathi ubuthi ubuthi.
- I-acute noma i-metabolic acidosis engalapheki.
- Isifo sikashukela sikashukela.
- Uhlobo oluncike ku-insulin lwenqubo ye-pathological.
Ngaphandle kokuthi namhlanje akukho lwazi mayelana nocwaningo lwezokwelapha mayelana nemiphumela yomuthi esibelethweni, kwenqatshelwe ukwelashwa ngalo ngokusebenzisa kwalo ngesikhathi sokuzala kwengane noma ngokuncelisa ibele.
Kufanele kuqashelwe ukuthi ngesikhathi sokuthula kwesiguli akukho bungozi be-hypoglycemia. Uma indlela yokuphila yomuntu ishintsha, ukuzikhandla okukhulu ngokomzimba, ukukhathala ngokweqile noma komzwelo, ukuguqulwa kokudla (kuze kufike isiteleka sendlala), izinga likashukela wegazi lingokwehla liye kumazinga abucayi.
Ngaphambi kokuqala ukwelashwa okuyinkimbinkimbi, izivivinyo zokuhlonza nokuhlaziya ezidingekayo kufanele zenziwe ukugwema imiphumela emibi nokubonakaliswa kokuthatha umuthi.
Imiphumela emibi nemiphumela emibi
Inhlala-kahle yesiguli kanye nengozi yokubonakaliswa kokungaphenduki kahle kwezitho zangaphakathi nezinhlelo kuncike ngqo kunembe lokuphuza umuthi kanye nokusebenzisana kwalo nezinye izidakamizwa.
Imiphumela emibi ngokuvamile yenzeka lapho isiguli sephula izincomo zezokwelashwa eziphathelene nokuphuza umuthi.
Ukuphendula okungalungile kungenzeka ngenxa yokwephulwa kwemithetho yokuphuza umuthi ohlanganisiwe.
Imiphumela emibi eyinhloko yile:
- ukuvela kwezinkinga ezahlukahlukene ngepheshana lesisu, yilezi, izimpawu zokuqala ezinjengokucanuzelelwa kwenhliziyo nokuhlanza, isifo sohudo, ukuqhakaza nobumnene besisu,
- ukubonakaliswa kokuphazamiseka kwe-dyspeptic,
- umuthi ukhulisa ubungozi be-anorexia,
- ukuguqulwa kwemizwa yokunambitha kungenzeka, okubonakaliswa lapho kuvela imidwebo yensimbi engathandeki emgodini womlomo,
- ukwehla kwenani lamavithamini B, okuphoqa ukuthi ngaphezu kwalokho uthathe izidakamizwa ngezithasiselo zemithi,
- ukonakala kwesimo esijwayelekile kanye nokubonakala komzwa wokukhathala okungapheli,
- kwehlisa umfutho wegazi
- ukuphazamiseka kwesigqi senhliziyo,
- ukubonakaliswa kwe-anemia,
- nge-overdose ebalulekile, kungahle kube nengozi ye-hypoglycemia.
Ngaphezu kwalokho, izinkinga ngesikhumba kungenzeka uma kuvela ukubonakala kokungahambi kahle komuthi ophuzwayo.
Ukubuyekezwa okuvela kubathengi nabachwepheshe bezokwelapha?
Mayelana nokuhlolwa kwezidakamizwa kukaJanumet kwehluka ngandlela thile ezigulini eziningi.
Isigaba esisodwa sabanesifo sikashukela sikhononda ngokuboniswa kokungafani kahle okuvelile okuvela ngenxa yokuphuza umuthi.
Abanye bakhombisa ukubekezela okuhle nomuthi, okukhombise izinga elanele lokusebenza kwawo.
Ngokuvamile, kungaphikiswa ukuthi umuthi uwenza ngempela umsebenzi wokusebenza kuwo - wehlisa izinga le-glucose egazini futhi wehlise ukubonakaliswa kokumelana ne-insulin. Izakhiwo ezinjalo ezinhle zikhonjiswa ngenxa yezakhi zalo ezimbili eziyinhloko.
Intengo yezidakamizwa iJanumet iphakeme impela, okungenye yezinto ezimbi zalo mkhiqizo wezokwelapha. Lokhu kubiza kwezokwelapha kungenxa yezici ezimbili ezinkulu:
- ukwakhiwa kokulungiswa kwethebhulethi,
- ukukhiqizwa yinkampani yaphesheya.
Ochwepheshe bezokwelapha baveza umbono omuhle ngokusebenza komuthi, bethi ukuhambisana nazo zonke izincomo ngaphandle kokuhluleka kuholela emiphumeleni emihle. Kulokhu, kuyadingeka ukuthatha ngokucophelela umuthi kubantu abanezifo zesibindi nezinso, kanye nasekugugeni.
Kumele kukhunjulwe ukuthi noma yiziphi izidakamizwa ze-hypoglycemic kufanele zithathwe kuphela ngokuyalelwa udokotela oholayo nangaphansi kokuholwa kwakhe okuqinile.
Yimiphi imishanguzo engingayifaka esikhundleni somuthi?
Izindleko eziphakeme zomuthi zikwenza ucabange ngokuthola imishanguzo efanayo engabizi kakhulu. Kufanele kuqashelwe ukuthi namuhla ama-analogue anamuhla e-Yanumet emakethe yamakhemikhali amelwe kuphela ithuluzi lezokwelapha iVelmetia. Kufanele kuqashelwe ukuthi izindleko ze-analog ezinjalo ziphakeme kaningana kunaleyo yaseYanumet. Ngaphezu kwalokho, isidakamizwa esinjalo kwesinye isikhathi asitholakali emakhemisi asedolobheni futhi singathunyelwa kuphela ngesicelo.
Ezinye izikhala zinomphumela ofanayo, kepha ziyehluka ezingxenyeni eziphambili zomuthi. Kunezidakamizwa ezimbalwa ezinomphumela ofanayo futhi ezihambelana nekhodi le-Yanumet ATC.
I-Glibomet umuthi we-hypoglycemic oqukethe izinto eziyisisekelo ezinjenge-metformin hydrochloride ne-glibenclamide. Umuthi futhi unomphumela ophansi we-lipid.
I-Douglimax yisidakamizwa esiyingxenye yeqembu lezidakamizwa ezinciphisa ushukela. Inezinto ezimbili ezisebenzayo ekwakhiweni kwayo - i-metformin hydrochloride ne-glimepiride.
I-Tripride yisidakamizwa esihlanganisa ithebhulethi esuselwa ku-metformin ne-pioglitazone. Inezinkomba ezifanayo zokwelashwa kuJanumet.
I-Avandamet nayo isetshenziselwa ukwenza amazinga e-glucose abe ngokwejwayelekile. Umphumela we-hypoglycemic utholakala ngenxa yokusebenzisana kwezinto ezinjenge-metformin hydrochloride ne-rosiglitazone.
Ochwepheshe kule vidiyo ekulesi sihloko bazonikeza ngemininingwane ngezidakamizwa ezisebenza ngempumelelo kakhulu ezinciphisa ushukela.
