I-Gliformin isidakamizwa se-hypoglycemic sokusetshenziswa komlomo, ingeqembu le-Biguanides. Umuthi uvimbela i-glycogenesis esibindini, wehlise ukumuncwa, ukhulisa ukuzwela kwezicubu kwi-insulin ye-hormone, futhi kuthuthukisa ukusetshenziswa koshukela.
Ngaso leso sikhathi, umuthi awukwazi ukuthonya ukukhiqizwa kwe-insulin, wehlisa inani lama-triglycerides, ama-lipoproteins aphansi kwabantu, futhi ujwayele izinkomba zesisindo. Ngaphezu kwalokho, ngenxa yokuvinjelwa kwe-plasminogen inhibitor ngohlobo lwezicubu, umphumela we-fibrinolytic uyenzeka.
Ngephakeji elilodwa lomuthi ekuhlanganisweni kwefilimu, isiguli kufanele sinikeze ama-ruble angama-300, amaphilisi weGliformin anezici ezihlukanisayo ezibiza cishe ama-ruble ayi-150. Ukubuyekezwa mayelana nomuthi muhle kakhulu, kuyaqabukela kunikeze ukusabela okungathandeki emzimbeni.
Isenzo se-Pharmacological
Umuthi ungathengwa ngemithamo ehlukene: 250, 500, 850 no-1000 mg. Isithako esisebenzayo somuthi yi-metformin. Ukusebenza kahle kokwelashwa kutholakala lapho onesifo sikashukela eqhubeka nokukhiqiza i-insulin yakhe uqobo noma le ihomoni ihanjiswa ngokungeziwe.
Abahambeli:
- i-sorbitol;
- isitashi samazambane;
- i-acid entshontsha;
- i-povidone.
Umuthi udonswa ngokushesha ngamaseli wezitho zomgudu wamathumbu, ukuqina kwawo okuphezulu kubuye kuqashelwe amahora amabili ngemuva kokuthatha amaphilisi. I-bioavailability ye-metformin hydrochloride izoba cishe ngama-50-60%, into leyo ayihlangani ne-protein. Kuvela emzimbeni, isidakamizwa sikhishwa ngendlela yaso yoqobo.
Onesifo sikashukela, uGliformin uthathwa ngomlomo kuphela. Kufanele wazi ukuthi indlela esebenza ngayo ayikafundwa ngokuphelele. Ngemuva kokungena ungene egazini, into esebenzayo yesidakamizwa ihlanganyela kulezo zinqubo:
- ukushesha kokuwohloka kwama-carbohydrate;
- ukuncishiswa kwenani le-glucose evela emathunjini;
- ukucindezelwa kokukhiqizwa kwama-molecule we-glucose esibindini.
Ukusetshenziswa kwezidakamizwa zesifo sikashukela kanye nezigaba ezahlukahlukene zokukhuluphala kubangela ukwehla kwesisindo somzimba kanye nesifiso sokudla. Imiyalo yokusebenzisa umuthi ithi isithako esisebenzayo se-metformin yezidakamizwa sisiza ukuqeda ukuhlukaniswa kwegazi, kuvimbela ukunamathela kweplatelet.
Imiyalo yokusebenzisa amaphilisi
Izinkomba zokusetshenziswa kwalesi sidakamizwa ziwuhlobo lwe-2 mellitus yesifo sikashukela, lapho izidakamizwa eziqinile zokudla nezidakamizwa ze-sulfonylurea zingenawo umphumela oyifunayo. IGlyformin nayo ibekelwa uhlobo 1 lwesifo sikashukela njengesijobelelo semijovo ye-insulin.
Ngesikhathi sokulashwa, ukusebenza kwezinso kufanele kugadwe, okungenani njalo ezinyangeni ezi-6 kunconyelwa ukuthatha ukucubungula ukuthola i-lactate ku-plasma yegazi.
Amathebulethi angadakwa ngesikhathi sokudla noma emva kokudla, umthamo ngqo kufanele unqunywe ngudokotela ohambelayo, kucatshangelwa imiphumela yokuhlolwa kweshukela egazini:
- ekuqaleni kwezokwelapha, umthamo awudluli ku-1 gram ngosuku;
- ngemuva kwezinsuku eziyi-15, inani lezimali lenyuswa.
Umthamo wokulungisa ojwayelekile akufanele udlule ama-2 amagremu ngosuku, kufanele usatshalaliswe ngokulingana ngaphezulu kwemithamo eminingana. Abantu abanesifo sikashukela sobudala obuphambili ngosuku banconywa ukuba bathathe isilinganiso esingu-1 gramu somuthi.
Uma udokotela enquma uGliformin ngesifo sikashukela, isiguli kufanele sazi ukuthi amaphilisi angadala ukusabela okuningana komzimba. Engxenyeni yesistimu ye-endocrine, i-hypoglycemia iyakhula, engxenyeni ye-anemia yokujikeleza kwegazi kungenzeka, engxenyeni yokuntuleka kwevithamini yokudla emzimbeni. Umzimba kwesinye isikhathi ubhekana nezidakamizwa ezinemiphumela engezwani nomzimba:
- i-urticaria;
- isikhumba esikhanyayo;
- imishayo.
Ezithobeni zepheshana lesisu kukhona ukwephulwa kokudla, isisu, ukugabha, ukunambitheka kwensimbi emlonyeni.
Uma kwenzeka kuvela ukuthi kukhona okungahambi kahle, kukhonjiswa ukwenqaba ukwelashwa no-Gliformin, thintana nodokotela.
Umuthi i-Glyformin (imiyalo yayo itholakala ngokukhululekile ku-Inthanethi) ungasetshenziselwa ukwehluleka okulingana kwezinso, kepha kuphela lapho kungekho khona ukwanda kwe-lactic acidosis. Kulesi simo, umsebenzi wezinso uhlala ubhekelwe (okungenani kanye ezinyangeni ezingama-3-6), lapho imvume ye-creatinine incipha ibe ngu-45 ml / min, ukwelashwa kumiswa masinyane.
Uma umsebenzi wezinso uncishiswa kwisifo sikashukela esithuthukile, umthamo we-metformin udinga ukulungiswa.
Contraindication, ukusebenzisana kwezidakamizwa
IGlatiniin akumele inikezwe i-ketoacidosis, izifo zesibindi ezingapheli, ikhefu likashukela, inhliziyo, ukwehluleka kwamaphaphu, ngesikhathi sokukhulelwa, ukuncelisa, ukufakwa kwe-myocardial, ukuzwela ngokweqile ezingxenyeni zomuthi.
Thatha ngokucophelela ikhambi lezifo zezifo ze-etiology ethelelekayo, ngaphambi kokuhlinzwa okukhulu.
Ukusebenza komuthi kungancipha ngokuphathwa okufana:
- izidakamizwa ze-glucocorticosteroid;
- ama-hormone egilo;
- okokugcobisa;
- i-nicotinic acid;
- lapho uthatha izindlela zokuvimbela inzalo ngomlomo.
Uma i-metformin isetshenziswa ndawonye ne-insulin, i-sulfonylurea derivatives, izidakamizwa ezingezona ze-steroidal anti-inflammatory, kanye ne-beta-blockers, kungenzeka ukuthi kube nokwanda komphumela wayo.
Ukwanda kwesikhathi
Kwezinye izimo, isiguli esinesifo sikashukela sikhonjiswa isikhathi eside i-Gliformin - Isikhathi eside seGliformin. Kuyaphuzwa ngomlomo, kugezwe ngenani elanele lamanzi. Ithuluzi lingasiza lodwa noma libe yingxenye yokwelashwa okuhlanganisa.
Uma umuntu onesifo sikashukela engakaze ayithathe i-metformin phambilini, kunconywa umthamo wokuqala we-750 mg kanye ngosuku. Ngemuva kwamaviki ama-2, udokotela uzolungisa umthamo (thatha amaphilisi ama-2 we-750 mg), ngokususelwa emiphumeleni yokuhlolwa ushukela. Ngokukhuphuka kancane kwenani lomuthi, kukhona ukwehla kokungaphenduki okungekuhle kusuka ohlelweni lokugaya ukudla, ikakhulukazi, isifo sohudo siphela.
Lapho umthamo onconyiwe ungavumeli ukufeza ukulawulwa okujwayelekile kwe-glycemia, kuyadingeka ukuthatha umthamo ophelele - amaphilisi ama-3 ama-750 mg Prolong kanye ngosuku.
Abanesifo sikashukela abathatha i-metformin ngesimo somenzeli wokukhululwa ojwayelekile:
- baphuze Ukuqhubeka kumthamo olinganayo;
- uma bethatha ngaphezu kwe-2000 mg, ukuguqulelwa kunguquko yesidakamizwa okuhlala isikhathi eside akunqunyelwe.
Ukufeza ukulawulwa okuphezulu kwe-glycemic, i-metformin ne-hormone insulin zisetshenziswa njengendlela yokwelapha ehlanganayo. Okokuqala, thatha umthamo ojwayelekile wemithi (i-1 ithebhulethi engu-750 mg) ngesikhathi sokudla, kanye nenani le-insulin kufanele likhethwe ngokwahlukana, ngokusekelwe kushukela wegazi.
Ubukhulu ngosuku, kuvunyelwe ukungathathi ngaphezu kwama-2250 mg wesidakamizwa, ukubukeza kodokotela kukhombisa ukuthi, uma nje isimo sesimo somzimba silawulwa ngendlela efanele, kungenzeka ukuthi ushintshe ekuthatheni umuthi ngokukhipha okwejwayelekile kwe-metformin kumthamo we-3000 mg.
Kwenzeka ukuthi isiguli siphuthele ukuphuza umuthi, kulapho kukhonjiswa khona ukuthi uphuza isibhebhe esilandelayo somuthi ngesikhathi esijwayelekile. Awukwazi ukuthatha umthamo ophindwe kabili we-metformin, lokhu kuzodala ukuthuthukiswa kwemiphumela emibi emibi, kwenze kube nzima kakhulu izimpawu zesifo sikashukela, okungafanele zivunyelwe.
I-Glyformin Prolong kumele ithathwe nsuku zonke, ukugwema ikhefu.
Isiguli kufanele sazise udokotela ohambayo ngokuqedwa kokwelashwa, athole umbono wakhe.
Analogs, ukubuyekezwa kodokotela
Ngenxa yobukhona be-contraindication, umuthi awulungele iziguli eziningi, kuleli cala kunesidingo sokukhetha i-analogues yomuthi, futhi aqukethe inani elihlukile lezinto ezisebenzayo (250, 500, 850, 1000). UGlatiniin angaba senkingeni yezidakamizwa:
- Glucoran;
- I-Metformin Teva;
- I-Diaberitis
Isifo sikashukela esesivele siphathe ukwelashwa kweGlatini sikhombisa amathuba amakhulu we-overdose. Ezimweni eziningi, lokhu kungenxa yokusebenzisa kabi umuthi.
I-overdose ingadala ukukhula kwesimo se-pathological njenge-lactic acidosis. Ukubonakaliswa kwayo okuyinhloko: Ubuhlungu bemisipha, ukugabha, isicanucanu, ukungazi kahle. Lapho kuvela izimpawu ezinjalo, kunconywa ukuthi uyeke ukuthatha umuthi.
Odokotela bathi umuthi i-Gliformin ubhekana kahle nesifo sikashukela, inqobo nje uma imithamo enconyiwe ibhekwa ngokuqinile. Okunye ukufaka umuthi inani lentengo elikhona nokutholakala kumakhemisi.
I-Endocrinologists ixwayisa ukuthi kuyo yonke inkambo yokwelashwa kuyadingeka ukuthatha izivivinyo ezihlelekile zamazinga we-serum creatinine. Umuthi i-Glyformin wesifo sikashukela akufanele uphathwe ndawonye:
- neziphuzo zotshwala;
- izidakamizwa eziqukethe i-ethanol.
Ngeshwa, isifo sikashukela sesiphenduke isifo esivamile, naphakathi kwabantu abasha. Ukuze uthole ukwelashwa, kuyadingeka ukuthi unikeze umuthi osiza ukuguqula izinga le-glycemia, enye yalezi zidakamizwa kwakunguGlyformin. Uma imiyalo yokusetshenziswa ilandelwa ngqo, umphumela womuthi wenzeka ngesikhathi esifushane.
Imininingwane ngezidakamizwa ezinciphisa ushukela inikezwe kuvidiyo kule ndatshana.
