Ngesifo sikashukela esingancike e-insulin, izidakamizwa ezinciphisa ushukela zivame ukusetshenziswa. IGlucophage ibhekwa njengezinye zezidakamizwa ezidumile, ngenxa yesenzo sayo esisebenzayo.
Isifo sikashukela i-mellitus, esiyisifo esijwayelekile, ekuqaleni kungenzeka singabonakali. Ngokuhamba kwesikhathi, izinga eliphakeme njalo le-glycemia liholela ekunqotshweni cishe kwazo zonke izitho zangaphakathi. Izinkinga eziyingozi kakhulu zesifo sikashukela yi-retinopathy, isifo sikashukela, i-nephropathy ne-neuropathy.
Ukuvimbela imiphumela enjalo engathandeki, kuyadingeka ukulandela yonke imithetho yokwelashwa, kufaka phakathi ukusetshenziswa njalo kwamatafula we-Glucofage.
Imininingwane ejwayelekile mayelana nomuthi
Lesi sidakamizwa siwumlomo futhi singokwesigaba sama-Biguanides, ngoba aqukethe isakhi esiyinhloko - i-metformin hydrochloride. Ikhiqizwa ngemithamo ehlukene, okungukuthi i-500, 850 noma i-1000 mg.
Umenzi uphinde akhiqize iGlucophage Long - ukulungiselela okufana kakhulu nokwakheka, okunomphumela omude. Kodwa-ke, kulesi sihloko sizokhuluma ngokukhethekile ngeGlucofage.
Ngaphezu kwento esebenzayo, ukwakhiwa komuthi we-antidiabetic kufaka phakathi izinto ezifana ne-magnesium stearate, povidone ne-opadra ehlanzekile.
Ngokuphathwa kwangaphakathi kweGlucofage, i-metformin ingena emgodini wesisu, igxiliswa ngokuphelele kuyo. Okuqukethwe okuphezulu kwengxenye esebenzayo kwenzeka ngemuva kwamahora amabili okuphathwa kwezidakamizwa. Ngenxa yesenzo somuthi, umuntu angakwazi ukuthola imiphumela elandelayo:
- Yehlisa ushukela wegazi kumanani ajwayelekile. Kulokhu, isimo se-hypoglycemic asibhekwa, ngoba umuthi awukuvimbi ukukhiqizwa kwe-insulin.
- Khulisa impendulo yezicubu kwi-hormone ekhiqizwayo.
- Yehlisa ukukhiqizwa kweglucose yesibindi ngokuvikela i-glycogenolysis ne-gluconeogeneis.
- Ukubambezela ukumuncwa kwamathumbu ushukela.
- Thuthukisa ukwakheka kwe-glycogen namandla okuhamba kwabathutha i-glucose.
- Qinisa futhi wehlise nesisindo somzimba wakho. Kulokhu, kunomkhuba wokuthatha lesi sidakamizwa ezigulini ezinempilo ezifuna ukunciphisa umzimba. Azinawo ukwehla kwamazinga kashukela ngaphansi kwamazinga ajwayelekile.
- Thuthukisa i-lipid metabolism kanye ne-cholesterol ephansi.
Into esebenzayo isatshalaliswa ngokulingene kuzo zonke izakhiwo zezicubu futhi ayibophele amaprotheni ku-plasma yegazi. Umuthi awumboziwe ngokuphelele, kepha ukhululiwe kanye nomchamo.
Njengoba usufundile ukuthi iGlucophage isebenza kanjani, ungaqokomisa izinkomba eziphambili zokuzisebenzisa. Lokhu kufaka phakathi isifo sikashukela esingancikeli i-insulin ngokungasebenzi kahle komsoco okhethekile kanye nokukhuluphala:
- ezinganeni nasentsheni engaphezu kweminyaka eyi-10 kuphela noma ngemijovo ye-insulin;
- kubantu abadala abanomthamo ohlukile noma ezinye izidakamizwa ze-antidiabetes.
Ku-prediabetes, lapho kunezizathu ezengeziwe zengozi yesifo sikashukela sohlobo 2, i-Glucofage nayo iyabekwa.
Imiyalo yokusebenzisa umuthi
I-Glucophage ene-Type 2 sikashukela isetshenziswa ngokucophelela ukuqaphela umthamo wayo nazo zonke izincomo zikadokotela ozoya. Lapho uthenga umuthi, kufanele uqiniseke ngokufaneleka kwawo futhi uzijwayeze ukufaka kwakho. Uma unemibuzo ehlobene nokusetshenziswa komuthi, ungabuza uchwepheshe.
I-abstract iqukethe imininingwane elandelayo ngokuthatha umuthi. Ekuqaleni kokwelashwa, baphuza kabili noma kathathu i-500-850 mg ngosuku ngesikhathi sokudla noma ngemuva kokudla. Kubaluleke kakhulu ukwahlukanisa ukubamba nsuku zonke izikhathi eziningana, ngoba izenzo ezinjalo zizokwenza buthaka umphumela omubi womuthi. Lokhu kusabela kuhlotshaniswa nomlutha womzimba emiphumeleni ye-metformin. Ngenxa yalokhu, abantu abanesifo sikashukela bavame kakhulu lapho bethatha i-Glucofage ikhononda ngokugaya, okuwukuthi isicanucanu, isifo sohudo, ukugabha, ukunambitheka kwensimbi emgodleni womlomo, Ubuhlungu besisu noma ukubumbeka. Ngokuhamba kwamasonto amabili, izimpawu ezinjalo ziyanyamalala, okukhombisa ukuthi kungenzeka ukuthi kungandiswa umthamo.
Umthamo wokulondolozwa ngu-1500-2000 mg ngosuku. Ubukhulu obuvunyelwe nsuku zonke ukuphuza umthamo we-Glucofage we-3000 mg.
Uma isiguli sidinga ukusuka kwezinye izidakamizwa zesifo sokulwa nokuthatha i-Glucofage, okokuqala kuzodingeka uyeke ukusebenzisa omunye umuthi.
Kwesinye isikhathi ama-endocrinologists ancoma ukusetshenziswa kwemijovo ye-insulin ne-Glucophage kuhlanganiswe nesifo sikashukela sohlobo 2. Ngomthamo we-500-850 mg kabili noma kathathu ngosuku, umthamo we-insulin unqunywa ukubheka okuqukethwe ushukela.
Mangaki amaphilisi weGlucofage izingane adinga ukuwaphuza? Ezigulini ezincane, kusukela eminyakeni eyi-10 ubudala, umuthi uvunyelwe ukusetshenziswa, womabili ngokwahlukile futhi ngokuhlanganiswa ne-insulin. Umthamo wokuqala wokuqala ungama-500-850 mg, ngokuhamba kwesikhathi ungangezelelwa kumithamo emibili kuya kwemithathu.
Ungaphuza kanjani i-Glucophage ene-prediabetes? Imvamisa kuthathwa ku-1000-1800 mg ngosuku, ihlukaniswe ngemithamo emibili.
Uma kwenzeka ukungasebenzi kahle kwezinso noma kubantu asebekhulile, umuthi weGlucophage uthathwa ngaphansi kokuqokwa okukhethekile kukadokotela ohambelayo. Ukuze wenze lokhu, kufanele uhlole ukusebenza kwezinso okungenani izikhathi ezingama-2-4 ngonyaka.
Ukupakisha kugcinwa endaweni emnyama engatholakali ezinganeni. Umbuso wokushisa akufanele udlule ama-25 degrees Celsius. Njengomthetho, impilo yeshelufu ye-Glucofage 500 noma i-850 mg yiminyaka emihlanu, kanti i-Glucofage 1000 mg yiminyaka emithathu.
Contraindication kanye nokulimala okungenzeka
Lapho uthenga i-Glucophage, imiyalo yokusebenzisa kumele ifundwe.
Iphepha elinamathiselwe liqukethe uhlu oluthile lwe-contraindication ukusetshenziswa kwe-glucophage.
Ngaphambi kokunikeza i-ejenti yokuthinteka kwesifo sikashukela, udokotela kufanele aqaphele yonke imigudu ehlangene yesifo sikashukela ukuze kugwemeke imiphumela emibi. Ngakho-ke, ukusetshenziswa kwamathebhulethi akuvunyelwe nge:
- Ukuzala umntwana noma isikhathi sokuncelisa.
- I-Hypersensitivity engxenyeni eyinhloko nezinto ezengeziwe.
- I-diabetesicoma, i-coma, i-ketoacidosis, kanye ne-lactic acidosis.
- Ukwehluleka kwangempela, umsebenzi wokuphazamiseka wezinso (i-creatinine ngaphansi kwe-45 ml ngomzuzu).
- Ukuphelelwa ngamandla komzimba, i-pathologies yokutheleleka, ukushaqeka, okunyusa amathuba wokungasebenzi kwezinso.
- Izifo ezikhulisa ubungozi be-tishu hypoxia. Lokhu kufaka hlangana ukwehluleka kwenhliziyo / okungalapheki kwenhliziyo, ukushaya kwenhliziyo okukhulu, noma ukwehluleka ukuphefumula.
- Ukungasebenzi kwesibindi noma ukwehluleka kwesibindi.
- Ukungenelela kokuhlinzwa noma amanxeba amakhulu adinga ukwelashwa kwe-insulin.
- Ukudla okunama-kilojoule amancane lapho kuthathwa kuze kufinyelele ku-1000 kcal ngosuku.
- Ukudakwa ngokweqile noma ukudakwa okungapheli.
- Ukusetshenziswa kwama-iodine aqukethe ama-ejenti wokuqhathanisa ngaphambi nangemva kwamahora angama-48 wokuhlolwa kwe-radiological.
IGlucophage isetshenziswa ngokuqapha ezigulini ezinesifo sikashukela, ezingaphezu kweminyaka engama-60, umsebenzi wayo uhlotshaniswa nokuzivocavoca okukhulu ngokomzimba, ngoba bakhulisa amathuba okukhula kwe-lactic acidosis. Iziguli ezinesifo sezinso futhi ziwela kulolu hlu.
Njengomphumela wokusetshenziswa okungafanele kwamathebulethi noma ngenxa yezinye izizathu, ukuthuthukiswa kokuphikiswa okungalungile kungenzeka. Imiyalo ichaza imiphumela elandelayo:
- ukuphazamiseka emgudwini wokugaya ukudla - isicanucanu noma ukugabha, ukunambitheka kwensimbi, uhudo, ukuthokomala, ubuhlungu besisu.
- ukusabela esikhumbeni - ukuqubuka, ukulunywa, i-erythema.
- ukuvela kwe-megaloblastic anemia.
- ukubonakala kwe-lactic acidosis.
- ukwephulwa kwesibindi noma i-hepatitis.
Ngaphezu kwalokho, umphumela oseceleni ubonakala ngokuvela kokuntuleka emzimbeni we-vithamini B12.
Izindlela zokuqapha ngokweqile
Kubaluleke kakhulu ukwazi ukuthi ungaphuza kanjani i-Glucofage kahle, ngoba ukweqisa kwayo kungaletha imiphumela engenakuphikwa kumuntu onesifo sikashukela, kwesinye isikhathi nokubulala.
Ucwaningo oluningi luye lwabonisa ukuthi ukusetshenziswa kwe-metformin emthanjeni ongama-gramu angama-85, okuwedlula umthamo wansuku zonke ophakeme kakhulu ngezikhathi ezingama-42,5, akuholeli ekwehlekeni okukhulu kwe-glycemia. Kodwa i-lactic acidosis ingahle ikhule, kepha yini ebangela lesi simo?
I-Lactic acidosis, noma i-acidosis, umphumela obubi wokuqalwa kwe-metformin. Uma kungekho ukwelashwa okusebenzayo nokusheshayo, umphumela obulalayo kungenzeka. Lapho uthatha i-Glucofage, i-overdose iboniswa kanje:
- Ukuquleka okuhambisana nokuphazamiseka kwengqondo.
- I-Asthenia nobuhlungu besisu.
- I-Acidotic dyspnea.
- Ukushisa komzimba okukhuphukile.
- Ukuthuthukiswa kwenhliziyo.
Uma isiguli siqaphele okungenani eyodwa yezimpawu ze-lactic acidosis, kufanele sithunyelwe esibhedlela ukuyonakekelwa okuphuthumayo. Ngokulandelayo, udokotela unquma okuqukethwe yi-lactate futhi ucacisa ukutholakala kwezifo. Ukususa i-metformin ne-lactate emzimbeni, i-hemodialysis isetshenziswa kakhulu. Kukhona nokwelashwa okuhlose ukuqeda izimpawu.
I-Glucophage namanye ama-hypoglycemic agents
Kukhona uhla oluthile lwezidakamizwa, ukusetshenziswa okuyinkimbinkimbi kwalo okuholela ezinkingeni ezingathandeki. Ezinye zazo zingandisa umphumela we-hypoglycemic we-Glucophage, kanti ezinye - ngokuhlukile, ziyanciphisa.
Kuphikiswe ngokuphelele ukusebenzisa umuthi i-Glucophage kanye nemithi ye-x-ray. Ezimweni ezinjalo, ithuba lokuvela kwe-lactic acidosis liyanda. Uma udinga ukuthatha imali enjalo, kufanele uyeke ukuthatha i-Glucofage ngaphambi nangemva kwamahora angama-48 wokucwaninga usebenzisa ama-x-ray.
Amathuba we-acidosis ku-mellitus yesifo sikashukela kungenzeka:
- ubuthi obudakayo obukhulu;
- nokudla okunganele;
- ngokudla okunama-kilojoule aphansi (ngaphansi kwama-kcal ayi-1000 ngosuku);
- ngokwephula isibindi.
Izidakamizwa ezinjenge-danazol, izidakamizwa ze-antihypertensive, ama-salicylates, i-acarbose, imijovo ye-insulin, i-sulfonylureas, i-nifedipine zandisa umphumela wehlisela ushukela umenzeli we-hypoglycemic.
Yehlisa umphumela wokwehlisa ushukela we-glucophage umuthi onjenge-GCS yasendaweni ne-systemic, chlorpromazine, i-agaists ye-beta-amabili-adrenergic.
Ukuhlanganisa i- “loop” diuretics ne-glucophage, kuyadingeka ukukhumbula ubungozi be-lactic acidosis ngenxa yokwehluleka kwezinso.
Ezinye izidakamizwa zingathinta i-metformin, okungukuthi ukuhlushwa kwayo. Lokhu kufaka phakathi izidakamizwa ze-cationic - i-quinidine, i-digoxin, i-amiloride, i-quinine nabanye.
I-Glucophage analogues
Izidakamizwa eziningi ze-hypoglycemic zisiza ngesifo sikashukela nezimpawu zalo eziphambili. Ngakho-ke, uma kungazelelwe, ngasizathu simbe, ukuthatha i-Glucophage kungeke kwenzeke, udokotela angazikhethela ezinye izidakamizwa ezifanayo emiphumeleni yazo yokwelapha.
Phakathi kwazo, izidakamizwa eziqukethe into efanayo esebenzayo ziyahlukaniswa - bomcondvofana. IMetformin iqukethe imikhiqizo efana neBagomet, Siofor, Gliminfor, Metospanin, Gliformin, Metformin Forte nabanye.
I-Siofor, isidakamizwa esinciphisa ushukela, okubandakanya i-povidone, i-magnesium stearate, hypromellose, titanium dioxide ne-polyethylene glycol, yayithandwa kakhulu phakathi kwemikhiqizo echazwe ngenhla. Ngenxa yokusetshenziswa kwesidakamizwa sikaSiofor, kungenzeka ukufezekisa ukwehla ekukhiqizeni ushukela, ukwanda kokuqalwa kwemisipha yezitha ezitholwayo kuyi-insulin ekhiqizwayo, kanye nokwehla kokufakwa kweglucose. Phakathi kokuphambana kanye nokuphendula okungathandeki, uSiofor ucishe afane nomuthi okukhulunywa ngawo. Umkhiqizi weSiofor yiJalimane, maqondana nalokhu kuyisikhundla esihle seGlucofage.
I-drug Glucophage nama-analogues ayatholakala - ama-ejenti angafaki i-metformin ekwakhekeni kwawo. Lokhu kufaka phakathi:
- I-Glurenorm umuthi olwa namagciwane onesifo i-glycidone. Ukuba yisisulu se-sulfonylurea, i-Glurenorm yehlisela umkhawulo we-beta-cell glucose irritability, ivuselela ukukhiqizwa kwe-insulin, ikhulisa ukuzwela kwezicubu kuyo, ivimbela i-lipolysis kumaseli wamafutha, futhi kunciphise nokwanda kwe-glucagon.
- I-Diabetesalong isidakamizwa esidumile esifaka i-gliclazide. Ngenxa yesenzo salo muthi, kukhona umthethonqubo we-carbohydrate metabolism, ukugqugquzela ukukhiqizwa kwamahomoni anciphisa ushukela, futhi kutholakala nomphumela we-hemovascular.
- I-Amaril M isidakamizwa saseJalimane esisetshenziselwa ushukela ongaxekile ku-insulin. Kubhekiselwa kokunye okusuka kwesizukulwane sesithathu sulfonylurea. Ngenxa yokuqukethwe kwe-glimepiride ekwakhiweni, lapho usebenzisa i-Amaril, kungenzeka ukufezekisa ukwehla kwe-plasma glucose futhi kuvuse ukukhiqizwa kwe-insulin.
Ngemuva kokubheka ukuthi yini i-analogues Glucophage enayo, ungathola ukubuyekezwa nge-Glucophage, kanye nezintengo zalo muthi.
Izindleko nombono ngalo muthi
Ekhemisi, umuthi ungathengwa kuphela uma kunikezwa kadokotela.
Iziguli eziningi zi-oda umuthi online, ngoba lokhu kusiza ukonga imali yazo. Futhi unikezwe ithuba lokubona izithombe zephakeji nencazelo yalo.
Akekho umenzi waseRussia walo mkhiqizo, ukhiqizwa yinkampani yezemithi yaseFrance iMerck Sante. Ngabe kubiza malini iGlucophage? Izindleko zomenzeli wokulwa nesifo sikashukela ngokuya ngenani lamathebulethi nomthamo:
- I-1000 mg (Cha. 60) - kusuka kuma-ruble angama-270 kuya kwangama-346;
- 850 mg (Cha. 60) - kusuka kuma-ruble ayi-150 kuye kwangama-180;
- 500 mg (Cha. 60) - kusuka ku-183 kuya kuma-ruble angama-230.
Njengoba ubona, intengo yeGlucofage yezidakamizwa iyamukeleka. Kwi-Intanethi, ungabona imibono eminingi emihle ngokusetshenziswa kweGlucophage. Isibonelo, ukubuyekezwa kukaMaria (iminyaka engu-56): "Ngabona i-Glucofage iminyaka emibili. Ngalesi sikhathi, ushukela ubuyela kokujwayelekile, kunjalo, ngilandela ngokuqinile ekudleni lapho ngiphuza umuthi. Ngakwazi ukulahlekelwa ngamakhilogremu angeziwe."
Mayelana nokuhlolwa kwezidakamizwa kwe-Glucofage kungaba yimbi. Lokhu kungenxa yemiphumela emibi ngesikhathi sokuzivumelanisa nomzimba ne-metformin. Kwezinye iziguli, umphumela umenyezwa kangangokuba bangasiphuzi lesi sidakamizwa.
Ungathola nokubuyekezwa kodokotela abahlobene nokusetshenziswa kwezidakamizwa ukuze unciphise isisindo. Umbono wochwepheshe abaningi kuleli cala mubi. Bancoma kakhulu ukungasebenzisi umuthi ngale njongo.
I-Glucophage isidakamizwa esisebenzayo abaningi be-endocrinologists abacebisa ukuthi balwe nesifo sikashukela sohlobo 2. Uma ungakayithathi le nkinga, zama i-Glucofage, futhi uma usuvele uyaphuza, yiphuze kakhulu. Izinzuzo zomenzeli wesifo sikashukela zinokuphindwe kaningi kunezindlela ezisabela ngayo.
Imininingwane mayelana nesidakamizwa esinciphisa ushukela i-Glucofage inikezwe kuvidiyo ekulesi sihloko.
