Ukwelashwa okuyisisekelo kwesifo sikashukela sohlobo 2 ngaso sonke isikhathi kususelwa ekwelashweni okuqinile kokudla kanye nesethi ekhethekile yokuvivinya umzimba. I-Diamerid yezidakamizwa imiselwe ukwehluleka kwalezi zindlela.
Ukusetshenziswa komkhiqizo onjalo wezokwelapha kuvunyelwana nodokotela ohambayo, obeka lo muthi ngokususelwa esithombeni esijwayelekile somtholampilo wesifo sesiguli, ubukhulu besifo.
Inkambo yokwelapha kufanele ibe nemithamo ekhethwe kahle ukuze igweme ukubonakaliswa okungekuhle komuthi onjenge-diamerid.
Amasu wokulashwa kwezidakamizwa
Namuhla, umuthi wanamuhla usebenzisa elinye lamaqembu ambalwa wezidakamizwa ukwelapha isifo sikashukela sohlobo 2. Izinhloso ezinkulu okufanele zifezekiswe ngenxa yokusetshenziswa kwezidakamizwa zibandakanya:
- ukukhuthaza kwe-insulin hormone secretionꓼ
- yehlisa ukungazweli kwe-insulin
- ukumiswa kokuhlanganiswa kweglucose futhi kwehlise ukungena kwayo egazini kusuka emathunjini
- ukulungiswa kokuphulwa kokuphakama kwesilinganiso sezingxenyana ze-lipid egazini.
Njengomthetho, ukwelashwa kuqala njalo ngokuphathwa kwomuthi owodwa; uma kungasebenzi, izidakamizwa zomphumela ohlangene noma ngokuhlangana kwemijovo ye-insulin zingabekwa.
Amaqembu amakhulu emithi esetshenziselwa ukwelapha isifo sikashukela sohlobo 2:
- Imithi etholakala kwe-sulfonylurea. Inzuzo yabo eyinhloko ukubekezelela okuhle kwezidakamizwa ezigulini eziningi. Ngesenzo sayo, banciphisa ukumelana ne-insulin futhi bavusa ukukhululeka kwe-hormone ngamaseli e-pancreatic.
- Izindlela ezivela eqenjini le-Biguanide zifaka i-metformin element. Ungumphumela we-metformin osiza ukunciphisa ukuthunyelwa kwe-insulin, uthinta kahle ukujwayeka kwe-fez, futhi uthuthukise iphrofayili ye-lipid. Ukukhetha umthamo ongalungile kungaholela emiphumeleni emibi eminingi.
- Ama -retretins
- Ukulungiselela okususelwa kokunye okususelwa ku-thiazolidinone kusiza ukunciphisa ushukela wegazi futhi kuthuthukise ikhwalithi yephrofayili ye-lipid.
Ama-inhibitors we-Alpha-glucosidase noma ama-dipeptidyl peptides 4 nawo abizwa ngokuthi izidakamizwa; anomphumela omuhle ekususeni i-hyperglycemia futhi akhulisa ukuzwela kwamaseli we-pancreatic beta kushukela.
Izici eziphambili zamakhemikhali zomuthi
I-Diameride isidakamizwa eqenjini le-sulfonylureas lesizukulwane sesithathu. Kuvame ukusetshenziselwa ukwelapha isifo sikashukela sohlobo lwe-2, uma ukwelashwa kokudla okuqunywe ngaphambilini kanye nokuzivocavoca komzimba kungalethi umphumela omuhle.
Umkhiqizo wezokwelapha uyatholakala ngesimo sethebhulethi emithanjeni ehlukahlukene - eyodwa, ezimbili, ezintathu noma ezine zamamilimitha ento esebenzayo enezakhi ezingeziwe ekwakhiweni. Isakhi esisebenzayo somuthi yi-glimepiride.
Izici eziphambili ze-pharmacological zesidakamizwa zivela emiphumeleni elandelayo:
- kwandisa ukuzwela kwamangqamuzana ku-insulin.
- ithinta ngokuqinile ukuvalwa kweziteshi ze-potassium, ngenxa yokuthi ukugxila kwe-intracellular kokukhuphuka kwe-potassium nokugcinwa kwe-insulin kusebenza.
- ithinta kahle izinga le-lipid.
- isiza ukwehlisa ukuhlangana kweplatelet.
Ngaphezu kwalokho, ukusetshenziswa kwamathebhulethi kuthuthukisa imiphumela ye-insulin ekufakweni kwe-glucose yizicubu zomzimba.
Imvamisa, umuthi usetshenziselwa ukwelashwa okuhlanganiswa ngokuhlangana nezidakamizwa ezisuselwa ku-metformin (ukulawulwa kwe-metabolic kuyathuthuka) noma i-insulin therapy.
Ukubuyekezwa okuningi kweziguli ezisebenzisa lo muthi kukhombisa ukubekezelelwa okulula nokwenza kahle okuphezulu komuthi.
Imiyalo yokusebenzisa umuthi
Imiyalo yokusebenzisa umuthi ithi ukuqala kokwelashwa kumele kwenziwe ngemithamo ephansi kakhulu yesidakamizwa. Ngakho-ke, kulawulwa i-metabolic control efanelekile.
Ngesikhathi sokuthatha umuthi, isiguli kufanele siqaphe njalo amazinga kashukela egazini, kanye nenkomba ye-glycosylated hemoglobin.
Ukuqokwa komkhiqizo okwelapha, kanye nokukhethwa kwemithamo edingekayo, kwenziwa kuphela udokotela ohambelayo. Kulokhu, ukuzelapha kunqatshelwe ngokuphelele.
Ukunemba kokuthatha amaphilisi ukuhambisana nezincomo ezilandelayo:
- Ezigabeni zokuqala zokwelashwa, umthamo ophelele ovunyelwe lomuthi uyigilogremu eyodwa yesithako esisebenzayo kanye ngosuku. Ngemuva kweviki elilodwa kuya kwamabili, uma kunesidingo, isilinganiso sansuku zonke singangezelelwa.
- Izinga eliphakeme elivumelekile lokudla izidakamizwa akumele lidlule amamiligremu ayisishiyagalombili omuthi, inqobo nje uma imithamo enjalo inyuka kancane futhi kahle, njalo ezinsukwini eziyishumi kuya kweziyishumi nane.
- Kulezo ziguli ezinamazinga kashukela egazi alawulwa kahle, ukusebenza kahle komuthi kutholakala lapho kuthathwa imiligremu eyodwa kuya kwemine yomuthi. Namuhla, kunenani elincane labantu abadinga ukwandisa le mithamo ukuya kumamiligram ayisishiyagalombili womuthi.
Kunconywa ukuthatha umuthi, ulandela yonke imiyalo kadokotela obonayo. Uchwepheshe wezokwelapha usetha isikhathi nenani lokwamukelwa, ngokuya ngempilo yesiguli, umsebenzi kanye nezinga lomsebenzi womzimba. Njengomthetho, ukusetshenziswa kwesidakamizwa kumiswa kanye ngosuku ngaphambi kokudla okuyinhloko (ngokwesibonelo, ekuseni ngaphambi kokudla kwasekuseni). Isidingo esidingekayo yisidlo sasekuseni esijwayelekile futhi esigcwele (isidlo sasemini, isidlo sakusihlwa), uma umuthi uthathwe. Ngaphezu kwalokho, kufanele kukhunjulwe ukuthi uma, ngasizathu simbe, iphilisi laliphuthelwa, asikho isidingo sokwandisa umthamo walo kwithamo elilandelayo.
Kunezimo lapho udokotela angalungisa khona umthamo womuthi. Ukulungiswa kwenziwa uma kunokulahlekelwa kwesisindo kwesiguli, kuye kwaba nezinguquko endleleni yokuphila yesiguli - inani nekhwalithi yokudla, izinga lomsebenzi womzimba, kunengozi ekhulayo ye-hypo- noma i-hyperglycemia ngenxa yanoma yiziphi ezinye izinto.
Yikuphi ukuphambana kokusetshenziswa okukhona?
Yize kunohlu olukhulu kakhulu lwezindawo ezinhle zomuthi, kuyadingeka ukuthi unake zonke izinhlobo zezinto ezingezinhle ezingaba khona ngemuva kokuwusebenzisa.
Okokuqala, kuyadingeka ukuthi unake uhlu lwezinto ezinqatshelwe lapho ukwelashwa nge-Diomexide kungenakwenziwa. Phakathi kokuphikiswa okuyinhloko kufaka phakathi izici ezilandelayo:
Ukwelashwa kwesifo sikashukela sohlobo lokuqala, futhi esimweni sokubheka i-ketoocytosis yesifo sikashukela noma isimo sokhokho onesifo sikashukela esigulini,
- ukubonakaliswa kwe-hypoglycemia esigulini,
- phambi kwama-pathologies wesimo esithathelwanayo,
- kuqhuma isifo sesibindi noma sezinso,
- ukungabekezeleli noma i-hypersensitivity engxenyeni eyodwa noma eziningi zomuthi,
- lapho kukhona ukungabekezelelani kwe-lactose noma ukuntuleka kwe-lactase.
Kuze kube manje, akukho mininingwane eyanele yokuthi lo muthi usebenza kanjani ekwelapheni isifo sikashukela ezinganeni. Ngakho-ke, ukwelashwa kweziguli ezinjalo (kuze kube yiminyaka eyishumi nesishiyagalombili) akunqunyelwe. Ngaphezu kwalokho, le mibiko ifaka phakathi ukuthatha lo muthi kumantombazane nabesifazane abakhulelwe ngesikhathi sokuncelisa.
Ngokuqapha ngokweqile, kudalwa isidakamizwa uma kunengozi eyandayo ye-hypoglycemia, uma kunezici ezidinga ukuthi isiguli sidluliselwe emjozweni we-insulin ngemuva kokuhlinzwa, uma kunesifo sohlelo lokugaya ukudla.
Yimiphi imiphumela emibi evela ekusebenziseni umuthi engenzeka?
Njengomphumela wokukhethwa okungafanele komthamo womuthi, ukungahambisani nazo zonke izincomo zikadokotela oholayo, izibonakaliso ezingezinhle ezihlukile zokuphuza umuthi zingakhula.
Omunye wemiphumela emibi ejwayelekile ubungozi obukhulayo kanye nokuthuthukiswa kwe-hypoglycemia esikhathini eside. Izimpawu eziphambili ezihambisana nalesi simo zingaba:
- isifiso sokudla nomuzwa oqhubekayo wendlala,
- ikhanda elibuhlungu
- isicanucanu nokuhlanza
- umuzwa oqhubekayo wokukhathala nobuthakathaka bomzimba,
- ukungaphatheki kahle
- ukungakwazi ukugxila
- ubunzima bokuphefumula
- isiyezi nokufiphala,
- ukwanda komfutho wegazi.
Ukuqala umuthi kungahle kuhambisane nokukhubazeka okubukwayo okwesikhashana. Le nto yinto yesikhashana futhi idlula iyodwa isikhashana.
Ngaphezu kwalokho, ukubonakaliswa okungalungile nemiphumela emibi ingafaka:
- Ukuphazamiseka okuhlukahlukene kwepheshana lesisu. Ubuhlungu esiswini kungenzeka, uhudo lungavela.
- Umsebenzi wesibindi ongasebenzi kahle, ukuthuthukiswa kwe-hepatitis, jaundice noma cholestasis.
- Ukusuka ohlelweni lokujikeleza, ezimweni ezingavamile, i-thrombocytopenia, i-leukopenia noma i-pancytopenia iyaboniswa.
- Ukwephulwa kohlelo lwezinzwa kungenzeka, okuvame ukubonakala ngendlela yokusabela okuhlukahlukene kwe-allergic - urticaria, ukulunywa kwesikhumba noma ukuqubuka.
I-overdose yesidakamizwa ivusa ukuhlaselwa kwe-hypoglycemia enesifo sikashukela i-mellitus, engahlala osukwini olulodwa kuya kwezintathu.
Ngabe umuthi ungafakwa esikhundleni somkhiqizo onezakhiwo ezifanayo?
Ithuluzi yisidakamizwa, okulula kakhulu ukusithola emakhemisi asedolobheni. Izindleko zalo ziyahlukahluka kusuka kuma-ruble angama-170 kuya kwangama-600, kuya ngomthamo, indawo athengiswa kuyo nenkampani yomenzi. Ukubuyekezwa kwamakhasimende kubonisa ukuthi lo muthi uhambisana ngokuphelele nezimpawu eziyisisekelo "zekhwalithi yenani". Kunezimo lapho kufanele ucabange ngokubuyisela umuthi nokuthola i-analogue efanelekile.
Namuhla, imakethe yanamuhla yezokwelapha inikezela ngokukhethwa kwemithi ehlukahlukene ngokulinganayo, ekwakhiweni kwayo noma yiziphi izifaniso zeDiamerid, noma iziphawulo zazo. Kumele kwaziwe ukuthi izidakamizwa ze-analog zingaba namagama ahlukile, zinikezwa ezinye izinkampani, kepha zibe nesakhi esisebenzayo esifanayo ngemithamo efanayo. Ngakolunye uhlangothi, izichazamazwi zinazo izakhiwo ezifanayo ze-pharmacodynamic, kepha ukwakheka kwazo kuhluke ngokuphelele kumkhiqizo wokuqala (ngokwesibonelo, amaphilisi weDiabeteson MV).
Kukhona ukufana kweDiamerid, phakathi kwazo okuthandwa kakhulu yi-Amaryl, Glemaz, Glimepiride
I-Amaryl M ilungiselelo lethebhulethi olutholakala kumithamo ehlukahlukene. Inezici ezifanayo nezinkomba zokusetshenziswa. Izici zomuntu kulo muthi azikwazi ukufinyeleleka kwezinye izindawo zezwe kanye nezindleko eziphakeme. Intengo ejwayelekile ingasukela kuma-ruble angama-300 kuye kwangama-1000 ngephakethe ngalinye (amaphilisi angama-30), kuya ngomthamo nenkampani yokukhiqiza.
U-Glemaz - amaphilisi atholakala kumthamo wamamiligremu amane ento esebenzayo. Iphakethe liqukethe amaphilisi angamashumi amathathu, izindleko zawo zingasukela kuma-ruble angama-325 kuya kwangama-865.
I-Glimepiride - iyi-analogue yesidakamizwa i-Diamerid. Inzuzo eyinhloko yethuluzi elinjalo intengo yalo ephansi kakhulu - kusuka kuma-ruble ayi-140 kuye kwangama-390.
Yiziphi izisebenzi ezisebenza ngempumelelo kakhulu ze-hypoglycemic ezizotshela uchwepheshe kuvidiyo ekulesi sihloko.
