I-Diabeteson, kanye nezinye izidakamizwa ze-sulfonylurea derivatives, isetshenziselwa ukwelapha inqubo ye-pathological efana ne-mellitus engavunyelwe yi-insulin.
Lo mmeleli wezidakamizwa ze-hypoglycemic uvame ukubekelwa abanesifo sikashukela ukukhuthaza ukukhiqizwa kwe-hormone insulin ngamaseli akhethekile we-pancreatic.
Emsebenzini wezokwelapha, izidakamizwa ezahlukahlukene zingasetshenziswa ekulweni ne-mellitus engavikelekile nge-insulin.
Izinsizakalo ze-sulfonylureas namuhla zikhiqize izizukulwane eziningana.
Ukusetshenziswa kwe-sulfonylureas ekwelashweni
Izidakamizwa zeqembu zibhekwa njengelinye lasebenza kakhulu kwe-hypoglycemic agents ukulawula ushukela wegazi.
Izikhombisi-ndlela eziphambili zokwelapha kufanele zifeze lezi zinhloso ezilandelayo:
- 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.
Ngokuya ngezinga nobunjalo bokuthuthuka kwenqubo ye-pathological, ochwepheshe bezokwelapha banquma ukusetshenziswa kwemithi efanelekile eqenjini elilodwa noma eziningana ngasikhathi sinye. Ama-dravatives we-sulfonylureas angaba ngomunye wezidakamizwa ezinjalo.
I-Sulfonylurea iyinto ye-hypoglycemic eyenziwe nge-sulfamide futhi isetshenziswa ngempumelelo ekwelapheni isifo sikashukela. Indlela enkulu yokusebenza yezidakamizwa ezinjalo ihlose ukuvusa amaseli we-beta ophilayo wepancreatic ukukhiqiza inani elidingekayo le-insulin. Ngenxa yalomphumela, hhayi kuphela ukukhiqizwa okwengeziwe kwehormone, kodwa nokuzwela kwezicubu zomzimba kuyo kukhuphuka kakhulu.
Ngaphezu kwalokho, imiphumela emihle yezidakamizwa ze-sulfonylurea yile:
- Khulisa imiphumela ye-insulin, okuholela ekwehlekeni okusebenzayo kakhulu kwamazinga kashukela.
- Babeka phansi umsebenzi wama-enzyme aphula i-insulin ekhona.
- Khuphula inani lama-insulin receptors kuma-membranes weseli.
- Ithinte kahle inqubo yokusebenzisa ushukela amaseli wesibindi.
- Bandisa ukumuncwa kanye ne-oxidation ye-glucose.
Imithi enjalo ivame ukubekelwa abantu abanesisindo esijwayelekile somzimba, abangahlushwa ukukhuluphala.
Zonke izinto ezisuselwa ku-sulfonyl zivezwa ngendlela yemithi eyezizukulwane ezintathu.
Izidakamizwa zesizukulwane sokuqala ezingasetshenziswa kwezokwelapha zesimanje, ngoba zinemiphumela enobuthi emzimbeni womuntuꓼ
Izidakamizwa zesizukulwane sesibili, eziphephe kakhulu, futhi ngenxa yalokho ezisetshenziselwa ukwelapha lesi sifo. Zifanekiselwa yinto esebenzayo efana ne-gliclazide, eyingxenye yamathebulethi e-Diabetes.
Izidakamizwa zesizukulwane sesithathu, ezinomphumela wesikhathi eside futhi zikuvumela ukuthi uthathe izidakamizwa ezinciphisa ushukela ngendlela efanelekile ukuthola imiphumela oyifunayo.
Isithako sabo esiyinhloko esisebenzayo yi-glimepiride.
Uyini umuthi onciphisa ushukela?
Umuthi i-Diabeteson umuthi obizwa nge-hypoglycemic, ofakwa eqenjini lokutholwa kwe-sulfonide yesizukulwane sesibili.
Isisekelo sokuqanjwa kwayo yi-gliclazide yezinto ezisebenzayo, ngenxa yalokho umphumela ofanele wokuthatha amaphilisi wenziwa.
Ngokungafani neminye imishanguzo ye-sulfonylurea (ngokwesibonelo, i-Glibenclamide), isifo sikashukela sinomphumela omnene we-hypoglycemic, othinta kahle i-microcirculation, heestasis, idatha ye-hematological kanye nezimpawu ze-rheological zegazi. Yilezi zindawo ezibaluleke kakhulu ezigulini ezazihlonza isifo sikashukela sohlobo 2.
I-Diabeteson yezidakamizwa ivusa isigaba sokuqala secretion se-insulin, esiphazamiseka ngenxa yokuthuthuka kwenqubo ye-pathological. Ngaphezu kwalokho, izici zokwelapha zomuthi zihlanganisa:
- ukwehla kwe-platelet aggregationꓼ
- umsebenzi owengeziwe we-activ activ of izicubu we-plasminogen ne-prekallikreinꓼ
- ukungathathi hlangothi ingozi yokuqhekeka kwegaziꓼ
- ukuncishiswa kwengcindezi oxidative kanye nokukhiqizwa kwama-molecule adhesionꓼ
- ukwehla kwenani le-atherogenic alpha tumor necrosis factor, ngenxa yokuthi kunomsebenzi wokuzivikela mayelana nokuthuthukiswa kwezifo zenhliziyo nezinkinga zezinkinga zokujikeleza kwesifo sikashukelaꓼ
- kusebenze kwenqubo ye-fibrinolysis.
Ngaphezu kwalokho, okwenzelwe i-Diabeteson, imiyalelo yokusetshenziswa ikhombisa ukuthi umuthi awunayo kuphela impahla ye-hypoglycemic, kodwa futhi unezimpawu ze-hemovascular, metabolic and antioxidant. Izici ezinjalo zamakhemikhali zingabeka eceleni ubungozi bezinkinga ezahlukahlukene ezenzeka ngenxa yesifo sikashukela.
Yiziphi izinkomba zokusetshenziswa kwaso ezikhona?
Umuthi obizwa ngokuthi yi-Diabeteson usatshalaliswa emakhemisi asedolobheni uma kunikezwa incwadi kadokotela ebekwe udokotela.
Uchwepheshe wezokwelapha ohola phambili unquma ngesidingo senkambo yokwelashwa usebenzisa umuthi.
Ngokungafani nezidakamizwa ezivela eqenjini le-Biguanide (njengeMetformin), i-Diabeteson yokunciphisa isisindo ayisetshenziswa. Ngaphezu kwalokho, ezinye iziguli ezithatha umuthi onjalo ziphawule ukwanda kwesisindo sazo ngesikhathi sokwelashwa.
Ngokwencazelo yesidakamizwa, izinkomba eziphambili zokusetshenziswa kwalo muthi yilezi:
- Ukuthuthukiswa kwesifo sikashukela i-mellitus yefomu elizimele le-insulin njenge-monotherapy noma njengokwelashwa okuyinkimbinkimbi. Imvamisa, amalungiselelo asuselwa ku-sulfonyl aqala ukusetshenziswa ngemuva kwezindlela zokwelapha ezingezona izidakamizwa (kulandela ukudla okudingekile kanye nokuzivocavoca komzimba) azange aveze umphumela oyifunayoꓼ
- Ukunciphisa ubungozi kanye nezinhloso zokuvimbela, ukuvikela ukuboniswa kwezinkinga ezahlukahlukene ezingezinhle ezenziwa yinkambo yesifo sikashukela.
Okokuqala, ukusetshenziswa komuthi kuzovikela ukwenzeka kwezinkinga ze-micro-vascular pathologies, ezifana ne-retinopathy nephthopathy, kanye nezinye izifo zesistimu yenhliziyo - ukushaya kwenhliziyo noma unhlangothi.
Imiyalo yokusebenzisa umuthi
I-Diabeteson yezidakamizwa iyatholakala kwifomu lethebhulethi.
Ngasikhathi sinye, ukwakheka kwalesi sidakamizwa kufaka ama-milligram angama-80 wesakhi esisebenzayo.
Amathebhulethi e-Diabeteson athathwa ngokuya ngemiyalo eqinile kadokotela wezokwelapha.
Njengomthetho, inkambo yokwelapha yokuphuza umuthi isuselwa kule migomo elandelayo:
- ukusetshenziswa komuthi kanye ngosuku, kungakhathalelwa ukuthathwa kokudla (ukukhetha kufanele kunikezwe isikhathi sasekuseni) ꓼ
- Amaphilisi wesifo sikashukela aphuzwa ngomlomo, ngamanzi amaningi amaminerali angenawo igesi
- umthamo wansuku zonke usethelwe uhla lwamamayela ayisishiyagalombili wesithako esisebenzayo ngokunokwenzeka kokukhuphuka uma kunesidingo, kuyilapho ngaso sonke isikhathi ukuqala inkambo yokwelashwa kwenzeka kuphela ngokusetshenziswa komthamo omncane, ogcinwe kwithebhulethi elilodwa lomuthi;
- umthamo odingekile womuthi unqunywa udokotela ohambela yena ngamunye esigulini ngasinye, kucatshangelwa izici zesifundo saleso sifo, iminyaka yesiguli kanye ne-hypoglycemiaꓼ
- ukuqeda ukuvela kwemiphumela emibi, lapho weqa umuthi olandelayo, akufanele ukwandise inani lezinto ezisebenzayo ngokuzayo lapho usebenzisaꓼ
- umthamo omkhulu ongaba khona wamatafula anciphisa ushukela phakathi nosuku akufanele udlule ku-320 mg, okungukuthi, amaphilisi amane, kuyilapho isidingo sokuphuza imithamo ephezulu yemithi kufanele sihambisane nokwanda kwenani lemithamo phakathi nosuku (umuthi udakiwe kabili kathathu ngosuku, kuye ngezincomo udokotela).
Kwezinye izimo, kunokwelashwa okuhlanganisa, okubandakanya ukuthatha imishanguzo ezigabeni ezahlukahlukene.
Ngakho-ke, umphumela wazo zonke izidakamizwa ezithathwa emzimbeni wesiguli uyathuthukiswa.
Ithebhulethi ye-hypoglycemic ingasetshenziswa ngokuhlangana nezidakamizwa ezivela emaqenjini we-Biguanide, i-alpha glucosidase inhibitors, noma i-insulin therapy. Ukwelashwa okuphelele kunganciphisa ingozi yezinkinga ezahlukahlukene, futhi kufinyelele nokujwayela ngokweqile kweqa ngokweqile kushukela wegazi.
Kufanele kukhunjulwe ukuthi umuthi owedlula imithamo enconyiwe ungaholela ekwakhiweni kwe-hypoglycemia.
Ngakho-ke, lapho wenza ukwelashwa okwelashwa, isiguli kufanele njalo sithathe izilinganiso zenani likashukela egazini.
Yiziphi izingozi zokusebenzisa umuthi?
Njengemithi eminingi, i-Diabeteson inemiphumela emibi kanye ne-contraindication.
Uma izincomo zokwelashwa zingalandelwa futhi kusetshenziswe inani lemithi yokwelashwa, isethi yesifo sikashukela esingajwayelekile singabonakala.
Le nto iholela esimweni sokukhathazeka kwesifo sikashukela, ukwazi ukungasebenzi kahle kanye ne-hypoglycemia enzima. Ukuqeda izimpawu ze-overdose, kuyadingeka ukwethula isiguli isixazululo se-hypertonic dextrose (ekuhlanganeni ngamaphesenti angamashumi amane) nekhambi le-glucagon, futhi sivumele nokuthi kuthathwe ushukela omncane.
Kunconyelwe futhi ukuthi amazinga eglucose egadwe abhekwe njalo ngemizuzu eyishumi nanhlanu. Omunye umthelela omubi we-overdose ukuthi kungenzeka kwe-cerebral puffness. Kulokhu, odokotela banquma i-Dexamethasone neMannitol njengendlela yokwelashwa.
Kumele kuqashelwe ukuthi umuthi awunqatshelwe ukuthi uwusebenzise ekuboniseni izimo nezici ezithile.
I-Diabeteson contraindication ine okulandelayo:
- Ukubonakaliswa kwe-ketoacidosis yohlobo lwesifo sikashukela.
- Uhlobo oluncike ku-insulin lokukhula kwenqubo ye-pathological.
- Izifo ezimbi kakhulu zezitho zangaphakathi ezinjengezinso nesibindi.
- Ukuba khona kwe-glycemic coma nezimo zokhokho.
- Ngesikhathi sokukhulelwa nokuncelisa.
- Uma isiguli sithola ukushiswa okukhulu kobunzima obulinganisile noma obukhulu.
- Ebusheni nasezigulini esezikhulile.
- Lapho kukhona ukungabekezelelani ngakunye kuya ezingxenyeni ezithile zomuthi.
Ngaphezu kwalokho, ekuqaleni kwenkambo yokwelashwa yokwelashwa, kuyadingeka ukubheka inhlala-kahle kanye nesimo sempilo, ngoba ukubonakaliswa okuhlukahlukene okungekuhle kusuka ohlangothini lwezitho zangaphakathi nezinhlelo kungakhula. Okokuqala, kufanele unake ukuba khona kokungahambi kahle komzimba, futhi uma kwenzeka kuboniswa, yeka ukuthatha lo muthi.
Ngaphezu kwalokho, imiphumela emqoka evela ekuphuzeni umuthi ifaka phakathi:
- ushukela wegazi ophansi ngaphansi kwamazinga amukelekileꓼ
- ukukhuphuka noma ukuntuleka kokudla, isisindo inzuzoꓼ
- ukukhathala okujwayelekile komzimba nokuphelelwa amandlaꓼ
- ukujuluka ngokweqileꓼ
- tachycardiaꓼ
- ukungaboni kahleꓼ
- Izinkinga zokulala kanye nokuqwasha
- umuzwa ongenakungabaza wokukhathazeka, uvalo noma ukungakhathaleliꓼ
- ukuvela kwamaqhubu emisipha yetholeꓼ
- ukuphazamiseka kwemizwaꓼ
- ukwanda kwama-enzymesꓼ abhakwe
- i-hypersomnia.
Uma kwenzeka noma yikuphi ukusabela okubi, kudingeka wazise udokotela ohambayo ngalokhu ukuze usebenzise izindlela ezidingekayo noma ungene esikhundleni somuthi.
Yimiphi imishanguzo engingangena esikhundleni somuthi ngayo?
Umuthi wesayensi wanamuhla unikeza imibono eminingi ekhombisa ukuthi ukusetshenziswa okuhlelekile kwesidakamizwa isikhathi eside kuholela ekubhujisweni kancane kancane kwamangqamuzana e-pancreatic beta futhi kungaba neqhaza ekwakhiweni kwesifo sikashukela esincike ku-insulin.
Ngasikhathi sinye, ngaphandle kwezinsolo ezinje, odokotela bayaqhubeka nokusebenzisa umuthi ukwelapha i-pathology.
Mayelana nesifo sikashukela, ukubuyekezwa kweziguli kwehlukile. Abanye abantu bathi umuthi usebenza kakhulu futhi kulula ukubekezelela, abanye bathukuthele ngokuntuleka kwemiphumela kanye nokwanda okukhulu kwesisindo ngemuva kokwelashwa.
Akufanele uthathe konke ukubuyekezwa mayelana neDiabeteson ngokwezwi nezwi, ngoba isitho ngasinye somuntu ngamunye, nokuthi yini ebingalingani nomuntu oyedwa ingahle ilungele omunye.
Intengo yesidakamizwa emakethe ingama-ruble angamakhulu amathathu. Uma kunesidingo, udokotela ohambelayo angabeka umuthi esikhundleni sawo nge-analogue yakhe eyakhekile.
Ukwenziwa kwethebhulethi ejwayelekile kufaka phakathi imithi efana:
- Glidia.
- I-Glykinorm.
- Gliklad.
- I-Gliclazide.
- Okwebhizinisi.
- Ukuxilonga.
- I-Diazide.
- Phindisela emuva.
Yonke le mithi ye-analogue engenhla ingeyeqembu lokutholwa kwesulfonyl lesizukulwane sesibili. Umehluko wabo ulele enkampanini yokukhiqiza (abanye bangabameli bezinkampani zamakhemikhali zakwamanye amazwe, ezinye zikhiqizwa eRussian Federation), izindleko nenani lemiphumela emibi, ukuphikisana.
Imininingwane nge-Diabeteson inikezwe kuvidiyo ekulesi sihloko.
