I-Metformin isetshenziselwa isifo sikashukela esincike ku-insulin futhi esingahloniphi i-insulin, sisodwa ngokwahlukana futhi sihlangana namanye amakhemikhali anciphisa ushukela.
Imvamisa, uhlobo 2 sikashukela luba khona ngemuva kwesisindo ngokweqile. Akuwona wonke umuntu okwazi ukunqoba isisindo ngokweqile. Kodwa-ke, ama-dragees asiza ukulahlekelwa ngamakhilogremu ambalwa angeziwe, ngakho-ke ngisho nabantu abanempilo bayayisebenzisa ukunciphisa umzimba.
Akumele sikhohlwe ukuthi ikhemikhali ngayinye yokwelapha inezici ezithile zokusetshenziswa neziexwayiso. Umuthi ochaziwe, igama lomhlaba wonke livumelana ngeyunithi esebenza ngalo ngokuyinhloko, nalo likhona. Noma yisiphi isiguli kufanele sazi ngokuningiliziwe ukuthi singaphuza kanjani amaphilisi ngalolu hlobo lwamakhemikhali olusebenzayo, izakhiwo zalo, ama-ejenti afanayo nokuthi kubiza malini iphakethe.
Izici ezijwayelekile zomuthi
Igama lamazwe omhlaba lalesi sakhi somthi yi-metformin hydrochloride. Kuyaziwa ochwepheshe abaningi abavela ezingxenyeni ezihlukene zomhlaba, ngakho-ke imakethe yamakhemikhali inikezela ngezinketho eziningi zamamisele ngaleli khompiyutha elisebenzayo.
Isici salo muthi singabizwa ngokuthi ukuncipha kwawo kancane kancane kuzinga le-glycemia in diabetesics. Njengoba kungukuphela kokumelwa kwesigaba se-Biguanide, ikhemikhali alithinti izinga loshukela kubantu abaphilile.
Umenzi ukhiqiza umuthi osefomini yethebhulethi ngomthamo wenhlanganisela enkulu yamakhemikhali engu-500, 850 ne-1000 mg. Ezitolo zezidakamizwa, indlela yokukhishwa yethonya elide itholakala futhi. Iqhubu elilodwa liqukethe amaphilisi angama-30 noma angama-120. Ngaphezu kwekhompiyutha enkulu, i-talc, i-magnesium stearate namanani amancane wesitashi afakiwe kumthamo owodwa.
Umphumela wokwelapha uhloselwe ukuvimbela inqubo yokukhiqizwa kwe-glucose yisibindi (gluconeogenesis). Akuthinti ukukhiqizwa kwe-insulin ngamaseli e-beta, ngakho-ke akubangeli ukwehla okukhulu kwezinga likashukela ngaphansi kokujwayelekile. Izakhiwo zivela ngale ndlela:
- Ukunciphisa izinga lokufakwa kwamakhompiyutha e-carbohydrate alula ngezindonga zamathumbu.
- Ukwanda kokuqalwa kwezakhi zezicubu ku-insulin.
- Ukuqinisa inqubo yokusetshenziswa kwe-glucose yangaphakathi
- Ukumisa i-hyperinsulinemia.
- Ukuzinza kanye nokwehla kokukhuluphala.
- Ukunciphisa inani lama-linoprotein aphansi kanye ne-triglycerides ku-plasma yegazi.
- Ngezindlela ezithile, ukuhlinzekwa komphumela we-fibrinolytic.
- Ukunciphisa isilinganiso se-oxidation yamafutha.
- Ukuvinjwa kokukhiqizwa kwamafutha acid.
- Umphumela omuhle enhliziyweni nasistimu yemithambo yegazi.
- Ukumiswa kokuthuthukiswa kokukhiqizwa kwesendlalelo semisipha esibushelelezi lodonga lwe-vascular.
Ukusebenza kwesenzo kunikela ukuvimbela kwezinkinga ezinjalo zesifo sikashukela njenge-angiopathy yesifo sikashukela, esithinta ukwakheka kwemithambo cishe yazo zonke izitho zomuntu zangaphakathi.
Ngemuva kokungena ngaphakathi, isenzo senzeka kungakapheli amahora angama-2,5. Le nto ifakwa emgodini wokugaya ukudla, bese ingena emikhunjini. Isiguli kufanele sazi ukuthi lapho kudliwa, ukumuncwa kwengxenye esebenzayo esetshenziswayo kuncishiswa kakhulu. Isigamu sempilo singamahora ayi-6.5. Isakhiwo esisebenzayo empeleni asihlanganisi namaprotheni e-plasma.
Cishe ama-20-30% womthamo udalulwa ezinso.
Imiyalo yokusebenzisa amaphilisi
Izinkomba ezisetshenziselwa ama-dragees zingokulandelayo: isifo sikashukela sohlobo lokuqala nolwesibili (zombili i-monotherapy futhi zihlanganiswa nezinye izidakamizwa), i-ovary polycystic. Umuthi ubalulekile ikakhulukazi lapho iziguli zingakwazi ukwehlisa amazinga kashukela ngokusebenzisa imidlalo kanye nokwelashwa ngokudla ngokweqile.
Lapho uthenga amaphilisi, imiyalo yokusebenzisa kumele ifundwe ngokucophelela. Uma unemibuzo, qiniseka ukuthi uthintana nodokotela wakho.
Ithebhulethi kufanele ligwenywe lonke, ligezwe ngamanzi amaningi. Ukuthatha umuthi okokuqala ngqa, imiyalo incoma ukuthi ingeqi ku-500-1000 mg ngosuku. Ngemuva kwamaviki amabili, udokotela angalungisa irejimithi yokwelashwa ngokunquma imithamo ephakeme yomuthi.
Kufanele kuqashelwe ukuthi ekuqaleni kokwelashwa, iziguli eziningi zithola ukusabela okuhlukile okuhambisana nohlelo lokugaya ukudla. Ukubonakaliswa okungathandeki okunjalo kungumphumela wokuzivumelanisa nomzimba nethonya lento esebenzayo. Ngemuva kokuba umzimba womuntu usujwayele, izimpawu ziyayeka.
Isilinganiso esiphezulu esivunyelwe ngosuku sifinyelela ku-3000 mg, kanti umthamo wokulungiswa uthathwa njenge-1500-2000 mg. Njengoba amaphilisi ezinesifo sikashukela asebekhulile angathinta ukusebenza kwezinso, umthamo onconyiwe akufanele udlule ku-2000 mg ngosuku. Lesi sexwayiso sisebenza nasezigulini ezinenkinga enkulu yokuphazamiseka kwemizwa.
Uma isiguli sithatha enye into ye-hypoglycemic sidinga ukuphuza umuthi okhonjisiwe, khona-ke kuyodingeka siyeke ukwelashwa kwangaphambilini. Ngokuhlanganisa amaphilisi kanye nemijovo ye-insulin, umthamo wokugcina ungancishiswa ngokufanayo ngokubonisana nodokotela okokuqala.
Usebenzisa amaphilisi akhipha isikhathi eside, umthamo omncane kufanele unamathelwe - 500 noma 850 mg (ngokuya ngesimo sokukhishwa). Ukuqokwa kwemithamo ephakeme yenziwa ngawodwana, kucatshangelwa izinga le-glucose ku-plasma yegazi kanye nenhlala-kahle yesiguli.
Zuza isidakamizwa kumakhemisi ngencwadi kadokotela. Ukufakwa kugcinwe ngokucophelela endaweni emnyama, kudinga umbuso okhethekile wokushisa ongabi ngaphezu kwama-25 degrees.
Lapho uthenga, udinga ukunaka usuku lokuphelelwa isikhathi, okuvame ukuba yiminyaka emithathu.
Contraindication kanye nomonakalo ongaba khona
Abanesifo sikashukela badinga ukwazi okuningi ngangokunokwenzeka mayelana nesakhiwo, ngoba la maphilisi anohlu olucatshangelwayo lwe-contraindication.
Ngokufunda incazelo yomuthi, kufanele ufunde ngokucophelela uhlu lwazo zonke izifo nezimo lapho ukusetshenziswa komuthi kwenqatshelwe.
Ngakho-ke, ukusetshenziswa kwezidakamizwa ze-antidiabetesic kuyenqatshelwe ezigulini uma kwenzeka izimo ezithile nezimo zomzimba.
Ukwemukelwa akuvunyelwe emacaleni alandelayo:
- ukuba khona kokuqina kwesibindi / izinso;
- ukuba khona kwezidingo zesifo sikashukela nesibalo;
- ku-pathologies ye-acute - ukomisa, umkhuhlane ophakeme, izifo ezahlukahlukene, isimo se-hypoxia (isifo se-bronchopulmonary, ukushaqeka, i-sepsis, ukutheleleka kwezintso);
- phambi kwe-pathologies eholela kwezicubu hypoxia (infarction ye-myocardial acute, ukuphefumula / ukuhluleka kwenhliziyo);
- ukuba khona kotshwala obudakayo, kanye nophuzo oludakayo;
- ukuvela kwezimpawu ze-lactic acidosis;
- uma kukhonjwa ukuzwela ngakunye ezingxenyeni eziphambili nezingezelelweyo;
- uma ama-ejenti aqukethe iodine ehlukile asetshenziswa ngesikhathi sokufunda kwe-X-ray noma i-radioisotope;
- isikhathi sokukhulelwa;
- uma kunokusetshenziswa kokudla okunama-kilojoule aphansi (ngaphansi kwenkulungwane eyi-kcal ngosuku);
- ukuncelisa;
- ngesikhathi sokuhlinzwa kakhulu noma ukulimala (ngokwethulwa kwemijovo ye-insulin).
Ukwelashwa okungafuneki kwabanesifo sikashukela abaneminyaka engaphezu kwengu-60, baphoqelelwa ukwenza umsebenzi onzima, ohambisana nomsebenzi omningi womzimba. Ngaphandle kwalokho, amathuba okukhula kwe-lactic acidosis aphezulu.
Phakathi kwemiphumela emibi evela ekusetshenzisweni kwezidakamizwa ze-hypoglycemic, okulandelayo kuyabonakala:
- Isiguli singakhononda ngokugayeka, okuwukuthi ukuhlanza, isicanucanu, ukunambitheka, ukuncipha noma ukuntuleka kokudla, ukwakheka kwegesi, ubuhlungu besisu kanye nohudo.
- Kwezinye izimo, ukuthuthukiswa kwe-megaloblastic anemia kungenzeka.
- Ngokulashwa isikhathi eside, uvithamini B12 uyeka ukumunwa ngokujwayelekile, obangela ukuntuleka.
- Ukuthuthukiswa kwe-lactic acidosis, hypoglycemia kanye nokuvela kwesiqubulo sesikhumba.
Amacala we-overdose kwesinye isikhathi anokwenzeka, okubandakanya ukuthuthukiswa kwe-lactic acidosis. Lesi simo siyingozi kakhulu ngoba kungaholela emiphumeleni ebulalayo. Izimpawu eziphambili ze-lactic acidosis ukuhlaselwa isicanucanu nokuhlanza, ukushisa komzimba okuphansi, isifo sohudo, ukungazi kahle kahle, isiyezi, izinhlungu zemisipha, ukuphefumula ngokushesha nokukhula komzimba.
Lapho kuvela izimpawu ezingenhla, isiguli kufanele siyiswe ngokushesha esibhedlela. Isikhungo sezokwelapha kumele sinqume ngokushesha izinga le-lactate kanye ne-hemodialysis.
Ukwelashwa okubonisa izimpawu kuyasetshenziswa futhi.
Ukuxhumana nezinye izinto zokwelapha
Akunasakhi sezidakamizwa esinjalo, lapho sisebenzisana nezinye izidakamizwa, esingeke sibe nomthelela emzimbeni womuntu.
Ngakho-ke nesakhi esichaziwe esisebenzayo: lapho kuhlanganiswa nezinto ezithile, kwenzeka i-hypoglycemia, lapho ihlanganiswa nezinye, i-hyperglycemia yenzeka, kanti nabanye, kuvela i-lactic acidosis.
Ukuhlanganiswa kwezinto ezibangela ukwanda okusheshayo kokugxila kwe-glucose kwabanesifo sikashukela akunconyiwe.
Le mithi yile:
- UDanazole;
- I-Chlorpromazine;
- ama-antipsychotic;
- glucocorticosteroids;
- isidakamizwa sokulawula ukuzalwa kwe-hormonal;
- Epinofirn;
- okuphuma ku-nicotinic acid ne-phenothiazine;
- i-loop diuretics;
- ama-hormone egilo;
- i-sympathomimetics;
- glucagon.
Izakhi ezilandelayo zokwelapha zandisa umphumela we-hypoglycemic:
- Okususelwa ku-sulfonylureas.
- Ama-NSAIDs.
- I-Mao ne-ACE inhibitors.
- I-Acarbose.
- ICyclophosphamide.
- Okususelwa ku-clofibrate.
- Umjovo we-insulin
- Ama-blocker e-Beta.
- I-Oxetetracycline.
Ukusetshenziswa kanyekanye kweziphuzo zotshwala ne-cimetidine kungaholela ekwakhiweni kwe-lactic acidosis. Ukusetshenziswa okuyinkimbinkimbi kwama-compact kanye nama-anticoagulants kungenza buthaka umphumela emzimbeni weyokugcina.
Iziguli eziningi zinesifiso sokuthi umuthi kanye nemithi elwa namagciwane isebenza kanjani. Abantu abanesifo sikashukela abelapha izifo zamagciwane abadingi ukungakhathazeki, ziyahambelana. Into esemqoka ukuzithatha ngezikhathi ezihlukile.
Ukubuyekezwa kwezindleko nokuxhumana
Imakethe yemithi inikezela ngamathebulethi amaningi ngesithako esisebenzayo esichaziwe.
Ngaphandle kokwakheka okuhlukile kwezakhi ezisizayo, amaphilisi awabizi kangako.
Isibonelo, izindleko eziseRussia zisukela kuma-ruble angama-90 kuya kwangama-260.
Intengo yeMetformin evela kwezinye izinkampani zamakhemikhali zakwamanye amazwe ayihlukile.
Izindleko zeMetformin ezivela kubakhiqizi bamanye amazwe abahlukahlukene yilezi:
- ISlovak - kusuka kuma-ruble ayi-130 kuye kwangama-210.
- IHungary - isuka kuma-ruble ayi-165 kuya kwangama-260.
- EPoland - kusuka kuma-ruble angama-75 kuye kwangama-320.
KwaMetformin, intengo ithembeke impela kuzo zonke iziguli. Leli ithuluzi elikhulu kakhulu lokuhlanganisa. Mayelana namaphilisi, ungathola izibuyekezo eziningi ezinhle kumaforamu ahlukahlukene. Ngempela, yisidakamizwa esinciphisa ngempumelelo ukugxilisa i-glucose. Ngokuphathwa okufanele, i-hypoglycemia cishe ayenzeki.
Nakhu okunye ukubuyekeza okuhle mayelana neMetformin evela eLyudmila (iminyaka engama-49):
Lesi sidakamizwa sokuqala esisize ukubhekana ne-hyperglycemia hhayi mina kuphela, kodwa futhi nomyeni wami. Siphuze futhi siyaqhubeka nokuyiphuza iminyaka emibili edlule. Kuyangipholisa impela, kimi awekho amanye amaphilisi. Vele, ekuqaleni bobabili bathola "ukuzivumelanisa nezimo", cishe amasonto ayi-1.5-2 kwaba nokuqunjelwa. Kepha manje izinga kashukela alidluli ku-6.5-7 mmol / l, futhi isisindo sami sehle ngamakhilogremu amane ngonyaka owedlule.
Ukubuyekezwa kodokotela nakho okuhle kakhulu. Ochwepheshe abaningi banquma lesi sidakamizwa ngenxa yempahla yaso ukuze sinciphise kancane kancane ushukela, ngaphandle kokuholela ku-hypoglycemia noma i-glycemic coma. Kodwa-ke, odokotela baxwayisa abantu abathatha isinqumo sokunciphisa isisindo ngokusebenzisa isithako esisebenzayo mayelana nomphumela wecala ongaba khona. Njengomthetho, odokotela abayinikezi leli khambi lokunciphisa isisindo.
Kwesinye isikhathi ungathola imibono engemihle evela ezigulini ezithatha i-compact. Zihlotshaniswa nepheshana lesisu elicasulayo. Iqiniso ukuthi isitho ngasinye sibona umuthi ngendlela ehlukile, ngakho-ke ubukhulu bokusabela okuhlukile nako kuhlukile. Kulokhu, abanye abanesifo sikashukela baphendukela ekwelashweni nomunye umenzeli we-hypoglycemic.
Isiguli esiphuza utshwala ngesikhathi sokwelashwa kweMetformin kufanele siqaphele izinkinga ezingaba khona ngenxa yokunganaki kwempilo yakhe.
Ama-analogues emithi yezokwelapha
Njengoba isakhi esichaziwe esisebenzayo asihambelani kubo bonke abantu abanesifo sikashukela, lapho bethinta isikhungo sezokwelapha, bakhethwa ama-analogues.
Phakathi kwalezi zimali, lezo eziqukethe isakhi esiyinhloko esifanayo, kanye nalezo eziqukethe izinto ezihlukile, kodwa ezinomphumela ofanayo wonyango, ziyahlukaniswa.
Izidakamizwa ezidume kakhulu ze-antidiabetic eziqukethe i-composed echaziwe yiGlyformin, iGlucofage, iMetfogamma Forte, iSiofor.
IGlatiniy Umuthi osekhaya. Ngaphezu kwento esebenzayo, kufakwa i-povidone, crospovidone, isitashi, i-silicon dioxide, i-glycerol ne-stearic acid.
IGlucophage yiphilisi elenziwa yiFrance. Empeleni, empeleni azifani. Ngakho-ke, udokotela kuphela ongalinganisa ukusebenza kwabo.
IMetfogamma Forte kungenye yezindleko ezingabizi. Ikakhulu, kuyaphumelela ekwehlulekeni ukwelashwa ngezidakamizwa ze-sulfonylurea. Ukuqanjwa kubandakanya izakhi ezifanayo.
I-Siofor - amaphilisi, ahlanganisa i-povidone, i-magnesium stearate, i-macrogol ne-silicon dioxide.
Ungathola ezinye iziphonsogama encwadini yezokwelapha kaVidal. Iwebhusayithi yeVidal inikeza isichasiselo mayelana nalo muthi, ukuthi usebenza kanjani, uvunyelwe ukuthi uwuphuze, nokuthi yini esiza. Yisiphi isidakamizwa esingcono kunzima ukusho. Isiguli sinquma lokhu uqobo, kususelwa kwinani lentengo nomphumela wokwelapha.
Ngokuzwela komuntu ngamunye engxenyeni eyinhloko, udokotela ubeka umuthi ogama lawo lihluke kakhulu. Isibonelo, i-Glibenclamide iyithebhulethi enomphumela we-hypoglycemic, antithrombotic and hypolipidemic. Ukuhlanganiswa kufaka ingxenye esebenzayo glibenclamide, Glucobai (Germany), Altar (Germany), njll. Nayo isihambile .Uvakashele umkhombandlela wezokwelapha weVidal, ungathola imininingwane kunoma iyiphi i-analogue enesithakazelo, ukwakheka kwayo nokuthi ihluke kanjani kwezinye izindlela.
Cishe zonke iziguli ezinesifo sikashukela zazizwa inzuzo lapho zithatha i-hydrochloride. Isetshenziswa yodwa noma imijovo ye-insulin. Futhi uma kungazelelwe amaphilisi engahambelani, qhathanisa nodokotela wakho amakhambi afanayo. Yikuphi okungcono kuzosiza ekuboneni ochwepheshe noma izinkomba zezokwelapha. Iphilisi idume ngokusebenza kahle kwayo, ngakho-ke nge-hyperglycemia kufanelekile ukuzama. Lapho uthatha i-glucose ubuyela kwesejwayelekile, futhi nempilo jikelele.
Ochwepheshe bazotshela ngezindawo ezinokwehlisa ushukela zeMetformin kuvidiyo kule ndatshana.
