Izindlela ezivela eqenjini le-Biguanide kudala zisetshenziswa ekwelapheni isifo sikashukela sohlobo 2. Kodwa-ke, izidakamizwa ezinjalo zinemiphumela emibi eminingi. Ngabe lokhu kusho ukuthi i-metformin ayinampilo, ngoba yiyo eseyisithako esiyinhloko ekwakhiweni kwezidakamizwa ezinje?
Namuhla, kutholakala izakhiwo ezintsha zalo msebenzi futhi ukusetshenziswa kwawo kukhula ngokwenele, kusetshenziswa umuthi hhayi kuphela ekwelapheni okunesifo sikashukela.
Isidakamizwa iMetformin kudala sisetshenziselwa ukwelapha isifo sikashukela sohlobo lwe-2 ngokuhlangana nokudla okunqunywe ngudokotela. Akuvumeli nje kuphela ukwenza izinga leshukela egazini lijwayeze, kepha futhi kuyasiza ekwehliseni isisindo ngokweqile, okubaluleke kakhulu kubantu abanalesi sifo.
Kuze kube manje, ezinye izici zalo muthi nazo sezihlonziwe. Kusungulwe ngokwesayensi ukuthi umuntu angathatha iMetformin ukufeza izinhloso ezilandelayo:
- Kuvikela ubuchopho ekuguga, okukuvumela ukuthi kusetshenziselwe izinjongo ze-prophylactic emelana nesifo i-Alzheimer's.
- Sithinta kahle isimo semithambo yegazi nemithambo yegazi. Ngakho-ke, ngosizo lweMetformin, ukuthuthukiswa kwe-vasher atherosulinosis, ukuhluleka kwenhliziyo, umfutho wegazi ophakeme, ukubalwa kwemithambo yegazi kungavinjelwa.
- Yehlisa amathuba womdlavuza.
- Ithinta kakhulu ukuthuthukiswa kwe-potency emadodeni, okwakhubazeka ngenxa yezifo ezihlukahlukene ze-senile.
- Ikunciphisa ukuthuthukiswa kwamathambo kwabanesifo sikashukela. Ikakhulu kaningi, abesifazane bahlushwa amathambo ama-brittle ngemuva kokunqamuka kokuya esikhathini, ngoba kukhona ukwehla okukhulu kwama-hormone - estrogen.
- Kuthinta kahle ukusebenza kwe-gland yegilo.
- Inomsebenzi wokuzivikela maqondana nohlelo lokuphefumula.
Ngaphandle kokuthi umuthi unezinzuzo eziningi kangaka, akunakwenzeka ukusho ukuthi uphilile futhi ungalapha izifo eziningi. Njengamanye amadivaysi ezokwelapha, iMetformin ingasetshenziswa kuphela njengoba iqondiswe udokotela oholayo, kucatshangelwa ukuthi kungenzeka kuboniswe yonke imiphumela yayo emibi kanye nokuphikiswa.
Izici ze-pharmacological zomuthi
I-Metformin umuthi wekilasi we-Biguanide osetshenziswa ngokuqinile ekwelapheni isifo sikashukela sohlobo 2.
Into esemqoka yokusebenza kwesidakamizwa yiMetroformin hydrochloride, i-silicon dioxide, ipovidone, i-magnesium stearate, i-macrogol asetshenziswa njengezakhi ezisizayo.
Umuthi usetshenziswa ngenkuthalo ukwehlisa ushukela wegazi. Ngaso leso sikhathi, ukwehla kwezinkomba kwenzeka hhayi kuphela ngemuva kokudla okuyinhloko, kodwa futhi kukuvumela ukuthi wehlise izinga lesisekelo. Isakhi esisebenzayo samathebhulethi sikuvumela ukuthi ulawule ukukhiqizwa kwe-insulin ngama-pancreas, athinta umzimba kahle futhi ungavusi ukuthuthukiswa kwe-hypoglycemia. Ngaphezu kwalokho, phakathi kwemiphumela emihle ifaka:
- ukungathathi hlangothi kwe-hyperinsulinomy;
- kunomthelela ekunciphiseni isisindo;
- kunciphisa ubungozi bokuthola izifo zohlelo lwethambo nenhliziyo;
- ithinta kahle i-lipid metabolism emzimbeni;
- kunciphisa inqubo ye-oxidation yamafutha;
- kunciphisa amazinga aphakeme e-cholesterol embi;
- kunciphisa ubungozi be-angiopathy yesifo sikashukela;
- kunciphisa ama-triglycerides.
Umuthi uthathwa ngomlomo, emva kwalokho ngemuva kwamahora amabili kuya kwamathathu umsebenzi wawo omkhulu uqala ukuvela. Cishe amahora ayisithupha ngemuva kokuthatha umuthi, i-plasma concentration ye-metformin iyancipha, ngoba ukufakwa kwengxenye esebenzayo kuyaphela.
Lapho uthola ukwelashwa nalesi sidakamizwa ngemuva kwezinsuku ezimbalwa, ungabona ukubakhona kwayo egazini ngamanani amancane.
Imiyalo yokusebenzisa umuthi
I-Metformin yezidakamizwa iyatholakala ngesimo sethebhulethi emithanjeni ehlukahlukene. Umuthi ungathengwa emakhemisi asedolobheni kule mithamo elandelayo:
- I-500 mg yento esebenzayo kwithebhulethi eyodwa;
- I-850 mg yesithako esisebenzayo;
- I-1000 mg ye-metformin.
Kuya ngomthamo, imithetho yokuphuza umuthi izoncika. Kumele kuqashelwe ukuthi udokotela oholayo kuphela ongancomela ukusetshenziswa kwalesi sidakamizwa, kufaka nokufaka okunye esikhundleni somuthi owaphuzwa ngaphambili. Inkambo yokwelashwa ichazwa kumthamo ophuma esithombeni esivamile somtholampilo walesi sifo kanye nezimpawu zomzimba womuntu ogulayo. Isinkomba esikhulu okudingeka unake ngaso uma ukhetha umthamo yigazi le-glucose egazini kanye nesigaba sesisindo sesiguli.
Umthamo omncane lapho ukwelashwa kuqala khona kungu-500 mg wesidakamizwa ngokwanda okulandelayo okulandelayo. Ngaphezu kwalokho, umthamo owodwa futhi awukwazi ukudlula isibalo esingenhla. Ukuze ukwazi ukubekezelela kangcono umuthi, kanye nasendabeni yemithamo ephezulu, inani lemithamo lingahlukaniswa kabili noma kathathu ngosuku. Ngakho-ke, kuzokwazi ukuvimbela ukuthuthukiswa kwemiphumela emibi. Umthamo omkhulu kakhulu wesidakamizwa akufanele wedlule i-3000 mg yento esebenzayo.
Kwezinye izimo, ngokwesibonelo, ukuthatha umuthi ngezinhloso ze-prophylactic, umthamo kufanele wehliswe amahlandla amabili kuya kwamathathu.
Umphumela omkhulu wokuphuza umuthi utholakala ngemuva kwesikhathi sokulashwa esithatha amasonto amabili.
Uma, ngenxa yezimo ezithile, umuthi ulahlekile, asikho isidingo sokuwunxephezela ngokwandisa umthamo olandelayo.
Lapho uthatha umuthi, kuyadingeka ukuthi ucabangele inkambo ejwayelekile yezinqubo ze-metabolic nempilo enhle.
Kumele kuqashelwe ukuthi kunobungozi obukhulu be-lactic acidosis.
Imiphumela emibi yokuphuza umuthi
Ukwelashwa nokwelashwa ngeMetformin kufanele kwenzeke ngaphansi kokuqashwa eduze kwezokwelapha. Akwamukelekile ukuthi uthathe lo muthi ngemithamo edlula izincomo zikadokotela, noma ngokuhlangana neminye imithi ekhethwe yisiguli.
Ukusetshenziswa okungalungile kweMetformin kungadala imiphumela emibi eminingi, izakhiwo eziyingozi zomuthi womzimba womuntu zizovuleka.
Ukubonakaliswa okungekuhle kwesidakamizwa kubandakanya lokhu okulandelayo:
- izinkinga zokugaya ukudla, okungahle kuhambisane nokubumbana, izinhlungu esiswini noma uhudo;
- imvubelo yensimbi engathandeki emlonyeni ingavela ngemuva kokudla;
- isicanucanu nokuhlanza
- ukuntuleka kwamaqembu athile wamavithamini, ikakhulukazi i-B12, ngakho-ke, kuyanconywa ukuthi ukuthola okungeziwe kwezakhiwo ezikhethekile zemithi, ezingamisa izinga lazo zonke izinto ezidingekayo emzimbeni
- ukubonakaliswa kokungafani komzimba engxenyeni eyodwa noma eziningi zomuthi;
- ukubonakala kwe-hypoglycemia;
- ukuthuthukiswa kwe-lactic acidosis;
- i-megaloblastic anemia ku-mellitus yesifo sikashukela.
Futhi yize iMetformin ifakiwe eqenjini lemithi ephephile, kufanele ufunde ngokucophelela konke ukubonakala okungalungile. Umuthi onjalo ungaba yingozi uma ungalandeli imithetho efanelekile yokuphathwa kwawo.
Eminye yemiphumela emibi ejwayelekile evela ekusetshenzisweni komuthi yi-lactic acidosis. Lesi simo sihambisana nezimpawu ezinjengokwehla kokuqina, ukuqina kwemisipha, ukwehla kwezinga lokushisa lomzimba nomfutho wegazi, nobunzima bokuphefumula. Ngokukhula kwesifo esinjalo, isiguli sidinga ukulashwa ngokuphuthumayo esibhedlela.
I-Lactic acidosis ingenye yemiphumela emibi eyenzeka ngenxa yokuqina ngokweqile komuthi.
Kukweziphi izimo ukunqatshelwa kwemithi?
I-Metformin yezidakamizwa inohlu olubalulekile lwe-contraindication ekusebenziseni kwayo.
Ngakho-ke, ngaphambi kokuqala inkambo yokwelashwa, kufanele ufunde ngokucophelela imiyalo. Uma kwenzeka kuba nemiphumela emibi, kufanele uthintane nodokotela wakho futhi nixoxe ngezinyathelo ezengeziwe maqondana nokuthatha umuthi.
Kuyenqatshelwa ukusebenzisa umuthi lapho kunezici nezifo ezilandelayo:
- ekwelashweni kohlobo lwe-1 isifo sikashukela, iziguli ezithembele ku-insulin;
- ukuthuthukiswa kwe-ketoacidosis, ikoma noma idlozi lohlobo lwesifo sikashukela;
- izinqubo ezibucayi ze-pathological ezinsweni noma esibindini, kanye nokuba khona kokuntuleka kwazo;
- ezinye izifo zomgudu wokuphefumula, futhi uma kunzima ukuphefumula;
- izifo zesistimu yenhliziyo, ukwehluleka kwenhliziyo noma ukufakelwa kwenhliziyo;
- ukuthuthukiswa kwesifo esibangelwa izifo ezahlukahlukene;
- ukuhlinzwa nokulimala kwakamuva;
- ngakusasa nangemva kokuhlolwa okuthile kokuxilonga, lokhu kufaka i-radiography noma i-radioisotropic diagnostics, ngoba kusetshenziswa i-ejenti yokuqhathanisa enokuqukethwe kwe-iodine.
- i-lactic acidosis;
- ukungabekezeleli noma i-hypersensitivity engxenyeni eyodwa noma eziningi zomuthi;
- phambi kokuphelelwa ngamanzi emzimbeni;
- ukudakwa okungapheli noma ukusetshenziswa kabi kotshwala njalo.
Amantombazane nabesifazane abakhulelwe ngesikhathi sokuqunjelwa ayenqatshelwa ukuthatha iMetformin, njengoba kunezinkinga eziningi ngokukhula okuvamile kwesibeletho. Ngesidingo esiphuthumayo somuthi, owesifazane kufanele ayeke ukuncelisa ibele.
Ngaphezu kwalokho, izingane ezingaphansi kweminyaka eyishumi nanhlanu zisengozini.
Izimpikiswano zomuthi iMetformin
Ukubuyekezwa kweziguli kubonisa umphumela omuhle owalethwa ukwelashwa kweMetformin. Izindleko zayo eziphakathi nendawo emkhakheni weRussian Federation zingasukela kuma-ruble ayi-170 kuye kwangama-260.
Uma kunesidingo, udokotela ohambelayo angangena esikhundleni somunye umkhiqizo wezokwelapha ngokuqanjwa okufanayo noma izakhiwo ezifanayo. Kuze kube manje, imakethe yamakhemikhali inikezela ngezifanekiselo ezilandelayo zesidakamizwa iMetformin, okuthi ngokwezibuyekezo, futhi ibe nemiphumela emihle:
- I-Glucophage - amaphilisi okwehlisa ushukela atholakala kwimithamo ehlukahlukene. Isithako esikhulu esisebenzayo yi-metformin hydrochloride. Isiza ngokwejwayelekile amazinga eglucose ngaphandle kokubangela i-hypoglycemia. Isigaba sentengo samathebhulethi anjalo, njengomthetho, awadluli kuma-ruble angama-200.
- I-Bagomet - umuthi, ekwakhekeni kwayo okukhona izinto ezimbili ezisebenzayo ngasikhathi sinye - i-metformin ne-glibenclamide. Lokhu kulungiselelo elihlanganisiwe elihlanganisa izakhiwo ze-Biguanides ne-sulfonylurea derivatives. Ngokuvamile kusetshenziselwa ukwelapha isifo sikashukela sohlobo 2. Intengo ephakathi yesidakamizwa ama-ruble angama-210-240.
- I-Siofor isidakamizwa esivela eqenjini le-Biguanide, okuyi-analogue ephelele yamathebulethi weMetformin. Intengo yayo ephakathi kumakhemisi asedolobheni ingahluka kusuka kuma-ruble angama-250 kuya kwangama-350.
- I-Sofamet - amaphilisi aqhamuka ekilasini lama-dimethylbiguanides, atholakala kwimithamo ehlukahlukene. Ngokuya ngenani lezinto ezisebenzayo, izindleko zomuthi ziyasungulwa. Njengomthetho, inani lentengo leSofamed kumakhemisi ehlukene aleli dolobha alidluli kuma-ruble ayi-130;
- UNova Met.
Kuze kube manje, inani le-analogues noma izichasazi impela. Zonke, njengomthetho, zinezindawo ezifanayo noma ezifanayo, kepha ziyehluka enkampanini yokukhiqiza, intengo, igama. Ngaphezu kwalokho, ochwepheshe bezokwelapha batusa ukusetshenziswa kwaleyo mishini yezokwelapha equkethe, ngaphezu kwengxenye eyisebenzayo, inani elincane lamadivayisi asizayo.
Imininingwane yeMetformin inikezwe kuvidiyo ekulesi sihloko.
