I-Langerin ingesinye sezidakamizwa eziningi zokwelapha ezisetshenziselwa ukwelapha inqubo ye-pathological ebizwa ngokuthi i-mellitus engaxuthi ne-insulin. Umuthi uyingxenye yeqembu le-Biguanide lemithi, umthelela omkhulu walo okuhloswe ngalo ukunciphisa isidingo sokukhiqizwa kwe-insulin.
Intengo yeLangerin emakhemisi, ngokuya ngomthamo odingekayo, ingaqala kusuka kuma-ruble ayikhulu kuya kwamakhulu amathathu.
ILangerin umuthi wethebhulethi womlomo osetshenziswa ekwelapheni isifo sikashukela esiyinkimbinkimbi. Isakhi sayo esiyinhloko yi-izidakamizwa metformin. Umuthi ungenye yezidakamizwa ezinciphisa ushukela futhi uvame ukusetshenziselwa ukuguqula amazinga kashukela egazini abanesifo sikashukela.
Enye yemithi ebekiwe yomuthi onjalo ukuphathwa kwawo uma kungasebenzi kahle kwamathebulethi asetshenziswe ngaphambilini eqenjini le-sulfonylurea. Ngaphezu kwalokho, ukukhuluphala yinkinga evamile yabo bonke abantu abanesifo sikashukela.
Kungakho, iLangerin ivumela hhayi ukwehlisa izinga likashukela kuphela, kepha futhi inomthelela ekunciphiseni okwejwayelekile kwesisindo sesiguli.
Izici zokwelapha nezinkomba zokusetshenziswa
Indlela yokusebenza yesakhi esiyinhloko somuthi ihlotshaniswa namandla ayo okucindezela izinqubo ze-gluconeogeneis, kanye nezinqubo zokwenziwa kwamafutha acid yamahhala ne-oxidation yamafutha. Ummeleli wesigaba se-Biguanide akathinti inani le-insulin ekhishwe egazini, kodwa ushintsha ama-pharmacodynamics akhe ngokunciphisa isilinganiso se-insulin eboshwe ukuze ikhulule futhi andise isilinganiso se-insulin ku-proinsulin.
Iphuzu elibalulekile ekusetshenzisweni kwamathebhulethi anjalo ukukhuthaza ukuthathwa koshukela ngamaseli emisipha.
Isibonakaliso esiyinhloko sokusebenzisa umuthi ukuthuthukiswa kwesifo sikashukela esincike kumuntu kumuntu, ikakhulukazi nokungasebenzi kahle kokudla okulandelayo.
Izici zokwelapha eziphambili zeLangerin zifaka:
- kunciphisa inani le-glycated hemoglobinꓼ
- yenza ukungalingani kwe-insulin kukhiqize amaseli ku-insulinꓼ ye-hormone
- kuthinta kahle ukujwayezwa kwephrofayili ye-lipid ye-plasmaꓼ yegazi
- kunciphisa cholesterolꓼ embi
Ngaphezu kwalokho, ukusetshenziswa kwesidakamizwa kungaqinisa isisindo somzimba.
Imiyalo yokusebenzisa amaphilisi
Umuthi uLangerin uyatholakala ngesimo samathebhulethi efakiwe.
Izibhebhe zigcwele esikhwameni sepulasitiki, esivalwe ngocingo lwe-aluminium.
Amaphakethe afakwa ebhokisini lekhadibhodi kanye nemiyalo yokusebenzisa umuthi.
Ngokuya ngethamo elidingekayo lomuthi osetshenzisiwe, umuthi ungathengwa ngomthamo:
- 500 milligrams.
- 850 milligrams.
- Igremu elilodwa lezinto ezisebenzayo.
Indlela yokuthatha amaphilisi ngomlomo, ngesikhathi sokudla noma ngemuva kwayo. Udokotela obonayo unquma umthamo wesiguli ngasinye ngokwahlukana kwalesi sifo. Futhi, uchwepheshe wezokwelapha unquma inani lemithamo yemithi phakathi nosuku.
Imiyalo ye-Langerin yokusetshenziswa itusa ukuqala inkambo yokwelapha ngomthamo omncane ka-500 mg wento esebenzayo. Inani lemithamo yomuthi phakathi nosuku ingaba ukusuka kokuthathu. Kancane kancane, umthamo ungakhushulelwa ku-850 mg wento esebenzayo usuku lonke (kanye kabili ngosuku). Udokotela ozobheka isimo sesiguli futhi, hhayi isikhathi esingaphezu kwesonto, uguqula umthamo womuthi ophuzwe phezulu.
Umuthi futhi unqunyelwe ukwelashwa kwalesi sifo ezinganeni ezingaphezulu kweminyaka eyishumi. I-monotherapy kufanele iqale ngomthamo wama-500 mg wento esebenzayo kanye noma kabili ngosuku. Ngemuva kwesikhathi esithile, ukwanda kancane kancane komthamo womuthi kuvunyelwe, kepha akukho ngaphezulu kwamagremu amabili ngosuku, ahlukaniswe ngemithamo emibili noma emithathu.
Imvamisa, ushintsho kumthamo womuthi kwenzeka ngemuva kwezinsuku eziyishumi kuya kweziyishumi nanhlanu ngokuya ngemiphumela yokuhlolwa kwegazi kwezinga le-glucose.
Kwezinye izimo, ukulungiswa kwethebhulethi kuyingxenye yokwelapha okuhlanganisa imijovo ye-insulin.
Kufanele kuqashelwe ukuthi ukuphathwa kanyekanye kweLangerin nge-insulin, okuphuma kusulfonylurea, i-acarbose, noma i-ACE inhibitors kukhulisa umphumela we-hypoglycemic wezidakamizwa.
Kwezinye izimo, udokotela ohambelayo angahle athathe indawo yokusetshenziswa kweLangerin ngamathebhulethi enhlanganisela efanayo. Namuhla, kunenqwaba yemithi, isithako esiyisisekelo esisebenzayo sayo i-metformin.
Intengo yezidakamizwa ze-analog ingahluka kakhulu, kuya ngenkampani yomenzi wezidakamizwa.
Yiziphi izinkomba zokusetshenziswa?
Umthamo okhethwe ngokungeyikho noma ukungahambisani nezincomo zikadokotela oholayo kungavusa ukubukeka kokubi lapho uthatha umuthi.
Ngaphezu kwalokho, kunezimo lapho ukusetshenziswa komuthi osuselwa ku-metformin kungavunyelwe.
Imiyalo yokusebenzisa umuthi ikhombisa uhla lwe-contraindication eyinhloko.
I-contraindication eyinhloko yokusetshenziswa kwamacwecwe weLangerin afaka lokhu okulandelayo:
- ukulimazeka okukhulu kwesibindi noma ukusebenza kwezinso, ukungakwazi kwazoꓼ
- uphuzo oludakayo, kufaka phakathi isimo esingamahlalakhona
- inhliziyo noma ukwehluleka ukuphefumulaꓼ
- i-acute myocardial infarctionꓼ
- isimo sokukhubazeka sikashukela noma ukhokhoꓼ
- ukuthuthukiswa kwesifo sikashukela sonyawo lwesifo sikashukela
- phambi kokungabekezelelani komuntu ngamunye ku-metformin nokukhula kokungezwani komzimba okwenziwe ngengxenyeꓼ
- ukuba khona kwezifo ezithathelwanayo
- ukuzila ukudla ngesifo sikashukela noma ukulandela ukudla okungukudla kwansuku zonke okungekho ngaphezu kwamakhilogremu ayinkulungwane
- ngaphambi nangemva kokuhlinzwaꓼ
- ngokulimala okuningi kwakamuvaꓼ
- ngaphambi nangemva kokuxilonga okusebenzisa i-isotropes ye-iodineꓼ enethiwekhi
- ketoacidosis ne-lactic acidosis.
Ngaphezu kwalokho, abesifazane akufanele bawuphuze umuthi ngesikhathi sokukhulelwa nokuqunjelwa.
Ukuvela kwemiphumela emibi kungazibonakalisa engxenyeni yezitho ezahlukahlukene kanye nezinhlelo zomzimba womuntu - ipheshana lesisu, umetabolism, uhlelo lwenhliziyo, izibalo zesikhumba. Imiphumela emibi ephikisayo engaba khona ngenxa yokuphuza umuthi yilena:
- Ukuphakanyiswa okuphezulu. Kwesinye isikhathi isicanucanu senzeka ngohlobo 2 lwesifo sikashukela. Isicanucanu singabekwa esikhundleni sokuhlanza.
- Uhlobo lwesisu esibuhlungu.
- Ukuvela kokunambitheka kwensimbi emgodini womlomo.
- IHematopoiesis kanye ne-heestasis.
- I-anemopablastic anemia.
- Ukwehlisa ushukela wegazi ngaphansi kwezinga elamukelekayo - i-hypoglycemia.
- Ukubonakala kobuthakathaka emzimbeni.
- Ukomela.
- I-Hypotension.
- Ukuphazamiseka kokuphefumula.
- Ukuvela kwesikhumba noma ukuqubuka esikhunjeni.
Ukuqapha kufanele kuthathwe lapho uthatha i-Langerin neminye imithi. Ukusetshenziswa kanyekanye kwamathebhulethi nge-cymeditine kukhulisa ubungozi be-lactic acidosis. Inhlanganisela yeLangerin ene-loop diuretics ingakha umphumela ofanayo. Kulokhu, ngaphezu kokubonakaliswa kwe-lactic acidosis, ukubonakaliswa kokwehluleka kwezinso kungabhekwa.
Kusetshenziswa umuthi, kuyadingeka ukuqapha ukusebenza okujwayelekile kwezinso nokuthola inani le-lactate ku-plasma okungenani kabili ngonyaka.
Imininingwane ngezidakamizwa ezisetshenziselwa ukwelapha isifo sikashukela inikezwe kuvidiyo kule ndatshana.
