I-Metformin notshwala yizitha ezinde futhi ezingenakufakelwa. Into ekhona ukuthi lo muthi ufakiwe ohlwini lwalezo zidakamizwa ezingeke zihlanganiswe notshwala.
Ngaphezu kwalokho, uma uthatha iMetmorphine kanye notshwala, ungathola ubuthi obunzima. Ngeshwa, kukude kakhulu ukuthi wonke umuntu azi ngalokhu, kungani ngezikhathi ezithile ukufa kweziguli ezinqunywe lo muthi kuqoshwa lapho kusenziwa utshwala.
Yini i-metformin?
Ngaphansi kwesidakamizwa iMetformin iqonde umuthi osetshenziswa ekwelapheni isifo sikashukela. Inhloso yawo eyinhloko ukunciphisa izinga lokuncipha kwe-insulin esigulini, kanye nokuvimbela ukuthuthukiswa kokukhuluphala.
Naphezu kweqiniso lokuthi uma uthatha iMetformin izinga le-insulin yegazi egazini alishintshi, umuthi uyakwazi ukuguqula indlela esebenza ngayo emzimbeni wesiguli. Ngakho-ke, ngokwesibonelo, into yayo esebenzayo isiza ukubambezela ukwakheka kwama-asidi wamafutha, ngenxa yalokho inqubo yokuguqula i-glucose kwezinye izinto ezidingwa ngumzimba isheshiswa.
Ngenxa yalokho, ukwakheka kwegazi lesiguli kuyathuthuka, futhi nezinga likashukela egazini lakhe liyancishiswa. Kuyaqapheleka ukuthi umuthi ungafinyelela ukunakwa okuphezulu egazini lesiguli kuphela ngemuva kwamahora ayisithupha ngemuva kokuwuthatha. Ngaphezu kwalokho, ukuqoqwa kwaso kuyancipha.
Kunezidakamizwa eziningana ezisuselwa kwiMetformin, zonke ezingabayiqembu le-Biguanide. Kwizidakamizwa ezikulolu chungechunge, ngokwesibonelo, umuntu angabiza uFenformin, Buformin, neMetformin uqobo. I-Sov remen6m eyokuqala emibili ayisebenzi, ngoba umphumela wayo oyiphutha ubuthi ubuthi besiguli nge-lactic acid.
Ngokuqondene neMetformin, kunamagama ambalwa alesi sidakamizwa, ngokwesibonelo, njengoGiliformin noma uFomuin Pliva. Imvamisa, iziguli ezinesifo sikashukela zibekelwa umuthi onjengeSiofor. Into ekhona ukuthi incasula kancane indlela yomguli futhi ishibhile kunezinye izinhlobo zeMetformin.
Kuyaqapheleka ukuthi yonke le mithi efakwe kuhlu inokwakheka okufanayo, ngenkathi ihlukile komunye nomunye ngezinga lokuhlanzwa kwezidakamizwa, kanye nasekwakheni kwezakhi ezisizayo. Kunoma ikuphi, zonke izidakamizwa ezikuleli qembu kufanele zithathwe kuphela ngokuyalelwa udokotela. Ngaphandle kwalokho, izinga likashukela wegazi lakhe lingase lehle kakhulu, okuzobangela ukoma kanye nokufa okuqhubekayo kwesiguli.
Uma unamathela kokubhalwe ngudokotela, kanye nemiyalo yomuthi, imvamisa ayikho imiphumela emibi. Ngasikhathi sinye, usimamisa ngokushesha isikhundla sesiguli, esinomthelela ekuthuthukisweni kwezimpawu ezijwayelekile zesifo sikashukela mellitus.
Ngenxa yalokhu, ukuthethelelwa okuzinzile kwalesi sifo esibi kungatholakala.
Imvamisa yokuphatha kanye nemiphumela emibi
I-Metformin, njenganoma yimuphi umuthi, inemiphumela yayo emibi. Ngakho-ke, ngokwesibonelo, ngokuvamile isiguli singathola ukungakhululeki okujwayelekile kanye nomuzwa wokucanuzelelwa kwenhliziyo. Kwezinye izimo, isifo sohudo siyatholakala, kanye nezehlakalo ezingezinhle ezinjenge-anemia ne-hypoglycemia. Umphumela oyingozi oyingozi kakhulu kungaba ubisi lwe-acidosis, kuyilapho iziguli eziningi zicabanga kanjalo: "uma ngiphuza utshwala obuncane, khona-ke ngingasebenzisa iMetformin ngasikhathi sinye." Lokhu kunjalo neze, ngoba ngisho nethamo elincane lotshwala lingalimaza kakhulu ukuthuthukiswa kwe-lactic acidosis.
Uthathwa yisiguli sikashukela, iMetformin imvama ukungena egazini ngegreythi yesisu. Njengoba ukusebenza kwawo kuthatha amahora amabili kuya kwayisikhombisa, lesi sidakamizwa kumele siphuzwe okungenani kathathu ngosuku. Uma kwenzeka weqa ukuthatha lo muthi, ukusebenza kwawo kuncishiswa kakhulu. Kungakho ungeke uvumele ukwamukelwa kotshwala ngenkathi ulashwa ngalo muthi.
Uma sikhuluma nge isiphuzo esinjenge-vodka, khona-ke utshwala bungena egazini cishe ngokushesha. Ngenxa yalokho, ngesikhathi sokuxhumana kwesidakamizwa esichaziwe ngotshwala, i-lactic acid ingahle ikhule, i-lactic acidosis ingahle ikhule. Kufanele kukhunjulwe ukuthi ngokomqondo, utshwala bungabuqeda ngemuva kwamahora ayisithupha kuya kwayisikhombisa ngemuva kokuphela kokuthatha lesi sidakamizwa. Kodwa-ke, iziphuzo ezidakayo zivimba umsebenzi wama-enzyme athile wesibindi, futhi lokhu, kungaholela ku-glycimia.
Ngakho-ke, akunakwenzeka ukuphuza utshwala ngeMetformin, uma kuphela ngoba isiguli sikashukela kufanele sigqoke ukuyeka ukwelashwa futhi siphuthe isilinganiso esisodwa salo muthi. Ngaphezu kwalokho, ezimweni eziningi, abaphuthelwa akekho, kodwa imithamo emibili yalesi sidakamizwa. Ngenxa yalokho, ukuphumelela kokwelashwa kwehla kakhulu futhi isiguli singazizwa siwohloka empilweni yabo.
Kunoma ikuphi, umuthi ochaziwe kufanele uphuzwe ngaphansi kokuqashwa ngokuqinile kodokotela. Iqiniso ngukuthi noma yikuphi ukwelashwa enkambweni yalo kudinga ukulungiswa, kuya ngemiphumela elindelekile.
Uma wenza umuthi wokuzilapha, ukusebenza kwawo kuzoba zero, futhi kwezinye izimo ukulimala okungathi sína kungenziwa esigulini.
Kuyini i-lactic acidosis?
Njengoba umuthi ochaziwe unokwakheka okuyinkimbinkimbi, ngesikhathi sokwelashwa ungalungiswa ukuphazamiseka kwe-metabolic. Ikakhulu uma kuthathwa notshwala.
Kulokhu, abantu abaningi abaphuzayo banobuthi, ngoba banokuphazamiseka komzimba. Into ekhona ukuthi ngemuva kokuthi isidakwa siphuze umuthi ochaziwe, ugezwe phansi notshwala, umzimba wakhe ungaqala ukukhiqiza inani elikhulu le-lactic acid.
Ngakho-ke, isiguli esphuze umthamo olandelayo wotshwala sithola ubuthi, okungaholela ekucindezelweni kwegazi okuncane, i-renal, i-cardiac noma ukwehluleka kwesibindi, izinkinga zamaphaphu. Izimpawu ze-lactic acidosis yilezi:
- Ukuba khona kwe-nausea obukhulu, okwandayo, ukuhlanza kakhulu.
- Ubuthakathaka nokunganaki.
- Ubuhlungu obukhali ngemuva kwe-sternum kanye nemisipha.
- Ukubonakala komsindo nokuphefumula okujulile.
- Isifo sikashukela esiqinile.
Esimweni esibi kakhulu, imiphumela yokuthatha iMetformin ingabonakala njengesimo sokuwa. Kuzwakala njengokwehla okucijile kwengcindezi, lapho isikhumba sivele siphuzi kakhulu, ubuso buye bakhombe, bese izandla nezinyawo “zingahola”. Imiphumela yobuthi ingenzeka kakhulu, ngokwesibonelo, kungaba ukwephulwa ekusebenzeni kwezitho zesistimu yenhliziyo
Ngaphezu kwalokho, lesi simo singase siqale ukuba nzima ngokwengeziwe njengoba emzimbeni wesiguli igazi lizungeza libi kakhulu, bese likhulisa isimo sesiguli. Esigabeni sokugcina salesi sifo, i-hypoxia yobuchopho ingakhula. Ngenxa yalokhu, isiguli sibhekene nokulahlekelwa ukwazi noma ukufa kusenesikhathi.
Uma umuntu enobuthi ngenxa yokuphuza lo muthi notshwala, udinga ucingo olusheshayo oluphuthumayo, kanye nokwelashwa okungelapheki.
Ngokwemvelo, kungcono ukungavumeli lokhu, ngakho-ke, okokuqala, kuzodingeka ukuthi ufunde imithetho yokuthatha iMetformin, ethi akufanele ithathwe ngokwesigaba uma isiguli sike saphuza utshwala phambilini. Lezo zakhamizi ezingawunaki lo mthetho zinobuthi ngendlela echaziwe, ziqhubeka nokululaza impilo yazo.
Kuyingozi kakhulu ubuthi obunjalo esimweni lapho isiguli sibuye senze iphutha ngomthamo womuthi. Kulokhu, ukufa kungenzeka emahoreni ambalwa.
Ngakho-ke, kunconyelwa ukuthi abanesifo sikashukela abaphathwa ngale ndlela bavame ukuyeka ukuphuza.
Usizo lokuqala lobuthi
Kunoma yikuphi, sonke isiguli sikashukela nezihlobo zakhe kufanele sazi okufanele sikwenze uma sinoshevu. Iqiniso ngukuthi imiphumela yalo mibi kakhulu, ngakho-ke into yokuqala ezodinga ukwenziwa ukuletha isakhamuzi esilimele esikhungweni sezokwelapha ngokushesha okukhulu. Esimweni esifanayo, lapho kumiswa ukuboshwa kokuphefumula, kanye nokuncipha kokugeleza kwegazi, kuzodingeka ukuthi ungabizi i-ambulensi kuphela, kodwa futhi wenze nezindlela zokuvuselela umuntu endaweni yakhe.
Ngaphambi kokuba i-ambulensi ifike, kunoma yisiphi isimo kuyodingeka ukuthi ihlinzeke ohlukunyezwa umoya omningi. Ngakho-ke esimweni lapho enoshevu ngenxa yokudla okwenziwe muva nje kwezokwelapha notshwala, nakanjani uzodinga ukunikeza ngokushesha umoya omusha.
Ngaphezu kwalokho, ngisho nangaphambi kokuba udokotela afike esigulini, kuyadingeka ukuthi aqale ngokuhlanza isisu ukuze avimbele ukufakwa kotshwala kanye nomuthi egazini lesiguli. Ngenhloso efanayo, unganika isisulu ukuthi siphuze cishe amalitha amahlanu amanzi afudumele ku-38-40 ° C. Futhi kuzodingeka ukuthi ubangele ukuhlanza kuye, okuthi izimpande zolimi nezansi zePharynx ziqale ukucasuka. Ngemuva kokuthi ukuhlanza kuqala, kuzodingeka unikeze isiphuzo esifudumele sesibili bese uphinda le nqubo amahlandla amane kuya kwayisithupha.
Ngokuqondene nokwelashwa okuthi ubuthi be-Metformin, empeleni kubhekiselwa ekulahlekeni okusebenzayo komzimba wesiguli kusuka kubuthi nakubuthi. Kulokhu, i-diuresis ephoqelelwe nge-alkalization efanayo yegazi ivame ukusetshenziswa. Ngaphezu kwalokho, umphumela omuhle futhi ohlala njalo unikezwa ukwelashwa ngama-antidote, okubandakanya ukwethulwa kwekhambi le-glucose elingama-20% ngaphakathi emithanjeni yesiguli ukuze kubuyelwe izinga layo elijwayelekile egazini. Futhi ezimweni ezinjalo, i-glycogen ilawulwa nge-intramuscularly.
Futhi, uma kunobungozi bokukhohlakala, isixazululo se-adrenaline sifakwa ngokungagudli, bese kuthi ngemuva kokudla izidakamizwa ezi-antidiabetic, banikeze ikhambi elifudumele le-sodium chloride, ebangela ukuhlanza. Okulandelayo, i-sodium sulfate inikezwa ngesilinganiso sepuni elilodwa nge-per yelitha lamanzi, eligezwa phansi ngetiye elimnandi noma ngamanzi. Ngokuzayo, isiguli sizokhonjiswa ukwelashwa okuyisimpawu kuphela.
Ngesikhathi sokwelashwa kwe-lactic acidosis enesifo sikashukela, kuyenqatshelwe ngokuphelele ukuphuza utshwala. Ngaphezu kwalokho, isiguli sizodinga ukuvikeleka ekuvezweni elangeni. Ukudla okuyisipesheli okunqunyiwe nakho kubekiwe.
Esimweni lapho i-acidosis ishiwo kancane futhi kungekho zimpawu zokuthuthumela kanti nezinso zisebenza ngokujwayelekile, kuzodingeka ukuthi kwenziwe ukuhlolwa kwelabhoratri kwe-alkalization nge-sodium bicarbonate.
Ividiyo ekulesi sihloko izokhuluma ngezindawo ezinokwehlisa ushukela zeMetformin.
