I-Maninil noma iMetformin, okungcono, umbuzo onjalo uvame ukuzwakala ezigulini ezinesifo sikashukela. Ukuze uphendule lo mbuzo, kuyadingeka ukuthi utadishe ngokuningiliziwe izici zemithi yomibili, i-contraindication yazo, izimo zokusebenzisa kanye nemiphumela emibi engenzeka ngokusetshenziswa kwazo.
Yomibili le mishanguzo inezakhiwo ze-hypoglycemic. Zombili lezi zidakamizwa zisetshenziswa ekwelapheni isifo sikashukela sohlobo 2. Imithi ihloselwe ukwehlisa izinga le-glucose kwiplasma yegazi yeziguli ezinesifo sikashukela sohlobo 2.
Umuthi ngamunye unezinzuzo zako kanye nobubi bawo, okufanele ubhekwe ngudokotela ohambayo lapho enza uhlobo oluthile lokwelashwa kweziguli. Lapho wenza uhlobo lokwelashwa, udokotela oholayo uyanquma. Yimuphi umuthi ozoba ophumelela kakhulu futhi omnene kakhulu kumuntu, kucatshangelwa izici zomzimba womuntu ogulayo.
Imithi ingeyamaqembu ehlukene ama-hypoglycemic agents.
IManinil ingumuthi ovela eqenjini le-sulfonylurea elithathwe ezizukulwaneni ezi-3.
I-Metformin ingumuthi weqembu le-Biguanide.
Izici zokwelapha umuthi Maninil
Isithako esikhulu esisebenzayo seManinyl yi-glibenclamide - 1- {4- [2- (5- [chloro-2-methoxybenzamido) ethyl] benzensulfonyl} -3-cycloxyxylurea. Leli khompiyutha elisebenzayo lisuselwa ku-sulfonylurea futhi linempahla ye-hypoglycemic.
Isenzo somuthi sincike emandleni okuwehlisa amazinga kashukela ngokuvuselela inqubo yokukhiqizwa nokukhululwa kwe-insulin ngamaseli we-beta wezicubu ze-pancreatic. Umphumela wesidakamizwa uncike ezingeni leshukela endaweni yemaseli we-beta.
Ithuluzi lezokwelapha lisiza ukuvimbela kwenqubo yokukhululwa kwe-glucagon amaseli we-pancreatic alpha. Ukusetshenziswa kwalesi sidakamizwa kukhulisa ukuthikamezeka kwe-insulin etholakala ngaphezu kwengqimba yeseli yamangqamuzana ezinsizakalo zomzimba ezithobela insulin.
Ngemuva kokulawulwa komuthi umuthi emzimbeni womuntu ogulayo, kucishe kungenwe ngokuphelele egazini. Ukuthatha umuthi ngasikhathi sinye ngokudla akukuphazamisi kakhulu inqubo yokumuncwa, umuntu kufanele akhumbule ukuthi ukuthatha lo muthi ngokudla kungaholela ekunciphiseni kwengxenye esebenzayo eplasma yegazi.
Isakhiwo esisebenzayo sibopha i-albhamu ye-plasma, izinga lokubopha lifinyelela ku-98%.
Ukuhlushwa okuphezulu kwesidakamizwa kutholakala emahoreni angama-1-2 ngemuva kokufakwa kwomuthi emzimbeni.
Umuthi ulolongwa cishe ngokuphelele esibindini ungene kuma-metabolites amabili ayinhloko. Lezi metabolites yilezi:
- I-4-trans-hydroxy-glibenclamide.
- I-3-cis-hydroxy-glibenclamide.
Yomibili le mikhiqizo ye-metabolic isuswa ngokuphelele emzimbeni ngamanani alinganayo, zombili yi-bile nomchamo. Ukuhoxiswa komuthi kwenziwa ngaphezulu kwamahora angama-45-72. Ukuphila kwesigamu sokwakheka okusebenzayo okusebenzayo kusuka emahoreni amabili kuya kwayi-5.
Uma isiguli sinesimo esinamandla sokwehluleka kwezinso, kunamathuba amaningi okuqongelelwa umuthi emzimbeni wesiguli.
Imithamo nokuhlanganiswa kweManinil nezinye izidakamizwa
Ukuqokwa kukaManilin ngudokotela ohambelayo kufanele kuhambisane nokulungiswa kokudla okufanelekile. Umthamo wesidakamizwa osetshenzisiwe uncike ngokuphelele kuzinkomba zamazinga kashukela eplasma yegazi atholakala ngesikhathi sokucwaninga.
Ukusetshenziswa komuthi kufanele kuqale ngemithamo emincane. Umthamo omncane weManinil yi-½-1 ithebhulethi kaManinil 3.5. Le nguqulo yesidakamizwa iqukethe i-3.5 mg yesithako esisebenzayo esisebenzayo. Esigabeni sokuqala sokwelashwa, umuthi kufanele uphuzwe kanye ngosuku.
Umthamo wokuqala osetshenzisiwe ungakhula kancane kancane uma kunesidingo. Isilinganiso esiphezulu somuthi esifanelekile ngu-15 mg / ngosuku.
Ukudlulisela isiguli ekusetshenzisweni kweManinil kusuka kwamanye amadivaysi ezokwelapha kufanele kwenziwe ngokuqapha.
Maninil singasetshenziswa zombili ngesikhathi monotherapy futhi njengengxenye yokwelashwa inhlanganisela. Ngesikhathi sokwelashwa, Maninil angasetshenziswa ngokuhlangana neMetformin. Uma isiguli singakubekezeleli iMetformin, iManinil ingasetshenziswa ngesikhathi sokwelashwa ngezidakamizwa zeqembu le-glitazone.
Uma kunesidingo, ukuhlanganiswa kweManinil nezidakamizwa ezinjengeGuarem ne-Acarbose kuvunyelwe.
Lapho uthatha umuthi, amaphilisi akufanele ahlafunwe. Ukuphuza umuthi kufanele kuhambisane nokuphuza amanzi amaningi. Isikhathi esifanele sokuthatha umuthi isikhathi ngaphambi kwesidlo sasekuseni.
Uma kwenzeka ulahlekelwe yisikhathi sokuphatha, ungasebenzisi umthamo ophindwe kabili womuthi.
Isikhathi sokwelashwa kwe-mono-futhi esiyinkimbinkimbi kuya ngesimo sesiguli kanye nohlobo lwenkambo yesifo.
Ngesikhathi sokulashwa, ukuqapha okujwayelekile kwesimo sezinqubo ze-metabolic kuyadingeka. Ushukela weplasma kufanele ubhekwe njalo.
Izinkomba kanye ne-contraindication zokusetshenziswa kweManinil
Isibonakaliso sokusebenzisa umuthi ubukhona besifo sikashukela sohlobo II esigulini.
Ukusetshenziswa kwesidakamizwa kunesizathu uma ukusetshenziswa komzimba okulinganiselayo nokudla okukhethekile kungakwazi ukuholela emiphumeleni emihle ebonakalayo lapho welapha isifo sikashukela sohlobo 2.
Njenganoma yimuphi umuthi, iManinil inezinombolo eziningi zokuphikisana okufanele zisetshenziswe.
I-contraindication eyinhloko ekusebenziseni umuthi yile elandelayo:
- isiguli sinokuzwela okwengeziwe komzimba ku-glibenclamide noma ezinye izinto zomuthi;
- isiguli sinokuzwela okwengeziwe kokutholwa kwe-sulfonylurea;
- ukuthuthukiswa kwesiguli esinohlobo lwe-1 isifo sikashukela;
- i-ketoacidosis yesifo sikashukela, ukuthuthukiswa kwezimpawu zesifo sokuqaqamba kwenhliziyo nesifo sikashukela;
- ukutholwa kokuhluleka okukhulu kwesibindi esigulini;
- ukuba khona kokwehluleka okukhulu kwezinso;
- ukutholwa kwe-leukopenia;
- ukwephulwa okukhulu ekusebenzeni kwendlela yokugaya ukudla;
- ukuba khona kokungabekezelelwani kwamafa nesiguli se-lactose;
- isikhathi sokukhulelwa nokuqunjelwa;
- iminyaka yesiguli ingafika eminyakeni eyi-18.
Ukuqashelwa ikakhulukazi kufanele kusetshenziswe lapho kunqunywa umuthi lapho isiguli siveze ukuba khona kwezifo ze-thyroid ezidala ukwephulwa komsebenzi osebenzayo.
Ukwakheka, izinkomba kanye nokuphikisana kokusetshenziswa kwe-Metformin
IMetformin yithebhulethi eyindilinga, ye-biconvex enombala omhlophe. Izibhebhe zenziwe ngaphandle ngokuhlanganiswa kwangaphakathi.
Isakhi esisebenzayo somuthi yi-metformin hydrochloride.
Ngaphezu kwalokho, ukwakheka kwalesi sidakamizwa kufaka uhla lonke lwezinto ezengeziwe ezenza umsebenzi wokusiza.
Izingxenye ezisizayo zifaka okulandelayo:
- IPovidone.
- Isitashi sombila.
- I-Crospovidone.
- Magnesium stearate.
- I-Talc.
Ukwakheka kwegobolondo kufaka phakathi okulandelayo:
- methaconic acid;
- methyl methacrylate Copolymer;
- macrogol 6000;
- titanium dioxide;
- i-talcum powder.
Izinkomba eziphambili zokusebenzisa umuthi yilezi ezilandelayo:
- Ukuba khona kwesifo sikashukela mellitus sohlobo lwesibili, lapho kungekho khona ukuthambekela kokuthuthukisa i-ketoacidosis, lapho kungekho khona ukungasebenzi kahle kwezindlela zokudla.
- Ekwelapheni uhlobo lwesifo sikashukela sohlobo 2 kuhlangene ne-insulin, ikakhulukazi lapho kunesilinganiso sokukhuluphala, esihambisana nokubonakala kokungabekezeleli kwe-insulin.
Ukuxhumana ngokusetshenziswa kwe-Metformin yile:
- ukuba khona kwe-precoma, kukoma, noma uma kutholakala isifo sikashukela;
- ukuba khona komsebenzi we-renal okhubazekile;
- ukukhonjwa kwezifo ezinzima ezenzeka ngokubonakala kwesilinganiso esikhulu sengozi yokuthola ukuphazamiseka kokusebenza kwezinso;
- isimo sokuphelelwa ngamandla, umkhuhlane, izifo ezinzima, isimo sokulamba komoya-mpilo;
- ukuba khona komzimba wezifo ezingelapheki nezingamahlalakhona okungaholela ekuqubukeni kokudalwa komoya-mpilo kwamangqamuzana ezicubu;
- ukuphazamiseka kokusebenza kwesibindi;
- uphuzo oludakayo, ubuthi obukhulu ngeziphuzo zotshwala;
- ukuthuthukiswa kwezimpawu ze-lactic acidosis;
- ukusetshenziswa kokudla okuphansi kwekhalori;
- isikhathi sokukhulelwa nokuqunjelwa;
I-contraindication eyengeziwe ukuqina kwesiguli kwizakhi zomuthi.
Izici ze-Pharmacological zeMetformin
Ukusetshenziswa kwomuthi kusiza ukwehlisa ijubane i-gluconeogeneis kumaseli wesibindi futhi kwehlise izinga lokufakwa kweglucose kusuka kulumbo lwamathumbu. Umuthi uthuthukisa ukuzwela kwamaseli we-insulin athembela ku-insulin.
I-Metformin ayikwazi ukuthonya inqubo yokukhiqizwa kwe-insulin ngamaseli e-pancreatic izicubu. Ukusetshenziswa kwalesi sidakamizwa akubeki ukubonakala kwezimpawu ze-hypoglycemia emzimbeni wesiguli.
Ukwethulwa kweMetformin emzimbeni kunganciphisa okuqukethwe yi-triglycerides kanye ne-low density lipoprotein.
Ngaphezu kwalokho, umuthi usiza ukunciphisa noma ukuqinisa isisindo somzimba. I-bioavailability yesidakamizwa ngu-50-60%. Iqoqo eliphezulu lomuthi ngemuva kokufakwa emzimbeni litholakala ngemuva kwamahora ayi-2,5. IMetformin cishe ayibophele amaprotheni e-plasma, inganqwabelana emangqamuzaneni e-salivary gce, kumaseli wezicubu zomsipha, isibindi nezinso.
Ukuhoxiswa kwalo muthi kwenziwa ngokungashintshwa yizinso. Ukuqedwa kwesigamu sempilo kwenza kusuka emahoreni ayi-9 kuye kwayi-12.
Ekwelashweni kokwelashwa okuhlanganisa, ingxube ye-Metformin ne-insulin ingasetshenziswa.
Ukusetshenziswa kweManinil lapho kukhona ukuphazamiseka okuthile ngokomzimba emzimbeni kungadala ukulimala esigulini ngenxa yokuvela kwenqwaba yemiphumela emibi. Uma kuqhathaniswa neManinil, ukulimaza umzimba weMetformin kwehle kakhulu.
Ukusetshenziswa kweMetformin kuvame kakhulu ukucaphukisa ukubonakala kokuphazamiseka kokugaya ezigulini. Ukubonakaliswa okunjalo kuhudo kanye ne-dyspepsia.
Zombili lezi zidakamizwa ziyasebenza impela uma zisetshenziswa ngokulandela imiyalo esetshenzisiwe.
Ukusetshenziswa kweMetformin 850 kuyanconywa uma isiguli esinesifo sikashukela sohlobo lwesibili sikhuluphele. Lokhu kukhetha kwezidakamizwa kungenxa yomphumela iMetformin onayo emzimbeni - ukwehla noma ukuqina kwesisindo somzimba sesiguli.
Ividiyo ekulesi sihloko ikhuluma ngesenzo seMetformin.
