Iziguli eziningi ezinesifo sikashukela zinentshisekelo kulo mbuzo: Metformin noma Diabeteson - yini engcono?
Zombili lezi zidakamizwa zenzelwe ukwehlisa ushukela onhlobo 2 sikashukela mellitus.
Njalo ngonyaka isibalo sabantu abahlaselwa yilesi sifo siyakhuphuka, ngakho-ke kunesidingo sokukhetha izidakamizwa ezisebenza kahle ezinciphisa ushukela. Ukuthandwa phakathi kwezidakamizwa eziningi ze-hypoglycemic, ngayinye yazo inezinzuzo kanye nobubi obuthile.
Izici zokusebenzisa iMetformin
I-Metformin yisidakamizwa esidalwa isifo sokulwa nesifo sikashukela esisetshenziswa emhlabeni wonke Akumangazi ukuthi ingxenye eyinhloko ye-metformin - hydrochloride isetshenziswa kwezidakamizwa eziningi ezifanayo.
Izinkomba zokusetshenziswa kwalesi sidakamizwa yisifo sikashukela (2) ngaphandle kokuthambekela kwe-ketoacidosis, kanye nokuhlanganiswa nokwelashwa kwe-insulin.
Lokhu ngumehluko obonakalayo phakathi kweMetformin, ngoba iDiabeteson ayisetshenziswa ngemijovo yamahomoni.
Ukusetshenziswa kwomuthi kungavinjelwa uma:
- hypersensitivity kuzakhi zomuthi;
- ukuthwala ingane nokuncelisa;
- ukudla ngokungaphansi kuka-1000 kcal / usuku;
- isifo sikashukela kanye nekhohlo, iketoacidosis;
- izimo ze-hypoxia kanye nokuphelelwa ngamandla komzimba;
- izifo ezingapheli nezingamahlalakhona;
- izifo ezithathelwanayo;
- ukungenelela kokuhlinzwa;
- ukungasebenzi kwesibindi;
- i-lactic acidosis;
- ubuthi obunobungozi obukhulu;
- Izifundo ze-X-ray neze-radioisotope ngokwethulwa kwezinto eziqukethe iodine.
Ungawuthatha kanjani umuthi ngendlela efanele futhi malini? Udokotela ohlanganyelayo kuphela onganquma umthamo, kucatshangelwa izinga le-glycemia kanye nesimo isiguli esivamile. Umthamo wokumaphakathi wokuqala uhluka kusuka kuma-500 kuye kwangama-1000 mg ngosuku.
Inkambo yokwelashwa ihlala kuze kube amasonto amabili, emva kwalokho udokotela uguqula umthamo ngokuya ngempatho yomuthi. Ngenkathi kugcinwe okuqukethwe ushukela okujwayelekile, kuyadingeka ukuphuza kuze kufike ku-2000 mg ngosuku. Umthamo omkhulu wansuku zonke yi-3000 mg. Iziguli zokuguga (iminyaka engaphezu kwengu-60 ubudala) kufanele zidle kuze kufike ku-1000 mg ngosuku.
Njengomphumela wokusetshenziswa okungafanele noma ngenxa yanoma yiziphi ezinye izizathu, ukubonakala kokuphikiswa okungalungile kungenzeka:
- Isimo se-Hypoglycemic.
- I-Megablastic anemia.
- Imisipha yesikhumba.
- Ukuphazanyiswa kwe-vitamini B12.
- I-Lactic acidosis.
Kaningi, emavikini amabili okuqala ezokwelapha, iziguli eziningi ziba nokugayeka. Kungaba ukugabha, isifo sohudo, igesi ekhuphukayo, ukunambitheka kwensimbi noma ubuhlungu besisu. Ukuqeda izimpawu ezinjalo, isiguli sithatha ama-antispasmodics, okuphuma ku-atropine nama-antacid.
Nge-overdose, i-lactic acidosis ingahle ikhule. Esimweni esibi kakhulu, lesi simo siholela ekuthuthukisweni komqondo nokufa. Ngakho-ke, uma isiguli sinokuhlukumezeka kokugaya ukudla, ukwehla kwezinga lokushisa komzimba, ukuqothuka nokuphefumula ngokushesha, kufanele siphuthunyiswe esibhedlela ngokuphuthumayo!
Izici zesidakamizwa i-Diabeteson MV
Umuthi wangempela ubhekwa njengoDiabetes.
Muva nje, lesi sidakamizwa sisetshenziswe kancane, ngoba iDiabeteson ithathelwe indawo yiDiabeteson MV, ethathwa isikhathi esisodwa ngosuku.
Isakhi esiyinhloko somuthi we-hypoglycemic yi-gliclazide.
Umuthi ukhonjiswa ushukela (2), lapho ukwelashwa kokudla nemidlalo kungasizi amazinga aphansi kashukela.
Ngokungafani ne-Metformin, i-Diabeteson isetshenziselwa izinjongo zokuvimbela ukuvimbela ukukhula kwe-nephropathy, retinopathy, stroke, kanye ne-myocardial infarction.
Kwezinye izimo, ukusetshenziswa kwesidakamizwa i-Diabeteson MV kungahle kuvunyelwe kwiziguli ngenxa:
- hypersensitivity kuzakhi eziqukethwe;
- ukuthwala ingane nokuncelisa;
- ukusetshenziswa kwe-miconazole kulokho okuyinkimbinkimbi;
- isifo sikashukela esincike ku-insulin;
- iminyaka yezingane (kuze kube iminyaka eyi-18);
- isifo sikashukela sikashukela, i-thoroma ne-ketoacidosis;
- ukwehluleka okukhulu kwe-renal kanye / noma ukwehluleka kwesibindi.
Ngaphezu kwalokho, akukhuthazwa ukusebenzisa umuthi ngokuhlanganiswa ne-danazol noma i-phenylbutazone. Ngenxa yokuthi umuthi uqukethe i-lactose, ukusetshenziswa kwayo akunasidingo ezigulini ezihlushwa ukungakwazi ukubekezelela i-lactose, i-glucose / galactose malabsorption syndrome noma i-galactosemia. Akunconyelwe kakhulu ukusebenzisa iDiabeteson MV ubudala (ngaphezulu kweminyaka engama-65) nangokuthi:
- Ama-pathologies wezinhliziyo.
- Ukudla okungalinganiseli.
- Ukwehluleka kanye / noma ukwehluleka kwesibindi.
- Yehlise umsebenzi we-thyroid.
- Ukuntuleka kwe-pituitary noma ye-adrenal.
- Uphuzo oludakayo.
- Ukwelashwa isikhathi eside kwama-corticosteroids.
Uchwepheshe ozoya kuphela onquma umthamo ofunekayo womuthi. Imiyalo incoma ukuthatha umuthi ekuseni kanye ngosuku. Umthamo wansuku zonke uvela ku-30 kuye ku-120 mg. Ezigulini ezineminyaka engaphezu kwengama-65 ubudala, umthamo omkhulu ophakanyisiwe ungama-30 mg ngosuku. Imithamo efanayo kufanele ilandelwe ngamathuba aphezulu okuthuthukisa i-hypoglycemia. Njengomphumela wokusetshenziswa okungafanele, ukulimala okungaba khona kuDiabeteson kuboniswa kanjena:
- Ukwehla okusheshayo kwamazinga kashukela (ngenxa yokudalwa ngokweqile);
- umsebenzi owandayo wama-enzyme wesibindi - i-ALT, i-alkaline phosphatase, AST;
- i-cholestatic jaundice;
- Ukugaya ukudla kuyacasuka;
- ukwephulwa kwezinsiza ezibukwayo;
- ihepatitis
- ukuphazamiseka kwe-hematological (i-leukopenia, i-anemia, i-granulocytopenia ne-thrombocytopenia);
Ngaphezu kwalokho, ukuvela okuhlukahlukene kwesikhumba (ukuqubuka, i-edema kaQuincke, ukusabela kwe-bullous, ukulunywa) kungavela.
Ukuqhathaniswa Kwezidakamizwa
Kwesinye isikhathi ukuhambisana kwanoma yiziphi izidakamizwa ezimbili akunakwenzeka.
Ngenxa yokusebenzisa kwabo, imiphumela engaphenduki, noma ebulalayo ingenzeka.
Ngalesi sizathu, isiguli sidinga ukubona udokotela onaka zonke izinto ezingathinta ukusebenza komuthi, kungaba ngabe yi-Diabeteson noma iMetformin.
Kukhona inani elithile lezidakamizwa ezingakhulisa futhi zinciphise umphumela wokwelapha umuthi.
Izidakamizwa ezithuthukisa isenzo seMetformin, lapho isilinganiselo soshukela sincipha:
- Okususelwa ku-sulfonylureas.
- Umjovo we-insulin Ngokuvamile, akuvami ukwaluleka ukuthi ufake i-insulin ngokungabonakali usebenzisa izidakamizwa ezinciphisa ushukela.
- Okususelwa ku-clofibrate.
- Ama-NSAIDs.
- β-blockers.
- ICyclophosphamide.
- I-Mao ne-ACE inhibitors.
- I-Acarbose.
Imithi lapho ishukela evamile ngemuva kokuthatha i-Diabeteson MV incishisiwe:
- I-Miconazole;
- I-Phenylbutazone;
- I-Metformin;
- I-Acarbose;
- Imijovo ye-Insulin;
- Ama-Thiazolidinediones;
- I-GPP-1 agonists;
- Ama-block-blockers;
- I-Fluconazole;
- I-MAO ne-ACE inhibitors;
- Clarithromycin;
- Ama-Sulfonamides;
- I-Histamine H2 receptor blockers;
- Ama-NSAIDs
- I-DPP-4 inhibitors.
Kusho ukuthi kunomthelela ekwandeni kwenani likashukela lapho kuthathwa iMetformin:
- UDanazole
- I-Thiazide ne-loop diuretics.
- I-Chlorpromazine.
- Ama-antipsychotic.
- I-GCS.
- Epinofrin.
- Okususelwa ku-nicotinic acid.
- I-Sympathomimetics.
- Epinephrine
- I-hormone yegilo.
- I-Glucagon.
- Izindlela Zokuvimbela inzalo (ngomlomo).
Izidakamizwa ezikhulisa i-hyperglycemia uma isetshenziswa nge-Diabeteson MV:
- I-Ethanol;
- UDanazole;
- I-Chlorpromazine;
- I-GCS;
- I-Tetracosactide;
- Ama-agonist we-Beta2-adrenergic.
I-Metformin, uma ithatha umthamo omkhulu womuthi, yenza buthaka imiphumela yama-anticoagulants. Ukusetshenziswa kwe-cimetidine notshwala kubangela i-lactic acidosis.
I-Diabeteson MB ingakhuphula umphumela wama-anticoagulants emzimbeni.
Ukubuyekezwa kwezindleko nezidakamizwa
Intengo yomuthi nayo idlala indima ebalulekile. Lapho ukhetha umuthi odingekayo, isiguli asicabangeli nje kuphela umphumela waso wokwelapha, kodwa futhi nezindleko, ngokusekelwe emandleni aso ngokwezezimali.
Njengoba umuthi iMetformin uthandwa kakhulu, ukhiqizwa ngaphansi kwezimpawu eziningi zokuthengisa. Isibonelo, intengo yeMetformin Zentiva iyahlukahluka kusuka kuma-ruble ayi-105 kuye kwangama-160 (ngokuya ngesimo sokukhishwa), iMetformin Canon - isuka kuma-ruble ayi-115 kuye kwangama-245, iMetformin Teva - isuka kuma-ruble angama-90 kuye kwangama-285, neMetformin Richter - isuka kuma-ruble ayi-185 kuye kwangama-245.
Ngokuqondene nesidakamizwa i-Diabeteson MV, izindleko zayo ziyehluka kusuka kuma-ruble angama-300 kuya kwangama-330. Njengoba ubona, umehluko wentengo ubonakala kakhulu. Ngakho-ke, isiguli esinemali ephansi sizothambekele ekukhetheni inketho ebiza kakhulu.
Kwi-Intanethi ungathola izibuyekezo eziningi ezinhle ngazo zombili lezi zidakamizwa. Isibonelo, okunye ukuphawula kuka-Oksana (oneminyaka engama-56 ubudala): "Nginesifo sikashukela sohlobo 2, ekuqaleni bengingakwenza ngaphandle kwemijovo ye-insulin, kodwa ekugcineni kwadingeka ngaphendukele kubo. Ngeshwa, angikwazanga ukufinyelela amazinga ajwayelekile kashukela. Ngabe senginquma ukuthatha I-Metformin: Ngemuva kokuthi ngiphuze amaphilisi futhi ngangena ne-insulin, ushukela wami awuzange ukhuphuke ngaphezu kwe-6-6.5 mmol / l ... "Kubukezwa nguGeorge (iminyaka engama-49):" Akunandaba ukuthi mangaki ama-drugi okwehlisa ushukela engiwazamile, nguDiabeteson MV kuphela osiza ukubhekana nesimo ngezinga le-glucose. Angazi umuthi omuhle kakhulu ... "
Ngaphezu kwalokho, iningi labanesifo sikashukela elashwa ngeMetformin liphawule ukwehla kwesisindo somzimba samakhilogremu ambalwa. Ngokuya kokubuyekezwa kwalo muthi, kunciphisa isifiso sesiguli. Vele, awukwazi ukwenza ngaphandle kokudla okunempilo.
Ngasikhathi sinye, kunokubuyekezwa okungalungile ngemithi. Zihambisana kakhulu nokuba khona kwemiphumela emibi, ikakhulukazi nge-hypersensitivity, i-indichedion kanye nokwehla okubukhali koshukela.
Singaphetha ngokuthi muthi ngamunye unezinzuzo zawo nobubi bawo. Ukuthemba umbono wabanye abantu akuyifanele.
Isiguli nodokotela uqobo banquma ukuthi yimuphi umuthi abawukhethile, ngokunikwa ukusebenza kwawo kanye nezindleko zawo.
Analogs of Metformin and Diabeteson
Esimweni lapho isiguli sinemibono ethile yokwelashwa noma sinemiphumela emibi, udokotela ushintsha irejimeni yokwelashwa. Kulokhu, ukhetha umuthi onomphumela ofanayo wokwelapha.
I-Metformin inamanxusa amaningi afanayo. Phakathi kwezidakamizwa ezibandakanya i-metformin hydrochloride, Gliformin, Glucofage, Metfogamma, Siofor neFomuetin zingahlukaniswa. Masihlale eminye imininingwane nge-Glucofage yezidakamizwa.
Leli ikhambi elisebenzayo lokulawula izimpawu zesifo sikashukela.
Phakathi kwezici ezinhle zokusebenzisa umuthi i-Glucophage zingahlukaniswa:
- Ukulawulwa kwe-glycemic;
- ukuzinza kweglucose yegazi;
- ukuvimbela izinkinga;
- ukunciphisa umzimba.
Ngokuqondene nemibango, ayihlukile kune-Metformin. Ukusetshenziswa kwayo kukhawulelwe ebuntwaneni nasegangeni. Izindleko zomuthi ziyahlukahluka kusuka kuma-ruble ayi-105 kuye kwangama-320, ngokuya ngesimo sokukhishwa.
Yini engcono - Glucophage noma Diabeteson? Lo mbuzo awukwazi ukuphendulwa ngokungathandeki. Konke kuncike kwizinga le-glycemia, ukuba khona kwezinkinga, izifo ezenzeka kanye nenhlala-kahle yesiguli. Ngakho-ke, okufanele usebenzise - Diabeteson noma Glucophage, kunqunywa uchwepheshe kanye nesiguli.
Phakathi kwezidakamizwa ezifanayo ze-Diabeteson MV, Amaryl, Glyclada, Glibenclamide, Glimepiride, kanye neGlidiab MV zithathwa njengezithandwa kakhulu.
UGlidiab ngesinye isidakamizwa sokukhishwa esisebenzayo esishintshiwe. Phakathi kwezinzuzo zalo muthi, kuyadingeka ukugqamisa inani layo lokuvimbela ukukhula kwezinkinga ze-hemorheological. Futhi kunciphisa futhi kuqinise amazinga kashukela kwabanesifo sikashukela. Intengo yayo isukela kuma-ruble ayi-150 kuye kwangama-185.
Njengoba ubona, umehluko esenzweni, ukuphambana kanye nokuhlangana kwezidakamizwa kumele kubhekwe. Kodwa ukwelashwa ngezidakamizwa akuyona yonke. Ukubona imithetho yokudla okunempilo kanye nemfundo yomzimba, ungasusa ukuhlaselwa yi-glycemic futhi ugcine lesi sifo silawulwa.
Isiguli Esithandekayo! Uma ungakayiphuzi imishanguzo ye-hypoglycemic, kepha izinga lakho likashukela alulawulwa ngokudla nokuzivocavoca, thatha iMetformin noma i-Diabeteson. Le mithi emibili inciphisa ngempumelelo ushukela. Kodwa-ke, thintana nodokotela wakho kuqala. Ividiyo ekulesi sihloko izoqhubeka nesihloko sokusebenzisa iMetformin.
