Ukuguqula ushukela wegazi kushukela, kusetshenziswa izidakamizwa ezikhethekile zokunciphisa ushukela. I-Metformin ibhekwa njengomuthi omuhle kakhulu wokulungisa i-glycemia.
Umuthi unenombolo enkulu yama-generics kanye ne-analogues yeqembu. Abanesifo sikashukela banesifiso, kepha kuthiwani uma iMetformin inemiphumela emibi? Vele, bakhona.
Kepha ngokushesha ngithanda ukuqaphela ukuthi noma yiziphi izinkinga zivela kuphela ngomthamo okhethwe ngokungalungile. Uma udokotela ekhetha umthamo ofanele, futhi ngaphambi kwalapho afunde ngokucophelela umlando wezokwelapha wesiguli, khona-ke amathuba emiphumela emibi acishe abe yi-zero.
Inani kanye nendlela yokusebenza kwesidakamizwa
I-Metformin isidakamizwa esidalwa yi-hypoglycemic esivela eqenjini le-Biguanide. Iyini intengo yomuthi? Ekhemisi, izindleko ezimaphakathi zeMetformin zingama-ruble ayi-120-200. Iphakethe elilodwa liqukethe amaphilisi angama-30.
Isakhi esisebenzayo somuthi yi-metformin hydrochloride. Futhi iqukethe izithako ezisizayo, njenge-E171, propylene glycol, talc, hypromellose, silicon dioxide, magnesium stearate, isitashi sommbila, i-povidone.
Ngakho-ke uyini umphumela wamakhemikhali we-metformin? Uma ukholelwa imiyalo yokusebenzisa umuthi, isakhi sawo esisebenzayo sisebenza ngokulandelayo:
- Iphelisa ukumelana ne-insulin. Lesi yisici esibaluleke kakhulu, njengoba iziguli eziningi ezinesifo sikashukela ziqala ukumelana nemiphumela ye-insulin. Lokhu kugqame ngokuqamba kwe-hyperglycemic coma nezinye izifo ezibucayi.
- Isiza ukwehlisa ukufakwa kweglue kusuka emathunjini. Ngenxa yalokhu, isiguli asinakho ukweqa okubukhali ushukela wegazi. Ngokuya ngomthamo ofanele weMetformin, izinga leshukela lizinza. Kepha kunohlangothini lwemali. I-Metformin hydrochloride ehambisana ne-insulin therapy ingaholela ekwakhiweni kwe-hypoglycemic coma. Kungakho ngokusetshenziswa kanyekanye kwalesi sidakamizwa kanye nokusetshenziswa kwe-insulin, kungenzeka kulungiswe ukulungiswa komthamo.
- Inqanda i-gluconeogenesis esibindini. Le nqubo iqukethe ukufakwa esikhundleni kwe-glucose, umzimba owuthola emithonjeni yamanye amandla. Ngenxa yokulibaziseka kokukhiqizwa kwe-glucose kusuka ku-lactic acid, ukugcwala ushukela kanye nezinye izinkinga zesifo sikashukela kungagwenywa.
- Yehlisa hamu. Kaningi, uhlobo 2 sikashukela luwumphumela wokukhuluphala. Kungakho, ngokumelene nesizinda sokwelashwa kokudla, isiguli sinconyelwa ukusebenzisa izidakamizwa ezisizayo. I-Metformin ihlukile ngohlobo lwayo, ngoba ayisizi nje kuphela ukuzinzisa ushukela wegazi, kodwa futhi ikhulisa ukusebenza kahle kokulashwa kokudla ngo-20-50%.
- Ijwayelekile i-cholesterol yegazi. Uma usebenzisa iMetformin, ukwehla kwezinga lama-triglycerides kanye ne-low density lipoprotein kuyabonakala.
I-Metformin hydrochloride futhi ivimbela inqubo ye-peroxidation yamafutha. Lolu uhlobo lokuvimbela umdlavuza.
Izinkomba nemiyalo yokusebenzisa iMetformin
Kukuziphi izimo lapho ukusetshenziswa kweMetformin kufanelekile? Uma ukholelwa imiyalo yokusebenzisa, umuthi ungasetshenziswa ekwelapheni isifo sikashukela sohlobo 2.
Ngaphezu kwalokho, amaphilisi angasetshenziswa njenge-monotherapy noma ukwelashwa okuhlanganisa namanye ama-hypoglycemic agents. Enye ikhambi isetshenziswa kabanzi ezimweni lapho ukwelashwa kokudla kungasizi isifo sikashukela.
Kuyaqapheleka ukuthi izinkomba zokusetshenziswa kweMetformin azikhawulwanga kulokhu. Umuthi usetshenziswa kabanzi ekwelapheni i-prediabetes kanye ne-cleropolicystosis yama-ovari. Phakathi kwezinkomba ezisetshenziswayo, i-metabolic syndrome kanye nokukhuluphisa nakho kuhlukaniswa, kuhambisana nentuthuko yokulwa ne-insulin.
Ungayikhetha kanjani imithamo ye-Metformin? Umthamo wansuku zonke weMetformin ungakhethwa kuphela. Kulokhu, udokotela kumele azijwayeze imininingwane yomlando, ngoba lomenzeli we-hypoglycemic unezindlela eziningi zokuphikisana okufanele zisetshenziswe.
Ngithanda ukuqaphela ukuthi iMetformin iyatholakala kumakhambi ahlukahlukene. Kungaba yi-1000, 850, 500, 750 mg. Ngaphezu kwalokho kunemithi yesifo sikashukela esihlanganisiwe equkethe cishe i-400 mg ye-metformin hydrochloride.
Ngakho-ke, imuphi umthamo osalungile? Umthamo wokuqala weMetformin ngu-500 mg, futhi imvamisa yokuphatha iyizikhathi ezingama-2-3 ngosuku. Udinga ukusebenzisa umuthi ngokushesha ngemuva kokudla.
Ngemuva kwamasonto ambalwa elashwa, umthamo ungashintshwa. Konke kuzoncika kushukela wegazi. I-Glycemia inconywa ukukalwa nsuku zonke esiswini esingenalutho. Ngalezi zinhloso, kungcono ukusebenzisa i-glucometer.
Kuthatha isikhathi esingakanani iMetformin? Akukwazi ukuphendula lo mbuzo. Lapho ukhetha isikhathi sokwelashwa, izici zomuntu ngamunye zizocatshangelwa, ikakhulukazi, izinga likashukela wegazi, isisindo nobudala. Ukwelashwa kungathatha izinsuku eziyi-15, izinsuku ezingama-21, noma “ukudlula” ngenyanga.
Umthamo omkhulu weMetformin ngu-2000 mg ngosuku. Kumele kuqashelwe ukuthi ngokusetshenziswa kanyekanye kwe-insulin, umthamo kufanele wehliswe ku-500-850 mg ngosuku.
Contraindication kanye nezici zesidakamizwa
Noma yimuphi umenzeli anciphisa ushukela kufanele akhethwe ngokucophelela, ngoba kunokuphikisana kokusetshenziswa. Ukunganaki kokufunda imiyalo kumane akwamukeleki, ngoba lokhu kungabulala nokufa.
Ngakho-ke, yiziphi izinto eziphikisanayo iMetformin enazo? Ukwephulwa okuqinile kokuwusebenzisa kungukungezwani nezinto ezenziwa nge-metformin hydrochloride noma izingxenye zomsizi zomuthi.
Faka phakathi ne-contraindication:
- I-acute noma i-acidosis engamahlalakhona.
- Okusanda kuhlupheka ukuqothuka kwe-myocardial.
- Ukwehluleka kwenhliziyo okuphathekayo noma okungamahlalakhona.
- Ukuba khona kwezinkinga zezinso. Ithuluzi alivumelekile ukuba lithathwe kubantu abahlushwa ukungaphatheki kahle kwe-renal.
- Ukuguga. Umuthi awunqunyelwe abanesifo sikashukela abaneminyaka engaphezu kweminyaka engama-80.
- Ukuba khona kokuhluleka kwesibindi noma ezinye izifo eziyingozi zohlelo lwe-hepatobiliary.
- Ukuzivocavoca okwedlulele noma ukudla okuqinile, okunikezela ukunciphisa okukhulu kokudla kwe-caloric.
- Ukwehla komzimba ngenxa yokuba khona kwezifo ezithathelanayo.
- Utshwala
Okunye ukuphikisana okunamandla yi-hypoxia, ulcer esiswini kanye ne-duodenal ulcer.
Imiphumela Emibi yeMetformin
Imiphi imiphumela emibi yeMetformin? Kukhona into efana nengozi eyisisekelo yama-hypoglycemic agents, ikakhulukazi iMetformin. Kuhlanganisani?
Iqiniso ukuthi ngesifo sikashukela sohlobo 2, isiguli kufanele siqaphe njalo okuqukethwe kwekhalori ekudleni, futhi ikakhulukazi inani lama-carbohydrate akulo. Uma isifo sikashukela sisebenzisa ama-hypoglycemic agents, futhi sihlala ekudleni okuqinile, khona-ke amathuba okuthola i-hypoglycemia aphezulu kakhulu - ukwehla okubukhali kweglucose yegazi.
Phakathi kwemiphumela emibi yeMetformin nayo ingahlukaniswa:
- Ukwephulwa kohlelo lwe-hematopoietic. Lapho kusetshenziswa iMetformin, kungenzeka ukuthi i-thrombocytopenia, i-leukocytopenia, i-erythrocytopenia, i-granulocytopenia, i-hemolytic anemia, i-pancytopenia. Kepha kufanele kuqashelwe ukuthi zonke lezi zinkinga ziphinde ziphenduke, futhi bazixazululele ngemuva kokukhanselwa kwalo muthi.
- Ukwehluleka kwesibindi. Zibonisa njengokuthuthuka kokuhluleka kwesibindi kanye ne-hepatitis. Kepha ngemuva kokwenqaba iMetformin, lezi zingqinamba ziyazixazulula. Lokhu kufakazelwa ukubuyekezwa kodokotela neziguli.
- Ukuphazamiseka kwengqondo. Le nkinga yenzeka kaningi kakhulu. Ukuthi ngqo inqubo yokuthuthukiswa kokuphazamiseka ukunambitheka ngaphansi kwethonya le-metformin hydrochloride ayaziwa.
- Isikhumba isikhumba, i-erythema, i-urticaria.
- I-Lactic acidosis. Le nkinga iyingozi kakhulu. Imvamisa iba khona uma ngabe kukhethwe umthamo ongalungile, noma uma onesifo sikashukela ephuze utshwala ngenkathi elashwa.
- Ukuphazamiseka emsebenzini wokugaya ukudla. Lolu hlobo lokuxakeka lubonakala kaningi ngokwanele, njengoba kufakazelwa ukubuyekeza kweziguli. Ukuphazamiseka emgudwini wokugaya ukudla kuboniswa ngendlela yesicanucanu, ukugabha, ukunambitheka kwensimbi emlonyeni, kanye nokuntuleka kokudla. Kepha ngokulunga kufanele kuqashelwe ukuthi lezi zinkinga zivame ukuvela ezigabeni zokuqala zokwelashwa, bese zizisombulula.
- Ukufakwa kwe-vitamin B12 okwehlisiwe.
- Ubuthakathaka obujwayelekile.
- I-Hypoglycemic coma.
Uma kuvela izinkinga ezingenhla, kunconywa ukusebenzisa izifaniso zeqembu leMetformin nokwelashwa okubonakalayo.
Ukusebenzelana Nezidakamizwa Metformin
I-Metformin yehlisa ushukela wegazi. Kepha lapho uxhumana nemithi ethile, lo muthi uyathuthukisa, noma okuphambene nalokho, wehlisa umphumela wawo we-hypoglycemic.
Lokhu kungaholela emiphumeleni engenakuphikwa. Ngingathanda ngokushesha ukuqaphela ukuthi imiphumela ye-hypoglycemic ithuthukiswa kakhulu lapho kuhlanganiswa iMetformin ne-sulfonylurea derivatives. Kulokhu, ukulungiswa komthamo kuyadingeka.
Okulandelayo futhi kungandisa kakhulu umphumela we-hypoglycemic weMetformin:
- I-Acarbose.
- Izidakamizwa ezingezona ezokwehlisa ukuvuvukala ezingezona ezibangelwa ukuvuvukala.
- I-Monoamine oxidase inhibitors.
- I-Oxetetracycline.
- Angiotensin-converting enzyme inhibitors.
- ICyclophosphamide.
- Okususelwa ku-clofibrate.
- Ama-blocker e-Beta.
Ama-corticosteroids, ama-diuretics, ama-analogues we-samostanin anciphisa ukusebenza kokwelashwa kwesifo sikashukela nge-Metformin. Kwaphawulwa futhi ukuthi umphumela we-hypoglycemic uyancipha ngokusetshenziswa kanyekanye kwe-glucagon, ama-hormone egilo, ama-estrogens, ama-nicotinic acid, ama-calcium antagonists nama-isoniazids.
Kumele futhi kukhunjulwe ukuthi i-cimetomedin, lapho isebenzisana ne-Metformin, ikhulisa amathuba okukhula kwe-lactic acidosis.
Yisiphi isidakamizwa esingasetshenziswa kanye ne-metformin?
Ekwelashweni kwesifo sikashukela, umuthi onjengeJanuvia uvame ukunqunywa ngokubambisana neMetformin. Izindleko zayo zingama-ruble ayi-1300-1500. Isakhi esisebenzayo somuthi yi-sitagliptin.
Le nto ivimbela i-DPP-4, futhi inyusa inani lama-GLP-1 ne-HIP. Ama-hormone omndeni wama-incretin athunyelwa emathunjini usuku, ngemuva kwalokho izinga lawo liphakama ngemuva kokudla.
Ama-incretin ayingxenye ebalulekile yohlelo lomzimba lokulawula i-glucose homeostasis. Ngamazinga kashukela egazi aphakanyisiwe, ama-hormone avela kulo mndeni andisa i-insulin synthes and secretion yayo ngamaseli e-beta.
Ungawuthatha kanjani umuthi? Umthamo wokuqala ngu-100 mg 1 isikhathi ngosuku. Kepha futhi, udokotela ofanele kufanele akhethe umthamo ofanele. Ukulungiswa kuvunyelwe, ikakhulukazi uma uJanuvia esetshenziswa ngokuhlangana neMetformin.
Contraindication nokusetshenziswa kweJanuvia:
- Thayipha isifo sikashukela sokuqala.
- Ukungezwani nezidakamizwa ezikhona.
- Isifo sikashukela sikashukela.
- Isikhathi sokukhulelwa nokukhulelwa.
- Iminyaka yezingane.
- Ngokuqapha ekwehlulekeni kwesibindi. Ngokungasebenzi kahle kohlelo lwe-hepatobiliary, ukuncishiswa komthamo kungenzeka kudingekile. Lokhu kufakazelwa idatha yocwaningo, nokubuyekezwa kwama-endocrinologists.
Ngabe umuthi unemiphumela emibi? Yiqiniso, banendawo okufanele babe kuyo. Kepha uJanuvia uvame ukudala izinkinga lapho umthamo ukhuphuka ufike kuma-200 mg. Ngenkathi kugcina imithamo ephansi, amathuba emiphumela emincane mancane.
Ngokusho kwemiyalo, lapho uphuza amaphilisi, ubunzima obufana nokutheleleka kwezifo zokuphefumula, i-nasopharyngitis, ikhanda, isifo sohudo, isicanucanu, ukuhlanza, i-arthralgia kungakhula.
Futhi, amathuba okuphendula komzimba kanye ne-hypoglycemia angeke kukhishwe.
I-analogue enhle kakhulu yeMetformin
I-analogue enhle kakhulu yeMetformin yi-Avandia. Le ejenti ye-hypoglycemic iyabiza impela - ama-ruble angama-5000-5500. Iphakethe elilodwa liqukethe amaphilisi angama-28.
Isakhi esisebenzayo somuthi yi-rosiglitazone. I-Avandia isetshenziswa ekwelapheni isifo sikashukela sohlobo 2. Ngaphezu kwalokho, singasetshenziswa ngokubambisana ne-Metformin, futhi singasetshenziswa ngokwehlukana.
Ungasikhetha kanjani isikhathi sokuphuza amaphilisi? Kumele kushiwo khona lapho ukuthi ungaphuza umuthi ngaphambi noma ngemuva kokudla. Umthamo wokuqala ngu-4 mg ngosuku ngemithamo ye-1-2. Ngemuva kwamaviki angama-6-8, umthamo ungakhuphuka kabili. Ukunyuka kwenziwa uma ku-4 mg ukujwayelekile kashukela wegazi akubonwa.
Ukuxhumana kokusetshenziswa kwesidakamizwa:
- Thayipha isifo sikashukela sokuqala.
- Ukungezwani komzimba kwizakhi zomuthi.
- Isikhathi sokuzala.
- Iminyaka yezingane (kuze kube iminyaka eyi-18).
- Ukukhulelwa
- Inhliziyo enkulu noma ukuhluleka kwezinso.
Lapho usebenzisa i-Avandia, izingqinamba ezivela ezithweni zezinhlelo zokuphefumula noma zenhliziyo ziyenzeka.
Kukhona futhi amathuba okunyusa isisindo somzimba. Imiyalo futhi ibeka ukuthi ikhambi lingaholela ku-anemia, ukungasebenzi kahle kwesibindi ne-hypercholesterolemia. Kepha ukubuyekezwa kweziguli kukhombisa ukuthi ukwelashwa okwelashwa kubekezelelwa kahle. Ividiyo ekulesi sihloko izokhuluma ngokuthi iMetformin isebenza kanjani.
