I-Metformin yinto engokwama-Biguanides. I-Metformin umuthi wezokwelapha osetshenziselwa ukwelapha isifo sikashukela.
Isenzo somuthi sisuselwa eqinisweni lokuthi liyakwazi ukuvimba inqubo ye-gluconeogenesis kumaseli wezicubu zesibindi, yehlise izinga lokuncipha kwe-glucose kusuka ku-lumen yamathumbu futhi ithuthukise izinqubo zokusebenzisa ushukela we-glucose.
Ngaphezu kwalokho, amaphilisi we-Metformin 850 mg akhulisa ukuzwela kwe-insulin kumaseli wezicubu zomzimba ezi-insulin.
Ukusetshenziswa kwesidakamizwa akunawo umthelela okhethekile enqubweni yokukhiqizwa kwe-insulin emanyikweni, akuvimbi ukuthuthuka kwesimo se-hypoglycemia emzimbeni. Ukuthatha umuthi kunganciphisa ukugcwala kwama-triglycerides nama-lipoprotein egazini.
Ukwakheka kwalo muthi kanye nezakhiwo zawo zokwelapha
Umuthi uvimbela ukuthuthukiswa kwe-polyperation yezakhi zemisipha ebushelelezi yezindonga zesistimu ye-vascular. Umphumela omuhle wesidakamizwa esimweni esivamile senhliziyo nenqubo yemithambo yembule futhi uvimbele ukuthuthukiswa kwe-angiopathy yesifo sikashukela.
Ukwelashwa kwesifo sikashukela ngeMetformin kungachazwa udokotela wakho kuphela ngemuva kokuhlolwa kweziguli ngokuphelele. Isikhathi sokwelashwa kanye nemithi yemithi esetshenziswayo kunqunywa kucatshangelwa zonke izici zenkathi yesifo emzimbeni wesiguli.
Into esebenzayo yesidakamizwa yiMetformin hydrochloride. Ithebhulethi elilodwa liqukethe ama-850 mg wekhompiyutha esebenzayo. Ngaphezu kwekhompiyutha enkulu, ukwakheka kwalo muthi kufaka phakathi amakhompiyutha asizayo.
Izakhi zamakhemikhali ezakha insiza yezokwelapha yilezi ezilandelayo:
- calcium phosphate dibasic;
- isitashi sommbila;
- i-lactose;
- i-povidone;
- i-sodium benzoate;
- i-talc;
- i-magnesium stearate;
- i-sodium starch glycolate;
- titanium dioxide;
- hydroxypropyl methylcellulose;
- i-ethyl cellulose;
- propylene glycol;
- polyethylene glycol.
Ukuphuza kwe-Metformin akulithinti izinga le-hormone emzimbeni womuntu, kepha kunesandla ekushintsheni kwe-pharmacodynamics yayo, eyenzeka ngenxa yokwehla kwesilinganiso esiphakathi kwe-insulin nekhululekile, ukwanda kwesilinganiso emzimbeni womuntu phakathi kwe-insulin ne-proinsulin. Enye yezinyathelo ezibaluleke kakhulu ekusebenzeni kwesenzo somuthi ukukhuthaza ukusetshenziswa kweglucose ngamaseli emisipha.
Into esebenzayo ithuthukisa ukuhamba kwegazi kwizicubu zesibindi futhi isize ukusheshisa ukucubungula i-glucose kuyi-glycogen. Ukusetshenziswa kweMetformin 850 mg kuthuthukisa izakhiwo zegazi ze-fibrinolytic. Lokhu kungenxa yokucindezela kwe-tishu plasminogen activator inhibitor.
Ukufakwa kwento esebenzayo kwenziwa kusuka ku-lumen wepheshana lesisu futhi kuyinkomba esukela ku-48 iye ku-52%. Isikhathi sokuphila sengxenye esebenzayo singamahora ayi-6.5. Into esebenzayo ikhishwa emzimbeni womuntu ngesimo sayo sokuqala. Ingxenye esebenzayo ayihlangani ne-protein complexes ye-plasma yegazi. Ukuqongelelwa umuthi kwenzeka ezinhlafunweni ze-salivary, izicubu zemisipha, izinso nesibindi. Ukukhishwa emzimbeni wezinso ezinhlotsheni zokwakhiwa komchamo.
Ngokukhula kokuphazamiseka ekusebenzeni kohlelo lomchamo, umuthi unqwabelana ezinso.
Izinkomba kanye ne-contraindication yokusebenzisa umuthi
Izinkomba eziphambili zokusebenzisa yilezi ezilandelayo:
- ukuba khona kohlobo lwesifo sikashukela sohlobo 2 ngaphandle kokuthambekela kokuvelela kokuvela kwe-ketoacidosis;
- ukuba khona kwesifo sikashukela ngokungabikho kokuphumelela kokulashwa kokudla;
- ukwelashwa kwesifo sikashukela sohlobo 2 kuhlangene nokwelashwa kwe-insulin, ikakhulukazi ngesilinganiso sokukhuluphala, okuhambisana nokuvela kokuphikiswa kwesibili kwe-insulin ye-hormone.
I-contraindication eyinhloko ukusetshenziswa komuthi ekwelapheni isifo sikashukela sohlobo 2 yile elandelayo:
- ukuthuthukiswa emzimbeni we-ketoacidosis yesifo sikashukela, i-diabetes noma i-coma;
- umsebenzi wokuphazamiseka kwezinso;
- ukuvela nokuthuthuka komzimba wesiguli kwezifo eziqatha ezinobungozi bokuphazamiseka kwemithambo yezinso - ukomisa, umkhuhlane, i-hypoxia, izifo ezithathelwanayo zezinso, ukuthuthukiswa kwezifo ezibangwa yi-bronchopulmonary
- ukuthuthukiswa kwezifo ezingelapheki futhi ezingalapheki ezingavusa ukuqhubeka kwe-izicubu hypoxia;
- ukungenelela okukhulu kokuhlinzwa emzimbeni kanye nesiguli esithola ukulimala okungathi sína emzimbeni;
- ukwenzeka nokuqhubeka kokuphazamiseka ekusebenzeni kwesibindi;
- isiguli sinobudakwa obungamahlalakhona noma ubuthi obudakayo obukhulu;
- ukuthuthukiswa komzimba we-lactic acidosis;
- isidingo sokudla kwe-hypocaloric;
- isikhathi sokukhulelwa;
- inkathi yokuhlanza;
- isiguli sine-hypersensitivity ezingxenyeni zomuthi.
Kuyenqatshelwa ukusebenzisa iMetformin ezinsukwini ezi-2 ngaphambi nezinsuku ezi-2 ngemuva kokuhlolwa komsakazo ngomzimba usebenzisa i-chemical i-iodine equkethe i-chemical ihlanganiswa.
Imiyalo yokusebenzisa umuthi
Ukuze wazi ukuthi uwaphuza kanjani umuthi ngendlela efanele, kufanele uthintane nodokotela wakho. Isiguli kufanele sifundwe ngemiyalo yokusebenzisa iMetformin.
Umthamo wesidakamizwa ubekwa kuphela yi-endocrinologist eye khona. Udokotela unquma umthamo wesiguli ngasinye, ngokunaka imiphumela etholakala ngesikhathi kuhlolwa umzimba futhi unaka nezimpawu zomzimba wesiguli. Umthamo womuthi isiguli okufanele usiphuze uncike kakhulu emazingeni kashukela eplasma yegazi emzimbeni wesiguli.
Ukuze uthathe iMetformin kahle, umthamo wokuqala kufanele ube ukusuka ku-500 kuye ku-1000 mg ngosuku, okungamathebulethi ayi-1-2. Ngemuva kwezinsuku eziyishumi nanhlanu zokuthatha, ngokwesinqumo se-endocrinologist ebuka isiguli, kunganda enye imithamo uma lokhu kudingezwa ngokuqukethwe okuphezulu kwe-glucose emzimbeni wesiguli.
Imiyalo yokusebenzisa itusa ukuthi usebenzise i-1500-2000 mg yomuthi njengethamo lokugcina, okungamaphilisi ama-3-4, kanye nethamo eliphakeme elivunyelwe ukwamukelwa ngu-3000 mg ngosuku.
Endabeni yokwelashwa kohlobo lwe-2 yesifo sikashukela ezigulini esezikhulile, umthamo osetshenziswa yithuluzi lezokwelapha akufanele weqe i-1 g noma amaphilisi amabili ngosuku.
Amacwecwe kufanele athathwe ngomlomo ngaphandle kokuhlafuna ngesikhathi noma ngokushesha ngemuva kokudla. Umuthi kufanele uthathwe ngevolumu encane ye-ketshezi. Ukuze uvikele ukuthuthukiswa kwemiphumela emibi emzimbeni, umthamo wansuku zonke unconywa ukuba uhlukaniswe ngemithamo emi-2.
Kusukela lapho uthatha umuthi, kunamathuba amaningi okuthuthukisa i-lactic acidosis, umthamo osetshenziselwa ukwelashwa kohlobo lwesifo sikashukela sohlobo 2 uyancishiswa uma isiguli sinokuphazamiseka okuqinile komzimba.
Esimweni sokuphathwa kanyekanye ne-insulin ngomuthi ongeqi kumayunithi angama-40 ngosuku, irekhodi lomuthi lihlala lingashintshiwe. Ekwelashweni okudinga umthamo we-insulin wansuku zonke amayunithi angaphezu kwangama-40 ngosuku, irekhodi lomthamo kufanele lithathwe ngokuqapha ngokweqile. Ukukhethwa komthamo kumele kwenziwe kuleli cala esibhedlela ngaphansi kokuqashwa udokotela ohlale ekhona.
I-Metformin yehlisa ukugxila kwe-glucose kuphela kubantu abanesifo sikashukela ngaphandle kokubonisa izakhiwo zabo kumuntu onempilo.
Imiphumela emibi yesidakamizwa emzimbeni
Ngokusebenzisa isikhathi eside umuthi, kungenzeka ukuthi umzimba ube nezinkinga ezihambisana nokumuncwa kuka-vithamini B12.
Ngokusebenzisa isikhathi eside umuthi, kufanele kubhekwe ngokukhethekile ukuqapha isimo sokusebenza kwezicubu zezinso nezinso.
Lapho usebenzisa umuthi, imiphumela emibi elandelayo ingenzeka:
- Kusukela ekusebenzeni kwendlela yomgudu esiswini, ukuphazamiseka kungenzeka, kuboniswa ngesimo sokuzwa kwenhliziyo, ukuhlanza, ubuhlungu esiswini, ukuncipha noma ukuntuleka kokudla, ukubonakala kokunambitheka kwensimbi emlonyeni.
- Ukusuka esikhunjeni kukhona ukusabela komzimba ngendlela yokuqhuma kwesikhumba.
- Uhlelo lwe-endocrine luyakwazi ukuphendula ukusetshenziswa komuthi ngokwakhiwa kwezimo ze-hypoglycemic. Imvamisa, izimo ezinjalo zivela ngenxa yemithamo enganele yomuthi.
- Kusukela ohlangothini lokudlula kwezinqubo ze-metabolic ezimweni ezingavamile, lapho kuthatha imithamo enganele, ukuthuthukiswa kwe-lactic acidosis emzimbeni kungenzeka. Uma kwenzeka lesi simo, ukuqedwa komuthi kuyadingeka.
- Uhlelo lokujikeleza luyakwazi ukuphendula ekwelashweni ngokwenziwa kwezinye izimo ze-megaloblastic anemia.
Ngenxa yengozi enkulu emzimbeni, ukusetshenziswa kwe-metformin lapho kukhona ukwehluleka kwezinso kumuntu kufanele kuyekwe noma kufanele kuthathwe ngaphansi kokuqashwa ngudokotela nangomthamo omncane.
Abaningi be-endocrinologists abakulesi simo batusa ukumisa umuthi ngokuphelele, futhi bawuphathe ngomthamo omncane kakhulu, ngoba ukuqapha okuqukethwe ushukela kubaluleke kakhulu.
Iqiniso ngukuthi ukwanda koshukela wegazi kungavusa ukuphazamiseka okukhulu emzimbeni okungaholela ekwandeni kokuthola kwesiphetho.
Imiyalo ekhethekile yokusebenzisa iMetformin
Lapho uhlela ukukhulelwa noma lapho kwenzeka, umuthi kufanele uyekwe. Uma kwenzeka ukhulelwe, ukusetshenziswa komuthi wesikhathi sokukhulelwa kuthathelwa indawo yi-insulin therapy.
Njengoba kungekho datha ekungeneni okungaba khona kwezakhi zomuthi nento esebenzayo ebisini, lapho usebenzisa ibele, ukusetshenziswa komuthi kufanele kuqedwe. Uma kunesidingo esiphuthumayo sokusebenzisa iMetformin ngesikhathi sokuqunjelwa, ukuncelisa ibele kufanele kuyekwe.
Ukusetshenziswa kwalesi sidakamizwa akuvunyelwe ezinganeni nasentsheni engaphansi kweminyaka engu-18.
Odokotela abancomi ukusebenzisa lesi sidakamizwa ekwelapheni isifo sikashukela asebekhulile, iminyaka yabo ifinyelele eminyakeni engama-60 nokwenza umsebenzi osindayo ohambisana nokukhula kwengcindezi emzimbeni. Lesi sincomo singenxa yokuthi iziguli ezinjalo kungenzeka kakhulu ukuthi zikhule nge-lactic acidosis emzimbeni.
Endabeni yokuthatha iMetformin, ingahlanganiswa nama-ejenti atholakala kwe-sulfonylurea. Ngokuphathwa okunjalo okuhlangene kwezidakamizwa, ukuqapha ngokucophelela isimo sesibonisi se-glucose emzimbeni kuyadingeka.
Kwenqatshelwe ukuphuza utshwala nemithi equkethe i-ethanol ngesikhathi sokuthatha umuthi. Ukutholwa kweMetformin ngasikhathi sinye notshwala kungakhuthaza ukuthuthukiswa kwe-lactic acidosis esigulini esinesifo sikashukela.
Uma usebenzisa umuthi, uvunyelwe ukushayela izimoto nezinqubo, ngoba ukuphathwa kwawo akukuthinti amandla okushayela.
Izindleko zeMetformin, izinkomba zayo kanye nokubuyekezwa kweziguli ngokusetshenziswa kwomuthi
Izidakamizwa ezilandelayo ziyizifaniso zeMetformin:
- I-Bagomet;
- I-Glycon;
- Glyminfor;
- Glyformin;
- IGlucophage;
- IGlucophage Long;
- ILangerine;
- Methadiene;
- I-Metospanin;
- Metfogamm 500, 850, 1000
- I-Metformin;
- Metformin Richter;
- I-Metformin Teva;
- Metformin hydrochloride;
- I-Nova Met;
- I-NovoFormin;
- Siofor 1000;
- Siofor 500;
- Siofor 850;
- I-Sofamet;
- IFommetin;
- IFomu Pliva.
Ukubuyekezwa kokusetshenziswa kwalesi sidakamizwa yiziguli ekwelapheni isifo sikashukela kubonisa ukuthi lesi sidakamizwa sinomphumela omuhle emzimbeni, okuvumela ukuthi ulawule ukugcwala kweglucose emzimbeni.
Kunezibuyekezo eziningi mayelana nomuthi okhombisa ushintsho oluhle emzimbeni lapho uthatha iMetformin noma ama-analogues ayo kanye nokuvela kwamandla amahle ekwelapheni isifo sikashukela. Imvamisa, iziguli ezinesifo sikashukela kanye nokukhuluphala kukhombisa kuzibuyekezo zazo ukuthi ukusetshenziswa kweMetformin kwinqubo yokwelapha izidakamizwa kwehlise kakhulu isisindo somzimba.
Izindleko zomuthi emakhemisi wezwe zincike esifundeni nasekufakweni komuthi.
Izindleko zomuthi iMetformin Teva 850 mg ezweni ziyisilinganiso sama-ruble ayi-100 ngephakethe ngalinye eliqukethe amaphilisi angama-30.
Umuthi onjengeMetformin Canon 1000 mg unezindleko ezimaphakathi ezweni lama-ruble angama-270 ngephakeji ngalinye, eliqukethe amaphilisi angama-60.
Izindleko zomuthi ikakhulukazi zincike ekutheni mangaki amaphilisi asephaketheni. Lapho uthenga lo muthi, kufanele kukhunjulwe ukuthi iholide lakhe lenziwa kuphela ngomuthi kadokotela wakho.
Kwividiyo ekulesi sihloko, uDkt Myasnikov uzokhuluma ngomgomo wokusebenza kweMetformin kushukela.
