Ukwelashwa kwesifo sikashukela sohlobo 2 kukude futhi kudinga ukusetshenziswa kwezidakamizwa ezikhethekile. Ukukhethwa kwezidakamizwa kuncike kuphela ebukhali besi sifo, kodwa futhi esimweni ngasinye sesiguli, izici zomzimba wakhe, ukuba khona kwezifo ezengeziwe.
Umuthi iMetformin wesifo sikashukela sohlobo 2 ungenye esetshenziswa amashumi amaningi eminyaka. Lokhu kususelwa kwe-Biguanides (isigaba samakhemikhali enziwe ngokwenziwe ngomzimba anemiphumela ye-hypoglycemic), imiphumela yokwelapha eholela ekunciphiseni kweglucose yegazi kanye nomphumela wokwelapha. Njengoba wazi, isifo sikashukela sohlobo 2 sincike kwe-insulin. Lokhu kusho ukuthi kunezindlela ezimbili zokwelashwa kwalo - ukwehlisa amazinga kashukela wegazi nokukhuthaza ukukhiqizwa kwe-insulin okwengeziwe. Ukusetshenziswa kwe-metformin yesifo sikashukela kukuvumela ukuthi uzinzise izinga le-glucose kuphela. Cabanga ngezinzuzo ezisemqoka kanye nokubi kwalo muthi.
Umgomo weMetformin
Into esebenzayo yi-metformin hydrochloride. Kusuka ekilasini lama-Biguanides, yiwo kuphela onomphumela omuhle wokwelapha.Ukubuyekezwa kweziguli kusikisela ukuthi lesi sidakamizwa sisebenza kangcono kunabanye abaningi esigabeni saso. Lokhu kungenxa yokuthi isebenza ezingeni lamaselula, ikhulisa ukuzwela kwayo ku-insulin. Ngenxa yokwelashwa kweMetformin, imiphumela elandelayo iyabonakala:
- isibindi sakha ushukela omncane;
- okunamafutha amaningi aqala ukukhipha i-oxidize;
- amaseli atheleka kakhulu kwi-insulin;
- ushukela omncane unconywa emathunjini amancane;
- izicubu ziqala ukudla ushukela omningi;
- ingxenye yeglucose ngesikhathi sokugaya iphenduka i-lactate (lactic acid).
Ngakho-ke, umuthi wehlisela ushukela wegazi ngendlela engaqondile, ngoba umphumela wawo oyinhloko ukwandisa umuzwa womzimba we-insulin.
Ngenxa yokuthi umuthi uvusa ukukhiqizwa kwama-acid amaningi, imiphumela eyengeziwe yokwelapha iyavela, inwebisa iqembu lalabo abaphakanyiselwe ukuphuza iMetformin. Lokhu kungokulandelayo:
- ukwakheka kwama-atherosranceotic vasque plaque kuyayeka;
- isisindo somzimba sehla, okuthinta kahle ukwelashwa kwe-metabolic syndrome;
- umfutho wegazi wejwayelekile.
Kumele kwaziwe ukuthi inqubo ye-oxidation yamafutha acid inakho ekubhujisweni kwabo nasekuguqukelweni amandla. Ngakho-ke, izinqolobane ezinamafutha ziyancishiswa, umzimba uqina. Ngakho-ke, umuthi uvame ukusetshenziselwa ukunciphisa umzimba, ngoba uvusa ukushiswa kwamafutha ngqo.
Izinhlangothi ezingezinhle zokuthatha iMetformin
Ukuzivocavoca kwezokwelapha nokubuyekezwa kweziguli kubonisa ukuthi le hypoglycemic inemiphumela emibi. Lokhu kungenxa yomsebenzi ofanayo owandayo ku-oxidation of lipids. Ngale nqubo ye-biochemical, amandla amaningi hhayi kuphela akhiqizwa, kepha futhi ne-lactate (lactic acid), okuvame ukuholela ku-acidosis, okuwukuthi, ukuguquka kwenkomba ye-hydrogen ohlangothini lwe-acid. Lokhu kusho ukuthi kune-asidi egazini okuningi kunalokho okudingekayo, okuhlanganisa umsebenzi wazo zonke izitho nezinhlelo kuze kube sekufeni.
I-Lactic acidosis ingenzeka kancane kancane futhi kungazelelwe. Imvamisa izimpawu zayo ziba mnene futhi azibaluleki, kepha kwesinye isikhathi ziye zifike ezinkingeni lapho kudingeka ngisho nokudayela (okuwukuthi, ukuxhuma izinso okwenziwe entweni). Izimpawu ze-lactic acidosis zingokulandelayo:
- ukubonakala kobuthakathaka;
- ukozela
- Isiyezi
- ukuphefumula okungashonile;
- ukuphefumula
- umfutho wegazi ophansi;
- izinga lokushisa lomzimba eliphansi;
- ubuhlungu bemisipha, njll.
Ukwelashwa kwe-lactic acidosis kuvame ukuba uphawu, ezimweni ezingavamile, kunikezwe i-hemodialysis (inqubo ekhethekile yokuhlanzwa kwegazi).
Ngabe iMetformin isetshenziselwa ini?
Ukusetshenziswa kwomuthi kuhloswe ngawo ukwelapha isifo sikashukela sohlobo 2, kanye nokuvikela lesi sifo. Odokotela bavame ukunikeza ikhambi lokulwa nesisindo ngokweqile, ukuguga okusheshayo, ukwenza ngokwejwayelekile imetabolism.
Contraindication nokusetshenziswa kweMetformin
I-ejenti yokwelapha isifo sikashukela akufanele isetshenziswe kulezi zimo ezilandelayo:
- ngesikhathi sokukhulelwa nokuqunjelwa;
- izingane ezingaphansi kweminyaka eyi-10;
- ukudla okuphansi kwekhalori;
- ngemuva kokuhlinzwa nokulimala;
- nge-pathologies yesibindi;
- nge-lactic acidosis yangaphambilini;
- uma kukhona ukuthambekela kwe-lactic acidosis;
- phambi kokwehluleka kwezinso ku-anamnesis.
Ungayithatha kanjani i-metformin?
Kubalulekile ezigulini ezifisa ukwelashwa nge-glucose eyeqile egazini ukuze zazi ukuthi zingaphuza kanjani i-metformin enesifo sikashukela. Kumele kuqashelwe ukuthi imakethe inikezela ngemali ngemithamo ehlukile, isukela ku-500 mg iye ku-1000 mg. Kukhona nezidakamizwa ezinomphumela oqhubeka isikhathi eside. Umthamo wokuqala unqunywe kumthamo omncane, emva kwalokho udokotela angancoma ukuthi unyuswe kuwo. Inani lezikhathi ngosuku lingaxhunyaniswa nodokotela, kepha umthamo ovunyelwe nsuku zonke awudluli kwe-2 g.
Okufanele ukwenze nge-overdose yesidakamizwa
Musa ukwandisa umthamo wesidakamizwa ukuthuthukisa umphumela wesidakamizwa noma ukusheshisa isikhathi sokuphulukisa. Imvamisa, i-overdose iphela ekudumazekeni - ibanga ukulimala okukhulu emzimbeni, amacala abulalayo akuvamile.
Ubungozi bokweqisa kwe-Metformin ukukhula kwe-lactic acidosis. Izimpawu zesifo yileso esiswini (okungukuthi, esiswini) nobuhlungu bemisipha, izinkinga zokugaya ukudla, ukuphefumula okusheshayo, izinga lokushisa lomzimba eliphansi, isiyezi kanye nokuphelelwa yimizwa kuze kuba sezingeni lokuphefumula.
Uma okungenani unalezi zibonakaliso, kufanele uyeke ukuphuza umuthi bese uthintana nodokotela ngokushesha. Isibhedlela sizothatha zonke izindlela ukuze kususwe i-lactate emzimbeni. Ezimweni ezimbi kakhulu, kunqunywa i-hemodialysis. Isebenza kakhulu futhi inika imiphumela esheshayo.
Ukuxhumana neminye imithi
Lokhu kususelwa kwe-Biguanide kunesici esibonakalayo - cishe yonke into iyakhishwa ngokusebenzisa izinso zingashintshiwe, kanti konke okunye (cishe i-10%) kuqongelela emzimbeni. Futhi uma izinso ziqala ukusebenza ngezikhathi ezithile, iMetformin iqongelela okuthe xaxa ezicutshini, okuholela emiphumeleni emibi kuze kube ukoma.
Kubalulekile futhi ukuvumelanisa kahle ukusetshenziswa kwama-hypoglycemic agents ne-insulin. Ngemuva kwakho konke, uma iMetformin ibonakala isegazini kakhulu kunalokho obekulindelwe, isiguli ngokwethulwa kwe-insulin singawela ku-hypoglycemic coma ngenxa yokwehla okukhulu kwamazinga kashukela.
Ukwehla okukhulu kweglucose yegazi kuyabonakala futhi nokusetshenziswa okuhlanganisiwe kwalezi zidakamizwa ezilandelayo ngeMetformin:
- izinto ezithathwe kuma-sulfonylurea;
- Ama-NSAIDs;
- oxytetracycline;
- Ama-inhibitors we-MAO (ama-antidepressants ama-classic);
- i-acarbose;
- Ama-inhibitors e-ACE;
- cyclophosphamide;
- β-blockers
Futhi lezi zimali, ngenkathi zisetshenziswa ngomuthi onciphisa ushukela, kunalokho, zinciphisa umsebenzi wawo:
- ama-corticosteroids;
- ama-hormone egilo;
- okokugcobisa;
- ama-estrogens;
- izindlela zokuvimbela inzalo ngomlomo;
- i-nicotinic acid;
- i-calcium receptor blockers;
- adrenomimetics;
- isoniazid, njll.
Ngakho-ke, iMetformin iyisidakamizwa esihle kakhulu esinciphisa ushukela esisebenza kahle kakhulu, kodwa ngasikhathi sinye asisiyo ikhambi lomhlaba wonke. Inemiphumela yayo emibi kanye ne-contraindication. Iningi lazo lincane futhi lidlula phakathi kwamasonto ayi-1-2, kepha abanye bangaphoqa ukuthi bayeke ukuthatha.
Ukuze umuthi uphumelele, kuyadingeka ukuhlanganisa umthamo nodokotela, ulandele zonke izincomo zawo, unamathele ngokuqinile ekudleni okuqunyelwe bese uqapha ngokucophelela ama-contraindication nemiphumela yako emibi. Udinga futhi ukukhumbula ukuthi utshwala buyisitha esikhulu seMetformin, ngakho-ke iziphuzo eziqukethe utshwala kufanele zingafakwa ngesikhathi sokwelashwa. Lokhu kungenxa yokuthi utshwala buvimba umsebenzi wama-enzyme amaningi wesibindi. Ngakho-ke, iMetformin engaphezulu ingena egazini, okuholela ekwehlekeni okukhulu kwamazinga kashukela kufinyelela ku-hypoglycemia. Ngaphezu kwalokho, utshwala lapho basebenzisana nezidakamizwa benza i-lactic acid. Ngakho-ke, ukusetshenziswa kwaso ngesikhathi sokwelashwa nalesi sidakamizwa kuyaphulwa.
