I-Metformin Canon: imiyalo esetshenziswayo nokuthi kungani iyadingeka

IMetformin Canon ungomunye wabamele iqembu elincane le-Biguanides. Manje into kuphela esebenzayo kuleli qembu evunyelwe ukuyisebenzisa - i-metformin. Ngokusho kodokotela, uyisidakamizwa esibekiwe kunesifo sikashukela, kuyena ukuthi ukwelashwa kuqalwa lapho isifo sitholakala. Kuze kube manje, isipiliyoni esimangazayo sesitholile ekusetshenzisweni kwalesi sidakamizwa - iminyaka engaphezu kwengu-60. Kuyo yonke le minyaka, ukuhambisana kwe-metformin akukaze kwehle nakancane. Ngokuphambene nalokho, lesi sidakamizwa siveze izinto eziningi ezisebenzayo zabanesifo sikashukela futhi sandisa ngisho nobubanzi.

Isebenza kanjani iMetformin Canon

I-Metformin Canon isidakamizwa i-hypoglycemic. Lokhu kusho ukuthi kuqeda ushukela kuphakama isimilo sesifo sikashukela futhi kuvimbele ubunzima obujwayelekile besifo sikashukela. Ngokwemiyalo, umuthi awuthinti izinga likashukela kubantu abanempilo, abakwazi ukubangela i-hypoglycemia.

Indlela yokusebenza yesenzo sayo:

1. I-Metformin ibuyisela umuzwa we-insulin kwisifo sikashukela. Ishintsha ukumiswa kwama-insulin cell receptors, ngenxa yokuthi i-insulin iqala ukubopha kuma-receptors ngokwengeziwe, okuthi futhi kuthuthukise ukudluliswa kwe-glucose kusuka egazini kuya kumaseli wamafutha, isibindi kanye nemisipha. Ukusetshenziswa kwe-glucose ngaphakathi kwamaseli akukhuphuki. Uma ukudla i-carbohydrate kungaphezulu futhi izindleko zamandla ekusebenzeni ngokomzimba zincane, ushukela ugcinwa ngendlela ye-glycogen ne-lactate.
2. I-Metformin Canon isiza ukunciphisa ushukela wokuzila ukudla. Lesi senzo sihambisana nekhono le-metformin ukuvimbela ukukhiqizwa kwe-glucose kwezicubu zesibindi ngama-30%, ukwandisa ukwakheka kwe-glycogen.
3. I-Metformin iqoqwa ngenkani ezicutshini zamathumbu. Ngasikhathi sinye, ukumunca ushukela kwehla ngo-12%. Ngenxa yalokhu, i-glycemia ngemuva kokudla ikhula ngejubane elincane, asikho isici esijabulile sokuxhuma kwabanesifo sikashukela ngokuwohloka kanyekanye enhlalakahleni. Ingxenye ye-glucose ayangeni emithanjeni nhlobo, kodwa ifakwa kwisisu ngqo emathunjini ukuze ifukame. Iqoqwe yisibindi futhi isetshenziselwe ukuphinda ibuye nemithombo yayo yeglucose. Esikhathini esizayo, lezi zibekelelo zichithwa ekuvinjelweni kwezimo ze-hypoglycemic.
4. I-Metformin isiza ukwehlisa isifiso sokudla, isiza ukulahleka kwesisindo ezigulini ezinokumelana ngokweqile kwe-insulin.
5. Umuthi uthinta ngokungafanele i-lipid metabolism kuzo zombili izifo sikashukela neziguli ezine-dyslipidemia ngaphandle kwesifo sikashukela. Ngenxa ye-metformin, izinga lama-triglycerides lehla cishe ngama-45%, i-cholesterol ephelele nge-10%, izinga le-cholesterol "enhle" landa kancane. Ngokusobala, lesi senzo sihambisana nekhono lomuthi lokucindezela u-oxidation wamafutha acid.
6. I-Metformin ivimbela izinkinga zesifo sikashukela ezincinci. Lo mphumela uchazwa ngokungenela kwento ezinqubweni ze-glycation zamaprotheni anoshukela wegazi ophezulu.
7. Umuthi uvuselela ukusebenza kwegazi kwe-fibrinolytic, kunciphisa amandla weplatelet ukunamathela ndawonye, ​​kunciphisa amathuba okuqhekeka kwegazi. Abanye odokotela bakholelwa ukuthi iMetformin ingcono kune-aspirin emiphumeleni yayo ye-antiplatelet.

Ubekwa ubani umuthi

Kuze kube manje, uhlu lwezinkomba zokuthatha i-Metformin Canon lilinganiselwe kuhlobo lwe-2 sikashukela kuphela kanye nezimo zalo ezandulele. Muva nje, isilinganiso somuthi siyakhula. Ukutholakala kokusetshenziswa kwayo kubantu abanokukhuluphala, isifo se-vascular, dyslipidemia kuyabhekwa.

Izinkomba zokuqokwa emiyalweni:

Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule

• Ukwehlela ushukela -95%
• Ukuqedwa kwe-vein thrombosis - 70%
• Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
• Ukuqeda umfutho wegazi ophakeme - 92%
• Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%

• Isinxephezelo sikashukela kubantu abadala kanye nezingane kusuka eminyakeni eyi-10. Umuthi kumele uxhaswe ngokudla nemfundo yomzimba. Sebenzisa namanye amaphilisi we-hypoglycemic ne-insulin kuvunyelwe. Imiphumela emihle yokwelashwa ibonwa kwabanesifo sikashukela esinesidala.
• Ukuvimbela ukuthuthukiswa kwesifo sikashukela kubantu abanomkhuba wokulimaza i-carbohydrate metabolism. Umuthi ubekelwa uma isiguli singakwazi ukufinyeleleka ngokwejwayelekile kwe-glycemia ngokudla nangemidlalo, futhi ubungozi besifo sikashukela buhlolwe buphakeme. I-Metformin inconyelwa ikakhulukazi abantu abangaphezu kweminyaka engama-60 abanokukhuluphala kakhulu, ifa elibi (isifo sikashukela komunye wabazali), ukuphazamiseka kwe-lipid metabolism, umfutho wegazi ophezulu nomlando wesifo sikashukela sokukhulelwa.

Ngokungafani neMetformin

Ukukhombisa indawo yesidakamizwa iMetformin Canon phakathi kwamanye amaphilisi amaningi abizwa ngeMetformin, siphendukela emlandweni. I-Biguanides isetshenziswe kwezokwelapha amakhulu amaningi eminyaka. Ngisho naseNkathini Ephakathi, ukuchama ngokweqile bekuphathwa nge-infusions kusuka kusitshalo seGalega officinalis. EYurophu, wayaziwa ngaphansi kwamagama ahlukile - ama-lilac aseFrance, uprofesa utshani, imbuzi (efunda ngembuzi yokwelapha), eRussia babevame ukuyibiza ngokuthi i-lily yaseFrance.

Imfihlo yalesi sitshalo yadalulwa ekuqaleni kwekhulu lama-20. Umuthi, owanikeza ukwehlisa ushukela, wanikezwa igama elithi guanidine. Ihlukaniswe nesitshalo, i-guanidine kwisifo sikashukela ibonise umphumela obuthakathaka, kepha unobuthi obuphakeme. Ukufuna into enhle yokwehlisa ushukela akuzange kuyeke. Ngawo-1950s, ososayensi bahlala ekuphepheni kuphela kwama-Biguanides - i-metformin. Umuthi wanikezwa igama elithi Glucophage - isithako sikashukela.

Ngasekupheleni kweminyaka yama-1980s, kwahlonzwa ukuthi esinye sezimbangela ezibaluleke kakhulu zesifo sikashukela ukumelana ne-insulin. Ngemuva kokushicilelwa kokutholwe ososayensi, isasasa le-glucophage lenyuke kakhulu. Kuphenywe ngenkuthalo ngempumelelo, ukuphepha, izindlela zomuthi, izifundo eziningi zokwelashwa zenziwe. Kusukela ngo-1999, amaphilisi ane-metformin asebe ngabokuqala ohlwini lokunconywa kwesifo sikashukela. Ahlala endaweni yokuqala kuze kube namuhla.

Ngenxa yokuthi iGlucofage yasungulwa eminyakeni eminingi edlule, imigomo yokuvikelwa kwelungelo lobunikazi kuyo yisikhathi eside iphelelwe yisikhathi. Ngokomthetho, noma iyiphi inkampani yezokwelapha ikhiqiza i-metformin. Manje emhlabeni kukhiqizwa amakhulukhulu ama-generator weGlucophage, iningi lawo ngaphansi kwegama elithi Metformin. E-Russia, kunabakhiqizi abangaphezulu kweshumi lamathebulethi ane-metformin. Izinkampani ezithole ukwethenjwa kweziguli zivame ukufaka inkomba yomenzi wazo igama lomuthi. IMetformin Canon ingumkhiqizo weCanonfarm Production. Le nkampani sekuphele iminyaka engama-20 ikhiqiza imishanguzo. Bahlangabezana ngokuphelele nezidingo zamazwe namazinga ekhwalithi. Amalungiselelo weCanonfarm alawulwa yizigaba eziningi, aqala ngezinto ezingavuthiwe ezisetshenziswayo, ephetha ngamathebhulethi eyenziwe ngomumo. Ngokusho kwesifo sikashukela, iMetformin Canon isondele kakhulu ekusebenzeni kwe-Glucofage yasekuqaleni.

ICanonpharma ikhiqiza i- metformin kumithamo eminingana:

Imiyalo yokuthatha umuthi

Umyalo ugcizelela ukugcinwa okuphoqelekile kokudla ngesikhathi sonke sokwelashwa nomuthi. Isiguli kudingeka sinciphise ukungena kwe-carbohydrate (udokotela unquma inani lokuncipha kubhekwe nobunzima besifo), basabalalise ngezingxenye ezilinganayo usuku lonke. Uma ukhuluphele, kunconywa ukudla okuncishisiwe kwekhalori. Ukudla okukhalori okuncane lapho uthatha iMetformin Canon kungu-1000 kcal. Ukudla okunamandla kukhulisa ubungozi bemiphumela emibi.

Uma umuntu onesifo sikashukela engakaze ayithathe i-metformin ngaphambili, ukwelashwa kuqala ngomthamo ongu-500-850 mg, isibhebhe siphuzwa esiswini esigcwele ngaphambi kokulala. Ekuqaleni, ubungozi bemiphumela emibi bukhulu kakhulu, ngakho-ke umthamo awukhushulwa amaviki ama-2. Ngemuva kwalesi sikhathi, hlola izinga lokuncipha kwe-glycemia futhi, uma kunesidingo, wandise umthamo. Njalo emavikini ama-2, ungangeza kusuka ku-500 kuye ku-850 mg.

Ukuphindaphindwa kokwamukelwa - izikhathi ezi-2-3 ngosuku, kanti enye yamukelwa kufanele ibe kusihlwa. Ngokusho kokubuyekezwa, ezigulini eziningi, i-glycemia ejwayelekile yanele 1500-2000 mg ngosuku (3x500 mg noma 2x850 mg). Umthamo omkhulu onqunywe yimiyalo ngu-3000 mg (3x1000 mg) kubantu abadala, u-2000 mg wezingane, i-1000 mg kwiziguli ezihluleke ngokwe-renal.

Uma isiguli silandela ukudla, sithatha i-metformin ngenani elilinganiselwe, kepha singekho amandla okuthola isinxephezelo sikashukela, udokotela angaphakamisa ukwehla okukhulu kokuqalwa kwe-insulin. Uma ukuntuleka kwe-insulin kuqinisekisiwe, eminye imishanguzo ebekiwe ye-hypoglycemic ekhuthaza ama-pancreas.

Kungaba namiphi imiphumela emibi

E-mucosa wamathumbu, ukuhlangana kwe-metformin kukhulu ngokuphindwe kayikhulu kunasegazini, esibindini nasezinso. Imiphumela emibi ejwayelekile yesidakamizwa ihambisana nalokhu. Cishe i-20% yeziguli ekuqaleni kokuthatha iMetformin Canon inezifo zokugaya ukudla: isicanucanu kanye nohudo. Ezimweni eziningi, umzimba uyakwazi ukujwayela umuthi, futhi lezi zimpawu ziphela zodwa kungakapheli amasonto ama-2. Ukwehlisa ubunzima bemiphumela emibi, imiyalo yokusebenzisa incoma ukuthatha umuthi ngokudla, qala ukwelashwa ngethamo elincane.

Uma kwenzeka kungabekezelelani kahle, odokotela bayalulekwa ukuba bashintshele amaphilisi we-metformin enziwe kusetshenziswa ubuchwepheshe bamuva. Zinesakhiwo esikhethekile, sibonga lapho into esebenzayo ingena egazini ngokulinganayo ezingxenyeni ezincane. Kulokhu, ukubekezelela isidakamizwa kwenziwa ngcono kakhulu. Amathebhulethi we-Canonfarm okwenzeka isikhathi eside abizwa ngokuthi iMetformin Long Canon. Ngokusho kokubuyekezwa, bayindlela enhle yokusebenzisa isidakamizwa iMetformin Canon ngokubekezelela.

Imininingwane mayelana nemvamisa yemiphumela emibi evela emiyalweni:

Imiyalo yokusebenzisa umphumela oyingozi oyingozi kakhulu yi-lactic acidosis. Lokhu kwephulwa kwenzeka ngokunyuka okuthe xaxa kokuhlushwa kwe-metformin kwezicubu ngenxa yokukhulu kakhulu komthamo noma ukuhluleka kwezinso. Izici zobungozi zibandakanya i-mellitus ebunjiwe yesifo sikashukela enezinkinga eziningi, indlala, ukusetshenziswa kabi kotshwala, i-hypoxia, i-sepsis nezifo zokuphefumula. Izimpawu zokuqalwa kwe-lactic acidosis kubuhlungu nokuqina kwemisipha, ubuthakathaka obusobala, ukufiphala komoya. Le nkinga ayivelakancane (amacala amathathu kumuntu ayizinkulungwane eziyikhulu) futhi iyingozi enkulu, ukubulawa kwabantu okuvela kwi-lactic acidosis kufinyelela kuma-40%. Ngokusola okuncane kwalo, udinga ukuyeka ukuthatha amaphilisi, uthintane nodokotela.

Contraindication

Iningi le-contraindication emiyalweni esetshenziselwa umzamo womenzi wokuvikela i-lactic acidosis. I-Metformin ayikwazi ukubekwa:

• uma isiguli sinokuhluleka kwe-renal kanye ne-GFR esingaphansi kwama-45;
• nge-hypoxia enzima, ebangelwa izifo zamaphaphu, ukuhluleka kwenhliziyo, ukushaya kwenhliziyo, i-anemia;
• ngokwehluleka kwesibindi;
• ngigula ngotshwala;
• uma ngabe isifo sikashukela sike sathola i-lactic acidosis, noma ngabe imbangela yaso ibingeyona i-metformin;
• ngesikhathi sokukhulelwa, kuvunyelwe i-insulin kuphela kusuka kuzidakamizwa ze-hypoglycemic ngalesi sikhathi.

Umuthi ukhanselwa nge-ketoacidosis, ngesikhathi sokwelashwa kwezifo ezinzima, ukulimala kanzima, ukuqeda ukopha, ngaphambi kokungenelela kokuhlinzwa. I-Metformin inqanyulwa ezinsukwini ezi-2 ngaphambi kwe-X-ray enomenzeli ohlukile, ukwelashwa kuqale kabusha ezinsukwini ezi-2 ngemuva kocwaningo.

Isifo sikashukela esigcina isikhathi eside singasasebenzi kahle sivame ukuhambisana nokuhluleka kwenhliziyo. Emiyalweni, lesi sifo sisho ukungqubuzana ekwelashweni nge-metformin, kodwa ekusebenzeni, odokotela kufanele banikeze umuthi kulezi ziguli. Ngokusho kocwaningo lokuqala, i-metformin ezigulini ezinezifo zenhliziyo ayithuthukisi kuphela isinxephezelo sikashukela, kodwa futhi inciphisa nokufa kwabantu futhi inciphisa isimo esivamile. Ingozi ye-lactic acidosis kuleli cala inyuka ngokungasho lutho. Uma ngabe lesi senzo siqinisekisiwe, ukwehluleka kwenhliziyo kuzokhishwa kuhlu lwe-contraindication.

Ukucwilisa iMetformin Canon

Iningi labanesifo sikashukela likhuluphele futhi banomkhuba othambile wokuthola amaphawundi amasha. Ngezindlela eziningi, lokhu kuthambekela kuhlotshaniswa nokumelana ne-insulin, okubonakala kuzo zonke izigaba zesifo sikashukela. Ukunqoba ukumelana, umzimba ukhiqiza i-insulin ngamanani amaningi, ngokuhlinzekwa okuqinisekisiwe. Ihomoni engaphezulu iholela ekuthambekeleni kokudla, ivimbela ukuwohloka kwamafutha, futhi inikele ekwenyukeni kwamafutha e-visceral. Ngaphezu kwalokho, isifo sikashukela esibi kakhulu siyalawulwa, kulapho kuthiwa khona ukuthambekela kwalolu hlobo lokukhuluphala.

Ukulahlekelwa isisindo kungenye yezinhloso ezibalulekile zokunakekelwa kwesifo sikashukela. Le nhloso inikezwa iziguli ayilula neze: kufanele banciphise kakhulu ama-carbohydrate nama-kilojoule, futhi balwe nokuhlaselwa kabuhlungu yindlala. I-Metformin Canon isiza ukunciphisa isisindo. Iyanciphisa ukumelana ne-insulin, okusho ukuthi amazinga e-insulin ancipha kancane kancane, ukuqhekeka kwamafutha kuyenziwa lula. Ngokusho kokubuyekezwa kokuncipha kwesisindo, imiphumela emibi yesidakamizwa nayo inenzuzo - umthelela ekudla.

Ukwehla kwesisindo, umuthi ungabekelwa hhayi kuphela kwabanesifo sikashukela, kodwa futhi nakubantu abane-insulin ukumelana okwembuliwe. Njengomthetho, lezi yiziguli ezinokukhuluphala ngokweqile, isilinganiselo esinqeni esingaphezu kwama-90 cm, i-BMI engaphezulu kwama-35. I-Metformin ayisona isidakamizwa sokukhuluphala, lapho sithathwa, ukulahleka kwesisindo okujwayelekile kungama-2-3 kg kuphela. Kuyindlela yokunciphisa isisindo. Ukuze isebenze, ukuncishiswa kokudla okwenziwa ngama-caloric kanye nokuzivocavoca umzimba kuyadingeka ezigulini.

Ama-Analog

IMetformin Canon inezikhalo eziningi. Amathebulethi anokwakheka okufanayo angathengwa ekhemisi ngalinye. Ethandwa kakhulu eRussia yilezi:

• Izinkampani ezifuywayo zeMetformin i-Akrikhin, Biosynthesis ne-Atoll;
• I-Russian Gliformin, iFormetin;
• I-French Glucophage;
• Czech Metformin Zentiva;
• I-Israeli Metformin Teva;
• Siofor.

Intengo yokufana komkhiqizo waseRussia nowakwa-Israyeli, kanye neGlucofage yasekuqaleni, icishe ifane neMetformin Canon. IGerman Siofor iyabiza ngo-20-50%. I-glucophage enwetshiwe ibiza izikhathi ezingama-1.5-2,5 ngaphezulu kwe-Metformin Long Canon efanayo.

Ukubuyekezwa kwesifo sikashukela