Udokotela kuphela obandakanyeka ekuqokweni kwemithi ye-antidiabetic, ukukhethwa kubangela ubunzima ngenxa yemiphumela emibi kanye ne-contraindication.
Izidakamizwa ezokwehlisa ushukela, njengeMetformin neManinil, ziyehluka emshinini wokusebenza namandla wethonya le-hypoglycemic.
Lokhu kungenxa yokwakheka okuhlukile kwezidakamizwa, cabanga ngezici nokwehluka kwazo.
Ukwakheka
I-Metformin yinto esetshenziswa eminingana nama-Biguanides anciphisa ngempumelelo ushukela wegazi ngokuvimbela ukumuncwa kwawo esibindini.
I-Maninyl ifaka i-izidakamizwa i-glibenclamide, i-sulfonylurea esuselwa esizukulwaneni sesibili ngomphumela ophonsa ushukela. Imithi yenziwa ezibhebheni kuphela ezinemithamo ehlukene yezithako ezisebenzayo.
Isenzo se-Pharmacological
Umgomo weMetformin ukucindezela i-gluconeogeneis. Umuthi usebenza i-enzyme ekhethekile esibindini evimbela ukungena kweglucose egazini. Umuthi uvimbela ukuguqulwa kwamafutha acid futhi uthuthukisa i-oxidation yawo, uvimbela ukufakwa koshukela emathunjini.
Uma kuqhathaniswa namanye ama-hypoglycemic agents, umuthi usebenza kakhulu ekuvimbeleni ukuthuthukiswa kwe-angiopathy yesifo sikashukela. Ngokusetshenziswa okuhleliwe, umuthi uvimbela ukuzuza kwesisindo, futhi uma udla, kuyasiza ekunciphiseni.
Amathebhulethi e-Metformin
Umuthi uvimbela ukuthuthukiswa kokumelana ne-insulin futhi unikeze amandla ukungena kwe-glucose kwezicubu zomuntu. Ngokuntuleka kwe-insulin egazini, into esebenzayo ayibonisi izakhiwo ze-hypoglycemic.
IManinyl ivuselela ukukhiqizwa kwe-insulin kumanyikwe ngenxa yokuvalwa kweziteshi ze-potassium kumaseli e-beta. Okuqukethwe kwama-ion e-potasium kuyanda, okunikeza ama-pancreas uphawu lokuhlanganisa i-insulin entsha.
Umuthi uyakwazi ukwandisa impendulo ye-metabolic ku-hormone, unciphisa ubungozi be-nephropathy nokufa. Ukusebenza kwesenzo akuhlobene nenani le-glucose esegazini, ngakho umuthi usebenza ngisho nange-standardoglycemia.
Izinkomba
I-Metformin ichazwa njenge-ejenti ye-hypoglycemic ngokuyinhloko yohlobo 2 sikashukela.
Kuhlobo 1 lwesifo sikashukela, umuthi ungabekwa njengenqubo yokuvimbela ekuthuthukiseni i-angiopathy yesifo sikashukela.
Umuthi we-hypoglycemic ungasetjenziselwa i-polycystic ovary, uma i-hyperinsulinemia nokubekezelelwa kweglucose kubhekwa.
I-Glibenclamide isetshenziswa kuphela uhlobo lwe-2 sikashukela mellitus, lapho usebenzisa izondlamzimba ezifanele nomthwalo owanele akunakwenzeka ukwehlisa ushukela wegazi.
Ngingakwazi ukuhlanganisa ndawonye?
Ukucabanga ukuthi kungenzeka inhlanganisela yezidakamizwa, kufanele unake izici zokuphuza kwazo nokuxhumana kwezinto ezisebenzayo.Umphumela wehlisela ushukela we-glibenclamide ngokuya ngomthamo: kukhulu lapho kunjalo, lapho umthelela omkhulu wamanyikwe uvela khona.
Lapho ivuselelwa into esebenzayo, i-insulin eyengeziwe iqala ukukhiqizwa, ngakho-ke ukukhethwa komthamo odingekayo weManinil kunqunywa ushukela wegazi.
Lapho unquma umuthi, udokotela kufanele anikeze imiyalo ngokudla futhi anake inani lama-carbohydrate ekudleni. Esigabeni sokuqala, ukwelashwa kuqala ngomthamo ophansi kakhulu, futhi ngemuva kokuphatha, umphumela kwisifo sikashukela uyabonakala.
Uma kunesidingo, engeza inani lomuthi. Thatha umuthi izikhathi ezi-1-2 ngosuku, umphumela wento esebenzayo okungenani amahora ayi-12.
Ukhuphula umphumela we-hypoglycemic futhi wehlise ukuthathwa kwama-carbohydrate egazini, ukuphathwa okufanayo kweManinil ngeMetformin kungenzeka.
Inhlanganisela yezidakamizwa isetshenziswa lapho kungenakwenzeka ukufeza umphumela wokwelapha odingekayo.
Ukudla okwengeziwe kwesidakamizwa esine-antidiabetes kufanele kubhekwe ngudokotela. Ngokuhambisana neminye imithi, umphumela we-glibenclamide emzimbeni uyathuthukiswa.
Yini engcono?
Lapho kunquma umenzeli we-hypoglycemic, baqondiswa umphumela owuthandayo wokwelapha, indlela yokusebenza yesakhi esisebenzayo, ukuphikisana kwamanje kokusetshenziswa nemiphumela emibi.
I-Metformin noma iManinil
Isici seMetformin ukuthi umphumela we-hypoglycemic emzimbeni awuhlobene nenani le-insulin. Umgomo wesidakamizwa ukucindezela inqubo yokuthatha ushukela.
I-Metformin ingesinye sezidakamizwa ezimbalwa ubungozi bokuqalwa yi-hypoglycemia lincane. Ngaphezu kokubukeka kokuphazamiseka kwamathumbu, umuthi awuzange ube nemiphumela emibi. I-Lactic acidosis ingenzeka ngedisidi enkulu futhi uma kwenzeka ukwehluleka kwezinso.
Isidakamizwa Maninil
Ngakho-ke, ngokukhiqizwa okujwayelekile kwe-peptide hormone yi-pancreas, kodwa ngokumelana okukhulu kwe-insulin, iMetformin iyancomeka.
Okubi kufaka phakathi iqiniso lokuthi i-biguanide ayikwazi ukunciphisa ushukela ngokuntuleka kwe-insulin emzimbeni. Ukusetshenziswa isikhathi eside kwesidakamizwa kuvimbela ukumuncwa kwe-vithamini B12, okungahle kuholele ekuthuthukisweni kwe-myalgia kanye ne-anemia.
I-Glibenclamide inqunyelwe kuphela isifo sesifo sikashukela sohlobo 2, lapho imiphumela yamanye amaphilisi okwehlisa ushukela inganele.
I-sulfonylurea derivative (glibenclamide) inemiphumela emibi eminingana:
- uma inani lezinto ezisebenzayo lidluliwe, i-hypoglycemia enkudlwana ingakhula;
- isisindo somzimba;
- izinhlungu ezihlangene
- ikhanda
- ukuzwela okukhulayo kokukhanya;
- umkhuhlane
- isifo sokugaya ukudla;
- ukukhathala okungapheli;
- i-proteinuria (amaprotheni avela kumchamo);
- i-cholestatic syndrome;
- ukungahambi kahle komzimba;
- ukuchama njalo.
Uhlu lwe-contraindication yezidakamizwa luyafana, ngaphandle kokuthi i-glibenclamide iyenqatshelwe ngokuphelele ukuthatha nesifo sikashukela esincike ku-insulin.
I-Metformin, iManinil ayikwazi ukusetshenziswa kumacala:
- isifo sikashukela;
- ukukhulelwa
- ukucaphuka;
- ukwephulwa kwesibindi nezinso;
- ukubonakala kwe-ketoacidosis;
- hypersensitivity.
I-Glibenclamide ingasetjenziswa ngokuqaphelisisa etshwaleni, okuyi-Biguanide kungumkhawulo ngokuphelele.
Ngaphezu kwalokho, iMetformin ikhanseliwe ezinsukwini ezi-2 ngaphambi nangemva kwe-x-ray, uma bekukhona ukwethulwa kokwehluka kwe-iodinated.
Maninil noma Amaryl
I-Amaryl yi-hypoglycemic esekwe kuma-sulfonylureas wesizukulwane se-III. Kuqukethe isithako esisebenzayo - glimepiride. Umgomo wesenzo ukukhuthaza ukukhishwa kwe-insulin yangaphandle yi-pancreas.
Izibhebhe ze-Amaryl
Ngokungafani neManinil, i-Amaryl inomphumela owengeziwe - umuthi uvimbela i-gluconeogeneis. Umphumela we-hypoglycemic we-Amaril ubizwa kakhulu futhi okungenani amahora angama-24.
IManinil ne-Amaril ayinakubekelwa uhlobo lwesifo sikashukela esincike ku-insulin. Lapho ukhetha umthamo we-Amaril nokwelashwa okwalandela, kufanele kufundwe ngoshukela wegazi, ngoba kungenzeka ukuthi kube nokwakhiwa kwe-hypoglycemia.
Ukubonakaliswa okungalungile kokusetshenziswa kwezidakamizwa kanye ne-contraindication empeleni akuhlukile. Ukukhishwa kungukuphazamiseka kokuphazamiseka kokugaya ukudla okwenzeka e-Amaril, okuhambisana nenqubo yokucindezela i-gluconeogenesis ngomuthi.
Amavidiyo ahlobene
Indlela yokusebenza, uhlobo lokukhululwa kanye nama-nuances wokusebenzisa iMetformin kuvidiyo:
UManinil no-Amaryl banomphumela we-hypoglycemic oqinile, kepha babe nohlu olubalulekile lwemiphumela emibi. Uma ukukhuthaza okwengeziwe kwe-pancreatic akudingekile ukukhiqizwa kwe-insulin,
I-Metformin inenzuzo ecacile. Kuya ngezinga elikhulu kunciphisa ubungozi be-atherosclerosis, akuholeli ekuzuzeni isisindo futhi kuvimbele ukukhula kwesifo senhliziyo. Imiphumela emibi evela emgodini wokugaya kusuka ekuthatheni i-Biguanide idlula ngokushesha.
