Muva nje, ama-ejenti we-metformin-based hypoglycemic (Buformin, Metformin, Fenformin, njll.) Asetshenziselwe ukwelapha isifo sikashukela. Ukusetshenziswa kwazo kunezinzuzo ezisobala. Bheka izici zalezi zingxubevange, umphumela wazo nezindlela zokwelapha ushukela ngosizo lwazo.
Basebenza kanjani
AmaBiguanides esifo sikashukela asetshenziswa kusukela ngawo-1970. Ababangeli ukuvikelwa kwe-insulin okwenziwa ngamanyikwe. Umphumela wezidakamizwa ezinjalo ubangelwa ukuvimbela inqubo ye-gluconeogeneis. Isidakamizwa esivame kakhulu salolu hlobo yiMetformin (Siofor).
Ngokungafani ne-sulfonylurea kanye nokuphuma kwayo, iMetformin ayilinciphisi ushukela futhi ayibangeli i-hypoglycemia. Lokhu kubaluleke kakhulu ngemuva kokuzila ngokushesha kobusuku. Umuthi ukhawulela ukwanda koshukela wegazi ngemuva kokudla. I-Metformin ikhulisa ukuzwela kwamangqamuzana nezicubu zomzimba ku-insulin. Ngaphezu kwalokho, kuthuthukisa ukuhamba kweglucose kumaseli nezicubu, kubambezela ukumuncwa kwayo emgudwini wamathumbu.
I-Metformin ingummeleli oyinhloko weqembu le-Biguanide yezidakamizwa
Ngokusetshenziswa isikhathi eside, ama-biguanides anomthelela omuhle kuma-metabolism wamafutha. Banciphisa inqubo yokuguqula ushukela abe ngamafutha acid, kanti kwezinye izikhathi banciphisa okuqukethwe yi-triglycerides, cholesterol egazini. Umphumela we-biguanides lapho kungekho insulin awutholakali.
I-Metformin igxiliwe kahle iphuma esiswini futhi ingena kuyi-plasma yegazi, lapho kufinyeleleka kakhulu ngemuva kwamahora amabili ngemuva kokuphathwa. Ukuqedwa kwesigamu sempilo kufike emahoreni angama-4,5.
Izinkomba kanye ne-contraindication
Mhlawumbe ukusetshenziswa kwe-biguanides kuhlangene ne-insulin. Ungazithatha futhi uhlangana nezinye izidakamizwa ezinciphisa ushukela.
I-Metformin ikhonjiswa ikakhulukazi kwiziguli ezinesifo sikashukela kanye nokukhuluphala okuhlobene.
Umuthi uphulwe emacaleni anjalo:
- isifo sikashukela esincike ku-insulin (ngaphandle uma sihlanganiswa nokukhuluphala);
- ukuqeda ukukhiqizwa kwe-insulin;
- ketoacidosis;
- ukwehluleka kwezinso, ukungasebenzi kahle kwesibindi;
- ukwehluleka kwenhliziyo nokuphefumula;
- ukomisa, ukushaqeka;
- uphuzo oludakayo;
- i-lactic acidosis;
- ukukhulelwa, ukuncelisa;
- Ukudla okunama-khalori aphansi (ngaphansi kwama-kilocalories ayi-1000 ngosuku);
- iminyaka yezingane.
Kufanele kuqashelwe ukusebenzisa ama-biguanides kubantu abaneminyaka engaphezu kwengu-60 uma benza umsebenzi onzima womzimba. Kulokhu, kunobungozi obukhulu bokuthuthukisa i-lactic acidosis coma.
Imiphumela emibi kanye ne-overdose
Cishe amaphesenti ayishumi kuya kwangama-25 ezimo, iziguli ezithatha ama-biguanides zibhekana nemiphumela emibi njengokunambitheka kwensimbi emlonyeni, ukulahleka kokudla kanye nenausea. Ukuze wehlise amathuba okuba nezimpawu ezinjalo, kubalulekile ukuthatha le mithi udle noma ngemuva kokudla. Umthamo kufanele lenyuswe kancane kancane.
Kwezinye izimo, ukuthuthukiswa kwe-megaloblastic anemia, ukusilela kwe-cyanocobalamin kungenzeka. Kuyaqabukela, kuqhamuke imishanguzo engafuneki emzimbeni wayo.
Uma kwenzeka kwe-overdose, kuvela izimpawu ze-lactic acidosis. Izimpawu zalesi simo ubuthakathaka, usizi lokuphefumula, ukozela, isicanucanu, nohudo. Ukupholisa kwamaphethelo, i-bradycardia, i-hypotension kuyaphawuleka. Ukwelashwa kwe-lactic acidosis kuwuphawu.
Nikeza umuthi bese ukhetha umthamo kufanele ube udokotela kuphela
Umthamo
Umthamo wesidakamizwa kumele usethe isikhathi ngasinye ngasodwa. Kufanele ngaso sonke isikhathi ube ne-glucometer esesandleni. Kubalulekile futhi ukuthi ubhekele inhlala-kahle: imiphumela emibi eminingi iba kuphela ngomthamo ongafanele.
Ukwelashwa nge-biguanides kufanele kuqale ngomuthi ophansi - hhayi ngaphezu kwe-500-1000 g ngosuku (ngokulandelana, amaphilisi ayi-1 noma ama-2 g we-0,5). Uma kungekho miphumela emibi ebonwa, khona-ke umthamo ungandiswa. Isilinganiso esiphezulu somuthi ngosuku ngama-3 amagremu.
Ngakho-ke, iMetformin iyithuluzi elisebenza kakhulu ekwelapheni nasekuvimbeleni isifo sikashukela. Kuyadingeka ukulandela ngokucophelela imiyalo yokusebenzisa umuthi.
