Siofor kuwonda, chithandizo cha matenda a shuga a 2 komanso kupewa kwake

Siofor ndiye mankhwala odziwika bwino kwambiri padziko lonse lapansi kupewa ndi kuchiza matenda a shuga a mtundu wachiwiri. Siofor ndi dzina lamalonda la mankhwala omwe mankhwala ake amagwiritsidwa ntchito ndi metformin. Mankhwalawa amawonjezera chidwi cha maselo kuti agwire insulin, i.e., amachepetsa kukana kwa insulin.

Mankhwalawa amathandizira cholesterol ndi triglycerides m'mwazi, amachepetsa chiopsezo cha matenda a mtima, ndipo koposa zonse - amathandizira kuchepetsa thupi.

Mamiliyoni a odwala matenda amtundu wa 2 padziko lonse lapansi amatenga Siofor. Izi zimawathandiza kukhala ndi shuga wabwino wamagazi, kuphatikiza pa kudya zakudya. Ngati matenda a shuga a mtundu 2 ayamba kuthandizidwa panthawi yake, Siofor (Glucophage) atha kuthandiza popanda jakisoni wa insulin komanso kumwa mapiritsi ena omwe amachepetsa shuga m'magazi.

Malangizo a mankhwala a Siofor (metformin)

Nkhaniyi ili ndi "chisakanizo" cha malangizo omwe abwera kwa Siofor, zambiri kuchokera m'magazini azachipatala ndi kuwunika kwa odwala omwe amamwa mankhwalawo. Ngati mukufuna malangizo a Siofor, mupeza zonse zofunikira ndi ife. Tikukhulupirira kuti tinatha kutumiza zidziwitso za mapiritsi otchuka kwambiri mwanjira yomwe ili yabwino kwambiri kwa inu.

Siofor, Glucofage ndi fanizo lawo

Glucophage ndi mankhwala oyamba. Ikutulutsidwa ndi kampani yomwe idapanga metformin ngati mankhwala ochizira matenda a shuga 2. Siofor ndi analogue ya kampani yaku Germany ya Menarini-Berlin Chemie. Awa ndi mapiritsi otchuka kwambiri a metformin m'maiko olankhula Chirasha ndi ku Europe. Ndiwotsika mtengo ndipo amagwira ntchito bwino. Glucophage kutalika - mankhwala osagwira. Amayambitsa zovuta m'mimba kawiri poyerekeza ndi metformin yokhazikika. Glucophage kutalika amakhulupiriranso kuti amachepetsa shuga bwino mu shuga. Koma mankhwalawa ndi okwera mtengo kwambiri. Zina zonse za mapiritsi a metformin omwe alembedwa pamwambapa sizimagwiritsidwa ntchito. Palibe deta yokwanira pakukwanira kwake.

Zizindikiro zogwiritsidwa ntchito

Type 2 matenda a shuga a mellitus (osadalira insulin), ochizira komanso kupewa. Makamaka kuphatikiza kunenepa kwambiri, ngati mankhwala othandizira pakudya ndi maphunziro akuthupi opanda mapiritsi sikugwira ntchito.

Pochiza matenda a shuga, Siofor angagwiritsidwe ntchito ngati monotherapy (mankhwala okhawo), komanso kuphatikiza ndi mapiritsi ena ochepetsa shuga kapena insulin.

Contraindication

Contraindations pakusankhidwa kwa siofor:

• lembani matenda a shuga 1 mellitus (*** kupatula ngati onenepa kwambiri. Ngati muli ndi matenda amtundu wa 1 kuphatikiza kunenepa - kumwa Siofor kungakhale kothandiza, funsani dokotala wanu);
• kuchotsa kwathunthu kwa insulin katulutsidwe ndi kapamba mu mtundu 2 shuga;
• matenda ashuga ketoacidosis, matenda a shuga;
• Kulephera kwaimpso ndi kuchuluka kwa creatinine m'magazi pamwamba pa 136 μmol / l mwa amuna ndipo pamwamba pa 110 μmol / l mwa akazi kapena glomerular filtration rate (GFR) yosakwana 60 ml / min;
• chiwindi ntchito
• kulephera kwamtima, kulowerera kwamtima;
• kulephera kupuma;
• kuchepa magazi
• zinthu pachimake zomwe zimayambitsa matenda a impso (kuchepa madzi m'thupi, matenda opha ziwopsezo, mantha, kuyambitsa zinthu zotsutsana ndi ayodini);
• Maphunziro a X-ray omwe ali ndi ayodini - amafunika kuthetseratu kwakanthawi;
• ntchito, kuvulala;
• zochitika za catabolic (machitidwe omwe ali ndi njira zowola zowonongeka, mwachitsanzo, ngati pali zotupa zamatenda);
• uchidakwa wambiri;
• lactic acidosis (kuphatikiza yomwe idasamutsidwa kale);
• mimba ndi mkaka wa m'mawere (yoyamwitsa) - musatenge Siofor panthawi yoyembekezera;
• kudya ndi malire ambiri a caloric kudya (zosakwana 1000 kcal / tsiku);
• zaka za ana;
• Hypersensitivity pamagawo a mankhwala.

Malangizowo akutsimikizira kuti mapiritsi a metformin ayenera kuikidwa mosamala kwa anthu azaka zopitilira 60 ngati akuchita ntchito yayikulu. Chifukwa gulu ili la odwala ali ndi chiwopsezo cha lactic acidosis. Mwakuchita izi, kuthekera kwa vuto ili mwa anthu omwe ali ndi chiwindi chathanzi kuli pafupi ndi zero.

Siofor pakuchepetsa thupi

Pa intaneti, mutha kupeza ndemanga zambiri zabwino kuchokera kwa anthu omwe amatenga Siofor kuti achepetse thupi. Malangizo omwe adagwiritsidwa ntchito pa mankhwalawa samanena kuti mankhwalawa amatha kugwiritsidwa ntchito pongopewa kapena kupewa matenda a shuga, koma kungofuna kuchepetsa thupi.

Komabe, mapiritsiwa amachepetsa chilimbikitso ndi kusintha kagayidwe kotero kuti anthu ambiri amatha "kutaya" mapaundi ochepa. Zotsatira za Siofor pakuchepetsa thupi zimapitilira mpaka munthu atazitenga, koma ndiye kuti mafuta osungirako amabweza msanga.

Zowona, Siofor yochepetsa thupi ndi imodzi mwanjira zotetezeka kwambiri pakati pa mapiritsi onse a kuchepetsa thupi. Zotsatira zoyipa (kupatula kumatulutsa, kutsegula m'mimba ndi kuphwanya) ndizosowa kwambiri. Kuphatikiza apo, ilinso mankhwala angakwanitse.

Siofor yochepetsa thupi - mapiritsi othandizira kuchepetsa thupi, otetezeka

Ngati mukufuna kugwiritsa ntchito Siofor kuti muchepetse kunenepa, chonde werengani gawo la "Contraindication". Zingakhalenso zolondola kukaonana ndi dokotala. Ngati sichoncho ndi endocrinologist, ndiye ndi gynecologist - nthawi zambiri amalembera mankhwala a polycystic ovary syndrome. Tengani magazi ndi mkodzo kuyesa kuti muwone ngati impso yanu imagwira ntchito.

Mukamamwa mapiritsi ochepetsa thupi - nthawi yomweyo muyenera kutsatira zakudya. M'malo mwake, muzochitika zotere, kumalimbikitsidwa kudya zakudya zamafuta ochepa. Koma tsamba la Diabetes-Med.Com pazotsatira zabwino kwambiri limalimbikitsa kugwiritsa ntchito Siofor pakuchepetsa thupi komanso zakudya zomwe zimaletsedwa ndi zakudya m'zakudya. Izi zitha kukhala zakudya za Dukan, Atkins kapena zakudya za Dr. Bernstein zamagulu ochepa a odwala matenda ashuga. Zakudya zonsezi ndizopatsa thanzi, zathanzi komanso zothandiza kuchepetsa thupi.

Chonde musapitirire mlingo womwe walimbikitsidwa kuti lactic acidosis isakule. Izi ndizovuta zovuta, koma zakupha. Mukapitirira muyeso womwe mwalimbikitsa, musamachepetse thupi msanga, ndipo mudzamva zotsatila zam'mimba kwathunthu. Kumbukirani kuti kutenga Siofor kumawonjezera mwayi wokhala ndi pakati osakonzekera.

Mu intaneti yolankhula ku Russia, mutha kupeza ndemanga zambiri za azimayi omwe amatenga Siofor kuti achepetse thupi. Miyezo ya mankhwalawa ndi yosiyana kwambiri - kuchokera pakukonda kupita kosakwiya.

Munthu aliyense amakhala ndi kagayidwe kake, kosafanana ndi wina aliyense. Izi zikutanthauza kuti machitidwe a thupi kwa Siofor nawonso azikhala amodzi. Ngati simukukonzekera kumwa mapiritsi nthawi imodzi ngati chakudya chochepa chamafuta, ndiye musayembekezere kutaya kulemera kochulukirapo monga wolemba ndemanga pamwambapa. Yang'anani pamphindi 2-4 kg.

Mwinanso, Natalia adatsata zakudya zama calorie ochepa, zomwe sizithandiza kuchepetsa thupi, koma m'malo mwake zimachepetsa kuchepa thupi. Ngati angagwiritse ntchito zakudya zamafuta ochepa, zotsatira zake zimakhala zosiyanasiyana. Zakudya zamapuloteni a Siofor + ndizothamanga komanso zosavuta kuwonda, zimakhala ndi mpweya wabwino komanso zopanda nkhawa.

Vutoli lomwe lingayambitse kupweteketsa mtima kwa Valentina ndi moyo wongokhala, ndipo matenda a shuga alibe kanthu. Munthu adabadwa kuti asunthe. Kuchita masewera olimbitsa thupi ndikofunikira kwa ife. Ngati mukukhala moyo wongokhala, ndiye kuti patatha zaka 40, matenda opatsirana ophatikizika, kuphatikizapo nyamakazi ndi nyamakazi, adzachitika. Njira yokhayo yowachepetsera ndikuphunzira kuchita masewera olimbitsa thupi mosangalatsa, ndikuyamba kuchita. Popanda kuyenda, palibe mapiritsi omwe angathandize, kuphatikizapo glucosamine ndi chondroitin. Ndipo Siofor alibe chilichonse choti anganene. Amachita ntchito yake mokhulupirika, akuthandiza kuchepetsa thupi komanso kuwongolera matenda ashuga.

Wina yemwe wakumana ndi vuto lochepa la calorie, chakudya chamafuta omwe madokotala amapereka kwa odwala matenda ashuga onse. Koma Elena adapitabe mosavuta. Amatha ngakhale kuchepetsa thupi. Koma chifukwa chakudya cholakwika, sipakanakhala nzeru kuti atenge Siofor, kapena chifukwa chochepetsa thupi, kapenanso kuchepetsa shuga m'magazi.

Nataliya adakulitsa pang'onopang'ono mlingo wake ndipo chifukwa cha izi adatha kupewa zovuta zonse. Pitani pa zakudya zamafuta ochepa - ndipo kulemera kwanu sikungasunthe, koma kuwuluka, kugwa.

Siofor yoletsa matenda ashuga amtundu wa 2

Njira zabwino zopewera matenda ashuga a 2 ndikuyamba kukhala ndi moyo wathanzi. Makamaka, kuwonjezera zolimbitsa thupi ndi kusintha kwa kavalidwe. Tsoka ilo, ambiri mwa odwala m'moyo watsiku ndi tsiku samatsata malangizowo pakusintha moyo wawo.

Chifukwa chake, funso lidafunsa mwachangu njira yopewera matenda a shuga a mtundu wachiwiri pogwiritsa ntchito mankhwala. Kuyambira 2007, akatswiri a American Diabetes Association adapereka malingaliro pazakugwiritsa ntchito kwa Siofor popewa matenda ashuga.

Kafukufuku yemwe adakhala zaka zitatu akuwonetsa kuti kugwiritsa ntchito Siofor kapena Glucofage kumachepetsa chiopsezo chokhala ndi matenda ashuga ndi 31%. Yerekezerani: ngati mungasinthe ndikukhala ndi moyo wathanzi, ndiye kuti chiwopsezochi chidzachepera ndi 58%.

Kugwiritsa ntchito mapiritsi a metformin popewa kumangolimbikitsidwa mwa odwala omwe ali ndi chiopsezo chachikulu cha matenda a shuga. Gululi limaphatikizapo anthu osakwanitsa zaka 60 onenepa kwambiri omwe mwanjira imodzi kapena zingapo zotsatirazi:

• Glycated hemoglobin wambiri - pamwamba 6%:
• matenda oopsa;
• mafuta ochepa 'a' cholesterol ”m'magazi;
• okwera magazi triglycerides;
• panali mtundu wachiwiri wa matenda ashuga achibale.
• index index yayikulu kuposa kapena yofanana ndi 35.

Odwala otere, kusankha kwa Siofor popewa matenda osokoneza bongo a 250-850 mg 2 kawiri pa tsiku angakambirane. Masiku ano, Siofor kapena Glucophage yake yosiyanasiyana ndi mankhwala okhawo omwe amatengedwa ngati njira yolepheretsa matenda ashuga.

Malangizo apadera

Muyenera kuwunika ntchito ya chiwindi ndi impso musanapereke mapiritsi a metformin kenako miyezi 6 iliyonse. Muyenera kuonanso kuchuluka kwa lactate m'magazi 2 pachaka kapena kangapo.

Pochiza matenda a shuga, kuphatikiza kwa siofor ndi zotumphukira za sulfonylurea ndi chiopsezo cha hypoglycemia. Chifukwa chake, kuwunika mosamala kuchuluka kwa shuga m'magazi kumafunika kangapo patsiku.

Chifukwa cha chiwopsezo cha hypoglycemia, odwala omwe amatenga siofor kapena glucophage ali osavomerezeka kuti achite nawo zochitika zomwe zimafuna kuti anthu aziganiza bwino komanso azigwiritsa ntchito kwambiri psychomotor.

Zotsatira zoyipa

10-25% ya odwala omwe akutenga Siofor ali ndi zodandaula za zoyipa zomwe zimapezeka m'matumbo, makamaka kumayambiriro kwa mankhwala. Uku ndikumva kukoma kwa "chitsulo" mkamwa, kusowa kudya, kutsekula m'mimba, kutulutsa magazi ndi mpweya, kupweteka kwam'mimba, mseru komanso kusanza.

Kuchepetsa pafupipafupi komanso kuchuluka kwa zotsatirazi, muyenera kudya siofor mukamadya kapena mukatha kudya, ndikuwonjezera pang'onopang'ono mankhwala. Zotsatira zoyipa kuchokera m'matumbo am'mimba siziri chifukwa cholembetsera Siofor. Chifukwa pakapita kanthawi nthawi zambiri amachoka, ngakhale ndi mlingo womwewo.

Matenda a metabolism: osowa kwambiri (omwe ali ndi mankhwala osokoneza bongo, pamaso pa matenda ophatikizika, momwe kugwiritsidwa ntchito kwa Siofor kumatsutsana, ndi uchidakwa), lactate acidosis imatha kukhazikika. Izi zimafuna kufafaniza mankhwala.

Kuchokera pa hematopoietic dongosolo: nthawi zina - megaloblastic anemia. Ndi chithandizo cha nthawi yayitali ndi siophore, kukula kwa B12 hypovitaminosis ndikotheka (kuyamwa). Nthawi zambiri pamakhala zovuta zina zoyipa - zotupa pakhungu.

Kuchokera ku endocrine dongosolo: hypoglycemia (ndi mankhwala osokoneza bongo).

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, kuchuluka kwambiri kwa metformin (ichi ndi mphamvu ya Siofor) m'magazi am'magazi imatha kufikira maola pafupifupi 2,5. Ngati mumamwa mapiritsi ndi chakudya, ndiye kuti mayamwidwe pang'ono amachepetsa ndikuchepetsa. Kuchuluka kwa metformin mu plasma, ngakhale pamlingo waukulu, sikapitilira 4 μg / ml.

Malangizowo akuti kukhudzika kwake kwathunthu mwa odwala athanzi ndi pafupifupi 50-60%. Mankhwala sakukhudzana ndi mapuloteni a plasma. Chidacho chikugwiritsidwa ntchito mu mkodzo kwathunthu (100%) osasinthika. Ichi ndichifukwa chake mankhwalawa sanalembedwe kwa odwala omwe aimpso glomerular kusefa kosachepera 60 ml / min.

Kuwonekera kwa aimpso kwa metformin kopitilira 400 ml / min. Amapitilira kuchuluka kwa kusefedwa kwa glomerular. Izi zikutanthauza kuti siofor imachotsedwa m'thupi osati kokha ndi kusefera, komanso kudzera mwa chobisalira mu proximal renal tubules.

Pambuyo pakukonzekera pakamwa, theka la moyo limakhala pafupifupi maola 6.5. Ndi kulephera kwa impso, kuchuluka kwa maselo a siofor kumatsika molingana ndi kuchepa kwa chilolezo chain. Chifukwa chake, theka la moyo limatenga nthawi yayitali ndipo kuchuluka kwa metformin m'madzi a m'magazi kumakwera.

Kodi Siofor amachotsa calcium ndi magnesium m'thupi?

Kodi kutenga Siofor kumakulitsa kuchepa kwa magnesium, calcium, zinc ndi mkuwa m'thupi? Akatswiri aku Romania adaganiza zofunsa. Kuphunzira kwawo kunakhudza anthu 30 azaka 30-60, omwe anali atangopezeka ndi matenda a shuga a 2 ndipo anali asanalandiridwepo kale. Onsewa adalembedwa Siofor 500 mg 2 kawiri pa tsiku. Siofor yekhayo amene adayikidwa kuchokera pamapiritsi kuti awone momwe zimakhalira. Madotolo adonetsetsa kuti zomwe aliyense akudya zimakhala ndi 200 mg ya magnesium patsiku. Magnesium-B6 mapiritsi sanalembedwe kwa aliyense.

Gulu lolamulira la anthu athanzi, lopanda matenda a shuga, linapangidwanso. Adayesanso chimodzimodzi kuyerekezera zotsatira zawo ndi za anthu odwala matenda ashuga.
Odwala a matenda amtundu wa 2 omwe anali ndi vuto la impso, matenda a chiwindi, matenda a m'mimba, pakati, matenda otsekula m'mimba, kapena omwe amamwa mankhwala okodzetsa sanali kuloledwa kuchita nawo phunzirolo.

Mlingo wa magnesium m'magazi a odwala omwe ali ndi matenda a shuga a 2 ndi ochepa kwambiri, poyerekeza ndi anthu athanzi. Kuperewera kwa magnesium m'thupi ndi chimodzi mwazomwe zimayambitsa matenda a shuga. Matenda a shuga atakula kale, impso zimachotsa shuga wambiri mkodzo, ndipo chifukwa cha izi, kutayika kwa magnesium kumawonjezeka. Mwa odwala matenda ashuga omwe apeza zovuta, pali kuchepa kwambiri kwa magnesium kuposa omwe ali ndi matenda ashuga popanda zovuta. Magnesium ndi gawo la michere yoposa 300 yomwe imayendetsa metabolism yama protein, mafuta ndi chakudya. Zatsimikiziridwa kuti kuchepa kwa magnesium kumathandizira kukana kwa insulin kwa odwala omwe ali ndi metabolic syndrome kapena matenda a shuga. Ndipo kutenga mankhwala othandizira a magnesium, ngakhale pang'ono, komabe kumakulitsa chidwi cha maselo kuti apange insulin. Ngakhale njira yofunikira kwambiri yothanirana ndi insulin ndi chakudya chamafuta ochepa, ena onse kumbuyo kwake amakhala mbali yayikulu.

Zinc ndi imodzi mwazinthu zofunika kwambiri zofufuza m'thupi la munthu. Zimafunikira njira zopitilira 300 mu maselo - ntchito ya enzyme, kaphatikizidwe ka mapuloteni, kuwonetsera. Zinc ndiyofunikira kuti chitetezo cha mthupi chizigwira ntchito, chizikhala ndi zinthu zachilengedwe, kuletsa kusintha zinthu mwaulere, kuchepetsa kuchepa komanso kupewa khansa.

Mkuwa nawonso ndi chinthu chofunikira kutsatira, gawo la michere yambiri. Komabe, ma ayoni amkuwa amaphatikizidwa ndikupanga mitundu yoyipa ya oxygen yomwe imagwira ntchito (ma radicals aulere), motero, ndiwothandiza. Onse akusowa komanso mkuwa owonjezera mthupi umayambitsa matenda osiyanasiyana. Pankhaniyi, owonjezera amakhala ponseponse. Matenda a 2 a shuga ndi matenda osachiritsika omwe amapanga mitundu yambiri yaulere, yomwe imayambitsa kupsinjika kwa oxidative kuwononga maselo ndi mitsempha yamagazi. Kafukufuku akuwonetsa kuti thupi la odwala matenda ashuga nthawi zambiri limadzaza ndi mkuwa.

Pali mapiritsi osiyanasiyana amtundu wa shuga. Chithandizo chodziwika bwino kwambiri ndi metformin, yomwe imagulitsidwa pansi pa mayina a Siofor ndi Glucofage. Zimatsimikiziridwa kuti sizimabweretsa kulemera, koma zimathandizira kuchepetsa thupi, zimapangitsa kuti magazi a cholesterol, komanso zonsezi zisakhale ndi zotsatirapo zoyipa. Siofor kapena glucophage yowonjezereka imalimbikitsidwa kuti iperekedwe nthawi yomweyo, wodwala akangopezeka ndi matenda a shuga 2 kapena metabolic syndrome.

Madokotala aku Romania adaganiza zoyankha mafunso otsatirawa:

• Kodi mulingo wachilengedwe wanji wa minyewa komanso zinthu zomwe zimapezeka mthupi la odwala omwe apezeka ndi matenda a shuga 2? Wokwezeka, wotsika kapena wabwinobwino?
• Kodi kugwiritsidwa ntchito kwa metformin kumakhudza bwanji kuchuluka kwa thupi la magnesium, calcium, zinc ndi mkuwa?

Kuti achite izi, adayetsa odwala odwala matenda ashuga:

• kuchuluka kwa magnesium, calcium, zinc ndi mkuwa mu madzi am'magazi;
• zomwe zili ndi magnesium, calcium, zinki ndi mkuwa pakukodzoza kwamkodzo kwa maola 24;
• mulingo wa magnesium m'magazi ofiira (!);
• komanso cholesterol chabwino “chabwino” komanso “choyipa”, triglycerides, shuga othamanga wamagazi, glycated hemoglobin HbA1C.

Odwala a shuga a Type 2 adayezetsa magazi ndi mkodzo:

• kumayambiriro kwa phunziroli;
• ndiye kachiwiri - mutatha miyezi 3 mutamwa metformin.

Zomwe zimatsata mu thupi la odwala omwe ali ndi matenda ashuga a 2 komanso mwaumoyo

Tikuwona kuti mwa odwala matenda ashuga zomwe zili ndi magnesium ndi zinc m'magazi zimachepetsedwa, ndikuyerekeza ndi anthu athanzi. Pali zolemba zambiri m'magazini a Chingerezi azachipatala omwe amatsimikizira kuti kusowa kwa magnesium ndi zinc ndi chimodzi mwazomwe zimayambitsa matenda ashuga a 2. Mkuwa wophatikiza ndi womwewo. Pazidziwitso zanu, ngati mumatenga zinc m'mapiritsi kapena makapisozi, imakhutitsa thupi ndi nthaka ndipo nthawi yomweyo imachotsa mkuwa wowonjezera kuchokera pamenepo. Ndi anthu ochepa omwe amadziwa kuti zowonjezera zazitini zimachita zinthu kawiri kawiri. Koma simuyenera kunyamulidwa kwambiri kuti pasakhale kuperewera kwamkuwa. Tengani zinc mu maphunziro 2-4 kawiri pachaka.

Zotsatira zakuwonetsa kuti kutenga metformin sikukweza kuchepa kwa kufufuza zinthu ndi mchere m'thupi. Chifukwa chimbudzi cha magnesium, zinki, mkuwa ndi calcium mumkodzo mwa odwala omwe ali ndi matenda a shuga a 2 sichinawonjezeke pambuyo pa miyezi itatu. Potengera momwe mankhwalawo amathandizira ndi mapiritsi a Siofor, odwala matenda ashuga adakweza michere mthupi. Olemba kafukufukuyu akuti izi zikuchitika ndi Siofor. Ndikukhulupirira kuti mapiritsi a shuga alibe chochita ndi izi, koma kuti omwe amaphunzira nawo adadya zakudya zopatsa thanzi pomwe madotolo amawayang'anira.

Panali mkuwa wambiri m'magazi a anthu odwala matenda ashuga kuposa anthu athanzi, koma kusiyana ndi gulu lolamuliraku sikunali kopanda tanthauzo. Komabe, madokotala aku Russia adawona kuti mkuwa wambiri m'madzi am'magazi, umakhala wolimba kwambiri shuga. Kumbukirani kuti phunziroli lidakhudza odwala 30 omwe ali ndi matenda ashuga a 2. Pambuyo pa chithandizo cha miyezi itatu, adaganiza zosiya 22 za iwo pa Siofor, ndipo mapiritsi ena 8 adawonjezeredwa - sulfonylurea. Chifukwa Siofor sanatsitse shuga wawo mokwanira. Omwe anapitiliza kuthandizidwa ndi Siofor anali ndi 103.85 ± 12.43 mg / dl yamkuwa m'magazi am'magazi, ndipo omwe amafunikira kupereka zotumphukira za sulfonylurea anali ndi 127.22 64 22.64 mg / dl.

Olemba kafukufuku adakhazikitsa ndikuwonetsa maubwenzi otsatirawa:

• Kutenga Siofor pa 1000 mg patsiku sikukuonjezera kuchuluka kwa calcium, magnesium, zinki ndi mkuwa kuchokera mthupi.
• Kuchuluka kwa magnesium m'magazi, kumawerengera bwino shuga.
• Kuchuluka kwa magnesium m'maselo am'magazi, kumapangitsa shuga ndi glycated hemoglobin bwino.
• Mkuwa wambiri, umakhala wolimba kwambiri ngati shuga, glycated hemoglobin, cholesterol ndi triglycerides.
• Mukakhala ndi hemoglobin wokwera kwambiri, ndiye kuti nthaka yambiri imathira mkodzo.
• Kuchuluka kwa calcium m'magazi sikusiyana mwa odwala omwe ali ndi matenda ashuga a 2 komanso anthu athanzi.

Ndikuwonetsa kuti kuyesa kwa magazi kwa plasma magnesium sikodalirika, sikuwonetsa kuchepa kwa mcherewu. Onetsetsani kuti mukuwunika zomwe zili mu magnesium m'magazi ofiira. Ngati izi sizingatheke, ndipo mukumva zofooka za magnesium m'thupi, ndiye ingotengani mapiritsi a magnesium okhala ndi vitamini B6. Ndiotetezeka pokhapokha mutakhala ndi matenda a impso. Nthawi yomweyo, calcium sikhala ndi vuto lililonse la matenda ashuga. Kutenga mapiritsi a magnesium okhala ndi mavitamini a B6 ndi zinc ndizofunikira kwambiri kuposa calcium.

Zotsatira za pharmacological

Siofor - mapiritsi ochepetsa shuga wamagazi kuchokera pagulu la Biguanide. Mankhwala amapereka kuchepa kwa kuchuluka kwa shuga m'magazi onse pamimba yopanda kanthu ndikatha kudya. Sichimayambitsa hypoglycemia, chifukwa sichimalimbikitsa kuteteza kwa insulin. Machitidwe a metformin mwina amatengera njira zotsatirazi:

• kuponderezana kwamatenda a glucose ochulukirapo mu chiwindi ndi kupondereza gluconeogeneis ndi glycogenolysis, ndiko kuti, siofor imalepheretsa kaphatikizidwe ka glucose kuchokera ku amino acid ndi zina "zopangira", komanso kupewa kutulutsa kwake m'misika yama glycogen;
• kusintha kukhathamira kwa glucose kuzinthu zotumphukira ndikugwiritsa ntchito kumeneko pochepetsa mphamvu ya insulin, ndiye kuti, minyewa yathupi imazindikira kwambiri zomwe zimapangitsa insulini, motero maselo "amayamwa" glucose mwa iwo eni;
• Kuchepetsa mayamwidwe am'matumbo m'matumbo.

Mosasamala kanthu za kukhudzidwa kwa glucose m'magazi, siofor ndi mankhwala ake othandizira metformin amasintha kagayidwe ka lipid, amachepetsa zomwe zili m'magazi a triglycerides m'mwazi, zimawonjezera zomwe zili ndi cholesterol "yabwino" (kachulukidwe kakang'ono) ndikuchepetsa kuchuluka kwa cholesterol yoyipa "

Molecule ya metformin imaphatikizidwa mosavuta mu lipid bilayer ya nembanemba maselo. Siofor imakhudza ma membrane am'mimba, kuphatikizapo:

• kukakamiza kwa mitochondrial kupuma tcheni;
• kuchuluka kwa tyrosine kinase wa insulin receptor;
• kukondoweza kwa kusintha kwa glucose transporter GLUT-4 kupita ku membrane wa plasma;
• kutsegula kwa AMP-activated protein kinase.

Kuchita kwachilengedwe kwa nembanemba ya khungu kumadalira kuthekera kwa mphamvu ya mapuloteni kuyenda momasuka mu lipid bilayer. Kuwonjezeka kwa kusakhazikika kwa membrane ndizodziwika bwino m'matenda a shuga, omwe angayambitse zovuta za matendawa.

Kafukufuku wasonyeza kuti metformin imachulukitsa kuchuluka kwa madzi am'magazi a anthu. Chofunika kwambiri ndi mphamvu ya mankhwalawa pa mitochondrial membrane.

Siofor ndi Glucofage zimakulitsa chidwi cha insulin makamaka maselo a minofu yolimba, komanso pang'ono - adipose minofu. Malangizo a boma akuti mankhwalawa amachepetsa kuyamwa kwa shuga m'matumbo ndi 12%. Odwala mamiliyoni ambiri akhulupirira kuti mankhwalawa amachepetsa kudya. Potengera maziko akumwa mapiritsiwo, magazi sakhala wandiweyani, mwayi wopanga magazi owopsa amachepa.

Glucophage kapena siofor: kusankha?

Glucophage kutalika ndi mtundu watsopano wa metformin. Amasiyana ndi siofor chifukwa imakhala ndi nthawi yayitali. Mankhwala kuchokera piritsi samamwa nthawi yomweyo, koma pang'onopang'ono. Mwa Siofor wamba, 90% ya metformin imatulutsidwa piritsi mkati mwa mphindi 30, ndipo mu glucophage yayitali - pang'onopang'ono, maola opitilira 10.

Glucophage ndiwofanana ndi suophore, koma nthawi yayitali. Zotsatira zoyipa zochepa komanso zosavuta kutenga, koma zimawononga ndalama zambiri.

Ngati wodwala satenga siofor, koma glucophage nthawi yayitali, ndiye kuti kufalikira kwa metformin m'madzi a m'magazi kumayamba pang'onopang'ono.

Ubwino wa glucophage wautali kuposa momwe zimakhalira

• ndikokwanira kuzitenga kamodzi patsiku;
• Zotsatira zoyipa za m'mimba thirakiti yomweyo.
• amatha kuwongolera shuga m'magazi komanso m'mawa pamimba yopanda kanthu;
• Kuchepetsa mphamvu ya shuga m'magazi kulibe vuto lofanana ndi "yofala" siofor.

Zomwe muyenera kusankha - siofor kapena glucophage yayitali? Yankho: ngati simulekerera siofor chifukwa cha kutulutsa, kufinya kapena kutsegula m'mimba, yesani glucophage. Ngati zonse zili bwino ndi Siofor, pitilizani kumwa, chifukwa mapiritsi amtundu wa glucophage ndi okwera mtengo kwambiri. Madokotala othandizira odwala matenda a shuga Dr. Bernstein amakhulupirira kuti glucophage ndiwothandiza kwambiri kuposa mapiritsi ofulumira a metformin. Koma mazana a odwala ambiri anali otsimikiza kuti siofor wamba amachita mwamphamvu. Chifukwa chake, kulipira zowonjezera kwa glucophage kumakhala kopindulitsa, kokha kuti muchepetse kugaya chakudya.

Mlingo wa mapiritsi a Siofor

Mlingo wa mankhwalawa umakhazikitsidwa nthawi iliyonse payokha, kutengera kuchuluka kwa shuga m'magazi ndi momwe wodwalayo amalolera kulandira chithandizo. Odwala ambiri amasiya chithandizo cha Siofor chifukwa cha kusefukira, kutsegula m'mimba, komanso kupweteka kwam'mimba. Nthawi zambiri, zoyipa izi zimachitika pokhapokha posankha mlingo woyenera.

Njira yabwino yotsatirira Siofor ndi kuchuluka pang'onopang'ono kwa mlingo. Muyenera kuyamba ndi mlingo wotsika - osaposa 0,5-1 g patsiku. Awa ndi mapiritsi 1-2 a mankhwala a 500 mg kapena piritsi limodzi la Siofor 850. Ngati palibe zotsatirapo zoyipa kuchokera m'matumbo am'mimba, ndiye kuti pambuyo pa masiku 4-7 mutha kuwonjezera mlingo kuchokera ku 500 mpaka 1000 mg kapena kuchokera ku 850 mg mpaka 1700 mg patsiku, i.e. ndi piritsi limodzi patsiku mpaka awiri.

Ngati pansipa pali zovuta kuchokera pamimba, ndiye kuti muyenera "kubwezeranso" mankhwalawo kwa omwe anali m'mbuyomu, kenako ndikuwonjezeranso. Kuchokera pamalangizo a Siofor, mutha kudziwa kuti mlingo wake wogwira ndi 2 mg patsiku, 1000 mg iliyonse. Koma nthawi zambiri zimakhala zokwanira kutenga 850 mg 2 kawiri pa tsiku. Kwa odwala akulu m'thupi, mulingo woyenera kwambiri ungakhale 2500 mg / tsiku.

Mlingo wapamwamba tsiku lililonse wa Siofor 500 ndi 3 g (mapiritsi 6), Siofor 850 ndi 2.55 g (mapiritsi atatu). Pafupifupi tsiku lililonse la Siofor® 1000 ndi 2 g (mapiritsi 2). Mlingo wake waukulu tsiku lililonse ndi 3 g (mapiritsi atatu).

Mapiritsi a Metformin mulingo uliwonse amayenera kumwa ndi chakudya, osafuna kutafuna, ndimadzi okwanira. Ngati mlingo wa tsiku ndi tsiku woposa piritsi limodzi, gawani pawiri. Ngati mwaphonya kumwa mapiritsi, ndiye kuti simuyenera kulipira izi pomwa mapiritsi ambiri nthawi ina.

Kutenga nthawi yayitali motani ya Siofor - izi zimatsimikiziridwa ndi adokotala.

Bongo

Ndi bongo wa Siofor, lactate acidosis imatha kukhazikika. Zizindikiro zake: kufooka kwambiri, kupuma, kugona, kugona mseru, kusanza, kutsekula m'mimba, kupweteka kwam'mimba, kuzizira kwamphamvu, kutsika kwa magazi, Reflex bradyarrhythmia.

Pakhoza kukhala zodandaula za kupweteka kwa minofu, kusokonezeka ndi kuwonongeka, kupumira mofulumira. Chithandizo cha lactic acidosis ndichizindikiro. Izi ndizovuta zomwe zingayambitse imfa. Koma ngati simupitirira muyeso wa impsozo ndi impso zanu zonse zili bwino, ndiye kuti mwina ziro ndi ziro.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwalawa ali ndi katundu wosiyana ndi ena onse. Uwu ndi mwayi wophatikiza ndi njira ina iliyonse yochepetsera kuchuluka kwa shuga m'magazi. Siofor ikhoza kutumikiridwa molumikizana ndi mtundu wina uliwonse wa mapiritsi a 2 a shuga kapena insulin.

Siofor itha kugwiritsidwa ntchito limodzi ndi mankhwala awa:

• ma sekalare (zotengera ma sulfonylurea, meglitinides);
• thiazolinediones (glitazones);
• incretin mankhwala (analogues / agonists a GLP-1, zoletsa za DPP-4);
• mankhwala omwe amachepetsa kuyamwa kwa ma carbohydrate (acarbose);
• insulin ndi mawonekedwe ake.

Pali magulu a mankhwala omwe amatha kupititsa patsogolo zotsatira za metformin pakuchepetsa magazi, ngati agwiritsidwa ntchito nthawi imodzi. Izi ndi zotumphukira za sulfonylurea, acarbose, insulin, NSAIDs, Mao inhibitors, oxytetracycline, ACE inhibitors, clofibrate zotumphukira, cyclophosphamide, beta-blockers.

Malangizo a Siofor akuti magulu ena a mankhwala amatha kufooketsa mphamvu yake yochepetsa shuga ya magazi ngati mankhwala agwiritsidwa ntchito nthawi imodzi. Awa ndi GCS, njira zakulera za pakamwa, epinephrine, sympathomimetics, glucagon, mahomoni a chithokomiro, zotumphukira za phenothiazine, zotumphukira za nicotinic acid.

Siofor imatha kufooketsa mphamvu ya anticoagulants. Cimetidine amachepetsa kuchotsedwa kwa metformin, yomwe imawonjezera chiopsezo cha lactic acidosis.

Osamamwa mowa pamene mukutenga Siofor! Kugwiritsa ntchito pamodzi ndi ethanol (mowa), chiopsezo chotenga zovuta zowopsa - lactic acidosis imachuluka.

Furosemide imachulukitsa kuchuluka kwa metformin m'madzi a m'magazi. Pankhaniyi, metformin imachepetsa kuchuluka kwakukulu kwa furosemide mu madzi am'magazi ndi theka la moyo wawo.

Nifedipine amalimbikitsa mayamwidwe ndi pazipita kuchuluka kwa metformin m'madzi am'magazi, amachedwa mayeso.

Mankhwala a Cationic (amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, vancomycin), omwe amatulutsidwa m'matumba, kupikisana ndi machitidwe ogwiritsira ntchito ma tubular. Chifukwa chake, ngati atenga nthawi yayitali, amatha kuonjezera kuchuluka kwa metformin m'madzi a m'magazi.

M'nkhaniyi, takambirana mwatsatanetsatane mitu yotsatirayi:

• Siofor pakuchepetsa thupi;
• Mapiritsi a Metformin a kupewa ndi kuchiza matenda a shuga 2;
• M'malo omwe mukuyenera kuti mutenge mankhwalawa mtundu 1 wa shuga;
• Momwe mungasankhire mlingo kuti musakhumudwitsidwe.

Kwa odwala matenda a shuga a 2, musadziikire malire pakumwa Siofor ndi mapiritsi ena, koma tsatirani dongosolo lathu la matenda ashuga la 2. Kufa msanga chifukwa cha vuto la mtima kapena sitiroko ndiye vuto. Ndipo kukhala munthu wodwala pakama chifukwa cha zovuta za matenda ashuga kumakhala kowopsa. Phunzirani kwa ife momwe mungathetsere matenda ashuga popanda zakudya "zanjala", maphunziro olimbitsa thupi komanso mwa 90-95% ya anthu osabayira jakisoni

Ngati muli ndi mafunso okhudzana ndi mankhwalawa Siofor (Glucofage), ndiye mutha kuwafunsa mu ndemanga, oyang'anira tsamba amayankha mwachangu.