Chithandizo choyambirira cha matenda a shuga a 2 nthawi zonse chimakhala chokhazikitsidwa ndi chithandizo chamankhwala chokhazikika komanso masewera olimbitsa thupi. Mankhwala Diamerid amalembedwa chifukwa cha kulephera kwa njirazi.
Kugwiritsa ntchito mankhwala ngati kumeneku kumavomerezana ndi adotolo, omwe amapereka mankhwalawa potengera chithunzi chachikulu cha matenda omwe wodwalayo ali nawo, kuopsa kwa matendawa.
Njira yothandizira achire iyenera kukhala ndi mitundu yosankhidwa moyenera kuti mupewe kuwonetsa koyipa kwa mankhwala monga diamerid.
Njira zamankhwala osokoneza bongo
Masiku ano, mankhwala amakono amagwiritsa ntchito imodzi mwa magulu angapo a mankhwalawa kuchiza matenda amtundu wa 2. Zolinga zazikulu zomwe zikuyenera kukwaniritsidwa chifukwa chogwiritsa ntchito mankhwalawa ndi monga:
- kukondoweza kwa insulin ya katemera wa insulin
- kuchepa kwa insulini ya maseloꓼ
- kuyimitsidwa kwa kaphatikizidwe ka glucose ndikuchepetsa kuyamwa kwake m'magazi kuchokera m'matumboꓼ
- kukonza kukonzekera kwa chiŵerengero cha lipid tizigawo m'magazi.
Monga lamulo, chithandizo nthawi zonse chimayamba ndi kuperekedwa kwa mankhwala amodzi; ngati sangathe, mankhwalawa ophatikizika kapena limodzi ndi jakisoni wa insulin atha kutumikiridwa.
Magulu akuluakulu a mankhwalawa omwe amagwiritsidwa ntchito pochiza matenda amiseche 2
- Mankhwala omwe amachokera ku sulfonylurea. Ubwino wawo waukulu ndi kulolera bwino mankhwala kwa odwala ambiri. Mwa zochita zake, amachepetsa kukana kwa insulini ndikulimbikitsa kutulutsa kwa mahomoni ndi maselo a pancreatic.
- Njira zochokera pagulu la Biguanide zimaphatikizanso gawo la metformin. Ndi mphamvu ya metformin yomwe imathandizira kuchepetsa kubisirana kwa insulin, imakhudza bwino mawonekedwe a fez, ndikuwongolera mbiri ya lipid. Kusankha Mlingo wolakwika kumatha kubweretsanso mavuto ambiri.
- Amayamwa
- Zokonzekera zochokera ku thiazolidinone zotumphukira zimathandiza kuchepetsa shuga wamagazi ndikuwongolera mawonekedwe a lipid.
Ma alpha-glucosidase inhibitors kapena dipeptidyl peptides 4 amatchulidwanso kuti mankhwala; amakhala ndi phindu pa kuthetseratu kwa hyperglycemia ndikuwonjezera chidwi cha maselo a pancreatic beta ku glucose.
Chachikulu pharmacological zimatha mankhwala
Diameride ndi mankhwala ochokera pagulu lachitatu sulfonylureas. Nthawi zambiri amagwiritsidwa ntchito pofuna kuchiza matenda a shuga 2, ngati mankhwala othandiziridwa pakudya asanachitike komanso zolimbitsa thupi sizinadzetse zotsatirapo zabwino.
Mankhwala amapezeka mu mawonekedwe a piritsi mitundu yambiri - imodzi, ziwiri, zitatu kapena zinayi za milligram yogwira ntchito yomwe ili ndi zina zowonjezera pazomwe zimapangidwira. Chofunikira chachikulu cha mankhwalawa ndi glimepiride.
Kupanga kwakukulu kwamankhwala kumakhala motengera zotsatirazi:
- zimawonjezera chidwi cha maselo ku insulin.
- amagwira ntchito yotsekera kutsata kwa potaziyamu, chifukwa chake kuchuluka kwa potaziyamu komwe kumawonjezeka ndi insulin katulutsidwe kumayambitsa.
- zimakhudza bwino mulingo wa lipid.
- amathandizira kuchepetsa kuphatikizira kwa masamba.
Kuphatikiza apo, kugwiritsa ntchito mapiritsi kumapangitsanso zovuta za insulin pakulowetsedwa kwa glucose ndi zotumphukira zimakhala.
Nthawi zambiri, mankhwalawa amagwiritsidwa ntchito kuphatikiza mankhwala molumikizana ndi mankhwala ogwirizana ndi metformin (metabolic control imasintha) kapena insulin.
Ndemanga zingapo za odwala omwe amagwiritsa ntchito mankhwalawa zimawonetsa kulolera mosavuta komanso kuthamanga kwa mankhwalawa.
Malangizo ogwiritsira ntchito mankhwalawa
Malangizo ogwiritsira ntchito mankhwalawa akuti kuyamba kwa mankhwalawa kuyenera kuchitika ndi mankhwala otsika kwambiri a mankhwalawa. Chifukwa chake, kuyang'anira kwa metabolic kofunikira kumaperekedwa.
Mukamamwa mankhwalawa, wodwalayo amayenera kuwunika kuchuluka kwa shuga m'magazi, komanso chisonyezo cha glycosylated hemoglobin.
Kukhazikitsidwa kwa mankhwala, komanso kusankha kwa mankhwala oyenera, kumachitika kokha ndi adokotala. Pankhaniyi, kudzipereka palokha ndi koletsedwa.
Kulondola kotenga miyala ndikutsatira malangizo awa:
- Pazigawo zoyambirira zamankhwala, muyezo woyenera wovomerezeka wa mankhwalawa ndi milligram imodzi ya mankhwala othandizira kamodzi patsiku. Pakatha sabata limodzi kapena awiri, ngati pakufunika thandizo, mlingo wa tsiku ndi tsiku utha kuwonjezereka.
- Mulingo wovomerezeka wa mankhwalawa sayenera kupitirira mamiligalamu asanu ndi atatu a mankhwalawo, malinga ngati mankhwalawa amawonjezeka pang'onopang'ono komanso bwino, masiku khumi mpaka khumi ndi anayi.
- Mwa odwala omwe misempha ya magazi amawongolera bwino, mphamvu ya mankhwalawa imatheka mukatenga gawo limodzi mpaka anayi a mankhwalawo. Masiku ano, pali anthu ochepa omwe amafunika kuwonjezera mankhwalawa kukhala mamiligalamu asanu ndi atatu a mankhwalawa.
Ndi bwino kumwa mankhwala, kutsatira malangizo onse a dokotala. Katswiri wazachipatala amayika nthawi ndi kuchuluka kwa kuvomerezedwa, kutengera ndi moyo wa wodwalayo, ntchito yake komanso kuchuluka kwa zochita zolimbitsa thupi. Monga lamulo, kugwiritsa ntchito mankhwalawa kumakhazikitsidwa kamodzi patsiku chakudya chachikulu (mwachitsanzo, m'mawa musanadye chakudya cham'mawa). Choyambirira ndichakudya choyenera komanso chokwanira (nkhomaliro, chakudya chamadzulo), ngati mankhwalawa adamwa. Kuphatikiza apo, ziyenera kukumbukiridwa kuti ngati, pazifukwa zina, mapiritsi adasemphana, palibe chifukwa chowonjezera mlingo wake pa mlingo wotsatira.
Pali nthawi zina pomwe dokotala angasinthe kuchuluka kwa mankhwalawa. Kuwongolera kumachitika ngati wodwala akuwonda kwambiri, pakhala kusintha pa moyo wa wodwalayo - kuchuluka kwake ndi kuchuluka kwa zakudya, kuchuluka kwa zochita zolimbitsa thupi, pamakhala chiwopsezo cha hypo- kapena hyperglycemia chifukwa cha zinthu zina.
Ndi ziti zotsutsana zomwe zimagwiritsidwa ntchito?
Ngakhale pali mndandanda wazakudya zabwino za mankhwalawo, ndikofunikira kuganizira mitundu yonse ya zinthu zoyipa zomwe zingachitike mutagwiritsidwa ntchito.
Choyamba, ndikofunikira kulabadira mndandanda wa zoletsa zomwe chithandizo cha Diomexide sichingachitike. Zina mwazinthu zazikuluzikulu zomwe zikuphatikizidwa ndi izi:
Chithandizo cha matenda ashuga a matenda oyamba, komanso panjira ya matenda a shuga kapena matenda a shuga wodwala.
- mawonetseredwe a hypoglycemia wodwala,
- Pamaso pa matenda a matenda opatsirana,
- matenda a chiwindi kapena impso amayamba.
- tsankho kapena hypersensitivity ku chimodzi kapena zingapo za mankhwalawa.
- pamaso pa lactose tsankho kapena lactase akusowa.
Mpaka pano, palibe chidziwitso chokwanira chokhudza momwe mankhwalawa amagwirira ntchito pochiza matenda a shuga kwa ana. Chifukwa chake, chithandizo cha odwala chotere (mpaka zaka khumi ndi zisanu ndi zitatu) sichosankhidwa. Kuphatikiza apo, zotsutsana zimaphatikizanso kumwa mankhwalawa kwa atsikana ndi amayi oyembekezera panthawi yoyamwitsa.
Mosamala kwambiri, mankhwala amalembedwa ngati pali chiopsezo chowonjezereka cha hypoglycemia, ngati pali zinthu zina zomwe zimafuna kuti wodwalayo asamutsidwe kuti apange jakisoni wa insulin pambuyo pakuchita opaleshoni, ngati pali vuto la m'mimba.
Ndi zovuta zoyipa ziti zomwe zimagwiritsidwa ntchito ndi mankhwalawa zomwe zingachitike?
Chifukwa chosankha molakwika mlingo wa mankhwalawa, osagwirizana ndi malingaliro onse a dokotala yemwe akupezeka, zotsatirapo zosiyanasiyana zoyipa za kumwa mankhwalawa zimatha kuyamba.
Chimodzi mwazotsatira zoyipa ndizoti chiwopsezo chowonjezeka ndikukula kwa hypoglycemia kwa nthawi yayitali. Zizindikiro zazikulu zomwe zimayenda ndi izi:
- kulakalaka kwambiri ndi kumva njala nthawi zonse,
- kupweteka kwambiri m'mutu
- kusanza ndi kusanza
- kumangokhala wotopa ndi kufooka kwa thupi,
- kusakhazikika
- kulephera kulolera
- kuvutika kupuma
- chizungulire ndi kukomoka,
- kuchuluka kwa kuthamanga kwa magazi.
Kukhazikitsa kwa mankhwalawa kumathandizikanso kuti azitha kuchepa. Vutoli limakhala lakanthawi ndipo limadutsa lokha kwa kanthawi.
Kuphatikiza apo, mawonekedwe owoneka ndi zoyipa zingaphatikizeponso:
- Matenda osiyanasiyana am'mimba. Ululu m'mimba ungachitike, kutsegula m'mimba kumatha.
- Kuwonongeka kwa chiwindi, kukula kwa chiwindi, jaundice kapena cholestasis.
- Kuchokera kuzungulira kwa magazi, nthawi zina, thrombocytopenia, leukopenia kapena pancytopenia amawonekera.
- Kuphwanya kwamanjenje kumatha kuchitika, komwe nthawi zambiri kumawonetsedwa m'njira zosiyanasiyana zamatsenga - urticaria, kuyabwa kwa khungu kapena zotupa.
Mankhwala osokoneza bongo amachititsa kuti munthu azidwala matenda a shuga oopsa kwambiri, omwe amatha tsiku limodzi mpaka atatu.
Kodi mankhwala amatha kusinthidwa ndi chinthu china?
Chida chake ndi mankhwala, omwe ndi osavuta kupeza m'masitolo azitawuni. Mtengo wake umasiyana kuchokera ku ma ruble 170 mpaka 600, kutengera mtundu, malo ogulitsa ndi kampani yopanga. Ndemanga za makasitomala zikuwonetsa kuti mankhwalawa amagwirizana kwathunthu ndizofunikira za "mtengo wapamwamba". Pali nthawi zina pamene mungaganizire zothana ndi mankhwala ndikupeza analogue yoyenera.
Masiku ano, msika wamakono wamankhwala umapereka kusankha mitundu ingapo yamankhwala osiyanasiyana, omwe kapangidwe kake ndi fanizo la Diamerid, kapena masanjidwe ake. Tiyenera kudziwa kuti mankhwala a analog amatha kukhala ndi mayina osiyanasiyana, operekedwa ndi makampani ena, koma ali ndi gawo lofananira lofanana ndi mitundu yofanana. Nawonso ma synonyms amafanananso ndi pharmacodynamic, koma kapangidwe kake kamasiyana kotheratu ndi kapangidwe koyambirira (mwachitsanzo, mapiritsi a Diabeton MV).
Pali ma fanizo a Diamerid, omwe otchuka kwambiri ndi Amaryl, Glemaz, Glimepiride
Amaryl M ndi piritsi yokonzekera yomwe imapezeka mu mitundu yosiyanasiyana. Ili ndi katundu wofanananso ndi mawonekedwe ogwiritsa ntchito. Makhalidwe ake a mankhwalawa ndi osatheka kuthekera m'madera ena a dziko lapansi komanso mtengo wokwera mtengo. Mtengo wapakati umatha kuchoka pa ruble 300 mpaka 1000 papaketi (mapiritsi 30), kutengera mlingo ndi kampani yopanga.
Glemaz - mapiritsi omwe amapezeka mu gawo la ma milligram anayi a chinthu chogwira. Phukusili limakhala ndi mapiritsi makumi atatu, mtengo wake umatha kuchoka pa 325 mpaka 865 rubles.
Glimepiride - ndi analogue ya mankhwala a Diamerid. Ubwino waukulu wa chida choterocho ndi mtengo wake wotsika kwambiri - kuchokera ku ma ruble 140 mpaka 390.
Kodi ndi othandizira othandiza kwambiri a hypoglycemic omwe angakuwuzeni katswiri mu kanemayu.
