Diabetes, pamodzi ndi mankhwala ena a mankhwala a sulfonylurea, amagwiritsidwa ntchito pochiza matenda monga matenda a shuga osagwirizana ndi insulin.
Woimira awa wa mankhwala a hypoglycemic nthawi zambiri amaperekedwa kwa odwala matenda ashuga kuti apititse patsogolo kupanga kwa insulin ya mahomoni ndi maselo apadera a pancreatic.
Muzochita zamankhwala, mankhwala osiyanasiyana angagwiritsidwe ntchito polimbana ndi matenda osokoneza bongo omwe amadalira shuga.
Zothandiza kuchokera ku sulfonylureas lero zimabala mibadwo ingapo.
Kugwiritsa ntchito sulfonylureas mankhwalawa
Mankhwala a gulu amatengedwa ngati amodzi a othandizira kwambiri a hypoglycemic othandizira kuwongolera shuga.
Njira zazikulu zamankhwala zimakwaniritsa izi:
- 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.
Kutengera ndi kuchuluka ndi kukula kwa njira ya pathological, akatswiri azachipatala amapereka mankhwala ogwiritsira ntchito gulu limodzi kapena angapo nthawi imodzi. Zothandiza kuchokera ku sulfonylureas zimatha kukhala imodzi mwamankhwala otere.
Sulfonylurea ndi chinthu cha hypoglycemic chomwe chimapangidwa kuchokera ku sulfamide ndipo chimagwiritsidwa ntchito mochizira matenda a shuga. Njira yayikulu yogwiritsira ntchito mankhwalawa imapangidwa kuti ilimbikitse maselo amoyo a pancreatic beta kuti apange kuchuluka kwa insulini. Chifukwa cha izi, sikuti kupangika kwina kwa mahomoni kumachitika, komanso chidwi cha minofu ya thupi kwa icho chimakula kwambiri.
Kuphatikiza apo, zabwino zomwe zimapezeka ndi mankhwala a sulfonylurea ndi:
- Kuchulukitsa zovuta za insulin, zomwe zimapangitsa kuchepa kwachulukirapo m'magazi a shuga.
- Zimasokoneza ntchito ya ma enzyme omwe amaphwanya insulin yomwe ilipo.
- Onjezani kuchuluka kwa zolandilira m'matumbo am'mimba.
- Makonda amakhudzidwa ndi njira yogwiritsira ntchito shuga m'magazi a chiwindi.
- Amakulitsa mayamwidwe ndi kukhathamiritsa kwa glucose.
Mankhwala otere nthawi zambiri amaperekedwa kwa anthu omwe ali ndi thupi labwino, osavutika ndi kunenepa kwambiri.
Zotsatira zonse za sulfonyl zimaperekedwa mwanjira zamankhwala a mibadwo itatu.
Mankhwala a m'badwo woyamba omwe sagwiritsidwa ntchito pochita zamakono zamankhwala, chifukwa ali ndi zotsatira zoyipa mthupi la munthuꓼ
Mankhwala a m'badwo wachiwiri, omwe ali otetezeka, motero amagwiritsidwa ntchito mosamala pochiza matendawa. Amayimiridwa ndi chinthu chogwira ntchito monga gliclazide, yomwe ndi gawo la mapiritsi a Diabetes.
Mankhwala a m'badwo wachitatu, omwe amakhala ndi mphamvu yayitali ndipo amakulolani kumwa mankhwala ochepetsa shuga mulingo wochepera kuti mukwaniritse zomwe mukufuna.
Chofunikira chawo chachikulu ndi glimepiride.
Kodi mankhwala ochepetsa shuga ndi ati?
Mankhwala a diabetes ndi mankhwala a hypoglycemic, omwe amaphatikizidwa ndi gulu la zotumphukira za m'badwo wachiwiri.
Zomwe zimapangidwira ndizogwira gliclazide, chifukwa chofunikira cha kutenga mapiritsi.
Mosiyana ndi mankhwala ena a sulfonylurea (mwachitsanzo, Glibenclamide), matenda ashuga ali ndi mtundu wofatsa kwambiri, womwe umakhudzanso ma cellcirculation, hemostasis, data hematological ndi mawonekedwe a rheological a magazi. Ndi malo awa omwe ndiofunika kwambiri kwa odwala omwe ali ndi matenda a shuga a 2.
Mankhwala a Diabeteson amalimbikitsa gawo loyambirira la insulin katulutsidwe, komwe kamasokonezedwa chifukwa chakukula kwa njira ya pathological. Kuphatikiza apo, mankhwalawo amatha kupezeka monga:
- kuchepa kwa kuphatikizika kwa maselo ꓼ
- kuchuluka kwa minofu activator wa plasminogen ndi prekallikreinꓼ
- kulowetsa chiwopsezo cha kuwundana kwamagaziꓼ
- Kuchepetsa kupsinjika kwa oxidative ndikupanga ma molekyulu adhesion
- kuchepa kwa chiwerengero cha pro-atherogenic alpha tumor necrosis factor, chifukwa chomwe chimagwira ntchito yoteteza pokhudzana ndi chitukuko cha matenda amtima ndi mavuto omwe amayenda m'magazi a anthu odwala matenda ashugaꓼ
- kutsegula kwa njira ya fibrinolysis.
Kuphatikiza apo, kwa odwala matenda ashuga, malangizo ogwiritsira ntchito akuwonetsa kuti mankhwalawa sanangokhala ndi hypoglycemic katundu, komanso ali ndi mawonekedwe a hemovascular, metabolic and antioxidant. Zotsatira zamankhwala zoterezi zimatha kuchepetsa ngozi ya zovuta zingapo zomwe zimachitika chifukwa cha matenda ashuga.
Ndi ziti zomwe zikuwonetsa kuti imagwiritsidwa ntchito?
Mankhwala a Diabeteson amaperekedwa m'masitolo amzinda ngati pali mankhwala omwe madokotala amakupatsani.
Dokotala wotsogola yekha ndiye amene akuganiza zofunikira pakuchipatala pochita mankhwala.
Mosiyana ndi mankhwala ochokera ku gulu la Biguanide (monga Metformin), Diabeteson pakuchepetsa thupi sagwiritsidwa ntchito. Komanso, odwala ena omwe amamwa mankhwalawa adazindikira kuwonjezeka kwa thupi lawo pakumwa mankhwala.
Malinga ndi zomwe zakupangitsani mankhwalawa, zomwe zikuluzikulu zakugwiritsa ntchito mankhwalawa ndi:
- Kukula kwa matenda osokoneza bongo a mellitus a fomu yodziyimira payekha ngati monotherapy kapena ngati chithandizo chovuta. Nthawi zambiri, kukonzekera koteroko kwa sulfonyl kumayamba kugwiritsidwa ntchito pambuyo poti njira zosagwiritsa ntchito mankhwalawa (kutsatira zakudya zoyenera komanso kuchita zolimbitsa thupi) sizinapange zotsatira zomwe mukufuna
- Kuti muchepetse chiopsezo komanso njira zodzitetezera, kupewa kuwonekera kwa zovuta zingapo zomwe njira ya matenda ashuga imanyamula.
Choyamba, kugwiritsa ntchito mankhwalawa kumalepheretsa kubwera kwa mavuto a micro-vascular pathologies, monga retinopathy ndi nephropathy, komanso matenda ena a mtima dongosolo - kugunda kwa mtima kapena stroko.
Malangizo ogwiritsira ntchito mankhwalawa
Mankhwala a Diabeteson amapezeka piritsi.
Nthawi yomweyo, kuphatikiza kwa mankhwalawa kumaphatikiza mamilimita makumi asanu ndi atatu a zomwe zimagwira.
Mapiritsi a matenda ashuga amatengedwa malinga ndi malangizo okhwima a akatswiri azachipatala.
Monga lamulo, njira yochizira mankhwalawa imachokera pa mfundo zotsatirazi:
- kugwiritsa ntchito mankhwalawa kamodzi patsiku, mosasamala za kudya kwakanthawi (zokonda ziyenera kuperekedwa nthawi yam'mawa) ꓼ
- Mabotolo a diabetes amaledzera pakamwa, amakhala ndimadzi amchere ochepa nthawi zonse popanda mpweya
- Mlingo wa tsiku ndi tsiku wakhazikitsidwa mosiyanasiyana mamiliyoni makumi asanu ndi atatu okhathamira yogwira pophika ndi mwayi wowonjezereka ngati kuli kofunikira, pomwe nthawi zonse kuyamba kwamankhwala kumachitika pokhapokha ngati mukugwiritsa ntchito mlingo wochepa, womwe umasungidwa piritsi limodzi lamankhwala;
- kuchuluka kwa mankhwala amathandizidwa ndi adokotala aliyense payekha kwa wodwala aliyense, potengera mawonekedwe a matendawa, zaka za wodwalayo komanso kuchuluka kwa hypoglycemiaꓼ
- kuti muthane ndi mavuto omwe amabwera chifukwa chodwala, mukadumpha mankhwala omwe simuyenera kufunsa, simuyenera kuwonjezera kuchuluka kwa zinthu zomwe mungagwiritse ntchito nthawi yotsatira mukagwiritsa ntchitoꓼ
- Mlingo woyenera wa mapiritsi ochepetsa shuga masana sayenera kupitirira 320 mg, ndiye kuti, mapiritsi anayi, pamene kufunika kwa kumwa kwambiri pamankhwala kuyenera kutsagana ndi kuwonjezeka kwa kuchuluka kwa Mlingo patsiku (mankhwalawa aledzera kawiri kapena katatu patsiku, kutengera ndi malingaliro dokotala).
Nthawi zina, pamakhala mankhwala othandizirana, omwe amaphatikizapo kumwa mankhwala ochokera m'makalasi osiyanasiyana.
Chifukwa chake, mphamvu ya mankhwala onse omwe amamwa thupi la wodwalayo imalimbikitsidwa.
Piritsi la hypoglycemic lingagwiritsidwe ntchito molumikizana ndi mankhwala ochokera m'magulu a Biguanide, alpha glucosidase inhibitors, kapena insulin. Kulandira chithandizo mwamphamvu kungachepetse chiopsezo cha zovuta zingapo, komanso kupangitsa kuti kuthamanga kwamagazi kukhale kwambiri.
Tiyenera kukumbukira kuti mankhwala owonjezera pazotsatira zomwe zingapangidwe zingayambitse kukula kwa hypoglycemia.
Chifukwa chake, pochita zochizira, wodwalayo ayenera kuyesa kuchuluka kwa shuga m'magazi.
Kodi kuopsa kwa mankhwala ndi chiyani?
Monga mankhwala ambiri, Diabetes amakhala ndi zovuta komanso contraindication.
Ngati malingaliro azachipatala satsatiridwa ndipo kuchuluka kwa mankhwala kumagwiritsidwa ntchito, odwala omwe ali ndi matenda osokoneza bongo amatha kuonedwa.
Izi zimabweretsa mkhalidwe wodwala matenda ashuga, kusokonezeka kwa chikumbumtima komanso matenda oopsa a hypoglycemia. Kuti muthane ndi vuto la bongo, ndikofunikira kuti mupatse wodwalayo njira yothetsera vuto la hypertonic dextrose (pazachulukitsa makumi anayi) ndi yankho la glucagon, komanso kuloleza shuga pang'ono.
Ndikulimbikitsidwanso kuti magawo a glucose amayang'aniridwa mphindi 15 zilizonse. Vuto linanso lalikulu la bongo ndi kuthekera kwa kutopa kwa m'mimba. Pankhaniyi, madokotala amapereka Dexamethasone ndi Mannitol ngati chithandizo.
Tiyenera kudziwa kuti mankhwala amaletsedwa kugwiritsa ntchito mawonetseredwe ena pazinthu zina.
Diabeteson contraindication ili ndi izi:
- Mawonekedwe a ketoacidosis a mtundu wa matenda ashuga.
- Njira yodalira insulini pakukula kwa pathological process.
- Matenda oopsa a ziwalo zamkati monga impso ndi chiwindi.
- Kupezeka kwa glycemic chikomokere ndi makolo.
- Pa nthawi yoyembekezera komanso yoyamwitsa.
- Ngati wodwalayo walandidwa kwambiri pang'ono.
- Mu ubwana ndi okalamba odwala.
- Pamaso pa tsankho la munthu kapena gawo limodzi la mankhwala.
Kuphatikiza apo, kumayambiriro kwa njira yothandizira achire, ndikofunikira kuwunika zonse zomwe zikuchitika komanso thanzi, chifukwa mawonekedwe owoneka osiyanasiyana kuchokera mbali zamkati ndi machitidwe angayambike. Choyamba, muyenera kulabadira kupezeka kwa thupi lawo siligwirizana, ndipo pakuwonetsa, siyani kumwa mankhwalawo.
Kuphatikiza apo, zovuta zoyambirira zomwe zimachitika pakumwa mankhwalawa ndi monga:
- kuthira shuga m'magazi m'miyeso yovomerezekaꓼ
- kuchuluka kapena kusowa kwa chakudya, kunenepa
- kutopa mthupi komanso kuchepa mphamvu of
- thukuta kwambiriꓼ
- tachycardiaꓼ
- kuwonongeka kwamawonekedweꓼ
- mavuto ogona ndi kusowa tulo
- kumva mopanda kuda nkhawa, mantha kapena kusokonekeraꓼ
- kuwoneka kwa kukokana mu minofu ya ng'ombeꓼ
- zosokoneza zamalingaliroꓼ
- kuchuluka kwa michere yophika
- Hypersomnia.
Pakachitika zovuta zina, ndikofunikira kudziwitsa adotolo za izi kuti mugwiritse ntchito zofunikira kapena kulowetsamo mankhwalawo.
Kodi ndimankhwala ati omwe nditha kusintha?
Mankhwala asayansi amakono amapereka malingaliro ambiri omwe amawonetsa kuti kugwiritsidwa ntchito mwadongosolo kwa mankhwala kwakanthawi yayitali kumayambitsa kuwonongeka pang'onopang'ono kwa maselo a pancreatic beta ndipo kungathandizire kukulitsa kwa matenda a shuga a insulin.
Panthawi imodzimodziyo, ngakhale ali ndi malingaliro otere, madokotala akupitilizabe kugwiritsa ntchito mankhwalawa kuchiza matenda amisempha.
About a Diabetes, ndemanga za odwala ndizosiyanasiyana. Anthu ena amati mankhwalawa ndi othandiza komanso osavuta kulekerera, ena amakwiya chifukwa cha kusowa kwa zotsatira ndi kuwonjezeka kwakukulu kwa mankhwalawa pambuyo pakuchiritsidwa.
Simuyenera kutenga ndemanga zonse za Diabeteson momwe ziliri, chifukwa chamoyo chilichonse chimachita payekha, ndipo zomwe sizinayenere munthu m'modzi ndizotheka.
Mtengo wa mankhwala kumsika ndi pafupi ma ruble mazana atatu. Ngati ndi kotheka, dokotala yemwe akupezekapo amatha kusintha mankhwalawo ndi analogue yake yopanga.
Mapiritsi opangidwa ndi generic ophatikizidwa ndi mankhwala monga:
- Glidia.
- Glykinorm.
- Gliklad.
- Gliclazide.
- Zamakolo.
- Dziwani.
- Diazide.
- Sinthani.
Mankhwala onse omwe ali pamwambapa ndi a gulu la zotumphukira za m'badwo wachiwiri. Kusiyana kwawo kuli pakampani yopanga (ena ndi oimira mafakiteriya akunja, ena amapangidwa ku Russian Federation), mtengo ndi kuchuluka kwa zoyipa, zotsutsana.
Zambiri pa Diabeteson zimaperekedwa mu kanema munkhaniyi.
