Nthawi zambiri, mapiritsi opsinjika a mtundu 2 a shuga amadziwika ndi odwala omwe amadziwika ngati ali ndi anti antiretretic.
Izi zimachitika chifukwa chakuti njira ya pathological yowonetsedwa molakwika osati pazomwe zimachitika pancreas, komanso imakhudzanso zovuta zina kuchokera ku machitidwe ena ndi ziwalo za thupi.
Kukula kwa matenda a shuga mellitus ndi owopsa osati ndi zizindikiritso zazikulu zokha, komanso ndi chiwopsezo chowonjezereka chowonetsera zotsatira zoyipa, kusokonezeka kwa magwiridwe antchito a ziwalo zambiri zamkati ndi machitidwe amthupi.
Choyamba, ndi mtundu wachiwiri wa matenda a shuga, kugwira ntchito kwa mtima ndi kuzungulira kwa magazi kumayamba kuwonongeka. Monga lamulo, zotsatira za kuphwanya koteroko ndi:
- pali kuwonongeka pakubwera kwa magazi mthupi lonse;
- chiwopsezo cha stroke kapena myocardial infarction chikuwonjezeka;
- kuchuluka kwa kuthamanga kwa magazi;
- atherossteosis, kupezeka kwa magazi kuwonongeka chifukwa chotumphukira kwamitsempha yamagazi ndi mitsempha.
Kupatula
Kuphatikiza apo, zovuta zoyipa zomwe zingachitike pakukula kwa matenda ashuga zikuphatikizapo:
Kutaya kwathunthu kapena pang'ono pang'ono kwamaso owoneka, chifukwa chiwonongeko cha retina chimachitika chifukwa cha shuga wambiri. Kukula kwa matenda ashuga a m'mimba, omwe amadziwoneka ngati opweteka kwambiri m'munsi.
Matenda aimpso ndi chiwindi. Anachepetsa chitetezo chokwanira.
Matenda osiyanasiyana amanjenje. Nthawi zambiri, mitsempha yamapeto imakhudzidwa, zomwe zimabweretsa dzanzi ndikuchepa kwa chidwi champhamvu. Matenda am'mimba. Kukula kwa matenda osiyanasiyana pakhungu.
Ichi ndichifukwa chake ndikofunikira kwambiri kuzindikira matendawa munthawi yake ndikuyamba chithandizo chovuta.
Kuchulukitsa kwa magazi ku matenda a shuga osagwirizana ndi insulin
Matenda a shuga ndi zovuta, zomwe zimawonetsedwa mwa kuthamanga kwa magazi, ndizinthu ziwiri zomwe zimalumikizana. Tiyenera kudziwa kuti matenda oopsa amatha kukhala chimodzi mwazomwe zimayambitsa kuoneka kwa matenda a m'mimba ndikupanga pambuyo pa kukhazikitsidwa kwa matenda ashuga.
Komabe, matenda onsewa ali ndi vuto logwira ntchito mthupi, lomwe limadziwonetsa lokha:
- kuwonongeka kwa ziwiya zaubongo;
- mavuto ndi mtima wabwinobwino kugwira ntchito;
- kuvuta kwamatumbo amaso;
- matenda aimpso.
Nthawi zambiri, matenda oopsa mu shuga mellitus amachititsa izi:
- Myocardial infaration ndi stroke.
- Ischemia wamtima.
- Kusokonezeka kwapang'onopang'ono kwa kufalikira kwa ubongo kumachitika.
- Kukula kwa aimpso kulephera kwa mtundu wodwala.
Kukhazikika kwa njira zoyipa monga matenda a shuga kumayambika nthawi zonse ndikuwonetsa kukana kwa insulin, komwe kumadziwonetsa pokhapokha kutayika kwakanthawi kwa minofu kumverera kwa insulin ya mahomoni. Thupi, kuti lithandizire kuchepa koteroko, limayamba kupanga kuchuluka kwa insulini, komwe kumawonjezera kuthamanga kwa magazi ndikupangitsa kuti chitukuko cha matenda oopsa chiwonongeke.
Mukuwonetsedwa kwa matenda a shuga, ma lumen am'mitsempha yamagazi (chifukwa cha atherosclerosis) amapindika pang'onopang'ono, omwe amawonjezeranso kukula kwa matenda oopsa.
Kuphatikiza apo, kupezeka kwa kunenepa kwambiri pamimba kumadziwika ndi anthu odwala matenda ashuga, omwe amachititsa kuti katundu azikhala ndi mtima komanso azithamanga. Chifukwa chake, njira zonse zomwe zimachitika mthupi zimalumikizidwa mosiyanasiyana. Ndipo kulephera pantchito ya chiwalo chimodzi kumayambitsa kuphwanya magwiridwe antchito a ena.
Dziwani kuti mwa munthu wathanzi, kuthamanga kwa magazi pakugona ndipo atadzuka nthawi yomweyo kumakhala kotsika poyerekeza ndi chizolowezi chokhazikitsidwa. Kukula kwa matenda ashuga kumabweretsa kuti kupsinjika sikumachepa usiku, ndipo nthawi zina, kumatha kukwera.
Ichi ndichifukwa chake mankhwalawa omwe amagwiritsidwa ntchito ngati matenda a shuga a 2 nthawi zambiri amaphatikizapo mankhwala opanikizika.
Kodi mungasankhe bwanji?
Ndingamwe mapiritsi ati oti nditha kumwa matenda oopsa mu shuga? Ndikofunika kumwa mankhwala okhawo omwe wodwala amapita, omwe samakulitsa kuchuluka kwa shuga m'magazi.
Mpaka pano, msika wama pharmacological umapereka kusankha kosiyanasiyana kwa mitundu yosiyanasiyana ya mankhwala omwe ali ndi antihypertensive effect. Komabe, ambiri aiwo saloledwa kudya pamaso pa anthu odwala matenda ashuga.
Mukamasankha chithandizo chamankhwala opatsirana matenda ashuga, mfundo zotsatirazi ziyenera kuganiziridwa:
- Zotsatira za mankhwalawa lipid ndi kagayidwe kachakudya kagayidwe kachakudya mthupi. Mankhwalawa amayenera kusankhidwa kuti zotsatira zake zitheke kapena kukonza kagayidwe kamafuta ndi chakudya.
- Mapiritsi a kuthamanga kwa magazi sayenera kukhala ndi contraindication pamaso pa mavuto ndi ntchito ya impso kapena chiwindi.
- Ndikwabwino kusankha mankhwalawa opanikizika mu shuga ndi zotsatira za organoprotective. Mankhwala oterewa amathandizira kukonza magwiridwe amthupi owonongeka.
Mankhwala othandizira kuthamanga kwa magazi a matenda akale a shuga ali osavomerezeka. Mankhwalawa omwe akuchita pakatikati pawo ali ndi zotsutsana ndi matenda ashuga.
Anthu omwe ali ndi matenda ashuga komanso matenda oopsa amakhala ndi chiopsezo chowonjezeka cha mtima. Ichi ndichifukwa chake, chithandizo chamankhwala chikuyenera kutsimikiziridwa pang'onopang'ono kuthamanga kwa magazi - m'mwezi woyamba mpaka 140/90 mm. Hg. Art., Pankhani ya kulolera bwino mankhwala. Kuphatikiza kwina kumaphatikizapo kutsika mpaka 130/80.
Choyambirira ndi momwe wodwalayo amasamutsira mankhwala omwe amamwa. Ngati pali ngozi yamavuto kapena kuchuluka kwa kuloleza mapiritsi sikufika pamlingo waukulu, zimakhala zomveka kuti pang'onopang'ono komanso pang'onopang'ono kuchepetsa magazi.
Dokotala wopezekapo amayenera kuwongolera mokwanira zomwe zikuchitika. Ndikwabwino ngati kupanikizika kumatsika ndi khumi peresenti pamwezi wodwalayo akumva bwino.
Monga lamulo, chithandizo chimatenga pafupifupi milungu itatu kapena inayi, pambuyo pake kusintha kosinthika.
Magulu a mankhwala oopsa?
Mpaka pano, pali magulu akuluakulu a mankhwalawa omwe amathandiza kuthana ndi matenda oopsa:
- pakati akuchita mankhwala;
- alpha ndi beta blockers;
- odana ndi calcium;
- ACE inhibitors (ACE inhibitors);
- angiotesin receptor okonda awiri;
- mankhwala okodzetsa;
- mankhwala okodzetsa.
Mankhwala otchinga matenda a beta nthawi zambiri amalembedwa ndi adotolo pamaso pa matenda amtundu wa arrhythmias kapena matenda a mtima. Kusiyana kwakukulu pakati pa mankhwalawa pakati pawo ndi izi:
- Kusankha.
- Lipophilicity.
- Hydrophilicity.
- Kutha kwamitsempha yamagazi.
Mankhwala a Alphablocker amachepetsa kuthamanga kwa magazi, kuphatikiza apo, amakhala ndi phindu pa mafuta ndi kagayidwe kazakudya, ndikuwonjezera chidwi cha insulin. Komabe, ngakhale atakhala ndi zabwino zonse, ayenera kugwiritsidwa ntchito mosamala kwambiri. Mankhwala oterewa amatha kuyambitsa orthostatic hypotension (kutsika kwakanthawi kolimba), kutupa kwa minofu, ndi tachycardia. Kuphatikiza apo, zotsutsana pazogwiritsidwa ntchito zimaphatikizapo anthu omwe ali ndi vuto la mtima.
Ma calcium antagonists ndi mankhwala othandiza kwambiri, koma kuwongolera kwawo kwa nthawi yayitali kungayambitse kuchepa kwa kapangidwe ka insulin. Akangotulutsa mankhwala ngati amenewo, thupi limayamba kugwira ntchito ndi mphamvu yomweyo. Phindu lamapiritsi ndi:
- kutsitsa kuthamanga kwa magazi ngakhale ndi kugwiritsa ntchito mankhwalawa ochepa;
- chiopsezo chokhala ndi matenda osokoneza bongo omwe samadalira insulin sichikula.
Otsutsana ndi calcium angatenge nthawi yayitali kapena kuwonekera nthawi yayitali. Kutengera mitundu yosiyanasiyana ya mankhwalawo, mphamvu zake zamankhwala komanso kuthekera kosiyanako kovuta kumaonekera. Nthawi zambiri, mankhwalawa amalembedwa kwa odwala pofuna kupewa matenda a stroke, omwe ali ndi kuthamanga kwa magazi.
ACE inhibitors ndiye njira yabwino kwambiri yochepetsera kuthamanga kwa magazi mu odwala matenda ashuga. Amakhudza ntchito ya mtima ndi kayendedwe ka mtima, kagayidwe kachakudya, komanso machitidwe a impso ndi chiwindi.
Mankhwala ochokera pagulu la ACE zoletsa ayenera kuyikidwa ndi adokotala okha, chifukwa ali ndi zotsutsana zingapo zogwiritsidwa ntchito.
Sizoletsedwa kugwiritsa ntchito zida zamankhwala kwa iwo omwe ali ndi vuto la pulmonary pathologies ndi mphumu ya bronchial. Mapiritsi amatha kuyambitsa kuwuma kwa chifuwa komanso zina.
Sitha kugwiritsidwa ntchito pamaso pa kulephera kwa impso, musanagwiritse ntchito mankhwalawa, ndikofunikira kuyang'ana kuthamanga kwa magazi, kupanga kwa metabolinine ndi potaziyamu m'magazi.
Mankhwala a gululi, monga lamulo, salembetsedwa kwa anthu achikulire omwe ali ndi atherosulinosis, chifukwa aimpso a stenosis angachitike.
Mankhwala a diuretic nthawi zambiri amapatsidwa mankhwala osakanikirana ndi mankhwala a gulu la ACE inhibitor. Mphamvu zazikulu za mapiritsi oterewa ndi:
- Zofewa thupi.
- Osakhudza kuchuluka kwa shuga ndi lipids m'magazi.
- Osasokoneza kugwira ntchito kwa chiwindi ndi impso.
Njira yabwino yogwiritsira ntchito diuretics yotereyi ikhoza kukhala Indapamide ndi Arefon Retard.
Zambiri Mapale
Mankhwala akuluakulu osasankha kuchokera ku gulu la betablocker ndi mapiritsi a Anaprilin ndi Nadodol, omwe amathandizira kwambiri pama receptors omwe amapezeka m'matumbo. Chifukwa cha kuwonekera kwawo, kupanga kwa insulin ya mahomoni kumalepheretsa. Mankhwala a antihypertensive a shuga ndi bwino kusankha mtundu wosankha. Izi ndi, zoyambirira, Atenolol, Bisoprolol, Metoprolol kukonzekera. Mankhwalawa amakhala ndi phindu pa ntchito ya mtima.
Lipophilic betablockers imawonetsedwa pamsika wamankhwala ndi othandizira oikidwa monga Metoprolol ndi Pindolol. Chomwe chimasiyanitsa ndikuti amachotsedwa kwathunthu ndi chiwindi. Ichi ndichifukwa chake, ndi chitukuko cha matenda a shuga, mankhwalawa amadziwitsidwa kawirikawiri, kuti asayambitse kuwonongeka kwa ziwalo.
Atenolol ndi Nadolol ali m'gulu la mankhwala osokoneza bongo a beta. Mankhwala oterewa amakhala ndi mphamvu yayitali atatha kuwongolera, komanso samakhala ndi vuto lililonse pakugwira ntchito kwa chiwindi ndi impso.
Ma Betablockers ochokera ku vasodilating ali ndi phindu pochepetsa kuchepa kwa insulin, kukulitsa chidwi cha zimakhala kuti insulin. Kuphatikiza apo, pakati pa zabwino zawo zimatha kudziwitsidwa kuti zimapangitsa kuti lipid ndi mafuta kagayidwe. Mukamakonzekera piritsi imeneyi, ndikofunikira kuwerenga mosamala mndandanda wazovuta zomwe zingachitike, popeza mndandanda wawo ndi waukulu. Omwe akuimira kwambiri m'gulu lino la mankhwalawa ndi Nebivolol ndi Cardiovolol.
Mwa mankhwala a gululi, otsutsana ndi calcium, odwala omwe ali ndi matenda ashuga ayenera kumwa kwa nthawi yayitali. Mankhwalawa ali ndi phindu pa machitidwe a impso. Omwe akuwayimira ndi Verapamil ndi Diltiazem.
ACE inhibitors nthawi zambiri amalembedwa kuti chitukuko cha matenda ashuga azitha kuthamanga magazi. Amathetsa chizindikiro cha matenda oopsa, amachepetsa katundu pamtima, komanso amathandizira kukulitsa mtima wa mtima. Mankhwala akuluakulu m'gululi ndi Captopril, Ramipril ndi Fosinopril.
Angiotesin 2 receptor antagonists ndi gulu latsopanoli la mankhwala omwe ali ndi zovuta zochepa zoyipa. Mapiritsi oterewa amadziwika pamisika iyi:
- Losartan;
- Telmisartan;
- Valsartan.
Ubwino wa mankhwala osokoneza bongo a angiotesin receptor antagonist ndi chiwopsezo chochepetsedwa cha kugunda kwamtima ndi mtima, chothandiza pa impso, komanso kuchepa kotsutsana.
Ndi mapiritsi ati omwe ndi bwino kupewa kupezeka ndi matenda ashuga?
Ngakhale kuphatikiza kwakukulu kwa mankhwala osiyanasiyana omwe amachepetsa kuthamanga kwa magazi, ziyenera kukumbukiridwa kuti si mankhwala onse omwe angakhale oyenera kwa anthu odwala matenda a shuga.
Ndi zoletsedwa kumwa mankhwala a thiazide diuretic (Hypothiazide, Chlortiazide, Xipamide), chifukwa amathandizira pakuwonjezeka kwa shuga wamagazi komanso kuchuluka kwa cholesterol yoyipa. Kuphatikiza apo, mapiritsi ngati amenewa amakhudza ntchito ya impso, yomwe imakhala yowopsa kwambiri kwa anthu omwe ali ndi vuto la impso. Osmotic okodzetsa amtundu wa 2 komanso matenda amtundu wa 1 angayambitse mkhalidwe wa hyperosmolar coma mu diabetes.
Mankhwala a antihypertensive a gulu la othandizira calcium amakhala osavomerezeka kuti atengedwe ngati mankhwalawa ndi a dihydropyrid osakhalitsa. Mapiritsi otere, ngakhale ochepa, amalimbikitsa kwambiri kufa kwa mtima ndipo amatsutsana ndi odwala omwe ali ndi matenda osokoneza bongo pomwe pali matenda a mtima ndi matenda a mtima. Woimira wamkulu wa mtundu uwu wa mankhwala ndi Nifedipine.
Atenolol, mankhwala ochokera pagulu la ophatikiza ndi beta, amatha kuyambitsa kudumpha m'magazi ndikupangitsa Hypo- kapena hyperglycemia. Kuphatikiza apo, mankhwalawa amachepetsa chidwi cha zimakhala mpaka insulini yopangidwa ndi kapamba.
Ndi mapiritsi ati omwe angatengedwe ndi kuthamanga kwa magazi kwa odwala matenda a shuga adzafotokozera vidiyoyi munkhaniyi.
