Zochizira mtundu wa 2 matenda a shuga, mankhwalawa amagwiritsidwa ntchito omwe angayambitse vuto lalikulu la hyperglycemia - kukhudzika kwa insulin. Popeza ambiri odwala omwe ali ndi mtundu wachiwiri wa matendawa ndi onenepa kwambiri, ndizokwanira ngati mankhwalawa atha kuthandiza nthawi yomweyo mankhwalawa onenepa.
Popeza mankhwalawa ochokera ku gulu la Biguanide - metformin (Metfogamma, Glucofage, Siofor, Dianormet) amatha kuthana ndi chakudya komanso mafuta, zimalimbikitsidwa pakulimbikitsa kwa odwala a shuga omwe ali ndi kunenepa kwambiri.
Mu 2017, kugwiritsa ntchito mankhwala omwe ali ndi Metformin anali ndi zaka 60, koma pakadali pano akuphatikizidwa pamndandanda wazipatala zochizira matenda a shuga mellitus malinga ndi malingaliro a WHO. Kufufuza zamtundu wa metformin kumabweretsa kukulira kwezowonetsa kwa kugwiritsidwa ntchito kwake.
Glucophage limagwirira ntchito
Mankhwala Glucofage amawonetsedwa m'masitolo amitundu amtundu wotulutsidwa motere: Glucofage 500, Glucofage 850, Glucofage 1000 ndi mitundu yowonjezeredwa - Glucofage yayitali. Ubwino wosakayika wa mankhwala ozikidwa pa metformin umaphatikizapo mtengo wotsika mtengo. Kupanga kwake kwa mankhwala kumveka bwino.
Maziko ake ndi momwe amapangira mamolekyulu atsopano a shuga m'chiwindi. Mu shuga mellitus, njirayi imakulitsidwa nthawi 3 poyerekeza ndi chizolowezi. Glucophage poyambitsa ma enzyme angapo amaletsa gluconeogeneis.
Kuphatikiza apo, odwala omwe ali ndi glucofage amalimbikitsa chidwi cha minofu kuti insulin (makamaka minofu minofu). Mankhwala amathandizira kulumikizana kwa insulin ndi ma receptor m'magazi ofiira, ma hepatocytes, maselo amafuta, myocyte, kukulitsa kuchuluka kwa kulowa kwa glucose ndikulanda kwake kuchokera magazi.
Kutsika kwa mapangidwe a shuga m'chiwindi kumayambitsa kutsika kwa kudya kwa glycemia, ndikuletsa kuyamwa kwa mafuta mu lumen ya m'matumbo ang'onoang'ono kumayambitsa nsonga ya kuwonjezeka kwa shuga wamagazi mukatha kudya. Glucophage imatha kuchepetsa kuthamanga kwa m'mimba ndikuwonjezera mphamvu ya matumbo ochepa.
Nthawi yomweyo, makutidwe ndi okosijeni amafuta achilengedwe aulere, cholesterolemia, kuchuluka kwa triglycerides ndi atherogenic lipids kumachepa. Zotsatira zonsezi zimachitika pokhapokha ngati insulin ili m'magazi.
Chifukwa cha chithandizo cha Glucofage, zotsatirazi zimadziwika:
- Kuchepetsa kwa glycemia ndi 20%, hemorrhea wambiri ndi 1.54%.
- Chiwopsezo cha myocardial infarction, kufa kwathunthu kumachepetsedwa.
- Akapatsidwa gawo la prediabetes, matenda a shuga amayamba pafupipafupi.
- Kuchulukitsa chiyembekezo cha moyo komanso kumachepetsa chiopsezo chotupa chotupa (zoyesa deta).
Glucophage imayamba kugwira ntchito mkati mwa maola 1-3, ndi mitundu yowonjezera (Glucophage yayitali) maola 4-8. Njira yokhazikika imawonedwa kwa masiku awiri ndi atatu. Zinadziwika kuti chithandizo cha metformin sichimatsogolera ku vuto la hypoglycemic, chifukwa sichitsitsa mwachindunji shuga m'magazi, koma imalepheretsa kuwonjezeka kwake.
Glucophage ndiye mankhwala oyamba a metformin, chifukwa chake amagwiritsidwa ntchito pofufuza. Mphamvu ya Glucophage pa kayendedwe ka matenda a shuga 2, komanso kuchepa kwa chiwopsezo cha matenda, makamaka mtima.
Glucophage wa matenda ashuga a 2
Chizindikiro chachikulu chogwiritsa ntchito mankhwalawa ndi mtundu wachiwiri wa shuga wophatikizana ndi kunenepa kwambiri, cholesterol yayikulu m'magazi, komanso kulemera kwakuthupi kwakanthawi. Odwala ena omwe ali ndi matenda ashuga samaloleza kukonzekera kwa sulfonylurea, kapena kukana nawo, Glucofage imatha kuthandiza gulu ili la odwala.
Komanso, metformin ikhoza kuphatikizidwa kuti iphatikizidwe ndi mankhwalawa ndi insulin ya matenda a shuga 1, komanso kuphatikiza kosiyanasiyana ndi mankhwala ochepetsa shuga m'mapiritsi a matenda a shuga a 2.
Ndimasankha mtundu wa Glucophage payekha, motsogozedwa ndi glycemia. Mlingo umodzi ndi 500-850 mg, ndipo mlingo watsiku ndi tsiku ndi 2,5 mpaka g. Mulingo woyenera kwa odwala ambiri ndi 2-2.25 g.
Chithandizo chimayamba ndi mlingo wochepa - 500 mg patsiku, ngati ndi kotheka, muwonjezeke ndi 500 mg ndi gawo la masiku 7. Mlingo wambiri (kupitirira 3 g) samabweretsa kusintha kwa kagayidwe kakang'ono ka shuga. Nthawi zambiri, glucophage imatengedwa katatu patsiku.
Popewa zovuta m'matumbo, mankhwalawa amalimbikitsidwa kuti amwe pakudya kapena mutatha kudya.
M'pofunika kuganizira kuchepa kwa Glucophage, omwe mankhwala ena ochepetsa shuga alibe - kuteteza kwa shuga m'magazi a m'mawa. Kuti mugwiritse ntchito chinthu chapaderachi mpaka pazambiri, muyenera kutenga glucophage musanagone.
Kupititsa patsogolo kagayidwe kachakudya kumawonekera pakatha masiku 7-10, ndipo kuchuluka kwa shuga m'magazi kumayamba kuchepa masiku awiri. Pambuyo pa kubwezeretsedwa kwa hyperglycemia ndikwaniritsidwa bwino, mutha kuyesa kuchepetsa pang'onopang'ono mlingo wa mankhwalawa powunika kwambiri shuga.
Mankhwala otsatirawa amagwiritsidwa ntchito:
- Glucophage + Glibenclamide: amagwiritsa ntchito njira zosiyanasiyana pokopa glycemia, onjezerani zochita za wina ndi mnzake.
- Glucophage + Insulin: kufunikira kwa insulin kumachepetsedwa mpaka 25-50% ya zoyambirira, dyslipidemia ndi kukakamizidwa zimakonzedwa.
Kafukufuku wambiri wa matenda osokoneza bongo amatipangitsa kuti tiziganiza kuti insulini imayamba kudwala kale kwambiri kuposa momwe amayembekezera. Chifukwa chake, Glucofage imalimbikitsidwa kuti igwiritsidwe ntchito mlingo wa 1 g patsiku, komanso zakudya komanso zolimbitsa thupi.
Prophylaxis yotere imachitika mwa odwala omwe ali ndi kunenepa kwambiri, kuchepa kwa chakudya chambiri, cholesterol yapamwamba, matenda oopsa komanso kutengera kwa chibadwa cha mtundu 2 wa matenda ashuga.
Glucophage imathandiza kuthana ndi insulin kukana ndipo imachepetsa kwambiri zomwe zili m'magazi, kupewa mtima.
Glucophage wokhala ndi polycystic ovary
Polycystic ovary ndi insulin kukana kumawonetsedwa ndi kuchuluka kwachulukidwe kwamathupi a amuna ogonana, kutalika kwa msambo komanso kusowa kwa ovulation, komwe kumapangitsa odwala kukhala osabereka.
Amayi nthawi zambiri amakhala onenepa kwambiri ndi polycystic ovary syndrome, amadwala matenda a carbohydrate kapena amatsimikizira matenda a shuga. Kugwiritsa ntchito Glucophage mu zovuta chithandizo cha odwala oterewa kumawongolera ntchito yobereka, nthawi yomweyo kumabweretsa kuchepa kwa thupi ndi kuphatikiza mawonekedwe a mahomoni.
Kugwiritsa ntchito Glucofage muyezo wa 1500 mg patsiku kwa miyezi isanu ndi umodzi kumachepetsa kuchuluka kwa insulin m'magazi, msambo umabwezeretsedwa pafupifupi 70% ya azimayi.
Nthawi yomweyo, zotsatira zabwino za kapangidwe ka magazi zidadziwika: kuchepa kwa mafuta m'thupi ndi lipoproteins yotsika.
Glucophage zimakhudza kulemera
Ngakhale mankhwala opangidwa ndi metformin alibe chisonyezo chachindunji chogwiritsa ntchito kunenepa kwambiri, amagwiritsidwa ntchito kuchepetsa thupi, makamaka ngati pali kuphwanya kwa kagayidwe kazakudya. About ndemanga ya Glucofage yochepetsa thupi, zonse zabwino ndikuwonetsa mphamvu yake yotsika.
Malingaliro osiyanasiyana awa: "Ndinachepetsa Glyukofage ndipo ndachepetsa makilogalamu 6," "Sindimachepetsa thupi, ngakhale ndimankhwala ochulukirapo," "Glyukofage yekha amathandizira kuchepetsa thupi", "poyamba ndinachepetsa thupi pa Glyukofage, kenako kulemera kunayima", "Ndataya kilogalamu imodzi m'mwezi umodzi ", zikuwonetsa kuti mankhwalawa mwina sangathandize aliyense.
Katundu wamkulu wa mankhwalawa, omwe amathandiza kuchepa thupi, ndikuwonjezera chidwi cha insulini, zomwe zimayambitsa kuchepa kwa chinsinsi chake, popeza kuchuluka kowonjezereka sikofunikira kuthana ndi kukana kwa receptor. Kutsika koteroko kwa insulin m'magazi kumapangitsa kutsika kwamafuta ndikuthamanga kukhathamiritsa kwake.
Kuphatikiza apo, mphamvu ya Glucofage imadziwoneka pakumva njala, imachepetsa chilimbikitso, komanso kuletsa kuyamwa kwa matumbo m'matumbo ndi kuchotsedwa kwawo kwothamanga chifukwa cha kuchuluka kwa peristalsis kukapezeka mu chakudya kumachepetsa kuchuluka kwa zopatsa mphamvu.
Popeza Glucophage siyimayambitsa kuchepa kwa shuga m'magazi pansi pazomwe zimachitika, kugwiritsidwa ntchito kwake kumatha kukhala ndi glycemia yokhazikika, ndiye kuti, mu gawo la kusokonezeka kwa chidwi cha glucose pakusokonezeka koyambirira kwa chakudya chamafuta ndi mafuta.
Pofuna kuti musasokonezedwe ndi metabolic pamodzi ndi kuwonda, muyenera kuganizira mukamatenga Glucofage kapena Glucofage yayitali:
- Kumwa mankhwalawa sikutanthauza kuwonda.
- Kutsimikiziridwa kwa mphamvu yakuchepa kuphwanya kulekerera kwa chakudya chamthupi ndi hyperinsulinemia.
- Muyenera kutsatira zakudya.
- Sipayenera kukhala chakudya chamagulu m'zakudya.
- Mlingo umasankhidwa payekha - mlingo woyambirira ndi 500 mg kamodzi patsiku.
- Ngati kutsegula m'mimba kumachitika pambuyo pa kutsata, izi zikutanthauza kuti pali chakudya chamagulu ambiri.
- Ngati nseru ikuchitika, chepetsani kwakanthawi.
Omanga a thupi amagwiritsa ntchito metformin limodzi ndi maphunziro aerobic kuti atenthe mafuta. Kutalika kwa maphunzirowa ndi masiku 20, kenako muyenera kupuma kwa mwezi umodzi. Kugwiritsa ntchito mankhwalawa koletsedwa mosavomerezeka ndi dokotala.
Chifukwa chake, titha kunena kuti kuikidwa kwa Glucofage kungakhale koyenera pochiza odwala omwe ali ndi vuto la metabolism ya metabolism, yomwe imayendera limodzi ndi kuchuluka kwa insulin m'magazi komanso kukana kwa chiwindi, minofu ndi mafupipafupi a mafuta.
Naturalization ya kagayidwe kachakudya njira kumabweretsa kuwonda, malinga ndi zakudya zoletsa komanso zokwanira zolimbitsa thupi. Mankhwala sakusonyezedwa mankhwalawa kunenepa popanda kuyeserera koyambirira.
Nthawi zambiri, kuchepa thupi kumachepa, ndipo chiwopsezo cha kusokonezeka kwa metabolic ndi chambiri.
Zotsatira zoyipa za glucophage komanso kuvulaza thanzi
Zotsatira zoyipa kwambiri za Glucophage ndizovuta m'matumbo, chosasangalatsa pambuyo pake pakamwa, kutsekula m'mimba, matumbo a colic, nseru, ulemu. Zotsatira zosasangalatsa zotere za kumwa mankhwalawa zimadziwika kwa masiku oyamba kugwiritsa ntchito Glucophage, kenako ndikungopereka okha, popanda chithandizo chowonjezera.
Ndi matenda otsekula m'mimba, mankhwalawa amatha. Thupi likazolowera, mphamvu ya metformin pamatumbo samamveka kwenikweni. Ndi kuchuluka pang'onopang'ono kwa mlingo, kusapeza bwino kungapeweke.
Kugwiritsa ntchito nthawi yayitali kwa Glucophage kumabweretsa chiwonetsero cha B12 hypovitaminosis: kufooketsa kukumbukira, kukhumudwa, kugona tulo. Ndizothekanso kukula kwa kuchepa kwa magazi m'thupi.
Popewa, tikulimbikitsidwa kuti mudye mavitaminiwa m'maphunziro pamwezi, makamaka ndi zakudya zamasamba.
Zotsatira zoyipa kwambiri za gulu la Biguanide, zomwe metformin yokha imagwiritsidwa ntchito, ndikupanga lactic acidosis. Ndi chifukwa chowopsa cha chitukuko chake kuti mankhwala otsala a gululi amachotsedwa pamsika wamankhwala. Vutoli limachitika chifukwa chakuti lactate imagwiritsidwa ntchito popanga shuga m'magazi, ndipo metformin imaletsa njira yotembenuka iyi.
Pa ntchito yachilendo impso, lactate yambiri imachotsedwanso, koma ndimakonda kugwiritsa ntchito mowa, kulephera kwa mtima, matenda am'mapapo kapena kuwonongeka kwa impso, lactic acid imadziunjikira, zomwe zimabweretsa mawonetsedwe:
- Kupweteka kwa minofu
- Ululu pamimba ndi kumbuyo kwa sternum.
- Kuchepetsa mseru
- Kupuma kwamphamvu.
- Chisoni ndi kugona.
Milandu yayikulu, lactic acidosis imatha kukhala ndi vuto. Kuphatikiza apo, Glucophage imachepetsa kuchuluka kwa mahomoni olimbikitsa chithokomiro, ndipo mwa amuna - testosterone.
Metformin imaphatikizidwa mu matenda a impso, chiwindi ndi mapapu, uchidakwa komanso kulephera kwamtima, ketoacidosis, zovuta za matenda a shuga mellitus mu mawonekedwe a hyperosmolar kapena lactic acidosis.
Mankhwala sinafotokozeredwe chakudya chochepa mphamvu ya calorie (pansi pa 1000 kcal patsiku), kuchepa magazi, pambuyo pa zaka 60, kuchita masewera olimbitsa thupi komanso nthawi yobereka.
Dr. Kovalkov kuchokera mu kanema munkhaniyi ayankhula za zabwino za Glucophage kwa anthu onenepa kwambiri.
