Metformin ndi chinthu chomwe chimakhala ndi biguanides. Metformin ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda ashuga.
Kuchita kwa mankhwalawa kumachitika chifukwa chakuti imatha kulepheretsa gluconeogeneis m'maselo a chiwindi, amachepetsa kuthamanga kwa shuga kuchokera m'matumbo a lumen, ndikuwonjezera njira zomwe zimagwiritsidwa ntchito pakupanga shuga.
Kuphatikiza apo, mapiritsi a Metformin 850 mg amawonjezera kukhudzika kwa insulin m'maselo a insulin omwe amadalira thupi.
Kugwiritsa ntchito mankhwalawa kulibe vuto lililonse pakapangidwe ka insulin mu kapamba, sikuti kumayambitsa chitukuko cha dziko la hypoglycemia. Kumwa mankhwala kumatha kuchepetsa kuchuluka kwa triglycerides ndi lipoprotein m'magazi.
The zikuchokera mankhwala ndi mankhwala
Mankhwala tikulephera kukula kwa polyperation wa yosalala minofu zinthu makoma a mtima dongosolo. Zotsatira zabwino za mankhwala pokhudzana ndi mtima ndi mtima zimawululidwa ndikulepheretsa kukula kwa matenda a shuga.
Chithandizo cha matenda ashuga ndi Metformin chitha kuperekedwa ndi dokotala pambuyo popenda wodwalayo mozama. Kutalika kwa mankhwalawa komanso mlingo wa mankhwalawa amagwiritsidwa ntchito kutsimikiza mawonekedwe onse amomwe matendawa ali mthupi la wodwalayo.
Chithandizo chogwira mankhwalawa ndi Metformin hydrochloride. Piritsi limodzi lili ndi 850 mg yogwira mankhwala. Kuphatikiza pazomwe zimapangidwira, kuphatikiza kwa mankhwalawa kumaphatikizapo mankhwala othandizira.
Mankhwala omwe amapanga chipangizo chachipatala ndi awa:
- calcium phosphate dibasic;
- wowuma chimanga;
- lactose;
- povidone;
- sodium benzoate;
- talc;
- magnesium wakuba;
- sodium wowuma glycolate;
- titanium dioxide;
- hydroxypropyl methylcellulose;
- mapangidwe a ethyl cellulose;
- propylene glycol;
- polyethylene glycol.
Kudya kwa Metformin sikukhudza kuchuluka kwa mahomoni m'thupi la munthu, koma kumathandizira kusintha kwa mankhwala ake, omwe amachitika chifukwa cha kuchepa kwa chiwerengero pakati pa insulin ndi mfulu, kuchuluka kwa thupi la munthu pakati pa insulin ndi proinsulin. Chimodzi mwazinthu zofunika kwambiri pakupanga mankhwala ndi kuchititsa kuti shuga agwiritsidwe ntchito.
Chithandizo chogwira ntchito chimathandizira kufalikira kwa magazi mu minyewa ya chiwindi ndikuthandizira kuthamanga kwa glucose mu glycogen. Kugwiritsidwa ntchito kwa Metformin 850 mg kumawongolera michere ya magazi. Izi ndichifukwa chokakamira minofu ya plasminogen activator inhibitor.
Kulowetsedwa kwa chinthu chogwira ntchito kumachitika kuchokera ku lumen ya m'mimba ndipo ndi chizindikiro chomwe chimachokera ku 48 mpaka 52%. Hafu ya moyo wa gawo yogwira ndi pafupifupi maola 6.5. Thupi lomwe limagwira limachotsedwa m'thupi la munthu momwe limapangidwira. Gawo lothandizirali siligwirizana ndi ma protein a plasma a magazi. Kudzikundikira kwa mankhwalawa kumachitika ndi tiziwalo tating'ono, minofu minofu, impso ndi chiwindi. Kuchoka m'thupi ndi impso pokonza mkodzo
Ndi kukula kwa zovuta pakugwira ntchito kwamikodzo, mankhwalawa amadziunjikira impso.
Zizindikiro ndi contraindication kugwiritsa ntchito mankhwala
Zizindikiro zazikulu zogwiritsidwa ntchito ndi izi:
- kukhalapo kwa mtundu wachiwiri wa matenda osokoneza bongo popanda kutanthauzira komwe kumachitika ketoacidosis;
- kukhalapo kwa matenda ashuga popanda kupezeka kwa zakudya;
- mankhwalawa a mtundu 2 a shuga limodzi ndi insulin, makamaka ndi kunenepa kwambiri, komwe kumayendetsedwa ndi kuwoneka kwachiwiri kwa insulin.
Chachikulu contraindication kugwiritsa ntchito mankhwala mankhwalawa mtundu 2 matenda ashuga ndi awa:
- kukula mu thupi la matenda ashuga ketoacidosis, matenda a shuga kapena chikomokere;
- kuphwanya impso ntchito;
- zikamera ndi kupita patsogolo kwa wodwalayo matenda a pachimake ndi chiwopsezo chaimpso ntchito - kuchepa magazi, kutentha thupi, matenda a impso, matenda a bronchopulmonary matenda;
- kukula kwa matenda pachimake komanso matenda omwe angayambitse kupitirira kwa minofu hypoxia;
- kuchitapo kanthu kwakukulu mthupi ndi wodwalayo kulandira kuvulala kwambiri m'thupi;
- kupezeka ndi kuwonjezereka kwa zovuta pakachitidwe ka chiwindi;
- wodwalayo ali ndi uchidakwa wambiri kapena chakumwa chakumwa chowawa;
- kukula mu thupi lactic acidosis;
- kufunikira kwa kudya kwama hypocaloric;
- nthawi ya bere;
- nthawi ya mkaka wa m`mawere;
- wodwalayo ali ndi hypersensitivity pamagawo a mankhwala.
Sizoletsedwa kugwiritsa ntchito Metformin masiku awiri m'mbuyomu komanso masiku awiri atatha kuyesedwa kwa radioisotope pogwiritsa ntchito mankhwala okhala ndi ayodini.
Malangizo ogwiritsira ntchito mankhwalawa
Kuti mudziwe momwe mungamwe mankhwalawo molondola, muyenera kufunsa dokotala. Wodwala ayenera kuphunzira malangizo ogwiritsira ntchito Metformin.
Mlingo wa mankhwalawa umakhazikitsidwa ndi endocrinologist wokhazikika. Dokotalayo ndi amene amawerengera kuti wodwala aliyense payekhapayekha azigwirizana ndi zotsatira za kupezeka kwa thupi ndikuzindikira momwe thupi la wodwalayo lilili. Mlingo wa mankhwala omwe wodwalayo amayenera kumwa umadalira kwambiri kuchuluka kwa shuga m'magazi am'magazi.
Kuti muthe kutenga Metformin molondola, mlingo woyambirira uyenera kukhala kuchokera 500 mpaka 1000 mg patsiku, ndiwo mapiritsi 1-2. Pambuyo masiku 10-15 atatenga, malinga ndi lingaliro la endocrinologist kuyang'ana wodwalayo, kuwonjezeranso kwinanso kwa mlingo ngati izi zingafunike ndi kuchuluka kwa shuga m'thupi la wodwalayo.
Malangizo ogwiritsira ntchito amalimbikitsa kuti mugwiritse ntchito 1500-2000 mg ya mankhwalawa ngati mlingo wokonzera, womwe ndi mapiritsi atatu, ndipo mlingo waukulu wololedwa ndi 3000 mg patsiku.
Pankhani ya chithandizo cha matenda a shuga 2 a odwala okalamba, mlingo womwe mankhwalawa amagwiritsidwa ntchito kuchipatala sayenera kupitilira 1 mapiritsi 2 kapena 2 patsiku.
Mapiritsi amayenera kumwedwa pakamwa popanda kutafuna nthawi yakudya kapena itatha. Mankhwala ayenera kumwedwa ndi madzi ochepa. Pofuna kupewa kukula kwa zoyipa mthupi, mlingo wa tsiku ndi tsiku umalimbikitsidwa kuti ugaledwe mu Mlingo wa 2-3.
Popeza mukamamwa mankhwalawa, pamakhala kuthekera kwakukulu kokuluka kwa lactic acidosis, mlingo womwe umagwiritsidwa ntchito pochiza matenda amisempha 2 amachepetsa ngati wodwala ali ndi vuto lalikulu la metabolic.
Pankhani ya munthawi yomweyo makonzedwe ndi insulin muyezo wa osaposa 40 magawo patsiku, mulingo wa mankhwalawa unasinthidwa. Mankhwala omwe amafunikira tsiku ndi tsiku insulin yoposa 40 magawo patsiku, muyezo wa mankhwala ayenera kumwedwa mosamala kwambiri. Kusankha kwa mankhwala kuyenera kuchitidwa mu chipatala moyang'aniridwa ndi adokotala.
Metformin imachepetsa magawo a glucose okha mwa anthu omwe ali ndi matenda ashuga osawonetsa zomwe ali mwa munthu wathanzi.
Zotsatira zoyipa za mankhwala m'thupi
Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, n`zotheka kuti thupi limayambitsa mavuto omwe amabwera chifukwa cha kuyamwa kwa vitamini B12.
Ndi kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, muyenera kuwunika chidwi chachikulu kuti muwone momwe minyewa ya chiwindi imagwira ntchito komanso impso.
Mukamagwiritsa ntchito mankhwalawa zotsatirazi zingachitike:
- Kuchokera pakugwira ntchito kwa m'mimba, kutayika kumatheka, kuwonetseredwa ngati mukumva nseru, kusanza, kupweteka m'mimba, kutsika kapena kusowa kwa chakudya, mawonekedwe a kutsekemera kwazitsulo mkamwa.
- Kuchokera pakhungu pali kuthekera kwa matupi awo sagwirizana ndi khungu.
- Dongosolo la endocrine limatha kuyankha kugwiritsa ntchito mankhwalawa popanga matenda a hypoglycemic. Nthawi zambiri, zotere zimachitika chifukwa cha kuchuluka kwa mankhwalawa.
- Kuchokera kumbali ya njira ya kagayidwe kachakudya kawirikawiri, mukamamwa mankhwala osakwanira, kukula kwa lactic acidosis mthupi kungatheke. Izi zikachitika, kusiya mankhwala kumafunika.
- Dongosolo lamagazi limatha kuyankha mankhwalawa mwa kupangidwa kwa magazi m'thupi.
Chifukwa choopsa kwambiri m'thupi, kugwiritsa ntchito metformin pamaso pa kulephera kwa impso kumayenera kuyimitsidwa kapena kuyenera kuyang'aniridwa ndi achipatala komanso muyezo wochepa.
Ambiri endocrinologists pankhaniyi amalimbikitsa kuyimitsa mankhwalawo kwathunthu, ndikuyamwa pamtengo wochepetsedwa kwambiri, chifukwa kuyang'anira shuga ndizofunikira.
Chowonadi ndi chakuti kuchuluka kwa shuga m'magazi kumatha kubweretsa zovuta zazikulu mthupi zomwe zingapangitse kuwonongeka kwakukulu.
Malangizo apadera ogwiritsira ntchito Metformin
Mukakonzekera kukhala ndi pakati kapena pakachitika, mankhwalawo ayenera kusiyidwa. Ngati muli ndi pakati, kugwiritsa ntchito mankhwalawa panthawi ya gestation kumachotsedwa ndi insulin.
Popeza palibe chidziwitso pakulowerera kwazomwe zimapangidwira mankhwalawa ndi zomwe zimagwira mu mkaka, mukamagwiritsa ntchito yoyamwitsa, kugwiritsa ntchito mankhwalawa kuyenera kusiyidwa. Ngati pakufunika kugwiritsa ntchito Metformin panthawi yotsekemera, kuyamwitsa kuyenera kuyimitsidwa.
Kugwiritsa ntchito mankhwalawa ndizoletsedwa kwa ana ndi achinyamata ochepera zaka 18.
Madokotala salimbikitsa kugwiritsa ntchito mankhwalawa mankhwalawa odwala matenda ashuga okalamba, omwe zaka zawo zafika zaka 60 ndikugwira ntchito yolemetsa yokhudzana ndi kupsinjika kwa thupi. Malangizowa akuchitika chifukwa chakuti odwala oterewa amatha kukulitsa lactic acidosis mthupi.
Pankhani yotenga Metformin, imatha kuphatikizidwa ndi othandizira omwe amachokera ku sulfonylurea. Ndi kuphatikiza komweku kwa mankhwala, kuyang'anira mosamala kwambiri momwe chizindikiro cha glucose chilili mthupi chimafunika.
Ndi zoletsedwa kumwa mowa ndi mankhwala omwe amakhala ndi ethanol panthawi yomwe amamwa mankhwalawa. Kulandiridwa Metformin munthawi yomweyo ndi mowa kumatha kuyambitsa lactic acidosis mwa wodwala yemwe ali ndi matenda ashuga.
Mukamagwiritsa ntchito mankhwalawa, amaloledwa kuyendetsa magalimoto ndi machitidwe ake, chifukwa kayendetsedwe kake sikukhudza kuyendetsa bwino.
Mtengo wa Metformin, mawonekedwe ake ndi kuwunika kwa wodwala pakugwiritsa ntchito mankhwalawa
Mankhwala otsatirawa ndi fanizo la Metformin:
- Bagomet;
- Glycon;
- Glyminfor;
- Glyformin;
- Glucophage;
- Glucophage Kutalika;
- Langerine;
- Methadiene;
- Metospanin;
- Metfogamm 500, 850, 1000
- Metformin;
- Metformin Richter;
- Metformin Teva;
- Metformin hydrochloride;
- Nova Met;
- NovoFormin;
- Siofor 1000;
- Siofor 500;
- Siofor 850;
- Sofamet;
- Fomu;
- Forin Pliva.
Ndemanga za kugwiritsidwa ntchito kwa mankhwalawa ndi odwala pochiza matenda osokoneza bongo akuwonetsa kuti mankhwalawa amathandizira thupi, omwe amakupatsani mwayi wolamulira kuchuluka kwa shuga m'thupi.
Pali ndemanga zambiri zokhudzana ndi mankhwalawa zomwe zimawonetsa kusintha kwamphamvu m'thupi mukamamwa Metformin kapena mawonekedwe ake ndikuwoneka kuti ali ndi mphamvu pakuthandizira odwala matenda ashuga. Nthawi zambiri, odwala matenda a shuga komanso kunenepa kwambiri amapereka umboni wawo kuti kugwiritsa ntchito Metformin pantchito yothira mankhwala kumachepetsa kwambiri thupi.
Mtengo wa mankhwalawa m'masitolo am'dziko muno zimatengera dera komanso ma CD ake.
Mtengo wa mankhwalawa Metformin Teva 850 mg mdziko muno ndi avareji ma ruble 100 pa paketi iliyonse okhala ndi mapiritsi 30.
Mankhwala ngati Metformin Canon 1000 mg ali ndi mtengo wokwanira m'dziko la ma ruble 270 pachilichonse, omwe ali ndi mapiritsi 60.
Mtengo wa mankhwalawa umadalira kuchuluka kwa mapiritsi omwe ali mumtengowo. Pogula mankhwalawa, muyenera kukumbukira kuti tchuthi chake chimachitika pokhapokha ngati adokotala akupezekapo.
Mu kanema munkhaniyi, Dr. Myasnikov amalankhula za mfundo zomwe Metformin angachite pa matenda ashuga.
