Chithandizo cha matenda a shuga amtundu wa 2 ndichachitali ndipo chimafuna kugwiritsa ntchito mankhwala apadera. Kusankhidwa kwa mankhwalawa kumangotengera zovuta za matendawa, komanso mkhalidwe wa wodwalayo, mawonekedwe a thupi lake, kupezeka kwa matenda owonjezera.
Mankhwala Metformin a matenda a shuga a 2 ndi amodzi mwa omwe amagwiritsidwa ntchito kwazaka zambiri. Izi ndi zotengera za biguanides (kalasi ya mankhwala opangidwa opangidwa mwanjira yomwe ali ndi vuto la hypoglycemic), zovuta zomwe zimayambitsa kutsika kwa glucose wamagazi ndi njira yothandizira. Monga mukudziwa, matenda a shuga a 2 samadalira insulin. Izi zikutanthauza kuti pali njira ziwiri zochizira - kutsitsa misempha ya magazi ndikulimbikitsanso kupanga insulin. Kugwiritsa ntchito metformin kwa odwala matenda ashuga kumakupatsani mwayi wokhwimira shuga. Ganizirani zabwino ndi zovuta za mankhwalawa.
Mfundo za Metformin
Zomwe zimagwiritsidwa ntchito ndi metformin hydrochloride. Kuchokera ku kalasi ya greatuanides, ndiokhawo omwe ali ndi chothandiza.Ndemanga za odwala zimanena kuti mankhwalawa amagwira bwino kuposa ena ambiri m'gulu lawo. Izi ndichifukwa choti zimachitika pamaselo a cellular, ndikuwonjezera chidwi chawo ku insulin. Chifukwa cha chithandizo cha Metformin, zotsatirazi zimawonedwa:
- chiwindi amapanga shuga wochepa;
- mafuta ochulukirapo amayamba kuphatikiza;
- maselo amatengeka kwambiri ndi insulin;
- shuga wocheperako amatengedwa m'matumbo aang'ono;
- minofu imayamba kudya shuga wambiri;
- gawo la shuga pa chimbudzi chimasandukanso lactate (lactic acid).
Chifukwa chake, mankhwalawa amachepetsa shuga m'magazi m'njira yosagwirizana, chifukwa chachikulu chake ndikuwonjezera chidwi cha thupi ku insulin.
Chifukwa chakuti mankhwalawa amathandizira kukhathamiritsa kwa mafuta acids, zotsatira zowonjezera zochizira zimawonekera, kukulitsa gulu la omwe akulimbikitsidwa kumwa Metformin. Izi ndi izi:
- mapangidwe a atherosselotic mtima mapepala amasiya;
- kulemera kwa thupi kumachepa, komwe kumakhudza bwino mankhwalawa a metabolic syndrome;
- kuthamanga kwa magazi kumatulutsa.
Tiyenera kudziwa kuti njira ya oxidation yamafuta acids imakhala mukuwonongeka kwawo ndikusintha kukhala mphamvu. Chifukwa chake, mafuta osungirako amachepetsedwa, thupi limakhala lochepera. Chifukwa chake, mankhwalawa nthawi zambiri amagwiritsidwa ntchito pakuchepetsa thupi, chifukwa amathandizira kuwotcha kwamafuta mwachindunji.
Mbali zoyipa zotenga Metformin
Zochita zamankhwala ndikuwunika kwa odwala zimawonetsa kuti hypoglycemic iyi imakhala ndi zoyipa. Izi zimachitika chifukwa cha kuchuluka komweko pantchito ya makulidwe a lipids. Munthawi yamitundu iyi, mphamvu zambiri zimangopezeka zokha, komanso lactate (lactic acid), zomwe nthawi zambiri zimabweretsa acidosis, ndiko kuti, kusintha kwa cholowezera cha hydrogen kupita ku mbali ya acid. Izi zikutanthauza kuti pali asidi wambiri m'magazi kuposa momwe amafunikira, omwe amasokoneza ntchito ya ziwalo zonse ndi machitidwe mpaka imfa.
Lactic acidosis imatha kuchitika pang'onopang'ono komanso mosayembekezereka. Nthawi zambiri zizindikiro zake zimakhala zofatsa komanso zosafunikira, koma nthawi zina zimafika pamavuto ngakhale ngati dialysis imafunikira (ndiye kuti, kulumikiza impso yochita kupanga ndi chida). Zizindikiro za lactic acidosis ndi motere:
- mawonekedwe ofooka;
- kugona
- Chizungulire
- kupuma kosakhazikika;
- kupuma movutikira
- kuthamanga kwa magazi;
- kutentha pang'ono kwa thupi;
- kupweteka kwa minofu, etc.
Chithandizo cha lactic acidosis nthawi zambiri chimakhala chizindikiro, nthawi zina, hemodialysis imalembedwa (njira yapadera yoyeretsa magazi).
Kodi Metformin imagwiritsidwa ntchito bwanji?
Kugwiritsa ntchito mankhwalawa ndikufuna kuchiza matenda a shuga a 2, komanso kupewa matenda. Madokotala nthawi zambiri amapereka chithandizo chothana ndi kunenepa kwambiri, kukhathamiritsa, kusintha matenda.
Contraindication pakugwiritsa ntchito Metformin
Wothandizira zochizira matenda ashuga sayenera kugwiritsidwa ntchito pazotsatirazi:
- pa mimba ndi mkaka wa m`mawere;
- ana ochepera zaka 10;
- Zakudya zopatsa mphamvu zochepa;
- pambuyo pa ntchito ndi kuvulala;
- ndi chiwindi pathologies;
- ndi m'mbuyomu lactic acidosis;
- ngati pali chizolowezi cha lactic acidosis;
- pamaso pa kulephera aimpso mu anamnesis.
Momwe mungatenge metformin?
Ndikofunikira kwa odwala omwe akufuna kuchiritsidwa glucose owonjezera m'magazi kuti adziwe momwe angapangire metformin yokhala ndi matenda ashuga. Tiyenera kudziwa kuti msika umapereka ndalama ndi mitundu yosiyanasiyana, kuyambira 500 mg mpaka 1000 mg. Palinso mankhwala omwe amakhala ndi mphamvu yayitali. Mlingo woyambirira umaperekedwa muyezo wocheperako, pambuyo pake dokotala angalimbikitse kuchuluka kwake. Kuchuluka kwa tsiku patsiku kungathenso kuchitika ndi dokotala, koma mlingo wololedwa tsiku lililonse ndi osapitilira 2 g.
Zoyenera kuchita ndi bongo wa mankhwala osokoneza bongo
Musachulukitse mlingo wa mankhwalawa kuti muwonjezere mphamvu ya mankhwalawa kapena kufulumizitsa nthawi yochira. Nthawi zambiri, bongo wambiri umatha posakhumudwitsa - umayambitsa kuvulaza thupi, milandu yakupha siyachilendo.
Kuopsa kwa bongo wa Metformin ndiko kukula kwa lactic acidosis. Zizindikiro za matendawa ndi zam'mimba (kutanthauza m'mimba) ndi kupweteka kwa minyewa, mavuto am'mimba, kuthamanga, kuthamanga, kutentha pang'ono kwa thupi, chizungulire komanso kutaya chikumbumtima mpaka kugona.
Ngati muli ndi chimodzi mwazizindikirozi, muyenera kusiya kumwa mankhwalawo ndipo muyenera kufunsa dokotala. Chipatala chitenga zonse zofunikira kuti muchotse lactate m'thupi. Milandu yoopsa kwambiri, hemodialysis ndi mankhwala. Imagwira kwambiri ndipo imapereka zotsatira mwachangu.
Kuchita ndi mankhwala ena
Chotulutsa chachikuluchi chimakhala ndi mawonekedwe - pafupifupi zinthu zonse zimafotokozedwa kudzera mu impso osasinthika, ndipo ena onse (pafupifupi 10%) amadziunjikira m'thupi. Ndipo ngati impso zikuyamba kugwira ntchito mosinthana, Metformin imadziunjikira kwambiri zimakhala, zomwe zimabweretsa zotsatira zoyipa mpaka kutseka.
Ndikofunikanso kwambiri kugwirizanitsa moyenera kugwiritsa ntchito othandizira a hypoglycemic omwe ali ndi insulin. Kupatula apo, ngati Metformin ikuwoneka kuti ili m'magazi kuposa momwe amayembekezeredwa, wodwala wokhazikitsa insulin amatha kugwa mu hypoglycemic coma chifukwa kuchepa kwambiri m'magazi a shuga.
Kutsika kwakukulu kwa shuga m'magazi kumawonedwanso pamodzi ndi kugwiritsa ntchito mankhwala otsatirawa ndi Metformin:
- zotumphukira sulfonylurea;
- NSAIDs;
- oxytetracycline;
- Mao zoletsa (antidepressants apamwamba);
- acarbose;
- ACE zoletsa;
- cyclophosphamide;
- β-blockers
Ndipo ndalamazi, ndikugwiritsa ntchito mankhwala ochepetsa shuga, m'malo mwake, zimachepetsa ntchito yake:
- corticosteroids;
- mahomoni a chithokomiro;
- okodzetsa;
- estrogens;
- kulera kwamlomo;
- nicotinic acid;
- calcium receptor blockers;
- adrenomimetics;
- isoniazids, etc.
Chifukwa chake, Metformin ndi mankhwala abwino kwambiri ochepetsa shuga omwe ali ndi mphamvu kwambiri, koma nthawi yomweyo siwothandiza konsekonse. Ili ndi zotsatira zake zoyipa ndi zotsutsana. Ambiri aiwo ndi ang'ono ndipo amadutsa mkati mwa masabata 1-2, koma ena amatha kukakamiza kuti atenge.
Kuti mankhwalawa agwire bwino ntchito, ndikofunikira kugwirizanitsa ndi dotolo, kutsatira malangizo ake onse, kutsatira mosamalitsa zakudya zomwe zimayikidwa ndikuwonetsetsa mosamala zotsutsana ndi zotsatirapo zake. Muyenera kukumbukiranso kuti mowa ndiye mdani wamkulu wa Metformin, chifukwa chake zakumwa zakumwa zoledzeretsa siziyenera kuperekedwa munthawi yamankhwala. Izi ndichifukwa choti mowa umaletsa ntchito za ma enzymes angapo a chiwindi. Chifukwa chake, Metformin yambiri imalowa m'magazi, zomwe zimapangitsa kutsika kwamphamvu kwa glucose mpaka hypoglycemia. Komanso, mowa akamagwiritsa ntchito mankhwalawa amapanga lactic acid. Chifukwa chake, kugwiritsa ntchito mankhwalawa pogwiritsa ntchito mankhwalawa amatsutsana.
