Metformin: zomwe zimalembedwa, malangizo, mavuto

Mankhwala odziwika bwino kwambiri padziko lonse a shuga ndi Metformin, ndipo amagwiritsidwa ntchito ndi anthu pafupifupi 120 miliyoni tsiku lililonse. Mbiri ya mankhwalawa ili ndi zaka zopitilira makumi asanu ndi limodzi, munthawi yomwe maphunziro ambiri akhala akuchita, akuwonetsa kugwira ntchito kwake komanso chitetezo kwa odwala. Nthawi zambiri, Metformin imagwiritsidwa ntchito ngati mtundu wa 2 matenda a shuga kuti muchepetse kukana kwa insulini, koma nthawi zina imatha kugwiritsidwa ntchito poletsa zovuta zamagulu a carbohydrate komanso kuwonjezera pa insulin yothandizira matenda a mtundu 1.

Mankhwalawa ali ndi zotsutsana pang'ono ndipo alibe zotsatira zoyipa za ena othandizira ena: sizimawonjezera chiopsezo cha hypoglycemia.

Tsoka ilo, Metformin akadali ndi zolakwika. Malinga ndi ndemanga, mu wachisanu mwa odwala omwe amamwa, matenda am'mimba amawonedwa. Ndikothekanso kuchepetsa mwayi womwe ungachitike ngati mankhwalawa atha kugaya chakudya m'thupi mwakuwonjezera pang'onopang'ono mankhwalawa ndikugwiritsa ntchito njira zatsopano zotulutsira nthawi yayitali.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

Zizindikiro Metformin

Metformin inachita kupangidwa ndi mankhwala a mbuzi, chofala wamba chomwe chimatchedwa kuti shuga. Kuchepetsa kawopsedwe ndikupititsa patsogolo hypoglycemic mbuzi, ntchito inayambika pakugawa zinthu zofunikira kuchokera pamenepo. Adakhala opanga ma biguanides. Pakadali pano, Metformin ndi mankhwala okhawo m'gululi omwe adakwanitsa kuyendetsa bwino chitetezo, ena onsewo adadzakhala ovulaza chiwindi ndipo adawonjezera kwambiri chiopsezo cha lactic acidosis.

Chifukwa chogwira ntchito bwino komanso ndi zovuta zochepa, ndi mankhwala a mzere woyamba wochizira matenda amtundu wa 2, ndiye kuti, adakhazikitsidwa koyamba. Metformin sikukula insulin. M'malo mwake, chifukwa cha kuchepa kwa shuga m'magazi, timadzi timatha kupangika mopanga kuchuluka, komwe nthawi zambiri kumachitika mtundu wa shuga wachiwiri ukayamba.

Kulandila kwake kumakupatsani mwayi:

1. Limbikitsani kuyankhidwa kwa maselo ku insulin, ndiye kuti, kuchepetsa kukana kwa insulini - chomwe chimayambitsa kusokonezeka kwa chakudya chamagulu mwa anthu onenepa kwambiri. Metformin kuphatikiza zakudya komanso kupsinjika kungathe kulipiritsa matenda a shuga a 2, ndikotheka kuchiritsa matenda a prediabetes ndikuthandizira kuthetsa metabolic syndrome.
2. Kuchepetsa mayamwidwe am'mimba m'matumbo, omwe amachepetsa shuga m'magazi.
3. Kuchepetsa kapangidwe ka shuga m'chiwindi, chifukwa cha momwe mulingo wake m'magazi umatsikira pamimba yopanda kanthu.
4. Amasokoneza ma lipid magazi: onjezani zomwe zili ndi milomo yambiri ya m'mimba mwake, kuchepetsa cholesterol ndi triglycerides yoyipa m'mitsempha yamagazi. Izi zimachepetsa chiopsezo cha zovuta zamatenda a shuga.
5. Sinthani kukonzanso kwa magawo atsopano m'magazi, kufooketsa kudziphatika kwa leukocytes, ndiye kuti, muchepetse chiopsezo cha atherosulinosis.
6. Kuchepetsa thupi, makamaka chifukwa chowopsa kwa kagayidwe ka mafuta a visceral. Pambuyo pazaka 2 zogwiritsidwa ntchito, kulemera kwa odwala kumatsika ndi 5%. Ndi kuchepa kwa caloric kudya, zotsatira za kuchepa thupi zimayenda bwino.
7. Yambitsani magazi kutuluka kwa zotumphukira zimakhala, ndiko kuti, kukonza zakudya zawo.
8. Kupanga ovulation ndi polycystic ovary, motero, imatha kutengedwa pokonzekera kutenga pakati.
9. Tetezani ku khansa. Izi zatsegulidwa posachedwa. Kafukufuku awonetsa kutulutsa katundu wa antitumor mu mankhwalawa; chiopsezo chokhala ndi oncology mwa odwala chatsika ndi 31%. Ntchito yowonjezereka ikuchitika kuti iphunzire ndikutsimikizira izi.
10. Chepetsani kukalamba. Uwu ndiye mphamvu yopanda tanthauzo ya Metformin, zoyeserera zimachitika kokha pa nyama, zimawonetsa kuwonjezeka kwa nthawi yomwe moyo ungayesedwe makoswe. Palibe zotsatira za kuyesedwa kwathunthu kwachipatala ndi kutenga nawo gawo kwa anthu, kotero ndizoyambiranso kunena kuti Metformin imachulukitsa moyo. Pakadali pano, izi ndizowona kwa odwala omwe ali ndi matenda ashuga okha.

Chifukwa cha kuchuluka kwa thupi mu thupi, zikuwonetsa kugwiritsidwa ntchito kwa Metformin sikuti amangothandiza kuchiza matenda a shuga a mtundu wachiwiri. Itha kuthandizidwa bwino kupewa matenda osokoneza bongo, kuwongolera kuonda. Kafukufuku wasonyeza kuti mwa anthu omwe ali ndi prediabetes (kulolera shuga), kunenepa, matenda oopsa, insulin yowonjezera) ndi Metformin kokha, matenda a shuga anali ochepa 31%. Powonjezera zakudya ndi maphunziro akuthupi ku chiwembucho kunakwanitsa bwino zotsatira: 58% ya odwala anatha kupewa matenda a shuga.

Metformin imachepetsa chiwopsezo cha zovuta zonse za shuga ndi 32%. Mankhwalawa akuwonetsa zotsatira zochititsa chidwi popewa macroangiopathies: mwayi wokhala ndi vuto la mtima komanso sitiroko umachepetsedwa ndi 40%. Kuchita uku ndikofanana ndi mphamvu ya cardiprotectors - mankhwala opsinjika ndi ma statins.

Mtundu wa kumasulidwa kwa mankhwala ndi kumwa

Mankhwala oyamba omwe ali ndi Metformin amatchedwa Glucofage, mtundu wa kampani ya ku France Merck. Chifukwa chakuti zaka zopitilira 10 zapita kuchokera pamene mankhwalawa adayamba kupanga ndikupeza patent yake, kupanga mankhwala omwe ali ndi mawonekedwe omwewo - majenito, ndizololedwa.

Malinga ndi ndemanga za madotolo, otchuka komanso apamwamba kwambiri:

• Germany Siofor ndi Metfogamma,
• Israeli Metformin-Teva,
• Russian Glyfomin, Novoformin, Formetin, Metformin-Richter.

Mitundu yamagetsi ili ndi mwayi wosatsutsika: ndiotsika mtengo kuposa mankhwala oyambirirawo. Sipangokhala zovutirapo: chifukwa cha mawonekedwe opangira, mphamvu zawo zitha kukhala zochepa, ndikuyeretsa kwambiri. Popanga mapiritsi, opanga amatha kugwiritsa ntchito zinthu zina, zomwe zimatha kubweretsanso zina.

Mankhwala amamasulidwa mu mawonekedwe a mapiritsi amkamwa, Mlingo wa 500, 850, 1000 mg. Kuchepetsa shuga mu zovuta zamatumbo a metabolism kumawonedwa kuyambira 500 mg. Kwa odwala matenda ashuga, mulingo woyenera kwambiri ndi 2000 mg.. Ndi kuwonjezeka kwa iye mpaka 3000 mg, mphamvu ya hypoglycemic imakula pang'onopang'ono kuposa chiwopsezo cha mavuto. Kuchulukanso kwa mlingo sikuti kungokhala kopindulitsa, komanso koopsa. Ngati mapiritsi awiri a 1000 mg sanakwaniritse kuchepa kwa glycemia, wodwalayo amamugwiritsanso ntchito mankhwala ochepetsa shuga a magulu ena.

Kuphatikiza pa Metformin yangwiro, mankhwala ophatikizira a shuga amapangidwa, mwachitsanzo, Glibomet (yokhala ndi glibenclamide), Amaryl (yokhala ndi glimepiride), Yanumet (yokhala ndi sitagliptin). Cholinga chawo chimakhala cholondola mu shuga wa nthawi yayitali, pomwe ntchito za pancreatic zimayamba kuwonongeka.

Palinso mankhwala omwe amakhala ndi nthawi yayitali - Glucofage Long (mulingo 500, 750, 1000 mg), analogues Metformin Long, Glformin Prolong, Formine Long. Chifukwa cha kapangidwe kapadera ka piritsi, kuyamwa kwa mankhwalawa kumachepetsedwa, zomwe zimayambitsa kuchepa kwapawiri kawiri kwa zovuta zoyambira m'mimba. Mphamvu ya hypoglycemic imasungidwa bwino. Metformin ikamwezedwa, gawo lolembamo mapiritsi limatulutsidwa mu ndowe. Chokhacho chingabwezeretse mawonekedwe awa ndiwowonjezeka pang'ono pamlingo wa triglycerides. Kupanda kutero, zotsatira zabwino pa lipid mbiri yamagazi zimatsalira.

Momwe mungatenge metformin

Yambani kutenga Metformin ndi piritsi limodzi la 500 mg. Ngati mankhwalawa amalekeredwa bwino, mlingo umawonjezereka mpaka 1000 mg. Kutsitsa kwa shuga kumayamba pang'onopang'ono, kutsika kwamphamvu kwa glycemia kumawonedwa pambuyo pa milungu iwiri yoyendetsa. Chifukwa chake, mlingo umakulitsidwa ndi 500 mg mu sabata kapena awiri, mpaka matenda a shuga amalipiridwe. Kuti muchepetse mavuto obwera chifukwa chimbudzi, tsiku ndi tsiku mlingo umagawidwa katatu.

Kutulutsa pang'onopang'ono metformin kumayamba kumwa ndi piritsi limodzi, nthawi yoyamba yomwe mankhwalawa amasinthidwa pambuyo masiku 10-15. Kuchuluka kwakuloledwa ndi mapiritsi atatu a 750 mg, mapiritsi 4 a 500 mg. Voliyumu yonse ya mankhwalawa amamwa nthawi yomweyo, nthawi yamadzulo. Mapiritsi sangathe kuphwanyidwa ndikugawika magawo, chifukwa kuphwanya kapangidwe kake kumayambitsa kutayika kwa nthawi yayitali.

Mutha kutenga Metformin kwa nthawi yayitali, kupuma kwa chithandizo sikofunikira. Pakudya, zakudya zamagulu ochepa komanso masewera olimbitsa thupi sizitha. Pamaso pa kunenepa kwambiri, amachepetsa kudya kwa calorie.

Kugwiritsa ntchito nthawi yayitali kungayambitse kuchepa kwa vitamini B12, chifukwa chake odwala matenda ashuga omwe amatenga Metformin amayenera kudya zopangidwa ndi nyama tsiku lililonse, makamaka chiwindi, impso ndi ng'ombe, ndikuyesedwa pachaka chifukwa cha kuchepa kwa magazi m'thupi kwa B12.

Kuphatikiza kwa metformin ndi mankhwala ena:

Zotsatira zoyipa ndi contraindication

Zotsatira zoyipa za kutenga Metformin ndi pafupipafupi zomwe zimachitika:

Lactic acidosis ndi osowa kwambiri koma akupha. Mu malangizo ogwiritsa ntchito, gawo lonse lagawidwa kwa iye. The Mwina acidosis ndi wapamwamba ndi:

• bongo wa metformin;
• uchidakwa;
• kulephera kwaimpso;
• kusowa kwa mpweya chifukwa cha angiopathy, kuchepa magazi, matenda am'mapapo;
• kuperewera kwambiri kwa vitamini B1;
• muukalamba.

Chidwi chachikulu mukamamwa Metformin iyenera kulipidwa kuti igwirizane ndi mowa. Kutsutsana kwambiri pakugwiritsa ntchito mankhwalawa ndi uchidakwa, makamaka ndi mavuto a chiwindi. Ngakhale mukafuna kumwa chikho chonse cha vinyo, Metformin yozolowereka iyenera kuthetsedwa mu maola 18, kukulitsidwa - patsiku. Kupuma kotalika kumapangitsa kubwezeredwa kwa shuga, chifukwa chake ndikwanzeru kusiya mowa kwathunthu.

Malinga ndi odwala, zovuta zam'mimba komanso zamakomedwe nthawi zambiri zimakhala zosakhalitsa ndipo zimatha thupi likagundana. Nthawi zambiri amadutsa osatha kulandira chithandizo pakatha milungu iwiri. Pofuna kuchepetsa kusapeza bwino, mulingo umachulukidwa bwino. Nthawi zina, ndikofunikira kusinthira ku Glucophage Long yaitali.

Mndandanda wa zotsutsana:

1. Zomwe zimafunikira kwakanthawi ka insulini ndi zovuta za matenda a shuga (ketoacidosis, thoroma ndi chikomokere), opaleshoni, mtima kulephera, kugunda kwa mtima.
2. Matenda a shuga a nephropathy, kuyambira gawo 3.
3. Matenda a impso, osakanizika kwakanthawi chifukwa cha kusowa kwamadzi, kugwedezeka, matenda oopsa.
4. Amasamutsidwa kale lactic acidosis.
5. Zakudya zoperewera zama calorie (1000 kcal kapena zochepa).
6. Mimba Ndi matenda a shuga a 2, Metformin iyenera kusiyidwa ndipo chithandizo cha insulin chimalimbikitsidwa pakukonzekera.

Sikuti kuphwanya kutenga Metformin, koma kumafuna kuyang'aniridwa kwazachipatala zaka zopitilira 60, ngati wodwala ali ndi matenda a impso kapena akuvutika kwambiri. Mankhwalawa amatha kudutsa mkaka wa m'mawere, koma palibe zotsatira zoyipa pamwana zomwe zidapezeka. Mukamadyetsa amaloledwa ndi chizindikiritso mu malangizo oti mugwiritse ntchito "mosamala". Izi zikutanthauza kuti lingaliro lomaliza limapangidwa ndi adokotala, akuganizira zaubwino ndi zovulaza za Metformin.

Ma analogi a Metformin - momwe mungasinthire?

Ngati Metformin ilibe kulekerera bwino, itha kubwezeretsedwera ndi mankhwala omwe akhala akuchita kwa nthawi yayitali kapena chithunzi chonse cha wopanga wina.

Pamaso pa contraindication, mankhwala amasankhidwa ndimayendedwe ofanana ndi ntchito, koma mawonekedwe osiyana:

Kusintha kwa mankhwalawa kuyenera kuchitika pokhapokha ngati akuwuzidwa ndi adokotala komanso moyang'aniridwa.

Kutenthetsa kwa Metformin

Metformin mwina singathandize aliyense kuti achepetse thupi. Kuchita kwake kwatsimikiziridwa pokhapokha ngati kunenepa m'mimba. Amakhala ochulukirapo mwa amuna, kulemera kwakukulu kumadziunjikira pamimba mwanjira yamafuta a visceral. Zatsimikiziridwa kuti Metformin imathandizira kuchepetsa kapena kuchepetsa thupi, kutsitsa kuchuluka kwa mafuta a visceral, ndipo pakapita nthawi yayitali - kugawa bwino kwamafuta amthupi. Amanenanso kuti mankhwalawa angakhudze dongosolo lamanjenje, kuchepetsa kulakalaka. Tsoka ilo, si onse amene amazindikira izi.

Ndikulimbikitsidwa kugwiritsa ntchito Metformin kuti muchepetse kulemera kokha kwa odwala omwe ali ndi kunenepa kwambiri (BMI≥30) kapena pophatikiza kulemera kwakukulu (BMI≥25) ndi matenda a shuga a m'matenda, matenda a mtima, matenda a mtima. Pankhaniyi, mankhwalawa ndi othandiza kwambiri, popeza ambiri mwa odwala amatenga insulin.

Mabuku ena amatchula mankhwalawo ngati choletsa cha m'mimba. Kwenikweni iye sichimaletsa kuyamwa kwa glucose, koma imangoletsa, zopatsa mphamvu zopatsa mphamvu zidzakhalabe chimodzimodzi. Chifukwa chake, simuyenera kuyesa kutaya mapaundi ochepa pa Metformin kuti mukwaniritse chithunzi choyenera. Mwa ichi iye si mthandizi.

Kuchepetsa Mphamvu

Metfomin sitingatchedwe njira yothandiza kwambiri yochepetsera thupi. Malinga ndi kafukufuku, kugwiritsa ntchito mankhwalawa kwakanthawi kumakhalabe ndi zakudya zam'mbuyomu kumapereka kuchepa kwa 0,5-4,5 kg. Zotsatira zabwino kwambiri zidawonedwa m'gulu la odwala omwe ali ndi metabolic syndrome: mutatenga 1750 mg ya Glucofage Long patsiku, kuchepa kwa thupi m'mwezi woyamba kunali 2.9 kg. Nthawi yomweyo, milingo yawo ya glycemia ndi lipid yamagazi yabwerera mwakale, ndipo kuthamanga kwa magazi awo kunachepa pang'ono.

Kukana kwa insulini kumayambitsa kuchuluka kwa insulin, komwe kumalepheretsa kuwonongeka kwa mafuta, ndipo njira yochepetsera thupi imachepa. Ndi kukana kwa insulin komwe kumatsimikiziridwa ndi kusanthula, kutenga Metformin kumakupatsani "kukankha" kagayidwe ndikuyamba njira yochepetsera kunenepa. Mwachilengedwe, munthu sangachite popanda kudya kalori wotsika, komanso bwino, zakudya zamafuta ochepa. Athandizira kupititsa patsogolo kagayidwe ndi masewera aliwonse.

Malysheva okhudza Metformin

Wotulutsa TV wotchuka Elena Malysheva amalankhula za Metformin kokha ngati njira yotalikitsira moyo, osanenapo kuti asayansi sanapereke umboni weniweni pazomwezi. Kuchepetsa thupi, amandipatsa zakudya zamagulu ochepa zopatsa mphamvu. Ndi thanzi labwino, uwu ndi mwayi weniweni wochotsa mafuta ochulukirapo. Anthu omwe ali ndi matenda ashuga sangathe kutsatira kadyedwe koteroko, chifukwa amadzaza mafuta.

Kusankhidwa kwa mankhwala

Kuchita bwino kwa Glucofage ndi mawonekedwe ake ali pafupi, mtengo umasiyananso pang'ono, choncho zilibe kanthu kuti asankhe ndani. Mankhwala omwe akhala akuchita kwa nthawi yayitali amaloledwa bwino, ndipo pamakhala mwayi wochepa wolumphira mlingo, popeza umamwa kamodzi patsiku.

Metformin yodwala matenda a chithokomiro

Ngati njira zomwe zili pamwambazi sizimapereka chifukwa, ndipo cholemera chikuyimilira, muyenera kulabadira zamankhwala. Ndikofunika kuti muyesedwe mayeso a hypothyroidism (thyrotropin, thyroxine, triiodothyronine) ndikuchezera endocrinologist. Chithandizo cha mahormoni chimaloledwa kuphatikiza ndi kugwiritsa ntchito Metformin.

Madokotala amafufuza

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