Kubwereza kwa mankhwala kuti muchepetse shuga

Pochiza matenda a shuga, mankhwalawa amapatsidwa mankhwala ochepetsa shuga.

Izi zimaphatikizira mankhwala opangitsa kuti khungu lizindikire insulin, kusintha katulutsidwe ka mahomoni. Njira zimagwiritsidwanso ntchito kusokoneza mayamwidwe am'mimba m'matumbo.

Mankhwala omwe amalimbikitsa katemera wa insulin

Mankhwala ambiri omwe amathandizira kubisika kwa insulin. Mankhwalawa amaphatikizapo mankhwala ochokera ku gulu la sulfonylurea ndi meglitinides.

Sulfonylureas

Ili ndi gulu la mankhwala opangira omwe amachepetsa glucose wamagazi. Mankhwala osokoneza bongo a gululi amachititsa kuti maselo a pancreatic, omwe amalimbikitsa kupanga kwa insulin ndi thupi. Pachifukwachi, maselo a beta athanzi ayenera kupezeka m'matumbo.

Kuchita kwa mankhwalawa ndi kuwonjezeka kwa katulutsidwe ka timadzi tambiri mu chiwindi, kukondoweza kwa maselo β-maselo, kuponderezedwa kwa glucagon, ketosis ndi secretion ya somatostatin.

Zomwe zimachokera ku sulfonylureas zimagawika m'magulu awiri: yayitali komanso yapakati. Zotsatira zakukulitsa katulutsidwe wa mahomoni zimatengera mulingo womwe utengedwa.

Mankhwala amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri; Wokhazikitsidwa ndi kuchepa mu chiwopsezo cha minyewa kupita ku mahomoni. Amapezeka piritsi.

Zotsatira za Sulfonylurea zimayimiriridwa ndi mibadwo iwiri ya mankhwala:

1. Butamide, Chlorpropamide. Mankhwala amaikidwa mu Mlingo waukulu ndikuwonetsa pang'ono.
2. Glipizide, Glibenclamide, Glycvidone. Amakhala ndi mphamvu yayitali ndipo amapatsidwa muyeso wotsika.

Contraindations akuphatikiza:

• kuchepa magazi
• matenda ashuga ketoacidosis;
• kukanika kwa impso;
• pachimake matenda opatsirana;
• mimba, mkaka wa m`mawere;
• kukanika kwa chiwindi;
• ntchito isanayambe / itatha;
• leukopenia;
• thrombocytopenia;
• mavuto a dyspeptic;
• kawirikawiri hepatitis;
• kunenepa.

Zotsatira zoyipa zomwe zimawonedwa:

• kapangidwe kazitsulo kamkamwa;
• chiwindi ntchito;
• matupi awo sagwirizana;
• matenda aimpso.

Chochitika chodziwika bwino kwambiri ndi hypoglycemia.

Meglitinides

Gulu la mankhwala omwe amalimbikitsa katemera wa insulin. Ndiomwe amatsogolera glycemia - amachepetsa shuga atatha kudya. Kugwiritsa ntchito mankhwala kukonza glucose yosala sikoyenera. Zizindikiro zovomerezeka - DM 2.

Oimira kalasi iyi ndi Nateglinides, Repaglinides. Mankhwala osokoneza bongo amakhudza maselo a pulogalamu ya islet, kuyambitsa kuteteza insulin. Kutsegula kwa mahomoni kumachitika mphindi 15 mutatha kudya. Mitundu ya insulin yayitali imawonedwa pambuyo pa ola limodzi, kuchepa - pambuyo pa maola atatu.

Kukondoweza kumachitika chifukwa cha kuchuluka kwa shuga - pamankhwala ochepa otsika pang'ono zimakhudza kutulutsidwa kwa mahomoni. Izi zikufotokozeranso za kusowa kwa hypoglycemia pomwa mankhwala.

Kuphatikizidwa ndi othandizira ena odwala matenda ashuga. Wochulukitsidwa ndi impso zochuluka, 9% yokha kudzera m'matumbo.

DM 1, ketoacidosis, pakati ndi mkaka wa m'mawere ndi njira zazikulu zotsatsira. Chenjezo liyenera kumwedwa pakumwa mankhwala okalamba odwala. M'pofunikanso kuyang'anitsitsa odwala omwe ali ndi matenda a chiwindi. Ndikulimbikitsidwa kuwunikira nthawi zingapo pachaka. Kuyang'ana mchaka choyamba chamankhwala ndichofunikira kwambiri.

Meglitinides safuna kusankha mlingo. Mankhwala amagwiritsidwa ntchito mukamadya. Mlingo wa insulin pambuyo pa maola atatu amabwerera ku mtengo wake wam'mbuyomu.

Zina mwazotsatira zoyipa:

• kuwonongeka kwamawonekedwe;
• matenda am'mimba;
• matupi awo sagwirizana;
• kuchuluka kwa hepatic mapangidwe a biochemical kusanthula;
• kawirikawiri kokwanira - hypoglycemia.

Sichikulimbikitsidwa kuti mugwiritse ntchito pazotsatirazi:

• Mtundu woyamba wa shuga;
• mimba ndi mkaka wa m`mawere;
• tsankho mankhwala;
• matenda ashuga ketoacidosis.

Mankhwala omwe amalimbikitsa chidwi cha minofu

Mtundu wachiwiri wa matenda ashuga, nthawi zambiri sikofunikira kulimbikitsa chinsinsi cha insulini, chifukwa amapangidwa mokwanira. Ndikofunikira kuwonjezera kukhudzika kwa minyewa kupita ku mahomoni, chifukwa ndikuphwanya zochita za minyewa yolandila minyewa yomwe imakwiyitsa magazi.

Biguanides

Biguanides - gulu la mankhwala omwe amalimbikitsa chidwi cha minofu kuti insulin. Amayimiridwa ndi Buformin, Metformin, Fenformin.

Amasiyana mosiyanasiyana, zotsatira zoyipa, mulingo wambiri kuti mupeze zotsatira zochizira. Pakadali pano, ndi Metformin yokha yomwe imagwiritsidwa ntchito.

Mukamamwa mankhwalawa, pamakhala kuchepa kwa insulin. The yogwira mankhwala linalake ndipo tikulephera gluconeogeneis, kusintha mayamwidwe a shuga. Mlingo wa "cholesterol yoyipa" ndi triglycerides umachepetsedwa. Biguanides amalowetsedwa mu chakudya cham'mimba, chomwe chimapukutidwa makamaka ndi impso, chindende chachikulu chimafika pambuyo pa maola awiri. Kutha kwa theka-moyo kuli mpaka maola 4.5.

Biguanides amalembedwa mtundu wa matenda ashuga a 2 ndipo mtundu 1 wa shuga ndi gawo limodzi la chithandizo chokwanira.

Oimira kalasi ya Biguanide sagwiritsidwa ntchito:

• mimba ndi mkaka wa m`mawere;
• kukanika kwa chiwindi;
• kukanika kwa impso;
• tsankho kwa chigawo chimodzi;
• vuto la mtima;
• pachimake yotupa njira;
• ketoacidosis, lactic acidosis;
• kulephera kupuma.

Biguanides samaphatikizidwa ndi mowa. Komanso sanapatsidwe masiku atatu kale komanso masiku atatu atandichita opareshoni. Odwala opitirira zaka 60 akulimbikitsidwa kuti amwe mankhwala mosamala kuchokera mgululi.

Zotsatira zoyipa mukamadzatenga:

• megaloblastic anemia;
• m'mimba kukhumudwa, makamaka, kutsegula m'mimba, kusanza;
• acidosis.

Mndandanda wamankhwala a gululi akuphatikizapo: Metfogamma, Metformin, Glyukofazh, Adebit, Langerin, Siofor, Bagomet. Mankhwala osokoneza bongo amatha kuphatikizidwa ndi mankhwala ena a glycemic.

Mukaphatikizidwa ndi insulin, chisamaliro chapadera chimafunika. Kugwira ntchito kwa impso ndi ma glucose dalili kumayang'aniridwa. Chisamaliro chachikulu chimalipidwa kuphatikiza ndi mankhwala ena omwe si glycemic - ena amatha kukulitsa kapena kuchepetsa mphamvu ya mankhwala a gulu la greatuanide.

Milaz

Thiazolidinediones - gulu latsopano la mankhwala ochepetsa shuga a pakamwa. Sachititsa kuti insulin isungike, koma imangokulitsa chiwopsezo cha zimakhala zake.

Pali 2 thiazolidinediones - pioglitazone (m'badwo wachiwiri) ndi rosiglitazone (m'badwo wachitatu). Troglitazone (m'badwo woyamba) adaonetsa zotsatira za hepatotoxic ndi cardiotoxic, ndichifukwa chake zinakanizidwa. Mankhwala amatha kugwiritsidwa ntchito limodzi ndi mankhwala ena kapena monga monotherapy.

Pogwiritsa ntchito minofu, chiwindi, mankhwala amawonjezera kukhudzika kwa mahomoni. Zotsatira zake, kukonzanso kwa glucose kumathandizidwa ndikuwonjezera kaphatikizidwe ka cell. Mphamvu yamankhwala imadziwonetsera yokha ngati ili ndi mahomoni ake.

Muli ndi gawo logaya chakudya, lomwe ndi impso, limapukusidwa m'chiwindi. Kuzindikira kwakukulu - pambuyo pa maola 2,5. Mphamvu yodzaza bwino imawonekera pakatha miyezi ingapo mutamwa mankhwalawo.

Mankhwala osokoneza bongo amachepetsa shuga, zimakhudza mbiri ya lipid. Zotsatira zake sizothandiza kwenikweni kuposa ma biguanides. Mankhwala onse m'gululi amawonjezera kulemera. Zotsatira zake zimatengera nthawi yayitali ya chithandizo komanso mlingo. Palinso kusunga madzi mthupi.

Pa mankhwala ndi thiazolidatediones, magwiridwe antchito a chiwindi amayesedwa nthawi ndi nthawi. Ngati wodwala ali ndi chiopsezo chokhala ndi vuto la mtima, ndiye kuti mankhwala a thiazolidine saikidwa.

Zikatero, adotolo amatipatsa insulin, sulfonylureas, metformin.

Mankhwala opangidwa ndi Thiazolidinedione: Avandia, Aktos.

Zoyipa:

• mimba, mkaka wa m`mawere;
• kuphwanya chiwindi;
• Mtundu woyamba wa shuga;
• wazaka 18.

Zotsatira zotsatirazi zinaonedwa ndikugwiritsa ntchito mankhwala:

• kulemera;
• chiwopsezo chowonjezereka cha kufooka chifukwa chakuchepa kwa kufupika kwa mafupa;
• kuphwanya chiwindi;
• hepatitis;
• kulephera kwa mtima;
• kutupa;
• chikanga

Zimatanthawuza kuchepa kwamatumbo kumimba

Alfa glucosidase inhibitors ndi mankhwala omwe amalepheretsa kuyamwa kwa matumbo m'matumbo. Ali ndi zowonjezera-endocrine pachithandizo cha matenda ashuga. Phatikizani kuchuluka kwa shuga mutatha kudya. Chifukwa cha izi, kukula kwa hypoglycemia kumachepetsedwa kwambiri.

Ma inhibitors a AG amasokoneza kuwonongeka kwa chakudya chamagulu, chifukwa chomwe mayamwidwe ake amachepetsa. Chithandizo chogwira ntchito chimayambitsa zotchinga kulowetsedwa kwa mafuta m'magazi.

Ma alpha glucosidase ma inhibitors amagwiritsidwa ntchito makamaka kuphatikiza ndi othandizira ena a glycemic ndi insulin. Wosankhidwa mtundu wa 2 shuga.

Woimira Voglibosis, Acarbose, Miglitol. Tsopano ndi mitundu iwiri yokha yomaliza yomwe imagwiritsidwa ntchito. Zotsatira zamankhwala ndizofanana, koma zotsatira zake zimakhala zosiyana pang'ono.

Acarbose imalepheretsa lactose ndi amylase ndipo sichigwira mu matumbo. Zitha kuwonjezera michere ya chiwindi. Miglitol imasungabe glycogeneis m'chiwindi, imadziwikiridwa m'matumbo. Zimakhudza mayamwidwe a Glibenclamide ndi Metformin popanda chiwonetsero chachipatala.

Pogwiritsa ntchito mankhwala a gululi amawona:

• kuchepa kwa mtima matenda;
• Kuchepetsa makulidwe a atherosulinosis;
• matenda am'mimba thirakiti, makamaka, kutsegula m'mimba ndi kuphwanya.

Contraindication kuti agwiritse ntchito:

• zilonda zam'mimba;
• matenda ashuga ketoacidosis;
• mimba
• matumbo kutsekeka;
• kuyamwa
• kukanika kwa chiwindi;
• kutsekeka kwamatumbo;
• kulephera kwa aimpso.

Zotsatira zoyipa zimawonetsedwa makamaka kuchokera m'mimba. Uku ndi kutsegula m'mimba, kupweteka kwam'deralo, kusanja, kuwonjezeka kwa michere ya chiwindi.

Ndi kulumikizana kwa matenda oletsa kupanikizika ndi mankhwala opatsirana pogwiritsira ntchito mankhwala osokoneza bongo ndi insulin, zotsatira zake zingathe kukulira. Popewa kuthamanga kwa hypoglycemic, mlingo umasankhidwa mosamala.

Sorbents, kukonzekera kwa enzymatic kumachepetsa mphamvu ya Miglitol ndi Acarbose. Corticosteroids, niacin, diuretics, mahomoni a chithokomiro amachepetsa ntchito ya zoletsa AH. Miglitol imachepetsa kukhudzana kwa bioavailability wa Ranitidine, Digoxin.

Incretinomimetics

Ma insretins ndi mahomoni apadera omwe amapangidwa mukatha kudya. Amachepetsa kuyamwa kwam'mimba, amasangalatsa kubisalira kwa insulin, amaletsa kutulutsa kwambiri kwa glucagon ndikuchepetsa chilakolako chofuna kudya. Mu matenda a shuga, ntchito zotere zimachepetsedwa, ndipo zomwe zimachitika mu mahormoni ndizosagwirizana. Chiwerengero chawo chimabwezeretseka pogwiritsa ntchito incretinomimetics. Amasintha zochizira ndipo ali ndi chidwi ndi mankhwala.

Asccinomimetics zimagwirizana ndi zomanga thupi. Amayimiridwa ndi magulu awiri a mankhwala:

• Gulu 1 - Exenatide. Ndi machitidwe a intretin mwachindunji. Izi zikuphatikiza Baeta, Viktoza. Amagwiritsidwa ntchito ngati jekeseni wa subcutaneous. Kuti musinthe, phatikizani ndi mankhwala ena a glycemic.
• Gulu lachiwiri - insulinotropic polypeptide. Imawonetsedwa ndi mankhwala: Galvus, Januvius. Fananizani ndi intretinomimetics yosalunjika. Dipeptidyl peptidase, yomwe imawola maretretins, imatsekedwa. Anapatsidwa padera komanso kuphatikiza ndi mankhwala ena.

Thupi limayambira limagwirira kupanga mahomoni - amalowa m'magazi patapita mphindi zochepa. Kuchulukidwa kusadziwika kumapangitsa kuti chi cell chikule komanso kuchuluka kwa mahomoni omwe amapangidwa. Zochita zamankhwala zimachitika pamisempha yambiri, ndipo pamlingo wotsika, chochitikacho chimatha.

Mwa zina zoyipa zotsutsana:

• matenda ashuga ketoacidosis;
• mimba, mkaka wa m`mawere;
• kukanika kwa impso;
• LED 1;
• wazaka 18.

Mwa zina zoyipa nthawi ya mankhwala anati:

• thupi lawo siligwirizana;
• mutu
• kusanza, kusanza
• kufooka, kugona.

Mankhwala a gulu la incretin mimetics atha kutumikiridwa pa magawo oyambirira a kuwonetsa matendawa. Amathandizira kusamalira beta cell zochita. Pakukonzekera kwa anthu okalamba, pamakhala zizindikiro zambiri zabwino. Mankhwalawa, mankhwalawa amachepetsa kukula kwa hypoglycemia.

Kanema pamankhwala atsopano a shuga:

Gulu lirilonse la mankhwala limayikidwa ndi dokotala potengera chithunzi cha chipatala komanso mawonekedwe a matenda a shuga. Zitha kugwiritsidwa ntchito kuphatikiza komanso ngati monotherapy. Pa chithandizo, tikulimbikitsidwa kutenga biochemistry yamagazi kuti iwone momwe ziwalo zimagwirira ntchito.