Iwo adayamba kukambirana za chinthu cha Metformin mu 1922, adafotokoza zomwe adachita makamaka mu 1929, ndipo adayamba kutchuka pambuyo pa 1950. Kuyambira pamenepo, asayansi adayamba kuwonetsa chidwi ndi metformin monga othandizira kuchepetsa shuga zomwe sizikhudza mtima ndi mitsempha yamagazi.
Pambuyo pakuphunzira mosamala ndikufananiza ndi mankhwala ena a gululi, adayikidwa mwachangu ku Canada m'ma 70s ndi matenda a shuga a 2, ndipo ku America idaloledwa kokha mu 1994, pomwe idavomerezedwa ndi FDA.
Zolemba
- 1 Kodi Metformin ndi chiyani?
- 2 Kuphatikizika ndi mawonekedwe a kumasulidwa
- 3 katundu
- 4 Zizindikiro ndi zotsutsana
- 5 Momwe mungatenge Metformin
- 6 Metformin pa nthawi yoyembekezera komanso mkaka wa m'mawere
- 7 Zotsatira zoyipa ndi bongo
- Malangizo apadera
- 9 Zotsatira za maphunziro ovomerezeka
- Kuwunikira mwachidule za mankhwala ochepetsa thupi komanso kuchiza matenda a shuga 2
- 10.1 Analogs a metformin
- 11 ndemanga zakuchepetsa thupi komanso odwala matenda ashuga
Kodi Metformin ndi chiyani?
Mwa kapangidwe ka mankhwala, metformin ndiye woimira wamkulu wa Biguanides. Ndi mankhwala a mzere woyamba kuchiza matenda a shuga a 2, amadziwika kuti ndiwotchuka kwambiri padziko lonse lapansi. Mosiyana ndi magulu ena a othandizira pakamwa, ndibwino kuti azikhala ndi mphamvu m'malo mwake kapena zimathandizira kuchepetsa. Komanso, metformin nthawi zina imagwiritsidwa ntchito ngati munthu amachepetsa thupi (kuchiza kunenepa kwambiri) mwa anthu opanda matenda a shuga, ngakhale sanapangidwe pachifukwa ichi.
Zokhudza kuchepa kwa thupi zimachitika pamachitidwe angapo:
- mulingo wa cholesterol "yoyipa" yafupika;
- kuyamwa kwa shuga wosavuta m'mimba kumachepetsedwa;
- mapangidwe a glycogen ali oletsedwa;
- glucose processing imathandizira kwambiri.
Kupanga ndi mawonekedwe a kumasulidwa
Metformin yonse yomwe ilipo imapezeka m'mapiritsi amtundu-wokhazikika kapena mapiritsi otulutsidwa, omwe amachepetsa maulamuliro. Kuphatikizikako kumaphatikizapo metformin hydrochloride mu Mlingo wa 500, 750, 850 kapena 1000 mg.
Mankhwala
Mankhwala ndi genuanide wothandizira. Kupadera kwake ndikuti samakulitsa kapangidwe ka insulin yake. Kuphatikiza apo, sizikhudza kuchuluka kwa glucose mwa anthu athanzi. Metformin imatha kuwonjezera mphamvu ya insulini ya ma receptors apadera, imalepheretsa kuyamwa kwa glucose m'matumbo am'mimba ndikuchepetsa kuchuluka kwake m'magazi poletsa kutembenuka kwa chiwindi.
Kuphatikiza apo, metformin imakhudzanso kagayidwe kamafuta: imatsitsa cholesterol, otsika osalimba lipoprotein ndi triglycerides, ndipo nthawi yomweyo imawonjezera zomwe zili ndi kuchuluka kwa milomo ya lipoproteins. Panthawi yamankhwala, kulemera kwa thupi kumakhalabe kosasinthika (komwe kumakhalanso zotsatira zabwino), kapena kuchepa pang'onopang'ono.
Kuphatikiza kwakukulu kwazinthu kumatheka pafupifupi maola 2.5 mutatha kugwiritsa ntchito. Hafu ya moyo ndi pafupifupi maola 7. Mu vuto la impso, chiopsezo chodzikundikira mthupi chimakulanso, chomwe chimadzaza ndi zovuta.
Zizindikiro ndi contraindication
Metformin imalembedwa mtundu wa odwala matenda ashuga a 2 omwe amayamba kunenepa kwambiri pomwe kusintha kwa zakudya komanso kukhalapo kwa masewera sizinabweretse zotsatira zomwe zikuyembekezeka. Itha kugwiritsidwa ntchito ngati mankhwala okhawo osagwirizana ndi matenda a shuga kwa ana azaka 10 ndi akulu, kapena monga mankhwala osokoneza bongo. Akuluakulu amathanso kuphatikiza ndi mapiritsi ena a hypoglycemic.
Mankhwala ali ndi zotsutsana zambiri:
- Thupi lawo ndi chinthu china chilichonse.
- Simungathe kuidya panthawi yokhwima zakudya ngati zosakwana 1000 kcal zimadyedwa patsiku.
- Mimba
- Kulephera kwamtima kwambiri, kuphwanya kwam'mimba kovuta, kupuma pamavuto.
- Matenda aimpso. Izi zimaphatikizanso kusokonezeka kwa kuchuluka kwa madzi, kugwedezeka, matenda opatsirana omwe angayambitse kulephera kwa impso.
- Zowonjezera zazikulu za opaleshoni ndikuvulala.
- Matenda a shuga ketoacidosis, precoma ndi chikomokere.
- Kuphwanya chiwindi, uchidakwa, poyizoni wazakumwa ndi zakumwa zoledzeretsa.
- Kudzikundikira kwa lactic acid mu chigoba minofu, khungu ndi ubongo, zomwe zimatchedwa lactic acidosis.
Metformin sayenera kumwedwa ndi anthu okalamba omwe amakhala ndi zolemera zolimbitsa thupi - izi zimachitika chifukwa cha kupezeka kwa lactic acidosis. Amayi omwe akuyamwitsa amayeneranso kusamala ndikumwa mankhwalawo monga momwe adagwirizana ndi adotolo, koma nthawi zambiri amamaliza kuyamwa kuti asavulaze mwana.
Momwe mungatenge metformin
Nthawi zambiri zimayambitsa zovuta kuchokera m'matumbo am'mimba, kusintha kulolerana, tikulimbikitsidwa kuti mukulitse mlingo pang'onopang'ono ndikuwaphwanya.
Malamulo olandila kwa achikulire ngati mankhwala okhawo ochizira kapena osakaniza ndi mapiritsi ena ochepetsa shuga:
- Mankhwalawa amamwetsa kapena kudya. Nthawi zambiri, koyamba mlingo ndi 500-850 mg patsiku, logawidwa zingapo. Kukula kwake kumakhudzana mwachindunji ndi kuchuluka kwa shuga m'magazi.
- Mlingo wokonza ndi 1500-2000 mg patsiku, umagawidwa pawiri Mlingo umodzi kuti usanthedwe ndi zomwe zimachitika m'matumbo.
- Mlingo wambiri watsiku ndi tsiku sayenera kupitirira 3000 mg.
Kuphatikiza ndi insulin:
- Mlingo woyambirira wa metformin ulinso 500-850 mg katatu patsiku, kuchuluka kwa insulin kumasankhidwa payekhapayekha pa shuga la magazi.
Ana azaka zapakati pa 10 ndi 10 amapatsidwa mankhwala a metformin 500-850 mg kamodzi patsiku chakudya. Kusintha kwa Mlingo ndikotheka pambuyo pakugwiritsa ntchito kwa milungu iwiri. Mlingo woyenera kwambiri sayenera kupitirira 2000 mg patsiku, umagawidwa pawiri.
Pali mitundu yotalikilapo ya mapiritsi omwe mungamwe kamodzi patsiku. Mlingo amasankhidwa ndikuwonjezeka payekhapayekha, mankhwalawa amagwiritsidwa ntchito pamenepa, nthawi zambiri mukatha kudya chakudya chamadzulo.
Metformin pa mimba ndi mkaka wa m`mawere
Panalibe maphunziro okwanira maimelo. Zowonera zochepa zikuwonetsa kuti palibe zolakwika zomwe zimapezeka mwa ana osabadwa, pomwe mayi woyembekezera amatenga mankhwalawo. Koma mayeso akuwongolera akuti mayi woyembekezera azidziwitse adokotala za momwe aliri, kenako akuwona ngati asintha kukonzekera insulini, ngati pakufunika kutero.
Zimatsimikiziridwa kuti chinthucho chimapukutidwa limodzi ndi mkaka wa m'mawere, koma zovuta za ana sizinawonebe. Ngakhale izi, sizingatengere mkaka wa m`mawere, ndikofunikira kuti muzimalize kuti zisayambitse zovuta zosayembekezereka mwa mwana.
Zotsatira zoyipa ndi bongo
Nthawi zambiri, mukamamwa mankhwalawa, kugaya kwam'mimba kumakhala ndi vuto: zimbudzi zam'mimba, mseru, kusanza kumawonekera, kusinthika kwa kusintha kwa chakudya, ndi chilakolako chofuna kudya zimatha kuchepa. Nthawi zambiri, zizindikirozi zimasinthika - zimachitika kumayambiriro kwa chithandizo ndipo zimazimiririka zokha monga zimawonekera.
Zovuta zina:
- Khungu: kuyabwa, zotupa, malo ofiira.
- Metabolism: osowa kwambiri lactic acidosis. Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, kumatheka B nthawi zina.12.
- Chiwindi: kuphwanya magawo a labotale, hepatitis. Zosintha zimasinthidwa ndikudutsa pambuyo pakuchotsedwa.
Ngati zotsatira zoyipa sizisokoneza thanzi lathunthu, mankhwalawa amapitilizidwa popanda kusintha. Zotsatira zikachitika zomwe sizikufotokozeredwa m'malamulo oyendetsedwa, muyenera kudziwitsa dokotala za iwo ndikutsatira malangizo ake.
Mankhwala osokoneza bongo a metformin amapezeka pokhapokha mlingo womwe umatenge umakhala wambiri kangapo kuposa tsiku ndi tsiku. Nthawi zambiri zimawonetsedwa ndi lactic acidosis - dongosolo lamkati lamanjenje limakhala lopsinjika, kupuma, zamtima komanso zovuta zowonekera m'machitidwe zimachitika. Pankhaniyi, kugonekedwa kuchipatala ndikofunikira!
Malangizo apadera
Opaleshoni.Metformin iyenera kuletsedwa masiku awiri asanachitike opaleshoni yomwe idakonzedweratu ndikulembedweratu pasanadutse masiku awiri itatha.
Lactic acidosis. Ndi zovuta kwambiri, ndipo pali zinthu zina zomwe zikuwonetsa kuwopsa kwake. Izi zikuphatikiza:
- kulephera kwambiri kwaimpso;
- mikhalidwe pamene sikutheka kuwongolera kuchuluka kwa shuga m'magazi;
- kupeza kuchuluka kwa matupi a ketone mthupi;
- kugwa kwamvula;
- mavuto akulu a chiwindi;
- uchidakwa wosatha.
Poyerekeza zakumwera kwa metformin, mowa uyenera kusiyidwa ndi kukonzekera komwe kumatha kukhala ndi ethanol (tinctures, solution, etc.)
Ntchito ya impso. Chenjezo makamaka liyenera kuchitidwa ndi anthu achikulire omwe amakonda kumwa mankhwala a antihypertensive, okodzetsa komanso osapatsa mankhwala omwe ali ndi vuto la impso.
Mankhwala ena omwe angayambitse mavuto osafunikira nthawi yomweyo:
- danazole;
- chlorpromazine;
- β2-adrenomimetics mu mawonekedwe a jakisoni;
- nifedipine;
- digoxin;
- ranitidine;
- vancomycin.
Zakugwiritsa ntchito kwawo, muyenera kuchenjeza adokotala pasadakhale.
Ana kuyambira zaka 10. Matendawa ayenera kukhazikitsidwa asanaikidwe ndi metformin. Kafukufuku watsimikizira kuti sizikhudza kutha ndi kukula. Koma kuwongolera magawo awa kuyenerabe kukhala koopsa, makamaka pazaka za 10-12.
Zina Kuti muchepetse kunenepa, tikulimbikitsidwa kuti muzitsatira zakudya kuti chakudya chamagulu azigwiritsa ntchito tsiku lonse. Tsiku lomwe muyenera kudya osachepera 1000 kcal. Njala yoletsedwa!
Zotsatira Zosavuta
Chiyeso china chofunikira chachipatala chotchedwa British Prospective Diabetes Study (UKPDS) chidachitika mwa anthu odwala matenda ashuga a 2 omwe anali onenepa kwambiri komanso omwe anali ndi metformin. Zotsatira:
- kufa kwa matenda ashuga a 2 amachepetsa ndi 42%;
- kuchepetsa chiopsezo cha zotupa zam'mimba - 32%;
- chiwopsezo cha myocardial infarction chimachepetsedwa ndi 39%, stroke - 41%;
- kufa kwathunthu kumachepetsedwa ndi 36%.
Kafukufuku waposachedwa kwambiri, Dongosolo la Kupewa matenda a shuga, adachitidwa pa mankhwala oyamba aku France, Glucofage. Pambuyo pake, mawu otsatirawa adatinso:
- kuchepa kapena kuletsa kukula kwa matenda ashuga mwa anthu omwe ali ndi vuto la chakudya m'thupi ndi 31% adadziwika.
Zambiri za mankhwala ochepetsa thupi komanso mankhwalawa a matenda a shuga 2
Zodziwika kwambiri komanso zabwino kwambiri ndi izi: Glucophage (mankhwala oyambirira achi French), Metformin yopangidwa ndi Gideon Richter ndi Siofor. Kusiyana pakati pawo sikokulira, zinthu zomwe zimagwiritsidwa ntchito ndizofanana, zothandizira zokhazokha zomwe zingakhale zosiyana zomwe zimakhudza kumasulidwa ndi kuperewera kwa mankhwalawo pawokha m'thupi.
Mankhwala otchuka omwe ali ndi "metformin" yogwira ntchito, mtengo wake umatengera mlingo:
Dzina la malonda | Wopanga | Mtengo, pakani |
| Glucophage | Merck Sante, France | Kuyambira 163 mpaka 310 |
| Metformin Richter | Gideon Richter-Rus, Russia | Kuyambira 207 mpaka 270 |
| Siofor | Berlin Chemie, Germany | 258 mpaka 467 |
Ma analogi a Metformin
Mankhwala ena oletsa kuchepa thupi ndi kuchiza matenda a shuga 2:
| Mutu | Zogwira ntchito | Gulu la Pharmacotherapeutic |
| Lycumia | Lixisenatide | Mankhwala ochepetsa shuga (mtundu 2 wa mankhwala a shuga) |
| Forsyga | Dapaliflozin | |
| Novonorm | Repaglinide | |
| Victoza | Liraglutide | |
| Golidi | Sibutramine | Malangizo a chakudya (kunenepa) |
| Xenical, Orsoten | Orlistat | Njira zochizira kunenepa |
Ndemanga yakuchepetsa thupi komanso odwala matenda ashuga
Inna, wazaka 39: Ndili ndi mapaundi owonjezera komanso matenda ashuga a 2. Dotolo adayambitsa metformin ndikuti amathandizanso kuonda. Poyamba sindinazikhulupirire, chifukwa ngakhale zakudya komanso masewera olimbitsa thupi apadera sizinathandize. Koma popeza mankhwalawo anali chiyambi cha matenda ashuga, ndidaganiza zondiyamwa choncho, kutsatira malangizo am'mbuyomu okhudza zakudya. Ndinadabwa kwambiri mwezi umodzi pambuyo pake nditawona pamiyeso yochepera kuposa masiku onse.
Ivan, wazaka 28: M'moyo wanga wonse ndakhala wonenepa: shuga ndi wabwinobwino, masewera alipo, ndimangodya chakudya - palibe chomwe chimagwira. Ndinayesa mankhwala osiyanasiyana ochepetsa thupi, kuphatikiza metformin. Kuphatikiza pakuperewera, sindinalandire kalikonse, kulemera kunakulanso chimodzimodzi ngati wopanda iye. Zingakhale kuti adatenga popanda mankhwala a dokotala ndikusankha mulingo woyenera.
Metformin ndi chida chapadera chochepetsera kunenepa komanso kuthana ndi matenda a shuga a 2, musadzitengere nokha. Kuphatikiza apo, amamugawa ndi mankhwala, omwe amapereka kuchuluka kwa kuchuluka ndi kuvomerezeka. Kudzichitira nokha mankhwala kungakhale kowopsa paumoyo wanu!
