Metformin Richter 500 mg

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Matenda a shuga a mellitus, chifukwa cha kukula msanga komanso kuthekera kwakukulu kwa kufa, amabweretsa vuto lalikulu kwa anthu. Pazaka 20 zapitazi, matenda ashuga alowa kwambiri pazomwe zimayambitsa kufa. Ndizosadabwitsa kuti matendawa amaphatikizidwa pazolinga zingapo zoyambira madokotala padziko lonse lapansi.

Mtundu wa mankhwalawa

Mankhwala Metformin-richter omwe ali ndi mankhwala othandizira a metformin hydrochloride amapangidwa ndi opanga mankhwala awiriawiri: 500 mg kapena 850 mg aliyense. Kuphatikiza pazinthu zoyambira, palinso mafayilo ophatikizidwa: Opadry II, silicon dioxide, magnesium stearate, Copovidone, cellulose, polyvidone.

Mankhwalawa amatha kuzindikiridwa ndi mawonekedwe a mawonekedwe: ozungulira (500 mg) kapena chowulungika (850 mg) mapiritsi oyera oyera mu chipolopolo amakhala ndi zotumphukira m'maselo a blister a zidutswa 10. Mu bokosi mutha kupeza kuchokera 1 mpaka 6 ma mbale otere. Mutha kulandira mankhwalawa kokha mwa mankhwala. Pa Metformin Richter, mtengo wa mapiritsi 60 a 500 mg kapena 850 mg ndi 200 kapena 250 rubles. motero. Wopanga anali atachepetsa tsiku la kumaliza ntchito mkati mwa zaka zitatu.

Limagwirira a zochita za mankhwala

Metformin Richter ndi wa gulu la Biguanides. Zopangira zake zoyambirira, metformin, zimatsitsa glycemia popanda kusinthitsa kapamba, motero palibe hypoglycemia pakati pamavuto ake.

Metformin-richter ili ndi njira zopangira zitatu zotsutsana ndi matenda ashuga.

Mankhwala amalepheretsa kupanga glucogen mu chiwindi ndi 30% poletsa glucogeneis ndi glycogenolysis.
Mankhwalawa amalepheretsa kuyamwa kwa glucose pamakoma a matumbo, kotero mafuta pang'ono amalowa m'magazi. Kumwa mapiritsi sikuyenera kukhala chifukwa chokana zakudya zamafuta ochepa.
Biguanide amachepetsa kukana kwa maselo ku glucose, imathandizira kugwiritsidwa ntchito kwake (m'misempha - kwakukulu, pamagulu owonda - ochepa).

Mankhwalawa amathandizanso kupezeka kwa magazi a lipid: mwakufulumizitsa mawonekedwe a redox, amalepheretsa kupanga kwa triglycerol, komanso mitundu yonse ya "zoipa" (otsika kachulukidwe) ya cholesterol, ndikuchepetsa kukana kwa insulin.

Popeza ma β-cell a islet zida omwe amapanga ma insulin amkati samakhudzidwa ndi metformin, izi sizikuwadzetsa kuwonongeka kwawo msanga komanso necrosis.

Mosiyana ndi mankhwala ena a hypoglycemic, kugwiritsa ntchito mankhwalawa nthawi zonse kumalimbikitsa. Izi ndizofunikira kwa odwala matenda ashuga ambiri, chifukwa mtundu wachiwiri wa matenda ashuga nthawi zambiri umayendetsedwa ndi kunenepa kwambiri, komwe kumapangitsa kuti glycemia iwongolere kwambiri.

Ili ndi biguanide ndi fibrinolytic zotsatira, zomwe zimakhazikitsidwa ndi kuletsa kwa plasminogen minulin inhibitor.

Kuchokera m'mimba, thirakiti yotsekemera imakhudzidwa kwathunthu ndi bioavailability mpaka 60%. Chiwonetsero cha kuchuluka kwake chimawonedwa patatha pafupifupi maola 2,5. Mankhwalawa amagawidwa mosiyanasiyana pa ziwalo ndi machitidwe: ambiri amadziunjikira m'chiwindi, aimpso parenchyma, minofu, ndi tiziwalo timene timagwira.

Zotsalira za metabolite zimathetsedwa ndi impso (70%) ndi matumbo (30%), kuphatikiza hafu ya moyo imasiyana maola 1.5 mpaka 4.5.

Ndani akuwonetsedwa mankhwalawo

Metformin-richter imayang'aniridwa kuti ayang'anire matenda a shuga a mtundu wa 2, onse ngati mankhwala oyambira ndi magawo ena a matendawa, ngati zosintha pamachitidwe (zakudya zotsika zamatumbo, kayendetsedwe ka zochitika zam'maganizo ndi zochitika zolimbitsa thupi) siziperekanso kuwongolera kwathunthu kwa glycemic. Mankhwalawa ndi oyenera kuthandizira monotherapy, amagwiritsidwanso ntchito povuta.

Zitha kuvulaza mankhwala

Mapiritsi amatsutsana ndi anthu omwe ali ndi hypersensitivity pazomwe zimapangidwira. Kuphatikiza apo, Metformin Richter sichosankhidwa:

Ndi kukanika kwa impso ndi chiwindi,
Anthu odwala matenda ashuga omwe ali ndi mtima wowonda komanso kupuma bwino,
Amayi oyembekezera komanso oyembekezera
Kwa oledzera komanso ozunzidwa ndi poyizoni owopsa,
Odwala omwe ali ndi lactic acidosis,
Pa opaleshoni, kuchiza kuvulala, kutentha,
Nthawi yayitali ya radioisotope ndi radiopaque maphunziro,
Nthawi yokonzanso pambuyo poyambitsa myocardial,
Ndi hypocaloric zakudya komanso kuchita masewera olimbitsa thupi.

Wotsutsa nkhani yasayansi pankhani zamankhwala ndi zaumoyo, wolemba pepala lasayansi ndi Ametov A.S., Demidova T.Yu., Kochergina I.I.

Matenda a shuga mellitus (DM) ndivuto lalikulu lazachipatala komanso chikhalidwe cha anthu. Matenda a shuga akuchulukirachulukira m'maiko onse, pomwe 95% amakhala odwala omwe ali ndi matenda a shuga a 2. Malinga ndi International Diabetes Federation, mu 2014 chiwerengero cha odwala matenda amtundu wa 2 anali 387 miliyoni. Uyu ndi aliyense wokhala padziko lapansi. Pofika chaka cha 2035, chiwerengero cha odwala T2DM chitha kuchuluka mpaka 592 miliyoni. Zochitika padziko lonse lapansi pakuchitika kwa matenda ashuga ku Russia. Malinga ndi kaundula waku Russia, ku Russia odwala 8 miliyoni omwe ali ndi matenda ashuga, kapena pafupifupi 5% ya anthu onse, 90% mwa iwo ndi odwala matenda a 2, pofika 2025 akuyembekezeka kuchuluka kwa odwala mpaka 13 miliyoni. Nthawi yomweyo, kuchuluka kwa odwala omwe amawaganizira malinga ndikusintha kwawonekera nthawi zambiri kumakhala kochepa kuposa 2, 3. Kuchulukitsa kwakukulu kwa odwala matenda a shuga kumachitika makamaka chifukwa cha kuchuluka kwa odwala omwe ali ndi matenda amtundu wa 2 m'magulu achikulire.

Kuchita kwa metformin pochizira matenda amishuga a 2

Matenda a shuga mellitus (DM) ndivuto lalikulu lazachipatala komanso chikhalidwe cha anthu. Matenda a shuga akuchulukirachulukira m'maiko onse, pomwe 95% ndi odwala matenda a shuga a 2. Malinga ndi International Diabetes Federation, mu 2014, chiwerengero cha odwala omwe ali ndi matenda a shuga 2 anali 387 miliyoni, kapena 12 aliyense wokhala padzikoli. Pofika chaka cha 2035, kuchuluka kwa odwala matenda amishuga a 2 akhoza kukwera mpaka 592 miliyoni. Zochitika zapadziko lonse zokhudzana ndi matenda ashuga inc> mtundu wachiwiri wa matenda ashuga. Pofika chaka cha 2025, chiwerengero cha odwala chikuyembekezeka kukwera mpaka 13 miliyoni. Chiwerengero cha odwala olembetsedwa nthawi zambiri chimakhala chochepa kwambiri poyerekeza ndi chiwerengero chenicheni. 2, 3 Kuthandizira kwakukulu pa chiwerengero cha odwala matenda ashuga kumachitika chifukwa cha kuchuluka kwa odwala matenda ashuga amtundu wa 2.

Zolemba pazaka yasayansi pamutu wakuti "Kugwiritsa ntchito bwino kwa mankhwala a metformin pochiza matenda amtundu wa 2"

A.S. AMETOV, MD, pulofesa, T.Yu. DEMIDOVA, MD, pulofesa, II. KOCHERGINA, Ph.D. Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia, Moscow

ZINSINSI ZOLEMBA

POPHUNZITSIRA CHIYANI CHOBWINO 2

mtundu 2 shuga

Kuyang'anitsitsa mtundu wa matenda ashuga a 2 a madokotala a zamisili zosiyanasiyana (othandizira, akatswiri a zamankhwala, maopaleshoni, maopaleshoni, ndi zina zotere) zimagwirizanitsidwa ndi zovuta zam'mitsempha, zomwe zimawonjezera kwambiri mwayi wokhala ndi matenda amtima komanso kufa. Mu 2014, anthu omwe amafa ndi matenda ashuga anali anthu 4.9 miliyoni. Matenda amtima mwa odwala omwe ali ndi matenda a shuga a 2 ndiwofala kwambiri kuposa ambiri.

Malinga ndi kafukufuku wapadziko lonse lapansi, kuchuluka kwa matenda a mtima (CHD) odwala omwe ali ndi matenda a shuga a 2 ndiwokulirapo kawiri, chiopsezo chotenga matenda osokoneza bongo owopsa (MI) ndi okwanira 6-10, ndipo matenda amitsempha m'mimba ndi maulendo 4-7 kuchuluka, ndi kupulumuka kwa odwala pambuyo pachimake mtima matenda ndi kutsika 2-3 kuposa odwala popanda matenda ashuga.

The pafupipafupi chitukuko cha matenda a mtima ndi pachimake infrction, makamaka zopweteka mawonekedwe am`mnyewa wamtima infarction, pamaso pa mtundu 2 matenda a shuga nthawi zambiri amagwirizana ndi kuwonongeka kwakanthawi kwa matenda ashuga komanso kukula kwa matenda ashuga a polyneuropathy ndi kuwonongeka kwa ziwiya zomwe zimadyetsa mitsempha, komanso kudziwikanso kwa chiwopsezo cha matenda a matenda a bongo. zigawo.

Matenda a mtima (CVD) komanso ngozi zapamtima zomwe zimapangitsa kuti odwala omwe ali ndi matenda ashuga a 2 apezeke mu 75-80% ya milandu: 60% ya iwo ndi

amapita ku mtima ndi

10% - ya zotupa za cerebrovascular 6, 3. Pafupifupi 50% ya odwala omwe ali ndi matenda a shuga 2 amafa chifukwa cha kupweteka kwambiri kwa myocardial. Udindo wotsogola wa kufa kwa mtima ndi mtima pansi pakuchepetsa chiyembekezo chokhala ndi moyo ambiri mwa odwala omwe ali ndi matenda amtundu wa 2 walola bungwe la American Cardiology Association kuphatikiza matenda ashuga a 2 ngati matenda amtima.

Kukula kwa zovuta za matenda ashuga kumalumikizidwa ndi hyperglycemia, yomwe yatsimikiziridwa motsimikizika m'zaka zambiri zakafukufuku wa sayansi yayikulu, monga DCCT pa mtundu 1 wa matenda ashuga ndi UKPDS - "Kuyembekezeredwa kwa matenda a shuga a Britain 2." Mu kafukufuku wa UKPDS, zidatsimikiziridwa kuti kulipiritsa zovuta za metabolic mu mtundu 2 wa shuga kuti muchepetse kupitilira kwa vuto la atherosclerosis ndi macrovascular, ndikofunikira kulingalira osati zokhazokha za glycemic, komanso zidziwitso za lipid spectrum ndi kuthamanga kwa magazi, zomwe ndizofunikira kwambiri pakukula kwa minyewa. zovuta.

Matenda a mtima komanso zovuta zam'mimba zopweteka ndizomwe zimayambitsa kufa kwa odwala omwe ali ndi matenda a shuga 2 mu 75-80% ya milandu.

Matenda a 2 a shuga ndi matenda osakhazikika omwe amadziwika ndi kupezeka kwa zoperewera ziwiri zofunika kwambiri: insulin kukana ndi vuto la pancreatic p-cell.

Kuchepa kwamafuta kagayidwe ka kunenepa kwambiri ndi mtundu wa 2 matenda a shuga amadziwika ndi kuwonjezeka kwa liphero la atherogenic m'magazi am'magazi komanso kuchepa kwa lipids zomwe zimalepheretsa atherosulinosis. Kuchuluka kwa magazi okwanira mafuta m'thupi, ma lipoprotein otsika kwambiri komanso otsika kwambiri, ma triglycerides ndi mafuta achilengedwe omasuka kumabweretsa kuti amadziunjikira ziwalo zosiyanasiyana ndi minyewa yathupi, kusokoneza ntchito yawo. Kupanga kwakukulu kwamafuta acids (FFA) a visceral adipose minofu yolimbana ndi maziko a insulin kukokana kumayambitsa kuchepa kwa chidwi cha chiwindi mpaka kutsekeka kwa insulini pa gluconeogeneis ndi kupanga kwa glucose ndi chiwindi, zomwe zimayambitsa kusala kwa hyperglycemia. Kuchuluka kwa lipids mu minofu kumabweretsa insulin kukana, mu chiwindi mpaka mafuta kuwonongeka kwa chiwindi, mu beta maselo a kapamba kuti achulukitse secretion wa insulin ndikuwonjezera kufa kwa maselo a beta nthawi 7 kapena kupitilira. Zotsatira zoyipa zamtunduwu za lipids zimatchedwa lipotoxicity. Hyper- ndi dyslipidemia zimatsogolera ku lipotoxicity ndi atherogeneis.

Pakadali pano, opitilira 90% odwala omwe ali ndi matenda ashuga 2 ali ndi kunenepa kwambiri kapena kunenepa kwambiri komanso kukana insulini. Kukana kwa insulin kumakhala kofanana ndi kunenepa kwambiri, ndipo kumayambira kukula kwa matenda ashuga. Chifukwa chake, mwachitsanzo, kukana insulini kumapezeka kwa abale omwe ali ndi 1 degree ya kinship ya odwala omwe ali ndi matenda a shuga 2 - 7 mpaka 7 zaka asanadziwe matenda a shuga.

Zatsimikiziridwa kuti kukana kwa insulin ndi njira yodziyimira payekha yopanga matenda a atherosulinosis ndi mtima: matenda oopsa, mtima wamatumbo, infarction ya coronary, matenda amitsempha yamagazi, stroke 12, 13. Hyperinsulinemia, matenda a lipid metabolism ndi hyperglycemia Matenda amtima omwe amapezeka mwa odwala omwe ali ndi matenda a shuga a 2 amatha kwambiri kangapo kuposa odwala omwe alibe shuga.

Pofuna kukhala ndi shuga nthawi yayitali m'magazi a insulin kukana komanso kuchepetsa kunenepa kwa glucose, maselo a pancreatic beta amayenera kugwira ntchito mopanikizika kuti apatse insulin yambiri. Pachiyambi, kuchuluka kwa insulini (hyperinsulinemia) ndikokwanira kusunga kuchuluka kwa shuga mkati mwazinthu zabwino, komabe, pakapita nthawi, ngakhale kuchuluka kwa insulini sikungagonjetse insulin. Ntchito ya maselo a beta yatha ndipo zizindikiro zamankhwala za kuchepa kwa insulin zimawonekera, zomwe zimawonetsedwa ndi kuwonjezeka kwa shuga wamagazi ndi kukula kwa kulolerana kwa shuga, kenako lembani matenda ashuga a 2.

Kuphwanya kaphatikizidwe ndi katemera wa insulin, komanso momwe amagwirira ntchito paziphuphu zama cell ofunikira, kumayambitsa kuchepa kwa kugwiritsidwa ntchito kwa glucose mutatha kudya komanso kuchepa kwa kapangidwe ka glycogen m'misempha ndi chiwindi, zomwe zimapangitsa kukula kwa chizindikiro chachikulu cha matenda a shuga 2 - postprandial hyperglycemia,

i.e., kuwonjezeka kwa shuga wamagazi mutatha kudya zopitilira muyeso wamba.

Kuwonjezeka kwa shuga wamagazi mutatha kudya> 7.9 mmol / L (wabwinobwino mpaka 7.8 mmol / L) kumabweretsa chitukuko cha zovuta za shuga. Mawuwo amatchedwa poizoni wa glucose, yemwe amadziwikika mu glycosylation wa mapuloteni (glucose deposition) omanga thupi (cell membrane) a ziwalo zosiyanasiyana za thupi, zomwe zimapangitsa kuti magazi azitha, komanso kuwonjezeka kwa shuga m'magazi - kukulira kwa zovuta za matenda ashuga: retinopathy. , kuwonongeka kwa mitsempha (polyneuropathy), matenda a impso (nephropathy), kuwonongeka kwa mtima (atherosulinosis).

Kudzikundikira kwa lipids mu minofu kumayambitsa kukana insulin, m'chiwindi - kwa mafuta a chiwindi, m'maselo a beta - kaphatikizidwe ka insulin ndikumachulukitsa kufa kwa maselo a beta

7 kapena kuposa apo

Chowoneka pakupezeka kwamatenda a 2 matenda ashuga ndi njira yayitali yodwalitsa, chifukwa, malinga ndi kafukufuku wapadziko lonse, kuzindikira kwa matenda ashuga a 2 kwachedwa ndi zaka 7-12 kuchokera pomwe matendawa adayamba.

Njira yayitali yokhala chete ya matenda a shuga imafikitsa pamenepa kuti oposa 50% ya odwala omwe adayamba kudziwa mtundu wachiwiri wa matenda ashuga kale ali ndi zovuta zosiyanasiyana:

Kuwonongeka kwa ziwiya zazikulu (macroangiopathy)

■ Matenda oopsa a arterial - 39%.

■ Matenda a mtima, matenda a m'mitsempha.

Kuwonongeka kwa ziwiya zamiyendo - 30%.

Kugonjetsedwa kwa ziwiya zazing'ono (microangiopathy)

■ retinopathy, kuwona kwakachepera - 15%.

■ Nephropathy, kuchepa kwa impso:

• Matenda aimpso aakulu - 1%.

■ Kuwonongeka kwa mitsempha - neuropathy - 15%. Matenda a matenda ashuga amapezeka pokhapokha

pamene matenda a shuga sawalipiridwira kwa nthawi yayitali, ndipo shuga m'magazi limakhalabe lokwera kwa nthawi yayitali. Akadzuka, zovuta za matenda ashuga zimayamba pang'onopang'ono, zimachepetsa kwambiri moyo ndikufupikitsa nthawi yake. 75-80% ya imfa zonse zomwe zimachitika chifukwa cha matenda ashuga zimakhudzana ndi zovuta zam'mimba - kugunda kwa mtima, sitiroko, matenda ashuga, kulephera kwaimpso.

Komabe, ngati matenda ashuga amalipiridwa bwino ndipo shuga m'magazi ali pafupi kwambiri momwe mungathere, ndiye kuyambika ndi kukula kwa matenda ashuga

zovuta zimachedwa ndikuima. Izi zatsimikiziridwa pakufufuza kwakutali kwa mtundu wa 2 matenda a shuga (UKPDS), kochitikira ku UK m'malo 23 azachipatala. Kwa zaka 20, madokotala adaphunzira momwe mtundu wachiwiri wa matenda ashuga umayambira komanso zovuta zake komanso mitundu yanji yamankhwala yomwe imawongolera thanzi la odwala.

Kafukufuku waku UKPDS adawona kuti kutsitsa kuchuluka kwa glucose pafupi kwambiri momwe kungathekere kumachepetsa chiopsezo chokhala ndi zovuta za matenda ashuga ndikuwathandiza kuti asadutsidwe.

Ndikulipirira kwabwino shuga, kuchepa kwa pafupipafupi kunawonedwa:

Matenda onse omwe amayambitsidwa ndi matenda a shuga - 12%.

■ Microangiopathies - ndi 25%.

■ Myocardial infarction - 16%.

■ Retinopathies - mwa 21%.

■ Nephropathy - ndi 33%.

Chithandizo cha matenda a shuga 2 a mtundu wachiwiri, kupatsidwa njira yovuta ya chitukuko ndi heterogeneity ya gulu ili la odwala, ndi ntchito yovuta.Pakadali pano, ndizosatheka kuchiritsa matenda ashuga, koma amatha kuyendetsedwa bwino ndikukhala ndi moyo wambiri kwa zaka zambiri, kwinaku akugwira ntchito yogwira ntchito komanso thanzi.

Pachifukwa ichi, cholinga chachikulu cha chithandizo cha matenda ashuga ndicho chindalama chokwanira cha zovuta za carbohydrate metabolism, chomwe chitha kupezeka chifukwa cha zovuta, zochiritsika komanso zothandizidwa pathogenetically zomwe zimaganizira nthawi yayitali ya matenda, kuchepa kwa matenda a metabolic, kuchepa kwapang'onopang'ono kwa kuchuluka kwa P-cell, kuchepa ntchito zawo, zaka za wodwalayo, kuopsa kwa hypoglycemia, komanso kufunika kokakwaniritsa kuwongolera glycemic kwa nthawi yayitali kuti muchepetse chiwopsezo cha matenda amtima, matenda a mtima ndi kufa kwa odwala omwe ali ndi matenda a shuga a 2.

Kupanga zolinga za mankhwala a matenda a shuga a mtundu wachiwiri ndi monga:

1. Kukwaniritsa kuyendetsa bwino kagayidwe kake: kuthetsa zizindikiro za hyperglycemia ndi dyslipidemia.

2. Kupewa kuwonongeka kwa matenda ashuga komanso kawiri zovuta - makamaka hypoglycemia.

3. Kupewa kwa chitukuko cha mochedwa mtima wamankhwala.

Malinga ndi zamakono, zomwe zidagwirizana pa ALA ndi EASD ma aligorimu pochizira matenda amtundu wa 2, pakukhazikitsa njira yoyenera, chithandizo chiyenera kuyambitsidwa ndikusintha kwa moyo wawo komanso kugwiritsa ntchito metformin.

Kusintha kwamoyo kumaphatikizapo zakudya (zakudya zoyenera), kufutukula zolimbitsa thupi ndi kuchepetsedwa kapena kuthetseratu zochitika zopsinja.

Kupambana kwamankhwala kumadalira kuchuluka kwa momwe wodwala amathandizira pulogalamu yachipatala, kudziwa kwake matenda ake, kuwalimbikitsa, kakhalidwe, kuphunzira mfundo za kudziletsa.

Cholinga cha chakudyacho ndikuchotsa matenda a postprandial hyperglycemia, kuthamanga kwa hyperglycemia ndi kuchepetsa kunenepa kwambiri, chifukwa kunenepa kwambiri kumapangitsa kuti matenda ashuga azitha.

Chinthu chachiwiri chofunikira kwambiri pakuperekera matenda a shuga a 2 ndikukula kwa zochitika zolimbitsa thupi. Kuchita masewera olimbitsa thupi sikuti kumangoyendetsa glycemia, ndikuthandizira kugwiritsidwa ntchito kwa glucose ndi minofu, komanso bwino metabolism yamafuta, kumakhala ndi phindu pa mtima dongosolo, kumadzutsa malingaliro abwino ndikuthandizira kupsinjika kwa zinthu, komanso kumabweretsa kuchepa kwa insulin kukokana ndi hyperinsulinemia. Zochita zolimbitsa thupi ziyenera kukhala zapadera, poganizira zaka za odwala, zovuta za matenda ashuga komanso matenda ena okhudzana nawo.

Zomwe zikuchitika pakukula kwamatenda a 2 matenda ashuga ndi njira yotalikirapo ya matendawa, chifukwa cha kupezeka kwa matenda a shuga 2, malinga ndi kafukufuku wapadziko lonse lapansi, kwatha zaka 7 mpaka 12 kuyambira chiyambi cha matenda

Kwa odwala omwe ali ndi matenda a shuga a 2, mphindi 30-45 kuyenda tsiku lililonse ndikokwanira katatu patsiku. Kuchita zolimbitsa thupi mwadongosolo kumalimbikitsidwa komwe kumagwirizana ndi kuthekera kwa wodwala, zikhumbo zake ndi moyo wake.

Zakudya ndi masewera olimbitsa thupi ndizo njira ziwiri zomwe zimayambitsa matenda a shuga a 2. Koma mwatsoka, odwala ambiri, makamaka okalamba, samatsata zakudya nthawi zonse ndipo samatha kukulitsa mphamvu yolimbitsa thupi chifukwa cha matenda ophatikizika, matenda a mtima, matenda oopsa kwambiri, komanso kulephera kwa mtima.

Mu magawo oyambirira a vuto la carbohydrate metabolism, kusintha kwa moyo kumatha kukhala kothandiza komanso kuchepetsa chiopsezo cha matenda a shuga 2 mwa 58%. Komabe, m'magawo apambuyo a matenda ashuga a mtundu wa 2, pamene apezeka nthawi zambiri, mukwaniritse zofunikira za HBa1c (sindingapeze zomwe mukufuna? Yesani ntchito yosankha mabuku.

Popeza kulibe glycemic yoyenera kwa miyezi iwiri. kulumikizana mankhwala wachiwiri tikulimbikitsidwa. Mwa mgwirizano, pakadali pano, pamankhwala ena aliwonse omwe amachepetsa shuga akhoza kuwonjezeredwa ndi metformin: agpist a GLP-1, ma DPP-4 zoletsa, mankhwala a sulfonylurea, SGLT-2 zoletsa, pioglitazone, basal insulin.

Chifukwa chake, metformin ndiyo mankhwala oyamba osankha kukwaniritsa mphamvu ya kagayidwe kachakudya kosakwanira ka chakudya komanso kuchuluka kwa zochitika zolimbitsa thupi kwa odwala omwe ali ndi matenda a shuga 2 onenepa kwambiri komanso kunenepa kwambiri.

Njira yayikulu yogwiritsira ntchito metformin ndiyo kutsekereza kwa kupanga kwa chiwindi ndi chiwindi, komwe kumapangitsa kutsika kwa kudya glycemia ndipo mutatha kudya (mkuyu.). Mphamvu ya metformin pa hepatic glucose metabolism yatsimikiziridwa ndi maphunziro angapo azachipatala. Mphamvu ya metformin pachiwindi imachulukitsidwa: imachulukitsa kaphatikizidwe ndikuchepetsa kuphwanya kwa glycogen, imachepetsa neoglucogeneis ndi kaphatikizidwe wamafuta, imagwiranso ntchito michere ya chiwindi, chifukwa chake imagwiritsidwa ntchito pochiza matenda a steatohepatitis komanso matenda osagonetsa zakumwa zam'mimba, matenda a shuga 2- mtundu, kunenepa.

Metformin imachepetsa mayamwidwe am'matumbo m'matumbo, kuletsa kuwonjezeka kwambiri kwa shuga m'magazi mutatha kudya ndikuwonjezera kulemera kwa thupi. Imakhala ndi anorexigenic zotsatira zosagwiritsa ntchito chakudya cham'mimba mosavuta komanso imathandizira kukhazikika kwa thupi. Mankhwala a Metformin odwala omwe ali ndi kunenepa kwambiri amatsogolera kuti munthu azitha kuwonda moyenera pafupifupi makilogalamu 5-7 mu miyezi 3-4.

Metformin imateteza ma cell a kapamba, amawateteza kuti asamadye kwambiri komanso azichoka

Niya, chifukwa samalimbikitsa kutulutsa kwa insulin ndi ma cell a p. Chifukwa chake, sizimayambitsa hyperinsulinemia ndipo sizimayambitsa hypoglycemia, yomwe imakhala yowopsa kwambiri kwa odwala omwe ali ndi matenda a shuga 2 chifukwa cha chitukuko cha matenda amtima kwambiri - kugunda kwa mtima kapena stroko.

Zinapezeka kuti metformin imawonjezera chidwi cha zotumphukira zimakhala ku insulin, imawonjezera kuyamwa kwa glucose ndi minofu chifukwa chakuyambitsa kwa anthu onyamula shuga - GLUT-4.

Metformin imakhala ndi angioprotective mwachindunji, yomwe siyimayenderana ndi kuchepa kwake kwa shuga.

Kuchuluka kwa mtima kwa metformin kunatsimikiziridwa mowerengeka mu kafukufuku wa UKPDS. Pakadali pano, kuwonetsa bwino kwa metformin kwa odwala omwe ali ndi matenda a shuga a 2 komanso kulephera kwamtima kosalekeza (CHF) kwawonetsedwa.

Pogwiritsa ntchito nthawi yayitali, metformin imapangitsa kuti glycemia ithetsedwere, kuchepa kwa glycemia tsiku lililonse, kuchepa kwa glycemia komanso kuchepa kwa matenda a glycated hemoglobin (HbA1c), omwe amathandiza kupewa zovuta za matenda a shuga.

Pochepetsa postprandial hyperglycemia, metformin imachepetsa chiopsezo chokhala ndi atherosulinosis kwa odwala omwe ali ndi hyperinsulinemia ndi insulin.

M'zaka zaposachedwa, chidwi chachikulu chaperekedwa ku antitumor mphamvu ya metformin. Izi zimatheka makamaka kudzera mu cyclic adenosine-monophosphate wodalira mapuloteni kinase (AMPK), omwe amawongolera kagayidwe kazakudya zam'mimba ndi lipid kagayidwe kazinthu zamagetsi. Pamaso pa AMPK, metformin inhibits mTOR (cholengedwa cham'mimba cha rapamycin), ndikubwezeretsa kwina kwa insulini komanso kuchepa kwa hyperinsulinemia, yomwe imakhala pachiwopsezo chotukuka kwa zotupa. Metformin imatha kuchedwetsa kuchuluka kwa maselo, kuimitsa kuzungulira kwa khungu

Zojambula. Zotsatira za Metformin pa Chiwindi

Blockade wa michere shuga neogeneis

Kuchepetsa komanso kusagwirizana

mgawo la G0 / G1, i.e., kumayambiriro kwa kubala kwa khungu. Kuphatikiza apo, AMPA ikhoza kukhudza kukula kwa mapuloteni a LKB-1 - suppressor chotupa. Pogwiritsa ntchito AMPK, metformin imagwira pa LKB-1-tumororis wodalirika, komanso imakhudza chotupa necrosis factor ndikuyambiranso ntchito ya kukumbukira kwa maselo a T omwe anali ndi vuto la mafuta acids aulere. Metformin imachepetsa kuchuluka kwa khansa ya m'mawere ndi Prostate, khansa yamatumbo, mapapu, ndi zina zambiri.

Mosiyana ndi kukonzekera kwa sulfonylurea, metformin imachepetsa shuga m'magazi osati chifukwa cha kukondoweza kwa insulin yotchinga ndi maselo a pancreatic,, koma chifukwa chowonjezeka pakupezeka kwa glucose chifukwa cha zotumphukira maselo a minofu.

Kulephera kukondoweza kwa insulin katulutsidwe kumayambitsa kuchepa kwa chidwi, kusowa kwa chiwopsezo cha hypoglycemia, komanso kuchepa kwamankhwala oyamba a insulin odwala omwe ali ndi mtundu wa 2 matenda a shuga, i.e, kuchepa kwa insulin.

Pochepetsa chidwi chomwe anthu ambiri amakhala nacho odwala 2 a mtundu wa shuga, metformin imalimbikitsa kuchepa thupi pang'onopang'ono, ndipo mwa kuchepetsa kuyamwa kwa matumbo m'matumbo, imalepheretsa kuchuluka kwa shuga wamagazi mutatha kudya komanso kuwonjezera kulemera. Chifukwa chake, metformin imagwira ntchito makamaka kwa odwala omwe ali ndi mtundu wa 2 matenda a shuga onenepa kwambiri. Kuphatikiza apo, kafukufuku wasayansi wawonetsa kuti metformin imachepetsa kudya, kulemera kwa thupi ndi kukana insulini kale pamlingo wongonenepa kwambiri, kupewa kapena kuchepetsa kwambiri mwayi wokhala ndi vuto la shuga komanso mtundu wachiwiri wa shuga.

Chifukwa chake, metformin imachita pathogenetically: imachepetsa kupanga shuga ndi chiwindi, zomwe zimathandiza kuchepetsa kuthamanga kwa magazi m'magazi, zimachepetsa kuyamwa kwa matumbo m'matumbo, zimachepetsa chilimbikitso, zomwe zimathandiza kuchepetsa PPG, imachepetsa shuga m'magazi, mosiyana ndi sulfonylurea (PSM), siziwonjezera kutulutsa kwa insulin ndipo sichimayambitsa hypoglycemia, kumawonjezera mphamvu ya zotumphukira zimakhala ku insulin, kumathandizira kuyamwa kwa glucose ndi maselo ndikuchepetsa kukana kwa insulin, kumathandizira kuchepetsa thupi mu ululu m kunenepa, kumakhudza opindulitsa pa kagayidwe zamadzimadzi: kuchepetsa okwana mafuta, otsika kachulukidwe lipoproteins ndi triglycerides, potero kuchepetsa kupitirira a atherosclerosis, kumathandiza kuti kuchepetsa magazi.

Metformin imagwira bwino kwambiri pa matenda a monotherapy komanso kuphatikiza mitundu 2 ya matenda a shuga kuphatikiza mankhwala ena aliwonse ochepetsa shuga kapena insulin.

Zotsatira zoyipa za metformin: nthawi zina pamakhala zovuta zam'mimba - matenda am'mimba, kuchepa kwa chakudya, kulawa kwazitsulo mkamwa, komwe nthawi zambiri kumachoka mwachangu popanda chithandizo.

Vuto lalikulu kwambiri ndi lactaciosis, chifukwa kuponderezedwa ndi neoglucogenesis yokhala ndi biguanides kumapangitsa

Izi zimabweretsa kuwonjezeka kwa kuchuluka kwa lactate, pyruvate, ndi alanine, omwe ali patsogolo pa mapangidwe a glucose mu njirayi. Komabe, maphunziro omwe adachitika m'zaka zaposachedwa atsimikizira chitetezo chake. Kufufuza kwa 2003 meta kwa anthu 176 omwe amayembekezeredwa maphunziro azachipatala ogwiritsa ntchito metformin monga monotherapy kapena kuphatikiza mankhwala ena adawonetsa kuti pafupipafupi lactic acidosis inali yotsika kuposa pagulu lolamulira kapena m'magulu okhala ndi mankhwala ena. Metformin ndiyo njira yayikulu yokha yomwe ivomerezedwa kuti igwiritsidwe ntchito. Chitetezo cha metformin sichinangotsimikiziridwa kokha mwa akulu, komanso mwa ana, chomwe chinakhazikitsa maziko chilolezo mu 2000 cha kugwiritsidwa ntchito kwawo ku United States kwa ana azaka za 10 ndi kupitirira.

Ngakhale metformin ndi mankhwala otetezeka, kuchuluka kwake chifukwa cha kuwonjezeka kwa anaerobic glycolysis kumatha kulimbikitsa kwambiri hypoxia mwa odwala omwe ali ndi matenda a mtima ndi m'mapapo, chifukwa chake metformin siyabwino kwa odwala opitirira zaka 60.

Pakadali pano, pazamalonda othandizira, Metformin kukonzekera kwaopanga osiyanasiyana kumagwiritsidwa ntchito. Kampani yaku Russia OJSC AKRIKHIN Chemical and Pharmaceutical Plant imapanga chiwonetsero chazakudya cha metformin - mankhwala Glformin mu Mlingo wa 500, 850 ndi 1,000 mg, omwe amagwirizana kwathunthu ndi analogies yakunja ndipo amakupatsani mwayi wosankha mtundu wanthawi yoyenera.

Zisonyezero zogwiritsidwa ntchito:

■ Gliformin ndi mankhwala osankhira odwala matenda amishuga onenepa 2.

■ Glyformin imathandizira kuwongolera glycemic kuphatikiza ndi mankhwala aliwonse omwe amachepetsa shuga ndi insulin, makamaka kunenepa kwambiri komanso kukana insulini.

Glyformin amachepetsa chiopsezo chokhala ndi vuto la matenda ashuga a mtima kwa odwala omwe ali ndi matenda ashuga a 2.

■ Ili ndi mphamvu ya antitumor.

■ Glformin osakanikirana ndi insulin amalepheretsa kuwonjezeka kwa thupi la odwala omwe ali ndi matenda a shuga a mtundu wachiwiri.

Chithandizo chimayamba nthawi zambiri ndi piritsi limodzi la 500 mg katatu patsiku ndikudya.

Pambuyo masiku 10-15, mlingo wa Glyformin ukhoza kuwonjezeka pang'onopang'ono motsogozedwa ndi glycemia, komabe, simungathe kutenga oposa 3,000 mg a Glyformin patsiku. Mlingo wamba ndi 2,000 mg / tsiku.

Gliformin silingatengedwe ndi matenda owopsa a mtima, mapapu, kulephera kwa magazi, kumwa kwambiri mowa, matenda owopsa a chiwindi ndi impso.

Matenda a shuga ketoacidosis, precoma, chikomokere.

Kuchepa kwa chiwindi ndi impso.

Gliformin adachitapo kafukufuku wazachipatala wambiri, kuphatikiza ku dipatimenti ya Endocrinology, RMAPO, momwe adawonetsera kuti akugwira ntchito kwambiri.

Anthu amasamala za Anthu

Pankhani yotsutsana ndi metformin kapena kusalolera kwake, pakalibe kuyamwa koyenera glycemic kale pa gawo la 1 la chithandizo cha matenda a shuga 2 mellitus, malinga ndi mgwirizano, tikulimbikitsidwa kulumikiza kukonzekera kwa sulfonylurea (SM) kapena ma glinides omwe amachititsa kuti insulin itulutsidwe, etc. kuti., ngakhale kukhalapo kwa odwala ambiri a hyperinsulinemia kumayambiriro kwa matendawa, insulini yawoyokha sikokwanira kuthana ndi insulin ndipo ndikofunikira kuwonjezera kuchuluka kwake m'magazi.

Pakati pa mankhwala omwe amachepetsa shuga pamlomo, kukonzekera kwa SM ndizodziwika kwambiri. Amachita kudzera mu njira ya ATP-yotengera potaziyamu ya ma cell a pancreatic P, omwe ali ndi mawonekedwe ovuta ndipo ali ndi zigawo zinayi za Kir 6,2 zopangira pore zomwe zikuyang'anizana ndi chida cha ion komanso sulfonylurea receptor (SUR). PSM yatseka njira zotsalira za KATp, zomwe zimapangitsa kutsekedwa kwa cell ya cell, kutsegulidwa kwa njira zama calcium zomwe zimadalira magetsi komanso kulowa kwa Ca ++ ions mu cytoplasm ya p-cell ndikutulutsa kwa insulini yomaliza m'magazi. Kuwonjezeka kwa plasma insulin ndende kumayambitsa kutsika kwa ma post-prandial glycemia komanso kudya glycemia.

Ndi kukula kwa matendawa kapena kupezeka kwa T2DM pamlingo wamatenda owonjezereka a metabolic, kukonzekera kwa SM kumawonjezeredwa ndi metformin, yomwe imalimbikitsa kubisirana kwa insulin komanso kuchepetsa shuga. Chimodzi mwa mankhwala abwino kwambiri a SM ndi gliclazide. Glyclazide imalimbikitsa pang'onopang'ono insulin katemera, imabwezeretsa mawonekedwe a biphasic a insulin secretion poyankha kudya, imachepetsa kupanga shuga wa chiwindi, imachepetsa kukana kwa insulin, imakhala ndi chiopsezo chochepa kwambiri cha hypoglycemia komanso kusowa kwa thupi, kupeza bwino kwamitsempha yamagazi - imachepetsa thrombosis, ndipo, koposa zonse, amachepetsa chiopsezo cha zovuta zamtima, amateteza mtima ndi mitsempha yamagazi pogwiritsa ntchito nthawi yayitali.

Popeza kufunika kogwiritsa ntchito kawiri mankhwala awiri pochizira matenda a shuga a 2, mankhwala

Ma Firms adayamba kupanga zophatikizika zomwe zinali ndi metformin ndi kukonzekera kwa SM piritsi limodzi, pomwepo lidaloleza kuchepetsa kuchuluka kwa mapiritsi omwe amatengedwa nthawi 2 ndikuwonjezera kwambiri kutsatira kwa wodwala, mwachitsanzo, kutsatira kwawo chithandizo, kufunitsitsa kuthandizidwa.

Kuphatikiza apo, kuphatikiza kwa mitundu iwiri ya mankhwala piritsi limodzi kunapangitsa kuti kugwiritsidwa ntchito kotsika kwambiri kuzikhala ndi zotsatira zabwino kwambiri chifukwa cha kuphatikiza komwe kumagwirizana ndi zomwe zigawo zake zimapanga.

Kampani yanyumba AKRIKHIN Chemical-Pharmaceutical Combine OJSC kwa nthawi yoyamba idapanga mankhwala okhawo ku Russia omwe ali ndi mankhwala awiri othandiza komanso otetezeka: glycoslazide ndi metformin.

Mankhwalawa pochiza matenda a shuga a mtundu wachiwiri amatchedwa Glimecomb ndipo ali ndi choyambirira

AKRIKHIN ndi amodzi mwa makampani opanga mankhwala othandizira ku Russia omwe amapanga mankhwala othandiza, okwera mtengo komanso apamwamba. Kampaniyi ili m'gulu la opanga 5 apamwamba kwambiri opanga mankhwala pamsika wama Russia ku malonda ogulitsa.

"AKRIKHIN" idakhazikitsidwa mu 1936. Zomwe zimachitika pakampaniyo ndizoposa mankhwala opitilira 200 a malo enieni a pharmacotherapeutic: mtima, neurology, ana, gynecology, dermatology, urology, ophthalmology. "AKRIKHIN" imapanga mitundu yambiri yamankhwala ofunika kwambiri, kukhala amodzi mwa opanga kwambiri ku Russia pamndandanda wofunikira wa mankhwalawo, komanso mankhwala othandizira chifuwa chachikulu komanso shuga.

4V J Sfwwk & M, ju j: “ndi.

Mbiri ya kukonzekera kwa endonrinologic ya kampani ya AKRIKHIN

kuphatikiza kwa glyclazide 40 mg + metformin 500 mg piritsi limodzi. Ubwino wa Glimecomb pazosakanikirana zomwe zilipo masiku ano za gliben-clamide ndi metformin pamsika zili mu kusankha kwakukulu kwa zochita za gliclazide, zomwe zimapangisa pang'ono ma cell a pancreatic, popanda kuchititsa kuchepa kwambiri kwa shuga m'magazi komanso popanda kuwononga dongosolo lamtima. Gliclazide imavomerezedwa ndi Mabungwe a US ndi European Diabetes Associates kuti ndi imodzi mwazamankhwala abwino kwambiri osankha chifukwa chochepa kwambiri cha hypoglycemia.

Metformin ndi mankhwala osankhika kuti akwaniritse kagayidwe kakang'ono ka kagayidwe kachakudya ka odwala omwe ali ndi matenda a shuga 2

Mosiyana ndi kuphatikiza komwe kulipo kwa glibenclamide ndi metformin, kuwonjezera kuchuluka kwa tsiku ndi tsiku kwa Glimecomb mpaka mapiritsi 5 malinga ndi glycazide (200 mg) kungachepetse kuopsa kwa hypoglycemia, makamaka kwa okalamba. Mu 2008, mankhwalawa adakwanitsa kuyesa mayeso azachipatala zazikulu, momwe Dipatimenti ya Endocrinology ya Russian Medical Academy of Postgraduate Education (RMAPO) ya Roszdrav idatenga nawo gawo (wamkulu wa dipatimentiyi ndi Wolemekezeka Sayansi, Pulofesa A.S. Ametov). Maphunziro athu awonetsa kukhathamiritsa kwambiri kwa Glimecomb komanso mwayi wophatikiza okhazikika pazopatukana

kumwa gliclazide ndi metformin chimodzimodzi. Chifukwa chake, atatha kumwa miyezi itatu ndi Glimecomb, kuchepa kwakukulu kwa glycemia kunawonedwa - kuyambira 8.2 mpaka 6.4 mmol / L, glycemia maola 2 atatha kudya - kuyambira 12.8 mpaka 8.9 mmol / L, glycated hemoglobin (HvA1s) - kuyambira 8.25 mpaka 7.07% (ndi chizolowezi cha 4-6%). Kutenga Glimecomb sikunayambitse kulemera ndipo kunalumikizidwa ndi chiopsezo chochepa cha hypoglycemia.

Kafukufuku wa kugwiritsa ntchito bwino kwa mankhwala a DM2 pogwiritsa ntchito pulogalamu yopitilira Glucose Monitoring System - CGMS, yomwe imangoyendetsa kafukufuku wa glycemia nthawi 288 patsiku ndipo imakupatsani mwayi wofufuza bwino za kuyendetsa glycemic masana, kuwonetsa kuphatikiza kwakukulu kwa kuphatikiza kwa mankhwala a Glymecomb poyerekeza ndi kudya magawo ake okonzekera. Kuphatikiza apo, Glimecomb anathetsa kusinthasintha kwa matenda a glycemia masana pamankhwala ochepera poyerekeza ndi kapangidwe kake ka mankhwalawa.

Glimecomb atha kukhala mankhwala oyamba kumayambiriro kwa chithandizo cha matenda a shuga a mtundu wachiwiri. Pokhala ndi makina amakono azakuwongolera, Glimecomb itha kugwiritsidwa ntchito m'malo mwa chithandizo chodziwikiratu ngati metformin ndi sulfonylurea.

Chifukwa chake, kampani yanyumba JSC Chemical and Pharmaceutical Plant AKRIKHIN imapanga mankhwala awiri odalirika komanso otetezeka pochiza matenda a shuga 2, omwe amalola kupititsa patsogolo chithandizo chamankhwala ndikupangitsa kuti zitheke kulipira bwino matenda ashuga mellitus. f

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ndi kupita patsogolo kwa zovuta zazitali kwa matenda a shuga a insulin. N. Engl. J Med, 1993, 329: 977-986.

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chifukwa cha zovuta za odwala onenepa kwambiri omwe ali ndi matenda a shuga 2 (UKPDS). Lancet, 1998, 352: 854-65.

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Malangizo ogwiritsira ntchito

Dokotala amatenga njira yothandizira aliyense wodwala matenda ashuga payekhapayekha, poganizira zidziwitso zasayansi, gawo la chitukuko cha matendawa, zovuta zina, zaka, momwe munthu angalandire mankhwalawo.

Kwa Metformin Richter, malangizo ogwiritsidwira ntchito amalimbikitsa kuti muyambe maphunzirowa ndi mulingo wocheperako wa 500 mg mosasunthika pang'ono pamasamba awiri aliwonse. Mulingo woyenera kwambiri wa mankhwalawa ndi 2.5 g / tsiku. Kwa odwala matenda ashuga okhwima, omwe nthawi zambiri amakhala ndi vuto la impso, mlingo waukulu ndi 1 g / tsiku.

Mukasinthira ku Metformin Richter kuchokera pamapiritsi ena ochepetsa shuga, muyezo woyambira ndi 500 mg / tsiku. Mukakonza chiwembu chatsopano, amathandizidwanso ndi kuchuluka kwa mankhwala omwe amapezeka kale.

Njira yamankhwala imatsimikiziridwa ndi dokotala, ndi mawonekedwe abwinobwino amthupi, odwala matenda ashuga amatenga moyo.

Kuunikira kwa mankhwalawa ndi madokotala ndi odwala matenda ashuga

About Metformin Richter, ndemanga zimasakanikirana. Madokotala ndi odwala matenda ashuga amawona kuchuluka kwa mankhwalawa: amathandizira kuwongolera shuga komanso kulakalaka kudya, palibe chosokoneza, zotsatira zoyipa zochepa, kupewa zabwino zamtima komanso zovuta zina.

Anthu athanzi omwe amayesa mankhwalawa kuti achepetse thupi amatha kudandaula za zotsatira zosafunikira. Malangizo pakuwongolera chiwerengero cha odwala pano ayeneranso kupangidwa ndi akatswiri azakudya, osati othandizira pa intaneti.

Osangokhala akatswiri a endocrinologists okha omwe amagwira ntchito ndi metformin, komanso akatswiri a zamankhwala, othandizira, oncologists, gynecologists, ndipo kuwunika kotsatiraku ndikutsimikizanso kwina kwa izi.

Irina, wazaka 27, St. Petersburg. Pamabwalo azisangalalo, Metformin Richter amakambirana zambiri ndi anthu odwala matenda ashuga kapena othamanga, ndipo ndinamwa kuti ndimve. Ndakhala ndikuchiza ovary yanga yotchedwa polycystic ovary, yomwe madokotala amati ndiyo imayambitsa matenda osabereka, kwa zaka pafupifupi 5. Pulogalamu ya Progesterone (jakisoni) kapena mapiritsi a mahomoni sanathandizire kuthana ndi vutoli, adaperekanso laparoscopy kuti ayambitsa thumba losunga mazira. Ndikukonzekera kuyesa ndikuchiritsa mphumu yanga - cholepheretsa pakuchita opareshoni, dokotala wina wazachipembedzo wanzeru adandiuza kuti ndiyese Metformin Richter. Pang'onopang'ono, mayendedwe adayamba kuyambiranso, ndipo miyezi isanu ndi umodzi pambuyo pake panali zizindikiro za kutenga pakati, sindinakhulupirire mayeso kapena madokotala! Ndikukhulupirira kuti mapiritsiwa adandipulumutsa, ndikulakalaka ndikukulangizani kuti muyese, ingovomerezani ndi dokotala wazamankhwala pazakudya zomwe mungadye.

Mankhwala osokoneza bongo ambiri komanso zoyipa

Kuchulukanso kakhumi pamiyeso ya metformin yomwe odzipereka adalandira muzipatala sizinayambitse hypoglycemia. M'malo mwake, lactic acidosis idayamba. Mutha kuzindikira kuti ndiwowopsa chifukwa cha kupweteka kwa minyewa ndi ma spasms, kutsitsa kutentha kwa thupi, kusokonezeka kwa magazi, kuchepa kwa mgwirizano, thupi kukomoka.

Wovutitsidwayo amafunikira kuchipatala mwachangu. Mu chipatala, metabolite imatsalira imachotsedwa ndi hemodialysis, ndipo chidziwitso chothandizira chimachitika ndikuwunika ntchito za ziwalo zonse zofunika.

Gawo logwira ntchito la metformin hydrochloride lili ndi umboni wolimba wa chitetezo. Koma izi zikugwira ntchito, choyambirira, kwa Glucophage yoyambirira. Zojambula zamtundu wina ndizosiyana pakupanga, maphunziro akulu pazakuchita kwawo sanachitidwe, chifukwa chake zotsatira zake zitha kutchulidwa.

Pafupifupi theka la odwala matenda ashuga amadandaula za matenda a dyspeptic, makamaka panthawi yosinthira. Ngati mungasinthe mlingo pang'onopang'ono, mankhwalani ndi zakudya, nseru, kulumikizana ndi zitsulo ndi zopsinjika zomwe zakhumudwitsidwa zitha kupewedwa. Kuphatikizidwa kwa chakudya kumathandizanso pakugwira ntchito: mawonekedwe a metformin komanso thupi ndizabwinobwino kupangira zinthu za protein (nyama, nsomba, mkaka, mazira, bowa, masamba osaphika).

Kodi ndingasinthe bwanji Metformin-richter

Mankhwala Metformin Richter, ma analogu amatha kukhala mapiritsi okhala ndi gawo limodzi la metformin hydrochloride, kapena mankhwala ena a hypoglycemic omwe ali ndi zotsatira zomwezo:

Chikwanje,
Glyformin
Metfogamma,
NovoFormin,
Metformin teva
Bagomet,
Diaformin OD,
Metformin Zentiva,
Forin Pliva,
Metformin Canon
Glyminfor,
Siofor
Methadiene.

Kuphatikiza pa kufanana ndi kutulutsidwa mwachangu, pali mapiritsi okhala ndi mphamvu yayitali, komanso kuphatikiza kwa zigawo zingapo zogwira ntchito mumapangidwe amodzi. Kusankha kwakukulu kwa mankhwala, ngakhale kwa madokotala, sikukukulolani kuti musankhe molondola komanso mulingo woyenera, ndikuyesera thanzi lanu palokha ndi pulogalamu yodzivulaza nokha.

Ntchito ya odwala matenda ashuga ndikuthandizira kuti mankhwalawa agwire ntchito bwino, chifukwa popanda kusintha mawonekedwe, malingaliro onse amataya mphamvu.

Upangiri wa Pulofesa E. Malysheva kwa onse omwe adotolo adamuuza metformin, pa odzigudubuza