Siofor: contraindication ndi zotsatira zoyipa

Mankhwala olimbikitsidwa othandizira odwala matenda ashuga nawonso amatchuka pakati pa omwe akufuna kuchepa thupi: Siofor amadziwika kwambiri m'gulu lino - malangizo ogwiritsira ntchito kuchepa kwa thupi samakhudzana ndikugwiritsa ntchito, koma ngakhale madokotala nthawi zina amapereka lingaliro lotere. Kodi mankhwalawa ndimafananidwe ake angakhudze kuchuluka kwamafuta ndi momwe mungasankhire mlingo woyenera, womwe sungapangitse thupi kuwonda?

Mapiritsi a Siofor

Mwa mankhwala omwe amapezeka mu njira yothandizira anthu odwala matenda a shuga a 2, omwe amawagwiritsa ntchito kwambiri ndi Siofor. Amagwiritsidwa ntchito pochiza matenda omwe alipo komanso kupewa, chifukwa amasintha kukana insulin, chifukwa chachikulu chodumphira mu shuga ndipo, makamaka, kunenepa kwambiri. Izi zakhala chifukwa chachikulu chomwe adokotala angapangire Siofor kuti achepetse thupi kwa wodwala wake. Imapezeka mu mawonekedwe a mapiritsi okhala ndi magawo osiyanasiyana a chinthucho.

Kuphatikiza apo, kugwiritsa ntchito mankhwalawa kumakhudza:

• mtima
• Zizindikiro za triglycerides,
• cholesterol.

Mankhwala a Siofor ochepetsa thupi amalembetsa "mabonasi" ena ambiri, osawerengera mphamvu yakuwongolera shuga:

• Kuchepetsa chilala, komwe kumathandizira kuti muzidya kapena kusinthasintha zakudya.
• Kuwonekera kwa mahomoni a chithokomiro (azimayi zimawavuta kuchepetsa thupi chifukwa cha zovuta za dongosolo la endocrine).

Siofor - zikuchokera

Kuti mumvetsetse bwino lomwe phindu la mankhwalawa poyerekeza ndi kuchepa thupi, kuphunzira malangizowo kuyenera kuyamba ndi mndandanda wazinthu zomwe zimapezeka. Kuphatikizidwa kwa Siofor kumatsegula gawo lotere monga metformin - uwu ndi woimira gulu la Biguanide, lomwe limapangitsa chidwi cha thupi m'thupi. Ine.e. Kugwiritsa ntchito mankhwalawa kumathandizira kuchepetsa shuga, ndipo mwayi wofunikira wa metformin ndi kusapezeka kwa impso. Zotsatira zoyipa za gawo ili la Siofor ndizosowa kwambiri, ndipo mwa "mabonasi" omwe amagwiritsidwa ntchito, kuchepa kwa TSH akuwonetsa.

Kuphatikiza pa metformin, Siofor ili ndi zinthu zothandiza (kuphatikizapo zipolopolo):

• hypromellose
• povidone
• magnesium wakuba,
• macrogol
• titanium dioxide.

Siofor - malangizo ogwiritsira ntchito

Kodi mudaganizira zochepetsa thupi pochepetsa kusinthasintha kwa insulin, kapena mukufuna kupewa matenda ashuga, muyenera kudziwa amene akulimbikitsidwa kugwiritsa ntchito Siofor, momwe angachitire komanso momwe angasankhe mlingo. Malangizo a Siofor akuti ndi shuga wokha (mtundu II) wokha womwe ungayesedwe ngati chizindikiro chokhacho chogwiritsidwa ntchito, pomwe mapiritsiwa amatengedwa ngati "gawo lomaliza", amagwiritsidwa ntchito pokhapokha potsatira zakudya ndipo amathandizidwa kuchita zolimbitsa thupi.

Siofor 500 pakuchepetsa thupi

Mlingo wocheperako wa metformin womwe ungatheke kwa Siofor (malinga ndi assortment yama Russian pharmacies) ndi 500 mg. Kugwiritsa ntchito piritsi loterolo kumaloledwa ngakhale mwa ana, ndipo anthu omwe akuwona njira yochepetsera kulemera ndi Siofor, ndikofunika kuchita izi. Pa anthu odwala matenda ashuga, madokotala amati njira ziwiri zomwe mungagwiritse ntchito mankhwalawa:

• monga monotherapy - 500 mg kawiri pa tsiku,
• kuphatikiza ndi insulin (ngati kudalira) - kuchuluka kuchokera ku 500 mg mpaka 2000 mg patsiku, i.e. kuchokera pa 1 mpaka 4 phwando.

Ngati titha kunena momwe titha kutenga Siofor 500 kuti muchepetse kunenepa, ndiye kuti ndikofunika kukhazikika pa lingaliro la monotherapy lomwe latsimikiziridwa ndi malangizo a boma: kumwa mapiritsi 1 a Siofor 500 mapiritsi mwezi umodzi. patsiku. Chitani izi ndi chakudya kapena mukatha kudya, chifukwa kugwiritsa ntchito metformin kwadzala ndi mkwiyo wam'mimba. Mlingo wocheperako wa Siofor pakuchepetsa thupi umakhudza pang'ono, koma zovuta zomwe zimachitika kwa izo ndizosowa. Ndi kulolerana kwabwino, malangizowo amalola kuwonjezera kuchuluka kwa mapiritsi awiri a Siofor.

Siofor 850

Njira iyi ya mankhwalawa, molingana ndi malangizo a boma, ndiyabwino kwambiri kwa odwala matenda ashuga, koma mwa munthu wathanzi amadziwika kuti ndi "lolemetsa", choncho imayenera kuyamba ndi theka la piritsi. Siofor 850 pakuchepetsa thupi imagwiritsidwa ntchito pang'ono poyerekeza ndi Siofor 500, koma malangizo ndi zomwe malangizo ochokera kwa wopanga akufanana:

• Chiwerengero cha tsiku ndi tsiku cha 3,000 mg cha metformin, ngakhale kuwonda msanga, sikuletsedwa kupitirira.
• Njira yochepetsera thupi mankhwalawa ndi mwezi kapena zochepa.
• Pambuyo pa masabata awiri, mutha kuyamba kumwa mankhwalawa - 2 mapiritsi a 850 mg patsiku.

Siofor 1000

Mtundu wamphamvu kwambiri wa mankhwalawa okhathamira omwe amaperekedwa ndi makampani opanga mankhwala ndi Siofor 1000. Madokotala amalingalira za kugwiritsa ntchito mankhwalawa pachimake cha mankhwalawa kuti achepetse thupi osafunikira, popeza izi zimakhala zowononga thupi. Impso zimatha kuvutika kwambiri, chifukwa metformin siyotetezedwa kwathunthu, ndipo kuchuluka kwa shuga ndikuwonekeratu. Musanayankhe nokha kuti mungatenge Siofor 1000 kuti muchepetse thupi, pitani mayeso a shuga, chifukwa Mlingo, malinga ndi malangizo, amasankhidwa molingana ndi malangizowo.

Malingaliro ochepa a mankhwalawa:

• Mlingo woyambirira wa kuchepa thupi ndi piritsi 1/4. M'masiku ochepa mutha kumwa theka la piritsi, ndipo kumapeto kwa sabata, ngati palibe zotsatira zoyipa, ndimakupsopsona.
• Ndikofunika kuti muchepetse mafuta osavuta m'zakudya panthawi yogwiritsa ntchito mankhwalawa Amawaletsa kutengeka kwawo. Kuchokera pamawunikidwe mutha kuwona kuti kugwiritsa ntchito piritsi ili ndi ma cookie kapena maswiti kumabweretsa kuyipa kwambiri m'mimba.

Siofor pa nthawi yoyembekezera

Amayi oyembekezera kuchepa thupi pa mankhwalawa ndikosayenera. Madokotala aku Russia amaletseratu Siofor pa nthawi yomwe ali ndi pakati, akufotokozera malingaliro awo ponena kuti kuchuluka kwa maphunziro pa thanzi la ana obadwa kwa amayi omwe amamwa mankhwalawa sikokwanira voti yovomerezeka "kapena" motsutsana ". Ngati mukukayikira zokhudzana ndi chitetezo cha mankhwalawo, mayi woyembekezerayo ali bwino ndikuwonetsetsa kuti asiyire piritsi loyipa, chifukwa pali njira zambiri zochepetsera thupi (zofatsa) panthawi yodikirira mwana.

Siofor - analogues

Madokotala amangoti mankhwala 2 okha ndi omwe amathandizanso kupezeka pa matenda a shuga komanso kusinthasintha kwa shuga malinga ndi gawo la chinthu chomwe chikugwiridwacho ndi zomwe mwaphunzitsidwa:

Analogue iliyonse ya Siofor ndiyofanana ndi mankhwalawa m'chigawo chake chachikulu. Amatha kupezekanso muyezo womwewo - kuchokera 500 mpaka 1000 mg, kotero mfundo yogwiritsira ntchito sasintha, malangizowo akubwereza pafupifupi kalata yomwe kalata yopita kwa Siofor. Kusiyanako kokha ndikomwe kapangidwe kazilombedwe ndikuti madokotala amalangiza Glucofage kuti amwe asanadye, osati pambuyo pake. Ponena za momwe mungatengere Metformin kuti muchepetse kunenepa, apa chilichonse chikufanana ndi malangizo a mankhwala a Glyukofazh.

Siofor - contraindication ndi mavuto

Chitetezo cha mankhwalawa ndi chofunikira kwambiri - kuchokera pazowunikira mutha kuwona kuti thupi limatha kuyankha mwamphamvu kwa metformin m'masiku oyamba kukonzekera. Zotsatira zoyipa za Siofor ndi ziti? Kwambiri ndikusanza ndi kutsekula m'mimba, i.e. kugaya chakudya, koma kumatha kusokonezeka chikumbumtima, komanso chifukwa cha bongo wambiri - chikomokere. Ngati pakukula kwa mankhwalawa ndi mankhwalawa simunatenge mafuta osavuta m'zakudya zanu, zimakupatsirani gal.

Maupangiri ochepa pamayendedwe a boma:

• Mukamamwa mankhwalawa, zakudya za tsiku ndi tsiku ziyenera "kulemera" zopatsa mphamvu zopitilira 1000.
• Zochita zolimbitsa thupi zazitali, makamaka aerobic, ndizoletsedwa.
• Ndi zoletsedwa kumwa mowa ndi mankhwala okhala ndi ayodini.

Zotsatira zamankhwala awa, madokotala amatcha matenda a shuga a I (amatha kugwiritsidwa ntchito pokhapokha ngati mukumvera, motsutsana ndi insulin), matenda a impso, chiwindi. Oncology ndi chifukwa choletsa kuchepa kwa thupi ndi Siofor. Malinga ndi malangizo a boma, simuyenera kumwa mankhwalawa panthawi ya matenda opatsirana komanso mukamamwa mowa. Kuphatikiza ndi mankhwala okhala ndi ethanol ndikofunikira kupewa.

Kanema: Matenda a shuga ndi Kuchepetsa Siofor

Inna, wazaka 29 sindinawone kusiyana kwakukulu pakati pa Siafor1000 ndi Siafor500, ndinamwa mitundu yonse iwiri. Piritsi limodzi lililonse, maphunzirowa anali milungu iwiri. Ngakhale mulingo wocheperako, ngakhale mlingo wake umakhala wokwera, zimangoyambitsa chimodzi - kuphunzitsanso koipa! Mukayesa kudya ma cookie, kusanza kumayamba, chifukwa mankhwalawa amaletsa chakudya. Zimakhudzanso munthu wanga momwemo, koma ndachimwira thupi langa.

Galina, wazaka 36 Siafor500 - 24/7 wogwirizira wathanzi! Ndikofunika kuyesa kudya china chosiyana ndi masamba / zipatso (chimadumpha phala, koma pazifukwa zina popanda mkaka), zotsatirapo zonse "zosangalatsa" zimatseguka nthawi yomweyo - m'mimba zimayamwa, kusekera msana, kupweteka m'mimba. Pakati pa sabata la "maulendo" amenewa, ndinasiya chizolowezi chochepetsa thupi komanso chakudya komanso kupewa kunenepa, komanso ndinataya makilogalamu 4 pamwezi.

Olga, wazaka 23 sindidwala matenda ashuga, ndidakhumudwa pa Siofor mwangozi, ndagula (zabwino, zotsika mtengo), ndimamwa mwezi umodzi. Sindinawone zotsatira zowonjezera pakuchepetsa thupi, ndipo ndimanena kuti zinatsalira ndi 2,5 makilogalamu pazakudya zomwe zimafunidwa ndi malangizo a mankhwalawo. Koma mndandanda wazotsatira zoyipa ndizambiri, ngakhale mavitamini sangaphatikizidwe ndi mankhwala.

Rita, wazaka 30 ndidawona Siofor850 kwa masabata atatu enieni, ndikugwiritsa ntchito mwayi pazomwe mzanga amamuchepetsa. Matumbo adayamba kukhumudwa, ngakhale piritsi lidatengedwa pambuyo pa chakudya chamtima. Ndaphunzira kuti ndibwino kumwa mankhwala pambuyo poyesa kuchuluka kwa shuga, osamangoyamwa mwachangu potsatira malangizo. Ndidapambana mayeso, ndidayamba kumwa theka la piritsi - zidapita bwino.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amapangidwa monga mapiritsi okhala ndi tulo:

• Siofor 1000: oblong, mbali ina yokhala ndi zojambula ngati "chithunzithunzi", mbali ina ili pachiwopsezo, yoyera (ma PC 15. Pachimake, pamakatoni a 2, 4 kapena 8 matuza),
• Siofor 850: oblong, wokhala ndi notch-mbali-ziwiri, zoyera (15 zidutswa chilichonse, ndipo pamakatoni a 2, 4 kapena 8 matuza),
• Siofor 500: biconvex, kuzungulira, zoyera (zidutswa 10 chilichonse pachimake, pamakatoni a 3, 6 ndi 12 matuza).

Piritsi 1:

• Mphamvu yogwira: metformin hydrochloride - 1000, 850 kapena 500 mg,
• Zowonjezera zina: magnesium stearate, povidone, hypromellose, chipolopolo: titanium dioxide (E171), macrogol 6000, hypromellose.

Zizindikiro zogwiritsidwa ntchito

Mankhwala tikulimbikitsidwa kuti ntchito mankhwalawa mtundu II matenda a shuga, makamaka odwala onenepa chifukwa kulibe mphamvu zolimbitsa thupi.

Siofor itha kugwiritsidwa ntchito ngati mankhwala a monotherapy kapena kuphatikiza ena othandizira pakamwa ndi hypulin.

Mlingo ndi makonzedwe

Siofor amatengedwa pakamwa pakudya kapena akangomaliza kudya.

Mlingo komanso nthawi yayitali ya mankhwala amatsimikiziridwa ndi dokotala payekhapayekha, poganizira kuchuluka kwa shuga m'magazi.

Pa monotherapy, achikulire amamuika 500 mg 1-2 pa tsiku kumayambiriro kwa mapiritsi (1 piritsi 500 mg kapena 1/1/1)₂ mapiritsi 1000 mg) kapena 1 pa tsiku kwa 850 mg ya mankhwalawa. Masiku 10-15 atayamba chithandizo, kuwonjezeka kwapang'onopang'ono kwa mlingo wa Siofor patsiku ndikuloledwa mpaka mapiritsi atatu a 500 mg, mapiritsi awiri a 850 mg kapena mapiritsi awiri a 1000 mg.

Mulingo wambiri watsiku ndi tsiku sungakhale wopitilira 3000 mg (mapiritsi atatu a 1000 mg kapena mapiritsi 6 a 500 mg) amagawidwa pazigawo zitatu. Mukamapereka mankhwala a 2000-3000 mg tsiku lililonse, mutha kusintha mapiritsi awiri a 500 mg piritsi limodzi la 1000 mg.

Ngati wodwalayo asinthana ndi metformin pothandizidwa ndi wothandizila wina wodwala matenda ashuga, omalizirawo amalephera ndipo Siofor amatengedwa mu Mlingo womwe watchulidwa pamwambapa.

Kupititsa patsogolo katemera wa glycemic, mankhwalawa amatha kuikidwa limodzi ndi sinulin. Pankhaniyi, mlingo woyambira wa akuluakulu ndi 500 mg amatengedwa kawiri pa tsiku, kapena 850 mg kamodzi patsiku. Pang'onopang'ono (ngati kuli kotheka) mlingo umakulitsidwa sabata iliyonse mpaka mapiritsi atatu a 500 mg, mapiritsi awiri a 1000 mg kapena mapiritsi a 2-3 a 800 mg.

Mlingo wa insulin umatsimikizika malinga ndi kuchuluka kwa shuga m'magazi. Mlingo wapamwamba wa metformin ndi 3000 mg patsiku, wogawidwa pazigawo zitatu.

Odwala okalamba, akakhazikitsa muyeso wa Siofor, zomwe zimapangidwira mu plasma zimawaganiziridwa (chifukwa cha kufooka kwa impso).

Pa mankhwala, ndikofunikira kuwunika ntchito ya impso.

Ana azaka zapakati pa 10-18 akamamwa mankhwala a monotherapy kapena osakanikirana ndi insulin kumayambiriro kwa maphunzirowa amalimbikitsidwa kumwa 500 kapena 850 mg kamodzi patsiku, atatha masiku 10-15 kuwonjezeka kwa pang'onopang'ono kwa mlingo kumaloledwa. Mlingo waukulu patsiku la ana ndi 2000 mg, womwe umagawidwa 2-3.

Zotsatira zoyipa

• Chiwindi ndi matenda amiseche: milandu ya munthu - chiwindi kapena kuwonjezereka kwa ntchito ya hepatic transaminases (zimazimiririka atasiya mankhwala),
• Machitidwe amsempha: nthawi zambiri - kulawa chisokonezo,
• Thupi lawo siligwirizana: kawirikawiri - zimachitika pakhungu (urticaria, kuyabwa, hyperemia),
• Matumbo: Kusanza, kulawa kwazitsulo mkamwa, nseru, kutsegula m'mimba, kusowa kwa chakudya, kupweteka kwam'mimba (zotulukazi zimayamba kumayambiriro kwa maphunzirowa ndipo nthawi zambiri zimapita zokhazokha, kuwaletsa, mlingo wa tsiku ndi tsiku uyenera kuchuluka pang'onopang'ono ndikugawidwa ndi 2-3 phwando)
• Metabolism: kawirikawiri - lactic acidosis (kuthetsedwa kwa chithandizo ndikofunikira), ndikugwiritsa ntchito nthawi yayitali - kuchepa kwa mayamwidwe a vitamini B₁₂ ndi kuchepa kwa kuchuluka kwake m'madzi am'magazi (ndikofunikira kuti muganizire odwala omwe ali ndi vuto la kuchepa kwa magazi m'thupi).

Pogwiritsa ntchito mankhwalawa mpaka 85 g, kukula kwa hypoglycemia sikunadziwike.

Pakakhala vuto lochulukirapo, lactic acidosis imatha kuchitika, yomwe imawonetsedwa ndi zizindikiro zotsatirazi: kusanza, kupweteka kwam'mimba, kutsegula m'mimba, kugona, kugona, kupuma, kufooka kwa magazi, kuchepa kwa magazi, kusokonezeka kwa magazi, kusokonezeka kwa minofu.

Mu chikhalidwe ichi, kuchoka kwachangu kwa mankhwala othandizira ndi kuchipatala kwadzidzidzi kumafunika. Njira zothandiza kwambiri zochotsera Siofor m'thupi zimaphatikizapo hemodialysis.

Malangizo apadera

Mankhwala a Metformin sakalowa m'malo olimbitsa thupi tsiku ndi tsiku komanso chakudya, mankhwalawa osagwiritsidwa ntchito ndi mankhwala amafunika kuphatikizidwa ndi Siofor monga adanenera dokotala. Odwala onse ayenera kutsatira zakudya zomwe zili ndi yunifolomu yambiri tsiku lonse, ndipo anthu onenepa kwambiri ayenera kutsatira zakudya zamafuta ochepa.

Kuchulukana kwa metformin kungayambitse kudzikundikira kwa lactic acid m'magazi, komwe kumapangitsa kuti pakhale njira yachilendo kwambiri komanso yowopsa monga lactic acidosis. Kukula kwake kwa odwala omwe ali ndi matenda a shuga kumadziwika makamaka pakakhala kulephera kwambiri kwaimpso. Kupewa kwa vutoli kumaphatikizapo kuzindikira zinthu zonse zomwe zikupezeka pachiwopsezo, zomwe zimaphatikizapo: kumwa kwambiri mowa, kusala kudya kwazotheka, matenda ashuga, kulephera kwa chiwindi, ketosis ndi vuto lina lililonse.

Asanayambike mankhwala, komanso pafupipafupi munthawi ya mayendedwe ake, plasma ndende ya creatinine iyenera kutsimikizika.

Kuwunikira kwapadera kumafunikira pakakhala vuto la ntchito yovuta yaimpso (mwachitsanzo, kumayambiriro kogwiritsa ntchito ma diuretics, antihypertensive mankhwala osokoneza bongo, mankhwala osapweteka a antiidal.

Popereka mawonekedwe a X-ray, limodzi ndi njira yolumikizira pakati ya ayodini, maola 48 isanachitike komanso itatha, Siofor ayenera m'malo mwake ndi wothandizira wina wa hypoglycemic. Kuyambiranso metformin ndizovomerezeka pokhapokha ngati ndende ya serum creatinine ili yachibadwa.

Tiyeneranso kuletsa mankhwalawa maola 48 asanafike pochita opaleshoni yomwe idakonzedweratu ndi opaleshoni ya msana kapena ya cell. Kupitiliza kumwa sikuloledwa kupitirira maola 48 mutachitidwa opaleshoni (kapena ndikuyambiranso kwamlomo).

Mu ana ndi achinyamata a zaka 10-18, kuwunika kwa matenda a shuga II ayenera kutsimikiziridwa asanamwe mankhwalawa. Ana omwe akutenga metformin, makamaka okalamba zaka 10-12 (nthawi yowonjezera) amafunika kuwunika mwapadera magawo a kukula ndi chitukuko.

Monotherapy ndi mankhwalawa sikuyambitsa hypoglycemia, komabe, kusamala kumalangizidwa pakukonzekera zochitika zomwe zimafuna kuchitapo kanthu mwachangu ndi chidwi chowonjezereka (kuphatikiza magalimoto oyendetsa galimoto) pochita limodzi ndi mankhwala a sulfonylurea kapena insulin chifukwa choopseza izi.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwalawa ndi Siofor, sizikulimbikitsidwa kumwa zakumwa kapena kukonzekera komwe kumakhala ndi ethanol, chifukwa chowonjezera chiopsezo cha lactic acidosis (makamaka motsutsana ndi maziko osowa zakudya m'thupi, kudya, kapena kulephera kwa chiwindi).

Kuphatikiza kwa metformin ndi mankhwala ena omwe amafunikira chisamaliro chapadera chifukwa cha mayanjano omwe angachitike:

• Cimetidine - kuwonongedwa kwa metformin kumachepetsa, chiopsezo cha lactic acidosis imakulitsidwa,
• Mankhwala a Cationic (quinidine, procainamide, morphine, amiloride, vancomycin triamteren, ranitidine) omwe amatulutsidwa m'matubu - kuchuluka kwakukulu kwa plasma kwa metformin kumawonjezereka,
• Danazole - kukula kwa vuto la hyperglycemic ndikotheka (kusintha kwa Siofor kungafunike),
• Nifedipine - kuchuluka kwa kuyamwa ndi mayamwidwe a metformin mu madzi a m'magazi kumawonjezera, kutuluka kwake kumakulitsidwa,
• Zotupa za phenothiazine, epinephrine, mahomoni a chithokomiro, glucagon, nicotinic acid, njira zakulera zamlomo - zimakulitsa kuchuluka kwa shuga m'magazi,
• Angiotensin-converting enzyme (ACE) zoletsa ndi mankhwala ena a antihypertensive - mwina kutsitsa shuga,
• Zotsatira za sulfonylureas, acarbose, salicylates, insulin - zotsatira za hypoglycemic zimatheka,
• Ma diuretics, beta-adrenergic agonists, glucocorticoids (wogwiritsa ntchito mwa zonse komanso zofunikira) - milingo yamagazi imachuluka,
• Ma anticoagulants osadziwika - zotsatira zawo zimafooka,
• Furosemide - ndende yake ndi theka la moyo zimachepa.

Pharmacological zimatha mankhwala Siofor

Metformin ndi a biguanide omwe ali ndi vuto la hypoglycemic, ndikupereka kuchepa kwa kutsika kwa glucose wa basal komanso postprandial glucose. Metformin simalimbikitsa kubisirana kwa insulin chifukwa chake siyambitsa hypoglycemia. Kuchulukitsa kwa shuga kwa metformin mwina kumachitika chifukwa cha njirazi: kuchepa kwa shuga m'magazi chifukwa cha kuletsa kwa gluconeogeneis ndi glycogenolysis, kuwonjezeka kwa minofu yolumikizira minofu ndi insulin, komwe kumapangitsa kukoka kwa glucose pamafupipafupi ndi kugwiritsidwa ntchito kwake, komanso kuchepa kwa kuthamanga kwa glucose. Metformin, akugwiritsa ntchito glycogen synthetase, imathandizira kaphatikizidwe ka glycogen, kumawonjezera kuthekera kwa glucose a mapuloteni onse amodzi odziwika a membrane kale (GLUT). Mwa anthu, metformin imakhudzanso kagayidwe ka mafuta, mosasamala kanthu momwe imakhudzira shuga wamagazi, ndikuchepetsa kuchuluka kwa cholesterol, cholesterol ya LDL, ndi plasma TG. Kuchepetsa zomwe zili ndi TG mu seramu, ilinso ndi mphamvu ya antithrombotic.
Pambuyo pakukonzekera kwa metformin, kuchuluka kwake kwambiri m'magazi am'magazi kumatha pambuyo pa maola 2,5, ndipo kutsata kwamphamvu kwambiri ndi 50-60%.
Mukamamwa pakamwa, mayamwidwe a metformin sakwanira ndipo ali ndi mawonekedwe apamwamba, amakhulupirira kuti metformin ili ndi pharmacokinetics yopanda ulalo. Mukamagwiritsa ntchito mankhwalawa monga muyezo komanso pafupipafupi, mgwirizano womwe umachitika m'magaziwo umafikiridwa pambuyo pa maola 24 mpaka 48. Kuphatikiza mapuloteni am'madzi a m'magazi titha kunyalanyaza. Metformin imadutsa m'magazi ofiira. Kuchuluka kwambiri m'magazi athunthu kumakhala kocheperako poyerekeza ndi madzi am'magazi, ndipo kumakhazikitsidwa pafupifupi nthawi yomweyo. Metformin imachotsedwa mu mkodzo. Mwa anthu, zinthu zowonongeka sizinadziwikebe. Chilolezo cha metformin 400 ml / min, chomwe chikuwonetsa kutuluka kwa metformin chifukwa cha kusefedwa kwa glaseti ndi katulutsidwe ka tubular. Ndi pakamwa Mlingo, kuchotsa hafu ya moyo ndi maola 6.5. Ngati ntchito yaimpso imakulirakulira, kutsimikizika kwa impso kumachepetsa molingana ndi kupezeka chilolezo cha creatinine, potero kumawonjezera kuphatikiza theka la moyo ndikupangitsa kuchuluka kwa metformin m'magazi a m'magazi.

Kugwiritsa ntchito mankhwala a Siofor

Gawani koyamba mlingo wa 500 mg / tsiku, pang'onopang'ono kukulira mpaka mlingo wogwira. Pambuyo masiku 10-15, ndikofunikira kukonza mankhwalawo molingana ndi zizindikiro zamagulu a shuga m'magazi. Kuwonjezeka kwapang'onopang'ono kwa mlingo kumathandizira kudziwa kukonzekera kwa m'mimba. Mlingo wapamwamba wa tsiku ndi tsiku wa akulu ndi 0,5-3 g wa metformin hydrochloride, yomwe imafanana ndi mapiritsi a Siofor 500 kapena 3 g mpaka mapiritsi atatu a Siofor 1000. Kuti mukwaniritse bwino kuchuluka kwa shuga m'magazi, metformin imatha kuphatikizidwa ndi insulin. Nthawi yomweyo, Siofor amatchulidwa muyezo wamba (500-850 mg katatu patsiku), pamene muyezo wa insulin umadalira kuwerenga kwa shuga m'magazi. Mapiritsi amatengedwa ndi chakudya, kumwa zamadzi zambiri.

Contraindication kugwiritsa ntchito mankhwala a Siofor

Hypersensitivity to metformin kapena zigawo zina za mankhwala, metabolic decompensation (hypoxic zikhalidwe zosiyanasiyana, diabetic ketoacidosis, diabetesic precoma ndi chikomokere), kulephera kwaimpso kapena kuwonongeka kwa impso (mwachitsanzo, serum creatinine 135 μmol / L mwa amuna ndi 110 μmol / L - mwa akazi), zotupa zomwe zimayambitsa matenda a impso (mwachitsanzo, kuchepa magazi, matenda opatsirana, mantha), kupweteka kwamitsempha ya othandizira omwe ali ndi ayodini, matenda owopsa komanso osachiritsika Hypoxia (mwachitsanzo, kukanika kwambiri kwa mtima wama mtima, kupuma kapena kulephera, kupweteka kwa m'matumbo am'mimba, mantha), kulephera kwa chiwindi, zochitika za catabolic (mwachitsanzo, njira zam'mimba), kuledzera kwambiri komanso uchidakwa. pa mimba ndi mkaka wa m`mawere.

Zotsatira zoyipa za mankhwala a Siofor

Kuchokera mmimba
Nthawi zambiri (10%) pamakhala madandaulo a mseru, kusanza, kutsegula m'mimba, kupweteka kwam'mimba komanso kusowa kwa chakudya. Amawonekera nthawi zambiri kumayambiriro kwa maphunzirowo ndipo nthawi zambiri amapita mosawerengeka. Nthawi zambiri (1 mpaka 10%) kukoma kwazitsulo kumapezeka mkamwa.
Khungu mbali
Nthawi zambiri (≤0.01%) mwa odwala omwe ali ndi hypersensitivity, erythema wofatsa amawoneka.
Kuchokera kumbali ya kagayidwe
Osowa kwambiri (≤0.01%), kuchepa kwa mayamwidwe a vitamini B12 kumatsimikiziridwa, ndipo ndi chithandizo cha nthawi yayitali, kuchepa kwake m'mitsempha yamagazi. Makamaka, izi zikuwoneka kuti sizothandiza.
Lactic acidosis
Osowa kwambiri (0.03 milandu kwa odwala 1000 pachaka), makamaka okhala ndi bongo, komanso zidakwa.

Mogwirizana ndi mankhwala Siofor

Kuphatikiza komwe kumafunikira chisamaliro chapadera
Kugwiritsa ntchito munthawi yomweyo kwa othandizira ena a hypoglycemic ndi insulin, NSAIDs, Mao inhibitors, oxytetracycline, ACE inhibitors, fibrate, cyclophosphamide potentiates hypoglycemic zotsatira za Siofor. Cimetidine amachepetsa kuchotsedwa kwa metformin ndikuwonjezera ngozi ya lactic acidosis.
Chepetsani mphamvu ya hypoglycemic ya Siofor corticosteroids, mankhwala osakanikirana a estrogen-progestogen, sympathomimetics, kukonzekera kwa mahomoni a chithokomiro, glucagon, phenothiazines ndi thiazide diuretics, zotumphukira za nicotinic acid. Chifukwa chake, kuyang'anira kuchuluka kwa shuga m'magazi omwe akulandira mankhwalawa ndikofunikira, makamaka kumayambiriro kwa chithandizo. Ngati ndi kotheka, kusintha kwa mankhwala a antidiabetes kumachitika onse munthawi ya chithandizo atatha. Kugwiritsira ntchito pamodzi kwa chingamu chimbudzi kapena colestyramine kumasokoneza kuyamwa kwa mankhwalawo ndikuchepetsa mphamvu yake.
Osavomerezeka kuphatikiza
Kugwiritsa ntchito nthawi yomweyo mowa kumatha kukulitsa mphamvu ya mankhwalawa ndikupangitsa kuti lactic acidosis ichitike, makamaka ndi njala, kuperewera kwa zakudya m'thupi kapena kulephera kwa chiwindi.

Mankhwala osokoneza bongo a Siofor, zizindikiro ndi chithandizo

Pa mlingo wa 85 g wa metformin, hypoglycemia sichinayambike, ngakhale lactic acidosis imapangika pazomwezi. Pogwiritsa ntchito mankhwala osokoneza bongo kwambiri komanso kukhalapo kwa zinthu zoika pachiwopsezo, lactic acidosis imayamba. Imeneyi ndi nkhani yokhazikika yomwe chithandizo chanthawi yofunikira ndiyofunika. Njira yothandiza kwambiri yothana ndi lactate ndi metformin ndi hemodialysis.

Cholinga cha Siofor

Siofor 850 imazindikiridwa molakwika ndi anthu ambiri ngati njira, cholinga chake chachikulu ndicho kuchepa thupi.

Cholinga chachikulu cha mankhwalawa ndikuchepetsa shuga la magazi mwa anthu omwe ali ndi matenda a shuga. Kunenepa kwambiri muzochitika izi ndizofala kwambiri, nthawi zambiri kumalumikizidwa ndi kuchuluka kwa shuga m'magazi komanso kuchepa kwa kagayidwe kazinthu.

Mankhwalawa ali ndi metformin, yomwe imachepetsa shuga ya magazi ndikuphwanya zotsalira za cholesterol. Chifukwa chake, odwala matenda ashuga amatha kuchepa thupi. Anthu athanzi nthawi zina amagwiritsanso ntchito mankhwalawa.

Ndemanga za Siofor za anthu athanzi omwe akufuna kuchepa thupi ndizovuta, chifukwa popanda kulankhula ndi dokotala ndikutsatira malangizowo, kuwonda sikuchitika, ndipo zotsatira zoyipa zimachitika.

Ngati munthu alibe kuchuluka kwa glucose m'magazi, ndiye kuti kuchepa kwambiri m'magazi kungakhale kovulaza, mpaka matenda amtundu wa endocrine komanso mawonekedwe a hypoglycemic coma, shuga atatsikira pamtengo wotsika kwambiri.

Mankhwala Siofor ali ndi mawonekedwe awa:

• Glycon.
• Bagomet.
• Glucophage.
• Glformin.
• Vero-Metformin.
• Glycomet 500.
• Dianormet.
• Langerine.
• Methadiene.
• Glyminfor.
• Metfogamma 1000.
• Dormin
• Metospanin.
• Metformin.
• Metfogamma.
• Metfogamm 500.
• NovoFormin.
• Metformin-BMS.
• Siofor 500.
• Metformin Richter.
• Sofamet.
• Fomu.

Pharmacological zochita ndi zikuchokera mankhwala

Mankhwala Siofor adapangidwa kuti achepetse shuga la magazi mwa anthu omwe ali ndi matenda amtundu wachiwiri wotsimikizika. Odwala otere nthawi zambiri amakhala onenepa kwambiri.

Mu malangizo omwe akupangidwira chida palibe chidziwitso chakugwiritsa ntchito anthu athanzi kuti achepetse thupi. Metformin ikalowa m'thupi la munthu wodwala matenda ashuga, zimakhudza maselo am'misempha kuti azitha kutulutsa shuga wowonjezereka omwe amachokera m'magazi.

Izi zimagwira ntchito makamaka kwa thupi la anthu odwala matenda ashuga a 2. Kwa iwo omwe alibe matenda otere, kugwiritsa ntchito mankhwalawa kumakhala kopanda ntchito. Zomwezi zimagwiranso ntchito pa mankhwala a Siofor.

Mlozera wa digito, womwe umayenera pambuyo pa dzina la zilembo, ndiye mtundu wake wa mlingo. Pakadali pano, mankhwala a Siofor amagulitsidwa pamiyeso:

Njira yamachitidwe

Mankhwala amachepetsa kufunika kwa shuga m'magazi, komanso chisonyezo chake mukatha kudya. Metformin sikukakamiza maselo a pancreatic beta kuti apange insulin yochulukirapo, zomwe zikutanthauza kuti hypoglycemia siziwoneka.

Njira yochepetsera kuchuluka kwa shuga mukamagwiritsa ntchito Siofor ndikuwonjezera mphamvu ya maselo kutenga shuga kuchokera m'magazi. Kuphatikiza apo, insulin sensitivity ya cell membrane imakulira.

Siofor amachepetsa kuyamwa kwa chakudya cham'matumbo ndi m'mimba. Mafuta acid oxidation amathamangitsidwanso ndipo anaerobic glycolysis imakonzedwa. Siofor mu matenda a shuga amachepetsa njala, zomwe zimathandizanso kuchepetsa kunenepa. Mwa anthu omwe alibe matenda ashuga, mapiritsi awa samachepetsa chidwi chawo cha shuga. Zochita za Siofor pankhaniyi sizikupezeka.

Anthu odwala matenda ashuga omwe amatenga Siofor ndikutsatira zakudya zapadera nthawi zina amachepetsa thupi. Izi zimatsimikizira nthano kuti metformin ndi njira yochepetsera kunenepa.

Ngati mankhwalawa amachepetsa thupi, akhonza kupatsidwa malangizo kwa anthu onse odwala matenda ashuga.

Tsoka ilo, anthu odwala matenda a shuga omwe amagwiritsa ntchito Siofor kwa nthawi yayitali kuyambira 500 mpaka 850 mg kangapo patsiku samazindikira kwambiri kuwonda.

Malangizo ogwiritsira ntchito mankhwalawa

Mlingo wa mankhwalawa umaperekedwa ndi adokotala okha. Monga lamulo, kugwiritsa ntchito mankhwalawa kumayamba ndi osachepera 500 mg.

Siofor imayikidwa muyezo woyambirira wa 500 mg / tsiku, pakapita nthawi, kuchuluka kumakulirakulira mpaka mfundo zomwe mukufuna zitheke. Pambuyo masiku 10 - 15, mlingo uyenera kusinthidwa pogwiritsa ntchito chisonyezo cha shuga m'magazi. Kuwonjezeka kwapang'onopang'ono kwa mlingo kumakhudza chidwi cha kukonzekera kwa kugaya chakudya.

Mlingo wapamwamba wa 0,5-3 g wa metformin hydrochloride amaloledwa tsiku lililonse, izi zikufanana ndi mapiritsi a Siofor 500 kapena 3 g ndi mapiritsi atatu a Siofor 1000. Mankhwalawa amatha kugwiritsidwa ntchito katatu patsiku, koma, nthawi zambiri, chifukwa chithandizo cha shuga chimakhala chokwanira 100 mg kawiri pa tsiku.

Kuti mukwaniritse kukonza bwino magazi, metformin imaphatikizidwa ndi insulin.

Choyamba, Siofor amayikidwa pa 500 - 850 mg kangapo patsiku, pomwe kuchuluka kwa insulin kumadalira kuchuluka kwa shuga m'magazi. Mankhwala ayenera kumwedwa ndi zakudya, osafuna kutafuna, amwe ndi madzi okwanira.

Mlingo wa 500 mg nthawi zambiri umagwiritsidwa ntchito ngati pali prediabetes kapena munthu amayamba kuchepa thupi. Ngati wodwala matenda ashuga alibe zotsatira zoyipa pambuyo pa sabata yogwiritsira ntchito, ndiye kuti mankhwalawo amawonjezeka, mwachitsanzo, Siofor 850 imagwiritsidwa ntchito kapena piritsi lina la Siofor 500 limawonjezeredwa maola 12 itatha yoyamba. Sabata iliyonse, 500 mg ya metformin imawonjezeredwa pang'onopang'ono, koma ndikofunikira kuyang'anira nthawi zonse kukhalapo kapena kusakhalapo kwa zotsatira zoyipa.

Ngati kuchuluka kwa mankhwalawa Siofor kumawonjezeka, ndiye kuti zovuta zake zimakhala zodziwika. Kenako muyenera kuchepetsa kuchuluka kwa kuchuluka kwapita. Popita nthawi, muyeneranso kuyesetsa kuwonjezera kuchuluka kwa mankhwalawa kukhala othandiza kwambiri.

Ngati mlingo wa mankhwalawo ndi 500 mg, waledzera 1 nthawi yamadzulo, motero kuchepetsa chiopsezo cha mavuto. Ngati Mlingo uli wa 1000 mg patsiku, ndiye kuti muyezo umagawidwa muyezo waukulu.

Ndikofunikira pakumwa mankhwala a kalasi ino kuti nthawi zonse muzichita mayeso omwe amawonetsa kugwira ntchito kwa chiwindi ndi impso. Makamaka, ziyenera kuchitika:

1. kuyezetsa magazi konse
2. mayeso a biochemical magazi (michere ya chiwindi, creatinine).

Mndandanda wazopondera

Siofor 850 ndi mankhwala amphamvu omwe samalimbikitsidwa kuti azigwiritsa ntchito popanda kufunsa dokotala.

Ngati lingaliro likutenga Siofor, ndiye kuti zotsutsana ndi motere:

• chidwi chapamwamba pazinthu zomwe zimapangidwa,
• zovuta za endocrine,
• kulephera kupuma
• mtundu 1 shuga
• chiwindi ndi matenda a impso,
• kuvulala kwambiri
• myocardial infaration pa siteji yowonjezera,
• matenda opatsirana opatsirana
• ntchito zaposachedwa
• zotupa pa oncological,
• uchidakwa wambiri,
• mimba
• Zakudya zochepa zopatsa mphamvu
• zaka za ana
• yoyamwitsa.

Madokotala amamulembera mankhwalawa kwambiri. Siofor 850 iyenera kumwedwa mosamala:

1. anthu opitilira 60
2. ana ochepera zaka 12
3. anthu omwe nthawi zambiri amakhala ndi masewera olimbitsa thupi.

Pali zovuta zowonjezera chifukwa chotenga Siofor, iyi ndi lactic acidosis. Vutoli limafunikira kuchipatala mwachangu ndi chithandizo chamankhwala osamala kwambiri.

Lactic acidosis ili ndi zizindikiro izi:

• dontho lakuthwa,
• kugunda kwamtima
• kulephera kupuma
• kusokonezeka kwa mtima
• kufooka ndi kugona,
• dontho mu kuthamanga kwa magazi.

Kuchokera ku Siofor pali zovuta zina zomwe zimawonjezeka pambuyo zolimbitsa thupi mwamphamvu. Ponyalanyaza mfundo iyi, azimayi ambiri amayamba kumwa mankhwalawo kuti achepetse thupi, kuphatikiza phwando ndi katundu mthambo kapena padziwe. Chifukwa chake, zotsatira zomwe sizikuyembekezeka sizichitika.

Chifukwa chogwiritsa ntchito Siofor mosaganizira, ndemanga zoyipa zimabuka za mankhwalawa.

Tiyeneranso kudziwa kuti mwayi wa lactic acidosis ukuwonjezeka ngati mumamwa zakumwa zoledzeretsa.

Siofor yoletsa matenda ashuga amtundu wa 2

Popewa kupangika kwa matenda ashuga amtundu wa 2, ndikofunikira kutsatira njira zonse zathanzi. Chifukwa chake, muyenera kuwonjezera zochita zanu zolimbitsa thupi ndikusintha makina anu azakudya.

Odwala ambiri m'moyo watsiku ndi tsiku samakonda kutsatira malingaliro a moyo. Nkhani yopanga njira yopeweretsera matenda a shuga a 2 ndikugwiritsa ntchito Siofor ndivuto lalikulu.

Zaka 10 zapitazo, malingaliro a ogwira ntchito ku American Diabetes Association pakugwiritsa ntchito Siofor popewa matenda oyamba ndi matenda a shuga amawonekera. Kafukufukuyu wasayansi adatenga zaka zitatu, ndikuthokoza kwake kudadziwika kuti kugwiritsa ntchito Glucophage kapena Siofor kumachepetsa mwayi wopanga matendawa ndi 31%.

Ngati munthu wasinthiratu ndi moyo wathanzi, ndiye kuti chiopsezo chidzagwa ndi 58%. Kutenga mapiritsi a metformin ngati njira yodzitetezera akulimbikitsidwa kwa odwala omwe ali pachiwopsezo chachikulu chotenga matenda a shuga.

Gululi limaphatikizapo anthu azaka zosaposa 60 omwe onenepa kwambiri, omwe ali ndi vuto limodzi kapena zingapo, zomwe ndi:

1. glycated hemoglobin - oposa 6%,
2. ochepa matenda oopsa
3. Anachepetsa cholesterol yayikulu kwambiri m'magazi,
4. triglycerides
5. lembani matenda ashuga 2 mwa achibale,
6. kulemera kwamphamvu kwa thupi kupitilira 35.

Odwala otere amatha kutenga Siofor kuti ateteze matenda a shuga. Mlingo mu nkhani iyi amachokera ku 250 mpaka 850 mg kawiri pa tsiku. Pakadali pano, Siofor kapena mitundu yake, Mankhwala Glucofage ndi mankhwala okhawo omwe amawerengedwa ngati prophylactic motsutsana ndi matenda a shuga.

Yang'anirani ntchito ya impso ndi chiwindi ziyenera kukhala musanapange ndalama ndi metformin kenako miyezi isanu ndi umodzi. Kuphatikiza apo, ndikofunikira kuyang'ana kuchuluka kwa magazi lactate kawiri pachaka. Mankhwalawa a shuga mellitus osakanikirana ndi Siofor omwe amachokera ku sulfonylurea, kuthekera kwakukulu kwa hypoglycemia kumawonekera.

Kuwunikira pafupipafupi kuchuluka kwa shuga m'magazi kumafunika, mpaka kangapo patsiku. Chifukwa cha chiwopsezo cha hypoglycemia mwa odwala omwe amatenga Glucofage 850 kapena Siofor, sizikulimbikitsidwa kuti azichita zinthu zomwe zimafunikira chidwi chochulukirapo komanso ma psychomotor reaction.

Pakadali pano, mtengo wa mankhwalawo umasiyanasiyana kutengera mtundu wake. Monga lamulo, phukusi la Siofor 850 limadya pafupifupi ma ruble 350.

Katswiri wa kanemayu munkhaniyi anena za Siofor wa hypoglycemic.

Ana a zaka 10-18

Mulingo woyambira woyamba kugwiritsa ntchito Siofor ngati monotherapy kapena osakaniza ndi insulin ndi nthawi 1 patsiku, 500 kapena 850 mg.

Pambuyo masiku 10-15 kuyambira poyambira kumwa Siofor, mlingo umatha kuwonjezeka pang'onopang'ono, kutengera zolembedwa zamagazi m'magazi. Kuwonjezeka pang'onopang'ono kwa mlingo kumachepetsa mwayi wosinthika wamtundu wamatumbo.

Zolemba malire - 2000 mg patsiku 2-3 waukulu.

Mlingo wa insulin umatsimikizika potengera kuchuluka kwa shuga m'magazi.