Metformin: contraindication ndi mavuto, pazipita tsiku lililonse

Metformin ndi mankhwala omwe amagwiritsidwa ntchito masiku onse kudziwa matenda a shuga. Kuphatikiza apo, imagwiritsidwa ntchito kuthana ndi kunenepa kwambiri ndikuchotsa ovary ya polycystic mu gynecology. Mankhwala amakulolani kuti muchepetse kunenepa kwambiri, kumachepetsa mulingo, koma sikuyambitsa zovuta zoyipa.

Kutenga Metformin ndi njira yodalirika yopewera kukula kwa zovuta za matenda ashuga, monga kugunda kwa mtima ndi sitiroko, potenga nthawi yayitali moyo wa odwala. Pali umboni kuti Metformin amateteza anthu ku mitundu ina ya zotupa za khansa.

Mtengo wa mankhwalawa ndi wotsika, chifukwa makampani ambiri azamankhwala akupanga nawo ntchito yake.

Zowonetsa kutenga Metformin, zomwe zimaperekedwa mu malangizo a boma:

Type 2 shuga.

Type 1 shuga mellitus odwala omwe ali ndi kunenepa kwambiri komanso kukana insulin.

Komabe, zenizeni, anthu ambiri amatenga Metformin kuti achepetse thupi. Amanenanso zochizira polycystic ovary syndrome mwa akazi. Kuchita izi kumawonjezera mwayi wodwala kudziwa bwino.

Kuphatikiza pa kumwa mankhwalawa, amayi omwe ali ndi vuto la ovary polycystic ayenera kutsatira zakudya zamagulu ochepa. Izi zimawonjezera mwayi woganiza bwino.

Metformin: malangizo ogwiritsira ntchito

Kodi mankhwalawa amagwira ntchito bwanji?

Metformin amalembera odwala matenda a shuga a mtundu wachiwiri, ndipo nthawi zina amaphatikizidwa ndi mankhwala othandizira odwala matenda ashuga amtundu woyamba. Mankhwalawa amathandizira kuchepetsa shuga m'magazi pamimba yopanda kanthu ndikatha kudya, komanso amakupatsani mphamvu yochepetsa hemoglobin.
Kumwa mankhwalawa kumapangitsa kuti muchepetse kupanga kwa shuga m'chiwindi, komanso kumalepheretsa kuyamwa kwa mafuta ambiri m'matumbo. Chifukwa cha Metformin, ndizotheka kuwonjezera chidwi cha maselo kuti apange insulin. Zikondamoyo pa mankhwala sizipanga insulin yowonjezera, yomwe imalepheretsa kukula kwa hypoglycemia.

Mankhwalawa sadziunjikira m'thupi. Ambiri a iwo amachotseredwa ndi impso. Mankhwala omwe akhala akugwiritsidwa ntchito kwa nthawi yayitali atagwiritsidwa ntchito, mwachitsanzo, Glucofage Long, Metformin imamizidwa nthawi yayitali ngati mungayerekeze nthawi ino ndi mapiritsi a nthawi zonse.
Malinga ngati munthu ali ndi vuto linalake la impso, Metformin iyenera kuyikidwa mosamala.

Mukatenga nthawi yanji

Mankhwalawa amalembedwa kwa odwala omwe ali ndi matenda a shuga 2, omwe amakhala ndi kunenepa kwambiri komanso omwe ali ndi chiwopsezo chochepa cha maselo a insulin.
Kuchiza ndi metformin kuyenera kuchitika motsutsana ndi maziko azokwanira zolimbitsa thupi komanso kudya zakudya zochepa.

Mankhwala sangathe kumwa

Contraindication chithandizo ndi Metformin:

• Matenda a shuga ketoacidosis.
• Matenda a shuga.
• ndi kulowetsedwa kwa glomerular ya 45 ml / min ndi pansi.
• Magazi a creatinine ndi 132 μmol / L kwa amuna ndi 141 μmol / L kwa akazi.
• Kulephera kwa chiwindi.
• Matenda opatsirana omwe ali pachimake gawo.
• Kuthetsa madzi m'thupi

Zomwe muyenera kulabadira mwapadera

Ngati wodwala wachita opaleshoni, kapena kumuyesa X-ray pogwiritsa ntchito kusiyanitsa, ndiye kuti ayenera kusiya kumwa Metformin patatsala masiku awiri asanafike pochita.
Nthawi zina odwala amatha kukhala ndi vuto lalikulu lactic acidosis. Izi zimatsatiridwa ndi kuchepa kwa magazi pH mpaka 7.25, yomwe imabweretsa chiwopsezo chachikulu osati thanzi komanso moyo. Chifukwa chake, pamene zizindikiro monga kupweteka kwam'mimba, kufooka kowonjezereka, kusanza ndi kupuma movutikira kuwonekera, ambulansi iyenera kuyitanidwa.
Monga lamulo, lactic acidosis imayamba pokhapokha ngati munthu wamwa mlingo waukulu kwambiri wa mankhwalawo, kapena chithandizo chikuchitika ngati pali zotsutsana. Nthawi zina, chithandizo cha Metformin sichimatsogolera pakukula kwa lactic acidosis.

Momwe mungatengere komanso mlingo

Kuchiza kuyenera kuyamba ndi mlingo wochepa wa 500-850 mg patsiku. Pang'onopang'ono, imawonjezeka ndikubwera mpaka 2550 mg pa tsiku, kumwa piritsi limodzi la 850 mg katatu patsiku. Kuchulukaku kuyenera kuchitika nthawi 1 m'masiku 7-10.
Ngati munthu agwiritsa ntchito mankhwala okhala ndi nthawi yayitali kuchitira mankhwala, tsiku ndi tsiku mlingo umachepetsedwa mpaka 2000 mg. Imwani mankhwalawa 1 nthawi patsiku, musanakagone.

Zotsatira zoyipa zimafotokozedwera mu mawonekedwe amisala pakuchitika kwa dongosolo la m'mimba. Munthu amadwala matenda otsekula m'mimba, nseru, kusanza, kulakalaka kwake kudya, kuonda kwake kungasokonekera. Monga lamulo, chisokonezo chotere chimawonedwa m'masiku oyambira okha kuyambira pachiyambire mankhwala.
Kuchepetsa mwayi wokhala ndi zotsatirapo zochepa, chithandizo chikuyenera kuyambitsidwa ndi Mlingo wochepa.
Ngati wodwala ali ndi zotupa pakhungu komanso kuyabwa, ndiye kuti izi zimafunikira upangiri wa udokotala, chifukwa zingasonyeze kuti munthu alibe vuto lakelo.
Pa chithandizo cha nthawi yayitali, kuperewera kwa vitamini B12 m'thupi ndikotheka.

Kuchepetsa ndi pakati

Pakubala kwa mwana komanso poyamwitsa, mankhwalawa saikidwa kwa akazi. Komabe, nthawi zambiri amagwiritsidwa ntchito pochiza polycystic ovary syndrome. Ngati panthawiyi mayi ali ndi pakati, ndiye kuti palibe chowopsa chomwe chidzachitike. Ndikofunika kuti musamwe mankhwalawo mukazindikira za vuto lakelo.

Ngati mlingo waukulu watengedwa

Ndi mankhwala osokoneza bongo, hypoglycemia samakula, koma lactic acidosis imatha kuchitika (pafupifupi 32% ya milandu). Munthu ayenera kugonekedwa kuchipatala mwachangu. Kuti muchotse mankhwalawo mwachangu m'thupi, kuyimba pamafunika. Mofananamo, chithandizo chamankhwala chimachitika.

Kuchita ndi mankhwala ena

Ndi munthawi yomweyo makonzedwe a Metformin omwe ali ndi insulin, kuchepa kwakukulu kwa shuga m'magazi ndikotheka. Komanso, mankhwalawa amatha kuthana ndi mankhwala kuti muchepetse kuthamanga kwa magazi komanso ndi mankhwala othandizira.

Fomu yotulutsidwa, malo osungira

Mankhwalawa amatha kupezeka pamankhwala a 500, 850 ndi 1000 mg. Ikupezeka piritsi.
Kutentha kozungulira sikuyenera kupitirira 25 digiri. Moyo wa alumali umasiyana zaka zitatu mpaka zisanu.

Prediabetes ndi Metformin

Metformin itha kumwa mankhwala onenepa a prediabetes. Izi zikuchepetsa mwayi wokhala ndi matenda ashuga amtundu wa 2.

Choyamba muyenera kuyesera kuchepetsa thupi ndi zakudya. Ngati zotsatira zake sizikwaniritsidwa, ndiye kuti mutha kulumikiza mankhwala. Kuphatikiza pa zakudya, munthu ayenera kuwonjezera zochita zake zolimbitsa thupi: kuchita masewera olimbitsa thupi, kuyenda kwambiri, kuthamanga. Mofananamo, ndikofunikira kuyang'anira kuchuluka kwa kuthamanga kwa magazi, komanso kuchuluka kwa shuga m'magazi, kuphatikizapo kusala kudya.

Metformin si mankhwala. Zimatengedwa mu moyo wonse, popanda zosokoneza, tsiku ndi tsiku.

Ngati munthu wayamba kutsegula m'mimba kapena matenda ena am'mimba, ndiye kuti ichi sichiri chifukwa chosiya kumwa. Ndizotheka kuti muchepetse mlingo kwakanthawi.

Kamodzi pa miyezi isanu ndi umodzi, kuyezetsa magazi kuyenera kutengedwa kuti athe kudziwa kuchuluka kwa vitamini B12 m'thupi. Ngati pali kuchepa, ndiye kuti iyenera kutengedwa padera. Palinso malingaliro kuti mutenge vitamini B12 ngati njira yothanirana.

Zakudya ndi Metformin

Kuti muchepetse kunenepa kwambiri, komanso munthawi ya matenda a shuga, muyenera kutsatira zakudya zochepa zamafuta.Sikokwanira kungodula zopatsa mphamvu za tsiku ndi tsiku ndi kuchuluka kwa mafuta omwe adawonongeka - izi sizingakulolani kuti mulibe shuga. Kuphatikiza apo, kudya zakudya zochepa zopatsa mphamvu kumathandizanso kuti munthu azikhala ndi chidwi chofuna kudya, zomwe zingayambitse kudya kwambiri, kusweka komanso kuchuluka kwa thupi.

Ngati simukuchepetsa kuchuluka kwa chakudya chamafuta omwe mumamwe, ndiye kuti simungathe kukwaniritsa zochizira pakumwa mapiritsi ngakhale mutaba jakisoni wa insulin. Kudya zakudya zoyenera kumakuthandizani kukhala odzala ndi kupewa kunenepa kwambiri.

Ndi mankhwala ati oti musankhe: Metformin, Siofor kapena Glucofage?

Glucophage ndi mankhwala oyamba ozikidwa metformin. Siofor ndi mankhwala ena omwe ali ndi fanizo.

Glucophage Long - chida chokhala ndi mphamvu yokhalitsa. Kuwongolera kwake sikungapangitse kuyambitsa zovuta pamtundu wa m'mimba kuposa mankhwala ochiritsira ofanana ndi metformin. Glucophage Long imatengedwa asanagone, zomwe zimalepheretsa kulumpha m'mawa m'magazi.

Mtengo wa Glucofage ndi Glucophage Long kukonzekera sikokwanira. Chifukwa chake, sizikupanga nzeru kusinthira kumafanizo awo. Kusungitsa ndalama kofunika sikungathandize.

Metformin yokhala yayitali kwa nthawi yayitali - ndi kusiyana kotani?

Ngati munthu watenga metformin wokhazikika, mankhwalawa amamwetsa mwachangu kwambiri. Pambuyo 4 mawola kudya magazi, ambiri pazomwe amagwira zimawonedwa. Fotokozerani mankhwala katatu patsiku ndi chakudya.

Munthu akatenga metformin yomasulidwa kwa nthawi yayitali, mankhwalawa amamwa nthawi yayitali, koma amakhalanso nthawi yayitali. Fotokozerani mankhwalawa 1 nthawi patsiku, musanakagone. Izi zithandiza kupewa m'mawa kwambiri.

Metformin yokhala yayitali sichimayambitsa zotsatira zoyipa mwanjira yakuphwanya kugwirira ntchito pamimba. Komabe, amawongolera kuchuluka kwa shuga masana. Chifukwa chake, ndikulimbikitsidwa kuvomerezedwa kwa anthu omwe ali ndi shuga othamanga kwambiri. Mankhwala oyamba a metformin ndi Glucofage Long. Pogulitsa palinso fanizo la mankhwalawa ndi mphamvu yayitali.

Zotsatira za metformin pachiwindi. Mafuta hepatosis ndi metformin

Metformin sayenera kumwedwa ndi kuwonongeka kwambiri kwa chiwindi, mwachitsanzo, ndi matenda a cirrhosis kapena chiwindi. Ndi mafuta a chiwindi hepatosis, kugwiritsa ntchito kwake, m'malo mwake, kudzabweretsa zabwino zambiri. Kuphatikiza apo, wodwalayo afunika kutsatira zakudya zamagulu ochepa. Mukamatsatira malangizowa, mudzatha kukonza moyo wawo mwachangu. Fatpat hepatosis imatha kugonjetsedwa kudzera muzakudya zoyenera komanso Metformin. Mofananamo, munthu amayamba kuchepa thupi.

Metformin ndi mahomoni

Metformin siyimakhudzanso potency ya amuna ndi kuchuluka kwa magazi a testosterone.

Ndi polycystic ovary syndrome mwa akazi, mahomoni ambiri ogonana amuna amawonedwa, komanso kusokonezeka kwa metabolic ndi insulin kukana. Kutenga metformin, mwachitsanzo, Siofor, kuchotsa vuto lomwe liripo. Mankhwalawa amathandizanso kukongoletsa maimidwe achikazi ndipo kumawonjezera mwayi woti akhale ndi chiyembekezo.

Ndi mankhwala ati omwe amayenera kumwa m'malo mwa metformin chifukwa cha kulephera kwa impso?

Kutenga Metformin chifukwa cha kulephera kwa impso nkoletsedwa. Silembedwera odwala omwe ali ndi matenda ashuga omwe amachepetsa mpaka kulowa kwa 45 ml / miniti.

Ndi kulephera kwa aimpso, mutha kumwa mankhwala monga Januvia, Galvus, Glyrenorm. Kukhazikitsidwa kwa jakisoni wa insulin ndikothekanso. Mulimonsemo, dokotala yekha ndiye ayenera kupereka mankhwala kwa odwala omwe ali ndi mavuto otere.

Metformin imakulitsa moyo - sichoncho?

Metformin bwino imathandizira kutalikitsa kwa moyo wa anthu omwe akudwala matenda ashuga, chifukwa amaletsa kukula kwa zovuta zovuta za matendawa.

Ponena za kuchuluka kwa chiyembekezo cha moyo mwa odwala omwe alibe matenda a shuga, palibe umboni wa sayansi pazowona izi. Komabe, kafukufuku wokhudza nkhaniyi wayambitsidwa kale.

Mutha kupezanso ndemanga kuti chithandizo ndi Glucofage chimachepetsa ukalamba. Izi zimatsimikiziridwa ndi anthu omwe samamwa mankhwala a shuga.

Prophylactic Metformin ndi mlingo wake

Ngati munthu ndi wonenepa kwambiri, ndiye kuti amatha kutenga Metformin kuti ikhale prophylactic. Mankhwalawa amakupatsani mwayi wochotsa ma kilogalamu angapo olemera kwambiri, komanso kuchepetsa matenda a cholesterol, omwe, amathandizanso kupewa matenda a shuga a 2.

Musanayambe mankhwala othandizira kupewa, muyenera kuphunzira malangizo oti mugwiritse ntchito ndikuonetsetsa kuti palibe zotsutsana.

Ndikulimbikitsidwa kuti muthe kutenga Metformin muli ndi zaka 35 mpaka 40, ngakhale palibe zomwe zasinthidwa pazomwezi. Kuphatikiza pa kuwongolera zolemetsa zamankhwala, muyenera kutsatira zakudya zochepa zamanyama. Tiyenera kumvetsetsa kuti kuchuluka kwa mapiritsi kumakhala kocheperako ngati mukupitiliza kudya mosayenera. Zomwe zimavulaza kwambiri ndizinthu zomwe zimakhala ndi shuga woyengetsa.

Anthu onenepa amafunika kumwa Metformin pa 2550 mg tsiku lililonse. Ngati mankhwalawa akuchitika ndi mankhwala okhala ndi mphamvu yayitali, ndiye kuti tsiku lililonse mlingo uyenera kukhala 2000 mg. Muyenera kuukweza bwino. Pakati pa sabata yoyamba, zidzakhala zokwanira kumwa 500-850 mg wa mankhwalawa patsiku. Izi zimalola thupi kuti lizolowere mankhwala.

Ngati munthu alibe vuto lolemera mopitirira muyeso, ndipo akufuna kutenga Metformin kuti aletse kukalamba koyambirira, ndiye kuti ndikokwanira kumwa 500-1700 mg ya mankhwalawa patsiku. Palibe zidziwitso zatsopano pankhaniyi.

Metformin imakupatsani mphamvu kuti muchepetse thupi popanda kuvulaza thanzi, chifukwa mankhwalawa samabweretsa zovuta zoyipa. Kuphatikiza apo, ndi chithandizo chake ndikotheka kutulutsa mtundu wa cholesterol ndi glucose m'magazi.

Popeza izi, sizodabwitsa kuti metformin imakonda kugwiritsidwa ntchito pakuchepetsa thupi. Zomwe zachitika ndikutenga zaka zopitilira 50. Mankhwala opangidwa ndi Metformin amapangidwa ndi makampani ambiri azamankhwala. Izi zimakuthandizani kuti musunge mtengo wa mankhwala oyambilira Glucofage pamlingo wotsika.

Pofuna kusokoneza kukula kwa zoyipa, metformin iyenera kutengedwa mu yaying'ono Mlingo woyamba. Musanayambe ndewu yolimbana ndi kunenepa kwambiri, muyenera kuonetsetsa kuti munthu alibe zotsutsana ndi mankhwalawa.

Kodi mungataye ndalama zingati ndi metformin?

Ngati simukumanganso zakudya zanu komanso osachita masewera olimbitsa thupi, ndiye kuti simungathe kuchita bwino chifukwa chochepetsa thupi kuposa makilogalamu 2-4.

Pambuyo miyezi 1.5-2 kuyambira poyambira kumwa metformin, zotulukapo zake palibe, ndipo kulemera kumakhalabe pamigawo yapitayo, izi zitha kuwonetsa kuti munthuyo ali ndi hypothyroidism. Onetsetsani kuti mwakumana ndi katswiri ndikupanga mayeso a mahomoni a chithokomiro.

Kutsatira zakudya zamafuta ochepa kuphatikiza ndi metformin kungachepetse kulemera ndi makilogalamu 15 kapena kuposerapo. Kuti musunge izi, muyenera kutenga Metformin mosalekeza. Mutasiya mapiritsiwo, kulemera kwake kumatha kubwerera.

Elena Malysheva akuti metformin ndi njira yothanirana ndi ukalamba, koma sakusonyeza za kuthekera kwake kuchepetsa kunenepa kwambiri. Wotulutsa TV wotchuka amalimbikitsa kumamatira ku zomwe adakula, osamwa mankhwala ochepetsa thupi. Komabe, muyeso wotere suyenera kwa munthu aliyense.

Metformin ndi hypothyroidism

Metformin imatha kutengedwa ndi hypothyroidism, chifukwa matendawa samawonetsedwa ngati cholakwira. Amaloledwa kugwiritsidwa ntchito molumikizana ndi mankhwala othandizira hypothyroidism. Ndizotheka kuti izi zikuthandizani kuti muchepetse thupi komanso mukhale ndi thanzi labwino.Komabe, adotolo ayenera kutenga nawo mbali pamankhwala a hypothyroidism, ndipo metformin ilibe vuto pamatendawa.

Metformin ndi matenda a shuga a 2

Metformin ndi mankhwala ochizira matenda amishuga amtundu wa 2, omwe amakupatsani mphamvu kuti muchepetse kuchuluka kwa shuga mutatha kudya komanso pamimba yopanda kanthu. Kugwiritsa ntchito metformin kumakupatsani mwayi wopewa kukula kwa zovuta zovuta za matenda, kuyimitsa kupitilira kwake komanso osavulaza thanzi. Metformin sayenera kuonedwa ngati machiritso ozizwitsa omwe angathandize kuthana ndi matenda ashuga. Zachidziwikire, panali zochitika pomwe munthu adalimbana ndi kunenepa kwambiri, ndipo matendawa amachepetsa, omwe amalola kusiya kugwiritsa ntchito metformin, koma zochitika ngati izi ndizosowa.

Ngati munthu amatenga metformin pafupipafupi komanso kwanthawi yayitali, ndiye kuti izi zimapangitsa kuti shuga, cholesterol ndi triglycerides m'magazi komanso kuchepa thupi.

Metformin ndi mankhwala otetezeka, motero, amapatsidwa mankhwala ochizira matenda osokoneza bongo komanso kunenepa kwambiri kwa ana opitirira zaka 10. Muyenera kuyamba kumwa mankhwalawa osachepera 500-850 mg patsiku, pang'onopang'ono kubweretsa kuchuluka kwa tsiku lililonse kwa 2250 mg. Ngati mankhwala Glucofage Long amagwiritsidwa ntchito pochiza, ndiye kuti mlingo wosakwana 2000 mg uyenera kumwedwa patsiku.

Kusunga matenda a shuga komanso kulemera pansi moyang'aniridwa ndi chithandizo chamankhwala sikungathandize. Wodwala amafunika kutsatira zakudya. Kupanda kutero, matenda a shuga akupitabe patsogolo ndikupangitsa kuti pakhale zovuta zazikulu.

Ndi mankhwala ati a metformin amene amachepetsa kwambiri shuga?

Zochizira matenda a shuga, glucophage ndiyabwino. Ichi ndi mankhwala oyambira pamtengo wotsika mtengo kwa anthu ambiri. Muthanso kutenga ma analog ake Siofor.

Kuti muchepetse shuga m'magazi kuti muuke m'mawa, mutha kugwiritsa ntchito mankhwala Glucofage Long. Amatengedwa asanagone, choncho amagwira ntchito usiku wonse. Njira izi zikapanda kukhazikika shuga, jakisoni wa insulin ingafunike. Kumbukirani kuti kuwuka kwam'magazi m'magazi kumathandizira kuti pakhale zovuta zamagulu a shuga. Chifukwa chake, kudumpha koteroko sikunganyalanyazidwe.

Ngati ndatsegula m'mimba kuchokera ku metformin kapena sizithandiza, ndiye kuti ndi chiyani chomwe chitha kusintha?

Ndikosavuta kupeza m'malo mwa metformin - ndi chinthu chapadera chochepetsera shuga m'magazi.

Chifukwa chake, choyamba muyenera kuyesa kupewa kupewa kutsekula m'mimba, kuti musayang'ane m'malo mwa metformin. Kuti muchite izi, yambani kulandira chithandizo cha mankhwala ochepa. Izi zimalola kuti thupi lizolowera mankhwalawo ndipo osayankhidwa chifukwa cholephera kugaya chakudya.

Pafupipafupi, mankhwala osasunthika othandizira. Chifukwa chake, kwakanthawi mutha kusintha m'malo mwa mapiritsi a Metformin.

Ngati kumwa mankhwalawa sikuchepetsa magazi, ndiye kuti munthu akhoza kuyamba kudwala matenda amishuga 1. Nthawi yomweyo, kapambayu wachotsa mphamvu zake zonse ndipo sanatulutsenso insulin. Kenako muyenera kusinthana ndi jakisoni wa timadzi timeneti. Kupanda kutero, munthu akhoza kufa chifukwa cha zovuta za shuga. Mapiritsi ayenera kutayidwa.

Pomwe metformin imatsitsa shuga m'magazi, koma izi sizokwanira, chithandizo chitha kuphatikizidwa ndi jakisoni wa insulin, koma muyezo waukulu.

Ngati munthu ali ndi thupi lochepa, koma amadwala matenda a shuga, ndiye kuti odwala oterowo amafunikira kupatsidwa insulin yomweyo. Mankhwala omwe amawotcha shuga sangakuthandizeni kuti mupirire matendawa.

Kutenga metformin kumabweretsa kuwonjezeka kwa shuga m'magazi, chifukwa chake nchiani?

Metformin sichithandiza shuga m'magazi ngati mtundu wachiwiri wa shuga ndi woopsa, kapena munthu akapezeka ndi matenda a shuga a mtundu woyamba. Pankhaniyi, jakisoni wa insulin adzafunika, komanso kudya.

Dokotala atha kukuthandizani kuti mulandire kapena kuwonjezera kukonzekera kwa metformin ndi mankhwala monga: Diabeteson MV, Amaril, Manil, etc. Mankhwala aposachedwa kwambiri akupezekanso kuti mugulidwe, kuphatikizapo Januvia, Galvus, Forsiga, Jardins, etc. amakulolani kuti mukwaniritse zomwe mukufuna, ndiye kuti muyenera kusinthira jakisoni wa insulin. Kukana insulin mankhwala sayenera. Komanso, kumwa mankhwala kumatha kuchepetsa mlingo wa insulin nthawi 2-7. Izi zimakuthandizani kuti musunge shuga komanso kuti musawononge thanzi lanu.

Chithandizo cha matenda a shuga ndi metformin ndi jakisoni wa insulin

Nthawi zambiri, kukonzekera kwa metformin kumayikidwa mu regimen zovuta ndi jakisoni wa insulin. Izi zidzakonza kuchuluka kwa shuga pa 4.0-5.5 mmol / L.

Kupyola pakudya ndi pakamwa pobweretsa mankhwala owotcha shuga omwe shuga amatha kuyatsidwa ngati ali pachiwopsezo chomakula. Nthawi zina, Mlingo wambiri wa insulin amafunikira. Izi ndizothandiza kwa odwala omwe mulingo wa shuga sagwera pansi pa 6.0-7.0 mmol / L. Ndi zizindikirozi, zovuta za matenda ashuga zipita patsogolo, ngakhale osati mwachangu kwambiri.

Ngati tilingalira za njira zochizira matenda osokoneza bongo, choyamba tiyenera kuyesa kukonza zakuphwanya mothandizidwa ndi dongosolo lazakudya zopatsa thanzi komanso zolimbitsa thupi. Pokhapokha amayamba kumwa mankhwala owotcha shuga. Mphamvuyo ikakhala kuti singatheke, jakisoni wa insulini akuwonetsedwa. Mlingo wa insulin ufunika kuchepetsedwa ndi 25% ngati nthawi yomweyo munthu alandire kukonzekera kwa metformin. Kuchulukitsa mlingo wa insulin panthawi ya mankhwala omwe amawotcha shuga amawopseza kukula kwa hypoglycemia.

Kuphatikiza pa njira zakuchiritsira zomwe zili pamwambapa, odwala matenda ashuga ayenera kusewera masewera. Zimathandizira kuchepetsa kuthamanga kwa matenda kapena, monga amatchedwanso, qi-run. Mutha kusinthanso zochita zanu zolimbitsa thupi ndi kuyenda kwa Nordic.

Metformin: kuvomera bwanji?

Metformin imatengedwa ndi zakudya, zomwe zimachepetsa chiopsezo cha mavuto.

Mapiritsi okhala ndi nthawi yayitali ayenera kumwa kwathunthu popanda kutafuna. Amakhala ndi matrix a cellulose, omwe amachititsa kuti pang'onopang'ono kumasulidwa kwa chinthu chachikulu chogwira ntchito. Kuwonongeka kwa matrix kotere kumachitika m'matumbo. Pankhaniyi, kusintha kwa kusunthika kwa chopondacho ndikotheka, koma popanda kutsegula m'mimba. Izi sizimabweretsa ngozi.

Kuchepetsa Ntchito

Kodi ndizotheka kumwa Metformin kuti muchepetse thupi, ngati shuga ndichabwinobwino? Kuwongolera uku pakukhudzana ndi mankhwala chifukwa cha kuthekera kwake kumenya nkhondo osati ma plaque m'mitsempha yamagazi, komanso ma deposits amafuta.

Kuchepetsa thupi mukamamwa mankhwala kumachitika chifukwa chotsatira:

• kuthamanga kwamafuta oxidation,
• kuchepa kwa kuchuluka kwa zomwe mwapeza
• kuchuluka kwa glucose chifukwa cha minofu.

Izi zimachotsanso kumverera kwanjala yosalekeza, zimathandizira kuti thupi lizikula msanga. Koma muyenera kutentha mafuta mukudya.

Kuti muchepetse kunenepa, muyenera kusiya:

Masewera olimbitsa thupi, monga masewera olimbitsa thupi olimbitsa thupi tsiku lililonse, amafunikanso. Ma regimen akumwa ayenera kuyang'aniridwa mosamala. Koma kumwa mowa ndikoletsedwa.

Tiyenera kukumbukira kuti kuchepa thupi kumangowonjezera mphamvu ya mankhwalawo. Ndipo adokotala okha ndi omwe angadziwe kufunika kwa Metformin kuti athane ndi kunenepa kwambiri.

Ntchito yoletsa kukalamba (anti-okalamba)

Metformin imagwiritsidwanso ntchito polepheretsa kusintha kokhudzana ndi zaka m'thupi.

Ngakhale mankhwalawa siwopanda chiyembekezo chaubwana wamuyaya, amakulolani:

• bwezeretsani kuchuluka kwa bongo ku mawu ofunikira,
• kuchepetsa chiopsezo cha neoplasms yoyipa,
• limbitsani mtima minofu.

Vuto lalikulu la chiwalo chokalamba ndi atherosulinosis, yomwe imasokoneza kugwira ntchito kwa mtima ndi mitsempha yamagazi. Ndiye amene amayambitsa imfa zambiri zomwe zimachitika asanakwane.

Zotsatira za cholesterol yomwe imatsogolera ku atherosulinosis imachitika chifukwa:

• kuphwanya kachitidwe koyenera ka kapamba,
• kulakwitsa kwa chitetezo chamthupi,
• mavuto a metabolic.

Cholinga chake ndikukhalanso ndi moyo womwe anthu okalamba amatsogolera, pomwe amakhala ndi chakudya chambiri komanso zopatsa mphamvu, ndipo nthawi zina zimawonjezera.

Izi zimabweretsa kukokomeza magazi m'mitsempha ndikupanga ma cholesterol amana. Mankhwalawa amathandizira kuchepetsa mafuta m'thupi, kusintha kayendedwe ka magazi ndi kusintha ntchito ya ziwalo zonse ndi machitidwe. Ndiye kodi Metformin ingatengedwe ngati palibe shuga? Ndizotheka, koma pokhapokha ngati pali contraindication.

Zoyipa pa Metformin ndi:

• acidosis (pachimake kapena chovuta),
• nthawi ya pakati, kudyetsa,
• Matendawa ndimankhwala
• chiwindi kapena vuto la mtima,
• myocardial infaration
• Zizindikiro za hypoxia mukamwa mankhwalawa.
• kuchepa kwa thupi ndi matenda opatsirana,
• matenda am'mimba thirakiti (zilonda),
• kuchita zolimbitsa thupi kwambiri.

Lemberani Metformin kuti muchepetse thupi komanso kuti musinthe thupi ndikufunika kukumbukira zotsatirapo zoyipa:

• chiopsezo chowonjezereka cha anorexia
• mseru, kusanza, kutsegula m'mimba kumachitika,
• nthawi zina kukoma kwazitsulo kumawonekera
• kuchepa magazi kumatha kuchitika
• pakuchepa kwa mavitamini a B, ndipo kukonzekera kowonjezereka kumafunikira,
• kugwiritsa ntchito kwambiri, hypoglycemia ingachitike,
• Kuchita zosafunikira kungayambitse mavuto amtundu wa khungu.

Makanema okhudzana nawo

Makhalidwe a pharmacological ndi malangizo ogwiritsira ntchito mankhwala Metformin:

Njira yogwiritsira ntchito Metformin osati pochiza matenda ashuga siyachilendo. Yambani kudzisankhira nokha ndikusankha mlingo woyenera nokha osakakumana ndi opereka chithandizo chamankhwala kuti akhale ndi zotsatila zoopsa zomwe sizingachitike. Ndipo ngakhale atayang'anitsitsa wodwalayo amamva bwanji, kutenga nawo mbali adotolo pakuchepetsa thupi / kuphatikizanso Metformin ndikofunikira.

Moni, owerenga okondedwa komanso obwera kumene ku bulogu yanga. Lero, nkhaniyi ikunena za kuchiza kwa “matenda otsekemera,” monga imodzi mwazinthu zofunika kwambiri pa matenda ashuga. Ndawona kale zitsanzo zokwanira za zolakwika, zomwe sizinapangitse kusintha ndikukhumudwitsa ena.

Metformin hydrochloride - mayendedwe ndi mayina a malonda a mankhwalawo
Metformin yapadziko lonse
Zokonzekera zomwe zimakhala ndi metformin (mayendedwe osokoneza bongo ndi mayina ogulitsa)
Malangizo ogwiritsira ntchito metformin
Njira zazikulu zoyeserera
Zizindikiro za Metformin
Contraindication
Zotsatira zoyipa ndi zotsatira zake
Mlingo ndi njira yoyendetsera metformin
Kuthandiza ndi mankhwala osokoneza bongo a metformin
Momwe mungasinthire metformin?
Chifukwa chiyani metformin siyothandiza?

Metformin hydrochloride - mayendedwe ndi mayina a malonda a mankhwalawo

Bizinesi yama pharmacological imawonedwa ngati imodzi yopindulitsa kwambiri ndipo kampani yokha yaulesi kwambiri siyipanga mankhwala omwe mankhwala ake ndi metformin.

Pakadali pano, mutha kupeza ma analogi ambiri omwe ali ndi mayina osiyanasiyana ogulitsa. Mwa iwo pali onse amtengo wokwera mtengo, pafupifupi wotchuka, ndipo osadziwika ndi aliyense, wotsika mtengo. Pansipa ndikuganiza kuti mudziwe mndandanda wamankhwala, koma choyamba tidzakumana ndi metformin yomwe.
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Metformin yapadziko lonse

M'malo mwake, metformin ndi dzina ladziko lonse lapansi, kapena metformin hydrochloride. Metformin ndi m'gulu la Biguanides ndipo ndi woimira yekha. Mayina ena onse omwe amapezeka muchipatala ndi mayina amalonda amakampani osiyanasiyana omwe amapanga mankhwalawa.

Mukalandira kalata kuchokera kwa dokotala kuti mupeze mankhwala aulere ku pharmacy, dzinalo limalembedwa. Ndipo kampani yomwe ingakupatseni zimadalira kupezeka kwa mankhwala opangira mankhwala komanso kwa omwe akuwayang'anira apamwamba omwe amasayina chilolezo chogulitsa ichi kapena mankhwalawo. Ndanena kale m'nkhani yanga "Momwe mungachiritsire matenda ashuga a 2?", Chifukwa chake ndimalimbikitsa kuti ndiwerenge kaye.

Tiyerekeze kuti akuluakulu aboma asayina mgwirizano ndi Akrikhin, ndiye kuti mankhwalawo amangokhala ndi glyformin ndipo osagwiritsa ntchito glucophage kapena siofor. Chifukwa chake, musadabwe ndipo musalumbirire kwa madokotala kuti sakupatsani zomwe mukufuna. Ndi kuti sizimadalira iwo, ndipo izi sizoyenera kwa madokotala. Iwo alemba dzina generic mu Chinsinsi. Malamulo amenewo.

Mndandanda wa mankhwala a metformin
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Zokonzekera zomwe zimakhala ndi metformin (mayendedwe osokoneza bongo ndi mayina ogulitsa)

Mankhwala aliwonse asanagulitsidwe, nthawi yambiri imadutsa, kwinakwake kuyambira zaka 10. Poyamba, kampani imodzi imakhudzidwa ndikukula ndikupanga mankhwala. Mankhwala oyamba omwe adatulutsidwa ndi kampaniyi ndi achikale. Ndiye kuti, kampani yomwe idakhazikitsa mankhwala omwe adayambitsa ndikuyipanga yoyamba, kenako ndikugulitsa patentyi yopanga mankhwalawo kumakampani ena. Mankhwala otulutsidwa ndi makampani ena azitchedwa mageneral.

Mankhwala oyamba azikhala okwera mtengo kuposa a generic, koma malinga ndi mtundu wake amakhalanso abwino, chifukwa adayesedwa muzomwe amaphatikizidwa, kuphatikiza ojambula mapiritsi kapena mapiritsi. Ndipo makampani opanga ma generic ali ndi ufulu wogwiritsa ntchito zinthu zina zothandiza komanso zothandiza, koma sawunikiranso ntchito yawo, chifukwa chake ukadaulo ungakhale wotsika.

Mankhwala oyamba a metformin ndi GLUCOFAGE, (France)

Pali mitundu yambiri ya zamagetsi, ndipo ndikuwonetsa otchuka kwambiri:

Siofor, (Germany)
Forin Pliva, (Croatia)
Bagomet, (Argentina)
Gliformin, (Russia)
Metfogamma, (Germany)
Novoformin, (Russia)
Foretin, (Russia)
Metformin, (Serbia)
Metformin Richter, (Russia)
Metformin-Teva, (Israel)

Kuphatikiza pa izi, pali zokonzekera zambiri zomwe opanga aku India ndi Chitchaina, omwe amakhala zotsika mtengo kwambiri poyerekeza ndi zomwe zaperekedwa, komanso ali kutali ndi iwo pogwira ntchito bwino.

Palinso mankhwala omwe amakhala ndi nthawi yayitali, mwachitsanzo, glucophage yomweyo. Komanso metformin ikhoza kukhala gawo lokonzekera mosakanikirana, monga glucovans, gluconorm, glybomet, yanumet, galvus met, amaryl M ndi ena. Koma zambiri za iwo munkhani zotsatirazi, chifukwa chake ndikukulangizani kuti mulembetse pazosintha za blog kuti musaphonye.

Ngati mungapeze metformin yaulere, pamaphikidwe okondera, ndiye kuti simuyenera kusankha. Ndipo aliyense amene adzagula ndi ndalama yake, amatha kusankha mankhwala oyenera kwambiri pamtengo ndi mtengo.

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Pali zotsutsana. Lankhulani ndi dokotala.
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Malangizo ogwiritsira ntchito metformin

Metformin ili ndi zotumphukira za hypoglycemic, zomwe zikutanthauza kuti sizilimbikitsa kubisirana kwa insulin ndi kapamba. Mankhwalawa ali ndi zotulukapo zambiri ndipo ndilembera zofunikira kwambiri, ndipo pazithunzi pansipa mutha kuwona zonse (dinani kuti mukulitse).

Kutsika kwa glycogen kumasuka, motero kumachepetsa kukula kwa shuga m'magazi
amalepheretsa kaphatikizidwe ka shuga kuchokera m'mapuloteni ndi mafuta
kumapangitsa kutsika kwa shuga mu chiwindi
zimawonjezera chidwi cha zotumphukira zolandilira ku insulin, potero kuchepetsa insulin
amachepetsa kuyamwa kwamatumbo
kuchuluka kutembenuka kwa glucose kuti agwirizane m'mimba
imakhala ndi phindu pa lipids yamagazi, imachulukitsa kuchuluka kwa ma lipoproteins (HDL), imachepetsa cholesterol yathunthu, triglycerides ndi otsika kachulukidwe lipoproteins (LDL)
kuchuluka kwa mayendedwe a glucose kudzera mu nembanemba kulowa mu minofu, i.e., kumathandizira kutulutsa kwa glucose

Limagwirira zake ntchito mankhwala metformin

Popeza metformin ilibe mphamvu yokhudza kapamba, ilibe zotsatira zoyipa monga hypoglycemia (kuchepa kwambiri kwa shuga m'magazi), koma zina pambuyo pake.
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Zizindikiro za Metformin

Mankhwala a Metformin si mankhwala antidiabetes okha. Mankhwalawa angagwiritsidwe ntchito:

Ndi kulolerana kwa glucose komanso kusokoneza shuga. Ndinalemba kale za izi mu nkhani yanga "Zizindikiro ndi Zizindikiro za matenda a shuga", kuti mutha kudzidziwa nokha.
Mankhwalawa kunenepa kwambiri, komwe kumayendetsedwa ndi insulin.
Mankhwalawa cleopolycystic ovary (PCOS) mu gynecology.
Ndi metabolic syndrome.
Pofuna kupewa kukalamba.
M'masewera.

Monga mukuwonera, metformin ili ndi mapulogalamu ambiri, ndipo ndilankhula zambiri za izi pazinthu zanga zamtsogolo. Posachedwa, pali chidziwitso chakuti mankhwalawa amaloledwa kwa ana azaka 10 kuti athandizidwe ku matenda a shuga mellitus MODY ndi kunenepa kwambiri. Mukamamwa metformin, ndikofunikira kuti musamwe mowa, chifukwa chomwe ndanena pamwambapa.
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Contraindication

Mankhwalawa ali otsutsana pazochitika zotsatirazi:

Mimba komanso kuyamwa
opaleshoni yayikulu ndi kuvulala
vuto la chiwindi
ana ochepera zaka 10
Zakudya zama kalori ochepa (osakwana 1000 kcal patsiku), popeza pali acidization ya thupi, i.e, metabolic acidosis imayamba
kulephera kwa aimpso (creatinine wambiri kuposa 0.132 mmol / l mwa amuna ndi 0.123 mmol / l mwa akazi)
m'mbuyomu lactic acidosis
kupezeka kwa zinthu zomwe zikuyambitsa mkaka wa m'mawere

Contraindative potenga metformin

Zinthu zomwe zingapangitse kuchuluka kwa lactic acid ndi kuchuluka kwa lactic acidosis:

Kuwonongeka kwa impso, komwe kumalepheretsa kuchotsa asidiyu mthupi
mankhwala oledzera osakhazikika komanso poyizoni wa ethanol
matenda osachiritsika komanso opweteka kwambiri omwe amachititsa kuti minofu ipume (kupuma komanso kulephera kwa mtima, kufooka kwa myocardial infarction, matenda opatsirana a m'mapapo)
matenda ashuga ketoacidosis
matenda opatsirana pachimake omwe amapezeka ndi kusowa kwamadzi (kusanza, kutsegula m'mimba, kutentha thupi)

Zikatero, ndikofunikira kuletsa mankhwalawo, mwina kwakanthawi, kufikira homeostasis ya thupi ibwezeretsedwa. Ndikulemba za mawonetseredwe a lactic acidosis mu gawo la bongo.
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Zotsatira zoyipa ndi zotsatira zake

Kuphatikiza pazabwino, kukonzekera kulikonse kopangidwa kumakhala ndi zotsatira zoyipa. Metformin sichoncho. Zotsatira zake zoyipa kwambiri ndi kugaya chakudya m'mimba. Ambiri mwa anthu omwe amatenga metformin amadandaula:

Kutsegula m'mimba
ukufalikira
nseru
masanzi
kukoma kwakanunkhira (kulawa kwazitsulo mkamwa)
kuchepa kwamtima

Monga lamulo, Zizindikiro zonsezi zimachitika kumayambiriro kwenikweni kwa chithandizo chamankhwala ndipo zimatha pambuyo pa milungu iwiri yoyendetsa. Zonsezi zimagwirizanitsidwa ndi kutsekeka kwa mayamwidwe am'matumbo, zomwe zimapangitsa kuti pakhale mpweya wambiri wopangidwa ndi mpweya woipa, womwe umayambitsa kutsekula m'mimba ndikutulutsa magazi mukamamwa metformin, ndipo patatha milungu ingapo thupi limakhala lovuta.

Zotsatira zoyipa za metformin

Ndichitenji ngati matumbo oyipa ndikudwala m'matumbo nditatulutsa metformin?

Chokhacho chomwe chingathandize ndikuchepetsa / kusiya kwa mankhwalawo kapena kudya ndi chakudya. Ngati izi sizithandiza ndipo zizindikilo sizikutha, ndiye kuti muyenera kusiyiratu mankhwalawa. Mutha kuyesanso kusintha mankhwalawo kukhala mankhwala kuchokera ku kampani ina. Poyerekeza ndi ndemanga, Glucophage satha kuyambitsa zizindikiro zosasangalatsa ngati izi.

Zoyipa kuti metformin ndizosowa, zomwe zimafunikanso kuchoka kwa mankhwalawo. Atha kukhala otupa, kapena erythema, kapena kuyabwa pakhungu. Musaiwale za lactic acidosis, yomwe ndalankhula zambiri zapamwamba.
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Mlingo ndi njira yoyendetsera metformin

Monga lamulo, mankhwalawa amaperekedwa kale pazizindikiro zoyambirira za matenda osokoneza bongo ndipo izi zimapangitsa kuti asankhidwa, chifukwa mankhwalawo amalembedwa pa nthawi yake, ndipo izi zikuchitika kale 50%. Kuti muyambe, ndikukuwuzani mtundu wa metformin hydrochloride wopangidwa. Masiku ano, pali mitundu iwiri ya mankhwala omwe amasiyana pakanthawi kachitidwe: fomu yowonjezera ndi mawonekedwe abwinobwino.

Mitundu yonseyi imapezeka pamapiritsi, koma imasiyana.

Metformin yachilendo imapezeka mu Mlingo wa 1000, 850 ndi 500 mg.
Metformin yayitali imapezeka mu Mlingo wa 750 ndi 500 mg

Kuphatikiza mankhwala, metformin ikhoza kukhala mu mlingo wa 400 mg. Mwachitsanzo, mu glibomet.

Mlingo ndi njira yoyendetsera metformin

Mlingo woyambirira wa mankhwalawa ndi 500 mg kokha patsiku. Mankhwala amatengedwa mosamalitsa pambuyo kapena pakudya katatu patsiku. M'tsogolomu, pakatha milungu iwiri, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa malinga ndi kuchuluka kwa shuga. Mlingo wapamwamba wa metformin patsiku ndi 2000 mg.

Ngati mumwa mankhwalawa musanadye, ndiye kuti mphamvu ya metformin imatsika kwambiri. Kumbukirani kuti mtundu uwu wa hypoglycemic unapangidwa kuti usinthe shuga, osasala kudya. Muyenera kukumbukiranso kuti popanda kuchepetsa zakudya zam'mimba, mphamvu ya mankhwalawa ndiyotsika kwambiri. Chifukwa chake muyenera kudya mukamamwa metformin molingana ndi mfundo zapakati pazakudya za shuga ndi kunenepa kwambiri.

Metformin ikhoza kuphatikizidwa ndi mankhwala ena ochepetsa shuga ndi insulin kuti mukwaniritse zotsatira zabwino kwambiri. Kuti muwone momwe mankhwalawa amathandizira, musathamangire ndipo nthawi yomweyo muziyembekezera kuchepa kwa glucose. Muyenera kudikirira masabata 1-2 mpaka mankhwalawo atakula kwambiri.

Pambuyo pake, tikulimbikitsidwa kuti tiwonetsetse msanga wa kudya magazi (m'mawa mpaka m'mawa) pogwiritsa ntchito glucometer (mwachitsanzo, Contour TC), komanso musanadye chakudya musanakagone. Koma muyenera kuwonetsetsa kuti nthawi yodyera isanathe maola 4-5. Ngati phindu la shuga la magazi silikufikiridwa munthawi imeneyi, ndiye kuti mutha kukulitsa mlingo, koma osapitirira pazovomerezeka.

Kodi ndingatenge metformin mpaka liti?

M'malo mwake, palibe yankho lomveka bwino la funso ili. Kutalika kwa ntchito kumadalira zolinga ndi zisonyezo poika metformin. Ngati zolinga za kanthawi kochepa zikwaniritsidwa, mwachitsanzo, kuchepa thupi, ndiye kuti metformin imathetsedwa mukangokwaniritsa. Ndi matenda a shuga, kagayidwe kazakudya umachepa kwambiri ndipo n`zotheka kuti mankhwalawa amayenera kuperekedwa kwa nthawi yayitali. Mulimonse momwe zingakhalire, muyenera kusankha funso lokhudza kumwa mankhwala ndi dokotala.

Kuthandiza ndi mankhwala osokoneza bongo a metformin

Ndi mankhwala osokoneza bongo a metformin, hypoglycemia sizichitika, koma lactic acidosis kapena lactic acidosis imayamba. Izi ndizovuta kwambiri zomwe zitha kutha. Itha kuchitika ndikusakanikirana kwa zinthu zomwe zimatsogolera ku hypoxia ndi kugwiritsa ntchito metformin. Pamwambapa, ndinakuwuzani kuti izi zitha bwanji.

Zizindikiro za lactic acidosis ndi:

Kusanza ndi kusanza
kutsegula m'mimba
kupweteka kwambiri pamimba
kutsitsa kutentha kwa thupi
kupweteka kwa minofu
kupumira msanga
chizungulire
kulephera kudziwa

Munthu akapanda kuthandizidwa, nthawi yomweyo amayamba kugwa, kenako kufa.

Kodi thandizo ndi lactic acidosis ndi chiyani? Choyamba, kuthetsedwa kwa metformin komanso kugonekedwa kuchipatala mwachangu. M'mbuyomu, izi zimathandizidwa ndi kulowetsedwa kwa sodium bicarbonate (koloko), koma chithandizo chotere ndichopweteketsa kuposa chabwino, chifukwa chake chidasiyidwa kapena kuchitidwa mwanjira zina.
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Momwe mungasinthire metformin?

Pali nthawi zina pomwe mankhwalawo sioyenera kapena pali zotsutsana pazolinga zake. Momwe mungachitire ndi zomwe zingalowe m'malo mwa metformin? Ngati izi ndizosagwirizana kwambiri ndi mapiritsi, ndiye kuti mutha kuyesa kuti musinthe kukhala mankhwala a kampani ina, koma kuti mulinso ndi metformin, ndiye kuti, mwa kuyankhula kwina, sinthani ndi analogue.

Koma pakakhala chosokoneza chilichonse, kusinthanitsa ma analogi sikungathetse vutoli, chifukwa kumakhala ndi zolakwika zomwezi. Pankhaniyi, metformin ikhoza kulowa m'malo mwa mankhwalawa, omwe adzakhala ndi machitidwe ofanana:

DPP-4 inhibitor (Januvia, galvus, onglise, trazenta)
fanizo la GLP-1 (byeta ndi victosa)
thiazolidinediones (avandium and actos)

Koma kusintha mankhwala ndikofunikira moyang'aniridwa ndi adokotala.
kukhutira
Chifukwa chiyani metformin siyothandiza?

Nthawi zina odwala amadandaula kuti mankhwalawa sawathandiza, ndiye kuti, sagwirizana ndi ntchito yake yayikulu - yotulutsa shuga. Izi zitha kuchitika pazifukwa zingapo. Pansipa ndalemba zifukwa zomwe metformin singathandizire.

Metformin sinatchulidwepo chizindikiro
Osakwanira mlingo
Chithandizo Cha Mankhwala
Kulephera kudya mukamamwa metformin
Munthu aliyense

Nthawi zina zimakhala zokwanira kukonza zolakwika ndikuchepetsa shuga sizingakudikirire.

Ndi chisangalalo ndi chisamaliro, endocrinologist Dilara Lebedeva

Metformin ndi mankhwala otchuka omwe amapangidwa kuti achepetse magazi a magazi. Cholinga chachikulu cha Metformin ndikuchiza matenda a shuga a mtundu wachiwiri. Mankhwala samakulitsa kupanga kwa insulin ndi maselo a beta a kapamba ndipo amayendetsa shuga m'magazi, osatsogolera pakuchepa kwake.

Kodi matenda ashuga ndi chiani ndipo bwanji?

Matenda a shuga amapezeka m'magulu awiri. Matenda a shuga 1 amtundu wa insulin amatchedwa wodalira insulin. Ndi matenda amtunduwu, kapangidwe ka enzyme yapadera mu kapamba, insulin, yomwe imaphwanya shuga, imasokonekera. Matenda a shuga a Type 2 amatchedwa kudalira insulin. Ndi mtundu wamtunduwu wa shuga, ntchito ya pancreatic sichiwonongeka, komabe, pali kuchepa kwa chidwi cha insulin m'matumbo a thupi, ndipo kupanga shuga m'magazi a chiwindi kumakulanso.

Anthu ambiri amadwala matenda amtundu wa 2 okalamba, koma posachedwa, matenda ashuga tsopano ndi "achichepere". Cholinga cha izi chinali moyo wongokhala, kupsinjika, kusiya kudya mwachangu komanso kusadya bwino. Pakadali pano, matenda ashuga ndi matenda oopsa, omwe pakakhala kuti palibe kuwonekera kwakunja kumawonjezera kwambiri chiopsezo cha kugunda kwamtima ndi stroke, magazi ndi mtima. Chifukwa chake, asayansi akhala akufufuza kwa nthawi yayitali mankhwala omwe angathandize kuchepetsa shuga m'magazi ndipo nthawi yomweyo sangavulaze thupi.

Kufotokozera za mankhwalawa

Kuchokera pamalingaliro amakanidwe, mankhwala a metformin amatanthauza Biguanides, zotumphukira za guanidine. Mwachilengedwe, guanidine amapezeka muzomera zina, mwachitsanzo, mankhwala a abulosi, omwe akhala akugwiritsidwa ntchito pochiza matenda ashuga kuyambira Middle Ages. Komabe, guanidine weniweni ndi woopsa kwa chiwindi.

Metformin inapangidwa molingana ndi guanidine mu 20s ya zaka zapitazi. Panthaŵiyo zinkadziwika kale zokhudzana ndi hypoglycemic yake, koma panthawiyo, chifukwa cha mafashoni a insulin, mankhwalawa adayiwalika kwakanthawi.Kungoyambira m'ma 1950s, pomwe zidadziwika kuti chithandizo cha insulin cha matenda a shuga a 2 chimakhala ndi zovuta zambiri, mankhwalawa adayamba kugwiritsidwa ntchito ngati othandizira odwala matenda ashuga ndipo patapita kanthawi pang'ono adadziwika chifukwa chogwira ntchito bwino, chitetezo komanso zovuta zingapo zoyipa ndi zotsutsana.

Masiku ano, metformin imadziwika kuti ndi mankhwala odziwika bwino kwambiri padziko lonse lapansi. Zalembedwa pa WHO Essential Medicines. Zakhazikitsidwa modalirika kuti kugwiritsa ntchito metformin nthawi zonse kumatha kuchepetsa chiopsezo cha kufa kuchokera ku matenda a mtima omwe amayamba chifukwa cha matenda ashuga. Kafukufuku awonetsa kuti mwa anthu omwe ali onenepa kwambiri komanso omwe ali ndi matenda a shuga a 2, chithandizo chokhala ndi metformin ndichothandiza kwambiri kuposa chithandizo chamankhwala a insulin ndi mankhwala ena othandizira, komanso 40% yothandiza kwambiri kuposa chithandizo chamadokotala okha. Poyerekeza ndi mankhwala ena opatsirana pogwiritsira ntchito mankhwala osokoneza bongo, mankhwalawa amakhala ndi zovuta zochepa, ndipo ma monotherapy ake samayambitsa hypoglycemia, samayambitsa zovuta - lactic acidosis (poyizoni wa magazi ndi lactic acid).

Metformin ndi m'gulu la mankhwala opangira matenda a shuga a mtundu wachiwiri. Mutatenga Metformin, imachepetsa kuchuluka kwa shuga m'magazi, kuchuluka kwa hemoglobin ya glycosylated ndikuwonjezera kulolera kwa glucose m'thupi. Mankhwala alibe carcinogenic katundu, sasokoneza chonde.

Limagwirira ntchito achire zochita za metformin zosiyanasiyana. Choyamba, amachepetsa kupanga shuga m'magazi a chiwindi. Mtundu wachiwiri wa matenda ashuga, kupanga shuga mu chiwindi ndikwambiri kangapo kuposa kwawonso. Metformin imatsitsa chizindikiro ichi ndi wachitatu. Kuchita kumeneku kukufotokozedwa ndi kutsegulidwa kwa michere ya ma enzymes ena a chiwindi, omwe amathandiza kwambiri pakupanga shuga ndi mafuta.

Komabe, limagwirira a metformin kuchepa kwa shuga m'magazi silimangoletsa nkhawa kupangika kwa shuga mu chiwindi. Metformin imakhalanso ndi zotsatirazi mthupi:

• bwino kagayidwe kachakudya njira,
• amachepetsa mayamwidwe m'matumbo,
• bwino magwiritsidwe a shuga mu zotumphukira zimakhala,
• kumawonjezera mphamvu minofu insulin,
• ali ndi fibrinolytic.

Pakakhala insulin m'magazi, mankhwalawa samawonetsa ntchito yake ya hypoglycemic. Mosiyana ndi mankhwala ena ambiri opatsirana, mankhwala a metformin samabweretsa zovuta - lactic acidosis. Kuphatikiza apo, sizikhudza kupanga insulin ndi maselo a kapamba. Komanso, mankhwalawa amatha kuchepetsa kuchuluka kwa cholesterol yoyipa "yoyipa" - lipoproteins yotsika kwambiri (popanda kuchepetsa kuchuluka kwa cholesterol "yabwino" - lipoproteins yapamwamba), kuchepetsa kuchepa kwa mafuta oxidation komanso kupanga mafuta aulere acids. Chofunikira, metformin imakulitsa mphamvu ya insulini kuti ipangitse mapangidwe a minofu yamafuta, chifukwa chake mankhwalawa amatha kuchepetsa kapena kukhazikitsa thupi. Katundu womaliza wa metformin ndi chifukwa chake mankhwalawa amagwiritsidwa ntchito nthawi zambiri ndi omwe akufuna kuchepetsa thupi.

Tiyeneranso kudziwa zabwino zomwe mankhwalawa amakhudzana ndi mtima. Metformin imalimbitsa minofu yosalala ya mitsempha yamagazi, imalepheretsa chitukuko cha matenda ashuga a shuga.

Pharmacokinetics

Mapiritsi, metformin imawonetsedwa ngati hydrochloride. Ndi ufa wopanda utoto wamadzimadzi, wosungunuka kwambiri m'madzi.

Metformin ndi mankhwala osokoneza bongo. Nthawi zambiri, zotsatira zabwino za kumwa zimayamba kuwonekera pambuyo pa masiku 1-2. Munthawi imeneyi, pamakhala kuchuluka kwa mankhwala omwe amakhala m'magazi, mpaka 1 μg / ml. Pankhaniyi, kuchuluka kwa mankhwalawa m'magazi kungawonedwe kale maola 2,5 pambuyo pa kuperekedwa.Mankhwalawa amamangirira kumapulogalamu am magazi. Hafu ya moyo ndi maola 9 mpaka 12. Imapukusidwa makamaka ndi impso zosasinthika.

Anthu omwe ali ndi vuto laimpso amatha kumva kuwonjezeka kwa mankhwala m'thupi.

Chizindikiro chachikulu cha kugwiritsa ntchito mankhwalawa Metformin ndi matenda a shuga a 2. Komanso, matendawa sayenera kuvomerezedwa ndi ketoacidosis. Ndikofunika kuperekera mankhwalawa kwa odwala omwe samathandizidwa ndi zakudya zama carb ochepa, komanso kwa odwala omwe onenepa kwambiri. Nthawi zina, mankhwalawa amatha kugwiritsidwa ntchito limodzi ndi insulin. Komanso, mankhwalawa nthawi zina amatha kuperekedwa kwa matenda osokoneza bongo (matenda ashuga oyambitsidwa ndi pakati).

Mankhwalawa atha kugwiritsidwanso ntchito ngati munthuyo wasokoneza insulin, koma zipatso za shuga zomwe zili m'magazi sizipitilira zotsutsa. Matendawa amatchedwa prediabetesic. Komabe, akatswiri ambiri amakonda kuti panthawiyi, masewera olimbitsa thupi komanso kudya ndizothandiza kwambiri, ndipo mankhwala othandizira odwala matenda a prediabetes siothandiza kwenikweni.

Kuphatikiza apo, mankhwalawa amatha kutumizidwa pamatenda ena, mwachitsanzo, ndi mazira a polycystic, mafupa a chiwindi osagwirizana ndi mowa, kutha msanga. Matendawa amaphatikizidwa chifukwa chakuti ndi iwo mumakhala kusazindikira kwa minofu kuti insulini. Komabe, kugwira ntchito kwa metformin m'matenda awa sikunakhalepo umboni wofanana ndi wa matenda ashuga. Nthawi zina mankhwalawa amagwiritsidwanso ntchito ngati munthu amachepetsa thupi, ngakhale mankhwala ovomerezeka amagwira ntchito ya Metformin modzikayikira, makamaka ngati sitikulankhula za anthu onenepa kwambiri.

Kutulutsa Fomu

Mankhwalawa amapezeka pokhapokha ngati mapiritsi omwe ali ndi Mlingo wa 500 ndi 1000 mg. Palinso mapiritsi okhala ndi mphamvu kwa nthawi yayitali ndi mlingo wa 850 mg, wokutidwa ndi kuphatikiza kwapadera kwa enteric.

Analogue yofunika kwambiri ya metformin yomwe ili ndi chinthu chomwechi ndi Gulcofage wothandizirana ku France. Mankhwalawa amadziwika kuti ndi oyamba, ndipo mankhwala ena onse omwe ali ndi metformin, opangidwa ndi makampani osiyanasiyana opanga mankhwala padziko lonse lapansi - ndi a majini. Mankhwalawa amagawidwa mu mankhwala popanda mankhwala.

Contraindication

Mankhwala ali ndi zingapo zotsutsana:

• mitundu yoopsa ya mtima, kupuma komanso aimpso,
• chiwindi ntchito,
• lakuthwa
• pachimake ubongo
• matenda ashuga ketoacidosis,
• matenda a shuga
• lactic acidosis (kuphatikizapo mbiri ya)
• Matenda ndi mikhalidwe yomwe imabweretsa chiwopsezo cha impso,
• kusowa kwamadzi
• matenda oopsa (makamaka bronchopulmonary ndi aimpso),
• hypoxia
• opaleshoni yayikulu (pankhani iyi, kugwiritsa ntchito insulin kukuwoneka),
• uchidakwa wambiri kapena kuledzera (chiwopsezo cha lactic acidosis),
• kuyesedwa kwa matenda ndikuyambitsa zinthu zokhala ndi ayodini (masiku awiri njirayi isanachitike komanso masiku awiri pambuyo pake),
• Zakudya zama hypocaloric (zosakwana 1000 Kcal patsiku),
• kuchuluka kwa creatinine m'magazi (135 μmol / l mwa amuna ndi 115 μmol / l mwa akazi),
• Matenda a matenda ashuga
• malungo.

Mosamala, mankhwalawa amayenera kuperekedwa kwa okalamba komanso anthu omwe akuchita ntchito yayikulu yochita masewera olimbitsa thupi (chifukwa choonjezera chiopsezo cha lactic acidosis).

Mankhwala ali osavomerezeka kwa odwala osakwana zaka 18, panthawi yoyembekezera komanso mkaka wa m`mawere, ndi kuchuluka kwa chidwi cha mankhwalawa. Nthawi zina, mumatha kugwiritsa ntchito mankhwalawa panthawi yapakati komanso muubwana (wopitilira zaka 10) moyang'aniridwa ndi dokotala.

Malangizo apadera

Ngati chithandizo chikuchitika, ndiye kuti ntchito ya impso iyenera kuyang'aniridwa. Osachepera kawiri pachaka, ndikofunikira kuyang'ana kuchuluka kwa asidi a lactic m'magazi.Ngati kupweteka kwamisempha kumachitika, onani mwachangu kuchuluka kwa lactic acid.

Komanso, kawiri pachaka ayenera kuwunika momwe impso imagwirira (mtundu wa creatinine m'magazi). Izi ndizowona makamaka kwa okalamba.

Ndi monotherapy, mankhwalawa samakhudza dongosolo lamkati lamanjenje, chifukwa chake amatha kugwiritsa ntchito mankhwalawa mwa anthu omwe amayendetsa magalimoto ndikumagwira ntchito yomwe imafunikira chidwi.

Zotsatira zoyipa

Zotsatira zoyipa kwambiri mukamamwa metformin zimakhudzana ndi m'mimba. Nthawi zambiri, mukamamwa mapiritsi, zochitika monga kupweteka pamimba, kusanza, kusanza, kuyamwa kumatha kuonedwa. Kuti mupewe izi, mapiritsi ayenera kumwedwa nthawi yakudya itatha kapena itangotha. Ndizothekanso kuwoneka ngati kulumikizana kwachitsulo mkamwa, kusowa chilakolako chofuna kudya, zotupa pakhungu.

Zotsatira zonse zili pamwambazi sizowopsa. Nthawi zambiri zimachitika kumayambiriro kwa zamankhwala ndikudziyendetsa zokha. Pofuna kupewa zinthu zosasangalatsa zomwe zimakhudzana ndi m'mimba, ma antispasmodics kapena maantacid akhoza kutengedwa.

Osowa kwambiri, mankhwalawa amatha kuyambitsa lactic acidosis, kuchepa kwa magazi m'thupi, hypoglycemia, kuchepa kwa kupanga kwa mahomoni a chithokomiro ndi testosterone mwa amuna. Hypoglycemia nthawi zambiri imachitika ngati mankhwala ena othandizira odwala shuga, mwachitsanzo, sulfonylureas, amatengedwa limodzi ndi metformin. Pogwiritsa ntchito nthawi yayitali, mankhwalawa angayambitse kuchepa kwa vitamini B12.

Zotsatira za Hypoglycemic sizimachotsedwa pakumwa NSAIDs, ACE inhibitors ndi Mao, beta-blockers, cyclophosphamide. Mukamamwa GCS, epinephrine, sympathomimetics, diuretics, mahomoni a chithokomiro, glucagon, estrogens, calcium antagonists, nicotinic acid, m'malo mwake, mphamvu ya mankhwalawa imachepa.

Mankhwala okhala ndi ayodini angayambitse kulephera kwa impso ndikuwonjezera mwayi wa lactic acidosis. Ngati lactic acidosis ikukayikiridwa, kuchipatala kumafunikira.

Malangizo ogwiritsira ntchito

Monga lamulo, kumayambiriro kwa mankhwala, mankhwalawa ayenera kugwiritsidwa ntchito 0.5-1 g kamodzi patsiku. Mlingo uwu uyenera kutsatiridwa kwa masiku atatu. Kuyambira masiku 4 mpaka 14 ndikofunikira kumwa mapiritsi a metformin 1 g katatu patsiku. Ngati kuchuluka kwa shuga kwatsika, mlingo umatha kuchepetsedwa. Monga mlingo wokonza, mapiritsi a metformin ayenera kumwedwa pa 1500-2000 mg patsiku. Pankhani ya mapiritsi okhala ndi nthawi yayitali (850 mg), ndikofunikira kumwa piritsi limodzi kawiri patsiku - m'mawa ndi madzulo.

Mulingo woyenera ndi 3 g (mapiritsi 6 a mankhwalawa, 500 mg aliyense) patsiku. Mu okalamba, kuwonongeka kwa impso ndikotheka, chifukwa chake, pazipita tsiku lililonse sayenera kupitirira 1000 mg (mapiritsi 2 a mankhwala 500 mg aliyense). Sayeneranso kusokoneza chithandizo ndi mankhwalawo, chifukwa chake ayenera kudziwitsa adokotala.

Ndikofunika kumwa piritsi mukangodya ndi madzi ambiri. Kumwa mankhwala mwachindunji ndi chakudya kumachepetsa mayamwidwe ake m'magazi. Mlingo wa tsiku ndi tsiku umalimbikitsidwa kuti ugaledwe mu Mlingo wa 2-3.

Mlingo wa mankhwalawa mukagwiritsidwa ntchito limodzi ndi insulin (pa mlingo wa insulin yochepera 40) tsiku limafanana chimodzimodzi ndi insulin. M'masiku oyamba kumwa metformin, mlingo wa insulin suyenera kuchepetsedwa. Pambuyo pake, mlingo wa insulin ungachepetse. Njirayi iyenera kuchitika moyang'aniridwa ndi dokotala.

Bongo

Metformin ndi mankhwala otetezeka ndipo ngakhale Mlingo wake waukulu (posagwirizana ndi mankhwalawa), monga lamulo, samatsogolera kuchepa koopsa kwa shuga wamagazi. Komabe, ndi mankhwala osokoneza bongo, pali ngozi inanso, yocheperako - kuwonjezereka kwa kuchuluka kwa lactic acid m'magazi, omwe amatchedwa lactic acidosis. Zizindikiro za lactic acidosis ndizopweteka pamimba ndi minofu, kusintha kwa kutentha kwa thupi, kusokonezeka kwa chikumbumtima.Vutoli limapezekapezeka pakalibe chithandizo chamankhwala limatha kubweretsa kumwalira chifukwa chokhala ndi vuto laukoma. Chifukwa chake, ngati pazifukwa zina mankhwala osokoneza bongo amachitika, wodwala amayenera kupita kwa dokotala. Pankhani ya bongo wambiri, symptomatic mankhwala amachitika. Kuchotsa mankhwalawa magazi pogwiritsa ntchito hemodialysis kumathandizanso.

Metformin ndi mankhwala otchuka kwambiri a matenda a shuga a 2, komanso kuwonda komanso kuchiritsa polysystosis a thumba losunga mazira mwa akazi. Imachepetsa shuga yamagazi ndikuthandizira kutaya mapaundi owonjezera osayambitsa zovuta zoyipa. Imachulukitsa moyo, imachepetsa chiopsezo cha matenda a mtima ndi sitiroko, komanso mitundu ina ya khansa. Mapiritsi awa ali ndi mtengo wotsika mtengo, chifukwa amapangidwa ndi masamba ambiri opanga mankhwala omwe amapikisana nawo.

Werengani mayankho a mafunso:

Otsatirawa ndi buku lophunzitsira lolemba m'chinenero chomveka. Dziwani zomwe zikuwonetsa, contraindication, Mlingo, komanso njira yochepetsera kuchepetsa mavuto.

Metformin yokhudza matenda ashuga komanso kuwonda: nkhani yatsatanetsatane

Werengani nawonso malingaliro oleza mtima a momwe metformin imakhudzira impso ndi chiwindi, momwe mapiritsiwo alili osiyana, ndi anzawo aku Russia.

Kodi mankhwalawa amalembedwera chiyani?

Zizindikiro zomwe zimagwiritsidwa ntchito ndi mtundu wa shuga wachiwiri, komanso mtundu wa 1 shuga, wovuta kwambiri chifukwa cha kunenepa kwambiri komanso kukana insulin. Komabe, anthu ambiri amatenga metformin kuti achepetse thupi kuposa kuchiritsa matenda ashuga. Komanso, mankhwalawa amathandizira ndi polycystic ovary syndrome (PCOS) mwa amayi, amawonjezera mwayi wokhala ndi pakati. Kugwiritsa ntchito metformin pakuchepetsa thupi komanso kuwongolera shuga kumafotokozedwa mwatsatanetsatane pansipa.

Mutu wamankhwala a PCOS ndi woposa tsambali. Amayi omwe akumana ndi vutoli, muyenera kupita, kukachita maphunziro akuthupi, kumwa mankhwala ndikutsatira malangizowo. Kupanda kutero, adzakhala ndi mwayi wochepa wokhala ndi pakati komanso chiwopsezo chachikulu chokhala ndi matenda osokoneza bongo a 2 zaka zopitilira 35-40.

Kodi Metformin Ikulitsa Moyo?

Metformin imachulukitsa moyo wa odwala omwe ali ndi matenda a shuga a 2, amachedwa kukulitsa zovuta zawo. Sizinatsimikiziridwebe kale kuti mankhwalawa amathandiza anthu athanzi ndi shuga wabwinobwino wamagazi kuyambira kukalamba. Kafukufuku wovuta pankhaniyi wayamba kale, koma zotsatira zake sizipezeka posachedwa. Komabe, anthu ambiri odziwika ku West adavomereza kuti amavomereza, kuyesera kuti achepetse ukalamba wawo. Adasankha kuti asadikire chitsimikiziro chovomerezeka.

Dokotala wodziwika komanso wowonetsa TV pa TV Elena Malysheva amalimbikitsanso kuti mankhwalawa ndi mankhwala ngati ukalamba.

Oyang'anira tsambali amaganizira za chiphunzitso cholimbikitsa chakuti metformin imachepetsa ukalamba, makamaka kwa anthu onenepa kwambiri. Elena Malysheva nthawi zambiri amafalitsa zinthu zolakwika kapena zachikale. Mankhwala omwe amawauza omwe samalankhula sawathandiza konse. Koma pankhani ya metformin, munthu angavomereze naye. Ichi ndi mankhwala othandiza kwambiri, ndipo popanda zovuta zoyipa, ngati mulibe zotsutsana nawo.

Kodi metformin ingatengedwe kuti ipewe? Ngati ndi choncho, mu milingo iti?

Ngati muli ndi kulemera pang'ono pang'ono, ndizomveka kutenga metformin kuti mupewe, kuyambira zaka zapakati. Mankhwalawa athandizira kuchepa makilogalamu ochepa, kusintha mafuta m'thupi, komanso kuchepetsa ngozi ya matenda ashuga a 2.

Musanayambe kumwa mapiritsi awa, phunzirani mosamala, makamaka magawo pazinthu zotsutsana ndi zoyipa.

Palibe deta yeniyeni pazaka zomwe mungayambe kutenga metformin. Mwachitsanzo, zaka 35 mpaka 40. Kumbukirani kuti chithandizo chachikulu ndi ichi. Mapiritsi aliwonse, ngakhale okwera mtengo kwambiri, amatha kungoonjezera zomwe chakudya chimakhala nacho mthupi lanu. Zakudya zoziziritsa kukhosi ndizowopsa.Palibe mankhwala oyipa omwe angabwezeretse zotsatira zawo zoyipa.

Anthu onenepa amalangizidwa kuti pang'onopang'ono abweretse kuchuluka kwa tsiku ndi tsiku - 2550 mg patsiku kwa mankhwala omwe amapezeka nthawi zonse ndi 2000 mg kwa mapiritsi otulutsidwa (ndi ma analogues). Yambani kumwa 500-850 mg patsiku ndipo musathamangire kuti muwonjezere mlingo kuti thupi likhale ndi nthawi yosinthira.

Tiyerekeze kuti mulibe kulemera kwambiri konse, koma mukufuna kutenga metformin kuti mupewe kusintha komwe kumayenderana ndi zaka. Pankhaniyi, sibwino kugwiritsa ntchito muyeso wokwanira. Yesani 500-1700 mg patsiku. Tsoka ilo, palibe chidziwitso chokwanira pamiyeso yolimbana ndi kukalamba ya anthu ochepa thupi.

Kodi ndimwe mankhwalawa kuti ndikhale ndi prediabetes?

Inde, metformin imakuthandizani ngati mukunenepa kwambiri, makamaka mafuta osunga pamimba komanso m'chiuno. Kuchiza ndi mankhwalawa kumachepetsa mwayi woti prediabetes isanduke mtundu 2 shuga.

Muyenera kutenga metformin kuti muchepetse thupi malinga ndi malingaliro omwe afotokozedwa patsamba lino, ndikuwonjezereka pang'onopang'ono kwa mlingo watsiku ndi tsiku. Werengani mosamala ndikuonetsetsa kuti mulibe zotsutsana ndi kugwiritsa ntchito chida ichi. Ndikofunika kubwerezanso kuti mafuta a hepatosis sikuti akuphwanya.

Kodi mungachepetse makilogalamu angati kuchokera ku metformin?

Mutha kuyembekezera kutaya makilogalamu 2-4 ngati simusintha kadyedwe kanu komanso kuchuluka kwa zolimbitsa thupi. Zitha kukhala mwayi kuti muchepetse kulemera kochulukirapo, koma palibe malonjezo.

Tikubwerezanso kuti metformin ndi mankhwala okhawo omwe amathandizira kuchepetsa thupi popanda kuvulaza thanzi. Ngati pakadatha masabata asanu ndi limodzi atatha kumwa, sizotheka kuthana ndi mapaundi owonjezera owerengeka - ambiri, munthu amakhala ndi kuchepa kwa mahomoni a chithokomiro. Yesani kuyezetsa magazi kwa mahomoni onsewa, osaperekedwa ndi TSH. Chofunikira kwambiri ndi T3 yaulere. Kenako funsani ndi endocrinologist.

Mwa anthu omwe amasinthira, zotsatira za kuchepa thupi zimakhala bwino. Ambiri mwa malingaliro awo amalemba kuti adatha kutaya 15 kg kapena kupitirira. Muyenera kumwa metformin mosalekeza kuti muzisunga zotsatira zomwe mwakwaniritsa. Mukasiya kumwa mapiritsi awa, ndiye kuti gawo lina la mapaundi owonjezera ayenera kubwerera.

Elena Malysheva adapangitsa kuti metformin ikhale yotchuka ngati machiritso aukalamba, koma samalimbikitsa monga njira yothandizira kunenepa kwambiri. Amalimbikitsa makamaka kudya kwake kuti achepetse thupi, osati mapiritsi ena ake. Komabe, chakudyachi chili ndi zakudya zambiri zomwe zimadzaza ndi chakudya chamafuta. Amachulukitsa kuchuluka kwa insulin m'magazi motero amalepheretsa kuchepa kwamafuta mthupi.

Zambiri pazamankhwala a shuga ndi kuwonda, zomwe zimagawidwa ndi Elena Malysheva, ndizambiri zomwe sizolondola.

Momwe mungasinthire metformin ngati sichithandiza matenda ashuga kapena amayambitsa matenda am'mimba?

Metformin siivuta kusinthana ndi china chake, ndimankhwala ambiri mwanjira zosiyanasiyana. Popewa kutsekula m'mimba, muyenera kumwa mapiritsi ndi chakudya, kuyamba ndi mlingo wotsika tsiku ndi tsiku ndikuwonjezera pang'onopang'ono. Mutha kuyesanso kwakanthawi kusintha kuchokera pamapiritsi a nthawi zonse kupita ku mankhwala omwe akhala akuchita kwa nthawi yayitali. Ngati metformin sichepetsa shuga m'magazi konse - ndikotheka kuti wodwalayo ali ndi matenda a shuga a 2 apamwamba kwambiri, omwe adasanduka mtundu 1 wa shuga. Pankhaniyi, muyenera kuyamba jekeseni insulin, palibe mapiritsi omwe angakuthandizeni.

Mu odwala matenda ashuga, metformin nthawi zambiri imatsitsa shuga, koma sikokwanira. Pankhaniyi, iyenera kuphatikizidwa ndi jakisoni wa insulin.

Kumbukirani kuti anthu owonda nthawi zambiri samatha kumwa mapiritsi a shuga. Afunika kusinthira ku insulin nthawi yomweyo. Kukhazikitsidwa kwa mankhwala a insulin ndi vuto lalikulu, muyenera kumvetsetsa. Nkhani zophunzira za insulin patsamba lino, funsani ndi dokotala. Choyamba, pitani. Popanda icho, kudziletsa pazabwino ndikosatheka.

Metformin (dimethylbiguanide) - wothandizira antidiabetic wogwiritsa ntchito mkati, omwe ali mgulu la biguanides. Kugwiritsa ntchito bwino Metformin Zokhudzana ndi kuthekera kwazinthu zogwira ntchito poletsa shuga m'magazi. The yogwira thunthu linalake ndipo tikulephera mayendedwe a ma elekitironi a kupuma maukonde a mitochondria. Izi zimapangitsa kuchepa kwa kuchuluka kwa ATP mkati mwa maselo ndi kukondoweza kwa glycolysis mwa njira yopanda mpweya. Zotsatira zake, glucose amatenga maselo kuchokera kumalo akunja kumawonjezereka, ndipo kupanga kwa lactate ndi pyruvate mu chiwindi, matumbo, adipose ndi minofu minofu kumakulanso. Malo ogulitsa a glycogen m'maselo a chiwindi amachepa. Sizimayambitsa zotsatira za hypoglycemic, chifukwa siziyambitsa kupanga insulin.

Imachepetsa njira zamafuta oxidation ndikuletsa zoletsa zamafuta a mafuta. Poyerekeza ndi momwe mankhwalawo amagwiritsidwira ntchito, mankhwalawo amasintha chifukwa cha kuchepa kwa insulin. Kuwonjezeka kwa kuchuluka kwa insulin / proinsulin kumadziwikanso. Chifukwa cha mapangidwe a momwe mankhwalawo amathandizira, pali kuchepa kwa shuga mu seramu yamagazi atadya chakudya, chizindikiro chachikulu cha shuga chimachepetsedwa. Chifukwa chakuti mankhwalawa samalimbikitsa kupangika kwa insulin ndi maselo a kapamba, zimayimitsa hyperinsulinemia, yomwe imawerengedwa kuti ndi imodzi mwazofunikira kwambiri pakuwonjezera kulemera kwa thupi mu shuga komanso kukula kwa zovuta zam'mimba. Kutsika kwa shuga m'magazi kumachitika chifukwa cha kuyamwa kwa glucose ndi maselo amisempha komanso kuwonjezeka kwa zotumphukira za insulin receptors. Mwa anthu athanzi (opanda matenda ashuga) mukamamwa metformin, kuchepa kwa shuga sikumawonedwa. Metformin imathandizira kuchepetsa thupi kunenepa kwambiri komanso matenda a shuga mwa kupondereza chilakolako cha chakudya, kuchepetsa kuyamwa kwa shuga m'zakudya ndi m'mimba thirakiti komanso kumalimbikitsa anaerobic glycolysis.

Metformin imakhalanso ndi vuto la fibrinolytic chifukwa cha kuletsa kwa PAI-1 (minofu mtundu wa plasminogen activator inhibitor) ndi t-PA (minitsi plasminogen activator).
Mankhwala amathandizira njira ya biotransfform ya glucose mu glycogen, imayendetsa magazi m'magazi a chiwindi. Katundu wa Hypolipidemic: amachepetsa mulingo wa LDL (otsika kachulukidwe lipoproteins), triglycerides (ndi 10-20% ngakhale ndikuwonjezeka koyambirira kwa 50%) ndi VLDL (otsika kwambiri a lipoproteins). Chifukwa cha zotsatira za metabolic, metformin imayambitsa kuwonjezeka kwa HDL (high density lipoproteins) ndi 20-30%.

Mankhwala tikulephera kukula kwa yosalala minofu zinthu za chotengera khoma. Imakhala ndi phindu pa mtima komanso kupewa matenda a matenda ashuga.

Pambuyo pakukonzekera kwa pakamwa, pazomwe zimakhala pazomwe zimagwira ntchito zimafikira m'magazi pambuyo pa maola 2,5. Odwala omwe adalandira mankhwalawa pazambiri zovomerezeka, zomwe zili kwambiri m'magazi a plasma sizinadutse 4 /g / ml. Patatha maola 6 mutamwa mapiritsi, kuyamwa kwa zinthu zomwe zimagwirizana ndi mankhwalawo kumatha, komwe kumayendetsedwa ndi kuchepa kwa plasma ndende metformin . Mukamamwa mankhwalawa pambuyo pa masiku awiri ndi awiri, kutsata kwa metformin kumapezeka m'magazi mkati mwa 1 μg / ml kapena kuchepera.

Ngati mumwa mankhwalawa mukudya chakudya, ndiye kuti pali kuchepa kwa mayamwidwe a metformin kuchokera ku mankhwalawa. Metformin imapangidwa makamaka m'makoma a chimba cham'mimba: yaying'ono ndi duodenum, m'mimba, komanso tiziwalo tating'ono ndi chiwindi. Hafu ya moyo ili pafupifupi maola 6.5. Ndi kugwiritsa ntchito kwamkati kwa metformin, kutsimikizira kwathunthu mwa anthu athanzi kuli pafupifupi 50-60%. Pang'onopang'ono mapuloteni a plasma.Kugwiritsa ntchito secretion ya tubular ndi kusefera kwa glomerular, imakumba impso kuyambira 20 mpaka 30% ya mlingo womwe umayendetsedwa (osasinthika, chifukwa, mosiyana ndi formin, sunapangidwe). Mu vuto la impso, kutsekeka kwa impso kumatsika molingana ndi kupezeka kwa creatinine, chifukwa chake, kuchuluka kwa plasma ndi theka la moyo wa metformin kuwonjezeka kuchokera mthupi, zomwe zingayambitse kudzikundikira kwa chinthu chogwira ntchito mthupi.

Njira yogwiritsira ntchito

Kuvomerezedwa kwa mankhwala ndi okalamba kumachitika pokhapokha poyerekeza ndi kuwunika kwa impso.
Zochizira zathunthu zimachitika pakatha masabata awiri mutamwa mankhwalawa.

Ngati muyenera kupita Metformin ndi wothandizila pakamwa wina wa hypoglycemic, ndiye kuti mankhwala am'mbuyomu ayenera kusiyidwa, kenako yambani ndi Metformin mkati mwa mlingo woyenera.

Ndi kuphatikiza kwa insulin ndi Metformin, mulingo wa insulin sunasinthidwe mu masiku 4- 6. M'tsogolomo, ngati pakufunika kutero, mlingo wa insulin umachepetsedwa - masiku angapo otsatirawa ndi 4-8 IU. Ngati wodwala alandila insulini yoposa 40 IU patsiku, ndiye kuti kuchepetsa kwa mankhwalawa pogwiritsa ntchito Metformin kumachitika kokha kuchipatala, chifukwa amafunika chisamaliro chachikulu.

Kuchita ndi mankhwala ena

Angiotensin-converting factor inhibitors, β2-adrenergic antagonists, monoamine oxidase inhibitors, cyclophosphamide derivatives and cyclophosphamide itself, clofibrate derivatives, non-steroidal anti-yotupa mankhwala ndi oxytetracycline ingayambitse Hypoglycemic zotsatira za Metformin. Kugwiritsa ntchito kwa intravenous kapena intraarterial kwa ogwiritsa ntchito ayodini chifukwa cha maphunziro a x-ray kungayambitse kulephera kwa impso, chifukwa chomwe Metformin imayamba kudziunjikira, zomwe zimawonjezera chiopsezo cha lactic acidosis. Mankhwala amayimitsidwa isanayambike, patapita masiku awiri pambuyo pa maphunziro a X-ray omwe ali ndi mitsempha ya makina osiyanitsa omwe ali ndi ayodini. Pambuyo pa izi, chithandizo cha Metformin sichitha kubwezeretsedwanso mpaka ntchito ya impso itayesedwanso ngati yabwinobwino.

Neuroleptic chlorpropamazine mu Mlingo waukulu umakulitsa shuga wa seramu ndipo umalepheretsa kutulutsidwa kwa insulin, komwe kungapangitse kuwonjezeka kwa mlingo wa Metformin (womwe umachitika motsogozedwa ndi seramu glucose).
Kuphatikiza kwa danazol ndi Metformin , popeza hyperglycemia ndiyotheka. Amiloride, morphine, quinine, vancomycin, quinidine, cimetidine, triamteren, ranitidine, procainamide, nifedipine (komanso calcium calcium inhibitors), trimethoprim, femotidine ndi digoxin amawonetsedwa ndi aimpso tubules. Ndi kugwiritsidwa ntchito kofananako kwa Metformin, amatha kupikisanapo kayendedwe ka ma tubular, kotero ndikugwiritsa ntchito nthawi yayitali amachititsa kuchuluka kwa plasma ndende yogwira mankhwala ndi 60%.

Guar ndi cholestyramine amalepheretsa kuyamwa kwa ntchito kwa mapiritsi a Metformin, omwe amatsagana ndi kuchepa kwake.

Mankhwalawa amayenera kumwedwa patangopita maola ochepa kuchokera pakukhazikitsidwa Metformin . Mankhwalawa amathandizira zotsatira za anticoagulants amkati mwa gulu la coumarin.

Zosankha

Kulembera mapiritsi kwa odwala azaka zapakati pa 60 ndi kupitilira apo sikulimbikitsidwa ngati agwira ntchito zolimba. Izi zingayambitse lactic acidosis. Milingo ya Serum creatinine iyenera kutsimikiziridwa musanachiritsidwe komanso pafupipafupi pakumwa (kamodzi pachaka pamlingo woyenera). Ngati mulingo woyambirira wa creatinine unali wopitilira wabwinobwino kapena pamlingo wapamwamba, ndiye kuti pafupipafupi ma phunziroli limakhala lambiri kawiri ndi chaka.Okalamba akhoza kukhala ndi asymptomatic course of re impuff kulephera, chifukwa chake, amathandizanso kuchuluka kwa creatinine 2-4 pachaka.
Ndi onenepa kwambiri, muyenera kutsatira zakudya zopatsa thanzi.

Mukumwa mankhwalawa, odwala ayenera kutsatira zakudya zomwe zimayikidwa payekha, zomwe zimawerengera kagawidwe kazakudya kabwino tsiku lililonse. Poyamba kumwa ma diuretics, mankhwala osapweteka a antiidal komanso mankhwala a antihypertensive, pakhoza kukhala zovuta monga kulephera kwa impso. Mwa odwala, Metformin iyenera kugwiritsidwa ntchito mosamala pokhudzana ndi kuwonongeka kwa impso.
Pambuyo pakuchita opaleshoni, mankhwala othandizira amapangidwanso pambuyo masiku awiri. Nthawi iyi isanachitike, Metformin sayenera kumwedwa. Mayeso amtundu wa Laborator owunikira njira ya shuga amachitika mosamala komanso pafupipafupi, kuwonera kwakanthawi.

Kodi ndingatenge metformin popanda kufunsa dokotala?

Mankhwala a Metformin amagawidwa ku mankhwala osokoneza bongo popanda mankhwala, kotero munthu amatha kuwagula osakacheza ndi dokotala kale. Musanayambe kugwiritsa ntchito mankhwalawa, muyenera kuwonetsetsa kuti wodwala alibe zotsutsana ndi ntchito yake. Ndikofunika kuyesa magazi chifukwa cha ichi. Ikuthandizani kuti muwone momwe chiwindi ndi impso zimayendera. Kuyesedwa koteroko kumayenera kuchitika kamodzi kamodzi m'miyezi 6. Ndikofunikanso kuwongolera kuchuluka kwa cholesterol m'magazi komanso kuchuluka kwa kuthamanga kwa magazi, zomwe zimapangitsa kuti pakhale zovuta zodwala zamtima.

Mlingo wa metformin wokwanira tsiku ndi tsiku ndi zingati?

Onse ochepetsa thupi komanso pochiza matenda amtundu wa 2 wodwala, wodwalayo amapatsidwa 2550 mg wa metformin tsiku lililonse. Pankhaniyi, munthu ayenera kumwa mapiritsi atatu a mankhwalawa katatu patsiku. Mlingo wa mankhwalawa ndi 850 mg.

Ngati mankhwala omwe atulutsidwa nthawi yayitali atagwiritsidwa ntchito pochiza, ndiye kuti mlingo wambiri tsiku lililonse ndi 2000 mg. Kuti muchite izi, imwani mapiritsi 4 a 500 mg a mankhwala Glucofage kale musanagone.

Mlingo woyamba wa mankhwalawa ukhale wocheperako: 500 kapena 850 mg. Kenako, kutsatira momwe thupi limagwirira ntchito, mlingo wake umakulitsidwa pang'onopang'ono. Kuyenda pang'onopang'ono kumalepheretsa kukula kwa zovuta m'mimba.

Ngati munthu angaganize kutenga metformin kuti achepetse moyo wobwera, ndikulimbikitsidwa kusunga mlingo wa 500-1700 mg patsiku, koma osatinso.

Kodi zotsatira zake zimatenga nthawi yayitali bwanji?

Metformin yokhala ndi nthawi yayitali imagwira ntchito kwa maola 8-9. Mapiritsi a metformin amchikhalidwe amakhalabe ndi zotsatira zosaposa maola 6. Ngati mlingo wotsatira watengedwa kumwa mankhwala asanachitike, musadandaule. Sizowononga thanzi. Ndikofunika kuonetsetsa kuti palibe mankhwala osokoneza bongo omwe amachitika. Pachifukwa ichi, mankhwalawa sayenera kumwedwa mopitirira muyeso wa tsiku lililonse.

Kodi metformin ikhoza kuphatikizidwa ndi ma statins?

Metformin imatha kutengedwa ndi ma statins, omwe amathandiza kuchepa kwa mafuta m'thupi. Ngati nthawi yomweyo munthu amatsatira zakudya, ndiye kuti zidzatha kutulutsa mafuta a cholesterol okha, komanso triglycerides ndi mgwirizano wa atherogenicity. Komanso, kudya metformin ndikudya chakudya kwakanthawi kumatha kukulolani kusiya kumwa. Menyu wokhala ndi zopatsa mphamvu zamagalimoto ambiri umakupatsani mwayi kuti muchotse madzi ochulukirapo m'thupi, muchotse edema, komanso magazi ochepa. Chifukwa chake, madokotala amalimbikitsa pang'onopang'ono kuchepetsa Mlingo wa mankhwalawa zochizira mtima, kenako mutha kuzisiyiratu. Ndizotheka kuti zitha kuyimitsa mankhwalawa ndi mankhwala okodzetsa.

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwalawa ali ngati mapiritsi, omwe amaphatikizidwa ndi nembanemba wamafilimu.500 mg ndi 850 mg mapiritsi amapangidwa. Chotumphukacho chimatha kukhala ma PC 30 kapena 120.

• Kapangidwe ka mankhwala kamakhala ndi gawo la metformin, komanso zinthu zina: wowuma, magnesium stearate, talc.

Gulu la zamankhwala ndi mankhwala: pakamwa hypoglycemic mankhwala.

Kodi chimathandiza metformin ndi chiani?

Amalembera achikulire omwe ali ndi matenda a shuga amtundu 1 ndi mtundu 2. Metformin imagwiritsidwa ntchito ngati chowonjezera kuchithandizo chachikulu ndi insulin kapena mankhwala ena a antidiabetic, komanso mawonekedwe a monotherapy (a mtundu 1 shuga mellitus amagwiritsidwa ntchito pokhapokha ndi insulin.

Zotsatira za pharmacological

Metformin imalepheretsa gluconeogenesis m'chiwindi, amachepetsa kuyamwa kwa m'matumbo, imakulitsa kugwiritsidwa ntchito kwa glucose, komanso kumakulitsa chidwi cha minofu kulowa insulin. Sichikukhudzana ndi kubisika kwa insulin ndi ma cell a beta, sikuti kumayambitsa kutengeka kwa hypoglycemic.

Amachepetsa mulingo wa ma triglycerides ndi ma linoprotein otsika m'magazi. Imakhazikika kapena kuchepetsa thupi. Ili ndi fibrinolytic mwina chifukwa chokakamira minofu ya plasminogen activator inhibitor.

Dzinalo Losayenerana

Mapiritsi, 500 mg, 850 mg ndi 1000 mg

Piritsi limodzi la 500 mg lili:

ntchito yogwira : metformin hydrochloride - 500 mg.

muobwera : microcrystalline cellulose, croscarmellose sodium, madzi oyeretsedwa, povidone (polyvinylpyrrolidone), magnesium stearate.

Piritsi limodzi la 850 mg lili:

ntchito yogwira : metformin hydrochloride - 850 mg.

Piritsi limodzi la 1000 mg lili:

yogwira chinthu: metformin hydrochloride - 1000 mg.

auxmachiritso zinthu: cellcrystalline cellulose, croscarmellose sodium, madzi oyeretsedwa, povidone (polyvinylpyrrolidone), magnesium stearate.

Mapiritsi 500 mg - mapiritsi ozungulira ozungulira amiyala yoyera kapena pafupifupi oyera okhala ndi chiopsezo mbali imodzi ndi chamfer kumbali zonse ziwiri.

Mapiritsi 850 mg, 1000 mg - mapiritsi a oic biconvex amtundu woyera kapena pafupifupi woyera wokhala ndi chiopsezo mbali imodzi.

Mankhwala

Pambuyo pakukonzekera pakamwa, metformin imatengedwa kuchokera kumimba kwathunthu. Mtheradi bioavailability ndi 50-60%. The ndende yambiri (Cmax) (pafupifupi 2 μg / ml kapena 15 μmol) mu plasma imatheka pambuyo maola 2,5.

Ndi kuyamwa kwa munthawi yomweyo, kuyamwa kwa metformin kumachepetsedwa ndikuchedwa.

Metformin imagawidwa mwachangu mu minofu, sikuti imagwira mapuloteni a plasma. Amapangidwira pamlingo wofooka kwambiri ndikuwonetsa impso. Kuvomerezeka kwa metformin m'maphunziro abwino ndi 400 ml / mphindi (kuchulukitsa kanayi kuposa kutulutsa chilolezo cha creatinine), zomwe zikuwonetsa kukhalapo kwa secalic secretion. Hafu ya moyo ndi pafupifupi maola 6.5. Ndi kulephera kwa aimpso, zimachulukana, pamakhala chiopsezo cha kukopeka kwa mankhwalawa.

Metformin imachepetsa hyperglycemia popanda kutsogola kukula kwa hypoglycemia. Mosiyana ndi zomwe zimachokera ku sulfonylurea, sizimalimbikitsa insulin komanso sizikhala ndi vuto pakati pa anthu athanzi. Zimawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikugwiritsa ntchito shuga ndi maselo. Amalepheretsa gluconeogenesis m'chiwindi. Iachedwetsa kuyamwa kwa mafuta m'matumbo. Metformin imalimbikitsa kapangidwe ka glycogen pochita glycogen synthase. Kuchulukitsa kuchuluka kwa mayendedwe amtundu uliwonse wa ma membrane glucose.

Kuphatikiza apo, imakhala ndi phindu pa metabolidi ya lipid: imachepetsa zomwe zimakhala ndi cholesterol yathunthu, lipoproteins yotsika komanso triglycerides.

Ngakhale mutamwa metformin, thupi la wodwalayo limakhalabe lolimba kapena limatsika pang'ono.

Zizindikiro zogwiritsidwa ntchito

Type 2 shuga mellitus, makamaka kwa odwala omwe ali ndi kunenepa kwambiri, komanso kulephera kwamankhwala othandizira kudya komanso zochitika zolimbitsa thupi:

Akuluakulu, monga monotherapy kapena kuphatikiza ena othandizira pakamwa hypoglycemic, kapena ndi insulin,

Mu ana kuyambira zaka 10 monotherapy kapena osakaniza insulin.

Ntchito yoyesera

Posachedwa, Metformin yakhala ikugwiritsidwa ntchito kwambiri pakumayesa matenda am'mimba a polycystic, matenda osokoneza bongo a mafuta osokoneza bongo, kutha msanga ndi matenda ena okhudzana ndi insulin kukana, monga acromegaly, hypercorticism.

Palibe zambiri zenizeni komanso lingaliro la sayansi pazokhudza Metformin pamatenda omwe atchulidwa pamwambapa, madokotala ena amati pambuyo pakupereka Metformin, kuchuluka kwa glucose ndi insulin kumachepa, koma izi sizokwanira kuphatikiza mankhwalawo mu protocol yovomerezeka pakuchiza matendawa.

Metformin ya polycystic ovary yochizira kukondoweza kwa ovulation imakhalabe yosavomerezeka, chifukwa maphunziro ambiri pazokhudza kubereka apeza zotsatira zolakwika zingapo. Madokotala ena, omwe amagwiritsa ntchito Metformin pa polycystic ovary ndi sekondale ya shuga, amawona kuwonjezeka kwa amayi omwe akutenga Metformin, mosiyana ndi omwe satero. Komabe, clomiphene kale amagwiritsidwa ntchito polimbikitsa ovulation.

MD Anderson Cancer Center adachita kafukufuku wamkulu yemwe adawonetsa zotsatira za Metformin popewa khansa ya kapamba. Zotsatira za phunziroli zidawonetsa kuti 62% yochepetsa chiopsezo chokhala ndi khansa ya kapamba mwa otenga nawo mbali omwe adatenga Metformin poyerekeza ndi gulu la odwala omwe sanatenge. Izi zidapangitsa kukhazikitsidwa kwa kafukufuku watsopano komanso kukhazikitsa pulogalamu yoletsa khansa ya kapamba.

Kutenthetsa kwa Metformin

Masiku ano, anthu ambiri onenepa kwambiri komanso onenepa kwambiri popanda matenda ashuga amatenga Metformin ngati njira yochepetsera kunenepa. Pali njira ina yothandizira ndi Metformin kuti muwotche thupi kwambiri. Endocrinologists samalangiza wodwala wawo kuti atenge Metformin popanda matenda a shuga komanso kuchepa kwa chidwi cha maselo kuti apange insulin. Malangizo ogwiritsira ntchito lembani za izi. Koma nthawi zambiri, odwala amachita izi popanda kufunsa dokotala. Izi ndizoyipa kwambiri.

Kulephera kutsatira zakudya zoyenera ndi shuga wambiri, osazindikira kuchuluka kwa mankhwalawa kumatha kubweretsa zovuta zambiri, izi ndizo. Kachiwiri, zikuwonetsedwa kuti Metformin sikukhudza kuchuluka kwa shuga m'magazi athanzi, zomwe zikutanthauza kuti chinthu chokhacho chothandiza kuchepetsa kuchuluka kwamafuta ndizomwe zingagwire ntchito pamenepa.

Metformin yochepetsa thupi, makamaka popanda mankhwala a dokotala, imatsutsana.

Dokotala amatha kupereka mankhwala pokhapokha ngati ali ndi matenda a prediabetes kapena insulin. Koma ngakhale zili choncho, kudya ndi kuchita masewera olimbitsa thupi ndizothandiza kwambiri kuposa mankhwala omwe Metformin ali. Malangizo ogwiritsira ntchito samalongosola momwe mankhwalawa amathandizira kuchepetsa thupi.

Zizindikiro ndi kuopsa kwa bongo

Mankhwala osokoneza bongo a Metformin ndi osowa kwambiri. M'mabukuwo, mutha kupeza tanthauzo limodzi lokha mukamamwa mankhwalawa 75g. Nthawi yomweyo, kuchuluka kwa shuga sikunasinthe, koma lactic acidosis inayamba - mkhalidwe wowopsa kwambiri momwe mulingo wa lactate m'magazi umakwezeka kuposa 5 mmol / l. Zizindikiro zoyambira zitha kukhala:

• chizungulire
• mutu mpaka isanayambike migraine,
• malungo
• zosokoneza pakupuma
• nseru
• kusanza
• kutsegula m'mimba
• kupweteka m'mimba
• spasms m'minyewa ya miyendo.

Milandu ingapo ikhoza kubweretsa kukhazikitsidwa kwa chikomokere ndi kufunika kolumikizana ndi mpweya wabwino.

Ngati muli ndi zizindikiro zotere, ndikofunikira kuchipatala wodwalayo mwachangu ndikuyesa mayeso onse ofunikira omwe akuwonetsa kuchuluka kwa lactate, pyruvate ndi kuchuluka kwake m'magazi.

Pochotsa Metformin mwachangu mthupi, ndibwino kugwiritsa ntchito hemodialysis.

Metformin pa mimba ndi mkaka wa m`mawere

Pa nthawi yoyembekezera, Metformin imatsutsana kwambiri. Itha ndipo iyenera kutengedwa asanatenge pakati azimayi omwe ali ndi matenda amtundu wa 2 komanso kunenepa kwambiri kuti achulukitse chiopsezo chotenga pakati komanso kuwonda, koma mankhwalawo amayenera kusiyidwa pakakhala pakati. Madokotala ambiri amapereka Metformin panthawi yoyamba trimester, koma izi zimakhala ndi zovuta za mwana wosabadwayo.

Pambuyo pake, ana omwe amayi awo adatenga Metformin panthawi yoyembekezera amakhala pachiwopsezo chotenga kunenepa kwambiri ndi matenda a shuga. Chifukwa chake, zimatsimikiziridwa kuti mkazi ayenera kutenga Metformin panthawi yokhayo pokhapokha pakufunika komanso kusowa kwina kwa mankhwala ena.

Pokonzekera kukhala ndi pakati, Metformin adalandira ulemu wokhala "wofunikira" pakati pa azimayi omwe ali ndi shuga, onenepa kwambiri komanso ovomereza. Amayi onenepa kwambiri amatha kuvutika ndi kubereka. Metformin imathandizira thupi kugawa glucose ndikuchepetsa kuchuluka kwamafuta acid, mwakutero imakhazikitsa chiyambi cha mahomoni ndikubwezeretsanso masiku oyenera a kusamba.

Mukamayamwa, ndikofunikira kuyimitsa kugwiritsa ntchito Metformin.

Metformin ya ana

M'zaka za m'ma 1900, matenda ashuga amtundu wa II mwa ana ndi achinyamata adayamba kuchuluka. Komanso, matendawa samapitirira ana amitundu ndi magulu osiyanasiyana. Ana padziko lonse lapansi amakonda kunenepa kwambiri ndipo amachepetsa mphamvu ya minofu ku insulin. Posachedwa, mapulogalamu ambiri apangidwa kuti asamachiritse ana mankhwala omwe ali ndi matenda osokoneza bongo a insulin, omwe amaphatikizapo kudya moyenera komanso kuchita masewera olimbitsa thupi. Komabe, ochulukirapo akuyenera kugwiritsa ntchito mankhwalawa. Moyo wamtopola komanso kudya mopanda thanzi wokhala ndi shuga ndi mafuta zinapangitsa kuti matendawa athe.

Metformin poyamba adalakwika mwa ana osakwana zaka 15. Pambuyo pa kafukufuku waposachedwa ndi madokotala aku America, momwe ana ndi achinyamata azaka zapakati pa 10-16 amatenga Metformin kwa masabata 16, kuchepa kwakukulu kwa asidi wamafuta am'magazi m'magazi, kuchepa kwa milingo yaopoproteins otsika kwambiri komanso otsika kwambiri, komanso triglycerides, ndi kuwonda. Zina mwazotsatira zoyipa, kapena hypoglycemia kapena lactic acidosis sizinawoneke, zochitika zosowa mwanjira ya nseru kapena kutsekula m'mimba sizinakhudze zotsatira za phunziroli.

Ubwino wogwiritsa ntchito Metformin muubwana watsimikiziridwa, kuyambira zaka 10 popanda zovuta zazikulu, koma ndi zotsatira zabwino komanso mtsogolomo kuti mutsirize kuyang'anira matenda ashuga ndikuchepetsa mlingo wocheperako ndi kuthekera kwa kuimitsidwa kwake.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito Metformin monga monotherapy sikuti kumabweretsa hypoglycemia, koma kuyenera kuphatikizidwa mosamala ndi sulfonylurea ndi insulin.

Zinthu zina zimatha kuchepetsa kuchuluka kwa Hypoglycemic kwa Metformin ndikulephera kuchiza: mahomoni a steroid, mahomoni a chithokomiro, glycogen, adrenaline ndi zina zomwe zimapangitsa kuti ma receptor amanjenje am'magazi azidziwitso, mahomoni ogonana achikazi (estrogen ndi progesterone), zotumphukira za nicotinic acid, diuretics, thiazide.

Kugwiritsa ntchito Metformin ndi mowa kumatsutsana, chifukwa ethanol imatha kuyambitsa lactic acidosis kuphatikiza ndi Metformin. Kutsatira mfundo zomwezi, kukonzekera konse kokhala ndi ethanol sikololedwa pamodzi ndi metformin. Lactic acidosis imatha kupangitsanso kugwiritsidwa ntchito kwa ayodini okhala ndi ayodini ndi Metformin. Njira zina zofufuzira sizingachite popanda kukhazikitsa kusiyanitsa ndi ayodini, mwanjira iyi ndikofunikira, Metformin iyenera kuchotsedwa kwa maola 48 isanachitike komanso itatha.

Odwala omwe amatenga chlorpromazine adzafunika kuchuluka kwa Metformin.Izi ndichifukwa choti chlorpromazine mu waukulu Mlingo umalepheretsa insulin.

Milk acidosis imatha kuchitika ngati Metformin ikuphatikizidwa ndi cimetidine.

Metformin ndi Vitamini B12

Vitamit B12 kapena cyanocobalomin ndi chinthu chofunikira pa hematopoiesis ndi magwiridwe amanjenje; chifukwa chake, mapuloteni amapangidwa m'thupi.

Amaganiza kuti kugwiritsa ntchito Metformin kwa nthawi yayitali, mankhwalawa amasokoneza mayamwidwe mu ileamu ya vitaminiyu, zomwe zimapangitsa kutsika pang'ono m'magazi mwake. Mu chaka chachisanu chovomerezedwa, mulingo wa B12 umatsika ndi 5% pachaka cha 13 - ndi 9.3%.

Ndizofunikira kudziwa kuti kuchepa kwa 9% sikumabweretsa hypovitaminosis komanso kukula kwa hemolytic anemia, koma kumawonjezera chiopsezo chamtsogolo.

Kusowa kwa B12 kumapangitsa kuti magazi azikhala ndi hemolytic anemia, zomwe zikutanthauza kuti maselo ofiira am'magazi amakhala osalimba ndikukangana mkatikati mwa magazi. Izi zimabweretsa kukula kwa magazi m'thupi komanso jaundice. Khungu ndi minyewa yakhungu imakhala yachikasu, wodwalayo amadandaula za kufooka, pakamwa pouma, dzanzi la miyendo ndi mikono, chizungulire, kulephera kudya, komanso kusowa kwa mgwirizano.

Kuti mudziwe kuchuluka kwa vitamini B12, muyenera kuyezetsa magazi kuti muwone mawonekedwe ndi kukula kwa maselo ofiira amwazi. Ndi B12 akusowa hemolytic anemia, maselo ofiira am'magazi amakhala okulirapo kuposa momwe amakhalira ndi nyukiliya, kuchepa kwa magazi kumawonetsedwa, ndipo bilirubin yopanda malire idzachulukitsidwa pakuwunika kwa magazi.

Ndikofunikira kupanga chifukwa chosowa vitamini B12 mukamatenga Metformin. Dokotala wanu angakupatseni mankhwala othandizira ndi mavitamini.

Kuchitika moseketsa komanso komveka, koma chithandizo cha kuchepa kwa B12 kumene kumachitikanso ndikupereka vitamini, kokha m'mitsempha.