Malangizo ogwiritsira ntchito mankhwala osokoneza bongo, analogi, ndemanga

Metformin hydrochloride ndi ufa wopanda utoto kapena loyera, womwe umasungunuka kwambiri m'madzi ndipo umakhala wochepa mu ether, acetone, chloroform, umakhala ndi kulemera kwa 165.63. Metformin hydrochloride ndi mankhwala amkamwa a hypoglycemic ochokera pagulu la Biguanide. Metformin hydrochloride imatsitsa mulingo wa hyperglycemia, pomwe sikupangitsa kuti hypoglycemia ipangidwe. Metformin hydrochloride ilibe vuto la hypoglycemic ndipo simalimbikitsa kubisalira kwa insulin mwa anthu athanzi, mosiyana ndi sulfonylureas. Metformin hydrochloride imawonjezera chidwi cha zotumphukira zolandilira ku insulin ndikuwonjezera kugwiritsidwa ntchito kwa glucose ndi maselo. Metformin hydrochloride imalepheretsa gluconeogeneis ndi glycogenolysis, zomwe zimapangitsa kuchepa kwa kupanga kwa shuga kwa chiwindi. Metformin hydrochloride imalepheretsa mayamwidwe a shuga m'matumbo. Metformin hydrochloride imawonjezera kuchuluka kwa mayendedwe amtundu uliwonse wama glucose membrane. Metformin hydrochloride imagwira glycogen synthase ndipo imalimbikitsa kapangidwe ka glycogen. Metformin hydrochloride imakhudzanso kagayidwe ka lipid: amachepetsa kuchuluka kwa cholesterol, triglycerides ndi otsika kachulukidwe lipoproteins. Pogwiritsa ntchito metformin hydrochloride, thupi la wodwalayo limachepetsedwa pang'ono kapena amakhazikika. Kafukufuku wachipatala adawonekeranso kugwira ntchito kwa metformin hydrochloride monga prophylaxis ya matenda osokoneza bongo omwe ali ndi odwala omwe ali ndi prediabetes, omwe ali ndi chiopsezo chowonjezereka cha chitukuko cha mtundu 2 shuga mellitus ndipo momwe kusintha kwamoyo kwawo sikunalole kuwongolera kokwanira kwa kuchuluka kwa shuga kwa serum.
Mukalandira metformin hydrochloride imalowetsedwa m'matumbo thirakiti kwathunthu komanso mwachangu. Mtheradi wa bioavailability wa metformin hydrochloride ukamamwa pamimba yopanda kanthu ndi 50 - 60%. Kuchuluka kwa metformin hydrochloride mu seramu yamagazi pafupifupi 2 μg / ml (15 μmol) kumatheka pambuyo pa maola 2 - 2,5. Mukamamwa metformin hydrochloride ndi chakudya, kuyamwa kwa mankhwalawa kumachepetsedwa ndikuchedwa, kuchuluka kwa mankhwalawa kumachepetsedwa ndi 40%, ndipo kukwaniritsa kwake kumatsitsidwa ndi mphindi 35. Metformin hydrochloride pafupifupi sikugwirizana ndi mapuloteni a plasma ndipo imagawidwa mwachangu mu minofu. Mgwirizano wofanana wa metformin hydrochloride mu seramu yamagazi umatheka mkati mwa masiku 1 mpaka 2 ndipo osapitilira 1 μg / ml. Kuchuluka kwa metformin hydrochloride (ndikugwiritsa ntchito kamodzi 850 mg ya mankhwalawa) kuchokera pa 296 mpaka 1012 malita. Metformin hydrochloride imatha kudziunjikira tiziwalo timene timataya, impso, ndi chiwindi. Metformin hydrochloride imapukusika kwambiri mu chiwindi ndikuchotsa impso. Kuvomerezeka kwa aimpso kwa metformin hydrochloride mwa anthu athanzi kuli pafupifupi 400 ml / mphindi (350 mpaka 550 ml / min) (kanayi kuposa kutulutsa chilolezo chainine), zomwe zimawonetsa kukhalapo kwa katulutsidwe katulutsidwe ka mankhwala. Hafu ya moyo wa metformin hydrochloride ndi pafupifupi maola 6.5 (kwa seramu yamagazi) ndi maola 17.6 (kwa magazi), kusiyana uku kumatsimikiziridwa chifukwa chakuti metformin hydrochloride imatha kudziunjikira m'maselo ofiira a magazi. Metformin hydrochloride imakumbidwa ndi impso makamaka ndi kubisala kwa tubular kosasinthika (90% masana). Odwala okalamba, theka la moyo wa metformin hydrochloride ukuwonjezeka ndipo pazotheka kuchuluka kwa mankhwalawa mu seramu yamagazi kumawonjezeka. Pakulephera kwa aimpso, theka la moyo wa metformin hydrochloride imachulukanso, chilolezo cha impso chimachepetsa, ndipo pamakhala chiwopsezo cha kukopeka kwa mankhwalawa. Kafukufuku wazinyama wogwiritsa ntchito metformin hydrochloride mu Mlingo womwe ndiwokwera katatu kuposa mulingo woyenera woperekedwa kwa anthu mukawerengedwa padziko lapansi sanawonetse carcinogenic, mutagenic, teratogenic katundu komanso zomwe zimapangitsa chonde.

Type 2 shuga mellitus, makamaka odwala omwe ali ndi kunenepa kwambiri, ndi kusakwanira kwa zochitika zolimbitsa thupi komanso zakudya, monga monotherapy kapena kuphatikiza ndi mankhwala ena amkamwa a hypoglycemic kapena insulin, kupewa matenda a shuga a 2 omwe ali ndi odwala omwe ali ndi vuto la prediabetes. lembani matenda ashuga a 2, ndipo momwe kusintha kwasintha pamoyo wawo sikunalole kukwaniritsa kuyenera koyenera ka glycemic.
Njira yogwiritsira ntchito metformin hydrochloride ndi Mlingo
Metformin hydrochloride imatengedwa pakamwa, mulingo ndi manambala a Metformin hydrochloride amakhazikitsidwa ndi adokotala payekhapayekha.
Akuluakulu a monotherapy komanso osakanikirana a metformin hydrochloride ndi mankhwala ena amkamwa a hypoglycemic a mtundu wa 2 shuga mellitus: Nthawi zambiri mlingo woyambira wa metformin hydrochloride ndi 500 kapena 850 mg 2 mpaka katatu patsiku panthawi kapena pambuyo chakudya, tikulimbikitsidwa kusintha mlingo uliwonse 10 mpaka 15 masiku ofotokoza zotsatira za kuyeza kuchuluka kwa shuga m'magazi a seramu, kuwonjezeka pang'onopang'ono kwa mankhwalawa kumathandizira kuchepetsa kuyipa kwa metformin hydrochloride kuchokera m'mimba, momveka bwino mlingo wa metformin hydrochloride ndi 1500 - 2000 mg patsiku mu 2 mpaka 3 Mlingo, mulingo woyenera watsiku ndi tsiku wa metformin hydrochloride ndi 3000 mg, wogawidwa pazigawo zitatu, mukakonzekera kusintha kwa mankhwala ena a hypoglycemic, muyenera kusiya kumwa mankhwalawa ndikuyamba kugwiritsa ntchito mankhwalawa metformin hydrochloride muyezo pamwambapa.
Akuluakulu omwe amaphatikiza metformin hydrochloride ndi insulin: kuti azitha kuwongolera kuchuluka kwa shuga m'magazi, metformin hydrochloride ndi insulin odwala omwe ali ndi matenda a shuga 2 amatha kugwiritsidwa ntchito ngati mankhwala osakanikirana, njira yoyambira ya metformin hydrochloride ndi 500 kapena 850 mg katatu tsiku, ndi mlingo wa insulin umakhazikitsidwa malinga ndi zomwe zili mu seramu yamagazi.
Mu ana osaposa zaka 10, metformin hydrochloride ingagwiritsidwe ntchito ngati monotherapy komanso kuphatikiza ndi insulin, mlingo woyambirira wa metformin hydrochloride ndi 500 kapena 850 mg kamodzi patsiku panthawi ya chakudya kapena itatha, ndikofunikira kusintha kwa metformin hydrochloride pambuyo masiku 10 - 15 kupitilira Kutengera zotsatira za kuyeza mulingo wa shuga m'magazi a seramu, mlingo woyenera wa tsiku lililonse wa metformin hydrochloride ndi 2000 mg, wogawidwa mu 2 mpaka 3 waukulu.
Monotherapy yokhala ndi metformin hydrochloride vuto la prediabetes: kawirikawiri mlingo wa tsiku ndi tsiku ndi 1000 - 1700 mg, wogawika pakawiri, pakudya kapena pambuyo chakudya, kuti athe kuwunika kufunika kowonjezereka kwa metformin hydrochloride, tikulimbikitsidwa kuwunika pafupipafupi kuchuluka kwa shuga mu seramu yamagazi.
Metformin hydrochloride ingagwiritsidwe ntchito kwa odwala omwe ali ndi kuchepa kwapakati mwamphamvu aimpso (ndi creatinine chilolezo cha 45 - 59 ml / mphindi) pokhapokha ngati pali zovuta zina zomwe zimawonjezera chiopsezo cha lactic acidosis, mlingo woyambirira wa metformin hydrochloride ndi 500 mg kapena 850 mg kamodzi patsiku, pazokwanira tsiku lililonse Mlingo wa metformin hydrochloride ndi 1000 mg, wogawidwa pawiri. Magwiridwe antchito a impso amayenera kuyang'aniridwa bwino miyezi itatu iliyonse mpaka isanu ndi umodzi. Ngati ntchito ya creatinine itatsika pansi pa 45 ml / min, kugwiritsa ntchito metformin hydrochloride kuyenera kuyimitsidwa nthawi yomweyo.
Okalamba odwala chifukwa cha kusokonezeka kwa magwiridwe antchito a impso, mlingo wa metformin hydrochloride uyenera kukhazikitsidwa poyang'anira pafupipafupi zizindikiro za ntchito zaimpso (kutsimikiza kwa plasma creatinine ndende osachepera 2 mpaka 4 pachaka.
Metformin hydrochloride iyenera kumwedwa tsiku lililonse, osasokoneza. Mukamaliza kulandira chithandizo, wodwalayo ayenera kudziwitsa omwe amakuthandizani pazaumoyo za izi.
Kuzindikiritsidwa kwa mtundu wa shuga wachiwiri 2 kuyenera kutsimikiziridwa musanagwiritse ntchito metformin hydrochloride.
Pogwiritsa ntchito metformin hydrochloride, ndikofunikira kuwunika momwe impso zimagwirira ntchito, kusefedwa kwa thupi, komanso kusala komanso seramu glucose m'm seramu yamagazi. Makamaka, kuwunika mosamala ma seramu glucose pamafunika pogwiritsa ntchito metformin hydrochloride molumikizana ndi mankhwala ena a hypoglycemic (kuphatikizapo insulin, repaglinide, sulfonylureas ndi mankhwala ena).
Lactic acidosis ndizosowa, koma zowopsa (kuvulala kwambiri pakalibe chithandizo chamankhwala mwadzidzidzi) zomwe zingayambitse chifukwa chotsatira cha metformin hydrochloride. Kwenikweni, lactic acidosis yogwiritsira ntchito metformin hydrochloride yopangidwa mwa odwala omwe ali ndi matenda osokoneza bongo komanso kulephera kwambiri kwaimpso. Zina zokhudzana ndi chiwopsezo, monga ketosis, matenda osokoneza bongo a shuga, kusala nthawi yayitali, kulephera kwa chiwindi, uchidakwa, komanso vuto lililonse lomwe limakhudzana ndi hypoxia yayikulu, liyeneranso kuganiziridwa. Izi zitha kuthandiza kuchepetsa zochitika za lactic acidosis. Ndikofunikira kuganizira za chiopsezo cha lactic acidosis ndi kukula kwa zizindikiro zosakhazikika, mwachitsanzo, kukokana kwa minofu, komwe kumayendetsedwa ndi kupweteka kwam'mimba, kusokonekera kwa dyspeptic, asthenia yayikulu. Lactic acidosis imadziwika ndi kupweteka kwam'mimba, kufupika kwa acidotic, hypothermia yokhala ndi chikumbumtima chowonjezereka. Diagnostic labotale magawo ndi kuchepa kwa magazi pH (osakwana 7.25), plasma mulingo wa lactate woposa 5 mmol / l, kuchuluka kwa anion ndi gawo lactate kuti pyruvate. Ngati metabolic acidosis ikukayikira, ndikofunikira kusiya kugwiritsa ntchito metformin hydrochloride ndipo nthawi yomweyo mufunsane ndi dokotala. Pogwiritsa ntchito metformin hydrochloride, ndikofunikira kudziwa kuchuluka kwa plasma lactate osachepera kawiri pachaka, komanso kukula kwa myalgia. Ndi kuchuluka kwa metformin lactate, hydrochloride imathetsedwa.
Odwala omwe amagwiritsa ntchito metformin hydrochloride nthawi zonse, ndikofunikira kudziwa kuchuluka kwa vitamini B12 kamodzi pachaka chifukwa kuchepa kwa mayamwidwe ake. Ngati vuto la kuchepa kwa magazi m'thupi la megaloblastic lagwiritsidwa ntchito ndi metformin hydrochloride, mwayi wochepetsera kuyamwa kwa vitamini B12 (wogwiritsa ntchito metformin hydrochloride nthawi yayitali) uyenera kuganiziridwa.
Nthawi zambiri, zotsatira zoyipa zamagetsi zimayamba nthawi yoyambira kugwiritsa ntchito metformin hydrochloride ndipo nthawi zambiri zimadutsa zokha. Popewa awo, tikulimbikitsidwa kumwa metformin hydrochloride kawiri kapena katatu patsiku pambuyo kapena pakudya. Kuchepetsa pang'onopang'ono mlingo wa metformin hydrochloride kumatha kulepheretsa kulolerana kwam'mimba kwa mankhwalawa.
Pogwiritsa ntchito metformin hydrochloride, n`zotheka kukulitsa zovuta za hepatobiliary system (kuphatikizapo hepatitis, zizindikiro zowoneka za magwiridwe antchito a chiwindi), omwe amatha kwathunthu atatha kugwiritsa ntchito mankhwalawa.
Popeza metformin hydrochloride imachotsedwa ndi impso, kuvomerezedwa kwa creatinine kuyenera kutsimikizika osachepera pachaka kwa odwala omwe ali ndi vuto laimpso, komanso pafupifupi 2-5 pachaka odwala okalamba ndi odwala creatinine chilolezo chotsika malire. Ndi creatinine chilolezo chochepera 45 ml / min, kugwiritsa ntchito metformin hydrochloride ndi kotsutsana. Kusamalidwa kwapadera kuyenera kuchitidwa kuti vuto la impso likhale mwa odwala okalamba, limodzi ndi mankhwala othandizira odwala omwe ali ndi mankhwala osokoneza bongo.
Metformin hydrochloride iyenera kuyimitsidwa maola 48 isanachitike opaleshoni yokonzekera ndipo ikhoza kupitilizidwa osadutsa maola 48 atamaliza, ngati ntchito ya impso idapezeka kuti inali yachilendo pakubwereza.
Odwala omwe ali ndi vuto la mtima wogwiritsa ntchito Metformin hydrochloride ali ndi chiopsezo chowonjezeka cha impso ndi hypoxia. Odwala omwe ali ndi vuto la mtima akudwala amafunikira kuwunika mtima ndi impso pogwiritsa ntchito metformin hydrochloride. Kugwiritsira ntchito metformin hydrochloride kumadzipakati kulephera kwa mtima ndi hemodynamics yosakhazikika.
M'mayesero azachipatala omwe adatha chaka chimodzi, adawonetsedwa kuti metformin hydrochloride siyimakhudza kukula ndi kutha. Koma poganizira za kuchepa kwa maphunziro a nthawi yayitali, tikulimbikitsidwa kuwunika mosamala zotsatira zamtsogolo za metformin hydrochloride pama paramu amenewa mwa ana, makamaka nthawi yakutha. Ana a zaka zapakati pa 10 ndi 12 amafunikira kuwunikidwa mosamala kwambiri.
Zambiri zosindikizidwa, kuphatikizapo zotsatsa zam'mbuyo, komanso kuchuluka kwa mayeso m'chipatala mwa ana ochepa (azaka 10 mpaka 16) zikuwonetsa kuti kusamvana mu ana kuli chimodzimodzi muukali ndi chilengedwe kwa iwo omwe ali odwala akulu.
Pogwiritsa ntchito metformin hydrochloride, odwala ayenera kupitiliza kutsatira zakudya zomwe zimadya thupi tsiku lonse. Odwala onenepa kwambiri akugwiritsa ntchito metformin hydrochloride akulimbikitsidwa kupitiliza kutsatira zakudya zama hypocaloric (koma osachepera 1000 kilocalories patsiku).
Pogwiritsa ntchito metformin hydrochloride, kuyesedwa kwa labotale koyenera komwe kumafunikira kuti muchepetse matenda ashuga kuyenera kuchitidwa pafupipafupi.
Ndi monotherapy, metformin hydrochloride siyambitsa hypoglycemia, koma kusamala kuyenera kugwiritsidwa ntchito molumikizana ndi insulin kapena mankhwala ena a hypoglycemic (mwachitsanzo, repaglinide, sulfonylurea derivatives, ndi ena). Kuphatikiza mankhwala ophatikizika ndi metformin hydrochloride ndi insulin kuyenera kuyambitsidwa ndikuchitika kuchipatala mpaka mlingo wokwanira wa mankhwala uliwonse ukakhazikitsidwa.
Kugwiritsira ntchito metformin hydrochloride ndikulimbikitsidwa kupewa matenda a shuga 2 odwala omwe ali ndi prediabetes komanso zina zowopsa pakukula kwa mtundu wachiwiri wa matenda a shuga, monga kuchuluka kwa mafuta a 35 kapena kuposa kg / m ... 2, zaka zosakwana zaka 60, mbiri ya matenda osokoneza bongo a gestational. triglycerides yayikulu, mbiri ya banja la anthu odwala achibale oyamba, matenda oopsa, otsika cholesterol okwera kachulukidwe ka lipoproteins.
Palibe chidziwitso pazotsatira zoyipa za metformin hydrochloride pakutha kuchita zinthu zoopsa zomwe zimafunikira kuti anthu azisamalira komanso azichita mwachangu. Komabe, kusamala kuyenera kuchitika pochita izi pogwiritsa ntchito metformin hydrochloride, makamaka ngati imagwiritsidwa ntchito limodzi ndi mankhwala ena a hypoglycemic (repaglinide, zotumphukira za sulfonylurea, insulini), potsatira zotsatira zoyipa, kuphatikizapo hypoglycemia, momwe kuthekera kukukulira, Chitani zinthu zoopsa zomwe zimafuna kuti muzikhala ndi chidwi komanso kuthamanga kwa zochitika zama psychomotor (kuphatikizapo kuwongolera magalimoto Lenie, makina). Muyenera kukana kuchita zinthu zamtunduwu popanga zovuta, kuphatikizapo hypoglycemia, motsutsana ndi momwe ntchito yamankhwalayo ilili.

Contraindication

Hypersensitivity (kuphatikizapo magawo othandizira a mankhwalawa), matenda a shuga, matenda ashuga, matenda ashuga ketoacidosis, pachimake kapena matenda a metabolic acidosis, kulephera kwa aimpso kapena kuwonongeka kwa impso (ndi kuvomerezedwa kwa creatinine osakwana 45 ml / mphindi), kuwonetsedwa mwakuthupi. matenda pachimake amene angayambitse kukula kwa minofu hypoxia (kuphatikizapo mtima kulephera ndi wosakhazikika hemodynamics, pachimake kulephera kwa mtima, pachimake myocardial infarction, kupuma movutikira, zinthu zina zomwe zimachitika ndi chiwopsezo cha impso (kuphatikiza kukomoka (ndi kusanza, kutsekula m'mimba), matenda opatsirana opatsirana, kugwedezeka), chiwindi, kusokonekera kwa chiwindi, ntchito yayikulu opareshoni ndikuvulala pamene insulin yasonyezedwa, poizoni wambiri, uchidakwa, lactic acidosis (kuphatikizapo mbiri), ntchito masiku awiri asanafike komanso asanadutse masiku awiri pambuyo poti X-ray kapena radioisotope yaphunzira ndikuyambitsa ntchito yotsitsa ayodini, kutsatira zakudya zochepa zopatsa mphamvu (zosakwana ma kilogalamu 1000 patsiku), mkaka wa m'mimba, pakati, zaka mpaka zaka 10, zaka mpaka zaka 18 (kutengera ntchito mawonekedwe a Mlingo), odwala omwe amagwira ntchito zolimba zolimbitsa thupi (chiopsezo chowonjezereka cha lactic acidosis).

Mimba komanso kuyamwa

Zosawerengeka za shuga m'mankhwala osakhazikika panthawi yomwe ali ndi pakati zimayenderana ndi chiwopsezo cha kufa kwa perinatal ndikukula kwa zolakwika zobadwa nazo. Zambiri zomwe zimawonetsa kuti kugwiritsa ntchito metformin hydrochloride azimayi panthawi yoyembekezera sikuti kumawonjezera vuto la kubereka mwa ana. Kafukufuku wokwanira komanso wowongolera mosamala pa kugwiritsa ntchito metformin hydrochloride pa nthawi ya pakati sikunachitike. Pokonzekera kutenga pakati, kuyambika kwa pakati ndi kugwiritsa ntchito metformin hydrochloride ngati matenda a prediabetes ndi matenda ashuga amtundu wachiwiri, metformin hydrochloride ayenera kuthetsedwa, ndipo chithandizo cha insulin chimalamulidwa kwa odwala matenda a shuga a mtundu wachiwiri. Pa nthawi ya pakati, seramu shuga yokhazikika iyenera kusungidwa pamlingo womwe uli pafupi kwambiri, zomwe zimachepetsa chiopsezo cha kusokonezeka kwa fetal. Metformin hydrochloride imafukusidwa mkaka wa m'mawere. Palibe zoyipa zomwe zimawonedwa mwa akhanda omwe akuyamwa panthawi yogwiritsira ntchito mankhwalawa. Koma chifukwa cha kuchuluka kwa deta, kugwiritsa ntchito metformin hydrochloride panthawi yoyamwitsa sikulimbikitsidwa. Pa mankhwalawa ndi metformin hydrochloride, kuyamwitsa kuyenera kuyimitsidwa.

Zotsatira zoyipa za metformin hydrochloride

Machitidwe amsempha, ma psyche ndi ziwalo zam'maganizo: kuphwanya kukoma.
Mtima dongosolo, zamitsempha yamagazi dongosolo ndi magazi (hemostasis, magazi mapangidwe): megaloblastic anemia (chifukwa cha malabsorption a vitamini B12 ndi folic acid).
Matumbo: nseru, kutsegula m'mimba, kusanza, kupweteka kwam'mimba, kusowa chilakolako cha chakudya, kugona m'mimba, kupweteka kwam'mimba, kutsekemera kwazitsulo mkamwa, chiwindi, kuwonongeka kwa chiwindi.
Metabolism ndi zakudya: lactic acidosis (kugona, kufooka, bradyarrhythmia, hypotension, kupuma, myalgia, m'mimba, hypothermia), hypoglycemia, kuchepa kwa mayamwidwe a vitamini B12 (pogwiritsa ntchito metformin hydrochloride).
Misempha, mucous nembanemba ndi minofu yamkati: zotupa pakhungu, kuyabwa pakhungu, erythema, dermatitis, zotupa.

Kugwirizana kwa metformin hydrochloride ndi zinthu zina

Ndi kulephera kwaimpso kwa odwala omwe ali ndi matenda osokoneza bongo, kuyezetsa radiology pogwiritsa ntchito mankhwala okhala ndi ayodini omwe angayambitse kukula kwa lactic acidosis. Chifukwa chake, kugwiritsa ntchito metformin hydrochloride kuyenera kusiyidwa malinga ndi momwe impso zimagwirira ntchito maola 48 isanachitike kapena panthawi yomwe mayeso a X-ray amagwiritsa ntchito kukonzekera kwa ayodini ndipo osayambiranso patatha maola 48 mutatha kafukufukuyu zabwinobwino. Kuphatikizidwa kwa metformin hydrochloride ndi iodine okhala ndi radiopaque kukonzekera kumapangidwa kwa masiku osakwana awiri asanachitike komanso mkati mwa masiku awiri pambuyo pa maphunziro a radiology kapena radioisotope.
Pogwiritsa ntchito metformin hydrochloride mu zakumwa zoledzeretsa kwambiri, chiopsezo chokhala ndi lactic acidosis imawonjezeka, makamaka ndi kulephera kwa chiwindi, kuperewera kwa zakudya m'thupi, komanso kudya zakudya zochepa zopatsa mphamvu. Kugwiritsa ntchito metformin hydrochloride ndi mowa sikulimbikitsidwa. Mukamamwa metformin hydrochloride, mowa ndi mankhwala omwe amakhala ndi ethanol ayenera kupewedwa. Metformin hydrochloride imagwirizana ndi mowa chifukwa choopsa cha lactic acidosis.
Kuphatikizidwa kwa metformin hydrochloride ndi danazole sikulimbikitsidwa kuti mupewe hyperglycemic zotsatira zoyipa. Ngati ndi kotheka, kuphatikiza kwa metformin hydrochloride ndi danazole, ndikuyimitsa kotsirizira, kusintha kwa metformin hydrochloride ndikofunikira mothandizidwa ndi serum glucose. Pa kuphatikiza kwa metformin hydrochloride ndi danazole, kusamala kuyenera kuchitidwa, kuwunika pafupipafupi kwa kuchuluka kwa shuga wa seramu kungafunike, makamaka kumayambiriro kwa chithandizo.
Chlorpromazine akamagwiritsa ntchito Mlingo waukulu (100 mg patsiku) amawonjezera shuga m'magazi a seramu pochepetsa kutulutsa insulin. Ndi kuphatikiza kwa Metformin hydrochloride ndi antipsychotic ndipo mutayimitsa kudya kotsirizira, kusintha kwa metformin hydrochloride ndikofunikira mothandizidwa ndi serum glucose. Pogwiritsa ntchito metformin hydrochloride ndi ma antipsychotic, chisamaliro chimayenera kutengedwa, kuwunika pafupipafupi kwa kuchuluka kwa shuga wa seramu kungafunike, makamaka kumayambiriro kwa chithandizo.
Glucocorticosteroids am'deralo komanso a dongosolo amachepetsa kulolera kwa glucose, kuwonjezera shuga wa seramu, nthawi zina kumapangitsa ketosis. Ndi kuphatikiza kwa metformin hydrochloride ndi glucocorticosteroids ndipo atayimitsa kotsirizira, kusintha kwa metformin hydrochloride ndikofunikira mothandizidwa ndi glucose mu seramu yamagazi. Pa kuphatikiza kwa metformin hydrochloride ndi glucocorticosteroids, chisamaliro chimayenera kutengedwa, kuwunika pafupipafupi kwa kuchuluka kwa shuga wa seramu kungafunike, makamaka kumayambiriro kwa chithandizo.
Ndi kuphatikiza kwa metformin hydrochloride ndi loop diuretics, lactic acidosis imatha kupezeka chifukwa cha kuwonongeka kwa impso. Metformin sayenera kugwiritsidwa ntchito ndi loop diuretics ngati kuvomerezeka kwa creatinine kumakhala kochepera 60 ml / min. Ndi kuphatikiza kwa Metformin hydrochloride ndi loop diuretics, kuwunika pafupipafupi kwa serum glucose kungafunike, makamaka kumayambiriro kwa chithandizo. Ngati ndi kotheka, mlingo wa metformin hydrochloride ungasinthidwe panthawi yolumikizana komanso pambuyo pake.
Kafukufuku wokhudzana ndi kumwa limodzi muyezo mu odzipereka athanzi kunawonetsa kuti furosemide imachulukitsa ndende ya plasma (ndi 22%) ndi malo omwe ali pansi pa pharmacokinetic curve concentration - nthawi (15%) ya metformin hydrochloride (popanda kusintha kwakukulu kwa aimpso a metformin hydrochloride), pomwe metformin hydrochloride amachepetsa kuchuluka kwa plasma ndende (mwa 31%), malo omwe ali pansi pa pharmacokinetic pamapindikira ndende - nthawi (pofika 12%) ndi theka la moyo (mwa 32%) la furosemide (wopanda kwambiri asintha chilolezo aimpso wa furosemide). Palibe data pakukhudzana kwa furosemide ndi metformin hydrochloride yogwiritsa ntchito nthawi yayitali.
Beta-2-adrenergic agonists kwa makulidwe a makolo amawonjezera kuchuluka kwa shuga mu seramu yamagazi, kulimbikitsa beta-2-adrenergic receptors. Ndi kuphatikiza kwa metformin hydrochloride ndi beta-2-adrenergic agonists, ndikofunikira kuyendetsa kuchuluka kwa shuga m'magazi a seramu, ndipo ngati pakufunika kuikidwa insulin tikulimbikitsidwa. Pogwiritsa ntchito metformin hydrochloride ndi beta-2-adrenergic agonists, kuwunika pafupipafupi kwa kuchuluka kwa ma serum glucose kungafunike, makamaka kumayambiriro kwa chithandizo. Ngati ndi kotheka, mlingo wa metformin hydrochloride ungasinthidwe panthawi yolumikizana komanso pambuyo pake.
Mankhwala a antihypertensive, kuwonjezera pa angiotensin otembenuza enzyme inhibitors, amatha kutsitsa shuga ya seramu. Ngati ndi kotheka, kugwiritsa ntchito mankhwala a antihypertensive ndi metformin hydrochloride, chisamaliro chiyenera kutengedwa ndi kusintha kwa metformin hydrochloride.
Ndi kuphatikiza kwa metformin hydrochloride ndi insulin, zotumphukira za sulfonylurea, salicylates, acarbose, kukulitsa kwa hypoglycemia ndikotheka. Ngati pakufunika kuphatikiza kugwiritsa ntchito mankhwalawa ndi metformin hydrochloride, chisamaliro chiyenera kutengedwa.
Nifedipine, ikagwiritsidwa ntchito palimodzi, imachulukitsa mayamwidwe ndi plasma yambiri ya metformin hydrochloride, kusamala ndikofunikira pakaphatikizidwe ndi nifedipine ndi metformin hydrochloride. Mlingo umodzi mu odzipereka athanzi, nifedipine kuchuluka kwa mayamwidwe, kuchuluka kwa plasma ndende (peresenti 20) ndi dera lomwe lili pansi pa pharmacokinetic curve ndende - nthawi (9%) ya metformin hydrochloride, pomwe nthawi yofika ndende ya plasma yambiri ndi theka la moyo wa metformin hydrochloride sizinasinthe.
Mankhwala a Cationic (kuphatikiza digoxin, amiloride, morphine, procainamide, quinidine, ranitidine, quinine, trimethoprim, triamteren, vancomycin) amatulutsidwa mu renal tubules ndipo, akamagwiritsidwa ntchito limodzi, amapikisana ndi metformin hydrochloride kwa machitidwe oyendetsa ma tubular ndipo amatha kuchulukitsa plasma 60 %) metformin hydrochloride. Ngati pakufunika kuphatikiza kugwiritsa ntchito mankhwalawa ndi metformin hydrochloride, chisamaliro chiyenera kutengedwa.
Akaphatikizidwa, cimetidine amachepetsa kuchotsedwa kwa metformin hydrochloride, yomwe imawonjezera chiopsezo cha lactic acidosis.
Metformin hydrochloride ingachepetse mayamwidwe a cyanocobalamin (vitamini B12).
Mphamvu ya metformin hydrochloride imachepetsedwa ndi okodzetsa, phenothiazines, glucocorticosteroids, glucagon, estrogens (kuphatikizapo gawo la njira zakulera zam'mlomo), mahomoni a chithokomiro, phenytoin, epinephrine, calcium antagonists, nicotinic acid, isoniazid, sympathomimetics.
Mphamvu ya hypoglycemic ya metformin hydrochloride imatheka chifukwa cha mankhwala a sulfonylurea, insulin, acarbose, mankhwala osokoneza bongo a anti-yotupa, oxytetracycline, monoamine oxidase inhibitors, angiotensin akatembenuza enzyme inhibitors, cyclophosphamide, clofibrenobrate.
Ndi kuphatikiza kwa metformin hydrochloride ndi azilsartan medoxomil, palibe kuyanjana kwa pharmacokinetic komwe kunawonedwa.

Bongo

Pogwiritsa ntchito metformin hydrochloride pa mlingo wa 85 g, sipanayambike vuto la hypoglycemia, koma munthawi imeneyi lactic acidosis idapangidwa, yomwe imawonetsedwa ndi nseru, kusanza, kutentha thupi, kupweteka m'mimba, kupweteka kwa minofu, kupumira mwachangu, chizungulire, chikumbumtima chovulala, kukula kwa chikomokere . Ma overdoses ofunikira a metformin hydrochloride kapena zinthu zina zangozi zomwe zingayambitse kukula kwa lactic acidosis.
Chithandizo: mukamalandira kuchuluka kwa metformin hydrochloride, kupuma kwa m'mimba ndikofunikira, ngati zizindikiro za lactic acidosis zitha, mankhwala a metformin hydrochloride ayenera kuyimitsidwa nthawi yomweyo, wodwala amayenera kugonekedwa kuchipatala mwachangu ndipo ndende ya lactate imatsimikiziridwa, njira yothandiza kwambiri yochotsa metformin hydrochloride ndi lactate ndi hemodialysis, komanso chisonyezo. Mankhwala, m`pofunika kuwongolera kuchuluka kwa shuga, creatinine, urea, lactate, electrolyte mu seramu Otke magazi. Palibe mankhwala enieni.

Mayina amalonda a mankhwala omwe amagwiritsidwa ntchito ndi mankhwala a metformin hydrochloride

Bagomet®
Glyformin ®
Glyformin Prolong®
Glucofage ®
Glucofage® Kutalika
Diaspora
Diaformin® OD
Langerine®
Methadiene
Metospanin
Metfogamma® 500
Metfogamm® 850
Metfogamma® 1000
Metformin
Metformin Zentiva
Metformin Canon
Metformin yayitali
Metformin MV-Teva
Metformin Novartis
Metformin Sandoz ®
Metformin Richter
Metformin teva
Metformin hydrochloride
Nova Met
NovoFormin ®
Siofor® 500
Siofor® 850
Siofor® 1000
Sofamet ®
Fomu
Forin Pliva

Mankhwala osakanikirana:
Vildagliptin + Metformin hydrochloride: Galvus Met,
Glibenclamide + Metformin hydrochloride: Bagomet Plus®, Glibomet®, Glucovans®, Gluconorm®, Metglib®, Metglib ® Force,
Glyclazide + Metformin hydrochloride: Glimecomb®,
Glimepiride + Metformin hydrochloride: Amaryl® M,
Linagliptin + Metformin hydrochloride: Gentadueto®,
Metformin hydrochloride + Rosiglitazone: Avandamet,
Metformin hydrochloride + Saksagliptin: Combogliz Prolong®,
Metformin hydrochloride + Sibutramine + Microcrystalline cellulose: Reduxin® Met,
Metformin hydrochloride + Sitagliptin: Janumet.

Kukonzekera ndi katundu wa chinthu

Metformin adayamba kufotokozedwa koyamba m'mabuku asayansi mu 1922 ndi Emil Werner ndi James Bell ngati chipangizo mu kapangidwe ka N, N-dimethylguanidine. Mu 1929, Slotta ndi Cheshe anapeza kutsika kwawo kwa akalulu, pozindikira kuti anali wolimba kwambiri pa ma turuanides omwe amaphunzira. Zotsatirazi zidayiwalika, monga momwe zimakhalira ndi ntchito ina ina ya guanidine analogues, monga synthalin, pakati pa kutchuka kwa insulin.

Chidwi ndi metformin, komabe, chinabwereranso kumapeto kwa m'ma 1940.Mu 1950, zidapezeka kuti metformin, mosiyana ndi mankhwala ena ofanana, samachepetsa kuthamanga kwa magazi komanso kuthamanga kwa mtima mwa nyama. M'chaka chomwecho, dokotala wa ku Philippines Eusebio Garcia adagwiritsa ntchito metformin (yomwe adayitcha fuluwenza) zochizira fuluwenza. Ananenanso kuti mankhwalawa "amatsitsa shuga m'magazi olimbitsa thupi 'pochiza odwala ndipo sanali oopsa. Garcia adakhulupiriranso kuti metformin ili ndi bacteriostatic, antiviral, antimalarial, antipyretic, ndi analgesic zotsatira. Munkhani zingapo mu 1954, dokotala wazachipatala wa ku Poland a Janusz Supnevsky sanathe kutsimikizira izi zambiri, kuphatikizapo kutsika magazi, koma adawona zovuta zina mwa anthu.

Ku chipatala cha Salpetriere, dokotala wa matenda ashuga wa ku France, Jean Stern, adaphunzira njira yotsitsa shuga ya galegin (alkaloid yotalikirana ndi mankhwala ambuzi), mothandizidwa ndi metformin, ndikuwunikira momwe amagwiritsidwira ntchito kwakanthawi ngati othandizira odwala matenda ashuga isanayambike. Pambuyo pake, akugwira ntchito ku malo ogwira ntchito ngati Aron ku Paris, adayang'ananso ntchito yochepetsera shuga ya metformin ndi ma biguanides angapo ofanana. Stern anali woyamba kuyesera kugwiritsa ntchito metformin pochiza matenda a shuga mwa anthu, adalemba dzina la "Glucophagus" (Eng. "Glucophage"-" glucose kudya ") mankhwalawa ndipo adafalitsa zotsatira zake mu 1957.

Metformin idapezeka pa Britain National Fomu mu 1958 ndipo idagulitsidwa koyamba ku UK.

Chidwi chofala mu metformin chimalimbikitsidwa pokhapokha atachotsedwa kwa Biguanides ena pakufalitsidwa kwa mankhwala mu 1970s. Metformin idavomerezedwa ku Canada mu 1972, ndipo ku United States idavomerezedwa ndi FDA pochiza matenda a shuga 2 okha mu 1994. Lolembedwa ndi Bristol-Myers squibb, Glucophage ndilo linali dzina loyamba lamalonda la metformin kugulitsidwa ku United States kuyambira pa Marichi 3, 1995. Mitundu ya jini tsopano ikupezeka m'maiko angapo, ndipo Metformin amadziwika kuti ndi mankhwala odziwika bwino kwambiri padziko lonse lapansi.

Kukonzekera ndi katundu wa chinthu kusintha |Kodi Metformin ndi chiyani?

"Metformin" ndi ofanana - mankhwala a hypoglycemic omwe amadziwika kuti amathandizira odwala matenda ashuga - makamaka mtundu wachiwiri, koma nthawi zina, mankhwalawa amatengedwa ndi mtundu woyamba. Chiyambireni mu 1957, Metformin adakhalabe mankhwala othandizira othandizira matenda a shuga, makamaka ndi zovuta monga kunenepa kwambiri. Insulin imalimbikitsa kuyika kwamafuta, ndipo Metformin, yotsitsa insulin yomwe ili mthupi, imathandizira kuti ichotse. Ndi chifukwa ichi. Anthu ambiri amagwiritsa ntchito Metformin ngati mapiritsi azakudya.

Mapangidwe a mapiritsi "Metformin"

Zomwe zimapangidwira mapiritsiwa ndizophatikizira metformin hydrochloride, yomwe imapangidwa kuchokera ku zinthu zachilengedwe zomwe zimapezeka ku French lilac ndi muzu wa mbuzi. Omwe amachokera ku mankhwalawa ndi talc, wowuma chimanga, mphamvu ya magnesium, titanium dioxide, komanso povidone K90, crospovidone ndi macrogol 6000.

Zizindikiro za Metformin

Choyamba, "Metformin" - mapiritsi omwe amalembera mtundu wa 2 matenda osokoneza bongo popanda chizolowezi cha ketoacidosis (kufooketsa kagayidwe kazakudya chifukwa cha kusowa kwa insulin). Mankhwalawa amawonetsedwa makamaka kwa odwala onenepa, ngati chithandizo cha zakudya sichinathandize. Komanso, kunenepa kwambiri, kumatha kutumikiridwa limodzi ndi insulin.

Podziwika ngati matenda a shuga, mapiritsi a Metformin amawonetsedwa ngati mankhwala odziyimira pawokha, komanso kuphatikiza mankhwala ochepetsa shuga a magulu ena, ngati tikulankhula za mtundu wachiwiri. Mtundu woyamba, umasankhidwa ngati wowonjezera kuchiritsi chachikulu cha insulin.

Kafukufuku waposachedwa wasonyeza kuti Metformin imagwiritsidwanso ntchito moyenera pothandizira matenda a oncology okhudzana ndi matenda a shuga.

Machitidwe a Metformin

Metformin imakulitsa chidwi cha maselo kuti apange insulin. Magazi a glucose ndi cholesterol amachepa. Zosakaniza zomwe zimagwiritsidwa ntchito ndi mankhwala zimayambitsa kusintha kwa oxidation yamafuta, musalole kuti mafuta azikhala ndi mafuta, ndipo potero kupewa kutulutsa mafuta m'thupi.

Insulin imayambira dongosolo lamafuta mafuta, makamaka m'malo ovuta (makamaka pamimba). Chifukwa chake, zakudya zambiri zimakhazikitsidwa ndikuchotsa zakudya zomwe zimawonjezera kuchuluka kwa shuga muzakudya. Metformin imapewanso njala yomwe imayamba chifukwa cha insulin.

Kutulutsa mawonekedwe ndi mlingo

"Metformin" - mapiritsi okhala ndi 500, 850 ndi 1000 mg, omwe amapezeka m'matumba a zidutswa 10 chilichonse, ndi oyera. Chithandizo cha mankhwalawa chimayamba ndi 500-1000 mg patsiku, ndiye kuti mapiritsi awiri ndi awiri. Mlingo, kutengera kuchuluka kwa shuga m'magazi, utha kuwonjezeka pang'onopang'ono pambuyo pa masiku oyamba a 10-15, koma osaposa 3000 mg patsiku ayenera kumwedwa. Mlingo wokonza ndi 1000-2000 mg (mapiritsi 3-4). Malangizo a "Metformin" salimbikitsanso kumwa Mlingo woposa 1000 mg patsiku la anthu okalamba.

Mapiritsi amatengedwa kwathunthu mukatha kudya, kutsukidwa ndi madzi. Nthawi zina pamabuka funso loti piritsi ("Metformin") lingagawikidwe pakati. Ngati tikulankhula za kuchuluka kwa 500 mg, ndiye kuti izi sizoyenera, chifukwa mlingo wotsikirapo sapereka zotsatira zomwe zikufunidwa, ndipo sizikulimbikitsidwa kuti aphwanye nembanemba ngati amaphimba piritsi. Ngati ndizovuta kumeza chifukwa cha kukula kwake, ndiye kuti ikhoza kugawidwa pawiri ndikugawana magawo awiri - koma nthawi yomweyo, gawo limodzi linzake.

Popeza Metformin imatha kubweretsa zovuta m'matumbo am'mimba, mlingo wa tsiku ndi tsiku sayenera kumwa kamodzi, koma pakawiri kapena katatu pa tsiku, makamaka ndi zakudya. Ngati kusokonezeka kwakukulu kwa metabolic kumawonedwa, mlingo uyenera kuchepetsedwa.

Mukamwa mankhwalawa munthawi yomweyo mukamwa Metformin (mapiritsi), malangizo omwe mungagwiritse ntchito ali ndi chidziwitso chokhudza mankhwala omwe angaphatikizidwe ndi Metformin komanso omwe sangathe. Ndikofunikanso kukambirana ndi dokotala wanu za momwe mankhwalawa amathandizira ndi Metformin.

Nthawi zambiri, odwala amachita chidwi ndi mankhwala - otsika mtengo kapena ogwira, kuphatikiza ngati akufuna mapiritsi a shuga. "Metformin" ili ndi ma fanizo ambiri omwe ali ndi machitidwe ofanana. Choyamba, awa ndi Glucofage ndi Siofor, imodzi mwanjira zotchuka kwambiri za Metformin, komanso mankhwala ena angapo omwe ali ndi zinthu zomwezi, chifukwa chomwe amachitanso chimodzimodzi pathupi ndipo ali ndi zisonyezo zofananira ngati Mapiritsi a Metformin. Ndemanga za analogues zitha kuwerengedwa pa intaneti, mungayerekezenso malangizo omwe mungagwiritse ntchito kuti mumvetse bwino ndikusankha mankhwala abwino kwambiri.

Ma Analogs a Metformin ndi:

Bagomet,
Hexal
Glycon,
Gliminfor,
Metospanin
"Metfogamma" (500, 850, 1000),
Nova Met
NovoFormin
Sofamet
"Fomu" ndi ena.
Siofor (500, 850, 1000) - mankhwala aku Germany omwe amatengedwa pakamwa, ali ndi vuto la hypoglycemic, m'malo mwake, jakisoni wa insulin.

Ponena za Glucofage, imakhala yodula kuposa Metformin, koma ikamatengedwa, odwala amakhala ndi mwayi wochepa wokhala ndi zovuta m'matumbo. "Glucophage" imawonetsedwa ngati mtundu wachiwiri wa matenda ashuga, umagwiritsidwa ntchito palokha komanso mophatikiza mankhwala ena. Kusintha "Glucophage nthawi yayitali" kuli ndi nthawi yowonjezereka.

Kwenikweni, mankhwalawa onse ali ndi lingaliro lomodzi kukhudzana ndi thupi, popeza ali ndi chinthu chimodzi chogwira ntchito pamaziko awo.

Palinso zakudya zowonjezera zomwe zimathandiza kuchepetsa misempha ya m'magazi:

"Vijar" (amathandizanso cholesterol, imayendetsa chitetezo cha mthupi, imalepheretsa kukula kwa ma virus ndi ma bacteria),
"Spirulina" (yothandiza pamatenda a metabolic, polimbana ndi kunenepa kwambiri),
Glucberry (amachepetsa chiopsezo cha zovuta za matenda ashuga) ndi ena.

Komabe, zowonjezera pazakudya sizingaganizidwe kuti ndizosintha kwina kwa mankhwalawa, zitha kugwiritsidwa ntchito ngati kuwonjezera kwa chithandizo chachikulu. Kuphatikiza apo, musanatenge zowonjezera zakudya, muyenera kufunsa dokotala za izi.

"Metformin" wa matenda ashuga

"Metformin" ndi imodzi mwazamankhwala abwino kwambiri odwala lero. Ndiwothandiza kwambiri pochiza matenda a shuga 2, amatha kuthandizidwa limodzi ndi insulin, ndipo mankhwalawo amasankhidwa malinga ndi kuchuluka kwa shuga m'magazi.

Pochiza matenda a shuga, amachepetsa glucogeneis osakhudza kuchuluka kwa insulin m'magazi. Zimathandizanso kufalikira kwa magazi m'chiwindi, chifukwa chomwe glucose imasandulika glycogen.

Mankhwalawa amtundu wachiwiri wa matenda ashuga, Metformin ikhoza kutumikiridwa moyo. Ngati adayikidwa limodzi ndi othandizira ena a hypoglycemic, ndikofunikira kuyang'anira kuchuluka kwa shuga kuti mupewe hypoglycemia. Ndi mankhwala osiyana ndi ena, hypoglycemia samakula.

Kuphatikiza apo, amagwiritsidwa ntchito pochiza odwala omwe ali ndi kunenepa kwambiri, omwe nthawi zambiri amakhala ndi shuga, chifukwa amachepetsa kudya ndipo amachepetsa kuyamwa kwa shuga m'zakudya.

Mtundu woyamba, mankhwalawa amagwiritsidwa ntchito ngati adjunct kuti apange insulin ndi mitundu ina ya matenda ashuga; payokha, angathe kungotengedwa ngati matenda a shuga a mtundu wachiwiri. Pakuyamba kwa chithandizo ndi Metformin, oyang'anira ena a hypoglycemic othandizira ayenera kuyimitsidwa.

Kuchiza ndi Metformin kumathandizanso kupezeka kwa kagayidwe kachakudya kagayidwe kachakudya ndi kagayidwe ka lipid.

Metabolic syndrome ndi mkhalidwe wa thupi momwe zinthu zingapo zimaphatikizidwira: kagayidwe kazakudya kamphamvu, wodwalayo amakhala ndi matenda oopsa a kunenepa kwambiri, kunenepa kwambiri, ndi zina zotere. Matendawa amakhala ndi chiopsezo chokhala ndi matenda amtima. Pamtima pa vutoli ndikulimbana ndi insulin, yomwe, malinga ndi kafukufuku waposachedwa, imagwirizana kwambiri ndi matenda a shuga komanso kuwonongeka kwa mtima.

Ponena za zovuta za lipid metabolism, chifukwa cha kafukufuku zidapezeka kuti kuchuluka kwa triglycerides, cholesterol yathunthu ndi LDL yafupika mukamamwa mapiritsi a shuga a Metformin. Ndemanga za asayansi zokhudzana ndi mankhwalawa zilinso ndi chidziwitso chokhudzana ndi mphamvu yake popewa matenda amtundu wa 2 pophwanya kulolerana kwa zakudya zamagulu.

"Metformin" yochepetsa thupi

Mphamvu zapadera za mankhwalawa komanso kuchepa kwa thupi kwa odwala omwe ali ndi matenda ashuga zapangitsa kuti Metformin atchuke kwambiri pakati pa iwo omwe akufuna kuchepa thupi.

Ngakhale kuti mankhwalawa ayamba njira zomwe zimathandizira kuwotcha mafuta ochulukirapo komanso kupewa mafuta atsopano kuti asapangidwe, ziyenera kugwiritsidwa ntchito mosamala ndi anthu omwe alibe matenda ashuga, ndikofunikira kuganizira zovuta zingapo.

Choyamba, ndikofunikira kukumbukira kuti mankhwalawo pawokha sawotcha mafuta, koma amangothandiza kugwiritsa ntchito kuchuluka kwake ngati kumathandizidwanso ndi masewera olimbitsa thupi komanso zakudya zapadera. "Metformin" - mapiritsi si katundu wodabwitsa, koma chida chowonjezera. Ngakhale pakati pa madotolo palibe malingaliro osagwirizana pa omwe angatenge mapiritsi a Metformin: maubwino ndi kuwonongeka kwa thupi kuchokera mankhwalawa kuyenera kuwunikiridwa payekhapayekha. Madokotala ena amawalemba kuti wodwalayo achepetse thupi msanga, ena amamuwona kuti ndiwowononga thupi. Chifukwa chake, mukamachepetsa thupi mothandizidwa ndi Metformin, kuyeserera koyambirira ndi kufunsidwa kwa katswiri ndikofunikira kuti mupange chisankho choyenera.

Chotsatira, muyenera kuganizira zotsutsana zingapo. Mwachitsanzo, ngati muli ndi matenda amtundu wa 2 kapena mtundu wa 2 popanda kupanga insulini, mutha kufotokoza Metformin ndikuthana ndi mavuto ochepetsa thupi mothandizidwa ndi endocrinologist.

Palibe chifukwa muyenera kumwa mankhwala a impso, mtima, m`mapapo mwanga, matenda a chiwindi, magazi m'thupi.

Mankhwalawa sangathe kugwiritsidwa ntchito ngati thupi lifooka - pambuyo pakuchita opaleshoni, kuvulala, kudwala kwambiri, liyenera kupewedwa panthawi yopatsirana matenda opatsirana.

Sizoletsedwa kudya "Metformin" ngati mumatsatira zakudya zamafuta ochepa.

Njira zazikulu zomwe zimapezeka mthupi motsutsana ndi Metformin chithandizo ndikuthandizira kuchepetsa:

mwachangu mafuta oxidation
kuchepa kwa chakudya
glucose wabwino amatenge minofu yamatenda
kunachepetsa njala, kuchititsa kuchepa kwa thupi.

Ndi kuchepa kwa thupi kosagwiritsa ntchito mankhwalawa, zotsatira zoyipa zimachitika pafupipafupi, makamaka ngati mwatenga mlingo wokulirapo kuposa momwe amaloledwa ndi malangizo. Kuphatikiza pazovuta zazikulu zam'mimba, mutha kukhala ofooka, kugona, kupha, lactic acidosis ndi zina zazikulu zomwe zingayambike.

Komanso, mukamamwa Metformin, muyenera kutsatira zakudya. Siphatikiza maswiti, pasitala, mbatata, mizimu. Chakudya chizikhala chokhazikika, simuyenera kufa ndi njala, koma nthawi yomweyo, phindu lazakudya siziyenera kupitirira 2500 kcal patsiku. Munthawi imeneyi, muyenera kumwa momwe mungathere madzi wamba.

Ngakhale kuti Metformin imathetsa kufunika kochita masewera olimbitsa thupi, izi sizitanthauza kuti kuchita masewera olimbitsa thupi kungapewedwe. Kuchita masewera olimbitsa thupi m'mawa, ntchito za panja, kulimbitsa thupi molimbika kuphatikiza ndi mankhwalawa kumathandizira kuti muchepetse mafuta ochulukirapo mwachangu kwambiri. Musakhale ndi chiyembekezo kuti Metformin ikupangirani zonse popanda zina zowonjezera!

Musatengeredwe ndi mankhwalawo ndikumutenga ngati "wabwino koposa": simuyenera kupitilira mlingo wake ngati mukumwa mankhwala a Metformin (mapiritsi). Malangizo ogwiritsira ntchito amapereka malangizo omveka bwino pazambiri zomwe zingagulitsidwe, ngati sizinaoneke, zitha kuvulaza thupi. Kuphatikiza apo, mankhwalawa sangatengedwe kuposa miyezi itatu, ndiye kuti muyenera kupuma.

Tsopano mutha kupeza ndemanga zambiri za omwe adamwa mapiritsi a Metformin. Ndemanga ndizosiyanasiyana: wina adachotsa mafuta ochulukirapo mwachangu ndipo kwanthawi yayitali, wina adaletsedwa ndi zizolowezi zoyipa kapena zoyipa. Koma kwakukulu, titha kunena kuti omwe Metformin adathandizira kuti ayang'anire moyang'aniridwa ndi dokotala, atamulemba mayeso, kwinaku akusunga zakudya zofunika komanso osanyalanyaza masewera olimbitsa thupi.

Contraindication ku Metformin

Musanayambe chithandizo cha Metformin, ngakhale mutakhala ndi matenda ashuga kapena mukufuna kuchepetsa thupi, muyenera kudziwa bwino mndandanda wazodabwitsazi komanso kufunsa dokotala.

Contraindication zimaphatikizapo aimpso, mtima, mapapo kulephera, kwambiri pathologies a chiwindi ndi biliary thirakiti, pathologies aakulu a ziwalo kupuma. Mankhwalawa sangatengedwe pambuyo povuta komanso pambuyo pothandizira, komanso pambuyo poyambitsa myocardial pakukonzanso. Kulandila "Metformin" imaphatikizidwa m'njira zopatsirana komanso zotupa komanso kuchulukitsa kwa matenda aliwonse osakhazikika, mitundu yayikulu ya kuchepa magazi.

Mankhwala ndi oletsedwa pa mimba ndi mkaka wa m`mawere. Mukakonzekera kutenga pakati kapena kupezeka kwake pamene mukumwa Metformin, mankhwalawa amayenera kusiyidwa ndikuwathandiza insulin. Kuyamwitsa, ngati pakufunika mankhwala wazaka. "Metformin" sinafotokozeredwe ana ndi achinyamata ochepera zaka 18.

Komanso, "Metformin" siyingatengedwe chifukwa cha uchidakwa ndi chakumwa chauchidakwa chakumwa. Mwambiri, muyenera kukana kumwa mowa wokhala ndi mankhwala a ethanol ngati mukumwa Metformin. Chowonadi ndi chakuti kuphatikiza kwa ethanol ndi metformin ngakhale mu Mlingo wocheperako kumakwiyitsa kukula kwapamwamba kwa lactocytosis, mpaka imfa.

Ndizowopsa kumwa "Metformin" wokhala ndi zopatsa mphamvu zochepa komanso "akudya".

Sizingatengeredwe kwa anthu opitilira zaka 60 ngati agwira ntchito yayikulu, kuti apewe kukula kwa lactic acidosis.

Mankhwala, odwala amafunika kuwunika ntchito ya aimpso, kuyang'anira kuchuluka kwa plasma lactate, serum creatinine.

Zotsatira zoyipa za mankhwalawa

"Metformin" imayambitsa zovuta zingapo. Chifukwa chake, munthawi yamankhwala, ndikofunikira kuyang'anitsitsa momwe thupi lanu liliri ndipo ngati muli ndi madandaulo, funsani dokotala nthawi yomweyo, makamaka ngati mukumwa mankhwalawa molingana ndi mawonekedwe ndi mankhwala a dokotala, koma nokha.

Choyamba, mankhwalawa amayambitsa zovuta m'matumbo. Pankhaniyi, mawonekedwe osasangalatsa monga:

nseru
kusanza kwambiri
kulimbikira m'mimba
chisangalalo
kusowa kwa chakudya
kuwoneka pakamwa pa chitsulo.
mawonekedwe a kupweteka kwam'mimba.

Wodwalayo amathanso kudandaula kuti kulephera kupuma, tachycardia, totupa ndi kusenda pakhungu, nthawi zambiri kumayabwa.

Zotsatira zoyipa koma zowopsa ndi lactic acidosis. Ndi lactic acidosis, lactic acid imalowa m'magazi, zizindikiro zoyambirira za matendawa ndi kufooka, kugona, kuwonjezeka kwa mseru, kusanza ndi mseru.

Ndi kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, kukanika kwa chiwindi ndi kotheka.

Ngati mungazindikire chimodzi mwazowonetserazi, muyenera kufunsa dokotala, kumuuza kuti mukumwa mapiritsi a Metformin. Phindu ndi kuvulaza thupi pankhaniyi zitha kukhala zopanda kufanana, mwina simungafunike kumwa mankhwalawo ndipo muyenera kupeza njira ina yothandizira kapena kuwonda.

"Metformin" - mapiritsi abwino kwambiri a matenda a shuga a 2. "Metformin" imathandizanso kuchepetsa kunenepa, koma ndikofunikira kukumbukira kuti mankhwalawa sakhala panacea, sichitha m'malo mwa chakudya chochepa cha carb ndi zochitika zolimbitsa thupi. Therapy "Metformin" iyenera kutsagana ndikuwunika kuchuluka kwa shuga m'magazi komanso kukana zizolowezi zoyipa, kuphatikizapo chakudya. Ngati mukufuna kuchepa thupi ndi izi, osasiya masewera olimbitsa thupi, idyani moyenera ndipo musaiwale kuti choyambirira ndi mankhwala oopsa, adapangidwa kuti athane ndi matenda a shuga, chifukwa chake muyenera kumwa mosamala komanso pokhapokha mukaonana ndi dokotala.