Momwe mungatenge Metformin ndi matenda a shuga a 2?

Mtundu wa shuga wodziyimira pawokha umadziwika ndi kusiyanasiyana pang'ono komwe kumapangidwa kwa timadzi timene timachepetsa shuga. Mankhwala Metformin a matenda a shuga a 2 amagwiritsidwa ntchito ngati sikungatheke kukhalabe ndi shuga mkati mwa mtundu wamba (3.3-5.5 mmol / lita) pogwiritsa ntchito zakudya zopatsa thanzi komanso masewera olimbitsa thupi.

Chifukwa chotchuka padziko lonse lapansi, Metformin imapangidwa pansi pa mayina osiyanasiyana amtundu. Kodi wothandizirayi wa hypoglycemic amachepetsa shuga m'magazi, komanso momwe mungatenge Metformin yemwe ali ndi matenda ashuga, nkhaniyi ifotokoza.

Zambiri pazamankhwala

Woyimira yekha wa kalasi ya greatuanides ndi metformin hydrochloride. Gawo lomwe limagwiritsidwa ntchito ndi mankhwala a Metformin lili ndi zinthu zabwino ndipo ndi gawo la mankhwala ena ambiri omwe amachepetsa shuga, omwe amasiyana kwambiri mtengo wake.

Mtundu woyamba wa matenda ashuga, inshuwaransi ya insulin iyenera kuchitidwa pafupipafupi kuteteza hyperglycemia. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, metformin imathandiza kuchepetsa msanga shuga popanda kutsogola mtundu wa hypoglycemic mwa anthu athanzi.

Mankhwala osokoneza bongo a shuga amachitika pamaselo a cellular, kukulitsa chidwi cha maselo olimbana ndi insulin. Mu thupi la munthu, mutamwa mapiritsi, zosintha zotsatirazi zimachitika:

kutsika kwa shuga m'magazi,
kukonza kuwonongeka kwa maselo kupita ku mahomoni,
Kuchepetsa mayamwidwe a shuga m'matumbo aang'ono,
kutsegula kwa makutidwe ndi okosijeni amafuta zidulo,
cholesterol yotsika.

Kuchiza pafupipafupi ndi Metformin kumathandizira kuti musangoletsa kuchuluka kwa shuga wamagazi, komanso kulimbana ndi kunenepa kwambiri. Zikomo zonse chifukwa cha mankhwalawa kuti muchepetse chidwi.

Metformin imachepetsa kuthamanga kwa magazi ndikupanga mapangidwe a atherosulinotic, kuchepetsa chiopsezo cha matenda a mtima ndi mtima komanso kupitirira kwa matenda a shuga a 2.

Malangizo ogwiritsira ntchito mapiritsi

Chizindikiro chachikulu chakuti muyenera kumwa Metformin ndi matenda amtundu wa 2, wovuta ndi kunenepa kwambiri, pamene kudya komanso kuchita masewera olimbitsa thupi sizithandiza kuchepetsa glycemia.

Musanatenge Metformin ngati mtundu wachiwiri wa matenda ashuga, muyenera kuonana ndi endocrinologist. Dokotala, poganizira zomwe zili ndi shuga komanso thanzi la wodwalayo, amamulembera mankhwala ndi kuwafotokozera. Mutagula mankhwalawo, tsamba lolembalo liyenera kuphunzira bwino.

Kutengera ndi zomwe zimagwiritsidwa ntchito ndi othandizira a hypoglycemic, mitundu yosiyanasiyana ndiyotheka:

Mapiritsi a 500 mg: mlingo wa tsiku ndi tsiku umachokera ku 500 mpaka 1000 mg. Kumayambiriro kwa mankhwalawa, kuwoneka kwa mavuto omwe amabwera ndi kudzimbidwa ndikotheka. Njira zotere zimachitika chifukwa choti thupi limazolowera mankhwala. Pambuyo pa masabata awiri, zotsatirapo zoyipa zimayima, kotero mlingo umatha kuchuluka mpaka 1500-2000 mg patsiku. Amaloledwa kutenga oposa 3000 mg patsiku.
Mapiritsi a 850 mg: poyamba, mlingo ndi 850 mg. Thupi la wodwalayo likangosintha machitidwe a mankhwalawo, mutha kuwonjezera kuchuluka kwake mwa kudya 1700 mg patsiku. Pazakudya zambiri za mankhwala Metformin a odwala matenda ashuga ukufika 2550 mg. Odwala okalamba salimbikitsidwa kupitilira mlingo wa 850 mg.
Mapiritsi a 1000 mg: poyamba, mlingo ndi 1000 mg, koma pambuyo pa masabata awiri amatha kuchuluka mpaka 2000 mg. Zolemba malire kuloledwa kudya 3000 mg.
Kugwiritsa ntchito zovuta ndi insulin mankhwala: Mlingo woyambirira wa Metformin ndi 500 kapena 850 mg. Kuchuluka kwa insulini yofunikira bwanji, jakisoni amasankha.

Mapiritsi a Metformin sangatengeke, amameza athunthu, atsukidwa ndi madzi. Mankhwalawa amayenera kuledzera pakudya kapena mutatha kudya.

Pogula mankhwala, muyenera kulabadira tsiku lotha ntchito lomwe lasonyezedwa pa phukusi. Amamuyang'aniridwa m'malo abwino amdima kutali ndi ana aang'ono.

Contraindication ndi zoyipa zimachitika

Malangizo akutsatira ali ndi mndandanda woyerekeza wa contraindication ndi mavuto.

Chifukwa chake, wodwalayo ayenera kuchenjeza za matenda onse okhudzana ndi matenda osokoneza bongo atasankhidwa ndi dokotala. Mwina wodwalayo adzafunikanso kupezedwa.

Malangizowo akuwonetseratu kuti kugwiritsa ntchito mapiritsi a shuga Metformin ndi koletsedwa ngati msinkhu wa wodwalayo sufika zaka 10.

Komanso, simungamwe mapiritsi ndi:

kulephera kwa aimpso (creatinine mwa akazi - opitilira 1.4 ml / dl, mwa amuna - oposa 1.5 ml / dl, chilolezo cha creatinine - osakwana 60 ml / min),
chidwi cha munthu ndi metformin hydrochloride ndi zigawo zina za mankhwala,
zinthu zomwe zimayambitsa kupezeka kwa lactic acidosis (kuchepa kwa madzi m'mimba, mtima kulephera, kupuma, kulephera kwamkati,
kuwonongeka kwa chiwindi ntchito (digiri yachiwiri kapena kusakwanira kwa chiwindi kugwira ntchito molingana ndi Mwana-Pugh),
kuchititsa kwa masiku awiri isanachitike komanso pambuyo pa x-ray, mayeso a radioisotope ndikuyambitsa njira yosiyanitsa,
kuvulala kwambiri komanso kuchitapo kanthu opaleshoni,
lactic acidosis, makamaka m'mbiri,
Zakudya zama calori ochepa, zomwe zimakupatsani mwayi woti mumwe 1000 kcal patsiku,
matenda ashuga ketoacidosis, matenda a shuga komanso chikomokere,
kunyamula mwana ndi kuyamwitsa,
kuledzera.

Munthu wodwala matenda ashuga yemwe sanatenge Metformin monga momwe adalimbikitsira adokotala amatha kuyambitsa zovuta zingapo:

CNS chisokonezo: kuphwanya kwa zomverera zokonda.
Kusokonezeka kwa m'mimba: Kupweteka kwam'mimba, mapangidwe owonjezera a mpweya, kutsegula m'mimba, kusanza, kusanza, kusowa kwa chilimbikitso. Kuti muchepetse kuwopsa kwa zizindikiro, muyenera kugawa mankhwalawo kangapo.
Matenda a Metabolic: kukula kwa lactic acidosis mu shuga.
Hematopoietic dongosolo kukanika: kumachitika megaloblastic anemia.
Thupi lawo siligwirizana: zotupa pakhungu, erythema, pruritus.
Kuchepa kwa chiwindi: kuphwanya zizindikiro zazikulu ndi hepatitis.
Kuyamwa kwa vitamini B12.

Ngati zizindikiro zomwe zili pamwambazi zadziwika pa nthawi ya chithandizo, muyenera kusiya kugwiritsa ntchito mapiritsi ndi kufunafuna chithandizo chamankhwala posachedwa.

Mtengo, ndemanga, analogi

Zokonzekera zomwe zimakhala ndi metformin hydrochloride nthawi zambiri zimapezeka kwa gulu lapakati. Mutha kusunga ndalama pogula mapiritsi a shuga pa intaneti. Mtengo wa Metformin umatengera mlingo:

500 mg (mapiritsi 60) - kuchokera ku 90 mpaka 250 ma ruble,
850 mg (mapiritsi 60) - kuchokera 142 mpaka 248 rubles,
1000 mg (mapiritsi 60) - kuchokera 188 mpaka 305 rubles.

Monga mukuwonera, mtengo wa hypoglycemic wothandizira Metformin siwokwera kwambiri, womwe ndi kuphatikiza kwakukulu.

Ndemanga za wodwala zamankhwala zimakhala zabwino. Metformin imachepetsa shuga m'magazi ndipo simatsogolera ku hypoglycemia. Madokotala amavomerezanso kugwiritsa ntchito mankhwala othandizira odwala matenda ashuga. Kugwiritsa ntchito Metformin kosalekeza popewa matenda amtima kulipira.

Anthu ena omwe alibe matenda ashuga amatenga mankhwala kuti achepetse kunenepa. Akatswiri salimbikitsa kugwiritsa ntchito mankhwalawa kuti muchepetse kunenepa kwa anthu athanzi.

Zidandaulo zazikulu zimakhudzana ndi kukhumudwa kwa chakudya, zomwe zimachitika chifukwa choti thupi limazolowera zomwe zimagwira. M'magulu ena a odwala, zizindikirazi zimatchulidwa kotero kuti amasiya kumwa Metfomin kuti achepetse kuchuluka kwa glucose.

Nthawi zina zimakhala zofunika kusankha analogue - chida chomwe chili ndi zofanana ndi othandizira. Koma momwe mungasinthire Metformin? Pali mankhwala ambiri omwe ali ndi vuto lofanana:

Metformin Richter,
Metformin teva
Novo-Metformin,
Langerine
Dianormet
Forin Pliva,
Siofor
Metfogamma,
Novoformin,
Diaphore
Orabet
Diaformin,
Chikwanje,
Bagomet,
Glyformin
Glucovans.

Uwu si mndandanda wathunthu wazinthu zomwe zimagwiritsidwa ntchito kuti muchepetse shuga. Dokotala wopezekapo angakuthandizeni kusankha njira yothandiza kwambiri yodwala matenda ashuga a 2.

Metformin ndi mankhwala othandiza omwe amasintha mayankho a maselo omwe akulimbana ndi insulin. Kugwiritsidwa ntchito kwa Metformin kumapangitsa glycemia, kumalepheretsa kukula kwa zovuta komanso kukhazikika kwa wodwala. Kuti muchepetse matenda a shuga, malingaliro onse a katswiri amayenera kutsatiridwa, ndipo ngati kuli kotheka, sankhani analogue yothandiza.

Katswiri wa kanema m'nkhaniyi anena za Metformin yemwe amachepetsa shuga.

Kutulutsa mawonekedwe, zikuchokera

Metformin imapezeka mu mawonekedwe a miyala, yokutidwa ndi chipolopolo choyera, oblong ndi biconvex. Mu chithuza chodziwika ndi zidutswa 10. Chofunikira chachikulu ndi Metformin hydrochloride, yomwe ndi yoyera kapena yopanda utoto wamkati. Imasungunuka mwachangu m'madzi ndipo imakhala popanda kusintha kwa acetone, ether ndi chloroform. Kulemera kwazinthu ndi 165.63.

Kulankhula za mapiritsi a Metformin, muyenera kulabadira kuti:

pamimba yopanda kanthu ndikatha kudya chakudya, imatha kutsitsa shuga. Zomwezi zimaphatikizanso ndi hemoglobin ya glycosylated,
chifukwa cha kugwiritsa ntchito mankhwalawa, kulolera kwa glucose kumakulitsidwa,
mayamwidwe m'mimba amachepetsa (kugaya chakudya, kapamba),
chiwopsezo gawo la mahomoni zimakhala zotumphukira minofu zida.

Metformin siyimathandizira kusintha kwa insulin katulutsidwe ka maselo a beta a pancreatic islets. Kuphatikiza apo, ndi mankhwala omwe amaperekedwa omwe amakhazikitsa mawonekedwe a lipid a madzi am'magazi mwa odwala omwe ali ndi matenda a mtundu woyamba. Mapiritsi amachepetsa chiŵerengero cha triglycerides komanso cholesterol. Kugwiritsa ntchito mankhwalawa mwadongosolo kumathandizira pakukhazikika kapena kuchepetsa thupi.

Mankhwalawa amatengedwa mwachangu kuchokera kugaya chakudya. Mtheradi bioavailability pamimba yopanda kanthu kuchokera pa 50 mpaka 60%. Kuchuluka kwa plasma kuzindikirika pambuyo pa mphindi 120. Kudya chakudya kumatha kuchepetsa ndende ndi 40% ndikuchepetsa kukwaniritsa kwake osaposa mphindi 35. Kudzikundikira kwa gawo lalikulu m'magazi kudzachitika mkati mwa maola 24-48 ndipo osapitilira 1 μg / ml.

Ndikofunikira kulingalira kuti mankhwalawa amamangiriza mapuloteni a plasma chifukwa. Imathanso kukhazikika m'matenda a chiwindi, chiwindi komanso, impso. Metformin imachotsedwa impso (makamaka chifukwa cha katulutsidwe kenakake ka tubular) kosasinthika (90% mkati mwa maola 24).

Zisonyezero zamankhwala

Mankhwalawa amagwiritsidwa ntchito pokhapokha kuchepetsa magazi. Ndi matenda amtundu wa 1 shuga, palibe chifukwa chofunikira cha mapiritsi. Polankhula mwatsatanetsatane za zomwe zikuwonetsa, amalipira mtundu wa 2 shuga mellitus mwa munthu wamkulu (makamaka odwala omwe ali ndi kunenepa kwambiri). Izi zimachitika ndi zochepa mphamvu ya kudya mankhwala ndi zolimbitsa thupi. Metformin itha kugwiritsidwa ntchito mu shuga monga monotherapy kapena molumikizana ndi mayina ena a pakamwa a hypoglycemic, komanso mitundu ina ya mahomoni.

Chizindikiro chinanso ndi mtundu wa shuga wachiwiri kwa mwana wamkulu kuposa zaka 10. Poterepa, ndizothekanso kuchoka ngati gawo la monotherapy komanso kuphatikiza ndi gawo la mahomoni. Akatswiri amalipira chidwi chakuti:

Metformin itha kugwiritsidwa ntchito pambuyo pamagulu a shuga,
kupewa ndi kupewa matenda am'matumbo, njira yayikulu ya chithandizo imalimbikitsidwa kuti ikambirane ndi katswiri,
kuchira komweko kudzakhala kothandiza pokhapokha ngati wodwala matenda ashuga amaganiza za kapangidwe kake, zotsutsana zazikulu ndi zina.

Momwe mungatenge Metformin ya matenda ashuga?

Owerenga mabakera anena zowona zonse zokhudza matenda ashuga! Matenda a shuga amapita pakatha masiku 10 ngati mumamwa m'mawa. »Werengani zambiri >>>

Mapiritsi ayenera kumwedwa pakamwa, kuwameza kwathunthu osatafuna. Izi zitha kuchitika panthawi ya chakudya komanso pambuyo pake. Ndikofunikira kumwa madzi ambiri ndi mapiritsi. Akuluakulu, Metformin itha kugwiritsidwa ntchito muyezo woyambira osaposa 1000-1500 mg mu maola 24. Kuti muchepetse mavuto kuchokera ku ziwalo zogaya, mlingo umayenera kugawidwa pawiri kapena katatu.

Pambuyo masiku 10-15, ngati palibe zovuta zoyipa kuchokera m'matumbo am'mimba, kuwonjezeka kwadongosolo mwazotsatira kudzakhala kololedwa. Komabe, siziyenera kukhala zopanda nzeru komanso zimatengera kuchuluka kwa shuga omwe ali m'magazi. Tiyenera kumvetsetsa kuti kuwonjezeka koyenera kwa chiwerengerocho komwe kungakhale ndi zotsatira zabwino pakukweza kwam'mimba ndi matumbo a matendawa.

Mlingo wokonza masana uyenera kukhala 1500-2000 mg. Kuchuluka kovomerezeka sikupitilira 3000 mg, ndipo tikulimbikitsidwa kuti agawidwe pawiri. Mukukonzekera kusintha kwa kuchoka pa njira ina yopangira pakamwa ya hypoglycemic kupita ku Metformin, ndikulimbikitsidwa kuti musiye kugwiritsa ntchito ina ndikuyamba kutenga Metformin Canon pazowerengera koyambira komwe tafotokoza kale.

Mankhwala Metformin a matenda a shuga a 2 amatha kugwiritsidwa ntchito limodzi ndi insulin. Ndikulimbikitsidwa kuti:

Mlingo woyambirira wa 500 mg ndi 850 mg ndi piritsi limodzi kawiri kapena katatu patsiku,
Metformin 1000 mg piritsi limodzi kamodzi pa maola 24 aliwonse,
Mlingo wa gawo la mahomoni mu nkhani iyi amasankhidwa potengera zomwe zili ndi shuga.

Kwa ana opitirira zaka 10, yankho lovomerezeka ndi kugwiritsa ntchito Metformin Canon. Itha kugwiritsidwa ntchito ngati gawo la monotherapy, komanso ngati gawo la mankhwala ophatikiza ndi gawo la mahomoni. Kulandila kwa Metformin mu nkhani iyi kuyenera kuyamba ndi kuchuluka kwa 500 mg kamodzi pa maola 24 pakudya. Pambuyo masiku 10-15, kuchuluka kumalimbikitsidwa kusinthidwa kokha malinga ndi kuchuluka kwa shuga m'magazi. Mlingo wokonza uzikhala kuchokera ku 1000 mpaka 1500 mg tsiku lililonse kwa awiri kapena atatu. Mulingo woyenera sayenera kupitirira 2000 mg pazakudya za tsiku ndi tsiku.

Chifukwa cha kuchuluka kwachulukidwe ka impso, kuchuluka kwa mankhwalawa Metformin kumalimbikitsidwa kuti anthu achikulire amasankhidwa ndikuwonetsetsa ntchito ya impso. Muyeso wofunikira pankhaniyi ndikuwongolera kuchuluka kwa creatinine m'magazi seramu osachepera awiri kapena anayi pachaka. Kutalika kwa chithandizo kuyenera kutsimikiziridwa ndi katswiri.

Kuyimitsa kugwiritsa ntchito Metformin popanda upangiri wa dotolo wodziwa za matenda a shuga a 2 sikulimbikitsidwa.

Mankhwalawa amatha kumwa kwa nthawi yayitali ndipo muyenera kukumbukira kuti:

pakukonzekera kapena chifukwa cha kukhalapo kwa pakati, Metformin Canon iyenera kuthetsedwa ndikuyambanso insulin.
Ndikofunika kuti wodwalayo achenjeze kuti ayenera kukamuuza mayi ake komanso mayi ake za matenda ashuga ngati ali ndi pakati.
mayi wamtsogolo ndi mwana wake adzafunika kuyang'anira kuyang'anira.

Palibe chidziwitso chodalirika ngati Metformin adachotsedwa mu mkaka wamkaka. Ngati mukufunikira kuganiza momwe mungamwere Metformin panthawi yoyamwitsa, mkaka wa m'mawere uyenera kuyimitsidwa.

Contraindication ndi zoyipa

Mndandanda wa contraindication umaphatikizapo makamaka hypersensitivity, komanso ma pathologies osiyanasiyana a impso kapena kukhalapo kwa aimpso kulephera. Chisamaliro chapadera chiyenera kulipidwa pakhungu loyipa la chiwindi, machitidwe omwe amayendetsedwa ndi hypoxia (mtima ndi kupuma, kulephera chifukwa cha kuchepa kwa magazi, kuchepa kwa magazi muubongo ndi kuchepa magazi).

Contraindations imaphatikizapo kuchepa kwamadzi, matenda opatsirana, opaleshoni yayikulu, ndi kuvulala kofananako. Musaiwale za zakumwa zoledzeretsa, pachimake metabolic acidosis (kuphatikizapo matenda ashuga a ketoacidosis kapena opanda chikomokere). Contraindication ndi:

lactic acidosis m'mbiri yamankhwala,
kufunika kotsatira zakudya zamagulu ochepa zopatsa mphamvu (zosakwana 1000 kcal patsiku),
kafukufuku wogwiritsa ntchito ayodini wa ayodini,
chilichonse mwazoyesa zam'mimba,
yoyamwitsa.

Pali zoletsa zina pazogwiritsa ntchito. Tikulankhula za ana osaposa zaka 10, zomwe zimachitika chifukwa choti magwiridwe antchito komanso chitetezo kwa mwana sichinakhazikitsidwe mokhulupirika. Komanso, chisamaliro chikuyenera kulipidwa kuukalamba (wopitilira zaka 65) chifukwa cha kukalamba kwa zinthu. Kuphatikiza apo, sikulimbikitsidwa kuti mupereke mankhwalawa kwa anthu omwe amagwira ntchito molimbika (mwayi wa kupangika kwa lactic acidosis ukuwonjezeka).

Zotsatira zoyipa za Metformin kuchokera kugaya dongosolo kumayambiriro kwa maphunzirowa ziyenera kuganiziridwanso monga anorexia, kutsegula m'mimba, kusanza komanso kusanza. Kuphatikiza apo, amatchera khutu ku flatulence ndi kupweteka kwam'mimba (kutsitsidwa akagwiritsidwa ntchito ndi chakudya). Vuto linanso lingakhale kulawa kwazitsulo mkamwa (zopezeka pafupifupi 3%).

Kumbali ya mtima ndi mtima dongosolo, komanso kapangidwe ka magazi ndi hemostasis, muzochitika zina za m'magazi a michere. Monga mukudziwa, ndi chifukwa cha kuphatikizika kwa mayamwidwe a vitamini B12 ndi folic acid. Zotsatira zoyipa zimatha kuchitika pokhudzana ndi metabolism. Choyamba, ichi ndi hypoglycemia. Nthawi zina, tikulankhula za lactic acidosis, mwachitsanzo, kufooka, kugona, kusokonekera komanso zina zowonetsera.

Maonekedwe oyipa amakhudzana ndi khungu. Ndizokhudza chitukuko cha zotupa ndi matendawa. Pofuna kuthana ndi mavuto, ndikulimbikitsidwa kuti muyenera kufunsa katswiri.

Migwirizano ndi magwiritsidwe akusungidwa

Ndikulimbikitsidwa kusunga mankhwalawo pamtunda wosaposa 25 digiri. Ndikofunikira kuti awa ndi malo osafikirika kwa ana. Kusungidwa kwovomerezeka kwa Metformin ndi miyezi 24. Sitikulimbikitsidwa kuti muziigwiritsa ntchito tsiku lotha ntchito litawonetsedwa paphukusi. Mankhwalawa amaperekedwa ndi mankhwala.

Kuyanjana Ndi Mankhwala Ena Ndi Mankhwala Ena

Samalani zophatikizika komanso osavomerezeka. Chifukwa chake, poyambirira tikukamba za kafukufuku wama radiology pogwiritsa ntchito mankhwala a radiopaque omwe ali ndi ayodini. Izi zimayambitsa kupangika kwa lactic acidosis mu matenda ashuga chifukwa kulephera kwa impso.

Kuphatikizidwa komwe kumayambitsa matenda ashuga ndi awa:

Kugwiritsa ntchito pamodzi pa Metformin ndi zakumwa zoledzeretsa ndi mayina okhala ndi Mowa,
kuledzera kwa pachimake,
kusala kapena kutsatira zakudya zamafuta ochepa,
Kulephera kwa chiwindi, komwe, monga kwina, mwayi wa kupangika kwa lactic acidosis ukuwonjezeka.

Palinso zophatikiza zomwe zimafuna chisamaliro chapadera. Tikuyankhula za kugwiritsa ntchito nthawi yomweyo Metformin ndi Danazole chifukwa cha vuto la hyperglycemic. Komanso, muyenera kusamala kwambiri ndi mankhwala monga Chlorpromazine, glucocorticosteroids (GCS) osiyanasiyana. Pogwiritsa ntchito munthawi yomweyo "loop" okodzetsa ndi Metformin, pali mwayi wopanga lactic acidosis chifukwa cha kulephera kwaimpso.

Metformin mwina sangathandize kuthana ndi matenda ashuga pogwiritsa ntchito jakisoni wa aga2-adrenergic agonists, zoletsa za eniotensin-kutembenuza enzyme. Kuphatikiza apo, ndikulimbikitsidwa kwambiri kuchiza zotumphukira za sulfonylurea, Nifedipine.

Kupanga ndi mawonekedwe a kumasulidwa

Kuchuluka kwa metformin mu mankhwala a dzina lomweli ndizosiyana kwambiri: piritsi limodzi limakhala ndi 500 kapena 850 mg ya chinthu chimodzi. Wothandizirana kwa nthawi yayitali wa hypoglycemic ali ndi 1000 mg ya metformin pa unit.

Mapiritsiwa amakhala atakutidwa ndi filimu, mawonekedwe ake ndi biconvex. Kukonzekera komweku kumakhala ndi utoto wa dyes indmm carmine, titanium dioxide, ndi quinoline wachikasu. Phukusili lili ndi miyala 30 kapena 60. Opanga - makampani ochokera ku Hungary, Russia, Israel.

Ma Analogs a Metformin

Matenda a shuga omwe amauzidwa ndi DIABETOLOGIST ndi odziwa Aleksey Grigorievich Korotkevich! ". werengani zambiri >>>

Siofor, Bagomet, Glycomet ndi Glikovin - awa ndi mndandanda wosakwanira wa zolemba zomwe zidasungidwa. Mndandandawu umathandizidwa ndi mayina monga Glyunet, Dianormet, Diaformin, Insufor ndi ena. Sankhani pazomwe zili zabwinoko, Siofor kapena Metformin, amangothandiza katswiri wa matenda ashuga. Sitikulimbikitsidwa kuti mudzipatse nokha kaphatikizidwe kodziyimira nokha.

Zochita pa thupi

Mankhwala opanga ali ndi phindu pa chakudya cham'mimba komanso lipid metabolism, imachepetsa shuga m'magazi, imalepheretsa hyperglycemia kutsutsana ndi mtundu woyamba wa matenda ashuga. Mapiritsi a Metformin ndi othandiza pakadutsa matenda a shuga komanso motsutsana ndi njira yayitali ya endocrine.

Ubwino ndikuwonekera padera (palibe zotsatira zama cell a pancreatic). Sizosadabwitsa kuti mukumwa Metformin, mukamawerengera mulingo woyenera, shuga m'magazi samatsika kwambiri. Kuchepa kocheperako kwa hypoglycemia kumayerekezera ndi antidiabetesic wothandizila ndi mankhwala ena kuti athe kulipira matenda a endocrine.

Pa mankhwalawa, kuchuluka kwa insulin kumachepa, glucose wochokera m'mimba am'mimba amathandizira kwambiri. Chowonadi ndi cholepheretsa kumasulidwa kwa glycogen kuchokera ku hepatocytes, kupititsa patsogolo kwa kusweka ndi kuthetsedwa kwa cholesterol "yoyipa". Pa mankhwala, kukoka kwa glucose komwe kumachitika minofu kumatheka.

Dziwani zambiri za kuperewera kwa adrenal mwa akazi, komanso malamulo othandizira matenda amisempha.

Werengani za zomwe zimachitika mu chithokomiro chithokomiro cha chithokomiro mu chithokomiro.

Zizindikiro zogwiritsidwa ntchito

Mankhwala wozikidwa pa metformin adalembedwa:

ndi mtundu wa shuga wosadalira insulin (II) ngati mankhwala a mzere woyamba. Wothandizira wamkulu wa hypoglycemic ayenera kumwedwa tsiku lililonse. Minyezi ya magazi ikamakhazikika, lipid ndi kagayidwe kazakudya zimapangika, mankhwalawa amachepetsa,
ndi mtundu wa insulin- wodalira (I) mtundu wa matenda amtundu wa endocrine monga adjunct jakisoni wa insulin. Kutsika kwa shuga m'magazi ophatikizidwa ndi kudya bwino kwambiri kwa insulin kumathandizira kubwezeredwa kwa shuga. Pamene mahomoni-ophatikizira akaphatikizidwa ndi Metformin, chiwopsezo cha zovuta zowopsa chimachepetsedwa: matenda a shuga, matenda amitsempha, nephropathy, zotupa zam'mimba, zotupa pakhungu, komanso nthawi zambiri kuwonetsa kwa matenda oopsa.

Mfundo za Metformin

Zomwe zimagwiritsidwa ntchito ndi metformin hydrochloride. Kuchokera ku kalasi ya Biguanides, ndiokhawo omwe ali ndi chothandiza. Ndemanga za odwala zimanena kuti mankhwalawa amagwira bwino kuposa ena ambiri m'gulu lawo. Izi ndichifukwa choti zimachitika pamaselo a cellular, ndikuwonjezera chidwi chawo ku insulin. Chifukwa cha chithandizo cha Metformin, zotsatirazi zimawonedwa:

chiwindi amapanga shuga wocheperako,
mafuta ochulukirapo amayamba kuphatikiza,
maselo amatha kugwedezeka ndi insulin,
shuga wocheperako amatengeka m'matumbo aang'ono,
minofu imayamba kudya shuga,
gawo la shuga pa chimbudzi chimasandukanso lactate (lactic acid).

Chifukwa chake, mankhwalawa amachepetsa shuga m'magazi m'njira yosagwirizana, chifukwa chachikulu chake ndikuwonjezera chidwi cha thupi ku insulin.

Chifukwa chakuti malonda amalimbikitsa kukhathamiritsa kwa mafuta acids, zowonjezera zowonjezera zowonjezera zimawoneka zomwe zimakulitsa gulu la omwe akulimbikitsidwa kumwa Metformin. Izi ndi izi:

mapangidwe a atherosselotic mtima mapepala amasiya
Kuchepa kwa thupi kumachepetsa, komwe kumakhudza bwino mankhwalawa a metabolic syndrome,
kuthamanga kwa magazi kumatulutsa.

Tiyenera kudziwa kuti njira ya oxidation yamafuta acids imakhala mukuwonongeka kwawo ndikusintha kukhala mphamvu. Chifukwa chake, mafuta osungirako amachepetsedwa, thupi limakhala lochepera. Chifukwa chake, mankhwalawa nthawi zambiri amagwiritsidwa ntchito pakuchepetsa thupi, chifukwa amathandizira kuwotcha kwamafuta mwachindunji.

Ndi matenda a shuga 1

Kuchuluka kwa zinthu zomwe zimagwiritsidwa ntchito zimayendetsedwa payekha ndi endocrinologist, kutengera jakisoni wa insulin. Onetsetsani kuti mukuganizira kuchuluka kwa glycemia. Kutalika kwa kugwiritsa ntchito Metformin kukufotokozedwa ndi dokotala yemwe amalingalira za kuthandizira kwokhudzana ndi kuphatikiza kwa mahomoni-kuphatikiza ndi kuphatikizira shuga.

Ndi mtundu 2 matenda

Pafupifupi tsiku lililonse piritsi limodzi, kuchuluka kwa zinthu zogwira ndi 850 kapena 500 mg. Kuchepetsa kusapeza bwino m'mimba yotsekemera, amaloledwa kumwa mankhwala pakudya. Ndi kulekerera kwabwino kwa metformin, kusapezeka kwa mseru komanso kutulutsa, ndikofunikira kulandira mapiritsi mphindi 30 mukatha kudya.

Ngati kuchuluka kwa shuga sikotsika kokwanira, endocrinologist imatha kuwonjezera kuchuluka kwa tsiku lililonse mpaka 2000 mg. Kuphatikizika ndi zotumphuka za sulufanilurea kumapangitsanso kagayidwe, shuga zizindikiro zimachepetsedwa ndi wachitatu kapena kuposerapo.

Mbali zoyipa zotenga Metformin

Zochita zamankhwala ndikuwunika kwa odwala kumawonetsa kuti izi hypoglycemic zimakhala ndi zotsatirapo zoipa. Izi zimachitika chifukwa cha kuchuluka komweko pantchito ya makulidwe a lipids. Mukuchita ntchito zamitundu iyi, mphamvu zambiri sizimangopangidwa zokha, komanso lactate (lactic acid), zomwe nthawi zambiri zimabweretsa acidosis, ndiko kuti, kusintha kwa index ya hydrogen kupita ku mbali ya acid. Izi zikutanthauza kuti pali asidi wambiri m'magazi kuposa momwe amafunikira, omwe amasokoneza ntchito ya ziwalo zonse ndi machitidwe mpaka imfa.

Lactic acidosis imatha kuchitika pang'onopang'ono komanso mosayembekezereka. Nthawi zambiri zizindikiro zake zimakhala zofatsa komanso zosafunikira, koma nthawi zina zimafika pamavuto ngakhale ngati dialysis imafunikira (ndiye kuti, kulumikiza impso yochita kupanga ndi chida). Zizindikiro za lactic acidosis ndi motere:

Mwa odwala ena, metformin ikhoza kupweteka minofu ndi m'mimba.

mawonekedwe ofooka
kugona
chizungulire
kupuma kosakhazikika
kupuma movutikira
kuthamanga kwa magazi
kutentha pang'ono kwa thupi
kupweteka kwa minofu, etc.

Chithandizo cha lactic acidosis nthawi zambiri chimakhala chizindikiro, nthawi zina, hemodialysis imalembedwa (njira yapadera yoyeretsa magazi).

Zotsatira zoyipa

Zotsatira zoyipa zogwiritsa ntchito mankhwalawa Metformin samakhala nthawi zambiri. Ndi kudziwa payekha, ziwengo, kusokonezeka kwa chopondapo, kusapeza bwino pakudya m'mimba, kusintha kwa makomedwe, kusinthika ndikotheka. Poyerekeza ndi kuchepa kwa magazi m'thupi, kuchepa kwa magazi kwa nthawi yayitali, vuto la vitamini B12

Zotsatira zina za kuphatikizidwa kwa hypoglycemic (erythema, urticaria, kuyabwa kwa khungu, kuwonongeka kwa chiwindi michere) ndizosowa. Pambuyo pakuleka kwa mankhwalawo kapena kutsitsa mlingo wa tsiku ndi tsiku, mawonekedwe osayenera amatha.

Lactic acidosis: ndi chiyani

Zosowa, koma zowopsa kwambiri ndikugwiritsa ntchito Metformin. Vuto la metabolic limayamba ndi kuphatikizika kwa chinthu chogwira ntchito mu minofu. Nthawi zambiri, lactic acidosis imawoneka popanda kusamala ndi contraindication monga kulephera kwa impso. Ngati mwadzidzidzi wazindikirika waimpso kulephera komanso aimpso kulephera, chiyambi cha maphunziro, kutsika kwadzidzidzi kwa glucose zikuwoneka ngati zovuta zazizindikiro zowoneka ndizotheka.

Mawonekedwe a lactic acidosis ayenera kudziwika kwa odwala matenda ashuga komanso abale. Kukhazikika kwa wodwala kuchipatala chamankhwala osagwiritsidwa ntchito mwamphamvu kumatha ndi ketoacidotic chikomokere ndi imfa.

dontho lakuthwa,
kupweteka kwam'mimba
dontho la shuga,
kufooka
kugwirana chanza
kupumira msanga (kufupika kwa asidi),
kutsegula m'mimba
wodwala matenda opatsirana
kulephera kudziwa.

kukokoloka kwa electrolyte,
seramu lactate ndi 5 mmol / l kapena kuposa,
kuchepa kwa magazi acid,
kuphwanya chiŵerengero cha lactate ndi pyruvate.

Zizindikiro zopanga lactic acidosis zimafuna kukhudzidwa mwachangu ndi ambulansi. Gulu lachipatala lisanafike, simuyenera kupatsa wodwala Metformin ndi mayina omwe amachepetsa glycemia.

Onani mndandanda wazitsanzo za sabata 9 la tebulo nambala 2 la matenda 2 a shuga.

Malamulo ndi mawonekedwe ogwiritsira ntchito mapiritsi a Triiodothyronine pochiza matenda a chithokomiro akufotokozedwa patsamba lino.

Pitani ku http://vse-o-gormonah.com/vnutrennaja-sekretsija/nadpochechniki/giperplaziya.html ndipo phunzirani za zodziwika ndi zomwe mungachite ndi adrenal hyperplasia.

Kodi mankhwalawa amagwira ntchito bwanji?

Metformin mu shuga imakhudza kwambiri thupi. Ntchito yake yayikulu ndikuchepetsa magazi. Komabe, nthawi imodzimodzi, machitidwe ena a thupi samachita nawo kanthu.

Mapiritsi amtundu wa shuga wachiwiri amachititsa kuti shuga azikhala ndi shuga, makamaka minofu, yomwe siyokwanira odwala matenda ashuga. Kumbukirani kuti kuti muthe kugwira ntchito yolimbitsa thupi muyenera kuchita zolimbitsa thupi.

Mapiritsi a matendawa amathandiza kuchepetsa kuchuluka kwa chakudya mu chiwindi, komanso kuchepetsa matenda a lipid m'thupi. Ndi mtundu 2 wa matenda ashuga, kagayidwe koyenera nkofunika.

Ndi mtundu 2 wa matenda ashuga, ndikofunikira kuti mukhale osakwanira, kupewa kudya kwambiri komanso kunenepa kwambiri. Mapiritsi onenepa kwambiri adzalowa m'malo mwa mankhwalawa, koma izi sizitanthauza kuti muyenera kusiya zakudya zoyenera komanso kuchita masewera olimbitsa thupi.

Kuphatikiza apo, mankhwalawa amatengera matendawa m'njira zina.

Contraindication kugwiritsa ntchito mankhwalawa

Odwala ena ali ndi chidaliro kuti mtundu uwu wa mankhwalawo ulibe vuto. Izi sizili choncho, chifukwa kugwiritsa ntchito mankhwala molakwika kungayambitse mavuto azaumoyo. Simungamwe metformin milandu:

Mimba kapena yoyamwitsa,
Ngati palibe shuga,
Matenda a 1 fomu,
Ngati nthendayo yatenga mawonekedwe
Mavuto a impso
Mtima ndi mapapu
Nthawi yoyamba pambuyo pangozi ya myocardial,
Nthawi yokonzanso itatha ntchito yayikulu.
Ngati matenda osachiritsika ayamba kudwala,
Ngati matenda alowa mthupi,
Kusowa kwazitsulo
Thupi lawo siligwirizana ndi zigawo za mankhwala,
Mowa,
Ngati mumakonda zakudya zamagulu ochepa zopatsa mphamvu (zomwe zimakhala zovulaza ngakhale munthu wathanzi).

Mankhwala a shuga a mtundu wachiwiri sayenera kumwa ngati chinthu chimodzi chikugwirizana ndi inu.

Zotsatira zoyipa

Ngati bongo, kudzichitira nokha, kunyalanyaza malangizo ndi malingaliro a dokotala, mavuto angachitike. Kuchiza ndi metformin kungayambitse mavuto ena:

Kuchepetsa mseru
Kutaya kwathunthu kapena pang'ono pang'ono,
Kubweza
Kutsegula m'mimba
Kuchepetsa kwambiri kutentha kwa thupi,
Kupweteka kwa minofu
Mutu ndi chizungulire,
Kupumira mwachangu
Matenda a shuga
Mavuto ndi malingaliro adziko lapansi,
Ngati mukumwa mankhwala a metformin a shuga ndi mankhwala ena, kuphatikiza uku kungayambitse hypoglycemia.

Kodi metformin ingatengedwe zizindikirozi zikaonekera? Ayi sichoncho. Kuphatikiza apo, pazizindikiro zoyambirira za thupi zosakwanira ndi mankhwalawa, muyenera kufunsa dokotala yemwe akupatseni mankhwala. Njira zochizira matenda amshuga achiwiri sikuti amangokhala ndi thanzi. Ngati itagwiritsidwa ntchito molakwika, imatha kupha.

Contraindication pakugwiritsa ntchito Metformin

Wothandizira zochizira matenda ashuga sayenera kugwiritsidwa ntchito pazotsatirazi:

pa mimba ndi kuyamwa,
ana ochepera zaka 10
Zakudya zochepa zopatsa mphamvu
pambuyo pa ntchito ndi kuvulala
ndi chiwindi
ndi lactic acidosis wam'mbuyomu,
ngati pali chizolowezi cha lactic acidosis,
pamaso pa kulephera aimpso mu anamnesis.

Momwe mungatenge metformin?

Ndikofunikira kwa odwala omwe akufuna kuchiritsidwa glucose owonjezera m'magazi kuti adziwe momwe angapangire metformin yokhala ndi matenda a shuga. Tiyenera kudziwa kuti msika umapereka ndalama ndi mitundu yosiyanasiyana, kuyambira 500 mg mpaka 1000 mg. Palinso mankhwala omwe amakhala ndi mphamvu yayitali. Mlingo woyambirira umaperekedwa muyezo wocheperako, pambuyo pake dokotala angalimbikitse kuchuluka kwake. Chiwerengero chogwiritsidwa ntchito patsiku chitha kutsegulidwanso ndi dokotala, koma mlingo wovomerezeka wa tsiku ndi tsiku sapitirira 2 g.

Zoyenera kuchita ndi bongo wa mankhwala osokoneza bongo

Musachulukitse mlingo wa mankhwalawa kuti muwonjezere mphamvu ya mankhwalawa kapena kufulumizitsa nthawi yochira. Nthawi zambiri, bongo wambiri umatha misozi - imayambitsa zovulaza thupi, milandu yakupha siyachilendo.

Kuopsa kwa bongo wa Metformin ndiko kukula kwa lactic acidosis. Zizindikiro za matendawa ndi zam'mimba (kutanthauza m'mimba) ndi kupweteka kwa minyewa, mavuto am'mimba, kuthamanga, kuthamanga, kutentha pang'ono kwa thupi, chizungulire komanso kutaya chikumbumtima mpaka kugona.

Ngati muli ndi chimodzi mwazizindikirozi, muyenera kusiya kumwa mankhwalawo ndipo muyenera kufunsa dokotala. Chipatala chitenga zonse zofunikira kuti muchotse lactate m'thupi. Milandu yoopsa kwambiri, hemodialysis ndi mankhwala. Imagwira kwambiri ndipo imapereka zotsatira mwachangu.

Kuchita ndi mankhwala ena

Izi zimachokera ku biguanides zili ndi mawonekedwe - pafupifupi zinthu zonse zimafotokozedwa kudzera mu impso osasinthika, ndipo ena onse (pafupifupi 10%) amadziunjikira m'thupi. Ndipo ngati impso zikuyamba kugwira ntchito mosinthana, Metformin imadziunjikira kwambiri mu minofu, zomwe zimabweretsa zotsatirapo zoipa.

Sizoletsedwa kugwiritsa ntchito metformin ndi mowa

Ndikofunikanso kwambiri kugwirizanitsa molondola kugwiritsa ntchito othandizira a hypoglycemic omwe ali ndi insulin. Kupatula apo, ngati Metformin ikuwoneka kuti ili m'magazi kuposa momwe amayembekezeredwa, wodwala wokhazikitsa insulin amatha kugwa mu vuto la hypoglycemic chifukwa kuchepa kwambiri m'magazi a shuga.

Kutsika kwakukulu kwa shuga m'magazi kumawonedwanso pamodzi ndi kugwiritsa ntchito mankhwala otsatirawa ndi Metformin:

zochokera sulfonylurea,
NSAIDs
oxytetracycline
Mao zoletsa (antidepressants apamwamba),
acarbose,
ACE zoletsa
cyclophosphamide,
β-blockers

Ndipo ndalamazi, ndikugwiritsa ntchito mankhwala ochepetsa shuga, m'malo mwake, zimachepetsa ntchito yake:

corticosteroids
mahomoni a chithokomiro,
okodzetsa
estrogens
kulera kwamlomo
nicotinic acid
calcium receptor blockers
adrenomimetics
isoniazids, etc.

Chifukwa chake, Metformin ndi mankhwala abwino kwambiri ochepetsa shuga omwe ali ndi mphamvu kwambiri, koma nthawi yomweyo siwothandiza konsekonse. Imakhala ndi zotsatirapo zake zoyipa ndi zotsutsana. Ambiri aiwo ndi ang'ono ndipo amadutsa mkati mwa masabata 1-2, koma ena angakakamize kusiya.

Kuti mankhwalawa agwire bwino ntchito, ndikofunikira kugwirizanitsa ndi dotolo, kutsatira malingaliro ake onse, kutsatira mosamalitsa zakudya zomwe zimayikidwa ndikuwonetsetsa mosamala zotsutsana ndi zotsatirapo zake. Muyenera kukumbukiranso kuti mowa ndiye mdani wamkulu wa Metformin, chifukwa chake zakumwa zakumwa zoledzeretsa siziyenera kuperekedwa munthawi yamankhwala. Izi ndichifukwa choti mowa umaletsa ntchito za ma enzymes angapo a chiwindi. Chifukwa chake, Metformin yambiri imalowa m'magazi, zomwe zimapangitsa kutsika kwakukulu kwa glucose mpaka hypoglycemia. Komanso, mowa akamagwiritsa ntchito mankhwala amapangira lactic acid. Chifukwa chake, kugwiritsa ntchito mankhwalawa pogwiritsa ntchito mankhwalawa amatsutsana.

Mlingo ndi njira ya mankhwala

Mankhwala a shuga mellitus "metformin" angatengedwe pokhapokha akuwuzidwa ndi dokotala. Dokotala ndikuyika mlingo woyenera. Ndi iyo, muyenera kufotokoza zonse za kumwa mankhwalawo. Malangizo pazomwe mungamwe metformin mu matenda a shuga:

Mlingo woyambirira nthawi zambiri ndi mapiritsi 1 kapena 2 a mankhwalawa.
Ngati pambuyo pa masabata awiri mavuto sanawonekere, muyezo mutha kuchuluka. Kuchulukitsa kumene kumachitika ndi lingaliro la dokotala. Zimatengera kuchuluka kwa shuga m'magazi,
Mlingo wamba, womwe umathandizira kuchepetsa shuga la magazi komanso kupewa zovuta, ndi mapiritsi atatu kapena anayi patsiku,
Ngati wodwalayo ali wokalamba, sayenera kumwa mankhwala ambiri mapiritsi awiri patsiku,
Mlingo wapamwamba kwambiri womwe ungamwe mowa wokhawo womwe dokotala wakupangira ndi mapiritsi 6 patsiku,
Kodi ndingamwe kumwa tsiku lililonse nthawi yomweyo? Madotolo amalangiza kugawa muyezo Mlingo 3,
Muyenera kumwa mankhwalawo mukatha kudya. Poterepa, onetsetsani kuti mumamwa mapiritsi ndi madzi ambiri.

Ndi bongo wambiri, mavuto onse amawonedwa nthawi yomweyo. Musamale, chifukwa kugwiritsa ntchito molakwika mankhwalawa kungayambitse zotsatira zoyipa. Metformin ya mankhwala a matenda a shuga a 2 imangothandiza pokhapokha ngati mukutsatira mosamalitsa malangizo ake.

Musaiwale kudya nthawi yomweyo monga kumwa mankhwalawo ndikuchita masewera olimbitsa thupi osavuta. Popanda izi, mankhwala aliwonse adzakhala opanda ntchito, ndipo simungathe kupewa zovuta zoyambira.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mapiritsi okhala ndi interic, Metformin ali ndi mawonekedwe ozungulira, mawonekedwe a biconvex ndi mtundu woyera. Chofunikira chachikulu pa mankhwalawa ndi metformin hydrochloride, zomwe zili piritsi limodzi ndi 500 mg. Komanso, kapangidwe kake kamaphatikizapo zinthu zothandiza, zomwe zimaphatikizapo:

Crospovidone.
Talc.
Magnesium wakuba.
Wowuma chimanga.
Methaconic acid ndi methylryacoplate patyl.
Povidone K90.
Titanium dioxide
Macrogol 6000.

Mapiritsi a Metformin amaikidwa mu chithuza chamtundu wa zidutswa 10. Phukusi la makatoni limakhala ndi matuza atatu (mapiritsi 30) ndi kofotokozera wogwiritsa ntchito mankhwalawo.

Zotsatira za pharmacological

Zomwe zimagwiritsidwa ntchito ndi mapiritsi a Metformin amachepetsa kuchuluka kwa shuga m'magazi chifukwa cha zotsatira zingapo zoyambira:

Kuchepetsa shuga m'matumbo a lumen kulowa m'magazi.
Kuchulukitsa chidwi cha minyewa yolandila minofu kupita ku insulin (mahomoni apachifinya omwe amalimbikitsa kugwiritsidwa ntchito kwa glucose kuchokera m'magazi m'thupi lathu).
Imawonjezera kugwiritsidwa ntchito kwina kwa chakudya chamafuta m'thupi lathu.

Metformin sikukhudza maselo a pancreatic omwe amachititsa kuti insulini ipangidwe, samakhudzanso kuchuluka kwake m'magazi, komanso sizitsogolera ku hypoglycemic state (kuchepa kwakukulu kwa kuchuluka kwa shuga m'magazi). Amachepetsa mulingo wa triglycerides (mafuta m'magazi), amathandizira kukonza kagayidwe m'thupi, kumabweretsa kuwonda, amakhala ndi vuto la fibrinolytic (amathandiza kupasuka kwa fibrin).

Mutatenga mapiritsi a Metformin mkati, chinthu chomwe sichikugwira bwino ntchito (bioavailability pafupifupi 60%). Imafikika pogawana tiziwalo tathupi tambiri, tomwe timadziphatikizika tiziwalo tating'ono, chiwindi, impso ndi minofu. The yogwira thunthu la mankhwala si zimapukusidwa ndi kuchotsedwa osasinthika mu mkodzo. Hafu ya moyo (nthawi yomwe theka lathunthu la mankhwalawa limachotsedwa m'thupi) ndi maola 9-12.

Mlingo ndi makonzedwe

Mapiritsi a Metformin amatengedwa pakamwa ndi chakudya kapena atangomaliza kumwa. Osatafuna piritsi ndi kumwa madzi ambiri. Kuchepetsa mwayi wokhala ndi zovuta m'mimba, njira ya tsiku ndi tsiku imatengedwa, ndikugawikana mu Mlingo wa 2-3. Dokotala amakhazikitsa mlingo ndi mankhwalawa a mankhwalawo payekhapayekha, kutengera mphamvu yoyamba ya shuga m'magazi, komanso chithandiziro chothandiza. Nthawi zambiri, mlingo woyambira ndi 500-1000 mg patsiku (mapiritsi 1-2). Pambuyo masiku 10-15, kutengera kuchuluka kwa kuchuluka kwa shuga m'magazi, ndizotheka kuwonjezera kuchuluka kwa mapiritsi a Metformin mpaka 1500-2000 mg patsiku. Mlingo wambiri watsiku ndi tsiku sayenera kupitirira 3000 mg. Mwa anthu okalamba, pazipita tsiku lililonse pazichiritsidwe zochiritsira siziyenera kupitirira 1000 mg.

Zotsatira zoyipa

Kutenga mapiritsi a Metformin kungayambitse kukulitsa zovuta kuchokera ku ziwalo ndi machitidwe osiyanasiyana:

Matumbo a pakhungu - "chitsulo" pakamwa, mseru, kusanza kwakanthawi, kupweteka kwam'mimba, kutsegula m'mimba, kusowa chilakolako cha chakudya mpaka kusowa kwathunthu (anorexia), flatulence (kuchuluka kwa mpweya m'mimba). Zotsatira zoyipazi nthawi zambiri zimayamba kumayambiriro kwa chithandizo cha mankhwalawo ndikudziwonera zokha. Kuti muchepetse kuopsa kwa zizindikirozi posachedwa, ma antacid, antispasmodics ndi mankhwala ofanana ndi atropine amalembedwa ndi adokotala.
Dongosolo la endocrine ndi hypoglycemia (kuchepa kwa ndende yamagazi m'munsi mwabwinobwino).
Metabolism - lactic acidosis (kuchuluka kwa lactic acid m'magazi), kuyamwa kwa vitamini B12 m'matumbo.
Magazi ndi mafupa ofiira - kuchepa kwa magazi m'thupi (megaloblastic anemia) (kuchepa kwa magazi ndi kupindika kwa maselo ofiira am'magazi chifukwa cha kuperewera kwa vitamini B12) sikungatheke.
Thupi lawo siligwirizana - zotupa pakhungu ndi kuyabwa.

Ndi chitukuko cha zotsatira zoyipa mutatha kumwa mapiritsi a Metformin, adotolo amasankha payekha pakubweza mankhwalawo, kutengera mtundu ndi kuuma kwawo.

Malangizo apadera

Musanayambe kumwa mapiritsi a Metformin, muyenera kuwerengera mosamala malangizo a mankhwalawo. Pali malangizo angapo okhudza kugwiritsidwa ntchito kwake, omwe akuphatikizapo:

Ndi kuwoneka kwa kupweteka kwa minofu (myalgia) mankhwala atayamba, kutsimikiza kwa labotale kwa mulingo wa lactic acid kumachitika.
Kugwiritsa ntchito mankhwalawa kwa nthawi yayitali kumafunikira kuwunikira pafupipafupi maulalo a ntchito ya impso.
Ndi kuphatikiza kwa mapiritsi a Metformin okhala ndi mankhwala ochokera ku sulfonylureas, kuwunika kwamisempha wamagazi pafupipafupi kumafunikira.
Pa nthawi ya mankhwala ayenera kupewa mowa ndi mankhwala okhala Mowa.
Mapiritsi a Metformin amatha kuyanjana ndi mankhwala a magulu ena a pharmacological, chifukwa chake, mukamamwa, ndikofunikira kuchenjeza adokotala omwe akupezekapo.
Ngati zizindikiro za bronchopulmonary ndi genitourinary pathology zikuwonekera kumbuyo kwa kumwa mankhwalawa, kugwiritsa ntchito kwake kuyenera kuyimitsidwa ndikuyang'ana kwa dokotala.
Mankhwala samakhudzana mwachindunji ndi magwiridwe antchito a ubongo. Komabe, mukagwiritsidwa ntchito ndi mankhwala ena ochepetsa shuga, chiwopsezo cha hypoglycemia chimawonjezeka, chifukwa chake, pogwira ntchito yofunikira pakuwonetsetsa kwambiri komanso kuthamanga kwa zochitika za psychomotor, muyenera kusamala.

Pulogalamu yamankhwala, mapiritsi a Metformin amapezeka pamankhwala. Kudziyang'anira nokha popanda mankhwala oyenera sikulimbikitsidwa.

Bongo

Ndiwowonjezera pazovomerezeka zochizira mapiritsi a Metformin, ndende ya lactic acid m'magazi imatuluka (lactic acidosis). Izi zimayendera limodzi ndi mseru, kusanza, kutsegula m'mimba, kuchepa kwa kutentha kwa thupi, kupweteka m'misempha ndi m'mimba, komanso kupumira mwachangu. Pankhaniyi, mankhwalawa ayenera kusiyidwa. Chithandizo chachikulu cha bongo chimachitika kuchipatala mothandizidwa ndi hemodialysis (kuyeretsa magazi kwa magazi).