Type 2 shuga indapamide: kuthamanga kwa chithandizo

Mankhwala osokoneza bongo a diabetes 2 mtundu wa shuga amagwiritsidwa ntchito kwambiri mankhwalawa omwe amapezeka ndikukula kwa matenda oopsa a shuga, kuchepa kwa magazi kapena ngati pakufunika kuthetsa Edema ya mwendo.

Mpaka pano, pali mitundu ingapo yamankhwala osiyanasiyana omwe apangidwa omwe amatha kuwonjezera mkodzo wambiri.

Kusankha kwa diuretic, ngati kuli kotheka, kuyenera kuchitika ndi adokotala pozindikira zotsatira za kusanthula kwake, poganizira umunthu wa thupi la wodwalayo.

Chimodzi mwa mankhwala wamba ndi indapamide.

Indapamide ndi ya gulu la thiazide-ngati diuretics. Mankhwala ali vasodilating.

Ma diuretics amagwiritsidwa ntchito ngati mankhwala othandizira odwala matenda ashuga. Mankhwalawa amalimbikitsa zotsatira za ACE inhibitors.

Taizide-ngati diuretics, kuphatikizapo Indapamide, amathandiza kwambiri matenda ashuga. Mankhwalawa sakukhudzidwa pang'ono pokhudzana ndi potaziyamu komanso kuchuluka kwa shuga ndi mafuta m'magazi.

Kuvomerezedwa kwa Indapamide kwa matenda a shuga a 2 sikuti kumayambitsa zovuta mu kugwira ntchito kwa impso za wodwalayo.

Mankhwalawa ali ndi phindu lalikulu m'thupi la wodwalayo nthawi iliyonse yovulala impso, yomwe imayendera limodzi ndi matenda a shuga a mtundu wodziimira pawokha a insulin.

Kuphatikizika kwa mankhwalawa, kufotokoza kwina ndi pharmacotherapy

Mankhwalawa amapangidwa ndi makampani azachipatala momwe amapangira mapiritsi amkamwa.

Mankhwala omwe ali pamwambapa ali ndi zokutira zamafuta.

Chofunikira chachikulu chothandizira cha mankhwalawa ndi indapamide, piritsi limodzi lili ndi 2,5 mg ya pawiri.

Kuphatikiza pazomwe zimagwira, mankhwala ena owonjezera omwe ali ndi gawo lothandizira amathandizidwa ndikupanga mankhwala.

Mapulogalamu othandizira ndi awa:

lactose monohydrate,
povidone-K30,
crospovidone
magnesium wakuba,
sodium lauryl sulfate,
talcum ufa.

Zomwe zikuchokera pamwamba pa chiganamba cha mapiritsi ndi izi:

Hypromellose.
Macrogol 6000.
Talc.
Titanium dioxide

Mapiritsiwo ali ndi mawonekedwe ozungulira, opindika ndipo ali penti yoyera.

Mankhwala ndi a gulu la mankhwala a diuretic. Malo ake ali pafupi kwambiri ndi thiazide diuretics.

Pambuyo kumwa mankhwalawa, kwamikodzo excretion wa sodium ndi chlorine kuchokera mthupi la munthu umachuluka. Pocheperako zimakhudza njira ya excretion wa potaziyamu ndi magnesium ayoni thupi.

Mankhwalawa amatha kuletsa njira zamkati mwa calcium ndikuwonjezera kukhuthala kwa khoma lamitsempha yama mitsempha, kuchepetsa kukanikizika kwathunthu kwamitsempha yama thupi.

Kumwa mankhwalawa kumathandiza kuchepetsa hypertrophy ya mtima wamanzere wamitsempha.

Kugwiritsa ntchito mankhwalawa sikukhudza kuchuluka kwa kuchuluka kwa lipid m'magazi ndipo sikukhudza kagayidwe kazakudya.

Kumwa mankhwala kumakuthandizani kuti muchepetse kuzindikira kwa khoma lamitsempha ku zotsatira za norepinephrine ndi angiotensin II pamenepo, ndipo amakupatsani mwayi wolimbitsa kaphatikizidwe ka prostaglandin E2 m'thupi.

Kugwiritsa ntchito mankhwala kumachepetsa kukula kwa mapangidwe a ma free radicals komanso okhazikika mthupi.

Kupitilira kwamphamvu kwa mankhwalawa kumachitika sabata pambuyo pa kuyamba kwa mankhwalawa ndikupitilira tsiku limodzi pakapita tsiku limodzi.

Pharmacokinetics wa mankhwala

Mutatha kumwa mankhwalawa, umatengetsa kwathunthu kuchokera m'matumbo amkati ndikuzungulira magazi. Mankhwalawa ali ndi bioavailability yayikulu, pafupifupi 93%.

Kudya kumachepetsa kuthira kwa mankhwala kulowa m'magazi, koma sikukhudza kuchuluka kwa mankhwala omwe amamwa. Kuzindikira kwakukulu kumatheka m'magazi 1-2 patatha kumwa mankhwalawo mkati.

Pogwiritsa ntchito mankhwalawa mobwerezabwereza, kusinthasintha kwake komwe kumapangitsa chidwi chake mthupi pakati pamadontho kumachepetsedwa. Mankhwalawa amafikira pakulingana mu thupi pambuyo masiku 7 atatha kumwa mankhwalawa.

Hafu ya moyo wa mankhwalawa imachokera ku maola 14 mpaka 24. Mankhwalawa amakumana ndi mapuloteni a m'magazi a m'magazi. Mlingo wa zomanga mapuloteni uli pafupi 79%.

Yogwira pophika mankhwala amathanso kumangiriza ku elastin ya yosalala minyewa yomwe ili mbali ya khoma lamankhwala.

Mankhwala amatha kudutsa zotchinga minofu, amatha kudutsa chotchinga chachikulu. Mukamwa mankhwala, imadutsa mkaka wa m'mawere.

Kupanga kagayidwe kogwira ntchito kumachitika m'ziwindi za chiwindi. Excretion wa gawo yogwira ikuchitika mu mawonekedwe a metabolites ndi impso mu buku kuchokera 60 mpaka 80%. Ndi ndowe, pafupifupi 20% imachotsedwa m'matumbo.

Ngati wodwala walephera, a pharmacokinetics a mankhwalawa sasintha. Kudzikundikira ndalama mthupi sikumachitika.

Zizindikiro ndi contraindication chifukwa cha mankhwala

Chizindikiro chachikulu chakumwa mankhwala a shuga ndikutukuka kwa wodwala yemwe ali ndi matenda oopsa.

Monga chida china chilichonse chachipatala, Indapamide imakhala ndi zotsutsana zingapo kuti zigwiritsidwe.

Kugwiritsa ntchito mankhwalawa kumaloledwa pokhapokha ngati pali zotsutsana ndi wodwala.

Milandu ikuluikulu yomwe imagwiritsidwa ntchito ngati mankhwala ndi awa:

wodwala amakhala ndi chidwi chambiri ndi mankhwala omwe amapangidwa pamaziko a sulfonamide,
tsankho kwa odwala ndi lactose,
wodwala ali ndi galactosemia,
munthu akaulula zizindikiro za malabsorption matenda a shuga kapena galactose,
Kuzindikira wodwala wolephera aimpso,
kukhalapo kwa zizindikiro za hypokalemia,
kupezeka kwa kulephera kwa chiwindi,
matenda a shuga a impso
nthawi ya bere ndi kuyamwitsa,
zaka wodwala zafika 18,
kuchitira chithandizo momwe munthawi yomweyo makonzedwe a othandizira amatha kutalikitsa nthawi ya QT akuchitika.

Mochenjera, muyenera kumwa mankhwalawa mukazindikira kuti pali vuto la impso ndi chiwindi, ngati wodwala akupezeka m'magazi a electrolyte, pamaso pa hyperparathyroidism.

Kuphatikiza apo, Indapamide iyenera kugwiritsidwa ntchito mosamala pochita mankhwala omwe antiarrhythmic mankhwala amagwiritsidwa ntchito kale.

Chenjezo limagwiritsidwa ntchito ngati mankhwala opanga matenda a shuga kumapeto kwa kuwonongeka.

Malangizo ogwiritsira ntchito mapiritsi

Kuvomerezeka kwa mankhwalawa kumachitika mosasamala ndondomeko yakudya. Zakudya zam'mapiritsi zimayenera kutsatiridwa ndikumwa madzi ambiri. Nthawi yomwe amakonda kumwa mankhwalawa ndi m'mawa.

Mlingo wamba wabwinowu wothandizidwa ndi 2,5 mg kapena piritsi limodzi patsiku. Ngati pambuyo pa masabata 4-8 a chithandizo chomwe mukufuna sichikwaniritsidwa, mulingo sayenera kuchuluka. Kuwonjezeka kwa mlingo kungasokoneze chitukuko m'thupi la zotsatira zoyipa kuchokera ku kugwiritsa ntchito mankhwalawa.

Pakakhala zotsatila zamankhwala, tikulimbikitsidwa kusintha mankhwalawo kukhala othandiza kwambiri. Zikachitika kuti mankhwalawa amachitika pogwiritsa ntchito mankhwala awiri, mlingo wa Indapamide amakhalabe osasinthika pa 2,5 mg patsiku.

Mukamamwa Indapamide mwa munthu, zotsatira zina zoyipa zimatha kuonekera zomwe zimawoneka m'magwiridwe antchito osiyanasiyana amthupi.

Zotsatira zoyipa zomwe mumakonda kugwiritsa ntchito Indapamide pa matenda ashuga ndi izi:

Matumbo oyenda. Mwina chitukuko cha kutsegula m'mimba, kudzimbidwa, kuwoneka kwa ululu pamimba. Nthawi zambiri pamakhala kugunda kwamkamwa komanso kuwuma pamkamwa. Mwina kuwoneka kusanza nthawi zina, kukula kwa kapamba kumatheka.
Pakati mantha dongosolo. Mwina chitukuko cha dziko la asthenic, mawonekedwe a manjenje owonjezereka, kupweteka kwa mutu ndi matenda ashuga, kuwodzera kugona. Nthawi zina, kufooka kwambiri ndi kufooka wamba kumawonekera. Nthawi zina pamakhala kumverera kwazonsezi, kuchepa kwa minofu, kusokonekera ndi nkhawa.
Njira yopumira imatha kukhala chifuwa, pharyngitis, sinusitis ndipo, nthawi zina, rhinitis.
Mtima wamtima. Mwinanso kukulitsa kwa orthostatic hypotension, kusintha kwa electrocardiogram, ndizotheka kuti wodwalayo akhale ndi arrhythmias pamtima ndikuchulukitsa kugunda kwa mtima.
Njira yamkodzo. Kuthekera kwakukulu kokulitsa matenda pafupipafupi ndi polyuria.
Khungu. Mwina chitukuko cha thupi lawo siligwirizana zikuwoneka mawonekedwe a zotupa pakhungu, kuyabwa kwa khungu ndi hemorrhagic vasculitis.

Kuphatikiza pazotsatira zoyipa izi, thrombocytopenia, leukopenia, agranulocytosis, komanso kuchulukitsa kwa systemic lupus erythematosus kumatha kukhala mthupi la wodwalayo.

Mndandanda wamankhwala, mawonekedwe omasulidwa, mtengo wake komanso malo osungira

Mankhwala amapezeka mu mawonekedwe a mapiritsi okhala ndi piritsi, piritsi lililonse lili ndi 2.5 mg ya mankhwalawa.

Mapiritsi a zidutswa 10 amadzaza phukusi lapadera la contour cell lopangidwa ndi polyvinyl chloride film komanso yokutira ndi zojambulajambula za aluminium. Mapaketi atatu apadera, komanso malangizo ogwiritsira ntchito mankhwalawa, aikidwa m'mathumba a makatoni.

Mankhwalawa amawaika kuti azisungidwa pamalo amdima pamoto pa 15 mpaka 25 digiri Celsius. Malo osungira mankhwalawa sayenera kupezeka kwa ana.

Alumali moyo wa mankhwala ndi zaka 3. Ikatha nthawi yosungirako, mankhwalawo ndi oletsedwa. Mankhwala omwe atha ntchito amataya.

Kuphatikiza pa Indapamide, mankhwala adapangidwa omwe ali ndi mawonekedwe ake.

Odziwika kwambiri ndi otchuka ndi awa:

Arifon Repard - analog wodziwika bwino wa Indapamide, samakhudza kagayidwe kazachilengedwe.
Acriptamide ndi analog ya Indapamide, yomwe ndi yaku Russia.
Indap ndi mankhwala opangidwa ku Czech Republic.
Noliprel ndi mankhwala osakanikirana omwe ndi othandiza kwambiri.
Perinide ndi mankhwala otchuka omwe ali oyenera odwala ambiri.

Mtengo wa Indapamide ku Russian Federation pafupifupi umachokera 12 mpaka 120 ma ruble, kutengera wopanga ndi dera lomwe mankhwalawo amagulitsidwa.

Katswiri kuchokera pa kanema munkhaniyi azikamba za zamtundu wa Indapamide.

Mapiritsi opanikizika a shuga mellitus mtundu 1, lembani 2: kuchokera kumtunda ndi wotsika womwe muyenera kutenga

Nthawi zambiri ndi shuga, kuthamanga kwa magazi, komwe kumasokoneza mtima, kumavulaza impso ndi ziwalo zina zamkati. Mtundu woyamba wa matenda ashuga, matenda oopsa amawonekera chifukwa cha matenda a impso.

Ngati munthu ali ndi mtundu wachiwiri, ndiye kuti kukhazikika kwa matenda a Itsenko-Cushing's, pheochromocytoma, kumathandizira kuwonjezeka. Odwala otere, matenda oopsa amathanso kupititsa patsogolo matendawa omwe amatsogolera kuimfa, chifukwa chake dokotala amalembera mapiritsi a antihypertensive.

Magulu akuluakulu a mankhwalawa amaphatikizapo: okodzetsa, ACE zoletsa, beta-blockers, BKK, ARB.

Ma diuretics ndi ma diuretics omwe amatengedwa molumikizana ndi mankhwala ena. Zimakhudza kugwira ntchito kwa impso ndikufulumizitsa kuchotsa kwamkodzo mthupi. Mu matenda ashuga, okodzetsa amatha kuchepetsa zizindikiro za matenda oopsa komanso kuthetsa kutupa.

Mankhwala a diuretic ndi amtundu awa:

Loop - thandizani mwachangu kutengera kukakamiza. Furosemide amadziwika kuti ndi mankhwala ambiri.
Thiazide - kuwonjezera kuchuluka kwa shuga, cholesterol ndi triglycerides. Awa ndi chlortalidone, clopamide, indapamide.
Osmotic - chotsani madzi ochulukirapo ku michere ya edematous chifukwa kuchepa kwa kuthamanga kwa magazi. Zothandiza kwambiri: Potaziyamu acetate, Mannitol.

Odwala ambiri omwe ali ndi kuthamanga kwa magazi amapatsidwa thiazide diuretics, yomwe imayenera kutengedwa kwa nthawi yayitali. Koma amatha kutsitsa sodium yambiri.

Tikutenga mankhwalawa, odwala ayenera kudya zipatso ndi ndiwo zamasamba zambiri, zomwe zingabwezeretse kuwonongeka kwa magnesium, potaziyamu ndi sodium.

Pa chithandizo, kuchuluka kwa shuga m'magazi kuyenera kuyang'aniridwa, ndikuwonjezera kuchuluka kwa diuretic ngati pakufunika.

Ngati wodwala yemwe ali ndi matenda a shuga a m'matumbo a 2 atayamba kutupa kwamiyendo ndikukumana ndi kuthamanga, dokotalayo amamulembera Indapamide kapena Arifon. Mankhwalawa onse samakhudza kagayidwe kazakudya. Zopatsa zina ndizogwiritsidwa ntchito pafupipafupi.

ACE zoletsa

Chofunikira kwambiri kwa anthu odwala matenda ashuga, omwe amaphatikizidwa ndi matenda oopsa, ACE inhibitors.

Mankhwalawa amasokoneza kupanga enzyme yomwe imayendetsa magazi muubongo, ndikuthandizira kutulutsa kwa aldosterone, komwe kumakola sodium ndi madzi m'thupi lathu.

Chifukwa cha kugwiritsidwa ntchito kwa ACE inhibitors, mitsempha ya m'magazi imachepetsa ndipo madzi ochulukirapo amachotsedwa m'thupi, zomwe zimapangitsa kuti magazi azikhala ochepa.

Mankhwalawa ali ndi tanthauzo la nephroprotective, lomwe limapitilira ngakhale kuchepa kwamphamvu kwa mavuto.

Kuphatikiza apo, ali ndi phindu pamakoma amitsempha yamagazi, kuletsa mapangidwe a atherosselotic plaque, ndipo amakhala ndi mtima wamtima, kuteteza motsutsana ndi kugunda kwa mtima komanso sitiroko.

ACE zoletsa sizimasokoneza kagayidwe ka mafuta ndi chakudya ndikuwonjezera chidwi cha minofu kuti insulin.

Mankhwalawa amatchulidwa mosamala mu kulephera kwa aimpso iwo akuchedwa kuchotsedwa kwa potaziyamu m'thupi. Nthawi zina, kusiyanitsa zakumwa zawo, zotsatira zoyipa zimachitika ngati chifuwa champhamvu, chomwe chimafuna kusiya kugwiritsa ntchito mankhwala. Iwo ali contraindicated pa mimba, yoyamwitsa, apakati aimpso mtsempha wamagazi stenosis.

Mankhwala othandiza kwambiri:

Enalapril, Attoril, Burlipril, Enap.
Quinapril, Quinafar, Accupro.
Lisinopril, Vitopril, Diroton, Zonixem.

Beta blockers

Beta-blockers amalembera odwala matenda ashuga komanso kuthamanga kwa magazi, pamene vutoli limapanikizika ndi kulephera kwa mtima, angina pectoris ndi tachycardia. Nthawi zambiri, adokotala amakonda mankhwala osokoneza bongo omwe samakhala ndi vuto pa kagayidwe ka shuga.

Atenolol, Atenol, Atenobene.
Metoprolol, Corvitol, Emzok.
Bisoprolol, Concor, Coronal, Bicard, Bidop.

Koma mankhwalawa amatha kuonjezera kuchuluka kwa shuga ndi cholesterol m'thupi ndikupangitsa insulini kukaniza.

Beta-blockers monga Nebilet, Coriol, Atram, ali ndi zowonjezera vasodilating. Mapiritsi opanikizika awa a shuga amachepetsa kukana kwa insulin ndipo amakhala ndi phindu pa lipid ndi carbohydrate metabolism.

Bcc (olimbana ndi calcium)

Calcium calcium blockers nthawi zambiri amalembera kukakamizidwa, chifukwa sizimakhudza metabolidi ya lipid ndi carbohydrate. Amagwiritsidwa ntchito ngati wodwala nawonso akudwala ischemia ndi angina pectoris. Choyamba, mankhwalawa amaperekedwa kwa okalamba.

Makonda amapatsidwa mankhwala omwe amakhala ndi mphamvu yayitali, omwe amayenera kumwa nthawi 1 patsiku:

Amlodipine ali ndi mphamvu yayitali.

Ma calcium antagonists amatsogolera pakupanga zotsatira zoyipa monga kutupa ndi kuwonjezeka kwa mtima, zomwe nthawi zambiri zimawabwezera. Mankhwala okhawo omwe alibe zoterezi ndi Lerkamen.

Sconce (angiotensin receptor antagonists)

Angiotensin II receptor blockers amagwira ntchito mochizira matenda oopsa omwe amakhala ndi matenda ashuga. Ali ndi izi:

chepetsa kukana insulini,
khalani ndi zotsatira zabwino,
chepetsa hypertrophy yamanzere yamtima,
sizimakhudza kagayidwe kachakudya,
wolekeredwa bwino komanso wokhala ndi zovuta zoyipa.

Kuchita kwa mankhwala kumayamba pang'onopang'ono ndikufikira pakatha zovuta zowerengeka zamtundu wa 2-3 pambuyo poyambitsa makonzedwe.

Mankhwala othandiza kwambiri:

Sartokad, Diosar, Vasar.
Makandulo, Othandizira, Omanga.
Closart, Lorista, Cozaar, Lozap.

Alfa oletsa

Kugwiritsa ntchito alpha-blockers, ntchito ya α-adrenergic receptors yomwe ili mumisempha yambiri ndi ziwalo zimatsekedwa. Mankhwalawa ndi osankha komanso osasankha. Zochizira matenda oopsa mu shuga, osakaniza-alpha-blockers amagwiritsidwa ntchito komanso pokhapokha pothandizira.

Mankhwalawa amachepetsa kuchuluka kwa shuga ndi lipids, komanso kukana kwa insulin. Chifukwa cha alpha-blockers, kupanikizika kumachepetsa bwino, osayambitsa kuwonjezeka kwambiri kwa kugunda kwa mtima. Koma mankhwalawa amayenera kuthandizidwa mosamala ndi neuropathy yayikulu, yomwe imadziwika ndi dontho la kuthamangitsidwa kwa orthostatic. Amadziwikanso ndi matenda amtima.

Terazosin amachepetsa kuchuluka kwa shuga ndi lipids.

Rasilez (woyang'anira mwachindunji renin inhibitor)

Ichi ndi mankhwala atsopano omwe amachepetsa kuthamanga kwa magazi tsiku lonse. Pambuyo pa milungu iwiri yokhudza kudya pafupipafupi, zimachitika modabwitsa ndipo zimabwezeretsa magawo a hemodynamic magawo.

Rasilez imagwiritsidwa ntchito kuphatikiza mankhwala ndi angiotensin ii receptor blockers kapena ACE inhibitors. Chifukwa cha kuphatikiza uku, impso ndi mtima zimatetezedwa bwino. Mankhwalawa amathandizira kukonza cholesterol m'magazi ndikuwonjezera chidwi cha minofu kuti insulin.

Ndi mapiritsi ati omwe ndi abwinoko kupewera pamaso pa matenda ashuga?

Ngakhale kuti pali mankhwala ambiri omwe amachepetsa kuthamanga kwa magazi, si mankhwala onse omwe ali oyenera kwa anthu odwala matenda a shuga. Mankhwala otsatirawa ndi oletsedwa - Xipamide, Hydrochlorothiazide, Hypothiazide.

Izi ndizopukusa zomwe zimachulukitsa shuga wamagazi ndikuwonjezera kuchuluka kwa cholesterol yoyipa. Kuphatikiza apo, mankhwalawa amakhudza kwambiri magwiridwe antchito, omwe ndi owopsa kwambiri kwa anthu omwe ali ndi vuto la impso.

Kugwiritsa ntchito mankhwala a antihypertensive monga calcium antagonists okhudzana ndi dihydropyridines yocheperako sikulimbikitsidwa kuthamanga kwa magazi komanso matenda ashuga. Ngakhale muyezo wochepa, amakulitsa mwayi wokhala ndi vuto la mtima ndipo amatsutsana ndi matenda a mtima. Izi zikuphatikizapo mankhwala Nifedipine.

Atenolol, omwe ali m'gulu la beta-blockers, ndi oletsedwa, chifukwa zimathandizira kulumpha lakuthwa mu shuga wamagazi ndi kukula kwa hypo- ndi hyperglycemia. Kuphatikiza apo, mankhwalawa amachepetsa chidwi cha minyewa kupita ku insulin, yomwe imapangidwa ndi kapamba.

Momwe mungakulitsire kuthamanga kwa magazi mu shuga?

Kuthamanga kwa magazi kwamtundu wa shuga wachiwiri nthawi zambiri kumachitika mwa akazi. Poterepa, pali kuphwanya kayendedwe kazinthu, ndipo ma cell amasiya kulandira zofunikira. Ngati matendawa sanalandiridwe, izi zimapangitsa kuti pakhale zovuta zamtima. Kuphatikiza apo, zovuta monga:

matenda ashuga
thrombosis
kufa kwa minofu kumapeto,
zilonda zam'mimba.

Hypotension mu shuga imayamba chifukwa:

kusowa tulo
matenda am'mimba
kusowa kwa mavitamini ndi michere mthupi,
kupsinjika
matenda a mtima
mankhwala a nthawi yayitali
matenda amanjenje.

Odwala achulukitsa thukuta, malekezero ozizira, kumva kuti ali ndi vuto, mantha amayamba, kufooka komanso kugona kumachitika. Kuti muwonjezere kupsinjika kwa shuga, mankhwala apadera amalembedwa. Mankhwala abwino kwambiri ndi Eleutherococcus ndi Leuzea. Amatengedwa masiku 7, kenako amapuma kwa mwezi umodzi.

Ndi hypotension, wowerengeka azitsamba amathandizira. Mutha kuphatikiza tiyi wobiriwira komanso ascorbic acid. Kugwiritsa kulowetsedwa kwa kabichi kabichi. Kuti muchite izi, kutsanulira 20 ga chomera chouma ndi kapu yamadzi otentha ndikuumirira maola atatu. The kulowetsedwa umasefedwa ndipo amatengedwa katatu patsiku. Malo osambira ogwiritsira ntchito mafuta onunkhira amathandizanso kuwonjezera kukakamiza. Kwa izi, ma cloves, bergamot, ndimu, lalanje, bulugamu ndi oyenera.

Kodi mungasankhe bwanji mapiritsi a vuto linalake lachipatala?

Madokotala amalimbikitsa kugwiritsa ntchito mankhwala angapo a magulu osiyanasiyana nthawi imodzi. Izi zimathandiza chithandizo chothandiza kwambiri cha matenda oopsa mu shuga.

Kuphatikiza chithandizo, mitundu yaying'ono yamankhwala imagwiritsidwa ntchito, ndipo mankhwala ambiri amatha kuyimitsa zotsatirapo zake.

Dongosolo la chithandizo limasankhidwa ndi adokotala kuti ateteze chiwopsezo cha matenda a mtima ndi sitiroko.

Ndi chiopsezo chochepa, monotherapy yotsika mtengo imachitika. Ngati sizotheka kuchepetsa kukakamira kwa manambala olondola, adotolo amakupatsirani mankhwala ena, ndipo ngati sangathe, kuphatikiza kwa mankhwala angapo a magulu osiyanasiyana.

Pachiwopsezo chachikulu cha kuwonongeka kwa mtima ndi mtima, chithandizo chamankhwala 2 omwe mumagwiritsa ntchito mankhwala ocheperako chimafunikira. Ngati chithandizo chotere sichinadze, ndiye kuti wofunsayo amapereka mankhwala lachitatu muyezo wochepa kapena muwapatse mankhwala onse mu muyeso wokwanira. Ngati palibe zotsatirapo zake, mankhwala a 3 a mankhwala omwe ali pakatikati kwambiri amatha.

Amlodipine (Norvask, Tenox, Normodipine) pa kukakamizidwa kwambiri

Algorithm posankha mankhwala osakanikirana ndi matenda ashuga (gawo ndi sitepe):

Kuchulukitsa kwapakati pa kuthamanga kwa magazi - mankhwala a ARB kapena ACE zoletsa.
Kuthamanga kwa magazi kumachulukitsidwa, koma kulibe protein mu mkodzo - kuwonjezera okodzetsa, BKK.
Kuthamanga kwa magazi ndiwokwera kuposa masiku onse, mapuloteni ochepa amapezeka mumkodzo - thiazides ndi BKK yayitali amawonjezeredwa.
Kuthamanga kwa magazi limodzi ndi kulephera kwa aimpso - onjezani BKK ndi kuzungulira kwa diuretic.

Asanapangire dongosolo la chithandizo, adokotala amaphunzira zotsatira za maphunziro othandizira komanso a labotale. Simungadzipatse nokha mankhwala osakanikira a shuga, chifukwa ambiri a iwo amatsogolera pamavuto akulu komanso amafa.

Kuchokera pa matenda ashuga ndi matenda oopsa - ndi ma diuretics otani omwe angatengedwe ndipo ndi chiyembekezo chotani kwa iwo?

Ma diuretics adawonekera m'zaka za zana la 19, koma adagwiritsidwa ntchito koyamba kutsitsa magazi mu 60s ya zaka zapitazi.

Kukula kwa diuretics kumachitika chifukwa cha impso ntchito mwanjira yoti imathandizira njira ya mkodzo kuchokera mthupi.

Ngati kugwiritsa ntchito okodzetsa pochiza matenda am'mitsempha yamagazi ndi mitsempha yamagazi (limodzi ndi kuthamanga kwa magazi) sikukayikira, ndiye kuti kugwiritsa ntchito mankhwala othandizira odwala matenda ashuga ndi kuthamanga kwa magazi kuyenera kufikiridwa mosamala, pokambirana ndi dokotala. Pali magulu anayi a ma diuretics, omwe tikambirana mwatsatanetsatane.

Loop diuretics (mankhwala omwe amachulukitsa kuchuluka kwa mapangidwe a mkodzo) ndiye wolimba kwambiri pazakumwa zonse zogwiritsidwa ntchito pakuchita kuchipatala.

Mankhwala oterewa amagwiritsidwa ntchito nthawi zambiri pa edema yamavuto osiyanasiyana komanso matenda oopsa. Dzinalo la gululi limachokera ku chakuti gawo lalikulu lakuwalimbikitsa limapezeka m'chiuno cha Henle - malo omwe madzi amabwezedwanso m'thupi.

Furosemide kuzungulira okodzetsa

Vutoli limachitika chifukwa cha “chopinga” cha kubwezeretsanso, kuthira madzi ndi kupanga mkodzo mwachangu, pomwe thupi limachotsa madzi ndi mchere. Mukamagwiritsa ntchito zida zodukiza, kumasuka kwa minofu yosalala ya mitsempha yamagazi ndi kuwonjezeka kwa magazi a impso kumachitika.

Kuphatikiza pa matenda oopsa, mankhwalawa amatha kuikidwa pa matenda a ubongo, hypercalcemia, kulephera kwa mtima, poyizoni ndi magulu ena a ziphe ndi kulephera kwaimpso. Zokonzekera zimapezeka mwanjira ya mapiritsi kapena ma ampoules a jakisoni. Chithandizo chodziwika bwino m'gululi ndi Furosemide.

Mtundu wamtundu wa mankhwala sioyenera kuthandizira matenda oopsa mu shuga. Kungogwiritsa ntchito kamodzi kokha pochepetsa kupweteka kwambiri.

Thiazide okodzetsa amapanga gulu lina la mankhwala omwe ali ndi mankhwala okodzetsa, omwe ali ndi vuto limodzi.

Zinthu za mankhwala zimasiyana mu mphamvu ndi nthawi yayitali.

M'mayiko ambiri padziko lapansi, mankhwala omwe ali ogulitsawa ndi okwera mtengo kwambiri: amawagulitsa m'mafakitala popanda mankhwala ndipo ali ndi mitengo yotsika mtengo. Othandizira a Thiazide samagwiritsidwa ntchito pongothandiza matenda oopsa, komanso kuwonjezereka kwa kutaya mtima, komwe kumakhala chifukwa cha chiwindi, mtima kapena kulephera kwa impso.

Kalasi ya diuretic iyi idapezeka mkatikati mwa zaka zapitazi. Liazide diuretics imakhala ndi tanthauzo la "kawiri": onse ndi mankhwala komanso mamolekyulu apadera omwe ali ndi mawonekedwe apadera.

Komabe, pali mankhwala angapo omwe ali ndi vuto lofananalo, kutengera zomwe palibe mamolekyulu a thiazide kuchokera ku lingaliro la mankhwala.

Pazifukwa izi, thiazide ndi thiazide-monga okodzetsa ayenera kusiyanitsidwa. Omalizawa akuphatikizapo Metolazone ndi Chlortalidone.

Mwina chinsinsi chodabwitsa kwambiri cha gulu ili la mankhwalawa ndi njira yothandizira odwala yomwe ili ndi thupi. Kufikira pamapeto pake, mapangidwe a thiazides sanaphunzire. Zimadziwika mosakayikira kuti zinthu zofunikira zikafika mthupi la munthu, njira zopangira mkodzo zimathandizira, mtima wake ndi kuchuluka kwa madzi m'magazi kumachepetsedwa.

Mtundu wa thiazide okodzetsa umagwira kwambiri ku matenda oopsa, omwe amayamba chifukwa cha matenda osokoneza bongo.

Pogwiritsa ntchito thiazide diuretics kwa nthawi yayitali, "kupumula" kwa minofu yosalala ya ziwiya kumawonedwa, komwe kumapangitsa kuchepa kwa kukana kwamphamvu. Omalizirawo amatenga gawo lofunikira polimbana ndi matenda oopsa.

Mitundu yonse ya mankhwala a thiazide amatha kugawidwa m'magulu awiri:

zotumphukira za chlorobenzamide ndi quinazolinone,
zotumphukira za benzothiadiazine ndi phthalimidine.

Oyimira gulu loyamba ali ndi mawonekedwe: iwo pamlingo uliwonse wa kulephera kwa impso amakhala ndi mphamvu yokodzetsa.

Malinga ndi chikhalidwe chawo pakupanga mankhwala, kukonzekera kwa gululi kumakumbutsa kwambiri zida zotentha.

Zina mwazotsatira zoyipa ndizomwe zimachitika chifukwa chosagwirizana, kusabala, dermatitis, hyperglycemia, paresthesia, kapamba, cholecystitis, kupweteka komanso kupsinjika pamimba.

Mitundu yodziwika kwambiri ya thiazide ndiyophatikizira:

Clopamide
Indapamide,
Chlortalidone
Hydrochlorothiazide,
Metolazone
Quinetasone.

Osmotic

Osmotic diuretics imapangitsa kuchotsedwa kwa madzimadzi kuchokera kumankhwala am'minyewa pakuchepetsa kuthamanga kwa magazi. Chifukwa cha izi, kuthamanga kwa magazi kumangowonjezera kwete mu zovuta, komanso mu nephrons.

Yotsirizirayi imabweretsa kusinthika kwa kusefedwa kwa zinthu mu ziwalo zothandizirana ziwalo. Mofananamo, kubwezeretsanso kwamphamvu kwa sodium ndi chlorine pakukwera kwa bondo la Henle kumachepa.

Osmotic diuretics nthawi zonse amathandizira kudzera m'mitsempha. Pakati pawo, wamba:

Zotsirizira zimayikidwa nthawi zambiri chifukwa cha zotsatira zazitali. Awiri oyambayo amadziwika ndi kufooka, kwakanthawi kochepa.

Gulu lama diuretics limasungunuka bwino m'thupi ndipo limayamba kudziunjikira. Chifukwa chake, kusinthidwanso kwa madzi ndi sodium ion kumasokonekera, zomwe zimapangitsa kuti achotsedwe m'thupi. Pamodzi ndi iwo, mankhwalawa nawonso amawachotsa.

Mwa zina zoyipa tikhoza kuzimva mutu, nseru, kukha magazi, minofu necrosis pamene mankhwalawo salowa m'mitsempha, koma pansi pa khungu. Mankhwala osokoneza bongo a gululi sakhazikitsidwa osati kokha chifukwa cha matenda oopsa, komanso poizoni, kuchepa kwa Hypovolemic komanso prophylactic kwa anuria.

Sizoletsedwa kutenga osmotic diuretics pakulephera kwa mtima.

Mwakutero, mtundu uwu wa mankhwala ungagwiritsidwe ntchito kwa matenda ashuga, koma ali ndi kanthawi kochepa. Njira yayitali ya chithandizo nthawi zambiri siyimasankhidwa, chifukwa ndi yoyenera kugwiritsa ntchito kamodzi.

Kuteteza potaziyamu

Makina a zochita za potaziyamu osokoneza bongo ali ndi gawo limodzi lodziwika: amasunga potaziyamu m'thupi, omwe amatsatira dzina la gulu la mankhwala.

Mankhwala amathandizira kwambiri maselo akuluakulu a distal tubule ya nephron.

Kuwonekera kwa mfundo kumapangitsa kuti muchepetse kusamutsa kwa potaziyamu kupita ku maselo ndipo potero amatchinga kutuluka kwawo limodzi ndi mkodzo. Potaziyamu ndi chinthu chofunikira kwambiri mthupi. Kuphatikiza apo, kupulumutsidwa kwake ndikofunikira kwambiri kwa anthu omwe ali ndi vuto la hypokalemia, lomwe limatsagana ndi kuchepa kwa kuchuluka kwa ions ya potaziyamu m'madzi a m'magazi.

Potaziyamu yosungirako diuretics imalembedwa osati kokha kwa odwala matenda oopsa, komanso mankhwalawa matenda osowa a adrenal cortex, gout, mtima kulephera komanso kuthetsa edema pakulepheretsa kupanga kwa adrenal mahomoni.

Potaziyamu yosawononga okodzetsa imadziwika ndi kufooka thupi, ndichifukwa chake mankhwalawa amawonedwa ngati osagwira ntchito.

Pachifukwachi, samadziwika ngati maziko a chithandizo, ndipo nthawi zambiri amakhala ngati mankhwala othandiza. Ngati mukumwa mankhwalawo palibe kusintha kwamthupi komwe kumayang'aniridwa konse, ndiye kuti mankhwalawo sayenera kupitilizidwa.

Mankhwala amangoyimitsidwa kapena “ndi inertia” amapitilizidwa kwakanthawi kuti atsimikizire kulephera kwa mankhwalawa. Mwa njira, mankhwalawa amawonedwa ngati osagwira ntchito mosayenera. Ndiwosungika kwambiri pakati pa okodzetsa, chifukwa chake, kutengeka kwake "kumakupangitsani kuti mudikire."

Potaziyamu yosagwiritsa ntchito shuga mu shuga imawonedwa ngati yopanda pake chifukwa cha chiwopsezo chachikulu cha zotsatirapo zake zoyipa.

Zofooka zochepa zimakhala chifukwa chakuti mankhwalawa amatsutsana ndi aldosterone. Aldosterone ndi mahormoni akuluakulu a adrenal cortex, omwe amathandizira molingana ndi mulingo wamadzi amthupi. Ma diuretics ali ndi mphamvu yolepheretsa mahomoni awa.

Aldosterone ndi yoletsedwa ndi ma aligorivimu awiri:

imathandizira kuyendetsa ma ayoni a sodium,
"Zoletsa" kupanga kwa timadzi tambiri, timene timagwira mosiyanasiyana monga momwe sodium umatulutsidwira mkodzo, ndipo potaziyamuyo amadzuka.

Potaziyamu yosunga diuretics imangolembedwa osati kokha ndi mavuto ndi kuthinikizidwa, komanso kuti muchepetse kutupa ndi kuchotsa madzi ambiri.

Pazifukwa izi, mankhwala amtunduwu amaperekedwa ngakhale kwa amayi apakati omwe ali omaliza.

Mankhwalawa mulinso mndandanda wazotsatira zoyipa, kuphatikiza mseru, kusanza, chizungulire, kutsekula m'mimba, kuchepa kwa msambo, kusanza, kugona, kutopa ndi kukhumudwa.

Potaziyamu yosunga diuretic Veroshpiron

Mndandanda wa mankhwala othandiza kwambiri poteteza potaziyamu ndi awa:

Ndi mankhwala ati omwe amagwiritsidwa ntchito bwino?

Ma diuretics ochokera ku kalasi ya thiazide ndi thiazide-ngati amadziwika kuti ndi gulu la "opita patsogolo" kwambiri okodzetsa, omwe samayambitsa mavuto ambiri ndipo amatha bwino pochotsa kutupa ndikuchepetsa magazi.

Gulu la osmotic limatha kupangitsa kuti mkodzo uchoke mu maola ochepa, koma zotsatira zake ndizakanthawi. Kwa chithandizo chakanthawi yayitali, ndi chosakwanira ndipo chimagwiritsidwa ntchito pokhapokha ngati pakufunika kuchepetsa mwachangu kapena kuchepetsa kupanikizika.

Mankhwala osokoneza bongo a Potaziyamu amaonedwa kuti ndi otha ntchito, amatha kuyambitsa mavuto ambiri, kotero amangogwiritsidwa ntchito ngati othandizira pochita matenda oopsa. Loop okodzetsa bwino amatha kupirira kuchepetsa.

Kuchita kwawo ndikwachilengedwe komanso kumachepera m'chiuno cha Henle. Gulu la mankhwala amaonedwa kuti ndi diuretic yamphamvu, motero kugwiritsa ntchito nthawi yayitali sikulimbikitsidwa.

Njira ya mankhwala, ndipo, motero, mtundu wa okodzetsa uyenera kutumizidwa ndi katswiri wazachipatala. Ndi dokotala yekhayo amene angasankhe mankhwala oyenera ochizira wodwala wina, poganizira mawonekedwe a thupi lake.

Mankhwala Othandizira

Ndi zovuta mankhwala, nthawi zambiri zotchulidwa mankhwala ophatikiza magulu osiyanasiyana.

Chifukwa chake, mwachitsanzo, pochotsa potaziyamu m'thupi kuti muipulumutse ndikubwezeretsa bwino, okhutira potaziyamu amapatsidwa "kuthandiza" okodzetsa magulu enawo.

Monga chowonjezera, mutha kumwa vitamini B6, magnesium ndi taurine. Zinthu zonse zomwe zili pamwambazi sizopatsa thupi, koma zimakhala ndi zofanana, zofatsa. Zimadzetsa mpumulo wamakoma amitsempha yamagazi ndikuwongolera magazi.

Kodi ndimotani momwe mungachiritsire matenda oopsa mu shuga? Mayankho mu kanema:

Mwa njira, awa omwe mankhwalawa amatha kutengedwa ngati prophylaxis yotsutsana ndi matenda osokoneza bongo. Mukamamwa mankhwala osmotic, muyenera kusamala kwambiri kugwiritsa ntchito mankhwala ena. Gulu lokhalo la okodzetsa lokha ndi lomwe limapangitsa chotchinga cha magazi kulowa mu mankhwala ena, omwe angayambitse kutaya magazi.

Zomwe Zimayambitsa Matenda a shuga

Kukhalapo kwa matenda osokoneza bongo kumatsutsa kumachitika kwa matenda oopsa, chifukwa amachititsa kusintha kwa m'mitsempha.

Izi zikuphatikiza:

Kupendekera ndi kupindika kumachitika.
Kuchulukana kwawo kwatayika. Amaperekedwa, makamaka, ndi insulin, koma siyokwanira mthupi la odwala matenda ashuga.
Kutsekeka kwa makoma a mitsempha kumawonjezeka. Izi zimayamba chifukwa cha madonthi a shuga m'magazi.
Atherosulinotic zolembera mawonekedwe. Amachepetsa lumen ya chotengera, zomwe zimabweretsa kuwonjezeka kwa magazi.
Zowonongeka zamitsempha yamagazi, makamaka zing'onozing'ono. M'malo ovulala, kutupa kumayamba, ma cholesterol plaque komanso kuwundana kwamagazi kumayamba kukula.

Izi zimaphatikizapo kuwonjezeka kwa kuthamanga kwa magazi komanso kusakwanira kwa ziwalo zogwirizana ndi minofu.

Amayi amatha kukhala ndi matenda ashuga amtundu wachiwiri.

Dziwani kuti kupsinjika kowonjezereka kumawonedwa nthawi zambiri mu mtundu woyamba wa shuga, koma magulu achikulire a odwala amasintha chithunzicho: nthawi zambiri amakhala ndi matenda oopsa a 2 shuga. 90% ya okalamba omwe ali ndi matenda oopsa amadwala matendawa.

Zizindikiro za kuthamanga kwa magazi

Kuwonetsedwa kwa matenda oopsa mu shuga mellitus sikusiyana ndi momwe amakhalira.

Izi zikuphatikiza ndi zotsatirazi.

mutu
chizungulire
kulemera kumbuyo kwa mutu
mawonekedwe owoneka bwino, mawonekedwe a mawanga amaso patsogolo pa maso,
khungu
miyendo kuzirala
kusanza, kusanza,
mphwayi, kukhumudwa,
kusachita bwino
kupuma movutikira
kuvutika pakuchita ntchito yakuthupi.

Amawoneka athunthu kapena gawo limodzi. Kusiyanitsa kokhako pakati pa matenda oopsa mu shuga ndi kusachita bwino kwa matenda oopsa ndi njira yake yovuta kwambiri.

Kuyang'anira mavuto

Umu ndiye momwe zinthu zilili bwino.

Wodwala amayenera kukonzekera mwatsatanetsatane kukakamizika, komanso kugunda kwa mtima ndikuyika chidziwitso mu "Observation diary".

Chizolowezi kwa odwala matenda ashuga ndi kuthamanga kwa magazi kwa 130/80 mm Hg.

Mankhwala

Pakadali pano, msika wazamankhwala ndi wolemera kwambiri kotero umakulolani kusankha mankhwala kwa wodwala aliyense.

Chithandizo cha mankhwala osokoneza bongo chimaphatikizapo kugwiritsa ntchito ndalama zomwe zimagulidwa ku malo ogulitsa mankhwala. Amapezeka mu mawonekedwe a mapiritsi, makapisozi, ngalande, njira zovomerezeka.

Mankhwala onse omwe alembedwa pansipa ali ndi contraindication akulu, chifukwa chake ayenera kuyikidwa kokha ndi cardiologist kapena psychapist. Ngati contraindication satiwone, chitukuko cha matenda omwe alipo ndizotheka.

Njira zochizira matenda oopsa mu shuga mellitus zimapangidwa momveka bwino ndipo zimaphatikizaponso mankhwala otsatirawa:

Calcium calcium blockers. Mankhwalawa amakulolani kupumula ma adventitia, ndiye kuti, minofu yamatumbo. Zotsatira zake, mavuto awo amachepa ndipo kuthamanga kwa magazi kumachepa. Gululi limaphatikizapo "Klentiazem", "Amlodipine", "Anipamil" ndi mankhwala ena.
Ma ARB zoletsa. Kuchita kwa mankhwalawa kumalepheretsa chidwi cha angiotensin receptors, omwe kupewa vasoconstriction. Gululi likuyimiriridwa ndi "Valsartan", "Candesartan", "Losartan" ndi mankhwala ena.
ACE zoletsa. Mankhwalawa amaletsa vasoconstriction, omwe amatsogolera kuwonjezeka kwa lumen yawo ndi kutsika kwa kupanikizika. Gululi limaphatikizapo Captopril, Lisinopril, Ramipril ndi mankhwala ena.
Beta blockers. Mankhwala amalepheretsa zolandilira zomwe zimakhudzidwa ndi adrenaline - mahomoni opsinjika ndi mavuto, chifukwa chomwe palibe kuchuluka kwa mtima, ndipo kuthamanga kwa magazi sikokwanira. Kuphatikiza apo, mankhwalawa amateteza mtima kuti usavale. Gululi likuyimiridwa ndi Anaprilin, Concor ndi fanizo lawo.
Zodzikongoletsera. Izi ndizopikulitsa. Amakulolani kuti muchotse madzimadzi owonjezera kuchokera mthupi, omwe amakakamiza ziwalo, kuphatikizapo mitsempha yamagazi, ndikupangitsa kuchulukana. Mankhwala a gululi akuphatikizapo "Kanefron", "Indapamide retard", "Aquaphor" ndi mankhwala ena.

Mukamagwiritsa ntchito mankhwalawa, muyenera kukumbukira malamulo akuluakulu:

Pali mankhwala othandizira mavuto obwera chifukwa omwe amangotengedwa kwakanthawi. Pali mankhwala omwe amafunikira kuti magazi azithamanga pamlingo wovomerezeka. Amatengedwa nthawi zonse.
Zokonzekera zogwiritsa ntchito mosalekeza ziyenera kugwiritsidwa ntchito popanda zosokoneza, kuti musayang'anitse kwambiri mukulumikizidwa. Zimatha kudwala matenda a mtima kapena sitiroko.
Mankhwala omwe amagwira ntchito kwa nthawi yayitali amagwira ntchito mthupi, kudziunjikira zochuluka. Ngati pali zosokoneza pakugwiritsa ntchito, makina awa sagwira ntchito.

Kuonda

Kunenepa kwambiri kwa mulingo uliwonse kumathandizira kuti magazi azithamanga komanso kukula kwa matenda ashuga.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Muzochepa, mutha kubwezeretsanso zovuta, kungoponya mapaundi owonjezera. Milandu ikakhala ndi matenda oopsa kwambiri, kuchepa thupi kumathandizira kuchepetsa kukakamira pang'ono, koma izi zikuthandizani kuti musinthe njira yodekha yochepetsera mankhwala pochepetsa Mlingo wa mankhwala omwe adamwa.

Zochita zolimbitsa thupi

Matenda a shuga ndi matenda oopsa ndi matenda omwe amatha kukhazikika mwa njira zolimbitsa thupi, ndiye kuti, osagwiritsa ntchito mankhwala kapena ndi Mlingo wocheperako.

Imodzi mwa njirazi ndi zolimbitsa thupi. Ayenera kukhala okwera mtengo, osangalatsa komanso osiyanasiyana. Wodwala yemwe ali ndi matenda ashuga komanso matenda oopsa amatha kupindulitsa pochita masewera olimbitsa thupi osakhudzana ndi kupsinjika, chifukwa angayambitse kukakamizidwa.

Zakudya za odwala matenda a shuga

Monga matenda osavuta a shuga, wodwalayo ayenera kudya pafupipafupi, pang'ono ndi pang'ono, komanso molondola. Sizoletsedwa kugwiritsa ntchito maswiti, makeke komanso zakudya zina zothamanga.

Zakudya zomanga thupi kwa nthawi yayitali zimaloledwa: chimanga, kupatula semolina, buledi wonenepa, masamba, zipatso, kuphatikiza nthochi ndi mphesa, nyemba, nandolo zobiriwira.

Mukamagwiritsa ntchito izi, muyenera kuyang'anira momwe zinthu ziliri. Ndi zovuta zowonjezereka, muyenera kuwasiya kwakanthawi kuti muwone momwe thupi limayambira.

Zogulitsa zina zitha kugwiritsidwa ntchito popanda zoletsa. Nyama ndi nyama yopendekera, mkaka, bowa, zipatso, mazira sizithandiza kungokulitsa shuga wamagazi, komanso kuthamanga kwa magazi.

Kuyenera kudziwika kuti matenda oopsa amawonjezera zofuna zake pakudya:

Ndikofunikira kuchepetsa kugwiritsa ntchito mchere, chifukwa zimathandizira kuwonjezeka kwa kuthamanga kwa magazi. Zinthu zambiri - zachilengedwe kapena zopangidwa mwaluso - zimakhala ndi mchere. Zomwezo zimapita ndi shuga. Zakudya zotsekemera komanso zopatsa thanzi, komanso zinthu zomalizidwa zomaliza, makeke, zakudya zomwe zimasunthidwa, siziyenera kuperekedwa kuchakudya.
Ndikofunikira kumwa malita 1.5 amadzi oyera tsiku lililonse. Iyenera kukumbukiridwa kufunika kwa madzi tsiku ndi tsiku kwa anthu: ndi 30 ml / kg.
Kumwa khofi ndi tiyi ziyenera kuchepetsedwa.
Kuletsedwa kwa mowa kumakhazikitsidwa. 70 ml ya vinyo wofiira amaloledwa kamodzi pa sabata.

Zovuta zamatenda a shuga

Mavuto obwera chifukwa cha matenda oopsa ndiwowonjezereka kapena pang'onopang'ono kuwonjezeka kwa kukakamizidwa kuzinthu zofunika.

Malamulo a kuyimitsa pamaso pa anthu odwala matenda ashuga sasiyana ndi malamulo othandizira wodwala yemwe alibe matenda. Kusiyana kokhako ndikuti muyenera kuyeza glucose wamagazi anu ndikuwasunga bwino.

Kunyumba, muyenera kuchita zotsatirazi.

Ikani mapilo pansi pa mutu wa wodwalayo kuti mupewe kuthamangitsidwa, komwe kumatha kuchitika ndi vuto lalikulu la matenda oopsa.
Mupatseni mankhwala othandizira komanso osokoneza bongo omwe munthu amakonda kugwiritsa ntchito. Kuti muchite mwachangu, mutha kuziyika pansi pa lilime. Zitangochitika izi, ndikofunikira kuthana ndi kupanikizika: ziyenera kuchepa, koma bwino. Pambuyo pa theka la ora, zizindikirozo ziyenera kugwa ndi 30 mm Hg, ndipo patatha ola limodzi - ndi 50 mm Hg.

Ndi zoletsedwa kuti muchepetse kuthamanga kwa magazi. Izi zimatha kudwala matenda a mtima kapena sitiroko.

Pakukhazikika kotereku, mutha kusiya wodwalayo kunyumba, kumamupatsa mtendere, mankhwala othandizira komanso mpweya wabwino.

Nthawi zina, muyenera kuyimbira foni ambulansi.

Momwe mungachepetse kuthamanga kwa magazi mu mtundu 2 wa shuga

Moni kwa owerenga blog onse! Monga ndidalonjezera dzulo, ndikukutumizirani gawo lachiwiri la ballet ya Marleson kwa inu. Kungosewera, zoona. Gawo lachiwiri la nkhaniyi lomwe limaperekedwa ku vuto la kuphatikiza kwa matenda oopsa ndi matenda ashuga.

Kwa iwo omwe adaphonya nkhani yomaliza, ndizinena kuti ndalongosola zolakwika ndi malingaliro ena pokhudzana ndi chithandizo cha matenda ashuga, komanso momwe ndidaperekera njira zosavuta, monga dziko, malangizo osagwiritsa ntchito mankhwala ochepetsa kuthamanga kwa magazi mu matenda ashuga, nkhaniyi ili pano.

Lero tikulankhula za mankhwala, omwe, mwatsoka, nthawi zambiri amakhala osakwanira.

Ndipo popeza nthawi zambiri ndikofunikira kugwiritsa ntchito mankhwala osokoneza bongo "kukakamiza," tiyeni tichite mosamala, podziwa zomwe timamwa ndi zomwe.

Mapeto, ndi thanzi lanu ndipo mumafunikira choyambirira, osati dokotala kapena oyandikana nawo. Chifukwa chake, tengani mankhwala anu onse "kuchokera kukakamizidwa" kunja kwa mabokosi, zikwama zam'manja ndi mabokosi.

Timamvetsetsa zomwe mukumwa, chifukwa chanji komanso momwe mankhwalawa amakhudzira kagayidwe kazakudya komanso lipid metabolism, chifukwa ndi izi zomwe zimathandizira poika wodwala yemwe ali ndi matenda a shuga a 2. Kuphatikiza apo, ndikuwonetsa kuti mankhwala a antihypertensive amathanso, kuwonjezera pazomwe zimapangitsa kuti "mavuto azitsika".

Asanayambe kusokoneza magulu a mankhwala, ndikufuna ndikuthandizireni. Pakadali pano, mankhwala omwe amachepetsa kuthamanga kwa magazi ndi ochuluka kwambiri.

Makampani okhawo a ulesi kwambiri samatulutsa mankhwala. Chifukwa chake, pamatha kukhala mayina angapo ogulitsa ndipo, mwachilengedwe, sindingathe kuwadziwa onsewo patokha.

Chofunikira kwambiri kwa inu si dzina la mankhwalawa, koma ntchito yake.

Dzinali limalembedwa ndi zilembo zikuluzikulu pabokosi ndi mankhwalawo, ndipo nthawi yomweyo pansi pazosindikiza zazing'ono ndi dzina la chinthu chomwe chimagwira.

Ndipamene mukuyenera kuyesa mankhwala anu ndikugwiritsa ntchito mayinawa ndikupereka zitsanzo za mayina ena amalonda.

Ngati sichinawonetsedwe pa phukusi, ndiye kuti chisonyezedwa m'makonzedwe ake kwa mankhwalawo pachiyambi, mwachitsanzo, chinthu chomwe chikugwira ndi enalapril.

Mankhwala a antihypertensive a matenda a shuga a 2

Loop diuretics (mankhwala omwe amachulukitsa kuchuluka kwa mapangidwe a mkodzo) ndiye wolimba kwambiri pazakumwa zonse zogwiritsidwa ntchito pakuchita kuchipatala.

Mtundu wamtundu wa mankhwala sioyenera kuthandizira matenda oopsa mu shuga. Kungogwiritsa ntchito kamodzi kokha pochepetsa kupweteka kwambiri.

Mankhwala othandizira pa matenda oopsa

Matenda oopsa oopsa komanso matenda a shuga a 2 amagwirizana kwambiri chifukwa ali ndi matenda ofanana a pathogenesis komanso zinthu zomwe zimayambitsa chiopsezo. Mwachitsanzo, kusuta, kunenepa kwambiri pamimba, kusungunuka kwa sodium m'magazi, nephropathy, atherosulinosis kumathandizira kukhazikitsa matenda oopsa kwambiri a matenda oopsa komanso matenda ashuga.

Kuphatikiza apo, kukana insulini pakokha kumapangitsa kuti magazi azitha. Insulin imakhala ndi vasodilating, koma ndi kukula kwa maselo, mphamvu yake m'mitsempha ya magazi imatsekedwa.

Kudzikika m'magazi a timadzi timeneti kumapangitsa kuti pakhale zotsutsana - kuchuluka kwa kamvekedwe ka mtima. Insulin imathandizanso kuwonjezeka kwa zochitika za mtima wachifundo, ndipo, zimathandizanso kuwonjezera kutulutsa mtima, kukana kwamitsempha yamagazi komanso kuwonjezera magazi.

Beta-blockers ndi mankhwala omwe amaletsa kuchita kwa beta-adrenergic receptors (β1, β2, β3), omwe amakhala m'magulu osiyanasiyana, kuphatikiza ziwiya ndi mtima. Beta-adrenergic receptors amalimbikitsidwa ndi mahomoni adrenaline ndi norepinephrine, ndipo mankhwala a beta-blocker sawalola kuti azigwiritsa ntchito mphamvu zawo zolimbikitsa.

Zosakaniza zonse zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimathera mu "-ol", kuti zithe kusiyanitsidwa ndi mankhwala ena kuchokera kukakamizidwa.

Mankhwalawa amafunikira kwa odwala omwe ali ndi matenda a mtima (CHD), kulephera kwa mtima, pambuyo pake infarction mtima, kuthamanga kwa mtima.

Amapangitsa mtima kugunda pang'ono komanso mphamvu zochepa.Koma amagwiritsidwa ntchito kwambiri mu matenda oopsa ndipo nthawi zambiri amalembera odwala matenda a shuga, ndiko kulakwitsa kwakukulu.

Pambuyo pake mudzazindikira chifukwa chake.

Zovuta zakuchepetsa zimatheka ndi blockade ya β1 receptors. Izi zikachitika:

kugunda kwa mtima
kugunda kwa mtima
mtima zotulutsa
idachepetsa kupanga kwa impso

Kubisa kwa β2 zolandilira zomwe zili m'ziwalo zina kumabweretsa zotsatira zosafunikira:

kuphipha kwa bronchi, komwe kumatsutsa mphumu ya bronchial
vasospasm
kuchepa kwamafuta
kuyimitsa kapangidwe ka shuga ndi chiwindi, komwe ndi kowopsa kwa hypoglycemia, i.e
amaletsa kumasulidwa kwa insulin ndi kapamba

Popeza zotsatira za blockade za β2 receptors ndizosafunikira kwathunthu, mankhwala adapangidwa omwe amatseketsa ma β1 receptors okha. Mankhwalawa amatchedwa kusankha, mwachitsanzo.

osasankha (propranolol (anaprilin))
kusankha (atenolol, metoprolol, betaxolol (Lokren), bisoprolol (Concor), ndi zina)
beta-blockers ndi zowonjezera vasodilating zotsatira (labetalol (Trandate), carvedilol (Dilatrend), nebivolol (Nebilet)

Mankhwala amakono komanso otetezeka kwambiri kwa odwala omwe ali ndi shuga wokhazikika ndi gulu lachitatu, chifukwa mankhwalawa amachepetsa ziwiya zazing'ono komanso amakhala ndi zotsatirapo zochepa.

Kuphatikiza apo, zimakhudza mbiri ya lipid ndi carbohydrate, ndikuthandizira kuchepa kwa insulin. Mankhwala osankha komanso osasankha, m'malo mwake, kuwonjezera cholesterol ndi triglycerides, kuwonjezera insulin, kuwonjezera shuga ndi magazi, zingayambitse kusowa kwa erectile mwa amuna.

Malinga ndi kafukufuku wambiri, mankhwala oyenera a beta-blocker kwa odwala omwe ali ndi ziwonetsero komanso zofanana ndi shuga ali awiri lero: carvedilol (Dilatrend) ndi nebivolol (Nebilet).

Popeza carvedilol ndi beta-blocker yosasankha, kugwiritsa ntchito kwake kwa odwala mphumu ya bronchial kumakhala kochepa. Ena onse, makamaka anaprilin, atenolol ndi metoprolol, amawonedwa ngati owopsa ndipo sagwirizana kwenikweni ndi matenda ashuga.

Tsoka ilo, onse opanga beta ali ndi vuto. Amasenda zisonyezo za hypoglycemia ndikuchepetsa kutuluka kodziyimira kumeneku, mwachitsanzo, kumasulidwa kwa glucose kuchokera ku chiwindi. Chifukwa chake, muyenera kusamala mwa odwala omwe samva bwino kuyambitsa zizindikiro za hypoglycemia kapena samawamva konse.

Tsopano taonani zomwe akatswiri a mtima amatenga? Ndimawona nthawi zambiri palandirani kuti metoprolol (Metocard, Betalok, Egilok) ndi mankhwala, nthawi zambiri atenolol, ngakhale nthawi zambiri bisoprolol (Concor), ndi zina zambiri.

Kupewa ndi malingaliro

Kupezeka kwa matenda ashuga amtundu wa 2 komanso matenda oopsa amathanso kukhudzana ndi moyo wopanda thanzi komanso zakudya zoperewera. Ichi ndichifukwa chake kupewa kwawo ndikukonzanso makamaka kumakhala koteteza madera awa.

Ndizosangalatsa kuti mayiko onsewa amatha kukhazikika mwa njira zomwe chilengedwe chimaganizira kwa munthu: zolimbitsa thupi, kupuma bwino, kudya mokwanira, kuthana ndi zovuta komanso kukhala ndi malingaliro abwino. Mwamwayi, imapezeka kwa aliyense.

Mu magawo apambuyo a matenda a shuga ndi matenda oopsa, njira izi, zachidziwikire, zimayenera kuthandizidwa ndi chithandizo chamankhwala.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

Aronova S.M. adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

Kuchokera kukanikiza Indapamide: momwe mungatenge, zikuwonetsa, contraindication

Munthawi ya chithandizo chovuta kwambiri cha matenda oopsa, dokotala amayenera kupereka okodzetsa, popeza kuthamanga kwa magazi kumachepetsa mwachangu ndi kutulutsa kwamadzi m'thupi.

Makampani opanga mankhwala apanga mankhwala ambiri okodzetsa. Nthawi zambiri, ngati pali edema, dokotala amalembera Indapamide kuti akapanikizike.

Komabe, mankhwalawa ali ndi contraindication komanso mawonekedwe ogwiritsira ntchito, chifukwa chake amafunika kugwirizanitsa chithandizo ndi dokotala.

Indapamide yotsitsa kuthamanga

Mankhwala ndi a diazitrate wofanana ndi thiazide, amakhala ndi kuchepetsa magazi. Indapamide imagwiritsidwa ntchito pochita matenda oopsa, pomwe kupanikizika kumayamba kupitirira 140/90 mm Hg. Art., Ndi kulephera kwa mtima kosatha, makamaka ngati wodwala watupa.

Mankhwala amamasulidwa monga mapiritsi ndi mapiritsi a 1.5 ndi 2.5 mg. Amapangidwa ku Russia, Yugoslavia, Canada, Macedonia, Israel, Ukraine, China ndi Germany. Zomwe zimagwiritsidwa ntchito ndi mankhwalawa ndi Indapamide.

Indapamide ndi mankhwala osungira calcium, omwe ndi abwino kwa odwala matenda oopsa a mafupa. Itha kugwiritsidwa ntchito ndi anthu omwe ali ndi hemodialysis, odwala matenda ashuga, okhala ndi hyperlipidemia. Pazovuta, amafunikira kuti azilamulira kuchuluka kwa glucose, potaziyamu, zizindikiro zina zomwe adokotala akuuzidwa.

Indapamide ya matenda oopsa

Makapiritsi kapena mapiritsi a kukakamiza kwa matenda oopsa amayamba kuchita mphindi 30 mutatha kumwa. Zotsatira za hypotonic zimatha maola 23-24.

Kuchepa kwa kuthamanga kwa magazi kumachitika chifukwa cha zotsatira za hypotensive, diuretic ndi vasodilating - kuthamanga kwa magazi kumayamba kutsika chifukwa cha mphamvu ya chinthu chomwe chikugwira, kuchotsa madzi owonjezera mthupi ndi kuchuluka kwa mitsempha yamagazi mthupi lonse.

Indapamide ilinso ndi katundu wamtima - amateteza ma cell a myocardial. Pambuyo pa chithandizo, matenda oopsa amatha bwino mkhalidwe wamanzere wamtima wamanzere.

Mankhwalawa amachepetsa kukana mu zotumphukira ndi ziwongo.

Popeza kuthamanga kwamkodzo kumapangitsa kuti mkodzo upangike ndipo ndimadzi amadzimadzi ambiri, ndikofunikira kumwa mankhwalawo ngati pali edematous syndrome.

Kuchita ndi mankhwala ena

Nthawi zambiri munthu amakakamizidwa kumwa mankhwala angapo a magulu osiyanasiyana a mankhwala. Zinthu zawo zomwe zimagwira zimatha kuchepa kapena kuwonjezera mphamvu ya Indapamide. Ndikofunikira kudziwa mwatsatanetsatane momwe "zochitika" zotere zimawonekera.

Mphamvu ya antihypertensive ya mankhwalawa imawonjezeka ngati imagwiritsidwa ntchito limodzi ndi ma antidepressants, ma antipsychotic - izi zitha kupangitsa kuti magazi abwere.

Akaphatikizidwa ndi erythromycin, munthu amakula tachycardia; mu zovuta za cyclosporin, kuchuluka kwa creatinine kumawonjezeka. Kugwiritsa ntchito limodzi nthawi yomweyo limodzi ndi mankhwala osokoneza bongo, kuphatikizapo ayodini, kumatha kupangitsa kuti madzi asungunuke. Kutayika kwa potaziyamu kumalimbikitsidwa ndi mankhwala othandizira, ma saluretics ndi mtima glycosides.

Tiyenera kukumbukira kuti corticosteroids ndi NSAIDs (omwe si a antiidal anti-yotupa mankhwala) amachepetsa mphamvu ya Indapamide - izi zimachepetsa mphamvu ya mankhwalawa. Popewa kuyanjana kotere ndi mankhwala ena, dokotala amayenera kupereka mndandanda wazamankhwala onse azitsamba zomwe zimagwiritsidwa ntchito.

Zotsatira zotsutsana ndi Indapamide

Odwala oopsa omwe ali ndi matenda amkodzo, endocrine, makumbo ndi mtima dongosolo ayenera kuwonjezera kufunsa dokotala. Kwa ma pathologies ena, mankhwalawa ali ndi mawonekedwe ogwiritsira ntchito kapena amatsutsana kwathunthu.

Indapamide sayenera kugwiritsidwa ntchito mwa ana ochepera zaka 18, oyembekezera. Ngati mankhwalawa amadziwitsidwa kwa mayi panthawi ya mkaka wa m`mawere, ndiye kuti mankhwalawa mwana amasamutsidwa ku zakudya zosafunikira.

Kugwiritsa ntchito Indapamide kumatsutsana ngati zotsatirazi zikupezeka:

tsankho
kulephera kwa aimpso
galactosemia, tsankho lactose,
hepatic encephalopathy,
kusokonezeka kwa magazi muubongo,
hypokalemia
gout
anuria

Musanagule mankhwalawa, ndikofunikira kuti muphunzire malangizo omwe wapangidwira (omwe ali mu phukusi la mankhwalawo), chifukwa akuwonetsa zonse zokhudza kapangidwe kake, mawonekedwe ogwiritsira ntchito, zotsutsana ndi zina.

Zotsatira zoyipa za indapamide

Kugwiritsa ntchito bwino mankhwalawa mu 97% ya milandu, mankhwalawa sasokoneza thupi. Mwa anthu omwe atsala 3%, Indapamide imayambitsa mavuto.

Zotsatira zoyipa kwambiri ndikuphwanya muyeso wamadzi-electrolyte: kuchuluka kwa potaziyamu ndi / kapena sodium kumachepa. Izi zimadzetsa kusowa kwamadzi (kusowa kwamadzi) m'thupi.

Osowa kwambiri, mankhwala amatha kuyambitsa arrhythmia, hemolytic anemia, sinusitis ndi pharyngitis.

Zotsatira zina za Indapamide:

ziwengo (urticaria, anaphylaxis, edincke's edema, dermatosis, zidzolo),
Matenda a Lyell
Kuuma kwa mucosa wamlomo,
Matenda a Stevens-Johnson
kutsokomola
kufooka
chizungulire
kusanza, kusanza,
kupweteka kwa minofu
migraine
mantha
kukanika kwa chiwindi
kapamba
kudzimbidwa
orthostatic hypotension.

Nthawi zina indapamide imasintha kapangidwe ka magazi ndi mkodzo. Mu kusanthula akhoza kuwona kuchepa kwa potaziyamu, sodium, kuchuluka kwa calcium, glucose, creatinine ndi urea. Supombocytopenia, leukopenia, kuchepa magazi, agranulocytosis kumachitika kawirikawiri.

Kodi ndingalowetse bwanji mankhwalawa

M'malo mwa Indapamide, Indap imaloledwa. Mankhwalawa ali ndi mawonekedwe omwewo, koma amapangidwa ndi wopanga wina ndipo atha kukhala ndi muyeso wosiyana wa zomwe zimagwira. Pakakhala kusiyana, dokotala wopezekapo amayenera kusintha mankhwalawa.

Dokotala adzakuthandizaninso kuti mupeze ma fanizo omwe ali ndi chinthu chofanana kapena chochita. Pofunsidwa payekha, dokotala adzakuwuzani kuti ndi mankhwala ati omwe mungagwiritse ntchito: Indapamide kapena Hypothiazide, Arifon Retard, Veroshpiron, Hydrochlorothiazide, Diuver, Acriptamide, Ionic, Retapres. Mwina kutumikiridwa kwa ma diuretics ena omwe cholinga chake ndi kuchepetsa magazi.

Pomaliza

Mankhwala Indapamide modekha amachepetsa kupanikizika tsiku lonse. Pogwiritsa ntchito nthawi zonse komanso molondola, kuthamanga kwa magazi kumachepa m'masiku 7 kuchokera poyambira kukhazikitsa.

Koma chithandizo sichingasokonezeke pakadali pano, chifukwa mankhwalawa amafika pakapita miyezi iwiri ndi iwiri kapena itatu.

Kuti mugwire bwino ntchito mankhwalawa, muyenera kutsatira malangizo azachipatala: kutsatira zakudya zamagazi, sinthani nthawi yopumula, mankhwala ena.