Biguanides so na udi nke guanidines, nke di ndu n’aria oria. E kwuwerị, klaasị ọgwụ a na-ebelata ume ọgụgụ glucose n'ọbara.
Ndị nnọchianya ndị a bụ: L-butylbiguanide (Buformin), N, N-dimethylbiguanide (Metformin), Phenethylbiguanide (Fenformin).
Ihe di iche na ihe mejuputara biguanides ndi nwere ike ime ka mmuo di iche-iche site na ahu na usoro onunu ogwu. Mana nsonaazụ nke ihe ndị dị n'ụdị guanidine na metabolism bụ otu ihe n'ọtụtụ ọnọdụ.
Agbanyeghị, ọgwụ antihyperglycemic ọgwụ anaghị ejikarị monotherapy. Dịka iwu, nke a na-eme na 5-10% nke ikpe.
Kedu ka biguanides si arụ ọrụ?
Achọpụtaghị etu ọgwụ ndị a si emetụta ahụ n’onweghị, n’agbanyeghi ọtụtụ ọmụmụ. Ma edepụtara ya na usoro ịre guineidine na-ebelata glucose ọbara dị ala na ụdị shuga 2, ọkachasị ma ọ bụrụ na onye ọrịa nwere nsogbu ibu oke ibu.
Biguanides nwere mmetụta “ichebe insulin”, yabụ ka oge na-aga, mkpa maka nchịkwa homonụ na-ebelata. Ọzọkwa, ọgwụ ndị a na-ebelata gluconeogenesis mụbara site na protein.
Na mgbakwunye, ụdị ngwaahịa ndị a na-eme ka uru glucose dị ala ma ọ bụrụ na ha atụgharị shuga ka lactate. N'ihi ngosipụta nke ihe ndị a dị n'ụdị guanidine, usoro nnabata nke ihe ndị dị ka:
- abụba
- vitamin B 12№
- amino acid;
- D-xylose.
Enwere echiche na usoro nke igbochi iku ume anụ ahụ, usoro nke ATP na-ebelata, n'ihi nke usoro metabolic dị iche iche na-eri ike (dịka ọmụmaatụ, gluconeogenesis) na-eji nwayọ nwayọ. Ikekwe, usoro nke biguanides bụ mmetụta ha na metabolism nke lipid.
Achọpụtakwara na ọgwụ ndị a na-arịa ọrịa shuga na-enweghị insulin na-enwe oke ibu na-enye aka na mbelata nke otu ahụ.
Mana mmetụta dị otú ahụ ka a na-ahụta naanị na mmalite ọgwụgwọ, mgbe ụfọdụ ihe adịghị etinye ya na eriri afọ, na-ebelata agụụ onye ọrịa.
Usoro onunu ogwu na nhazi
Klaasị nke biguanides nwere ọgwụ ọgwụ nwere aha ndị a:
- Siofor 1000/850/500;
- Akpa;
- Metformin Acre;
- Avandamet;
- Glucophage;
- Metfogamma.
Taa, a na-ejikarị ụdị methylbiguanide, nke bụ metformin. Ihe ndị a gụnyere Gliformin, Glucofag, Dianormet na ihe ndị ọzọ.
Ofzọ itinye ọtụtụ biguanides si yie. Na mbu, a na-enye obere doses, mana na ntachi obi dị mma, ọ na-abawanye kwa ụbọchị 2-4. Ọzọkwa, polyhexamethylene biguanide aghaghị ị beụ mmanya mgbe ha risịrị nri, nke ga-egbochi mmepe nke nsonaazụ akụkụ eriri afọ.
Otu ndi biguanides ejiri mee ihe maka ọgwụgwọ oria shuga na-adighi insulin nwere uto ọgwụgwọ iri na abuo. Ya mere, ubochi ubochi kwesiri ikewaputa onwa abuo.
Na mmalite ọgwụgwọ, a na-ewere Metformin 850, Siofor na ihe ndị yiri ya, na 500 mg otu ugboro (na mgbede). Mgbe otu izu gasịrị, ọ bụrụhaala na onye ọrịa ahụ enweghị nsogbu na akwara afọ, a na-abawanye usoro ọgwụ kwa ụbọchị ruo 850 mg ma ọ bụ onye ọrịa ahụ na-a anụ ọgwụ 500 ọzọ n'ụtụtụ.
N'ọnọdụ mmeghachi omume na-adịghị mma, a ga-ebelata ọgwụ gị, ma mgbe oge ụfọdụ gasị gbalịa ịbawanye ya. A na-enweta ntinye uche kachasị n'ime ahụ mgbe ọnwa 1-2 gachara.
Na-akwado usoro onunu ogwu - rue 2000 mg kwa ubochi. Ego ole a na-anabata bụ 3000 mg kwa ụbọchị, mana ọ bụ naanị maka ndị ọrịa na-eto eto. Ogwu kachasị maka ndị ọrịa agadi abụghị ihe karịrị 1000 mg.
Polyhexamethylene biguanide nwere ike jikọta ya na secretogens (sulfonylureas na aids), insulin na glitazones. Ya mere, ụlọ ọrụ na-emepụta ọgwụ na-emepụta nkwadebe ndị ejikere nke nwere mmetụta hypoglycemic na obere usoro, nke na-ebelata ihe ize ndụ nke mmetụta ndị ọzọ:
- Glucovans (metformin na glibenclamide);
- Glibomet.
Ọ bụrụ n’inwe ụdị ngwaahịa a ejikọtara ọnụ, mgbe ahụ ịta oke shuga n’ime ọbara na - agbanwezi mgbe elekere abụọ gachara, nsonaazụ ahụ ga - adịgide ruo awa iri na abụọ.
A na-ewere ọgwụ ndị dị otú ahụ na 1 mbadamba ụbọchị kwa ụbọchị yana mmụba na-esote usoro iji 2 kapsinles kwa ụbọchị.
Mmeghachi omume ọjọọ na contraraindications
Polyhexamethylene biguanide na ihe ndi ozo sitere na otu a nwere ike ibute otutu ndi ojoo. Ihe kachasị dị na ya bụ ọdịda na-emebi emebi, nri na-adịghị mma, ọnụnọ nke ụtọ dị n'ọnụ na mmepe nke lactic acidosis.
Ihe ngosiputa maka ịkwụsị oriri sitere na usoro guanidine bu agha nke oria afọ. Agbanyeghị, n'iji ndozi ọgwụ mee ihe, ọtụtụ mmetụta ndị ọzọ na-akwụsị.
A na - egbochi Metformin n'ọnọdụ ndị a:
- okpu iku ume;
- ọrịa shuga anaemia;
- nsogbu imeju
- ọnya;
- ime
- nnukwu ọrịa;
- encephalopathy diski;
- Mgbe ọ bụla achụrụ creatinine n'ime ọbara karịrị 1.5 mmol / l.
Ọzọkwa, enweghị ike ị withụ ọgwụ ọjọọ na coma mamịrị, gụnyere ketoacidosis na, ọ bụrụ na enwere akụkọ mgbe ochie nke lactic acidosis. Na mgbakwunye, a na-egbochi ọgwụ ndị dị otú ahụ n'ọnọdụ hypoxic (nkụchi obi, angina pectoris, mgbasa ọbara na-adịghị mma).
Metformin adabaghị na mmanya. Ma ọ bụrụ na imeju na-abawanye, mgbe ahụ, ọgwụ ndị dị otú ahụ ka edepụtara naanị mgbe ọrịa ịba ọcha n'anya malitere na nzụlite hepatostatosis mamịrị.
N'ihe banyere dystrophic, nfụkasị ma ọ bụ ọnya ọnya na-efe efe, biguanides nwere ike imetụta hepatic parenchyma. N'ihi ya, a na-ahụ ya na mgbanwe na ule nyocha arụmọrụ. Cholestasis nwekwara ike ịmalite, yana ihe ịrịba ama doro anya nke jaundice.
N'iji ya na usoro nke sulfonylurea, ọgwụ sitere n'ọtụtụ guanidine enweghị mmetụta na-egbu egbu na akụrụ na ụmị ọkpụkpụ. Agbanyeghị, ha na - contraindicated bụrụ nke ajọ anaemia, njigide, toxins nitrogen na ọnụnọ nke ọrịa akụrụ na-eme ka ọnụlata filtration ụwa.
Ọzọkwa, ọ bụrụ na agwakọta ọgwụgwọ na biguanides na fructose, antihistamines, barbiturates, teturam na salicylates, nke a ga-akpalite lactic acidosis.
A na-ekwu okwu nkuzi banyere ọgwụ ọgwụ shuga na vidiyo n'isiokwu a.
