Kedu ihe bụ biguanides: nsonaazụ nke otu ọgwụ maka ọrịa shuga

Biguanides bụ ọgwụ ndị emepụtara iji belata glucose ọbara. Ngwá ọrụ dị n'ụdị mbadamba nkume.

A na-eji ha, ọtụtụ mgbe, na-arịa ụdị ọrịa shuga mellitus 2, dị ka ihe na-arụ ọrụ.

Dịka akụkụ nke monotherapy, a na-enye ọgwụ hypoglycemic ọgwụ obere. Ọtụtụ mgbe nke a na - eme na 5-10% nke ikpe.

Biguanides gụnyere ọgwụ ndị a:

• Akpa,
• Avandamet
• Metfogamma,
• Glucophage,
• Metformin Acre
• Siofor 500.

Ugbu a, na Russia, nakwa gburugburu ụwa, a na-eji biguanides eme ihe, maka akụkụ kachasị, methylbiguanide, ya bụ, metformin:

1. glucophage
2. Siofor
3. metast-gamma,
4. dianormet
5. glyformin na ndị ọzọ.

Metformin na-etisa otu awa na ọkara ruo awa atọ. A na-emepụta ọgwụ ahụ na mbadamba 850 na 500 mg.

Usoro ọgwụgwọ ọgwụgwọ bụ 1-2 g kwa ụbọchị.

Nwere ike iri ihe dịka 3 g kwa ụbọchị maka ọrịa shuga.

Nchịkọta Butylbiguanide:

• silin
• buformin
• Adebite.

Biko mara na a na-eji biguanides eme ihe nwa oge, n'ihi nsonaazụ dị njọ, ya bụ gastric dyspepsia.

Ugbu a ndị dọkịta anaghị atụ aro iji usoro phenylbiguanide, ebe emere ka ọ pụta ìhè na ha na-eduga n'ịba ụba ọbara mmadụ:

• pyruvate
• lactate

Iji ọgwụ ọjọọ eme ihe

Ndị ọkà mmụta sayensị achọpụtala na mmetụta shuga nke metformin na-arịa ọrịa shuga metụtara mmetụta ọgwụ ahụ nwere na ọdọ mmiri na njikọ. Mmetụta na-ebelata shuga nke metformin na ndị na - ebuga glucose na sel.

Olu ndi na - ebugharị glucose na - abawanye n’ihi ikpughe biguanides. E gosiputara nke a na nnweta glucose dị mma gafere sel ụkwara ahụ.

Mmetụta a na - akọwa nsonaazụ nke omume insulin na ahụ insulin na - esite na mpụta. Ọgwụ ndị ahụ na-emekwa ihe n’ime akpụkpọ ahụ mitochondrial.

Biguanides na - egbochi gluconeogenesis, site na nke a ha na - enye aka na mmụba nke ọdịnaya:

1. lactate
2. pyruvate,
3. Alanine

Ihe ndi a bu ihe ndi choputara glucose n’iru na gluconeogenesis.

Olu nke ndị na-ebuga glucose na-abawanye n'okpuru ọrụ nke metformin na akpụkpọ ahụ plasma. Ọ bụ banyere:

• ILU-4,
• GLUT-2,
• ILU-1.

Transportgbọala glucose na-agba ngwa ngwa:

1. na akwara anụ ahụ
2. endothelium
3. Akwara obi.

Nke a na - akọwa mbelata nguzogide insulin na ndị mmadụ nwere ụdị ọrịa shuga mellitus nke 2 n'okpuru mmetụta nke metformin. Mmụba na uche insulin na-esoghị mmụba nke nzuzo ya site na pancreas.

N'ọnọdụ ndabere nke mbelata insulin na-eguzogide ọgwụ, ọkwa nke na-egosi insulin n'ọbara na-ebelata. Mmụba na uche insulin na-esoghị mmụba nke nzuzo ya site na pancreas, dị ka mgbe ị na-eji sulfonylureas.

Mgbe ị na-emeso metformin n'ime ndị mmadụ, a na-achọpụta ibu na-anyịbelata, mana mgbe ị na-emeso ndị nnọchianya na insulin, mmetụta dị iche nwere ike. Na mgbakwunye, metformin na-enyere aka belata egbugbere ọnụ ọbara.

Nsonaazụ

Ekwesịrị ị mata mmetụta dị iche iche sitere n'iji metformin, usoro dị ka ndị a:

• afọ ọsịsa, ọgbụgbọ, ọgbụgbọ;
• ọla n ’ọnụ;
• mgbakasị ahụ n’afọ;
• afọ ojuju na agụụ na-agụ ya, wee rapu nri;
• lactic acidosis.

Nsonaazụ na omume ndị egosipụtara, dị ka iwu, ga-apụ ngwa ngwa n'iwe ya. Mwakpo nke afọ ọsịsa bụ ihe ngosipụta iji kwụsị metformin.

Ọ bụrụ na ị were Metformin 200-3000 mg kwa ụbọchị ogologo oge, mgbe ahụ i kwesiri icheta na nnabata nke eriri afọ ga-ebelata:

1. B vitamin,
2. folic acid.

Ọ dị mkpa idozi n'ọnọdụ nke ọ bụla maka nsogbu nke mgbakwunye vitamin.

Ọ dị mkpa idobe ọdịnaya lactate ọbara, wee lelee nke a opekata mpe ugboro n'afọ. Nke a dị mkpa nyere ikike nke metformin iji kwalite anaerobic glycolysis na obere eriri afọ yana gbochie glycogenolysis na imeju.

Ọ bụrụ na mmadụ nwere mkpesa nke mgbu akwara na ụtọ ọla na ọnụ, ọ dị mkpa ịmụ ogo lactate. Ọ bụrụ na ọdịnaya ọbara ya na-abawanye, mgbe ahụ, a ga-akwụsị ihe maka ọgwụgwọ na metformin.

Ọ bụrụ na ọ gaghị ekwe omume ịmụ ọkwa nke lactate n'ime ọbara, wee kagbuo metformin rue mgbe ọnọdụ ahụ ga-aba uru, mgbe ahụ, a na-enyocha ohere niile ọ ga-esi na nchịkwa ya.

Ihe ndị bụ isi contraindications

Enwere contraindications doro anya maka iji metformin:

1. ọrịa sheto nke kediacidosis, yana coma na ọnọdụ ndị ọzọ nke ọrịa mamịrị;
2. arụ ọrụ na-arụ ọrụ n’ịrụ ọrụ, mụbara creatinine n’ime ọbara karịrị 1.5 mmol / l;
3. Ọnọdụ hypoxic nke mkpụrụ ndụ ọ bụla (angina pectoris, ọdịda ọbara, 4 FC, angina pectoris, infarction myocardial);
4. okpu iku ume;
5. nnukwu nsogbu encephalopathy,
6. ụkwara
7. anaemia
8. nnukwu ọrịa na-efe efe, ọrịa ịwa ahụ;
9. mmanya
10. afọ imeju;
11. ime
12. ihe ngosi banyere akụkọ ihe mere eme nke lactic acidosis.

N'ime usoro nke imeju imeju, edepụtara biguanides mgbe a ghọtara hepatomegaly dị ka nsonaazụ nke hepatostatosis mamịrị.

Site na ọrịa na-efe efe na -akpata na ọrịa dystrophic nke imeju, enwere ike idekọ mmetụta nke biguanides na hepatic parenchyma, nke ekwuputara na:

• ọdịdị nke cholestasis, oge ụfọdụ ruo jaundice anya,
• mgbanwe na nyocha imeju na-arụ ọrụ.

Na ịba ọcha n'anya na-adịghị ala ala, ekwesịrị iji ọgwụ mee ihe n'ichebara anya.

N'adịghị ka usoro nke sulfonylurea, biguanides enweghị mmetụta nsị na-egbu egbu na ọrụ hematopoietic nke ụmị ọkpụkpụ na akụrụ. Agbanyeghị, ha na-contraindicated na:

• Ọrịa akụrụ na-akwalite mbelata nke mmeto ikuku
• njigide nke slag nitrogenous
• oke anaemia, n'ihi ihe ojoo nke lactacidemia.

Ndị agadi na-arịa ọrịa kwesịrị iji nlezianya depụta ọgwụ, ebe ọ bụ na nke a metụtara iyi egwu nke lactic acidosis. Nke a metụtara ndị ọrịa ahụ na-arụ nnukwu ọrụ anụ ahụ.

Enwere ọgwụ ọgwụ, ojiji nke iji ọgwụgwọ biguanides na-eme ka usoro lactic acidosis dịkwuo njọ, ndị a bụ:

• fructose
• teturam
• ọgwụ mgbochi
• salicylates,
• mgbochi ego.