Iji kpochapụ ọrịa shuga na ihe mgbaàmà ya, a na-eji ọgwụ pụrụ iche eme ihe iji belata ọkwa shuga n’ọbara onye ọrịa. Ndị nnọchi ọgwụ antidiabetic (hypoglycemic) nwere ike ịbụ maka parenteral ojiji, yana ọnụ.
A na-egosikarị ọgwụ hypoglycemic ọgwụ hypoglycemic dị ka ndị a:
- Ngwurugwu sulfonylurea (ndị a bụ Glibenclamide, Glikvidon, Gliklazid, Glimepirid, Glipizid, Chlorpropamide);
- alfa glucosidase inhibitors ("Acarbose", "Miglitol");
- meglitinides ("Nateglinide", "Repaglinide");
- biguanides ("Metformin", "Buformin", "Fenformin");
- thiazolidinediones (Pioglitazone, Rosiglitazon, Tsiglitazon, Englitazon, Troglitazon);
- incretinomimetics.
Njirimara na ime ihe ndị dị n'ụkpụrụ sulfonylurea
Achọpụtara dị iche iche nke sulfonylureas na mberede na etiti narị afọ gara aga. Ikike nke ogige ndị dị otu a ka edoziri n’oge ọ bịara bụrụ na ndị ọrịa ahụ tookụrụ ọgwụ sulfa iji kpochapụ ọrịa na-efe efe nwetakwara shuga ọbara ha. N'ihi ya, ọgwụ ndị a nwekwara mmetụta akpọsa hypoglycemic n'ahụ ndị ọrịa.
Maka nke a, malitere nchọta ozigbo nke sulfonamides jiri ikike belata ogo glucose n’ahụ. Ọrụ a nyere aka na njikọ nke njikọ izizi sulfonylurea nke ụwa mbụ, bụ nke nwere ike idozi nsogbu nke ọrịa shuga.
A na - ejikọta ihe ngosipụta nke sulfonylurea n'ụkpụrụ nke mkpụrụ ndụ beta nke a na - eme ahụ, na - ejikọ ya na mkpali na mmụba nke insulin endogenous. Ihe dị mkpa maka ezi mmetụta bụ ọnụnọ na pancreas nke ibi ndụ yana sel beta zuru oke.
Ọ bụ ihe kwesịrị ịrịba ama na iji ojiji nke usoro sulfonylurea mee ihe ruo ogologo oge, mmetụta mbụ ha dị mma na-efu kpamkpam. Ọgwụ kwụsịrị imetọ insulin. Ndị ọkà mmụta sayensị kwenyere na nke a bụ n'ihi mbelata nke ọnụ ọgụgụ ndị na-anabata ya na mkpụrụ ndụ beta. E kpughere na mgbe izu ike dị otú a, mmeghachi nke mkpụrụ ndụ ndị a na ọgwụ nwere ike iweghachi kpamkpam.
Sulffọdụ sulfonylureas nwekwara ike inye nsonaazụ ya. Omume dị otú a enweghị uru ọgwụgwọ dị mkpa. Ihe ndi ozo a puru iche.
- ịmụba insulin nke anụ ahụ na - eme ka insulin ghara ịdị nkọ;
- mbelata mmepụta nke glucose na imeju.
Usoro mmepe nke mmetụta ndị a na ahụ niile bụ n'ihi ihe ndị mepụtara ("Glimepiride" kachasị):
- mụbaa ọnụ ọgụgụ nke ndị na-anabata ihe banyere insulin na cell lekwasịrị;
- qualitatively na-eme ka mmekọrịta insulin-receptor nke nnabata;
- dozie mmegharị nke mgbaàmà postreceptor.
Na mgbakwunye, enwere ihe akaebe na usoro nke sulfonylurea nwere ike ịghọ ihe enyemaka maka ntọhapụ nke somatostatin, nke ga-eme ka o kwe omume igbochi mmepụta glucagon.
Sulfonylureas
E nwere ọtụtụ ọgbọ nke ihe a:
- Otu ọgbọ: "Tolazamide", "Tolbutamide", "Carbutamide", "Acetohexamide", "Chlorpropamide";
- Ọgbọ nke abụọ: Glibenclamide, Glikvidon, Gliksoksid, Glibornuril, Gliklazid, Glipizid;
- Ọgbọ nke atọ: Glimepiride.
Ruo ugbu a, na mba anyị, ọgwụ nke ọgbọ nke mbụ ejighị ya na omume.
Isi ihe dị iche n'etiti ọgwụ ọjọọ nke ọgbọ nke 1 na nke 2 n'ọtụtụ ogo ọrụ ha. Enwere ike iji usoro nke abụọ nke sulfonylurea na usoro ọgwụgwọ dị ala, nke na-enyere aka ịbelata ikike dị iche iche.
N'ikwu na ọnụọgụgụ, ọrụ ha ga-abụ 50 ma ọ bụ karịa 100 ugboro karịa. Yabụ, ọ bụrụ na nkezi achọrọ kwa ụbọchị usoro ọgwụ nke ọgbọ 1 kwesịrị ịbụ nke 0.75 ruo 2 g, mgbe ahụ ọgwụ ọgwụ ọgbọ nke abụọ ewepụtalarị 0.02-0.012 g.
Dfọdụ usoro hypoglycemic nwekwara ike ịdị iche na ịnagide.
Ọgwụ ndị kachasị ewu ewu
Gliclazide - Nke a bụ otu n'ime ọgwụ ndị ahụ ka edepụtara ọtụtụ oge. Ọgwụ ọ bụghị naanị na ọkwa hypoglycemic mmetụta, mana ọ na-emekwa ka ọ ka mma:
- ihe ngosi ọbara;
- akụrụngwa nke ọbara;
- sistemụ hemostatic, microcirculation nke ọbara;
- ọrụ heparin na fibrinolytic;
- heparin ndidi.
Na mgbakwunye, Glyclazide nwere ike igbochi mmepe nke microvasculitis (mbibi azụ), na-ebelata ngosipụta ọ bụla nke platelet, na-eme ka nrụpụta nkewa dịkwuo elu ma gosipụta njirimara nke antioxidant dị mma.
Glycvidon - ọgwụ a ga - edenye ndị otu ndị ọrịa ahụ nwere obere nsogbu gbasara ezumike. N’aka ozo, ọ bụrụhaala na akụrụ gafere pesenti ise nke metabolites, ma ndị fọdụrụ 95 - eriri afọ
Glipizide Ọ nwere mmetụta akpọpụtara ma nwee ike ịnọchite anya ntakịrị ihe egwu dị na mmeghachi omume hypoglycemic. Nke a na - eme ka ọ ghara ikwe nkụ ma ghara inwe metabolites na - arụ ọrụ.
Njirimara nke ihe eji eme ihe
Mkpụrụ ọgwụ Antidiabetic nwere ike ịbụ ọgwụgwọ bụ isi maka ọrịa shuga 2, na-enweghị nnweta insulin. A na-atụ aro ọgwụ ndị dị otú ahụ maka ndị ọrịa karịa afọ 35 na enweghị ụdị nsogbu ọ bụla.
- ketoacidosis;
- ụkọ nri;
- ọrịa chọrọ ọgwụgwọ insulin ngwa ngwa.
Achọpụtaghị nkwadebe nke Sulfonylurea maka ndị ọrịa ahụ, ọbụlagodi na nri zuru oke, ihe a chọrọ kwa ụbọchị maka insulin homonụ karịrị akara nke 40 nkeji. Na mgbakwunye, dọkịta agaghị edenye ha ma ọ bụrụ na enwere ụdị ọrịa shuga mellitus, akụkọ ihe mere eme nke ọrịa mamịrị na glucoseuria dị elu megide usoro ndabere nri kwesịrị ekwesị.
Nyefee na ọgwụgwọ na sulfonylurea ga-ekwe omume n'okpuru ọnọdụ metabolism na-egbu, na-egbu ya site na injections ọzọ nke insulin na usoro onunu erughi 40. Ọ bụrụ na ọ dị mkpa, ruo PEEJI 10, a ga-agafe ntụgharị ahụ na usoro ọgwụ a.
Iji usoro sulfonylurea ruo ogologo oge nwere ike ime ka mmepe nke nguzogide, nke a ga-emeri naanị na njikọta ọgwụ yana nkwadebe insulin. N'ime ụdị shuga 1, ụdị ụzọ ahụ ga-enye nsonaazụ dị mma ngwa ngwa ma ga - enyere aka belata insulin kwa ụbọchị chọrọ, ma melite ụzọ nke ọrịa ahụ.
Achọpụtara ngaghari nke retinopathy n'ihi sulfonylurea, ọrịa retinopathy na-arịa ọrịa shuga bụ nnukwu nsogbu. Nke a nwere ike ịbụ n'ihi ọrụ angioprotective nke usoro ya, ọkachasị ndị nke ọgbọ nke abụọ. Ka osi di, enwere ike puru iche nke ndu ha atherogenic.
Ekwesiri iburu n'uche na enwere ike ijikọ ọgwụ ndị a na insulin, yana biguanides na "Acarbose". Nke a ga - ekwe omume n'ọnọdụ ebe ahụike onye ọrịa anaghị enwe ọfụma ọbụlagodi usoro ọgwụ insulin kwa 100 na -ekwu kwa ụbọchị.
Iji ọgwụ ndị na-eme ka mmiri na-ebelata mmiri ọgwụ sulfonamide, a ga-echetarịrị na enwere ike belata ọrụ ha:
- anticoagulants na-apụtaghị ìhè;
- salicylates;
- "Butadion";
- Ethionamide;
- Cyclophosphamide;
- tetracyclines;
- Chloramphenicol.
Mgbe ị na-eji ego ndị a na mgbakwunye na ọgwụ sulfa, metabolism nwere ike imebi, nke ga-eduga mmepe nke hyperglycemia.
Ọ bụrụ na ijikọtara ihe ndị a na - akpọ sulfonylurea na thiazide diuretics (dịka ọmụmaatụ, "Hydrochlorothiazod") na BKK ("Nifedipine", "Diltiazem") na oke onunu ogwu, mgbe ahụ ịlụ ọgụ nwere ike ịmalite ịmalite. Thiazides na-egbochi ịdị irè nke ihe nrụpụta sulfonylurea site na imeghe ọwa potassium. LBC na-ebute ọgba aghara na ntinye nke calcium ion na beta nke pancreas.
Nchịkwa sitere na sulfonylureas na-eme ka mmelite mmanya na - aba n'anya dị ukwuu. Nke a bụ n'ihi oge igbu oge na usoro oxidation nke acetaldehyde. Ngosipụta nke mmeghachi omume mgbochi na-ekwekwa omume.
Na mgbakwunye na hypoglycemia, nsonaazụ na-adịghị mma nwere ike ịbụ:
- ọrịa dyspeptik;
- jalestice cholestatic;
- uru dị arọ;
- ọrịa aplastic or hemolytic anemia;
- mmepe nke mmeghachi omume nfụkasị ahụ;
- leukopenia atụgharị;
- thrombocytopenia;
- agranulocytosis.
Meglitinides
N'okpuru meglitinides kwesịrị ịghọta usoro nchịkwa nke prandial.
"Repaglinide" bụ usoro nke benzoic acid. Ọgwụ dị iche n'ụdị kemịkalụ sitere na usoro nke sulfonylurea, mana ha nwere otu mmetụta ahụ. Repaglinide na-egbochi ọwa mmiri ọgwụ ATP na-egbochi na mkpụrụ ndụ beta na-arụ ọrụ ma na-akwalite mmepụta nke insulin.
Nzaghachi nke anụ ahụ na-abịa ọkara awa mgbe i risịrị nri ma ọ na-egosipụta site n’ibelata shuga ọbara. N’etiti nri, ịta insulin anaghị agbanwe agbanwe.
Dị ka ọgwụ ndị e sitere na usoro sulfonylurea, mmeghachi omume kasị njọ bụ hypoglycemia. Kachasị anya, enwere ike ịkwado ọgwụ ahụ maka ndị ọrịa nwere ọrịa gbasara akụrụ ma ọ bụ imeju.
Nateglinide bụ akara nke D-phenylalanine. Ogwu a di iche na ndi ozo ndi ozo yiri ya na adighi ike. Ọ dị mkpa iji ọgwụ maka ụdị shuga mellitus nke 2 mee ka ikike belata hypglycemia postprandial.
A mata ndị Biguanides kemgbe afọ 70 nke narị afọ gara aga ma debere ha ihe nzuzo nke mkpụrụ ndụ beta nke pancreas. A na-ekpebi mmetụta ha site na mgbochi nke gluconeogenesis na imeju yana mmụba na ikike nke ike glucose. Na mgbakwunye, ngwaọrụ nwere ike belata inaculin insulin ma nwekwuo njikọta ya na ndị na-anabata insulin. N'ime usoro a, metabolism na nnabata nke glucose na-abawanye.
Biguanides adịghị eweda ọkwa shuga dị ala nke ahụike na ndị na-arịa ụdị ọrịa shuga mellitus nke 2 (enyere abalị abalị).
Enwere ike iji hypoglycemic biguanides mee ihe na mmepe nke ụdị ọrịa shuga 2. Na mgbakwunye na mbenata shuga, ụdị ọgwụ a nwere ogologo oge ha na-emetụta metabolism abụba.
N'ihi iji ọgwụ ọjọọ eme ihe otu a:
- a na-eme ka lipolysis (usoro nke oke abụba);
- agụụ riri;
- ibu na-eji nwayọ laghachi nkịtị.
N'ọnọdụ ụfọdụ, ojiji ha na mbelata ọdịnaya nke triglycerides na cholesterol n'ime ọbara, enwere ike ikwu na biguanides bụ mbadamba iji belata shuga ọbara.
Typedị nke abụọ nke ọrịa shuga mellitus, metabolism na-egbu ike nwere ike ka na-enwe nsogbu na metabolism abụba. N'ihe dị ka pasent 90 nke ikpe, ndị ọrịa buru ibu. N'ihi nke a, na mmepe nke ọrịa shuga, yana oke ibu, ọ dị mkpa iji ọgwụ ndị na-eme ka usoro metabolism dị ọcha.
Ihe kachasị egosi maka iji biguanides bụ ọrịa shuga nke 2. Ogwu a di nkpa karie n ’iribiga ibu na ike nri adighi nma ma obu adighi ike nke nkwadebe. E gosiputara ihe nke biguanides na enweghi insulin n'ime ọbara.
Alpha glucose na-egbochi mmebi nke polysaccharides na oligosaccharides. A na-ebelata nnabata na imepụta glucose ma na-enwe ịdọ aka ná ntị banyere mmepe nke hyperglycemia postprandial. Carbohydrates nile nke eji nri, n’ọnọdụ ha adịghị agbanwe agbanwe, na-abanye na ngalaba nke obere eriri afọ yana nnukwu. Ntinye nke monosaccharides na-ewe ihe ruru awa anọ.
N'adịghị ka ọgwụ sulfa, ndị na-egbochi glucose na-eme ka insulin na-amịpụta ma ghara ịkpata hypoglycemia.
Site na nyocha, e gosipụtara na ọgwụgwọ site na enyemaka nke "Acarbose" nwere ike isonyere yana mbelata nke ohere nke ibute nnukwu nsogbu nke atherosclerosis.
Ojiji nke inhibitors ndị dị otú ahụ nwere ike ịbụ n'ụdị monotherapy, ma jikọta ha na ọgwụ ndị ọzọ na -ebelata ọbara shuga. Ọgwụ nke mbụ bụkarị 25 ruo 50 mg ozugbo tupu ma ọ bụ n'oge nri. Site na ọgwụgwọ na-esote, usoro ọgwụgwọ ahụ nwere ike ịbawanye oke (mana ọ bụghị karịa 600 mg).
Ihe ngosiputa di iche iche banyere nhọpụta nke alfa-glucosidase inhibitors bụ: ụdị shuga mellitus nke 2 nwere usoro nri nri na-adịghị mma, ụdị shuga mellitus nke 1, mana ọ dabere na usoro ọgwụgwọ.
