Aia ʻo Biguanides i keʻano o ka guanidines, ka mea kūpono i ka maʻi diabetes. Ma hope o nā mea a pau, ʻoi ka papa o nā lāʻau lapaʻau e hoʻohaʻahaʻa i ka kaʻa o ka glucose i ke koko.
ʻO kēia mau mau mea: L-butylbiguanide (Buformin), N, N-dimethylbiguanide (Metformin), Phenethylbiguanide (Fenformin).
ʻO ka ʻokoʻa ma ka hoʻolālā ʻana o nā hānō e hoʻohaʻahaʻa i nā biguanides e waiho ʻia i loko o kā lākou hoʻoweliweli ʻana e ke kino a me ka nui dosage. Akā ʻo ka hopena o nā derivatives guanidine ma ka hana metabolism ka mea like i ka hapa nui.
Eia nō naʻe, ʻaʻole i hoʻohana pinepine ʻia nā ʻaina antihyperglycemic e like me ka monotherapy. Ma ke kānāwai, hana kēia i 5-10% o nā hihia.
Pehea e hana ai ka biguanides?
Pehea e ʻike ʻole ai kēia mau lāʻau i ke kino no ka ʻike ʻole ʻana. Akā ua hōʻike ʻia ʻo nā derivatives guanidine e hoʻohaʻahaʻa i ka haʻahaʻa koko i ka maʻi diabetes 2 type, ʻoiaʻiʻo inā inā pilikia ka mea maʻi me ka momona nui.
Loaʻa i ka Biguanides ka hopena o ka "insulin-mālama", no laila ke kū ka lōʻihi o ka makemake o ka hoʻokele hormone synthetic. Pēlā nō, ua hōʻemi ʻia kēia mau lāʻau i ka gluconeogenesis hoʻonui mai ka protein.
Eia kekahi, hoʻonui nā huahana i ka uptake glucose glucose ma ka hoʻololi ʻana i ke kō i ka lactate. Ma muli o ka hōʻike ʻana i nā derivatives guanidine, ke kaʻina o ka hoʻopili ʻana o nā mea e like me:
- nā loko
- waiora B 12№
- waʻa amino;
- D-xylose.
Aia kekahi manaʻo e i ke kaʻina o ka pale ʻana o ka hanu o ke kiko, ke emi ana ka hoʻokumu o ATP, ma muli o nā ʻano like ʻole o ka metabola e hoʻopau ai i ka ikehu (no ka laʻana, ʻo gluconeogenesis) e lohi ana. Akahi, ʻo ke hana o ka hana o ka biguanides ko lākou hopena ma ka lipid metabolism.
Ua loaʻa ʻia nā lāʻau lapaʻau nei me nā maʻi maʻi non-insulin-like me ka nui o ka paona e hāʻawi i ke emi ʻana i ka nui o ke kaumaha o ke kino.
Akā ʻo ia mau hopena i ʻike ʻia ma ka hoʻomaka ʻana o ka hoʻōla, ke kū ʻole ʻia kekahi mau mea i loko o ka ʻōpū, a hoʻemi ʻia ka makemake o ka mea maʻi.
ʻLoe a me ke kākele
ʻO ka papa o ka Biguanides kekahi mau lāʻau lapaʻau e loaʻa ai ka inoa nei:
- Siofor 1000/850/500;
- Bagometua;
- Metformin Acre;
- Avandamet;
- Huhu;
- Metfogamma.
I kēia mau lā, hana pinepine nā kumu methylbiguanide, ʻo ia hoʻi ka metformin. Hoʻopili kēia me Gliformin, Glucofag, Dianormet a me nā mea'ē aʻe.
ʻO ke ʻano o ke noi ʻana o ka nui o ka biguanides e like. I ka mua, ua kuhikuhi ʻia nā dosis liʻiliʻi, akā me ka hoʻomanawanui maikaʻi ua hoʻonui ʻia lākou i kēlā me kēia 2-4 mau lā. Eia kekahi, pono e inu i ka polyhexamethylene biguanide ma hope o ka ʻai ʻana, i mea e pale ai i ka hoʻomohala ʻana o nā hopena ʻaoʻao mai ka gastrointestinal tract.
Ka hui o nā biguanides e hana i ka maʻi non-insulin-dependence i loaʻa i ka hopena therapeutic ʻumikumamālua hola. No laila, e hoʻokaʻawale i kahi inikua ʻo ia i nā lā he 2.
I ka hoʻomaka ʻana o ka lāʻau, ʻo ka Metformin 850, Siofor a me nā mea like ʻole, e lawe ʻia ma ka nui o 500 mg hoʻokahi (ma ke ahiahi). Ma hope o hoʻokahi hebedoma, i hoʻolako ʻia ʻole ka pilikia o ka mea maʻi me ka ʻeha gastrointestinal, hoʻokahi ka nui o ka nui i kēlā me kēia lā i 850 mg a i ʻole ka mea maʻi e inu i kahi 500 mg ma ke kakahiaka.
I ka hopena o nā hopena maikaʻiʻole, pono e hoʻemi ʻia ka nui o hope, a ma hope o ka manawa e hoʻāʻo e hoʻonui. Loaʻa ka kikoo kiʻekiʻe o kahi mea i loko o ke kino ma hope o 1-2 mau lā o ka mālama ʻana.
Kākoʻo kākoʻo ʻana - a i ka 2000 mg i kēlā me kēia lā. ʻO ka nui o ka nui e hiki ai ke 3000 mg i kēlā me kēia lā, akā no nā maʻi maʻi ʻōpio wale nō. ʻAʻole ʻoi aku ka nui o ka paena nui no nā maʻi maʻi ma mua o 1000 mg.
Hiki ke hoʻohui pū i ka polyhexamethylene biguanide me nā secretogens (sulfonylureas a me nā palapala lepo), insulin a me glitazones. No laila, ʻo nā ʻoihana lapaʻau e hana i nā hoʻomākaukau pono i hoʻomākaukau ʻia i loaʻa ka hypoglycemic hopena i ka palena haʻahaʻa, e hōʻemi ana i ka hopena o nā hopena pili:
- ʻO Glucovans (metformin a me glibenclamide);
- ʻO Glibomet.
Inā ʻoe e lawe i ia huahana hui like ʻole, a laila hoʻoliʻiliʻi ka ʻike o ke kō i loko o ke koko ma hope o 2 mau hola, a mau nō ka hopena a hiki i 12 mau hola.
Kuhi ʻia nā lāʻau like me 1 papa i kēlā me kēia lā me kahi piʻi aʻe ma hope o 2 i mau capsules i ka lā.
ʻO nā manaʻoʻinoʻino a me nā contraindications
Hiki i nā polyhexamethylene biguanide a me nā mea aʻe mai kēia ʻāpana ke hana i kahi nui o nā hana maikaʻi ʻole. ʻO ka ʻākia maʻamau ka hoʻohemo ʻana i ka hana a ka digestive, hemahema ʻilihune, ka hiki ʻana o ka loea metallic i loko o ka waha a me ka hoʻomohala ʻana i ka waʻawa o ka lactic.
ʻO kahi hōʻailona no ka hoʻokuʻu ʻana i ka komo ʻana o nā mea ulu mai ke ʻano guanidine he mea hōʻeuʻeu i ka maʻi hopena. Eia naʻe, me ka hoʻoponopono hoʻoponopono ʻia, hapa nā hapa ʻaoʻao.
Hoʻopili ʻia ʻo Metformin i kēia mau pilikia:
- ke aho hanu;
- anemia diabetes;
- pilikia pilikia
- he poho;
- hapai
- nā maʻiʻehā;
- encircal encephalopathy;
- rōpula maʻi, i ka wā o ka pae o ka hana i loko o ke koko he ʻoi aku ma mua o 1.5 mmol / l.
Eia kekahi, ʻaʻole hiki ke lawe ʻia nā lāʻau lapaʻau me ka coma maʻi maʻi, me ka ketoacidosis a inā, inā he moʻolelo o ka lactic acidosis. Eia kekahi, ua kūlike nā lāʻau lapaʻau i nā kūlana hypoxic (hōʻeha ka naʻau, ka angina pectoris, kaʻe o ke koko maikaʻi).
ʻAʻole kūpono ʻo Metformin i ka waiʻona. A inā i hoʻonui ʻia ka palaka, a laila kuhikuhi ʻia nā lāʻau lapaʻau wale nō i ka wā e hele mai ai ka hepatomegaly e pili ana i ke kua o ka maʻi hepatostatosis maʻi.
I loko o nā hihia o ka dystrophic, allergic a maʻi infectious lesi, biguanides hiki ke hoʻopilikia i ka parenchyma hepatic. I ka hopena, ʻike ʻia i nā loli i nā hoʻokolohua hana. E ulu pū ka Cholestasis, me nā hōʻailona maʻalahi o ka jaundice.
Hoʻohālikelike ʻia i nā derivatives sulfonylurea, nā lāʻau mai nā mea he nui o ka guanidines ʻaʻole i loaʻa ka hopena o nā mea i loko o kaʻeha a me ka iwi. ʻOiai, ke hoʻohālikelike ʻia lākou i ka hihia o ka anemia koʻikoʻi, ka noho ʻana, nā pakanā o ka nitrogen a i ka hele ʻana mai o nā maʻi o ka pūpū e hoʻohewa ai i ka kānana glomerular.
Eia nō hoʻi, inā e hoʻohui pū ka mālama ʻana me biguanides i ka fructose, antihistamines, barbiturates, teturam a me ka salicylates, e hoʻonani kēia i ka acidosis lactic.
Hāʻawi kahi haʻawina e pili ana i nā lāʻau lapaʻau i ka wikiō ma kēia ʻatikala.
