I nā maʻi me ka maʻi diabetes type 2, kū pinepine ka nīnau, pehea ka lōʻihi e lawe ai ka Metformin? Kuhi, ʻaʻole ka manaʻo o ka nīnau i kēia nīnau. ʻAʻole hiki i kekahi kauka ke kuhikuhi i ka manawa kūpono, ʻoiai ke mālama nei ka mea mālama i kēlā me kēia maʻi i kona ʻano maʻamau o ke olakino, ka pae glucose, ka hōʻeha o ka maʻi maʻi a me nā maʻi pili.
ʻOi ka maʻi diabetes mellitus ua kapa ʻia ke ahulau o ke kenekulia 21. ʻO kēia ma muli o kaʻoiaʻiʻo i kēlā me kēia makahiki ka nui o ka nui o nā mea maʻi me kēia pathology. Hōʻike ka hōʻike helu 90% o nā maʻi maʻi āpau i ka lua o nā maʻi, ma waena o lākou ka nui o nā wahine momona ʻokoʻa ma mua o nā kāne.
He lāʻau lapaʻau kaulana ʻo Metformin ma waena o nā maʻi maʻi like ʻole o ka insulin e hiki ʻole ke hoʻokō i ka hoʻemi ʻana i ke kō me ka meaʻaiʻai kūikawā a me ke ʻano. Eia kekahi, hoʻohana ʻia nō hoʻi e pale i nā hopena koʻikoʻi ma ka maʻi maʻamau a maʻa mau ʻūlū maʻi. Akā he aha ke ʻano o ka hana o ka lāʻau lapaʻau, pehea e lawe pololei ai i nā mea ʻole e hōʻino iā ʻoe iho? Ma, e hoʻāʻo e kiʻi i kēia.
Ka hana o ka hana a Metformin
Ke hana nei i ka mea hana i ke pale ʻole i ke kaʻina hana o ka gluconeogenesis e loaʻa ana i loko o ka ate. Ke hoʻemi ʻia ka hana ʻana o ka glucose i loko o kahi ʻōpū, ua emi hoʻi kona pae koko. Pono e haʻi ʻia ma ka maʻi pākiki, ʻo ka nui o ka maʻi glucose i loko o ke akeʻai e ʻoi aku ma kahi o ʻekolu mau manawa i nā manawa maʻamau.
Ma ke ate ka mea o ka enzyme i kapa ʻia AMP-hoʻoneʻe kinase (AMPK), e hana ana i ka hana nui ma ka hōʻailona ʻana i ka insulin, ka hana metabolism o nā momona a me ka glucose, a me ka paleʻana o ka ikehu. Hoʻokomo ʻo Metformin i ka AMPK e kāohi i ka hana o ka glucose.
Ma kahi o ka hoʻokipa ʻana i ke kaʻina o ka gluconeogenesis, hana ka metformin i nā hana ʻē aʻe, ʻo ia hoʻi:
- hoʻomaikaʻi i ka ʻikeʻana o nā ʻolua peripheral a me nā selela i ka hoʻohaʻahaʻaina o ke kō;
- hoʻonui i ka uptake glucose e nā cell;
- alakaʻi i ka hoʻonui nui o nā momona momona;
- kūlike i ka komo ʻana o ka glucose mai ka papa hana ʻana o ka digestive tract.
ʻO ka lawe ʻana i ka lāʻau lapaʻau e kōkua i ka hōʻemi o ka momona ma ka poʻe. ʻO Metformin ka haʻahaʻa serum cholesterol, TG a me LDL cholesterol i kahi ʻōpū ʻole. I ka manawa like, ʻaʻole ia e hoʻololi i ka nui o nā lipoproteins o nā mea ʻē aʻe. ʻO ke kanaka olakino (me nā waiwai glucose maʻamau) e lawe i ka metformin, ʻaʻole lākou e manaʻo i ka hopena therapeutic.
Ke hoʻohana nei i ka lāʻau lapaʻau, hiki i ka mea maʻi ke hōʻemi i ka emi ʻana o ke kō i loko o ka puna ma o 20%, a me ka ʻike ʻana i ka hemoglobin glycosylated e pili ana iā 1.5%. ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau e like me ka monotherapy, ka hoʻohālikelike ʻana me nā lāʻau lapaʻau e hoʻohaʻahaʻa i ka wai, ka insulin a me ka meaʻai kūikawā, e hōʻemi ana i ka hoʻoulu ʻana i ka puʻuwai puʻuwai. Eia kekahi, ʻo kahi noi ma ka noiʻi 2005 (Cochrane Collaboration) i hōʻoia i ka hala ma waena o nā mea maʻi me ka diabetes type 2 a hōʻemi ʻia e ka lawe ʻana i ka Metformin.
Ma hope o ka inu ʻana i ka mea maʻi i kahi papa o ka metformin, e hoʻonui kona pae koko i nā hola 1-3 a hoʻomaka ʻo ia e hana. Hoʻomaʻa koke ka lāʻau i loko o ka gastrointestinal tract.
ʻAʻole metabolized ia mea, akā excreted mai ke kino kanaka me ka urine.
Nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau
Hoʻokuʻu ʻia ka lāʻau lapaʻau Metformin i ke ʻano o nā papa i loaʻa iā 500 mg o ka mea ikaika (metformin hydrochloride). Ma kahi o ia mea, aia ka hāmeʻa i nā mea liʻiliʻi e pono ai nā waihona: starch corn, crospovidone, povidone K90, magnesium stearate a talc. Hoʻokahi i hoʻokahi pahu me 3 mau palaka o nā papa he 10.
ʻO kahi wale nō i hele i ka loiloi e hōʻike pololei ana i ke olakino maʻi hiki ke kuhikuhi i ka hoʻohana ʻana i ka lāʻau Metformin. Ke lawe nei ka mea maʻi i nā pōpoki, pono pono ʻo ia i ka hahai ʻana i nā ʻōlelo a ke kauka a pau.
Kuhi ʻia kahi palapala ʻōlelo i loko o kēlā me kēia pūpū o ka lāʻau lapaʻau. Ma ia mea e hiki ai iā ʻoe ke loaʻa i kēia mau hōʻike maʻamau no ka hoʻohana ʻana:
- ʻO ka diabetes mellitus type 2, keu i nā poʻe momona keu ʻole i ka hopena ʻole i ka ketoacidosis (metabolism ka hopena o ka ʻai).
- I ka hui pū me ka maʻi insulin me ka pale ʻana i ka hormone, i kū i ke kekona.
Pono e hoʻolilo a hiki i kahi loea ke hiki ke helu i ka nui o ka maʻa, i hāʻawi ʻia i ka nui o ke kō i loko o ke koko o kahi maʻi maʻi. Hāʻawi nā ʻōlelo i nā ʻāpana ʻokoʻa i ka lāʻau lapaʻau, e koi pinepine ai i ka loiloi a me ke hoʻoponopono.
ʻO ka inikua mua o ka lāʻau lapaʻau he 1-2 papa (a hiki i ka 1000 mg i ka lā). Ma hope oʻelua pule, hiki i ka hoʻonuiʻana o ke ana o ka metformin ka mea.
ʻO nā papa mālama mālama o ka lāʻau lapaʻau he 3-4 papa (a hiki i 2000 mg i ka lā). ʻO ka papa helu kiʻekiʻe o kēlā me kēia lā he 6 mau papa (3000 mg). No nā mea elemakule (mai 60 mau makahiki), ua ʻōlelo ʻia e inu i ka metformin ʻaʻole iʻoi aʻe ma mua o 2 papa i kēlā me kēia lā.
Pehea e inu ai i nā paila? Ua hoʻopau ʻia lākou a pau, holoi ʻia me kahi ipu aniani o ka wai, i ka wā pāʻina a ma hope paha. No ka hōʻemi ʻana i ka manawa kūpono e pili ana i ka ʻōnaehana o ka digestive, pono e hoʻokaʻawale ʻia ka lāʻau lapaʻau i nā manawa he nui. Ke hele mai nei nā pilikia o ka metabola, e hoʻemi ʻia ka nui o ka lāʻau e pale i ka hoʻomohala ʻana i ka acidosis lactic (lactic coma).
Pono e mālama i ka Metformin ma kahi maloʻo a pouli hoʻi me ka loaʻa ʻole o nā keiki liʻiliʻi. Nā kikowaena o ka mālama ʻana mai ka +15 a +25 degere. ʻO 3 mau ka lōʻihi o ka lāʻau lapaʻau he 3 mau makahiki.
Nā hiʻohiʻona a me nā hopena maikaʻiʻole
E like me nā lāʻau olakino, hiki ke hoʻohana ʻia ka metformin i nā poʻe me kekahi mau palaka a i nā kumu ʻē aʻe.
E like me ka mea i ʻōlelo ʻia ma mua, no nā poʻe maʻi ʻoi aku ma mua o 60 mau makahiki, ka poʻe keu nui e hana nei i ka hana nui, ʻaʻole pono nā lāʻau e hoʻohana ʻia, no ka mea hiki ke alakaʻi i ka hoʻomōhola lactic acidosis.
ʻAʻole liʻiliʻi ka papa inoa o nā contraindications no kēia lāʻau lapaʻau. Hoʻohana ʻia ka hoʻohana ʻana o ka metformin i ka manawa:
- precoma a i ʻole coma, kahi hōʻike no ka ketoacidosis maʻi maʻi;
- ake ʻeleu a me nā ate;
- nā maʻi maʻi e hoʻopilikia ana i ka hana o nā ʻōpū (dehydration, hypoxia, nā maʻi like ʻole, ka maʻi ʻoe);
- makehewa me nā mea inu ʻakaʻaka a i ʻole ke kala ʻole;
- nā maʻi ākea a me nā pilikia paha e alakaʻi i ke kūkulu ʻana i ka infarction myocardial, ka hanu a me ka naʻau ʻole ʻole;
- lactic acid coma (ma ke ʻano ponoʻi);
- ke noho nei ma kahi o ʻelua mau lā ma mua a no nā lā ʻelua ma hope o nā x-ray a me nā radioisotope e hōʻike ai me ka hoʻonāukiuki ʻana o ka māhele like i ʻike ʻia iodine;
- nā meaʻai haʻahaʻa-haʻahaʻa (emi iho ma lalo o 1000 mau calorie i kēlā me kēia lā);
- lawe ana i kahi pēpē a me ka umauma;
- hoʻonui mahuahua i nā manaʻo o ka lāʻau.
Ke lawe ʻia nei ka mea maʻi i kahi lāʻau lapaʻau me ka ʻole e hoʻopili ai i nā ʻōlelo a ke kauka, hiki mai nā ʻano like ʻole. Ua pili pū lākou me ka hana ʻole ʻana:
- hoʻoili i ke aʻala (ka luaʻi, hoʻololi i ka ʻono, hoʻonui lemulence, ka nele o ka makemake, ʻeha a i ʻole ʻeha ʻeha);
- hematopoietic mau kino (ka hoʻomohala ʻana o ka anemia megaloblastic - ka hapa ʻole o ka waikawa folic a me ka momona B12 i ke kino);
- ka paepae (ka hoʻomohala ʻana o ka acidact lactic a me B12 hypovitaminosis e pili ana i ka malabsorption);
- pūnao endocrine (ka ulu ʻana o ka hypoglycemia, ka mea i hōʻike ʻia e ka nāhā, ka huhū, ka ʻeha a me ka dizz, ka nalowale o ka ʻike).
I kekahi manawa aia paha ka ʻōpala kino. ʻO nā hopena ʻino e pili ana i ka haki ʻana o ka hana kūwili e kū pinepine mau i nā hebedoma ʻelua pule. He ʻano maʻamau kēia o ke kino, ma hope o nā lā 14, ka hoʻohui ʻana i ka metformin e hele ana, a hala nā hōʻailona ma kā lākou.
Kākoʻo overdose
Ma kahi maʻi hilahila e lawe i ka lāʻau lapaʻau ma nā wahi kiʻekiʻe ma mua o ka mea i hōʻike ʻia i loko o ke kuhikuhi a kuhikuhi ʻia e ke kauka hele e hiki ke hōʻeha i kona kino, ʻaʻole ia e pili ana i ka make. Me kahi overdose, hiki ke hopena i ka hopena hopena - ka lactic acidosis ma ka maʻi diabetes. ʻO ke kumu ʻē aʻe no kona hoʻomohala ʻana, ʻo ka hoʻopili ʻana o ka lāʻau lapaʻau inā loaʻa kahi maʻi renal.
ʻO kahi hōʻailona o ka lactic acidosis ka indigestion, ʻeha o ka ʻōpū, hōʻemi o ke kino, ʻehaʻeha o ka naʻau, ke piʻi ʻana o ka ʻōpū, hōʻeha a me ka ʻeha i ke poʻo, nāwaliwali, a me ka piko.
Inā ʻike ka mea maʻi i ka liʻiliʻi o kekahi o nā mea i luna aʻe, pono ka hoʻopau ʻana i ka metformin. ʻO ka hana aʻe, pono koke ʻoe i ka hoʻokipa i ka mea maʻi no ka mālama olakino. Hoʻoholo ke kauka i ka ʻike lactate, ma ke kumuʻo ia, e hōʻoia ana a hōʻole paha i ka maʻi maʻi.
ʻO ke ala maikaʻi loa no ka wehe ʻana i ke kao nui loa o ka lactate me ka metformin ʻo ke kaʻina hana hemodialysis. E hoʻopau i nā hōʻailona i koe, hana ʻia ke ʻano hōʻailona.
Pono e hoʻomaopopo ʻia ka hoʻohana nui ʻana o ka metformin a me nā mea me nā molony sulfonylurea e hiki ai i ka wikiwiki o ka neʻe o ka kō.
Hoʻohui a me nā ʻano ʻē aʻe
I ka wā o ka hoʻohana ʻana i ka metformin i kahi paʻakikī me nā lāʻau'ē aʻe, e kū mai ana ka hopena kūlohelohe ma waena o nā mea o nā lāʻau lapaʻau, e hoʻomaikaʻi ana a hoʻoemi paha i ka hopena o ke kohi i ka metformin.
No laila, ʻo ka hoʻohana ʻana i ka metformin a me danazole i ka manawa like e alakaʻi i kahi hoʻonui wikiwiki i nā pae gula. Me ka mālama aka, pono ʻoe e hoʻohana i ka chlorpromazine, e hoʻoemi ana i ka hoʻokuʻu o ka insulin, a laila e hoʻonui ana i ka glycemia. I ka wā o ka maʻi me nā antipsychotics a ma hope o ka hōʻemi ʻana i ka lāʻau, pono ke hoʻoponopono ʻia ka nui o ka metformin.
ʻO ka ulu ʻana o ka hoʻonui i ka hopena e hoʻohiolo i ke kō i ka wā e pau ai:
- ʻO Glucocorticosteroids (GCS).
- ʻO nā Sympathomimetics.
- Nā ʻāpana ʻokoʻa no ka hoʻohana ʻana i loko.
- Epinofrina.
- ʻO ka hoʻomakaʻana o ka glucagon.
- Nā huahelu thyroid.
- ʻO nā hua o nā phenothiazone.
- ʻO nā diuretics a me nā thiazides.
- ʻO nā derivatives waikawa Nicotinic.
Ma muli o ka hopena me ka cimetidine e alakaʻi i ka hoʻomohala ʻana i ka waihā lactic acidosis. ʻO ka hoʻohana ʻana i ka metformin, ma ka hopena e hoʻonāukiuki i ka hopena o nā anticoagulants.
ʻO ka inu ʻawaʻawa e hoʻohālikelike ʻia i ka wā e hoʻohana ai i ka metformin. ʻO ka inu nui me ka hoʻohaʻahaʻa kalala a me ka paleʻole ʻole, ka pōloli a me ka hāʻule ʻole ʻana o ka ate e alakaʻi i ka hoʻokumu ʻana o ka acidosis lactic.
No laila, i ka wā o ka mea lapaʻau me ka metformin, pono nā poʻe maʻi e kiaʻi i ka hana o nā keiki. No ka hana i kēia, pono lākou ma ka liʻiliʻi o ʻelua mau manawa i ka makahiki e aʻo ai i ka ʻike o ka lactate i ka plasma. Pono hoʻi e lawe i kahi loiloi no ka ʻike o ka likinine ma ke koko. Inā hōʻike nā hopena i ʻoi aku ka nui o ka kukuna creatinine ma mua o 135 mmol / L (kāne) a me 110 mmol / L (wahine), pono loa ka hoʻopau ʻana i ka lāʻau.
Inā ʻike ʻia ka mea maʻi i kahi maʻi infectious bronchopulmonary a i ʻole he ʻano hopohopo o ka ʻōnaehana genitourinary, pono e kūkākūkā nui ʻia kekahi loea.
ʻO ka hui pūʻana o ka metformin me nā lāʻau e hoʻohiolo ana i ke kō, e like me nā inikini a me ka sulfonylureas, i kekahi manawa ke alakaʻi nei i ka kaohi o ke kō. Pono e noʻonoʻo ʻia kēia ʻano maʻi no nā poʻe maʻi e hoʻokele nei i nā kaʻa a i ʻole nā hana ʻano paʻakikī. Hiki iā ʻoe ke haʻalele i kēlā hana hōʻino i ka wā o ka mālama ʻana.
Ke hoʻohana nei i kekahi mau lāʻau lapaʻau ʻē aʻe, pono e ʻike ka mea maʻi i ke kauka e pili ana i kēia, ka mea e hoʻololi i ka hewa a me ka lōʻihi o ke ʻano o ka ʻoihana.
ʻO ke kumukūʻai, nā loiloi a me nā hoʻohālike
Kūpaʻa ke kumukūʻai o Metformin inā he mea lawe a kau ʻia a domestically paha.
ʻO ka mea paʻa o nā mea kanu loea he hypoglycemic waiwai i nā wahi like ʻole o ka honua, nui nā ʻāina e hana ana.
Oe ke kuai i ka lāʻau lapaʻau ma ka hōʻike ʻana i ka lāʻau lapaʻau ma ka lāʻau lapaʻau, aia kekahi ma ke ʻano e kauoha i ka lāʻau lapaʻau ma ka pūnaewele.
Pili ke kumukūʻai o ka lāʻau lapaʻau ma ka wahi o ka lāʻau lapaʻau ma ka teritori o ka Russian Federation a me ka mea hana
- Metformin (Lūkia) No. 60 - ʻo ka uku haʻahaʻa he 196 rubles, a ʻo ka nui ka 305 mau rubles.
- Metformin-Teva (Polīkiki) No. 60 - ke kumukūʻai liʻiliʻi he 247 rubles, a ʻo ka nui ka 324 mau rubles.
- Metformin Richter (Hanau) ʻAʻohe 60 - ʻo ka uku palena loa he 287 rubles, a ʻo 344 mau rubles ka lōʻihi.
- Metformin Zentiva (Slowakia) No. 30 - ke kumukūʻai haʻahaʻa he 87 mau rubles, a ʻo 20% ka lōʻihi.
- Metformin Canon (Lūkia) ʻAkake 60 - nā kumukūʻai liʻiliʻi he 230 rubles, a ʻo ka lōʻihi loa ka 278 rubles.
E like me kāu e ʻike ai, ua haʻahaʻa loa ke kumukūʻai o ka lāʻau Metformin, no laila hiki i nā mea āpau me nā mea kālā ʻē aʻe ke kūʻai aku. Eia kekahi, ʻoi aku ka ʻoi aku o ke kūʻai ʻana i ka lāʻau lapaʻau home, no ka mea he haʻahaʻa kona kumukūʻai, a ʻo ka hopena o ka lāʻau.
Hōʻike nā loiloi o nā maʻi āpau he Metformin kahi lāʻau hypoglycemic maikaʻi. ʻAno wikiwiki ka hoʻohaʻahaʻa ʻana i ke kao o ka glucose i ke koko a hoʻolōʻihi i ka hopena hypoglycemic me ka hoʻohana lōʻihi ʻana o ka lāʻau. Hoʻomaopopo ka hapa nui o nā mea maʻi i ka maʻalahi o ka hoʻohana ʻana i ka lāʻau lapaʻau a me kona uku haʻahaʻa, ʻo ia kahi mea hōʻoluʻolu nui. I ka manawa i nīnau ʻia ai he hiki ke inu i ka metformin e nalowale i ke kaumaha, pane maikaʻi nā poʻe.
Manaʻo ka nui o nā poʻe inā he hila hōʻemi ke kiʻi ma hope o ka lawe ʻana i ka metformin. ʻO ka haʻalele ʻana i ka lāʻau ka hopena ʻaʻole e hoʻonui i ka glucose i ke koko a me ka hoʻonui o ke kaumaha o ke kino.
I waena o nā hemahema, aia kahi hewaʻole o ka digestive hoʻopili e pili ana i ka hoʻohui ʻana o ke kino i ka hana o ka lāʻau lapaʻau. Ma hope o nā pule he ʻelua, ʻo ia mau ʻano leʻaleʻa e lele aku i kā lākou.
Ma muli o ka hana o ka lāʻau me ka metformin hāmeʻa ikaika ua hua ʻia i ka honua holoʻokoʻa, he nui nā inoa. ʻO ka ʻokoʻa wale nō ka mea i hoʻohana ʻia i nā mea hou aʻe. Nā inoa o ka lāʻau Metformin he Gliformin, Metfogamma, Bagomet, Siofor, Glyukofazh, Altar a me nā mea ʻē aʻe. ʻO ka lāʻau lapaʻau e hoʻohana pono ai e hoʻopilikia maikaʻi i ka kūlana o ke olakino, me ka ʻole o nā hopena maikaʻi ʻole.
ʻO ka like ʻole o ka lapaʻau ʻana me ka metformin e pili pū me ka hiki ʻole ke ukali i kekahi meaʻai kūikawā no ka maʻi maʻi, ka nohona maʻalahi, a me ka kaohi ʻole o ke kō. I ka ʻoiaʻiʻo, ʻo ka lawe ʻana i nā lāʻau lapaʻau ʻaʻole hiki ke hāʻawi piha i ka hopena hypoglycemic. Mālama wale nō i kahi ola olakino, ka lāʻau lapaʻau a me ka hahai ʻana i nā ʻōlelo a ke kauka a pau e hiki ke hoʻomaikaʻi i ke olakino a hoʻoneʻe i nā hōʻailona o ka maʻi maʻi. ʻO ke wikiō i kēia ʻatikala e hāʻawi pū i ka ʻikepili e pili ana i ka lāʻau lapaʻau.
