He aha nā biguanides: ka hopena o kahi hui o nā lāʻau lapaʻau no ka maʻi maʻi

ʻO Biguanides nā lāʻau i hoʻokumu ʻia e hoʻohaʻahaʻa i ka glucose koko. Loaʻa ka papahana i ke ʻano o nā papa.

Hoʻohana ʻia ka manawa maʻamau ka manawa maʻamau me ka maʻi mellitus type 2, e like me kahi ʻano.

Ma keʻano he monotherapy, hypoglycemic drug i hoʻohālikelike pinepine ʻia. Hoʻohā pinepine kēia e hana i 5-10% o nā hihia.

Aia hoʻi ʻo Biguanides i kēia mau lāʻau lapaʻau:

• Bagometua,
• Avandamet
• Metfogamma,
• Hopu,
• ʻO ka Metformin Acre
• Siofor 500.

I kēia manawa, ma Rūsia, a me ka honua a puni, ʻo ka biguanides e hoʻohana ʻia, no ka hapa nui, nā derivatives methylbiguanide, ʻo ia hoʻi, he metformin:

1. hoʻokaʻinaʻa
2. Siofor
3. metpho-gamma,
4. dianormet
5. glyformin a me nā mea ʻē aʻe.

Hoʻokiʻi ʻo Metformin mai hoʻokahi a me ka hapa a ʻekolu mau hola. Hoʻonui ʻia ka lāʻau lapaʻau i nā papa o 850 a me 500 mg.

ʻO nā dosage therapeutic he 1-2 g i kēlā me kēia lā.

Hiki iā ʻoe ke hoʻopau i ka 3 g i kēlā me kēia lā no ka maʻi maʻi.

Butylbiguanide derivatives:

• silubin
• buformin
• Adebite.

E hoʻomaopopo ka hoʻohana liʻiliʻi ʻia nā biguanides, ma muli o nā hopena hōʻeha, ʻo ia ka dyspepsia gastric.

ʻAʻole manaʻo nā kauka i ka hoʻohana ʻana i nā derivatives phenylbiguanide, no ka mea ua hōʻike ʻia ua alakaʻi lākou i ka hōʻemi ʻana i ke koko o kekahi kanaka:

• Pyruvate
• lactate

Nā hana lāʻau

Ua hōʻoia nā ʻepekema ʻepekema ʻo ka hopena o ke kōkōloko o ka metformin i ka maʻi diabetes ua pili i ka hopena kūikawā o ka lāʻau i ka wai a me ka synthesis. ʻO ka hopena o ke kōkō hilahila o ka metformin e hoʻopili ʻia me nā mea lawe huki i loko o ka pūpū.

Ke hoʻonui ʻia nei ka nui o nā mea halihali glucose no ka hōʻike ʻana i nā biguanides. Hōʻike ʻia kēia i ka neʻe ʻana o ka holomua glucose i waena o nā membrane kelepona.

E wehewehe kēia hopena i ka hopena ma nā hana a ke kino o ke kino a me ka insulin e puka ana mai waho. Ke hana nei nā lāʻau lapaʻau i ka membrane mitochondrial.

Mālama ʻo Biguanides i ka gluconeogenesis, a laila kōkua lākou i ka hoʻonui ʻana i nā ʻike o:

1. lactate
2. piula,
3. Alanine

ʻO kēia mau mea he precursor glucose ma ka hoʻopili o ka gluconeogenesis.

Ke piʻi aʻe nei ka nui o nā mea lawe i ka glucose i lalo o ka hana o ka metformin i ka membrane plasma. E pili ana ia:

• GLUT-4,
• HUA-2
• HUA-1.

Hoʻopuka ka halihali o ka hoʻonā:

1. ma ka ʻiʻo pīhoihoi paipai
2. hoʻōliulium
3. hoolana o ka naau.

Hōʻike kēia i ka emi ʻana o ka pale o ka insulin i ka poʻe me ka diabetes mellitus type 2 ma lalo o ka mana o ka metformin. Hoʻonui ʻia ka naʻau i ka insulin i ka piʻi ʻole ʻana o ka mea huna i ka neʻe ʻana e ka pancreas.

E kū'ē i ke kua o ka emi ʻana o ke kū i ka insulin, ke kū ka pae kumu e hōʻike ana i ka insulin i loko o ke koko. Hoʻonui ʻia ka naʻau i ka insulin i ka piʻi ʻole ʻana o ka mea huna i ka neʻe ʻana e ka pancreas, e like me ka hoʻohana ʻana o ka sulfonylureas.

Ke mālama nei me ka metformin i ka poʻe, ʻike ʻia ka pohō kaumaha, akā inā ke mālama nei me nā mālamalama sulfonylurea a me ka insulin, hiki i ka hopena kū'ē. Eia kekahi, kōkua nā metformin e hoʻohaʻahaʻa i nā lipum serum.

Nā hopena hopena

Pono e hōʻike ʻia nā hopena koʻikoʻi mai ka hoʻohana ʻana i ka metformin, penei:

• huehue, huehue, maeela;
• kaila metallic i loko o ka waha;
• ʻeha ʻole ma ka ʻōpū;
• ka ʻemi a me ka nalo ʻana o ka momona, a hiki i kahi ka mea e ʻai;
• lactic acidosis.

ʻO nā hopena a me nā hana i hōʻike ʻia, e like me ke kānāwai, e hele koke me ka hoʻohaʻahaʻa ʻana i ka nui. ʻO kahi hoʻouka o ka hopena pākuhi he hōʻailona ia e hoʻopau ai i ka metformin.

Inā ʻoe e lawe Metformin 200-3000 mg i kēlā me kēia lā no ka manawa lōʻihi, a laila pono ʻoe e hoʻomanaʻo e hoʻoneʻe ke komo ʻana o ka pēpē gastrointestinal:

1. Nā huaora B,
2. folic acid.

Pono e hoʻoponopono i kēlā me kēia hihia i ka pilikia o ka koho hou ʻana o nā huaora.

He mea pono e mālama i ka lactate o ke koko ma lalo o ke kaohi, a nānā i kēia ma kahi o ka liʻiliʻi he ʻelua i ka makahiki. Hāʻawi ʻia kēia mea nui i hiki i ka metformin e hoʻomaikaʻi ai i ka glycolysis anaerobic i loko o ka pākī liʻiliʻi a hoʻopaʻa i ka glycogenolysis i loko o ka ate.

Inā loaʻa i kahi kanaka ka hoʻopiʻi o ka hōʻeha o ka naʻau a me ka ʻaha metallic i loko o ka waha, pono ia e hoʻomaʻamaʻa i ka pae o lactate. Inā hoʻonui ʻia kona pili koko, a laila pono e hoʻōki nā hana no ka mālama ʻana me ka metformin.

Inā hiki ʻole e aʻo i ke kiʻekiʻe o ka lactate i loko o ke koko, a laila hoʻopau ʻia ka metformin a hiki i ke ʻano ʻana o ke ʻano, a laila ua loiloi ʻia nā mea kūpono a pau o kāna ʻoihana.

ʻO nā maʻi nui

Aia kekahi mau contraindications i ka hoʻohana ʻana o ka metformin:

1. ketoacidosis maʻi maʻi, a me ka coma a me nā kūlana ʻē aʻe o ka maʻi maʻi maʻi;
2. hana renal maʻi ʻole, hoʻonui i hana i loko o ke koko ma luna o 1.5 mmol / l;
3. nā kūlana hypoxic o kekahi genesis (angina pectoris, pila i pio ʻole, 4 FC, angina pectoris, myocardial infarction);
4. ke aho hanu;
5. encephalopathy wāwā,
6. pohō
7. anemia
8. maʻi maʻi pāpaʻi, nā maʻi ʻoihana;
9. waiʻona
10. pūpū hema;
11. hapai
12. nā hōʻailona o ka mōʻaukala lactic acidosis.

Ma ke kaʻina o ka hoʻonui ʻana i ka ate, ua kuhikuhi ʻia nā biguanides i ka wā e ʻike ʻia ka hepatomegaly ma kahi o ka maʻi maʻi hepatostatosis.

Me nā pilikia o ka infectious-allergic a me dystrophic o ka pāpaʻi, hiki ke hoʻopaʻa ʻia ka hopena o ka biguanides ma ka parenchyma hepatic.

• ke ʻano o ka cholestasis, i kekahi manawa i ʻike ʻia ka jaundice,
• nā hoʻololi i nā hoʻokolilo hoʻomaʻamaʻa hana.

I ka hepatitis hoʻomau mau ʻana, pono nā lāʻau o nā lāʻau e mālama me ka mālama.

ʻAʻole e like me derivatives sulfonylurea, ʻaʻole i ka hopena o ka toxuanides ka hopena hematopoietic o ka hana pumehana o ka iwi a me ka pōpilikia. Eia naʻe, ua contraindicated ma:

• Nā maʻi lohi e hoʻoulu ai i ka emi ʻana o ka kānana glomerular
• ka hoʻokō ʻana i ka molekōlū
• anemia koʻikoʻi, ma muli o ka pilikia o ka lactacidemia.

Pono nā kānaka kahiko e kahakaha pono i nā lāʻau lapaʻau, ʻoiai ua pili kēia me ka hoʻoweliweli o ka maʻi lactic acidosis. Hoʻopau kēia i nā mea maʻi e hana i ka hana kino kino.

Aia he mau lāʻau lapaʻau, ka hoʻohana ʻana o ia ma ka mālama ʻana i biguanides e hoʻomāhuahua i ka ʻoihana o ka acidosis lactic, eia kēia:

• friposa
• teturam
• antihistamines
• liuliu
• pani ʻia.