No ka hoʻopauʻana i ka lolo a me kāna mau hōʻailona, hoʻohana ʻia nā lāʻau lapaʻau kūikawā e kuhikuhi ana i ka hoʻohaʻahaʻa i ka pae o ke kō i loko o ke koko o kahi mea maʻi. Kēia mea āpau antidiabetic (hypoglycemic) hiki i nā makua makua, ʻoi pū ka waha.
ʻO nā maʻi lāʻau hypoglycemic oral hypoglycemic mahele like ʻole penei:
- olonylurea derivatives (kēia mau Glibenclamide, Glikvidon, Gliklazid, Glimepirid, Glipizid, Chlorpropamide);
- inhibitors alpha glucosidase ("Acarbose", "Miglitol");
- meglitinides ("Nateglinide", "Repaglinide");
- biguanides ("Metformin", "Buformin", "Fenformin");
- thiazolidinediones (Pioglitazone, Rosiglitazon, Tsiglitazon, Englitazon, Troglitazon);
- incretinomimetics.
ʻO nā waiwai a me nā hana o nā derivatives sulfonylurea
ʻIke ʻia nā kumulā o ka sulfonylureas me ka ulia i ka waenakonu o ke kenekulia hope. Ua hoʻokū ʻia ka hiki i nā pūhui like i ka manawa i kipa ʻia ai ua loaʻa nā mea maʻi i lawe i nā lāʻau sulfa e hoʻokaʻawale i nā maʻi maʻi i ka maʻi hōʻeha. No laila, ua loaʻa pū kēia mau mea a me ka hopena hypoglycemic ma nā maʻi.
No kēia kumu, hoʻomaka koke ka huli ʻana i nā derivatives o sulfonamides me ka hiki ke hoʻohaʻahaʻa i ka pae o ka glucose i ke kino. Ua kōkua kēia hana i ka hoʻopalike ʻana o ka derivatives sulfonylurea mua o ka honua, i hiki ke hoʻopau pono i nā pilikia pilikia o ka maʻi maʻi.
Hoʻohālikelike ʻia nā mea pili i nā derivatives sulfonylurea me ka hoʻihoʻi ʻana o nā pehu beta pancreatic kūikawā, ka mea i pili me ka hoʻoulu ʻana a hoʻonui i ka hana o ka insulin endogenous. ʻO kahi mea nui no ka hopena maikaʻi, ʻo ka hele ʻana i nā pancreas o nā ola a me nā hāmeʻa piha piha.
He mea nui ia me ka hoʻohana mau ʻana o ka derivatives sulfonylurea, ua pau loa ko lākou hopena maikaʻi mua. Hoʻomaʻa ʻia ka lāʻau lapaʻau e pili i ka mea huna o ka insulin. Manaʻo nā kānakaʻepekema kahi o kēia no ka emi o ka nui o nā mea i hōʻea i nā cell beta. Ua hōʻike ʻia nō hoʻi ma hope o ka hoʻomaha ʻana o ia ʻano hana, hiki ke hoʻihoʻi hou i ka hoʻopili ʻana o kēia mau sela.
Hiki paha i kekahi sulfonylureas ke hāʻawi i kahi hopena tambahan-pancreatic. ʻAʻole ʻike ʻia kahi hana koʻikoʻi i ka maʻi koʻikoʻi. Hoʻohui kekahi o nā hopena pancreatic:
- hoʻonui nui hiki i ka insulin-hilinaʻi i ka insulin i ka endogenous ʻano;
- hoʻololi i ka hana o ka glucose i loko o ka ate.
ʻO ka hana holoʻokoʻa o ka hoʻomohala ʻana o kēia mau hopena ma ke kino no ka mea ʻoi nā mea kanu ("Glimepiride" kūikawā):
- hoʻonui i ka nui o nā mea i hoʻokae i ka insulin i ka pūnaewele hoʻonā;
- hoʻomaikaʻi kūloko i ka hoʻohuihui insulin-receptor;
- hoʻohanohano i ka hoʻoili ʻana o ka hōʻailona postreceptor.
Eia kekahi, aia kahi hōʻike e hiki i nā derivatives sulfonylurea hiki ke lilo i mea hoʻomehana no ka hoʻokuʻu ʻia o somatostatin, i mea e hiki ai ke pale aku i ka pae ʻana o glucagon.
Sulfonylureas
Nui nā hanauna o kēia ʻano mea.
- ʻO ka hanauna mua: "Tolazamide", "Tolbutamide", "Carbutamide", "Acetohexamide", "Chlorpropamide";
- ʻO ka hanauna 2: Glibenclamide, Glikvidon, Glisoksid, Glibornuril, Gliklazid, Glipizid;
- ʻO ka hanauna 3: Glimepiride.
I kēia lā, ma ko mākou'āina, ua pau ʻole nā lāʻau lapaʻau o ka hanauna mua i ka hoʻomaʻamaʻa.
ʻO ka ʻokoʻa nui ma waena o nā lāʻau lapaʻau o ka hanauna mua a me ka 2 o nā ʻano like ʻole o kā lākou hana. Hiki ke hoʻohana 'ia nā' īlima'lima a me ka hiki ke ho'ēmi i nā hopena like ʻole.
E ʻōlelo ana i nā helu, he 50 a i ʻole 100 mau manawa ko lākou hana. No laila, inā ʻo ka awelika e koi pono i kēlā me kēia lā o nā lā mua o ka laʻa o ka makahiki mua mai 0.75 i 2 g, a laila ua hāʻawi aku ka lāʻau laʻi no ka huaʻōlelo o ka lā 2 mau.
ʻO kekahi mau mea derogative hypoglycemic ʻokoʻa i ka hoʻomanawanui.
ʻO nā lāʻau lapaʻau kaulana loa
Gliclazide - Eia kekahi o kēlā mau lāʻau i kuhikuhi pinepine i nā manawa. ʻAʻole wale ka hopena o ka lāʻau lapaʻau e pili ana i ka hopena hypoglycemic qualitative, akā ua hāʻawi pū kekahi i ka holomua:
- nā hōʻailona hematological;
- rheological waiwai o ke koko;
- nā ʻōnaehana kiʻekiʻe, microcirculation o ke koko;
- heparin a me nā hana fibrinolytic;
- heparin tolerance
Eia kekahi, hiki iā Glyclazide ke pale i ka hoʻomohala ʻana o ka microvasculitis (hōʻino i ka make retina), e kāohi i kekahi ʻano hōʻike hoʻonā o nā platelets, hoʻonui nui i ka ʻikekahi kūwaho a hōʻike i nā waiwai o kahi antioxidant maikaʻi loa.
ʻO Glycvidon - he lāʻau lapaʻau i hiki ke kuhikuhi ʻia i kēlā mau hui o nā maʻi i loaʻa i kahi hana nona ka maʻi. I nā huaʻōlelo'ē aʻe, hoʻolako ʻia e kaʻili e nā puʻupuʻu 5 i ka pakeneka o nā hana o ka metabolites, a ʻo ke koena 95 - nā mea kani
Hoʻolālā Loaʻa ia i ka hopena a hiki ke hōʻike i kahi palena liʻiliʻi o ka pilikia i nā hopena hypoglycemic. Mālie kēia i nā mea hiki ʻole ke kāohi a ʻaʻole i ka metabolites ikaika.
Nā hiʻohiʻona o ka hoʻohana ʻana i nā hana waha
Hiki i nā lāʻau antidiabetic ke ʻano nui no ka maʻi maʻamau ʻo ka maʻi 2, kahi kū hoʻokahi i ka intake o ka insulin. ʻAno ʻia nā mea maʻi no nā mea maʻi ma luna o 35 mau makahiki a ʻaʻole hoʻi e loaʻa nā ʻōiwi like o kāna papa:
- ketoacidosis;
- nā hemahema kai;
- nā maʻi e koi pono ai i ka inika insulin therapy.
ʻAʻole hōʻike ʻia ka hoʻomākaukau ʻana o Sulfonylurea no kēlā mau mea maʻi, ʻoiai me ka mea e lawa ai ke koina, ʻo ka pono o kēlā me kēia lā no ka insulin hormone ma mua o ka māka o nā papa āpau o 40 (UNITS). Eia kekahi, ʻaʻole ke kauka ke kauka iā lākou inā inā loaʻa kahi ʻano maʻi mellitus o ka maʻi mellitus, he mōʻaukala o ka coma maʻi a me ka glucosuria kiʻekiʻe e kū nei i ke kumu o ka pono ʻana o ka lāʻau kūpono.
Hiki i ke hoʻololi ʻia me ka lapaʻau me ka sulfonylurea ma lalo o ke ʻano o ka hoʻonaninohi a me ka momona o ka lolo, ke hoʻopaʻi ʻia e ka nui o nā inikini o ka insulin i nā make ʻana o ka liʻiliʻi o 40 mau ʻāpana. Inā kūpono, a hiki i 10 PIECES, e hoʻolilo ʻia ka hoʻololi i nā derivatives o kēia lāʻau lapaʻau.
ʻO ka hoʻohana lōʻihiʻana i nā derivatives o ka sulfonylurea hiki ke hoʻoulu i ka hoʻomohala ʻana, e hiki ke nalo wale aku i ka hui pū ʻana me ka hoʻomākaukau o ka insulin. I ke ʻano kīpona 1, e hāʻawi i kēlā ʻano kaila i ka hopena maikaʻi a kōkua iā ia e hōʻemi i ka koi ʻana o kēlā me kēia lā i ka insulin, me ka hoʻomaikaʻi ʻana i ka papa o ka maʻi.
ʻO ka lohi ʻana o ka holomua o ka retinopathy ma muli o ka sulfonylurea i hoʻomaopopo ʻia, a me ka maʻi retinopathy maʻi maʻi. ʻO kēia paha ma muli o ka hana angioprotective o kāna mau mea waiwai, ʻo ia hoʻi ka poʻe o ka hanauna 2. Eia naʻe, aia kekahi hopena o kā lākou hopena atherogenic.
Pono e hoʻomaopopo ʻia he hiki i nā hua o kēia lāʻau ke hoʻohui pū me ka insulin, a me Biguanides a me "Acarbose" hoʻi. Hiki paha i kēia i nā hihia kahi e holomua ai ka olakino o ka mea maʻi me nā ʻōnaehana o ka insulin i kuhikuhi ʻia i kēlā me kēia lā.
Ke hoʻohana nei i ka lawena hoʻohuihui sulfonamide, pono e hoʻomanaʻo ʻia e hiki ke hoʻolōʻihi ʻia kā lākou hana.
- kūlohelohe anticoagulants;
- salicylates;
- "Butadion";
- Ethionamide;
- Cyclophosphamide;
- pilikipuna;
- Chloramphenicol.
Ke hoʻohana nei i kēia mau kālā me ka hoʻohui i nā lāʻau sulfa, hiki ke hoʻōla i ka metabolism, kahi e hiki ai i ka hoʻomohalaʻana o ka hyperglycemia.
Inā ʻoe e hoʻohui i nā derivatives sulfonylurea me ka diuretio thiazide (no ka laʻana, "Hydrochlorothiazod") a me BKK ("Nifedipine", "Diltiazem") i nā dosis nui, a laila hiki ke hoʻomaka ka antagonism e hoʻomohala. Hoʻopili ke Thiazides i ka hopena o nā derivatives o ka sulfonylurea ma ka weheʻana i nā kahe pāhana. Hiki i nā LBC ke hoʻonāukiuki i ka hāʻawiʻana i nā mea calcium i nā cell beta o ka pancreas.
Hoʻonui nui ka mea hoʻohua mai ka sulfonylureas i ka hopena a me ka hoʻomanawanui i ka inu ʻaka. ʻO kēia ma muli o ke lohi i ka kaʻina hoʻomehana o ka acetaldehyde. ʻO ka hōʻike ʻana o nā ʻano hana antabuse-like pū kekahi.
Hoʻohui i ka hypoglycemia, hiki i nā hopena hiki ke loaʻa.
- ʻeha nā huapuni;
- jaundice kikestice;
- ʻo ka waiwai kaumaha;
- aplastic a hemolytic anemia;
- ka hoʻomohala ʻana o nā maʻi kūlohelohe;
- leukopenia hōʻano hou;
- thrombocytopenia;
- agranulocytosis.
Meglitinides
Ma lalo o ka meglitinides e pono e hoʻomaopopo i ka hoʻoponopono prandial regulators.
"ʻO Repaglinide" kahi huaʻai o ka benzoic acid. Heʻokoʻa ka lāʻau i ka hoʻolālā kemika mai nā derebatives sulfonylurea, akā he like ka like me ka kino. Hoʻopili ke Repaglinide i nā pāheʻe potassium i nā ATP i nā kikowaena beta ikaika a hoʻolaha i ka hana o insulin.
Hōʻike ka pane o ke kino i ka hapalua hola ma hope o ka ʻaina a hōʻike ʻia e ke kahe ʻana o ke kōʻai koko. Ma waena o nā mea ʻai, ʻaʻole i loli ka lohi o ka insulin.
E like me nā lāʻau e pili ana i nā derivatives sulfonylurea, ʻo ka hopena nui ka hopena he hypoglycemia. ʻOi pono loa, hiki ke mālama ʻia ka lāʻau lapaʻau no kēlā mau maʻi i loaʻa i ka renal a i ʻole hemahema ke ʻano.
ʻO Nateglinide kahi mea iʻike o D-phenylalanine. Kūlike ka lāʻau lapaʻau mai nā mea like ʻole ma ka ʻoi aku ka wikiwiki, akā ʻoi aku ka paʻa. Pono e hoʻohana pono i ka lāʻau lapaʻau no ka type 2 diabetes mellitus i qualitatively e hōʻemi i ka hyperglycemia postprandial.
Ua ʻike ʻia ʻo Biguanides mai nā makahiki 70 o ke kenekulia i hala a ua kuhikuhi ʻia no ka huna ʻana o ka insulin e nā beta beta o ka pancreas. Ua hoʻoholo ko lākou mana i ka pale o ka gluconeogenesis i loko o ka pēpē a me ka hoʻonui o ka hiki ke excrete glucose. Eia kekahi, hiki i ka hāmeʻa ke hoʻolōʻihi i ka hana ʻole o ka insulin a hoʻonui i kona hāmeʻa ʻana i nā ʻāpana insulin. Ma kēia kaʻina hana, hoʻonui ka metabolism a me ka haʻalulu o ka glucose.
ʻAʻole nā Biguanides i hoʻohaʻahaʻa i ka pae koko koko o kahi kanaka olakino a me nā mea e loaʻa ka maʻi i ka diabetes mellitus type 2 (hāʻawi ʻia ka ʻaina pō.
Hiki ke hoʻohana ʻia nā biguanides Hypoglycemic i ka hoʻomohala ʻana o ka maʻi diabetes type 2. Ma kahi o ka hoʻemi ʻana i ke kō, ʻo kēia māhele o nā lāʻau lapaʻau me ka hoʻohana lōʻihi e kōkua i ka momona metabolism.
Ma muli o ke hoʻohana o nā lāʻau lapaʻau o kēia hui.
- hoʻāla ʻia ka lipolysis (ʻo ke kaʻina o nā manamana wāwā).
- ua hōʻemi i ka momona;
- hoʻi maoli ke kaumaha i ka maʻamau.
I kekahi mau hihia, ua hoʻohana ʻia ko lākou hoʻohana me ka hoʻohaʻahaʻa ʻana i ka ʻike o ka triglycerides a me ka kolamu ma ke koko, hiki ke ʻōlelo ʻia he mau papa momona ʻo ka beuanides no ka hoʻohaʻahaʻa i ke kō koko.
Ma ke ʻano 2 diabetes mellitus, hoʻonaninani ka huina o ka pale a me ka hoʻoliʻi kino i ka metabolism momona. Ma kahi o 90 pakeneka o nā hihia, ʻoi aku ka nui o nā maʻi. No kēia kumu, me ka hoʻomohala ʻana i ka maʻi diabetes, me ka huakaʻi o ka maʻi nui, pono ia e hoʻohana i nā lāʻau e hoʻomaʻamaʻa i ka lipid metabolism.
ʻO ka hōʻike nui no ka hoʻohana ʻana i biguanides ko ka maʻi diabetes type 2. Pono pono ka lāʻau i ke kūpaʻa o ka nui o ke kaupaona ʻana a me ka hoʻohana ʻole ʻana i ka hoʻoponopono ʻana i ka meaʻai a ʻaʻole lawa ka maikaʻi o ka hoʻomākaukau ʻana o ka sulfonylure. ʻAʻole hōʻike ʻia ka hana o ka biguanides i ka ʻike ʻole ʻana o ka insulin i ke koko.
ʻO nā mea mālama i ka glucose glucose e pale ai i ka wāwahi i ka polysaccharides a me oligosaccharides. ʻO ka hoʻemi ʻana a me ka hoʻoneʻe o ka glucose e hoʻemi ʻia a no laila aia kahi wānana e pili ana i ka hoʻomohala ʻana i ka hyperglycemia postprandial. ʻO nā koho āpau i lawe ʻia me ka meaʻai, i kā lākou loli ʻole, e komo i nā mahele haʻahaʻa o ka ʻōpū a me ka nunui. ʻO ka hoʻokomo ʻana o nā monosaccharides e lōʻihi i ka hola 4.
ʻAʻole e like me nā lāka sulfa, nā alpha inhibitors ke hoʻonui i ka hoʻokuʻu ʻana i ka insulin a ʻaʻole hiki ke kumu hypoglycemia.
I loko o nā hopena o nā haʻawina, ua hōʻoia ʻia ka terapi me ke kōkua o "Acarbose" i hoʻohui ʻia me ka hoʻohaʻahaʻa ʻana i ka hiki i ka hoʻomohala ʻana i nā kaumaha nui o ka atherosclerosis.
Hiki i ke hoʻohana ʻana i ia mau mea ke hoʻohālikelike i ka monotherapy, a hoʻohui pū iā lākou me nā lāʻau lapaʻau ʻē aʻe e hōʻemi i ke kō koko. ʻO ka papa hana mua ma mua o 25 a 50 mg mau koke ma mua a i ka manawa o ka papaʻaina. Me ka hoʻolālā hou aʻe, hiki ke hoʻonui ʻia ka nui o ka nui (akā ʻaʻole iʻoi aʻe ma mua o 600 mg).
ʻO nā hōʻailona nui no ka koho ʻana o nā inhibitors o alpha-glucosidase ka: type 2 diabetes mellitus me ka maikaʻiʻole o ka mālama ʻana i ka meaʻai, ka ʻano type o ka maʻi mellitus type 1, akā pili ʻia ka therapy hoʻohui.
