Me ka loaʻa ʻole o ka insulin, ua ulu lākou i ka hoʻonui ʻana i loko. Aia nā huaʻala o ka sulfonylureas no nā lāʻau lapaʻau e hoʻonui ai i ka mea huna o ka hormone a komo i nā lāʻau lapaʻau hypoglycemic synthetic.
Hoʻohui ʻia lākou e kahi hopena i hoʻohālikelike ʻia ʻē aʻe i nā ʻaina papa tablet me kahi hopena like.
E pōkole i nā lāʻau lapaʻau o ka hui
ʻO nā derivatives o Sulfonylurea (PSM) kahi hui o nā lāʻau lapaʻau i hoʻolālā ʻia e mālama i ka maʻi maʻi. Hoʻopili i nā hypoglycemic, loaʻa lākou i ka hopena hypocholesterolemic.
Ka helu ʻana i nā lāʻau lapaʻau mai ka hoʻomaka ʻana:
- ʻĀpana mua
i hōʻike ʻia e chlorpropamide, Tolbutamide. ʻAʻole hoʻohana lākou i kēia lā. Hoʻohālikelike lākou e kekahi hana ʻoi aku ka lōʻihi, e hoʻokō i ka hopena i kuhikuhi ʻia ai lākou ma kahi ka nui. - ʻO ka hanauna ʻelua he Glibenclamide, Glipizide, Gliclazide, Glimepiride. He liʻiliʻi lākou i ka hōʻike o nā hopena ʻokoʻa, i kuhikuhi ʻia i kahi liʻiliʻi liʻiliʻi.
i hōʻike ʻia e chlorpropamide, Tolbutamide. ʻAʻole hoʻohana lākou i kēia lā. Hoʻohālikelike lākou e kekahi hana ʻoi aku ka lōʻihi, e hoʻokō i ka hopena i kuhikuhi ʻia ai lākou ma kahi ka nui.Me ke kōkua o kahi pūʻulu o nā lāʻau lapaʻau, hiki ke loaʻa kahi uku kūpono no ka maʻi diabetes. ʻAe kēia iā ʻoe e pale a lohi i ka hoʻomohala ʻana o nā hoʻopiʻi.
Hāʻawi ʻo PSM i nā:
- hōʻemi i ka hana glucose glucose;
- Hoʻomaka pancreatic stim-cell e hoʻomaikaʻi i ka hoʻoliʻi glucose;
- hoʻonui hoʻonui maʻi i ka hormone;
- kaohi ʻana i ka hiʻi ʻana o somatostatin, ka mea e pale ai i ka insulin.
ʻO ka papa inoa o nā mākaukau PSM: Glibamide, Maninil, Glibenclamide, Teva, Amaril, Glisitol, Glemaz, Glisitol, Tolinase, Glibetik, Gliclada, Meglimid, Glidiab, Diabeton, Diazid, Reklid, Oziklid. Glibenez, Minidab, Movogleck.
Nā hana hana i ka hana
Hoʻokomo ka māhele koʻikoʻi i nā ʻāpana ʻokoʻa kikoʻī a paʻa iā lākou. Aia kahi depolarization o nā membran β-cells, a me ke kumu, ka wehe ʻana o nā kano kalala. Ma hope o kēia, hoʻokomo nā kelepona i nā pū beta.
ʻO ka hopena, ʻo ia ka hoʻokuʻu ʻana i ka hormone mai ka granule intracellular a me kona hoʻokuʻu i ke koko. He kūʻokoʻa ka hopena o PSM i ka neʻe ʻana o ka glucose. No kēia kumu, hele pinepine kahi kūlana hypoglycemic.
Hoʻomoʻa ʻia nā lāʻau lapaʻau i ka hana kūwili ʻana, ʻo ko lākou hopena e hoʻomaka i 2 mau hola ma hope o ka hoʻokele ʻana. Hoʻopili i ka puʻuwai, excreted, koe wale no Glycvidon, ma o nā keiki.
ʻOkoʻa ka hapalua ola a me ka lōʻihi o ka hana a kēlā me kēia lāʻau lāʻau i ka hui. Hoʻohālikelike i nā protein protein - mai 94 a 99%. ʻO ke ala kāpae, e pili ana i ka lāʻau, renal, renal-hepatic, a me ka hepatic. Hoʻopau i ka hoʻopauʻana o nā mea hana ikaika me kahi hui pūʻai.
Nā hōʻailona no ka koho
Hoʻomaopopo ʻia nā honu o nā sulfonylureas no nā maʻi maʻi type 2 i kēlā mau kūlana:
- me ka ʻike ʻole i ka insulin;
- me ka hoʻohaʻahaʻa ʻana i ka ʻike o ke kō o nā ʻiʻo;
- me ka hikiʻole o ka hoʻomaʻamaʻa o kaʻai.
Nā hiʻohiʻona a me nā hopena ʻaoʻao
ʻO nā ʻōnaʻi ʻolima sulfonylurea:
- ʻAno maʻi type 1;
- molepole hana;
- hapai
- liilii;
- hana lima kino;
- ketoacidosis;
- hoʻoweliweli kaʻaila;
- hypersensitivity o sulfonamides a me nā mea kōkua;
- ka antole i PSM;
- anemia
- kaʻeha hoʻonā kino hana;
- makahiki i 18 makahiki.
ʻAʻole kuhikuhi ʻia nā lāʻau lapaʻau no ka nui o ka hoʻokeo koko kiʻekiʻe ma mua o 14 mmol / L. Eia nō naʻe, mai noi no nā koi insulin i kēlā me kēia lā e ʻoi aku ma mua o 40 mau pūʻulu. ʻAʻole ia i hōʻike ʻia no nā maʻi me ka maʻi maʻi maʻa 2 i mua o ka maʻi o β-cell.
Hoʻololi ʻo Biguanide
Hiki ke kuhikuhi ʻia ʻo Glycvidone i nā poʻe me ka hoʻohaʻahaʻa o ka hana o ka pēpē. Hoʻokuʻu ʻia kona hoʻoneʻe ʻia (ma kahi o 95%) ma o nā ʻōpū. Hiki i ke hoʻohana o PSM ke hana i ka pale ʻana. No ka hōʻemi i kēlā mau hanana, hiki ke hoʻohui iā lākou me ka insulin a me biguanides.
Hoʻololi maikaʻi ʻia kahi pūʻulu o nā lāʻau lapaʻau. Ma waena o nā hopena maikaʻi ʻole, hele pinepine ka hypoglycemia, hypoglycemia koʻikoʻi, ʻike wale ʻia ma 5% o nā hihia. Eia kekahi, i ka wā o ke aʻo, ua mālama ʻia ke kaupaona ʻana. ʻO kēia ke kumu o ka huni ʻana o ka insulin endogenous.
ʻO nā hopena ʻokoʻa hope loa he mea maʻamau.
- ʻeha nā huapuni;
- kaila metallic i loko o ka waha;
- hyponatremia;
- hemolytic anemia;
- hana ʻole;
- kūlohelohe;
- kuʻe o ka pāpaho;
- leukopenia a me thrombocytopenia;
- jaundice cholestatic.
ʻLoe a me ke kākele
Hoʻolaha ʻia nā kauka PSM e ke kauka. Hoʻoholo ʻia ia e lawe i ka nānā ʻana i ka hoʻokele o ka mokuahi o ka hana a ka hopena.
Hoʻomaopopo ʻia e hoʻomaka i ka maʻi maʻi me PSM me nā mea nāwaliwali, a me ka pau ʻana o ka hopena, hoʻohuli i nā lāʻau ikaika ikaika. ʻO Glibenclamide kahi hopena i hoʻoili ʻia ka nui o ke kōpō ma mua o nā mea hana waha e hoʻohālikelike i ka waha.
ʻO ka lawe ʻana i ka lāʻau lapaʻau i ʻōlelo ʻia mai kēia pūʻulu me ka liʻiliʻi liʻiliʻi. I hoʻokahi mau pule, ua hoʻonui pinepine ʻia. Hiki ke kuhikuhi ʻia ka PSM me ka insulin a me nā mea āpau tableted hypoglycemic tablet.
Hoʻemi ʻia ka dosle i ia mau hihia, ʻoi aku ke koho pono ʻia. Ke hoʻokō ʻia ka uku hoʻomau, ʻike ka hana i ka regimen mālama maʻamau. Inā emi mai ka pono o ka insulin i nā ʻāpana o 10 mau lā / lā, e hoʻololi ke kauka i ka mea maʻi i ka lālani sulfonylurea.
ʻAno maʻi type 2
Hōʻike ʻia ka hopena o kahi lāʻau lapaʻau kūikawā i nā ʻōlelo kuhikuhi no ka hoʻohana. Hoʻohana ʻia ka hanauna a me nā hiʻohiʻona o ka lāʻau lapaʻau iho (ka waiwai ikaika). ʻO ka lākau o kēlā me kēia lā no ka chlorpropamide (hanauna 1) - 0.75 g, Tolbutamide - 2 g (2 mau hanauna), Glycvidona (2 mau hanauna) - a hiki i ka 0.12 g, Glibenclamide (mau makahiki 2) - 0,02 g. hoʻemi ʻia ka hana ma mua.
Lawe ʻia nā kālā a pau o ka hui PSM i ka hapalua hola a i ʻole hola ma mua o ka ʻaina. Hāʻawi kēia i kahi o ka hōʻoluʻolu o nā lāʻau lapaʻau a, ma muli o kēia, he hōʻemi i ka glycemia postprandial. Inā he mau pilikia dyspeptic maopopo, lawe ʻia ka PSM ma hope o ka ʻai.
ʻO nā mea mālama palekana
I nā poʻe kahiko, ʻoi aku ka kiʻekiʻe o ka uluʻana o ka hypoglycemia. No kēia māhele o nā mea maʻi, nā lāʻau lapaʻau me ka wā pōkole loa i kuhikuhi ʻia e pale ai i nā hopena maikaʻi ʻole.
Manaʻo ʻia e haʻalele i nā lāʻau lapaʻau lōʻihi (Glibenclamide) a hoʻololi i nā hana pōkole (Glycvidone, Glyclazide).
ʻO ka lawe ʻana i nā derivatives sulfonylurea e hōʻeha i ka hopena o ka hypoglycemia. I ka wā mālama, pono ia e nānā i nā pae o ke kō. Kauku ʻia ʻia e hahai ʻoe i ka hoʻolālā lapaʻau i hoʻokumu ʻia e kāu kauka.
Me nā hana hoʻowalewale, hiki i ka nui o nā glucose ka mea e loli. I nā hihia o ka hoʻomohala ʻana o nā maʻi ʻē aʻe i ka wā ʻo PSM, pono e hōʻike i ke kauka.
Ma ke ʻano o ka mālama ʻana, e nānā ʻia nā mea ʻike i lalo:
- pae miki;
- hemoglobin glycosylated;
- kōpili koko
- lipid pae;
- hōʻike ʻaihue.
ʻAʻole ia e kuhikuhi i ka hoʻololi i ka dosage, huli i kekahi lāʻau lapaʻau hou, kāpae i ka mālama ʻana me ke ʻole kūkākūkā. He mea nui e hoʻohana i nā lāʻau lapaʻau i ka manawa i ʻōlelo ʻia.
ʻO ka hoʻonāukiuki ʻana i ka maʻa i ʻōlelo ʻia e hiki ke alakaʻi i ka hypoglycemia. E hoʻopau iā ia, e lawe ka mea maʻi i ka 25 g o ka glucose. ʻO kēlā me kēia kūlana like i ka hihia o ka nui o ka nui o ka lāʻau, ua hōʻike ʻia i ke kauka.
I ka hypoglycemia koʻikoʻi, ka mea i hui pū ʻia e ka nalowale o ka noʻonoʻo, pono ia e ʻimi i ke kōkua olakino.
Hoʻolālā ʻia ka Glucose. Pono ʻoe e hoʻonui i nā kaha inikini o ka glucagon i loko o / m, i loko / i loko. Ma hope o ke kōkua mua, pono ʻoe e nānā i ke ʻano no nā lā he nui me ka hoʻokaʻina ʻana o ke kō.
Wikiō ma nā lāʻau maʻi maʻi maʻi 2:
ʻO ka pilina o PSM me nā lāʻau lapaʻau ʻē aʻe
I ka wā e lawe ai i kekahi mau lāʻau lapaʻau, ʻo kā lākou hoʻohālikelike me nā derogative sulfonylurea. ʻO nā hormones anabolic, antidepressants, beta-blockers, sulfonamides, clofibrate, nā kāne kāne, nā Coumarins, tetracycline lāʻau lapaʻau, miconazole, salicylates, nā lāʻau lapaʻau hypoglycemic a me ka insulin e hoʻonui i ka hopena hypoglycemic.
Hoʻemi ka PSM i ka hopena o nā corticosteroids, barbiturates, glucagon, laxatives, estrogens a me nā gestagens, nicotinic acid, chlorpromazine, phenothiazine, diuretics, thyroid hormones, isoniazid, thiazides.
