Metformin: pehea ka lōʻihi e hiki ai iaʻu ke lawe a hoʻohui ʻia?

I kāu mau noiʻi (ka wikiwiki glucose 7.4, glycated hemoglobin 8.1), ʻaʻole i kānalua ka nui o ka maʻi o ka maʻi - ua hōʻike pololei ʻoe. Hāʻawi maoli ʻia ʻo Metformin i ke kumu o T2DM, ua koho ʻia ke ʻano he hoʻokahi. Kōkua ka Metformin i ka hoʻokahe koko koko a me ke kaumaha.

Me ke kau ʻana ma hope o 60 mau makahiki: inā e hana ʻia nā hana o nā kino o ke kino (ma mua o ke ake, nā ʻōpū, nā ʻōpū, a me nā ʻōnaehana cardiovascular), a laila ʻae ʻia ʻo Metformin e loaʻa ma hope o 60 mau makahiki. Me kahi emi i hoʻokaʻawale ʻia i ka hana o nā ʻōpū kūloko, a emi ke ʻano o ka Metformin, a laila ua kāpae ʻia.

I ka hui pū me L-thyroxine: L-thyroxine e lawe i ke kakahiaka ma kahi ʻōpū ʻole 30 mau minuke ma mua o ka ʻai, holoi ʻia me ka wai maʻemaʻe.
Lawe ʻia ka Metformin ma hope o kaʻaina kakahiaka a a ma hope o ka ʻaina ʻaina (ʻo ia hoʻi, ʻo 1 a ʻelua paha mau manawa ma kahi lā ma hope o ka pāʻina), me ka launa ʻana i ka metformin ka ʻōpū o ka ʻōpū a me nā ʻōpū.
Hiki ke hoʻohui pū ʻia ka mīkini me metformin a me L-thyroxine, ʻo ia ka hui pinepine (ʻo ka maʻi maʻi a me ka hypothyroidism).

ʻO ka mea nui e hoʻomanaʻo ai e pili ana i ka hāmeʻa e pili ana i ka hahai ʻana i kahi meaʻai, hana kino (e kōkua kēia i ka hoʻemi ʻana i ke kaumaha) a me ka kaohi ʻana i ke kō koko.

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 emi ka hana ʻana o ka glucose i loko o kahi mea maʻi, e emi hoʻi kona pae koko. Pono e hoʻomanaʻo ʻia ma ka maʻi diabetes, ʻo ka nui o ka pae ʻai o ka glucose i loko o ka ate ka nui o ʻekolu mau manawa ko nā waiwai 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 hana o gluconeogenesis, hana i ka metformin i nā hana ʻē aʻe, ʻo ia hoʻi:

• hoʻomaikaʻi i ka ʻikeʻana i nā ʻolua peripheral a me nā selela i ka honi e hoʻohiolo ana i ke kō.
• hoonui i ka glucose i kaʻili 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 ia 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 o nā kō i ka 20%, a me ke koʻi ʻana o 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 loko o nā hola 1-3 a hoʻomaka ʻo ia e hana. Hoʻomaʻa maikaʻi 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

Loaʻa ka lāʻau Metformin i ka papa o nā papa i loaʻa iā 500 mg o ka mea ikaika (metformin hydrochloride). Ma kahi o ia mea, ua loaʻa ka huahana i kahi liʻiliʻi o nā mea hoʻohui aʻe: starch corn, crospovidone, povidone K90, magnesium stearate a talc. Hoʻokahi i hoʻokahi pahu me 3 mau palaka o nā papa he 10.

ʻO ka mea wale i hele aku i ka loiloi e hōʻike pololei ana i ke olakino maʻi hiki ke kuhikuhi i ka hoʻohana ʻana i ka lāʻau Metformin. Ke lawe ka mea maʻi i nā paila, pono ʻo ia e hahai i nā ʻōlelo a ke kauka a pau.

Aia kahi ʻōlelo i kau ʻia ma kēlā me kēia pūpū o ka hoʻomākaukau. Ma ia mea e hiki ai iā ʻoe ke loaʻa i kēia mau hōʻike hōʻike no ka hoʻohana ʻana:

1. 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).
2. 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 ʻōmua 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 nui 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 makua (mai 60 mau makahiki), ʻoi ʻia ke 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 kekahi mau manawa. Ke hele mai ka 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 ke 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 lapaʻau ʻē aʻe, 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 loa, 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 hoʻomōhala 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, ʻike ʻia me ka maʻi ketoacidosis maʻi,
• akeʻe a me nā aʻalā.
• nā maʻi maʻi e hoʻopilikia ana i ka hana o nā ʻōpū (dehydration, hypoxia, nā maʻi like ʻole, ka maʻi ʻoe),
• ʻo ka huakino me nā mea ʻawaʻawa a i ʻole nā ​​waiʻona o ke kala,
• nā maʻi ākea a i ʻole e alakaʻi ai i ka hoʻomohala ʻana o ka infarction myocardial, ʻeha hanu a ʻole hoʻi naʻau ʻole,
• lactic acid coma (ma ka moʻolelo, ka mōʻaukala),
• hana i ka liʻiliʻi o ʻelua mau lā ma mua a no nā lā ʻelua ma hope o nā hoʻokolokolo x-ray a me ka radioisotope me ka ʻōlelo ʻana o ka māhele like like me iod.
• nā meaʻai haʻahaʻa-haʻahaʻa (emi iho ma lalo o 1000 mau kalona i ka lā),
• e hali ana i ka pēpē a me ka umauma.
• hoʻonui mahanū 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:

1. hoʻoweliweli a kaʻiole (luka, ʻono hoʻololi, hoʻonui lemulence, ka nele o ka makemake, ʻeha a ʻehaʻeha paha).
2. hematopoietic mea ola (ke hoʻomohala ʻana o ka anemia megaloblastic - ka hapa ʻole o ka waikawa folic a me ka huaora B12 i ke kino),
3. ka hana o ka hoʻokūkū (ka hoʻomohala ʻana o ka acidact lactic a me B12 hypovitaminosis e pili ana i ka malabsorption),
4. 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 loaʻa paha ka ʻōpala ʻili. 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 hele ʻana o ka hoʻohui ʻana i ka metformin, 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 nā ʻōkuhi a i 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 koʻikoʻi - ka lactic acidosis i ka maʻi diabetes. ʻO kekahi kumu nui no kona hoʻomohala ʻana, ʻo ka hoʻopili ʻana i ka lāʻau lapaʻau no ka hana ʻana i ka maʻi maʻi.

ʻO kahi hōʻailona o ka lactic acidosis ka digestive hoʻonāukiuki, ʻeha o ka ʻōpū, hōʻemi o ke kino, ʻehaʻeha o ka naʻau, ʻōpū o ka ʻōpū, hōʻeha a me ke ʻeha ma 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 hoʻolilo i ka hoʻohana paʻakikī o nā metformin a me nā mea hoʻomehana me nā derivatives sulfonylurea e hiki ai i ka wikiwiki o ka hoihoi o ke 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.

Loaʻa ka hoʻonui ʻia ʻana o ka hopena hoʻohaʻahaʻa i ke kō i ka wā e pau ai.

1. ʻO Glucocorticosteroids (GCS).
2. ʻO nā Sympathomimetics.
3. Nā ʻāpana ʻokoʻa no ka hoʻohana ʻana i loko.
4. Epinofrina.
5. ʻO ka hoʻomakaʻana o ka glucagon.
6. Nā huahelu thyroid.
7. Nā hua kiko o nā phenothiazone.
8. ʻO nā diuretics a me nā thiazides.
9. 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 acidact lactic.

No laila, i ka wā o ka mea lapaʻau me ka metformin, pono nā mākaʻi e nānā i nā 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 manamana ma ka 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 hōʻoki ʻana i ka lāʻau.

Inā ʻike ka mea maʻi e loaʻa mai i kahi maʻi infectious bronchopulmonary a i ʻole he ʻano hopohopo o ka ʻōnaehana genitourinary, pono e kūkākūkā ʻia kahi loea.

ʻO ka hui pūʻana o ka metformin me nā lāʻau lapaʻau e hoʻemi ana i ke kō, e like me nā inikini insulin a me ka sulfonylureas, i kekahi manawa ke alakaʻi nei i ka kaohi o ke kō. Pono e noʻonoʻo ʻia kēia hanana no nā poʻe maʻi e hoʻokau i nā kaʻa a i ʻole paha nā mea ʻona 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, kahi e hoʻololi ai i ka hewa a me ka lōʻihi o ka papa o ka lapaʻau.

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 hoʻopuka ana ia.

Oe ke kuai i ka lāʻau lapaʻau ma ka hōʻike ʻana i ka lāʻau lapaʻau ma ka lāʻau lapaʻau, aia hoʻi ke koho i ke 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 (ʻĀpana) ʻAʻohe 60 - nā kumukūʻai liʻiliʻi he 247 rubles, a ʻo ka nui ka 324 mau rubles.
• Metformin Richter (Hanawai) Helu 60 - ʻo ke kumukūʻai liʻiliʻi he 287 rubles, a ʻo ka lōʻihi ka 344 mau rubles.
• Metformin Zentiva (Slowakia) No. 30 - ke kumukūʻai haʻahaʻa he 87 mau rubles, a ʻo 20 ka nui ka rubles.
• 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 kālā like ʻole 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 o ka glucose i ke koko a hoʻolōʻihi i ka hopena hypoglycemic me ka hoʻohana lōʻihi ʻana o ka lāʻau. Hoʻomaopopo ka hapanui 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 mea hiki ke inu i ka metformin e nalowale i ke kaumaha, e pane maikaʻi ana ka 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 ʻaʻole hoʻonā i ka glucose i loko o ke koko a hoʻonui i ke kaupaona o ke kino.

I waena o nā hemahema kahi hikiʻole ke hoʻopili ʻia ke kūpili me kahi pili 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 mea i hoʻonui ʻia ai ka lāʻau me ka metformin hāmeʻa hou i ka honua holoʻokoʻa, he nui nā inoa. ʻO ka ʻokoʻa ka mea wale nō e hoʻohana ʻia nā mea hou aku. 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 o ke hahai i kekahi meaʻai kūikawā no ka maʻi maʻi, ka nohona maʻalahi, a me ka kaohi ʻole o nā kōkō. I ka ʻoiaʻiʻo, ʻo ka lawe ʻana i nā lāʻau lapaʻau wale nō ʻaʻole e 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.