Metformin: nā mea i kuhikuhi ʻia, nā ʻōlelo aʻo, nā hopena pili

Hoʻokaʻawale ʻia nā Diabetes mellitus i ʻelua mau ʻano. Kāhea ʻia ke ʻano maʻi diabetes like 1 me ka hilinaʻi ʻana i ka insulin. Me kēia ʻano maʻi, ʻike ka hana ʻole o ka enzyme kūikawā i ka pancreas, insulin, e wāwahi ana i ka glucose, nahaʻole. Kāhea ʻia ʻo ke ʻano maʻi diabetes like ʻole me ka non-insulin. Me kēia ʻano maʻi o ka maʻi maʻi, ʻaʻole i kau ʻia ka hana pancreatic, eia naʻe, ke emi nei ka hōʻemi ʻana i ka naʻau o ka insulin i nā kōpoli peripheral o ke kino, a ke hoʻonui pū ʻia ka hana glucose i loko o nā ʻāpana o ke ake.

ʻO ka hapa nui o ka poʻe i maʻi me ka diabetes type 2 i ka wā ʻelemakule, akā ua hala koke ka maʻi diabetes "ʻōpio". ʻO ke kumu no kahi nohona maʻalahi, ke kaumaha, ka hoʻohui ʻana i ka meaʻai wikiwiki a me nā hana ʻai ʻona maikaʻi. Eia naʻe, ʻo ka maʻi maʻi ʻoi kahi maʻi pōpilikia, ʻo ia i ka ʻole o nā hōʻike o waho e hoʻonui nui ai i ka hōʻeha o ka hoʻoulu ʻana i ka naʻau a me ka hahau, ke koko a me nā vascular pathologies. No laila, ua ʻimi nā poʻe ʻepekema i nā lāʻau lapaʻau e kōkua i ka hoʻohaʻahaʻa ʻana i ke kō o ke koko a me ka manawa like ʻaʻole e hōʻeha i ke kino.

ʻO ka wehewehe ʻana i ka lāʻau lapaʻau

Mai kahi kakano, pili i ka metformin e pili ana i ka biguanides, kahi hua o ka guanidine. Ke kūlohelohe nei, ʻike ʻia ka guanidine i kekahi mau mea kanu, no ka laʻana, i ka lāʻau lapaʻau kao, ka mea i hoʻohana ʻia e mālama i ka maʻi maʻi mai ka waʻīua. Eia naʻe, hōʻino ka guanidine maʻemaʻe i ka paʻakai.

Kūkulu ʻia ʻo Metformin e pili ana i ka guanidine i loko o nā makahiki 20 o ka makahiki hope. ʻO ia, ua ʻike ʻia no kona mau hypoglycemic waiwai, akā i kēlā manawa, ma muli o ke ʻano no ka insulin, ua poina kekahi lāʻau lapaʻau no kekahi manawa. ʻO ka ʻoi loa mai ka makahiki 1950, i ka wā i ʻike ʻia ai ka nui o nā pōʻino o ka insulin no ka diabetes type 2, ua hoʻomaka ʻia ka lāʻau lapaʻau e like me ka ʻāpana antidiabetic a ma hope o ka manawa pōkole ua loaʻa ka ʻike ma muli o kona pono, palekana a me kahi helu liʻiliʻi o nā hopena ʻaoʻao a me nā contraindications.

I kēia mau lā, ʻike ʻia ka metformin e hoʻohana pinepine ʻia ai ka lāʻau i ka honua. Kāhea ʻia ia ma nā lāʻau lapaʻau nui o ka WHO pono. Ua maopopo i ka hana maʻamau o ka metformin hiki ke hōʻemi i ka make o ka make mai nā pathologies o ke ʻano o ka pūnaehana ma o ka maʻi maʻi. Ua hōʻike ʻia nā haʻawina ma ka poʻe i momona nui a me ke ʻano diabetes type 2, ʻo ka mālama ʻana me ka metformin he 30% ʻoi loa ka ʻoi aku ma mua o ka mālama ʻana i ka insulin a me nā lāʻau antidiabetic ʻē aʻe, a me ka 40% ʻoi aku ka maikaʻi ma mua o ka mālama ʻana me ka ʻai ʻana. Hoʻohālikelike me nā lāʻau lapaʻau antidiabetic, he liʻiliʻi nā hopena o ka lāʻau, me ka monotherapy e hoʻomaʻamaʻa ʻole ʻaʻole ia i ka hypoglycemia pōʻino, he mea maʻamau loa ia e hōʻeha i ka hoʻopiʻi kino - ka lactic acidosis (huakui koko me ka lactic acid).

Aia ʻo Metformin i ka papa o nā lāʻau lapaʻau i manaʻo ʻia no ka mālama ʻana i ka maʻi maʻi 2. Ma hope o ka lawe ʻana i ka Metformin, hoʻemi ʻia ke kahe o ka glucose i loko o ke koko, ka pae o ka hemoglobin glycosylated a hoʻonui i ka hoʻololi o ka glucose o ke kino. ʻAʻole loaʻa ka lāʻau i nā carcinogenic waiwai, ʻaʻole i hoʻopilikia i ka ulu pono.

ʻO ke ʻano o ka hana therapeutic o ka metformin he versatile. ʻO ka mea mua, ke hōʻemi nei i ka hana o ka glucose i nā kiko o ke ake. Ma ke ʻano maʻi diabetes 2, hoʻohālikelike ka hana i ka ate i nā manawa he nui ma mua o ka mea maʻamau. Hoʻomaka ka Metformin i kēia hōʻailona e kahi hapakolu. Hōʻike ʻia kēia hana ma ka hoʻōla ʻana e ka metformin o kekahi mau enzyme ati, he mea koʻikoʻi kahi i ka metabolism o ka glucose a me nā momona.

Eia naʻe, ʻo ka hana o ka metformin e hōʻemi ai i ka glucose i loko o ke koko, ʻaʻole i kaupalena i ke kaohi ʻana i ka hana o ka glucose i loko o ka ate. Aia hoʻi ka hopena o ka Metformin ma ke kino:

hoʻomaikaʻi i nā kaʻina loina metabolic,
hōʻemi ʻana i ke kao o ka glucose mai loko o nā ʻōpū, a
hoʻomaikaʻi i ka hoʻohana ʻana i ka glucose i loko o nā kiko peripheral,
hoonui i ka ike
he hopena fibrinolytic.

ʻO ka haʻalele ʻana o ka insulin i loko o ke koko, ʻaʻole ka mea hōʻike hōʻike i kāna hana hypoglycemic. ʻAʻole i like me nā mea'ē aʻe o nā lāʻau antidiabetic, ʻaʻole metformin i alakaʻi i ka hoʻopiʻi weliweli - lactic acidosis. Eia kekahi, ʻaʻole ia e pili i ka hana ʻana o ka insulin e nā cell o ka pancreas. Eia nō hoʻi, hiki i ka lāʻau lapaʻau ke hōʻemi i ka pae o ka kolamu "hewa" kino - lipoproteins haʻahaʻa haʻahaʻa a me ka triglycerides (me ka hoʻēmi ʻole ʻana i ka nui o ka kolamu "maikaʻi" - lipoproteins kiʻekiʻe) He mea nui, hiki i nā metformin ke kaha i ka insulin e hoʻoikaika i ka hoʻokumu ʻana o nā io momona, no laila hiki i ka lāʻau lapaʻau ke hiki ke hōʻemi a e hoʻoponopono paha i ka paona kino. ʻO ke kumu waiwai o ka metformin ke kumu ke hana pinepine nei kēia lāʻau lapaʻau e ka poʻe makemake e hoʻemi i ka paona.

Pono e hoʻomaopopo ʻia i ka hopena maikaʻi o ka lāʻau lapaʻau ma ka ʻōnaehana cardiovascular. Ua hoʻoikaika ʻo Metformin i nā pālahalaha o nā pā o nā kahe koko, ke pale i ka hoʻomohala ʻana o ka angiopathy maʻi maʻi.

Lapaʻau lāʻau

I nā papa, hōʻike ʻia nā metformin e like me ka hydrochloride. He keʻokeʻo kala kala ʻole ia, he kala nui i ka wai.

ʻO ka Metformin kahi lāʻau lapaʻau lohi iki i hala. ʻO ka maʻamau, ʻo ka hopena maikaʻi o ka lawe ʻana e hoʻomaka e puka ma hope o 1-2 mau lā. I loko o kēia manawa, aia ke kaila o ke kūlohelohe o ka lāʻau i ke koko, e hōʻea ana i 1 μg / ml. I kēia hihia, hiki ke nānā ʻia ka nui o ka ʻike ʻana i ka lāʻau ma ke koko i ka manawa he 2 mau hola ma hope o ka hoʻokele ʻana. Hoʻopaʻa ikaika ka lāʻau i nā protein koko. ʻO ka hapalua kahi he 9-12 mau hola. Ua hoʻopiʻi ʻia ia e nā kuli ʻaʻole loli.

Loaʻa i nā poʻe me ka hana renal impalired ka hōʻemi ʻia o ka lāʻau lapaʻau i loko o ke kino.

ʻO ka hōʻailona nui no ka hoʻohana o ka lāʻau Metformin ka maʻi diabetes type 2. Eia kekahi, ʻaʻole e pilikia ka maʻi e ka ketoacidosis. ʻOi aku ka maikaʻi ke kuhikuhi i ka lāʻau lapaʻau i nā poʻe maʻi ʻaʻole i kōkua ʻia e kahi meaʻai haʻahaʻa-waiho, a i ka poʻe maʻi hoʻi e kaumaha nui ʻia. I kekahi mau hihia, hiki ke hoʻohana ʻia ka lāʻau lapaʻau me ka hui pū me ka insulin. Eia kekahi, ʻo ka lāʻau lapaʻau i kekahi manawa hiki ke kuhikuhi no ka maʻi gestational (maʻi ma muli o ka hāpai ʻana).

Hiki ke hoʻohana ʻia ka lāʻau lapaʻau inā hoʻokomo ke kanaka i ka hoʻomanawanui ʻana o ka insulin, akā ʻaʻoleʻoi aku ka waiwai o ka glucose koko ma mua o nā helu koʻikoʻi. Ua kapa ʻia kēia kūlana ʻo ka prediabetic. Akā, ʻoi aku ka nui o nā poʻe loea i ka mea i kēia kūlana, ʻoi aku ka maikaʻi o ka hoʻomaʻamaʻa a me ka meaʻai, a ʻaʻole maikaʻi loa nā lāʻau antidiabetic me ka prediabetes.

Eia kekahi, hiki ke kahakaha ʻia ka lāʻau lapaʻau no kekahi mau maʻi ʻē aʻe, no ka laʻana, me nā ovaries polycystic ovaries, nā alakaʻi wai momona alakiko, ʻo ka wīwī. Hoʻohui ʻia kēia mau maʻi me ka ʻoiaʻiʻo e pū me ia he insensitivity o nā kiko i ka insulin. Eia nō naʻe, ʻaʻole i loaʻa ka waihona kumu hōʻike like o ka hopena o ka maʻi i loko o kēia mau maʻi. ʻO kekahi manawa hoʻi ka lāʻau lapaʻau ka hoʻohana ʻia no ka lilo ʻana o ka mea kaumaha, ʻoiai no ka lāʻau lapaʻau e pili ana i kēia hoʻohana ʻana i ka metformin me kahi hoʻohālike o ka kānalua, ʻoiai inā ʻaʻole ia e pili ana i ka poʻe me ka momona o ka pathologically.

E hoʻokuʻu i ke ʻano

Loaʻa ka lāʻau lapaʻau i loko o ke ano o nā papa i loaʻa ka nui o 500 a me 1000 mg. Aia nō kekahi mau papa hana lōʻihi ma kahi papa o 850 mg, kālai ʻia me kahi kāʻei enteric kūikawā.

ʻO ka analogue kumuʻikepili koʻikoʻi o ka metformin e loaʻa ana i ka mea hana ikaika ʻo ia ka French French Glucofage. Manaʻo kēia lāʻau lapaʻau i nā hana maoli, a me nā lāʻau lapaʻau me ka metformin, i hana ʻia e nā ʻano lāʻau lapaʻau like ʻole ma ka honua - generics. ʻAe ʻia ka lāʻau i loko o kahi kīkē me ka ʻole o ke ʻano maka.

Nā Hoʻohui

He nui nā contraindications i ka lāʻau lapaʻau:

nā ʻano kumu nui o ka naʻau, ka hanu a me nā hana ʻole ʻole
lawelawe aho ʻaia,
myocardial pili hewa
ulia pōpilikia maʻamau,
maʻi maʻamau ketoacidosis,
maʻiʻeleʻele coma a me ka precoma,
lactic acidosis (me ka mōʻaukala o)
nā maʻi a me nā kūlana e pōʻino ai ka hana holo ʻole o nā maʻi lēwa.
huehue
nā maʻi koʻikoʻi (ʻoi paha bronchopulmonary a iha)
hypoxia
pihoihoi
sepsis
nā hana maʻi kaumaha (ma kēia hihia, ua hōʻike ʻia ka hoʻohana ʻana o ka insulin),
ka wai hoʻowahāwahā a i ʻole ke inu ʻana i ka wai (ʻo wai o ka lactic acidosis),
nā hoʻokolohua diagnostic me ka hoʻolauna ʻana i nā mea i loko o ka iodine (ʻelua mau lā ma mua o ke kaʻina hana a me ʻelua mau lā ma hope iho).
Pāʻaiʻai hypocaloric (ʻoi aku ma mua o 1000 Kcal i kēlā me kēia lā),
ka pae kiʻekiʻe o ka hana i loko o ke koko (135 mmol / l i nā kāne a me 115 mmol / l i nā wahine),
ʻO ka maʻi wāwae maʻi maʻi
fiva.

Me ka mālama aka, pono e kuhikuhi ʻia ka lāʻau i ka poʻeʻelemakule a me nā poʻe e hana ana i nā hana kino olakino (ma muli o ka nui o ka nui o ka nui o ka lactic acidosis).

ʻAʻole ʻōlelo ʻia ka lāʻau no nā poʻe maʻi ma lalo o ka 18 mau makahiki o ka makahiki, i ka wā hāpai a me ka lactation, me ka piʻi nui o ka lāʻau. I kekahi mau manawa, hiki ke hoʻohana pono i ka lāʻau lapaʻau i ka wā hāpai a ʻo i ka wā kamaliʻi (ma mua o 10 mau makahiki) ma lalo o ka mākaʻikaʻi koʻikoʻi o kahi kauka.

Nā ʻōlelo kikoʻī

Inā e hoʻomau ʻia ka mālama ʻana, a laila pono ke nānā ʻia ka hana o ka pēpē. I ka liʻiliʻi o ʻelua ma ka makahiki, pono ia e nānā i ka ʻike ʻana o ka waikawa lactic i loko o ke koko. Inā hele ka ʻeha o ka naʻau, e nānā koke i ka paʻa ʻana o ka waikaʻi lactic.

Eia kekahi, ʻo 2-4 mau manawa o ka makahiki e nānā i ka hana o nā keiki (level the creatinine i ke koko). Hoʻopau maoli kēia i ka mea makua.

Me ka monotherapy, ʻaʻole pili ka lāʻau i ka hoʻonāukiuki ma waena o ia mea, no laila hiki ke hoʻohana pono i ka lāʻau lapaʻau i nā poʻe e hoʻokau i nā kaʻa a hoʻokō i nā hana e pono ai ke kukuna.

Nā hopena hopena

ʻO nā hopena koʻikoʻi ka wā e lawe ai i ka metformin i hoʻopili ʻia me ka gastrointestinal tract. I ka manawa pinepine ke hāpai i nā paila, nā mea e like me ka ʻeha o ka ʻōpū, ke ʻano hōʻino, ka luaʻi, ka maʻi ʻaʻī, nā lemela ʻē aʻe e ʻike ʻia. I mea e pale ʻole ai i kēia, pono e lawe ʻia nā papa i ia wā a i ʻole ma hope o ka ʻaina. Hiki nō hoʻi i ke ʻano o ka ʻaha metallic i loko o ka waha, ka nele ʻole o ka momona, ka ʻūhū ʻili.

ʻO nā hopena a pau i luna, ʻaʻole e hoʻoweliweli. Kuhi pinepine lākou ma ka hoʻomaka ʻana o ka lāʻau a kau ma ke ʻano pono. I mea e pale aku ai i nā hanana ʻano leʻaleʻa e pili ana i ka gastrointestinal tract, hiki ke lawe i ka antispasmodics a me nā antacids.

Kuhi loa, hiki i ka lāʻau lapaʻau ke alakaʻi i ka lactic acidosis, megaloblastic anemia, hypoglycemia, kahi make i ka hana ʻana o ka hormone thyroid a me ka testosterone i nā kāne. Hōʻike pinepine ʻia ʻo ka hypoglycemia inā ke hoʻohana ʻia kekahi mau lāʻau antidiabetic, no ka laʻana, he sulfonylureas, i hui pū ʻia me metformin. Me ka hoʻohana mau ʻana, hiki i ka lāʻau lapaʻau ke alakaʻi i ka nele o ka vitamin B12.

ʻAʻohe o nā hopena Hypoglycemic ke lawe ʻana i ka wā e lawe ana i ka NSAID, nā ACE inhibitors a me MAO, beta-blockers, cyclophosphamide. Ke lawe nei i GCS, epinephrine, sympathomimetics, diuretics, thyroid hormones, glucagon, estrogens, calcium antagonists, nicotinic acid, a me ka hopena, ua emi ka hopena o ka lāʻau lapaʻau.

Hiki i nā lāʻau lapaʻau ke iodine hiki ke hoʻonui i ka lolo a hoʻonui i ka nui o ka acidosis lactic. Inā kānalua ka lactic acidosis, koi koke i ka hoʻokipa.

Nā ʻōkuhi no ka hoʻohana

Ma ke ʻano he kānāwai, i ka hoʻomaka ʻana o ka lāʻau, pono e hoʻohana i ka lāʻau i ka 0.5-1 g i hoʻokahi lā i ka lā. Pono e mālama ʻia kēia kaila i nā lā ʻekolu. Mai ka 4 a hiki i ka 14 lā pono e lawe i nā papa metformin 1 g ʻekolu mau manawa i ka lā. Inā ua emi ka pae o ka glucose, hiki ke hoʻemi ʻia ka make. Ma ke ʻano he mālama mālama, pono e lawe ʻia nā papa metformin i 1500-2000 mg i kēlā me kēia lā. I ka hihia o nā papa hana lōʻihi (850 mg) pono e lawe i ka lāʻau lapaʻau 1 papa ʻelua ʻelua i ka lā hoʻokahi - i ke kakahiaka a i ke ahiahi.

ʻO ka palena loa he 3 g (6 mau papa o ka lāʻau, 500 mg i kēlā me kēia lā. I ka poʻe ʻelemakule, hiki ke hana ʻia kahi hana ʻole, no laila, ʻaʻole pono ka nui o ka lā nui ma mua o 1000 mg (2 mau papa o ka lāʻau 500 mg pākahi). ʻAʻole hoʻi lākou e ke hoʻopale i ka mālama ʻana i ka lāʻau lapaʻau, no ia mea e pono ai e hoʻomaopopo i ke kauka.

ʻOi aku ka maikaʻi ma ka lawe ʻana i ka paila ma hope o ka ʻai ʻana me ka wai nui. ʻO ka lawe ʻana i ka lāʻau lapaʻau me ka meaʻai hiki ke hoʻemi i kona komo ʻana i ke koko. Hoʻomaopopo ʻia ka ʻōkuhi o kēlā me kēia lā i kā 2 dosis.

ʻO ka nui o ka lāʻau i ka wā e hoʻohana pū ʻia me ka insulin (ma kahi o ka nui o ka insulin ma lalo o 40 mau pūʻulu / lā) ka mea like like me ka ʻole o ka insulin. I nā lā mua o ka lawe ʻana i ka metformin, ʻaʻole pono e hōʻemi ʻia ka nui o ka insulin. Ma hope aʻe, hiki ke hoʻēmi ʻia ka nui o ka insulin. Pono e hana ʻia kēia kaʻina ma lalo o ka nānā o kekahi kauka.

Ke keu

ʻO ka Metformin kahi lāʻau lapaʻau palekana palekana a kūwaho hoʻi i kona mau doses nui (ma ka pau ʻole o ka launa pū ʻana o ka lāʻau lapaʻau), ma ke ʻano he kānāwai, ʻaʻole i alakaʻi i ka emi ʻana o ke kō koko. Eia nō naʻe, me kahi overdose, aia kekahi, ʻaʻohe emi iki ka hopena - ke hoʻonui nui i ka hoʻoweliweli o ka lactic acid i loko o ke koko, ka mea i kapa ʻia ka lactic acidosis. Nā hōʻailona o ka lactic acidosis he ʻeha ma ka ʻōpū a me nā ʻōpū, hoʻololi i ke ʻano kino o ke kino, ʻike ʻole i ka ʻike. ʻO kēia hoʻopiʻi i ka haʻalele ʻana o ka mālama olakino hiki ke alakaʻi i ka make ma muli o ka hoʻomohala ʻana i ka coma. No laila, ma kahi o kahi kumu i hele ai kahi overdose o ka lāʻau, pono e lawe ʻia ka mea maʻi i kauka. I kahi hihia o ka overdose, hana ʻia ke ʻano hōʻailona maʻi. ʻO ka weheʻana i ka lāʻau lapaʻau mai ke koko me ka hoʻohana ʻana i ka hemodialysis he maikaʻi hoʻi.

Kūʻai a me ka hana o ka hana o ka lāʻau lapaʻau

ʻO Metformin kahi lāʻau lapaʻau hypoglycemic waha mai ka pūʻulu biguanide. He aha ke kumukūʻai o ka lāʻau lapaʻau? I kahi lāʻauʻai, ka uku kumukūʻai o Metformin he 120-200 rubles. ʻO ka pūpū he 30 mau papa.

ʻO ka hana ikaika o ka lāʻau lapaʻau ka metformin hydrochloride. Loaʻa pū kekahi i nā mea kōkua, e like me E171, propylene glycol, talc, hypromellose, silicon dioxide, magnesium stearate, mais starch, povidone.

No laila he aha ka hopena lapaʻau lāʻau o ka metformin? Inā manaʻo ʻoe e nānā i nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau, a laila e hana ʻia kāna ʻano hana:

Hoʻopau i nā pale kino insulin. He hiʻohiʻona koʻikoʻi kēia, no ka mea he nui nā maʻi me ka maʻi diabetes e hāpai i ka pale ʻana i ka hopena o ka insulin. Hoʻopau ʻia kēia me ka hoʻomohala ʻana o ka comg hyperglycemic a me nā ala ʻē aʻe koʻikoʻi.
Kōkua i hoʻolōʻihi i ka hoʻopili ʻana o ka glucose mai nā ʻōpū. Ma muli o kēia, ʻaʻole pono ka mea maʻi e lele i ka puna koko. Kuhi i ka hopena kūpono o Metformin, e hoʻomau ka pae o ka glucose. Akā aia kahi ʻaoʻao flip i ka ʻāpana. ʻO ka metformin hydrochloride i ka hui pū me ka hoʻomehana insulin e hiki i ka hoʻomohala ʻana i ka coma hypoglycemic coma. ʻO ia ke kumu me ka hoʻohana pinepine ʻana i kēia lāʻau lapaʻau a me ka hoʻohana ʻana i ka insulin, pono paha ke hoʻoponopono ʻia ka dosage.
Hoʻopaʻa ia i ka gluconeogenesis i loko o ka puʻuwai. Ma loko o kēia kaʻina ke hoʻololi ʻana i ka maʻi glucose, kahi e loaʻa ai ke kino mai nā kumuwaiwai kumu ʻokoʻa.Ma muli o ka lohiʻana o ka hoʻōla o ka glucose mai ka lactic acid, hiki ke pale i nā kō a me nā pilikia o ka maʻi diabetes.
Hoʻemi i ka momona. ʻO ka pinepine pinepine, ʻo ka maʻi maʻamau ʻo 2 ke hopena o ka momona. ʻO ia ke kumu, kū'ē i ke ʻano o ke kahua o ka papaʻai, ua noi ʻia ka mea maʻi e hoʻohana i nā lāʻau lapaʻau. He ʻokoʻa ʻo Metformin i kāna ʻano, me ka mea nāna e kōkua i ka hoʻonāukiuki wale i ke kōpaʻa koko, akā hoʻonui pū i ka hoʻokau o nā lāʻau lapaʻauʻai e 20-50%.
ʻO ka hoʻokaʻawale i ke kolamu o ke koko. Ke hoʻohana nei i ka Metformin, ua nānā ʻia kahi emi o ka nui o nā triglycerides a me nā lipoproteins density haʻahaʻa.

Hoʻololi pū ka Metformin hydrochloride i ke kaʻina hana o ka peroxidation o nā momona. ʻO kēia ke ʻano o ka pale ʻana i ka maʻi kanesa.

Nā ʻōkuhi a me nā ʻōlelo aʻoaʻo no ka hoʻohana ʻana iā Metformin

I nā kūlana e kūpono ai ke hoʻohana ʻana o Metformin? Inā manaʻo ʻoe e pili ana i nā ʻōkuhi no ka hoʻohana ʻana, hiki ke hoʻohana ʻia i ka lāʻau lapaʻau ma ka mālama ʻana i ka maʻi maʻi type 2.

Eia kekahi, hiki ke hoʻohana ʻia nā papa ma ke ʻano monotherapy a i ʻole hui pū me nā ʻaina hypoglycemic ʻē aʻe. Hoʻohana pālahalaha kekahi hana ʻē aʻe i nā hihia kahi e kōkua ʻole ai ka lāʻau lapaʻau i ka maʻi diabetes.

ʻAʻole ia he mea kūpono ia i hōʻike ʻia nā hōʻailona no ka hoʻohana ʻana i ka Metformin. Hoʻohana nui ʻia ka lāʻau lapaʻau i ka mālama ʻana o ka prediabetes a me cleropolicystosis o nā ovaries. Ma waena o nā hōʻailona no ka hoʻohana ʻana, ka metabolic syndrome a me ka obesity e hoʻokaʻawale ʻia, me ke ʻano o ka hoʻomohala ʻana o ka kū i ka insulin.

Pehea e koho ai i ka dosis Metformin? Hiki ke koho kuokoa ʻia ka kaha o kēlā me kēia lā o Metformin. I kēia hihia, pono ke ʻike i ke kauka i ka ʻike mōʻaukala, no ka mea, he nui kēia contraindications i kēia loea hypoglycemic no ka hoʻohana ʻana.

Makemake wau makemake e ʻike inā loaʻa ʻo Metformin i nā palapala like ʻole. Hiki iā 1000, 850, 500, 750 mg. Eia kekahi, loaʻa nā lāʻau lapaʻau no ka maʻi maʻi, kahi e pili ana i ka 400 mg o ka metformin hydrochloride.

No laila, he aha ka dosage i hoʻomau mau ai? ʻO ka dosis mua o Metformin he 500 mg, a ʻo ka neʻe o ka lawelawe i 2-3 mau lā i ka lā. Pono e hoʻohana koke i ka lāʻau lapaʻau ma hope koke o ka ʻai ʻana.

Ma hope o kekahi mau pule o ka mālama ʻana, hiki ke hoʻoponopono ʻia ke kaona. E hilinaʻi nā mea a pau i ke kō koko. Hoʻoikaika ʻia ka glycemia e ana ʻia i kēlā me kēia lā ma kahi ʻōpū ʻole. No kēia mau pahuhopu, ʻoi aku ka maikaʻi e hoʻohana i ka glucometer.

Pehea ka lōʻihi o Metformin e hele? ʻAʻole hiki ke pane i kēia nīnau. Ke koho ʻana i ka lōʻihi o ka mālama ʻana, e noʻonoʻo pono nā ʻano pilikino o kekahi kanaka, e like me ia, ke kiʻekiʻe o ka glucose koko, ke kaumaha a me ka makahiki. Hiki i ka mālamaʻana ke 15 mau lā, 21 mau lā a "ʻole" e pā "i hoʻokahi mahina.

ʻO ka dosis kiʻekiʻe loa o Metformin ʻo 2000 mg i kēlā me kēia lā. Pono e hoʻomaopopo ʻia me ka hoʻohana like ʻana o ka insulin, pono ke hoʻohaʻahaʻa ʻia ka make i 500-850 mg i kēlā me kēia lā.

Nā ʻlelo ʻaoʻao o Metformin

He aha nā hopena pili o Metformin? Aia kekahi kumu like i ka hopena koʻikoʻi o nā loea hypoglycemic, i ka Metformin kūikawā. He aha ia e pili ai?

ʻO ka meaʻoiaʻiʻo me ke ʻano type type 2, pono ke nānā mau ka mea maʻi i ka nui o ka calorie o kaʻai, a nui ka nui o nā waihona ʻai i loko. Inā hoʻohana ka mea maʻi i nā mākaʻi hypoglycemic a noho ma kahi meaʻai koʻikoʻi, a laila kiʻekiʻe loa ke kuʻina o ka ulu ʻana i ka hypoglycemia - he kuʻuna nui o ka glucose koko.

Ma waena o nā hopena hopena o ka Metformin hiki ke hoʻokaʻawale ʻia:

ʻO ka pale aku o ka ʻōnaehana hematopoietic. I ka hoʻohana ʻana o Metformin, ʻaʻole hiki ke pau i ka ʻai o ka thrombocytopenia, leukocytopenia, erythrocytopenia, granulocytopenia, hemolytic anemia, pancytopenia ʻaʻole hiki ke hoʻoholo ʻia. Akā he mea hoʻi e hōʻole ʻia kēia mau hoʻopiʻi a pau, a hoʻoholo lākou iā lākou iho ma hope o ka hoʻopau ʻana i ka lāʻau.
Hoʻopau i nā ate. Hōʻike lākou i ka hoʻomohala ʻana o ka hana palupalu a me ka hepatitis. Akā ma hope o ka hōʻole ʻana iā Metformin, hoʻoholo kēia mau pilikia i ka hopena. Ua hoʻopaʻa ʻia kēia ma nā loiloi a nā kauka a me nā maʻi.
Hoʻopiʻi maikaʻi. Hōʻike pinepine kēia hoʻonāukiuki. ʻAʻole ʻike ka hana maoli no ka hoʻomohala ʻana i ka hopena o ka ʻono ma lalo o ka mana o ka metformin hydrochloride.
ʻO ka ʻōpū ʻili, erythema, urticaria.
Lactic acidosis. Hoʻopilikia nui kēia hoʻonāukiuki. Hoʻohāla pinepine ia inā ua koho ʻia ka hewa hala, a inā ua loaʻa ka mea maʻi me ka mea ʻawaʻawa i ka wā mālama.
ʻO nā kolohe i loko o ka hana o ka papa kūloko. Hōʻike pinepine ʻia kēia ʻano hoʻopiʻi e like me ka hōʻike ʻia e nā loiloi loiloi. Hōʻike ka ʻeha i ka huehue ʻana i ke ʻano o ka nausea, ka luaʻi, ka mea ʻala metallic i loko o ka waha, a me ka nele o ka momona. Akā i ka laulā, pono ke hoʻomaopopo ʻia i kēia mau ʻōuli lohi e hele mai i loko o nā kahua mua o ka mālama ʻana, a laila e hoʻoholo iho iā lākou iho.
Hoʻemi i ka loaʻaʻana o ka vitamin B12.
Nā nāwaliwali nui.
ʻO ka piko hāpū pīhoihoi.

Ke kū ʻia nei nā ʻano hoʻopiʻi ma luna, e ʻōlelo ʻia e hoʻohana i nā hui o nā ʻano o Metformin a ma lalo o ka hana maʻi.

Nā lāʻau lapaʻau lāʻau Metformin

Hoʻomau ka metformin i ka hoʻokahe o ke koko. Akā i ka wā e launa pū me kekahi mau lāʻau lapaʻau, e hoʻoikaika ai kēia lāʻau lapaʻau, a i ʻole ʻokoʻa, hoʻēmi i kona hopena hypoglycemic.

Hiki i kēia ke alakaʻi i nā hopena hikiʻole. Makemake koke wau e nānā pono e hoʻonui ka hopena hypoglycemic i ka wā e hoʻohui pū ai i ka Metformin me nā mahi a sulfonylurea. I kēia hihia, pono kahi hoʻoponopono hoʻoponopono ʻia.

Hiki i kēia ke hoʻonui nui i ka hopena hypoglycemic o Metformin:

Acarbose.
ʻO nā lāʻau anti-inflammatory Nonsteroidal.
Nā Monoamine oxidase inhibitors.
PolohanaHula.
ʻO Angiotensin-hoʻohuli i ka pale o ka enzyme.
Cyclophosphamide.
ʻO nā hua o ka clofibrate.
Nā māka hua Beta.

ʻO ka corticosteroids, diuretics, nā mea hoʻohālike o samostanin e hōʻemi ana i ka hopena o ka hoʻomehana maʻi o ka maʻi me Metformin. Ua hōʻike ʻia ua emi iho ka hopena o ka hypoglycemic me ka hoʻohana pinepine ʻana i nā glucagon, nā thyroid hormones, estrogens, nicotinic acid, calcium antagonist a me isoniazids.

Pono e hoʻomanaʻo hoʻi i ka cimeteredin, i ka wā e launa pū me Metformin, e hoʻonui i ka hiki ke hoʻomohala i ka waikena lactic.

He aha ka lāʻau e hiki ai ke hoʻohana pū me ka metformin?

I ka mālamaʻana i ka maʻi mellitus o ka maʻi maʻi, kahi lāʻau e like me Januvia i kuhikuhi pinepine ʻia e pili pū me Metformin. ʻO kona kumu he 1300-1500 rubles. ʻO ka hana nui o ka lāʻau sitagliptin.

Hoʻopili kēia mea i ka DPP-4, a hoʻonui i ka ʻike o GLP-1 a me HIP. Hoʻokomo ʻia nā haʻalulu o ka ʻohana tumuhala i loko o nā ʻōpū i hoʻokahi lā, ma hope o ke kū ʻana o ko lākou pae ma hope o ka ʻai ʻana.

ʻO ka incretins he ʻāpana komo o ka ʻōnaehana physiological no ka hoʻoponopono ʻana i ka home home home glucose. Me ke kiʻekiʻe o ke kō koko koko, ua kōkua nā hormon mai kēia ʻohana i ka hoʻonui ʻana i ka synthesis o ka insulin a me kāna neʻe ʻana e nā cell beta.

Pehea e lawe ai i ka lāʻau lapaʻau? ʻO ka hoʻomakaʻana hoʻomaka ka 100 mg 1 mau lā i kēlā me kēia lā. Akā ke koho nei i ka momona kūpono loa, pono nō ia i ke kauka hele mai. ʻAe ʻia ka hoʻoponopono, ʻoiai inā hoʻohana ʻo Januvia i hui pū me Metformin.

Nā maʻi hoʻohālikelike i ka hoʻohana ʻana iā Januvia:

ʻAno maʻi type 1.
Allergy i nā lāʻau lapaʻau konoho.
Maʻi molaʻi.
ʻO ka wā hāpai a me ka lactation.
Nā makahiki o nā keiki.
Me ka mālama ʻana i ka hiki ʻole o ka ate. Me ka dysfunction system hepatobiliary, pono paha ka hoʻēmi ʻana. Hōʻoiaʻiʻo ʻia kēia e nā ʻikepili noiʻi, a me nā loiloi o nā endocrinologists.

Loaʻa iā lākou ka hopena? ʻOiaʻiʻo, loaʻa iā lākou kahi wahi. Akā ʻo Lonvia e hana pinepine i nā hoʻopiʻi ʻana i ka wā e piʻi ai ka dosage i 200 mg. ʻOiai ke mālama nei i nā dole haʻahaʻa, liʻiliʻi ka hopena o nā hopena hopena.

E like me nā ʻōlelo i ka wā, i ka wā e hoʻohana ai i nā papa, nā hōʻeha e like me ka pāpā ʻana i ka papa ʻalopona, nasopharyngitis, ʻeha, ka ʻōpū, ka luaʻi, hoʻopuka, arthralgia hiki ke ulu.

Eia nō hoʻi, ʻaʻole hiki ke hoʻoholo ʻia ka hopena me ka maʻi kūlohelohe a me ka hypoglycemia.

ʻO ka metala uila maikaʻi loa ʻo Metformin

ʻO ka analogue maikaʻi loa o Metformin ʻo Avandia. He kumukūʻai koʻikoʻi kēia loea hypoglycemic - 5000-5500 rubles. ʻO ka pūpū he 28 mau papa papa.

ʻO ka hana ikaika o ka lāʻau ʻo rosiglitazone. Hoʻohana ʻia ʻo Avandia i ka mālama ʻana i ka maʻi diabetes 2 type. Eia kekahi, hiki ke hoʻohana pū me ka Metformin, a hiki ke hoʻohanaʻokoʻa.

Pehea e koho ai i ka manawa o ka lawe ʻana i nā peni? Pono e ʻōlelo pololei hiki iā ʻoe ke lawe i ka lāʻau lapaʻau ma mua o a ma hope o ka ʻai. ʻO ka ma mua mua he 4 mg o kēlā me kēia lā ma 1-2 inā. Ma hope o nā hebedoma 6-8, hiki ke hoʻonui ʻia i ka dosage ʻelua mau manawa ʻelua. Hoʻomaopopo ʻia kahi hoʻonui inā ʻike ʻia i ka 4 mg normalization o ke kō koko koko.

Nā maʻi hoʻohālikelike i ka hoʻohana ʻia ʻana o ka lāʻau lapaʻau:

ʻAno maʻi type 1.
Allergy i nā māhele o ka lāʻau lapaʻau.
Lactation wā.
Nā makahiki o nā keiki (a hiki i ka 18 mau makahiki).
Kahawai
ʻO ka puʻuwai kūpilikiʻi a i ʻole kaʻehaʻole.

Ke hoʻohana nei iā Avandia, hiki i nā hopena hoʻopiʻi mai nā kino o nā mea hanu a i ʻole nā ʻōnaehana cardiovascular.

Aia nō hoʻi hiki ke hoʻonui ʻia ke kaumaha o ke kino. Ua kuhikuhi aku nā ʻōlelo i ka hopena e hiki ai i ka hopena ke alakaʻi i ka anemia, hana hewa o ka nui a me ka hypercholesterolemia. Akā hōʻike i nā loiloi maʻi e hoʻomaopopo ʻia ka holomua therapeutic. ʻO ke wikiō ma kēia ʻatikala e kamaʻilio e pili ana i ka hana a Metformin.

Nā hōʻailona no ka hoʻohana ʻana

ʻO ka maʻi diabetes mellitus Type II (non-insulin-depend) me ka hana ʻole o ka papa ʻaina, ʻoi aku hoʻi i nā maʻi hānai.

- E like me monotherapy a i ʻole hui pū ʻana i hui pū me nā ʻaila hypoglycemic waha a i ʻole i hui pū ʻia me ka insulin no ka mālama ʻana i nā pākeke.

- E like me monotherapy a i ʻole hui pū me ka insulin no ka mālama ʻana i nā keiki i ʻoi aku ma mua o 10 mau makahiki.

ʻ a me ke kākele

Monotherapy a hui pū paha hui e hui pū me nā mea hana waha hypoglycemic waha.

Nā pākeke ʻO ka maʻamau, ʻo ka maʻa mua o 500 mg a i ʻole 850 mg o ka metformin 2-3 mau manawa i ka lā i ka wā a ma hope o ka ʻai. Ma hope o nā lā 10-15 o ka mālama ʻana, pono ke hoʻoponopono ʻia i ke aniani e like me nā hopena o ke ana o ka nui o ka glucose o ka serum. Ke hoʻonui iki nei i ka hopena e kōkua i ka hōʻemi ʻana i nā hopena ʻaoʻao mai ka digestive tract.

ʻO ka nui loa e hōʻike ʻia ai he 3000 mg i kēlā me kēia lā, hoʻokaʻawale ʻia i 3 mau pona.

I ka mālamaʻana i nā dosis kiʻekiʻe, ʻo Metformin e hoʻohana ʻia i kahi waihona o 1000 mg.

I ka hihia o ke kao ʻana i ka mālama ʻana me Metformin, pono e hooki ʻia i ka lawe ʻana i kekahi ʻaila antidiabetic.

Hoʻohui hui pū ʻana me ka insulin.

E hoʻokō ʻoi aku ka maikaʻi o nā kaila glucose, hiki ke hoʻohana i ka metformin a me ka insulin e like me ka hui pū ʻana. ʻO ka pinepine, ʻo ka 500 mauʻai a i ʻole 850 mg o ka metformin 2-3 mau manawa i ka lā, ʻoiai ke koho ʻia ka nui o ka insulin e like me nā hopena o ke ana ʻana i ka glucose o ke koko.

Hoʻololi a hoʻohui pū paha i nā mea hoʻohui me ka insulin.

E na keiki. ʻ islelo ʻia ʻo Metformin no nā keiki ma mua o 10 mau makahiki. ʻO ka maʻamau, ʻo ka dosis mua he 500 mg a i ʻole 850 mg o ka metformin 1 manawa i ka lā i ka wā a ma hope o ka pāʻina. Ma hope o nā lā 10-15 o ka mālama ʻana, pono ke hoʻoponopono ʻia i ke aniani e like me nā hopena o ke ana o ka nui o ka glucose o ka serum.

Ke hoʻonui iki nei i ka hopena e kōkua i ka hōʻemi ʻana i nā hopena ʻaoʻao mai ka digestive tract.

ʻO ka dosis kiʻekiʻe loa e hōʻike ʻia ana ʻo 2000 mg i kēlā me kēia lā, mahele ʻia i 2-3 pona.

I nā maʻi maʻi maʻi hana 'ia no ka renal functioning, no laila, pono ke koho pono' ia ka helu o ka metformin e pili ana i ka loiloi o ka hana papau, kahi hana pono.

Hoʻopili pū me nā lāʻau ʻē aʻe

ʻAʻole i pili ʻole me ka ethanol, ka diuretika loop, nā iodine e pili ana i ka radiopaque, no ka mea e hoʻonui ai i ka nui o ka acidact lactic, ʻoi aku hoʻi i nā hihia o ka pōloli a me kaʻai haʻahaʻa-calorie. I ka wā o ka hoʻohana ʻana i ka metformin, waiʻona a me ka waiʻona waiʻona e pono ke pale ʻia. Ke hoʻokō nei i kahi hōʻike X-ray, pono e kāpae ʻia ka lāʻau lapaʻau ma loko o nā hola 48 a ʻaʻole i hoʻōla hou i loko o 2 mau lā ma hope o ke aʻo ʻana.

E hoʻohana me ka akahele me ka hui pū me nā anticoagulants kūpaʻa a me ka cimetidine. ʻO nā derivatives o Sulfonylurea, insulin, acarbose, monoamine oxidase inhibitors (MAOs), oxytetracycline, angiotensin e hoʻohuli ana i ka enzyme (ACE) inhibitors, clofibrate, cyclophosphamide a me salicylates e hoʻonui i ka hopena o ka metformin.

Me ka hana like me ka glucocorticosteroids, ua hui pū ʻia ka ʻōpū o ka waha, ka epinephrine, ka glucagon, nā thyroid hormones, ka huaʻala o nā phenothiazine, ka momona nicotinic, thiazide diuretics, kahi hoʻemi i ka hopena o ka metformin i hiki.

Hoʻonui ka Nifedipine i ka hoʻopili ʻana, C_maxkaho luhi i ka excretion.

ʻO nā mea kūmole (nā amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamteren, a me ka vancomycin) hoʻokūkū i nā ʻōnaehana o ka maʻi tubular a, me ka hoʻomanawanui lōʻihi, hiki ke hoʻonui i ka C_max e 60%.

ʻO nā mea mālama palekana

Lactic acidosis He hopena hoʻopiʻi kūlohelohe akā paʻakikī ka hiki ke hele mai ma muli o ka hoʻopiʻi ʻana o ka metformin hydrochloride. ʻO nā hihia o ka acidosis lactic i loko o nā mea maʻi me ka maʻi mellitus me ka hopena ʻole o ka renal nui i hōʻike ʻia. ʻO nā mea pilikia no ka acidosis lactic: ke kaukaʻi ʻole ʻia e ka maʻi mellitus, ketosis, hoʻoku ʻana lōʻihi, ka ʻawaʻawa ka nui o ka waiʻona, ka maʻi hema ʻana, a i ʻole kekahi ʻano pili i ka hypoxia.

Hōʻoia ka lactic acidosis e nā mākeke o ka mākona, ka waikawa o ka hanu, ka ʻeha o ka ʻōpū a me ka hypothermia, hiki ke hoʻomohala hou. ʻO nā hōʻailona o ka hana lōkahi o ka uluʻana o ka lactic acidosis he hoʻonui i nā pae o ka serum lactate ma mua o 5 mmol / l, kahi hōʻemi i ka koko pH i ke kakano electrolyte, a me ka hoʻonui ʻana i ka lactate / pyruvate ratio. Inā kānalua ka lactic acidosis, pono e pani i ka hoʻohana ʻana i ka lāʻau lapaʻau a hoʻokaʻawale i ka mea maʻi.

ʻO Renal hiki ʻole. ^ E Ha yM. No ka mea, ua hoʻohālikelike ʻia ka metformin e nā keiki, ma mua a i ka wā e mālama ai me ka Metformin, pono e nānā pono nā pae serum creatinine, ʻoi aku i nā mea maʻi me nā hana renal impaired a ma nā mea maʻi. Hoʻohana pono ʻia ka mālama ʻana i nā hihia kahi e pilikia ai ka hana o ka renal, no ka laʻana, me ka hoʻomaka ʻana o ka mālama ʻana me nā lāʻau antihypertensive, diuretics, a i ka hoʻomaka ʻana o ka hopena NSAID.

ʻO nā mea hoʻopihapiha Iodine. ^ E Ha yM. Ke hana nei i nā haʻawina radiological me ka hoʻohana ʻana i nā ʻaina radiopaque, pono e pani i ka hoʻohana ʻana o ka metformin 48 mau hola ma mua o ke aʻo ʻana a ʻaʻole i hoʻokau hou ma mua o nā hola 48 ma hope o ka hoʻokolokolo ʻana a me ka loiloi o ka hana kūleʻa.

Nā mea lawelawe. ^ E Ha yM. Pono e ho'ōla i ka hoʻohana ʻana o ka metformin 48 mau hola ma mua o ke komo ʻana o ka hoʻomaʻamaʻi ʻana i hoʻolālā ʻia, a ʻaʻole hoʻi e hoʻokau hou ma mua o 48 mau hola ma hope o ka hana a me ka loiloi o ka hana honu.

E na keiki. Wahi a nā hopena o nā noiʻi ʻoihana ma ka hopena, ʻaʻole i hōʻike ʻia ka hopena o ka metformin i ka ulu a me ka puberty ma nā keiki. Eia nō naʻe, ʻaʻohe ʻikepili ma ka hopena o ka metformin i ka ulu a me ka puberty me ka hoʻohana mau ʻana i ka metformin, no laila pono e hoʻohana i ka lāʻau lapaʻau me ka mālama kūikawā i nā keiki i ka wā o ka wā kamaliʻi, ʻoiai paha i nā makahiki he 10 a 12 paha.

Pono ka poʻe maʻi e hahai i ka ʻai a nānā i nā ʻāpana laboratorium. Me ka hoʻohana pū ʻana o ka metformin me ka ololi a i ʻole ka hopena sulfonylurea, hiki i ka hoʻonui ʻia ʻana o ka hopena hypoglycemic.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini.

Ke hui pū ʻia kahi lāʻau lapaʻau me nā lāʻau lapaʻaka hypoglycemic ʻē aʻe (sulfonylurea derivatives, insulin), hiki i ke kūlana hypoglycemic ke hanana i ka hiki ke alakaʻi i nā kaʻa a me nā hana ʻē aʻe ʻē aʻe e koi ai i ka nānā nui a me ka wikiwiki o ka hopena psychomotor.

Hoʻohana i ka wā hāpai a me ka lactation

Hoʻokomo ʻia ka lāʻau lapaʻau no ka hoʻohana ʻana i ka wā hāpai a i ka wā a ka umauma.

I ka manawa e hoʻomaka ana a hoʻomaka i ka hāpai ʻana, pono e hoʻokaʻawale ke metformin a i ʻōkohu ʻia i ka insulin. Pono e hōʻike ʻia ka mea maʻi e pili ana i ka pono e hōʻike i ke kauka inā he hapai. Pono ka nānā o ka makuahine a me ke keiki.

ʻAʻole i ʻike ʻia inā excreted i ka metformin i loko o ka waiū umauma. Inā pono, e hoʻohana i ka lāʻau lapaʻau i ka wā lactation e ho'ōki i ka umauma.

Ka hana o ka hana o ka metformin

Metformin hoʻōla ka hoʻokuʻu ʻana o ka enzyme hepatic AMP-activated kinase protein (AMPK), nona ke kuleana o ka metabolism a me ka momona. Pono ʻia ka hana AMPK no pale i ka hopena o ka metformin i ka gluconeogenesis i loko o ka puʻuwai.

Ma kahi o ka hoʻokapu ʻana i ke kaʻina o ka gluconeogenesis ma loko o ka ate hoʻonui ka metformin i ka hoʻonaninani ʻana i ka inika, e hoʻonui i ka uptake glucose peripheral, hoʻonui i ka hoʻohuihui momona momona, ʻoiai e hoʻemi ana i ka hoʻoliʻi glucose ma ka gastrointestinal tract.

E hoʻokomo maʻalahi ia, a laila ma hope o ka ʻai me ka ʻai o nā mea laʻa kāwailua i loko o ke kino, e hoʻomaka ʻia ke kūmākena pancreatic e mālama i nā pae koko i loko o nā palena maʻamau. ʻO ka kalapona e mau nei i loko o nā meaʻai i kāwili ʻia i loko o nā ʻāpana a huli i ka glucose, kahi e komo ai i ke kahe. Me ke kōkua o ka insulin, ua hāʻawi ʻia i nā ʻāpana a loaʻa i ka ikehu.

Hiki i ke aʻuhima a me nā puʻuwai ke mālama i nā glucose keu, a hoʻokuʻu koke iā ia i loko o ke kahe koko inā pono (no ka laʻana, me ka hypoglycemia, me ka hoʻoikaika kino). Eia kekahi, hiki i ka ate ke mālama i ka glucose mai nā mea kanu ʻē aʻe, no ka laʻana, mai nā momona a me nā waikawa amino (nā ʻōnaehana o nā protein).

ʻO ka hopena nui o ka metformin ka hoʻololi ʻana (ka paʻa ʻana) o ka hana o ka glucose e ka ʻāʻī, ʻo ia ka mea maʻamau no ka maʻi maʻi type 2.

Hōʻike ʻia kahi hopena o ka lāʻau lapaʻau i ka lohi ʻana o ke kaʻe o ka glucose i loko o nā pā, e hiki ai iā ʻoe ke kiʻi i ke koena o ke koko haʻahaʻa ma hope o ka ʻaina (a me ke kōpaʻa koko postprandial), a me ka hoʻomaikaʻi ʻana i ka paʻakai i nā ʻāpana o ka insulin (e hoʻomaka ana nā ʻōleʻa i pane hou aʻe i ka insulin, ka mea i hoʻokuʻu ʻia i ka wā o ka uptake glucose).

Hōʻailona o Dr. R. Bernstein ma metformin: "Loaʻa i ka hoʻohanaʻana o Metformin i kekahi mau waiwai kūpono - e hōʻemi ana i ka loaʻa ʻana o ka maʻi kanesa a kāohi ʻia i ka hiʻona ʻana o ka hiʻona ʻana, a laila hoʻi e hōʻemi ai i ka ulu ʻana. Akā, i koʻuʻike, ʻaʻole e like nā like āpau o ka metformin. Hoʻomau mau wau iā Glucophage, ʻoiai ʻoi aku ka mea ma mua o kona mau hoa mai ”(Diabetes Soluton, 4 edition. P. 249).

Pehea ka wikiwiki o ka metformin?

Ma hope o ka lawelawe waha, ua hoʻopili ʻia ka pā metformin i loko o ka ʻeha gastrointestinal. Hoʻomaka ka hana a ka mea hana ikaika 2,5 hola ma hope o ka hoʻokele ʻana a hala hope o 9-12 mau hola e hoʻoneʻe ʻia e nā keiki. Hiki i ka metformin hōʻiliʻili i loko o ke ake, nāole, a me nā ʻōpū o ke ʻano.

Hoʻololi pinepine ʻia ka metforminum ma ka hoʻomaka ʻana o ka hopena. ʻelua a ʻekolu mau manawa i kēlā lā ma mua a i ʻole ma hope o ka ʻai, 500-850 mg. Ma hope o kahi papa hana 10-15-lā, ka loiloi ʻia o kona pono ma ka kōʻai koko, a inā pono, hoʻonui ʻia ke ʻano ma lalo o ka mālama ʻana o kekahi kauka. ʻ .lelo helu Metformin nui paha e hoʻonui i ka 3000 mg. ^ E Ha yM. i kēlā me kēia lā, hoʻokaʻawale ʻia i 3 mau pālua like.

Inā ʻaʻole emi ka pae koko koko i ka maʻamau, a laila e noʻonoʻo ʻia ka nīnau no ka koho ʻana o ka hui hoʻohui. Loaʻa nā lāʻau lapaʻau metformin i loaʻa i ka mākeke Lūkia a me Iukelika, nā ʻāpana: Pioglitazone, Vildagliptin, Sitagliptin, Saksagliptin a me Glibenclamide. Hiki nō hoʻi ke kuhikuhi i ka launa hui me ka insulin.

ʻO ka metformin lōʻihi lōʻihi e hana nei a me nā mea hoʻohālike

No kēia hoʻokuʻu i nā pilikia o gastrointestinal a hoʻomaikaʻi i ke ola o nā mea maʻi, ua hoʻomohala ʻia ʻo Farani metformin lōʻihi. ^ E Ha yM. Glucophage Long - kahi lāʻau lapaʻau me ka hoʻokuʻuʻole ʻana i nā mea hana ikaika, hiki ke lawe wale ʻia i hoʻokahi manawa i kēlā me kēia lā. Ke pale nei kēia kaʻina hana i ka hoʻokipa ʻana o nā peaks i ka paʻa ʻana o ka metformin i ke koko, he hopena maikaʻi i ka hoʻomanawanui o ka metformin a me ka hōʻemi ʻana i ka hopena o nā pilikia o ka hana ʻana.

ʻO ka hoʻopili ʻana o ka metformin ka lōʻihi i ka hanana o ka digestive tract kiʻekiʻe. Ua hoʻomohala e nā ʻepekema ʻepekema ka ʻōnaehana diffusion o ka gelShield ("ka pū i loko o ka gel"), he mea kōkua i ka metformin e neʻeneʻe iki a hoʻokuʻu i ka puka papa.

ʻO nā mea hoʻohālike metformin

ʻO ka laʻa like ʻole ka Palani Hoʻolaha. ^ E Ha yM. Nui nā hui (generics) o ka metformin. Hoʻopili kēia me ka hoʻomākaukau ʻana o Rukia Gliformin, Novoformin, Formmetin a me Metformin Richter, Keleman Metfogamma a me Siofor, Kūkulu Formin Pliva, ʻAtenean Bagomet, Israeli Metformin-Teva, Slovak Metformin Zentiva.

ʻO ka lōʻihi ka hoʻolālā metformin analogs a me kā lākou kumukūʻai

Pehea e pili ai ka metformin i ka pūpū a me nā keiki?

Metformin mau hopena paha i ke kōpaʻa a me nā ʻiliNo laila, pāpā ʻia ka lawe ʻana aku i nā mea maʻi i nā maʻi maʻi (me ka loaʻa ʻole o ka renal maikaʻi ʻole, hepatitis, cirrhosis, etc.).

Pono e hōʻalo ʻia ka metformin i nā maʻi me cirrhosis. ka hopena o ka lāʻau i ka pololei i loko o ka pehu a hiki i ke kumu i loko o ia mea a alakaʻi i ka hypoglycemia koʻikoʻi, ke kāohi i ka synthesis o gluconeogenesis. Loaʻa paha i ka hoʻokumu ʻana i ka momona i loko o ke akea.

Eia nō naʻe, i kekahi mau hihia, ʻike nui ʻia ka metformin i nā maʻi o ka naʻau, no laila ke mālama pono ʻia ka maʻi o ka peʻa i ka lawe ʻana i kēia lāʻau lapaʻau.

I ka maʻi hepatitis, pono e haʻalele ʻia ka metformin, no ka mea e hele aʻe paha ka maʻi ʻeha. I kēia hihia, ʻoi ʻia ka hoʻomaʻamaʻa ʻana i ka maʻi o ka insulin, ʻo komo pololei ka insulin i loko o ke koko, e kahe ana i ka nuku, a i ʻole kuhikuhi i ka mālama ʻana me ka sulfonylureas.

ʻAʻole i ʻike ʻia nā hopena ʻokoʻa o ka metformin ma luna o ke akeʻai.

Hiki iā ʻoe ke heluhelu hou ma ka pūnaewele. e pili ana i ka lawe ʻana i ka metformin no ka maʻi maʻi.

Pehea e pili ai ka metformin i nā wahine hāpai me ka maʻi maʻi gestational?

ʻO ke koho ʻana i ka metformin i nā wahine hāpai ʻaʻole he contraindication pololei loa; ʻoi aku ka maikaʻi o ka maʻi maʻi gestational uncompensated Eia nō naʻe, eia naʻe Hōʻike pinepine ʻia ka insulin e hana i ka maʻi diabetes gestational. ʻO kēia ka mea i wehewehe ʻia e ka hopena hakakā o nā noiʻi i ka hopena o ka metformin i nā maʻi maʻi hāpai.

ʻO kekahi noiʻi i ʻAmelika Huipū ʻia i hōʻike mai ua palekana ka metformin i ka wā hāpai. ʻO nā wahine me ka maʻi maʻi maʻi gestational i lawe i ka metformin he mea liʻiliʻi loa ka loaʻa ʻana o ka loaʻa ʻana i ka wā hāpai ma mua o nā mea maʻi ma ka insulin. ʻO nā keiki i hānau ʻia i nā wahine i loaʻa i ka metformin he haʻahaʻa haʻahaʻa ia i ka momona visceral, kahi e hōʻemi ai lākou i ka paleʻana i ka insulin i ka hope o ke ola.

I nā hoʻokolohua holoholona, ʻaʻole i ʻike ʻia ka hopena maikaʻi o ka metformin i ka hoʻomohala ʻana i ka wahine hāpai.

ʻOiai i kēia, i kekahi mau ʻāina, ʻaʻole i ʻōlelo ʻia ka metformin e hoʻohana ʻia e nā wahine hāpai. No ka laʻana, ma Kelemania, ua kāohi maoli ʻia ke ʻano o kēia lāʻau lapaʻau i ka wā hapai a me nā maʻi maʻi gestational, a me nā poʻe maʻi e makemake nei e lawe i nā āpau āpau a uku i kā lākou ponoʻī. Wahi a nā kauka Kelemania, hiki i ka metformin ke hopena i ka hopena o ka ʻōpio a hana i kona predisposition e kū'ē i ka insulin.

Me ka lactation, pono ke kiʻina ʻia ka metformin.no ka mea ua komo ʻia i ka waiū umauma. Pono e hoʻōla ʻia ka lāʻau me ka metformin i ka wā aloha.

Pehea e pili ai ka metformin i nā ovaries?

ʻO ka Metformin ka hoʻohana pinepine ʻia no ka mālama ʻana i ke ʻano maʻi type 2, akā ua ʻōlelo ʻia no ka polycystic ovary syndrome (PCOS) ma muli o ka pilina o kēia mau maʻi, no ka mea Hoʻohā pinepine ka lāʻau polycystic ovary i ka pale ʻana i ka insulin.

Ua hoʻokō ʻia nā hoʻokolohua hauoli ma 2006-2007 e ʻoi aku ka maikaʻi o ka metformin no ka polycystic ovary ma mua o ka hopena pletebo, a me ka metformin i hui pū ʻia me clomiphene ʻaʻole maikaʻi ma mua o clomiphene wale nō.

Ma UK, ʻaʻole kōkua ʻia ka hoʻohana ʻana i ka metformin ma kahi o ka lālani mua o ka lāʻau no ka polycystic ovary syndrome. Hōʻike ʻia ke kumu o clomiphene ma ke ʻano he hōʻike a me ka pono o nā loli ola, ke ʻano o ka mālama ʻana i ka lāʻau lapaʻau.

ʻO ka Metformin no ka maʻi wahine

Ua hōʻike ʻia kekahi mau haʻawina o ka lāʻau lapaʻau i ka hopena o ka metformin i ka maʻiʻino, a me nā clomiphene. Pono e hoʻohana ʻo Metformin i ka lāʻau lapaʻau ʻāpana lua inā i hōʻike ʻia ka mālama ʻana me ka clomiphene i hōʻike ʻia ʻaʻole pono.

Kūleʻa kekahi hōʻike hou i ka metformin me ka hoʻokaʻawale ʻana me ke koho pono o ka mālama mua ʻana, no ka mea e loaʻa ana ka hopena maikaʻi ʻaʻole i ka anovulation wale nō, akā no ka pale ʻana i ka insulin, ka hirsutism a me nā momona, i mālama pinepine ʻia me PCOS.

ʻO nā maʻi maʻi a me ka metformin

Hiki ke kuhikuhi ʻia ka metformin no ka prediabetes (nā mea i pilikia i ka hoʻomohala ʻana i ke ʻano maʻi type 2), ʻo ia ka mea e hōʻemi i kā lākou manawa no ka hoʻomohala ʻana i ka maʻi, ʻoiai kahi mea hoʻoikaika kino a me ka pāʻai me nā mea hōʻemi o nā kalepona i ʻoi aku ka makemake no kēia kumu.

MaʻAmelika Hui Pū ʻIa, ua hana ʻia kahi haʻawina e like me kahi pūʻulu o nā kumuhana i hāʻawi ʻia i ka metformin, a ʻo kekahi ʻē aʻe i komo no ka hākena a hahai i kahi papaʻaʻai. I ke hopena, ʻo ka ulu ʻana o ka maʻi maʻi ma ka pūʻulu o ke olakino olakino e 31% emi ma mua o ka prediabetics e kiʻi ana i ka metformin.

Eia kahi mea a lākou e kākau ai e pili ana i ka prediabetes a me ka metformin i loko o kahi loiloi ʻepekema i paʻi ʻia ma PubMed - ka ʻōlelo Pelekane-ʻōlelo Pelekane o nā pono a me nā paʻi olakino (PMC4498279):

"ʻO ka poʻe me ke kō koko koko kiʻekiʻe, ʻaʻole ka maʻi me ka maʻi maʻi maʻi, e hopohopo no ka hoʻomohala ʻana i ke ʻano maʻi diabetes ʻano 2, ka mea i kapa ʻia" prediabetes. maʻi pākaukau pili pinepine i palena palena ka wikiwiki o ka glucose i loko o ke kaila koko (ʻaʻai huakaʻi ʻai wikiwiki) a i ʻole a pae paha i ka pae o ka glucose i loko o ke koko koko i hāʻawi ʻia i mau hola 2 ma hope o ka hoʻāʻo ʻana i ka hoʻoliʻi waha ma ka 75 g. ka meli (ʻaina glucose i hoʻohaʻahaʻa). I USA, ʻo ka palena o ka palena o ka hemoglobin glycated (HbA1c) i manaʻo ʻia he prediabetes.
ʻO ka poʻe me ka prediabetes ka nui o ka piʻi ʻana o ka pōʻino o kā ka microvascular me ka hoʻomohala ʻana o nā maʻi macrovascular.like me nā hoʻopiʻi lōʻihi o ka maʻi diabetes. Ke hoʻolei a hōʻole hou i ka holomua o ka hoʻemi ʻana i ka hoʻāʻo ʻana i ka insulin a me ka luku ʻana i nā hana β-cell ka mea nui i ka hoʻokō ʻana i ka maʻi diabetes type 2.

Ua hoʻomohala ʻia nā hana he nui i ke kau ʻana o ka momona: ʻo ka lapaʻau lāʻau lapaʻau (metformin, thiazolidinediones, acarbose, nā kuhi ʻana i ka insulin basal a lawe i nā lāʻau lapaʻau no ka lilo ʻana o ka mea hoʻolilo), a me ka ʻoihana ʻoiatric. Hoʻokumu kēia mau hana i ka hoʻemi ʻana i ka maʻi o ka maʻi diabetes type 2 i ka poʻe me ka prediabetes, ʻoiai ʻaʻole mau nā hopena maikaʻi i ka manawa mau ʻia.

Hoʻonui ka Metformin i ka hana o ka insulin i ka pīpī a me ka hāmeʻe ʻālaʻia ʻo kona hana pono ʻana i ka hiki ʻana a pale i ka hoʻomaka ʻana o ka maʻi diabetes ua hōʻike ʻia ma nā ʻano nui, hoʻolālā maikaʻi ʻia, nā hoʻokolohua maʻamau.

me nā papahana pale pale diabetes. Ua hōʻike ʻia i nā decades o ka hoʻohana ʻana i nā lāʻau lapaʻau metformin maʻamau maʻamau ʻae a me ka palekana. "

Hiki iaʻu ke lawe i ka Metformin no ka pohō kaumaha? Nā hopena noiʻi

Wahi a nā haʻawina, hiki ke kōkua ana i ka metformin i kekahi poʻe e hōʻemi i ka paona. Eia nō naʻe, eia naʻe ʻaʻole naʻe i maopopo ka pehea e alakaʻi ai ka metformin i ka pohō kaumaha.

ʻO hoʻokahi ʻano manaʻo e hōʻemi ana ke metformin i ka momona, e hoʻolilo i ka kaumaha. ʻOiai ka mea nāna e kōkua ka metformin e lilo i ka momona, ʻaʻole kuhi pololei ʻia kēia lāʻau lapaʻau no kēia kumu.

Wahi a randomly study wā lōʻihi (see: PubMed, PMCID: PMC3308305), ʻoi aku ka pohō kaumaha mai ka hoʻohana ʻana i ka metformin e hāneʻe i loko o ka hopena, ma mua o hoʻokahi a ʻelua mau makahiki. Hoʻololi ʻē ka helu o nā kilograms i waena o nā poʻe ʻē aʻe a pili pū i nā mea ʻē aʻe - me ke kumukūʻai o ke kino, me ka helu o nā kalori i hoʻopau ʻia i kēlā me kēia lā, me ke ʻano ola. E like me nā hualoaʻa o ke aʻo ʻana, nā kumuhana, ma ka awelika, nalo mai ka 1.8 a he 3.1 kg ma hope o ʻelua mau makahiki a i ʻole ka lawe ʻana i ka metformin. Hoʻohālikelike ʻia me nā ala ʻē aʻe o ka hoʻolilo ʻana i ka momona (haʻahaʻa-pahu liʻiliʻi, ʻaina kino olakino, wikiwiki, wikiwiki), ʻoi aku kēia ma mua o kahi hopena haʻahaʻa.

Ma muli o ka mālama ʻana i ka lāʻau lapaʻau me ka ʻole e nānā ana i nā ʻaoʻao ʻē aʻe o ke ola kino e alakaʻi i ka lawe kaumaha. ʻO ka poʻe e hahai ana i kahi meaʻai olakino a hoʻomaʻamaʻa aʻo ka lawe ʻana i ka metformin e lilo ka nui o ke kaumaha. ʻO kēia ma muli o ka mea i hoʻonui ai i ka metformin i ka nui o ka puhi ʻana i nā kalori i ka wā e hoʻomaʻamaʻa ana. Inā ʻaʻole ʻoe e pili i ka haʻuki, a laila ʻaʻole ʻoe ʻoe e loaʻa i kēia pono.

Eia kekahi, e hoʻomau ka loaʻa o ke kaupaona i ka manawa e lawe ai ʻoe i ka lāʻau lapaʻau. ʻO kēia ke kaʻa inā pau ʻoe e lawe i ka metformin, nui nā manawa e hoʻi i ka paona kumu. A i kāu lawe ʻana ʻoe i ka lāʻau lapaʻau, hiki iā ʻoe ke hoʻomaka malie e loaʻa ka kaumaha. I nā huaʻōlelo ʻē aʻe ʻaʻole metformin he "pill pulu" no ka lilo ʻana o ka mea kaumaha kue i na manao o kekahi poe. E heluhelu hou e pili ana i kēia ma kā mākou mea: ʻO ka hoʻohana ʻana i ka metformin no ka hoʻolilo ʻana i ka momona: nā loiloi, nā hōʻike, ʻōlelo ʻōlelo

Ua kuhikuhi ʻia ʻo metformin no nā keiki?

ʻO ka ʻae ʻana o nā metformin e nā keiki a me nā ʻōpio i ʻoi aku he ʻumi makahiki o ke makahiki he ʻokoʻa - ua hōʻoia ʻia kēia i nā haʻawina ʻoihana like ʻole. ʻAʻole lākou i hōʻike i kekahi mau hopena kikoʻī e pili ana i ka hoʻomohala ʻana o ke keiki, akā pono e mālama ʻia ke ʻano ma lalo o ka mālama ʻana o kekahi kauka.

Hoʻopau ka Metformin i ka hana o ka glucose i loko o ke akea (gluconeogenesis) a hoʻonui i ka ʻike ʻana i nā ʻāpana o ke kino i ka insulin.
ʻOiai ka kiʻekiʻe kiʻekiʻe o ka lāʻau lapaʻau i ka honua, ʻaʻole i maopopo ka ʻano o ka hana a ke ʻano, a he nui nā haʻawina e kūʻē kūʻē kekahi i kekahi.
ʻO ka lawe ʻana i ka metformin ma mua o 10% o nā hihia e hoʻokau ai i nā pilikia o ka ʻōpū. No ka hoʻopau ʻana i kēia pilikia, ua hoʻomohala ka lōʻihi o ka metformin (ʻo ka Glucofage Long ka mea maʻamau), e hoʻohaʻahaʻa ana i ke kaʻa o ka mea ikaika a hana i kona hopena ma ka ʻōpū i ʻoi aku ka nui o ka sparing.
ʻAʻole pono ʻo Metformin e lawe ʻia no nā maʻi ʻeha hōʻeha (hepatitis maʻi, cirrhosis) a me nā pōpilikia (kidney renal failed, ʻeha nephritis).
I ka hui pū me ka waiʻona, hiki i ka metformin ke hoʻomake i kahi maʻi lactic acidosis maʻi, ʻo ia ke kumu e pāpā ʻia ʻole ai ka lawe ʻana i nā mea ʻawaʻawa me nā dosis wai nui.
Hoʻohana ka lōʻihi o ka metformin i ka nele o ka vitamin B12, no laila e noʻonoʻo e lawe i nā mea hoʻohui o kēia huaora i ka manawa ʻē aʻe.
ʻAʻole ʻōlelo ʻia ʻo Metformin no ka hāpai ʻana a me ka maʻi maʻi gestational, a me ka hoʻomaʻamaʻa ʻana hoʻi, e like me komo i loko o ka waiū.
ʻAʻole ʻo ia ka Metformin he "magic pill" no ka poho kaumaha.ʻOi aku ka maikaʻi o ka hoʻoluhi ʻana ma o ka hahai ʻana i kahi meaʻai olakino (e pili ana hoʻi i ka kaupalena ʻana i nā momona) me ka hana kino.

Nā Kumuwai:

Petunina N.A., Kuzina I.A. Hāʻawi lōʻihi i ka metformin analogs // Ke hele nei i ke kauka. 2012. No3.
No ke kumu ka metformin acidact lactic acidosis? / Hōʻike loiloi Cochrane: nā manaʻo nui // ʻO ka lono o ka lāʻau lapaʻau a me ka lāʻau lapaʻau. 2011. No. 11-12.
ʻO ka palekana lōʻihi, ʻokoʻa, a me ka momona kaumaha e pili pū ana me ka Metformin i ka papahana hoʻomaʻemaʻe pū ʻana i ka maʻi diabetes. 2012 Apr, 35 (4): 731–737. PMCID: PMC3308305.