Txhawm rau cov ntshav qab zib nyob rau hauv ntshav qab zib kom muaj ntshav qab zib, tshwj xeeb kev txo cov ntshav qab zib yog siv. Metformin suav hais tias yog ib qho tshuaj zoo heev rau kev kho glycemia.
Cov tshuaj muaj ntau ntawm cov generics thiab pab pawg analogues. Tus mob ntshav qab zib tau txaus siab, tab sis yog tias Metformin muaj kev mob tshwm sim? Yog lawm, lawv yeej muaj.
Tab sis tam sim ntawd kuv xav nco ntsoov tias txhua qhov kev nyuaj tshwm sim tsuas yog nrog kev xaiv tshuaj tsis yog. Yog tias tus kws kho mob xaiv cov koob tshuaj uas tsim nyog, thiab ua ntej nyeem kom zoo zoo txog tus neeg mob keeb kwm kev noj qab haus huv, ces qhov muaj feem ntawm kev phiv yuav luag xoom.
Nqe thiab mechanism ntawm kev txiav txim ntawm cov tshuaj
Metformin yog ib qhov ncauj tshuaj hypoglycemic los ntawm pab pawg biguanide. Tus nqi tshuaj yog dab tsi? Hauv khw muag tshuaj, tus nqi nruab nrab ntawm Metformin yog 120-200 rubles. Ib pob muaj 30 ntsiav tshuaj.
Cov tshuaj tiv thaiv tseem ceeb ntawm cov tshuaj yog metformin hydrochloride. Kuj tseem muaj cov khoom xyaw pabcuam, xws li E171, propylene glycol, talc, hypromellose, silicon dioxide, magnesium stearate, pob kws nplej, povidone.
Yog li dab tsi yog cov nyhuv pharmacological ntawm metformin? Yog tias koj ntseeg tias cov lus qhia rau kev siv tshuaj, tom qab ntawd nws cov khoom siv cuam tshuam ua haujlwm raws li hauv qab no:
- Tshem tawm cov tshuaj insulin tsis kam. Qhov no yog qhov tseem ceeb heev, vim tias ntau tus neeg mob ntshav qab zib muaj peev xwm tiv taus qhov cuam tshuam ntawm insulin. Qhov no yog fraught nrog txoj kev loj hlob ntawm hyperglycemic coma thiab lwm yam loj pathologies.
- Pab ua kom qeeb kev nqus ntawm cov piam thaj ntawm txoj hnyuv. Vim tias qhov no, tus neeg mob tsis muaj lub ntsej muag zoo hauv cov ntshav qab zib. Kev txiav txim siab kom raug qhov tseeb ntawm Metformin, qib piam thaj yuav ruaj khov. Tab sis muaj flip sab rau cov kis. Metformin hydrochloride txuam nrog kev kho tshuaj insulin tuaj yeem ua rau kev txhim kho hypoglycemic coma. Yog vim li ntawd nrog kev siv cov tshuaj ib txhij no thiab kev siv cov tshuaj insulin, kev hloov kho ntau dua yuav tsim nyog.
- Nws inhibits gluconeogenesis nyob rau hauv daim siab. Txoj kev no muaj nyob hauv qhov hloov cov piam thaj, uas lub cev tau txais los ntawm lwm txoj hauv kev siv hluav taws xob. Vim tias ncua sij hawm tsim cov piam thaj los ntawm lactic acid, qab zib ntxiv thiab lwm yam mob ntshav qab zib tuaj yeem zam dhau.
- Txo qhov qab los noj mov. Ntau zaus, yam ntshav qab zib hom 2 yog qhov txiaj ntsig ntawm kev rog dhau. Tias yog vim li cas, tawm tsam keeb kwm ntawm kev noj zaub mov noj, tus neeg mob raug nquahu kom siv cov tshuaj tiv thaiv kab mob. Metformin muaj qhov tsis xws leej twg, vim nws pab tsis tsuas tswj cov ntshav qab zib kom tsis txhob muaj kab mob ntshav qab zib, tab sis kuj tseem nce cov txiaj ntsig ntawm kev noj zaub mov noj los ntawm 20-50%.
- Kuaj ntshav muaj roj. Thaum siv Metformin, qhov txo qis hauv qib ntawm triglycerides thiab qis lipoproteins tsawg tau pom.
Metformin hydrochloride tseem ua rau kev cuam tshuam ntawm cov txheej txheem peroxidation ntawm cov rog. Nov yog hom kev tiv thaiv mob qog noj ntshav.
Cov lus qhia thiab cov lus qhia rau siv Metformin
Lub sijhawm twg yog qhov siv ntawm Metformin tsim nyog? Yog tias koj ntseeg tias cov lus qhia rau kev siv, cov tshuaj yuav siv tau rau hauv kev kho mob ntshav qab zib hom 2.
Ntxiv mus, cov ntsiav tshuaj tuaj yeem raug siv los kho kev kho mob lossis tshuaj ua ke nrog lwm tus neeg mob hypoglycemic. Lwm qhov kev kho mob tau siv dav hauv qee qhov kev pabcuam kev noj zaub mov pab tsis muaj ntshav qab zib.
Nws yog tsim nyog teev cia tias qhov ntsuas ntawm kev siv Metformin tsis yog tas rau qhov no. Cov tshuaj yog siv dav hauv kev kho mob ntshav qab zib thiab cleropolicystosis ntawm zes qe menyuam. Ntawm cov kev ntsuas rau kev siv, metabolic syndrome thiab rog rog kuj yog qhov txawv txav, nrog kev txhim kho ntawm insulin tsis kam.
Yuav xaiv cov tshuaj Metformin ntau npaum li cas? Cov koob tshuaj txhua hnub ntawm Metformin tuaj yeem xaiv tshwj tsis yog qee tus. Hauv qhov no, tus kws kho mob yuav tsum tau paub nws tus kheej nrog cov ntaub ntawv keeb kwm, vim tias tus neeg sawv cev hypoglycemic no muaj ntau yam kev sib kis rau kev siv.
Kuv xav nco ntsoov tias Metformin muaj nyob hauv ntau koob. Nws tuaj yeem yog 1000, 850, 500, 750 mg. Ntxiv mus, muaj cov tshuaj mob ntshav qab zib ua ke uas muaj txog li 400 mg ntawm metformin hydrochloride.
Yog li, yog dab tsi ntau npaum noj tau? Thawj koob tshuaj ntawm Metformin yog 500 mg, thiab qhov ntau zaus ntawm kev tswj hwm yog 2-3 zaug hauv ib hnub. Koj yuav tsum siv cov tshuaj tam sim ntawd tom qab noj mov.
Tom qab ob peb lub lim piam ntawm kev kho mob, qhov tshuaj yuav tuaj yeem hloov kho. Txhua yam yuav yog nyob ntawm cov ntshav qab zib. Glycemia pom zoo kom ntsuas txhua hnub ntawm lub plab khoob. Rau cov laj thawj no, nws yog qhov zoo tshaj plaws los siv ntsej muag.
Metformin siv sijhawm ntev npaum li cas? Nws tsis muaj peev xwm los teb cov lus nug no. Thaum xaiv qhov ntev ntawm kev kho mob, tus yam ntxwv ntawm ib tus neeg yuav raug coj los txiav txim, tshwj xeeb, ntshav qabzib qib, qhov hnyav thiab hnub nyoog. Txoj kev kho mob tuaj yeem siv 15 hnub, 21 hnub, lossis "dhau" hauv ib hlis.
Qhov tshuaj ntau tshaj plaws ntawm Metformin yog 2000 mg ib hnub. Nws yuav tsum raug sau tseg tias nrog kev siv tshuaj insulin ib txhij, qhov koob tshuaj yuav tsum raug txo kom 500-850 mg ib hnub twg.
Cov tshuaj tiv thaiv thiab nta ntawm cov tshuaj
Txhua tus neeg saib xyuas cov piam thaj hauv qab yuav tsum tau ua tib zoo xaiv, vim nws muaj contraindications rau kev siv. Kev tsis quav ntsej ntawm kev kawm cov lus qhia tsuas yog qhov tsis lees paub, vim tias qhov no tuaj yeem ua rau tuag taus.
Yog li, dab tsi contraindications uas Metformin muaj? Kev siv tshuaj tiv thaiv nruj kom siv yog ib qho kev tsis haum rau metformin hydrochloride lossis ntu sib txuam ntawm cov tshuaj.
Kuj suav nrog contraindications:
- Mob acid los yog mob ntev.
- Tsis ntev los no muaj kev txom nyem myocardial infarction.
- Mob ntsws lossis mob plawv tsis zoo.
- Muaj teeb meem lub raum. Cov cuab yeej tsis pub coj mus rau cov neeg raug mob los ntawm kev mob raum tsis zoo.
- Laus lub caij nyoog. Cov tshuaj tsis raug txwv rau cov neeg mob ntshav qab zib uas nws hnub nyoog yog ntau dua 80 xyoo.
- Lub xub ntiag ntawm daim siab tsis ua haujlwm lossis lwm yam mob hnyav ntawm cov kab mob siab hepatobiliary.
- Kev siv dag zog ntau dhau los lossis kev noj zaub mov nruj, uas qhia kom txo qis caloric kom tsawg.
- Lub cev qhuav dej vim muaj cov kabmob kis tau zoo.
- Kev quav cawv
Lwm qhov kev tiv thaiv tsis zoo yog hypoxia, mob plab zom mov thiab mob plab duodenal.
Sab Tshuaj Los Ntawm Metformin
Qhov tshwm sim tshwm sim los ntawm Metformin yog dab tsi? Muaj qhov zoo li no yog ib qho tseem ceeb txaus ntshai ntawm cov kab mob hypoglycemic, tshwj xeeb hauv Metformin. Dab tsi nws muaj?
Qhov tseeb yog tias muaj yam mob ntshav qab zib hom 2, tus neeg mob yuav tsum soj ntsuam cov khoom noj tsis muaj calorie kom ntau, thiab tshwj xeeb tshaj yog cov nyiaj carbohydrates hauv nws. Yog tias tus mob ntshav qab zib siv hypoglycemic cov neeg sawv cev, thiab zaum ntawm cov zaub mov nruj, ces qhov ntxim nyiam ntawm kev txhim kho hypoglycemia yog qhov ntau heev - txo qis hauv cov ntshav qabzib.
Ntawm cov kev phiv los ntawm Metformin kuj tuaj yeem hais qhov txawv:
- Ua txhaum ntawm cov hom hematopoietic. Thaum siv cov Metformin, kev muaj peev xwm ntawm thrombocytopenia, leukocytopenia, erythrocytopenia, granulocytopenia, hemolytic anemia, pancytopenia tsis tuaj yeem tswj hwm tau. Tab sis nws yuav tsum raug sau tseg tias tag nrho cov kev cuam tshuam no yog qhov thim rov qab, thiab daws lawv tus kheej tom qab tshem tawm cov tshuaj.
- Ua tiav nyob rau hauv daim siab. Lawv pom tias yog kev loj hlob ntawm daim siab ua haujlwm thiab mob siab. Tab sis tom qab nws tsis kam Metformin, cov teeb meem no daws tau lawv tus kheej. Qhov no muaj tseeb los ntawm kev txheeb xyuas ntawm kws kho mob thiab cov neeg mob.
- Saj tsis cuam tshuam. Qhov kev tsis zoo no tshwm sim ntau zaus. Qhov tseem ceeb ntawm cov tshuab rau kev txhim kho saj cov nyom puas hlwb nyob hauv qab ntawm metformin hydrochloride tsis paub meej.
- Cov tawv nqaij ua pob, erythema, urticaria.
- Lactic acidosis. Qhov kev tsis txaus ntseeg no txaus ntshai heev. Nws feem ntau loj hlob yog tias kev xaiv cov tshuaj tsis yog, lossis yog tias tus mob ntshav qab zib tau haus cawv thaum lub sijhawm kho.
- Qhov kev ntxhov siab hauv kev ua haujlwm ntawm txoj hnyuv. Hom mob no tshwm sim ntau txaus, raws li muaj pov thawj los ntawm kev kuaj xyuas neeg mob. Cov teeb meem hauv lub plab zom mov tau tshwm sim los ntawm kev ua kom ntuav, ntuav, lub ntsej muag hlau hauv lub qhov ncauj, thiab tsis qab los noj mov. Tab sis hauv kev ncaj ncees nws yuav tsum tau sau tseg tias cov kev mob no tshwm sim thaum thawj theem ntawm kev kho mob, thiab tom qab ntawd daws lawv tus kheej.
- Txo tsawg dua kev nqus ntawm cov vitamin B12.
- General tsis muaj zog.
- Qog taub hau ntshav qab zib.
Yog tias cov teeb meem saum toj no tshwm sim, nws raug pom zoo kom siv rau pawg pawg sib piv ntawm Metformin thiab yauv mus kuaj mob.
Kev Sib Tham Yeeb Tshuaj Metformin
Metformin txo cov ntshav qabzib. Tab sis thaum sib cuam tshuam nrog qee cov tshuaj, cov tshuaj no ua kom zoo dua, lossis rov ua dua, txo nws cov nyhuv hypoglycemic.
Qhov no tuaj yeem ua rau tsis muaj kev cuam tshuam. Kuv tam sim ntawd xav nco ntsoov tias qhov kev tiv thaiv hypoglycemic tseem ceeb muaj txiaj ntsig zoo thaum sib xyaw nrog Metformin nrog sulfonylurea derivatives. Hauv qhov no, yuav tsum tau txhaj tshuaj.
Cov hauv qab no tuaj yeem ua rau kom muaj kev tiv thaiv hypoglycemic ntawm Metformin:
- Acarbose.
- Cov tshuaj nonsteroidal anti-inflammatory.
- Monoamine oxidase inhibitors.
- Oxytetracycline.
- Angiotensin-hloov ua enzyme inhibitors.
- Cyclophosphamide.
- Derivatives ntawm clofibrate.
- Beta blockers.
Corticosteroids, diuretics, analogues ntawm samostanin txo qis kev ua haujlwm ntawm kev kho ntshav qab zib nrog Metformin. Nws tseem tau sau cia tias cov nyhuv hypoglycemic tsawg dua nrog kev siv glucagon, thyroid hormones tib lub sijhawm, estrogens, nicotinic acid, calcium antagonists thiab isoniazids.
Nws tseem yuav tsum tau nco ntsoov hais tias cimetomedin, thaum sib tham nrog Metformin, ua rau muaj kev pheej hmoo ntxiv ntawm kev tsim mob lactic acidosis.
Cov tshuaj twg siv tau nrog rau metformin?
Hauv kev kho mob ntshav qab zib, ib yam yeeb tshuaj xws li Januvia feem ntau tau sau nrog kev sib xyaw nrog Metformin. Nws tus nqi yog 1300-1500 rubles. Lub hauv paus ua haujlwm tseem ceeb ntawm cov tshuaj yog sitagliptin.
Cov tshuaj no inhibits DPP-4, thiab nce qhov kev sib txuam ntawm GLP-1 thiab HIP. Cov tshuaj hormones ntawm tsev neeg incretin yog zais cia hauv cov hnyuv rau ib hnub, tom qab ntawd lawv qib nce tom qab noj mov.
Tus incretins yog ib qho kev sib koom ua ke ntawm lub cev kev txheeb ze rau kev tswj hwm ntshav qabzib homeostasis. Nrog kev ua kom cov ntshav qab zib ntau ntau, cov tshuaj hormones los ntawm tsev neeg no nce insulin synthesis thiab nws txoj kev zais los ntawm cov qe ntshav.
Yuav noj cov tshuaj li cas? Qhov tshuaj pib yog 100 mg 1 zaug nyob rau ib hnub. Tab sis ib zaug ntxiv, tus kws kho mob mus koom yuav tsum xaiv cov koob tshuaj kom zoo tshaj. Kev kho raug tso cai, tshwj xeeb tshaj yog yog tias Januvia siv nrog nrog Metformin.
Cov kev txwv tsis pub siv Januvia:
- Yam 1 ntshav qab zib.
- Ua xua rau cov tshuaj noj.
- Ntshav qab zib ketoacidosis.
- Lub sijhawm ntawm cev xeeb tub thiab lactation.
- Cov me nyuam lub hnub nyoog.
- Nrog ceev faj nyob rau hauv daim siab tsis ua hauj lwm. Nrog rau kev ua kom muaj kab mob ntshav siab kev tsis haum tshuaj, kev noj tshuaj txo qis yuav tsim nyog. Qhov no yog pov thawj los ntawm cov ntaub ntawv tshawb fawb, thiab tshuaj xyuas cov kws paub txog endocrinologist.
Cov tshuaj puas muaj kev phiv? Tau kawg, lawv muaj ib qho chaw nyob. Tab sis Januvia feem ntau ua rau muaj teeb meem thaum qhov ntau dua rau 200 mg. Thaum tswj hwm cov koob tshuaj qis, qhov ntxim nyiam ntawm kev phiv yog qhov tsawg heev.
Raws li cov lus qhia, thaum noj tshuaj, muaj teeb meem xws li mob ntsws, mob nasopharyngitis, mob taub hau, raws plab, xeev siab, ntuav, mob caj pas tuaj yeem tshwm sim.
Ntxiv thiab, qhov ntxim nyiam ntawm kev fab tshuaj tiv thaiv kev ua xua thiab lub qog ntshav qab zib tsis tuaj yeem siv tau.
Qhov zoo tshaj plaws ntawm Metformin
Qhov zoo tshaj plaws ntawm Metformin yog Avandia. Tus neeg sawv cev hypoglycemic no nws kim heev - 5000-5500 rubles. Ib pob muaj 28 ntsiav tshuaj.
Cov tshuaj tivthaiv kev ua haujlwm ntawm cov tshuaj yog rosiglitazone. Avandia yog siv rau hauv kev kho mob ntawm ntshav qab zib hom 2. Ntxiv mus, nws tuaj yeem siv txuas nrog Metformin, thiab tuaj yeem siv cais.
Yuav ua li cas xaiv lub sijhawm ntawm kev noj tshuaj? Nws yuav tsum tau hais tam sim ntawd koj tuaj yeem noj cov tshuaj ua ntej lossis tom qab noj mov. Thawj koob tshuaj yog 4 mg ib hnub nyob rau hauv 1-2 koob tshuaj. Tom qab 6-8 lub lis piam, cov koob tshuaj tuaj yeem tau nce ntxiv ob zaug. Ib qho kev nce ntxiv yog tsim yog thaum 4 mg normalization cov ntshav qab zib tsis tau pom.
Cov kev txwv tsis pub siv rau qhov tshuaj:
- Yam 1 ntshav qab zib.
- Kev tsis haum tshuaj rau cov feem ntawm cov tshuaj.
- Lactation lub sijhawm.
- Cov menyuam yaus hnub nyoog (txog 18 xyoo).
- Cev xeeb tub
- Mob lub plawv heev lossis lub raum tsis ua haujlwm.
Thaum siv Avandia, cov teeb meem cuam tshuam los ntawm cov kab mob ntawm cov pa ntawm txoj hlab ntsws lossis hlab plawv tuaj yeem tau.
Kuj tseem muaj qhov ua kom lub cev hnyav ntxiv. Cov lus qhia tseem sau tseg tias cov tshuaj no tuaj yeem ua rau mob ntshav tsis txaus, ua haujlwm ntawm lub siab thiab mob hypercholesterolemia. Tab sis kev tshawb xyuas neeg mob qhia tau tias kev kho mob kom zoo yog qhov ua tau zoo. Cov vis dis aus hauv tsab xov xwm no yuav tham txog Metformin ua haujlwm li cas.
