Tsis ntev los no, metformin-based hypoglycemic agents (Buformin, Metformin, Fenformin, thiab lwm yam) tau siv los kho ntshav qab zib. Lawv siv tau pom tseeb zoo. Xav txog cov yam ntxwv ntawm cov tebchaw no, lawv cov txiaj ntsig thiab cov hau kev ntawm kev kho mob ntshav qab zib nrog lawv cov kev pab.
Yuav ua li cas lawv ua haujlwm
Biguanides rau cov ntshav qab zib tau siv txij li xyoo 1970. Lawv tsis ua rau cov insulin secretion los ntawm txoj cai txiav. Qhov tshwm sim ntawm cov tshuaj no yog vim qhov tsis pom tseeb ntawm cov txheej txheem gluconeogenesis. Cov tshuaj feem ntau ntawm hom no yog Metformin (Siofor).
Tsis zoo li sulfonylurea thiab nws cov keeb kwm yav dhau los, Metformin tsis txo qis piam thaj thiab tsis ua rau cov ntshav qabzib. Qhov no tseem ceeb tshaj plaws tom qab kev pw ib hmos. Cov tshuaj txwv qhov nce hauv cov ntshav qab zib tom qab noj mov. Metformin tsub kom rhiab cov hlwb thiab cov nqaij hauv lub cev rau cov tshuaj insulin. Tsis tas li ntawd, nws txhim kho txoj kev ntws ntawm cov piam thaj mus rau hauv cov hlwb thiab cov ntaub so ntswg, txo nws txoj kev nqus hauv txoj hnyuv.
Metformin yog tus sawv cev tseem ceeb ntawm loj pawg ntawm cov tshuaj
Nrog rau siv ntev, biguanides muaj qhov cuam tshuam zoo ntawm cov roj metabolism. Lawv qeeb hauv cov txheej txheem ntawm kev hloov ua cov kua nplaum mus rau cov roj ntsha, thiab qee qhov kev txo cov ntsiab lus ntawm triglycerides, cov roj cholesterol hauv cov ntshav. Cov nyhuv ntawm biguanides nyob rau hauv qhov tsis muaj cov tshuaj insulin tsis raug kuaj.
Metformin tau zoo nqus los ntawm lub plab zom mov thiab nkag mus rau hauv cov ntshav ntshav, qhov twg nws siab tshaj plaws tau mus txog ob teev tom qab kev coj noj coj ua. Qhov kev tshem tawm ib nrab-lub neej yog ntev txog 4,5 teev.
Kev taw qhia thiab contraindications
Tej zaum siv cov biguanides txuam nrog cov tshuaj insulin. Koj tuaj yeem nqa lawv nrog kev sib xyaw nrog lwm cov tshuaj txo suab thaj.
Metformin tshwj xeeb yog qhia rau cov neeg mob ntshav qab zib thiab rog rog ntsig txog.
Cov tshuaj yog contraindicated nyob rau hauv xws li mob:
- mob ntshav qab zib insulin-tshwj tsis yog (tshwj tsis yog thaum nws tau sib xyaw nrog kev rog);
- kev txiav tawm cov kua dej ntau lawm;
- ketoacidosis;
- lub raum tsis ua haujlwm, ua kom lub siab ua haujlwm tsis zoo;
- hlab plawv thiab ua pa tsis ua haujlwm;
- lub cev qhuav dej, poob siab;
- cawv ntev ntev;
- lactic acidosis;
- cev xeeb tub, pub niam mis;
- kev noj zaub mov kom tsawg (tsawg dua 1000 kilocalories ib hnub);
- cov me nyuam muaj hnub nyoog.
Ceev faj yuav tsum tau siv rau hauv kev thov loj loj rau cov neeg laus dua 60 xyoo yog tias lawv koom nrog kev ua haujlwm nyhav. Hauv qhov xwm txheej no, nws muaj qhov pheej hmoo siab ntawm kev tsim muaj cov kab mob tuag tes tuag taw tsis hnov qab.
Phiv thiab haus tshaj
Txog thaj tsam li 10 txog 25 feem pua ntawm cov neeg mob, cov neeg mob noj loj dua cov kev mob tshwm sim xws li cov xim hlau hauv lub qhov ncauj, tsis qab los noj mov, thiab xeev siab. Txhawm rau kom txo qis kev txhim kho ntawm cov tsos mob no, nws yog ib qho tseem ceeb kom noj cov tshuaj no nrog lossis tom qab noj mov. Qhov muab tshuaj yuav tsum tau nce ntxiv maj mam.
Muaj qee kis, kev loj hlob ntawm megaloblastic anemia, cyanocobalamin tsis muaj peev xwm tau. Tsis tshua muaj pob, ua pob ua xua tshwm rau ntawm daim tawv nqaij.
Nyob rau hauv cov ntaub ntawv ntawm overdose, lactic acidosis tshwm sim. Cov tsos mob ntawm tus mob no yog ua kom tsis muaj zog, ua pa nyuaj, tsaug zog, xeev siab thiab raws plab. Txias ntawm qhov kawg, bradycardia, hypotension tsis pom zoo. Kev kho mob ntawm cov kab mob lactic acidosis yog yam mob.
Sau ntawv rau cov tshuaj thiab xaiv cov tshuaj yuav tsum yog kws kho mob nkaus xwb
Tsuas tshuaj
Qhov ntau thiab tsawg ntawm cov tshuaj yuav tsum tau teem ib zaug zuj zus mus. Koj yuav tsum nco ntsoov muaj glucometer ntawm tes. Nws kuj yog ib qho tseem ceeb yuav tsum tau coj los rau hauv kev saib xyuas lub neej zoo: feem ntau cov kev mob tshwm sim tsuas yog vim kev noj tshuaj tsis tsim nyog.
Kev kho mob nrog biguanides yuav tsum pib nrog ib koob tshuaj kom tsawg - tsis pub ntau tshaj 500-1000 g ib hnub (feem, 1 lossis 2 ntsiav tshuaj ntawm 0.5 g). Yog tias tsis muaj kev mob tshwm sim, tom qab ntawd cov koob tshuaj tau nce ntxiv. Qhov ntau tshaj plaws qhov ntau ntawm cov tshuaj ib hnub yog 3 grams.
Yog li, Metformin yog cov cuab yeej siv tau los kho thiab kho mob ntshav qab zib. Koj yuav tsum ua tib zoo ua raws li cov lus qhia rau kev siv tshuaj.
