Yuav noj cov Metformin uas muaj ntshav qab zib hom 2 li cas?

Daim insulin-ywj siab hais txog hom mob ntshav qab zib yog yam ntxwv ua los ntawm kev txiav ib feem ntawm kev tsim cov khoom qab zib uas muaj suab thaj. Cov tshuaj Metformin rau cov ntshav qab zib hom 2 yog siv yog tias nws tsis muaj peev xwm tswj tau cov piam thaj hauv ib txwm li (3.3-5.5 mmol / litre) siv cov khoom noj tshwj xeeb thiab kev tawm dag zog.

Vim muaj koob meej hauv ntiaj teb, Metformin yog tsim nyob rau hauv ntau cov npe khoom lag luam. Puas yog tus neeg sawv cev hypoglycemic no txo qis qis ntshav qab zib, thiab yuav ua li cas noj Metformin nrog ntshav qab zib, cov ntsiab lus no yuav qhia.

Cov ntaub ntawv dav dav txog cov tshuaj

Tsuas yog tus sawv cev ntawm chav kawm ntawm biguanides yog metformin hydrochloride. Cov tshuaj ua haujlwm tseem ceeb ntawm cov tshuaj Metformin muaj cov yam ntxwv zoo thiab yog ib feem ntawm ntau lwm cov tshuaj muaj suab thaj, uas txawv txav hauv tus nqi.

Hauv hom 1 Ntshav Qab Zib, kev txhaj tshuaj insulin yuav tsum tau ua ntu zus los txhawm rau tiv thaiv hyperglycemia. Hauv cov neeg mob uas muaj ntshav qab zib hom 2, metformin pab txo cov ntshav qabzib sai sai yam uas tsis ua rau cov neeg mob ntshav qab zib tsawg nyob rau hauv cov neeg noj qab haus huv.

Kev siv tshuaj kho ntshav qab zib ua rau qib cellular, nce qhov rhiab heev ntawm cov phiaj hlwb mus rau insulin. Hauv tib neeg lub cev, thaum noj tshuaj, muaj kev hloov pauv hauv qab no:

txo cov piam thaj ntau lawm los ntawm lub siab,
kev txhim kho qhov ua rau muaj kev cuam tshuam ntawm cov hlwb rau cov tshuaj hormones,
txos qhov kev nqus ntawm cov piam thaj hauv cov hnyuv,
kev ua haujlwm ntawm cov txheej txheem ntawm oxidation ntawm fatty acids,
cov roj (cholesterol) tsawg.

Kev kho mob tsis tu ncua nrog Metformin pab tsis tsuas yog txwv tsis pub muaj ntshav qab zib ntau ntxiv, tab sis kuj pab tua rog. Txhua tus ua tsaug rau cov cuab yeej ntawm cov tshuaj kom txo qis qab los noj mov.

Metformin tseem yuav txo cov ntshav siab thiab qhov tsim ntawm atherosclerotic plaques, txo cov kev pheej hmoo ntawm cov kab mob plawv thiab vascular nrog kev muaj mob ntawm cov ntshav qab zib hom 2.

Cov lus qhia rau kev siv ntsiav tshuaj

Qhov tseem ceeb qhia tias koj yuav tsum haus Metformin yog hom ntshav qab zib 2, cuam tshuam los ntawm cov rog dhau, thaum kev noj zaub mov zoo thiab kev tawm dag zog tsis pab txo glycemia.

Ua ntej noj cov tshuaj Metformin rau cov ntshav qab zib hom 2, koj yuav tsum sab laj nrog tus kws kho mob endocrinologist. Tus kws kho mob, suav txog cov ntsiab lus qabzib thiab kev noj qab nyob zoo ntawm tus neeg mob, sau tshuaj rau thiab txiav txim qhov ntau npaum li cas. Tom qab kev yuav cov tshuaj, cov ntawv ntxig yuav tsum tau ua tib zoo kawm.

Ua raws li cov ntsiab lus ntawm cov tshuaj nquag ntawm ib tus neeg sawv cev hypoglycemic, sib txawv tshuaj yog tau:

500 mg ntsiav tshuaj: ntau npaum tshuaj txhua hnub txij li 500 txog 1000 mg. Thaum pib ntawm txoj kev kho, qhov pom ntawm kev phiv nrog cuam tshuam yog tau. Cov txheej txheem zoo li no tshwm sim vim lub cev tau siv los ua cov haujlwm tseem ceeb ntawm cov tshuaj. Tom qab 2 lub lis piam, cov tshuaj tiv thaiv tsis zoo nres, yog li lub koob tshuaj yuav nce ntxiv rau 1500-2000 mg ib hnub. Nws raug tso cai kom noj ntau tshaj 3000 mg ib hnub.
850 mg ntsiav tshuaj: thaum pib, ntau npaum yog 850 mg. Sai li tus neeg mob lub cev hloov mus rau qhov kev ua los ntawm cov tshuaj, koj tuaj yeem nce ntxiv nws los ntawm kev noj haus 1700 mg ib hnub twg. Kev siv tshuaj ntau tshaj plaws ntawm cov tshuaj Metformin rau cov ntshav qab zib nce mus txog 2550 mg. Cov neeg mob ntawm lub hnub nyoog qib siab tsis pom zoo kom tshaj li ib koob ntawm 850 mg.
1000 mg ntsiav tshuaj: thaum xub thawj, qhov tshuaj yog 1000 mg, tab sis tom qab 2 lub lis piam nws tuaj yeem nce ntxiv txog 2000 mg. Qhov siab tshaj plaws tau tso cai rau haus 3000 mg.
Txoj kev siv nyuaj nrog kev kho cov tshuaj insulin: kev txhaj tshuaj thawj zaug ntawm Metformin yog 500 lossis 850 mg. Yuav siv cov insulin ntau npaum li cas rau kev txhaj tshuaj, cov kws kho mob xaiv.

Cov tshuaj Metformin tsis tuaj yeem zom, lawv nqos tag nrho, ntxuav nrog dej. Cov tshuaj yuav tsum haus cawv thaum lossis noj mov tom qab noj mov tas.

Thaum muas cov tshuaj, koj yuav tsum them sai sai rau qhov hnub tas sij hawm qhia ntawm pob. Nws tau raug hlub nyob hauv qhov chaw txias tsaus kom deb ntawm cov menyuam yaus.

Cov tshuaj tiv thaiv thiab kev tsis haum

Cov lus qhia ntxig muaj cov npe zoo heev ntawm cov tsis muaj qhov sib txuam thiab cov kev mob tshwm sim.

Yog li, tus neeg mob yuav tsum ceeb toom txog txhua yam mob cuam tshuam nrog ntshav qab zib mellitus ntawm tus kws kho mob lub sijhawm teem sijhawm. Tej zaum tus neeg mob yuav tsum tau rov kuaj mob dua.

Cov lus qhia tau qhia meej meej meej tias kev siv ntshav qab zib cov ntsiav tshuaj Metformin raug txwv yog tias tus neeg mob lub hnub nyoog tsis txog 10 xyoo.

Tsis tas li, koj tsis tuaj yeem noj tshuaj nrog:

lub raum tsis ua haujlwm (creatinine rau cov poj niam - ntau dua 1.4 ml / dl, hauv cov txiv neej - ntau dua 1.5 ml / dl, creatinine tshem tawm - tsawg dua 60 ml / min),
cov tib neeg rhiab rau metformin hydrochloride thiab lwm yam tshuaj,
cov xwm txheej uas ua rau muaj qhov tshwm sim ntawm cov kab mob lactic acidosis (lub cev qhuav dej, lub plawv tsis ua haujlwm, ua pa tsis ua haujlwm, mob myocardial infarction, mob sib tsoo ntawm cerebrovascular),
lub siab ua rau lub siab ua haujlwm (qib ob lossis ntau dua lub siab ua haujlwm tsis txaus ntawm lub siab ua haujlwm raws li Child-Pugh),
ua rau 2 hnub ua ntej thiab tom qab xoo hluav taws xob, kev kuaj mob radioisotope nrog kev qhia ntawm qhov sib piv nruab nrab,
kev raug mob hnyav thiab kev phais mob,
lactic acidosis, tshwj xeeb hauv keeb kwm,
Kev noj zaub mov kom tsawg, uas tso cai rau koj noj 1000 kcal ib hnub,
ketoacidosis, mob ntshav qab zib precoma thiab coma,
nqa tus me nyuam thiab pub niam mis,
cawv intoxication.

Tus mob ntshav qab zib uas tsis tau noj cov tshuaj Metformin raws li kws kho mob pom zoo yuav ua rau muaj ntau cov kev mob tshwm sim:

Qhov tsis zoo CNS: ua txhaum ntawm kev hnov saj.
Lub plab zom mov tsis meej: mob plab, muaj roj ntxiv, ua kom raws plab, xeev siab, ntuav, tsis qab los. Txhawm rau txo qhov mob hnyav cov tsos mob, koj yuav tsum faib cov koob tshuaj ob peb zaug.
Kev tsis haum xeeb: kev loj hlob ntawm cov kab mob lactic acidosis hauv ntshav qab zib.
Hematopoietic kev ua haujlwm tsis zoo: qhov tshwm sim ntawm megaloblastic anemia.
Ua xua: ua pob khaus tawv nqaij, ua pob, ua pob, ua pob.
Lub siab ua haujlwm: ua txhaum ntawm cov ntsuas tseem ceeb thiab kab mob siab.
Tsis hnov qab nqus ntawm cov vitamin B12.

Yog tias cov tsos mob saum toj no tau pom thaum kho, koj yuav tsum tsis txhob siv tshuaj sai thiab nrhiav kev pab kho mob sai li sai tau.

Nqi, tshuaj xyuas, analogues

Kev npaj muaj metformin hydrochloride feem ntau muaj rau cov theem nrab. Koj tuaj yeem txuag nyiaj los ntawm kev yuav tshuaj ntsiav ntshav qab zib online. Rau Metformin, tus nqi nyob ntawm qhov ntau npaum:

500 mg (60 ntsiav tshuaj) - los ntawm 90 txog 250 rubles,
850 mg (60 ntsiav tshuaj) - los ntawm 142 txog 248 rubles,
1000 mg (60 ntsiav tshuaj) - los ntawm 188 txog 305 rubles.

Raws li koj tuaj yeem pom, tus nqi ntawm tus neeg sawv cev hypoglycemic Metformin tsis yog qhov siab heev, uas yog qhov loj ntxiv.

Tus neeg mob tshuaj xyuas txog cov tshuaj feem ntau zoo. Metformin txo cov ntshav qab zib kom huv si thiab tsis ua rau lub qog ntshav qab zib. Cov kws kho mob kuj pom zoo siv cov tshuaj tiv thaiv kab mob siab. Kev siv Metformin tas li rau kev tiv thaiv kab mob plawv tau them tas mus.

Qee cov neeg uas tsis muaj ntshav qab zib noj tshuaj pab txo qhov hnyav. Cov kws txawj tsis pom zoo tsis pom zoo kom siv cov tshuaj no rau qhov poob phaus rau cov neeg noj qab haus huv.

Cov kev tsis txaus siab tseem ceeb muaj feem cuam tshuam txog kev zom zaub mov tsis zoo, uas tshwm sim vim lub cev tau siv mus rau cov tshuaj nquag. Hauv qee kis ntawm cov neeg mob, cov tsos mob tau tshaj tawm tias lawv yuav tsum tsis txhob noj cov Metfomin kom txo cov ntshav qabzib.

Qee lub sij hawm nws tsim nyog xaiv cov analogue - cov khoom siv uas muaj cov yam ntxwv zoo sib xws. Tab sis yuav ua li cas los hloov Metformin? Muaj ntau cov tshuaj uas muaj cov kev kho zoo sib xws:

Metformin Richter,
Metformin teva
Novo-Metformin,
Looj Yaj
Dianormet
Formin Pliva,
Siofor
Metfogamma,
Novoformin,
Tub Npis
Orabet
Diaformin,
Glucophage,
Bagomet,
Glyformin
Glucovans.

Qhov no tsis yog tiav cov npe ntawm cov khoom siv tau los txo qis qab zib. Tus kws kho mob uas koom nrog yuav pab koj xaiv cov tshuaj zoo tshaj plaws rau ntshav qab zib hom 2.

Metformin yog ib hom tshuaj uas tsim kho kom zoo rau cov lus teb ntawm lub hom phiaj cell mus rau insulin. Kev siv cov Metformin normalizes glycemia, tiv thaiv kev txhim kho ntawm cov nyom thiab ua rau tus neeg mob lub cev hnyav. Txhawm rau tswj ntshav qab zib kom tswj, txhua qhov kev pom zoo ntawm tus kws tshaj lij yuav tsum tau ua raws, thiab yog tias tsim nyog, xaiv ib qho tshuaj tiv thaiv zoo.

Tus kws tshaj lij hauv cov yeeb yaj kiab hauv tsab xov xwm no yuav qhia txog cov tshuaj ua kom ntshav qab zib Metformin.

Tso tawm daim ntawv, muaj pes tsawg leeg

Metformin muaj nyob rau hauv cov qauv hauv cov ntsiav tshuaj, coated nrog lub plhaub dawb, oblong thiab biconvex. Hauv tus qauv blister yog 10 daim. Cov khoom siv tseem ceeb yog Metformin hydrochloride, uas yog xim dawb los yog tsis muaj xim crystalline hom hmoov. Nws sai sai hauv dej thiab yauv yauv tsis muaj kev hloov hauv acetone, ether thiab chloroform. Lub phaus molecular ntawm cov khoom yog 165.63.

Tham txog Metformin ntsiav tshuaj, koj yuav tsum them sai sai rau qhov tseeb:

ntawm lub plab khoob thiab tom qab noj mov tag, nws muaj peev xwm ua kom qis dua cov piam thaj. Tib yam mus rau glycosylated hemoglobin,
vim kev siv cov tshuaj, Cov kua nplaum ua kom siab ntev tau nce,
kev nqus plab hnyuv tso tawm tsawg (ua kom lub plab zom mov, txiav),
ntxim rau cov tshuaj tiv thaiv hormonal ntawm peripheral cov ntaub so ntswg ntau ntxiv.

Metformin tsis pab ua rau muaj qhov hloov pauv hauv cov kua dej los ntawm cov hlwb ntawm pancreatic islets. Tsis tas li ntawd, nws yog cov tshuaj qhia uas kho cov lipid profile ntawm cov ntshav ntshav hauv cov neeg mob uas muaj hom 1. Cov ntsiav tshuaj ua kom qis dua qhov sib piv ntawm triglycerides zoo li roj (cholesterol). Kev siv cov tshuab muaj zog ua rau muaj txiaj ntsig zoo ntawm kev tswj lub zog los yog txo lub cev qhov hnyav.

Cov tshuaj yog nqus sai sai ntawm lub plab zom mov. Kev tsis txaus siab txog kev noj qab haus huv ntawm lub plab khoob ntawm 50 txog 60%. Qhov siab tshaj plaws hauv cov ntshav yuav qhia tau tom qab 120 feeb. Kev noj zaub mov noj tuaj yeem txo qhov kev kub siab los ntawm 40% thiab maj mam ua tiav nws los ntawm tsis pub dhau 35 feeb. Kev sib xyaw ua ke ntawm cov khoom tseem ceeb hauv cov ntshav yuav ua tiav nyob hauv 24–48 teev thiab tsis pub tshaj 1 μg / ml.

Nws yog ib qho tseem ceeb uas yuav tsum xav txog tias cov tshuaj khi rau plasma proteins ua qhov txiaj ntsig. Nws kuj tseem muaj peev xwm mloog zoo hauv lub qog ua kua qaub ncaug, nplooj siab thiab, tau kawg, lub raum. Metformin raug tso tawm los ntawm lub raum (feem ntau vim yog qhov tshwj xeeb tubular zais zis) tsis hloov pauv (90% hauv 24 teev).

Kev qhia rau kev siv tshuaj

Cov tshuaj yog siv tshwj xeeb kom txo qis ntshav qab zib. Nrog ntshav qab zib hom 1, tsis tas yuav tshuaj ntsiav. Hais lus ntau dua txog cov cim, lawv mob siab rau hom 2 mob ntshav qab zib mellitus hauv cov laus (tshwj xeeb tshaj yog rau cov neeg mob rog rog). Qhov no yog ua tiav nrog lub txiaj ntsig ntawm kev noj haus tsawg thiab kev tawm dag zog. Metformin tuaj yeem siv rau hauv cov ntshav qab zib li kev kho mob ntshav lossis ua kom sib xyaw nrog lwm cov npe ntawm qhov ncauj hypoglycemic, thiab qee yam ntawm cov tshuaj tiv thaiv hormonal.

Lwm qhov taw qhia yog hom 2 ntshav qab zib hauv cov menyuam hnub nyoog ntau dua 10 xyoo. Hauv qhov no, nws kuj tseem tuaj yeem tau tshem tawm los ua ib feem ntawm kev kho mob monotherapy thiab muaj kev sib txuam nrog cov tshuaj tiv thaiv hormonal. Cov kws tshwj xeeb tau mob siab rau qhov tseeb tias:

Metformin tuaj yeem siv tom qab ua haujlwm li qub ntawm cov ntshav qab zib,
los tiv thaiv thiab tiv thaiv kab mob pathological, chav kawm tseem ceeb ntawm kev kho yog pom zoo kom tham nrog tus kws tshaj lij,
qhov kev ua kom rov zoo yuav ua tau zoo yog tias tus mob ntshav qab zib yuav siv sij hawm rau hauv qhov kev suav tus qauv ntawm qhov muaj pes tsawg leeg, cov kab mob tseem ceeb thiab lwm yam ntxwv.

Yuav noj Metformin rau cov ntshav qab zib li cas?

Cov kws kho mob tau qhia txog qhov tseeb txog tus mob ntshav qab zib! Mob ntshav qab zib yuav ploj mus nyob rau hauv 10 hnub yog tias koj haus nws sawv ntxov. »Nyeem ntxiv >>>

Cov ntsiav tshuaj yuav tsum tau noj ntawm qhov ncauj, nqos lawv kiag thiab tsis yog zom. Qhov no tuaj yeem ua tau ob qho tib si thaum noj mov thiab tam sim ntawd. Nws yog ib qho tseem ceeb kom haus dej ntau nrog lub ntsiav tshuaj. Rau cov neeg laus, Metformin tuaj yeem siv rau hauv kev pib qhov ntau tsis tshaj 1000-1500 mg hauv 24 teev. Txhawm rau kom txo cov kev mob tshwm sim los ntawm cov hnyuv plab zom mov, zaub mov yuav tsum muab faib ua ob rau peb koob.

Tom qab 10-15 hnub, yog tias tsis muaj qhov cuam tshuam tshwm sim los ntawm txoj hnyuv, qhov kev mob ntxiv rau kev noj tshuaj ntau ntxiv yuav siv tau. Txawm li cas los xij, nws yuav tsum tsis tsim nyog thiab nyob ntawm qhov sib piv ntawm cov piam thaj hauv cov ntshav. Nws yuav tsum nkag siab tias nws yog ib qho kev nce xov hauv ib nrab uas tuaj yeem muaj qhov txiaj ntsig zoo ntawm kev txhim kho lub plab zom mov thiab lub plab hnyuv ntawm cov ntsiav tshuaj.

Kev saib xyuas txij nkawm thaum nruab hnub yuav tsum yog li 1500-2000 mg. Cov nyiaj uas tau tso cai ntau tshaj tsis pub dhau 3000 mg, thiab nws raug nquahu kom lawv muab faib ua peb zaug sib law. Hauv cov txheej txheem ntawm kev npaj hloov mus los ntawm kev siv lwm qhov ncauj ntawm qhov ncauj hypoglycemic mus rau Metformin, nws raug nquahu kom koj tsis txhob siv lwm tus thiab pib siv Metformin Canon hauv qhov tsawg kawg nkaus tau hais ua ntej.

Cov tshuaj Metformin rau cov ntshav qab zib hom 2 tuaj yeem raug siv los ua ke nrog kev kho mob. Nws raug nquahu tias:

kev pom zoo thawj zaug tau txais 500 mg thiab 850 mg yog 1 ntsiav tshuaj ob lossis peb zaug ib hnub,
Metformin 1000 mg yog 1 ntsiav tshuaj ib zaug txhua 24 teev,
qhov ntau npaum li cas ntawm cov tshuaj tiv thaiv hormonal hauv qhov no yog xaiv raws li cov piam thaj hauv qab.

Rau cov menyuam yaus hnub nyoog ntau dua 10 xyoo, qhov kev daws teeb meem zoo tau yog siv ntawm Metformin Canon. Nws tuaj yeem raug siv ua ib feem ntawm kev kho mob monotherapy, ntxiv rau ntu ntawm kev sib xyaw nrog kev kho mob nrog tshuaj tiv thaiv hormonal. Txais tos ntawm Metformin nyob rau hauv cov ntaub ntawv no yuav tsum pib nrog xws li tsawg kawg yog 500 mg ib zaug rau 24 teev hauv cov txheej txheem ntawm kev noj zaub mov. Tom qab 10-15 hnub, qhov nyiaj tau pom zoo kom yuav tsum tau hloov kho raws li kev mloog zoo ntawm cov piam thaj hauv cov ntshav. Qhov kev saib xyuas cov tshuaj yuav yog los ntawm 1000 txog 1500 mg rau ib hnub rau ob txog peb koob. Qhov siab tshaj plaws yuav tsum tsis pub tshaj 2000 mg rau kev noj haus txhua hnub.

Vim tias qhov cuam tshuam txog kev hloov pauv ntawm lub raum muaj nuj nqi, cov tshuaj Metformin raug pom zoo rau cov neeg laus kom raug xaiv nrog kev soj ntsuam tas li ntawm lub raum kev ua haujlwm. Qhov yuav tsum tau ua hauv qhov kev ntsuas qhov no yog tswj hwm qhov sib piv ntawm creatinine hauv ntshav cov ntshav tsawg kawg ob rau plaub zaug hauv ib lub xyoo. Lub sijhawm kho yuav tsum yog txiav txim los ntawm tus kws tshaj lij.

Tsis txhob siv Metformin yam tsis muaj kev qhia los ntawm kws kho mob tshwj xeeb rau kev mob ntshav qab zib hom 2 tsis pom zoo.

Cov tshuaj yuav siv tau ntev thiab koj yuav tsum nco ntsoov tias:

thaum npaj tswv yim lossis qhov tseeb ntawm qhov muaj cev xeeb tub, Metformin Canon yuav tsum raug tshem tawm thiab kho cov tshuaj insulin,
Nws yog ib qho tseem ceeb heev rau tus neeg mob ceeb toom tias nws yog lub luag haujlwm yuav tsum ceeb toom nws tus kws kho mob poj niam thiab kws tshuaj txog ntshav qab zib yog tias muaj menyuam,
tus niam tom ntej thiab nws tus menyuam yuav tsum tsim kev tswj hwm.

Tsis muaj ib qho ntaub ntawv txaus ntseeg hais txog seb Metformin puas raug txuam nrog mis niam. Yog tias koj yuav tsum txiav txim siab yuav haus Metformin li cas thaum pub niam mis, kev pub mis niam yuav raug tso tseg.

Cov kev thaiv tsis zoo thiab cov tshwm sim

Daim ntawv ntawm contraindications suav nrog feem ntau hypersensitivity, raws li zoo li ntau pathologies ntawm lub raum los yog muaj lub raum tsis ua hauj lwm. Kev saib xyuas tshwj xeeb yuav tsum tau them rau qhov pom tseeb hauv lub siab, cov xwm txheej nrog hypoxia (mob plawv thiab ua pa tsis ua haujlwm, mob theem vim yog myocardial infarction, ntshav ncig hauv lub hlwb thiab ntshav liab).

Cov txheej txheem tau suav nrog nrog lub cev qhuav dej, kis kab mob, phais mob dav, thiab raug mob zoo ib yam. Tsis txhob hnov qab txog kev haus cawv mus ntev, mob plab metabolic acidosis (suav nrog ketoacidosis mob ntshav qab zib nrog lossis tsis nco qab lawm). Contraindications kuj yog:

lactic acidosis hauv keeb kwm kev kho mob,
qhov yuav tsum tau ua raws li kev noj zaub mov kom tsis txhob muaj calories ntau (tsawg dua 1000 kcal ib hnub),
tshawb fawb siv isotopes hluav taws xob ntawm iodine,
ib qho ntawm trimesters ntawm cev xeeb tub,
pub niam mis.

Muaj qee qhov kev txwv ntawm kev siv. Peb tab tom hais txog cov menyuam yaus hnub nyoog qis dua 10 xyoo, uas yog vim qhov tseeb tias qhov ua tau zoo thiab kev nyab xeeb ntawm kev siv rau hauv menyuam yaus tsis tau muaj kev ntseeg tau. Tsis tas li, yuav tsum saib xyuas rau lub hnub nyoog laus dua (ntau dua 65 xyoos) vim tias kev siv tshuaj lom cov roj metabolism hauv lub cev. Tsis tas li ntawd, nws tsis pom zoo kom muab tshuaj rau cov neeg uas ua lub cev ua haujlwm nyuaj (yuav ua rau lactic acidosis tsim ntau ntxiv).

Qhov tshwm sim ntawm Metformin los ntawm lub plab zom mov thaum pib rov ua haujlwm yuav tsum txiav txim siab tsis nco qab, zawv plab, xeev siab thiab ntuav. Ntxiv rau, lawv tau them sai sai rau kev ua kom mob plab thiab mob plab (txo qis thaum siv nrog khoom noj). Lwm qhov kev phiv tuaj yeem yog cov xim quav hlau hauv lub qhov ncauj (pom nyob ntawm kwv yees li 3% ntawm cov neeg mob).

Ntawm ib feem ntawm cov kab mob plawv thiab hlab ntshav, nrog rau kev tsim cov ntshav thiab hemostasis, muaj qee zaus megaloblastic anemia tuaj yeem ua tau. Raws li koj paub, nws yog tshwm sim ntawm destabilization ntawm kev nqus ntawm nqus ntawm vitamin B12 thiab folic acid. Kev phiv tshuaj tuaj yeem yuav cuam tshuam nrog cov metabolism. Ua ntej tshaj plaws, qhov no yog hypoglycemia. Hauv qee qhov tsis tshua muaj tshwm sim, peb tab tom tham txog cov kab mob lactic acidosis, piv txwv li, tsis muaj zog, nkees nkees, mob ntshav siab thiab lwm yam kev tshwm sim tshwj xeeb.

Cov tsos mob tshwm sim nrog cuam tshuam nrog daim tawv yog qhov yuav tshwm sim. Nws yog hais txog kev tsim pob khaus thiab mob caj dab. Txhawm rau tshem tawm cov kev mob tshwm sim no, nws raug nquahu tias koj yuav tsum xub sab laj nrog tus kws tshaj lij.

Cov lus thiab cov xwm txheej ntawm kev cia

Nws raug nquahu kom khaws cov tshuaj ntawm qhov kub ntawm tsis ntau tshaj 25 degrees. Nws yog ib qho tseem ceeb uas qhov no yog qhov chaw nkag rau menyuam yaus. Kev tso cai cia ntawm Metformin yog 24 lub hlis. Nws tsis pom zoo kom siv nws tom qab hnub tas sij hawm uas tau hais ntawm pob ntawv. Cov tshuaj raug faib tawm los ntawm lub hwj tshuaj.

Kev Siv Tshuaj Yeeb nrog Lwm Cov Tshuaj Yeeb

Them sai sai rau cov contraindicated thiab tsis pom zoo kev sib txuas ua ke. Yog li, hauv thawj kis peb tab tom tham txog kev tshawb nrhiav radiological siv cov tshuaj radiopaque uas muaj iodine. Qhov no tuaj yeem ua rau qhov tsim muaj cov kab mob lactic acidosis hauv cov neeg mob ntshav qab zib vim yog lub raum tsis ua haujlwm.

Cov kev pom zoo ua ke rau mob ntshav qab zib yog:

tib lub sij hawm siv cov Metformin nrog cov dej cawv thiab cov npe uas muaj cawv muaj,
qaug cawv ua rau qaug cawv,
yoo mov los yog ua raws cov zaub mov noj tsis muaj calorie tsawg,
daim siab ua haujlwm, hauv uas, zoo li lwm yam, muaj peev xwm tsim cov kab mob lactic acidosis nce ntxiv.

Tseem muaj kev sib xyaw ua ke uas xav tau kev saib xyuas tshwj xeeb. Peb tab tom hais txog kev siv Metformin nrog Danazole tib lub sijhawm vim kev ua yuav tshwm sim hyperglycemic. Tsis tas li, koj yuav tsum ceev faj txog cov tshuaj zoo li Chlorpromazine, ntau yam glucocorticosteroids (GCS). Nrog rau kev siv "voj" diuretics thiab Metformin tib lub sijhawm, muaj qhov ntxim nyiam ntawm kev tsim cov kab mob lactic acid vim kev ua haujlwm ntawm lub raum tsis ua haujlwm.

Metformin feem ntau yuav tsis pab tshem ntshav qab zib los ntawm kev siv tshuaj hno beta2-adrenergic agonists, inhibitors ntawm angzyensin-hloov mus rau enzyme. Tsis tas li ntawd xwb, nws tau pom zoo kom kho sulfonylurea derivatives, Nifedipine.

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Tus nqi ntawm cov tshuaj metformin nyob rau hauv cov tshuaj ntawm tib lub npe yog qhov sib txawv: ib ntsiav tshuaj muaj 500 lossis 850 mg ntawm qhov nquag tivthaiv. Tus neeg sawv cev tiv thaiv tus qog ntshav ntshav mus ntev ntev muaj 1000 mg ntawm metformin hauv ib koog.

Cov ntsiav tshuaj yog xim-txheej, cov duab yog biconvex. Qhov kev npaj muaj dyes indigo carmine, titanium dioxide, thiab daj quinoline. Cov pob muaj 30 lossis 60 ntsiav tshuaj. Cov neeg tsim khoom - cov tuam txhab los ntawm Hungary, Russia, Ixayees.

Cov qauv ntawm Metformin

Ntshav qab zib mellitus pom zoo los ntawm DIABETOLOGIST nrog kev paub txog Aleksey Grigorievich Korotkevich! ". nyeem ntxiv >>>

Siofor, Bagomet, Glycomet thiab Glikovin - qhov no tsuas yog ua tiav ntawm cov npe tsis zoo ntawm cov nyiaj tau hais tawm. Cov ntawv sau tau ntxiv los ntawm cov npe xws li Glyunet, Dianormet, Diaformin, Insufor thiab lwm tus. Txiav txim siab qhov twg yog qhov zoo dua, Siofor lossis Metformin, tsuas yog yuav pab tau tus mob ntshav qab zib nkaus xwb. Nws tsis tshua pom zoo kom muab ib qho lossis lwm yam tshuaj rau koj tus kheej.

Ua rau lub cev

Cov tshuaj hluavtaws muaj cov txiaj ntsig zoo ntawm kev ua kom tau cov carbohydrate thiab lipid metabolism, normalizes qib ntshav qabzib, tiv thaiv hyperglycemia tawm tsam keeb kwm ntawm thawj thiab hom mob ntshav qab zib. Cov tshuaj Metformin ua tau zoo nyob rau hauv kev pib ntawm kev mob ntshav qab zib mellitus thiab tawm tsam keeb kwm ntawm cov chav kawm ntev ntawm endocrine pathology.

Qhov kom zoo dua yog qhov cuab yeej siv peripheral (tsis muaj qhov cuam tshuam rau lub hlwb pancreatic). Nws tsis yog qhov raug xwm txheej tias thaum noj cov tshuaj Metformin, thaum suav cov tshuaj noj kom zoo, cov ntshav qab zib feem ntau yuav poob rau qib tseem ceeb. Qhov muaj feem tsawg tshaj plaws ntawm kev txo qog ntshav qab zib ua piv rau cov kab mob antidiabetic nrog rau lwm cov tshuaj los them rau cov kab mob endocrine pathology.

Thaum kho, cov degree ntawm cov tshuaj tiv thaiv insulin tsawg dua, cov piam thaj ntawm kev zom zaub mov yog nqus tsawg dua. Qhov taw tes zoo yog qhov kev txwv ntawm kev tso tawm glycogen los ntawm hepatocytes, kev ua kom nrawm nrawm ntawm kev rhuav tshem thiab tshem tawm cov roj "tsis zoo". Thaum lub sij hawm kho, qabzib uptake los ntawm cov leeg ua kom zoo dua.

Kawm paub txog cov tsos mob ntawm adrenal tsis txaus hauv cov poj niam, nrog rau cov cai rau kev kho kab mob.

Nyeem txog cov cai ntawm cov thyroid-stimulating hormone hauv poj niam thiab txiv neej, nrog rau nws lub luag haujlwm hauv lub cev ntawm qhov chaw nyob no.

Kev ntsuas rau siv

Ib cov tshuaj raws li metformin yog tshuaj:

nrog rau cov tsis muaj tshuaj insulin-cuam tshuam (II) hom ntshav qab zib yog thawj cov tshuaj. Lub ntsiab hypoglycemic tus neeg sawv cev yuav tsum tau noj txhua hnub. Raws li cov ntshav qabzib nyob qib siab, lipid thiab carbohydrate metabolism li qub, noj ntau dua,
nrog rau cov tshuaj insulin-tiv thaiv (I) hom kab mob endocrine ua qhov txuas rau cov tshuaj insulin. Kev poob qis hauv cov piam thaj hauv lub siab ua ke nrog cov tshuaj insulin zoo tshaj plaws yuav pab kho cov ntshav qab zib kom tsawg. Thaum cov tshuaj hormone-accumulator ua ke nrog Metformin, qhov kev pheej hmoo ntawm cov teeb meem phom sij tau txo: mob ntshav qab zib rhinopathy, mob neuropathy thiab mob hlwb, mob ntshav, mob rau ntawm daim tawv nqaij, thiab tsawg dua qhov tshwm sim ntawm kev mob ntshav siab.

Lub hauv paus ntsiab lus ntawm Metformin

Cov tshuaj ua hauj lwm yog metformin hydrochloride. Los ntawm chav kawm ntawm biguanides, nws tsuas yog tib qho uas muaj kev kho mob zoo. Kev tshuaj xyuas tus neeg mob tau qhia tias cov tshuaj no ua haujlwm zoo dua li lwm qhov hauv nws chav kawm. Qhov no yog vim qhov tseeb tias nws ua nyob rau hauv qib ntawm tes, nce lawv qhov rhiab rau insulin. Ua tsaug rau kev kho mob Metformin, cov teebmeem hauv qab no raug pom:

lub siab synthesizes tsawg qabzib,
fatty acids uas yog pib oxidize,
cov hlwb ua kev puas tsuaj rau insulin,
piam thaj tsawg dua yog nqus hauv txoj hnyuv,
cov leeg pib haus cov dej qab zib ntau dua,
ib feem ntawm cov piam thaj thaum kev zom plab hloov mus ua lactate (lactic acid).

Yog li, cov tshuaj txo cov ntshav qab zib hauv qhov tsis ncaj, vim nws qhov txiaj ntsig tseem ceeb yog ua kom lub cev nkag siab zoo rau insulin.

Vim tias qhov tseeb tias cov khoom lag luam ua rau lub zog oxidation ntawm fatty acids, muaj cov txiaj ntsig kho ntxiv tshwm sim uas nthuav cov pab pawg ntawm cov neeg uas tau pom zoo kom haus cov tshuaj Metformin. Lawv muaj raws li hauv qab no:

qhov tsim ntawm atherosclerotic vascular plaques nres
lub cev hnyav txo, uas zoo cuam tshuam kev kho mob ntawm metabolic syndrome,
ntshav siab normalizes.

Nws yuav tsum raug sau tseg tias cov txheej txheem ntawm oxidation ntawm fatty acids muaj nyob rau hauv lawv qhov kev rhuav tshem thiab hloov mus rau hauv lub zog. Yog li, cov roj ntsha txuag tau tsawg, lub cev yuav ua neeg yuag dua. Yog li no, cov tshuaj feem ntau siv rau qhov poob phaus, vim tias nws txhawb qhov ncaj qha hlawv cov rog.

Nrog ntshav qab zib hom 1

Tus nqi ntawm cov tshuaj nquag yog tswj hwm tus kheej los ntawm endocrinologist, nyob ntawm kev txhaj tshuaj ntawm insulin. Nco ntsoov coj mus rau hauv tus account qib ntawm glycemia. Lub sijhawm siv Metformin tau teev tseg los ntawm tus kws kho mob koom nrog qhov kev saib xyuas cov txiaj ntsig ntawm kev sib xyaw ntawm cov tshuaj hormones-accumulator nrog cov suab thaj txo qis.

Nrog hom 2 pathology

Qhov nruab nrab txhua hnub tus nqi yog 1 ntsiav tshuaj, qhov ntau ntawm cov tshuaj nquag yog 850 lossis 500 mg. Txhawm rau txo qis qhov tsis xis nyob hauv txoj hnyuv, nws raug tso cai siv tshuaj thaum noj mov. Nrog rau kev zam zoo ntawm cov tshuaj metformin, qhov tsis muaj xeev siab thiab tsam plab, nws raug nquahu kom tau txais cov ntsiav tshuaj 30 feeb tom qab noj mov.

Yog tias qib qab zib tsis qis txaus, tus endocrinologist tuaj yeem nce tus nqi txhua hnub rau 2000 mg. Kev sib xyaw nrog sulfanilurea derivatives txhim kho cov metabolism, qab zib ntsuas yog txo los ntawm ib feem peb lossis ntau dua.

Qhov tsis zoo ntawm kev noj cov tshuaj Metformin

Kev siv tshuaj kho mob thiab tshuaj xyuas tus neeg mob qhia tias qhov hypoglycemic no muaj cov kev tsis zoo. Qhov no yog vim tib qho kev nce ntau hauv cov oxidation ntawm lipids. Hauv cov txheej txheem ntawm cov tshuaj biochemical no, ntau lub zog tsis tsuas yog tsim, tab sis kuj tseem muaj lactate (lactic acid), uas feem ntau ua rau acidosis, uas yog, kev hloov ntawm hydrogen index rau cov kua qaub. Qhov no txhais tau hais tias muaj ntau cov kua qaub nyob rau hauv cov ntshav tshaj li qhov yuav tsum tau, uas ua rau kev ua haujlwm ntawm txhua lub nruab nrog cev thiab tshuab ua haujlwm kom tuag.

Cov kab mob lactic acid tuaj yeem tshwm sim ob qho zuj zus thiab tsis poob nthav. Feem ntau nws cov tsos mob yog mob me me thiab tsis tseem ceeb, tab sis qee zaus nws tshwm sim rau cov teeb meem thaum lub sijhawm lim ntshav tseem ceeb (uas yog, txuas lub raum cuav rau lub cuab yeej). Cov tsos mob ntawm tus kab mob lactic acidosis muaj raws li hauv qab no:

Hauv qee cov neeg mob, metformin yuav ua rau mob nqaij thiab lub plab.

qhov zoo li tsis muaj zog
tsaug zog
kiv taub hau
pa ua tsis taus pa
txog siav
ntshav siab
tsawg lub cev kub
mob leeg, thiab lwm yam.

Kev kho mob ntawm cov kab mob lactic acidosis feem ntau yog cov tsos mob, nyob rau qee zaus, hemodialysis yog tus kws kho mob (cov txheej txheem tshwj xeeb rau kev ntxuav ntshav).

Muaj kev phiv ntau

Cov kev xav tsis zoo thaum lub caij siv cov tshuaj Metformin tsis tshua muaj kev loj hlob. Nrog rau cov tib neeg rhiab, ua xua, tso quav, tsis xis nyob hauv txoj hnyuv, hloov pauv, saj tau. Tawm tsam keeb kwm ntawm megaloblastic anemia, nrog lub caij ntev tau txais ntawm tus neeg sawv cev hypoglycemic, vitamin B12 kev nqus tuaj yeem ua rau tsis muaj zog.

Lwm qhov kev phiv los ntawm hypoglycemic muaj pes tsawg leeg (erythema, urticaria, tawv nqaij khaus, tsis hnov mob ntawm daim siab enzymes) muaj tsawg. Tom qab tsis ua hauj lwm ntawm cov tshuaj lossis txo qis hauv koob tshuaj txhua hnub, cov tsos mob tsis zoo ploj.

Lactic acidosis: nws yog dab tsi

Tsis tshua muaj, tab sis qhov phom sij txaus ntshai tshaj plaws nrog kev siv tshuaj Metformin. Kev tsis haum xeeb hauv lub cev zom zaub mov nthuav dav nrog kev sib txuam ntawm cov khoom muaj sia nyob hauv cov ntaub so ntswg. Feem ntau, lactic acidosis tshwm rau qhov tsis muaj kev saib xyuas rau xws li contraindication li lub raum tsis ua haujlwm. Yog tias tsis pom tseeb tias qhov mob raum tsis ua haujlwm thiab mob raum tsis ua haujlwm, qhov pib ntawm qhov kev kho mob, qhov kev tso ntshav qabzib sai sai nrog kev tshwm sim ntawm kev sib txuam ntawm cov pa tsis zoo yog ua tau.

Cov tsos mob ntawm tus kab mob lactic acidosis yuav tsum paub txog cov ntshav qab zib thiab cov txheeb ze. Kev tsis txaus ntseeg ntawm tus neeg mob hauv lub tsev kho mob rau kev kho mob hnyav tau xaus nrog lub ketoacidotic tsis meej pem thiab kev tuag.

poob ncaj hauv qhov kub thiab txias,
mob plab heev
poob hauv qab zib,
tsis muaj zog
tes co
ua pa nrawm (ua pa acid txog siav),
zawv plab
mob huam
tsis nco qab.

electrolyte tsis txaus,
ntshiab lactate yog 5 mmol / l lossis ntau dua,
txo nyob rau hauv cov ntshav acidity,
ua txhaum ntawm qhov sib piv ntawm lactate thiab pyruvate.

Cov tsos mob ntawm kev tsim tus kab mob lactic acid xav tau kev thov sai mus rau tsheb thauj neeg mob. Ua ntej tuaj txog ntawm pab pawg kho mob, koj yuav tsum tsis txhob qhia tus neeg mob Metformin thiab cov npe uas ua rau txo qis glycemia.

Saib daim ntawv qhia ua piv txwv rau lub lim tiam 9 ntawm kab ntawv 2 rau cov ntshav qab zib hom 2.

Cov cai thiab cov yam ntxwv ntawm kev siv cov ntsiav tshuaj Triiodothyronine hauv kev kho mob ntawm cov thyroid kab mob tau piav qhia nyob rau nplooj ntawv no.

Nkag mus rau hauv http://vse-o-gormonah.com/vnutrennaja-sekretsija/nadpochechniki/giperplaziya.html thiab kawm txog cov yam ntxwv ntawm tus yam ntxwv thiab kho tau zoo rau adrenal hyperplasia.

Cov tshuaj ua haujlwm li cas?

Metformin hauv ntshav qab zib muaj cov yam ntxwv ua rau lub cev muaj zog heev. Nws lub luag haujlwm tseem ceeb yog txo cov ntshav qab zib. Txawm li cas los xij, tib lub sijhawm, lwm cov kab ke hauv lub cev tsis tuaj koom nrog.

Cov ntsiav tshuaj no rau hom 2 mob ntshav qab zib mellitus txhim kho kev nqus ntawm cov piam thaj los ntawm cov ntaub so ntswg, tshwj xeeb tshaj yog cov leeg, uas tsis txaus rau cov ntshav qab zib. Nco ntsoov tias rau kev ua haujlwm cov leeg koj xav tau lub cev kom ruaj khov.

Cov ntsiav tshuaj los ntawm tus kab mob pab txo qhov kev mloog ntawm cov carbohydrates hauv lub siab, thiab tseem ua tsis tiav lipid metabolism hauv lub cev. Nrog ntshav qab zib hom 2, cov metabolism hauv kev hnyav yog qhov tseem ceeb.

Muaj ntshav qab zib hom 2, nws yog ib qho tseem ceeb kom ua kom haum, zam dhau kev hnyav thiab nce lub cev. Kev pham yuav hloov cov tshuaj no, tab sis qhov no tsis txhais tau tias koj yuav tsum tau muab cov khoom noj kom zoo thiab tawm dag zog.

Tsis tas li ntawd, cov tshuaj rau cov kabmob no muaj cov txiaj ntsig zoo ntawm lub plawv thiab lub plab zom mov.

Cov tshuaj tiv thaiv kom zoo rau kev siv tshuaj

Qee tus neeg mob paub meej tias hom tshuaj no tsis muaj kev phom sij. Nws tsis zoo li no vim tias kev siv tshuaj ib qho twg tuaj yeem ua rau muaj mob. Koj tsis tuaj yeem haus cov tshuaj metformin nyob rau hauv cov xwm txheej:

Cev xeeb tub lossis pub niam mis,
Yog tias tsis muaj ntshav qab zib,
Kab mob ntawm daim ntawv thib 1,
Yog hais tias tus kab mob tau noj daim ntawv decompensated,
Teeb meem lub raum
Lub plawv thiab lub ntsws muaj teeb meem
Thawj thawj zaug tom qab myocardial infarction,
Lub sijhawm rov ua kom zoo dua tom qab muaj kev ua haujlwm loj,
Yog tias mob ntev mus rau qhov mob tsis zoo,
Yog tias muaj tus kab mob nkag mus rau hauv lub cev,
Hlau tsis muaj peev xwm
Kev fab tshuaj rau cov tshuaj,
Cawv kev quav dej cawv,
Yog tias koj yog tus kiv cua ntawm cov khoom noj hauv cov zaub mov tsis muaj calorie ntau ntau (uas tsis zoo rau tus neeg noj qab nyob zoo).

Cov tshuaj rau ntshav qab zib hom 2 yuav tsum tsis txhob noj yog tias tsawg kawg ib yam cuam tshuam rau koj.

Sab sij huam

Yog tias dhau ntawm kev noj tshuaj ntau dhau, kho tus kheej, tsis saib xyuas cov lus qhia thiab lus qhia ntawm kws kho mob, kev phiv tuaj yeem tshwm sim. Kev kho mob nrog metformin tuaj yeem ua rau cov kev mob tshwm sim:

Xeev siab
Tag nrho lossis ib nrab tsis xav noj,
Ntuav
Zawv plab
Tus ntse lub cev tsis kub,
Mob leeg mob
Mob taub hau thiab kiv taub hau,
Ua pa ceev,
Mob qab zib coma
Cov teeb meem nrog kev pom ntawm lub ntiaj teb,
Yog tias koj noj cov tshuaj metformin rau cov ntshav qab zib nrog rau lwm cov tshuaj, qhov sib xyaw no tuaj yeem ua rau ntshav qab zib ntshav qab zib.

Yuav noj tshuaj metformin tau tom qab cov tsos mob no tshwm sim? Yeej tsis yog. Ntxiv mus, ntawm thawj cov cim ntawm kev tsis txaus ntseeg ntawm lub cev rau cov tshuaj, koj yuav tsum tau sab laj nrog tus kws kho mob uas yuav sau ntawv kho. Kev kho mob ntshav qab zib hom 2 tsis yog saib xyuas kom muaj kev noj qab haus huv. Yog siv qhov tsis raug, nws tuaj yeem ua rau tuag taus.

Qhov ua kom tsis haum rau siv Metformin

Tus neeg sawv cev rau kev kho mob ntshav qab zib yuav tsum tsis txhob siv rau cov mob hauv qab no:

thaum cev xeeb tub thiab lactation,
cov me nyuam qis dua 10 xyoo
cov khoom noj tsis muaj calorie tsawg
tom qab ua haujlwm thiab raug mob
nrog daim siab pathologies,
nrog rau yav dhau los lactic acidosis,
yog tias muaj kev mob siab rau cov kab mob lactic acidosis,
nyob rau hauv muaj mob raum tsis ua hauj lwm nyob rau hauv lub anamnesis.

Yuav noj cov tshuaj metformin li cas?

Nws yog ib qho tseem ceeb rau cov neeg mob uas xav kom ua kom zoo tshaj cov piam thaj hauv ntshav kom paub yuav ua li cas noj metformin nrog ntshav qab zib. Nws yuav tsum nco ntsoov tias kev ua lag luam muaj cov nyiaj nrog ntau cov tshuaj sib txawv, thaj tsam li 500 mg txog 1000 mg. Kuj tseem muaj cov tshuaj uas muaj lub sijhawm ntev. Qhov tshuaj tiv thaiv thawj zaug tau muab rau hauv qhov ntau kawg, tom qab ntawd tus kws kho mob yuav pom zoo kom nce ntxiv. Tus lej ntawm kev siv rau ib hnub tseem tuaj yeem kho los ntawm tus kws kho mob, tab sis qhov siab tshaj plaws uas tau tso cai rau txhua hnub tsis pub tshaj 2 g.

Yuav ua li cas nrog ib tug overdose ntawm cov tshuaj

Tsis txhob nce qhov koob tshuaj ntawm cov tshuaj los txhim kho cov nyhuv ntawm cov tshuaj lossis nce siab kho lub sijhawm. Feem ntau, ib qho kev noj qab haus huv xaus rau hauv lub kua muag - nws ua rau muaj kev phom sij rau lub cev, kev tuag taus yuav tsis yooj yim dua.

Qhov phom sij ntawm kev siv ntau tshaj ntawm Metformin yog kev txhim kho ntawm cov kab mob lactic acidosis. Cov yam ntxwv ntawm tus kabmob yog mob plab (uas yog, hauv plab) thiab mob nqaij, muaj teeb meem plab zom mov, ua pa nrawm nrawm, lub cev kub tsawg, kiv taub hau thiab tsis nco qab mus txog thaum tsis nco qab.

Yog tias koj muaj tsawg kawg yog ib qho ntawm cov phiajcim no, koj yuav tsum tsum tsis txhob noj tshuaj tam sim ntawd thiab sab laj nrog kws kho mob. Lub tsev khomob yuav siv txhua yam kev coj ua thiaj li yuav tshem tau lactate tawm ntawm lub cev. Nyob rau hauv feem ntau qhov xwm txheej loj, hemodialysis yog kev kho mob. Nws ua tau zoo tshaj plaws thiab muab cov txiaj ntsig ceev.

Kev cuam tshuam nrog lwm yam tshuaj

Qhov keeb kwm ntawm biguanides muaj cov yam ntxwv tshwj xeeb - yuav luag txhua qhov tshuaj tawm los ntawm lub raum tsis hloov, thiab nws seem (li ntawm 10%) accumulates hauv lub cev. Thiab yog tias lub raum pib ua haujlwm tsis tu ncua, Metformin tsub ntxiv ntau nyob rau hauv cov ntaub so ntswg, uas ua rau muaj kev tsis zoo tshwm sim mus txog rau qhov tsis nco qab.

Nws yog txwv tsis pub siv cov metformin nrog cawv

Nws kuj yog ib qho tseem ceeb heev los kho kom haum rau kev siv cov tshuaj tiv thaiv hypoglycemic nrog insulin. Tom qab txhua qhov, yog tias Metformin tshwm sim hauv cov ntshav ntau tshaj qhov xav tau, tus neeg mob nrog cov lus qhia ntawm insulin tuaj yeem poob rau hauv lub ntsej muag hypoglycemic vim tias txo qis cov piam thaj hauv lub cev.

Kev poob qis hauv cov ntshav hauv lub ntsej muag tseem raug pom nrog kev siv cov tshuaj hauv qab no nrog Metformin:

sulfonylurea derivatives,
NSAIDs
oxytetracycline
MAO inhibitors (cov tshuaj tiv thaiv kab mob ib ce),
acarbose,
ACE inhibitors
cyclophosphamide,
β-blockers

Thiab cov nyiaj no, thaum siv nrog cov tshuaj txo suab thaj, ntawm qhov tsis sib xws, txo nws cov haujlwm:

corticosteroids
cov thyroid hormones,
tshuaj kho mob
estrogens
tshuaj tiv thaiv qhov ncauj
nicotinic acid
calcium receptor blockers
adrenomimetics
isoniazids, thiab lwm yam.

Yog li, Metformin yog ib cov tshuaj muaj suab thaj zoo heev uas muaj qhov ua tau siab, tab sis tib lub sij hawm tsis yog ib qho tshuaj uas suav daws. Nws muaj nws qhov tsis zoo thiab tsis pom kev. Lawv feem ntau muaj hnub nyoog me thiab dhau mus li ntawm 1-2 lub lis piam, tab sis lwm tus yuav yuam kom tsum tsis txhob noj.

Txhawm rau cov tshuaj kom tau txais txiaj ntsig, nws yuav tsum koom tes nrog kev noj tshuaj nrog tus kws kho mob, ua raws txhua yam nws pom zoo, nruj me ntsis rau cov khoom noj kom zoo thiab ua tib zoo saib xyuas contraindications thiab nws cov kev mob tshwm sim. Koj tseem yuav tsum nco ntsoov tias dej cawv yog yeeb ncuab tseem ceeb ntawm Metformin, yog li cov dej cawv muaj cawv yuav tsum tau cais tawm thaum kho. Qhov no yog vim qhov tseeb tias cawv txwv tsis pub ua haujlwm ntawm ntau lub siab enzymes. Yog li, ntau Metformin nkag mus rau hauv cov hlab ntshav, uas ua rau cov ntshav qabzib nce siab txog cov ntshav qabzib. Ib qho ntxiv, haus dej cawv thaum sib cuam tshuam nrog cov tshuaj lactic acid. Yog li, nws txoj kev siv thaum kho nrog cov tshuaj no yog contraindicated.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj

Cov tshuaj rau ntshav qab zib mellitus "metformin" tuaj yeem noj tsuas yog qhia los ntawm kws kho mob. Tus kws kho mob thiab teeb tsa qhov tsim nyog tau tshuaj. Nrog nws, koj yuav tsum tau stipulate tag nrho cov ntsiab lus ntawm kev noj tshuaj. Cov lus qhia dav dav ntawm yuav ua li cas noj metformin hauv ntshav qab zib mellitus:

Thawj zaug muab ntau npaum li cas feem ntau yog 1 lossis 2 ntsiav tshuaj ntawm cov tshuaj,
Yog tias tom qab 2 lub lim tiam cov kev mob tshwm sim tsis tshwm sim, cov koob tshuaj muaj peev xwm nce ntxiv. Ntau npaum li cas qhov kev nce no tshwm sim yog tus kws kho mob qhov kev txiav txim siab. Nws nyob ntawm qib ntawm cov piam thaj hauv cov ntshav,
Kev siv li niaj zaus, uas pab tswj cov ntshav qab zib thiab tiv thaiv kom tsis txhob muaj teeb meem, yog 3 lossis 4 ntsiav tshuaj hauv ib hnub,
Yog tias tus mob ntshav qab zib yog neeg laus, nws yuav tsum tsis txhob haus tshuaj ntau dua 2 ntsiav tshuaj ib hnub twg,
Qhov siab tshaj plaws uas yuav haus tau dej cawv nkaus xwb uas tus kws kho mob tau sau tseg yog 6 ntsiav tshuaj hauv ib hnub,
Kuv puas haus tau cov tshuaj txhua hnub? Cov kws kho mob qhia kom faib cov koob tshuaj rau hauv 3 koob tshuaj,
Koj yuav tsum tau haus cov tshuaj tam sim ntawd tom qab noj mov. Hauv qhov no, nco ntsoov haus cov ntsiav tshuaj nrog kua kom txaus.

Nrog ib qho kev tshaj tawm, txhua qhov kev mob tshwm sim tau pom tam sim ntawd. Ceevfaj, vim kev siv tshuaj txhaum cai ntawm cov tshuaj no tuaj yeem ua rau lub txim tuag. Cov tshuaj metformin rau cov ntshav qab zib hom 2 tsuas ua tau zoo tsuas yog ua raws nraim li cov lus qhia.

Tsis txhob hnov qab noj zaub mov zoo thaum noj tshuaj thiab ua lub cev qoj ib ce yooj yim. Yog tsis muaj cov kev ntsuas no, kev hais daws yuav tsis muaj qab hau, thiab koj yuav tsis muaj peev xwm tiv thaiv kev ua txhaum loj.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Cov ntsiav tshuaj Enteric coated, Metformin muaj qhov hloov puag ncig, biconvex nto thiab xim dawb. Lub ntsiab tseem ceeb ntawm cov tshuaj yog metformin hydrochloride, nws cov ntsiab lus hauv ib ntsiav tshuaj yog 500 mg. Tsis tas li, nws muaj pes tsawg leeg suav nrog cov khoom siv sib txuam, uas suav nrog:

Crospovidone.
Talc.
Magnesium stearate.
Pob kws nplej siab.
Methacrylic acid thiab methyl methacrylate copolymer.
Povidone K90.
Titanium dioxide
Macrogol 6000.

Cov tshuaj Metformin tau ntim rau hauv ib lub paug blooj ntawm 10 daim. Daim npav pob ntawv muaj 3 lub hlwv (30 ntsiav tshuaj) thiab ib qho lus piav qhia txog kev siv tshuaj.

Pharmacological kev txiav txim

Cov tshuaj ua hauj lwm zoo ntawm Metformin ntsiav tshuaj txo qhov kev saib xyuas ntawm cov piam thaj hauv cov ntshav vim muaj ntau cov kev mob lom:

Txo kev nqus ntawm cov piam thaj los ntawm cov hnyuv lumen rau hauv cov ntshav.
Txhim kho qhov tsis txaus siab ntawm cov ntaub so ntswg txais rau cov tshuaj insulin (ib tus kabmob pancreatic uas ua rau muaj kev siv cov piam thaj ntau ntawm cov ntshav hauv cov nqaij hauv lub cev).
Txhim kho qhov siv txuas nrog ntawm cov carbohydrates hauv cov nqaij ntawm lub cev.

Metformin tsis cuam tshuam rau lub hlwb pancreatic lub luag haujlwm rau kev tsim cov tshuaj insulin, tsis cuam tshuam rau nws qib hauv cov ntshav, thiab kuj tsis ua rau cov ntshav qog ntshav qis (ib qho cim txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav). Nws txo qib ntawm triglycerides (rog hauv cov ntshav), pab txhim kho cov metabolism hauv lub cev, ua rau lub cev poob phaus, muaj cov nyhuv fibrinolytic (pab yaj tawm fibrin).

Tom qab noj cov tshuaj Metformin rau sab hauv, cov tshuaj yeeb dej cawv tsis cuam tshuam tag nrho (kev siv tshuaj tua kab mob mus txog 60%). Nws yuav luag sib luag faib tawm hauv cov ntaub so ntswg ntawm lub cev, me ntsis ntau ntxiv hauv cov qaub ncaug qaub ncaug, nplooj siab, raum thiab cov leeg. Cov tshuaj qaug tshuaj ntawm cov tshuaj tsis tau metabolized thiab ua rau tsis txawv txav hauv cov zis. Ib nrab-lub neej (lub sijhawm lub sijhawm uas ib nrab ntawm tag nrho cov tshuaj ntawm cov tshuaj tawm ntawm lub cev) yog 9-12 teev.

Tsuas tshuaj thiab tswj hwm

Metformin ntsiav tshuaj noj ntawm qhov ncauj nrog zaub mov lossis tam sim ntawd tom qab noj. Tsis txhob zom cov ntsiav tshuaj thiab haus dej ntau. Txhawm rau txo qhov zoo li ntawm kev txhim kho cov nyom tshwm sim los ntawm lub plab zom mov, cov tshuaj txhua hnub yog noj, faib rau 2-3 koob. Tus kws kho mob teev qhov ntau thiab tsawg ntawm cov tshuaj ib leeg zuj zus, nyob ntawm seb thawj zaug cov suab thaj hauv cov ntshav tau zoo li cas, thiab kev kho kom zoo li cas. Feem ntau, cov tshuaj pib yog 500-1000 mg ib hnub (1-2 ntsiav tshuaj). Tom qab 10-15 hnub, nyob ntawm theem ntawm cov piam thaj hauv cov ntshav, nws muaj peev xwm nce cov tshuaj ntau ntxiv ntawm Metformin ntsiav tshuaj rau 1500-2000 mg ib hnub. Qhov siab kawg txhua hnub noj tshuaj yuav tsum tsis pub tshaj 3000 mg. Hauv cov neeg laus, qhov siab tshaj plaws qhov kev kho txhua hnub yuav tsum tsis pub tshaj 1000 mg.

Sab sij huam

Noj cov tshuaj Metformin tuaj yeem ua rau muaj kev txhim kho kev phiv los ntawm ntau yam kabmob thiab cov kab ke:

Lub plab zom mov - "nws yog xim hlau" saj hauv lub qhov ncauj, xeev siab, ntuav raws sij hawm, mob plab, zawv plab, tsis qab los noj mov kom txog thaum nws qhaj tag (tsis nco qab), flatulence (nce roj tsim hauv plab hnyuv). Cov kev mob tshwm sim no feem ntau pib thaum pib ntawm txoj kev kho mob nrog tshuaj thiab ploj ntawm lawv tus kheej. Txhawm rau txo qis qhov mob hnyav ntawm cov tsos mob no kom sai li sai tau, antacids, antispasmodics thiab atropine-xws li cov tshuaj yog kws kho los ntawm tus kws kho mob uas koom
The endocrine system yog hypoglycemia (kev txo qis hauv cov ntshav qab zib cov ntsiab lus qis dua ib txwm).
Metabolism - lactic acidosis (nce siab ntawm cov lactic acid hauv cov ntshav), tsis tuaj yeem cuam tshuam ntawm cov vitamin B12 los ntawm txoj hnyuv.
Cov ntshav thiab cov pob txha pob txha liab - megaloblastic anemia (anemia cuam tshuam nrog kev ua txhaum ntawm kev tsim thiab kev loj hlob ntawm cov qe ntshav liab hauv cov pob txha pob txha vim tsis muaj cov vitamin B12 txaus) tsis tshua muaj tshwm sim.
Ua xua - tawv nqaij ua pob khaus thiab khaus.

Nrog rau kev txhim kho kev mob tshwm sim tom qab noj cov tshuaj Metformin, tus kws kho mob txiav txim siab txog kev tshem tawm cov tshuaj ib tus zuj zus, nyob ntawm lawv hom thiab mob hnyav.

Cov lus qhia tshwj xeeb

Ua ntej noj cov tshuaj Metformin, koj yuav tsum ua tib zoo nyeem cov lus qhia rau cov tshuaj. Muaj ntau ntau cov lus qhia tshwj xeeb txog nws qhov kev siv, uas suav nrog:

Nrog cov tsos ntawm cov leeg mob (myalgia) tom qab pib siv yeeb tshuaj, ib qho kev txiav txim siab hauv chaw kuaj ntshav ntawm qib lactic acid hauv cov ntshav tau nqa tawm.
Kev siv sijhawm ntev siv cov tshuaj yuav tsum muaj kev tshuaj xyuas txhua lub sijhawm ntawm kev sim ntsuas ntawm lub cev ua haujlwm ntawm lub raum.
Nrog rau kev siv ua ke ntawm Metformin ntsiav tshuaj nrog cov tshuaj tau los ntawm sulfonylureas, ceev faj txhua lub sijhawm saib xyuas cov ntshav qabzib yuav tsum muaj.
Lub sijhawm kho mob yuav tsum tsis txhob haus cawv thiab tshuaj muaj tshuaj ethanol.
Cov tshuaj Metformin tuaj yeem cuam tshuam nrog cov tshuaj ntawm lwm pawg pharmacological, yog li ntawd, thaum noj lawv, nws yog qhov yuav tsum ceeb toom cov kws kho mob uas tuaj kawm txog qhov no.
Yog tias cov tsos mob ntawm tus mob bronchopulmonary thiab genitourinary pathology tshwm sim keeb kwm ntawm kev noj tshuaj, nws txoj kev siv yuav tsum nres thiab sab laj nrog kws kho mob.
Cov tshuaj tsis cuam tshuam ncaj qha rau cov kev ua haujlwm ntawm lub hlwb, cortex, txawm li cas los xij, thaum siv nrog lwm tus neeg lub cev hypoglycemic, qhov kev pheej hmoo ntawm hypoglycemia nce, yog li ntawd, thaum ua haujlwm ua haujlwm koom nrog kev xav tau nce ntxiv ntawm kev saib xyuas thiab ceev ntawm psychomotor cov tshuaj tiv thaiv, yuav tsum ceev faj.

Hauv cov khw muag tshuaj network, Metformin ntsiav tshuaj muaj nyob rau hauv cov tshuaj. Kev tswj hwm tus kheej yam tsis tau tshuaj yam tsis tsim nyog yuav tsis pom zoo.

Noj ntau dhau

Nrog rau qhov muaj nuj nqi ntau dhau ntawm cov tshuaj kho pom zoo ntawm cov tshuaj Metformin, cov tshuaj lactic acid hauv cov ntshav nce siab (lactic acidosis). Qhov no nrog rau xeev siab, ntuav, raws plab, txo qhov kub ntawm lub cev, mob hauv cov leeg thiab plab, thiab ua pa ceev. Hauv qhov no, cov tshuaj yuav tsum tsis ua mus ntxiv. Kev noj tshuaj ntau dhau yog nqa hauv tsev kho mob nrog kev pab los ntawm hemodialysis (kho vajtse lim ntshav).