Biguanides yana cikin nau'in guanidines, waɗanda ke tasiri a cikin ciwon sukari. Bayan haka, wannan aji na kwayoyi na rage karfin tasirin glucose a cikin jini.
Wadannan wakilai sune: L-butylbiguanide (Buformin), N, N-dimethylbiguanide (Metformin), Phenethylbiguanide (Fenformin).
Bambanci a cikin tsarin samar da sukari mai raguwar biguanides ya ta'allaka ne akan tsarin su ta jiki da sashi na sashi. Amma tasirin guanidine akan metabolism daidai ne a yawancin halaye.
Koyaya, ba a amfani da wakilai na antihyperglycemic azaman monotherapy. A matsayinka na mai mulkin, wannan yana faruwa a cikin 5-10% na lokuta.
Ta yaya biguanides ke aiki?
Yadda waɗannan magungunan ke shafar jikin mutum ba shi da cikakkiyar fahimta, duk da yawan karatu. Amma an rubuta cewa abubuwanda ke haifar da ragewar glucose na jini a cikin nau'in ciwon sukari na 2, musamman idan mai haƙuri yana da matsala da kiba.
Biguanides suna da tasirin "kiyayewa ta insulin", don haka a tsawon lokaci buƙatu na kula da kwayar halittar roba yana raguwa. Hakanan, waɗannan magungunan suna rage yawan gluconeogenesis daga furotin.
Bugu da ƙari, irin waɗannan samfurori suna haɓaka ƙwayar tsoka ta hanyar sauya sukari zuwa lactate. Sakamakon yaduwa da abubuwan da aka samo daga guanidine, tsarin sha abubuwa kamar su:
- fats
- bitamin B 12№
- amino acid;
- D-xylose.
Akwai ra'ayi cewa a cikin aiwatar da hanawa na juyawar nama, samuwar ATP yana raguwa, wanda ke rage jigilar matakai daban-daban wanda ake cinye makamashi (alal misali, gluconeogenesis). Mai yiwuwa, hanyar aiwatar da biguanides shine tasirin su akan metabolism na lipid.
Hakanan an gano cewa waɗannan magunguna a cikin masu ciwon sukari da ke fama da rashin insulin tare da nauyi mai yawa suna taimakawa wajen rage girman jiki.
Amma ana lura da irin wannan tasirin ne kawai a farkon farfaɗo, lokacin da wasu abubuwa ba su cika cikin hanji ba, za a rage ciwar mai haƙuri.
Sashi da gudanarwa
Tsarin biguanides ya haɗa da kwayoyi waɗanda ke da suna kamar haka:
- Siofor 1000/850/500;
- Bagomet;
- Metformin Acre;
- Avandamet;
- Glucophage;
- Metfogamma.
A yau, ana amfani da abubuwan da ake amfani da su na methylbiguanide, watau metformin. Waɗannan sun haɗa da Gliformin, Glucofag, Dianormet da sauran abubuwa.
Hanyar aikace-aikacen yawancin biguanides yana kama. Da farko, an tsara ƙananan allurai, amma tare da haƙuri mai kyau ana ƙara su a cikin kowane kwanaki 2-4. Haka kuma, polyhexamethylene biguanide dole ne ya bugu bayan cin abinci, wanda zai hana ci gaban sakamako daga cututtukan hanji.
Ofungiyar biguanides da aka yi amfani da su don magance cututtukan da ba su da insulin-insulin yana da tasirin warkewa na sa'o'i goma sha biyu. Sabili da haka, ya kamata a raba sashi na yau da kullum zuwa kashi biyu.
A farkon farawa, ana ɗaukar Metformin 850, Siofor da makamantan su a cikin adadin 500 MG sau ɗaya (da yamma). Bayan mako guda, da aka bayar da cewa mara lafiya ba shi da matsala tare da ƙwayar ƙwayar jijiyoyi, ana ƙaruwa da kullun sashi zuwa 850 MG ko haƙuri yana shan ƙarin 500 MG da safe.
Game da halayen masu illa, dole ne a rage kashi, kuma bayan ɗan lokaci sake gwadawa don ƙara shi. Matsakaicin mafi kyawun abu a cikin jiki yana faruwa ne bayan watanni 1-2 na jiyya.
Tallafar sashi - har zuwa 2000 MG kowace rana. Matsakaicin izini mai izini shine 3000 MG kowace rana, amma kawai ga matasa marasa lafiya. Matsakaicin adadin don marasa lafiya tsofaffi bai wuce 1000 mg ba.
Polyhexamethylene biguanide za a iya haɗe shi tare da ɓoyayyen abubuwa (sulfonylureas da amo), insulin da glitazones. Sabili da haka, kamfanonin magunguna suna samar da shirye-shiryen haɗuwa da aka shirya waɗanda ke da tasirin hypoglycemic a cikin ƙananan matakin, wanda zai rage haɗarin sakamako masu illa:
- Glucovans (metformin da glibenclamide);
- Glibomet.
Idan kun dauki irin wannan samfurin haɗin, to, yawan taro na sukari a cikin jinin yana daidaitawa bayan sa'o'i 2, kuma tasirin zai kasance har zuwa awanni 12.
Ana ɗaukar irin waɗannan kwayoyi tare da kwamfutar hannu 1 a kowace rana tare da ƙaruwa mai zuwa akan sashi zuwa capsules 2 kowace rana.
M Yan adawar da Contraindications
Polyhexamethylene biguanide da wasu abubuwa daga wannan rukunin na iya haifar da wasu munanan ayyuka. Mafi yawan abubuwan sun hada da kasawa a cikin narkewa, narkewar abinci, kasancewar dandano mai karfi a cikin bakin da kuma ci gaban lactic acidosis.
Mai nuna alama don dakatar da shan kayan maye daga jerin guanidine shine farmakin zawo. Koyaya, tare da daidaitawa na kashi, yawancin sakamako masu illa suna ɓacewa.
An hana karuwar Metformin a cikin wadannan lamura:
- gazawar numfashi;
- ciwon sukari anaemia;
- matsalolin hanta
- bugun jini;
- ciki
- m cututtuka;
- encephalopathy rarrabuwa;
- renal dysfunction, lokacin da matakin creatinine a cikin jini ya fi 1.5 mmol / l.
Hakanan, magunguna ba za a iya ɗauka tare da coma mai ciwon sukari ba, ciki har da ketoacidosis kuma, idan akwai tarihin lactic acidosis. Bugu da kari, irin wadannan kwayoyi suna contraindicated a cikin hypoxic yanayi (tashin zuciya, angina pectoris, matalauta jini wurare dabam dabam).
Metformin ba ta dace da barasa ba. Kuma idan hanta tana ƙaruwa, to irin waɗannan kwayoyi ana wajabta su ne kawai lokacin da hepatomegaly ya faru akan asalin cutar hepatostatosis mai ciwon sukari.
A cikin yanayin dystrophic, rashin lafiyan ko cututtukan hanta na hanta, biguanides na iya shafar cututtukan hepatic parenchyma. Sakamakon haka, ana iya gani a cikin canje-canje a cikin gwaje-gwajen aiki. Hakanan za'a iya inganta Cholestasis, tare da alamun bayyanar cutar ta jaundice.
Idan aka kwatanta da abubuwan da ake amfani da su na sulfonylurea, kwayoyi daga yawan guanidines ba su da wani sakamako mai guba a kan kodan da ragowar kasusuwa. Kodayake, suna contraindicated idan akwai mummunar cutar rashin ƙarfi, riƙewa, gubobi na nitrogen da kuma a gaban cututtukan koda wanda ke haifar da raguwa cikin tacewar duniya.
Hakanan, idan magani tare da biguanides an haɗu da fructose, antihistamines, barbiturates, teturam da salicylates, wannan zai kara lactic acidosis.
An bayar da lacca game da magungunan cutar sankara a cikin bidiyo a cikin wannan labarin.
