Sau da yawa, allunan don matsa lamba a cikin nau'in ciwon sukari na 2 na mellitus ana gano su ta hanyar marasa lafiya tare da ingantaccen ganewar asali kamar kullun magungunan antipyretic.
Wannan dalili shine saboda gaskiyar cewa tsarin cututtukan cututtukan cuta an nuna shi ba kawai akan aikin da yake faruwa na kashin baya ba, har ma yana tattare da matsaloli daban-daban daga wasu bangarori da gabobin jikin mutum.
Haɓaka ciwon sukari mellitus yana da haɗari ba kawai ta hanyar manyan alamu da alamun cutar ba, har ma ta ƙara haɗarin bayyanawar mummunan sakamako, rushewar aiki na yau da kullun na yawancin gabobin ciki da tsarin jikin mutum.
Da farko dai, tare da nau'in ciwon sukari na 2 na ciwon sukari, wasan kwaikwayon tsarin zuciya da jijiyoyin jini suna fara lalacewa. A matsayinka na mai mulkin, sakamakon irin wannan take hakkin sune:
- akwai barna a cikin wadatar jini a jiki baki daya;
- haɗarin bugun jini ko infarction myocardial yana ƙaruwa;
- karuwa cikin karfin jini;
- atherosclerosis, abin da ya faru na ƙwanƙwasa jini a sakamakon toshe hanyoyin jini da jijiyoyin jini.
Banda
Bugu da kari, mummunan sakamakon da ka iya faruwa yayin ci gaban ciwon sukari sun hada da:
Cikakken ko ɓataccen asarar ji na gani, saboda lalata retina yana faruwa ne sakamakon sukarin jini. Haɓaka ƙwayar tsoka, wanda ke bayyana kanta a cikin nau'i mai raɗaɗi mai raɗaɗi a cikin ƙananan ƙarshen.
Mai ƙarancin aiki na ƙodan da hanta. Rage rigakafi.
Cutar daban-daban na tsarin juyayi. Mafi sau da yawa ana shafar jijiyoyin wannan ƙarshen, wanda ke haifar da lambobi da asarar jijiyoyin. Rashin narkewar ƙwayar cuta. Ci gaban cututtuka daban-daban na fata.
Abin da ya sa yana da matukar muhimmanci a bincika cutar ta dace kuma a fara ɗaukar magani.
Pressureara yawan jini a cikin ƙwayar mellitus-non-insulin-dogara da yawan ƙwayar cuta
Ciwon sukari da cuta, wanda aka bayyana ta hanyar kamuwa da cutar hawan jini a kai a kai, abubuwa ne da ba za a iya raba su biyu ba. Ya kamata a lura cewa hauhawar jini na iya zama ɗayan abubuwan da ke haifar da bayyanar cututtukan cuta da haɓaka bayan kafa cutar sankara.
Koyaya, dukkanin cututtukan biyu suna da mummunar tasiri a cikin aiki na jiki, wanda zai iya bayyana kansa a cikin hanyar:
- lalacewar tasoshin kwakwalwa;
- matsaloli tare da aikin zuciya na yau da kullun;
- mummunan tasiri a kan tasoshin idanun;
- lalataccen aikin na koda.
Mafi sau da yawa, hauhawar jini a cikin ciwon sukari mellitus yana haifar da cututtukan masu zuwa:
- Myocardial infarction da bugun jini.
- Ischemia na zuciya.
- Wani tashin hankali a hankali na rarrabuwar hanji ke faruwa.
- A ci gaba da na koda gazawar da m irin.
Farkon irin wannan mummunan tsari kamar ciwon sukari mellitus koyaushe yana farawa tare da bayyanar da juriya na insulin, wanda ke nuna kanta a cikin nau'i na asarar ɓangaren jijiyoyin ƙwaƙwalwar ƙwayar jiki zuwa hormone wanda insulin ya samar. Jiki, don rama irin wannan raguwar hankalin, ya fara samar da insulin girma mai yawa, wanda ke kara karfin jini kuma yana kaiwa ga ci gaban hawan jini.
Yayin aiwatar da bayyanar cutar sankarar mellitus, ƙwayar lumen tasoshin jini (sakamakon atherosclerosis) sannu a hankali ta narke, wanda ke ƙara haɓaka haɓakar hauhawar jini.
Bugu da kari, kasancewar yawan kiba na ciki halaye ne ga masu ciwon sukari, wanda ke kara kaya a jikin jijiyoyin jini, yana kara karfin jini. Don haka, duk tafiyar matakai da suke faruwa a jiki suna da alaƙa. Kuma gazawa a aikin wani bangare yana haifar da keta tsarin aikin wasu.
Ya kamata a lura cewa a cikin mutum mai lafiya, hawan jini yayin bacci kuma nan da nan bayan farkawa ya ɗan ƙanƙanta da ka'idodin da aka kafa. Haɓaka ciwon sukari yana haifar da gaskiyar cewa matsin lamba baya raguwa da dare, kuma a wasu yanayi, har ma yana iya tashi.
Wannan shine dalilin da yasa maganin da ake amfani da shi don maganin ciwon sukari na 2 sau da yawa ya ƙunshi magungunan matsa lamba.
Yadda ake yin zaɓin da ya dace?
Wadanne kwayoyin magunguna zan iya sha don bi da hauhawar jini a cikin ciwon sukari na mellitus don kada in tsokani bayyanar da mummunan halayen? Wajibi ne a ɗauki magunguna kawai kamar yadda likitan halartar ya umarta, waɗanda ba sa ƙara yawan glucose a cikin jini.
Zuwa yau, kasuwar pharmacological tana ba da zaɓi mai yawa na magunguna daban-daban tare da tasirin antihypertensive. Koyaya, yawancinsu an hana su shan gaban masu ciwon sukari.
Lokacin zabar magani don matsa lamba don ciwon sukari, dole ne a yi la’akari da waɗannan abubuwan:
- Sakamakon magani a kan lipid da carbohydrate tafiyar matakai a cikin jiki. Ya kamata a zaba maganin saboda tasirinsa ya zama tsaka tsaki ko yana haɓaka metabolism na fats da carbohydrates.
- Allunan don hawan jini kada su sami contraindications a gaban matsaloli tare da aiwatar da kodan ko hanta.
- Zai fi kyau zaɓar magani don matsa lamba a cikin ciwon sukari tare da tasirin ƙwaƙwalwar ƙwayar cuta. Irin waɗannan kwayoyi suna ba da gudummawa wajen haɓaka ayyukan ƙwayoyin cuta da suka lalace.
Magunguna don hawan jini a cikin tsohuwar tsara don ciwon sukari ba da shawarar ba. Irin waɗannan kwayoyi na tsakiya suna da contraindications a gaban ciwon sukari.
Mutanen da suke da guda biyu masu ciwon sukari da hauhawar jini suna da haɗarin haɓaka rikitar rikicewar zuciya. Abin da ya sa ke nan, ya kamata a nemi magani na warkewa a raguwar hankali a cikin bugun jini - a wata na fari zuwa 140/90 mm. Hg. Art., A yanayin saukan kyale da kwayoyi. Therapyarin ilimin likita ya ƙunshi raguwa zuwa 130/80.
Babban abin lura shi ne yadda mara lafiya ke tura magungunan da suke shan. Idan akwai haɗarin rikice-rikice ko kuma matsayin haƙuri ga allunan ba su kai babban matakan ba, yana yin ma'ana a hankali a hankali sannu a hankali rage karfin jini.
Dole ne Likita mai halartar aiki ya zama dole ya sarrafa ayyukan gaba. Zai fi kyau idan matsin lamba ya ragu da kashi goma a kowane wata tare da mai haƙuri yana jin daɗi.
A matsayinka na mai mulkin, jiyya na ɗaukar kimanin makonni uku zuwa huɗu, bayan wannan akwai daidaitawar hanyoyin da aka kafa.
Kungiyoyin kwayoyi don hauhawar jini?
Har zuwa yau, akwai irin waɗannan manyan kungiyoyin magunguna waɗanda ke taimakawa wajen yaƙar hauhawar jini:
- magungunan kwayoyi;
- alfa da beta na hanawa;
- masu maganin tashin zuciya;
- ACE inhibitors (ACE inhibitors);
- angiotesin mai karɓar baƙi na biyu;
- magungunan diuretic;
- diuretic kwayoyi.
Magungunan Beta-tarewa sune mafi yawan lokuta ana umurce su da likitocin halartar a gaban cututtukan haɗuwa da cututtukan arrhythmias ko cututtukan zuciya. Babban bambance-bambance tsakanin irin waɗannan kwayoyi a tsakanin su sune halaye masu zuwa:
- Zaɓi.
- Lipophilicity.
- Hydrophilicity.
- Abilityarfin lalata diyoyin jini.
Magungunan Alfablocator suna da ƙananan haɓakar hawan jini, haka ma, suna da fa'ida a kan mai da haɓakar carbohydrate, da haɓaka jijiyar nama zuwa insulin. Koyaya, duk da ire-ire iri iri, dole ne a yi amfani dasu da taka tsantsan. Irin waɗannan magungunan na iya haifar da hypoension orthostatic (raguwa mai ƙarfi), kumburi nama, da tachycardia. Bugu da ƙari, contraindications don amfanin su sun haɗa da mutanen da ke fama da rashin zuciya.
Masu adawa da Calcium sune magunguna masu inganci sosai, amma tsawon mulkin su na iya haifar da raguwar samarda insulin. Da zaran an cire irin wannan magungunan, jikin ya fara aiki da wannan ƙarfin. Kyakkyawan kaddarorin allunan sune:
- rage matakin karfin jini har ma da amfani da miyagun ƙwayoyi a cikin ƙananan allurai;
- haɗarin haɓaka ciwon sukari wanda ba shi da insulin-insulin-ciki ba yana ƙaruwa.
Masu adawa da Calcium na iya zama gajere ko tsawan lokaci. Ya danganta da nau'ikan miyagun ƙwayoyi, kayan aikin magani da yiwuwar raunin halayen suna bayyana. Sau da yawa, irin waɗannan magunguna ana wajabta wa marasa lafiya don rigakafin bugun jini, tare da babban matakin hawan jini.
ACE inhibitors sune mafi kyawun zaɓi don rage hawan jini a cikin masu ciwon sukari. Suna da tasiri a kan aikin jijiyoyin jini, metabolism, da aikin kodan da hanta.
Magunguna daga ƙungiyar ACE inhibitors ya kamata a wajabta su ta musamman daga likitan halartar, saboda suna da yawancin contraindications don amfani.
Haramun ne a yi amfani da na'urorin lafiya ga wadanda ke fama da cutar sankara ta hanji. Kwayoyi na iya haifar da abin da ya faru na bushe tari da sauran halayen masu illa.
Ba za a iya amfani da shi ba a gaban lalacewar koda, kafin amfani da maganin, ya zama dole don saka idanu kan karfin jini, matakan creatinine da potassium a cikin jini.
Magunguna na wannan rukunin, a matsayin mai mulkin, ba a ba da umarnin ga tsofaffi masu ɗauke da cutar ta atherosclerosis, tunda za su iya faruwa.
Yawancin lokaci ana ba da magungunan diuretic a hade tare da magunguna na ƙungiyar inhibitor ACE. Babban mahimmancin waɗannan ƙwayoyin diuretic sune:
- Tasirin laushi a jiki.
- Karka shafi matakin glucose da lipids a cikin jini.
- Karku hana aikin hanta da ƙodan.
Mafi kyawun zaɓi don amfani da irin wannan maganin yana iya kasancewa Indapamide da Arefon Retard.
Siffar Allunan
Babban magungunan da ba a zaɓa daga ƙungiyar betablocker sune Anaprilin da Allunan Nadodol, waɗanda ke da tasiri kai tsaye ga masu karɓar da ke cikin ƙwayar cuta. Sakamakon yaduwar su, ya hana samar da sinadarin hodar da ke cikin jikinta illa. Magungunan rigakafin ƙwayoyin cuta don ciwon sukari sun fi kyau zaɓi nau'in zaɓe. Waɗannan su ne, da farko, shirye-shiryen Atenolol, Bisoprolol, Metoprolol. Irin waɗannan ƙwayoyi suna da amfani mai amfani akan aikin zuciya.
An gabatar da lipophilic betablockers a kan kasuwar magunguna tare da irin waɗannan wakilan tebur kamar Metoprolol da Pindolol. Halinsu na rarrabe shine cewa hanta gaba daya ke cire su daga jiki. Abin da ya sa, tare da haɓakar ciwon sukari mellitus, ana tsara irin waɗannan magungunan da wuya sosai, don kada su haifar da mummunar illa ga aikin ƙwayar cuta.
Atenolol da Nadolol suna cikin rukunin rukuni na magungunan beta masu hana ruwa ruwa. Irin waɗannan kwayoyi suna da sakamako mai tsawo bayan gudanarwa, kuma basu da mummunar tasiri akan aikin hanta da kodan.
Betablockers daga vasodilating tasiri suna da amfani mai amfani don rage ciwo na juriya na insulin, yana kara yawan jijiyar kyallen takarda zuwa insulin. Bugu da kari, daga cikin m Properties za a iya danganta mai kyau sakamako a kan normalization na lipid da mai metabolism. Lokacin ɗaukar irin waɗannan shirye-shiryen kwamfutar hannu, ya zama dole a hankali karanta jerin abubuwan da za'a iya amsawa masu lahani, tunda jerin su sunyi yawa. Babban wakilan wannan rukuni na kwayoyi sune Nebivolol da Cardiovolol.
Daga cikin magungunan ƙungiyar, masu maganin tashin hankali na calcium, marasa lafiya da ke fama da cutar sankarau yakamata su dauki fitsari marasa aiki na tsawon lokaci. Irin waɗannan kwayoyi suna da amfani mai amfani ga ayyukan ƙwayoyin yara. Babban wakilansu sune Verapamil da Diltiazem.
ACE masu hana yara yawanci ana wajabta su don haɓakar ciwon sukari don rage karfin jini. Sun kawar da alamun hauhawar jini, da rage kaya a zuciya, haka kuma suna hana ci gaban cututtukan zuciya. Babban magunguna a cikin wannan rukunin sune Captopril, Ramipril da Fosinopril.
Masu adawa da Angiotesin 2 sune sabon rukuni na magunguna tare da rashin yiwuwar tasirin sakamako. Irin waɗannan kwamfyutocin ana kasuwa a ƙarƙashin waɗannan sunaye:
- Losartan;
- Telmisartan;
- Valsartan.
Amfanin magungunan antagonist mai karɓar maganin angiotesin sune rage haɗarin bugun jini da bugun zuciya, sakamako mai amfani akan kodan, da ƙananan haɗarin halayen masu illa.
Wadanne kwayoyin ne suka fi dacewa a kauracewa gaban masu cutar siga?
Duk da babban zaɓi na magunguna daban-daban waɗanda zasu iya rage cutar hawan jini, ya kamata a ɗauka a zuciya cewa ba duk magunguna ba zasu iya dacewa da mutanen da ke fama da ciwon sukari.
An hana shi shan magungunan thiazide diuretic (Hypothiazide, Chlortiazide, Xipamide), tunda suna ba da gudummawa ga haɓakar sukari na jini da haɓaka mummunan cholesterol. Bugu da ƙari, irin waɗannan kwayoyin suna da mummunan tasiri ga aikin ƙodan, wanda ke da haɗari musamman ga mutanen da ke fama da gaɓar koda. Osmotic diuretics don nau'in 2 da nau'in 1 na ciwon sukari na iya haifar da yanayin cutar hyperosmolar a cikin masu ciwon sukari.
Magungunan rigakafin ƙwayoyi daga rukunin masu maganin ƙwaƙwalwar ƙwaƙwalwa ba a ba da shawarar a ɗauka ba idan magungunan sun kasance dihydropyrid na gajere. Irin waɗannan kwayoyin hana daukar ciki, har ma da ƙananan allurai, suna ƙara haɗarin yawan mace-mace kuma ana rikicewa a cikin marasa lafiya da masu ciwon sukari a cikin cututtukan zuciya da bugun zuciya. Babban wakilin wannan nau'in magani shine Nifedipine.
Atenolol, magani daga rukuni na beta-blockers, na iya tsokani tsalle-tsalle a cikin glucose a cikin jini kuma ya haifar da hypo- ko hyperglycemia. Bugu da kari, irin wannan magungunan yana rage karfin jijiyoyin jikin kwayar halittar zuwa ga insulin wanda sinda ke haifar da ita.
Abin da magungunan za a iya ɗauka tare da hawan jini ga masu ciwon sukari za su faɗi bidiyon a wannan labarin.
