Biguanides magunguna ne da aka kirkira don rage yawan gulcer a cikin jini. Ana samun kayan aiki a cikin nau'ikan allunan.
Ana amfani dasu, mafi yawan lokuta, tare da nau'in ciwon sukari na 2 na mellitus, azaman adjuvant.
A matsayin ɓangare na monotherapy, an tsara kwayoyi na hypoglycemic da wuya. Yawancin lokaci wannan yana faruwa a 5-10% na lokuta.
Biguanides ya haɗa da waɗannan magunguna:
- Bagomet,
- Avandamet
- Metfogamma,
- Glucophage,
- Metformin Acre
- Siofor 500.
A halin yanzu, a cikin Rasha, har ma a duk duniya, ana amfani da biguanides, don mafi yawan ɓangarorin, ana samar da ma'anar methylbiguanide, wato, metformin:
- glucophage
- Siofor
- gamma-gamma,
- dianormet
- glyformin da sauransu.
Metformin yana fashewa daga sa'a daya da rabi zuwa uku. An samar da miyagun ƙwayoyi a cikin allunan 850 da 500 MG.
Magungunan warkewa suna 1-2 g kowace rana.
Kuna iya cinye har zuwa 3 g kowace rana don ciwon sukari.
Maɓallin Butylbiguanide:
- siliki
- buformin
- Adebite.
Lura cewa ana amfani da biguanides marasa iyaka, saboda mummunan sakamako masu illa, shine na ciki dyspepsia.
Yanzu likitoci ba su ba da shawarar yin amfani da abubuwan da ake amfani da su na phenylbiguanide, tunda an tabbatar da cewa sun kai ga tarawa cikin jinin mutum:
- pyruvate
- lactate
Tsarin magani
Masana kimiyya sun tabbatar da cewa tasirin rage sukari na metformin a cikin ciwon sukari yana da alaƙa da takamaiman tasirin maganin a kan tafkin da kira. Tasirin rage yawan sukari na metformin yana da alaƙa da masu gulukos a cikin tantanin halitta.
Ofaukar masu jigilar gulukos yana ƙaruwa saboda haɗuwa da biguanides. An bayyana wannan cikin ingantacciyar hanyar sufurin glucose a cikin sel membrane.
Wannan tasirin yana bayanin sakamako ne kan ayyukan insulin na jikin mutum da na insulin din daga waje. Har ila yau kwayoyi suna aiki a cikin membrane na mitochondrial.
Biguanides yana hana gluconeogenesis, ta haka ne suke ba da gudummawa ga haɓaka abubuwan da ke cikin:
- lactate
- pyruvate,
- Alanine
Wadannan abubuwa sune abubuwanda suka dace na glucose a cikin mahallin gluconeogenesis.
Theaukar masu jigilar glucose yana ƙaruwa a ƙarƙashin aikin metformin a cikin membrane na jini. Game da:
- GLUT-4,
- GLUT-2,
- GLUT-1.
Jirgin glucose na hanzarta:
- a jijiyoyin jiki mai santsi
- endothelium
- tsoka na zuciya.
Wannan yana bayanin raguwar juriya insulin a cikin mutanen da ke dauke da nau'in ciwon sukari na 2 na sukari a cikin tasirin metformin. Haɓakawar ƙwayar hankalin mutum zuwa insulin baya haɗuwa tare da karuwa cikin ɓoyewar shi daga ƙwayar ƙwayar cuta.
A kan tushen raguwa a cikin juriya na insulin, matakin asali wanda ke nuna insulin a cikin jini shima ya ragu. Increasearin haɓakar hankalin mutum zuwa insulin baya haɗuwa tare da haɓakawa ta cikin ƙwayar kansa, kamar lokacin amfani da sulfonylureas.
Lokacin kulawa tare da metformin a cikin mutane, ana lura da asarar nauyi, amma lokacin da ake jiyya tare da wakilan sulfonylurea da insulin, sakamako na gaba zai iya zama. Bugu da kari, metformin yana taimaka wajan rage lipids magani.
Side effects
Dole ne a lura da babban sakamako masu illa daga amfani da metformin, inji shine kamar haka:
- zawo, tashin zuciya, amai;
- ƙarfe ɗanɗano a bakin;
- rashin jin daɗi a cikin ciki;
- raguwa da asarar ci, har zuwa ƙi abinci;
- lactic acidosis.
Sakamakon sakamako na sakamako da ayyuka, azaman doka, da sauri tafi tare da rage yawan sashi. Harin cutar gudawa alama ce ta daina shan metformin.
Idan kun dauki Metformin 200-3000 MG kowace rana na dogon lokaci, kuna buƙatar tuna cewa shaƙar hanji zai ragu:
- B bitamin,
- folic acid.
Wajibi ne a warware kowace matsala matsalar ƙarin bitamin.
Yana da matuƙar mahimmanci a kula da abubuwan da ke motsa jini, kuma a bincika wannan aƙalla sau biyu a shekara. Wannan yana da mahimmanci da aka ba da ƙarfin metformin don haɓaka glycolysis anaerobic a cikin ƙananan hanji da kuma hana glycogenolysis a cikin hanta.
Idan mutum yana da gunaguni na raɗaɗin tsoka da dandano mai ƙarfe a cikin bakin, lallai ne a yi nazarin matakin lactate. Idan abun hawan jini ya karu, to ya kamata a dakatar da ayyukan da suka shafi magani tare da metformin.
Idan ba zai yiwu a yi nazarin matakin lactate a cikin jini ba, to sai a soke metformin har sai yanayin ya daidaita, to kuwa an kimanta duk hanyoyin da ya kamata na gudanarwarsa.
Babban contraindications
Akwai takamaiman matakan hana amfani da metformin:
- ketoacidosis na mai ciwon sukari, da na ciki da sauran yanayi na asalin masu ciwon sukari;
- lalataccen aikin na koda, ya karu da creatinine a cikin jini sama da 1.5 mmol / l;
- yanayin hypoxic na kowane ƙwayar cuta (angina pectoris, gazawar jini, 4 FC, angina pectoris, infarction na myocardial);
- gazawar numfashi;
- mai yawa rarrabe encephalopathy,
- shanyewar jiki
- anemia
- m cututtuka, cututtukan tiyata;
- barasa
- gazawar hanta;
- ciki
- alamomi na tarihin lactic acidosis.
A cikin aiwatar da haɓakar hanta, ana rubanya biguanides lokacin da aka san hepatomegaly a sakamakon cutar hepatostatosis mai ciwon sukari.
Tare da cututtukan ƙwayar cuta-rashin lafiyan da dystrophic na hanta, ana iya rikodin sakamakon biguanides akan hepatic parenchyma, wanda aka bayyana a:
- bayyanar cutar kwalara, wani lokacin har zuwa wani lokacin da za a iya gani,
- canje-canje a gwaje gwajen hanta na aiki.
A cikin cututtukan hepatitis na kullum, ya kamata a yi amfani da magunguna tare da taka tsantsan.
Ba kamar magungunan sulfonylurea ba, biguanides basu da sakamako mai guba kai tsaye akan aikin hematopoietic na huhun kashi da koda. Koyaya, an sabunta su cikin:
- cututtukan koda wanda ke taɓar da raguwa a cikin matattara ta duniya
- riƙe da nitrogenous slag
- matsanancin amai, saboda haɗarin lactacidemia.
Tsofaffi marasa lafiya suna buƙatar kulawa da magunguna a hankali, tunda wannan yana da alaƙa da barazanar lactic acidosis. Wannan ya shafi waɗancan marasa lafiya waɗanda ke yin aiki na zahiri.
Akwai kwayoyi, amfanin abin da a cikin lura da biguanides ya ƙaru da aikin lactic acidosis, waɗannan sune:
- fructose
- teturam
- maganin antihistamines
- salicylates,
- barbiturates.
