Yayin maganin ciwon sukari, an tsara wasu magunguna don rage sukarin jini.
Waɗannan sun haɗa da kwayoyi don haɓakar jijiyar nama zuwa insulin, don inganta ƙwayar hormone. Hakanan ana amfani da ma'anar don rage yawan sha na carbohydrates a cikin hanji.
Magungunan da ke haɓaka ƙwayar insulin
Magungunan ƙwayoyin cuta waɗanda ke motsa ƙwayar insulin. Irin waɗannan magungunan sun haɗa da kwayoyi daga ƙungiyar sulfonylurea da meglitinides.
Sulfonylureas
Wannan rukuni ne na magungunan roba waɗanda ke rage yawan glucose na jini. Magunguna na wannan aji suna kunna ƙwayoyin ƙwayar ƙwayar ƙwayar cuta, wanda ke haɓaka samar da insulin ta jiki. Don wannan, ƙwayoyin beta masu lafiya dole ne su kasance cikin gland.
Ayyukan magungunan shine karuwa da ɓoyewar hormone da kuma saurin samar da glucose a cikin hanta, ƙarfafa β-sel, hana glucagon, ketosis da somatostatin ɓoye.
Abubuwan rarrabuwa na sulfonylureas sun kasu kashi biyu: aiki mai tsayi da matsakaici. Sakamakon ƙarfafa ƙwayar hormone yana dogara da sashi lokacin ɗauka.
Magunguna an yi su ne don maganin ciwon sukari na 2; ba a yi amfani da su don maganin ciwon sukari na 1 ba. An sanya shi tare da raguwa a cikin yiwuwar kyallen takarda zuwa hormone. Akwai shi a cikin kwamfutar hannu.
Abubuwan da ke cikin Sulfonylurea suna wakiltar ƙarni biyu na kwayoyi
:
- Butamide, Chlorpropamide. An tsara magunguna a cikin manyan allurai kuma suna nuna ɗan gajeren sakamako.
- Glipizide, Glibenclamide, Glycvidone. Suna da tasiri mai tsayi kuma an wajabta su a cikin ƙananan sashi.
Contraindications sun hada da:
- anemia
- mai ciwon sukari mai ciwon sukari;
- ƙarancin koda;
- m cutar tsarin;
- ciki, lactation;
- dysfunction hanta;
- kafin / bayan ayyukan;
- leukopenia;
- thrombocytopenia;
- rikicewar dyspeptic;
- da wuya hepatitis;
- nauyi.
Abin da m illa ana lura:
- samuwar wani dandano na ƙarfe a cikin bakin;
- aikin lalata hanta;
- bayyanar rashin lafiyan;
- lalataccen aikin na koda.
Babban haɗarin haɗari shine hypoglycemia.
Meglitinides
Groupungiyar ƙwayoyi da ke haɓaka ƙwayar insulin. Su ne prandial regulates na glycemia - suna rage sukari bayan cin abinci. Amfani da magunguna don daidaita glucose na azumi bai dace ba. Alamu don shiga - DM 2.
Wakilan wannan aji sune Kateglinides, Repaglinides. Magunguna suna shafar sel na ɗar islet, kunna asirin insulin. Kunna bakin ciki na faruwa awanni 15 bayan cin abinci. Ana lura da matakan insulin mafi girma bayan awa daya, raguwa - bayan sa'o'i 3.
Starfafawa yana faruwa ne akan yawan sukari - a ƙananan matakan magunguna a cikin ƙaramin abu yana shafar ɓoyewar ƙwayar. Wannan yana bayanin kusan rashin haihuwar hypoglycemia lokacin shan magunguna.
A hade tare da sauran jami'ai masu maganin antidi. An rage cikin kima daga ƙwayoyin cuta, kawai 9% ta cikin hanji.
DM 1, ketoacidosis, ciki da lactation sune manyan abubuwan hana daukar ciki. Ya kamata a yi taka tsantsan wajen ɗaukar magunguna don marasa lafiya tsofaffi. Hakanan wajibi ne don kulawa da hankali ga marasa lafiya da cututtukan hanta. An bada shawara don saka idanu kan alamu sau da yawa a shekara. Dubawa a cikin shekarar farko ta farfajiyar ya dace sosai.
Meglitinides baya buƙatar zaɓin sashi. Ana amfani da magunguna lokacin cin abinci. Matsayi na insulin bayan 3 hours ya koma ga ƙimar da ya gabata.
Daga cikin sakamako masu illa an lura:
- raunin gani;
- rikicewar gastrointestinal;
- bayyanar rashin lafiyan;
- increasedara yawan abubuwan kula da hepatic a cikin nazarin kwayoyin halittu;
- da wuya isa - hauhawar jini.
Ba'a ba da shawarar don amfani da waɗannan lamura ba:
- Nau'in cuta guda 1;
- ciki da lactation;
- rashin haƙuri;
- mai fama da ciwon sukari ketoacidosis.
Magunguna waɗanda ke haɓaka jijiyar nama zuwa insulin
A cikin nau'in ciwon sukari na 2, ba lallai ba ne don tayar da ɓoye insulin, tun da yake ana samarwa da isasshen yawa. Wajibi ne a kara tasirin kyallen takarda zuwa hormone, tunda take hakkin aikin masu karban kwayoyin ne wadanda ke haifar da karuwar glucose din jini.
Biguanides
Biguanides - rukuni na kwayoyi waɗanda ke haɓaka hankalin ƙwayar sel zuwa insulin. Buformin, Metformin, Fenformin suna wakilta.
Sun bambanta da bambanci daban-daban, sakamako masu illa, sashi don samun sakamako na warkewa. A halin yanzu, ana amfani da Metformin kawai.
Lokacin shan maganin, akwai raguwa a cikin juriya na insulin. Abubuwa masu aiki suna hana gluconeogenesis, canza canji na glucose. Hakanan an rage matakin "mummunan cholesterol" da triglycerides. Biguanides yana narkewa daga narkewa, narkewa akasarin ƙodan, mafi yawan maidawa ya kai bayan sa'o'i 2. Rayuwa ta rabin rabin lokaci har zuwa awa 4 da rabi.
An sanya Biguanides don kamuwa da cututtukan type 2 da nau'in 1 na sukari a matsayin wani ɓangare na cikakken magani.
Ba a yi amfani da wakilan ajin biguanide don:
- ciki da lactation;
- dysfunction hanta;
- ƙarancin koda;
- rashin haƙuri a cikin aiki bangaren;
- bugun zuciya;
- m mai kumburi tsari;
- ketoacidosis, lactic acidosis;
- gazawar numfashi.
Ba a haɗa Biguanides tare da barasa. Ba a kuma sanya su kwana 3 kafin da kuma kwanaki 3 bayan tiyata. An ba da shawarar marasa lafiya da suka wuce shekaru 60 su ɗauki magunguna daga wannan rukunin tare da taka tsantsan.
Abubuwan da suka haifar da sakamako masu mahimmanci kan aiwatarwa sun hada da:
- megaloblastic anemia;
- ciwon ciki, musamman, zawo, amai;
- acidosis.
Jerin magungunan kungiyar sun hada da: Metfogamma, Metformin, Glukofazh, Adebit, Langerin, Siofor, Bagomet. Za'a iya haɗu da kwayoyi tare da sauran ƙwayoyin glycemic.
Idan aka haɗu da insulin, ana buƙatar kulawa ta musamman. Ana kiyaye aikin kodan da alamomin glucose. Ana kulawa da kulawa ta musamman don haɗuwa tare da wasu magunguna marasa glycemic - wasu na iya ƙaruwa ko rage tasirin magungunan kungiyar biguanide.
Sawarshan
Thiazolidinediones - sabon rukuni na magunguna masu rage sukari don gudanar da maganin baka. Ba su kunna ɓoyewar insulin ba, amma suna ƙaruwa sauƙaƙƙun ƙwayoyin jikinta.
Akwai thiazolidinediones 2 - pioglitazone (ƙarni na biyu) da rosiglitazone (ƙarni na uku). Troglitazone (ƙarni na farko) ya nuna cutar hepatotoxic da tasirin cututtukan zuciya, wanda shine dalilin da yasa aka yanke shi. Za'a iya amfani da magunguna a hade tare da wasu magunguna ko azaman monotherapy.
Ta hanyar aiki akan kyallen takarda, hanta, kwayoyi suna ƙaruwa da haɗarin hormone. A sakamakon haka, haɓaka aikin glucose yana haɓaka ta hanyar ƙara yawan kwayar halitta. Sakamakon kwayoyi ya bayyana kansa a gaban kansa kansa hormone.
Abun ciki a cikin narkewar abinci, da ƙodan ya raba shi, ya lalata cikin hanta. Matsakaicin mafi girman hankali - bayan sa'o'i 2.5. Cikakken sakamako yana bayyana bayan watanni bayan shan magani.
Magunguna na iya rage sukari sosai, suna tasiri sosai kan bayanin martaba. Sakamakon bai da tasiri sosai fiye da biguanides. Duk magunguna a cikin wannan rukuni suna ƙaruwa da nauyi. Sakamakon ya dogara da tsawon lokacin magani da kan kashi. Hakanan akwai riƙewar ruwa a jiki.
Yayin aikin jiyya tare da thiazolidinediones, ana kimanta yanayin aikin hanta lokaci-lokaci. Idan mai haƙuri yana da haɗarin haɓakar bugun zuciya, to ba a sanya maganin thiazolidine ba.
A irin waɗannan halayen, likita ya tsara insulin, sulfonylureas, metformin.
Magungunan Thiazolidinedione: Avandia, Aktos.
Yardajewa:
- ciki, lactation;
- take hakkin hanta;
- Nau'in cuta guda 1;
- shekaru zuwa shekaru 18.
An lura da sakamako masu illa na gaba tare da amfani da magunguna:
- karin nauyi;
- increasedarin haɗarin fashewa a sakamakon raguwa a cikin ƙashin kashi;
- take hakkin hanta;
- hepatitis;
- bugun zuciya;
- kumburi;
- eczema
Yana nufin ma'anar narkewar ƙwayar ƙwayar ƙwayar jijiyoyin jiki
Alpha glucosidase inhibitors sune magunguna waɗanda ke lalata shaƙar carbohydrates a cikin hanjin. Suna da tasirin-endocrine a cikin maganin cututtukan siga. Shafa hankalin taro na sukari bayan cin abinci. Saboda wannan, haɓakar haɓakar jini yana raguwa da muhimmanci.
AG inhibitors yana kawo cikas ga rushewar carbohydrates, wanda dalilin shafan su yake raguwa. Abubuwan da ke aiki suna haifar da shinge ga shigarwar carbohydrates zuwa cikin jini.
Ana amfani da inhibitors na alpha glucosidase a yawanci a hade tare da sauran glycemic jamiái da insulin. An sanya shi a cikin nau'in ciwon sukari na 2.
Voglibosis, Acarbose, Miglitol ne suka wakilta. Yanzu kawai magunguna biyu na ƙarshe ana amfani dasu. Sakamakon asibiti iri ɗaya ne, amma sakamakon yana da ɗan bambanci.
Acarbose yana hana lactose da amylase kuma kusan ba a tsa shi cikin hanjin ba. Zai iya ƙara enzymes hanta. Miglitol ya riƙe glycogenesis a cikin hanta, yana tunawa cikin hanji. Yana rinjayar sha daga Glibenclamide da Metformin ba tare da bayyanar asibiti ba.
Lokacin amfani da magunguna na wannan aji an lura:
- rage cututtukan cututtukan zuciya;
- rage gudu na atherosclerosis;
- rikicewar ƙwayar gastrointestinal, musamman, zawo da ƙanshi.
Contraindications don amfani:
- ulcerative colitis;
- mai ciwon sukari mai ciwon sukari;
- ciki
- toshewar hanji;
- lactation
- dysfunction hanta;
- tsaurin hanji;
- na gazawar.
Ana iya gano tasirin sakamako daban-daban daga hanji. Wannan da zawo, zafin gida, flatulence, karuwa a cikin hanta enzymes.
Tare da hulɗa da masu hana hawan jini tare da magungunan antidiabetic da insulin, sakamakon ƙarshen na iya ƙaruwa. Don hana tasirin hypoglycemic, an zaɓi sashi a hankali.
Abubuwan tsoro, shirye-shiryen enzymatic suna rage darajar ingancin Miglitol da Acarbose. Corticosteroids, niacin, diuretics, hormones thyroid suna rage ayyukan AH inhibitors. Miglitol yana rage bioavailability na Ranitidine, Digoxin.
Baranzaman
Abubuwan da ke faruwa a cikin su sune hormones na musamman da ake samarwa bayan abinci. Suna rage jinkirin ɓoye ciki, ta da ruɗar insulin, dakatar da yawan ɓoyewar glucagon da rage cin abinci. A cikin ciwon sukari, ana rage waɗannan ayyukan, kuma ana iya kula da abubuwan da ke cikin hormone. Lambar su an dawo dasu ta amfani da incretinomimetics. Suna haɓaka tasirin warkewa kuma suna da amfani na ɗan adam game da magani.
Cinarin ƙwaƙwalwar ƙwayar cuta yana da alaƙa da mahaɗin furotin. Groupsungiyoyin magunguna biyu suna wakilta:
- Kungiya 1 - Exenatide. Yana da wani ainihin kai tsaye mimetic. Wannan ya hada da Baeta, Viktoza. Ana amfani dasu azaman allurar subcutaneous. Don haɓaka sakamako, haɗaka tare da sauran magungunan glycemic.
- Rukuni na 2 - polypeptide insulinotropic. Magunguna ne suka gabatar da shi: Galvus, Januvius. Koma kai tsaye zuwa tsarin kai tsaye. Dipeptidyl peptidase, wanda ke lalata abubuwan ɓoye, an toshe shi. Sanya hannu daban kuma a hade tare da wasu magunguna.
Abubuwan yana farawa ta hanyar samar da hormone - suna shiga cikin jini bayan 'yan mintuna. Anara yawan rashin hankali yana ƙarfafa dawowar ƙwayar ƙwayar ƙwayar ƙwayar cuta da kuma adadin hormone da aka samar. Ayyukan kwayoyi suna faruwa a matakan sukari mai yawa, kuma a ƙananan matakan, aikin ya daina.
Daga cikin abubuwanda ake shigo dasu
- mai ciwon sukari mai ciwon sukari;
- ciki, lactation;
- ƙarancin koda;
- LED 1;
- shekaru zuwa shekaru 18.
Daga cikin sakamako masu illa yayin lura an lura da su:
- halayen rashin lafiyan;
- ciwon kai
- tashin zuciya, amai
- rauni, nutsuwa.
Magunguna na aji na incretin mimetics za a iya wajabta su a farkon matakin bayyanuwar cutar. Suna taimakawa wajen kiyaye ayyukan kwayar beta. A kan aiwatar da aikin jiyya a cikin tsofaffi, galibi akwai ingantaccen ci gaba na alamun. Yayin magani, ƙwayar har zuwa ƙarancin tasiri yana shafar ci gaban hypoglycemia.
Bidiyo kan sabbin kwayoyi don ciwon sukari:
Kowane rukuni na miyagun ƙwayoyi an tsara shi ta hanyar likita dangane da hoton asibiti da kuma halayen hanyar ciwon sukari. Ana iya amfani da su duka a hade kuma azaman maganin tafinotinama. Yayin aikin jiyya, ana bada shawara don shan ilimin halittar jini don tantance yanayin gabobin.
