Cov neeg mob ntshav qab zib hom 2 yuav tsum saib xyuas lawv cov ntshav qabzib tas li. Tsuas yog nrog cov ntsuas ib txwm muaj koj tuaj yeem ua lub neej ib txwm muaj. Yog tias cov ntshav qab zib nce siab, tus kws kho mob yuav muab tshuaj tshwj xeeb los ua kom tus neeg mob tus mob zoo li qub. Feem ntau ntawm cov tshuaj nyob rau hauv pawg no yog tsim nyob rau hauv cov ntsiav tshuaj. Tag nrho cov tshuaj (hyperglycemic) tau muab faib ua sulfonylurea derivatives, prandial glycemic regulators, biguanides, alpha-glucosidase inhibitors, thiab insulin rhiab heev. Hauv khw muag tshuaj, koj tuaj yeem pom cov khoom sib xyaw ua ke.
YSulfonylurea derivatives
Kev kho tshuaj tau pib sau rau cov neeg mob ntshav qab zib hom 2 thaum ntxov 60s ntawm lub xyoo pua xeem. Niaj hnub no, sulfonylurea derivatives yog nrov heev. Cais cov tshuaj ntawm thawj thiab thib ob tiam. Cov qub yog tsis tshua muaj siv nyob rau hauv niaj hnub xyaum. Cov tshuaj Antidiabetic los ntawm pab pawg no tau muab rau cov neeg mobLub cev hnyav, yog tias tsis yog-insulin-dependant mob ntshav qab zib mellitus tau pom. Qhov tsis muaj nyiaj them rau cov metabolism hauv carbohydrate yog qhov qhia ncaj qha rau kev teem caij ntawm sulfonylurea derivatives.
Cov tshuaj tiv thaiv kab mob tshiab tiam tshiab raws li sulfonylurea tsis tuaj yeem siv los ua kev kho mob ywj pheej. Cov tshuaj tsuas yog kho ntxiv. Noj zaub mov ua lub luag haujlwm tseem ceeb. Yog tias tus neeg mob noj cov zaub mov txwv tsis pub noj thiab tib lub sijhawm noj cov tshuaj uas txo cov ntshav qab zib, yuav tsum tsis txhob xav tias qhov tshwm sim zoo.
Ua tib zoo mloog! Cov tshuaj hypoglycemic tsis tau muab rau cov neeg mob uas muaj cov tshuaj insulin-dependant, nrog rau cov ntshav qab zib pancreatic. Tsis txhob siv tshuaj los ntawm pab pawg no rau cov menyuam yaus, nrog rau cov poj niam cev xeeb tub thiab lactating.
Glipizide
Cov tshuaj muaj nyob rau thib ob tiam sulfonylurea derivatives. Tus neeg sawv cev txhawb kev tso tawm ntawm insulin los ntawm kev ua haujlwm ntawm beta-cells ntawm pancreas, thiab tseem tswj hwm cov piam thaj hauv cov hlwb hauv cov neeg mob uas muaj mob hnyav thiab mob ntshav qab zib tsis-insulin. Cov tshuaj yog muag nyob rau hauv khw muag tshuaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, txhua tus muaj 0.005 g ntawm active ingredient. Cov tshuaj "Glipizide" pib ua haujlwm li ntawm 30 feeb tom qab noj, thiab tom qab 24 teev nws raug tshem tawm tag nrho ntawm lub cev.
Cov tshuaj noj yog tus kws kho mob teem rau ntawm tus kheej. Ib qho tshuaj hypoglycemic tsuas yog tom qab kev sim ntau zaus. Tus kws kho mob yuav tsum txiav txim siabdaim duab kho mob tiav. Thawj koob tshuaj txhua hnub yuav tsum tsis pub tshaj 0.005 g (ib ntsiav tshuaj). Hauv qhov nyuaj tshaj plaws, tus neeg mob tuaj yeem noj 2-3 ntsiav tshuaj ib zaug. Qhov siab tshaj plaws txhua hnub koob tshuaj yuav tsum tsis pub tshaj 0.045 g. Cov ntsiav tshuaj tau noj 30 feeb ua ntej noj mov. Thaum hloov los ntawm insulin, theem ntawm glycemia yuav tsum tau tswj thawj ob peb hnub.
Cov kev mob tshwm sim thaum siv cov tshuaj "Glipizide" yog xyaum tsis tuaj. Muaj tsawg zaus, qaug zog thiab kiv taub hau tuaj yeem tshwm sim. Xws li ib tug nuisance yog yooj yim tshem tawm los ntawm kev kho cov tshuaj. Feem ntau, cov kev mob tshwm sim tshwm sim hauv cov neeg laus. Ib tiam tshiab ntawm cov tshuaj hypoglycemic yog tsom rau kev txhim kho kev noj qab haus huv ntawm cov neeg mob ntshav qab zib. Tej yam tshwm sim tsis kaj siab ploj mus ob peb hnub tom qab pib kho. Contraindications rau noj Glipizide yog cev xeeb tub, nrog rau tus neeg intolerance rau sulfonamides. Cov menyuam yaus kuj tsis tau sau tshuaj.
Gliquidone
Lwm cov tshuaj hypoglycemic uas yog sulfonylurea derivatives. Zoo li yav dhau los kev kho mob, nws txhawb kev tsim cov tshuaj insulin hauv beta hlwb ntawm pancreas, thiab tseem ua rau cov tshuaj insulin rhiab heev ntawm cov ntaub so ntswg peripheral. Txhais tau tias "Gliquidone" yog tus cwj pwm los ntawm cov nyhuv zoo thiab kav ntev. Ntau cov tshuaj (hyperglycemic) ua rau hyperinsulinemia. Dab tsi tuaj yeem hais tsis tau txog cov tshuaj "Gliquidone"
Cov tshuaj muaj nyob rau hauv cov khw muag tshuaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj. Nws yog tshuaj rau cov neeg mob nrogHom 2 mob ntshav qab zib mellitus, nrog rau cov neeg laus cov neeg mob uas kev noj zaub mov tsis zoo tau txais txiaj ntsig zoo. Qhov ntau npaum li cas yog txiav txim siab raws li tus yam ntxwv ntawm tus neeg, nrog rau nws daim duab kho mob. Qhov tsawg kawg nkaus koob tshuaj txhua hnub yog 15 mg, qhov siab tshaj plaws yog 120 mg. Cov ntsiav tshuaj tau noj tam sim ua ntej noj mov. Hauv hom mob ntshav qab zib mellitus, ib ntsiav tshuaj ib hnub yog txaus. Tsawg zaus, cov tshuaj noj 2-3 zaug hauv ib hnub.
Cov kev mob tshwm sim los ntawm kev noj Gliquidone muaj nyob, tab sis lawv txhua tus thim rov qab. Thaum pib ntawm kev kho mob, cov neeg mob yuav muaj khaus thiab kiv taub hau. Cov tsos mob tsis zoo yuav ploj mus rau hnub tom ntej tom qab pib kho. Tso tseg cov tshuaj tsuas yog thaum muaj kev tsis haum tshuaj loj. Ib tug neeg intolerance tshwm sim tsis tshua muaj. Cov tshuaj tiv thaiv kab mob ntshav qab zib los ntawm koob no tsis tau sau rau cov neeg mob ntshav qab zib hom 1. Thaum lub sijhawm kho, ib tus yuav tsum tsis txhob hnov qab tswj cov suab thaj hauv cov ntshav. Yog tias cov ntsuas ntsuas tau dhau qhov kev cai, koj yuav tsum sab laj nrog kws kho mob uas yuav hloov txoj kev kho mob.
Thaum twg cov tshuaj sulfonylurea tsis tau sau?
Pre-coma, nrog rau ntshav qab zib coma yog ib qho kev txwv loj rau kev teem caij tshuaj raws li sulfonylurea. Cov tshuaj hypoglycemic ntawm qhov ncauj los ntawm koob no kuj tseem tsis tau siv thaum cev xeeb tub thiab lactation, txawm tias qhov tshwm sim tau ua tiav dhau los.
Ib qho kev cuam tshuam kev phais yog kev hem thawj rau lub cev ntawm tus neeg mob ntshav qab zib hom 2. Rautxhawm rau ntxiv dag zog rau tus neeg mob cov kev tiv thaiv, sulfonylurea derivatives kuj raug tso tseg ib ntus. Lub hauv paus ntsiab lus no yog ua raws li cov kab mob sib kis. Lub ntsiab tseem ceeb yog nyob rau hauv kev kho mob ntawm tus kab mob nyob rau hauv lub mob theem. Thaum tus neeg mob txoj kev noj qab haus huv rov zoo li qub, cov tshuaj hypoglycemic tshiab tuaj yeem raug sau tseg. Yog tias tsis muaj contraindications rau kev siv sulfonylurea derivatives, koj tuaj yeem pib noj tshuaj los ntawm koob no.
Prandial glycemic regulators
Muaj ntau qhov kev tshawb fawb ntawm cov amino acids, thaum lub sijhawm lawv lub luag haujlwm hauv insulin secretion tau raug pov thawj. Nws tau pom tias analogs ntawm benzoic acid thiab phenylalanine muaj cov nyhuv hypoglycemic. Prandial glycemic regulators muaj peev xwm tswj tau cov insulin secretion tam sim ntawd tom qab noj mov. Tab sis nyob rau theem no, qib ntawm glycemia nce siab heev. Cov tshuaj hypoglycemic tshiab muaj cov nyhuv luv luv. Yog li ntawd, lawv tsuas yog noj thaum lub sij hawm los yog tom qab noj mov. Nws tsis pom zoo siv tshuaj rau kev tiv thaiv.
Txawm hais tias qhov kev faib tawm ntawm cov tshuaj hypoglycemic suav nrog prandial glycemic regulators, lawv tsis siv ntau zaus. Cov tshuaj los ntawm cov koob no tsim cov nyhuv luv luv, yog li ntawd, lawv tsis tuaj yeem muab tshuaj rau hauv txoj kev kho mob hnyav rau hom 2 mob ntshav qab zib.
Novnorm
Ib qho tshuaj hypoglycemic qhov ncauj muaj nyob hauv cov khw muag tshuaj hauv daim ntawv ntsiav tshuaj. Cov tshuaj yog sau tseg thaum noj kev kho mob thiabkev ua si lub cev tsis muab cov txiaj ntsig xav tau. Cov neeg mob ntshav qab zib hom 2 feem ntau noj Novanorm ua ke nrog lwm cov tshuaj hypoglycemic. Qhov no tso cai rau cov neeg mob tswj lawv cov qib glycemic zoo dua.
ntsiav tshuaj "Novanorm" yuav tsum tau siv ua ke nrog kev noj haus. Cov tshuaj tau noj ntawm qhov ncauj ua ntej noj mov peb zaug hauv ib hnub. Muaj tsawg zaus, qhov koob tshuaj yuav nce ntxiv. Cov neeg mob uas nquag noj khoom txom ncauj lossis tsis noj mov yuav tsum sab laj nrog lawv tus kws kho mob txog kev siv cov tshuaj Novanorm kom raug.
Raws li twb tau hais lawm, cov tshuaj hypoglycemic rau ntshav qab zib tsis yog ib txwm sau. Qee tus neeg tswj hwm lawv cov ntshav qabzib nrog kev noj zaub mov ib leeg. Cov ntsiav tshuaj "Novanorm" tuaj yeem siv thaum tswj glycemic poob ib ntus. Kev mob tshwm sim los ntawm kev noj tshuaj yog tsawg thiab ib ntus. Tus neeg mob yuav hnov xeev siab thiab mob plab. Cov kev xav tsis zoo yuav dhau mus sai. Tso tseg cov tshuaj tsuas yog thaum tus neeg intolerance. Novanorm ntsiav tshuaj yog contraindicated rau cov menyuam yaus, cov poj niam thaum cev xeeb tub thiab lactation, cov neeg mob uas muaj lub siab ua haujlwm tsis zoo.
Biguanides
Kev faib tawm ntawm cov tshuaj hypoglycemic yuav tsum suav nrog cov tshuaj uas koom nrog pawg ntawm biguanides. Cov tshuaj los ntawm koob no tsis yog lub luag haujlwm rau kev txhawb nqa cov tshuaj insulin. Txawm li cas los xij, biguanides ua lub luag haujlwm tseem ceeb hauv kev kho mob ntshav qab zib hom 2.hom, raws li lawv nce peripheral siv cov piam thaj los ntawm lub cev nqaij daim tawv. Kev tsim cov tshuaj no los ntawm lub siab yog txo qis. Biguanides tuaj yeem txo cov ntshav qabzib ntau. Qee zaum, nws muaj peev xwm ua tiav qhov kev ua tau zoo ntawm txhua qhov. Lub ntsiab contraindication rau kev siv hom tshuaj no yog lub xeev pre-coma hauv cov neeg mob ntshav qab zib. Cov tshuaj hypoglycemic tiam thib 3 tau sau tseg nrog kev ceev faj rau cov neeg mob uas nyiam haus cawv, nrog rau lub siab ua haujlwm tsis zoo.
Metformin Y
Cov tshuaj hypoglycemic ntawm qhov ncauj uas yog pawg ntawm biguanides. Cov tshuaj muaj nyob rau hauv cov khw muag tshuaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj. Lub ntsiab active ingredient txwv tsis pub nqus cov piam thaj nyob rau hauv cov hnyuv, thiab kuj zoo kawg nkaus txhim khu kev siv ntawm cov piam thaj nyob rau hauv peripheral cov ntaub so ntswg. Cov ntsiav tshuaj Metformin tsis ua rau cov tshuaj tiv thaiv hypoglycemic. Cov tshuaj no tau muab rau cov neeg mob uas muaj ntshav qab zib hom 2 uas tsis muaj kev nyiam rau ketoacidosis. Cov ntsiav tshuaj kuj tuaj yeem raug sau ua ke nrog insulin rau cov neeg mob rog.
Txawm li cas los xij, nyob ntawm qib qabzib hauv cov ntshav, tus kws kho mob tus kheej tsim cov tshuaj noj. Koj tuaj yeem pib kho los ntawm kev noj ib ntsiav tshuaj ib hnub (500 mg). Kev nce qib ntawm koob tshuaj tuaj yeem pib tsuas yog tom qab ob lub lis piam ntawm kev kho mob tas mus li. Qhov siab tshaj plaws noj txhua hnub yuav tsum tsis pub tshaj 6 ntsiav tshuaj. Cov neeg mob tshaj 70 xyoo yuav tsum tsis txhob noj ntau tshaj 2 ntsiav tshuaj ib hnub twg.
Cov ntsiav tshuaj txo qis ntshav qab zibCov tshuaj yog contraindicated nyob rau hauv cov neeg uas muaj mob raum. Yog tias muaj kab mob tshwm sim uas tuaj yeem ua rau lub raum tsis ua haujlwm, cov ntsiav tshuaj Metformin raug tso tseg ib ntus. Koj tsis tuaj yeem coj lawv kuj nyob rau lub sijhawm hloov kho tom qab phais. Ib qho contraindication loj yog mob cawv lom.
Alpha-glucosidase inhibitors
Nov yog ib pawg tshuaj uas tuaj yeem thaiv kev tsim cov enzyme tshwj xeeb hauv plab (alpha-glucosidases). Ua tsaug rau cov kev npaj los ntawm cov koob no, qhov nqus ntawm cov carbohydrates yooj yim xws li cov hmoov txhuv nplej siab, sucrose thiab m altose tau txo qis. Yog tias noj kom raug, cov tshuaj hypoglycemic niaj hnub ntawm pab pawg no tsis muaj kev phiv kiag li. Tsis muaj mob plab lossis mob plab txhua.
Alpha-glucosidase inhibitors yuav tsum tau noj nrog thawj zaug ntawm zaub mov. Digested ua ke nrog zaub mov, cov khoom ntawm cov tshuaj muab cov nyhuv hypoglycemic zoo. Cov tshuaj los ntawm koob no tuaj yeem noj nrog sulfonylurea lossis insulin. Qhov no ua rau muaj kev pheej hmoo ntawm hypoglycemia.
Miglitol
Tus neeg sawv cev txo qis qab zib uas yog los ntawm pawg alpha-glueosidase inhibitors. Nws raug sau tseg rau cov neeg mob uas muaj qhov nruab nrab ntawm hom 2 mob ntshav qab zib mellitus yog tias kev tawm dag zog txaus thiab kev noj zaub mov tsis ua rau qhov xav tau. Miglitol ntsiav tshuaj zoo tshaj plaws thaum noj ntawm lub plab khoob. Nyob rau hauv tsawg zaus, lwm cov tshuaj hypoglycemic ntawm qhov ncauj yog ntxiv. Kev faib tawm ntawm qib tswj cov khoomCov ntshav qabzib tau hais saum toj no.
Cov khoom tseem ceeb ntawm Miglitol yog absorbed tag rau hauv cov ntaub so ntswg thaum noj me me (1-2 ntsiav tshuaj). Thaum noj 50 g, nqus yog 90%. Cov tshuaj nquag yog tawm los ntawm lub raum tsis hloov pauv. Cov tshuaj hypoglycemic tsis tau sau tseg rau cov menyuam yaus, nrog rau cov poj niam cev xeeb tub thiab lactating. Contraindications yog mob plab hnyuv kab mob, nrog rau cov hernias loj. Kev mob tshwm sim thaum noj cov ntsiav tshuaj Miglitol tsis tshua muaj. Tau muaj cov kab mob ua xua nyob rau hauv daim ntawv ntawm pob khaus thiab khaus ntawm daim tawv nqaij.
Cov tshuaj hypoglycemic sib xyaw
Feem ntau, kev kho mob ntshav qab zib hom 2 pib nrog kev kho mob monotherapy. Cov tshuaj ntxiv tuaj yeem muab tau tsuas yog thaum qhov kev kho mob tsis muab qhov xav tau. Qhov teeb meem yog tias ib qho tshuaj tsis tas yuav npog ntau yam teeb meem cuam tshuam nrog ntshav qab zib. Koj tuaj yeem hloov ntau yam tshuaj ntawm cov chav kawm sib txawv nrog ib tus neeg sawv cev hypoglycemic ua ke. Cov kev kho mob zoo li no yuav muaj kev nyab xeeb dua. Tom qab tag nrho, qhov kev pheej hmoo ntawm kev mob tshwm sim yog txo qis. Qhov zoo tshaj plaws, raws li kws kho mob, yog kev sib xyaw ntawm thiazolidinediones thiab metformin, nrog rau sulfonylurea thiab metformin.
Cov tshuaj sib xyaw tsim los kho mob ntshav qab zib hom 2 tuaj yeem nres qhov kev loj hlob ntawm hyperinsulinemia. Ua tsaug rau qhov no, cov neeg mob hnov zoo dua, thiab tseem muaj sijhawm los poob qee qhov hnyav. Feem ntauKev xav tau hloov mus rau kev kho tshuaj insulin yog tshem tawm tag nrho.
Ib qho ntawm cov tshuaj hypoglycemic nrov tshaj plaws yog Glibomet. Cov tshuaj yog tso tawm nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj. Lawv raug sau tseg thaum kev kho yav dhau los tsis pom qhov tshwm sim zoo. Tsis txhob siv cov tshuaj no los kho mob ntshav qab zib hom 1. Cov ntsiav tshuaj kuj tseem contraindicated rau cov neeg uas muaj lub siab ua haujlwm tsis zoo thiab lub raum tsis ua haujlwm. Cov menyuam yaus, nrog rau cov poj niam thaum cev xeeb tub thiab lactation, cov tshuaj tsis raug sau tseg.
Glibomet ntsiav tshuaj muaj ntau yam kev phiv. Lawv tuaj yeem ua rau raws plab, xeev siab, kiv taub hau. Tsawg zaus, kev ua xua tshwm sim nyob rau hauv daim ntawv ntawm daim tawv nqaij khaus thiab pob khaus. Nws raug nquahu kom siv cov tshuaj nruj me ntsis raws li tus kws kho mob cov tshuaj.
