Yog tias koj ntseeg qhov kev tshuaj xyuas thiab cov lus qhia, "Metformin" yog ib txoj hauv kev zoo thiab txhim khu kev qha ntawm kev kho cov ntshav qab zib. Cov ntsiav tshuaj yog tsim los txo cov concentration ntawm qab zib nyob rau hauv lub circulatory system. Nyob rau hauv qeb ntawm biguanides, muaj nyob rau hauv daim ntawv rau qhov ncauj noj. "Metformin" tau pom nws daim ntawv thov hauv kev kho mob ntshav qab zib hom 2. Cov txiaj ntsig zoo tshaj plaws yog qhia tawm tsam keeb kwm ntawm kev rog rog, hnyav dhau nrog lub raum ua haujlwm txaus.
cov ntaub ntawv dav dav
Metformin tau ua pov thawj nws tus kheej zoo tshaj plaws hauv ntshav qab zib hom 2, tab sis qee cov kws tshawb fawb tau hais tias cov tshuaj no tuaj yeem siv tau rau cov kab mob ntshav qab zib thaum cev xeeb tub vim yog qhov tsis txaus ntawm cov tshuaj hormones, nrog rau hauv cov zes qe menyuam polycystic, nrog rau cov mob tshwj xeeb. Tam sim no, kev sim tseem tab tom ua los ua pov thawj qhov ua tau zoo lossis tsim kom tsis muaj txiaj ntsig ntawm cov ntsiav tshuaj hauv cov xwm txheej no. Cov kev sim yav dhau los tau tsim los txiav txim siab qhov muaj peev xwm ntawm kev siv Metformin rau kev kho mobCov xwm txheej uas tus neeg mob raug kev txom nyem los ntawm kev tiv thaiv insulin ntau ntxiv.
Raws li tuaj yeem pom los ntawm kev tshuaj xyuas thiab cov lus qhia rau kev siv, Metformin tsis tshua muaj qhov tshwm sim tsis zoo los ntawm lub cev yog tias cov tshuaj noj kom raug. Txij li cov kev paub ntawm kev siv, kev kho mob ntawm daim ntawv thov yog voluminous, cov lus teb no tuaj yeem ntseeg tau - cov qauv loj txaus kom raug. Cov neeg mob uas noj cov tshuaj tau sau tseg tias qee zaum thaum lub sijhawm kho mob muaj kev cuam tshuam hauv kev ua haujlwm ntawm lub plab, plab hnyuv. Nyob rau tib lub sijhawm, muaj qhov ua rau hypoglycemia, tab sis qhov kev pheej hmoo no raug ntsuas tsawg kawg.
Metformin tuaj yeem ua rau lactic acidosis, ib yam mob uas lactic acid tsim hauv cov hlab ntsha. Kev pheej hmoo siab dua ntawm nws qhov tshwm sim ntawm keeb kwm yav dhau los ntawm kev siv tshuaj ntau dhau, nrog rau kev siv cov tshuaj nyob rau hauv lub xub ntiag ntawm contraindications.
pov thawj muaj txiaj ntsig
Hnub no, ntawm cov tshuaj hypoglycemic zoo tshaj plaws yog Metformin, uas txo cov concentration ntawm cov roj (cholesterol) phem, triglycerides, thiab lipoproteins tsawg ntom ntom hauv cov hlab ntshav. Cov tshuaj tsis ua rau hnyav nce. Cov ntaub ntawv kho mob tau tshaj tawm: tawm tsam keeb kwm yav dhau los ntawm kev siv cov ntsiav tshuaj hauv nqe lus nug, kev pheej hmoo ntawm kev tuag vim muaj teeb meem tshwm sim los ntawm ntshav qab zib tau txo qis.
Kev ua tau zoo ntawm "Metformin" hauv ntshav qab zib mellitus tau ua rau muaj kev suav nrog cov tshuaj ntawm cov tshuaj tseem ceeb tshaj plaws. Cov tshuaj muaj nyob rau hauv WHO thematic daim ntawv teev npe, uas suav nrog lwm yam tshuaj rau ntshav qab zib -Glibenclamide.
Kev xyaum ntawm daim ntawv thov: nws pib li cas
Qhia tias koj tuaj yeem siv "Metformin" hauv ntshav qab zib, xyoo 1922. Tus sau ntawm thawj cov lus piav qhia ntawm cov tshuaj yog cov kws tshawb fawb Tswb, Werner, uas tau txais kev kho mob raws li qhov tshwm sim ntawm cov tshuaj tiv thaiv N-dimethylguanidine. Tom qab xya xyoo ntxiv, lub peev xwm ntawm qhov sib xyaw kom txo cov ntshav qab zib cov ntsiab lus ntawm guinea npua tau ua pov thawj. Cov khoom tshiab yog qhov zoo tshaj plaws biguanide paub thaum lub sijhawm. Muaj tseeb, cov ntaub ntawv no tau poob nws qhov cuam tshuam rau keeb kwm ntawm qhov kev thov rau insulin.
Xyoo 1950, cov kws tshawb fawb pom: "Metformin" tsis txo cov ntshav siab, uas txawv ntawm keeb kwm ntawm ntau cov tshuaj hypoglycemic. Kev ntsuam xyuas tsiaj tau ua pov thawj tsis muaj kev cuam tshuam rau lub plawv cov leeg nqaij. Nyob rau tib lub sijhawm, Metformin tau siv thawj zaug hauv chav kho mob tiv thaiv kab mob khaub thuas thiab paub tseeb tias nws cov txiaj ntsig zoo li ib txoj hauv kev txo qis cov concentration hauv cov hlab ntshav mus rau qhov tsawg kawg nkaus ntawm lub cev. Tsis tas li ntawd, kev xyaum ua tau pom tias tsis muaj cov tshuaj lom. Nyob rau tib lub sijhawm, nws tau pom tias Metformin muaj ntau yam khoom tseem ceeb: lub peev xwm los tua cov kab mob malaria, txo qhov kub hnyiab, rhuav tshem cov kab mob, nrog rau cov kab mob bacteriostatic, analgesic.
Xyoo 1954, feem ntau ntawm cov kev xav tsis tau lees paub thaum lub sijhawm kuaj ntawm tus kws tshawb fawb Supnevsky, txawm hais tias qee qhov kev tiv thaiv kab mob tseem tau txais.
Kev txhim kho lub tswv yim: tshuaj tsis sawv ntsug
Kuv tuaj yeem noj Metformin li cas, kuv tuaj yeem ua tiav li caslos ntawm nws cov txiaj ntsig tau hais, tau kawm Fabkis tus kws kho mob Stern. Thaum pib, nws txoj kev tshawb fawb tau mob siab rau galegin tau los ntawm kev ua cov khw muag tshuaj tshis rue, cov qauv uas muaj cov yam ntxwv zoo sib xws nrog metmorphine, cov khoom tseem ceeb ntawm cov tshuaj niaj hnub Metformin. Txawm tias ua ntej qhov tshwm sim ntawm thawj cov synthalins, nws tau sau cov txiaj ntsig ntawm Metformin tiv thaiv ntshav qab zib.
Stern, tom qab tsiv mus rau cov chaw tshawb fawb hauv Paris, tau lees paub tias Metformin qhia tau zoo hauv cov ntshav qab zib hom 2. Ntxiv nrog rau cov khoom no, nws tau kawm lwm yam biguanides. Stern tau dhau los ua thawj tus kws kho mob tau sim sim siv Metformin hauv kev kho mob hauv kev tawm tsam ntshav qab zib. Nws yog tus tswv txoj cai rau lub npe "Glucophage". Cov txiaj ntsig ntawm cov kev soj ntsuam tau raug tshaj tawm hauv xyoo 1957. Ib xyoos tom qab, cov tshuaj tau los ua muaj nyob rau hauv lub teb chaws cov qauv ntawm Great Britain, tau tshwm sim hauv cov khw muag tshuaj Askiv.
Kev nce qib ntawm lub tsev muag tshuaj assortment
Nyob rau xyoo 1970, yuav luag tag nrho cov biguanides tau raug rho tawm ntawm cov khw muag tshuaj, thiab nws yog lub sijhawm ntawm cov tshuaj Metformin pib. Cov kws kho mob Canadian tau pom zoo rau xyoo 1972, xyoo 1994 rau hom mob ntshav qab zib thib ob, kev kho mob tau txais los ua tus neeg sawv cev kho mob hauv Asmeskas. Thawj thawj zaug hauv Tebchaws Meskas, cov tshuaj tau muag nyob rau hauv lub npe "Glucophage", qhov pib ntawm kev muag khoom tau tshwm sim nyob rau lub Peb Hlis 1995. Tam sim no, ntau generics raws li matformin tau nthuav tawm hauv ntau lub tebchaws. Cov ntaub ntawv kho mob qhia tias cov tshuaj metformin yog cov tshuaj nquag tshaj plaws rau cov neeg mob ntshav qab zib hnub no hauv ntiaj teb.
Synthesis thiabkws tshuaj
Thawj zaug, kev tsim cov tshuaj tau piav qhia hauv xyoo 1922: nws yog qhov tshwm sim ntawm kev sib cuam tshuam ntawm dimethylamine hydrochloride thiab dicyandiamide. Cov tshuaj tiv thaiv yuav tsum muaj qhov kub thiab txias. Ib daim ntawv pov thawj uas tau tshaj tawm hauv xyoo 1975, nrog rau cov ntawv xov xwm tshwj xeeb rau cov kws tshuaj, muaj cov lus pom zoo hauv qab no: equimolar ntim ntawm cov khoom yuav tsum tau yaj hauv toluene, txias, mus txog qib siab, tom qab ntawd diluted nrog hydrogen chloride. Lub resulting muaj pes tsawg leeg boils ntawm nws tus kheej, ces txias. Lub precipitate tsim thaum lub sij hawm cov tshuaj tiv thaiv yog metformin. Cov tshuaj tiv thaiv efficiency yog 96%.
Nyob tsis ntev los no, ib txoj hauv kev zoo dua thiab kev nyab xeeb dua rau kev tsim cov khoom sib xyaw tau tsim. Txhawm rau ua haujlwm, koj xav tau ob peb milligrams ntawm cov khoom, ob peb tee kua. Cov tshuaj tiv thaiv kav ntev li tsib feeb, ua tiav raws li kev cuam tshuam ntawm microwave hluav taws xob.
Dynamics
Txhawm rau nkag siab txog lub ntsiab lus tseem ceeb ntawm kev ua ntawm "Metformin", koj yuav tsum ua tib zoo kawm cov lus qhia txuas nrog rau cov khoom xyaw: cov tuam txhab piav qhia hauv qee qhov kev nthuav dav li cas cov tshuaj ua haujlwm. Cov kev tshawb fawb tau pom tias qhov txo qis hauv cov piam thaj hauv cov ntshav hauv lub cev yog vim qhov inhibition ntawm cov piam thaj tsim cov tshuaj tiv thaiv uas ib txwm tshwm sim hauv daim siab hlwb. Tawm tsam keeb kwm yav dhau los ntawm hom mob ntshav qab zib hom 2, cov tshuaj tiv thaiv ntawm cov piam thaj hauv cov neeg mob lub cev yog qhov nruab nrab peb zaug siab dua li ib txwm, thiab noj cov tshuaj tuaj yeem txo qhov ntsuas li ib feem peb.
Raws li cov lus qhia ntawm "Metformin" ("Kanon", "Teva" thiab lwm txoj kev tso tawm) thaum nws nkag mus.tib neeg lub cev ua rau lub siab enzyme AMPK, uas yog qhov tseem ceeb hauv cov txheej txheem qhia cov tshuaj insulin. Qhov no tswj lub zog sib npaug, metabolic cov tshuaj tiv thaiv nrog lipids, suab thaj. Ua kom lub siab enzyme tso cai kom ua tiav cov txiaj ntsig ntawm inhibition ntawm gluconeogenesis.
Information: new and tested
Cov kev tshawb fawb tsis ntev los no tau tshaj tawm txog kev ua haujlwm ntawm metformin. Cov kws tshawb fawb tau pom tias kev ua kom AMPK ua rau muaj protein ntau, inhibiting kev qhia ntawm cov khoom tsim nyog rau kev tsim cov piam thaj los ntawm daim siab hlwb: qabzib-6-phosphatase, phosphoenolpyruvic acid.
Vim nws cov txheej txheem ntawm kev ua, metformin tau dhau los ua tus neeg koom tes tseem ceeb hauv kev cuam tshuam nrog AICA ribonucleotide, ua lub luag haujlwm ntawm AMPK antagonist. Thaum cov kws tshawb fawb tsis paub meej tias yog vim li cas cov biguanides tuaj yeem ua kom lub enzyme tsim los ntawm lub siab, tab sis cov kev tshawb fawb pom tau tias cov concentration ntawm cytosolic AMP yog nce.
Kev sim tau ua pov thawj tias cov tshuaj uas nrov kho mob ntshav qab zib yog raws li muaj kev cuam tshuam me me rau thawj qhov ua pa nyuaj. Nws yog assumed tias qhov zoo no yog ib qho ntawm cov hauv paus uas ua kom cov cuab yeej ua tau zoo.
Kev Ua Haujlwm Zoo
Lub luag haujlwm ntawm kev ua ntawm "Metformin" cuam tshuam nrog kev nce ntxiv ntawm cov ntaub so ntswg organic rau cov tshuaj hormone insulin. Raws li kev cuam tshuam ntawm cov tshuaj, cov kev ua ntawm peripheral qab zib uptake nce vim phosphorylation ntawm ib qho ntawm cov piam thaj transporters. Oxidative tshwm sim nrog fatty acids ua kom nquag plias,lub peev xwm ntawm lub plab hnyuv mucosa kom nqus cov piam thaj. Kev ua haujlwm ntawm peripheral siv tej zaum yog vim muaj peev xwm zoo dua ntawm cov tshuaj hormones los khi rau insulin receptors.
Lub siab enzyme AMPK tau pom tias ua haujlwm ntau dua hauv kev txhawb nqa cov leeg pob txha, uas tseem yog vim lub tshuab ua haujlwm ntawm Metformin. Cov enzyme no cuam tshuam rau cov piam thaj thauj mus los, pib lawv cov kev koom ua ke rau hauv cov ntshav plasma, uas ua rau nws muaj peev xwm ua rau cov piam thaj nce siab tshwm sim yam tsis muaj kev koom tes ntawm insulin. Nws tau xav tias cov metabolism ntawm "Metformin" tsis nyob ntawm AMPK. Kev tshawb fawb tau ua nyob rau xyoo 2008 tau pom meej meej tias nyob rau hauv cov leeg hauv lub plawv, qhov ua tau zoo ntawm cov tshuaj tau pom tsis hais txog qib ntawm daim siab enzymes.
Nuances of action
Raws li cov lus qhia, "Metformin" txo qis cov ntsiab lus ntawm triglycerides, lipoproteins tsawg ntom ntom, hauv cov hlab ntsha, thaum lwm yam ntawm cov tshuaj no nyob ruaj khov. Cov tshuaj pab kom stabilizes qhov hnyav thiab txo nws. Yog tias tsis muaj cov tshuaj insulin hauv cov hlab ntshav, nws tsis muaj txiaj ntsig. Tus neeg sawv cev tsis ua rau cov lus teb hypoglycemic, nce cov ntshav fibrinolytic zoo, vim nws inhibits plasminogen.
Siv Metformin raws li cov lus qhia, koj tuaj yeem txo qis cov suab thaj los ntawm ib feem tsib, thiab glycosylated hemoglobin li ntawm ib thiab ib nrab feem pua. Kev siv tsuas yog tus neeg saib xyuas uas tsis muaj kev sib xyaw nrog lwm cov tshuaj kom txo cov piam thaj hauv cov hlab ntshav txo qis kev pheej hmoo ntawm lub plawv nres. Ib qho txiaj ntsig zoo sib xws tau pom nyob rau hauv kev sib piv nrogCov pab pawg tswj hwm placebo thiab cov neeg mob noj zaub mov noj insulin. Cov tshuaj tau tso cai kom txo qis kev pheej hmoo ntawm kev tuag tawm tsam keeb kwm yav dhau los ntawm ob hom kab mob ntshav qab zib. Cov txiaj ntsig ntawm kev tshawb fawb lees paub qhov tseeb no tau luam tawm xyoo 2005. Cov txheeb cais tau suav nrog 29 qhov haujlwm.
Kinetics
Thaum noj ntawm lub plab khoob 500 mg "Metformin" bioavailability ntawm cov tshuaj - 50-60%. Kev siv tshuaj nrog zaub mov txo tus nqi los ntawm 10%. Qhov siab tshaj plaws nyob rau hauv lub circulatory system yog pom nyob rau hauv 1-3 teev los ntawm lub sij hawm ntawm noj cov ntsiav tshuaj, thaum noj nrog zaub mov - rau ib nrab ib teev ntev dua. Thaum xaiv ib daim ntawv ntev, qhov siab tshaj plaws yog tsau nyob rau hauv lub caij nyoog ntawm 4-8 teev tom qab siv cov tshuaj. Cov tshuaj yog xyaum tsis muaj peev xwm los khi rau plasma proteins. Kwv yees qhov ntim ntawm kev faib khoom yog kwv yees li ntawm 654 litres. Cov qib ruaj khov ntawm cov concentration hauv tus neeg mob lub cev tau pom zoo rau 2-3 hnub ntawm kev siv tas li.
Thaum noj "Metformin" (500 mg, 850 mg thiab lwm yam kev xaiv noj), cov tshuaj metabolic tsis pib. Cov tshuaj raug tshem tawm hauv cov zis hauv nws daim ntawv qub los ntawm cov tubules ntawm lub raum. Hauv cov ntshav ntshav ib hnub tom qab siv ib zaug tsis pom. Qhov nruab nrab ib nrab ntawm lub neej yog 6.2 teev, qhov tseem ceeb, cov khoom sib xyaw yog faib rau hauv erythrocytes, nws tawm los ntawm lawv qeeb dua; qhia tias metformin tuaj yeem khaws cia hauv cov qe ntshav no. Nrog rau ib koob tshuaj, kev tshem tawm ib nrab ntawm lub neej ntawm erythrocytes tuaj yeem ncav cuag 31.5 teev. Diabetics.
Qib absorbability ntawm Metformin analogues yog kwv yees li ntawm 50% nrog qhov sib txawv ntawm 2% nce thiab nqis. Lub compound yog haum sai sai absorbed thaum dhau los ntawm lub plab hnyuv ib ntsuj av. Hauv cov ntshav cov ntshav, qhov concentration ntawm 24-48 teev yog khaws cia ntawm li 1 μg / ml.
Ntshav Qab Zib: Nws yuav pab li cas?
Cov tshuaj nws tus kheej thiab metformin analogues yog npaj rau kev kho mob ntshav qab zib hom 2. Cov tshuaj yog pom zoo rau cov neeg uas rog dhau. Ntau caum xyoo ntawm kev tshawb fawb tau pom tias cov khoom siv tau zoo txo qhov kev pheej hmoo ntawm kev mob ntshav qab zib mellitus thiab qhov zaus ntawm kev tuag los ntawm ib feem peb hauv kev sib piv nrog cov pab pawg tswj hwm uas siv cov tshuaj sulfonylurea, insulin. Cov txheeb ze rau cov neeg uas ua raws li kev noj haus, tab sis zam kev siv tshuaj, cov neeg uas noj Metformin yog 40% tsawg dua yuav tsim teeb meem. Tom qab txoj kev tshawb no, cov neeg koom nrog kev sim siab tau ua raws li 5-10 xyoo ntxiv. Nyob rau lub sijhawm no, qhov sib txawv txuas ntxiv.
Raws li kev tshuaj xyuas, kev siv "Metformin" tsis yog qhov nyuaj heev: nws txaus los noj cov tshuaj tsis tu ncua, tsis nco lub sijhawm, saib kev siv tshuaj ntawm lub plab khoob. Cov chav kawm zoo li no suav hais tias yog qhov hnyav, txo qhov kev pheej hmoo ntawm cov ntshav qab zib cov ntsiab lus kawg. Txo qhov kev pheej hmoo ntawm kev tawm tsam hypoglycemic. Qhov sib txawv ntawm qhov zaus ntawm kev tawm tsam hypoglycemic yog tshwj xeeb tshaj yog nyob rau hauv kev sib piv nrog cov pab pawg neeg ntawm cov neeg mob uas siv sulfonylurea tshuaj. Hypoglycemia tuaj yeem nrog cov chav kawm kho mob tiv thaiv keeb kwm yav dhauKev tawm dag zog lub cev ntau dhau, kev tshaib plab calorie, siv lwm txoj kev los txo cov ntshav qab zib.
Koj tuaj yeem siv, ua raws li cov lus qhia rau kev siv, "Metformin" rau kev poob phaus. Cov tshuaj yog muab rau kev rog rog ua ke nrog rau lwm yam tshuaj, kev noj haus thiab kev ua si lub cev. Nws yog tsis yooj yim sua kom siv cov muaj pes tsawg leeg rau yuag poob ntawm koj tus kheej, tsis muaj kev saib xyuas los ntawm kws kho mob - qhov no yuav ua rau muaj teeb meem loj.
Kev sim thiab ua haujlwm
Tsis ntev los no, cov kws tshawb fawb tau ua haujlwm rau txoj kev xav ntawm kev siv "Metformin" hauv polycystic ovary syndrome. Piv txwv li, cov tshuaj yuav siv tau rau fatty daim siab pathologies, yog hais tias lawv tsis txuam nrog kev siv ntawm sieve. Xyaum kev txais tos ntawm "Metformin" thaum cev xeeb tub ua ntej. Cov kev qhia tam sim no tau muab cais ua kev sim.
Lub ntsiab zoo ntawm cov lus nug nyob rau hauv cov xwm txheej no tseem tsis tau muaj pov thawj tseeb. Ntau qhov kev tshawb fawb random tau ua, thaum lub sijhawm kev txhim kho kev noj qab haus huv ntawm cov neeg mob tau tshwm sim thaum noj Metformin. Txog tam sim no, cov ntaub ntawv no tsis muaj ntau txaus rau qhov kev sim ua pov thawj.
Kev sib xyaw thiab cov duab
"Metformin" yog tsim los ntawm cov tshuaj nquag ntawm tib lub npe. Ntxiv rau nws, txhua lub ntsiav tshuaj muaj cov khoom pabcuam. Cov chaw tsim khoom muab cov npe tag nrho ntawm cov khoom siv hauv cov lus piav qhia ntawm cov khoom tshwj xeeb. Raws li txoj cai, talc, povidone, starch, magnesium sterate, macrogol, titanium dioxide yog siv.
Metformin muaj nyob rau hauv daim ntawvntsiav tshuaj. Cov ntawv luam tau ntim rau hauv ib lub hlwv, ib lub thawv muaj peb lub hlwv. Sab nraud, tus nqi ntawm cov khoom tau qhia, qhov concentration ntawm cov khoom tseem ceeb hauv ib ntsiav tshuaj.
Rules of application
Thaum twg siv cov tshuaj, koj yuav tsum siv "Metformin" npaum li cas thiab ntau npaum li cas, tus kws kho mob yuav qhia rau koj thaum lub sijhawm teem tseg, muab daim ntawv xaj rau cov tshuaj. Cov koob tshuaj ib txwm xaiv ib tus zuj zus, tsom mus rau qhov ntsuas ntawm cov suab thaj hauv cov hlab ntshav. Raws li txoj cai, lawv pib nrog 0.5-1 g ntawm cov tshuaj, uas yog, ib ntsiav tshuaj lossis ob. Tom qab ib thiab ib nrab mus rau ob lub lis piam, cov nyiaj tuaj yeem nce ntxiv yog tias cov ntsuas ntshav siab xav tau.
Rau cov neeg mob feem ntau, Metformin ntawm kev saib xyuas yog 1.5-2 g ib hnub, uas yog, tsis pub ntau tshaj plaub ntsiav tshuaj. Qhov siab tshaj plaws ntawm 6 ntsiav tshuaj ib hnub twg, lossis 3 g ntawm cov muaj pes tsawg leeg, raug tso cai. Thaum muaj hnub nyoog laus, Metformin tau noj tsis ntau tshaj 1 g ib 24 teev.
Cov ntsiav tshuaj tau noj yam tsis tau zom, tsis ua txhaum kev ncaj ncees ntawm lub plhaub. Raws li txoj cai, kev tso tawm yog npaj kom noj rau ntawm lub plab khoob, tab sis cov yam ntxwv ntawm lub plhaub ntawm cov ntsiav tshuaj tshwj xeeb yuav tsum tau siv nrog lossis tam sim tom qab noj mov. Yog tias tsim nyog, cov chaw tsim khoom qhia cov ntaub ntawv cuam tshuam hauv cov lus qhia ua ke. "Metformin" yuav tsum tau ntxuav nrog cov kua hauv qhov tsim nyog. Txhawm rau txo qhov kev pheej hmoo ntawm cov lus teb tsis zoo ntawm plab hnyuv, nws yog qhov tsim nyog los faib cov koob tshuaj txhua hnub rau hauv ob peb koob tshuaj (txog peb zaug).
Vim tias tus neeg sawv cev tuaj yeem ua rau lactic acidosis, nrog rau qhov ua tsis tau zooCov tshuaj metabolic hauv lub cev, txo qhov ntau npaum li cas.
Tsis pub dhau
"Metformin" yog txwv tsis pub noj tawm tsam keeb kwm ntawm precoma, coma vim ntshav qab zib, tshwm sim los ntawm nws yog ketoacidosis. Cov tshuaj tsis yog siv rau mob raum mob hnyav thiab mob hnyav, cov chav kawm uas muaj qhov tshwm sim siab tuaj yeem ua rau muaj kev ua txhaum ntawm lub raum ua haujlwm. "Metformin" tsis raug sau tseg rau lub cev qhuav dej, ua npaws thiab hypoxia, mob hnyav. Nws yog txwv tsis pub noj cov tshuaj yog tias mob ntev, cov kab mob hnyav nrog rau kev pheej hmoo ntawm cov ntaub so ntswg hypoxia.
"Metformin" tsis tuaj yeem siv ua ntej kev ua haujlwm ntev ntev, tawm tsam keeb kwm ntawm kev raug mob hnyav. Cov tshuaj tsis yog siv nyob rau hauv cov ntaub ntawv ntawm tsis ua hauj lwm ntawm lub raum functionality, tiv thaiv keeb kwm yav dhau ntawm mob cawv lom los yog ntev kev quav dej quav cawv. Yog tias kev ntsuam xyuas nrog kev qhia txog cov tshuaj sib txawv uas muaj iodine rau hauv lub cev tau qhia, ob hnub ua ntej qhov kev tshwm sim, Metformin raug muab tso tseg, thiab txuas ntxiv coj mus rau ob hnub tom qab cov txheej txheem.
"Metformin" raug txwv tsis pub tawm tsam keeb kwm ntawm lactic acidosis, suav nrog yav dhau los. Cov tshuaj tsis raug muab rau cov poj niam cev xeeb tub thiab lactating, cov neeg uas tau pom tias muaj qhov tsis haum rau cov tshuaj. Nws raug txwv tsis pub ua ke Metformin thiab txo qis calorie noj (txog 1,000 calories ib hnub twg).
Metformin yuav tsum tsis txhob siv los ntawm cov neeg mob hauv pawg hnub nyoog 60 xyoo thiab laus dua, yog tias tsim nyog yuav tsum ua kom lub cev hnyav tsis tu ncua, vim tias cov chav kawm zoo li no tau nrog kev pheej hmoo ntawm lactic acidosis.
Nuancessiv tau nyab xeeb
Kev kho mob nrog "Metformin" yuav tsum tau saib xyuas lub raum ua haujlwm. Ob zaug hauv ib xyoos hauv cov ntaub ntawv dav dav, thiab nrog cov tsos mob ntawm myalgia, qhov qhia meej ntawm qhov concentration ntawm lactate nyob rau hauv cov ntshav yog tam sim ntawd qhia. Creatinine tshem tawm yuav tsum tau saib xyuas ob zaug hauv ib xyoos. Qhov no tseem ceeb tshwj xeeb rau cov neeg laus. Yog hais tias qhov concentration ntawm creatinine nyob rau hauv ib tug txiv neej tus neeg mob yog ntau tshaj 135 μmol / l, nyob rau hauv ib tug poj niam tus neeg mob - 110 μmol / l, Metformin yog muab tso tseg.
Nws raug tso cai los ua ke tus neeg sawv cev hauv nqe lus nug thiab cov khoom lag luam sulfonylurea, tab sis tsuas yog tias nws muaj peev xwm los saib xyuas cov ntsiab lus qab zib hauv cov hlab ntshav.
Thaum kuaj pom tus kab mob bronchi, ntsws, kis kab mob hauv cheeb tsam hauv lub cev xeeb tub, koj yuav tsum sab laj nrog kws kho mob. Cov chav kawm kho mob yog categorically tsis ua ke nrog cawv thiab tshuaj uas muaj ethanol.
Kev siv tus neeg sawv cev hauv nqe lus nug ntawm nws tus kheej, tsuas yog cov tshuaj kho mob nkaus xwb, tsis cuam tshuam nrog kev ua tsis zoo ntawm lub peev xwm ua kom pom tseeb, yog li nws tsis cuam tshuam rau lub peev xwm ua haujlwm nrog cov tshuab, cuab yeej, thiab kev thauj mus los.. Yog tias "Metformin" ua ke nrog lwm cov tshuaj kom txo qis cov piam thaj hauv cov hlab ntshav, muaj kev pheej hmoo ntawm hypoglycemia, uas cuam tshuam nrog kev ua tsis zoo ntawm lub peev xwm mloog, tswj kev ua haujlwm ntawm cov khoom txaus ntshai.
Thaum teem caij?
"Metformin" yog qhia rau hom mob ntshav qab zib thib ob, yog tias tus neeg mob tsis ua rau ketoacidosis. Cov tshuaj yog siv yog tias kev noj haus tsis pom qhov xav tau. Koj tuaj yeem sib xyaw cov tshuaj nrog insulin hauv hom ntshav qab zib thib ob. Nws yog tshwj xeeb tshaj yog zoo rau rog rog thiab theem nrab cov tshuaj tiv thaiv.
Mutual influence
Koj yuav tsum tsis txhob muab tshuaj Metformin thiab Danazol rau tus neeg mob tib lub sijhawm, vim tias kev sib xyaw ua ke no cuam tshuam nrog kev pheej hmoo ntawm hypoglycemia. Yog tias tsim nyog siv "Danazol", thiab tseem tsis ntev tom qab tso tseg nws cov kev tswj hwm, "Metformin" yog siv los txo cov koob tshuaj. Kev hloov pauv ntawm qhov ntim yog tsim los ntawm tus kws kho mob paub txog.
Kev saib xyuas tshwj xeeb yuav tsum tau siv tib lub sijhawm ntawm cov lus nug thiab ntau npaum li cas ntawm "Chlorpromazine" (ntawm 100 mg ib hnub thiab ntau dua). Kev sib xyaw ua ke no ua rau txo qis hauv kev tso tawm insulin, uas ua rau muaj kev pheej hmoo ntawm glycemia. Kev siv cov tshuaj tiv thaiv kev puas siab puas ntsws, nrog rau lub sijhawm luv luv tom qab ua tiav cov haujlwm zoo li no, yuav tsum tau kho qhov ntim ntawm Metformin, tsom mus rau cov suab thaj hauv tus neeg mob lub cev.
Paj siab
Kev sib xyaw ntawm Metformin thiab MAOIs, ACE inhibitors, insulin, beta-blockers, clofibrate cov khoom, cov tshuaj tsis yog tshuaj hormonal anti-inflammatory, acarbose, oxytetracycline, cyclophosphamide thiab sulfonylurea kev npaj yog txuam nrog kev ua kom cov nyhuv hypoglycemic ntawm tus neeg sawv cev. hauv lus nug.
Kev noj ib txhij ntawm hormonal anti-inflammatory, hormonal contraceptives, sympathomimetics, nicotinic acid cov khoom, diuretics rau hauv tus neeg mob lub cev tuaj yeem ua rau tsis muaj zog ntawm Metformin. Ib qho txiaj ntsig zoo sib xws yog ua tauThaum siv cov khoom ntawm phenothiazine ua, cov tshuaj hormonal zoo ib yam li cov thyroid caj pas, glucagon, epinephrine.
Special accent
Cov kev sim tau pom: "Metformin" tuaj yeem txo cov txiaj ntsig ntawm coumarin derivatives.
Kev haus cawv tawm tsam keeb kwm yav dhau los ntawm kev kho mob ua rau muaj kev pheej hmoo ntawm lactic acidosis. Qhov tshwm sim ntawm kev tsim muaj tus mob no tshwj xeeb tshaj yog tiv thaiv keeb kwm yav dhau los ntawm kev haus cawv lom, nyob rau theem ntawm kev tshaib kev nqhis thiab, yog tias tsim nyog, ua raws li cov khoom noj uas muaj calorie tsawg kawg nkaus.
Tau heev
Kev siv ntau dhau ntawm "Metformin" cuam tshuam nrog kev pheej hmoo ntawm lactic acidosis, uas tuaj yeem ua rau tus neeg mob tuag. Nws paub tias kev tuag yog ua tau los ntawm cov nyhuv cumulative vim lub raum tsis ua haujlwm. Kev ua xua tuaj yeem raug xav tias yog ua txhaum ntawm cov quav, qhov kub thiab txias, thiab mob plab. Tus neeg mob cov leeg teb nrog qhov mob, nws ntuav thiab hnov mob, ua pa nrawm dua, kiv taub hau. Kev tsis nco qab, coma.
Nrog cov tsos mob ntawm lactic acidosis, nws yuav tsum tau tshem tawm Metformin tam sim ntawd thiab mus pw hauv tsev kho mob tus neeg raug tsim txom. Kev tshuaj xyuas thawj zaug yog tsom rau kev qhia meej txog cov ntsiab lus lactate thiab lees paub qhov kev kuaj mob, tom qab ntawd cov ntshav lim ntshav thiab kev kho mob tau raug sau tseg raws li cov nuances ntawm cov tsos mob ntawm ib kis.
