Li-Biguanides ke karolo ea mofuta oa li-guanidine, tse sebetsang ho lefu la tsoekere. Ntle le moo, sehlopha sena sa lithethefatsi se theola khatello ea tsoekere maling.
Litsi tsena ke: L-butylbiguanide (Buformin), N, N-dimethylbiguanide (Metformin), Phenethylbiguanide (Fenformin).
Phapang ea sebopeho sa li-biguanides tse fokotsa tsoekere e teng ka har'a mmele le boholo ba litekanyetso. Empa litlamorao tsa li-guanidine tse tsoang ho metabolism li tšoana hantle maemong a mangata.
Leha ho le joalo, li-antihyperglycemic agents ha li sebelisoe hangata e le monotherapy. Ha e le molao, sena se etsahala ho 5-10% ea linyeoe.
Li-biguanides li sebetsa joang?
Hore na lithethefatsi tsena li ama 'mele joang ha li utloisisoe ka botlalo, leha ho bile le lithuto tse ngata. Empa ho tlalehiloe hore litekanyetso tsa guanidine li theola tsoekere e maling ea mali ho mofuta oa 2 lefu la tsoekere, haholoholo haeba mokuli a e-na le mathata a ho ba motenya.
Li-Biguanides li na le phello ea "ho boloka insulin", kahoo ha nako e ntse e feta tlhokahalo ea tsamaiso ea li-synthetic ea li-hormone ea fokotseha. Hape, lithethefatsi tsena li fokotsa gluconeogenesis e tsoang liprotheine.
Ntle le moo, lihlahisoa tse joalo li ntlafatsa tsoekere ea mesifa ka ho fetola tsoekere ho lactate. Ka lebaka la ho pepesehela li-derivatives tsa guanidine, ts'ebetso ea ho monya lintho tse kang:
- mafura
- vithamine B 12№
- li-amino acid;
- D-xylose.
Ho na le maikutlo a hore ts'ebetsong ea ho thibela ho phefumoloha ha mesifa, sebopeho sa ATP sea fokotseha, ka lebaka leo lits'ebetso tse fapaneng tsa metabolic tse sebelisang matla (mohlala, gluconeogenesis) li fokotseha butle. Mohlomong mokhoa oa ts'ebetso ea li-biguanides ke phello ea bona ho metabolism ea lipid.
Ho ile ha boela ha fumaneha hore lithethefatsi tsena tsa batho ba nang le lefu la tsoekere tse sa itšetleheng ka insulin tse nang le boima bo feteletseng li kenya letsoho ho fokotseha ho lekaneng ha boima ba 'mele.
Empa phello e joalo e lemohuoa feela qalong ea kalafo, ha lintho tse ling li sa kenngoe ka popelong, mme takatso ea mokuli e fokotsehile.
Tekanyetso le tsamaiso
Sehlopha sa Biguanides se kenyeletsa lithethefatsi tse nang le lebitso le latelang:
- Siofor 1000 / 850/500;
- Bagomet;
- Metformin Acre;
- Avandamet;
- Glucophage;
- Metfogamma.
Kajeno, melemo ea methylbiguanide e sebelisoa haholo, e leng metformin. Tsena li kenyelletsa Gliformin, Glucofag, Dianormet le lintho tse ling.
Mokhoa oa ts'ebeliso ea li-biguanides tse ngata oa tšoana. Pele, ho nooa litekanyetso tse nyane, empa ka mamello e ntle li eketsoa ka matsatsi ohle a 2-4. Ho feta moo, polyhexamethylene biguanide e lokela ho nooa kamora ho ja, e tla thibela nts'etsopele ea litla-morao ho tsoa mpeng ea gastrointestinal.
Sehlopha sa li-Biguanides tse sebelisitsoeng ho phekola lefu la tsoekere le sa ts'epeng insulin se na le phello ea kalafo ea lihora tse leshome le metso e 'meli. Ka hona, litekanyetso tsa letsatsi le letsatsi li lokela ho aroloa likarolo tse peli.
Qalong ea phekolo, Metformin 850, Siofor le tse ling, li nkuoa ka bongata ba 500 mg hang (ka shoalane). Kamora beke, ha feela mokuli a se na mathata le tsitsipano ea ka mpeng, moriana o le mong oa letsatsi o eketsoa ho 850 mg kapa mokuli a noe 500 mg hoseng.
Maemong a karabelo e mpe, tekanyetso e tlameha ho fokotsoa, 'me kamora nakoana o leke hape ho e eketsa. Khokahano e phahameng ea ntho e 'meleng e fumanoa ka mor'a likhoeli tse 1-2 tsa kalafo.
Motsoako o tšehetsang - ho fihlela ho 2000 mg ka letsatsi. Palo e lumelletsoeng ka bongata ke 3000 mg ka letsatsi, empa ho bakuli ba bacha feela. Tekanyo e phahameng ea bakuli ba tsofetseng ha e fetang 1000 mg.
Polyhexamethylene biguanide e ka kopanngwa le secretogens (sulfonylureas le letsopa), insulin le glitazones. Ka hona, lik'hamphani tsa meriana li hlahisa litokisetso tse kopaneng tse lokiselitsoeng tse nang le phello ea hypoglycemic ho litekanyetso tse tlase, tse fokotsang kotsi ea litlamorao:
- Glucovans (metformin le glibenclamide);
- Glibomet.
Haeba u nka sehlahisoa se kopaneng joalo, phallo ea tsoekere maling e ea tloaeleha ka mor'a lihora tse peli, 'me phello e tla ba lihora tse 12.
Lithethefatsi tse joalo li nooa le pilisi e le 'ngoe ka letsatsi ka keketseho e latelang ea litekanyetso ho li-capsules tse 2 ka letsatsi.
Likarabo tse fapaneng le likhokahano
Polyhexamethylene biguanide le lintho tse ling tse tsoang sehlopheng sena li ka baka liketso tse ngata tse mpe. Tse atileng haholo li kenyelletsa ho hloleha ha tšilo ea lijo, takatso e fokolang ea lijo, boteng ba tatso ea tšepe molomong le nts'etsopele ea lactic acidosis.
Letšoao la ho emisa ho kenella ha lintho ho tsoa letotong la li-guanidine ke tlhaselo ea lets'ollo. Le ha ho le joalo, ka tokiso ea tekanyetso, litla-morao tse ngata lia nyamela.
Metformin e hanyetsitsoe maemong a latelang:
- ho hloleha ho phefumoloha;
- lefu la tsoekere la lefu la tsoekere;
- mathata a sebete
- stroke:
- boimana
- tšoaetso ea methapo;
- discirculatory encephalopathy;
- renal dysfunction, ha boemo ba creatinine maling bo feta 1.5 mmol / l.
Hape, lithethefatsi li ke ke tsa nkuoa ka lefu la tsoekere, ho kenyeletsa ketoacidosis mme, haeba ho na le nalane ea lactic acidosis. Ntle le moo, lithethefatsi tse joalo li hanyetsoa maemong a hypoxic (ho nyekeloa ke pelo, angina pectoris, phallo e mpe ea mali).
Metformin ha e tsamaisane le joala. Mme haeba sebete se hola, joale lithethefatsi tse joalo li laeloa feela ha hepatomegaly e hlaha khahlano le semelo sa lefu la tsoekere le lefu la tsoekere.
Tabeng ea dystrophic, allergic kapa tšoaetso ea maqeba a sebete, li-biguanides li ka ama hepatic parenchyma. Ka lebaka leo, e bonahala ka liphetoho ho liteko tsa ts'ebetso. Cholestasis le eona e ka hlaha, ka matšoao a hlakileng a jaundice.
Ha ho bapisoa le litlamorao tsa sulfonylurea, lithethefatsi tse tsoang ho li-guanidine tse 'maloa ha li na phello e chefo liping le mokokotlong oa masapo. Leha, li kopantsoe ha ho na le khaello ea mali e matla, ho bolokoa, chefo ea naetrojene le ha ho e-na le mafu a liphio a bakang ho fokotseha hoa fragole ea glomerular.
Hape, haeba kalafo e nang le "biguanides" e kopantsoe le fructose, antihistamines, barbiturates, teturam le salicylates, sena se tla mpefatsa lactic acidosis.
Puo ka lithethefatsi tsa lefu la tsoekere e fanoa videong e sehloohong sena.
