Tlhahlobo ea lihlahisoa tsa sulfonylurea

Ka tlhahiso e sa lekaneng ea insulin, ba sebelisa keketseho ea khatello ea bona. Liphetho tsa sulfonylureas ke tsa meriana e eketsang sephiri sa lihormone ebile e le ea meriana ea maiketsetso ea hypoglycemic.

Li tšoauoa ka phello e phatlalalitsoeng haholoanyane ha e bapisoa le baemeli ba bang ba tafoleng ba nang le phello e tšoanang.

Ka bokhutšoanyane ka lithethefatsi tsa sehlopha

Sulfonylurea derivatives (PSM) ke sehlopha sa lithethefatsi tse etselitsoeng ho phekola lefu la tsoekere. Ntle le hypoglycemic, li na le phello ea hypocholesterolemic.

Sehlopha sa lithethefatsi ho tloha ha se hlahisoa:

1. Moloko oa pele e emeloa ke chlorpropamide, Tolbutamide. Kajeno ha li sebelisoe. Li tšoauoa ka ketso e khuts'oane, ho fihlella phello eo ba e laetsoeng ka bongata bo boholo.
2. Moloko oa bobeli ke Glibenclamide, Glipizide, Gliclazide, Glimepiride. Ba na le liponahatso tse fokolang tsa litla-morao, tse fanoeng ka tekanyo e nyane.

Ka thuso ea sehlopha sa meriana, puseletso e ntle ea lefu la tsoekere e ka fumaneha. Sena se o lumella ho thibela le ho liehisa nts'etsopele ea mathata.

Re amohela kamohelo ea PSM:

• tlhahiso ea tsoekere e fokotsang matla;
• pancreatic β sele e le ho ntlafatsa kutloisiso ea tsoekere;
• kutloisiso ea mesifa e matlafatsang ea lihormone;
• thibela thibelo ea somatostatin, e hatellang insulin.

Lenane la litokisetso tsa PSM: Glibamide, Maninil, Glibenclamide, Teva, Amaril, Glisitol, Glemaz, Glisitol, Tolinase, Glibetik, Gliclada, Meglimid, Glidiab, Diabeteson, Diazid, Reklid, Oziklid. Glibenez, Minidab, Movogleck.

Mokhoa oa ketso

Karolo e ka sehloohong e ama li-receptor tse khethehileng tsa seteishene ebe e li thibela ka matla. Ho na le depilarization ea membrane ea β-cell, ka lebaka leo, ho buloa ha liteishene tsa calcium. Kamora sena, Ca ions e kena liseleng tsa beta.

Phello ke ho ntšoa ha homone ho tsoa lipapaling tsa intracellular le ho tsoa ha eona maling. Litlamorao tsa PSM li ikemetse ka har'a khatello ea tsoekere. Ka lebaka lena, boemo ba hypoglycemic hangata bo hlaha.

Meriana e kenella kahare ho tšilo ea lijo, phello ea eona e qala lihora tse 2 kamora ho tsamaisoa. E entsoe ka sebeteng, e qheletsoe ntle le Glycvidon, ka liphio.

Nako ea bophelo le halofo ea ts'ebetso ea lithethefatsi ka bomong e fapane. Ho kopanya liprotheine tsa plasma - ho tloha ho 94 ho isa ho 99%. Mokhoa oa ho felisa, ho latela moriana, o oa renal, renal-hepatic, le hepatic. Ho sutumetsoa ha ntho e sebetsang ho fokotseha ka sejo se kopaneng.

Matšoao a ho khethoa

Litlamorao tsa sulfonylureas li fuoe mofuta oa lefu la tsoekere la 2 maemong a joalo:

• ka tlhahiso e sa lekaneng ea insulin;
• ka ho fokotseha ha kutloisiso ea kutlo ea lihormone tsa li-tishu;
• ka ho se sebetse hantle hoa kalafo ea ho ja.

Contraindication le litla-morao

Contraindication sulfonylurea e tsoa ho:

• Mofuta oa 1 lefu la tsoekere;
• ho se sebetse ha sebete;
• boimana
• ho anyesa;
• ho se sebetse ha liphio;
• ketoacidosis;
• ts'ebetso ea ho buoa;
• hypersensitivity ho sulfonamides le likarolo tse thusang;
• ho hloka mamello ho PSM;
• phokolo ea mali
• mekhoa ea tšoaetso e mpe;
• lilemo tse 18.

Lithethefatsi ha li fuoe litekanyo tse phahameng tsa tsoekere tse fetang 14 mmol / L. Hape, u se ke ua etsa kopo ea litlhoko tsa insulin tsa letsatsi le letsatsi tsa likarolo tse fetang 40. Ha e khothalletsoe ho bakuli ba nang le lefu la tsoekere le tebileng 2 boteng ba khaello ea β-cell.

Molek'hule oa Biguanide

Glycvidone e ka fuoa batho ba nang le ts'oaetso e fokolang ea ts'ebetso ea liphio. Ho nts'oa ha eona ho etsoa (hoo e ka bang 95%) ka mala. Ts'ebeliso ea PSM e ka baka khanyetso. Ho fokotsa liketsahalo tse joalo, li ka kopanngoa le insulin le biguanides.

Sehlopha sa meriana hangata se mamelloa hantle. Har'a litla-morao tse mpe, hypoglycemia e etsahala khafetsa, hypoglycemia e matla e bonoa feela maemong a 5%. Hape, nakong ea phekolo, boima ba 'mele boa bonoa. Sena se bakoa ke secretion ea "endulin" ea insulin.

Litlamorao tse latelang ha li sa tloaeleha:

• mathata a dyspeptic;
• tatso ea tšepe e molomong;
• hyponatremia;
• anemia ea hemolytic;
• mosebetsi o sa sebetseng oa renal;
• karabelo ea mmele o mong le o mong;
• tlolo ea sebete;
• leukopenia le thrombocytopenia;
• cholestatic jaundice.

Tekanyetso le tsamaiso

Litekanyetso tsa PSM li fanoa ke ngaka. E ikemiselitse ho nka kakanyo ea tlhahlobo ea metabolism.

Ho bohlokoa ho qala kalafo le PSM ka tse fokolang, mme ha e sa sebetse, fetohela litlhare tse matla ho feta. Glibenclamide e na le phello e matlafatsang ea ho fokotsa tsoekere ho feta baemeli ba bang ba molomo ba hypoglycemic.

Ho nka meriana e boletsoeng sehlopheng sena ho qala ka litekanyetso tse fokolang. Ho feta libeke tse peli, butle-butle e eketseha. PSM e ka khethoa ka insulin le li-agents tse ling tse boletsoeng ka har'a hypoglycemic.

Tekanyetso litekong tse joalo li ea fokotsoa, ​​ho khethoa tse nepahetseng haholoanyane. Ha matšeliso a tšoarellang a fumanoa, ho khutlela ho kalafo e tloaelehileng ea kalafo ho etsahala. Haeba tlhokahalo ea insulin e ka tlase ho likarolo tse 10 / ka letsatsi, ngaka e fetohela mokuli hore e fumane litokollo tsa sulfonylurea.

Type 2 lefu la tsoekere

Tekanyetso ea lithethefatsi tse itseng e bontšoa litaelong tsa ts'ebeliso. Moloko le litšoaneleho tsa lithethefatsi ka botsona (ntho e sebetsang) li nkuoe hloko. Sekhahla sa letsatsi le letsatsi bakeng sa chlorpropamide (moloko oa 1) - 0,75 g, Tolbutamide - 2 g (moloko oa bobeli), Glycvidona (moloko oa 2) - ho fihlela 0,12 g, Glibenclamide (moloko oa 2) - 0,02 g. litekanyetso li beiloe.

Chelete eohle ea sehlopha sa PSM e nkuoa halofo ea hora kapa hora pele ho lijo. Sena se fana ka ho kenngoa ha lithethefatsi hamolemo, ka lebaka leo, ho fokotseha ha gracemia ea postprandial. Haeba ho na le mathata a dyspeptic a hlakileng, PSM e nkuoa kamora lijo.

Litlhokahalo tsa polokeho

Ho batho ba baholo, kotsi ea ho ba le hypoglycemia e phahame haholo. Bakeng sa sehlopha sena sa bakuli, lithethefatsi tse nang le nako e khuts'oane haholo li laetsoe ho thibela litlamorao tse sa rateheng.

Ho khothalletsoa ho tlohela lithethefatsi tse nkang nako e telele (Glibenclamide) le ho fetohela ho tse nkang nakoana (Glycvidone, Glyclazide).

Ho nka lintho tse tsoang ho sulfonylurea ho baka likotsi tsa hypoglycemia. Nakong ea kalafo, ho hlokahala hore ho hlahlojoe maemo a tsoekere. Ho khothalletsoa hore u latele moralo oa kalafo o thehiloeng ke ngaka ea hau.

Ka ho kheloha ha eona, tekanyo ea tsoekere e ka fetoha. Maemong a ntlafatso ea maloetse a mang nakong ea kalafo ea PSM, ho hlokahala ho tsebisa ngaka.

Nakong ea kalafo, ho bonts'oa matšoao a latelang:

• boemo ba tsoekere ea moroto;
• glycosylated hemoglobin;
• tsoekere ea mali
• boemo ba lipid;
• liteko tsa sebete.

Ha ho kgothaletswe ho fetola litekanyetso, fetohela moriana o mong, emisa kalafo ntle le ho buisana. Ho bohlokoa ho sebelisa meriana ka nako e behiloeng.

Ho eketsa tekanyetso e boletsoeng ho ka lebisa ho hypoglycemia. Ho e felisa, mokuli o nka 25 g ea glucose. Boemo bo bong le bo bong bo tšoanang ha ho ka eketsoa tekanyetso ea moriana ho tlaleheloa ngaka.

Ho hypoglycemia e matla, e tsamaeang le ho lahleheloa ke kelello, ho hlokahala ho batla thuso ea bongaka.

Glucose e tsamaisoa ka matla. U kanna ua hloka liente tse ling tsa glucagon ho / m, in / in. Kamora thuso ea pele, o tla hloka ho lekola boemo ka matsatsi a 'maloa ka tekanyo ea tsoekere hangata.

Video ka lithethefatsi tsa mofuta oa 2 tsa lefu la tsoekere:

Tšebelisano ea PSM le lithethefatsi tse ling

Nakong ea ho nka meriana e meng, ho ikamahanya ha bona le melemo ea sulfonylurea hoa tsotelloa. Lihormone tsa anabolic, li-antidepressants, beta-blockers, sulfonamides, clofibrate, lihormone tsa banna, li-coumarin, lithethefatsi tsa tetracycline, miconazole, salicylates, lithethefatsi tse ling tsa hypoglycemic le insulin li eketsa phello ea hypoglycemic.

PSM e fokotsa phello ea corticosteroids, barbiturates, glucagon, laxatives, estrogens le gestagens, nicotinic acid, chlorpromazine, phenothiazine, diuretics, lihormone tsa qoqotho, isoniazid, thiazides.