Metformin Richter 500 mg

Maka ọgwụgwọ nkwonkwo, ndị na-agụ akwụkwọ anyị ejirila DiabeNot nke ọma. Thehụ ihe ndị ama ama n’ahịa a, anyị kpebiri inyefe ya n’aka gị.

Ọrịa shuga mellitus, n'ihi uto ya ngwa ngwa yana oke ọnwụ, nwere nnukwu ihe egwu nye mmadụ. N'ime afọ 20 gara aga, ọrịa shuga abanyela ihe atọ na-akpata ọnwụ. Ọ bụghị ihe ijuanya na ebunye ọrịa a n'ọtụtụ ebumnuche ebumnuche ndị setịpụrụ ndị dibịa gburugburu ụwa.

Formdị usoro ọgwụgwọ

Ọgwụ Metformin-richter na isi arụ ọrụ metformin hydrochloride bụ nke onye na-emepụta ụlọ mepụtara na usoro abụọ: 500 mg ma ọ bụ 850 mg nke ọ bụla. Na mgbakwunye na akụrụngwa bụ isi, enwere ndị na-ese ihe n'ime ihe mejupụtara: Opadry II, silicon dioxide, magnesium stearate, copovidone, cellulose, polyvidone.

Enwere ike mata ọgwụ a site na njirimara agwa: okirikiri (500 mg) ma ọ bụ oval (850 mg) mbadamba ọcha na shei na-ejupụta na mkpụrụ ndụ na-acha uhie uhie. N'ime igbe ị nwere ike ịchọta site na 1 ruo 6 efere dị otú ahụ. Nwere ike ị nweta ọgwụ naanị site na ndenye ọgwụ. Na Metformin Richter, ọnụahịa nke mbadamba 60 nke 500 mg ma ọ bụ 850 mg bụ 200 ma ọ bụ 250 rubles. kwekọrọ. Onye rụpụtara ya mere ka ụbọchị mmebi ahụ kwụsị n'ime afọ atọ.

Ofzọ usoro nke ọgwụ ahụ

Metformin Richter bụ otu biguanides. Ngwakọta ya bụ isi, metformin, belata glycemia n’etinyeghị ume n’akpata, yabụ enweghi hypoglycemia n’etiti mmetụta ya.

Metformin-ọgaranya nwere usoro ọrụ atọ nke mmetụta antidiabetic.

Ọgwụ ahụ na-egbochi mmepụta glucogen n'ime imeju site na 30% site na igbochi glucogenesis na glycogenolysis.
Ọgwụ a na-egbochi itinye glucose site na mgbidi nke eriri afọ, ya mere, carbohydrates na-abanye akụkụ ọbara. Illsụ ọgwụ ekwesịghị ịbụ ihe mere ị ga-eji jụ nri obere carb.
Biguanide na -eme ka iguzogide sel ka glucose, mee ka ojiji ya ike (na akwara ike) - rue n’odu buru ibu, na nke abuba - nke di ala.

Ọgwụ a na-eme ka mmerụ ọbara dịkwuo elu: site na ịbawanye mmeghachi omume redox, ọ na - egbochi mmepụta nke triglycerol, yana oke na "ọjọọ" (obere nju) ụdị cholesterol, ma belata nguzogide insulin nke ndị na - anabata ya.

Ebe ọ bụ na mkpụrụ ndụ nke islet ngwa nke rụpụtara insulin endogenous anaghị emetụta metformin, nke a anaghị ebute mbibi oge ha na necrosis.

N'adịghị ka ọgwụ hypoglycemic ọzọ, ị ofụ ọgwụ ahụ mgbe niile na-enye nkwụsi ike. Eziokwu a dị mkpa maka ọtụtụ ndị ọrịa shuga, ebe ọ bụ na ọrịa shuga 2dị nke abụọ na-esokarị ibu, nke na-agbagha njikwa nke glycemia nke ukwuu.

O nwere uto biguanide na fibrinolytic, nke dabere na mgbochi nke plasminogen tissue inhibitor.

Site na eriri afọ, ọnya na-agbakasị ahụ kpamkpam na bioavailability dị 60%. A na-ahụ ọnụ ọgụgụ kachasị elu nke ntinye uche ya ka ihe dị ka awa 2.5. A na-ekesa ọgwụ ahụ n'ụzọ na-enweghị isi na akụkụ ahụ na sistemụ: ọtụtụ n'ime ya na-agbakọta na imeju, akụrụ parenchyma, akwara, na gland salivary.

Site na akụrụ (70%) na eriri afọ (30%) na-ewepụ ihe metabolite dị na ya, mkpochapu ọkara ndụ dị iche site na awa 1.5 ruo 4.5.

Onye gosiputara ogwu ahu

Ejiri Metformin-ọgaranya karịa maka njikwa ụdị shuga 2, ma dịka ọgwụ nke mbụ yana na ọkwa ndị ọzọ nke ọrịa ahụ, ọ bụrụ na mgbanwe ndụ (nri nri obere nri, njikwa ọnọdụ mmetụta na mmega ahụ) anaghị enye njikwa glycemic zuru ezu. Ogwu a dabara adaba maka monotherapy, a na-ejikwa ya na ọgwụgwọ di omimi.

Enwere ike imerụ ọgwụ ahụ

Mbadamba ụrọ bụ contraindicated maka ndị nwere hypersensitivity na ihe nke usoro. Na mgbakwunye, a naghị enye Metformin Richter iwu:

Na decompensated akụrụ na dinar dysfunctions,
Ọrịa mamịrị na-arịa ọrịa obi na nsogbu iku ume,
Ndị nne dị ime na ndị na-enye nwa ara
Maka ndị a alcoụrụma na ndị mmanya na-egbu egbu
Ọrịa na ọnọdụ lactic acidosis,
N'oge ịwa ahụ, ọgwụgwọ nke mmerụ ahụ, ọkụ,
Ruo ogologo oge nke radioisotope na radiopaque,
N'oge mmegharị ahụ mgbe infarction myocardial,
Site na nri hypocaloric na mgbatị anụ ahụ dị ukwuu.

Ibepu edemede banyere sayensi na ogwu na ahuike, onye dere akwukwo sayensi bu Ametov A.S., Demidova T.Yu., Kochergina I.I.

Ọrịa shuga mellitus (DM) bụ nnukwu nsogbu ahụike na mmekọrịta mmadụ na ibe ya. Ọrịa shuga na-arịwanye elu na mba niile, ebe 95% bụ ndị ọrịa nwere ọrịa shuga 2. Dabere na thelọ Ọrụ Mba Ọrịa Shuga, na 2014 ọnụ ọgụgụ ndị ọrịa nwere ụdị shuga 2 bụ nde mmadụ 387. Nke a bụ onye ọ bụla bi na iri na abụọ nke mbara ala. Ka ọ na-erule 2035, ọnụ ọgụgụ ndị ọrịa nwere T2DM nwere ike iru mmadụ 592. A na-ahụ ọnọdụ ụwa maka ọrịa shuga na Russia. Dabere na ndekọ Russia, na Russia nde mmadụ asatọ nwere ọrịa shuga, ma ọ bụ ihe dị ka 5% nke ọnụ ọgụgụ mmadụ, 90% n'ime ha bụ ndị nwere ọrịa shuga 2, ka ọ na-erule 2025 mmụba n'ọnụ ọgụgụ ndị ọrịa na nde 13 na-atụ anya. N'otu oge ahụ, ọnụọgụ ndị ọrịa a na-elebara anya na nhazigharị na-abụkarị ugboro 2-3 karịa nke 2, 3. Nnukwu mmụba na ndị ọrịa nwere ọrịa shuga na-abụkarị n'ihi mmụba n'ọnụ ọgụgụ ndị ọrịa nwere ụdị ọrịa shuga 2 na ndị agadi.

Nrụpụta nke metformin n'ịgwọ ụdị ọrịa shuga 2

Ọrịa shuga mellitus (DM) bụ nnukwu nsogbu ahụike na mmekọrịta mmadụ na ibe ya. Ọrịa shuga na-arịwanye elu na mba niile, ebe 95% bụ ndị nwere ọrịa shuga 2. Dabere na thelọ Ọrụ Mba Ọrịa Shuga, na 2014, ọnụ ọgụgụ ndị ọrịa nwere ụdị shuga 2 bụ nde 387, ma ọ bụ onye ọ bụla bi na 12 nke bi na mbara ala. Site na 2035, ọnụ ọgụgụ ndị ọrịa nwere ụdị shuga 2 nwere ike iru mmadụ 592. Usoro zuru ụwa ọnụ nke ọrịa shuga na-arịa ụdị shuga 2. N'ime afọ 2025, a na-atụ anya na ọnụ ọgụgụ ndị ọrịa ga-eru nde mmadụ 13. Onu ogugu nke ndi oria edebara aha na-abụkarị ugboro abụọ na-erughị ezigbo ọnụ ọgụgụ. 2, 3 Ihe ntinye kachasi elu na onu ogugu ndi oria shuga bu na-abawanye na onu ogugu oria ndi oria abuo n’abia.

Ederede nke ọrụ sayensị na isiokwu "Ọfụma ọgwụ ọgwụ metformin na ọgwụgwọ nke ụdị shuga 2"

A.S. AMETOV, MD, prọfesọ, T.Yu. DEMIDOVA, MD, prọfesọ, I.I. KOCHERGINA, Ph.D. Russian Medical Academy nke Postgraduate Mmụta, Ozi nke Russia, Moscow

METFORMIN EFFICIENCY

N'TBỌCH OF Tdị 2dị 2

ụdị ọrịa shuga 2

Ejikọtara anya na ụdị ọrịa shuga 2 nke ndị dọkịta nke ọpụrụiche dị iche iche (ndị na-agwọ ọrịa, ndị ọrịa obi, akwara ozi, ndị dọkịta na-awa ahụ) na mmepe nke nsogbu vaskụla, nke na-abawanye n'ihe ize ndụ nke ibute ọrịa obi na ọnwụ. N'afọ 2014, ọnwụ na-arịa ọrịa shuga dị nde mmadụ 4.9. Ọrịa Cardiovaskụk na ndị ọrịa nwere ọrịa shuga 2 bụ ihe a na-ahụkarị karịa ọnụọgụ niile.

Dabere na ọmụmụ mba ụwa, ọnụ ọgụgụ ọrịa obi na-efe efe (CHD) na ndị ọrịa nwere ụdị ọrịa shuga 2 bụ okpukpu 2-4 karịa, ihe egwu nke ịrịa ọrịa myocardial infarction (MI) bụ 6-10 ugboro karịa, na ọrịa strok bụ 4-7 ugboro dị elu, yana lanarị ndị ọrịa mgbe ọrịa vaskụla nnukwu na-agbakarị okpukpu abụọ karịa ndị ọrịa na-arịa ọrịa shuga.

Ọganii karia nke ọrịa obi na ọrịa myocardial infarction, ọkachasị ụdị mgbu myocardial infarction, na ọnụnọ nke ụdị ọrịa shuga 2 na-ejikọkarị ya na mkpụkọ nke ọrịa shuga na mmepe nke polyneuropathy nke ọrịa mamịrị na mmebi nke arịa ndị na-enye akwara, yana nbibi ugboro ugboro nke ọrịa atherosclerotic ọrịa shuga. paịlị.

Ọrịa obi (CVD) na nnukwu ihe ọghọm vaskụla bụ ihe kpatara ọnwụ nke ndị ọrịa nwere ọrịa shuga 2 na 75-80% nke ikpe: 60% n'ime ha bụ

na -akwanu obi na

10% - maka ọnya ụbụrụ 6, 3. Ihe fọrọ nke nta ka ọ bụrụ 50% nke ndị ọrịa nwere ụdị ọrịa shuga 2 na-anwụ site na nnukwu myocardial infarction. Ọrụ kachasị na ndị ọrịa obi na mbido ịtụ anya ịtụwa ndụ na ihe ka n'ọnụ ọgụgụ nke ndị ọrịa nwere ụdị shuga 2 enyela ndị otu American Cardiology Association ịkepụta ụdị ọrịa shuga 2 dị ka ọrịa obi.

Mmepe nke nsogbu ịrịa ọrịa mamịrị na hyperglycemia na-adịghị ala ala, bụ nke gosipụtara n'ụzọ doro anya n'ọtụtụ afọ nke nyocha sayensị buru ibu, dịka DCCT na-arịa ụdị shuga 1 na UKPDS - "Ọmụmụ ihe ọmụmụ Britain na-ele anya nke ụdị shuga 2." N'ime ọmụmụ UKPDS, egosiri na iji kwụọ ụgwọ maka ọrịa metabolic n'ụdị ọrịa shuga 2 iji gbochie ọganihu nke atherosclerosis na nsogbu akwara, ọ dị mkpa iburu n'uche ọ bụghị naanị ihe ngosi glycemic, kamakwa ihe ngosipụta nke egbugbere ọnụ na ọbara ọgbụgba, nke bụkwa ihe ndị dị egwu maka mmepe nke vaskụla. nsogbu.

Ọrịa obi na nnukwu ọrịa vaskụla bụ ihe kpatara ọnwụ nke ndị ọrịa nwere ụdị shuga 2 na 75-80% nke ikpe.

Ọrịa shuga 2dị nke Abụọ bụ ọrịa na-adịghị ala ala nke na-arịa ọnụnọ nke nkwarụ abụọ gbara ọkpụrụkpụ: nnwale insulin na arụ ọrụ p-cell na-arụ ọrụ.

A na - amata metabolism nke abụba na - ebu oke ibu na ụdị shuga 2 bụ mmụba nke libids atherogenic na plasma ọbara na mbelata lipids nke na - egbochi atherosclerosis. Mmụba nke cholesterol ọbara, ala dị ala nke ukwuu na lipoproteins, triglycerides na abụba abụba n'efu na-eduga n'eziokwu ahụ na ha na-agbakọ na akụkụ dị iche iche na anụ ahụ, na-akpaghasị ọrụ ha. Mmepụta nke abụba abụba n'efu (FFA) site na visceral adipose anụ ahụ megide ndabere nke nguzogide insulin na-eduga n'ịbelata uche nke umeji na-egbochi mmetụta insulin na gluconeogenesis na mmepụta glucose site na imeju, na-akpata ibu ọnụ hyperglycemia. Nchịkọta nke lipids na akwara na-eduga na imegide insulin, n'ime imeju na-eme ka imeju na-egbu abụba, n'ime mkpụrụ ndụ beta nke pancreas iji belata secretion nke insulin ma mụbaa ọnwụ nke mkpụrụ ndụ beta site ugboro asaa ma ọ bụ karịa. Akpọwo mmetụta ọjọọ a nke lipids lipotoxicity. Hyper- na dyslipidemia na-eduga na lipotoxicity na atherogenesis.

Ugbu a, ihe karịrị 90% nke ndị ọrịa nwere ụdị shuga 2 nwere oke ibu ma ọ bụ ibu na insulin na-eguzogide. Nlegide insulin na -adikarị ihe oke ibu, ọ bukwara mmepe nke ọrịa shuga. Yabụ, dịka ọmụmaatụ, achọpụtara insulin na-achọpụta na ndị ikwu nke ọkwa mbu nke kinship nke ndị ọrịa nwere ụdị ọrịa shuga 2 ruo afọ 7-12 tupu achọpụta ọrịa shuga mellitus.

E gosiputara na iguzogide insulin bu ihe mmadu nwere onwe ya maka mmepe nke atherosclerosis na ọrịa obi: ọbara mgbali elu, ọrịa obi, miocardial infarction, ọrịa obi, ọrịa ọnya afọ 12, 13. Hyperinsulinemia, ọrịa metabolism na hyperglycemia bụkwa ihe ndị dị ize ndụ maka mmepe nke atherosclerosis na Ọrịa obi na-etolite na ndị ọrịa nwere ụdị ọrịa shuga 2 dị ọtụtụ oge karịa na ndị ọrịa na-arịa ọrịa shuga.

Iji mee ka ọ̀tụ̀tụ̀ shuga dị n'ọbara dị ala n'okpuru ọnọdụ nke iguzogide insulin na iji belata ume glucose, mkpụrụ ndụ beta pancreatic ga-arụ ọrụ na nrụgide iji zoo insulin ọzọ. Na mbido, mmụba nke insulin (hyperinsulinemia) ezuru iji mee ka ọkwa glucose dị n'etiti ụkpụrụ kwesịrị ịdị, ka oge na-aga, ọnụ ọgụgụ insulin na-aba ụba enweghị ike ịkwụsị mmeri insulin. Ọrụ nke sel beta na-agbari ma na akara ngosipụta nke insulin insulin na-apụta, nke a na-egosipụta site na mmụba shuga ọbara na mmepe nke nnabata glucose na-akpata, wee tinye ọrịa shuga 2.

Mmebi nke njikọ na nsị nke insulin, yana omume ya na ọkwa nke mkpụrụ ndụ mgbaru ọsọ, na-eduga n'ịbelata ike glucose mgbe e risịrị nri yana mbelata nsị nke glycogen na akwara na umeji, na-ebute mmepe nke ọrịa ọnya nke ụdị ọrịa shuga 2 - ọrịa postprandial hyperglycemia,

i.e., mmụba na shuga n'ọbara mgbe ị risịrị nri karịa ụkpụrụ nkịtị.

Mmụba na glucose ọbara mgbe ị risịrị nri> 7.9 mmol / L (nkịtị ka 7.8 mmol / L) na-eduga na mmepe nke nsonaazụ glucose. Okwu a na-akpọ uto na-egbu egbu nke glucose, nke na-egosipụta onwe ya na glycosylation nke protein (itinye glucose na protein nke membranes cell) nke anụ ahụ na akwara dị iche iche, nke na-enweghị mgbagha na-eduga n'ịrụ ọrụ, yana mmụba n'ọbara shuga - na mmepe nke nsogbu ọrịa mamịrị: mmebi anya (retinopathy) , mmebi akwara (polyneuropathy), ọrịa akụrụ (nephropathy), mmebi vaskụla (atherosclerosis).

Nchịkọta nke lipids na akwara na-eduga na imegide insulin, n'ime imeju - imeju abụba, n'ime mkpụrụ ndụ beta nke pancreas - iji belata insulin na-amụba ma mee ka ọnwụ nke mkpụrụ ndụ beta

Oge asaa ma ọ bụ karịa

Otu njiri mara banyere oria oria oria nke abuo bu oria ogologo oge bu oria a, dika omumu ihe omumu mba si di, oria oria nke oria nke abuo anaburu site na mmalite nke oria.

Ọrịa shuga dị ogologo oge "nkịtị" na-eduga na eziokwu ahụ bụ na ihe karịrị 50% ndị ọrịa nwere nchọpụta mbụ banyere ụdị shuga 2 bụ ọrịa enwelarị nsogbu dịgasị iche:

Mmebi na nnukwu arịa (macroangiopathy)

Pert Ọbara mgbali elu - 39%.

Ọrịa obi, ọrịa obi akwara na-arịa.

■ Mebiri emebi n'ụkwụ ụkwụ - 30%.

Mmeri nke obere arịa (microangiopathy)

Retinopathy, ọhụhụ ụzọ - 15%.

■ Nehropathy, arụlatala ọrụ ọrụ gbasara akụrụngwa:

• ọdịda okuku na - adịghị ala ala - 1%.

Damage Nmebi akwara - neuropathy - 15%. Ọrịa mamịrị na-eme naanị mgbe

mgbe a naghị akwụghachi ndị ọrịa shuga ụgwọ ogologo oge, shuga na-adịkwa elu ruo ogologo oge. Ozugbo ebilite, ọrịa mamịrị ji nwayọ nwayọ na-aga n’ihu, belata ogo ndụ ma belata oge ọ ga-ebi. 75-80% nke ọnwụ niile sitere na ọrịa shuga na-esite na nsogbu vaskụla - nkụchi obi, ọnya afọ, ọrịa mamịrị, ọrịa gbasara akụrụ.

Agbanyeghị, ọ bụrụ n ’ụgwọ ọrịa shuga ọfụma ma nweekwa ọbara dị nso n’otu o kwere mee, mgbe ahụ mmalite na mmepe nke ọrịa shuga

nsogbu na-akwụsịlata na-akwụsị. Emere ka nke a gosipụtara n'ọtụtụ ọmụmụ ogologo oge maka ụdị shuga mellitus 2 (UKPDS), nke emere na UK na ụlọọgwụ iri abụọ na atọ. Ruo afọ 20, ndị dọkịta mụrụ otú ụdị shuga 2 na ọrịa ya si etolite na ụdị ọgwụgwọ dị a improveụ na-eme ka ọnọdụ ahụike nke ndị ọrịa dị.

Nnyocha UKPDS chọpụtara na iwetulata ọkwa glucose dị ka ọ dị nso na nkịtị ka enwere ike belata ihe egwu nke ịrịa ọrịa mamịrị ma na - enyere aka igbochi ha.

Site na ezigbo ụgwọ maka ọrịa shuga, ọnụọgụ ugboro ugboro hụrụ:

Ọrịa niile metụtara ọrịa shuga - 12%.

Microangiopathies - nke 25%.

Inf Myocardial infarction - nke 16%.

Ino Retinopathies - nke 21%.

■ Nehropathy - Nke 33%.

Ọgwụ ụdị shuga mellitus nke 2, nyere usoro dị mgbagwoju anya nke mmepe ya na oke ọnụ ọgụgụ ndị ọrịa a, bụ ọrụ siri ike.Ugbu a, ọ gaghị ekwe omume ịgwọ ọrịa shuga, mana enwere ike ijikwa ya nke ọma ma biekwa ndụ zuru oke ruo ọtụtụ afọ, ka ị na-ejikwa ike na ọdịmma.

N'akụkụ a, ebumnuche bụ isi nke ịgwọ ọrịa shuga bụ ụgwọ zuru oke maka nsogbu ọrịa carbohydrate, nke enwere ike nweta naanị n'ihi usoro dị mgbagwoju anya, usoro ọgwụgwọ na usoro ọgwụgwọ nke na-eburu n'uche oge ọrịa ahụ, oke mkpali nke ọrịa metabolic, mbelata nke P-cell na-ebelata, belata ọrụ ha, afọ onye ọrịa, ihe egwu nke hypoglycemia, yana mkpa iji nweta nchịkwa glycemic dị ogologo oge iji belata ihe egwu nke ibute ọrịa obi, ọrịa obi na ọrịa obi na ndị ọrịa nwere ọrịa shuga nke 2.

Nhazi nke ebumnuche ọgwụgwọ maka ụdị shuga 2 gụnyere:

1. control nweta ezigbo njikwa metabolic: iwepu ihe mgbaàmà nke hyperglycemia na dyslipidemia.

2. Mkpochapu ọrịa shuga na nsogbu abụọ - isi hypoglycemia.

3. Mwepu nke mmepe nke nsogbu vaskụla mbido.

Dika ihe omuma ohuru a, ekwenyero na ADA na EASD algorithms maka ọgwụgwọ nke oria oria abuo, mgbe ichoputara oria, ogha kwesiri ịmalite ngbanwe nke ndu ya na ojiji nke metformin.

Mgbanwe obibi ndụ gụnyere nri (nri kwesịrị ekwesị), mgbasawanye nke mmega ahụ na mbelata ma ọ bụ iwepụ ọnọdụ ndị na-akpata nrụgide.

Ọganiihu ọgwụgwọ dabere na ole onye ọrịa na-esonye na mmemme ọgwụgwọ, na ihe omuma ya banyere ọrịa ya, mkpali ya, akparamagwa ya, na-amụta ụkpụrụ njide onwe onye.

Ebumnuche nke nri bụ iwepụ ọrịa postprandial hyperglycemia, ibu ọnụ hyperglycemia ma belata oke ibu, n'ihi na oke ibu na-atụnye ụtụ na nsogbu nke ọrịa mamịrị.

Ihe nke abuo di nkpa banyere ọgwụgwọ nke oria 2 bu mmụba nke mmega ahụ. Ọrụ anụ ahụ ọ bụghị naanị na ọ na-emetụta glycemia, na-enye aka na ojiji nke glucose site na akwara, mana ọ na-emekwa ka metabolism abụba, na-enwe mmetụta bara uru na usoro obi, na-akpali mmetụta dị mma ma na-enyere aka ịnagide ọnọdụ ndị na-akpata nrụgide, na-eduga na mbelata insulin iguzogide na hyperinsulinemia. Ekwesịrị ịhazi mmega ahụ ahaziri iche, na-eburu n'uche afọ onye ọrịa, nsogbu nke ọrịa shuga na ọrịa ndị metụtara ya.

Otu njiri mara banyere oria oria oria nke abuo bu ihe oria a na-egbu egbu, dika ihe omumu nke mba n’agha siri di, odi n’afo asaa rue iri-abuo asaa tupu oria oria a puta.

Maka ndị ọrịa nwere ọrịa shuga nke 2, nkeji iri atọ ruo iri anọ na ise kwa ụbọchị iji ụkwụ dị ụbọchị 2-3. A na-agba ume usoro mmega ahụ nke na-emetụta ike onye ọrịa, ọchịchọ ya na ụzọ ndụ ya.

Nri na mmega ahụ bụ ụzọ nkuku abụọ na - enyere mmadụ aka ịgwọ ụdị ọrịa shuga 2. Mana ọ bụ ihe nwute, ọtụtụ ndị ọrịa, ọkachasị ndị agadi, anaghị agbaso nri mgbe niile, ha enweghị ike ịbawanye ụba nke mmega ahụ n'ihi ọnụnọ nke ọrịa nkwonkwo, ọrịa obi obi, ọbara mgbali elu akwara, na ọbara obi.

N'oge mmalite nke ọrịa metabolism metabolism, mgbanwe ndụ nwere ike ịdị oke mma ma belata ihe ọghọm nke ọrịa shuga 2 site na 58%. Agbanyeghị, na usoro nke ikpeazụ nke ụdị shuga 2, mgbe a na-achọpụtakarị ya, rụpụta ihe HBa1c na-anakwere (enweghị m ike ịchọta ihe ịchọrọ? Gbalịa ọrụ nhọrọ akwụkwọ.

Enweghị njikwa glycemic kwesịrị ekwesị maka ọnwa 2-3. a na-atụ aro njikọ nke ọgwụ nke abụọ. Site na nkwekọrịta, na usoro ọgwụgwọ a, ọgwụ ọ bụla na-ebelata shuga nwere ike ịgbakwunye metformin: GLP-1 agonist, DPP-4 inhibitors, sulfonylurea ọgwụ, SGLT-2 inhibitors, pioglitazone, basal insulin.

Ya mere, metformin bụ ọgwụ izizi ịhọrọ nweta ezigbo metabolic nke glucose na arụmọrụ nri na-ezighi ezi na ịba ụba na-emega ahụ na ndị ọrịa nwere ụdị ọrịa shuga 2 nke oke ibu na oke ibu.

Mainzọ kachasị nke metformin bụ mgbochi imeju na - egbochi glucose mepụta, nke na - eduga n'ịbelata mkpịsị glycemia na iri nri (Fig.). E gosipụtawo mmetụta nke metformin na metabolism metabolism site n'ọtụtụ ọmụmụ. Mmetụta metformin na imeju nwere ọtụtụ: ọ na - eme ka njikọ ahụ belata ma kwụsịlata mmebi nke glycogen, belata neoglucogenesis na protein acid na - eme, emeziwanye ọrụ nke enzymes imeju, ya mere ejiri ya na - agwọ ọrịa steatohepatitis na ọrịa imeju na - adịghị egbu egbu (NAFLD), nke bụ ihe mejupụtara ọrịa shuga. ụdị, oke ibu.

Metformin na-ebelata oriri nke carbohydrates na eriri afọ, na-egbochi mmụba dị elu na shuga ọbara mgbe ị risịrị nri ma nwekwa ahụ anụ ahụ. O nwere mmetụta anorexigenic megide carbohydrates na-agbari ngwa ngwa ma na-enyere aka ime ka ahụ sie ike. Usoro ọgwụgwọ nke ndị ọrịa nwere oke ibu na-eduga n'ibelata oke oke na nkezi site na 5-7 n'arọ n'ime ọnwa 3-4.

Metformin na-echekwa mkpụrụ ndụ nke akwara, na-echebe ha pụọ na iku ume ma na-agbasa

Ee, n'ihi na ọ naghị akpali ntọhapụ nke mkpụrụ ndụ p-cell. Ya mere, ọ dịghị ebute hyperinsulinemia ma ghara ịkpata hypoglycemia, nke dị ize ndụ karịsịa na ndị ọrịa nwere ụdị ọrịa shuga nke 2 n'ihi ọrịa nwere ike ibute ọrịa obi na - arịa obi ma ọ bụ ọrịa strok.

Achọpụtara na metformin na-eme ka ahụ mmadụ dịkwuo elu na insulin, na-abawanye nnabata nke glucose site na akwara n'ihi na ndị na - ebugharị ndị na - ebugharị glucose - GLUT-4.

Metformin nwere mmetụta angioprotective kpọmkwem, nke a na-ejikọghị ya na nsonye yana iwetulata shuga.

Ekwesiri ntụkwasị obi cardioprotective metformin na nyocha UKPDS. Ka ọ dị ugbu a, e gosipụtara mmetụta dị mma nke metformin na ndị ọrịa nwere ọrịa shuga 2 na ọrịa obi na-adịghị ala ala (CHF).

Site n'iji ogologo oge, metformin na-eduga na ọkwa nke usoro glycemic kwa ụbọchị, mbelata na glycemia kwa ụbọchị, mbelata na glyceated hemoglobin (HbA1c), nke na-enyere aka igbochi nsogbu oge ịrịa ọrịa mellitus.

Site n'ibelata hyperglycemia postprandial, metformin na-ebelata ihe ize ndụ nke ịmalite atherosclerosis na ndị ọrịa nwere hyperinsulinemia na nguzogide insulin.

N'afọ ndị na-adịbeghị anya, a na-elebara ntị dị ukwuu n'ihi mmetụta mgbochi nke metformin. O yikarịrị ka a ga-ahụ mmetụta a site na mgbakwunye nke cyclic adenosine-monophosphate-based protein kinase (AMPK), nke na-achịkwa glucose na metabolism lipid na ike nke mkpụrụ ndụ. Na ọnụnọ AMPK, metformin na-egbochi mTOR (ebumnuche mammalian nke rapamycin), na mweghachi mweghachi insulin na-esote ya na mbelata hyperinsulinemia, nke bụ ihe dị ize ndụ maka mmepe nke etuto ahụ. Metformin nwere ike igbu oge ịgbatị sel, na-akwụsị usoro sel

.Se. Mmetụta Metformin na ọkwa imeju

Ihe mgbochi nke enzymes glucone neogenesis

Belatara na ekwekọghị ekwekọ

na usoro G0 / G1, i.e., na mmalite mmalite ọmụmụ sel. Na mgbakwunye, AMPA nwere ike imetụta protein LKB-1 - protein na-ebelata uto ahụ. Site na ịgbalite AMPK, metformin na-eme na tumorigenesis nke LKB-1, ọ na-emetụtakwa tumor necrosis factor ma weghachite ọrụ nke mkpụrụ ndụ T ebe nchekwa na-ata ahụhụ na nsonaazụ nke abụba n'efu. Metformin na - ebelata ọnọdụ ara nke kansa na ọrịa prostate, kansa nke eriri afọ, akpa ume, wdg.

N'ụzọ dị iche na nhazi nke sulfonylurea, metformin na-ebelata shuga ọbara ọ bụghị n'ihi mkpali nke insulin na -akpata site na mkpụrụ ndụ pancreatic but, kama n'ihi mmụba nke glucose site na mkpụrụ ndụ anụ ahụ.

Enweghị mkpali insulin na-eduga n'inwe agụụ, enweghị ihe ọ bụla nke hypoglycemia, yana ịbelata ọkwa insulin dị elu na ndị ọrịa nwere ụdị ọrịa shuga 2, i.e., mbelata nguzogide insulin.

Site n’ibelata agụụ na-arịwanye elu na ndị ọrịa nwere ụdị ọrịa shuga nke 2, metformin na-akwalite ịbelata nwayọ nwayọ nwayọ, ma site na ibelata mmịkọta nke glucose na eriri afọ, ọ na-egbochi mmụba nke shuga ọbara mgbe ị risịrị nri. Ya mere, metformin na-arụ ọrụ nke ọma na ndị ọrịa nwere ụdị ọrịa shuga 2 nke nwere oke ibu. Na mgbakwunye, ọmụmụ sayensị egosila na metformin na-ebelata agụụ, ike nke anụ ahụ na iguzogide insulin ugbua na ọkwa nke oke oke ibu, na-egbochi ma ọ bụ belata nnukwu ihe ize ndụ nke ịnwe ndidi glucose na ụdị ọrịa shuga 2.

Ya mere, metformin na-arụ ọrụ pathogenetically: ọ na-ebelata mmepụta glucose site na imeju, nke na-enyere aka belata ibu glycemia, na-ebelata oriri nke carbohydrates na eriri afọ, na-ebelata agụụ, nke na-enyere aka belata PPG, jiri nwayọ belata shuga ọbara, n'adịghị ka usoro sulfonylurea (PSM), adịghị eme ka insulin na-enyocha ya. ma ọ dịghị akpata hypoglycemia, na-eme ka ịdị ọcha nke anụ ahụ na - eme ka insulin dịkwuo elu, na - eme ka nnabata glucose site na mkpụrụ ndụ ma belata nkwụghachi insulin, na - enyere aka belata ahụ mmadụ na mgbu. s ibu oké ibu, nwere mmetụta bara uru na lipid metabolism: mbenata ngụkọta cholesterol dị ala, nke njupụta lipoproteins na triglycerides, si otú mbenata progression nke atherosclerosis, na-eme ka a gụnyere ya ná ọbara mgbali.

Metformin na-arụ ọrụ nke ọma ma na monotherapy yana njikọ ọgwụgwọ nke ụdị shuga shuga nke 2 yana ọgwụ ndị ọzọ na-ebelata shuga ma ọ bụ na insulin.

Nke nsonaazụ metformin: mgbe ụfọdụ enwere mmebi site na eriri afọ - afọ ọsịsa, agụụ belatara, ụtọ dị na ọnụ, nke na-apụkarị ọsọsọ na-enweghị ọgwụgwọ.

Nsogbu kachasị akpụ akpụ bụ lactaciosis, ebe ọ bụ na mwepu nke neoglucogenesis na biguanides rụpụtara

Nke a na-ebute mmụba nke mkpokọta lactate, pyruvate, na alanine, bụ ihe na-ebido ịmalite glucose na usoro a. Agbanyeghị, ọmụmụ ndị emepụtara n'afọ ndị na-adịbeghị anya gosipụtara nchekwa ya. Nyocha 2003 meta nke nyocha nke 176 nke nyocha ọgwụ gbasara ojiji nke metformin dịka monotherapy ma ọ bụ na njikọta na ọgwụ ndị ọzọ gosiri na ugboro ole nke lactic acidosis dị ala karịa na ngalaba nchịkwa ma ọ bụ na otu na ọgwụ ndị ọzọ. Metformin bụ naanị biguanide akwadoro ugbu a maka ojiji. Ekwenyewo nchekwa nke metformin ọ bụghị naanị na ndị okenye, kamakwa na ụmụaka, nke jere ozi dị ka ntọala maka ikike na 2000 iji ya na United States maka ụmụaka gbara afọ 10 na karịa.

Ọ bụ ezie na metformin bụ ọgwụ dịtụ nchebe, nnukwu onunu ogwu n'ihi mmụba nke glycolysis anaerobic nwere ike ịkwalite hypoxia na-arịa ala na ọrịa obi na ngụ, na ya mere anaghị atụ aro metformin maka ndị ọrịa karịa afọ 60.

Ugbu a, na usoro nlekọta ahụike dị irè, a na-eji nkwadebe Metformin nke ndị nrụpụta dị iche iche. Companylọ ọrụ Rọshịa OJSC AKRIKHIN Chemical na ọgwụ na-emepụta ọgwụ anaput na ime ụlọ nke metformin - ọgwụ Gliformin na usoro nke 500, 850 na 1,000 mg, nke kwekọrọ na analogues nke na-ebute ma na-enye gị ohere ịhọrọ usoro ọgwụgwọ kwesịrị ekwesị.

Ihe ngosi maka ojiji:

■ Gliformin bụ ọgwụ a họọrọ maka ndị oke ọria nke ọrịa diabetesdị 2 oke ọrịa oke.

■ Glyformin na-emeziwanye nchịkwa glycemic na ọgwụ ọ bụla na-ebelata shuga na insulin, karịsịa na oke oke ibu na nguzogide insulin.

■ Glyformin na-ebelata ihe ize ndụ nke ịmalite ọrịa shuga na-arịa ndị ọrịa nwere ụdị shuga 2.

Ọ nwere mmetụta nke antitumor.

■ Gliformin na insulin na-egbochi mmụba nke aru nke ndị ọrịa nwere ụdị shuga 2.

Ọgwụgwọ na-ebido na mbadamba 1 nke 500 mg 2-3 ugboro kwa ụbọchị na nri.

Mgbe ụbọchị 10-15 gachara, enwere ike ịbawanye ụba nke Glyformin n'okpuru nchịkwa nke glycemia, n'agbanyeghị, ị nweghị ike ị karịa karịa 3,000 mg nke Glyformin kwa ụbọchị. Ọgwụ mbụ bụ 2,000 mg / ụbọchị.

Enweghị ike ibute Gliformin na ọrịa siri ike nke obi, akpa ume, ọdịda ọbara, ị excessiveụbiga ihe ọ alcoụ alcoụ na-aba n'anya ókè, ọrịa imeju na akụrụ.

Eto Ọrịa mamịrị ketoacidosis, precoma, coma.

Liver Imeju akụrụ arụ ọrụ.

Gliformin enyochaala nnukwu nyocha ụlọ ọgwụ, gụnyere na Ngalaba Endocrinology, RMAPO, nke gosipụtara na arụmọrụ ya dị elu.

Ndị mmadụ na-eche banyere ndị mmadụ

N'ihe banyere contraindications iji metformin ma ọ bụ ihe ọ na-anabataghị, na enweghị nchịkwa glycemic kwesịrị ekwesị ugbua na ọkwa 1st nke ọgwụgwọ nke ụdị ọrịa shuga 2 dị ka nkwenye, a na-atụ aro ka ị jikọọ nkwadebe ma ọ bụ glinides na-akpali insulin insulin, wdg. ka., n'agbanyeghị ọnụnọ nke ọtụtụ ndị ọrịa nwere hyperinsulinemia na mbido ọrịa ahụ, insulin nke onwe ha ezughi iji merie nguzogide insulin na ọ dị mkpa iji mee ka itinye uche ya n'ọbara.

N'etiti ọgwụ na-ebelata shuga shuga, nkwadebe ndị SM bụ ihe kachasị ewu ewu. Ha na-arụ ọrụ site na ọwa mmiri ATP nke gbadoro azụ nke mkpụrụ ndụ P-pancreatic, nke nwere usoro dị mgbagwoju anya ma mejupụtara ngalaba sub-anọ na-eme kris 6,2 na-eche ihu n'usoro ion na ihe nnabata nke sulfonylurea (SUR). PSM na-emechi uzo KATp dabere, nke na-eduga n'ịgbanwe sel 'sel, oghere nke mkpụrụ ndụ kalselị na ntinye aka nke Ca ++ ion na cytoplasm nke mkpụrụ ndụ p na ntinye insulin nke emechara na ọbara. Mmụba nke ịba ụba nke insulin plasma na-eduga n'ịbelata ma glycemia post-prandial ma na-ebu ọnụ.

Site na mgbasa nke ọrịa ahụ ma ọ bụ nchọpụta nke T2DM na ọkwa nke nsogbu ọrịa metabolic ọzọ, a na-agbakwunye SM maka metformin na-akpali mkpụrụ ndụ insulin ma belata shuga ọbara. Otu n'ime ọgwụ kachasị mma maka SM bụ gliclazide. Glyclazide jiri nwayọ kpalie insulin, na-eweghachi profaịlụ biphasic nke insulin na nzaghachi maka nri nri, na-ebelata mmepụta glucose, na-ebelata insulin, na-enwe ntakịrị nsogbu hypoglycemia na enweghị oke ahụ, na-eme ka ihe omimi ọbara rịa elu - na-ebelata thrombosis, na, nke kachasị mkpa, na-ebelata ihe ize ndụ nke nsogbu obi, na-echebe obi na arịa ọbara site na iji ogologo oge.

Nyere mkpa iji ọgwụ abụọ ga-aga n’ihu maka ịgwọ ụdị ọrịa shuga 2, ọgwụ

Firms malitere imepụta ngwakọta jikọtara ọnụ nwere nkwadebe metformin na SM n'otu mbadamba, nke a na-enye ohere ozugbo belata ọnụ ọgụgụ mbadamba mbadamba oge abụọ na-arịwanye elu na nnabata nnabata, na ntinye anya na ọgwụgwọ, ọchịchọ ịgwọ ya.

Na mgbakwunye, ngwakọta nke ọgwụ abụọ n'ime otu mbadamba mere ka o kwe omume iji nchịkọta kachasị dị ala na nsonaazụ kachasị mma n'ihi nkwalite mmekọrịta nke ihe mejupụtara ya.

Thelọ ọrụ ụlọ AKRIKHIN Chemical-Pharmaceutical Combine OJSC maka oge mbụ mepụtara naanị ọgwụ na Russia nwere ọgwụ abụọ dị oke mma ma dị mma: glycoslazide na metformin.

A na-akpọ ọgwụ a maka ịgwọ ụdị ọrịa shuga 2 Glimecomb ma nwekwaa ihe mbụ emere

AKRIKHIN bụ otu n'ime ụlọ ọrụ ndị na-emepụta ọgwụ na Russia na-emepụta ọgwụ ndị dị irè, ọnụ na ọnụ ala. Companylọ ọrụ ahụ so n'etiti ndị na-emepụta ọgwụ na mpaghara 5 kachasị elu na ahịa ọgwụ Russia na usoro ahịa.

"AKRIKHIN" bụ nke hibere na 1936. Pọtụfoliyo ngwaahịa ụlọ ọrụ gụnyere ihe karịrị ọgwụ 200 nke isi ọgwụ ọgwụ: cardiology, neurology, pediatrics, gynecology, dermatology, urology, ophthalmology. “AKRIKHIN” na -emepụta ọgwụ dịgasị iche iche n'obodo, na-abụ otu n'ime ndị Russia na-emepụta ọgwụ maka ndepụta ọgwụ dị mkpa, yana ọgwụ maka ịgwọ ụkwara nta na ọrịa shuga.

4V J Sfwwk & M, ju j: “na.

Pọtụfoliyo nke usoro endonrinologic nke ụlọ ọrụ AKRIKHIN

nchikota glyclazide 40 mg + metformin 500 mg na mbadamba ihe. Uru Glimecomb nwere maka mkpokọta gliben-clamide na metformin na ahịa dị na nnukwu nhọrọ nke gliclazide, nke na-akpali mkpụrụ ndụ akwara ji nwayọ nwayọ, n’ebughi oke okpukpo ọbara ma gharakwa inwe mmetụta na-adịghị mma na sistem. Njikọ Ọrịa Ọrịa Shuga na America na European na-atụ aro Gliclazide dị ka otu n'ime ọgwụ kachasị mma ịhọrọ n'ihi obere elele hypoglycemia.

Metformin bụ ọgwụ ịhọrọ iji nweta ezigbo metabolic nke glucose na ndị ọrịa nwere ụdị shuga 2 nke mellitus na oke ibu

N'ụzọ dị iche na njikọta nke glibenclamide na metformin dịnụ, na-abawanye oke onunu ogwu nke Glimecomb kwa ụbọchị 5 na glycazide (200 mg) nwere ike belata ihe ize ndụ nke hypoglycemia, karịsịa na ndị ọrịa agadi. N’afọ 2008, ọgwụ ahụ nwere ihe ịga nke ọma n’ịga ule ndị dị ukwuu n’ụlọ ọgwụ, nke Ngalaba Endocrinology nke Russian Medical Academy of Postgraduate Education (RMAPO) nke Roszdrav mere (onye isi nke ngalaba ahụ bụ Ọkachasị Sayensị, Prọfesọ A.S. Ametov). Ihe omumu anyi gosiputara oru oma nke Glimecomb na uru nke nchikota akuko di iche

na-ewere gliclazide na metformin na usoro ọgwụ ndị ọzọ. Yabụ, mgbe ọnwa atọ gachara Glimecomb ọgwụgwọ, a hụrụ mbelata dị ukwuu na glycemia na-ebu ọnụ - site na 8.2 ruo 6.4 mmol / L, glycemia awa 2 mgbe nri gasịrị - site na 12.8 ruo 8.9 mmol / L, gemo na haemoglobin (HvA1s) - site na 8.25 ruo 7.07% (yana usoro 4-6%). Inweta Glimecomb emeghị ka ibu belata ma jikọtara ya na ọnọdụ dị ala nke hypoglycemia.

Ọmụmụ banyere ịdị irè nke ọgwụgwọ DM2 site na iji Sistem Nlekọta Glucose Na-aga n'ihu - CGMS, nke na-eduzi nyocha glycemia ugboro 288 kwa ụbọchị ma na-enye gị ohere iji nlezianya nyochaa ịdị irè nke njikwa glycemic n'ụbọchị, gosipụtara arụmọrụ dị elu nke mkpokọta ọgwụ ọgwụ Glymecomb ka ejiri tụnyere ya. iche iche n’usoro ihe ndi mebere ya. Na mgbakwunye, Glimecomb wepụrụ ngbanwe nke pathologies nke glycemia n'ụbọchị nke obere dosages ma e jiri ya tụnyere nlekọta dị iche iche nke ọgwụ ndị a.

Glimecomb nwere ike ịbụ ọgwụ ịhọrọ mbụ na mmalite ọgwụgwọ maka ụdị shuga 2. N'inwe usoro mmeghachi omume nke oge a na ịdị mfe nke nchịkwa, enwere ike iji Glimecomb dochie usoro ọgwụgwọ na monoformparations nke metformin na sulfonylurea.

Ya mere, ụlọ ọrụ ụlọ JSC Chemical na ọgwụ na AKRIKHIN na-emepụta ọgwụ abụọ a pụrụ ịdabere na na-adịghị mma maka ịgwọ ụdị ọrịa shuga dị n'ọrịa 2, nke na-enye ohere iwepụta ọgwụgwọ ma na-eme ka o kwe omume inweta nkwụghachi ụgwọ kachasị mma maka ọrịa mellitus. f

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2. Suntsov Yu.I., Dedov II, Kudryakova S.V. Deba aha steeti nke Ọrịa Shuga Mellitus: Njirimara oria ọrịa nke ọrịa shuga Mellitus na-abụghị insulin. Ọrịa mamịrị Mellitus, 2002, 1: 41-3

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5. Sliver VB, Chazova I.E. Ọkpụkpụ akụrụkasị ọrịa shuga dị iche iche 2. Medicili Consumum, 2003, 5 (9): 504-509.

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7. Ndi otu nyocha nke DCCT. Mmetụta ọgwụgwọ ọgwụgwọ ọrịa shuga siri ike na mmepe ahụ

na mgbanwe nke ogologo oge nsogbu insulin na-arịa ọrịa shuga mellitus. N. Engl. J Med, 1993, 329: 977-986.

8. Otu Ọmụmụ Ahụ Ọrịa Ọrịa UK. Nchịkwa ọbara mgbali elu yana ihe ọghọm nke ọrịa microvascular na microvascular n'ụdị ọrịa shuga 2: (UKPDS 38). BMJ, 1998, 317: 703-13.

9. Fruhbeek G, Salvador J. Relation n'etiti leptin na nhazi nke metabolism metabolism, Diabetologia, 2000, 43 (1): 3-12.

10. Trujillo ME, Scherer PE Adiponectin: njem site na protein protein adipocyte ruo biomarker syndrome. J Intern Med, 2005, 257: 167-175.

11. Wisse B.. Ọrịa mbufụt: ọrụ nke adipose anụ ahụ cytokines na nsogbu metabolic metụtara ibu. J Am Soc Nephrol, 2004, 15: 2792-80.

12. Rosen ED, Spiegelman BM. Ihe na - eme ka uru akpukpo ahu di aru ma obu onye ogbugbo nke insulin iguzogide oke ibu. Curr echiche Endocrinol Metab, 1999, 6: 170-176.

13. Sevter CP, Digby JE et al. Regulation nke tumo necrosis factor-Alfa weputara aru mmadu adiro na vitro. J Endocrinol, 1999, 163: 33-38.

14. Otu Ọmụmụ Ahụ Ọrịa Ọrịa UK. Mmetụta nke nchịkwa glucose dị ukwuu na metform-

na nsogbu na ndị ọrịa oke ibu na-arịa ụdị shuga 2 (UKPDS). Lancet, 1998, 352: 854-65.

15. Tuomilehto J, Lindstrom J, Ericsson J et al. Mgbochi ụdị shuga mellitus nke 2 site na mgbanwe obibi ndụ n'etiti isiokwu ndị nwere ndidi glucose na-adịghị mma. N Eng J Med, 2001, 344: 1343-50.

16. Jonson AB, Webster JM. SUM CF Mmetụta nke usoro ọgwụgwọ metformin na mmepụta hepatic glucose na-akwụsị ọrụ ọkpụkpụ muscule glycogen synthase muscle dị oke ibu na ndị ọrịa shuga 2 buru ibu. Metabolism, 1993, 42: 1217-22.

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18. Salpeter SR, Greyber E et al. Egwu nke egbu acid na nonctical lactic acidosis na iji metformin na ụdị ọrịa mellitus nke 2: nyocha usoro na meta-analisis. Arch Intern Med, 2003, 163 (21): 2594-602.

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Ndụmọdụ maka iji ya

Dọkịta na-ewepụta usoro ọgwụgwọ maka ndị na-arịa ọrịa shuga n’otu n’otu, na-eburu n’uche nyocha ụlọ nyocha, usoro mmepe nke oria, nsonaazụ na-agbanwe agbanwe, afọ, mmeghachi omume nke ọgwụ.

Maka Metformin Richter, ntuziaka maka ojiji na-atụ aro ka ịmalite were usoro dịkarịa ala nke 500 mg site na iji otu nzọụkwụ na usoro ahụ na-ezughị ezu kwa izu abụọ. Maximumkpụrụ kachasị maka ọgwụ ahụ bụ 2.5 g / ụbọchị. Maka ndị ọrịa mamịrị na-arịa ọrịa, bụ ndị na-enwekarị nsogbu akụrụ, ọgwụ kachasị bụ 1 g / ụbọchị.

Mgbe ị na-agbanye na Metformin Richter site na mbadamba shuga ndị ọzọ na-eme ka mmiri dị, usoro mbido mbụ bụ 500 mg / ụbọchị. Mgbe ị na -emepụta atụmatụ ọhụrụ, ọnụ ọgụgụ ọgwụ ndị ọ gara aga na-eduzi ha.

Dọkịta kpebisiri ike ikpebi ọgwụgwọ ahụ, na-emeghachi omume na ahụkarị, ndị ọrịa shuga na-egbu maka ndụ.

Nyocha nke ọgwụ ndị dọkịta na ndị ọrịa mamịrị

Banyere Metformin Richter, a na-agwakọta nyocha. Ndị dọkịta na ndị na-arịa ọrịa shuga na-ahụkarị ọgwụ dị elu: ọ na-enyere aka ịchịkwa shuga na agụụ, enweghị mmetụta na-eri ahụ, ntakịrị mmetụta ọ bụla, mgbochi dị mma nke obi na nsogbu ndị ọzọ.

Ndị ahụike na-a experimentụ ọgwụ na -efu efelata nwere ike ime mkpesa maka nsonaazụ na-achọghị. Ndị na-ahụ maka nri na-edozi ahụ ga-akwado ndụmọdụ maka idozi ọnụ ọgụgụ ndị ọrịa a, ọ bụghị ndị na-ahụ maka nri na ntanetị.

Ọ bụghị naanị na endocrinologists na-arụ ọrụ na metformin, kamakwa ndị ọkà mmụta obi, ndị na-agwọ ọrịa, oncologists, gynecologists, na nyocha na-esote bụ nkwenye ọzọ nke a.

Irina, 27 afọ, St. Petersburg. Na nnọkọ egwuregwu ha, Metformin Richter na-atụlekarị ndị ọrịa mamịrị ma ọ bụ ndị na-eme egwuregwu, m na-arankụ ya iji tụrụ ime. Anọwo m na-agwọ nsị polycystic m, nke ndị dọkịta kpọrọ ihe kpatara infertility, ruo ihe dị ka afọ 5. Ma Progesterone (injections) ma ọ bụ ọgwụ homonụ na-enyere aka ịkwaga nsogbu ahụ, ha na-enye ọbụna laparoscopy iji kpata ụmụ nwanyị. Mgbe m na-akwado ule na ịgwọ ọrịa ashma m - nnukwu ihe mgbochi na ịwa ahụ, otu ọkachamara n'ọrịa ụmụ nwanyị gwara m ka m nwalee Metformin Richter. Nke nta nke nta, usoro ahụ malitere gbakee, mgbe ọnwa isii gasịkwara ihe ịrịba ama nke ịtụrụ ime, ekwetaghị m ma nnwale ndị ahụ ma ọ bụ ndị dọkịta! Ekwenyere m na ọgwụ ndị a zọpụtara m, n'enweghị olileanya m na-adụ gị ọdụ ka ị nwaa nwalee, naanị kwenye na ndị ọkachamara n'ọrịa ụmụ nwanyị maka oge oriri.

Dodoụbiga ya ókè na mmetụta ọ na-akpata

Ọbụna mmụba okpukpu iri na usoro nke metformin nke ndị ọrụ afọ ofufo natara na ule ụlọ ọgwụ akpaliteghị hypoglycemia. Kama, lactic acidosis malitere. You ga - amata ọnọdụ dị ize ndụ site na mgbu na ọnya mmụba, iwetulata ahụ ọkụ, ọgba aghara dyspeptik, ọnwụ nke nhazi, itufu anụ ahụ na coma.

Onye merụrụ ahụ chọrọ ụlọ ọgwụ ozugbo. N'ụlọ ọgwụ, a na-ewepụ ọgwụ metabolites site na usoro akụrụngwa, a na-ejikwa ọgwụgwọ symptomatic site na nyochaa ọrụ nke akụkụ ahụ niile dị mkpa.

Akụkụ metformin hydrochloride nọ n'ọrụ nwere ihe akaebe siri ike maka nchekwa. Mana nke a metụtara, nke mbu, na Glucophage mbụ. Ihe omumu ihe banyere aru di iche na ndi ozo, emebeghi otutu omimi banyere odi nma ha, yabụ ihe ekwuputara nwere ike igosi ya.

Ihe dị ka ọkara nke ndị ọrịa mamịrị na-eme mkpesa nke nsogbu dyspeptik, karịsịa n'oge mmegharị. Ọ bụrụ na i dozie dose ahụ nke nta nke nta, were ọgwụ ahụ rie nri, ọgbụgbọ, enwere ike ịhapụ ụdị uto nke metal na nkụ iwe. Ngwakọta nke nri ahụ na-arụkwa ọrụ dị mkpa: mmeghachi omume nke metformin ma anụ ahụ bụ ihe dị mma maka ngwaahịa protein (anụ, azụ, mmiri ara ehi, àkwá, olu, akwụkwọ nri).

Kedu ka m ga - esi dochie Metformin-ọgaranya

Maka ọgwụ ọgwụ Metformin Richter, analogues nwere ike ịbụ mbadamba nkume nwere otu ihe mejupụtara metformin hydrochloride, ma ọ bụ ọgwụ hypoglycemic ọzọ nwere otu mmetụta:

Glucophage,
Glyformin
Metfogamma,
NovoFormin,
Metformin teva
Akpa,
Diaformin OD,
Metformin Zentiva,
Pliva,
Metformin Canon
Glyminfor,
Siofor
Methadiene.

Na mgbakwunye na analogues na weputara ngwa ngwa, enwere mbadamba nkume nwere mmetụta na-adịte aka, yana yana ngwakọta nke ọtụtụ arụ ọrụ na-arụ ọrụ n'otu usoro. Nhọrọ oke ọgwụ, ọbụlagodi ndị dọkịta, anaghị enye gị ohere ịhọrọ onye dochie anya na ọgwụ ịchọrọ iji dozie ya, yana ịnwale ahụike gị n'onwe gị bụ usoro mbibi onwe gị.

Ọrụ nke ndị ọrịa mamịrị bụ iji nyere ndị ọgwụ aka ịrụ ọrụ na arụmọrụ kachasị, ebe ọ bụ na na-enweghị mgbanwe ndụ, usoro ntinye niile na-efunahụ ike ha.

Ndụmọdụ Prọfesọ E. Malysheva nye ndị niile dọkịta nyere ha ọgwụ metformin, n'osisi