Acarbose (Acarbose) > Chithandizo ndi kupewa

Mokulira komanso mobwerezabwereza tikuletsa pancreatic alpha-amylase (hydrolyzes polysaccharides to oligosaccharides) ndi matumbo membrane-alpha-glucosidases (kuphwanya oligo-, tri- ndi disaccharides kwa glucose ndi monosaccharides ena) mu lumen yamatumbo ang'onoang'ono. Amachepetsa mapangidwe ndi kuyamwa kwa shuga m'matumbo, amachepetsa postprandial hyperglycemia, kusinthasintha kwa tsiku ndi tsiku m'magazi. Sikuwonjezera insulin komanso sikuyambitsa hypoglycemia.

M'maphunziro oyesera mu vitro ndi mu vivo palibe umboni wa mutagenicity. Kupanga makoswe ndi chakudya sizinakhudze chonde komanso kubereka kwathunthu.

Pafupifupi 35% ya mlingo wothandizidwa umatengedwa kuchokera m'mimba, mwina mu mawonekedwe a metabolites (omwe 2% ali mu mawonekedwe), bioavailability ndi 1-2%. C_max akwaniritsa pambuyo 1 ora, metabolites - pambuyo maola 14-24. Odwala ndi kulephera kwaimpso (Cl creatinine 2) C_max amachulukitsa ka 5, okalamba - nthawi 1.5. Amapukusidwa kokha m'matumbo am'mimba, makamaka ndi matumbo a m'matumbo ndi michere ina, ndikupanga ma mankhwala osachepera 13. Ma metabolites ofunikira amadziwika kuti amachokera ku 4-methylpyrogallol (mu mawonekedwe a sulfate, methyl ndi glucuronic conjugates). Mmodzi metabolite, yemwe amapangidwa ndi molekyu wa glucose mu acarbose, amatha kuletsa glucosidase ya alpha. Acarbose wosasinthika (pafupifupi 51% ya mlingo) amachotseredwa ndowe kwa maola 96. Pafupifupi 34% ya mankhwalawa amachotsedwa ndi impso mu mawonekedwe a metabolites, ochepera 2% - osasinthika komanso mawonekedwe a metabolite yogwira. T_1/2 Gawo logawa - maola 4, magawo a zotupa - maola 10

Kugwiritsa ntchito mankhwala Acarbose

Type 2 shuga mellitus yokhala ndi chithandizo chamankhwala osagwiritsa ntchito (njira yomwe imayenera kukhala osachepera miyezi isanu ndi umodzi) kapena kuperewera kwa chakudya cha sulfonylurea motsutsana ndi zakudya zochepa zopatsa mphamvu, lembani matenda a shuga 1, monga gawo la mankhwala osakanikirana), lembani matenda ashuga a 2 a shuga shuga kuphatikiza zakudya ndi masewera olimbitsa thupi.

Contraindication

Hypersensitivity, shuga .h. pang'ono kapena kudziwikiratu kwa icho, kupindika ndi zilonda zamatumbo, hernias yayikulu, kulephera kwaimpso (kulenga zomwe zili pamwambapa 2 mg / dl), kutenga pakati, kuyamwitsa.

Zotsatira zoyipa za mankhwala Acarbose

Kuchokera kumbali yam'mimba: kupweteka kwam'mimba, kusweka mtima, kusanza, kutsegula m'mimba, kawirikawiri - kuchuluka kwa transaminases (ALT ndi AST), kutsekeka kwamatumbo, jaundice, hepatitis (nthawi zina, kwathunthu ndi zotsatira zakupha).

Zotsatira zoyipa: zotupa pakhungu, hyperemia, exanthema, urticaria.

Zina: kawirikawiri - kutupa.

Kuchita

Zotsatira zimachepetsa kukonza kwa carbon ndi zina zam'mimba adsorbents, kukonzekera kwa enzyme kukonzekera komwe kumakhala ndi pancreatin kapena amylase. Thiazide diuretics, corticosteroids, phenothiazines, mahomoni a chithokomiro, estrogens, kuphatikiza monga gawo la njira yolerera pakamwa, phenytoin, nicotinic acid, sympathomimetics, calcium antagonists, isoniazid ndi mankhwala ena omwe amachititsa hyperglycemia, amachepetsa kwambiri ntchito yeniyeni (zotheka kuwonongeka kwa matenda a shuga mellitus), sulfonylureas, insulin, metformin - kuwonjezera hypoglycemic.

Chenjezo la mankhwala Acarbose

M'pofunika kutsatira mosamalitsa zakudya. Tiyenera kukumbukira kuti zakudya ndi zakumwa zomwe zimakhala ndi chakudya chochuluka, shuga ya nzimbe imatha kubweretsa m'matumbo. Kuchiza kuyenera kuchitika motsogozedwa ndi kuchuluka kwa shuga m'magazi ndi / kapena mkodzo, glycosylated hemoglobin ndi transaminases mchaka choyamba cha chithandizo - 1 nthawi m'miyezi itatu kenako. Kuchulukitsa kwa mankhwalawa kupitirira 300 mg / tsiku kumayendetsedwa ndi kupitirira, koma kutchulidwa pang'ono kuchepa kwa hypprlycemia ya postprandial ndi kuwonjezeka kwamtunduwu pachiwopsezo cha hyperfermentemia (kuchuluka kwa AST ndi ALT m'magazi). Pogwiritsa ntchito munthawi yomweyo sulfonylurea kapena insulin, mutha kupanga hypoglycemia, yomwe imakonzedwa ndikuwonjezera shuga (glucose, koma osayenerana) ndi chakudya, kapena kuyambitsa shuga, kapena kugwiritsa ntchito glucagon (woopsa). Pakakhala matenda oopsa a hypoglycemia, ziyenera kukumbukiridwa kuti shuga ya chakudya imang'ambika pang'onopang'ono mu fructose ndi glucose panthawi yamankhwala ndipo siyabwino pakuchotsa hypoglycemia mwachangu, munthawi zonsezi ndikofunika kugwiritsa ntchito shuga mu waukulu.

Mlingo

50 mg ndi mapiritsi a 100 mg

Piritsi limodzi lili

yogwira mankhwala - acarbose 50 kapena 100 mg,

zotuluka: colloidal anhydrous silicon dioxide, magnesium stearate, chimanga wowuma, cellcrystalline cellulose.

Mapiritsi kuyambira oyera mpaka oyera okhala ndi chikaso chachikasu, mozungulira mawonekedwe, olembedwa "G 50" mbali imodzi ndikusainira Bayer mtanda mbali ina (pamtengo wa 50 mg).

Mapiritsi kuyambira oyera mpaka oyera okhala ndi chikasu chachikasu, chowumbika, wokhala ndi chizindikiro ndikulemba "G 100" mbali imodzi ndikulemba mbali inayo (kwa mulingo wa 100 mg).

Mankhwala

Pharmacokinetics ya acarbose anaphunziridwa pambuyo pakamwa makonzedwe a radioactive olembedwa chinthu (200 mg).

Popeza pafupifupi 35% ya ma radioactivity athunthu (kuchuluka kwathunthu kwa zinthu ndi ma metabolites) amachotsedwa impso kwa maola 96, ndiye kuti mwina mayeso a mayamwidwewo ali mkati mwa malire awa.

Kuzungulira kwa plasma kwathunthu kumadziwika ndi nsonga ziwiri. Peak yoyamba, yofanana ndi kuchuluka kwa ma acarbose a 52.2 + 15.7 μg / L, imawonedwa pambuyo pa maola a 1.1 + 0,3. Mtengo wachiwiri umakhala pakati pa 586.3 + 282.7 μg / L ndipo umawonedwa pambuyo pa maola 20.7 + 5.2. Mosiyana ndi ma radioacase ambiri, kuchuluka kwa zoletsa zinthu m'magazi a plasma ndi 10-20 nthawi yotsika. Kuwonekera kwa nsonga yachiwiri pambuyo pa maola 14 mpaka 24 ndikuwoneka kuti ndikuchitika chifukwa cha kuyamwa kwa zinthu zomwe zimawola bakiteriya kuchokera m'malo akuya amkati mwanga.

The bioavailability ya mankhwalawa ndi 1-2% yokha. Kuchuluka koperewera kwambiri kwa kupezeka kwadongosolo ndikofunikira chifukwa ma acarbose amangogwira matumbo okha. Chifukwa chake, kuchepa kwachilengedwe kwa mankhwalawa sikukhudza zochizira.

Voliyumu yomwe ikuwoneka ndi 0,32 l / kg kulemera kwa thupi.

Kuthetsa theka la moyo wogawika ndikugawa magawo ndi ma 3.7 + 2.7 maola ndi 9.6 + maola 4.4, motere, 51% yazinthu zomwe zimagwira ntchito zimatulutsidwa m'matumbo mkati mwa maola 96, 1.7% yosasinthika komanso yogwira ntchito metabolite - kudzera impso.

The yogwira pophika mankhwala Glucobay ® - acarbose ndi pseudotetrasaccharide wa tizilombo tating'onoting'ono. Glucobay ® ikhoza kugwiritsidwa ntchito pochiza matenda a shuga omwe amadalira insulin komanso insulin.

Acarbose amachita pamlingo wamatumbo, kulepheretsa ntchito ya michere yaying'ono yamatumbo (alpha-glucosidase), yomwe ikuphatikizidwa ndi kuphwanya kwa di-, oligo- ndi polysaccharides. Zotsatira zake, kuchepa kwa dokotala kumayimbira chakudya, kumatsatiridwa ndikuthamangitsidwa ndikumayamwa kwa glucose, komwe kumapangika pakuwonongeka kwa chakudya. Chifukwa chake, acarbose imachedwa ndikuchepetsa kuchuluka kwa gluprose m'magazi. Chifukwa champhamvu chamafuta am'matumbo kuchokera m'matumbo, kuchuluka kwa glucose komanso kusinthasintha kwake kwa tsiku ndi tsiku m'magazi kumachepetsedwa. Pankhani yakuwonjezeka kwa ndende ya glycosylated hemoglobin, acarbose imachepetsa mulingo wake.

M'mayeso osankhidwa mwadzidzidzi, zidapezeka kuti odwala omwe ali ndi vuto loleza shuga, kuwongolera pafupipafupi kwa Glucobaya® kumachepetsa chiopsezo chokhala ndi matenda a shuga a 2. Kuphatikiza apo, zidapezeka kuti panthawi imodzimodziyo amachepetsa kwambiri zochitika zamtima wamtima komanso kulowerera kwamkati.

Kugwiritsa ntchito Glucobaya® kwa matenda a shuga a 2 kumachepetsa chiopsezo chokhala ndi matenda amtima komanso kulowerera kwam'kati.

Zizindikiro zogwiritsidwa ntchito

- chithandizo cha matenda a shuga kuwonjezera pa mankhwala othandizira

- kupewa matenda ashuga amtundu wa 2 odwala omwe ali ndi vuto loleza shuga * kuphatikiza zakudya ndi masewera olimbitsa thupi

* amatanthauzidwa kuti plasma glucose concentration 2 patatha kuchuluka kwa glucose 7.8-11 mmol / l (140-200 mg / dl) komanso kusala kwa glucose okwanira 5.6 - 7.0 mmol / l (100-125 mg / dl )

Mlingo ndi makonzedwe

Mlingo wa mankhwalawa umasankhidwa ndi dokotala aliyense payekhapayekha kwa wodwala aliyense, popeza momwe zimagwirira ntchito komanso kulolerana kwake zimasiyana.

Mapiritsi a Glucobaya ® amagwira ntchito pokhapokha atamwa nthawi yomweyo musanadye chakudya chonse, osafuna kutafuna, ndimadzimadzi ochepa, kapena kutafuna ndi gawo loyamba la chakudya.

Chithandizo cha matenda a shuga kuwonjezera pa zakudya

Pokhapokha atafotokozeredwa mwanjira ina, Mlingo wotsatirawu ukulimbikitsidwa:

Mlingo woyamba ndi piritsi limodzi la 50 mg katatu pa tsiku ndi chakudya chachikulu chilichonse kapena piritsi la 100 mg katatu pa tsiku ndi chakudya chachikulu chilichonse. M'tsogolo, mlingo uyenera kuwonjezeka pafupifupi tsiku lililonse la 300 mg patsiku (mapiritsi 2 a 50 mg katatu pa tsiku ndi chakudya chachikulu chilichonse kapena piritsi 1 la 100 mg katatu pa tsiku ndi chakudya chachikulu chilichonse).

Nthawi zina, ngati pakufunika, mlingo wa mankhwalawa utha kuwonjezeka mpaka 200 mg katatu pa tsiku ndi chakudya chachikulu chilichonse.

Mlingo utha kuchulukitsidwa pambuyo pa masabata a 4-8 ngati njira yofunikira ya kuchipatala singalandire mwa odwala omwe adalandira mlingo woyamba.

Ngati wodwalayo, ngakhale akutsatira kwambiri zakudya, kusungunuka ndi matenda otsekula m'mimba, ndiye kuti kuchuluka kwa mankhwalawa kuyenera kuyimitsidwa, ndipo nthawi zina, kuchepetsa mlingo.

Wapakati tsiku lililonse mankhwala ndi 300 mg patsiku.

Kupewa kwa matenda a shuga a 2 odwala omwe ali ndi vuto la glucose osagwirizana ndi zakudya komanso masewera olimbitsa thupi

Mlingo woyambirira ndi 50 mg kamodzi patsiku (mapiritsi a 50 mg kapena mapiritsi a ½ 100 mg kamodzi patsiku). Pakupita kwa miyezi itatu, mlingo woyambayo umakulitsidwa pang'onopang'ono mpaka mu njira yovomerezeka ya 100 mg katatu pa tsiku (mapiritsi awiri a 50 mg kapena piritsi 1 la 100 mg katatu patsiku ndikudya kwakukulu).

Kusintha kwa muyezo kapena mtundu wa mankhwala sikufunikira.

Odwala omwe ali ndi vuto la chiwindi

Odwala omwe ali ndi vuto la chiwindi, kusintha kwa mankhwalawa sikofunikira.

Palibe zoletsa paliponse pakutenga Glucobay®.

Idyani ndi kuchepetsa thupi

Ili ndiye vuto lalikulu. Malangizo osavuta monga kuchepetsa mafuta ndi kuwonjezera kuchuluka kwa masamba, nsomba yophika ndi chakudya chonse sizimagwirizana ndi anthu. Monga lamulo, munthu amafuna kudya zomwe zimabweretsa zosangalatsa kwambiri, zosasangalatsa za masamba. Ndipo osati kuwonjezera kulemera, komanso kuchotsa zomwe anapeza. Tsoka ilo, palibe zozizwitsa padziko lapansi. Ngati mungagwiritse ntchito zopatsa mphamvu zambiri kuposa zomwe mumawononga, zidzayikidwa pambali.

Koma lamuloli sadziwika kwa aliyense. Kupanda kutero, tingafotokozere bwanji kufalikira kwachangu kwa mitundu yambiri ya blockers yamafuta ndi chakudya? Kutsatsa kumatilonjeza kuti mutha kusangalala ndi zakudya zomwe mumakonda, mutangomwa mapiritsi. Ndipo chilichonse chakudya chimasiya thupi popanda vuto. Kodi zili choncho - tiyeni tiziwerengere limodzi.

Njira zonse ndi zabwino

Ndizosavuta kuzindikira izi, ndikokwanira kulingalira pamsika wamapiritsi amakono kuti muchepetse kunenepa. Pakati pawo pali mankhwala osokoneza bongo ngakhale mankhwala ophera tizilombo, mankhwala a mahomoni. Posachedwa, mankhwala omwe amathandizidwa odwala omwe ali ndi matenda ashuga ayamba kutchuka. Amagwiritsidwa ntchito pakuchepetsa "Acarbose". Ndemanga za iwo omwe adayesa mankhwalawa ndiosiyana kwambiri ndi zina, zina ndizabwino. Ayi, anthu adachepa kwenikweni, koma zotsatirapo zake zinali zopanda pake kotero kuti zotsatirapo zake sizinali zokondweretsa. Kuti aliyense akhale ndi mwayi woganiza za zotsatila zake, lero tilingalira za mawonekedwe a mankhwalawa, cholinga chake komanso momwe thupi limagwirira ntchito.

Osati panacea

Mdani woopsa kwambiri wa munthu wokongola ndi maswiti. Ndikovuta kwambiri kukana bala kapena makeke, mkate kapena mchere. Zotsatira zake, thupi limalandira chakudya chambiri. Zachidziwikire, simungathe kuwononga, pokhapokha mutagwira ntchito yomanga.

Ichi ndichifukwa chake chidwi cha azimayi chimakopeka ndi mankhwala omwe amatha kutsekereza mafuta osavuta, chifukwa amatha kugwiritsidwa ntchito pakuchepetsa thupi. Pali ndemanga zosiyana kwambiri za "Acarbose", koma muyenera kukumbukira nthawi zonse kuti mankhwalawa adapangidwa kuti apereke chithandizo chofunikira kwa odwala matenda ashuga. Kuchepetsa thupi ndi mbali yake.

Zogwira ntchito

Popanda mankhwala a dokotala, ndizosatheka kugula. Inde, sizokayikitsa kuti mudzatha kutsimikizira endocrinologist kuti mumamufuna kuti akonze zolakwika za thupi. Ichi ndi mankhwala, kugwiritsa ntchito kwake kuyenera kukhala koyenera. Kuphatikiza apo, pogwiritsidwa ntchito molumikizana "Acarbose" ndi mankhwala ena, zotsatira zoyipa zimatha kukula.

Zomwe zimagwiritsidwa ntchito ndi acarbose, blocker wa alpha-glucosidase, puloteni ya kapamba. Imaphwanya shuga wovuta ku glucose ndi fructose. Tiyeni tiime apa pang'ono, chifukwa ndikofunikira kumvetsetsa momwe mankhwalawa amagwirira ntchito komanso chifukwa chomwe "Acarbose" amathandizira kuchepetsa thupi. Makina a madokotala alibe chiyembekezo chambiri, samangolimbikitsa kuyesa zaumoyo wawo.

Chifukwa chake, alpha glucosidase inhibitor imalepheretsa chimbudzi ndi kulowetsedwa kwa chakudya cham'mimba. Chifukwa chake, kuwonjezeka kwa shuga m'magazi kumachepetsedwa pambuyo podya zakudya zopatsa mphamvu. Zotsatira zake, thupi lanu limalandira zopatsa mphamvu zochepa, zomwe zimakonza kuchepa pang'onopang'ono.

Kwa dzino lokhazikika

Ndi gulu ili la anthu omwe nthawi zambiri amayesera zotsatira za mankhwalawa pakokha. Mulimonsemo, izi zimatsimikiziridwa ndikuwunika. "Acarbose" yochepetsa thupi imawoneka kuti ndiyabwino. Tsopano simungathe kuwerengera mosamala carb. Sangalalani ndi chakudya chomwe mumakonda osawopa kupeza masentimita owonjezera m'chiuno ndi m'chiuno.

Nthawi yomweyo, anthu ambiri adzakhala ndi funso: kodi thupi lingachite bwanji popanda chakudya? Ngakhale munthu wathanzi, izi zimakhala ndi mavuto akulu, ndipo ngati timalankhula za odwala omwe ali ndi matenda osokoneza bongo, amathanso kugwa chifukwa cha njala. Wopanga akuti zotsatira za hypoglycemic za mankhwalawo ndizochepa. Ndiye kuti, sangathe kutsitsa shuga wamagazi pansi pazovuta.

Zoyambirira

Tsopano tiyeni tiwone momwe chida ichi chimagwirira ntchito. Zothandiza zake ndi izi:

Mankhwala pafupifupi amalepheretsa mayamwidwe obwera, kupatula ochepa awo. Zotsatira zake, kulemera kumayamba kugwa mwachangu. Zili ngati kuti mwapereka shuga, buledi, masikono ndi makeke.
Njirayi siyikhudzanso minofu, chifukwa mapuloteni olowa m'thupi amalowetsedwa popanda mavuto.
Mankhwalawa amachepetsa kudya, motero njira yochepetsera thupi imakhala yosavuta.

Tiyenera kudziwa kuti osati "Acarbose" okha, komanso mankhwala ena a hypoglycemic omwe ali ndi vuto limodzi. Ndi odwala matenda ashuga, odwala amachepetsa kudya maswiti, makeke ndi mkate, motero palibe mavuto pakumwa mankhwala. Koma munthu wamba sadziwa malamulo awa ndipo amapitilirabe chakudya cham'mawa ndi tiyi wokoma ndi mkaka, mpukutu kapena makeke. Kodi chimachitika nchiyani? M'matumbo mumakhala michere yambiri, palibe chomwe chingawasokoneze, kuwoneka mwachangu, kuwawa komanso kulimbikitsa kuchimbudzi. Simukufuna kumva zotere? Pewani magwero azakudya zomanga thupi, kupatula mbewu yambewu yonse palokha. Ndiye mankhwala a hypoglycemic safunika. Zotsatira zake zimadza zokha.

Izi ndi malingaliro a madotolo ambiri, akatswiri a zaumoyo komanso ma endocrinologists. Palibe chifukwa chomwa mankhwala omwe mwachidziwikire amapangidwira zina. Koma zoona, azimayi ndi okhazikika. Ndipo ngati mungasankhe kugwiritsa ntchito "Acarbose" / fanizo la mankhwalawa, sangasiye. Kukongola kumafuna kudzipereka. Koma kodi okhudzidwa ndi mawu ngati amenewa? Muyenera kulingalira zotsatira za izi.

Zomwe muyenera kudziwa

Nthawi zambiri, wodwalayo safunika kuti aphunzire mawonekedwe a mankhwalawa ndikusankha Mlingo, ngati dokotala atapereka lingaliro ndikutsimikizira njira. Koma ngati mungaganize zotenga nokha, onetsetsani kuti mwawerengera malangizo kuti agwiritse ntchito. "Acarbose" amagwiritsidwa ntchito ngati matenda a shuga a 2 komanso osagwiritsa ntchito bwino mankhwala. Komanso, nthawi yomaliza iyenera kukhala miyezi isanu ndi umodzi. Wothandizanso amamulembera ngati gawo la zovuta za matenda a shuga 1.

Zotsatira zoyipa

Uwu ndiwowawa, chifukwa mndandanda wazotsatira "zoyipa" ndizotsatsa chidwi. Koma aspirin wodziwika bwino sangatchedwa wotetezeka kwathunthu. Zotsatira zotsatirazi zalembedwa mu malangizo:

Vuto la mtima
Thupi lawo siligwirizana.
Mavuto m'mimba. Uku ndikubala, kutsekula m'mimba, mseru.
Kugwirizana kwa chiwindi. Izi zitha kukhala zopatuka zazing'ono zomwe sizikukukhudzani thanzi. Koma ndizothekanso kukula kwa jaundice.

Kukhala kofunikira kudzidziwitsa nokha ndi malingaliro omwera mankhwalawo. "Acarbose" yochepetsa thupi imagwiritsidwa ntchito, ngakhale machenjezo onse azakudya. M'malo mwake, pali anthu ambiri omwe sanakumanepo ndi zovuta zilizonse ndipo amakhutira ndi zotsatira za mankhwalawo. Ndemanga zina zimatcha kuti ndizokhulupirika kwathupi kuposa Xenical, zomwe zimapangitsanso zomverera zopweteka, makamaka, ngati munthu amakonda zakudya zamafuta.

Zochitika zenizeni

Pafupipafupi, motere potsatira maupangiri, zovuta zina zimachitika ndimatumbo. Koma pali anthu ena osati ochepa mwamanyazi omwe asankha kuyesa mphamvu ya zozizwitsa pawokha. Pa mtengo "Acarbose" ulipo, ichi ndi chifukwa chowonjezeranso mankhwalawa. Zotsatira zake, kwa kuchepa thupi china chilichonse ndichabwino kwambiri kotero kuti amatenga kwa miyezi ingapo motsatana, nthawi imodzimodzi amasangalala ndi maswiti ndikutaya ma kilogalamu ochepa. Tsoka ilo, si aliyense amene ali ndi mwayi.

Kumbukirani kuti ndi mayeso enieni a litmus, omwe amawonetsa kumwa kwambiri kwa chakudya chamafuta. Koma zilidi choncho, ndipo m'masiku akudza anthu akhulupirira izi. Ngati zakudya zili ndi zoperewera, ndiye kuti palibe vuto.

Kupatula komweko kumatha kuganiziridwa ngati kutsegula m'mimba kapena nseru m'masiku atatu atayamba kumwa mankhwalawa. Koma ndikofunikira kuwonjezera kuchuluka kwa zotsekemera, "nkhondo" ikayamba m'mimba. Zovuta, kuweruza ndi kuwunika kwa omwe ali ndi vutoli, ndizosasangalatsa: kudwala, kupindika, kudula, mabingu ndi mkwiyo.

Kutuluka

Tasanthula kale kachitidwe ka Acarbose. Zakudya zomanga thupi zimadziunjikira m'matumbo, chifukwa sizingagawanikidwe ndikuyamwa. Pamenepo amayendayenda, zomwe zimabweretsa zotsatirapo zake. Chifukwa chake, titha kunena kuti mankhwalawa alinso ndi ntchito yophunzitsa. Zimakuphunzitsani kudya maswiti kunyumba kokha komanso kumapeto kwa sabata. Izi pazokha ndizabwino. Ndipo ngati ayamba "kulimba", ndiye kuti timachotsa mafuta onse, kuphatikizapo mkate ndi chimanga, kwa maola 4-6 - ndipo zonse zimadutsa. Chifukwa chake anthu amalemba m'mawu awo. Koma kodi kuli koyenera kuchepetsa thupi mwanjira imeneyi? Kusokonezeka m'thupi nthawi zina kumatha kusinthika.

Limagwirira ntchito ndi malangizo ntchito Acarbose Glucobay

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Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Chifukwa cha kuchepa kwakukulu kwa timadzi ta insulin, matenda oopsa a endocrine amakula mthupi - matenda a shuga.

Kuchita bwino kwa anthu omwe ali ndi matenda amtunduwu amathandizidwa ndi mankhwala a hypoglycemic omwe amawongolera kuchuluka kwa shuga. Acarbose ndi mankhwala othandizira odwala matenda ashuga.

Zisonyezero zakudikirira

Mankhwala ndi mankhwala endocrinologist ngati pali zotsatirazi matenda:

lembani matenda ashuga 2
kuchuluka kwa magazi ndi minyewa ya lactic acid (lactic diabetesic chikomokere).

Kuphatikiza apo, kuphatikiza ndi chakudya chamagulu, chakudya chimawonetsedwa ngati mtundu 1 wa shuga.

Kugwiritsa ntchito mankhwalawa ndikosavomerezeka ngati wodwalayo apeza zotsatirazi:

tsankho lako,
zovuta za matenda ashuga (diabetesic ketoacidosis kapena DKA),
Kusintha kwamphamvu kwa chiwindi (cirrhosis),
chimbudzi chovuta komanso chopweteka (dyspepsia) chachilengedwe chovuta,
kusintha kwa mtima kwamphamvu kwa mtima kumene kumachitika mutatha kudya (a Remkheld's syndrome),
nthawi ya bere ndi kuyamwitsa,
kuchuluka kwa mpweya m'matumbo,
matenda otupa a mucous nembanemba (colcerative colitis),
kutuluka kwamimba ziwalo zam'mimba pansi pa khungu.

Kapangidwe ndi kapangidwe ka zochita

Acarbose (dzina lachi Latin loti Acarbosum) ndi chakudya chopatsa mphamvu chokhala ndi shuga wochepa wosavuta, wosungunuka mosavuta m'madzi.

Thupi limapangidwa kudzera mu kukonzanso kwamankhwala amitundu mothandizidwa ndi michere. Zophatikiza ndi Actinoplanes utahensis.

Acarbose hydrolyzes polymeric chakudya poletsa zomwe zimapangitsa chidwi cha enzyme. Chifukwa chake, mulingo wa mapangidwe ndi kuyamwa kwa shuga m'matumbo amachepetsedwa.

Izi zimathandizira kukhazikika kwamisempha yamagazi. Mankhwala samayambitsa kupanga ndi kubisalira kwa insulin ya mahomoni ndi kapamba ndipo salola kuchepa kwambiri kwa shuga m'magazi. Chithandizo chanthawi zonse chimachepetsa mwayi wokhala ndi matenda amtima komanso kupitirira kwa shuga.

Mafuta a chinthu (mayamwidwe) si oposa 35%. Kukumana kwa chinthu m'thupi kumachitika m'magawo: mayamwidwe oyamba amapezeka mkati mwa ola limodzi ndi theka, sekondale (mayamwidwe azinthu za metabolic) - pamtunda kuchokera maola 14 mpaka tsiku limodzi.

Ndi matenda a impso kuwonongeka kwa impso (aimpso kulephera), ndende ya mankhwalawa ukuwonjezeka kasanu, mwa anthu azaka 60+ - 1.5 zina.

Mankhwalawa amachotsedwa m'thupi kudzera m'matumbo ndi mkodzo. Kutalika kwa nthawi kwa njirayi kumatha kupitilira maola 10-12.

Malangizo ogwiritsira ntchito

Kugwiritsa ntchito acarbose kumafuna njira yayitali yothandizira. Mapiritsi ayenera kuledzera osachepera kotala la ola pamaso chakudya.

Mu nthawi yoyamba ya mankhwalawa, 50 mg ya mankhwala imayikidwa katatu patsiku. Palibe kuyipa kwina, mlingo ukuwonjezeka 2-4 nthawi ndi imeneyi ya miyezi 1-2.

Mlingo umodzi wambiri ndi 200 mg, tsiku lililonse - 600 mg.

Pazifukwa za prophylactic, mankhwalawa amatengedwa osachepera 50 mg kamodzi patsiku. Malinga ndi zomwe zikuwonetsa, muyezowo ungathe kuwirikiza.

Kodi Acarbose Glucobai angagwiritsidwe ntchito poonda?

Mankhwala ambiri omwe amapangidwa pamaziko a Acarbose ndi mankhwala a ku Germany Glucobay. Matenda ake a pharmacological, zikuonetsa ndi ma contraindication ogwiritsa ntchito ali ofanana ndi Acarbose. Komabe, kugwiritsa ntchito mankhwalawa sikuti kungochiza matenda a shuga.

Glyukobay ndiodziwika kwambiri pakati pa othamanga komanso anthu omwe akulimbana ndi kunenepa kwambiri. Ichi ndichifukwa chachikulu cha mankhwalawa - kuthekera kotchinga mapangidwe ndi kuyamwa kwa shuga. Zomwe zimayambitsa kulemera mopitirira muyeso, monga lamulo, ndizokwanira zamafuta. Nthawi yomweyo, mafuta am'mimba ndi gwero lalikulu la mphamvu zamthupi.

Mukamayanjana ndi ziwalo zogaya, chakudya chophweka chamthupi chimayamwa nthawi yomweyo matumbo, ma carbohydrate ovuta amapitilira gawo la kuwonongeka kukhala losavuta. Ikamamwa, thupi limayesetsa kuyamwa zinthuzo ndikazikhazika "pambali". Pofuna kupewa njirazi, iwo omwe akufuna kuchepa thupi amatenga Glucobai ngati wothandizira kutsekereza wamafuta.

Makanema pazakudya zotchingira zakudya

Zotsatira zoyipa, bongo ndi malangizo apadera

Zotsatira zosafunikira pakayendetsedwe ka mankhwala zimachitika makamaka kuchokera ku khungu ndi m'mimba thirakiti.

Izi zikuphatikiza:

chisangalalo
phokoso mokhumudwa
chimbudzi chowawa (dyspepsia),
kuvutika kolimbikitsa zomwe zili m'mimba;
kuchuluka kwa bilirubin (jaundice),
Kucha kwa khungu komwe kumachitika chifukwa cha kukulira kwa ma capillaries (erythema),
matenda apakati.

Kupitilira muyeso womwe wapatsidwa ukuwonetsedwa ndi kupweteka kwamatumbo, mapangidwe owonjezera a mpweya, kutsekula m'mimba. Mpumulo wa izi ndi chizindikiro, kuphatikiza kuphatikiza chakudya chamthupi.

Acarbose amalembedwa mosamala kwambiri kwa odwala omwe ali ndi matenda opatsirana ndi tizilombo, komanso achinyamata osakwana zaka 18.

Panthawi ya mankhwala, mankhwalawa ndi awa:

kutsatira mosamalitsa kudya
kuwunika kosalekeza kwa hemoglobin, transaminases ndi shuga (kuchuluka kwa magazi).

Mu chakudya, sucrose iyenera kusintha ndi shuga.

Mitu ya mankhwalawa

Mankhwala okhala ndi vuto lofananalo amakhala ndi acarbose monga chinthu chachikulu chogwira ntchito.

Mankhwala awiri amagwiritsidwa ntchito ngati olowa m'malo:

Glucobay50 ndi 100 mg piritsiBAYER PHARMA, AG (Germany) AluminaMapiritsi a 100 mg"Abdi Ibrahim Ilach Sanay ve Tijaret A.Sh." (Turkey)

Maganizo a odwala

Kuchokera pakuwunika kwa wodwala, titha kunena kuti Acarbose imagwira bwino ntchito popanga shuga m'magazi ochepa, koma kayendetsedwe kake nthawi zambiri kumayendetsedwa ndi zotsatirapo zoyipa, chifukwa chake kugwiritsidwa ntchito ndikosathandiza kuchepetsa thupi.

Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Mankhwalawa adaperekedwa monga adauzidwa ndi adokotala ndipo mosamalitsa malinga ndi malangizo. Kuphatikiza apo, ndimatenga 4 mg ya NovoNorm nthawi ya nkhomaliro. Mothandizidwa ndi mankhwala awiri, ndizotheka kusunga shuga wabwinobwino masana. Acarbose "ozimitsa" momwe zimapangira chakudya chamaofesi, ndizowonetsa zanga maola awiri nditatha kudya ndi 6.5-7,5 mmol / L. M'mbuyomu, zosakwana 9-10 mmol / L sizinali. Mankhwalawa amagwiradi ntchito.

Ndili ndi matenda ashuga a 2. Dotolo adalimbikitsa Glucobai. Mapiritsi samalola kuti shuga azilowetsedwa m'matumbo am'mimba, ndiye, kuchuluka kwa shuga "sikumalumpha". M'malo mwanga, mankhwalawa amasintha shuga kuti akhale ochepa shuga.

Ndidayesa Glucobai ngati njira yochepetsera kunenepa. Zotsatira zoyipa. Matendawa pafupipafupi, komanso kufooka. Ngati simukudwala matenda ashuga, iwalani za mankhwalawa ndikuchepetsa thupi mothandizidwa ndi zakudya komanso zolimbitsa thupi.

Mankhwala ndi mankhwala. Mtengo wa mapiritsi a Glucobai ndi pafupifupi ma ruble 560 pazinthu 30, ndi mulingo wa 100 mg.

Mankhwala Atsopano a shuga a Mtundu Watsopano

Wodwala yemwe amalembera chithandizo cha matenda a shuga 2, mankhwalawa amasankhidwa mu njira yophatikizira. Zakudya zawo nthawi zambiri sizimatha pamoyo wonse. Zowona, chakudya choyambirira chimapangidwa. Ndipo pokhapokha ngati pakufunika thandizo, ndi mankhwala omwe amapezeka ndi mankhwala. Izi zitha kufotokozedwa ndikuti chifukwa cha zakudya, glucose akhoza kukhala bwinobwino. Chifukwa chake palibe chifukwa chokonzekera insulin. Zimawonekera pomwe matenda akayamba kukula.

Zolemba pakugwiritsira ntchito mankhwala

Matendawa amadziwika ndi kukula pang'onopang'ono. Poyamba, zizindikiro zake zimafotokozedwa mofooka. Chifukwa chake, mwatsoka, ambiri amatembenukira kwa madokotala pakabuka mavuto. Ngati matendawa anyalanyazidwa kwa nthawi yayitali, kuwonongeka kwake kungachitike mwachangu.

Chikhazikitso cha chithandizo cha matenda a shuga ndikugwiritsa ntchito mankhwala. Mankhwala a shuga amabwera m'magulu angapo.

Chithandizo chake chiyenera:

Imathandizira kupanga insulin.
Kuchulukitsa kumverera kwa minofu ku mahomoni.
Kuletsa kuyamwa kwa shuga ndikuchepetsa gluconeogeneis, ndiko kuti, kaphatikizidwe.
Olondola tizigawo ta lipid.

Mwachidule, mothandizidwa ndi mankhwalawa amayenera kukhazikitsa njira yayitali yogwiritsira ntchito kagayidwe kachakudya ndi kupewa zovuta.

Gulu lalikulu la mankhwala amtundu wa matenda ashuga a 2 ndi:

Mankhwala, chifukwa chake, kapamba amapanga insulin yabwino. Tikulankhula za kukonzekera kwa sulfonylurea komwe kumakhala kofanana ndi kapangidwe kake ka mankhwala ndipo kamasiyana m'mibadwo. Posachedwa, mankhwala atsopano, Novonorm ndi Starlix, nawonso adawonekeranso.
Biguanides, cholinga chake ndikuwonjezera chiwopsezo cha ma cell mahomoni. Awiri odziwika kwambiri amachokera ku metformin (Siofor, Glucofage). Amawalembera anthu onenepa kwambiri, chifukwa amathandizira kuti achepetse kuchepa kwake.
Alfa glucosidase zoletsa. Muchepetse mayamwidwe a glucose. Nthawi zambiri amagwiritsa ntchito mankhwala "Glucobay."
Othandizira (ogwiritsa ntchito). Chifukwa cha iwo, kuyankha kwa minofu ku mahomoni kumachuluka. Kuwonetsedwa kwa ma cell receptors nthawi zambiri kumachitika pogwiritsa ntchito Actos.

Pagulu lina pali mankhwala omwe amaletsa matenda ashuga a 2. Amafuna, pakakhala zovuta za mtima. Kupanikizika kwa magazi nthawi zambiri kumayendetsedwa ndi thiazide diuretics, komanso calcium channel blockers (calcium antagonists).

Mapiritsi olimbitsa insulin

Pakati pa mankhwalawa, thiazolidinediones ndi biguanides ziyenera kusiyanitsidwa. Gulu lililonse lili ndi zopindulitsa zake.

Mankhwala 2 a shuga, monga thiazolidinediones, amagwiritsidwa ntchito:

muchepetse ngozi yowonjezera mavuto obwera ndi mitsempha yamagazi,
kukhazikika kwa shuga,
maselo otulutsa khunyu
njira zopewera komanso zochizira.

Tsoka ilo, amakhalanso ndi zolakwika.

Mankhwala a Thiazolidatedione angayambitse:

mawonekedwe amapaundi owonjezera,
Kutupa kwa m'munsi,
matenda a mafupa.

Kuti mukwaniritse zotsatira zambiri kapena zochepa, ndalama ziyenera kutengedwa kwa nthawi yayitali. Kuphatikiza apo, pali zoletsa kugwiritsa ntchito kwawo.

Mndandanda wa odwala omwe saloledwa ku mankhwalawa amaphatikizapo azimayi oyembekezera komanso oyembekezera, komanso anthu omwe akuvutika ndi:

matenda osatha a chiwindi,
kulephera kwa mtima
matenda a mtima.

Simungathe kuphatikiza insulin ndi thiazolidinediones nthawi imodzi.

Njira yabwino yothandizirana imawonedwanso pogwiritsa ntchito Biguanides.

pali kusintha kwamankhwala, pomwe kuchuluka kwa cholesterol kumachepa,
hypoglycemia mbisoweka,
chiopsezo cha matenda a mtima mwa odwala omwe ali ndi kunenepa kwambiri amachepetsedwa.

Biguanides samayambitsa kunenepa. Ngakhale, akamagwiritsa ntchito, wodwalayo amatha kudandaula kuti samva bwino m'mimba.

kulephera kwa chiwindi
uchidakwa
kubala mwana.

Madokotala amakonda kugwiritsa ntchito mankhwalawa kutsatira mankhwalawa: Siofor, Glyukofazh, Metfogamm.

Hormone kaphatikizidwe kamene kamalimbikitsa mankhwala

Ntchito ya pancreatic imayendetsedwa mothandizidwa ndi sulfonylurea zotumphukira ndi meglitinides. Njira yoyamba ndi mankhwala, omwe amakhudzidwa nthawi yomweyo. Chifukwa cha iwo, zovuta zam'mimba zimachitika kawirikawiri. Nthawi zambiri zotchulidwa ndi "Diabeteson MV", "Maninil." Nthawi zina, kugwiritsa ntchito mankhwala a sulfonylurea ndi koletsedwa.

odwala ndi aimpso kulephera kapena ketoacidosis,
woyembekezera
azimayi oyamwitsa.

Ngakhale mankhwalawa amapereka zotsatira zake mwachangu, ndizotheka:

achina,
kukula kwa kukana
onenepa kwambiri.

Ponena za meglitinides, amatha kugwiritsidwa ntchito kuti shuga azikhala pamlingo woyenera. Amathandizanso mwachangu. Nthawi zambiri, NovoNorm ndi Starlix amasankhidwa.

Zoyipa ndizopezekanso. Choyamba, kulemera kwa thupi kumatha kuchuluka. Kachiwiri, sizinatsimikizidwebe kuti ngati ntchito yayitali, mphamvu ya meglitinides imakhalabe.

Mankhwala onse omwe ali pamwambawa angayambitse matenda a mtima, stroko komanso glycemic. Chifukwa chake, m'zaka zaposachedwa, madokotala ambiri amakana ndalamazi, m'malo mwake ndimankhwala atsopano.

Siofor ndi Glyukofazh

Kwa odwala matenda ashuga, mankhwalawa amatengera metformin. Ngati matenda a shuga a mtundu wachiwiri achitika kumayambiriro, ngati zakudya zomwe wodwalayo ali nazo zimakhala zochepa, ndipo akamamwa metformin pafupipafupi, ndiye kuti mankhwala ena owonjezera ndi jakisoni a mahomoni sangafunike.

"Siofor" sikuwonetsedwa kwa odwala matenda ashuga okha, komanso kwa aliyense yemwe ali ndi vuto la systolic ndi diastolic. Mapiritsi amathandizira kusintha mayendedwe achikazi ndikubwezeretsa ntchito yobereka.

Odwala pambuyo pa 65, komanso omwe akukumana ndi zolimbitsa thupi kwambiri tsiku ndi tsiku, ayenera kupatsidwa Siofor mosamala (lactic acidosis, yomwe imayendera limodzi ndi kuwonjezeka kwa acidity, sikuthiridwa).

Kupititsa patsogolo zochita za Siofor, endocrinologists amalimbikitsa mankhwala atsopano - glucagon-like peptide-1 receptor agonists (GLP-1) ndi dipeptyl peptidase-4 (DPP-4) zoletsa.

Poyambirira, ndi mankhwala omwe amakhala ndi mahomoni omwe amachepetsa chilakolako chofuna kudya ndikuthandizira kupanga insulin. Amapezeka mu cholembera. Jekeseni ayenera kuchita ola limodzi asanadye. Njira imodzi ndi yokwanira patsiku.

Njira yachiwiri ndi mtundu wamankhwala omwe ali ndi enzyme yomwe imawonongeka pa GLP-1. Mlingo womwe umalimbikitsa ndi piritsi limodzi tsiku lonse.

Makhalidwe abwino a "Glucophage":

Kuchepetsa kwamphamvu zamafuta m'mimba.
Kutsitsa kupanga shuga ndi chiwindi.
Kuchuluka kwa insulin.
Kupititsa patsogolo njira yogwiritsira ntchito shuga maselo.

Ochepa ochepa odwala omwe atenga metformin, kuwonetsa koyipa ndikotheka mwa:

nseru
kulawa kwazitsulo pamkamwa,

kusanza,
matumbo colic
kuchuluka kwambiri kwa mpweya m'matumbo,
kutsegula m'mimba.

Popewa izi, mankhwala omwe akhala akuchita kwa nthawi yayitali amapangidwira mtundu wachiwiri wa matenda osokoneza bongo, omwe samayambitsa mavuto. Ndi za Kutalika Kwakukulu.

Makapisozi amatengedwa kamodzi patsiku. Zotsatira zake, metformin imaperekedwa pang'onopang'ono komanso mosalekeza. Palibe kuchuluka kwa spasmodic koyamba mu kuphatikizika kwa zinthu.

Ziyenera kunenedwa padera pazochitika zomwe Siofor ndi Glucophage zimatsutsana.

Kupewa chithandizo ndi othandizawa ndikofunikira:

Kulephera kwamkati komanso hepatic.
Hypoxia ya mtima dongosolo kapena kupuma.
Matenda a mtima, angina pectoris, mtima arrhythmias.
Mavuto ndi kufalikira kwa ziwalo.
Wopsinjika ndi wopsinjika.
Matenda owopsa.

Kuvulala.
Kusowa kwazitsulo ndi folic acid.
Mowa.
Mimba

Munthawi ya ntchito, mankhwalawa amaletsedwanso.

Ndalama zophatikizika

Nthawi zambiri, kwa matenda a 2 a shuga, chithandizo chimaperekedwa ndi mankhwala amodzi. Koma pomwe mankhwalawa sanabweretse zotsatira zomwe zimafunikira, ndikofunikira kuwonjezera mankhwala ena. Nthawi zambiri, mankhwalawa amasankhidwa sangathe kuthetsa mavuto onse omwe amakhalapo. Chifukwa chake, imasinthidwa ndi wophatikiza.

Mutha kuchiza ndi mankhwalawa popanda chiopsezo cha mavuto. Nthawi zambiri, madokotala amapanga mitundu yosiyanasiyana ya thiazolidinediones ndi metformin, komanso zotumphukira za sulfonylurea ndi metformin yomweyo.

Mankhwala osokoneza bongo ophatikizidwa a shuga amapangidwa kuti aletse kupititsa patsogolo kwa hyperinsulinemia. Zotsatira zake, kufunika kwa mankhwala a insulin kumatha.

Njira yodziwika bwino ndi Glibomet. Ndizoyenera ngati mankhwalawo sanakhale othandiza.

Komabe, Glibomet iyenera kutayidwa ngati pali:

mavuto ndi ntchito kwa chiwindi,
kulephera kwa aimpso.

Mankhwala ena amasankhidwa kwa amayi oyembekezera komanso oyembekezera.

"Glibomet" nthawi zina imayambitsa zovuta mu mawonekedwe a:

matenda amkuwa
nseru
chizungulire
zotupa pakhungu ndi kuyabwa.

Mankhwalawa amayenera kumwedwa mosamalitsa monga wotsogolera.

Mankhwala Osokoneza bongo Omwe Amakonda

Ngati wodwala amafuna chithandizo cha matenda a shuga a mtundu wachiwiri, amalandiridwa. Pali mndandanda wapadera womwe umandandalika mankhwala onse okondera omwe amaperekedwa kwa odwala mwezi uliwonse pangozi.

Anthu odwala matenda ashuga amayembekeza kulandira:

mankhwala ena - Acarbose, Glycvidon, Glibenclamide, Glucofage, Metformin, Gliclazide, Glimepiride, Rosiglitazone, Repaglinide,
mayankho a insulin,
"Isofan-insulin" mu mawonekedwe a kuyimitsidwa,
100 g mowa wa ethyl,
insulini ndi singano.

Wodwala akafuna mahomoni, amapatsidwa glucometer, komanso zinthu zina zothandizira, kuti azichita mayeso atatu patsiku. Ndalama zimaperekedwa pamtengo wotsika. Ngati pakufunika insulin, ndiye kuti mungathe kupezerapo mwayi pamizere yoyeserera. Mutha kuyika Mzere umodzi patsiku. Ngati pali zovuta ndi masomphenya, odwala amaperekedwa kwaulere ndi ma glucometer, komanso zida zomwe zimaloleza kusanthula kamodzi patsiku.

Ngati mumatsatira mosamalitsa malangizo a zamankhwala mosamala, gwiritsani ntchito mankhwala omwe mumalandira, kutsatira zakudya, chotsani zopweteketsa mumenyu, zinthu zidzakuyenderani bwino kwambiri ndipo matenda a shuga a 2 adzayang'aniridwa. Zaumoyo zimatsimikizira kukhala ndi moyo wathunthu popanda zovuta zowopsa. Kuti muchite izi, muyenera kupewa kuti pasakhale shuga.