Pioglitazone - mankhwala a 2 odwala matenda ashuga

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

Mankhwala a Antidiabetesic (hypoglycemic) ndi mankhwala omwe amamwa ndi anthu onse omwe akudwala matenda ashuga. Amathandizira thupi kukhalabe ndi shuga wofunikira m'magazi, amawayika kutengera mtundu wa shuga ndipo, mosiyanasiyana, m'badwo, nthawi ya zochita, ndi zina zambiri.

• Zolemba za mankhwala antidiabetes
• Gulu la othandizira odwala matenda ashuga
• Othandizira odwala matenda ashuga odwala matenda a shuga 1
• Mankhwala ochepetsa shuga a mtundu 2 shuga
• Mankhwala opatsirana a m'badwo watsopano
• Malipiro a matenda a shuga

Limagwirira ntchito pioglitazone

Kuchepetsa chidwi cha insulin ndi chimodzi mwazomwe zimayambitsa matenda a shuga mellitus. Pioglitazone imatha kuchepetsa kukonzekera kwa insulin, komwe kumabweretsa kuponderezedwa kwa gluconeogeneis m'chiwindi, kuchepa kwa kuchuluka kwa mafuta m'magazi, komanso kuwonjezeka kwa njira yogwiritsira ntchito glucose pogwiritsa ntchito minofu. Nthawi yomweyo, glycemia amachepetsa, lipids yamagazi imasintha, ndipo glycation imachepetsa. Malinga ndi kafukufuku, pioglitazone imatha kuwonjezera kukhathamika kwa glucose ndi 2,5.

Pachikhalidwe, metformin yakhala ikugwiritsa ntchito kuchepetsa insulin. Izi zimathandizira kudziwa kukoka kwa mahomoni makamaka m'chiwindi. Mu minofu ndi adipose zimakhala, mphamvu zake sizitchulidwa. Pioglitazone amachepetsa kukana ndendende mu mafuta ndi minofu, kupitirira mphamvu ya metformin. Amawonetsedwa ngati mankhwala a mzere wachiwiri pamene mphamvu ya metformin ilibe yokwanira (nthawi zambiri imakhala ndi kunenepa kwambiri komanso kusuntha pang'ono) kapena singalole kudwala matenda ashuga.

Mankhwalawa ndi pioglitazone, zovuta za glucose ndi lipids pamasamba a beta zimachepa, motero zochitika za maselo a beta zikuwonjezeka pang'onopang'ono, njira yawo ya kufa imachepa, kuphatikizira kwa insulin kumatheka.

Mu malangizo ogwiritsira ntchito, zotsatira zabwino za Pioglitazone pazomwe zimayambitsa matenda a mtima. Pambuyo pa zaka 3 zakulamulira, kuchuluka kwa triglycerides kutsika pafupifupi 13%, cholesterol "yabwino" imawonjezeka ndi 9%. Chiwopsezo cha kugwidwa ndi matenda a mtima ndikuchepetsedwa ndi 16%. Zinatsimikiziridwa kuti, motsutsana ndi kagwiritsidwe ntchito ka Pioglitazone, makulidwe amitsempha yamagazi amathandizika, pomwe chiopsezo cha matenda ashuga a shuga chikuchepa.

Pioglitazone silipanga phindu lochulukirapo, monga mankhwala omwe amakhudza kaphatikizidwe ka insulin. M'malo mwake, mwa odwala matenda a shuga pali kuchepa kwam'mimba chifukwa cha kuchepa kwa mafuta a visceral.

Pharmacokinetics of Pioglitazone malinga ndi malangizo: pambuyo pakamwa, zinthu zimalowa m'magazi pambuyo pa theka la ola. Kupsinjika kwakukulu kumachitika pa maola awiri ngati mapiritsiwo aledzera pamimba yopanda kanthu, ndipo maola 3.5 ngati atengedwa ndi chakudya. Zotsatira zake kamodzi kamodzi zimasungidwa kwa tsiku limodzi. Mpaka 30% ya Pioglitazone ndipo ma metabolites ake amamuchotsa mkodzo, ena onse ndi ndowe.

Kukonzekera kwa pioglitazone

Mankhwala oyamba a Pioglitazone amadziwika kuti ndi Aktos opangidwa ndi kampani yaku America ya mankhwala Eli Lilly. Zomwe zimagwiritsidwa ntchito pamapiritsi ndi Pioglitazone hydrochloride, zigawo zothandizira ndi cellulose, magnesium stearate ndi lactose. Mankhwala amapezeka Mlingo wa 15, 30, 45 mg. Tsopano tsiku lomalizira kulembetsa kwa Aktos ku Russia kwatha, kulembetsa kukonzanso kwa mankhwalawo sikunadutse, ndiye kuti simungagule m'mafakitore. Mukayitanitsa kuchokera ku Europe, mtengo wa gulu la Aktos udzakhala pafupifupi ruble 3300. pa paketi 28 yamapiritsi.

Ma Analogs ku Russia atenga mtengo wotsika mtengo. Mwachitsanzo, mtengo wa Pioglar ndi ma ruble 400. 30 mapiritsi 30 mg. Kukonzekera kwotsatira kwa Pioglitazone kwalembedwa m'kaundula wa boma:

Mankhwalawa onse ndi fanizo lathunthu la Aktos, ndiye kuti, amabwereza zonse zamapangidwe amomwe mankhwala apoyamba. Kuchita bwino kofanana kumatsimikiziridwa ndi maphunziro azachipatala. Koma ndemanga za anthu odwala matenda ashuga sizimagwirizana nawo nthawi zonse, anthu amakhulupirira Aktos kwambiri.

Chizindikiro chovomerezeka

Pioglitazone amagwiritsidwa ntchito kuchepetsa glycemia kokha mu mtundu 2 shuga. Monga othandizira odwala matenda amkamwa, Pioglitazone sangasinthe magazi ngati wodwalayo sanasinthe moyo wake. Osachepera, muyenera kuchepetsa kuchuluka kwa chakudya chamafuta omwe amamwetsedwa, ndikulemera kwambiri - ndi zopatsa mphamvu, ikani zolimbitsa thupi zanu zolimbitsa thupi. Kupititsa patsogolo glycemia ya postprandial, muyenera kusiyanitsa zakudya zomwe zili ndi GI yayikulu pazakudya, gawani chakudya chokwanira chakudya chonse.

Pioglitazone imagwiranso ntchito ngati monotherapy, koma nthawi zambiri imafotokozedwa ngati gawo limodzi la mankhwala omwe amaphatikiza angapo othandizira a hypoglycemic. Malangizo ogwiritsira ntchito amakupatsani mwayi kugwiritsa ntchito Pioglitazone molumikizana ndi metformin, sulfonylureas, insulin.

Zisonyezo za mapiritsi:

1. Posachedwa wapezapo matenda a shuga oletsa odwala onenepa kwambiri, ngati odwala matenda ashuga ali ndi contraindication (kulephera kwaimpso) kapena kulekerera bwino (kusanza, kutsegula m'mimba) a metformin.
2. Pamodzi ndi metformin mu onenepa kwambiri a diabetes ngati metformin monotherapy sikokwanira kuti matenda akhale ndi shuga.
3. Kuphatikiza ndi kukonzekera kwa sulfonylurea, ngati pali chifukwa chokhulupirira kuti wodwalayo adayamba kuwononga kapangidwe ka insulin yake.
4. Matenda a shuga omwe amadalira insulin ngati wodwala amafuna kwambiri Mlingo wa insulin chifukwa cha kuchepa kwa chidwi chake.

Contraindication

Malangizowa amaletsa kutenga Pioglitazone pazochitika zotsatirazi:

• ngati hypersensitivity chimodzi mwa zigawo za mankhwala wapezeka. Matenda ofooka omwe amakoka mu mawonekedwe a kuyabwa kapena kuzimiririka, sikutanthauza kuti mankhwalawo athetse.
• ndi mtundu 1 shuga mellitus, ngakhale wodwalayo akana insulin,
• ana odwala matenda ashuga
• pa pakati ndi HB. Kafukufuku m'magulu awa odwala omwe ali ndi matenda ashuga sanachitike, kotero sizikudziwika ngati Pioglitazone akudutsa chotchinga ndi kulowa mkaka. Mapiritsiwo amathetsedwa mwachangu amayi akangotenga pakati.
• kulephera kwamtima kwambiri
• mu pachimake zomwe zimafunikira insulin mankhwala (kuvulala kwambiri, matenda ndi maopaleshoni, ketoacidosis), onse othandizira piritsi amachepa kwakanthawi.

Malangizowo akutsimikiza kumwa mankhwalawa mosamala vuto la edema, kuchepa magazi. Sikuti kuphwanya malamulo, koma kulephera kwa chiwindi kumafuna kuyang'aniridwa kwachipatala kowonjezera. Ndi nephropathy, pioglitazone ingagwiritsidwe ntchito mwachangu kuposa metformin, popeza mankhwalawa sakutulutsidwa ndi impso.

Kuchita chidwi makamaka kumafuna kuikidwa kwa Pioglitazone pa matenda aliwonse a mtima. Analogue yapafupi kwambiri, rosiglitazone, adawonetsa chiopsezo chowonjezeka cha myocardial ndi kufa chifukwa cha zovuta zina za mtima. Pioglitazone sanakhale ndi zoyipa zotere, koma njira zowonjezera mosamala mukamazitenga sizingasokoneze. Malinga ndi madotolo, amayesa kusewera nawo motetezeka ndipo samapereka Pioglitazone pachiwopsezo chochepa cha kugunda kwa mtima.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi kuphatikiza kwa pioglitazone ndi mankhwala ena, kusintha kwa magwiridwe ake ndikotheka:

Mankhwala ena, palibe kuyanjana ndi Pioglitazone komwe kunapezeka.

Kuphatikizika, mawonekedwe omasulidwa

Mankhwalawa amapitilizidwa kugulitsidwa m'makatoni atatu kapena 10, okhala ndi mapiritsi khumi ndi awiri ozungulira. Gawo logwira ntchito litha kukhala nawo mmagawo 15, 30 kapena 45 mg.

Zomwe zimakhazikitsidwa ndi mankhwalawa ndi pioglitazone hydrochloride, yomwe imachepetsa kukhudzika kwa chiwindi ndi minyewa yake kuchitapo kanthu cha mahomoni, chifukwa chomwe kuphatikiza kwa glucose kumachuluka, ndipo kapangidwe kake ka chiwindi kamachepa.

Kuphatikiza pa chachikulu, mapiritsi ali ndi zina zowonjezera:

• lactose monohydrate,
• magnesium wakuba,
• hydroxypropyl cellulose,
• calcium carboxymethyl cellulose.

Zotsatira za pharmacological

Pioglitazone amatanthauza othandizira pakamwa a hypoglycemic malinga ndi thiazolidindine. Thupi limaphatikizidwa ndikuwongolera kwa glucose wamagazi ndi metabolidi ya lipid. Kuchepetsa kukana kwa zimakhala za thupi ndi chiwindi kupita ku insulin, kumapangitsa kuti chiwonetsero cha kuchuluka kwa glucose chimadalira insulin komanso kuchepetsedwa kwa mpweya wake ku chiwindi.

Komabe, iye samawonetsa kukondoweza kwa ma β-cell a kapamba, omwe amawapulumutsa kuti asakalambe msanga. Zotsatira za mankhwala amtundu wa 2 shuga zimayambitsa kutsika kwa magazi ndi glucose wa glycosylated hemoglobin. Chochita chitha kugwiritsidwa ntchito chokha kapena kuphatikiza ndimankhwala ena ochepetsa shuga.

Kugwiritsa ntchito mankhwalawa kumathandizira kuti metabolidi ya metabolid ikhale yachilendo, zomwe zimapangitsa kutsika kwa TG komanso kuwonjezeka kwa HDL osakhudza cholesterol yathunthu ndi LDL.

Pharmacokinetics

Kuthira kwa mankhwalawa kumachitika m'matumbo am'mimba, njirayi imachitika mwachangu, ndikukulolani kuti mupeze chinthu chogwira ntchito m'magazi theka la ola mutatha kumwa mankhwalawo. Patatha maola awiri, mulingo wake ukuposa 80 peresenti. Kulandila ndi chakudya kumachedwetsa kuyamwa.

Mphamvu ya mankhwalawa imawonekera kale sabata yoyamba ya kudya pafupipafupi. Kudzikundikira kwa zigawo zikuluzikulu za mankhwala m'thupi sizimachitika, patatha tsiku limodzi zimatulutsidwa kwathunthu kudzera m'mimba ndi impso.

Zizindikiro ndi contraindication

Pioglitazone imavomerezeka ngati njira yowongolera matenda amtundu wa 2 shuga. Itha kugwiritsidwa ntchito ngati mankhwala amodzi, chifukwa nthawi zambiri amalembedwa kwa odwala matenda ashuga kapena omwe Metformin adatsutsana.

Kwambiri, mankhwalawa amagwiritsidwa ntchito ngati zovuta pazochita zotsatirazi:

• kuphatikiza kawiri ndi mankhwala a metformin kapena sulfonylurea,
• kuphatikiza katatu ndi magulu onse awiri a mankhwalawa

Monga contraindations ndi:

• kudziwa kwambiri mbali iliyonse ya mankhwala,
• mbiri ya mtima matenda,
• kukanika kwambiri kwa chiwindi,
• mtundu 1 shuga
• matenda ashuga ketoacidosis,
• kukhalapo kwa khansa
• kukhalapo kwa macroscopic hematuria ochokera kosatsimikizika.

Milandu imeneyi, mankhwalawa amasinthidwa ndi ma analogi omwe ali ndi mawonekedwe osiyana ndi kapangidwe kake.

Malangizo ogwiritsira ntchito

Mlingo wa mankhwalawa umaperekedwa kwa wodwala aliyense payekhapayekha. Ili ndiye ntchito ya dokotala, yemwe, atazindikira, awunika kuwonongeka kwa wodwalayo ndikupanga njira yothandizira.

Malinga ndi malangizo, mankhwalawa amatengedwa kamodzi patsiku, pakamwa. Komabe, ndikofunikira kuchita izi m'mawa.

Mlingo woyambirira umalimbikitsidwa mu 15-30 mg, umatha kukula mpaka 45 mg kugogoda, ndiye muyeso wokwanira.

Pankhani ya kuphatikiza mankhwalawa ndi mankhwala ena a hypoglycemic, mulingo wofika 30 mg patsiku umaperekedwa, koma umatha kusintha malinga ndi momwe gluceter amawerengera ndi momwe wodwalayo alili.

Ndikofunikira kwambiri kusankha mlingo woyenera mukamamwa ndi insulin. Monga lamulo, limayikidwa pa 30 mg patsiku, pomwe kuchuluka kwa insulin kumachepetsedwa.

Kuchita bwino kwa mankhwalawa kumayendera miyezi itatu iliyonse ndikusanthula kwa hemoglobin wa glycated. Ngati palibe zotsatira, phwando limayimitsidwa.

Odwala Apadera ndi Mayendedwe

Kwa okalamba, palibe njira zapadera za kuchuluka. Zimayambanso pang'onopang'ono, pang'onopang'ono zimachulukirachulukira.

Pa nthawi yoyembekezera, mankhwalawa saloledwa kugwiritsidwa ntchito, momwe zimakhalira ndi mwana wosabadwayo samamvetsetsa bwino, chifukwa chake zimakhala zovuta kulosera zotsatira zake. Pa nthawi yobereka, ngati mayi akufunika kugwiritsa ntchito mankhwalawa, ayenera kukana kudyetsa mwana.

Odwala omwe ali ndi matenda a mtima ndi mitsempha ya m'magazi amagwiritsa ntchito mlingo wochepa, komabe ndikofunikira kuwunika momwe ziwalo zamavuto zikuyendetsedwera ndi pioglitazone.

Kutenga Pioglitazone kuonjezera mwayi wokhala ndi khansa ya chikhodzodzo ndi 0,06 peresenti, yomwe adotolo ayenera kuchenjeza wodwalayo ndikuwonetsa kuti achepetse zina zomwe zingayambitse ngozi.

Kwa odwala omwe ali ndi vuto la chiwindi chachikulu, mankhwalawa amakwiririka, komanso mwamphamvu, kugwiritsa ntchito mosamala ndikotheka. Pankhaniyi, ndikofunikira kuwongolera kuchuluka kwa michere ya chiwindi, ngati ichulukitsa masiku atatu, mankhwalawo amachotsedwa.

Kanema wokhudzana ndi zovuta za mankhwala osokoneza bongo omwe ali ndi matenda osokoneza bongo:

Zotsatira zoyipa ndi bongo

Zotsatira zoyipa zoyambitsa kumwa ndi hypoglycemia, koma nthawi zambiri zimachitika ndi mankhwala osokoneza bongo kapena osagwirizana ndi ena othandizira ena. Ndikothekanso kutsitsa hemoglobin ndi kuchepa kwa magazi.

Mankhwala osokoneza bongo amawonetsedwa mu:

• kutupa, kulemera,
• Hypersthesia ndi mutu,
• kuphwanya mgwirizano
• glucosuria, protenuria,
• vertigo
• kugona bwino
• kukanika kwa erectile
• kuwonongeka kwa matenda a kupuma,
• mapangidwe zotupa zosiyanasiyana zachilengedwe,
• defecation chisokonezo
• chiopsezo chowonjezereka cha kuwonongeka ndi maonekedwe a ululu m'miyendo.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito pioglitazone kumatha kuchepetsa magwiridwe antchito oletsa kubereka.

Chogwiritsidwacho sichisintha ntchito yake ikagwiritsidwa ntchito limodzi ndi Digoxin, Metformin, Warfarin Ifenprokumon. Nthawi yomweyo, mawonekedwe awo sasintha. Kugwiritsa ntchito nthawi imodzimodzi kwa sulfonylureas ndi zotumphukira sikusinthanso mphamvu zawo.

Mphamvu ya Pioglitazone pa calcium blockers, cyclosporins, ndi reductase inhibitors ya HMCA-CoA sichinadziwike.

Mukagwiritsidwa ntchito limodzi ndi gemfibrozil, AUC ya glitazone imachulukitsa, kukulitsa ubale wama nthawi atatu. Pankhaniyi, ndikofunikira kuwunika wodwalayo ndipo ngati kuli kotheka, musinthe mankhwalawa.

Kugwiritsa ntchito palimodzi ndi rifampicin kumabweretsa kuchuluka kwa pioglitazone.

Kukonzekera kofananako

Ma analogi a pioglitazone amaperekedwa pamsika ndi zinthu zambiri.

Zida zomwe zili ndi mawonekedwe ofanana ndizophatikiza:

• Indian mankhwala pioglar,
• Zofananira zaku Russia za Diaglitazone, Astrozone, Diab-Norm,
• Mapale a ku Ireland a Actos,
• Ku Croatia kuchiritsa Amalvia,
• Peoglite
• Piouno ndi ena.

Mankhwalawa onse ali m'gulu lokonzekera glitazone, yomwe imaphatikizanso troglitazone ndi rosiglitazone, omwe ali ndi magwiritsidwe ofanana, koma amasiyana mu kapangidwe ka mankhwala, kotero amatha kugwiritsidwa ntchito pamene pioglitazone ikakanidwa ndi thupi. Alinso ndi zabwino ndi zovuta zawo, zomwe zimapezeka mu malangizo a mankhwala.

Komanso ma analogu okhala ndi maziko osiyana omwe alipo omwe amatha kukhala ngati analogues: Glucofage, Siofor, Bagomet, NovoFormin.

Ndizofunikira kudziwa kuti kuwunika kwa odwala omwe adagwiritsa ntchito pioglitazone ndi ma genetic ake ndizosiyana. Chifukwa chake, poyerekeza ndi mankhwalawo pakokha, odwala amayankha bwino, kulandira zolakwika zochepa.

Kulandila kwa analogues nthawi zambiri kumayendetsedwa ndi zovuta, monga kulemera, edema, kuchepa kwa hemoglobin.

Monga momwe masewera amasonyezera, mankhwalawa amathandizadi kutsika kwa shuga komanso amatha kugwiritsidwa ntchito moyenera pakukonzekera matenda a shuga a 2. Komabe, ndikofunikira kusankha mankhwala ndi mlingo woyenera.

Mitengo yeniyeni

Popeza chida chimatha kupangidwa pansi pa mayina osiyanasiyana, kutengera wopanga, mtengo wake umasiyanasiyana. Gulani Pioglitazone mu pharmacies zoweta mu mawonekedwe ake oyera ndizovuta, imayendetsedwa ngati mankhwala omwe ali ndi mayina ena. Imapezeka pansi pa dzina la Pioglitazone Asset, mtengo womwe mu mulingo wa 45 mg umachokera ku ruble 2,000.

Pikoko imakhala ndi ma ruble 600 ndi ma ruble ochepa pa mapiritsi 30 ndi mulingo wa 15 mg ndi mtengo wocheperako kuposa chikwi chimodzi pa mulingo womwewo ndi mlingo wa 30 mg.

Mtengo wa Aktos, mwanjira yomwe mankhwala omwe amagwiritsidwa ntchito amalembedwa, amachokera ku 800 ndi 3000 rubles.

Amalvia angawononge ma ruble 900 pa mlingo wa 30 mg, ndi Diaglitazone - kuchokera ku ruble 300 pa kipimo cha 15 mg.

Kupita patsogolo kwamakono kwamankhwala kumapangitsa kuti zitheke bwino. Kugwiritsa ntchito mankhwala amakono kungakwaniritse izi mwachangu komanso moyenera, ngakhale sizoyipa, zomwe muyenera kudziwa musanayambe kumwa mankhwalawo.

Zolemba za mankhwala antidiabetes

Anthu omwe amadalira insulin (mtundu 1), omwe alibe mahoni okwanira a pancreatic m'matupi awo, ayenera kudzipweteka tsiku lililonse. Mtundu 2, maselo akakula kulolerana ndi shuga, mapiritsi apadera ayenera kumwedwa omwe amachepetsa shuga m'magazi.

Gulu la othandizira odwala matenda ashuga

Mtundu woyamba wa matenda ashuga a mellitus (jakisoni wa insulin):

• kopitilira muyeso kochepa
• zochita zazifupi
• nthawi yayitali yochitapo
• kuchitapo kanthu kwa nthawi yayitali
• kuphatikiza mankhwala.

Tinakambirana kale za njira yoperekera insulin pano.

Mtundu wachiwiri wa matenda ashuga:

• biguanides (metformins),
• kachikachiyama (glitazones),
• α-glucosidase zoletsa,
• glinids (meglitinides),
• kuphatikiza mankhwala
• sulfonylurea kukonzekera woyamba, wachiwiri ndi wachitatu.

Othandizira odwala matenda ashuga odwala matenda a shuga 1

Kukonzekera kwa gulu la pharmacological "Insulin" amadziwika ndi chiyambi, nthawi ya chithandizo, nthawi yodwala. Mankhwalawa sangathe kuchiza matenda a shuga, koma amathandizira thanzi la munthu ndikuwonetsetsa kuti magwiritsidwe ntchito a ziwalo, chifukwa insulin imakhudzidwa mu njira zonse za metabolic.

Mankhwala, insulini yomwe imapezeka kuchokera ku zikondamoyo za nyama imagwiritsidwa ntchito. Bovine insulin idagwiritsidwa ntchito kale, koma monga chotulukapo chake, kuwonjezereka kwa kusasinthika kwa thupi kumadziwika, chifukwa mahomoni amtunduwu amasiyana mu mawonekedwe a maselo kuchokera ku ma amino acids atatu pamapangidwe a anthu. Tsopano amawonjezera ndi insulin ya nkhumba, yomwe imasiyana ndi amino acid modzi ndi munthu, chifukwa chake imavomerezedwa kwambiri ndi odwala. Komanso pakalipano pogwiritsa ntchito matekinoloje obadwa nawo, pali kukonzekera kwa insulin yaumunthu.

Mothandizidwa ndi mankhwalawa, mankhwalawa omwe amagwiritsidwa ntchito ngati 1 shuga ndi 40, 80, 100, 200, 500 IU / ml.

Zotsatira za jakisoni wa insulin:

• pachimake chiwindi matenda
• zilonda zam'mimba zam'mimba,
• kupunduka kwa mtima
• pachimake koronare kusowa.

Zotsatira zoyipa. Ndiwowonjezera kuchuluka kwa mankhwalawa osakanikirana ndi kudya kosakwanira, munthu amatha kudwala matenda a hypoglycemic. Zotsatira zoyipa zimatha kukhala kuchuluka kwa chilakolako cha chakudya, motero, kuwonjezeka kwa thupi (chifukwa chake, ndikofunikira kwambiri kutsatira zakudya zomwe zidanenedwa). Kumayambiriro kwa kukhazikitsidwa kwa mtundu wamtunduwu, mavuto ammaso ndi edema amatha kuchitika, omwe mu milungu ingapo amapita okha.

Kuti mupeze jakisoni, ndikofunikira kuyimba kuchuluka kwa mankhwalawo (motsogozedwa ndi glucometer ndi ndondomeko ya mankhwala yomwe adalandira dokotala), mankhwala oyeserera a jekeseni ndi misozi ya mowa, sonkhanitsani khungu mu khola (mwachitsanzo, pamimba, mbali kapena mwendo), onetsetsani kuti mulibe thovu tsegulani ndikuyambitsa chinthucho m'mafuta a subcutaneous mafuta, mutagwira singano perpendicular kapena pakona madigiri 45. Musamale ndipo musayike singano mu minofu (kuphatikiza ndi jakisoni wapadera wamitsempha). Pambuyo polowa m'thupi, insulin imamangilira zolandilira zam'mimba ndipo imapangitsa kuti "kayendedwe" ka glucose kupita mu cell, komanso zimathandizira pakugwiritsidwa ntchito kwake, kumalimbikitsa njira zambiri zokhudzana ndi ma cell.

Kukonzekera mwachidule ndi ultrashort insulin

Kutsika kwa shuga m'magazi kumayamba kuonekera pambuyo pa mphindi 20-50. Zotsatira zimatha maola 4-8.

Mankhwalawa akuphatikizapo:

• Chichewa
• Apidra
• Actrapid HM
• Gensulin r
• Biogulin
• Monodar

Kuchita kwa mankhwalawa kumatengera kutsanzira kwachilengedwe, malinga ndi physiology, kupanga kwa mahomoni, omwe amachitika monga kuyankha kukoka kwake.

Malangizo a nthawi yayitali komanso nthawi yayitali

Amayamba kuchita ma 2-7 maola, zotsatira zimatha maola 12 mpaka 30.

Mankhwala amtunduwu:

• Biosulin N
• Monodar B
• Monotard MS
• Lantus
• Levemir Penfill

Amasungunuka kwambiri, mphamvu yake imatenga nthawi yayitali chifukwa cha zinthu zina zokulirapo (protamine kapena zinc). Ntchitoyi imakhazikika pakulinganiza masoka opanga insulin.

Biguanides (metformins)

Amawonjezera kukhudzika kwa zimakhala kuti apange insulin, kupewa kulemera, kutsika kwa magazi ndikutchingira magazi.

Mankhwalawa akuphatikizapo:

Ubwino wa gululi la mankhwala antidiabetic ndikuti mankhwalawa ndi oyenera kwa anthu omwe ali ndi kunenepa kwambiri. Komanso, chifukwa chakudya kwawo, mwayi wa hypoglycemia umachepetsedwa kwambiri.

Impso ndi hepatic kuchepa, uchidakwa, pakati ndi kuyamwitsa, kugwiritsa ntchito zosiyana.

Zotsatira zoyipa: kutulutsa, mseru, kulawa kwazitsulo mkamwa.

Ma glinids (meglitinides)

Kugwiritsa ntchito bwino shuga ya magazi onse palokha popanda kuphatikizidwa ndi insulin. Otetezeka, ogwira ntchito komanso osavuta.

Gulu la antidiabetic mankhwala limaphatikizapo:

• Repaglinide
• Nateglinide

Sizoletsedwa kutenga matenda ashuga amtundu woyamba, akagwiritsidwa ntchito molumikizana ndi PSM, panthawi yoyembekezera, chiwindi ndi impso.

Pangamira (glitazones)

Kuchepetsa kukana kwa insulin, kuonjezera chiwopsezo cha minofu ya mthupi kupita ku ma pancreatic hormone.

Malangizo a mtundu uwu:

• Rosiglitazone (Avandia)
• Pioglitazone (Aktos)

Contraindication: matenda a chiwindi, kuphatikiza ndi insulin, pakati, edema.

Ndikofunika kudziwa "malo ovuta" otsatirawa a mankhwalawa: kuyambiranso pang'ono pang'onopang'ono, kuchuluka kwa thupi ndi kusungunuka kwamadzi, zomwe zimapangitsa edema.

Malamulo otenga Pioglitazone

Mosatengera kuchuluka kwa mankhwalawa, a pioglitazone amaledzera ndi shuga kamodzi patsiku. Zakudya sizimafunika.

Njira yosankha:

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

1. Monga kumwa poyambira, imwani 15 kapena 30 mg. Kwa odwala matenda ashuga onenepa kwambiri, malangizowo akuonetsa kuti ayambe kulandira mankhwala ndi 30 mg. Malinga ndi ndemanga, ndi mlingo wophatikizika ndi metformin, 15 mg ya Pioglitazone patsiku ndikokwanira kwa ambiri.
2. Mankhwalawa amachepetsa kukana insulini, motero ndizovuta kuyesa momwe amagwirira ntchito ndi glucometer kunyumba. Anthu odwala matenda ashuga amafunikira kuwunika kwa hemoglobin kotala. Mlingo wa Pioglitazone umachulukitsidwa ndi 15 mg ngati, pambuyo pa miyezi itatu itatenga GH, idakhalabe pamwamba 7%.
3. Ngati pioglitazone amagwiritsidwa ntchito limodzi ndi sulfonylurea kapena insulin, hypoglycemia ikhoza kukhala mwa odwala matenda ashuga. Pankhaniyi, muyenera kuchepetsa kuchuluka kwa mankhwala ena, mankhwalawa a pioglitazone sanasinthe. Kuunika kwa odwala omwe akukana insulin kumawonetsa kuti mankhwalawa amatha kuchepetsa kuchuluka kwa insulini yomwe imagwiritsidwa ntchito ndi pafupifupi kotala.
4. Mlingo wambiri wololedwa ndi malangizo a shuga ndi 45 mg ndi monotherapy, 30 mg mukamagwiritsidwa ntchito molumikizana ndi mankhwala ena ochepetsa shuga. Ngati patatha miyezi itatu atalandira pioglitazone pa mlingo waukulu, GH sanabwerere mwakale, wodwala wina amamuwuza kuti azilamulira glycemia.

Α-glucosidase zoletsa

Mfundo zoyenera kuchitidwa ndizokhazikitsidwa ndi kuponderezedwa kwa zochita za ma enzymes omwe amagwiritsidwa ntchito pakugawa chakudya. Tengani mankhwalawa, komanso kukonzekera kwa gulu la dongo, ndikofunikira panthawi yomweyo monga kudya.

Sulfonylurea

Kuchulukitsa chidwi cha minofu yodalira ma insulin ya mahomoni, kumalimbikitsa kupanga kwake β-insulin.

Kukonzekera kwa m'badwo woyamba (m'badwo) koyamba kuwonekera mu 1956 (Carbutamide, Chlorpropamide). Zinali zothandiza, zochizira matenda a shuga 2, koma zinali ndi zovuta zake zingapo.

Tsopano mankhwala a mibadwo yachiwiri ndi yachitatu amagwiritsidwa ntchito:

Matenda opatsirana opatsirana, kutenga pakati, impso ndi chiwindi.

Zotsatira zoyipa zimaphatikizapo kulemera, kuwonjezeka kwamavuto ndikupanga insulin yawo, komanso ziwopsezo zakugwiritsa ntchito kwa okalamba.

Mankhwala osakanikirana

Amayamba kugwira ntchito maola 2-8, kutalika kwa zotulukazo ndi maola 18-20.

Izi ndizoyimitsidwa pazigawo ziwiri, zomwe zimaphatikizapo insulin yochepa komanso yapakati:

• Biogulin 70/30
• Humodar K25
• Gansulin 30P
• Mikstard 30 nm

Mankhwala ochepetsa shuga a mtundu 2 shuga

Biguanides (metformins)

Amawonjezera kukhudzika kwa zimakhala kuti apange insulin, kupewa kulemera, kutsika kwa magazi ndikutchingira magazi.

Mankhwalawa akuphatikizapo:

Ubwino wa gululi la mankhwala antidiabetic ndikuti mankhwalawa ndi oyenera kwa anthu omwe ali ndi kunenepa kwambiri. Komanso, chifukwa chakudya kwawo, mwayi wa hypoglycemia umachepetsedwa kwambiri.

Impso ndi hepatic kuchepa, uchidakwa, pakati ndi kuyamwitsa, kugwiritsa ntchito zosiyana.

Zotsatira zoyipa: kutulutsa, mseru, kulawa kwazitsulo mkamwa.

Ma glinids (meglitinides)

Kugwiritsa ntchito bwino shuga ya magazi onse palokha popanda kuphatikizidwa ndi insulin. Otetezeka, ogwira ntchito komanso osavuta.

Gulu la antidiabetic mankhwala limaphatikizapo:

• Repaglinide
• Nateglinide

Sizoletsedwa kutenga matenda ashuga amtundu woyamba, akagwiritsidwa ntchito molumikizana ndi PSM, panthawi yoyembekezera, chiwindi ndi impso.

Pangamira (glitazones)

Kuchepetsa kukana kwa insulin, kuonjezera chiwopsezo cha minofu ya mthupi kupita ku ma pancreatic hormone.

Malangizo a mtundu uwu:

• Rosiglitazone (Avandia)
• Pioglitazone (Aktos)

Contraindication: matenda a chiwindi, kuphatikiza ndi insulin, pakati, edema.

Ndikofunika kudziwa "malo ovuta" otsatirawa a mankhwalawa: kuyambiranso pang'ono pang'onopang'ono, kuchuluka kwa thupi ndi kusungunuka kwamadzi, zomwe zimapangitsa edema.

Α-glucosidase zoletsa

Mfundo zoyenera kuchitidwa ndizokhazikitsidwa ndi kuponderezedwa kwa zochita za ma enzymes omwe amagwiritsidwa ntchito pakugawa chakudya. Tengani mankhwalawa, komanso kukonzekera kwa gulu la dongo, ndikofunikira panthawi yomweyo monga kudya.

Sulfonylurea

Kuchulukitsa chidwi cha minofu yodalira ma insulin ya mahomoni, kumalimbikitsa kupanga kwake β-insulin.

Kukonzekera kwa m'badwo woyamba (m'badwo) koyamba kuwonekera mu 1956 (Carbutamide, Chlorpropamide). Zinali zothandiza, zochizira matenda a shuga 2, koma zinali ndi zovuta zake zingapo.

Tsopano mankhwala a mibadwo yachiwiri ndi yachitatu amagwiritsidwa ntchito:

Matenda opatsirana opatsirana, kutenga pakati, impso ndi chiwindi.

Zotsatira zoyipa zimaphatikizapo kulemera, kuwonjezeka kwamavuto ndikupanga insulin yawo, komanso ziwopsezo zakugwiritsa ntchito kwa okalamba.

Mankhwala osakanikirana

Chochitikacho chimapangidwa nthawi yomweyo kukulitsa kupangika kwa insulin ya mahomoni ndikuwonjezera chiwopsezo cha minofu yake.

Chimodzi mwazinthu zophatikizika kwambiri ndi Glibomed: Metformin + Glibenclamide.

Mankhwala opatsirana a m'badwo watsopano

Glucovans. Ubwino wake komanso kupadera kwake ndikuti kukonzekera kumeneku kumakhala ndi mawonekedwe a glibenclamide (2,5 mg), omwe amaphatikizidwa piritsi limodzi ndi metformin (500 mg).

Manilin ndi Amaril, omwe adafotokozedwa pamwambapa, nawonso ndi am'badwo watsopano wa mankhwalawa.

Diabeteson (Gliclazide + Excipients). Imayendetsa katulutsidwe wa mahomoni a kapamba, imathandizira chiwopsezo cha minofu ya thupi.

Munkhani yotsatirayi muphunzira: Kodi Maninil kapena Diabeteson wabwino ndi uti?

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

Contellindus a mtundu 1 shuga, matenda oopsa a chiwindi ndi impso, zaka mpaka zaka 18, kutenga pakati. Kugwiritsa ntchito ndi miconazole koletsedwa!

Zotsatira zoyipa: hypoglycemia, njala, kusokonekera komanso kukwiya kwambiri, kukhumudwa, kudzimbidwa.

Werengani zambiri zamankhwala atsopano a shuga pano.

Malipiro a matenda a shuga

Ndalama zimagwiritsidwa ntchito ngati chithandizo chowonjezera, chothandizira, koma sizingakhale chithandizo chachikulu. Ngati mungasankhe kuzigwiritsa ntchito, muyenera kudziwitsa dokotala za izi.

Malipiro a matenda a shuga 1

1. 0,5 makilogalamu a ndimu, 150 g atsopano a parsley, 150 g wa adyo.Zonsezi zimadutsa chopukusira nyama (sitimachotsa mandimu - timangochotsa mafupawo), kusakaniza, kusinthira mumtsuko wamagalasi ndikuumirira milungu iwiri m'malo opanda phokoso.
2. Sinamoni ndi uchi (kulawa). Mu kapu yamadzi otentha, tsitsani ndodo ya sinamoni kwa theka la ola, onjezani uchi ndikuwugwira kwa maola angapo. Chotsani wand. Kusakaniza kumawotentha m'mawa ndi madzulo.

Mutha kupeza zithandizo zina za anthu odwala matenda ashuga amtundu woyamba pano.

Ndi matenda a shuga a 2:

1. 1 makilogalamu a udzu winawake ndi 1 makilogalamu a mandimu. Tsuka zosakaniza, peza udzu, kusiya ndimu pakhungu, ingochotsani mbewuzo. Zonsezi zimapangidwa pogwiritsa ntchito chopukusira nyama ndikuyika poto. Musaiwale kusakaniza! Kuphika posamba m'madzi kwa maola awiri. Pambuyo pa zosakaniza zonunkhira komanso zopatsa thanzi, kuziziritsa, kusinthira ku mtsuko wagalasi ndikusungira mufiriji pansi pa chivindikiro. Idyani mphindi 30 musanadye.
2. 1 chikho chowuma linden inflorescence pa 5 malita a madzi. Thirani linden ndi madzi ndikuphika pamoto wochepa (kusenda pang'ono) kwa mphindi 10. Ozizira, kupsyinjika ndi sitolo mufiriji. Kumwa nthawi iliyonse, ndikofunikira kusintha tiyi ndi khofi ndi kulowetsedwa uku. Mukamwa msuzi wokonzedweratu, imwani kupumula kwa masiku 20 ndiye kuti mutha kukonzanso zakumwa zabwinozi.

Mu kanemayo, endocrinologist amalankhula za mankhwala atsopano a shuga, ndipo katswiri wazamankhwala ena amagawana maphikidwe a mankhwala antidiabetes omwe amapangidwa mwachilengedwe:

Matenda a shuga a mtundu woyamba ndi wachiwiri sangathe kuchiritsidwa kwathunthu, koma pakadali pano pali mankhwala ambiri omwe angathandize kukhala ndi thanzi laumunthu. Njira zina mwanjira yolipira ziyenera kugwiritsidwa ntchito ngati kuwonjezera kwa chithandizo chachikulu komanso pokambirana ndi adokotala.

Kugwiritsa ntchito mankhwala ochepetsa shuga

Matenda a shuga ndi matenda osokoneza bongo a endocrine omwe amafunikira kuwunikira nthawi zonse. Matenda a shuga amakula chifukwa chosakwanira kupanga mahomoni - insulin, yomwe imapangidwa ndi kapamba. Pakupanga kwa matenda a shuga martitus mthupi la munthu, njira zonse za metabolic zimasokonekera, zomwe zimabweretsa zotsatira zoyipa kuzinthu zonse.

Chithandizo chokwanira cha matenda ashuga ndizovuta kuyang'aniridwa ndi adokotala. Ngati wodwala amadalira insulin (tikulankhula za matenda a shuga 1), ndiye kuti amafunika insulin tsiku lililonse. Pankhani ya matenda a shuga a mtundu wachiŵiri, jakisoni wa insulini safunika, koma dokotala amapereka mankhwala ochepetsa shuga.

Mapiritsi a antidiabetesic amalembedwa mtundu wachiwiri wa matenda ashuga, pomwe kuchuluka kwa insulin m'magazi kukupitilira muyeso. Mankhwala ochepetsa shuga ayenera kutumizidwa ndi endocrinologist aliyense payekha kwa wodwala aliyense, ndipo kudya kwawo kuyenera kuchitika molumikizana ndi zakudya.

Njira yamachitidwe

Makampani ogulitsa mankhwala amapereka mitundu yambiri ya mankhwala kuti achepetse shuga. Iliyonse ya mankhwalawa ili ndi mawonekedwe osiyana a pharmacokinetic, kapangidwe kake, amapangidwa ndi opanga osiyanasiyana, koma ali ndi katundu wofanana.

Ndikofunikira kudziwa kuti othandizira odwala matenda ashuga sangathe kuchiritsa matenda ashuga kwathunthu, kudya kwawo kumakwaniritsa kuchepetsa shuga. Kugwiritsa ntchito kwawo kukhoza kukonza bwino, kuwonjezera phindu.

Kukonzekera kwa Sulfonylurea

Odwala kwambiri pakati pa odwala omwe ali ndi mtundu wachiwiri wa matenda ashuga ndipo amakhala pafupifupi 90% ya mankhwala onse ochepetsa shuga.

1. Glyclazide - ali ndi hypoglycemic, antioxidant ndi hemovascular effect. Zimathandizanso pakufalikira kwa magazi mu ma capillaries; amagwiritsidwa ntchito pochiza matenda a shuga a 2.
2. Glibenclamide - imathandiza kupanga kuchuluka kwa insulin kokwanira. Poyerekeza ndi mankhwala ena omwe ali mgululi, glibenclamide imalowetsedwa m'magazi, imakhala ndi zochita zapamwamba.
3. Glimeprimide ndi mankhwala a m'badwo wachitatu wokhazikika mtundu II shuga mellitus, womwe umagwira mwachangu, samachepetsa kuchuluka kwa insulini m'magazi pophunzira zolimbitsa thupi, ndipo amagwiritsidwa ntchito kamodzi patsiku. Anthu omwe ali ndi vuto la Impso osadwala amatha kumwa mankhwalawa.
4. Maninil ndi mankhwala othandizira odwala matenda ashuga pofuna kukonza ma insulin m'magazi. Mankhwala amapezeka mu mawonekedwe a mapiritsi a 1.75 mg ndi 3.5 mg. Kumwa mankhwalawa kungapangitse ntchito ya kapamba, kuonjezera kutulutsidwa kwa insulin.

Pali mankhwala ena ochepetsa shuga kuchokera ku gulu la sulfonylurea, machitidwe omwe cholinga chake ndi kutsitsa shuga m'magazi, koma Mulimonsemo, kugwiritsa ntchito kwawo kuyenera kuchitika pokhapokha ngati dokotala amusankha. Mankhwala ochokera pagululi sakhazikitsidwa kwa odwala omwe ali ndi matenda a shuga 1 komanso azimayi oyembekezera. Malinga ndi ziwerengero, pafupifupi gawo limodzi mwa magawo atatu a odwala omwe akukonzekera sulfonylurea ayenera kuwaphatikiza ndi mankhwala ena kapena kusintha mankhwalawa ndi jakisoni wa insulin.

Mankhwala a antidiabetesic omwe amaletsa kutulutsa shuga m'maselo a chiwindi. Gulu la mankhwalawa limaletsedwa kwa odwala omwe ali ndi mbiri yolephera kupweteka kwa impso. Biguanides akuphatikiza mankhwala:

Alpha Glycosidase Inhibitors

Kumwa mankhwala m'gululi kumakupatsani mwayi woletsa ma enzyme omwe amachepetsa chimbudzi cha chakudya m'mimba:

Kumwa mapiritsi m'gululi kumatha kuyambitsa kugaya chakudya komanso kusokonezeka kwa magazi. Adalinganiza zochizira matenda amtundu wa II osakanikirana ndi zakudya ndi mankhwala ena othandizira.

Thimang

Glitazones amachita kuti achepetse insulin kukaniza minofu monga minofu ndi mafuta. Amayambitsa ma insulin receptors. Imasunga ntchito yamaselo a chiwindi.

Rosiglitazone - amachepetsa kuchuluka kwa glucose m'magazi, amateteza kagayidwe kachakudya njira. Kutenga mankhwalawa kumafunikira kuwunika chiwindi. Madokotala ena amati kugwiritsa ntchito nthawi yayitali ma glitazones kumawonjezera mwayi wopanga matenda a mtima.

Mankhwala onse a hypoglycemic amapatsirana m'mimba komanso mkaka wa m`mawere. Amasankhidwa ndi dokotala nthawi iliyonse. Munthawi yakuvomerezedwa, ndizoletsedwa kusintha mlingo osafunsa dokotala, izi zimatha kuyambitsa bongo ndikukula kwa mavuto.

Mukamasankha chithandizo cha hypoglycemic, dokotala amayenera kuganizira kuchuluka kwa matendawo, komanso alabadire za mawonekedwe a thupi la wodwalayo.

Mankhwala ena

Posachedwa, m'badwo watsopano wamankhwala wapezeka pamsika wamankhwala, omwe ndi analogue ya zinthu zopangidwa ndi matumbo ochepa. Kudya kwawo kumakupatsani mwayi wowongolera glucose mwa kupanga insulin. Mankhwalawa akuphatikizapo Januvia, Galvus. Amagwiritsidwa ntchito limodzi ndi othandizira ena odwala matenda ashuga.

Zotsatira zabwino zitha kupezeka kuchokera ku homeopathy, yomwe imagwiritsidwa ntchito pa matenda a shuga 1 kapena mtundu 2. Mankhwala a homeopathic sakhala ndi poizoni m'thupi; kugwiritsa ntchito kwawo kuphatikizidwa ndi mankhwala ena.

Glucostab ndi chida chatsopano chothandizira matenda amishuga amtundu wa 2, omwe amapezeka ngati madontho pakamwa. Kudya kwake kumathandiza kugwira ntchito kwamitsempha yamagazi, kumathandizira kutuluka kwa magazi. Ubwino wa mankhwalawa ndimapangidwe ake achilengedwe komanso kuthekera kotenga limodzi ndi mankhwala ena a m'badwo wachiwiri kapena wachitatu.

Malangizo onse

Mankhwala ochepetsa shuga a m'badwo wachiwiri ndi wachitatu amapangidwa pamaziko a sulfonylurea. Sizingagwiritsidwe ntchito ngati chithandizo chachikulu, koma chithandizo chokwanira cha matenda a shuga a 2 chokha. Zotsatira zamankhwala ngati awa sizadziwika ngati munthu sakufuna kutsatira zakudya kapena masewera olimbitsa thupi. Ndikofunika kukumbukira kuti zizindikiritso za matenda ashuga a mitundu yonseyi zimatha kuthetsedwa mwa njira yophatikizidwa, pokhapokha pokhapokha pazotheka zabwino.

Mankhwala a antidiabetesic saperekedwa kwa odwala omwe amadalira insulin kapena omwe ali ndi matenda a shuga a pancreatic. Amalembedwanso mu ana ndi amayi apakati. Mlingo, komanso kusankha kwa anthu omwe ali ndi vuto la hypoglycemic, amakhalabe ndi dokotala. Matenda a shuga sayenera kuwonedwa ndi munthu ngati sentensi. Kutsatira malingaliro onse a dokotala, kumwa mankhwala oyenera, kuyang'anira kuchuluka kwa shuga, kutsatira zakudya kumathandiza kuchepetsa shuga m'magazi komanso kupewa kutuluka kwake.

Pioglitazone: chithunzi cha mankhwala, malangizo ndi shuga

Matenda a shuga amatchedwa "mliri" wa m'zaka za XXI. Chifukwa chake, kumwa mankhwala ndi imodzi mwazinthu zofunikira kwambiri pochiza matendawa. Kukonzekera kwa malangizo a pioglitazone kuli ndi kufotokoza mwatsatanetsatane kagwiritsidwe ntchito kake.

Mankhwala akuluakulu a shuga omwe ali ndi izi ndi Aktos, Pioglar, Diab-standard, Diaglitazone. Pioglitazone palokha ndi yoyera yamakristali yoyera, yomwe ndi yopanda fungo.

Sichisungunuka m'madzi, koma chimaphatikizidwa kwambiri mu dimethylformamide. Ponena za amadzimadzi ethanol, acetone ndi acetonitrile, zinthu zomwe zimakhala momwemo zimasungunuka pang'ono.

Peoglitazone ndi gawo la gulu la thiazolidinediones (glitazones); kudya kwake kumawonetsedwa kuti muchepetse shuga. Popeza mtundu wachiwiri wa matenda a shuga umadziwika ndi kuphwanya kwamphamvu kwamaselo am'mthupi kuti mupange insulini, glitazones imayambitsa ma receptors omwe ali mu minofu yawo. Zotsatira zake, zotumphukira zimayamba kuyankha ku insulin ya mahomoni.

Odwala ambiri amafunsa ngati nkotheka kumwa mankhwala okhala ndi pioglitazone mu mtundu woyamba wa matenda. Glitazones ndi mankhwala osokoneza bongo amtundu wachiwiri wa matenda ashuga. Amagwiritsidwa ntchito ngati mankhwala akuluakulu, komanso owonjezera ndi metformin, sulfonamide kapena insulin. Odwala amayamba kumwa mankhwalawa ngati kuchita masewera olimbitsa thupi komanso kudya moyenera kulibe vuto - shuga wabwinobwino.

Glitazones, poyerekeza ndi ena omwe amachepetsa shuga, amathetsa bwino insulin kukana. Amachepetsa kuchuluka kwamafuta m'magazi a anthu ndikugawa minofu ya adipose kuchoka pamimba kupita kudera lamkati. Kuphatikiza apo, zinthu zimatsika triglycerides.

Zotsatira zoyipa

Pooglitazone poika matenda azachipatala amalephera chifukwa cha zinthu zomwe sizabwino, zomwe zambiri zimachulukana ndikugwiritsa ntchito nthawi yayitali:

1. M'miyezi isanu ndi umodzi yoyambirira, mu 5% ya odwala matenda ashuga, mankhwalawa ndi pioglitazone osakanikirana ndi sulfonylurea kapena insulin amathandizana ndi kuwonjezeka kwa kulemera mpaka 3,7 kg, ndiye izi zimachitika. Mukamamwa ndi metformin, kulemera kwa thupi sikukula. Mu shuga mellitus, izi zosafunikira ndizofunikira, chifukwa odwala ambiri ndi onenepa kwambiri. Kuteteza mankhwalawa, ziyenera kunenedwa kuti kuchuluka kumachuluka makamaka chifukwa champhamvu yamafuta, ndipo kuchuluka kwamafuta owopsa kwambiri, m'malo mwake, kumachepa. Ndiye kuti, ngakhale akulemera kwambiri, Pioglitazone samathandizira kuti pakhale zovuta zama mtima a shuga.
2. Odwala ena amazindikira kusungunuka kwa madzi mthupi. Malangizo ogwiritsira ntchito amadziwitsa kuti kufalikira kwa edema ndi monotherapy ndi Pioglitazone ndi 5%, pamodzi ndi insulin - 15%. Kusungidwa kwa madzi kumayendetsedwa ndi kuchuluka kwa magazi ndi madzi akunja kwama cell. Ndi mbali iyi yomwe milandu yolephera mtima imalumikizana ndi Pioglitazone.
3. Chithandizo chitha kutsagana ndi kuchepa pang'ono kwa hemoglobin ndi hematocrit. Cholinga chake ndikutsatiranso kwa madzimadzi, palibe zotsatira zoyipa pakapangidwe ka magazi komwe kamapezeka mu mankhwalawo.
4. Pogwiritsa ntchito nthawi yayitali ya rosiglitazone, analogue ya Pioglitazone, kuchepa kwa kufooka kwa mafupa komanso chiwopsezo chowonjezereka cha ma fractures adapezeka. Kwa Pioglitazone, palibe deta yotere.
5. Mu 0.25% ya odwala omwe ali ndi matenda a shuga, kuwonjezereka katatu kwa ALT kumapezeka. Nthawi zina, chiwindi adapezeka.

Mlingo wa mawonekedwe ndi mapangidwe a Pioglitazone

Gawo lofunikira la mankhwalawa ndi pioglitazone hydrochloride. Piritsi limodzi, kuchuluka kwake kumatengera mlingo - 15 kapena 30 mg. Yogwira pophika mu kapangidwe amathandizidwa ndi lactose monohydrate, hydroxypropyl cellulose, calcium carboxymethyl cellulose, magnesium stearate.

Mapiritsi oyera oyera amatha kuzindikiridwa ndi mawonekedwe a mawonekedwe a convex ndikujambula "15" kapena "30".

Mu mbale imodzi mapiritsi 10, m'bokosi - 3-10 mbale zotere. Alumali moyo wa mankhwala 2 zaka. Kwa pioglitazone, mtengo wake umatengera mlingo wa mankhwalawo, komanso wopanga opanga: mapiritsi 30 a Indian Pioglar 30 mg aliyense akhoza kugulidwa ma ruble 1083, mapiritsi 28 a Irish Actos 30 mg aliyense - kwa ma ruble 3000.

Makhalidwe

Pioglitazone ndi mankhwala amkamwa a hypoglycemic a gulu la thiazolidatedione. Zochita za mankhwala zimaphatikizidwa ndi kukhalapo kwa insulin: kutsitsa pansi kwa mphamvu ya chiwindi ndi minyewa yake kumadzi, kumakweza mtengo wa shuga ndipo kumachepetsa kapangidwe kake m'chiwindi. Poyerekeza ndi mankhwala a sulfonylurea, pioglitazone simalimbikitsa maselo a b omwe ali ndi vuto la kupanga insulin ndipo sathandizira kukalamba ndi necrosis.

Ikalowa m'mimba, mankhwalawa amatengeka kwambiri, mpaka amafika m'magawo awiri pambuyo potalika ma 2 ndi bioavailability 80%. Kuchulukana kophatikizana kwa kuchuluka kwa mankhwalawa m'magazi kunalembedwa chifukwa cha 2 mpaka 60 mg. Zotsatira zokhazikika zimapezeka mutatha kumwa mapiritsiwo m'masiku 4 mpaka 7-7.

Kugwiritsanso ntchito mobwerezabwereza sikumapangitsa kuti mankhwalawa akhale ochuluka. Kuchuluka kwa mayamwa sikudalira nthawi yomwe mulandire michere.

Pioglitazone amachotsedwa ndowe (55%) ndi mkodzo (45%). Mankhwalawa, omwe amachotsedwa mu mawonekedwe osasinthika, amakhala ndi theka la moyo wa maola 5-6, chifukwa cha metabolites - maola 16-23.

Zaka za odwala matenda ashuga sizikhudza mankhwala a pharmacokinetics. Ndi kukanika kwa aimpso, zomwe zimakhala ndi glitazone ndi ma metabolites ake zimakhala zotsika, koma mawonekedwewo azikhala ofanana, kotero kugwiritsidwa ntchito kwa mankhwala aulere kumasungidwa.

Ndi kulephera kwa chiwindi, kuchuluka kwa mankhwalawo m'magazi kumakhala kosalekeza, ndikuwonjezereka kwa kuchuluka kwa magawidwe, kutsimikizika kumachepetsedwa, ndipo gawo la mankhwala laulere lidzakulitsidwa.

Zizindikiro zogwiritsidwa ntchito

Pioglitazone imagwiritsidwa ntchito kuwongolera matenda amtundu wa 2 shuga onse ngati chithandizo cha mankhwala ammotherapy komanso chithandizo chovuta, ngati kusintha kwasinthidwe (zakudya zama carb otsika, zochitika zolimbitsa thupi, komanso kuwunika momwe munthu akumvera) sikumalipira mokwanira glycemia.

Pazithandizo zovuta, mapangidwe awiri omwe ali ndi metformin amagwiritsidwa ntchito (makamaka kunenepa kwambiri), ngati monotherapy yokhala ndi metformin mu Mlingo wothandizirana sapereka 100% glycemic control. Pankhani yotsutsana ndi metformin, pioglitazone imaphatikizidwa ndi mankhwala a sulfonylurea, ngati kugwiritsa ntchito monotherapy sikumapereka zotsatira zomwe mukufuna.

Kuphatikizidwa kwa pioglitazone komanso kuphatikiza kwapatatu ndi metformin ndi sulfonylurea kukonzekera ndikotheka, makamaka kwa odwala onenepa kwambiri, ngati malingaliro am'mbuyomu sangapereke mbiri yabwino ya glycemic.

Mapiritsi ndi oyeneranso odwala matenda a shuga a 2 omwe amadalira insulin, ngati jakisoni wa insulin sangayang'anire shuga moyenera, ndipo metformin imatsutsana kapena siyimalekeredwa ndi wodwalayo.

Malangizo ogwiritsira ntchito Pioglitazonum

Malangizo a pioglitazone ogwiritsira ntchito amalimbikitsa kugwiritsa ntchito odwala matenda ashuga 1 tsa / tsiku.Piritsi imamezedwa ndi madzi, adokotala amasankha mlingo womwe umaganizira zamankhwala am'mbuyomu, zaka, gawo la matendawa, concomitant pathologies, kusintha kwa thupi.

Ndi chithandizo chovuta ndi insulin, mlingo wa chomaliza umasinthidwa molingana ndi glucometer ndi mawonekedwe a zakudya.

Kwa odwala matenda ashuga okalamba, palibe chifukwa chosinthira kuchuluka kwa mankhwalawa, amayamba ndi otsika, amawonjezeka pang'onopang'ono, makamaka pogwiritsa ntchito malingaliro - izi zimathandizira kusintha ndikusinthanso ntchito.

Ndi kukanika kwa aimpso (kulengedwa kwa creatinine kupitirira 4 ml / min.), Glitazone imalembedwa mwachizolowezi, sichisonyezedwa kwa odwala a hemodialysis, komanso kulephera kwa chiwindi.

Malangizo owonjezera

Mphamvu ya regimen yosankhidwa imawunikidwa miyezi itatu iliyonse pogwiritsa ntchito glycated hemoglobin. Ngati palibe chochita, siyani kumwa mankhwalawo. Kugwiritsa ntchito pioglitazone nthawi yayitali kumakhala ndi chiopsezo, motero dokotala amayenera kuyang'anira chitetezo cha mankhwalawa.

Mankhwala amatha kusunga madzimadzi m'thupi ndikuwonjezera vuto mu mtima. Ngati wodwala matenda ashuga ali pachiwopsezo cha ukalamba, vuto la mtima kapena matenda a mtima, mlingo woyambira uyenera kukhala wochepa.

Kusintha kumathekera ndi zoyeserera zabwino. Gulu ili la odwala matenda ashuga ayenera kuwunika kawirikawiri thanzi lawo (kulemera, kutupa, zizindikiro za matenda amtima), makamaka ndi malo ochepera a diastolic.

Chidwi chachikulu popereka mankhwala ayenera kuperekedwa kwa odwala matenda ashuga okalamba (kuyambira azaka 75), popeza palibe chidziwitso pakugwiritsa ntchito mankhwalawa. Ndi kuphatikiza kwa pioglitazone ndi insulin, kuwonjezeka kwa mtima pathologies ndikotheka. Pazaka izi, chiopsezo cha khansa, ma fractures chikuwonjezeka, chifukwa chake, polemba mankhwala, ndikofunikira kuti muwunikire phindu lenileni komanso mavuto omwe angakhalepo.

Ziyeso zamankhwala zimatsimikizira mwayi wokhala ndi khansa ya chikhodzodzo mutatha kudya pioglitzone. Ngakhale chiwopsezo chotsika (0,06% poyerekeza 0,02% pagulu lolamulira), zinthu zonse zomwe zimatulutsa khansa (kusuta fodya, kupanga zovulaza, kutsitsa kwa pelvic, zaka) ziyenera kuwunikiridwa.

Mankhwala asanaikidwe, ma enzyme a chiwindi amayendera. Ndi kuwonjezeka kwa ALT ndi 2,5 nthawi komanso kukomoka kwa chiwindi, mankhwalawa amatsutsana. Ndi kukula kwamphamvu kwa ma cell a chiwindi, pioglitazone imatengedwa mosamala.

Ndi zizindikiro za hepatic kusokonezeka (kusokonezeka kwa dyspeptic, kupweteka kwa epigastric, anorexia, kutopa kosalekeza), michere ya chiwindi imayendera. Kupitilira muyeso wofanana ndi katatu, komanso mawonekedwe a chiwindi, ziyenera kukhala chifukwa chosiya mankhwala.

Ndi kuchepa kwa kukana kwa insulin, kugawidwanso kwa mafuta osanjikiza kumachitika: ma visceral amatsika, ndikuwonjezereka. Ngati kulemera kumalumikizidwa ndi edema, ndikofunikira kuwongolera kugwira ntchito kwa mtima ndi kudya kwa kalori.

Chifukwa cha kuchuluka kwa magazi, hemoglobin imatha kutsika ndi 4%. Kusintha kofananako kumawonedwa mukamamwa mankhwala ena a antiidiabetesic (a metformin - 3-4%, sulfonylurea kukonzekera - 1-2%).

Pakuphatikiza kawiri komanso katatu ndi pioglitazone, insulin ndi sulfonylurea, chiopsezo cha hypoglycemia chikuwonjezeka. Ndi zovuta zochizira, kusinthanitsa kwa mankhwalawa panthawi yake ndikofunikira.

Thiazolidinediones zimatha kuchititsa kuti masomphenya azikhala ndi kutupa. Mukalumikizana ndi ophthalmologist, ndikofunikira kulingalira za mtundu wa macular edema mukamagwiritsa ntchito pioglitazone. Pali chiopsezo cha mafupa owundana.

Chifukwa cha umboni wokwanira wosakwanira komanso chitetezo pokhudzana ndi pakati komanso mkaka wa m`mawere, azimayi sasankhidwa polyglitazone nthawi imeneyi. Mankhwala ndi contraindified mu ubwana.

Mukamayendetsa kapena kugwiritsa ntchito njira zovuta, mwina mavuto azotsatira za glitazone ayenera kuganiziridwanso.

Mankhwala osokoneza bongo osokoneza bongo komanso osafunika

Ndi monotherapy komanso mapulani ovuta, zochitika zosafunikira zalembedwa:

• Macular edema, vuto la kusawona bwino, hypoglycemia, chilakolako chosalamulirika,
• Hypesthesia, mgwirizano wolakwika,
• Vertigo
• Kulemera ndi kukwera ALT,
• Glucosuria, proteinuria.

Maphunzirowa adayesa chitetezo cha mlingo wa 120 mg, omwe odzipereka adatenga masiku 4, kenako masiku ena 7 mg ndi 180 mg. Palibe zizindikiro zowonjezera bongo zomwe zapezeka.

Mikhalidwe ya Hypoglycemic ndiyotheka ndi regimen yovuta ndi insulin ndi kukonzekera kwa sulfonylurea. Chithandizo cha mankhwalawa ndichizindikiro komanso chothandizira.

Pioglitazone - analogues

Pamsika waku US wa mankhwala opha maantiotic, omwe ndi amodzi kwambiri padziko lapansi, pioglitazone amakhala ndi gawo lofanana ndi metformin. Pankhani ya mikangano kapena kulekerera bwino kwa pioglitazone, itha kulowedwa ndi Avandia kapena Roglit - analogues yozikidwa pa rosiglitazone - mankhwala a gulu lomwelo la thiazolidinediones, komabe, kulosera kwakutali kwa gululi ndikukhumudwitsa.

Kuchepetsa kukana insulin ndi biguanides. Pankhaniyi, pyoglizatone ikhoza kusinthidwa ndi Glucophage, Siofor, Bagomet, NovoFormin ndi mankhwala ena ofikira a metformin.

Kuchokera pagawo la mankhwala osokoneza bongo a hypoglycemic, analogues aku Russia ndi otchuka: Diab-standard, Diaglitazone, Astrozone. Chifukwa cha mndandanda wokhazikika wa contraindication, kuchuluka kwake komwe kumachulukana ndi zovuta mankhwala, munthu ayenera kusamala ndi kusankha kwa analogues.

Kufufuza kwa Makasitomala

About pioglitazone, ndemanga za anthu odwala matenda ashuga amasakanikirana. Omwe adamwa mankhwala oyambirirawo amawona kugwira ntchito bwino komanso zotsatira zoyipa zochepa.

Mapeto ake ndi osagwirizana: mankhwalawa amachepetsa kwambiri glycemia, glycated hemoglobin komanso kufunika kwa insulin (makamaka ndi zovuta mankhwala). Koma sioyenera aliyense, chifukwa chake simuyenera kuyesa azaumoyo, kupeza mankhwalawa popatsidwa upangiri ndi abwenzi. Katswiri yekha ndi amene amatha kusankha kuthekera kwa chithandizo chotere komanso algorithm yolandirira pioglitazone.

Mutha kuphunzira zambiri zakugwiritsa ntchito thiazolidatediones pamankhwala azachipatala kuchokera pa kanema:

Kuwongolera zaumoyo

Kugwiritsa ntchito pioglitazone kumafuna kuwunika momwe munthu wodwala matenda ashuga:

Ndemanga, zabwino ndi zoyipa

Ndemanga za odwala ambiri omwe amagwiritsa ntchito Aktos, Pioglar ndi mankhwala ena ali ndi zabwino. Mwa zabwino, ndizotheka kuwunikira mphamvu yakuchepetsa kukana kwa insulin pakati pa mankhwala onse ochepetsa shuga omwe amamwa pakamwa.

Koma pali zovuta zina za glitazones, zomwe zimawonetsedwa motere: amatsika pamankhwala omwe ali ndi metformin ndi sulfonylurea, hemoglobin amachepetsedwa ndi 0.5-1,5%, akagwiritsidwa ntchito, phindu lolemera makilogalamu 1-3 limawonedwa chifukwa cha kuchuluka kwa mafuta ndi kusungika kwa madzi mthupi.

Chifukwa chake, musanatenge glitazones, muyenera kufunsa dokotala ndikuwerenga ndemanga za odwala omwe adawamwa kale.

Wodwala yemwe akutenga zinthu za pioglitazone, mtengo wake womwe umadalira mankhwalawo, ayenera kusankha njira yothandizira. Mtengo wapakati wa mapiritsi a Pioglar (zidutswa 30 za 30 mg aliyense) ndi ma ruble 1083, Actos (28 zidutswa 30 mg aliyense) ndi ma ruble 3000. Mwakutero, munthu wa zaka zapakati amatha kugula mankhwalawa. Mtengo wawo wokwera umachitika chifukwa chakuti mankhwalawa amalowetsedwa kunja, Pioglar amapangidwa ku India, Actos - ku Ireland.

Kutsika mtengo ndi mankhwala opangidwa ku Russia. Izi zikuphatikiza:

Mukamagwiritsa ntchito, zotsatira za hypoglycemic zimaperekedwa. Diaglitazone, yomwe imagula pafupifupi ma ruble 295, imatha kukhala njira yabwino kwambiri kuposa mankhwala okwera mtengo. Astrozone ndi Mdyerekezi-ali ndi zotsutsana zomwezi ndi zotsutsana.

Diagnitazone itha kuchepa mphamvu yogwiritsa ntchito njira yolerera pakamwa, yomwe iyenera kukumbukiridwa.

Pioglitazone analogues

Chifukwa cha tsankho ndi zovuta zina, kugwiritsa ntchito Pioglitazone kungakhale koletsedwa. Chifukwa chake, adotolo amafotokozera mankhwala ena okhala ndi rosiglitazone.

Izi zimaphatikizidwanso m'gulu la thiazolidinediones (glitazones). Mukamagwiritsa ntchito, zotsatira zomwezi zimapangika kuchokera ku pioglitazone, ndiko kuti, kukondoweza kwa maselo a cell ndi minofu kuti athetse insulin.

Mankhwala akuluakulu omwe ali ndi rosiglitazone ndi awa:

Musanagwiritse ntchito, muyenera kufunsa dokotala ndikuwerenga malangizo kuti mugwiritse ntchito.

Kukonzekera kwa Biguanide kumachepetsa kukana kwa insulin. Metformin, yomwe ndi gawo la malonda, amachepetsa kupanga shuga ndi chiwindi. Gwiritsani ntchito mankhwalawa mosamala, popeza ma biguanides amasokoneza kugwira ntchito kwa mtima mwa okalamba, zomwe zimapangitsa kugwira ntchito kwa impso ndi chitukuko chifukwa cha lactic acidosis imatha kuperekedwanso. Kukonzekera ndi metformin yogwira ntchito kumaphatikizapo Bagomet, Glucofage, Metformin-BMS, NovoFormin, Siofor ndi ena.

Komanso amachepetsa shuga ya magazi Acarbose. Amayendedwe a zochita zake amayeserera kulepheretsa michere yomwe imathandizira kupanga michere m'mimba. Hypoglycemia ndiyotheka ndikugwiritsa ntchito mankhwala ena ndi insulin. Popewa kupezeka kwa mavuto omwe amabwera chifukwa cha kudzimbidwa, ndibwino kuyamba kumwa ndi yaying'ono.

Pochiza matenda a shuga a mtundu wa 2, mankhwala okhala ndi pioglitazone kapena analogies, kaya ndi Diaglitazone kapena Metformin, angagwiritsidwe ntchito. Popeza mankhwalawa ali ndi kuchuluka kwakukulu kwa contraindication ndi zovuta, ndikulimbikitsidwa kuti muzigwiritsa ntchito mukamalankhula ndi matenda a shuga. komanso ndi adotolo. Kanema yemwe ali munkhaniyi akuwunika mwachidule zokambirana za

Momwe mungasinthire Pioglitazone

Mwa zinthu zomwe zili m'gulu la thiazolidinediones, kuphatikiza Pioglitazone, rosiglitazone yokha ndi yomwe imalembetsedwa ku Russia. Ndi gawo lokonzekera Roglit, Avandia, Avandamet, Avandaglim. Kafukufuku akuwonetsa kuti chithandizo cha nthawi yayitali ndi rosiglitazone chimawonjezera chiopsezo cha mtima, kufa kwa myocardial infarction, chifukwa chake, amadziwitsidwa pokhapokha pena palibenso njira ina.

Kuphatikiza pa Pioglitazone, mankhwala opangidwa ndi metformin amachepetsa kukana kwa insulin. Kupititsa patsogolo kulekerera kwazinthu izi, mapiritsi osinthidwa osinthika adapangidwa - Glucofage Long ndi analogues.

Onse rosiglitazone ndi metformin ali ndi zotsutsana zambiri, chifukwa chake angathe kuperekedwa ndi adokotala.

Ndemanga za madotolo ndi odwala

Endocrinologists amati pioglitazone nthawi zambiri. Cholinga chakusakonda kwa mankhwalawa, amachitcha kufunikira kowongolera ma hemoglobin ndi ntchito za chiwindi, chiwopsezo chachikulu chodziwitsa mankhwala a angiopathy ndi odwala okalamba, omwe amapanga odwala ambiri. Nthawi zambiri, madokotala amawona ngati Pioglitazone ngati njira ina yopangira metformin ngati kuli kovuta kuigwiritsa ntchito, osati monga hypoglycemic yodziyimira payokha.

M'magawo a anthu odwala matenda ashuga, Pioglitazone nawonso satchuka. Cholepheretsa chachikulu kugwiritsa ntchito mankhwalawo ndi mtengo wokwera wa mankhwalawo, kulephera kumulandira kwaulere. Mankhwalawa sangapezeke ku mankhwala aliwonse, omwe sawonjezeranso kutchuka kwake. Zotsatira zoyipa za mankhwalawa, makamaka kuwonda, komanso nthawi ndi nthawi kuwonetsa zambiri zokhudzana ndi chiwopsezo cha matenda a mtima mukamamwa glitazones kumadabwitsa odwala omwe ali ndi matenda ashuga.

Mapiritsi enieni adavoteredwa ndi odwala kuti ndi othandiza komanso otetezeka kwambiri. Amadalira zida zamagetsi zochepa, amakonda kulandira chithandizo mwanjira: metformin ndi sulfonylureas.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>