The analogue mapiritsi Diagnlinid

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Repaglinide. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Repaglinide machitidwe awo. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, zomwe mwina sizinalengezedwe ndi wopanga. Ma Analogs a Repaglinide pamaso panu pali ma analogu. Gwiritsani ntchito mankhwalawa odwala matenda ashuga omwe samadalira insulin 2 akuluakulu, ana, komanso pa nthawi ya bere. Kapangidwe ka mankhwalawa ndikuyenderana ndi mowa.

Repaglinide - wothandizira pakamwa hypoglycemic. Mofulumira amachepetsa shuga m'magazi ndikulimbikitsa kutulutsa kwa insulini pakugwira maselo a pancreatic beta. Limagwirira ntchito limalumikizidwa ndi kuthekera kotchinga njira za adenosine triphosphate (ATP) modalira mwa ma cell a beta-cell pochita zinthu zinazake zolandilira, zomwe zimapangitsa kutsekeka kwa maselo ndi kutsegulidwa kwa njira za calcium. Zotsatira zake, kuchuluka kwa calcium kumapangitsa kuti insulin itulutsidwe ndi maselo a beta.

Pambuyo potenga Repaglinide, kuyankha kwa insulinotropic pazowonjezera zakudya kumawonedwa mkati mwa mphindi 30, zomwe zimapangitsa kutsika kwa shuga m'magazi. Pakati pa chakudya, palibe kuwonjezeka kwa insulin. Odwala omwe ali ndi matenda a shuga a mtundu wa 2 aellellus (osadalira insulin) akamamwa Repaglinide mu Mlingo wa 500 μg mpaka 4 mg, amadziwika kuti kuchuluka kwa shuga m'magazi kumadziwika.

Kupanga

Repaglinide + zokopa.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, repaglinide imatengedwa mwachangu kuchokera kumimba; Panalibe kusiyana kwakukulu m'magawo a pharmacokinetic a repaglinide pamene amatengedwa musanadye, 15 ndi 30 mphindi musanadye kapena pamimba yopanda kanthu. Kumanga mapuloteni a Plasma ndi oposa 90%. Repaglinide imangokhala biotransformed mu chiwindi ndikupanga ofooka metabolites. Repaglinide ndi metabolites ake amuchotsa makamaka ndi bile, osachepera 8% - ndi mkodzo (monga metabolites), ochepera 1% - okhala ndi ndowe (zosasinthika).

Zizindikiro

• shuga yosadalira insulin (mtundu 2 shuga mellitus).

Kutulutsa Mafomu

Mapiritsi 0,5 mg, 1 mg ndi 2 mg.

Malangizo ogwiritsira ntchito ndi mtundu wa mankhwala

Rimage regimen imakhazikitsidwa payekhapayekha, kusankha mlingo kuti mukulitse milingo ya shuga.

Mlingo woyambira wabwino ndi 500 mcg. Kuchulukitsa kwa mankhwalawa kuyenera kuchitidwa osapitilira sabata ziwiri za kudya kwambiri, kutengera magawo a labotale ofooketsa kagayidwe.

Mlingo waukulu: umodzi - 4 mg, tsiku lililonse - 16 mg.

Mukatha kugwiritsa ntchito mankhwala ena a hypoglycemic, mlingo woyambira ndi 1 mg.

Cholandiridwa musanadye chakudya chachikulu chilichonse. Nthawi yoyenera kumwa mankhwalawa ndi mphindi 15 musanadye, koma imatha kumwa mphindi 30 musanadye kapena musanadye.

Zotsatira zoyipa

• kukhudza kagayidwe kachakudya kagayidwe kazakudya - hypoglycemic mamiriro (pallor, kutuluka thukuta, palpitations, zovuta kugona, kugwedezeka),
• kusinthasintha kwamiseche yamagazi kungayambitse kuwonongeka kwakanthawi, makamaka kumayambiriro kwa mankhwalawa (adanenedwa ochepa odwala ndipo sanafune kuti mankhwala athetse),
• kupweteka m'mimba
• kutsegula m'mimba, kudzimbidwa,
• kusanza, kusanza,
• kuchuluka kwa michere ya chiwindi,
• thupi lawo siligwirizana: kuyabwa, erythema, urticaria.

Contraindication

• lembani matenda a shuga 1 mellitus (wodalira insulin),
• matenda ashuga ketoacidosis (kuphatikiza ndi kukomoka),
• kuvulala kwambiri aimpso,
• kukanika kwambiri kwa chiwindi,
• kuchitira limodzi ndi mankhwala omwe amaletsa kapena kuyambitsa CYP3A4,
• Mimba (kuphatikizapo kukonzekera) ndi mkaka wa m'mawere (yoyamwitsa),
• Hypersensitivity kuti repaglinide.

Mimba komanso kuyamwa

Kugwiritsa ntchito Repaglinide pa nthawi ya pakati komanso mkaka wa m`mawere ndi zotsutsana.

M'maphunziro oyesera, zidapezeka kuti palibe mphamvu ya teratogenic, koma ikagwiritsidwa ntchito pamlingo wambiri m'magawo omaliza a mimbayo, embryotoxicity komanso kusokonezeka kwa miyendo mwa mwana wosabadwayo.

Repaglinide imafukusidwa mkaka wa m'mawere.

Gwiritsani ntchito ana

Ntchito muubwana sichinafotokozedwe.

Malangizo apadera

M'matenda a chiwindi kapena impso, opaleshoni yayikulu, atadwala kapena matenda aposachedwa, kuchepa kwa mphamvu ya Repaglinide ndikotheka.

Gwiritsani ntchito mosamala odwala omwe ali ndi matenda a impso.

Odwala ofooka kapena odwala omwe amachepetsa zakudya, Repaglinide iyenera kutengedwa pang'ono. Popewa kuthana ndi hypoglycemic pagulu la odwala, mlingo uyenera kusankhidwa mosamala.

Mikhalidwe yomwe ikukwera ya hypoglycemic nthawi zambiri imakhala yotsogola ndipo imaletseka mosavuta kudya mafuta. Woopsa angafunike kupaka shuga m'mitsempha. Kuchepa kwa kukhazikika kotereku kumatengera mlingo, zakudya mthupi, kulimbitsa thupi, kupsinjika.

Chonde dziwani kuti beta-blockers amatha kufinya zizindikiro za hypoglycemia.

Mankhwalawa, odwala ayenera kupewa kumwa mowa, chifukwa Mowa umatha kukulitsa mphamvu ya hypoglycemic ya Repaglinide.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Poyerekeza ndi kagwiritsidwe ntchito ka Repaglinide, kuthekera koyendetsa galimoto kapena kuchita zinthu zina zoopsa kuyenera kuyesedwa.

Kuyanjana kwa mankhwala osokoneza bongo

Mphamvu ya hypoglycemic ya Repaglinide imatheka chifukwa chogwiritsa ntchito munthawi yomweyo ma monoamine oxidase inhibitors (MAOs), osagwiritsa ntchito beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, salicylates, non-steroidal anti-kutupa anti (NSAIDs), octreotide, anabolic steroid,

Kuchepa kwa mphamvu ya hypoglycemic ya Repaglinide ndikotheka ndikugwiritsa ntchito nthawi yomweyo michere yoletsa kubereka pakamwa, thiazide diuretics, glucocorticosteroids (GCS), danazole, mahomoni a chithokomiro, sympathomimetics (popereka kapena kuletsa mankhwalawa, ndikofunikira kuyang'anira kuchuluka kwa carbo.

Pogwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo omwe amapezeka mu ndulu, mwayi womwe ungathe kuyanjana pakati pawo uyenera kuganiziridwa.

Pokhudzana ndi deta yomwe ikupezeka pa metabolism ya repaglinide ndi CYP3A4 isoenzyme, kuyanjana kwa CYP3A4 inhibitors (ketoconazole, intraconazole, erythromycin, fluconazole, mibefradil), zomwe zikutsogolera kuwonjezeka kwa plasma repaglinide, iyenera kukumbukiridwa. Zoyambitsa CYP3A4 (kuphatikizapo rifampicin, phenytoin) zitha kuchepetsa kusungunuka kwa plaglinide mu plasma. Popeza kuchuluka kwa kupangidwako sikunakhazikitsidwe, kugwiritsa ntchito mobwerezabwereza kwa repaglinide ndi mankhwalawa kumatsutsana.

Mndandanda wa mankhwala Repaglinide

Zofanana muzochitika zamagulu:

Mndandanda wa mankhwala Repaglinide ndi pharmacological gulu (kupanga hypoglycemic ndi mankhwala ena):

• Avandia
• Adebite
• Acarbose
• Antidiab
• Arfazetin,
• Astrozone
• Bagomet,
• Betanase
• Bukarban,
• Victoza
• Vildagliptin,
• Vipidia,
• Galvus
• Gilearm
• Glibenez
• Glibenclamide,
• Glyclazide
• Glycon
• Glimepiride
• Glyminfor,
• Glyformin
• Chikwanje,
• Guarem
• Diabetes
• Diamerid,
• Diastabol,
• Eglinides
• Xelevia,
• Lycumia,
• Maninil
• Metformin
• Minidiab
• Movoglek,
• Nateglinide
• Onglisa,
• Phuli
• Peoglite
• Sinthani
• Rosiglitazone,
• Saxenda
• Saterex,
• Siofor
• Sofamet
• Statiglin,
• Trazenta,
• Kukhazikika
• Fomu,
• Fomu
• Forsiga
• Chlorpropamide
• Blueberry akuwombera
• Euglucon,
• Yuglin,
• Januvius
• Yasitara.

Maganizo a Endocrinologist

Mankhwala Repaglinide ndimalandira ena mwa odwala omwe ali ndi matenda ashuga a 2. Ndimasankha Mlingo uliwonse payekha komanso tsiku lililonse kwa wodwala aliyense payekhapayekha ndikuwasintha, kuyang'anira kuchuluka kwa shuga m'magazi. Ndibwino kuti odwala ambiri omwe ali ndi matenda ashuga azikhala ndi ma glucometer awo, zomwe zimapangitsa kukhala kosavuta kuyang'ana mphamvu ya glycemia pa nthawi ya kusankha kwa mankhwalawa komanso nthawi ya chithandizo. Kulekerera kwa mankhwala Repaglinide ndikwabwino. Sindikukumbukira kuti wodwala wina yemwe ankamudwalitsa nthawi zambiri ankangodandaula za zovuta zina.

Mndandanda wa mankhwala Diagninid

Analogue ndiotsika mtengo kuchokera 0 rub.

Jardins ndi mankhwala achilendo wochizira matenda amtundu wa 2. Empagliflozin mu 25 mg piritsi lililonse limagwira ntchito ngati gawo limodzi lokhazikika. Jardins ali ndi contraindication ndi zoletsa zaka, motero funsani ndi dokotala musanayambe chithandizo.

Analogue ndiotsika mtengo kuchokera ku ma ruble 59.

Wopanga: Novo Nordisk (Denmark)
Kutulutsa Mafomu:

• Tab. 1 mg, ma PC 30., Mtengo kuchokera 175 ma ruble
• Tab. 2 mg, ma PC 30., Mtengo kuchokera ku ma ruble 219

NovoNorm ndimakonzedwe a piritsi kuchokera ku gulu lomwelo lamankhwala, koma pogwiritsa ntchito njira ina. Repaglinide imagwiritsidwa ntchito pano pa mulingo wa 0,5 mpaka 2 mg. Zizindikiro zakupangira zikufanana, koma ma contraindication amasiyana chifukwa cha ma DV osiyanasiyana pamapiritsi, kotero werengani malangizo mosamala ndikuwonana ndi dokotala.

Analogue ndiokwera mtengo kwambiri kuchokera ku ma ruble 2219.

Wopanga: Ikufotokozedwa
Kutulutsa Mafomu:

• Tab. tsa / obol. 100 mg, 30 ma PC., Mtengo kuchokera 2453 rubles
• Tab. 2 mg, ma PC 30., Mtengo kuchokera ku ma ruble 219

Novo Nordisk (Denmark) NovoNorm ndi cholowa m'malo mwa Forsigi. Chokhacho chomwe chimagwira ntchito mankhwalawa ndi repaglinide. Mankhwala mkati mphindi 30 kumawonjezera insulin ndende mu magazi. Chifukwa chosowa deta pamaphunziro omwe amachitika pachitetezo cha mankhwalawa komanso kugwiritsa ntchito bwino mapiritsi pagulu la ana, sizikulimbikitsidwa kuti mugwiritse ntchito mankhwalawa kwa ana osakwana zaka 18. Mwanjira yonyansa, kutsegula m'mimba ndi kupweteka pamimba nthawi zambiri kumachitika.

Analogue ndiokwera mtengo kwambiri kuchokera ku ma ruble a 1908.

Wopanga: Ikufotokozedwa
Kutulutsa Mafomu:

• Tab. tsa / obol. 10 mg, 30 ma PC., Mtengo kuchokera ku 2142 rubles
• Tab. 2 mg, ma PC 30., Mtengo kuchokera ku ma ruble 219

Forsiga ndi piritsi yokonzekera mankhwalawa a mtundu 2 matenda a shuga ochokera dapagliflozin mu gawo la 5 mg. Itha kutumikiridwa kuphatikiza pa zakudya zomwe anthu odwala matenda ashuga amachita komanso zolimbitsa thupi. Forsigi ali ndi contraindication ndi zoletsa zaka, werengani mosamala malangizo musanayambe chithandizo.

Mtengo Repaglinide ndi kupezeka kwa malo ogulitsa mankhwala amzindawu

Yang'anani! Pamwambapa pali tebulo lowoneka bwino, zambiri zitha kukhala kuti zasintha. Zambiri pa mitengo ndi kupezeka kwake zimasintha pa nthawi yeniyeni kuti muwone - mutha kugwiritsa ntchito kusaka (nthawi zonse zidziwitso pofufuza), komanso ngati mungafunike kusiya lamulo lamankhwala, sankhani malo amzindawu kuti mupeze kapena mupeze pokhapokha pokhapokha mankhwala.

Mndandanda womwe uli pamwambapa umasinthidwa kamodzi pa maola 6 aliwonse (unasinthidwa pa 07/14/2019 nthawi ya 11: 47 - nthawi ya Moscow). Fotokozani mitengo ndi kupezeka kwa mankhwalawa posaka (batani losakira lili pamwamba), komanso manambala a foni asananyamuke. Zomwe zili patsamba lino sizingagwiritsidwe ntchito ngati njira zodziyambitsira nokha. Musanagwiritse ntchito mankhwala, onetsetsani kuonana ndi dokotala.

Kukonzekera kukonzanso

Repaglinide ndi dzina lapadziko lonse lapansi lomwe mankhwala amatha kuzindikirika kulikonse padziko lapansi. Monga chida chogwira ntchito, repaglinide ndi gawo lamapiritsi omwe amapangidwa ndi makampani osiyanasiyana azamankhwala omwe ali pansi pazinthu zawo. Mayina amalonda otsatirawa a repaglinide amalembetsa mu registry yama Russian mankhwala:

Mankhwala oyamba ndi Danish NovoNorm. Maphunziro onse akuluakulu adachitika ndi kutenga nawo mbali mankhwalawa. NovoNorm imapezeka mu 0,5, 1 ndi 2 mg phukusi la mapiritsi 30. Mtengo wa paketi ndiwotsika - kuchokera 157 mpaka 220 rubles. pamtundu wina.

Diagninid ndi Iglinid ndi ma genics, kapena analogues, a NovoNorma. Mankhwalawa amayesedwa kuti adziwe momwe amakhalanso ndi choyambirira, ali ndi vuto lofanana la hypoglycemic komanso mlingo, chitetezo chofanana. Malangizo a mankhwala ali pafupi kwambiri. Kusiyana kwa moyo wa alumali kumafotokozedwa ndi kapangidwe kosiyanasiyana ka zinthu zothandiza (zopanda ntchito). Kuunika kwa odwala matenda ashuga kumatsimikizira kuti choyambirira ndi ma analogue zimasiyana kokha mu mawonekedwe apiritsi ndi ma CD. Mtengo wa Diclinid ndi ma ruble 126-195. pa paketi iliyonse.

Iglinid ndiwatsopano kwambiri mwa kukonzanso komwe kumachitika ku Russia. Pang'onopang'ono mankhwalawa akuyamba kuwonekera mu intaneti yogulitsa. Palibe ndemanga za Iglinid pano.

Zotsatira za pharmacological

Repaglinide ndi yochokera ku benzoic acid. Thupi limalumikiza ma receptor apadera omwe amapezeka pa membrane wa maselo a beta, amatseka njira za potaziyamu, amatsegula njira za calcium, potero amathandizira kubisalira kwa insulin.

Kuyambiranso kumwa pambuyo piritsi kumayamba msanga. Zotsatira zoyambirira za mankhwalawa zimadziwika pambuyo pa mphindi 10, ndiye kuti mankhwalawa akhoza kumwedwa musanadye. Kuzindikira kwakukulu m'matumbo kumatheka pambuyo pa mphindi 40-60, zomwe zimakupatsani mwayi wochepetsera posachedwa glycemia. Kukwaniritsidwa mwachangu kwa Normoglycemia mutatha kudya ndikofunikira kwambiri kuchokera pakulinga koteteza matenda osokoneza bongo omwe ali ndi matenda a shuga. Mafuta ochulukirapo, omwe amakhala kuyambira pakudya cham'mawa mpaka nthawi yogona, amawonjezera magazi, amalimbikitsa magazi, amapanga kusokonezeka kwa lipid, kumabweretsa kuwonongeka m'mitsempha yamagazi, komanso kumapangitsa kupsinjika kosalekeza.

Mosiyana ndi sulfonylurea derivatives (PSM), zotsatira za repaglinide zimatengera glycemia. Ngati zidutsa 5 mmol / l, mankhwalawa amagwira ntchito molimbika kuposa ndi shuga wochepa. Mankhwalawa amatha mofulumira, atatha theka la theka la repaglinide kuti atuluke m'thupi. Pambuyo maola 4, kuphatikiza kochepa kwa mankhwalawa kumapezeka m'magazi omwe sangathe kukhudza glycemia.

Phindu lokhalitsa zinthu mwachidule:

1. Kupanga kwa insulin komwe kumachitika pafupi kwambiri ndi zachilengedwe momwe zingathere.
2. Kutha kukwaniritsa chindapusa cha matenda ashuga.
3. Kuchepetsa chiopsezo cha hypoglycemia. Mukamamwa repaglinide, palibe mlandu umodzi womwe unalembedwa.
4. Kuperewera kwa hyperinsulinemia kosatha. Izi zikutanthauza kuti odwala matenda ashuga alibe kulemera.
5. Kuchepetsa kuchepa kwa beta cell ndi kupitirira kwa shuga.

Repaglinide imapukusidwa mu chiwindi, 90% kapena kuposerapo amathandizidwa ndi ndowe, mpaka 8% ya mankhwalawa imapezeka mkodzo. Zochitika zotere za pharmacokinetics zimalola kugwiritsa ntchito mankhwalawa kumapeto kwa matenda a shuga ndi nephropathy komanso matenda ena akuluakulu a impso.

Chizindikiro chovomerezeka

Repaglinide adapangira amitundu yachiwiri ya ashuga okha. Chofunikira ndi kupezeka kwa maselo a beta. Mu ma algorithms aku Russia ndi akunja pochiza matenda osokoneza bongo, ma glinides amatchulidwa ngati mankhwala osungirako, amadziwika ngati mapiritsi ena saloledwa.

Zizindikiro zogwiritsidwa ntchito:

1. Ngati njira ina ya metformin, ngati siyolekeredwa bwino kapena yoponderezedwa. Ndikofunika kulingalira kuti repaglinide ilibe mphamvu zowonekera pakumverera kwama cell kuti insulini, kuchepa kwa shuga kumatheka pokhapokha polimbana ndi insulin chifukwa cha kuchuluka kwa mahomoni.
2. M'malo mwa mankhwala a sulfonylurea, ngati wodwalayo ali ndi vuto losagwirizana ndi imodzi mwa mankhwala omwe ali mgululi.
3. Kukulitsa dongosolo la mankhwalawo, ngati mankhwala omwe kale anali ataleka kuperekanso shuga. Malangizowa amakupatsitsani kuphatikiza repaglinide ndi metformin ndi insulin yayitali, thiazolidatediones. Ndi PSM, mankhwalawa sangathe kugwiritsidwa ntchito kuti asadzaze ma cell a kapamba.
4. Malinga ndi madotolo, repaglinide imagwiritsidwa ntchito bwino mu odwala matenda ashuga omwe amafuna kusintha kosinthika pa mapiritsi: kudya kwambiri, kudumpha chakudya, pakudya.

Monga mapiritsi ena aliwonse a shuga, repaglinide imangogwira ntchito limodzi ndi zakudya komanso masewera olimbitsa thupi.

Pamene repaglinide amaletsa

Malangizo ogwiritsira ntchito oletsedwa kupereka mankhwala kwa amayi apakati ndi kuyamwa, ana ndi odwala matenda ashuga kuposa zaka 75, popeza m'magulu awa odwala chitetezo cha repaglinide sichitsimikiziridwa.

Monga othandizira onse pakamwa hypoglycemic, repaglinide singagwiritsidwe ntchito pazovuta za matenda ashuga (ketoacidosis, hyperglycemic coma ndi precoma) komanso m'malo ovuta kwambiri (kuvulala, maopareshoni, kuwotcha kwambiri kapena kutupa, matenda oopsa) - mndandanda wazovuta zonse. Ngati wodwala matenda ashuga akufuna kuchipatala, lingaliro la kuletsa mapiritsiwo ndikusunthira ku insulin limapangidwa ndi adokotala.

Kuti mankhwalawa athe kuyamwa mwachangu, ntchito za chiwindi zotetezeka ndizofunikira. Ngati chiwindi chikulephera, mankhwalawa ndi repaglinide amaletsedwa ndi malangizo.

Ngati wodwala wodwala matenda a shuga atenga gemfibrozil kukonzanso kwa lipid mbiri yamagazi, NovoNorm ndi Diagninid sayenera kufotokozedwa, chifukwa pamene amatengedwa pamodzi, kufunsanso kwa repaglinide m'magazi kumadzuka katatu kapena kuposerapo, ndipo hypoglycemia imatheka.

Malamulo Ovomerezeka

Repaglinide yaledzera chakudya chachikulu chisanachitike (kadzutsa, nkhomaliro, chakudya chamadzulo). Ngati chakudya chatulutsidwa kapena m'menemo osapatsa mafuta, musamwe mankhwalawo. Malinga ndi ndemanga, njira iyi yothandizira mankhwalawa ndiyothandiza kwa achinyamata odwala matenda ashuga omwe ali ndi moyo wokangalika, komanso kwa okalamba omwe ali ndi vuto losakhazikika.

Zambiri pakugwiritsa ntchito mankhwalawa:

• kuchuluka kwa kuvomereza ndi nthawi 2-4,
• nthawi musanadye: analimbikitsa - mphindi 15, zovomerezeka - mpaka theka la ola,
• kumwa koyambirira ndi 0,5 mg wa odwala omwe apezeka ndi shuga, 1 mg posinthira kutulutsa mapiritsi ena ochepetsa shuga.
• Mlingo umakulitsidwa ngati chiwopsezo cha matenda ashuga sichokwanira. Makhalidwe - milingo yayikulu yaposachedwa yam'magazi komanso hemoglobin ya glycated,
• nthawi yomwe kuchuluka kwachulukidwe kamapitilira sabata,
• pazipita limodzi mlingo 4, tsiku lililonse 16 mg.

Malinga ndi malingaliro amakono, kumwa mapiritsi ochepetsa shuga mu mulingo woyenera siwofunika, chifukwa izi zimawonjezera chiopsezo cha zotsatila zawo. Ngati 2-3 mg ya repaglinide sikupereka chindapusa cha matenda a shuga, ndikofunika kuwonjezera mankhwala ena, osachulukitsa kuchuluka kwa mankhwalawa.

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 Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. 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!

Zotsatira zoyipa

Zotsatira zoyipa kwambiri za repaglinide ndi hypoglycemia. Zimachitika ngati insulin yambiri yatulutsidwa m'magazi kuposa momwe ikufunikira kuti gwiritsidwe ntchito wa glucose obwera. Chiwopsezo cha hypoglycemia chimatengera zifukwa zake: mlingo wa mankhwalawa, zakudya, zovuta zina, nthawi yayitali ndi kulimbitsa thupi.

Zotsatira zoyipa ndi pafupipafupi molingana ndi malangizo ogwiritsira ntchito:

Kuyanjana kwa mankhwala osokoneza bongo

Onjezerani kuchuluka kwa repaglinide m'magazi kapena kuonjezera mphamvu yake ya gemfibrozil, maantivitamincacithycin ndi rifampicin, ma antifungals, immunosuppressant cyclosporin, mao inhibitors, ACE inhibitors, NSAIDs, beta-blockers, salicylates, steroids, mowa.

Njira zakulera zam'mlomo, zotumphukira za barbituric acid ndi thiazide, glucocorticoids, antiepileptic carbamazepine, mankhwala a sympathomimetic, mahomoni a chithokomiro amachepetsa mphamvu ya kubwezeretsanso.

Popereka ndi kuletsa mankhwala omwe ali pamwambapa, kufunsa kwa dokotala komanso kuwongolera glycemic pafupipafupi kumafunikira.

Repaglinide analogues

Analogue yapafupi kwambiri ya repaglinide ndi phenylalanine derivative nateglinide, thunthu limakhala ndi zotsatira zofananira komanso zazifupi. Ku Russia, ndi mankhwala amodzi okha omwe amapezeka ndi ichi - Starlix, wopanga NovartisPharma. Nateglide ya iye imapezeka ku Japan, mapiritsi okha - ku Italy. Mtengo wa Starlix ndi pafupifupi ruble 3,000 pamapiritsi 84.

Ma analogues a bajeti - kufalikira kwa PSM glibenclamide (Maninil), glycidone (Glyurenorm), glyclazide (Diabeteson, Diabetalong, Glidiab, etc.) ndi glimepiride (Amaryl, Diamerid, ndi ena otero.) Amatenga PSM nthawi zambiri kuposa repaglinide, popeza mphamvu zawo zimakhala zazitali.

Gliptins (Galvus, Januvia ndi ma analogi awo), opangidwa mwanjira ya mapiritsi ndi jekeseni wa insretin mimetics (Baeta, Victoza) nawonso ali m'gulu la othandizira omwe amalimbitsa kaphatikizidwe ka insulin. Mtengo wa chithandizo ndi gliptins umachokera ku ma ruble 1500. Mimetic incretin ndi okwera mtengo kwambiri, kuchokera ku ma ruble 5200.

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

Kupanga ndi kufotokoza kwa mankhwalawa

Piritsi lililonse limakhala ndi 0,5 kapena 1 mg ya yogwira popanga micronized repaglinide, yophatikizidwa ndi zinthu zothandiza: calcium hydrogen phosphate anhydrous, colloidal silicon dioxide, cellcrystalline cellulose, croscarmellose sodium, hydroxypropyl cellulose, meglumine, magnesium stearate, dyes.

Mapiritsi ozungulira a biconvex amatha kuzindikiridwa mwalemba ndi manambala omwe akuwonetsa kuchuluka. Ndi chizindikiro cha 0,5, ndiyoyera, ndi 1 mg - lavenda kapena chikasu. Kumbuyo mutha kuwona chidule RP, J ndi ena. Mapiritsi 10 ali mmatumba. Padzakhala mbale zingapo pabokosi lamakatoni.

Mankhwala omwe akupezeka. Mtengo wa Repaglinide ndi bajeti yeniyeni: mapiritsi 30 a 2 mg ku Moscow atha kugulitsidwa ma ruble 200-220. Amamasula mankhwala ku Denmark, Israel, India ndi maiko ena, kuphatikizanso gawo la Soviet.

Alumali moyo wa mankhwalawa, wolengezedwa ndi wopanga, ndi wazaka zitatu. Mankhwalawa safuna mikhalidwe yapadera kuti asungidwe. Pambuyo pa nthawi yomwe ikunenedwa, mapiritsiwo amawataya.

Zotsatira za pharmacological

Zotsatira zazikulu za mankhwalawa ndi hypoglycemic. Mankhwalawa amalepheretsa njira zotsalira za potaziyamu za PAP zomwe zimapezeka mu membala wa b-cell, zimathandizira kukhumudwa kwawo ndikumasulidwa kwa njira za calcium. Chifukwa chake, secretagogue imapangitsa kutengeka kwa mahomoni.

Kafukufuku wa zamankhwala sanapeze mutagenic, teratogenic, carcinogenic zotsatira mu zinyama komanso kuphwanya chonde.

Repaglinide imayamwa mwachangu komanso mokwanira kuchokera m'matumbo am'mimba, mpaka kufika pazokwanira zake m'magazi mu ola limodzi.

Ngati amamwa ndi zakudya, Cmax imachepetsedwa ndi 20%. The kuchuluka kwa mankhwalawa amatsika msanga ndipo pambuyo 4 maola ukufika ochepa chizindikiro. Mankhwalawa amamangidwa ku mapuloteni a plasma pafupifupi kwathunthu (kuchokera 98%) ndi bioavailability a 56%. Biotransformation ndi mapangidwe a inert metabolites amapezeka m'chiwindi.

Mankhwalawa amachotsedwa mu maola 4-6 ndi theka la moyo wa ola 1. Pa 90% imadutsa pamiyendo ya bile, pafupifupi 8% imachotsedwa ndi impso.

Repaglinide ndi ndani?

Mankhwalawa adapangidwira kuti azitha kuthana ndi matenda a shuga a mtundu wa 2 ngati kusintha kwasinthidwe (zakudya zama carb otsika, katundu wokwanira wa minofu, chiwongolero chazomvera) samapereka chiwongolero chonse cha glycemic.

Ndizotheka kugwiritsa ntchito glinide panjira yovuta ndi metformin ndi thiazolidatediones, ngati monotherapy, mankhwala othandizira komanso masewera olimbitsa thupi sapereka zotsatira zomwe mukufuna.

Yemwe Repaglinide adatsutsana

Kuphatikiza pa zoletsa zachikhalidwe (kusalolera, kubereka, ana, kuyamwitsa), mankhwalawa ndi otsutsana:

• Anthu odwala matenda ashuga a mtundu woyamba,
• Ndi matenda ashuga a ketoacidosis,
• Muli mkhalidwe wokoma mtima komanso wowoneka bwino,
• Ngati wodwala ali ndi vuto la impso komanso chiwindi.
• Muzochitika zosinthira kwakanthaŵi kwa insulin (matenda, zoopsa, opaleshoni).

Makamaka chidwi chikuyenera kuperekedwa kuti apereke mankhwala osokoneza bongo kwa oledzera, anthu omwe ali ndi matenda a impso, komanso malungo.. Pali zoletsa zaka: osapereka mankhwala kwa odwala matenda ashuga asanafike 18 ndi zaka 75 chifukwa cha kusowa kwa umboni wamagulu awa.

Njira yogwiritsira ntchito

Kwa repaglinnid, malangizo omwe angagwiritsidwe ntchito amalimbikitsa kumwa mapiritsi musanadye. Dokotala adzasankha mlingo wofunikira pakuwongolera glycemic molingana ndi zotsatira za kusanthula, gawo la matendawa, concomitant pathologies, zaka, momwe thupi limayendera ndi dongo.

Kuti mumvetse bwino za kuchuluka kwa mankhwala othandizira, ndikofunikira kuthana ndi shuga komanso matenda a postprandial kunyumba komanso ku labotale. Mukakonza zikhalidwe za mankhwalawa, amathandizidwanso ndikuwonetsa ma hemoglobin a glycated.

Kuyang'anira kuyenera kuzindikira kulephera koyambirira komanso kwachiwiri, pomwe msambo wa glycemia ukugwa pang'onopang'ono kumayambiriro kwa maphunzirowa kapena pambuyo poyambira.

Nthawi yakumwa repaglinide sichikhala chokhazikika: mphindi 15-30 musanadye chakudya kapena nthawi yomweyo kumayambiriro kwa chakudya. Ngati akamwe zoziziritsa kukhosi (ndiye kuti amazidumpha), ndiye kuti piritsi lina limawonjezeredwa (kapena kudumphidwa).

Ngati wodwala matenda ashuga sanalandirebe mankhwala ochepetsa shuga, muyeso wa dongo uyenera kukhala wotsika ngati 0,5 mg asanadye chilichonse. Ngati angasinthe ndikupereka mankhwala ena okhudzana ndi matenda ashuga, mutha kuyamba ndi 1 mg musanadye.

Ndi mankhwala othandizira, mulingo woyenera sapitilira 4 mg musanadye. Zakudya zadothi tsiku lililonse siziyenera kupitirira 16 mg.

Ndi zovuta mankhwala, mlingo wa repaglinide sasintha, ndipo miyambo ina ya mankhwalawa imasankhidwa molingana ndi kuwerenga kwa glucometer ndi regimens yachiwiri yamankhwala.

Zotsatira zoyipa

Mwa zovuta zoyipa zomwe zimadziwika ndi ma glinids, hypoglycemia ndiyowopsa. Popereka mankhwala, dokotalayo ayenera kuyambitsa odwala kudziwa zomwe akuwona komanso njira zomwe amathandizira poyambira komanso kudzithandiza nokha.

Mwa zina zomwe sizinachitike.

1. Matenda a Dyspeptic
2. Kuphwanya miyambo yamatumbo,
3. Zotupa pakhungu,
4. Kuchepa kwa chiwindi mu mawonekedwe a transistor yowonjezera mu ntchito ya transaminase,
5. Zowonongeka chifukwa cha kusiyana kwa glycemic level.

Zotsatira Zogwiritsa Ntchito Mankhwala

Kugwiritsanso ntchito kwa repaglinide ndi β-blockers, ACE inhibitors, chloramphenicol, zakumwa zoledzeretsa, mao inhibitors, osagwirizana a NSAID anticoagulants, probenecid, salicylates, sulfonamides, anabolic steroids, mphamvu ya dongo imachulukirachulukira.

The munthawi yomweyo makonzedwe a repaglinide ndi calcium njira blockers, corticosteroids, thiazide diuretics, isoniazid, nicotinic acid munthawi yopanda muyeso, estrogen (yomwe ili ndi njira zakulera), sympathomimetics, phenothiazines, phenytoin, mahomoni a chithokomiro amachepetsa mphamvu ya glinides.

Kuthandiza ndi bongo

Izi zitha kudziwika ndi:

• Chilango chosalamulirika
• Kutopa,
• Khungu loyera,
• Tachycardia,
• Misempha spasms
• Thukuta kwambiri
• Kukomoka, chikomokere.

Kuthandiza munthu amene akuzunzidwayo ndi chizindikiro komanso kumathandizira. Ngati wodwalayo akudziwa, ayenera kupatsidwa chakudya (shuga, maswiti), pakapita nthawi, thupi limadzaza ndi shuga liyenera kubwerezedwa, chifukwa akhoza kuyambiranso.

Ngati wodwalayo alibe chizindikiro cha chikumbumtima, njira ya glucose (50%) imayendetsedwa pamitsempha, kuti apitirize kuchuluka kwa glycemic pamtunda wa 5.5 mmol / l, dontho limayikidwa ndi 10% shuga. Muzovuta kwambiri, kuchipatala chofunikira kumafunika.

Malangizo owonjezera

Chidwi chachikulu (kuwongolera kusala kudya ndi shuga wa m'mbuyo, magwiritsidwe a ziwalo zomwe mukufuna) mukamayambitsa dongo amafunika odwala matenda ashuga a impso ndi hepatic pathologies. Ayenera kudziwa kuti ngati pali kuphwanya mlingo wa mankhwalawa komanso mankhwalawa, kugwiritsa ntchito mowa, zakudya zopatsa mphamvu zochepa, kupsinjika kwa minofu, kupsinjika, ndikofunikira kusintha mtundu wa repaglinide, popeza mikhalidwe yotere imayambitsa hypoglycemia.

Pazokhudzana ndi zovuta zoyipa, chisamaliro chimayenera kuthandizidwa poyendetsa magalimoto ndi makina ovuta, oopsa, mukamagwira ntchito pamalo okwera, etc.

Popewa hypoglycemia, odwala matenda ashuga okhala ndi zizindikiro zakufooka za am'mbuyomu, komanso omwe ali ndi vutoli sizachilendo, muyenera kusamala, kuwunikira zomwe zingachitike ndikuwopsa.

Repaglinide - analogues

Repaglinide imamasulidwa pansi pa mayina osiyanasiyana azamalonda: NovoNorm, Diclinid, Iglinid, Repodiab.

Malinga ndi code ya ATX ya mulingo wachinayi, othandizira odwala matenda a shuga mu Bayeta jakisoni wothandizirana ndi exenatide ndi Viktoza ndi yogwira pophika liraglitide ikugwirizana nawo.

Anthu ena omwe amadwala matenda ashuga amawona matenda awo kukhala kusamvetseka kwamatsoka, osazindikira kuti matenda opusitsawa amatha kutumiza kudziko lina nthawi ina iliyonse.

Repaglinide ndi othandizira kwambiri a hypoglycemic, kuyesa kudzipatsa mankhwala ndikusintha ndi koopsa kuumoyo, popeza mankhwalawa amachita mofulumira, mndandanda wazovuta kwambiri zotsutsana ndi zotsutsana. Ngati mwapezeka kuti muli ndi matenda a shuga, muyenera kuwalandira bwino, osazengereza pambuyo pake.

Zosankha zamankhwala zamatenda a shuga a 2 zimapezeka pavidiyo.