Acarbose: kuwunika ndi kumasula mafomu, malangizo ogwiritsira ntchito

Acarbose ndi wothandizira wa hypoglycemic yemwe amagwiritsidwa ntchito pochita zachipatala pochiza matenda am'mimba a shuga. Munkhaniyi tiona zomwe ma acarbose ali - malangizo omwe angagwiritsidwe ntchito.

Yang'anani! Mu gulu la anatomical-Therapeutic-kemikali (ATX), "Acarbose" akuwonetsedwa ndi code A10BF01. Dongosolo losavomerezeka padziko lonse lapansi: Acarbose.

Pharmacodynamics ndi pharmacokinetics

Acarbose ndi pseudotetrasaccharide yemwe amapangidwa ndi ma actinomycetes. Mankhwalawa amapikisana ndipo amabwezeretsa m'mimba α-glucosidase omwe akukhudzidwa ndikuwonongeka kwa di-, oligo- ndi polysaccharides. M'matumbo ang'onoang'ono a munthu, mlingo wa acarbose umachedwetsa kutha kwa chakudya kuti mutsetse monosaccharides (shuga, fructose). Njira yeniyeni yovomerezeka ya acarbose siyikhudzidwa.

Popeza ntchito ya hydrolytic yama glucosidase osiyanasiyana ikhoza kusiyanasiyana pakati pa anthu, zitha kuyembekezereka kuti mayamwidwe amthupi amatha kusiyanasiyana malinga ndi kuchuluka kwa mankhwalawo. Zakudya zamafuta osakwanira sizimagwirizana m'matumbo ang'onoang'ono (malabsorption), koma zimakola m'mimba ndi mabakiteriya kuti achepetse mafuta achesi ndi mpweya. Zinthu zopaka mphamvu zimatengedwa ndikugwiritsa ntchito thupi.

1-2% yokha ya mankhwala omwe amaperekedwa ndi pakamwa ndi omwe amawamwa. M'matumbo, metabolites amapangidwa ndi michere yam'mimba ndi mabakiteriya am'mimba. Pafupifupi 1/3 yamkamwa yoyamwa imayamwa m'magazi mu mawonekedwe. Acarbose metabolism mankhwala amabisika makamaka kudzera impso.

Zizindikiro ndi contraindication

Pakufufuza kwamaso kawiri, mphamvu ya acarbose (100 mg katatu patsiku) poyerekeza ndi placebo idayesedwa mu odwala matenda ashuga a 94 kwa milungu 24. Odwala sanamwe mankhwala a antiidiabetes ndipo sanatsatire zakudya zinazake. Pakupita kwamasabata 4, asayansi anayeza glucose wamagazi pamimba yopanda kanthu ndikatha kudya (400 kcal, 50% chakudya). Ofufuzawo anayeza nawonso kuchuluka kwa glycated hemoglobin (Hb-A1), C-peptide, plulin, insulin, ndi triglycerides. Odwala omwe ali mgulu la acarbose adawonetsa kuchepa kwakukulu kwa glycemia atatha kudya (mpaka maola 5 mutatha kudya): kuchuluka kwa shuga m'magazi (ola limodzi mutatha kudya) kunali 14.5 mmol / L musanalandire chithandizo, ndi 10.5 mmol / mutatha kumwa acarbose l

Mu gulu la placebo, kuchuluka kwa glucose atatha kudya kunachepa pang'ono. Miyezo ya HbA1 inachepa pang'ono ndi asidi wa acarbose (kuyambira 9,3% mpaka 8.7%), pomwe placebo sinasinthe. Acarbose adachepetsa mulingo wa postprandial ndende ya insulin ndi triglycerides.

Maphunziro ena adachitidwa makamaka ndi ochepa odwala. Mankhwalawa amagwiritsidwa ntchito mwa anthu omwe ali ndi madigiri osiyanasiyana a shuga (kuchokera kwa odwala omwe amangofunika kudya kwa odwala matenda ashuga). Mwambiri, maphunziro awa amatulutsa zotsatira zofanana ndi zomwe tafotokozazi: panali kuchepa kwa glycemia atatha kudya ndikuchepetsa shuga. Zotsatira zopindulitsa pakusala kudya kwa glucose kapena HbA1c zakhala zikudziwika pokhapokha pa maphunziro pawokha. Miyezo ya insulin ya plasma ndi kulemera kwa thupi sizinasinthidwe m'maphunziro ambiri.

Pakufufuza kwakhungu komwe kumayendetsedwa kawiri, ma acarbose sakanakhoza m'malo mwa zotsatira za sulfonylurea. Mwa odwala 29, chithandizo chokhala ndi sulfonylureas chinaleka ndipo m'malo mwake ndi acarbose kapena placebo. Mlingo wa acarbose unakulitsidwa pang'onopang'ono kuchokera pa 150 mg / tsiku mpaka 500 mg / tsiku. Pambuyo pa milungu 16 yochizira, mulingo wa monosaccharide (woyesedwa mosasamala) anali 50%, ndipo HbA1 mulingo wake anali 18% kuposa sulfonylurea. Acarbose ndi placebo sizinasiyane machitidwe awo.

Kuperekera kwa acarbose kwa odwala omwe ali ndi matenda a shuga a I amachepetsa glycemia. Zowona kuti acarbose imatha kulepheretsa hypoglycemia yausiku sichinatsimikizidwe kutengera deta yosindikizidwa.

Zotsatira zoyipa: kufotokozera

Mankhwalawa amayambitsa kusokonezeka kwa odwala ambiri, osachepera m'mimba komanso kupweteka kwam'mimba. Anthu opitilira 50% amadandaula chifukwa cha kusasamala, pafupifupi 5% ya mankhwalawa anasiya chifukwa chakukhumudwa m'mimba.

Popita nthawi, zizindikirozi ziyenera kuchepa. Osakwana 5% odwala amakhala ndi mseru, kudzimbidwa, kapena mutu. Hypoglycemia sichimachitika kawirikawiri kuposa ndi placebo. Kuchulukanso mobwerezabwereza kwa transaminases kumawonekeranso, m'maphunziro ena pafupifupi 5% ya odwala adakhudzidwa.

Mlingo ndi bongo

Acarbose imapezeka m'mapiritsi a 100 mg. Mlingo woyambirira nthawi zambiri umakhala 50 mg katatu patsiku, mutatha sabata limodzi mpaka 2 mutha kugwiritsa ntchito pafupifupi 300 mg. Mlingo womwe ungakhalepo mpaka 600 mg / tsiku. Mapiritsi ayenera kumeza lonse ndi madzi musanadye.

Mankhwala amayenera kupangidwira payekhapayekha kuti apewe kupweteka kwambiri m'mimba. Pamavuto akulu, tikulimbikitsidwa kusintha zakudya ndipo mwina, muchepetsani mlingo wa mankhwalawo.

Ngati odwala amakonda mankhwala ochepera a monosaccharides nthawi zina patsiku, tikulimbikitsidwa kuti mankhwalawa asinthidwe. Odwala ochepera zaka 18, komanso amayi apakati ndi oyamwitsa sayenera kumwa mankhwalawa. Mankhwala, monga lamulo, ayenera kupewedwa ndi odwala omwe ali ndi matumbo osalekeza.

Malangizo ogwiritsira ntchito mankhwalawa

Kwa Acarbose, malangizo ogwiritsa ntchito amapereka zambiri zokhudzana ndi mphamvu ya mankhwalawa m'thupi.

Musanagwiritse ntchito, muyenera kuwerenga mosamala mankhwalawa komanso zovuta zomwe zingakhalepo.

Mankhwalawa amaperekedwa kuchokera ku malo ogulitsa mankhwala pokhapokha ngati pali mankhwala kuchokera kwa dokotala. Nthawi yomweyo, mtengo wamapiritsi umapezeka m'magulu onse a anthu.

Mlingo wovomerezeka wamankhwala umawerengeredwa potengera kulemera kwa thupi la wodwalayo. Pankhaniyi, gawo limodzi loyambirira m'magawo oyamba a chithandizo sayenera kupitirira milligram makumi awiri ndi zisanu. Mapiritsi ayenera kumwedwa katatu patsiku musanadye kapena panthawi ya chakudya chachikulu.

Ngati mulingo womwe suwonetsedwa sakubweretsa zabwino, mogwirizana ndi adotolo, akhoza kuwonjezereka mpaka kupitirira mamiligalamu mazana asanu ndi limodzi patsiku. Katswiri wa zamankhwala amadzisankhira yekha mankhwala malinga ndi momwe wodwalayo alili ndi chithunzi chake chonse chachipatala.

Sitikulimbikitsidwa kuwonjezera kuchuluka kwa okalamba, komanso omwe ali ndi vuto lachiwindi.

Mankhwalawa amayamba kukhudza ola limodzi atatha kumwa. Zochita zake zimatha kwa maola awiri. Ngati mankhwalawa adaphonya, palibe chifukwa chowonjezerera mulingo wotsatira. Acarose amaphatikiza bwino ndi sulfonylureas, zotumphukira za metformin kapena jakisoni wa insulin.

Njira ya mankhwala ndi mankhwala ayenera limodzi ndi kuvomerezedwa zakudya. Kupanda kutero, kudzimbidwa kumatha kuchitika.

Mankhwala ophimbawo ayenera kusungidwa kutentha, kupewa dzuwa.

Mtengo wa mankhwala umasiyana ndi ma ruble 350 mpaka 500 phukusi lililonse (mapiritsi 30 okhala ndi mulingo wa 50 mg).

Kuchita

Ma adsorbents ndi michere yamagaya amachepetsa mphamvu ya mankhwalawa. Odwala omwe amamwa mankhwalawa, zovuta zam'mimba zimawonedwa. Sikulimbikitsidwa kuphatikiza acarbose ndimankhwala osiyanasiyana otupa.

Ma analogues (othandizira) othandizira:

Lingaliro la madokotala odziwa bwino komanso odwala omwe amamwa mankhwala osokoneza bongo.

Dokotalayo adatilembera kalata yofunsira za mankhwalawo, malinga ndi momwe ndidatha kugula ku pharmacy. Ndimatenga miyezi ingapo ndikuwona kuti zofunikira pa glucometer zikuchepera. Mankhwala anga anapweteka pang'ono ndi nseru, omwe anasowa patatha sabata limodzi atalandira chithandizo.

Mankhwala a Hypoglycemic amachepetsa msanga kuchuluka kwa shuga m'magazi, osakhudza kapamba. Ubwino waukulu ndikusapezeka kwa zovuta zomwe zimagwiritsidwa ntchito mukamagwiritsa ntchito mankhwala ena. Kugwiritsa ntchito nthawi yayitali kumabweretsa kuchepa kwakukulu kwa glycemia.

Maxim Olegovich, katswiri wa matenda ashuga

Mtengo (mu Russian Federation)

Mankhwalawa pano amagwiritsidwa ntchito kwambiri kawirikawiri m'matenda a shuga. Ndi mlingo wa 300 mg wa acarbose, mtengo wa chithandizo ndi ma ruble 3000 pamwezi. Poyerekeza, mankhwalawa ndi glibenclamide (tsiku ndi tsiku mlingo: 7.5 mg wa mankhwala osokoneza bongo) amawononga ndalama zosakwana 1000 ruble pamwezi.

Uphungu! Musanagwiritse ntchito mankhwala aliwonse, muyenera kufunsa katswiri kuti mupewe mavuto. Kudzipatsa nokha koletsedwa. Kudzichitira wekha mankhwala kumatha kubweretsa zosakonzekera ndipo, nthawi zina, mavuto osasintha. Mwa ma alamu aliwonse, muyenera kufunsa uphungu wa dokotala.