Mankhwala Jardins: malangizo, ntchito, ndemanga, zithunzi, wopanga

Mankhwala atsopano a Jardins (empagliflozin) ochokera ku Eli Lilly & Company, omwe amagwiritsidwa ntchito pochiza matenda ashuga, amachepetsa kwambiri ngozi yakufa komanso kuchipatala kwa odwala omwe ali ndi matenda amtundu wa 2, omwe ali pachiwopsezo chachikulu cha kulephera kwa mtima - izi zidapezeka ndi ofufuza pa Novembala 9 ngati gawo limodzi la Msonkhano wapachaka wa American Heart Association (AHA), womwe udachitika kuyambira Novembara 7 mpaka 11, 2015 ku Orlando, Florida, USA.

Kafukufuku wogwiritsa ntchito Jardins, omwe adakhudza odwala 7,000 omwe ali ndi matenda a shuga a 2 komanso kulephera kwa mtima, omwe adachitika nawo gawo la Eli Lilly ndi Böhringer Ingelheim, adakhala zaka zitatu. Zotsatira zoyambirira za kafukufuku yemwe adalembedwa mu Seputembala chaka chino zidapangitsa chidwi: kumwa mankhwalawa kunachepetsa chiwerengero cha anthu omwe amafa ndi matenda a shuga komanso kulephera kwa mtima 32%.

Kafukufuku wofanananso wa mankhwala ena omwe amagwiritsidwa ntchito mu matenda a shuga amellitus adachitidwa kale, komabe, cholinga cha maphunziro awa chinali chowerenga zovuta zomwe zingakhalepo pamisempha yamtima.

Kuchokera lipoti lomaliza, lolengeza pa Novembala 9, zikutsatira izi: kutenga Jardins kumachepetsa chiopsezo chakugonekedwa m'chipatala chifukwa cholephera mtima ndi kufa chifukwa cha vuto la mtima 39% (poyerekeza ndi placebo).

Kulephera kwa mtima - mkhalidwe wopita patsogolo momwe mtima umataya mwayi wopopa magazi okwanira, ndiye chifukwa chachikulu chogonekera kuchipatala ndi kufa.

"Sizachilendo komanso zolimbikitsa kupeza mankhwala ochizira matenda ashuga, omwe samakhudza mtima wamtima zokha, komanso amachepetsa chiopsezo chakugonekedwa m'chipatala chifukwa cholephera mtima"A Dr. Silvio Inzucchi, wolemba malipoti. "Zotsatira zabwino zotenga odwala a Jardins, tidalemba pafupifupi atangoyamba kuphunzira"Ananenanso.

Odwala omwe ali ndi matenda ashuga amakonda kupunduka kawiri mpaka katatu kuposa omwe alibe matenda ashuga, asayansi akuti: pafupifupi theka la omwalira mwa odwala matenda amtundu wa 2 amayamba chifukwa cha nthenda ya mtima, ndipo chiwopsezo cha matenda a mtima chimachepa Matenda a mtima amatengedwa ngati chinthu chofunikira kuchizira matenda ashuga.

Dr. Inzucci, akuti: "Jardins akuwonekeratu kuti akhoza kuthandiza odwala matenda ashuga omwe ali ndi matenda a shuga atayamba kale . Tiyenera kudziwa mfundo imeneyi tikamasankha njira zina zochizira matendawa. ”.

Jardins (Jardiance, Empagliflozin) - mankhwala osokoneza bongo a hypoglycemic monga mapiritsi, amatengedwa kamodzi patsiku, omwe akuimira kalasi yatsopano ya zoletsa zam'kamwa za sodium glucose cotransporter mtundu 2 (SGLT2).

Kuchita kwa Jardins cholinga chake ndikulepheretsa kusungidwenso kwa glucose mu chiphuphu cha impso - glucose-wosasefa wa impso osabweranso kulowa m'magazi ndi kuthira mkodzo. SGLT2 imaphatikizanso Invokana kuchokera kwa Johnson & Johnson ndi Farxiga kuchokera ku AstraZeneca.

Kufufuza ndi a Jardins

Kafukufuku wazotsatira za Jardins wodwala yemwe ali ndi vuto la mtima adachitidwa ndi asayansi a Yale motsogozedwa ndi Silvio Inzucci. Kuchokera pazotsatira zomwe kafukufuku wakale anachita, izi: Mankhwala omwe amagwiritsidwa ntchito pochiza matenda osokoneza bongo samakhudza mtima, ndipo kugwiritsa ntchito mankhwala ndi odwala matenda ashuga sikuvomerezeka nthawi zonse. Zotsatira za SGLT2 zoletsa, zomwe Jardins ali, sizinaphunzire mpaka posachedwa.

Maphunzirowa anali okhudza odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi chiopsezo chotenga matenda a mtima. Kuphatikiza pa chithandizo chamankhwala, odwala ena amatenga Jardins tsiku lililonse, pomwe ena amatenga placebo (m'malo mwa Jardins).

Zotsatira zakuwonetsa zinawonetsa: mwa odwala omwe akutenga Jardins, kuchepa kwa thupi, shuga m'magazi amabwerera kwazonse, ndipo kuthamanga kwa magazi kunakhazikikanso pamitengo yoyenera. Odwala omwe amatenga Jardins anali 35% yochepa kwambiri pakufunika kuchipatala komwe kumayenderana ndi kulephera kwa mtima, chiwopsezo cha kufa ndi kuchipatala chifukwa cha matenda amtima chatsika ndi 34%.

Matenda a shuga

Matenda a shuga, matenda ashuga, matenda a shuga ndi gulu lamatenda amtundu wa endocrine omwe amadziwika ndi matenda a hyperglycemia (shuga wamagazi) kwambiri, chifukwa cha mtheradi (shuga 1) kapena wachibale (shuga 2) kuperewera kwa insulin ya pancreatic. mitundu yonse kagayidwe: chakudya, mafuta, mapuloteni, mchere wamchere ndi mchere. Mabwenzi okhazikika a shuga ndi glucosuria (glycosuria, glucose mu mkodzo), acetonuria (acetone mu mkodzo, ketonuria), nthawi zambiri sa hematuria (magazi obisika mumkodzo) komanso mapuloteni mu mkodzo (proteinuria, albuminuria).

Mtundu wachiwiri wa matenda a shuga a mtundu wachi 2 (matenda ashuga a 2, osadalira insulini) ndi nthenda yopanda autoimmune yodziwika ndi wachibale insulin akusowa chifukwa kuphwanya mogwirizana kwa insulin ndi maselo minofu. Type 2 matenda a shuga amayamba mwa anthu opitirira 40 omwe ali onenepa kwambiri.

Matenda a shuga a shuga adaganiziridwa kwa nthawi yayitali kuti sakhala ngati endocrine pathology, koma ngati matenda omwe amakhudza mtima ndi mtima.

Kulephera kwa mtima

Kulephera kwa mtima ndi matenda opatsirana omwe amachitika chifukwa cha kupweteka kwambiri kwa minofu ya mtima, komwe kumapangitsa kuti magazi asakwanitse kuziperekanso minofu ya thupi. Lakuthwa Kulephera kwa mtima kumagwirizanitsidwa ndi kuvulala, zotsatira za poizoni, matenda amtima, popanda kulandira chithandizo chokwanira kumatha kubweretsa imfa.

Matenda kulephera kwa mtima kumayamba kwakutali, kuwonetseredwa ndi kutopa kochulukirapo, kupuma movutikira ndi edema chifukwa chosakwanira mafuta a ziwalo ndi minyewa komanso kusungika kwa madzi mthupi.

Zolemba

Zolemba ndi kumveketsa bwino nkhani "Jardins amathandiza ndi mtima kulephera."

• Böhringer Ingelheim (Boehringer Ingelheim) ndi kampani yaboma yopanga mankhwala, yomwe imayang'aniridwa mumzinda wa Ingelheim (Germany), kuyambira Meyi Meyi, ikuphatikizidwa ndi TOP-20 yamakampani opanga mankhwala padziko lonse lapansi. Böhringer Ingelheim amapanga mankhwala othandizira khansa, mtima, matenda opatsirana, matenda a Parkinson, HIV, matenda amisala, thromboembolism, hepatitis ndi matenda a shuga. M'madera omwe kale anali USSR, kampaniyo imagwira ntchito ku Russia, Ukraine, Belarus ndi Kazakhstan.
• Pafupifupi 50% ya odwala omwe adatenga nawo kafukufukuyu adatenga insulini, chomwe ndi chizindikiro cha matenda apamwamba.
• Zoletsa, reaction inhibitor (kuchokera ku Latin chikhala - "Kuchedwa, gwiritsitsani, siyani") - dzina lambiri la zinthu zomwe limaletsa kapena kuponderezana ndi zochita za physico-chemical kapena zokhudza thupi (makamaka enzymatic).

Kuletsa kapena kupewa kutulutsa kumachitika chifukwa chakuti cholepheretsa chimalepheretsa malo omwe amathandizira kapena imakhudzana ndi tinthu tomwe timapanga kuti tipeze zochita zotsika kwambiri.

Polemba nkhani kuti Jardins amathandiza odwala omwe ali ndi matenda a shuga a 2 komanso kulephera kwa mtima, zida kuchokera kuzidziwitso ndi makanema azachipatala azachipatala, tsamba la ScienceDaily.com, News.Yahoo.com, ReutersHealth.com, Mtima udagwiritsidwa ntchito ngati magwero. org, Volgmed.ru, Med.SPBU.ru, Wikipedia, komanso zofalitsa zotsatirazi:

• Henry M. Cronenberg, Shlomo Melmed, Kenneth S. Polonsky, P. Reed Larsen, "Matenda a shuga ndi matenda a carbohydrate metabolism". Nyumba yosindikiza "GEOTAR-Media", 2010, Moscow,
• Peter Hin, Bernhard O. Boehm Kuzindikira, chithandizo, matenda. ” Nyumba yosindikiza "GEOTAR-Media", 2011, Moscow,
• Moiseev V.S., Kobalava J.D. "Kulephera kwa mtima." Publishing House, 2012, Moscow.

Kufotokozera za mawonekedwe ndi mawonekedwe ake

Mankhwala "Jardins" (onani chithunzi phukusi pamwambapa) akupezeka mu mawonekedwe a mapiritsi ozungulira a biconvex ophatikizidwa ndi filimu yamafuta. Akapakidwa chikasu. Chofunikira chachikulu cha mankhwalawa ndi empagliflozin. Mankhwala omwe ali ndi Mlingo wosiyanasiyana amapezeka pamsika wamakono wamankhwala - 10 kapena 30 mg wa chinthu chogwiritsidwa ntchito akhoza kukhala piritsi limodzi.

Mwachilengedwe, zida zina zothandizira zilipo mu mankhwalawa. Makamaka, lactose, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, anhydrous colloidal silicon dioxide, hydroxypropyl cellulose. Ulusi wamakanema womwe umakhala ndi macrogol 400, hypromellose, oxide wachikasu, titanium dioxide ndi talc.

Chachikulu pharmacological zimatha mankhwala

Nthawi zambiri pamankhwala amakono, mankhwalawa "Jardins" amagwiritsidwa ntchito. Ndemanga za akatswiri amati mankhwalawa atha kukwaniritsa bwino. Koma kodi mankhwalawa amakhudza bwanji thupi la munthu?

Empagliflozin ndiosankha, kusintha, kugwiritsa ntchito mphamvu yampikisano ya mtundu wachiwiri wa transporter yodalira shuga. Kafukufuku akuwonetsa kuti izi zimapangitsa chiwongolero cha glycemic mwa odwala omwe ali ndi matenda amtundu wa 2. Empagliflozin amachepetsa kuchuluka kwa shuga m'impso. Monga mukudziwa, kuchuluka kwa glucose amene amachotseredwa ndi impso zimatengera kukhazikika kwake m'magazi, komanso kuchuluka kwa kusefedwa kwa glomerular. Odwala omwe amatenga mapiritsiwa, kuchuluka kwa shuga komwe kumachitika ndi mkodzo kumawonjezeka. Chifukwa chake, mankhwalawa amathandizira kuchepetsa shuga m'magazi odwala omwe ali ndi matenda a shuga 1.

Kapangidwe kake ka mankhwalawo mwanjira iliyonse sikudalira mphamvu ya insulin kapena ntchito ya maselo a beta, chifukwa chake chiopsezo cha hypoglycemia ndi chochepa. Zidadziwikanso kuti mankhwalawa amathandizira kugwira ntchito kwa maselo a beta, komanso amathandizira pakuwotcha mafuta, kumabweretsa kuchepa kwa thupi, komwe kumawoneka kuti ndikothandiza ngati wodwala wambiri.

Pharmacokinetics ndi zambiri zowonjezera

Pali chiwerengero chambiri cha mankhwala a pharmacokinetics a mankhwalawa omwe amapezeka kudzera m'maphunziro a labotale (odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo adatenga nawo mbali).

Pambuyo pa makonzedwe, chinthu chachikulu chogwiritsa ntchito mankhwalawa chimalowa mwachangu, kulowa mkati mwa makhoma am'mimba. Kuzindikira kwakukulu m'magazi a wodwala kumawonekera pambuyo pa maola 1-1,5 pambuyo pa kuperekedwa. Zitatha izi, kuchuluka kwa mphamvu ya plagma kumachepa - choyamba pali gawo logawa mwachangu lamankhwala, kenako pang'onopang'ono nthawi yomaliza yogwira ntchito.

Pa maphunziro, zidadziwika kuti kuchuluka kwa kayendedwe kazinthu zomwe zimapangitsa kuti mphamvu ya empagliflozin iwonjezeke ndi kuchuluka kwa mankhwalawa. Mayeso adawonetsanso kuti ngati mumwa mankhwalawo ndi mafuta apamwamba, chakudya chamafuta, mphamvu yake imachepetsedwa. Komabe, kusinthaku sikofunikira mwakuthupi, chifukwa chake mapiritsi amatha kudyedwa mosasamala zakudya.

Chithandizo chogwira mankhwalawa ndi 86% chomangiriridwa kumapuloteni a plasma.Pa kafukufukuyu, ma metabolites atatu a glucuronide anapezeka m'magazi a anthu, koma dongosolo lawo silinali loposa 10% ya kuchuluka konse kwa empagliflozin.

Hafu yamoyo theka la mankhwalawa ndi pafupifupi maola 12-12,5. Ngati odwala amatenga mapiritsi kamodzi patsiku, ndiye kuti khola lomwe limakhazikika m'magazi limawonedwa pambuyo pa mlingo wachisanu. Monga tanena kale, mankhwalawa samapanga metabolites. Ambiri a iwo amachotseredwa pamodzi ndi ndowe, zina zonse - ndi impso ndi mkodzo, komanso osasinthika.

Komanso pakufufuza, zidatsimikizika kuti kulemera kapena jenda la wodwala limakhudza zotsatira za mankhwalawa. Kuyesa pa gulu la odwala omwe ali ndi zaka zopitilira 85, komanso pakati pa ana ndi achinyamata, sizinachitike, chifukwa chake palibe chidziwitso chachitetezo cha mankhwalawa pamagulu omwe atchulidwa a odwala.

Ngakhale limagwirira ntchito mankhwala, kupambana kwa mankhwala zimadalira makamaka pa impso. Ichi ndichifukwa chake musanayambe kumwa mapilitsi, ndikofunikira kuyeserera kwathunthu kwa mayeso, komanso mayeso a mkodzo. Macheke otere amayenera kubwerezedwa nthawi ndi nthawi pamankhwala (osachepera kamodzi pachaka). Kuphatikiza apo, kuyezetsa kuyeneranso kumwedwa ngati mankhwala atsopano adalowetsedwa mu kagwiritsidwe kamankhwala. Ndizoyenera kunena kuti mwa odwala omwe amamwa mankhwalawa, mu wowerengeka kuphunzira mkodzo, kuyesedwa kwa shuga kudzakhala kotsimikizika - izi ndizabwinobwino, chifukwa zimagwirizanitsidwa ndi zadzidzidzi zomwe zimachitika chifukwa cha mphamvu ya empagliflozin.

Mpaka pano, palibe chidziwitso chokhudza momwe mankhwalawa amakhudzira thupi la mayi woyembekezera komanso mwana wosabadwa, komanso ngati zomwe zimagwira zimalowa mkaka wa m'mawere.

Zizindikiro zazikulu za kumwa mankhwalawo

Ndi liti pamene muyenera kumwa mankhwala a Jardins? Malangizo ogwiritsira ntchito akuwonetsa kuti mankhwala amakono, mankhwala amagwiritsidwa ntchito pazotsatirazi:

• mtundu 2 shuga
• kusintha ndi kuwongolera kwa glycemia mwa okalamba odwala.

Monotherapy imachitika ngati sizotheka kuyendetsa glycemia mwa odwala ngakhale atakhala ndi zakudya zoyenera komanso ndandanda yoyenera yochita masewera olimbitsa thupi, pazifukwa zosiyanasiyana, kugwiritsa ntchito metformin sikutheka (mwachitsanzo, chifukwa cha tsankho la munthu payekha).

Monga gawo la zovuta mankhwala, mankhwalawa amagwiritsidwa ntchito limodzi ndi insulin komanso mankhwala ena a hypoglycemic, ngati njira yoyambira yothandizira, kudya moyenera komanso kuchita zolimbitsa thupi sikungathandize wodwalayo kuti azidwala.

Mulimonsemo, ndikofunikira kukumbukira kuti ndi dokotala yekha yemwe angalowe mapiritsi awa munthawi ya mankhwala. Kugwiritsa ntchito molakwika mankhwalawa kumatha kukulitsa vutoli, ndipo ngati nthenda yofanana ndi matenda a shuga, imatha kubweretsa zovuta.

Mankhwala "Jardins": malangizo ogwiritsira ntchito

Mwachilengedwe, nkhani yofunika ndi njira yodalitsira mapiritsiwo. Ndi dokotala yekhayo amene angasankhe mlingo woyenera wa Jardins. Malangizo ogwiritsira ntchito ali ndi malingaliro ofunikira.

Monga lamulo, odwala amalangizidwa kuti atenge 10 mg ya empagliflozin kamodzi patsiku - izi zimagwira ntchito palimodzi komanso kuphatikiza monotherapy. Nthawi zomwe thupi la wodwalayo limalekerera bwino mankhwalawo, koma mlingo wamba sapereka zotsatira zomwe zikufunikira, kuchuluka kwake tsiku ndi tsiku kumatha kukwera mpaka 25 mg. Palibe piritsi limodzi lomwe limaloledwa patsiku.

Mwachilengedwe, mlingo umasinthidwa ndi dokotala kutengera momwe wodwalayo alili, msinkhu wake, komanso, momwe amathandizira. Komanso dziwani za mankhwala ena omwe munthu amamwa.

Mutha kumwa mapiritsi onse m'mawa m'mimba yopanda kanthu ndipo pambuyo pake, mukatha kudya, popeza njira zamagaya sizikhudza mayamwidwe ndi kugawa kwa zinthu zomwe zimagwiritsidwa ntchito ndi mankhwala.

Kutalika kwa mankhwalawa kumatengera momwe wodwalayo alili, kuchuluka kwa shuga m'magazi. Nthawi zina dokotala amatha kuletsa mankhwala pambuyo pakutsatira kwa hyperglycemia. Nthawi zina, mapiritsi amatengedwa kwa nthawi yayitali, ndipo nthawi zina makonzedwe amachitika m'maphunziro. Itha kutsimikizidwanso pokhapokha ngati dokotala amapezekapo malinga ndi momwe amathandizira, komanso zotsatira za mayeso omwe anakonzekera.

Kodi pali choletsa china chilichonse pakuvomerezedwa? Kuphwanya kwakukulu

Sikuti odwala onse amaloledwa kulandira mapiritsi a Jardins. Malangizowo akuwonetsa kuti mankhwalawa ali ndi zotsutsana zingapo. Muyenera kudziwa bwino mndandanda wawo musanayambe mankhwala, chifukwa zingachitike zovuta zina. Chifukwa chake, mankhwalawa sangathe kugwiritsidwa ntchito pazinthu zotsatirazi:

• mtundu 1 shuga
• kukhalapo kwa matenda ashuga a ketoacidosis,
• mankhwala "Jardins" sanalembedwe pamaso pa hypersensitivity aliyense mwa zigawo za zigawozi (onetsetsani mawonekedwe ake musanatenge),
• Contraindication imaphatikizapo matenda ena achilendo omwe amabadwa nawo, mwachitsanzo, tsankho la lactose, glucose-galactose malabsorption, kuchepa kwa lactase (enzyme yomwe imaphwanya mamolekyulu a lactose), etc.
• Munthawi zina kulephera kwa impso, mapiritsi awa nawonso sagwiritsa ntchito, chifukwa alibe mphamvu,
• mankhwalawa ali ndi zoletsa zaka zina, makamaka, sizolembedwa kwa odwala azaka zosaposa 18, popeza maphunziro omwe adachitika ndi gululi sanachitike, mankhwalawa amaletsedwanso kwa anthu achikulire (zaka 85),
• Mankhwala angayambitse kutsika kwakukulu kwa kuthamanga kwa magazi, chifukwa chake matenda ena amtima amadziwika kuti akuponderezedwa,
• Pa nthawi yobereka komanso yoyamwitsa, mankhwalawo saloledwa kumwa, popeza kuchuluka kwa matendawa nthawi imeneyi kwa moyo wa mayi sikumafotokozedwa.

Mankhwala "Jardins" ali ndi zomwe zimatchedwa kuti contraindication. Izi zikutanthauza kuti kumwa mankhwalawa ndizotheka, koma kuyang'aniridwa ndi achipatala okhawo, popeza pamakhala chiwopsezo cha zovuta. Pangozi ndi omwe ali pachiwopsezo cha kukhala ndi hypovolemia. Komanso mapiritsi amagwiritsidwa ntchito mosamala ndi insulin yopanga.

Contraindication zothandizira zimaphatikizira matenda am'mimba, omwe amathandizidwa ndi kutaya kwamadzi (kutsegula m'mimba, kusanza). Mapiritsi amalembedwa mosamala pamaso pa zotupa zamtundu wa genitourinary system. Odwala opitilira zaka 75 azithandizanso kuwayang'anira. Mulimonsemo, muyenera kumuwuza dokotalayo za kukhalapo kwa matenda ena - mwanjira imeneyi katswiri ndi amene angakupatseni njira yotetezedwa bwino kwambiri.

Zotheka zimachitika

Si chinsinsi kuti mankhwala ambiri nthawi zina amatha kuyambitsa mavuto osiyanasiyana. Ndiye kodi pali ngozi yowonetsera zovuta mukamamwa mankhwala "Jardins"? Malangizowo akuwonetsa kuti zovuta zina ndizotheka. Nayi mndandanda wazotsatira zoyipa kwambiri:

• Chomwe chimachitika kwambiri ndi hypoglycemia, ngakhale imadziwonetsera motsutsana ndi maziko a munthawi imodzimodzi yopanga mphamvu ya empagliflozin yopanga insulin kapena zotumphukira za sulfonylurea.
• Nthawi zina, pamankhwala, odwala amatenga matenda opatsirana komanso ma parasitic, makamaka, venvovaginitis, balanitis, vagidi candidiasis, komanso matenda ena amtundu wa genitourinary thirakiti.
• Kuchokera kumbali ya metabolism, osati hypoglycemia yokha, komanso hypovolemia imatha kukulira.
• Odwala ena adadandaulanso kukokana pafupipafupi.
• Mwa odwala okalamba, kuchepa magazi kunkachitika nthawi zambiri.

Izi ndi zovuta zazikulu zomwe mapiritsi a Jardins angayambitse. Ndemanga, komabe, zikuwonetsa kuti zovuta zoyipa ndizosowa kwambiri. Komabe, ngati mungazindikire kuwonongeka kulikonse mukamalandira chithandizo, muyenera kufunsa dokotala. Mwinanso kusintha kosavuta kwa mankhwalawa kungakhale kokwanira kuti muchotse zotsatira zoyipa. Komabe, nthawi zina ndikofunikira kusiya kumwa mankhwalawo, ndikusintha ndi mankhwala ena.

Zambiri pazokhudzana ndi mankhwala ena

Kodi mankhwalawa "Jardins" amagwirizana bwanji ndi mankhwala ena? Ndemanga za madotolo zikuwonetsa kuti ndi mankhwala omwe adapangidwira moyenera, chiwopsezo cha odwala ndi chochepa. Komabe, zigawo zikuluzikulu za mankhwalawa limodzi ndi zinthu zina zimakhudza thupi la munthu m'njira zosiyanasiyana:

• Mankhwalawa nthawi zina amalimbikitsa mphamvu yokongoletsera ya otchedwa "loop" ndi thiazide diuretics. Chifukwa chake, pamakhala chiwopsezo cha kuchepa madzi m'thupi ndipo, monga chotulukapo chake, chitukuko cha hyperial hypotension.
• Chifukwa chakuti odwala amatha kuchepa magazi, kuphatikiza kwa mankhwalawa kuti muwonjezere magazi ndi mapiritsi a Jardins ndikosayenera. Ndemanga za madotolo, komabe, zikuwonetsa kuti mulingo woyenera wa mankhwalawa onse amachepetsa ngozi.
• Monga tanena kale, kugwiritsa ntchito mankhwalawa munthawi yomweyo ndi insulin yopanga ndi mankhwala omwe amachititsa kuti chinsinsi cha mahomoni m'thupi la munthu chibadwire chingayambitse kukula kwa hypoglycemia. Zikatero, kuyang'anira mosamala ndi kusintha kwa mankhwalawo kumafunikiranso.

Mankhwala "Jardins": ma fanizo ndi othandizira

Kupatula odwala onse, mankhwalawa ndi oyenera. Pazifukwa zingapo, anthu amakana kugwiritsa ntchito mankhwalawa "Jardins." Ma synonyms a mankhwalawa mwachilengedwe amakhalapo. Komanso, msika wamakono wamankhwala umapereka mankhwala osiyanasiyana omwe amakhudza thupi motere.

Mwachitsanzo, nthawi zambiri, odwala amapatsidwa mankhwala osokoneza bongo monga Bayeta ndi Viktoza. Mwa njira, awa ndi omwe amalowa m'malo abwino kuchokera ku kampani yodziwika bwino yaku Germany. Nthawi zina odwala amamuika mankhwala a Guarem m'migulu yamagetsi. Palinso mankhwala ena omwe amatha kulowa m'malo mwa Jardins. Ma analogi ake ndi magome a "Attokana", "Novonorm" ndi "Repodiab".

Ngakhale pali ena ambiri otengera mmalo, mulibe chifukwa chodzilingalira. Ndi dokotala yekha amene amadziwa mbiri yanu yamankhwala omwe angapeze analogue yabwino, yothandiza komanso yotetezeka. Apanso, ndikofunikira kubwereza kuti matenda ashuga ndi matenda oopsa, ndipo kugwiritsa ntchito mankhwala osokoneza bongo pamenepa kungayambitse zovuta zambiri, ngakhale kufa.

Kodi mankhwalawo ndi angati?

Si chinsinsi kuti kwa odwala ambiri mtengo wamankhwala ena ndi wofunikira kwambiri. Tiyenera kumvetsetsa kuti manambala pamilandu iyi amatengera zinthu zambiri. Mwachitsanzo, ndikofunikira kuganizira kuchuluka ndi kuchuluka kwa mapiritsi omwe ali phukusili, mzinda wokhalamo wodwalayo, mfundo zachuma zamankhwala ndi othandizira, etc.

Mankhwala "Jardins" (wopanga - "Beringer Ingelheim Pharma") ndi mulingo wa 10 mg wothandizila ungagule 2000-2200 ma ruble 30. Ngati tikulankhula za mankhwala omwe ali ndi Mlingo wa 25 mg, ndiye kuti mtengo wake udzakhala wokwera pang'ono, kuyambira 2100 mpaka 2600 rubles. Phukusi lokhala ndi mapiritsi 10 limakhala lotsika mtengo, mtengo wake umachokera ku 800 mpaka 1000 rubles. Tsopano muli ndi mwayi wopanga bajeti yoyenerana ndi mankhwalawa a Jardins. Wogwiritsa ntchito mankhwala osokoneza bongo, mwa njira, amatha ndalama zambiri. Komabe, mtengo wa mankhwala ena ofanana ndiwotsika pang'ono. Mulimonsemo, ndikofunikira kuyang'ana osati mtengo wake, komanso zomwe zingachitike chifukwa cha mankhwalawo, chifukwa thanzi limakhala ndi ndalama zilizonse.

Ndemanga za madokotala ndi odwala za mankhwalawa

Zachidziwikire kuti anthu ambiri amadziwa kuti, mutakhala ndi chidwi ndi lingaliro la odwala omwe atha kuphunzitsidwa kale, mutha kupeza zidziwitso zambiri zothandiza. Nanga akuti chiyani za mankhwala a Jardins? Ndemanga za madokotala nthawi yayitali. Inde, mapiritsi amathandizira kuteteza kagayidwe, kusintha mkhalidwe wa odwala. Malinga ndi kafukufuku wa ziwerengero, zoyipa pamankhwala zimachitika nthawi zambiri, ndipo mutha kuzipewa mwa kungosintha mlingo.

Odwala nawonso amakonda mankhwala a Jardins. Zowunikirazi ndi zabwino, popeza dongosolo la kudya ndilosavuta, ndipo zotsatira zabwino zimawoneka bwino kwambiri. Mapiritsiwa amakwaniriradi miyezo yapamwamba yaukadaulo waku Germany. Zoyipa za mankhwalawa zimaphatikizapo mtengo wotsika mtengo, chifukwa ma analogu ena ndi otsika mtengo kwambiri. Kumbali inayo, mankhwala ofanana ndi omwe amapanga ku Europe nthawi zina amatenga mtengo wawiri, kapena katatu wotsika mtengo.

Mulimonse momwe zingakhalire, ndikofunikira kumvetsetsa kuti Jardins ndi mapiritsi omwe amathandizira thupi kugwira ntchito yofanana ndi matenda a shuga 2, koma sangathetse matenda oopsawa. Kudzipatsa mankhwala panthawiyi ndikosayenera, choncho musaiwale kuti ndikofunikira kutsatira malingaliro onse ndi malangizo a adotolo. Kugwiritsa ntchito moyenera mankhwalawa kumathandizira kuwongolera kuchuluka kwa shuga m'magazi ndipo, motero, kusintha moyo wamunthu wodwala matenda ashuga.

Jardins: malangizo ogwiritsira ntchito

Nthawi zambiri, impso zimayamba kupaka shuga limodzi ndi mkodzo kuchokera mthupi pamene kukhazikika kwake m'magazi kumafikira 9-11 mmol / L. Kumwa mankhwala Jardins kumathandizira kuti glucose ayambe kuwonetsedwa ndi impso ngakhale pamene kuchuluka kwake m'magazi kumafikira 6-7 mmol / l.
Izi zimakupatsani mwayi kuti shuga musakhale ochepa kwambiri mukatha kudya komanso pamimba yopanda kanthu.
Empagliflozin yokha simadziunjikira m'thupi ndikusiya mothandizidwa ndi machitidwe amkodzo ndi hepatobiliary.

Mukamwa mankhwala

Jardins amalembedwa kwa odwala omwe ali ndi matenda a shuga 2, ngati kuli kotheka kuwongolera matendawa mothandizidwa ndi zakudya komanso zolimbitsa thupi.
Jardins angagwiritsidwe ntchito mu pulogalamu yovuta yochiritsira yokhala ndi jekeseni wa metformin ndi insulin. Komabe, ndizosavomerezeka kuphatikiza ndi agonists okonda gluc-peptide-1 receptor agonists (Baeta, Trulicity, Lixumia, Victoza).

Kodi osavomera

Zotsatira za kumwa mankhwala:

• Mtundu woyamba wa shuga.
• Matenda a shuga ketoacidosis.
• Kusokonezeka kwa ntchito ya impso ndi kuchepa kwa kuchepa kwa msambo wa glomerular pansi pa 45 ml / min.
• Kusalolera payekha pazinthu zomwe zimapanga mankhwala.
• Age ali ndi zaka 18.

Palinso mikhalidwe yomwe Jardins amalembedwa mosamala.
Izi zikuphatikiza:

• Zaka zopitilira 75.
• Kugwirizana ndi zakudya zotsika kwambiri za carb.
• Kuthamanga kwa magazi.
• Kuwonongeka kwa genitourinary system ndi matenda opatsirana.
• Kuthetsa madzi m'thupi

Zomwe muyenera kulabadira mwapadera

Jardins, akatengedwa limodzi ndi jekeseni wa sulfonylurea kapena jakisoni wa insulin, amatha kuchititsa kuti hypoglycemia. Zizindikiro za matendawa ndizosiyanasiyana. Munthuyo akhoza kukulitsa mantha, mtima umayamba kugunda pafupipafupi. Wozunzika kwambiri, amagwa chikomokere ndipo amwalira.

Pa magawo oyambirira a chithandizo patsiku, ndikokwanira kumwa 10 mg ya mankhwalawa. M'tsogolomu, adotolo amatha kuonjezera mlingowu mpaka 25 mg, koma pokhapokha ngati zotsatira zomwe sizinachitike sizinachitike.
Muyenera kumwa piritsi limodzi patsiku. Izi zikuyenera kuchitika nthawi yomweyo, osasamala chakudyacho.

Kumwa mankhwalawa sikungayambitse kugwa kwamphamvu m'magazi, ngati sikuphatikizidwa ndi mankhwala ena omwe amawotcha shuga.
Zotsatira zoyipa za mankhwala Jardins akuphatikizapo:

• Chiwopsezo cha pyelonephritis.
• Chiwopsezo chotenga matenda obwera chifukwa cha maliseche.
• Kuchulukitsa ludzu.
• Kuchulukitsa pokodza.
• Kuopsa kwa kusowa kwamadzi.
• Kutsitsa magazi.
• Chizungulire

Kuyamwitsa ndi kubereka mwana

Pa nthawi yoyembekezera komanso nthawi yoyamwitsa, mankhwalawa amaletsedwa kugwiritsa ntchito. Ngati mayi akakhala ndi matenda ashuga, ayenera kumwa ma jakisoni ang'onoang'ono a insulin.

Kuphatikizika kwa mankhwala ndi mankhwala ena

Ndi osavomerezeka kumwa mankhwalawa ndi mankhwala okodzetsa.
Pogwiritsa ntchito munthawi yomweyo Jardins wokhala ndi zotumphukira za sulfonylurea komanso insulin, mwayi wokhala ndi hypoglycemia ukuwonjezeka.
Ndi mankhwala ena, Jardins satenga. Komabe, musanayambe chithandizo, muyenera kufunsa dokotala.

Ngati munthu wamwa mankhwala ambiri, ndiye kuti ayenera kupita kuchipatala kuti akalandire chithandizo. Kuphatikiza pa kuwonjezeka kwa kutulutsa mkodzo, palibe zovuta zina zomwe zidanenedwapo.

Kutulutsa mawonekedwe, malo osungira ndi kapangidwe kake

Mankhwala amamasulidwa mu mawonekedwe a piritsi ndi mlingo wa 10 ndi 25 mg. Maziko a mankhwalawa ndi empagliflozin. Zothandiza: cellulose, lactose monohydrate, magnesium stearate, colloidal silicon dioxide, hypromellose, titanium dioxide, talc, macrogol 400, yellow oxide.
Mankhwala safuna malo osungirako apadera. Ziyenera kutsimikiziridwa kuti mwana samamulandira. Moyo wa alumali ndi zaka zitatu.

Zotsatira zoyipa zomwe amatenga Jardins ndikukula kwamatenda amtundu wa mycotic, kutupa kwa impso ndi chikhodzodzo. Komanso, kuchotsa pyelonephritis kumakhala kovuta kwambiri ndipo mankhwala opha maantibayotiki sakhala opambana nthawi zonse. Ndizovuta kunena kuchuluka kwa Jardins ndi fanizo lake (Forsig, Invokana) ndi mankhwala otetezeka, chifukwa amagwiritsidwa ntchito posachedwa.

Kuphatikiza pa zovuta zazikulu zaumoyo, odwala omwe akutenga Jardins amakumananso ndi mavuto ena ochepa. Izi zimagwira ntchito popita kuchimbudzi, kutsika magazi. Chifukwa chake, musanaganize za chithandizo chotere, muyenera kuyeza limodzi ndi adokotala zifukwa zonse zotsutsana ndi.

Kodi ndingalowe bwanji m'malo a Jardins?

Choyamba muyenera kuyesa kusintha shuga m'magazi anu ndi zakudya zama carb ochepa ndikuwonjezera zolimbitsa thupi. Kuthamangira, kuyenda, kukonza zambiri zaumoyo, mutha kuchita zolimbitsa thupi. Mutha kulowetsa Jardins ndikukonzekera metformin (Glucophage, etc.). Ngati kumwa mankhwala otentha shuga sikulola kuti mulamulire kwathunthu shuga, ndiye kuti mutha kuwonjezera mankhwalawo ndi jakisoni wa insulin.

Kodi ma jardins ndi metformin angaphatikizidwe?

Jardins angathe kumwedwa limodzi ndi kukonzekera kwa metformin. Komabe, ndibwino kuyambitsa chithandizo ndi mankhwala amodzi. Metformin iyenera kukondedwa, chifukwa siyimayambitsa zovuta komanso yakhala ikugwiritsidwa ntchito pochiza matenda ashuga zaka zambiri. Chisankho chokomera Jardins chikuyenera kupangidwa pokhapokha ngati wodwalayo sangathe kutenga metformin.

Kodi ndizotheka kuphatikiza kugwiritsa ntchito mankhwala Jardins ndi mowa?

Ponena za ngati zingatheke kuphatikiza kuphatikiza kwa mankhwala a Jardins ndi mowa, palibe chilichonse chodziwika. Chifukwa chake, munthu amene amamwa mowa pachidwi cha mankhwalawa amaika moyo wake pachiswe. Malangizo a boma alibe chilichonse.

Za adotolo: Kuyambira 2010 mpaka 2016 Othandizira pachipatala chachipatala chapakati chaumoyo Na. 21, mzinda wa elektrostal. Kuyambira mu 2016, agwira ntchito ku malo ozindikira matenda No. 3.

Zifukwa 20 zodya nthanga za nthungu - mbewu zabwino kwambiri padziko lapansi - tsiku lililonse!

Zabodza 9 pazakudya zochepa za carb

Matenda a shuga ndi kuphwanya kagayidwe kazakudya zomanga thupi ndi madzi mthupi. Zotsatira zake ndi kuphwanya ntchito za kapamba. Ndiye kapamba yemwe amatulutsa timadzi timene timatchedwa insulin. Insulin imakhudzidwa pokonza shuga. Ndipo popanda icho, thupi silingakwanitse kusintha kwa shuga kukhala shuga.

Chithandizo chothandiza kwa matenda ashuga ndi kulowetsedwa kwa zitsamba zamankhwala. Kuti mukonzekere kulowetsedwa, tengani theka kapu ya masamba a masamba, supuni ya maluwa ocheperako ndi supuni ziwiri za masamba a quinoa. Thirani zonsezi ndi madzi okwanira 1 litre a madzi owiritsa kapena owonekera. Kenako sakanizani bwino ndikupaka masiku 5 pamalo owala.

Ambiri amanyalanyaza kufunikira kwa zakudya zoyenera mu zovuta zamankhwala zilizonse. Pankhani ya matenda ashuga, makamaka mtundu wachiwiri, izi siziyenera kutsutsidwa konse. Kupatula apo, zimakhazikitsidwa ndi vuto la metabolic, lomwe limayambitsidwa ndendende ndi zakudya zosayenera.

Osangokhala shuga mu lingaliro lokhazikika la mawu omwe ali ndi chiwopsezo kwa odwala matenda ashuga. Zakudya zokhazikika, ndipo zakudya zilizonse zopatsa mphamvu zamagulu, zimapangitsa kuwerengera kwamamita kumawonekera.

Chimodzi mwazomwe chimadandaula m'matenda ambiri ndi pakamwa pouma. Awa atha kukhala matenda am'mimba, matenda a pachimake a ziwalo za celiac, omwe amafunika chithandizo cha opaleshoni, matenda amtima ndi wamanjenje, matenda a metabolic ndi endocrine, komanso matenda a shuga.