Zotsatira zakugwiritsa ntchito kwa nthawi yayitali ka sibutramine

Kusiyana kwake ndi kukhalapo kwa metformin pamapiritsi, omwe amachepetsa shuga ndi mafuta omwe amawotcha mafuta.

Chifukwa chake, mankhwalawa amadziwitsa mankhwalawa kunenepa kwambiri, olemedwa ndi shuga.

M'malo otsika mtengo othandizira a sapxin.

Zomwe zimagwiritsidwa ntchito ndi linoleic acid, yomwe imachepetsa bwino mawonekedwe a mafuta.

Kutengera ndi kuwunika kwa kuchepetsa thupi, mapiritsi awa amathandizira kuchepetsa kulakalaka, ndipo kuchepa thupi kumathamanga.

Ndizolowera zabwino kwambiri zosexin kuchokera kwa wopanga woweta.

Kutulutsa fomu - mapiritsi, makapisozi, mafuta, ma cookta, mipiringidzo, ma syrup, tiyi, mphete, maswiti.

Zotsika mtengo kwambiri pafupi ndi mtengo wa sapxin.

Malinga ndi kugwiritsa ntchito opanga, turboslim imayendetsa dongosolo lamanjenje, imakulitsa chimbudzi, ndikuyenda bwino.

M'malo mwa Ukraine

Pakati pa mankhwala omwe amapangidwa ku Ukraine, mutha kupezanso mankhwala omwe angakuthandizeni kuyankha funso loti muthane nawo.

• Styfimol . Kutulutsa Fomu - makapisozi. Gawo lalikulu la mapiritsi ndi Garcinia Cambogia Extract, lomwe lakhala lodziwika bwino chifukwa cha ntchito yake yazakudya. Kumwa mankhwalawa kumachepetsa cholesterol, kumachepetsa chilimbikitso, ndikuwongolera kuchuluka kwa shuga. Mtengo wapakati ndi ma ruble 560-750.

Zojambula zaku Belarusi

Tebulo ili ndi mndandanda wa Belarus generic usaxin, womwe umagwiritsidwa ntchito mochizira kunenepa kwambiri, kapena phukusi la zinthu zochepetsa thupi.

Zofanizira zina zakunja

Ma analogi amakono omwe adzagulitsidwe amapezeka mu gulu lotsika mtengo la mankhwala, komanso pakati pa mankhwala okwera mtengo. Ganizirani zothandiza kwambiri.

• Lindax . Mankhwala a anorexigenic opangidwa kuti apititse patsogolo kumverera kwodzaza. Dziko loyambira - Czech Republic. Mtengo wapakati ndi ma ruble 1700-6800.
• Slimia . Mankhwalawa amapangidwa ku India. Analog yotsika mtengo kwambiri yochokera ku tsoxin. Amapangidwa pamaziko a sibutramine ndipo amapezeka m'mapiritsi. Amagwiritsidwa ntchito pokhapokha pazachipatala pochizira kunenepa. Mtengo wapakati ndi ma ruble 140-350.
• Meridia . Mankhwala ochepetsa thupi, amagwira ntchito ngati wowongoletsa kudya. Dziko loyambira - Germany. Mtengo wapakati ndi ma ruble 2500- 3500.
• Zelieli . Njira yothetsera kunenepa. Dziko loyambira - Poland. Mtengo wapakati ndi ma ruble 1800-2500.
• Mchiuno . Chogulacho chimapezeka ngati mawonekedwe a makapisozi. Ndi m'gulu la anorexigens. Dziko loyambira - India. Mtengo wapakati ndi ma ruble 780-950.

Sibutramine ndi mawonekedwe ake ndizinthu zamphamvu zama psychotropic zomwe zingalepheretse pulogalamu yamkati ya mantha. Amayambitsa vuto la narcotic, mapiritsi awa angayambitse kudalira kwa odwala.

Pali zitsanzo za anthu omwe amwalira pambuyo panjira yodziyimira payokha ya mankhwalawa kuti athetse kulemera "kowonjezera".

Chonde dziwani kuti kumwa mankhwala a anorexigen ndi cholinga chokongoletsa sikuletsedwa. Mankhwala omwe amawotcha mafuta amatha kugwiritsidwa ntchito kokha pochiza kunenepa kwambiri, molingana ndi malangizo a dokotala.

Sibutramine poyambirira adayesedwa kuti agwiritsidwe ntchito ngati njira yothandizira pakukhumudwa, koma mwatsoka, sizinalandire zabwino. Koma panthawi yoyeserera, kuwunika kwake komwe kudapangitsa chidwi chake kudali kuwona. Kuyambira pamenepo, sibutramine wagwiritsidwa ntchito ngati. Pali mayiko angapo omwe mankhwalawo amaletsedwa. Chifukwa chake, kutumizidwa kumayiko a CIS kuyimitsidwa.

Kugwiritsa ntchito mankhwalawa kuli komwe kungachitike ngati njira zina zochepetsera thupi sizipereka mphamvu. Sibutramine imagwiritsidwa ntchito limodzi ndi zakudya kapena zolimbitsa thupi. Chifukwa chake zibweretsa zina zambiri:

• Chepetsani chilakolako
• Kuwonongeka kogwira mafuta,
• Kukhazikitsa kwa serotonin, komwe kumathandizira kuti muzitha bwino,
• Imachepetsa kupendekera ndi kuthekera kotukuka,
• Pazinthu zabwino, kuwonda kuyambira 7 mpaka 15 makilogalamu pamwezi.

Kodi ali ndi mankhwala ati?

Pali mankhwala angapo omwe ali ndi sibutramine, awa ndi ochepa:

• Meridia (kupanga ku Germany),
• Lindaksa (Kupanga Czech),
• Reduxin (kupanga Russia),
• , Sliema (kupanga India).

Mankhwalawa onse amakhala ndi sibutramine ndi mankhwala ena othandizira. Sibutramine amakhalanso ndi ma analogu, nawonso amachepetsa thupi, koma mphamvu yake m'thupi imakhala yofewa komanso osati yoopsa. Mapiritsi ofanana: denfluramine, dexfenfluramine, lorcaserin. Zina mwazifanizo ndi mankhwala omwe amaletsa kubwezeretsanso kwa serotonin.

Bongo

Zizindikiro: kuwopsa kwa mavuto. Ambiri omwe ali ndi kuthamanga kwa magazi, palpitations, migraines ndi chizungulire. Izi zitha kuchitika mwadzidzidzi kuchokera ku mankhwala osokoneza bongo mwangozi, komanso kuchokera kwa apadera.

Chithandizo chachikulu cha bongo: itanani dokotala, yemwe akupatseni chithandizo chamankhwala mwadzidzidzi mpaka matenda atakhazikika.

Kugwiritsa

Malangizo a mapiritsi a Sibutramine ogwiritsira ntchito. Mlingo woyambirira wa mankhwalawa sayenera kupitirira 10 mg patsiku. Ngati mankhwalawa ali m'mapapu, ndiye kuti makapisozi amayenera kumwa m'mawa wokha ndi madzi ambiri. Ngati mlingo umodzi udasowa, musangowonjezera kawiri mlingo wotsatira. Ngati palibe phindu lililonse pa mwezi, ndiye kuti mutha kuwonjezera mlingo wake mpaka 15 mg pa tsiku, koma osatinso. Pokhapokha ndi kulekerera bwino kwa mankhwalawa.

Panthawi yotenga sibutramine, malingaliro amasiyana apa. Koma simuyenera kumwa kwa nthawi yoposa chaka, popeza palibe chidaliro pa chitetezo ndi kugwiritsa ntchito mankhwalawa kwa nthawi yayitali. Ngati palibe zabwino pakuchepa kwa thupi zosachepera 5% ya kulemera konse m'miyezi itatu yoyambirira yogwiritsa ntchito, muyenera kusiya kumwa mankhwalawo.

Njira zopewera kupewa ngozi

Tiyenera kumvetsetsa kuti mankhwalawa amabweretsa zotsatira zabwino kuphatikiza ndi zakudya. Povomereza izi, muyenera kutsatira malamulo angapo, powona omwe mungapewe zotsatira zosasangalatsa.

Nayi mfundo zazikulu:

• Kuyendetsa galimoto
• Kugwiritsa ntchito munthawi yomweyo sibutramine ndi mankhwala ena a anorexigenic,
• Osamwa mowa limodzi ndi sibutramine,
• Zaka zaka 65.

Sikulimbikitsidwa kutenga sibutramine pa nthawi yoyembekezera komanso mkaka wa m'mawere, popeza maphunziro sanachitike. Sizikudziwika ngati mankhwalawo ndi zinthu zake za metabolic zimadutsa mkaka wa m'mawere.

Sibutramine ndi mankhwala amphamvu omwe ali ndi zabwino komanso zopweteka. Mukamaganiza zochepetsa thupi ndi mapiritsi ozikidwa pa sibutramine, onetsetsani kuti mukumane ndi adokotala, werengani malangizo ndikugwiritsa ntchito ndikuwunika ndemanga za iwo omwe akutenga ndalamazi. Yambirani bwino ndi zakudya, masewera. Mochulukirapo, pali zakudya zowonjezera zomwe zimachepetsa chilakolako, koma zowononga.

Ndemanga yanu pankhaniyi:

Mankhwala Sibutramine ntchito ngati chothandiza polimbana ndi kunenepa kwambiri. Mankhwalawa amagwiritsidwa ntchito limodzi ndi zakudya zoyendetsedwa mosamala komanso kuwonjezera zolimbitsa thupi. Sibutramine owonetsedwa kokha kwa odwala omwe ali ndi index ya body mass (BMI) ya osachepera 30 komanso odwala omwe ali ndi BMI yoposa 27 ndi ziwopsezo monga matenda a shuga kapena kuthamanga kwa magazi.

Sibutramine: Zowopsa

Kufalikira kwa sibutramine ku America ndi ku Europe, pali umboni wowonjezereka woti kumwa mapiritsi azakudya chifukwa chodwala kumabweretsa chiwonjezeke chachikulu cha milandu yodzipha, kugunda kwa mtima ndi stroko, ogula ambiri "adakhala" pa sibutramine.

Opanga izi adakakamiza kufufuza kwathunthu sibutramine ndi kuletsa kugulitsidwa, ndikuti sibutramine ndi gulu la oopsa omwe amafanana ndi mankhwala wamba.

M'malamulo aku Russia, sibutramine ndi zofananira zake amaperekedwa ku gulu lamankhwala amphamvu ndipo saloledwa kuzigulitsa popanda mankhwala apadera a dokotala.Kupatulako ndi milandu ya kunenepa kwambiri komanso kulephera kugwiritsa ntchito njira zina, zopweteketsa kuchepetsa thupi.

Kwa yemwe sibutramine adalumikizidwa

Mu zochuluka zazambiri zamankhwala omwe ali ndi sibutramine, palibe zomwe zikuwonetsa (kapena ndizochepa komanso zosakwanira) za zoyipa ndi zotsutsana. Opanga amawabisira, chifukwa izi zingakhudze kwambiri kugulitsa kwa mankhwala omwe ali ndi sibutramine.

Komabe, mndandanda wa contraindication ndiwambiri kwambiri. Izi zikuphatikiza:

• matenda a mtima ndi mtima (matenda oopsa, matenda a mtima, matenda a mtima),
• ngozi yamatenda,
• matenda amisala ndi mitsempha ndi bulimia kapena anorexia,
• chiwindi kapena matenda a impso
• kuvala zovuta
• matenda a maso (glaucoma, myopia),
• khunyu, kupweteka kwa matenda.

Kuphatikiza apo, sibutramine amaletsedwa kugwiritsa ntchito limodzi ndi mankhwala ambiri - mankhwala ochizira matenda amanjenje, maantibayotiki, mankhwala omwe amakhudza magazi.

Mankhwalawa sagwirizana ndi zakumwa zoledzeretsa, amaletsedwa kumwa mankhwalawa panthawi yokhala ndi pakati komanso zaka zapakati pa 60. Ndipo malire ndi zoletsa sizimathera pamenepo.

Sibutramine: zotsatira zoyipa

Pambuyo potenga sibutramine, pamakhala zotsatirapo zoyipa zingapo. Choyamba, kumwa mankhwala pogwiritsa ntchito mankhwalawa kumapereka chiyembekezo chofanana ndi kudalira. Mukaletsa kutha kuchitika:

• kugona komwe kumachitika monga kumachitika.
• kusakwiya, chizolowezi chofuna kudzipha,
• chizungulire, kupweteka mutu,
• kupsinjika, kufooka.

Milandu yayikulu kwambiri, kusanza ndi kusanza, kutupa, kupweteka pachifuwa, kuwona kwamaso, ululu wammbuyo, kuvuta kupuma, kusokoneza, kugaya chakudya, kukanika, kugona, kugona, mavuto obwera ndi khungu.

Ndipo izi sizotsatira zoyipa zilizonse za kutenga sibutramine. Chosafunikanso ndichakuti pakuyesa nyama, chidziwitso chowoneka cha sibutramine chinapezeka, ndikuyambitsa kusokonezeka kwa fetal.

Njira yochepetsera thupi imatha kukhala yovuta kwambiri kotero kuti zithandizo zilizonse mkati mwake zimatha kukhala zabwino. Izi zimagwiranso ntchito kwa mankhwala osokoneza bongo. Sibutramine ndi mawonekedwe ake amafunikira ulemu wapadera pakati pa iwo ochepera. Izi zidagawidwa m'magawo a Russian Federation ndipo zidagulitsidwa ndi mankhwala, monga zikuwonetsedwa bwino ndi malangizo a Sibutramine. Koma pakadali pano, m'mafakitala, mankhwala omwe ali ndi dzinali sangathe kupezeka. Pali ma analogu ake omwe ali ndi sibutramine ngati chinthu chogwira ntchito.

Zinali ngati mankhwala ochepetsa mphamvu kuti mchere wa sibutramine hydrochloride monohydrate upangike. Kuphatikizika kwake kunachitika ndi asayansi aku America. Pakuyesa kwa mankhwalawa, zidapezeka kuti kumwa mankhwalawo chifukwa chogwiritsidwa ntchito sikothandiza - palinso zovuta komanso zovuta zingapo pakuphatikiza ndi mankhwala ena. Popanga kafukufuku, anorexigenic zotsatira adadziwika chifukwa cha sibutramine - kuthekera kuletsa chidwi chamthupi pamlingo wamkati wamanjenje, pambuyo pake mankhwalawa adawerengedwa ngati njira yochepetsera thupi.

Kupambana mu Zakudya

Pakadali pano, sibutramine mu mankhwalawa amalembedwa pa 10 ndi 15 mg. Panthawi yoyesa mankhwala, mankhwalawa amagwiritsidwa ntchito omwe anali apamwamba kwambiri kuposa mlingo wapano. Zotsatira zake - kuchepa thupi kunali kosavuta komanso mwachangu. Chidwi cha wodwalayo chinali chitasowa kwathunthu, ndipo malo ogulitsa mafuta anali kugwiritsidwa ntchito kawiri konse, chifukwa mphamvu za thupi zimafunikira kukhutitsidwa kosalekeza.

Sibutramine inali yothandiza polimbana ndi kunenepa kwambiri kwa thupi, pomwe mndandanda wam'mimba wambiri unatha pazaka zopitilira 30.Kugwiritsa ntchito milingo yayikulu kumayendera limodzi ndi zovuta zingapo, kuphatikizapo:

• kugwidwa mtima
• kutentha kwa mtima
• zam'mimba zotupa,
• kupweteka kwa migraine
• mavuto amisala.

Chifukwa chake, panthawiyo sakanatha kuyambitsa mankhwalawo kuti azigwiritsidwa ntchito kwambiri. Atapeza njira zochepa zochizira, asayansi adapeza zabwino pakuchepetsa mavuto, zomwe zidapangitsa kutilembetsere mankhwala ngati mankhwala ochizira kunenepa.

Makampani ambiri opanga mankhwala ayamba kupanga mtundu ndi zomwe zimafanana nawo. Komabe, izi sizinayende bwino kwenikweni, popeza mauthenga anapitilizabe za zovuta zina. Zotsatira zake, kuyambira mu 2010, America ndi European Union aphatikiza sibutramine mndandanda wazinthu zoletsedwa zamankhwala. Maiko ena, mwachitsanzo, Russia, adaliphatikiza pamndandanda wamankhwala amphamvu kwambiri, zomwe zimachepetsa kwambiri mwayi wokhala ndi mankhwala omwe.

Kuchepetsa thupi

"Sibutramine" kapena fanizo lake limafotokozedwa ndi akatswiri azakudya zamagetsi kapena amisala kwa anthu omwe ali ndi vuto la kunenepa kwambiri komanso omwe ali ndi vuto lakudya. Nthawi zambiri kuikidwa kumachitika ngati njira zina zochepetsera thupi zatha. Sibutramine amachita pakhungu lotsatira:

• Imaletsa kugwidwa kwa ma neurotransmitter serotonin,
• imaletsa kugwidwa kwa neurotransmitter norepinephrine,
• Kuchepetsa kwambiri zomwe zimalepheretsa kupezeka kwa dopamine.

Kuphwanya zakumwa ndi kusinthana kwa oyimira pakati pa dongosolo lamanjenje kumayambitsa kukulitsa kwa machitidwe ofanana mu ziwalo zonse. Zotsatira za kutenga sibutramine ndi izi:

• chilala - wodwala akumva kuwawa kwambiri, sangathe kuzimva, ngakhale patalibe chakudya chimodzi tsiku limodzi,
• kagayidwe - chifukwa cha kamvekedwe ka mtima, kusintha kwa kutentha kumawonjezeka, thupi limakakamizidwa kuti ligwiritse ntchito mphamvu zambiri, pogwiritsa ntchito nkhokwe zake kuchokera ku depos,
• kutentha kwa mafuta - kutengera zomwe zidachitika kale, chifukwa mphamvu zakunja zimachepa,
• kukomoka - chifukwa cha kudya, chidwi cha wodwalayo chimachitika nthawi yomweyo chakudya chikayamba.
• chimbudzi - chimakula bwino chifukwa chakuwonjezeka kwa ndende ya serotonin mucous membrane ya m'mimba (gIT), ma peristalsis ndi kapangidwe ka mandimu,
• Kusintha - kumachitika bwino chifukwa cha kuchuluka kwa "mahomoni achisangalalo", wodwala amasangalala ngakhale zitakhala kuti akudalira chakudya,
• ntchito - ukuwonjezeka chifukwa cha kuchuluka kwa mphamvu ya chapakati yamanjenje, wodwalayo akumva kuwonjezeka kwa mphamvu, mphamvu, okonzekera kuchitapo tsiku lonse.

Zosintha zingapo mu ubongo zomwe zimakwiya chifukwa chogwiritsa ntchito sibutramine zimathandizira kuchepetsa kulemera konse: thupi, m'maganizo, m'thupi. Chimodzi mwa mankhwalawa ndikutha kulimbikitsa kuwotcha "mafuta a bulauni". Ngakhale izi ndizomwe zimapangidwira yaying'ono mthupi la munthu, zimagwira gawo lofunikira kwambiri pakuwonjezera kutentha. Ndipo kugawanika kwawo kumayambitsa kudyedwa kwa "mafuta oyera", owonjezera omwe amatsatira kunenepa kwambiri.

Komanso ndizofala kwa sibutramine kuti azitha kuyendetsa bwino mafuta m'thupi. Makamaka, mankhwalawa amayambitsa kupanga ndi kubisala kwa bile. Pazifukwa izi, zikuwonetsa kugwiritsidwa ntchito kwa mankhwalawa kumaphatikizapo kunenepa kwambiri mu mtundu 2 wa shuga ndi matenda a lipid metabolism. Mkhalidwe wokhazikitsidwa ndi sibutramine mu milandu iyi ndiwowonjezera wa index ya body 27%.

Malangizo ogwiritsira ntchito sibutramine

Sibutramine ndi m'gulu la mankhwala onenepa omwe amatsata "monga chomaliza chomaliza". Kulandila ndalama kuyenera kuvomerezana ndi dokotala kuti awonetsetse kuti njira zonse zomwe zilipo pakuwongolera thupi zimatha. Njirayi ndiyofunikira chifukwa cha chiwopsezo chachikulu cha thanzi chomwe chadzala ndi kusokonezedwa pakugwira ntchito kwamanjenje.

Nthawi zambiri, kudya kumayamba ndi 10 mg. Piritsi limodzi la mulingo woyenera amatengedwa kamodzi kuti agwe pansi ndimadzi okwanira. Kumwa mankhwalawa sikudalira nthawi ya chakudyacho, koma madokotala amalimbikitsa kumwa mapiritsi m'mawa wopanda kanthu pambuyo podzuka kuti atsimikizire kuchuluka kwa mankhwalawa m'magazi m'mawa.

Izi zikuchitika motere:

• 80% yazomwe zili piritsi zimalowa m'matumbo aang'ono,
• metabolites yogwira ya sibutramine - imatulutsidwa m'mwazi ndikumanga mapuloteni ake,
• Mitsempha yamagazi imafika patali - maola atatu mpaka anayi atamwa,
• metabolites a mankhwalawa - amagawidwa mthupi lonse, kudziunjikira mafupa a synaptic,
• mutatenga piritsi lachinayi, njira yokhazikika yodalirika yamankhwala imatheka.

Kulandila ndikosayenera kuphatikiza ndi chakudya. Chowonadi ndikuti kuyamwa kwa mankhwalawa kuchokera pachakudya cha chakudya ndikulakwika - amachepetsa ndi wachitatu. Thupi limachotsedwa m'thupi ndi impso. Zidutswa za metabolites zili mu minyewa pafupifupi mwezi, koma kugwiritsidwa ntchito kwake kumapeto kwa kayendetsedwe sikumakhala ndi tanthauzo lachire.

Mapiritsi a zakudya a Sibutramin amatha kumwa mpaka chaka. Tsopano amathanso kumwa ma analogues. Ngati mulingo wocheperako wa 10 mg ndiwokhutiritsa, umakhalabe mpaka kumapeto kwa chithandizo. Kufunika kwa kuchuluka kwa mankhwalawa kumachitika ngati, pakatha miyezi iwiri kapena itatu kuyambira pomwe amayamba kudya, "plumb" ya wodwalayo imafika 3% ya kulemera konse kwa thupi. Kenako mankhwala a sibutramine mu 15 mg. Zingachitike kuti chingwe cholimira sichikhala chochepa kwambiri, mankhwalawo amachotsedwa chifukwa chosakwanira. Zisankho zonse zokhudzana ndi kuchuluka kwa mankhwalawa, komanso nthawi yanthawi yamankhwala, zimapangidwa ndi dokotala.

Zowopsa

Popeza chithandizo chokwanira cha mankhwalawo pakuchepetsa thupi, funso limadzuka: "Ndilipira chiyani pothandizidwa mooneka bwino panjira yolumikizana?" Yankho lagona mu zotsatira za kafukufuku wa chinthu, chomwe chimawonetsa bwino mavuto ake. Koma poyang'ana za kuwunikira kwa kunenepa, titha kunena kuti mankhwalawa nthawi zambiri amaloledwa. Zina zoyipa zomwe zimachitika kumayambiriro kwa mankhwalawa zimataya mphamvu kapena zimatha kwathunthu ngati sibutramine yatengedwa moyenera. Zotsatira zoyipa kwambiri:

• kamwa yowuma
• kuphwanya chopondapo
• kuchuluka kwa zotupa m'mimba,
• mutu
• kugunda kwa mtima
• kusowa tulo
• kusowa kudya kwathunthu,
• kuchuluka pang'ono kwa kuthamanga kwa magazi.

Zotsatira zoyipa za sibutramine, monga momwe zimakhalira ndi mankhwala ena, zimaphatikizidwa ndi vuto la matupi awo, lomwe limawonetsedwa ndi urticaria ndi pruritus. Pankhaniyi, mankhwalawa adathetsedwa.

Zotsatira zoyipa zoopsa za mankhwalawa zimaphatikizaponso kusuta ndi kusiya. Kudalira mankhwala osokoneza bongo sikuchitika, koma nthawi yoyamba atasiya kulandira chithandizo, wodwalayo amatha kukhala ndi nkhawa kwambiri, zomwe zimatha kubweretsanso chizolowezi chamadyedwe akale. Kuti achepetse kuchuluka kwa zotulukazi, madokotala amalimbikitsa kusiya kuyamwa, pang'onopang'ono kuchepetsa Mlingo wa mankhwalawa.

Zowopsa zosakhudzidwa ndikuphatikizapo:

• mavuto amisala (mpaka kufuna kudzipha),
• Mavuto azakudya (bulimia, anorexia),
• chiopsezo chowopsa cha matenda a mtima,
• kusowa tulo
• kuchuluka kwakukulu kwa kuthamanga kwa magazi,
• tachycardia
• kukomoka
• kusokonekera kwa kufalikira kwazungulira.

Popeza kuti sibutramine m'mbuyomu ikhoza kugulidwa popanda mankhwala, mavuto ena sangakhale olembetsedwa ndi wopanga ndipo osawonetsedwa muzowongolera. Madokotala amayang'ana chidwi cha iwo omwe akuchepetsa kulemera kwa kufunikira kwa mankhwala othandizira. Mwanjira imeneyi kuthekera kwa zovuta kumatsitsidwa kwambiri.

Orlistat (Orlistat, Orlistatum)

• Ili ndi zotumphukira
• Makina ochitapo kanthu ali ofanana ndi chikhalidwe cha triglycerides pamene mamolekyu a chapamimba ndi pancreatic lipase amamangirira, osawalola kuyanjana ndi lipids. Mwanjira ina, ma enzyme a m'mimba mothandizidwa ndi orlistat sangathe "kupukusa" mafuta mokwanira, omwe amachotsedwa m'thupi mwachilengedwe (kutanthauza ndi ndowe) panthawi yonse yagaya m'mimba m'matumbo (m'mimba).
• Thupi silimamwa kuchokera m'matumbo am'mimba, i.e. sikulowa mthupi (zambiri zimachotsedwa pakatha masiku 3 - 5, ndipo pafupifupi 2% zimachotsedwa kudzera mu impso)
• Lowers LDL (Low Density Lipoproteins)
• Kuchulukitsa HDL (Kachulukidwe Kwakukulu)
• Kutsitsa magazi (kuthamanga kwa magazi)
• Imachepetsa kusala
• Amagwiritsidwa ntchito pochiza, ndipo chifukwa ndi izi chipukuta cha carbohydrate metabolism chitha kupezeka
• Mlingo Wovomerezeka: kapisozi 1 (120 mg) katatu katatu tsiku lililonse

• Fumbi, mafuta okumbika
• Kutaya kwamafuta
• Fecal kulephera
• Amachepetsa mayamwidwe a mavitamini osungunuka (multivitamin ula)

Sibutramine (Sibutramine, sibutramine hydrochloride monohydrate)

• Ili ndi tanthauzo lapakati
• Ndi anorexigenic yomwe imachepetsa chilimbikitso (pambuyo pake munthu amayamba kudya zakudya zochepa)
• Imawonjezera kumverera kwodzaza
• Kuchulukitsa kutentha kwa thupi (kumawonjezera kutentha kwa thupi)
• Kuchulukitsa HDL
• Amachepetsa LDL, triglycerides, cholesterol yathunthu, uric acid
• Kuchulukitsa kuthamanga kwa magazi ndikuthamanga kugunda kwa mtima, nthawi zina pamlingo waukulu ("kunama" kukuwoneka)
• Olowetsedwa m'thupi ndi 77%
• Kutalika kwake kwakukulu kumachitika patatha maola 1.2 mutamwa mankhwalawa
• Ntchito mankhwalawa kunenepa kwambiri ndi BMI ya 30 kg / m 2 kapena kupitilira apo kapena ndi BMI ya 27 kg / m 2
• Zingasokoneze ntchito yamapulateri

• Kusowa tulo
• Mutu
• Chizungulire
• Kusakwiya
• Kuda nkhawa
• Paresthesia (kusokonezeka kwamalingaliro amthupi osiyanasiyana)
• Kusintha kwamakomedwe
• Pachimake psychosis ndi kulanda paokha
• Tachycardia
• Zosangalatsa pamtima
• Kuchuluka kwa kuthamanga kwa magazi
• Opaleshoni (khungu la khungu lotengeka ndi kutentha)
• Shenlein-Genoch matenda ndi thrombocytopenia mwaokha
• Pakamwa pakamwa
• Kuchepetsa chidwi
• Kudzimbidwa
• Kutsegula m'mimba
• Kuchepetsa mseru
• Kuchulukitsa kwa zotupa m'mimba

Mwanjira ina, chinthu ichi chimakhudza mbali zonse ziwiri zamanjenje ndi mtima. Chifukwa chake, singagwiritsidwe ntchito molumikizana ndi mankhwala ena omwe amagwira ntchito pamitsempha yamafupa (antidepressants, antipsychotic, tryptophanes). Imawonjezera katundu pachiwindi ndi impso, chifukwa imagwidwa ndikulowa mthupi kudzera m'mimba.

Ngakhale izi, kugwiritsidwa ntchito kwakutali kwakuloledwa chaka chimodzi!

Pharmacology

Pharmacological kanthu - anorexigenic.

Imalepheretsa kubwezeretsanso kwa ma neurotransmitters - serotonin ndi norepinephrine kuchokera ku synaptic cleft, zimatha kuyanjana kwa synergistic pakati pa norepinephrine yapakati ndi kachitidwe ka serotonergic. Imachepetsa chilimbikitso ndi kuchuluka kwa chakudya chomwe chimamwetsa (kumakulitsa kumverera kwodzaza), kumawonjezera thermogenesis (chifukwa cha kuyambitsa kwina kwa beta3-adrenergic receptors), kumakhudza minofu ya bulauni ya adipose. Amapanga metabolites yogwira thupi (ma pulayimale oyambira ndi sekondale), opambana kwambiri kuposa sibutramine mu kuthekera kwake kuti aletse kubwezeretsanso kwa serotonin ndi norepinephrine. Mu maphunziro a in vitro, metabolites yogwira imalepheretsanso kubwezeretsa dopamine, koma imakhala yofupika katatu kuposa 5-HT ndi norepinephrine. Ngakhale sibutramine kapena metabolites yake yogwira imakhudza kutulutsidwa kwa ma monoamines ndi ntchito ya MAO, osayanjana ndi ma neurotransmitter receptors, kuphatikizapo serotonergic, adrenergic, dopaminergic, benzodiazepine ndi glutamate (NMDA), ndipo alibe anticholinergic ndi antihistamine. Imalepheretsa mapulogalamu a 5-HT ndipo amatha kusintha ntchito.

Kutsika kwa kulemera kwa thupi kumayendera limodzi ndi kuwonjezeka kwa kuchuluka kwa HDL mu seramu ndi kuchepa kwa kuchuluka kwa triglycerides, cholesterol yathunthu, LDL ndi uric acid.

Pakumwa, pali kuwonjezeka kwapang'onopang'ono kwa kuthamanga kwa magazi kupumula (mwa 1-3 mmHg) komanso kuwonjezeka kwapang'onopang'ono kwa kugunda kwa mtima (mwa ma 3- 7 kumenyedwa / mphindi), koma pazovuta zina zotchulidwa ndizotheka. Pogwiritsa ntchito munthawi yomweyo ma microsomal oxidation inhibitors, kugunda kwa mtima kumawonjezeka (mwa 2,5 bpm) ndi mautali apakati a QT (mwa 9.5 ms).

M'maphunziro a 2 a makoswe ndi mbewa mukamagwiritsa ntchito Mlingo, chifukwa chomwe malo omwe ali munthawi yogwirira ntchito (AUCs) yolumikizira kawiri nthawi yayitali ndi nthawi ya 0.5 mpaka kuposa MRI, kuchuluka kwa zotupa testicular interstitial minofu makamaka makoswe amuna. Palibe zowonongeka chifukwa cha makoswe ndi makoswe achikazi. Alibe mutagenic kwenikweni, sasokoneza chonde. Pamene Mlingo umaperekedwa ku makoswe, ma AUC omwe ali ndi ma metabolites onse omwe anali okwera ka 43 kuposa omwe amawonetsedwa ndi MRI, panalibe mphamvu ya teratogenic. Komabe, mu maphunziro omwe adachitidwa pa akalulu achi Dutch Belted pansi pamikhalidwe pomwe AUCs yogwira metabolites ya sibutramine anali okulirapo nthawi 5 kuposa momwe amagwiritsira ntchito MRI, zosayenerakukula kwakumaso zimapezeka mwa ana (kusintha pamawonekedwe kapena kukula kwa muzzle, auricle, mchira, ndi makulidwe amafupa )

Pambuyo pakukonzekera pakamwa, imatengedwa mwachangu kuchokera kumimba yotseguka ndi pafupifupi 77%. Pa "gawo loyamba" kudzera m'chiwindi, limadutsa biotransfform mothandizidwa ndi CYP3A4 isoenzyme ya cytochrome P450 ndikupanga metabolites awiri (mono- ndi didemethylsibutramine). Mutatenga mlingo umodzi wa 15 mg wa Cmax, monodesmethylsibutramine ndi 4 ng / ml (3.2-4.8 ng / ml), ndipo didesmethylsibutramine ndi 6.4 ng / ml (5.6-7.2 ng / ml). Cmax imafikiridwa pambuyo pa maola 1.2 (sibutramine), maola 3-4 (metabolites yogwira). Chakudya chofananacho chimatsitsa Cmax ya metabolites ndi 30% ndikuwonjezera nthawi kuti zitheke ndi maola atatu osasintha AUC. Imagawidwa mwachangu pazovala. Kumanga kwa mapuloteni ndi 97% (sibutramine) ndi 94% (mono- ndi didemethylsibutramine). Kuyanʻanila kwa metabolites yogwira ntchito m'magazi kumafikiridwa pakatha masiku 4 chiyambireni chithandizo ndipo ndiwofupikira nthawi ziwiri poyerekeza ndi plasma mutatha kumwa kamodzi. T1 / 2 ya sibutramine - maola 1,1, monodemethylsibutramine - maola 14, didesmethylsibutramine - maola 16. Ma metabolites omwe amagwira ntchito amayenda ndi hydroxylation ndikuphatikizana ndikupanga ma metabolites osagwira, omwe amachotsedwa makamaka ndi impso.

Kodi sibutramine ndi chiyani?

Sibutramine ndi mankhwala amphamvu. Poyamba, idapangidwa ndikuyesedwa ngati antidepressant, koma asayansi adaona kuti ili ndi mphamvu ya anorexigenic, ndiye kuti imatha kuchepetsa chilakolako cha kudya.

Kuyambira 1997, yakhala ikugwiritsidwa ntchito ku United States ndi mayiko ena ngati njira yabwino yochepetsera thupi, kupereka kwa anthu odwala matenda osiyanasiyana. Zotsatira zoyipa sizinatenge nthawi.

Zinapezeka kuti sibutramine ndiwosuta komanso wokhumudwitsa, womwe ungafanane ndi mankhwala. Kuphatikiza apo, adakulitsa chiwopsezo cha matenda amtima, anthu ambiri adadwala stroko komanso mtima pamene adatenga. Pali umboni wosagwirizana wosonyeza kuti kugwiritsa ntchito sibutramine kunayambitsa kufa kwa odwala.

Kwa omwe ndalamazo zaletsedwa

Mankhwala okhala ndi Sibutramine ali ndi mndandanda wochititsa chidwi wa zotsutsana zazikulu. Zomwe zimayesedwa ndikuphwanya magwiridwe antchito a mtima, chiwindi ndi impso, chifukwa chinthucho chimapanga katundu pazonsezi.

Zowonongeka zamankhwala ndizofunika kwambiri ngati kunenepa kwambiri sikunachokera kwa alimentary, koma kwachiwiri. Nthawi zambiri, mavuto a kagayidwe kachakudya ndi ntchito ya ziwalo zamkati zimayambitsa.Zochita zamankhwala zimatsimikizira kusakwanira kwa sibutramine muzochitika zotere. Zotsatira zina zotsutsana ndi mankhwalawa:

• osakwana zaka 18
• patatha zaka 65
• ndi bulimia,
• ndi matenda a anorexia,
• mavuto amisala
• hyperthyroidism
• ochepa matenda oopsa
• Prostate adenoma
• glaucoma
• kugwiritsa ntchito mankhwala osokoneza bongo
• kudalira mankhwala
• uchidakwa.

Kusamalira makamaka kumafuna kuikidwa kwa sibutramine ku khunyu ndipo anthu amakonda kukomoka, komanso omwe ali ndi vuto la hematopoiesis kapena magazi.

Popeza chiwopsezo chowonjezereka cha bongo ndi zovuta, mowa uyenera kusiyidwa kwathunthu pakumwa. Kuti muchotse m'thupi mankhwala owonjezereka mwadala kapena mwangozi, chapamimba chamatumbo chiyenera kuchitidwa, adsorbent iyenera kutengedwa ndikuyitanitsa ambulansi.

Ndi iti mwa mankhwala abwino kwambiri ochepetsa thupi?

Nthawi yakwana yoti mutenge zotsatira zazing'ono ndikusankha zoyipa ziwiri (ngati izi zingachitike konse).

Sititopa kukumbutsa owerenga onse kuti ndibwino kungosankha zachilengedwe popanda kugwiritsa ntchito mankhwala aliwonse komanso kugwiritsa ntchito thandizo lawo pokhapokha ngati chithandizo china sichingatheke popanda iwo. Ndikwabwino kutsatira zomwe zidapangidwa mu nthawi za Soviet ndi mpaka pano, akatswiri azamankhwala masiku ano sanasinthe kwambiri ku zakudya zamankhwala.

Koma popeza adokotala adakuwuzani, ndiye kuti tiwona kuti ndi iti mwazinthu ziwiri zomwe zili zovulaza?

Kumbukirani kuti palibenso malo oyesera omwe mungatsimikizire mankhwala mpaka lero. Zambiri pazakutetezedwa kwawo zimadalira mayeso omwe amachitika pa nyama, ndipo izi zimapangitsa zotsatira zathu kukhala zovuta. Koma tikuuzeni chinsinsi, ambiri mwa mankhwala omwe amagulitsidwa ku malo ogulitsa mankhwala ku Russian Federation sanayesedwe moyenera (ambiri sangatchulidwe kuti "mankhwala", popeza samayang'ana pa chithandizo, koma pakuchepetsa zizindikiro zazikulu za matendawa). Chachikulu chomwe chimapezeka m'mankhwala amakono ndikuti "amagwira ntchito", ndipo ndindende ndi yachiwiri komanso yosafunikira kwenikweni.

Kodi pali kusiyana kotani pakati pa zinthu ziwirizi?

Tiyeni tiwalingalire motengera momwe angapangidwire njira yodziwitsira komanso njira yowonekera, popeza ngati chinthucho chitha kutulutsidwa m'thupi, ndiye kuti, ngakhale chimatambasulidwa, chimatha kutchedwa chopanda vuto.

Popeza ambiri a sibutramine pambuyo pakutsata pakamwa amatengeka ndi thupi lathu, ndipo zovuta zake ndizambiri, ndibwino kusiya kugwiritsa ntchito omwe ali ndi vuto lalikulu la chiwindi ndi impso. Kuphatikiza apo, imagwira ntchito pakatikati kwamanjenje, kuchepetsa nkhawa, kupangitsa anthu kukhala osazindikira, osokonezeka, komanso kugona. Simalimbikitsidwa kwa anthu omwe amayendetsa galimoto tsiku lililonse kapena amene amayendetsa galimoto yamtundu wina.

Kuwonekera kwa chinthu ichi ndi kwakukulu, chifukwa chake, ndibwino kuyang'ana pa orlistat, yomwe imachotsedwa kwathunthu mthupi. Iye, monga, amapatsa thupi chithandizo chofunikira, chifukwa "chimatsuka" zakudya zonse zomwe zimalowa m'mimba kuchokera kumafuta, koma timafunikiranso kulipira ntchitoyi, chifukwa odwala ambiri omwe amamwa mankhwala a orlistat amaperekeka ndi matenda am'mimba komanso mavuto ena m'mimba. Ndiwosagwira mtima kwambiri kuposa sibutramine, kotero, kuyika kwake m'mutu umodzi kumaposa 100 mg (kuchokera ku 120 mg).

Kaya ndi mankhwala ati omwe mungasankhe, kumbukirani kuti sizikulimbikitsidwa kuti muzigwiritsa ntchito popanda kufunsa dokotala!

Chisankho chimakhala chanu nthawi zonse, koma ndibwino kupatsa chisankho pamasewera ndi zakudya zoyenera!

Khalani athanzi!

Ndi cholinga chochepetsa thupi, atsikana ndi amayi ambiri amamwa mankhwala apadera kuti achepetse kunenepa kwambiri. Izi zimaphatikizapo mapiritsi okhala ndi sibutramine. Musanayambe kumwa mankhwala amenewa, muyenera kuwerenga malangizo ogwiritsira ntchito sibutramine omwe aperekedwa pansipa.

Kulandila pa mimba ndi mkaka wa m`mawere

Akatswiri amaletsa kumwa mankhwalawa kwa amayi omwe ali ndi pakati kapena pakubala. Muzochitika izi, zovuta zam'mapiritsiwo sizingakhale zabwino kwa mayi yekha, komanso kwa mwana wake wosabadwayo. Malangizowa sayenera kuyiwalika, chifukwa odwala ambiri omwe ali ndi thanzi labwino komanso ngakhale kufa adawazindikira pazoyeserera kwanthawi yayitali.

Zotsatira zoyipa

Ngakhale kumwa mankhwalawa kuti muchepetse kunenepa, mavuto ena akhoza kuchitika. Zitha kukhala zazifupi komanso zazitali. Ngati apezeka, muyenera kudziwitsa dokotalayo za izi, chifukwa pali ngozi yakukulitsa vuto lanu ngati mupitiliza kumwa mapiritsi.

Mndandanda wazotsatira ziyenera kukhala:

• kudzimbidwa
• kusowa kwa chakudya
• paresthesia
• nseru
• kuthamanga kwa magazi
• mutu
• agwiritse
• thrombocytopenia
• kuchuluka kwa zotupa m'mimba,
• kusintha kwa kukoma
• nkhawa
• chizungulire
• redness m'malo osiyanasiyana pakhungu,
• interstitial nephritis.

Kuchita ndi mankhwala ena

Nthawi zambiri pamakhala kuwunikiridwa kwa iwo omwe akuchepetsa thupi za Sibutramine pazokhudzana ndi momwe amapangira mankhwala ena. Pogwiritsa ntchito mankhwala ndi othandizawa, ndikofunikira kukumbukira kuti mukamagwiritsa ntchito mapiritsi oterewa ndi erythromycin, ketoconazole, cyclosporine ndi mankhwala ena omwe amalepheretsa zochitika za CYP3A4, kuchuluka kwa mankhwala a metabolites mu plasma kumatha kuwonjezeka mosavuta, chifukwa chomwe nthawi ya QT ingakulidwe.

Chiwopsezo cha kupitirira kwa serotonin syndrome chidzakulitsidwa pamene mukumwa mankhwala a Sibutramine ndi awa:

• opioid analgesics,
• Paroxetine
• Fluoxetine
• zopondera chifuwa chapakati,
• "Citalopram".

Gwiritsani ntchito kunjaku

Sibutramine ndi mankhwala ofananawa amagwiritsidwa ntchito mwachangu osati ku Russia. Mwachitsanzo, ku United States zinthu zotere zimatuluka pansi pa dzina la "Meridia" ndipo zimangogulitsidwa monga adalangizidwa ndi adokotala. Akatswiri amderali, omwe adayesera ambiri odzipereka omwe ali ndi madigiri osiyanasiyana onenepa, chifukwa chake adalandira anthu ochepa kwambiri omwalira. Pachifukwa ichi, amalola kuti mapiritsi atengedwe kokha ndi odwala athanzi omwe alibe mavuto azaumoyo, makamaka ndi mtima.

Ku European Union, kumasulidwa kwa Sibutramine kudayimitsidwa. Chomwe chidachitika ndichakuti adapezeka kuti akatswiri ofufuza amtundu wa mtima ndi mtsempha wamagazi. Kuti timvetse bwino izi, kafukufuku osiyanasiyana wachitika pa anthu omwe ali ndi matenda a ziwalozi, pomwe zotsatira zake sizinali zolimbikitsa.

Anthu ena sangathe kugula "Sibutramine", chifukwa chake amafunafuna mankhwala omwe ali ofanana ndi iwowa pakuwonetsa komanso mogwira ntchito. Mwamwayi, pali zinthu zambiri zotere. Koma nthawi yomweyo, ndikofunikira kukumbukira kuti ndalama zomwe zimakhala ndi sibutramine zimangogulitsidwa pokhapokha ngati mwalandira mankhwala. Odziwika kwambiri a iwo ndi:

1. Meridia Mankhwala opangidwa ku Germany amapangidwa kuti muchepetse kunenepa komanso kuti wodwalayo azikhala mwamatenda. Amagwiritsidwa ntchito muyezo wowerengeka, ngakhale amafunika mlingo wautali. Chipangizocho chili ndi mndandanda waukulu wazotsatira zoyipa ndi zotsutsana zomwe zimayikidwa pachiwopsezo cha moyo wa munthu.
2. Slimia. Mankhwala abwino amakhala ndi cholinga chochepetsa thupi. Imatha kupititsa patsogolo kagayidwe ka lipid ndikupulumutsa wodwala ku kudalira chakudya. Mankhwalawa ndi othandizadi, koma njira ya mankhwalawa imatha kuposa miyezi isanu ndi umodzi.
3. "Obstat." Chida chopangidwa kuti chikhazikitse kulemera, chimagwira ntchito zambiri, komanso zochulukirapo. Imakonza kadyedwe ndipo imagwiritsidwa ntchito pokhapokha pochiza kunenepa kwambiri.
4. Lindax. Anthu amagula mapiritsi kuti achepetse kudalira zakudya. Madokotala amapereka mankhwala awa kuti asinthe zizolowezi pakudya ngati sikotheka kuthana ndi njala munjira zina. Mankhwala oterewa siwosokoneza bongo ndipo salola kuti mapangidwe azidalira pazinthu zake.
5. Reducil. Chida ichi chikugwiritsidwa ntchito mmaiko angapo, koma malinga ndi malangizo a dokotala. Zimathandizira kulimbana mapaundi owonjezera mwachangu, osayambitsa chizolowezi.

Ma Analogs a Sibutramine amakhalanso ndi ndemanga. Zosadabwitsa, pakati pawo palibe mawu osagwirizana ndi ogula, popeza anthu amakhutira ndi zomwe akuchita. Ngakhale atakhala ndi zovuta, kugwiritsa ntchito mankhwalawa ndizodabwitsa. Chifukwa cha izi, ma analogu a Sibutramine sakhala otchuka kwambiri. Amagulidwa ndikugwiritsidwa ntchito ndi anthu akumayiko osiyanasiyana, ndikupeza zotsatira zabwino.

Mayankho abwino

Lero pali ndemanga zosiyanasiyana zakutaya thupi za Sibutramin. Amasiyidwa ndi anthu azaka zosiyanasiyana omwe akhalapo kapena akumana ndi izi.Ogula m'mawu awo akuwonetsa zina zomwe zimasiyanitsa mapiritsiwa ndi mankhwala opikisana, komanso ogwira ntchito.

Nthawi zambiri, kuwunika kumatsalira ndi ogula omwe adakumana ndi ndalama zambiri ndipo sanathe kupeza zotsatira kuchokera kwa iwo. Amatsutsa kuti Sibutramin adachepetsa kudya ndipo adathandizira kuti ataya mapaundi oyamba m'sabata yoyamba kuvomerezedwa. Ogwiritsanso ntchito akuti sanakhale ndi zotsatirapo konse kapena kuwonetsa kwakanthawi kochepa, chifukwa chake panalibe chifukwa chodandaula.

Makamaka, anthu amawonetsa kuti akapita kukalandira chithandizo, kulemera ndi chidwi champhamvu sizibwerera. Chifukwa cha izi, popanda kuyesetsa mwamphamvu mutha kukhalabe okwanira komanso kupeza zotsatira zatsopano, koma popanda kuwononga ndalama pamapiritsi.

Zotsatira zoyipa za chinthu Sibutramine

Pakafukufuku wolamulidwa ndi placebo, 9% ya odwala omwe amalandila sibutramine (n = 2068) ndi 7% ya odwala omwe alandila placebo (n = 884) anasiya chithandizo chifukwa cha zovuta.

M'maphunziro omwe amayendetsedwa ndi placebo, zotsatira zoyipa kwambiri zinali pakamwa youma, kugona, kugona, kudzimbidwa, komanso kupweteka mutu.

Izi ndi zotsatira zoyipa zomwe zimawonedwa mwa odwala omwe amatenga sibutramine, omwe amakhala ndi ≥1% komanso pafupipafupi kuposa gulu la placebo. Pafupipafupi pafupipafupi gawo lomwe limatenga sibutramine likuwonetsedwa pafupi ndi dzinalo, zofanana ndi zomwe zili mgulu la placebo m'mabokosi.

• Thupi lonse: mutu - 30.3% (18.6%), ululu wammbuyo - 8.2% (5.5%), matenda ngati chimfine - 8.2% (5.8%), kuvulala mwangozi - 5.9% (4.1%), asthenia - 5.9% (5.3%), kupweteka kwam'mimba - 4.5% (3.6%), kupweteka pachifuwa - 1.8% (1.2%), kupweteka khosi - 1.6% (1.1%), thupi lawo siligwirizana - 1.5% (0.8%).
• Kuchokera pamtima ndi magazi (hematopoiesis, hemostasis): tachycardia - 2.6% (0.6%), vasodilation (kutuluka kwa khungu ndi kutentha) - 2.4% (0.9%), migraine - 2.4% (2.0%), matenda oopsa / kuthamanga kwa magazi - 2.1% (0.9%), kugunda kwa mtima - 2.0% (0.8%).
• Kuchokera m'mimba: anorexia - 13.0% (3.5%), kudzimbidwa - 11.5% (6.0%), kuchuluka kwa chidwi - 8.7% (2.7%), nseru - 5.9% (2.8 %), dyspepsia - 5.0% (2.6%), gastritis - 1.7% (1.2%), ludzu - 1.7% (0.9%), kusanza - 1.5% (1 , 4%), kuchuluka kwa zotupa m'mimba - 1.2% (0.5%).
• Kuchokera ku minculoskeletal system: arthralgia - 5.9% (5.0%), myalgia - 1.9% (1.1%), tendosynovitis - 1.2% (0.5%), matenda olowa - 1.1% (0.6 %).
• Kuchokera wamanjenje ndi ziwalo zam'maganizo: kamwa yowuma - 17.2% (4.2%), kusowa tulo - 10.7% (4.5%), chizungulire - 7.0% (3.4%), mantha - 5.2% (2, 9%), nkhawa - 4.5% (3.4%), kukhumudwa - 4.3% (2.5%), paresthesia - 2.0% (0.5%), kuwodzera - 1.7% ( 0,9%), woukitsa - 1.5% (0.5%), wogwira ntchito mwamalingaliro - 1,3% (0.6%), kusintha kusintha - 2.2% (0.8%), matenda amkhutu - 1.7% (0.9%), khutu - 1.1% (0.7%).
• Kuchokera pakapumidwe: rhinitis - 10,2% (7.1%), pharyngitis - 10,0% (8.4%), sinusitis - 5.0% (2.6%), kuchuluka kwa chifuwa - 3.8% (3.3 %), laryngitis - 1.3% (0.9%).
• Pa khungu: zotupa - 3.8% (2.5%), thukuta - 2,5% (0.9%), Herpes simplex - 1.3% (1.0%), ziphuphu - 1.0% (0.8 %).
• Kuchokera ku genitourinary system: dysmenorrhea - 3.5% (1.4%), matenda amkodzo - 2.3% (2.0%), candidiasis - 1.2% (0.5%), metrorrhagia - 1.0% (0 , 8%).
• Zina: edema yowonjezera - 1.2% (0.8%).

Chithandizo chisanachitike, nthawi yapakati komanso yapakati

Nthawi zina kunenepa kwambiri kumayambitsa kusalinganika kwa mahomoni mwa akazi, kumalepheretsa kutenga pakati, kutenga pakati komanso kubereka kwa mwana wathanzi. Vutoli likufunika kuti pakhale chithandizo chamankhwala komanso chamankhwala. Ngati njira zina zolembetsera kulemera sizothandiza, sibutramine imatha kutumikiridwa musanabadwe. Ndikofunika kulingalira kuti mankhwalawa ali ndi mphamvu ya teratogenic, ndiko kuti, angayambitse kukondera mukukula kwa mwana wosabadwayo.

Nthawi yonse ya chithandizo, mkazi ayenera kupereka njira zodalirika zakulera. Osachepera miyezi iwiri ayenera kutha kuchokera kumapeto kwa maphunzirowo mpaka kufika pakubala. Nthawi imeneyi, thupi limachotsa zotsalira za mankhwala. Kuchiza ndi mankhwalawa panthawi yoyembekezera komanso yoyamwitsa ndizoletsedwa.

Zofananira zonse za Sibutramin ndi mankhwala osokoneza bongo:

Mitundu yapamwamba ya Sibutramine ndi Goldline Plus ndi Reduxine Met.Kuphatikiza pazomwe zimagwira, microcrystalline cellulose imaphatikizidwanso muzomwe zimapangidwa, zomwe zimalimbitsa mphamvu ya anorexigenic ya sibutramine. Reduxin Met imaphatikizanso ndi metformin, yomwe imalimbikitsa chidwi cha maselo a thupi kupita ku insulin.

Mankhwala onse a analogi ndi oopsa monga momwe sibutramine imakhala yowopsa, ali ndi zotsutsana zomwezo ndi zoyipa zake. Zakudya zamafuta a Goldline Light sizikhala ndi sibutramine, chifukwa chake sizingafanane ndi mankhwala oyamba.

Mwa zina zotetezedwa zotchedwa sibutramine, Xenical ndiwotchuka kwambiri. Chosakaniza chake, orlistat, ndiye mankhwala omwe amaphunziridwa kwambiri ochepetsa thupi pogwiritsa ntchito chitetezo chotsimikizika. Thupi limangokhala m'matumbo a lumen, kutsekereza kuyamwa kwa mafuta, ndipo silikuwakhudza dongosolo lamkati lamanjenje.

Pali anthu ambiri omwe pazifukwa zosiyanasiyana amalephera kunenepa kwambiri. Kumuchotsa kumakhala kovuta nthawi zonse. Kuchita masewera olimbitsa thupi, kudya sikuyenera kukhala njira yothandiza nthawi zonse. Kuphatikiza apo, kuwonjezera poti ndizofunikira kuti zilekane ndi zoletsa zina, komanso kugawa nthawi yina kuti muchite izi, ndikofunikira kukhala ndi mphamvu yabwino. Ichi ndichifukwa chake anthu ambiri amalabadira zamankhwala, makamaka, mankhwala Kuchepetsa Sibutramine .

Chiwerengero cha anthu onenepa kwambiri chikukula chaka chilichonse. Chifukwa chake, kufulumira kwa vutoli kukukulira. Kulemera kwambiri sikuti ndi vuto lokha. Izi zimayambitsanso kusokonezeka kwamaganizidwe: munthu amakwanira za kuchuluka kwake. Sizotheka kuti muzipewa kunenepa kwambiri, ngakhale mutakhala kuti mumakonda masewera tsiku lililonse ndikudya moyenera. Ichi ndichifukwa chake madokotala amapereka mankhwala, makamaka, Sibutramine.

Sibutramine imalembedwa kwa anthu omwe akudwala komanso onenepa kwambiri. Pankhaniyi, chimodzi mwazofunikira kwambiri ndikusowa kwa zotsatira mukamagwiritsa ntchito njira zina zochepetsera thupi, mwachitsanzo, kutsatira zakudya zoyenera, kudya, kuchita masewera olimbitsa thupi komanso kuchita masewera olimbitsa thupi. Ngakhale kuti mankhwalawa Sibutramine ndi othandiza ndipo pambuyo popanga zotsatira zabwino amawunikira, ziyenera kumvetsedwa kuti mapiritsiwa ndi mankhwala amphamvu.

Chonde dziwani: Monga mankhwala ena ambiri, Sibutramine ali ndi zotsatira zake zoyipa ndi zotsutsana zina.

Sibutramine, monga mankhwala aliwonse, ayenera kugwiritsidwa ntchito pokhapokha atakambirana ndi dokotala wotsogola, chifukwa kuigwiritsa ntchito molakwika kungayambitse zotsatira zoyipa komanso mankhwala osokoneza bongo. Mwambiri, ndemanga zakuchepetsa thupi za Sibutramine ndizosiyanasiyana. Kupatula apo, monga mankhwala ena ambiri, sizingakhale zoyenera kwa munthu.

Zambiri

Mankhwalawa adawoneka zoposa makumi awiri zapitazo. Sibutramine ili ndi vuto lalikulu pochiza kunenepa kwambiri komanso kunenepa kwambiri. Ndikofunika kumvetsetsa kuti kuchepetsa thupi pokhapokha kumwa mapiritsi awa sikugwira ntchito. Sibutramine tikulimbikitsidwa kuti izigwiritsidwa ntchito pokhapokha pokhapokha ngati wodwala amawongolera zakudya, komanso kuchita pafupipafupi komanso pang'onopang'ono zolimbitsa thupi.

Chinthu choyamba chomwe chimamveka mutatenga mapiritsi a Sibutramine ndikumverera kokwanira. Ngakhale mutamadya chakudya chochepa kwambiri, ndikokwanira kwa thupi ndipo lidzakhuta. Ichi ndi chimodzi mwazinthu zofunika kwambiri za Sibutramine. Izi zimachitika chifukwa cha mphamvu yake kumbali ya ubongo yomwe imayambitsa satiety. Chifukwa chake, izi zimatsogolera kuti wodwalayo amadya chakudya chochepa kwambiri, zomwe asunga komanso mafuta amthupi amawotchedwa.

Amatembenuka ndikugwiritsa ntchito mankhwalawa pochitika kuti njira zina sizinakhale ndi kufunika kochepera. Ndizotheka kwambiri kuti madokotala amalimbikitsa kumwa mapiritsi a Sibutramine. Munthawi yonse ya chithandizo, wodwalayo amayenera kuyang'aniridwa ndi dokotala yemwe amathandizira pazovuta zakuchepera.

Kuphatikiza apo, ntchito zotsatirazi ziyenera kutchulidwa:

• chakudya chamagulu,
• kusintha kwa moyo wanu ndi zizolowezi zina,
• kuchuluka kwa zolimbitsa thupi, masewera.

Kugawidwa kwa Sibutramine

Poyamba, mankhwalawa amapangidwa ku United States, koma lero aletsedwa kuti azigwiritsidwa ntchito m'maiko ngati Canada, Europe, Australia, United States. Izi zidachitika chifukwa choti zotsatira zoyipa za sibutramine pamtima zimatsimikiziridwa. Ku Russia, mankhwala, monga mawonekedwe ake, angagulidwe ku pharmacy kokha mwa mankhwala. Adzalemba mndandanda wa mankhwala amphamvu. Komabe, imayikidwa pokhapokha pakutha kwa zakudya komanso zolimbitsa thupi.

Atsikana amakono amakonda kuchepa thupi komanso kukhala ndi chiuno chochepa. Kupita ku cholinga ichi sikophweka, koma mankhwala osiyanasiyana ndi othandiza kwambiri pankhani yotere. Ndemanga yakuchepetsa "Sibutramine" imatsutsa kuti mapiritsiwa ndi othandizadi. Chida ichi chimathandizira kuchepetsa thupi mwachangu, koma pokhapokha potsatira malamulo ogwiritsa ntchito ndi kuwasunga.

Pakumva zakugwiritsa ntchito bwino kwa mankhwalawa, anthu ali ndi chidwi ndi malangizo ndikuwunika pa "Sibutramine." M'malo mwake, zimasiyana ndi omwe amapikisana nawo pazinthu zina zomwe zimawonetsedwa ndikugwiritsa ntchito. Ngati simutsatira malamulowo, musayerekeze kuchita zabwino, koma utha kuwononga thanzi lanu m'njira imeneyi mwachangu.

M'nkhaniyi mutha kudziwa zambiri za mankhwalawa. Mndandanda wa Sibutramina, malangizo ogwiritsira ntchito ndi kuwunikira - zonsezi zitha kukhala zothandiza kwa amayi ndi abambo omwe sakhutira ndi mawonekedwe awo.

Malangizo apadera

Kugwiritsira ntchito ndikotheka pokhapokha ngati njira zina zonse zothandizira kuchepetsa thupi sizigwira ntchito. Chithandizo chikuyenera kuchitika moyang'aniridwa ndi dokotala wodziwa kukonza kunenepa ngati gawo la zovuta mankhwala (zakudya, kusintha kadyedwe ndi moyo, kuwonjezera zolimbitsa thupi). Mlingo wa 15 mg uyenera kuchepa nthawi.

Zotsatira za sibutramine m'thupi

Sibutramine ndiwofanana ndi amphetamines, ngakhale samapatsidwa mphamvu zachilengedwe. Ndizofunikira kwambiri pakapangidwe kake, choletsa kubwezeretsanso kwa serotonin, norepinephrine ndi dopamine.

Chifukwa chake, zotsatira za sibutramine m'thupi zimachepetsedwa kupondereza njala poonjezera kuchuluka kwa serotonin m'thupi. Kumwa mankhwala osokoneza bongo a sibutramine kumachepetsa chilakolako chofuna kudya, kumapangitsa kuti munthu azikhala ndi mtima wofulumira, kumachepetsa kufunika kwa chakudya chamafuta, kumathandizira njira zama metabolic - thupi limayamba kugwiritsa ntchito mafuta ake momwe limasungidwira, ndipo minofu imalowetsa glucose bwino.

Pambuyo potenga sibutramine, imatenga bwino m'matumbo ndikuwupanga m'chiwindi ndikupanga zinthu zofunikira. The pazipita ambiri yogwira plasma amadziwika ola limodzi ndi theka atatha pharmacological wothandizila metabolites - pambuyo maola atatu.

Mankhwala

Sibutramine ikuletsa kubwezeretsanso kwa ma neurotransmitters (norepinephrine ndi serotonin) kuchokera ku synaptic cleft, kumathandizira kusintha kwa synergistic kwa chapakati pa serotonergic ndi norepinephrine. Imachepetsa kuchuluka kwa chakudya chomwe chimadyedwa ndi chilakolako cha chakudya (kumawonjezera kukhuta), zimakhudza minofu ya bulauni ya adipose, imachulukitsa thermogenesis (chifukwa cha kusakhazikika kwa beta3-adrenergic receptors). Sibutramine imapanga metabolites yogwira ntchito mthupi, yomwe imaposa kwambiri mu mphamvu yake yoletsa kubwezeretsanso kwa norepinephrine ndi serotonin. Kuphatikiza apo, ma metabolites awa amalepheretsanso kubwezeretsa kwa dopamine, koma katatu kokha ofooka kuposa norepinephrine ndi serotonin. Sibutramine yokhala ndi metabolites yake yogwira sikukhudza ntchito ya MAO komanso kutulutsidwa kwa ma monoamines, alibe zotsatira za antihistamine ndi anticholinergic, ndipo sagwirizana ndi ma neurotransmitter receptors (kuphatikizapo adrenergic, serotonergic, benzodiazepine, dopaminergic ndi glutamate). Sibutramine imalepheretsa kupatsidwa zinthu za m'magazi a serotonin ndipo amatha kusintha ntchito. Ndi kuchepa kwa thupi mu seramu yamagazi, zomwe zili mu HDL zimachuluka komanso kuchuluka kwa cholesterol, triglycerides, uric acid ndi LDL kumachepa.

Pa chithandizo cha sibutramine, kupuma magazi kumangowonjezereka pang'ono (ndi 1-3 mm Hg) ndipo zimachitika mokulira (mwa ma 3- 7 kumenyedwa / mphindi), koma nthawi zina kusintha kumeneku kumatha kutchulidwa. Mukamagwiritsa ntchito sibutramine ndi zoletsa za microsomal oxidation, nthawi ya QT imatenga nthawi yayitali (ndi 9.5 ms) ndipo kugunda kwamphamvu kumawonjezeka (mwa 2,5 kumenyedwa / mphindi).

Kafukufuku mu mbewa ndi makoswe a carcinogenic, mutagenic, teratogenic zotsatira komanso zovuta pakubala kwa sibutramine sizinawonetsedwe, kuchuluka kwa zotupa za zotumphukira za mkati mwa minofu ya testes kumawonjezeka makamaka m'makola amuna. Koma mu maphunziro a akalulu mu mbadwa, zodwala pakukula kwa thupi zidawululidwa (kusintha kukula kapena mawonekedwe a mchira, auricle, muzzle, ndi mafupa makulidwe).

Mukamamwa pakamwa, sibutramine imatengedwa mwachangu m'mimba ndi osachepera 77%. Mu "gawo loyambirira" kudzera m'chiwindi, mankhwalawa amaphatikizidwa ndi gawo la CYP3A4 isoenzyme ya cytochrome P450 ndikupanga metabolites awiri (di - ndi monodesmethylsibutramine). Mukamamwa 15 mg ya mankhwalawa, kuchuluka kwa monodemethylsibutramine pafupifupi 4 ng / ml, didesmethylsibutramine pafupifupi 6.4 ng / ml. Kuzungulira kwakukulu kwa sibutramine kumatheka pambuyo pa maola 1,2, metabolites yake yogwira pambuyo pa maola 3-4. Kuphatikizika kwa mankhwalawa ndi chakudya kumachepetsa kuchuluka kwa ma metabolites ndi 30% ndikuwonjezera nthawi kuti mufikire maola 3, pomwe AUC sasintha. The kuchuluka kwa ndende mu magazi a metabolites yogwira ya sibutramine zimatheka mkati mwa masiku 4 atayamba chithandizo ndipo pafupifupi kawiri kuposa momwe plasma imakhalira atamwa kamodzi. Sibutramine imagawidwa mwachangu monseponse. Sibutramine imamangiriza mapuloteni a plasma ndi 97%, metabolites ake yogwira - mwa 94%. Hafu ya moyo wa sibutramine ndi maola 1.1, didesmethylsibutramine ndi maola 16, monodesmethylsibutramine ndi maola 14. Ma metabolites omwe amagwira ntchito amakumana ndi kuphatikizika kwa hydroxylation ndi kupangika kwa metabolites osagwira, omwe amuchotsa makamaka ndi impso.

Yang'anani! Kuyambira 2010, sibutramine ndi kukonzekera zomwe zili mmenemu zaletsedwa kugulitsa ku Europe, USA, Canada ndi Australia chifukwa chotsimikiziridwa ndi zochita za mtima ndi mtima. EMEA imalangiza kuti madokotala samapereka mankhwala ochulukirapo kuposa sibutramine, omwe amamasulira sawamasula, ndipo odwala ayenera kufunsa dokotala kuti asinthe chithandizo.

Chithandizo chokwanira chamtundu wa odwala omwe ali onenepa kwambiri ndi kunenepa kwambiri kwa alimentary ndi index ya 30 kg / m2 kapena kuposerapo kapena ndi index yaumwini wa 27 kg / m2 kapena kuposa, koma pamaso pazinthu zina zowopsa zomwe zimalumikizidwa ndi kunenepa kwambiri kwa thupi ( dyslipoproteinemia, mtundu 2 shuga mellitus).

Contraindication

Hypersensitivity, bulimia manthaosa kapena anorexia manthaosa, kukhalapo kwa organic zomwe zimayambitsa kunenepa kwambiri, Gilles de la Tourette syndrome, zotumphukira zamagetsi zamatsenga, kufooka kwa mtima, matenda amisala, matenda amtima, matenda obadwa nawo m'mitsempha, kuthamanga kwa magazi (kupanikizika kwa magazi kufalikira kwa 145) / 90 mmHg), matenda amiseche (ngozi yochepa yamitsempha yamagazi, sitiroko), kuwonongeka kwakukulu kwa magwiridwe antchito a impso kapena chiwindi, maso chikomokere, hyperthyroidism, pheochromocytoma, benign Prostatic hyperplasia, yomwe imayendera limodzi ndi kukhalapo kwa mkodzo wotsalira, mankhwala osokoneza bongo, kudalirika kwamankhwala komanso zakumwa zoledzeretsa, kugawana kapena nthawi yochepera masabata awiri atachotsa ma inhibitors a MAO kapena mankhwala ena omwe amagwira ntchito pamitsempha yapakati yamitsempha ndi antidepressants, antipsychotic, tryptophan), komanso mankhwala ena ochepetsa thupi.

Mayina ogulitsa mankhwala osokoneza bongo omwe ali ndi yogwira mankhwala sibutramine

Sibutramine, komanso mawonekedwe ake ofanana omwe ali ndi mawonekedwe ofanana ndi psychoactive, akuphatikizidwa mu "Mndandanda wazinthu zamphamvu pazolinga za Article 234 ndi zolemba zina za Criminal Code of the Russian Federation", yovomerezedwa ndi Lamulo la Boma la Russian Federation ya Disembala 29, 2007 N 964. Chidziwitso Pandandanda chikusonyeza. kuti mitundu yonse ya mulingo, ngakhale atchulidwa mayina (amalonda), omwe amaphatikizira zomwe zalembedwa mndandandawu kuphatikiza ndi zinthu zomwe sizikuyenda bwino pamankhwala TH mndandanda. Ku Russia, mankhwalawa amatha kugulidwa mwalamulo ndi mankhwala a dokotala komanso pokhapokha ngati ali ndi zilolezo zochitira mankhwala omwe ali ndi ufulu wogwira ntchito ndi zinthu zoopsa komanso zowopsa, malinga ndi mindandanda ya PKKN.

Njira ya kumwa mankhwala kutengera yogwira mankhwala sibutramine

Sibutramine ya kuwonda iyenera kutengedwa mosamalitsa malinga ndi malangizo. Opanga mankhwala amati kuti asamamwe kudya, ndikokwanira kumwa 10 mg ya sibutramine patsiku. Nthawi yomweyo, amalimbikitsa kuchepetsa kudya kalori tsiku lililonse ndi 20% ndikuchita zolimbitsa thupi kangapo pa sabata.

Njira yotenga ndalama pokhazikitsidwa ndi ichi ndi yayitali - kuyambira miyezi itatu mpaka isanu ndi umodzi, nthawi zina imatha kukhala chaka chimodzi. Kugwiritsa ntchito sibutramine kumatheka pokhapokha pomwe wodwala sangachepetse thupi mothandizidwa ndi kulimbitsa thupi komanso kudya. Nthawi zambiri, musanapereke mankhwala omwe amathandizira kupanga serotonin, wodwalayo amamuika pakudya, kumuyang'ana kwakanthawi. Ngati kusintha kwa zakudya sikunathandize pakuchepetsa thupi, mankhwala omwe ali ndi sibutramine adayikidwa.

Kodi chiwopsezo cha sibutramine: mavuto ndi zotsatira zake

Sibutramine yokhudza kuchepetsa thupi ndi mankhwala omwe amapezeka paliponse, koma pang'onopang'ono, atsikana onenepa komanso akatswiri azachipatala amatcha poizoni ndi mankhwala amphamvu. Opanga mankhwala opanga mankhwalawa m'njira zonse zotheka amatsutsa izi ndikugawa sibutramine movomerezeka mwamaina osiyanasiyana ogulitsa.

Kodi chiwopsezo cha sibutramine ndikuti chimavulaza thupi? Popeza kuti chinthu chomwe chimagwira ntchito chimakhudza ubongo, zotsatira zoyipa za njira imeneyi yochepetsera thupi zimatheka.Mwa zina zoyipa zomwe zimachitika chifukwa cha sibutramine, akatswiri amati kudwala kwa mtima ndi psyche. Kuopsa komanso kukayikira kwa mankhwala opangidwa ndi mankhwala okhala ndi zoterezi zimatsimikiziridwa ndikuti amaletsedwa m'maiko ambiri aku Europe.

Sibutramine poyambirira adayesedwa kuti agwiritsidwe ntchito ngati njira yothandizira pakukhumudwa, koma mwatsoka, sizinalandire zabwino. Koma panthawi yoyeserera, kuwunika kwake komwe kudapangitsa chidwi chake kudali kuwona. Kuyambira pamenepo, sibutramine wagwiritsidwa ntchito ngati. Pali mayiko angapo omwe mankhwalawo amaletsedwa. Chifukwa chake, kutumizidwa kumayiko a CIS kuyimitsidwa.

Kugwiritsa ntchito mankhwalawa kuli komwe kungachitike ngati njira zina zochepetsera thupi sizipereka mphamvu. Sibutramine imagwiritsidwa ntchito limodzi ndi zakudya kapena zolimbitsa thupi. Chifukwa chake zibweretsa zina zambiri:

• Chepetsani chilakolako
• Kuwonongeka kogwira mafuta,
• Kukhazikitsa kwa serotonin, komwe kumathandizira kuti muzitha bwino,
• Imachepetsa kupendekera ndi kuthekera kotukuka,
• Pazinthu zabwino, kuwonda kuyambira 7 mpaka 15 makilogalamu pamwezi.

Momwe mungasinthire sibutramine

Mankhwala osokoneza bongo: