Diagninide - malangizo a boma ogwiritsira ntchito
Fomu ya Mlingo - mapiritsi: flat-cylindrical, oyera oyera otsekemera kapena achikasu (mapiritsi a 0,5 ndi 2 mg) kapena kuchokera ku chikasu chopepuka mpaka chikasu (mapiritsi 1 mg), omwe amakhala ndi bevel (ma PC 10. Ma contour cell) phukusi, mu katoni 2 kapena 6 phukusi).
Piritsi 1:
- yogwira mankhwala: repaglinide - 0,5, 1 kapena 2 mg,
- zotuluka: meglumine, potaziyamu polacryline, cellcrystalline cellulose, lactose monohydrate, magnesium stearate, colloidal silicon dioxide, poloxamer, ndi utoto wachikasu utoto mapiritsi - 1 mg mapiritsi.
Zizindikiro zogwiritsidwa ntchito
Diagninide imapangidwira zochizira matenda amitundu iwiri matenda osokoneza bongo ngati sangathe kudya, kuwonda komanso kuchita zolimbitsa thupi. Amagwiritsidwa ntchito ngati monotherapy kapena kuphatikiza ndi thiazolidinediones kapena metformin, ngati nthawi ya monotherapy ndi imodzi mwa mankhwalawa - repaglinide, metformin kapena thiazolidinediones - glycemic control yokhutiritsa sizinachitike.
Contraindication
- kufupika kwa lactase, tsankho lactose, malabsorption wa glucose-galactose,
- matenda opatsirana, chithandizo chachikulu cha opaleshoni kapena zikhalidwe zina zomwe zimafuna chithandizo cha insulin,
- matenda ashuga ketoacidosis,
- matenda a shuga
- mtundu 1 shuga
- kukanika kwambiri kwa chiwindi,
- wazaka 18
- Mimba ndi kuyamwa
- munthawi yomweyo kugwiritsa ntchito gemfibrozil,
- Hypersensitivity iliyonse yamtundu wa mankhwala.
- febrile syndrome
- aakulu aimpso kulephera
- Kuchepa kwa chiwindi modekha komanso koyenera.
- uchidakwa
- kuperewera kwa zakudya m'thupi
- zambiri zowopsa.
Kafukufuku wachipatala wokhudzana ndi kugwiritsa ntchito repaglinide mwa odwala osakwanitsa zaka 18 ndi zaka zopitilira 75 sizinachitike.
Mlingo ndi makonzedwe
Mankhwala ndi mankhwala kuwonjezera pa zolimbitsa thupi ndi zakudya mankhwala.
Tengani Diagnlinide mkati makamaka mphindi 15 chakudya chisanafike, komanso chotheka kuyambira pamphindi 30 mpaka nthawi yoyamba kudya.
Mlingo woyenera wa wodwala aliyense amasankhidwa payekha kutengera kuchuluka kwa shuga m'magazi.
Ndikulimbikitsidwa kuti muyambe kulandira chithandizo cha mankhwala tsiku lililonse ndi 0,5 mg. Ngati zisanachitike kuti wodwalayo alandiranso mankhwala ena amkamwa, ndiye kuti mlingo woyambirira ndi 1 mg patsiku. Ngati ndi kotheka, sinthani kamodzi kamodzi masabata awiri. Pafupifupi tsiku lililonse 4 mg 3 pa tsiku. Mulingo wovomerezeka tsiku lililonse ndi 16 mg.
Kusamutsa ku Diagninid kuchokera ku mankhwala ena amkamwa kumatha kuchitika nthawi yomweyo. Komabe, kuchuluka kwa mankhwalawa kwa mankhwalawa sikunayambike, chifukwa chake, sikulimbikitsidwa kupitilira muyeso wa 1 mg.
Mu milandu yomwe Diaglinide imagwiritsidwa ntchito ngati gawo la zovuta mankhwala, momwemonso koyamba mlingo umagwiritsidwa ntchito ngati monotherapy. Kuphatikiza apo, Mlingo wa mankhwala uliwonse umasinthidwa payekhapayekha, kutengera kuchuluka kwa shuga m'magazi.
Diagninide: mitengo pamafakitale apakompyuta
Dilesi yotizindikira. 1mg n30
Diagninide 1 mg mapiritsi 30 ma PC.
DIAGLINID 1mg 30 ma PC. mapiritsi
Zambiri zokhudzana ndi mankhwalawa ndizofanana, zimaperekedwa pazidziwitso ndipo sizilowa m'malo mwa malangizo ovomerezeka. Kudzipatsa nokha mankhwala kuopsa!
Kulemera kwaubongo wamunthu kuli pafupifupi 2% ya kulemera konse kwathupi, koma kumadya pafupifupi 20% ya mpweya womwe umalowa m'magazi. Izi zimapangitsa kuti ubongo wamunthu ukhale wovuta kwambiri kuwonongeka chifukwa cha kusowa kwa mpweya.
Pa moyo, munthu wamba amapanga miyala yocheperako yoposa awiri.
Impso zathu zimatha kuyeretsa malita atatu a magazi mphindi imodzi.
Ngakhale mtima wa munthu sugunda, akhoza kukhalabe ndi moyo nthawi yayitali, monga asodzi aku Norweji a Jan Revsdal. "Galimoto" yake idayima kwa maola 4 asodzi atasowa ndikugona mu chisanu.
Malinga ndi kafukufuku, azimayi omwe amamwa magalasi angapo a mowa kapena vinyo pamlungu amakhala pachiwopsezo chotenga khansa ya m'mawere.
Caries ndimatenda ofala kwambiri padziko lonse lapansi omwe ngakhale chimfine sangathe kupikisana nawo.
Okonda akapsopsona, aliyense wa iwo amataya 6.4 kcal pamphindi, koma nthawi yomweyo amasinthana mitundu pafupifupi 300 ya mabakiteriya osiyanasiyana.
Ku UK, kuli lamulo malinga ndi momwe dokotala wothandizira amatha kukanachita opaleshoni ngati atasuta kapena wonenepa kwambiri. Munthu ayenera kusiya zizolowezi zoipa, kenako, mwina, sangafunikire opareshoni.
Ngati mumamwetulira kawiri kokha patsiku, mutha kuchepetsa kuthamanga kwa magazi ndikuchepetsa chiopsezo cha matenda a mtima ndi stroko.
Mimba ya munthu imagwira ntchito yabwino ndi zinthu zakunja komanso popanda chithandizo chamankhwala. Madzi am'mimba amadziwika kuti amasungunula ngakhale ndalama.
Chiwindi chanu chikasiya kugwira ntchito, imfa imatha pakatha tsiku limodzi.
Pali ma syndromes osangalatsa kwambiri azachipatala, monga kuphatikiza zinthu. M'mimba mwa wodwala m'modzi wodwala mania uyu, zinthu 2500 zakunja zidapezeka.
Mankhwala odziwika bwino "Viagra" adapangidwa poyambirira pochizira matenda oopsa.
Asayansi ochokera ku Oxford University adachita kafukufuku wambiri, pomwe adazindikira kuti zamasamba zimatha kuvulaza ubongo wa munthu, chifukwa zimapangitsa kuti kuchuluka kwake kuzikhala kochepa. Chifukwa chake, asayansi amalimbikitsa kuti asachotsere konse nsomba ndi nyama muzakudya zawo.
Malinga ndi kafukufuku wa WHO, kuyankhulana kwa theka la ola limodzi pafoni kumawonjezera mwayi wokhala ndi chotupa muubongo ndi 40%.
Mphepo yoyamba ya maluwa ikufika kumapeto, koma mitengo yotulutsa maluwa idzasinthidwa ndi udzu kuyambira koyambirira kwa Juni, zomwe zimasokoneza omwe ali ndi vuto lodziwika bwino.
Fomu ya Mlingo:
Piritsi limodzi lili:
ntchito: repaglinide malinga ndi zinthu 100% - 0,5 mg, 1 mg ndi 2 mg,
zokopa: poloxamer (mtundu 188) 3 mg 3 mg kapena 3 mg, meglumine 10 mg 10 mg kapena 13 mg, lactose monohydrate 47.8 mg, 47,55 mg kapena 61.7 mg, microcrystalline cellulose 33.7 mg, 33.45 mg kapena 45 mg, potaziyamu ya polacryline 4 mg 4 mg kapena 4 mg, colloidal silicon diodig 0.5 mg 0,5 mg kapena 0,7 mg, magnesium stearate 0,5 mg wa 0,5 mg kapena 0,6 mg, motsatana.
Mapiritsi ozungulira ozungulira amiyala yoyera ndi oyera otuwa kapena achikasu. Mapiritsi 1 mg ali pachiwopsezo
Mankhwala
Mankhwala
Oral hypoglycemic wothandizira, amathandizira kutulutsa kwa insulini pakugwiritsa ntchito maselo a beta a kapamba. Imalepheretsa njira zotsalira za ATP munkati mwa maselo a beta kudzera m'mapuloteni enieni, omwe amachititsa kuti maselo a beta atsegulidwe komanso kutsegulidwa kwa njira za calcium. Kuchulukanso kwa calcium ions kumapangitsa insulin kutulutsa.
Odwala omwe ali ndi matenda a shuga 2, mayankho a insulinotropic amadya pakatha mphindi 30 atayamba kumwa. Izi zimapereka kuchepa kwa kuchuluka kwa shuga m'magazi nthawi yonse ya chakudya. Pankhaniyi, kuchuluka kwa mankhwala obaya omwe amapezeka m'madzi a m'magazi kumatha kuchepa, ndipo maola 4 atatha kumwa mankhwalawa m'magazi a odwala matenda a shuga 2, amayamba kupezeka m'magazi. Mukamagwiritsa ntchito repaglinide mu mlingo wochokera pa 0,5 mpaka 4 mg, kuchepa kwa shuga komwe kumachitika mu glucose kumadziwika.
Pharmacokinetics
Mukamamwa pakamwa, mayamwidwe a repaglinide kuchokera m'matumbo am'mimba amakhala okwera. Nthawi yofika ndende yayitali ndi ola limodzi. Nthawi zambiri bioavailability wa repaglinide ndi 63% (kusintha kosiyanasiyana ndi 11%). Popeza titration wa mlingo wa repaglinide ikuchitika kutengera yankho la mankhwala, kusinthasintha osiyanasiyana sikukhudza mphamvu ya mankhwala. Kugawa voliyumu - 30 l. Kuyankhulana ndi mapuloteni a plasma - 98%. Zimapukusidwa kwathunthu m'chiwindi pakukhudzana ndi CYP3A4 kuma metabolites osagwira. Amapukusidwa makamaka ndi bile, impso - 8% mu mawonekedwe a metabolites, kudzera m'matumbo - 1%. Hafu ya moyo ndi ola limodzi.
Kulephera kwa chiwindi. Kugwiritsanso ntchito kwa repaglinide mwachizolowezi kwa odwala omwe ali ndi vuto la chiwindi kungayambitse kuchuluka kwa chitetezo cham'magazi komanso metabolites kuposa odwala omwe ali ndi chiwindi chokwanira. Pankhaniyi, kugwiritsa ntchito repaglinide kumakhudzana ndi odwala omwe ali ndi vuto la chiwindi, ndipo odwala omwe ali ndi vuto la hepatic ntchito yofatsa komanso yolimbitsa chiwindi amayenera kugwiritsidwa ntchito mosamala. Zotheka pakati pakusintha kwa mankhwalawa ziyeneranso kuwonjezeredwa kuti zitsimikizike moyenera momwe mankhwalawo amathandizira.
Kulephera kwina. Madera omwe ali munthawi ya ndende (AUC) komanso yodziwika kwambiri ya plasma ndende ya repaglinide (C) ali chimodzimodzi kwa odwala omwe ali ndi vuto laimpso komanso odwala omwe ali ndi vuto laimpso. Odwala omwe ali ndi vuto la impso, kuwonjezeka kwa AUC ndi C kunadziwika, komabe, kulumikizana kofooka pakati pa kuchuluka kwa repaglinide ndi chilolezo cha creatinine kumapezeka. Zikuwoneka kuti odwala omwe ali ndi vuto la impso palibe chifukwa chosinthira koyamba mlingo. Komabe, kuwonjezeka kwa mlingo wotsatira kwa odwala omwe ali ndi mtundu wa matenda a shuga 2 kuphatikiza kwambiri kuwonongeka kwa impso, komwe kumafunikira hemodialysis, kuyenera kuchitika mosamala.
Chizindikiro chogwiritsidwa ntchito.
Type 2 shuga mellitus (wokhala ndi vuto la kudya, kuchepa thupi komanso kuchita masewera olimbitsa thupi) mu monotherapy kapena kuphatikiza ndi metformin kapena thiazolidatediones pakagwiridwe kokwanira ka glycemic sikungatheke ndi monotherapy ndi repaglinide kapena metformin kapena thiazolidinediones.
Mlingo ndi makonzedwe.
Diagninide imafotokozedwa ngati njira yowonjezerapo zakudya komanso zolimbitsa thupi kuti muchepetse kuchuluka kwa shuga m'magazi, kumayambiriro kwake kumayenera kukhala kwa chakudya. Mankhwalawa amatengedwa pakamwa asanadye kaye, nthawi zambiri mphindi 15 isanayambike chakudya, koma amathanso kuumwa pakadutsa mphindi 30 chakudya chisanachitike. Mlingo wa mankhwalawa amasankhidwa payekha kwa wodwala aliyense, kutengera kuchuluka kwa shuga m'magazi. Mlingo woyambirira ndi 0,5 mg / tsiku (ngati wodwalayo adatenga mankhwala ena amkamwa a hypoglycemic - 1 mg). Kusintha kwa Mlingo kumachitika kamodzi pa sabata kapena kamodzi pa masabata awiri (poyang'ana kwambiri kuchuluka kwa shuga m'magazi monga chisonyezo cha kuyankha kwa mankhwala). Pafupifupi tsiku lililonse tsiku ndi 4 mg katatu patsiku, kuchuluka kwake ndi 16 mg / tsiku.
Kusamutsa odwala ndi mankhwala ena amkamwa hypoglycemic mankhwala Repaglinide chithandizo chitha kuchitika nthawi yomweyo. Komabe, ubale womwe ulipo pakati pa mlingo wa repaglinide ndi mlingo wa mankhwala ena a hypoglycemic sunawululidwe. Mulingo woyambira woyambira wa repaglinide mukamachokera ku mankhwala ena a hypoglycemic ndi 1 mg musanadye.
Kuphatikiza mankhwala Repaglinide ikhoza kutumikiridwa limodzi ndi metformin kapena thiazolidatediones ngati magazi sayenda mokwanira m'magazi a monotherapy ndi metformin, thiazolidinediones kapena repaglinide. Pankhaniyi, mlingo womwewo wa repaglinide umagwiritsidwanso ntchito ngati monotherapy. Kenako patsani kusintha kwa mankhwalawa aliyense malinga ndi kuchuluka kwa shuga m'magazi.
Magulu apadera a odwala (onani gawo "Malangizo Apadera"). Sitikulimbikitsidwa kupatsanso repaglinide kwa anthu ochepera zaka 18 chifukwa cha kusowa kwa chidziwitso chokwanira pa chitetezo chake komanso kugwira ntchito bwino m'gululi.
Kupanga ndi mawonekedwe a kumasulidwa
Mapiritsi - 1 piritsi:
Zinthu zothandizira: repaglinide - 1 mg.
Othandizira: poloxamer - 3 mg, meglumine - 10 mg, lactose monohydrate - 47,5 mg, microcrystalline cellulose - 33.45 mg, potaziyamu polacryline - 4 mg, colloidal silicon diabetes - 500 μg, utoto wachikasu wachinayi - 500 μg mcg.
Oral hypoglycemic mankhwala. Imalimbikitsa kutulutsidwa kwa insulin pochita cells-maselo a kapamba. Imalepheretsa njira zotsalira za ATP mumitsempha yama β-cell kudzera m'mapuloteni opindika, omwe amatsogolera pakuwonongeka kwa maselo a β-ndikutsegulidwa kwa njira za calcium. Kuchulukanso kwa calcium ions kumapangitsa insulin kutulutsa. Odwala omwe ali ndi matenda a shuga 2, mayankho a insulinotropic amadya pakatha mphindi 30 atayamba kumwa. Izi zimapereka kuchepa kwa kuchuluka kwa shuga m'magazi nthawi yonse ya chakudya. Pankhaniyi, kuchuluka kwa repaglinide mu plasma kumachepa kwambiri, ndipo maola 4 mutatha kumwa mankhwalawa m'magazi a odwala matenda a shuga a 2, kutsika kwa repaglinide kumapezeka. Mukamagwiritsa ntchito repaglinide mu mlingo wochokera pa 0,5 mpaka 4 mg, kuchepa kwa shuga komwe kumachitika mu glucose kumadziwika.
Mukaperekedwa, kuyamwa kwa repaglinide kuchokera m'matumbo am'mimba kumakhala kwakukulu. Nthawi yofikira Cmax ndi ola limodzi. Nthawi zambiri bioavailability wa repaglinide ndi 63% (kusintha kosiyanasiyana ndi 11%). Popeza titration wa mlingo wa repaglinide ikuchitika kutengera yankho la mankhwala, kusinthasintha osiyanasiyana sikukhudza mphamvu ya mankhwala.
Kugawa ndi kagayidwe:
Vd - 30 l. Kumangiriza kwa mapuloteni a plasma - 98%. Zimapukusidwa kwathunthu m'chiwindi pakukhudzana ndi CYP3A4 kuma metabolites osagwira.
Amapukusidwa makamaka ndi bile, impso - 8% mu mawonekedwe a metabolites, kudzera m'matumbo - 1%. T1 / 2 - 1 ora
Pharmacokinetics pazochitika zapadera zamankhwala:
Kugwiritsanso ntchito kwa repaglinide mwachizolowezi kwa odwala omwe ali ndi vuto la chiwindi kungayambitse kuchuluka kwa chitetezo cham'magazi komanso metabolites kuposa odwala omwe ali ndi chiwindi chokwanira. Pankhaniyi, kugwiritsa ntchito repaglinide kumakhudzana ndi odwala omwe ali ndi vuto la chiwindi, ndipo odwala omwe ali ndi vuto la hepatic ntchito yofatsa komanso yolimbitsa chiwindi amayenera kugwiritsidwa ntchito mosamala. Zotheka pakati pakusintha kwa mankhwalawa ziyeneranso kuwonjezeredwa kuti zitsimikizike moyenera momwe mankhwalawo amathandizira.
AUC ndi Cmax ndi omwe amathandizanso odwala omwe ali ndi vuto laimpso komanso odwala omwe ali ndi vuto laimpso ofatsa kapena owonjezera. Odwala omwe ali ndi vuto la impso, kuwonjezeka kwa AUC ndi Cmax kunadziwika, komabe, kuphatikizika kofooka kokha komwe kumapezeka pakati pa kuchuluka kwa repaglinide ndi chilolezo cha creatinine. Zikuwoneka kuti odwala omwe ali ndi vuto la impso palibe chifukwa chosinthira koyamba mlingo. Komabe, kuwonjezeka kwa mlingo wotsatira kwa odwala omwe ali ndi mtundu wa matenda a shuga 2 kuphatikiza kwambiri kuwonongeka kwa impso, komwe kumafunikira hemodialysis, kuyenera kuchitika mosamala.
Wothandizira pakamwa wa hypoglycemic amathandizira kuti amasulidwe a insulini pakugwira ntchito kwa maselo a beta a kapamba. Imalepheretsa njira zotsalira za ATP munkati mwa maselo a beta ndi mapuloteni ojambulidwa, omwe amatsogolera pakuwonongeka kwa maselo a beta komanso kutsegulidwa kwa njira za calcium. Kuchulukana kwa calcium ions kumapangitsa kuti insulin itulutsidwe. Odwala omwe ali ndi matenda a shuga 2, mayankho a insulinotropic amawonedwa pakadutsa mphindi 30 atayamba kumwa.Izi zimapereka kuchepa kwa kuchuluka kwa shuga m'magazi nthawi yonse ya chakudya. Pankhaniyi, kuchuluka kwa repaglinide mu plasma kumatsika msanga, ndipo patatha maola 4 mutatha kumwa mankhwalawa m'magazi a odwala omwe ali ndi matenda amtundu wa 2, kutsika kwa mapangidwe a repaglinide kumapezeka. Mukamagwiritsa ntchito repaglinide mu mlingo wochokera pa 0,5 mpaka 4 mg, kuchepa kwa shuga komwe kumachitika mu glucose kumadziwika.
Oral hypoglycemic mankhwala.
Diagninide imafotokozedwa ngati njira yowonjezerapo zakudya komanso zolimbitsa thupi kuti muchepetse kuchuluka kwa shuga m'magazi, kumayambiriro kwake kumayenera kukhala kwa chakudya.
Mankhwalawa amatengedwa pakamwa asanadye kaye, nthawi zambiri mphindi 15 isanayambike chakudya, koma amathanso kuumwa pakadutsa mphindi 30 chakudya chisanachitike.
Repaglinide ikhoza kutumikiridwa limodzi ndi metformin kapena thiazolidatediones ngati magazi sayenda mokwanira m'magazi a monotherapy ndi metformin, thiazolidinediones kapena repaglinide. Pankhaniyi, mlingo womwewo wa repaglinide umagwiritsidwanso ntchito ngati monotherapy. Kenako patsani kusintha kwa mankhwalawa aliyense malinga ndi kuchuluka kwa shuga m'magazi.
Dziwani zotsatira zoyipa
Zotsatira zoyipa kwambiri ndizo hypoglycemia, pafupipafupi zomwe zimadalira, monga mtundu uliwonse wa mankhwala a shuga ogwirira ntchito, pazinthu zina monga machitidwe a kadyedwe, kumwa mankhwala, zochita zolimbitsa thupi komanso kupsinjika. Izi ndi zotsatirapo zoyipa zomwe zimawonedwa ndikugwiritsanso ntchito kwa repaglinide ndi othandizira ena pakamwa. Zotsatira zonse zoyipa zimagawika m'magulu potengera chitukuko: nthawi zambiri (> = 1/100 mpaka = 1/1000 mpaka = 1/10 000 mpaka Mtengo kuchokera pa ruble 293.
Mndandanda wa mankhwala Diagninid
Analogue ndiotsika mtengo kuchokera 0 rub.
Jardins ndi mankhwala achilendo wochizira matenda amtundu wa 2. Empagliflozin mu 25 mg piritsi lililonse limagwira ntchito ngati gawo limodzi lokhazikika. Jardins ali ndi contraindication ndi zoletsa zaka, motero funsani ndi dokotala musanayambe chithandizo.
Analogue ndiotsika mtengo kuchokera ku ma ruble 59.
Wopanga: Novo Nordisk (Denmark)
Kutulutsa Mafomu:
- Tab. 1 mg, ma PC 30., Mtengo kuchokera 175 ma ruble
- Tab. 2 mg, ma PC 30., Mtengo kuchokera ku ma ruble 219
Malangizo ogwiritsira ntchito
NovoNorm ndimakonzedwe a piritsi kuchokera ku gulu lomwelo lamankhwala, koma pogwiritsa ntchito njira ina. Repaglinide imagwiritsidwa ntchito pano pa mulingo wa 0,5 mpaka 2 mg. Zizindikiro zakupangira zikufanana, koma ma contraindication amasiyana chifukwa cha ma DV osiyanasiyana pamapiritsi, kotero werengani malangizo mosamala ndikuwonana ndi dokotala.
Analogue ndiokwera mtengo kwambiri kuchokera ku ma ruble 2219.
Wopanga: Ikufotokozedwa
Kutulutsa Mafomu:
- Tab. tsa / obol. 100 mg, 30 ma PC., Mtengo kuchokera 2453 rubles
- Tab. 2 mg, ma PC 30., Mtengo kuchokera ku ma ruble 219
Malangizo ogwiritsira ntchito
Novo Nordisk (Denmark) NovoNorm ndi cholowa m'malo mwa Forsigi. Chokhacho chomwe chimagwira ntchito mankhwalawa ndi repaglinide. Mankhwala mkati mphindi 30 kumawonjezera insulin ndende mu magazi. Chifukwa chosowa deta pamaphunziro omwe amachitika pachitetezo cha mankhwalawa komanso kugwiritsa ntchito bwino mapiritsi pagulu la ana, sizikulimbikitsidwa kuti mugwiritse ntchito mankhwalawa kwa ana osakwana zaka 18. Mwanjira yonyansa, kutsegula m'mimba ndi kupweteka pamimba nthawi zambiri kumachitika.
Analogue ndiokwera mtengo kwambiri kuchokera ku ma ruble a 1908.
Wopanga: Ikufotokozedwa
Kutulutsa Mafomu:
- Tab. tsa / obol. 10 mg, 30 ma PC., Mtengo kuchokera ku 2142 rubles
- Tab. 2 mg, ma PC 30., Mtengo kuchokera ku ma ruble 219
Malangizo ogwiritsira ntchito
Forsiga ndi piritsi yokonzekera mankhwalawa a mtundu 2 matenda a shuga ochokera dapagliflozin mu gawo la 5 mg. Itha kutumikiridwa kuphatikiza pa zakudya zomwe anthu odwala matenda ashuga amachita komanso zolimbitsa thupi. Forsigi ali ndi contraindication ndi zoletsa zaka, werengani mosamala malangizo musanayambe chithandizo.
Zotsatira zoyipa.
Zotsatira zoyipa kwambiri ndizo hypoglycemia, pafupipafupi zomwe zimadalira, monga mtundu uliwonse wa mankhwala a shuga ogwirira ntchito, pazinthu zina monga machitidwe a kadyedwe, kumwa mankhwala, zochita zolimbitsa thupi komanso kupsinjika. Izi ndi zotsatirapo zoyipa zomwe zimawonedwa ndikugwiritsanso ntchito kwa repaglinide ndi othandizira ena pakamwa.
Zotsatira zonse zimayikidwa m'magulu potengera chitukuko, chomwe chimafotokozedwa motere:> 1/100 mpaka 1/1000 mpaka 1/10000 kupita
Diagninide: malangizo ogwiritsira ntchito komanso mtengo wa mankhwalawa
Diagninide ndi mankhwala amkamwa a hypoglycemic. Kuchita kwa mankhwalawa kumadalira kukondoweza kwa kutulutsa kwa insulin kuchokera ku maselo a beta a pancreatic minofu.
Diagninide ndimakonzedwe azachipatala omwe njira yake yothandizira imadalira mphamvu ya gawo lalikulu lomwe limagwira ntchito kuti ilimbikitse magwiridwe antchito a ATP omata m'mitsempha ya maselo am'mimba pancreatic. Gawo lolimbikira limalepheretsa mayendedwe a potaziyamu ndikutsegula njira zoyendetsera calcium.
Zomwe zimachitika m'maselo zimapangitsa kuchuluka kwa calcium, komwe ma ayoni ake amathandizira kupanga insulin.
Mukamamwa mankhwalawa ndi munthu wodwala matenda a shuga a 2, yankho la insulini limawonedwa patatha mphindi 30 mankhwala atatha.
Kuchita kwamtunduwu kumayambiriro kwa mankhwalawa kumapereka kuchepa kwa shuga m'madzi am'magazi nthawi yonse ya chakudya.
Kuphatikizika kwa gawo lomwe limagwira m'magazi amwazi kumatha kuwonjezeka mofulumira komanso kuchepa. Pambuyo maola 4 mutatha kumwa mankhwalawa, kuponya kwake kwakukulu m'thupi kumawonedwa.
Mankhwala ali pafupifupi 63% bioavailability. Zokwanira pazomwe zimagwira ntchito zimawonedwa m'magazi ola limodzi mutatha kumwa mankhwalawo. Pakumeza, kuchuluka kwa mapuloteni omanga kumafika 98%.
Yogwira pophika mankhwala amaphatikizidwa kwathunthu mothandizidwa ndi CYP3A4 m'maselo a chiwindi. Pakupanga kagayidwe, phata imakhala yosagwira. Kutupa kwa metabolites kumachitika ndi bile komanso kudzera mu impso ya impso.
The zikuchokera mankhwala, kumasulidwa mawonekedwe ndi ma CD
Mankhwalawa amapezeka ngati mapiritsi oyera, omwe amatha kukhala ndi kirimu kapena chikasu. Ma mapiritsiwo ndiwopyapyala; pamakhala miyala. Kutengera kuchuluka kwa ntchito yogwira, mtundu wa kukonzekera umasiyana mtundu.
Chofunikira kwambiri pa mankhwalawa ndi repaglinide. Zomwe mapangidwe ake amapangidwe ndi piritsi ndi 50 μg, mtundu wa mapiritsiwo ndi woyera.
Ngati piritsi ili ndi 1 mg ya mankhwala othandizira, mtundu wa mankhwalawo ndi wopepuka wachikasu kapena wachikasu.
Ngati pali mankhwala ena omwe amapangika mu 2 mg mu mankhwala, mapiritsiwo amawapaka utoto woyera ndi kirimu kapena tint yachikasu.
Kuphatikiza pazomwe zimagwira, zinthu zotsatirazi zimaphatikizidwa ndikuphatikizidwa kwa mankhwala:
- Poloxamer.
- Meglumine.
- Lactose Monohydrate.
- Cellulose
- Polyacryline Potaziyamu.
- Silicon dioxide magnesium yozizira.
Kuphatikizika uku kumagwiritsidwa ntchito pokonzekera ndi 500 μg ya mankhwala othandizira. Ngati kaphatikizidwe kamakhala ndi 1 mg wotsiriza, utoto umawonjezeredwa pazinthu zothandizira. Chikasu chachitsulo chimagwiritsidwa ntchito ngati utoto.
Zogulitsa kwa ogula, mitundu yonse ya mankhwalawa imayikidwa m'matumba a chithuza. Paketi iliyonse ili ndi mapiritsi 10.
Phukusi lachi cell ladzaza m'makatoni, omwe amakhalanso malangizo ogwiritsira ntchito mankhwalawa.
Zizindikiro, contraindication kugwiritsa ntchito mankhwala
Chizindikiro chachikulu pakugwiritsa ntchito malangizo a Diclinid chikuwonetsa kukhalapo kwa matenda ashuga a 2.
Mankhwalawa amagwiritsidwa ntchito pochiritsa ngati kugwiritsa ntchito zakudya zapadera zamagetsi komanso njira zochepetsera thupi komanso mphamvu zolimbitsa thupi thupi sizinalole kukwaniritsa zotsatira zabwino.
Mankhwalawa angagwiritsidwe ntchito pochiza, onse ngati mankhwala apakati pa monotherapy, komanso monga chimodzi mwazinthu zomwe zimagwiritsidwa ntchito pochiza zovuta.
Mukamapangira zovuta mankhwala, mankhwalawa amatha kugwiritsidwa ntchito molumikizana ndi metformin ndi thiazolidatediones.
Monga mankhwala aliwonse, Diclinid ali ndi zifukwa zingapo zotsutsana zomwe zimatha kuchepetsa mwayi wogwiritsa ntchito mankhwalawa kuchiza matenda a shuga.
Milandu yayikuluyi yogwiritsidwa ntchito molingana ndi malangizo ogwiritsira ntchito ndi awa:
- kupezeka kwa thupi la wodwala matenda a shuga 1,
- kukhalapo kwa zizindikiro za matenda ashuga a ketoacidosis wodwala,
- kupezeka kwa matenda opatsirana m'thupi,
- opaleshoni yayikulu yomwe ikufuna kuti asinthe kugwiritsa ntchito mankhwala a insulin,
- kuvulala kwambiri aimpso,
- kukhalapo kwa kuchepa kwa lactose ndi tsankho lake,
- nthawi ya bere,
- ana ndi zaka zapakati pa wodwala,
- kukhalapo kwa hypersensitivity ku zigawo za mankhwala.
Kusamala kumafuna kugwiritsa ntchito mankhwala ngati pali kuphwanya kayendedwe ka chiwindi mthupi.
Chenjezo makamaka liyenera kuchitika mukamamwa mankhwalawa, ngati wodwalayo alibe thanzi lokwanira kapena kupezeka kwa kulephera kwapezekanso m'thupi, timafunikanso kugwiritsa ntchito mankhwalawa mosamala kwa odwala omwe ali ndi vuto la uchidakwa.
Malangizo ogwiritsira ntchito mankhwalawa
Diagninide adapangira kuti agwiritsidwe ntchito pochiza matenda amisempha 2 a shuga limodzi ndi zolimbitsa thupi. Cholinga chachikulu cha mankhwalawa ndikusunga index ya glycemic mthupi mozungulira malire oyandikira ndi thupi.
Mankhwalawa amayenera kumwedwa nthawi yomweyo ndikudya, tikulimbikitsidwa kuti mumwa mankhwalawa muyeso wofunikira, kenako ndikudya pakatha mphindi 15.
Dokotala wopezekapo amasankha kuchuluka kwa mankhwalawa kwa wodwala aliyense payekhapayekha, poganizira mawonekedwe a thupi la wodwalayo ndi chizindikiro cha hyperglycemia.
Nthawi zambiri, muyeso woyamba wa mankhwalawa ndi 0,5 mg patsiku, ngati kale wodwala amatenga ena ogwiritsira ntchito hypoglycemic, ndiye kuti mlingo wa mankhwalawo ndi 1 mg. Kusintha kwa Mlingo kuyenera kuchitika sabata iliyonse kapena kamodzi pa sabata ziwiri zilizonse.
Mlingo wamba womwe umagwiritsidwa ntchito mankhwalawa ndi 4 mg patsiku, ndipo mulingo wambiri si woposa 16 mg pa tsiku.
Pogwiritsa ntchito mankhwalawa monga mankhwala othandizira, angagwiritsidwe ntchito limodzi ndi metformin kapena thiazolidinediones. Popanga mankhwala ophatikiza, mankhwalawa amakhalabe amodzimodzi pa nthawi ya monotherapy.
Ndi chithandizo china, mlingo womwe umagwiritsidwa ntchito umasinthidwa.
Kuwongolera kumachitika mbali zosiyanasiyana, kutengera mulingo wa glycemia m'thupi la wodwala wokhala ndi matenda a shuga 2.
Zotsatira zoyipa ndi mankhwala osokoneza bongo
Mavuto ambiri omwe amakumana nawo mukamalandira mankhwala ndi mawonekedwe a hypoglycemia wodwala wodwala matenda a shuga. Pafupipafupi mwadzidzidzi mbali iyi yamphamvu imangotengera mlingo wa mankhwalawo, komanso pa umunthu wa wodwalayo.
Kuphatikiza apo, mawonekedwe a zoyipa zomwe zimakhudzana ndi ntchito yamagulu osiyanasiyana ndi ziwalo za munthu.
Kutengera ndi pafupipafupi zomwe zimachitika, zovuta zonse zimatha kugawidwa m'magulu akulu akulu - pafupipafupi, ocheperako, osowa, osowa kwambiri komanso osadziwika.
Mankhwala angayambitse zotsatirazi:
- Zokhudza immunological mu mawonekedwe a kuyabwa, zidzolo ndi urticaria.
- Hypoglycemic boma ndi mkhalidwe wa hypoglycemia ndi kutaya chikumbumtima.
- Nthawi zina, kuwonongeka kowonekera kumawonedwa mu shuga. Mbali iyi imawonedwa kumayambiriro kwa mankhwalawa.
- Kusokonezeka kwa kayendedwe ka mtima.
- Ululu pamimba, kuwonongeka kwa chiwindi
- Kuchuluka kwa chiwindi michere.
Pakakhala mankhwala osokoneza bongo, matenda a hypoglycemia nthawi zambiri amakula mthupi, omwe amakhala ndi zotsatirazi:
- maonekedwe a njala,
- kutuluka thukuta kwambiri
- kuchuluka kwa mtima,
- mutu
- kukhumudwa
- malankhulidwe osokoneza.
Chithandizo cha mankhwala osokoneza bongo ndikuchulukitsa kuchuluka kwa shuga m'thupi mwa kutenga ma dextrose komanso kupukusa chakudya cham'mimba mosavuta.
Mtengo wa mankhwalawa, mawonekedwe ake ndi ndemanga zake za mankhwalawa
Mtengo wa mankhwala mdera la Russian Federation zimatengera dera lomwe mankhwalawo amagulitsidwa ndipo pafupifupi pafupifupi 200-220 ma ruble pachilichonse. Mankhwala, mankhwala amaperekedwa ndi mankhwala.
Mankhwala ayenera kusungidwa kuti ana asawafikire. Malo osungiramo mankhwalawo amayenera kutetezedwa ku dzuwa. Kutentha kosungiramo mankhwalawo sikuyenera kupitirira 25 digiri Celsius. Alumali moyo wa mankhwala 2 zaka.
About Diaglinide, mutha kupeza ndemanga zosiyanasiyana za odwala omwe adagwiritsa ntchito mankhwalawa pochiza matenda a shuga a mtundu wachiwiri. Komabe, malingaliro ambiri ndiabwino.
Izi zikuwonetsa kuti mankhwalawa amagwira ntchito mokwanira kuti ayang'anire plasma glycemia. Kukhalapo kwa malingaliro osokoneza okhudza mankhwalawa nthawi zambiri kumayenderana ndi kuphwanya mlingo wa mankhwalawa komanso momwe mungagwiritsire ntchito mankhwalawa.
Ma fanizo odziwika bwino a mankhwalawa ndi NovoNorm ndi Repaglinide.
Mu kanema munkhaniyi, katswiriyo akuuzani momwe mungachepetse shuga.
Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD
Mapiritsi ake ndi achikasu. Amapezeka mu mitundu itatu ya mankhwala: 500 mcg, 1 ndi 2 mg.
- poloxamer
- meglumine
- lactose monohydrate,
- cellcrystalline mapadi,
- potaziyamu polacryline,
- silica colloidal
- magnesium wakuba.
Atadzaza matuza a zidutswa 15, mu paketi okhala ndi makatoni akhoza kukhala matuza awiri kapena 6.
Zotsatira za pharmacological
Oral hypoglycemic mankhwala. Imagwira ntchito mwachangu, koma zotsatira zake zimakhala zakanthawi. Repaglinide imathandizira kupanga insulin ndi maselo a beta a kapamba. Izi zimakulitsa kuchuluka kwa calcium, zomwe zimathandizanso kupanga mahomoni. Zotsatira zimawonekera kale theka la ola mutatha kumwa mapiritsi, kuchuluka kwa shuga m'magazi kumatsika komanso kukhazikika.
Pharmacokinetics
Kuchotsa m'mimba. Kuzindikira kwakukulu kumafika ola limodzi mutatha kumwa mankhwalawo. Amapangidwa maselo a chiwindi. Amachotseredwa ndi bile, komanso matumbo ndi impso. Kuchotsa theka-moyo ndi ola limodzi.
Type 2 shuga mellitus ndi chakudya chosagwira komanso zovuta zolimbitsa thupi.
Amagwiritsidwa ntchito onse mu monotherapy komanso pamankhwala othandizira.
Malangizo ogwiritsira ntchito (njira ndi Mlingo)
Amawerengera ngati chida chowonjezera pachakudya ndi magawo olimbitsa thupi ochepetsa shuga. Tengani ndi chakudya kapena mphindi 15 zisanachitike. Mlingo wake umasankhidwa ndi dokotala wopezekapo malinga ndi umboni ndi zofunikira za thupi. Mlingo woyambirira ndi 500 mcg patsiku. Konzani kamodzi kapena kawiri pa sabata kupatula kukhazikitsa zovuta.Pafupifupi tsiku lililonse nthawi zambiri mumagwiritsidwa ntchito 4 mg mu 3 mgawidwe. Zolemba malire - 16 mg patsiku. Kutumiza kuchokera ku mankhwala ena a hypoglycemic amakupatsani mwayi woti mutenge 1 mg kamodzi nthawi yomweyo.
Kuphatikiza ndi metformin ndi thiazolidinediones ndizothandiza kwambiri. Amapangidwanso chimodzimodzi ndi monotherapy.
Bongo
Zitha kutsogola kukula kwa hypoglycemia. Zizindikiro zake: kufooka, khungu, khungu, kusanza, kusazindikira (mpaka chikomokere), njala, ndi zina zambiri. Hypoflycemia yofatsa imatha kuchotsedwa ndi shuga. Ndi mawonekedwe olimbitsa komanso okhwima, mudzafunika jakisoni wa shuga kapena njira ya dextrose. munthuyu atachira, ayenera kudyetsedwa chakudya chopezeka ndi chakudya. Onetsetsani kuti mwawonana ndi dokotala kuti musinthe mlingo.
Kuyanjana kwa mankhwala
Limbikitsani zotsatira za "Diagninid":
- gemfibrozil
- madalin,
- trimethoprim,
- ketoconazole,
- rifampicin
- mankhwala ena a hypoglycemic,
- osasankha beta-blockers,
- itraconazole,
- cyclosporin
- NSAIDs
- Mao ndi ACE zoletsa,
- Mowa
- salicylates,
- octreotide
- anabolic steroids.
- kulera kwamlomo
- carbamazepine
- rifampicin
- thiazides,
- barbiturates
- mahomoni a chithokomiro
- GKS,
- danazol
- amphanomachul.
Beta-blockers amatha kumasula zizindikiro za hypoglycemia. Wodwala atatenga chilichonse mwa ndalama zomwe zili pamwambazi, ayenera kudziwitsa katswiriyo kuti asankhe nthawi yochiritsika.
Malangizo apadera
Amagwiritsidwa ntchito mosamala pamene:
- malungo
- chiwindi ntchito,
- uchidakwa
- matenda akuthupi komanso kusowa kwa chakudya.
Ndi mankhwala ophatikiza, chiopsezo cha hypoglycemia chimakulanso.
Zinthu zina (zoyaka kwambiri, kuchitapo kanthu opaleshoni, kuchulukitsa kwa matenda osachiritsika ndi opatsirana) zingafune kusintha kwa insulini.
Ndikofunikira kumayesa pafupipafupi ndikuwunika momwe zinthu zilili. Wodwala ayenera kudziwa zizindikiro za hypoglycemia ndi ketoacidosis, ngati mukukayikira kukula kwawo, muyenera kufunsa dokotala nthawi yomweyo.
Chiwopsezo cha kukhala ndi hypoglycemia ndichapamwamba ndi:
- kupsinjika
- kulimbitsa thupi kwambiri,
- ndege komanso kusintha kwa malo,
- mgwirizano wama mankhwala ena.
Zimatha kuthana ndi kuyendetsa magalimoto, chifukwa funso lakuyendetsa galimoto panthawi yodzikongoletsa limasankhidwa pamodzi ndi adotolo.
Imatulutsidwa kokha pamankhwala!
Fananizani ndi fanizo
Mankhwalawa ali ndi mitundu ingapo ya kapangidwe kake komanso kapangidwe kake. Muyenera kuwalingalira poyerekeza zomwe zimachitika.
NovoNorm. Mankhwala ofanana ndi repaglinide. Palinso mitundu itatu yamasulidwe. Mtengo - kuchokera ma ruble a 180 phukusi lililonse. Wopanga - "Novo Nordisk", Denmark. Ndi mndandanda wathunthu wa "Diaglinide" mumapangidwe ndi katundu. Mankhwala otsika mtengo, ogwira, mndandanda wa contraindication ndi omwewo. Osakhala koyenera kwa ana, okalamba ndi amayi oyembekezera.
"Diabeteson MV". Gawo lothandizira ndi gliclazide. Mtengo ndi ma ruble 300 ndi zina zambiri. Amapanga kampani "Service", France. Ili pafupi ndi zake. Ambiri contraindication ndi mavuto. Osakhala oyenera kwa odwala onse, makamaka, osavomerezeka kwa anthu okalamba.
Glucobay. Mapiritsi okhala ndi acarbose. Mtengo wa ma phukusi umachokera ku ma ruble 500 (malingana ndi kuchuluka kwa gawo lomwe likugwira). Wopanga - Bayer Pharma, Germany. Kugwiritsidwa ntchito mu shuga ngati mankhwala a kunenepa kwambiri. Mitundu yamapulogalamuyi ndi yotakata, koma mndandanda wazotsutsa ndiwopatsa chidwi. Dongosolo loyambirira limafunika kugula ku pharmacy.
Glucophage. Muli ndi metformin. Mtengo - kuchokera ku ma ruble 270. Pali mawonekedwe apakatikati ndi nthawi yayitali. Wopanga - Merck Sante, France. Mankhwala abwino a shuga, samayambitsa hypoglycemia. Itha kugwiritsidwa ntchito kuphatikiza mankhwala. Zimathandizira kuchepetsa kulemera kwa thupi ndikuzisunga bwino. Imakhala ndi ndemanga zabwino pakati pa odwala matenda ashuga komanso madokotala.
Siofor. Mankhwala ofanana ndi Metformin. Mtengo wa ma CD ndi ma ruble pafupifupi 250. Kampaniyo imatulutsa Menarini kapena Berlin Chemie, Germany. Itha kugwiritsidwa ntchito pochiza ana azaka zopitilira 10. Komabe, mndandanda wazotsatira zoyipa ndi zotsutsana ndi muyezo wamtunduwu wa chinthu chogwira ntchito.
Kusinthira kwa othandizira ena a hypoglycemic kumachitika kokha mwa chilolezo cha dokotala. Kudzipatsa nokha koletsedwa!
Pali ndemanga zosiyanasiyana za mankhwalawa. Ena amati mankhwalawo sanawakwane. Ena amatamanda zotsatira zake zachangu komanso zodalirika, luso logwiritsa ntchito ndi hypoglycemics ina. Nthawi zambiri sizimayambitsa zovuta.
Lydia: “Ndili ndi matenda ashuga kwa nthawi yayitali. Ndinayesa mankhwala ambiri kuti ndikhale ndi shuga wabwino ndikatha kudya. Tsopano ndidayima ku "Diaglinide." Chidachi chimathandiza bwino ndipo sichimayambitsa kudandaula kulikonse kuchokera kwa ine. Ndimagwiritsa ntchito mosangalatsa. ”
Dmitry: “Tidapezeka miyezi ingapo yapitayo. Pang'onopang'ono, zakudya zinasiya kuthandiza, panali zovuta za hypoglycemia atatha kudya. Adotolo adauza mankhwalawa. Ndakhala ndikugwiritsa ntchito kwa miyezi iwiri, zonse zakhala bwino. Palibenso hypo, thanzi langa lomwe linayambika bwino. Komanso ndili ndi mapiritsi otsika mtengo komanso angakwanitse kugula, zomwe zimandisangalatsa. "
Alexandra: “Ndimachiritsa matenda a shuga. Pakufunika kulumikizana ndi mankhwalawa mankhwala omwe amathandiza kukhala ndi shuga pambuyo pudya. Adotolo adandiwuza kuti ndigule Diaglinide. Zimayenda bwino ndimankhwala anga, amathandizadi shuga wokhazikika. Ndimakonda. ”
Alexei: “Ndakhala ndikudwala matenda a shuga kwa zaka zingapo. Mapiritsi anga anasiya kupirira, ndinayenera kuwonjezera Diagnlinide pa mankhwalawa. Amakhala ndi kanthawi kochepa, zomwe mukufuna masana. Ndidatenga miyezi ingapo, koma panali zovuta ndi impso. Adakakamizidwa kusinthira ku insulin. "
Alla: “Agogo anga aakazi akudwala kwambiri. Komanso shuga adawonjezeredwa. Amathandizidwa ndi zinthu zambiri, tsopano adotolo awonjezera mapiritsi awa. Poyamba anali ndi nkhawa kuti ndi ya Russia. Koma atayesa, adadabwa kwambiri ndi mtundu wa mankhwalawo. Kuchita mwachangu, wodalirika. Ndipo palibe zotsatira zoyipa, zomwe ndizofunikira kwambiri kwa iye. Mwambiri, tili okondwa ndi mankhwalawa. ”
Pomaliza
Monga mukuwonera, mankhwalawa ndiwofulumira komanso osakhazikika. Mankhwala osokoneza bongo amaletsa mpikisano ndi anzawo akunja. Kuunikiridwa kwa mankhwalawa kumatsimikizira kuti mtengo wake ndi wokwanira bwino. Chifukwa chake, mapiritsi awa nthawi zambiri amalembedwa ngati adjunct pothandizira matenda a shuga.