Mapiritsi a Farmiga

Kwa zaka zambiri osalimbana ndi ma DIABETES?

Mutu wa Bungwe: “Mudzadabwitsidwa kuti kumakhala kovuta motani kuchiritsa matenda a shuga tsiku lililonse.

Ndi matenda amtundu wa 2 shuga, kapamba amasokonezeka, chiwopsezo cha minofu ya m'thupi chimayamba kuchepa. Matenda ofananawo nthawi zambiri amapezeka mwa anthu opitirira zaka 45.

Chithandizo cha matendawa chimakhala ngati mumwa mankhwala a hypoglycemic, ndipo adotolo amakupatsaninso mankhwala ena othandizira komanso masewera olimbitsa thupi. Choyamba odwala matenda ashuga ayenera kusinkhasinkhanso moyo wanu, kusintha zakudya zamagulu onse ndikuwonjezera ntchito zamagalimoto.

Kuti muwonetsetse kuti kuchuluka kwa shuga m'magazi ndikwabwinobwino, mapiritsi omwe amachepetsa shuga m'magazi amadziwika. Mankhwala amabwezeretsa kukhudzika kwa minyewa kupita ku mahomoni, amachepetsa kuyamwa kwa insulin m'matumbo, amachepetsa kupanga shuga m'maselo a chiwindi, komanso amachepetsa cholesterol.

Kuchepetsa Matendawa

Mankhwala onse ochizira matenda amhuga a 2 amatha kugawidwa m'magulu angapo molingana ndi zomwe akuchita. Izi zikuphatikiza ndi Biguanides, zotumphukira za sulfanylurea, ma insretin, alpha-glucosidase inhibitors, zotumphukira za thiazolidinone, dipeptidyl peptidiase 4 inhibitors, GLP-1 receptor agonists.

Biguanides amachititsa maselo otumphuka kuti azitha kutengeka ndi insulin, amachepetsa kupanga kwa mahomoni, komanso amachititsa kuti azikhala ndi chidwi chofuna kudya. Izi zimaphatikizapo mapiritsi Siofor ndi Metformin. Mankhwala, odwala matenda ashuga amachepetsa kulemera, zamadzimadzi metabolism amakhala. Mankhwalawa nthawi zambiri amayambitsa kugwiritsidwa ntchito kwa mawonekedwe a kupukusa chakudya, kotero, mankhwalawa amatengedwa muyezo wochepa pokhapokha atakambirana ndi adokotala.

Nthawi zambiri, mtundu wachiwiri wa matenda a shuga umagwiritsidwa ntchito ndi zotumphukira za sulufayidi - Chlorpropamide, Starlix, Glimepiride, Tolbutamide, Diabeteson. Mankhwalawa amalimbikitsa kupangidwa kwa mahomoni ndi maselo a kapamba ndipo amachepetsa chiwopsezo cha minyewa kupita ku insulin. Mankhwala oterowo amatha kufooketsa kapamba, ngati mulingo wambiri umalakwika, umayambitsa hypoglycemia.

1. Mankhwala Insulinotropic polyptipid ndi Enteroglucagon amasiyana pamaso pa ma impretins - mahomoni am'mimba ochita kupanga, omwe amapanga zomwe zimachitika munthu atatha kudya. Ma mahormonewa amapangitsa kuti insulini ipange. Ndi zaka, katundu wa maselo amachepetsa m'munthu, amapangira mankhwala kuti abwezeretsenso ntchitoyi.
2. Ma alpha-glucosidase inhibitors samalola kuti ma carbohydrate azilowetsedwa m'matumbo ang'onoang'ono, potero amachepetsa glycemia atatha kudya ndikuchepetsa kufunika kwa kupanga kwa insulin. Glucobai, Miglitol, Acarbose, mapiritsi a Voglibosis amalembedwa ngati mankhwala owonjezera.
3. Chifukwa cha zotumphukira za thiazolidinone, kukana kwa insulin zolandila kumachulukanso, shuga ya magazi imachepa, lipid metabolism imabwezeretseka, kutulutsa kowonjezera shuga m'thupi kumachitika mofulumira. Mafuta a cholesterol okwera kwambiri komanso otsika amawonjezekanso. Odziwika kwambiri ndi mankhwala a pioglitazone ndi Rosiglitazone. Gulu la mankhwalawa limayambitsa mavuto ambiri komanso limawonjezera kulemera kwa thupi.
4. Kuonjezera kuyankha kwa ma kapamba a shuga, shuga m'munsi mwa glycated ndi triglycerides m'magazi, chithandizo ndi zoletsa za dipeptidyl peptidiasis 4 Mothandizidwa ndi Sitagliptin, Vildagliptin, wodwala matenda ashuga amatha kuyang'anira glycemia. Mankhwala amatengedwa onse palokha komanso mogwirizana ndi Metformin.
5. Kuti muchepetse kulakalaka kwanu, dokotala angakupatseni wodwala matenda ashuga kuti atenge GLP-1 receptor agonists. Mankhwalawa amakhazikika thupi msanga komanso samalola kudya kwambiri. Chifukwa cha izi, kulemera kwa wodwala kumachepa ndipo mawonekedwe a glycemic amakhala osasinthika. Mankhwala a gululi akuphatikiza mayankho a jakisoni wa Viktoz ndi Baeta, mtengo wawo ndiwokwera kwambiri ndipo umafika ku ruble 10,000.

Malinga ndi lingaliro la kuchitapo kanthu, mankhwalawa amatha kugawidwa m'magulu atatu: Mankhwala omwe amakhudza ma isls a Langerhans ndi kapamba kuti apititse mankhwala a insulin, mankhwala omwe amalimbikitsa mphamvu ya mahomoni pa shuga ndi antipyretic mankhwala omwe amakhudza kuchuluka kwa shuga.

Zotsatira pa kapamba

Mankhwala omwe amakhudza kapamba kuti athandize kupanga insulin kuphatikiza Maninil, Diabeteson, Glyurenorm, Amaril.

Maninil amakhumudwitsa kapamba kuti amasule kuchuluka kwa mahomoni ofunikira kuti glucose omwe amalowa mthupi kudzera mu chakudya amamwe mwachangu. Mankhwalawa nthawi zina amayambitsa sayanjana, amapangika kwa amayi apakati, ana ndi odwala omwe ali ndi matenda amtundu 1.

Diabetes imachita modekha, imathandizira kuteteza mitsempha yamagazi ndikuchita gawo loyamba la insulin. Mankhwalawa ali ndi zoyipa zingapo mwanjira ya mutu, hypoglycemia, kuchepa kwa chidwi, kuchepetsedwa poyankha, kukhumudwa, kulephera kudziletsa. Mankhwala contraindicated pa mkaka wa m`mawere, ndi matenda a chiwindi ndi impso.

• Glurenorm imayikidwa kwa okalamba ndipo imatha kuthandizidwa ndi matenda a impso. Zimathandizira kupanga insulin. Kuchuluka kwake kumachitika ola limodzi mutatha kudya. Pangakhale zovuta zina mwanjira ya leukopenia, thrombocytopenia, kupweteka mutu, chizungulire, kugona, kutopa, kulephera kwa mtima. Ndi matenda amtundu woyamba 1, mankhwalawo amatsutsana.
• Amaryl ndi njira yothandiza m'badwo wotsiriza. Mankhwalawa amatha nthawi yayitali ndipo amathandizira kuchepetsa chiopsezo cha hypoglycemia. Contraindication imaphatikizapo matenda a shuga 1.

Inalimbikitsa insulin

Mankhwala omwe amathandizira pakuchitika kwa mahomoni amaphatikizapo Siofor ndi Metformin. Mankhwalawa samakhudzana ndi kapamba, koma achulukitse ntchito ya insulin, amachepetsa mayamwidwe a shuga ndi mafuta kuchokera m'matumbo. Thandizani glucose kumizidwa mwachangu.

Mapiritsi a Siofor amachepetsa shuga m'magazi, amachepetsa thupi ndikuthandizira kunenepa kwambiri. Mankhwalawa ali contraindised mu matenda ashuga, hypoglycemia, uchidakwa, pa mimba. M'masiku oyamba kumwa mankhwalawa, wodwala matenda ashuga amatha kumva kutsekemera kwamkamwa komanso kupweteka m'mimba.

Metformin imadziwika kuti ndi hypoglycemic yothandiza; imatengedwa limodzi ndi insulin.

Kumwa mankhwalawa contraindised mu aimpso ndi chiwindi kulephera, matenda ashuga, ketoacidosis, matenda oopsa, hypersensitivity, mtima kulephera, kugunda kwa mtima.

Kuyamwa Mkulu Wowonjezera

Kuti achepetse mayamwidwe ndikuchepetsa shuga m'magazi, omwe amapangidwa chifukwa chakutha kwa chakudya, dokotala amafotokozera kuti atenge Acarbose ndi Glucobay. Mapiritsiwa amatha kuyambitsa mavuto osiyanasiyana mwanjira ya dysbiosis, cholecystitis, njira yotupa m'mimba ndi matumbo.

Acarbose ali ndi vuto la hypoglycemic. Mankhwala contraindicated mu cirrhosis, ketoacidosis, matenda a m'mimba ziwalo, mkhutu aimpso ntchito, pa mimba ndi mkaka wa m`mawere. Pakhoza kukhala zovuta zina mwanjira ya m'mimba ndi kusanja.

Glucobai imathandizira kuchepetsa kuchuluka kwa glucose mutatha kudya, mankhwalawa amatchulidwa ngati njira yowonjezeranso ku chithandizo chamankhwala. Mankhwalawa sangathe kumwa ndi matumbo, nthawi yapakati komanso mkaka wa m'mawere.

Nthawi zina munthu wodwala matenda ashuga amatha kuona kukomoka komanso kudekha m'mimba.

Mankhwala opatsa chidwi

Masiku ano, intaneti imatsatsa malonda osiyanasiyana osiyanasiyana omwe amachotsa shuga kudzera mkodzo. Mankhwala odziwika kwambiri ndi mankhwala a Farmiga a shuga, Farsida, Forbinol.

Mankhwalawa ali ndi ndemanga zambiri zabwino kuchokera kwa ogwiritsa ntchito. Komabe, malinga ndi madotolo, simuyenera kukhulupirira matamando amenewa. Chowonadi ndi chakuti pakadali pano palibe mankhwala omwe angachiritse kwathunthu kupweteka kwa kapamba.

Kuphatikiza apo, njira zamakono zomwe zili ndi njira zambiri zimakhala ndi zotsutsana. Makamaka, kugwiritsa ntchito mankhwala nthawi zambiri kumayambitsa matenda a kwamikodzo, chifukwa choti wodwala matenda ashuga atha kulephera.

Mankhwalawa alibe malangizo onse, chomwe chikuwonetsa kuti katunduyo ndi wopanda pake. Mwanjira, mankhwalawa sangathe kwa odwala matenda ashuga ambiri.

Kanemayo munkhaniyi akufotokozerani zambiri zamankhwala ochepetsa shuga.

Ntchito malangizo Forsig ndi mankhwala ake

Malangizo a Forsig ogwiritsira ntchito amagwiritsidwa ntchito mwatsatanetsatane. Mankhwalawa adatchuka kwambiri chifukwa chogwira ntchito kwambiri komanso kupezeka. Komabe, musanalowetse mankhwalawa mu njira yochizira, ndikofunikira kuti muphunzire mosamala mawonekedwe a mankhwalawo, makamaka kugawa mlingo, komanso kuwerenga ndemanga.

Zotsatira za mankhwala Forsig

Musanayambe kumwa mankhwalawa, ndikofunikira kuti muphunzire zamankhwala ndi kudziwa dokotala. Forsiga ndi mankhwala othandizira pakamwa, ntchito yake yayikulu ndikukhazikitsa kuchuluka kwa shuga ndi hypoglycemia. Amagwiritsidwa ntchito pochiza matenda a shuga a mtundu wachiwiri. Chofunikira chachikulu ndi dapagliflozin propanediol monohydrate. Imapezeka mu mawonekedwe a mapiritsi okhala ndi filimu.

Zizindikiro zazikulu pakugwiritsidwa ntchito kwa Forsig ndi izi:

• hypoglycemia monotherapy,
• zovuta za mankhwala molumikizana ndi mankhwala ozikidwa ndi insulin ndi metformin pakakhala kuti palibe mokwanira kuwongolera shuga,
• kuyamba mankhwala osakaniza ndi metformin.

Kutenga mapiritsi a Forsig sikulimbikitsidwa pamaso pa syndromes otsatirawa:

• tsankho limodzi la mankhwala
• lembani 1 hypoglycemia,
• matenda ashuga ketoacidosis,
• odziwika bwino mpaka kulephera kwa aimpso, kudwala kwamatenda,
• lactose kusalolera onse mu mawonekedwe pawokha, komanso kuphatikiza shuga.
• matenda am'mimba thirakiti
• mimba ndi kuyamwitsa,
• ana ochepera zaka 18,
• okalamba kuyambira zaka 75.

Musanalowetse mankhwalawa mu njira yochiritsira, funsani ndi endocrinologist za kufotokozera za thupi lanu pazinthu zomwe zaperekedwa.

Zotsatira zoyipa

Monga mankhwala aliwonse, mankhwalawa Forsig amatha kukhala ndi zovuta zina. Nthawi zambiri, zomwe zimayambitsa zovuta zimatha kukhala kutsika kwamphamvu kwa shuga chifukwa chosankhidwa cholakwika cha mankhwala tsiku lililonse.

Mawonetsedwe otsatirawa nthawi zambiri amalembedwa kuti:

1. Zovuta zamtundu wa genitourinary system. Monga gawo limodzi la izi, wodwalayo angawonetse zilonda zapakhungu. Nthawi zina, chizindikirochi monga kuyimitsidwa kwa mitsempha komanso zotulutsa kumaliseche kumatha kuoneka mwa akazi.
2. Kulephera mu kagayidwe. Nthawi zina, odwala omwe amamwa mankhwalawa chifukwa cha matenda ashuga amatha kukhala ndi chidwi chofuna kudya, kunenepa kwambiri komanso kuwonda, komanso zizindikiro za kuchepa thupi.

Monga lamulo, izi zoyipa ndizosowa. Koma kuwanyalanyaza sikuli koyenera. Pankhani ya zovuta za kutenga Forsig, tikulimbikitsidwa kufunsa dokotala nthawi yomweyo kuti musinthe njira zochizira.

Kutumiza kwa Mlingo

Amadziwika kuti kupambana kwa zamankhwala kumakhudzidwabe ndi kulondola kwa kusankha kwa tsiku ndi tsiku la mankhwalawa. Endocrinologists amati kumwa mankhwalawa ndikofunikira kamodzi patsiku, mosasamala nthawi yakudya. Kuphatikiza apo, pakuchita bwino kwambiri, mankhwalawa amathandizira kuti amwe nthawi yokhazikika.

Mlingo watsiku ndi tsiku umalimbikitsidwa kuti ugawidwe motsatira mfundo iyi:

Ndikofunika kukumbukira kuti chithandizo chamankhwala sichikhala chothandiza popanda kusintha moyo wa wodwala. Kumwa mankhwala a Forsig, ndikofunikira kusintha njira yodyetsera odwala motere. Mafuta, osuta, okoma ndi amchere sayenera kuyikidwa kunja kwa zakudya. Ndikulimbikitsidwa kuti popanga zakudya zatsiku ndi tsiku, kutsatira malamulo a kadyedwe koyenera.

Ndikulimbikitsidwa kuti mupereke pafupifupi 1 ola limodzi pa zochitika zolimbitsa thupi. Izi zikuthandizani kuti muchepetse kunenepa komanso kupewa kunenepa kwambiri, komwe kumakhala kofala kwambiri m'matenda a shuga.

Malangizo apadera ogwiritsira ntchito mankhwalawa

Makamaka tikulimbikitsidwa kuti apange dongosolo la chithandizo kwa odwala omwe ali ndi ziwalo zina zamkati.

Kwa odwala omwe ali ndi vuto la impso, tsiku lililonse mankhwalawa amayenera kusankhidwa mosamala kwambiri. Ndikulimbikitsidwa kukhazikitsa mankhwala a Forsig pokhapokha limodzi ndi mankhwala ena. Nthawi yomweyo, ndikofunikira kuwunika mwadongosolo momwe impso zimayendera malinga ndi mfundo iyi:

• kufufuza bwino kwa impso,
• kukonza mankhwalawa tsiku lililonse la mankhwala a Forsig komanso mankhwala ena mogwirizana ndi momwe wodwalayo alili,
• ntchito kwa nthawi yayitali (zaka 4), tikulimbikitsidwa kuti nthawi zonse musatenge mankhwala a Forsig ku pulani ya mankhwalawa ndikugwiritsa ntchito analogues (NovoNorm, Diagnlinid).

Kwa odwala omwe awonetsa zotupa za genitourinary system, tikulimbikitsidwa kuti mankhwalawa a matenda a kwamikodzo azichitira limodzi ndi mankhwalawa a matenda a shuga. Nthawi ya mankhwala ophatikiza monga awa ayenera kukhala osachepera masiku 24.

Odwala omwe adapezeka kuti adapezeka ndi matenda amtima amathandizidwa kuti athandizire dongosolo lachipatala ndi mtima. Kufunika uku kumachitika chifukwa chakuti zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa zimatha kusokoneza ntchito ya mtima.

Ndemanga za Odwala

Posankha mankhwala kuti muchepetse shuga m'magazi, kuphatikiza pazomwe zimapezeka ndimankhwala komanso mtengo, odwala ambiri amatenganso malingaliro pa mankhwalawa. Nawa malingaliro pa mankhwala a Forsig.

“Pa moyo wanga wonse ndakhala ndikuchita masewera olimbitsa thupi. Ali ndi zaka 24, adakwatira, nabereka, amayenera kunena zabwino zamasewera ambiri. Ngati, atakhala othamanga, adadziletsa, kenako nkuyamba moyo “wabwino”, sanadziwenso. Ndinayamba kutsamira kwambiri zakudya zopatsa mphamvu kwambiri. Anayamba kunenepa, koma sanasokoneze zambiri, mpaka atayamba kufooka, ludzu lalikulu komanso chizungulire. Malinga ndi upangiri wa amuna awo, adadutsa mayeso a shuga, chifukwa, adayika matenda ashuga a 2. Kuchepetsa kugwira ntchito, adokotala adalembera Forsigu. Ndakhala ndikutenga kwa pafupifupi chaka tsopano. Ndimamva bwino. "

Valery, wazaka 56:

“Kwa zaka 15 ndakhala ndikudwala matenda ashuga. Ndinayesa mankhwala osiyanasiyana osiyanasiyana. Ena adathandizira, ena sanatero. Mu zaka 3 zapitazi, pamalangizo a endocrinologist wanga, ndakhala ndikumwa mapiritsi a Forsig. Ndikunena nthawi yomweyo, mankhwalawa ndiabwino, ndimawakonda. Miyezi ya shuga idayamba kutsika kwenikweni kuyambira milungu yoyamba kumwa mapiritsi. Pambuyo pamiyezi isanu ndi umodzi, chizindikirocho chimadzichinjiriza ndikuziphatikiza pakati pazomwe zinali kale.Tsopano ndimatha kukhala ndi moyo wabwino komanso wosamva ngati wokalamba. ”

“Ndilibe matenda a shuga inenso, koma matendawa anakhudza banja langa. Chaka chatha, adapezeka ndi amayi anga. Mkazi wazaka 46, sanadandaule za chilichonse ndipo pamakhala zodabwitsazi! Pa upangiri wa endocrinologist, amayi anga anayamba kumwa Forsig. Ndinafunikiranso kugwira ntchito yopatsa thanzi, kupatula zakudya zonse zopanda pake. Poyerekeza ndi zomwe zikuwonetsa, shuga m'magazi adagwa, koma amayi anga adayamba kudandaula kuti akumva kupweteka pokodza. Tikasinthana ndi mapiritsi ena, ndiye kuti sichoncho. Ndani akudziwa, mwina ndi momwe Forsyga amakhudzira thupi. ”

Matenda a shuga ndi matenda omwe mankhwala sayenera kunyalanyazidwa mwanjira iliyonse. Pofuna kuchepetsa chiwonetsero cha matendawa popanda kulemetsa kwapadera m'thupi, gwiritsani ntchito mankhwala Forsig. Komabe, musanalowetse mankhwalawa kukhala lingaliro lazithandizo, muyenera kukambirana ndi dokotala za kuyanjana kwa mankhwala othandizira ndi thupi lanu. Dzisamalire nokha ndikukhala wathanzi!

Hypoglycemic mankhwala a odwala matenda ashuga Januvia

Type 2 matenda a shuga a 90% amitundu yonse ya matenda ashuga. Mbali imodzi, kukana insulini kumapangitsa kuti maselo asayankhe pafupipafupi ndi insulin. Komabe, kukanika kwa β-cell: kuchokera kuphwanya kwa plasticity mpaka kufa kwathunthu, ndipo odwala matenda ashuga kuchuluka kwawo kumatsitsidwa ndi 63% (mwa owonda - ndi theka pang'ono). Zonsezi sizilola kuti thupi likwaniritse bwino zofunikira zamahomoni kuti mugonjetse insulin.

Kuti athane ndi gulu loyipa ili, mankhwala ambiri apangidwira kuthana ndi glycemic. Biguanides ndi thiazolidinediones amalimbana ndi insulin kukana, sulfonylureas ndi zotengera zakudongo zimapangitsa kapangidwe ka insulin ya amkati, Acarbose ndi Glucobay amalepheretsa kuyamwa kwa glucose m'matumbo, koma, kuwonjezera pa kugwiranso ntchito, palinso nkhani yachitetezo. Makamaka, ambiri aiwo amawonongeratu kulemera kwa thupi, pomwe kunenepa kwambiri ndi chifukwa chachikulu cha matenda ashuga 2.

M'badwo waposachedwa wa mankhwala ndi mndandanda wamankhwala ampretin. Inhibitor DPP-4 Januvia (dzina lapadziko lonse - Sitagliptin, Januvia, Sitagliptin) satenga nawo gawo pankhaniyi - amachepetsa kulakalaka, komanso nthawi yayitali - komanso kulemera, ndipo si mwayi wokhawo.

Pazaka zopitilira 10 zochita zamankhwala, umboni wokwanira wachitachita wapezeka.

Mlingo wa mawonekedwe ndi kapangidwe kake

Chithunzi cha Janucius incretomimetic, chithunzi chake chomwe chaperekedwa m'gawoli, chimapangidwa pamaziko a sitagliptin, omwe amaperekedwa mwanjira ya phosphate monohydrate. Gwiritsani ntchito mapiritsi a mitundu yosiyanasiyana ndi mafilimu: magnesium, cellcrystalline cellulose, sodium, calcium hydrogen phosphate.

Anthu odwala matenda ashuga amatha kusiyanitsa kuchuluka kwa mankhwalawa mu utoto: ndi mlingo wochepa - pinki, wokhala ndi mtengo wambiri - beige. Kutengera kulemera, mapiritsiwo amalembedwa: "221" - mlingo 25 mg, "112" - 50 mg, "277" - 100 mg. Mankhwalawa amadzaza m'matumba otupa. Pakhoza kukhala matuza angapo m'bokosi lililonse.

Pa boma lotentha lofika 30 ° C, mankhwalawa amatha kusungidwa mkati mwa nthawi yovomerezeka (mpaka chaka).

Momwe Januvia amagwirira ntchito

Mankhwala opangidwa a hypoglycemic ndi a gulu la ma insretin mimetics omwe amaletsa DPP-4. Kugwiritsa ntchito pafupipafupi kwa Januvia kumawonjezera kupanga ma insretin, kumalimbikitsa ntchito yawo. Kupanga kwamkati mwa insulin kumachulukitsa, kaphatikizidwe ka glucagon mu chiwindi kumachepetsa.

Kuwongolera kwa pakamwa kumalepheretsa kuwonongeka kwa glucagon-ngati peptide GLP-1, komwe kumapangitsa gawo labwino kwambiri pakuwona insulini yodalira shuga, ndikuyambiranso kuzungulira kwazinthu zathupi. Njira izi zimathandizira kuti glycemia ikhale yachilendo.

Sitagliptin imathandizira kuchepetsa hemoglobin ya glycated, glucose othamanga, komanso kulemera kwa thupi. Kuchokera pamimba yodyetsera, mankhwalawa amalowetsedwa m'magazi mkati mwa maola 1-4. Nthawi ya ingestion ndi chakudya chama caloric sichimakhudza ma pharmacokinetics a inhibitor.

Mankhwalawa ndi oyenera kutsatiridwa nthawi iliyonse yoyenera: musanadye, mutamaliza kudya komanso musanadye. Mpaka 80% ya yogwira pophika imapukutidwa ndi impso. Mankhwalawa angagwiritsidwe ntchito onse mu monotherapy komanso mu zovuta za chithandizo cha matenda a shuga a 2, makamaka ngati chiwopsezo cha hypoglycemic chikuwonjezeka.

Mu chiwembu chokhazikika, Januvia amathandizidwa ndi Metformin, zakudya zotsika kwambiri za carb komanso masewera olimbitsa thupi.

Mutha kuwona momwe limagwirira ntchito yamankhwala pa vidiyoyi:

Yemwe amawonetsedwa ngati mankhwalawo

Januvia amawerengedwa mtundu wa matenda ashuga amitundu iwiri pamagawo osiyanasiyana owongolera matenda.

Akaphatikizidwa ndi mankhwala ena a hypoglycemic, Januvia amalembedwa:

• Kuphatikiza pa Metformin, ngati kusintha kwamakhalidwe sikunabweretse zotsatira zomwe zikuyembekezeka,
• Pamodzi ndi zotumphukira za gulu la sulfonylurea - Euglucan, Daonil, Diabeteson, Amaril, ngati chithandizo cham'mbuyomu sichinali chokwanira kapena wodwalayo samalekerera Metformin,
• Kufanana ndi thiazolidinediones - Pioglitazan, Rosiglitazone, ngati kuphatikiza koteroko kuli koyenera.

Mankhwala atatu, Januvius amaphatikizidwa:

• Ndi Metformin, zotumphukira za sulfonylurea, zakudya zamagetsi otsika ndi masewera olimbitsa thupi, popanda popanda Januvia sizingatheke kukwaniritsa 100% glycemic control,
• Imodzi ndi Metformin ndi thiazolidinediones, PPARy okonda, ngati matenda ena oyendetsa matenda sanakhale othandiza kwambiri.

Ndizotheka kugwiritsa ntchito Januvia kuwonjezera pa insulin mankhwala ngati mankhwalawa athetsa vuto la kukana insulini.

Ndani sayenera kutumizidwa sitagliptin

Ndi matenda amtundu 1 shuga ndi ziwopsezo zomwe zimapangidwa ndimomwe zimapangidwira, Januvia adatsutsana. Osatipatsa mankhwala:

1. Amayi oyembekezera komanso oyembekezera
2. Ndi matenda ashuga a ketoacidosis,
3. Muubwana.

Odwala omwe ali ndi aimpso amtunduwu popereka Januvia amayenera kuti awonjezere chidwi. Woopsa mawonekedwe, ndibwino kusankha analogi mankhwala. Odwala pa hemodialysis amayang'aniridwa nthawi zonse.

Kukhoza kwamavuto

Pankhani ya bongo, hypersensitivity, osankhidwa bwino mankhwalawa, zotsatira zosafunikira zitha kuoneka ngati zachulukitsa za matenda omwe alipo kapena kukula kwa atsopano. Zochitika zoterezi ndizothekanso chifukwa chogwirizana ndi zovuta za mankhwala omwe munthu wodwala matenda ashuga amalandira.

Mwa zovuta za matenda ashuga, pali mitundu yovuta kwambiri ya matenda a shuga (diabetesic ketoacidosis, precoma ndi glycemic coma) komanso yayitali - angiopathy, neuropathy, retinopathy, nephropathy, encephalopathy, etc. retinopathy ndiyomwe imayambitsa khungu ku matenda ashuga: ku United States, 24,000 yatsopano milandu chaka chilichonse. Nephropathy ndiye njira yofunika kwambiri yothetsera matenda a impso - 44% ya milandu pachaka, mitsempha ndiyo imayambitsa mabala osapweteka kwambiri (60% ya milandu yatsopano pachaka).

Ngati malingaliro a dokotala pokhudzana ndi kuchuluka ndi nthawi yavomerezekayo satsatiridwa, zovuta za dyspeptic ndi vuto la kuchepa kwa malungo ndizotheka.

Zotsatira zina zoyipa, kufooka kwa chitetezo chathupi kumachitika nthawi zambiri, limodzi ndi matenda opatsirana thirakiti.

Za mankhwala a Januvia mu ndemanga, odwala matenda ashuga amadandaula za kupweteka kwa mutu komanso kutsika kwa magazi. Pazowunikira, kuwerengera kwa leukocyte kumatha kuwonjezeka pang'ono, koma madokotala sawona kuti izi ndizofunikira. Mosadalirika sanapeze kulumikizana ndi mankhwalawa ndi chitukuko cha kapamba.

Pogwiritsa ntchito nthawi yayitali ya sitagliptin, kuphwanya kumbali ya mtima, mitsempha yamagazi, ndikupanga magazi ndizotheka. Wodwala matenda ashuga ayenera kudziwitsidwa za kufunika kokachezera dokotala ngati kusintha kwa kuthamanga kwa magazi kapena kugunda kwa mtima pamene mukumwa Januvia.

Sipanakhalepo milandu yosokoneza mankhwalawa machitidwe azachipatala; kusinthika kwakukwanira kwaumoyo, kungogwira kwake ntchito kochepa ndizotheka.

Milandu yambiri

Januvia ndi mankhwala oopsa, ndipo kutsatira kwambiri malangizo a endocrinologist ndiye chofunikira pakuchita bwino kwake. Mlingo wotetezeka wa sitagliptin ndi 80 mg.

Kafukufuku wokhudzana ndi bongo wa bongo anachitika ndi kuwonjezeka kakhumi pa mlingo uwu.

Ngati vuto la hypoglycemic litayamba, wolakwiridwayo amadandaula mutu, kufooka, matenda osokoneza bongo, kuipira kwa thanzi, ndikofunikira kutsuka m'mimba, kupatsa wodwalayo mankhwala othandiza. Chithandizo cha Syndrome chimaperekedwa kuchipatala cha odwala matenda ashuga.Milandu ya bongo imagwiritsidwa ntchito kwambiri nthawi zambiri. Izi zimakonda kuphatikizidwa ndi tsankho la munthu payekha kapena chifukwa cha mankhwala ena omwe amagwiritsidwa ntchito popanga zovuta.

Hemodialysis ya Januvia siyothandiza. Kwa maola 4, pomwe njirayi imatha, mutatha kumwa kamodzi, 13% yokha ya mankhwalawo ndi yomwe idatulutsidwa.

Kuthekera kwa Januvia ndi zovuta mankhwala

Sitagliptin sikuletsa ntchito ya Simvastatin, Warfarin, Metformin, Rosiglitazone. Januvia amatha kugwiritsidwa ntchito ndi amayi omwe amagwiritsa ntchito njira zakulera pakamwa pafupipafupi. Kukhazikika kwapakati pa Dioxin kumathandizira pang'ono kuti izi zitheke, koma kusintha kotereku sikutanthauza kusintha kwa mlingo.

Januvia angagwiritsidwe ntchito limodzi ndi cyclosporine kapena zoletsa (monga ketoconazole). Zotsatira za sitagliptin mu zochitika izi sizowopsa ndipo sizisintha momwe mungalandire mankhwalawa.

Malangizo ogwiritsira ntchito

Mankhwala a Januvia, malangizo ogwiritsira ntchito amapangidwa mwatsatanetsatane, ndipo ayenera kuphunziridwa isanayambike maphunziro.

Ngati nthawi yakuvomerezedwa yasowa, mankhwalawo amayenera kuledzera nthawi yoyamba. Nthawi yomweyo, kuwerengetsa kawiri kawiri ndizowopsa, popeza payenera kukhala nthawi yotalikirana pakati Mlingo.

Mlingo wofanana wa Januvia ndi 100 mg / tsiku. Ndi a impso pathologies ofatsa pang'ono zolimba, 50 mg / tsiku amathandizira ngati matendawa akula ndikukula kwambiri, mankhwalawa amasinthidwa kukhala 25 mg / tsiku. Ngati mankhwalawa agwiritsidwa ntchito limodzi ndi mankhwala ena ochepetsa shuga, milingo ya insulin kapena mapiritsi iyenera kuchepetsedwa kuti muchepetse hypoglycemia.

Ngati ndi kotheka, dialysis ikuchitika, pomwe mankhwala osachepera mlingo. Nthawi yolandila Januvia siimakhudzidwa ndi nthawi ya mchitidwe. Paakula (kuyambira zaka 65), odwala matenda ashuga amatha kugwiritsa ntchito mankhwalawa popanda zoletsa zina, ngati pakadalibe zovuta kuchokera ku impso. Potsirizira pake, kusintha kwa mlingo kumafunika.

Malangizo apadera

Januvia ungagulidwe mu pharmacy network kokha ndi mankhwala. Hypoglycemia, malinga ndi kafukufuku, chithandizo chovuta kwambiri sichachulukanso kuposa placebo. Zokhudza thupi la Januvia motsutsana ndi maziko a insulin yayikulu sizinaphunzire, kotero odwala ali ndi malire pa kuwongolera kwa hypoglycemic.

Zotsatira zoyipa za mankhwalawa pakutha kuyendetsa kayendedwe kapena njira zovuta sizinalembedwe, popeza kuti gawo la yogwira pakatikati lamanjenje sililetsa.

Hypersensitivity mukatenga Januvia imatha kufotokozedwa ngati mantha a anaphylactic. Nkhope ya wovutikayo imatupa, totupa totuluka. Mwazovuta kwambiri, edema ya Quincke imawonedwa. Ndi zizindikiro zotere, mankhwalawa amangoimitsidwa ndikupempha thandizo kuchipatala.

Januvia mu zovuta mankhwala amagwiritsidwa ntchito posowa zotsatira zofunika mutatenga Metformin ndi kusintha kwasinthidwe. Muthanso kugwiritsa ntchito mankhwalawa posintha insulin.

Ndemanga za Januvia

Ndi mtundu wa 2 wodwala matenda osokoneza bongo popanda mapiritsi ochepetsa shuga, ndi ochepa omwe amatha kupewa kuyamwa kwa glucose.

Ndikofunikanso kupeza mankhwala anu omwe angakuthandizeni kuthana ndi matenda anu osawonjezera mavuto anu atsopano ku shuga.

Mukamasankha mankhwala oyenera a hypoglycemic a kulowererapo kwa matenda ashuga, akatswiri amatchera khutu ku glycemic komanso kuthekera kopanda glycemic. Poyamba, uku ndi kuchepa kwa glycated hemoglobin, chiopsezo cha hypoglycemia, insulin secretion, ndi mbiri yotetezeka. Kachiwiri - kusintha kwa kulemera kwa thupi, HF zowopsa, kulekerera, mbiri yachitetezo, kuthekera, mtengo, kugwiritsa ntchito mosavuta.

Za mankhwala a Januvia, ndemanga za madotolo zili ndi chiyembekezo: glycemia yotsala ili pafupi ndi yokhazikika, kuchuluka kwa gluprose pambuyo poti mudye kudya sikupitirira malire ovomerezeka, palibe kutsika kwa shuga kwambiri, mankhwalawa amakhala otetezeka komanso ogwira ntchito ndipo amakwaniritsa machitidwe omwe akukwaniritsidwa. Maganizo a Pulofesa A.S. Ametova, mutu. Dipatimenti ya Endocrinology and Diabetesology GBOU DPO RMAPO Ministry of Health of the Russian Federation, za mwayi wa sitagliptin, onani vidiyo:

Kuyerekezera kofananira kwa fanizo la Januvia

Ngati tingayerekeze mankhwalawa malinga ndi code ya ATX 4, ndiye m'malo mwa Januvia, mutha kusankha analogues:

• Onglizu ndi saxagliptin wogwira,
• Galvus, yopangidwa pamaziko a vildagliptin,
• Galvus Met - vildagliptin kuphatikiza ndi metformin,
• Trazentu ndi yogwira mankhwala linagliptin,
• Combogliz Prolong - potengera metformin ndi saxagliptin,
• Nesinu ndi yogwira pophika alogliptin.

Mphamvu yamakonzedwe a mankhwalawa ndi ofanana: amaletsa kulakalaka, osalepheretsa dongosolo lamkati lamanjenje komanso mtima. Ngati mungayerekeze analogi ndi Yanuvia pamtengo, ndiye kuti mutha kupeza zotsika mtengo: kwa mapiritsi 30 a Galvus Meta omwe ali ndi mlingo womwewo, muyenera kulipira rubles 1,448, pazidutswa 28 za Galvus - 841 rubles. Onlisa adzagwiritsa ntchito ndalama zambiri: 1978 rubles for 30 pcs. Mugawo lamtengo womwewo ndi Trazhenta: 1866 rubles. mapiritsi 30. Odula kwambiri pamndandandawu adzakhala Combogliz Kutalika: 2863 rubles. 30 ma PC.

Ngati sizotheka kupeza chindapusa chochepa cha mtengo wa mankhwala othandizira odwala matenda ashuga, mutha kusankha njira yovomerezeka ndi dokotala.

Masiku ano, matenda a shuga a 2 siwolepheretsa moyo wathunthu. Anthu odwala matenda ashuga amatha kugwiritsa ntchito mankhwala aposachedwa amitundu osiyanasiyana paziwonetsero, zida zamankhwala zothandizira kuperekera mankhwala ndikudziyang'anira nokha glycemia. Sukulu za odwala matenda ashuga adapangidwa m'mabungwe azachipatala komanso malo ophunzirira, ndipo pali zidziwitso zonse zapaintaneti.

Kodi Januvia ndi piritsi yatsopano yovomerezeka yothandizira matenda a shuga a 2 kapena chofunikira mwasayansi.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mtundu wa kutulutsidwa kwa Forsigi ndi mapiritsi okhala ndi mafilimu: chikasu, biconvex, 5 mg aliyense, mozungulira, mbali imodzi ndi cholemba "5", wina "1427", 10 mg aliyense - wopangidwa ndi diamondi, mbali imodzi wolembedwa "10 ", Zina -" 1428 "(ma PC 10. M'matumba, pamatabwa 3 kapena 9 matuza, ma PC 14. M'matumba, pamatumbu 2 a matuza 2 kapena 4).

Piritsi 1:

• yogwira mankhwala: dapagliflozin - 5 kapena 10 mg (propanediol dapagliflozin monohydrate - 6.15 kapena 12.3 mg, motero),
• othandizira zigawo (5/10 mg): cellcrystalline cellulose - 85.725 / 171.45 mg, anactrous lactose - 25/50 mg, crospovidone - 5/10 mg, silicon dioxide - 1.875 / 3.75 mg, magnesium stearate - 1.25 / 2,5 mg
• chipolopolo (5/10 mg): Opadry II wachikasu (pang'ono hydrolyzed polyvinyl mowa - 2/4 mg, titanium dioxide - 1.177 / 2.35 mg, macrogol 3350 - 1.01 / 2.02 mg, talc - 0.74 / 1.48 mg, utoto wa iron okusayidi wachikasu - 0,073 / 0,15 mg) - 5/10 mg.

Mankhwala

The yogwira mankhwala a Forsigi, dapagliflozin, ndizoletsa zamphamvu mosalekeza (K_i) - 0,55 nM yosankha mtundu wa 2 sodium glucose cotransporter (SGLT2) inhibitor, yomwe imasankhidwa bwino mu impso komanso mu minofu ina yoposa 70 ya thupi (kuphatikiza chiwindi, minofu yamatumbo, minofu ya adipose, gland ya mammary, chikhodzodzo. ndi ubongo) sichinapezeke.

SGLT2 ndiye chonyamula chachikulu mu glucose reabsorption mu aimpso tubules. Mtundu wachiwiri wa matenda a shuga a mellitus (T2DM), glucose reabsorption mu aimpso tubules ukupitilira ngakhale hyperglycemia. Dapagliflozin, yoletsa kusintha kwa impso, imachepetsa kuyambiranso mu impso tubules, zomwe zimapangitsa kuti impso zithetsedwe.Zotsatira za dapagliflozin mwa odwala matenda a shuga 2, kuchuluka kwa glucose ndipo atatha kudya kumachepetsedwa, komanso kuchuluka kwa hemoglobin ya glycosylated kumachepetsedwa.

Mphamvu ya glucosuric (glucose excretion) imawonedwa mutatenga mlingo woyamba wa Forsigi, zotsatira zake zimapitirira kwa maola 24 otsatira ndipo zimapitiliza nthawi yonse yogwiritsa ntchito. Kuchuluka kwa shuga komwe impso zimapangidwa chifukwa cha njirayi kumadalira kuchuluka kwa kusefera kwa magazi (GFR) komanso kuchuluka kwa shuga m'magazi. Dapagliflozin yachilengedwe kupanga glucose amkati potsatira hypoglycemia sichikuphwanya. Mphamvu ya chinthu pa insulin katulutsidwe ndi kumva kwa izo sizitengera. M'maphunziro azachipatala a Forsigi, kusintha kwa β-cell kunadziwika.

Kuchuluka kwa shuga kwa impso chifukwa cha dapagliflozin kumayendera limodzi ndi kuchepa kwa zopatsa mphamvu komanso kuchepa thupi. Kuletsa kwa sodium glucose cotransport kumachitika ndi ofooka osakhazikika natriuretic ndi okodzetsa zotsatira.

Dapagliflozin ilibe gawo lililonse kwa ena omwe amayendetsa glucose omwe amayenda ndi glucose kuzinthu zotumphukira. Katunduyu akuwonetsa kupitilira nthawi 1400 kwakanthawi kwa SGLT2 kuposa SGLT1, yomwe ndi gawo lalikulu lamatumbo lomwe limayambitsa kuyamwa kwa shuga.

Mankhwala

Malinga ndi mayesero azachipatala, T2DM motsutsana ndi maziko a maphunziro autali (mpaka zaka 2) muyezo wa 10 mg wa 10 mg, kuchotsa kwa shuga kumachitika panthawi yonse yomwe amamwa mankhwalawa.

Kutulutsa shuga kwa impso kumathandizanso kuti osmotic diuresis ndi kuchuluka kwamkodzo kwamkati, komwe kumatenga milungu 12 (375 ml / tsiku). Kuwonjezeka kwa kuchuluka kwa mkodzo kumayendera limodzi ndi kuchepa komanso kuwonjezeka pang'ono kwa impso ndi impso, zomwe sizinapangitse kusintha kwa seramu sodium ndende m'magazi.

Malinga ndi zotsatira za kafukufuku, zidapezeka kuti kugwiritsa ntchito mankhwalawa kumabweretsa kutsika kwa magazi a systolic ndi diastolic (SBP ndi DBP) ndi 3.7 ndi 1.8 mm RT. Art. (motsatana) pa sabata la 24 la kutenga 10 mg ya dapagliflozin patsiku poyerekeza ndi gulu la placebo (kutsika kwa SBP ndi DBP - ndi 0,5 mm Hg). Zotsatira zofananazo zimawonedwa pamasabata 104 a mankhwala.

Mukamagwiritsa ntchito 10 mg ya dapagliflozin patsiku kwa odwala omwe ali ndi matenda a shuga 2 omwe ali ndi ochepa matenda oopsa komanso kuwonongeka kokwanira kwa glycemic kulandira angiotensin II receptor blockers, angiotensin-kutembenuza enzyme zoletsa, kuphatikizapo kuphatikiza ndi mankhwala ena a antihypertensive, pambuyo pa milungu 12 ya mankhwala poyerekeza ndi placebo kuchepa kwa hemoglobin ya glycosylated ndi 3.1% ndi kuchepa kwa SBP ndi 4.3 mm Hg. Art.

Pharmacokinetics

Pambuyo pakamwa, dapagliflozin imatha kwathunthu ndipo imatengedwa mwachangu kuchokera kumimba. Ndikotheka kumwa mankhwalawa panthawi yonse ya chakudya komanso kunja kwake. C_max (pazipita kuchuluka kwa chinthu) cha dapagliflozin m'madzi am'magazi, monga lamulo, zimatheka mkati mwa maola 2 mutatha kudya. Makhalidwe a C_max ndi AUC (dera lomwe limapanikizidwa ndi nthawi yoponderezedwa) limawonjezeka molingana ndi mlingo womwe umalandira. Mtheradi bioavailability wa mankhwala akumwa pakamwa 10 mg ndi 78%. Mwa odzipereka athanzi, kudya pa pharmacokinetics ya dapagliflozin imakhala yothandiza. Zakudya zamafuta kwambiri zimachepetsa C_max 50% dapagliflozin yatalika T_max (nthawi yofika ndende kwambiri) mu plasma pafupifupi ola limodzi, koma sizinathandize pa AUC poyerekeza ndi kusala kudya. Kusintha kumeneku sikofunikira pachipatala.

Kumangidwa kwa dapagliflozin kupita ku mapuloteni a plasma kuli pafupifupi 91%. Matenda a impso / chiwindi ndi matenda ena sakhudzanso chizindikiro.

Dapagliflozin ndi glucoside yolumikizidwa ndi C yomwe aglycon yake imalumikizidwa ndi glucose ndi chomangira cha mpweya. Thupi limapangidwa kuti lipangidwe makamaka dapagliflozin-3-O-glucuronide (metabolite metabolite).

61% ya mlingo wotengedwa pambuyo pakukonzekera kwa 50 mg ya 14 C-dapagliflozin imapangidwa kuti dapagliflozin-3-O-glucuronide (imatenga 42% ya kuchuluka kwa placma radioacaction). Gawo la mankhwala osasinthika ndi 39% ya kuchuluka kwa placma radioactivity, ya metabolites yotsalira payekhapayekha - mpaka 5%. Dapagliflozin-3-O-glucuronide ndi ma metabolites ena alibe mankhwala.

Wapakati T_1/2 (theka-moyo) kuchokera ku plasma mwa odzipereka athanzi ndi maola 12.9 patatha mlingo umodzi wa 10 mg wa dapagliflosin. Kutulutsa kwa thunthu ndi metabolites ake kumachitika makamaka ndi impso, ochepera 2% - osasinthika. Mutatenga 50 mg ya 14 C-dapagliflozin, 96% ya radioacaction yapezeka (mumkodzo - 75%, mu ndowe - 21%). Pafupifupi 15% ya ma radioacities omwe amapezeka mu ndowe ndi dapagliflozin osasinthika.

Pa equilibrium (ndikutanthauza AUC), kuwonekera kwa dapagliflozin mwa odwala omwe ali ndi matenda a shuga a 2 komanso ofatsa, ochepa kapena ochepa aimpso anali 32%, 60% ndi 87%, motero, kuposa momwe amagwirira ntchito. Kuchuluka kwa shuga komwe kumatsitsidwa ndi impso mkati mwa maola 24 mukamamwa dapagliflozin mofananirana zimatengera mtundu wa impso. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, aimpso amagwira ntchito bwinobwino, mofatsa kapena mwamphamvu kwambiri, 85, 52, 18 ndi 11 ga glucose amachotsedwera patsiku, motero. Kusiyana pakumanga kwa dapagliflozin kwa mapuloteni odzipereka mwaumoyo komanso mwa odwala omwe ali ndi vuto laimpso mosiyanasiyana samadziwika. Sizikudziwika ngati hemodialysis imakhudzana ndi mawonekedwe a dapagliflozin.

Pakuchepetsa pang'ono kuwonongeka kwa hepatic, amatanthauza C_max ndi dapagliflozin AUC anali 12% ndi 36% (motsatana) apamwamba poyerekeza ndi odzipereka athanzi (alibe tanthauzo lakuchipatala). Kulephera kwakukulu kwa chiwindi, mitengo yapakati pazisonyezozi imakhala yapamwamba ndi 40% ndi 67% (motsatana).

Kwa odwala omwe ali ndi zaka zopitilira 65, kuwonjezereka kwawonetsero kungayembekezere, komwe kumalumikizidwa ndi kuchepa kwa impso.

Mtengo wapakati wa AUC mu kufanana kwa akazi ndi 22% kuposa kuposa amuna.

Ndi kuchuluka kwa thupi, kuchuluka kwa maonekedwe ochepa kumadziwika (kulibe phindu).

Zizindikiro zogwiritsidwa ntchito

Forsig adalembedwa kuti athandize mtundu wa matenda a shuga 2 ngati njira yowonjezera pakudya ndi masewera olimbitsa thupi kuti azitha kuyendetsa bwino glycemic control.

Mankhwala angagwiritsidwe ntchito motere:

• monotherapy
• kuyamba mankhwala ophatikiza ndi metformin (ngati kuphatikiza uku ndikofunika),
• kuphatikiza pa chithandizo ndi metformin, thiazolidinediones, sulfonylurea zotumphukira (kuphatikizapo kuphatikiza ndi metformin), dipeptidyl peptidase 4 (DPP-4) zoletsa (kuphatikiza ndi metformin), kukonzekera kwa insulini (kuphatikiza ndi metformin) kuphatikiza ndi amodzi kapena awiri amkamwa mankhwala a hypoglycemic) pakakhala kusowa koyenera kwa glycemic.

Contraindication

• cholowa m'magazi-galactose tsankho, tsankho lactose, kusowa kwa lactase,
• mtundu 1 shuga
• kulephera kwa aimpso kapena pakati kapena kuperewera kwambiri kwaimpso (GFR 2),
• matenda ashuga ketoacidosis,
• kuphatikiza mankhwala othandizira kuzungulira kapena magazi ochepetsa magazi, omwe amagwirizana, mwachitsanzo, ndi matenda owopsa (monga matenda am'mimba),
• wazaka 18
• zaka 75 zakubadwa (kuyamba kugwiritsa ntchito),
• Mimba ndi kuyamwa
• tsankho limodzi ndi zigawo zikuluzikulu za mankhwala.

Wachibale (Forsyga amalembedwa moyang'aniridwa ndi achipatala):

• kuchuluka hematocrit
• kulephera kwa mtima
• kulephera kwambiri kwa chiwindi
• chiwopsezo cha kuchepa kwa magazi mozungulira,
• matenda a kwamkodzo thirakiti
• ukalamba.

Malangizo ogwiritsira ntchito Forsigi: njira ndi mlingo

Forsigu amatengedwa pakamwa. Kudya sikukhudza kuthandizira kwa mankhwalawa.

Mlingo wothandizidwa kamodzi pa tsiku, 10 mg iliyonse.

Mukamapangira mankhwala osakanikirana ndi kukonzekera kwa insulin kapena mankhwala omwe amalimbikitsa katemera wa insulin (makamaka, zotumphukira za sulfonylurea), kuchepetsedwa kwa mlingo kungafunike.

Ngati Forsiga amagwiritsidwa ntchito poyambira kuphatikiza ndi metformin, mlingo wake wa tsiku ndi tsiku ndi 500 mg mu 1 mlingo. Ndi osakwanitsa kuyang'anira glycemic, mlingo wa metformin ukuwonjezeka.

Mlingo woyambirira wa kuvuta kwambiri kwa chiwindi ndi 5 mg. Ndi kulolera bwino, kugwiritsa ntchito Forsigi 10 mg ndikotheka.

Zotsatira zoyipa

Zina mwazovuta zomwe zimapangitsa kuti Forsigi achedwe, chizungulire, matenda amkodzo, nseru, zotupa, ndi kuchuluka kwa ndende yamagazi. Munthawi ina, kukula kwa vuto losafunikira la chiwindi (autoimmune ndi / kapena hepatitis ya mankhwala) adadziwika. Nthawi zambiri, hypoglycemia imachitika panthawi yochizira.

Zotheka kuchita zoyipa (> 10% - nthawi zambiri,> 1% ndi 0,1% ndi bongo

Malinga ndi malangizo, Forsig ndi mankhwala otetezeka, pamene amamwa kamodzi mpaka 500 mg ndi odzipereka athanzi, amaloledwa bwino. Pankhani ya mankhwala osokoneza bongo, pafupipafupi pakachitika zinthu zovuta, kuphatikizapo kuwonongeka kwa magazi kapena kuchepa kwa madzi, ndi ofanana ndi pafupipafupi pagulu la placebo, popanda kusintha kwakukulu pamadokotala.

Mu nkhani ya bongo, kukonza kukonza ziyenera kuchitidwa poganizira momwe wodwalayo alili. Kutulutsa kwa dapagliflozin ndi hemodialysis sikunaphunzire.

Kuyanjana kwa mankhwala

• thiazide ndi loop okodzetsa: kukulitsa mphamvu yawo yokhudza kukodzetsa magazi ndikuwonjezera mwayi wa ochepa hypotension ndi madzi am'mimba,
• insulin ndi mankhwala omwe amalimbikitsa katulutsidwe ka insulini: kukula kwa hypoglycemia, kuphatikiza kumafunikira kusamala ndipo mwina, kusintha kwa mankhwalawa.

Zambiri zofananira za Forsigi zikusowa.

Ndemanga za Forsig

Malinga ndi ndemanga, Forsig ndi mankhwala othandiza omwe amagwiritsidwa ntchito pochotsa shuga m'thupi. Nthawi zina, chithandizo chamankhwala chimakuthandizani kuti musiye insulin kwathunthu. Komabe, ambiri amawona kukula kwa zovuta zoyipa, kuphatikiza pafupipafupi, kuchulukitsa kwa matenda otupa a genitourinary system, kusokonezeka kwa tulo, kuyabwa, kutentha thupi, kufupika.

Mitundu ya matenda ashuga

Pali mitundu iwiri yamatenda. Onsewa amadziwika ndi shuga yayikulu yamagazi, yomwe imachitika pazifukwa zosiyanasiyana. Ndi matenda a shuga amtundu 1, omwe amatchedwanso insulin, thupi silipanga mwaokha mahomoni ofunikira awa. Izi ndichifukwa cha kuwonongeka kwa maselo a pancreatic. Ndipo chithandizo chachikulu cha mtundu wa wodwalayo wa shuga ndi insulin.

Ngati ntchito za kapamba sizilemala, koma pazifukwa zina zimatulutsa timadzi tating'onoting'ono, kapena maselo athupi sangathe kutero. Amadziwikanso kuti insulin-Independent. Pankhaniyi, kuchuluka kwa shuga kumatha kukwera chifukwa cha kuchuluka kwa chakudya chamagulu, kusokonezeka kwa metabolic. Nthawi zambiri, munthu akamakhala ndi matenda a shuga a 2, amakhala wonenepa kwambiri. Chifukwa chake, tikulimbikitsidwa kuchepetsa kuchepa kwa chakudya chamafuta, makamaka zinthu za ufa, maswiti ndi wowuma. Koma, kuwonjezera pa chakudya, kugwiritsa ntchito mankhwala osokoneza bongo ndikofunikanso. Pali mitundu yosiyanasiyana ya matenda a shuga a 2, amaikidwa ndi dokotala kutengera mtundu wa matendawa.

Insulin-wodwala matenda a shuga:

Palibe mankhwala ochiritsira matendawa. Mankhwala othandizira amangofunikira. Chifukwa chiyani mankhwalawa samathandizira? Mwa munthu wathanzi, kapamba amatulutsa mahomoni a insulin, omwe amafunikira kagayidwe kabwinobwino. Amatulutsidwa m'magazi pomwe munthu akadya, zomwe zimapangitsa kuti kuchuluka kwake kwa glucose kukwere. Ndipo insulin imalitulutsa kuchokera ku magazi kupita ku maselo ndi minyewa. Ngati shuga ndi wochuluka, timadzi timeneti timathandizira pakupanga malo ake m'chiwindi, komanso kuphatikizidwa kwamafuta kwambiri.

Mu insellusus yodalira shuga, kutulutsa kwa insulin ndi kapamba kumasokoneza. Chifukwa chake, shuga wamagazi amakwera, omwe ndi owopsa kwambiri. Vutoli limayambitsa minyewa ya minyewa, kukula kwa impso ndi mtima, kupangika kwa magazi ndi mavuto ena. Chifukwa chake, odwala omwe ali ndi matenda ashuga ayenera kuwonetsetsa kuti insulini ikubwera kuchokera kunja. Ili ndi yankho ku funso lomwe amamwa mankhwala a shuga 1. Ndi mankhwala molondola a insulin, kuphatikiza kwa mankhwala owonjezera nthawi zambiri sikufunika.

Zokhudza kugwiritsa ntchito insulin

Hormoni iyi imasweka mwachangu m'mimba, kotero singathe kumwa mapiritsi. Njira yokhayo yobayira insulin mthupi ndi syringe kapena pampu yapadera mwachindunji m'magazi. Mankhwalawa amalowetsedwa mwachangu ngati adayikika mu khola lamkati pamimba kapena kumtunda kwa phewa. Tsamba lomwe silothandiza kwenikweni ndi ntchafu kapena matako. Ndikofunikira nthawi zonse kubayira mankhwala pamalo omwewo. Kuphatikiza apo, pali zina mwazinthu zothandizira odwala omwe ali ndi matenda a shuga omwe amadalira insulin. Kuzindikiritsa kwa mahomoni kumadalira kuchuluka kwa zomwe wodwala amayenda, zomwe amadya, komanso zaka zake. Kutengera izi, mitundu yosiyanasiyana ya mankhwalawa imaperekedwa ndipo mlingo umasankhidwa. Kodi pali mitundu yotani ya mahomoni iyi?

• Insulin-yochitika kwa nthawi yayitali - imagwiritsa ntchito shuga tsiku lonse. Chitsanzo chowoneka bwino ndi mankhwala a Glargin. Amakhala ndi shuga wamagazi nthawi zonse ndipo amatumizidwa kawiri pa tsiku.
• Insulin yokhala ndi nthawi yochepa imapangidwa kuchokera ku mahomoni amunthu pogwiritsa ntchito mabakiteriya apadera. Awa ndi mankhwalawa "Humodar" ndi "Actrapid". Zochita zawo zimayamba pambuyo pa theka la ola, motero tikulimbikitsidwa kuti muwabweretse musanadye.
• Ultrashort insulin imayendetsedwa pambuyo chakudya. Imayamba kuchita mphindi 5-10, koma zotsatira zake sizikupitilira ola limodzi, chifukwa chake, imagwiritsidwa ntchito limodzi ndi mitundu ina ya insulin. Mankhwalawa ali ndi kuchitapo kanthu mwachangu: Humalog ndi Apidra.

Mellitus wosadalira insulin: mankhwala

Kukonzekera mankhwalawa a matenda a shuga a mtundu wachiwiri ndikosiyanasiyana. Matenda amtunduwu amapezeka pazifukwa zosiyanasiyana: chifukwa cha kuperewera kwa zakudya m'thupi, moyo wokhazikika, kapena kunenepa kwambiri. Mafuta owonjezera m'magazi omwe ali ndi matendawa amatha kuchepetsedwa m'njira zingapo. Poyamba, kusintha kwa moyo wanu komanso zakudya zina ndizokwanira. Ndiye mankhwala ndi ofunika. Pali mankhwala osokoneza bongo:

• insulin yolimbikitsa othandizira, mwachitsanzo, sulfonylureas kapena dongo,
• zikutanthauza kusintha insulin komanso minofu kukhudzika kwa izo, awa ndi Biguanides ndi thiazolidinediones,
• mankhwala omwe amalepheretsa kuyamwa kwa shuga,
• magulu atsopano a mankhwala amathandizira kuchepetsa kulakalaka komanso kuchepa thupi.

Mankhwala omwe amathandizira thupi kupanga insulin pawokha

Mankhwala osokoneza bongo a shuga amadziwika mu magawo oyambirira a chithandizo cha matenda. Ngati kuchuluka kwa shuga m'magazi kumangokulitsidwa pang'ono, zolimbitsa chitetezo cha insulin zimayikidwa. Ndiwakanthawi kochepa - meglitinides ndi sulfonylurea zotumphukira, zomwe zimakhala ndi phindu lokhalitsa. Ambiri a iwo amayambitsa mavuto ambiri, mwachitsanzo, hypoglycemia, mutu, tachycardia. M'badwo watsopano wokha wamankhwala, Maninil ndi Altar, alibe zolakwa izi.Koma chimodzimodzi, madokotala nthawi zambiri amakupatsani mankhwala omwe amadziwa bwino komanso omwe amayesedwa nthawi yayitali: Diabetes, Glidiab, Amaril, Glurenorm, Movogleken, Starlix ndi ena. Amatengedwa katatu patsiku, kutengera nthawi yochitapo kanthu.

Mankhwala omwe amasintha mayamwidwe a insulin

Ngati thupi lipanga kuchuluka kokwanira kwa timadzi timeneti, koma kuchuluka kwa glucose ndikokwera, mankhwala ena amawaikira. Nthawi zambiri awa amakhala a biguanides, omwe amasintha kuyamwa kwa insulin ndi maselo. Amathandizira kuchepetsa kulakalaka, amachepetsa kupanga shuga ndi chiwindi ndi mayamwidwe ake m'matumbo. Biguanides omwe amakonda kwambiri ndi Siofor, Glyukofazh, Bagomet, Metformin ndi ena. The thiazolidinediones: Actos, Pioglar, Diaglitazone, Amalvia ndi ena omwe ali ndi zotulukapo zofanana ndi minofu yomwe imawonjezera kukhudzika kwawo ndi insulin.

Kodi pali mankhwala ena ati a shuga?

Magulu ena a mankhwala nthawi zambiri amathandizira odwala matenda ashuga. Amawonekera posachedwa, koma atsimikizira kale kugwiriridwa kwawo.

• Mankhwala "Glucobai" amalepheretsa kuyamwa kwa glucose m'matumbo, chifukwa chomwe mulingo wake m'magazi umachepa.
• Mankhwala osakanikirana "Glucovans" amaphatikiza njira zingapo zoyambitsa thupi.
• Mapiritsi a Januvia amagwiritsidwa ntchito popanga mankhwala ochepetsa shuga.
• Mankhwala "Trazhenta" ali ndi zinthu zomwe zimawononga ma enzymes omwe amasunga shuga wambiri.

Zakudya zowonjezera zakudya

M'magawo oyamba a shuga omwe amadalira insulin, kuchuluka kwa mankhwala omwe amawononga m'mimba amatha kuchepetsedwa. Mankhwalawa amathandizidwa ndi zakudya zapadera komanso zamagulu a mankhwala azitsamba ndi zina zowonjezera zamankhwala. Njira izi sizingathe mmalo mwa chithandizo chamankhwala chokhazikitsidwa ndi dokotala, mutha kungowonjezera.

• BAA "Insulin" imasintha kagayidwe, imalimbikitsa kapamba ndipo imachepetsa mayamwidwe a glucose.
• Mankhwala opangidwa ku Japan "Tuoti" amathandiza kuchepetsa shuga komanso kuchepetsa matenda
• Mankhwala ozikidwa ndi zitsamba "Glucberry" samangoyendetsa shuga, komanso amateteza thupi, komanso amalepheretsa kukula kwa zovuta za matenda ashuga.

Zolemba za mtundu wa 2 shuga

Mankhwalawa amapezeka pamapiritsi. Zambiri zimayambitsa mavuto:

• kunenepa
• kutupa
• fragility
• kukanika kwa mtima,
• nseru ndi m'mimba zopweteka
• chiwopsezo cha kukhala ndi hypoglycemia.

Kuphatikiza apo, mankhwala ochokera m'magulu osiyanasiyana amakhudza thupi mosiyanasiyana. Chifukwa chake, wodwalayo sangathe kusankha mtundu wa mankhwala omwe amayenera kumwa. Ndi dokotala yekhayo amene angadziwe momwe mungachepetse shuga wanu. Ngati pali zizindikiro za kagwiritsidwe ntchito ka insulini, ndiye kuti ndibwino kusinthira kwa iyo mwachangu, osayesa kusintha magome ochepetsa shuga.

Ndi mankhwala ena ati omwe mungalandire odwala matenda ashuga?

Wodwala wotere sayenera kuwunika zakudya zokha. Ndikofunikira kuphunzira mosamalitsa malangizo a mankhwala aliwonse, ngakhale chimfine kapena mutu. Ambiri a iwo amatsutsana mu shuga. Mankhwala onse sayenera kukhudzana ndi shuga komanso akhale ndi zovuta zochepa.

• Kodi ndingamwe mankhwala ati a shuga? Ovomerezeka ndi "Indapamide", "Torasemide", "Mannitol", "Diacarb", "Amlodipine", "Verapramil", "Rasilez".
• Ma pinkiller ambiri komanso mankhwala osokoneza bongo omwe amalimbana ndi kutupa amaloledwa kukhala ndi shuga, chifukwa sizikhudza shuga wamagazi: Aspirin, Ibuprofen, Citramon ndi ena.
• Pakazizira, madzi a shuga omwe amagwiritsidwa ntchito ndi shuga ndi lozenges wa resorption ayenera kupewedwa. Sinupret ndi Bronchipret amaloledwa.

Kupanga ndi mawonekedwe a kumasulidwa

Mankhwala amapangidwa mwanjira ya mapiritsi, omwe amakhathamira. Kuphatikizidwa kwa mankhwalawa kumakhala ndi magawo awiri ogwira ntchito - metformin ndi sitagliptin monohydrate phosphate. Kuchuluka kwa sitagliptin ndi 50 mg, ndipo chinthu chachiwiri chogwira ntchito ndi 500, 850 ndi 1000 mg, kutengera mlingo. Zowonjezera zake ndi MCC, povidone ndi sodium lauryl sulfate. Mapiritsiwo amapezeka pamatumbo a zidutswa 14.

Njira yamachitidwe

Sitagliptin imakhudzanso mphamvu ya thupi m'thupi, chifukwa cha momwe ziwalo zamkati zimasinthira glucose homeostasis. Ponena za metformin, imalepheretsa kutsika kwa glucose wabwinobwino m'thupi. Ndikofunika kudziwa kuti mankhwalawa atha kumwa mosamala odwala omwe ali ndi matenda ashuga komanso anthu athanzi labwino omwe amafunika kukhala ndi shuga.

Zizindikiro zogwiritsidwa ntchito

Nthawi zambiri, mankhwalawa "Yanumet" amagwiritsidwa ntchito pochiza odwala matenda a shuga a 2. Kuphatikiza apo, mankhwalawa amagwiritsidwanso ntchito pazinthu zotere:

Mankhwalawa amagwiritsidwa ntchito limodzi ndi insulin.

• pofuna kuthana ndi mafuta othandizira monga shuga ngati njira yowonjezerapo kuchikhalidwe chamadokotala komanso zakudya,
• monga gawo la zovuta mankhwala, pamene mankhwala a sulfonylurea ndi metformin sanakhale othandiza,
• ikaphatikizidwa ndi insulin.

Kutenga?

Malangizo ogwiritsira ntchito akuwonetsa kuti mapiritsi a Yanumet ayenera kugwiritsidwa ntchito kawiri pa tsiku asanadye. Mankhwalawa satetemera ndikusambitsidwa ndimadzi ambiri, makamaka ndi madzi. Ngati mukufunikira kuchuluka kwa mankhwalawa, muyenera kuchita izi pang'onopang'ono kuti muchepetse mavuto omwe amabwera chifukwa cha m'mimba. Mlingo waukulu patsiku suyenera kupitilira mapiritsi 2. Mlingo woyenera ungathe kutumizidwa ndi adokotala okha, kutengera mtundu wa wodwalayo komanso matendawa.

Zotsatira zoyipa

Malangizo ogwiritsira ntchito akuwonetsa kuti nthawi zina "Yanumet" momwe amapangira mapiritsi amayambitsa zotsatirazi zizindikiro:

• kupweteka m'mutu
• kufooka
• kulumikizana
• matenda amkuwa
• kuyuma mkamwa
• akukumbutsa
• zotupa pa kapamba,
• kudzikuza.

Mankhwala osokoneza bongo a "Janumet" a shuga

Ngati wodwala watenga kuchuluka kwa Yanumet, ndikofunikira kutsuka m'mimba posachedwa. Kenako kugwiritsa ntchito kaboni yokhazikitsidwa mu mlingo wofunikira umayikidwa ndipo zizindikiro zofunika zimayang'aniridwa. Nthawi zina, kuyeretsa magazi kwambiri kumatha kuchitidwa. Izi zimatsatiridwa ndi chithandizo chamankhwala.

Tchuthi ndi malo osungira

Mutha kugula mapiritsi a Yanumet m'matangadza a mankhwala okha ndi mankhwala a dokotala. Sungani mankhwalawa osaposa zaka ziwiri kuyambira tsiku lopanga, lomwe limawonetsedwa pamakatoni. Tsiku lotha litatha, kugwiritsa ntchito "Yanumet" kuletsedwa. Mankhwalawa amasungidwa m'chipinda momwe mulibe magetsi owongolera dzuwa ndi ana. Kutentha komwe kumakhalako sikuyenera kupitirira 25 digiri Celsius.

Mitu ya mankhwalawa

Mankhwala ali ndi analogue imodzi, yomwe ili ndi zigawo zofanana ngati Yanumet. Mankhwalawa amatchedwa Velmetia. Pali mankhwala omwe amakhudzanso thupi. Ogwira ntchito zachipatala ambiri amapereka mankhwalawa:

Ndikofunika kudziwa kuti mankhwala aliwonse omwe ali pamwambawa ali ndi zingapo zoyipa ndi zoyipa zake. Kudziyendetsa pakokha kapena kuisinthira mankhwala kumakhala kukuwonekera chifukwa cha zovuta ndi zovuta zazikulu zaumoyo. Mankhwala a matenda a shuga a mtundu wachiwiri akhonza kuperekedwa ndi adotolo, omwe azichita mayeso onse ofunikira pasadakhale ndipo zitatha izi ndiye kuti angathe kusankha mtundu umodzi mwamankhwala.

Lemberani mankhwala a shuga atatu

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amatha mapiritsi ochepetsa shuga kwa nthawi yayitali ndikukhalabe ndi shuga yamagazi pokhapokha ngati akutsatira zakudya zamagulu ochepa komanso kuchita masewera olimbitsa thupi okwanira. Koma zosungirako zamkati za thupi sizikhala zopanda malire ndipo zikafooka, odwala ayenera kusintha kuti amwe mankhwala.

Mankhwala ochiza matenda amisala 2 a shuga amadziwika kuti zakudya sizipereka zotsatira ndipo shuga wamagazi akupitilira kuchuluka kwa miyezi itatu. Koma nthawi zina, ngakhale kumwa mankhwala akumwa sikothandiza. Kenako wodwalayo amasinthira jakisoni wa insulin.

Mndandanda wamankhwala a matenda a shuga a 2 ndiwambiri kwambiri, onse amatha kugawidwa m'magulu akulu akulu:

Chithunzi: mankhwala osokoneza bongo a matenda a shuga 2

1. Ma siriagog ndi mankhwala omwe amachititsa kuti insulin itulutsidwe. Nawonso, amagawika m'magulu awiri: mabungwe a sulfonylurea (Diabeteson, Glurenorm) ndi meglitinides (Novonorm).
2. Sensitizer - mankhwala omwe amachititsa chidwi cha minyewa pakutsata insulin. Amagawidwanso m'magulu awiri: Biguanides (Metformin, Siofor) ndi thiazolidinediones (Avandia, Aktos).
3. Alfa glucosidase zoletsa. Mankhwala omwe ali mgululi ali ndi udindo wokhazikitsa kuyamwa kwa matumbo m'matumbo ndikuchotsedwa kwawo mthupi (Acarbose).
4. Mankhwala a mtundu wachiwiri wa matenda am'badwo watsopano ndi ma insretin. Izi zikuphatikizapo Januvia, Exenatide, Lyraglutide.

Tikhazikike pagulu lililonse la mankhwala:

Sulfonylureas

Chithunzi: Zochokera ku Sulfonylurea

Kukonzekera kwa gululi lakhala likugwiritsidwa ntchito pochita zachipatala kwa zaka zoposa 50 ndipo ndi koyenera. Amakhala ndi hypoglycemic chifukwa cha mwachindunji maselo a beta omwe amapanga insulin mu kapamba.

Zimachitika zomwe zimachitika m'magawo am'magazi zimapereka kutulutsidwa kwa insulin ndikutulutsa kwake m'magazi. Mankhwala osokoneza bongo omwe ali mgululi amalimbikitsa chidwi cha maselo ku glucose, amateteza impso kuwonongeka, komanso amachepetsa chiopsezo cha zovuta zam'mitsempha.

Nthawi yomweyo, kukonzekera kwa sulfonylurea kumachepetsa maselo a pancreatic, kumayambitsa zovuta zoyipa, kulemera, kudzimbidwa, ndikuwonjezera chiopsezo cha mikhalidwe ya hypoglycemic. Samagwiritsidwe ntchito mwa odwala omwe ali ndi matenda a shuga a pancreatic, ana, amayi apakati komanso oyamwitsa.

Pakumwa mankhwala, wodwala amayenera kutsatira zakudya zamafuta ochepa ndikumangiriza kudya mapiritsi ake. Oimira otchuka a gululi:

Chithunzi: Glycidon

Glycvidone - mankhwalawa ali ndi zochepa zotsutsana, chifukwa chake amalembera odwala omwe mankhwala omwe samupatsa omwe amadwala sapereka zotsatira zomwe akufunazo komanso okalamba. Zochitika zochepa zoyipa (kuyabwa pakhungu, chizungulire) zimasinthidwanso. Mankhwalawa akhoza kuikidwa ngakhale ndi kulephera kwa aimpso, chifukwa impso sizichita nawo gawo lanyama kuchokera m'thupi.

Mtengo wapakati wa kukonzekera kwa sulfonylurea ndi wochokera ku ma ruble 170 mpaka 300.

Meglitinides

Chithunzi: Starlix

Mfundo zoyenera kuchita ndi gulu ili la mankhwala ndikulimbikitsa kupanga kwa insulin ndi kapamba. Kugwiritsa ntchito bwino kwamankhwala kumadalira kuchuluka kwa glucose m'magazi. Mukakhala ndi shuga, insulin yambiri imapangidwa.

Oimira meglitinides ndi kukonzekera kwa Novonorm ndi Starlix. Ndiwo m'badwo watsopano wamankhwala, amadziwika ndi zochita zazifupi. Mapiritsi ayenera kumwedwa kwa mphindi zochepa asanadye. Mankhwalawa amawerengedwa monga gawo la zovuta za matenda a shuga. Amatha kuyambitsa mavuto monga kupweteka kwam'mimba, kutsegula m'mimba, matupi awo sagwirizana ndi hypoglycemic.

1. Novonorm - dokotala amasankha mlingo wa mankhwalawo payekha. Piritsi imatengedwa katatu patsiku, musanadye. Novonorm amachepetsa shuga m'magazi bwino, kotero ngozi yotsika ndi shuga m'magazi ndi yochepa. Mtengo wa mankhwalawa umachokera ku ma ruble a 180.
2. Starlix - pazipita mphamvu ya mankhwala zimachitika mphindi 60 pambuyo makonzedwe ndipo kumakhala kwa 6-8 maola. Mankhwalawa ndi osiyana chifukwa samapangitsa kuchulukitsa, sakhala ndi vuto pa impso ndi chiwindi. Mlingo umasankhidwa payekha.

Chithunzi: Biguanides

Mankhwalawa a shuga a mtundu 2 amasokoneza kutulutsa shuga kwa chiwindi ndipo amathandizira kuti mayamwidwe abwino komanso kusuntha kwa glucose m'maselo ndi minyewa ya thupi. Mankhwala a gululi sangagwiritsidwe ntchito ngati 2 odwala matenda ashuga omwe ali ndi vuto la mtima kapena la impso.

Kuchita kwa ma gluuanides kumatenga maola 6 mpaka 16, amachepetsa kuyamwa kwa shuga ndi mafuta kuchokera m'matumbo ndipo samayambitse kutsika kwamphamvu kwa shuga m'magazi. Amatha kuyambitsa kusintha kwamakomedwe, nseru, kutsekula m'mimba. Mankhwala otsatirawa ndi a gulu la Biguanides:

1. Siofor. Mankhwalawa nthawi zambiri amawalembera odwala omwe ali ndi kunenepa kwambiri, chifukwa kumwa mapiritsi kumathandizira kuchepetsa thupi. Mlingo wapamwamba kwambiri wa mapiritsi tsiku lililonse ndi 3 g, imagawidwa pawiri. Mulingo woyenera wa mankhwala amasankhidwa ndi adokotala.
2. Metformin. Mankhwala amachepetsa kuyamwa kwa glucose m'matumbo ndikuti amathandizira kugwiritsidwa ntchito kwake mu zotumphukira. Mapiritsi amaloledwa bwino ndi odwala, amatha kuikidwa limodzi ndi insulin ndi kunenepa kwambiri. Dokotala amasankha mlingo wa mankhwalawo payekha. Chotsutsana pa kugwiritsa ntchito Metformin ndichikhalidwe cha ketoacidosis, matenda akulu a impso, komanso nthawi yobwezeretsanso opereshoni.

Mtengo wamba wa mankhwalawa umachokera ku ma ruble 110 mpaka 260.

Thimang

Chithunzi: Thiazolidinediones

Mankhwala osokoneza bongo a shuga m'gululi, komanso ma biguanides, amathandizira kuyamwa kwa glucose ndi minofu ya thupi ndikuchepetsa kumasulidwa kwa shuga ku chiwindi. Koma mosiyana ndi gulu lakale, ali ndi mtengo wokwera kwambiri ndi mndandanda wazotsatira zoyipa. Izi ndi kulemera kwakukulu, kusokonekera kwa mafupa, chikanga, kutupa, kusokoneza ntchito za mtima ndi chiwindi.

1. Aktos - chida ichi chitha kugwiritsidwa ntchito ngati mankhwala amodzi pochiza matenda a shuga a 2. Kuchita kwa mapiritsiwo ndi cholinga chowonjezera kukhudzika kwa minyewa kupita ku insulin, kuchepetsa kapangidwe ka shuga m'chiwindi, kumachepetsa chiopsezo cha kuwonongeka kwa mtima. Mwa zovuta za mankhwalawa, kuwonjezeka kwa thupi panthawi ya makonzedwe kumadziwika. Mtengo wamankhwala amachokera ku ruble 3000.
2. Avandia - othandizira amphamvu a hypoglycemic omwe zochita zake zimayang'ana kukonza njira zama metabolic, kutsitsa shuga m'magazi ndikuwonjezera chidwi cha insulin. Mapiritsi amatha kugwiritsidwa ntchito ngati matenda a shuga a 2 monga monotherapy kapena kuphatikiza ndi othandizira ena a hypoglycemic. Mankhwalawa sayenera kuperekedwa chifukwa cha matenda a impso, pakakhala pakati, ubwana komanso hypersensitivity ku chinthu chogwira ntchito. Mwa zina zoyipa zomwe zimachitika, mawonekedwe a edema ndi kuphwanya ntchito za mtima ndi zida zamagayidwe amadziwika.Mtengo wapakati wamankhwala amachokera ku ruble 600.