Nthawi zina zakudya zopatsa thanzi komanso kuchita masewera olimbitsa thupi sizingapereke kuchuluka kwa shuga m'thupi la odwala matenda ashuga omwe ali ndi mtundu wa 2 wa matendawa.
Thupi lomwe limakhala ndi INN Repaglinide, malangizo omwe amamangidwa phukusi lililonse la mankhwala omwe amapezeka, ali ndi vuto la hypoglycemic pamene sikutheka kuyendetsa kuchuluka kwa shuga m'magazi. Nkhaniyi iyankha funso la momwe mungagwiritsire ntchito mankhwalawa moyenera ndikuwonetsa kuti kugwiritsidwa ntchito kwake ndikosatheka.
Pharmacological zimatha mankhwala
Chosakaniza chogwira, Repaglinide, chimapezeka mu mawonekedwe oyera a ufa kuti mugwiritse ntchito mkati. Kupanga kwa gawo la zomwe zimapangidwazo ndikumasulidwa kwa insulin (mphamvu yotsitsa shuga) kuchokera ku maselo a beta omwe amapezeka mu kapamba.
Pogwiritsa ntchito repaglinide pa ma receptor apadera, njira zotsalira za ATP zomwe zimapezeka mkati mwa maselo a beta zimatsekedwa. Kuchita kotereku kumapangitsa mkwiyo wa maselo komanso kutsegulidwa kwa njira za calcium. Zotsatira zake, kupanga insulini kumachulukitsidwa ndikuwonjezera kuchuluka kwa calcium.
Wodwalayo atatenga muyezo wa Repaglinide, thunthu limalowetsedwa m'mimba. Nthawi yomweyo, pambuyo pa ola limodzi mutatha kudya, imadziunjikira kwambiri m'madzi a m'magazi, ndiye kuti patatha maola 4 phindu lake limatsika mofulumira ndikutsika kwambiri. Kafukufuku wa mankhwalawa watsimikizira kuti panalibe kusiyana kwakukulu pama mfundo a pharmacokinetic mukamagwiritsa ntchito Repaglinide musanadye kapena nthawi ya chakudya.
Thupi limagwirira kumapuloteni a plasma oposa 90%. Komanso, phindu lokwanira la bioavailability limafika pa 63%, ndipo voliyumu yake yogawa ndi malita 30. Muli mu chiwindi komwe biotransformation ya Repaglinide imachitika, chifukwa chomwe metabolites ofooka amapangika. Kwenikweni, amawachotsa ndi bile, komanso mkodzo (8%) ndi ndowe (1%).
Mphindi 30 mutatenga Repaglinide, kutulutsidwa kwa mahomoni kumayamba. Zotsatira zake, kuchuluka kwa shuga m'magazi kumatsika mofulumira. Pakati pa chakudya, palibe kuchuluka kwa insulin.
Odwala omwe ali ndi shuga omwe amadalira insulin omwe samatenga 0,5 mpaka 4 g wa Repaglinide, kuchepa kwa shuga kumawonedwa.
Malangizo ogwiritsira ntchito mankhwalawa
Repaglinide ndiye gawo lalikulu la NovoNorm, lomwe limapangidwa ku Denmark. Makampani opanga mankhwala a Novo Nordisk A / C amapanga mankhwala mwanjira ya mapiritsi okhala ndi mitundu yosiyanasiyana - 0,5, 1 ndi 2 mg. Chithuza chimodzi chimakhala ndi mapiritsi 15; matuza angapo akhoza kupezeka phukusi limodzi.
Mu phukusi lirilonse la mankhwala omwe ali ndi chigawo china cha repaglinide, malangizo ogwiritsidwira ntchito amakakamizidwa. Mlingo umasankhidwa payekhapayekha ndi katswiri wowachiritsa yemwe amayeza kuchuluka kwa shuga ndi zomwe zimagwirizanitsidwa ndi odwala. Asanagwiritse ntchito mankhwalawa, wodwalayo ayenera kuwerenga mosamala malangizo omwe aphatikizidwa.
Mlingo woyambirira ndi 0.5 mg, umatha kuwonjezeka pokhapokha sabata limodzi kapena awiri, kudutsa mayeso a labotale kwa kuchuluka kwa shuga. Mlingo umodzi waukulu kwambiri ndi 4 mg, ndipo mlingo wa tsiku ndi tsiku ndi 16 mg. Mukasinthika kuchokera ku mankhwala ena ochepetsa shuga Repaglinide imwani 1 mg. Muyenera kugwiritsa ntchito mankhwalawa kwa mphindi 15-30 musanadye kaye.
Mankhwala a NovoNorm ayenera kusungidwa kutali ndi ana ang'ono pamtunda wa mpweya wa 15-25C pamalo otetezedwa ku chinyezi.
Alumali moyo wa mankhwalawa wafika zaka 5, nthawi imeneyi singagwiritsidwe ntchito.
Contraindication ndi zomwe zingavulaze
Tsoka ilo, si aliyense amene angalandire NovoNorm. Monga mankhwala ena, ali ndi zotsutsana.
The repaglinide ya mankhwala silingatengedwe ndi:
- mtundu wa shuga wodalira insulin;
- matenda ashuga ketoacidosis, kuphatikizapo chikomokere;
- chiwindi chachikulu ndi / kapena kukanika kwa impso;
- kugwiritsa ntchito mankhwala owonjezera omwe amalepheretsa kapena kuletsa CYP3A4;
- lactose tsankho, lactase akusowa ndi shuga-galactose malabsorption;
- kuchuluka kwa magawo a zinthu;
- wosakwana zaka 18;
- mimba kapena kukonzekera;
- yoyamwitsa.
Kafukufuku yemwe anachitika pa makoswe adatsimikizira kuti kugwiritsa ntchito ma repaglinide panthawi yobereka mwana kumakhudza mwana wosabadwayo. Chifukwa cha kuledzera, kukula kwa malekezero akumtunda ndi otsika kwa mwana wosabadwayo kunasokonekera. Komanso, kugwiritsa ntchito chinthucho ndikuloledwa pa mkaka wa m'mawere, popeza umaperekedwa mkaka wa mayi kupita kwa mwana.
Nthawi zina osagwiritsa ntchito molakwika mankhwala kapena mankhwala osokoneza bongo, amakumana ndi zovuta monga:
- chikhalidwe cha hypoglycemia (kuchuluka thukuta, kunjenjemera, kugona tulo, tachycardia, nkhawa);
- kuwonongeka kwa zida zowonekera (magawo oyambawo kumwa mankhwalawo, ndiye nkudutsa)
- kupukusa m'mimba (kupweteka kwam'mimba, kusanza ndi kusanza, kudzimbidwa kapena kutsegula m'mimba, kuchuluka kwa michere mu chiwindi);
- ziwengo (redness of the khungu - erythema, zidzolo, kuyabwa).
Kugwiritsa ntchito kuchuluka kwa mankhwalawa kuposa momwe dokotala ananenera pafupifupi nthawi zonse kumayambitsa hypoglycemia. Ngati munthu wodwala matenda ashuga akumva mankhwala osokoneza bongo ndipo amadziwa, ayenera kudya zakudya zopatsa mphamvu ndipo akafunsirane ndi dokotala pazomwe mungasinthe.
Mu hypoglycemia yayikulu, wodwala akakhala kuti akupuma kapena sakomoka, amapaka jekeseni wa 50% ya glucose pansi pa khungu ndikuwonjezeranso kulowetsedwa kwa 10% yothetsera kukhalabe ndi shuga osachepera 5.5 mmol / L.
Kuchita kwa Repaglinide ndi Mankhwala Ena
Kugwiritsa ntchito mankhwala olumikizana nthawi zambiri kumakhudza mphamvu ya kuyambiranso kwa ndende ya glucose.
Mphamvu yake ya hypoglycemic imakonzanso pamene wodwala atenga ma MAO ndi ACE zoletsa, osagwiritsa ntchito beta-blockers, mankhwala osagwiritsa ntchito mankhwala a anti-yotupa, salicylates, anabolic steroids, okreotide, mankhwala okhala ndi ethanol.
Kuthekera kwa chinthu chochepetsa glucose kumachitika chifukwa cha mankhwala otere:
- thiazide okodzetsa;
- njira zakulera zogwiritsira ntchito pakamwa;
- danazole;
- glucocorticoids;
- mahomoni a chithokomiro;
- amphanomachul.
Komanso, wodwalayo ayenera kuganizira kuti repaglinide imalumikizana ndi mankhwala omwe amachotsedwa mu ndulu. CYP3A4 inhibitors monga intraconazole, ketoconazole, fluconazole ndi ena ambiri amatha kuwonjezera magazi ake. Kugwiritsa ntchito kwa CYP3A4 inducers, makamaka rifampicin ndi phenytoin, kumatsitsa mulingo wa chinthu cham'magazi. Popeza kuti mulingo wazolowera sunatsimikizidwe, kugwiritsa ntchito Repaglinide ndi mankhwalawa ndizoletsedwa.
Malangizo ogwiritsira ntchito
Nthawi zina, odwala ayenera kugwiritsa ntchito mankhwalawa mosamala kwambiri moyang'aniridwa ndi dokotala yemwe amapereka mankhwala ochepera. Odwala oterowo akuphatikizapo odwala omwe ali ndi vuto la chiwindi ndi / kapena impso, omwe adachitapo maopaleshoni ochulukirapo, omwe adangokhala ndi kachilombo kapena matenda opatsirana, okalamba (kuyambira wazaka 60) omwe amatsata zakudya zama calorie otsika.
Ngati wodwala ali ndi mtundu wa hypoglycemic wofatsa kapena wowonda, amatha kuthetsedwa payokha. Kuti muchite izi, muyenera kudya zakudya zokhala ndi zopatsa mphamvu mosavuta - chidutswa cha shuga, maswiti, msuzi wokoma kapena zipatso. Mwa mawonekedwe owopsa ndi kutaya chikumbumtima, monga tanena kale, yankho la shuga limayendetsedwa kudzera m'mitsempha.
Tiyenera kudziwa kuti beta-blockers amatha kuphimba zizindikiro zomwe zikubwera za hypoglycemia. Madokotala amalimbikitsa kuti musamamwe mowa ngati ethanol imakulitsa ndikupitiliza kuthamanga kwa hypoglycemic ya Repaglinide.
Komanso, zinthu zimachepetsa chidwi cha anthu.
Chifukwa chake, oyendetsa moyang'anizana ndi maziko ogwiritsira ntchito repaglinide, ndikofunikira kupewa kuyendetsa magalimoto kapena kugwira ntchito zina zoopsa panthawi ya chithandizo.
Mtengo, ndemanga ndi fanizo
Repaglinide monga gawo lalikulu limagwiritsidwa ntchito mu mankhwala a NovoNorm.
Itha kugulidwa ku malo ogulitsa mankhwala kapena kuyitanitsa pa intaneti patsamba laogulitsa. Komabe, kugula kwa mankhwalawo kumatheka pokhapokha ngati wapezeka ndi udokotala.
Mtengo wamankhwala umasiyanasiyana:
- Mapiritsi 1 mg (zidutswa 30 pa paketi) - kuchokera ku 148 mpaka 167 ma ruble aku Russia;
- Mapiritsi a 2 mg (zidutswa 30 pa paketi) - kuchokera ku 184 mpaka 254 rubles aku Russia.
Monga mukuwonera, mitengo ndiyodalirika kwambiri kwa anthu omwe ali ndi ndalama zochepa. Kuwerenga ndemanga za anthu ambiri odwala matenda ashuga, titha kudziwa kuti mtengo wotsika wa mankhwalawa ndiwophatikiza, ndikupatsidwa ntchito. Kuphatikiza apo, zabwino za NovoNorm ndi:
- kugwiritsa ntchito mosavuta mapiritsi poyerekeza ndi jakisoni;
- kuthamanga kwa mankhwalawa, mu ola limodzi lokha;
- Kutenga nthawi yayitali mankhwalawa.
Mfundo yomalizayi ikutanthauza kuti odwala ambiri omwe amapezeka ndi matenda osokoneza bongo omwe amadalira insulin akhala akutenga NovoNorm kwa zaka 5 kapena kuposerapo. Amaonanso kuti zotulukapo zake sizimodzimodzi ndipo sizifupika. Komabe, kuchuluka kwa mankhwalawa kwa mankhwalawa kumachepetsedwa mpaka zero: OSATI:
- kutsatira zakudya zabwino (kupatula chakudya chambiri cham'mimba ndi mafuta);
- khalani ndi moyo wokangalika (kuyenda kwa mphindi 30, masewera olimbitsa thupi, ndi zina);
- Nthawi zonse muziyang'anira kuchuluka kwa shuga (pafupifupi katatu patsiku).
Mwambiri, odwala ndi madokotala amawona kuti NovoNorm ndi antipyretic wabwino kwambiri. Koma nthawi zina kugwiritsa ntchito mapiritsi kumaletsedwa, chifukwa zimabweretsa zotsatira zosayenera. Zikatero, adotolo akuganiza zosintha mlingo wa mankhwalawo kapena kupereka mankhwala osiyana ndi ena onse.
Ma Synonyms amakhala ndi chinthu chimodzi chomwe chimagwira ndipo chimasiyana pazinthu zina zowonjezera. Mapiritsi a NovoNorm ali ndi vuto limodzi - Diagniniside (avareji ma ruble 278).
Mankhwala ofanana a NovoNorm, omwe ali osiyana m'magawo awo, koma ali ndi zofanana, ndi awa:
- Jardins (mtengo wapakatikati - ma ruble 930);
- Victoza (mtengo wapakatikati - ma ruble 930);
- Saksenda (mtengo wapakatikati - ma ruble 930);
- Forsyga (mtengo wapakatikati - ma ruble 2600);
- Attokana (mtengo wapakatikati - ma ruble 1630).
Titha kunena kuti mankhwalawa NovoNorm, omwe ali ndi yogwira pophika, amagwira ntchito pochiza matenda amtundu wa 2 shuga. Imatsika msanga kwambiri misempha yokhazikika. Ngati mutsatira zakudya, kuchita masewera olimbitsa thupi komanso kuwunika pafupipafupi kuchuluka kwa shuga, mutha kuthana ndi hypoglycemia ndi zizindikiro zazikulu za matenda ashuga. Kanema yemwe ali munkhaniyi akufotokozerani momwe mungachiritsire matenda ashuga.
