Matenda a shuga amatchedwa "mliri" wa m'zaka za XXI. Chifukwa chake, kumwa mankhwala ndi imodzi mwazinthu zofunikira kwambiri pochiza matendawa. Kukonzekera kwa malangizo a pioglitazone kuli ndi kufotokoza mwatsatanetsatane kagwiritsidwe ntchito kake.
Mankhwala akuluakulu a shuga omwe ali ndi izi ndi Aktos, Pioglar, Diab-standard, Diaglitazone. Pioglitazone palokha ndi yoyera yamakristali yoyera, yomwe ndi yopanda fungo.
Sichisungunuka m'madzi, koma chimaphatikizidwa kwambiri mu dimethylformamide. Ponena za amadzimadzi ethanol, acetone ndi acetonitrile, zinthu zomwe zimakhala momwemo zimasungunuka pang'ono.
Pioglitazone ndi gawo la gulu la thiazolidinediones (glitazones); kugwiritsa ntchito kwake kukuwoneka kuti kuchepetsa shuga m'magazi. Popeza mtundu wachiwiri wa matenda a shuga umadziwika ndi kuphwanya kwamphamvu kwamaselo am'mthupi kuti mupange insulini, glitazones imayambitsa ma receptors omwe ali mu minofu yawo. Zotsatira zake, zotumphukira zimakhala ndikuyamba kuyankha ku insulin ya mahomoni.
Odwala ambiri amafunsa funso, kodi ndizotheka kumwa mankhwala okhala ndi pioglitazone mu mtundu woyamba wa matenda? Glitazones ndi mankhwala osokoneza bongo amtundu wachiwiri wa matenda ashuga. Amagwiritsidwa ntchito ngati mankhwala akuluakulu, komanso owonjezera ndi metformin, sulfonamide kapena insulin. Odwala amayamba kumwa mankhwalawa ngati kuchita masewera olimbitsa thupi komanso kudya moyenera kulibe vuto - shuga wabwinobwino.
Glitazones poyerekeza ndi mankhwala ena ochepetsa shuga amachotsa bwino kukana insulin. Amachepetsa kuchuluka kwamafuta m'magazi a anthu ndikugawa minofu ya adipose kuchoka pamimba kupita kumadera oyandikira. Kuphatikiza apo, zinthu zimatsika triglycerides.
Malangizo ogwiritsira ntchito mankhwalawa
Kumwa mankhwalawo kumasonyezedwa pokhapokha ngati atakambirana ndi dokotala, yemwe akupereka mlingo woyenera, poganizira zomwe wodwalayo ali nazo. Pankhani yakudzigwiritsa ntchito nokha za pioglitazone, malangizo a mankhwalawa ayenera kuphunziridwa mosamala kuti apewe zovuta zilizonse.
Mankhwala amawonetsedwa kuti agwiritsidwe ntchito ngati mulingo woyambira ukutalika kuchokera pa 15 mpaka 30 mg, ndipo pazowonjezera (patsiku) ndi 45 mg. Ngati muphatikiza mankhwalawa ndi mankhwala ena, mankhwalawa sayenera kupitirira 30 mg. Pioglitazone imawonetsedwa kuti imagwiritsidwa ntchito kamodzi patsiku.
Pa mankhwala, muyenera kupitiliza kutsatira zakudya komanso masewera olimbitsa thupi. Ndikofunikira kwambiri kuwona kuchuluka kwa hemoglobin m'magazi.
Pioglitazone imawonetsedwa ndi chisamaliro chapadera kwa odwala omwe atupa, ndipo chiwindi chimakhala ndi kuchuluka kwa michere. Ndi kukula kwa hypoglycemia pa kuphatikiza mankhwala kumafuna kuchepetsa Mlingo wa insulin kapena sulfonamides. Ngati wodwala ali ndi matenda a jaundice, vutoli limathanso kuthandizidwa, choncho ayenera kuyimitsidwa. Odwala omwe ali ndi mzunguko wothandizira panthawi ya premenopausal ali pachiwopsezo cha kutenga pakati, motero kulera kuyenera kugwiritsidwa ntchito.
Contraindication ndi zoyipa
Musanagwiritse ntchito mankhwala ozikidwa pa Pioglitazone, muyenera kufunsa dokotala. Izi zili ndi zotsutsana zambiri: kusalolera kwa pioglitazone, mtundu 1 wa matenda a shuga, matenda ashuga ketoacidosis (kufooketsa kagayidwe kachakudya chifukwa cha kusowa kwa insulin), matenda a chiwindi pakudwala kwambiri.
Mlingo wa ALT (alanine aminotransferase) ndiwambiri kuposa 2,5, momwe ungawonetse kukula kwamatenda akulu, a zaka mpaka 18 (kuchuluka kwa zinthu mwa odwala a m'badwo uno sikunadziwike), nthawi ya kubala ndi kuyamwitsa.
Ngati pioglitazone sagwiritsidwa ntchito molakwika kapena pazifukwa zina, wodwala atha kukumana ndi zotsatirazi:
- hypoglycemia - kuchepa msanga kwa shuga m'magazi;
- kutupa, komanso kuphatikiza ndi insulin kumawonjezera chiopsezo chotupa mpaka 15,3%;
- kuchepa magazi - hemoglobin wotsika m'magazi a anthu;
- kutsika kwa bilirubin;
- kuchepa kwa alanine aminotransferase (ALT) - enzyme ya hypogenic;
- kutsitsa aspartate aminotransferase (AST) - enzyme yomwe imayang'anira kapangidwe ka amino acid;
- kuchepa kwa alkaline phosphatase (ALP) - enzyme yomwe imaphwanya phosphates kuchokera ku mapuloteni, ma alkaloids, ndi zina;
- yafupika ka gamma glutamyl transferase.
Kuphatikiza apo, kukonzekera komwe kumakhala ndi sulfonamide, zotumphukira, insulin, kumayambitsa hypoglycemia.
Komanso, mukagwiritsidwa ntchito, mphamvu yochepetsera kugwiritsa ntchito njira zolerera za pakamwa imatha kupereka.
Ndemanga, zabwino ndi zoyipa
Ndemanga za odwala ambiri omwe amagwiritsa ntchito Aktos, Pioglar ndi mankhwala ena, zabwino kwambiri. Mwa zabwino, ndizotheka kuwunikira mphamvu yakuchepetsa kukana kwa insulin pakati pa mankhwala onse ochepetsa shuga omwe amatengedwa pakamwa.
Koma pali zovuta zina za glitazones, zomwe zimawonetsedwa motere: ndizotsika ndi mankhwala omwe ali ndi metformin ndi sulfonylurea, hemoglobin amatsika ndi 0.5-1,5%, mukamagwiritsa ntchito, phindu lolemera makilogalamu 1-3 limawonedwa chifukwa cha kuchuluka kwa mafuta ndi kusungika kwa madzi mthupi.
Chifukwa chake, musanatenge glitazones, muyenera kufunsa dokotala ndikuwerenga ndemanga za odwala omwe adawamwa kale.
Wodwala yemwe akutenga zinthu za pioglitazone, mtengo wake womwe umadalira mankhwalawo, ayenera kudziwa njira yothandizira. Mtengo wapakati wa mapiritsi a Pioglar (zidutswa 30 za 30 mg aliyense) ndi ma ruble 1083, Actos (zidutswa 28 za 30 mg aliyense) ndi ma ruble 3000. Mwakutero, munthu wa zaka zapakati amatha kugula mankhwalawa. Mtengo wawo wokwera umachitika chifukwa chakuti mankhwalawa amalowetsedwa kunja, Pioglar amapangidwa ku India, Actos - ku Ireland.
Kutsika mtengo ndi mankhwala opangidwa ku Russia. Izi zikuphatikiza:
- Miyezo ya Mdyerekezi;
- Astrozone;
- Diaglitazone.
Mukamagwiritsa ntchito, zotsatira za hypoglycemic zimaperekedwa. Diaglitazone, yomwe imawononga ma ruble 295, ikhoza kukhala njira yabwino kwambiri yodula ndi mankhwala okwera mtengo kwambiri. Astrozone ndi Mdyerekezi-ali ndi zotsutsana zomwezi ndi zovuta zake.
Diagnitazone itha kuchepa mphamvu yogwiritsa ntchito njira yolerera yokhala ndi pakamwa, yomwe iyenera kukumbukiridwa.
Pioglitazone analogues
Chifukwa cha tsankho ndi zovuta zina, kugwiritsa ntchito Pioglitazone kungakhale koletsedwa. Chifukwa chake, adotolo amafotokozera mankhwala ena okhala ndi rosiglitazone.
Izi zimaphatikizidwanso mgulu la thiazolidinediones (glitazones). Mukamagwiritsa ntchito, zotsatira zomwezi zimapangika kuchokera ku pioglitazone, ndiko kuti, kukondoweza kwa maselo a cell ndi minofu kuti athetse insulin.
Mankhwala akuluakulu omwe ali ndi rosiglitazone ndi awa:
- Avandia
- Osunthika.
Musanagwiritse ntchito, muyenera kufunsa dokotala ndikuwerenga malangizo kuti mugwiritse ntchito.
Kukonzekera kwa Biguanide kumachepetsa kukana kwa insulin. Metformin, yomwe ndi gawo la malonda, imachepetsa kupanga kwa chiwindi ndi chiwindi. Gwiritsani ntchito mankhwalawa mosamala, popeza ma biguanides amasokoneza ntchito ya mtima mwa okalamba, zotsatira zoyipa za impso ndi chitukuko chifukwa cha lactic acidosis imatha kugwiritsidwanso ntchito. Kukonzekera ndi metformin yogwira ntchito kumaphatikizapo Bagomet, Glucofage, Metformin-BMS, NovoFormin, Siofor ndi ena.
Komanso amachepetsa shuga ya magazi Acarbose. Amayendedwe a zochita zake amayeserera kulepheretsa michere yomwe imathandizira kupanga michere m'mimba. Hypoglycemia ndiyotheka ndikugwiritsa ntchito mankhwala ena ndi insulin. Popewa kupezeka kwa mavuto omwe amabwera chifukwa cha kudzimbidwa, ndibwino kuyamba kumwa ndi yaying'ono.
Pochiza matenda a shuga a mtundu wa 2, mankhwala okhala ndi pioglitazone kapena analogies, kaya ndi Diaglitazone kapena Metformin, angagwiritsidwe ntchito. Popeza mankhwalawa ali ndi kuchuluka kwakukulu kwa contraindication ndi zotsatira zoyipa, tikulimbikitsidwa kuti muzigwiritsa ntchito pambuyo pofunsira matenda a shuga. komanso ndi adotolo. Kanema yemwe ali munkhaniyi akuwunika mwachidule zokambirana za
