Munthawi yamatekinoloje azidziwitso komanso mibadwo yatsopano ya mankhwala opatsirana a shuga, mankhwalawa omwe ayesedwa kwa nthawi yayitali amakhalabe ofunikira. Zotchuka kwambiri ndizomwe zimapangitsa kuti kapamba apange insulin yowonjezera. Tikuyankhula za zotumphukira za mndandanda wa sulfonylurea ndi nesulfanylurea zachinsinsi - matope.
Repaglinide ndiyonso ya gulu lomaliza. Kusiyana kwake kwakukulu ndi momwe gawo loyambirira latulutsira timadzi m'magazi, mukatha kudya m'magazi mumadumphadumpha kwambiri, ndipo thupi la munthu wodwala matenda ashuga (wokhala ndi matenda a 2) sangathe kulimbana nawo.
Mukatha kuwerenga malangizo, kuyerekeza zabwino ndi mavuto onse, mutha kukambirana ndi dokotala njira yanu yothandizira odwala matenda ashuga.
Kupanga ndi kufotokoza kwa mankhwalawa
Piritsi lirilonse limakhala ndi 0,5 kapena 1 mg ya yogwira popanga micronized repaglinide yophatikizidwa ndi zinthu zothandizira: calcium hydrogen phosphate anhydrous, colloidal silicon dioxide, cellcrystalline cellulose, croscarmellose sodium, hydroxypropyl cellulose, meglumine, magnesium stearate, ndi utoto.
Mapiritsi ozungulira a biconvex amatha kuzindikiridwa mwalemba ndi manambala omwe akuwonetsa kuchuluka. Ndi chizindikiro cha 0,5, ndi yoyera, ndi 1 mg - lavenda kapena chikasu. Kumbuyo mutha kuwona chidule RP, J ndi ena. Mapiritsi 10 ali mmatumba. Padzakhala mbale zingapo pabokosi lamakatoni.
Mankhwala omwe akupezeka. Mtengo wa Repaglinide ndi bajeti yeniyeni: mapiritsi 30 a 2 mg ku Moscow atha kugulitsidwa ma ruble 200-220. Amamasula mankhwala ku Denmark, Israel, India ndi maiko ena, kuphatikizanso gawo la Soviet.
Alumali moyo wa mankhwalawa, wolengezedwa ndi wopanga, ndi wazaka zitatu. Mankhwalawa safuna mikhalidwe yapadera kuti asungidwe. Pambuyo pa nthawi yomwe yatchulidwa, mapiritsiwo ayenera kutayidwa.
Zotsatira za pharmacological
Zotsatira zazikulu za mankhwalawa ndi hypoglycemic. Mankhwalawa amalepheretsa njira zotsalira za potaziyamu za PAP zomwe zimapezeka mu membala wa b-cell, zimathandizira kukhumudwa kwawo ndikumasulidwa kwa njira za calcium. Chifukwa chake, siriagogue imapangitsa kutengeka kwa mahomoni.
Kafukufuku wa zamankhwala sanapeze mutagenic, teratogenic, carcinogenic zotsatira mu zinyama komanso kuphwanya chonde.
Repaglinide imayamwa mwachangu komanso mokwanira kuchokera m'matumbo am'mimba, mpaka kufika pazokwanira zake m'magazi mu ola limodzi.
Ngati amamwa ndi zakudya, Cmax imachepetsedwa ndi 20%. The kuchuluka kwa mankhwalawa amatsika msanga ndipo pambuyo 4 maola ukufika ochepa chizindikiro. Mankhwalawa amamangidwa ndi mapuloteni a plasma pafupifupi kwathunthu (kuchokera 98%) ndi bioavailability a 56%. Biotransformation ndi mapangidwe a inert metabolites amapezeka m'chiwindi.
Mankhwalawa amachotsedwa mu maola 4-6 ndi theka la moyo wa ola 1. Pa 90% imadutsa pamiyendo ya bile, pafupifupi 8% imachotsedwa ndi impso.
Repaglinide ndi ndani?
Mankhwalawa adapangidwa kuti azitha kuthana ndi matenda a shuga a mtundu wa 2 ngati kusintha kwasinthidwe (zakudya zama carb otsika, katundu wokwanira wa minofu, chiwongolero chazomvera) samapereka chiwongolero chonse cha glycemic.
Ndizotheka kugwiritsa ntchito glinide panjira yovuta ndi metformin ndi thiazolidatediones, ngati monotherapy, mankhwala othandizira komanso masewera olimbitsa thupi sapereka zotsatira zomwe mukufuna.
Yemwe Repaglinide adatsutsana
Kuphatikiza pa zoletsa zachikhalidwe (kusalolera, kubereka, ana, kuyamwitsa), mankhwalawa ndi otsutsana:
- Anthu odwala matenda ashuga omwe ali ndi matenda amtundu 1;
- Ndi matenda ashuga ketoacidosis;
- Mu chikhalidwe cha chikomokere ndi chodalirika;
- Ngati wodwala ali ndi vuto lalikulu la impso ndi chiwindi;
- Muzochitika zosinthira kwakanthaŵi kwa insulin (matenda, zoopsa, opaleshoni).
Makamaka chisamaliro chikuyenera kuperekedwa kuti apereke mankhwala osokoneza bongo kwa oledzera, anthu omwe ali ndi matenda a impso, komanso malungo.. Pali zoletsa zaka: osapereka mankhwala kwa odwala matenda ashuga asanafike 18 ndi zaka 75 chifukwa cha kusowa kwa umboni wamagulu awa.
Njira yogwiritsira ntchito
Kwa repaglinnid, malangizo omwe angagwiritsidwe ntchito amalimbikitsa kumwa mapiritsi musanadye. Dokotala adzasankha mlingo wofunikira pakuwongolera glycemic molingana ndi zotsatira za kusanthula, gawo la matendawa, concomitant pathologies, zaka, momwe thupi limayendera ndi dongo.
Kuti mumvetse bwino za kuchuluka kwa mankhwala othandizira, ndikofunikira kuthana ndi shuga komanso matenda a postprandial kunyumba komanso ku labotale. Mukakonza zikhalidwe za mankhwalawa, amathandizidwanso ndikuwonetsa ma hemoglobin a glycated.
Kuwunikira ndikofunikira kuti muzindikire kulephera koyambira komanso kwachiwiri, pomwe glycemia imagwera pokhazikika pamayambiriro a maphunzirowa kapena pambuyo poyambira.
Nthawi yakumwa repaglinide sichikhala chokhazikika: mphindi 15-30 musanadye chakudya kapena nthawi yomweyo kumayambiriro kwa chakudya. Ngati akamwe zoziziritsa kukhosi (ndiye kuti amazidumpha), ndiye kuti piritsi lina limawonjezeredwa (kapena kudumphidwa).
Ngati wodwala matenda ashuga sanalandirebe mankhwala ochepetsa shuga, muyeso wa dongo uyenera kukhala wochepa - 0,5 mg asanadye chilichonse. Ngati angasinthe ndikupereka mankhwala ena okhudzana ndi matenda ashuga, mutha kuyamba ndi 1 mg musanadye.
Ndi mankhwala othandizira, mulingo woyenera sapitilira 4 mg musanadye. Zakudya zadothi tsiku lililonse siziyenera kupitirira 16 mg.
Ndi zovuta mankhwala, mlingo wa repaglinide sasintha, ndipo miyambo ina ya mankhwalawa imasankhidwa molingana ndi kuwerenga kwa glucometer ndi regimens yachiwiri yamankhwala.
Zotsatira zoyipa
Mwa zovuta zoyipa zomwe zimadziwika ndi ma glinids, hypoglycemia ndiyowopsa. Popereka mankhwala, dokotalayo ayenera kufotokozera odwala zomwe akuona ndi njira zake zothandizira ndi kudzisamalira pothana ndi vutoli.
Mwa zina zomwe sizinachitike.
- Matenda a Dyspeptic;
- Kuphwanya miyambo yamatumbo;
- Thupi lawo siligwirizana;
- Kukanika kwa chiwindi mu mawonekedwe a transistor kuchuluka mu ntchito ya transaminases;
- Zowonongeka chifukwa cha kusiyana kwa glycemic level.
Zotsatira Zogwiritsa Ntchito Mankhwala
Kugwiritsanso ntchito kwa repaglinide ndi β-blockers, ACE inhibitors, chloramphenicol, zakumwa zoledzeretsa, mao inhibitors, osagwirizana anticoagulants NSAIDs, probenecid, salicylates, sulfonamides, anabolic steroids, mphamvu ya dongo imachulukirachulukira.
The munthawi yomweyo makonzedwe a repaglinide ndi calcium njira blockers, corticosteroids, thiazide diuretics, isoniazid, nicotinic acid munthawi yopanda muyeso, estrogen (yomwe ili ndi njira zakulera), sympathomimetics, phenothiazines, phenytoin, mahomoni a chithokomiro amachepetsa mphamvu ya glinides.
Kuthandiza ndi bongo
Izi zitha kudziwika ndi:
- Chilango chosalamulirika;
- Kutopa;
- Kusangalala kwakukulu;
- Kuchulukitsa nkhawa;
- Mavuto ogona;
- Kusintha kakhalidwe (chikhalidwe chofanana ndi kuledzera);
- Kulankhula ndi kuwonera;
- Kuperewera kwa mgwirizano ndi chisamaliro;
- Chikumbumtima chosokonezeka;
- Khungu loyera;
- Tachycardia;
- Minofu spasms;
- Kutuluka thukuta kwambiri;
- Kukomoka, chikomokere.
Kuthandiza munthu amene akuzunzidwayo ndi chizindikiro komanso kumathandizira. Ngati wodwalayo akudziwa, ayenera kupatsidwa chakudya (shuga, maswiti), pakapita kanthawi, thupi lodzaza ndi shuga liyenera kubwerezedwa, chifukwa akhoza kuyambiranso.
Ngati wodwalayo alibe chizindikiro cha chikumbumtima, njira ya glucose (50%) imayendetsedwa pamitsempha, kuti azikhala ndi glycemic pamwamba pa 5.5 mmol / l, dontho limayikidwa ndi 10% shuga. Muzovuta kwambiri, kuchipatala chofunikira ndikofunikira.
Malangizo owonjezera
Chidwi chachikulu (kuwongolera kusala kudya ndi shuga wa m'mbuyo, magwiritsidwe a ziwalo zomwe mukufuna) mukamayambitsa dongo amafunika odwala matenda ashuga a impso ndi hepatic pathologies. Ayenera kudziwa kuti ngati kuphwanya mlingo wa mankhwala ndi mankhwalawa, kugwiritsa ntchito zakumwa zoledzeretsa, zakudya zopatsa mphamvu, kutsitsa minofu, kupsinjika, ndikofunikira kusintha mtundu wa repaglinide, chifukwa zinthu ngati izi zingayambitse hypoglycemia.
Pazokhudzana ndi zovuta zoyipa, muyenera kusamala mukamayendetsa magalimoto ndi makina ovuta, oopsa, mukamagwira ntchito pamalo okwera, etc.
Pofuna kupewa hypoglycemia, anthu odwala matenda ashuga okhala ndi zofooka za am'mbuyomu, komanso omwe ali ndi vutoli sizachilendo, njira zowonjezera ziyenera kuchitidwa, kuwunika kuopsa komwe kungachitike komanso kuopsa kwake.
Repaglinide - analogues
Repaglinide imamasulidwa pansi pa mayina osiyanasiyana azamalonda: NovoNorm, Diclinid, Iglinid, Repodiab.
Malinga ndi code ya ATX ya level 4, antidiabetic agents ku Bayeta jakisoni wothandizirana ndi exenatide ndi Viktoza ndi yogwira pophika liraglitide ikugwirizana nawo.
Anthu ena omwe amadwala matenda ashuga amatenga matenda awo ngati kusamvetseka kwamatsoka, osazindikira kuti matenda opusitsawa angatumize kudziko lina nthawi ina iliyonse.
Repaglinide ndi othandizira kwambiri a hypoglycemic, kuyesa kudzipatsa mankhwala ndikusintha ndi koopsa kuumoyo, popeza mankhwalawa amachita mofulumira, mndandanda wazovuta kwambiri zotsutsana ndi zotsutsana. Ngati mwapezeka kuti muli ndi matenda a shuga, muyenera kumalandira chithandizo kwambiri, osanyanyala mpaka mtsogolo.
Pazithandizo zamankhwala zochizira matenda amtundu wa 2 zimapezeka pavidiyo.
