Sibutramine - malangizo, ntchito, malingaliro, madokotala komanso kuchepetsa thupi

World Health Organisation yati vuto la kunenepa kwambiri ndi mliri wa zaka za zana la 21. Mwa anthu 7 biliyoni padziko lapansi, miliyoni 1,700 ndi onenepa kwambiri ndipo 500 miliyoni ndi onenepa. Malinga ndi kulosera kukhumudwitsa, pofika chaka cha 2025 kuchuluka kwa anthu onenepa kwambiri kudzapitilira 1 biliyoni! Ku Russia, amuna 46,5% ndi azimayi 51% ndi onenepa kwambiri, ndipo ziwerengerozi zikuchulukirachulukira.

Malinga ndimalingaliro azachipatala, kunenepa kwambiri kumawerengedwa kuti ndikochuluka kwa thupi ndi 30% kapena kuposa. Kulemera kwakukulu chifukwa cha mafuta, kotupa makamaka m'mimba ndi ntchafu.

Kuphatikiza pa kusokonezeka kwakuthupi ndi kwamaganizidwe, vuto lalikulu la kunenepa kwambiri ndi zovuta: kuchepa kwamatenda am'mimba, matenda a musculoskeletal system, matenda oopsa, matenda oopsa, komanso matenda a shuga 2.

Kulinganiza kulemera m'malo oterowo mothandizidwa ndi zakudya zolimbitsa thupi komanso zamafashoni sikungatheke kwa aliyense, ambiri amatengera thandizo la mankhwala. Mfundo yodziwitsa ena za mankhwalawa ndi yosiyana: ena amachepetsa kudya, ena amaletsa kuyamwa kwa mafuta ndi mafuta, ndipo ena amakhala ndi vuto lotayirira lomwe silimalola kuti chakudya chizikhala chokwanira.

Mwa zina mwa mankhwalawa ndi Sibutramine (mu mankhwala achi Latin - Sibutramine).

Ntchito yoletsa kukonzanso, yomwe idapangidwa kumapeto kwa zaka zana lapitayo ndi kampani yaku America ya Abbott Laboratories, sikuti adakwaniritsa zomwe amayembekeza, koma adatsimikizira kuti ndiwopatsa mphamvu. Kuchepetsa thupi kunali kwakukulu kwambiri kotero kuti adayamba kusankha odwala omwe ali ndi kunenepa kwambiri, osalamulira kudya kwawo.

Chifukwa chiyani Sibutramine Ndi Oletsedwa

Mwa mafani a zovuta zonse kuthetsa piritsi yodabwitsa, mankhwalawa adadziwika padziko lonse lapansi. Mankhwala omwe amathandizira kagayidwe kazakudya ndipo amachepetsa chilakolako chosagwirizana, WHO inaneneratu za tsogolo labwino.

Kuphatikiza apo, Sibutramine adayambitsa kudalira kokhudzana ndi mankhwala (zotsatira za ecstasy kapena amphetamine). Odwala okalamba anali ovuta kwambiri kulolera chithandizo. Asanaphunzire zowonjezera, mankhwalawo anali oletsedwa ku USA, Canada, Australia, Europe, Ukraine. Patsamba lapa mankhwala, litha kugulidwa ndi mankhwala.

Anorectic imalembedwa chifukwa cha kunenepa kwambiri kwa digiri ya II-III, pomwe BMI imaposa 30-35 kg / m 2 ndi njira zina zochizira sizothandiza. Mtundu wa achire umaphatikizapo zakudya zapadera, komanso masewera olimbitsa thupi okwanira.

Adasankhidwa kwa onse ochita naye koma popanda iye. Koma posakhalitsa madotolo adayamba kuwomba alamu chifukwa cha zotsatira zoyipa: odwala anali ndi mavuto amisala, chiwopsezo cha mtima, kudzipha.

Mankhwala amasonyezedwanso mtundu wachiwiri wa matenda ashuga, hyper- hyperproteinemia. Zikatero, cholembera chachikulu cha thupi chizikhala chachikulu kuposa 27kg / m². Chithandizo chokwanira, kuphatikiza Sibutramine ndi mawonekedwe ake, chikuchitika moyang'aniridwa ndi achipatala.

Gawo lofunikira pamaphunziroli ndikulimbikitsa kwa wodwalayo kusintha momwe amakhalira ndi kadyedwe ndikusungabe zotsatira zake mukalandira chithandizo. Chifukwa chomwe Sibutramine amaletsedwa m'maiko otukuka, onani kanemayo mu lipoti la TV:

Pharmacodynamics anorectic

M'mutu, maumboni osiyanasiyana a ubongo ndi omwe amachititsa kuti anthu azimva bwino. Kulumikizana pakati pawo kumachitika chifukwa cha zochitika za ma neurons, zomwe zimapangitsa kuti anthu azikhala ndi chidwi chofuna kudya.

Chakudya chikalowa m'mimba, mitsempha ya mitsempha imasangalatsa ubongo. Koma kumverera kwa njala sikutanthauza kuti mukhale ndi thupi: nthawi zina mumafuna kukhala ndi kuluma kuti muchepetse kusamvana, kupumula, ndikusangalala ndi njirayi.

Sibutramine imagwirizanitsa dongosolo lonse, imagwira ma neurons. Maselo amalumikizidwa pogwiritsa ntchito ma synapses - mankhwala omwe amayendetsa chizindikirocho ngati kulumikizana mu zingwe. Chochita chilichonse cha neuron chimayendetsedwa ndi kutulutsidwa kwa ma neurotransmitter - pawiri yogwira zomwe zimalumikizana ndi ma cell a ma neurons otsala. Chifukwa chake zisonyezo zimadutsa pamatcheni awo. Zambiri zokhudzana ndi njala kapena kukhuta zimafotokozedwanso m'njira iyi.

Mlingowo umathandizira kuyang'anira serotonin: ngati kuchuluka kwake kumatsikira, munthu amamva njala. Mukamadya, neurotransmitter imapangidwa, kuchuluka kwake kumafikira malire, thupi limakumana ndi kukodzedwa.

Mankhwala amathandizira kumverera motere mwa kukhala ndi mulingo woyenera wa serotonin mu mnofu wofanana. Chifukwa cha izi, wodwalayo amakhala ndi zizolowezi zabwino za kudya, zovuta za usiku zimatha, ndipo kuchuluka kwa chakudya komwe kumachepetsedwa.

Anorectic imalepheretsa kubwezeretsanso kwa norepinephrine, yomwe imapangidwa mu dongosolo lamanjenje lamkati, komwe limagwira gawo limodzi monga neurotransmitter. Kuwonjezeka kwazinthu zake m'magawo a synoptic kumabweretsa mphamvu zambiri. Chimodzi mwa zinthu za chinthu ichi ndi kutsegula kwa thermogenesis, yomwe imatulutsa mphamvu ku chiwindi, adipose ndi minofu minofu. Izi zimathandiza kuchepetsa mafuta m'thupi komanso kusintha matenda a lipid.

Mothandizidwa ndi kapangidwe kazakudya ka Sibutraminum, kusintha kwa chikhalidwe cha kudya, Thermogenis imakulirakulira. Mafuta osungidwa amawotchedwa, ndipo kudya calorie sikulola kuti zibwezeretsedwe. Thermogenesis yowonjezera imayendetsa ma b-adrenergic receptors omwe amawongolera kupanga mphamvu. Kutsika kwamasewera olimbitsa thupi kumayenderana ndi kuletsa kubwezeretsanso kwa norepinephrine ndi serotonin.

Kutengera Mlingo, zotsatira zoyipa nthawi zambiri zimawonetsa kusinthasintha kwakuchuluka kwa magazi ndi tachycardia. Mutha kuwona kuthekera kwa Sibutramine ndi magwiritsidwe ake pa kanema:

Pharmacokinetics a Sibutramine

Mpaka 80% ya mankhwala amkamwa amayamba msanga m'matumbo. Mu chiwindi, imasinthidwa kukhala metabolites - monodemethyl- ndi didemethylsibutramine. Chiwonetsero cha peak cha chida chachikulu chogwira ntchito chinajambulidwa pambuyo pa mphindi 72 kuyambira nthawi yomwe piritsi likugwiritsa ntchito 0,015 g, metabolites imakhazikika maola 4 otsatira.

Ngati mutenga kapisozi panthawi yachakudya, mphamvu zake zimatsika ndi wachitatu, ndipo nthawi yoti mufikire zotsatira zabwino imakulitsidwa ndi maola atatu (kuchuluka kwathunthu ndikugawa sikusasinthe). Kufikira 90% ya sibutramine ndipo ma metabolites ake amamangiriza seramu albin ndipo amagawidwa mwachangu mu minofu ya minofu.

Zomwe zimapangidwira m'magazi zimafikika pakapita maola 96 kuchokera nthawi yogwiritsira ntchito piritsi loyambalo ndipo ndiwonjeza kutalika kawiri kuposa ndende pambuyo pa kumwa koyamba kwa mankhwala.

Sibutramine pa nthawi yoyembekezera

Mankhwalawa anaphunziridwa mu nyama zapakati. Mankhwalawa sanakhudze kubereka, koma poyesa akalulu panali mphamvu ya teratogenic ya mankhwala pa mwana wosabadwayo. Zochitika zokomera zinaonedwa pakusintha maonekedwe ndi kapangidwe ka mafupa.

Zofananira zonse za Sibutramine zimathetsedwa ngakhale pa gawo lokonzekera kubereka. Ndi kuyamwitsa, mankhwalawa amadziwikanso.

Nthawi yonse ya mankhwalawa ndi Sibutramine ndi masiku 45 atatha, amayi omwe ali ndi zaka zobereka ayenera kugwiritsa ntchito njira zotsimikiziridwa. Musanaganize kuti muchepetse kunenepa ndi mankhwalawo, muyenera kuganizira zakonzekera mimba yanu yotsatira.

Mankhwalawa ndi teratogenic, ndipo ngakhale kuthekera kwake kuyambitsa masinthidwe sanakhazikitsidwe, mankhwalawo alibe umboni wokwanira, ndipo mndandanda wazotsutsana udzathandizidwa.

Mndandanda wa zotsutsana ndi Sibutramine

Kwa anorectics, pali, choyambirira, mawonekedwe azaka: mankhwalawa saikidwa kwa ana ndi akulu (pambuyo pa zaka 65). Pali zotsutsana zina za Sibutramine:

• Kunenepa kwambiri, komwe kumayambitsa ma pathologies a endocrine system ndi chapakati chamanjenje, komanso mfundo zina zachikhalidwe;
• Mavuto akudya - kuchokera ku anorexia kupita ku bulimia (onse pamaso ndi anamnesis);
  kusokonezeka kwa malingaliro;
• Kusokonezeka kwa kayendedwe ka magazi a ubongo (komwe kulipo kapena m'mbiri);
• Goiter wa chikhalidwe chakupha;
• Pheochromocytoma;
• IHD, amasintha pamlingo wamatumbo amtima komanso kusakhazikika kwake pamlingo wovunda;
• Glucose-galactose malabsorption, hypolactasia;
• Kuwonongeka kwa magazi ku ziwiya zotumphukira;
• Kutsika kosagwirizana ndi kuthamanga kwa magazi kuchokera ku 145 mm Hg. Art. ndi mmwamba;
• Kuwonda kwambiri kwa chiwindi ndi impso;
• Prostate adenoma ndi mkodzo kukodza;
• Kuledzera;
• Glaucoma wotseka;
• Kumvera pazomwe zili mwanjira iliyonse.

Kuwonetsetsa makamaka poika Sibutramine kuyenera kuperekedwa kwa odwala matenda oopsa, odwala omwe ali ndi vuto la kuthamanga kwa magazi, zodandaula za kupweteka, mbiri yokhala ndi kuperewera kwa magazi, khunyu, chiwindi kapena matenda a impso, glaucoma, cholecystitis, hemorrhage, tics, komanso odwala omwe akumwa mankhwala omwe amakhudza omwe akukhudzidwa ndi mankhwala. magazi coagulability.

Zotsatira zoyipa

Sibutramine ndi mankhwala oopsa, ndipo monga mankhwala ena alionse ovuta komanso zotsatira zoyipa, sizowopsa kuti m'Mayiko ambiri mankhwala ake ovomerezeka amaletsa. Zosavuta ndizomwe zimachitikira. Osati kudana ndi anaphylactic, inde, koma zotupa za pakhungu ndizotheka. Kuthamanga pakokha kumachitika pamene mankhwalawo amachotsedwa kapena atatha kusintha.

Zotsatira zoyipa kwambiri ndizo kusuta. Zakumwa zoledzeretsa zaka 1-2, koma ambiri satha kusiya, kulimbitsa kudalira kwa mankhwala, ofanana ndi mankhwala osokoneza bongo. Kuchuluka kwakuthupi kanu komwe kumakhudzidwa ndi Sibutramine, ndizosatheka kudziwa pasadakhale.

Zotsatira zodalirika zitha kuonedwa kale m'mwezi wa 3 wogwiritsidwa ntchito nthawi zonse.

Kuletsa kuyamwa pang'onopang'ono. Mkhalidwe wofanana ndi "kuphwanya" ndi migraine, kulumikizana bwino, kugona pang'ono, kuda nkhawa nthawi zonse, kusakwiya, kusinthana ndi malingaliro opanda chidwi komanso malingaliro ofuna kudzipha.

Mankhwalawa amasokoneza ntchito ya "zopatulikitsa" - ubongo wamunthu komanso zamanjenje. Sizotheka nthawi zonse kukhudza ubongo ndi ubongo wamkati popanda zotsatira za psyche. Kuyesera koyamba kuchipatala kunatha ndikudalira kwambiri, kudzipha, kusokonezeka m'maganizo, kufa ndi mtima ndi ubongo.

Mankhwala amakono amatsukidwa kwambiri, mlingo wake umachepetsedwa, koma zotsatira zosayembekezereka siziperekedwa. Ponena ndi kutenga nawo mbali pamagalimoto ndi kasamalidwe ka zinthu zovuta, kugwira ntchito motalika, m'njira zina zilizonse zomwe zimafuna kuchitapo kanthu mwachangu ndi chidwi chowonjezereka, sikuloledwa pa chithandizo ndi Sibutramine.

Ku Sibutramine, malangizo ogwiritsira ntchito akutsimikizira kuti zizindikilo zambiri (tachycardia, hyperemia, matenda oopsa, kusowa kwa kudya, kusintha kwa kakomedwe, kusokonezeka kwa mtundu wa defecation, hemorrhoids, dyspeptic vuto, thukuta, nkhawa, ndi isomnia) zimatha pambuyo posiya mankhwala.

Kafukufuku wa Sibutramine ku Europe - lingaliro la akatswiri

Kafukufuku wa SCOUT, woyambitsidwa ndi oyang'anira oyenerera a EU atapenda maumboni omvetsa chisoni azachipatala, adakhudzapo odzipereka omwe ali ndi index yayikulu ya thupi komanso chiopsezo chokhala ndi mtima wamitsempha yamagazi.

Zochitika zina zoyipa zimaphatikizira ziwopsezo zosiyanasiyana zakusiyana, kuwonongeka kwa kapangidwe ka magazi (kuchepa kwa ziwalo zam'magazi), kuwonongeka kwa autoimmune m'mitsempha ya mtima, komanso kuvulala kwamisala.

Mchitidwe wamanjenje unapereka zomwe zimachitika mu mawonekedwe a minofu yamasamba, kulephera kukumbukira. Ena mwa ophunzirawo anali ndi zowawa m'makutu, kumbuyo, mutu, komanso masomphenya komanso kumva. Matenda am'mimba nawonso adawonedwa. Pamapeto pa lipotilo, zidadziwika kuti kusiya mankhwala kumatha kuyambitsa mutu komanso kusadandaula.

Werengani zambiri za momwe Sibutramine amawotcha mafuta ndikuwongolera kusinthasintha - mu kanema

Momwe mungagwiritsire ntchito anorectics

Piritsi imatengedwa kamodzi. Zakudya zambiri sizikhudza zotsatira zake. Kumayambiriro kwa maphunzirowa, ndikulimbikitsidwa kumwa kapisozi imodzi yolemera 0,01 g. Amamezedwa yonse ndikutsukidwa ndi madzi.

Ngati m'mwezi woyamba kulemera kwapita mkati mwa 2 kg ndipo mankhwalawo amalekeredwa pafupipafupi, mutha kuwonjezera kuchuluka kwa 0, 015 g Ngati m'mwezi wotsatira kuchepa kwa thupi kumalembedwa ndi zosakwana 2 kg, mankhwalawo amathetsedwa, popeza ndizowopsa kusintha mankhwalawa mopitilira apo.

Lowetsani chithandizo cha zochitika zotsatirazi:

1. Ngati ochepera 5% a misa yoyambirira amataika m'miyezi itatu;
2. Ngati njira yochepetsera thupi yaima pazowonetsa mpaka 5% ya misa yoyamba;
3. Wodwalayo adayambanso kulemera (atachepetsa thupi).

Gwiritsani ntchito mankhwala osavomerezeka osaposa zaka ziwiri.

Kuti mumve zambiri za Sibutramine, onani maphunziro pa kanema:

Bongo

Kulephera kutsatira malingaliro, kuwonjezereka Mlingo kumawonjezera chiopsezo cha bongo. Zotsatira za zotere sizinaphunziridwe mokwanira, kotero, mankhwalawa sanapangidwe. Monga gawo la chisamaliro chodzidzimutsa chotere, m'mimba mumatsukidwa wovulalayo, amapatsidwa ma enterosorbents ngati osapitirira ola limodzi atatenga Sibutramine.

Onani kusintha kwamunthu amene akuzunzidwa masana. Ngati zizindikiro za zoyipa zikuwonetsedwa, chithandizo chamankhwala chimachitika. Nthawi zambiri, kuthamanga kwa magazi komanso kuthamanga kwa mtima kumawonedwa. Zizindikiro zoterezi zimayima ndi β-blockers.

Zosankha zomwe zimachitika ndi Sibutramine ndi mankhwala ena

Sitikulimbikitsidwa kugwiritsa ntchito anorectic:

• Ndi mankhwala ochizira matenda amisala kapena kunenepa kwambiri kwam'mimba, omwe ali ndi vuto lalikulu;
• Ndi mankhwala omwe amalepheretsa mwayi wa monoamine oxidase (pakati pa kugwiritsa ntchito Sibutramine ndi kugwiritsa ntchito ma inhibitors, nthawi yopitilira masiku 14 iyenera kusamalidwa);
• Ndi mankhwala omwe amalimbikitsa kupanga kwa serotonin ndi kuletsa kuyambiranso;
• Ndi mankhwala omwe amathandizira microsomal hepatic michere;
• Ndi mankhwala omwe amakhumudwitsa tachycardia, amatsika m'magazi, kukondoweza kwa mtima wamanjenje.

Sibutramine sigwirizana ndi mowa. Mapiritsi ozikidwa ndi pulogalamu ya chakudya samasintha ma pharmacodynamics a njira zakulera zamlomo.

Migwirizidwe yogula ndi kusungidwa

Ngakhale kuti m'maiko ambiri Sibutramin ndi yoletsedwa mu chipatala chovomerezeka, Intaneti ndi yodzaza ndi zinthu zotere. Chifukwa chake mutha kugula ma anorectics popanda mankhwala. Zowona, zotsatirapo pankhaniyi ziyenera kusamaliridwa payekha. Kwa Sibutramin, mtengo (pafupifupi ma ruble 2,000) ulinso wa aliyense.

Malamulo osungira mankhwalawa ndi muyezo: kutentha kwa chipinda (mpaka 25 ° C), kayendetsedwe ka moyo wa alumali (mpaka zaka 3, malinga ndi malangizo) ndi kupezeka kwa ana. Mapiritsi amasungidwa bwino kwambiri mmatumba oyambira.

Sibutramine - analogues

Umboni waukulu kwambiri (koma osati wotsika mtengo) uli ndi Xenical - mankhwala omwe ali ndi mankhwala ofanana, omwe amagwiritsidwa ntchito mu kunenepa kwambiri kwa ana. Pamaintaneti ogulitsa pamakhala mawu ofanana a Orlistat. Gawo lolimbikira limaletsa kuyamwa kwa mafuta ndi makoma am'mimba ndikuwachotsa mwachilengedwe. Mphamvu yokhazikika (20% yapamwamba) imawonetsedwa pokhapokha pakudya.

Kusiyana pakati pa Sibutramine ndi Xenical ndikuthekera kwama pharmacological: ngati wakaleyo amachepetsa chilimbikitso pochita ubongo ndi malo amitsempha, omaliza amachotsa mafuta, kumangirira kwa iwo ndikukakamiza thupi kuti lizigwiritsa ntchito mafuta ake mokwanira kulipirira ndalama zowonjezera mphamvu. Kudzera mkati mwa dongosolo lamanjenje lapakati, Sibutramine imagwira ziwalo zonse za machitidwe, Xenical simalowa mthupi, ndipo sizimakhudza ziwalo ndi machitidwe.

Fenfluramine ndi analogue ya serotonergic kuchokera pagulu la amphetamine. Ili ndi makina ofanana ndi Sibutramine ndipo ndi oletsedwa pamsika ngati zinthu zosokoneza bongo.

Fluoxetine, antidepressant omwe amapanikiza serotonin kubwezeretsanso, ali ndi mphamvu yowonjezera anorectic.

Mndandandawu ukhoza kuphatikizidwa, koma mankhwala onse a anorexigenic, ngati oyambirirawo, ali ndi zovuta zambiri ndipo amatha kuvulaza thanzi. Zoyambirira sizikhala ndi ma analogi okhathamira, magwiritsidwe azomwe amapanga omwe amapanga India ndi ochulukirapo kapena osadziwika - Slimia, Gold Line, Redus. Palibe chifukwa choyankhulira zothandizira odwala ku China - mphaka 100% mchikwama.

Kuwala kwa Reduxin - zakudya zowonjezera zochokera ku oxytriptan, zomwe sizigwirizana ndi sibutramine, zimakhala ndi mphamvu yosintha, ndipo zimalepheretsa chilakolako chofuna kudya. Kodi pali ma fanizo otsika mtengo a Sibutramine? Zakudya zopezekera za Listata ndi Gold Line Light zili ndi mawonekedwe osiyana, koma kapangidwe kake kamafanana ndi Sibutramine yoyambirira. Chinyengo chotsatsira chotere sichikhudza mtundu wa zowonjezera.

Maganizo a kuchepa thupi komanso madokotala

Ndemanga zina zikudetsa nkhawa za Sibutramine, ozunzidwawa komanso abale awo akuwopsezedwa ndi zotsatira zoyipa zomwe akufuna, akufuna kuti asiye mankhwala. Koma omwe adapulumuka nthawi yosinthira ndipo sanasiye maphunziro, zikuwonetsa kupita patsogolo.

About Sibutramine, kuwunika kwa madokotala kumalepheretsa: madokotala samakana kugwira ntchito kwakukulu kwa Sibutramine, amatikumbutsa kutsatira kwambiri malangizo komanso kuwunika pafupipafupi kuti muchepetse kunenepa. Amachenjeza za kuopsa kodzipangira nokha mankhwala, popeza mankhwalawa ndi akulu kwambiri ndipo palibe otetezeka pazotsatira zoyipa.

Malinga ndi ziwerengero, osachepera chimodzi mwa zosasangalatsa zomwe amakumana ndi 50% ya omwe amachepetsa thupi ndi Sibutramine. Sizodziwika kuti mankhwalawa aletsedwa m'maiko ambiri otukuka, ndipo Russia ikuphatikizidwanso m'ndandanda wazomwe zingagwiritsidwe ntchito.

Kufunsidwa kwa katswiri pamagwiritsidwe ntchito a Sibutramine ndikudziwongolera komwe mukumvera - mu kanema: