Acarbose ndi mankhwala otchuka pakati pa odwala matenda ashuga: amapatsidwa mankhwala a prediabetes, shuga a mitundu yonse iwiri, metabolic syndrome. Mankhwala osokoneza bongo, inhibitor imatha kugwira matenda osokoneza bongo omwe amayamba chifukwa cha hyperglycemia. Pali mankhwala ambiri okhala ndi mphamvu zofananira pamsika wa pharmacological, phindu la acarbose ndi lotani?
Ulendo wakumbiri
Kuyesera kuthana ndi “mliri wokoma” waumunthu kunapangidwa m'zaka zana zapitazi.
Zowona, malinga ndi ziwerengero, ndiye kuti palibe anthu ambiri odwala matenda ashuga. Matendawa adayamba kufalikira mwachangu pomwe mashelufu athu adayamba kupasuka kuchokera kuzinthu zoyipa, chifukwa Soviet GOSTs idathetsedwa, ndipo zatsopano sizinapangitse wopanga kuyesa paumoyo wathu.
Pomvetsetsa kuti vuto lalikulu la matenda a shuga mellitus (DM) ndikuphwanya kagayidwe kazakudya, asayansi adayesetsa kupanga mankhwala padziko lonse omwe amalepheretsa kugwiritsa ntchito zakudya zamagulu, zomwe zimapatsa munthu wamkulu theka la tsiku la zopatsa mphamvu.
Zachidziwikire, palibe amene wakwanitsa kukwaniritsa cholinga ichi ngakhale lero popanda chakudya chochepa-carb, koma kukondoweza kowonjezera kwamafuta ndi chakudya chamafuta sikungapweteke odwala matenda ashuga, makamaka popeza ochepa aiwo amatha kutsatira malingaliro a endocrinologist.
Mukawerengera zakudya zama tsiku ndi tsiku zopanda matenda ashuga:
- Monosaccharides (mu mawonekedwe a fructose ndi shuga) - 25 g;
- Disaccharides (sucrose) - 100g;
- Polysaccharides (monga wowuma) - 150g.
Mutha kumvetsetsa kuti kutsekereza shuga owonjezera kumaperekedwa bwino pa gawo loyambirira la metabolism, m'matumbo, kuchokera komwe adzatulukire momwe adalili kale.
Chifukwa chiyani chidwi chachikulu chimaperekedwa kwa wowuma? Gawo lachilengedwe la α-amylase lili ndi amylose ndi amylopectin, ndipo lingathe kuthyoledwa kuti litulutse matumba pogwiritsa ntchito malovu ndi kapamba, zomwe zimakhala ndi ma enzymes a α-amylase. Disaccharides imagwera mu glucose ndi fructose m'matumbo mothandizidwa ndi α-glucosidases. Ndi ma monosaccharides awa omwe amalowa m'magazi kuchokera m'matumbo.
Ndizachidziwikire kuti kuchepa kwa ntchito ya kapamba ndi matumbo kumachepetsa chidwi chokwanira cha kuchuluka kwa mafuta omwe amalowa mthupi ndi chakudya. Zoletsa za michere ya saccharolytic, yomwe imapezeka m'mazomera ena (mwachitsanzo, mu stevia), sizikumba mosavuta ndipo sizimapereka zotsatira zosayenera. Ma Analogs adapezeka mu buluwheat, rye, chimanga, nyemba ndi nandolo. Tsoka ilo, kuthekera kwawo kunali kosakwanira pakuwongolera magazi kwa magazi.
Ma gawo ochepa a Microbial adapezeka kuti ndi othandiza, omwe ma inhibitors omwe ali ndi mawonekedwe osiyanasiyana azotsatira adapezeka: mapuloteni, aminosaccharides, oligosaccharides, glycopolypeptides. Olisaccharide wolonjeza kwambiri anali Acarbosum, yemwe amapangidwa kuchokera ku tizilombo tating'onoting'ono timene timabzala. Poletsa glucosidases ang'onoang'ono am'matumbo, amachepetsa kusintha kwa wowuma kukhala glucose.
Zotulutsa zina zimapangidwa mwanjira ya ascarbose, koma sizikhala ndi mphamvu zambiri.
Kuthekera kwama pharmacological
Mankhwala ofanana ndi Ascarbose:
- Muchepetse kuyamwa kwa matumbo m'matumbo;
- Kuchepetsa postprandial (mutatha kudya, "prandial" - "nkhomaliro") glycemia;
- Pewani hypoglycemia;
- Musatulutse kuthekera kwa insulin kuchuluka.
Mukamadya zakudya zokhala ndi chakudya chamagulu ambiri, vuto la asogbose limadziwika kwambiri.
The inhibitor amathandiza kulimbana ndi kunenepa kwambiri, kutsika kudya ndi caloric kudya zakudya za tsiku ndi tsiku, komanso amachepetsa mawonekedwe a visceral mafuta.
Zowonjezera zamafuta, mafuta am'makolo ambiri amachepetsa kwambiri mphamvu ya acarbose, chifukwa mphamvu yake imakhala ndi kuphatikiza chakudya, m'malo mwa metabolidi ya lipid.
Acarbose pogwiritsa ntchito makina ochitapo kanthu akufanana ndi mphamvu ya CHIKWANGWANI, ulusi wopota womwe umapanga chipika, osafikika pakumbidwa ndi michere. Kusiyanako ndikuti mankhwalawo amalepheretsa mphamvu za ma enzyes omwe. Monga kusazindikira kwa maselo, chakudya cham'mimba chimakhala "chosatheka" kwa madzi a m'mimba ndikuchokera osasinthika, zomwe zikuwonjezera kuchuluka kwa fecal. Kuchokera pamenepa izi zimapangitsa kuti mphamvu ya inhibitor ikhoza kupitilizidwa ngati zinthu zopangidwa ndi ulusi wa coarse zimagwiritsidwa ntchito limodzi. Njira imeneyi imathandiza kwambiri kuchepetsa kunenepa.
Ngakhale chimalepheretsa katundu wake, inhibitor sikuti imaphwanya magwiridwe antchito am'mimba, chifukwa sizikhudza mwachindunji ntchito ya amylo-, proteino- ndi lipolytic ya timadziti tam'mimba.
Mphamvu ya mankhwalawa imadalira mlingo: ndi kuchuluka kwa chizolowezi, zizindikiro za hypoglycemic ndizambiri.
Anthu odwala matenda ashuga omwe atenga acarbose ndi zotumphukira zake awonetsa zotsatira zabwino pama paramu ena ofunika:
- Kutsika kwa triglycerol ndi cholesterol m'mwazi;
- Kuchepa kwa lipoprotein lipase ndende mu adipose zimakhala.
Ngati inhibitor itabayidwa mwachindunji m'mimba, imalepheretsa zochitika za α-glucosidases. Zakudya zomanga thupi zimapakidwa kwa nthawi yayitali kotero kuti gawo lina la iwo silingasinthidwe. Izi zimakhudzira zizindikiritso za glucometer m'njira zabwino kwambiri: ngakhale zimachuluka, sizofunikira kwenikweni popanda kutenga acarbose. Mwa kuchita kwake, titha kufananizidwa ndi Metformin wotchuka, yemwe amatsutsana ndi odwala matenda ashuga komanso kulephera kwa aimpso.
Ndikofunika kuti acarbose, ndi kuthekera kwake konse kukopa kagayidwe kazakudya, osasinthika magwiridwe antchito a kapamba. Zomwe zimakhala ndi shuga ndi insulin, zomwe zimapangidwa motsatira kusinthasintha kwa glycemic, zimachepetsedwa chimodzimodzi.
Acarbose imalembedwanso mtundu woyamba wa matenda ashuga, popeza kugwiritsidwa ntchito kwake kumachepetsa kuchuluka kwa insulin yokwanira theka.
Mankhwalawa amathandizira kuti glycemia ikhale yachilendo, koma zakudya zake zimayenera kusinthidwa, chifukwa kuchepa kwa chakudya m'thupi kumakhala koopsa ngati owonjezera.
Ngakhale muzochitika zapamwamba, ndi shuga wowola, pamene insulini imalipira shuga, pambuyo pa chithandizo chimodzi cha acarbose, odwala matenda ashuga adati kuchepa kwa glucosuria (kukhalapo kwa glucose mkodzo).
Zimawonjezera kulolerana kwa mankhwalawa ndi glucose, koma sikuti m'malo mwa 100% mankhwala oyamba ochizira matenda a shuga. Amawerengedwa kuti ndiwonjezeranso ngati mankhwala. Mwachitsanzo, acarbose idzakulitsa mphamvu ya sulfonylurea.
Mankhwalawa amasonyezedwanso kwa odwala omwe alibe matendawa omwe sangathe kulekerera insulin.
Ndikofunikira kuti mtundu wamtunduwu wa inhibitor ulibe carcinogenic, embryotoxic ndi mutagenic.
Mankhwalawa satenga pakatumbo, mabakiteriya ndi ma enzyme amathandizira kupanga mitundu 13 ya zinthu. Acarbose wosagwiritsidwa ntchito amasulidwa kudzera m'matumbo mu maola 96.
Kwa amene acarbose akuwonetsedwa ndikutsutsana
Anhibitor amalembera:
- Mtundu 2 shuga;
- Carbohydrate metabolism metabolism;
- Matenda a metabolism;
- Matenda a shuga;
- Kunenepa kwambiri;
- Kuperewera kwa shuga;
- Kuphwanya kosala kudya glycemia;
- Lactate ndi matenda ashuga;
- Mtundu woyamba wa shuga.
Kugwiritsa ntchito acarbose kumapangidwa mu:
- Matenda a chiwindi;
- Ketoacidosis;
Kutupa ndi zilonda zam'mimba thirakiti;- Zilcerative colitis;
- Kutsekeka kwamkati;
- Matenda ashuga nephropathy;
- Mimba, kuyamwa;
- Zaka za ana.
Kutupa ndi zilonda zam'mimba thirakiti;Mosamala, acarbose ndi zotumphukira zake zimayikidwa pambuyo povulala, munthawi ya matenda opatsirana, popeza thupi lofooka silikhala ndi mphamvu zokwanira kuti libwerenso. Ndi kuchepa kwa shuga kapena kutsekereza kwake, hypoglycemia kapena acetonemic syndrome ndizotheka.
Zotsatira zoyipa ndizotheka:
- Kusokonezeka kwa kayendedwe ka matumbo;
- Matenda a Dyspeptic;
- Kuchulukitsa kwa kuchuluka kwa transaminases;
- Kuchepetsa mu hematocrit;
- Kuchepetsa zomwe zimakhala ndi mavitamini ndi calcium m'magazi;
- Kutupa, kuyabwa, matupi awo sagwirizana.
Vuto la Stool, kupweteka kwam'mimba, komanso mavuto ena m'mimba ndi matumbo zimatha kuchitika chifukwa chakuti kuchepa kwakanthawi kwamakina amthupi kumapangitsa kuti ena a iwo azikundikirana mumatumbo ndipo amakhala motalika kuti alowe m'matumbo akulu. Zambiri zotsekemera zimayambitsa kukula kwa mabakiteriya omwe amayambitsa kupesa, bata, komanso zovuta zina za dyspeptic.
Zofananazo zimawonedwa pakupanga champagne, pamene mabakiteriya omwe amadalira mafuta ochulukitsa amachepetsa shuga ya mphesa, kusiya zotsatira za moyo wawo wobisika. Mwina, poganiza za chithunzichi, ambiri atasiya mowa.
Mphepo yamatumbo imatha kusakanikirana ndi metronidazole, yomwe adotolo amati imayenderana ndi acarbose. Yoyambitsa kaboni ndi ma ufesi ena amachepetsa matumbo am'mimba nawonso ali ndi vuto lofananalo.
Kuchepetsa mphamvu ya acarbose munthawi yomweyo:
- Zowonjezera;
- Corticosteroids;
- Estrogen;
- Mankhwala a mahomoni a chithokomiro;
- Njira zakulera za pakamwa;
- Otsutsa a calcium;
- Phenothiazines ndi mankhwala ena.
Acarbose - malangizo ntchito
Malinga ndi malangizo, mlingo umatsimikiziridwa malinga ndi kulemera kwa wodwalayo. Ngati, mwachitsanzo, munthu wamkulu wodwala matenda ashuga ali ndi kulemera kwa 60 makilogalamu, mlingo wa 25-50 mg ndi wokwanira kwa iye, ndi mawonekedwe akulu, 100 mg 3 r / tsiku limayikidwa. Mlingo wa inhibitor uyenera kuchuluka m'magawo, kuti thupi lizitha kusintha, ndipo ndizotheka kuzindikira zoyipa pakapita nthawi.
Imwani mankhwala musanadye kapena nthawi yomweyo. Amatsukidwa ndimadzimadzi aliwonse, ngati akakhala kuti alibe chakudya chamafuta, acarbose sangatenge.
Ngati thupi siligwirizana bwino ndi mlingo wosankhidwa, mutha kuwonjezereka mpaka 600 mg / tsiku. komanso kukwera kwambiri ngati thanzi limalola.
Inhibitor Analogs
Mndandanda wotchuka kwambiri wa acarbose ndi Glucobay. Hypoglycemic wothandizira amapangidwa ku Germany. Kutulutsa mawonekedwe - mapiritsi olemera 50-100 mg, phukusi lililonse lili ndi 30 mpaka 100 zidutswa.
Kuphatikiza pa mankhwala oyamba ku China ndi ku Europe, mutha kugula generic yokhala ndi dzina lodziwika bwino Glucobay, ku USA ndi England - Precose, ku Canada - Prandase. Kwa odwala matenda ashuga okhala ndi zakudya zakum'mawa, mankhwalawa ndi othandizika, ndipo amatchuka kwambiri ku China, ku USA - m'malo mwake, kugwiritsidwa ntchito kwake kumakhala kochepa chifukwa cha kutsegula m'mimba komanso kuphwanya thupi.
Ndemanga za acarbose
Za mankhwala omwe ali ndi acarbose Glucobay, ndemanga yochepetsera thupi ndi yam'magulu. Mankhwalawa sanapangidwe kuti achepetse thupi, amathandizira odwala matenda ashuga, nthawi zambiri amtundu wa 2.
Popeza ambiri aife timalandira mphamvu zamafuta owonjezera, mankhwala ovomerezeka amathandizadi odwala matenda ashuga komanso iwo omwe amachepetsa thupi kudya ndipo samakhala ndi zotsatirapo zoyipa monga ma analogues, chifukwa amatha kuthandizidwa pamaso pa chidutswa cha keke kapena mayeso ena.
