Mitundu yambiri ya mankhwala omwe amagwiritsidwa ntchito mu shuga sikuti amangokhala ndi insulin kwa nthawi yayitali.
Pharmacology lero imapereka zida zambiri zothandizira kutsitsa shuga mu mtundu 2 wa matenda ashuga. Gawo lalikulu la iwo amapangidwa mwakapangidwe, monga Pioglitazone (Pioglitazone).
Kuphatikizika, mawonekedwe omasulidwa
Mankhwalawa amapitilizidwa kugulitsidwa m'makatoni a 3 kapena 10, okhala ndi mapiritsi khumi ndi awiri ozungulira. Gawo logwira ntchito litha kukhala nawo mmagawo 15, 30 kapena 45 mg.
Zomwe zimakhazikitsidwa ndi mankhwalawa ndi pioglitazone hydrochloride, yomwe imachepetsa kukhudzika kwa chiwindi ndi minyewa yake kuchitapo kanthu cha mahomoni, chifukwa chomwe kuphatikiza kwa glucose kumachuluka, ndipo kapangidwe kake ka chiwindi kamachepa.
Kuphatikiza pa piritsi yayikulu, ilinso ndi zina zowonjezera:
- lactose monohydrate;
- magnesium wakuba;
- hydroxypropyl cellulose;
- calcium carboxymethyl cellulose.
Zotsatira za pharmacological
Pioglitazone amatanthauza othandizira pakamwa a hypoglycemic malinga ndi thiazolidindine. Thupi limaphatikizidwa ndikuwongolera kwa glucose wamagazi ndi metabolidi ya lipid. Kuchepetsa kukana kwa thupi ndi ziwindi zimakhala ku insulin, kumapangitsa kuti chiwonetsero cha kuchuluka kwa glucose chimadalira insulin komanso kuchepetsedwa kwa mpweya wake kuchokera ku chiwindi.
Komabe, satiwonetsa zowonjezera za ma β-cell a kapamba, omwe amawapulumutsa kuti asakalambe msanga. Zotsatira za mankhwala amtundu wa 2 shuga zimayambitsa kutsika kwa magazi ndi glucose wa glycosylated hemoglobin. Chochita chitha kugwiritsidwa ntchito chokha kapena kuphatikiza ndimankhwala ena ochepetsa shuga.
Kugwiritsa ntchito mankhwalawa kumathandizira kuti metabolidi ya metabolid ikhale yachilendo, zomwe zimapangitsa kutsika kwa TG komanso kuchuluka kwa HDL popanda kukhudza cholesterol ndi LDL yonse.
Pharmacokinetics
Kuthira kwa mankhwalawa kumachitika m'matumbo am'mimba, njirayi imachitika mwachangu, ndikukulolani kuti mupeze chinthu chogwira ntchito m'magazi theka la ola mutatha kumwa mankhwalawo. Patatha maola awiri, mulingo wake ukuposa 80 peresenti. Kulandila ndi chakudya kumachedwetsa kuyamwa.
Mphamvu ya mankhwalawa imawonekera kale sabata yoyamba ya kudya pafupipafupi. Kudzikundikira kwa zigawo zikuluzikulu za mankhwala mthupi sikumachitika, pambuyo pa tsiku kumachotsedwa kwathunthu kudzera m'mimba ndi impso.
Zizindikiro ndi contraindication
Pioglitazone imavomerezeka ngati njira yolamulira matenda a shuga a 2. Itha kugwiritsidwa ntchito ngati mankhwala amodzi, chifukwa nthawi zambiri imalembedwa kwa odwala matenda ashuga kapena omwe Metformin adatsutsana.
Kwambiri, mankhwalawa amagwiritsidwa ntchito ngati zovuta pazochita zotsatirazi:
- kuphatikiza kawiri ndi mankhwala a metformin kapena sulfonylurea;
- kuphatikiza katatu ndi magulu onse awiri a mankhwalawa
Monga contraindations ndi:
- kumva kwambiri mbali iliyonse ya mankhwala;
- mbiri yakale ya mtima;
- kukanika kwambiri kwa chiwindi;
- mtundu 1 matenda a shuga;
- matenda ashuga ketoacidosis;
- kukhalapo kwa khansa;
- kukhalapo kwa macroscopic hematuria ochokera kosatsimikizika.
Milandu imeneyi, mankhwalawa amasinthidwa ndi ma analogi omwe ali ndi mawonekedwe osiyana ndi kapangidwe kake.
Malangizo ogwiritsira ntchito
Mlingo wa mankhwalawa umaperekedwa kwa wodwala aliyense payekhapayekha. Ili ndiye ntchito ya dotolo, yemwe, atazindikira, awunika kuwonongeka kwa wodwalayo ndikupanga njira yothandizira.
Malinga ndi malangizo, mankhwalawa amatengedwa kamodzi patsiku, pakamwa. Komabe, ndikofunikira kuchita izi m'mawa.
Mlingo woyambirira umalimbikitsidwa mu 15-30 mg, umatha kukula mpaka 45 mg pogogoda, uku ndiye muyeso wokwanira.
Pankhani ya kuphatikiza mankhwalawa ndi mankhwala ena a hypoglycemic, mulingo wofika 30 mg patsiku umayikidwa, koma umatha kusintha malinga ndi kuwerenga kwa glucometer ndi momwe wodwalayo alili.
Ndikofunikira kwambiri kusankha mlingo woyenera mukamamwa ndi insulin. Monga lamulo, limayikidwa pa 30 mg patsiku, pomwe kuchuluka kwa insulin kumachepetsedwa.
Kuchita bwino kwa mankhwalawa kumayendera miyezi itatu iliyonse ndikusanthula kwa hemoglobin wa glycated. Ngati palibe zotsatira, phwando limayimitsidwa.
Odwala Apadera ndi Mayendedwe
Kwa okalamba, palibe njira zapadera za kuchuluka. Zimayambanso pang'onopang'ono, pang'onopang'ono zimachulukirachulukira.
Pa nthawi yoyembekezera, mankhwalawa saloledwa kugwiritsidwa ntchito, momwe zimakhalira ndi mwana wosabadwayo samamvetsetsa bwino, chifukwa chake zimakhala zovuta kulosera zotsatira zake. Pa nthawi yobereka, ngati mayi akufunika kugwiritsa ntchito mankhwalawa, ayenera kukana kudyetsa mwana.
Odwala omwe ali ndi matenda amtima komanso minyewa amagwiritsa ntchito mlingo wochepa, pomwe pakufunika kuwunika momwe vutoli likuyendetsedwera ndi pioglitazone.
Kutenga Pioglitazone kuonjezera mwayi wokhala ndi khansa ya chikhodzodzo ndi 0,06 peresenti, pomwe adotolo ayenera kuchenjeza wodwalayo ndikuwonetsa kuti achepetse zina zomwe zingayambitse chiopsezo.
Kwa odwala omwe ali ndi vuto la chiwindi chachikulu, mankhwalawa amakwiririka, komanso mwamphamvu, kugwiritsa ntchito mosamala ndikotheka. Pankhaniyi, ndikofunikira kuwongolera kuchuluka kwa ma enzymes a chiwindi, ngati apitilira zomwe zimachitika katatu, mankhwalawo amathetsedwa.
Kanema wokhudzana ndi zovuta za mankhwala osokoneza bongo omwe ali ndi matenda osokoneza bongo:
Zotsatira zoyipa ndi bongo
Zotsatira zoyipa zoyambitsa kumwa ndi hypoglycemia, koma nthawi zambiri zimachitika ndi mankhwala osokoneza bongo kapena osayenera ndi ena othandizira ena a hypoglycemic. Ndikothekanso kutsitsa hemoglobin ndi kuchepa kwa magazi.
Mankhwala osokoneza bongo amawonetsedwa mu:
- kutupa, kulemera;
- Hypersthesia ndi mutu;
- kuphwanya mgwirizano;
- glucosuria, protenuria;
- vertigo;
- kuchepa kwa kugona;
- kukanika kwa erectile;
- kuwonongeka kwa matenda a kupuma;
- mapangidwe zotupa zosiyanasiyana zachilengedwe;
- defecation matenda;
- chiopsezo chowonjezereka cha kuwonongeka ndi maonekedwe a ululu m'miyendo.
Kuchita ndi mankhwala ena
Kugwiritsa ntchito pioglitazone kumatha kuchepetsa magwiridwe antchito oletsa kubereka.
Chogwiritsidwacho sichisintha ntchito yake ikagwiritsidwa ntchito limodzi ndi Digoxin, Metformin, Warfarin Ifenprokumon. Nthawi yomweyo, mawonekedwe awo sasintha. Kugwiritsa ntchito nthawi imodzimodzi kwa sulfonylureas ndi zotumphukira sikusinthanso mphamvu zawo.
Zotsatira za Pioglitazone pa calcium blockers, cyclosporins, ndi HMCA-CoA reductase inhibitors sizinadziwikebe.
Mukagwiritsidwa ntchito limodzi ndi gemfibrozil, AUC ya glitazone imakulanso, kukulitsa ubale wa nthawi yolimbikitsidwa ndi zifukwa zitatu. Pankhaniyi, ndikofunikira kuwunika wodwalayo ndipo ngati kuli kotheka, musinthe mankhwalawa.
Kugwiritsa ntchito limodzi ndi rifampicin kumapangitsa kuti pioglitazone achuluke.
Kukonzekera kofananako
Ma analogi a pioglitazone amaperekedwa pamsika ndi zinthu zambiri.
Zida zomwe zili ndi mawonekedwe ofanana ndizophatikiza:
- Indian mankhwala Pioglar;
- Zofanizira zaku Russia za Diaglitazone, Astrozone, Diab-Norm;
- Mapale a ku Ireland a Actos;
- Ku Croatia kuthana ndi Amalvia;
- Pyoglitis;
- Piouno ndi ena.
Mankhwalawa onse ali m'gulu lokonzekera glitazone, yomwe imaphatikizanso troglitazone ndi rosiglitazone, omwe ali ndi magwiritsidwe ofanana, koma osiyana mu kapangidwe ka mankhwala, kotero amatha kugwiritsidwa ntchito pamene pioglitazone ikakanidwa ndi thupi. Alinso ndi zabwino ndi zovuta zawo, zomwe zimapezeka mu malangizo a mankhwala.
Komanso ma analogu okhala ndi maziko omwe alipo omwe atha kukhala ngati ma analogues: Glucofage, Siofor, Bagomet, NovoFormin.
Ndizofunikira kudziwa kuti kuwunika kwa odwala omwe adagwiritsa ntchito Pioglitazone ndi ma genetic ake ndizosiyana. Chifukwa chake, poyerekeza ndi mankhwalawo pakokha, odwala amayankha bwino, kulandira zolakwika zochepa.
Kulandila kwa analogues nthawi zambiri kumayendetsedwa ndi zovuta, monga kulemera, edema, ndi kuchepa kwa hemoglobin.
Monga momwe masewera amasonyezera, mankhwalawa amathandizadi kutsika kwa shuga komanso amatha kugwiritsidwa ntchito moyenera pakukonzekera matenda a shuga a 2. Komabe, ndikofunikira kusankha mankhwala ndi mlingo woyenera.
Mitengo yeniyeni
Popeza chida chimatha kupangidwa pansi pa mayina osiyanasiyana, kutengera wopanga, mtengo wake umasiyanasiyana. Gulani Pioglitazone mu pharmacies zoweta mu mawonekedwe ake oyera ndizovuta, imayendetsedwa ngati mankhwala omwe ali ndi mayina ena. Imapezeka pansi pa dzina la Pioglitazone Asset, mtengo womwe mu mulingo wa 45 mg umachokera ku ruble 2,000.
Pikoko imakhala ndi ma ruble 600 ndi ma ruble ochepa pa mapiritsi 30 ndi mulingo wa 15 mg ndi mtengo wocheperako kuposa chikwi chimodzi pamlingo womwewo ndi mlingo wa 30 mg.
Mtengo wa Aktos, mwanjira yomwe mankhwala omwe amagwiritsidwa ntchito amalembedwa, amachokera ku 800 ndi 3000 rubles.
Amalvia angawononge ma ruble 900 pa mlingo wa 30 mg, ndi Diaglitazone - kuchokera ku ruble 300 pa mulingo wa 15 mg.
Kupita patsogolo kwamakono kwamankhwala kumapangitsa kuti zitheke bwino. Kugwiritsa ntchito mankhwala amakono kungakwaniritse izi mwachangu komanso moyenera, ngakhale sizoyipa, zomwe muyenera kudziwa musanayambe kumwa mankhwalawa.
