Zotsatira zamankhwala omwe amachokera ku repaglinide (Repaglinide)

Kugwiritsa ntchito mankhwala opangira hypoglycemic ndi chifukwa chomveka chothana ndi vuto la matenda ashuga. Amathandizira kuyang'anira kuchuluka kwa shuga m'magazi ndikuchepetsa zotsatira za matendawa.

Chimodzi mwazinthu izi ndi Repaglinide.

Kutulutsa Fomu

Repaglinide ikuphatikizidwa kapangidwe ka mankhwala ambiri omwe ali ndi dzina la malonda:

• NovoNorm;
• Diaglinide;
• Eglinides ndi ena.

Zotsatira za mankhwalawa zimakhazikitsidwa ndimomwe amapangira mankhwala omwe amapezeka m'zinthu zina (repaglinide), omwe ali gawo lawo lalikulu, ndipo amatha kuwonjezeredwa kapena kusinthidwa mothandizidwa ndi zinthu zothandizira.

Nthawi zambiri, mankhwalawa amapezeka mu mawonekedwe a piritsi ndi kuchuluka kwa yogwira mu 0,5, 1 kapena 2 milligram.

Mankhwala

Zotsatira zazikuluzikulu za chinthucho ndikuchepetsa shuga m'magazi, zimakhazikitsidwa pamapangidwe olepheretsa ntchito ya ma tubules odalira a ATP omwe amapezeka mu zipolopolo za pancreatic β-cell.

Repaglinide imagwira pamayendedwe a potaziyamu, ndikuthandizira kutulutsa kwa K ions⁺ kuchokera mu khungu, lomwe limathandizira kuchepetsa kupota kwake kwa makoma ake ndikumasulidwa kwa njira za calcium. Zonsezi zimawonjezera kuchuluka kwa kupanga insulini ndikutulutsa kwake m'magazi.

Kuyamwa kwa zinthu kumachitika msanga, pambuyo pa ola limodzi pamakhala kuchuluka kwa magazi m'magazi, pang'onopang'ono ndikuchepa komanso kuwonongeka patatha maola 4.

Pankhaniyi, malonda amalumikizidwa bwino ndi mapuloteni a plasma, oposa 90 peresenti, ndipo zitatha izi zimakonzedwa kwathunthu ndikumasulidwa:

• oxidized dicarboxylic acid;
• mafungo onunkhira;
• acyl glucuronide.

Zinthu izi zilibe mphamvu ya hypoglycemic ndipo zimachotsedwa chifukwa cha m'mimba komanso pang'ono kudzera mu impso.

Zizindikiro ndi contraindication

Mankhwala ozikidwa pa repaglinide amalimbikitsidwa kuti apange mtundu wachiwiri wa matenda ashuga wachiwiri, onse ngati mankhwala odziyimira pawokha komanso kuphatikiza ndi metformin kapena thiazolidinediones, kuwonjezeredwa pomwa mankhwala amodzi sikuwonetsa mphamvu yokwanira.

Zotsatira zoyenera kumwa mankhwalawa ndi:

• kupezeka kwa matenda ashuga choyambirira;
• matenda akulu a chiwindi;
• kuphwanya lactose kagayidwe;
• nthawi ya pakati ndi mkaka wa m`mawere;
• kugwiritsa ntchito mankhwala opangidwa ndi gemfibrozil;
• matenda ashuga ketoacidosis, chikomokere kapena precoma;
• kukhalapo kwa matenda opatsirana, kufunika kwa kulowererapo kwa maopaleshoni kapena mavuto ena omwe mankhwala a insulin amafunikira;
• zaka zazing'ono;
• chidwi chachikulu ndi zigawo zikuluzikulu ndi mbali za mankhwala.

Popeza chinthu chomwe chikugwiridwapo ndi impso pang'ono, odwala omwe ali ndi matenda m'derali ayenera kumwa mosamala mankhwalawo. Zomwezi zimagwiranso ntchito kwa odwala omwe ali ndi thanzi labwino komanso akuvutika.

Panthawi yopanga repaglinide, ndikofunikira kuwunika mosamala Zizindikiro za shuga wa magazi pofuna kupewa boma la hypoglycemia ndi chikomokere. Ndi dontho lakuthwa la shuga, mlingo wa mankhwalawa umachepetsedwa.

Malangizo ogwiritsira ntchito

Kulandila kwa mankhwalawa kumachitika mogwirizana ndi malangizo a mankhwalawa, omwe amaphatikizanso zinthu. Mankhwala ambiri amapezeka mu mawonekedwe a piritsi, amamwa pakamwa mphindi 15-20 asanadye. Mlingo umasankhidwa pachilichonse.

Ndikwabwino kuyamba kutenga repaglinide ndi mawonekedwe osachepera: 0,5 mg. Pakatha sabata, mutha kusintha zina ndi zina mwa kuchuluka kwa mankhwalawa ndi 0,5 mg. Mlingo wovomerezeka woyenera uyenera kukhala 4 mg pa nthawi kapena 16 mg patsiku.

Ngati wodwalayo kale adagwiritsa ntchito mankhwala ena a hypoglycemic ndikusamutsidwanso kuti apangidwenso, mlingo woyambirira wa iye uyenera kukhala pafupifupi 1 mg.

Ngati mwaphonya kumwa mapiritsi, osachulukitsa mlingo wotsatira, izi zitha kupangitsa kutsika kwamphamvu m'magazi komanso kuyambika kwa hypoglycemia. Kusintha kwa mtundu uliwonse kapena kusintha kwa mankhwalawa kuyenera kuchitika moyang'aniridwa ndi dokotala komanso kuyang'aniridwa ndikuwonetsa shuga mu mkodzo ndi magazi a munthu wodwala matenda ashuga.

Zotsatira zoyipa

Nthawi zambiri, mukamagwiritsa ntchito mankhwala omwe amapezeka chifukwa cha repaglinide, hypoglycemia imachitika, yomwe imatha kuchitika chifukwa chosagwirizana ndi malamulo ogwiritsira ntchito mankhwalawa, komanso chifukwa chazinthu zina: kuwonjezera zolimbitsa thupi, kusatsatira zakudya, ndi zina zambiri.

Kuphatikiza apo, zotsatira zoyipa zitha kupezeka mwa:

• kuwonongeka kwamawonekedwe;
• vasculitis;
• kukula kwa matenda a mtima;
• chitetezo mthupi mu mawonekedwe a totupa;
• hypoglycemic chikomokere ndi kusazindikira;
• kuphwanya chiwindi;
• kupweteka pamimba, nseru, kutsegula m'mimba, kapena kudzimbidwa.

Ndi makulidwe a kusintha kwa mankhwalawo kapena kusinthira ku mankhwala ena, zizindikiro zimatha.

Kanema wochokera kwa Dr. Malysheva okhudza zizindikiro za matenda ashuga:

Kuyanjana kwa mankhwala osokoneza bongo

Pankhani yogwiritsira ntchito repaglinide, ndikofunikira kulingalira momwe zimagwirira ntchito ndi zinthu zina.

Kupititsa patsogolo zotsatira za mankhwala:

• Gemfibrozil;
• anabolic steroids;
• Rifampicin;
• Trimethoprim;
• Clarithromycin;
• Itraconazole;
• Ketoconazole ndi ena othandizira a hypoglycemic;
• oponderezana a monoamine oxidase ndi angiotensin-otembenuza enzyme;
• mankhwala osapweteka a antiidal;
• osasankha beta-blockers;
• salicylates.

Kugwiritsa ntchito mankhwala mosokoneza bongo monga repaglinide ndi gemfibrozil kumatsutsana, chifukwa kumapangitsa kuti munthu azichita zinthu zambiri mosiyanasiyana.

Pogwira ntchito yodzikonzanso, othandizira monga:

• Cimetidine;
• Simvastatin;
• Estrogen;
• Nifedipine.

Chifukwa chake, zimatha kugwiritsidwa ntchito palimodzi.

Zovuta zochepa pamtundu wa repaglinide zimawonedwa pokhudzana ndi mankhwala: Warfarin, Digoxin ndi Theophylline.

Mphamvu ya mankhwala yafupika:

• kulera kwamlomo;
• glucocorticosteroids;
• Rifampicin;
• mahomoni a chithokomiro;
• barbiturates;
• Danazole;
• sympathomimetics;
• Carbamazepine;
• zotumphukira zotumphukira.

Kugwiritsa ntchito kumalimbikitsidwa kuti kuphatikizidwe ndi kusintha kwa mankhwala.

Malangizo ogwiritsira ntchito

Repaglinide ndi mankhwala kuti mugwiritse ntchito mukamadya zakudya komanso kuchita zolimbitsa thupi sizikulolani kuwongolera shuga.

Popita nthawi, kugwiritsa ntchito bwino mankhwalawa kumachepa, komwe kumalumikizidwa ndi kupitilira kwa matendawa komanso kuchepa kwa chidwi cha thupi pakuchita zinthu za mankhwala. Kenako dokotalayo amupatsanso mankhwala ena kapena akamawonjezera mankhwalawo.

Kugwiritsa ntchito bwino kwa mankhwalawa kumayang'aniridwa nthawi zonse ndikusanthula kwa kuchuluka kwa shuga m'magazi ndi mkodzo. Wodwala amatha kuunikiranso payekha pogwiritsa ntchito mankhwala akunyumba, koma nthawi zina pamayenera kuyan'aniridwa ndi adokotala. Kwa iye, ndikofunikira kumayesedwa mu labotale yamankhwala.

Ikuwunikanso kuchuluka kwa hemoglobin ya glycosylated, yomwe imakupatsani chithunzithunzi chokwanira cha njira yochizira. Zizindikiro zikasintha, kusintha kwamankhwala kumachitika.

Chidacho chokha chimagwiritsidwa ntchito molumikizana ndi chithandizo chamankhwala komanso masewera olimbitsa thupi, omwe amayenera kupangidwa ndi dokotala. Nthawi yomweyo, kusintha kwa zakudya kapena zolemetsa zamasewera kumabweretsa kusinthasintha kwa shuga m'magazi, zomwe zimafunikira kusintha kwamankhwala. Popeza wodwalayo sangachite izi mwachangu, tikulimbikitsidwa kupewa kusintha mwadzidzidzi pakudya ndi kupsinjika.

Repaglinide singagwiritsidwe ntchito nthawi imodzi ndi othandizira omwe ali ndi zakumwa zoledzeretsa, chifukwa zimathandizira zotsatira zake. Mankhwala pawokha samakhudza kuyendetsa galimoto, koma hypoglycemia ikachitika, kuthekera kwake kumachepetsedwa kwambiri. Chifukwa chake, mukamamwa mankhwalawa, muyenera kuyang'anira kuchuluka kwa glucose komanso kupewa kutsika kwake.

Monga tafotokozera, odwala omwe ali ndi matenda a impso ndi chiwindi, komanso akuvutika ndi matenda a mtima ndi mitsempha yamagazi, ayenera kugwiritsa ntchito mankhwalawa makamaka mosamala.

Panalibe kafukufuku wokhudza momwe azimayi apakati komanso oyamwitsa amakhalira. Chifukwa chake, chitetezo cha mankhwalawa kwa mwana sichimatsimikiziridwa ndipo mankhwalawa sanalembedwe nthawi imeneyi. Mkazi amene akufunika mankhwala ayenera kukana kuyamwitsa mwana wake.

Zomwezo zimagwiranso ntchito pazikhalidwe zausinkhu. Kuchuluka kwa mankhwalawa kwa odwala ochepera zaka 18 ndi pambuyo pa 75 sikudziwika. Zikatero, Repaglinide imasinthidwa ndi analogue yomwe ilipo kapena ikhoza kupitiliza kugwiritsidwa ntchito ndi wodwalayo atakalamba, ngati ikuyang'aniridwa ndi endocrinologist.

Kukonzekera kochokera ku Repaglinide

Mawu ofanana ndi mankhwalawa ndi Repaglinide-Teva, yemwe machitidwe ake amachokera pazinthu zomwe zikufunsidwa.

Ma Analogs ndi:

• Mtengo wazindikiritso kuchokera ku 200 ma ruble a mapiritsi 30;
• Jardins kuchokera ku ruble 200 kwa mapiritsi 30;
• NovoNorm kuchokera ku ma ruble a 170 mapiritsi 30;
• Invokana kuchokera ku ruble 2000 pamapiritsi 30 okhala ndi mulingo wa 100 mg.;
• Forsiga kuchokera ku 2000 ma ruble a 30 mapiritsi okhala ndi 10 mg .;

Mtengo wa repaglinide ndi analogues zimatengera zinthu zingapo:

• Mlingo
• wopanga;
• kukhalapo kwa zinthu zothandizirana;
• Ndondomeko zamitengo yamapiritsi ndi zina.

Kumwa mankhwala a hypoglycemic ndikofunikira kwambiri kwa odwala ambiri omwe ali ndi matenda a shuga a 2. Zimawalola kusintha moyo ndikuchepetsa zowopsa za matendawa. Komabe, zonsezi zimatheka pokhapokha ngati zofunika za malangizo ogwiritsira ntchito mankhwalawa ndikuwongolera zizindikiro zamtundu wa thupi zimawonedwa.