Thessig mankhwala - malangizo, ntchito, ndemanga, zotsika mtengo

Odwala omwe ali ndi matenda ashuga nthawi zambiri amalephera kuchepetsa matenda a glycemia pokhapokha ngati amadya.

Ambiri a iwo amayenera kumwa mankhwala osiyanasiyana ochepetsa shuga. Chimodzi mwa zinthu ngati izi za matenda ashuga pamsika wamankhwala ndi Forsiga.

Zambiri, kapangidwe, mawonekedwe a kumasulidwa

Posachedwa, gulu latsopano lamankhwala lapezeka ku Russia lomwe limakhala ndi zinthu zotsitsa shuga, koma zimakhala ndi zotsatira zosiyana poyerekeza ndi zomwe zidagwiritsidwa ntchito kale. M'modzi mwa oyamba mdziko muno adalembetsedwa mankhwala a Forsig.

Wothandizidwa ndi pharmacological amaperekedwa mu radar system (registry ya mankhwala) ngati mankhwala a hypoglycemic omwe cholinga chake ndi pakamwa.

Akatswiri ochita kafukufukuyu atatha kupeza zotsatira zochititsa chidwi zotsimikizira kuchepetsa kuchuluka kwa mankhwala omwe amwedwa kapena ngakhale kuchotsedwa kwa mankhwala a insulin nthawi zina chifukwa chogwiritsa ntchito mankhwalawa.

Ndemanga za endocrinologists ndi odwala pankhaniyi ndizosakanikirana. Ambiri amasangalala ndi mwayi watsopano, ndipo ena a iwo amaopa kuugwiritsa ntchito, kuyembekezera chidziwitso cha zotsatira za kugwiritsidwa ntchito kwa nthawi yayitali.

Mankhwalawa amapezeka mu mawonekedwe a mapiritsi okhala ndi Mlingo wa 10 kapena 5 mg ndipo amamuyika m'matumba ambiri, 10 komanso zidutswa 14.

Piritsi lirilonse limakhala ndi dapagliflozin, chomwe ndiye chimapangitsa chachikulu.

Zosangalatsa zimaphatikizapo zinthu zotsatirazi:

• ma cellcose a microcrystalline;
• lactose wam'madzi;
• silika;
• crospovidone;
• magnesium wakuba.

Ma Shell:

• pang'ono hydrolyzed polyvinyl mowa (Opadry II chikasu);
• titanium dioxide;
• macrogol;
• talc;
• Utoto wachikasu wachitsulo.

Zotsatira za pharmacological

Dapagliflozin, wogwira ntchito ngati mankhwala, amalepheretsanso SGLT2 (mapuloteni), ndiye kuti, amachepetsa ntchito yawo. Mothandizidwa ndi zinthu zamankhwala, kuchuluka kwa glucose omwe amachokera ku mkodzo woyamba amachepetsedwa, chifukwa chake, kutulutsa kwake kumachitika kwathunthu chifukwa cha ntchito ya impso.

Izi zimabweretsa matenda a magazi glycemia. Chowoneka mosiyana ndi mankhwalawa ndi kusankha kwake kwapamwamba, chifukwa sichikhudza kayendedwe ka glucose kupita ku minofu ndipo sikasokoneza mayamwidwe ake akalowa matumbo.

Kuphatikizika kwakukulu kwa mankhwalawa ndikufuna kuthana ndi glucose, yomwe imakhazikika m'magazi, kudzera impso. Thupi laumunthu limadziwika nthawi zambiri kuzinthu zosiyanasiyana za metabolic komanso poizoni.

Chifukwa cha ntchito yokhazikika ya impso, zinthu izi zimasefedwa bwino ndikuchotsa limodzi ndi mkodzo. Pa chofufumitsa, magazi amadutsa kangapo kudzera mu mawonekedwe aimpso. Zigawo zamapuloteni zimasungidwa koyambilira m'thupi, ndipo madzi onse otsala amasefedwa, ndikupanga mkodzo woyamba. Kuchuluka kwake patsiku kungafike 10 malita.

Kusintha madziwo kukhala mkodzo wachiwiri ndi chikhodzodzo, kuyika kwake kuyenera kuchuluka. Cholinga ichi chimakwaniritsidwa ndikubweza m'magazi pazinthu zonse zofunikira, kuphatikizapo shuga.

Pakalibe matenda, zinthu zonse zimabwezedwa kwathunthu, koma ndi matenda ashuga pamakhala kutayika kwa shuga mu mkodzo. Izi zimachitika pamlingo wa glycemia woposa 9-10 mmol / L.

Kutenga mankhwalawa muyezo wabwino kumalimbikitsa kutulutsa kwa 80 g m'magazi a mkodzo. Kuchuluka kumeneku sikudalira kuchuluka kwa insulin yomwe imapangidwa ndi kapamba kapena kulandira jakisoni.

Kuchotsa shuga kumayamba pambuyo piritsi, ndipo zotsatira zake zimatha kwa maola 24. Zomwe zimagwiritsidwa ntchito ndi mankhwalawa sizikhudza masoka opanga glucose wamkati pakachitika hypoglycemia.

Pazotsatira za mayesowa, kuwongolera kunawonekera pantchito ya maselo a beta omwe amayang'anira kupanga mahomoni. Odwala omwe adamwa mankhwalawa pa 10 mg kwa zaka ziwiri, shuga anali kuwachotsa, zomwe zimapangitsa kuchuluka kwa osmotic diuresis. Kuwonjezeka kwa kuchuluka kwa mkodzo kumatha kuyenda limodzi ndi kuwonjezeka pang'ono kwa sodium excretion kudzera mu impso, koma sikunasinthe phindu la seramu ndende ya chinthu ichi.

Kugwiritsidwa ntchito kwa Forsigi kumathandizira kutsika kwa kuthamanga kwa magazi kale pakatha masabata 2-4 atayamba kuyang'anira. Kuphatikiza apo, kugwiritsa ntchito mankhwalawa kwa miyezi itatu kumachepetsa glycosylated hemoglobin.

Pharmacokinetics

Mphamvu ya pharmacokinetic imadziwika ndi mawonekedwe a mayamwidwe, kugawa, kagayidwe ndi kutulutsa kwa zigawo zikuluzikulu:

1. Mafuta Pambuyo kolowera, ziwalo za wothandizirazo zimatilira kwathunthu ndi makhoma am'mimba (m'mimba), mosasamala nthawi yomwe chakudya chimatha. Yambiri pazomera mutatenga chopanda kanthu m'mimba chimatha pambuyo 2 maola ndikuwonjezeka molingana ndi mlingo. Gawo la bioavailability mtheradi wa gawo lalikulu ndi 78%.
2. Kugawa. Gawo lomwe limagwiritsa ntchito mankhwalawo lili pafupifupi 91% yomangidwa kumapuloteni. Matenda a impso kapena matenda a chiwindi sizikhudza chizindikiro ichi.
3. Kupenda. Chofunikira cha mankhwalawa ndi glucoside wokhala ndi mpweya wokhala ndi mpweya, womwe umalongosola kukana kwake kwa glucosidases. Zaka theka la moyo zomwe zimafunikira theka la moyo wa mankhwala opangidwa kuchokera ku madzi am'magazi anali maola 12.9 m'gulu lophunziridwa la odzipereka athanzi.
4. Kupatula. Zigawo za mankhwala zimapukutidwa kudzera mu impso.

Nkhani ya kanema pa njira ya Forsig, gawo 1:

Zizindikiro ndi contraindication

Mankhwala sangathe kusintha glycemia ngati wodwalayo akupitiliza kudya zakudya zosafunikira.

Ichi ndichifukwa chake zakudya zamagulu olimbitsa thupi komanso kukhazikitsa zina zolimbitsa thupi ziyenera kukhala zofunikira pakuchiritsa. Forsig imatha kutumikiridwa ngati mankhwala okhawo ochizira, koma nthawi zambiri mapiritsi awa amalimbikitsidwa kuphatikiza ndi Metformin.

Zowonetsa:

• kuwonda kwa odwala osadalira insulin;
• gwiritsani ntchito ngati mankhwala ena mwa odwala omwe ali ndi matenda ashuga;
• kukonza pafupipafupi zakudya mavuto;
• kukhalapo kwa ma pathologies omwe amaletsa zolimbitsa thupi.

Zoyipa:

1. Matenda a shuga a insulin.
2. Mimba Contraindication amafotokozedwa ndi kusowa kwachidziwitso chotsimikizira chitetezo chogwiritsa ntchito panthawiyi.
3. Nthawi yochepetsetsa.
4. Zaka kuyambira zaka 75 ndi kupitilira. Izi zikuchitika chifukwa cha kuchepa kwa ntchito zomwe zimapangidwa ndi impso, komanso kuchepa kwa magazi.
5. Lactose tsankho, yomwe ndi gawo lothandiza pamapiritsi.
6. Zoyipa zomwe zimatha kupanga utoto utagwiritsidwa ntchito pagulu la piritsi.
7. Kukweza mulingo wa matupi a ketone.
8. Nephropathy (wodwala matenda ashuga).
9. Kutenga diuretics, momwe imapangidwira ndi munthawi yomweyo mankhwala okhala ndi mapiritsi a Forsig.

Zotsutsana:

• matenda opatsirana;
• mowa, chikonga (palibe mayeso okhudzana ndi mankhwalawa omwe anachitika);
• kuchuluka hematocrit;
• matenda a kwamikodzo;
• ukalamba;
• kuvulala kwambiri kwa impso;
• kulephera kwa mtima.

Malangizo ogwiritsira ntchito

Mapiritsi amatengedwa pakamwa Mlingo womwe umadalira chithandizo chomwe wodwala amapatsa:

1. Monotherapy. Mlingo sayenera kupitilira 10 mg patsiku.
2. Kuphatikiza mankhwala. Tsiku lililonse, amaloledwa kutenga 10 mg ya Forsigi kuphatikiza ndi Metformin.
3. Mankhwala oyambira ndi 500 mg a Metformin ndi 10 mg (kamodzi patsiku).

Kukonzekera kwa pakamwa kwa mankhwala sikudalira nthawi yakudya. Kuchepetsa mulingo wa mankhwalawa nthawi zambiri kumafunika ndi mankhwala a insulin kapena ndi mankhwala omwe amachititsa kuti achulukane.

Odwala omwe ali ndi matenda a impso kapena chiwindi ayenera kuyamba kumwa mapiritsi a 5 mg. M'tsogolomu, imatha kuwonjezeka mpaka 10 mg, malinga ngati zigawozo zimalekeredwa bwino.

Nkhani yavidiyo pa njira ya Forsig, gawo lachiwiri:

Odwala apadera

Mphamvu ya mankhwala imatha kusiyanasiyana ndi zina za wodwala kapena mawonekedwe:

1. Matenda a impso. Kuchuluka kwa glucose yemwe amawonjezera mwachindunji kumatengera momwe ziwalozi zimagwirira ntchito.
2. Pankhani yakuphwanya chiwindi, zotsatira za mankhwalawa zimasintha pang'ono, kotero, kusintha kwa Mlingo wokhazikitsidwa sikofunikira. Kupatuka kwakukuru mu zomwe zimagwiritsidwa ntchito zimawonedwa pokhapokha ngati pali matenda oopsa.
3. M'badwo. Odwala osakwana zaka 70 sanawonetse kuwonekera kwakukulu.
4. Okwatirana Pogwiritsa ntchito mankhwalawa, azimayi amapitilira AUC ndi 22% poyerekeza ndi amuna.
5. Kuyanjana ndi mitundu sikumabweretsa kusiyana pakukhudzana kwatsatanetsatane.
6. Kulemera. Odwala onenepa kwambiri anali ndi mfundo zotsika kwambiri panthawi yamankhwala.

Zotsatira za mankhwalawa kwa ana sizinaphunzire, kotero siziyenera kugwiritsidwa ntchito ngati chithandizo cha matendawa. Zoletsa zomwezo zimagwiranso ntchito kwa amayi apakati komanso oyamwitsa, popeza palibe chidziwitso chokhudza kulowa kwa zigawo za chinthucho kukhala mkaka.

Malangizo apadera

Mphamvu ya mankhwalawa zimatengera kupezeka kwa matenda okhudzana ndi matenda ashuga odwala:

1. Matenda a impso. Nthawi zambiri, kuchepa kwa mphamvu yogwiritsa ntchito mankhwalawa kulibe mwa anthu omwe ali ndi vuto lochepa. Woopsa mitundu ya mapiritsi, kumwa mapiritsi sangathe kutsogolera kwa achire zotsatira. Malangizo oterewa amafotokoza kufunikira kwa kuyang'anira ntchito ya impso, yomwe iyenera kuchitika kangapo pachaka malinga ndi malangizo azachipatala.
2. Matenda a chiwindi. Ndi kuphwanya koteroko, kuwonekera kwa chinthu chogwira ntchito chomwe ndi gawo la mankhwalawa kumatha kuchuluka.

Njira ya Forsig imabweretsa izi:

• kumawonjezera chiopsezo chochepetsa kuchuluka kwa magazi ozungulira;
• kumawonjezera mwayi woti chiwopsezo chikukwera;
• kuphwanya malire a electrolyte;
• chiopsezo chotenga matenda omwe amakhudza kwamikodzo thirakiti amawonjezeka;
• ketoacidosis imatha kuchitika;
• kumawonjezera hematocrit.

Ndikofunikira kumvetsetsa kuti kumwa mapiritsi kuyenera kuchitika atakambirana ndi adokotala.

Zotsatira zoyipa ndi bongo

Dapagliflozin amadziwika kuti ndi mankhwala otetezeka ndipo panthawi imodzi mapiritsi amodzi, opitilira muyeso wovomerezeka mwa nthawi 50, amalekeredwa bwino.

Kutsimikiza kwa mkodzo m'magazi kunawonedwa kwa masiku angapo, koma kuchepa kwa madzi, komanso kusokonekera kwa magazi ndi kusokonekera kwa electrolyte sizinapezeke.

M'magulu omwe aphunziridwa, momwe anthu ena adatenga Forsig ndipo enawo adatenga placebo, zochitika za hypoglycemia, komanso zochitika zina zoyipa, sizinasiyane kwambiri.

Kuchotsa chithandizo chamankhwala kuyenera kuchitika motere:

• creatinine kuchuluka;
• matenda osiyanasiyana apezeka omwe akhudza kwamikodzo thirakiti;
• nseru adawonekera;
• chizungulire amamva;
• chotupa chapanga khungu;
• matenda a chiwindi.

Ngati mankhwala osokoneza bongo apezeka, muyenera kukonza mankhwalawo poganizira thanzi lake.

Kodi nditha kuchepetsa thupi ndi Forsiga?

Mu malangizo a mankhwalawa, wopanga amawonetsa kuchepa kwa thupi komwe kumawonedwa pakumwa. Izi zimadziwika kwambiri kwa odwala omwe alibe matenda a shuga okha, komanso kunenepa kwambiri.

Chifukwa cha diuretic katundu, mankhwalawa amachepetsa kuchuluka kwa madzi mthupi. Kuthekera kwa zigawo zina za mankhwala kuphatikiza gawo la glucose kumathandizanso kuti kutaya kwamapaundi owonjezera.

Mikhalidwe yayikulu yokwaniritsira kugwiritsa ntchito mankhwalawa ndizosakwanira kudya komanso kuyambitsa zoletsa pazokhazokha malinga ndi zakudya zomwe zaperekedwa.

Anthu athanzi sayenera kugwiritsa ntchito mapiritsiwa kuti muchepetse kunenepa. Izi zimachitika chifukwa cha kuchuluka kwambiri kwa impso, komanso kusadziwa bwino kwa Forsigi.

Kuyanjana Ndi Mankhwala Ndi Analogi

Mankhwalawa amathandizira kulimbitsa ma diuretics, insulin ndi mankhwala omwe amakulitsa chinsinsi chake.

Kugwiritsa ntchito bwino kwa mankhwalawa kumachepetsa pamene mukumwa mankhwalawa:

• Rifampicin;
• yogwira chotengera inductor;
• Ma enzyme omwe amalimbikitsa kagayidwe kazinthu zina.

Kudya kwa mapiritsi a Forsig ndi mefenamic acid kumawonjezera kufunikira kwa zinthu zogwira ndi 55%.

Forsiga ndi mankhwala okhawo omwe ali ndi Dapagliflozin omwe akupezeka ku Russia. Zina, zotsika mtengo za choyambirira sizipangidwa.

Njira ina ya mapiritsi a Forsig ingakhale mankhwala a glyphosine:

• Jardins
• Attokana.

Maganizo a akatswiri ndi odwala

Kuchokera pakuwunika kwa madotolo ndi odwala za mankhwala a Forsig, titha kunena kuti mankhwalawa amachepetsa shuga m'magazi ndipo amathandizanso thupi lonse, komabe, ena amakhala ndi zovuta zoyipa, zomwe zimayenera kukumbukiridwa mukamamwa mankhwalawa.

Mankhwalawa adatsimikizira kugwira ntchito kwake poyeserera. Matenda a glycemia nthawi zambiri amatha kuchitika popanda zovuta. Odwala ena amasiya kubayitsa insulin. Izi zimatengedwa pazotsatira za kuyesa komwe anthu 50,000 omwe anali ndi glycemia ochokera 10 mmol / l adatenga nawo gawo. Kuphatikiza pakukhazikitsa shuga, mankhwalawa anali ndi phindu pa thanzi lathunthu.

Alexander Petrovich, endocrinologist

Forsyga ndi mankhwala oyamba m'gululi la zoletsa zatsopano. Kukula kwa mankhwalawa sikudalira ntchito ya maselo a beta, komanso insulin. Zigawo zomwe zimagwira zimalepheretsa kukhathamiritsa kwa glucose m'm impso, potero kuchepetsa zake m'magazi. Mapindu ofunikanso ndikuchepetsa thupi ndi kuchepetsa mwayi wa hypoglycemia. Mayeso awonetsa kuti chithandizo sichiri chotsatira limodzi. Mankhwalawa agwiritsidwa ntchito mwanzeru kunja kwazaka zingapo, komwe kwatsimikizira kugwira ntchito kwake mobwerezabwereza.

Irina Pavlovna, endocrinologist

Mapiritsi a Forsig adalembedwa kwa amayi anga atagwirizana kwambiri ndi insulin. Panthawi yomwe amayamba kudya, pafupifupi zonse zowonetsa za amayi zinali zachilendo. C-peptide inali pansi pa malire ovomerezeka, ndipo shuga, m'malo mwake, inali pafupifupi 20. Patatha masiku anayi piritsi loyamba litatengedwa, kusintha kwadziwika. Shuga anasiya kutuluka pamwamba pa 10, ngakhale anali ndi Mlingo wambiri wa mankhwala ena (Amaril, Siofor). Patatha mwezi umodzi ndimankhwala awa, mankhwala ambiri adathetsedwa chifukwa cha mayi. Ndinganene kuti ngakhale njira za Forsig ndizokhutira kwambiri.

Vladimir, wazaka 44

Ndinawerenga ndemanga kuchokera kwa ogwiritsa ntchito ena ndipo ndimadabwa. Mankhwalawa adathandiza ambiri, koma osati ine. Chiyambireni kudya kwake, shuga anga sanangobwerera kwawokhawo, komanso alumpha. Koma choyipa kwambiri ndikumayamwa kumamveka mthupi lonse, komwe sikungatheke.Ndikhulupilira kuti mankhwala omwe ali ndi mavuto ngati amenewa sayenera kugwiritsidwa ntchito ndi aliyense.

Elena, wazaka 53

Mtengo wa paketi ya Forsig wa mapiritsi 30 (10 mg) ndi pafupifupi ma ruble 2,600.