Sibutramine - mankhwala oopsa pakuchepetsa thupi: malangizo, mayendedwe, ndemanga

Kodi sibutramine ndi chiyani?

Sibutramine ndi mankhwala amphamvu. Poyamba, idapangidwa ndikuyesedwa ngati antidepressant, koma asayansi adaona kuti ili ndi mphamvu ya anorexigenic, ndiye kuti imatha kuchepetsa chilakolako cha kudya.

Kuyambira 1997, idayamba kugwiritsidwa ntchito ku United States ndi maiko ena ngati njira yabwino yochotsera kulemera kwakukulu, kupereka kwa anthu odwala matenda osiyanasiyana. Zotsatira zoyipa sizinatenge nthawi.

Zinapezeka kuti sibutramine ndiwosuta komanso wokhumudwitsa, womwe ungafanane ndi mankhwala. Kuphatikiza apo, adakulitsa chiwopsezo cha matenda amtima, anthu ambiri adadwala stroko komanso mtima pamene adatenga. Pali umboni wosonyeza kuti kugwiritsa ntchito sibutramine kunayambitsa kupha kwa odwala.

Pharmacological zochita za mankhwala

Sibutramine palokha ndi yomwe imatchedwa prodrug, ndiye kuti, kuti igwire ntchito, mankhwalawa amayenera "kuwola" kukhala zigawo zikuluzikulu, kudutsa m'chiwindi. Kuchuluka kwa metabolites m'magazi kumatheka pambuyo pa maola 3-4.

Ngati kudya kumachitika nthawi yomweyo ndi chakudya, ndiye kuti kuchuluka kwake kumatsika ndi 30% ndikufika pazokwanira pambuyo pa maola 6-7. Pambuyo masiku 4 ogwiritsidwa ntchito pafupipafupi, kuchuluka kwake m'magazi kumakhala kosalekeza. Nthawi yayitali kwambiri pamene theka la mankhwalawo limatuluka m'thupi limakhala pafupifupi maola 16.

Mfundo zoyenera kuchitira thupilo zimakhazikika poti zimatha kuwonjezera kutentha kwa thupi, kupondereza chilakolako chofuna kudya chakudya komanso kuwonjezera kukhuta. Ndikusunga kutentha kosafunikira, thupi silifunikira kupanga mafuta m'tsogolo, kuwonjezera apo, omwe analipo "amawotchedwa" mwachangu.

Pali kuchepa kwa mafuta m'thupi ndi mafuta m'magazi, pomwe cholesterol "yabwino" imakwera. Zonsezi zimakuthandizani kuti muchepetse thupi msanga komanso kwa nthawi yayitali kuti mukhale ndi kulemera kwatsopano pambuyo pakuchotsedwa kwa sibutramine, koma pokhazikika pakudya.

Zizindikiro zogwiritsidwa ntchito

Mankhwala amangoperekedwa ndi adokotala komanso pokhapokha ngati njira zotetezeka sizibweretsa zotsatira zowoneka:

• Kunenepa kwambiri. Izi zikutanthauza kuti vuto la kunenepa kwambiri lidayamba chifukwa cha zakudya zopanda pake komanso kusachita masewera olimbitsa thupi. Mwanjira ina, kuti zopatsa mphamvu zikamalowa m'thupi kwambiri kuposa momwe amaziwonongera. Sibutramine amathandizira pokhapokha index boima wa thupi ukadutsa 30 kg / m².
• Matenda onenepa kwambiri osakanikirana ndi mtundu wachiwiri wa matenda ashuga. BMI iyenera kupitirira 27 kg / m².

Contraindication ndi zoyipa

Zofunikira pamene sibutramine amaletsedwa kuvomereza:

• thupi lawo siligwirizana ndi tsankho kwa chilichonse cha zigawo zikuluzikulu;
• milandu ngati kulemera kwambiri kumachitika chifukwa cha kupezeka kwa zifukwa zilizonse zofunikira (mwachitsanzo, kusowa kwa nthawi yayitali komanso kosatha kwa mahomoni a chithokomiro - hypothyroidism);
• kupangika kwakukulu kwa mahomoni a chithokomiro;
• anorexia manthaosa ndi bulimia;
• matenda amisala;
• Tourette's syndrome (CNS chisokonezo, momwe mumakhala zochitika zingapo zosalamulira komanso zolakwika);
• kugwiritsa ntchito munthawi yomweyo antidepressants, ma antipsychotic ndi mankhwala ena omwe amagwiritsidwa ntchito pakatikati kwamanjenje, komanso nthawi iliyonse yomwe mankhwalawa amagwiritsidwa ntchito masabata awiri asanafike poika sibutramine;
• mankhwala odziwika, mowa ndi kudalira mankhwala;
• matenda a mtima dongosolo (CVS): matenda a mtima, kulephera kosatha, kusokonezeka kobadwa nako, tachycardia, arrhythmia, sitiroko, ngozi ya mtima;
• kuthamanga kwa magazi sikuchiritsika;
• kuphwanya kwambiri chiwindi ndi impso;
• kuchuluka kwachilengedwe mbali ya Prostate gland;
• zaka zisanachitike zaka 18 ndi zaka 65;
• nthawi ya pakati komanso yoyamwitsa.

Zotsatira zoyipa zimafotokoza bwino chifukwa chake sibutramine adalembedwa mosamalitsa.

1. CNS Nthawi zambiri, odwala amafotokoza za kusowa tulo, kupweteka mutu, nkhawa kuchokera pakayamba ndi kusintha kwa kakomedwe, kuwonjezera pa izi, pakamwa lowuma nthawi zambiri limasokoneza.
2. СС. Mosachepera kawirikawiri, komabe pali kuwonjezeka kwa kugunda kwa mtima, kuthamanga kwa magazi, kuchuluka kwa mitsempha yamagazi, chifukwa chomwe pali kufooka kwa khungu komanso kumverera kwadzuwa.
3. Matumbo. Kulephera kudya, kusayenda matumbo, kusanza komanso kusanza, komanso kufalikira kwa zotupa - izi ndizofala kwambiri ngati kusowa tulo.
4. Khungu. Kutuluka thukuta kumadziwika nthawi iliyonse pachaka, mwamwayi, izi mbali sizachilendo.
5. Ziwengo Zitha kuchitika mokhazikika ngati mawonekedwe totupa tating'ono m'dera laling'ono la thupi, komanso mawonekedwe a anaphylactic mantha, omwe adotolo ayenera kuthandizidwa mwachangu.

Nthawi zambiri, zoyipa zonse zimawonedwa pakatha mwezi umodzi mutatha kumwa mankhwalawo, osakhala ndi njira yodziwikiratu ndikumapita okha.

Pazinthu zakutali, zotsatirazi zosasangalatsa za sibutramine zidalembedwa movomerezeka:

• kusamba kwa msambo;
• kutupa;
• kupweteka kumbuyo ndi m'mimba;
• Khungu;
• mkhalidwe wofanana ndi kumva kwa fuluwenza;
• kuwonjezeka kosayembekezereka ndi kwakuthwa kwa chisangalalo ndi ludzu;
• dziko lokhumudwa;
• kugona kwambiri;
• kusintha kwadzidzidzi;
• kukokana
• kuchepa kwa chiwerengero cha maselo am'magazi chifukwa cha momwe magazi amatuluka;
• pachimake psychosis (ngati munthu ali kale ndi vuto lalikulu pamaganizidwe).

Njira yogwiritsira ntchito

Mlingo wake umasankhidwa ndi adokotala pokhapokha ataganizira mosamala zoopsa zonse ndi mapindu ake. Palibe chifukwa muyenera kumwa nokha mankhwalawo! Kuphatikiza apo, sibutramine imagawidwa ku pharmacies mosamalitsa!

Imakhazikitsidwa kamodzi patsiku, makamaka m'mawa. Mlingo woyambirira wa mankhwalawa ndi 10 mgkoma, ngati munthu salekerera bwino, umatsikira mpaka 5 mg. Kapepalako kamayenera kutsukidwa ndi kapu ya madzi oyera, pomwe sikulimbikitsidwa kutafuna ndi kutsanulira zomwe zili pachilombacho. Itha kumwedwa pamimba yopanda kanthu komanso nthawi ya chakudya cham'mawa.

Ngati mwezi woyamba kusintha kwa thupi sizinachitike, mulingo wa sibutramine ukuwonjezeka mpaka 15 mg. Mankhwalawa nthawi zonse amaphatikizidwa ndi masewera olimbitsa thupi komanso zakudya zapadera, zomwe zimasankhidwa payekha kwa munthu aliyense ndi dokotala wodziwa bwino.

Kuchita ndi mankhwala ena

Musanatenge sibutramine, muyenera kukambirana ndi dokotala mankhwala onse omwe amamwa mosalekeza. Si mankhwala onse omwe amaphatikizidwa ndi sibutramine:

1. Mankhwala osakanikirana omwe ali ndi ephedrine, pseudoephedrine, etc., achulukitsa kuchuluka kwa kuthamanga kwa magazi ndi kugunda kwa mtima.
2. Mankhwala omwe akukhudzidwa ndikuwonjezera serotonin m'magazi, monga mankhwala ochizira kukhumudwa, anti-migraine, ma pinkiller, mankhwala osokoneza bongo osowa nthawi zambiri amatha kuyambitsa "serotonin syndrome." Amwalira.
3. Maantibayotiki ena (gulu la macrolide), phenobarbital, carbamazepine imathandizira kusweka ndi kuperewera kwa sibutramine.
4. Osiyana ma antifungals (ketoconazole), immunosuppressants (cyclosporin), erythromycin amatha kukulitsa kuchuluka kwa sibutramine wokhazikika komanso kuwonjezeka pafupipafupi kwa mapangidwe a mtima.

Kuphatikizidwa kwa mowa ndi mankhwalawa sikukuwononga thupi molingana ndi mayamwidwe awo, koma zakumwa zoledzeretsa ndizoletsedwa kwa iwo omwe amatsatira zakudya zapadera ndikufuna kuchepetsa thupi.

Chifukwa chiyani sibutramine ndi oletsedwa komanso owopsa

Kuyambira mu 2010, chinthuchi chakhala chikuletsedwa kugawidwa m'maiko angapo: USA, Australia, mayiko ambiri aku Europe, Canada. Ku Russia, kutulutsa kwake kumayendetsedwa mwamphamvu ndi mabungwe aboma. Mankhwala atha kutumizidwa pokhapokha ngati akupereka mankhwala ndi zisindikizo zonse zofunika. Ndizosatheka kugula izo movomerezeka popanda mankhwala.

Sibutramine anali oletsedwa ku India, China, New Zealand. Kuletsa, adatsogolera zotsatira zoyipa zomwe zimafanana ndi "kusiya" kuchokera ku mankhwala osokoneza bongo: kusowa tulo, kuda nkhawa mwadzidzidzi, kukwera kwa kukhumudwa ndi malingaliro odzipha. Anthu ambiri adasinthiratu poyerekeza ndi momwe amagwiritsidwira ntchito. Odwala ambiri omwe ali ndi vuto lamtima wamtima wamwalira ndi matenda a mtima ndi stroko.

Kwa anthu omwe ali ndi vuto lamaganizidwe, iye amaletsedwa kulandira! Ambiri anali atorexia ndi bulimia, anali oganiza kwambiri komanso osintha. Mankhwalawa samangoletsa chidwi chofuna kudya, komanso amakhudza mutu.

Sibutramine pa nthawi yoyembekezera

Amayi omwe adalandira mankhwala awa ayenera kudziwitsidwa kuti palibe chidziwitso chokwanira chokhudzana ndi chitetezo cha sibutramine kwa mwana wosabadwa. Zofananira zonse za mankhwalawa zimathetsedwa ngakhale pa gawo lokonzekera kubereka.

Pa mankhwala, mayi ayenera kugwiritsa ntchito njira zolerera komanso zodalirika. Ndi kuyesa kwabwino kwamimba, muyenera kumadziwitsa dokotala wanu ndikusiya kugwiritsa ntchito sibutramine.

Kuphunzira mwalamulo kwa mankhwalawa

Siputramine woyamba wa mankhwala osokoneza bongo (Meridia) adatulutsidwa ndi kampani yaku Germany. Mu 1997, idaloledwa kugwiritsidwa ntchito ku United States, ndipo mu 1999 ku European Union. Kutsimikizira kugwira bwino kwake, maphunziro ambiri adatchulidwa, momwe anthu opitilira 20,000 adatenga nawo gawo, zotsatirapo zake zinali zabwino.

Mu 2002, zidaganiziridwa kuchititsa kafukufuku wa SCout kuti awone omwe magulu omwe ali pachiwopsezo cha zotsatira zoyipa ali apamwamba kwambiri. Kuyesera uku kunali kofufuza kawiri-kawiri, koyesedwa ndi placebo. Mayiko 17 adatenga nawo gawo. Tidaphunzira ubale womwe ulipo pakati pa kuchepetsa thupi munthawi ya mankhwala ndi sibutramine komanso mavuto ndi mtima.

Pakutha kwa 2009, zotsatira zoyambirira zidalengezedwa:

• Kuchitidwa kwa nthawi yayitali ndi Meridia mwa anthu okalamba onenepa kwambiri ndipo ali kale ndi mavuto a mtima ndi mitsempha yamagazi achulukitsa chiopsezo cha matenda amtima ndi mikwingwirima ndi 16%. Koma imfa sizinalembedwe.
• Panalibe kusiyana pakati pa imfa pakati pa gulu lomwe linalandira placebo ndi gulu lalikulu.

Zinadziwika kuti anthu omwe ali ndi matenda amtima ali pachiwopsezo chachikulu kuposa wina aliyense. Koma sizinali zotheka kudziwa kuti ndi magulu ati omwe odwala omwe angamwe mankhwalawo atayika pang'ono.

Mu 2010 pokhapokha, malangizo omwe adaperekedwa anali okalamba (zaka 65) monga kuphwanya malamulo, komanso: tachycardia, kulephera kwa mtima, matenda a coronary, etc. Pa Okutobala 8, 2010, wopanga adakumbukira mwakufuna kwake mankhwala omwe amapezeka pamsika wamankhwala mpaka zonse zitamveka bwino. .

Kampaniyi ikadikirira maphunziro owonjezera, zomwe zikuwonetsa kuti ndi magulu ati a odwala omwe mankhwalawa amabweretsa zabwino zambiri komanso kuvulaza pang'ono.

Mu 2011-2012, kafukufuku adachitika ku Russia pansi pa dzina la code "VESNA". Zotsatira zosafunikira zidalembedwa mu 2.8% ya odzipereka; palibe zoyipa zambiri zomwe zingafune kuti sibutramine ichoke. Anthu opitilira 34,000 azaka za 18 mpaka 60 adatenga nawo gawo. Amwa mankhwala Reduxin mu mankhwala omwe atchulidwa kwa miyezi isanu ndi umodzi.

Kuyambira 2012, kafukufuku wachiwiri wachitika - "PrimaVera", kusiyana kwake kunali nthawi yogwiritsa ntchito mankhwalawa - kuposa miyezi 6 yothandizira mosalekeza.

Kuwongolera Analogs

Sibutramine imapezeka pansi pa mayina awa:

• Golide;
• Goldline Plus;
• Reduxin;
• Reduxin Met;
• Slimia
• Lindax;
• Meridia (kulembetsa kale kubwezeretsedwa).

Ena mwa mankhwalawa ali ndi kuphatikizika. Mwachitsanzo, Goldline Plus imaphatikizanso ma cellcose a microcrystalline, ndipo Reduxin Met imakhala ndi mankhwalawa 2 nthawi imodzi - sibutramine limodzi ndi MCC, ndi metformin (njira yochepetsera shuga mu mtundu 2 wa shuga) m'magulu osiyana.

Nthawi yomweyo, palibe sibutramine mu Reduxin Light konse, ndipo ngakhale ndi mankhwala.

Momwe mungasinthire sibutramine

Mankhwala osokoneza bongo:

Mtengo

Mtengo wa sibutramine mwachindunji umatengera mlingo, kuchuluka kwa mapiritsi ndi wopanga mankhwalawa.

Ndemanga za kuchepetsa kunenepa

Maganizo a anthu pa sibutramine:

Maria Ndikufuna kugawana nawo zomwe ndakhala ndikugwiritsa ntchito. Atabereka, adachira kwambiri, ndimafuna kuti ndichepe thupi msanga. Pa intaneti, ndidakumana ndi mankhwala Lida, pali sibutramine wophatikizika. Ndinatenga 30 mg patsiku, kuchepa thupi msanga. Patatha sabata limodzi mankhwala atasiya, mavuto azaumoyo adayamba, adapita kuchipatala. Pamenepo ndidapezeka kuti ndalephera.