Isifo sikashukela i-mellitus sibizwa ngokuthi "isifo" sekhulu le-XXI. Ngakho-ke, ukuphuza umuthi kungenye yamaphuzu abalulekile ekwelapheni lesi sifo. Ukulungiswa kwemiyalo yePioglitazone kunencazelo enemininingwane yokusebenzisa kwabo.
Izidakamizwa eziphambili zesifo sikashukela eziqukethe le nto ama-Aktos, uPioglar, uDik-standard, iDiaglitazone. IPioglitazone ngokwayo iyi-white crystalline powder, engenaphunga.
Empeleni ayincibiliki emanzini, kepha ihlanjululwe kakhulu ku-dimethylformamide. Ngokuqondene ne-ethanol ye-anhydrous, i-acetone ne-acetonitrile, into ekuyo incibilika kancane.
I-pioglitazone iyingxenye yesigaba se-thiazolidinediones (glitazones); ukusetshenziswa kwayo kukhonjisiwe ukunciphisa ushukela wegazi. Njengoba uhlobo lwesibili sikashukela lubonakala ngokwephula ukuzwela kwamangqamuzana omzimba ukuze afake i-insulin, ama-glitazones enza kusebenze ama-receptors akwi-nuclei yawo. Ngenxa yalokhu, izicubu zekhompiyutha ziqala ukuphendula kwi-insulin ye-hormone.
Iziguli eziningi zibuza lo mbuzo, kungenzeka yini ukuthatha umuthi oqukethe i-pioglitazone ohlotsheni lokuqala lwesifo? I-Glitazones izidakamizwa kuphela zohlobo lwesibili sikashukela. Zisetshenziswa njengomuthi oyinhloko, futhi ezingeziwe nge-metformin, sulfonamide noma i-insulin. Iziguli ziqala ukuthatha umuthi uma ukuzivocavoca nokudla okufanele kungenawo umphumela owufunayo - ushukela wegazi ojwayelekile.
Ama-Glitazones ngokuqhathanisa nezinye izidakamizwa ezinciphisa ushukela ziqeda ngempumelelo ukumelana ne-insulin. Zinciphisa inani lama-acid amaningi egazini lomuntu futhi lihambise izicubu ze-adipose zisuka emathunjini esiswini ziye esifundeni esingaphansi komhlaba. Ngaphezu kwalokho, izinto ziphansi ama-triglycerides.
Imiyalo yokusebenzisa umuthi
Ukuthatha umuthi kukhonjiswa kuphela ngemuva kokubonisana nodokotela ohambayo, onquma umthamo ofanele, kucatshangelwa izici zesiguli ngasinye. Endabeni yokuzisebenzisa ngokwakho into yePioglitazone, imiyalo yomuthi kumele ifundwe ngokucophelela ukuze kugwenywe izinkinga.
Umuthi ukhonjiswa ukusetshenziselwa uma umthamo wokuqala uvela ku-15 uye ku-30 mg, kuthi lowo ophezulu (ngosuku) ngu-45 mg. Uma uhlanganisa into neminye imithi, umthamo kumele ungabi ngaphezu kwama-30 mg. I-pioglitazone ikhonjiswa ukusetshenziswa kanye ngosuku.
Ngesikhathi sokwelashwa, kufanele uqhubeke nokulandela ukudla nokuzivocavoca. Kubaluleke kakhulu ukuhlola izinga le-hemoglobin egazini.
I-pioglitazone iboniswa ngokunakekelwa okukhethekile kweziguli ezinokuvuvukala, kanti isibindi siqukethe inani elikhulisiwe lama-enzyme. Ngokuthuthukiswa kwe-hypoglycemia ngesikhathi sokwelapha okuhlanganisiwe kudinga ukuncishiswa kumthamo we-insulin noma i-sulfonamides. Uma isiguli sine-jaundice, umphumela ongemuhle emzimbeni ungakhishwa, ngakho-ke ukwelashwa kufanele kumiswe. Iziguli ezinomjikelezo we-anovulatory ngesikhathi sangaphambi kokusengozini zisengozini yokukhulelwa, ngakho-ke inqubo yokuvimbela inzalo kufanele isetshenziswe.
Contraindication kanye nemiphumela emibi
Ngaphambi kokusebenzisa umuthi osuselwa kuPioglitazone, udinga ukubonana nodokotela wakho. Le nto ine-contraindication eminingi: ukungabekezelelani komuntu ngamunye kuPioglitazone, uhlobo lwe-1 sikashukela i-mellitus, i-ketoacidosis yesifo sikashukela (okhubazekile we-carbohydrate metabolism ngenxa yokuntuleka kwe-insulin), i-pathology yesibindi esiteji esibi.
Izinga le-ALT (alanine aminotransferase) liphakeme izikhathi ezingama-2,5 kunokujwayelekile, okungakhombisa ukuthuthukiswa kwezifo eziningi ezimbi, iminyaka efinyelela eminyakeni eyi-18 (ukusebenza kwento ezigulini zalo mkhakha wobudala akukanqunywa), isikhathi sokukhulelwa nokuncelisa ibele.
Uma iPioglitazone isetshenziswe ngendlela engafanele noma nganoma yisiphi esinye isizathu, isiguli singathola ukusabela okulandelayo okulandelayo:
- i-hypoglycemia - ukwehla ngokushesha kweglucose yegazi;
- ukuvuvukala, kanye nokuhlanganiswa ne-insulin kukhulisa ubungozi bokuvuvukala kufike ku-15,3%;
- i-anemia - i-hemoglobin ephansi egazini lomuntu;
- ukwehla kwezinga le-bilirubin;
- ukwehla kwe-alanine aminotransferase (ALT) - i-enzyme ye-hypogenic;
- ukwehlisa i-aspartate aminotransferase (AST) - i-enzyme ebhekele ukwakheka kwama-amino acid;
- ukwehla kwe-alkaline phosphatase (ALP) - i-enzyme echitha ama-phosphates kusuka kumaprotheni, ama-alkaloids, njll;
- kuncishiswe ukudluliswa kwe-gamma glutamyl.
Ngaphezu kwalokho, amalungiselelo wokuhlanganisa aqukethe i-sulfonamide derivatives, i-metformin, i-insulin, iholela ku-hypoglycemia.
Futhi, uma isetshenziswa, umphumela wokwehlisa ukusebenza kwezindlela zokuvimbela inzalo ngomlomo ungasebenza.
Ukubuyekezwa, okuhle nokubi
Ukubuyekezwa kweziguli eziningi ezisebenzisa ama-Aktos, uPioglar nezinye izidakamizwa, zinhle kakhulu. Phakathi kwezinzuzo, kungenzeka ukugqamisa ukusebenza kokunciphisa ukumelana kwe-insulin phakathi kwazo zonke izidakamizwa ezinciphisa ushukela ezithathwa ngomlomo.
Kepha kunezinkinga ezithile ze-glitazones, eziboniswa kokulandelayo: zingaphansi kwezidakamizwa eziqukethe i-metformin ne-sulfonylurea, i-hemoglobin incishiswa ngo-0,5-1,5%, uma isetshenziswa, inzuzo eyisisindo eyi-1-3 kg ibonwa ngenxa yokuqongelela kwamafutha nokugcinwa kwamanzi emzimbeni.
Ngakho-ke, ngaphambi kokuthatha i-glitazones, udinga ukubonana nodokotela futhi ufunde ukubuyekezwa kweziguli esezivele zizisebenzisile.
Isiguli sithatha into i-Pioglitazone, intengo yaso encike kulo muthi, kufanele sinqume ukuthi iliphi ikhambi okufanele silisebenzise. Izindleko ezijwayelekile zamacwecwe kaPioglar (izingcezu ezingama-30 zama-30 mg ngayinye) ngama-ruble ayi-1083, ama-Actos (izingcezu ezingama-28 zama-30 mg ngayinye) ngama-ruble ayi-3000. Ngokuyinhloko, umuntu osezingeni eliphakathi nendawo uyakwazi ukukhokhela lezi zidakamizwa. Izindleko zabo eziphakeme zenzeka ngenxa yokuthi le mithi ingeniswa kwamanye amazwe, iPioglar ikhiqizwa eNdiya, e-Actos - e-Ireland.
Akubizi kakhulu izidakamizwa ezenziwa eRussia. Lokhu kufaka phakathi:
- Izinkambiso zikaDeveli;
- I-Astrozone;
- I-Diaglitazone.
Uma sisetshenzisiwe, umphumela we-hypoglycemic uzonikezwa. I-Diaglitazone, ebiza isilinganiso sama-ruble angama-295, ingaba indawo enhle kwezinye izidakamizwa ezibizayo. I-Astrozone ne-Diab-ejwayelekile inezinto ezifanayo ezifanayo eziphikisayo nemiphumela emibi.
I-Diagnitazone inganciphisa ukusebenza kahle kokusebenzisa inzalo yomlomo, okufanele icatshangelwe.
I-pioglitazone analogues
Ngenxa yokungabekezeleli nemiphumela emibi, ukusetshenziswa kwePioglitazone kungavinjelwa. Ngakho-ke, udokotela unquma ezinye izidakamizwa eziqukethe i-rosiglitazone.
Le nto ifakiwe futhi eqenjini le-thiazolidinediones (glitazones). Uma uwusebenzisa, umphumela ofanayo uzokhishwa njengowususelwa ku-pioglitazone, okuwukuthi, ukukhuthaza amaseli nezicubu receptors ukuqeda ukumelana ne-insulin.
Izidakamizwa eziphambili eziqukethe i-rosiglitazone yilezi:
- Avandia
- Qoqa.
Ngaphambi kokuzisebenzisa, udinga ukubonana nodokotela bese ufunda imiyalo yokusebenzisa.
Ukulungiswa kweBiguanide kunciphisa ukumelana ne-insulin. I-Metformin, eyingxenye yomkhiqizo, yehlisa ukukhiqizwa koshukela isibindi. Sebenzisa lezi zidakamizwa ngokuqapha, ngoba ama-biguanides athinta kabi ukusebenza kwenhliziyo asebekhulile, umphumela ongemuhle ekusebenzeni kwezinso nasekuthuthukisweni ngenxa ye-lactic acidosis nakho kungahunyushwa. Ukulungiselela nge-metformin esebenzayo yezinto kufaka iBagomet, iGlucofage, Metformin-BMS, i-NovoFormin, iSiofor nabanye.
Futhi kwehlisa ushukela wegazi i-Acarbose. Indlela esebenza ngayo ihlose ukuvimbela ama-enzyme asiza ukuhlanganisa ama-carbohydrate emgodini wokugaya ukudla. I-Hypoglycemia kungenzeka ngokusetshenziswa okwengeziwe kwezinye izidakamizwa ne-insulin. Ukuvimbela ukuvela kwemiphumela emibi ehambisana nokugayeka, kungcono ukuqala ukuthatha ngemithamo emincane.
Ekwelashweni kwesifo sikashukela sohlobo 2, izidakamizwa eziqukethe i-pioglitazone noma i-analogues yayo, noma ngabe i-Diaglitazone noma iMetformin, singasetshenziswa. Njengoba le mithi iqukethe inani elikhulu kakhulu le-contraindication nemiphumela emibi, kunconywa kakhulu ukuyisebenzisa ngemuva kokubonisana nesifo sikashukela. nodokotela. Ividiyo ekulesi sihloko ifingqa ingxoxo ngayo
