Muva nje, isigaba esisha sabenzeli be-hypoglycemic abanomphumela ohlukile ngokuyisisekelo sitholakele kwabanesifo sikashukela eRussia. Umuthi wokuqala weForig sohlobo 2 sikashukela wabhaliswa ezweni lethu, kwenzeka ngonyaka we-2014. Imiphumela yezifundo zalo muthi iyahlaba umxhwele, ukusetshenziswa kwayo kunganciphisa kakhulu umthamo wezokwelapha, futhi kwezinye izimo ngisho nokufaka ngaphandle imijovo ye-insulin ezimweni ezinzima zesifo.
Ukubuyekezwa kwe-endocrinologists kanye neziguli kuxutshwe. Omunye ujabule ngamathuba amasha, abanye bakhetha ukulinda kuze kube yimiphumela yokuphuza umuthi isikhathi eside.
Ngabe isidakamizwa iForig sisebenza kanjani
Umphumela wesidakamizwa i-Forsig ususelwa ekhonweni lezinso lokuqoqa ushukela egazini futhi ulisuse umchamo. Igazi emzimbeni wethu lingcoliswa njalo yimikhiqizo ye-metabolic nezinto ezinobuthi. Indima yezinso ukuhlunga lezi zinto bese uzisusa. Kulokhu, igazi lidlula ku-renal glomeruli kaningi ngosuku. Esigabeni sokuqala, izingxenye zamaprotheni egazi kuphela azidluleli kusihlungi, lonke lonke uketshezi lungena kwi-glomeruli. Lona okuthiwa umchamo oyinhloko, amashumi wamalitha akhiwa phakathi nosuku.
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Ukuze ube yisibili futhi ufake i-bladder, uketshezi oluhlungiwe kumele lugxile kakhulu. Lokhu kutholakala esigabeni sesibili, lapho zonke izinto eziwusizo - i-sodium, i-potassium, nezinto zegazi - zidonswa zibuyiselwa egazini kwifomu encibilikisiwe. Umzimba futhi ubheka i-glucose iyadingeka, ngoba yiwona mthombo wamandla wemisipha nobuchopho. Amaprotheni akhethekile we-SGLT2 transporter awubuyisela egazini. Bakha uhlobo lomhubhe ku-tubule ye-nephron, lapho ushukela udlulela egazini. Kumuntu ophile kahle, i-glucose ibuya ngokuphelele, esigulini esinesifo sikashukela, ingena ngokuchama umchamo lapho izinga laso lidlula umkhawulo wezinhlungu we-9-10 mmol / L.
Umuthi i-Forsig watholakala sibonga izinkampani ezenza amakhemikhali zifuna izinto ezingavala le mihubhe zivimbele noshukela emchameni. Ukucwaninga kuqale ngekhulu leminyaka eledlule, kwathi ekugcineni, ngonyaka ka-2011, uBristol-Myers squibb no-AstraZeneca bafaka isicelo sokubhalisa umuthi omusha oyisisekelo ukwelapha isifo sikashukela.
Into esebenzayo yeForigi yi-dapagliflozin, iyi-inhibitor yamaprotheni e-SGLT2. Lokhu kusho ukuthi uyakwazi ukucindezela umsebenzi wabo. Ukuqunjelwa ushukela okuvela kumchamo oyinhloko kuyancipha, kuqala ukudalulwa izinso ngamanani akhuphukayo. Ngenxa yalokhu, izinga legazi lehla ushukela, isitha esiyinhloko semithambo yegazi futhi imbangela enkulu yazo zonke izinkinga zesifo sikashukela. Isici esiyingqayizivele se-dapagliflozin ukukhetha kwaso okuphezulu, cishe akunawo nomthelela kwabahambisa ushukela ezinhlinini futhi kungaphazamisi ukumuncwa kwaso esiswini.
Kumthamo ojwayelekile womuthi, cishe i-80 g yeglucose ikhishwa umchamo ngosuku, ngaphezu kwalokho, kungakhathalekile ukuthi inani le-insulini elikhiqizwa ama-pancreas, noma elitholwe ngomjovo. Akuthinti ukusebenza ngempumelelo kweForigi kanye nokuba khona kokuphikiswa kwe-insulin. Ngaphezu kwalokho, ukwehla kokuxineka koshukela kusiza ukudlula koshukela osele ngokusebenzisa ulwelwesi lweseli.
Kukuziphi izimo abelwe zona
I-Forsyga ayikwazi ukususa lonke ushukela okweqile ngesikhathi sokudla okungalawulwa kwama-carbohydrate ekudleni. Ngokuqondene namanye ama-ejenti we-hypoglycemic, ukudla kanye nokuzivocavoca umzimba phakathi nokuwusebenzisa kuyimfuneko. Kwezinye izimo, i-monotherapy enalesi sidakamizwa kungenzeka, kodwa iningi lama-endocrinologists kaningi libeka iForig kanye neMetformin.
Ukuqokwa komuthi ezimeni ezilandelayo kunconyiwe:
- ukwenza lula ukuncipha kweziguli ezinesifo sikashukela sohlobo 2;
- njengethuluzi elingeziwe uma kungenzeka ukugula kakhulu;
- ukulungiswa kwamaphutha avamile ekudleni;
- phambi kwezifo eziphazamisa ukusebenza komzimba.
Ukwelashwa kwesifo sikashukela sohlobo 1, lesi sidakamizwa asivunyelwe, ngoba inani le-glucose elisetshenziswa ngosizo lwalo liyahlukahluka futhi kuya ngezici eziningi. Akunakwenzeka ukubala ngokufanele umthamo odingekayo we-insulin ezimeni ezinjalo, ogcwele i-hypo- ne-hyperglycemia.
Naphezu kokusebenza okuphezulu nokubuyekezwa okuhle, i-Forsiga ayikatholi ukusatshalaliswa okubanzi. Kunezizathu eziningana zalokhu:
- inani layo eliphakeme;
- isikhathi esanele sokutadisha;
- ukuvezwa kuphela uphawu lwesifo sikashukela, ngaphandle kokuthinta izimbangela zaso;
- imiphumela emibi yesidakamizwa.
Imiyalo yokusebenzisa umuthi
IForig iyatholakala ngesimo samathebhulethi ayi-5 no-10 mg. Umthamo onconywayo wansuku zonke lapho kungekho khona ama-contraindication uhlala njalo - 10 mg. Umthamo we-metformin ukhethwa ngamunye. Lapho kutholwa isifo sikashukela, i-Forsigu 10 mg ne-500 mg ye-metformin ngokuvamile ibekwa, emva kwalokho umthamo wokugcina ulungiswa ngokuya ngezinkomba ze-glucometer.
Isenzo sephilisi sithatha amahora angama-24, ngakho-ke umuthi uthathwa kuphela 1 ngosuku ngosuku. Ukufakwa ngokuphelele kwe-Forsigi akuxhomekile ekutheni umuthi wawudakwe yini esiswini esingenalutho noma ngokudla. Into esemqoka ukuwaphuza ngenani elanele lamanzi futhi uqinisekise ngezikhathi ezilinganayo phakathi kwemithamo.
Umuthi uthinta umthamo wansuku zonke womchamo, ukuze ususe ama-80 g kashukela, cishe u-375 ml koketshezi kuyadingeka. Lokhu cishe uhambo lokuya endlini yangasese olulodwa. Uketshezi olulahlekile kufanele luthathelwe indawo ukuvikela ukonakala. Ngenxa yokuqedwa kwengxenye yeglucose lapho uthatha umuthi, okuqukethwe okuphelele kwekhalori kuncishiswa cishe amakhalori angama-300 ngosuku.
Imiphumela emibi yesidakamizwa
Lapho kubhaliswa i-Forsigi e-US naseYurophu, abakhiqizi bayo bahlangabezana nobunzima, ikhomishini ayizange ivume lesi sidakamizwa ngenxa yokwesaba ukuthi ingabangela isimila esigaxeni. Ngesikhathi sokuvivinywa komtholampilo, lokhu kucatshangelwa kwenqatshwa, izidumbu ze-carcinogenic azidalulwanga eForigi.
Kuze kube manje, kunedatha evela ezifundweni ezingaphezu kweshumi eziqinisekisile ukuphepha okuhlobene kwalesi sidakamizwa namandla ayo okunciphisa ushukela wegazi. Uhla lwemiphumela emibi kanye nemvamisa yokuvela kwayo kuyenziwa. Yonke imininingwane eqoqwe isuselwa ekuphuzeni okwesikhashana kwesidakamizwa i-Forsig - cishe izinyanga eziyisithupha.
Akukho datha emiphumeleni yokusebenzisa umuthi isikhathi eside okuqhubekayo. Izazi ze-Nephrologists ziveza ukukhathazeka ngokuthi ukusetshenziswa isikhathi eside kwalo muthi kungathinta ukusebenza kwezinso. Ngenxa yokuthi baphoqeleka ukuthi basebenze ngokugcwala ngokweqile, izinga lokuhlunga le-glomerular lingase lehlise futhi umthamo wokuphuma komchamo ungancipha.
Imiphumela emibi ekhonjwe kuze kube manje:
- Lapho kunqunywe njlwwe njengethuluzi elengeziwe, ukwehla ngokweqile ushukela wegazi kungenzeka. I-hypoglycemia ebhekelwe imvamisa imnene.
- Ukuvuvukala kohlelo lwe-genitourinary olubangelwa izifo.
- Ukwanda kwenani lomchamo kungaphezu kwenani elidingekayo ukususa ushukela.
- Amanani akhuphukayo e-lipids ne-hemoglobin egazini.
- Ukukhula kwegazi le-creatinine okuhambisana nomsebenzi wokuphazamiseka wezinso ezigulini ezingaphezulu kweminyaka engama-65.
Ngaphansi kwe-1% yeziguli ezinesifo sikashukela, umuthi ubangela ukoma, ukuncipha kokuncipha, ukuqunjelwa, ukujuluka ngokweqile, ukuchama njalo ebusuku.
Ukuqwashisa okukhulu kodokotela kubangelwa ukukhula kwezifo zomkhakha wezitho zofuzo ngenxa yokusebenzisa iForigi. Le mphumela wecala uvame impela - ezigulini ezingama-4,8% ezinesifo sikashukela. I-6.9% yabesifazane bane-vaginitis yomsuka wamagciwane nowokungunda. Lokhu kuchazwa yiqiniso lokuthi ushukela okhuphukile uvusa ukwanda okushesha kwamagciwane ku-urethra, umchamo kanye nesitho sangasese sowesifazane. Ekuvikeleni umuthi, kungashiwo ukuthi lezi zifo ikakhulukazi zinobumnene noma zilinganisela futhi ziphendula kahle ekwelashweni okujwayelekile. Kaningi kwenzeka ekuqaleni kokudla kwe-Forsigi, futhi akuvamile ukuphindwa ngemuva kokwelashwa.
Imiyalo yokusebenzisa umuthi ihlala iqhubeka nezinguqukoezihambisana nokutholwa kwemiphumela emisha emisha kanye ne-contraindication. Isibonelo, ngoFebhuwari 2017, kukhishwe isexwayiso sokuthi ukusetshenziswa kwe-SGLT2 inhibitors kukhulisa ubungozi bokunqunywa kwezinzwane noma ingxenye yonyawo amahlandla ama-2. Imininingwane ebuyekeziwe izovela kwimiyalo yesidakamizwa ngemuva kwezifundo ezintsha.
Contraindication Forsigi
Contraindication yokwamukelwa yile:
- Thayipha i-mellitus yesifo sikashukela esingu-1, ngoba kungenzeka ukuthi i-hypoglycemia enkulu ingabandakanywa.
- Isikhathi sokukhulelwa nokukhulelwa, iminyaka efinyelela eminyakeni eyi-18. Ubufakazi bokuphepha kwalesi sidakamizwa kwabesifazane abakhulelwe nezingane, kanye nokuthi kungenzeka ukuthi kudalulwe ubisi lwebele, akukatholakali.
- Iminyaka engaphezu kweminyaka engama-75 ngenxa yokwehla komzimba emsebenzini wezinso kanye nokwehla kokujikeleza kwegazi.
- Ukungabekezelelani kwe-lactose, kuyinto esetshenziswayo njengengxenye yethebhulethi.
- Allergy kudayi asetshenziselwa amaphilisi egobolondo.
- Ukunyuka kokuhlushwa egazini lemizimba ye-ketone.
- I-nephropathy yesifo sikashukela enokwehla kwezinga lokuhlunga lama-glomerular ukuya kuma-60 ml / min noma ukwehluleka kakhulu kwe-renal engahlobene nesifo sikashukela mellitus.
- Ukuthola i-loop (furosemide, torasemide) ne-thiazide (dichlothiazide, polythiazide) diuretics ngenxa yokwanda komphumela wazo, okugcwala ukuncipha kwengcindezi nokuphelelwa ngamandla komzimba.
Ukwemukelwa kuvunyelwe, kepha ukuqapha nokungezelela ukwelashwa kuyadingeka: iziguli esezikhulile ezinesifo sikashukela, abantu abane-hepatic, inhliziyo noma ukuhluleka kwethambo okubuthakathaka, izifo ezingalapheki.
Ukuhlolwa kwemiphumela yotshwala, i-nicotine nemikhiqizo ehlukahlukene yokudla umphumela womuthi akukenziwa.
Ngabe kungasiza ukwehlisa isisindo
Esichasisweni somuthi, umenzi we-Forsigi wazisa ngokwehla kwesisindo somzimba okubonakala ngesikhathi sokuphatha. Lokhu kuyabonakala ikakhulukazi ezigulini ezinesifo sikashukela i-mellitus esinokukhuluphala. I-Dapagliflozin isebenza njenge-diuretic emnene, inciphisa iphesenti uketshezi emzimbeni. Ngobunzima obukhulu kanye nokuba khona kwe-edema, lokhu kususwa kilo-3-5 kg wamanzi ngeviki lokuqala. Umphumela ofanayo ungatholwa ngokushintshela ekudleni okungenawo usawoti futhi umane unciphise inani lokudla - umzimba ngokushesha uqala ukukhipha umswakama ongadingekile.
Isizathu sesibili sokunciphisa isisindo ukwehla kilojoule ngenxa yokususwa kwengxenye yeglucose. Uma u-80 g we-glucose ukhishwa umchamo ngosuku, lokhu kusho ukulahleka kwamakhalori angama-320. Ukulahlekelwa ikhilogremu yesisindo ngenxa yamafutha, udinga ukususa amakhalori angama-7716, okungukuthi, ukulahlekelwa i-1 kg kuzothatha izinsuku ezingama-24. Kucace bha ukuthi iForig izosebenza kuphela uma kunokuntuleka komsoco. Ngokuqina, ukuncipha kwesisindo kuzofanela kunamathele ekudleni okunqunyiwe futhi ungakhohlwa ngokuqeqeshwa.
Abantu abaphilile akufanele basebenzise i-Forsigu ukunciphisa umzimba. Lesi sidakamizwa sisebenza kakhulu ngamazinga eglucose aphezulu. Ukusondela kakhulu kokujwayelekile, kuhamba kancane umphumela womuthi. Ungakhohlwa ngokucindezelwa ngokweqile kwezinso nokuhlangenwe nakho okwanele ngokusetshenziswa komuthi.
I-Forsyga itholakala kuphela ngomuthi futhi ihloselwe kuphela iziguli ezinesifo sikashukela sohlobo 2.
Ukubuyekezwa kweziguli
I-endocrinologist ibeke kimi i-Forsig nokudla kuphela kimi, kodwa ngesimo sokuthi ngiyolandela imithetho ngokuqinile futhi ngibe khona njalo emukelweni. IGlucose esegazini inciphile kahle, ifinyelela ezinsukwini eziyi-7 kwezingu-10. Manje sekuyizinyanga eziyisithupha, angikaze ngibekelwe ezinye izidakamizwa, ngizizwe ngiphilile, ngilahlekelwe ngama-10 kg ngalesi sikhathi. Manje emhlanganweni omkhulu: Ngifuna ukuthatha ikhefu ekwelashweni futhi ngibone ukuthi ngingakwazi yini ukugcina ushukela uqobo, ekudleni kuphela, kepha udokotela akakuvumeli lokho.
Yini ama-analogues
Umuthi i-Forsig uwukuphela kwesidakamizwa esitholakala ezweni lethu esine-dapagliflosin esetshenziswayo ezweni lethu. Ama-analogues agcwele we-Forsigi yasekuqaleni akhiqizwanga. Njengokuthi ungene esikhundleni, ungasebenzisa noma yiziphi izidakamizwa ezivela esigabeni sama-glyphosines, isenzo saso esuselwe ekuvinjelweni kwabathuthi be-SGLT2. Izidakamizwa ezimbili ezinjalo zedlulisa ukubhaliswa eRussia - uJardins no-Attokana.
| Igama | Into esebenzayo | Umkhiqizi | Umthamo | ~ Izindleko (inyanga yokwamukelwa) |
| I-Forsyga | dapagliflozin | Izinkampani zeBristol Myers squibb, e-USA I-AstraZeneca UK Ltd, UK | 5 mg, 10 mg | 2560 rub. |
| UJardins | empagliflozin | Beringer Ingelheim International, Germany | 10 mg, 25 mg | 2850 rub. |
| Attokana | canagliflozin | UJohnson noJohnson, e-USA | 100 mg, 300 mg | 2700 rub. |
Izintengo ezisondele ku-Forsigu
Inyanga yokuthatha isidakamizwa sikaForig izodla cishe ama-ruble ayizinkulungwane ezimbili. Ukukubeka ngobumnene, akushibhile, ikakhulukazi uma unaka ama-ejenti adingekayo we-hypoglycemic, amavithamini, okudliwayo kweglucometer, kanye noshukela okufaka esikhundleni, okudingekayo kushukela. Esikhathini esizayo esiseduze, lesi simo ngeke sishintshe, ngoba umuthi musha, futhi umakhi ufuna ukuphinda akhokhe imali ebekwe kututhuko nasekucwaningeni.
Ukwehliswa kwentengo kungalindelwa kuphela ngemuva kokukhishwa kwamajenerikhi - imali enokwakheka okufanayo kwabanye abenzi. Ama-analogues ashibhile azovela ngaphambi kuka-2023, lapho ukuvikela kwepatent ka-Forsigi kuphelelwa yisikhathi, futhi umenzi womkhiqizo wokuqala alahlekelwa amalungelo akhe akhethekile.
