Esikhathini sobuchwepheshe bolwazi kanye nezizukulwane ezintsha zemithi ye-antidiabetic, izidakamizwa zakudala ezisetshenziswe isikhathi eside zihlala zifunwa. Okuthandwa kakhulu yilezo ezishukumisa ama-pancreas ukukhiqiza i-insulin eyengeziwe. Sikhuluma ngokutholakala ochungechungeni lwe-sulfonylurea kanye ne-nesulfanylurea secretagogues - i-ironides.
I-Repaglinide nayo ingeyeqembu lokugcina. Umehluko wayo omkhulu ngomphumela esigabeni sokuqala sokukhishwa kwe-hormone ungene egazini, lapho ngemuva kokudla egazini kuba nokugxuma okubukhali emazingeni kashukela, kanti nomzimba wesifo sikashukela (onalesi sifo sesibili) awukwazi ukubhekana nakho.
Ngemuva kokufunda imiyalo, ukala konke okuhle nokubi, ungaxoxa nodokotela wakho ngohlobo lwakho lokwelashwa sikashukela.
Ukwakheka nokuchazwa kwalo muthi
Ithebhulethi ngayinye iqukethe i-0.5 noma i-1 mg yesakhi esisebenzayo se-micagised repaglinide efakwe izithako ezisizayo: i-calcium hydrogen phosphate anhydrous, i-colloidal silicon dioxide, i-microcrystalline cellulose, i-croscarmellose sodium, i-hydroxypropyl cellulose, i-meglumine, i-magnesium stearate, kanye nodayi.
Amaphilisi we-biconvex ajikelezayo angakhonjwa ngokuqoshwa kwezinombolo ezibonisa umthamo. Ngomaka ka-0.5, mhlophe, ane-1 mg - i-lavender noma ephuzi. Ngasemuva ungabona isifinyezo RP, J nabanye. Amathebhulethi ayi-10 ahlanganiswe emabhulini. Kuzoba namathafa amaningi anjalo ebhokisini lekhadibhodi.
Umuthi kadokotela otholakalayo. Intengo yeRepaglinide isabelomali impela: Amathebulethi angama-30 we-2 mg eMoscow angathengwa ama-ruble angama-200-220. Bakhipha umuthi eDenmark, kwa-Israyeli, eNdiya nakwamanye amazwe, kubandakanya nasendaweni yangemva kweSoviet.
Impilo yeshalufini yesidakamizwa, emenyezelwe ngumenzi, imaphakathi neminyaka emi-3. Umuthi awudingi izimo ezikhethekile zokugcinwa. Ngemuva kwesikhathi esibekiwe, amaphilisi kufanele alahlwe.
Izici ze-Pharmacological
Umphumela oyinhloko wesidakamizwa yi-hypoglycemic. Izidakamizwa zivimba amashaneli we-potassium athembele ku-ATP atholakala kulolusizi lwe-b-cell, anomthelela ekudumeni kwawo nasekukhishweni kweziteshi ze-calcium. Ngakho-ke, i-secretagogue ibamba ukuthathwa kwama-hormone.
Izifundo zemitholampilo azitholanga imiphumela ye-mutagenic, teratogenic, carcinogenic ezilwaneni nokuzala okulimazayo.
I-Repaglinide idonswa ngokushesha futhi ngokuphelele kusuka ohlelweni lokugaya ukudla, ifinyelela esiphezulu sayo egazini ngehora.
Uma kudliwa ngokudla, i-Cmax incishiswa ngo-20%. Iqoqo lomuthi lehla ngokushesha bese kuthi ngemuva kwamahora amane lifinyelele umaki omncane. Umuthi ubopha amaprotheni e-plasma cishe ngokuphelele (kusuka ku-98%) nge-bioavailability ka-56%. I-Biotransformation nokwakhiwa kwama-inert metabolites kwenzeka esibindini.
Umuthi uqedwa emahoreni ayi-4-6 nempilo yehora le-1. Ku-90% udlula emigudwini ye-bile, cishe ama-8% akhishwa yizinso.
IRepaglinide yenzelwe bani?
Umuthi wenzelwe ukulawula isifo sikashukela sohlobo 2 uma ukuguqulwa kwendlela yokuphila (ukudla okune-carb ephansi, imithwalo eyanele yemisipha, ukulawulwa kwesimo somzwelo) kunganikeli ngokuphelele ukulawula kwe-glycemic.
Kungenzeka ukusebenzisa i-glinide ekwelapheni okuyinkimbinkimbi nge-metformin ne-thiazolidatediones, uma i-monotherapy, ukondleka okwelaphayo kanye nomsebenzi womzimba kunganikeli ngomphumela oyifunayo.
Kuphikiswa ubani i-Repaglinide
Ngaphezu kwemikhawulo yendabuko (ukungabekezelelani ngakunye, ukukhulelwa, izingane, ukuncelisa ibele), umuthi uphuliwe:
- Isifo sikashukela esinesifo sohlobo 1;
- Nge-ketoacidosis yesifo sikashukela;
- Isesimweni sokuthokomala nokucacile;
- Uma isiguli sinezinkinga ezinzima zezinso kanye nesibindi;
- Ezimweni ezidinga ukushintshwa kwesikhashana kwe-insulin (ukutheleleka, ukuhlukumezeka, ukuhlinzwa).
Kufanele kubhekwe ikakhulukazi ekunqumeni ama-glinides kwabaphuza kakhulu, abantu abanesifo sezinso esingapheli, nomkhuhlane.. Kunemikhawulo yeminyaka: unganikeli umuthi kubantu abanesifo sikashukela ngaphambi kweminyaka eyi-18 nangemva kweminyaka engama-75 ngenxa yokushoda kobufakazi bale mikhakha.
Indlela yokusebenzisa
Okwe-repaglinnid, imiyalo yokusebenzisa itusa ukuthatha iphilisi kuqala (ngaphambi kokudla). Udokotela uzokhetha umthamo odingekayo wokulawulwa kwe-glycemic efanelekile ngokuhambisana nemiphumela yokuhlaziywa, isigaba sesifo, i-pathologies ehambisanayo, iminyaka, ukusabela komzimba komuntu ngamunye kubumba.
Ukucacisa umthamo omncane wolwelwesi, kuyadingeka ukulawula ushukela olambile nowokubeletha ekhaya naselebhu. Lapho ulungisa izinkambiso zomuthi, ziqondiswa futhi izinkomba ze-glycated hemoglobin.
Ukuqapha kuyadingeka ukukhomba ukwehluleka okuyisisekelo nokwesibili, lapho izinga le-glycemia liwela ngaphansi kwesijwayelekile ekuqaleni kwekhosi noma ngemuva kwesikhathi sokuqala sokwelashwa.
Isikhathi sokuthatha i-repaglinide asisiqinile: imizuzu eyi-15 kuya kwengama-30 ngaphambi kokudla noma ngokushesha ekuqaleni kokudla. Uma kufakwe i-snack eyodwa (noma yeqa), kufakwe elinye iphilisi (noma leqa).
Uma umuntu onesifo sikashukela engakayitholi imishanguzo enciphisa ushukela, umthamo wokuqala wobumba kufanele ube omncane - 0.5 mg ngaphambi kokudla ngakunye. Uma eshintsha ukuphindisela omunye umuthi we-antidiabetes, ungaqala ngo-1 mg ngaphambi kokudla ngakunye.
Ngokwelashwa kwesondlo, umthamo onconyiwe awudluli ku-4 mg ngaphambi kokudla okuyinhloko. Ukudla okwenziwe nsuku zonke ngobumba akumele kudlule ku-16 mg.
Ngokulashwa okuyinkimbinkimbi, umthamo we-repaglinide awuguquki, futhi izinkambiso zezinye izidakamizwa zikhethiwe ngokuya ngokufundwa kwe-glucometer kanye nerejimeni yangaphambili yokwelapha.
Imiphumela engathandeki
Ezimweni ezibucayi ezibucayi eziguqukayo ezibonakala ngama-glinids, i-hypoglycemia iyingozi ikakhulukazi. Lapho enquma umuthi, udokotela kufanele azise iziguli ngezimpawu nezindlela zalo zosizo lokuqala nokuzinakekela ohlukunyeziwe.
Phakathi kwezinye izehlakalo ezingabikwa:
- Ukuphazamiseka kwe-dyspeptic;
- Ukwephulwa kwesigqi sokunyakaza kwamathumbu;
- Ukuqhuma kwesikhumba se-allergic;
- Ukudonswa kwesibindi ngesimo sokwanda kwe-transistor emsebenzini wama-transaminases;
- Ukulimazeka okubukwayo ngenxa yokuhluka kwezinga le-glycemic.
Imiphumela Yokusebenzelana Kwezidakamizwa
Ngokusetshenziswa okufanayo kwe-repaglinide nge-β-blockers, i-ACE inhibitors, i-chloramphenicol, iziphuzo ezidakayo, i-MAO inhibitors, i-anticoagulants engaqondile i-NSAIDs, i-probenecid, ama-salicylates, ama-sulfonamides, ama-anabolic steroid, ukusebenza kokukhuphuka kobumba.
Ukuphathwa kanyekanye kwama-repaglinide kanye ne-calcium blockers, i-corticosteroids, i-thiazide diuretics, isoniazid, i-nicotinic acid emthanjeni ongeyona ejwayelekile, i-estrogen (equkethe izindlela zokuvimbela inzalo), ama-sympathomimetics, ama-phenothiazines, ama-phenytoin, ama-hormone e-thyroid anciphisa amandla e-glinides.
Siza ngokweqile
Lesi simo singabonakala ku:
- Isifiso esingalawulwa;
- Ukukhathala;
- Ukwehla okukhulu;
- Ukwanda kokukhathazeka;
- Izinkinga zokulala;
- Ushintsho ekushintsheni kokuziphatha (isimo esifana nokudakwa kotshwala);
- Ukukhubazeka kwenkulumo nokubukwa;
- Ukuntuleka kokuxhumana nokunaka;
- Ukwazi ukudideka;
- Isikhumba esiphuzi;
- I-Tachycardia;
- Imisipha imisipha;
- Ukujuluka ngokweqile;
- Ukuhluleka, i-coma.
Ukusizwa kohlukunyezwayo kuyimpawu futhi kuyasekela. Uma umuntu onesifo sikashukela eyazi, kudingeka anikezwe ama-carbohydrate asheshayo (ushukela, uswidi), ngemuva kwesikhashana, umzimba ugcwele ushukela kufanele uphindwe, ngoba kungenzeka ukuthi abuyele emzimbeni.
Uma isiguli singenazimpawu zokungazi, ikhambi le-glucose (50%) liphathwa ngaphakathi, ukuze kulondolozwe izinga le-glycemic ngenhla le-5.5 mmol / l, kufakwa i-dropper ene-10% glucose solution. Ezimweni ezimbi kakhulu, ukulashwa esibhedlela okuphuthumayo kuyadingeka.
Izincomo ezingeziwe
Ukunakwa ikakhulukazi (ukulawulwa kokuzila ukudla okushukela noshukela we-postprandial, ukusebenza kwezitho ezihlosiwe) lapho kunqunywa ubumba kuyadingeka ngabanesifo sikashukela nge-renal kanye ne-hepatic pathologies. Kufanele bazi ukuthi uma wephula imithamo kanye nohlobo lomuthi, ukusetshenziswa kotshwala, ukudla okunama-khalori aphansi, ukugcwala kwemisipha, ukucindezela, kuyadingeka ukulungisa umthamo we-repaglinide, ngoba lezo zimo zingavusa i-hypoglycemia.
Mayelana nemiphumela emibi kakhulu, kufanele kuqashelwe lapho ushayela izimoto nemishini eyinkimbinkimbi, eyingozi, lapho usebenza ezindaweni eziphakeme, njll.
Ukuvimbela i-hypoglycemia, abanesifo sikashukela abanezimpawu ezibuthakathaka zangaphambi kwangaphambi kwalokho, kanye nalabo abanezimo ezinjengalezi akujwayelekile, kufanele kuthathwe izinyathelo zokuhlola kuqala, kuhlolwa ubungozi obukhona kanye nokuthi kungenzeka kwabo.
Repaglinide - analogues
I-Repaglinide ikhishwa ngaphansi kwamagama ahlukahlukene okuhweba: I-NovoNorm, i-Diclinid, i-Iglinid, ne-Repodiab.
Ngokwekhodi ye-ATX yezinga 4, ama-antidiabetic agents eBayeta injekishini esebenza nawo exenatide kanye neViktoza ngesithako se-liraglitide esebenzisana naso.
Abanye abantu abanesifo sikashukela babheka lesi sifo sabo njengokungaqondi kahle, bangaqapheli ukuthi lesi sifo esibi singathumela komunye umhlaba nganoma yisiphi isikhathi.
I-Repaglinide yi-ejenti ebaluleke kakhulu ye-hypoglycemic, ukuzama ukuzibeka kanye nokufaka esikhundleni sayo kuyingozi empilweni, ngoba umuthi uthatha isinyathelo ngokushesha, nohlu olubucayi lwe-contraindication kanye nemiphumela emibi. Uma kutholakala ukuthi unesifo sikashukela i-mellitus, kudingeka welashwe kakhulu, ngaphandle kokubekeka kuze kube ngokuhamba kwesikhathi.
Ezinketho zokwelashwa zokwelapha isifo sikashukela sohlobo 2 zingatholakala kuvidiyo.
