Uhla lwezidakamizwa ezisetshenziswa kushukela alukhawulwanga ku-insulin isikhathi eside.
I-Pharmacology namuhla inikezela ngamathuluzi ahlukahlukene wokusiza ukwehlisa ushukela kuhlobo 2 sikashukela. Ingxenye ebalulekile yazo yenziwe ngobuciko, njengePioglitazone (iPioglitazone).
Ukwakheka, ifomu lokukhulula
Umuthi uyaqhubeka uthengiswe ugcwele emabhokisini amakhadibhodi amapuleti amathathu noma ayi-10, aqukethe izibhebhe eziyishumi nambili zomumo oyindilinga nombala omhlophe. Ingxenye esebenzayo ingaqukethelwa kubo ekuhlanganeni kwe-15, 30 noma i-45 mg.
Into esetshenziswayo yesidakamizwa yi-pioglitazone hydrochloride, enciphisa ukuzwela kwesibindi nezicubu esenzweni se-hormone, ngenxa yalokho ukwanda kokusebenzisa ushukela kweglucose, futhi umkhiqizo wayo esibindini uyancipha.
Ngaphezu kwephilisi elikhulu, aqukethe nezinye izinto ezengeziwe:
- i-lactose monohydrate;
- i-magnesium stearate;
- i-hydroxypropyl cellulose;
- calcium carboxymethyl cellulose.
Isenzo se-Pharmacological
I-pioglitazone isho ngomlomo ama-hypoglycemic agents asuselwa ku-thiazolidindine. Umuthi ubandakanyeka ekuphathweni kwe-glucose yegazi ne-lipid metabolism. Ngokunciphisa ukumelana komzimba nezicubu zesibindi ku-insulin, kuholela ekwandeni kokusetshenziswa kwemali kwe-glucose exhomeke nge-insulin kanye nokwehliswa kokukhishwa kwayo kwesibindi.
Kodwa-ke, akadaluli ukukhuthaza okwengeziwe kwe-β-cell of pancreas, ebasindisa ekuguleni okusheshayo. Umphumela womuthi ohlotsheni 2 sikashukela uholela ekwehlekeni kwamazinga egazi kanye ne-glycosylated hemoglobin. Umkhiqizo ungasetshenziswa wedwa noma uhlanganiswe neminye imithi yokwehlisa ushukela.
Ukusetshenziswa kwesidakamizwa kusiza ukwenza ngokwezifiso umzimba we-lipid metabolism, okuholela ekwehleni kwamazinga we-TG kanye nokwanda kwe-HDL ngaphandle kokuthinta i-cholesterol ephelele ne-LDL.
I-Pharmacokinetics
Ukufakwa kwesidakamizwa kwenzeka ohlelweni lokugaya ukudla, le nqubo kwenzeka ngokushesha, ikuvumela ukuthi ubone into esebenzayo egazini isigamu sehora ngemuva kokuthatha umuthi. Ngemuva kwamahora amabili, izinga laso lingaphezulu kwamaphesenti angama-80. Ukwemukelwa ngokudla kubambezela inqubo yokufakwa emzimbeni.
Ukusebenza kwesidakamizwa sekuvele phakathi kwesonto lokuqala lokudla njalo. Ukuqongelela izingxenye zezidakamizwa emzimbeni akwenzeki, ngemuva kosuku kukhishwa ngokuphelele ngohlelo lokugaya nezinso.
Izinkomba kanye ne-contraindication
I-pioglitazone iyanconywa njengendlela yokulawula isifo sikashukela sohlobo 2. Ingasetshenziswa njengesidakamizwa esisodwa, njengoba kuvame ukunqatshelwa abanesifo sikashukela abakhuluphele noma okwahlulelwa uMetformin kuye.
Ngamandla amaningi, umuthi usetshenziswa ekwelapheni okuyinkimbinkimbi kulezi zinhlelo ezilandelayo:
- ukuhlanganiswa okuphindwe kabili nezidakamizwa ze-metformin noma ze-sulfonylurea;
- inhlanganisela kathathu nawo womabili amaqembu ezidakamizwa
Njengoba imibango yile:
- ukuzwela ngokweqile kunoma yiziphi izingxenye zomuthi;
- umlando we-pathologies wezinhliziyo;
- ukungasebenzi kahle kwesibindi;
- thayipha i-1 isifo sikashukela;
- isifo sikashukela sikashukela;
- ukuba khona komdlavuza;
- ukuba khona kwe-macroscopic hematuria yemvelaphi engaqinisekile.
Kulezi zimo, umuthi uthathelwa indawo ngama-analogues anokwakheka okuhlukile nendlela yokwenza okuthile.
Imiyalo yokusebenzisa
Umthamo wezidakamizwa ubekelwe isiguli ngasinye ngawodwana. Lokhu kungukusebenza kukadokotela, okuthi, ngemuva kokuxilongwa, ahlole izinga lomonakalo ogulini bese enza uhlobo lokwelashwa.
Ngokusho kwemiyalo, umuthi uthathwa kanye ngosuku ngomlomo, kungakhathaleki ukuthi kudliwe kangakanani. Kodwa-ke, kungcono ukwenza lokhu ekuseni.
Umthamo wokuqala unconywa ku-15-30 mg, ungakhuphuka kancane kancane ufike ku-45 mg ngokungqongqoza, lokhu kuyinto evamile.
Endabeni yokwelashwa okuhlanganiswa nezinye izidakamizwa ze-hypoglycemic, kuthathwa umthamo ofinyelela kuma-30 mg ngosuku, kepha ungashintshwa ngokuya ngokufundwa kwe-glucometer kanye nesimo sesiguli.
Kubaluleke kakhulu ukukhetha umthamo ofanele lapho uthathwa nge-insulin. Njengomthetho, kunqunywa ku-30 mg ngosuku, ngenkathi ivolumu ye-insulin incishisiwe.
Ukusebenza kwezokwelapha kuhlolwa njalo ezinyangeni ezintathu ngokuhlaziywa kwe-hemoglobin ye-glycated. Uma kungekho miphumela, ukwamukela kuyamiswa.
Iziguli Ezikhethekile Nezinkomba
Kubantu asebekhulile, azikho izidingo zomthamo ezikhethekile. Ibuye iqale ngokuncipha, ikhule kancane kancane.
Ngesikhathi sokukhulelwa, umuthi awuvunyelwe ukusetshenziselwa, umphumela wawo ku-fetus ungaqondakali ngokuphelele, ngakho-ke kunzima ukubikezela imiphumela. Ngesikhathi sokukhulelwa, uma owesifazane edinga ukusebenzisa lo muthi, kufanele wenqabe ukondla ingane.
Iziguli ezinesifo senhliziyo nezemithambo zisebenzisa umthamo omncane, ngenkathi kudingekile ukubheka isimo sezitho zezinkinga ngesikhathi sokuphathwa kwePioglitazone.
Ukuthatha iPioglitazone kungandisa ingozi yokuba nomdlavuza wesinye ngamaphesenti angama-0.06, udokotela okufanele axwayise isiguli futhi asikisele ukwehlisa ezinye izici zobungozi.
Ezigulini ezinokwehluleka kwesibindi okukhulu, umuthi uphambene, futhi ngamandla olinganiselayo, ukusetshenziswa ngokuqapha kungenzeka. Kulokhu, kuyadingeka ukulawula izinga lama-enzyme wesibindi, uma edlula okwejwayelekile kathathu, umuthi ukhanseliwe.
Ividiyo emiphumela yemithi yesifo sikashukela emzimbeni:
Imiphumela emibi kanye ne-overdose
Umphumela omkhulu ongemuhle wokuphuza umuthi yi-hypoglycemia, kepha kuvame ukwenzeka ngokuhlanganiswa okweqisayo noma okungafanele namanye ama-hypoglycemic agents. Kungenzeka futhi ukuthi wehlise i-hemoglobin kanye ne-anemia.
Ukweqisa komuthi kukhonjiswa ku:
- ukuvuvukala, inzuzo yesisindo;
- i-hypersthesia nekhanda;
- ukwephulwa kokuxhumana;
- glucosuria, protenuria;
- vertigo;
- ukwehla kwekhwalithi yokulala;
- ukungasebenzi kwe-erectile;
- ukulimala kokutheleleka ohlelweni lokuphefumula;
- ukwakheka kwezimila zesimo semvelo ehlukahlukene;
- ukukhubazeka;
- ingozi eyengeziwe yokuphuka nokubukeka kobuhlungu emilenzeni.
Ukuxhumana neminye imithi
Ukusetshenziswa kwe-pioglitazone kunganciphisa ukusebenza kwezindlela zokuvimbela inzalo.
Ithuluzi aliguquli umsebenzi walo uma lisetshenziswa ndawonye ne-Digoxin, Metformin, Warfarin Ifenprokumon. Ngasikhathi sinye, izimfanelo zabo azishintshi. Ukusetshenziswa ngasikhathi sinye kwe-sulfonylureas ene-derivatives nakho akuguquki amandla abo.
Umphumela wePioglitazone kuma-blocker calcium blockers, cyclosporins, kanye ne-HMCA-CoA reductase inhibitors awukhonjwa.
Lapho isetshenziswa ndawonye ne-gemfibrozil, i-AUC ye-glitazone iyanda, ikhulisa ubudlelwano bokuhlushwa isikhathi yinto yesithathu. Kulokhu, kuyadingeka ukuqapha isimo sesiguli futhi, uma kunesidingo, silungisa umthamo womuthi.
Ukusetshenziswa okuhlanganayo nge-rifampicin kuholela esenzweni esengeziwe se-pioglitazone.
Amalungiselelo esenzo esifanayo
Ama-analog we-pioglitazone anikezwa emakethe ngezinhlobonhlobo zezinto.
Amathuluzi anokwakheka okufanayo afaka:
- Isidakamizwa saseNdiya uPioglar;
- Izithonjana zaseRussia zeDiaglitazone, i-Astrozone, uDiy-Norm;
- Amacwecwe ase-Ireland ama-Actos;
- IsiCroatia silungisa i-Amalvia;
- I-Pyoglitis;
- UPiouno nabanye.
Yonke le mishanguzo ingeyeqembu lokulungiswa kwe-glitazone, futhi okubandakanya i-troglitazone ne-rosiglitazone, enomshini ofanayo wokusebenza, kodwa ohlukile ngesakhiwo samakhemikhali, ngakho-ke angasetshenziswa lapho i-pioglitazone yenqatshwa umzimba. Zibuye zibe nezinzuzo nezinzuzo zazo, ezitholakala emiyalweni yemithi.
Futhi, ama-analogues anesizinda esehlukile esikhona angasebenza njengama-analogues: I-Glucofage, iSiofor, iBagomet, iNovoFormin.
Kuyaqapheleka ukuthi ukubuyekezwa kweziguli ezisebenzisa iPioglitazone nama-generics ayo kuhlukile. Ngakho-ke, maqondana nomuthi uqobo, iziguli ziphendula kakhulu, zithola inani elincane lemiphumela emibi.
Ukwemukelwa kwama-analogues kuvame ukuhambisana nemiphumela emibi, njengokuqina kwesisindo, i-edema, kanye nokwehla kwamazinga e-hemoglobin.
Njengoba umkhuba ukhombisa, umuthi empeleni uholela ekwehleni kwamazinga kashukela futhi usetshenziswe ngempumelelo ekwelapheni isifo sikashukela sohlobo 2. Noma kunjalo, kubalulekile ukukhetha umuthi ofanele kanye nomthamo ofanele.
Amanani akhona
Njengoba ithuluzi lingakhiqizwa ngaphansi kwamagama ahlukile, kuye ngomkhiqizi, izindleko zalo ziyehluka kakhulu. Thenga iPioglitazone kumakhemisi asekhaya ngendlela yawo emsulwa iyinkinga, isetshenziswa ngendlela yezidakamizwa namanye amagama. Kutholakala ngaphansi kwegama lePioglitazone Asset, izindleko zazo kumthamo we-45 mg zisukela kuma-ruble ayizinkulungwane ezimbili.
I-pioglar izobiza ama-ruble angama-600 kanye nama-ruble ambalwa wamathebulethi angama-30 ngomthamo we-15 mg futhi ebiza kancane kunenkulungwane ngenani elifanayo ngomthamo ka-30 mg.
Intengo yama-Aktos, emiyalweni lapho kunqunyelwe khona into efanayo esebenzayo, isuka kuma-ruble angama-800 nama-3000.
I-Amalvia izobiza ama-ruble angama-900 ngomthamo ongu-30 mg, kanye ne-Diaglitazone - kusuka kuma-ruble angama-300 umthamo ka-15 mg.
Intuthuko yanamuhla yamakhemikhali yenza ukuba kube nokwenzeka ukufeza imiphumela engcono emkhakheni wokuqapha nokulungisa amazinga kashukela egazini. Ukusetshenziswa kwezidakamizwa zesimanje kungafinyelela lokhu ngokushesha nangendlela efanele, yize kungenazo izithiyo, okudingeka wazi ngakho ngaphambi kokuqala umuthi.
