Ukusetshenziswa kwama-ejenti okwenziwa kwe-hypoglycemic kufanelekile ngokwemibandela yokuxazulula inkinga yesifo sikashukela. Basiza ukugcina amazinga kashukela egazini ahlolwe futhi banciphise imiphumela yesifo.
Enye yalezi zinto yi-Repaglinide.
Khipha ifomu
I-Repaglinide ifakiwe 
ekwakhiweni kweqembu elibanzi lezidakamizwa ezinegama lokuhweba:
- I-NovoNorm;
- I-Diaglinide;
- I-Eglinides nabanye.
Umphumela wale mishanguzo ususelwa kuzakhiwo zamakhemikhali we-drug repaglinide (repaglinide), okuyisakhi sawo esiyinhloko, futhi ungathuthukiswa noma ukuguqulwa ngosizo lwezinto ezisizayo.
Imvamisa, izidakamizwa zitholakala kwifomu lethebhulethi ngokuhlanganiswa kwento esebenzayo ku-0.5, 1 noma 2 milligrams.
Amakhemikhali atholakala entweni
Umphumela omkhulu wento ukwehlisa ushukela wegazi, kususelwa emgomeni wokuvimbela umsebenzi wama-tubules-ancike ku-ATP akhiwe kumagobolondo e-pancreatic β-cell.
I-Repaglinide isebenza eziteshini ze-potassium, inomthelela ekukhululweni kwama-K ions+ kusuka esitokisini, esiza ukunciphisa ukubumbana kwezindonga zayo nokukhipha iziteshi ze-calcium. Konke lokhu kunomthelela ekwandeni kokukhiqizwa kwe-insulin nokukhululwa kwayo egazini.
Ukufakwa kwento kwenzeka ngokushesha okukhulu, ngemuva kwehora kunokucwilisa okukhulu kwegazi, kancane kancane kunciphe bese kunyamalala ngemuva kwamahora ama-4.
Kulokhu, umkhiqizo uxhumeke kahle ngamaprotheni e-plasma, ngamaphesenti angaphezu kwangama-90, kuthi ngemuva kwalokho kucutshungulwe ngokuphelele ngokukhishwa kwe:
- i-oxidized dicarboxylic acid;
- amines elimnandi;
- acyl glucuronide.
Lezi zinto azinamphumela we-hypoglycemic futhi zidedelwa ngenxa yepheshana yesisu futhi ngokwengxenye yezinso.
Izinkomba kanye ne-contraindication
Imithi esekwe kwi-repaglinide iyanconywa ukuthi ithuthukise uhlobo 2 lwesifo sikashukela, kokubili njengesidakamizwa esizimele futhi sihlanganiswe ne-metformin noma i-thiazolidinediones, engezwa lapho ukuphuza umuthi owodwa kungakhombisi umphumela owanele.
Ukuxhumana kokuphuza umuthi yilezi:
- ukuba khona kwesifo sikashukela
uhlobo lokuqala; - i-pathology engathi sína yesibindi;
- ukwephulwa kwe-lactose metabolism;
- isikhathi sokukhulelwa nokukhulelwa;
- ukusetshenziswa kwezidakamizwa ezisuselwa ku-gemfibrozil;
- isifo sikashukela sikashukela, ikoma noma i-precoma;
- ukuba khona kwezifo ezithathelwanayo, isidingo sokungenelela kokuhlinzwa noma okunye ukuphazamiseka lapho ukwelashwa kwe-insulin kudingekile;
- iminyaka emincane;
- ukuzwela ngokweqile ezingxenyeni eziphambili nezaseceleni zomuthi.
uhlobo lokuqala;Njengoba into esebenzayo isuswe ngokwengxenye yezinso, iziguli ezinama-pathologies akule ndawo kufanele zisebenzise umuthi ngokuqapha. Kwenzeka okufanayo nasezigulini ezinempilo engeyinhle futhi ezihlushwa yisimo esibuthakathaka.
Ngesikhathi sokuphatha i-repaglinide, kuyadingeka ukubhekisisa izinkomba zikashukela wegazi ukuze uvikele isimo se-hypoglycemia kanye nethonya. Ngokuhla okubukhali koshukela, isilinganiso semithi siyancishiswa.
Imiyalo yokusebenzisa
Ukwemukelwa kwalo muthi kwenziwa ngokwemiyalelo yesidakamizwa, okubandakanya into. Iningi lezidakamizwa litholakala kwifomu lethebhulethi, ziphuza ngomlomo imizuzu eyi-15 ukuya kwengama-20 ngaphambi kokudla. Umthamo ukhethiwe esimweni ngasinye mathupha.
Kungcono ukuqala ukuthatha i-repaglinide ngesilinganiso esisezingeni eliphansi: 0.5 mg. Ngemuva kwesonto, ungenza ushintsho ngokwandisa umthamo womuthi ngo-0,5 mg. Umthamo omkhulu ovunyelwe kufanele ube ngu-4 mg ngesikhathi noma u-16 mg ngosuku.
Uma isiguli sisebenzisa umuthi ohlukile we-hypoglycemic futhi sidluliselwe ku-repaglinide, umthamo wokuqala wakhe kufanele ube ngu-1 mg.
Uma uphuthelwe ukuthatha amaphilisi, ungangezi umthamo ngaphambi kokulandelayo, lokhu kungaba nomthelela ekwehlekeni okukhulu kwe-glucose egazini nasekuqalisweni kwe-hypoglycemia. Noma yiluphi ushintsho kumthamo noma ekushintsheni umuthi kufanele lwenziwe ngaphansi kokuqondisa udokotela nangaphansi kokuqondiswa kwezinkomba zoshukela emchameni nasegazini likashukela.
Imiphumela emibi
Imvamisa, uma usebenzisa umuthi osuselwa ku-repaglinide, i-hypoglycemia yenzeka, okungenzeka zombili ngenxa yokungalandeli kwemithetho yokusetshenziswa komuthi, futhi ngenxa yezici ngazinye: ukwanda komzimba, ukungahambisani nokudla, njalonjalo.
Ngaphezu kwalokho, umphumela oseceleni kungenzeka ngohlobo lwe:
- ukungaboni kahle
- i-vasculitis;
- ukuthuthukiswa kwesifo senhliziyo;
- ukusabela kokuzivikela komzimba ngendlela yamaphashaza nokuluma;
- i-hypoglycemic coma kanye nokulahlekelwa ukwazi;
- ukwephulwa kwesibindi;
- Ubuhlungu esiswini, isicanucanu, isifo sohudo, noma ukuqunjelwa.
Lapho umthamo usujwayelekile noma umuthi ushintshelwa komunye umuthi, izimpawu ziyanyamalala.
Ividiyo evela kuDkt Malysheva mayelana nezimpawu zesifo sikashukela:
Ukusebenzelana kwezidakamizwa
Endabeni yokusebenzisa i-repaglinide, kuyadingeka ukuthi unake ukusebenzisana kwayo nezinye izinto.
Ukuze uthuthukise umphumela wesidakamizwa unga:
- I-Gemfibrozil;
- ama-anabolic steroid;
- I-Rifampicin;
- I-Trimethoprim;
- Clarithromycin;
- I-Itraconazole;
- I-Ketoconazole namanye ama-ejenti we-hypoglycemic;
- abacindezeli be-monoamine oxidase ne-angiotensin-eguqula i-enzyme;
- izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala;
- ama-beta-blockers angakhethi;
- ama-salicylates.
Ukuphathwa kanyekanye kwezidakamizwa okune-repaglinide ne-gemfibrozil kuyaphulwa, ngoba kuholela ekwandeni okuningana kwesenzo sento kanye namathuba okuba nethambo.
Emsebenzini wokuphindaphinda, ama-ejenti anjengalawa:
- I-Cimetidine;
- Simvastatin;
- I-estrogen;
- INifedipine.
Ngakho-ke, zingasetshenziswa ndawonye.
Umphumela omncane engxenyeni ye-repaglinide ubonwa maqondana nemithi: iWarfarin, iDigoxin neTheophylline.
Ukusebenza kwezidakamizwa kuncishisiwe:
- izindlela zokuvimbela inzalo ngomlomo;
- glucocorticosteroids;
- I-Rifampicin;
- ama-hormone egilo;
- ama-barbiturates;
- UDanazole;
- i-sympathomimetics;
- Carbamazepine;
- okususelwa ku-thiazide.
Ukusetshenziswa kwabo kunconyelwa ukuhlanganiswa nokulungiswa komthamo womkhiqizo.
Iziphakamiso zokusetshenziswa
I-Repaglinide imiselwe ukusetshenziswa lapho ukwelashwa kokudla kanye nemizamo ejwayelekile yomzimba ingakuvumeli ukulawula ushukela wegazi.
Ngokuhamba kwesikhathi, ukusebenza kahle kwomuthi kuyancipha, okuhambisana nokuqhubeka kwesifo kanye nokwehla kokuzwela komzimba esenzweni somuthi. Ngemuva kwalokho udokotela ubeka elinye ikhambi noma enze ukulungisa imithamo.
Ukusebenza kwesidakamizwa kubhekwe njalo ngokuhlaziywa kwe-glucose egazini nomchamo. Isiguli singenza uhlaziyo ngokwaso sisebenzisa amakhambi asekhaya, kodwa ngezikhathi ezithile kufanele kube nokuhlolwa ngudokotela ohambelayo. Kuyena, kuyadingeka ukuthi kwenziwe izivivinyo endaweni yelabhorathri.
Ibuye ihlole izinga le-hemoglobin ye-glycosylated, ekuvumela ukuthi uthole isithombe esiphelele senqubo yokwelashwa. Lapho izinkomba ziguquka, kulungiswa impendulo yomthamo womuthi.
Ithuluzi ngokwalo lisetshenziswa ngokubambisana nokwelashwa kokudla nokuzivocavoca umzimba njalo, okufanele kuthuthukiswe ngudokotela. Ngasikhathi sinye, ushintsho ekudleni noma emithwalweni yezemidlalo kuholela ekushintshashintsheni kwe-glucose esegazini, okudinga ukulungiswa okufanele komuthi. Njengoba isiguli singeke sikwenze lokhu ngokushesha, kunconywa ukugwema ushintsho olungazelelwe ekudleni nasekucindezelekeni.
I-Repaglinide ayikwazi ukusetshenziswa ngasikhathi sinye nama-ejenti aqukethe utshwala, ngoba andisa umphumela wawo. Umuthi uqobo awuthinti amandla okushayela imoto, kodwa lapho kwenzeka i-hypoglycemia, leli khono lehliswa kakhulu. Ngakho-ke, ngenkathi uthatha umuthi, udinga ukulawula izinga lokuhlushwa kwe-glucose futhi uvikele ukwehla kwawo okubukhali.
Njengoba kukhonjisiwe, iziguli ezinama-pathologies emisebenzi yezinso nesibindi, kanye nezifo zenhliziyo nemithambo yegazi, zidinga ukusebenzisa umuthi ikakhulukazi ngokucophelela.
Kwakungekho ocwaningwayo ngomphumela kwabesifazane abakhulelwe nabakhanyayo. Ngakho-ke, ukuphepha komuthi enganeni akuqinisekisiwe futhi umuthi awuchaziwe ngalesi sikhathi. Owesifazane odinga umuthi kufanele wenqabe ukuncelisa ingane yakhe ibele.
Okufanayo kusebenza ezimeni zobudala. Umphumela oqondile wesidakamizwa ezigulini ezingaphansi kweminyaka engu-18 nangemva kweminyaka engama-75 awaziwa. Ezimweni ezinjalo, iRepaglinide ithathelwa indawo yi-analogue etholakalayo noma ingaqhubeka isetshenziswe yisiguli esegugile, uma ingaphansi kokuqondisa kwe-endocrinologist.
Amalungiselelo asuselwa ku-repaglinide
Isichazamazwi somuthi yi-Repaglinide-Teva, isenzo sayo sisekelwe kulokho okukhulunywa ngakho.
Analogs yile:
- Izindleko zokuxilonga zisuka ku-200
ama-ruble wezibhebhe ezingama-30; - Ama-jardins avela kuma-ruble angama-200 amaphilisi angama-30;
- I-NovoNorm kusuka kuma-ruble angama-170 amaphilisi angama-30;
- I-invokana kusuka kuma-ruble angama-2000 amaphilisi angama-30 ngomthamo ka-100 mg .;
- I-Forsiga kusuka kuma-ruble angama-2000 amaphilisi angama-30 ngomthamo we-10 mg .;
ama-ruble wezibhebhe ezingama-30;Intengo ye-repaglinide nama-analogues incike ezicini eziningana:
- umthamo
- umenzi;
- ukuba khona kwezinto ezihlanganayo;
- izinqubomgomo zamanani ezentambo ekhemisi nabanye.
Ukuphuza izidakamizwa ze-hypoglycemic kuyinto ebaluleke kakhulu ezigulini eziningi ezinesifo sikashukela sohlobo 2. Ibavumela ukuba bathuthukise ikhwalithi yempilo futhi banciphise imiphumela elimazayo yesifo. Kodwa-ke, konke lokhu kungenzeka kuphela uma izidingo zemiyalo yokusebenzisa umuthi nokulawulwa kwezinkomba zesimo somzimba zibhekwa.
