Isidakamizwa i-Forsig - imiyalo yokusebenzisa, ukubuyekezwa, ama-analogues ashibhile

Iziguli ezinesifo sikashukela i-mellitus zivame ukwehluleka ukwenza i-glycemia ibe yodwa ngokulandela isidlo.

Abaningi babo kufanele bathathe izidakamizwa ezahlukahlukene ezinciphisa ushukela. Umuthi owodwa onjalo wesifo sikashukela emakethe yezokwelapha i-Forsiga.

Imininingwane ejwayelekile, ukwakheka, indlela yokukhululwa

Muva nje, isigaba esisha sezidakamizwa sesitholakala eRussia esinezindawo ezinokwehlisa ushukela, kepha sibe nomphumela ohlukile ngokuqhathaniswa nezidakamizwa ezazisetshenziswa ngaphambili. Omunye wabokuqala ezweni wabhaliswa umuthi weForig.

I-ejenti ye-pharmacological yethulwe ohlelweni lwe-radar (irejista yezidakamizwa) njengesidakamizwa se-hypoglycemic esenzelwe ukusetshenziswa komlomo.

Ochwepheshe phakathi nezifundo bakwazi ukuthola imiphumela ehlaba umxhwele, beqinisekisa ukuncipha komthamo wemithi othathwe noma ngisho nokukhanselwa kokwelashwa kwe-insulin kwezinye izimo ngenxa yokusebenzisa umuthi omusha.

Ukubuyekezwa kwe-endocrinologists kanye neziguli kulokhu kuxubile. Abaningi bathokozela amathuba amasha, futhi abanye babo bayasaba ukuwasebenzisa, belinde imininingwane ngemiphumela yokusetshenziswa isikhathi eside.

Umuthi uyatholakala ngesimo samathebulethi anomthamo we-10 noma 5 mg futhi uhlanganiswe emabhulini ngenani le-10, kanye nezicucu eziyi-14.

Ithebhulethi ngayinye iqukethe i-dapagliflozin, okuyisithako esiyinhloko esisebenzayo.

Abangenayo bafaka izinto ezilandelayo:

• i-microcrystalline cellulose;
• i-anhydrous lactose;
• isilika;
• i-crospovidone;
• i-magnesium stearate.

Ukwakheka kwe-Shell:

• utshwala obuncane be-hydrolyzed polyvinyl (opadry II ophuzi);
• titanium dioxide;
• i-macrogol;
• i-talc;
• Udayi wensimbi ephuzi.

Isenzo se-Pharmacological

I-Dapagliflozin, esebenza njengengxenye esebenzayo yomuthi, iyisithinteli se-SGLT2 (amaprotheni), okungukuthi, icindezela umsebenzi wabo. Ngaphansi kwethonya lezakhi zezidakamizwa, inani le-glucose elithathwe kusuka kumchamo oyinhloko liyancishiswa, ngakho-ke, ukuphuma kwalo kwenziwa ngokuphelele ngenxa yomsebenzi wezinso.

Lokhu kuholela ekujuleni kwegazi glycemia. Isici esihlukile somuthi ukukhethwa kwawo okuphezulu, ngenxa yokuthi akuphazamisi ukuthuthwa kweglucose kwezicubu futhi kungaphazamisi ukumuncwa kwawo lapho singena emathunjini.

Umphumela ophambili wesidakamizwa uhlose ukuqeda i-glucose, ehlanganiswe egazini, ngokusebenzisa izinso. Umzimba womuntu uvulelwa njalo imikhiqizo ehlukahlukene yama-metabolic kanye nobuthi.

Ngenxa yomsebenzi osunguliwe wezinso, lezi zinto zihlungwa ngempumelelo futhi zithungwa kanye nomchamo. Ngesikhathi sokukhipha, igazi lidlula kaningana nge-glomeruli ye-renal. Izakhi zamaphrotheni zigcinwa emzimbeni, futhi lonke uketshezi osele luhlungiwe, lwenze umchamo oyinhloko. Inani laso ngosuku lingafinyelela amalitha ayi-10.

Ukuguqula lolu manzi lube umchamo wesibili kanye nesinye, ukuqina kwalo kufanele kukhuphuke. Lo mgomo ufinyelelwa ngokufaka okubuyiselwe egazini lazo zonke izinto eziwusizo, kubandakanya noshukela.

Uma kungekho i-pathology, zonke izinto zibuyiselwa ngokuphelele, kepha ngesifo sikashukela kunokulahlekelwa okuningana koshukela kumchamo. Lokhu kwenzeka ngezinga le-glycemia elingaphezu kuka-9-10 mmol / L.

Ukuthatha umuthi ku-dosage ejwayelekile kuthuthukisa ukukhishwa okufika ku-80 g kashukela egazini. Leli nani alincikile kubungako be-insulin ekhiqizwa yi-pancreas noma etholwe ngomjovo.

Ukususwa kwe-glucose kuqala ngemuva kokuthatha iphilisi, futhi umphumela wayo uhlala amahora angama-24. Into esebenzayo yesidakamizwa ayithinti kabi ukukhiqizwa kwendalo kwe-glucose yemvelo lapho kwenzeka i-hypoglycemia.

Emiphumeleni yezivivinyo, kwathuthukiswa intuthuko emsebenzini wamaseli we-beta obhekene nokukhiqizwa kwe-hormone. Ezigulini ezaziphuze umuthi nge-10 mg iminyaka emi-2, ushukela wayevulwa njalo, okuholela ekwandeni kwesilinganiso se-osmotic diuresis. Ukwanda kwethamo lomchamo kungahambisana nokukhuphuka okuncane kokuchithwa kwe-sodium ngokusebenzisa izinso, kepha akuzange kushintshe inani lokuxineka kwe-serum kulokhu.

Ukusetshenziswa kweForigi kufaka ukwehla komfutho wegazi vele emavikini angama-2-4 ngemuva kokuqala kokuphatha. Ngaphezu kwalokho, ukusetshenziswa komuthi izinyanga ezintathu kunciphisa i-glycosylated hemoglobin.

I-Pharmacokinetics

Umphumela we-pharmacokinetic ubonakala ngezimpawu zokufakwa, ukusatshalaliswa, imetabolism kanye nokuchithwa kwezingxenye eziphambili:

1. Ukungena Ngemuva kokungena, izingxenye zomenzeli zimunca ngokuphelele izindonga zephethini lesisu (ipheshana emathunjini), kungakhathalekile isikhathi sokudla okungakanani. Ukuhlushwa okuphezulu ngemuva kokuthatha isisu esingenalutho kufinyelelwa ngemuva kwamahora ama-2 futhi kukhuphuke ngokulingana nomthamo. Izinga le-bioavailability eliphelele lesakhi esiyinhloko ngu-78%.
2. Ukusatshalaliswa. Ingxenye esebenzayo yesidakamizwa icishe ibe yi-91% eboshelwe kumaprotheni. Izifo zezinso noma i-pathology yesibindi azithinti lesi sikhombisi.
3. Ukukhohlisa umzimba. Into esemqoka yesidakamizwa yi-glucoside enesibopho se-carbon ne-glucose, echaza ukumelana kwayo nama-glucosidases. Isikhathi sokuphila esidingekayo engxenyeni yesikhathi sempilo yezakhi zezidakamizwa ezivela ku-plasma yegazi sasingamahora ayi-12,9 eqenjini elifundiwe lamavolontiya anempilo.
4. Ukuzikhulula. Izakhi zomuthi zidalulwa ngokusebenzisa izinso.

Inkulumo yevidiyo yezindlela zikaForig, ingxenye 1:

Izinkomba kanye ne-contraindication

Umuthi awukwazi ukuguqula i-glycemia uma isiguli siqhubeka nokudla okungafuneki kokulawula i-carbohydrate.

Kungakho ukondliwa kokudla kanye nokwenza umsebenzi othile wokuzivocavoca umzimba kufanele kube yizinyathelo zokuphoqelelwa zokwelashwa. IForig ingabekwa njengokuwukuphela kwesidakamizwa eselaphayo, kepha imvamisa kakhulu la mapilisi anconywa ngokuhlanganiswa neMetformin.

Izinkomba:

• ukwehla kwesisindo kwiziguli ezinganciki i-insulin;
• sebenzisa njengomuthi owengeziwe ezigulini ezinesifo sikashukela esinzima;
• ukulungiswa kwezinkinga zokudla ezenziwa njalo;
• ukuba khona kwe-pathologies evimbela ukusebenza ngokomzimba.

Contraindication:

1. Isifo sikashukela esincike ku-insulin.
2. Ukukhulelwa I-Contraindication ichazwa ukungabikho kolwazi okubonisa ukuphepha kokusetshenziswa ngalesi sikhathi.
3. Isikhathi sokuzala.
4. Iminyaka kusukela eminyakeni engama-75 nangaphezulu. Lokhu kungenxa yokwehla kwemisebenzi eyenziwa yizinso, kanye nokwehla kwenani legazi.
5. I-Lactose ukungabekezeleli, okuyingxenye esekelwayo kumathebhulethi.
6. I-allergy engakhula lapho kusetshenziswa udayi kugobolondo lwethebhulethi.
7. Ukuphakamisa izinga lemizimba ye-ketone.
8. I-Nephropathy (isifo sikashukela).
9. Ukuthatha okokuhlanza okuthile, umphumela wawo kuthuthukiswa ngokwelashwa kanyekanye namathebulethi eForig.

Ukuphulwa okuhlobene:

• izifo ezingapheli;
• utshwala, i-nicotine (akukho ukuhlolwa komphumela womuthi okwenziwe);
• ukukhulisa i-hematocrit;
• izifo zohlelo lomchamo;
• ubudala
• ukulimala kwezinso okunzima;
• ukuhluleka kwenhliziyo.

Imiyalo yokusebenzisa

Amathebulethi athathwa ngomlomo kusithamo esincike ekwelashweni okunikezwe isiguli:

1. I-Monotherapy. Umthamo akufanele wedlule i-10 mg ngosuku.
2. Ukwelashwa okuhlanganisiwe. Ngosuku, kuvunyelwe ukuthatha i-10 mg yeForigi ngokuhlanganiswa ne-Metformin.
3. Ukwelashwa kokuqala nge-500 mg yeMetformin ngu-10 mg (kanye ngosuku).

Ukuphathwa ngomlomo kwesidakamizwa akuxhomekile esikhathini sokudla kokudla. Ukwehlisa umthamo wesidakamizwa kuvame kakhulu ukwelashwa nge-insulin noma ngezidakamizwa ezikhulisa ukugcinwa kwaso.

Iziguli ezinesifo esinamandla sezinso noma isibindi se-pathology kufanele ziqale ukuthatha amaphilisi ngomthamo we-5 mg. Ngokuzayo, ingakhushulwa ibe ngu-10 mg, uma nje izakhi zibekezelelwa kahle.

Inkulumo yevidiyo yezindlela zikaForig, ingxenye 2:

Iziguli ezikhethekile

Izici zesidakamizwa zingahluka ngezindlela ezithile zesiguli noma izici:

1. Isifo sezinso. Inani le-glucose ekhishwe ngokuqondile lincike ekusebenzeni kwalezi zitho zomzimba.
2. Uma kwenzeka ukwephulwa esibindini, umphumela wesidakamizwa ushintsha kancane, ngakho-ke, ukulungiswa kwemithamo enqunyelwe akudingekile. Ukuphambuka okubalulekile ezimweni zento esebenzayo kwabonwa kuphela ngesilinganiso esibucayi se-pathology.
3. Iminyaka. Iziguli ezingaphansi kweminyaka engama-70 ubudala azikhombisanga ukwanda okukhulu kokuvezwa.
4. Ubulili Ngesikhathi sokusebenzisa lesi sidakamizwa, abesifazane badlula i-AUC ngama-22% uma beqhathaniswa nabesilisa.
5. Ukuzibandakanya ngokobuhlanga akuholeli ekungahambisani nokuchayeka okuhleliwe.
6. Isisindo. Iziguli ezikhuluphele zazinezindinganiso eziphansi zokuvezwa ngesikhathi sokwelashwa.

Umphumela wesidakamizwa ezinganeni awuzange ufundwe, ngakho-ke akufanele usetshenziswe njengendlela yokwelapha lesi sifo. Umkhawulo ofanayo uyasebenza kwabesifazane abakhulelwe nababambisayo, ngoba akukho mininingwane mayelana nokungeniswa kokufakwa kwezakhi zomkhiqizo ubisi.

Imiyalo ekhethekile

Ukusebenza kahle kwalo muthi kuncike ekubeni khona kwezifo ezihlobene noshukela esigulini:

1. Isifo sezinso. Ezimweni eziningi, ukwehla komphumela wokusetshenziswa kwesidakamizwa akukhona kubantu abahlushwa ukungasebenzi kwezitho ezincane. Ngezindlela ezibucayi ze-pathology, ukuthatha amaphilisi kungahle kungaholeli emiphumeleni yokwelashwa oyifunayo. Imiyalo enjalo ichaza isidingo sokuqapha njalo ukusebenza kwezinso, okufanele senziwe kaningana ngonyaka ngokuya ngezincomo zezokwelapha.
2. I-Pathology yesibindi. Ngokuphulwa okunjalo, ukuvezwa kwengxenye esebenzayo engxenye yomuthi kungakhuphuka.

Izindlela zeForig ziholela kulezi zinguquko ezilandelayo:

• kukhulisa ubungozi bokwehlisa inani legazi elijikelezayo;
• kwandisa amathuba okukhuphuka kwengcindezi;
• yephula ibhalansi ye-electrolyte;
• ubungozi bokuthola izifo ezithinta ipheshana lomchamo liyanda;
• i-ketoacidosis kungenzeka;
• kwandisa i-hematocrit.

Kubalulekile ukuqonda ukuthi ukuthatha amaphilisi kufanele kwenziwe ngemuva kokubonisana nodokotela.

Imiphumela emibi kanye ne-overdose

I-Dapagliflozin ithathwa njengesidakamizwa esiphephile futhi ngesikhathi sedosi elilodwa lamathebulethi, edlula inani lomthamo ovumelekile izikhathi ezingama-50, ibekezelelwa kahle.

Ukunqunywa kwe-urine kwe-glucose kwaqanjwa izinsuku eziningana, kepha amacala okuphelelwa ngamandla, kanye ne-hypotension nokungalingani kwe-electrolyte akuzange kutholakale.

Emaqenjini afundile, lapho abanye abantu bathatha i-Forsig kwathi elinye lathatha i-placebo, izehlakalo ze-hypoglycemia, nezinye izehlakalo ezingezinhle, azangehluka kakhulu.

Ukuyekiswa kokwelashwa kufanele kwenziwe kulezi zimo ezilandelayo:

• i-creatinine ikhuphukile;
• izifo ezehlukene zenzekile ezithinte umgudu wokuchama;
• isicanucanu kwavela;
• isiyezi sizwakala;
• kuqhamuke isikhumba esikhumbeni;
• izinqubo ze-pathological kwesibindi zakhiwa.

Uma kutholakala i-overdose, ukwelashwa kwesondlo kuyadingeka kucatshangelwa inhlala-kahle yakhe.

Ngingakwazi ukunciphisa umzimba ngeForsiga?

Ngemiyalo yomuthi, umenzi ukhombisa ukwehla kwesisindo okubonakala ngesikhathi sokwelashwa. Lokhu kuyabonakala kakhulu ezigulini ezihlushwa hhayi isifo sikashukela kuphela, kodwa futhi nokukhuluphala.

Ngenxa yezakhi ze-diuretic, isidakamizwa sehlisela inani lamanzi emzimbeni. Amandla ezinto zemithi ukufaka ingxenye yeglucose nayo inomthelela ekulahlekelweni kwamakhilogremu angeziwe.

Izimo eziphambili zokufeza umphumela wokusetshenziswa komuthi ukungondleki okwanele kanye nokufakwa kwemikhawulo ekudleni ngokuya ngokudla okunconyiwe.

Abantu abaphilile akufanele basebenzise la maphilisi ukunciphisa umzimba. Lokhu kungenxa yomthwalo omningi okhishwe ezinso, kanye nolwazi olwanele ngokusetshenziswa kweForigi.

Ukusebenzisana kwezidakamizwa kanye nama-analog

Umuthi usiza ukuqinisa ama-diuretics, i-insulin nezidakamizwa ezandisa ukucekelwa kwawo.

Ukusebenza komuthi kuyancipha ngenkathi uthatha izidakamizwa ezilandelayo:

• I-Rifampicin;
• i-inductor esebenzayo;
• Ama-enzyme agqugquzela imetabolism yezinye izingxenye.

Ukudonswa kwamathebhulethi weForigig ne-mefenamic acid kukhulisa ukubonwa kwento okusebenzayo ngo-55%.

IForsiga ithathwa njengomuthi okuyiwona wodwa oqukethe iDapagliflozin otholakala eRussia. Okunye, ama-analogues ashibhile asekuqaleni awakhiqizi.

Enye indlela yamathebulethi eForig kungaba izidakamizwa zekilasi le-glyphosine:

• UJardins
• Attokana.

Umbono wochwepheshe neziguli

Ukusuka kokubuyekezwa kodokotela neziguli mayelana nomuthi iForiging, singaphetha ngokuthi umuthi wehlisela ushukela egazini futhi unomphumela omuhle emzimbeni wonke, nokho, abanye banemiphumela emibi eqinile, okumele icatshangelwe lapho uthatha umuthi.

Umuthi ukhombisile ukusebenza kwawo kahle ngesikhathi sokuhlolwa. I-Normalization ye-glycemia ezimweni eziningi ingatholakala ngaphandle kokuvela kwemiphumela emibi. Ezinye iziguli ziyeka ukujova i-insulin. Lolu lwazi luthathwe emiphumeleni yokuhlolwa lapho abantu abangu-50 000 abane-glycemia kusuka ku-10 mmol / l bahlanganyele khona. Ngaphezu kokuqinisa amazinga kashukela, lesi sidakamizwa saba nomthelela omuhle empilweni ephelele.

U-Alexander Petrovich, i-endocrinologist

I-Forsyga isidakamizwa sokuqala eqenjini lesigaba esisha sama-inhibitors. Izici zesidakamizwa azinciki emsebenzini wamaseli we-beta, kanye ne-insulin. Izakhi ezisebenzayo zivimba ukubuyiselwa kweglucose ezinso, ngaleyo ndlela kunciphisa amanani alo egazini. Izinzuzo ezibaluleke ngokulinganayo yikhono lokunciphisa isisindo somzimba nokunciphisa amathuba we-hypoglycemia. Uvivinyo lukhombisile ukuthi ukwelashwa cishe akuhambisani nemiphumela emibi. Umuthi usetshenziswe ngempumelelo phesheya iminyaka eminingana, lapho ukhombise khona ukusebenza kwawo okuphindaphindiwe.

U-Irina Pavlovna, udokotela wobuchopho

Amaphilisi we-Forsig anikezwa umama ngemuva kokwenqaba kwakhe i-insulin. Ngesikhathi sokuqala kokudla, cishe zonke izinkomba zikamama zazingajwayelekile. I-C-peptide yayingaphansi komkhawulo ovumelekile, futhi ushukela, kunalokho, wawungaba ngu-20. Cishe ezinsukwini ezine ngemuva kokuthathwa kwethebhulethi lokuqala, intuthuko yabonakala. Ushukela uyeke ukukhuphuka ngaphezulu kwe-10, naphezu kwemithamo engapheli yezinye izidakamizwa (Amaril, Siofor). Ngemuva kwenyanga elashwa nalawa maphilisi, izidakamizwa eziningi zakhanselwa omama. Ngingasho ukuthi ngenkathi izindlela zeForigs ziyaneliseka kakhulu.

UVladimir, oneminyaka engama-44

Ngifunda ukubuyekezwa kwabanye abasebenzisi futhi ngiyamangala. Umuthi wasiza abaningi, kepha hhayi mina. Selokhu kwaqala ukuthathwa kwayo, ushukela wami awugcinanga ngokubuyela kwesejwayelekile, kodwa futhi wagxuma. Kepha okubi kakhulu ukuthi ukulunywa kuzwakala emzimbeni wonke, okungenakubekezelelwa.Ngikholwa ukuthi umuthi onemiphumela emibi enjalo akufanele usetshenziswe yinoma ngubani.

U-Elena, oneminyaka engama-53

Intengo yephakethe le-Forsig lamacwecwe angama-30 (10 mg) cishe ngama-ruble angama-2600.