I-Sibutramine - umuthi oyingozi wokunciphisa umzimba: imiyalo, ama-analogues, ukubuyekezwa

Kuyini i-sibutramine?

ISibutramine isidakamizwa esinamandla. Ekuqaleni, yathuthukiswa futhi yahlolwa njenge-antidepressant, kodwa ososayensi baqaphela ukuthi inomphumela onamandla we-anorexigenic, okungukuthi, iyakwazi ukunciphisa ukuthambekela.

Kusukela ngo-1997, yaqala ukusetshenziswa e-United States nakwamanye amazwe njengendlela ephumelelayo yokuqeda isisindo ngokweqile, ichaza abantu abanezifo ezahlukahlukene ezihlangana nabo. Imiphumela emibi ibingapheli isikhathi esizayo.

Kwavela ukuthi i-sibutramine ingumlutha futhi iyadabukisa, engaqhathaniswa nomuthi. Ngaphezu kwalokho, wandisa ingozi yesifo senhliziyo, abantu abaningi bahlaselwa yimivimbo nokuhlaselwa yisifo senhliziyo ngenkathi bethatha. Kunobufakazi obungekho emthethweni bokuthi ukusetshenziswa kwe-sibutramine kwabangela ukufa kweziguli.

Isenzo se-Pharmacological somuthi

ISibutramine uqobo lwayo ibizwa ngokuthi yi-prodrug, okungukuthi, ukuze isebenze, umuthi kumele "ubole" ube yizakhi ezisebenzayo, udlule esibindini. Ukuqoqwa okuphezulu kwama-metabolites egazini kutholakala ngemuva kwamahora we-3-4.

Uma ukuthathwa kwenziwa kanyekanye nokudla, khona-ke ukugcwala kwayo kuncipha ngo-30% bese kufinyelela inani layo eliphezulu ngemuva kwamahora angama-6-7. Ngemuva kwezinsuku ezi-4 zokusetshenziswa njalo, inani layo egazini liba njalo. Isikhathi eside kunazo zonke lapho isigamu somuthi siphuma emzimbeni cishe amahora angama-16.

Umgomo wokusebenza kwento ususelwa ekutheni uyakwazi ukukhuphula umkhiqizo wokushisa komzimba, ucindezele isifiso sokudla ukudla futhi uthuthukise umuzwa wokugcwala. Ngokulondolozwa okuzinzile kwezinga lokushisa elidingekayo, umzimba awudingi ukwenza ukonga amafutha ngekusasa, ngaphezu kwalokho, lawo akhona 'asha' ngokushesha.

Kukhona ukwehla kwe-cholesterol namafutha egazini, kuyilapho kukhuphuka okuqukethwe i-cholesterol "enhle". Konke lokhu kukuvumela ukuthi wehlise isisindo masisha futhi isikhathi eside ukuze ulondoloze isisindo esisha ngemuva kokukhanselwa kwe-sibutramine, kodwa kuncike ekugcinweni kokudla.

Izinkomba zokusetshenziswa

Umuthi unqunyelwa udokotela kuphela futhi ezimweni lapho izindlela eziphephile zingalethi imiphumela ebonakalayo:

• Ukukhuluphala kwe-alimentary. Lokhu kusho ukuthi inkinga yokukhuluphala yavela ngenxa yokungondleki okungafanele kanye nokuntuleka komzimba. Ngamanye amagama, lapho amakhalori engena emzimbeni kungaphezu kwamandla akhe ukuwasebenzisa. ISibutramine isiza kuphela lapho inkomba yesisindo somzimba idlula ama-30 kg / m².
• Ukukhuluphala ngokweqile okuhambisana nohlobo 2 sikashukela. I-BMI kufanele ibe ngaphezulu kwama-27 kg / m².

Contraindication kanye nemiphumela emibi

Imibandela lapho i-sibutramine inqatshelwe ukwamukelwa:

• ukungahambi kahle komzimba nokungabekezeleli kunoma yiziphi izakhi ezakhiwayo;
• amacala lapho isisindo ngokweqile kubangelwa ukuba khona kwanoma yiziphi izimbangela ze-organic (ngokwesibonelo, ukuntuleka isikhathi eside nokuqhubekayo kwama-hormone e-thyroid - hypothyroidism);
• ukwakheka ngokweqile kwama-hormone egilo;
• i-anorexia nervosa ne-bulimia;
• ukugula kwengqondo;
• I-Tourette's syndrome (CNS disorder, okukhona kuyo ama-tics amaningi angalawulwa nokuziphatha okungalungile);
• ukusetshenziswa kanyekanye kwama-antidepressants, ama-antipsychotic nezinye izidakamizwa ezisebenza ohlelweni lwezinzwa oluyinhloko, futhi nalapho noma iyiphi yalezi zidakamizwa yayisetshenziswa amaviki ama-2 ngaphambi kokuqokwa kwe-sibutramine;
• izidakamizwa ezaziwayo, utshwala kanye nokuxhomekeka kwezidakamizwa;
• ukuphazamiseka kwesistimu yezinhliziyo (CVS): isifo senhliziyo, ukwehluleka okungapheli, ukungasebenzi kahle kwemvelo, i-tachycardia, i-arrhythmia, unhlangothi, ingozi yemithambo yegazi;
• umfutho wegazi ophakeme awelapheki;
• ukwephulwa okukhulu kwesibindi nezinso;
• ukukhuphuka okungajwayelekile kwengxenye ye-prostate gland;
• iminyaka ngaphambi kweminyaka eyi-18 nangemva kweminyaka engama-65;
• inkathi yokukhulelwa nokuncelisa.

Imiphumela emibi ichaza ngombala ukuthi kungani i-sibutramine inqunyelwe ngokuqinile.

1. CNS Ngokuvamile, iziguli zibika ukuqwasha, ikhanda, ukukhathazeka kusuka ekuqaleni nezinguquko ekunambithekeni, ngaphezu kwalokhu, umlomo owomile uvame ukuphazamisa.
2. ССС. Ngokuphindaphindwe kaningi, kepha nokho kukhona ukwanda kwesilinganiso senhliziyo, ukukhuphuka kwengcindezi yegazi, ukunwetshwa kwemithambo yegazi, ngenxa yalokho okubomvu kwesikhumba nomuzwa wendawo wokufudumala.
3. Amapheshana wesisu. Ukuphelelwa isifiso sokudla, ukunyakaza kwamathumbu okungahambi kahle, isicanucanu nokuhlanza, kanye nokwanda kwama-hemorrhoid - lezi zimpawu zivame njengokuqwasha.
4. Isikhumba. Ukujuluka ngokweqile kuqashelwa nganoma yisiphi isikhathi sonyaka, ngenhlanhla, lo mphumela wecala awunqabile.
5. Allergy Ingenzeka zombili ngesimo sokuqhuma okuncane endaweni encane yomzimba, futhi ngesimo sokuqhaqhazeka kwe-anaphylactic, lapho udokotela kufanele abonane ngokuphuthumayo kakhulu.

Imvamisa, yonke imiphumela emibi ibonwa kungakapheli inyanga eyi-1 ngemuva kokuphuza umuthi, ube nenkambo engashiwongo kakhulu bese udlulisela eyabo.

Ezimweni ezingazodwa, izehlakalo ezilandelayo ezingemnandi ze-sibutramine zabhalwa ngokusemthethweni:

• ukopha okubuhlungu kokuya esikhathini;
• ukudumba;
• Ubuhlungu emuva kanye nesisu;
• isikhumba esikhanyayo;
• isimo esifana nemizwa yomkhuhlane;
• ukwanda okungalindelekile nokubukhali kokuthamba nokoma;
• isimo sokudangala;
• ukozela kakhulu;
• ukuguquka kwemizwelo okungazelelwe;
• iminyakazo
• ukwehla kwesibalo seplatelet ngenxa yokuqhamuka kwegazi;
• i-psychosis eyingozi (uma umuntu esenenkinga enkulu yengqondo).

Indlela yokusebenzisa

Umthamo ukhethwa kuphela ngudokotela futhi kuphela ngemuva kokuhlola ngokucophelela zonke izingozi nezinzuzo. Akunakusho ukuthi kufanele uthathe lesi sidakamizwa ngokwakho! Ngaphezu kwalokho, i-sibutramine isatshalaliswa emakhemisi ngokuqinile ngomuthi!

Kunqunywa kanye ngosuku, mhlawumbe ekuseni. Umthamo wokuqala wesidakamizwa ngu-10 mgkepha, uma umuntu engakubekezeleli kahle, kwehlela ku-5 mg. I-capsule kufanele igezwe phansi ngengilazi yamanzi ahlanzekile, kuyilapho kunganconywa ukuba uyihlafune futhi ithulule okuqukethwe okuvela egobolondweni. Ingathathwa bobabili ngesisu esingenalutho nangesikhathi sasekuseni.

Uma ngenyanga yokuqala ukuguquguquka okufanele kwesisindo somzimba kungekenzekanga, umthamo we-sibutramine unyuka waba ngu-15 mg. Ukwelashwa kuhlangana njalo nokuzivocavoca okufanelekile komzimba nokudla okukhethekile, okukhethwa ngakunye kumuntu ngamunye ngudokotela onolwazi.

Ukuxhumana nezinye izidakamizwa

Ngaphambi kokuthatha i-sibutramine, kufanele uxoxe nodokotela wakho yonke imishanguzo ephuzwa njalo noma ngezikhathi ezithile. Akuwona wonke umuthi ohlanganiswa ne-sibutramine:

1. Imithi ehlanganisiwe equkethe i-ephedrine, i-pseudoephedrine, njll., Inyusa amanani omfutho wegazi kanye nesilinganiso senhliziyo.
2. Imithi ebandakanyeka ekwandiseni i-serotonin esegazini, njengezidakamizwa zokwelapha ukudangala, i-anti-migraine, i-painkiller, izinto ze-narcotic ezimweni ezingandile zingadala "i-serotonin syndrome." Uyabulala.
3. Amanye ama-antibiotics (iqembu le-macrolide), i-phenobarbital, i-carbamazepine asheshisa ukuqhekeka nokuqunjelwa kwe-sibutramine.
4. Ama-antifungals ahlukile (ketoconazole), ama-immunosuppressants (cyclosporin), ama-erythromycin akwazi ukukhulisa ukugcwala kwe-sibutramine ehlobene kanye nokwanda kwemvamisa yokuqothuka kwenhliziyo.

Ukuhlanganiswa kotshwala nomuthi akuwuphazamisi kabi umzimba ngokwemizwa yawo, kepha iziphuzo ezinamandla azivunyelwe kulabo abanamathela ekudleni okukhethekile futhi bafuna ukunciphisa umzimba.

Kungani i-sibutramine inqatshelwe futhi yini eyingozi

Kusukela ngo-2010, le nto inqunyelwe ukusatshalaliswa emazweni amaningi: i-USA, Australia, amazwe amaningi ase-Europe, Canada. E-Russia, inzuzo yayo ilawulwa ngokuqinile yizinhlangano zombuso. Umuthi ungabekwa kwifomu kadokotela kuphela nazo zonke izimpawu ezidingekayo. Akunakwenzeka ukuyithenga ngokusemthethweni ngaphandle kadokotela.

ISibutramine yavalwa eNdiya, China, New Zealand. Kokuvinjelwa, wayeholwa yimiphumela emibi efana "nokuqhekeka" ezidakamizweni: ukuqwasha, ukukhathazeka okungazelelwe, isimo esandayo sokudangala nemicabango yokuzibulala. Abantu abaningana baxazulula izimpilo zabo ngokuhambisana nesizinda sokusebenza kwayo. Iziguli eziningi ezinezinkinga zenhliziyo ziye zafa ngenxa yokuhlaselwa yisifo senhliziyo nemivimbo.

Kubantu abanokuphazamiseka kwengqondo, wenqatshelwe ngokuphelele ukuthola! Abaningi baphuca i-anorexia ne-bulimia, kwakukhona izingqondo ezesabekayo nezinguquko emqondweni. Lo muthi awugcini amandla kuphela wokudla, kodwa futhi uthinta nekhanda ngokoqobo.

I-Sibutramine ngesikhathi sokukhulelwa

Owesifazane owabekwa lesi sidakamizwa kufanele aziswe ukuthi akukho mininingwane eyanele ngokuphepha kwe-sibutramine enganeni engakazalwa. Zonke izifanekiso zomuthi zikhanseliwe ngisho nasezingeni lokuhlela ukukhulelwa.

Ngesikhathi sokwelashwa, umuntu wesifazane kufanele asebenzise izindlela zokuvimbela inzalo ezifinyelelekayo nezingazethemba. Ngokuhlolwa okuhle kokukhulelwa, kufanele wazise udokotela wakho ngokushesha futhi uyeke ukusebenzisa i-sibutramine.

Ucwaningo olusemthethweni ngomuthi

I-sibutramine yezidakamizwa yasekuqaleni yakhishwa yinkampani yaseJalimane. Ngo-1997, savunyelwa ukusetshenziswa e-United States, kwathi ngonyaka we-1999 e-European Union. Ukuqinisekisa ukusebenza kwayo, kucwaningwe izifundo eziningi, lapho abantu abangaphezu kwezinkulungwane ezingama-20 bahlanganyela, umphumela waba muhle.

Ngo-2002, kwathathwa isinqumo sokuqhuba ucwaningo lwe-SCout ukukhomba ukuthi yibaphi amaqembu ezingozini zemiphumela emibi aphezulu kakhulu. Lokhu kuhlola kwakuwukuhlola okungaboni okubili, okulawulwa yi-placebo. Amazwe ayi-17 abamba iqhaza kuwo. Safunda ubudlelwano phakathi kokuncipha kwesisindo ngesikhathi sokwelashwa nge-sibutramine nezinkinga ngohlelo lwenhliziyo.

Ekupheleni kuka-2009, imiphumela yokuqala yamenyezelwa:

• Ukwelashwa isikhathi eside neMeridia kubantu asebekhulile ngokweqile futhi banezinkinga zenhliziyo nemithambo yegazi kwandise ingozi yokuhlaselwa yisifo senhliziyo nemivimbo ngo-16%. Kepha ukufa akuzange kubhalwe phansi.
• Kwakungekho mehluko ekufeni phakathi kweqembu elithole i-placebo neqembu eliphambili.

Kwacaca ukuthi abantu abanesifo senhliziyo basengozini enkulu kunawo wonke umuntu. Kepha akwenzekanga ukuthola ukuthi yimaphi amaqembu eziguli angaphuza umuthi ngokulahlekelwa okuncane kwezempilo.

Ku-2010 kuphela, imiyalo esemthethweni yayihlanganisa ukuguga (ngaphezulu kweminyaka engama-65) njengokuphula umthetho, kanye: ne-tachycardia, ukuhluleka kwenhliziyo, isifo se-coronary, njll. Ngo-Okthoba 8, 2010, umenzi wakhumbula ngokuzithandela umuthi wakhe emakethe yemithi kuze kube yilapho zonke izimo zicacisiwe. .

Le nkampani isalinde izifundo ezengeziwe, ezizokhombisa ukuthi imaphi amaqembu eziguli umuthi oyoletha izinzuzo eziningi kanye nokulimala okuncane.

Ngo-2011-2012, kwenziwa ucwaningo eRussia ngaphansi kwegama lekhodi "VESNA". Imiphumela engathandeki yabhalwa ku-2.8% wamavolontiya; akukho miphumela emibi engadinga ukuthi kuhoxiswe i-sibutramine. Abantu abangaphezu kwezinkulungwane ezingama-34 abaneminyaka engama-18 kuya kwengama-60 bahlanganyela. Bathathe umuthi i-Reduxin ku-dose ebekiwe izinyanga eziyisithupha.

Kusukela ngonyaka ka-2012, kwenziwa isifundo sesibili - i-PrimaVera, umehluko kwakuyinkathi yesidakamizwa - izinyanga ezingaphezu kwezi-6 zokwelashwa okuqhubekayo.

I-Analogs ecwazimulayo

ISibutramine iyatholakala ngaphansi kwamagama alandelayo:

• IGoldline;
• IGoldline Plus;
• I-Reduxin;
• I-Reduxin Met;
• Slimia
• Lindax;
• IMeridia (ukubhaliswa okwamanje kuyachithwa).

Ezinye zalezi zidakamizwa zinokwakheka okuhlanganisiwe. Isibonelo, i-Goldline Plus ibuye ifake ne-microcrystalline cellulose, kanti iReduxin Met iqukethe izidakamizwa ezi-2 ngasikhathi sinye - sibutramine kanye ne-MCC, ne-metformin (izindlela zokunciphisa izinga likashukela ngohlobo 2 sikashukela) emalungeni ahlukile.

Ngasikhathi sinye, akukho sibutramine kuReduxin Light nhlobo, futhi awusiwo umuthi.

Ungayishintsha kanjani i-sibutramine

Izidakamizwa zokunciphisa umzimba:

Intengo

Izindleko ze-sibutramine ngokuqondile zincike kumthamo, inani lamathebulethi kanye nomenzi wezidakamizwa.

Ukubuyekezwa kokunciphisa umzimba

Umbono wabantu nge-sibutramine:

UMaria Ngifuna ukuhlanganyela nesipiliyoni sami ekusebenziseni. Ngemuva kokubeletha, walulama kakhulu, bengifuna ukunciphisa umzimba ngokushesha. Kwi-Intanethi, ngathola iLida yezidakamizwa, kukhona i-sibutramine ekwakhiweni kwayo. Ngathatha ama-30 mg ngosuku, ukunciphisa umzimba ngokushesha. Ngemuva kwesonto kuqedwe umuthi, kwaqala izinkinga zempilo, waya esibhedlela. Lapho, ngatholakala nginehluleka kwezinso okungamahlalakhona.