Thiazolidinediones bụ ìgwè ọhụrụ nke ọgwụ aidiụrụma. Dika biguanides, ha adighi aria kari akwara, na-akpali imeputa insulin nke ihe ana aru, kama ha na –ebelata nguzo nke sel na homonụ.
Na mgbakwunye na nkịtị glycemia, ọgwụ ndị ahụ na-emeziwanye ụdị egbugbere ọnụ: ntinye nke HDL na-abawanye, ọkwa nke triglycerol na-ebelata. Ebe ọ bụ na nsonaazụ ọgwụ na-esite na mkpali sitere na mkpụrụ ndụ mkpụrụ ndụ, a ga-atụ anya nsonaazụ kachasị mma site na ọgwụgwọ ọgwụgwọ na ọnwa 2-3. N'ime ule nke ụlọ ọgwụ, monotherapy nwere thiazolidinediones belatara mgbake haemoglobin gly 2%.
Agwakọta ọgwụ nke otu a jikọtara ya na ndị ọrụ antidiabetic ọzọ - metformin, insulin, sulfonylurea. Njikọ ya na metformin ga-ekwe omume n'ihi usoro dị iche iche: biguanides na-egbochi glucogenesis, yana thiazolidinediones na-abawanye uru glucose.
Ha anaghị akpalite mmetụta hypoglycemic na monotherapy, mana, dị ka metformin, na usoro ọgwụgwọ dị mgbagwoju anya na ọgwụ hypoglycemic nwere ike ịkpata nsonaazụ ndị dị otú ahụ.
Dika ogwu ndi n’eme ka uche ndi nnabata banye na insulin, thiazolidinediones bu otu n’ime ogwu ndi kacha ekwe n’agha maka ijikwa oria oria abuo. Mmetụta mgbochi a mgbe ị takingụsịrị ọgwụ ahụ were ọnwa asatọ ka ọnwa ngwụcha nke usoro ahụ.
Enwere echiche nke ọgwụ ndị klas a nwere ike idozi ntụpọ mkpụrụ ndụ ihe nketa nke ọrịa metabolic, na-egbu oge na-aga n'ihu ụdị ọrịa shuga 2 ruo mgbe mmeri zuru oke megide ọrịa ahụ.
N'ime thiazolidinediones, Ak 2 na-ahụ maka ọgwụ Aktos nke ụlọ ọrụ ọgwụ “Eli Lilly” (USA) bụ aha na ahịa Russia taa. Ojiji o meghere ohere ohuru obughi na diabetology, kamakwa na akwara obi, ebe a na-eji ogwu a egbochi oria akwara obi na obara obara, kariri nnagide insulin.
Usoro onunu ogwu na ihe eji eme Pioglitazone
Akụkụ bụ isi nke ọgwụ ahụ bụ pioglitazone hydrochloride. N'ime otu mbadamba, ego ya dabere na dose - 15 ma ọ bụ 30 mg. Ihe na-arụ ọrụ n'ime ya bụ site na mkpụrụ ndụ lactose monohydrate, cellulose hydroxypropyl, kalsium carboxymethyl, magnesium stearate.
Enwere ike mata mbadamba ọcha mbụ site na njiri convex gburugburu na kanye "15" ma ọ bụ "30".
Na mbadamba mbadamba 10, na igbe - 3-10 ụdị efere ahụ. Ndụ nchekwa nke ọgwụ ahụ bụ afọ 2. Maka pioglitazone, ọnụahịa dabere na ọ bụghị naanị na usoro ị theụ ọgwụ ahụ, kamakwa na ọgwụ ndị mepụtara: mbadamba 30 nke Indian Pioglar 30 mg nke ọ bụla nwere ike zụta maka 1083 rubles, mbadamba 28 nke Irish Actos 30 mg nke ọ bụla - 3000 rubles.
Njirimara nke ogwu
Pioglitazone bụ ọgwụ ọgwụ hypoglycemic nke klas thiazolidinedione. A na-ejikọta ọrụ nke ọgwụ ahụ na ọnụnọ insulin: iwetulata ọnụ ụzọ nnabata nke imeju na anụ ahụ na homonụ, ọ na -ekwu ọnụ ahịa glucose ma belata imepụta ya na imeju. E jiri ya tụnyere ọgwụ ọgwụ sulfonylurea, pioglitazone anaghị akpali mkpụrụ ndụ b ndị nwere nrụpụta insulin ma ọ dịghị eme ka ha ghara ịka nká na necrosis.
Mbelata nguzogide insulin na ụdị ọrịa shuga 2 na-enyere aka ịme profaịlụ glycemic na ụkpụrụ gemocated. Site na nkwarụ metabolic, ọgwụ ahụ na-eme ka mmụba nke ọkwa HDL yana mbelata nke ọkwa triglycerol. Ọdịnaya nke cholesterol na LDL na-agbanwe agbanwe.
Mgbe ọ na-abanye na ngba nri, a na-etinye ọgwụ ahụ n'ọrụ, na-eru ogo oke n'ọbara mgbe awa 2 jiri bioavailability nke 80%. Edekọtara mmụba dị ukwuu nke ọgwụ ọgwụ n'ime ọbara maka onunu ogwu si 2 ruo 60 mg. A na-enweta nsonaazụ kwụsiri ike mgbe ịrechara mbadamba nkume ahụ n'ime ụbọchị anọ anọ na mbụ
Ighaghachi ugboro ugboro anaghị akpalite ịgwọ ọgwụ. Ọnụ ọgụgụ a na-enweta maka nri anaghị adabere n'oge ịnata nri.
A na-ewepụ Pioglitazone na feces (55%) na mmamịrị (45%). Ọgwụ ahụ, nke a na-agbanye n'ụdị na-agbanweghị agbanwe, nwere ọkara ndụ nke 5-6 awa, maka metabolites ya, awa 16-23.
Afọ nke onye ọrịa mamịrị anaghị emetụta ọgwụ ọgwụ nke ọgwụ a. Site na dysfunctions kidal, ọdịnaya nke glitazone na metabolites ya ga-adị ala, mana nwechapụ ahụ ga-abụ otu, ya mere a na-echeba echiche nke ọgwụ n'efu.
Site na imeju imeju, ogo ọgwụ niile dị n'ọbara na-agbanwe agbanwe mgbe niile, na-abawanye na oke nkesa, a ga-ebelata nhichapụ, belata nke ọgwụ n'efu.
Ihe ngosi maka ojiji
A na-eji Pioglitazone achịkwa ụdị ọrịa shuga abụọ dị ka monotherapy na ọgwụgwọ siri ike, ma ọ bụrụ na mmezi ụdị ndụ (nri na-enye carbohydrate dị ala, mmega ahụ zuru oke, njikwa ọnọdụ mmetụta) anaghị akwụghachi ụgwọ glycemia.
Na usoro ọgwụgwọ siri ike, a na-eji usoro abụọ nwere metformin (ọkachasị maka oke ibu), ma ọ bụrụ na monotherapy na metformin na usoro ọgwụgwọ anaghị enye 100% nchịkwa glycemic. N'ihe banyere contraindications maka metformin, a na-ejikọ pioglitazone na ọgwụ sulfonylurea, ma ọ bụrụ na ojiji nke ikpeazụ na monotherapy anaghị enye nsonaazụ achọrọ.
Nchikota pioglitazone na ngwakọta okpukpu atọ na nkwadebe metformin na sulfonylurea ga-ekwe omume, kachasị maka ndị ọrịa buru ibu, ma ọ bụrụ na atụmatụ ndị gara aga anaghị enye profaịlụ glycemic nkịtị.
Mbadamba dị mma maka ụdị shuga na-akpata insulin 2, ọ bụrụ na inje insulin anaghị egbochi shuga, zuru oke ma ọ bụrụ na onye ọrịa anabata ya.
Ihe ngbanwe
Na mgbakwunye na hypersensitivity nke ihe dị n'ime usoro ahụ, a naghị akwado pioglitazone:
- Ndi nwere oria 1;
- Na ketoacidosis na-arịa ọrịa mamịrị;
- Oria nwere oke umeji;
- Ọ bụrụ na na anamnesis - gbasara ọrịa nka nke art. M - IV NYHA;
- Na hematuria macroscopic nke etiology na-ejighị n'aka;
- Ọrịa mamịrị na oncology (ọnya afọ ime).
Njikọ Ọgwụ
Ojikọtara ọnụ nke pioglitazone na digoxin, warfarin, fenprocoumone na metformin anaghị agbanwe ike ọgwụ ha. Ọ naghị emetụta ọgwụ pharmokokinetics na ojiji nke glitazone nwere usoro sulfonylurea.
Ihe omumu banyere nmekorita nke pioglitazone ya na mgbochi ogwu a na-egbochi, ihe ndi mmadu na - egbochi calcium, cyclosporine, na HMCA-CoA reductase inhibitors ekwuputaghi mgbanwe nke ha.
Ojiji nke pioglitazone na gemfibrozil na-akpalite mmụba okpukpu atọ na AUC nke glitazone, nke a na-egosipụta ịdabere na ntinye oge. Ọnọdụ dị otú a na-abawanye ohere nke ọdịdị nke mmetụta na-adịghị atụ aro, yabụ, usoro pioglitazone kwesịrị idozi mgbe ejiri ya na onye na-egbochi ya.
Ọnụego pioglitazone na-abawanye mgbe ejiri jikọtara rifampicin. Nyochaa mmekpa ahụ glycemia bụ iwu.
Ndụmọdụ maka iji Pioglitazonum
Ntuziaka Pioglitazone maka ijiji ndị ọrịa mamịrị na-eji 1 p / ụbọchị. Ejiri mmiri were were mbadamba nkume a dum, dọkịta na-ahọrọ ọgwụ na-eburu n'uche usoro ọgwụgwọ gara aga, afọ, ọkwa nke ọrịa ahụ, nje na-emetụta ahụ, mmeghachi ahụ.
Site na usoro ọgwụgwọ siri ike na insulin, a na-edozi ọ̀gwụ nke nke ikpeazụ dịka agụ nke akụkụ glucose na nri.
Maka ndị ọrịa shuga, ọ nweghị mkpa ịgbanwe usoro ọgwụgwọ, ha na-amalite site na nke dị ala, na-abawanye nwayọ, ọkachasị na atụmatụ ndị agbakọtara - nke a na-eme ka mmegharị ahụ belata ma belata mmetụta nke mmetụta ndị ọzọ.
Site na dysfunctions gbasara akwara (mwepụta creatinine karịrị 4 ml / min.), Edepụtara Glitazone dịka ọ dị na mbụ, egosighi ya maka ndị ọrịa ịba ọcha n'anya, yana maka ọrịa imeju.
Ọzọ aro
A na-enyocha arụmọrụ nke usoro ahọpụtara ahọrọ na ọnwa atọ ọ bụla site na iji glycated haemoglobin ass. Ọ bụrụ na enweghị mmeghachi omume zuru oke, kwụsịrị ị .ụ ọgwụ. Ogologo oge iji pioglitazone na-ebute ihe egwu nwere ike ime, yabụ, dọkịta kwesịrị inyocha profaịlụ nchekwa nke ọgwụ.
Ọgwụ nwere ike ijigide mmiri n'ime ahụ ma mee ka ọnọdụ ahụ ka njọ na nkụda mmụọ. Ọ bụrụ na ndị nwere ọrịa shuga nwere ihe ndị dị ize ndụ n'ụdị okenye, nkụchi obi ma ọ bụ ọrịa obi, usoro ịmalite ịmalite kwesịrị ịdị ntakịrị.
Titration ga-ekwe omume na nti ike. Otu a nke ndị ọrịa mamịrị chọrọ ileba anya na ahụike ha oge niile (oke ibu, ọzịza, ihe ịrịba ama nke ọrịa obi), ọkachasị na-enwe obere nri diastolic.
Nlebara anya mgbe ị na-edepụta ọgwụ a ga-enye ndị ọrịa shuga tozuru oke (site na afọ 75), ebe ọ bụ na enweghị ahụmịhe banyere iji ọgwụ ahụ maka ụdị a. Site na njikọta nke pioglitazone na insulin, enwere ike ịbawanye ọrịa obi. Na afọ a, ihe ize ndụ nke kansa, ọnya na-abawanye, yabụ mgbe ị na-ede ọgwụ, ọ dị mkpa iji nyochaa ezigbo uru yana nsogbu ọ nwere.
Udiri nlebara anya nke ulo ogwu na-egosiputa ohere o nwere ike ibute oria akwara ikpu oria riri pioglitzone. N'agbanyeghị ihe egwu dị ala (0.06% dị ka 0.02% na ndị na-ahụ maka nchịkwa), ekwesịrị ịtụle ihe niile na-akpata ọrịa kansa (ise siga, mmepụta ihe na-akpata ọrịa, oge ịba ahụ, afọ)
Tupu nhọpụta ọgwụ ahụ, a na-enyocha enzymes imeju. Site na mmụba na ALT site na oge 2.5 yana ọrịa imeju na-egbu egbu, a na-egbochi ọgwụ ahụ. Site n'ịkpa oke ọgbụgba nke ọrịa akwara, a na-ewere pioglitazone na ịkpachapụ anya.
Site na mgbaàmà nke nkwarụ hepatic (nsogbu nke dyspeptik, mgbu epigastric, anorexia, ike ọgwụgwụ oge niile), a na-enyocha enzymes imeju. Ceedgabiga iwu ahụ ugboro atọ, yana mpụta nke ịba ọcha n'anya, kwesịrị ịbụ ihe kpatara iwepu ọgwụ.
Site na mbelata insulin na-eguzogide ọgwụ, a na-eweghachi abụba ahụ: visceral na-ebelata, na -emekwa imeju. Ọ bụrụ n ’ibu metụtara ya na edema, ọ dị mkpa ijikwa ọrụ obi na iri nri kalori.
N'ihi mmụba ọbara na-aba ụba, haemoglobin nwere ike ibelata ọkara nke 4%. A na-ahụ mgbanwe ndị yiri ya mgbe ị na-a drugsụ ọgwụ antidiabet ọzọ (maka metformin - 3-4%, nkwado sulfonylurea - 1-2%).
Na njikọta okpukpu abụọ na okpukpu atọ na pioglitazone, insulin na usoro sulfonylurea, ohere nke hypoglycemia na-abawanye. Site na usoro ogwu di omimi, itinye ahihia nke oge choro ka odi nkpa.
Thiazolidinediones nwere ike itinye aka na ọhụhụ anya na ọzịza. Mgbe ị na-akpọtụrụ dọkịta anya, ọ dị mkpa ịtụle ohere nke edema macio nwere pioglitazone. E nwere ihe ọghọm nke agbaji ọkpụkpụ.
N'ihi isi ihe akaebe ezughi ezu maka ịdị irè na nchekwa n'ihe gbasara afọ ime na ịrara, a naghị enye ndị inyom polyglitazone n'oge ndị a. Ọ bụ ọgwụ contraindicated na nwata.
Mgbe ị na-anya ụgbọ ala ma ọ bụ usoro mgbagwoju anya, ekwesiri ịtụle nsonaazụ ndị ọzọ mgbe ejiri glitazone.
Doụbiga mmanya ókè
Site na monotherapy na usoro dị mgbagwoju anya, a na-edekọ ihe ndị na-adịghị mma:
- Ọkpụkpụ ụbụrụ, nsogbu anya;
- Ọbara
- Hypersthesia, isi ọwụwa;
- Ọrịa nke akụkụ iku ume, sinusitis na pharyngitis;
- Allergy, anaphylaxis, hypersensitivity, angioedema;
- Ihi ụra ure;
- Ahịhịa nke ọdịdị dị iche iche: polyps, cysts, cancer;
- Mmebi ụkwụ na mgbu n’akụkụ nile;
- Ndakpọ ọgbụgba;
- Ẹphe adụhe ike;
Hypoglycemia, agụụ na-achịkwa;- Hypesthesia, nghazi;
- Vertigo;
- Ikike ịdị arọ na uto ALT;
- Glucosuria, proteinuria.
Hypoglycemia, agụụ na-achịkwa;Ọmụmụ nyocha ahụ nwalere nchekwa nchekwa nke 120 mg, nke ndị ọrụ afọ ofufo were ụbọchị 4, ma emesịa ụbọchị 7 ọzọ na 180 mg. Onweghi ihe mgbaàmà riri oke
Ọnọdụ Hypoglycemic ga-ekwe omume na usoro nwere mgbagwoju anya na nhazi insulin na sulfonylurea. Usoro ọgwụgwọ ahụ na-apụta ma na-akwado ya.
Pioglitazone - analogues
Na ahịa US ọgwụ nje, otu n'ime ndị kasị ibu n'ụwa, pioglitazone nwere mpaghara nke yiri metformin. Site na contraindications ma ọ bụ enweghị nkwekọrịta, pioglitazone nwere ike dochie anya Avandia ma ọ bụ Roglit - analogues sitere na rosiglitazone - ọgwụ nke otu klas nke thiazolidinediones, na-agbanyeghị, amụma ogologo oge na otu a bụ ndakpọ olileanya.
Belata insulin iguzogide na biguanides. N'okwu a, pyoglizatone nwere ike dochie Glucophage, Siofor, Bagomet, NovoFormin na ọgwụ ndị ọzọ metụtara metformin.
Site na ngalaba mmefu ego nke ọgwụ hypoglycemic, analogues Russia bụ nke a ma ama: Diab-norm, Diaglitazone, Astrozone. N'ihi ndepụta siri ike nke contraindications, ọnụ ọgụgụ nke na-abawanye na usoro ọgwụgwọ siri ike, mmadụ ga-akpachara anya na nhọrọ nke analogues.
Ntụle Ahịa
Banyere pioglitazone, nyocha nke ndị ọrịa mamịrị agwakọ. Ndị riri ọgwụ mbụ ahụ hụrụ na arụmọrụ dị elu na ntakịrị nsonaazụ.
Nkwubi okwu a bụ enweghị nkwekọrịta: ọgwụ ahụ nwere oke belata ogo nke glycemia, hemoglobin glyc ọbụna na mkpa insulin (ọkachasị na usoro ọgwụgwọ siri ike). Mana ekwesighi onye ọ bụla, yabụ, ịgaghị anwale ahụike, na-enweta ọgwụ ahụ na ndụmọdụ ndị enyi. Naanị ọkachamara nwere ike ikpebi na ọ ga-ekwe omume ụdị ọgwụgwọ a na algọridim nke ịnata pioglitazone.
Can nwere ike ịmụtakwu banyere iji thiazolidinediones na omume ụlọ ọgwụ site na vidiyo ahụ:
