Wasu lokuta abinci na musamman da aikin jiki ba zai iya samar da daidaitaccen glucose na al'ada a cikin masu ciwon sukari tare da nau'in cutar 2 ba.

Wani abu mai dauke da INN Repaglinide, koyarwar wacce aka haɗo shi a kan kowane kunshin magungunan da ke ɗauke da shi, yana da tasirin hypoglycemic lokacin da ba zai yiwu a sarrafa taro na sukari a cikin jini ba. Wannan labarin zai magance tambayar yadda ake amfani da maganin tare da maganin disaglinide daidai kuma a cikin waɗancan lokuta amfani ba zai yiwu ba.

Kayan magunguna na maganin

Sinadaran da ke aiki, Repaglinide, ana samun su cikin farin foda don amfanin ciki. Hanyar aiwatar da aikin shine sakin insulin (hormone mai rage sukari) daga sel beta da ke cikin farji.

Yin amfani da repaglinide akan masu karɓa na musamman, ana toshe hanyoyin tashoshin ATP da ke cikin membranes na sel. Wannan tsari yana haifar da lalacewawar sel da kuma buɗe tashoshi na alli. A sakamakon haka, haɓakar insulin yana ƙaruwa ta hanyar ƙara yawan ƙwayoyin haɓin alli.

Bayan mai haƙuri ya ɗauki kashi na Repaglinide, abu ya narke cikin narkewa. A lokaci guda, bayan awa 1 bayan cin abinci, an fi mayar da hankali ne ga jini, to bayan awa 4 ƙimar sa da sauri ta ragu kuma ta zama ƙasa kaɗan. Nazarin maganin yana nuna cewa babu wani bambanci mai mahimmanci a cikin ƙimar magunguna lokacin amfani da Repaglinide kafin ko lokacin abinci da aka samo.

Abubuwan da ke ɗaure sunadaran sunadaran plasma sama da 90%. Haka kuma, cikakkar ingancin bioavailability ya kai kashi 63%, kuma yawan rarraba shi shine lita 30. A cikin hanta ne cewa biotransformation na Repaglinide ya faru, sakamakon abin da aka gina metabolites mara aiki. Ainihin, ana fesa su da bile, har da fitsari (8%) da feces (1%).

Mintuna 30 bayan cinye Repaglinide, farawar hormone ta fara. A sakamakon haka, rage yawan glucose a cikin jini yana raguwa da sauri. Tsakanin abinci, babu karuwa a cikin matakan insulin.

A cikin marasa lafiya waɗanda ba su da insulin-da ke fama da ciwon sukari waɗanda ke ɗaukar daga 0,5 zuwa 4 g na Repaglinide, ana lura da raguwar abin dogara da glucose.

Umarnin don amfani da miyagun ƙwayoyi

Repaglinide shine babban bangaren NovoNorm, wanda aka samar a Denmark. Kamfanin Pharmacological Novo Nordisk A / C yana samar da magani a cikin nau'ikan Allunan tare da magunguna daban-daban - 0.5, 1 da 2 mg. Blaya daga cikin kumburi ya ƙunshi allunan 15, a cikin kunshin ɗaya ana iya samun blister ɗaya.

A cikin kowane kunshin na miyagun ƙwayoyi tare da kayan haɗin maganin, umarnin don amfani wajibi ne. Dosages an zaɓa ta daban-daban jiyya gwani wanda da gangan tantance matakin sukari da kuma hade pathologies na haƙuri. Kafin amfani da miyagun ƙwayoyi, mai haƙuri yakamata a karanta umarnin da aka haɗa.

Maganin farko shine 0.5 MG, ana iya haɓaka shi kawai bayan mako ɗaya ko biyu, ƙaddamar da gwaje gwaje gwaje-gwaje don matakan sukari. Mafi girman sati daya shine 4 MG, kuma maganin yau da kullun shine 16 MG. Yayin jujjuyawar daga wani ƙwayar rage sukari Repaglinide ɗauki 1 MG. Yana da kyau a yi amfani da maganin 15-30 na mintuna kafin manyan abinci.

Ya kamata a adana magungunan NovoNorm daga ƙananan yara a cikin zafin jiki na 15-25C a cikin wani wuri mai kariya daga danshi.

Rayuwar shiryayye na miyagun ƙwayoyi ya kasance har zuwa shekaru 5, bayan wannan lokacin ba shi yiwuwa a yi amfani da shi a kowane yanayi.

Contraindications da yiwuwar cutar

Abin baƙin ciki, ba kowa bane ke iya karɓar NovoNorm. Kamar sauran kwayoyi, yana da contraindications.

Ba za a iya ɗaukar abu mai ƙyalli tare da:

1. nau'in insulin-dogara da ciwon sukari
2. masu ciwon sukari mai cutar sukari, ciki har da coma,
3. mai tsanani hanta da / ko koda dysfunction,
4. ƙarin amfani da kwayoyi waɗanda ke sa ko hana CYP3A4,
5. rashin maganin lactose, karancin lactase da karancin maganin glucose-galactose malabsorption,
6. susara yawan mai saukin kamuwa zuwa bangaren,
7. a karkashin shekara 18
8. Tsarin ciki ko ci gaba,
9. nono.

Binciken da aka gudanar akan berayen sun tabbatar da cewa amfani da maganin repaglinide a lokacin haihuwar yaro yana cutar da tayin. A sakamakon maye, ci gaban babba da na ƙarshen tayin ya zama mai rauni. Hakanan, an haramta amfani da kayan yayin lactation, kamar yadda ake yada shi tare da madarar uwa ga jariri.

Wani lokaci tare da amfani da miyagun ƙwayoyi ko abin sha fiye da kima, yanayin bayyanar da martani kamar:

• hypoglycemia (karuwar gumi, rawar jiki, barcin mara kyau, tachycardia, damuwa),
• lalata abubuwa na gani (da farko, shan magani, sannan ya wuce),
• narkewa a ciki (ciki na ciki, tashin zuciya da amai, maƙarƙashiya ko zawo, karuwar ayyukan enzymes a cikin hanta),
• alerji (jan fata - erythema, fitsari, itching).

Amfani da girma na miyagun ƙwayoyi fiye da likita ya nuna kusan koyaushe yana haifar da hypoglycemia. Idan mai ciwon sukari ya ji alamun rashin ruwa fiye da kima kuma yana da hankali, to yana bukatar ya ci samfurin-carbohydrate kuma ya nemi likita game da gyaran fuska.

A cikin matsanancin rashin ƙarfi na jini, lokacin da mara lafiya ya shiga cikin rashin lafiya ko kuma bai san komai ba, ana allurar dashi da sinadarin glucose kashi 50% a cikin fata tare da ƙarin haɓakar maganin 10% don kula da matakin sukari na akalla 5.5 mmol / L.

Abun hulɗa da Repaglinide tare da Sauran Magunguna

Yin amfani da magunguna masu jituwa sau da yawa yana tasiri tasirin maganin repaglinide akan haɗuwar glucose.

Sakamakon hypoglycemic dinsa yana haɓaka lokacin da mai haƙuri ya ɗauki MAO da masu hana ACE, masu hana beta-blockers, magungunan anti-mai kumburi, salicylates, steroids anabolic, okreotide, magungunan da ke ɗauke da ethanol.

Wadannan magungunan da ke gaba suna ba da tasiri ga ikon abu ya rage glucose:

• karin bayani
• hana haihuwa don amfani da baka,
• danazol
• glucocorticoids,
• hodar iblis,
• tausayawa.

Hakanan, mai haƙuri yakamata yayi la'akari da cewa sanayya tana ma'amala da magunguna waɗanda aka fallasa galibi cikin bile. CYP3A4 inhibitors kamar intraconazole, ketoconazole, fluconazole da wasu mutane zasu iya haɓaka matakin jini. Yin amfani da inducers na CYP3A4, musamman takaddar rifampicin da phenytoin, yana rage matakin abu a cikin plasma. Ganin cewa ba a ƙaddara matakin induction ba, an haramta amfani da maganin Repaglinide tare da irin waɗannan kwayoyi.

Sake Juyawa

Sake Juyawa
Kwayar kemikal
IUPAC	(S) - (+) - 2-ethoxy-4-2- (3-methyl-1-2- (piperidin-1-yl) phenylbutylamino) -2-oxoethylbenzoic acid
Tsarin gaba ɗaya	C27H36N2O4
Taro na Molar	452.586 g / mol
Cas	135062-02-1
BugaI	65981
Bankin Drug	DB00912
Tsara
ATX	A10BX02
Pharmacokinetics
Yanada	56% (na baka)
Plainma na Rashin Lafiya	>98%
Tsarin rayuwa	Hanyar cutar sankara da gubar glucuronidation (CYP3A4-matsakanci)
Rabin rayuwa.	Awa 1
Nishadi	Fecal (90%) da na dan ƙasa (8%)
Hanyar gudanarwa
Magana
Fayilolin Mai amfani da Wikimedia

Sake Juyawa - maganin antidiabetic, an kirkireshi ne a 1983. Repaglinide magani ne na baki wanda ake amfani dashi ban da abinci da motsa jiki don sarrafa sukarin jini a cikin nau'in ciwon sukari na 2. Hanyar aiwatar da aikin Repaglinide ya ba da shawarar ƙara yawan sakin insulin daga sel β-islet na pancreas, kamar yadda yake tare da sauran magungunan antidiabetic, babban tasirin sakamako shine hypoglycemia. Novo Nordisk ne ke sayar da maganin a cikin sunan Prandin a cikin Amurka Glucoorm a Kanada Surpost a Japan Sake Juyawa zuwa Misira ta Ifi, kuma NovoNorm a wani wurin. A Jafana, Dainippon Sumitomo Pharma ne ya samar da shi.

Mallakar fasaha

Repaglinide magani ne na baki wanda ake amfani dashi ban da abinci da motsa jiki don sarrafa sukarin jini a cikin nau'in ciwon sukari na 2.

Contraindications

Repaglinide yana contraindicated a cikin mutane tare da:

1. Ketoacidosis mai ciwon sukari
2. Type 1 ciwon sukari
3. Amfani da aiki tare da gemfibrozil
4. Hypersensitivity ga miyagun ƙwayoyi ko abubuwan rashin aiki

Side effects

Sakamakon sakamako na yau da kullun sun haɗa da:

• Cututtuka na ciki na sama (16%)
• Sinusitis (6%)
• Rhinitis (3%)

Abubuwa masu cutarwa sun hada da:

• Ishembiya mai dauke da jini (2%)
• Angina pectoris (1.8%)
• Mutuwa saboda cututtukan zuciya (0.5%)

Ga alumma na musamman

Yankin Yammacin C: Cutar da lafiyar mata masu ciki ba a kafa ta ba. Bayanai sun iyakance, kuma akwai shari’a guda daya, rahoton ya lura cewa ba a sami rikice-rikice ba game da amfani da maganin repaglinide yayin daukar ciki.

Ya kamata a yi taka tsantsan tare da mutanen da ke da cutar hanta da rage aikin koda yayin amfani da wannan magani.

Hulɗa da ƙwayoyi

Repaglinide shine babban maganin SUR3A4 kuma bai kamata a tsara shi lokaci guda tare da gemfibrozil, clarithromycin, ko magungunan antizozoal kamar Itraconazole da Ketoconazole. Repaukar maganin hutawa tare da ɗaya ko fiye na waɗannan magungunan yana haifar da karuwa a cikin ƙwayar plasma repaglinide kuma yana iya haifar da hypoglycemia. Haɗin gwiwar clopidogrel da repaglinide (da cyp2c8 inhibitor) na iya haifar da raguwa a cikin matakan glucose na jini sakamakon hulɗa da miyagun ƙwayoyi. a zahiri, yin amfani da waɗannan magunguna tare aƙalla rana ɗaya na iya haifar da mummunar cutar hypoglycemia. Ba za a ɗauki Repaglinide a hade tare da sulfonylurea ba, saboda suna da tsari guda ɗaya na aiki.

Hanyar aikin

Repaglinide yana saukar da glucose na jini ta hanyar karfafa sakin insulin daga sel beta na tsibirin pancreatic. Ana samun wannan ta hanyar rufe tashoshin potassium na ATP-dogara a cikin membrane na beta sel. Wannan yana ɓoye ƙwayoyin beta, buɗe buɗe tashoshi mai ƙirar salula, kuma a sakamakon haka, ƙaddamar da ƙwayar alli yana haifar da ɓoye insulin.

Pharmacokinetics

Baƙon abu: Repaglinide yana da 56% bioavailability lokacin da aka ƙoshi daga ƙwayar gastrointestinal. Ana rage bioavailability lokacin ɗauka tare da abinci, mafi girman taro ana rage shi da 20%.

Rarraba: ɗaukar furotin na repalglinide zuwa albumin ya fi 98%.

Metabolism: Repaglinide yana metabolized da farko a cikin hanta, musamman CYP450 2C8 da 3A4 kuma zuwa mafi ƙaranci ta hanyar glucuronidation. Sauyawa metabolites baya aiki kuma basu nuna tasirin rage sukari ba.

Excretion: Ragewar kashi 90% cikin fitsari da kashi 8 cikin fitsari. An cire 0.1% tare da fitsari mara canzawa. Kasa da 2% ba canzawa a feces.

Labarin

An kirkiro abubuwanda za a iya amfani da su a ƙarshen 1983 a Bieberrach kan Rice a kudancin Jamus.

Dukiya ta Ilimi

A cikin Amurka, wanda Patent ke ba shi kariya, an yi rajista a cikin Maris 1990, wanda daga karshe ya zama lamban Amurka 5,216,167 (Yuni 1993), 5,312,924 (Mayu 1994) da 6,143,769 (Nuwamba 2000). Bayan

Shawarwarin don amfani

A wasu yanayi, marassa lafiya yakamata suyi amfani da miyagun ƙwayoyi tare da taka tsantsan a ƙarƙashin kulawar likita wanda ya tsara mafi ƙarancin maganin. Irin waɗannan marasa lafiya sun haɗa da marasa lafiya da ke fama da cututtukan hanta da / ko kodan, waɗanda suka yi zurfin gudanar da ayyukan tiyata, waɗanda ba da daɗewa ba sun kamu da kwayar cuta ko cutar, tsofaffi (daga shekara 60) waɗanda ke bin raunin kalori kaɗan.

Idan mai haƙuri yana da yanayin hypoglycemic a cikin m ko matsakaici, ana iya cire shi da kansa. Don yin wannan, kuna buƙatar cin abincin da ke ƙunshe da ƙwayoyin carbohydrates cikin sauƙi - yanki na sukari, alewa, ruwan 'ya'yan itace mai ɗanɗano ko' ya'yan itace. A cikin nau'i mai tsanani tare da asarar hankali, kamar yadda aka ambata a baya, ana gudanar da maganin glucose a cikin jijiya.

Ya kamata a sani cewa beta-blockers sun sami damar rufe alamun da ke faruwa na rashin lafiyar hypoglycemia. Likitocin sun ba da shawarar da guji shan giya kamar yadda ethanol ke haɓakawa da ci gaba da tasirin hypoglycemic na Repaglinide.

Hakanan, abu yana rage maida hankali.

Sabili da haka, direbobi waɗanda suke kan asali na amfani da maɓallin su, ana buƙatar su guji tuki motoci ko yin wasu ayyukan haɗari yayin aikin jiyya.

Kudin, sake dubawa da kuma analogues

Ana amfani da Repaglinide kamar yadda ake amfani da babban bangaren a cikin magungunan NovoNorm.

Ana iya siyanta a kantin magani ko yin oda ta yanar gizo a gidan yanar gizon mai siyarwa. Koyaya, siyan maganin yana yiwuwa ne kawai yayin gabatar da takardar sayan magani.

Kudin maganin sun sha bamban:

• Allunan kwayoyi 1 MG (guda 30 a kowane fakitin) - daga 148 zuwa 167 rubles na Rasha,
• Allunan 2 MG (guda 30 a kowane fakitin) - daga 184 zuwa 254 rubles na Rasha.

Kamar yadda kake gani, farashi yana da aminci ga mutane masu ƙarancin kuɗi. Karanta karatun masu ciwon sukari da yawa, ana iya lura da cewa ƙarancin farashin maganin yana daɗaɗawa, gwargwadon tasiri. Bugu da kari, amfanin NovoNorm sune:

• sauƙi na amfani da allunan kwatankwacin inje,
• saurin maganin, a cikin awa 1 kawai,
• dogon lokaci shan magani.

Matsayi na ƙarshe yana nufin cewa yawancin marasa lafiya da aka gano tare da ciwon sukari da basu da insulin-insulin sun kwashe NovoNorm na shekaru 5 ko fiye. Sun lura cewa aikinta ya kasance iri ɗaya ne kuma baya raguwa. Koyaya, sakamakon hypoglycemic na miyagun ƙwayoyi an rage shi zuwa sifili idan KADA KADA:

1. bi don dacewa da abinci mai kyau (warwatsewar carbohydrates da fats mai sauƙin narkewa),
2. lura da rayuwa mai aiki (tayi tafiya aƙalla minti 30, motsa jiki, da sauransu),
3. koyaushe kula da matakin glucose (aƙalla sau uku a rana).

Gabaɗaya, marasa lafiya da likitoci suna ɗaukar NovoNorm a matsayin kyakkyawan antipyretic. Amma wani lokacin an haramta amfani da allunan, saboda suna haifar da sakamako mara amfani. A irin waɗannan halayen, likita ya yanke shawarar canza kashi na miyagun ƙwayoyi ko kuma ya tsara wani magani daban.

Maganganun suna dauke da kayan aiki guda ɗaya kuma sun bambanta kawai da ƙarin abubuwa. AllvoNorm Allunan suna da synonym guda ɗaya kawai - Diagniniside (matsakaita na 278 rubles).

Irin waɗannan magungunan NovoNorm, waɗanda suka bambanta ga tsarin haɗin gungun, amma suna da sakamako iri ɗaya, sune:

• Jardins (matsakaicin farashin - 930 rubles),
• Victoza (matsakaici farashin - 930 rubles),
• Saksenda (matsakaicin farashin - 930 rubles),
• Forsyga (matsakaici farashin - 2600 rubles),
• Invokana (matsakaicin farashin - 1630 rubles).

Ana iya kammala cewa miyagun ƙwayoyi NovoNorm, wanda ya ƙunshi rayayyun kayan aiki, yana da tasiri a cikin lura da ciwon sukari na 2. Yana da sauri rage matakan sukari zuwa matakan al'ada. Idan kuna bin abinci, motsa jiki da kulawa akai-akai game da tattarawar glucose, zaku iya kawar da cututtukan jini da mummunan alamun cutar sankara. Bidiyo a cikin wannan labarin zai gaya maka yadda ake bi da ciwon sukari.