Acarbose: sake dubawa da siffofin sakewa, umarnin don amfani

Acarbose shine wakili na hypoglycemic wanda ake amfani dashi a cikin aikin likita don magance nau'in ciwon sukari na 2 na mellitus. A cikin labarin za mu bincika menene acarbose - umarnin don amfani.

Hankali! A cikin rarrabuwa na kwayoyin halittar-kimiyyar sunadarai (ATX), "Acarbose" aka nuna ta lambar A10BF01. Sunan kasa da kasa mai zaman kansa: Acarbose.

Magunguna da magunguna

Acarbose shine pseudotetrasaccharide wanda aka kirkireshi da actinomycetes. Magungunan yana gasa kuma yana sakewa yana hana α-glucosidases na hanji da ke tattare da lalata lalata, oligo- da polysaccharides. A cikin karamin hanjin mutum, acarbose kashi-dogara dogara da jinkirtar da rushewar carbohydrates zuwa monosaccharides tunawa (glucose, fructose). Haƙiƙanin tsarin sha na acarbose baya shafawa.

Tun da aikin hydrolytic na glucosidases daban-daban na iya bambanta sosai tsakanin mutane, ana iya tsammanin cewa ɗaukar ƙwayar carbohydrates na iya bambanta dangane da takamaiman maganin na miyagun ƙwayoyi. Abubuwan carbohydrates marasa ƙarfi masu rauni ba su warware cikin ƙananan hanji (malabsorption), amma ana ba da ƙwayar cuta ta cikin ƙwayoyin cuta zuwa gajerar sarkar acid da gas. Kayan shakatawa suna amfani da jiki.

Kashi 1-2% na maganin da ake magana da shi kawai ana shan shi canzawa. A cikin hanji, metabolites suna samuwa ta hanyar narkewar enzymes da kwayoyin cuta na hanji. Kimanin kashi ɗaya cikin uku na kashi na maganin yana shafawa cikin jini a cikin tsarin metabolized. Acarbose metabolism kayayyakin ana adana su musamman ta hanyar kodan.

Manuniya da contraindications

A cikin binciken makafi-biyu, da ingancin acarbose (100 MG sau uku a rana) idan aka kwatanta da placebo an gwada shi a cikin masu ciwon sukari guda 94 na makonni 24. Marasa lafiya ba sa shan maganin antidiabetic kuma ba sa bin takamaiman abincin. A cikin tsaka-tsaka na makonni 4, masanan kimiyya sun auna glucose jini a cikin komai a ciki kuma bayan cin abinci (400 kcal, carbohydrates 50%). Masu binciken sun kuma auna tarowar haemoglobin (Hb-A1), C-peptide, plasma insulin, da triglycerides. Marasa lafiya a cikin ƙungiyar acarbose sun nuna raguwa sosai a cikin glycemia bayan cin abinci (har zuwa 5 hours bayan cin abinci): matsakaicin matakin sukari na jini (awa daya bayan cin abinci) shine 14.5 mmol / L kafin magani, da 10.5 mmol / bayan shan acarbose l

A cikin rukunin placebo, matakan glucose bayan cin abinci ya ragu kaɗan. Matakan HbA1 sun rage kadan tare da yawan acarbose (daga 9.3% zuwa 8.7%), yayin da placebo bai canza ba. Acarbose ya kuma rage matakin postprandial maida hankali ne na insulin da triglycerides.

An yi ƙarin binciken tare da ƙaramin adadin marasa lafiya. Ana amfani da miyagun ƙwayoyi a cikin mutanen da ke da matakai daban-daban na masu ciwon sukari (daga marasa lafiya waɗanda ke buƙatar abinci kawai don masu ciwon sukari masu tsanani). Gabaɗaya, waɗannan nazarin sun ba da irin wannan sakamako ga binciken da aka bayyana a sama: akwai raguwa ko moreasa daɗaɗɗun faɗuwar glycemia bayan cin abinci da ƙananan urinary glucose excretion An gano tasirin fa'ida akan azumin glucose na jini ko kuma HbA1c a cikin karatun mutum kawai. Ba a canza matakan insulin plasma da nauyin jiki a yawancin karatu ba.

A cikin binciken makafi mai sarrafawa sau biyu, acarbose bazai iya maye gurbin tasirin maganin sulfonylurea ba. A cikin marasa lafiya 29, an dakatar da jiyya tare da maganin cizon sauron kuma an maye gurbinsu da acarbose ko placebo. An haɓaka yawan ƙwayar acarbose daga 150 MG / rana zuwa 500 MG / rana. Bayan makonni 16 na aikin likita, matakin monosaccharide (wanda aka auna bazuwar) ya kasance 50% mafi girma, kuma matakin HbA1 ya kasance 18% mafi girma fiye da na sulfonylurea. Acarbose da placebo ba su bambanta da yawa game da tasirin su.

Gudanar da acarbose ga marasa lafiya da nau'in ciwon sukari na 1 ya rage yawan cutar glycemia. Gaskiyar cewa acarbose na iya hana cututtukan cututtukan cututtukan daji a cikin daji ba a tabbatar dasu ba dangane da bayanan da aka wallafa.

Side effects: bayanin

Magungunan yana haifar da rashin jin daɗi a cikin marasa lafiya da yawa, ƙarancin zawo da ciwon ciki. Fiye da 50% na mutane sun koka da rashin jin daɗi, kusan 5% na magani an daina shi saboda ciwon ciki.

A tsawon lokaci, waɗannan alamun za su ragu. Kasa da 5% na marasa lafiya suna fuskantar tashin zuciya, maƙarƙashiya, ko ciwon kai. Hypoglycemia ba ya faruwa sau da yawa fiye da placebo. An lura da maimaitawa, wanda ba a bayyana ba sauyawa a cikin transaminases, a wasu nazarin game da 5% na marasa lafiya ya shafa.

Sashi da yawan abin sama da ya kamata

Acarbose yana samuwa a cikin allunan 100 MG. Maganin farko shine yawanci 50 mg sau 3 a rana, bayan sati 1 zuwa 2 zaku iya amfani da matsakaita na yau da kullun na 300 mg. M kashi karuwa to 600 MG / rana. Allunan za a hadiye su da ruwa nan da nan kafin abinci.

Ya kamata a sha magungunan daban-daban don kaurace wa matsanancin ciwon ciki. A cikin mummunar rikice-rikice, ana bada shawara don canza abincin kuma, mai yiwuwa, rage kashi na maganin.

Idan marasa lafiya suna da haɗari ga ƙananan monosaccharides na jini a wasu lokuta na rana, ana bada shawara don daidaita sashi. Marasa lafiya marasa shekaru 18, da kuma masu juna biyu da masu shayarwa bai kamata su sha maganin ba. Magungunan, a matsayin mai mulkin, yakamata a guji bijiro da marasa lafiya da cutar hanji.

Umarnin don amfani da miyagun ƙwayoyi

Don Acarbose, umarnin don amfani yana ba da cikakken bayani game da tasirin miyagun ƙwayoyi a jiki.

Kafin amfani, ya kamata karanta a hankali karanta shawarar dosages da yiwu mummunan al'amurran.

Wannan magani ana bayar da shi ne daga kantin magunguna kawai idan akwai takardar izini daga wurin masu halartar aikin. A lokaci guda, farashin allunan yana samuwa ga duk nau'ikan jama'a.

An ƙididdige abubuwan da za a iya bayarwa na maganin da aka ɗauka ana yin su ne bisa la'akari da nauyin jikin mai haƙuri. A wannan yanayin, kashi na farko a matakin farko na aikin ba zai wuce miligram ashirin da biyar ba. Allunan dole ne a sha sau uku a rana kafin ko lokacin babban abinci.

Idan alamar da aka nuna ba ta kawo kyakkyawan sakamako ba, cikin yarjejeniya tare da likitan halartar, ana iya ƙara yawan zuwa milligramms ɗari shida a rana. Kwararrun likitanci da kansu ke tantance mahimmancin allurai ta danganta da yanayin halaye na mara lafiya da kuma hotonsa na asibiti gaba daya.

Ba'a ba da shawarar ƙara yawan sashi na tsofaffi ba, kazalika da waɗanda ke da matsala game da aikin hanta na yau da kullun.

Magungunan ya fara shafar awa daya bayan shan shi. Ayyukanta na tsawon awa biyu. Idan aka rasa magungunan, babu buƙatar ƙara yawan sashi a amfani na gaba. Acarose yana haɗuwa sosai tare da maganin sulfonylureas, abubuwan da suka dace da metformin ko allurar insulin.

A hanya da magani tare da magani dole ne a bi tare da m abinci. In ba haka ba, damuwa na iya faruwa.

Dole ne a adana shirye-shiryen kwamfutar hannu a zazzabi a daki, guje wa hasken rana kai tsaye.

Farashin magani yana bambanta daga 350 zuwa 500 rubles a kowace kunshin (Allunan 30 tare da sashi na 50 MG).

Haɗa kai

Adsorbents da narkewa na enzymes suna rage tasirin maganin. A cikin marasa lafiyar da ke shan maganin maye gurbi, an lura da mummunan rikice-rikice na gastrointestinal. Ba'a ba da shawarar a hada acarbose tare da magunguna masu yawa na laxative.

Babban analogues (maye gurbin) na miyagun ƙwayoyi:

Ra'ayoyin kwararrun likitoci da marasa lafiya ke shan kwayoyi.

Likita ya rubuta takardar izini ta magani, wanda a ciki na sami sayo shi a kantin magani. Ina ɗaukar fewan watanni kuma na ga cewa alamun da ke kan silikoni suna raguwa a hankali. My miyagun ƙwayoyi na haifar da ƙarancin zuciya da tashin zuciya, wanda ya ɓace mako guda bayan jiyya.

Magungunan ƙwayar cuta na hanzari yana rage haɗuwa da glucose a cikin jini, ba tare da shafar farji ba. Babban fa'ida shine rashin bayyanar tasirin da ake amfani da ita lokacin amfani da wasu magunguna. Yin amfani da dogon lokaci yana haifar da raguwar yawan kwayoyi a cikin glycemia.

Maxim Olegovich, likitan dabbobi

Farashi (a cikin Tarayyar Rasha)

A halin yanzu ana amfani da magungunan musamman a cikin masu cutar siga. Tare da kashi ɗaya na rana na 300 mg na acarbose, farashin magani shine 3000 rubles a wata. Don kwatantawa, jiyya tare da glibenclamide (kashi ɗaya na yau da kullun: 7.5 MG na kayan sarrafawa na micronized) farashin ƙasa da 1000 rubles a wata.

Shawara! Kafin amfani da kowane magani, kuna buƙatar tuntuɓi ƙwararrun likita don magance cutarwa mai yiwuwa. An haramta shan magungunan kai. Kai magani na iya haifar da wanda ba a iya tsammani ba, kuma a wasu yanayi, raunin da ba a iya juyawa. Don kowane ƙararrawa, dole ne ku nemi shawarar likita.